Miracle-dz/UniFAR-FTUs huggingface dataset:
Topical Apraclonidine Testing Discloses Pupillary Sympathetic Denervation in Diabetic Patients

Background:Autonomic denervation is common in diabetes mellitus (DM). Pupillary sympathetic denervation (PSD) has been found in Horner syndrome following instillation of apraclonidine 0.5%. We have applied this technique to investigate the prevalence of PSD in DM. Methods:Apraclonidine 0.5% was instilled in the eyes of 50 patients with DM and 30 age-matched and gender-matched subjects without DM (control subjects). Pupil diameters (PD) were measured before and 60 minutes after instillation. The duration of DM and the degree of diabetic retinopathy (DR) were recorded for each patient. Results:Apraclonidine instillation caused an average of 0.9 mm of mydriasis (range 0 to 4.5 mm) in DM and −0.1 mm miosis (range 0.5 to −1 mm) in control subjects (P < 0.001). Mydriasis of at least 1 mm was observed in 42% of DM patients. The change in PD was highly correlated with the duration of DM (r = 0.368, P = 0.008) and the presence of DR (r = 0.532, P < 0.001). Conclusion:Apraclonidine testing, which is easy to perform and not distressing to the patient, identified PSD in nearly half of DM patients, the degree of mydriasis being correlated to the duration of DM and the presence of DR.
Depression in epilepsy

Purpose of review To review some aspects of the relationship between epilepsy and depression that have recently received increasing attention and may become major research topics in the near future. Recent findings Epidemiological studies show that depression and suicide are, in some cases, premorbid symptoms preceding the onset of the epilepsy. Suicide is also three times more frequent in epilepsy than in the general population. Reliable screening instruments for depression and suicidality in patients with epilepsy are now available but data from real life clinical settings are needed to develop shared clinical pathways between neurology and psychiatry. Data in children with epilepsy are still limited although it is well known that, outside epilepsy, almost 50% of adult patients with mood and anxiety disorders have a previous history during childhood. Despite increasing attention to the problem, the additional stigma associated with mental health problems still represents one of the major barriers to prompt diagnosis and treatment. Summary New studies will focus on the development of shared clinical pathways between neurology and psychiatry for mood disorders and suicide prevention. New global campaigns on the double stigma will support this process in areas where psychiatric comorbidities are still underdiagnosed and undertreated.
Medicare Part D and Changes in Prescription Drug Use and Cost Burden: National Estimates for the Medicare Population, 2000 to 2007

ContextThe full effect of Medicare Part D, after the initial policy transition period and across the United States Medicare population, remains unclear. ObjectiveTo estimate nationally representative changes in prescription drug use and out-of-pocket drug costs 2 years after implementation of Part D. Design, Setting, and ParticipantsWe examined study outcomes over 8 years (2000 to 2007) and estimated changes after Part D, accounting for earlier trends. Our analyses used the community-dwelling sample of the Medicare Current Beneficiary Survey (unweighted unique n=38,798). Actual post-Part D outcomes were compared with projected values using 2000 to 2005 data. Subgroup analyses and standardization weights were used to address population-level shifts over time in health status and demographic characteristics. Main Outcome MeasuresAnnual prescription drug fills and out-of-pocket drug costs. ResultsWe observed significant average per person increases of 1.8 prescription fills [95% confidence interval (CI), 1.1-2.5] in 2006 and 3.4 prescription fills (95% CI, 2.7-4.1) in 2007 above pre-Part D increases of 0.9 prescription fills per year. Average out-of-pocket drug costs decreased significantly by $143 (95% CI, −182.5-−103.1) in 2006 and $148 (95% CI, −181.2-−114.1) in 2007 above average pre-Part D increases of $12 per year. Prescription fills did not change for beneficiaries with fair to poor health until 2007 when large increases occurred (increases of 3.7 to 11.0 fills above pre-Part D trends). Significant reductions in OOP drug costs occurred in 2006 and persisted into 2007 across all groups except for sick and poor beneficiaries without Medicaid. ConclusionsAfter the transition year of 2006, the impact of Part D seemed larger and more consistent across the Medicare population. Of note, sick and poor beneficiaries experienced significant improvements in prescription drug use in 2007.
Serum interleukin‐6, procalcitonin and C‐reactive protein levels in subjects with active Behçet's disease

Background Erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP) and cytokines, including serum interleukin (IL)‐6, IL‐8 and IL‐10, and tumour necrosis factor‐alpha (TNF‐α) have been proposed as disease activity markers in Behçet's disease (BD), although studies have shown conflicting results for IL‐6. Serum procalcitonin (PCT) levels in active BD have not yet been investigated.
On the Existence of Nash Equilibrium for a Two-player Pursuit—Evasion Game with Visibility Constraints

In this paper, we present a game-theoretic analysis of a visibility-based pursuit—evasion game in a planar environment containing obstacles. The pursuer and the evader are holonomic having bounded speeds. Both players have a complete map of the environment. Both players have omnidirectional vision and have knowledge about each other’s current position as long as they are visible to each other. The pursuer wants to maintain visibility of the evader for the maximum possible time and the evader wants to escape the pursuer’s sight as soon as possible. Under this information structure, we present necessary and sufficient conditions for surveillance and escape. We present strategies for the players that are in Nash equilibrium. The strategies are a function of the value of the game. Using these strategies, we construct a value function by integrating the adjoint equations backward in time from the termination situations provided by the corners in the environment. From these value functions we recompute the control strategies for the players to obtain optimal trajectories for the players near the termination situation. This is the first work that presents the necessary and sufficient conditions for tracking for a visibility based pursuit—evasion game and presents the equilibrium strategies for the players.
Structural studies of pulsed‐laser deposited nanocomposite metal‐oxide films

Pulsed laser deposition in vacuum has been used to develop metal‐oxide nanocomposite films with well controlled structural quality. Results for the copper–aluminium oxide (Cu:Al2O3) system are used to illustrate the main morphological and structural features of these films. High resolution transmission electron microscopy (TEM) analysis shows that the films consist of Cu nanocrystals with average dimensions that can be controlled between 2 nm and 10 nm embedded in an amorphous Al2O3 matrix. It is observed that the in‐plane shape of the nanocrystals evolves from circular to elongated, and the number of nanocrystals per unit area decreases as their size increases. This evolution is explained in terms of nucleation at the substrate surface and coalescence during the later stages of growth. The thermal stability of the films has been studied by in situ TEM annealing and no transformation could be observed up to about 800 °C when partial crystallization of the Al2O3 starts.
Integrated-optic electrorefraction modulators

The large electroabsorption (EA) and electrorefraction (ER) effects that can be achieved in coupled quantum well (CQW) structures give these structures great potential for use in intensity, phase, and polarization modulators for future optical links. This thesis focuses on designing structures that will result in state-of-the-art performance of CQW-based modulators. In this thesis, a design for a push-pull polarization-modulation scheme is presented, and it requires placing multiple repetitions of two different CQW structures in the optical waveguide of the proposed polarization modulator. The main function of one of the two structures is to provide a large increase of the refractive index for the TM polarization, without a proportionate increase of the refractive index for the TE polarization. It is shown that this effect can be achieved by anticrossing light holes. The main function of the other structure is to provide a large decrease of the refractive index for the TE polarization, without a proportionate decrease of the refractive index for the TM polarization. It is shown that, although this effect can be efficiently achieved by anticrossing heavy holes, the CQW structures that achieve this effect by anticrossing electrons are less sensitive to the layer thickness and compositional variations that may be expected during the growth process. The large EA and ER effects in CQW structures are typically seriously compromised by the layer variations, and, it is shown in this thesis that decreasing the confinement of the anticrossing wave functions can decrease the sensitivities of the CQW structures to these variations. In addition, the very small confinement of light holes in the InGaAlAs-based material systems together with the small sensitivity of the light-hole band edge to the compositional variations, make the anticrossing of the light holes the most robust-to-growth and, therefore, the most promising mode of operation for CQW-based ER intensity, phase, and polarization modulators. The absorption spectra of the novel CQW structures designed in this thesis are obtained using the variational method for solving the 1S exciton equation in the effective-mass, envelope-function approximation, and the electric-field-induced refractive index changes are obtained using the Kramers-Krbnig relations.
Gender Gaps in Income and Productivity of Obstetricians and Gynecologists

OBJECTIVE: To investigate differences in income, productivity, and practice style between male and female obstetrician–gynecologists between 1990 and 2002. METHODS: The primary data were the Socioeconomic Surveys of Fellows conducted by the American College of Obstetricians and Gynecologists (ACOG). The surveys contained complete responses from 3,698 obstetrician–gynecologists. Linear regression analysis was used to investigate gender differences in income, productivity, and practice style. RESULTS: Female obstetrician–gynecologists were younger, had been in medical practice fewer years, earned lower annual incomes ($196,000 versus $257,000), and exhibited lower productivity. Even when considering only young obstetrician–gynecologists (40 years old or younger), women earned annual incomes that were 23% lower, worked 10% fewer hours, saw 9% fewer patients, and performed 21% fewer procedures. The raw income gap between male and female obstetrician–gynecologists of all ages fell from 31% in 1990 to 19% in 2002, whereas for young obstetrician–gynecologists it remained stable at approximately 19%. However, despite this apparent stability, the nature of the income gap changed: whereas differences in productivity and practice style explained only half of the income gap in the 1990s, by 2002 these factors explained nearly all of the income gap. CONCLUSION: Between 1990 and 2002, female obstetrician–gynecologists earned lower annual incomes than male obstetrician–gynecologists, even when matched on age. However, by 2002 this income gap was almost entirely explained by gender differences in productivity and practice patterns. LEVEL OF EVIDENCE: III
National characteristics of residency program interview processes.

Interest in pharmacy residency training continues to grow, evidenced by a 52% increase in the number of student pharmacists applying to residency programs from 2010 to 2014 (3938 applicants versus 5978 applicants). [1][1],[2][2] Securing a residency position has become more competitive, and
Increased NBS1 Expression Is a Marker of Aggressive Head and Neck Cancer and Overexpression of NBS1 Contributes to Transformation

Purpose: Head and neck squamous cell carcinoma (HNSCC) represents the sixth most frequent type of cancer worldwide. However, the molecular genetic alterations underlying its malignant behavior and progression are little known. We showed previously that c-MYC directly activates the expression of the DNA double-strand break repair gene NBS1, and NBS1 overexpression contributes to transformation. Here, we investigate the role of NBS1 overexpression in HNSCC. Experimental Design: Immunohistochemistry analysis of NBS1 expression was done in 81 locally advanced HNSCC patients. Real-time PCR and Western blot analysis were used to confirm immunohistochemistry results. Human hypopharyngeal cancer cell lines (FADU) with overexpressing NBS1 (FADUNBS) or inducible short interference RNA to repress endogenous NBS1 (FADUNBSi) were generated by stable transfection. Soft agar clonogenicity assay was used to determine the transformation activity. Western blot analysis and phosphatidylinositol 3-kinase (PI3K) assay were done to evaluate the signaling pathways that were involved. Results: NBS1 overexpression was identified in 45% of advanced HNSCC patients. It was an independent marker of poor prognosis. NBS1 expression levels correlated with the transformation activity of FADU clones and also correlated with the phosphorylation levels of Akt and its downstream target mammalian target of rapamycin (mTOR). PI3K activity was increased in NBS1-overexpressing FADU clones. NBS1 overexpression also correlated with increased Akt phosphorylation levels in tumor samples. Conclusions: Increased NBS1 expression is a significant prognostic marker of advanced HNSCC, and the underlying mechanism may involve the activation of the PI3K/Akt pathway.
Increasing HIV Treatment Optimism but No Changes in HIV Risk Behavior Among Men Who Have Sex With Men in Vancouver, Canada

BACKGROUND Antiretroviral therapy (ART) has dramatically reduced mortality among HIV-positive individuals and has been associated with declining HIV incidence.1–3 Numerous guidelines now recommend ART for all HIV-positive individuals, irrespective of CD4 counts.4–6 These approaches are supported by randomized trials demonstrating the benefits of early ART on improved clinical outcomes for HIVpositive individuals,7 as well as reductions in onward transmission.8 However, concerns remain that changes in HIV risk behavior could undermine “treatment as prevention” (TasP) effectiveness. Previous research studies have found associations between HIV sexual risk behavior and positive attitudes toward ART’s preventive value,9 particularly among men who have sex with men (MSM). 10,11 Most of this research pre-dates any formal adoption of TasP as policy, but relied on knowledge acquired from peers or health care providers. Several jurisdictions have recently adopted and are actively promoting TasP.12–14 In British Columbia (BC), Canada, TasP was introduced in 2010 through a pilot project in Vancouver and expanded province wide in 2012.15 Thus, MSM in Vancouver have been exposed to TasP messages for several years through clinicians, the media, and likely discussions with peers and community leaders.16 A previous crosssectional analysis from our group demonstrated that indeed, higher HIV treatment optimism was associated with risky sex and that HIV-positive MSM had much higher HIV treatment optimism scores than those of HIV-negative/ unknown MSM.17 To explore temporal changes in these relationships, we used data from the prospective cohort of the same study of Vancouver-based MSM to examine trends in attitudes regarding the benefits of ART and risky sex over a 3-year period, whereas TasP policy was actively implemented across BC.
Editorial: Flt3 ligand—friend or foe?

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Delayed Infection After Elective Spinal Instrumentation and Fusion: A Retrospective Analysis of Eight Cases

Study Design. A retrospective analysis of eight cases of delayed spinal infection after elective posterior or combined anterior and posterior spinal instrumentation and fusion. Objectives. These cases are reviewed to identify risk factors for delayed spinal infection after elective instrumentation and to describe the treatment of this complication. Summary of Background Data. Delayed spinal infection after elective spinal instrumentation and fusion is uncommon. This diagnosis is frequently difficult. Methods. Five cases seen in the senior author's practice and three referral cases are reviewed. Results. Of these eight cases, the organisms were Staphylococcus epidermidis in six cases, Propionibacterium acnes in one case, and in the final patient, all intraoperative cultures were negative. Clinical presentations were variable; however, all patients reported back pain. Seven patients had elevated erythrocyte sedimentation rates, averaging 57 mm/hour. Only two had elevated white blood cell counts. No distant foci of infection were identified in any patient. Five patients were found to have at least one pseudarthrosis. All patients were treated with debridement, instrumentation removal, and primary wound closure over drains followed by a minimum 6‐week course of culture‐directed post‐operative antibiotics. At an average follow‐up of 18 months, no patient has evidence of infection. Conclusions. The diagnosis of delayed infection after elective spinal instrumentation and fusion requires a high index of suspicion. These infections may have been caused by intraoperative inoculation. All patients were successfully treated with debridement, instrumentation removal, and culture‐directed postoperative antibiotics.
Self-regulated learning of basic arithmetic skills: a longitudinal study.

BACKGROUND Several studies have examined young primary school children's use of strategies when solving simple addition and subtraction problems. Most of these studies have investigated students' strategy use as if they were isolated processes. To date, we have little knowledge about how math strategies in young students are related to other important aspects in self-regulated learning. AIM The main purpose of this study was to examine relations between young primary school children's basic mathematical skills and their use of math strategies, their metacognitive competence and motivational beliefs, and to investigate how students with basic mathematics skills at various levels differ in respect to the different self-regulation components. SAMPLE The participants were comprised of 27 Year 2 students, all from the same class. METHOD The data were collected in three stages (autumn Year 2, spring Year 2, and autumn Year 3). The children's arithmetic skills were measured by age relevant tests, while strategy use, metacognitive competence, and motivational beliefs were assessed through individual interviews. The participants were divided into three performance groups; very good students, good students, and not-so-good students. RESULTS Analyses revealed that young primary school children at different levels of basic mathematics skill may differ in several important aspects of self-regulated learning. Analyses revealed that a good performance in addition and subtraction was related not only to the children's use of advanced mathematics strategies, but also to domain-specific metacognitive competence, ability attribution for success, effort attribution for failure, and high perceived self-efficacy when using specific strategies. CONCLUSIONS The results indicate that instructional efforts to facilitate self-regulated learning of basic arithmetic skills should address cognitive, metacognitive, and motivational aspects of self-regulation. This is particularly important for low-performing students.
Volatile anesthetic-induced preconditioning

The myocardium has an innate ability to protect itself from ischemic events. This protection occurs when the myocardium is exposed to a brief ischemic period prior to a more extreme ischemic event. This is termed ischemic preconditioning. Ischemic preconditioning induces a series of molecular pathways that protect the cardiac myocyte; first, for a period of 1-6 hours (early preconditioning) and, also, for a second period from 24-72 hours (delayed phase). The early preconditioning is mediated by the release of adenosine which induces a protective signal that is related to the mitochondrial KATP channel activation and activation of the δ-opioid and bradykinin receptors. The delayed phase is related to the induction of inducible nitric oxide synthase, superoxide dismutase and heat-shock proteins. Indirect evidence indicates that O2-derived free radicals are involved in the delayed phase, as noted in the early preconditioning phase. Applying ischemic preconditioning to clinical practice can be dangerous and difficult to implement in a controlled fashion. However, recent studies have shown that the use of volatile anesthetics, such as sevoflurane, isoflurane and desflurane, can mimic the early phase of ischemic preconditioning through a multi-pathway signaling of mitochondrial KATP channels. This important finding can easily be applied to clinical practice for patients undergoing surgery. It can also be significantly important for patients undergoing off-pump cardiac bypass surgery or cardiac bypass surgery where there is no cross-clamp or cardioplegia used where the probability of myocardial ischemia is greatly increased. This report will, therefore, discuss the mechanism, safety and efficacy of volatile anesthetics as inducers of cardiac preconditioning.