Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of comorbidity indices in patients admitted for Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a condition with significant mortality; yet, the majority of patients with COPD die from other diseases [1-4]. This evidence has lead to the further study of co-morbidity and COPD. Seventy three percent of patients with COPD have at least one co-morbid condition [5]. In COPD cohort studies, patients with increased co-morbidity have reduced survival [6-9]. Given the potential importance of co-morbidity when studying COPD, methods are needed to quantify the burden of co-morbidity for analysis. There have been several approaches to quantifying the burden of co-morbidity in studies of obstructive lung disease. One method is to simply sum the number of co-morbid conditions. This has not been shown to predict mortality in patient with COPD [10, 11]. Another approach has been to use a validated co-morbidty instrument. The Charlson Co-morbidity Index (CCI) is the only co-morbidity instrument previously used to study the relationship between co-morbidity and mortality in patients with COPD. Though most studies have shown an decrease in survival as the Charlson Co-morbidity Index rises [6-9] there have been some studies that have shown no association [12, 13]. Though the CCI has been validated in many other populations [14,15] it has limited content validity [16] which could explain its unreliable performance in patients with COPD. Many conditions have been shown to affect long term mortality; yet, the CCI captures only 16 different medical conditions. Furthermore, the severity of co-morbidities may affect long term survival. For example, a patient with severe heart failure awaiting transplant has a different prognosis than someone with asymptomatic heart failure [17]. The CCI only measures the severity of 2 of the 16 conditions it captures. An instrument which overcomes the limitations of the CCI may have a more consistent performance. The Adult Co-morbidity Evaluation (ACE-27) [18] is a modified Kaplan Feinstein Index (KFI) [19]. It overcomes the limitations of the CCI by collecting the presence and severity of 27 different co-morbid conditions. We sought to examine whether the ACE-27 was predictive of survival in patients with COPD exacerbations. We also reexamined the predictive validity of the CCI.
Endotoxic shock model with fluid resuscitation in Macaca mulatta

These studies established a macaque model of early-phase endotoxic shock, and investigated the resuscitation effects of three different solutions. Twenty-four macaques were assigned to four groups. Nineteen animals were given an intravenous dose of 2.8 mg/kg lipopolysaccharide (LPS). At 60 min after LPS challenge, the animals were given (i) 5 mL/kg normal saline (Ns group, n = 6), (ii) 5% of 5 mL/kg sodium bicarbonate (Sb group, n = 6), (iii) hypertonic 3.5% sodium chloride of 5 mL/kg (Hs group, n = 7). The control group (Co group, n = 5) was first injected with 1 mL/kg Ns and with 5 mL/kg Ns 60 min later. Haemodynamic parameters and blood gases were measured during the experiment, and myocardial morphology was examined on termination of the experiment. Administration of LPS caused hypotension and decreases of the left ventricular work index (LVWI). In the Sb group, mean arterial pressure, cardiac index, systemic vascular resistance index, LVWI and right ventricular work index were significantly higher than those of the Ns group. Pathological changes of myocardium were identified in all of the LPS groups. The studies suggest that macaques are suitable models for studying endotoxic shock and potential fluid therapies.
Spatial memory deficits in patients with lesions affecting the medial temporal neocortex

Lesion studies in monkeys suggest that neocortical subregions of the medial temporal lobe (MTL) carry memory functions independent of the hippocampal formation. The present study investigates possible differential contributions of MTL subregions to spatial memory in humans. Eye movements toward remembered spatial cues (memory‐guided saccades) with unpredictably varied memorization delays of up to 30 seconds were recorded in patients with postsurgical lesions of the right MTL, either restricted to the hippocampal formation (n = 3) or including the adjacent neocortex (n = 5) and in 10 controls. Although saccadic targeting errors of patients with selective hippocampal lesions did not differ from controls, saccadic targeting errors of patients with additional neocortical involvement showed a significant and contralaterally pronounced increase at memorization delays above 20 seconds. We conclude that the human medial temporal neocortex carries spatial memory functions independent of the hippocampal formation and distinct from spatial short‐term memory. Ann Neurol 1999;45:312–319
A comparison of 15% azelaic acid gel and 0.75% metronidazole gel in the topical treatment of papulopustular rosacea: results of a randomized trial.

OBJECTIVE To compare the efficacy and safety of a novel formulation of 15% azelaic acid gel (Finacea; Berlex Laboratories, Inc, Montville, NJ) with 0.75% metronidazole gel (MetroGel; Galderma Laboratories LP, Fort Worth, Tex) as topical therapy for moderate, papulopustular facial rosacea. DESIGN Multicenter, double-blind, randomized, parallel-group study. SETTING Thirteen US centers. PATIENTS A total of 251 patients with papulopustular rosacea with persistent erythema and telangiectasia. INTERVENTIONS Patients were randomized to receive azelaic acid gel or metronidazole gel twice daily for 15 weeks. MAIN OUTCOME MEASURES Nominal and percent change in inflammatory lesion count, change in erythema and telangiectasia severity ratings, investigator's global assessment of rosacea, and investigator's and patient's overall improvement ratings. RESULTS Azelaic acid gel was superior to metronidazole gel in reduction of mean nominal lesion count (-12.9 vs -10.7, respectively) (P =.003) and mean percent decrease in inflammatory lesions (-72.7% vs -55.8%, respectively) (P<.001). With respect to erythema severity, 56% of azelaic acid gel-treated patients were rated improved vs 42% of metronidazole gel-treated patients (P =.02). The effectiveness of metronidazole gel on these variables seemed to plateau after week 8, whereas azelaic acid gel demonstrated progressive improvement through week 15. Neither treatment had a clinically appreciable effect on telangiectasia. Both the investigator's global assessment (P =.02) and overall assessment of improvement (P =.005) showed a significant therapeutic advantage for azelaic acid gel. Azelaic acid gel also scored higher on the patient's overall assessment of efficacy. Both treatments were rated as having high cosmetic acceptability. No serious or systemic treatment-related adverse events were reported in either group. CONCLUSION Use of 15% azelaic acid gel twice daily for 15 weeks demonstrated significant superiority over using 0.75% metronidazole gel in improving principal signs of rosacea (inflammatory lesions and erythema).
Acquired aphasia in children after surgical resection of left‐thalamic tumors

Five children (three males, two females; four right‐, one left‐handed; age range 6 to 14 years) who developed aphasia after gross‐total excision of left predominantly thalamic tumors are reported. Three patients had Broca aphasia, one had mixed transcortical aphasia, and one patient had conduction aphasia. In the months after surgery, three children improved while receiving radiation and/or chemotherapy, although none recovered completely. Two patients with malignant tumors developed worsening aphasia when the tumor recurred, and later died. Two of three patients tested had visuospatial difficulties in addition to language deficits. Attention and executive functioning were affected in three of three patients tested. Memory, verbal and/or visual functioning, were affected in four of four patients tested. Both patients who were tested showed transient right hemineglect. Two of two patients tested were probably apraxic. The wide range of deficits in these children highlights the importance of the thalamus and other subcortical structures in developing cognition.
Rib Fracture Stabilization in Patients Sustaining Blunt Chest Injury

Conservative management for the majority of patients with severe chest injuries has produced a reduction in mortality, complications, and hospital length of stay. More recently, operative stabilization of rib fractures has been used with the implication of improved outcome. We assessed the impact of operative rib fracture stabilization on outcome among trauma patients. A matched case-control study of patients undergoing operative rib fracture stabilization was performed. Thirty patients undergoing rib stabilization were matched with 30 controls. Length of intensive care unit (controls, 14.1 ± 2.7 vs cases, 12.1 ± 1.2, P = 0.51) and total hospital (controls, 21.1 ± 3.9 vs cases, 18.8 ± 1.8, P = 0.59) stay were similar for both groups. There was a trend toward fewer total ventilator days for operative patients (6.5 ± 1.3 days vs 11.2 ± 2.6 days, P = 0.12). Ventilator days for operative patients from the time of stabilization was 2.9 ± 0.6 days compared with 9.4 ± 2.7 days in controls (P = 0.02). Rib fracture fixation may reduce ventilator requirements in trauma patients with severe thoracic injuries. Long-term functional outcomes need to be assessed to ascertain the impact of this procedure.
Differentiation Capacity of Human Urine-Derived Stem Cells to Retain Telomerase Activity

Telomerase activity is essential for the self-renewal and potential of embryonic, induced pluripotent, and cancer stem cells, as well as a few somatic stem cells, such as human urine-derived stem cells (USCs). However, it remains unclear how telomerase activity affects the regeneration potential of somatic stem cells. The objective of this study was to determine the regenerative significance of telomerase activity, particularly to retain cell surface marker expression, multipotent differentiation capability, chromosomal stability, and in vivo tumorigenic transformation, in each clonal population of human primary USCs. In total, 117 USC specimens from 10 healthy male adults (25–57 years of age) were obtained. Polymerase chain reaction amplification of a telomeric repeat was used to detect USCs with positive telomerase activity (USCsTA+). A total of 80 USCsTA+ (70.2%) were identified from 117 USC clones, but they were not detected in the paired normal bladder smooth muscle cell and bone marrow stromal cell specimens. In the 20–40 years age group, approximately 75% of USC clones displayed positive telomerase activity, whereas in the 50 years age group, 59.2% of the USC clones expressed positive telomerase activity. USCsTA+ extended to passage 16, underwent 62.0 ± 4.8 population doublings, produced more cells, and were superior for osteogenic, myogenic, and uroepithelial differentiation compared to USCsTA−. Importantly, USCs displayed normal chromosome and no oncological transformation after being implanted in vivo. Overall, as a safe cell source, telomerase-positive USCs have a robust regenerative potential in cell proliferation and multipotent differentiation capacity.
The aberrantly fed varicocele: frequency, venographic appearance, and results of transcatheter embolization.

OBJECTIVE Retrograde flow in the internal spermatic vein, which is characteristic of varicocele, can occur despite competent valves because of the presence of bypassing anastomoses. The resulting condition has been called aberrantly fed varicocele. The purpose of this study was to determine the frequency of aberrantly fed varicocele, to analyze its various venographic appearances, and to review the results of attempted embolotherapy. SUBJECTS AND METHODS We performed left-sided (n = 213) and/or right-sided (n = 121) spermatic venography in 213 patients who were examined for infertility (n = 179), for physical complaints of their varicocele (n = 17), or for varicocele impeding testicular growth (n = 17). The resulting 334 venograms were subdivided as negative or positive for varicocele, and positive venograms were further classified as showing normally or aberrantly fed varicoceles. The aberrantly fed varicoceles were classified according to the sites of the bypassed competent valves and the levels at which the bypassing anastomoses joined the internal spermatic veins. The technical success rate of 192 attempted embolizations of normally and aberrantly fed varicoceles was determined. RESULTS Of the left-sided spermatic venograms, 42 (20%) were negative and 171 (80%) were positive for varicoceles, which in turn consisted of 125 normally and 30 (19%) aberrantly fed varicoceles (16 could not be classified). On the right side, 78 (64%) venograms were negative and 43 (36%) were positive for varicoceles, consisting of 34 normally and seven (17%) aberrantly fed varicoceles (two were not classified). Venographic classification showed that about half of the cases were in patients with competent orificial valves, which were bypassed by anastomoses joining the internal spermatic veins in their cranial lumbar subsegments. Competent valves lower down were seen only on the left side, and anastomoses joining the internal spermatic veins in their cranial pelvic subsegments occurred relatively more frequently on the right side. Coil embolization was attempted in 118 left-sided and 32 right-sided normally fed varicoceles and in 30 left-sided and seven right-sided aberrantly fed varicoceles. The technical success rate was 97% for left- and right-sided normally fed varicoceles and 73% for left-sided and 57% for right-sided aberrantly fed varicoceles. CONCLUSION Aberrantly fed varicoceles are found in 17-19% of patients examined with spermatic venography. Coil embolization of aberrantly fed varicoceles is usually successful, but not as reliably as with normally fed varicoceles.
Spectrum of Lesions Affecting the Renal Pelvis and Pelviureteric Junction: A 13-Year Retrospective Analysis.

INTRODUCTION Both, the renal pelvis and the ureter, are affected by developmental, reactive and neoplastic disorders, though rare in incidence. AIM This series of cases were analysed to study the clinicopathological characteristics of the common and comparatively rare lesions involving the renal pelvis and pelviureteric junction. MATERIALS AND METHODS A retrospective collection of 476 nephrectomies and pelviureteric junction resections, received over a period of 13 years from 2001 to 2013 was done. The patients' clinical details were obtained and the histopathological findings reviewed. The lesions were classified into non-neoplastic and neoplastic categories. RESULTS Primary involvement of the renal pelvis and pelviureteric junction was seen in 105 of 476 specimens. The mean age was 54.5 years with a male to female ratio of 2.2:1. The non-neoplastic lesions accounted for 76.2% of cases with a majority being pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy (68.6%) causing hydronephrosis. Urothelial carcinomas were encountered in 20% of the cases. A majority of the urothelial carcinomas were infiltrative (81%) and high grade (71%) tumours. CONCLUSION Renal pelvis, a conduit to propel urine, can be the site for numerous disorders. Non-neoplastic lesions were more common than neoplasms. Pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy was the commonest lesion in our study. In the neoplastic category, urothelial carcinoma was most common. However, rare lesions such as hamartomatous fibroepithelial polyp, Von Brunn's nests, flat urothelial hyperplasia and intramuscular haemangioma of upper ureter at the pelviureteric junction were encountered along with occasional cases of tuberculosis and squamous cell carcinomas.
Interventions for foot disease in rheumatoid arthritis: a systematic review.

OBJECTIVE To systematically review medical and surgical foot intervention studies in rheumatoid arthritis (RA), focusing on clinical efficacy, study quality, and risk of harm. METHODS We searched appropriate databases using a combination of the terms "rheumatoid arthritis" and "foot" against terms indicating treatment; we also hand-searched references. We selected articles in English (1968-2003) comprising randomized controlled trials (RCTs), controlled clinical trials (CCTs), prospective observational studies, and large retrospective observational surgical studies (> 50 cases). RCT quality was examined using Jadad scoring; other designs were assessed qualitatively. RESULTS Inclusion criteria were met by 33 of 894 identified studies, comprising 5 RCTs and 1 CCT (all nonsurgical), 15 prospective observational studies (8 nonsurgical, 7 surgical), and 12 large retrospective studies (all surgical). Functional, custom-designed and semirigid orthoses and extra-depth shoes were effective in single RCTs of variable quality; no comparative studies have been conducted. This finding was supported by a CCT and prospective observational studies. There was no evidence of harm. There were no controlled trials of surgery. Prospective observational studies suggest that forefoot arthroplasty and first metatarsophalangeal joint implants, but not plantar callous debridement, are effective. Comparative retrospective analyses suggest that some procedure variants may be better, and surgery may relieve pain better than orthoses. Infection was the main risk. CONCLUSION RCT evidence shows that orthoses and special shoes are likely to be beneficial in patients with RA. The only evidence of benefit from surgery comes from observational studies, because no RCTs have been conducted. Further RCT evidence is needed, although well-designed observational studies may be helpful.
Gap Effect in Reflexive and Intentional Prosaccades

The analysis of saccadic eye movements has assumed an important role as a pathophysiological approach in neuropsychiatric diseases. However, before abnormal cognitive saccade behavior can be fully understood, some basic psychophysiological aspects have to be further investigated. Previous studies have demonstrated a shortening of saccade latency when the fixation stimulus was removed prior to the appearance of a peripheral visual target. This gap effect is smaller for antisaccades (AS; away from the target) than for reflexive saccades (RS; towards the target). Apart from the generation of an intentional eye movement, AS rely on different processes including reflex inhibition and spatial reversal of the saccade direction. We wondered whether intentional prosaccades (IpS) that do not rely on these additional processes also show a reduced gap effect. Therefore, we compared the gap effect in a saccade paradigm for RS and IpS in healthy subjects. We found a smaller gap effect in IpS than in RS and suggest that this reduction reflects endogenous strategic processes. Our findings further imply that reflex inhibition is not the unique cause for the smaller gap effect in AS than in RS and suggest that an endogenous component may be involved. We hypothesize that frontal control on the superior colliculus fixation cell activity may continue even after the fixation stimulus has disappeared, thus inhibiting a fixation offset and reducing the gap effect.
Purification and Characterization of an Extracellular Laccase from Phlebia radiata Strain BP-11-2 That Decolorizes Fungal Melanin

Phlebia radiata strain BP-12-2, isolated from forest soil, decolorized fungal melanin and produced an extracellular laccase in culture. The enzyme was purified to homogeneity and characterized. It showed no absorption bands in the ultraviolet above 300 nm or visible regions. It differed from the reported laccases in substrate specificity, kinetic parameters, and NH2-terminal amino acid sequences.
Localized bone augmentation with cortical bone blocks tented over different particulate bone substitutes: a retrospective study.

PURPOSE To assess the efficacy of a block tenting technique for reconstruction of vertical or horizontal alveolar ridge defects. MATERIALS AND METHODS Patients who underwent a block tenting graft technique between 2005 and 2010 were analyzed retrospectively. Intraoral bone blocks (ramus, chin, or tuberosity) or allogeneic blocks were fixed at 4 mm from the deficient area, and the gap was filled with bone substitutes, with or without plasma rich in growth factors (PRGF). Implants were placed simultaneously or 4 to 5 months postgrafting. Patient demographic information, amount of width/height augmentation after 4 to 5 months of healing, complications, and contributing factors were gathered and analyzed. RESULTS One hundred two patients were enrolled. Among the horizontal augmentations, the greatest width increase was achieved in the anterior maxilla (4.31±0.93 mm). The average height increase in the vertically augmented regions was greatest in the posterior maxilla (5.75±2.22 mm). Mean horizontal augmentation was the greatest with ramus (3.65±0.65 mm) and allogeneic materials (3.97±0.79 mm). The greatest vertical gain was achieved with tuberosity blocks (4.25±3.06 mm) and a combination of allogeneic/autogenous bone particles (3.90±1.05 mm). Application of PRGF showed no appreciable effect. The most common primary complications of surgery were hematoma and inflammation. The most common complication in the anterior maxilla was hematoma. Inflammation was the most common complication associated with ramus grafts, while hematoma occurred most often in cases with chin and tuberosity grafts. Total graft failure occurred in 13 patients, mainly associated with the allogeneic blocks. Most patients were followed for 11 to 38 months. Five of 237 inserted implants failed to osseointegrate. CONCLUSION The block tenting technique might be effective for localized ridge augmentation and may reduce the amount of autograft required from donor sites.
Dynamic Ligand-induced Conformational Rearrangements in P-glycoprotein as Probed by Fluorescence Resonance Energy Transfer Spectroscopy*

Background: P-glycoprotein is an ATP-binding cassette transporter involved in multidrug resistance. Results: The two nucleotide binding domains are found to be in close association during the catalytic cycle as determined by fluorescence spectroscopy. Conclusion: Small distance changes were observed during ATP hydrolysis supporting an alternating site mechanism. Significance: Understanding the mechanism of P-glycoprotein is pertinent for developing inhibitors aimed at overcoming multidrug resistance. P-glycoprotein (Pgp), a member of the ATP-binding cassette transporter family, functions as an ATP hydrolysis-driven efflux pump to rid the cell of toxic organic compounds, including a variety of drugs used in anticancer chemotherapy. Here, we used fluorescence resonance energy transfer (FRET) spectroscopy to delineate the structural rearrangements the two nucleotide binding domains (NBDs) are undergoing during the catalytic cycle. Pairs of cysteines were introduced into equivalent regions in the N- and C-terminal NBDs for labeling with fluorescent dyes for ensemble and single-molecule FRET spectroscopy. In the ensemble FRET, a decrease of the donor to acceptor (D/A) ratio was observed upon addition of drug and ATP. Vanadate trapping further decreased the D/A ratio, indicating close association of the two NBDs. One of the cysteine mutants was further analyzed using confocal single-molecule FRET spectroscopy. Single Pgp molecules showed fast fluctuations of the FRET efficiencies, indicating movements of the NBDs on a time scale of 10–100 ms. Populations of low, medium, and high FRET efficiencies were observed during drug-stimulated MgATP hydrolysis, suggesting the presence of at least three major conformations of the NBDs during catalysis. Under conditions of vanadate trapping, most molecules displayed high FRET efficiency states, whereas with cyclosporin, more molecules showed low FRET efficiency. Different dwell times of the FRET states were found for the distinct biochemical conditions, with the fastest movements during active turnover. The FRET spectroscopy observations are discussed in context of a model of the catalytic mechanism of Pgp.