Miracle-dz/UniFAR-FTUs huggingface dataset:
Accuracy and value of breast ultrasound for primary imaging evaluation of symptomatic women 30-39 years of age.

OBJECTIVE The purpose of this study was to determine the accuracy and value of breast ultrasound for primary imaging evaluation of women 30-39 years of age who present with focal breast signs or symptoms. METHODS We identified all women 30-39 years of age who underwent imaging evaluation (ultrasound and mammography) at our institution between January 1, 2002, and August 31, 2006, for focal breast signs or symptoms. Each area of concern was designated a study case. Benign versus malignant outcomes were determined by biopsy or imaging surveillance and through linkage with a tumor registry with a minimum 24-month follow-up. Overall cancer yield, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of ultrasound and mammography were calculated. RESULTS We identified 1208 cases in 954 patients. Outcomes were benign in 1185 of 1208 (98.1%) and malignant in 23 of 1208 (1.9%) cases. Sensitivities for ultrasound and mammography were 95.7% and 60.9%, respectively. Specificities for ultrasound and mammography were 89.2% and 94.4%, respectively. NPV was 99.9% for ultrasound and 99.2% for mammography. PPV was 13.2% for ultrasound and 18.4% for mammography. Mammography detected one additional malignancy in an asymptomatic area in a 32-year-old woman who was subsequently found to have a BRCA2 gene mutation. CONCLUSION Breast imaging is warranted in women 30-39 years of age with focal signs or symptoms because of the small (1.9%) but real risk of malignancy. Ultrasound has high sensitivity (95.7%) and high NPV (99.9%) in this setting and should be the primary imaging modality of choice. The added value of adjunct mammography is low.
Switching versus augmentation: a prospective, naturalistic comparison in depressed, treatment-resistant patients.

OBJECTIVE (1) To directly compare the effectiveness of switching antidepressants with augmenting them in depressed patients who do not respond to an initial adequate trial and (2) to determine whether there is a decreased likelihood of response to a second switch or augmentation trial in those patients who did not respond to the first intervention for treatment-resistant depression. METHOD In a naturalistic, open-label design, all depressed outpatients (DSM-IV criteria) who were treatment resistant were prospectively assessed. Short- and long-term outcomes of switching versus augmentation were compared using the Clinical Global Impressions scale. RESULTS In the acute phase, 37 (50.0%) of 74 subjects responded to 1 of the 2 interventions for treatment-resistant depression. Forty-five percent (N = 17) and 56% (N = 20) of the patients who had their antidepressant switched or augmented, respectively, responded to that intervention. Nearly three fourths (71.4%) of the acute responders maintained their response through 6 months of follow-up. In 18 patients who did not respond to the first switch or augmentation, 9 (50.0%) responded to a second trial. CONCLUSION Switching antidepressants was somewhat less effective than augmentation, although this difference was not statistically significant. For patients who do not respond to an augmentation or switch, our results suggest that a second trial for treatment-resistant depression may be as effective as the first.
Measurement of dynamic stocks portfolio VaR and its forecasting model based on vine copula

Taking the ten most important stock markets indexes as examples,this paper calculated the predicted VaR value of the portfolio with the four vine copula models,R-vine,D-vine,C-vine and R-vine all t,based on the rolling technique of monte carlo simulation.Furthermore,using rigorous Backtesting method,we compared the performance of forecasting VaR of the four vine copula models.The empirical results show that,the R-vine is the best model in measuring and predicting of the portfolio of the VaR no matter under the condition of equal weight or mean-CVaR.Under high quantile condition,the performance is better.Moreover,the overall prediction accuracy of D-vine is higher than that of C-vine and R-vine all t,however,the performance of R-vine all t is relatively worse when there is only t copula between the nodes.
Independent function of two destruction domains in hypoxia‐inducible factor‐α chains activated by prolyl hydroxylation

Oxygen‐dependent proteolytic destruction of hypoxia‐inducible factor‐α (HIF‐α) subunits plays a central role in regulating transcriptional responses to hypoxia. Recent studies have defined a key function for the von Hippel–Lindau tumour suppressor E3 ubiquitin ligase (VHLE3) in this process, and have defined an interaction with HIF‐1α that is regulated by prolyl hydroxylation. Here we show that two independent regions within the HIF‐α oxygen‐dependent degradation domain (ODDD) are targeted for ubiquitylation by VHLE3 in a manner dependent upon prolyl hydroxylation. In a series of in vitro and in vivo assays, we demonstrate the independent and non‐redundant operation of each site in regulation of the HIF system. Both sites contain a common core motif, but differ both in overall sequence and in the conditions under which they bind to the VHLE3 ligase complex. The definition of two independent destruction domains implicates a more complex system of pVHL–HIF‐α interactions, but reinforces the role of prolyl hydroxylation as an oxygen‐dependent destruction signal.
Beta Adrenergic Stimulation of Insulin Release in Man

Normal men and women were infused with the π-adrenergic receptor stimulator, isoproterenol (isopropylnorepinephrine, Isuprel). At a low dose (2 μg./min.), immunoreactive insulin (IRI) and free fatty acid (FFA) concentrations rose without a measurable change in plasma glucose. The rise in IRI was not blocked by pretreatment with nicotinic acid to prevent FFA mobilization by isoproterenol. Higher doses of isoproterenol (6 μg./min.) caused larger increments of IRI and FFA concentrations but also elevated plasma glucose. All effects of isoproterenol were the β-adrenergic receptor DlocKing agent y propranolol. Propranolol had no effect on glycogenolysis or IRI stimulation by glucagon. It is concluded that isoprotenol inereases IRI levll by direet seimnlation of β-adrenergic receptors. The ability of glucagon to stimulate the pancreatic islet and to elevate IRI appears to be mediated by a different mechanism.
Sexual and treatment-seeking behaviour for sexually transmitted infection in long-distance transport workers of East Africa

Objective: To investigate the sexual and treatment-seeking behaviour for sexually transmitted infection (STI) in long-distance transport workers of East Africa. Methods: A health-seeking behaviour survey was carried out at four sites on the Mombasa–Kampala trans-Africa highway (n = 381). The questionnaires probed details of STI knowledge, symptoms and care-seeking behaviour. In one site at the Kenya–Uganda border, a sexual patterning matrix was used (n = 202) to measure sexual behaviour in truck drivers and their assistants over the 12-month period before the interview. Results: Over half of the sexual acts of long-distance transport workers over 12 months were with female sex workers, with an annual average of 2.8 sexual partners. Condom use was reported at 70% for liaisons with casual partners. 15% of truckers had had a self-reported STI and one-third exhibited high-risk sexual behaviour in the previous year. Of those with an STI, 85% had symptoms when on the road and 77.2% sought treatment within 1 week of onset of symptoms. 94% of drivers and 56% of assistants sought treatment for STI in a private health facility or pharmacy. The cost of private facilities and pharmacies was not significantly higher than in the public sector. Waiting times were three times longer in the public sector. Only 28.9% of patients completed their medication courses as prescribed. Conclusions: Truck drivers and their assistants in East Africa have high rates of reported STIs and many continue to exhibit high-risk sexual behaviour. The transport workers studied here favoured private health facilities because of convenience and shorter waiting times.
Recent clinical progress in virus-based therapies for cancer

As our knowledge of the molecular basis of cancer expands, viral vectors have been increasingly studied as potential antitumour therapeutic agents. With their ability to invade and replicate within target cells, viruses have been utilised as oncolytic agents to directly lyse tumour cells. Viruses can also deliver their genetic payload into infected cells, allowing for the repair of defective tumour suppressor genes, disruption of oncogenic pathways, and production of cytokines that activate the immune system. Finally, viruses encoding tumour-associated antigens can infect dendritic cells, triggering the development of a tumour-specific immune response. The ability to engineer viruses with high levels of tumour specificity and efficient rates of infection has enhanced the safety profile of these agents, allowing for the development of viable therapeutic options that have been examined in the clinic, either alone or in conjunction with more conventional therapies. This review highlights the principles underlying virus-based therapies for cancer, with an emphasis on recent developments from the clinic.
Benign B-Cell Precursors (Hematogones) Are the Predominant Lymphoid Population in the Bone Marrow of Preterm Infants

Bone marrow (BM) findings in 3rd-trimester stillborns and full-term living neonates have been previously described. However, there is no information regarding BM composition in living preterm infants. Specifically, it is unknown whether the BM lymphocytosis seen in full-term infants at 1–4 weeks of age also occurs in preterm infants. Furthermore, the lineage of these cells has never been investigated. We used a panel of immunohistochemical stains to characterize the BM composition in 11 neonates (8 living and 3 deceased). Unlike in the other age groups, immature B cells (hematogones) were the most common lymphoid population, accounting for 10–60% (mean 34%) of all cells. In two additional cases (both living patients), flow cytometry revealed a level of 3.8% of immature B cells in a <1-week-old neonate and 25.7% in a 19-week-old infant. Immature B cells were not identified in 6 peripheral blood samples from preterm neonates. These findings are pertinent for the interpretation of BM and peripheral blood samples in this age group as survival improves and diagnostic samples become more common.
Dental caries prevalence and dental care utilization among the very old.

BACKGROUND This article reports on coronal and root caries prevalence and dental care utilization patterns of elderly Iowans aged 79 years or older. METHODS The sample for this study was 449 people who were surviving members of the Iowa 65+ Rural Health Study cohort originally recruited in 1981. The authors focused their analyses on the 342 of these who were dentate. Examinations were conducted in subjects' homes by trained and calibrated examiners, using a halogen headlight, a mouth mirror, a color-coded periodontal probe and a no. 23 explorer. RESULTS The mean age of subjects was 85.1 years (range 79-101 years), and they had a mean of 19.4 remaining teeth. Nearly all subjects (96 percent) had coronal decay experience, while 23 percent of the subjects had untreated coronal decay, about one-fourth of which was recurrent. Nearly two-thirds (64 percent) of the sample had root caries experience, with 23 percent having untreated root caries. Utilization of dental services was high among the dentate elderly, with nearly three-quarters reporting having visited a dentist within the past year. Nearly all reported that they paid for dental care themselves with no third-party coverage. CONCLUSIONS The findings from this study of the very old suggest that coronal and root caries remain prevalent, with high levels of dental care utilization among those who have retained natural teeth. CLINICAL IMPLICATIONS As the U.S. population ages, and more teeth are retained, demand for dental services in the population of the oldest elderly people is likely to increase.
Estimates of the worldwide mortality from 25 cancers in 1990

We present here worldwide estimates of annual mortality from all cancers and for 25 specific cancer sites around 1990. Crude and age‐standardised mortality rates and numbers of deaths were computed for 23 geographical areas. Of the estimated 5.2 million deaths from cancer (excluding non‐melanoma skin cancer), 55% (2.8 million) occurred in developing countries. The sex ratio is 1.33 (M:F), greater than that of incidence (1.13) due to the more favourable prognosis of cancer in women. Lung cancer is still the most common cause of death from cancer worldwide with over 900,000 deaths per year, followed by gastric cancer with over 600,000 deaths and colorectal and liver cancers accounting for at least 400,000 deaths each. In men, deaths from liver cancer exceed those due to colo‐rectal cancer by 38%. Over 300,000 deaths of women are attributed to breast cancer, which remains the leading cause of death from cancer in women, followed by cancers of the stomach and lung with 230,000 annual deaths each. In men, the risk of dying from cancer is highest in eastern Europe, with an age‐standardised rate for all sites of 205 deaths per 100,000 population. Mortality rates in all other developed regions are around 180. The only developing area with an overall rate of the same magnitude as that in developed countries is southern Africa. All of eastern Asia, including China, has mortality rates above the world average, as do all developed countries. The region of highest risk among women is northern Europe (age‐standardised rate = 125.4), followed by North America, southern Africa and tropical South America. Only south‐central and western Asia (Indian subcontinent, central Asia and the middle‐eastern countries) and Northern Africa are well below the world average of 90 deaths per 100,000 population annually. Our results indicate the potential impact of preventive practices. It is estimated that 20% of all cancer deaths (1 million) could be prevented by eliminating tobacco smoking. Infectious agents account for a further 16% of deaths. Int. J. Cancer 83:18–29, 1999. © 1999 Wiley‐Liss, Inc.
Multidisciplinary obstetric simulated emergency scenarios (MOSES): Promoting patient safety in obstetrics with teamwork‐focused interprofessional simulations

Introduction: We describe an example of simulation‐based interprofessional continuing education, the multidisciplinary obstetric simulated emergency scenarios (MOSES) course, which was designed to enhance nontechnical skills among obstetric teams and, hence, improve patient safety. Participants' perceptions of MOSES courses, their learning, and the transfer of learning to clinical practice were examined. Methods: Participants included senior midwives, obstetricians, and obstetric anesthetists, including course faculty from 4 purposively selected delivery suites in England. Telephone or e‐mail interviews with MOSES course participants and facilitators were conducted, and video‐recorded debriefings that formed integral parts of this 1‐day course were analyzed. Results: The team training was well received. Participants were able to check out assumptions and expectations of others and develop respect for different roles within the delivery suite (DS) team. Skillful facilitation of debriefing after each scenario was central to learning. Participants reported acquiring new knowledge or insights, particularly concerning the role of communication and leadership in crisis situations, and they rehearsed unfamiliar skills. Observing peers working in the simulations increased participants' learning by highlighting alternative strategies. The learning achieved by individuals and groups was noticeably dependent on their starting points. Some participants identified limited changes in their behavior in the workplace following the MOSES course. Mechanisms to manage the transfer of learning to the wider team were weakly developed, although 2 DS teams made changes to their regular update training. Discussion: Interprofessional, team‐based simulations promote new learning.
Comparison of single-microphone noise reduction schemes: can hearing impaired listeners tell the difference?

Abstract Objective: The perceived qualities of nine different single-microphone noise reduction (SMNR) algorithms were to be evaluated and compared in subjective listening tests with normal hearing and hearing impaired (HI) listeners. Design: Speech samples added with traffic noise or with party noise were processed by the SMNR algorithms. Subjects rated the amount of speech distortions, intrusiveness of background noise, listening effort and overall quality, using a simplified MUSHRA (ITU-R, 2003) assessment method. Study sample: 18 normal hearing and 18 moderately HI subjects participated in the study. Results: Significant differences between the rating behaviours of the two subject groups were observed: While normal hearing subjects clearly differentiated between different SMNR algorithms, HI subjects rated all processed signals very similarly. Moreover, HI subjects rated speech distortions of the unprocessed, noisier signals as being more severe than the distortions of the processed signals, in contrast to normal hearing subjects. Conclusions: It seems harder for HI listeners to distinguish between additive noise and speech distortions or/and they might have a different understanding of the term “speech distortion” than normal hearing listeners have. The findings confirm that the evaluation of SMNR schemes for hearing aids should always involve HI listeners.
Cost‐effectiveness of combination versus sequential docetaxel and carboplatin for the treatment of platinum‐sensitive, recurrent ovarian cancer

In a randomized controlled trial (RCT) of patients with recurrent, platinum‐sensitive ovarian cancer, the combination weekly docetaxel and carboplatin was associated a with progression‐free survival (PFS) of 13.7 months compared with 8.4 months for sequential, single‐agent docetaxel followed by carboplatin. The objective of the current study was to construct a cost‐utility model to compare these 2 regimens with the incorporation of prospectively collected quality‐of‐life (QoL) data.
Na-H exchange in myocardium: effects of hypoxia and acidification on Na and Ca.

Historically, increase in cell Na content during ischemic and hypoxic episodes were thought to result from impaired ATP production causing decreased Na(+)-K(+)-ATPase activity. Here we report the results of testing the alternate hypothesis that hypoxia-induced Na uptake is 1) the result of increased entry, as opposed to decreased extrusion 2) via Na-H exchange operating in a pH regulatory capacity and that cell Ca accumulation occurs via Na-Ca exchange secondary to collapse of the Na gradient. We used 23Na-, 19F-, and 31P-nuclear magnetic resonance (NMR) to measure intracellular Na content (Nai), Ca concentration [( Ca]i), pH (pHi), and high-energy phosphates in Langendorff-perfused rabbit hearts. When the Na(+)-K(+)-ATPase was inhibited by ouabain and/or K-free perfusion, hearts subjected to hypoxia gained Na at a rate greater than 10 times that of normoxic controls [during the first 12.5 min Nai increased from 7.9 +/- 5.8 to 34.9 +/- 11.0 (SD) meq/kg dry wt compared with 11.1 +/- 16.3 to 13.6 +/- 9.0 meq/kg dry wt, respectively]. When normoxic hearts were acidified using a 20 mM NH4Cl prepulse technique, pHi rapidly fell from 7.27 +/- 0.24 to 6.63 +/- 0.12 but returned to 7.07 +/- 0.10 within 20 min, while Na uptake was similar in rate and magnitude to that observed during hypoxia (24.5 +/- 13.4 to 132.1 +/- 17.7 meq/kg dry wt). During hypoxia and after NH4Cl washout, increases in [Ca]i were similar in time course to those observed for Na. (ABSTRACT TRUNCATED AT 250 WORDS)
The potential impact of trade on the economy of Lesotho

The potential impact of trade on the economy of Lesotho was assessed using the Lesotho Social Accounting Matrix (SAM) 2000 as a data base to construct a Computable General Equilibrium (CGE) model, to design trade policy scenarios, and to simulate the impact of trade policy scenarios on the Lesotho economy Since the Lesotho SAM was unbalanced, it was necessary to balance the initial matrix, using the cross-entropy optimization procedure with the aid of GAMS software. Four simulation sets were carried out. Results from two sets (duty-free access (DFA) and a +10% increase in world prices) indicate significantly increased textile exports and decreased prices for imported commodities. DFA will also be associated with increased textile imports, while a +10% increase in world prices will lead to increased crop imports. Demand and supply prices of textile commodities produced and sold domestically will decrease, as will composite goods prices in the textile sector. Average output price of textiles will decrease with DFA and with a 10% increase in world prices; the aggregated marketed commodity quantity for textiles will increase.
Working conditions of Iranian hand-sewn shoe workers and associations with musculoskeletal symptoms

The working conditions and the prevalence of self-reported musculoskeletal symptoms among 180 Iranian hand-sewn shoe workers were evaluated in this cross-sectional study. Data were collected using both questionnaire (for assessing musculoskeletal symptoms and associated risk factors) and direct observations of posture (by the Rapid Upper Limb Assessment [RULA] method). The prevalence and severity of symptoms was very high among the study population. The mean RULA grand score of 6.2 indicates that in most cases the workers' postures at their workstations need to be investigated and some changes are required immediately. Multiple logistic regression models indicated that the job experience, daily working hours, duration of continuous work without breaks, feeling pressure due to work and working postures were significantly associated with musculoskeletal symptoms of different body regions. The results are discussed in terms of their implications for hand-sewing tasks. These findings can help to better understand the working conditions of those jobs involving hand-sewing operation and highlight the potential for ergonomic interventions to reduce musculoskeletal symptoms among these working groups. Practitioner Summary: Working conditions of hand-sewn shoe workers and their musculoskeletal symptoms were investigated. The prevalence and severity of musculoskeletal symptoms was very high among the study population. Poor working postures, feeling pressure due to work, long duration of work without breaks and prolonged daily working hours were positively associated with musculoskeletal symptoms.