Miracle-dz/UniFAR-FTUs huggingface dataset:
Experiences and perceptions of medical discrimination among a multiethnic sample of breast cancer patients in the Greater San Francisco Bay Area, California.

OBJECTIVES We conducted qualitative interviews with breast cancer survivors to identify themes related to institutional, personally mediated, and internalized discrimination in the medical setting. METHODS We conducted 7 focus groups and 23 one-on-one interviews with a multiethnic sample of breast cancer survivors randomly selected from a population-based registry covering the Greater San Francisco Bay Area, California. RESULTS Participants reported experiencing different forms of medical discrimination related to class, race, and language. Among African Americans, participants reported experiencing internalized discrimination and personal or group discrimination discrepancy-perceiving discrimination against them as a racial/ethnic group, yet not perceiving or discussing personal experiences of discrimination. Among Asian immigrants, participants reported experiencing institutional and personally mediated overt types of discrimination, including lack of access to quality and readily available translation services. Our results also indicated well-established coping mechanisms in response to discrimination experiences in both groups. CONCLUSIONS Participants reported experiencing medical discrimination at all 3 levels, which may have deleterious health effects through the biopsychosocial stress pathway and through active coping mechanisms that could lead to delayed- or underutilization of the health care system to avoid discrimination.
Update in Sleep‐disordered Breathing 2016

Update in Sleep-disordered Breathing 2016 Najib T. Ayas, Luciano F. Drager, Mary J. Morrell, and Vsevolod Y. Polotsky Sleep Disorders Program and Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Hypertension Unit, Heart Institute (InCor) and Hypertension Unit, Renal Division, University of Sao Paulo Medical School, Sao Paulo, Brazil; Sleep and Ventilation Unit, National Heart and Lung Institute, Imperial College London, London, United Kingdom; National Institute for Health Research Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield National Health Service Foundation Trust and Imperial College London, London, United Kingdom; and Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Using DNA Fingerprints to Infer Familial Relationships Within NHANES III Households

Developing, targeting, and evaluating genomic strategies for population-based disease prevention require population-based data. In response to this urgent need, genotyping has been conducted within the Third National Health and Nutrition Examination (NHANES III), a nationally representative household-interview health survey. However, before these genetic analyses can occur, family relationships within households must be accurately ascertained. Unfortunately, reported family relationships within NHANES III households based on questionnaire data are incomplete and inconclusive with regard to actual biological relatedness of family members. We inferred family relationships within households using DNA fingerprints (Identifiler®) that contain the DNA loci used by law enforcement agencies for forensic identification of individuals. The performance of these loci for relationship inference is not well understood, however. We evaluated two competing statistical methods for relationship inference on pairs of household members: an exact likelihood ratio relying on allele frequencies to an identical-by-state (IBS) likelihood ratio that only requires matching alleles. We modified these methods to account for genotyping errors and population substructure. The two methods usually agree on the rankings of the most likely relationships; however, the IBS method underestimates the likelihood ratio by not accounting for the informativeness of matching rare alleles. The likelihood ratio is sensitive to estimates of population substructure, and parent–child relationships are sensitive to the specified genotyping error rate. These loci were unable to distinguish second-degree relationships and cousins from being unrelated. The genetic data also are useful for verifying reported relationships and identifying data quality issues. An important byproduct is the first explicitly nationally representative estimates of allele frequencies at these ubiquitous forensic loci.
Vaginal Progesterone to Reduce the Rate of Preterm Birth and Neonatal Morbidity: A Solution at Last

ISSN 1745-5057 Women's Health (2011) 7(5), 501–504 10.2217/WHE.11. 60 shortand long-term complications. However, age alone does not tell us why the preterm birth occurred, and this has profound consequences as to the prognosis of the newborn and the likelihood that we will ever be able to prevent the different types of preterm birth. When we look at the other end of the spectrum of life (i.e., geriatrics), the older an individual is, the more likely it is that she/he would have disease due to organ senescence or cumulative insults experienced during life. Yet, we do not define disease purely on the basis of age, and we treat an elderly individual differently if the cause of the disorder is cardiac failure, pneumonia, renal failure or cancer, and so forth. In obstetrics, we may be guilty of oversimplification by not considering the cause of preterm birth or other obstetrical syndromes with sufficient depth to allow meaningful prevention. It is now clear that preterm birth is not a single condition. Two-thirds of preterm births occur because women go into spontaneous preterm labor (with intact or ruptured membranes). The remainder are due to preterm deliveries indicated for potentially life-threatening complications of the mother, such as pre-eclampsia, or fetal complications, such as intrauterine growth restriction. The complexity of the problem extends further than just whether a preterm birth was spontaneous or induced. A deeper examination reveals that preterm labor with intact membranes, premature rupture of membranes, pre-eclampsia and intrauterine growth restriction are all syndromes caused by multiple mechanisms of disease: ‘the great obstetrical syndromes’ [3,4]. Therefore, since preterm birth is not a single condition, there will never be a single test to predict it, a single intervention to treat it, or one approach to prevent it all. I believe that oversimplification of the nature of disease in obstetrics has been an obstacle to Preterm delivery: an important healthcare issue for women & their families Preterm delivery has been, and remains, the most important challenge to modern obstetrics. In 2009, 13 million babies were born preterm: 11 million in Africa and Asia and 500,000 in the USA [1]. The highest rates of preterm birth are in Africa (11.9%) and North America (10.6%). Premature neonates are at increased risk of death and short-term complications such as respiratory distress syndrome, intraventricular hemorrhage, neonatal sepsis and necrotizing enterocolitis. Long-term complications include neurodevelopmental disorders such as cerebral palsy, chronic lung disease, blindness and deafness [2]. The financial cost of preterm birth has been estimated to be US $26 billion per year in the USA alone, but that is only part of the story: the less-appreciated burden of preterm birth is borne by the families caring for preterm babies.
Klassifikation von Sprachentwicklungsstörungen

Zusammenfassung. Sprache ist ein wichtiger Bestandteil unserer Kultur und ermoglicht den Austausch von Gedanken und Gefuhlen sowie die Aneignung von Wissen. Defizite in den sprachlichen Fahigkeiten konnen sich auf verschiedenen linguistischen Ebenen ausern, was in der Diagnostik von Sprachentwicklungsstorungen berucksichtigt werden sollte. Es folgt ein Uberblick zur Symptomatik und zur Untergliederung von Sprachentwicklungsstorungen in den psychiatrischen Klassifikationssystemen DSM-5 und ICD-10. Zusatzlich wird ein Ausblick auf die ICD-11 (Beta-Entwurf) gegeben. Die diagnostischen Klassifikationssysteme werden der Interdisziplinaren S2k-Leitlinie gegenubergestellt. Keines der dargestellten Systeme berucksichtigt die einzelnen linguistischen Ebenen der Sprache, wie es in der S2k-Leitlinie gefordert wird. Zudem bestehen deutliche Unterschiede in den Diagnosekriterien. In der Praxis fuhrt dies zu erheblichen Schwierigkeiten in der differenzierten Erfassung von Sprachdefiziten. Die zuverlassige Abklarung ein.
Pretreatment Serum Cystatin C Levels Predict Renal Function, but Not Tumor Characteristics, in Patients with Prostate Neoplasia

To evaluate the role of Cystatin C (Cys-C) in tumorigenesis and progression of prostate cancer (PCa), we retrospectively collected the clinical information from the records of 492 benign prostatic hyperplasia (BPH), 48 prostatic intraepithelial neoplasia (PIN), and 173 PCa patients, whose disease was newly diagnosed and histologically confirmed. Pretreatment serum Cys-C levels were compared across the various groups and then analyzed to identify relationships, if any, with clinical and pathological characteristics of the PCa patient group. There were no significant differences in serum Cys-C levels among the three groups (P > 0.05). In PCa patients with normal SCr levels, patient age was correlated with serum Cys-C level (P ≤ 0.001) but did not correlate with alkaline phosphatase (AKP), lactate dehydrogenase (LDH), prostate specific antigen (PSA), Gleason score, or bone metastasis status (P > 0.05). Age and SCr contributed in part to the variations in serum Cys-C levels of PCa patients (r = 0.356, P ≤ 0.001; r = 0.520, P ≤ 0.001). In conclusion, serum Cys-C levels predict renal function in patients with prostate neoplasia, but were not a biomarker for the development of prostate neoplasia, and were not correlated with the clinicopathological characteristics of PCa.
HOMOTRANSPLANTATION OF THE LIVER IN HUMANS.

A number of problems are described which must be surmounted for the clinical use of liver homotransplantation, based upon experience with 3 patients. The first patient died of hemorrhage during conclusion of the operation. The second and third patients lived for 22 and 7½ days, respectively, both ultimately dying from multiple pulmonary emboli. The operative requirements for successful liver transplantation appear to be subject to practical solution. Of the utmost importance is the procurement of a viable and relatively undamaged donor organ. This has been accomplished with the use of an extracorporeal circuit which perfuses and cools the liver immediately after death. In addition, the time interval between death of the donor and restoration of a hepatic blood supply in the transplanted site has been shortened by operating on the recipient patient in 2 stages. At the preliminary operation, all structures are skeletonized above and below the liver with facilitation of the recipient hepatectomy and multiple anastomoses which are performed at the second and definitive procedure. While the transplantation is being performed, the venous return from the splanchnic and inferior vena caval systems is temporarily occluded. It has been found necessary to decompress only the inferior vena cava during this time with an external bypass from the inferior to the superior vena caval systems. Changes in the coagulation mechanisms constitute a serious deterrent to success. During operation, a bleeding diathesis is regularly detectable by laboratory examination. Postoperatively, a state of hypercoagulability has developed, which probably contributed to the lethal complication of multiple pulmonary embolization in 2 patients. It is also possible that the use of the external bypass contributed to the formation of the emboli. After operation, hepatic functions were immediately deranged, probably as the result of injury incurred during the transplantation, with progressive improvement thereafter. Later, biochemical evidence of homograft rejection was not observed, and at autopsy in the last 2 patients there was surprisingly good gross and histologic preservation of graft structure. It is thought that the therapy with azathioprine, prednisone, and actinomycin C had forestalled the rejection process.
Nosocomial sepsis: evaluation of the efficacy of preventive measures in a level-III neonatal intensive care unit

Abstract Objective: To evaluate nosocomial infections preventive bundle, implemented in April 2010 in Centro Hospitalar de São João (CHSJ) Neonatal Intensive Care Unit (NICU) effectiveness. Methods: Newborns admitted to level-III NICU of CHSJ, between 1 April 2007 and 31 March 2013, with sepsis as discharge diagnosis, were selected and divided into two periods (Period 1 and 2, before and after new preventive bundle introduction). Data from the two periods were compared. Results: Nosocomial sepsis incidence density decreased significantly from 8.6 to 4.8 per 1000 patient days from Period 1 to 2. Nosocomial infections preventive bundle implementation led to a significant decrease in central line-associated bloodstream infections (CLABSI) rates from 14.1 to 10.4 per 1000 catheter days. Conclusions: Nosocomial infections preventive bundle implemented revealed efficient in decreasing the incidence density of nosocomial sepsis. However, CLABSI rates remain high. Physicians should be alert to the need to adhere to strict infection control protocols and institute effective measures for nosocomial infection surveillance.
Skin microneedling plus platelet-rich plasma versus skin microneedling alone in the treatment of atrophic post acne scars: a split face comparative study

Abstract Introduction: Acne scarring is a permanent disfiguring sequel, which can take varied morphological forms. Many therapeutic measures have been performed to improve acne scarring such as microneedling. Our objective is to evaluate the efficacy and safety of microneedling alone versus microneedling combined with platelet rich plasma in the treatment of post acne. Methods: The study included 35 patients with mild to severe post acne atrophic scar. All the patients received four sequential treatments of skin microneedling alone on the right side of the face and skin microneedling followed by topical application of platelet rich plasma (PRP) on the left side of the face with an interval of 3 weeks. Two blinded dermatologists evaluated the clinical response according to qualitative global acne scarring system grading of Goodman & Baron. Patients are queried about their satisfaction with the treatment outcomes. Results: The study included 35 patients with a mean age of 24.7 ± 6.8 years. There was a significant improvement in the degree of scar severity before and after treatment on both the sides. Regarding patient’s satisfaction grades, there was a significant improvement after both treatment modalities with insignificant differences between both treatment modalities. Conclusions: Both microneedling and microneedling in combined with PRP showed satisfactory results.
Adult Neurogenesis, Mental Health, and Mental Illness: Hope or Hype?

Psychiatric and neurologic disorders take an enormous toll on society. Alleviating the devastating symptoms and consequences of neuropsychiatric disorders such as addiction, depression, epilepsy, and schizophrenia is a main force driving clinical and basic researchers alike. By elucidating these disease neuromechanisms, researchers hope to better define treatments and preventive therapies. Research suggests that regulation of adult hippocampal neurogenesis represents a promising approach to treating and perhaps preventing mental illness. Here we appraise the role of adult hippocampal neurogenesis in major psychiatric and neurologic disorders within the essential framework of recent progress made in understanding “normal” adult neurogenesis. Topics addressed include the following: the life cycle of an adult hippocampal stem cell and the implications for aging; links between learning and hippocampal neurogenesis; the reciprocal relationship between cocaine self-administration and adult hippocampal neurogenesis; the role of adult neurogenesis in an animal model of depression and response to antidepressant exposure; the impact of neonatal seizures on dentate gyrus neurogenesis; and the contribution of a schizophrenia-susceptibility gene to adult hippocampal neurogenesis. These topics are discussed in light of the regulation of adult neurogenesis, the relationship to normal neurogenesis in adulthood and aging, and, importantly, the manipulation of neurogenesis to promote mental health and treat mental illness.
COL1 C‐propeptide cleavage site mutations cause high bone mass osteogenesis imperfecta

Osteogenesis imperfecta (OI) is most often caused by mutations in the type I procollagen genes (COL1A1/COL1A2). We identified two children with substitutions in the type I procollagen C‐propeptide cleavage site, which disrupt a unique processing step in collagen maturation and define a novel phenotype within OI. The patients have mild OI caused by mutations in COL1A1 (Patient 1: p.Asp1219Asn) or COL1A2 (Patient 2: p.Ala1119Thr), respectively. Patient 1 L1–L4 DXA Z‐score was +3.9 and pQCT vBMD was+3.1; Patient 2 had L1–L4 DXA Z‐score of 0.0 and pQCT vBMD of −1.8. Patient BMD contrasts with radiographic osteopenia and histomorphometry without osteosclerosis. Mutant procollagen processing is impaired in pericellular and in vitro assays. Patient dermal collagen fibrils have irregular borders. Incorporation of pC‐collagen into matrix leads to increased bone mineralization. FTIR imaging confirms elevated mineral/matrix ratios in both patients, along with increased collagen maturation in trabecular bone, compared to normal or OI controls. Bone mineralization density distribution revealed a marked shift toward increased mineralization density for both patients. Patient 1 has areas of higher and lower bone mineralization than controls; Patient 2's bone matrix has a mineral content exceeding even classical OI bone. These patients define a new phenotype of high BMD OI and demonstrate that procollagen C‐propeptide cleavage is crucial to normal bone mineralization. Hum Mutat 32:1–12, 2011. © 2011 Wiley‐Liss, Inc.
NGS based identification of mutational hotspots for targeted therapy in anaplastic thyroid carcinoma

Context Anaplastic thyroid carcinoma (ATC) represents one of the most aggressive carcinomas with no consistent survival benefit when treated with conventional radiochemotherapy. Approaches targeting “oncogene addiction” of ATC are increasingly explored and first promising results have been reported in single case studies. Objective To determine the prevalence of mutations in known thyroid oncogenes and signalling pathways amendable to targeted therapy in a large cohort of ATC. Results In 118 ATC (57 male/ 61 female) a total of 165 mutations were found. Genes involved in the MAPK/ERK and PI3K pathway (BRAF 11.0%, HRAS 4.2%, KRAS 7.6%, NRAS 7.6%, PI3KCA 11.8%) were altered in 33%. Targetable receptor tyrosine kinases were mutated in 11%. The most frequently altered genes were TERT in 86/118 (73%) and p53 in 65/118 (55%) cases. No mutations were found analysing ALK, KIT, MET and mTOR. Materials and Methods Next generation sequencing (NGS) was performed in FFPE samples from 118 ATC using MiSeq (Illumina) and CLC Cancer Research Workbench (CLCbio; Qiagen) for mutation analysis in: ALK, BRAF, CDKN2A, EGFR, ERBB2, HRAS, KIT, KRAS, MET, mTOR, NRAS, PDGFRA, PI3KCA, p53, RB1, RET and TSC2. Sanger sequencing was used to detect TERT promotor mutations. Conclusions To our knowledge this is the largest study analysing mutations for targeted therapy of ATC. We found that 33% of ATC harbour mutations in pathways amendable to targeted therapy. Molecular screening in ATC is suggested for targeted therapies since current conventional treatment for ATC proved mainly futile.
Quality Control of Valerianae Radix by Attenuated Total Reflection Fourier Transform Infrared (ATR-FTIR) Spectroscopy

Abstract (Acetoxy-)valerenic acid and total essential oil content are important quality attributes of pharmacy grade valerian root (Valerianae radix). Traditional analysis of these quantities is time-consuming and necessitates (harmful) solvents. Here we investigated an application of attenuated total reflection Fourier transform infrared spectroscopy for extractionless analysis of these quality attributes on a representative sample comprising 260 wild-crafted individuals covering the Central European taxonomic diversity of the Valeriana officinalis L. s. l. species aggregate with its three major ploidy cytotypes (i.e., di-, tetra- and octoploid). Calibration models were built by orthogonal partial least squares regression for quantitative analysis of (acetoxy-)valerenic acid and total essential oil content. For the latter, we propose a simplistic protocol involving apolar extraction followed by gas chromatography as a reference method for multivariate calibration in order to handle the analysis of samples taken from individual plants. We found good predictive ability of chemometric models for quantification of valerenic acid, acetoxyvalerenic acid, total sesquiterpenoid acid, and essential oil content with a root mean squared error of cross-validation of 0.064, 0.043, and 0.09 and root mean squared error of prediction of 0.066, 0.057, and 0.09 (% content), respectively. Orthogonal partial least squares discriminant analysis revealed good discriminability between the most productive phenotype (i.e., the octoploid cytotype) in terms of sesquiterpenoid acids, and the less productive ones (i.e., di- and tetraploid). All in all, our results demonstrate the application of attenuated total reflection Fourier transform infrared spectroscopy for rapid, extractionless estimation of the most important quality attributes of valerian root and minimally invasive identification of the most productive phenotype in terms of sesquiterpenoid acids.
Optimal distributed scheduling of real-time traffic with hard deadlines

In this paper, we consider optimal distributed scheduling of real-time traffic with hard deadlines in an ad hoc wireless network. Specifically, we assume the links share a common wireless channel and interference is represented by a conflict graph. Periodic single-hop traffic is considered where packets arrive at the beginning of each frame and need to be delivered by the end of the frame (otherwise, packets will be dropped). Each link is required to guarantee a maximum allowable packet dropping rate. We show that the real-time scheduling problem is combinatorial and tends to be intractable as the network size increases. To solve the real-time scheduling problem, we propose a frame-based carrier-sense multiple access (CSMA) algorithm which is shown to be asymptotically optimal. Moreover, it can be implemented in a distributed manner with low complexity. Simulation results also demonstrate the ability of our algorithm to meet the QoS requirements on deadlines.
Premenstrual dysphoric disorder: evidence for a new category for DSM-5.

Premenstrual dysphoric disorder, which affects 2%–5% of premenopausal women, was included in Appendix B of DSMIV, "Criterion Sets and Axes Provided for Further Study. " Since then, aided by the inclusion of specific and rigorous criteria in DSM-IV, there has been an explosion of research on the epidemiology, phenomenology, pathogenesis, and treatment of the disorder. In 2009, the Mood Disorders Work Group for DSM-5 convened a group of experts to examine the literature on premenstrual dysphoric disorder and provide recommendations regarding the appropriate criteria and placement for the disorder in DSM-5. Based on thorough review and lengthy discussion, the work group proposed that the information on the diagnosis, treatment, and validation of the disorder has matured sufficiently for it to qualify as a full category in DSM-5. A move to the position of category, rather than a criterion set in need of further study, will provide greater legitimacy for the disorder and encourage the growth of evidence-based research, ultimately leading to new treatments.