Miracle-dz/UniFAR-FTUs huggingface dataset:
Differential inflammatory involvement in retina and choroïd in birdshot chorioretinopathy.

BACKGROUND Birdshot chorioretinopathy is characterised by dual unrelated inflammatory involvement of the retina and the choroid. Indocyanine green angiography made it possible to assess and follow choroidal disease with the same precision as retinal involvement was followed so far. The aim of this study was to analyse the severity, progression and response to therapy of both retinal involvement using fluorescein angiography and choroidal involvement using indocyanine green angiography. PATIENTS AND METHODS Patients with birdshot retinochoroidopathy followed at La Source Eye Centre in Lausanne, Switzerland from January 1995 to December 2002 were subdivided into three subgroups according to the duration of evolution of the disease: untreated patients with no more than one year duration of the disease (group 1, n = 6); treated patients with disease duration of 1 - 7 years duration (group 2, n = 5) and patients with disease lasting for more than 7 years (group 3, n = 4). Fluorescein and indocyanine green angiographic signs (angiographic scores given by a masked observer) were analysed in the 3 groups and compared to the "cream-coloured" fundus lesions. RESULTS Fifteen out of the 742 patients (2.0 %) seen at La Source Eye Centre during the time period considered presented BC and were included in the study. In the "early disease group" fluorescein and ICG angiography showed more severe choroidal than retinal involvement with respective scores of 3 +/- 0.79 (ICG) and 2 +/- 1.17 (FA) while there were few depigmented fundus lesions to be seen (score 1 +/- 0.27). The choroidal involvement responded well to systemic corticosteroids +/- immunosuppressive therapy (scores in groups 2 and 3 = 1.2 and 0.75), while retinal disease was stabilised at best (scores in groups 2 and 3 = 2.2. and 2.4) and depigmented fundus lesions increased (scores in groups 2 and 3 = 2.8 and 3). CONCLUSION The evolution and response to therapy of retinal and choroidal disease in birdshot chorioretinopathy have a different course with choroidal disease responding well to therapy while retinal disease is more resistant, possibly explaining the slow deterioration of functional parameters despite therapy. The increase of "cream-coloured" fundus lesions despite good choroidal response to therapy could be explained by depigmentation left behind after resolution of choroidal stromal granulomas, a hypothesis recently confirmed by an autopsy case of birdshot chorioretinopathy.
The determination of ecological status in shallow lakes - a tested system (ECOFRAME) for implementation of the European Water Framework Directive

1. The European Water Framework Directive requires the determination of ecological status in European fresh and saline waters. This is to be through the establishment of a typology of surface water bodies, the determination of reference (high status) conditions in each element (ecotype) of the typology and of lower grades of status (good, moderate, poor and bad) for each ecotype. It then requires classification of the status of the water bodies and their restoration to at least 'good status' in a specified period. 2. Though there are many methods for assessing water quality, none has the scope of that defined in the Directive. The provisions of the Directive require a wide range of variables to be measured and give only general guidance as to how systems of classification should be established. This raises issues of comparability across States and of the costs of making the determinations. 3. Using expert workshops and subsequent field testing, a practicable pan-European typology and classification system has been developed for shallow lakes, which can easily be extended to all lakes. It is parsimonious in its choice of determinands, but based on current limnological understanding and therefore as cost-effective as possible. 4. A core typology is described, which can be expanded easily in particular States to meet local conditions. The core includes 48 ecotypes across the entire European climate gradient and incorporates climate, lake area, geology of the catchment and conductivity. 5. The classification system is founded on a liberal interpretation of Annexes in the Directive and uses variables that are inexpensive to measure and ecologically relevant. The need for taxonomic expertise is minimized. 6. The scheme has been through eight iterations, two of which were tested in the field on tranches of 66 lakes. The final version, Version 8, is offered for operational testing and further refinement by statutory authorities.
Do difficulties in accessing in-hours primary care predict higher use of out-of-hours GP services? Evidence from an English National Patient Survey

Introduction It is believed that some patients are more likely to use out-of-hours primary care services because of difficulties in accessing in-hours care, but substantial evidence about any such association is missing. Methods We analysed data from 567 049 respondents to the 2011/2012 English General Practice Patient Survey who reported at least one in-hours primary care consultation in the preceding 6 months. Of those respondents, 7% also reported using out-of-hours primary care. We used logistic regression to explore associations between use of out-of-hours primary care and five measures of in-hours access (ease of getting through on the telephone, ability to see a preferred general practitioner, ability to get an urgent or routine appointment and convenience of opening hours). We illustrated the potential for reduction in use of out-of-hours primary care in a model where access to in-hours care was made optimal. Results Worse in-hours access was associated with greater use of out-of-hours primary care for each access factor. In multivariable analysis adjusting for access and patient characteristic variables, worse access was independently associated with increased out-of-hours use for all measures except ease of telephone access. Assuming these associations were causal, we estimated that an 11% relative reduction in use of out-of-hours primary care services in England could be achievable if access to in-hours care were optimal. Conclusions This secondary quantitative analysis provides evidence for an association between difficulty in accessing in-hours care and use of out-of-hours primary care services. The findings can motivate the development of interventions to improve in-hour access.
GCaR: Garbage Collection aware Cache Management with Improved Performance for Flash-based SSDs

Garbage Collection (GC) is an important performance concern for flash-based SSDs, because it tends to disrupt the normal operations of an SSD. This problem continues to plague flash-based storage systems, particularly in the high performance computing and enterprise environment. An important root cause for this problem, as revealed by previous studies, is the serious contention for the flash resources and the severe mutually adversary interference between the user I/O requests and GC-induced I/O requests. The on-board buffer cache within SSDs serves to play an essential role in smoothing the gap between the upper-level applications and the lower-level flash chips and alleviating this problem to some extend. Nevertheless, the existing cache replacement algorithms are well optimized to reduce the miss rate of the buffer cache by reducing the I/O traffic to the flash chips as much as possible, but without considering the GC operations within the flash chips. Consequently, they fail to address the root cause of the problem and thus are far from being sufficient and effective in reducing the expensive I/O traffic to the flash chips that are in the GC state. To address this important performance issue in flash-based storage systems, particularly in the HPC and enterprise environment, we propose a Garbage Collection aware Replacement policy, called GCaR, to improve the performance of flash-based SSDs. The basic idea is to give higher priority to caching the data blocks belonging to the flash chips that are in the GC state. This substantially lessens the contentions between the user I/O operations and the GC-induced I/O operations. To verify the effectiveness of GCaR, we have integrated it into the SSD extended Disksim simulator. The simulation results show that GCaR can significantly improve the storage performance by reducing the average response time by up to 40.7%.
Evaluation of nutritional properties of high protein-fiber based snack s formulated from wheat , soybean concentrate and cassava fiber

Functional snacks were produced from soybean concentrate, cassava fibre and wheat flour. Food materials were processed into flour and blended in the ratio of 65:22:13 (SWC1), 75:18:7 (SWC2), 85:13:2 (SWC3) and 75:25:0 (SC). Each sample was mixed with condiments, water, manually extruded, baked, and evaluated for proximate compositions, microbial loads, physical and sensory properties. Results showed that the formulated snacks had crude protein value of 12.43 67.0%, ash 2.41 5.97%, moisture content 6.89 10.43%, crude fat 2.81 3.85%, crude fibre 2.77 6.09% and carbohydrate 9.35 72.68%. Mineral contents (mg/100g), i.e., iron had value of (17.31 201.17), Zn (20.30 29.87), Mn (3.43 7.10), Cu (1.37 9.13) and Na (3346.67 13466.67). Nickel, lead and Cadmium were not detected. Glutamic acid (23.93-19.83g/100g protein) had the highest values of amino acids, while tryptophan had the least (0.72 0.95g/100g protein). Anti-nutritional factors and microbial loads of the snacks were low and within the acceptable level, water absorption capacity of the snacks had value of 1.77 2.20%, oil absorption capacity 0.87 1.78%, loose bulk density 0.60 0.78g/ml, packed bulk density 0.90 1.20 g/ml, swelling capacity 0.65 0.82% and least gelation concentration 0.60 0.77%. Sample SC was most preferred than other samples, but less preferred to control sample (CS). The study concluded that sample SC was preferred to others and comparable to control (CS).
Vitamin D Status among Older Adults Residing in the Littoral and Andes Mountains in Ecuador

Objectives. To estimate the prevalence of 25-hydroxyvitamin D (25(OH)D) deficiency and its determinants among older adults in Ecuador. Methods. 25(OH)D deficiency and insufficiency prevalence rates were examined among participants in the National Survey of Health, Wellbeing, and Aging. Logistic regression models were used to evaluate demographic characteristics associated with 25(OH)D deficiency. Results. Of 2,374 participants with a mean age of 71.0 (8.3) years, 25(OH)D insufficiency and deficiency were present in 67.8% (95% CI, 65.3–70.2) and 21.6% (95% CI, 19.5–23.7) of older adults in Ecuador, respectively. Women (OR, 3.19; 95% CI, 3.15–3.22), self-reported race as Indigenous (OR, 2.75; 95% CI, 2.70–2.80), and residents in rural (OR, 4.49; 95% CI, 4.40–4.58) and urban (OR, 2.74; 95% CI, 2.69–2.80) areas of the Andes Mountains region were variables significantly associated with 25(OH)D deficiency among older adults. Conclusions. Despite abundant sunlight throughout the year in Ecuador, 25(OH)D deficiency was significantly prevalent among older women, Indigenous subjects, and subjects residing in the Andes Mountains region of the country. The present findings may assist public health authorities to implement policies of vitamin D supplementation among older adults at risk for this condition.
Future Doctors' Perceptions about Incorporating Nutrition into Standard Care Practice

ABSTRACT Objective: The increasing prevalence of chronic disease has been largely attributed to long-term poor nutrition and lifestyle choices. This study investigates the attitudes of our future physicians toward nutrition and the likelihood of incorporating nutrition principles into current treatment protocols.Methods: Setting: The setting of this study was an Australian university medical school. Subjects: Subjects including year 1–4 students (n = 928) in a 4-year medical bachelor, bachelor of surgery (MBBS) degree program. Students were invited to participate in a questionnaire based on an existing instrument, the Nutrition in Patient Care Attitude (NIPC) Questionnaire, to investigate their attitudes toward nutrition in health care practices.Results: Respondents indicated that “high risk patients should be routinely counseled on nutrition” (87%), “nutrition counseling should be routine practice” (70%), and “routine nutritional assessment and counseling should occur in general practice” (57%). However, despite overall student support of nutritional counseling (70%) and assessment (86%), students were reluctant to perform actual dietary assessments, with only 38% indicating that asking for a food diary or other measure of dietary intake was important.Conclusion: These findings demonstrate that future physicians are aware of the importance of considering nutrition counseling and assessment. However, students are unlikely to adequately integrate relevant nutritional information into their treatment protocols, evidenced by their limited use of a basic nutritional assessment. This is potentially the result of a lack of formal nutrition education within their basic training.
Metabolic outcome during 1 year in newly detected hypertensives: results of the Antihypertensive Treatment and Lipid Profile in a North of Sweden Efficacy Evaluation (ALPINE study)

Objective The aim of the Antihypertensive Treatment and Lipid Profile in a North of Sweden Efficacy Evaluation study was to compare the long-term effect of the commonly used inexpensive medication with a low-dose diuretic (hydrochlorothiazide), alone or in combination with a β-adrenoceptor (atenolol), with that of more modern but also more expensive antihypertensive treatment with an angiotensin-II-receptor blocker (candesartan), alone or in combination with a calcium antagonist (felodipine), and to do so in newly diagnosed patients with primary hypertension. The objectives included comparisons of the effects on the glucose metabolism, lipoprotein metabolism, electrolytes, blood pressure, and subjective symptoms. Design A 1-year, prospective randomized, double-blind, controlled trial. Subjects In an investigator-initiated study, we included 392 patients (mean age 55 years, 48% men); 370 patients (94%) had never been treated with antihypertensive drugs before the study. No patient was lost to follow-up. Results Both treatment regimens lowered blood pressure well (23/13 mmHg in the hydrochlorothiazide group and 21/13 mmHg in the candesartan group), with a majority of patients needing two drugs. Fasting levels of both serum insulin and plasma glucose increased in the hydrochlorothiazide group in contrast to unaffected levels in the candesartan group. Diabetes mellitus was diagnosed in nine patients during follow-up, in eight patients in the hydrochlorothiazide group (4.1%) and in one patient (0.5%) in the candesartan group (P = 0.030). Triglycerides increased and high-density lipoprotein-cholesterol decreased more in the hydrochlorothiazide group than in the candesartan group. Both the low-density lipoprotein/high-density lipoprotein and the apolipoprotein B/apolipoprotein A-I ratios increased in the hydrochlorothiazide group. At 12 months, 18 patients in the hydrochlorothiazide group versus five in the candesartan group had a ‘metabolic syndrome', as defined by the World Health Organization (P = 0.007) despite 1 year of active blood pressure-lowering therapy. There were less (P = 0.020) adverse events in the candesartan group, but no major differences in the subjective symptoms assessment profile. One subject in each group had a myocardial infarction. Conclusion Antihypertensive treatment with a diuretic, if needed combined with a β-adrenoceptor blocker, was associated with an aggravated metabolic profile; this was not so for patients treated with an angiotensin-II-receptor blocker, if needed combined with a calcium antagonist. An antihypertensive treatment strategy that costs more in the short run but has no metabolic adverse effects may have a health economic impact in the long term.
Gastrointestinal manifestations and complications of Henoch-Schönlein purpura.

BACKGROUND Henoch-Schönlein purpura (HSP) is a systemic vasculitic disorder commonly affecting young children. Gastrointestinal (GI) involvement is frequently seen, and it varies from mild symptoms to severe complications. METHODS In the 5 years from July 1995 to June 2000, 208 children were diagnosed with HSP in our hospital. There were 116 males and 92 females with ages ranging from 9 months to 15 years (mean, 6.4 years; median, 5.5 years). Their medical records were reviewed. We focused on their gastrointestinal manifestations and complications. The hospital course and management of these patients were also analyzed. RESULTS GI manifestations were present in 162 cases (77.8%), and among them the most common presentation was colicky abdominal pain in 159 cases (98.1%), followed by vomiting in 64 cases (39.5%). Severe complications included massive GI bleeding in 5 patients, intussusception in 1, protein-losing enteropathy in 1, and a patient with pancreatitis. GI symptoms occurred before the manifestation of skin lesions in 41 patients (25.3%). Five of them underwent a laparotomy. Four cases were operated on due to suspicion of acute appendicitis or peritonitis. Another patient had an emergent operation due to ileo-ileo intussusception. CONCLUSIONS GI manifestations of HSP are common. Colicky abdominal pain was the most common GI manifestation of Henoch-Schönlein purpura. Some patients may have GI complications, but those requiring surgical intervention in our study were rare.
Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease: Implications and Future Research

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with high morbidity and mortality. [1] With increasing use of computed tomography in the assessment of patients with COPD, the presence of previously unrecognized radiological bronchiectasis is being identified. [2] Accumulating evidence shows that bronchiectasis has an important impact on the natural history of COPD. Moderate-severe COPD with comorbid bronchiectasis has more severe symptoms, higher frequency of exacerbations, and increased mortality. [3] Given the prognostic implications of bronchiectasis in COPD, its detection could serve as a guide to better management and eventually improved survival. [1] Therefore, bronchiectasis was proposed as a comorbidity of COPD by Global Initiative for Chronic Obstructive Lung Disease (GOLD) updated 2014.
On the motivations to enroll in doctoral studies in Computer Science — A comparison of PhD program models

While student motivation has been intensively researched, only a few studies cover motivation at doctoral level and even less focus on doctoral education in Computer Science. In this paper we investigate the motivation of graduate students to pursue doctoral studies specifically in Computer Science. We interviewed 63 doctoral students, from two different doctoral models (traditional and structured) in Finland and Austria, on their initial reasons and experiences that led them to enroll in doctoral studies. We identified five disjoint main motivational drivers that relate with different aspects of extrinsic and intrinsic motivation. Together with a measure of the strength of their initial motivation, we develop clear motivation profiles of different doctoral program models. We observed that students in structured programs were mainly driven by extrinsic motivation while participants in traditional European doctoral studies were mainly influenced by intrinsic factors. Our results give a practical overview of student motivation for the enhancement of student selection, support, and supervision processes in doctoral programs.
Embryonic lethality and abnormal cardiac myocytes in mice lacking ryanodine receptor type 2

The ryanodine receptor type 2 (RyR‐2) functions as a Ca2+‐induced Ca2+ release (CICR) channel on intracellular Ca2+ stores and is distributed in most excitable cells with the exception of skeletal muscle cells. RyR‐2 is abundantly expressed in cardiac muscle cells and is thought to mediate Ca2+ release triggered by Ca2+ influx through the voltage‐gated Ca2+ channel to constitute the cardiac type of excitation–contraction (E–C) coupling. Here we report on mutant mice lacking RyR‐2. The mutant mice died at approximately embryonic day (E) 10 with morphological abnormalities in the heart tube. Prior to embryonic death, large vacuolate sarcoplasmic reticulum (SR) and structurally abnormal mitochondria began to develop in the mutant cardiac myocytes, and the vacuolate SR appeared to contain high concentrations of Ca2+. Fluorometric Ca2+ measurements showed that a Ca2+ transient evoked by caffeine, an activator of RyRs, was abolished in the mutant cardiac myocytes. However, both mutant and control hearts showed spontaneous rhythmic contractions at E9.5. Moreover, treatment with ryanodine, which locks RyR channels in their open state, did not exert a major effect on spontaneous Ca2+ transients in control cardiac myocytes at E9.5–11.5. These results suggest no essential contribution of the RyR‐2 to E–C coupling in cardiac myocytes during early embryonic stages. Our results from the mutant mice indicate that the major role of RyR‐2 is not in E–C coupling as the CICR channel in embryonic cardiac myocytes but it is absolutely required for cellular Ca2+ homeostasis most probably as a major Ca2+ leak channel to maintain the developing SR.
Erim Report Series Research in Management Predicting Customer Potential Value an Application in the Insurance Industry Bibliographic Data and Classifications

For effective Customer Relationship Management (CRM), it is essential to have information on the potential value of customers. Based on the interplay between potential value and realized value, managers can devise customer specific strategies. In this article we introduce a model for predicting the potential value of a current customer. Furthermore, we discuss and apply different modeling strategies for predicting this potential value.
Sex Differences in the Impact of Number of Older and Number of Younger Siblings on Scholastic Aptitude

It is hypothesized that females are less likely than males to show deficits in intellectual development normally associated with larger numbers of siblings (i.e., family size), particularly if those siblings are younger brothers and sisters. Scholastic Aptitude Test scores, as well as measures of socioeconomic status, number of older siblings, and number of younger siblings, were available for each of 1,811 college freshmen (963 males and 848 females). With socioeconomic status controlled, the results indicate that number of older siblings is associated with lower SAT scores for both males and females. However, a sex difference emerges with respect to the impact of number of younger siblings. For males, increasing numbers of younger siblings are associated with lower SAT scores. But for females, increasing numbers of younger siblings are associated with higher SAT scores. A role-differentiation explanation is proposed to account for the beneficial impact of younger siblings on females' SAT scores. The implications of this study for future research on family constellation effects are discussed.
Multiple sclerosis: impact of physical activity on psychosocial constructs.

OBJECTIVES To determine the impact of physical activity (PA) interventions and experience with PA on psychosocial constructs. METHODS PA, self-efficacy, self-identity, social support, and expected PA frequency were measured pre and post intervention in 39 persons with multiple sclerosis. RESULTS The MANOVA analysis indicated that self-efficacy and expectation decreased, whereas self-identity and PA improved (P<0.05). Regressions analyses indicated pretest self-identity (beta(2)=0.44) and social support (beta(2)=0.34) were associated with PA. Posttest self-efficacy (beta(2)=0.38) and social support (beta(2)=0.31) were associated with PA (P<0.05). CONCLUSIONS The interventions and experience with PA caused changes in psychosocial constructs, which subsequently affected the correlation of these constructs with PA.