Miracle-dz/UniFAR-FTUs huggingface dataset:
Visitor satisfaction at the museum: Italian versus foreign visitors.

Trying to understand what comprises and influences visitor satisfaction is one of the most relevant areas of research for the tourism sector. The aim of this study is to analyze which factors influence overall satisfaction with the visit at the museum, with particular interest in origin, feelings, and motivations. The research is based on 1038 questionnaires collected from June to December 2011 among the visitors of the South Tyrol Museum of Archaeology (OIˆTZI) in Bolzano, Northern Italy. Logit models were used in order to estimate the set of independent variables that significantly influence both the overall satisfaction of the sample and the eventually differences between Italian and foreign visitors in the perception of satisfaction. The results suggested that the overall satisfaction was related to the origin of the respondent, their feelings, and motivations. Furthermore, opinion about showrooms and other services received during the visit appears to be positively and significantly related with overall satisfaction. From this knowledge, museum managers can profit in their willingness to offer the optimal museum experience, as well as museum marketers in their advertisement campaigns in Italy and abroad.
Triple-contrast helical CT in penetrating torso trauma: a prospective study to determine peritoneal violation and the need for laparotomy.

OBJECTIVE A prospective study was performed to determine the usefulness of triple-contrast helical CT in predicting peritoneal violation and the need for laparotomy in the treatment of penetrating torso trauma. SUBJECTS AND METHODS Triple-contrast helical CT scans were obtained in 104 hemodynamically stable patients with penetrating injuries to the torso (thoracoabdominal region including tangential wounds to the anterior abdomen, flank, back, and pelvis) over a 17-month period. The study group included 54 patients with gunshot wounds and 50 with stab wounds. No patient had a radiographic or clinical indication for immediate laparotomy. A positive finding on CT was defined as evidence of peritoneal violation or injury to the retroperitoneal colon, major vessel, or urinary tract. Patients with a positive CT, except patients with isolated liver injury or free fluid, underwent laparotomy. Patients with a negative finding on CT were initially observed. RESULTS CT studies were positive in 35 (34%) of 104 patients and negative in 69 (66%) of 104 of patients. Laparotomy was performed in 21 (60%) of 35 patients with positive CT; 19 (86%) of 22 were therapeutic, two (9%) were nontherapeutic, and one (5%) was negative (no injury was found). Nine patients with isolated hepatic injuries were successfully treated without laparotomy. Among patients with a negative CT, 67 (97%) of 69 were treated nonoperatively with success. CT had 100% (19/19) sensitivity, 96% (69/72) specificity, 100% (69/69) negative predictive value, and 97% (101/104) accuracy in predicting the need for laparotomy. CONCLUSION Triple-contrast helical CT can accurately predict the need for laparotomy and exclude peritoneal violation in penetrating torso trauma including tangential abdominal wounds.
The postwar hospitalization experience of U.S. veterans of the Persian Gulf War.

BACKGROUND Since the Persian Gulf War ended in 1991, many veterans of that conflict have reported diverse, unexplained symptoms. To evaluate the health of Gulf War veterans, we studied their postwar hospitalization experience and compared it with that of other military personnel serving at the same time who did not go to the Persian Gulf. METHODS Using a retrospective cohort approach and data from Department of Defense hospitals, we studied hospitalizations of 547,076 veterans of the Gulf War who were serving in the Army, Navy, Marine Corps, and Air Force and 618,335 other veterans from the same era who did not serve in the Persian Gulf. Using multivariate logistic-regression models, we analyzed risk factors for hospitalization both overall and in 14 broad diagnostic categories during three periods from August 1991 through September 1993 (a total of 45 specific comparisons). RESULTS After the war, the overall odds ratio for hospitalization of the Gulf War veterans was not higher than that of the other veterans, even after adjustment for selection effects related to deployment. In 16 of the 42 comparisons involving specific diagnoses, the risk of hospitalization among Gulf War veterans differed significantly from that among other veterans. Among these 16 comparisons, Gulf War veterans were at higher risk in 5: neoplasms (largely benign) during 1991, diseases of the genitourinary system during 1991, diseases of the blood and blood-forming organs (mostly forms of anemia) during 1992, and mental disorders during both 1992 and 1993. The differences were not consistent over time and could be accounted for by deferred care, postwar pregnancies, and postwar stress. CONCLUSIONS During the two years after the Persian Gulf War, there was no excess of unexplained hospitalization among Americans who remained on active duty after serving in that conflict.
Refractory Heartburn to Proton Pump Inhibitors: Epidemiology, Etiology and Management

Patients with refractory heartburn to proton pump inhibitors (PPIs) represent a distinctive group which is difficult to manage. In a systematic review of the relative literature we found that approximately 20% of patients with erosive esophagitis and 15–25% of patients with normal endoscopy and abnormal 24-hour esophageal pH monitoring continue to report heartburn despite treatment with standard dose PPIs. Furthermore, approximately 30–40% of patients with normal endoscopy and 24-hour pH studies and 15–20% of patients with Barrett’s esophagus have refractory heartburn to double dose PPIs. In such cases, compliance to therapy, duodeno-gastroesophageal reflux, gastro-esophageal motility disorders and eradication of Helicobacter pylori infection may contribute to symptoms. Based on the available evidence, we suggested an algorithm for the evaluation and management of these patients.
Evidence for Superantigen Involvement in Preeclampsia

PROBLEM: Preeclampsia is the leading cause of maternal morbidity and premature fetal delivery in the United States, most likely involving the immune system in disease genesis. In this report, we tested the hypothesis that a superantigen phenomenon is an important factor in the pathogenesis of the disease. METHOD OF STUDY: A semi‐quantitative polymerase chain reaction (PCR) was used to assess T‐cell receptor (TCR) β chain variable (Vβ) regions as an indicator of T‐cell expansion in both peripheral blood and basal plate of preeclamptic patients. All the subjects were also molecularly typed to identify their HLA‐class II alleles. RESULTS: In peripheral blood of the majority of the patients, there was a high abundance of the Vβ4 gene family, which was not observed in the control group. Polyclonality of this Vβ gene family was confirmed by analysis of the Vα chain and the complementary determining region 3 (CDR3). The majority of patients carried the Human Leukocyte Antigens (HLA)‐DRB1*13 allele. CONCLUSION: We present evidence for the existence of a superantigen‐like effect in at least a subset of patients with preeclampsia.
Understanding N‐Acetyl‐L‐Glutamate Synthase Deficiency: Mutational Spectrum, Impact of Clinical Mutations on Enzyme Functionality, and Structural Considerations

N‐acetyl‐L‐glutamate synthase (NAGS) deficiency (NAGSD), the rarest urea cycle defect, is clinically indistinguishable from carbamoyl phosphate synthetase 1 deficiency, rendering the identification of NAGS gene mutations key for differentiation, which is crucial, as only NAGSD has substitutive therapy. Over the last 13 years, we have identified 43 patients from 33 families with NAGS mutations, of which 14 were novel. Overall, 36 NAGS mutations have been found so far in 56 patients from 42 families, of which 76% are homozygous for the mutant allele. 61% of mutations are missense changes. Lack or decrease of NAGS protein is predicted for ∼1/3 of mutations. Missense mutations frequency is inhomogeneous along NAGS: null for exon 1, but six in exon 6, which reflects the paramount substrate binding/catalytic role of the C‐terminal domain (GNAT domain). Correspondingly, phenotypes associated with missense mutations mapping in the GNAT domain are more severe than phenotypes of amino acid kinase domain‐mapping missense mutations. Enzyme activity and stability assays with 12 mutations introduced into pure recombinant Pseudomonas aeruginosa NAGS, together with in silico structural analysis, support the pathogenic role of most NAGSD‐associated mutations found. The disease‐causing mechanisms appear to be, from higher to lower frequency, decreased solubility/stability, aberrant kinetics/catalysis, and altered arginine modulation.
Attitude and self-reported practice regarding hospice referral in a national sample of internists.

Systematic, nationally representative information about physicians' attitudes and behavior with respect to hospice care is not available. We sought to describe these previously unexamined attitudes and practices. We conducted a mail survey of a random national sample of 1311 internists, of whom 697 responded (an unadjusted response rate of 53%). We elicited physician's attitudes and self-reported practice with respect to hospice. Most internists (89%) felt that hospice care was a good form of terminal care. Physicians with longer definitions of what constitutes "terminal" illness and those whose patients were more accepting of their prognoses were more likely to hold this opinion. Over the course of a year, the median internist referred five patients to hospice. Specialists and those with longer definitions of "terminal" were more likely to have done so. When asked "If you knew exactly how long a patient had to live, how long before death would you refer them to hospice? " the average response was 12.1 +/- 8.5 weeks, but responses varied from 1 to 52 weeks, and the pattern of responses was bimodal, with one peak at about 13 weeks (73% of internists) and one at about 25 weeks (27%). Moreover, the distribution of hospice enrollment times implied by physician reports about ideal practice is significantly more compact than the distribution of survival that is actually observed; physicians support far fewer very short (<2 weeks) and very long (>6 months) stays in hospice than are observed. We conclude that internists show significant support for, and utilization of, hospice and they endorse a length of stay that is longer than currently observed. These findings suggest that it may be possible to increase both the number of patients using hospice and their duration of use of hospice.
Adaptive Beamforming Algorithms for Cancellation of Multiple Interference Signals

This paper proposes a fast Minimum-Variance-Distortionless-Response (MVDR) beam- forming algorithm for an antenna array for cancellation of multiple interference signals. The proposed algorithm uses Sample-Average Estimate (SAE) of the data covariance matrix and reduces its compu- tational effort by applying the Matrix-Inversion-Lemma (MIL) to its covariance Matrix Inversion (MI) operation. The proposed algorithm is compared to two SAE-based algorithms: the Sample Matrix Inversion (SMI) algorithm that requires an MI operation and the Auxiliary Vector (AV) algorithm that does not need an MI operation. A non-SAE based algorithm using the Least Mean Square (LMS) method is also included for comparison. Simulation results show that the proposed algorithm converges slower than the SMI scheme but outperforms the AV and LMS schemes during the transient phase. Once convergence is achieved, the proposed algorithm converges to a better Mean Square Error than the rest of the algorithms evaluated.
BENTHIC HABITAT MAPPING AND BIODIVERSITY ANALYSIS IN THE PRIMEIRAS AND SEGUNDAS ARCHIPELAGO RESERVE

The Primeiras and Segundas Archipelago Reserve is a recently established marine protected area, the largest in Africa, located in the waters of Northern Mozambique. This protected area is of significant local economic importance and global ecological relevance, containing the southernmost coral reefs in Eastern Africa. However, information related to the marine ecosystem, notably benthic habitat is very scarce. Twelve atolls were mapped in the region using object-based image classification of very-high resolution satellite imagery (IKONOS, Quickbird, and WorldView-2). Geographically referenced data on benthic cover and depth were gathered in the course of three fieldwork expeditions covering a total of four atolls and two shallow reef structures in the Segundas Archipelago. The resulting map allows the estimation of three distinct types of coral cover (field, patches, spurs and grooves); the differentiation of sand, rubble and rock substrate; and the detection of seagrass and brown macroalgae, identifying up to 24 benthic habitats. Average overall accuracy was above 50%. The high variability of the optical properties on the reef systems, in large due to the connectivity with the mainland via plumes, while interesting from an ecological perspective increases the challenges for remote sensing of bottom cover. New information indicates the presence of deep benthic cover extending from the atolls, suggesting the need for further research on Coastal Eastern African corals, namely on their resilience and connectivity, and supporting current knowledge of the existence of an almost continuous coral reef from Kenya to Mozambique. Coral and fish biodiversity data have been analysed together with the satellite-derived maps. Results support the local perception that ecosystems are in decline and uncover new information about biodiversity’s spatial patterns. Our work provides a detailed depiction of marine habitats that may aid the management of the protected area, namely in the definition of fishing zones and coral cover monitoring.
Evaluation of Environmental Data for Identification of Anopheles (Diptera: Culicidae) Aquatic Larval Habitats in Kisumu and Malindi, Kenya

Abstract This research evaluates the extent to which use of environmental data acquired from field and satellite surveys enhances predictions of urban mosquito counts. Mosquito larval habitats were sampled, and multispectral thermal imager (MTI) satellite data in the visible spectrum at 5-m resolution were acquired for Kisumu and Malindi, Kenya, during February and March 2001. All entomological parameters were collected from January to May 2001, June to August 2002, and June to August 2003. In a Poisson model specification, for Anopheles funestus Giles, shade was the best predictor, whereas substrate was the best predictor for Anopheles gambiae, and vegetation for Anopheles arabensis Patton. The top predictors found with a logistic regression model specification were habitat size for An. gambiae Giles, pollution for An. arabensis, and shade for An. funestus. All other coefficients for canopy, debris, habitat nature, permanency, emergent plants, algae, pollution, turbidity, organic materials, all MTI waveband frequencies, distance to the nearest house, distance to the nearest domestic animal, and all land use land cover changes were nonsignificant. MTI data at 5-m spatial resolution do not have an additional predictive value for mosquito counts when adjusted for field-based ecological data.
Asymptomatic herpes simplex virus shedding and Russian roulette.

Herpes simplex viruses (HSVs) are remarkably clever pathogens capable of causing a variety of illnesses, including oralfacial infections and genital herpes. These viruses have evolved the capacity to persist silently in the host, and the infections that they cause are often asymptomatic. These properties facilitate HSV spread. Indeed, in many parts of the world, 175% of adults have been infected with HSV type 1 (HSV-1) [1]. HSV type 2 (HSV-2) infections are also becoming increasingly prevalent worldwide [1]. Genital infections caused by HSV are epidemic in the United States [2].
Prepulse inhibition of the startle reflex depends on the catechol O-methyltransferase Val158Met gene polymorphism

Background Recent evidence suggests that dopamine (DA) agonist-induced disruption of prepulse inhibition (PPI) depends on basal PPI values, in a manner that suggests an inverted U-shaped relationship between PPI and prefrontal DA levels. This is the first study to examine possible genetic determinants of PPI and the catechol O-methyltransferase (COMT) Val158Met polymorphism, the main catabolic pathway of released DA in the prefrontal cortex (PFC). Method PPI was measured in 93 healthy males presented with 75-dB and 85-dB prepulses at 60-ms and 120-ms prepulse–pulse intervals. Subjects were grouped according to their COMT status into a Val/Val, a Val/Met and a Met/Met group. Results ANOVAs showed that at all prepulse and interval conditions, Val/Val individuals had the lowest PPI, Met/Met the highest, and Val/Met were intermediate. Conclusions These results suggest that PPI is regulated by DA neurotransmission in the PFC and its levels depend on the COMT Val158Met gene polymorphism. These findings enhance the value of the PPI paradigm in examining individual variability of early information processing in healthy subjects and psychiatric disorders associated with changes in PFC DA activity and attentional deficits such as schizophrenia.
Obstructive sleep apnea affects hospital outcomes of patients with non-ST-elevation acute coronary syndromes.

STUDY OBJECTIVE We aimed to test the hypothesis that clinically suspected obstructive sleep apnea (OSA) independently predicts worse in-hospital outcome in patients with non-ST elevation acute coronary syndromes. DESIGN At admission, individuals were evaluated for clinical probability of OSA by the Berlin Questionnaire. Primary cardiovascular endpoint was defined as the composite of death, nonfatal myocardial infarction, or refractory angina during hospitalization. SETTING Coronary care unit. PATIENTS There were 168 consecutive patients admitted with unstable angina or non-ST elevation acute myocardial infarction. MEASUREMENTS AND RESULTS During a median hospitalization of 8 days, the incidence of cardiovascular events was 13% (12 deaths, 4 nonfatal myocardial infarctions, and 6 refractory anginas.) Incidence of the primary endpoint was 18% in individuals with high probability of OSA, compared with no events in individuals with low probability (P = 0.002). After logistic regression adjustment for the Global Registry of Acute Coronary Events (GRACE) risk score, anatomic severity of coronary disease, and hospital treatment, probability of OSA remained an independent predictor of events (odds ratio [OR] = 3.4; 95% confidence interval [CI] = 1.3 - 9.0; P = 0.015). Prognostic discrimination of the GRACE score, measured by a C-statistic of 0.72 (95% CI = 0.59-0.85), was significantly improved to 0.82 (95% CI = 0.73-0.92) after inclusion of OSA probability in the predictive model (P = 0.03). CONCLUSION Considering the independent prognostic and incremental value of suspected OSA, this condition may represent an aggravating factor for patients with non-ST elevation acute coronary syndrome.
Reproductive biology The immature human ovary shows loss of abnormal follicles and increasing follicle developmental competence through childhood and adolescence

Publisher Rights Statement: Copyright © The Author 2013. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
[The correlation between Kawasaki disease and polymorphisms of Tumor necrosis factor alpha and interleukin-10 gene promoter].

OBJECTIVE Kawasaki disease (KD) is an acute febrile vasculitic syndrome of unknown etiology that preferentially affects coronary artery. It has been suggested that proinflammatory cytokines like tumor necrosis factor alpha (TNF-alpha) and interleukin-10 (IL-10) are key players during acute KD. Recently, the polymorphisms relative to major transcriptional start site of TNF-alpha and IL-10 gene were shown to influence the level of TNF-alpha and IL-10 production in vitro. This study was aimed to investigate the genetic association of TNF-alpha and IL-10 promoter polymorphisms in juvenile patients of Han nationality with KD, and to investigate the possible associations with clinical manifestations of the disease. METHODS Four polymorphism sites of TNF-alpha and IL-10 gene promoter regions from 96 children with KD were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). One hundred and sixty age-matched normal children of the Han nationality were used as control. All patients accepted Doppler echocardiography examination in order to differentiate coronary artery lesions. RESULTS There was significant difference in allele frequencies of -308 (A/G) site of the TNF-alpha gene between children of the Han nationality and those of Japanese and Caucasian in America. There were significant differences in the allele frequencies of -1082 (G/A), -819 (C/T) and -592 (A/C) of IL-10 gene between children of the Han nationality and their British Counterparts (P < 0.01). There was no significant difference in allele frequencies of -308 (A/G) site of TNF-alpha gene between children with KD and normal controls. There was no significant difference in the haplotypes and the allele frequencies of the above three sites of IL-10 between the two groups. However, when clinical features were examined, the genotype frequency of TNF-alpha-308A was significantly higher in IVIG-resistant KD patients than that of TNF-alpha-308G genotype (67% vs 5%, chi(c)(2) = 90.48, P < 0.01). The genotype of TNF-alpha-308A was closely associated with IVIG-resistant KD (P < 0.01, relative risk 42.25, 95% confidence interval 15.81-112.88). The haplotype frequency of IL-10 -1082A/-819T/-592A was also higher in patients with coronary artery lesion (CAL) caused by KD than those of Non-ATA haplotype (52% vs 20%, chi(2) = 18.36, P < 0.01). The haplotypes of IL-10 -1082A/-819T/-592A was significantly associated with CAL caused by KD (P < 0.01, relative risk 4.26, 95% confidence interval 2.20-8.25). CONCLUSION The genotype of TNF-alpha-308A is one of the important factors that probably influence the therapeutic effect of KD. The haplotypes (-1082/-819/-592) of IL-10 gene promoter might be related to the pathogenesis of coronary artery complication of KD and -1082A/-819T/-592A haplotypes might be regarded as a genetic marker of risk factor for coronary artery lesion in KD.
Hereditary stomatocytosis: An underdiagnosed condition

Hereditary stomatocytoses are a wide class of hemolytic anemias characterized by alterations of ionic flux with increased cation permeability that results in inappropriate shrinkage or swelling of the erythrocytes, and water lost or gained osmotically. The last few years have been crucial for new acquisitions in this field in terms of identifying new causative genes and of studying their pathogenetic mechanisms. This review summarizes the main features of erythrocyte membrane transport diseases, dividing them into forms with either isolated erythroid phenotype (nonsyndromic) or extra‐hematological manifestations (syndromic), and focusing particularly on the most recent advances regarding dehydrated forms of hereditary stomatocytosis and familial pseudohyperkalemia.