Miracle-dz/UniFAR-FTUs huggingface dataset:
Dietary Vitamin K and Association with Hepatic Vitamin K Status in a Yup'ik Study Population from Southwestern Alaska

SCOPE The relationship between dietary vitamin K and plasma PIVKA-II concentration, a biomarker of hepatic vitamin K status, in a Yup'ik study population in southwestern Alaska is investigated. METHODS AND RESULTS A total of 659 male and female, self-reported Yup'ik people, ≥14 years of age, were enrolled. Blood is collected for genotyping and plasma PIVKA-II biomarker analysis. A Yup'ik-specific dietary food frequency questionnaire is used to assess vitamin K intake. Among the participants, 22% report not consuming foods rich in vitamin K during the past year and 36% have a PIVKA-II concentration ≥ 2 ng mL-1 , indicating vitamin K insufficiency. The odds of an elevated PIVKA-II concentration are 33% lower in individuals reporting any versus no consumption of vitamin-K-rich foods. The association is significant after adjusting for CYP4F2*3 genotype. Tundra greens are high in vitamin K1 content, but an exploratory analysis suggests that subsistence meat sources have a greater effect on vitamin K status. CONCLUSIONS A substantial proportion of the Yup'ik population exhibits vitamin K insufficiency, which is associated with low consumption of vitamin K rich foods and which might affect an individual's response to anticoagulant drugs such as warfarin that target the vitamin K cycle.
Adverse drug reaction profile of pegylated liposomal doxorubicin versus conventional doxorubicin: An observational study

Background : Potential life-threatening cardiac toxicities limit the lifetime dose of doxorubicin. The pegylation of the molecule protects the drug from detection by methoxypolyethylene glycol resulting increase of circulation time. Encapsulation of doxorubicin inside a pegylated liposome alters bioavailability, biodistribution and thus its biological activity significantly. We conducted an intensive monitoring of the adverse drug reactions (ADRs) profile of pegylated liposomal doxorubicin (PLD) in comparison with conventional doxorubicin in a tertiary care cancer center. Materials and Methods : ADR data were collected from 30 patients receiving PLD and 30 age-matched controls receiving conventional doxorubicin in this longitudinal observational study. Severity was graded as per US National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAEs). For the evaluation of acute and chronic toxicities, we adopted the basic scale from CTCAE version 4 of the National Cancer Institute. Results : The median disease duration was greater in PLD arm. Totally, 357 ADRs were noted with PLD and 375 with conventional doxorubicin. Of these, 75 (21%, 95% confidence interval [CI] 13.69-28.33%) in the PLD group and 60 (16.26%, 95% CI: 9.74-22.78%) in the conventional doxorubicin group were of grade 3/4 severity. Common events included myelosuppression, nausea, vomiting, anorexia, stomatitis, palmer-planter erythrodysesthesia, alopecia with PLD and myelosuppression, nausea, vomiting, anorexia, stomatitis, alopecia, and cardio-toxicities with conventional doxorubicin. For hematological toxicities, there was no statistical significant difference between two arms. Furthermore, gastrointestinal toxicities (nausea, vomiting, diarrhea, anorexia and stomatitis) were same for both arms. Among the skin toxicities palmar-plantar-erythrodysesthesia grade 2 toxicity was found in 60% patients receiving liposomal doxorubicin (P = 0.046). In cardio-toxicities, left ventricular ejection dysfunction found in 60% patients of conventional doxorubicin arm (P - 0.038). Conclusions: This observational study suggests that PLD has a better tolerability with less ventricular dysfunction but increased yet manageable palmar-plantar-erythrodysesthesia. This needs confirmation through further interventional study.
Effectiveness and Safety of Aprotinin Use in Thoracic Aortic Surgery.

OBJECTIVE To determine the effectiveness and safety of aprotinin use in adult patients undergoing thoracic aortic surgery. DESIGN Single-center, retrospective study. SETTING All cases performed at a single university hospital. PARTICIPANTS Between January 2004 and December 2014, 846 adult patients underwent thoracic aortic surgery. Due to missing or duplicated data on primary outcomes, 314 patients were excluded. The final sample of 532 patients underwent surgery on the thoracic aorta. INTERVENTIONS The patients were divided in the following 2 groups: 107 patients (20.1%) received aprotinin during the surgery, which represented the study group, whereas the remaining 425 patients (79.9%) underwent surgery without the use of aprotinin. MEASUREMENTS AND MAIN RESULTS To adjust for patient selection and preoperative characteristics, a propensity score-matched analysis was conducted. Mean total blood loss at 12 hours after surgery was similar between the 2 groups. The blood product transfusion rates did not differ in the 2 groups, except for the rate of fresh frozen plasma transfusion being significantly higher in the aprotinin group. Re-exploration for bleeding and the incidence of a major postoperative bleeding event were similar between the groups. Rates of in-hospital mortality, renal failure, and cerebrovascular accidents did not show any statistically significant difference. Aprotinin did not represent a risk factor for mortality over the long term (hazard ratio 1.14, 95% confidence interval 0.62-2.08, p = 0.66). CONCLUSIONS The use of aprotinin demonstrated a limited effect in reducing postoperative bleeding and prevention of major bleeding events. Aprotinin did not adversely affect early outcomes and long-term survival.
Influencing adherence to physical activity behaviour change in obese adults

Objective: Regular physical activity has beneficial health effects and aids weight management in obese adults, yet satisfactory adherence to physical activity behaviour change is rare. The primary objective was to summarise research evidence concerning influences on long-term physical activity behaviour change in obese adults. Secondary objectives were to scrutinise study quality, and to present recommendations for future research in terms of study design and research areas. Design: Narrative review. Papers were identified from a comprehensive electronic and manual literature search, and included/excluded according to set inclusion/exclusion criteria. Data from included studies was extracted and summarised. Results: Negative influences were social physique anxiety, unrealistic activity messages, and low motivation. Positive influences included social support, activity self-monitoring, increased activity-specific self-efficacy, moderate intensity activities (40-70% of V0 2 -max), moderate activity volumes (2-3 hours/week), short-bout sessions (10-15 minutes) with treadmill access, and home-based physical activity. However, limited strength and volume of evidence or inconclusive findings reduced our confidence in several purported influences. Conclusions: Many factors appear to influence adherence to physical activity behaviour change in obese adults. Although information on influences is accumulating, more research is still needed on how to provide best therapeutic support for this challenging task. Keywords: Adherence, adults, behaviour change, exercise, physical activity, obesity
The Challenge of HIV/TB in Asia

Even today, tuberculosis remains a public health problem ofenormous importance, and a leading infectious cause ofdeath among adults in many developing countries. The rapid spread of HIV and its close and deadly association with tuberculosis poses a great challenge toAsia. As has al ready been seen in Africa, TB notifications have either doubled or quadrupled, attributed primarily to HIV. Although the overall impact in Asia is not substantially visible, it is essential that the national AIDS and TB programmes work together and build partnerships to minimise the potential impact of HIV/TB in countries of the region.
Spatial Reasoning and Multi-Sensor Fusion, edited by Avi Kak and Su-shing Chen, Morgan Kaufmann Publishers, Los Altos, California 1987 (£22.50)

FUZZY MATHEMATICAL TECHNIQUES WITH APPLICATIONS by Abraham Kandel Addison-Wesley Publishing Company, USA 1986 (£37.95). This very complete 274 page treatise on fuzzy mathematics is aimed at readers at a graduate level with a strong (repeat strong) mathematical background. The seven chapters are entitled "Fuzzy Sets". "Possibility Theory and Fuzzy Quantification", "Fuzzy Functions", "Fuzzy Events and Fuzzy Statistics", "Fuzzy Relations", "Fuzzy Logics" and "Some Applications". The book is concluded with a 41 page bibliography containing about 1,000 references to fuzzy set theory and its applications. As an exhaustive research monograph this book meets the needs of all students, teachers and researchers interested in the subject of fuzzy mathematics. However, it should not be thought of, nor recommended as, a easy introduction or relaxing guide to the subject of fuzzy mathematics.
Correlates of Co-Occurring Depressive Symptoms and Alcohol Use in an Older Primary Care Clinic Population

ABSTRACT Objective: This report describes the prevalence and correlates of co-occurring depressive symptoms and alcohol use in an older Veteran's Affairs primary care clinic population. Methods: Participants include 8,782 older primary care patients (age 65 +) who responded to a self-report, mailed survey. Patients were classified into six mutually exclusive groups based upon screening indicators for problem drinking (quantity/frequency questions) and depressive symptoms (General Health Questionnaire). Groups included: (a) neither problem drinking nor depressive symptoms (n = 6,415, 73.0%); (b) at-risk alcohol use (n = 761; 8.7%); (c) heavy alcohol use (n = 201; 2.3%); (d) depressive symptoms (n = 1,234, 14.1%); (e) depressive symptoms and at-risk alcohol use (n = 120; 1.4%); and (f) depressive symptoms and heavy alcohol use (n = 51; 0.6%). Chi-square and ANOVA were used to test for equality of demographic and clinical characteristics across groups. Results: 12.9% of patients reported alcohol use consistent with problem drinking (including 10.0% with at-risk alcohol use and 2.9% with heavy alcohol use) and 16.1% screened positive for possible depressive symptoms (including 2.0% with co-occurring at-risk or heavy alcohol use). The combination of heavy alcohol use and depressive symptoms was associated with the highest rates of death and suicidal ideation; living alone; being divorced, separated, or widowed; and regular cigarette smoking. The presence of depressive symptoms (regardless of amount of alcohol use) was associated with worse perceived health, and perceived lack of social support. Finally, individuals with at-risk alcohol use alone were younger and had better perceived health compared to those with non-problem alcohol use or no alcohol use. However, there were no differences between those with at-risk drinking and depressive symptoms and those with depressive symptoms alone. Conclusions: Self-reported heavy alcohol use combined with depressive symptoms identifies a subgroup of older primary care patients at especially high risk with respect to suicidal ideation and poor mental and physical well-being. In contrast, older adults with depressive symptoms and self-reported “at-risk” alcohol use were not differentiated from older persons with depressive symptoms reporting non-problematic or nonuse of alcohol.
Monte Carlo calculation of conversion coefficients for dose estimation in mammography based on a 3D detailed breast model

Purpose At present, the Chinese specification for testing of quality control in x‐ray mammography is based on a simple breast model, and does not consider the glandular tissue distribution in the breast. In order to more precisely estimate the mean glandular dose (MGD) in mammography for Chinese women, a three‐dimensional (3D) detailed breast model based on realistic structures in the breast and Chinese female breast parameters was built and applied in this study. Methods To characterize the Chinese female breast, Chinese female breast parameters including breast size, compressed breast thickness (CBT), and glandular content were investigated in this study. A mathematical model with the detailed breast structures was constructed based on the Chinese female breast parameters. The mathematical model was then converted to a voxel model with voxels. The voxel model was compressed in craniocaudal (CC) view to obtain a deformation model. The compressed breast model was combined with the Chinese reference adult female whole‐body voxel phantom (CRAF) to study the effects of backscatter from the female body. Monte Carlo simulations of the glandular dose in mammography were performed with Geant 4. The glandular tissue dose conversion coefficients for breasts with different glandular contents (5%, 25%, 50%, 75%, and 100% glandularity) and CBTs (3 cm, 4 cm, 5 cm, and 6 cm) were calculated, respectively, at various x‐ray tube voltages (25 kV, 28 kV, 30 kV, 32 kV, and 35 kV) for various target/filter combinations (Mo/Mo, Mo/Rh, Rh/Rh, and W/Rh). Results A series of glandular tissue dose conversion coefficients for dose estimation in mammography were calculated. The conversion coefficients calculated in this study were compared with those estimated with the simple breast model. A discrepancy of 5.4–38.0% was observed. This was consistent with the results obtained from the realistic breast models in the literature. Conclusions A 3D detailed breast model with realistic structures in the breast was constructed based on the Chinese female breast parameters. It was used to calculate glandular tissue dose conversion coefficients for mammography. Although the accuracy of the proposed model could not be directly assessed, the consistency of the obtained results with previously performed analyses increases the confidence in the applicability of the proposed model. The proposed model could be used in dose estimation and dose optimization for mammography of Chinese women.
BK virus nephropathy complicated with meningoencephalitis after kidney transplantation

BK disease is an opportunistic infection in organ transplant recipients and patients with other cellular immunodeficiencies. To the best of our knowledge, we report the second case of BK meningoencephalitis associated with nephropathy in a kidney transplant recipient. A 15‐yr‐old boy underwent a cadaveric kidney transplant without complications; however, 11 wk after the transplantation, he was admitted to the hospital for graft dysfunction and cytopenia, which were confirmed by BK nephropathy (plasma viral replication and histological evidence). Four days after his hospital admission, he developed a high‐grade fever and headache. CSF analysis revealed pleocytosis with a positive PCR for BK virus. Reduction in immunosuppression and supportive care conducting cycles of immunoglobulin and cidofovir were successful in treating the patient. BK meningoencephalitis should be considered in kidney transplant recipients who present with signs and symptoms of meningoencephalitis.
Placement of an internal–external biliary drain through a bilio‐enteric fistula in a neonate to re‐establish antegrade bile flow after liver transplantation

Three‐month‐old baby girl with history of post‐liver transplant hepatic artery dissection treated with ligation after take down of the biliary anastomosis and placement of a surgical external common bile duct drain. There was persistent malfunction of this drain. A bilio‐enteric fistula was noted during the later placement of an image guided percutaneous external drain. Subsequently, an internal–external biliary drain was successfully placed through this fistula. An excellent clinical and functional result was achieved.
Intraoperative localized constrained registration in navigated bronchoscopy

Purpose: One of the major challenges in electromagnetic navigated bronchoscopy is the navigation accuracy. An initial rigid image‐to‐patient registration may not be optimal for the entire lung volume, as the lung tissue anatomy is likely to have shifted since the time of computer tomography (CT) acquisition. The accuracy of the initial rigid registration will also be affected throughout the procedure by breathing, coughing, patient movement and tissue displacements due to pressure from bronchoscopy tools. A method to minimize the negative impact from these factors by updating the registration locally during the procedure is needed and suggested in this paper. Methods: The intraoperative local registration method updates the initial registration by optimization in an area of special interest, for example, close to a biopsy position. The local registration was developed through an adaptation of a previously published registration method used for the initial registration of CT to the patient anatomy. The method was tested in an experimental breathing phantom setup, where respiratory movements were induced by a robotic arm. Deformations were also applied to the phantom to see if the local registration could compensate for these. Results: The local registration was successfully applied in all 15 repetitions, five in each of the three parts of the airway phantom. The mean registration accuracy was improved from 11.8–19.4 mm to 4.0–6.7 mm, varying to some degree in the different segments of the airway model. Conclusions: A local registration method, to update and improve the initial image‐to patient registration during navigated bronchoscopy, was developed. The method was successfully tested in a breathing phantom setup. Further development is needed to make the method more automatic. It must also be verified in human studies.
Micromarrows--three-dimensional coculture of hematopoietic stem cells and mesenchymal stromal cells.

Hematopoietic stem cell (HSC) transplant is a well established curative therapy for some hematological malignancies. However, achieving adequate supply of HSC from some donor tissues can limit both its application and ultimate efficacy. The theory that this limitation could be overcome by expanding the HSC population before transplantation has motivated numerous laboratories to develop ex vivo expansion processes. Pioneering work in this field utilized stromal cells as support cells in cocultures with HSC to mimic the HSC niche. We hypothesized that through translation of this classic coculture system to a three-dimensional (3D) structure we could better replicate the niche environment and in turn enhance HSC expansion. Herein we describe a novel high-throughput 3D coculture system where murine-derived HSC can be cocultured with mesenchymal stem/stromal cells (MSC) in 3D microaggregates--which we term "micromarrows. " Micromarrows were formed using surface modified microwells and their ability to support HSC expansion was compared to classic two-dimensional (2D) cocultures. While both 2D and 3D systems provide only a modest total cell expansion in the minimally supplemented medium, the micromarrow system supported the expansion of approximately twice as many HSC candidates as the 2D controls. Histology revealed that at day 7, the majority of bound hematopoietic cells reside in the outer layers of the aggregate. Quantitative polymerase chain reaction demonstrates that MSC maintained in 3D aggregates express significantly higher levels of key hematopoietic niche factors relative to their 2D equivalents. Thus, we propose that the micromarrow platform represents a promising first step toward a high-throughput HSC 3D coculture system that may enable in vitro HSC niche recapitulation and subsequent extensive in vitro HSC self-renewal.
Antibodies to Bovine Serum Albumin in Japanese IDDM Children; No Association with GAD Antibodies and HLA Risk Genotypes

The implications of Bovine serum albumin (BSA) in cow's milk proteins in the pathogenesis of insulin-dependent diabetes mellitus (IDDM) have been suggested, but is controversial even in Caucasians, and have been addressed in limited studies in other ethnic groups. We studied the prevalence of antibodies to BSA (BSAAb) in sera from Japanese children with IDDM, and compared it to those in children with other diseases including non insulin-dependent diabetes mellitus (NIDDM), autoimmune thyroid disease (AITD) and congenital hypothyroidism (cretinism) by using enzymelinked immunosorbent assay (ELISA). Significant levels of BSAAb were detected in sera from non-diabetic normal children, and higher levels in younger (1-3 years of age) than in older children (4-9 years of age). Only 2 of 20 (10%) recent-onset IDDM patients of age ≥ 4 years were assessed to have high titers of BSAAb compared to normal controls, and none of 8 sera from those of age <4 years were positive for BSAAb. No significant difference in the incidence of BSAAb was found among the various groups of children examined in both age groups. It appeared that BSAAb in IDDM patients bound to different sites on BSA from ABBOS (a 17-amino acid peptide, position 152 to 168 of BSA), based on the result that no significant blocking of BSAAb by the addition of ABBOS was detected by inhibition assay. Antibodies to glutamic acid decarboxylase (GADAb) in sera and human leukocyte antigen (HLA) -DR, -DQ genotypes of 28 recent-onset IDDM patients were examined. In addition, there was no significant difference between GADAb-positive and -negative IDDM patients in the titers of BSAAb. No association of BSAAb with HLA genotypes such as HLA-DR9-DQ9 and DR4-DQ4 was found in recent-onset IDDM patients. Collectively, BSAAb was not associated with IDDM in Japanese children.
Esophagus segmentation in CT via 3D fully convolutional neural network and random walk

Purpose: Precise delineation of organs at risk is a crucial task in radiotherapy treatment planning for delivering high doses to the tumor while sparing healthy tissues. In recent years, automated segmentation methods have shown an increasingly high performance for the delineation of various anatomical structures. However, this task remains challenging for organs like the esophagus, which have a versatile shape and poor contrast to neighboring tissues. For human experts, segmenting the esophagus from CT images is a time‐consuming and error‐prone process. To tackle these issues, we propose a random walker approach driven by a 3D fully convolutional neural network (CNN) to automatically segment the esophagus from CT images. Methods: First, a soft probability map is generated by the CNN. Then, an active contour model (ACM) is fitted to the CNN soft probability map to get a first estimation of the esophagus location. The outputs of the CNN and ACM are then used in conjunction with a probability model based on CT Hounsfield (HU) values to drive the random walker. Training and evaluation were done on 50 CTs from two different datasets, with clinically used peer‐reviewed esophagus contours. Results were assessed regarding spatial overlap and shape similarity. Results: The esophagus contours generated by the proposed algorithm showed a mean Dice coefficient of 0.76 ± 0.11, an average symmetric square distance of 1.36 ± 0.90 mm, and an average Hausdorff distance of 11.68 ± 6.80, compared to the reference contours. These results translate to a very good agreement with reference contours and an increase in accuracy compared to existing methods. Furthermore, when considering the results reported in the literature for the publicly available Synapse dataset, our method outperformed all existing approaches, which suggests that the proposed method represents the current state‐of‐the‐art for automatic esophagus segmentation. Conclusion: We show that a CNN can yield accurate estimations of esophagus location, and that the results of this model can be refined by a random walk step taking pixel intensities and neighborhood relationships into account. One of the main advantages of our network over previous methods is that it performs 3D convolutions, thus fully exploiting the 3D spatial context and performing an efficient volume‐wise prediction. The whole segmentation process is fully automatic and yields esophagus delineations in very good agreement with the gold standard, showing that it can compete with previously published methods.