Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevention of CMV disease in pediatric kidney transplant recipients: Evaluation of pp67 NASBA‐based pre‐emptive ganciclovir therapy combined with CMV hyperimmune globulin prophylaxis in high‐risk patients

Abstract: A new prevention strategy for CMV infection was evaluated in our pediatric kidney transplant unit. This approach comprises a pre‐emptive therapy, based upon the monitoring of CMV pp67 mRNA in whole blood by the qualitative NASBA, combined with prophylactic CMV‐IG in high risk (R−/D+) children. Thirty‐one kidney transplant children were followed for six months with serial measurements of CMV pp67 mRNA in the blood. The R−/D+ patients were given prophylactic CMV‐IG for the first 16 wk after transplantation. I.v. ganciclovir was administered upon CMV detection by NASBA and was discontinued after two consecutive negative results. CMV infection, detected by NASBA, developed in 11 (35%) recipients: one (33%) of the R+/D− patients and 10 (72%) of the R−/D+ patients. CMV disease developed in 9.6% of the patients (3/31), exclusively in the R−/D+ group. These three patients presented concurrently with CMV viremia and disease. It is noteworthy that two of the three patients could not receive a complete course of CMV‐IG, and one of the latter two subjects had been treated for acute rejection 15 days before CMV infection. Ganciclovir was given for the 11 cases of primary infection, and for three cases of relapsed CMV infection. pp67 NASBA‐based pre‐emptive ganciclovir therapy, combined with prophylactic CMV‐IG in high‐risk patients leads to a lower rate of CMV disease, as long as a complete course of CMV‐IG has been administered and ganciclovir is given during the period of treatment for acute rejection in high‐risk populations.
A connectivity-preserving flocking algorithm for multi-agent systems based only on position measurements

Most existing flocking algorithms rely on information about both relative position and relative velocity among neighbouring agents. In this article, we investigate the flocking problem with only position measurements. We propose a provably-stable flocking algorithm, in which an output vector is produced by distributed filters based on position information alone but not velocity information. Under the assumption that the initial interactive network is connected, the flocking algorithm not only can steer a group of agents to a stable flocking motion, but also can preserve the connectivity of the interactive network during the dynamical evolution. Moreover, we investigate the flocking algorithm with a virtual leader and show that all agents can asymptotically attain a desired velocity even if only one agent in the team has access to the information of the virtual leader. We finally show some numerical simulations to illustrate the theoretical results.
Inanspruchnahme und Akzeptanz klassischer Naturheilverfahren und alternativer Heilmethoden in Deutschland – Ergebnisse einer repräsentativen Bevölkerungsstudie

Summary Use and Acceptance of Classical Natural and Alternative Medicine in Germany - Findings of a Representative Population-Based Survey Background: The use of classical natural therapies and alternative medicine is becoming increasingly popular in Germany and other European countries. Only few population-based studies in Germany have investigated the use and acceptance of a variety of classical and alternative methods, including their possible determinants. Methods: Cross-sectional survey of a nationally representative sample of men and women aged 18 to 69 years, applying a standardized self-administered questionnaire, that included questions on 21 different healing methods, on personal reasons for use, on individual attitudes to natural therapies, and on the socioeconomic background. Results: Overall, 70% of women and 54% of men had used at least one classical natural or alternative healing method (including homeopathic and anthroposophic medicine) during the 12 months preceding the study. The most frequently used methods were classical therapies such as exercise therapy (32% of women, 26% of men), herbal medicine (33% of women, 20% of men), hydrotherapy (24% of women, 17% of men), and medical massage (22% of women, 15% of men). About 20% of women and 10% of men had applied homeopathic therapies, and about 9% (11% women, 6% men) had used acupuncture. In multivariate logistic regression analyses gender and education were the best predictors of classical and alternative medicine use. Women and persons with at least high-school education used these methods significantly more often than men and persons with lower education. Age-stratified analyses revealed that the age-group of the 40-49-year-old people used classical and alternative methods significantly more often than younger or older age-groups. The most frequently reported health problems for which natural therapies had been applied were back pain (57%), cold (29%), headaches (19%), strain (15%) and gastrointestinal ailments (12%). Overall, the efficacy and usefulness of natural healing methods was evaluated positive by the majority of the study population. 58% would appreciate it if physicians would more often prescribe such therapies, and 48% would like to have more information about the benefit of natural healing methods. Conclusions: The prevalence of use of natural medicine varies substantially across different types of healing methods. The observed overall acceptance together with the marked need for more information should be used more intensively for the development of health promotion strategies and underpins the necessity of reinforced research activities in this field.
Intravenous immunoglobulin as rescue therapy for BK virus nephropathy

Abstract: BKVN has emerged as an important cause of pediatric renal allograft nephropathy, with significant graft dysfunction in majority of the cases. Reduced immunosuppression and cidofovir therapy are the most commonly used therapeutic options for the treatment of BKVN in these patients. Recently, a preliminary study in adult renal allograft recipients with BKVN showed a therapeutic response to a combined approach of immunosuppression reduction and IVIg administration. A therapeutic benefit of IVIg without another concomitant treatment intervention has not been evaluated. We report stabilization of renal functions, histological resolution of BKVN and significant reduction in BK viremia in pediatric renal transplant with the use of IVIg, after an inadequate response to immunosuppression reduction and cidofovir therapy. In addition, we review the current literature on the use of cidofovir in pediatric renal transplant patients with BKVN and the potential of IVIg use in this condition.
Robust model reduction of uncertain systems maintaining uncertainty structure

This article presents a new approach for or robust model reduction for uncertain systems based on an optimisation algorithm applied directly in the space of reduced-order model parameters. The proposed approach can be applied to both polytopic or affine parameter-dependent models as well as for continuous or discrete-time systems.The developed procedure is capable of computing both fixed reduced-order model as well as uncertain reduced-order model keeping the original uncertainty structure. The resulting reduced-order model is guaranteed to be robust stable.
Cytomegalovirus infection in children who underwent hematopoietic stem cell transplantation at a single center: A retrospective study of the risk factors

Abstract: CMV infection is one of the major causes of morbidity and mortality after HSCT. The aim of this single center retrospective study was to analyze risk factors for CMV infection in pediatric patients who underwent HSCT. We retrospectively reviewed the medical records of 117 pediatric patients who underwent allogeneic HSCT at Asan Medical Center between December 2000 and January 2007. After HSCT, CMV antigenemia was detected by identifying CMV pp65 early antigen in white blood cells. The incidence of CMV antigenemia was 24% (28/117) at a median of 38 days (range: 19–123 days) after HSCT. In multivariate analysis, CMV antigenemia occurred significantly more often in CMV seropositive recipients, patients who received grafts from alternative donors, T‐cell depleted grafts, patients on ATG‐containing conditioning regimens, or patients who received steroid for acute GVHD (p < 0.05). CMV antigenemia tend to develop earlier in patients who received ATG‐containing conditioning regimens (p = 0.09). A second episode of CMV antigenemia was observed in three out of 28 patients (11%). The incidence of CMV disease was 5.9% (7/117) at a median of 97 days (range: 34–120 days). Manifestation of CMV disease included retinitis in two, pneumonitis in two, hepatitis in one, hepatitis with colitis in one, and gastritis in one. Six of the 12 patients (50%) with HG antigenemia (CMV pp65 antigen positivity ≥40 cells) developed clinical CMV disease, a rate that was significantly higher than seen in patients with LG antigenemia (6.25%; p < 0.01). We recommend that patients with these risk factors should carefully undergo regular evaluations for CMV infection. We also suggest that earlier and more aggressive preemptive treatment and serial follow‐up of CMV disease is necessary in patients with HG‐antigenemia.
Strict positive realness of descriptor systems in state space

In this article, we give necessary and sufficient spectral conditions for various notions of strict positive realness for single-input single-output descriptor systems. These conditions only require calculation of eigenvalues of a single matrix. A characterisation of a Kalman–Yacubovich–Popov-like lemma for descriptor systems is also derived, and its implications for the stability of a class of switched descriptor systems are briefly discussed.
Loxiglumide abolishes the effects of intraduodenal oleic acid on gastric motility and emptying in the pig

Abstract The role of cholecystokinin in mediating the effects of intraduodenal fat infusion on gastric motility and gastric emptying and the pattern of transpyloric flow was evaluated in conscious pigs. Concurrent measurements of antropyloroduodenal motility with an eight‐channel sleeve/sidehole catheter, transpyloric flow and gastric emptying after instillation of 1000 ml of saline into the stomach, were made during intraduodenal infusion of either normal saline or oleic acid at 5 ml min−1. Studies with intraduodenal oleic acid were performed with and without intravenous infusion of loxiglumide (30 mg kg−1 intravenous bolus 15 min before intraduodenal oleic acid, followed by intravenous infusion of 10 mg kg−1 h−1), Intraduodenal oleic acid was associated with stimulation of isolated pyloric pressure waves (P < 0.05), inhibition of antral pressure waves (P < 0.05), reduced pulsatile transpyloric flow (P < 0.05) and retardation of gastric emptying (P < 0.05). when compared to intraduodenal saline. Loxiglumide prevented retardation of gastric emptying by intraduodenal oleic acid (P < 0.05), and maintained it at values that were not significantly different from saline. After loxiglumide there were more antral pressure waves (P < 0.05) and less isolated pyloric pressure waves (P < 0.05) when compared to oleic acid.
Domino liver graft from a patient with homozygous familial hypercholesterolemia

Liu C, Niu D‐M, Loong C‐C, Hsia C‐Y, Tsou M‐Y, Tsai H‐L, Wei C. Domino liver graft from a patient with homozygous familial hypercholesterolemia. Pediatr Transplantation 2010: 14:E30–E33. © 2009 John Wiley & Sons A/S.
Discrete-time minimal control synthesis adaptive algorithm

This article proposes a discrete-time Minimal Control Synthesis (MCS) algorithm for a class of single-input single-output discrete-time systems written in controllable canonical form. As it happens with the continuous-time MCS strategy, the algorithm arises from the family of hyperstability-based discrete-time model reference adaptive controllers introduced in (Landau, Y. (1979), Adaptive Control: The Model Reference Approach, New York: Marcel Dekker, Inc.) and is able to ensure tracking of the states of a given reference model with minimal knowledge about the plant. The control design shows robustness to parameter uncertainties, slow parameter variation and matched disturbances. Furthermore, it is proved that the proposed discrete-time MCS algorithm can be used to control discretised continuous-time plants with the same performance features. Contrary to previous discrete-time implementations of the continuous-time MCS algorithm, here a formal proof of asymptotic stability is given for generic n-dimensional plants in controllable canonical form. The theoretical approach is validated by means of simulation results.
Size reduction of donor organs in pediatric lung transplantation

Mueller C, Hansen G, Ballmann M, Schwerk N, Simon AR, Goerler H, Strueber M. Size reduction of donor organs in pediatric lung transplantation. Pediatr Transplantation 2010:14: 364–368. © 2009 John Wiley & Sons A/S.
Is calculating the standard deviation of tacrolimus blood levels the new gold standard for evaluating non‐adherence to medications in transplant recipients?

No it is not. Not yet. But looking at blood level variation might – in the near future - indeed become the de-facto gold standard for assessment of nonadherence in the transplant setting. If it does, this measurement method could lead to important discoveries not only for the transplant field but for adherence and outcomes research in other areas of medicine as well. Since nonadherence accounts for a majority of late rejections in pediatric solid organ transplant recipients (1–3), the discovery of a useful measure of adherence could be of great clinical importance in the provision of posttransplant care.
Putting the Public Back in Public Health

Fatality reviews are part of the public health arsenal to mortality prevention. As such they rely on medico-legal practitioners’ participation. Yet medico-legal practice in the United States is still divided between the scientific approach of medical examiners systems and the political approach of coroners systems. I argue that this is related to the public’s reluctance to let go of its jurisdiction over death as a social fact. I posit that attempts at systematizing coroners’ inquests, as in Washington State, illustrate such resistance, yet could be conceived as a compromise between the political and the scientific, benefiting public health and the goal of fatality reviews.
Mathematical modeling of the cause of tuberculosis during tumor necrosis factor blockade.

OBJECTIVE Tumor necrosis factor (TNF) blockade increases the risk of tuberculosis (TB). The purpose of this study was to use Markov modeling to examine the contributions of reactivation of latent tuberculous infection (LTBI) and the progression of new infection with Mycobacterium tuberculosis to active TB due to TNF blockade. These 2 pathogenic mechanisms cannot otherwise be readily distinguished. METHODS Monte Carlo simulation was used to represent the range of reported values for the incidence of TB associated with infliximab (TNF monoclonal antibody) and etanercept (soluble TNF receptor) therapy. Iterative methods were then used to identify for each pair of incidence rates the Markov model parameters that most accurately represented the distribution of time to onset of TB as reported to the Food and Drug Administration. RESULTS Modeling revealed an apparent median monthly rate of reactivation of LTBI by infliximab treatment of 20.8%, which was 12.1 times that with etanercept treatment (P<0.001). In contrast, both drugs appeared to pose a high risk of progression of new M tuberculosis infection to active TB. Progression of new infection appeared to cause nearly half of the etanercept-associated cases; it became the predominant cause of infliximab-associated cases only after the first year. CONCLUSION Despite sharing a common therapeutic target, infliximab and etanercept differ markedly in the rates at which they reactivate LTBI. Confirmation of these findings will require the application of molecular epidemiologic tools to studies of TB in future biologics registries. Hidden Markov modeling and Monte Carlo simulation are powerful tools for revealing otherwise hidden aspects of the pathogenesis of TB.
Reliability and validity of the center for epidemiologic studies depression scale in patients with systemic sclerosis.

OBJECTIVE Reported rates of depressive symptoms in patients with systemic sclerosis (SSc) are high. No depression assessment tools, however, have been validated for patients with SSc. Our objective was to assess the internal consistency reliability, convergent validity, and structural/construct validity of the Center for Epidemiologic Studies Depression Scale (CES-D) in patients with SSc. METHODS We conducted a cross-sectional, multicenter study of 470 SSc patients. Internal consistency reliability was assessed with Cronbach's alpha and structural/construct validity with confirmatory factor analysis. RESULTS Internal consistency reliability was good for the overall CES-D scale (alpha = 0.88) and for its 4 factors (alpha = 0.67-0.88). Correlations of the CES-D total score were -0.73 with mental health, -0.36 with physical health, 0.41 with disability, and 0.44 with pain. The 4-factor model originally found in the general population and validated for patients with rheumatoid arthritis (depressed affect, somatic/vegetative, [lack of] positive affect, and interpersonal factors) fit the data well, as did a second-order version of the same model with an overarching depression factor that loaded onto each of the 4 first-order factors. The 4-factor model fit the SSc data better than alternative models. CONCLUSION Internal consistency reliability and convergent validity were good, the 4-factor structure reported in the general population was replicated, and a second-order model with an overarching depression factor fit well. These findings indicate that the CES-D is a valid and reliable measure of depressive symptoms for patients with SSc.
A followup study of antiphospholipid antibodies and associated neuropsychiatric manifestations in 137 children with systemic lupus erythematosus.

OBJECTIVE To determine the prevalence of anticardiolipin antibodies (aCL), anti-beta(2)-glycoprotein I (anti-beta(2)GPI) antibodies, and lupus anticoagulant (LAC) in a large cohort of children with systemic lupus erythematosus (SLE), and to evaluate the associations with neuropsychiatric manifestations. METHODS A single-center retrospective cohort study with longitudinal followup of antiphospholipid antibodies (aPL) in 137 children with SLE (25 boys and 112 girls, mean age at diagnosis 13.0 years) was performed. Patients were followed up for a mean of 31 months. RESULTS At the time of diagnosis, 65% of the children were aCL positive, 41% had anti-beta(2)GPI antibodies, and 26% were LAC positive. Analysis of the association between presence of aPL and individual neuropsychiatric manifestations at diagnosis showed a statistically significant association of positive LAC with cerebrovascular disease (5 patients; P = 0.015). A persistently positive aCL was observed in 50%, anti-beta(2)GPI antibodies in 29%, and LAC in 16% of children over time. The prevalence of anti-beta(2)GPI antibodies, but not aCL and LAC, was found to be statistically significantly higher in children with neuropsychiatric disease compared with those without (P = 0.02). Comparison for specific neuropsychiatric manifestations showed a statistically significant association between a persistently positive LAC and chorea (2 patients; P = 0.02). CONCLUSION The prevalence of anti-beta(2)GPI antibodies was found to be higher in the group of SLE patients with neuropsychiatric disease compared with those without. Our data suggest an association between LAC and cerebrovascular disease at the time of SLE diagnosis and chorea over the disease course, but not between aPL and other neuropsychiatric manifestations.
Gluteal tendinopathy in refractory greater trochanter pain syndrome: diagnostic value of two clinical tests.

OBJECTIVE To evaluate the value (sensitivity and specificity) of 2 modified physical tests for the diagnosis of gluteal tendinopathy in patients with refractory greater trochanter pain syndrome (GTPS). METHODS The 2 tests were prospectively evaluated by a single physician in all consecutive patients with persistent (> or =4 months) GTPS and no hip joint arthropathy seen on radiography between 2002 and 2006. The 2 tests evaluated the occurrence of pain similar to spontaneous pain during a single-leg stance held for 30 seconds and resisted external derotation in a supine position (hip flexed 90 degrees ) then prone position (hip extended). A matched control population without hip pain was examined similarly. Tendinitis, tendon tear, and associated bursitis in the target group were documented by magnetic resonance imaging (MRI) in transverse, coronal, and sagittal planes, with MRI serving as the gold standard. RESULTS Seventeen patients completed the study (mean +/- SD age 68.1 +/- 10.8 years, mean duration of symptoms 13 months). MRI revealed tendinopathy and/or bursitis of the gluteus medius and/or minimus tendons in all patients, with evidence of tearing in 15. Sensitivity and specificity were 100% and 97.3%, respectively, for the single-leg stance test and 88% and 97.3%, respectively, for the resisted external derotation test in the supine position. CONCLUSION The 30-second single-leg stance and resisted external derotation tests had very good sensitivity and specificity for the diagnosis of tendinous lesion and bursitis in patients with MRI-documented refractory GTPS.
A measurement-based approach for designing reduced-order controllers with guaranteed bounded error

The objective of this paper is to present a measurement-based control-design approach for single-input single-output linear systems with guaranteed bounded error. A wide range of control-design approaches available in the literature are based on parametric models. These models can be obtained analytically using physical laws or via system identification using a set of measured data. However, due to the complex properties of real systems, an identified model is only an approximation of the plant based on simplifying assumptions. Thus, the controller designed based on a simplified model can seriously degrade the closed-loop performance of the system. In this paper, an alternative approach is proposed to develop fixed-order controllers based on measured data without the need for model identification. The proposed control technique is based on computing a suitable set of fixed-order controller parameters for which the closed-loop frequency response fits a desired frequency response that meets the desired closed-loop performance specifications. The control-design problem is formulated as a nonlinear programming problem using the concept of bounded error. The main advantages of our proposed approach are: (1) it guarantees that the error between the computed and the desired frequency responses is less than a small value; (2) the difficulty of finding the globally optimal solution in the error minimisation problem is avoided; (3) the controller can be designed without the use of any analytical model to avoid errors associated with the identification process; and (4) low-order controllers can be designed by selecting a fixed low-order controller structure. To experimentally validate and illustrate the efficacy of the proposed approach, proportional-integral measurement-based controllers are designed for a DC (direct current) servomotor.