Miracle-dz/UniFAR-FTUs huggingface dataset:
Diagnostic Performance of On-Site Coronary CT Angiography-derived Fractional Flow Reserve Based on Patient-specific Lumped Parameter Models.

Purpose To evaluate the diagnostic performance of a prototype on-site coronary CT angiography-derived fractional flow reserve (CT FFR) algorithm, based on patient-specific lumped parameter models, for the detection of functionally significant stenosis defined by invasive FFR, and to compare the performance to anatomic evaluation of stenosis degree. Materials and Methods In this retrospective feasibility study, 77 vessels in 57 patients (42 of 57 [74%]) men; mean age, 58.5 years ± 9.2 [standard deviation]) who underwent clinically indicated coronary CT angiography within 60 days prior to an invasive FFR measurement were analyzed. Invasive FFR less than or equal to 0.80 was used to indicate a functionally significant stenosis. Diagnostic performance of CT FFR was evaluated and compared with evaluation of stenosis degree. Analysis was performed on a per-vessel basis. Results Invasive FFR revealed functionally significant stenoses in 37 vessels (48%). CT FFR showed a significantly increased ability to indicate functionally significant stenosis (area under the receiver operating characteristic curve [AUC], 0.87) compared with degree of stenosis at coronary CT angiography (AUC, 0.70; ΔAUC 0.17; P < .01). Using a cutoff of less than or equal to 0.80 for CT FFR and greater than or equal to 50% degree of stenosis at coronary CT angiography to indicate a significant stenosis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 33 of 37 (89.2%), 31 of 40 (77.5%), 33 of 42 (78.6%), 31 of 35 (88.6%), and 64 of 77 (83.1%), respectively, for CT FFR, and 33 of 37 (89.2%), 17 of 40 (42.5%), 33 of 56 (58.9%), 17 of 21 (81.0%), and 50 of 77 (64.9%), respectively, for degree of stenosis at coronary CT angiography. Conclusion Diagnostic performance of on-site CT FFR was superior to stenosis evaluation at coronary CT angiography for identification of functionally significant coronary artery stenosis in patients suspected of having or known to have coronary artery disease. © RSNA, 2019See also commentary by Schoepf et al.
Odontoma Composto em Região Anterior de Maxila: Relato de Caso

Odontoma is the most common type of benign mixed odontogenic tumor. They are considered as developmental anomalies similar to the tooth. Thus, they may consist of dental structures such as enamel, dentin, cementum and pulp tissue. They are classified as compound or complex odontoma and tend to affect individuals asymptomatically in the second decade of life and are more prevalent in the anterior maxilla or posterior mandible. Radiographically, composite odontoma appears as a collection of tooth-like structures of varying sizes and shapes, surrounded by a thin radiolucent zone, and is rarely confused with another lesion. In contrast, the complex odontoma is more similar to a radiopaque mass, commonly located in the posterior region of the mandible. They are usually diagnosed on routine radiographic examinations. The aim of this study is to report a clinical case of a patient with asymptomatic maxillary composite odontoma associated with the unit included and surgically treated by excision of the lesion. Case report: A 29year-old female patient with a composite odontoma in the anterior maxilla, associated with a dental unit 13 included. As treatment, we opted for surgical removal of the lesion and orthodontic traction of the included unit. Conclusion: Based on the case described above, it can be stated that the proposed treatment was adequate without complications. Interdisciplinary treatment can often be a benefit in the surgical and orthodontic approach. Accurate diagnosis of the lesion as well as adequate surgical intervention are essential in the treatment of these benign tumors.
A Review on Synthesis and Applications of Statin Family Drugs as a New Generations of Anti-Blood Medicines

Cardiovascular disease (CVD) represents one of the most important health problems. One of the main risk factors for CVD death is the high cholesterol levels. Statins have been shown to lower low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular disease, and are currently the first line of treatment for hypercholesterolemia. Atorvastatin is one of the most effective drugs and is part of the blood lipid lowering drug group. This work studies the mechanism of the use of statin family drugs and atorvastatin to determine the clinical requirements for improving the dermatology and the statins.
Uric Acid, Metabolic Risk Factors, and Chronic Kidney Disease: Clinical Investigation in a Female Elderly Occupational Population in Taipei, Taiwan

Chronic Kidney Disease (CKD) has become a global public health challenge because of its higher prevalence and the concomitant increase in risk of End-Stage Renal Disease (ESRD), Cardiovascular Disease (CVD), and premature death [1-4]. Patients with early-stage CKD had no symptoms and the majority of individuals in early stage of CKD had gone undiagnosed even in developed countries [5]. In addition, previous study showed that a vast number of patients with moderate CKD die before they develop more advanced CKD [6]. The early detection of this disorder by routine screening followed by appropriate clinical intervention would offer a practical means for the prevention of condition-associated severe kidney abnormalities.
Vascular response to social cognitive performance measured by infrared thermography: A translational study from mouse to man

To assess complex social recognition in mice, we previously developed the SocioBox paradigm. Unexpectedly, 4 weeks after performing in the SocioBox, mice displayed robust social avoidance during Y‐maze sociability testing. This unique “sociophobia” acquisition could be documented in independent cohorts. We therefore employed infrared thermography as a non‐invasive method of stress‐monitoring during SocioBox testing (presentation of five other mice) versus empty box. A higher Centralization Index (body/tail temperature) in the SocioBox correlated negatively with social recognition memory and, after 4 weeks, with social preference in the Y‐maze. Assuming that social stimuli might be associated with characteristic thermo‐responses, we exposed healthy men (N = 103) with a comparably high intelligence level to a standardized test session including two cognitive tests with or without social component (face versus pattern recognition). In some analogy to the Centralization Index (within‐subject measure) used in mice, the Reference Index (ratio nose/malar cheek temperature) was introduced to determine the autonomic facial response/flushing during social recognition testing. Whereas cognitive performance and salivary cortisol were comparable across human subjects and tests, the Face Recognition Test was associated with a characteristic Reference Index profile. Infrared thermography may have potential for discriminating disturbed social behaviors.
Inpatient Psychiatric Care Outcomes for Adolescents: A Test of Clinical and Psychosocial Moderators

ABSTRACT Financial pressures have led to a reduced length of stay (LOS) in inpatient psychiatric facilities for adolescents, yet research on the outcomes of short-term programs remains scant. The present study evaluated the outcomes of an adolescent inpatient program by: (1) probing depression, anxiety, and suicidal ideation at admission and discharge and (2) testing whether clinical or psychosocial factors moderate treatment response. Participants included adolescents (n = 777) aged 13–19 years admitted to an inpatient treatment program for acute psychiatric concerns. Clinical interviews were administered to probe mental disorders and past suicidal thoughts and behaviors (STBs), and self-report measures assessed symptom severity, child abuse, and peer victimization (i.e., bullying). Results showed a significant decrease in depression, anxiety, and suicidal ideation from admission to discharge. Comorbidity, past month NSSI, and lifetime suicide attempts emerged as moderators of treatment response, and peer victimization predicted symptom severity at discharge. Although findings suggest an overall improvement, participants with more severe clinical presentations (e.g., comorbidity, past month NSSI, lifetime suicide attempts, and more severe bullying) reported greater symptom severity at admission and discharge, suggesting that these patients may benefit from longer inpatient stays to achieve further symptom reduction. Although this may incur greater costs in the short-term, it also may prevent unintended economic and psychosocial consequences in the long-term.
Post-tonsillectomy hemorrhage : analysis of risk factors

Objectives: Tonsillectomy is a common surgical intervention in otorhinolaryngology. Reported post-tonsillectomy hemorrhage (PTH) rate varies considerably, from 0.5 to 16%. This study was undertaken to analyze the frequency, characteristics, and risk factors of PTH in adults and children undergoing tonsillectomy. Methods: A retrospective analysis was performed of all patients undergoing tonsillectomy for benign indications between January 2008 and May 2014 at the otorhinolaryngology department of Ghent University Hospital. PTH was defined as active bleeding or signs of a recent bleeding from the tonsillar fossa, as observed by a physician. Factors related to patients, medication, and procedure were analyzed for potential risk associations with PTH. Results: Among 957 patients (524 adults. 433 children), 9.2% experienced a PTH (6.6% adults, 2.6% children). In 6.3%. surgical intervention was required to control the bleeding. Whereas the indication for tonsillectomy, season of surgery, peroperative administration of dexamethasone, and per- or postoperative use of non-steroidal anti-inflammatory drugs did not influence PTH rate, significant and independent risk factors for PTH were male sex and being in early and middle adulthood. Conclusions: Hemorrhage following tonsillectomy is not uncommon and leads to revision surgery in a significant number of patients. Male sex and adult age are significant risk factors for postoperative hemorrhage.
A Randomized Phase 3 Clinical Trial of the Combination of Plinabulin (plin) + Pegfilgrastim (peg) Versus (vs) Peg Alone for Tac (docetaxel, doxorubicin, cyclophosphamide) Induced Neutropenia (cin)

Trial in Progress: Granulocyte colony stimulating factors (G-CSFs) (including Peg) reduce, but do not completely ameliorate CIN. Plinabulin is a novel, small molecule, single-dose-per cycle therapy, with equal activity against docetaxel CIN vs. Peg, but with several advantages: Plin has 1. Less bone pain, 2. Anticancer effects, and 3. Dosing 30 min after chemotherapy (chemo). The CIN nadir with Plin occurs in week 2 and with Peg in week 1 of the chemo cycle. All these features suggest a mechanism of action (MoA) with Plin that is different from Peg (Blayney, ASCO 2018; IASLC 2018). Neutrophil demargination with Plin and a reduced neutrophil transit time consistent with IL-6 signaling, and reversal of a LSK block in bone marrow, suggest protective rather than a stimulatory MoA for Plin in CIN (Blayney, SLB 2018; Ghosh, AACR 2018, Suwa, Am J Physiol 2000). Due to their differences in MoA, there is a strong rationale to combine Plin and Peg, as this offers the potential of better protection against CIN in both week 1 and 2 in the chemo cycle. In the Phase II portion of study BPI2358-106 (Study 106., NCT03294577), we evaluated the effects of the Plin combined with Peg on CIN and Bone Pain. Study 106 treated breast cancer (BC) patients with TAC with 6 mg Peg alone (Peg6), or Peg6+Plin. Plin dose was 20 mg/m2. Grade (Gr) 3 and 4 neutropenia frequency, duration of Gr 3 and 4 neutropenia (DSMN), and neutrophil nadir was based on absolute neutrophil counts, obtained on days 0, 1, 3, 6, 7, 8, 9, 10, 11, 12, 13, 15. Bone pain was assessed by a validated questionnaire on days 1, 2, 3, 4, 6, 7, 8, 9, and expressed as % of patients reporting bone pain. Phase II Results. The confirmatory phase 3 portion of study 106 will test addition of Plin to Peg6, which may offer superior protection against TAC CIN vs Peg alone without bone pain. The Plin/Peg combination is a novel CIN approach with the potential to optimize chemotherapy, by minimizing chemotherapy dose modifications due to CIN or bone pain. *p<0.05; **p<0.001; ***P<0.01 Peg+Plin vs Peg 6mg Table Blayney: BeyondSpring Pharmaceuticals: Research Funding. Huang:BeyondSpring Pharmaceuticals: Employment. Mohanlal:BeyondSpring Pharmaceuticals: Employment.
Posttraumatic Stress Disorder is Associated With Alpha Dysrhythmia Across the Visual Cortex and the Default Mode Network

Anomalies in default mode network (DMN) activity and alpha (8-12 Hz) oscillations have been independently observed in posttraumatic stress disorder (PTSD). Recent spatiotemporal analyses suggest that alpha oscillations support DMN functioning via inter-regional synchronization and sensory cortical inhibition. Therefore, we examined a unifying pathology of alpha deficits in the visual-cortex-DMN system in PTSD.Patients with PTSD (N = 25) and two control groups—patients with Generalized Anxiety Disorder (N = 24) and healthy controls (N = 20)—underwent a standard eyes-open resting state (S-RS) and a modified resting state (M-RS) of passively viewing salient images (known to deactivate the DMN). High-density electroencephalogram (hdEEG) were recorded, from which intracortical alpha activity (power and connectivity/Granger causality) was extracted using the exact low-resolution electromagnetic tomography (eLORETA). Patients with PTSD (vs. controls) demonstrated attenuated alpha power in the visual cortex and key hubs of the DMN (posterior cingulate cortex/PCC and medial prefrontal cortex/mPFC) at both states, the severity of which further correlated with hypervigilance symptoms. With increased visual input (at M-RS vs. S-RS), patients with PTSD further demonstrated reduced alpha-frequency directed connectivity within the DMN (PCC→mPFC) and, importantly, from the visual cortex (VC) to both DMN hubs (VC→PCC and VC→mPFC), linking alpha deficits in the two systems.These interrelated alpha deficits align with DMN hypoactivity/hypoconnectivity, sensory disinhibition, and hypervigilance in PTSD, representing a unifying neural underpinning of these anomalies. The identification of visual-cortex-DMN alpha dysrhythmia in PTSD further presents a novel therapeutic target, promoting network-based intervention of neural oscillations.
The Retinoids : biology, chemistry, and medicine

lntroduction Michael B. Sporn and Anita B. Roberts The Synthetic Chemistry of Retinoids Marcia I. Dawson and Peter D. Hobbs Retinoid Skeletal-Bond Methodology / Methodology for Constructing the Polar Terminus of the Retinoid Skeleton Retinoids Specifically Designed to Aid Biologic Studies. Analytical Methods Harold C. Furr, Arun B. Barua, and James Allen Olson Biologic Samples / Reference Standards / Separation Methods Other Methods. Vitamin A In Human Nutrition: Public Health Considerations Barbara A. Underwood Historical Perspectives / Magnitude of the Problem of Vitamin A Deficiency Globally / Extraocular Health Consequences of Subclinical Deficiency / Assessment of Vitamin A Status. Retinol and Retinoic Acid Metabolism William S. Blaner and James Allen Olson Intestinal Uptake and Metabolism of Retinol / Hepatic Metabolism and Storage of Retinol / Uptake, Storage, and Metabolism of Retinol by Extrahepatic Tissues / Retinoic Acid Uptake and Formation / Metabolism of Retinoic Acid / Other Metabolites of Retinol. Plasma Retinol-Binding Protein Dianne Robert Soprano and William S. Blaner Retinol-Binding Protein Structure and Physiochemical Properties / The Molecular Biology of Retinol-Binding Protein / The Expression of Retinol-Binding Protein in the Liver and Extrahepatic Tissues / The Cellular Synthesis and Secretion of Retinol-Binding Protein and Its Regulation / Retinol Delivery to Cells by Retinol-Binding Protein / Clinical Studies and Possible Involvement of Retinol-Binding Protein in Disease. Cellular Retinoid-Binding Proteins David E. Ong, Marcia E. Newcomer, and Frank Chytil Discovery, Initial Characterization and Distribution of the Cellular-Retinoid Binding Proteins / Physical Properties of the Cellular-Retinoid Binding Proteins / Gene Structure and Regulation of Expression / Functions. The Retinoid Receptors David J. Mangelsdorf, Kazuhiko Umesono, and Ronald M. Evans Retinoid Receptors / A New Hormone: 9-cis-Retinoic Acid / Target-Gene Specificity / The Retinoid X Receptor Heterodimer: Master Regulator of Hormonal Signalling / Cross-Coupling in Retinoid Signalling Pathways / Retinoic Acid Receptor and Retinoid X Receptor Pattems of Expression / Human Disease. Retinoids In Photosensitive Systems John C. Saari Introduction / Overview of the Visual Process / Chromophores of Visual Pigments /photoisomerisation / Wavelength Regulation The Visual Cycle /Cellular Uptake of Retinol. Retinoids In Development Clementine Hofmann and Gregor Eichele Retinoids and Limb Development / Retinoids and the Pattern Along the Anteroposterior Body Axis / Effects of Retinoids on the Regenerating Amphibian Limb. Cellular Biology and Biochemistry of the Retinoids Lorraine J. Gudas, Michael B. Sporn, and Anita B. Roberts Overview of Mechanisms of Gene Regulation by Retinoids/ Effects of Retinoids on the Activity and Synthesis of Growth Factors and Their Receptors / Effects of Retinoids on the Activity and
Role of stromal SPARC in PDAC tumorigenesis and drug delivery

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive solid tumors in humans. Median survival is around 12 months and is due to late diagnosis, early metastatic spread, and a high resistance towards available chemotherapeutic regimens. The desmoplastic reaction is a key feature of PDAC which contributes to disease progression and has also been reported to confer to chemoresistance and impaired drug delivery. Secreted protein acidic and rich in cysteine (SPARC) is an important matricellular protein that regulates collagen deposition and ECM remodeling. In human PDAC, SPARC is expressed by peritumoral fibroblasts and high expression is associated with a poor prognosis. In several other cancer entities, SPARC has been shown to play either tumor promoting or tumor suppressing roles. However, the functional role of SPARC in PDAC is unclear. In my thesis, I investigated the expression of SPARC and its role during tumor progression from preneoplastic lesions to frank carcinomas in genetically engineered mouse models (GEMMs) of PDAC. In order to achieve this, I generated SPARCwt, SPARC-/-, KC-SPARCwt and KC-SPARC-/- mice with a global SPARC knock-out for in vivo studies. Furthermore, primary epithelial and fibroblast cell lines were derived from preneoplastic murine tissues and murine pancreas tumors for in vitro experiments. The in vivo results showed that the development of the murine pancreas was unaffected by germ- line SPARC knock-out. Immunohistochemical and western blot analysis revealed that SPARC is not expressed in the normal pancreas with a marked increase of SPARC in activated fibroblasts during preneoplastic stages and tumor progression. However, loss of SPARC in KC-SPARC-/- mice resulted in a significant reduction of intratumoral collagen deposition. Notably, SPARC and subsequent collagen depletion did not alter pancreatic intraepithelial neoplasia (PanIN) progression, tumor incidence or metastatic frequency to the liver. Both KC-SPARCwt and KC-SPARC-/- tumors exhibited similar tumor characteristic including proliferation, apoptosis and mean vessel density. Primary epithelial and fibroblast cell lines from both genotypes showed comparable morphology and proliferation rates. However, tumor bearing KC-SPARC-/- mice lived significantly shorter than of KC-SPARCwt mice, a finding that was most likely due to more severe clinical complications such as ascites, diarrhea and bile duct obstruction in KC-SPARC-/- mice. Interestingly, SPARC mediated collagen deposition did not impede the delivery and metabolism of gemcitabine in pre-neoplastic lesions and tumors as determined by LC-MS/MS. Strikingly, the amount of gemcitabine increased from normal pancreas tissues to pancreatic tumors questioning the drug delivery hypothesis for gemcitabine in PDAC.
Invasive micropapillary breast carcinoma in a young lactating woman: A rare entity

Breast carcinoma is the most common malignancy in women with high mortality rates if diagnosed in advanced stages. Breast carcinoma is not uncommon in pregnant and lactating women but is usually diagnosed late due to physiological hormonal changes. Invasive micropapillary breat carcinoma is a rare variant. Here we describe a case of this rare entity in a young lactating woman.
Variation of some antioxidant biomarkers in Cameroonian patients treated with first-line anti-tuberculosis drugs

M. tuberculosis infection and its treatment are responsible of an oxidative stress response that contribute to the antioxidant/prooxidant imbalance. The analysis of antioxidant biomarkers appears as a potential monitoring tool of the treatment response. The objective of this work was to study the evolution of enzymatic antioxidant biomarkers under the effect of the 1st line antituberculosis therapy. A cohort study, conducted at Jamot Hospital of Yaounde, took place from February to October 2018. After obtaining an informed consent, clinical parameters were collected and the catalase and SOD activities were assayed in the blood samples from Tuberculosis (TB) patients before treatment (T1), at the end of the 2 nd month (T2) and at the 5 th month of treatment (T3). There were 50 men and 25 women (mean age: 34 + 13 years). Tuberculosis was mainly pulmonary (85.3%) with 16% of HIV-TB co-infected patients and 28% smokers. Catalase activity varied significantly (T1=3588 + 244.8 IU; T2= 2541 + 590.7 IU; T3= 3049 + 204.4 IU) with the lowest threshold at T2 (p < 0.0001) and SOD activity increased from T1 (0.041 + 0.021 IU) to T3 (0.062 + 0.040 IU) (p= 0.0112). There was no influence of disease-related factors (site, duration of signs, microscopy, HIV and smoking status) on both catalase and SOD activities. In the study population, catalase and SOD varied significantly between the pre-treatment and the 5th month of treatment phase. However, the profile of evolution of these 2 biomarkers was different. Therefore the evaluation of catalase and SOD could represent additional relevant parameters in the monitoring of the treatment response. © 2019 International Formulae Group. All rights reserved Keywords: Tuberculosis, HIV, treatment, antioxidant/prooxidant balance, catalase, superoxide dismutase, biomarkers
Reader response: Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage: A prospective study

Ma et al.1 presented robust epidemiologic evidence in the association of very low levels of low-density lipoprotein cholesterol (LDL-cholesterol) with risk of intracerebral hemorrhage using the data of a huge prospective cohort of Chinese with repeated measures of LDL-cholesterol. Contrasted with the “high cholesterol ischemic heart disease hypothesis,” their result is consistent to support a “very low cholesterol intraparenchymal hemorrhage hypothesis;”2–4 one of them showed a graded excess risk of mortality from intracerebral hemorrhage only among persons with LDL-cholesterol levels of <100 mg/dL2, which supported the finding from Ma's study.1