Miracle-dz/UniFAR-FTUs huggingface dataset:
The Impact of Increased Duration of Exercise Therapy on Functional Recovery Following Stroke — What Is the Evidence?

Abstract This article focuses on the impact of increased duration of exercise therapy on functional recovery after stroke. A comprehensive literature search using multiple databases was used to identify all relevant randomized controlled trials. Their quality was reviewed by two independent assessors, and a narrative systematic review and meta-analysis was completed. Methodological quality of all the 20 randomized controlled trials (RCTs) identified had a median of 6 points (range 5–8) on the 10-point PEDro scale. A meta-analysis was completed for studies that had a common outcome measure. For each outcome measure, the estimated effect size (ES) and the summary effect size (SES) were expressed as standardized mean differences (SMD). The results of the meta-analysis demonstrated that increased duration of exercise therapy time has a small but positive effect on activities of daily living as measured by the Barthel Index (SES 0.13; CI 0.01–0.25; Z = 2.15; p = .03) and that these improvements are maintained over a 6-month period (SES 0.15; CI 0.05–0.26; Z = 2.8; p = .00). Pooling reported differences in the various upper and lower extremity outcome measures demonstrated no significant SESs. However, the meta-analysis is supportive of the hypothesis that additional, focused exercise on the lower extremity has a favourable effect on lower extremity impairment and walking speed. The narrative review raises a number of issues that need to be considered in the development of future RCTs.
Essays in Macroeconomics with Financial Frictions

How can governments design policies that alleviate the macroeconomic implications of financial frictions? This dissertation contributes to answer this question focusing on two aspects: international borrowing and crisis prevention at the country's level, and the impact of taxation and financial regulation on entrepreneurship at the agent's level. In the first chapter, debt crises arise from the incompleteness of sovereign debt markets: the government cannot credibly commit to repay or default in certain states of the world and this gives way to non-fundamental debt crises. In a strategic default environment, I show that international reserve holdings help to reduce the probability of these market-driven debt crises, advancing the theoretical literature that had struggled to explain why countries hold reserves while indebted. The results are consistent with previous empirical results that had shown countries with greater reserve holdings faced lower spreads in the sovereign debt markets, which is at odds with the previous theories. In the second chapter, a small open economy faces an aggregate borrowing constraint and the agents fail to internalize how their private borrowing decisions push the total debt towards the limit, making the current account adjustment more severe. We model the decentralized and planner’s problem and find the optimal capital control policies, these are very effective to move the economy to the first-best scenario but also very hard to implement, given their state contingent nature. We then address the effectiveness of simpler policy rules, and find that they can bring welfare gains but had to be carefully designed. Finally, in the third chapter, the competition among investors for the most promising entrepreneurs, under adverse selection and limited liability, leads to an excessive entry into entrepreneurship activity and allocates resources to socially inefficient projects. We solve the optimal contracting problem and show that the inefficiency disappears if at least one of the next three is missing: competition in financial intermediation, adverse selection or limited liability. We also show that a small cost or fee per contract, like red-tape requirements, is enough to restore efficiency, making a case for financial regulation. Degree Type Dissertation Degree Name Doctor of Philosophy (PhD) Graduate Group Economics First Advisor Enrique G. Mendoza
Effects of acetylcholine, isoprenaline and forskolin on electrolyte and protein composition of rabbit mandibular saliva.

1. The major purpose of this study was to investigate cellular regulation of the ductal transport processes in salivary glands which act to modify the electrolyte composition of primary saliva and cause it to become hypotonic. This was achieved using an isolated mandibular gland preparation by observing the effect of different stimuli on the electrolyte composition of saliva secreted at the same flow rate, on the assumption that these stimuli do not influence primary saliva composition. The effects of the same stimuli on the volume of primary fluid secretion and on protein secretion were also observed. Proteins were measured in total and as individual components after their separation by high‐performance liquid chromatography. 2. Acetylcholine was used as a ‘Ca2+‐mobilizing’ agonist (i.e. one which both elevates intracellular Ca2+ concentration and activates protein kinase C). Isoprenaline was initially used to elevate intracellular cyclic AMP concentration but was subsequently abandoned in favour of forskolin. 3. Acetylcholine was a very potent stimulus of primary fluid secretion. By contrast, isoprenaline and forskolin were essentially without effect, even when superimposed on acetylcholine stimulation. 4. As judged by saliva electrolyte composition, increasing the concentration of acetylcholine enhanced ductal absorption of Na+ and Cl‐ and secretion of K+ (and presumably HCO3‐). Forskolin had the opposite effect: when superimposed on submaximal acetylcholine stimulation it caused saliva concentrations of Na+ and Cl‐ to remain high and K+ low (i.e. it inhibited ductal transport processes). The inhibitory effect of forskolin on ductal transport could be overcome by increasing the concentration of acetylcholine, and vice versa. 5. Acetylcholine, isoprenaline and forskolin each increased salivary protein secretion, although the kinetics of secretion differed. The spectrum of proteins secreted in response to the three stimuli was the same. The relative proportions of the individual proteins was influenced by the strength of stimulation (i.e. the proportions at high total protein output differed from those at low total protein output) but not apparently by the nature of the stimulus. 6. Thus, the three major secretory processes in the rabbit mandibular salivary gland respond differently to the two major signal transduction mechanisms. For primary fluid secretion, Ca2+ is stimulatory and cyclic AMP almost without effect; for ductal transport, Ca2+ is stimulatory and cyclic AMP inhibitory; and for protein secretion both Ca2+ and cyclic AMP are stimulatory.
The Effect of Outcome Uncertainty on Budgetary Slack and Risk Sharing: An Experimental Examination

While managers commonly possess private information regarding future production cost when developing their cost budget, they also face outcome uncertainty regarding that future cost. This outcome uncertainty, however, has largely been ignored by experimental researchers examining various controls for opportunistic budgetary slack. Social norm theory suggests that managers may view outcome uncertainty as an opportunity to evade an honesty norm and thereby increase budgetary slack. Alternately, the theory suggests that managers may view outcome uncertainty as a cue that they are expected to behave responsibly in their fiduciary role and thereby decrease budgetary slack. We test these competing theoretical effects using a participative budgeting experiment found in the literature. We find evidence that, rather than encouraging opportunism in managerial reporting, outcome uncertainty activates a responsibility norm that reduces budgetary slack. Specifically, we find that outcome uncertainty primes some managers to voluntarily share the risk of higher production cost with their principal, which leads to a decrease in budgetary slack relative to an experimental condition with no outcome uncertainty. This study extends the literature in participative budgeting by examining norm behavior under outcome uncertainty and helps explain the continued use of this organizational control in practice.
Spot urinary creatinine excretion in pervasive developmental disorders

Background: Excretion of creatinine in urine represents the end‐point of endogenous energy transfer from stored adenosine triphosphate in skeletal and cardiac muscle. Measurement of urinary creatinine is commonly used to correct for total urine concentration. Various quantitative measures of compounds suspected to be either pathological to, or indicative of, possible therapeutic interventions for Pervasive Developmental Disorders (PDD) have relied extensively on spot creatinine as a ratio quantity, although this important metabolite has not been exclusively studied within this population.
Acetylcholine Content in Rat Brain Is Elevated by Status Epilepticus Induced by Lithium and Pilocarpine

Abstract: The effects of status epilepticus on the concentration, synthesis, release, and subcellular localization of acetylcholine, the concentration of choline, and the activity of acetylcholinesterase in rat brain regions were studied. Generalized convulsive status epilepticus was induced by the administration of pilocarpine to lithium‐treated rats. The concentration of acetylcholine in the cortex, hippocampus, and striatum decreased prior to the onset of spike activity or status epilepticus. Once status epilepticus began, the concentration of acetylcholine increased over time in the cortex and hippocampus, reaching peak levels that were 461% and 304% of control levels, respectively, after 2 h of seizures. Such high in vivo levels of acetylcholine had not been reported previously following any treatment. During status epilepticus, the concentration of acetylcholine in the striatum returned to control levels after the initial depression, but did not accumulate to high levels as it did in the other two regions. The in vivo cortical efflux of acetylcholine was also increased during the seizures. Choline levels were increased by status epilepticus in all three brain regions. Inhibition of seizures by pretreatment with atropine blocked the increases of acetylcholine and choline. Synaptosomes prepared from the cortex and from the hippocampus of rats with status epilepticus had elevated concentrations of acetylcholine: in the hippocampus the acetylcholine was principally in the cytoplasmic fraction, whereas in the cortex the acetylcholine was elevated in both the cytoplasmic and the vesicular fractions. The extra acetylcholine was in a releasable compartment, since increased K+ in the media or ouabain increased the release of acetylcholine from cortical slices to a greater extent in tissue from seized rats than from controls. The activity of acetylcholinesterase was not reduced by status epilepticus. These findings demonstrate that status epilepticus induced by lithium and pilocarpine alters the regulation of acetylcholine synthesis.
Dental Trauma in a Pediatric Emergency Department Referral Center

Objective The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. Methods We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition. Results We identified 108 children with dental and if present, associated oral injuries. The median age was 12.3 years, the most common tooth injured were the primary (25.9%) or permanent (62%) upper central incisors, and the majority of subjects presented in the afternoon (mean time was 3:50 PM, SD ±24 minutes). A large proportion of dental injuries occurred in patients with permanent dentation (62%) and half of all children had more than 1 tooth injury. The majority of children (75%) were evaluated by either pediatric dental, oral surgery, or otolaryngology services, whereas 3.7% of the cases required multiple services. Twenty-five percent of children had an associated jaw fracture. Eighty-three percent of children were discharged home, of those, 49.1% were prescribed opioids, and 38.3% oral antibiotics. Conclusions Emergency departments are often relied upon to evaluate and treat simple and complex dental and oral injuries. The ability to use a multidisciplinary team to manage pediatric oral and dental trauma is essential for care.
Characterization of comQ and comX, Two Genes Required for Production of ComX Pheromone in Bacillus subtilis

ABSTRACT Many microbes use secreted peptide-signaling molecules to stimulate changes in gene expression in response to high population density, a process called quorum sensing. ComX pheromone is a modified 10-amino-acid peptide used by Bacillus subtilis to modulate changes in gene expression in response to crowding. comQ and comX are required for production of ComX pheromone. We found that accumulation of ComX pheromone in culture supernatant paralleled cell growth, indicating that there was no autoinduction of production of ComX pheromone. We overexpressed comQ and comX separately and together and found that overexpression of comX alone was sufficient to cause an increase in production of ComX pheromone and early induction of a quorum-responsive promoter. These results indicate that the extracellular concentration of ComX pheromone plays a major role in determining the timing of the quorum response and that expression of comX is limiting for production of ComX pheromone. We made alanine substitutions in the residues that comprise the peptide backbone of ComX pheromone. Analysis of these mutants highlighted the importance of the modification for ComX pheromone function and identified three residues (T50, G54, and D55) that are unlikely to interact with proteins involved in production of or response to ComX pheromone. We have also identified and mutated a putative isoprenoid binding domain of ComQ. Mutations in this domain eliminated production of ComX pheromone, consistent with the hypothesis that ComQ is involved in modifying ComX pheromone and that the modification is likely to be an isoprenoid.
Emphasis on autonomy and propensity for suicidal behavior in younger and older adults.

A cognitive style marked by emphasis on autonomy has been linked to negative outcomes throughout the life span. Two preliminary studies are presented that examined factors on a measure of autonomy (Personal Style Inventory-Revised) in relation to propensity for suicidal behavior (Suicidal Behaviors Questionnaire-14; SBQ-14). Perfectionism, B=. 15, SE=0.03, p<. 01, and Defensive Separation, B=. 04, SE=0.01, p ≤ . 01, predicted SBQ-14 in younger adults. Need for Control, B=. 234, SE=0.10, p<. 05, predicted SBQ-14 in older adults. Findings suggest that aspects of autonomy may be relevant to understanding suicidal behavior; however, more research is needed examining the association between autonomy and suicidal behavior in the context of depression. Nonetheless, these studies suggest a promising avenue for future research.
Interpretations of Innovation in Rural Development. The Cases of Leader Projects in Lecce (Italy) and Granada (Spain) in 2007–2013 Period

Abstract In the Leader approach, innovation plays a key role in European territories, especially in marginal and peripheral ones, being essentially assumed, from a programmatic point of view, as social innovation. This paper aims to understand the interpretation and the declination of innovation in the practice of Leader initiative at local scale and analyze contextual factors related to its implementation in two southern provinces of Spain and Italy (Granada and Lecce). The study aims to analyze the projects reported as innovative by the leaders of the Local Action Groups, starting from the literature and using a key Community document entitled “Extended report on preserving the innovative character of LEADER”. Lastly, the study reveals common significant problems linked to local awareness of the role of social innovation, as well as the absence or limitations of key institutions.
Detection of cancer in the pediatric emergency department

We reviewed the Tumor Registry for 1981 at the Children's Hospital of Philadelphia to identify all the children with newly diagnosed cancer who were seen initially in the emergency department (ED). Of the 220 new patients listed, 16 (7.3%) sought initial care in the ED (1 per 4,500 ED visits). Seven had leukemia, five had non-CNS solid tumors (2 lymphoreticular, 1 Wilms', 1 neuroblastoma, and 1 ovarian), and four had CNS tumors Among the children with leukemia, pallor (6) and decreased activity (4) were the most common complaints. Duration of symptoms ranged from 4 days to 3 weeks. Physical examination showed pallor (5), splenomegaly (4), fever (3), hepatomegaly (3), lymphadenopathy (3), and ecchymoses or petechiae (2). The complete blood count and peripheral smears were all abnormal The five patients with non-CNS solid tumors had symptoms related to the location of their neoplasms. The patients with Wilms' tumor, neuroblastoma, and ovarian dysgerminoma had abdominal masses; the patient with lymphoma had a large, painful inguinal node; and the patient with histiocytosis X had an infiltrative rash, gingivitis, and pneumonitis. Of the four children with CNS tumors, three had headache, two had vomiting, fever, or balance problems, and one had an incidentally detected scotoma following head trauma. All four eventually had abnormal neurologic exams and computer tomographic scans, but two were discharged initially with psychiatric diagnoses We conclude that cancer, although rare in children, occurs with greater relative frequency in the referral hospital ED than that predicted by published cancer rates from the referring hospital's ED. The complete blood count or peripheral smear serves to diagnose leukemia. Most solid tumors can be palpated, but CNS tumors present difficult diagnostic problems.
Detection of Keratoconus With a New Biomechanical Index.

PURPOSE To evaluate the ability of a new combined biomechanical index called the Corvis Biomechanical Index (CBI) based on corneal thickness profile and deformation parameters to separate normal from keratoconic patients. METHODS Six hundred fifty-eight patients (329 eyes in each database) were included in this multicenter retrospective study. Patients from two clinics located on different continents were selected to test the capability of the CBI to separate healthy and keratoconic eyes in more than one ethnic group using the Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany). Logistic regression was employed to determine, based on Database 1 as the development dataset, the optimal combination of parameters to accurately separate normal from keratoconic eyes. The CBI was subsequently independently validated on Database 2. RESULTS The CBI included several dynamic corneal response parameters: deformation amplitude ratio at 1 and 2 mm, applanation 1 velocity, standard deviation of deformation amplitude at highest concavity, Ambrósio's Relational Thickness to the horizontal profile, and a novel stiffness parameter. The receiver operating characteristic curve analysis of the training database showed an area under the curve of 0.983. With a cut-off value of 0.5, 98.2% of the cases were correctly classified with 100% specificity and 94.1% sensitivity. In the validation dataset, the same cut-off point correctly classified 98.8% of the cases with 98.4% specificity and 100% sensitivity. CONCLUSIONS The CBI was shown to be highly sensitive and specific to separate healthy from keratoconic eyes. The presence of an external validation dataset confirms this finding and suggests the possible use of the CBI in everyday clinical practice to aid in the diagnosis of keratoconus. [J Refract Surg. 2016;32(12):803-810. ].
A randomized controlled trial of corneal collagen cross-linking in progressive keratoconus: preliminary results.

PURPOSE This prospective, randomized, controlled trial aims to provide evidence in relation to the efficacy and safety of corneal collagen cross-linking (CXL) in the management of progressive keratoconus. METHODS Eligible eyes were separately randomized into either treatment or control groups. Collagen crosslinking was performed using 0.1% riboflavin (in 20% dextran T500) and ultraviolet A (UVA) irradiation (370 nm, 3 mW/cm2, 30 min) in accordance with a previously published protocol. At each review, a full clinical ophthalmic examination was performed including endothelial cell count and confocal microscopy. RESULTS To date, 66 eyes of 49 patients with documented progression of keratoconus have been enrolled and randomized. Interim analysis of treated eyes showed a flattening of the steepest simulated keratometry value (K-max) by an average of 0.74 diopters (D) (P = .004) at 3 months, 0.92 D (P = .002) at 6 months, and 1.45 D (P = .002) at 12 months. A trend toward improvement in best spectacle-corrected visual acuity was also observed. In the control eyes, mean K-max steepened by 0.60 D (P = .041) after 3 months, by 0.60 D (P = .013) after 6 months, and by 1.28 D (P < or = .0001) after 12 months. Best spectacle-corrected visual acuity decreased by logMAR 0.003 (P = .883) over 3 months, 0.056 (P = .092) over 6 months, and 0.12 (P = .036) over 12 months. No statistically significant changes were found for spherical equivalent or endothelial cell density. CONCLUSIONS Preliminary results of this randomized controlled trial suggest a temporary stabilization of all treated eyes after CXL.
Comparison between Pentacam HR and Orbscan II after Hyperopic Photorefractive Keratectomy

Purpose: The aim of this study was to determine the agreement between Pentacam HR (Scheimpflug imaging, Oculus) and Orbscan II (scanning slit topography, Bausch and Lomb) in measuring corneal parameters after photorefractive keratectomy (PRK) for hyperopia. Methods: In this prospective cross-sectional study, 38 hyperopic eyes undergoing PRK were examined before refractive surgery and 8 to 10 months postoperatively using Pentacam HR and Orbscan II. Ultrasound (US) pachymetry was also used to measure central corneal thickness (CCT). The radius of anterior (A-) and posterior (P-) best-fit sphere size (BFS), central elevation (CE), and anterior maximum tangential power in 3 mm (TG3) and 3-5 mm (TG5) zones, anterior chamber depth (ACD), and central corneal thickness (CCT) were collected and used in the analyses. To study the agreement between the measurements made by the two devices, the method described by Bland and Altman was used and the 95% limits of agreement were calculated. Results: The 95% limits of agreement show reasonable agreement between the measurements by Pentacam HR and Orbscan II for A-BFS, P-BFS, A-TG3, and CCT, but not for A-CE, P-CE, A-TG5, or ACD. CCT values obtained by both Pentacam HR and Orbscan II correlated well with the values determined by US pachymetry. Conclusion: Pentacam HR and Orbscan II after PRK for hyperopia show reasonable agreement for determining A-BFS, P-BFS, A-TG3, and CCT, but not for A-CE, P-CE, A-TG5, or ACD. CCT measurements with Pentacam HR have reasonable agreement with US pachymetry.
The Slope of the Yield Curve and the Near-Term Outlook

The yield spread between long-term and short-term Treasury securities is known to be a good predictor of economic activity, particularly of looming recessions. One way to learn more is through a careful scrutiny of the historical variation of such yield spreads and how they relate to the current slope of the Treasury yield curve. The results suggest that the recent flattening of the yield curve implies only a slightly elevated risk of a recession in the near term relative to any other month.