Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of actual porcine tooth crown development stages and computer image analysis

Tooth developmental stage evaluation is important in dental and chronological age estimation, and it is important for accurate diagnoses and appropriate treatment in dental practice. It is routinely assessed by clinical observations and radiographic techniques. This study aimed at ascertaining tooth developmental stage judgments made by examiners and Mimics software according to the Nolla method with radiographs. Meanwhile, the true tooth developmental stages would be explored with histological analysis. Twenty freshly slaughtered porcine heads were collected and hemisected, and both the left and right mandibular samples were numbered. The developmental stages of the second and third permanent molars (M2 and M3) were evaluated by examiners and Mimics software analysis. The ratio of the radiopaque calcified area to the dental follicle (RCA/DF) at different stages was calculated. Both non‐decalcified and decalcified samples were processed for histologic observation. The results showed significant differences between RCA/DF ratios from different developmental stages. There was a high positive correlation between the examiners' evaluation results and Mimics analysis results. Radiograph judgments and histology observation results were consistent from Stages 2–6. However, radiograph images of Stage 1 samples showed only crypts present, while under a surgical operating microscope, a bell‐shaped tooth germ was observed. This was also confirmed by normal and hard tissue histology. In conclusion, radiograph judgments made by either examiners or Mimics software were both reliable. Mimics analysis can be a useful tool in evaluating tooth developmental stages. However, judgments need to be made cautiously in early developmental stages.
New records and genetic diversity of Mycoplasma ovis in free-ranging deer in Brazil

Abstract Cervids represent a mammal group which plays an important role in the maintenance of ecological balance. Recent studies have highlighted the role of these species as reservoirs for several arthropods-borne pathogens. Globally, hemotropic mycoplasmas (haemoplasmas) are emerging or remerging bacteria that attach to red blood cells of several mammals species causing hemolytic anaemia. Therefore, the aim of this study was to investigate the occurrence and assess the phylogenetic positioning of Mycoplasma ovis in free-ranging deer from Brazil. Using a polymerase chain reaction targeting the 16S rRNA region, 18 (40%) out of 45 sampled deer were positive to M. ovis. Among the nine sequences analysed, four distinct genotypes were identified. The sequences detected in the present study were closely related to sequences previously identified in deer from Brazil and the USA. On the other hand, the Neighbour-Net network analysis showed that the human-associated M. ovis genotypes were related to genotypes detected in sheep and goats. The present study shows, for the first time, the occurrence of M. ovis in Mazama gouazoubira and Mazama bororo deer species, expanding the knowledge on the hosts harbouring this haemoplasma species. Once several deer species have your population in decline, additional studies are needed to evaluate the pathogenicity of M. ovis among deer populations around the world and assess its potential as reservoir hosts to human infections.
Laparoscopic Gastric Plication vs Laparoscopic Sleeve Gastrectomy - A Single Center, Prospective and Case-Control Study.

BACKGROUND AND OBJECTIVES The laparoscopic gastric plication (LGP) is a restrictive bariatric procedure, still under investigation, considered to be an alternative to laparoscopic sleeve gastrectomy (LSG). The aim of the present study was to compare the outcome of LGP with the results of LSG. Materials and Methods: The study was conducted on a total of 100 patients, from which 50 patients underwent LGP and other 50 patients had the LSG operation. To analyze the effectiveness of both procedures total weight loss (%TWL), change in body mass index ( BMI) and percentage of excess weight loss (%EWL) were measured and calculated for four distinct timelines: 6 months, 12 months, 24 months and 36 months after the procedure. Comorbidities were evaluated based on clinical and laboratory investigation. Results: Starting from 6 months after surgery, weight reduction was statistically significant in favor of the LSG group, with the highest differences found after two and three years postoperatively (p=0.0001). No differences were found between the two procedures in terms of compliance or improvement of the main comorbidities. Conclusions: As compared to LSG, LGP has similar outcomes in terms of the length of hospitalization, major complications and improvement of the main comorbidities. LSG procedure was found to be superior in terms of medium- to long-term weight reduction. LGP is a technique that may provide better results in obese patients with a lower BMI (less than 40 kg/m2).
A young patient with type 2 diabetes associated non-alcoholic steatohepatitis, liver cirrhosis, and hepatocellular carcinoma

Abstract The rising prevalence of the metabolic syndrome has led to an increase of non-alcoholic fatty liver disease (NAFLD), and its progressive-inflammatory form called non-alcoholic steatohepatitis (NASH). In recent years, NAFLD and NASH have become major risk factors for developing liver cirrhosis and hepatocellular carcinoma (HCC). In this case, we report a 46-year-old patient with type 2 diabetes mellitus and metabolic comorbidities including obesity and arterial hypertension, who was referred because of rising liver enzymes. After clinical and diagnostic evaluation, the patient was diagnosed with NASH-associated liver cirrhosis, Child-Pugh stage B. A normal blood sugar level was difficult to achieve, and the patient presented with consistently elevated HbA1c-levels irresponsive to insulin therapy. Due to the underlying liver cirrhosis, the patient was enrolled in the HCC-surveillance program. Sonography during follow up showed a focal lesion. On magnetic resonance imaging (MRI), the diagnosis of HCC (BCLC stage A) was confirmed based on typical contrast enhancement and portal-venous wash-out. The patient was evaluated for liver transplantation with a labMELD of 17, and an intermittent therapy with TACE was initiated. Only 2 months after liver transplantation, the patient developed severe and lethal complications. Overall, this case highlights the different medical issues of patients with metabolic syndrome developing a chronic liver disease. In this patient, a rapid progression from NASH-associated liver cirrhosis to HCC was seen, and therefore highlights the importance of close surveillance to identify and treat potential risk factors early in the course of the disease.
Obstetrician-gynecologists' screening and management of depression during perimenopause.

OBJECTIVE Depression in women is more common during perimenopause (the time period around and during menopause) than pre and postmenopause. Obstetrician-gynecologists (ob-gyns) play a vital role in the detection and management of depression symptoms in women because for many women ob-gyns are the first and most frequent point of medical contact. This study assessed ob-gyns' screening practices and management of depression in perimenopause. METHODS A survey regarding depression during perimenopause was sent to 500 practicing ob-gyns who were fellows of the American College of Obstetricians and Gynecologists and members of the Collaborative Ambulatory Research Network. RESULTS The survey response rate was 41.8% (209 of 500 surveys returned). Over a third of respondents (34.1%) reported that they did not regularly screen perimenopausal patients for depression. Higher-quality education about depression, respondent sex, and personal experience with depression were associated with higher rates of screening. While 85.7% of respondents believed that they could recognize depression in perimenopausal women, only about half (55.8%) were confident in their ability to treat these patients. CONCLUSION Increased education of ob-gyn physicians related to depression during perimenopause may increase the screening and treatment of women during this phase of life.
Differential MicroRNA Signatures in the Pathogenesis of Barrett's Esophagus

OBJECTIVES: Barrett's esophagus (BE) is the precursor lesion and a major risk factor for esophageal adenocarcinoma (EAC). Although patients with BE undergo routine endoscopic surveillance, current screening methodologies have proven ineffective at identifying individuals at risk of EAC. Since microRNAs (miRNAs) have potential diagnostic and prognostic value as disease biomarkers, we sought to identify an miRNA signature of BE and EAC. METHODS: High-throughput sequencing of miRNAs was performed on serum and tissue biopsies from 31 patients identified either as normal, gastroesophageal reflux disease (GERD), BE, BE with low-grade dysplasia (LGD), or EAC. Logistic regression modeling of miRNA profiles with Lasso regularization was used to identify discriminating miRNA. Quantitative reverse transcription polymerase chain reaction was used to validate changes in miRNA expression using 46 formalin-fixed, paraffin-embedded specimens obtained from normal, GERD, BE, BE with LGD or HGD, and EAC subjects. RESULTS: A 3-class predictive model was able to classify tissue samples into normal, GERD/BE, or LGD/EAC classes with an accuracy of 80%. Sixteen miRNAs were identified that predicted 1 of the 3 classes. Our analysis confirmed previous reports indicating that miR-29c-3p and miR-193b-5p expressions are altered in BE and EAC and identified miR-4485-5p as a novel biomarker of esophageal dysplasia. Quantitative reverse transcription polymerase chain reaction validated 11 of 16 discriminating miRNAs. DISCUSSION: Our data provide an miRNA signature of normal, precancerous, and cancerous tissue that may stratify patients at risk of progressing to EAC. We found that serum miRNAs have a limited ability to distinguish between disease states, thus limiting their potential utility in early disease detection.
Coding of odour and space in the hemimetabolous insect Periplaneta americana

ABSTRACT The general architecture of the olfactory system is highly conserved from insects to humans, but neuroanatomical and physiological differences can be observed across species. The American cockroach, inhabiting dark shelters with a rather stable olfactory landscape, is equipped with long antennae used for sampling the surrounding air-space for orientation and navigation. The antennae's exceptional length provides a wide spatial working range for odour detection; however, it is still largely unknown whether and how this is also used for mapping the structure of the olfactory environment. By selectively labelling antennal lobe projection neurons with a calcium-sensitive dye, we investigated the logic of olfactory coding in this hemimetabolous insect. We show that odour responses are stimulus specific and concentration dependent, and that structurally related odorants evoke physiologically similar responses. By using spatially confined stimuli, we show that proximal stimulations induce stronger and faster responses than distal ones. Spatially confined stimuli of the female pheromone periplanone B activate a subregion of the male macroglomerulus. Thus, we report that the combinatorial logic of odour coding deduced from holometabolous insects applies also to this hemimetabolous species. Furthermore, a fast decrease in sensitivity along the antenna, not supported by a proportionate decrease in sensillar density, suggests a neural architecture that strongly emphasizes neuronal inputs from the proximal portion of the antenna. Summary: Selective labelling of the cockroach's antennal lobe output neurons shows that odour responses are stimulus specific and concentration dependent, and preserve information on the spatial structure of the stimulus.
An Electrochemical Oxidation-Membrane Distillation Hybrid Process: Utilizing Electric Resistance Heating for Distillation and Membrane Defouling through Thermal Activation of Anodically Formed Persulfate.

This study reports distillation-based salt removal by ohmic heating in a hybrid process, in which electrochemical oxidation (EO) and direct contact membrane distillation (DCMD) are performed sequentially. In addition to anodically destructing the organics, the hybrid process also separated the sulfate-based electrolytes from treated water through distillation, without consuming external energy, owing to the temperature of the aqueous sulfate solution being elevated to 70℃ via resistive heating. The hybrid process treated organic compounds in a non-selective fashion, whereas the DCMD alone did not completely reject (semi)volatile organics. Integrating EO with DCMD made the hybrid process resistant toward the wetting phenomenon; the process exhibited a steady distillate flux and salt rejection as the initial loading of amphiphilic sodium dodecyl sulfate was increased to 0.3 mM. Anodic persulfate formation from the sulfate plus ohmic heating caused an in situ yield of sulfate radical in the feed solution; this eliminated membrane fouling, according to the observation that the water flux, which was drastically reduced upon adding alginate, was recovered immediately after an electric current was applied. The hybrid process concurrently decomposed spiked organics and removed naturally present inorganic ions in actual flue gas desulfurization wastewater, without an external supply of electrolyte and heat energy.
Risk of specific types of ovarian cancer after borderline ovarian tumors in Denmark: A nationwide study

Population‐based evidence regarding risk of ovarian cancer after a borderline ovarian tumor (BOT) is sparse. We aimed to examine the incidence of specific types of ovarian cancer in women with serous or mucinous BOTs in a nationwide cohort study with up to 36 years of follow‐up. Using the nationwide Danish Pathology Data Bank, we identified 4,281 women with a BOT (2,058 serous BOTs and 2,223 mucinous BOTs) in Denmark during 1978–2012. We computed standardized incidence ratios (SIRs) to compare the incidence of ovarian cancer among women with BOTs compared to general population rates. We found that a serous BOT was especially and strongly associated with subsequent serous ovarian cancer (SIR = 9.2; 95% CI: 6.8–12.2), and that a mucinous BOT was strongly related to mucinous ovarian cancer (SIR = 18.6; 95% CI: 10.8–29.8). The SIRs remained elevated ≥10 years after a serous BOT and up to 5–9 years after a mucinous BOT. The increased incidence of serous ovarian cancer in women with a serous BOT was mostly pronounced in women <50 years at the serous BOT diagnosis. In conclusion, women with a serous BOT experience long‐term increased incidence of serous ovarian cancer, and women with a mucinous BOT have long‐term elevated incidence of mucinous ovarian cancer compared to the general population. This is the first population‐based study to show compelling evidence of the histo‐specific increased risk of ovarian cancer following specific types of BOTs. Thus, these results are supportive of the hypothesis that BOTs may be precursor lesions to carcinomas of the corresponding histologic type.
Clinical and Economic Impact of Ibalizumab for People With Multidrug-Resistant HIV in the United States.

BACKGROUND We projected the clinical outcomes, cost-effectiveness, and budget impact of ibalizumab plus an optimized background regimen (OBR) for people with multidrug-resistant (MDR) HIV in the United States. METHODS Using the Cost-Effectiveness of Preventing AIDS Complications microsimulation model and a health care sector perspective, we compared 2 treatment strategies for MDR HIV: (1) IBA + OBR-ibalizumab plus OBR and (2) OBR-OBR alone. Ibalizumab efficacy and cohort characteristics were from trial data: mean age 49 years, 85% male, and mean CD4 150/µL. Six-month viral suppression was 50% with IBA + OBR and 0% with OBR. The ibalizumab loading dose cost $10,500, and subsequent ibalizumab injections cost $8400/month; OBR cost $4500/month. Incremental cost-effectiveness ratios (ICERs) were calculated using discounted (3%/year) quality-adjusted life years (QALYs) and costs. ICERs ≤$100,000/QALY were considered cost-effective. We performed sensitivity analysis on key parameters and examined budget impact. RESULTS In the base case, 5-year survival increased from 38% with OBR to 47% with IBA + OBR. Lifetime costs were $301,700/person with OBR and $661,800/person with IBA + OBR; the ICER for IBA + OBR compared with OBR was $260,900/QALY. IBA + OBR was not cost-effective even with 100% efficacy. IBA + OBR became cost-effective at base case efficacy if ibalizumab cost was reduced by ≥88%. For an estimated 12,000 people with MDR HIV in the United States, IBA + OBR increased care costs by $1.8 billion (1.5% of total treatment budget) over 5 years. CONCLUSIONS For people with MDR HIV lacking other treatment options, ibalizumab will substantially increase survival when effective. Although adding ibalizumab to OBR is not cost-effective, the low number of eligible patients in the United States makes the budget impact relatively small.
Reporting Clinical Laboratory Critical Values: A Focus On The Recommendations Of The American College Of Pathologists.

BACKGROUND Reporting critical values continues to receive a widespread attention from health care givers as it symbolizes a crucial clinic-laboratory link. This is because healthcare providers did realize the importance of prompt and timely communication of the critical results, which have positive implications on patient safety and treatment outcomes. In addition to physician and nurses, patients are also recipients of critical values, where they can make informed decisions prior to clinical intervention. The College of American Pathologists (CAP) requires stringent policies for reporting critical values in all laboratories, including adoption of a robust quality assurance system. Research studies have indicated that there still no universally accepted critical values list. This is because of various factors; such as differences in institutional organization, patient population, clinical demand, staffing, and instrumentation. However, through collaboration with other stakeholders involved in the delivery of healthcare, lab professionals may be able to come up with a realistic critical values list that reflects on the local needs and dynamics of patients' service. CONCLUSIONS This review offers an insight into the process of reporting critical values, some challenges encountered, as well as the policies and procedures of effective reporting with a particular focus on the guidelines of the College of American Pathologists. There should be a common global guideline introduced by the health care governing agencies to be adapted with some flexibility in clinical laboratories in different clinical settings.
Effect of sevoflurane anaesthesia on nasal mask in endoscopic retrograde cholangiopancreatography: is it a preferred alternative?

Background/aim Endoscopic retrograde cholangiopancreatography (ERCP) often requires deep sedation. Propofol provides adequate sedation and amnesia at subhypnotic doses, but safe guarding the patient’s airway is important for preventing respiratory depression or u28ba events. This study compared sedation levels, operator satisfaction, intraoperative and recovery characteristics using sevoflurane with nasal mask and propofol in ERCP. Material and methods Sixty-one patients underwent ERCP (Group I: propofol, n = 31; Group II, sevoflurane, n = 30), with sedation controlled by the Ramsay sedation scale (RSS). The patients’ demographic data, procedure length, overall drug dose, hemodynamic changes, duration of recovery and Aldrete scores during recovery were evaluated. In addition, satisfaction of the gastroenterologist was evaluated. Results The mean sphincterotomy satisfaction scores were statistically significant (P= 0.043). The Aldrete scores and RSS of the groups were similar; there was a significant difference between groups at the beginning of the procedure regarding peripheric oxygen saturations and Group II’s saturation levels increased during sedation. Conclusion In ERCP, propofol infusion provides shorter recovery duration and adequate sedation levels. Sevoflurane and oxygen with a nasal mask can be chosen to generate specific anaesthesia in patients, especially for strong airway support and safety treating hypoxemic patients.
Investigation of injury severity in urban expressway crashes: A case study from Beijing

Urban expressway is the main artery of traffic network, and an in-depth analysis of the crashes is crucial for improving the traffic safety level of expressways. This study intended to address the injury severity of expressways in Beijing by proposing Bayesian ordered logistic regression model. Crash data were collected from urban express rings and expressways in 2015 and 2016. The results showed that crash location, time and crash season are significant variables influencing injury severity. The findings revealed that the proposed model can address the ordinal feature of injury severity, while accommodating the data with small sample sizes that may not adequately represent population characteristics. The conclusions can provide the management departments with valuable suggestions for the injury prevention and safety improvement on the urban expressways.
Laparoscopic treatment of duplicate gallbladder with acute cholecystitis

Duplication of gallbladder is a rare congenital anomaly of the extrahepatic biliary tract. Patients with duplicate gallbladder who develop symptoms due to gallstones require surgery. Laparoscopic cholecystectomy in such cases is challenging due to altered biliary anatomy. We report a case of duplicate gallbladder with acute calculus cholecystitis successfully treated by laparoscopic removal of both the gallbladders.