Miracle-dz/UniFAR-FTUs huggingface dataset:
Bone mass is related to creatinine clearance in normal elderly women

We determined the relationship between bone mass and age, anthropometric variables, creatinine clearance (Ccr), and serum and urine biochemical variables in 77 normal white women (aged 41–86, mean = 67) living in their own homes. A total of 74 women were postmenopausal. Skeletal status was assessed in all subjects by x‐rays of the hand with measurement of the mean combined cortical thickness (CCT) of the second metacarpal bones. In 53 women, bone mineral content of the radial shaft (RMBC) was also measured by single‐photon absorptiometry (SPA) and lumbar bone mineral density (LBMD) was measured by dual‐photon absorptiometry (DPA). Serum and urine biochemical variables were measured under standardized conditions on the sixth and seventh days of a controlled diet. There was a strong positive correlation between Ccr and bone mass. Although our subjects showed the expected linear decline in Ccr with age, we found that the relationship between Ccr and bone mass in the radius and lumbar spine was independent of age. On the other hand, the relationship between Ccr and CCT was not independent of age. We concluded that the relationship between Ccr and lumbar and radial bone mass is probably indicative of a relationship between glomerular filtration rate and bone mass, although this requires validation with a noncreatinine method for measurement of glomerular filtration rate. Age per se does not appear to be a cause of declining lumbar bone mass after the menopause.
Comparison of screening procedures in hydroxychloroquine toxicity.

OBJECTIVES To compare different screening procedures for hydroxychloroquine sulfate (Plaquenil) toxicity at different stages of damage. METHODS Ten patients were studied using 10-2 automated fields, multifocal electroretinography, spectral domain optical coherence tomography (SD-OCT), and fundus autofluorescence. RESULTS All 10 patients used hydroxychloroquine for more than 6 years, and those with severe toxicity had been overdosed. Fundus examination findings were normal except for the patients with severe toxicity. All the patients showed parafoveal field loss, but this was sometimes subtle. Multifocal electroretinography demonstrated parafoveal weakness in the milder cases. The SD-OCT subfield thickness plots showed a ring of parafoveal thinning in all the patients. The SD-OCT cross-sections showed parafoveal loss of the inner segment-outer segment and cone outer segment tip lines at early stages of toxicity, progressing to parafoveal thinning of the outer nuclear layer and eventually to retinal pigment epithelium damage. There was a ring of autofluorescence in most patients. CONCLUSIONS Overdosage with hydroxychloroquine seemed a significant risk factor for toxicity. Different individuals were more or less sensitive to different tests. Fields can be sensitive but only if read with a low threshold for change. Hydroxychloroquine causes early parafoveal loss of the outer segment lines on SD-OCT, with the first changes often evident in the inferotemporal quadrant. Parafoveal thinning of the outer nuclear layer follows, before retinal pigment epithelium damage is visible. Careful screening with multiple tests can detect toxic damage before prominent loss of the outer nuclear layer.
Clinical, Virologic, and Pathologic Significance of Elevated Serum Alpha-fetoprotein Levels in Patients with Chronic Hepatitis C

Elevated serum alpha-fetoprotein (AFP) in patients with chronic hepatitis C is not uncommonly seen, but the pathogenesis of this phenomenon remains unclear. The aims of this study were to assess the prevalence of elevated serum AFP in patients with chronic hepatitis C and to evaluate the clinical, virologic, and histopathologic significance of this phenomenon. One hundred and fifteen Chinese patients with a histologic diagnosis of chronic hepatitis C were enrolled. None had evidence of hepatocellular carcinoma by image study at enrollment and for at least 2 years' follow-up. Of the 115 patients, 33 (29%) had elevated serum AFP (more than 12 ng/mL). There was a significantly lower mean serum albumin (4.0 ± 0.1 vs. 4.3 ± 0.1 gm/dL, p <0.001) and higher mean scores for periportal necroinflammation (3.3 ± 0.3 vs. 2.3 ± 0.2, p = 0.007) and fibrosis (2.3 ± 0.2 vs. 1.1 ± 0.1, p < 0.001) in patients with elevated serum AFP when compared with patients without elevated serum AFP. Patients with elevated serum AFP had significantly more incidences of genotype 1b infection when compared with patients without elevated serum AFP (77% vs. 51%, p = 0.021). Mean serum hepatitis C virus (HCV) RNA titer showed no significant difference between the two groups. Multivariate logistic regression analysis showed that as serum albumin of less than 4.2 gm/dL, a histology fibrotic score of more than 3, and HCV genotype 1b infection were significantly independent predictors associated with elevated serum AFP. In conclusion, elevated serum AFP levels were significantly correlated with lower serum albumin levels, advanced fibrosis/cirrhosis, and genotype 1b infection in patients with chronic hepatitis C.
Patterns of accidental craniocerebral injury occurring in early childhood

Objective To describe the range of intracranial injuries encountered in 0–2-year-olds in cases of accidental head injury where the mechanism of trauma was well characterised and to assess the clinical consequences. Design A retrospective review of imaging and clinical data. Setting Two tertiary paediatric referral centres. Patients All children aged 0–2 undergoing cranial CT as indicated by National Institute for Health and Clinical Excellence guidance for head injury from 2006 to 2011. After exclusion criteria, 149 patients were included. Main outcome measures Rates of skull fracture, intracranial haemorrhage, parenchymal injuries and ischaemic change per type of mechanism of injury. Rates of neurological sequelae on follow-up. Results Skull fractures were demonstrated in 54 (36%) patients of whom 17 (11%) had thin underlying subdural haemorrhage (SDH). Extradural haemorrhage complicated one fracture and two cases of isolated subdural haematomas were seen without skull fracture. Radiologically evident brain parenchymal injuries were present in three patients, all with mechanisms of injury involving high levels of force; severe neurological sequelae were only seen in one patient, who had diffuse hypoxic–ischaemic damage at presentation and whose (accidental) mechanism of injury involved extensive acceleration/deceleration/translational forces. Conclusions Skull fractures and focal SDH are relatively common following minor trauma in this age group but in the vast majority of cases there are no long-term neurological sequelae. Conversely, diffuse brain injury with severe subsequent neurological impairment was only seen in patients with a correspondingly severe mechanism of injury.
In vitro evaluation of casein phosphopeptide-amorphous calcium phosphate effect on the shear bond strength of dental adhesives to enamel

Background: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is applied for remineralization of early caries lesions or tooth sensitivity conditions and may affect subsequent resin bonding. This in vitro study investigated the effect of CPP-ACP on the shear bond strength of dental adhesives to enamel. Materials and Methods: Sixty extracted human molar teeth were selected and randomly divided into three groups and six subgroups. Buccal or lingual surfaces of teeth were prepared to create a flat enamel surface. Adhesives used were Tetric N-Bond, AdheSE and AdheSE One F. In three subgroups, before applying adhesives, enamel surfaces were treated with Tooth Mousse CPP-ACP for one hour, rinsed and stored in 37°C temperature with 100% humidity. This procedure was repeated for 5 days and then adhesives were applied and Tetric N-Ceram composite was adhered to the enamel. This procedure was also fulfilled for the other three subgroups without CPP-ACP treatment. After 24 hour water storage, samples were tested for shear bond strength test in a universal testing machine. Failure modes were determined by stereomicroscope. Data were analyzed by t-test and one-way analysis of variance with P < 0.05 as the level of significance. Results: In comparison between applied and non-applied CPP-ACP subgroups, there was no significant decrease in the shear bond strength to enamel only in Tetric N-Bond (P > 0.05). In non-applied CPP-ACP subgroups, there were statistically significant differences among all subgroups. Tetric N-Bond had the highest and AdheSE One F had the lowest shear bond strength. Conclusion: CPP-ACP application reduces the shear bond strength of AdheSE and AdheSE One F to enamel but not Tetric N-Bond.
Telithromycin-Nonsusceptible Clinical Isolates of Streptococcus pneumoniae from Europe

ABSTRACT Telithromycin-nonsusceptible pneumococcal clinical isolates (n = 17) were analyzed for their antimicrobial susceptibility, macrolide resistance mechanisms, and genetic relatedness. All strains showed the erm(B) genotype and showed a wide range of combinations of macrolide resistance mechanisms. The predominant clone (n = 7) was serotype 14, sequence type 143.
PD-L1 Expression in the Merkel Cell Carcinoma Microenvironment: Association with Inflammation, Merkel Cell Polyomavirus, and Overall Survival

Using paraffin-embedded specimens from 49 patients diagnosed with various stages of Merkel cell carcinoma (MCC), Lipson and colleagues found PD-L1 expression in approximately 50% of these rare tumors. PD-L1+ carcinomas were invariably associated with immune infiltrates and the presence of Merkel cell polyomavirus DNA. These findings suggest that an endogenous immune response, perhaps directed in part to MCC-related antigen, promotes PD-L1 expression in the tumor microenvironment and provide a rationale for investigating therapies blocking PD-1/PD-L1 for patients with MCC. Merkel cell carcinoma (MCC) is a lethal, virus-associated cancer that lacks effective therapies for advanced disease. Agents blocking the PD-1/PD-L1 pathway have shown objective, durable tumor regressions in patients with advanced solid malignancies and efficacy has been linked to PD-L1 expression in the tumor microenvironment. To investigate whether MCC might be a target for PD-1/PD-L1 blockade, we examined MCC PD-L1 expression, its association with tumor-infiltrating lymphocytes (TIL), Merkel cell polyomavirus (MCPyV), and overall survival. Sixty-seven MCC specimens from 49 patients were assessed with immunohistochemistry for PD-L1 expression by tumor cells and TILs, and immune infiltrates were characterized phenotypically. Tumor cell and TIL PD-L1 expression were observed in 49% and 55% of patients, respectively. In specimens with PD-L1(+) tumor cells, 97% (28/29) showed a geographic association with immune infiltrates. Among specimens with moderate-severe TIL intensities, 100% (29/29) showed PD-L1 expression by tumor cells. Significant associations were also observed between the presence of MCPyV DNA, a brisk inflammatory response, and tumor cell PD-L1 expression: MCPyV(-) tumor cells were uniformly PD-L1(-). Taken together, these findings suggest that a local tumor-specific and potentially MCPyV-specific immune response drives tumor PD-L1 expression, similar to previous observations in melanoma and head and neck squamous cell carcinomas. In multivariate analyses, PD-L1(-) MCCs were independently associated with worse overall survival [HR 3.12; 95% confidence interval, 1.28–7.61; P = 0.012]. These findings suggest that an endogenous immune response promotes PD-L1 expression in the MCC microenvironment when MCPyV is present, and provide a rationale for investigating therapies blocking PD-1/PD-L1 for patients with MCC. Cancer Immunol Res; 1(1); 54–63. ©2013 AACR.
Adverse prognosis of clustered‐cell versus single‐cell micrometastases in pN0 early gastric cancer

The clinical significance of lymph node micrometastasis (MM) for pN0 early gastric cancer is not well documented. The aim of this study is to clarify the risk factors of lymph node MM and the prognostic significance of the type of lymph node MM in patients with pN0 early gastric cancer.
Los efectos del compartimiento social de las emociones sobre el trauma del 11 de Marzo en personas no afectadas directamente

Este estudio longitudinal evalua la validez predictiva del compartimiento social y la expresion de las emociones sobre el atentado del 11 de Marzo en Madrid. Se aplico a 1793 estudiantes y conocidos o familiares de estos (38% de la muestra), en seis ciudades y ocho universidades, una bateria de pruebas, compuesta por preguntas acerca de la comunicacion verbal sobre lo ocurrido, la intensidad de la activacion emocional, pensamientos repetitivos, apoyo social subjetivo, soledad, afectividad positiva, beneficios inferidos de la respuesta al trauma y una escala de clima emocional. Estas pruebas se aplicaron en tres momentos: una semana despues del atentado, tres semanas y dos meses despues. Los resultados muestran que quienes mas hablaron y escucharon sobre el 11-M una semana despues del atentado informaban percibir, tanto tres semanas como dos meses despues, un mayor nivel de apoyo social subjetivo, menor soledad, mas afectividad positiva, asi como un mayor grado de acuerdo con los aspectos positivos o beneficios personales, interpersonales y sociales de la reaccion al trauma colectivo. Los resultados muestras que el compartimiento social emocional mantiene y predice la intensidad emocional tras el atentado. Los resultados se analizan desde un marco teorico funcionalista social de recuerdo, que incluyen el compartir social de las emociones y la participacion en ceremonias y rituales. Se concluye que las formas de afrontamiento social colectivas son funcionales.
The missing kiss of life: transcriptional activity of the metastasis suppressor gene KiSS1 in early breast cancer.

BACKGROUND KiSS-1 is a metastasis suppressor gene encoding a neuropeptide with potent antimetastatic activities in tumour cell lines. The transcriptional activity of the gene and its associations in resected breast cancer were analysed. MATERIALS AND METHODS Tumour messenger RNA (mRNA) of the KiSS1 exon I/II boundary was extracted from paraffin-embedded stage II or III node-positive breast adenocarcinomas of 272 women. KiSS1 mRNA was examined for associations with outcome, disease and molecular characteristics. RESULTS Only 8 out of 272 tumours (3%) yielded detectable KiSS1 mRNA levels. There was no evidence of correlation of KiSS1 transcription with the number of involved axillary nodes, grade, hormone receptor status or tumour size. Of women with increased KiSS1 mRNA tumour levels, 87.5% were postmenopausal, whereas only 48% were postmenopausal among patients without detectable KiSS1 mRNA (p = 0.03). No association of KiSS1 transcription was found with transcription of the cell cycle-regulators HER2, VEGF, p53, BCL2, PAEP, or BIRC5. At a median follow-up of 62 months, there was no statistically significant difference between women harbouring KiSS1 mRNA-negative versus-positive tumours in terms of disease-free and overall survival (log-rank test p = 0.54 and p = 0.55, respectively). CONCLUSION The metastasis suppressor gene KiSS1 is silenced in the vast majority of resected node-positive breast adenocarcinomas. These findings support the antimetastatic role of the gene and warrant its study as a prognostic marker and a therapeutic target.
Gut-directed hypnotherapy for irritable bowel syndrome: piloting a primary care-based randomised controlled trial.

BACKGROUND In western populations irritable bowel syndrome (IBS) affects between 10% and 30% of the population and has a significant effect on quality of life. It generates a substantial workload in both primary and secondary care and has significant cost implications. Gut-directed hypnotherapy has been demonstrated to alleviate symptoms and improve quality of life but has not been assessed outside of secondary and tertiary referral centres. AIM To assess the effectiveness of gut-directed hypnotherapy as a complementary therapy in the management of IBS. DESIGN OF STUDY Randomised controlled trial. SETTING Primary care patients aged 18-65 years inclusive, with a diagnosis of IBS of greater than 6 weeks' duration and having failed conventional management, located in South Staffordshire and North Birmingham, UK. METHOD Intervention patients received five sessions of hypnotherapy in addition to their usual management. Control patients received usual management alone. Data regarding symptoms and quality of life were collected at baseline and again 3, 6, and 12 months post-randomisation. RESULTS Both groups demonstrated a significant improvement in all symptom dimensions and quality of life over 12 months. At 3 months the intervention group had significantly greater improvements in pain, diarrhoea and overall symptom scores (P<0.05). No significant differences between groups in quality of life were identified. No differences were maintained over time. Intervention patients, however, were significantly less likely to require medication, and the majority described an improvement in their condition. CONCLUSIONS Gut-directed hypnotherapy benefits patients via symptom reduction and reduced medication usage, although the lack of significant difference between groups beyond 3 months prohibits its general introduction without additional evidence. A large trial incorporating robust economic analysis is, therefore, urgently recommended.
Differentiating Small Cell Carcinoma From Squamous Cell Carcinoma in Cytologic Specimens: A Head-to-Head Comparison of p40 and p63 Using Cell Block Immunocytochemistry

Distinguishing small cell carcinoma (SCC) from poorly differentiated squamous cell carcinoma (SCCA) can be challenging on fine needle aspiration (FNA). p63 immunocytochemistry is frequently used to support the presence of squamous differentiation. However, issues relating to specificity have arisen, and the common pan-p63 clone (4A4) has been challenged by antibodies specific for the &Dgr;N isoform of p63 (p40), which show superior specificity for SCCA. A total of 50 SCC and 25 SCCA FNA cell blocks were stained with antibodies for p40, p63, K903, and CK5/6. For each marker, both extent and intensity of immunoreactivity were recorded, blinded to diagnosis, and H-scores (extent×intensity) were calculated. A total of 4%, 34%, 4%, and 2% of SCCs were positive for p40, p63, K903, and CK5/6, respectively. The rate of p63 positivity was significantly higher than for the other markers. Median H-scores in p63-positive SCCs (40) and SCCAs (270) were significantly different (P<0.0001), though, and 94% of p63-positive SCCs showed an H-score <150. SCCs frequently express p63 (34%). In the SCCA versus SCC differential diagnosis, p40 and K903 are each marginally more sensitive (92%) than p63 (88%), whereas CK5/6 boasts the greatest specificity (98%). p63’s poor specificity (66%) can be improved to 94%, if an H-score ≥150 is used as the cutoff for a positive result.
Individual Differences and Similarities in the Stability, Timing Consistency, and Natural Frequency of Rhythmic Coordinated Actions

Abstract Under preferred speed conditions, 15 adults undertook bimanual in-phase and antiphase tapping, clapping, galloping, galloping while clapping, and crawling on their hands and feet. We measured stability of interlimb coordination (standard deviation of mean interlimb relative phasing), single limb timing consistency (coefficient of variation of mean single limb cycle durations), and natural limb frequency. Pearson product-moment correlations among tasks established that only the natural limb frequencies were significantly correlated (specifically among gross motor actions in which larger contributions of inertial loads contribute to natural frequencies). Intraclass correlations were high for tasks, meaning that within each task, all participants performed similarly. Thus, only frequency has a tendency to show a common time-based process within a participant, but common time-based processes exist between participants.
Programmed Application of Transforming Growth Factor β3 and Rac1 Inhibitor NSC23766 Committed Hyaline Cartilage Differentiation of Adipose‐Derived Stem Cells for Osteochondral Defect Repair

Hyaline cartilage differentiation is always the challenge with application of stem cells for joint repair. Transforming growth factors (TGFs) and bone morphogenetic proteins can initiate cartilage differentiation but often lead to hypertrophy and calcification, related to abnormal Rac1 activity. In this study, we developed a strategy of programmed application of TGFβ3 and Rac1 inhibitor NSC23766 to commit the hyaline cartilage differentiation of adipose‐derived stem cells (ADSCs) for joint cartilage repair. ADSCs were isolated and cultured in a micromass and pellet culture model to evaluate chondrogenic and hypertrophic differentiation. The function of Rac1 was investigated with constitutively active Rac1 mutant and dominant negative Rac1 mutant. The efficacy of ADSCs with programmed application of TGFβ3 and Rac1 inhibitor for cartilage repair was studied in a rat model of osteochondral defects. The results showed that TGFβ3 promoted ADSCs chondro‐lineage differentiation and that NSC23766 prevented ADSC‐derived chondrocytes from hypertrophy in vitro. The combination of ADSCs, TGFβ3, and NSC23766 promoted quality osteochondral defect repair in rats with much less chondrocytes hypertrophy and significantly higher International Cartilage Repair Society macroscopic and microscopic scores. The findings have illustrated that programmed application of TGFβ3 and Rac1 inhibitor NSC23766 can commit ADSCs to chondro‐lineage differentiation and improve the efficacy of ADSCs for cartilage defect repair. These findings suggest a promising stem cell‐based strategy for articular cartilage repair.
Effect of the novel cholecystokinin receptor antagonist CR-1392 on cholecystokinin-induced antroduodenal and pyloric motor activity in vivo.

The effects of i.a. injected cholecystokinin (CCK)-octapeptide on pyloric and antroduodenal motility, measured with strain gauges and combined side hole-sleeve manometry, were investigated in 16 dogs in vivo. CCK-octapeptide (OP) induced strong pyloric contractions when injected into the pylorus (threshold of 2 x 10(-13) mol; ED50, 8 x 10(-13) mol). Similar responses were obtained in the distal antrum (threshold, 6 x 10(-13) mol; ED50, 3 x 10(-12) mol) and the proximal duodenum (threshold, 5 x 10(-13) mol; ED50, 3 x 10(-12) mol). The nonsulfated form of CCK-OP was about 2 to 3 log units less potent in eliciting these excitatory responses in the pylorus (threshold, 9 x 10(-10) mol). Atropine shifted the dose-response curve of CCK-OP in pylorus, duodenum and antrum to the right suggesting a neural action of CCK-OP. However, an excitatory effect of CCK-OP was still present after neural blockade with tetrodotoxin i.a. Therefore, there was probably a muscular as well as a neural site of action of CCK-OP in these tissues. Systemic application of the novel CCK-antagonist CR-1392 in a dose of 1.2 mg/kg i.v. plus 100 micrograms i.a. shifted the dose-response curve of CCK-OP 1 log unit to the right without affecting the dose-response curve to acetylcholine. This dose of CR-1392 did not interfere with the pyloric motor responses to duodenal field stimulation or to intraduodenal acid infusion. These results demonstrate the dual peripheral action on nerve and muscle of CCK-OP in the pylorus in vivo. (ABSTRACT TRUNCATED AT 250 WORDS)