Miracle-dz/UniFAR-FTUs huggingface dataset:
Distinguishing Erosive Lichen Planus From Differentiated Vulvar Intraepithelial Neoplasia

ObjectiveErosive lichen planus (LP) and differentiated vulvar intraepithelial neoplasia (dVIN) may display overlapping histopathologic features. Materials and MethodsWe searched the local pathology database for vulvar biopsies reported as dVIN or erosive vulvitis during 2011 to 2013 inclusive. After review of patient notes and slides, there were 5 cases with a clinical appearance and course consistent with erosive LP and histopathology showing epithelial regeneration. We then selected 5 cases of dVIN in which the clinical course and histopathology supported the diagnosis. We performed immunohistochemistry for p16 and p53 on all cases and did copy variant analysis on 1 case each of erosive LP and dVIN. ResultsHistopathology of the LP cases showed epithelial thinning, absent stratum corneum, lack of maturation, as well as nuclear changes of enlargement, pleomorphism, and hyperchromasia. Three LP cases (60%) showed a wild-type p53 pattern and 2 (40%) were confluent positive. Two dVIN cases (40%) showed full-thickness loss of differentiation. One case (20%) of dVIN was p53 negative, 2 (40%) were wild-type, 1 was confluent positive, and 1 showed dark suprabasilar staining. All cases were negative for p16. Compared with control, erosive LP epithelium showed a similar copy-number pattern, whereas the dVIN epithelium had many copy-number changes. ConclusionsA small subset of clinically diagnosed vulvovaginal erosive LP will show on histopathology a regenerative erosive vulvitis with loss of epithelial maturation and nuclear changes, which requires clinicopathologic correlation to distinguish from dVIN.
Gilbert Thomas Walker, 1868-1958

Gilbert Thomas Walker was born on 14 June 1868, the eldest son and fourth child of a family of eight. His father, Thomas Walker, M.I. C.E. , was Borough Engineer of Croydon, and was one of the pioneers in the use of concrete for big structures like reservoirs for town water supplies. He came from Eckington, a village north of Chesterfield, and was one of seven children. Gilbert’s mother, Elizabeth Haslehurst, was one of a family of four. She became a permanent invalid when Gilbert was about six years old. Gilbert’s first school was Whitgift Grammar School of Croydon, which he entered in 1876. There he showed an early interest in arithmetic and mechanics. In 1881 he won a scholarship to St Paul’s School, then under the famous headmaster F. W. Walker. There, according to his own account, he spent two years on the classical side but was then ‘sent in disgrace’ to the mathematical side when he made some appalling linguistic blunder. In 1884, he passed the London matriculation and was given a small prize awarded to the best students who intended to take a London degree.
Evaluation of Viral Load as a Triage Strategy With Primary High-Risk Human Papillomavirus Cervical Cancer Screening

Objective The aim of the study was to evaluate the human papillomavirus (HPV) viral load combined with cytology as a secondary screening strategy after primary HPV screening. Materials and Methods The data referring to direct Hybrid Capture 2 (HC2), cytology, and histology from Shenzhen Cervical Cancer Screening Trial II were re-analyzed to determine the correlation between viral load and cervical lesions. In addition, algorithms using different viral loads as cut points for immediate colposcopy plus cytology triage were compared with several recommended or controversial primary screening methods. Results A total of 8,556 women with a mean age of 38.9 years were included in the analysis, of which 13.67% tested high-risk HPV positive with a prevalence of 2.72% for cervical intraepithelial neoplasia 2+ (CIN 2+) and 1.65% for CIN 3+. A significant correlation was observed between increasing relative light units/control (RLU/CO) values and worsening cervical lesions. The mean RLU/CO values for negative, CIN 1, CIN 2, CIN 3, and cancer were 6.86, 119.43, 410.90, 449.39, and 853.26, respectively. A larger proportion of HPV infections with relative high viral load (≥10 RLU/CO) were found in higher-grade lesions. The algorithm using 10 or greater RLU/CO as cut point for immediate colposcopy followed by triage cytology for the other positive (≥1 < 10 RLU/CO) had sensitivity of 93.13%/96.45% and specificity of 92.32%/91.44% for CIN 2+/3+, and the colposcopy referral rate was 10.00%. Conclusions Human papillomavirus viral load level is positively associated with cervical lesion grade. Ten relative light units/control or greater is a viable threshold for immediate colposcopy whereas 1 or greater or less than 10 RLU/CO is advised to reflex cytology for optimizing sensitivity and specificity, as well as referral rates.
Increased detection of clue cells in smears from cervical intraepithelial lesions with reduced expression of COX‐2

The relation between the detection of clue cells in cervical smears of women with CIN and the expression of COX‐2 in these lesions were determined. Samples from 228 women, treated due to CIN and who underwent cervical conization, were obtained. Hybrid Capture II and Pap smear samples were collected immediately before performing conization. Pathological diagnoses were 11 (5%) normal cervix, 35 (15%) CIN1, 31 (14%) CIN2, and 151 (66%) CIN3. COX‐2 immunoreactivity grading on the pathological specimens was based on the German ImmunoReactive score. In cervical smears, 20 fields (40x) were examined, each of them with a minimum count of 10 epithelial cells. When 20% or more of clue cells were detected the sample was considered positive for clue cells. The prevalence of clue cells was similar across histological strata (P = 0.42). Although the expression of COX‐2 did not differ in lesions with varying severities (P = 0.24), there was a negative association between the expression of COX‐2 and the presence of clue cells in Pap smear (OR = 0.4; 95% CI = 0.2–0.9): only 12% of women with moderate and strong expression of COX‐2 had clue cells in their smears, contrasted to 22% of those with negative and weak expression of COX‐2. HPV infection was associated in a borderline manner to the expression of COX‐2 (P = 0.04; OR = 2.3 95% CI = 1.0–5.4). The reduced expression of COX‐2 in CIN specimens may suggest that clue cells interfere with the inflammatory component of the carcinogenic process that lead to CIN. Diagn. Cytopathol. 2008;36:705–709. © 2008 Wiley‐Liss, Inc.
Developments in CT

The overall performance of a CT system depends on key components such as gantry, X-ray source, a high-powered generator, detector and detector electronics, data transmission systems, and the computer system for image reconstruction and manipulation.Multidetector row CT (MDCT) is the most significant development in CT since the introduction of spiral CT. MDCT allows for larger volume coverage in shorter scan times and improved longitudinal resolution, approaching the ideal of “isotropic” spatial resolution. The ability to acquire near isotropic volume data paved the way for CT from a cross-sectional slice modality to a volume imaging modality.ECG-controlled MDCT for the evaluation of the heart and the coronary arteries has entered clinical routine with the latest generation of 64-slice MDCT systems.MDCT has reached a level of saturation, and a further increase in the number of simultaneously acquired slices will only result in limited clinical benefit. Hence, new system concepts are currently being evaluat.
Reliability study of the microFET for pressure pain thresholds of myofascial trigger points in patients who have been operated on for herniated nucleus pulposi

Thirty-seven patients were tested for the presence of myofascial trigger points after undergoing a hernia nucleus pulposi operation at the L+L5 or L5-S1 level. In 19 of the 37 patients, at least one myofascial trigger point was found. The pressure pain thresholds of these myofascial trigger points were established by means of a microFET. The reliability of these measurements ranged from r=0.63 to r=0.98. In addition, we also studied the influence of one measurement upon another, and the amount of pain that patients had on the affected side, as scored on a visual analogue scale.
Electroanatomic Remodeling of the Left Atrium in Paroxysmal and Persistent Atrial Fibrillation Patients Without Structural Heart Disease

Atrial Remodeling in Atrial Fibrillation. Introduction: The nature of the atrial substrate thought to contribute toward maintaining atrial fibrillation (AF) outside the pulmonary veins remains poorly defined. Therefore, our objective was to determine whether patients with paroxysmal and persistent AF have an abnormal electroanatomic substrate within the left atrium (LA).
Temporal Consequences, Message Framing, and Consideration of Future Consequences: Persuasion Effects on Adult Fruit Intake Intention and Resolve

Message framing is a persuasive strategy that has seen mixed evidence for promoting fruit intake intentions, potentially because framed messages for fruit intake have not (a) explicitly compared short-term consequences versus long-term consequences, (b) considered individual-level differences in time perspective, and (c) used alternative measures of fruit intake intentions. In the present online study, the effects of persuasive messages created from temporal context (short term vs. long term) and message frame (gain framed vs. loss framed) were investigated on fruit intake intentions and resolve among a sample of Dutch adults who were categorized as either present oriented or future oriented. For intention and resolve, results showed a significant Type of Frame × Type of Temporal Context interaction, such that gain-framed messages were more persuasive when combined with long-term consequences and loss-framed messages were more persuasive when combined with short-term consequences. The effect sizes for these differences were similar for resolve and intention, but only differences for intentions were significant. No other effects were found. These results demonstrate that message framing theory may usefully consider the inclusion of temporal context of outcomes and alternative motivation measures to maximize their persuasive effects.
Behavioral Recommendations in Health Research News as Cues to Action: Self-Relevancy and Self-Efficacy Processes

This study argues that behavioral recommendations in health news function as cues to action. A proposed self-oriented model seeks to explore the impacts of behavioral recommendations in health research news as cues to action through their influences on self-relevancy and self-efficacy. A content analysis (Study 1) first establishes that health research news commonly features behavioral recommendations. A message experiment (Study 2) then explores the utility of behavioral recommendations as cues to action by demonstrating a self-relevancy effect: Health research news with, as opposed to without, behavioral recommendations increases the self-relevancy of advocated health behaviors, which then improve people’s attitudes toward and intentions to adopt those behaviors. A second message experiment (Study 3) tests whether varying presentations of behavioral recommendations alter their effectiveness as cues to action and thus people’s behavioral intentions through a dual effect process. In addition to the previously demonstrated self-relevancy effect, this experiment shows that concrete, as opposed to abstract, behavioral recommendations trigger a self-efficacy effect, increasing perceived self-efficacy and further improving behavioral intentions.
A Content Analysis of Newspaper Coverage of the Seasonal Flu Vaccine in Ontario, Canada, October 2001 to March 2011

Seasonal flu vaccine uptake has fallen dramatically over the past decade in Ontario, Canada, despite promotional efforts by public health officials. Media can be particularly influential in shaping the public response to seasonal flu vaccine campaigns. We therefore sought to identify the nature of the relationship between risk messages about getting the seasonal flu vaccine in newspaper coverage and the uptake of the vaccine by Ontarians between 2001 and 2010. A content analysis was conducted to quantify risk messages in newspaper content for each year of analysis. The quantification allowed us to test the correlation between the frequency of risk messages and vaccination rates. During the time period 2001–2010, vaccination rates were positively and significantly related to the frequency of risk messages in newspaper coverage (r = .691, p < .05). The most commonly identified risk messages related to the flu vaccine being ineffective, the flu vaccine being poorly understood by science, and the flu vaccine causing harm. Newspaper coverage plays an important role in shaping public response to seasonal flu vaccine campaigns. Public health officials should work alongside media to ensure that the public are exposed to information necessary for making informed decisions regarding vaccination.
Becoming Responsible Teens: Promoting the Health of Adolescents in Foster Care

BACKGROUND: As a result of traumatic early histories, female adolescents in foster care are at great risk for contracting human immunodeficiency virus (HIV) and other sexually transmitted diseases. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of the Becoming a Responsible Teen (BART) curriculum on adolescents’ condom awareness and HIV risk knowledge. BART is an 8-week group intervention that combines education and behavior skills training with content on topics such as sexual assertion, refusal, problem solving, and risk recognition. DESIGN: Adolescents living in residential foster care participated in the BART intervention. The study used a pretest/posttest design with one group. FINDINGS: Preintervention and postintervention measures of outcomes of condom awareness and HIV risk knowledge improved significantly after the BART group intervention. CONCLUSION: Adolescent females in foster care have experienced multiple early adversities and are a high-risk group for sexually transmitted diseases. BART increased the adolescents knowledge related to condom use and HIV risk and encouraged participants to spread the word to other adolescents.
Preconditioning During Ischemia: Basic Mechanisms and Potential Clinical Applications

In ischemic preconditioning a preliminary 5-min coronary occlusion is capable of reducing the extent of myocardial infarction after a subsequent prolonged coronary occlusion. This remarkable endogenous protection is triggered by release of adenosine during the brief ischemic period. Occupied adenosine receptors couple to pertussis toxin-senstive G proteins that in turn activate phospholipase C, leading to membrane phospholipid metabolism and release on diacylglycerol. The latter leads to stimulation of protein kinase C (PKC), presumably by cadsing translocation of inactive cytosolic enzyme to the cell membranes, where it resides in its activated state. As long as PKC is resident in the membranes approximately 1 hour in rabbits the cell is in the preconditioned state and PKC is poised to act to protect the cell. If there is recurrent ischemia within that hour renewed release of adenosine reinitiates intracellular signalling with the production of more diacylglycerol. Because PKC is already in the membranes restimulation can result in almost immediate phosphorviation of critical cell constituents one of which is the yet unidentified end effector of protection. In this scheme, adenosine release occurs twice and PKC is stimulated twice—to translocate during the first ischemia and to phospherylate during the second ischemia. Other receptors such as muscarinic M2 angiotensin ± AT2 α1-adrenergic, and bradykinin B2 are also known to couple to PKC. Exogenous administration of any of these in new of the brief ischemia can also precondition rabbit myocardium, Chronic receptor stimulation by exogenous administration of an adenosine analogue result in receptor downregulation and loss of the ability to protect the myocardium with additional adenosine analogue infusion. Therefore, clinical application must await development of an agent that can initiate the protection cascade without the development of tolerance. But this preconditioning phenomenon is the first described technique of clear and unequivocal salvage of ischemic myocardium and as such it holds great promise.
Impact of Ablation Catheter Irrigation Design on Silent Cerebral Embolism After Radiofrequency Catheter Ablation of Atrial Fibrillation: Results from a Pilot Study

Catheter Design and Anticoagulation on Postablation Silent Cerebral Ischemia. Introduction: Silent cerebral lesions (SCL) are a sensitive tool to evaluate thromboembolic risk of catheter ablation. Recent data showed the possibility to reduce thrombus formation when the electrode–tissue interface cooling is optimized by a homogeneous flushing of saline along the entire surface of the distal electrode through a larger number of irrigation holes. The study aim is to compare procedural parameters and safety of pulmonary vein isolation (PVI) performed by using open‐irrigated catheters with different irrigation design.
Do Fitness Apps Need Text Reminders? An Experiment Testing Goal-Setting Text Message Reminders to Promote Self-Monitoring

Fitness tracking apps have the potential to change unhealthy lifestyles, but users’ lack of compliance is an issue. The current intervention examined the effectiveness of using goal-setting theory-based text message reminders to promote tracking activities on fitness apps. We conducted a 2-week experiment with pre- and post-tests with young adults (n = 50). Participants were randomly assigned to two groups—a goal-setting text message reminder group and a generic text message reminder group. Participants were asked to use a fitness tracking app to log physical activity and diet for the duration of the study. Participants who received goal-setting reminders logged significantly more physical activities than those who only received generic reminders. Further, participants who received goal-setting reminders liked the messages and showed significantly increased self-efficacy, awareness of personal goals, motivation, and intention to use the app. The study shows that incorporating goal-setting theory-based text message reminders can be useful to boost user compliance with self-monitoring fitness apps by reinforcing users’ personal goals and enhancing cognitive factors associated with health behavior change.
An Analysis on Risk of Influenza-Like Illness Infection in a Hospital Using Agent-Based Simulation

The purpose of the research is to develop a framework to assess the risk of a highly contagious and mortal influenza-like illness infection to health care workers in a hospital under different scenarios of infection control. The method is to build an agentbased model for simulating infection of the virus in the hospital and use an open-source software to visualize a risk graph of infection. The simulation results show a high risk of infection among health care workers who directly take care of inpatients and the evidence of the risk is visualized in the form of graphs. The research contributes a novel risk assessment for hospital staff to prepare for an influenza pandemic in the future. KeywordsNosocomial Infection; Infection Control; Agent-Based Simulation; Risk Assessment
Challenging healthcare discrimination: COMMENTARY ON … DISCRIMINATION AGAINST PEOPLE WITH MENTAL ILLNESS

Stigma-discrimination against people with mental health problems is more prevalent and damaging than the weaker ‘stigma by association’ experienced by mental healthcare professionals. Not only are patients reluctant to seek psychiatric help, but they are shunned by society and discriminated against by general healthcare services when they do. Other clinicians see psychiatric services as a last resort and government funding of these services is disproportionately low. Psychiatrists must engage in anti-stigma activities. I suggest ways in which, both in the clinical arena and in the wider context of education and society, psychiatrists can challenge clinicians’ and the public’s value judgements of psychiatric patients.
Disseminated emm Type 12 Group A Streptococcus and Review of Invasive Disease

Abstract:The authors present a case of invasive group A Streptococcus (GAS) in a previously healthy 63-year-old male complicated by trans-esophageal echocardiogram negative endocarditis, septic arthritis, and multiple cerebral septic emboli. Despite antibiotics and drainage of his largest brain abscess, the patient expired. This case highlights the potential mortality from invasive GAS disease. Included is a review of current literature regarding invasive GAS that addresses its presentation, prevalence, virulence and treatment.
Curcumin Inhibits Apoptosis and Brain Edema Induced by Hypoxia-Hypercapnia Brain Damage in Rat Models

Abstract:Curcumin, extracted from South Asian spice turmeric, has been determined to have the promising ability in antioxidation and anti-inflammation. However, the effect of curcumin on treating brain damage has been not reported. In this article, the aim was to evaluate the effect of curcumin on cell apoptosis in rats exposed to hypoxia-hypercapnia and explore the therapeutic potential of curcumin in hypoxia-hypercapnia brain damage (HHBD). Sprague Dawley rats were randomly assigned into 3 groups: control group, hypoxia-hypercapnia group and curcumin group. The Fas/FasL expressions in HHBD rats treated by curcumin were measured by immunohistochemical staining and western blotting. The pathological changes of brain cells were observed by transmission electron microscope. Rats with HHBD showed significant increase of Fas/FasL expression and ultrastructural changes in brain tissue cells. Curcumin intervention effectively reversed the Fas/FasL-mediated apoptosis and HHBD-induced brain edema. Curcumin may be a potential therapeutic alternative for HHBD.
FNA in diagnosis of orbital lesions causing proptosis in adults

The orbit is affected by a wide range of pathologic lesions, for which a morphologic diagnosis is needed to allow adequate therapy. With increasing use of fine needle aspiration (FNA) in diagnostic pathology, the procedure has been applied for the diagnosis of space occupying lesions of the orbit. We present the cytomorphological diagnosis on orbital FNA in adult patients presenting with proptosis.
Antileukotriene treatment in children with asthma--new patents.

Leukotrienes, and especially cysteinyl leukotrienes have been shown to be involved in many processes that play a role in asthma pathophysiology: eosinophil recruitment, the most characteristic processes of asthma pathogenesis, increased mucosal secretion, which impairs the normal process of airway clearance and favors the development of mucus plugs, mucosal edema, caused by increased vascular permeability and bronchoconstriction, leading to smooth muscle hypertrophy. Latest progress in the understanding of chronic asthma pathology events underline the leukotriene synthesis pathway enzymes and different leukotriene receptors as potential targets of asthma treatment in children. Agents inhibiting the production of leukotrienes or agents antagonising their receptor's action, attract attention. Studies on molecular mechanisms of leukotrienes action have led to the development and patents of potential drugs including new 5- lipoxygenase inhibitors, 5-lipoxygenase-activating protein (FLAP) inhibitors, leukotriene B4 receptor antagonists, or nanoparticulate leukotriene receptor antagonist formulations.