Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment thresholds for stroke prevention in atrial fibrillation: observations on the CHA2DS2-VASc score

Atrial fibrillation (AF) is an expanding epidemic,1 and ischaemic stroke due to cardioembolism remains a trademark serious complication of AF.2 The now historical stroke prevention in AF trials demonstrated that compared with placebo/control, anticoagulation with a vitamin K antagonist (VKA, e.g. warfarin) reduced stroke by 64% while also reducing all-cause mortality in patients with non-valvular AF, whereas platelet inhibition with aspirin had a non-significant 19% reduction in stroke and no benefit on mortality.3 Thus, effective stroke prevention means oral anticoagulation. Although highly effective, antithrombotic drugs increase the risk of bleeding events, and the expected benefits and harms for the individual patient must be carefully weighed when deciding on whether or not to initiate treatment. More specifically, a certain absolute level of thromboembolic risk is required before the protective antithrombotic effect outweighs the associated serious bleeding risk. To alleviate this clinical conundrum and aid decision making, the use of validated stroke and bleeding risk scores is recommended.4 Most contemporary guidelines recommend using the CHA2DS2-VASc score to determine whether an atrial fibrillation (AF) patient has an indication for antithrombotic treatment.5–8 Nonetheless, guideline recommendations are conflicting (see Table 1 ). View this table: Table 1 Conflicting guideline recommendations for antithrombotic management of women and men with atrial fibrillation Some guidelines have used the CHA2DS2-VASc score in a categorical manner, artificially dividing patients into low-, moderate- and, high-risk strata—and making treatment recommendations based on these strata. Also, all guidelines actually provide treatment recommendations that extend beyond what has been specifically investigated in randomized trials. Randomized trials are the gold standard to testing the effectiveness and safety of an intervention but clinical trials focus on highly selected populations with specific inclusion/exclusion criteria. The historical stroke prevention trials testing the effect of antithrombotic therapy against no treatment or …
Emergence of Vibrio cholerae Serotype Hikojima in Northern Tamil Nadu

Out of the 13 isolates first case was reported in Feb 2009. Maximum of 4 cases were reported in August 2009. Among the 13 isolates most of the patients were from Vellore and the rest from neighbouring towns. Males (61.53%) were more affected than females (38.45%). All the cholera cases were in the pediatric age group (1 to 10 years). More cases were seen in the age group less than 2 years (38.46%). This was similar to previous studies from other parts of the country which showed that the infection rate of cholera is increasingly reported in children. (2)
Fibronectin is more active than fibrin or fibrinogen in promoting Staphylococcus aureus adherence to inserted intravascular catheters.

To further define the role of fibrin(ogen) and fibronectin in Staphylococcus aureus adherence to central venous catheters, the amount, chemical integrity, and biologic activity of these proteins adsorbed on lines inserted in hospitalized patients were prospectively studied. Polyurethane cannulas promoted a significantly lower adherence of S. aureus than polyvinyl chloride (P < .01) or Hickman (P < .001) cannulas and contained the lowest amount of immunologically assayed fibronectin but not of fibrin(ogen). Fibrinogen showed an extensive loss of adherence-promoting activity on inserted cannulas, which was related to its proteolytic breakdown, as detected by SDS-PAGE and immunoblots with antifibrinogen antibodies and confirmed by in vitro studies with purified protein fragments. In contrast, either intact or fragmented fibronectin, although present in much lower amounts than fibrin(ogen), could actively promote S. aureus adherence onto intravenous catheters.
Describing health-related outcomes for couples experiencing prostate cancer: differences and similarities.

PURPOSE/OBJECTIVES To describe health-related outcomes for couples dealing with prostate cancer before the patient started treatment and 6, 12, and 18 months after treatment. DESIGN Survey with longitudinal, comparative, and predictive elements. SETTING Tertiary care nonprofit medical center in the southwestern United States. SAMPLE A convenience sample of 216 patients treated for prostate cancer and their partners was enrolled. The mean age of patients was 68 years; 64 years for their partners. The average length of marriage was about 35 years. About 75% of patients and more than 50% of partners had at least some college education. METHODS Study participants completed questionnaires before treatment and 6, 12, and 18 months after treatment. MAIN RESEARCH VARIABLES Health-related quality of life, health status, and marital satisfaction. FINDINGS Patients' scores were associated with partners' scores more than 50% of the time throughout the study. Relationship satisfaction was the most strongly related variable between patient and partner. Cross-lag analyses suggest that couples' scores demonstrate a reciprocal pattern of influence between the dyads throughout the study. CONCLUSIONS Patients' scores were associated with partners' scores on most outcome variables. Both are affected by prostate cancer and the treatment experience. IMPLICATIONS FOR NURSING Nurses should actively include partners in all information and education sessions connected with prostate cancer treatment and follow-up. In addition, the unique experiences of partners of patients with prostate cancer should be identified and addressed.
Fundamental concepts of product/technology/process informational integration for process modelling and process planning

The aim of this paper is to summarize the main basic concepts for data integration during a product's life cycle. This integration is necessary in order to favour a more efficient communication between collaborators from inside or outside the company, in a distributed design or e-design context. The information is based on models that structure the concepts and allow their re-use due to the memorization of design history. The current evolutions extend the prospective fields of this approach both to earlier stages (functional aspects, etc) and to later stages (logistics, recycling, etc). There remain, in a global vision of the enterprise, many prospective fields that should allow the total traceability of products during their life cycle.
Control of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a children's hospital by changing antimicrobial agent usage policy

Conclusions: The substitution of piperacillin/tazobactam for extended-spectrum cephalosporins successfully decreased the prevalence of ESBL production of K. pneumoniae and E. coli in an institute for children where ESBLs were endemic. The impact of change in antibiotic policy was more evident in K. pneumoniae than E. coli.
NMR and molecular modeling of wine tannins binding to saliva proteins: revisiting astringency from molecular and colloidal prospects

In organoleptic science, the association of tannins to saliva proteins leads to the poorly understood phenomenon of astringency. To decipher this interaction at molecular and colloidal levels, the binding of 4 procyanidin dimers (B1–4) and 1 trimer (C2) to a human saliva proline‐rich peptide, IB714, was studied. Interactions have been characterized by measuring dissociation constants, sizes of complexes, number, and nature of binding sites using NMR (chemical shift variations, diffusion‐ordered spectroscopy, and saturation transfer diffusion). The binding sites were identified using molecular mechanics, and the hydrophilic/hydrophobic nature of the interactions was resolved by calculating the molecular lipophilicity potential within the complexes. The following comprehensive scheme can be proposed: 1) below the tannin critical micelle concentration (CMC), interaction is specific, and the procyanidin anchorage always occurs on the same three IB714 sites. The tannin 3‐dimensional structure plays a key role in the binding force and in the tannin's ability to act as a bidentate ligand: tannins adopting an extended conformation exhibit higher affinity toward protein and initiate the formation of a network. 2) Above the CMC, after the first specific hydrophilic interaction has taken place, a random hydrophobic stacking occurs between tannins and proteins. The whole process is discussed in the general frame of wine tannins eliciting astringency. —Cala, O. , Pinaud, N. , Simon, C. , Fouquet, E. , Laguerre, M. , Dufourc, E. J., Pianet, I. NMR and molecular modeling of wine tannins binding to saliva proteins: revisiting astringency from molecular and colloidal prospects. FASEB J. 24, 4281–4290 (2010). www.fasebj. org
Adaptive Noise Mitigation in Impulsive Environment: Application to Power-Line Communications

In this paper, we address the general issue of asynchronous impulsive noise mitigation and its application over coded power-line communications (PLC). As is well known, PLC channels usually suffer from significant degradation due to impulsive interference generated by electrical appliances. The use of a level limiter is a simple and intuitive technique, widely used to mitigate the noxious effect of impulsive noise in these channels. However, the determination of the clipping threshold remains, most of the time, empirical, and the impulse statistics are usually assumed to be known. In a previous study, we proposed an original threshold determination based on signal detection theory, using the well-known false alarm and good detection tradeoff. Here, we further investigate the proposed optimization method in closed form. We compare two tradeoff criteria by means of a receiver operating curves analysis. We clearly show that the resulting decision fits well with encountered bit-error rate performances. We also evaluate the influence of impulsive noise statistics estimation on the performance of the proposed approach. To do so, we assess the robustness of the classical method of moments on Gaussian mixture estimation. It clearly appears that the estimation method is reliable for reasonable values of the impulse occurrence. As one of the main results of this paper, we make a proposal for impulse statistics estimation under ¿severe¿ conditions (i.e., for very rare impulse events, based on impulse detection over corrupted OFDM symbols). Subsequently, we propose a general scheme of automatic impulse mitigation, according to the disturbance ratio of the environment. Finally, the performance of the approach is evaluated over the Home-Plug AV (HPAV) physical layer.
Streptozotocin-Induced Liver Damage in Mice

Diabetes incidence and liver damage was studied and identified in C3H-s mice 21 days after Streptozotocin (SZ) administration (250 mg/kg/i.v.) at 04 hs (4 a.m.) and 16 hs (4 p.m.). Metabolic disturbances were assessed by daily control of glycosuria and serum glucose determined at the end of the experiment. Liver damage was controlled by light and electron microscopy. Both effects showed a circadian variation, with significant greatest values in the 16-h-injected group. Liver damage appeared whether the animals became diabetic or not, consisting in degranulation of the rough-surfaced endoplasmic reticulum, mitochondrial swelling with loss of cristae and edema of the ground substance, with flocculent amorphous precipitate. In some hepatocytes, a dilated cisternae of the endoplasmic reticulum was seen. It was concluded that: a) beta-cell and hepatocytes have a synchronic circadian sensitivity to SZ; b) liver damage was present whether the animals became diabetic or not, suggesting the presence of a different threshold for SZ effect in hepatocytes. These results might be taken into account when planning SZ use, either for experimental or clinical purposes.
Multiple local minima in radiotherapy optimization problems with dose-volume constraints.

The cause of multiple local minima in beam weight optimization problems subject to dose-volume constraints is analyzed. Three objective functions were considered: (a) maximization of tumor control probability (TCP), (b) maximization of the minimum target dose, and (c) minimization of the mean-squared-deviation of the target dose from the prescription dose. It is shown that: (a) TCP models generally result in strongly quasiconvex objective functions; (b) maximization of the minimum target dose results in a strongly quasiconvex objective function; and (c) minimizing the root-mean-square dose deviation results in a convex objective function. Dose-volume constraints are considered such that, for each region at risk (RAR), the volume of tissue whose dose exceeds a certain tolerance dose (DTol) is kept equal to or below a given fractional level (VTol). If all RARs lack a "volume effect" (i.e., VTol = 0 for all RARs) then there is a single local minimum. But if volume effects are present, then the feasible space is possibly nonconvex and therefore possibly leads to multiple local minima. These conclusions hold for all three objective functions. Hence, possible local minima come not from the nonlinear nature of the objective functions considered, but from the "either this volume or that volume but not both" nature of the volume effect. These observations imply that optimization algorithms for dose-volume constraint types of problems should have effective strategies for dealing with multiple local minima.
Replacement of inorganic phosphorus by microbial phytase for young pigs fed on a maiz–soyabean-meal diet

Ninety-six crossbred young pigs (body weight 7.8 kg) were used in a 5-week trial to determine the effectiveness of microbial phytase (EC 3.1.3.26) in improving the bioavailabilities of P and other nutrients in maize–soyabean-meal diets and, thus, replacing inorganic P with phytase. A 2 x 5 factorial arrangement of treatments was employed with two available P (aP) levels (0.7 and 1.6 g/kg) and five phytase levels (0, 350, 700, 1050, 1400 U (the quantity of enzyme that liberates 1µmol inorganic phosphate/min from 5.1 mm-sodium phytate at pH 5.5 and 37°)/kg diet). In addition, two extra diets were formulated to supply the National Research Council (1988) recommended level of aP (3.2 g/kg) with 0 or 1400 U phytase. The addition of graded levels of phytase resulted in linear increases in average daily weight gain, average daily feed intake and weight gain:feed intake for pigs fed on diets containing 0.7 or 1.6 g aP/kg (P < 0.04). Also, the addition of phytase linearly increased apparent digestibilities of P and Ca (P < 0.01), whereas faecal P excretion was linearly decreased (P < 0.01). Linear increases in shear force, shear energy and ash content of both the metacarpal and tenth rib, and shear stress of the metacarpal were found to respond to added phytase (P < 0.01). These improvements in performance, apparent P absorption and bone measurements by phytase were also observed by increasing dietary aP levels for most measurements. Adding 1400 U phytase to the 3.2 g aP/kg diet further increased average daily weight gain, average daily feed intake, apparent absorption of P, Ca and N and metatarsal shear force and ash content (P < 0.01 to 0.05). Generally, maximum responses occurred at a phytase level of 1050 U/kg diet for the 0.7 g aP/kg diets and 700 U for the 1.6 g aP/kg diets. Based on non-linear and linear response equations generated for the phytase and aP levels, the average function of the equivalency of P (Y, g/kg) v. microbial phytase (X, U/kg) was developed across aP levels of 0.7 and 1.6 g/kg for average daily weight gain and apparent digestibility of P: Y = 2.622–2.559e-0.00185x. The replacement of 1 g inorganic P as defluorinated phosphate would require about 246 U microbial phytase. This represents 41% of released P from phytate.
HIV infection in pregnancy: maternal and perinatal outcomes in a tertiary care hospital in Calabar, Nigeria

Background Human immunodeficiency virus (HIV) infection is likely to have untoward effects on pregnancy and its outcome. This study assessed the impact of maternal HIV infection on pregnancy outcomes in a tertiary centre in Calabar, Nigeria. Methods This retrospective study analysed delivery records of 258 HIV-positive and 257 HIV-negative women for pregnancy and delivery complications. Maternal and fetal outcomes of HIV-positive pregnancies were compared with those of HIV-negative controls. Results Adverse pregnancy outcomes significantly associated with HIV status were: anaemia: 33 (8.1%) vs. 8 (3.1%) in controls; puerperal sepsis: 18 (7%) vs. 2 (0.8%); and low birth weight: 56 (21.7%) vs. 37 (14.4%). Caesarean delivery was higher among HIV-positive women than controls: 96 (37.2%) vs. 58 (22.6%). Preterm births were higher in those HIV cohorts who did not receive antiretroviral therapy (ART): 13 (16.9%) vs. 7 (3.9%). Conclusion HIV-positive status increased adverse birth outcome of pregnancy. ART appeared to reduce the risk of preterm births in HIV-positive cohorts.
Research Aircraft Observations and Numerical Simulations of a Warm Front Approaching Vancouver Island

Abstract The mesoscale structure of the low-level flow and the character of the turbulence are investigated for a warm front as it approached the prominent terrain of the Pacific Northwest in the vicinity of Vancouver Island. Flight-level and airborne Doppler radar measurements collected from a National Oceanic and Atmospheric Administration P-3 research aircraft on 9 December 1995 during the Coastal Observation and Simulation with Topography experiment and high-resolution numerical simulations, performed with the Naval Research Laboratory’s nonhydrostatic Coupled Ocean–Atmosphere Mesoscale Prediction System (COAMPS) model, have been used to document the warm front as it approached the coast and the structure of cool air trapped along Vancouver Island. This air mass was capped by a flat, thin transition zone of enhanced static stability and vertical wind shear. The flow within the trapped air mass was oriented parallel to the terrain of Vancouver Island, but appears to have been more an outflow from the S.
Grr1 of Saccharomyces cerevisiae is connected to the ubiquitin proteolysis machinery through Skp1: coupling glucose sensing to gene expression and the cell cycle

Grr1 protein of the yeast Saccharomyces cerevisiae is a central component of a glucose signal transduction mechanism responsible for glucose‐induced gene expression. It is required for glucose‐stimulated regulation of Rgt1, a repressor of several glucose‐induced HXT genes. Grr1 also plays a role in regulating the cell cycle, because it is required for degradation of the G1 cyclins Cln1 and Cln2. We discovered that Grr1 physically interacts with Skp1, a protein that has been implicated in a ubiquitin‐conjugating enzyme complex that targets for degradation the cell cycle regulators Cln1 and Cln2, and the cyclin‐dependent kinase inhibitor Sic1. Thus, Grr1 may regulate the cell cycle and glucose‐induced gene expression via ubiquitin‐mediated protein degradation. Consistent with this idea, Skp1, like Grr1, was found to be required for glucose‐induced HXT gene expression. Two functional domains of Grr1 are required for its interaction with Skp1: 12 leucine‐rich repeats (LRR) and an adjacent F‐box. The Grr1‐Skp1 interaction is enhanced by high levels of glucose. This could provide yeast with a mechanism for coupling nutrient availability to gene expression and cell cycle regulation.
Prevention of invasive fungal infections in immunocompromised patients: the role of delayed-release posaconazole

Posaconazole is a triazole antifungal agent that has broad-spectrum activity against many yeasts and filamentous fungi, including Candida species, Cryptococcus neoformans, Aspergillus species, and Zygomycetes. This drug has been approved for the prevention of invasive fungal infections in patients with neutropenia and for the treatment of invasive fungal infections in hematopoietic stem cell transplant recipients with graft-versus-host disease. Studies on the clinical efficacy, safety, tolerability, and cost-effectiveness of posaconazole therapy were performed using the oral suspension form of the drug. Pharmacokinetic studies have found that the oral suspension form of posaconazole has problemeatic bioavailability: its absorption is affected by concomitant medication and food. This article discusses the pharmacokinetic properties of the newly developed posaconazole delayed-release tablet formulation and reviews the efficacy, safety, and cost-effectiveness of both the oral suspension and the new tablet formulation. In conclusion, the posaconazole tablet formulation has better systemic bioavailability, thereby enabling once-daily administration and better absorption in the presence of concomitant medication and food. However, well-designed clinical studies are needed to evaluate the use of the tablet formulation in real-life settings.
Theories of international regimes

Over the last decade, international regimes have become a major focus of empirical research and theoretical debate within international relations. This article provides a critical review of this literature. We survey contending definitions of regimes and suggest dimensions along which regimes vary over time or across cases; these dimensions might be used to operationalize “regime change. ” We then examine four approaches to regime analysis: structural, game-theoretic, functional, and cognitive. We conclude that the major shortcoming of the regimes literature is its failure to incorporate domestic politics adequately. We suggest a research program that begins with the central insights of the interdependence literature which have been ignored in the effort to construct “systemic” theory.
Local auxin production: a small contribution to a big field

Auxin is a plant growth regulator involved in diverse fundamental developmental responses. Much is now known about auxin transport, via influx and efflux carriers, and about auxin perception and its role in gene regulation. Many developmental processes are dependent on peaks of auxin concentration and, to date, attention has been directed at the role of polar auxin transport in generating and maintaining auxin gradients. However, surprisingly little attention has focussed on the role and significance of auxin biosynthesis, which should be expected to contribute to active auxin pools. Recent reports on the function of the YUCCA flavin monooxygenases and a tryptophan aminotransferase in Arabidopsis have caused us to look again at the importance of local biosynthesis in developmental processes. Many alternative and redundant pathways of auxin synthesis exist in many plants and it is emerging that they may function in response to environmental cues.