Miracle-dz/UniFAR-FTUs huggingface dataset:
Special issues in pediatric Hodgkin's disease

Abstract: Childhood Hodgkin's disease (HD) is not a biologically unique disease; it differs from adult HD primarily in the relative incidence of disease histology. Preadolescent children are more likely to have Mixed Cellularity and nodular lymphocyte predominant HD. Adolescent and young adult HD is indistinguishable, with a predominance of nodular sclerosing (NS) HD. Nonetheless, treatment paradigms have diverged over the years as pediatric oncologists responded first to developmental issues in the young child, and later to the long‐term treatment consequences in all young survivors. The latter concerns are of equal relevance to the young adult with HD. The increasing convergence of treatment approaches in the past decade is therefore most appropriate. Reproductive potential, risk of secondary malignancy and cardiopulmonary consequences of therapy have driven the pediatric treatment paradigm of care. Chemotherapy with low dose, limited field radiation is standard, with low‐stage patients often treated by chemotherapy alone. Algorithms tailor therapy to response. The prognostic importance of very early chemotherapy response rather than end‐of‐chemotherapy response has led the Children's Oncology Group to use early response (after 6 wk) to titrate individual therapy and dense regimens to maximize the early response rates. Although the dose dense regimens of adult groups are similar, the pediatric algorithms emphasize using the enhanced efficacy to limit cumulative therapy. This review intends to address the special issues of childhood HD, with the intent of further encouraging understanding that will foster convergence of pediatric and adult treatment paradigms.
Continuity of Care: Perspectives of Uninsured Free Clinic Patients

Background: Continuity of care is vital to the success of a health-care system because it improves patient satisfaction and health outcomes, and reduces hospitalizations and emergency room visits. Objective: The purpose of this study was to examine free clinic patients’ perspectives of continuity of care in the United States. Method: A convenience sample of free clinic patients who were the age of 18 or older and spoke English or Spanish participated in a self-administered survey from January to April in 2017 (N = 580). Results: Better instructions from providers were associated with higher levels of continuity of care (P < .01). Higher levels of stress and worse self-rated general health were related to lower levels of continuity of care (P < .05 for stress, P < .01 for general health). Being employed was associated with lower levels of continuity of care (P < .05). Non-US born English speakers and Spanish speakers rated continuity of care higher than US born English speakers (P < .01). Conclusion: Even if a patient is unable to see the same physician over time, quality instructions from a well-coordinated provider team may enhance continuity of care from patient perspectives. The social context of patients such as working poor individuals is very important for providers to understand in order to identify barriers to continuity of care.
Influência de Políticas de Ação Afirmativa no Perfil Sociodemográfico de Estudantes de Medicina de Universidade Brasileira

RESUMO A adoção de políticas públicas de inclusão pela Universidade Estadual de Campinas (Unicamp) desde o processo seletivo de 2005, atrelada às modificações nos vestibulares de 2014 e, mais recentemente, no de 2016, possivelmente trouxe grandes mudanças no perfil do estudante de Medicina dessa universidade. Desse modo, o objetivo do presente estudo é avaliar o perfil sociodemográfico desses acadêmicos, bem como suas pretensões na escolha da carreira médica e da futura especialidade. O estudo de corte transversal foi realizado com 290 acadêmicos do primeiro, terceiro e sexto ano da graduação médica da Unicamp por meio de um questionário anônimo aplicado após aprovação do Comitê de Ética em Pesquisa. Houve coleta de dados sociodemográficos, além dos fatores de influência para a escolha da profissão e da especialidade médica. A análise dos dados revelou uma amostra com idade média de 20-24 anos, predominantemente composta por mulheres (63,2%), da etnia branca (77,5%), procedentes do Estado de São Paulo (84,8%) e de regiões interioranas (62,3%). Para o primeiro ano, houve presença de negros (6,6%) e diferença estatística para pardos (22,6%), comparativa com o terceiro e sexto ano, egressos de ensino fundamental (42,5%) e médio (73,6%) públicos, com menor escolaridade materna (ensino médio) e renda familiar inferior (p < 0,001). Por sua vez, o terceiro e sexto ano eram compostos majoritariamente por alunos brancos (76,7% e 90,3%, respectivamente), oriundos de escola privada no ensino fundamental e médio, com maior escolaridade materna (ensino superior ou pós-graduação) e renda familiar mais elevada. Ainda, verificou-se variação das opções de especialidade ao longo do curso (p < 0,001). No primeiro ano, as especialidades mais pretendidas foram Cirurgia/Ortopedia (37,7%), Clínica Médica/Neurologia (23,6%) e Psiquiatria (11,3%). Para o terceiro ano, as especialidades mais desejadas foram Clínica Médica/Neurologia (40%), Cirurgia/Ortopedia (13,4%) e Ginecologia/Obstetrícia (13,3%). Entre os alunos do sexto ano, as especialidades mais escolhidas foram Clínica Médica/Neurologia (24,5%), Ginecologia/Obstetrícia (20,2%) e Cirurgia/Ortopedia (17%). Acadêmicos do primeiro ano também apresentaram diferentes aspirações abrangendo o local de trabalho futuro, com mais desejo de atuar somente no SUS ou em programas internacionais. Nesse contexto, os resultados apontam que a política de bonificação da Unicamp e suas alterações ao longo do tempo, em especial no vestibular de 2016, mostraram-se efetivas em democratizar o acesso à graduação médica, com maior pluralidade demográfica, social, econômica e étnica atreladas a variações na escolha da carreira e da especialidade médica ao longo das turmas analisadas.
Case studies: Use of salicylic acid (Avosil) and hydrogel (Avogel) in limiting scar formation.

Thirty years ago, Larson et al observed that elastic pressure wrap dressings were effective in reducing scar hypertrophy in healing burn scars.1 Since that report, 20 to 24 mm Hg pressure garments have become the mainstay of scar prevention. The mechanism of action of pressure dressings is uncertain, particularly in view of the fact that they remain effective following several weeks of daily use despite a loss of elasticity and a diminution of pressure exertion. Biochemical assays of tissue healing beneath pressure garments show moderate decreases in wound metabolism and increased collagenase activity.2 However, pressure garments are poorly tolerated because of the general discomfort and restriction of movement that accompanies their use. In the past decade, another topical device, silicone gel sheeting, has been found to be useful clinically in controlling scar formation.3–5 As with elastic garments, the mechanism of action has not been convincingly elucidated but postulated mechanisms include induction of scar hypoxia, increased hydration of the epidermis covering the scar,6 and increased scar temperature.7,8 The effect does not depend on the composition of the gel sheeting used, and it is clear that release of silicone into the scar is not the mode of action. Recently, several reports have shown that hydrogel sheeting is just as effective as silicone but has fewer adverse side effects.9,10 Hydrogel sheeting has been approved by the Food and Drug Administration and is considered to be substantially equivalent to silicone for treatment of hypertrophic scars. Thus, the effect of the topical gel sheeting seems independent of its composition. Hydrogels have the added advantages of being useful as drug-delivery vehicles and of having higher heat capacities for buffering scar temperature.8 Inflammation is critically important for healing and scarring. Dang et al11 and O'Kane12 recently reviewed the biology of scar formation. Both reviews underscore the importance of inflammation as the essential epigenetic stimulator of scarring. Therefore, we performed a pilot investigation of topical salicylic acid (2%) treatment in conjunction with hydrogel sheeting to determine whether there is an added beneficial effect from using a topical nonsteroidal anti-inflammatory drug in scar management. Here, we report our experience with the first patients.
A diagnostic test for heparin-induced thrombocytopenia

Heparin-induced thrombocytopenia can be a serious and difficult-to- diagnose complication of heparin therapy. Serum from patients with heparin-induced thrombocytopenia can cause heparin-dependent platelet aggregation, but the low sensitivity and specificity of this test limit its clinical usefulness. In this report we describe an assay for heparin-induced thrombocytopenia that is both sensitive and specific. The improvement in the assay was accomplished by measuring platelet release instead of aggregation and by measuring platelet release at two heparin concentrations. The rationale for the use of two heparin concentrations was that sera from patients with heparin-induced thrombocytopenia caused release at therapeutic but not at high concentrations of heparin. Twenty-eight sera samples from patients suspected of having heparin-induced thrombocytopenia and 573 controls were coded and tested in the assay. The patients with possible heparin- induced thrombocytopenia were ranked according to the likelihood of having this disorder by using prospectively defined criteria. The test had a high specificity (99%); only one of 573 controls showed a positive result. The test was also very sensitive, and the likelihood of a positive test result was directly correlated with the clinical likelihood of the patient having heparin-induced thrombocytopenia. Six of six patients with definitive heparin-induced thrombocytopenia had positive test results, whereas zero of four patients in whom the diagnosis was unlikely had positive test results. The two-point test for heparin-induced thrombocytopenia represents a sensitive and specific test for this disorder. This test may be useful not only in confirming the diagnosis of this disorder but also may provide information about its pathogenesis.
Effects of phacoemulsification on intraocular pressure and anterior chamber depth

Objective To investigate the effects of phacoemulsification and intraocular lens implantation on intraocular pressure(IOP) and anterior chamber depth in patients with cataract or cataract combined with angle closure glaucoma.Methods 361 patients(481 eyes) with senile cataract(cataract group) and 44 patients(52 eyes) with cataract combined with angle closure glaucoma(cataract with glaucoma group) accepted phacoemulsification and intraocular lens implantation from July 2005 to May 2007,and were followed up for 3-25 months.Results There was a significant difference between preoperative and postoperative IOP(t=9.270,P0.01) in the cataract group,and the preoperative IOP was 14.86±3.79 mmHg and the postoperative IOP was 12.56±3.43 mmHg;there was a significant difference between preoperative and postoperative IOP(t=3.29,P0.01) in the cataract with glaucoma group,and the preoperative IOP was 19.92±3.76 mmHg and the postoperative IOP was 16.52±3.15 mmHg;there was no significant difference in preoperative IOP(t=-2.437,P0.05)and the IOP 3 months after operation(t=2.154,P0.05)between the two groups.There was a significant difference between the preoperative and postoperative depths of the anterior chamber(t=7.781,P0.01) in the cataract group,and the preoperative depth of the anterior chamber was 2.28±0.32 mm and the postoperative depth of the anterior chamber was 3.04±0.39 mm;there was a significant difference between preoperative and postoperative depths of the anterior chamber(t=4.528,P0.01)in the cataract with glaucoma group, and the preoperative depth of the anterior chamber was 1.69±0.35 mm and the postoperative depth of the anterior chamber was 2.82±0.41 mm;there was a significant difference between the two groups in the preoperative depth of the anterior chamber(t=8.325,P0.01)and no significant difference after operation(t=2.86,P0.05). Conclusion Phacoemulsification and intraocular lens implantation are effective in curing cataract and decreasing IOP.If the IOP of patients with cataracts and glaucoma was controlled to normal preoperatively,the anti-glaucoma medication was no longer needed after phacoemulsification and intraocular lens implantation.
Evaluation of the sleep pattern in Nursing professionals working night shifts at the Intensive Care Units

Objetivo: Avaliar a qualidade do sono e verificar a presenca de Sonolencia Diurna Excessiva (SDE) dos profissionais de Enfermagem dos plantoes noturnos das Unidades de Terapia Intensiva do Instituto Central Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo. Metodos: Foram avaliados 75 profissionais de Enfermagem: 33% enfermeiros, 66% auxiliares de Enfermagem, sendo que 81% eram do genero feminino. A idade teve uma variacao de 22 a 60 anos, com media de idade de 38 anos. Os instrumentos utilizados foram: o Indice de Qualidade de Sono de Pittsburgh e a Escala de Sonolencia de Epworth. Rresultados: Este estudo demonstrou que 97,3% dos profissionais apresentam ma qualidade de sono e 70,67% uma sonolencia diurna excessiva. Cconclusoes: Diante disso, algumas intervencoes tornam-se necessarias, como o planejamento de um local como uma sala de conforto com televisao, radio e camas adequadas; uma rotina de rodizio de horario por funcionario para o descanso e alimentacao; mudanca da carga horaria do turno noturno alterando a jornada de 12 horas para oito horas e pausas de 15 minutos a cada duas horas de trabalho.
Stressors of Academic Stress - A Study on Pre-University Students

Academic stress among college students has been a topic of interest for many years. College students experience high stress due to various stressors. When stress is perceived negatively or becomes excessive, it can affect both health and academic performance. The study was conducted to know the stressors of academic stress among pre-university students. The sample consisted of 360 pre-university students of both boys and girls drawn using random sampling method from four co-educational colleges.Study Habits Schedule was developed by combining relevant items selected from the Study involvement inventory development and study problems schedule developed by combining relevant items from student problems and adjustment inventory developed and student personal problems developed were the scales used to collect the data from students. The results showed that high aspiration, poor study habits, more study problems, change in medium of instruction and low socio-economic conditions are the factors responsible for to academic stress and become stressors for stress among selected respondents
Segmentation Refinement of Small-Size Juxta-Pleural Lung Nodules in CT Scans

Background: In order to evaluate the growth rate of lung cancer, pulmonary nodule segmentation is an essential and crucial step. Segmentation of juxta-pleural pulmonary nodule in CT scans, especially small size ones, is still a challenge. Objectives: To better support the following radiomics analysis, this study aims to propose and develop a novel segmentation method for small-size juxta-pleural pulmonary nodules. Materials and Methods: In this study, we investigated and developed a novel approach based on transition region thresholding and chain code analysis to segment juxta-pleural pulmonary nodules. First, we cropped the region of interest (ROI) from the lung CT scans, and enhanced the nodule regions by using an anisotropic diffusion algorithm. Second, to extract the foreground pixels (including the attached chest wall) from ROIs, we applied an adaptive segmentation process by incorporating a threshold segmentation method with transition region analysis. Third, we smoothed the lung contour by using iterative weighted averaging algorithm. Then, we utilized chain code analysis to repair lung parenchyma boundaries. Finally, we obtained the segmentation result by overlapping the extracted foreground with the repaired lung parenchyma mask. Results: To validate the performance of the proposed segmentation approach, we selected 50 juxta-pleural nodules with diameter ranges from 5 mm to 10 mm from Lung Image Database Consortium (LIDC) database. Compared with the ground truth generated by radiologists, we achieved an average overlap rate of 76.93% ± 0.06 with a false positive rate of 13.09% ± 0.09. Conclusion: After comparing and analyzing the segmentation results, we found that our approach outperformed the method reported in other literature. The experimental results demonstrated that our new method is an effective approach to segment small-size juxta-pleural pulmonary nodules accurately.
Tension Headaches and Vertigo in a Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy Patient

Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is caused by mutations in NOTCH3 gene, and it is the most common cause of inherited cerebral small vessel disease. Patient Description: We present a 37-year-old male patient, member of a family with the C162R mutation of the NOTCH3 gene. Instead of migraine with aura, and ischemic events, he presented with tension headaches and episodes of vertigo. Later on, he developed mild cognitive impairment. Conclusions: Atypical presentations are not unusual in CADASIL including non-specific tension headaches and vertigo.
EFFECTIVENESS OF MINDFULNESS BSED COGNITIVE THERAPY ONANXIETY, STRESS AND DEPRESSION OF PREGNANT YOUTHS:A RANDOMIZED CLINICAL TRIAL

Introduction: Pregnancy in adolescence could be risky and planning supportive programs is critical for pregnant youths. Therefore, this study aimed to explore the effectiveness of cognitive therapy (based on mindfulness) on the reduction of anxiety, stress and depression among pregnant woman younger than 20 years of age. Material and Methods: This study employed pre-post-test method with control group. The study population included all pregnant women of Ardebil who was below 20 years of age and who reported higher than normal level scores in anxiety, stress or depression during 2013. The selected sample comprised 30 youth pregnant females below 20 years age. They were selected by convenience method from health care centers of Ardebil, and assigned randomly in control and experimental group. The data collected by standard anxiety, stress and depression questionnaire and trait anxiety. The collected data analyzed by Multiple Analysis of Variance (MANOVA). Results: The result of MANOVA revealed that mindfulness based cognitive therapy significantly is effective on stress [F (1,29) = 57.58 p < . 0005], anxiety [F (1,29) = 57.58 p < . 0005 ] and depression [F (1,29) = 79.52 p < . 0005] of pregnant women who aged below 20 years. Conclusion: According to the findings of this study and other relevant studies as pregnancy is a very sensitive stage of every womans life and they need proper care. The authors suggest to future researchers to design and explore MBCT based on pregnancy condition associated problems.
What matters versus what’s the matter – exploring perceptions of person-centred practice in nursing and physiotherapy social media communities: a qualitative study

This is a pre-copyedited, peer-reviewed version of the following article Ward, A. , Eng, C. , McCue, V. , Stewart, R. , Strain, K. , McCormack, B. , Dukhu, S. , Thomas, J. & Bulley, C. (2018) What matters versus what’s the matter – exploring perceptions of person-centred practice in nursing and physiotherapy social media communities: a qualitative study. International Practice Development Journal, 8 (2), [Article: 3], which has been published in final form at https://doi.org/10.19043/ipdj.82. 003 in the International Journal of Practice Development.
The significance of collateral circulation in acute ischemic stroke

The human brain accounts for about 2% of the total body weight, but it consumes about 15% of cardiac output and about 20% of the total body energy at rest [1]. The neurovascular coupling in the brain is a mechanism that increases the blood flow in the part of the brain where neurons are the most active [1]. If, for whatever reason, the blood flow drops below the threshold and there is a loss of ionic homeostasis and anoxic depolarization, consequent neuronal necrosis, i.e. brain infarction develops. Complete arrest of blood supply, or inadequate supply of neurons with glucose and oxygen, leads to metabolic and neuronal disorders (within 30 seconds), then functional disorders occur (after 1 minute), and finally (after 5 minutes) irreversible changes and neuronal death occur; this leads to brain infarction, which clinically manifests as ischemic stroke [2]. If the flow of oxygenated blood is re-established quickly enough, the neuronal damage is reversible.
Role of the scavenger receptor class B members LmpA, LmpB and LmpC during phagocytosis and phagosome maturation

Mycobacterium tuberculosis invades immune phagocytes and reprograms their otherwise bactericidal phagosome maturation pathway to establish a replication niche. Recent reports indicate that uptake of mycobacteria depends on the scavenger receptors class B (CD36 and SR-B1). We have established Dictyostelium as an alternative host model for pathogenic Mycobacterium marinum, a close cousin of M. tuberculosis. Dictyostelium discoideum possesses three CD36 homologs, the Lysosomal Membrane glycoProteins A, B and C. We investigated the importance of the proteins during phagocytic uptake, killing and digestion. Our results suggest that the plasma membrane protein LmpB is specifically implicated in the uptake of mycobacteria. LmpA, on the other hand, is found on phagolysosomes. Interestingly, cells with reduced LmpA protein levels showed impairments in actin-dependent processes such as phagocytosis and phagosome maturation. Additionally, these cells were more susceptible towards infection with M. marinum. Altogether, our results indicate that LmpA is a host cell defense factor, which modulates the dynamics of the actin cytoskeleton.
Evolutionary trends in the individuation and polymorphism of colonial marine invertebrates

Evolutionary Trends in the Individuation and Polymorphism of Colonial Marine Invertebrates by Edward Peter Venit Department of Biology Duke University Date:_______________________ Approved: ___________________________ Daniel W. McShea, Supervisor ___________________________ Robert Brandon ___________________________ Sonke Johnsen ___________________________ V. Louise Roth ___________________________ Gregory Wray An abstract of a dissertation submitted in partial fulfillment of the requirements for the degree of Doctor in the Department of Biology in the Graduate School of Duke University 2007 Copyright by Edward Peter Venit 2007
Overview and Analysis of Various Coil Structures for Dynamic Wireless Charging of Electric Vehicles

Dynamic wireless charging (DWC) for EVs is one of the emerging technologies that reduces the size of the onboard vehicle battery as well as reduces the waiting time to charge the battery. In this paper, various coil structures are demonstrated which are mostly used in DWC. The various structures of coils are investigated and new structure of the coil is proposed in this work. The Finite element analysis of the DWC coil structures are illustrated and the effect due to variation in physical parameters is closely observed. Further, the advantages and new findings in proposed coil structure are compared with the existing coil arrangements and the comparative results are presented which confirm the prosed coil structure gives higher flux density among all the existing coil structures. The simulation results are expounded to verify the theoretical findings.