Miracle-dz/UniFAR-FTUs huggingface dataset:
Retinal nerve fiber layer defects in RP patients.

PURPOSE To determine, with the use of optical coherence tomography (OCT), the peripapillary retinal nerve fiber layer (RNFL) thickness among patients with retinitis pigmentosa (RP) of different degrees of disease severity. METHODS One eye in each of 25 RP patients was included. All patients underwent complete ocular examination, including the measurement of intraocular pressure, corneal thickness, and detailed fundus examination. Visual fields were evaluated by Goldmann perimetry. An RNFL thickness protocol was used to acquire circular scans of 3.46 mm in diameter around the optic nerve. For each eye, RNFL thickness was studied in the temporal (316 degrees -45 degrees ), superior (46 degrees -135 degrees ), nasal (136 degrees -225 degrees ), and inferior (226 degrees -315 degrees ) quadrants. Three smaller segments were also measured within each quadrant, all automatically calculated by the existing OCT software. The severity of damage to the peripapillary nerve fiber layer was compared with the clinical appearance of the optic disc, severity of field loss, and mode of inheritance for RP. RESULTS The mean age of patients included in the study was 48.6 years (range, 23-73 years). Of the 25 patients examined, 10 had abnormal thinning of the peripapillary RNFL in 2 or more segments, and 7 of those had abnormal thinning in at least 1 quadrant. The number of patients with abnormal thinning of the RNFL was considerably greater in those with clinically observed moderately severe or severe pallor of the optic disc than in those with normal appearance or mild pallor of the optic disc. No consistent association was noted between the remaining visual field and the presence of a RNFL defect (P > 0.05). CONCLUSIONS Patients with retinitis pigmentosa may have a measurable degree of RNFL thinning as determined by OCT. These observations could have an impact on future treatment strategies and imply that patients considered for various treatment options would benefit by an evaluation of nerve fiber layer thickness.
Percutaneous Drainage of a Diverticular Abscess Should be Limited to Two Attempts for a Resilient Diverticular Abscess

Management of a resilient diverticular abscess poses a big challenge. Currently there are no guidelines for the number of percutaneous drainages to be performed in resilient diverticular abscesses before attempting surgery. All patients (n = 117) who presented with a computed tomography scan-proven diverticular abscess from July 2008 to June 2011 were studied. They were divided into four groups based on the number of percutaneous drainages they underwent for their diverticular abscess: six patients underwent three or more drainages, nine patients underwent two drainages, 27 patients had one drainage, and 75 patients had no drainage. Readjustment, flushing, and upgrading size of the drain were not considered as separate drainage procedures. The size of abscess cavity was significantly higher for the patients who had three or more drainages (mean 8 cm, P < 0.001). A Hartmann's procedure was performed in the majority of patients in the three or more drainage group (83%) but in decreasing frequency as the number of drainages performed dropped: two drainage group (44%), one drainage group (15%), and no drainage group (19%). There was a significantly higher preoperative hospital stay for drainage and antibiotics in the patients from the three or more drainage group (P < 0.001). Patients with a resilient diverticular abscess are very likely to undergo a Hartmann's procedure after two attempted drainages. By performing additional percutaneous drainages in an attempt to avoid ostomy, patients are at an increased risk of sepsis and peritonitis with prolonged antibiotics and increased healthcare costs. We recommend limiting percutaneous drainage procedures to two attempts to cool down a resilient diverticular abscess before definitive surgery.
Ipsilateral Prominent Thalamostriate Vein on Susceptibility-Weighted Imaging Predicts Poor Outcome after Intravenous Thrombolysis in Acute Ischemic Stroke

BACKGROUND AND PURPOSE: The impact of deep cerebral veins on neurologic outcome after intravenous thrombolysis in patients with acute ischemic stroke is unclear. We investigated the relationship between the appearance of deep cerebral veins on susceptibility-weighted imaging and neurologic outcome in patients who underwent thrombolysis. MATERIALS AND METHODS: We retrospectively analyzed 109 consecutive patients with acute ischemic stroke who had pretreatment SWI and received intravenous thrombolysis within 6 hours. We calculated the signal difference ratio (defined as the relative difference in signal intensity between the ipsilateral and contralateral veins) of the thalamostriate vein, septal vein, and internal cerebral vein on pretreatment SWI. RESULTS: Only the signal difference ratio of the thalamostriate vein was significantly associated with poor outcome (3-month modified Rankin Scale score > 2, P = .008). The optimal threshold was relative hypointensity of the ipsilateral vein of >4.8% (sensitivity of 53.7% and specificity of 80.9%). We defined a signal difference ratio of the thalamostriate vein of ≥5% as an ipsilateral prominent thalamostriate vein. Patients with an ipsilateral prominent thalamostriate vein were more likely to have poor outcome (OR = 3.66; 95% CI, 1.25–10.68; P = .02) and a lower rate of successful reperfusion (reperfusion rate of ≥70%; OR = 0.35; 95% CI, 0.13–0.92; P = .03), compared with those without an ipsilateral prominent thalamostriate vein. However, patients with an ipsilateral prominent thalamostriate vein were still less likely to experience poor outcome when reperfusion was achieved compared with when reperfusion did not occur (80.0% versus 44.4%, P = .04). CONCLUSIONS: A pretreatment ipsilateral prominent thalamostriate vein was associated with reduced reperfusion after thrombolysis and poor outcome. More intensive reperfusion approaches may be required for patients with an ipsilateral prominent thalamostriate vein.
Multilocus Variable Number of Tandem Repeat Analysis Reveals Multiple Introductions in Spain of Xanthomonas arboricola pv. pruni, the Causal Agent of Bacterial Spot Disease of Stone Fruits and Almond

Xanthomonas arboricola pv. pruni is the causal agent of the bacterial spot disease of stone fruits, almond and some ornamental Prunus species. In Spain it was first detected in 2002 and since then, several outbreaks have occurred in different regions affecting mainly Japanese plum, peach and almond, both in commercial orchards and nurseries. As the origin of the introduction(s) was unknown, we have assessed the genetic diversity of 239 X. arboricola pv. pruni strains collected from 11 Spanish provinces from 2002 to 2013 and 25 reference strains from international collections. We have developed an optimized multilocus variable number of tandem repeat analysis (MLVA) scheme targeting 18 microsatellites and five minisatellites. A high discriminatory power was achieved since almost 50% of the Spanish strains were distinguishable, confirming the usefulness of this genotyping technique at small spatio-temporal scales. Spanish strains grouped in 18 genetic clusters (conservatively delineated so that each cluster contained haplotype networks linked by up to quadruple-locus variations). Furthermore, pairwise comparisons among populations from different provinces showed a strong genetic differentiation. Our results suggest multiple introductions of this pathogen in Spain and redistribution through contaminated nursery propagative plant material.
Towards the parallel repetition conjecture

We consider the behavior of the error probability of a two-prover one-round interactive protocol repeated n times in parallel. We point out the connection of this problem with the density form of Hales-Jewett's theorem in Ramsey theory. This allows us to show that the error probability converges to 0 as n/spl rarrspl infin/. <<ETX>>
Enhancement of Mental Rotation Abilities and Its Effect on Anatomy Learning

Background: Mental rotation (MR) is improved through practice and high MR ability is correlated to success in anatomy learning. Purposes: We investigated the effects of improving the MR ability on the Vandenberg and Kuse MR test performance and the consequences on learning functional human anatomy. Methods: Forty-eight students were assigned into three groups: MR group (16 students attending functional anatomy course and MR training), anatomy group (16 students attending the same functional anatomy course), and the control group (n = 16). Instead of MR training, the latter 2 groups were engaged in physical activities for an equivalent time, and the control group did not attend anatomy course. Results: MR group performed better than the two others in the MR test and better than the anatomy group in the anatomy test. Conclusions: The MR training sessions were found to improve MR test performance and were further transferred to anatomy learning.
Visual Outcome and Prognostic Factors after Vitrectomy for Posterior Segment Foreign Bodies

Purpose To identify the prognostic factors that predict final visual outcome in eyes with posterior segment intraocular foreign body (IOFB) injuries managed by primary pars plana vitrectomy. Methods Ninety-six consecutive patients with posterior segment IOFB injuries were retrospectively reviewed. Factors analyzed included initial visual acuity (VA), time between injury and presentation, site of entrance wound, uveal prolapse, vitreous prolapse, traumatized iris, endophthalmitis, location and size of IOFB, use of scleral buckling and/or an encircling band, gas tamponade, lensectomy, number of surgical procedures, and development of retinal detachment. Data were analyzed using univariate and multivariate logistic regression analysis. Results After a mean follow-up of 8.6 months, 63 eyes (65.6%) achieved VA of 20/200 or better, and 9 eyes (9.4%) had total retinal detachment complicated by inoperable proliferative vitreoretinopathy. On univariate analysis, predictors of poor vision (hand movements or less) were poor initial VA, corneoscleral entrance wound, uveal prolapse, vitreous prolapse, traumatized iris, and development of retinal detachment. In contrast, predictors of good visual outcome (20/200 or better) were absence of uveal prolapse, no endophthalmitis, and no retinal detachment. Multivariate analysis identified corneoscleral entrance wound, uveal prolapse, and development of retinal detachment as the only factors significantly associated with poor visual outcome. Absence of uveal prolapse was the only factor significantly associated with good visual outcome. Conclusions Final visual outcome is greatly determined by the severity of the primary injury. On multivariate analysis, significant predictive factors of final VA were corneoscleral entrance wound, presence or absence of uveal prolapse, and development of retinal detachment.
Self-generated validity and other effects of measurement on belief, attitude, intention, and behavior.

Drawing from recent developments in social cognition, cognitive psychology, and behavioral decision theory, we analyzed when and how the act of measuring beliefs, attitudes, intentions, and behaviors affects observed correlations among them. Belief, attitude, or intention can be created by measurement if the measured constructs do not already exist in long-term memory. The responses thus created can have directive effects on answers to other questions that follow in the survey. But even when counterparts to the beliefs, attitudes, and intentions measured already exist in memory, the structure of the survey researcher's questionnaire can affect observed correlations among them. The respondent may use retrieved answers to earlier survey questions as inputs to response generation to later questions. We present a simple theory predicting that an earlier response will be used as a basis for another, subsequent response if the former is accessible and if it is perceived to be more diagnostic than other accessible inputs. We outline the factors that determine both the perceived diagnosticity of a potential input, the likelihood that it will be retrieved, and the likelihood that some alternative (and potentially more diagnostic) inputs will be retrieved. This article examines the effects of measurement operations on revealed correlations among survey measures of belief, attitude, intention, and behavior. The potential reactivity of measurement has long been of concern in psychology. Methodologists (e.g., Campbell & Stanley, 1966; Cook & Campbell, 1979; Runkel & McGrath, 1972) warn of measurement-induced distortions relating to social desirability, evaluation apprehension, and sensitization to experimental treatments. Although it is true that the problem of reactivity of measurement affects work in both the social and physical sciences, in the physical sciences, measurement effects are expressed in terms of substantive theory. For instance, Heisenberg's uncertainty principle links basic
The toxicity of Phaseolus vulgaris lectins. Nitrogen balance and immunochemical studies.

Inclusion of pure lectins isolated from the seeds of kidney bean (Phaseolus vulgaris L. cv. Processor) in diets for rats increased both faecal and urinary losses of N and resulted in a negative N balance for the animals. The relationship between total body N change [y (mg)] and lectin concentration [x (g kg−1)] of the diet was: y=421.5-75.1 x, which was statistically significant (P=0.05). These rats developed circulating antibodies of low avidity to the dietary lectins, while no other proteins of the diet elicited a similar antibody response. Additionally, in several serum samples from rats which had been fed raw beans, the presence of small amounts of a protein reactive with rabbit anti-lectin antibodies was detected. This protein was isolated from the immune precipitate and was shown by sodium dodecylsulphate-gel electrophoresis to contain a protein subunit of 30 000, which was very similar to that of pure lectins. It is tentatively suggested that lectin toxicity results from the combined effects of the interference with normal intestinal digestion and/or absorption of N through the damaged enterocytes and of systemic immune (and other) responses of the rat to the internalised lectin.
Editorial: Expanding insecticide‐treated mosquito net coverage in Africa: tradeoffs between public and commercial strategies

Insecticide-treated materials and particularly mosquito nets treated with synthetic pyrethroid insecticides (insecticidetreated net ITN) as a tool in malaria control had received renewed interest some two to three decades ago (Lindsay & Gibson 1988). During the 1980s a number of smallscale studies had demonstrated significant reductions in malaria morbidity associated with ITN use in different African Asian and Latin American populations (Rozendaal 1989; Bermejo & Veeken 1992). Subsequently three large randomized controlled ITN efficacy and one effectiveness trial have been conducted during the 1990s in Sub-Saharan Africa (SSA). These trials have consistently demonstrated the efficacy of ITN in reducing malaria morbidity and mortality in young children over a broad range of malaria transmission intensities (Lengeler 1998; Phillips-Howard et al. 2003). Thus ITN are considered the most efficacious currently available intervention for malaria control (Whitty et al. 2002; Hawley et al. 2003ab). This should however not impair the overriding importance of treating all malaria patients early with an effective drug preferably as combination therapy (Guerin et al. 2002). (excerpt)
Left Ventricular Assist Device Pump Thrombosis: Is There a Role for Glycoprotein IIb/IIIa Inhibitors?

Left ventricular assist devices (LVADs) fill a critical need by providing circulatory support to patients with end-stage heart failure who are either ineligible for heart transplant or too ill to stably wait for an eventual donor organ. Furthermore, they are critical to the arsenal of the heart failure cardiologist, given the supply/demand mismatch for donor organs. Unfortunately, these devices present their own complications. Despite antiplatelet agents and systemic anticoagulation, a number of patients present with pump thrombosis, a life-threatening event requiring either pump exchange or treatment with systemic thrombolytics. In an effort to avoid these morbid therapies, glycogen IIb/IIIa inhibitors, which have both antiplatelet and thrombolytic properties, have been proposed to treat pump thrombosis. We report here the largest case series using these agents and document a previously unreported high failure rate with this therapy.
Genome-Wide Study of KNOX Regulatory Network Reveals Brassinosteroid Catabolic Genes Important for Shoot Meristem Function in Rice[W][OPEN]

Gain- and loss-of-function studies revealed that the rice KNOX transcription factor OSH1 negatively regulates the brassinosteroid (BR) phytohormone pathway. Genomics approaches identified BR catabolism genes as direct targets of OSH1 in the shoot meristems. RNAi knockdown studies suggested that BR catabolism is important for shoot meristem function and for regulation of panicle branch angle. In flowering plants, knotted1-like homeobox (KNOX) transcription factors play crucial roles in establishment and maintenance of the shoot apical meristem (SAM), from which aerial organs such as leaves, stems, and flowers initiate. We report that a rice (Oryza sativa) KNOX gene Oryza sativa homeobox1 (OSH1) represses the brassinosteroid (BR) phytohormone pathway through activation of BR catabolism genes. Inducible overexpression of OSH1 caused BR insensitivity, whereas loss of function showed a BR-overproduction phenotype. Genome-wide identification of loci bound and regulated by OSH1 revealed hormonal and transcriptional regulation as the major function of OSH1. Among these targets, BR catabolism genes CYP734A2, CYP734A4, and CYP734A6 were rapidly upregulated by OSH1 induction. Furthermore, RNA interference knockdown plants of CYP734A genes arrested growth of the SAM and mimicked some osh1 phenotypes. Thus, we suggest that local control of BR levels by KNOX genes is a key regulatory step in SAM function.
Entrustment Decision Making in Clinical Training

The decision to trust a medical trainee with the critical responsibility to care for a patient is fundamental to clinical training. When carefully and deliberately made, such decisions can serve as significant stimuli for learning and also shape the assessment of trainees. Holding back entrustment decisions too much may hamper the trainee’s development toward unsupervised practice. When carelessly made, however, they jeopardize patient safety. Entrustment decision-making processes, therefore, deserve careful analysis. Members (including the authors) of the International Competency-Based Medical Education Collaborative conducted a content analysis of the entrustment decision-making process in health care training during a two-day summit in September 2013 and subsequently reviewed the pertinent literature to arrive at a description of the critical features of this process, which informs this article. The authors discuss theoretical backgrounds and terminology of trust and entrustment in the clinical workplace. The competency-based movement and the introduction of entrustable professional activities force educators to rethink the grounds for assessment in the workplace. Anticipating a decision to grant autonomy at a designated level of supervision appears to align better with health care practice than do most current assessment practices. The authors distinguish different modes of trust and entrustment decisions and elaborate five categories, each with related factors, that determine when decisions to trust trainees are made: the trainee, supervisor, situation, task, and the relationship between trainee and supervisor. The authors’ aim in this article is to lay a theoretical foundation for a new approach to workplace training and assessment.
Síntomas de ansiedad y depresión tras la hospitalización en una unidad de cuidados intensivos

Los grandes avances cientifico-tecnicos acontecidos durante las ultimas decadas han dado lugar a una medicina altamente especializada cuya maxima expresion se encuentra en las Unidades de Cuidados Intensivos (UCIs), donde tecnologia y eficacia se unen para intentar restablecer el estado de salud de pacientes gravemente enfermos. Si bien es cierto que este ha sido uno de los principales objetivos de la medicina intensiva tambien lo es que este proceso, incluso en el mejor de los casos, no esta exento de gran malestar y sufrimiento. En este sentido, si el ambiente hospitalario en si mismo se considera extrano e intimidante, cuanto mas puede serlo una Unidad de Cuidados Intensivos en la que ademas de la gravedad medica del paciente, con todo lo que esto conlleva, convergen diferentes aspectos caracteristicos de estas unidades que pueden afectar de manera particular a los pacientes y sus familias (Llubia y Canet, 2000). Tal es el caso de la alta tecnologia, el constante ir y venir de los profesionales sanitarios, el ruido de maquinas y alarmas, gran cantidad de tubos y cables que limitan la movilidad y posibilidades de comunicacion en la persona enferma, el aislamiento de la familia y la ruptura con la vida cotidiana, viendose alterado el normal funcionamiento del circulo familiar en su conjunto. De esta manera, el ingreso en UCI puede constituir una experiencia realmente estresante y disruptiva (Novaes et al., 1997; Novaes et al.,1999; Llubia, 2008) tanto para el paciente como para sus familiares, pudiendo dar a lugar a un grado variable de afectacion emocional durante el ingreso en UCI e incluso varios meses despues del alta de la unidad (Curtis, 2003; Pattison, 2005; Azoulay et al., 2005; Abizanda et al., 2006). Todo esto pone de relieve la importancia de entender al paciente como un ser biopsicosocial, ofreciendole una atencion integral, en la que ademas de las dolencias fisicas, de vital importancia en estos momentos, se atiendan sus necesidades psicologicas, sociales y espirituales, con la finalidad de disminuir el impacto del ingreso en UCI y facilitar en la medida de lo posible un afrontamiento adaptativo a esta situacion, tanto en pacientes como en sus familiares y allegados.
Paraquat and Adrenal Cortical Necrosis

SIR,-I note that Mr. J. E. Cairns in his article on corneal disease (4 April, p. 33) states that surgical removal of a pterygium has a recurrence rate of some 50%. This, of course, used to be true. Mr. Cairns seems to be unaware of the fact that the use of eye drops consisting of a 1/2,000 solution of triethylene thiophosphoramide (Thio-Tepa) reduces the recurrence rate to less than 1 %1 . The drops are used every three hours during the waking period for six to eight weeks. The solution keeps its activity for at least two weeks if stored in a refrigerator and gives better results and none of the complications that can occur with beta-radiation therapy. -I am, etc.,