Miracle-dz/UniFAR-FTUs huggingface dataset:
Epidemiologic, Clinical, Ultrasonographic, and Cytological Features of Thyroid Nodules in Predicting Malignancy Risk: A Retrospective Study of 442 French Afro-Caribbean Patients

Objective To evaluate epidemiologic, clinical, cytological, and ultrasonographic features of thyroid nodules in a sample French Afro-Caribbean population to determine if the standard criteria for predicting malignancy risk are applicable to this specific ethnic population. Methods and Design. This retrospectively designed study consisted of 442 patients who had consulted with the Endocrinology Department in Martinique (French overseas department) between 2007 and 2011. Of the 442 patients, 641 ultrasound-guided fine-needle aspirations (US-FNA) were performed by two experienced endocrinologists, and 212 patients underwent surgery. The geographical situation, age, gender of the patient, clinical and ultrasonographic features, TSH level, and US-FNA results were considered and cross-referenced with their pathology results. Results The overall malignancy rate on final histopathology was 9% (women only), 80% of which were papillary cancer, and 20% were follicular cancer. Occult micropapillary carcinoma represented 35% of the papillary cancer. There was no significant difference in age, nodule localization, number of nodules, or thyroid function test between benign and malignant nodules. Contrary to the literature, we found only 12% incidentaloma in our series, while more than half of the nodules were discovered on palpation or as a clinical symptom. Hypoechogenicity in solid pattern nodules and nodules between 2 and 3 cm in size revealed a high diagnostic value in detecting malignancy. The corresponding rate of malignancy on Bethesda system histopathologic examination was as follows: 0% in undiagnosed (I), 0% benign (II) (micropapillary), 5% (FLUS)/atypia (III), 9% follicular neoplasm (IV), 33% suspected malignancy (V), and no malignant cytology (VI). These results show a different Bethesda system predictive value for this French Afro-Caribbean population. Conclusion Studies evaluating ethnic cancer disparities among patients with thyroid cancer are limited and do not specifically focus on the French Afro-Caribbean population. Despite rare thyroid incidentaloma, 35% of the papillary cancer cases were micropapillary carcinoma, and the incidence and standardized mortality rate in Martinique are lower than in metropolitan France. The malignant risk distribution of thyroid FNA Bethesda classification in this sample population differs from the standard risk, and it is necessary to take that into account in the decision to operate by associating it with echographic malignancy criteria.
The Prevalence of Human Immunodeficiency Virus Infection in Patients with Sexually Transmitted Diseases

Background: Human immunodeficiency virus (HIV) transmission pattern in Iran has been changed from injection drug to sexual contact. Lack of accurate assessment of HIV in people with sexually transmitted diseases (STDs) in Iran prompted us to conduct this study to determine the frequency of HIV infection in these patients.Materials and Methods: In this cross-sectional study which conducted in 2016–2017, overall, 190 patients with STDs referring to two hospitals of Hamadan were enrolled in the study. All of the patients were examined for HIV in the first visit by rapid test and then 1 and 4 months later by the 4th generation ELISA. A questionnaire including demographic data, clinical manifestations, and high-risk behaviors was completed for all of the referring people. The collected data were analyzed using appropriate statistical tests. Results: Of 190 patients, 126 (66.3%) were female with a mean age of 34.1 ± 10.1 years and 64 (33.7%) were male with a mean age of 30.8 ± 7.8 years. One hundred twenty-eight (67.4%) got married, 73 (38.4%) and 76 (40%) had a diploma and postgraduate education, respectively, 32 (16.8%) mentioned the history of unsafe sex, and 23 (12.1%) had used condoms continuously during sexual contacts. The most common STDs were reported genital warts, 107 patients (56.3%), vaginal discharge (28, 14.7%), and genital ulcer (33, 17.4%). Two (1%) patients were positive for HIV at the first visit. Conclusion: Patients with STDs should be considered as an important source of HIV transmission, so clinicians should pay more attention to screening these patients for HIV infection.
Long-Term Effectiveness of Secukinumab in Patients with Axial Spondyloarthritis

Objectives The primary aim of our study was to evaluate long-term efficacy of secukinumab (SCK) in patients with axial spondyloarthritis (axSpA); secondary aims were to evaluate drug retention rate and to identify differences in the clinical and laboratory assessment according to axSpA clinical features, dosage administered, and biologic treatment lines. Patients and Methods. We collected clinical, demographical, and treatment data from 39 patients affected by axSpA consecutively treated with SCK. Laboratory assessment was based on inflammation parameters; clinical assessment was performed with the Ankylosing Spondylitis Disease Activity Score- (ASDAS-) CRP and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Data were recorded at baseline and every 3 months for the first year and then every 6 months in the second year. Results Twelve males and 27 females were enrolled; both BASDAI and ASDAS-CRP showed a statistically significant reduction during the observation period (p < 0.0001 and p < 0.0001, respectively). C-reactive protein significantly decreased (p = 0.006), with significant reduction at the post hoc analysis between baseline and both 6-month evaluation (p = 0.02) and 24-month visit (p = 0.036). No statistical significance was observed in BASDAI and ASDAS-CRP improvement (p = 0.482 and p = 0.164, respectively) between different dosages administered. No significant differences emerged in the BASDAI and ASDAS-CRP variations between biologic-naïve patients and subjects previously failing to tumour necrosis factor (TNF) inhibitors (p = 0.53 and p = 0.148, respectively). At the end of our observation, 7 out of 39 patients discontinued SCK. The global retention rate at the end of the study period was 78.2%, without any significant differences between biologic-naïve and anti-TNF-failure patients (p = 0.619) or between subjects administered with different SCK dosages (p = 0.614). No adverse events were reported. Conclusions In our cohort, SCK has proved a remarkable effectiveness regardless biologic treatment line and dosages employed. As suggested by the notable drug retention rate, SCK has been able to maintain its effectiveness over a considerable long period of treatment.
The formation of α-(1[right-facing arrow]3) D-glucosidic linkages by exocellular α-D-glucansucrases from Leuconostoc mesenteroides and Streptococcus mutans

Leuaonostoo mesentevoides NREtL B-I355 grows on sucrose to produce two extracellular a-D-glucans. Although both are termed dextrans, they are chemically and physically distinct, and can be separated by fractional ethanol precipitation into fractions designated L and S. Fraction L is similar to B-512F dextran, having 95% a-(l->6) linkages and 5% a-(l->3) branch linkages, but Fraction S has an alternating sequence of a-(l->6) and a-(l->-3) linkages. Because of its structural differences from dextran, its different physical characteristics, and its resistance to hydrolysis by endodextranase, we have named glucan S, alternan, and the enzyme that syn­ thesizes it from sucrose, alternansucrase. Alternansucrase has been iso­ lated by two different methods. The first involves removal of the fraction L glucan from the culture fluid via hydrolysis by an endodextranase, fol­ lowed by chromatography on Bio-Gel A-Sm. The void-volume fraction synthe­ sizes only alternan, whereas the slower-migrating, second fraction synthe­ sizes mainly dextran, together with some alternan. The second method utilized hydrophobic chromatography on O-(phenoxyacetyl)cellulose; a por­ tion of the alternansucrase did not bind, whereas the bound portion, re­ moved by eluting with detergent, contained both alternansucrase and dextransucrase. The glucans were identified by physical appearance, the con­ centration of ethanol required for precipitation, periodate-oxidation behavior, and susceptibility to hydrolysis by endodextranase. Also studied was the inhibition of the enzymes by 3-deoxy-3-fluoro-a-D-glucopyranosyl fluoride, tris(hydroxymethyl)aminomethane, 2-aminoethanol, and octyl 3-D-glucopyranoside.
The impact of United States Medical Licensing Exam (USMLE) step 1 cutoff scores on recruitment of underrepresented minorities in medicine: A retrospective cross‐sectional study

United States Medical Licensing Exam (USMLE) scores are the single, most objective criteria for admission into residency programs in the country. Underrepresented minorities in medicine (URiM) are found to have lower USMLE scores compared to their White counterparts. The objective of this study is to examine how USMLE step 1 cutoff scores may exclude self‐reported URiM from the residency interview process across various specialties.
Extracellular pH, Ca2+ Influx, and Response of Vascular Smooth Muscle Cells to 5-Hydroxytryptamine

Background and Purpose—Cerebral vascular smooth muscle cells (VSMCs) contract on extracellular pH (pHo) increases and relax on pHo decreases. These changes in tone are believed to result from changes in [Ca2+]i, although the responsible mechanisms are not fully understood. VSMCs also contract in response to 5-hydroxytryptamine (5-HT), which increases [Ca2+]i via both Ca2+ release and influx. We hypothesized that examining effects of pHo decreases on 5-HT–induced [Ca2+]i changes would allow us to identify mechanisms whereby pHo influences tone. Accordingly, we compared [Ca2+]i increases in cerebral VSMCs, evoked by 5-HT, with increases evoked by increased pHo and examined 5-HT–dependent [Ca2+]i increases at normal and decreased pHo. Methods—We monitored [Ca2+]i,, using the Ca2+-sensitive dye fura 2, in cultured rat cerebral VSMCs obtained by enzymatic digestion of middle cerebral arteries and their branches (passages 1 to 3) grown on glass coverslips and superfused with physiological saline. Results—Increa.
MODEL PENGEMBANGAN PARSISIPASI KELUARGA PASIEN DENGAN PREVENTIONT OF DISABILITY DI RS SUMBERGLAGAH MOJOKERTO

The onset of disability prevention efforts on lepers who have yet to experience a disability. One of the factors that influence self-care lepers is family participation. The purpose of this research was to prove the relationship family participation with in the prevention of disability lepers. This Design of this research was Analytic korelasionalwith crossectional approach. Population research namely whole leprosy in the outpatient room atSumberglagah hospital Pacet Mojokerto as much as 137 survivors. Samples taken with the concecutivesamplingtechnique as much as 20 respondents. There are two research variablewere family participation as the independent variable and the dependent variable as a disability prevention. Data collected by questionnaire instrument. Then the results of and tested with Chi-Square. The results showed that respondents from 11 his family participate in the prevention of disability most respondents can prevent the onset of disability as many as 10 respondents (55%) and 9 (45%) respondents were not able to prevent the occurrence of disability. and 19 respondents whose families participate less mostly not able to prevent the occurrence of defects as much as 11 respondents (55%) and which can prevent the onset of disability 9 respondents (45%). Chi-Square test results retrieved data ρ = 0.008 <α = 0.05 it means H1 accepted so there is a connection With Family participation in the prevention of disability. This shows the more active participation of the family given in lepers will be leprosy will be able to do the prevention of leprosy disability well anyway. So expect more families be active in the care of lepers in the home and can encourage the sufferer to be able to do self care on a regular basis in preventing the onset of disability
Introducing the recovery inspiration group: promoting hope for recovery with inspirational recovery stories

Purpose The purpose of this paper is to undertake a preliminary evaluation of a novel intervention – Recovery Inspiration Group, which uses recovery stories to promote hope and inspiration for recovery among people with complex mental health difficulties. Design/methodology/approach The Recovery Inspiration Group was delivered to women on a specialist personality disorder inpatient unit, who were concurrently participating in a dialectical behaviour therapy (DBT) Programme. In total, 12 service users participated in the RIG and as part of the intervention, wrote down key reflections after hearing each recovery story. A thematic analysis of these reflections formed the primary basis of the evaluation. Descriptive statistics derived from a service user feedback survey (n=6) supplemented the qualitative findings. Findings Three themes were identified in the qualitative data, suggesting that participants had engaged with recovery-oriented reflections and experiences: recovery stories as validating and inspiring; Generalisation of DBT skills; shifting perspectives of recovery: doing better rather than being better. The survey results unanimously endorsed the RIG as a worthwhile and validating experience, which participants would recommend to other service users. Practical implications Recovery Inspiration Group appears to be a low-cost and easily replicable intervention with the potential to promote hope and inspiration for recovery among people with complex mental health difficulties. Originality/value Recovery Inspiration Group is a novel approach to harnessing the wisdom of people with lived experience of mental health difficulties, to foster hope among users of mental health inpatient services.
Rheumatic heart failure: A review of clinical status and meta-analysis of echocardiography diagnosis and efficacy of shorter duration of antibiotic

Rheumatic heart failure (RHF) is a potentially preventable cardiac complication of rheumatic fever (RF) characterized by scarring or stretching in one or more cardiac valves leading to low cardiac output. Over the past five decades, the epidemiology of RHF has shifted markedly, reducing in high-income countries while increasing in low/middle-income countries. However, the shift has lacked a matching proportional expansion in research and public health practices. Prophylactic and curative therapies combined with targeted public health control programs have been associated with the reducing prevalence in high-income countries but such strategies either have not been adequately implemented or have not translated into reduced burden in low-income countries. Further, the lack of recent research has undermined access to evidence-based data to support the development of treatment guidelines appropriate for low/middle-income countries. In the present paper, we review published data to provide a comprehensive update on epidemiology, pathophysiology, diagnosis, and management strategies for RHF. *Correspondence to: Aref Albakri, St-Marien hospital Bonn Venusberg, Department of Internal Medicine, Bonn, Germany, E-mail: arefalbakri@yahoo.com
Establishment and characterization of a cell line HRC-99 from human rectal adenocarcinoma

目的:建立一人直肠癌细胞系并探讨其生物学特性. 方法:取人直肠癌新鲜手术标本,经组织块体外培养并克隆建系,命名为HRC-99. 采用光镜、电镜、免疫组化、染色体核型分析及异种移植瘤实验对细胞系生物学特性进行观察. 结果:原位肿瘤、细胞系及移植瘤标本经光镜、电镜证实该细胞系具有腺上皮性恶性细胞特征,并观察了其体外生长曲线、倍增时间和分裂指数;免疫组化CEA和CK-20呈阳性表达;染色体核型分析众数为60,为亚三倍体,G显带出现标记染色体和染色体易位;裸鼠皮下异种移植形成移植瘤. 结论:HRC-99为一株新的来源于直肠中分化腺癌的细胞系.
Prevalence of Malnutrition among Hospitalized Medical Intensive Care Unit Patients in a University Hospital, Cairo, Egypt: Hospital Based Survey

Background/Aims: Malnutrition in critically ill adults in the intensive care unit (ICU) is a serious public health problem that has been associated with a significantly elevated risk of infectious and non-infectious complications. This study aimed to estimate the prevalence of malnutrition among adult patients admitted to medical ICU. Methods: This was a hospital based prospective cross-sectional study carried out for 3 months in medical ICU of the internal medicine ward in AL-Zahra University hospital, Cairo, Egypt. Patients were evaluated for the nutritional status by using subjective global assessment (SGA) within the first 24 hours of admission. Results: A total of 68 patients were participated in the study (61.1±13.3 years; 54.4% females). According to SGA, 50% of ICU patients were malnourished either mild/moderate (35.3%) or severely malnourished (14.7%). Malnourished patients had a mortality rate of (55.9%) versus well-nourished group (26.5%). Conclusions: Malnutrition was highly prevalent among critically ill patients in medical ICU and increased the risk of mortality. Nutritional screening is mandatory in ICU sitting to initiate timely nutritional therapy.
Comparison of coronary heart disease stratification using the Jakarta cardiovascular score between main office and site office workers

The risk of cardiovascular disease has been reported to be associated with a sedentary behavior, which is characterized by long-term activities that involve lying down or sitting, especially when done for more than 10 h a day, compared with less than 5 h a day. One underlying problem in this company was the significant number of cardiovascular disease risk factors that were obtained during periodic check of employees in one department and the lack of assessment in the other departments. The purpose of this research was to determine the cardiovascular disease risk stratification using the Jakarta Cardiovascular Score as a recommendation to the company management to use this score to assess the risks for cardiovascular disease among workers, especially those in the main office. A cross-sectional study design was used with comparative analysis. The factor that was most closely related with cardiovascular risk stratification was a family history of cardiovascular disease (p = 0.021, OR = 1334.3, dan 95% CI = 147.1–12,103.6).
Muscle wasting diseases has two distinct trajectories on the 3‐dimensional age‐BMI‐peak VO2 scatterplot

Frailty and sarcopenia are age‐related morbid states, and a low body mass index (BMI) is a characteristic of frailty and cachexia. However, no common index for assessing these three muscle wasting states is available, making it difficult to understand the relationship among them. Peak oxygen uptake (peak VO2), an index of life expectancy, may be a useful common index. Therefore, this study aimed to investigate the relationship among sarcopenia, frailty, and cachexia using age, BMI, and peak VO2.
A Better Life - What Older People With High Support Needs Value

Finding the best way to develop and fund support for the increasing numbers of older people in society is a political priority. Understanding, measuring, improving and monitoring their overall quality of life (not just the quality of their care) will be the main challenge. This study presents the views of older people with high physical and mental support needs who have described what they want and value in their lives, and proposes a model to assist policy-making, research and practice.
THE NATURE OF HERPES ZOSTER: A LONG-TERM STUDY AND A NEW HYPOTHESIS.

Dr Hope-Simpson presents a study of all cases of herpes zoster occurring in his general practice during a sixteen-year period. The rate was 3·4 per thousand per annum, rising with age, and the distribution of lesions reflected that of the varicella rash. It was found that severity increased with age, but that the condition did not occur in epidemics, and that there was no characteristic seasonal variation. A low prevalence of varicella was usually associated with a high incidence of zoster. Dr Hope-Simpson suggests that herpes zoster is a spontaneous manifestation of varicella infection. Following the primary infection (chickenpox), virus becomes latent in the sensory ganglia, where it can be reactivated from time to time (herpes zoster). Herpes zoster then represents an adaptation enabling varicella virus to survive for long periods, even without a continuous supply of persons susceptible to chickenpox.
Arobase: A phase III trial of exemestane (Exe) and bevacizumab (BEV) as maintenance therapy in patients (pts) with metastatic breast cancer (MBC) treated in first line with paclitaxel (P) and BEV—A Gineco study.

501 Background: Combination of P+BEV significantly improves progression-free survival (PFS) in MBC pts, but is associated with adverse events (AEs), mainly neuropathy and fatigue worsening over time. Endocrine therapy (ET) combined to BEV has been proven tolerable and may be a option as maintenance therapy after P+BEV. Methods: in this prospective, randomized, open label, phase III study, pts with histologically confirmed ER+ HER2- locally advanced or MBC, who had not progressed after 16-24 weeks of 1st-line P+BEV therapy, were randomized to P+BEV continuation vs ET+BEV (Exe 25 mg/d+BEV 15 mg/kg q3w). Primary endpoint was PFS. To demonstrate an improvement in the 6-month PFS rate (PFS-6m) from 50% with P+BEV to 65% with ET+BEV (2-sided α=5%) with 80% power, 141 events were requiered and 198 pts were planned. An interim analysis (IA) was planned after 40% of required events. Secondary endpoints included overall survival (OS) and toxicity. Results: At the cut-off date for the IA (May 2013), 113 pts were inc.
Antimetabolic effects of plant proteins on homopteran insect pests

Homopteran insect pests can cause severe economical damage to crop plants by both direct physical means and as vectors of plant viral diseases. They are notoriously difficult insects to control by conventional methods, primarily due to their ability to evolve resistance-breaking biotypes within a relatively short time period. The production of genetically modified crop plants, expressing insecticidal genes, offers a novel method of control for a wide range of insect species. Once suitable gene products, such as plant- derived proteins, have been identified as having insecticidal effect against specific insects in vitro, their effect can be determined in vivo by expressing the relevant gene in transgenic plants. Insect feeding trials were carried out to determine the effects of incorporating a range of plant-derived proteins into artificial diets fed to planthopper, leafliopper and aphid pests and to aphids in planta. The lectins Galanthus nivalis agglutinin (GNA) and wheat germ agglutinin (WGA), and the enzyme soybean lipoxygenase (LPO) were shown to exhibit significant antimetabolic effects towards first and third instar nymphs of rice brown planthopper (Nilaparvata lugens Stal) when incorporated into artificial diet at 0 1% {w/v}, 0-1% (w/v) and 0 08% {w/v} levels respectively. The lectin GNA was also shown to exhibit a significant antimetabolic effect towards third instar nymphs of the rice green leafhopper (Nephottetix cinciteps Uhler) and the peach potato aphid {Myzus persicae Sulzer). A number of inert proteins, lectins, protein inhibitors and enzymes also tested showed relatively little or no effect towards both insects. The mechanism of action of all three effective proteins was examined using BPH as a model insect. As judged by honeydew production, the proteins all had a deterrent effect on insect feeding. However, subsequent toxic effects are also indicated. When fed sub-optimal concentrations of effective proteins in combination no synergistic or additive effects were observed, indicating that pyramiding the genes of these effective proteins would be of no advantage in protecting the crop against BPH.