Miracle-dz/UniFAR-FTUs huggingface dataset:
Inappropriate oophorectomy at time of benign premenopausal hysterectomy*

Objective: We assessed rates of oophorectomy during benign hysterectomy around the release of the American College of Obstetricians and Gynecologists 2008 practice bulletin on prophylactic oophorectomy, and evaluated predictors of inappropriate premenopausal oophorectomy. Methods: A cross-sectional administrative database analysis was performed utilizing the California Office of Statewide Health Planning Development Patient Discharge Database for years 2005 to 2011. After identifying all premenopausal women undergoing hysterectomy for benign conditions, International Classification of Diseases (ICD)-9 diagnosis codes were reviewed to create a master list of indications for oophorectomy. We defined appropriate oophorectomy as cases with concomitant coding for ovarian cyst, breast cancer susceptibility gene carrier status, and other diagnoses. Using patient demographics and hospital characteristics to predict inappropriate oophorectomy, a logistic regression model was created. Results: We identified 57,776 benign premenopausal hysterectomies with oophorectomies during the period studied. Of the premenopausal oophorectomies, 37.7% (21,783) were deemed “inappropriate” with no documented reason for removal. The total number of premenopausal inpatient hysterectomies with oophorectomy decreased yearly (12,227/y in 2005 to 5,930/y in 2011). However, the percentage of inappropriate oophorectomies remained stable. In multivariate analysis, Hispanic and African American ethnicity/race associated with increased odds of inappropriate oophorectomy (P < 0.001). Urban and at low Medi-Cal utilization hospitals showed increased odds of inappropriate oophorectomy. Conclusions: In premenopausal women undergoing benign hysterectomy, over one-third undergo oophorectomy without an appropriate indication documented. The rate of inappropriate oophorectomy in California has not changed since the 2008 American College of Obstetricians and Gynecologists guidelines. Whereas the absolute number of inpatient hysterectomies for benign indications has decreased, our work suggests persistent utilization of oophorectomy in premenopausal women, despite well-documented long-term adverse health implications.
Rebreathing affects deadspace measurements using the Siemens-Elema 930 CO2 analyzer.

Dr. Fletcher presents an excellent discussion of respiratory deadspace in anesthetized children with cardiac disease (1). However, he does not caution against an error that may occur when using the Siemens-Elema 930 CO, analyzer. The design of this analyzer is such that it always assumes that there is no rebreathing of expired gases (2 ) . The inspired gases are taken as the reference against which to measure the CO, concentration in the expired gases. If rebreathing occurs, the 930 analyzer will indicate that end-tidal CO, is lower than it actually is. We observed rebreathing measured by mass spectrometry in infants and children ventilated with a Siemens-Elema W C Servo when inspirat0ry:expiratory ratios (1:E) were d : 3 . 5 (i.e., 1:4, 1:5, 1:6) (3). Therefore, if rebreathing occurred in Dr. Fletcher’s patients, the PaCO, P,,CO, gradient would be inaccurate and non-invasive measurement of respiratory deadspace would be affected.
Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women's Health Initiative Observational Study

Objective: To determine the association between use of vaginal estrogen and risk of a global index event (GIE), defined as time to first occurrence of coronary heart disease (CHD), invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, or death from any cause. Methods: For this prospective observational cohort study, we used data from participants of the Women's Health Initiative Observational Study, who were recruited at 40 US clinical centers, aged 50 to 79 years at baseline and did not use systemic estrogen therapy during follow-up (n = 45,663, median follow-up 7.2 years). We collected data regarding incident CHD, invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, death, and self-reported use of vaginal estrogen (cream, tablet). We used Cox proportional-hazards regression models to adjust for covariates. Results: Among women with an intact uterus, the risks of stroke, invasive breast cancer, colorectal cancer, endometrial cancer, and pulmonary embolism/deep vein thrombosis were not significantly different between vaginal estrogen users and nonusers, whereas the risks of CHD, fracture, all-cause mortality, and GIE were lower in users than in nonusers (GIE adjusted hazard ratio 0.68, 95% confidence interval 0.55-0.86). Among hysterectomized women, the risks of each of the individual GIE components and of the overall GIE were not significantly different in users versus nonusers of vaginal estrogen (GIE adjusted hazard ratio 0.94, 95% confidence interval 0.70-1.26). Conclusions: The risks of cardiovascular disease and cancer were not elevated among postmenopausal women using vaginal estrogens, providing reassurance about the safety of treatment.
The role of hysteroscopy with eye-directed biopsy in postmenopausal women with uterine bleeding and endometrial atrophy

Objective:To determine the diagnostic accuracy of transvaginal ultrasonography (TVS) and hysteroscopy for the diagnosis of endometrial pathology in postmenopausal women with abnormal uterine bleeding (AUB). Design:This prospective nonrandomized study was conducted on 752 postmenopausal women with AUB who underwent TVS and outpatient hysteroscopy with eye-directed biopsy. Histologic diagnoses were compared with the ultrasonographic and hysteroscopic findings, and the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were determined. Results:In three cases of atrophic endometrium on hysteroscopy, histologic examination revealed endometrial carcinoma. TVS using an endometrial thickness of less than 4 mm as the cutoff showed sensitivity of 89%, specificity of 86%, a positive predictive value of 82%, a negative predictive value of 92%, and diagnostic accuracy of 87%. Hysteroscopy was technically successful in all women and revealed sensitivity of 98%, specificity of 91%, a positive predictive value of 88%, a negative predictive value of 98%, and diagnostic accuracy of 94%. Conclusions:Hysteroscopy is a significantly more accurate diagnostic method for the detection of endometrial pathology than TVS, has better specificity, and should be considered for all patients with AUB with an endometrial thickness of more than 4 mm. Hysteroscopy shows great efficiency in the diagnosis of focal abnormalities of the endometrium, which are unlikely recognized by ultrasonography and should be indicated in cases of AUB with an endometrial thickness less than 4 mm on ultrasonography because of the possibility of missing infrequent (0.8%) but relevant endometrial pathologies. Among such women showing abnormal or suspicious lesions, it is necessary to perform hysteroscopy with eye-directed biopsy because some cases of endometrial carcinoma could be missed.
Regulation and localization of ribosomal protein S6 kinase 1 isoforms

Ribosomal protein S6 kinase 1 (S6K1), a critical mediator of cell growth, is overexpressed in breast cancer and is associated with poor prognosis. S6K1 has two known isoforms, p85S6K1 and p70S6K1. p85S6K1 is characterized by 23 additional amino acids in the N-terminus of p70S6K1. This is thought to target p85S6K1 to the nucleus, while p70S6K1 is mainly cytoplasmic. We sought to determine the activation, regulation, and function of p70S6K1 and p85S6K1 in breast cancer. We found that most breast cancer cell lines expressed both isoforms. Mitogen-dependent pathways concordantly regulated phosphorylation on T389, S371, and T421/S424. Phosphorylation of both isoforms was inhibited by PI3K/mTOR inhibitors. Mitogen-dependent pathways concordantly regulated the phosphorylation of the two isoforms on T389, S371, and T421/S424. Both isoforms had S6 kinase activity. We also detected a p60 isoform with antibodies to the p70S6K1 C-terminal but not the N-terminal. Further studies on S6K1 isoforms are warranted for therapeutically targeting this pathway.
Preparation and optimization of rivastigmine-loaded tocopherol succinate-based solid lipid nanoparticles

Abstract Rivastigmine hydrogen tartrate (RHT) is a pseudo-irreversible inhibitor of cholinesterase and is used for the treatment of Alzheimer's. However, RHT delivery to the brain is limited by the blood–brain barrier (BBB). The purpose of this study was to improve the brain-targeting delivery of RHT by producing and optimizing rivastigmine hydrogen tartrate-loaded tocopherol succinate-based solid lipid nanoparticles (RHT-SLNs). RHT-SLNs were prepared using the microemulsion technique. The impact of significant variables, such as surfactant concentration and drug/lipid ratio, on the size of RHT-SLNs and their drug loading and encapsulation efficiency was analysed using a five-level central composite design (CCD). The minimum size of particles and the maximum efficiency of loading and encapsulation were defined according to models derived from a statistical analysis performed under optimal predicted conditions. The experimental results of optimized RHT-SLNs showed an appropriate particle size of 15.6 nm, 72.4% drug encapsulation efficiency and 6.8% loading efficiency, which revealed a good correlation between the experimental and predicted values. Furthermore, in vitro release studies showed a sustained release of RHT from RHT-SLNs.
Risk Factors for the Spread of Parasitic Zoonoses among Domestic Cat Owners and Their Families in Rural Areas

The close animal – human contacts are risky for people especially in cases of any negligence towards proper veterinary care, deworming and vaccination procedures as well as human and cat hygiene. Among possible risks there are parasitic zoonoses threats. The study involved 146 cat owners from selected rural areas in Lublin province. Altogether they possessed 309 cats. A special original inquiry questionnaire was used. The survey was carried out during the period: January 2011– May 2011. Most of polled (84.9%) have reported deworming procedure negligence, 60.4% of polled have never bathed their cats, only 63.7% of cat owners have declared separations of humans’ and cats’ sleeping places, 65.1% of owners have declared no any restrictions concerning cats’ movement around both wild environment and children’s places for fun and recreation. Conclusions: In rural areas, hygiene and veterinary cats care negligence as well as animal – human coexistence conditions may increase the risk of zoonotic parasite diseases spreading.
Is long-term bisphosphonate therapy associated with benefits to the periodontium in postmenopausal women?

Objective: The aim of this study was to compare the periodontium of postmenopausal women with known low bone mineral density who are receiving long-term bisphosphonate therapy with those who are not. Methods: The periodontal status of 28 white postmenopausal women with low bone density using bisphosphonate therapy for at least 2 years was compared with that of a matching group not using such therapy. All women underwent a cone-beam CT scan of the jaw and a complete periodontal examination evaluating for plaque score, periodontal probing depth, clinical attachment loss, bleeding on probing, and alveolar bone height. Results: Bisphosphonate users had higher plaque score, lower probing depth, and lesser clinical attachment loss compared with the controls. These differences were determined to be significant by both t test and Wilcoxon's tests. Bleeding on probing was lower and the alveolar bone height was higher in the bisphosphonate group than in controls, but these differences were not statistically significant. Linear models showed no significant interactions between plaque score and bisphosphonate use, suggesting that the association of periodontal status and outcome measures was constant across all levels of plaque scores. Bisphosphonate use was a significant factor for probing depth but was not significant for the other parameters when adjusted for plaque score. Conclusions: Long-term bisphosphonate use seems to have some beneficial effects on the periodontium of postmenopausal women with low bone density, across all levels of plaque score.
Hydroboration of graphene oxide: towards stoichiometric graphol and hydroxygraphane.

Covalently functionalized graphene materials with well-defined stoichiometric composition are of a very high importance in the research of 2D carbon material family due to their well-defined properties. Unfortunately, most of the contemporary graphene-functionalized materials do not have this kind of defined composition and, usually, the amount of heteroatoms bonded to graphene framework is in the range of 1-10 at. %. Herein, we show that by a well-established hydroboration reaction chain, which introduces -BH2 groups into the graphene oxide structure, followed by H2O2 or CF3COOH treatment as source of -OH or -H, we can obtain highly hydroxylated compounds of precisely defined composition with a general formula (C1O0.78H0.75)n, which we named graphol and highly hydroxylated graphane (C1(OH)0.51H0. 14)n, respectively. These highly functionalized materials with an accurately defined composition are highly important for the field of graphene derivatives. The enhanced electrochemical performance towards important biomarkers as well as hydrogen evolution reaction is demonstrated.
A Case of Central Serous Chorioretinopathy after Glaucoma Filtering Surgery

Purpose: To report a case of central serous chorioretinopathy development after glaucoma filtering surgery and spontaneous resolution in a patient with a history of central serous chorioretinopathy in the contralateral eye. Case summary: A 46-year-old male with a history of chronic uveitis in both eyes presented with uncontrolled intraocular pressure (IOP) in his left eye. Initial IOP was 34 mm Hg in his left eye. On preoperative evaluation, central serous chorioretinopathy, which was diagnosed in another clinic 1 month prior, was observed in his right eye. Slightly pale optic disc and retinal nerve fiber layer defects were noted in the left eye. However, macular abnormalities were not observed in the left eye. Trabeculectomy and peripheral iridectomy using mitomycin C were performed in the left eye. The patient was prescribed triamcinolone 8 mg daily for 4 days to reduce the post-surgical inflammation. On postoperative day 4, IOP in the left eye was 7 mm Hg and newly developed central serous chorioretinopathy was noted. On follow-up, IOP was maintained at 7-10 mm Hg and central serous chorioretinopathy disappeared 7 months postoperatively. Conclusions: When clinicians consider performing an ophthalmological procedure in a patient with a history of central serous chorioretinopathy in the contralateral eye, careful observation of central serous chorioretinopathy development is recommended. J Korean Ophthalmol Soc 2014;55(12):1895-1900
Visual and proprioceptive contributions to postural control of upright stance in unilateral vestibulopathy

Abstract Preserving upright stance requires central integration of the sensory systems and appropriate motor output from the neuromuscular system to keep the centre of pressure (COP) within the base of support. Unilateral peripheral vestibular disorder (UPVD) causes diminished stance stability. The aim of this study was to determine the limits of stability and to examine the contribution of multiple sensory systems to upright standing in UPVD patients and healthy subjects. We hypothesized that closure of the eyes and Achilles tendon vibration during upright stance will augment the postural sway in UPVD patients more than in healthy subjects. Seventeen UPVD patients and 17 healthy subjects performed six tasks on a force plate: forwards and backwards leaning, to determine limits of stability, and upright standing with and without Achilles tendon vibration, each with eyes open and closed (with blackout glasses). The COP displacement of the patients was significantly greater in the vibration tasks than the controls and came closer to the posterior base of support boundary than the controls in all tasks. Achilles tendon vibration led to a distinctly more backward sway in both subject groups. Five of the patients could not complete the eyes closed with vibration task. Due to the greater reduction in stance stability when the proprioceptive, compared with the visual, sensory system was disturbed, we suggest that proprioception may be more important for maintaining upright stance than vision. UPVD patients, in particular, showed more difficulty in controlling postural stability in the posterior direction with visual and proprioceptive sensory disturbance.
Effect of sitting postures and shoulder position on the cervicocephalic kinesthesia in healthy young males

Abstract Information about head orientation, position, and movement with respect to the trunk relies on the visual, vestibular, extensive muscular, and articular proprioceptive system of the neck. Various factors can affect proprioception since it is the function of afferent integration, and tuning of muscular and articular receptors. Pain, muscle fatigue, and joint position have been shown to affect proprioceptive capacity. Thus, it can be speculated that changes in body posture can alter the neck proprioception. This study was undertaken to investigate the effect of body posture on cervicocephalic kinesthetic sense in healthy subjects. Cervicocephalic kinesthetic sensibility was measured by the kinesthetic sensibility test in healthy young adults while in (a) habitual slouched sitting position with arms hanging by the side (SS), (b) habitual slouched sitting position with arms unloaded (supported) (SS-AS), and (c) upright sitting position with arms hanging by the side (US) during maximum and 30 degree right, left rotations, flexion, and extension. Thirty healthy male adults (mean age 27.83; SD 3.41) volunteered for this study. The least mean error was found for the SS-AS position (0.48; SD 0.24), followed by SS (0.60; SD 0.43) and US (0.96; SD 0.71), respectively. For all test conditions, there was significant difference in mean absolute error while head repositioning from maximum and 30 degree rotation during SS and SS-AS positions (p < 0.05). In conclusion, body posture can affect the proprioception function of the neck. Supporting the upper extremities in such a way that their weight is unloaded, which leads to reduction in the tension between the neck and shoulder girdle, can improve cervicocephalic kinesthetic sense in both the horizontal and vertical planes. The findings of this study can be implemented in people who have to do repeated arm and neck movements, by using ergonomically effective chairs with proper arm supports. This might help in prevention and treatment of neck pain.
Transmission of Hepatitis C Virus From a Mother to a Child Carrying IL28B Heterozygote rs8099917 Among Three Brothers: A Long-Term Follow-Up

Three male children were born every 2 years by spontaneous delivery from a mother infected with hepatitis C virus (HCV) genotype 2b, and all have been followed up after birth. The viral load in the serum of the mother was high before their deliveries, and anti-HCV antibody immunoglobulin G, which is allowed to pass through placenta, was positive in the umbilical blood of all the children. Mother-to-child transmission of HCV was confirmed in the second son, who was positive for both anti-HCV antibody and serum HCV RNA when first examined 108 days after birth, but not in the other siblings. Persistent HCV genotype 2b infection with mild elevation of the serum alanine aminotransferase level has been established in the second son for more than 14 years. The interleukin 28B ( IL28B ) genotype (rs8099917) of the second son showed the TG heterozygote, which is unfavorable for viral clearance, and this may predict persistent HCV infection. Among the three brothers sharing the same delivery conditions with exposure to the same virus, as well as sharing the same environment after birth, HCV infection has not been consistent, and one of them possessing the TG genotype of the IL28B gene (rs8099917) has had chronic HCV infection. These cases suggest that maternal HCV transmission does not occur so often, even among multiple children who are exposed to the same HCV with a high viral load, and that this variation might be attributable to very minor events that can impact on viral exposure in the perinatal period. J Med Cases. 2014;5(4):227-231 doi: http://dx.doi. org/10.14740/jmc1736w
Effects of low-frequency repetitive transcranial magnetic stimulation on upper extremity motor recovery and functional outcomes in chronic stroke patients: A randomized controlled trial

Abstract Background: Repetitive transcranial magnetic stimulation (rTMS) was suggested as a preconditioning method that would increase brain plasticity and that it would be optimal to combine rTMS with intensive rehabilitation. Objective: To assess the efficacy of inhibitory rTMS on upper extremity motor recovery and functional outcomes in chronic ischemic stroke patients. Methods: In this randomized controlled trial, experimental group received low-frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT), and control group received PT. Results: No statistically significant difference was found in baseline demographical and clinical characteristics of the subjects including stroke severity or severity of paralysis prior to intervention. There were statistically significant improvements in all clinical outcome measures except for the Brunnstrom Recovery Stages. Fugl–Meyer Assessment, Box and Block test, motor and total scores of Functional Independence Measurement (FIM), and Functional Ambulation Scale (FAS) scores were significantly increased in both groups, however, these changes were significantly greater in the rTMS group except for FAS score. FIM cognitive scores and standardized mini-mental test scores were significantly increased and distal and hand Modified Ashworth Scale scores were significantly decreased only in the rTMS group (p < .05). Conclusions: LF-rTMS can safely facilitate upper extremity motor recovery in patients with chronic ischemic stroke. TMS seems to be a promising treatment for motor, functional, and cognitive deficits in chronic stroke. Further studies with a larger number of patients with longer follow-up periods are needed to establish its effectiveness in stroke rehabilitation.
Effect of TPMPA (GABAC receptor antagonist) on neuronal response properties in rat barrel cortex

Abstract GABAC receptors are ligand-gated chloride channels and have important roles in some neurological functions like vision. Recent investigations demonstrated that these receptors are also expressed in the somatosensory cortex. In this study, we investigated the effect of (1,2,5,6-tetrahydropyridin-4-yl)methylphosphinic acid (TPMPA) (GABAC receptor antagonist) on the properties of the neuronal response to natural stimuli (whisker deflection) in deep layers of rat barrel cortex. Twenty-eight male Wistar rats, weighing 230–260 g, were used in this study. TPMPA (100 μmol/rat) was administered intracerebroventricularly (ICV). Neuronal responses to deflection of principal (PW) and adjacent (AW) whiskers were recorded in barrel cortex using tungsten microelectrodes. A computer-controlled mechanical displacement was used to deflect whiskers individually or in combination at 30 ms inter-stimulus intervals. ON and OFF responses for PW and AW deflections were measured. A condition-test ratio (CTR) was computed to quantify neuronal responses to whisker interactions. Our data suggest that ICV administration of TPMPA increased neuronal spontaneous activity, ON and OFF responses to PW, and/or AW deflections. However, CTR for neither ON nor OFF responses changed following TPMPA administration. The results of this study demonstrated that inhibition of GABAC receptors by TPMPA can modulate neuronal response properties in rat barrel cortex.