Miracle-dz/UniFAR-FTUs huggingface dataset:
CONTEMPO UPDATES LINKING EVIDENCE AND EXPERIENCE Surgical Treatment of Parkinson Disease

SEVERAL EFFECTIVE NEUROSURGIcal treatments for Parkinson disease (PD) have been developed based on an improved understanding of basal ganglia circuitry and the continuing evolution of neurosurgical techniques. Currently, there are 3 surgical targets for the treatment of movement disorders, the globus pallidus interna (Gpi), the subthalamic nucleus (STN), and the Ventralis intermedius nucleus of the thalamus. The Gpi and the STN are the preferred targets for the treatment of PD while Ventralis intermedius is now primarily targeted in the treatment of tremor. Options for treatment include the placement of a deep brain stimulating (DBS) electrode in any of these areas or the creation of a small lesion in the Gpi (pallidotomy) or in the thalamus (thalamotomy).
Hereditary angioedema: epidemiology, management, and role of icatibant

Hereditary angioedema (HAE) is an autosomal dominant, potentially life-threatening condition, manifesting as recurrent and self-limiting episodes of facial, laryngeal, genital, or peripheral swelling with abdominal pain secondary to intra-abdominal edema. The estimated prevalence of HAE in the general population is one individual per 50,000, with reported ranges from 1:10,000 to 1:150,000, without major sex or ethnic differences. Various treatment options for acute attacks and prophylaxis of HAE are authorized and available in the market, including plasma-derived (Berinert®, Cinryze®, and Cetor®) and recombinant (Rhucin® and Ruconest™) C1 inhibitors, kallikrein inhibitor-ecallantide (Kalbitor®), and bradykinin B2 receptor antagonist-icatibant (Firazyr®). Some of these drugs are used only to treat HAE attacks, whereas others are only approved for prophylactic therapies and all of them have improved disease outcomes due to their different mechanisms of action. Bradykinin and its binding to B2 receptor have been demonstrated to be responsible for most of the symptoms of HAE. Thus icatibant (Firazyr®), a bradykinin B2 receptor antagonist, has proven to be an effective and more targeted treatment option and has been approved for the treatment of acute attacks of HAE. Rapid and stable relief from symptoms of cutaneous, abdominal, or laryngeal HAE attacks has been demonstrated by 30 mg of icatibant in Phase III clinical trials. Self-resolving mild to moderate local site reactions after subcutaneous injection of icatibant were observed. Icatibant is a new, safe, and effective treatment for acute attacks of HAE. HAE has been reported to result in enormous humanistic burden to patients, affecting both physical and mental health, with a negative impact on education, career, and work productivity, and with substantial economic burdens. The timely and proper use of disease-specific treatments could improve patients’ quality of life, reduce the disease-specific morbidity and mortality, and, last but not least, reduce costs associated with hospitalizations and emergency room visits. Therefore, the paradigm of HAE treatment has the potential to evolve significantly, thereby exponentially improving a patient’s quality of life.
Bigger Is Fitter? Quantitative Genetic Decomposition of Selection Reveals an Adaptive Evolutionary Decline of Body Mass in a Wild Rodent Population

In natural populations, quantitative trait dynamics often do not appear to follow evolutionary predictions: Despite abundant examples of natural selection acting on heritable traits, conclusive evidence for contemporary adaptive evolution remains rare for wild vertebrate populations, and phenotypic stasis seems to be the norm. This so-called ‘stasis paradox’ highlights our inability to predict evolutionary change, which is especially concerning within the context of rapid anthropogenic environmental change. While the causes underlying the stasis paradox are hotly debated, comprehensive attempts aiming at a resolution are lacking. Here we apply a quantitative genetic framework to individual-based long-term data for a wild rodent population and show that despite a positive association between body mass and fitness, there has been a genetic change towards lower body mass. The latter represents an adaptive response to viability selection favouring juveniles growing up to become relatively small adults, i.e. with a low potential adult mass, which presumably complete their development earlier. This selection is particularly strong towards the end of the snow-free season, and it has intensified in recent years, coinciding which a change in snowfall patterns. Importantly, neither the negative evolutionary change, nor the selective pressures that drive it, are apparent on the phenotypic level, where they are masked by phenotypic plasticity and a non-causal (i.e. non-genetic) positive association between body mass and fitness, respectively. Estimating selection at the genetic level thereby enabled us to uncover adaptive evolution in action, and to identify the corresponding phenotypic selective pressure. We thereby demonstrate that natural populations can show a rapid and adaptive evolutionary response to a novel selective pressure, and that explicitly (quantitative) genetic models are able to provide us with an understanding of the causes and consequences of selection that is superior to purely phenotypic estimates of selection and evolutionary change.
The New York-New York housing initiative and use of public shelters by persons with severe mental illness.

OBJECTIVE The study examined changes in the use of shelters in New York City by mentally ill persons with a history of homelessness who received housing placements through the New York-New York (NY/NY) housing initiative between 1990 and 1999 and the impact of the initiative on the overall demand for shelter beds in the city. METHODS Computerized service records on housing, shelter use, and health care services were linked to create an integrated data set for 3,167 persons who received NY/NY housing placements, which provided mental health services, and for a matched control group of persons with mental illness who used shelters but did not receive housing placements. Regression analyses were used to assess the relationships between shelter use and receipt of a placement. Differences in postplacement shelter use between NY/NY housing recipients and the matched control group were then examined at an individual level and a population level. RESULTS Heavy users of the shelter system were more likely to be placed in NY/NY housing. In the two-year postplacement period, persons who received a NY/NY housing placement used, on average, 128.2 fewer shelter days than those in the control group. In 1996, the NY/NY housing initiative reduced the average nightly census in New York City shelters by an estimated 4.6 percent. CONCLUSIONS Providing housing combined with mental health services is an effective approach to reducing shelter use among mentally ill persons who have a history of homelessness.
Effect of Cold Plasma-Surface Modification on Surface Wettability and Initial Cell Attachment

A thin coating of hexamethyldisiloxane and subsequent O2-plasma treatment was performed on mirror-polished titanium in order to regulate the wide range of wettability including 106 and almost 0 degrees of contact angles. The adsorption behavior of fibronectin and albumin in both individual and competitive mode, and initial attachment of fibroblasts and osteoblasts were investigated. Individually, fibronectin adsorption showed a biphasic inclination, whereas albumin showed greater adsorption to hydrophobic surfaces. In competitive mode, in solution containing both fibronectin and albumin, fibronectin showed greater adsorption on hydrophilic surfaces, whereas Alb predominantly adsorbed on hydrophobic surfaces. Initial attachment of both cells increased with increase in surface wettability, in particular, on super-hydrophilic surface, which correlated well with fibronectin adsorption in competitive mode. These results suggest that a cold plasma-surface modification enabled to regulate the surface wettability, and fibronectin adsorption may be responsible for increasing cell adhesion on hydrophilic surfaces in a
Vitamin D and Calcium Supplementation and One-Year Change in Mammographic Density in the Women's Health Initiative Calcium and Vitamin D Trial

Background: Calcium and vitamin D may be inversely related to breast cancer risk, in part by affecting mammographic density. However, results from previous, mostly cross-sectional studies have been mixed, and there have been few randomized clinical trials of the effect of calcium and vitamin D supplementation on change in mammographic density. Methods: We assessed the effect of one year of supplementation on mammographic density in 330 postmenopausal women enrolled in the Women's Health Initiative hormone therapy (HT) and calcium and vitamin D (CaD) trials. Women were randomized to receive 1,000 mg/d of elemental calcium carbonate plus 400 IU/d of vitamin D3 or placebo. Results: After approximately one year, mammographic density decreased 2% in the CaD supplementation group and increased 1% in the placebo group (ratio of means = 0.97; 95% CI = 0.81–1.17). Results suggested potential interaction by HT use (P = 0.08). Among women randomized to HT placebo, the ratio of mean density comparing CaD supplementation and placebo groups was 0.82 (95% CI = 0.61–1.11) vs. 1.16 (95% CI = 0.92–1.45) in women randomized to active HT. In sensitivity analyses limited to women taking ≥80% of study supplements, ratios were 0.67 (95% CI = 0.41–1.07) in women not assigned to HT and 1.07 (95% CI = 0.79–1.47) women assigned to HT. Conclusions: We observed no overall effect of vitamin D and calcium supplementation on mammographic density after one year. Impact: Potential interaction between these nutrients and estrogen as related to mammographic density warrants further study. Cancer Epidemiol Biomarkers Prev; 21(3); 462–73. ©2012 AACR.
Two-year clinical evaluation of ormocer and nanofill composite with and without a flowable liner.

PURPOSE The aim of this clinical follow-up study was to determine the clinical performance of ormocer and a new nanofill composite material, lined or not lined with flowable composites, after 2 years. MATERIALS AND METHODS Occlusal restorations (n = 108) were placed in 54 patients with two symmetric restorations per patient. In one of the two restorations in each patient, cavities were first lined with the flowable composite material Admira Flow or Filtek Flow after applying the two-step total-etch one-bottle adhesive (Admira Bond) or single bond adhesive (Single Bond). Admira or Filtek Supreme was then applied. Restorations were examined using the USPHS modified Ryge criteria for retention, color matching, cavosurface marginal discoloration, anatomic form, marginal adaptation, surface texture, and secondary caries by two previously calibrated dentists. The overall performance of the restorations was evaluated by Wilcoxon signed ranks test. The chi-square test was used to determine differences in the performance of the restorations in which the flowable composite was applied first. RESULTS There was no secondary caries or postoperative sensitivity in any of the restorations at the 6-month, 1-year, and 2-year follow-up examinations. After 2 years, only one Admira restoration had failed; all other restorations were available for evaluation. There were no statistically significant differences among the materials regardless of the prior use of flowable material (p > 0.05). There was no statistically significant difference between the restorations with and without the prior application of flowable materials (p > 0.05). CONCLUSION The clinical performance of occlusal restorations using ormocer or nanofill composite did not benefit from the additional use of the flowable composite. Both of the restorative materials exhibited ideal clinical performance.
Insight into the frequent occurrence of dura mater graft-associated Creutzfeldt-Jakob disease in Japan

Objective More than 60% of patients worldwide with Creutzfeldt-Jakob disease (CJD) associated with dura mater graft (dCJD) have been diagnosed in Japan. The remarkable frequency of dura mater grafts in Japan may possibly contribute to the elevated incidence of dCJD, but reasons for the disproportionate use of this procedure in Japan remain unclear. We investigated differences between dCJD patients in Japan and those elsewhere to help explain the more frequent use of cadaveric dura mater and the high incidence of dCJD in Japan. Methods We obtained data on dCJD patients in Japan from the Japanese national CJD surveillance programme and on dCJD patients in other countries from the extant literature. We compared the demographic, clinical and pathological features of dCJD patients in Japan with those from other countries. Results Data were obtained for 142 dCJD patients in Japan and 53 dCJD patients elsewhere. The medical conditions preceding dura mater graft transplantation were significantly different between Japan and other countries (p<0.001); in Japan, there were more cases of cerebrovascular disease and hemifacial spasm or trigeminal neuralgia. Patients with dCJD in Japan received dura mater graft more often for non-life-threatening conditions, such as meningioma, hemifacial spasm and trigeminal neuralgia, than in other countries. Conclusions Differences in the medical conditions precipitating dura mater graft may contribute to the frequent use of cadaveric dura mater and the higher incidence of dCJD in Japan.
A national evaluation using standardised patient actors to assess STI services in public sector clinical sentinel surveillance facilities in South Africa

Objectives Quality concerns in STI service delivery and missed opportunities for integration with HIV testing and prevention services in South Africa have been well documented. This national evaluation aimed to evaluate current utilisation and adherence to national STI guidelines, including partner notification and integration with HIV services, for diagnosis and management of STIs. Methods Facility surveys assessed infrastructure and resource availability, and standardised patient (SP) assessments evaluated quality of STI care in 50 public clinics in nine provinces in South Africa. The primary outcome was the proportion of SPs receiving essential STI care, defined as: offered an HIV test, condoms, partner notification counselling and correct syndromic treatment. Weighted proportions were generated, and SP findings were compared by gender using χ2 tests with Rao-Scott correction. Results More than 80% of facilities reported medications in stock, with the exceptions of oral cefixime (48.3%), oral erythromycin (75.1%) and paediatric syrups. Among 195 SP encounters, 18.7% (95% CI 10.7% to 30.5%) received all hypothesised essential STI services: offered HIV test (67.1%), offered condoms (31.4%), partner notification counselling (70.2%) and recommended syndromic treatment (60.7%). Men were more likely than women to be offered all services (25.1% vs 12.3%, p=0.023), recommended treatment (70.7% vs 50.9%, p=0.013) and partner notification counselling (79.9% vs 60.6%, p=0.020). Only 6.3% of providers discussed male circumcision with male SPs, and 26.3% discussed family planning with female SPs. Conclusions This evaluation of STI services across South Africa found gaps in the availability of medications, adherence to STI guidelines, condom provision and prevention messaging. Limited integration with HIV services for this high-risk population was a missed opportunity. Quality of STI care should continue to be monitored, and interventions to improve quality should be prioritised as part of national strategic HIV and primary healthcare agendas.
Augmented Renal Clearance in Patients With Febrile Neutropenia is Associated With Increased Risk for Subtherapeutic Concentrations of Vancomycin

Background: Augmented renal clearance (ARC) has frequently been observed in critically ill patients. The risk factors for ARC in patients, including those in the general ward, and their influences on vancomycin (VCM) treatment remain unclear. The aims of this study were to investigate the risk factors for ARC and to evaluate the influence of ARC on the pharmacokinetic parameters of VCM. Methods: This study included a total of 292 patients with VCM treatment who had normal serum creatinine concentrations. ARC was defined by an estimated creatinine clearance ≥130 mL·min−1·1.73 m−2. The risk factors for ARC were determined with stepwise logistic regression analysis. The pharmacokinetic parameters of VCM were estimated through the Bayesian method using a 2-compartment model. Results: ARC was observed in 48 patients (16.4%). Age ⩽65 years [odds ratio (OR): 5.77; 95% CI: 2.89–11.97; P < 0.0001], brain injury (OR: 5.11; 95% CI: 1.49–17.57; P = 0.0086), febrile neutropenia (OR: 2.76; 95% CI: 1.11–6.67; P = 0.0254), and a mean volume of infusion fluid ≥1500 mL/d (OR: 2.53; 95% CI: 1.27–5.16; P = 0.0091) were independent risk factors for the occurrence of ARC. The patients with ARC exhibited higher VCM clearance values than the non-ARC patients. The median trough serum concentrations of VCM were 7.4 (interquartile range: 5.2–11.6) mcg/mL in the ARC patients and 12.2 (8.9–16.3) mcg/mL in the non-ARC patients (P < 0.0001). Subtherapeutic trough concentrations of VCM (<10.0 mcg/mL) were found in 68.8% of the ARC patients and in 32.8% of the non-ARC patients (P < 0.0001). Conclusions: This observational study investigated the influence of febrile neutropenia on the emergency of ARC for the first time. ARC was strongly associated with VCM pharmacokinetics, and two-thirds of the ARC patients had subtherapeutic VCM concentrations. In patients with ARC, individualized dosing regimens are required to achieve the target trough concentration.
Submitted to the Annals of Statistics LASSO-TYPE RECOVERY OF SPARSE REPRESENTATIONS FOR HIGH-DIMENSIONAL DATA

UC Berkeley The Lasso [28] is an attractive technique for regularization and variable selection for high-dimensional data, where the number of predictor variables p is potentially much larger than the number of samples n. However, it was recently discovered [23, 38, 39] that the sparsity pattern of the Lasso estimator can only be asymptotically identical to the true sparsity pattern if the design matrix satisfies the so-called irrepresentable condition. The latter condition can easily be violated in applications due to the presence of highly correlated variables. Here we examine the behavior of the Lasso estimators if the irrepresentable condition is relaxed. Even though the Lasso cannot recover the correct sparsity pattern, we show that the estimator is still consistent in the `2-norm sense for fixed designs under conditions on (a) the number sn of non-zero components of the vector βn and (b) the minimal singular values of the design matrices that are induced by selecting of order sn variables. The results are extended to vectors β in weak `q-balls with 0 < q < 1. Our results imply that, with ∗We would like to thank Noureddine El Karoui and Debashis Paul for pointing out interesting connections to Random Matrix theory. Some results of this manuscript have been presented at the Oberwolfach workshop “Qualitative Assumptions and Regularization for High-Dimensional Data”. Nicolai Meinshausen is supported by DFG (Deutsche Forschungsgemeinschaft) and Bin Yu is partially supported by a Guggenheim fellowship and grants NSF DMS-0605165 (06-08), NSF DMS-03036508 (03-05) and ARO W911NF05-1-0104 (05-07).
Immunostaining in Mohs Micrographic Surgery: A Review

BACKGROUND With the advent of incorporating the immunoperoxidase staining technique into the processing of frozen tissue, the use of Mohs micrographic surgery (MMS) has been expanded to include several high‐risk tumors such as lentigo maligna, malignant melanoma, and dermatofibrosarcoma protuberans. OBJECTIVES To thoroughly review the English medical literature pertaining to the use of immunohistochemical staining techniques on frozen sections during MMS and to summarize the basic relevant outcomes from the different relevant studies. MATERIALS AND METHODS Medline search was conducted, with the following words used in the search criteria: “Mohs surgery,” “staining,” “immunostaining,” and “immunoperoxidase. ” RESULTS Generally, all immunostains showed advantage over the traditional hematoxylin and eosin approach. Studies of MART‐1 in melanoma chemosurgery indicated that it is typically crisp and has less background staining than MEL‐5 and better staining consistency than HMB‐45. In cases of desmoplastic melanomas, S100 is the stain of choice. CONCLUSION Immunostaining offers an advantage in MMS. Large, randomized, prospective studies comparing the different immunostains are still lacking in the literature. The authors have indicated no significant interest with commercial supporters.
The Shutdown of Celiac Disease-Related Gliadin Epitopes in Bread Wheat by RNAi Provides Flours with Increased Stability and Better Tolerance to Over-Mixing

Celiac disease is a food-sensitive enteropathy triggered by the ingestion of wheat gluten proteins and related proteins from barley, rye, and some varieties of oat. There are no interventional therapies and the only solution is a lifelong gluten-free diet. The down-regulation of gliadins by RNAi provides wheat lines with all the gliadin fractions strongly down-regulated (low-gliadin). The technological properties of doughs prepared from the low-gliadin lines indicated a general weakening effect, although some of the lines displayed similar properties to that of the wild-type lines. In contrast, the stability was increased significantly in some of the transgenic lines, indicating better tolerance to over-mixing. Results reported here are the first analyses of the mixing and bread-making quality of the wheat lines with all gliadin fractions strongly down-regulated. Flour from these lines may be an important breakthrough in the development of new products for the celiac community. These lines might be used directly or blended with other non-toxic cereals, as raw material for developing food products that can be safely tolerated by CD patients and others with gluten intolerance or gluten sensitivity, incrementing the range of available food products and enhancing their diet.