In this task, you are given a passage which has a question and the context. You have to generate an answer to the question based on the information present in the context.
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Question: Context: Thyroid cancer is the most common endocrine gland malignancy. Advances in understanding the genetic basis for thyroid cancer revealed the potential involvement of several genes in the formation of thyroid tumors. Mutations in the gene coding for succinate dehydrogenase subtype B (SDHB) have been implicated in papillary thyroid cancer (PTC). Succinate dehydrogenase (SDH) is a heterotetrameric protein composed of four subunits, SDHA, SDHB, SDHC, and SDHD, and participates in both the electron transport chain and the tricarboxylic acid cycle. The aim of the study was to evaluate the association between variants in the SDHA, SDHB, SDHC, and SDHD genes and familiar PTC in a large Brazilian family.', 'Four patients with PTC, 1 patient with PTC and gastrointestinal stromal tumor (GIST), 1 patient with GIST, and their relatives - several of them with different thyroid problems - from a large Brazilian family were screened for genetic variations of SDHx genes with the use of polymerase chain reaction-single-stranded conformational polymorphism and direct sequencing.', 'Only one rare variation in SDHA was found in some of the family members, but not segregating with the disease. No other genetic variants of these genes were detected in the family members that presented with PTC and/or GIST.\Question: Is familiar Papillary Thyroid Carcinoma in a Large Brazilian Family Associated with Succinate Dehydrogenase Defects?

Answer: Familiar PTC and a GIST were not associated with SDHx mutations; additional genetic defects, yet unknown, may be responsible for the development of tumor.


Question: Context: Although the echolucent plaque in carotid stenosis is associated with future ischemic stroke, the predictive value of echogenicity in small and medium size carotid plaques on vascular events has not been thoroughly examined. Thus, we prospectively tested the hypothesis that plaque echogenicity of carotid atheroma can predict the future total cardiovascular events in patients with vascular risk factors.', 'Ultrasound assessment of carotid intima-media complex thickness (IMT) and plaque echogenicity using integrated backscatter (IBS) analysis was performed in 596 patients aged 40 or more, with any history of vascular events or with at least 1 risk factor, who were enrolled between 2001 and 2006 in the Osaka Follow-up Study for Carotid Atherosclerosis, part 2 (OSACA2). We followed the incidence of total cardiovascular events including cerebrovascular events, coronary heart disease (CHD), and peripheral artery disease (PAD) for 6.4 years. We divided the patients into two groups according to the IBS index above (echorich plaques) and under (echolucent plaque) the median value, and calculated the hazard ratios (HR) of the echolucent group compared with the echogenic group in the risk of cardiovascular events.', 'Among 596 patients, carotid stenosis was found only in 87 patients. During the follow-up period, we observed 121 cardiovascular events including 63 cerebrovascular events, 45 CHD cases, and 13 PAD cases. The patients with incident cardiovascular events had larger plaque thickness and lower IBS index than those without incident vascular events. The relative risk of vascular events for echolucent versus echorich plaques was 1.45 (95% confidence interval [CI] 0.99-2.13, p = 0.058) after adjustment for risk factors and plaque thickness. In patients with plaque size above the median value (>2.1 mm), the relative risk of vascular events for echolucent plaques was 1.72 (95% CI 1.06-2.85, p = 0.029), but this association was not observed in patients with plaque size <2.0 mm.\Question: Does echogenicity of medium-to-large carotid plaques predict future vascular events?

Answer: The association between echogenicity of carotid plaque and incident vascular events is dependent on the plaque size. Echolucent medium-to-large plaques, but not small plaques, are associated with the risk of future total cardiovascular events. This finding suggests that measurement of echolucency in medium-to-large carotid plaques may improve selection of patients at high risk for total vascular events.


Question: Context: In vitro biomechanical study using a programmable testing apparatus that replicated physiologic flexion/extension cervical spine motion and loading mechanics.', 'To determine the influence of anterior plating on multilevel cervical strut-graft mechanics in vitro.', 'The addition of anterior instrumentation does not prevent construct failure in multilevel cervical corpectomy.', 'Six fresh human cadaveric cervical spines (C2-T1) were tested in the four following sequential conditions: harvested, C4-C6 corpectomy, strut-grafted, and strut-grafted with an anterior cervical plate. A force-sensing strut-graft was used to measure compression/tension, flexion/extension and lateral bending moments, and axial torsion. Parameters of stiffness, vertebral motion, and strut-graft loads were compared to determine differences between the four spine conditions.', 'Application of the anterior plate significantly increased the global stiffness (P < 0.01) and decreased the local motion (P < or = 0.01) of the instrumented levels (C3-C7). Flexion of the strut-grafted spine loaded the strut-graft, whereas extension unloaded the strut-graft. With the anterior plate, flexion of the plated spine unloaded the strut-graft. Extension significantly loaded the strut-graft more than similar degrees of flexion in the strut-grafted condition (P = 0.01). Strut-graft loading end limits of 225 N were reached with a mean 7.5 degrees extension in the plated spines.\Question: Does anterior cervical plating reverse load transfer through multilevel strut-grafts?

Answer:
Anterior multilevel cervical plating effectively increases stiffness and decreases local cervical motion after corpectomy. However, anterior cervical plating also reverses graft loads and excessively loads the graft in extension, which may promote pistoning and failure of multilevel constructs.