Miracle-dz/UniFAR-FTUs huggingface dataset:
Surgically staged focal liver lesions: accuracy and reproducibility of dual-phase helical CT for detection and characterization.

PURPOSE To assess the accuracy and reproducibility of dual-phase helical computed tomography (CT) in enabling preoperative detection and characterization of surgically staged focal liver lesions. MATERIALS AND METHODS Surgically and histopathologically proven liver lesions were evaluated by three experienced CT readers. These lesions were present in 77 patients who underwent dual-phase helical CT. Images were interpreted separately by the three blinded reviewers. Each lesion was graded on a nine-point scale of confidence, with 1 being definitely benign, 9 being definitely malignant, and 5 being indeterminate. The chi2 test was used to determine if the distribution of lesion classifications was different between readers. RESULTS There was a total of 237 lesions: 73 were benign and 164 were malignant. Sensitivity for lesion detection was 69%, 70%, and 71% for the three reviewers, respectively. Specificity was 91%, 86%, and 90%, and the area under the curve for the alternative-free response receiver operating characteristic curve was 0.84, 0.83, and 0.85, respectively. The difference in the distributions of lesion classification between the three reviewers was not statistically significant (P =.67) as determined by chi2 analysis. CONCLUSION Dual-phase CT has sensitivity of 69%-71% and high specificity (86%-91%) in enabling the detection and characterization of focal liver lesions. Interpretation is highly reproducible, as there is minimal variation between experienced reviewers.
[Botulinum toxin and medical liability: is the patient sufficiently informed?].

INTRODUCTION The use of botulinum toxin injection therapy is soaring significantly today, with an ever-wider field of applications despite well-known side effects of the treatment. This article aims at analysing the medicolegal practices of practitioners who use this therapy, especially the information given to patients and finding a common practice for providing that information. METHODS We sent a questionnaire to 340 practitioners who might use the therapy (physiatrists, neurologists, ophthalmologists, ENT specialists, plastic surgeons) working in hospitals and in physical therapy and rehabilitation centres in France. Besides mentioning the possible side effects of the therapy, the questionnaire focused on how such information was transmitted before the injection. RESULTS Data collection and analysis were performed by use of a spreadsheet software programme. A total of 124 questionnaires were analysed. We did not analyse the items dealing with side effects. Sixty-five percent of the responders said they did not seek statutory authorisation for injections. Only 31% provided written, detailed information and 12% required a signed consent form. Complaints were rare, approximately 12%, were written or verbal, and were always dismissed. DISCUSSION Side effects after botulinum toxin injection are clearly described in the medical literature. Therefore, it is of utmost importance for this product to be used therapeutically and only by experienced therapists who will carefully respect the product's standard rules of use and inform their patients to the best of their ability. Issuing a detailed letter of information describing all the side effects seems necessary. We suggest a model information letter such as that provided to the patients in our facility. CONCLUSION Botulinum toxin is a very worthwhile product for numerous abnormalities but has side effects, often brief, at the site of the injection. Therefore it is our duty to inform patients effectively.
Function of the 30 kd protein of tobacco mosaic virus: involvement in cell‐to‐cell movement and dispensability for replication

We have investigated the function of the 30 kd protein of tobacco mosaic virus (TMV) by a reverse genetics approach. First, a point mutation of TMV Ls1 (a temperature‐sensitive mutant defective in cell‐to‐cell movement), that causes an amino acid substitution in the 30 kd protein, was introduced into the parent strain, TMV L. The generated mutant showed the same phenotype as TMV Ls1, and therefore the one‐base substitution in the 30 kd protein gene adequately explains the defectiveness of TMV Ls1. Next, four kinds of frame‐shift mutants were constructed, whose mutations are located at three different positions of the 30 kd protein gene. All the frame‐shift mutants were replication‐competent in protoplasts but none showed infectivity on tobacco plants. From these observations the 30 kd protein was confirmed to be involved in cell‐to‐cell movement. To clarify that the 30 kd protein is not necessary for replication, two kinds of deletion mutants were constructed; one lacking most of the 30 kd protein gene and the other lacking both the 30 kd and coat protein genes. Both mutants replicated in protoplasts and the former still produced the subgenomic mRNA for the coat protein. These results clearly showed that the 30 kd protein, as well as the coat protein, is dispensable for replication and that no cis‐acting element for replication is located in their coding sequences. It is also suggested that the signal for coat protein mRNA synthesis may be located within about 100 nucleotides upstream of the initiation codon of the coat protein gene.
Upper extremity improvements in chronic stroke: coupled bilateral load training.

BACKGROUND The current treatment intervention study determined the effect of coupled bilateral training (i.e., bilateral movements and EMG-triggered neuromuscular stimulation) and resistive load (mass) on upper extremity motor recovery in chronic stroke. METHODS Thirty chronic stroke subjects were randomly assigned to one of three behavioral treatment groups and completed 6 hours of rehabilitation in 4 days: (1) coupled bilateral training with a load on the unimpaired hand, (2) coupled bilateral training with no load on the unimpaired hand, and (3) control (no stimulation assistance or load). RESULTS Separate mixed design ANOVAs revealed improved motor capabilities by the coupled bilateral groups. From the pretest to the posttest, both the coupled bilateral no load and load groups moved a higher number of blocks and demonstrated more regularity in the sustained contraction task. Faster motor reaction times across test sessions for the coupled bilateral load group provided additional evidence for improved motor capabilities. CONCLUSIONS Together these behavioral findings lend support to the contribution of coupled bilateral training with a load on the unimpaired arm to improved motor capabilities on the impaired arm. This evidence supports a neural explanation in that simultaneously moving both limbs during stroke rehabilitation training appears to activate balanced interhemispheric interactions while an extra load on the unimpaired limb provides stability to the system.
The d‐xylose reductase of Hypocrea jecorina is the major aldose reductase in pentose and d‐galactose catabolism and necessary for β‐galactosidase and cellulase induction by lactose

The Hypocrea jecorinad‐xylose reductase encoding gene xyl1 shows low basal transcript levels, and is induced by d‐xylose, l‐arabinose and l‐arabinitol and, to a lesser extent, by lactose, d‐galactose, galactitol and xylitol. The recombinantly expressed XYL1 catalyzes the NADPH‐dependent reduction of the pentoses d‐xylose and l‐arabinose and the hexose d‐galactose. Deletion of xyl1 slightly reduces growth on all carbon sources, but a significant decrease is found on d‐xylose, l‐arabinose and d‐galactose. Similar to pentose degradation, XYL1 reduces d‐galactose to galactitol in a recently identified second d‐galactose pathway. Strains impaired in both d‐galactose pathways are almost unable to grow on d‐galactose. Δxyl1 strains show reduced growth on lactose and are impaired in β‐galactosidase expression and induction of the major cellobiohydrolase gene cbh1. A strain deleted in the cellulase regulator XYR1 is even more severely impaired in growth and β‐galactosidase expression on lactose, and does not produce any cbh1 transcript at all. In this strain, only a low basal level of xyl1 transcription is found on lactose. Galactitol, but not d‐galactose is able to induce xyl1 transcription in a XYR1‐independent manner. Our results show that the role of the H. jecorina XYL1 is not restricted to d‐xylose catabolism and demonstrates its importance for induction of cellulases and β‐galactosidases.
Using Data Augmentation to Facilitate Conduct of Phase I–II Clinical Trials With Delayed Outcomes

A practical impediment in adaptive clinical trials is that outcomes must be observed soon enough to apply decision rules to choose treatments for new patients. For example, if outcomes take up to six weeks to evaluate and the accrual rate is one patient per week, on average three new patients will be accrued while waiting to evaluate the outcomes of the previous three patients. The question is how to treat the new patients. This logistical problem persists throughout the trial. Various ad hoc practical solutions are used, none entirely satisfactory. We focus on this problem in phase I–II clinical trials that use binary toxicity and efficacy, defined in terms of event times, to choose doses adaptively for successive cohorts. We propose a general approach to this problem that treats late-onset outcomes as missing data, uses data augmentation to impute missing outcomes from posterior predictive distributions computed from partial follow-up times and complete outcome data, and applies the design’s decision rules using the completed data. We illustrate the method with two cancer trials conducted using a phase I–II design based on efficacy–toxicity trade-offs, including a computer stimulation study. Supplementary materials for this article are available online.
Percepción del clima de aceptación de la diversidad en las organizaciones: un estudio con líderes argentinos

El objetivo de este trabajo consistio en construir y validar una prueba (clima de aceptacion de la diversidad, CLIAD) en idioma espanol para evaluar el clima percibido por los miembros de una organizacion acerca de su ambiente de trabajo. El clima de aceptacion de la diversidad es entendido como las creencias generalizadas acerca de las normas y conductas reinantes en una organizacion y como los premios estan relacionados con los esfuerzos de los empleados. La version final de la prueba consta de 13 items. Los resultados obtenidos permiten afirmar que el CLIAD presenta propiedades psicometricas satisfactorias (fiabilidad y validez). Para obtener la evidencia de validez externa se utilizaron otros instrumentos (Organizational Description Questionnaire, Bass y Avolio, 1992; Bienestar Laboral, Ward, 1990). El CLIAD corre¬laciona positivamente con un clima organizacional transformacional y con satisfaccion laboral percibida. Participaron 374 lideres, 241 habian liderado personal en el exterior en un promedio de 3,45 anos (DE=4.99). Por otro lado, participaron 133 lideres que no habian liderado en el exterior. Todos eran residentes de la Ciudad Autonoma de Buenos Aires y Conurbano Bonaerense.
Knowledge of AIDS, Perceived Risk of AIDS, and At–Risk Sexual Behaviors Among Older Adults

Purpose To identify older adults' knowledge of acquired immune deficiency syndrome (AIDS), perceptions of their risk of AIDS, and at‐risk behaviors by using a questionnaire derived from the health belief model. Data Sources A descriptive correlation design was used to survey persons 50 years of age and older who participate in university‐based senior programs. The sample of 166 persons (55% return rate) had a mean age of 71 years and included 33% males. The sample is representative of the participants in these programs. Conclusions Five hypotheses based on the health belief model were tested. Statistical analyses showed significant predictors of the likelihood of using recommended safe sexual practices were gender, knowledge of AIDS, perceived susceptibility to AIDS, and perceived threat of AIDS. The results indicated the respondents were knowledgeable about human immunodeficiency virus (HIV) transmission through casual contact and medical aspects of AIDS. Although the respondents recognized the seri‐ousness of AIDS, they generally did not believe that they were susceptible to this disease, even though about 10% indicated sexual activity outside of a long‐term relationship. Implications for Practice The study findings support the need for nurse practitioners to assess sexual behaviors in and provide information about safe sex practices to older clients because of the documented rising incidence of AIDS in persons over 50 years of age.
Neural regeneration along longitudinal polyglactin sutures across short and extended defects in the rat sciatic nerve.

OBJECT The authors have previously shown that longitudinal sutures without artificial tube support regeneration across a 7-mm gap in the rat sciatic nerve. In the present study, the authors compared this new approach with the use of autologous nerve grafts across short defects and examined whether the approach could be used to support regeneration across extended gaps and whether the interposition of a short nerve segment (the stepping-stone procedure) was applicable in this model. METHODS Longitudinal sutures were used to bridge 7- and 15-mm gaps in the rat sciatic nerve. Contralateral comparisons were made to nerve autografts in the 7-mm group and to sutures plus a short interposed nerve segment in the 15-mm group. Regeneration was evaluated at 2, 4, and 12 weeks by using immunocytochemical analysis for Schwann cells, neurofilament protein, and macrophages and at 12 weeks also by using histological examination, including morphometry in the distal tibial trunk and tetanic force measurements in the gastrocnemius muscle. CONCLUSIONS The authors found that the results of regeneration after repair with longitudinal polyglactin sutures across short defects were not significantly different from those produced by the use of autologous nerve grafts. Regeneration, although poor, occurred along sutures across extended gaps and was significantly enhanced by an interposed nerve segment acting as a Schwann cell resource in this model.
Functional studies on the role of the C-terminal domain of mammalian polo-like kinase

Mammalian polo-like kinase (Plk) acts at various stages in early and late mitosis. Plk is phosphorylated and activated in mitosis, and the proper subcellular localization of Plk is essential for mitotic regulation. We have observed that overexpression of the C-terminal domain of Plk is more effective than wild-type or kinase-defective Plk in causing mitotic delay or arrest. The specific activity of Plk with C-terminal deletions or substitution of aspartate for threonine-210 is increased severalfold relative to wild type. We show in this communication that the C-terminal domain can bind to full-length or the catalytic domain of Plk and inhibit its kinase activity, and that this binding is disrupted when threonine-210 is substituted with an aspartic acid residue. The C-terminal domain binds unphosphorylated Plk from G2 arrested cells, but not phosphorylated Plk from mitotic cells. Green fluorescent protein–C-terminal Plk is localized at the centrosome and the midbody of transfected cells as shown previously for full-length enzyme. These and other data indicate that although the C terminus serves to regulate Plk kinase activity, the localization of the C terminus at the centrosome and other sites in transfected cells may block the correct localization of endogenous Plk.
Activity of a specific inhibitor of the BCR-ABL tyrosine kinase in the blast crisis of chronic myeloid leukemia and acute lymphoblastic leukemia with the Philadelphia chromosome.

BACKGROUND BCR-ABL, a constitutively activated tyrosine kinase, is the product of the Philadelphia chromosome. This enzyme is present in virtually all cases of chronic myeloid leukemia (CML) throughout the course of the disease, and in 20 percent of cases of acute lymphoblastic leukemia (ALL). On the basis of the substantial activity of the inhibitor in patients in the chronic phase, we evaluated STI571 (formerly known as CGP 57148B), a specific inhibitor of the BCR-ABL tyrosine kinase, in patients who had CML in blast crisis and in patients with ALL who had the Ph chromosome. METHODS In this dose-escalating pilot study, 58 patients were treated with STI571; 38 patients had a myeloid blast crisis and 20 had ALL or a lymphoid blast crisis. Treatment was given orally at daily doses ranging from 300 to 1000 mg. RESULTS Responses occurred in 21 of 38 patients (55 percent) with a myeloid-blast-crisis phenotype; 4 of these 21 patients had a complete hematologic response. Of 20 patients with a lymphoid blast crisis or ALL, 14 (70 percent) had a response, including 4 who had complete responses. Seven patients with a myeloid blast crisis continue to receive treatment and remain in remission from 101 to 349 days after starting the treatment. All but one patient with a lymphoid blast crisis or ALL has relapsed. The most frequent adverse effects were nausea, vomiting, edema, thrombocytopenia, and neutropenia. CONCLUSIONS The BCR-ABL tyrosine kinase inhibitor STI571 is well tolerated and has substantial activity in the blast crises of CML and in Ph-positive ALL.
Distinction between intraductal carcinoma of the prostate (IDC‐P), high‐grade dysplasia (PIN), and invasive prostatic adenocarcinoma, using molecular markers of cancer progression

Prostate ducts and acini whose lumens are filled with malignant cells represent a well‐recognized histological pattern recently termed intraductal carcinoma of the prostate (IDC‐P). These tumors are often associated with rapid disease progression, and most recur after radical surgery. Controversy exists as to whether IDC‐P should be recognized as a separate entity, an extension of high‐grade dysplasia (PIN) or invasive carcinoma as described by the Gleason grading system. This study investigates the use of molecular markers in defining the position of IDC‐P in the evolutionary hierarchy of prostate cancer progression.
The association between body mass index and increased utilization of healthcare services: a retrospective cohort study of 51,521 young adult males.

OBJECTIVE To examine the association between the entire body mass index (BMI) range and healthcare utilization. METHODS Weight and height were measured during medical examinations of recruits prior to their entry into the military in Israel. All recruits were followed-up during service and all of their medical information was recorded in a central electronic medical record. We extracted medical and sociodemographic data for all Jewish male combat recruits during their first year of service. The study included 51,521 subjects who were divided into quintiles according to BMI. Using logistic regression models, we determined the association between BMI and high numbers of physician encounters, emergency room visits, referrals to specialists, imaging, laboratory tests, and medication prescriptions. RESULTS In comparison with the lowest BMI quintile, there was a significant increase in the highest quintile with regard to an increased number of physician encounters (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19-1.36), emergency room visits (OR, 1.2; 95% CI, 1.12-1.29), referrals to specialists (OR, 1.22; 95% CI, 1.14-1.31), and medication prescriptions (OR, 1.23; 95% CI, 1.15-1.32). An increase in the number of laboratory tests was not statistically significant and there was no difference in imaging referrals. Adjustment for various sociodemographic variables and medical conditions did not significantly change the results. CONCLUSION Higher BMI is related to increased utilization of healthcare services, even for BMI values in the normal range.
Improved long-term clinical outcomes in patients with ST-elevation myocardial infarction undergoing remote ischaemic conditioning as an adjunct to primary percutaneous coronary intervention.

AIMS Remote ischaemic conditioning as an adjunct to primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction increases myocardial salvage. We investigated the effect of remote ischaemic conditioning on long-term clinical outcome. METHODS AND RESULTS From February 2007 to November 2008, 333 patients with a suspected first acute ST-elevation myocardial infarction were randomized to receive primary percutaneous coronary intervention with (n = 166) or without (n = 167) remote ischaemic conditioning (intermittent arm ischaemia through four cycles of 5-min inflation followed by 5-min deflation of a blood-pressure cuff). Patient follow-up extended from the randomization date until an outcome, emigration or January 2012 (median follow-up = 3.8 years). The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE)-a composite of all-cause mortality, myocardial infarction, readmission for heart failure, and ischaemic stroke/transient ischaemic attack. The individual components of the primary endpoint comprised the secondary endpoints. Outcomes were obtained from Danish nationwide medical registries and validated by medical record review and contact to patients' general practitioner. In the per-protocol analysis of 251 patient fulfilling trial criteria, MACCE occurred for 17 (13.5%) patients in the intervention group compared with 32 (25.6%) patients in the control group, yielding a hazard ratio (HR) of 0.49 (95% confidence interval: 0.27-0.89, P = 0.018). The HR for all-cause mortality was 0.32 (95% confidence interval: 0.12-0.88, P = 0.027). Although lower precision, the HRs were also directionally lower for all other secondary endpoints. CONCLUSION Remote ischaemic conditioning before primary percutaneous coronary intervention seemed to improve long-term clinical outcomes in patients with ST-elevation myocardial infarction.
The synaptophysin/synaptobrevin interaction critically depends on the cholesterol content

Synaptophysin interacts with synaptobrevin in membranes of adult small synaptic vesicles. The synaptophysin/synaptobrevin complex promotes synaptobrevin to built up functional SNARE complexes thereby modulating synaptic efficiency. Synaptophysin in addition is a cholesterol‐binding protein. Depleting the membranous cholesterol content by filipin or β‐methylcyclodextrin (β‐MCD) decreased the solubility of synaptophysin in Triton X‐100 with less effects on synaptobrevin. In small synaptic vesicles from rat brain the synaptophysin/synaptobrevin complex was diminished upon β‐MCD treatment as revealed by chemical cross‐linking. Mice with a genetic mutation in the Niemann–Pick C1 gene developing a defect in cholesterol sorting showed significantly reduced amounts of the synaptophysin/synaptobrevin complex compared to their homo‐ or heterozygous littermates. Finally when using primary cultures of mouse hippocampus the synaptophysin/synaptobrevin complex was down‐regulated after depleting the endogenous cholesterol content by the HMG‐CoA‐reductase inhibitor lovastatin. Alternatively, treatment with cholesterol up‐regulated the synaptophysin/synaptobrevin interaction in these cultures. These data indicate that the synaptophysin/synaptobrevin interaction critically depends on a high cholesterol content in the membrane of synaptic vesicles. Variations in the availability of cholesterol may promote or impair synaptic efficiency by interfering with this complex.