Miracle-dz/UniFAR-FTUs huggingface dataset:
Plasma cell‐rich rejection accompanied by acute antibody‐mediated rejection in a patient with ABO‐incompatible kidney transplantation

We report a case of plasma cell‐rich rejection accompanied by acute antibody‐mediated rejection in a patient with ABO‐incompatible kidney transplantation. A 33‐year‐old man was admitted for an episode biopsy; he had a serum creatinine (S‐Cr) level of 5.7 mg/dL 1 year following primary kidney transplantation. Histological features included two distinct entities: (1) a focal, aggressive tubulointerstitial inflammatory cell (predominantly plasma cells) infiltration with moderate tubulitis; and (2) inflammatory cell infiltration (including neutrophils) in peritubular capillaries. Substantial laboratory examination showed that the patient had donor‐specific antibodies for DQ4 and DQ6. Considering both the histological and laboratory findings, we diagnosed him with plasma cell‐rich rejection accompanied by acute antibody‐mediated rejection. We started 3 days of consecutive steroid pulse therapy three times every 2 weeks for the former and plasma exchange with intravenous immunoglobulin (IVIG) for the latter histological feature. One month after treatment, a second allograft biopsy showed excellent responses to treatment for plasma cell‐rich rejection, but moderate, acute antibody‐mediated rejection remained. Therefore, we added plasma exchange with IVIG again. After treatment, allograft function was stable, with an S‐Cr level of 2.8 mg/dL. This case report demonstrates the difficulty of the diagnosis of, and treatment for, plasma cell‐rich rejection accompanied by acute antibody‐mediated rejection in a patient with ABO‐incompatible kidney transplantation. We also include a review of the related literature.
A Population-Based Evaluation of Cervical Screening in the United States: 2008–2011

Background: Cervical screening consumes substantial resources, but little is known about utilization in the United States or compliance with guideline recommendations. Methods: To describe population screening coverage, utilization, and outcomes and examine time trends from 2008 to 2011, cervical cytology reports from women residing in New Mexico (981,063 tests from 511,381 women) were evaluated. Results: From 2008 to 2011 cervical screening utilization decreased at all ages, but especially in younger women, with a two-third reduction at ages 15 to 20 years. Ninety-four percent of women ages 25 to 29 years were screened within 48 months but coverage decreased at older ages to 69% at 45 to 49 years and 55% at 60 to 64 years. Intervals between screening tests were significantly longer in 2011 compared with 2008 [HR = 1.23; 95% confidence intervals (CI), 1.22–1.24], although the commonest rescreening interval was 13 months. In 2011, 91.9% of screening tests for women ages 21 to 65 years were negative, 6.6% showed minor abnormalities, and 1.0% high-grade abnormalities. High-grade abnormality rates were relatively constant over time, but minor abnormalities and atypical cells cannot rule out high-grade (ASC-H) were increasing. Conclusions: This population-based evaluation of cervical screening shows high coverage under the age of 40 years, but lower levels in older women. Screening under age 21 years is becoming less common and screening intervals are lengthening, reflecting updates in national screening guidelines. Impact: Assessment of cervical screening intervals and population outcomes is essential for accurately estimating the impact and effectiveness of changing recommendations and vaccination against human papilloma virus infections. Cancer Epidemiol Biomarkers Prev; 23(5); 765–73. ©2013 AACR.
Effect of density and season on stress and behaviour in broiler breeder hens

1. We examined the effect of density (5, 7, 9 and 11 birds/m2) and season (summer and winter; different hens each season) on stress and behaviour in two flocks of 64 broiler breeder females divided among 8 pens. 2. The hens, approximately the same age and body mass in each season, were maintained on hard-packed ground, without litter, in an open-sided chicken house and were offered the same amount of food each season. 3. Mean house max/min temperatures varied between 18 and 33°C in summer and 7 and 17°C in winter. Mean relative humidity in summer varied between 68% at 08:00 h and 42% at 14:00 h and in winter was 64% at 08:00 h and 47% at 14:00 h. 4. No difference was found in heterophil:lymphocyte ratios among densities and between seasons; however, basophil numbers were higher in winter than in summer indicating prolonged stress in winter. 5. Stereotyped pecking increased with an increase in density and was higher in winter than in summer. Pecking on the ground was higher in winter, but was not affected by density. 6. In summer the hens spent more time lying and eating than in winter, whereas in winter the hens spent more time walking, preening and drinking than in summer. They spent the same amount of time standing in both seasons. None of these behaviours was density dependent. 7. We conclude that season had more of an effect than density on stress and behaviour in broiler breeder hens under the conditions of our study.
Prevalence and predictors of affective lability after paediatric traumatic brain injury

Abstract Objective: Paediatric severe traumatic brain injury (TBI) is associated with significant post-injury affective and behavioural problems. Few studies have examined the prevalence and characteristics of affective lability after paediatric TBI. Methods: Ninety-seven children with severe TBI were evaluated 1 year post-injury for the presence of affective lability using the Children’s Affective Lability Scale (CALS). Demographic, clinical and brain lesion characteristics were also assessed. Results: Affective lability significantly increased after injury. Eighty-six children had a pre-injury CALS score of 1 SD or less from the group pre-injury mean (M = 8.11, SD = 9.31), of which 35 and 15 children had a 1 SD and 2 SD increase in their CALS score from pre- to post-injury, respectively. A variety of affective shifts manifested post-injury including anxiety, silliness, dysphoria and irritability. The most severe symptoms were irritability and unpredictable temper outbursts. Risk factors for affective lability included elevated pre-injury affective lability and psychosocial adversity as well as greater damage to the orbitofrontal cortex. Post-injury affective lability was most frequently associated with a post-injury diagnosis of attention-deficit hyperactivity disorder. Conclusions: Affective lability is common after paediatric TBI and frequently manifests as irritability and unpredictable outbursts. Early intervention is needed to improve psychiatric outcomes.
Evaluation of teledermatology adoption by health-care professionals using a modified Technology Acceptance Model

We examined the main factors affecting the intention of physicians to use teledermatology using a modified Technology Acceptance Model (TAM). The investigation was carried out during a teledermatology pilot study conducted in Spain. A total of 276 questionnaires were sent to physicians by email and 171 responded (62%). Cronbach's alpha was acceptably high for all constructs. Theoretical variables were well correlated with each other and with the dependent variable (Intention to Use). Logistic regression indicated that the original TAM model was good at predicting physicians' intention to use teledermatology and that the variables Perceived Usefulness and Perceived Ease of Use were both significant (odds ratios of 8.4 and 7.4, respectively). When other theoretical variables were added, the model was still significant and it also became more powerful. However, the only significant predictor in the modified model was Facilitators with an odds ratio of 9.9. Thus the TAM was good at predicting physicians' intention to use teledermatology. However, the most important variable was the perception of Facilitators to using the technology (e.g. infrastructure, training and support).
Clinical significance of the expression of endothelial-monocyte activating polypeptide II (EMAPII) in the treatment of glioblastoma with recombinant mutant human tumor necrosis factor-alpha (TNF-SAM2).

BACKGROUND The application of human mutant recombinant TNF-alpha (TNF-SAM2) to glioblastoma has shown that there is marked variation in its sensitivity to TNF. To determine whether the production of endothelial-monocyte activating polypeptide II (EMAPII) by tumors confers TNF sensitivity and whether EMAPII expression in glioblastoma can predict the clinical response to TNF therapy, we evaluated EMAPII expression and the efficacy of TNF in patients with glioblastoma. MATERIALS AND METHODS We analyzed EMAPII mRNA expression using reverse transcriptase-polymerase chain reaction (RT-PCR) of frozen tissue sections of glioblastoma and evaluated if there was any correlation between EMAPII expression and the response to TNF therapy in patients with glioblastoma. RESULTS Amplified bands corresponding to EMAPII were obtained by RT-PCR in 8 out of 11 glioblastomas. There was a significant correlation between the time to tumor progression after TNF-SAM2 treatment and the expression of EMAPII (p < 0.05). Patients with positive expression of EMAPII in their tumor tissues tended to have longer progression-free survival. CONCLUSION Variable responses to combined chemotherapy with mutant TNF-alpha (TNF-SAM2) might be explained by EMAPII expression in glioblastoma. EMAPII expression in glioblastoma might predict the clinical response to TNF therapy and potentially identify patients with cytokine-responsive tumors.
Immunologic and clinicopathologic features of common acute lymphoblastic leukemia antigen‐positive childhood T‐cell leukemia A pediatric oncology group study

The immunologic and clinicopathologic features of common acute lymphoblastic leukemia antigen (CALLA)‐positive and CALLA‐negative T‐acute lymphoblastic leukemia (ALL) and of CALLA‐positive non‐T, non‐B ALL (common ALL) of childhood were compared. Twenty‐seven percent of children with T‐ALL had blasts that expressed CALLA. This expression was not associated with a significantly different incidence of expression of sheep erythrocyte‐rosette receptors, glucocorticoid receptors, peanut agglutinin receptors, or T‐cell antigens. CALLA‐positive T‐cell blasts were more likely to express a p24 leukemia‐associated antigen (CD9, 50% versus 8%) and Ia antigens (39% versus 8%) than were CALLA‐negative blasts. Patients with CALLA‐positive and CALLA‐negative T‐ALL had similar clinicopathologic features at diagnosis. In contrast, compared to patients with common ALL, patients with CALLA‐positive T‐ALL were older, had higher leukocyte counts, and an increased incidence of splenomegaly, lymphadenopathy and mediastinal mass, similar to patients with CALLA‐negative T‐ALL. Patients with CALLA‐positive T‐ALL were more likely to achieve a complete remission (95% versus 83%, P = 0.055) and tended to have an increased duration of event‐free survival (P = 0.07) than did patients with CALLA‐negative T‐ALL. The expression of T‐cell antigens is more important than the expression of CALLA in defining biologically similar subgroups of childhood ALL. Preliminary evidence suggests that within T‐ALL the expression of CALLA may be prognostically important.
Treatment of ductal carcinoma in situ among patients cared for in large integrated health plans.

OBJECTIVE To examine whether use of adjuvant therapy varies by race/ethnicity among patients with ductal carcinoma in situ (DCIS) at 3 integrated health plan delivery sites based in California and Massachusetts. STUDY DESIGN Cross-sectional study nested within a cohort of women diagnosed as having DCIS between 1990 and 2001. METHODS We reviewed medical records of 3000 non-Hispanic white (69%), black (10%), Hispanic (9%), and Asian or Pacific Islander (12%) women diagnosed as having DCIS between 1990 and 2001 and treated with breast-conserving therapy. chi(2) Test and multinomial logistic regression analysis were used to examine the association between race/ethnicity and use of adjuvant treatments after controlling for patient and clinical variables, including certain pathologic factors. RESULTS We found no significant differences in DCIS adjuvant treatment among racial/ethnic groups in bivariate or multinomial analyses after adjusting for demographic characteristics, comorbidity, and clinical factors. Minority women were as likely to undergo adjuvant radiation therapy as non-Hispanic white women. However, women 70 years or older (odds ratio, 0.40; 95% confidence interval, 0.31-0.51) and women who lived in areas with low geocoded median family income (odds ratio, 0.65; 95% confidence interval, 0.48-0.89) were less likely to receive adjuvant radiation therapy. Tumor size and comedo histologic growth pattern were associated with increased likelihood of receiving radiation therapy. CONCLUSION Use of adjuvant therapy by minority women in these managed care plans is similar to that by non-Hispanic white women, although use was less among older women and among women who lived in poorer neighborhoods.
Characterization of porcine growth differentiation factor‐9 and its expression in oocyte maturation

During follicular development, the importance of the interaction between oocytes and somatic cells is well‐known for maturation oocyte. Growth differentiation factor‐9 (gdf‐9) is thought to play an important role in such process. In this study, we characterized porcine gdf‐9 gene and investigate its expression during development. Also we determined its expression by different hormones during in vitro oocyte maturation. Overall length of pig gdf‐9 cDNA was cloned and its presumptive protein sequence of isolated cDNA has high homology to human or mouse GDF‐9 sequences. The gdf‐9 transcript was expressed in all stage of preimplantation embryos and fetuses, and was also expressed in the heart, brain, cumulus cells, spleen, ovary, and testis. Porcine GDF‐9 protein was specifically localized in in vitro matured oocyte and oocytes from adult ovary. In order to investigate the potential regulator of gdf‐9 gene expression, expression level of gdf‐9 gene was determined using serum‐free in vitro maturation (IVM) system. Supplementing with human chorionic gonadotrophin (hCG), pregnant mare serum gonadotrophin (PMSG), gonadotropin‐releasing hormone (GnRH), follicular stimulating hormone, luteinizing hormone (LH), or epidermal growth factor (EGF) did not affect level of gdf‐9 gene expression during ooycte maturation. In conclusion, porcine gdf‐9 gene is expressed in the porcine reproductive organ, especially in oocytes and embryos, and its expression is decreased during IVM. Mol. Reprod. Dev. 75: 707–714, 2008. © 2007 Wiley‐Liss, Inc.
Personality and social competency following unilateral stroke

Neuropsychological research indicates that the left hemisphere plays a dominant role in verbal production and processing, while the right hemisphere plays a dominant role in nonverbal production and processing. This study sought to examine the effects of such differential hemispheric specialization on personality and social competency. Ten left hemisphere damaged (LHD) stroke patients, 11 right hemisphere damaged (RHD) stroke patients, and 7 neurologically normal (NHD) patients were videotaped while engaging in social interaction with their spouse and an interviewer. Segments of the interactions were independently coded by two observers. Patients and spouses were rated with respect to their level of social competency and the extent to which they were characterized by 10 personality adjectives (e.g., outgoing, warm). Ratings for the personality items were summed to create an aggregate score. Analysis of these scores revealed both LHD and RHD patients to have lower (i.e., more negative) mean scores than NHD patients, suggesting that stroke patients as a whole were seen as socially impaired. Analysis of the socially competent item revealed particular LHD deficits; LHD patients were seen as less socially competent than both RHD and NHD patients. Spouses of LHD, RHD, and NHD patients, in contrast, did not differ in observer-rated social behavior. (JINS, 1998, 4, 447–455.)
A Study on the Performance Evaluation of Construction Project Integrated Management

In the integrated management system of construction projects, quality, schedule and cost are an entia in which they influence and restrict each other, and the change of anyone of the three objectives can induce the changes of the other two. So, how to make the performance evaluation of construction project integrated management objective and equitable, and provide a feasible reference benchmarking for integrated dynamic control, is a problem that should be studied carefully. Most previous project management performance evaluation method mainly adopted the single item linear analysis method. This method is easy, but can not reflect the complicated non-linear interaction between the evaluation indexes. In the light of the merit of BP artificial neural network method, the authors established a construction project integrated management performance evaluation model, which is based on the BP (back-propagation network) neural network, considering project time limit, quality requirements, cost, three major factors on construction project integration management. The analysis of a practical example shows that the evaluation results are more overall, scientific and objective.
Pre-procedural dual antiplatelet therapy in patients undergoing transcatheter aortic valve implantation increases risk of bleeding

Objective To evaluate the clinical benefit of pre-procedural antiplatelet therapy in patients undergoing transfemoral (TF) transcatheter aortic valve implantation (TAVI). Methods OCEAN (Optimized transCathEter vAlvular interveNtion)-TAVI is a prospective, multicentre, observational cohort registry, enrolling 749 patients who underwent TAVI from October 2013 to August 2015 in Japan. We identified 540 patients (median age 85 years, 68.1% female) undergoing TF-TAVI; of these, 80 had no pre-procedural antiplatelet therapy and 460 had antiplatelet therapy. The endpoints were any bleeding (life-threatening, major, and minor bleeding) and thrombotic events (stroke, myocardial infarction, and valve thrombosis) during hospitalisation. Results Patients with dual antiplatelet therapy (DAPT) had a significantly higher incidence of any bleeding than those with single antiplatelet therapy (SAPT) (36.5% vs 27.5%, p=0.049) and no antiplatelet therapy (36.5% vs 21.3%, p=0.010). Patients without pre-procedural antiplatelet therapy did not experience an increased risk of thrombotic events. In multivariable logistic regression analysis, DAPT before TF-TAVI significantly increased any bleeding compared with SAPT (OR 2.05, 95% CI 1.16 to 3.65) and no antiplatelet therapy (OR 2.30, 95% CI 1.08 to 4.90). Conclusions The current study demonstrated that DAPT before TF-TAVI increased the risk of bleeding compared with single or no antiplatelet therapy. Lower intensity antiplatelet therapy was not associated with thrombotic events. In modern practice, it might be reasonable to perform TAVI using single or no pre-procedural antiplatelet therapy with an expectation of no increase of adverse events. Trial registration number UMIN-ID; 000020423; Results.
Liver biopsy–related infection in liver transplant recipients: A current matter of concern?

Data from published studies regarding risk factors for liver biopsy (LB)–related infectious complications in liver transplant recipients are inconsistent. We carried out a retrospective cohort study analyzing consecutive LBs for orthotopic liver transplant patients at a tertiary hospital (2001‐2011): there were 667 LB procedures (575 percutaneous procedures and 92 transjugular procedures) in 286 liver transplant recipients. There were 20 complications in 19 patients (overall incidence = 3.0%): 10 were infectious complications (8 cases of bacteremia and 2 cases of peritonitis). The causal microorganisms were mainly Pseudomonas aeruginosa (4 patients) and Enterobacteriaceae (4 patients). All complications occurred with biopsies performed in patients hospitalized for more than 48 hours (381 biopsies for 201 patients); hence, only this group was included in the risk factor analysis. The variables associated with the development of infectious complications after LB were the presence of impaired biliary drainage at the time of biopsy (40% versus 15.1%, P = 0.03) and low albumin levels (2.4 versus 3.1 g/dL, P = 0.01). In conclusion, according to our experience, infectious complications secondary to LB in liver transplant recipients are related to hospitalization at the time of biopsy, particularly in the presence of impaired biliary drainage and low albumin levels. Liver Transpl 20:552–556, 2014. © 2014 AASLD.
Approximate Optimal Control Design for Nonlinear One-Dimensional Parabolic PDE Systems Using Empirical Eigenfunctions and Neural Network

This paper addresses the approximate optimal control problem for a class of parabolic partial differential equation (PDE) systems with nonlinear spatial differential operators. An approximate optimal control design method is proposed on the basis of the empirical eigenfunctions (EEFs) and neural network (NN). First, based on the data collected from the PDE system, the Karhunen-Loève decomposition is used to compute the EEFs. With those EEFs, the PDE system is formulated as a high-order ordinary differential equation (ODE) system. To further reduce its dimension, the singular perturbation (SP) technique is employed to derive a reduced-order model (ROM), which can accurately describe the dominant dynamics of the PDE system. Second, the Hamilton-Jacobi-Bellman (HJB) method is applied to synthesize an optimal controller based on the ROM, where the closed-loop asymptotic stability of the high-order ODE system can be guaranteed by the SP theory. By dividing the optimal control law into two parts, the linear part is obtained by solving an algebraic Riccati equation, and a new type of HJB-like equation is derived for designing the nonlinear part. Third, a control update strategy based on successive approximation is proposed to solve the HJB-like equation, and its convergence is proved. Furthermore, an NN approach is used to approximate the cost function. Finally, we apply the developed approximate optimal control method to a diffusion-reaction process with a nonlinear spatial operator, and the simulation results illustrate its effectiveness.