Miracle-dz/UniFAR-FTUs huggingface dataset:
Sense of coherence and risk of breast cancer

Sense of coherence (SoC) is the origin of health according to Antonovsky. The link between SoC and risk of cancer has however rarely been assessed. We performed a cohort study of 46,436 women from the Karolinska Mammography Project for Risk Prediction of Breast Cancer (Karma). Participants answered a SoC-13 questionnaire at recruitment to Karma and were subsequently followed up for incident breast cancer. Multivariate Cox models were used to assess the hazard ratios (HRs) of breast cancer in relation to SoC. We identified 771 incident cases of breast cancer during follow-up (median time: 5.2 years). No association was found between SoC, either as a categorical (strong vs. weak SoC, HR: 1.08, 95% CI: 0.90–1.29) or continuous (HR: 1.08; 95% CI: 1.00–1.17 per standard deviation increase of SoC) variable, and risk of breast cancer. In summary, we found little evidence to support an association between SoC and risk of breast cancer.
Superior Mesenteric and Inferior Mesenteric Artery Diameters in Colorectal Cancer.

OBJECTIVE To compare the superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) diameters in colorectal cancer compared to control. STUDY DESIGN Observational study. PLACE AND DURATION OF STUDY Taizhou Hospital, Zhejiang University, Taizhou, China, from March 2019 to June 2020. METHODOLOGY A total of 203 diagnosed colorectal cancer patients and 40 patients as control subjects were reviewed. Patients were divided into three groups based on tumor location as the right colon, left colon, and rectal groups. The diameters were measured on axial computed tomography images independently by two observers. RESULTS The SMA diameter did not differ between the right colon and control groups (p=0.626). The IMA diameter was significantly higher in the left colon group than in the control group (p=0.002), but there was no significant difference in the IMA diameter between the different tumour stages (p=0.263). The IMA diameter was significantly higher in the rectal group than in the control group (p<0.001). There was a significant increase in the IMA diameter from stage I to stage II rectal cancers (p=0.022) and from stage II to stage III rectal cancers (p=0.003). The IMA diameter did not differ between stage III and IV rectal cancers (p=0.600). In locoregional rectal cancer patients, there was a significant correlation between the IMA diameter and tumour-node-metastasis stage (p<0.001, rs = 0.494). CONCLUSION Patients with rectal cancer and left colon cancer have a wider IMA diameter than patients without colorectal cancer. IMA diameter can be a potential marker for locoregional staging of rectal cancer. Key Words: Superior mesenteric artery, Inferior mesenteric artery, Colorectal cancer, Markers, Diameter.
Biomechanical evaluation of a modified proximal humeral locking plate application for distal extra‐articular diaphyseal humeral fractures

The extra‐articular distal humerus locking plate (EADHP) is widely used for distal extra‐articular diaphyseal humeral fracture fixation. However, it occasionally causes skin prominence and discomfort. The upside‐down use of a proximal humerus internal locking system (PHILOS) plate is suggested as an alternative option, but it lacks biomechanical evidence. The purpose of this study was to compare the biomechanical performance between two different fixation methods: the modified use of the PHILOS plate on the anterior cortex versus conventional use of an EADHP on the posterior cortex. Twelve pairs of fresh‐frozen cadaveric humeri were used and 7 mm gap osteotomy was performed at 50 mm proximal to the lateral epicondyle to simulate an AO/OTA 12‐C1.3 fracture type. Single load to failure was measured after five stiffness tests of the plate‐bone constructs in anterior/posterior bending, internal/external torsion, and axial compression. There were no significant differences in metrics between the two groups, except for the load to failure in posterior bending, which was significantly higher for PHILOS (1589.3 ± 234.5) compared to EADHP (1430.1 ± 188.6), p < . 023. In conclusion, the modified use of the PHILOS plate showed comparable biomechanical performance compared to the conventional EADHP. The new fixation method offers potential clinical advantages, considering the patient's position and surgical approach at the time of surgery as well as postoperative soft tissue irritation. Therefore, this could be an option for distal humeral extra‐articular diaphyseal fracture fixation when the use of EADHP is not suitable or preferred.
Reward does not modulate corticospinal excitability in anticipation of a Stroop trial

Action preparation is associated with a transient decrease of corticospinal excitability just before target onset. We have previously shown that the prospect of reward modulates preparatory corticospinal excitability in a Simon task. While the conflict in the Simon task strongly implicates the motor system, it is unknown whether reward prospect modulates preparatory corticospinal excitability in tasks that implicate the motor system less directly. To that effect, we examined reward‐modulated preparatory corticospinal excitability in the Stroop task. We administered a rewarded cue‐target delay paradigm using Stroop stimuli that afforded a left or right index finger response. Single‐pulse transcranial magnetic stimulation was administered over the left primary motor cortex and electromyography was obtained from the right first dorsal interosseous muscle. In line with previous findings, there was a preparatory decrease in corticospinal excitability during the delay period. In contrast to our previous study using the Simon task, preparatory corticospinal excitability was not modulated by reward. Our results indicate that reward‐modulated changes in the motor system depend on specific task‐demands, possibly related to varying degrees of motor conflict.
MGIDI: towards an effective multivariate selection in biological experiments

Multivariate data are common in biological experiments and using the information on multiple traits is crucial to make better decisions for treatment recommendations or genotype selection. However, identifying genotypes/treatments that combine high performance across many traits has been a challenger task. Classical linear multi-trait selection indexes are available, but the presence of multicollinearity and the arbitrary choosing of weighting coefficients may erode the genetic gains. We propose a novel approach for genotype selection and treatment recommendation based on multiple traits that overcome the fragility of classical linear indexes. Here, we use the distance between the genotypes/treatment with an ideotype defined a priori as a multi-trait genotype-ideotype distance index (MGIDI) to provide a selection process that is unique, easy-to-interpret, free from weighting coefficients and multicollinearity issues. The performance of the MGIDI index is assessed through a Monte Carlo simulation study where the percentage of success in selecting traits with desired gains is compared with classical and modern indexes under different scenarios. Two real plant datasets are used to illustrate the application of the index from breeders and agronomists’ points of view. Our experimental results indicate that MGIDI can effectively select superior treatments/genotypes based on multi-trait data, outperforming state-of-the-art methods, and helping practitioners to make better strategic decisions towards an effective multivariate selection in biological experiments.
Disability in clinically stable patients of schizophrenia

Purpose: Disability associated with schizophrenia affects every aspect of life. In India, persons with schizophrenia are eligible for disability benefits. Only a handful of patients are aware and able to avail the benefits. We intended to assess disability in clinically stable patients of schizophrenia as even though they are stable but are disabled and may benefit from disability benefits and rehabilitation. Methods: Sixty-two clinically stable patients of schizophrenia were assessed on the Mini-International Neuropsychiatric Interview, Positive and Negative Syndrome Scale (PANSS), and Schizophrenia Cognition Rating Scale. Disability was assessed on the Indian Disability Evaluation and Assessment Scale (IDEAS). Results: Nearly one-fourth of the “stable patients” had moderate-to-severe disability (22.6% – moderate and 1.6% – severe), i.e., certifiable disability as per IDEAS. Disability had a significant correlation with all three domains of PANSS as well as total PANSS score. The correlation was stronger with negative than with positive symptom scores. Disability also strongly correlated with cognitive impairment. “Work,” “communication and understanding,” and “interpersonal relationship” domains of IDEAS had a strong correlation with cognitive impairment. Conclusion: Nearly 25% of the stable patients had certifiable disability. The “work” domain of IDEAS was most affected. It demonstrates that the rehabilitation of this population may contribute to reducing disability.
Comparative evaluation of use of a diode laser and electrode application with and without two dentinal tubule occluding agents in the management of dentinal hypersensitivity – A clinical study

Background: Dentinal hypersensitivity (DH) is common problem in dentistry. Traditional agents along with alternative therapies have been researched. Aim: To study the efficacy of a diode laser (DL) and electrode application with and without hydroxyapatite (HAP) and strontium chloride (SrCl2) powder. Materials and Methods: 60 Patients with mild cervical abrasion in at least two quadrant with two teeth per quadrant were selected and randomly divided into four groups: (i) Group 1– DL versus DL with HAP (ii) Group 2 – electrode application versus electrode application with HAP (iii) Group 3 - DL versus DL with SrCl2 (iv) Group 4 - electrode application versus electrode application with SrCl2 and were subjected to tactile stimulus and air blast test and scores were recorded on verbal rating scale (VRS) and visual analogues scale (VAS) at different time for 3 months. The data was statistically evaluated by one way ANOVA and paired t test. Results: In group 1 and 3, DL alone had a short term reduction of hypersensitivity (P = 0.001). Synergistic effect of DL and HAP (group 1) showed a prolonged reduction on both scales (P < 0.001) whereas the additive effect of SrCl2 with DL (group 3) showed statistically significant reduction on both scales at all time (p< 0.001). In group 2 there is insignificant difference on both scales at all time (P > 0.05) however group 4 showed significant reduction only in VAS score (p>0.05). Conclusion: DL alone had a short lived effect however with adjunctive sustained results were obtained whereas electrode application was neither beneficial nor did cause any adverse effect.
Endocrine Involvement in COVID-19: Mechanisms, Clinical Features, and Implications for Care

Coronavirus 2019 (COVID -19) has rapidly emerged as a global pandemic with multi-system involvement. Involvement of the endocrine system is expected in COVID-19 as the interplay between severe acute respiratory syndrome corona virus-2 (SARS CoV-2) and the endocrine system occurs at multiple levels. The widespread presence of ACE-2 receptors on various tissues suggests scope for direct viral infection. The interactions via the activation of inflammatory mediators and indirect immune-mediated damage are also postulated. Evidence so far suggests that COVID-19 can cause functional hypopituitarism by direct and indirect effects on the hypothalamo-pituitary axis resulting in inappropriate adrenal response to stress. Several reports highlight possible immune-mediated damage to thyroid glands resulting in subacute thyroiditis. COVID-19 is implicated in precipitating hyperglycemia in known diabetics and uncovering insulin resistance in those previously undiagnosed. COVID-19 has also been shown to trigger Type 1 Diabetes with ketosis. Various mechanisms including direct virus-induced beta cell apoptosis and immune-mediated beta-cell damage have been demonstrated. The presence of virus in semen has unclear clinical significance at present. In this mini-review summarize the endocrine manifestations reported so far in COVID-19 disease and explore mechanisms to decipher how SARS CoV-2 may affect various endocrine organs.
Paget's Disease of Bone in Tunisia: A Study of 69 Patients

Context: Paget's disease of bone is a common bone disease with a striking variation in its incidence and characteristics in different parts of the world. It is uncommonly reported in African patients. Aims: Given the lack of studies describing the characteristics of patients with Paget's disease of bone in North Africa, we aimed to describe demographic, clinical, biochemical, and imaging characteristics, as well as treatment outcomes of Tunisian patients with Paget's disease of bone. Subjects and Methods: This bicentric and retrospective study included patients with Paget's disease of bone. Clinical, laboratory, radiological profile, and response to treatment were analyzed. Results: Sixty-nine patients were identified. The mean age was 64.9 ± 11.6 years and 52.2% were women. One patient reported a positive family history. Seven patients were asymptomatic. Bone pain was the most common presenting symptom. Eight patients had a history of malignancy. In three patients, Paget's disease of bone was diagnosed as part of a metastatic workup. Monostotic disease was found in half of the cases. The most commonly involved sites were pelvis (43.5%), femur (21.7%), and spine (21.7%). The mean serum alkaline phosphatase level at presentation was 591 U/L (68–8380). Two patients received salmon calcitonin (2.8%) and 47 patients (68.1%) received bisphosphonates. After a mean follow-up of 55 months (2–240 months), bone pain improved in 43.1% of patients and the serum alkaline phosphate levels had normalized in 22 of them (43.1%). During follow-up, there was no malignant transformation. Conclusions: In this series of Tunisian patients, Paget's disease of bone had a female predominance and was usually monostotic. The clinical and radiological presentations were similar to the European series.
Rapid, Economic, Acetic Acid Papanicolaou Stain (REAP): An Economical, Rapid, and Appropriate Substitute to Conventional Pap Stain for Staining Cervical Smears

Background: The unanimous method of screening cervical cancer is a cervical smear stained with Papanicolaou stain. However, in spite of the various modifications, the staining procedure takes 20 min and uses substantial amount of alcohol which is highly priced. The aim of the study was to assess and analyze the quality of staining of cervical smears stained with Rapid Economical Acetic acid Papanicolaou (REAP) as compared to conventional pap stain in order to establish REAP as an alternative to conventional pap stain. Methods and Material: In this prospective study, a total of two smears each were collected from 50 females who visited the gynecology outpatient department. One of the smears was stained with conventional pap and the other with REAP. The conventional pap and REAP smears were evaluated and compared for the quality of staining. Results: The cervical smears stained with REAP showed optimal cytoplasmic and nuclear staining in 86% and 90% cases, respectively. The cytological findings and diagnosis of REAP stained smears correlated with their corresponding smears stained with conventional pap in 96% of cases. The turnaround time and cost per smear was much low for REAP as compared to conventional pap stain. Conclusion: The present study was able to establish REAP as an appropriate alternative to conventional pap stain. The staining by REAP was comparable to conventional pap stain.
The Effects of Exercise Training on Physical Performance and Self-efficacy in Hemodialysis Patients: A Randomized Controlled Clinical Trial

Background: Hemodialysis patients are faced with challenges in carrying out their daily activities. Self-efficacy is a social cognitive concept that can affect behavioral control in these patients. Hence, the purpose of the present study was to investigate the effects of exercise training on physical performance and self-efficacy in hemodialysis patients. Materials and Methods: This randomized controlled clinical trial was conducted on 60 hemodialysis patients who visited hospitals affiliated to Mazandaran University of Medical Sciences in Sari, Iran. The participants were randomly divided into two groups. The patients in the intervention/exercise group received the 8-week exercise program. Patients in the control group received routine care. The Six-Minute Walk Test (6MWT) was used to assess the patients' functional ability and the Exercise Self-Efficacy Scale (ESES) and Chronic Disease Self-Efficacy Scale (CDSES) were used to assess their self-efficacy before and 2 and 8 weeks after the intervention. For statistical analysis, independent t-test and paired t-test were used. Results: The comparison of self-efficacy between the exercise group and control group after 8 weeks of intervention showed a significant difference between the groups in terms of the CDSES (F1,43= 22.92, p < 0.001) and ESES (F1,38= 10.84, p < 0.001) results. Moreover, the comparison of mean distance walked based on the 6MWT showed significant changes in this variable (F1= 2.05, p = 0.015). Conclusions: The designed exercise program can improve self-efficacy and physical performance in hemodialysis patients. This intervention is recommended for hemodialysis patients due to its effectiveness, simplicity, and uncomplicated characteristics
Quality of life, adjustment, and associative comorbid conditions in children diagnosed with attention deficit hyperactivity disorder: A comparative study

Introduction: Attention deficit hyperactivity disorder (ADHD) is a common pediatric, neurodevelopmental disorder, with serious impacts on lives of those suffering from it. ADHD is known to be associated with social and emotional difficulties, poor self-regulation, aggression, reduced empathy, inability to regulate socially desirable behavior along with conflicts within family, and increased conflict with peers and several associated comorbid conditions. Aim: The study aims at exploring quality of life (QOL) and adjustment along with associated comorbid conditions in children diagnosed with ADHD in comparison with normal children. Methods: A total sample of 60 children including 30 children diagnosed with ADHD and 30 normal children were selected and assessed using Vanderbilt ADHD Parent rating scale Childhood Psychopathology Measurement Schedule, KINDL QOL: Parent Questionnaire and Pre-Adolescent adjustment Scale to assess level of ADHD, comorbid psychopathologies, their QOL and adjustment respectively. Results: Overall results have indicated that parents reported lesser symptom and pathology in comparisons to teachers for ADHD. Those diagnosed with ADHD had positive and significant comorbidities associated of; low intelligence with behavioral problems and high levels of conduct problems, anxiety, depression, psychotic tendencies, physical illness with emotional problems and somatization in comparison to normal and thus a poor adjusted life, with significant report of poor self-esteem and peer relations and QOL. Conclusion: The results of the present study has clearly stated that severe burden has been perceived by ADHD children, with a poor perceived QOL, several adjustment issues, and sufferance of one or other comorbidity. Thus, the study could help understand and emphasize the need of holistic treatment comprising medicinal and therapeutic methods, including intervention for parents, focusing exclusively on enhancing and curbing these factors.
Is Subdivision of Atypia of Undetermined Significance AUS/Follicular Lesion of Undetermined Significance Cases According to Detailed Nuclear Features Vital for Assessing the Risk of Malignancy?

Background: It has been known that the “atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS)” category is the most problematic category in Bethesda system due to its highly heterogeneous morphological features. Recently, it has been reported that aspirates including nuclear atypia in the AUS/FLUS category have a higher risk of malignancy. Aims: This study aimed to assess each nuclear property in aspirates with cytological atypia and also to determine the relationship with the risk of malignancy. Material and Methods: We reviewed 980 AUS/FLUS fine-needle aspirations (FNAs) performed between '2012 and 2019' at a single institution. We classified these aspirates into four groups: AUS-N (nuclear atypia), AUS-A (architectural atypia), AUS-H (Hurthle cell change), and AUS-O (other). Nuclear features were detailed sub-classified; size and shape (enlargement, elongation, and overlapping), membrane irregularities (irregular contours, grooves, pseudoinclusion), and chromatin characteristics (pale chromatin). The estimated risk of malignancy (ROM) was calculated for each subgroup. Results: Of 980 AUS/FLUS cases, follow-up histological outcome data were available for 209 cases. Among these cases, the estimated ROM was 27.8%. The ROM were 26.4%, 15.4%, and 22.5% for AUS-N, A, and H, respectively. The most common nuclear findings associated with ROM were nuclear groove (67.9%); irregular contours (76.9%) suspected pseudoinclusion (100%) and overlapping (56%) (P < 0,001). But nuclear findings such as nuclear enlargement, mild pleomorphism, or pale chromatin have a similar ROM as architectural atypia. Conclusion: Although it is known that the presence of cytological atypia in an AUS/FLUS nodule increases the estimated risk of malignancy, all nuclear properties are not equally effective in predicting malignancy risk. Emphasizing nuclear atypia details in reports of AUS case may be a more sensitive way to identify nodules with a high risk of malignancy.
A psychoeducational intervention increases use of a delirium protocol by Neurologists and Neurosurgeons in patients with brain disorders

Objectives: Over 50% of inpatients with neurological disorders may present with a co-morbid psychiatric illness. Delirium has a reported point prevalence of 20% in hospital inpatients and is frequently undetected. We aimed to (1) examine inpatient referrals to a Liaison Neuropsychiatry service and (2) review the diagnosis and management of delirium before and after an educational intervention. Methods: An initial 6-month audit of referrals to the inpatient Liaison Neuropsychiatry service was conducted in 2018. We then undertook a psychoeducational intervention to raise awareness of the diagnosis and management of delirium. We conducted a re-audit of referrals to the service in 2019. Results: On initial audit, of 84 referrals, the most common referral was for mood (38%; n = 32). Just 4% (n = 3) had a specific delirium query. Following assessment by Neuropsychiatry, organic disorders (43%; n = 32), including delirium (33%; n = 25), were the most common diagnoses. On re-audit, of 86 referrals, mood assessment remained the most common reason for referral (38%; n = 33) and 2% (n = 2) were referred for possible delirium. Organic disorders remained the most common diagnoses (53%; n = 45) including delirium (38%; n = 32). We found a significant increase in the use of the delirium protocol from 12% (n = 3) on initial audit to 47% (n = 15); p < 0.01 on re-audit despite no increase in the number of specific delirium queries. Conclusions: A psychoeducational intervention improves the management of delirium by Neurologists and Neurosurgeons in patients with brain disorders.