Miracle-dz/UniFAR-FTUs huggingface dataset:
Nephrology Dialysis Transplantation Aluminium toxicity : its relationship with bone and iron metabolism

Chronic renal failure leads to secondary hyperparathyroidism; the spontaneous evolution of this entity results in high bone remodelling. However, throughout the last decades we have learnt that several medical interventions, particularly those which involve a high degree of aluminium exposure, may change the evolution of secondary hyperparathyroidism, leading to other diseases such as aluminium-induced osteomalacia and aluminium-induced adynamic bone disease, both characterized by low-bone remodelling [1-6]. In addition to these two well-known effects of aluminium in bone, aluminium may also induce alterations in iron metabolism [7-10]. This review will focus on the mechanisms of aluminium toxicity in bone metabolism and also the interference of aluminium in erythropoiesis.
Consultation behaviour of doctor-shopping patients and factors that reduce shopping.

RATIONALE, AIMS AND OBJECTIVES To investigate the subsequent behaviour of doctor-shopping patients (defined as those attending multiple hospitals for the same complaint) who consulted our department and factors related to cessation of doctor shopping. METHODS Patients who presented without referral to the Department of General Medicine at Chiba University Hospital in Japan (our department) completed a questionnaire at their first visit. A follow-up questionnaire was also sent to them in order to assess doctor shopping after 3 months. Then items in the questionnaires were investigated for significant differences between patients who continued or stopped doctor shopping. Logistic regression analysis was performed with items showing a significant difference between patients who stopped doctor shopping and those who continued it, in order to identify independent determinants of the cessation of shopping. RESULTS A total of 978 patients who presented spontaneously to our department consented to this study, and 929 patients (95.0%) completed questionnaires correctly. Among them, 203 patients (21.9%) were identified as doctor shoppers. The follow-up survey was completed correctly by 138 patients (68.0%). Among them, 25 patients (18.1%) were found to have continued doctor shopping, which was a significantly lower rate than before (P < 0.001). Logistic regression analysis selected the following factors as independent determinants of the cessation of doctor shopping: 'confirmation of the diagnosis' (odds ratio: 8.12, 95% confidence interval: 1.46-45.26), and 'satisfaction with consultation' (odds ratio: 2.07, 95% confidence interval: 1.42-3.01). CONCLUSION Doctor shopping decreased significantly after patients consulted our department, with 'confirmation of the diagnosis' and 'satisfaction with consultation' being identified as contributing factors.
Effects of continuum breakdown on hypersonic aerothermodynamics for reacting flow

This study investigates the effects of continuum breakdown on the surface aerothermodynamic properties (pressure, stress, and heat transfer rate) of a sphere in a Mach 25 flow of reacting air in regimes varying from continuum to a rarefied gas. Results are generated using both continuum [computational fluid dynamics (CFD)] and particle [direct simulation Monte Carlo (DSMC)] approaches. The DSMC method utilizes a chemistry model that calculates the backward rates from an equilibrium constant. A preferential dissociation model is modified in the CFD method to better compare with the vibrationally favored dissociation model that is utilized in the DSMC method. Tests of these models are performed to confirm their validity and to compare the chemistry models in both numerical methods. This study examines the effect of reacting air flow on continuum breakdown and the surface properties of the sphere. As the global Knudsen number increases, the amount of continuum breakdown in the flow and on the surface increas.
Sex differences in health status and rehabilitation outcomes in patients with atrial fibrillation treated with ablation: Results from the CopenHeartRFA trial

Background: Increased physical capacity after comprehensive rehabilitation in patients with atrial fibrillation (AF) undergoing ablation has been found in the CopenHeartRFA trial. The purpose of this study was to investigate: (a) sex differences in health status, psychological distress and quality of life, (b) sex differences in rehabilitation outcomes and (c) predictors of effect of rehabilitation. Methods: We conducted an exploratory analysis of data from the randomized CopenHeartRFA trial, where patients treated with ablation were randomized with 1:1 to comprehensive rehabilitation consisting of a physical exercise program and psycho-educational consultations versus usual care. Sex disparities in health status were tested using Chi-square and t-tests. Results: Included were: 151 men (median age 59.25 years) and 59 women (median age 62.5 years). At hospital discharge, women reported lower physical health status compared with men. Among women, significant differences were found in the 6-min walk test [rehabilitation: 496.8 meters (SD 98.5) versus 559.3meters (SD 55.5) and usual care: 521.9 meters (SD 97.8) versus 530.9 meters (SD 102.2), p = 0.01] and exercise time [rehabilitation: 387.6 s (SD 126.0) versus 463.2 s (SD 121.8) and usual care: 353.4 s (SD 145.2) versus 355.8 s (SD 154.8), p < 0.004] and among men in the sit-to-stand test. Significant differences were found in mental health outcomes among men and in quality of life scores among women. Patients with a European Heart Rhythm Association (EHRA) score I-II had a positive effect of rehabilitation. Conclusion: The results suggest that sex differences exist in self-reported health after rehabilitation in patients ablated for AF. Patients with an I–II EHRA score seem more likely to gain from the rehabilitation programme compared with those with a III–IV score.
Home care by general practitioners for cancer patients in the last 3 months of life: An epidemiological study of quality and associated factors

Background: Stronger generalist end-of-life care at home for people with cancer is called for but the quality of end-of-life care delivered by general practitioners has been questioned. Aim: To determine the degree of and factors associated with bereaved relatives’ satisfaction with home end-of-life care delivered by general practitioners to cancer patients. Design: Population-based mortality followback survey. Setting/participants: Bereaved relatives of people who died of cancer in London, United Kingdom (identified from death registrations in 2009–2010), were invited to complete a postal questionnaire surveying the deceased’s final 3 months of life. Results: Questionnaires were completed for 596 decedents of whom 548 spent at least 1 day at home in the last 3 months of life. Of the respondents, 55% (95% confidence interval: 51%–59%) reported excellent/very good home care by general practitioners, compared with 78% (95% confidence interval: 74%–82%) for specialist palliative care providers and 68% (95% confidence interval: 64%–73%) for district/community/private nurses. The odds of high satisfaction (excellent/very good) with end-of-life care by general practitioners doubled if general practitioners made three or more compared with one or no home visits in the patient’s last 3 months of life (adjusted odds ratio: 2.54 (95% confidence interval: 1.52–4.24)) and halved if the patient died at hospital rather than at home (adjusted odds ratio: 0.55 (95% confidence interval: 0.31–0.998)). Conclusion: There is considerable room for improvement in the satisfaction with home care provided by general practitioners to terminally ill cancer patients. Ensuring an adequate offer of home visits by general practitioners may help to achieve this goal.
O R I G I N a L a R T I C L E Open Access

Microbial community in microbial fuel cell (MFC) medium and effluent enriched with purple photosynthetic bacterium (Rhodopseudomonas sp.) Abstract High power densities have been obtained from MFC reactors having a purple color characteristic of Rhodopseudomonas. We investigated the microbial community structure and population in developed purple MFC medium (DPMM) and MFC effluent (DPME) using 16S rRNA pyrosequencing. In DPMM, dominant bacteria were Comamonas (44.6%), Rhodopseudomonas (19.5%) and Pseudomonas (17.2%). The bacterial community of DPME mainly consisted of bacteria related to Rhodopseudomonas (72.2%). Hydrogen oxidizing bacteria were identified in both purple-colored samples: Hydrogenophaga and Sphaerochaeta in the DPMM, and Arcobacter, unclassified Ignavibacteriaceae, Acinetobacter, Desulfovibrio and Wolinella in the DPME. The methanogenic community of both purple-colored samples was dominated by hydrogenotrophic methanogens including Methanobacterium, Methanobrevibacter and Methanocorpusculum with significantly lower numbers of Methanosarcina. These results suggeste that hydrogen is actively produced by Rhodopseudomonas that leads to the dominance of hydrogen consuming microorganisms in both purple-colored samples. The syntrophic relationship between Rhodopseudomonas and hydrogenotrophic microbes might be important for producing high power density in the acetate-fed MFC under light conditions.
Autoantibodies Associated with Rheumatic Diseases

Abstract The identification of circulating autoantibodies contributes to the correct diagnosis as well as to the follow-up of rheumatic diseases. Some autoantibodies are even included in diagnostic and classification criteria for these types of autoimmune diseases. There are several relatively specific screening and identification methods for the measurement of autoantibodies available. The type of assay crucially influences the diagnostic value of the parameters. In general, routine laboratories should prefer enzyme immunoassays (ELISA) using well characterized antigens, although ELISA tests tend to produce more false-positive and true weakly positive results, which reduce their positive predictive value. Therefore one should be aware that laboratory results can only be properly interpreted when there is a correlation with the clinical situation and when the limitations of the technologies used for autoantibody identification have been taken into consideration. A diagnostic algorithm consisting of screening and identification steps should be established by each laboratory in order to create a rational, evidence-based and cost-effective basis for the diagnosis of rheumatic diseases.
The Association of Gamma-Glutamyl Transferase and Atrial Fibrillation

Background: Atrial fibrillation (AF) is the most commonly diagnosed cardiac arrhythmia in clinical practice and is related to significant morbidity and mortality. AF etiology and thus, predictive biomarkers are currently lacking. Liver enzymes have shown a correlation to cardiovascular disease. Gamma-glutamyl transferase (GGT) is a liver enzyme associated with oxidative stress that is postulated to have a link to AF occurrence. Researchers have recently placed emphasis on discovering a potential biomarker to predict AF. An elevation of systemic serum GGT and the association with the risk of AF development is the area of interest. Methods: Exhaustive search of available medical literature was performed using MEDLINE-Ovid, MEDLINE-Pubmed, Web of Science, Google Scholar, and UpToDate. Articles were determined relevant based on keywords and eligibility criteria. Results: Nine articles were reviewed and two were deemed relevant. Two observational studies were assessed for quality and critically reviewed. One study found that those in the highest quintile of GGT levels had a 40% increased risk of AF (HR 1.44, (95% CI 1.17-1.77). Another study found that there was a log-linear positive association of GGT with AF risk in analyses initially adjusted for age. Conclusion: The two studies both indicated an elevation in GGT and may be associated as a biomarker for the development of AF. Further study of this correlation is indicated before this biomarker can be implemented in clinical practice as a screening tool for AF.
In Vivo Measurement of Brain Tissue Response After Irradiation: Comparison of T2 Relaxation, Apparent Diffusion Coefficient, and Electrical Conductivity

Radiation therapy (RT) has been widely used as a powerful treatment tool to address cancerous tissues because of its ability to control cell growth. Its ionizing radiation damages the DNA of cancerous tissues, leading to cell death. Medical imaging, however, still has limitations regarding the reliability of its assessment of tissue response and in predicting the treatment effect because of its inability to provide contrast information on the gradual, minute tissue changes after RT. A recently developed magnetic resonance (MR)-based conductivity imaging method may provide direct, highly sensitive information on this tissue response because its contrast mechanism is based on the concentration and mobility of ions in intracellular and extracellular spaces. In this feasibility study, we applied T2-weighted, diffusion-weighted, and electrical conductivity imaging to mouse brain, thus, using the MR imaging to map the tissue response after radiation exposure. To evaluate the degree of response, we measured the T2 relaxation, apparent diffusion coefficient (ADC), and electrical conductivity of brain tissues before and after irradiation. The conductivity images, which showed significantly higher sensitivity than other MR imaging methods, indicated that the contrast is distinguishable in different ways at different areas of the brain. Future studies will focus on verifying these results and the long-term evaluation of conductivity changes using various irradiation methods for clinical applications.
Survival, morbidity, and resource use of infants of 25 weeks' gestational age or less.

OBJECTIVE The objective of this study was to examine survival, morbidity, and resource use in a large cohort of extremely preterm infants. STUDY DESIGN We examined all (n = 754) neonatal intensive care unit admissions born at < or =25 weeks' gestation and inborn deliveries (n = 949) between 22 and 25 weeks' gestation at 17 Canadian neonatal intensive care units. RESULTS The overall survival rate was 63%, with a range from 14% at 22 weeks' gestation to 76% at 25 weeks' gestation. There was a high incidence of chronic lung disease (33%-51%), > or =grade 3 intraventricular hemorrhage (0%-16%), necrotizing enterocolitis (0%-14%), > or =stage 3 retinopathy of prematurity (27%-55%), nosocomial infection (25%-39%), and multiple gestation (18%-46%). Extremely preterm infants comprise 4% of neonatal intensive care unit admissions but account for 22% of deaths, 20%-60% of major morbidities, 11% of patient days, and 10%-35% of major procedures. Outborn infants had a higher incidence of chronic lung disease, severe retinopathy of prematurity, and intraventricular hemorrhage. CONCLUSION Extremely preterm infants have a high incidence of mortality and morbidity and consume disproportionate amounts of neonatal intensive care unit resources.
Reporting of incorrect cause-of-death causal sequence on death certificates in the USA: using hypertension and diabetes as an educational illustration

Background Little is known about the extent of reporting an incorrect cause-of-death (COD) causal sequence on death certificates. Objective To determine the frequency of incorrect reporting of hypertension as cause of diabetes on death certificates in the USA. Methods Multiple-cause mortality files were used to identify death certificates which mentioned both hypertension and diabetes in the USA from 1985 to 2005. The frequency of reporting hypertension on the line below diabetes in part I of the death certificate was calculated. Results The percentage of cases in which both hypertension and diabetes were included in part I of the death certificate, in which hypertension was reported on the line below diabetes on the death certificate—that is, suggesting that hypertension was a cause of diabetes—increased from 15.5% in 1985 to 36.1% in 2000 and 38.2% in 2005. Conclusions The frequency of reporting of an incorrect COD causal sequence on death certificates in the USA has increased. Education, training and questioning the opinions of certifying physicians are needed to improve the quality of reporting of COD statements.
Phonological awareness, vocabulary, and reading in deaf children with cochlear implants.

PURPOSE To explore the phonological awareness skills of deaf children with cochlear implants (CIs) and relationships with vocabulary and reading development. METHOD Forty-three deaf children with implants who were between 5 and 15 years of age were tested; 21 had been implanted at around 2.5 years of age (Early CI group), and 22 had been implanted at around 5 years of age (Late CI group). Two control groups-a deaf hearing aided group (16 children) and a typically developing group of hearing children (19 children)-were also tested. All children received a battery of phonological processing tasks along with measures of reading, vocabulary, and speechreading. Analyses focus on deaf children within the normal IQ range (n = 53). RESULTS Age at cochlear implantation had a significant effect on vocabulary and reading outcomes when quotient scores were calculated. Individual differences in age at implant, duration of fit, phonological development, vocabulary development, auditory memory, visual memory, and speech intelligibility were all strongly associated with progress in reading for the deaf implanted children. Patterns differed somewhat depending on whether quotient scores or standard scores were used. CONCLUSIONS Cochlear implantation is associated with development of the oral language, auditory memory, and phonological awareness skills necessary for developing efficient word recognition skills. There is a benefit of earlier implantation.
Summary-Based Context-Sensitive Data-Dependence Analysis in Presence of Callbacks

Building a summary for library code is a common approach to speeding up the analysis of client code. In presence of callbacks, some reachability relationships between library nodes cannot be obtained during library-code summarization. Thus, the library code may have to be analyzed again during the analysis of the client code with the library summary. In this paper, we propose to summarize library code with tree-adjoining-language (TAL) reachability. Compared with the summary built with context-free-language (CFL) reachability, the summary built with TAL reachability further contains conditional reachability relationships. The conditional reachability relationships can lead to much lighter analysis of the library code during the client code analysis with the TAL-reachability-based library summary. We also performed an experimental comparison of context-sensitive data-dependence analysis with the TAL-reachability-based library summary and context-sensitive data-dependence analysis with the CFL-reachability-based library summary using 15 benchmark subjects. Our experimental results demonstrate that the former has an 8X speed-up over the latter on average.
Quadratic Inference Functions for Varying‐Coefficient Models with Longitudinal Data

Summary Nonparametric smoothing methods are used to model longitudinal data, but the challenge remains to incorporate correlation into nonparametric estimation procedures. In this article, we propose an efficient estimation procedure for varying‐coefficient models for longitudinal data. The proposed procedure can easily take into account correlation within subjects and deal directly with both continuous and discrete response longitudinal data under the framework of generalized linear models. The proposed approach yields a more efficient estimator than the generalized estimation equation approach when the working correlation is misspecified. For varying‐coefficient models, it is often of interest to test whether coefficient functions are time varying or time invariant. We propose a unified and efficient nonparametric hypothesis testing procedure, and further demonstrate that the resulting test statistics have an asymptotic chi‐squared distribution. In addition, the goodness‐of‐fit test is applied to test whether the model assumption is satisfied. The corresponding test is also useful for choosing basis functions and the number of knots for regression spline models in conjunction with the model selection criterion. We evaluate the finite sample performance of the proposed procedures with Monte Carlo simulation studies. The proposed methodology is illustrated by the analysis of an acquired immune deficiency syndrome (AIDS) data set.
Low-power, high-speed CMOS VLSI design

Ubiquitous computing is a next generation information technology where computers and communications will be scaled further, merged together, and materialized in consumer applications. Computers will be invisible behind broadband networks as servers, while terminals will come closer to us as wearable/implantable devices, more friendly devices with sophisticated human-computer interactions. IC chips will be implanted everywhere so that things can think and talk for distributed information processing. Key technologies here are low power, low cost, and good interfaces, especially for wireless data communications. Low-power, high-speed CMOS circuit techniques are presented in this paper, including low-voltage design with variable/multiple V/sub DD//V/sub TH/ control, embedded memory technology for reducing capacitance, and low-switching activity design.
Defining retinal progenitor cell competence in Xenopus laevis by clonal analysis

Extrinsic cues and intrinsic competence act in concert for cell fate determination in the developing vertebrate retina. However, what controls competence and how precise is the control are largely unknown. We studied the regulation of competence by examining the order in which individual retinal progenitor cells (RPCs) generate daughters. Experiments were performed in Xenopus laevis, whose full complement of retinal cells is formed in 2 days. We lineage-labeled RPCs at the optic vesicle stage. Subsequently we administered a cell cycle marker, 5-bromodeoxyuridine (BrdU) at early, middle or late periods of retinogenesis. Under these conditions, and in this animal, BrdU is not cleared by the time of analysis, allowing cumulative labeling. All retinal cell types were generated throughout nearly the entire retinogenesis period. When we examined the order that individual RPCs generated daughters, we discovered a regular and consistent sequence according to phenotype: RGC, Ho, CPr, RPr, Am, BP, MG. The precision of the order between the clones supports a model in which RPCs proceed through stepwise changes in competence to make each cell type, and do so unidirectionally. Because every cell type can be generated simultaneously within the same retinal environment, the change in RPC competence is likely to be autonomous.
Results of median nerve repair in children

Seven children ranging in age from 1 to 13 years (mean 8 years) were evaluated at a range of B months to 15 years (mean 4.7 years) following group fascicular repair of the median nerve at the wrist following a sharp transection of the nerve. At the follow‐up evaluation, they were measured with Semmes‐Weinstein nylon monofilaments, moving and static two‐point discrimination, and were judged for the presence or absence of paresthesias in their hands. The children did not receive sensory reeducation in the postoperative period. All children recovered to normal levels of moving and static two‐point discrimination and were free from disabling paresthesias. These results are contrasted with a group of similar nerve injuries in adult patients treated in the same way and over the same period of time. It is concluded that the capacity for peripheral neural regeneration and cerebral plasticity in children is such that excellent recovery of functional sensation in the hand can occur without the need for sensory reeducation.