Miracle-dz/UniFAR-FTUs huggingface dataset:
Is the personalized approach the key to improve clinical diagnosis of peri-implant conditions? the role of bone markers.

BACKGROUND Study objectives were 1) to estimate diagnostic capacity of clinical parameters, receptor-activator-nuclear factor kappa-B (RANKL) and osteoprotegerin (OPG) to diagnose healthy peri-implant condition (HI), peri-implant mucositis (PIM) and peri-implantitis (PIMP) by assessing respective diagnostic accuracy, sensitivity, specificity and diagnostic ranges 2) to develop personalized diagnostic model (PDM) for implant monitoring. METHODS Split-mouth study included 126 patients and 252 implants (HI = 126, PIM = 57 and PI = 69). RANKL and OPG concentrations were estimated in peri-implant crevicular fluid using ELISA method and assessed with clinical parameters using routine statistics, while the diagnostic capacity of individual parameters and overall clinical diagnosis were estimated using classifying algorithms. PDM was developed using decision trees. RESULTS Bleeding on probing (BOP), plaque index and probing depth (PD) were confirmed reliable discriminants between peri-implant health and disease, while increase in PD (PD>4mm) and SUP were good discriminants amongst PIM/ PIMP. BTMs demonstrated presence of bone resorption in PIM, comparable diagnostic ranges between PIM/PIMP, PIMP was clinically distinguished from PIM in about 60% of patients while 40% remined diagnosed as false negatives. PDM demonstrated highest diagnostic capacity (accuracy: 96.27%, sensitivity: 95.00%, specificity: 100%) and defined HI: BOP≤0.25%; PIM: BOP>0.25%, PD≤4.5mm; PIMP: BOP>0.25%, PD>4.5mm and RANKL≤19.9 pg/site; PIM: BOP>0.25%, PD>4.5mm and RANKL>19.9 pg/site. CONCLUSION BTMs demonstrated capacity to substantially improve clinical diagnosis of peri-implant conditions. Considering lack of difference in BTMs between PIM/ PIMP and cluster of PIM with exceeding BTMs, a more refined definition of peri-implant conditions according to biological characteristics is required for further BTMs validation and appropriate PIMP management. This article is protected by copyright. All rights reserved.
Reciprocal and Autonomous Glucocorticoid and Androgen Receptor Activation in Salivary Duct Carcinoma

Purpose: To determine the expression of glucocorticoid receptor (GR) and androgen receptor (AR) in salivary duct carcinoma (SDC) and to analyze the role of these proteins in the development and management of this disease entity. Experimental Design: We performed a phenotypic assessment of GR and AR localization and expression, and determined their association with clinicopathologic factors in 67 primary SDCs. In vitro functional and response analysis of SDC cell lines was also performed. Results: Of the 67 primary tumors, 12 (18%) overexpressed GR protein, 30 (45%) had constitutive expression, and 25 (37%) had complete loss of expression. Reciprocal GR and AR expression was found in 32 (48%) tumors, concurrent constitutive GR and AR expression in 23 (34%), and simultaneous loss of both receptors and high GR with AR expressions were found in 12 (18%). GR overexpression was significantly associated with worse clinical outcomes. In vitro ligand-independent AR activation was observed in both male- and female-derived cell lines. GR antagonist treatment resulted in decreased cell proliferation and survival in GR-overexpressing cells, irrespective of AR status. Reciprocal GR- and AR-knockdown experiments revealed an independent interaction. Conclusions: Our study, for the first time, demonstrates differential GR and AR expressions, autonomous GR and AR activation, and ligand-independent AR expression and activation in SDC cells. The findings provide critical information on the roles of GR and AR steroid receptors in SDC tumorigenesis and development of biomarkers to guide targeted steroid receptor therapy trials in patients with these tumors.
Prevalence and Risk Factors for Thrombotic Complications Following Venovenous Extracorporeal Membrane Oxygenation: A CT Scan Study.

OBJECTIVES The aims of this study were to: 1) analyze the cannula-associated deep vein thrombosis frequency after venovenous extracorporeal membrane oxygenation using a CT scan and 2) identify the associated risk factors for cannula-associated deep vein thrombosis. DESIGN Retrospective observational analysis at a single center. SETTING Tertiary referral university teaching hospital. PATIENTS Patients under venovenous extracorporeal membrane oxygenation with a femorofemoral or femorojugular cannulation admitted for acute respiratory distress syndrome or primary graft dysfunction after pulmonary transplantation. CT scan was performed within 4 days after decannulation. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We included 105 of 228 patients screened. Bacterial pneumonia was the main indication of venovenous extracorporeal membrane oxygenation (46.7%). CT scans were performed at a median of 2 days (1-3 d) after decannulation. Cannula-associated deep vein thrombosis was found in 75 patients (71.4%) despite it having a mean activated partial thromboplastin time ratio of 1.60 ± 0.31. Femorofemoral cannulation induced femoral cannula-associated deep vein thrombosis more frequently than femorojugular cannulation (69.2% vs 63.1%, respectively; p = 0.04). Seventeen of the 105 patients (16.2%) had a pulmonary embolism. Multivariate logistic regression analysis showed that higher the percentage of thrombocytopenia less than 100 G/L during extracorporeal membrane oxygenation period, lower the risk for developing cannula-associated deep vein thrombosis (hazard ratio, 0.98; 95% CI, 0.98-1.00; p = 0.02). CONCLUSIONS Cannula-associated deep vein thrombosis after venovenous extracorporeal membrane oxygenation is a frequent complication. This plead for a systematic vascular axis imaging after venovenous extracorporeal membrane oxygenation. Thrombocytopenia is associated with a reduction in the occurrence of thrombotic events.
A pressure-based single beat method for estimation of right ventricular ejection fraction: proof of concept

The utility of considering right ventricular (RV) contractility and afterload as independent entities and summarising their balance or “coupling” using single beat methods has become widely appreciated [1–3]. Typically expressed as the ratio of end-systolic ventricular elastance (Ees, a load-independent measure of contractility), to arterial elastance (Ea, a lumped parameter measure of afterload) data suggest that when Ees/Ea reaches a critical threshold, the risk of cardiovascular decompensation begins to rise [4]. This proof of concept study suggests that estimation of RV ejection fraction based solely on analysis of the RV pressure waveform may be feasible http://bit.ly/32ZRoOi
Stratified performance on the Test of Memory Malingering (TOMM) is associated with differential responding on the Personality Assessment Inventory (PAI)

ABSTRACT Introduction: This study evaluated symptom endorsement patterns in participants at various stratified performance levels on the Test of Memory Malingering (TOMM). It was hypothesized that the lowest stratum (chance performance and below) would have the most pathological (i.e., elevated item endorsement) responding on the Personality Assessment Inventory (PAI) validity and clinical scales. This study was primarily a replication of previous work with emphasis on the PAI scales and consideration of varying degrees of performance on TOMM Trial 2. Methods: Participants were 760 (54% female, 85.4% Caucasian, mean age = 42.01 (SD = 15.89), mean education = 13.55 (SD = 2.35)) consecutively referred neuropsychological outpatients who completed the TOMM and PAI. Participants were placed in one of 5 stratified TOMM Trial 2 performance level groups (High Pass, Low Pass, High Fail, Low Fail, and Chance). No significant differences were found between the demographic variables except for referral source, which was overrepresented in the Chance group relative to the other groups. Results: Due to the highly skewed nature of TOMM Trial 2, Spearman rank order correlations were calculated for the 5 stratified levels of TOMM performance and all the main PAI scales. The NIM, SOM, DEP, ANX, SCZ and SUI scales had significant correlations, so a series of One-way ANOVAs were calculated to examine these scales at different TOMM stratified performance levels. Results indicated that the Chance group had the highest level of responding on all scales, with NIM, SOM, DEP, SCZ and SUI having mean elevations above the clinical cutoff (T = 70). Conclusions: Results were consistent with previous pass-fail PVT research, but extended earlier research to provide evidence that Chance performance group had more pathological PAI responding. The results provide preliminary evidence to support the notion that patients who fail PVTs at different levels do not have the same characteristics.
High Specific Efficiency of Venom of Two Prey-Specialized Spiders

The venom of predators should be under strong selection pressure because it is a costly substance and prey may potentially become resistant. Particularly in prey-specialized predators, venom should be selected for its high efficiency against the focal prey. Very effective venom paralysis has been observed in specialized predators, such as spiders preying on dangerous prey. Here, we compared the toxicity of the venoms of two prey-specialized species, araneophagous Palpimanus sp. and myrmecophagous Zodarion nitidum, and their related generalist species. We injected different venom concentrations into two prey types—the prey preferred by a specialist and an alternative prey—and observed the mortality and the paralysis of the prey within 24 h. We found that the venoms of specialists were far more potent towards the preferred prey than alternative prey. The venoms of generalists were similarly potent towards both prey types. In addition, we tested the efficacy of two venom fractions (smaller and larger than 10 kDa) in araneophagous Palpimanus sp. Compounds larger than 10 kDa paralyzed both prey types, but smaller compounds (<10 kDa) were effective only on preferred prey, suggesting the presence of prey-specific compounds in the latter fraction. Our results confirm that prey-specialized spiders possess highly specific venom that allows them to subdue dangerous prey.
Breast Cancer Care Quality in South Africa’s Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures

PURPOSE The quality of breast cancer care in sub-Saharan Africa contributes to the region’s dismal breast cancer mortality. ASCO has issued quality measures focusing on delivery of adjuvant chemotherapy, radiotherapy, and endocrine therapy. We applied these measures in five South African public hospitals and analyzed factors associated with care concordance. MATERIALS AND METHODS Among 1,736 women with breast cancer who were enrolled in the South African Breast Cancer and HIV Outcomes study over 24 months, we evaluated care using ASCO’s three measures. We also evaluated adjuvant chemotherapy receipt in 957 women with an indication. We used logistic regression to estimate associations between measure-concordant care and patient factors. RESULTS Of 235 women with hormone receptor–negative cancer, 173 (74%) began adjuvant chemotherapy within 120 days from diagnosis. Of 194 patients who received breast-conserving surgery, 73 (37%) began radiotherapy within 365 days from diagnosis. Of 999 women with hormone receptor–positive cancer, 719 (72%) initiated endocrine therapy within 365 days from diagnosis. Chemotherapy and radiotherapy measure-concordant care were more common among women residing < 20 km from the hospital (odds ratio [OR], 1.79; 95% CI, 1.32 to 2.44 and OR, 3.17; 95% CI, 1.57 to 6.42). Endocrine therapy measure-concordant care was more common among English-speaking women (OR, 2.12; 95% CI, 1.12 to 4.02). Participating hospitals varied in care concordance. HIV infection did not affect care quality. CONCLUSION More timely delivery of chemotherapy, radiotherapy, and endocrine therapy is needed in South Africa, particularly for women living > 20 km from the hospital or not speaking English. Focused quality improvement efforts could support that goal.
The Effect of Treatment during A Haze/Post-Haze Year on Subsequent Respiratory Morbidity Status among Successful Treatment Tuberculosis Cases

The purpose of this study was to evaluate the respiratory morbidity status within the two to three years among successful (completed/cured) treatment of tuberculosis cases during a haze year (2015) and a post-haze year (2016). The study was conducted among 133 cases of a 2015 group and 103 cases of a 2016 group between January to March 2018 in Pekanbaru city, Indonesia. The St George Respiratory Questionnaire (SGRQ) was used to assess respiratory morbidity status. A higher score corresponds to worse respiratory morbidity. Based on a directed acyclic graph, quantile regression models were constructed to assess the associations between haze/post-haze year and the SGRQ (symptom, activity, impact, and total) domains score. The subsequent respiratory morbidity status of tuberculosis (TB) cases was poorer among respondents treated during a haze year (2015). Among SGRQ domains, only the activity domain score showed significant difference, in which the median for the 2015 group was 23.7 (inter-quartile range (IQR); 17.2, 30.9) compared to 18.4 (IQR; 11.9, 24.8) for the 2016 group. The effect was limited to the 2015 group who were exposed by an average PM10 index ≥ 55 during TB treatment. This raises concern for monitoring and improving the quality of life of TB patients treated during a haze year.
Comparison of diagnostic methods for uterine health in dairy cattle on different days postpartum

Background Uterine health status is a key factor for dairy management. Methods The uteri of 28 Holstein cows were assessed weekly by three different methods: ultrasonography (UT), Metricheck device (MT) and cytobrush (CYT), during two weeks to seven weeks postpartum. Results The percentage of cows with an MT-positive, UT-positive and CYT-positive result decreased dramatically at three weeks, four weeks and five weeks postpartum, respectively. The agreement of the results was poor or weak within six weeks postpartum (κ=0.09–0.35), and only at seven weeks moderate or good agreement was achieved (κ=0.60–0.70). When comparing the results obtained by UT and MT, 30 per cent or more of the total cows had conflicting results from postpartum three weeks to six weeks. The uterine health of cows was re-evaluated by the combined usage of UT and MT referring to CYT. The highest sensitivity was achieved when positive individuals were identified as either MT-positive or UT-positive, whereas the highest specificity occurred when results were positive by both MT- and UT- methods. Conclusion The accuracy of early postpartum uterine health status by three methods depended heavily on the time postpartum. The combined use of UT and MT is a practical candidate for cow-side monitoring method of uterine health.
Elevation is Associated with Human Skin Microbiomes

Human skin microbiota plays a crucial role in the defense against pathogens, and is associated with various skin diseases. High elevation is positively correlated with various extreme environmental conditions (i.e., high ultraviolet radiation), which may exert selection pressure on skin microbiota, and therefore influence human health. Most studies regarding skin microbial communities have focused on low-elevation hosts. Few studies have explored skin microbiota in high-elevation humans. Here, we investigated the diversity, function, assembly, and co-occurrence patterns of skin microbiotas from 35 health human subjects across three body sites (forehead, opisthenar, and palm) and seven elevation gradients from 501 to 3431 m. Alpha diversity values (i.e., Shannon diversity and observed operational taxonomic units (OTUs)) decreased with increasing elevation regardless of the body site, while beta diversity (Jaccard and Bray–Curtis dissimilarities) showed an increasing trend with elevation. Elevation is a significant factor that influences human skin microbiota, even after controlling host-related factors. Skin microbiotas at high elevation with more than 3000 m on the Qinghai–Tibet Plateau, had a significant structural or functional separation from those at low elevation with less than 3000 m. Notably, the clustering coefficient, average degree, and network density were all lower at high-elevation than those at low-elevation, suggesting that high-elevation skin networks were more fragile and less connected. Phylogenetic analysis showed that human skin microbiotas are mainly dominated by stochastic processes (58.4%–74.6%), but skin microbiotas at high-elevation harbor a greater portion of deterministic processes than those at low-elevation, indicating that high-elevation may be conducive to the promotion of deterministic processes. Our results reveal that the filtering and selection of the changeable high-elevation environment on the Qinghai–Tibet Plateau may lead to less stable skin microbial community structures.
Evaluation of the effect of P‐glycoprotein inhibition and induction on talazoparib disposition in patients with advanced solid tumours

In vitro data show that talazoparib is a substrate for P‐glycoprotein (P‐gp) and breast cancer resistance protein transporters. This open‐label, 2‐arm, drug–drug interaction Phase 1 study in patients with advanced solid tumours assessed the effect of a P‐gp inhibitor (itraconazole) and a P‐gp inducer (rifampicin) on the pharmacokinetics of a single dose of talazoparib. The safety and tolerability of a single dose of talazoparib with and without itraconazole or rifampicin were also assessed.
A systematic review and meta-analysis

Background:New York esophageal squamous cell carcinoma 1 (NY-ESO-1) is a member of the cancer testis antigen family. NYESO-1 has documented potential as an effective target for cancer immunotherapy. The prognostic value of NY-ESO-1 expression in solid tumors, however, remains controversial because of inconclusive data. Methods:For this analysis, the Medline, Embase, and Cochrane Library databases were searched up to February 2018 for studies investigating NY-ESO-1 expression in solid tumors and overall survival (OS), progression-free survival (PFS), or disease-free survival (DFS). Hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted from each study. Pooled HRs and CIs were calculated using the Mantel-Haenszel fixed effects or random effects model. Results:A total of 23 studies were included in the analysis. The combined HR (95% CI) estimates for OS, PFS, and DFS were 1.41 (95% CI: 1.24–1.61; I=0%), 1.62 (95% CI: 1.42–1.84; I=17%), and 0.95 (95% CI: 0.56–1.59; I=57%), respectively. Conclusions:NY-ESO-1 expression in solid tumors is associated with worse OS and PFS. Studies are still needed to providemore evidence. Abbreviations: CI = confidence interval, CSC = cancer stem cell, CTA = cancer testis antigen, DFS = disease-free survival, HR = hazard ratio, MSC =mesenchymal stem cell, NY-ESO-1 = New York esophageal squamous cell carcinoma 1, OS = overall survival, PFS = progression-free survival, SE = standard error.
Epidemiologia do transtorno bipolar Epidemiology of Bipolar Disorders

Abstract Information about the epidemiology of bipolar disorders is essential forproviding a framework for the formulation of effective mental health policy.In the last two decades, population surveys of psychiatric morbidity in adultshave been conducted and as a result details on the frequency, risk factor,social disabilities, and service use rates of mental disorders are now available.Epidemiological findings on bipolar disorders are discussed on the light ofresults from recent large population-based surveys namely the EpidemiologicalCatchment Area Study (ECA), the National Comorbidity Survey (NCS), theOPCS Survey of Psychiatric Morbidity in Great Britain, the BrazilianMulticentric Study of Psychiatric Morbidity, and the longitudinal studiesconducted in Zurich by Angst. Prevalence rates for bipolar disorder weregenerally low, regardless setting, the type of instrument used for generatingpsychiatric diagnosis, and the time periods by which prevalence is defined.Since the introduction of the concept of bipolar spectrum, broadening theboundaries of the disease, the estimate rates have been found to be substantiallyhigher. Such rates still need to be validated by populational-based studies.Bipolar disorder is as prevalent in women as in men, more common amongsingles and separated or divorced people. Those affected by the disease aremore likely to use medical services and to be hospitalized. The cost-effectiveness of treatments must be balanced with the high individual andsocial impact associated to the bipolar illness.Key words: Bipolar disorder, bipolar spectrum, prevalence, epidemiology.
Removal efficiency of central vacuum system and protective masks to suspended particles from dental treatment

Background High levels of suspended particulate matters (PMs) and bioaerosols are created by dental procedures. The present study aimed to evaluate the size and concentration of PMs produced by drilling and grinding teeth, and to assess the efficiency of central vacuum system and protective masks for the removal of PMs. Methods A total of 20 extracted permanent teeth were collected. A novel experimental system and particle counter were used to evaluate the PMs produced by dental procedures and the PM removal efficiency of a central vacuum system and surgical/N95 masks. Results The number concentration of total PMs produced by drilling and grinding teeth was significantly higher than the indoor background concentration. The average aerodynamic diameter of particle was generally less than 1 μm. The average number concentration of ultrafine particles was 2.1x1011 particles/m3 during tooth drilling and grinding. The efficiency of the central vacuum system was 35.74% for PM≥0.5 and 35.41% for PM10. For PM≥0.5, the ratios of inside and outside masks were 0.8–1.34 without vacuum and 1.18–1.36 with vacuum. No difference was found with the use of surgical/N95 masks during dental therapy, with or without vacuum use. Conclusions High levels of PMs were found during tooth drilling and grinding procedures, especially among PM1. The PM removal efficiency of a central vacuum system and surgical/N95 masks were limited.
Risk Factors for Suicide and Suicide Attempts Among Patients With Treatment-Resistant Depression: Nested Case-Control Study

The risk of suicide is elevated among patients with treatment-resistant depression (TRD). Risk factors for suicide and suicide attempts among cases and controls with TRD were investigated using data from nationwide Swedish registers. Among 119,407 antidepressant initiators with a diagnosis of depression, 15,631 patients who started a third sequential treatment trial during the same depressive episode were classified with TRD. A nested case-control study compared cases with suicide and suicide attempts with up to three closely matched controls. Sociodemographic and clinical risk factors were assessed using conditional logistic regression analyses. In all, 178 patients died by suicide and 1,242 experienced a suicide attempt during follow-up. History of suicide attempts, especially if <1 year after the attempt, was a significant independent risk factor for suicide (adjusted odds ratio [aOR], 8.9; 95% confidence interval [CI], 5.1–15.7) as were 10 to 12 years of education compared to lower education (aOR, 1.69; 95% CI, 1.02–2.81). For attempted suicide, the strongest independent risk factors were history of suicide attempts (<1 year aOR, 5.1; 95% CI, 4.0–6.5), substance abuse (aOR, 2.6; 95% CI, 2.2–3.1), personality disorders (aOR, 1.9; 95% CI, 1.5–2.3), and somatic comorbidity (aOR, 2.0; 95% CI, 1.04–3.9). Suicide attempts, especially if recent, are strong risk factors for completed suicide among patients with TRD. Established risk factors for suicide attempts were confirmed for patients with TRD.