Miracle-dz/UniFAR-FTUs huggingface dataset:
How Sustained Is 24-Hour Diffusion-Weighted Imaging Lesion Reversal?: Serial Magnetic Resonance Imaging in a Patient Cohort Thrombolyzed Within 4.5 Hours of Stroke Onset

Background and Purpose— Here, we assessed how sustained is reversal of the acute diffusion lesion (RAD) observed 24 hours after intravenous thrombolysis, and the relationships between RAD fate and early neurological improvement. Methods— We analyzed 155 consecutive patients thrombolyzed intravenously 152 minutes (median) after stroke onset and who underwent 3 MR sessions: 1 before and 2 after treatment (median times from onset, 25.6 and 54.3 hours, respectively). Using voxel-based analysis of diffusion-weighted imaging (DWI)1, DWI2, and DWI3 lesions on coregistered image data sets, we assessed the outcome of RAD voxels (hyperintense on DWI1 but not on DWI2) as transient or sustained on DWI3, and their relationships with early neurological improvement, defined as &Dgr;National Institutes of Health Stroke Scale ≥8 or National Institutes of Health Stroke Scale ⩽1 at 24 hours. Tmax and apparent diffusion coefficient values were compared between sustained and transient RAD voxels. Results— The median (interquartile range) baseline National Institutes of Health Stroke Scale and DWI1 lesion volume were 11 (7–18) mL and 15.6 (6.0–50.9) mL, respectively. The median (interquartile range) RAD volume on DWI2 was 2.8 (1.1–6.6) mL, of which 70% was sustained on DWI3. Sixteen (10.3%) patients had sustained RAD ≥10 mL. As compared with transient RAD voxels, sustained RAD voxels had nonsignificantly higher baseline apparent diffusion coefficient values (median [interquartile range], 793 [717–887] versus 777 [705–869]×10−6 mm2·s −1, respectively; P=0.08) and significantly better perfusion (Tmax, mean±SD, 6.3±3.2 versus 7.8±4.0 s; P<0.001). At variance with transient RAD, the volume of sustained RAD was associated with early neurological improvement in multivariate analysis (odds ratio, 1.08; 95% confidence interval, [1.01–1.17], per 1-mL increase; P=0.03). Conclusions— After thrombolysis, over two-thirds of the DWI lesion reversal captured on 24-hour follow-up MR is sustained. Sustained DWI lesion reversal volume is a strong imaging correlate of early neurological improvement.
[Identification of factors responsible for oral over-anticoagulation in outpatients with heart disease].

BACKGROUND Few studies have attempted to investigate the clinical course or identify factors responsible for excessive anticoagulation in patients with heart disease. OBJECTIVES To determine the incidence of excessive anticoagulation in outpatients with heart disease treated with acenocoumarol, analyze the factors related with over-anticoagulation, and identify bleeding complications. PATIENTS AND METHOD This 7-month prospective observational study included consecutive outpatients anticoagulated with acenocoumarol. They were seen in an anticoagulation unit. The high INR group of 55 over-anticoagulated patients had at least one test with INR > 5. The control group of 49 patients had INR results strictly within therapeutic range. RESULTS A total of 3,683 INR determinations were made in 512 patients. Seventy-seven tests had an INR > 5 (a 2% overall incidence of high-INR). In the group of 55 INR < 5 patients, 31% had more than one INR determination > 5 during follow-up. Multivariate analysis identified four variables as independent predictors of over-anticoagulation: artificial heart valve, poor treatment compliance, addition of potentially interactive new drugs, and illness in the last month. The high-INR group patients had more bleeding episodes (21.8 vs 4.08%; p = 0.008), one of which was major. CONCLUSION The incidence of excessive oral anticoagulation in our outpatient population was similar to that reported in other studies. Patients with INR > 5 had more total bleeding complications, mostly minor. It is recommended to proceed carefully with oral anticoagulant therapy in patients with an artificial heart valve, suspected poor treatment compliance, addition of potentially interactive new drugs, and illness in the last month.
Phenotypic Changes Resulting from Distinct Point Mutations in the Azospirillum brasilense glnA Gene, Encoding Glutamine Synthetase

ABSTRACT Sequencing the glnA genes of two chemically induced Azospirillum brasilense glutamine synthetase mutants revealed an Arg→Cys mutation, corresponding to the glutamate binding site, in one mutant and an Asp→Asn mutation, corresponding to the ammonium binding site, in the second mutant. The phenotypic changes in these mutants are discussed in relation to their genotypes.
Iterative detection of MIMO signals with linear detectors

We investigate an iterative receiver structure performing joint symbol detection and decoding to suppress the strong interference in multiple input multiple output (MIMO) systems. A linear minimum mean-squared error (MMSE) detector is compared with a simplified approach. Existing approaches for related scenarios are modified and extended to fit to a generalized MIMO transmitter structure such that the developed detectors are applicable to many known MIMO systems. Simulation results show that the proposed iterative receivers achieve large gains over standard solutions. Interestingly, feeding back the entire a posteriori information from the decoder to the detector outperforms the common approach of feeding back extrinsic information.
A physiologically‐based early warning score for ward patients: the association between score and outcome *

We analysed the physiological values and early warning score obtained from 1047 ward patients assessed by an intensive care outreach service. Patients were either referred directly from the wards (n = 245, 23.4%) or were routine critical care follow‐ups. Decisions were made to admit 135 patients (12.9%) to a critical care area and limit treatment in another 78 (7.4%). An increasing number of physiological abnormalities was associated with higher hospital mortality (p < 0.0001) ranging from 4.0% with no abnormalities to 51.9% with five or more. An increasing early warning score was associated with more intervention (p < 0.0001) and higher hospital mortality (p < 0.0001). For patients with scores above one (n = 660), decisions to admit to a critical care area or limit treatment were taken in 200 (30.3%). Scores of all physiological variables except temperature contributed to the need for intervention and all variables except temperature and heart rate were associated with hospital mortality.
The epidemiology and treatment of ALS: Focus on the heterogeneity of the disease and critical appraisal of therapeutic trials

Abstract Effective treatments for amyotrophic lateral sclerosis (ALS) have remained elusive. Only riluzole, a drug thought to affect glutamate metabolism, improves survival albeit to modest extent. Explanations for the negative results of therapeutic trials include a likely heterogeneity, both in disease susceptibility and pathogenic mechanisms, and faulty methodology of clinical trials. Further understanding of these factors will lead to improvements in patient stratification, and in the design of future clinical trials.
Improved motor and cognitive performance with sodium nitrite supplementation is related to small metabolite signatures: a pilot trial in middle-aged and older adults

Advancing age is associated with reductions in nitric oxide bioavailability and changes in metabolic activity, which are implicated in declines in motor and cognitive function. In preclinical models, sodium nitrite supplementation (SN) increases plasma nitrite and improves motor function, whereas other nitric oxide-boosting agents improve cognitive function. This pilot study was designed to translate these findings to middle-aged and older (MA/O) humans to provide proof-of-concept support for larger trials. SN (10 weeks, 80 or 160 mg/day capsules, TheraVasc, Inc.) acutely and chronically increased plasma nitrite and improved performance on measures of motor and cognitive outcomes (all p<0.05 or better) in healthy MA/O adults (62 ± 7 years). Untargeted metabolomics analysis revealed that SN significantly altered 33 (160 mg/day) to 45 (80 mg/day) different metabolites, 13 of which were related to changes in functional outcomes; baseline concentrations of 99 different metabolites predicted functional improvements with SN. This pilot study provides the first evidence that SN improves aspects of motor and cognitive function in healthy MA/O adults, and that these improvements are associated with, and predicted by, the plasma metabolome. Our findings provide the necessary support for larger clinical trials on this promising pharmacological strategy for preserving physiological function with aging.
Comparative numerical modelling of a debris-flow fan in the Eastern Italian Alps

Abstract Knowledge of rheology can reduce damage caused by debris flows, providing a means to delineate hazard-prone areas and to estimate the dangerous effects of these phenomena. The application of numerical models of debris-flow propagation and deposition for hazard prediction requires detailed topographical, hydrological and rheological data, which are not always available. The large Rivoli Bianchi Fan on the Eastern Italian Alps is mainly built from sediment transported by debris flows along the Citate Torrent and its tributaries. We compared the results of numerical simulations performed with two different single-phase, non-Newtonian, two-dimensional models, FLO-2D and IDRA2D-DF, to test their reliability in simulating the behaviour of debris flows on alluvial fans. Data from field topographic surveys and from rain gauges were used as input for the boundary conditions, referring to the Rivoli Bianchi Fan as an example location. The commercial FLO-2D model creates a more accurate representation of the hazard-prone zone in terms of flooded area, but the results in terms of runout distances and deposit thickness are similar to those obtained through the open-source IDRA2D-DF. Parameters obtained through back analysis with both models can be cautiously applied to predict hazard in areas of similar geology, morphology and climate.
[Therapeutic plasma exchange: applications in neurology].

INTRODUCTION Plasma exchange is a technique used in the treatment of some neurological autoimmune disorders since the 80s, especially in acute conditions. In recent years new data about it use has been published in many diseases with autoimmune basis, expanding the range of use of this technique. AIM To update the current indications of this technique in the treatment of neurological diseases. DEVELOPMENT We conducted a thorough review of all articles about the efficacy of plasma exchange in the treatment of different neurological diseases published since the 80s. We have also carried out a detailed analysis of recommendations and evidence of the use of this procedure by analyzing the guidelines of different scientific societies. CONCLUSIONS Plasma exchange has proven to be an effective alternative treatment with high grade scientific evidence in diseases such as Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and myasthenia gravis. It has been effective in treating acute demyelinating episodes unresponsive to other therapies, neuromyelitis optica relapses and other central nervous system diseases induced by antibodies. In comparative studies with intravenous immunoglobulin efficacy of both therapies is similar. Comparative studies should continue to be conducted in order to better understand the mechanisms of action, prioritize indications and compare the cost-effectiveness ratio of both procedures.
Establishment of human embryonic stem cell lines from frozen-thawed blastocysts using STO cell feeder layers.

BACKGROUND Recently, human embryonic stem (hES) cells have become very important resources for basic research on cell replacement therapy and other medical applications. The purpose of this study was to test whether pluripotent hES cell lines could be successfully derived from frozen-thawed embryos that were destined to be discarded after 5 years in a routine human IVF-embryo transfer programme and whether an STO cell feeder layer can be used for the culture of hES cells. METHODS Donated frozen embryos (blastocysts or pronuclear) were thawed, and recovered or in vitro developed blastocysts were immunosurgically treated. All inner cell masses were cultured continuously on an STO cell feeder layer and then presumed hES cell colonies were characterized. RESULTS Seven and two cell lines were established from frozen-thawed blastocysts (7/20, 35.0%) and pronuclear stage embryos (2/20, 10.0%), respectively. The doubling time of hES cells on the immortal STO cell feeder layer was approximately 36 h, similar to that of cells grown using fresh mouse embryonic fibroblast (MEF) feeder conditions. Subcultured hES cell colonies showed strong positive immunostaining for alkaline phosphatase, stage-specific embryonic antigen-4 (SSEA-4) and tumour rejection antigen 1-60 (TRA1-60) cell surface markers. Also, the hES colonies retained normal karyotypes and Oct-4 expression in prolonged subculture. When in vitro differentiation of hES cells was induced by retinoic acid, three embryonic germ layer cells were identified by RT-PCR or indirect immunocytochemistry. CONCLUSIONS This study indicates that establishment of hES cells from frozen-thawed blastocysts minimizes the ethical problem associated with the use of human embryos in research and that the STO cell feeder layer can be used for the culture of hES cells.
Data-Mining-Based Coronary Heart Disease Risk Prediction Model Using Fuzzy Logic and Decision Tree

Objectives The importance of the prediction of coronary heart disease (CHD) has been recognized in Korea; however, few studies have been conducted in this area. Therefore, it is necessary to develop a method for the prediction and classification of CHD in Koreans. Methods A model for CHD prediction must be designed according to rule-based guidelines. In this study, a fuzzy logic and decision tree (classification and regression tree [CART])-driven CHD prediction model was developed for Koreans. Datasets derived from the Korean National Health and Nutrition Examination Survey VI (KNHANES-VI) were utilized to generate the proposed model. Results The rules were generated using a decision tree technique, and fuzzy logic was applied to overcome problems associated with uncertainty in CHD prediction. Conclusions The accuracy and receiver operating characteristic (ROC) curve values of the propose systems were 69.51% and 0.594, proving that the proposed methods were more efficient than other models.
Pediatric Acute Respiratory Distress Syndrome: Fluid Management in the PICU

The administration of an appropriate volume of intravenous fluids, while avoiding fluid overload, is a major challenge in the pediatric intensive care unit. Despite our efforts, fluid overload is a very common clinical observation in critically ill children, in particular in those with pediatric acute respiratory distress syndrome (PARDS). Patients with ARDS have widespread damage of the alveolar–capillary barrier, potentially making them vulnerable to fluid overload with the development of pulmonary edema leading to prolonged course of disease. Indeed, studies in adults with ARDS have shown that an increased cumulative fluid balance is associated with adverse outcome. However, age-related differences in the development and consequences of fluid overload in ARDS may exist due to disparities in immunologic response and body water distribution. This systematic review summarizes the current literature on fluid imbalance and management in PARDS, with special emphasis on potential differences with adult patients. It discusses the adverse effects associated with fluid overload and the corresponding possible pathophysiological mechanisms of its development. Our intent is to provide an incentive to develop age-specific fluid management protocols to improve PARDS outcomes.
An MDP-Based Vertical Handoff Decision Algorithm for Heterogeneous Wireless Networks

The architecture for the Beyond 3rd Generation (B3G) or 4th Generation (4G) wireless networks aims at integrating various heterogeneous wireless access networks. One of the major design issues is the support of vertical handoff. Vertical handoff occurs when a mobile terminal switches from one network to another (e.g., from wireless local area network to code-division multiple-access 1x radio transmission technology). The objective of this paper is to determine the conditions under which vertical handoff should be performed. The problem is formulated as a Markov decision process with the objective of maximizing the total expected reward per connection. The network resources that are utilized by the connection are captured by a link reward function. A signaling cost is used to model the signaling and processing load incurred on the network when vertical handoff is performed. The value iteration algorithm is used to compute a stationary deterministic policy. For performance evaluation, voice and data applications are considered. The numerical results show that our proposed scheme performs better than other vertical handoff decision algorithms, namely, simple additive weighting, the technique for order preference by similarity to ideal solution, and Grey relational analysis.
A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis

Within healthcare settings, HIV‐related stigma is a recognized barrier to access of HIV prevention and treatment services and yet, few efforts have been made to scale‐up stigma reduction programs in service delivery. This is in part due to the lack of a brief, simple, standardized tool for measuring stigma among all levels of health facility staff that works across diverse HIV prevalence, language and healthcare settings. In response, an international consortium led by the Health Policy Project, has developed and field tested a stigma measurement tool for use with health facility staff.
Better Survival with Three-Dimensional Conformal Radiotherapy Than with Conventional Radiotherapy for Cervical Cancer: A Population-Based Study

Three-dimensional conformal radiation therapy (3DCRT) has emerged as a preferred treatment for gynecologic malignancies. Yet its superiority to conventional radiotherapy (2-dimensional radiotherapy (2DRT)) for gynecologic malignancies has not been well established. Data from the 2005 to 2010 National Health Insurance Research Database (NHIRD) provided by the National Research Institutes in Taiwan were analyzed to address this issue. Patients were initially diagnosed as having cervical cancer according to the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) code 180, and this clinical diagnosis was confirmed histopathologically or cytologically. Kaplan-Meier method and Cox proportional hazards regression were used to analyze the reported data. Between January 2005 and December 2010, there were 776 patients with newly diagnosed cervical cancer without metastasis, local recurrence, or surgical treatment before RT and 132 and 644 patients, respectively, who received 2DRT and 3DCRT. After adjustment for age, diabetes mellitus, hypertension, coronary heart disease, hyperlipidemia, side effects, urbanization level, geographic region, and enrollee category in the 5-year follow-up period, the HR was 1.82 (95% CI, 1.16–2.85, P = 0.009). The 5-year survival rate in the 2DRT and 3DCRT groups was 73.0% and 82.3%, P = 0.007, respectively. Cervical cancer patients treated with 3DCRT had better overall survival.
Origin and significance of diamonds and other exotic minerals in the Dingqing ophiolite peridotites, eastern Bangong-Nujiang suture zone, Tibet

We have recovered unusual mineral assemblages of diamond, moissanite, zircon, quartz, corundum, rutile, titanite, almandine garnet, kyanite, and andalusite from the peridotites of the Late Triassic Dingqing ophiolite along the Bangong-Nujiang suture zone in south-central Tibet. Diamond grains are 100–300 μm, pale yellow and reddish-orange to colorless, commonly anhedral in habit, and range in morphology from elongated to octahedral and subhedral crystals. They display a characteristic shift in the Raman spectra between 1325 cm -1 and 1333 cm -1 , mostly at 1331.51 cm -1 or 1326.96 cm -1 . Chromian spinels in the Dingqing harzburgites and dunites are high-Cr varieties with Cr# = 40.1–49.1 and Cr# = 65.3–69.6, respectively. Recovered diamonds, ultrahigh-pressure, and highly reduced minerals appear to have crystallized and then been encapsulated in chromian spinel grains over a wide range of depth in the diamond stability field near the mantle transition zone. These chromian spinels and their host peridotites were then brought up to shallow mantle levels by the convecting asthenosphere, and were subsequently trapped in a mantle wedge of an intraoceanic subduction zone. The peridotites underwent further partial melting processes and reactions with island arc tholeiitic and boninitic melts, significantly modifying their whole-rock and mineral compositions. The preexisting chromian spinel grains with the inclusions of diamonds and other exotic minerals coalesced to form podiform chromitites during this stage in a suprasubduction zone setting.
Automatic Verb Extraction from Historical Swedish Texts

Even though historical texts reveal a lot of interesting information on culture and social structure in the past, information access is limited and in most cases the only way to find the information you are looking for is to manually go through large volumes of text, searching for interesting text segments. In this paper we will explore the idea of facilitating this time-consuming manual effort, using existing natural language processing techniques. Attention is focused on automatically identifying verbs in early modern Swedish texts (1550--1800). The results indicate that it is possible to identify linguistic categories such as verbs in texts from this period with a high level of precision and recall, using morphological tools developed for present-day Swedish, if the text is normalised into a more modern spelling before the morphological tools are applied.
Mitochondria-targeted Cytochrome P450 2E1 Induces Oxidative Damage and Augments Alcohol-mediated Oxidative Stress*

The ethanol-inducible cytochrome P450 2E1 (CYP2E1) is also induced under different pathological and physiological conditions. Studies including ours have shown that CYP2E1 is bimodally targeted to both the endoplasmic reticulum (microsomes) (mc CYP2E1) and mitochondria (mt CYP2E1). In this study we investigated the role of mtCYP2E1 in ethanol-mediated oxidative stress in stable cell lines expressing predominantly mt CYP2E1 or mc CYP2E1. The ER+ mutation (A2L, A9L), which increases the affinity of the nascent protein for binding to the signal recognition particle, preferentially targets CYP2E1 to the endoplasmic reticulum. The Mt+ (L17G) and Mt++ (I8R, L11R, L17R) mutant proteins, showing progressively lower affinity for signal recognition particle binding, were targeted to mitochondria at correspondingly higher levels. The rate of GSH depletion, used as a measure of oxidative stress, was higher in cells expressing Mt++ and Mt+ proteins as compared with cells expressing ER+ protein. In addition, the cellular level of F2-isoprostanes, a direct indicator of oxidative stress, was increased markedly in Mt++ cells after ethanol treatment. Notably, expression of Mt++ CYP2E1 protein in yeast cells caused more severe mitochondrial DNA damage and respiratory deficiency than the wild type or ER+ proteins as tested by the inability of cells to grow on glycerol or ethanol. Additionally, liver mitochondria from ethanol-fed rats containing high mt CYP2E1 showed higher levels of F2-isoprostane production. These results strongly suggest that mt CYP2E1 induces oxidative stress and augments alcohol-mediated cell/tissue injury.