Miracle-dz/UniFAR-FTUs huggingface dataset:
Endoscopic Versus Surgical Ampullectomy: An Algorithm to Treat Disease of the Ampulla of Vater

Objective: The objective of this study was to compare the effectiveness, morbidity, and mortality associated with endoscopic ampullectomy (EA) and surgical ampullectomy (SA). Background: The proposed management of benign ampullary lesions includes local resection (EA or SA) and en bloc resection (pancreaticoduodenectomy). Most agree that en bloc resection entails a significant morbidity and mortality. No study has previously compared EA and SA for the treatment of benign ampullary lesions. Methods: Medical records of patients selected for ampullectomy at Duke University Medical Center from 1991 to 2010 were reviewed. Results: After review, 109 patients were confirmed to have undergone ampullectomy for a suspected benign ampullary lesion. Sixty-eight patients underwent EA, whereas 41 patients underwent SA. Patients in each group were identical in terms of age, sex, race, and comorbid conditions, except that EA had a higher rate of severe obesity (body mass index >35). Endoscopic ampullectomy was found to have a significantly reduced length of stay, lower morbidity, and readmission rates, but it had similar rates of mortality, margin-positive excisions, and reinterventions. Conclusions: In patients selected for ampullectomy for benign ampullary lesions, EA was found to have equivalent efficacy when compared with SA. Moreover, EA had lower morbidity and identical mortality. These findings suggest that patients would likely benefit from an aggressive endoscopic approach before consideration for surgery.
Family History of Alzheimer’s Disease and Cortical Thickness in Patients With Dementia

A first-degree family history of Alzheimer’s disease reflects genetic risks for the neurodegenerative disorder. Recent imaging data suggest localized effects of genetic risks on brain structure in healthy people. It is unknown whether this association can also be found in patients who already have dementia. Our aim was to investigate whether family history risk modulates regional medial temporal lobe cortical thickness in patients with Alzheimer’s disease. We performed high-resolution magnetic resonance imaging and cortical unfolding data analysis on 54 patients and 53 nondemented individuals. A first-degree family history of Alzheimer’s disease was associated with left hemispheric cortical thinning in the subiculum among patients and controls. The contribution of Alzheimer’s disease family history to regional brain anatomy changes independent of cognitive impairment may reflect genetic risks that modulate onset and clinical course of the disease.
Inferring emotional reactions in social situations: differences in children with language impairment.

Anticipating and responding to a partner's emotional reactions are key components in the comprehension of daily social discourse. Kindergarten children with language impairment (LI) and age-matched controls (CA) were asked to label facial expressions depicting 1 of 4 emotions (happy, surprised, sad, mad) and to identify those expressions when given a verbal label. Children then chose among these facial expressions when asked to infer emotional reactions from stories (3-sentence scenarios) presented in 1 of 3 modalities: verbal, visual, and combined. Although all children were able to identify and label the facial expressions, children with LI had difficulty integrating emotion knowledge with event context in order to infer a character's feelings. When these inferencing errors occurred, children in the LI group were more likely to provide emotions of a different valence (e.g., substituting happy for mad) than were children in the CA group. Inferencing ability was related to language comprehension performance on a standardized test. The findings suggest that inferencing errors made by children with LI occur during the early stages of social processing and may contribute to social difficulties often experienced by this group of children.
Predictors of adherence among Alzheimer's disease patients receiving oral therapy

Abstract Objectives: Treatment effectiveness depends upon administering medications as prescribed, and adherence is critical for Alzheimer's disease (AD) patients to receive optimal benefit from therapy. The objective of this study was to investigate factors associated with adherence to AD oral medications. Methods: This retrospective claims analysis identified AD patients who initiated oral AD therapy (rivastigmine, donepezil, galantamine, or memantine) between January 1, 2006 and December 31, 2007 from a large US health plan. Patient baseline characteristics were assessed during the 6-month pre-index period; outcomes were assessed during the 1-year post-index period. Pill burden was measured as a count of unique units of medication/day. Adherence was measured by medication possession ratio (MPR), with MPR ≥80% defined as adherent. Multivariate logistic regression was used to assess how potential covariates affect adherence probability. Results: A total of 3091 AD patients (36% male; mean age 80 [8.25 SD]) were identified. Only 58% of patients were adherent to oral AD medications. Compared to patients <75 years, patients ≥86 years were likely to be more adherent (OR = 1.401, p < 0.001). Other factors found to be positively associated with the probability of adherence to AD medications were male gender (OR = 1.175, p < 0.05), overall pill burden (OR = 1.192, p < 0.001), and a lower formulary tier status of the AD medication (OR = 1.332, p < 0.001). Conclusion: Among the several variables assessed, being male, ≥86 years of age, having a greater overall daily pill burden, or using a lower formulary tier AD medication was associated with better adherence to oral AD medication in patients diagnosed with AD. The database had no information on caregiver support, medication management interventions, or use of adherence aids that may have affected adherence in this cohort, yet, a substantial proportion of patients (42%) remained non-adherent. A better understanding of the causes of non-adherence is necessary, and methods to improve adherence, such as transdermal medications and educational programs, should be considered.
Novel Telestroke Program Improves Thrombolysis for Acute Stroke Across 21 Hospitals of an Integrated Healthcare System

Background and Purpose— Faster treatment with intravenous alteplase in acute ischemic stroke is associated with better outcomes. Starting in 2015, Kaiser Permanente Northern California redesigned its acute stroke workflow across all 21 Kaiser Permanente Northern California stroke centers to (1) follow a single standardized version of a modified Helsinki model and (2) have all emergency stroke cases managed by a dedicated telestroke neurologist. We examined the effect of Kaiser Permanente Northern California’s Stroke EXpediting the PRrocess of Evaluating and Stopping Stroke program on door-to-needle (DTN) time, alteplase use, and symptomatic intracranial hemorrhage rates. Methods— The program was introduced in a staggered fashion from September 2015 to January 2016. We compared DTN times for a seasonally adjusted 9-month period at each center before implementation to the corresponding 9-month calendar period from the start of implementation. The primary outcome was the DTN time for alteplase administration. Secondary outcomes included rate of alteplase administrations per month, symptomatic intracranial hemorrhage, and disposition at time of discharge. Results— This study included 310 patients treated with alteplase in the pre–EXpediting the PRrocess of Evaluating and Stopping Stroke period and 557 patients treated with alteplase in the EXpediting the PRrocess of Evaluating and Stopping Stroke period. After implementation, alteplase administrations increased to 62/mo from 34/mo at baseline (P<0.001). Median DTN time decreased to 34 minutes after implementation from 53.5 minutes prior (P<0.001), and DTN time of <60 minutes was achieved in 87.1% versus 61.0% (P<0.001) of patients. DTN times <30 minutes were much more common in the Stroke EXpediting the PRrocess of Evaluating and Stopping Stroke period (40.8% versus 4.2% before implementation). There was no significant difference in symptomatic intracranial hemorrhage rates in the 2 periods (3.8% versus 2.2% before implementation; P=0.29). Conclusions— Introduction of a standardized modified Helsinki protocol across 21 hospitals using telestroke management was associated with increased alteplase administrations, significantly shorter DTN times, and no increase in adverse outcomes.
Academic Motivation and the Big Five Yaman KÖSEOĞLU

Bahçeşehir University, Đstanbul, Turkey. _______________________________________________________________________________________ Abstract The objective of this study is to explore the relationship between the Big Five personality traits and the individual differences in the academic motivations of university students in order to develop more effective teaching strategies. 188 first-year university students were asked to complete questionnaires containing the Academic Motivations Inventory and the NEO Five factor Inventory. The results revealed an intriguing complex of relationships among the Big Five traits and the 16 subscales of the Academic Motivations Inventory. Factorial analysis revealed three underlying groupings of these subscales which are labeled escapism, commitment and performance. The association between these groupings and personality traits were refined further by means of multiple regressions. Escapism was best explained by extraversion, neuroticism and by an inverse relationship with openness to experience and conscientiousness. Of the remaining two, performance was best clarified by conscientiousness, neuroticism, and openness to experience; commitment by openness to experience and extraversion. Results are interpreted in terms of making optimal choices between teaching practices and academic motivations of the students, the range of which is due to the differences in personality traits. Recommendations for future research and educational methodologies are provided.
Nonalcoholic steatohepatitis is the most rapidly growing indication for liver transplantation in patients with hepatocellular carcinoma in the U.S.

Nonalcoholic steatohepatitis (NASH) is currently the third leading indication for liver transplantation (LT) in the U.S. and is predicted to become the leading indication for LT in the near future. The trends in NASH‐related hepatocellular carcinoma (HCC) among LT recipients in the U.S. remain undefined. We performed a retrospective cohort study to evaluate trends in the etiology of HCC among adult LT recipients in the U.S. from 2002 to 2012, using national data from the United Network for Organ Sharing registry. From 2002‐2012, there were 61,868 adults who underwent LT in the U.S., including 10,061 patients with HCC. The total number and proportion of HCC LT recipients demonstrated a significant increase following the implementation of the Model for Endstage Liver Disease (MELD) scoring system in 2002 (3.3%, n = 143 in 2000 versus 12.2%, n = 714 in 2005 versus 23.3%, n = 1336 in 2012). The proportion of hepatitis C virus (HCV)‐related HCC increased steadily from 2002 to 2012, and HCV remained the leading etiology of HCC throughout the MELD era (43.4% in 2002 versus 46.3% in 2007 versus 49.9% in 2012). NASH‐related HCC also increased significantly, and NASH is the second leading etiology of HCC‐related LT (8.3% in 2002 versus 10.3% in 2007 versus 13.5% in 2012). From 2002 to 2012, the number of patients undergoing LT for HCC secondary to NASH increased by nearly 4‐fold, and the number of LT patients with HCC secondary to HCV increased by 2‐fold. Conclusion: NASH is the second leading etiology of HCC leading to LT in the U.S. More important, NASH is currently the most rapidly growing indication for LT in patients with HCC in the U.S. (Hepatology 2014;59:2188–2195)
Revisiting ‘The influence of literacy in paraphasias of aphasic speakers’

Literature suggests that illiterate subjects are unaware of the phonological structure of language. This fact may influence the characteristics of aphasic speech, namely the structure of paraphasias. A battery of tests was developed for this study to be used with aphasic subjects (literate and illiterate), in order to explore this topic in more detail. This article aims to present the experimental design and the results of this test battery composed of two sub-tests: (i) a naming test with words that belong to three distinct groups: high frequency simple words (HFSW), low frequency simple words (LFSW), and low frequency complex words (LFCW); and (ii) a word repetition test. The variables of literacy, frequency and word morphology, and their effect on the performance of aphasic groups, were correlated in this study. Morphology was the variable that exercised the greatest influence on the verbal production of the participants.
DNA fingerprinting, biological and chemical investigation of certain Yucca species

Abstract Yucca aloifolia, Y. aloifolia variegata, Y. elephantipes and Y. filamentosa were investigated. DNA sequencing was performed for the four plants and a genomic DNA fingerprint was obtained and provided. The cytotoxic activities against four human cancer cell lines were investigated. The ethanolic extracts of leaves of Y. aloifolia variegata prevailed, especially against liver cancer HepG-2 and breast cancer MCF-7. In vivo assessment of hepatoprotective activity in rats also revealed the hepatoprotective potential of the ethanolic extracts of the four plants against CCl4- induced rats’ liver damage. Qualitative and quantitative analysis of the flavonoid and phenolic content of the promising species was performed using HPLC. The analysis identified and quantified 18 flavonoids and 19 phenolic acids in the different fractions of Y. aloifolia variegata, among which the major flavonoids were hesperidin and kaemp-3-(2-p-coumaroyl) glucose and the major phenolic acids were gallic acid and protocatechuic acid.
Genotypic Molecular Detection of Certain Genes Encoding Virulence Determinates and Antibiotic Resistance in Staphylococcus Aureus Isolates from Mastitis Cows

A total of 10Staphylococcusaureusisolates were recovered from 117 milk samples which were obtained from 93 dairy cows indifferent farms suffered from clinical mastitis, these isolates were phenotypically characterized and identified based on colony morphology andbiochemical tests. In addition, antibiotic susceptibility pattern of these strains was investigated and a trial to investigate the mechanism of the isolated bacterium to antibiotic resistance by PCR detection of class 1 integron. The milk samples were examined bacteriologically: Thirty-three out of 117 samples (28.2%) were positive for staphylococcus. Ten out of 33 samples (30.3%) were coagulase positive staphylococcus. The S. aureus isolates were highly sensitive to Cephalothin (DF30), Ampicillin/sulbactam (SAM), Methicillin(DP5µg), Amoxicillin-Clavulanic acid (AMC30) and Trimethoprime-Sulphamethaxole (SXT25µg), Susceptibility rates of S. aureus to these antibiotics were: 90, 80, 80, 70 and70%, respectively. Higher resistance was observed to Streptomycin (S10µg), Kanamycine (K30µg), Tetracycline (Te30µg), Erythromycin (E15µg), Cefotasime (CTX30µg), Cefoperazone (CFP75µg), Ampicillin (AMP10µg), Gentamycine (GN10µg), Amoxicillin (AX25µg) and Ciprofloxacin(CIP5µg), Susceptibility rates of S. aureus to these antibiotics were: 30, 30, 30, 30, 40, 40, 40, 40,40 and 50%, respectively. The molecular detection of S. aureus specific sequence gene(Sa), genes encoding clumping factor A (clfA), gene encoding S. aureus protein A (spa)and the class 1 integron using Polymerase Chain Reaction were carried out. A total of 10 Staphylococcus aureus isolates were negative for the presence of class 1 integron but yielded an amplicon size of about107 bp in case of S. aureus specific sequence gene (Sa), an amplicon size of about 638bp in case ofclfA gene. Amplification of the(spa) gene encoding S. aureus protein A was detected in 9 strains out of 10 (90%)and yielded an amplicon size of about 226bp. The data in this study provided an overview on the incidence of staphylococcus aureus in clinical mastitis and the distribution of virulence determinants and antibiotic resistance of these S. aureus strains.
Galaxy Bias and non-Linear Structure Formation in General Relativity

Length scales probed by the large scale structure surveys are becoming closer and closer to the horizon scale. Further, it has been recently understood that non-Gaussianity in the initial conditions could show up in a scale dependence of the bias of galaxies at the largest possible distances. It is therefore important to take General Relativistic effects into account. Here we provide a General Relativistic generalization of the bias that is valid both for Gaussian and for non-Gaussian initial conditions. The collapse of objects happens on very small scales, while long-wavelength modes are always in the quasi linear regime. Around every small collapsing region, it is therefore possible to find a reference frame that is valid for arbitrary times and where the space time is almost flat: the Fermi frame. Here the Newtonian approximation is applicable and the equations of motion are the ones of the standard N-body codes. The effects of long-wavelength modes are encoded in the mapping from the cosmological frame to the local Fermi frame. At the level of the linear bias, the effect of the long-wavelength modes on the dynamics of the short scales is all encoded in the local curvature of the Universe, which allows us to define a General Relativistic generalization of the bias in the standard Newtonian setting. We show that the bias due to this effect goes to zero as the square of the ratio between the physical wavenumber and the Hubble scale for modes longer than the horizon, confirming the intuitive picture that modes longer than the horizon do not have any dynamical effect. On the other hand, the bias due to non-Gaussianities does not need to vanish for modes longer than the Hubble scale, and for non-Gaussianities of the local kind it goes to a constant. As a further application of our setup, we show that it is not necessary to perform large N-body simulations to extract information about long-wavelength modes: N-body simulations can be done on small scales and long-wavelength modes are encoded simply by adding curvature to the simulation, as well as rescaling the time and the scale.
Polymeric behavior evaluation of PVP K30-poloxamer binary carrier for solid dispersed nisoldipine by experimental design

Abstract Context: High melting point polymeric carrier without plasticizer is unacceptable for solid dispersion (SD) by melting method. Combined polymer–plasticizer carrier significantly affects drug solubility and tableting property of SD. Objective: To evaluate and optimize the combined effect of a binary carrier consisting PVP K30 and poloxamer 188, on nisoldipine solubility and tensile strength of amorphous SD compact (SDcompact) by experimental design. Materials and methods: SD of nisoldpine (SDnisol) was prepared by melt mixing with different PVP K30 and poloxamer amount. A 32 factorial design was employed using nisoldipine solubility and tensile strength of SDcompact as response variables. Statistical optimization by design expert software, and SDnisol characterization using ATR FTIR, DSC and microscopy were done. Results: PVP K30:poloxamer, at a ratio of 3.73:6.63, was selected as the optimized combination of binary polymeric carrier resulting nisoldipine solubility of 115 μg/mL and tensile strength of 1.19 N/m2. Discussion: PVP K30 had significant positive effect on both responses. Increase in poloxamer concentration after a certain level decreased nisoldipine solubility and tensile strength of SDcompact. Conclusion: An optimized PVP K30–poloxamer binary composition for SD carrier was developed. Tensile strength of SDcompact can be considered as a response for experimental design to optimize SD.
Activation‐induced T cell death, and aberrant T cell activation via TNFR1 and CD95‐CD95 ligand pathway in stable cardiac transplant recipients

Specific blockade by antibodies (Abs) utilized in induction therapy may cause activation‐induced cell death (AICD) in lymphocytes of transplant recipients, preactivated via CD95 and tumour necrosis factor‐α receptor type 1 (TNFR1), and reduce allograft rejection frequency. Amongst 618 heart transplant (HTX) patients receiving antithymocytes globulin (ATG) therapy, 14 recipients with IVUS‐verified freedom of transplant vasculopathy were studied. The control group contained 14 patients awaiting transplantation, classified by the New York Hearth Association heart failure as class IV. From 618 HTX patients 89% were free of rejection grade ISHLT ≥2–3 within 3‐month post transplantation and 86% after one year. The death inducing receptors (DIR) such as CD95, CD95L and soluble TNFR1 were significantly increased in HTX recipients versus controls, as demonstrated by FACS, immunoblotting or ELISA (P < 0·001). The presence of increased DIR and in vivo apoptosis in HTX recipients, indicated by annexin‐V binding, was further confirmed by the presence of high concentration of histones in the sera of patients. ATG, anti‐IL‐2R and OKT‐3 Abs inhibited cell proliferation in a dose‐dependent manner. The induction of apoptosis and/or necrosis was demonstrated in cells cultured with these Abs by annexin‐V and 7‐aminoactinomycin staining, respectively. Our findings demonstrate that T cells from HTX recipients express high level of CD95, CD95L and soluble TNFR1, and undergo apoptosis and AICD. These cells recognizing donor alloantigens may be selectively eliminated in vivo, and should be responsible for the observed immunological unresponsiveness, indicated by low rejection rates in our patient cohort treated by conventional triple therapy.
Genetic patterns across multiple introductions of the globally invasive crab genus Carcinus

The European green crab Carcinus maenas is one of the world's most successful aquatic invaders, having established populations on every continent with temperate shores. Here we describe patterns of genetic diversity across both the native and introduced ranges of C. maenas and its sister species, C. aestuarii, including all known non‐native populations. The global data set includes sequences from the mitochondrial cytochrome c oxidase subunit I gene, as well as multilocus genotype data from nine polymorphic nuclear microsatellite loci. Combined phylogeographic and population genetic analyses clarify the global colonization history of C. maenas, providing evidence of multiple invasions to Atlantic North America and South Africa, secondary invasions to the northeastern Pacific, Tasmania, and Argentina, and a strong likelihood of C. maenas × C. aestuarii hybrids in South Africa and Japan. Successful C. maenas invasions vary broadly in the degree to which they retain genetic diversity, although populations with the least variation typically derive from secondary invasions or from introductions that occurred more than 100 years ago.