Miracle-dz/UniFAR-FTUs huggingface dataset:
Vaccination coverage among children in Germany estimated by analysis of health insurance claims data

In Germany, the national routine childhood immunization schedule comprises 12 vaccinations. Primary immunizations should be completed by 24 mo of age. However, nationwide monitoring of vaccination coverage (VC) is performed only at school entry. We utilized health insurance claims data covering ~85% of the total population with the objectives to (1) assess VC of all recommended childhood vaccinations in birth-cohorts 2004–2009, (2) analyze cross-sectional (at 24 and 36 mo) and longitudinal trends, and (3) validate the method internally and externally. Counting vaccine doses in a retrospective cohort fashion, we assembled individual vaccination histories and summarized VC to nationwide figures. For most long-established vaccinations, VC at 24 mo was at moderate levels (~73–80%) and increased slightly across birth-cohorts. One dose measles VC was high (94%), but low (69%) for the second dose. VC with a full course of recently introduced varicella, pneumococcal, and meningococcal C vaccines increased across birth-cohorts from below 10% above 60%, 70%, and 80%, respectively. At 36 mo, VC had increased further by up to 15 percentage points depending on vaccination. Longitudinal analysis suggested a continued VC increase until school entry. Validation of VC figures with primary data showed an overall good agreement. In conclusion, analysis of health insurance claims data allows for the estimation of VC among children in Germany considering completeness and timeliness of vaccination series. This approach provides valid nationwide VC figures for all currently recommended pediatric vaccinations and fills the information gap between early infancy and late assessment at school entry.
Sex differences in risk factors for hiv seroconversion among injection drug users: a 10-year perspective.

BACKGROUND Injection drug use directly or indirectly accounts for nearly half the annual human immunodeficiency virus (HIV) infections in the United States. Prospective studies that investigate both sexual and parenteral HIV risks among injection drug users (IDUs) are needed. We studied factors for HIV seroconversion among male and female IDUs in Baltimore, Md. METHODS The HIV-negative IDUs (1447 male and 427 female) were recruited into a prospective study from 1988 to 1989 or in 1994. Participants underwent semiannual HIV tests and surveys through December 1998. Poisson regression was used to identify risk factors for HIV seroconversion, stratified by sex. Behaviors were treated as time-dependent covariates that varied at each semiannual period. RESULTS Subjects were primarily African American (91%), and median age at enrollment was 35 years. Incidence of HIV was 3.14 per 100 person years (95% confidence interval, 2.78-3.53) and did not significantly differ by sex. Younger age independently predicted HIV seroconversion for both men and women. Among men, factors that independently predicted HIV seroconversion were the following: less than a high school education, recent needle sharing with multiple partners, daily injection, and shooting-gallery attendance. The incidence of HIV was double for men recently engaging in homosexual activity and cocaine injection. Among women, the incidence of HIV was more than double for those recently reporting sexually transmitted diseases. CONCLUSIONS The incidence of HIV remained high among IDUs in Baltimore over the past decade. Risk factors for HIV seroconversion differed markedly by sex. Predominant risks among men included needle sharing and homosexual activity; among women, factors consistent with high-risk heterosexual activity were more significant than drug-related risks. Human immunodeficiency virus interventions aimed at IDUs should be sex-specific and incorporate sexual risks.
Noninvasive monitoring of respiratory mechanics during sleep

The sleep apnoea–hypopnoea syndrome is characterised by recurrent obstructions of the upper airway, resulting in sleep disruption and arterial oxygen desaturations. Noninvasive assessment of respiratory mechanics during sleep is helpful in facilitating the diagnosis and treatment of patients with sleep apnoea–hypopnoea syndrome. This series summarises the different tools that are currently available to noninvasively assess respiratory mechanics during sleep breathing disturbances. These techniques are classified according to the main variable monitored: ventilation, breathing effort or airway obstruction. Changes in patient ventilation are assessed by recording flow or volume signals by means of pneumotachographs, thermistors or thermocouples, nasal prongs or thoraco-abdominal bands. Common tools to noninvasively assess breathing efforts are the thoraco-abdominal bands and the pulse transit time technique. Upper airway obstruction is noninvasively characterised by its upstream resistance and its critical pressure or by means of the forced oscillation technique. Given the technical and practical limitations of each technique, combining different tools improves the reliability and robustness of patient assessment during sleep.
Qigong Yi Jinjing Promotes Pulmonary Function, Physical Activity, Quality of Life and Emotion Regulation Self-Efficacy in Patients with Chronic Obstructive Pulmonary Disease: A Pilot Study.

PURPOSE The purpose of this pilot study was to examine the effect of a Chinese traditional exercise program, Qigong Yi Jinjing (QYJJ), on patients with chronic obstructive pulmonary disease (COPD). METHODS One hundred and thirty eligible COPD patients were randomly divided into three groups: the QYJJ group (n = 42), the self-management exercise group (n = 43), and the control group (n = 45). Data were collected and analyzed at baseline and again at one, three, and six months. A pulmonary rehabilitation index, consisting of pulmonary function, six-minute walk test, Regulatory Emotion Self-Efficacy questionnaire, and exercise of the COPD Assessment Test widely used to evaluate health-related quality of life (HRQL) in participants with COPD, was measured. RESULTS Compared with the other groups, participants in QYJJ group had significantly better lung function (forced expiratory volume in one second: F = 8.96, p = 0.000; forced expiratory volume in one second/forced vital capacity: F = 11.55, p = 0.000; the percentage of forced expiratory volume in one second in prediction: F = 24.27, p = 0.000); walked a longer distance (F = 152.52, p = 0.000), and had more satisfactory HRQL (F = 14.08, p = 0.000). QYJJ training also contributed to improving the ability of emotion regulation (F = 36.56, p = 0.000). There were significant positive changes in expressing positive affect (F = 56.25, p = 0.000) and managing despondency/distress (F = 21.58, p = 0.000), apart from the ability to regulate anger/irritation (F = 1.20, p = 0.305). The longer QYJJ is practiced, the more effective the influence is on the pulmonary rehabilitation-related index measures. CONCLUSIONS These results indicate that QYJJ exercise produced positive effects on pulmonary function, physical activity, emotion regulation self-efficiency (modulating the expression of despondency or distress and experiencing and expressing positive affect), and HRQL in patients with COPD.
Exercise-Enhanced, Ultrasound-Guided Anterior Scalene Muscle/Pectoralis Minor Muscle Blocks Can Facilitate the Diagnosis of Neurogenic Thoracic Outlet Syndrome in the High-Performance Overhead Athlete

An imaging-guided injection of a local anesthetic into the anterior scalene muscle (ASM) and/or pectoralis minor muscle (PMM) is a well-established adjunct to clinical diagnosis in patients with neurogenic thoracic outlet syndrome (NTOS) in which a temporary blockade of ASM/PMM spasm can alleviate brachial plexus nerve compression within the scalene triangle and/or subcoracoid space. Interpreting the results of an ASM/PMM block is based on an improvement in the resting symptoms of pain, numbness, and paresthesia that typically characterize NTOS, as well as some degree of improved upper extremity function, for a period of several hours. In high-performance overhead athletes, upper extremity symptoms attributable to NTOS may only be evident during vigorous exercise, often characterized as a ‘‘dead arm’’ sensation, for which other diagnoses must be carefully considered (eg, shoulder microinstability, type II superior labral anterior and posterior [SLAP] lesions, and rotator cuff weakness). Even when clinical suspicion of NTOS is high, the absence of symptoms at rest in such cases can make the clinical diagnosis and interpretation of ASM/ PMM blocks quite difficult. We describe here a modification of ultrasound-guided ASM/PMM blocks to augment the clinical diagnosis of NTOS in 2 high-performance overhead athletes, who each undertook vigorous sports-specific upper extremity exercise immediately after completion of the anesthetic injection. In each patient, the successful outcome of an exercise-enhanced ASM/PMM block was mirrored by a resolution in symptoms and a return to athletic performance after the treatment for NTOS. These cases illustrate the applicability of this modification to standard ASM/PMM blocks for assessments and treatment planning in athletes with ‘‘dead arm’’ symptoms suspected to be caused by NTOS. Each of the patients described in this report provided written consent to be published.
Module placement with boundary constraints using the sequence-pair representation

In VLSI module placement, it is very practical to consider placing some modules along the pre-specified boundaries of the chip so that the modules are easier to be connected to certain I/O pads. In this paper, we study the module placement problem where some modules have boundary constraints, and present a simulated annealing based algorithm that represents each placement topology by a sequence-pair. The major contribution of our algorithm is that a feasible placement is always obtainable. Our algorithm has been implemented, and its effectiveness is supported by the encouraging experimental results.
HISTOLOGICAL STUDY ON THE STOMACH OF IMMOBILIZED - STRESSED ALBINO RAT AND THE CURATIVE ROLE OF DIAZEPAM -

The present work is planned to study the histopathological changes that may occur in the stomach of the immobilized-stressed rats and the possible curative role of diazepam injected intraperitoneally with therapeutic dose (0.1 mg / kg BW) daily for 30 days. Eighty adult male albino rats weighing 110 Â± 5 g were used and divided equally into eight groups, group(І) served as control rats; group(ІІ) rats treated with diazepam; group (ІІІ) , (ІV), and (V)served as stressed rats (10 animals each): in which the rats were immobilized individually for 2 hrs / day for different durations ( 5 , 15, and 30 days, respectively); groups (VI), (VII), and (VIII) served as immobilized- stressed rats (10 animals each) for 2 hrs / day for 5, 15 and 30 days and treated with diazepam for 30 days, respectively. The results recorded a significant increase in sera cortisol of the stressed - rats for 5, 15, and 30 days. Histological results of stomach demonstrated hypertrophy of parietal cells, detachment of gastric cells from the basement membrane, degeneration of the gastric glandular cells and irregular topography of the gastric gland. Appearance of karyolytic and pyknotic nuclei was also seen. Infiltration of inflammatory cells in lamina propria of mucosa was elucidated as well as congestion and dilatation of blood vessels. Moreover, the increment of collagen fibres in the lamina propria of mucosa and submucosa of the stressed rats was obviously demonstrated. These alterations were time-depended. Treatment with diazepam resulted in marked improvement and restoration of the histological changes. The results indicated that diazepam is recommended to be used as a curative drug to improve the disturbances in the stomach caused under the effect of stress.
Confidence intervals of reference limits in small reference sample groups.

BACKGROUND Reference intervals are the most common tool used to interpret results of laboratory tests. However, in veterinary clinical pathology, the number of available reference individuals is often small. OBJECTIVES The purpose of this study was to investigate the effects of small reference sample groups on the imprecision of the reference limits. METHODS Gaussian and log-Gaussian distributions of 10 ≤ n ≤ 750 values were analyzed. Reference limits and 90% confidence interval of limits (90% CI) were calculated. Imprecision of limits was estimated by the ratio of the width of the 90% CI: width of the reference interval (WCI/WRI). RESULTS For Gaussian distributions, the WCI/WRI ratio cannot be expected to be lower than 0.2 when n < 55. In log-Gaussian distributions, the ratio greatly increases for the upper limit with skewness toward high values, whereas it moderately decreases for the lower limit. CONCLUSION Independent of the size of the reference sample group, it is very important to report the CIs of the reference limits, which can be very large for small reference sample groups. When the sample size is very small (n < 20), calculations maybe misleading and it is better to instead report all values.
Joint Rate and SINR Coverage Analysis for Decoupled Uplink-Downlink Biased Cell Associations in HetNets

Load balancing by proactively offloading users onto small and otherwise lightly-loaded cells is critical for tapping the potential of dense heterogeneous cellular networks (HCNs). Offloading has mostly been studied for the downlink, where it is generally assumed that a user offloaded to a small cell will communicate with it on the uplink as well. The impact of coupled downlink-uplink offloading is not well understood. Uplink power control and spatial interference correlation further complicate the mathematical analysis as compared to the downlink. We propose an accurate and tractable model to characterize the uplink SINR and rate distribution in a multi-tier HCN as a function of the association rules and power control parameters. Joint uplink downlink rate coverage is also characterized. Using the developed analysis, it is shown that the optimal degree of channel inversion (for uplink power control) increases with load imbalance in the network. In sharp contrast to the downlink, minimum path loss association is shown to be optimal for uplink rate. Moreover, with minimum path loss association and full channel inversion, uplink SIR is shown to be invariant of infrastructure density. It is further shown that a decoupled association-employing differing association strategies for uplink and downlink-leads to significant improvement in joint uplink-downlink rate coverage over the standard coupled association in HCNs.
Micromechanical Finite Element Simulations of Crack Propagation in Silicon Nitride

Silicon nitride is used for challening applications like cutting inserts or forming rolls, which require high strength and fracture toughness. The elongated grains support the crack path deviation and, therefore, the fracture toughness. This complex material behavior has been modeled with 3D unit cells for finite element simulations, which include the thermoelastic properties and the fracture behavior. The key result is that the reinforcement by elastic bridging grains has been observed in detail, which supports recent research. Furthermore, effective load paths have been used for the examination of different aspects of the model. Finally, an effective fracture model has been implemented, which allows for a comparison of the findings on the microscale with experimental results. So, based on the micromechanical results, R-curve experiments have been reproduced. This thesis improves the understanding for the fracture behavior of silicon nitride and clears the way for new applications.
Reconciling self-protection with self-improvement: Self-affirmation theory.

A persistent puzzle emerges from a review of the psychological research literature on how people defend the self from potentially threatening information and events: People can be adamantly protective of their sense of self-worth and defensively resistant to threatening information, on the one hand, and yet capable of accepting threatening, critical information and changing their behavior, on the other. The general tendency for self-enhancement that is the focus of so many of the chapters in this book (see also Sedikides & Gregg, 2008; Taylor & Brown, 1988) is a testament to people's ability to maintain a view of the self as capable, adaptive, and culturally appropriate despite the many threats that they may encounter. However, only a very maladaptive organism would be so engaged in self-protection that it was incapable of change. And so the question is raised as to how individuals can put aside their ego-protective needs when faced with criticism and threats and come to recognize that potentially painful and self-threatening pursuits could also help one improve. For example, at times people will resist information from their doctors that they need to change their health behavior, from their teachers that they need to improve their study skills, and from their family members that they need to adjust their interpersonal style. Yet, despite the self-threat that comes with acknowledging imperfections, flaws, and mistakes, individuals can come to change such important behaviors. In this chapter, we propose that one way that people can resolve the tension between self-protection and self-improvement is by affirming the self in an important domain of self-worth in response to threat, thereby reaffirming an overall image of self-integrity. Since the inception of self-affirmation theory
Prognostic and predictive values of CDK1 and MAD2L1 in lung adenocarcinoma

Lung cancer remains as the leading cause of cancer-related death worldwide, and lung adenocarcinoma (LUAD) is the most common histological subtype. This study aims to investigate biomarkers associated with cancer progression and prognosis of LUAD. We integrated expression profiles of 668 lung cancer patients in five datasets from the Gene Expression Omnibus (GEO) and identified a panel of differentially expressed genes (DEGs). Function enrichment analysis highlighted that these genes were closely associated with the carcinogenesis of LUAD, such as cell cycle, ECM-receptor interaction and p53 signaling pathway. Cyclin-dependent kinase 1 (CDK1) and MAD2 mitotic arrest deficient-like 1 (MAD2L1), two critical mitotic checkpoint genes, were selected for further study. Elevated expression of CDK1 and MAD2L1 was validated in an independent LUAD cohort. Kaplan-Meier analysis revealed that CDK1 and MAD2L1 expression was negatively correlated with both overall survival (OS) and relapse-free survival (RFS). In conclusion, CDK1 and MAD2L1 were adverse prognostic biomarkers for LUAD whose increased expression could render patients with LUAD a high risk of cancer recurrence and poor survival, suggesting that they might be applied as potential targets for LUAD treatment.
Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison.

BACKGROUND Chronic sleep-onset insomnia is a prevalent health complaint in adults. Although behavioral and pharmacological therapies have been shown to be effective for insomnia, no placebo-controlled trials have evaluated their separate and combined effects for sleep-onset insomnia. The objective of this study was to evaluate the clinical efficacy of behavioral and pharmacological therapy, singly and in combination, for chronic sleep-onset insomnia. METHODS This was a randomized, placebo-controlled clinical trial that involved 63 young and middle-aged adults with chronic sleep-onset insomnia. Interventions included cognitive behavior therapy (CBT), pharmacotherapy, or combination therapy compared with placebo. The main outcome measures were sleep-onset latency as measured by sleep diaries; secondary measures included sleep diary measures of sleep efficiency and total sleep time, objective measures of sleep variables (Nightcap sleep monitor recorder), and measures of daytime functioning. RESULTS In most measures, CBT was the most sleep effective intervention; it produced the greatest changes in sleep-onset latency and sleep efficiency, yielded the largest number of normal sleepers after treatment, and maintained therapeutic gains at long-term follow-up. The combined treatment provided no advantage over CBT alone, whereas pharmacotherapy produced only moderate improvements during drug administration and returned measures toward baseline after drug use discontinuation. CONCLUSIONS These findings suggest that young and middle-age patients with sleep-onset insomnia can derive significantly greater benefit from CBT than pharmacotherapy and that CBT should be considered a first-line intervention for chronic insomnia. Increased recognition of the efficacy of CBT and more widespread recommendations for its use could improve the quality of life of a large numbers of patients with insomnia.
Auranofin induces apoptosis by ROS-mediated ER stress and mitochondrial dysfunction and displayed synergistic lethality with piperlongumine in gastric cancer

Gastric cancer (GC) is one of the leading causes of cancer mortality in the world. In addressing the need of treatments for relapsed disease, we report the identification of an existing U.S. Food and Drug Administration-approved small-molecule drug to repurpose for GC treatment. Auranofin (AF), clinically used to treat rheumatic arthritis, but it exhibited preclinical efficacy in GC cells. By increasing intracellular reactive oxygen species (ROS) levels, AF induces a lethal endoplasmic reticulum stress response and mitochondrial dysfunction in cultured GC cells. Blockage of ROS production reversed AF-induced ER stress and mitochondrial pathways activation as well as apoptosis. In addition, AF displays synergistic lethality with an ROS-generating agent piperlongumine, which is a natural product isolated from the long pepper Piper longum L. Taken together, this work provides a novel anticancer candidate for the treatment of gastric cancer. More importantly, it reveals that increased ROS generation might be an effective strategy in treating human gastric cancer.