Miracle-dz/UniFAR-FTUs huggingface dataset:
Artificial neural networks for breathing and snoring episode detection in sleep sounds

Obstructive sleep apnea (OSA) is a serious disorder characterized by intermittent events of upper airway collapse during sleep. Snoring is the most common nocturnal symptom of OSA. Almost all OSA patients snore, but not all snorers have the disease. Recently, researchers have attempted to develop automated snore analysis technology for the purpose of OSA diagnosis. These technologies commonly require, as the first step, the automated identification of snore/breathing episodes (SBE) in sleep sound recordings. Snore intensity may occupy a wide dynamic range (>95 dB) spanning from the barely audible to loud sounds. Low-intensity SBE sounds are sometimes seen buried within the background noise floor, even in high-fidelity sound recordings made within a sleep laboratory. The complexity of SBE sounds makes it a challenging task to develop automated snore segmentation algorithms, especially in the presence of background noise. In this paper, we propose a fundamentally novel approach based on artificial neural network (ANN) technology to detect SBEs. Working on clinical data, we show that the proposed method can detect SBE at a sensitivity and specificity exceeding 0.892 and 0.874 respectively, even when the signal is completely buried in background noise (SNR <0 dB). We compare the performance of the proposed technology with those of the existing methods (short-term energy, zero-crossing rates) and illustrate that the proposed method vastly outperforms conventional techniques.
Pirfenidone for the treatment of idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is an under-recognised, rare, progressive disease of the lungs with unknown aetiology and high mortality. The currently advocated pathogenic mechanism is represented by progressive multifocal fibrosis. It is diagnosed based on clinical, radiographic, physiological and histopathological criteria. Existing therapeutic guidelines recommend anti-inflammatory and immunosuppressive combinations, despite proven limited efficacy. There is no therapy approved specifically for IPF, but several antifibrotic agents are currently under development for this indication. Pirfenidone is an antifibrotic agent potentially effective for IPF therapy, and preclinical and available clinical data support its use in IPF. Future clinical studies are expected to provide more consistent information on survival benefit, lung function and health-related quality of life.
Immune tolerance treatment in haemophilia patients with inhibitors: the Spanish Registry

We present a retrospective study of immune tolerance treatment (ITT) carried out in 42 Spanish haemophiliac patients. Most of the patients were high responders (39/42), with a median maximum titre of 67 Bethesda units (BU) (range 6–2984). The median inhibitor titre at the start the ITT was 11 BU (range 1–256 BU) and the median age of the patients was 7 years (range 0–57). The mean factor dosage was 140 IU kg bodyweight−1 day−1 (range 25–500). In most of the ITTs, plasma‐derived factor concentrate of intermediate and high purity was used. The inhibitor was eradicated in 26/38 (68%) of the patients who completed the treatment and two patients changed their status from high to low responders. Multivariate logistic regression analysis showed that three significant variables were associated with the highest probability of success: (i) the use of low factor doses for ITT (≤ 100 IU kg−1 day−1; P=0.0106; 95% CI 0.000289–0.342); (ii) a titre of < 10 BU at start of ITT (P=0.0286; 95% CI 0.00253–0.7189) and (iii) a lower maximum titre (P=0.0214; 95% CI 0.98–0.9994).
Vitamin C and E supplementation in women at risk of preeclampsia is associated with changes in indices of oxidative stress and placental function.

OBJECTIVE We have previously reported a reduced incidence of preeclampsia in women who were at risk and were taking vitamin C (1000 mg/d) and vitamin E (400 IU/d) supplements. In this study, we determined whether supplementation in the same cohort was associated with an improvement in indices of placental dysfunction and oxidative stress toward values determined in women who were at low risk of preeclampsia. STUDY DESIGN Seventy-nine women who were at high risk and who were taking vitamin supplements and 81 who were taking placebos were compared with 32 women who were at low risk and who were not taking supplements who were studied simultaneously. RESULTS Indices of oxidative stress and placental function were abnormal in the placebo group. When the placebo group was compared with the women who were at low risk, ascorbic acid, plasminogen activator inhibitor-2, and placenta growth factor concentrations were decreased; and 8-epi-prostaglandin F(2alpha),leptin, and the plasminogen activator inhibitor-1/-2 ratio were increased. In the group that received vitamin supplements, ascorbic acid, 8-epi-prostaglandin F(2alpha), leptin, and plasminogen activator inhibitor-1/-2 values were similar to women who were at low risk. CONCLUSION Antioxidant supplementation in women who were at risk of preeclampsia was associated with improvement in biochemical indices of the disease.
An integrated model of travelers’ pro-environmental decision-making process: the role of the New Environmental Paradigm

ABSTRACT This study integrated Value-Belief-Norm and Modified Norm Activation Model into a theoretical framework to identify the role of the New Environmental Paradigm (NEP) in tourists’ pro-environmental decision-making process. Results of the structural model from 484 sample travelers provide a comprehensive view of travelers’ pro-environmental decision-making process. Findings highlight that the integrated model captures a conceptual foundation by better-predicting travelers’ pro-environmental behaviors with the NEP playing a critical role in facilitating predictive power improvement. This study expands the literature on the NEP in the environment and tourism research and suggests destinations for incorporation of the concept into developing promotional campaigns.
Iodine-123-vasoactive intestinal peptide receptor scanning in patients with pancreatic cancer.

UNLABELLED Recent data demonstrated a high sensitivity (>90%) in the visualization of primary/recurrent pancreatic cancer as well as metastases by means of 123I-labeled vasoactive intestinal peptide (VIP). The aim of this study was to investigate the diagnostic value of radioiodinated VIP in patients suffering from adenocarcinoma of the exocrine pancreas. METHODS Sixty consecutive patients (26 women, 34 men; mean age 59 yr) with histologically verified pancreatic cancer were investigated in this study. Twenty-one patients presented with organ-confined malignancy (19 at study entry and 2 during follow-up after initial surgery developed tumor recurrence), while 25 patients had distant metastases along with the local malignancy, and 7 patients had liver metastases after resection of the primary lesion (6 on study entry and 1 during follow-up showed tumor development). In 5 of these patients, abdominal lymph node metastases were present at the time of scanning. Of 10 patients, who had undergone potentially curative surgery for their cancer, 7 remained free of disease during follow-up until death or for at least 6 mo. Iodine-123-VIP (150-200 MBq; approximately 1 microg VIP) was administered to all patients. Scintigraphic results were evaluated as compared to conventional radiologic imaging methods and surgical exploration. RESULTS Primary pancreatic tumors were visualized by 123I-VIP in 19/21 patients (90%) with disease confined to the pancreas and in 8/25 patients (32%) suffering both from locoregional and disease metastatic to the liver. The overall 123I-VIP scan sensitivity for primary pancreatic adenocarcinomas was 58% (27/46 scans). Liver metastases were imaged in 29/32 patients (scan sensitivity 90%) and abdominal lymph node metastases in 4/5 patients. In 5 patients, the VIP receptor scan indicated the malignant lesion before CT. In vitro results confirmed specific binding of 123I-VIP to primary pancreatic tumor cells as well as to PANC1 adenocarcinoma cells. CONCLUSION Iodine-123-VIP receptor scanning has the potential to offer additional information to augment diagnostic standard methods and could influence the decision-making process in the treatment of pancreatic cancer.
Computerized kinematic analysis of the clock drawing task in elderly people with mild Major Depressive Disorder: an exploratory study

ABSTRACT Background: Developments in data collection technology enable evaluation of kinematic characteristics of the drawing process. We examined the clock drawing task in elderly patients with mild Major Depressive Disorder (MDD), assessed the relative importance of kinematic measures that differentiate the groups and analyzed associations between computerized measures, and the cognitive and depression status of the study groups. Methods: The participants comprised 20 elderly people with mild MDD and 20 matched controls. Both groups performed a clock drawing task using a computerized system. Kinematic measures included: number of segments drawn, performance time, pressure implemented towards the drawing surface, and pen azimuth. Three representative spatial characteristics were analyzed per segments drawn on the paper: height, width and length. The clock drawing tasks were blindly scored with Freedman's method. Cognitive state was quantified using the Mini-mental State Examination (MMSE) and depression with the Geriatric Depression Scale (GDS). Results: Freedman's method found no between-group differences. Pressure and azimuth measures and spatial measures of segments height, width and length were significantly lower in the mild MDD group, while the number of paper segments and performance time did not differ. The azimuth measure correlated with the GDS score, and pressure with the MMSE and the GDS scores. Spatial measures did not correlate with either the MMSE or GDS. Pressure, segment width and length, azimuth and segment height allowed correct classification of 81.1% of the participants. Conclusions: A computerized system focusing on the clock drawing task might be sensitive to altered performance among elderly people with mild MDD.
Development, Differentiation, and Maturation of Macrophages in the Fetal Mouse Liver

Primitive macrophages emerged in the sinusoidal lumen of the fetal mouse liver at 10 days of gestation before the Initiation of hepatic hematopoiesis and matured into fetal macrophages. In the culture of cell suspensions from the fetal liver with LP3‐conditioned medium, monocyte colonies were formed, but monocytopoiesis was poor in the early stage of hepatic hematopoiesis in vivo. In the culture of cell suspensions obtained from the fetal liver at 10 days of gestation on the monolayer of a mouse bone marrow stromal cell line, ST2, primitive/fetal macrophage colonies were formed before the development of monocyte/macrophage colonies and showed differentiation of primitive macrophages into fetal macrophages without passing through the stage of promonocytes and monocytes. At this time, the fetal cardiovascular system was connected with the vitelline vein just before the formation of the liver. With the progress of gestation, a monocytic cell series was observed to develop and form a monocyte/macrophage population. This was confirmed by in vitro studies with an LP3‐conditioned medium and on a monolayer of ST2. Thus, it appears that there exist two different macrophage populations, a primitive/ fetal macrophage population and a monocyte/macrophage population in hepatic hematopoiesis. It also appears that fetal macrophages are differentiated from primitive macrophages which are colonized into the fetal liver from the yolk sac or which develop in loco, presumably from hematopoietic stem cells.
[Clinical and genetic analysis of Dent disease in 4 Chinese children].

OBJECTIVE To study the clinical features and gene mutations of 4 Chinese children with Dent disease. METHODS The clinical and laboratory data of 4 children with Dent disease were analyzed retrospectively. Genetic testing of the 4 cases was carried out. RESULTS All of 4 cases were boys. The first impression of Cases 1-3 was Fanconi syndrome. Proteinuria was presented as the first impression in Case 4. All 4 boys presented with low-molecular weight proteinuria (LMWP) and hypercalciuria, including 3 cases with hematuria, 1 case with kidney stones, 2 cases with nephrocalcinosis, 3 cases with hypophosphatemia, and 3 cases with rickets. Mutations of the CLCN5 gene were revealed in three patients (Cases 1, 2 and 4), including exon 6-7del, c. 785_787de l(p.263del Leu) and c.1039 C>T (p.Arg347Term). The first two gene mutations had never reported before. CONCLUSIONS Urine protein electrophoresis should be carried out for patients with proteinuria. Dent disease should be taken into consideration when patients with Fanconi syndrome have hypercalciuria, nephrocalcinosis or kindey stones. Genetic analyses are needed for a definite diagnosis.
Chemotherapy of breast cancer: are the taxanes going to change the natural history of breast cancer?

Among the novel chemotherapeutic drugs introduced in the last decade, taxanes have emerged as the most powerful compounds and results available to date suggest that they will be remembered in the future as the breast cancer chemotherapy of the 1990s. The two taxanes (paclitaxel, Taxol™, Bristol-Myers Squibb and docetaxel, Taxotere™, Rhône-Poulenc Rorer) share some characteristics, but are also significantly different both in preclinical profile and, most importantly, in clinical characteristics. The main clinical differences are related to their different efficacy-toxicity ratio in relation to dose and schedule; the differing integrability of paclitaxel and docetaxel in anthracycline-taxane containing regimens, secondary to major differences in pharmacokinetic interactions between each taxane and the anthracyclines, and; the potential differences in level of synergism between each taxane and herceptin (HeR2Neu antibody/trastuzumab, Genentech/Roche). In clinical practice, the taxanes are now standard therapy in metastatic breast cancer after prior chemotherapy, in particular anthracyclines, has failed. Their role in combination with anthracyclines in first-line therapy of advanced breast cancer is emerging and sheds new light on the potential role of taxanes in the adjuvant setting. However, the impact of taxanes on the natural history of breast cancer is yet to be defined, despite the trend of results suggesting that these agents have the potential for significant improvements in advanced and, most importantly, adjuvant therapy of breast cancer. The results of all completed or ongoing Phase III trials in first-line metastatic and the adjuvant setting will help determine if taxanes will further improve the outcome of breast cancer or not.
Pediatricians' use of and attitudes about personal digital assistants.

BACKGROUND Personal digital assistants (PDAs) are being increasingly used in medical practice. Although they have been touted as having the ability to improve efficiency and safety, little is known about pediatricians' use of and attitudes about PDAs. OBJECTIVE Our goals were to 1) determine the percentage of pediatricians using PDAs and computers, 2) determine perceived strengths and weaknesses of PDAs, and 3) explore characteristics associated with beliefs and use. DESIGN/METHODS Pediatricians (2130) were selected randomly from the American Medical Association Physician Masterfile of US-licensed physicians. All participants were mailed a survey along with a prepaid return envelope and a 1 dollar incentive. Up to 3 mailings were sent per participant. RESULTS Of eligible participants, 63.2% returned a survey. There were no significant differences between respondents and nonrespondents with respect to sex, type of practice, and present employment. Thirty-five percent of respondents currently use PDAs at work, and 40% currently use PDAs for personal use. Of those using PDAs, the most commonly used applications were for drug reference (80%), personal scheduling (67%), and medical calculations (61%). Few pediatricians are currently using PDAs for prescription writing (8%) or billing (4%). Users of PDAs were more likely to be male (adjusted odds ratio [AOR]: 2.29; 95% confidence interval [CI]: 1.64-3.19), in an urban community (AOR: 1.81; 95% CI: 1.30-2.55), in training (AOR: 2.64; 95% CI: 1.58-4.42), not in private practice (AOR: 1.47; 95% CI: 1.03-2.11), and a more recent graduate of medical school (AOR: 1.04 per year; 95% CI: 1.02-1.06). When controlling for covariates, those using PDAs were more likely to believe that PDAs can decrease medical errors (AOR: 2.22; 95% CI: 1.46-3.38) and increase efficiency (AOR: 2.40; 95% CI: 1.56-3.71). When compared with nonusers, users were less likely to view the small screen size (AOR: 0.53; 95% CI: 0.37-0.77) or system speed (AOR: 0.47; 95% CI: 0.26-0.84) as a problem but were significantly more likely to view memory as an issue (AOR: 3.48; 95% CI: 2.30-5.25). CONCLUSIONS More than one third of pediatricians are using PDAs in clinical practice. There seems to be a general consensus among users that they have the potential to improve patient safety and streamline care. Future studies should explore means to utilize their potential.
Prognostic risk factors that identify patients with clinical stage I nonseminomatous germ cell tumors at low risk and high risk for metastasis

The purpose of this study was to develop a reliable model to identify clinical Stage I nonseminomatous germ cell tumors (NSGCTs) associated with low risk or high risk for occult retroperitoneal metastasis, so that the model could be used to customize the therapeutic approach for patients with these tumors. The model was to be based on pathohistologic parameters and immunohistochemical expression of proliferation markers, proteases, and adhesion molecules in the primary tumor.
Evaluating Forest Protection Strategies: A Comparison of Land-Use Systems to Preventing Forest Loss in Tanzania

Understanding the effects of forest management strategies is especially important to avoid unregulated natural resource extraction that leads to ecosystem degradation. In addition to the loss of crucial forest services, inefficiencies at converting these natural resources into economic gain for people ultimately exacerbates poverty. Therefore, it is important to know which conservation strategies have proven to be effective in preventing ecosystem degradation and thus be encouraged in future management plans. Here, we used a high-resolution remotely sensed dataset spanning 15 years to study forest cover dynamics across various protected areas in Tanzania. Our findings highlight particular management approaches more effective in preventing forest cover loss and promote forest cover gain, and provide valuable information for conservation efforts. Results show that National Parks have the least forest cover loss, whereas multiple-use Game Controlled Areas have the highest rates of forest loss. In fact, results suggest that these multiple use areas tend to lose more forest cover than areas with no protection or management status at all. These findings suggest the need for more effective strategies for enforcing the existing policies to ensure that socio-economic benefits to local communities are maximized and national interests are sustained.
Age and gender responses to strength training and detraining.

PURPOSE The purpose of this study was to examine the effects of age and gender on the strength response to strength training (ST) and detraining. METHODS Eighteen young (20-30 yr) and 23 older (65-75 yr) men and women had their one-repetition maximum (1 RM) and isokinetic strength measured before and after 9 wk of unilateral knee extension ST (3 d x wk(-1)) and 31 wk of detraining. RESULTS The young subjects demonstrated a significantly greater (P < 0.05) increase in 1 RM strength (34+/-3%; 73+/-5 vs 97+/-6 kg; P < 0.01) than the older subjects (28+/-3%; 60+/-4 vs 76+/-5 kg, P < 0.01). There were no significant differences in strength gains between men and women in either age group with 9 wk of ST or in strength losses with 31 wk of detraining. Young men and women experienced an 8+/-2% decline in 1 RM strength after 31 wk of detraining (97+/-6 vs 89+/-6 kg, P < 0.05). This decline was significantly less than the 14+/-2% decline in the older men and women (76+/-5 vs 65+/-4 kg, P < 0.05). This strength loss occurred primarily between 12 and 31 wk of detraining with a 6+/-2% and 13+/-2% decrease in the young and older subjects, respectively, during this period. DISCUSSION These results demonstrate that changes in 1 RM strength in response to both ST and detraining are affected by age. However, ST-induced increases in muscular strength appear to be maintained equally well in young and older men and women during 12 wk of detraining and are maintained above baseline levels even after 31 wk of detraining in young men, young women, and older men.
Virtual microscopy in a veterinary curriculum.

Teaching faculty in the University of Tennessee College of Veterinary Medicine assist students in their professional education by providing a new way of viewing microscopic slides digitally. Faculty who teach classes in which glass slides are used participate in a program called Virtual Microscopy. Glass slides are digitized using a state-of-the-art integrated system, and a personal computer functions as the "microscope. " Additionally, distribution of the interactive images is enhanced because they are available to students online. The digital slide offers equivalent quality and resolution to the original glass slide viewed on a microscope and has several additional advantages over microscopes. Students can choose to examine the entire slide at any of several objectives; they are able to access the slides (called WebSlides) from the college's server, using either Internet Explorer or a special browser developed by Bacus Laboratories, Inc.,(a) called the WebSlide browser, which lets the student simultaneously view a low-objective image and one or two high-objective images of the same slide. The student can "move the slide" by clicking and dragging the image to a new location. Easy archiving, annotation of images, and Web conferencing are additional features of the system.
Physical activity estimated by the bone-specific physical activity questionnaire is also associated with cardiovascular risk

Abstract The nature of physical activity that benefits bone is traditionally thought to differ from that benefiting cardiovascular health. Accordingly, exercise recommendations for improving bone health and cardiovascular health are largely incongruent. Our aim was to determine the associations between high-impact physical activity participation and both cardiovascular disease risk factors and bone mass. We recruited 94 men and women (age 34.0 ± 13.3 years) to undergo measures of cardiovascular disease risk (BMI, total cholesterol, fasting blood glucose, waist-to-hip ratio, and mean arterial pressure) and dual-energy X-ray absorptiometry (DXA XR-800, Norland) measures of bone mass (femoral neck, lumbar spine, and whole body BMD) and body composition (whole body lean mass and fat mass). Physical activity participation was estimated using the bone-specific physical activity questionnaire (BPAQ). Those in the upper tertile for current BPAQ score exhibited lower total cholesterol, waist-to-hip ratio, and mean arterial pressure than those in the lower tertiles (P < 0.05) with the relationship being mild-to-moderate (r = −0.49 to 0.29, P < 0.01). Those in the upper tertile for BPAQ score also had greater lumbar spine BMD than those in the lower tertile (P = 0.008), with BPAQ score predicting 6% of the variance in BMD (P = 0.02). We conclude that high-impact physical activity as captured by the BPAQ may be beneficial for both bone health and for attenuating cardiovascular disease risk.