Miracle-dz/UniFAR-FTUs huggingface dataset:
Lumen-apposing metal stents for pancreatic fluid collection drainage: may not be business as usual?

We read with interest the paper by Bang et al 1 concerning their interim analysis of an ongoing randomised study comparing a novel fully covered self-expanding metal stent (fcSEMS) to plastic stents in patients undergoing endoscopic drainage of walled-off pancreatic necrosis (WOPN). This was following concerns over higher than expected adverse events in the fcSEMS (50%) compared with the plastic stent group (0%). Specifically, these adverse events were three cases of bleeding, two cases of buried stent and one case of biliary stricture. The three cases of bleeding were found to have pseudoaneurysms, which were treated by radiologically guided coiling. One of the buried stent cases developed severe bleeding on removal and requiring radiological intervention. The biliary stricture was managed endoscopically with fcSEMS removal and biliary …
Mind the gap! Risk factors for poor continuity of care of TB patients discharged from a hospital in the Western Cape, South Africa

Background TB patients discharged from hospitals in South Africa experience poor continuity of care, failing to continue TB treatment at other levels of care. Factors contributing to poor continuity of TB care are insufficiently described to inform interventions. Objective To describe continuity of care and risk factors in TB patients discharged from a referral hospital in the Western Cape, South Africa. Design This retrospective observational study used routine information to describe continuity of care and risk factors in TB patients discharged from hospital. Results 788 hospitalized TB patients were identified in 6 months. Their median age was 32 years, 400 (51%) were male, and 653 (83%) were urban. A bacteriological TB test was performed for 74%, 25% were tested for HIV in hospital, and 32% of all TB patients had documented evidence of HIV co-infection. Few (13%) were notified for TB; 375 (48%) received TB medication; 284 (36%) continued TB treatment after discharge; 91 (24%) had a successful TB treatment outcome, and 166 (21%) died. Better continuity of care was associated with adults, urban residence, bacteriological TB tests in hospital and TB medication on discharge. Fragmented hospital TB data systems did not provide continuity with primary health care information systems. Conclusions Discharged TB patients experienced poor continuity of care, with children, rural patients, those not tested for TB in hospital or discharged without TB medication at greatest risk. Suboptimal quality of hospital TB care and a fragmented hospital information system without linkages to other levels underpinned poor continuity of care.
A comparison of three materials used for tactile symbols to communicate colour to children and young people with visual impairments

A series of 14 tactile symbols were developed to represent different colours and shades for children and young people who are blind or have visual impairment. A study compared three different methods for representing the symbols: (1) embroidered thread, (2) heated ‘swell’ paper, and (3) representation in plastic using Additive Manufacturing (AM; three-dimensional printing). The results show that for all three materials, the recognition of particular symbols varied between 2.40 and 3.95 s. The average times for the three materials across all colours were 2.26 s for AM material, 3.20 s for swell paper, and 4.03 s for embroidered symbols. These findings can be explained by the fact that the AM material (polylactide) is firmer and more easily perceived tactually than the other two materials. While AM plastic offers a potentially useful means to communicate colours for appropriate objects, traditional media are still important in certain contexts.
A machine learning attack resistant multi-PUF design on FPGA

Current approaches for building physical unclonable function (PUF) designs resistant to machine learning attacks often suffer from large resource overhead and are typically difficult to implement on field programmable gate arrays (FPGAs). In this paper we propose a new arbiter-based multi-PUF (MPUF) design that utilises a Weak PUF to obfuscate the challenges to a Strong PUF and is harder to model than the conventional arbiter PUF using machine learning attacks. The proposed PUF design shows a greater resistance to attacks, which have been successfully applied to other Arbiter PUFs. A mathematical model is presented to analyse the complexity and obfuscation properties of the proposed PUF design. Moreover, we show that it is feasible to implement the proposed MPUF design on a Xilinx Artix-7 FPGA, and that it achieves a good uniqueness result of 40.60 % and uniformity of 37.03 %, which significantly improves over previous work into multi-PUF designs.
Voltage-based electromigration immortality check for general multi-branch interconnects

As VLSI technology features are pushed to the limit with every generation and with the introduction of new materials and increased current densities to satisfy the performance demands, Electromigration (EM) is projected to be a key reliability issue for current and future VLSI technologies. Existing EM signoff mainly relies on current density-based assessment using Black's equation and Blech product. This model does not work well for multi-branch interconnect wires as the stresses developed in each wire segment is not independent of one another. In this paper, we present a novel and fast EM Immortality check for general multi-branch interconnect trees. Instead of using current density as the key parameter as in traditional methods, the new method estimates the EM-induced stress in general multi-branch interconnects based on the terminal voltages or potentials. It can be viewed as the Blech product for multi-branch interconnects for fast check of EM immortality of wires. Besides, this voltage-based EM (VBEM) assessment technique can naturally comprehend the impact of the topology of the wire structure on EM-induced stress. As a result, this new VBEM analysis method is very amenable to EM violation fixing as it brings new capabilities to the physical design stage. The VBEM stress estimation method is based on the fundamental steady-state stress equations. This approach eliminates the need for complex look-up tables for different geometries and can be implemented in CAD tools very easily as we demonstrate on real design examples. We show that its solution is consistent with the physics-based dynamic EM stress evaluations from the numerical analysis by COMSOL.
Validation of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-Expanded (FACIT-Sp-Ex) Across English and Spanish-Speaking Hispanics/Latinos: Results From the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

The validity of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) has been examined in primarily non-Hispanics/Latinos with chronic illness. This study assessed the psychometric properties of the nonillness, expanded FACIT-Sp (FACIT-Sp-Ex) in 5,163 U.S. Hispanic/Latino adults. Measures were interviewer-administered in English or Spanish. Confirmatory factor analyses indicated 4 factors: meaning, peace, faith, and relational. The scale demonstrated measurement invariance across English and Spanish. Subscales displayed adequate internal and test–retest reliability. Scores were positively associated with Duke Religion Index (DUREL; Koenig, Parkerson, & Meador, 1997) subscales. When all subscales were entered in a single model, meaning and peace were inversely associated with depressive symptoms and positively associated with physical health-related quality of life (HRQOL). Faith was positively associated with depressive symptoms and inversely associated with HRQOL. Relational was not associated with any outcome. FACIT-Sp-Ex subscales were generally more strongly associated than DUREL subscales with well-being. The FACIT-Sp-Ex appears to be a valid measure of spiritual well-being in U.S. Hispanics/Latinos.
Orphan Nuclear Receptor Nur77 Regulates Androgen Receptor Gene Expression in Mouse Ovary

The androgen receptor (AR) is a nuclear receptor that is expressed in growing follicles and involved in folliculogenesis and follicle growth. The orphan nuclear receptor, Nur77, also has an important role in steroid signaling and follicle maturation. We hypothesized that AR levels and androgen signaling through AR are regulated by Nur77 in the ovary. In the ovaries of Nur77 knockout mice (n = 5), real-time PCR results showed that the mRNA levels of AR and an androgen signaling target gene, Kitl, were decreased by 35% and 24%, respectively, relative to wild-type mice (n = 5), which suggested transcriptional regulation of AR by Nur77 in vivo. In cultured mouse granulosa cells and a steroidogenic human ovarian granulosa-like tumor cell line, KGN, mRNA and protein expression levels of AR were increased by overexpressing Nur77 but decreased by knocking down endogenous Nur77. Consistent with increased AR expression, chromatin immunoprecipitation showed that Nur77 bound to the NGFI-B response element (NBRE) in the AR promoter sequence. AR promoter activity was stimulated by Nur77 in HEK293T cells and attenuated in Nur77 knockout mouse granulosa cells (luciferase assay). Overexpression of Nur77 enhanced the androgenic induction of Kitl (200 nM; 48h), while knockout of Nur77 attenuated this induction. These results demonstrate that AR is regulated by Nur77 in the ovaries, and they suggest that the participation of Nur77 in androgen signaling may be essential for normal follicular development.
"May I help You?" Increasing Trust in Cloud Computing Providers through Social Presence and the Reduction of Information Overload

Despite the potential benefits of Cloud Computing (CC), many (potential) users are reluctant to use CC as they have concerns about data security and privacy. Moreover, the perceived social distance to CC providers can increase risk perceptions. Thus, gaining users’ trust is a key challenge for CC providers. The results of our online experiment confirm that the intention to use CC services is highly dependent on a user’s assessment of a provider’s trustworthiness. We show that embedding two different assistive website elements (Search Box and Social Recommendation Agent) into CC providers’ Service-Level Agreements and privacy policies positively influences the perceived trustworthiness of a CC provider by reducing perceived Information Overload and increasing perceived Control as well as Social Presence. Thus, besides improving security, CC providers not only have to communicate trust-critical information but also have to facilitate the search process for that information in order to be perceived as trustworthy.
Brief Report: Geographical Variation in Prevalence of Cryptococcal Antigenemia Among HIV-Infected, Treatment-Naive Patients in Nigeria: A Multicenter Cross-Sectional Study

Objective:Worldwide, HIV-associated cryptococcal meningitis affects approximately 1 million persons and causes 600,000 deaths each year mostly in sub-Saharan Africa. Limited data exist on cryptococcal meningitis and antigenemia in Nigeria, and most studies are geographically restricted. We determined the prevalence of cryptococcal antigenemia (CrAg) among HIV-infected, treatment-naive individuals in Nigeria. Design/Methods:This was a retrospective, cross-sectional study across 4 geographic regions in Nigeria. We performed CrAg testing using a lateral flow immunoassay on archived whole-blood samples collected from HIV-infected participants at US President's Emergency Plan for AIDS Relief (PEPFAR)-supported sites selected to represent the major geographical and ethnic diversity in Nigeria. Eligible samples were collected from consenting patients (>15 years) naive to antiretroviral therapy with CD4+ count less than 200 cells per cubic millimeter and were stored in an −80°C freezer. Results:A total of 2752 stored blood samples were retrospectively screened for CrAg. Most of the samples were from participants aged 30–44 years (57.6%), and 1570 (57.1%) were from women. The prevalence of CrAg positivity in specimens with CD4 <200 cells per cubic millimeter was 2.3% (95% confidence interval: 1.8% to 3.0%) and varied significantly across the 4 regions (P < 0.001). At 4.4% (3.2% to 5.9%), the South East contained the highest prevalence. Conclusions:The significant regional variation in CrAg prevalence found in Nigeria should be taken into consideration as plans are made to integrate routine screening into clinical care for HIV-infected patients.
Development of a Respiratory Virus Panel Test for Detection of Twenty Human Respiratory Viruses by Use of Multiplex PCR and a Fluid Microbead-Based Assay

ABSTRACT Virology laboratories historically have used direct fluorescent-antibody assay (DFA) and culture to detect six or seven respiratory viruses. Following the discovery of five new human respiratory viruses since 2000, there is an increasing need for diagnostic tests to detect these emerging viruses. We have developed a new test that can detect 20 different respiratory virus types/subtypes in a single 5-h test. The assay employs multiplex PCR using 14 virus-specific primer pairs, followed by a multiplexed target-specific primer extension (TSPE) reaction using 21 primers for specific respiratory virus types and subtypes. TSPE products were sorted and identified by using a fluid microsphere-based array (Universal Array; TmBioscience Corporation, Toronto, Canada) and the Luminex x-MAP system. The assay detected influenza A and B viruses; influenza A virus subtypes H1, H3, and H5 (including subtype H5N1 of the Asian lineage); parainfluenza virus types 1, 2, 3, and 4; respiratory syncytial virus types A and B; adenovirus; metapneumovirus; rhinovirus; enterovirus; and coronaviruses OC43, 229E, severe acute respiratory syndrome coronavirus, NL63, and HKU1. In a prospective evaluation using 294 nasopharyngeal swab specimens, DFA/culture detected 119 positives and the respiratory virus panel (RVP) test detected 112 positives, for a sensitivity of 97%. The RVP test detected an additional 61 positive specimens that either were not detected by DFA/culture or were positive for viruses not tested for by DFA/culture. After resolution of discordant results by using a second unique PCR assay and by using a combined reference standard of positivity, the RVP test detected 180 of 183 true positives, for a sensitivity of 98.5%, whereas DFA and culture detected only 126 of 183 true positives, for a sensitivity of 68.8%. The RVP test should improve the capabilities of hospital and public health laboratories for diagnosing viral respiratory tract infections and should assist public health agencies in identifying etiologic agents in respiratory tract infection outbreaks.
Brief Report: Pharmacokinetic/Pharmacodynamic Investigation of Single-Dose Oral Maraviroc in the Context of HIV-1 Pre-exposure Prophylaxis

Abstract:To investigate the pharmacokinetics/pharmacodynamics of single-dose maraviroc 300 mg in HIV-1 exposure compartments. Maraviroc concentrations in blood, secretions (vaginal, urethral, oral, and rectal), and tissue (vaginal and rectal) were measured, and ex vivo challenge was performed in 54 healthy volunteers to study protection from HIV infection. Maraviroc Cmax occurred within 4 hours in most compartments. Concentrations from 4 to 72 hours were above intracellular (IC) IC90 in all compartments, range 15–8095 ng/mL. Mean AUC0-72 compartment-to-plasma ratios were highest in the rectum (45–819) and urethra (144) compared with the female genital tract (1.6–4.8) and saliva (0.2). No sex differences in AUC0-72 or Cmax were observed. No ex vivo protection from HIV-1BaL occurred in rectal or vaginal tissue. Despite high and sustained concentrations, single-dose maraviroc was not protective against ex vivo challenge of vaginal/rectal tissue.
Roxadustat in the treatment of anaemia in chronic kidney disease

ABSTRACT Introduction: Anaemia is one of the hallmarks of advanced chronic kidney disease (CKD); it correlates with a lower quality of life and increased cardiovascular risk. Currently its management is based on iron and erythropoiesis-stimulating agents (ESAs) therapy. Given safety issues on ESA therapy and excessive iron use, anaemia management is still suboptimal. Areas covered: The inhibitors of the prolyl-hydroxylases domain (PHD) are oral drugs which activate the hypoxia-inducible factors (HIF) and stimulate the production of endogenous erythropoietin. Roxadustat (FG-4592) is a second-generation PHD inhibitor; it is undergoing now phase-III clinical development. Expert opinion: Phase-II clinical trials have shown that roxadustat is effective and save in the short term in either non-dialysis or dialysis CKD patients. Roxadustat is a chemical drug and thus has the potential of being cheaper than traditional ESAs. Given that the peaks of endogenous EPO are much lower than those observed with traditional ESA, it is possible to speculate the roxadustat (and more in general PHD inhibitors) will be safer than ESA on cardiovascular safety end-points. Considering that HIFs are involved in different pathways, with possible promotion of relevant side effects, their safety must be proven in long-term studies.
Influence of the Type of Plateletpheresis on the Value of Corpuscular Elements in the Blood Donors.

INTRODUCTION During the plateletpheresis procedure the number of trombocites in the donor's blood significantly decreases, and the levels of the other components of blood as hematocrit, hemoglobin, and leukocyte diminish as well. Influence of the type of procedure DN-CFCS and SN-ICFS it is one of the factors that affects the decrease of the levels of HCT, Hgb and WBC. In this study, our goal was to see the difference in the value of HCT, Hgb, WBC, and platelets after the plateletfphresis process between DN-CFCS and SN-IFCS on the same cell separator - Fenval AMICUS. DONORS AND METHODS The criteria for participation: men between age of 25-45. Two groups were formed. Group I 112 separation done with the method SN-ICFS and Group II 180 separation done with the method DN-CFCS. STATISTICAL ANALYSIS To confirm the statistical difference we used Student t-test for independent or dependent samples, as well as Mann-Whitney U test as non parametric alternative. The possibility of errors were accepted for α<0.05, and the difference between groups were accepted as statistical relevant for p<0.05. RESULTS Statistically significant lower values were observed of all researched parameters after separation for the donors on the equipement Amicus DN, and for donors on Amicus SN. A significant higher value of HCT before procedure was found in the AM DN group, in the researches of the other variables there were no significant differences. The resultst for the comparison of variables after procedure procedure for DN and SN procedure. A significant higher value of HCT and a significant higher level of Hgb, as well as a significant lower level of WBV after procedure in the AM DN group, while for the levels of PLT there were no significant differences. CONCLUSION On the decrease of the value of the observed parameters the type of procedure has an influence that means DN-CFCS or SN-IFCS, continuous or discontinuous flow.
Shrinking the Cross Section

We construct a robust stochastic discount factor (SDF) that summarizes the joint explanatory power of a large number of cross-sectional stock return predictors. Our method achieves robust out-of-sample performance in this high-dimensional setting by imposing an economically motivated prior on SDF coefficients that shrinks the contributions of low-variance principal components of the candidate factors. While empirical asset pricing research has focused on SDFs with a small number of characteristics-based factors-e.g., the four- or five-factor models discussed in the recent literature-we find that such a characteristics-sparse SDF cannot adequately summarize the cross-section of expected stock returns. However, a relatively small number of principal components of the universe of potential characteristics-based factors can approximate the SDF quite well.
Adaptive Test Schemes for Control of Paratuberculosis in Dairy Cows

Paratuberculosis is a chronic infection that in dairy cattle causes reduced milk yield, weight loss, and ultimately fatal diarrhea. Subclinical animals can excrete bacteria (Mycobacterium avium ssp. paratuberculosis, MAP) in feces and infect other animals. Farmers identify the infectious animals through a variety of test-strategies, but are challenged by the lack of perfect tests. Frequent testing increases the sensitivity but the costs of testing are a cause of concern for farmers. Here, we used a herd simulation model using milk ELISA tests to evaluate the epidemiological and economic consequences of continuously adapting the sampling interval in response to the estimated true prevalence in the herd. The key results were that the true prevalence was greatly affected by the hygiene level and to some extent by the test-frequency. Furthermore, the choice of prevalence that will be tolerated in a control scenario had a major impact on the true prevalence in the normal hygiene setting, but less so when the hygiene was poor. The net revenue is not greatly affected by the test-strategy, because of the general variation in net revenues between farms. An exception to this is the low hygiene herd, where frequent testing results in lower revenue. When we look at the probability of eradication, then it is correlated with the testing frequency and the target prevalence during the control phase. The probability of eradication is low in the low hygiene herd, and a test-and-cull strategy should probably not be the primary strategy in this herd. Based on this study we suggest that, in order to control MAP, the standard Danish dairy farm should use an adaptive strategy where a short sampling interval of three months is used when the estimated true prevalence is above 1%, and otherwise use a long sampling interval of one year.
Strategies for the prevention of contact lens‐related Acanthamoeba keratitis: a review

Acanthamoeba keratitis is a severe, often sight threatening, corneal infection which in Western countries is predominantly seen in daily wear of contact lenses. This review aims to summarise the pathobiology and epidemiology of contact lens‐related Acanthamoeba keratitis, and to present strategies for prevention, particularly with respect to modifiable risk factors in contact lens wear.