Miracle-dz/UniFAR-FTUs huggingface dataset:
Composite Medullary and Papillary Thyroid Carcinoma In a Patient With MEN 2B: Case Report and Review of C-Cell Lesions of the Thyroid

C-cell lesions of the thyroid can be classified as C-cell hyperplasia, medullary thyroid carcinoma, and tumors showing a composite pattern of medullary carcinoma and a follicular cell-derived carcinoma. Medullary thyroid carcinoma comprises 5% to 10% of all thyroid carcinomas; in contrast, composite tumors are rare, representing fewer than 0.5% of all thyroid tumors. We report a case of composite medullary and papillary thyroid carcinoma in a patient with multiple endocrine neoplasia type 2B. The pathogenesis of composite thyroid carcinomas is not known. They may be coincidental collision tumors or they may represent a response to a common pathogenetic stimulus. We review the embryonic origin of C-cells and the thyroid gland, the histologic and molecular aspects of C-cell lesions, and the pathogenetic factors implicated in their development.
REHABILITATION: A CRUCIAL COMPONENT IN THE FUTURE OF HIV CARE AND SUPPORT opinion

Provision of antiretroviral therapy (ART) is not an end in itself but a means to achieving improved wellness for people living with HIV. Rehabilitation, broadly defined, is another key contributor to wellness within this context. Understanding the potential for rehabilitation requires that one is able to consider HIV not only within a biomedical model that focuses on body systems, diagnoses and symptoms, but also within a rehabilitation framework that focuses on how these diagnoses and symptoms affect people’s lives more broadly. Furthermore, rehabilitation is a human rights imperative, which deserves the energetic attention enjoyed by other aspects of HIV treatment and care. In particular, the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is shining a long-overdue spotlight on the human rights imperatives associated with disability. For South Africa and other countries, proactively and meaningfully engaging rehabilitation in the HIV response will require major shifts on several fronts, including practice, education, policy and research. We argue that in settings where ART delivery is now widespread, HIV should be understood not only as a medical issue, but as a rehabilitation and disability concern. Whereas medicine adds years to life, it is rehabilitation that aims to add life to years.
Prenatal Rh‐Immune Prophylaxis With 300 μg Immune Globulin Anti‐D In The 28th Week Of Pregnancy

As immune globulin anti‐D given in the immediate post partum period fails to prevent the development of anti‐D antibodies in about 1.5–2% of women at risk, probably as a result of feto‐maternal bleeding during pregnancy, 300 μg of immune globulin anti‐D was administered to 609 Rh‐negative women in the 28th gestational week. Three hundred and forty‐six had Rh‐positive babies, and were given additionally 200 μg anti‐D post partum. Of these, 291 had an antibody screen test done 10 months after delivery. No anti‐D antibodies were found. The test results of the study group were compared with those of a control group of 354 women who did not receive prenatal immune globulin, but otherwise the same examinations and treatment. In this group, 322 had a screen test performed 10 months post partum or in their next pregnancy, when 1.8% had anti‐D antibodies. The difference in immunization incidence between the groups was significant (p<0.05). There was no difference between the groups regarding the number of women with fetal erythrocytes in serum after delivery, but the number of fetal erythrocytes found was significantly lower in the group receiving prenatal prophylaxis (p<0.001). No adverse effects were found in the infants exposed to anti‐D prenatally.
A New Start for Triglycerides and Remnant Cholesterol-Nonfasting.

Featured Article: Nordestgaard BG, Benn M, Schnohr P, Tybjaerg-Hansen A. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA 2007;298:299–308.3 My first independent scientific project was to understand why patients with lipoprotein lipase (LPL) deficiency, the chylomicronemia syndrome, and severely increased plasma triglycerides did not develop cardiovascular disease. At the time this was a great mystery, one that led to the belief that triglycerides, unlike cholesterol, were not important for the development of atherosclerosis and cardiovascular disease. This belief was supported by studies by George Lyman Duff and others, published in the late 1940s, showing that the alloxan-diabetic, cholesterol-fed rabbit with severely increased triglycerides likewise did not develop atherosclerosis. I started my studies in the mid-1980s at the University of Copenhagen together with Dr. and later Professor Steen Stender, and continued in the laboratory of Professor Donald Zilversmit at Cornell University in New York. Using the alloxan-diabetic, cholesterol-fed rabbit we showed that, at severely increased triglycerides, most lipoproteins were chylomicron-like with diameters above 75 nm and that these lipoproteins were unable to enter into the arterial intima, explaining the lack of atherosclerosis development …
Use of Metabolomics in Improving Assessment of Dietary Intake.

BACKGROUND Nutritional metabolomics is rapidly evolving to integrate nutrition with complex metabolomics data to discover new biomarkers of nutritional exposure and status. CONTENT The purpose of this review is to provide a broad overview of the measurement techniques, study designs, and statistical approaches used in nutrition metabolomics, as well as to describe the current knowledge from epidemiologic studies identifying metabolite profiles associated with the intake of individual nutrients, foods, and dietary patterns. SUMMARY A wide range of technologies, databases, and computational tools are available to integrate nutritional metabolomics with dietary and phenotypic information. Biomarkers identified with the use of high-throughput metabolomics techniques include amino acids, acylcarnitines, carbohydrates, bile acids, purine and pyrimidine metabolites, and lipid classes. The most extensively studied food groups include fruits, vegetables, meat, fish, bread, whole grain cereals, nuts, wine, coffee, tea, cocoa, and chocolate. We identified 16 studies that evaluated metabolite signatures associated with dietary patterns. Dietary patterns examined included vegetarian and lactovegetarian diets, omnivorous diet, Western dietary patterns, prudent dietary patterns, Nordic diet, and Mediterranean diet. Although many metabolite biomarkers of individual foods and dietary patterns have been identified, those biomarkers may not be sensitive or specific to dietary intakes. Some biomarkers represent short-term intakes rather than long-term dietary habits. Nonetheless, nutritional metabolomics holds promise for the development of a robust and unbiased strategy for measuring diet. Still, this technology is intended to be complementary, rather than a replacement, to traditional well-validated dietary assessment methods such as food frequency questionnaires that can measure usual diet, the most relevant exposure in nutritional epidemiologic studies.
The long and short term effects of alcohol consumption on cognitive decline

Background With an increase in ageing population, cognitive decline represents a major reason of concern. Alcohol has been shown to have a differential impact on cognitive decline according to the level of consumption, but less is known on the longitudinal effects. Objective To examine the influence of alcohol consumption at age 36 and 43 years on cognitive decline between 43 and 53 years. Design Birth cohort study. Setting UK. Participants 735 men and 778 women from the Medical Research Council (MRC) National Survey of Health and Development, followed up since their birth in March 1946. Main outcome measures Decline in verbal memory and visual search speed. Methods Alcohol data was obtained over 7 days using 5 days diet diary and 2 days interview recall at age 36 and 43. The confounding variables included were father's social class, childhood cognition, education, adult social class and depression. Statistical methods Cognition at 53 years was regressed on cognition at 43 years, alcohol consumption, and confounders, separately for men and women. Results Long-term effects: Alcohol consumption at age 36 was associated with decline in verbal memory performance in men. Light drinkers (0-3 units/day) and moderate drinkers (2-5 units/day) had 1.80 (95% CI: 0.73 to 2.88) and respectively 1.72 (0.57- 2.86) slower decline than non-drinkers, while heavy drinkers (3-8 units/day) showed a more rapid decline with 1.28 (0.11-2.45). These associations become non-significant after controlling for the confounders (in particular when controlling for education). No associations were found in women. There was non-significant association between alcohol at age 36 and decline in visual search performance. Short-term effects: Alcohol at age 43 had a stronger impact on verbal memory decline in men, which was maintained after adjusting for all the confounders. The regression coefficients for light, moderate and heavy drinkers were 1.18, 1.34, and 1.32 (0.21-2.15; 0.24-2.44; 0.25-2.40) in reference to non-drinkers, highlighting a protection for moderate drinkers. No associations were found for verbal memory decline in women. For the visual search speed test no associations were found in men. However, for women, was a significant association between alcohol behaviour at 43 and decline in visual search performance. Conclusion The short-term effect of alcohol consumption on cognitive decline is stronger than the long-term effect, which was explained by educational attainment at age 26. Future policies on drinking behaviour should not only highlight the debilitating effects of different levels of drinking, but also take into account the beneficial influence of education.
Medication Adherence in Outpatients with Arterial Hypertension

SUMMARY The degree of patient cooperation plays a key role in the success of antihypertensive drug therapy. Non-adherence is the major health and economic problem in the treatment of arterial hypertension (HTA). The aim of the study was to evaluate the degree of adherence in hypertensive patients and to study risk factors affecting adherence and the effects of non-adherence on blood pressure (BP). We performed a cross-sectional study, which involved 170 outpatients with HTA, treated in primary healthcare. Patients were divided into two groups, depending on the degree of adherence, measured using a validated survey form. Statistical analysis was performed using the Pearson's Chi-square and t-test. Good adherence was observed in 126 (74.12%) outpatients. Elderly patients with longer duration of HTA and larger number of drugs in the therapy showed a lower degree of adherence, with more side-effects (p<0.01). Patients younger than 65 years were found to be more likely to adhere to their medication regimen, compared to elderly patients (χ2=21.3; p<0.01; OR=6.0 95%, CI 2.76-13.04). Uncontrolled BP occurred in the significantly higher percentage in non-adherent patients (59.1%) compared to the adherent group (21.4%) (χ2=19.84; p<0.01; OR=5.30 95%, CI 2.39-11.85). The most common reason for poor adherence was non-compliance with dosage regimen (27.27%). The medication adherence rate was found to be low among elderly patients. A poor adherence was found to negatively affect BP control. Determining the factors for non-adherence and developing multidisciplinary intervention programs to address the identified factors are necessary to improve adherence to medication and BP control.
Prevalence of Neural Tube Defects in Yasuj, South West Iran

Background: Neural tube defects (NTDs), anencephaly, meningocele, and meningoencephalocele, are of the most common congenital anomalies of the central nervous system caused by defects in closure of the neural cord in the third and fourth gestational weeks. We aimed to investigate the prevalence of NTDs among the total births in clinics under supervision of Yasuj University of medical sciences, Yasuj, southwest Iran. Methods: All newborns with NTDs who were delivered in obstetrics and gynecology hospital wards of Yasuj University of medical sciences, south west Iran, from April 2005 to March 2011 were included. The mothers with NTD deliveries were also compared with the mothers with physically healthy deliveries for blood indices. After an interview a form was filled regarding their demographic information such as maternal age, address, gestational age, mother's blood group, blood indices, and due date of delivery. Results: Of the 14034 infants who were born in hospitals of Yasuj university of medical sciences, south west Iran, during the 6years period of this study, 68 (36 girls and 24 boys; P = 0.46) had NTDs. 59 (86.8%) infants had anencephaly and 9 (13.2%) had other types of NTDs. The prevalence of NTDs was 4.84/1000 birth during the 6years period. No significant difference was found between the groups regarding the other demographic variables and blood indices. Conclusion: The prevalence of NTDs in Yasuj, is much higher compared with previous reports. This warning sign should be beard in mind by policy makers to address the related etiological factors and prevention plans.
A Partisan Divide on the Uninsured

The partisan split in Congress over health reform may reflect a broader divide among the public in attitudes toward the uninsured. Despite expert consensus over the harms suffered by the uninsured as a group, Americans disagree over whether the uninsured get the care they need and whether reform legislation providing universal coverage is necessary. We examined public perceptions of health care access and quality for the uninsured over time, and we found that Democrats are far more likely than Republicans to believe that the uninsured have difficulty gaining access to care. Senior citizens are less aware than others of the problems faced by the uninsured. Even among those Americans who perceive that the uninsured have poor access to care, Republicans are significantly less likely than Democrats to support reform. Thus, our findings indicate that even if political obstacles are overcome and health reform is enacted, future political support for ongoing financing to cover the uninsured could be uncertain.
Reinventing primary care: a task that is far 'too important to fail'.

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Six weeks of multistation program on the knee proprioception and performance of futsal players.

BACKGROUND Proprioception and vertical jump are important parameters in the performance and prevention of injuries in futsal. However, very few studies have analyzed the role of multistation exercises to improve these variables. The purpose of this study was to assess the effects of a six-week multistation exercise program on knee joint position sense (JPS) and countermovement jump (CMJ) of futsal players. METHODS Thirty-four male futsal players randomly classified into experimental (N.=17) or control group (N.=17). The experimental group included a multistation exercise protocol to their training routines (2 times/week - 6 weeks); the control group continued their training routines. All the players completed similar training routines outside of the multistation exercises. Before (baseline), just after the intervention (Post6Wk) and four weeks later (Post10Wk), CMJ and knee JPS (absolute, relative and variable angular error: AAE, RAE and VAE, respectively) were evaluated. RESULTS ANOVA showed that the experimental group significantly decreased VAE at Post10Wk compared to baseline, suggestive of greater proprioceptive precision, while the control group significantly increased AAE, RAE and VAE at Post10Wk compared to baseline. The experimental group exhibited lower and thus, better AAE and VAE than the control group at Post10Wk, although no significant differences were found at Post6Wk. No significant differences was found in the CMJ. CONCLUSIONS A six weeks of multistation program may help improve proprioceptive precision of futsal players, even one month after finishing the 6-wk multistation training program. However, this is not long enough to improve proprioceptive acuity and maximum vertical jump. Therefore, the meaningful of these results in term of performance are unclear.
Balancing career and care

Just as the responsibility of raising children is lifting, many families face a new challenge— providing care to aging parents, relatives or friends. In 2002, over 1.7 million adults aged 45 to 64 provided informal care to almost 2.3 million seniors with long-term disabilities or physical limitations (Stobert and Cranswick 2004). While seniors receive some help from formal sources such as agencies, organizations or paid individuals, almost three-quarters of the hours spent assisting them are provided by a network of family and friends (Lafreniere et al. 2003). This informal support system may be sufficient to delay their entry into care institutions. Most informal providers of elder care are also in the labour market. In 2002, 70% of caregivers aged 45 to 64 were employed. 1 Many of these were women, who traditionally have provided much of the caregiving in our society. With the employment rate for women increasing substantially in the past two decades (from 44% in 1985 to 64% in 2005 for women aged 45 to 64) and concerns about labour shortages in the future, it is looking more likely that many men and women in this age group, particularly the upper end, will be pulled in two directions. The expectation may be not only to continue working, but also to act as caregiver for extended periods as life expectancy increases. At the same time, combining a heavy workload, family support and day-to-day tasks may lead to fatigue or quitting a job earlier than expected (Pitrou 2005).
Work-related complaints in the upper extremity : prevention and treatment

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Farmacología de los opioides

Endogenous and exogenous opioid bind to specific receptors. There are four different types of opioid receptors: mu, kappa, delta and nociceptin. All of them are membrane receptors coupled to protein G. Opioid drugs are classified, taking into account its affinity and efficacy for receptors, in four classes: pure agonists, agonist-antagonists, partial agonists and antagonists. The main pharmacological effects induced by agonists are sedation, euphoria, analgesia, nausea and vomiting, miosis, cough suppression, respiratory depression, truncal rigidity, constipation, face flushing and pruritus, urinary retention, and dependence (tolerance, withdrawal). The upregulation of the AMPc pathway seem responsible for tolerance and withdrawal symptoms. Opioide agonist induce long-lasting neural adaptations that are related to the synthesis of some transcription factors as CREB and ΔFosB, that seem relevant in relapse. Pharmacokinetic, drug interactions and therapeutic indications are reviewed.
Current and future treatments of bone metastases

Bone metastases contribute to a significant degree of morbidity in patients with common cancers through the development of skeletal related events (SRE) such as bone pain and pathological fracture. Traditional therapy has relied on surgical removal of lesions and, with the advent of adjuvant therapies, has been combined with radiotherapy, chemotherapy, and more recently osteoclast inhibiting agents like bisphosphonates. Although these therapeutic combinations can achieve a degree of local control, and rarely cure, across the vast majority of metastatic cancers they provide only palliation. Newer molecular agents currently under investigation, combined with innovations in surgery and radiation therapy offer a more targeted approach to bone metastasis. These utilise our understanding of key steps in the metastatic cascade including chemotactic attraction to bone, secretion of proteases, the cancer supporting microenvironment of bone matrix and the RANK-RANKL interaction for osteoclast activation. Direct inhibition of metastasis progression and osteolysis with less reliance on cytotoxic agents and invasive therapy should result in improved metastatic control, longer survival and less overall morbidity.
A compliance feedforward scheme for a class of LTV motion systems

The implementation of lightweight high-performance motion systems in lithography applications imposes among others lower requirements on actuators, amplifiers, and cooling. However, the decreased stiffness of lightweight designs brings the effect of structural flexibilities to the fore especially when the so-called point of interest is not at a fixed location. This is for example the case when exposing a silicon wafer. To deal with structural flexibilities, a feedforward controller is proposed that combines two concepts: (a) continuous compliance compensation control and (b) snap feedforward control. Expanded to a subclass of LTV motion systems, the resulting controller compensates for the position-dependent and time-varying compliance of a flexible structure. The compliance function used will be derived using partial differential equations (PDE). The method is validated by simulation results.
A remote attestation infrastructure for verifying the application of software updates

Cloud computing offers opportunities for organizations to reduce IT costs by using the computation and storage of a remote provider. Despite the benefits offered by the cloud computing paradigm, organizations are still wary of delegating their computation and storage to a cloud service provider due to trust concerns. The trust issues with the cloud can be addressed by a combinatiog of regulatory frameworks and supporting technologies. However, there appears to be little existing work that includes the application of software updates in trust assessment. Not applying software updates that fix security vulnerabilities can lead to serious problems. For example, the Canada Revenue Agency failed to update OpenSSL on their servers resulting in a temporary shutdown of tax filing. To address this issue we have developed a framework based on remote attestation and integrity measurements to address this problem. We showed that this could be effective in ensuring that software updates are done and our initial results suggests little run-time overhead.