Miracle-dz/UniFAR-FTUs huggingface dataset:
ASSOCIATION OF INTERLEUKIN-10 GENE PROMOTER POLYMORPHISM IN ACUTE CORONARY SYNDROME PATIENTS AND THEIR FIRST DEGREE RELATIVES

Inflammation plays an important role in the pathogenesis of acute coronary syndrome (ACS). Recent studies have shown that interleukin (IL)-10, an anti inflammatory cytokine with pleiotropic properties involves in the progression of the disease, but the relationship between the genetic variants of IL-10 has not been extensively studied in the ACS patients and their first degree relatives (FDRs). The present case-control study A total of 1407 subjects including ACS patients (651) their FDRs (324) along with age and sex matched healthy controls (432) were recruited. Serum IL-10 concentrations and IL-10 gene polymorphisms were evaluated to analyse their association with susceptibility to ACS. Serum IL-10 concentrations were significantly elevated in ACS patients and FDRs (p<0.001) in comparison with controls. IL-10 -1082 AA and -592 CC genotypes were significantly associated with the disease (p<0.001& p=0.0021). FDRs also had shown an increase in frequency of these genotypes when compared to controls (p<0.001). Patients having A-C (1082-592) haplotype was significantly associated with the disease (p=0.034). These results suggest that IL-10 concentrations and its polymorphisms could be involved in the risk of developing ACS in the ACS patients and their FDRs. IL-10 may be a valuable risk factor for prediction in early onset of ACS thus it can be considered as an alternative for other inflammatory markers.
3.55 keV hint for decaying axionlike particle dark matter

Recently, indications for an emission line at 3.55 keV have been found in the combined spectra of a large number of galaxy clusters and also in Andromeda. This line could not be identified with any known spectral line. It is tempting to speculate that it has its origin in the decay of a particle contributing all or part of the dark matter. In this note we want to point out that axion-like particles being all or part of the dark matter are an ideal candidate to produce such a feature. More importantly the parameter values necessary are quite feasible in extensions of the Standard Model based on string theory and could be linked up to a variety of other intriguing phenomena, which also potentially allow for new tests of this speculation.
Erythrocyte sedimentation rate values in active tuberculosis with and without HIV co-infection.

A retrospective descriptive study was undertaken to examine ESR values within the active period of TB disease. TB patients seen at the hospital during a 12-month period from 1 April 2004 to 31 March 2005 were included. Values were described in terms of two categories namely ESR = 100 mm/h and ESR < 100 mm/h in TB cases with and without concomitant HIV infection. For the purposes of the study active TB disease was defined as recently diagnosed TB that had not been treated for more than 2 weeks. The NHLS in Nelspruit measures the ESR using the Westergren method and gives normal reference ranges of 0 - 10 mm/h for males 0 - 15 mm/h for females and 0 - 31 mm/h for people over 60 years of age. The laboratory uses the enzyme-linked immunosorbent assay (ELISA) method as the confirmatory test for HIV infection. (excerpt)
Fungal encephalitis following bone marrow transplantation: clinical findings and prognosis.

BACKGROUND Central nervous system fungal infections (FI) are important complications and a cause of mortality in patients who receive hematopoietic stem cell transplantation (HSCT). AIMS To study the clinical aspects of fungal encephalitis (FE). SETTINGS AND DESIGN The study was carried out at the HSCT Center of the Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil. MATERIALS AND METHODS Clinical records and autopsy reports from patients submitted to HSCT with a diagnosis of FE. RESULTS Twelve patients were diagnosed with FE presenting with lowered level of consciousness, hemiparesis and seizures. We were able to identify two subgroups regarding susceptibility to FE: (1) patients with early onset FI and severe leucopenia, and (2) patients with later onset FI with graft-versus-host disease using immunosuppressive drugs. Eleven of the patients died directly due to the neurological complication, all had post-mortem confirmation of the diagnosis of FI. CONCLUSIONS These clinical, paraclinical and temporal patterns may provide the opportunity for earlier diagnosis and interventions.
Neurological toxicity of long‐term (>1 yr) thalidomide therapy in patients with multiple myeloma

Objective: Thalidomide is remarkably active in advanced relapsed and refractory multiple myeloma (MM), so that its use has been recently proposed either in newly diagnosed patients or as maintenance treatment after conventional or high‐dose therapy. This latter therapeutic approach has risen the concern of side‐effects of long‐term therapy with this drug. Methods: We analysed long‐term toxicity of 40 patients (27 M, 13 F, median age = 61.5 yr) who received salvage therapy with thalidomide ± dexamethasone for longer than 12 months (median 15, range 12–44) at our centre. All the patients had achieved at least a stable disease upon treatment with thalidomide alone (200–400 mg/d, n = 20) or thalidomide (200 mg/d) and dexamethasone (40 mg/d for 4 d every 4 wk) (n = 20). Results and conclusions: Neurotoxicity was the most troublesome and frequent toxic effect that was observed after long‐term treatment, the incidence averaging 75%. Among these 30 patients symptoms included paraesthesias, tremor and dizziness. Neurotoxicity was grade 1 in six patients (15%); grade 2 in 13 patients (32.5%), thus determining thalidomide dose reduction to 100 mg/d; and grade 3 in 11 patients (27.5%) who had subsequently to interrupt therapy despite their response. Electromyographic study, performed in patients with grade ≥2 neurotoxicity, revealed a symmetrical, mainly sensory peripheral neuropathy, with minor motor involvement. The severity of neurotoxicity was not related to cumulative or daily thalidomide dose, but only to the duration of the disease prior to thalidomide treatment, although no patients presented neurological symptoms at study entry. These results suggest that long‐term thalidomide therapy in MM may be hampered by the remarkable neurotoxicity of the drug, and that a neurological evaluation should be mandatory prior to thalidomide treatment, in order to identify patients at risk of developing a peripheral neuropathy.
The role of leadership in implementing and sustaining an evidence-based intervention for osteoarthritis (ESCAPE-pain) in NHS physiotherapy services: a qualitative case study

Abstract Purpose To explore the role of leadership by physiotherapists in implementing and sustaining an evidence-based complex intervention (ESCAPE-pain) for osteoarthritis. Materials and methods A qualitative case study approach using in-depth interviews with 23 clinicians and managers from 4 National Health Service (NHS) physiotherapy providers in England between 2016 and 2017. Data were analysed using thematic analysis. Results Different leadership roles and actions were characterised with four themes: (1) Clinical champions – clinicians driving the sustainability of ESCAPE-pain; (2) Supporters – junior clinicians directly supporting clinical champions’ efforts to sustain ESCAPE-pain; (3) Senior Manager – clinical champions’ senior managers influence on sustainability; (4) Decision-making – (in)formal processes underpinning decisions to (not) sustain the programme. Conclusions The study characterises the role of leadership in physiotherapy to sustain an evidence-based intervention for osteoarthritis (OA) within the NHS. Sustaining the intervention required on-going leadership, it did not stop at implementation. Senior specialist physiotherapists (as Champions) had a critical leadership role in driving sustainability. Their structural position (bridging the operational and strategic) and personal attributes allowed them to integrate different levels of leadership (i.e., senior managers and operational staff) to mobilise the collective, on-going work required for sustaining the programme. IMPLICATIONS FOR REHABILITATION Senior managers and clinicians in practice settings need to be aware that sustaining an intervention is an on-going, collective effort that continues post-implementation. Senior managers need to enable senior clinicians (who straddle strategic and operational functions) to have sufficient autonomy to access and mobilise resources and scope to restructure local systems and practice to support intervention sustainability. Operational staff need to be supported to have the practical know-how to deliver evidence-based intervention, which includes instilling the value of and a commitment for the interventions. Managers need to utilise dispersed leadership to empower and enthuse frontline clinicians to participate fully in the work to refine and sustain interventions, because it cannot be achieved by lone individuals.
Antecedents and outcomes of perceived locus of causality: An application of self-determination theory.

We extended self-determination theory by examining personality antecedents and self-regulatory consequences of perceived locus of causality (PLOC), which is the extent to which individuals perceive their actions as caused by internal or external reasons. We theorized that personality would influence PLOC and that individuals with internal PLOC would engage in more self-regulatory activities, which would in turn predict performance and enjoyment. We used structural equation modeling with data collected from 260 students at 4 time points to test our hypotheses. The model fit the data well. Although personality had direct effects on the self-regulatory activities of effort and meta-cognitive strategies, in addition to the indirect effects via PLOC, tests confirmed that including the indirect effects produced the best-fitting model.
Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI).

BACKGROUND AND OBJECTIVES Novel urinary kidney damage biomarkers detect AKI after cardiac surgery using cardiopulmonary bypass (CPB-AKI). Although there is growing focus on whether AKI leads to CKD, no studies have assessed whether novel urinary biomarkers remain elevated long term after CPB-AKI. We assessed whether there was clinical or biomarker evidence of long-term kidney injury in patients with CPB-AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We performed a cross-sectional evaluation for signs of chronic kidney injury using both traditional measures and novel urinary biomarkers in a population of 372 potentially eligible children (119 AKI positive and 253 AKI negative) who underwent surgery using cardiopulmonary bypass for congenital heart disease at Cincinnati Children's Hospital Medical Center between 2004 and 2007. A total of 51 patients (33 AKI positive and 18 AKI negative) agreed to long-term assessment. We also compared the urinary biomarker levels in these 51 patients with those in healthy controls of similar age. RESULTS At long-term follow-up (mean duration±SD, 7±0.98 years), AKI-positive and AKI-negative patients had similarly normal assessments of kidney function by eGFR, proteinuria, and BP measurement. However, AKI-positive patients had higher urine concentrations of IL-18 (48.5 pg/ml versus 20.3 pg/ml [P=0.01] and 20.5 pg/ml [P<0.001]) and liver-type fatty acid-binding protein (L-FABP) (5.9 ng/ml versus 3.9 ng/ml [P=0.001] and 3.2 ng/ml [P<0.001]) than did AKI-negative patients and healthy controls. CONCLUSIONS Novel urinary biomarkers remain elevated 7 years after an episode of CPB-AKI in children. However, there is no conventional evidence of CKD in these children. These biomarkers may be a more sensitive marker of chronic kidney injury after CPB-AKI. Future studies are needed to understand the clinical relevance of persistent elevations in IL-18, kidney injury molecule-1, and L-FABP in assessments for potential long-term kidney consequences of CPB-AKI.
The Vascular Anatomy and Dissection of the Free Scapular Flap

This article refers to the author's personal experience with a new scapular flap based on the dissection of 35 cadavers. In total, 70 free flaps were dissected. Its main advantages are the following: constancy of vascular anatomy; adequate size, length, and diameter of its vascular pedicle (which is formed by the cutaneous scapular artery and two veins); easy surgical dissection; primary closure of the donor site; and limited scar. However, this technique is not recommended in cases in which a large loss of substance is to be replaced. The first successful surgical application of the microsurgical scapular flap was performed in Paris in October of 1979.
Non-neurological major complications of extreme lateral and related lumbar interbody fusion techniques

Background: Complications exclusive of new neurological deficits/injuries that follow extreme lateral interbody fusion (XLIF) and related lateral lumbar interbody techniques should be better recognized to determine the safety of these procedures. Unfortunately, a review of the XLIF literature did not accurately reflect the frequency of these “other complications” as few US surgeons publish such adverse events that may lead to medicolegal suits. Methods: Major complications occurring with XLIF included sympathectomy, major vascular injuries, bowel perforations, sterile seromas, and instrumentation failures. Results: The frequency of sympathectomy was 4% for XLIF vs. 15% for anterior lumbar interbody fusion (ALIF). There were three major vascular injuries for XLIF; one fatal intraoperative event, one life-threatening retroperitoneal hematoma, and one iatrogenic lumbar artery pseudoaneurysm that was successfully embolized. Two bowel perforations were reported, whereas a third was a “direct communication. ” One patient developed a sterile recurrent seroma due to vancomycin powder utilized for an XLIF. One study cited malpositioning of an XLIF cage resulting in a lateral L3–L4 extrusion, whereas the second series looked at the 45% risk of cage-overhang when XLIF devices were placed in the anterior one-third of the vertebral body. Conclusion: Excluding new neurological deficits, XLIF techniques resulted in multiple other major complications. However, these small numbers likely reflect just the tip of the iceberg (e.g., 10%) and the remaining 90% may never be known as many US-based spine surgeons fail to publish such adverse events as they are discoverable in a court of law and may lead to medicolegal suits.
Prolactin Induces MAPK Signaling in Neural Progenitors without Alleviating Glucocorticoid-Induced Inhibition of in vitro Neurogenesis

We recently demonstrated that prolactin (PRL) prevents chronic stress-induced inhibition of adult hippocampal neurogenesis. It remained unsettled, however, whether PRL is acting directly on neural stem and progenitors cells (NPCs) or if neurogenesis is affected by an indirect mechanism, for example through the extensively described effects of PRL on the HPA axis. To address this point, we used neurosphere cultures derived from the adult rat hippocampus as an in vitro model for NPCs. Dexamethasone (DEX) was applied to stress the NPCs, and proliferation, survival and differentiation of cells were examined. DEX markedly inhibited proliferation of NPCs and cells entered the G₀ phase of cell cycle. Moreover, DEX reduced NPC survival and repressed astroglial differentiation, which is normally induced by serum or bone morphogenetic protein application. Even though we could demonstrate that NPCs express the PRL receptor and ERK1/2 signaling is induced by PRL, we did not observe any effect of PRL on NPCs proliferation, differentiation or survival, neither in the presence nor during absence of DEX. In summary, our results indicate that PRL action on NPCs and neurogenesis in vivo occurs via an indirect mechanism.
A case of subcutaneous Mycoleptodiscus indicus infection in a liver transplant recipient successfully treated with antifungal therapy

Abstract: Mycoleptodiscus indicus, a dematiaceous mold, occurs on the leaves of a number of different host plants and has been only recently described as a cause of human infection. Immunosuppressed individuals are at risk for developing infections with opportunistic fungal pathogens, which are a major cause of morbidity and mortality in this population. In addition, the treatment of infections caused by these fungi is frequently challenging. We report a case of M. indicus subcutaneous infection in a 51‐year‐old man with human immunodeficiency virus and hepatitis C co‐infection, who had a liver transplant. He developed skin nodules with a sporotrichoid lymphangitic distribution. Histopathology demonstrated unusual fungal elements with angioinvasion. Mycology cultures isolated a dematiaceous mold with the characteristic curved hyaline conidia of M. indicus. Initial treatment involved a combination of amphotericin B lipid complex and voriconazole, followed by monotherapy with voriconazole. The subcutaneous lesions resolved completely after 4 months of antifungal therapy.
Incremental Recovery in Main Memory Database Systems

Recovery activities, like checkpointing and restart, in traditional database management systems are performed in a quiescent state where no transactions are active. This approach impairs the performance of online transaction processing systems, especially when a large volatile memory is used. An incremental scheme for performing recovery in main memory database systems (MMDBs), in parallel with transaction execution, is presented. A page-based incremental restart algorithm that enables the resumption of transaction processing as soon as the system is up is proposed. Pages are recovered individually and according to the demands of the post-crash transactions. A method for propagating updates from main memory to the backup database on disk is also provided. The emphasis is on decoupling the I/O activities related to the propagation to disk from the forward transaction execution in memory. The authors also construct a high-level recovery manager based on operation logging on top of the page-based algorithms. The proposed algorithms are motivated by the characteristics of large MMDBs, and exploit the technology of nonvolatile RAM. >
Fundamentals of Relativization II with Computational Analyses

Relativization: The act of constructing a physical model which obeys the Einstein equivalence principle. This paper corrects and extends the initial results regarding black hole thermodynamics revealed in the preceding paper. In the process of correcting and extending those initial upper bounds on the intensity of Hawking radiation from a micro black hole, I will Quantitative find much more. It will be demonstrated that a Schrodinger like equation derived in the previous papers once solved in position basis with the proper boundary conditions will give a model which works on any imaginable length scale. This will be worked out analytically with accuracy precision by the aid of
Object detection using voting spaces trained by few samples

Abstract. A method to detect generic objects by training with a few image samples is proposed. A new feature, namely locally adaptive steering (LAS), is proposed to represent local principal gradient orientation information. A voting space is then constructed in terms of cells that represent query image coordinates and ranges of feature values at corresponding pixel positions. Cell sizes are trained in voting spaces to estimate the tolerance of object appearance at each pixel location. After that, two detection steps are adopted to locate instances of object class in a given target image. At the first step, patches of objects are recognized by densely voting in voting spaces. Then, the refined hypotheses step is carried out to accurately locate multiple instances of object class. The new approach is training the voting spaces based on a few samples of the object. Our approach is more efficient than traditional template matching approaches. Compared with the state-of-the-art approaches, our experiments confirm that the proposed method has a better performance in both efficiency and effectiveness.
Liver failure is uncommon in adults receiving long-term parenteral nutrition.

BACKGROUND Abnormal liver enzymes and endstage liver disease are reported to occur in 25%-100% and 15%-40% of adult patients receiving long-term parenteral nutrition (PN), respectively. The purpose of this historic cohort study was to investigate the incidence of and possible factors leading to the development of liver disease in our large home PN population. METHODS All patients on home PN for at least 6 months from July 1991 through June 2002 were eligible. Patients were excluded if they had active malignancy, underlying liver disease, or exposure to a hepatotoxin. The presence of PN-associated liver disease was only considered if test results were elevated on more than 1 occasion over at least 6 or more months. The severity of liver-associated enzymes was based on the degree of elevation and was stratified as mild (<2 times normal), moderate (2-5 times normal), and severe (>5 times normal). Severe liver dysfunction was defined as having all of the following criteria: total bilirubin >3 mg/dL; albumin <3.2 g/dL; and prothrombin time >3 seconds prolonged. A cumulative logit model was used to compare age, gender, underlying disease, PN indication, and PN formulas in patients with normal vs abnormal laboratory test results. RESULTS Two hundred eight patients received PN for more than 6 months, 36 had exclusion criteria, and 10 could not be analyzed, because of incomplete laboratory test results, leaving 162 in the study group. The average PN duration was 2.14 +/- 2.19 years (maximum, 10.28 years). Abnormal liver tests occurred in 154 patients, with most having a moderate elevation of alkaline phosphatase or aspartate aminotransferase; severe liver dysfunction occurred in 7 patients; 1 patient had completely normal liver enzymes. On average, patients received a PN formula that was high in amino acids (1.45 +/- 0.65 g/kg/d), modest in energy (24.7 +/- 13.4 kcal/kg/d), and in most cases with enough lipid emulsion to meet essential fatty acid requirements (0.28 +/- 0.25 g/kg/d). Only female gender was found to be associated with a greater likelihood of liver failure (p = .02). There was a trend toward a greater amount of total calories, dextrose calories, and duration of PN exposure leading to the development of severe liver dysfunction. CONCLUSIONS When long-term PN is given with a modest amount of total energy and a minimal amount of lipid emulsion, abnormal liver enzymes are common, but severe liver dysfunction is unusual.