Miracle-dz/UniFAR-FTUs huggingface dataset:
H1N1 influenza in pregnancy: cause for concern.

To the Editor: We read with great interest the article by Saleeby et al regarding the presentation and treatment of H1N1 influenza in pregnancy.1 The authors provide an excellent practice guideline to help clinicians treat patients with H1N1 influenza. In addition, they summarize the evidence that supports the use of higher doses of oseltamivir for longer duration in critically ill patients. We would like to take the opportunity to make one additional point on this topic. Although not approved for use, limited supplies of aqueous zanamivir are available on a compassionate-use basis for the treatment of patients who are critically ill with pandemic H1N1 influenza.2 Aqueous zanamivir can be administered intravenously or by nebulization. These routes of administration make aqueous zanamivir an attractive option for intubated patients in whom Relenza (dry powdered zanamivir for inhalation, GlaxoSmithKline, Philadelphia, PA) is contraindicated and enteral absorption of oseltamivir may be low. Recently, Kidd et al reported on the use of aqueous zanamivir in a 22-yearold immunocompromised woman with H1N1 influenza.3 The patient was admitted to the intensive care unit after failing to respond to standard dosing of oral oseltamivir. Further deterioration mandated intubation and mechanical ventilation on day 3. After intubation, she was treated with oseltamivir using a nasogastric tube at both standard and accelerated doses and with nebulized aqueous zanamivir. The patient continued to deteriorate, and, on day 16, intravenous zanamivir was started as unlicensed monotherapy. Her condition began to improve within 48 hours. She was extubated 3 days later and subsequently was discharged from the intensive care unit. Although a single case report cannot prove cause and effect, the findings warrant further investigation. Aqueous zanamivir can be requested for compassionate use from GlaxoSmithKline. Inclusion criteria are seriously ill, hospitalized patients with laboratory-confirmed H1N1 influenza who cannot take or have not responded to other antivirals. Exclusion criteria include hypersensitivity to zanamivir and pregnancy, unless the expected benefit to the patient is thought to outweigh any possible risk to the fetus. Critically ill postpartum patients similar to the one described in case 1 may qualify for the compassionate use of zanamivir.
Aflatoxin Exposure after Weaning: Solid Food Contaminant Impairs Growth

j Abstract Objective The aim was to investigate the hypothesis that patients with first episode schizophrenic disorders have a more favorable treatment response than those with multiple episodes. Method A total of 400 inpatients from an ongoing multi-centre, follow-up program who fulfilled ICD-10 criteria for schizophrenic disorders (F2) were assessed at admission to and discharge from hospital using the Positive and Negative Syndrome Scale (PANSS). Results At admission, first episode patients (n = 121) showed higher levels of positive symptoms (PANSS positive subscore) and lower ones of negative symptoms (PANSS negative subscore) than multiple episode patients (n = 279), whereas the global disease severity (PANSS total score) was comparable. Analyses of covariance revealed that treatment response (adjusted symptom levels at discharge) was more favorable in first-episode patients, with respect to both positive and negative symptoms. Conclusion The results are The study was performed within the framework of the German Research Network on Schizophrenia, which is funded by the German Federal Ministry for Education and Research BMBF (grant 01 GI 0233).
I-Pic: A Platform for Privacy-Compliant Image Capture

The ubiquity of portable mobile devices equipped with built-in cameras have led to a transformation in how and when digital images are captured, shared, and archived. Photographs and videos from social gatherings, public events, and even crime scenes are commonplace online. While the spontaneity afforded by these devices have led to new personal and creative outlets, privacy concerns of bystanders (and indeed, in some cases, unwilling subjects) have remained largely unaddressed. We present I-Pic, a trusted software platform that integrates digital capture with user-defined privacy. In I-Pic, users choose alevel of privacy (e.g., image capture allowed or not) based upon social context (e.g., out in public vs. with friends vs. at workplace). Privacy choices of nearby users are advertised via short-range radio, and I-Pic-compliant capture platforms generate edited media to conform to privacy choices of image subjects. I-Pic uses secure multiparty computation to ensure that users' visual features and privacy choices are not revealed publicly, regardless of whether they are the subjects of an image capture. Just as importantly, I-Pic preserves the ease-of-use and spontaneous nature of capture and sharing between trusted users. Our evaluation of I-Pic shows that a practical, energy-efficient system that conforms to the privacy choices of many users within a scene can be built and deployed using current hardware.
Replacing Animal Tests to Improve Safety for Humans

Animal safety testing for new medicines is arguably the most difficult use of non-human animals (hereinafter referred to as animals) to challenge, for two reasons: first, it is required by governments (regulatory testing); second, pro­ tecting patients is a vital goal, and it seems intuitively obvious that animal tests must protect patients. Animal testing became institutionalized in the mid twentieth century (Parke, 1994) in response to early drug disasters, with the aim of preventing further tragedies. However, even the laudable aim of protecting patients cannot justify animal testing, unless it is the most effec­ tive means to ensure the safety of medicines. European Union (EU) law (Euro­ pean Parliament, 2010, Directive 2010/63/EU) states that animals must not be used if a non-animal method could achieve the same purpose. So, it is crucial to know how well animal tests predict the safety of medicines, and whether any other methods are equally or more predictive. In addition to the question of predictive value, other important issues must also be taken into consider­ ation, including the efficiency of different methods in terms of time and costs; and the ethical acceptability of using animals, if their use is deemed to be of irreplaceable value. The issue of whether animals should be used as human surrogates for safety testing is highly contentious; individual views range from no use of animals
The Role of Mutation Rates of GNAQ or GNA11 in Cases of Uveal Melanoma in Japan

GNAQ and GNA11 mutations are thought to be important for the tumorigenesis of uveal melanoma. Although previous studies have reported on mutation rates in cases of uveal melanoma, presently, no such report for the Japanese population exists. In this study, we examined the frequency of GNAQ and GNA11 somatic mutations in cases of uveal melanoma in Japan and their relationship with clinicopathologic features or Ki-67-positive cell rates (Ki-67 labeling index: Ki-67 LI) using immunofluorescence methods. The study involved 19 cases of uveal melanoma. We extracted the template DNA from formalin-fixed, paraffin-embedded specimens using a DNA extraction kit. We amplified the DNA sequences of GNAQ and GNA11 using polymerase chain reaction and analyzed mutations by direct sequencing. We evaluated Ki-67 LI using immunofluorescence methods. The frequencies of GNAQ and GNA11 somatic mutations were 26.3% (5/19) and 31.6% (6/19), respectively. The GNAQ and GNA11 mutations were mutually exclusive, as indicated in previous reports. The frequency of GNA11 mutations was significantly higher in epithelioid cells; however, no significant association between GNAQ mutations and cell type was evident, and there was no significant difference in Ki-67 LI between the mutation-positive and mutation-negative tumors. GNAQ and GNA11 mutations were identified in cases of uveal melanoma in Japan, although at lower frequencies than in white counterparts. The mutation frequency of GNA11 was significantly higher in epithelioid cells.
Intensive Supportive Care plus Immunosuppression in IgA Nephropathy.

Copyright © 2015 Massachusetts Medical Society. BACKGROUND The outcomes of immunosuppressive therapy, when added to supportive care, in patients with IgA nephropathy are uncertain. METHODS We conducted a multicenter, open-label, randomized, controlled trial with a two-group, parallel, group-sequential design. During a 6-month run-in phase, supportive care (in particular, blockade of the renin–angiotensin system) was adjusted on the basis of proteinuria. Patients who had persistent proteinuria with urinary protein excretion of at least 0.75 g per day were randomly assigned to receive supportive care alone (supportive-care group) or supportive care plus immunosuppressive therapy (immunosuppression group) for 3 years. The primary end points in hierarchical order were full clinical remission at the end of the trial (protein-to-creatinine ratio <0.2 [with both protein and creatinine measured in grams] and a decrease in the estimated glomerular filtration rate [eGFR] of <5 ml per minute per 1.73 m2 of body-surface area from baseline) and a decrease in the eGFR of at least 15 ml per minute per 1.73 m2 at the end of the trial. The primary end points were analyzed with the use of logistic-regression models. RESULTS The run-in phase was completed by 309 of 337 patients. The proteinuria level decreased to less than 0.75 g of urinary protein excretion per day in 94 patients. Of the remaining 162 patients who consented to undergo randomization, 80 were assigned to the supportivecare group, and 82 to the immunosuppression group. After 3 years, 4 patients (5%) in the supportive-care group, as compared with 14 (17%) in the immunosuppression group, had a full clinical remission (P = 0.01). A total of 22 patients (28%) in the supportive-care group and 21 (26%) in the immunosuppression group had a decrease in the eGFR of at least 15 ml per minute per 1.73 m2 (P = 0.75). There was no significant difference in the annual decline in eGFR between the two groups. More patients in the immunosuppression group than in the supportive-care group had severe infections, impaired glucose tolerance, and weight gain of more than 5 kg in the first year of treatment. One patient in the immunosuppression group died of sepsis. CONCLUSIONS The addition of immunosuppressive therapy to intensive supportive care in patients with high-risk IgA nephropathy did not significantly improve the outcome, and during the 3-year study phase, more adverse effects were observed among the patients who received immunosuppressive therapy, with no change in the rate of decrease in the eGFR. (Funded by the German Federal Ministry of Education and Research; STOP-IgAN ClinicalTrials.gov number, NCT00554502.) A BS TR AC T Intensive Supportive Care plus Immunosuppression in IgA Nephropathy
Cerebrospinal fluid dynamics in the human cranial subarachnoid space: an overlooked mediator of cerebral disease. I. Computational model

Abnormal cerebrospinal fluid (CSF) flow is suspected to be a contributor to the pathogenesis of neurodegenerative diseases such as Alzheimer's through the accumulation of toxic metabolites, and to the malfunction of intracranial pressure regulation, possibly through disruption of neuroendocrine communication. For the understanding of transport processes involved in either, knowledge of in vivo CSF dynamics is important. We present a three-dimensional, transient, subject-specific computational analysis of CSF flow in the human cranial subarachnoid space (SAS) based on in vivo magnetic resonance imaging. We observed large variations in the spatial distribution of flow velocities with a temporal peak of 5 cm s−1 in the anterior SAS and less than 4 mm s−1 in the superior part. This could reflect dissimilar flushing requirements of brain areas that may show differences in susceptibility to pathological CSF flow. Our methods can be used to compare the transport of metabolites and neuroendocrine substances in healthy and diseased brains.
Serotype Prevalence and Penicillin-susceptibility of Streptococcus pneumoniae in Oman.

OBJECTIVES to determine the prevalent serotypes of Streptococcus pneumoniae and the rate of penicillin-nonsusceptibility among pneumococci in Oman. METHODS Pneumococcal isolates encountered during the period of September 2002 to December 2007 in the Royal Hospital were serotyped. Clinical information as well as the penicillin susceptibility reports were retrieved from the hospital information system and medical records. RESULTS 120 strains of Streptococcus pneumoniae were isolated of which 85 strains were seroptyped. 20 different serotypes were identified, the most common seroptypes were 9A, 6B, 19F, 14 and 23F. 56% of the strains were not susceptible to pencillin, while 99% of these were susceptible to ceftriaxone. 74.3% and 46.1% of the serotypes are covered by the pneumococcal polysaccharide vaccine and the 7-valent pneumococcal conjugate vaccine respectively. CONCLUSION Certain few pneumococcal serotypes such as 9A, 6B and 19F are more prevalent in the Omani community than others. More than half of S. pneumoniae are not susceptible to penicillin while the great majority of the strains are susceptible to ceftriaxone.
A dichotomy theorem for constraints on a three-element set

The Constraint Satisfaction Problem (CSP) provides a common framework for many combinatorial problems. The general CSP is known to be NP-complete; however, certain restrictions on the possible form of constraints may affect the complexity, and lead to tractable problem classes. There is, therefore, a fundamental research direction, aiming to separate those subclasses of the CSP which are tractable, from those which remain NP-complete. In 1978 Schaefer gave an exhaustive solution of this problem for the CSP on a 2-element domain. In this paper we generalise this result to a classification of the complexity of CSPs on a 3-element domain. The main result states that every subclass of the CSP defined by a set of allowed constraints is either tractable or NP-complete, and the criterion separating them is that conjectured by Bulatov et al. (2001). We also exhibit a polynomial time algorithm which, for a given set of allowed constraints, determines whether if this set gives rise to a tractable problem class. To obtain the main result and the algorithm we extensively use the algebraic technique for the CSP developed by Jeavons (1998) and Bulatov et al.
A Randomized Trial Comparing Clinical Outcomes Between Zero-Profile and Traditional Multi-Level Anterior Cervical Discectomy and Fusion Surgery for Cervical Myelopathy.

STUDY DESIGN Prospective randomized study from a single center OBJECTIVE. : The purpose of this study was to compare outcomes between a zero-profile (ZP) anterior cervical discectomy and fusion (ACDF) construct to a traditional ACDF with anterior plate (ACP) in the treatment of multilevel cervical spondylotic myelopathy. SUMMARY OF BACKGROUND DATA Multi-level cervical spondylotic myelopathy can be treated by a variety of techniques, most commonly with corpectomy, ACDF, posterior cervical fusion or a combination of the three. Examples in the literature of comparative effectiveness of different anterior approach types are few. METHODS A total of 104 patients with multi-level cervical spondylotic myelopathy were randomized in equal proportion between treated with ACDF and ZP or ACDF with ACP. Clinical efficacy of two groups were evaluated preoperatively and at all postoperative time points through two years postoperative by the Japanese Orthopedic Association (JOA) score and the neck disability index (NDI). Radiographic changes from baseline, including disc height and cervical lordosis, were evaluated at the same postoperative time points. Complications were assessed perioperatively and through two years postoperative. RESULTS The ZP and ACP ACDF groups demonstrated substantially equivalent JOA, NDI, disc height, and lordosis improvements from baseline, which were maintained through two years postoperative. Complications occurred in 4% of ZP and 17% of ACP patients (p = 0.052), and zero (0%) ZP and four (8%) ACP patients reported hoarseness or dysphagia. CONCLUSION Zero-profile utilized in multi-level ACDF may obtained favorable clinical outcomes and a lower postoperative complications. LEVEL OF EVIDENCE 2.
Exploring Protein Kinase Inhibitors: Unveiling Gemcitabine Resistance in Pancreatic Cancer

To the Editor: Gemcitabine is one of first-line therapies for locally advanced pancreatic cancer; however, severe resistance is responsible for less than 6 months of median survival and less than 20% of response rate. Although efforts to overcome gemcitabine resistance have been underway, the only combination treatment that has shown a small but statistically significant outcome is gemcitabine with erlotinib, an epidermal growth factor receptor inhibitor. Improvements in pancreatic cancer therapy can be made by understanding gemcitabine resistance. Currently, expression levels of several proteins such as equilibrative nucleoside transporter 1, multidrug resistance-associated proteins, deoxycytidine kinase, and cytidine deaminase have been reported tobe involved ingemcitabine resistance. However, these are not sufficient to address the full mechanisms of resistance and to direct feasible therapeutic strategies. Instead, gemcitabine-resistant cells might use several biochemical pathways to survive gemcitabine-induced cytotoxic or genotoxic damages. To enhance the treatment benefits of conventional therapeutic drugs, targeting protein kinases in combination with DNA damaging drugs has been aggressively attempted for several types of cancers. As part of this effort in pancreatic cancer, we explored 76 protein kinase inhibitors (PKIs) for probing new targetable protein kinases and found that several PKIs possess promising efficacy in combination with gemcitabine. Additionally, parallel investigations on the nature of drug resistance are prerequisite for developing substantial therapeutic strategies in the treatment of pancreatic cancer. Gemcitabine-resistant cells may alter the dependency on several key kinases to facilitate cell proliferation and survival. Thus, searching the bypass of biochemical pathways in gemcitabine-resistant cells may be achieved by the comparison of sensitivities on PKIs between parental and gemcitabine-resistant cells. For efficient isolation of target kinases, we used a method in which half maximal effective concentration (EC50) ratios were compared. MATERIALS AND METHODS For creating gemcitabine-resistant cells, MiaPaCa2 cells (ATCC, Manassas, Va) were exposed to incrementally increasing doses (starting at 0.1 Kmol/L) of gemcitabine. When the cells adapted to a dose, the gemcitabine concentration was increased by 0.1 Kmol/L. After 3 months of selection, MiaPaCa2 cells surviving at 1.5Kmol/L of gemcitabine were generated. To determine the EC50 in parental and gemcitabine-resistant cells, we measured cell viability using 3-(4,5-dimethyl) ethiazole assays after treatment with each PKI (from 0.1 to 10 Kmol/L). Then, EC50 of each PKIs in both cell types were determined using CompuSyn software (ComboSyn, Inc, Paramus, NJ). To compare the efficacy of PKIs in gemcitabine resistant cells, we calculated the EC50 ratio [(EC50 in parental cell)/(EC50 in resistant cell)].
Joint Segmentation and Recognition of License Plate Characters

The segmentation and recognition modules are usually implemented sequentially in most traditional automatic license recognition (LPR) systems. In this work, we integrate segmentation and recognition into a Markov network, where bidirectional constraints between segmentation and recognition are exploited for LPR. In addition, both low-level structural attributes and compositional semantics of license plates are incorporated in a probabilistic way. A belief propagation (BP) algorithm is used for statistical inference that is able to separate and recognize license characters simultaneously. Experiments on Chinese license plates show that the proposed approach work well even when connected and distorted characters present.
Effects of bicarbonate- and lactate-buffered replacement fluids on cardiovascular outcome in CVVH patients.

BACKGROUND Bicarbonate-buffered replacement fluid (RF-bic) in continuous venovenous hemofiltration (CVVH) may be superior to lactate-buffered replacement fluid (RF-lac) in acute renal failure. In an open, randomized, multicenter study, we investigated the effects of RF-bic and RF-lac on cardiovascular outcome in patients requiring CVVH following acute renal failure. METHODS One hundred seventeen patients between the age of 18 and 80 years were randomized to CVVH either with RF-bic (N = 61) or RF-lac (N = 56). Patients were treated with CVVH for five days or until either renal function was restored or the patient was removed from the study. Data were analyzed on day 5 or according to the "last observation carried forward" (LOCF) option. Adverse events were classified according to the WHO-Adverse Reaction Terminology system. RESULTS Blood lactate levels were significantly lower and blood bicarbonate levels were significantly higher in patients treated with RF-bic than in those treated with RF-lac (lactate, 17.4 +/- 8.5 vs. 28.7 +/- 10.4 mg/dL, P < 0.05; bicarbonate, 23.7 +/- 0.4 vs. 21.8 +/- 0.5 mmol/L, P < 0. 01). The number of hypotensive crises was lower in RF-bic-treated patients than in RF-lac-treated patients (RF-bic 14 out of 61 patients, RF-lac in 29 out of 56 patients; 0.26 +/- 0.09 vs. 0.60 +/- 0.31 episodes per 24 h, P < 0.05). Nine out of 61 patients (15%) treated with RF-bic and 21 out of 56 patients (38%) treated with RF-lac developed cardiovascular events during CVVH therapy (P < 0. 01). A multiple regression analysis showed that the occurrence of cardiovascular events was dependent on replacement fluid and previous cardiovascular disease and not on age or blood pressure. Patients with cardiac failure died less frequently in the group treated with RF-bic (7 out of 24, 29%) than in the group treated with RF-lac (12 out of 21, 57%, P = 0.058). In patients with septic shock, lethality was comparable in both groups (RF-bic, 10 out of 27, 37%; RF-lac, 7 out of 20, 35%, P = NS). CONCLUSIONS The results show that the administration of RF-bic solution was superior in normalizing acidosis of patients without the risk of alkalosis. The data also suggest that the use of RF-bic during CVVH reduces cardiovascular events in critically ill patients with acute renal failure, particularly those with previous cardiovascular disease or heart failure.
Psychiatric symptoms associated with focal hand dystonia

Myoclonus dystonia and idiopathic dystonia are associated with a greater frequency of obsessive compulsive disorder (OCD) and major depression. We investigated the frequency of OCD in 39 patients with primary focal hand dystonia (FHD) using a semistructured interview. OCD and subsyndromal OCD was diagnosed in 5 of 39 (12.82%) patients with FHD, whereas OCD occurs in 2.3% of the general population. Recurrent depression occurred in (7 of 39) 17.95% of patients with FHD along with a family history of depression in (16 of 39) 41.02%. Overlapping mechanisms manifesting as FHD may also predispose to OC symptoms and likely implicates a common striatal dysfunction. © 2010 Movement Disorder Society