Miracle-dz/UniFAR-FTUs huggingface dataset:
Responsiveness and Interpretability of the Portuguese Version of the Neck Disability Index in Patients With Chronic Neck Pain Undergoing Physiotherapy.

STUDY DESIGN A prospective cohort study with a 7-week follow-up of 113 patients with chronic neck pain undergoing physiotherapy. OBJECTIVE To examine the responsiveness of the Portuguese Version of the Neck Disability Index (NDI-PT), and to determine the minimal clinically important difference (MCID), minimal detectable change (MDC), and floor/ceiling effects. SUMMARY OF BACKGROUND DATA Studies that determine MDC and MCID are needed to provide more accurate outcome evaluation and critically assess potential relevant sources for differences in the minimal important change values for the NDI. METHODS The NDI-PT was administered twice: at the baseline and after 7 weeks of physiotherapy treatment. A Global Transition Scale was used as an external criterion measure to distinguish between improved and nonimproved patients' scores between baseline and follow-up. The responsiveness of the NDI-PT was assessed through anchor-based methods (correlation coefficient and receiver operating characteristics curves---ROC curves). The MCID was estimated by the ROC curve method, and the MDC through the standard Error of Measurement (SEM). RESULTS The NDI-PT revealed moderate responsiveness when applied to patients with chronic neck pain undergoing physiotherapy (ρ = 0.328 and area under the curve of 0.595, 95% confidence interval: 0.484-0.706). The MDC achieved 12 points, whereas the MCID was found to be 5.5 points. A complementary ROC analysis based on percentage differences in NDI-PT scores from baseline revealed an optimal cutoff point of 27%. The optimal cutoff point was found to be dependent of disability baseline scores. CONCLUSION The NDI-PT demonstrated moderate levels of responsiveness. The amount of change in questionnaire scores perceived by the patient to be meaningful is smaller than the amount of change required to be statistically 95% confident that score change is not just measurement error. LEVEL OF EVIDENCE N/A.
Sample size determination for logistic regression on a logit-normal distribution

Although the sample size for simple logistic regression can be readily determined using currently available methods, the sample size calculation for multiple logistic regression requires some additional information, such as the coefficient of determination ( R cov 2 ) of a covariate of interest with other covariates, which is often unavailable in practice. The response variable of logistic regression follows a logit-normal distribution which can be generated from a logistic transformation of a normal distribution. Using this property of logistic regression, we propose new methods of determining the sample size for simple and multiple logistic regressions using a normal transformation of outcome measures. Simulation studies and a motivating example show several advantages of the proposed methods over the existing methods: (i) no need for R cov 2 for multiple logistic regression, (ii) available interim or group-sequential designs, and (iii) much smaller required sample size.
Effect of Chipper Type, Biomass Type and Blade Wear on Productivity, Fuel Consumption and Product Quality

The study determined the time consumption, fuel consumption and chip size obtained with two different industrial chippers, working with logging residues (tops and branches), thinning material and pulpwood. Specific time consumption per oven dry tons (odt) was 83% higher for the less powerful disc chipper, and chipping forest residues resulted in a 35% increase in specific time consumption compared to chipping thinning material. What is more, the interaction between the two factors pointed at a different suitability of the two machines to chip different materials, since the difference in specific time consumption between the drum and the disc chipper was larger when chipping forest residues rather than thinning. Specific time and fuel consumption of the more powerful drum chipper increased by 30% and 39%, respectively, when working with dull blades compared to working with sharp blades. The best product quality was obtained when applying the disc chipper to pulpwood material. However, the same machine produced more fines when fed with forest residues.
Rifaximin: A Nonabsorbed Antimicrobial in the Therapy of Travelers’ Diarrhea

Background/Aims: Bacterial enteropathogens, the major cause of travelers’ diarrhea, are customarily treated with antibacterial drugs. Rifaximin, a nonabsorbed antimicrobial was examined as treatment for travelers’ diarrhea. Methods: A randomized, prospective, double-blind clinical trial was carried out in 72 US adults in Mexico. Patients with acute diarrhea received one of three doses of rifaximin (200, 400 and 600 mg t.i.d.) or trimethoprim/sulfamethoxazole (TMP/SMX, 160 mg/800 mg b.i.d.) for 5 days. Results were compared with data from 2 placebo-treated historical control populations. Results: The shortest duration of treated diarrhea was seen in the group receiving 200 mg rifaximin t.i. d (NS). Clinical failure to respond to treatment occurred in 6 of 55 (11%) rifaximin-treated subjects versus 5 of 17 (29%) of TMP/SMX-treated subjects (NS). Sixteen of twenty (80%) of the enteropathogens isolated from the rifaximin-treated subjects and 7 of 7 (100%) from the TMP/SMX group were eradicated by treatment (NS). Sixteen of twenty-four (67%) enteropathogens identified were susceptible to TMP and all 24 were inhibited by ≤50 µg/ml of rifaximin. Rifaximin reduced the number of unformed stools passed during the first 24 h of treatment when compared with 2 control placebo groups (3.3 versus 5.1; p = 0.008 and 0.0001) and led to a reduced duration of post-enrollment diarrhea (mean values of 43.1 versus 68.1 and 81.9 h; p = 0.001). Conclusions: Rifaximin shortened the duration of travelers’ diarrhea compared with TMP/SMX and 2 earlier studied placebo-treated groups. A poorly absorbed drug if effective in treating bacterial diarrhea has pharmacologic and safety advantages over the existing drugs.
Malignant hilar and perihilar biliary obstruction: use of MR cholangiography to define the extent of biliary ductal involvement and plan percutaneous interventions.

PURPOSE To determine the usefulness of magnetic resonance (MR) cholangiography in defining the extent of biliary ductal involvement in patients with malignant hilar and perihilar biliary obstruction and to evaluate whether findings at MR cholangiography alone are sufficient to plan percutaneous interventions in these patients. MATERIALS AND METHODS Twenty-nine patients with malignant hilar and perihilar biliary obstruction were examined with MR cholangiography. Two radiologists evaluated MR images and determined the extent of biliary ductal involvement. A hypothetical plan for biliary drainage was established prior to any intervention. All patients underwent percutaneous cholangiography, and 27 of 29 patients also underwent biliary drainage and/or stent placement within 7 days after MR cholangiography. By using direct cholangiography as the standard of reference, the usefulness of MR cholangiography in defining the extent of biliary ductal involvement was determined. The type of drainage performed was compared with the type that had been anticipated at MR cholangiography. RESULTS MR cholangiography was adequate in helping predict the extent of biliary ductal involvement in 28 (96%) of 29 patients and led to underestimation of the extent of the disease in one patient. The therapeutic plan anticipated with MR cholangiography matched the one actually used in 24 (83%) of 29 patients. CONCLUSION The high accuracy of MR cholangiography for defining extent of ductal involvement in patients with malignant hilar and perihilar obstruction allows adequate planning of percutaneous interventions in a majority of patients.
HIV-1 Capsid Inhibitors as Antiretroviral Agents.

BACKGROUND The infectious human immunodeficiency virus (HIV) particle is characterized by a conical capsid that encloses the viral RNA genome. The capsid is essential for HIV-1 replication and plays crucial roles in both early and late stages of the viral life cycle. Early on, upon fusion of the viral and cellular membranes, the viral capsid is released into the host cell cytoplasm and dissociates in a process known as uncoating, tightly associated with the reverse transcription of the viral genome. During the late stages of viral replication, the Gag polyprotein, precursor of the capsid protein, assemble at the plasma membrane to form immature non-infectious viral particles. After a maturation step by the viral protease, the capsid assembles to form a fullerene-like conical shape characteristic of the mature infectious particle. Mutations affecting the uncoating process, or capsid assembly and maturation, have been shown to hamper viral infectivity. The key role of capsid in viral replication and the absence of approved drugs against this protein have promoted the development of antiretrovirals. Screening based on the inhibition of capsid assembly and virtual screening for molecules binding to the capsid have successfully identified a number of potential small molecule compounds. Unfortunately, none of these molecules is currently used in the clinic. CONCLUSION Here we review the discovery and the mechanism of action of the small molecules and peptides identified as capsid inhibitors, and discuss their therapeutic potential.
European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS

Thyroid ultrasound (US) is a key examination for the management of thyroid nodules. Thyroid US is easily accessible, noninvasive, and cost-effective, and is a mandatory step in the workup of thyroid nodules. The main disadvantage of the method is that it is operator dependent. Thyroid US assessment of the risk of malignancy is crucial in patients with nodules, in order to select those who should have a fine needle aspiration (FNA) biopsy performed. Due to the pivotal role of thyroid US in the management of patients with nodules, the European Thyroid Association convened a panel of international experts to set up European guidelines on US risk stratification of thyroid nodules. Based on a review of the literature and on the American Association of Clinical Endocrinologists, American Thyroid Association, and Korean guidelines, the panel created the novel European Thyroid Imaging and Reporting Data System, called EU-TIRADS. This comprises a thyroid US lexicon; a standardized report; definitions of benign and low-, intermediate-, and high-risk nodules, with the estimated risks of malignancy in each category; and indications for FNA. Illustrated by numerous US images, the EU-TIRADS aims to serve physicians in their clinical practice, to enhance the interobserver reproducibility of descriptions, and to simplify communication of the results.
Through the Eyes of the Beholder: Simulated Eye-Movement Experience (“SEE”) Modulates Valence Bias in Response to Emotional Ambiguity

Although some facial expressions provide clear information about people’s emotions and intentions (happy, angry), others (surprise) are ambiguous because they can signal both positive (e.g., surprise party) and negative outcomes (e.g., witnessing an accident). Without a clarifying context, surprise is interpreted as positive by some and negative by others, and this valence bias is stable across time. When compared to fearful expressions, which are consistently rated as negative, surprise and fear share similar morphological features (e.g., widened eyes) primarily in the upper part of the face. Recently, we demonstrated that the valence bias was associated with a specific pattern of eye movements (positive bias associated with faster fixation to the lower part of the face). In this follow-up, we identified two participants from our previous study who had the most positive and most negative valence bias. We used their eye movements to create a moving window such that new participants viewed faces through the eyes of one our previous participants (subjects saw only the areas of the face that were directly fixated by the original participants in the exact order they were fixated; i.e., Simulated Eye-movement Experience). The input provided by these windows modulated the valence ratings of surprise, but not fear faces. These findings suggest there are meaningful individual differences in how people process faces, and that these differences impact our emotional perceptions. Furthermore, this study is unique in its approach to examining individual differences in emotion by creating a new methodology adapted from those used primarily in the vision/attention domain.
Gradual Adaptation Toward a Range-Expansion Phenotype Initiated the Global Radiation of Toads

Evolutionary Hops In order for animals to colonize new environments and disperse, specific traits may be required. Toads form a large and ecologically diverse group and have achieved extremely wide distribution in a very short time frame. To test what traits may be associated with species range in modern toads, Van Bocxlaer et al. (p. 679; see the news story by Pennisi) phylogenetically reconstructed the evolutionary history of morphological and physiological traits linked to the toads' geographic ranges. Toads have evolved an optimal dispersal phenotype comprising many traits, including those affecting reproductive choices and water retention, which preceded their expansion and radiation. The range expansions and species radiations of toads required the evolution of an optimal dispersal phenotype. Recent studies have identified range expansion as a potential driver of speciation. Yet it remains poorly understood how, under identical extrinsic settings, differential tendencies for geographic movement of taxa originate and subsequently affect diversification. We identified multiple traits that predict large distributional ranges in extant species of toads (Bufonidae) and used statistical methods to define and phylogenetically reconstruct an optimal range-expansion phenotype. Our results indicate that lineage-specific range-shifting abilities increased through an accumulation of adaptive traits that culminated in such a phenotype. This initiated the episode of global colonization and triggered the major radiation of toads. Evolution toward a range-expansion phenotype might be crucial to understanding both ancient widespread radiations and the evolutionary background of contemporary invasive species such as the cane toad.
Analysis of ThinPrep cytology in establishing the diagnosis of small cell carcinoma of lung

ThinPrep liquid‐based cytology (TP) preparations are being used increasingly in nongynecologic specimens. To the authors' knowledge, few studies to date have evaluated TP cytology in the setting of small cell carcinoma of the lung (SCCL). Accurately differentiating SCCL from other lung tumors has important clinical and therapeutic implications. Herein, the authors evaluated the diagnostic utility and cytomorphology of TP in the setting of SCCL.
Early administration of probiotic Lactobacillus acidophilus and/or prebiotic inulin attenuates pathogen-mediated intestinal inflammation and Smad 7 cell signaling.

Immaturity of gut-associated immunity may contribute to pediatric mortality associated with enteric infections. A murine model to parallel infantile enteric disease was used to determine the effects of probiotic, Lactobacillus acidophilus (La), prebiotic, inulin, or both (synbiotic, syn) on pathogen-induced inflammatory responses, NF-κB, and Smad 7 signaling. Newborn mice were inoculated bi-weekly for 4 weeks with La, inulin, or syn and challenged with Citrobacter rodentium (Cr) at 5 weeks. Mouse intestinal epithelial cells (CMT93) were exposed to Cr to determine temporal alterations in NF-Kappa B and Smad 7 levels. Mice with pretreatment of La, inulin, and syn show reduced intestinal inflammation following Cr infection compared with controls, which is associated with significantly reduced bacterial colonization in La, inulin, and syn animals. Our results further show that host defense against Cr infection correlated with enhanced colonic IL-10 and transforming growth factor-β expression and inhibition of NF-κB in syn-treated mice, whereas mice pretreated with syn, La, or inulin had attenuation of Cr-induced Smad 7 expression. There was a temporal Smad 7 and NF-κB intracellular accumulation post-Cr infection and post-tumor necrosis factor stimulation in CMT93 cells. These results, therefore, suggest that probiotic, La, prebiotic inulin, or synbiotic may promote host-protective immunity and attenuate Cr-induced intestinal inflammation through mechanisms affecting NF-κB and Smad 7 signaling.
Epidural analgesia, intrapartum fever, and neonatal sepsis evaluation.

OBJECTIVE Although several studies have documented an increase in maternal temperature associated with use of epidural analgesia during labor, none have investigated the impact of epidural use on the rate of intrapartum fever or the consequences for the fetus and newborn of this elevated maternal temperature. This study evaluates the impact of epidural analgesia use during labor on the rate of intrapartum fever and the performance of neonatal sepsis evaluations and treatment with antibiotics. METHODS We studied 1657 nulliparous women with term pregnancies and singleton vertex fetuses who were afebrile at admission for delivery. The rates of maternal intrapartum fever >100.4 degrees F, neonatal sepsis evaluation, and neonatal antibiotic treatment according to use of epidural analgesia during labor were determined. Rate ratios and 95% confidence intervals (CI) were calculated. Multiple logistic regression was used to examine associations while controlling for confounding factors. RESULTS Intrapartum fever >100.4 degrees F occurred in 14.5% of women receiving an epidural but only 1.0% of women not receiving an epidural (adjusted odds ratio (OR) = 14.5, 95% CI = 6.3, 33.2). Without epidural, the rate of fever remained low regardless of length of labor; with epidural, the rate of fever increased from 7% for labors < or = 6 hours to 36% for labors >18 hours. Neonates whose mothers received epidurals were more often evaluated for sepsis (34.0% vs 9.8%; adjusted OR = 4.3, 95% CI = 3.2, 5.9) and treated with antibiotics (15.4% vs 3.8%; adjusted OR = 3.9, 95% CI = 2.1, 6.1). Although 63% of women received epidurals, 96.2% of intrapartum fevers, 85.6% of neonatal sepsis evaluations, and 87.5% of neonatal antibiotic treatment occurred in the epidural group. CONCLUSIONS Use of epidural analgesia during labor is strongly associated with the occurrence of maternal intrapartum fever, neonatal sepsis evaluations, and neonatal antibiotic treatment.
Engraftment after myeloablative doses of 131I-metaiodobenzylguanidine followed by autologous bone marrow transplantation for treatment of refractory neuroblastoma.

BACKGROUND Metaiodobenzylguanidine (MIBG) labeled with 131I has been used for targeted radiotherapy of neural crest tumors, with bone marrow suppression being the primary dose-limiting toxicity. The purpose of this study was to examine the engraftment and toxicity of higher myeloablative doses of 131I-MIBG with autologous bone marrow support. PROCEDURE Twelve patients with refractory neuroblastoma were given infusions of their autologous, cryopreserved bone marrow following 1-4 doses of 131I-MIBG. The median cumulative administered activity per kilogram of 131I-MIBG was 18.0 mCi/kg (range 14.1-50.2 mCi/kg), the median total activity was 594 mCi (range 195-1,353 mCi), and the median cumulative whole body irradiation from 131I-MIBG was 426 cGy (range 256-800 cGy). A median of 2.5 x 10(8) viable cells/kg (range 0.9-4.7 x 10(8) cells/kg) was given in the bone marrow infusion. RESULTS All 12 patients achieved an absolute neutrophil count > 500/microliter with a median of 19 days, but only 5/11 evaluable patients achieved red cell transfusion independence, in a median of 44 days; and 4/11 evaluable patients achieved platelet count > 20,000/microliter without transfusion, in a median of 27 days. CONCLUSIONS Autologous bone marrow transplantation may allow complete hematopoietic reconstitution following ablative 131I-MIBG radiotherapy in patients with neuroblastoma. Risk factors for lack of red cell or platelet recovery include extensive prior chemotherapy, progressive disease at the time of transplant, especially in the bone marrow, and a history of prior myeloablative therapy with stem cell support.
Pivotal Politics as Normal Science

Pivotal Politics: A Theory of U.S. Lawmaking was conceived as an instance of normal science within a nascent but nebulous paradigm. In the two decades following publication of the book, three disciplinary changes are noteworthy. First, the paradigm in which much political science is conducted has become more clearly identifiable. Second, more scholars are working within the emerging paradigm. Third, adherence to the paradigm’s norms of good research practice has become more consistent. This essay explicates four conceptually distinct but implicit components of the paradigm. Labeled the Components of Institutional Analysis, the framework has many uses. Several of these are illustrated with reference to Pivotal Politics and to the subsequent, constructively critical literature. The preponderance of this scholarship is normal science in the best sense. In its entirety, paradigm-guided research on institutions comports well with William Riker’s prognosis for a science of politics and Gerald Kramer’s requirements for scientific understanding.
Red blood cell storage lesion.

OBJECTIVE To summarize current understanding of the mechanisms responsible for changes occurring during red blood cell (RBC) storage, collectively known as the storage lesion, and to review the biological and clinical consequences of increasing storage time of RBCs. DATA SOURCES Human and veterinary clinical studies, experimental animal model studies, and reviews of the RBC storage lesion with no date restrictions. HUMAN DATA SYNTHESIS Experimental studies have characterized the evolution of human RBC and supernatant changes that occur during storage and form the basis for concern about the potential for harm from long-term storage of RBCs. Although 4 randomized controlled trials of varying sizes failed to find an association between RBC storage time and negative clinical outcomes, a recent meta-analysis and numerous observational clinical studies have demonstrated that transfusion of old versus fresh stored RBCs is associated with an increased risk of morbidity and mortality, particularly among trauma victims and cardiac surgery patients. Potential clinical consequences of RBC transfusion following development of the storage lesion include risk of organ dysfunction, organ failure, infections, and death. VETERINARY DATA SYNTHESIS Experimental animal models have contributed to the evidence supporting adverse consequences of the RBC storage lesion. Studies on relevant RBC storage issues such as the effect of different preservative solutions and leukoreduction have been completed. Transfusion with RBCs stored for 42 days increases mortality in dogs with experimental sepsis. CONCLUSION Storage of RBCs induces progressive biochemical, biomechanical, and immunologic changes that affect red cell viability, deformability, oxygen carrying capacity, microcirculatory flow, and recipient response. Most reports in the human and veterinary literature support the concept that there are deleterious effects of the RBC storage lesion, but additional studies with improved experimental design are needed to identify compelling reasons to modify current blood banking and transfusion practices.