Miracle-dz/UniFAR-FTUs huggingface dataset:
Burch colposuspension versus fascial sling to reduce urinary stress incontinence.

BACKGROUND Many surgical procedures are available for women with urinary stress incontinence, yet few randomized clinical trials have been conducted to provide a basis for treatment recommendations. METHODS We performed a multicenter, randomized clinical trial comparing two procedures--the pubovaginal sling, using autologous rectus fascia, and the Burch colposuspension--among women with stress incontinence. Women were eligible for the study if they had predominant symptoms associated with the condition, a positive stress test, and urethral hypermobility. The primary outcomes were success in terms of overall urinary-incontinence measures, which required a negative pad test, no urinary incontinence (as recorded in a 3-day diary), a negative cough and Valsalva stress test, no self-reported symptoms, and no retreatment for the condition, and success in terms of measures of stress incontinence specifically, which required only the latter three criteria. We also assessed postoperative urge incontinence, voiding dysfunction, and adverse events. RESULTS A total of 655 women were randomly assigned to study groups: 326 to undergo the sling procedure and 329 to undergo the Burch procedure; 520 women (79%) completed the outcome assessment. At 24 months, success rates were higher for women who underwent the sling procedure than for those who underwent the Burch procedure, for both the overall category of success (47% vs. 38%, P=0.01) and the category specific to stress incontinence (66% vs. 49%, P<0.001). However, more women who underwent the sling procedure had urinary tract infections, difficulty voiding, and postoperative urge incontinence. CONCLUSIONS The autologous fascial sling results in a higher rate of successful treatment of stress incontinence but also greater morbidity than the Burch colposuspension. (ClinicalTrials.gov number, NCT00064662 [ClinicalTrials.gov] .).
Diagnosis of Crohn's Ileitis and Monitoring of Disease Activity: Value of Doppler Ultrasound of Superior Mesenteric Artery Flow

Objective:To assess the value of measurements of superior mesenteric artery flow using Doppler ultrasound for detecting disease activity in patients with proven or suspected Crohn's disease.Methods:Superior mesenteric artery flow was measured prospectively in 31 patients with known or suspected small-bowel disease. Sixteen patients were known to suffer from Crohn's disease and were suspected of having active disease. Fifteen patients had abdominal complaints without a specific diagnosis. Enteroclysis was used as the standard of reference to detect Crohn's disease, to define the location of small-bowel Crohn's disease, and to assess disease activity by demonstrating cobblestoning. Disease activity was further substantiated by clinical signs, laboratory values, and clinical follow-up.Results:Ten patients with active disease on enteroclysis made up group 1. Group 2 comprised nine patients known to have Crohn's disease but without active disease (inactive small-bowel disease). The remaining 12 patients made up group 3. In group 1, the flow volume values were significantly higher than those in group 2 and group 3:738 ± 411 (mean ± SD) versus364 ± 101 and 300 ± 91, respectively (p < 0.05). Conclusions:Whereas the initial diagnosis of small-bowel involvement in Crohn's disease may rely on enteroclysis, Doppler measurements of superior mesenteric artery flow are useful to monitor the activity of Crohn's disease.
Compressed Sensing Based Real-Time Dynamic MRI Reconstruction

This work addresses the problem of real-time online reconstruction of dynamic magnetic resonance imaging sequences. The proposed method reconstructs the difference between the previous and the current image frames. This difference image is sparse. We recover the sparse difference image from its partial k-space scans by using a nonconvex compressed sensing algorithm. As there was no previous fast enough algorithm for real-time reconstruction, we derive a novel algorithm for this purpose. Our proposed method has been compared against state-of-the-art offline and online reconstruction methods. The accuracy of the proposed method is less than offline methods but noticeably higher than the online techniques. For real-time reconstruction we are also concerned about the reconstruction speed. Our method is capable of reconstructing 128 × 128 images at the rate of 6 frames/s, 180 × 180 images at the rate of 5 frames/s and 256 × 256 images at the rate of 2.5 frames/s.
Prevalence of health problems and primary care physicians' specialty referral decisions.

OBJECTIVE The researchers tested the hypothesis that the frequency with which patients present to primary care physicians with certain types of health problems is inversely related to the chances of specialty referral during an office visit. STUDY DESIGN Cross-sectional analysis. POPULATION The researchers used a data set composed of 78,107 primary care visits from the 1989 to 1994 National Ambulatory Medical Care Surveys. The physicians completed questionnaires after office visits. OUTCOMES MEASURED The frequency of a health problem's presentation to primary care (practice prevalence) was defined as the percentage of all visits made to family physicians, general internists, and general pediatricians for that particular problem. The researchers estimated the correlation between a condition's practice prevalence and its referral ratio (percentage of visits referred to a specialist) and used logistic regression to estimate the effect of practice prevalence on the chances of referral during a visit. RESULTS The practice prevalence of a condition and its referral rate had a strong inverse linear relationship (r=-0.87; P<.001). Compared with visits made for the uncommon problems, the odds of referral for those with intermediate or high practice prevalence were 0.49 (P=.004) and 0.22 (P<.001), respectively. Surgical conditions were referred more often than medical conditions, and a greater burden of comorbidities increased the odds of referral. CONCLUSIONS Primary care physicians are more likely to make specialty referrals for patients with uncommon problems than those with common conditions This finding highlights the responsible judgment primary care physicians employ in recognizing the boundaries of their scope of practice. Practice prevalence is a defining feature of the primary care-specialty care interface.
Identification of distinct antigenic determinants on Semliki Forest virus by using monoclonal antibodies with different antiviral activities

Fifteen monoclonal antibodies (MAs) directed against either the E1 or E2 glycoprotein of Semliki Forest virus (SFV) were characterized by immunoglobulin subclass, pI traject, hemagglutination inhibition, neutralization of infectious virus, and protection against virulent infection in mice. All MAs except UM8.4 (immunoglobulin M [IgM]) belonged to various subclasses of IgG and predominantly to IgG2a, but all were unique as indicated by their banding patterns in isoelectric focusing. Competitive binding assays with these MAs revealed the presence of at least six distinct antigenic determinants (epitopes) on the E1 glycoprotein and five epitopes on the E2 glycoprotein. Two of the epitopes on E1, as defined by the properties of the MAs, were associated with hemagglutination inhibition (E1c and E1d), three were associated with neutralization (E1a, E1b, and E1f), and five were associated in various degrees with protection (E1a, E1b, E1c, E1e, and E1f) of mice against virulent SFV infection. With the MAs against E2, the epitopes on E2 were similarly defined. Epitopes E2b and E2e were associated with hemagglutination inhibition, E2c and E2d were associated with neutralization, and three epitopes were associated with in vivo protection (E2a, E2c, and E2d). Furthermore, for each MA the relative avidity to purified SFV was determined with an enzyme-linked immunosorbent assay. The binding of some MAs to purified SFV was enhanced by a second MA. The relative avidities of individual MAs did not correlate with their neutralizing capacities. From the results, we suggest that the amino acid sequence which makes up determinant E2d and is recognized by the highly protective MA UM5.1 is an excellent candidate for the production of a synthetic vaccine.
Alcohol-Use Disorder and Severe Mental Illness

Alcohol-use disorders (AUD’s) commonly occur in people with other severe mental illnesses, such as schizophrenia or bipolar disorder, and can exacerbate their psychiatric, medical, and family problems. Therefore, to improve detection of alcohol-related problems, establish correct AUD diagnoses, and develop appropriate treatment plans, it is important to thoroughly assess severely mentally ill patients for alcohol and other drug abuse. Several recent studies have indicated that integrated treatment approaches that combine AUD and mental health interventions in comprehensive, long-term, and stagewise programs may be most effective for these clients.
Effects of a Mindfulness Intervention on Sports-Anxiety, Pessimism, and Flow in Competitive Cyclists.

BACKGROUND This study investigated whether mindfulness training increases athletes' mindfulness and flow experience and decreases sport-specific anxiety and sport-specific pessimism. METHODS Cyclists were assigned to an eight-week mindfulness intervention, which incorporated a mindful spin-bike training component, or a wait-list control condition. Participants completed baseline and post-test measures of mindfulness, flow, sport-anxiety, and sport-related pessimistic attributions. RESULTS Analyses of covariance showed significant positive effects on mindfulness, flow, and pessimism for the 27 cyclists in the mindfulness intervention condition compared with the 20 cyclists in the control condition. Changes in mindfulness experienced by the intervention participants were positively associated with changes in flow. CONCLUSIONS Results suggest that mindfulness-based interventions tailored to specific athletic pursuits can be effective in facilitating flow experiences.
Expression of BORIS in melanoma: Lack of association with MAGE‐A1 activation

Several genes with specific expression in germ cells show aberrant activation in different types of tumors. These genes, termed cancer‐germline (CG) genes, encode tumor‐specific antigens, which represent potential targets for therapeutic vaccination against cancer. The germline‐specific gene BORIS (Brother Of the Regulator of Imprinted Sites), which encodes an 11‐zinc‐fingers transcriptional regulator, was recently qualified as a new CG gene, as it was found to be activated in a variety of tumor samples. Moreover, it was suggested that BORIS might be responsible for the activation of most other CG genes, including gene MAGE‐A1, in tumors. In the present study, we evaluated the frequency of BORIS activation in melanoma by quantitative RT‐PCR. BORIS activation was detected in 27% (n = 63) melanoma tissue samples. Surprisingly, many melanoma samples expressed MAGE‐A1 and other CG genes in the absence of BORIS activation, suggesting that BORIS is not an obligate factor for activation of these genes in melanoma. Consistently, forced expression of BORIS in melanoma cell lines did not induce expression of MAGE‐A1. Our results indicate that BORIS may serve as a useful target for immunotherapy of melanoma. However, it appears that BORIS is neither necessary nor sufficient for the activation of other CG genes. © 2007 Wiley‐Liss, Inc.
Major solutes, metals, and alkylated aromatic compounds in high-latitude maritime snowpacks near the trans-Alaska pipeline terminal, Valdez, Alaska

The chemical constituents within a snowpack can provide information about the atmosphere through which the snow was deposited. Valdez is located in south-central Alaska and has a high-latitude maritime climate, with annual snowfall typically exceeding 8 m within the city limits. Valdez is also the termination point of the trans-Alaska pipeline system, where tankers are loaded with crude oil from the North Slope of Alaska. Integrated samples of the top 1 m of snow were collected at seven sites near Valdez and analyzed for major solutes, lead, and alkylated aromatic compounds, in particular benzene, toluene, ethylbenzene, and xylene (BTEX). For comparison, sites were also sampled near Juneau, Alaska, which has a similar climate but no petroleum transport infrastructure. Major solute chemistry at all sites was dominated by chloride and was consistent with a marine air mass source of ions in precipitation. Sulfate levels in Valdez were typically on the order of 10 µeq l−1 and significantly higher than found in Juneau snow. Other major solute levels were low in Valdez and Juneau. Lead levels were below detection limits for all sites, with the exception of trace concentrations (<0.4 µg l−1) reported at two Valdez locations. Alkylated organics were present at all Valdez locations, at levels similar to those documented previously in urban locations. No alkylated organics were detected in Juneau snowpacks.
Spontaneous fine-tuning to environment in many-species chemical reaction networks

Significance A qualitatively more diverse range of possible behaviors emerge in many-particle systems once external drives are allowed to push the system far from equilibrium; nonetheless, general thermodynamic principles governing nonequilibrium pattern formation and self-assembly have remained elusive, despite intense interest from researchers across disciplines. Here, we use the example of a randomly wired driven chemical reaction network to identify a key thermodynamic feature of a complex, driven system that characterizes the “specialness” of its dynamical attractor behavior. We show that the network’s fixed points are biased toward the extremization of external forcing, causing them to become kinetically stabilized in rare corners of chemical space that are either atypically weakly or strongly coupled to external environmental drives. A chemical mixture that continually absorbs work from its environment may exhibit steady-state chemical concentrations that deviate from their equilibrium values. Such behavior is particularly interesting in a scenario where the environmental work sources are relatively difficult to access, so that only the proper orchestration of many distinct catalytic actors can power the dissipative flux required to maintain a stable, far-from-equilibrium steady state. In this article, we study the dynamics of an in silico chemical network with random connectivity in an environment that makes strong thermodynamic forcing available only to rare combinations of chemical concentrations. We find that the long-time dynamics of such systems are biased toward states that exhibit a fine-tuned extremization of environmental forcing.
Incidence of initial local therapy among men with lower-risk prostate cancer in the United States.

BACKGROUND The frequently indolent nature of early-stage prostate cancer in older men and in men with low- or moderate-grade tumors and the demonstration that the survival benefits of radical prostatectomy are primarily among men younger than 65 years have led to concerns about prostate cancer overtreatment. METHODS Using data from 13 Surveillance, Epidemiology, and End Results registries, we performed a retrospective cohort study of 71,602 men who were diagnosed with localized or regional prostate cancer between 2000 and 2002. We quantified the incidence of initial curative therapy (i.e., surgery or radiation therapy) among men with lower-risk cancers as defined by their limited likelihood of either dying from expectantly managed prostate cancer or achieving a survival benefit from local therapy. Stratified analyses and multinomial logistic regression models were used to quantify the absolute and relative rates of curative therapy among men in various age-grade strata. All statistical tests were two-sided. RESULTS We identified 24,405 men with lower-risk prostate cancers and complete data for the first course of treatment. Initial curative therapy was undertaken in 13,537 of these men (55%); 81% of treated men received radiation therapy. The likelihood of curative therapy, relative to expectant management, varied statistically significantly among lower-risk age-grade strata (all P<.05). Assuming that initial expectant management is appropriate for all lower-risk cancers, 2564 men (10%) in this population-based sample were overtreated with radical prostatectomy and 10,973 (45%) with radiation therapy. CONCLUSIONS These data quantify a target population for whom greater use of expectant approaches may reduce overtreatment and improve the quality of localized prostate cancer care.
Molecular Basis for a Direct Interaction between the Syk Protein-tyrosine Kinase and Phosphoinositide 3-Kinase*

After engagement of the B cell receptor for antigen, the Syk protein-tyrosine kinase becomes phosphorylated on multiple tyrosines, some of which serve as docking sites for downstream effectors with SH2 or other phosphotyrosine binding domains. The most frequently identified binding partner for catalytically active Syk identified in a yeast two-hybrid screen was the p85 regulatory subunit of phosphoinositide 3-kinase. The C-terminal SH2 domain of p85 was sufficient for mediating an interaction with tyrosine-phosphorylated Syk. Interestingly, this domain interacted with Syk at phosphotyrosine 317, a site phosphorylated in trans by the Src family kinase, Lyn, and identified previously as a binding site for c-Cbl. This site interacted preferentially with the p85 C-terminal SH2 domain compared with the c-Cbl tyrosine kinase binding domain. Molecular modeling studies showed a good fit between the p85 SH2 domain and a peptide containing phosphotyrosine 317. Tyr-317 was found to be essential for Syk to support phagocytosis mediated by FcγRIIA receptors expressed in a heterologous system. These studies establish a new type of p85 binding site that can exist on proteins that serve as substrates for Src family kinases and provide a molecular explanation for observations on direct interactions between Syk and phosphoinositide 3-kinase.
Optimization of a Dry Powder Inhaler Formulation of Nacystelyn, a New Mucoactive Agent

The aim of this study was to optimize a dry powder inhaler formulation containing a new mucoactive drug, nacystelyn. Formulations were made using three types of lactose, crystalline α‐lactose, spray‐dried lactose and a roller‐dried anhydrous β‐lactose. The roller‐dried anhydrous β‐lactose possessed the most adequate surface properties, resulting in a significantly higher (P < 0.05) in‐vitro lung deposition of nacystelyn than the conventional crystalline α‐lactose and spray‐dried lactose. The particle size distribution of roller‐dried α‐lactose was optimized also. Within the size ranges tested (63–100, 90–125 and 100–160 μm), the coarser the lactose, the higher the in‐vitro deposition of the drug (up to 40%). In contrast, the in‐vitro lung deposition of 100–160 μm roller‐dried β‐lactose was very low (< 0.5%), so limiting the potential risk of lung irritation due to the carrier. The influence of the ratio of active ingredient/excipient (w/w) was also investigated. No difference was observed for mixtures from 1:2 to 1:4 while higher dilutions (1:5 and 1:6) showed significantly (P < 0.005) lower deposition results. Finally, the influence of the airflow rate was assessed. No dependence of the fine particle dose was observed between 40 and 80 L min−1 while significantly higher results were obtained at 100 L min−1.
The Periplasmic Chaperone SurA Exploits Two Features Characteristic of Integral Outer Membrane Proteins for Selective Substrate Recognition*

The Escherichia coli periplasmic chaperone and peptidyl-prolyl isomerase (PPIase) SurA facilitates the maturation of outer membrane porins. Although the PPIase activity exhibited by one of its two parvulin-like domains is dispensable for this function, the chaperone activity residing in the non-PPIase regions of SurA, a sizable N-terminal domain and a short C-terminal tail, is essential. Unlike most cytoplasmic chaperones SurA is selective for particular substrates and recognizes outer membrane porins synthesized in vitro much more efficiently than other proteins. Thus, SurA may be specialized for the maturation of outer membrane proteins. We have characterized the substrate specificity of SurA based on its natural, biologically relevant substrates by screening cellulose-bound peptide libraries representing outer membrane proteins. We show that two features are critical for peptide binding by SurA: specific patterns of aromatic residues and the orientation of their side chains, which are found more frequently in integral outer membrane proteins than in other proteins. For the first time this sufficiently explains the capability of SurA to discriminate between outer membrane protein and non-outer membrane protein folding intermediates. Furthermore, peptide binding by SurA requires neither an active PPIase domain nor the presence of proline, indicating that the observed substrate specificity relates to the chaperone function of SurA. Finally, we show that SurA is capable of associating with the outer membrane. Together, our data support a model in which SurA is specialized to interact with non-native periplasmic outer membrane protein folding intermediates and to assist in their maturation from early to late outer membrane-associated steps.
Video Angiography of Cilioretinal Artery Infarction in Central Retinal Vein Occlusion.

We describe a fluorescein angiogram performed on a 35-year-old man with central retinal vein occlusion and associated cilioretinal artery hypoperfusion. The fluorescein angiogram video showed pulsatile filling and complete emptying of the right cilioretinal artery throughout the run indicating insufficient blood flow through the cilioretinal artery. The cilioretinal artery is also only partially filled with each systolic phase leaving an area of reduced perfusion that is well demarcated by the area of hypofluorescence at the macula (Figure 1). The corresponding near-infrared reflectance images and associated optical coherence tomography images of the area at the time of presentation and 6 weeks later clearly has thickened and hyperreflective inner retinal layers with a hyperreflective inner nuclear layer at presentation and significant thinning 6 weeks later confirming ischemia in the area (Figure 2). Fig. 1. Fluorescein angiography. The arrows in all images points towards the cilioretinal artery. A and C. Evidence of cilioretinal artery filling; B and D. Cilioretinal artery empties. The arrowheads point toward the maximum fill of fluorescein in the retinal arteries in images (A and B). The maximum fill retracts from (A) to (B).
Combinational enhancing effects of formulation and encapsulation on digestive stability and intestinal transport of green tea catechins

The hypothesis was that green tea catechins (GTCs) formulated with vitamin C and xylitol followed by enteric coating with hydroxypropyl methyl cellulose phthalate (HPMCP) or encapsulated into γ-cyclodextrin (γ-CD) could enhance intestinal absorption of GTCs. Surface morphology and size obtained by SEM were different. Digestive stability of GTCs encapsulated into γ-CD or coated with HPMCP was enhanced up to 65.56% or 57.63%, respectively. When GTCs were formulated, the digestive stability was greater than the one not formulated. Formulated GTCs followed by encapsulation into γ-CD significantly increased intestinal transport. Absorption of GTCs was 2.8%, 9.64%, 11.97%, 8.41% and 14.36% for only GTCs, GTCs encapsulated into γ-CD, formulated GTCs encapsulated into γ-CD, GTCs coated with HPMCP and formulated GTCs coated with HPMCP, respectively. This study suggests that GTCs, formulated with vitamin C and xylitol followed by γ-CD encapsulation or HPMCP enteric coating, provide combinational effect to increase bioavailability of GTCs.