Miracle-dz/UniFAR-FTUs huggingface dataset:
Measles case fatality ratio in India a review of community based studies.

CONTEXT Measles remains a major cause of child mortality in India. Measles case fatality ratios (CFRs) vary substantially between countries and even within the same community over time. We present a review of Indian community-based measles CFR studies conducted from 1975 to 2008. EVIDENCE ACQUISITION PubMed, Cochrane Libraries, and all WHO databases were searched using a combination of terms. All community-based studies were abstracted into a database. RESULTS We identified 25 studies with data on 27 communities. The median CFR was 1.63 per 100 cases (Q1= 0.00 and Q3= 5.06). Studies conducted after 1994 had significantly lower CFRs (P=0.031). Studies in rural settings had significantly higher CFRs compared to urban studies (P=0.015). No differences were found by study design or outbreak/endemic setting. CONCLUSIONS This review suggests measles CFR may be declining in India. We hypothesize that increased measles vaccination coverage is the main factor contributing to the decline. Widespread vaccination increases both the average age of infection and the proportion of total measles cases previously vaccinated. Vitamin A treatment/supplementation is also likely to have contributed. In order to further reduce measles burden in India, vaccination and vitamin A treatment/supplementation coverage should be increased and a two dose vaccine strategy should be implemented in all areas.
Differential Regulation of E2F1, DP1, and the E2F1/DP1 Complex by ARF

ABSTRACT The tumor suppressor protein ARF inhibits MDM2 to activate and stabilize p53. Recent studies provided evidence for p53-independent tumor suppression functions of ARF. For example, it has been shown that ARF induces proteolysis of certain E2F species, including E2F1. In addition, ARF relocalizes E2F1 from the nucleoplasm to nucleolus and inhibits E2F1-activated transcription. Because DP1 is a functional partner of the E2F family of factors, we investigated whether DP1 is also regulated by ARF. Here we show that DP1 associates with ARF. Coexpression of ARF relocalizes DP1 from the cytoplasm to the nucleolus, suggesting that DP1 is also a target of the ARF regulatory pathways. Surprisingly, however, the E2F1/DP1 complex is refractory to ARF regulation. Coexpression of E2F1 and DP1 blocks ARF-induced relocalization of either subunit to the nucleolus. The E2F1/DP1 complex localizes in the nucleoplasm, whereas ARF is detected in the nucleolus, suggesting that ARF does not interact with the E2F1/DP1 complex. Moreover, we show that E2F1 is more stable in the presence of ARF when coexpressed with DP1. These results suggest that ARF differentially regulates the free and heterodimeric forms of E2F1 and DP1. DP1 is a constitutively expressed protein, whereas E2F1 is mainly expressed at the G1/S boundary of the cell cycle. Therefore, the E2F1/DP1 complex is abundant only between late G1 and early S phase. Our results on the differential regulation E2F1, DP1, and the E2F1/DP1 complex suggest the possibility that ARF regulates the function of these cell cycle factors by altering the dynamics of their heterodimerization during progression from G1 to S phase.
Guidelines for the Institutional Implementation of Developmental Neuroprotective Care in the Neonatal Intensive Care Unit. Part A

The use of age-appropriate care as an organized framework for care delivery in the neonatal intensive care unit is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the work of Gibbins and colleagues with the “universe of developmental care” conceptual model and developmental care core measures which were endorsed by the National Association of Neonatal Nurses in their age-appropriate care of premature infant guidelines as best-practice standards for the provision of high-quality care in the neonatal intensive care unit. These guidelines were recently revised and expanded. In alignment with the Joint Commission’s requirement for health-care professionals to provide age-specific care across the lifespan, the core measures for developmental care suggest the necessary competencies for those caring for the premature and critically ill hospitalized infant. Further supported by the Primer Standards of Accreditation and Health Canada, the institutional implementation of theses core measures requires a strong framework for institutional operationalization, presented in these guidelines. Part A of this article will present the background and rationale behind the present guidelines and their condensed table of recommendations.
Determination of the optimal sample size for a clinical trial accounting for the population size

The problem of choosing a sample size for a clinical trial is a very common one. In some settings, such as rare diseases or other small populations, the large sample sizes usually associated with the standard frequentist approach may be infeasible, suggesting that the sample size chosen should reflect the size of the population under consideration. Incorporation of the population size is possible in a decision‐theoretic approach either explicitly by assuming that the population size is fixed and known, or implicitly through geometric discounting of the gain from future patients reflecting the expected population size. This paper develops such approaches. Building on previous work, an asymptotic expression is derived for the sample size for single and two‐arm clinical trials in the general case of a clinical trial with a primary endpoint with a distribution of one parameter exponential family form that optimizes a utility function that quantifies the cost and gain per patient as a continuous function of this parameter. It is shown that as the size of the population, N, or expected size, N∗ in the case of geometric discounting, becomes large, the optimal trial size is O(N1/2) or O(N∗1/2) . The sample size obtained from the asymptotic expression is also compared with the exact optimal sample size in examples with responses with Bernoulli and Poisson distributions, showing that the asymptotic approximations can also be reasonable in relatively small sample sizes.
Two-site sandwich ELISA for detection of Plasmodium vivax blood stage antigens using monoclonal and polyclonal antibodies.

Two systems of sandwich enzyme-linked immunosorbent assay (ELISA), a two-site monoclonal antibody sandwich ELISA MAb-MAb sandwich ELISA) and a two site polyclonal-monoclonal antibody sandwich ELISA (PAb-MAb sandwich ELISA) for the detection of Plasmodium vivax antigens were developed. The assays showed good correlation with the level of parasitemia when tested against serially diluted P. vivax parasites (r = 0.937, and 0.997 for MAb-MAb and PAb-MAb sandwich ELISA, respectively), with the ability to detect as few as 6.68 parasites/10(6) erythrocytes and 2.69 parasites/10(3) erythrocytes, respectively. The MAb-MAb sandwich ELISA was specific, since it was positive only with P. vivax-infected erythrocytes from vivax malaria patients and negative when erythrocytes from 34 healthy individuals and 30 falciparum malaria cases were tested. In contrast, cross-reaction was found in the PAb-MAb sandwich ELISA when the plates were coated with polyclonal IgG and tested against the serially diluted P. falciparum SO strain antigen prepared from in vitro cultures. Comparison between the two systems of two-site sandwich ELISA showed that the MAb-MAb sandwich ELISA was superior to the PAb-MAb sandwich ELISA: (1) it gave a higher sensitivity when tested with serially diluted P. vivax antigen preparations from vivax malaria patients; (2) it gave a higher specificity when tested with the SO strain of P. falciparum from in vitro cultures, (3) it gave a lower absorbance value when tested with erythrocytes from healthy individuals. All 281 cases of vivax malaria already proven by microscopic examination were positive by MAb-MAb sandwich ELISA. (ABSTRACT TRUNCATED AT 250 WORDS)
Magnitude and variability of effect sizes for the associations between chronic pain and cognitive test performances: a meta-analysis

Objectives and Methods: A systematic review and meta-analysis were performed to estimate the size and variability of the association between chronic pain (CP) and poorer cognitive test performances as a function of individual tests, pain sub-types, and study sources on 22 studies having (1) a control group, (2) reported means and standard deviations (SDs) and (3) tests studied at least 3 times. Results: CP patients performed significantly poorer with small to moderate effects (d = −.31 to −.57) on Digit Span Backward; STROOP Word; Color and Color-Word; Digit Symbol; Trail Making A and B; Rey Auditory Learning Immediate and Delayed Recall and Recognition. For these 10 measures, single effects (no interaction) were supported (I2 = 0%–8%) and Random and Fixed models yielded similar results. No group differences were found for Corsi Blocks Forward or Wisconsin Cart Sorting Test Categories Achieved, or Perseveration. Effects for the Rey Complex Figure Immediate and Delayed Recall were significant, but effect size was inconclusive, given moderate to high heterogeneity and lack of consistency between Random and Fixed models. For the Paced Auditory Serial Addition Test, there was a homogeneous (I2 = 0%) and significantly lower performance in fibromyalgia (d = −.47), but no effect in diagnostically undifferentiated pain samples, and wide variability across studies of whiplash (d = −.15 to −1.04, I2 = 60%). Conclusion: The magnitude and consistency of the CP – cognition effect depended on the test, pain subgroup and study source. Summary points Among tests showing a chronic pain (CP) – cognition effect, the magnitude of this association was consistently small to moderate across tests. Effect size estimation was inconclusive for Digit Span Forwards, the Paced Auditory Serial Addition Test and the Rey Complex Figure Test. Variance was too heterogeneous for testing cognitive domain specificity of the CP – cognition effect.
Economic Convergence in the Euro Area: Coming Together or Drifting Apart?

We examine economic convergence among euro area countries on multiple dimensions. While there was nominal convergence of inflation and interest rates, real convergence of per capita income levels has not occurred among the original euro area members since the advent of the common currency. Income convergence stagnated in the early years of the common currency and has reversed in the wake of the global economic crisis. New euro area members, in contrast, have seen real income convergence. Business cycles became more synchronized, but the amplitude of those cycles diverged. Financial cycles showed a similar pattern: sychronizing more over time, but with divergent amplitudes. Income convergence requires reforms boosting productivity growth in lagging countries, while cyclical and financial convergence can be enhanced by measures to improve national and euro area fiscal policies, together with steps to deepen the single market.
The Relation Between Pragmatic Awareness and Realization of Requests Among Non-Native English Instructors

Language acquisition requires the learners to develop their pragmatic competence so that they are able to comprehend and produce the language as a mean of conveying meaning that is understandable by certain strategy or manner. Foreign language learners with lack of pragmatic awareness realized inappropriate target language. This study, therefore, was aimed to describe the English instructors’ pragmatic awareness and realization in requests, and how the awareness relates to the realization. The study used a descriptive qualitative in order to describe and elaborate the pragmatic awareness and realization of request speech acts among the 12 representations of non-native English instructors studying English Education in Graduate Program of State University of Semarang. Multiple Discourse Completion Task (MDCT) and role play were used in collecting data. Triangulation that included English native speaker’s analysis was also used in order to enhance the validity of the data. The result of the study shows that the participants’ awareness was high in the term of power relation but lower in ranking of imposition and social distance. Power relation was the social factor that mostly influenced the choices of request strategies in the oral production of requests. It is, therefore, concluded that there is causal relation between pragmatic awareness and its realization.
[Corneal thickness distribution and its relationship with corneal topography in ametropic population].

OBJECTIVE To explore the distribution of relational corneal thickness parameters including central corneal thickness (CCT), thinnest pachymetry (TP), cornea thickness spatial profile (CTSP), percentage thickness increase (PTI), pachymetric progression index (PPI) and Ambrósio's relational thickness (ART) in the normal population, and their relationships with corneal astigmatism and curvature. METHODS A total of 1 203 eyes from 1 203 normal outpatients were enrolled in this cross-sectional study. The data information of CCT, TP, CTSP, PTI, PPI-max, PPI-min, PPI-ave, axes of PPI-max and PPI-min, ART-max and ART-ave was collected from Pentacam HR for the subsequent analysis of their distribution. Astigmatism, astigmatism axis (AA), and keratometry (K) including Km and Kmax were also collected to explore their relationships with relational thickness parameters. RESULTS The mean values for CCT and TP were (547.20 ± 31.441) µm and (543.26 ± 31.271) µm, respectively. The mean values for CTSP-2, CTSP-4, CTSP-6 and CTSP-8 were (552.11 ± 31.654) µm, (580.72 ± 32.919) µm, (632.11 ± 34.738) µm and (711.80 ± 37.880) µm, respectively. PTI-2, PTI-4, PTI-6 and PTI-8 were (1.67 ± 0.471)%, (6.89 ± 0.945)%, (16.37 ± 1.996)% and (31.10 ± 3.652)%. PPI-max, PPI-min and PPI-ave were 1.222 ± 0.175, 0.733 ± 0.138 and 0.994 ± 0.123. The axes of PPI-max and PPI-min were 230.74 ± 104.862 and 159.81 ± 62.292. ART-max and ART-ave were (454.940 ± 78.506)µm and (556.140 ± 86.492)µm. CCT, TP, PPI and ART were found to have a weak but significant correlation with Kmax-front, Km-front and Km-back. PPI and ART were also found to weakly correlate with Astig-back. The converted astigmatism axis was found to correlate with the axes of PPI-max (rs = -0.125, P = 0.000) and PPI-min (rs = 0.613, P = 0.000). CONCLUSIONS The front and back curvatures and the back astigmatism correlate with the distribution of corneal thickness, while the front astigmatism does not correlate with it. The front astigmatism axis tends to distribute coincidently with PPI-min axis.
Racial and ethnic differences in receipt of antidepressants and psychotherapy by veterans with chronic depression.

OBJECTIVE This study characterized racial-ethnic differences in treatment of veterans with chronic depression by examining antidepressant and psychotherapy use among non-Hispanic black, non-Hispanic white, Hispanic, Asian, and American Indian-Alaska Native (AI/AN) veterans. METHODS Logistic regression models were estimated with data from the U.S. Department of Veterans Affairs (VA) medical records for a sample of 62,095 chronically depressed patients. Data (2009-2010) were from the VA External Peer Review Program. Three primary outcome measures were used: receipt of adequate antidepressant therapy (≥80% medications on hand), receipt of adequate psychotherapy (at least six sessions in six months), and receipt of guideline-concordant treatment (either of these treatments). RESULTS Compared with whites, nearly all minority groups had lower odds of adequate antidepressant use and guideline-concordant care in unadjusted and adjusted models (antidepressant adjusted odds ratio [AOR] range=.53-.82, p<.05; guideline-concordant AOR range=.59-.83, p<.05). Although receipt of adequate psychotherapy was more common among veterans from minority groups in unadjusted analyses, differences between Hispanic, AI/AN, and white veterans were no longer significant after covariate adjustment. After adjustment for distance to the VA facility, the difference between black and white veterans was no longer significant. CONCLUSIONS A better understanding of how patient preferences and provider and system factors interact to generate differences in depression care is needed to improve care for patients from racial-ethnic minority groups. It will become increasingly important to differentiate between health service use patterns that stem from genuine differences in patient preferences and those that signify inequitable quality of depression care.
Fast characterization of parameterized cell library

In Standard cell library based design methodology, maintaining multiple driving strengths for each gate type is critical for timing closure and low power. However, due to formidable burden on library designers, often only a few gate implementations are available for many gate types. The problem becomes more difficult if constructing accurate delay tables is considered. This imposes a great challenge on efficient cell library design. This challenge is tackled in this paper. We propose a fast cell characterization approach for parameterized cell (p-cell) library. By our approach, the layout and the accurate delay table of any integer-sized cell can be automatically generated on the fly solely from the smallest cell without any additional simulations. Thus, dense cell library can be efficiently generated. As a result, significant area can be saved by the synthesis using the dense p-cell library compared to the sparse cell library which is often the case in practice.
Neurotrophins facilitate neuronal differentiation of cultured neural stem cells via induction of mRNA expression of basic helix‐loop‐helix transcription factors Mash1 and Math1

Neurogenesis is promoted by basic helix‐loop‐helix (bHLH) transcription factors Mash1, Math1, or NeuroD but suppressed by another set, Hes1 and Hes5. It remains unknown what kinds of extracellular signals are involved in their regulation; therefore, the effects of neurotrophins on the expression of bHLH factors and neuronal differentiation were investigated by the use of cultured mouse neural stem cells. Each neurotrophin increased Mash1 and Math1 mRNAs of the stem cells growing in the presence of fibroblast growth factor‐2 (FGF‐2), but did not alter Hes1, Hes5, or NeuroD mRNA levels. Simultaneously, most of the cells expressed nestin but not microtubule‐associated protein 2 (MAP2), and remained undifferentiated. FGF‐2 removal from the medium reduced the levels of Hes1 and Hes5 mRNAs and increased those of Mash1, Math1, and NeuroD mRNAs, resulting in substantial neuronal differentiation. When the cells were pretreated with brain‐derived neurotrophic factor, a neurotrophin, FGF‐2 removal enhanced earlier NeuroD expression and generated many more MAP2‐positive cells. The high level of Mash1 and Math1 that had been elevated at FGF‐2 withdrawal accelerated NeuroD expression in cooperation with the reduced Hes1 and Hes5 expression. Our present results suggest that neurotrophins stimulate neuronal differentiation by altering the balance of expression of various bHLH transcription factors. © 2002 Wiley‐Liss, Inc.
Radiofrequency energy delivery to the gastroesophageal junction for the treatment of GERD.

BACKGROUND In this multi-center study, the feasibility, safety, and efficacy of radiofrequency (RF) energy delivery to the gastroesophageal junction (GEJ) for the treatment of gastroesophageal reflux disease (GERD) were investigated. METHODS Forty-seven patients with classic symptoms of GERD (heartburn and/or regurgitation), a daily anti-secretory medication requirement, and at least partial symptom response to drugs were enrolled. All patients had pathologic esophageal acid exposure by 24-hour pH study, a 2 cm or smaller hiatal hernia, grade 2 or less esophagitis, and no significant dysmotility or dysphagia. RF energy was delivered with a catheter and thermocouple-controlled generator to create submucosal thermal lesions in the muscle of the GEJ. GERD symptoms and quality of life were assessed at 0, 1, 4, and 6 months with the short-form health survey (SF-36). Anti-secretory medications were withdrawn 7 days before each assessment of symptoms and pH/motility study. Medication use, endoscopic findings, esophageal acid exposure, and motility were assessed at 0 and 6 months. RESULTS Thirty-two men and 15 women underwent treatment. At 6 months there were improvements in the median heartburn score (4 to 1, p < or = 0.0001), GERD score (26 to 7, p < or = 0.0001), satisfaction (1 to 4, p < or = 0.0001), mental SF-36 (46.2 to 55.5, p = 0.01), physical SF-36 (41.1 to 51.9, p < or = 0.0001), and esophageal acid exposure (11.7% to 4.8%, p < or = 0.0001). Esophagitis was present in 25 patients before treatment (15 grade 1 and 10 grade 2) and 8 had esophagitis at 6 months (4 grade 1 and 4 grade 2, p = 0.005). At 6 months, 87% no longer required proton pump inhibitor medication. There was no significant change in median lower esophageal sphincter pressure (14.0 to 12.0 mm Hg, p = 0.19), peristaltic amplitude (64 to 66 mm Hg, p = 0.71), or lower esophageal sphincter length (3.0 to 3.0, p = 0.28). There were 3 self-limited complications (fever for 24 hours, odynophagia lasting for 5 days, and a linear mucosal injury that was healed after 3 weeks). CONCLUSION RF energy delivery significantly improved GERD symptoms, quality of life, and esophageal acid exposure while eliminating the need for anti-secretory medication in the majority of patients with a heterogeneous spectrum of clinical disease severity but with minimal active esophagitis or hiatal hernia.
Hospital-based emergency department visits with dental conditions among children in the United States: nationwide epidemiological data.

PURPOSE To provide nationally representative estimates of hospital-based emergency department visits (ED) for dental caries, pulp and periapical lesions, gingival/periodontal lesions, and mouth cellulitis occurring among patients who were 21 years old and younger. METHODS Nationwide Emergency Department Sample (NEDS) for the year 2008 was used. All ED visits with dental conditions were included. Discharge patterns, demographics, disposition following ED visit, and hospital charges, were examined. NEDS is a uniform, stratified dataset, and can be projected to the national level. RESULTS A total of 215,073 ED visits with dental conditions occurred among children. These visits included diagnosis of dental caries (50 percent of visits), pulpal and periapical conditions (41 percent), gingival (15 percent) and periodontal diseases (five percent), and mouth abscess/cellulitis (three percent). Forty-two percent were covered by Medicaid, and 32 percent were uninsured. Mean charge per visit was $564, and total ED charge across the United States (US) was $104.2 million. Among those hospitalized following ED visits, total hospitalization charge across US was $162 million. CONCLUSIONS A substantial amount of hospital resources are spent treating dental conditions in the ED. A total of 43 percent of ED visits were covered by Medicaid, and 32 percent were uninsured.