Miracle-dz/UniFAR-FTUs huggingface dataset:
Performance of the Bethesda System for Reporting Thyroid Cytology in Multi-Institutional Large Cohort of Pediatric Thyroid Nodules: A Detailed Analysis

Background: To evaluate the performance of TBSRTC through multi-institutional experience in the paediatric population and questioning the management recommendation of ATA Guidelines Task Force on Paediatric Thyroid Cancer; Methods: A retrospective search was conducted in 4 institutions to identify consecutive thyroid FNAC cases in paediatric population between 2000 and 2018. Following the 2nd TBSRTC, the risk of malignancy ratios (ROMs) was given in ranges and calculated by 2 different ways. Sensitivity, specificity, PPV, NPV and DA ratios were calculated using histologic diagnosis as the gold standard; Results: Among a total of 405 specimens, the distribution of cases for each category was, 44 (11%) for ND, 204 (50%) for B category, 40 (10%) for AUS/FLUS, 36 (9%) for FN/SFN, 24 (6%) for SFM and 57 (14%) for M categories. 153 cases have a histological diagnosis. The ratio of surgery was 23% in ND, 16% in the B, 45% for AUS/FLUS, 75% for SFN/FN and 92% for SFM and 75% in M categories; Conclusions: The data underlines the high ROM values in paediatric population which might be clinically meaningful. The high rate of malignancy of the cohort of operated patients (50%) also underlines the need of better preoperative indicators for stratification. Considering that more than half of the nodules in AUS/FLUS category were benign, direct surgery recommendation could be questionable as proposed in ATA 2015 guidelines.
Risk Factors for Early and Late Complications after Laparoscopic Sleeve Gastrectomy in One-Year Observation

Background: Although laparoscopic sleeve gastrectomy (LSG) is considered a safe bariatric procedure in the treatment of obesity, it still involves a risk of developing postoperative complications. Knowledge of risk factors for possible complications would allow appropriate preoperative planning, optimization of postoperative care, as well as early diagnosis and treatment. The aim of this study was to evaluate risk factors for complications after laparoscopic sleeve gastrectomy. Methods: A retrospective study of 610 patients who underwent LSG at a tertiary institution were included in the study through retrospective analysis of the medical data. Complications were categorized as early (<30 days) and late (≥30 days) and evaluated according to the Clavien–Dindo Classification. Results: Early complications were observed in 35 patients (5.74%) and late complications occurred in 10 patients (1.64%). Independent risk factors of early complications after laparoscopic sleeve gastrectomy included hypercholesterolemia (OR 3.73; p-value = 0.023) and smoking (OR = 274.66, p-value < 0.001). Other factors that may influence the postoperative course are length of hospital stay and operation time. Smoking, peptic ulcer diseases and co-existence of hiatal hernia were found to be an independent predictors of late complications. Conclusions: Smoking is associated with the higher risk of both, early and late complications, while hypercholesterolemia with only <30 days complications after laparoscopic sleeve gastrectomy.
Employment Trajectories Across the Life Course and Oral Health Among Older Persons in a Developing Country

A significant research gap on socioeconomic determinants of oral health among older persons is that socioeconomic indicators, like employment status, have essentially been problematized and measured using a cross-sectional approach. Based on a life course approach, and using data from a population-representative, face-to-face and longitudinal-retrospective survey focused on older people in Chile (N = 802), we reconstructed representative types of individual employment trajectories and measured their association with different oral health indicators in old age. Our results show that employment trajectories characterized by continuous, formal, full-time employment have a protective effect for multiple oral health indicators among older people. Our study demonstrates the need for public policies on oral health in old age to incorporate a life course approach and to consider the negative impact of constantly working in informal employment or being out of the labor market permanently, particularly in countries like Chile where temporary and informal employment has risen steadily.
Chinese College Students’ Attitudes towards Animal Welfare

Simple Summary College students, specifically from veterinary, animal, agricultural, and life sciences majors represent the future professionals who will closely work with animal industry stakeholders. Therefore, it is important to understand their attitudes towards animals and their knowledge about animal welfare. A survey on Chinese college students was conducted across different majors and Chinese geographical regions to understand their attitude towards the animal Sentient and the Five Freedoms models for pets, laboratory, farm, and wild animals. Most of the respondents exhibited a good attitude towards both the animal Sentient and the Five Freedoms models, with best scoring for pet animals followed by wild animals. Respondents showed less concerns towards farm and laboratory animals. A previous animal welfare education, the ownership of animals, and the participation in laboratory work involving animals positively influenced the attitude of the respondents towards animal welfare. These experiences might have helped students to develop concerns towards the animals’ treatment. When compared to previous studies, our results suggest that Chinese college students improved their attitudes towards animals in recent years. Abstract Understanding the attitude of stakeholders towards animals is critical for the development and improvement of animal welfare in a country. College students from veterinary, animal, and life sciences majors represent future key stakeholders that will interact with professionals from animal industries. Therefore, it is critical to understand these college students’ attitudes towards animals and their knowledge about animal welfare. The present survey aimed to investigate Chinese college students’ concerns towards different animal classes (i.e., pets, farm, laboratory, and wild animals) through the animal Sentient and Five Freedoms models. Chinese college students from different majors (i.e., related to animal sciences or not) scored very well in their attitude towards both the animal Sentient and Five Freedoms models, with differences depending on the animal class considered. Pets (dogs and cats) had better consideration for both animal Sentient and Five Freedoms models, followed by wild animals, while farm and laboratory animals were less considered. Veterinary science major students showed the strongest differences in attitudes depending on the animal classes considered compared to other majors. Furthermore, respondents showed better attitude scoring if they currently owned or had owned animals, had participated in animal welfare courses, or in laboratory work that involved animals. When compared to previous studies, our results suggest a general improvement of Chinese college students’ attitudes towards animals.
Serum or Plasma for Quantification of Direct Oral Anticoagulants?

Background: Direct oral anticoagulants are increasingly replacing vitamin K antagonists for prevention of stroke in patients with atrial fibrillation, partly owing to the lack of a need for routine monitoring. Therapeutic drug monitoring may still be warranted under certain circumstances. It is generally assumed that serum and plasma can be interchangeably used for this purpose. The aim of this study was to investigate possible differences between the serum, citrate-plasma, and ethylenediaminetetraacetic acid (EDTA)-plasma concentrations of apixaban and rivaroxaban in a larger patient group and their relation to factor X measurements. Methods: Plasma and serum samples were drawn during the same venipuncture from patients treated with apixaban or rivaroxaban. Drug levels were measured using ultrahigh-performance liquid chromatography combined with tandem mass spectrometry. Three sample matrices were obtained from 8 healthy volunteers for measurement of factor X antigen and activity. Results: Mean concentrations of apixaban and rivaroxaban were 16.8% and 36.6% higher in serum than in citrate-plasma, respectively (both P < 0.001). The corresponding differences in serum versus EDTA-plasma were 4.5% for apixaban and 13.1% for rivaroxaban (both P < 0.001). Factor X antigen measurements in citrate-plasma, EDTA-plasma, serum with clot activator, and serum without additives yielded comparable results, and factor X activity was significantly higher in serum than in plasma. Conclusions: Apixaban and rivaroxaban concentrations were significantly higher in serum than in plasma. The difference was more pronounced with rivaroxaban and was larger between serum and citrate-plasma than between serum and EDTA-plasma. Higher factor X activity in serum may explain the observed concentration differences. The choice of matrix is, thus, important when interpreting therapeutic drug monitoring results and in research involving analyses of direct oral anticoagulants. The authors recommend citrate-plasma as the preferred matrix.
Accuracy and reproducibility of the visualisation of occlusal contact points using analogue articulating foil or digital intraoral scanners in vitro.

AIM The accuracy and reproducibility of occlusal contact points visualized by articulation foil (AF) should be investigated and then compared with contact points calculated by three different intraoral scanners (IOS). MATERIALS AND METHODS Occlusal contact points were visualized on a standardized resin dental tooth model using AF 50 times with maximum intercuspidation and constant biting force. The points were photographed from a vertical position above the model and superimposed on a screen in order to test the reproducibility of the model. This was followed by fifty-fold repetition by scans and computation of the occlusal contact points by the respective IOS CS3600 (CS ScanFlow v.1 4th version), TRIOS 3 (Basic 2019), and CEREC Omnicam (Software version 5.1). The results of computation were captured with screenshots, and were then overlaid with the photographs of the AF. The image overlays were classified into five categories: category 1 = total overlapping of contact points, category 2 = partly overlapping, category 3 = adjacent contact points without overlapping, category 4 = contact points identified only by IOS, category 5 = contact points identified only by AF. All data were statistically evaluated (95% CI). RESULTS In total, the visualisation of the occlusal contact points by the IOS were significantly less accurate and less reproducible compared to the AF (p < 0.05). In the combination of sensitivity and accuracy, the TRIOS3 by 3Shape showed significantly better results than the other IOS tested (p < 0.05). CONCLUSION In vitro, AF displayed a significantly more accurate visualisation of the occlusal contact points than IOS.
Reflux scintigraphy in gastro-esophageal reflux disease: a comparison study with 24 hour pH-impedance monitoring

Abstract Objective Reflux scintigraphy is often used to diagnose gastro-esophageal reflux disease (GERD). However, the efficacy of this study remains controversial. Our aim was to determine the role of reflux scintigraphy in diagnosing GERD by comparing it to 24 h combined pH-impedance study as the gold standard. Materials and methods Adult patients who presented for investigations of reflux symptoms were prospectively recruited into the study. All patients underwent high resolution esophageal manometry and those with major motor disorders of the esophagus were excluded. Eligible patients immediately underwent reflux scintigraphy following insertion of the pH-impedance catheter. Results Thirty patients were included in the study. Using a total acid exposure time (AET) of >4.2% as the reference for abnormal acid reflux, reflux scintigraphy had a sensitivity and specificity of 62.5 and 68.2%, respectively, in detecting acid reflux. When compared to AET >6%, reflux scintigraphy had a sensitivity and specificity of 66.7 and 62.5%, respectively, and a positive predictive value of 30.8% and a negative predictive value of 88.2%. There were no associations between outcomes of reflux scintigraphy and total AET (p = .46), total (acid or non-acid) reflux events (p = 0.11), proximal AET (p = .33) or the number of proximal reflux episodes (p = .75) on 24 h pH-impedance study. Conclusions Reflux scintigraphy has limited role in diagnosing GERD when compared to 24 h combined pH-impedance monitoring.
Cemented versus screw‐retained zirconia‐based single‐implant restorations: 5‐year results of a randomized controlled clinical trial

Abstract Objectives To compare cemented and screw‐retained one‐piece zirconia‐based restorations in terms of clinical, radiographic, and technical outcomes 5 years after insertion. Materials and methods Thirty‐four patients with single‐tooth implants were randomly restored with either a cemented lithium disilicate crown on a one‐piece customized zirconia abutment (CEM, 17 patients) or a screw‐retained crown based on a directly veneered one‐piece customized zirconia abutment (SCREW, 16 patients). All patients were recalled for a baseline examination (7–10 days after crown insertion) and then annually up to 5 years. The following outcomes were assessed: marginal bone level (changes), technical, and clinical (bleeding on probing, plaque control record, probing depth, and keratinized tissue) parameters. The Mann–Whitney U‐test was used to assess differences between the two groups. Results At 5 years, 26 patients (13 in each group) were re‐examined. The survival rates on the implant and restorative levels were 100% and 82.4% (equally for both groups), respectively. At 5 years, the median marginal bone level was located at −0.15 mm (IQR: −0.89 mm; 0.27 mm) (CEM) and −0.26 mm (IQR: −0.38 mm; 0.01 mm) (SCREW) below the implant shoulder (intergroup p = .9598). The median changes between baseline and the 5‐year follow‐up amounted to −0.23 mm (CEM; intragroup p = .0002) and −0.15 mm (SCREW; intragroup p = .1465) (intergroup p = .1690). The overall technical complication rate at 5 years was 15.4% (CEM) and 15.4% (SCREW) (intergroup p = 1.00). Clinical parameters remained stable over time (baseline to 5 years). Conclusions At 5 years, screw‐retained and cemented restorations rendered largely the same clinical, technical, and radiographic outcomes. Technical complications were frequent in both groups.
Development of Physical Activity Competence Test Battery and Evaluation Standards for Korean Children

The purpose of this study is to develop a comprehensive and systematic method and standard for evaluating children’s physical activity competency as a solution to the problem of increasing child obesity rates due to a decrease in physical activity among children. This study was used a cross-sectional study design. A literature review and Delphi survey were conducted to develop children’s physical activity competency evaluation. The evaluation criteria were presented based on the measurement data of metropolitan area kindergarten students (228 subjects) on the 2016 winter vacation. Items in the evaluation of children’s physical activity competency test battery include health physical strength, basic movement skills, physical activity habits, and physical activity attitudes. Physical fitness for health consisted of muscle strength and endurance (sit-up), flexibility (sit and reach, trunk lift) and body composition (BMI). Fundamental movement skills consisted of mobility (run, hop, jump), stability (static balance, dynamic balance), and control (throw kick). Physical activity habits consisted of the amount of daily steps (steps), exercise time, screen time, and sleep time. Physical activity attitudes consisted of preference, enjoyment, and confidence. The evaluation criteria for child physical activity competency test battery were presented in five stages, divided by age and gender. With the developed evaluation of children’s physical activity competency, the overall level of physical fitness for health, fundamental movement skills, physical activity habits, and physical activity attitudes of kindergarteners in the metropolitan area could be confirmed, and standards were presented.
Mapping health behaviour related to Chagas diagnosis in a non-endemic country: Application of Andersen’s Behavioural Model

Background Chagas disease has become a challenge for non-endemic countries since population mobility has increased in recent years and it has spread to these regions. In order to prevent vertical transmission and improve the prognosis of the disease, it is important to make an early diagnosis. And to develop strategies that improve access to diagnosis, it is important to know the factors that most influence the decision of the population to know their serological status. For this reason, this study uses Andersen’s Behavioural Model and its proposed strategies to explore the health behaviours of Bolivian population. Methods Twenty-three interviews, two focus groups, and two triangular groups were performed with Bolivian men and women, involving a total of 39 participants. In addition, four interviews were conducted with key informants in contact with Bolivian population to delve into possible strategies to improve the Chagas diagnosis. Results The most relevant facts for the decision to being diagnosed pointed out by participants were having relatives who were sick or deceased from Chagas disease or, for men, having their pregnant wife with a positive result. After living in Spain more than ten years, population at risk no longer feels identified with their former rural origin and the vector. Moreover, their knowledge and awareness about diagnosis and treatment still remains low, especially in younger people. Limitations on access to healthcare professionals and services were also mentioned, and proposed strategies focused on eliminating these barriers and educating the population in preventive behaviours. Conclusions Based on Andersen’s Behavioural Model, the results obtained regarding the factors that most influence the decision to carry out Chagas diagnosis provide information that could help to develop strategies to improve access to health services and modify health behaviours related to Chagas screening.
Characterization of a C-Type Lectin Domain-Containing Protein with Antibacterial Activity from Pacific Abalone (Haliotis discus hannai)

Genes that influence the growth of Pacific abalone (Haliotis discus hannai) may improve the productivity of the aquaculture industry. Previous research demonstrated that the differential expression of a gene encoding a C-type lectin domain-containing protein (CTLD) was associated with a faster growth in Pacific abalone. We analyzed this gene and identified an open reading frame that consisted of 145 amino acids. The sequence showed a significant homology to other genes that encode CTLDs in the genus Haliotis. Expression profiling analysis at different developmental stages and from various tissues showed that the gene was first expressed at approximately 50 days after fertilization (shell length of 2.47 ± 0.13 mm). In adult Pacific abalone, the gene was strongly expressed in the epipodium, gill, and mantle. Recombinant Pacific abalone CTLD purified from Escherichia coli exhibited antimicrobial activity against several Gram-positive bacteria (Bacillus subtilis, Streptococcus iniae, and Lactococcus garvieae) and Gram-negative bacteria (Vibrio alginolyticus and Vibrio harveyi). We also performed bacterial agglutination assays in the presence of Ca2+, as well as bacterial binding assays in the presence of the detergent dodecyl maltoside. Incubation with E. coli and B. subtilis cells suggested that the CTLD stimulated Ca2+-dependent bacterial agglutination. Our results suggest that this novel Pacific abalone CTLD is important for the pathogen recognition in the gastropod host defense mechanism.
Combined Endoscopic and Radiologic Healing Is Associated With a Better Prognosis Than Endoscopic Healing Only in Patients With Crohn's Disease Receiving Anti-TNF Therapy

INTRODUCTION: Although endoscopic healing (EH) is recommended as the therapeutic goal in patients with Crohn's disease (CD), combined EH and radiologic healing (RH) could be a more ideal therapeutic goal considering the transmural nature of CD. We compared the prognosis of patients with CD who achieved EH, RH, both EH and RH (deep healing; DH), or no healing under treatment with anti-tumor necrosis factor (TNF) agents. METHODS: We analyzed 392 patients with CD who received anti-TNF treatment for more than 1 year and evaluated with CT enterography or magnetic resonance enterography together with colonoscopy within 3 months between July 2017 and December 2018. Major outcomes (anti-TNF dose intensification, switch to other biologics, CD-related bowel resection, and hospitalization) were compared according to the EH and RH status. RESULTS: During the follow-up (median 18 months; interquartile range, 15–21), the DH group showed a better rate of major outcome-free survival compared with other groups (P < 0.001). In multivariable analysis, elevated C-reactive protein (adjusted hazard ratio [aHR], 2.166; 95% confidence interval [CI], 1.508–3.110; P < 0.001), EH-only (aHR, 3.903; 95% CI, 1.635–9.315; P = 0.002), RH-only (aHR, 3.843; 95% CI, 1.545–9.558; P = 0.004), and no healing (aHR, 8.844; 95% CI, 4.268–18.323; P < 0.001) were associated with increased risks of major outcomes. DISCUSSION: Patients with CD who achieved DH under anti-TNF therapy showed a better prognosis compared with those who only achieved EH. The possibility of DH being used as a new therapeutic target for patients with CD should be investigated in further studies.
Detection of minor variants in Mycobacterium tuberculosis whole genome sequencing data

Abstract The study of genetic minority variants is fundamental to the understanding of complex processes such as evolution, fitness, transmission, virulence, heteroresistance and drug tolerance in Mycobacterium tuberculosis (Mtb). We evaluated the performance of the variant calling tool LoFreq to detect de novo as well as drug resistance conferring minor variants in both in silico and clinical Mtb next generation sequencing (NGS) data. The in silico simulations demonstrated that LoFreq is a conservative variant caller with very high precision (≥96.7%) over the entire range of depth of coverage tested (30x to1000x), independent of the type and frequency of the minor variant. Sensitivity increased with increasing depth of coverage and increasing frequency of the variant, and was higher for calling insertion and deletion (indel) variants than for single nucleotide polymorphisms (SNP). The variant frequency limit of detection was 0.5% and 3% for indel and SNP minor variants, respectively. For serial isolates from a patient with DR-TB; LoFreq successfully identified all minor Mtb variants in the Rv0678 gene (allele frequency as low as 3.22% according to targeted deep sequencing) in whole genome sequencing data (median coverage of 62X). In conclusion, LoFreq can successfully detect minor variant populations in Mtb NGS data, thus limiting the need for filtering of possible false positive variants due to sequencing error. The observed performance statistics can be used to determine the limit of detection in existing whole genome sequencing Mtb data and guide the required depth of future studies that aim to investigate the presence of minor variants.