Miracle-dz/UniFAR-FTUs huggingface dataset:
Breast Cancer Screening in Older Women

reast cancer screening guidelines have traditionally inB cluded monthly breast self-examination (BSE), periodic clinical breast examination (CBE) and periodic mammography. The latter has generated considerable controversy in regard to the codbenefit of screening women at younger ages (40-49 years). ' At older ages the contention is less visible, but the guidelines for screening are not in agreement. The United States Preventive Services Task Force (USPSTF) currently recommends biennial mammography for women aged 50 to 70, citing the absence of clinical trial evidence to support the value of continued screening at older ages.2 The American College of Physicians (ACP) recommends mammography screening until age 74, based on the oldest ages of clinical trial participant^. ^ The American Cancer Society (ACS) and the National Cancer Institute (NCI) currently advise annual mammography with no upper age cut-off. Randomized clinical trials of mammography have established that early detection of breast cancer offers women aged 50 to 64 the best chance for longer survival and potential cure. ' Nonetheless, nearly half of all incident breast cancers and more than half of breast cancer deaths occur among women older than age 65.4 Recent cancer mortality statistics have shown promising declines in breast cancer mortality among women younger than age 70 but no improvement in cancer mortality among the oldest ~ o m e n . ~ . ~ The lack of improvement in survival among women older than age 70 reflects later stage at diagnosis and could reflect poorer host performance7 or less than definitive therapy. ' Analysis of Surveillance, Epidemiology and End Results Program (SEER) data indicate that breast cancer cause-specific mortality in older women is associated with the stage of disease at first diagnosis and with the number of comorbid conditions. ' Thus, screening older women for early stage breast cancer offers the potential for longer survival and enhanced quality of life since treatment of early stage breast cancer is far less burdensome than that required to treat advanced disease. Unfortunately, older women who are at greatest risk for breast cancer are less likely to be screened either by mammography or by clinical breast exam than younger, lower-risk women. " The reasons for the reduced amount of screening in older women include patient, physician, and system barriers. Surveys of older women indicate that physician recommendation is the major determinant of screening adherence. "
Warfarin dosage adjustment strategy in Chinese population.

BACKGROUND Blood anticoagulation after heart valve replacement is a recognized difficulty all over the world. In this study, we identified the effect of amiodarone on the function of warfarin and confirmed the countermeasure by concluding the genotype distribution of vitamin K epoxide reductase complex 1 (VKORC1) and cytochrome P450 2C9 (CYP2C9) of the patient to predict the security dose of warfarin. METHODS Studying on the VKORC1 (-1639G>A) and CYP2C9 genotype of 271 cases on heart valve replacement in the First Affiliated Hospital of Soochow University from Jan. 2012 to Jan. 2014. Warfarin's multivariable regression equation was taken to calculate their warfarin dosage. In the study, 80 of them were selected and divided into 4 groups according to their different warfarin dosage and their usage of amiodaron. The differences of INR values at the 5(th), 8(th), 11(th), 14(th) days of operation were analyzed. RESULTS Among the 80 cases, VKORC1 (-1639G>A) AA types accounted for 90%, and AG types accounted for another 10%, while GG types were not found. In addition that, all of the patients (100%) had CYP2C9*1/*1 type, and CYP2C9*1/*3 had not appeared. There was significant difference in INR values between the groups who used amiodarone or not. The pharmacogenetic equation was accurate in the predicting of the warfarin dosage, so that satisfied anticoagulation efficacy had been achieved in 2 weeks after surgery. CONCLUSION It is necessary for the patients to do the warfarin pharmacogenetic test to get the suitable dose before heart valve replacement. Amiodarone can enhance the anticoagulant efficacy of warfarin, so the dosages of warfarin should be reduced properly because of the medicine combination, and INR values must be monitored more frequently to make the anticoagulant process secure and efficient.
Glial S100B is elevated in serum across the spectrum of west nile virus infection

Introduction: We previously reported that protein biomarkers of neuronal death and glial pathology were elevated in the cerebrospinal fluid of patients with West Nile virus (WNV) infection, including WNV fever. Therefore, we hypothesized that the glial biomarker S100B would also be elevated in serum across the spectrum of WNV disease. Methods: Serum levels of S100B were measured by enzyme‐linked immunoassay (ELISA) in 90 WNV patients (35 with neuroinvasive disease and 55 with WNV fever) and compared with 34 healthy controls. Results: Serum S100B was significantly higher in patients (median 0.17 ng/ml) than in controls (0.09 ng/ml, P < 0.0001). Serum S100B was elevated in 16 cases (46%) with neuroinvasive disease and in 19 cases (35%) with WNV fever. Conclusions: The increase in serum S100B reaffirms pathological changes across the spectrum of WNV disease. The elevated S100B in over one third of WNV fever cases implies that neuroinvasion occurs in a much greater proportion of patients than anticipated by clinical and epidemiological data. Muscle Nerve 45: 826–830, 2012
Partial Seizures due to Sclerosis of the Right Amygdala Presenting as Panic Disorder

The differential diagnosis between panic disorder and focal epilepsy may sometimes pose a serious challenge. We report the case of a 32-year-old woman who complained of paroxysmal episodes of acute anxiety that evaded diagnosis for 8 years. Standard EEGs and brain CT scan showed no clear pathologic findings. Antidepressants, support psychotherapy and several courses of antiepileptic drugs were not beneficial. She was referred to our centre for a comprehensive diagnostic assessment. Clinical and standardized personality assessment did not reveal the personality organization typically associated with proneness to develop phobic anxiety disorders. Also, agoraphobic avoidance was absent, and the patient’s main worries during the episodes involved negative social judgments rather than health. A brain MRI revealed a slightly increased signal at FLAIR images in the right amygdala. Video-EEG monitoring was decisive in establishing the diagnosis of drug-resistant right mesial temporal lobe epilepsy. Anteromesial temporal lobectomy was offered and successfully performed. Pathological examination of removed brain tissue revealed amygdalar sclerosis and mild hippocampal neuronal loss. At a 6-month follow-up visit, the paroxysmal episodes had completely disappeared. Depression, anxiety and quality of life were markedly improved. This case suggests that focal epilepsy should be considered in patients with paroxysmal episodes of anxiety, especially if dissociative symptoms and atypical clinical features for panic disorder are present, and if there is no satisfactory response to adequate trials of medication and psychotherapy within one year. A careful psychopathological analysis rather than a descriptive enumeration of symptoms is needed to bring these features to light. In such cases, even if routine EEGs or MRI are inconclusive and there is no response to antiepileptic drugs, it would be advisable to perform video-EEG monitoring to rule out partial seizures.
Highly Selective Inhibition of Inducible Nitric Oxide Synthase Ameliorates Experimental Acute Pancreatitis

Objectives: Inducible nitric oxide synthase (iNOS) activity is increased in experimental acute pancreatitis. The aim of this study was to evaluate treatment with the selective iNOS inhibitors AR-C (AR-C102222AA) and L-NIL (L-N6-(1-iminoethyl)-lysine) in experimental acute pancreatitis. Methods: Acute pancreatitis was induced in anesthetized Australian possums by topical administration of carbachol on the sphincter of Oddi. AR-C treatment was 2 intravenous infusions (2.5 μmol/kg over 15 minutes) at 2 and 4 hours after acute pancreatitis induction. L-NIL treatment was an intraarterial infusion (1 mg/kg/h) from 2 hours after acute pancreatitis induction. At 8 hours, pancreatic tissue was harvested and inflammation assessed (histologic score). Blood samples were collected for plasma amylase, lipase, and amino acid levels. Blood pressure, central venous pressure, supplementary fluids, and urine output were monitored. Results: Treatment with AR-C or L-NIL reduced the plasma levels of amylase and the volume of supplementary fluids and improved the histological score (all P < 0.05). In animals with acute pancreatitis, plasma arginine levels were reduced (P < 0.05), while citrulline and ornithine levels increased (P < 0.05), consistent with increased nitric oxide production. Treatment with AR-C ameliorated the reduced arginine level. Conclusions: Treatment with AR-C or L-NIL, commencing 2 hours after the induction of acute pancreatitis, has significant and beneficial effects in experimental acute pancreatitis in Australian possums.
Bone Mineral Density and Blood Flow to the Lower Extremities: The Study of Osteoporotic Fractures

This study tests the hypothesis that reduced blood flow to the lower extremities may affect bone remodeling, resulting in a decrease in bone mineral density (BMD). BMD was measured in the axial and appendicular skeleton of 1292 elderly women (mean age, 71 years) enrolled in the Study of Osteoporotic Fractures. The ratio of the posterior tibial and brachial systolic blood pressures, the ankle/arm index, was used as a measure of blood flow to the legs. In the cross‐sectional analysis, this index was positively correlated with BMD at the radius, calcaneus, and hip, but not at the spine. A decrease in the index of 2 standard deviations (SD) (as might occur in patients with moderate arterial disease) was associated with a decrease of 3.7% (95% CI, 1.7%, 5.8%) in hip BMD. The effect size at the hip decreased from 3.7 to 1.8% (and was not statistically significant) when adjustment was made for smoking and/or body mass index (BMI). In the prospective analysis, the rate of bone loss at the hip and calcaneus was greater (p < 0.05) among women whose annual decrease in ankle/arm index was more than 1 SD greater than the mean decrease. This increase was independent of estrogen use, smoking, BMI, pattern of fat distribution, history of diabetes, exercise, and ability to walk. The results from this prospective community‐based study provide the first evidence that among relatively healthy older women decreased vascular flow in the lower extremities may be associated with an increased rate of bone loss at the hip and calcaneus.
Decrease of Antibiotic Consumption in Children with Upper Respiratory Tract Infections after Implementation of an Intervention Program in Cyprus

ABSTRACT To assess the impact of intervention on antibiotic misuse in children, parents' and pediatricians' knowledge, attitudes, and practices (KAP) concerning antibiotic use were evaluated pre- and postintervention in Larnaca (Cyprus) and Limassol (Cyprus). Concurrently, pediatricians documented upper respiratory tract infection (URTI) visits and pharmacists provided antibiotic consumption data. Intervention was implemented for parents and pediatricians residing in Larnaca. The consumption/URTI incidence index was significantly reduced in Larnaca but not in Limassol. Parental responses to a KAP questionnaire remained unchanged; therefore, antibiotic consumption reduction is attributable to pediatricians' education.
The Evolution of Costing During the Period 1985-2015: Progress or Inactivity?

Purpose – This paper examines the evolution of costing process during the past thirty years. More specifically, the technological developments that have affected industrial firms are analysed, focusing on the type of production and the innovations that have been developed and affected costing related issues. Additionally, the creation of a new framework is examined, focusing on costing information that could be useful for making business decisions. Design/methodology/approach – A field survey was conducted on a sample of Greek manufacturing firms. A structured questionnaire was used as a research instrument for collecting primary data. It was constructed incorporating questions used by similar surveys reported in the relevant literature. Findings –The use of cost information for short-term decisions is prevailed over long-term (strategic planning decisions, evaluation of alternative options for the design or production of goods, product mix determination, introduction of new products), while the examination of the cost structure showed that the proportion of fixed cost covers almost 50 per cent of the total cost (fixed and variable) for most of half firms. Additionally, the proportion between direct and indirect production costs revealed that 76.8 per cent of the firms estimate that their direct costs would be up 80% of their total cost. Research limitations/implications – The omission of other important factors and the relation between specific factors such as firm’s size, industry sector and decision making process should be considered as well as the differentiation of the results according to the industry sector, or due to different costing purposes. Originality/value – This is one of the few studies exploring the costing practice implemented by Greek industrial firms. The analysis of the findings shows that despite the technological developments that affected the costing area and the criticisms concerning the limitations of the traditional costing approaches, they are still predominant.
The Flypaper Effect in Germany: An East-West Comparison

We investigate the effect of general-purpose transfers on different expenditure categories and tax rates in the municipalities of Saxony (eastern Germany) and North Rhine-Westphalia (western Germany). Findings from the panel data analysis suggest the existence of the "flypaper effect" - municipalities use transfers to increase expenditures but do not reduce taxes. For most expenditure subcategories the estimated coefficients are alike, suggesting similarity of spending priorities in the two federal states despite the differences in the transfer dependency. Targeted support of eastern municipalities could potentially explain few identified differences in the spending behavior.
CONVERGENCE AND DIVERGENCE DURING THE ADAPTATION TO SIMILAR ENVIRONMENTS BY AN AUSTRALIAN GROUNDSEL

Adaptation to replicate environments is often achieved through similar phenotypic solutions. Whether selection also produces convergent genomic changes in these situations remains largely unknown. The variable groundsel, Senecio lautus, is an excellent system to investigate the genetic underpinnings of convergent evolution, because morphologically similar forms of these plants have adapted to the same environments along the coast of Australia. We compared range‐wide patterns of genomic divergence in natural populations of this plant and searched for regions putatively affected by natural selection. Our results indicate that environmental adaptation followed complex genetic trajectories, affecting multiple loci, implying both the parallel recruitment of the same alleles and the divergence of completely different genomic regions across geography. An analysis of the biological functions of candidate genes suggests that adaptation to coastal environments may have occurred through the recruitment of different genes participating in similar processes. The relatively low genetic convergence that characterizes the parallel evolution of S. lautus forms suggests that evolution is more constrained at higher levels of biological organization.
Probabilistic accounting of uncertainty in forecasts of species distributions under climate change

Forecasts of species distributions under future climates are inherently uncertain, but there have been few attempts to describe this uncertainty comprehensively in a probabilistic manner. We developed a Monte Carlo approach that accounts for uncertainty within generalized linear regression models (parameter uncertainty and residual error), uncertainty among competing models (model uncertainty), and uncertainty in future climate conditions (climate uncertainty) to produce site‐specific frequency distributions of occurrence probabilities across a species' range. We illustrated the method by forecasting suitable habitat for bull trout (Salvelinus confluentus) in the Interior Columbia River Basin, USA, under recent and projected 2040s and 2080s climate conditions. The 95% interval of total suitable habitat under recent conditions was estimated at 30.1–42.5 thousand km; this was predicted to decline to 0.5–7.9 thousand km by the 2080s. Projections for the 2080s showed that the great majority of stream segments would be unsuitable with high certainty, regardless of the climate data set or bull trout model employed. The largest contributor to uncertainty in total suitable habitat was climate uncertainty, followed by parameter uncertainty and model uncertainty. Our approach makes it possible to calculate a full distribution of possible outcomes for a species, and permits ready graphical display of uncertainty for individual locations and of total habitat.
Ipragliflozin, a sodium–glucose cotransporter 2 inhibitor, in the treatment of type 2 diabetes

Introduction: Type 2 diabetes is the fastest growing non-communicable chronic disease worldwide. One of the newer treatment options is the class of sodium–glucose cotransporter 2 inhibitors that offer improved glycemia through increased urinary glucose excretion. The class has shown to be effective, safe and well-tolerated in newly diagnosed and long-standing diabetes. Additional benefits of the inhibitors include low risk of hypoglycemia and weight loss. Areas covered: This perspective reviews ipragliflozin – a sodium–glucose cotransporter 2 inhibitor – that has gained approval for clinical use in Type 2 diabetes in Japan. The paper discusses pharmacokinetics (PK), pharmacodynamics, clinical efficacy, safety and tolerability of the drug. Expert opinion: Due to its efficacy (hemoglobin A1c reduction of ≈1%), safety (low risk of hypoglycemia and very low rate of urinary tract infections), favorable PK interaction with other anti-diabetes medications and mechanism of action that is independent from β-cell function and insulin sensitivity, ipragliflozin can be used as a monotherapy or as an add-on to other agents in any stage of Type 2 diabetes.
The alpha particulate liver glycogen. A morphometric approach to the kinetics of its synthesis and degradation.

Electron micrographs of rat hepatocytes with a glycogen content between 0.36 and 2.55% (w/w) were submitted to morphometrical analysis. From the number and size of glycogen profiles, the distribution of radius and volume of glycogen alpha particles were computed. The 7-fold difference in glycogen content was accompanied by an only 1.8-fold increase in the mean volume of the particles while their number increased by a factor of 4. On the basis of these observations, it is proposed that the population of glycogen particles can be divided in two groups. The first one is made of growing particles, still associated with glycogen synthase; they are the only particles present at low glycogen concentration and their number is limited. Application of a simple mathematical model allows to estimate their number in hepatocytes as 49 X 10(12) particles . ml-1. The second group is made of glycogen particles which have reached their maximal size and the number of which is in principle unlimited. The maximal particle size is estimated to be 0.36 X 10(-15) ml, corresponding to an average molecular weight of 178 X 10(6). The average molecular weight of glycogen, as measured from the actual size of the particles, varied from 89 X 10(6) to 161 X 10(6).
Idiosyncratic Volatility, Its Expected Variation, and the Cross-Section of Stock Returns

We show that the widely documented negative relation between idiosyncratic volatility (IVOL) and expected returns can be explained by the mean reversion of stocks' idiosyncratic volatilities. We use option-implied information to extract the mean reversion speed of IVOL in an almost model-free fashion. This allows us to identify stocks for which past IVOL is a bad proxy for expected IVOL. These stocks solely drive the negative relation, and a long--short portfolio earns a monthly risk-adjusted return of 2.74%, on average. In a horse race, the mean reversion speed is superior to prominent competing explanations of the IVOL puzzle.
Evidence for preserved direct pupillary light response in Leber's hereditary optic neuropathy.

AIMS/BACKGROUND--Pupillary light response is usually defective in all types of optic neuropathy. However, the authors have observed in patients with Leber's hereditary optic neuropathy (LHON) relatively normal light response, with consequent misdiagnosis psychogenic visual loss in some cases. To confirm this clinical impression, afferent pupillary defect was assessed by measurement of adjusted constriction amplitude (CA) and escape rate (ER) by infrared videopupillography (Iriscorder-C 2515). METHODS--Thirteen consecutive patients (26 eyes) with LHON (average age 27.2 years) were examined; 12 had the mitochondrial DNA 11778 mutation and one the 14484 mutation. Seven of these patients had a positive family history. For comparison, the above rates were determined in 19 patients (23 eyes) with idiopathic optic neuritis (ON; average age 35.1 years), 18 patients (19 eyes) with anterior ischaemic optic neuropathy (AION; average age 58.1 years), and 25 volunteers (50 eyes) with healthy eyes (average age 39.6 years). RESULTS--The distribution of visual acuity was essentially the same in all optic neuropathy groups. Reduction in CA and increase in ER were significant in patients with ON and AION, but not in those with LHON. Only slight afferent pupillary defect was evident even 2 years after the onset of LHON. CA in AION and ER in ON were correlated statistically with visual acuity and Humphrey mean threshold deviation, while CA and ER in LHON were not. CONCLUSION--Pupillary light response in patients with LHON obviously differs from that in patients with other types of optic neuropathy. LHON appears to be pathophysiologically characterised by well preserved afferent fibres for pupillary light response (probably from W cells). Besides being of pathogenetic interest, the detection of clinical features should facilitate the diagnosis of LHON particularly when family history provides no indication.
Procoagulant Activity of T Lymphoblastoid Cells due to Exposure of Negatively Charged Phospholipid

Summary We have characterised the Procoagulant activity (PCA) of six well-established cell lines by assays of tissue factor (TF), thrombin and FXa generation, flow cytometry using Annexin V, and by binding studies with Factors VIII and IXa. The monocytic (THP-1 & U937) and promyelocytic (NB4) cells expressed high concentrations of TF antigen and activity, whereas TF in the lymphocytic cells (Molt 4, Jurkat & Nalm 6) was very low or absent. However the T-lymphoblastoid cells (Molt 4 & Jurkat) promoted the generation of large amounts of thrombin despite their low TF content, and these cells were also the most active in supporting Factor Xa generation. Molt 4 cells bound Factors VIII and IXa with high capacity and their activity was inhibited by Annexin V. These results indicate that the PCA of T-lymphoblastoid lines is due to expression of negatively charged phospholipids. Flow cytometry studies showed Annexin V binding to the major population of nonapoptotic Molt 4 cells and the PCA of Molt 4 was not increased when apoptosis was induced by staurosporine, indicating that PCA is independent of apoptotic status.