Miracle-dz/UniFAR-FTUs huggingface dataset:
PNOC Expressed by B Cells in Cholangiocarcinoma Was Survival Related and LAIR2 Could Be a T Cell Exhaustion Biomarker in Tumor Microenvironment: Characterization of Immune Microenvironment Combining Single-Cell and Bulk Sequencing Technology

Background Cholangiocarcinoma was a highly malignant liver cancer with poor prognosis, and immune infiltration status was considered an important factor in response to immunotherapy. In this investigation, we tried to locate immune infiltration related genes of cholangiocarcinoma through combination of bulk-sequencing and single-cell sequencing technology. Methods Single sample gene set enrichment analysis was used to annotate immune infiltration status in datasets of TCGA CHOL, GSE32225, and GSE26566. Differentially expressed genes between high- and low-infiltrated groups in TCGA dataset were yielded and further compressed in other two datasets through backward stepwise regression in R environment. Single-cell sequencing data of GSE138709 was loaded by Seurat software and was used to examined the expression of infiltration-related gene set. Pathway changes in malignant cell populations were analyzed through scTPA web tool. Results There were 43 genes differentially expressed between high- and low-immune infiltrated patients, and after further compression, PNOC and LAIR2 were significantly correlated with high immune infiltration status in cholangiocarcinoma. Through analysis of single-cell sequencing data, PNOC was mainly expressed by infiltrated B cells in tumor microenvironment, while LAIR2 was expressed by Treg cells and partial GZMB+ CD8 T cells, which were survival related and increased in tumor tissues. High B cell infiltration levels were related to better overall survival. Also, malignant cell populations demonstrated functionally different roles in tumor progression. Conclusion PNOC and LAIR2 were biomarkers for immune infiltration evaluation in cholangiocarcinoma. PNOC, expressed by B cells, could predict better survival of patients, while LAIR2 was a potential marker for exhaustive T cell populations, correlating with worse survival of patients.
Food Sharing Practices in Households Receiving Supplemental Foods for the Treatment of Moderate Acute Malnutrition in Ethiopian Children

The objective of this article is to evaluate food sharing practices in households receiving corn–soya blend (CSB) and ready-to-use supplementary food (RUSF) in southern Ethiopia. Ethiopian children with moderate acute malnutrition from 10 supplementary feeding sites received CSB (1413 kcal/day) or RUSF (500 kcal/day). Data on food sharing and consumption practices were collected from 1125 households via structured questionnaires administered by trained local health professionals after 6 weeks of treatment. CSB was shared among a significantly higher number of family members (1.9 ± 1.0) compared to RUSF (0.1 ± 0.4; P < .001). In only 14% of CSB households, children consumed equal or more than three quarters of the ration, compared to 98% of RUSF households. Only 9% of RUSF households reported food sharing, the majority (86%) of whom were children in the same household under 5 years of age. Comparatively, CSB was shared within the household with a greater number of family members and in greater quantities compared to RUSF. CSB was reported to be widely consumed by all members of the household, whereas RUSF was sparingly shared and only with children under 5 years of age in the household.
Novel Approaches to Acute Myeloid Leukemia Immunotherapy

Acute myeloid leukemia (AML) is a rapidly progressive, poor-prognosis malignancy arising from hematopoietic stem/progenitor cells. The long history of successful use of allogeneic hematopoietic cell transplantation (alloHCT) in AML indicates that this disease is immunoresponsive, leading to optimism that novel immunotherapies such as bispecific antibodies, chimeric antigen receptor T cells, and immune checkpoint inhibitors will generate meaningful disease control. However, emerging data on the immunoevasive tactics employed by AML blasts at diagnosis and at relapse indicate that optimism must be tempered by an understanding of this essential paradox. Furthermore, AML has a low mutational burden, thus presenting few neoantigens for attack by autologous T cells, even after attempted reversal of inhibitory receptor/ligand interactions. In this review, we outline the known AML targets, explore immune evasion mechanisms, and describe recent data and current clinical trials of single and combination immunotherapies. Clin Cancer Res; 24(22); 5502–15. ©2018 AACR.
Malignancy in Solitary Thyroid Nodules: Evaluation of Risk Factors

Background: The aim of the present study was to evaluate patients with suspicious solitary nodules undergoing bilateral total thyroidectomy for the presence of malignancy. Patients and Methods: 141 patients with true solitary thyroid nodules who underwent bilateral total thyroidectomy at the Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital between 2008 and 2013 were retrospectively evaluated. Parameters including demographics, ultrasonographic findings, and laboratory values were analyzed. Results: When the final pathology results were evaluated, malignancy was found in 52/141 (36.9%) patients. 49 (94.2%) of these lesions were papillary carcinoma. Colloidal nodules accounted for 30.3% of all benign cases. Nodular irregularity, increased vascularity, microcalcification, and central/lateral lymphadenopathy significantly increased the risk of malignancy. Among these factors, increased vascularity was the most important risk factor and microcalcification the second. Nodule size did not affect the risk of malignancy. Conclusion: Irregular borders, microcalcification, increased vascularity, and detection of cervical lymphadenopathy were found to be correlated with malignancy in solitary nodules.
Role of Serum TNFα Level in Atherosclerosis in Egyptian Systemic Lupus Erythematosus Patients

Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease that principally affects women in their childbearing years. Many cytokines have been implicated in regulating disease activity and the involvement of different organs in patients with SLE. The study was conducted to determine serum tumor necrosis factor alpha (TNFα) levels in SLE patients and its relation to clinically active disease and to assess the possible role of serum TNFα level in atherosclerosis. Thirty Egyptian female patients with SLE and 15 matched healthy control subjects had serum TNFα levels measured. In addition, the relation of common carotid artery intima-media thickness (CIMT) to serum TNFα was evaluated. Mean serum TNFα level of SLE patients was 48.36 ± 58.27 pg/ml, significantly different from the control group (17.62 ± 16.63 pg/ml; P = .014). There was a statistically significant difference in right carotid CIMT between SLE patients (0.06 ± 0.01 cm) and the control group (0.054 ± 0.009; P = .002). There was also a statistically significant difference in left carotid CIMT between lupus nephritis patients (0.07 ± 0.01) and non–lupus nephritis patients (0.06 ± 0.01; P = .027). These data indicate the activation of immune response in SLE patients suggested by their high levels of TNFα. Increased CITM in lupus patients was not related to TNFα and the lipid profile, suggesting an underlying etiology for atherosclerosis in lupus patients other than those factors. High CIMT in nephritis patients denote the role of nephritis in atherosclerosis.
Preventing Suicide and Depression: A Training Program for Long-Term Care Staff

Approximately 5 percent of those sixty-five and older live in long-term care facilities (1.5 million). Neither suicide and depression among the elderly who reside in long-term care facilities nor prevention techniques are well-understood by staff. This article discusses the development of a curriculum designed to train long-term care staff in preventing suicide among the elderly and the results of a pilot test of a training program based on that curriculum. The participants (N=43) significantly improved their scores from pre- to post-test on the knowledge, attitudes, and practices subtests. The knowledge areas in which staff performed the most poorly at pre-test were related to identifying appropriate primary and secondary interventions, the relationship between dementia and suicide, methods of self-destruction used by the elderly, and understanding of depression in the elderly. There was a significant relationship between pre-test and post-test scores on all subtests. Staff with higher levels of education had significantly higher pre- and post-test scores on the knowledge and attitudes subtests. More experienced staff had significantly higher post-test scores on the practices subtest. A large majority of the participants had highly positive attitudes toward the program and thought the program had been very useful or useful to them as caregivers. The study demonstrated the need for staff training related to suicide prevention in long-term care as well as the usefulness of even a brief training.
A Physician's Guide to the Physical Examination of the Shoulder

Abstract Shoulder pain is the third most frequent musculoskeletal complaint presented to physicians. Often considered a benign entity by patients and even their physicians, shoulder disorders can have a devastating effect on a patient's ability to function, as well as serve as an indicator of poor general health. For these reasons, it is important for the physician to be able to identify the etiology of a patient's shoulder problem(s). However, making a correct diagnosis is often difficult because there can be many causes for a patient's shoulder pain, weakness, or loss of function. Moreover, the shoulder girdle is an intricate group of structures that work together to allow for the largest range of motion in the body. This complexity makes it difficult to diagnose a patient's condition(s) based on history alone. A thorough and well-performed physical examination is the key to making a correct diagnosis and helping to distinguish different etiologies of shoulder dysfunction. In this article, we review relevant shoulder anatomy and biomechanics, and general shoulder examinations with special tests for various shoulder pathologies. We provide an effective and methodical approach to the physical examination of the shoulder.
Utility of MRI in Blunt Trauma Patients with a Normal Cervical Spine CT and Persistent Midline Neck Pain on Palpation

Introduction: The blunt trauma patient with a normal neurologic exam, and persistent midline cervical spine tenderness remains a diagnostic challenge. The patient with a symptomatic neck can be subsequently treated with flexion-extension cervical spine X-rays, MRI of the cervical spine, or no further imaging. Methods: This is a single center, retrospective study that spanned five years. Our current protocol for cervical spine clearance is described, which utilizes neck MRI for the trauma patients with persistent midline neck tenderness, a normal neurologic exam, and a normal CT of the neck. These symptomatic neck patients were identified from the institution's radiology database of patients that had both a CT and an MRI. Results: There were 6237 patients identified during the time of the study, and 81 were found to have both a CT and an MRI of the cervical spine for a symptomatic neck without a neurological deficit. There were 4 patients identified that had a normal CT, and subsequently had a new finding on the MRI scan; all were discharged with their cervical collar on with Spine Specialist followup. Conclusion: In 4.94% of our patients, the MRI had significant findings that changed the management of the patient. We will continue to perform cervical MRI in our symptomatic neck patients after blunt trauma with a normal cervical spine CT.
Standardized Low–Molecular-Weight Heparin Bridging Regimen in Outpatients on Oral Anticoagulants Undergoing Invasive Procedure or Surgery: An Inception Cohort Management Study

Background— Bridging therapy with low–molecular-weight heparin is usually recommended in patients who must stop oral anticoagulants before surgical or invasive procedures. To date, there is no universally accepted bridging regimen tailored to the patient’s thromboembolic risk. This prospective inception cohort management study was designed to assess the efficacy and safety of an individualized bridging protocol applied to outpatients. Methods and Results— Oral anticoagulants were stopped 5 days before the procedure. Low–molecular-weight heparin was started 3 to 4 days before surgery and continued for 6 days after surgery at 70 anti–factor Xa U/kg twice daily in high-thromboembolic-risk patients and prophylactic once-daily doses in moderate- to low-risk patients. Oral anticoagulation was resumed the day after the procedure with a boost dose of 50% for 2 days and maintenance doses afterward. The patients were followed up for 30 days. Of the 1262 patients included in the study (only 15% had mechanical valves), 295 (23.4%) were high-thromboembolic-risk patients and 967 (76.6%) were moderate- to low-risk patients. In the intention-to-treat analysis, there were 5 thromboembolic events (0.4%; 95% confidence interval, 0.1 to 0.9), all in high-thromboembolic-risk patients. There were 15 major (1.2%; 95% confidence interval, 0.7 to 2.0) and 53 minor (4.2%; 95% confidence interval, 3.2 to 5.5) bleeding episodes. Major bleeding was associated with twice-daily low–molecular-weight heparin administration (high-risk patients) but not with the bleeding risk of the procedure. Conclusions— This management bridging protocol, tailored to patients’ thromboembolic risk, appears to be feasible, effective, and safe for many patients, but safety in patients with mechanical prosthetic valves has not been conclusively established.
Cerebral blood flow and temporal lobe epileptogenicity

Long-term surface cerebral blood flow (CBF) monitoring was performed to test the hypothesis that temporal lobe epileptogenicity is a function of epileptic cortical perfusion. Forty-three bitemporal 2-hour periictal CBF studies were performed in 13 patients. Homotopic regions of temporal cortex maintained interictal epileptic cortical hypoperfusion and nonepileptic normal cortical CBF. At 10 minutes preictus, a statistically significant, sustained increase in CBF was detected on the epileptic temporal lobe. Two minutes preictus, there was approximation of CBF in the epileptic and nonepileptic temporal lobes. Thereafter, electrocorticographic (ECoG) and clinical seizure onset occurred. The linear relationship between CBF in the two hemispheres (epileptic and nonepileptic) was the inverse of normal (y = -0.347x + 62.767, r = 0.470, df = 95, p < 0.05). The data indicated a direct linear correlation between epileptic cortical CBF and seizure interval (frequency-1), a clinical measure of epileptogenicity (r = 0.610, df = 49, p < 0.05). Epileptogenicity was also found to be a logarithmic function of the difference between nonepileptic and epileptic cortical perfusion (r = 0.564, df = 58, t = 5.20, p < 0.05). The results showed that progressive hypoperfusion of the epileptic focus correlated with a decreased seizure interval (increased epileptogenicity). Increased perfusion of the epileptic focus correlated with an increased seizure interval (decreased epileptogenicity). The fact that CBF alterations precede ECoG seizure activity suggests that vasomotor changes may produce electrical and clinical seizure onset.
Weight loss during oligofructose supplementation is associated with decreased ghrelin and increased peptide YY in overweight and obese adults.

BACKGROUND Rodent studies show that oligofructose promotes weight loss, stimulates satiety hormone secretion, reduces energy intake, and improves lipid profiles. OBJECTIVE Our objective was to examine the effects of oligofructose supplementation on body weight and satiety hormone concentrations in overweight and obese adults. DESIGN This study was a randomized, double-blind, placebo-controlled trial. Forty-eight otherwise healthy adults with a body mass index (in kg/m2) > 25 were randomly assigned to receive 21 g oligofructose/d or a placebo (maltodextrin) for 12 wk. Body composition (by dual-energy X-ray absorptiometry); meal tolerance tests, including satiety hormone response; food intake; and subjective appetite ratings were determined. RESULTS There was a reduction in body weight of 1.03 +/- 0.43 kg with oligofructose supplementation, whereas the control group experienced an increase in body weight of 0.45 +/- 0.31 kg over 12 wk (P = 0.01). A lower area under the curve (AUC) for ghrelin (P = 0.004) and a higher AUC for peptide YY (PYY) with oligofructose (P = 0.03) coincided with a reduction in self-reported caloric intake (P < or = 0.05). Glucose decreased in the oligofructose group and increased in the control group between initial and final tests (P < or = 0.05). Insulin concentrations mirrored this pattern (P < or = 0.05). Oligofructose supplementation did not affect plasma active glucagon-like peptide 1 secretion. According to a visual analog scale designed to assess side effects, oligofructose was well tolerated. CONCLUSIONS Independent of other lifestyle changes, oligofructose supplementation has the potential to promote weight loss and improve glucose regulation in overweight adults. Suppressed ghrelin and enhanced PYY may contribute in part to the reduction in energy intake. The trial was registered at clinicaltrials.gov as NCT00522353.
Thermal management issues and evaluation of a novel, flexible substrate, 3-dimensional (3-D) packaging concept

The 3D MCM is an attractive choice to meet the speed, power, weight and cost-effectiveness requirements of current electronic packaging, but presents challenges in terms of thermal management, reliable high density electrical interconnects, and mechanical configuration. This paper addresses the thermal and electrical aspects of flexible substrate (flex) 3D MCM structures. A 3D polymer-based flex substrate configuration is proposed, and modeling results show the concept's feasibility. Test results are presented and discussed relative to modeling results. The flex configuration is discussed in terms of the high density electrical interconnection using elastomers and SMT connections between flex layers. Although flex has low thermal conductivity, tests and simulation show that up to 6 W can be dissipated through a 6 mm/spl times/6 mm area. Vias contribute to an increased interconnect density and assist with thermal management. Moreover, epoxy used to attach die to flex and flex to heat spreader should be used sparingly to reduce thermal resistance. Better thermal and electrical performance can be realized by a flip chip configuration rather than wire bonded chips, as a flipped die is best cooled from the upper side. Consideration must be given to assembly process and operational stresses, and the implications of such factors on system performance are discussed. Furthermore, the impact of the use of embedded passives on interconnect and passive device densities in terms of electrical performance is addressed. Finally, the future direction of the work is reviewed.
Examining the Impact of Individual, Community, and Market Factors on Methamphetamine Use: A Tale of Two Cities

Although prior studies have monitored the trends in methamphetamine use and reported its increase over the years, few studies have considered how community-level characteristics affect the use of methamphetamine. In this study, we utilize data from the Arrestee Drug Abuse Monitoring (ADAM) program from two cities to examine how individual-level, community-level, and drug market factors influence methamphetamine use. Results indicate that both individual and community-level data significantly influence methamphetamine use. Also, findings show that predictors of methamphetamine use (at the individual and community-level) differ significantly from marijuana, cocaine, and opiate use. Policy implications regarding law enforcement suppression and the treatment of methamphetamine users are discussed.
The complete mitochondrial genome structure of the jaguar (Panthera onca)

Abstract The jaguar (Panthera onca) is the largest felid in the Western hemisphere, and the only member of the Panthera genus in the New World. The jaguar inhabits most countries within Central and South America, and is considered near threatened by the International Union for the Conservation of Nature. This study represents the first sequence of the entire jaguar mitogenome, which was the only Panthera mitogenome that had not been sequenced. The jaguar mitogenome is 17,049 bases and possesses the same molecular structure as other felid mitogenomes. Bayesian inference (BI) and maximum likelihood (ML) were used to determine the phylogenetic placement of the jaguar within the Panthera genus. Both BI and ML analyses revealed the jaguar to be sister to the tiger/leopard/snow leopard clade.
Differences in Functional Disability of Rural American Indian and White Older Adults With Comorbid Diabetes

This study examines racial/ethnic differences in functional disability among a sample of rural older adults with comorbid diabetes. In 2002, interviews were conducted with 62 rural American Indian and 64 White community-dwelling persons aged 65 years or older. Examination of disability levels by group suggested that functional disability for Whites was concentrated in the lower levels (1-2 limitations), whereas disability for American Indians was concentrated in the higher levels (3 or more limitations). Adjusted prevalence rates indicated that American Indian older adults were significantly more likely than Whites to require assistance with dressing, walking, bathing, and shopping. Conversely, for reaching the toilet in time, Whites were significantly more likely than American Indians to report a limitation. Results of this study, coupled with previous literature, suggest that American Indians are more functionally disabled than other racial/ethnic groups and have a marked need for future long-term care.
Screening of chlamydia trachomatis infection in men, is it necessary in Iran?

Background: Chlamydia trachomatis is one of the most prevalent causative bacteria in sexually transmitted infections with adverse effects, which almost remain asymptomatic in society. Objectives: This project designed to determine the prevalence of Chlamydial infection in men and comparing the related risk factors in two groups of referrals based on the study inclusion criteria. Materials and Methods: Two hundreds of men who attended in the Mehrad hospital in Tehran Iran were selected and classified into two groups (symptomatic and asymptomatic). 10 mL of first void urine from each person collected and tested by polymerase chain reaction for the presence of C. trachomatis cryptic plasmid gene. association between condom usage as a variable and infection in asymptomatic group (P â�¤ 0.05). Results: In total, 8.5 of all subjects were positive (11 of symptomatic and 6 of asymptomatic men). Statistical analysis revealed an Conclusions: Findings of this study show that Chlamydial infection screening especially in males with urogenital symptoms is necessary (at least in Tehran) and we recommend more epidemiological studies in other cities of Iran. Â© 2013, Ahvaz Jundishapur University of Medical Sciences.