Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of COPD Exacerbations on Osteoporosis Assessed by Chest CT Scan

Abstract Background: COPD pathology involves not only the lungs but also extrapulmonary abnormalities. Osteoporosis is one of the most important abnormalities because it may cause vertebral compression fractures and deteriorate pulmonary function. COPD patients have many risk factors for osteoporosis, such as low BMI, decreased activity, systemic inflammation, and use of corticosteroids. Some of these factors have been shown to deteriorate with COPD exacerbations. We previously demonstrated the correlation between emphysema and osteoporosis and between emphysema progression and COPD exacerbations. Thus, the hypothesis that exacerbation causes osteoporosis progression in COPD patients was investigated. Methods: Forty-two COPD patients not on osteoporosis treatment for over 2 years were recruited. During follow-up, exacerbations had been prospectively recorded. Thoracic vertebral bone mineral density (BMD) was measured using chest CT, and the annual change in BMD was calculated. The change was compared between patients with and without a history of exacerbations. Results: The decrease in thoracic vertebral BMD was greater in patients with than in those without a history of exacerbations (median ΔBMD mg/ml⋅year: –3.78 versus –0.30, p = 0.02). Moreover, multivariate regression analysis showed that exacerbations and baseline PaO2 were independent predictors of the BMD decrease (R2 = 0.20, p = 0.007, and R2 = 0.09, p = 0.03, respectively) after adjustment for baseline age, smoking status, and airflow limitation. Conclusions: This is the first longitudinal study to demonstrate that COPD exacerbations are independently associated with osteoporosis progression. Osteoporosis progression should be evaluated in COPD patients, especially in those with a history of frequent exacerbations.
Perspectives on: ion selectivity: design principles for K+ selectivity in membrane transport.

Selection among competing alternatives is always interesting, but when organisms select between K+ and Na+ for transport across biological membranes, it is especially intriguing for a couple of reasons (Hille, 2001). First, the results are physiologically significant. Second, K+ and Na+ are nearly as similar as they could be while not being the same things. Perhaps the separation of isotopes of the same chemical species is more demanding. Despite decades of research, the question remains: how do K+-selective ion channels catalyze K+ movement but recognize the detailed molecular-scale differences of Na+ and discriminate against it? Suggestions based on channel size and coordination chemistry (Bezanilla and Armstrong, 1972; Eisenman and Horn, 1983) have been available for a long time, but the determination of a KcsA K+ channel crystal structure (Doyle et al., 1998) enabled molecularly specific modeling studies of this K+/Na+ selectivity. In the subsequent flood of computational studies, finding consistency in results and interpretations has proven challenging. Here, we describe our perspective on how molecular modeling has advanced our understanding of the specific chemical and structural design elements of biological molecules that enable selective ion transport.
Emerging drugs to treat squamous cell carcinomas of the head and neck

Importance of the field: Head and neck squamous cell carcinoma (HNSCC) is the eighth leading cause of cancer death worldwide. Despite advances in surgery and chemoradiation therapy, there has been little improvement in survival rates over the past 4 decades. Additionally, surgery and chemoradiotherapy have serious side effects. The development of agents with greater efficacy and tolerability is needed. Areas covered in this review: EGFR is the only proven molecular target for HNSCC therapy. Cetuximab, the sole FDA-approved molecular targeted HNSCC therapy, and other potential targeted therapies are being evaluated in preclinical, clinical and post-marketing studies. Here, we review the emerging targets for biological agents in HNSCC and the rationale for their selection. What the reader will gain: Key information in the development of new drug targets and the emergence of new biomarkers are discussed. Readers will gain insight regarding the limitations of current therapies, the impact of recently approved targeted therapies and the influence that predictive biomarkers will have on drug development. Take home message: The head and neck cancer drug market is rapidly evolving. Coordination between drug and biomarker development efforts may soon yield targeted therapies that can achieve the promise of personalized cancer medicine.
A note on some solutions of micropolar fluid in a channel with permeable walls

Purpose The purpose of this paper is to investigate different branches of the solution of micropolar fluid in a channel with permeable walls. Moreover, the intention of the study is to examine the effect of different physical parameters on fluid flow. Design/methodology/approach The mathematical modeling is performed on the basis of law of conservation of mass, momentum and angular momentum. The governing partial differential equations were transformed into ordinary differential equations by applying suitable similarity transformation. Afterwards, the set of nonlinear ordinary differential equations was solved numerically by a shooting method. Findings The study reveals that various branches of the solution of the proposed problem exist only in the case of strong suction. Originality/value The investigation of new branches of the solution of non-Newtonian micropolar fluid is relatively difficult as far as the single solution is concern. This study explores the new branches of the solution of a micropolar fluid in a channel with suction/injection. Simultaneous effect of suction Reynolds number and vortex viscosity parameter on velocity and micro-rotation profile is examined for different branches of solution in order to make the analysis more interesting.
Frequency of vascular and pregnancy morbidity in patients with low vs. moderate-to-high titers of antiphospholipid antibodies

Antiphospholipid syndrome (APLS) is an autoimmune hypercoagulable syndrome characterized by thrombotic and obstetric manifestations. We sought to determine the rate of APLS feature in patients tested positive for antiphospholipid antibodies (APLA) regardless of the serum level of anticardiolipin (ACL) and/or anti-&bgr;2-glycoprotein I (&bgr;2GPI) antibodies. An inception cohort of individuals who were tested positive for ACL and/or &bgr;2GPI IgG/IgM antibody, and/or lupus anticoagulant (LAC) on two occasions of at least 12 weeks apart. A total of 243 patients were included; their mean age was 40.1 ± 15.9 years. Thrombotic vascular events occurred in 118 patients (48.5%) of the entire cohort, of which 62 patients (25.5%) suffered from an arterial event and 56 patients (23%) from thrombotic venous events. Obstetrical morbidity occurred in 106 female patients (43.6%). In our cohort, we found no difference in the frequency of thrombotic or obstetric manifestations of APLS between patients with ACL IgG/IgM of low serum antibody level (<40 U) and medium-to-high level (≥40 U) and/or anti-&bgr;2GPI IgG, IgM higher than the 99th percentile vs. lower (>20 U). We suggest that in ‘real life’ the diagnosis of APLS should not be excluded because of low titer of APLA.
Increased gray matter volume of left pars opercularis in male orchestral musicians correlate positively with years of musical performance

To compare manual volumetry of gray matter (GM) / white matter (WM) of Broca's area subparts: pars opercularis (POP) and pars triangularis (PTR) in both hemispheres between musicians and nonmusician, as it has been shown that these regions are crucial for musical abilities. A previous voxel‐based morphometric (VBM) study conducted in our laboratory reported increased GM density in Broca's area of left hemisphere in male orchestral musicians. Functional segregation of POP/PTR justified separate volumetric analysis of these parts.
THE ORIGIN AND EVOLUTION OF METALLICITY GRADIENTS: PROBING THE MODE OF MASS ASSEMBLY AT z ≃ 2

We present and discuss measurements of the gas-phase metallicity gradient in four gravitationally lensed galaxies at z = 2.0–2.4 based on adaptive optics-assisted imaging spectroscopy with the Keck II telescope. Three galaxies with well-ordered rotation reveal metallicity gradients with lower gas-phase metallicities at larger galactocentric radii. Two of these display gradients much steeper than found locally, while a third has one similar to that seen in local disk galaxies. The fourth galaxy exhibits complex kinematics indicative of an ongoing merger and reveals an “inverted” gradient with lower metallicity in the central regions. By comparing our sample to similar data in the literature for lower redshift galaxies, we determine that, on average, metallicity gradients must flatten by a factor of 2.6 ± 0.9 between z = 2.2 and the present epoch. This factor is in rough agreement with the size growth of massive galaxies, suggesting that inside-out growth can account for the evolution of metallicity gradients. Since the addition of our new data provides the first indication of a coherent picture of this evolution, we develop a simple model of chemical evolution to explain the collective data. We find that metallicity gradients and their evolution can be explained by the inward radial migration of gas together with a radial variation in the mass loading factor governing the ratio of outflowing gas to the local star formation rate. Average mass loading factors of ≲ 2 are inferred from our model in good agreement with direct measurements of outflowing gas in z ≃ 2 galaxies.
A Structural Model of Pestivirus Erns Based on Disulfide Bond Connectivity and Homology Modeling Reveals an Extremely Rare Vicinal Disulfide

ABSTRACT Erns is a pestivirus envelope glycoprotein and is the only known viral surface protein with RNase activity. Erns is a disulfide-linked homodimer of 100 kDa; it is found on the surface of pestivirus-infected cells and is secreted into the medium. In this study, the disulfide arrangement of the nine cysteines present in the mature dimer was established by analysis of the proteolytically cleaved protein. Fragments were obtained after digestion with multiple proteolytic enzymes and subsequently analyzed by liquid chromatography-electrospray ionization mass spectrometry. The analysis demonstrates which cysteine is involved in dimerization and reveals an extremely rare vicinal disulfide bridge of unknown function. With the assistance of the disulfide arrangement, a three-dimensional model was built by homology modeling based on the alignment with members of the Rh/T2/S RNase family. Compared to these other RNase family members, Erns shows an N-terminal truncation, a large insertion of a cystine-rich region, and a C-terminal extension responsible for membrane translocation. The homology to mammalian RNase 6 supports a possible role of Erns in B-cell depletion.
Bereavement in adult life

EDITOR—Parkes summarises issues associated with bereavement in adulthood but risks medicalising a fundamental life experience.1 The concept that grief is a process with discrete phases which must be passed through before final adjustment to the loss can take place has been challenged.2 A more sociological model would suggest that rather than working their way through a range of emotions, bereaved people attempt to construct an accurate story about the life of the deceased which allows their memory of the dead to become part of their lives. This biography is created by people who knew the individual, not by detached professionals. Many general practitioners try to visit families at home shortly after a death has occurred; this may be, at least partially, related to the general practitioner's own needs since there is no compelling evidence that it is beneficial to the family. Indeed, it may be that a general practitioner's desire to do something to ease the pain of bereavement leads to more prescribing …
Robotic surgery in gynecology

FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon′s console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D) vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over.
Myopic Loss Aversion Revisited: the Effect of Probability Distortions in Choice Under Risk

When the performance of a risky asset is frequently assessed, the probability of detecting a loss is high, which averts the loss averse investors. This effect is known as myopic loss aversion (MLA). This paper reexamines several recent experimental studies documenting the existence of MLA. A closer look at the experimental data reveals that the effect of MLA is largely neutralized by the overweighting of small probabilities and the underweighting of moderate and high probabilities. Remarkably, the two effects exactly balance each other out for conventional parameterizations of cumulative prospect theory. MLA alone cannot explain the observed investment decisions.
Passivity and Finite-Gain Performance for Two-Dimensional Digital Filters: The FM LSS Model Case

This brief considers the two-dimensional (2-D) passivity performance analysis problem of 2-D digital filters in the Fornasini-Marchesini local state-space (FM LSS) form. The purpose is to establish a new criterion in terms of linear matrix inequality such that the 2-D digital filters in the FM LSS form ensure 2-D passivity performance with a storage function. Moreover, this brief reveals that the 2-D digital filters exhibit the 2-D finite-gain performance under the proposed criterion. Without interference, the criterion guarantees the asymptotic stability of 2-D digital filters. An application example to a 2-D low-pass filter is given to demonstrate the usefulness of the presented passivity criterion. The criteria in this brief and in a previous work of one of the authors, as a whole, give methodical results for the 2-D passive removal of the overflow oscillation of 2-D digital filters with external inferences.
Evaluation of Titanium Nitride (TiN) and Titanium Aluminum Nitride ((Ti,Al)N) Surface Coating on Bond Strength and Microleakage at Metal-Ceramic Interfaces

Statement of Problem: Base metals are still widely used in dentistry. However, biological and aesthetic disadvantages related to base metal alloy supported restorations are reported. There are not enough studies about surface coating processes that improve the mechanical, aesthetic and biological properties of the surface they are applied to. Purpose: The purpose of this study was to evaluate the effect of surface coatings of metal frameworks on early and long-term bond strength and microleakage at metal-ceramic interfaces. Material and Methods: A total of 72 metal frameworks were abraded with 50-μm aluminum oxide (Al2O3) particles and randomly divided into three main groups (n=24). Group C: no coating was applied (Control); Group TN: specimens were coated by titanium nitride; Group TAN: specimens were coated by titanium aluminum nitride. Surface morphology was examined under a Scanning Electron Microscope (SEM). Veneering porcelain was applied to all metal frameworks. Half of the specimens in each group were subjected to an early bond strength test. The remaining specimens were subjected to early microleakage analysis, thermocycled for 6,000 cycles, and thereafter subjected to long-term microleakage analysis and a bond strength test, respectively. Data were statistically analyzed by a one-way Analysis of Variance (ANOVA), independent-samples t-test, and pairedsamples t-test (α=0.05). Results: The group TN showed significantly higher values in the early flexural bond strength test, but no significant difference (P=0.068) was found among the groups in the long-term test results. In early microleakage analysis, no significant difference (P=0.481) was found among the groups, whereas the group TN was significantly different (P<0.001) from other groups in the long-term analysis. Conclusions: Both surface coating methods have shown no superior microleakage results compared with the control group in early and long-term analyses. Titanium Nitride (TiN) and Titanium Aluminum Nitride ((Ti,Al)N) coating of metal frameworks are not effective methods to increase porcelain bond strength.
Study of the charge distribution on liposome particles aerosolized by air-jet atomization.

BACKGROUND Air-jet atomization is a common technique used for the generation of therapeutic aerosols from liposome suspensions for drug delivery to the lungs. Although the technique does not use an electric field, the aerosols generated by this technique are still charged, and this may affect respiratory drug deposition. METHODS In this study, the charge distribution of liposomes aerosolized by an air-jet atomizer was measured using a tandem differential mobility analyzer (TDMA) technique. The liposomes, composed of a mixture of two amphiphilic lipids and cholesterol, were synthesized by the dehydration-rehydration vesicle method. The effect of the precursor suspension properties, such as medium composition, pH, conductivity, and lipid mass concentration, on the charge distribution of the liposome aerosols was studied. RESULTS AND CONCLUSIONS Results showed that the atomized liposomes have a bipolar charge distribution, and the number-fraction of charged liposome aerosols was influenced strongly by properties of the precursor solution under investigation. Liposomes synthesized in deionized water were observed to carry much higher charges than those synthesized in phosphate-buffered saline (PBS). Increasing the lipid mass concentration in the precursor suspension resulted in a decrease in the charge on the aerosols. Thus, the precursor suspension properties--composition, pH, and conductivity--can be used to control the magnitude of charge on liposome aerosols and to synthesize engineered liposome particles for the pulmonary delivery of drugs with controlled alveolar deposition and controlled delivery to alveolar macrophages.
Does the Integrated Management of Childhood Illness cost more than routine care? Results from the United Republic of Tanzania.

OBJECTIVE The Integrated Management of Childhood Illness (IMCI) strategy is designed to address the five leading causes of childhood mortality, which together account for 70% of the 10 million deaths occurring among children worldwide annually. Although IMCI is associated with improved quality of care, which is a key determinant of better health outcomes, it has not yet been widely adopted, partly because it is assumed to be more expensive than routine care. Here we report the cost of IMCI compared with routine care in four districts in the United Republic of Tanzania. METHODS Total district costs of child care were estimated from the societal perspective as the sum of child health-care costs incurred in a district at the household level, primary health-facility level and hospital level. We also included administrative and support costs incurred by national and district administrations. The incremental cost of IMCI is the difference in costs of child health-care between districts with and without IMCI, after standardization for population size. FINDINGS The annual cost per child of caring for children less than five years old in districts with IMCI was USD 11.19, 44% lower than the cost in the districts without IMCI (USD 16.09). Much of the difference was due to higher rates of hospitalization of children less than 5 years old in the districts without IMCI. Not all of this difference can be attributed to IMCI but even when differences in hospitalization rates are excluded, the cost per child was still 6% lower in IMCI districts. CONCLUSION IMCI was not associated with higher costs than routine child health-care in the four study districts in the United Republic of Tanzania. Given the evidence of improved quality of care in the IMCI districts, the results suggest that cost should not be a barrier to the adoption and scaling up of IMCI.
Intimate examinations and other ethical challenges in medical education

Education and debate p 97 In this issue, Coldicott et al report an exploratory survey that shows, among other findings, that up to a quarter of intimate examinations in anaesthetised or sedated patients seem not to have had adequate consent from patients (p 97). 1 This paper will generate a firestorm of controversy, wide media interest, and perhaps even calls for a public inquiry. Through the controversy, let us keep one point uppermost in mind: identifying the problem is only half the battle—the other half is coming up with an effective solution. The fact that this report has been published at all represents a triumph of academic freedom. In particular, Coldicott, a medical student, deserves high praise for seeing this controversial study through to publication. The medical school examined in the study is probably not the only medical school in the world with similar practices, and the …
Extremum Seeking Control for Energy Optimization of Vapor Compression Systems

In this paper, an energy optimizing extremum seeking controller is developed for vapor compression systems (VCS) that automatically discovers sets of inputs that minimizes the energy consumption while the machine is in operation. This controller optimizes an input-output map (from VCS inputs to electrical energy consumed) in realtime, and without relying on a model of the dynamics of a vapor compression system. A detailed algorithm and rules for tuning the controller gains will be described. Experiments are performed on an inverter-driven room air conditioner that demonstrate convergence of inputs to their optimal values, resulting in an improvement in COP of 10-20% for some operating points.