Miracle-dz/UniFAR-FTUs huggingface dataset:
A novel genotype of hepatitis E virus prevalent among farmed rabbits in China

In total, 335 serum samples were collected from rabbits from two farms in Gansu province, China, and tested for anti‐hepatitis E virus (HEV) antibody using EIA and for HEV RNA using nested RT‐ PCR with ORF2 primers. The overall prevalence of anti‐HEV antibody and HEV RNA was 57.0% (191/335) and 7.5% (25/335), respectively. The positivity rate of HEV RNA in the anti‐HEV antibody negative group (7.6% (11/144)) did not differ significantly from that in the positive group (7.3% (14/191)). The concordance between HEV RNA and anti‐HEV antibody was 43.3% with no significant correlation (P < 0.05). All 25 amplicons from the ORF2 region were cloned and sequenced. On the basis of nucleotide sequence comparison, they had 84–99% identity to each other and 73–77%, 70–76%, 75–82%, 71–77%, and 53–65% with the corresponding regions of genotypes 1, 2, 3, 4, and avian HEV, respectively. Samples that were positive with the ORF2 primers were amplified using ORF1 region primers; 17 were positive and shared 71–78%, 73–76%, 74–82%, 72–78%, and 39–58% identity with the corresponding regions of genotypes 1, 2, 3, 4, and avian HEV, respectively, at the nucleotide level. Two representative full‐length sequences were determined. These two sequences shared 85% identity with each other and had 74%, 73%, 78–79%, 74–75%, and 46–47% identity to full‐length genotypes 1, 2, 3, 4, and avian HEV, respectively. Thus, the sequences isolated from the rabbits represent a novel genotype of HEV. This study provides novel information about HEV genotypes infecting rabbits as well as evidence of a new mammalian genotype of HEV. J. Med. Virol. 81:1371–1379, 2009. © 2009 Wiley‐Liss, Inc.
Access control and confidentiality in radiology

A medical record contains a large amount of data about the patient such as height, weight and blood pressure. It also contains sensitive information such as fertility, abortion, psychiatric data, sexually transmitted diseases and diagnostic results. Access to this information must be carefully controlled. Information technology has greatly improved patient care. The recent extensive deployment of digital medical images made diagnostic images promptly available to healthcare decision makers, regardless of their geographic location. Medical images are digitally archived, transferred on telecommunication networks, and visualized on computer screens. However, with the widespread use of computing and communication technologies in healthcare, the issue of data security has become increasingly important. Most of the work until now has focused on the security of data communication to ensure its integrity, authentication, confidentiality and user accountability. The mechanisms that have been proposed to achieve the security of data communication are not specific to healthcare. Data integrity can be achieved with data signature. Data authentication can be achieved with certificate exchange. Data confidentiality can be achieved with encryption. User accountability can be achieved with audits. Although these mechanisms are essential to ensure data security during its transfer on the network, access control is needed in order to ensure data confidentiality and privacy within the information system application. In this paper, we present and discuss an access control mechanism that takes into account the notion of a care process. Radiology information is categorized and a model to enforce data privacy is proposed.
Effect of Inhaled Lavender and Sleep Hygiene on Self-Reported Sleep Issues: A Randomized Controlled Trial.

OBJECTIVES To compare the effectiveness of lavender (Lavandula angustifolia) and sleep hygiene versus sleep hygiene alone on sleep quantity and sleep quality and to determine sustained effect at two-week follow-up. DESIGN A randomized controlled trial with investigator blinding and steps taken to blind the participants. SETTING Participants' usual sleep setting. SUBJECTS Seventy-nine college students with self-reported sleep issues. INTERVENTIONS The intervention took place over five nights with baseline, postintervention, and two-week follow-up assessments. Both groups practiced good sleep hygiene and wore an inhalation patch on their chest at night. One group wore a patch with 55 μl of lavender essential oil and the other group wore a blank patch. OUTCOME MEASURES Sleep quantity was measured using a Fitbit(®) tracker and a sleep diary, and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) sleep disturbance short form. RESULTS The lavender and sleep hygiene group demonstrated better sleep quality at postintervention and two-week follow-up (PSQI p=0 .01, <0.001 and PROMIS p=0.04, 0.007, respectively). The sleep-hygiene-only group also demonstrated better sleep quality but to a lesser extent (PSQI p=0.02, 0.06 and PROMIS p=0.03, 0.03, respectively). Additionally, a clinical effect was found for the lavender group at postintervention, along with a significant finding for waking feeling refreshed (p=0.01). Sleep quantity did not differ between groups. CONCLUSIONS Lavender and sleep hygiene together, and sleep hygiene alone to a lesser degree, improved sleep quality for college students with self-reported sleep issues, with an effect remaining at follow-up.
An Acknowledgment of Priority.

Chicago, July 25, 1902. To the Editor: —Since writing my article, describing an improved method of examining the female bladder, I have found that Dr. William Pryor of New York read a paper before the New York County Medical Association, Jan. 21, 1901, in which he advocated the posture which I have recommended as being most advantageous in the examination of the female bladder, and which I have obtained by a slight modification of the Boldt table. I was first convinced of the value of the posture on witnessing Dr. Kelly's demonstration of his method of examining the bladder in the genupectoral position, before the British Medical Association in Montreal, and I immediately afterward adopted the Boldt table to obtain the elevated lithotomy posture, in the Royal Victoria Hospital. I am glad to acknowledge Dr. Pryor's claim to priority in this matter. Working independently, we arrived at the same conclusions,
Weber-Christian disease: ultrasound can see it

Weber-Christian disease, also known as idiopathic relapsing febrile nodular non-suppurative panniculitis, is a rare inflammatory disorder of the subcutaneous tissue characterized by recurrent nodules often associated with constitutional symptoms, in particular pain and fever. A 50-year-old female patient underwent ultrasound examination of the soft tissues because of relapsing painful subcutaneous nodules of the left arm, accompanied by fever. Ultrasonography showed subcutaneous nodules suggestive of panniculitis. An ultrasound-guided biopsy was performed. The ultrasound-guided biopsy from the nodules with mixed echostructure revealed lobular panniculitis with a mixed cell infiltrate, consistent with Weber-Christian disease, after clinical and pathological exclusion of several differential diagnoses. Recurrent painful subcutaneous nodules associated with fever necessitate a careful medical history and thorough physical examination. Ultrasound can be useful to formulate the hypothesis of panniculitis. Histological examination of a ultrasound-guided biopsy of a nodule with mixed echostructure is needed to confirm the diagnosis. Weber-Christian disease remains a diagnosis of exclusion, when no other cause for the lobular panniculitis can be identified.
Evaluated the L-spine Magnetic Resonance Imaging for the Scanning Method of the Lateral Recumbent Position with to the Embarrassed Control of the Acute Low Back Pain

The acute lumbar pain patients who were unavoidable to take MRI examination were made to take altered lateral recumbent position. they were also not able to control their painfulness and to be in supine position. In this study, it is supposed to increase success rate of the MRI examination through taking the altered lateral recumbent position in using spine and body matrix coil. This altered position made relaxing lumber pain and fatigue for the patients who suffered from sever lumber pain. In these reasons, it decreases the motion artifacts through correcting uncomfortable posture. As a result, qualitative analysis for the image quality was estimated to have average points of supine position A group(lateral recumbent position) of normal candidates and B group(lateral recumbent position) of the abnormal candidates who have sever pain at 4.64, 3.44, and 3.40, respectively. In conclusion, while qualitative analysis in the examination with supine position of the normal patients had significantly high points, the qualitative analysis in the examination with lateral recumbent position of the normal patients and abnormal patients who had sever lumbar pain was almost same. In addition, it was judged that radiologists' imagery interpretation had no other problems in the image evaluation of B group who had acute lumbar pain of abnormal patients. Hereupon, if this technique becomes generalized for the patients who suffer from supine position in the examination, it is supposed to be useful in medical field.
The challenge of intratumour heterogeneity in precision medicine

Cells within tumours have diverse genomes and epigenomes and interact differentially with their surrounding microenvironment generating intratumour heterogeneity, which has critical implications for treating cancer patients. Understanding the cellular and microenvironment composition and characteristics in individual tumours is critical to stratify the patient population that is likely to benefit from specific treatment regimens. Here, we will review the current understanding of intratumour heterogeneity at the genomic, epigenomic and microenvironmental levels. We will also discuss the clinical implications and the challenges posed by intratumour heterogeneity and evaluate noninvasive methods such as circulating biomarkers to characterize the cellular diversity of tumours. Comprehensive assessment of the molecular features of patients based on tumour specimen characterization (including intratumour spatial and temporal variations), ancillary noninvasive methods (such as circulating biomarkers and molecular imaging approaches) and the correct design of clinical trials are required to guide administration of targeted therapy and to control therapeutic resistance. Finding the means to accurately determine and effectively control tumour heterogeneity and translate these achievements into patient benefit are major goals in modern oncology.
Occult hepatitis C virus infection in Iranian patients with cryptogenic liver disease

The diagnosis of cryptogenic liver disease is made when after extensive evaluations, recognizable etiologies of chronic liver disease are excluded. In this study, the presence of hepatitis C virus (HCV) RNA was tested in peripheral blood mononuclear cells (PBMCs) taken from Iranian patients who although were found negative for plasma HCV RNA and anti‐HCV antibodies, suffered from chronic liver disease of unknown etiology. From September 2007 to March 2010, 69 patients from Tehran with chronic liver disease of unknown etiology who were referred to our center were enrolled in the present study. PBMCs were isolated from 10 mL peripheral blood specimens. HCV‐RNA status was tested in plasma and PBMCs samples by reverse‐transcription polymerase chain reaction (RT‐PCR). HCV‐RNA was detected in HCV‐positive PBMCs specimens by RT‐PCR method. HCV genotypes were subsequently analyzed in HCV‐positive samples using restriction fragment length polymorphism (RFLP) assay; then HCV genotypes were confirmed by sequencing of 5′ non‐coding fragments after cloning PCR products into pJET1.2/blunt cloning vector. HCV‐RNA was detected in PBMCs specimens belonging to 7 (10%) out of 69 patients. Genotyping of the HCV‐RNA isolated from PBMCs showed that 3 (43%) patients with occult HCV infection had genotype 1b, 2 (29%) had genotype 1a, and another 2 (29%) had genotype 3a. The results of this study suggest that patients with chronic liver disease of unknown etiology may have occult HCV infection in the absence of anti‐HCV antibodies and plasma HCV‐RNA. It has been suggested that in the absence of liver biopsy specimens, analysis of PBMC sample for HCV‐RNA would be informative. J. Med. Virol. 83:989–995, 2011. © 2011 Wiley‐Liss, Inc.
Subtype diversity associated with the development of HIV‐1 resistance to integrase inhibitors

We used genotypic and phylogenetic analysis to determine integrase diversity among subtypes, and studied natural polymorphisms and mutations implicated in resistance to integrase inhibitors (INI) in treatment‐naïve persons (n = 220) and ‐experienced individuals (n = 24). Phylogenetics revealed 7 and 10% inter‐subtype diversity in the integrase and reverse transcriptase (RT)/protease regions, respectively. Integrase sequencing identified a novel A/B recombinant in which all viruses in a male‐sex‐male (MSM) transmission cluster (n = 12) appeared to possess subtype B in integrase and subtype A in the remainder of the pol region. Natural variations and signature polymorphisms were observed at codon positions 140, 148, 151, 157, and 160 among HIV subtypes. These variations predicted higher genetic barriers to G140S and G140C in subtypes C, CRF02_AG, and A/CRF01_AE, as well as higher genetic barriers toward acquisition of V151I in subtypes CRF02_AG and A/CRF01_AE. The E157Q and E160Q mutational motif was observed in 35% of INI‐naïve patients harboring subtype C infections, indicating intra‐subtype variations. Thirteen patients failed raltegravir (RAL)‐containing regimens within 8 ± 1 months, in association with the major Q148K/R/H and G140A/S (n = 8/24) or N155H (n = 5/24) mutational pathways. Of note, the remaining patients on RAL regimens for 14 ± 3 months harbored no or only minor integrase mutations/polymorphisms (T66I, T97A, H114P, S119P, A124S, G163R, I203M, R263K). These results demonstrate the importance of understanding subtype variability in the development of resistance to INIs. J. Med. Virol. 83:751–759, 2011. © 2011 Wiley‐Liss, Inc.
Towards new tuberculosis vaccine

According to WHO, about one third of the world’s population is infected with bacteria of the Mycobacterium tuberculosis complex. Currently there is globally 9.15 million recorded cases of overt tuberculosis (TB) annually and due to lack of adequate diagnostics presumably a large but unknown number of non-recorded cases. TB is estimated to cause 1.65 million deaths per annum which accounts for one-fifth of all deaths by infectious diseases of adults in low-income countries. During recent years a rapid spread of multi-drug resistant bacteria causing about 0.5 million TB cases per year has worsened the problem. The live attenuated Bacillus Calmette-Guérin (BCG) vaccine which is the only currently available TB vaccine does not confer any significant protection against the most common and contagious form of TB – adult pulmonary TB.
Interpretation of Positive Flow Cytometric Crossmatch in the Era of the Single-Antigen Bead Assay

Background. Prognosis of renal transplants with positive flow cytometric crossmatch (FCXM) remains controversial. Methods. We analyzed the outcome of these kidney transplant recipients by human leukocyte antigen (HLA) donor-specific antibodies (HLA-DSA) using single-antigen bead (SAB) assays in major histocompatibility complex classes I and II. We compared them with controls with a negative FCXM. Results. Forty-five patients consecutively transplanted with a positive FCXM had significantly more acute rejection episodes than the control patients (33.3% vs. 8.9%, P=0.002). Risk of acute rejection was increased with day 0 (D0) positive T-cell FCXM (odds ratio [OR]=9.04, P=0.002), D0 positive B-cell FCXM (OR=7.43, P=0.02), and D0 HLA-DSA identified by SAB assay (OR=6.5, P=0.03). The 21 patients with D0 positive FCXM and D0 HLA-DSA had more acute rejection (62%, P=0.0001) and a lower estimated glomerular filtration rate 1-year posttransplantation (P=0.0001), when compared with controls. Mainly anti-Cw and anti-DP HLA-DSA were found in patients displaying acute rejection. The remaining FCXM-positive patients displayed short-term outcomes similar to controls. The presence of HLA-DSA detected only by the SAB assay in the context of a negative FCXM crossmatch was not associated with increased risk of acute rejection. Conclusion. Identification of HLA-DSA in D0 sera by the two sensitive techniques FCXM and SAB assay indicates which patients are at highest risk of subsequent acute allograft rejection and chronic allograft dysfunction.
Contribution of common and recently described respiratory viruses to annual hospitalizations in children in South Africa†

The contribution of viruses to lower respiratory tract disease in sub‐Saharan Africa where human immunodeficiency virus may exacerbate respiratory infections is not well defined. No data exist on some of these viruses for Southern Africa. Comprehensive molecular screening may define the role of these viruses as single and co‐infections in a population with a high HIV‐AIDS burden. To address this, children less than 5 years of age with respiratory infections from 3 public sector hospitals, Pretoria South Africa were screened for 14 respiratory viruses, by PCR over 2 years. Healthy control children from the same region were included. Rhinovirus was identified in 33% of patients, RSV (30.1%), PIV‐3 (7.8%), hBoV (6.1%), adenovirus (5.7%), hMPV (4.8%), influenza A (3.4%), coronavirus NL63 (2.1%), and OC43 (1.8%). PIV‐1, PIV‐2, CoV‐229E, ‐HKU1, and influenza B occurred in <1.5% of patients. Most cases with adenovirus, influenza A, hMPV, hBoV, coronaviruses, and WU virus occurred as co‐infections while RSV, PIV‐3, and rhinovirus were identified most frequently as the only respiratory pathogen. Rhinovirus but not RSV or PIV‐3 was also frequently identified in healthy controls. A higher HIV sero‐prevalence was noticed in patients with co‐infections although co‐infections were not associated with more severe disease. RSV, hPMV, PIV‐3, and influenza viruses had defined seasons while rhinovirus, adenovirus, and coronavirus infections occurred year round in this temporal region of sub‐Saharan Africa. J. Med. Virol. 83:1458–1468, 2011. © 2011 Wiley‐Liss, Inc.
Clinical evaluation of the signal‐to‐cutoff ratios of hepatitis C virus antibody screening tests used in China

The clinical diagnosis of hepatitis C virus (HCV) infection is important to direct an accurate course of therapy. Previous studies have reported a correlation between the signal‐to‐cutoff (S/CO) ratios of the anti‐HCV screening test and confirm HCV infections for American anti‐HCV screening kits as well as for those in China. It is currently unknown whether clinical laboratories use the same threshold S/CO ratios under routine conditions and if these values are acceptable for the analysis of Chinese samples. A total of 336 anti‐HCV screening‐test‐positive serum samples were tested in duplicate using different lots of three most commonly used enzyme immunoassay (EIA) kits available in China. Samples were also tested using the Architect Anti‐HCV chemiluminescent microparticle immunoassay (CMIA) kit and measured for HCV RNA. Recombinant immunoblot assays (RIBA) were additionally performed on samples with HCV RNA‐negative results with RIBA HCV 3.0. The relationship between S/CO ratios and confirmed HCV infection rates were analyzed. The threshold S/CO ratio for each screening kit correlated with the ≥95% positive predictive value was InTec 12.0, KHB 4.0, Wantai 5.0, and Abbott Architect 5.0. Therefore, the same threshold S/CO ratios for manufactured domestically EIA kits was difficult to attain. A multi‐center study with a large sample size is required to identify a uniform threshold S/CO ratio for use in different diagnostic laboratories. Alternatively, individual laboratories may be required to establish threshold S/CO ratios in their own laboratories to obtain consistent diagnostic results. J. Med. Virol. 83:1930–1937, 2011. © 2011 Wiley‐Liss, Inc.
As Depressing as It Was Predictable? Lung Cancer, Clinical Trials, and the Medical Research Council in Postwar Britain

In recent years lung cancer specialists have complained that due to stigma resulting from the association of the disease with smoking, theirs is a neglected field. This paper demonstrates that in the 1950s and 1960s, when the British Medical Research Council (MRC) started to organize clinical trials for various forms of cancer, this was not the case. Rather, the organizers of these trials saw lung cancer as a particularly promising object of research, for much was known about the disease. The cancer trials were part of a strategy to use the Randomized Controlled Trial (RCT) technology to cement the role of the MRC as the dominant body overseeing medical research in Britain. The organization of the trials, however, turned out to be very difficult, due to ethical problems and the dominance of one form of therapy, surgery. The trial results were deeply disappointing. I argue that these frustrating results contributed to the notion of hopelessness that has come to surround lung cancer, and to the shift of focus from cure to prevention that was triggered by epidemiologic studies identifying tobacco smoke as the main cause of the disease. The paper deals with an important episode in the history of clinical cancer research in postwar Britain, illustrating the ethical and practical problems faced by the organizers.
Long‐term interferon monotherapy reduces the risk of HCV‐associated hepatocellular carcinoma

The aims of this study were to evaluate the efficacy of long‐term interferon (IFN) monotherapy on hepatocellular carcinoma (HCC) in patients who showed no virological response to the first course of IFN therapy, define predictive factors for HCC in patients on long‐term IFN monotherapy, and evaluate the clinical impact of amino acid (aa) substitutions in the hepatitis C virus (HCV)‐1b core region on HCC rate. This retrospective study included 494 consecutive treatment‐naive patients infected with HCV‐1b who failed to achieve sustained virological response after ≥24‐week IFN monotherapy. Of 494 patients, 113 (22.9%) received another course of ≥48‐week IFN monotherapy (additional‐IFN group), while the remaining 381 (77.1%) received no such therapy (no‐additional‐IFN group), and 10 years have elapsed since the end of the first IFN monotherapy. The cumulative HCC rate was significantly higher in the no‐additional‐IFN group than additional‐IFN group, and in those with aa substitutions in the core region of Gln70(His 70) and Met 91 than those with Arg 70 and/or Leu 91. Multivariate analysis identified stage of liver fibrosis, liver enzymes, age, treatment group, aa substitution in the core region, low‐density lipoprotein cholesterol (LDL‐cholesterol), and gender as determinants of HCC, and that additional IFN treatment significantly lowered the cumulative rate of HCC, even in patients with cirrhosis. In conclusion, long‐term IFN monotherapy reduces the risk of HCC, even in patients with cirrhosis. Substitution of aa at position 70 and/or 91 in the core region and lipid metabolism are important predictors of HCC in long‐term IFN monotherapy. J. Med. Virol. 84: 1199–1207, 2012. © 2012 Wiley Periodicals, Inc.
A Case of Anti-p200 Pemphigoid

80歳，男性。 初診の約3ヵ月前より全身にそう痒を伴う紅斑が出現した。 次第に拡大し，水疱を伴ってきたため受診した。 顔面を含む略全身に大小様々の浮腫性紅斑が多発し，紅斑局面上に比較的小さな緊満性水疱を認め，一部は環状に配列していた。 病理組織学的に表皮下水疱を認め，水疱内と真皮上層に好酸球やリンパ球を主体とする炎症性細胞浸潤を認めた。 蛍光抗体直接法では，表皮真皮境界部にIgGとC3の線状沈着を認め，1M食塩水剥離皮膚を基質に用いた蛍光抗体間接法では，真皮側にIgGの反応を認めた。 EDTA剥離真皮抽出液を用いた免疫ブロット法では，患者血清は200kD蛋白に反応した。 以上より抗p200類天疱瘡と診断した。 治療としてプレドニゾロン内服(30mg/日)にて皮疹は消退した。