Miracle-dz/UniFAR-FTUs huggingface dataset:
Facial Dog Bite Injuries in Children: Treatment and Outcome Assessment

AbstractDog bite injuries to a child’s face are not an infrequent occurrence. They may require primary and revisional surgery. All result in permanent facial scars. This report describes the treatment and outcomes of dog bites of the face, scalp, and neck based on a case series of 107 children over a 10-year period.The average children’s age was 5.9 years. In cases where the dog was identified (95%), it was known to the victim and their family. The events leading to the dog bite were categorized as provoked (77%) in the majority of the cases.The majority of wounds could be closed primarily without a significant risk of wound infection. Complex reconstructions were required in more severe cases. The majority of families (77%) opted for scar revision between 9 and 18 months after initial treatment to improve the aesthetic outcome.Lawsuit actions resulted in 39 of the cases making good documentation an essential part of treatment.Dogbite injuries to the face in children frequently require multiple scar revisions to obtain the best possible aesthetic outcome, and the family should be so counseled at the onset of treatment.
Pilot study of DCE-MRI to predict progression-free survival with sorafenib therapy in renal cell carcinoma

Background: The investigation of angiogenesis inhibitors is of particular interest in renal cell carcinoma (RCC), in which dysregulated blood vessel formation has been correlated with shortened survival. Sorafenib is a novel RAF and VEGF receptor tyrosine kinase inhibitor. We conducted this study to (a) determine if sorafenib is anti-angiogenic, and (b) to relate anti-angiogenic effect to outcome. Patients and Methods: Seventeen patients with metastatic RCC underwent dynamic- contrast enhanced magnetic resonance imaging (DCE-MRI). DCE-MRI was used to calculate the gadolinium exchange constant between blood and tumor interstitial tissue, Ktrans. Results: Four patients achieved partial response by WHO criteria (ORR 24%). Median time to progression (TTP) was 12.9 months. Ktrans decreased significantly during treatment with sorafenib (60.3% decline, 95% CI 46.1-74.6%). The percent decline in Ktrans and change in tumor size by CT scan were significantly associated with progression-free survival (p=0.01and 0.05, respectively). In addition, Ktrans at baseline was also significantly associated with progress-free survival (p = 0.02). Conclusions: In patients with RCC, inhibition of tumor vascular permeability by sorafenib was associated with improved outcome. Moreover, baseline tumor vascular permeability, expected to be a poor prognosis factor, was a predictive marker of favorable response to therapy.
A 7 gene signature identifies the risk of developing cirrhosis in patients with chronic hepatitis C

Clinical factors such as age, gender, alcohol use, and age‐at‐infection influence the progression to cirrhosis but cannot accurately predict the risk of developing cirrhosis in patients with chronic hepatitis C (CHC). The aim of this study was to develop a predictive signature for cirrhosis in Caucasian patients. All patients had well‐characterized liver histology and clinical factors; DNA was extracted from whole blood for genotyping. We validated all significant markers from a genome scan in the training cohort, and selected 361 markers for the signature building. Using a “machine learning” approach, a signature consisting of markers most predictive for cirrhosis risk in Caucasian patients was developed in the training set (N = 420). The Cirrhosis Risk Score (CRS) was calculated to estimate the risk of developing cirrhosis for each patient. The CRS performance was then tested in an independently enrolled validation cohort of 154 Caucasian patients. A CRS signature consisting of 7 markers was developed for Caucasian patients. The area‐under‐the‐ROC curves (AUC) of the CRS was 0.75 in the training cohort. In the validation cohort, AUC was only 0.53 for clinical factors, increased to 0.73 for CRS, and 0.76 when CRS and clinical factors were combined. A low CRS cutoff of <0.50 to identify low‐risk patients would misclassify only 10.3% of high‐risk patients, while a high cutoff of >0.70 to identify high‐risk patients would misclassify 22.3% of low‐risk patients. Conclusion: CRS is a better predictor than clinical factors in differentiating high‐risk versus low‐risk for cirrhosis in Caucasian CHC patients. Prospective studies should be conducted to further validate these findings. (HEPATOLOGY 2007.)
Azithromycin paradox in the treatment of cystic fibrosis airway disease.

Evaluation of: Saiman L, Anstead M, Mayer-Hamblett N et al.: Effect of azithromycin on pulmonary function in patients with cystic fibrosis uninfected with Pseudomonas aeruginosa: a randomized controlled trial. JAMA 303(17), 1707–1715 (2010). Chronic airway infection and inflammation are hallmarks of cystic fibrosis (CF). Disease progression can be described as chronic inflammation punctuated by acute exacerbations with overt immunological responses. Macrolide antibiotics, which have both immunomodulatory and antibacterial activities, have been shown to be beneficial in the management of CF airway disease, although the mechanism of action is unknown. It is also unclear whether all patients, particularly those not colonized with Pseudomonas aeruginosa, benefit from this treatment. In this article, Saiman et al. examine the effects of azithromycin on lung function in pediatric and adolescent CF patients who are not colonized with P. aeruginosa. The data indicate beneficial effects of azithromycin treatment a.
Shining LIGHT on the metabolic role of the cytokine TNFSF14 and the implications on hepatic IL‐6 production

The cytokine Tumor Necrosis Factor Superfamily member 14, TNFSF14 (or LIGHT), is a controversial player in numerous diseases. We investigated the role of endogenously expressed TNFSF14 in diet‐induced obesity in vivo. Firstly, we studied the effects of Tnfsf14 ablation on the development of obesity, glucose intolerance, insulin resistance, steatosis, tissue inflammation, and mitochondrial respiration in the liver. Secondly, we examined the role of TNFSF14 expression in hematopoietic cells on obesity and insulin sensitivity. Male Tnfsf14 knockout (KO) and wild type mice were fed chow or high fat diet (HFD) for 12 weeks and were assessed for weight gain, glucose intolerance, insulin resistance, hepatosteatosis, mitochondrial dysfunction, and cytokine expression. Wild‐type mice were also reconstituted with bone marrow cells from Tnfsf14 knockout mice and were fed chow or HFD for 12 weeks. These mice were examined for weight gain and insulin resistance. HFD fed mice had elevated circulating levels of serum TNFSF14. Liver and white adipose tissue are potential sources of this elevated TNFSF14. Tnfsf14 deficient mice displayed increased obesity, glucose intolerance, insulin resistance, hepatosteatosis, and mitochondrial dysfunction compared to control mice on a HFD. Hepatic cytokine profiling pointed to a potential novel role of decreased IL‐6 in the metabolic disturbances in obesogenic Tnfsf14 knockout mice. Bone marrow cells from Tnfsf14 deficient mice appeared to promote diet‐induced obesity, insulin resistance and reduced FGF21 levels in white adipose tissue and liver. Our novel data suggest that Tnfsf14 ablation exacerbates parameters of the metabolic syndrome under high fat feeding conditions and provides evidence to support the development of TNFSF14 agonists as potential therapeutics in diet‐induced obesity.
Expression of CD14, CD16 and CD45RA on monocytes from periodontitis patients.

BACKGROUND AND OBJECTIVE Peripheral blood monocytes are a heterogeneous population, with phenotypes that change on activation or differentiation. Most of the monocytes express lipopolysaccharide (LPS) receptor, CD14 intensely, and do not express Fc gamma receptor III, CD16 (CD14++CD16- monocytes). But monocytes expressing CD16 with reduced CD14 (CD14+CD16+ monocytes) increase in inflammatory diseases as well as sepsis and bacteremia in hemodialysis patients. CD45RA is expressed on activated monocytes, and is regarded as an activation marker of peripheral blood monocytes. The purpose of this study was to determine the phenotypic and functional alteration of monocytes in periodontitis patients. METHODS Peripheral blood was collected from 33 aggressive periodontitis patients (22 females, 11 males), 55 chronic periodontitis patients (35 females, 20 males) and 30 healthy subjects (16 females, 14 males), and the expression of CD14, CD16 and CD45RA on monocytes was determined using flow cytometry. The production of interleukin-6 (IL-6) by CD16+ and CD16- monocytes stimulated with LPS from Escherichia coli and Actinobacillus actinomycetemcomitans was also examined using flow cytometry. RESULTS The percentage of CD14+CD16+ monocytes was significantly increased in chronic periodontitis patients. Percentage of monocytes expressing CD45RA was significantly increased in aggressive periodontitis patients compared to healthy subjects. CD16+ and CD16- monocytes produced IL-6 in response to LPS from E. coli and A. actinomycetemcomitans, and the percentage of IL-6 producing cells was higher in CD16+ monocytes than CD16- monocytes, suggesting that CD14+CD16+ monocytes represent a hyper-reactive phenotype. CONCLUSIONS The present study demonstrated that CD14+CD16+ monocytes and CD45RA+ monocytes were increased in chronic and aggressive periodontitis, respectively. These findings suggest that alteration of monocytes in periodontitis patients could be evaluated by monitoring the surface expression of CD14, CD16 and CD45RA on monocytes.
High expression levels of the ETS-related gene, ERG, predict adverse outcome and improve molecular risk-based classification of cytogenetically normal acute myeloid leukemia: a Cancer and Leukemia Group B Study.

PURPOSE To validate ERG overexpression as an adverse predictor and assess its prognostic value in the context of other molecular markers in cytogenetically normal (CN) -acute myeloid leukemia (AML). PATIENTS AND METHODS Seventy-six adult patients with primary CN-AML, younger than 60 years and treated on Cancer and Leukemia Group B (CALGB) trial 19808, were evaluated for ERG expression by quantitative reverse transcriptase polymerase chain reaction. They were then combined with 72 patients enrolled onto CALGB 9621 for analyses that included other molecular markers. RESULTS Similar to patients enrolled onto CALGB 9621, high ERG expressers on CALGB 19808 had fewer complete remissions (CRs; P = .03) and worse event-free survival (EFS; P = .016) than low ERG expressers. In the combined set, high expressers (n = 55) had fewer CRs (P = .004) and shorter EFS (P < .001) than low expressers (n = 93). High ERG predicted failure to achieve CR (P = .004) after adjusting for BAALC expression (P = .04) and age (P = .008), and EFS (P = .004) after adjusting for FLT3 internal tandem duplication (ITD; P < .001). Among patients without FLT3-ITD (FLT3-ITD negative), only high ERG predicted shorter EFS (P = .001). Among NPM1-mutated (NPM1 positive) patients, high ERG predicted shorter EFS (P = .003), after adjusting for FLT3-ITD (P < .001). When all three markers were considered together, in the favorable FLT3-ITD-negative/NPM1-positive subset, high ERG was the only factor predicting shorter EFS (P = .002). CONCLUSION We validated ERG overexpression as an adverse predictor in CN-AML. Moreover, by using ERG expression levels, we improved the previously proposed molecular-risk classification of CN-AML based on the presence or absence of FLT3-ITD and NPM1 mutations, given that we identified subsets with different outcome among FLT3-ITD-negative, NPM1-positive, and FLT3-ITD-negative/NPM1-positive patients.
Weighting and valuing quality-adjusted life-years using stated preference methods: preliminary results from the Social Value of a QALY Project.

OBJECTIVES To identify characteristics of beneficiaries of health care over which relative weights should be derived and to estimate relative weights to be attached to health gains according to characteristics of recipients of these gains (relativities study); and to assess the feasibility of estimating a willingness-to-pay (WTP)-based value of a quality-adjusted life-year (QALY) (valuation study). DESIGN Two interview-based surveys were administered - one (for the relativities study) to a nationally representative sample of the population in England and the other (for the valuation study) to a smaller convenience sample. SETTING The two surveys were administered by the National Centre for Social Research (NatCen) in respondents' homes. PARTICIPANTS 587 members of the public were interviewed for the relativities study and 409 for the valuation study. METHODS In the relativities study, in-depth qualitative work and considerations of policy relevance resulted in the identification of age and severity of illness as relevant characteristics. Scenarios reflecting these, along with additional components reflecting gains in QALYs, were presented to respondents in a series of pairwise choices using two types of question: discrete choice and matching. These questions were part of a longer questionnaire (including attitudinal and sociodemographic questions), which was administered face to face using a computer-assisted personal interview. In the valuation study, respondents were asked about their WTP to avoid/prevent different durations of headache or stomach illness and to value these states on a scale (death = 0; full health = 1) using standard gamble (SG) questions. RESULTS Discrete choice results showed that age and severity variables did not have a strong impact on respondents' choices over and above the health (QALY) gains presented. In contrast, matching showed age and severity impacts to be strong: depending on method of aggregation, gains to some groups were weighted three to four times more highly than gains to others. Results from the WTP and SG questions were combined in different ways to arrive at values of a QALY. These vary from values which are in the vicinity of the current National Institute for Health and Clinical Excellence (NICE) threshold to extremely high values. CONCLUSIONS With respect to relative weights, more research is required to explore methodological differences with respect to age and severity weighting. On valuation, there are particular issues concerning the extent to which 'noise' and 'error' in people's responses might generate extreme and unreliable figures. Methods of aggregation and measures of central tendency were issues in both weighting and valuation procedures and require further exploration.
A Model for the Rice and Wheat Economy in Malaysia: An Empirical Assessment of Alternative Specifications

A model of the Malaysian rice and wheat economy is specified and fitted to data from 1960-87. Several diagnostic tests were employed in the analysis to determine the specification of the model. The present work incorporates the interaction between rice and wheat. The estimate for the short-run supply price elasticity is 0.03 while the long-run price elasticity is estimated at 0.11. The matrix of price and income elasticities obtained from the demand analysis indicates that the own-price elasticities are less than unity. The present work supports the hypothesis that rice is an inferior good while wheat is normal. The leVel of imports depends on domestic supply, income level and domestic prices of rice and wheat.
CD8 Lymphocytes are Sufficient for the Development of Chronic Rejection

Background. The role of CD8 lymphocytes, in chronic rejection or cardiac allograft vasculopathy (CAV), is incompletely understood. The purposes of this study were to determine whether CD8 lymphocytes, in the absence of CD4 lymphocytes, are capable of causing the intimal lesions of CAV; and if so, to define the effector mechanism(s) of CD8 lymphocytes. Methods. We modified a previously characterized major histocompatibility complex class II mismatched murine model of CAV. Wild-type CD8 lymphocytes were transferred to nude mice followed by heterotopic heart transplantation. Recipient mice were then treated with a CD40 activating antibody, which is known to provide help for CD8 lymphocyte activation, in the absence of CD4 lymphocytes. Donor hearts were harvested on day 40 posttransplantation and analyzed for cellular infiltrates and intimal thickening. In separate experiments, isolated perforin −/−, Fas ligand (FasL) −/−, and interferon (IFN)-&ggr; −/− CD8 lymphocytes were transferred to nude mice followed by identical experimented protocol. Results. With adaptive transfer of wild-type CD8 lymphocytes, the donor hearts were infiltrated with activated CD8 lymphocytes and displayed significant intimal lesions. Adoptive transfer of perforin −/− and FasL −/− CD8 lymphocytes to nude mice resulted in similar patterns of CD8 lymphocyte infiltration and similar severity of intimal lesions. The donor hearts from IFN-&ggr; −/− CD8 lymphocyte reconstituted recipients displayed minimal intimal lesions, although CD8 lymphocytes were present in the allografts. Conclusions. Unprimed CD8 lymphocytes in the absence of CD4 lymphocytes can cause intimal lesions of CAV. CD8 lymphocytes production of IFN-&ggr;, but not the perforin or the FasL-mediated cytotoxicity, is the critical step in the development of intimal lesions.
Predictive Modeling of the Shelf Life of Fish under Nonisothermal Conditions

ABSTRACT The behavior of the natural microflora of Mediterannean gilt-head seabream (Sparus aurata) was monitored during aerobic storage at different isothermal conditions from 0 to 15°C. The growth data of pseudomonads, established as the specific spoilage organisms of aerobically stored gilt-head seabream, combined with data from previously published experiments, were used to model the effect of temperature on pseudomonad growth using a Belehradek type model. The nominal minimum temperature parameters of the Belehradek model (Tmin) for the maximum specific growth rate (μmax) and the lag phase (tLag) were determined to be −11.8 and −12.8°C, respectively. The applicability of the model in predicting pseudomonad growth on fish at fluctuating temperatures was evaluated by comparing predictions with observed growth in experiments under dynamic conditions. Temperature scenarios designed in the laboratory and simulation of real temperature profiles observed in the fish chill chain were used. Bias and accuracy factors were used as comparison indices and ranged from 0.91 to 1.17 and from 1.11 to 1.17, respectively. The average percent difference between shelf life predicted based on pseudomonad growth and shelf life experimentally determined by sensory analysis for all temperature profiles tested was 5.8%, indicating that the model is able to predict accurately fish quality in real-world conditions.
Ask Me 3: improving communication in a Hispanic pediatric outpatient practice.

OBJECTIVE To implement Ask-Me-3, a program that encourages patients to ask questions of physicians, in a low-income, predominantly Hispanic pediatric practice. METHODS We publicized Ask-Me-3 with posters/brochures in clinic. We interviewed parents before and 6 months after implementation to determine if they knew about and used the Ask-Me- 3 questions. RESULTS No parents knew about Ask-Me-3 before implementation. Of 393 parents interviewed 6 months later, 42% knew about Ask-Me-3, and half of these used the questions. CONCLUSIONS With a simple strategy for introducing Ask-Me-3, 20% of parents were using Ask-Me-3 six months later.
Aliso: A Journal of Systematic and Evolutionary Botany Molecular Phylogenetics of Bromus (Poaceae: Pooideae) Based on Chloroplast and Nuclear DNA Sequence Data

We conducted a phylogenetic analysis to characterize relationships among Bromus and test the monophyly of ﬁve of the seven morphologically distinct groups within Bromus (Poaceae: Pooideae) that have been treated as sections, subgenera, or genera. We sequenced the chloroplast trn L (UAA) intron, the 3 ! -end of the chloroplast ndh F gene, and the internal transcribed spacers (ITS) of the nuclear ribosomal DNA region for 46 species that represent a large proportion of the morphological and geographical diversity in the genus. Independent analyses of plastid and nuclear ribosomal data identiﬁed several lineages in Bromus, but there is some evidence of incongruence between these linkage groups. Nuclear ribosomal trees indicate that two clades comprising some North and South American species of sect. Bromopsis are the successive sister groups of the rest of the genus, and that Old World species of sect. Bromopsis are more closely related to sects. Ceratochloa and Neobromus than they are to the remaining North American species of sect. Bromopsis. In contrast, plastid trees indicate a close relationship between Old World and some North American species of sect. Bromopsis. In the nuclear ribosomal trees, sects. Genea and Bromus (if sect. Triniusia is included within it, as treated by most authors) are monophyletic and not closely related. In the plastid trees, species of these two sections are intermixed, supporting a hybrid origin for B. pectinatus. The monophyly of sect. Cera- tochloa is supported in the plastid and nuclear ribosomal trees, and the monophyly of sect. Neobromus is robustly supported in the nuclear ribosomal trees. Current classiﬁcation schemes do not reﬂect phylogenetic relationships in Bromus. Tentative evidence of conﬂict among nuclear and plastid data partitions needs clariﬁcation with more robustly supported plastid and nuclear ribosomal gene trees.
Standardization of Prothrombin Time for Laboratory Control of Oral Anticoagulant Therapy

Laboratory monitoring of oral anticoagulants is mandatory to ensure efficacy and safety of therapy. The test of choice is the prothrombin time (PT), using thromboplastins, which vary markedly in respect of the defect induced by oral anticoagulants. Standardization is improved by the use of the WHO calibration model for thromboplastins. This system defines the International Sensitivity Index (ISI) of a reagent in relation to a reference material. This is then used together with a locally determined mean normal PT to derive the International Normalized Ratio (INR). There is an inverse relationship between sensitivity and ISI, the lower the ISI the greater is the sensitivity of the reagent. There are important practical advantages to using a sensitive reagent with ISI of 1.2 or less. The ISI system was originally designed for manual tests and in some cases the ISI is influenced by the use of coagulometers, which generally have the effect of lowering the ISI. For this reason the ISI should be assigned for the combination of reagent and endpoint detection system. A thromboplastin should not be used with techniques for which the ISI is unknown. In some instances there is variation between instruments of the same type, in which case a local calibration using plasma calibrants with assigned values can be considered. The precise requirements for such local calibrations are presently the subject of research in a number of centers. The INR/ISI system is increasingly being adopted in many countries for anticoagulant therapy. Some past difficulties leading to discrepancies between results with different reagents have now been resolved and the view that this is the best available system for standardization of the PT for monitoring oral anticoagulants is widely held.