Miracle-dz/UniFAR-FTUs huggingface dataset:
Snow and Rain Modify Neighbourhood Walkability for Older Adults

RÉSUMÉ La littérature a documenté une relation positive entre la mobilité à l’extérieur chez les personnes âgées et les environnements bâtisables et marchables. Cependant, étonnamment, toute considération de la façon dont le temps modifie l’accessibilité piétonnière à travers les quartiers est absente. À Vancouver, au Canada, on a utilisé des données météorologiques archivées liées à des données recueillies auprès d’un échantillon d’aînés. On a constaté que, lorsqu’il neige, les quartiers où l’on dépend d’automobiles (comportant des blocs plus longs, moins d’intersections et une plus grande distance aux commodités) sont devenus inaccessibles. Même les adultes plus âgés qui vivaient dans les quartiers qui étaient très bien adaptés au traffic pietonnier marchait à 25 pour cent moins de destinations pendant la neige. Il est essentiel de tenir compte de l’impact des conditions météorologiques dans la relation entre la marchabilité des quartiers et la mobilité des personnes âgées. ABSTRACT The literature has documented a positive relationship between walkable built environments and outdoor mobility in older adults. Yet, surprisingly absent is any consideration of how weather conditions modify the impact of neighbourhood walkability. Using archived weather data linked to survey data collected from a sample of older adults in Vancouver, Canada, we found that car-dependent neighbourhoods (featuring longer block lengths, fewer intersections, and greater distance to amenities) became inaccessible in snow. Even older adults who lived in very walkable neighbourhoods walked to 25 per cent fewer destinations in snow. It is crucial to consider the impact of weather in the relationship between neighbourhood walkability and older adult mobility.
Acceptability and Effectiveness of Assisted Human Immunodeficiency Virus Partner Services in Mozambique: Results From a Pilot Program in a Public, Urban Clinic

Background Assisted partner services (APS) involves offering persons with human immunodeficiency virus (HIV) assistance notifying and testing their sex partners. Assisted partner services is rarely available in sub-Saharan Africa. We instituted a pilot APS program in Maputo, Mozambique. Methods Between June and September 2014, community health workers (CHWs) offered APS to persons with newly diagnosed HIV (index patients [IPs]). Community health workers interviewed IPs at baseline, 4 and 8 weeks. At baseline, CHWs counseled IPs to notify partners and encourage their HIV testing, but did not notify partners directly. At 4 weeks, CHWs notified partners directly. We compared 4- and 8-week outcomes to estimate the impact of APS on partner notification, HIV testing and HIV case finding. Results Community health workers offered 223 IPs APS, of whom 220 (99%) accepted; CHWs collected complete follow-up data on 206 persons; 79% were women, 74% were married, and 50% named >1 sex partner. Index patients named 262 HIV-negative partners at baseline. At 4 weeks, before APS, IPs had notified 193 partners (74%), but only 82 (31%) had HIV tested; 43 (13%) tested HIV positive. Assisted partner services resulted in the notification of 22 additional partners, testing of 83 partners and 43 new HIV diagnoses. In relative terms, APS increased partner notification, testing, and HIV case finding by 13%, 101%, and 125%. Seventy-two (35%) of 206 IPs were in ongoing HIV serodiscordant partnerships. Only 2.5 IPs needed to receive APS to identify a previously undiagnosed HIV-infected partner or an ongoing HIV serodiscordant partnership. Two (1%) IPs reported APS-related adverse events. Conclusions Assisted partner services is acceptable to Mozambicans newly diagnosed with HIV, identifies large numbers of serodiscordant partnerships and persons with undiagnosed HIV, and poses a low risk of adverse events.
Human immunodeficiency virus–infected and uninfected adults with non–genotype 3 hepatitis C virus have less hepatic steatosis than adults with neither infection

Hepatic steatosis (HS) is common in individuals with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections, but the independent contributions of HCV and HIV to HS are unclear. Magnetic resonance imaging and spectroscopy were used to measure visceral adipose tissue (VAT) and liver fat fraction (LFF) (total lipids/[total lipids + water]) in 356 adults: 57 with HCV monoinfection, 70 with HIV/HCV coinfection, 122 with HIV monoinfection, and 107 with neither infection. Participants who were infected with HCV genotype 3 were excluded because of the genotype's reported steatogenic effects. For prevalence estimates, HS was defined as LFF ≥ 0.05. We estimated the association of HIV and HCV status with LFF using multivariable linear regression, adjusting for demographics, lifestyle, and metabolic factors including the homeostasis model assessment estimate of insulin resistance (HOMA‐IR) and liver fibrosis defined using the aspartate aminotransferase‐to‐platelet ratio index (APRI). The prevalence of HS was highest in the uninfected (33%) and HIV‐monoinfected (28%), followed by the HCV‐monoinfected (19%) and HIV/HCV‐coinfected (11%) (P = 0.003 across groups). Compared with uninfected participants—and after adjusting for demographics, lifestyle, and metabolic factors—HIV monoinfection, HCV monoinfection, and HIV/HCV coinfection were associated with 19% (95% confidence interval [CI], −39% to 6%), 38% (95% CI, −55% to −12%), and 42% (95% CI, −59% to −18%) lower LFF, respectively. HCV monoinfection and HIV/HCV coinfection remained strongly associated with lower LFF after further adjusting for APRI, and results were unchanged after excluding subjects with suspected cirrhosis. Among the entire cohort, Hispanic ethnicity, male sex, VAT, and HOMA‐IR were independently associated with greater LFF. Conclusion: Contrary to expectations, HIV/HCV‐coinfected and HCV‐monoinfected adults had significantly less liver fat than uninfected adults, even after adjusting for demographics, lifestyle, metabolic factors, and hepatic fibrosis. Our findings suggest that non–genotype 3 HCV infection may be protective against HS. The mechanisms by which this occurs and the impact of HCV treatment on HS requires further investigation. (Hepatology 2017;65:853‐863)
Determinants of Early Case-Fatality among Stroke Patients in Maputo, Mozambique and Impact of in-Hospital Complications

The burden of stroke is increasing in developing countries that struggle to manage it efficiently. We identified determinants of early case-fatality among stroke patients in Maputo, Mozambique, to assess the impact of in-hospital complications. Patients admitted to any hospital in Maputo with a new stroke event were prospectively registered (n = 651) according to the World Health Organization's STEPwise approach, in 2005–2006. We assessed the determinants of in-hospital and 28-day fatality, independently of age, gender and education, and computed population attributable fractions. In-hospital mortality was higher among patients with Glasgow score at admission ≤6 (more than fivefold) or needing cardiopulmonary resuscitation during hospitalization (approximately 2·5-fold). Pneumonia and deep vein thrombosis/other cardiovascular complications during hospitalization were responsible for 19·6% (95% confidence interval, 5·3 to 31·7) of ischaemic stroke and 15·9% (95% confidence interval, 5·8 to 24·9) of haemorrhagic stroke deaths until the 28th day. Ischaemic stroke patients with systolic blood pressure 160–200 mmHg had lower in-hospital mortality (relative risk = 0·32, 95% confidence interval, 0·13 to 0·78), and, for those with haemorrhagic events (haemorrhagic stroke), 28-day mortality was higher when systolic blood pressure was over 200 mmHg (hazard ratio = 3·42; 95% confidence interval, 1·02 to 11·51), compared with systolic blood pressure 121–140 mmHg. Regarding diastolic blood pressure, the risk was lowest at 121–150 mmHg for ischaemic stroke and at 61–90 mmHg for haemorrhagic stroke. Early case-fatality was mostly influenced by stroke severity and in-hospital complications. The allocation of resources to the latter may have a large impact on the reduction of the burden of stroke in this setting.
Infraorbital Nerve Decompression for Infraorbital Neuralgia/Causalgia following Blowout Orbital Fractures: A Case Series

The purpose of this study was to present the management of a series of patients referred with infraorbital nerve paraesthesia that developed after insignificant orbital floor fracture without diplopia or exophthalmos, and that did not require initial surgical repair. This is a retrospective interventional case series. The main outcome and measures were assessment of preoperative symptoms including neuralgia and sensory symptoms; review of periorbital computed tomography (CT) scans; and assessment of postoperative effects of surgery for infraorbital nerve decompression. Nine patients were identified who developed neuralgia affecting the infraorbital nerve distribution from a cohort of 79 patients who presented with orbital floor fracture. Six were female and three were male. Age range was 22 to 73 years with a mean of 48 years. Six patients were clinically depressed due to the chronic pain. In addition, two patients had dizziness on upgaze; one patient had blurring of central vision on eye movements; and one patient had mood swings. Reviews of CT scans revealed subtle disruption of the infraorbital canal in all cases. All nine patients underwent infraorbital nerve decompression. Abnormal adhesions between the nerve and its bony canal were found in five of nine cases. Follow-up ranged from 3 to 37 months (mean: 18 months). Following surgery, after a variable period of time ranging from 1 day to 3 months, all patients had resolution of their symptoms. Mean follow-up was 18 months. Reconstructive surgeons should be aware that infraorbital nerve neuralgia, secondary to disruption of the nerve in the distorted bony canal, may be another indication for surgical intervention following orbital floor trauma in selected cases, in addition to more traditionally accepted indications. Neuralgia and causalgia are probably more common than previously thought and symptoms should be actively sought in the patient's history or else risk being overlooked and inappropriately managed. Long-term follow-up of such patients is unlikely to be practical. Patient and/or family practitioner education of possible sequelae may be one possible solution to detect this type of problem early. Nerve decompression, where indicated, may improve the patient's neuralgia and associated behavioral changes and quality of life. An optimal diagnostic and management algorithm is yet to be established.
The Predictive Ability of PV-ACO2 Gap and PV-ACO2/CA-VO2 Ratio in Shock: A Prospective, Cohort Study

Introduction: Compromised tissue oxygenation leads to anaerobiosis, leading to organ failure and death. This study attempts to demonstrate the predictive abilities of the Pv-aCO2 gap and Pv-aCO2/Ca-vO2 ratio in shock patients undergoing resuscitation. Methods: In a prospective study, consecutive patients with shock were included. Timed measurements of Pv-aCO2 gap, ScvO2, lactate, and Pv-aCO2/ Ca-vO2 ratio were obtained. The association between the mortality and each variable at all intervals was analyzed. Receiver operating characteristics curves were built. Results: Fifty patients were enrolled. Intensive care unit survivors had a higher Pv-aCO2/ Ca-vO2 ratio at time 0 (0.21, interquartile range [IQR] 0.14 vs. 0.27, IQR 0.38, P = 0.032) and at 3 h (0.27, IQR 0.08 vs. 0.21, IQR 0.12, P = 0.035). Twenty-eight day survival was higher in patients with a low Pv-aCO2 gap at time 0 (7.5, IQR 7 vs. 4.8, IQR 5, P = 0.007). Baseline Pv-aCO2 gap and Pv-aCO2/Ca-vO2 ratio showed good ability to predict 28-day mortality as seen by AUC 0.728 (95% CI 0.578–0.877, P = 0.007) and 0.711 (95% CI 0.563–0.860, P = 0.013). A cut-off point of Pv-aCO2 gap ≥6 mm Hg identified 28-day mortality (75% vs. 45.5%, P = 0.034). The best cutoff values, at baseline, to predict 28-day mortality were 0.25 for the Pv-aCO2/Ca-vO2 ratio (sensitivity 58%, specificity 85%, LR+ 3.86, LR− 0.49) and 6.3 for the Pv-aCO2 gap (sensitivity 58%, specificity 79%, LR+ 2.76, LR− 0.53). Conclusion: This study suggests that Pv-aCO2 gap and Pv-aCO2/Ca-vO2 ratio are discriminating predictors of 28-day mortality and can be used to provide supplementary information during resuscitation in shock.
Primary outcome switching among drug trials with and without principal investigator financial ties to industry: a cross-sectional study

Objectives To determine the relationship between manufacturer-related financial ties among investigators of published drug trials and rates of discrepant registered and published primary trial outcomes. Design Cross-sectional study. Setting Human subjects drug trials published in ‘core clinical’ MEDLINE journals in 2013. Primary and secondary outcome measures The primary study endpoint was the presence of a prospectively registered, clearly defined primary outcome that matched the published primary outcome for each included trial. Secondary outcomes included assessments of registration timing and quality, and the impact of outcome discrepancies between registration and publication on the statistical significance of the included trials. Results Of 192 included trials, 134 (70%) were positive and 58 (30%) were negative. Financial ties were present between first or last authors and drug manufacturers for 130 trials (68%), of which 78% were positive, versus 53% of trials with no financial ties that were positive. Clearly defined, prospectively registered outcomes that matched the published outcomes were present in just 76 of the 192 trials (40%). After adjusting for study start date and sample size, the observed relationship between investigator financial ties and the presence of a match between prospectively registered and published primary outcomes was of borderline statistical significance (OR 2.12, 95% CI 0.998 to 4.50). Studies with financial ties present were more likely than studies without ties to have been prospectively registered (78%vs48%, P<0.001) and were more likely to have prospectively registered a clearly defined primary outcome(62%vs35%, P<0.001). Conclusions Less than half of the trials in this cohort were prospectively registered with a clear primary outcome that was consistent with the primary outcome reported in the published manuscript. The presence of investigator financial ties was associated with higher quality registration practices, though this association diminished after adjusting for factors that impact registration quality.
Safety and Efficacy of Intratumoral Injections of Chimeric Antigen Receptor (CAR) T Cells in Metastatic Breast Cancer

Transiently expressed chimeric antigen receptor T cells specific for c-Met, expressed in breast cancer, were injected into breast cancer tumors of six patients in a phase 0 clinical trial. Injections resulted in tumor necrosis and were well tolerated. Chimeric antigen receptors (CAR) are synthetic molecules that provide new specificities to T cells. Although successful in treatment of hematologic malignancies, CAR T cells are ineffective for solid tumors to date. We found that the cell-surface molecule c-Met was expressed in ∼50% of breast tumors, prompting the construction of a CAR T cell specific for c-Met, which halted tumor growth in immune-incompetent mice with tumor xenografts. We then evaluated the safety and feasibility of treating metastatic breast cancer with intratumoral administration of mRNA-transfected c-Met-CAR T cells in a phase 0 clinical trial (NCT01837602). Introducing the CAR construct via mRNA ensured safety by limiting the nontumor cell effects (on-target/off-tumor) of targeting c-Met. Patients with metastatic breast cancer with accessible cutaneous or lymph node metastases received a single intratumoral injection of 3 × 107 or 3 × 108 cells. CAR T mRNA was detectable in peripheral blood and in the injected tumor tissues after intratumoral injection in 2 and 4 patients, respectively. mRNA c-Met-CAR T cell injections were well tolerated, as none of the patients had study drug–related adverse effects greater than grade 1. Tumors treated with intratumoral injected mRNA c-Met-CAR T cells were excised and analyzed by immunohistochemistry, revealing extensive tumor necrosis at the injection site, cellular debris, loss of c-Met immunoreactivity, all surrounded by macrophages at the leading edges and within necrotic zones. We conclude that intratumoral injections of mRNA c-Met-CAR T cells are well tolerated and evoke an inflammatory response within tumors. Cancer Immunol Res; 5(12); 1152–61. ©2017 AACR.
Prevalence of and risk factors for age-related macular degeneration in Nepal: the Bhaktapur Retina Study

Aim This study aimed to explore the prevalence of and risk factors for age-related macular degeneration (AMD) in an elderly population in Nepal. Subjects and methods This is a population-based, cross-sectional study. A sample size of 2,100 was calculated. A total of 1,860 (88.6%) subjects aged >60 years were enrolled for the study from 30 clusters in the district. Detailed history, visual acuity, and anterior segment and posterior segment examinations were performed. AMD was graded according to the International ARM Epidemiological Study Group. Results Among the total study population, 659 subjects had any AMD (35.43%; 95% confidence interval [CI]: 33.25–37.65), 484 had mild dry AMD (26.02%; 95% CI: 24.04–28.08), 143 had intermediate dry AMD (7.69%; 95% CI: 6.52–8.99), 19 had geographic atrophy (1.02%; 95% CI: 0.61–1.59), and 13 had wet AMD (0.70%; 95% CI: 0.37–1.19). The overall prevalence of early and late AMD was 33.71% and 1.72%, respectively. Among subjects with dry and wet AMD, 36.53% and 46.1% had visual impairment, while 2.78% and 23.08% were blind, respectively. In multivariate analysis, AMD was significantly higher in subjects with an increased number of cigarettes smoked per day (odds ratio [OR] 1.02, 95% CI: 1.01–1.04; P=0.007) and in subjects with pseudophakia (OR 1.45, 95% CI: 1.12–1.87; P=0.005). Conclusion One-third of the population aged ≥60 years have some form of AMD. There was a significant association with the number of cigarettes consumed and with previous cataract surgery.
The effect of continuous illumination of incubating chicken eggs on embryonic development.

Abstract The objective of the experiment was to determine the influence of continuous illumination of incubating chicken eggs upon embryonic development. The weights of embryos from eggs that were exposed to fluorescent light during incubation and those from eggs that were incubated without illumination were compared on each day of incubation from the fifth through the fourteenth day. Embryos from the illuminated eggs were significantly heavier than those from the non-illuminated eggs. Egg size had no effect upon embryo weight for the period studied.
Randomized Cross-Over Study Comparing Two Infusion Sets for CSII in Daily Life

Background: Continuous subcutaneous insulin infusion (CSII) therapy is a valuable option especially for people with type 1 diabetes. Although insulin infusion sets (IIS) are essential components of most insulin pump systems, only few studies have been conducted on their performance and safety. In this study 2 IIS with soft cannulas were compared. Methods: In an open-label, randomized, crossover, multicenter 8-week study 80 type 1 diabetic subjects on CSII (20-74 years, mean 46.5 ± 12.9 years, 58.8% male) were enrolled to evaluate the use of 2 IIS. The Accu-Chek® FlexLink Plus (FL Plus) and the Accu-Chek® FlexLink infusion set (FL) were used 4 weeks each under real-life conditions at home. All patients had to record details about every IIS change in a diary. Insertion-related pain was assessed by means of a visual analogue scale (VAS). Results: The mean pain noted during insertion was similar for both IIS (VAS 6.1 ± 6.4 mm for the FL Plus and 5.8 ± 6.3 mm for the FL, P = .92). 20.0% of the 895 IIS changes with FL Plus and 16.0% of the 854 with FL were unplanned. During the 4243 patient days of the study, 13 patients had adverse events. Among these, 2 serious adverse events occurred. Both serious events and 1 nonserious adverse event were considered as related to the IIS. Of the patients, 18.7% had kinked cannulas. Most patients were satisfied with both IIS. Conclusion: Both IIS are safe and effective. The 2 IIS did not differ from each other with respect to pain observed during insertion.
Novel Process for Isolating Fibrils from Cellulose Fibers by High-Intensity Ultrasonication. II. Fibril Characterization

Received 24 September 2008; accepted 29 January 2009DOI 10.1002/app.30160Published online 26 October 2009 in Wiley InterScience (www.interscience.wiley.com). ABSTRACT: High-intensity ultrasonication with a batchprocess was used to isolate ﬁbrils from several cellulosesources, and a mixture of microscale and nanoscaleﬁbrils was obtained. The geometrical characteristics ofthe ﬁbrils were investigated with polarized light micros-copy, scanning electron microscopy, and atomic force mi-croscopy. The results show that small ﬁbrils withdiameters ranging from about 30 nm to several micro-meters were peeled from the ﬁbers. Some ﬁbrils wereisolated from the ﬁbers, whereas some were still on theﬁber surfaces. The lengths of untreated and treated cellu-lose ﬁbers were investigated by a ﬁber size analyzer. Thecrystallinities of some cellulose ﬁbers were evaluated bywide-angle X-ray diffraction and Fourier transform infra-red spectroscopy. The high-intensity ultrasonication tech-nique is an environmentally benign method and asimpliﬁed process that conducts ﬁber isolation and chem-ical modiﬁcation simultaneously and helps signiﬁcantlyreduce the production cost of cellulose nanoﬁbers andtheir composites.
Signal integration at spherical bushy cells enhances representation of temporal structure but limits its range

Neuronal inhibition is crucial for temporally precise and reproducible signaling in the auditory brainstem. Previously we showed that for various synthetic stimuli, spherical bushy cell (SBC) activity in the Mongolian gerbil is rendered sparser and more reliable by subtractive inhibition (Keine et al., 2016). Here, employing environmental stimuli, we demonstrate that the inhibitory gain control becomes even more effective, keeping stimulated response rates equal to spontaneous ones. However, what are the costs of this modulation? We performed dynamic stimulus reconstructions based on neural population responses for auditory nerve (ANF) input and SBC output to assess the influence of inhibition on acoustic signal representation. Compared to ANFs, reconstructions of natural stimuli based on SBC responses were temporally more precise, but the match between acoustic and represented signal decreased. Hence, for natural sounds, inhibition at SBCs plays an even stronger role in achieving sparse and reproducible neuronal activity, while compromising general signal representation.