Miracle-dz/UniFAR-FTUs huggingface dataset:
Proportion and risk indicators of nonadherence to antihypertensive therapy: a meta-analysis

Purpose The World Health Organization (WHO) concluded that poor adherence to treatment is the most important cause of uncontrolled high blood pressure, with approximately 75% of patients not achieving optimum blood pressure control. The WHO estimates that between 20% and 80% of patients receiving treatment for hypertension are adherent. As such, the first objective of our study was to quantify the proportion of nonadherence to antihypertensive therapy in real-world observational study settings. The second objective was to provide estimates of independent risk indicators associated with nonadherence to antihypertensive therapy. Materials and methods We performed a systematic literature review and meta-analysis of all studies published between database inception and December 31, 2011 that reviewed adherence, and risk indicators associated with nonadherence, to antihypertensive medications. Results In the end, 26 studies met our inclusion and exclusion criteria and passed our methodological quality evaluation. Of the 26 studies, 48.5% (95% confidence interval 47.7%–49.2%) of patients were adherent to antihypertensive medications at 1 year of follow-up. The associations between 114 variables and nonadherence to antihypertensive medications were reviewed. After meta-analysis, nine variables were associated with nonadherence to antihypertensive medications: diuretics in comparison to angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs), ACE inhibitors in comparison to ARBs, CCBs in comparison to ARBs, those with depression or using antidepressants, not having diabetes, lower income status, and minority cultural status. Conclusion This study clarifies the extent of adherence along with determining nine independent risk indicators associated with nonadherence to antihypertensive medications.
Granule cell as a site of gene action in the weaver mouse cerebellum: evidence from heterozygous mutant chimeras

Experimental mouse chimeras were used to determine the site(s) of gene action in the weaver mutant cerebellum. Chimeras containing mixtures of heterozygous weaver (wv/+) and non-weaver (+/+) cells were produced by the standard embryo aggregation technique. The non-weaver component of the chimera was chosen so that Purkinje cells or granule cells could be distinguished histologically from weaver Purkinje or granule cells. Levels of beta-glucuronidase activity were used to mark Purkinje cells, with the weaver strain having a high beta-glucuronidase activity, while the non-weaver strain had low beta-glucuronidase activity. The increased centralized clumping of heterochromatin in ichthyosis (ic) mutant mice compared to non-ic mice was used to mark granule cell populations. In the weaver chimera, there was a decreased cerebellar size, decreased numbers of Purkinje and granule cells, and increased ectopic Purkinje and granule cells compared to non-weaver, control mice. With the glucuronidase cell marker, it was found that there was no correlation between ectopia and genotype; that is, genetically normal cells, as well as weaver cells, were found in ectopic positions. Thus, the weaver gene acts extrinsic to the Purkinje cells in creating the ectopia characteristic of heterozygous weaver mutants. Analysis of the ectopic granule cells, however, revealed that 100% of the ectopic granule cells were from the weaver component of the chimera. Thus, the weaver gene intrinsically affects granule cells in causing ectopia. Other hypothetical sites of gene action would produce a genetically mixed population of ectopic granule cells, which was not the case in this study. These findings are discussed in relation to other abnormalities in the heterozygous weaver mutant and in regard to the Bergmann glia and homozygous mutant. Finally, speculations on the nature of the granule cell deficit are discussed briefly.
Clinical importance of HIV and depressive symptoms among veterans with HIV infection

OBJECTIVE: To compare the clinical importance (association with illness severity and survival) of depressive and HIV symptoms among veterans with HIV infection.DESIGN: Cross-sectional study; survival analysis.SETTING: Infectious Disease Clinics at 3 VA Medical Centers.PARTICIPANTS: HIV-infected patients (N=881) and their health care providers from June 1999 through July 2000.MEASUREMENTS AND MAIN RESULTS: Depressive symptoms were assessed using the 10-item Centers for Epidemiologic Studies Depression Scale (CES-D). Patient baseline survey included an HIV Symptom Index measuring the frequency and bother of 20 common symptoms. Providers were surveyed on patients’ illness severity, and survival data were obtained from VA death records. Of 881 patients, 46% had significant depressive symptoms (CES-D ≥10). Increasing depression symptom severity was associated with increasing HIV symptom frequency (P<.001) and bother (P<.001). Multiple regression results revealed that having moderate or severe depressive symptoms was not associated with provider-reported illness severity or survival. However, HIV symptoms were significantly associated with provider-reported illness severity (P<.01) and survival (P=.05), after adjusting for moderate and severe depressive symptoms, CD4 cell count/mm3, viral load, age, race, and antiretroviral use.CONCLUSIONS: Depression, while common in this sample, was not associated with illness severity or mortality after adjusting for HIV symptoms. HIV symptoms are associated with severity of illness and survival regardless of patients’ severity of depressive symptoms. This suggests that equal medical consideration should be given to HIV symptoms presented by HIV-infected patients regardless of their depression status, rather than automatically attributing medical complaints to depression.
The impact of mobile augmented reality in geography education: achievements, cognitive loads and views of university students

ABSTRACT Augmented reality (AR) technology is commonly used in education. AR offers a combination of the virtual and real world; thus, it can help students in learning abstract and complex subjects. The purpose of the current study was to determine the impact of mobile AR technology on achievement, cognitive load levels and views of 95 first-year university students (40 in the experimental group and 55 in the control group) enrolled in a geography course in the social sciences education department of the education faculty of a university in Turkey. A sequential explanatory design, a mixed method type of research, was used. The data were collected using an achievement test, a cognitive load scale, and a semi-structured interview form. The results of the study showed that AR increases students’ achievement and decreases their cognitive load levels, and the students’ views about AR technology were positive. Consequently, it can be stated that mobile AR technology is a useful tool for teaching geography, especially geomorphology topics.
Disruption of the Putative Vascular Leak Peptide Sequence in the Stabilized Ricin Vaccine Candidate RTA1-33/44-198

Vitetta and colleagues identified and characterized a putative vascular leak peptide (VLP) consensus sequence in recombinant ricin toxin A-chain (RTA) that contributed to dose-limiting human toxicity when RTA was administered intravenously in large quantities during chemotherapy. We disrupted this potentially toxic site within the more stable RTA1-33/44-198 vaccine immunogen and determined the impact of these mutations on protein stability, structure and protective immunogenicity using an experimental intranasal ricin challenge model in BALB/c mice to determine if the mutations were compatible. Single amino acid substitutions at the positions corresponding with RTA D75 (to A, or N) and V76 (to I, or M) had minor effects on the apparent protein melting temperature of RTA1-33/44-198 but all four variants retained greater apparent stability than the parent RTA. Moreover, each VLP(−) variant tested provided protection comparable with that of RTA1-33/44-198 against supralethal intranasal ricin challenge as judged by animal survival and several biomarkers. To understand better how VLP substitutions and mutations near the VLP site impact epitope structure, we introduced a previously described thermal stabilizing disulfide bond (R48C/T77C) along with the D75N or V76I substitutions in RTA1-33/44-198. The D75N mutation was compatible with the adjacent stabilizing R48C/T77C disulfide bond and the Tm was unaffected, whereas the V76I mutation was less compatible with the adjacent disulfide bond involving C77. A crystal structure of the RTA1-33/44-198 R48C/T77C/D75N variant showed that the structural integrity of the immunogen was largely conserved and that a stable immunogen could be produced from E. coli. We conclude that it is feasible to disrupt the VLP site in RTA1-33/44-198 with little or no impact on apparent protein stability or protective efficacy in mice and such variants can be stabilized further by introduction of a disulfide bond.
Radiofrequency Catheter Ablation and Antiarrhythmic Drug Therapy: A Prospective, Randomized, 4-Year Follow-Up Trial: The APAF Study

Background— Information on comparative outcome between radiofrequency catheter ablation (RFA) and antiarrhythmic drugs (AADs) >1 year after randomization is important for clinical decision-making. Methods and Results— A total of 198 patients (age, 56±10 years) with paroxysmal atrial fibrillation were randomly assigned to RFA (99 patients) or to AADs (99 patients). We evaluated efficacy of RFA or AADs in a comparable 48-month follow-up period according to intention-to-treat analysis. Cardiac rhythm was assessed with daily transtelephonic transmissions. Quality of life was also analyzed. At 4 years, among the 99 patients first assigned to RFA, the procedure was repeated because of recurrent atrial fibrillation/atrial tachycardia in 27 patients (27.3%). Among the 99 patients randomly assigned to AADs, 87 (87.9%) crossed over to undergo RFA and 4 years after random assignment only 12 (12.1%) were in sinus rhythm with AAD alone without ablation. Despite the high level of crossovers, at 4 years the intention-to-treat analysis showed that 72.7% of patients in the ablation arm and 56.5% of those initially randomly assigned to AADs were free of recurrent atrial fibrillation/atrial tachycardia (P=0.017). During the follow-up, 19.2% of AAD patients progressed to persistent atrial fibrillation before switching to RFA. RFA significantly improved quality of life (P<0.001), whereas before crossing over to RFA, patients receiving AADs showed poorer quality of life. Except for new left atrial tachycardia, there were no serious complications caused by RFA. Conclusions— With follow-up extended to 4 years after randomly assigned, ablation remains superior to antiarrhythmic drug in these patients with paroxysmal atrial fibrillation. Clinical Trial Registration— URL: http://www.clinicaltrials. gov. Unique identifier: NCT00340314.
Human adipose tissue as a reservoir for memory CD4+ T cells and HIV

Objective:The objective of this study is to determine whether adipose tissue functions as a reservoir for HIV-1. Design:We examined memory CD4+ T cells and HIV DNA in adipose tissue–stromal vascular fraction (AT-SVF) of five patients [four antiretroviral therapy (ART)-treated and one untreated]. To determine whether adipocytes stimulate CD4+ T cells and regulate HIV production, primary human adipose cells were cocultured with HIV-infected CD4+ T cells. Methods:AT-SVF T cells were studied by flow cytometry, and AT-SVF HIV DNA (Gag and Env) was examined by nested PCR and sequence analyses. CD4+ T-cell activation and HIV production were measured by flow cytometry and ELISA. Results:AT-SVF CD3+ T cells were activated (>60% CD69+) memory CD4+ and CD8+ T cells in uninfected and HIV-infected persons, but the AT-SVF CD4+/CD8+ ratio was lower in HIV patients. HIV DNA (Gag and Env) was detected in AT-SVF of all five patients examined by nested PCR, comparably to other tissues [peripheral blood mononuclear cell (PBMC), lymph node or thymus]. In coculture experiments, adipocytes increased CD4+ T-cell activation and HIV production approximately two to three-fold in synergy with gamma-chain cytokines interleukin (IL)-2, IL7 or IL15. These effects were mitigated by neutralizing antibodies against IL6 and integrin-&agr;1&bgr;1. Adipocytes also enhanced T-cell viability. Conclusion:Adipose tissues of ART-treated patients harbour activated memory CD4+ T cells and HIV DNA. Adipocytes promote CD4+ T-cell activation and HIV production in concert with intrinsic adipose factors. Adipose tissue may be an important reservoir for HIV.
An Energy-efficient Rate Adaptive Media Access Protocol (RA-MAC) for Long-lived Sensor Networks

We introduce an energy-efficient Rate Adaptive Media Access Control (RA-MAC) algorithm for long-lived Wireless Sensor Networks (WSNs). Previous research shows that the dynamic and lossy nature of wireless communications is one of the major challenges to reliable data delivery in WSNs. RA-MAC achieves high link reliability in such situations by dynamically trading off data rate for channel gain. The extra gain that can be achieved reduces the packet loss rate which contributes to reduced energy expenditure through a reduced numbers of retransmissions. We achieve this at the expense of raw bit rate which generally far exceeds the application’s link requirement. To minimize communication energy consumption, RA-MAC selects the optimal data rate based on the estimated link quality at each data rate and an analytical model of the energy consumption. Our model shows how the selected data rate depends on different channel conditions in order to minimize energy consumption. We have implemented RA-MAC in TinyOS for an off-the-shelf sensor platform (the TinyNode) on top of a state-of-the-art WSN Media Access Control Protocol, SCP-MAC, and evaluated its performance by comparing our implementation with the original SCP-MAC using both simulation and experiment.
Investigation of the Lack of Angiogenesis in the Formation of Lymph Node Metastases.

BACKGROUND To date, antiangiogenic therapy has failed to improve overall survival in cancer patients when used in the adjuvant setting (local-regional disease with no detectable systemic metastasis). The presence of lymph node metastases worsens prognosis, however their reliance on angiogenesis for growth has not been reported. METHODS Here, we introduce a novel chronic lymph node window (CLNW) model to facilitate new discoveries in the growth and spread of lymph node metastases. We use the CLNW in multiple models of spontaneous lymphatic metastases in mice to study the vasculature of metastatic lymph nodes (n = 9-12). We further test our results in patient samples (n = 20 colon cancer patients; n = 20 head and neck cancer patients). Finally, we test the ability of antiangiogenic therapy to inhibit metastatic growth in the CLNW. All statistical tests were two-sided. RESULTS Using the CLNW, we reveal the surprising lack of sprouting angiogenesis during metastatic growth, despite the presence of hypoxia in some lesions. Treatment with two different antiangiogenic therapies showed no effect on the growth or vascular density of lymph node metastases (day 10: untreated mean = 1.2%, 95% confidence interval [CI] = 0.7% to 1.7%; control mean = 0.7%, 95% CI = 0.1% to 1.3%; DC101 mean = 0.4%, 95% CI = 0.0% to 3.3%; sunitinib mean = 0.5%, 95% CI = 0.0% to 1.0%, analysis of variance P = .34). We confirmed these findings in clinical specimens, including the lack of reduction in blood vessel density in lymph node metastases in patients treated with bevacizumab (no bevacizumab group mean = 257 vessels/mm(2), 95% CI = 149 to 365 vessels/mm(2); bevacizumab group mean = 327 vessels/mm(2), 95% CI = 140 to 514 vessels/mm(2), P = . 78). CONCLUSION We provide preclinical and clinical evidence that sprouting angiogenesis does not occur during the growth of lymph node metastases, and thus reveals a new mechanism of treatment resistance to antiangiogenic therapy in adjuvant settings. The targets of clinically approved angiogenesis inhibitors are not active during early cancer progression in the lymph node, suggesting that inhibitors of sprouting angiogenesis as a class will not be effective in treating lymph node metastases.
Impact of matrix-assisted laser desorption ionization time-of-flight mass spectrometry on the clinical management of patients with Gram-negative bacteremia: a prospective observational study.

BACKGROUND Early identification of pathogens from blood cultures using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry may optimize the choice of empirical antibiotic therapy in the setting of bloodstream infections. We aimed to assess the impact of this new technology on the use of antibiotic treatment in patients with gram-negative bacteremia. METHODS We conducted a prospective observational study from January to December 2010 to evaluate the sequential and separate impacts of Gram stain reporting and MALDI-TOF bacterial identification performed on blood culture pellets in patients with gram-negative bacteremia. The primary outcome was the impact of MALDI-TOF on empirical antibiotic choice. RESULTS Among 202 episodes of gram-negative bacteremia, Gram stain reporting had an impact in 42 cases (20.8%). MALDI-TOF identification led to a modification of empirical therapy in 71 of all 202 cases (35.1%), and in 16 of 27 cases (59.3%) of monomicrobial bacteremia caused by AmpC-producing Enterobacteriaceae. The most frequently observed impact was an early appropriate broadening of the antibiotic spectrum in 31 of 71 cases (43.7%). In total, 143 of 165 episodes (86.7%) of monomicrobial bacteremia were correctly identified at genus level by MALDI-TOF. CONCLUSIONS In a low prevalence area for extended spectrum betalactamases (ESBL) and multiresistant gram-negative bacteria, MALDI-TOF performed on blood culture pellets had an impact on the clinical management of 35.1% of all gram-negative bacteremia cases, demonstrating a greater impact than Gram stain reporting. Thus, MALDI-TOF could become a vital second step beside Gram stain in guiding the empirical treatment of patients with bloodstream infection.
Ideal observer approximation using Bayesian classification neural networks

It is well understood that the optimal classification decision variable is the likelihood ratio or any monotonic transformation of the likelihood ratio. An automated classifier which maps from an input space to one of the likelihood ratio family of decision variables is an optimal classifier or "ideal observer. " Artificial neural networks (ANNs) are frequently used as classifiers for many problems. In the limit of large training sample sizes, an ANN approximates a mapping function which is a monotonic transformation of the likelihood ratio, i.e., it estimates an ideal observer decision variable. A principal disadvantage of conventional ANNs is the potential over-parameterization of the mapping function which results in a poor approximation of an optimal mapping function for smaller training samples. Recently, Bayesian methods have been applied to ANNs in order to regularize training to improve the robustness of the classifier. The goal of training a Bayesian ANN with finite sample sizes is, as with unlimited data, to approximate the ideal observer. The authors have evaluated the accuracy of Bayesian ANN models of ideal observer decision variables as a function of the number of hidden units used, the signal-to-noise ratio of the data and the number of features or dimensionality of the data. The authors show that when enough training data are present, excess hidden units do not substantially degrade the accuracy of Bayesian ANNs. However, the minimum number of hidden units required to best model the optimal mapping function varies with the complexity of the data.
Understanding Project Survival in an ES Environment: A Sociomaterial Practice Perspective

Modern organizations are increasingly choosing to adopt off-the-shelf software applications (e.g., Enterprise Systems, ES) rather than develop tailor-made solutions. However, many studies have shown that adopting prepackaged software is difficult with these highly integrated systems amplifying the potential for organizational conflict; especially once the system is rolled out to users. There is a gap in the literature related to this changing pattern of systems development, and researchers have begun investigating it. We contribute to this emerging literature while also shifting the focus of ES implementation research by offering a new perspective to understand the processes of mutual adaptation of the technical and social during system implementation and maintenance of large scale systems (ES). We focus on the turnaround process by which a troubled project at go-live becomes a working information system. Much IS literature to date has focused on the problems associated with configuration and implementation or the immediate (often negative) reaction to, and use of, packaged software. Yet, there is significant evidence that projects often do survive and yield a working information system in the face of, and despite, a negative release. Based on data from an intensive qualitative field study within a university, we find that practices are negotiated through processes of use rather than being permanently and systematically selected at a particular moment in time and, in so doing, we offer one of the first works to address the issue of sociomateriality and its implications for understanding the evolution of large scale IT systems.
Organizational Characteristics, Computer Literacy and Attitudes of CEOs' toward the Use of Information Technology: A Study of Bruneian Small & Medium Business Enterprises

The overwhelming dependency on the organizational use of Information Technology (IT) during the last two decades of twentieth centaury has dramatically changed the way of working for the most of the business organizations. IT not only holds benefits for organizations and for their chief executives officers’ (CEOs) but has also caused difficulties for CEOs to optimize the computing resources. In order to get a deeper insight into the subject a survey of seventy-four small and medium business organizations were conducted to investigate the degree of IT usage in Brunei Darussalam. The study attempts to assess the depth and breadth of IT usage in business. Moreover, parameters such as organizational (size, sale or profitability and type of business) and chief executives (computer literacy and computer attitudes) are studied. The study highlights characteristics: Sales, type of business, and computer attitudes of the chief executives significantly contribute toward the use of IT. None of the other organizational and CEOs variables were found to be significant. The results are discussed, and some suggestions are offered for further studies.