Miracle-dz/UniFAR-FTUs huggingface dataset:
Gender-related variation in the clinical presentation and outcomes of critical limb ischemia

Critical limb ischemia (CLI) is a major cause of limb loss and mortality among patients with advanced peripheral artery disease. Our objective was to evaluate the gender-specific differences in patient characteristics and clinical outcomes among patients with CLI. We performed a retrospective analysis of 97 women and 122 men presenting with CLI who underwent angiography from 2006 to 2010. Baseline demographics, procedural details, and lesion characteristics were assessed for each patient. Kaplan–Meier analysis was used to assess long-term patient and lesion-level outcomes. Cox proportional hazard modeling was used to evaluate the relationship between gender and major adverse cardiovascular events (MACE). Compared to men, women were less likely to have a history of coronary artery disease (39% vs 54%, p = 0.02) or diabetes (57% vs 70%, p = 0.05) but had similar baseline medical therapy. At angiography, women were more likely to have significant femoropopliteal (77% vs 67%, p = 0.02) and multi-level infrainguinal disease (63% vs 51%, p = 0.02). Women were also more likely to undergo multi-vessel percutaneous intervention (69% vs 55%, p = 0.05), but had similar rates of limb salvage after percutaneous intervention or surgical bypass (HR 0.94 [95% CI 0.45–1.94], p = 0.9). During follow-up, women had higher rates of subsequent major adverse cardiovascular events (HR 1.63 [95% CI 1.01–2.63], p = 0.04). In conclusion, women with CLI are more likely to present with femoropopliteal and multi-level infrainguinal disease. Despite similar rates of limb salvage, women with CLI have an increased rate of subsequent major adverse cardiovascular events.
Expression and Functional Role of Peroxisome Proliferator-Activated Receptor-γ in Ovarian Folliculogenesis in the Sheep1

Abstract Peroxisome proliferator-activated receptor (PPARγ) is a nuclear receptor that is activated by fatty acids and derivatives and the antidiabetic glitazones, which plays a role in the control of lipid and glucose homeostasis. In the present work, we tested the hypothesis that PPARγ plays a role in reproductive tissues by studying its expression and function in the hypothalamo-pituitary-ovary axis in the sheep. PPARγ 1 and PPARγ 2 proteins and mRNAs were detected in whole ovine pituitary and ovary but not in hypothalamic extracts. In situ hybridization on ovarian section localized PPARγ mRNA in the granulosa layer of follicles. Interestingly, PPARγ expression was higher in small antral (1–3 mm diameter) than in preovulatory follicles (>5 mm diameter) (P < 0.001) and was not correlated with healthy status. To assess the biological activity of ovarian PPARγ, ovine granulosa cells were transfected with a reporter construct driven by PPARγ-responsive elements. Addition of rosiglitazone, a PPARγ ligand, stimulated reporter gene expression, showing that endogenous PPARγ is functional in ovine granulosa cells in vitro. Moreover, rosiglitazone inhibited granulosa cell proliferation (P < 0.05) and increased the secretion of progesterone in vitro (P < 0.05). This stimulation effect was stronger in granulosa cells from small than from large follicles. In contrast, rosiglitazone had no effect on LH, FSH, prolactin and growth hormone secretion by ovine pituitary cells in vitro. Overall, these data suggest that PPARγ ligands might stimulate follicular differentiation in vivo likely through a direct action on granulosa cells rather than by modulating pituitary hormone secretion.
The Redistributive Consequences of Segregation

In this paper I present a model in which an increase in inequality can lead to a decrease in voters' demand for redistribution. In my model, people sort into groups according to income and as a result they become biased about the shape of the income distribution. I demonstrate that an increase in inequality can lead to a decrease in perceived inequality in the presence of segregation, and hence to a fall in people's support for redistribution. I motivate my main assumptions with empirical evidence from a small survey that I conducted via Amazon Mechanical Turk.
Up‐regulated cten by FGF2 contributes to FGF2‐mediated cell migration

Cten is a focal adhesion molecule that is expressed at very low levels in most normal tissues. Nonetheless, its expression has been found to increase dramatically in many types of cancer including colorectal, breast, gastric, and pancreatic cancer, suggesting that cten may play a critical role during tumorigenesis. To study the mechanisms that induce cten expression and the function of up‐regulated cten, we examined the effects of several cancer‐associated growth factors and cytokines on cten expression. We found that EGF, FGF2, NGF, PDGF, TGF‐β, IGF‐1, IL‐6, and IL‐13 were able to induce cten expression in a dose‐ and time‐dependent manner. The Mek‐Erk and PI3K‐Akt pathways were two main signaling cascades responsible for cten up‐regulation, whereas the Jak‐Stat pathway could contribute to the increase in some conditions. Since many of these factors are known to promote cell migration, we hypothesized that up‐regulated cten might contribute to this process. This hypothesis was investigated in FGF2‐mediated cell migration. Silencing of cten not only reduced regular cell motility but also FGF2‐mediated cell migration. Overexpression of cten promoted cell migration and FGF2 treatment failed to further enhance cell migration. Our findings that (1) cten is a common downstream molecule of these cancer‐associated growth factors and cytokines; and that (2) up‐regulated cten modulates cell migration induced by FGF2 and likely other growth factors as well, strongly suggest that cten could be a potential downstream therapeutic target for treating cancers associated with aberrant signaling of these growth factors and cytokines. © 2013 Wiley Periodicals, Inc.
Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal.

BACKGROUND Surgical resection is the most effective treatment for colorectal liver metastases but only a minority of patients are candidates for a potentially curative resection. Our experience with neoadjuvant chemotherapy followed by resection and five years survival analysis of the patients treated is presented. METHODS Between February of 1988 and September of 1996, 701 patients with unresectable colorectal liver metastases were treated with neoadjuvant chemotherapy. Four categories of nonresectable disease were defined: large size, ill location, multinodularity, and extrahepatic disease. Liver resection was performed in those patients whose disease became resectable. After resection, the patients were followed up every 3 months. A 5-year survival analysis by the different categories described was performed. RESULTS Ninety-five patients (13.5%) were found to be resectable on reevaluation and underwent a potentially curative resection. There was no perioperative mortality, and the complication rate was 23%. As of December of 1999, 87 patients have completed 5 years of follow-up. The overall 5-year survival is 35% from the time of resection and 39% from the onset of chemotherapy. Respective 5-year survival rates are 60% for large tumors, 49% for ill-located lesions, 34% for multinodular disease, and 18% for liver metastases with extrahepatic disease. In this latter category, however, a 35% 5-year survival was found when all the patients with extrahepatic disease were analyzed rather than only those for whom extrahepatic disease was the main cause of nonresectability. CONCLUSIONS Neoadjuvant chemotherapy enables liver resection in some patients with initially unresectable colorectal metastases. Long-term survival is similar to that reported for a priori surgical candidates.
The Need for Uniqueness among Gulf Cooperation Council Countries¡¯ Consumers: A Cross-Culture Study

Understanding differences among consumers across varying cultures is of great importance to the success of international retailers. Ignoring the influence of culture and centralized marketing has led to a decline in profits for some international companies. Studying the culture of Middle East countries, particularly the Gulf Cooperation Council Countries (GCCC), Saudi Arabia, United Arab Emirates, Kuwait, Bahrain, Qatar, and Oman, is essential before marketing in these countries. Additionally, the GCCC is one of the top 10 luxury markets in the world. Hofstede model of national culture is crucial for GCCC due to the fact culture norms regarding dress and appearance are nationally adopted. A sample of 170 participants from the GCCC was collected using an online questionnaire of 45 items measuring national culture dimensions and need for uniqueness when shopping for luxury goods. It was found that power distance in all GCCC countries was a significant predictor of having a need for uniqueness, as well as indulgence. Power distance had a positive relationship with the need for uniqueness while indulgence had a negative relationship with the need for uniqueness. For other dimensions, findings indicated that long term vs short term orientation, masculinity, uncertainty avoidance, and individualism were not significant predictors leading to uniqueness. Additionally, the important construct for uniqueness among GCCC consumers is unpopular choice followed by avoiding similarity. Creative choice is less important among the three constructs of uniqueness for GCCC participants.
A retrospective comparison of the influence of surgical clipping and endovascular embolization on recovery of oculomotor nerve palsy in patients with posterior communicating artery aneurysms.

BACKGROUND Oculomotor nerve palsy (ONP) is a common symptom of posterior communicating artery aneurysms (PcomAAs). Surgical clipping and endovascular embolization are used to treat PcomAAs with ONP. OBJECTIVE To analyze the impact of these 2 techniques on recovery of ONP caused by PcomAAs. METHODS The clinical data for 176 patients with intracranial PcomAAs with ONP admitted to the Department of Neurosurgery, Sichuan Provincial People's Hospital, between June 2008 and May 2013 who undergone surgical clipping or endovascular embolization were studied retrospectively. The 2 treatment groups were compared with respect to age, sex, aneurysm size, levels of hypertension and hyperlipidemia, preadmission ONP duration, subarachnoid hemorrhage (SAH), complete ONP, postoperative recovery time from ONP symptoms, and degree of recovery. The follow-up duration was a minimum of 12 months. Multivariate Cox regression was used for analysis. RESULTS A total of 132 patients were treated by surgical clipping, and 44 were treated by endovascular embolization. Significant differences were found in postoperative recovery time (83.87 ± 34.70 days for clipping and 137.45 ± 44.94 days for embolization, P < .001) and recovery rates (130 [98.5%] for clipping and 30 [68.2%] for embolization, P < .001). The period between ONP onset and admission was associated with recovery. Postoperative complications included significant cerebral vasospasms (6 in the clipping group and 2 in the embolization group) and hydrocephalus (16 in the clipping group and 9 in the embolization group). CONCLUSION Simultaneous elimination of 2 injury mechanisms, compression and pulsation, when treating the oculomotor nerve by surgical clipping may be more advantageous than endovascular embolization to treat ONP caused by PcomAA.
Is the professional satisfaction of general internists associated with patient satisfaction?

AbstractBACKGROUND: The growth of managed care has raised a number of concerns about patient and physician satisfaction. An association between physicians’ professional satisfaction and the satisfaction of their patients could suggest new types of organizational interventions to improve the satisfaction of both. OBJECTIVE: To examine the relation between the satisfaction of general internists and their patients. DESIGN: Cross-sectional surveys of patients and physicians. SETTING: Eleven academically affiliated general internal medicine practices in the greater-Boston area. PARTICIPANTS: A random sample of English-speaking and Spanish-speaking patients (n=2,620) with at least one visit to their physician (n=166) during the preceding year. MEASUREMENTS: Patients’ overall satisfaction with their health care, and their satisfaction with their most recent physician visit. MAIN RESULTS: After adjustment, the patients of physicians who rated themselves to be very or extremely satisfied with their work had higher scores for overall satisfaction with their health care (regression coefficient 2.10; 95% confidence interval 0.73–3.48), and for satisfaction with their most recent physician visit (regression coefficient 1.23; 95% confidence interval 0.26–2.21). In addition, younger patients, those with better overall health status, and those cared for by a physician who worked part-time were significantly more likely to report better satisfaction with both measures. Minority patients and those with managed care insurance also reported lower overal satisfaction. CONCLUSIONS: The patients of physicians who have higher professional satisfaction may themselves be more satisfied with their care. Further research will need to consider factors that may mediate the relation between patient and physician satisfaction.
Early oseltamivir treatment of influenza in children 1-3 years of age: a randomized controlled trial.

BACKGROUND Oseltamivir provides modest clinical benefits to children with influenza when started within 48 hours of symptom onset. The effectiveness of oseltamivir could be substantially greater if the treatment were started earlier during the course of the illness. METHODS We carried out a randomized, double-blind, placebo-controlled trial of the efficacy of oseltamivir started within 24 hours of symptom onset in children 1-3 years of age with laboratory-confirmed influenza during the seasons of 2007-2008 and 2008-2009. Eligible children received either orally administered oseltamivir suspension or a matching placebo twice daily for 5 days. The children received clinical examinations, and the parents filled out detailed symptom diaries for 21 days. RESULTS Of 408 randomized children who received the study drug (oseltamivir, 203, and placebo, 205), 98 had laboratory-confirmed influenza (influenza A, 79, and influenza B, 19). When started within 12 hours of the onset of symptoms, oseltamivir decreased the incidence of acute otitis media by 85% (95% confidence interval, 25%-97%), but no significant reduction was observed with treatment started within 24 hours. Among children with influenza A, oseltamivir treatment started within 24 hours shortened the median time to resolution of illness by 3.5 days (3.0 vs 6.5 days; P = .006) in all children and by 4.0 days (3.4 vs 7.3; P = .006) in unvaccinated children and reduced parental work absenteeism by 3.0 days. No efficacy was demonstrated against influenza B infections. CONCLUSIONS Oseltamivir treatment started within 24 hours of symptom onset provides substantial benefits to children with influenza A infection. Clinical trials registration. ClinicalTrials.gov identifier: NCT00593502.
Enhancement of Signal Performance in LED Visible Light Communications Using Mobile Phone Camera

Visible light communication (VLC) is attractive as a supplementary method for future fifth-generation (5G) wireless communication owing to the shortage of radio-frequency bandwidth in conventional wireless communications. The VLC systems reported in the literature are mainly based on PIN receivers (Rxs). It is highly desirable if these VLC signals can be detected by using built-in complementary metal-oxide-semiconductor (CMOS) cameras as Rxs to provide flexible and low-cost wireless communications. However, using the CMOS camera is challenging. In this paper, we propose and demonstrate a VLC link using a CMOS mobile phone camera as Rx. By using the rolling shutter effect of the CMOS sensor, the VLC data rate can be significantly enhanced. We first use a second-order polynomial fitting to mitigate the “blooming effect” (saturation of pixels) of the CMOS sensor. In order to extend the VLC transmission distance and mitigate the influence of the background noise, we also propose and demonstrate using histogram equalization and Sobel filter to enhance VLC signal performance. Finally, a third-order polynomial fitting is used to define the threshold. The experimental results show that significant improvement of bit error rate (BER) for about an order of magnitude under different illuminances can be achieved.
A preliminary study of the relation of neuropsychological performance to neuroanatomic structures in bipolar disorder.

OBJECTIVE To investigate the relation between neuropsychological dysfunction and volumetric measures of neuroanatomic structures in patients with bipolar disorder. BACKGROUND Previous research suggests that neuropsychological deficits are associated with neuroanatomic changes in patients with bipolar disorder. METHOD Twenty-six outpatients who met Diagnostic and Statistical Manual, Third Edition-Revised criteria for bipolar disorder were administered a battery of neuropsychological tests that assessed memory, abstracting ability, psychomotor performance, sustained attention, and intelligence. Patients also received a magnetic resonance imaging scan, from which volumes of the temporal lobes, hippocampus, third ventricle, and areas of the lateral ventricles were calculated. Using multiple regression analyses, neuroanatomic structures were compared with neuropsychological test variables. RESULTS Data suggest that a larger right hippocampal volume is associated with poorer neuropsychological functioning. CONCLUSIONS Further studies are needed to both replicate and examine the relation between potential mechanisms of neuroanatomic alterations and neuropsychological dysfunction in patients with bipolar disorder.
A simple, dynamic measure of antiretroviral therapy adherence predicts failure to maintain HIV-1 suppression.

BACKGROUND High levels of antiretroviral therapy adherence are important for human immunodeficiency virus type 1 (HIV-1) suppression, yet the magnitude of adherence required to maintain it is less well characterized. Furthermore, methods to accommodate changes in adherence over time are lacking. In the present study, our objective was to determine the magnitude of antiretroviral therapy adherence needed to maintain HIV-1 suppression by use of a time-updated adherence measure that has the potential to be of use in a clinical setting. METHODS We examined a population-based cohort of HIV-1-infected subjects > or =18 years of age, residing in British Columbia, Canada, who started receiving antiretroviral therapy between 1 August 1996 and 30 September 2003, who had at least 2 consecutive viral loads <500 copies/mL and who had prescriptions filled at least 3 times during a follow-up period ending 30 September 2004. Virological failure was defined as the second of 2 consecutive viral loads >1000 copies/mL. Cox proportional hazards model was used to determine the relationship between virological failure and refill-based, time-updated surrogate measure of adherence. RESULTS Among the 1634 participants > or =18 years of age who initiated triple combination therapy during the study, 606 virological failure events were identified. In multivariate analyses, subjects with < or =95% adherence were 1.66 (95% confidence interval, 1.38-2.01) times more likely to experience virological failure than those with >95% adherence. CONCLUSIONS The highest levels of antiretroviral therapy adherence are associated with higher rates of maintained virological suppression. This simple, dynamic surrogate measure of adherence overcomes the limitation of single-point-in-time calculations of adherence and may be useful in real time to determine whether an individual is exhibiting incomplete adherence.
A multiple criteria group decision-making approach for the assessment of small and medium-sized enterprise competitiveness

PurposeSmall- and medium-sized enterprises (SMEs) have become increasingly important in national and international markets because they contribute to the development of local and national economies. SMEs often face serious challenges when competing with multinational companies. The purpose of this paper is to develop a method for assessing SMEs’ competitiveness.Design/methodology/approachBased on a constructivist epistemology, this study makes an integrated use of cognitive mapping and the measuring attractiveness by a categorical-based evaluation technique (MACBETH). To this end, face-to-face sessions were conducted with a panel of entrepreneurs and senior managers who deal with the challenges of maintaining SME competitiveness every day. The proposed assessment system was tested and validated by the panel members.FindingsThe methodological processes adopted in this study provide promising results for decision makers seeking to identify the most competitive SMEs. Specifically, the results emphasize, among other points, the importance of innovation and the human dimension to gaining competitive advantages.Research limitations/implicationsThe evaluation system developed in this study is extremely versatile and confirms the usefulness of integrating cognitive mapping and MACBETH to facilitate evaluations of SME competitiveness. However, due to its idiosyncratic and process-oriented nature, generalizations need to be done with caution.Practical implicationsThe proposed method can be valuable to researchers seeking to develop mechanisms for evaluating SMEs’ entrepreneurial performance and include specialized know-how and sensemaking in organizational decision-making processes.Originality/valueThe integrated use of cognitive maps and MACBETH contributes to a better understanding of how to assess SMEs’ competitiveness. No prior work reporting the use of this dual methodology in this study context has been found.
A NEW SPECIES OF ACANTHOBOTHRIUM (CESTODA: TETRAPHYLLIDEA: ONCHOBOTHRIIDAE) FROM THE OCELLATE RIVER STINGRAY, POTAMOTRYGON MOTORO (CHONDRICHTHYES: POTAMOTRYGONIDAE), IN ARGENTINA

Examination of the spiral intestines of 44 freshwater stingrays, Potamotrygon motoro, from tributary rivers of the Paraná River in Argentina, allowed for the collection of specimens of an undescribed species of Acanthobothrium. Acanthobothrium ramiroi n. sp. can be distinguished from all other congeners by the combination of the following characters: asymmetrical hooks (medial and lateral hooks conspicuously different in size and form, with axial prong of medial hooks stouter than abaxial prong), hook size (total length of medial hooks up to 242 μm, total length of lateral hooks up to 239 μm), bothridia not fused to the scolex proper at posterior ends, worm size (51–84 mm long), and the presence of a conspicuous vaginal sphincter. The new species is different from all other species of Acanthobothrium in freshwater potamotrygonids, except Acanthobothrium terezae, in having conspicuous asymmetrical hooks. The main differences that allow for the distinction between A. ramiroi and A. terezae include hook size, the way the bothridia are attached to the scolex proper, and the shape of the older gravid segments. The discovery of a new species of Acanthobothrium from a potamotrygonid extends our understanding of the diversity of the genus in freshwater stingrays in South America.