Miracle-dz/UniFAR-FTUs huggingface dataset:
Single-center experience with simultaneous thoracic endovascular aortic repair and abdominal endovascular aneurysm repair

Objective To evaluate the efficacy and outcomes of simultaneous thoracic endovascular aortic repair (TEVAR) and abdominal endovascular aneurysm repair (EVAR). Methods A total of 21 patients (20 men; mean 65 ± 7 years, range 54–77) underwent simultaneous TEVAR and EVAR between September 2010 and June 2015 at a single center were retrospectively reviewed. All patients had concomitant thoracic pathologies (aneurysm, penetrating aortic ulcer, intramural hematoma, or dissection) and abdominal aortic aneurysm. The abdominal aneurysms diameters ranged from 5.9 cm to 10 cm. Thoracic lesions in 17 patients were complicated with acute aortic syndrome, and the remainders had indications for simultaneous repair. All patients were followed up postoperative at 1 month, 6 months, and yearly thereafter. Technique success, procedure-related complications were evaluated. Results All patients received local anesthesia, perioperative relative high arterial pressure (above 130/80 mmHg) maintenance, and prophylactic high-dose corticosteroid. The technical success rate was 100%. Average procedural time was 157.6 ± 45.6 min. The length of thoracic coverage was 20.4 ± 4.7 cm (range 15–27). Two patients required left subclavian artery coverage during TEVAR and two patients required lowest renal artery coverage during EVAR. Chimney stents were deployed simultaneously. Patients were followed between 2 and 59 months postoperatively. No patients developed acute cardiopulmonary complications and contrast-induced nephropathy. Two patients developed transient lower extremity weakness that resolved with blood pressure elevation, cerebrospinal fluid drainage, and intravenous drips of high-dose corticosteroid. The average hospital stay was 10.7 ± 7.9 days (range 4–30). During follow-up, one patient died of aneurysm rupture at postoperative 6 months, two patients developed type Ib endoleak at 9 months and 48 months respectively, one was successfully sealed with iliac stent-graft extension, the other received conservative treatment and is symptom free till now. Conclusion Combined TEVAR and EVAR can be performed safely with minimal morbidity and mortality. When anatomically feasible, simultaneous TEVAR and EVAR can be considered as an acceptable alternative for multilevel aortic diseases.
Meniett Therapy for Ménière's Disease: An Updated Meta-analysis

Objective: To re-evaluate the efficacy of Meniett therapy for the treatment of Ménière's disease (MD). Data Sources: PubMed, Embase, Cochrane Library, Clinicaltrials.gov, ChiCTR, and the CNKI database were searched for articles in English and Chinese published before August 31, 2015. Study Selection: Included in this meta-analysis were studies that dealt with outcomes of Meniett therapy for the treatment of MD, including randomized controlled clinical trials, case-control studies, and prospective or retrospective cohort studies, with sample sizes of ≥10 subjects. Data Extraction: Keywords included endolymphatic hydrops, Ménière's disease, pressure, Meniett, and transtympanic micropressure treatment. Data Synthesis: Fourteen studies were included, involving a total of 345 MD patients. Data were analyzed using the Meta package in R. Dichotomous outcomes were expressed as risk ratios with 95% confidence intervals, and weighted mean differences with 95% confidence intervals were used to present continuous outcomes. Heterogeneity of the included studies was quantitatively assessed by &khgr;2 and I2 tests. Fixed-effects models were used for I2 < 50%; otherwise, random-effects models were used. Funnel plots were constructed to test the publication bias. Conclusion: This study showed that Meniett therapy may prevent vertigo attacks and substantially reduce its frequency in MD patients. It may also alleviate the functional deficit. The impact of Meniett therapy on hearing remains uncertain. The optimal effect might maintain for approximately 18 months. This meta-analysis suggested that Meniett therapy may be a useful second-line therapy in the treatment of MD.
Mass Media and Aspiration Manipulation: An Experiment Altering Preferences Over Goals

Mass media consumption has increasingly been found to adversely impact upon psychological states but research has largely neglected the potential influence of media on aspirations. An experiment demonstrates aspirational incomes to be dramatically altered by a textual narrative despite it not presenting any new information. The narrative is constructed to elicit peer comparison effects, a common element of a variety of media formats. The effect of the narrative rapidly dissipates when concentration is redirected to unrelated tasks however, suggesting any influence media presentations have on aspirations may only be fleeting. Nevertheless the results suggest that mass media might currently be augmenting aspirations with potential implications for satisfaction levels, educational attainment and risk preferences. Also the results imply preferences can be altered without new information being presented, a violation of individual decision making theory. An amendment to the theory is proposed.
RELATIONSHIP BETWEEN NUTRITIONAL STATUS AND THE CLINICAL OUTCOMES OF PATIENTS WITH AND WITHOUT NEOPLASMS ACCORDING TO MULTIPLE CORRESPONDENCE ANALYSIS.

BACKGROUND For many years, many studies have reported undesirable outcomes that may occur during the hospital stay of patients diagnosed with malnutrition or even at some nutritional risk. OBJECTIVE To investigate the relationship between nutritional status and clinical outcomes during hospital stay using the multiple correspondence analysis technique. METHODS This cross-sectional study included 600 patients with and without neoplasms. The following data were collected: subjective global assessment, nutritional indicators, nutritional risk screening, anthropometric data (body mass index (BMI), mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MUAMC), triceps skinfold thickness (TST), recent weight loss (RWL)), and habitual energy intake (HEI/ER <75%). The clinical outcomes of interest were complications, length of hospital stay (LOHS), and death. The data were analyzed by the chi-square or Fisher's exact test at a significance level of 5%. Multiple correspondence analysis was used for the multivariate data analysis. RESULTS The multiple correspondence analysis map for the patients with neoplasms showed that the following characteristics were associated and represented by death, complications, and a greater likelihood of LOHS ≥7 days: underweight according to BMI; TST, MUAC, and MUAMC ≤15th percentile; malnutrition according to the subjective global assessment; at nutritional risk according to the nutritional risk screening; being male; age ≥60 years; and HEI/ER <75%. The multiple correspondence analysis map for the patients without neoplasms showed that the following characteristics were associated and represented by death: underweight according to BMI; TST ≤15th percentile; malnutrition according to the subjective global assessment; and at nutritional risk according to the nutritional risk screening. Complications and LOHS ≥7 days represented the categories male, no recent weight loss, HEI/ER <75%, MUAC and MUAMC ≤15th percentile, TST between the 15th and 85th percentiles, and age <60 years. CONCLUSION The results of this study confirm an association between unsatisfactory nutritional indicators and undesirable clinical outcomes.
Efficacy and safety of a recombinant factor VIII produced from a human cell line (simoctocog alfa)

ABSTRACT Introduction: The development of inhibitors against infused factor VIII (FVIII) has a detrimental impact on health and quality of life of patients with hemophilia A. Several observational studies and a recently published randomized trial indicate that the inhibitor risk in previously untreated patients (PUPs) is higher following the use of recombinant FVIII (rFVIII) products compared with plasma-derived FVIII concentrates. There is currently a great interest towards newer rFVIII products that adopt various technological solutions to reduce the inhibitor risk. Areas covered: This review describes the efficacy and safety of simoctocog alfa (Nuwiq), a human cell-line derived rFVIII developed for the prevention and treatment of bleeding in hemophilia A patients. Particular relevance will be given to the safety aspects of this product, with special emphasis on the rate of inhibitor development, presenting the results of the phase II and III clinical trials on previously treated patients (PTPs) and the interim data from the phase III trial on PUPs. Expert opinion: The final results from PTP studies and the preliminary data from the PUP study document the high efficacy and safety profile of this rFVIII product, which has the potential to reduce the inhibitor risk in PUPs with severe hemophilia A.
A Comparison of Intrathecal and Epidural Analgesia and Its Effect on Length of Labor

Abstract : A retrospective study was conducted to determine the effects of intrathecal analgesia on length of labor. There have been a number of investigations which show contradictory evidence as to the effect of epidural (EPI) analgesia on the progress of labor. Combined spinal-epidural (CSE) and intrathecal analgesia (ITA) techniques have been used to provide effective pain relief for parturients, but currently there are few data comparing EPI, CSE, and ITA techniques and their effect on progress of labor. Intrathecal opioids provide immediate pain relief for the parturient without autonomic, sensory or motor blockade. All are associated with prolongation of labor and increased incidence of instrumental delivery. A 1995 study reported CSE for labor analgesia is associated with shorter duration of first stage in primiparas (Campbell et al.). The last two hundred thirteen uncomplicated obstetric charts were reviewed in a 70-bed Air Force hospital which currently provides EPI, CSE, and ITA for their obstetric department. The study consisted of four groups: (1) CSE n=76 (2) EPI n= 41(3) ITA n=49 and (4) NR (no regional analgesia) n=47. Demographic data was also collected. It was found that length of first stage labor was significantly less for those who received ITA (p.001) as compared to all other groups. Second stage labor was significantly shorter for the NR group as compared to CSE (p=.000) and EPI (p=.006) groups. There was no significant difference between length of second stage for ITA and NR groups. ITA analgesia shortened first stage most significantly (p=.006) in both primiparas and multiparas. Stage two was significantly prolonged for both primiparas (p=.047) and multiparas (p=.012) in the CSE group. Since CSE analgesia during labor is both versatile and requires less re-dosing of the epidural catheter, thus less manpower hours, implications for use in anesthesia departments unable to offer a full obstetric regional analgesia service are made.
Do Politicians 'Put Their Money Where Their Mouth Is?' Ideology and Portfolio Choice

We examine the role of political ideology in portfolio formation by studying a unique set of investors whose ideology can be precisely captured by a well-defined, continuous measure and whose personal asset allocation decisions are mandatorily disclosed - namely, the members of the U.S. Congress. As such, we overcome important methodological issues facing previous work in this area. We find that politicians with similar beliefs hold similar portfolios and that more liberal members engage in more socially responsible investing (SRI), even within political parties. Politicians disproportionately favor the SRI categories that reflect their favorite issues, while salience plays an important role in activating their ideologically-based preferences for SRI. In addition, more ideological investors are less likely to engage in the quid pro quo behavior documented in Tahoun (2014). We conclude that ideology is a pervasive psychological factor that governs decisions across the domains of politics, investing, and even ethics.
Supporting Transgender Children: New Legal, Social, and Medical Approaches

The author, a lawyer who advocates for transgender children and youth, explores how clinical approaches to transgender children and youth are keeping pace with social and legal changes affecting these young people and with recent evidence suggesting that children are harmed by family and societal rejection as well as by attempts to change their gender identity or gender expression. The author urges providers and legal advocates to work with policymakers and the families of transgender children and youth to create a future in which these young people can reach their full potential and be embraced as fully equal, respected, and participating members of society.
A brief review on the laboratory diagnosis of leptospirosis

Abstract Leptospirosis is a ubiquitous zoonotic disease that may be maintained in either wild or domesticated animal species. These bacteria have been classified into serovars based on their antigenic characteristics and, more recently, into species based on genomic studies. They produce both chronic and acute infections. Chronic infections of serovars in the host species to which they have become adapted can result in long term shedding, providing a source of acute infection for other species. As clinical presentation can vary greatly, diagnosis often depends on laboratory methods. In addition to diagnostic testing, herd health monitoring and screening for international trade purposes are performed at veterinary laboratories. The test method selected varies depending on the samples available and the purpose of testing. An increasing variety of laboratory methods are being described for detection of bacteria and antibodies. In addition to classical methods such as culture, dark-field, microscopy and the microscopic agglutination test (MAT), a variety of polymerase chain reaction (PCR), indirect enzyme-linked immunosorbent assay (ELISA), competitive ELISA and other rapid serological tests have been described. This review describes the advantages and limitations of these assays together with other factors that may affect results and their interpretation, such as species variation, vaccination and antibiotic administration.
Population based epidemiology and prognosis of mesothelioma in Leeds, UK

Introduction: Malignant mesothelioma is a fatal neoplasm, which is rapidly increasing in incidence throughout Western Europe. To date there have been no studies reporting on the natural history and interventional practices on a comprehensive unselected population, as opposed to reports from referral institutions or compensation claimants. We present a population based study capturing data on all patients with mesothelioma presenting within a defined geographical area over a 4 year period in the UK. Method: Data of all cases occurring in Leeds with a population of 750 000 were collected retrospectively from 2002 to 2003 and prospectively from 2004 to 2005. All patients’ hospital records and the Trust histology database were reviewed, as well as coroner’s reports on all patients with a post mortem diagnosis of mesothelioma. Results: Over the 4 year study period, there were a total of 146 cases in Leeds; 77% were male. Median age was 74 years (range 36–93). Median survival from diagnosis was 8.9 months. 92% and 8% had histological or cytological confirmation, respectively. 85% had documented evidence of definite or probable exposure to asbestos. 110/146 (75%) had symptomatic pleural effusions at presentation. Twice the number of patients (42 vs 17) were managed with surgical rather than bedside pleurodesis and these had a lower recurrence rate (14% vs 47%; p = 0.02). 122 patients had video assisted thoracoscopic surgery/cutting CT biopsies or chest drains. 73/122 (60%) had prophylactic radiotherapy to these sites. There were seven cases (5%) of tract invasion by tumour and six of these had received prophylactic radiotherapy. Median time to seeding was 174 days. 92/146 (63%) had a performance status of 2 or better at diagnosis but only 54/146 were considered fit for chemotherapy. Of these, 28 (52%) declined chemotherapy; the overall uptake of chemotherapy or entry into a trial was 18%. No patient had radical surgery. Conclusion: This comprehensive population based audit has shown that the median age at presentation of malignant mesothelioma is increasing and baseline performance status and survival is worse than in selected series. 37% of patients were considered suitable for palliative chemotherapy but less than 20% accepted this offer. Thorascopic pleurodesis appears to be associated with fewer recurrences. The role of prophylactic radiotherapy to chest drain and biopsy sites needs reappraisal.
Fonctionnement de peuplements en semis direct associant du blé tendre d'hiver (Triticum aestivum L.) à différentes plantes de couverture en climat tempéré

Des systemes de culture innovants doivent etre proposes pour repondre aux nouveaux objectifs de l'agriculture qui devront allier productivite, respect de l'environnement et rentabilite economique. Les systemes de culture en semis direct sous couvert vegetal (SCV) avec cultures associees permettraient d'atteindre ces objectifs. Si ces systemes ont en effet montre des interets en climat tropical, ils sont presque inexistants en climat tempere. Cette these se propose d'accroitre les connaissances scientifiques sur ces systemes particuliers pour faciliter leur conception et leur evaluation en climat tempere. Le travail repose sur un dispositif experimental mis en place a Grignon (Yvelines, France) en 2002 pour trois campagnes culturales. Du ble tendre d'hiver (Triticum aestivum L.) est seme (i) dans un sol laboure, (ii) directement dans les residus de la culture precedente et, (iii) directement dans six plantes de couverture differentes. En combinant sur ce dispositif une double approche, systemique et analytique, les objectifs de la these sont de comprendre, selon l'espece de couverture, (i) l'impact des differents SCV avec cultures associees sur le rendement de la culture de vente en mettant en evidence les phases de sensibilite aux stress de cette culture, (ii) les relations de competition et/ou de facilitation pour l'azote et la lumiere entre les especes associees et, (iii) l'evolution, a court terme, de la structure du sol et de ses proprietes hydriques. Ce travail montre que la presence d'une plante de couverture peut reduire, parfois fortement, le rendement de la culture de vente, differemment selon l'espece de couverture, sa conduite technique et les conditions climatiques ; les phases d'elaboration du rendement qui sont perturbees dans ces situations culturales dependent aussi de ces trois facteurs. De plus, l'etude met en evidence que la competition pour le rayonnement lumineux entre les especes associees est le processus le plus defavorable au rendement du ble. A court terme, il n'apparait pas de differences marquees entre la structure d'un sol non travaille sans plante de couverture et celle d'un sol non travaille avec une plante de couverture. Toutefois, l'etude revele que les proprietes hydriques peuvent etre modifiees selon l'absence ou la presence d'une plante de couverture sur un sol non travaille sans demontrer de variations importantes de ces proprietes selon l'espece de couverture. La these fournit des informations scientifiques et techniques sur le fonctionnement, en climat tempere, de peuplements associant sur un sol non travaille, une culture de vente a differentes plantes de couverture. Elle montre la faisabilite mais aussi les risques des SCV avec cultures associees ; elle permet d'identifier des axes de recherche pour completer les connaissances et fournir des references pour reduire ces risques.
Multi-institutional melanoma lymphatic mapping experience: the prognostic value of sentinel lymph node status in 612 stage I or II melanoma patients.

PURPOSE To compare the effect of pathologic sentinel lymph node (SLN) status with that of other known prognostic factors on recurrence and survival in patients with stage I or II cutaneous melanoma. PATIENTS AND METHODS We reviewed the records of 612 patients with primary cutaneous melanoma who underwent lymphatic mapping and SLN biopsy between January 1991 and May 1995 to determine the effects of tumor thickness, ulceration, Clark level, location, sex, and SLN pathologic status on disease-free and disease-specific survival. RESULTS In the 580 patients in whom lymphatic mapping and SLN biopsy were successful, the SLN was positive by conventional histology in 85 patients (15%) but negative in 495 patients (85%). SLN status was the most significant prognostic factor with respect to disease-free and disease-specific survival by univariate and multiple covariate analyses. Although tumor thickness and ulceration influenced survival in SLN-negative patients, they provided no additional prognostic information in SLN-positive patients. CONCLUSION Lymphatic mapping and SLN biopsy is highly accurate in staging nodal basins at risk for regional metastases in primary melanoma patients and identifies those who may benefit from earlier lymphadenectomy. Furthermore, pathologic status of the SLN in these patients with clinically negative nodes is the most important prognostic factor for recurrence. The information from SLN biopsy is particularly helpful in establishing stratification criteria for future adjuvant trials.
Why A Global Exchange for Scaling Up Success Scaling Up Poverty Reduction : A Global Learning Process and Conference Shanghai , May 25 27 , 2004 Online Delivery of Land Titles to Rural Farmers in Karnataka , India

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Energy efficient coverage planning in cellular networks with sleep mode

In this paper, we consider energy efficient coverage planning in cellular networks. To save energy, each base station (BS) can work in sleep mode when there is no user in its coverage or the users can be served by neighbor base stations. With increasing coverage overlap, there is a tradeoff between the number of BSs per unit area and the proportion of active base stations. Analytical and numerical methods are presented to evaluate coverage planning schemes with different inter-BS distance. Evaluation results show that compared with the minimum coverage overlap scheme, the optimal planning scheme can reduce the network energy consumption by more than 20%, and the performance improvement depends on the user density, network topology, and the power consumption of sleep mode.
Enumeration of intestinal enterococci and interfering organisms with Slanetz‐Bartley agar, KF streptococcus agar and the MUST method

The recovery of intestinal species of enterococci and streptococci and potentially interfering nonfaecal species was measured on KF streptococcus agar, Slanetz‐Bartley agar and in a medium based on 4‐methylumbelliferyl‐β‐d‐glucoside (MUST method) using pure cultures. Both of the solid media yielded high recoveries of the target species. Their selectivity was better at elevated incubation temperature but nonfaecal Enterococcus and Staphylococcus species were not eliminated even at the elevated temperature. The MUST method tended to give slightly lower recoveries than the agar cultivation methods with some target species at 44°C but recoveries were better at 41°C.