Miracle-dz/UniFAR-FTUs huggingface dataset:
Endovascular treatment for acute ischemic stroke.

BACKGROUND In patients with ischemic stroke, endovascular treatment results in a higher rate of recanalization of the affected cerebral artery than systemic intravenous thrombolytic therapy. However, comparison of the clinical efficacy of the two approaches is needed. METHODS We randomly assigned 362 patients with acute ischemic stroke, within 4.5 hours after onset, to endovascular therapy (intraarterial thrombolysis with recombinant tissue plasminogen activator [t-PA], mechanical clot disruption or retrieval, or a combination of these approaches) or intravenous t-PA. Treatments were to be given as soon as possible after randomization. The primary outcome was survival free of disability (defined as a modified Rankin score of 0 or 1 on a scale of 0 to 6, with 0 indicating no symptoms, 1 no clinically significant disability despite symptoms, and 6 death) at 3 months. RESULTS A total of 181 patients were assigned to receive endovascular therapy, and 181 intravenous t-PA. The median time from stroke onset to the start of treatment was 3.75 hours for endovascular therapy and 2.75 hours for intravenous t-PA (P<0.001). At 3 months, 55 patients in the endovascular-therapy group (30.4%) and 63 in the intravenous t-PA group (34.8%) were alive without disability (odds ratio adjusted for age, sex, stroke severity, and atrial fibrillation status at baseline, 0.71; 95% confidence interval, 0.44 to 1.14; P=0.16). Fatal or nonfatal symptomatic intracranial hemorrhage within 7 days occurred in 6% of the patients in each group, and there were no significant differences between groups in the rates of other serious adverse events or the case fatality rate. CONCLUSIONS The results of this trial in patients with acute ischemic stroke indicate that endovascular therapy is not superior to standard treatment with intravenous t-PA. (Funded by the Italian Medicines Agency, ClinicalTrials.gov number, NCT00640367.).
Emergency treatment of malignant extradural spinal cord compression: an evidence-based guideline.

PURPOSE To review the literature for malignant extradural spinal cord compression (MSCC), produce evidence-based recommendations based on the criteria used by the Canadian Task Force on the Periodic Health Examination, and make suggestions regarding future research directives. METHODS A systematic review of the literature with explicit study selection and evaluation criteria was performed. Primary outcome measure was posttreatment ambulation rate. RESULTS There is good evidence to support the use of high-dose dexamethasone (96 mg/d), but inconclusive evidence for the use of moderate-dose steroids (16 mg/d) in conjunction with radiotherapy (RT) for the treatment of MSCC. Fair evidence exists for not using steroids in patients who are nonparetic and ambulatory pretreatment, and to give radiation to patients with subclinical spinal cord compression (SCC). The remainder of the recommendations are based on inconclusive evidence: RT alone should be the first-line treatment for ambulatory patients except when there is spinal instability, bony compression, or paraplegia on presentation, in which case surgery should be performed. Either modality can be used for paraparetic patients who are nonambulatory. Postoperative RT should be considered for tumor in residua. Ambulatory, undiagnosed patients should have needle biopsy attempted first. Patients should be aggressively screened and educated about SCC. CONCLUSION In general, there were very few papers of high methodologic quality found in the literature. More studies are needed to satisfy the validity of many of the clinical decisions that are made today with regard to the management of MSCC.
Early microbial colonization of cystic fibrosis patients identified by neonatal screening, with emphasis on Staphylococcus aureus.

OBJECTIVES To assess bacterial colonization prospectively in patients with cystic fibrosis identified by neonatal screening. To assess susceptibility to antimicrobials and to perform the molecular typing of Staphylococcus aureus strains isolated from the oropharynx of patients during the study. METHODS Twenty-five cystic fibrosis patients receiving regular treatment at the Cystic Fibrosis Outpatient Clinic of Hospital de Clínicas of Universidade Federal do Paraná, Brazil, were included in the study. All patients were identified by trypsin-like immunoreactivity and their diagnosis was confirmed by two or more sweat tests. Oropharyngeal swabs were collected and cultured according to routine methods; bacterial colonies were phenotypically identified and their susceptibility to antimicrobials was tested. S. aureus isolates were submitted to molecular typing using pulsed-field gel electrophoresis. RESULTS Out of 234 oropharyngeal swabs, S. aureus was the most frequently isolated strain (76% of patients, 42% of swabs), followed by Pseudomonas aeruginosa (36% of patients, 16% of swabs) and Haemophilus spp. (76% of patients; 19% of swabs). Seventy-three isolates were obtained from 19 patients colonized with S. aureus, of which 18 were oxacillin-resistant (24.6%), isolated from two patients, with the same electrophoretic profiles as that of the Brazilian clone. The remaining oxacillin-sensitive isolates were distributed into 18 electrophoretic profiles. CONCLUSION There was higher prevalence of S. aureus, with earlier isolation than other pathogens. Multi-sensitive isolates were distributed into different clones, characterizing non-transmissibility among community-acquired strains. The isolated oxacillin-resistant S. aureus showed identical electrophoretic profiles, probably acquired in hospital. P. aeruginosa was not so frequent in the studied population.
Bone Marrow Transplantation Helps Restore the Intestinal Mucosal Barrier after Total Body Irradiation in Mice

Bone marrow transplantation (BMT) substantially improves 10-day survival after total body irradiation (TBI), consistent with an effect on intestinal radiation death. Total body irradiation, in addition to injuring the intestinal epithelium, also perturbs the mucosal immune system, the largest immune system in the body. This study focused on how transplanted bone marrow cells (BMCs) help restore mucosal immune cell populations after sublethal TBI (8.0 Gy). We further evaluated whether transplanted BMCs: (a) home to sites of radiation injury using green fluorescent protein labeled bone marrow; and (b) contribute to restoring the mucosal barrier in vivo. As expected, BMT accelerated recovery of peripheral blood (PB) cells. In the intestine, BMT was associated with significant early recovery of mucosal granulocytes (P = 0.005). Bone marrow transplantation did not affect mucosal macrophages or lymphocyte populations at early time points, but enhanced the recovery of these cells from day 14 onward (P = 0.03). Bone marrow transplantation also attenuated radiation-induced increase of intestinal CXCL1 and restored IL-10 levels (P = 0.001). Most importantly, BMT inhibited the post-radiation increase in intestinal permeability after 10 Gy TBI (P = 0.02) and modulated the expression of tight junction proteins (P = 0.01–0.05). Green fluorescent protein-positive leukocytes were observed both in intestinal tissue and in PB. These findings strongly suggest that BMT, in addition to enhancing general hematopoietic and immune system recovery, helps restore the intestinal immune system and enhances intestinal mucosal barrier function. These findings may be important in the development and understanding of strategies to alleviate or treat intestinal radiation toxicity.
Rate-dependent prolongation of cardiac action potentials by a methanesulfonanilide class III antiarrhythmic agent. Specific block of rapidly activating delayed rectifier K+ current by dofetilide.

Class III antiarrhythmic agents act by selective prolongation of cardiac action potential duration (APD). Methanesulfonanilide class III agents (e.g., E-4031 and dofetilide) are extremely potent and lengthen action potentials in a "reverse" rate-dependent manner; i.e., effects are greater at low compared with high rates of stimulation. By using the whole-cell current-clamp technique in isolated guinea pig ventricular myocytes, APD was shortened by rapid pacing (244 +/- 16 msec at 30 pulses per minute, 166 +/- 8 msec at 240 pulses per minute; n = 8). Dofetilide (1 microM) prolonged APD more when cells were stimulated at the rate of 30 pulses per minute (44 +/- 10-msec increase) than at 240 pulses per minute (21 +/- 5-msec increase). We investigated the mechanism of APD prolongation using voltage-clamp techniques. Dofetilide selectively inhibited IKr (IC50, 31.5 nM), defined as the rapidly activating inward rectifying component of net delayed rectifier K+ current (IK), without effects on the larger but more slowly activating component of IK (IKs) or on the inward rectifier K+ current (IK1). To examine the rate-dependent effects of dofetilide on APD, trains of conditioning pulses to 0 mV (200-msec duration) were applied at either 30 or 240 pulses per minute to mimic the action potential experiments. Test pulses or ramps were given after the conditioning train to quantitate changes in IK1, IKr, or IKs. The magnitude of neither IK1 nor IKr was dependent on the rate of the preceding train of depolarizations. Sensitivity to block of IKr by dofetilide was rate independent. (ABSTRACT TRUNCATED AT 250 WORDS)
A new risk-sensitive maximum principle

In this paper, a new maximum principle for the risk-sensitive control problem is established. One important feature of this result is that it applies to systems in which the diffusion term may depend on the control. Such control dependence gives rise to interesting phenomena not observed in the usual setting where control independence of the diffusion term is assumed. In particular, there is an additional second order adjoint equation and additional terms in the maximum condition that involve this second order process as well as the risk-sensitive parameter. Moreover, contrary to a conventional maximum principle, the first-order adjoint equation involved in our maximum principle is a nonlinear equation. An advantage of considering this new type of adjoint equation is that the risk-sensitive maximum principle derived is similar in form to its risk-neutral counterpart. The approach is based on the logarithmic transformation and the relationship between the adjoint variables and the value function. As an example, a linear-quadratic risk-sensitive problem is solved using the maximum principle derived.
Structure, morphology and crystal growth of anisotropic magnetite crystals in magnetotactic bacteria

Bacterial magnetite particles of anisotropic morphology have been studied by high-resolution transmission electron microscopy. Lattice images of individual crystals are consistent with a well-ordered magnetite cubic inverse spinel structure. The idealized morphology of the biogenic crystals is based on an elongated cubo-octahedral form comprising a hexagonal prism of {111} and {100} faces capped by (1̄1̄1) and (111̄) faces with associated {111} and {100} truncations. Analysis of many particles of diverse size suggests that crystal growth takes place in two stages. The first stage is associated with the formation of well-ordered, isotropic, single-domain crystals of cubo-octahedral morphology. In this stage the crystal length and width develop concurrently up to a size of 20 nm. The second stage involves the anisotropic growth of the isotropic particles along the [112̄] direction. A crystal growth mechanism is postulated which involves the specific nucleation of the (1̄1̄1) face on a surrounding organic membrane. Unidirectional growth then occurs by selective suppression of certain crystallographic axes through spatial and chemical constraints induced by the adjacent organic boundary.
Reinforcement Learning in Energy Trading Game Among Smart Microgrids

Reinforcement learning (RL) is essential for the computation of game equilibria and the estimation of payoffs under incomplete information. However, it has been a challenge to apply RL-based algorithms in the energy trading game among smart microgrids where no information concerning the distribution of payoffs is a priori available and the strategy chosen by each microgrid is private to opponents, even trading partners. This paper proposes a new energy trading framework based on the repeated game that enables each microgrid to individually and randomly choose a strategy with probability to trade the energy in an independent market so as to maximize his/her average revenue. By establishing the relationship between the average utility maximization and the best strategy, two learning-automaton-based algorithms are developed for seeking the Nash equilibria to accommodate the variety of situations. The novelty of the proposed algorithms is related to the incorporation of a normalization procedure into the classical linear reward-inaction scheme to provide a possibility to operate any bounded utility of a stochastic character. Finally, a numerical example is given to demonstrate the effectiveness of the algorithms.
POTT'S Disease: a review of 58 cases

Backgrounds: Pott's disease is a rare form of extrapulmonary tuberculosis, and presents with several clinical patterns. Delay in diagnosis and management may cause serious complications. We conducted a retrospective study between 19912006 to evaluate clinical presentation, radiologic and laboratory findings, and therapeutic approaches to spinal tuberculosis. Methods: We reviewed clinical presentation, radiological and laboratory findings of 58 patients with spinal tuberculosis retrospectively. The diagnosis of tuberculous spondylitis was based on characteristic histology or microbiologic evidence of the disease. The results of study were recorded, and statistically analyzed by SPSS 11.5. Results: The most frequent symptom was back pain (84%), with thoracic region being the most affected site (46%). Paravertebral abscess noted in 67% of cases and the average time for diagnosis was 16 months. Conclusions: The 42 cases of this study underwent surgery and all were treated with drug therapy for 12 months . There was no worsening of the neurologic status in any patient. All patients with tuberculous spondylitis began to improve 3 months after chemotherapy and healed within 12 months in nonsurgical and surgical groups.
Shear heating-induced strain localization across the scales

We investigate the dynamics of thermally activated shear localization in power law viscoelastic materials. A two-dimensional (2D) thermomechanical numerical model is applied that uses experimentally derived flow laws for rock. We consider viscous and viscoelastic rheologies and show that the numerical solutions for shear bands are mesh insensitive and energetically conservative. Deformation under long-term tectonic strain rates () yields to shear localization on the scale of kilometres. Although viscous and viscoelastic models exhibit comparable shear zone thickness, the timing of shear localization and stress magnitudes are affected by viscoelasticity. Large values of shear modulus ( Pa) promotes fast stress loading (within strain) and localization ( strain), whereas lower values ( Pa) delays localization ( strain) and reduces the maximum effective stress by a factor two. High stress exponents (up to ) focuses the deformation into narrow shear zones ( m) while maintaining a relatively high average stress level in the material outside the shear zone (stress drop of ). Conversely, Newtonian materials produce broad shear zones ( larger than for ) and exhibit a stronger thermal weakening (stress drops of ). Finally, we evaluate the thickness of shear zones for a wide range of strain rates (from to ) using both numerical models and an analytical scaling law. Our results suggest that thermally activated shear localization may occur from the scale of kilometre down to the nanometre.
Ab initio modelling of the stability of nanocrystalline diamond morphologies

Ab initio (density functional theory) relaxation of nanocrystalline diamond structures of cubic, octahedral and cuboctahedral morphologies, up to about 1.3 nm in diameter are presented. Results show that the crystal morphology plays an important role in the structural stability, in the absence of external fields. Our results illustrate the transition of nanocrystalline diamonds (nanodiamonds) into onion-like structures showing preferential exfoliation of the (111) surfaces, in agreement with experimental observations. The cohesive energy for the relaxed nanodiamond is also examined and compared with bulk diamond. We have found that the cohesive energy of nanodiamond differs from that of bulk diamond by approximately 0.34 eV.
MIMO Gaussian Bidirectional Broadcast Channels with Common Messages

In this work, the MIMO Gaussian bidirectional broadcast channel (BBC) with common messages is studied. The problem is motivated by the concept of bidirectional relaying in a three-node network, where a half-duplex relay node establishes a bidirectional communication between two other nodes using a decode-and-forward protocol and thereby adds an own multicast message to the communication. The capacity region of the broadcast phase is derived and the corresponding transmit covariance matrix optimization problem is analyzed in detail. Thereby, it is shown that the transmit covariance optimization problem is strongly connected to the corresponding one of the MIMO Gaussian BBC without common messages. In particular, this knowledge can be exploited to transfer results such as optimal transmit strategies from one scenario to the other one.
Anthropometric, penile and testis measures in post-pubertal Italian males

Background: Relationships between anthropometric measures, Furthermore, although male fertility has declined in last decades, no data on testicular volume (the best surrogate measure for spermatogenic potential) are available for the general population of young men in Italy. Aim: To analyze anthropometric measures and proportions, testicular volumes, and penile dimensions in a large cohort from the general population of young Italian men aged 18–19 yr. Materials/subjects: We analyzed 2019 students aged 18–19 years for height, weight, body mass index (BMI), waist circumference, arm span, pubis-to-floor and crown-to-pubis length, and penile dimensions. Testicular volumes were measured by ultrasound in 776 subjects. Results: Thirty-six percent of the subjects had a pathological arm span-height difference (>3 cm) and 44.7% had a pathological pubis-to-floor/crown-to-pubis ratio (≤0.92). The mean penis length was 8.9±1.4 cm and the penis circumference was 9.5±1.0 cm. BMI was positively associated with arm span-height difference and negatively with penis length; 23.2% of the subjects had low mean testicular volume (<12 ml). Conclusions: The findings highlight a strong influence of BMI on skeletal proportions and penis length, identify a large proportion of subjects with testicular hypotrophy at risk for future fertility, and suggest to consider worldwide studies to redefine normal values for arm span-height difference and upper/lower body segment ratio.
Serum Hepcidin Levels, Iron Dyshomeostasis and Cognitive Loss in Alzheimer’s Disease

This pilot study examined the status of the master iron regulatory peptide, hepcidin, and peripheral related iron parameters in Alzheimer’s disease (AD) and mild cognitive impairment patients, and evaluated the relationship between iron dyshomeostasis and amyloid-beta (Aβ), cognitive assessment tests, neuroimaging and clinical data. Frozen serum samples from the Oregon Tissue Bank were used to measure serum levels of hepcidin, ferritin, Aβ40, Aβ42 using enzyme-linked immunosorbent assay. Serum transferrin levels were determined indirectly as total iron binding capacity, serum iron was measured and the percent saturation of transferrin calculated. The study variables were correlated with the patients’ existing cognitive assessment tests, neuroimaging, and clinical data. Hepcidin, and iron-related proteins tended to be higher in AD patients than controls, reaching statistical significance for ferritin, whereas Aβ40, Aβ42 serum levels tended to be lower. Patients with pure AD had three times higher serum hepcidin levels than controls; gender differences in hepcidin and iron-related proteins were observed. Patient stratification based on clinical dementia rating-sum of boxes revealed significantly higher levels of iron and iron-related proteins in AD patients in the upper 50% as compared to controls, suggesting that iron dyshomeostasis worsens as cognitive impairment increases. Unlike Aβ peptides, iron and iron-related proteins showed significant association with cognitive assessment tests, neuroimaging, and clinical data. Hepcidin and iron-related proteins comprise a group of serum biomarkers that relate to AD diagnosis and AD disease progression. Future studies should determine whether strategies targeted to diminishing hepcidin synthesis/secretion and improving iron homeostasis could have a beneficial impact on AD progression.
Reconciling Agency and Structure in Empirical Analysis: Smallholder Land Use in the Southern Yucatán, Mexico

The agent-structure binary in human-environment relations has historically ascribed primacy to either decision-making agents or political-economic structures as the anthropogenic force driving landscape change. This binary has, in part, separated cultural and political ecology, despite important research weaving structure and agency in each of these and related subfields. The implications of approaching explanations of land use using this binary are illustrated systematically, drawing from empirical research on smallholder land use in the southern Yucatán of Mexico, a development frontier and environmental conservation region. The land-use strategies of mixed subsistence-market smallholder cultivators are explored through agent, structure, and integrated agent-structure models addressing parcel allocations to a suite of regionally evolving and/or extant land uses. The models are compared to illustrate what understanding is missed by a focus on either approach alone and what is gained by joining them. Results suggest that focusing on structure or agency alone may lead to inadequate and even erroneous characterizations of the variables that are of interest to the chosen approach. A sectorally disaggregated approach can identify suites of factors that drive particular land uses.