Miracle-dz/UniFAR-FTUs huggingface dataset:
Therapy of Advanced-stage Mature B-cell Lymphoma and Leukemia in Children and Adolescents With Rituximab and Reduced Intensity Induction Chemotherapy (B-NHL 2004M Protocol): The Results of a Multicenter Study

Pediatric mature B-cell non-Hodgkin lymphomas (B-NHLs) are highly aggressive malignant tumors that are curable with chemotherapy (ChT). High-dose methotrexate (MTX) is considered indispensable for successful treatment, but this therapy frequently induces severe mucositis and infectious complications, especially in induction, which can cause treatment failure. A prospective multicenter trial of combined immunochemotherapy for advanced-stage B-NHL with rituximab and the modified NHL-BFM-90 protocol was conducted. The major differences from the original protocol were a decrease in the dose of MTX from 5000 to 1000 mg/m2/24 h in the first 2 ChT blocks and the addition of rituximab at 375 mg/m2 to each of the first 4 blocks of ChT. Eighty-three newly diagnosed patients with a median age of 8.84 years with Burkitt lymphoma/leukemia and diffuse large B-cell lymphomas stage III to IV were included. Four patients died during induction ChT due to tumor lysis syndrome and infection. Two additional patients died subsequently due to tumor resistance. Complete remission was achieved in 77 (92.8%) patients; 2 patients relapsed at 1 and 3 months, and 2 developed secondary malignancies at 1 and 6.5 years, respectively, after the completion of therapy. The overall survival probability was 82%±8% with a median follow-up of 65.2 months. Combined therapy with rituximab and intensive ChT with a reduced MTX dose of 1 g/m2 in the 2 induction courses was feasible and produced high cure rates in patients with pediatric advanced-stage mature B-NHL.
Long-term adequacy of exclusive breast-feeding: how scientific research has led to revised opinions

The present paper reviews the research of the authors and their colleagues over the past 20 years to provide improved nutritional and anthropometric guidelines for the assessment of lactational adequacy and for when the weaning process might be initiated. The nutritional guidelines are based on revised dietary energy requirements. The basic assumption is that since breast milk is a well-balanced food, if energy needs are satisfied so will those for essential nutrients. Energy requirements for young babies have been derived from the application of the doubly-labelled-water technique. This approach indicated that 460 kJ (110 kcal)/kg per d at 1 month and 397 and 355 kJ (95 and 85 kcal)/kg per d at 3 and 6 months respectively would be satisfactory for a nutrient content of high bioavailability. Translated into a breast-milk intake of 850 ml/d the latter would cover the dietary energy needs of the average child growing along the 50th centile until at least 4 months, but the typical child from many developing countries following the 25th centile until 6 months. The importance of revised growth reference values for infancy, equally crucial for assessing lactational adequacy, is also reviewed. In contrast with the shapes of earlier reference patterns, growth trajectories are different when babies are fed in accordance with modern paediatric advice. Mothers and health professionals using the older growth charts to assess the progress of a baby can be misled into assuming that the weaning process needs to be introduced sooner than necessary. Examples of this situation within the context of a developing country are provided.
Genetic susceptibility to retinopathy of prematurity: the evidence from clinical and experimental animal studies

Despite advances in management and treatment, retinopathy of prematurity remains a major cause of childhood blindness. Evidence for a genetic basis for susceptibility to retinopathy of prematurity is examined, including the influences of sex, ethnicity, and ocular pigmentation. The role of polymorphisms is explored in the genes for vascular endothelial growth factor and insulin-like growth factor-1, and of mutations in the Norrie disease gene. Insights into the genetic basis of retinopathy of prematurity provided by the animal model of oxygen induced retinopathy are examined. Evidence for a genetic component for susceptibility to retinopathy of prematurity is strong, although the molecular identity of the gene or genes involved remains uncertain.
Hidden Entrepreneurs: Informal Practices within the Formal Economy

The focus of this study is ‘hidden entrepreneurs’ who bridge formal and informal economies. While their business activities are legal, the governance and ownership structures of their organizations are illegal. This qualitative study draws upon institutional theory to illuminate the emergence of international hidden entrepreneurs in Oman as an unintended response to institutional configurations, and to examine its perceived effects on the domestic entrepreneurial ecosystem. Hidden practices, shaped by the dynamics of institutional environments, are perceived negatively by policy makers and domestic entrepreneurs, but offer potential contributions for entrepreneurial development. In-depth interviews with entrepreneurs and stakeholders reveal how hidden practices are shaped by the dynamics of regulatory and social institutions. Loopholes, or flawed institutional configurations, and prevailing sociocultural factors drive the emergence of hidden practices. The study contributes to informal entrepreneurship literature and policy making through highlighting the relevance of international entrepreneurs in enabling entrepreneurial ecosystem development.
Patients with mild traumatic brain injury: Immediate and long-term outcome compared to intra-cranial injuries on CT scan

Background: Mild traumatic brain injury (MTBI) defined as Glasgow Coma Scale (GCS) 14 or 15 has shown contradictory short- and long-term outcomes. The objective of this study was to correlate intra-cranial injuries (ICI) on CT scan to neurocognitive tests at admission and to complaints after 1 year. Methods: Two hundred and five patients with MTBI underwent a CT scan and were examined with neurocognitive tests. After 1 year complaints were assessed by phone interviews. Results: The neurocognitive tests in 51% of the patients showed significant deficits; there was no difference for patients with GCS 14–15, nor was there a difference between patients with ICI to patients without. After 1 year patients with ICI had significantly more complaints than patients without ICI, the most frequent complaint was headache and memory deficits. Conclusions: No correlation was found between GCS or ICI and the neurocognitive tests upon admission. After 1 year, patients with ICI have significantly more complaints than patients without ICI. No cost savings resulted by doing immediate CT scan on all.
Measuring Gait Speed in the Out-Patient Clinic: Methodology and Feasibility

BACKGROUND: Gait speed is a simple physical function measure associated with key outcomes in the elderly population. Gait speed measurements may improve clinical care in patients with COPD. However, there is a knowledge gap about the reliability and variability of gait speed testing protocols in COPD. We evaluated established techniques of measuring gait speed in patients with COPD and assessed feasibility of implementing gait speed as a routine vital sign in an out-patient clinic. METHODS: The usual 4-meter gait speed (4MGS) (“walk at a comfortable/natural pace”), maximal 4MGS (“walk as fast as you can safely”), usual 10-meter gait speed (10MGS), and maximal 10MGS of subjects with stable COPD were measured. Walks were measured using a stopwatch and automated timing system. For the feasibility/implementation phase, patients from the entire spectrum of respiratory diseases completed acceptability surveys, and clinical assistants administered gait speed measurements using an automated timing system. Time to train and to administer the test and acceptability by the staff were evaluated. RESULTS: Seventy subjects enrolled; 60% were men, and the mean age ± SD was 69 ± 10 years. All methods showed excellent test-retest reliability (intraclass correlation coefficient of 0.95–0.97). The difference between the two timing systems did not exceed the suggested minimal clinically important difference of 0.1 m/s for the usual pace instructions but did exceed 0.1 m/s for maximal pace walks. The difference between 4MGS and 10MGS was 0.13 ± 0.10 m/s. FEASIBILITY: Most subjects reported that gait speed measurement prior to clinic appointment was very acceptable (66%) or acceptable (33%). Time added to clinic visit measuring 4MGS was 95 ± 20 seconds, and clinical assistants reported gait speed measurements as very acceptable (60%), acceptable (30%), and somewhat acceptable (10%). CONCLUSIONS: Gait speed is a reliable measure in COPD, regardless of instructed pace, distance, or timing mechanism; however, adhering to one protocol is suggested. 4MGS was easily implemented into clinical practice with high acceptability by patients and clinic staff.
Simultaneous Observation of Hybrid States for Cyber-Physical Systems: A Case Study of Electric Vehicle Powertrain

As a typical cyber-physical system (CPS), electrified vehicle becomes a hot research topic due to its high efficiency and low emissions. In order to develop advanced electric powertrains, accurate estimations of the unmeasurable hybrid states, including discrete backlash nonlinearity and continuous half-shaft torque, are of great importance. In this paper, a novel estimation algorithm for simultaneously identifying the backlash position and half-shaft torque of an electric powertrain is proposed using a hybrid system approach. System models, including the electric powertrain and vehicle dynamics models, are established considering the drivetrain backlash and flexibility, and also calibrated and validated using vehicle road testing data. Based on the developed system models, the powertrain behavior is represented using hybrid automata according to the piecewise affine property of the backlash dynamics. A hybrid-state observer, which is comprised of a discrete-state observer and a continuous-state observer, is designed for the simultaneous estimation of the backlash position and half-shaft torque. In order to guarantee the stability and reachability, the convergence property of the proposed observer is investigated. The proposed observer are validated under highly dynamical transitions of vehicle states. The validation results demonstrates the feasibility and effectiveness of the proposed hybrid-state observer.
Identification of an hnRNP A1-Dependent Splicing Silencer in the Human Papillomavirus Type 16 L1 Coding Region That Prevents Premature Expression of the Late L1 Gene

ABSTRACT We have previously identified cis-acting RNA sequences in the human papillomavirus type 16 (HPV-16) L1 coding region which inhibit expression of L1 from eukaryotic expression plasmids. Here we have determined the function of one of these RNA elements, and we provide evidence that this RNA element is a splicing silencer which suppresses the use of the 3′ splice site located immediately upstream of the L1 AUG. We also show that this splice site is inefficiently utilized as a result of a suboptimal polypyrimidine tract. Introduction of point mutations in the L1 coding region that altered the RNA sequence without affecting the L1 protein sequence resulted in the inactivation of the splicing silencer and induced splicing to the L1 3′ splice site. These mutations also prevented the interaction of the RNA silencer with a 35-kDa cellular protein identified here as hnRNP A1. The splicing silencer in L1 inhibits splicing in vitro, and splicing can be restored by the addition of RNAs containing an hnRNP A1 binding site to the reaction, demonstrating that hnRNP A1 inhibits splicing of the late HPV-16 mRNAs through the splicing silencer sequence. While we show that one role of the splicing silencer is to determine the ratio between partially spliced L2/L1 mRNAs and spliced L1 mRNAs, we also demonstrate that it inhibits splicing from the major 5′ splice site in the early region to the L1 3′ splice site, thereby playing an essential role in preventing late gene expression at an early stage of the viral life cycle. We speculate that the activity of the splicing silencer and possibly the concentration of hnRNP A1 in the HPV-16-infected cell determines the ability of the virus to establish a persistent infection which remains undetected by the host immune surveillance.
From child to grown up in a medical world: developing an adolescent transition programme at a Norwegian University hospital

Abstract Background Akershus University Hospital has since 2012 worked systematically towards improving the process of transfer for adolescents from the Department for Paediatric and Adolescent Medicine (DPAM) to adult services in our hospital. Objective To improve the transfer process of adolescents we aimed at moving from a more administrative focus on transfers to a transition programme. The aim was both short-term and long-term gains, namely quality improvement of the healthcare we are providing and valued health promotion outcomes. Methods A guided transition programme for adolescents was developed, piloted and introduced. It was developed in close collaboration with our youth council. An e-learning programme and a handbook for health care professionals were developed for implementation. Results Data from the pilot testing the transition programme show that the adolescent participants found the information material to be relevant. They reported that it was used actively by the health professionals in their consultations and that they found this to be helpful. It was crucial that the management acknowledged and took responsibility for the programme. We experienced that a shared understanding of the adolescent patient in both sending and receiving departments was crucial. Conclusion Adolescent medicine should include competence and professionalism. Health care personnel must possess knowledge, skills and attitude that enable good, health promoting encounters. Further evaluation of pre- and post-implementation clinical outcomes, of patient empowerment and of satisfaction among employees will need to follow for evaluation of the effectiveness of this transition programme.
Two types of cold sensitivity associated with the A184→V change in the DnaA protein

Multicopy dnaA(Ts) strains carrying the dnaA5 or dnaA46 allele are high‐temperature resistant but are cold sensitive for colony formation. The DnaA5 and DnaA46 proteins both have an A184→V change in the ATP binding motif of the protein, but they also have one additional mutation. The mutations were separated, and it was found that a plasmid carrying exclusively the A184→V mutation conferred a phenotype virtually identical to that of the dnaA5 plasmid. Strains carrying plasmids with either of the additional mutations behaved like a strain carrying the dnaA+ plasmid. In temperature downshifts from 42°C to 30°C, chromosome replication was stimulated in the multicopy dnaA46 strain. The DNA per mass ratio increased threefold, and exponential growth was maintained for more than four mass doublings. Strains carrying plasmids with the dnaA(A184→V) or the dnaA5 gene behaved differently. The temperature downshift resulted in run out of DNA synthesis and the strains eventually ceased growth. The arrest of DNA synthesis was not due to the inability to initiate chromosome replication because marker frequency analysis showed high initiation activity after temperature downshift. However, the marker frequencies indicated that most, if not all, of the newly initiated replication forks were stalled soon after the onset of chromosome replication. Thus, it appears that the multicopy dnaA(A184→V) strains are cold sensitive because of an inability to elongate replication at low temperature. The multicopy dnaA46 strains, on the contrary, exhibit productive initiation and normal fork movement. In this case, the cold‐sensitive phenotype may be due to DNA overproduction.
Relationships of Salinity Tolerance to Immunolocalization of Na+,K+-ATPase in the Gill Epithelium during Seawater and Freshwater Adaptation of the Guppy, Poecilia reticulata

Abstract The relationships of salinity tolerance to immunolocalization of Na+,K+-ATPase in the gill epithelium were examined during seawater and freshwater adaptation of the guppy. In fresh water, immunoreactivity for Na+,K+-ATPase appeared in two types of chloride cells, which are located on the primary lamellae of the gills. Immunoreactivity was strong in the chloride cells located at the base of the secondary lamellae and weak in the chloride cells located at the interlamellar region. During seawater adaptation, the strongly-immunoreactive chloride-cells increased in number and size while the weakly-immunoreactive chloride-cells decreased in number with an increase in salinity tolerance. In the fish of the seawater-adapted strain, on the other hand, most of the chloride cells were located at the base of the secondary lamellae and showed strong immunoreactivity. During freshwater adaptation, the strongly-immunoreactive chloride-cells decreased in number and size while the weakly-immunoreactive chloride-cells increased in number with a decrease in salinity tolerance. A positive correlation was observed between the salinity tolerance and the occupying area of the strongly-immunoreactive chloride-cells while a negative correlation was observed between the salinity tolerance and the occupying area of the weakly-immunoreactive chloride-cells during the seawater and freshwater adaptation. These results directly suggested that not only the occupying area of chloride cells but also the expression of Na+,K+-ATPase protein in the cells is important with respect to the osmoregulatory function in the gills and hypoosmoregulatory ability at the individual level.
Surgical management of small intestinal incarceration through the gastrosplenic ligament: 14 cases (1994-2006).

OBJECTIVE To determine prevalence, clinical findings, and long-term survival rate after surgery associated with incarceration of the small intestine through the gastrosplenic ligament (ISIGL) in horses. DESIGN Retrospective case series. ANIMALS 14 horses with ISIGL. PROCEDURES Medical records of horses with ISIGL examined between January 1994 and December 2006 were reviewed. Signalment, initial physical examination findings, results of abdominal fluid analysis, and clinical laboratory values were recorded, along with surgical findings, including segment of incarcerated intestine and surgical procedures performed. Long-term survival data were obtained through client interviews. RESULTS Clinical findings included small intestinal distention identified via rectal palpation (10/14 horses) or transabdominal ultrasonography (8/11), nasogastric reflux (4/14), and abnormal abdominal fluid (9/9). All horses required intestinal resection and anastomosis. Postoperative complications included adynamic ileus (5/14 horses), incisional infection (4/14), diarrhea (3/14), and laminitis (1/14). No breed or age predilection was detected, although geldings were at increased risk for ISIGL. Long-term survival rate was 79% (11/14 horses). CONCLUSIONS AND CLINICAL RELEVANCE ISIGL was an uncommon cause of colicin this hospital population. With appropriate surgical intervention and postoperative management, the long-term prognosis for surgically treated horses was fair to good.
Trade-Openness Effects Through Price Channels on Sectoral Informal Employment: The Case of Peru

This paper seeks to estimate the impact of sector specific international price shocks on informal employment demand. Such impact is specified by a theoretical model where law enforcement (regulation) is an important determinant of the formal-informal employment demand allocation decision. It is shown that trade-openness effects on informality are channeled through prices, thus the proposed price-informality multiplier is interpreted as a formal labour vulnerability to trade openness proxy indicator. By combining national accounts and labour force survey data the multiplier is estimated for a set of tradable sectors of the Peruvian economy for 2004-2013. The theoretical and empirical evidence suggests the presence of structural sector specific ‘informality traps’. It also raises awareness regarding the need of sector specific regulatory frameworks that could ease the regulatory burden at firms exhibiting structural proneness to formality.
Ultrasound of the Extrahepatic Bile Duct: Issues of Size

Ultrasound is a pivotal study for evaluation of the biliary tree. In particular, the size of the extrahepatic bile duct is a critical measurement and has been a contentious issue since the early days of diagnostic ultrasound. This article reviews the history and ongoing issues regarding sonography of the normal-size duct and a variety of factors that may affect its size, including age, prior surgery, congenital abnormalities, anatomical variations, and medications. Other related sonographic issues are discussed including abnormal nondilated ducts and abnormal intraluminal contents such as sludge or air that make evaluation of the duct more difficult, particularly in patients with primary sclerosing cholangitis and prior liver transplantation. Ultimately, the luminal size of the extrahepatic duct should be considered as a single part of the entire assessment of the biliary tree that must also include the intrahepatic and pancreatic ducts, the pattern of dilatation (variable vs progressively dilated to a single point of obstruction), any wall thickening, intraluminal sludge, calculi or mass, and extraluminal compression. Clinical symptoms and abnormal laboratory values should prompt further evaluation despite a normal appearance of the bile duct, whereas pursuit of an isolated finding of an enlarged duct without supporting clinical data may not be warranted.