Miracle-dz/UniFAR-FTUs huggingface dataset:
OriginalBasicScienceçGeneral Transplant Site Influences the Immune Response After Islet Transplantation : Bone Marrow Versus Liver

Background. The aim of this study was to characterize the immune response against intrabone marrow (BM-Tx) or intraliver (liver-Tx) transplanted islets in the presence or in the absence of immunosuppression. Methods. Less (C57BL/6 in Balb/c) and highly (Balb/c in C57BL/6) stringent major histocompatibility complex fully mismatched mouse models were used to evaluate the alloimmune response. Single antigen-mismatched mouse model (C57BL/6 RIP-GP in C57BL/6) was used to evaluate the antigen-specific immune response.Mice received tacrolimus (FK-506, 0.1mg/kg per day)/mycophenolatemofetil (MMF, 60mg/kg per day), and anti-CD3 (50 μg/day) either alone or in combination. Results. Transplant site did not impact the timing nor the kinetics of the alloimmune and single antigen-specificmemory Tcell responses in the absence of immunosuppression or in the presence of MMF/FK-506 combination. On the other hand, the median time to graft rejection was 28 ± 5.2 days and 16 ± 2.6 days (P = 0.14) in the presence of anti-CD3 treatment, 50 ± 12.5 days and 10 ± 1.3 days (P = 0.003) in the presence of anti-CD3/ MMF/FK-506 treatment for liver-Tx and BM-Tx, respectively. Anti-CD3 did not differentially reach BM and liver tissues but was more effective in reducing graft associated Tcell responses in liver-Tx than in BM-Tx.Conclusions. Islets infused in the BM appear less protected from the adaptive immune response in the presence of the anti-CD3 treatment. This result raises some concerns over the potential of the BM as a site for islet allotransplantation.
What Have We Gained by Performing Robotic Rectal Resection? Evaluation of 64 Consecutive Patients Who Underwent Laparoscopic or Robotic Low Anterior Resection for Rectal Adenocarcinoma

Background: Robotic surgery is thought to be a solution to overcome the limitations of laparoscopy in sphincter-saving resections. In this study, we present our results on patients undergoing robotic and laparoscopic low anterior resection (LAR) consecutively for rectal adenocarcinoma. Materials and Methods: Between February 2008 and June 2011, consecutive patients who underwent laparoscopic or robotic LAR by a single surgical team for rectal cancer were evaluated. The patients’ demographic, operative, postoperative short-term follow-up, and histopathologic data were analyzed. Results: Twenty-seven patients underwent robotic LAR, whereas 37 patients underwent laparoscopic LAR. The operation time of the laparoscopy group was significantly shorter than that of the robotic group (P=0.02). The complete total mesorectal excision rate was significantly higher in the robotic group (P=0.02). The overall complication rates were 11.11% and 21.62% in the robotic and laparoscopy groups, respectively (P=0.45). Conclusions: Good quality of resected specimens could be achieved with robotic LAR. Further prospective studies including long-term oncologic outcomes and costs with higher patient number are definitely needed to assess the benefits of robotic resection in rectal cancer treatment.
C-Reactive Protein Level Is an Indicator of the Aggressiveness of Advanced Pancreatic Cancer

Objectives This study investigated the ability of serum levels of C-reactive protein (CRP) to stratify the aggressiveness of advanced pancreatic cancer (PCa), including poor outcomes, systemic weakness, and extent of the disease in patients receiving first-line chemotherapy. Methods The prognostic CRP classification was constructed in the retrospective cohort, consisting of advanced PCa patients with first-line gemcitabine monotherapy (GEM). Stratification using the prognostic CRP classification was validated for relationships with the aggressiveness of advanced PCa in the prospective cohort, consisting of treatment-naive patients without obvious infections who received first-line GEM or GEM-based regimens. Results C-reactive protein low (<0.5 mg/dL), intermediate (≥0.5 and <2.0 mg/dL), and high (≥2.0 mg/dL) related good, moderate, and poor survival, respectively, and were independent predictors of survival in multivariate analyses among the 280 patients in the retrospective cohort and the 141 patients in the prospective cohort. Low Karnofsky Performance Status, hypoalbuminemia, anemia, and large tumor burden were more common in the high CRP group than in the low CRP group. The intermediate CRP group showed a larger burden of tumor than the low CRP group. Conclusions C-reactive protein stratified the outcomes, systemic weakness, and tumor burden. C-reactive protein is an indicator of the aggressiveness of advanced PCa.
Aseptic insertion of central venous lines to reduce bacteraemia

TO THE EDITOR: We would like to congratulate the Central Line Associated Bacteraemia in NSW Intensive Care Units Collaborative for reducing central line-associated bacteraemia (CLAB), and showing that this reduction was associated with compliance with evidence-based aseptic central venous line (CVL) insertion, which included a patient bundle and a clinician bundle, as reported by Burrell and colleagues.1 As part of a quality improvement program in Western Australia, we conducted a collaborative cohort study (unpublished) in two major Perth teaching hospitals with adult intensive care units (ICUs), from April 2007 to September 2008, covering 36 ICU-months and 15 459 catheterdays. Both ICUs implemented the WA Safety and Quality Investment for Reform central line bundle.2 Compliance was monitored by an observer with a checklist. Adherence to all components of the central line bundle was required for compliance to be recorded. This measure was reported monthly. CLAB and catheter-days were monitored by the hospitals’ infection control practitioners. Compliance with the bundle increased from a mean of 10% to greater than 90%. Infection rates declined over the study period from more than six infections per 1000 catheter-days to zero (P = 0.019 for Hospital 1 and P = 0.10 for Hospital 2). In the final 8 ICU-months (4 months in both hospitals), there was no CLAB. The New South Wales study demonstrated the importance of the clinician bundle components over the patient bundle components, which should inform future quality improvement initiatives. We note the comment that the hat, mask and eyewear components of the bundle were unpopular with clinicians. However, there is a risk of recontaminating disinfected skin “Compliance with the bundle increased from a mean of 10% to greater than 90%
The Hug–Kellerer equation as the universal cell survival curve

The Hug–Kellerer (H-K) equation is one of the earliest proposed radiation cell survival curves. We examine this equation in view of the recent perceived need for a universal cell survival curve which would be applicable to single radiation fractions at high doses. We derive relationships between the three parameters of the H-K equation and the parameters α and β of the linear-quadratic equation. Using these relationships we show how the H-K equation can be used to determine single-fraction doses which are equivalent in theory to the dose in a conventional multi-fraction course of radiation therapy.
South Asian chronic lymphocytic leukaemia patients have more rapid disease progression in comparison to White patients

Ethnicity has a major impact on the prevalence of chronic lymphocytic leukaemia (CLL) and may also influence disease phenotype. We compared the clinical features of Southern Asian and White CLL patients managed within one UK region. Asians required treatment almost twice as often as Whites (HR, 1·94) and had a shorter time to first treatment (P = 0·0063). This difference remained significant after adjusting for stage, lymphocyte doubling time and IGHV status (P = 0·026). CLL was diagnosed at younger ages in Asians and racial‐specific variations in IGHV usage were demonstrated. Our findings indicate that Southern Asian race has a negative impact on CLL phenotype.
On the Performance of Short Tail-BitingConvolutional Codes for Ultra-ReliableCommunications

Motivated by the increasing interest in powerful short channel codes for low-latency ultra-reliable communications, we analyze the performance of tail-biting convolutional codes with different memories, block lengths and code rates over the additive white Gaussian noise channel. The analysis is carried out both through Monte Carlo simulations and by upper bounding the error probability via Poltyrev’s tangential sphere bound at very low error rates. For the simulations, the near maximum likelihood wrap-around Viterbi algorithm is considered. We then compare the performance of tail-biting convolutional codes both with finite-length performance bounds and with that of other channel codes that have been recently considered for ultra-reliable satellite telecommand links. For the shortest block lengths, tail-biting convolutional codes outperform significantly state-of-the-art iterative coding schemes, while as expected their performance degrades visibly with increasing block lengths
Fronto-temporal dysfunction in schizophrenia: A selective review

Schizophrenia is conceptualized as a disorder of aberrant neurodevelopment, with evident stigmata such as minor physical anomalies (MPA), neurological soft signs (NSS), and abnormalities of brain structure and function, proposed as disease endophenotypes. We have examined the neurobiology of schizophrenia using neurodevelopmental markers, structural MRI (sMRI), EEG spectral power, and coherence as well as neuropsychological testing in neuroleptic-naïve, recent-onset schizophrenia (NRS) subjects. It has been our focus to link the positive and negative symptom dimensions of schizophrenia with their underlying neural correlates specifically reflecting fronto-temporal circuitry dysfunction. We found that MPAs and NSSs constituted independent neurodevelopmental markers of schizophrenia and would afford greater predictive validity when used as a composite endophenotype. In an exploratory factor analytic study of the dimensionality of psychopathology, we noted that the symptoms segregated into three dimensions, viz., positive, negative, and disorganization, even in NRS subjects. Executive function tests as well as EEG spectral power and coherence studies revealed that the symptom dimensions of schizophrenia could be linked to specific neural correlates. In an attempt to study the relationship between the symptom dimensions and brain structure and function using MRI, we have proposed neuroanatomical definitions with cytoarchitectonic meaning for parcellation of the prefrontal sub-divisions. Using sMRI, we have found specific corpus callosal abnormalities that possibly link the temporo-parietal association cortices with the positive symptom dimension. Recently, we also found evidence for neurodevelopmental deviance in schizophrenia possibly involving the frontal pole (FP)-driven cortical network, in a sMRI study linking FP volume and total brain volume with age in NRS subjects and age-, gender- and education-matched healthy subjects. Overall, our findings highlight the potential significance of linking the homogeneous symptom dimensions of schizophrenia with dysfunctional connectivity in the fronto-temporal region.
Extending Rest between Unloading Cycles Does Not Enhance Bone's Long-Term Recovery.

PURPOSE Multiple exposures to unloading are overall more deleterious to the skeleton than is single exposure, although the rate of bone loss may diminish during multiple exposures. Here, we determined whether extending the reambulation (RA) period from 3 wk to 9 wk will mitigate bone loss during three distinct 3-wk hindlimb unloading (HLU) periods and enhance long-term recovery in skeletally mature, genetically heterogeneous mice. METHODS Female adult mice (4 months old) were subjected to three cycles of 3-wk unloading with 3-wk or 9-wk RA periods in between. Mice were terminated 46 wk after initiation of the study. Outcome measures for the distal femur were determined from multiple in vivo micro-computed tomography scans and finite-element modeling. RESULTS Tripling RA duration enhanced trabecular bone recovery in between HLU periods but also increased the rate of loss of bone volume fraction (bone volume/tissue volume) and metaphyseal stiffness during subsequent HLU periods. With shorter RA periods, the magnitude of bone loss decreased by the second HLU period, whereas this decrease was delayed with longer RA periods. RA duration did not affect long-term recovery 46 wk after the start of the experimental protocol, as both HLU groups had similar levels of bone volume/tissue volume, cortical area, and stiffness. Individual cage activity levels were unrelated to the magnitude of bone loss during HLU or bone recovery during RA. CONCLUSIONS These data suggest that extending recovery duration between periods of unloading may provide temporary benefits but is an ineffective long-term strategy for combating the devastation of trabecular morphology and mechanics, as temporarily enhanced recovery is largely cancelled out by greater susceptibility to unloading. They also emphasize that cortical bone is more amenable to long-term recovery than is trabecular bone.
Corneal Sublayers Thickness in Patients With Mitral Valve Prolapse

Objectives: The aim of this study was to compare the thickness of each corneal sublayer in patients with mitral valve prolapse (MVP) and healthy individuals. Methods: A total of 38 eyes from 38 patients with MVP and 34 eyes from 34 age- and sex-matched healthy individuals were included in this study. The thickness of the corneal epithelium, Bowman layer, stroma, and Descemet membrane—endothelium complex were measured on the central cornea (i.e., corneal apex) and both the inferior and superior halves of the cornea with anterior segment module of spectral domain optical coherence tomography. Results: No statistically significant differences emerged between the study and control groups in terms of Bowman layer thickness in the central cornea and the cornea's superior half (P=0.092 and P=0.128, respectively). However, in the inferior half of the cornea, Bowman layer thickness among patients with MVP was 11.95±2.34 &mgr;m (range 7–16 &mgr;m) and in the control group was 13.03±1.62 &mgr;m (range 10–16 &mgr;m), which made for a statistically significant difference (P=0.025). Conclusions: Our study revealed thinning of Bowman layer in the inferior half of the cornea in patients with MVP.
Rhinocerebral mucormycosis: the disease spectrum in 27 patients

The variable forms of clinical complaints, findings and time interval of presentation in 27 cases of mucormycosis have been described, which were encountered over a span of 8 years. The previous concept about this fungal infection attacking chronic, debilitated, immunocompromised patients does not appear to hold true. Seven of the 27 patients (22.2%) did not reveal any predisposing factors and their outcome of 42.9% survival seems to be poorer than the total outcome (66.7%). ‘Chronic form’ of disease presentation, the definition of which is still not delineated, was encountered in four patients (14.8%). Again, the outcome was not significantly different from the total survival. Burr‐hole tap of an intracranial abscess revealing mucor in a 2‐month‐old infant has been described. Even in the present era, extranasal exenteration of sinuses along with disfiguring orbital exenteration is required to ensure satisfactory surgical debridement. Control of the underlying predisposing illness, along with the aggressive surgical debridement and the parenteral administration of amphotericin B, remains the treatment essentials even today.
The Challenges Encountered By County Goverments In Kenya During Budget Preparation

The research was centered on the challenges encountered by county governments in budget preparation in Kenya, using Kilifi county as a case study. In carrying out the research, objectives were formulated to find out if budget preparation procedures and proper planning were being adhered to at the counties and the extent to which politicians influenced the budget preparation process. Descriptive analysis was used to analyze the data collected, and from the conclusion, it was found that budget preparation procedures are in place at the counties and being adhered to, however, political influence and public participation affected the budget preparation process, and to avert this, the researcher recommended that public participation be enhanced at the county level by introduction of systems. Publicity should also be enhanced and efforts made to incorporate the views of the public in the budget, as well as enhancing capacity building within the county treasury staff, as the central government makes efforts to deploy staff, to assist the counties in budget preparation.
Angiotensin Type 2 Receptor-Mediated Hypotension in Angiotensin Type-1 Receptor-Blocked Rats

The type-2 (AT2) angiotensin (Ang) II receptor has been characterized as potentially counterregulatory to the actions of Ang II at its type-1 (AT1) receptor. We investigated the effects of Ang II and CGP-42112A (CGP), a selective peptide AT2 receptor agonist, on blood pressure (BP) in rats with or without pharmacological blockade of the AT1 receptor with losartan (LOS) or valsartan (VAL). In anesthetized rats (n=5 per group) receiving normal sodium intake, Ang II (200 pmol/kg per minute IV) alone increased BP from a control of 112±3 to 168±7 mm Hg (P <0.001) and LOS (30 mg/kg) alone decreased BP to 89±7 mm Hg (P <0.0001 from control). Ang II administered together with LOS decreased BP further to 71±4 mm Hg (P <0.00001 from control and LOS alone). AT2 receptor antagonist PD 123,319 (PD) completely blocked the hypotensive response to LOS combined with Ang II (P =NS from control). In conscious rats (n=5 per group) receiving normal sodium intake, VAL (10 mg/kg) alone decreased BP from a control of 98±5 to 86±3 mm Hg (P <0.00001). Ang II combined with VAL induced a consistent, highly significant decline in BP for 6 days to a nadir of 69±3 mm Hg (P <0.01 versus daily VAL alone). PD completely blocked the chronic hypotensive response to the combination of Ang II and VAL to control levels before VAL administration. In another study in conscious rats (n=5 per group), CGP (70 &mgr;g/kg per minute) also decreased BP in VAL-treated conscious rats. BP was 119±3 mm Hg during the control period, decreased to 86±6 mm Hg during 3 days of VAL alone, (P <0.00001) and decreased further to 65±7 mm Hg (P <0.001 from daily VAL alone) with 7 days of CGP in the presence of VAL. In the absence of VAL, CGP decreased BP for 4 consecutive days, and this response was blocked by PD. Also, the CGP-induced decrease in BP over a 7-day period was blocked by NG-nitro-l-arginine methyl ester, an inhibitor of NO synthase. The results strongly suggest that the AT2 receptor induces a systemic vasodilator response mediated by NO that counterbalances the vasoconstrictor action of Ang II at the AT1 receptor.
Diabetes eye screening in urban settings serving minority populations: detection of diabetic retinopathy and other ocular findings using telemedicine.

IMPORTANCE The use of a nonmydriatic camera for retinal imaging combined with the remote evaluation of images at a telemedicine reading center has been advanced as a strategy for diabetic retinopathy (DR) screening, particularly among patients with diabetes mellitus from ethnic/racial minority populations with low utilization of eye care. OBJECTIVE To examine the rate and types of DR identified through a telemedicine screening program using a nonmydriatic camera, as well as the rate of other ocular findings. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study (Innovative Network for Sight [INSIGHT]) was conducted at 4 urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority and uninsured persons with diabetes. Participants included persons aged 18 years or older who had type 1 or 2 diabetes mellitus and presented to the community-based settings. MAIN OUTCOMES AND MEASURES The percentage of DR detection, including type of DR, and the percentage of detection of other ocular findings. RESULTS A total of 1894 persons participated in the INSIGHT screening program across sites, with 21.7% having DR in at least 1 eye. The most common type of DR was background DR, which was present in 94.1% of all participants with DR. Almost half (44.2%) of the sample screened had ocular findings other than DR; 30.7% of the other ocular findings were cataract. CONCLUSIONS AND RELEVANCE In a DR telemedicine screening program in urban clinic or pharmacy settings in the United States serving predominantly ethnic/racial minority populations, DR was identified on screening in approximately 1 in 5 persons with diabetes. The vast majority of DR was background, indicating high public health potential for intervention in the earliest phases of DR when treatment can prevent vision loss. Other ocular conditions were detected at a high rate, a collateral benefit of DR screening programs that may be underappreciated.
Cryptic ecological diversification of a planktonic estuarine copepod, Acartia tonsa

The recent discovery of cryptic species in marine holoplankton, organisms that ‘drift’ in oceanic currents throughout their life cycle, contrasts with their potential for long‐distance passive dispersal and presumably high gene flow. These observations suggest that holoplankton species are adapting to surprisingly small‐scale oceanographic features and imply either limited dispersal or strong selection gradients. Acartia tonsa is a widespread and numerically dominant estuarine copepod containing deep mitochondrial lineages within and among populations along the northwestern Atlantic coast. In this study, we intensively investigated A. tonsa populations in Chesapeake Bay with the goals of testing species status for the deep lineages and testing for their association with environmental features over space and time. Phylogenetic analyses of DNA sequences from mitochondrial cytochrome c oxidase I (mtCOI) and the nuclear ribosomal internal transcribed spacer (nITS) resolved two concordant monophyletic clades. Deep divergence between the two clades (13.7% uncorrected sequence divergence for mtCOI and 32.2% for nITS) and genealogical concordance within sympatric populations strongly suggest that the two clades represent reproductively isolated cryptic species. Based on restriction fragment length polymorphisms of mtCOI, representatives from the two clades were found consistently associated with contrasting salinity regimes (oligohaline vs. meso‐polyhaline) with an overlap between 2 and 12 PSU in samples from 1995 to 2005. Finding these patterns in one of the best‐known estuarine copepods reinforces the conclusion that marine biodiversity is underestimated, not only in terms of species numbers, but also with respect to niche partitioning and the potential importance of ecological divergence in marine holoplankton.