Miracle-dz/UniFAR-FTUs huggingface dataset:
Subjective Quality-of-Life Predictors for Older Adults with Physical Disabilities

Levasseur M, Desrosiers J, St-Cyr Tribble D: Subjective quality-of-life predictors for older adults with physical disabilities. Am J Phys Med Rehabil 2008;87: 830-841. Objectives:To study changes in quality of life (QOL) and to explore predictors of QOL of community-dwelling older adults with physical disabilities. Design:A 2-yr longitudinal study involved a convenience sample of 49 people with physical disabilities aged 60–94 yrs. QOL was estimated twice at a 2-yr interval with the Quality of Life Index, which includes four domains: health and functioning, socioeconomic, psychological/spiritual, and family. The potential predictors evaluated at baseline were health condition, activity, participation (level and satisfaction), personal factors, and environmental factors (obstacles and facilitators). Results:No change over time in QOL mean score was observed (mean: −0.41; SD: 2.5; 95% confidence interval: −1.1 to 0.30; P = 0.25). However, about half the participants had a clinically significant change (either increase or decrease). Greater satisfaction with participation in social roles and fewer obstacles in the physical environment were identified as the best predictors (R2 = 0.27; P = 0.001) of better QOL. Greater participation in daily activities, fewer obstacles in the physical environment, and greater satisfaction with participation in social roles were found to be the best predictors (R2 = 0.49; P < 0.001) of high health and functioning QOL. Finally, increased QOL score over the 2-yr period was best predicted by initial lower socioeconomic QOL and activity level perceived as unstable (R2 = 0.27; P = 0.001). Conclusions:QOL is partially explained by participation and environmental factors. These factors may be positively modified and thus may warrant special attention in health interventions. Identified predictors of QOL changes over time need to be considered in intervention studies.
Association of hospital participation in a quality reporting program with surgical outcomes and expenditures for Medicare beneficiaries.

IMPORTANCE The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) provides feedback to hospitals on risk-adjusted outcomes. It is not known if participation in the program improves outcomes and reduces costs relative to nonparticipating hospitals. OBJECTIVE To evaluate the association of enrollment and participation in the ACS NSQIP with outcomes and Medicare payments compared with control hospitals that did not participate in the program. DESIGN, SETTING, AND PARTICIPANTS Quasi-experimental study using national Medicare data (2003-2012) for a total of 1,226,479 patients undergoing general and vascular surgery at 263 hospitals participating in ACS NSQIP and 526 nonparticipating hospitals. A difference-in-differences analytic approach was used to evaluate whether participation in ACS NSQIP was associated with improved outcomes and reduced Medicare payments compared with nonparticipating hospitals that were otherwise similar. Control hospitals were selected using propensity score matching (2 control hospitals for each ACS NSQIP hospital). MAIN OUTCOMES AND MEASURES Thirty-day mortality, serious complications (eg, pneumonia, myocardial infarction, or acute renal failure and a length of stay >75th percentile), reoperation, and readmission within 30 days. Hospital costs were assessed using price-standardized Medicare payments during hospitalization and 30 days after discharge. RESULTS After accounting for patient factors and preexisting time trends toward improved outcomes, there were no statistically significant improvements in outcomes at 1, 2, or 3 years after (vs before) enrollment in ACS NSQIP. For example, in analyses comparing outcomes at 3 years after (vs before) enrollment, there were no statistically significant differences in risk-adjusted 30-day mortality (4.3% after enrollment vs 4.5% before enrollment; relative risk [RR], 0.96 [95% CI, 0.89 to 1.03]), serious complications (11.1% after enrollment vs 11.0% before enrollment; RR, 0.96 [95% CI, 0.91 to 1.00]), reoperations (0.49% after enrollment vs 0.45% before enrollment; RR, 0.97 [95% CI, 0.77 to 1.16]), or readmissions (13.3% after enrollment vs 12.8% before enrollment; RR, 0.99 [95% CI, 0.96 to 1.03]). There were also no differences at 3 years after (vs before) enrollment in mean total Medicare payments ($40 [95% CI, -$268 to $348]), or payments for the index admission (-$11 [95% CI, -$278 to $257]), hospital readmission ($245 [95% CI, -$231 to $721]), or outliers (-$86 [95% CI, -$1666 to $1495]). CONCLUSIONS AND RELEVANCE With time, hospitals had progressively better surgical outcomes but enrollment in a national quality reporting program was not associated with the improved outcomes or lower Medicare payments among surgical patients. Feedback on outcomes alone may not be sufficient to improve surgical outcomes.
IgA nephropathy.

From the Children’s Foundation Research Institute at Le Bonheur Children’s Hospital and the Department of Pediatrics, University of Tennessee Health Science Center, Memphis (R.J.W.); and the Department of Medicine, University of Alabama at Birmingham, Birmingham (B.A.J.). Address reprint requests to Dr. Wyatt at Rm. 520, Children’s Foundation Research Institute, 50 North Dunlap, Memphis, TN 38103, or at rwyatt@uthsc . edu.
Hepatic cannabinoid‐1 receptors mediate diet‐induced insulin resistance by increasing de novo synthesis of long‐chain ceramides

Obesity is associated with increased activity of two lipid signaling systems (endocannabinoids [ECs] and ceramides), with both being implicated in insulin resistance. Cannabinoid‐1 receptor (CB1R) antagonists reverse obesity and insulin resistance, but have psychiatric side effects. Here we analyzed the role of ceramide in CB1R‐mediated insulin resistance in C57Bl6/J mice with high‐fat diet‐induced obesity (DIO), using JD5037, a peripherally restricted CB1R inverse agonist. Chronic JD5037 treatment of DIO mice reduced body weight and steatosis and improved glucose tolerance and insulin sensitivity. Peripheral CB1R blockade also attenuated the diet‐induced increase in C14:0, C16:0, C18:0, and C20:0 ceramide species with either C16 or C18 sphingosine‐base in the liver. Decreased ceramide levels reflected their reduced de novo synthesis, due to inhibition of the activity of serine‐palmitoyl transferase (SPT) and the expression of its SPTLC3 catalytic subunit, as well as reduced ceramide synthase (CerS) activity related to reduced expression of CerS1 and CerS6. JD5037 treatment also increased ceramide degradation due to increased expression of ceramidases. In primary cultured mouse hepatocytes and HepG2 cells, the EC anandamide increased ceramide synthesis in an eIF2α‐dependent manner, and inhibited insulin‐induced akt phosphorylation by increased serine phosphorylation of IRS1 and increased expression of the serine/threonine phosphatase Phlpp1. These effects were abrogated by JD5037 or the SPT inhibitor myriocin. Chronic treatment of DIO mice with myriocin or JD5037 similarly reversed hepatic insulin resistance, as verified using a euglycemic/hyperinsulinemic clamp. Conclusion: ECs induce CB1R‐mediated, endoplasmic reticulum stress‐dependent synthesis of specific ceramide subspecies in the liver, which plays a key role in obesity‐related hepatic insulin resistance. (Hepatology 2014;58:143–153)
Role of circulating adipocytokines vaspin, apelin, and visfatin in the loss of appetite in underweight children: a pilot trial

Abstract Objectives: To investigate serum concentrations of vaspin, apelin, and visfatin in underweight children and their association with anthropometric and nutritional markers of malnutrition. Subjects and methods: We recruited 44 underweight prepubertal children (youngest age=2 years) with thinness grades of 1, 2, and 3, and body weights <90% of ideal body weight due to loss of appetite and less frequent hunger episodes. Forty-one healthy age- and gender-matched controls were also included in the study. Serum fasting vaspin, apelin, and visfatin concentrations were measured by enzyme immunoassay technique. Results: Mean vaspin and apelin levels were significantly lower in underweight children compared to controls (vaspin: 0.44±0.18 vs. 0.58±0.35 pg/mL, p=0.024; apelin: 483.37±333.26 vs. 711.71±616.50 pg/mL, p=0.041). Visfatin levels were lower in underweight children compared to controls, but the values were not statistically significant (177.81±158.01 vs. 221.15±212.94 pg/mL, p=0.119). Conclusions: In underweight children, decreased vaspin and apelin levels should be considered in the etiology of anorexia.
Expansion of spatial and host range of Puumala virus in Sweden: an increasing threat for humans?

SUMMARY Hantaviruses are globally distributed and cause severe human disease. Puumala hantavirus (PUUV) is the most common species in Northern Europe, and the only hantavirus confirmed to circulate in Sweden, restricted to the northern regions of the country. In this study, we aimed to further add to the natural ecology of PUUV in Sweden by investigating prevalence, and spatial and host species infection patterns. Specifically, we wanted to ascertain whether PUUV was present in the natural reservoir, the bank vole (Myodes glareolus) further south than Dalälven river, in south-central Sweden, and whether PUUV can be detected in other rodent species in addition to the natural reservoir. In total, 559 animals were collected at Grimsö (59°43′N; 15°28′E), Sala (59°55′N; 16°36′E) and Bogesund (59°24′N; 18°14′E) in south-central Sweden between May 2013 and November 2014. PUUV ELISA-reactive antibodies were found both in 2013 (22/295) and in 2014 (18/264), and nine samples were confirmed as PUUV-specific by focus reduction neutralization test. Most of the PUUV-specific samples were from the natural host, the bank vole, but also from other rodent hosts, indicating viral spill-over. Finally, we showed that PUUV is present in more highly populated central Sweden.
Diffusion-Weighted Imaging of the Rectosigmoid Colon: Preliminary Findings

Objectives: The aims of this study were to determine and evaluate the apparent diffusion coefficient (ADC) values of the rectal wall for identifying inflammatory bowel disease (IBD) and rectosigmoid (rectum and sigmoid colon) malignancies. Methods: Diffusion-weighted magnetic resonance imaging (DWI) findings of 23 patients (mean age, 57 years) consisting of 14 patients with rectosigmoid adenocarcinomas and 9 patients with IBD (6 with ulcerative colitis and 3 with Crohn disease) were retrospectively reviewed. In addition, 30 healthy controls (mean age, 45 years) were enrolled in the study. Diffusion-weighted imaging was performed with b factors of 0, 500, and 1000 s/mm2. Results: The mean (SD) ADC values of the control, IBD, and rectosigmoid adenocarcinoma groups were 1.47 (0.19) × 10−3 mm2/s, 1.37 (0.12) × 10−3 mm2/s, and 0.97 (0.14) × 10−3 mm2/s, respectively. Among the patients with IBD, 2 were in the active, and the rest were in the inactive period, with mean (SD) ADC values of 1.21 (0.08) × 10−3 and 1.42 (0.09) × 10−3, respectively. The ADC values of the normal rectum and rectosigmoid malignancy group and rectosigmoid carcinoma and IBD groups were significantly different (P < 0.01). A cutoff value for carcinomas of 1.14 × 10−3 mm2/s yielded a sensitivity and specificity of 93.3% and 93.3%, respectively. Conclusions: Our preliminary findings show that quantitative DWI may be able to differentiate the normal rectum from neoplastic involvement, in addition to distinguishing between inflammatory and neoplastic involvements. However, radiologists should be aware of possible overlaps that may lead to misdiagnoses when DWI is used alone.
Impact of age on the efficacy of newer adjuvant therapies in patients with stage II/III colon cancer: findings from the ACCENT database.

PURPOSE Prior studies have suggested that patients with stage II/III colon cancer receive similar benefit from intravenous (IV) fluoropyrimidine adjuvant therapy regardless of age. Combination regimens and oral fluorouracil (FU) therapy are now standard. We examined the impact of age on colon cancer recurrence and mortality after adjuvant therapy with these newer options. PATIENTS AND METHODS We analyzed 11,953 patients age < 70 and 2,575 age ≥ 70 years from seven adjuvant therapy trials comparing IV FU with oral fluoropyrimidines (capecitabine, uracil, or tegafur) or combinations of fluoropyrimidines with oxaliplatin or irinotecan in stage II/III colon cancer. End points were disease-free survival (DFS), overall survival (OS), and time to recurrence (TTR). RESULTS In three studies comparing oxaliplatin-based chemotherapy with IV FU, statistically significant interactions were not observed between treatment arm and age (P interaction = .09 for DFS, .05 for OS, and .36 for TTR), although the stratified point estimates suggested limited benefit from the addition of oxaliplatin in elderly patients (DFS hazard ratio [HR], 0.94; 95% CI, 0.78 to 1.13; OS HR, 1.04; 95% CI, 0.85 to 1.27). No significant interactions by age were detected with oral fluoropyrimidine therapy compared with IV FU; noninferiority was supported in both age populations. CONCLUSION Patients age ≥ 70 years seemed to experience reduced benefit from adding oxaliplatin to fluoropyrimidines in the adjuvant setting, although statistically, there was not a significant effect modification by age, whereas oral fluoropyrimidines retained their efficacy.
Chatter Simulation and Detection in CNC Milling

A key feature to maintaining a safe and efficient machining operation is the avoidance of unstable vibrations of the cutting tool, commonly called chatter. This thesis explores chatter simulation and a new chatter detection algorithm developed for use in a CNC milling machine. This algorithm, based on a once per revolution sampling method, samples forces experienced during the milling process, and calculates the variance of the differences between consecutive samples. As a selected level of variance, chatter is assumed. An existing milling simulation program is modified to produce a stability lobe diagram for a given CNC machine, workpiece material, and cutting tool. Stable, unstable, and marginally stable cuts are indicated as a function of spindle speed and axial depth of cut. The chatter detection algorithm is initially verified by simulation and then added to the simulation to autogenerate stability lobe diagrams. A collection of experimental aluminum cuts is run to collect force data that can be analyzed by the detection algorithm and compared to simulation results. Experimental cut stability is determined by observation of the noise, force, and cut surface. Comparing algorithm results to observed results shows the effectiveness of the algorithm in distinguishing between stable and unstable cuts. However, further testing is needed, particularly in determining the variance threshold of the algorithm. The simulation and algorithm are also used to explore the effect of system parameters; specifically, spring constant (k) and damping ratio (ζ). This exploration shows there being a strong connection between the maximum attainable stable axial depth and the parameters.
Secrecy Enhancement Analysis Against Unknown Eavesdropping in Spatial Modulation

In multiple-input-multiple-output (MIMO) wireless communications, spatial modulation (SM) has recently emerged as a new transmission method. This letter explores the physical-layer security in typical SM systems. We present a secrecy rate analysis for multiple antenna destination and eavesdroppers receivers. Targeting against passive eavesdroppers in unknown locations, we study the efficacy of active security measure through joint signal and jamming transmission without the typical requirement of eavesdropper channel information. We demonstrate the secrecy rate and transmission power tradeoff in active source jamming by providing numerical results on achieved secrecy rate and the bit error rate (BER) at different receivers.
Occupational Endotoxin Exposure Reduces the Risk of Atopic Sensitization but Increases the Risk of Bronchial Hyperresponsiveness

Background: Microbial exposures in both childhood and adult life are protective against atopy, allergic rhinitis and atopic asthma. In adults, this protective effect is paralleled by an increased prevalence of non-atopic asthma. This study was undertaken to investigate associations between occupational endotoxin exposure and atopic sensitization and bronchial hyperresponsiveness to methacholine (BHR) in agricultural workers. In addition, the role of atopy in endotoxin-related respiratory effects was studied. Methods: Data were available for 427 farmers and agricultural industry workers, for whom airborne endotoxin exposure levels were estimated by 249 personal exposure measurements. Atopy was assessed as specific serum IgE to common inhalant allergens, and respiratory symptoms and personal characteristics by standardized questionnaires. BHR was determined in a subset of 113 subjects. Associations were adjusted for age, sex, smoking and living on a farm during childhood. Results: Endotoxin exposure was positively associated with BHR and wheeze (p < 0.05). In contrast, endotoxin exposure was inversely associated with atopy and IgE to grass pollen (p < 0.001). The proportions of wheeze and BHR that were attributable to atopy were only 16.6 and 32.8%, respectively. Conclusions: High endotoxin exposure is a risk factor for BHR and wheeze, which were characterized by a predominantly non-atopic phenotype. At the same time, endotoxin exposure is related to a reduced risk of atopy and IgE to grass pollen in adults. It is unlikely that this is entirely a result of healthy worker selection, as significant inverse associations between endotoxin and IgE to grass pollen were found regardless of reported allergic symptoms.
The effects of exercise in hypoxic and normoxic conditions on endothelin-1 and arterial compliance

Abstract The purpose of this study was to determine the effects of short-term normoxic and hypoxic exercise on plasma endothelin-1 and nitric oxide levels, and the relationship of arterial compliance and pulmonary artery pressure to endothelin-1. Seven endurance-trained males completed two incremental and two steady-state exercise tests performed at ventilatory threshold in normoxia and hypoxia (fraction of inspired oxygen = 0.14). Plasma endothelin-1was measured throughout steady-state tests. Arterial compliance using applanation tonometry, plasma nitric oxide and pulmonary artery pressure using Doppler echocardiography were measured before and after exercise. Small arterial compliance and pulmonary artery pressure significantly increased following exercise. There were no main effects of condition or time for plasma endothelin-1and nitric oxide levels. There were no significant relationships between plasma endothelin-1 and arterial compliance or pulmonary artery pressure. In conclusion, mechanisms other than the endothelial system may play a role in the exercise-induced changes in small artery compliance in this study population. Moderate hypoxia and a 30-minute steady-state exercise have limited effects on plasma endothelin-1 in endurance-trained males.
Liver disease in cystic fibrosis

Cystic fibrosis-associated liver disease (CFLD) affects ca. 30% of patients. The CFLD is now considered the third cause of death, after lung disease and transplantation complications, in CF patients. Diagnostics, clinical assessment and treatment of CFLD have become a real challenge since a striking increase of life expectancy in CF patients has recently been observed. There is no elaborated “gold standard” in the diagnostic process of CFLD; clinical evaluation, laboratory tests, ultrasonography and liver biopsy are used. Clinical forms of CFLD are elevation of serum liver enzymes, hepatic steatosis, focal biliary cirrhosis, multilobular biliary cirrhosis, neonatal cholestasis, cholelithiasis, cholecystitis and micro-gallbladder. In children, CFLD symptoms mostly occur in puberty. Clinical symptoms appear late, when damage of the hepatobiliary system is already advanced. The CFLD is more common in patients with severe mutations of CFTR gene, in whom a complete loss of CFTR protein function is observed. CFLD, together with exocrine pancreatic insufficiency and meconium ileus, is considered a component of the severe CF phenotype. Treatment of CFLD should be complex and conducted by a multispecialist team (gastroenterologist, hepatologist, dietician, radiologist, surgeon). The main aim of the treatment is to prevent liver damage and complications associated with portal hypertension and liver cirrhosis. Ursodeoxycholic acid is used in the treatment of CFLD. There is no treatment of proven long-term efficacy in CFLD. Liver transplantation is a treatment of choice in end-stage liver disease.
How much should I eat? Situational norms affect young women's food intake during meal time

Portion size and the intake of others have been found to influence people's food intake. No study, however, has tested the potential influences of both types of situational norms on intake during the same eating occasion. We experimentally tested the effects of manipulating portion size and the intake of others on young women's meal intake during a 20 min eating opportunity. An experimental design with a three (confederate's intake: small, standard, large) by two (portion size: small, standard) between-participants design was used. A total of eighty-five young women participated. Portion size and the confederate's intake both influenced young women's intake. Participants consumed more when offered a larger portion than when offered a smaller portion, and they also ate more when their eating companion ate more. The present results indicate that the effects of portion size and the intake of others were independent but additive. Thus, both types of situational norms might independently guide an individual's intake during a single eating occasion.
PRIMARY CUTANEOUS B-CELL LYMPHOMA IN A CHILD

Primary cutaneous B-cell lymphoma is a B-cell lymphoma of the skin with no evidence of extracutaneous involvement at the time of diagnosis. In this report, we describe an 8-year-old boy who presented with a firm, alopecic, skin-colored, smooth nodule over the right frontal scalp. Histological examination revealed a mid-to deep-dermal mononuclear lesion. Immunohistochemical staining revealed a B-cell population that was CD10(+), CD5(−), CD21(+), and bcl2(−). This pattern of reactivity is characteristic of primary cutaneous B-cell lymphoma of follicle-center subtype. To the best of our knowledge, this is the first report of this type of cutaneous lymphoma in a child.
Patent ductus arteriosus

our shunts (the foramen ovale, dudus arteriosus, Superior Veno Cava Ductus Arteriosus ductus venosus, and the \ / umbilical vessels) permit much of the fetal blood to bypass the lungs and liver. -Pulrnona~ However, immediately after birth, when Artery circulation of fetal blood through the placenta ceases, the lungs begin to . ~ulrnoribry function, and the sphincter in the ductus Inferior Vena Cava Veins venosus constricts so that all the blood that reaches the liver must pass through the hepatic sinusoids (Figures 1and 2). Postnatal aeration of the lungs is associated with thinning of the walls of the pulmonary arteries, a dramatic drop in pulmonary vascular resistance, and a marked increase in pulmonary blood flow. These phenomena occur as the Inferior Vena Cova