Miracle-dz/UniFAR-FTUs huggingface dataset:
Zonisamide discontinuation due to psychiatric and cognitive adverse events

Objectives: Zonisamide (ZNS) is an antiepileptic drug (AED) that has been associated with psychiatric adverse events (PAE) and cognitive adverse events (CAE); controlled studies evaluating these adverse events are limited. Our objectives were to 1) determine the incidence of PAE and CAE leading to the discontinuation of ZNS and 2) identify risk factors for PAE and CAE associated with the discontinuation of ZNS. Methods: All patients exposed to ZNS at MINCEP Epilepsy Care between March 2000 and September 2008 were identified. Reasons for discontinuing ZNS were documented. Separate case-control studies were performed to identify risk factors associated with the discontinuation of ZNS due to PAE or CAE via multivariate binary logistic regression. Results: A total of 544 patients were exposed to ZNS during the study period. PAE and CAE were the most frequently identified reasons for terminating ZNS therapy. The incidence of PAE severe enough to be associated with the discontinuation of ZNS was 6.9%; the incidence of CAE was 5.8%. Factors associated with termination of ZNS therapy due to PAE were past psychiatric history (p = 0.005), symptomatic generalized epilepsy (p = 0.027), and lower maximum ZNS serum concentration (mean = 17.9 mg/L vs 34.7 mg/L, p < 0.001). Independent variables associated with discontinuing ZNS due to CAE were greater number of concomitant AEDs (p = 0.011) and lower maximum ZNS serum concentration (mean = 16.6 mg/L vs 30.6 mg/L, p = 0.002). Conclusions: We have identified clinically relevant risk factors associated with the discontinuation of ZNS. Our findings support the concept that selected patients are relatively more vulnerable to CNS adverse events when exposed to ZNS.
Capitation-Based Financing Hampers the Provision of Preventive Services in Primary Health Care

Mortality caused by non-communicable diseases has been extremely high in Hungary, which can largely be attributed to not performed preventive examinations (PEs) at the level of primary health care (PHC). Both structures and financial incentives are lacking, which could support the provision of legally defined PEs. A Model Programme was launched in Hungary in 2012 to adapt the recommendations for PHC of the World Health Organization. A baseline survey was carried out to describe the occurrence of not performed PEs. A sample of 4320 adults representative for Hungary by age and gender was surveyed. Twelve PEs to be performed in PHC as specified by a governmental decree were investigated and quantified. Not performed PEs per person per year with 95% confidence intervals were computed for age, gender, and education strata. The number of not performed PEs for the entire adult population of Hungary was estimated and converted into expenses according to the official reimbursement costs of the National Health Insurance Fund. The rate of service use varied between 16.7 and 70.2%. There was no correlation between the unit price of examinations and service use (r = 0.356; p = 0.267). The rate of not performed PEs was not related to gender, but older age and lower education proved to be risk factors. The total number of not performed PEs was over 17 million in the country. Of the 31 million euros saved by not paying for PEs, the largest share was not spent on those in the lowest educational category. New preventive services offered in the reoriented PHC model program include systematic and scheduled health examination health promotion programs at community settings, risk assessment followed by individual or group care, and/or referral and chronic care. The Model Programme has created a pressure for collaborative work, consultation, and engagement at each level, from the GPs and health mediators up to the decision-making level. It channeled the population into preventive health services shown by the fact that more than 80% of the population in the intervention area has already participated in the health status assessment.
Vagotomy Suppresses Cephalic Phase Insulin Release in Sheep

The effect of selective vagotomy of the abomasum, pylorus, duodenum and liver on insulin release during the cephalic phase of digestion was investigated in wethers and lactating ewes. Electrical stimulation of the cervical vagus nerves was carried out to test the completeness of the vagotomies performed. In experiment 1, using wethers, the abomasal, pyloric and duodenal branches (ADV; n= 7) or the hepatic, abomasal, pyloric and duodenal branches (HADV; n= 10) of the ventral and/or dorsal vagus nerves were cut; a third group of wethers underwent sham‐operation (SO; n= 8). In experiment 2, vagotomy (ADV; n= 5) or sham‐operations (SO; n= 5) were carried out in lactating ewes. Jugular blood was drawn before and after presentation of food for glucose and insulin determination (experiments 1 and 2) or before, during and after the electrical stimulation of the peripheral ends of the cut cervical vagus nerves in randomly selected lactating ewes (experiment 3: ADV = 3, SO = 3) and wethers (experiment 4: ADV = 4, HADV = 4, SO = 4), for determination of insulin only. Presentation of food caused an immediate and significant (P < 0.05) rise in plasma insulin levels in SO animals compared with ADV or HADV wethers (experiment 1) or ADV ewes (experiment 2) without any significant change in blood glucose concentrations. In comparison with the SO group the baseline‐corrected areas under the insulin response curve were significantly (P < 0.05) smaller for the respective vagotomized groups for periods 1‐2, 2‐4 and 4‐6 min (experiment 1) and 1‐2 and 2‐4 min (experiment 2) after presentation of food. Total area under the response curve for 10 min was significantly (P < 0.05) lower (experiment 1) and tended (P < 0.10) to be lower (experiment 2) for the vagotomized groups compared with that of the control groups. Direct electrical stimulation of the cervical vagus nerves raised plasma insulin concentrations to significantly (P < 0.05) higher levels in the SO ewes but not in the ADV ewes (experiment 3). It was also evident that in experiment 1, HADV did not have any additive effect over that achieved by ADV alone. These results indicate that the vagal innervation of the gut mediates insulin release during the cephalic phase of feeding in sheep. It is concluded that insulin secretion from the pancreatic β‐cells in response to either food‐related reflex activation of the vagal nuclei in the hypothalamus or direct cervical vagus nerve stimulation is mediated through the vagal efferent fibres carried in the abomasal, pyloric and duodenal branches of the vagus nerves in sheep.
The Causal Effect of Education on Farm‐Related Disability: Evidence from a Compulsory Schooling Reform in Taiwan

We investigate the causal effect of education on the incidence and severity of farm-related disability. Our dataset is comprised of 75,708 farmers drawn from the Taiwanese Agriculture Census supplemented with administrative data on farmer disability. Approximately 46% of the farmers in our sample were affected by legislation expanding compulsory schooling from the primary school level to the junior high school level. Utilizing the compulsory schooling reform as a natural experiment for identification, we estimated an instrumental variable two-part model of the incidence and severity of disability, where the latter is measured using the number of disabled days for farmers aged from 35 to 45. We find that greater educational attainment significantly reduced the likelihood of farm-related disability as well as the severity of disability. Two potential mechanisms for this effect were fewer on-farm work days and less use of chemical inputs to farm production among more educated farmers.
Genome Sequence, Full-Length Infectious cDNA Clone, and Mapping of Viral Double-Stranded RNA Accumulation Determinant of Hypovirus CHV1-EP721

ABSTRACT Cryphonectria parasitica strain EP721 is infected with a strain of hypovirus CHV1, CHV1-EP721, and exhibits typical hypovirulence-associated traits such as reduced pigmentation and reduced asexual sporulation. However, the accumulation of the viral double-stranded RNA (dsRNA) in this hypovirus-infected C. parasitica strain is atypically low. We now report the complete nucleotide sequence and construction of a full-length infectious cDNA clone for hypovirus CHV1-EP721. The genome sequence of CHV1-EP721 was determined to be 12,724 bp in length and to share extensive homology with two other hypovirus strains, CHV1-Euro7 and CHV1-EP713, with an average of 99% and 90% identities at the nucleotide level and 99% and 92% identities at the amino acid level, respectively. CHV1-EP721 was successfully introduced into virus-free fungal host strain EP721(-v) by transfection with transcripts derived from a full-length viral cDNA. The transfected strain had a phenotype indistinguishable from that of EP721, and the accumulation of CHV1-EP721 dsRNA in the transfectant was lower than those transfected by CHV1-Euro7 and CHV1-EP713 transcripts. Through the construction of chimeric viruses by domain swapping using infectious cDNA clones of CHV1-EP721, CHV1-EP713, and CHV1-Euro7 hypoviruses, the determinant for the low level of viral dsRNA accumulation in CHV1-EP721 was mapped to the second of two CHV1-EP721 open reading frames (ORFs), ORF B. Further refined swapping of domains within ORF B identified a 2.5-kb coding region between p48 and the polymerase domain of CHV1-EP721 as being responsible for the low viral dsRNA accumulation. Evidence is also provided that low rates of hypovirus transmission through conidial spores correlates with low viral dsRNA accumulation.
Possible molecular mechanism of promotion of repair of acute Achilles tendon rupture by low intensity-pulsed ultrasound treatment in a rat model.

OBJECTIVE This study investigated the effect of Low Intensity-pulsed Ultrasound (LIPUS) on the repair process of ruptured Achilles tendon using a rat model and also examined the regulation of a biological molecule that may contribute to this in vivo and in vitro. METHODS To investigate the effect of LIPUS and its biological mechanism of promoting Achilles tendon repair after acute injury, ninety-eight male Sprague-Dawley (SD) rats (mean body weight, 258 +/- 9.8 g) aged 12 weeks were used in this study. To create the model, the Achilles tendon attachment site and musculotendinous junction were ruptured under direct vision. The leg on one side was exposed to LIPUS (frequency at 1.5 MHz, the repetition cycle at 1.0 kHz, the burst width at 200 msec and the power output at 45 mW/cm2), for 20 minutes daily with a 0.7 mm diameter probe. RESULTS Low Intensity-pulsed Ultrasound treatment accelerated the repair of the Achilles tendon compared to the untreated group, judged by electron microscopy. Both cyclo-oxygenase (COX)-2* and EP4* expressions were over-expressed in the LIPUS treated group in the inflammatory period, and TGFbeta1* expression was markedly induced in LIPUS treated groups followed by collagen I* and II* expression in the repair and reconstitution process. CONCLUSION These findings suggest that LIPUS is potentially able to accelerate the repair of acute ruptured Achilles tendon in several ways: by exaggerating inflammation by inducing COX-2 and EP4 and reconstituting tissue by inducing TGFbeta1 followed by collagen I and III. (*: p < 0.05, **: 0.001).
The Economic Effectiveness of Diplomatic Representation

This chapter follows an interdisciplinary approach using relevant elements from economic science and econometrics (the applied gravity model of international trade) and political science methods (the policy analysis on international representation) in order to determine the effectiveness of countries' international representations. The chapter focuses on the empirical question of whether diplomatic representation is economically effective, in the sense that representation is statistically associated with trade volumes. The chapter considers the questions of which types of diplomatic representation are most effective and which countries deploy these economic diplomatic instruments most effectively across the globe. The chapter also focuses on a specific, narrowly defined aspect of the international diplomatic network of nations and its relationship to the economic diplomacy of international trade, because it is measurable and therefore a practical means to operationalize the broad concept of economic diplomacy. Keywords:diplomatic representation; econometrics; economic diplomacy; economic effectiveness; economic science; international trade
In vivo exposure of murine dendritic cell and macrophage bone marrow progenitors to the phosphorylcholine‐containing filarial nematode glycoprotein ES‐62 polarizes their differentiation to an anti‐inflammatory phenotype

We have previously shown in an in vitro study that the filarial nematode phosphorylcholine (PC)‐containing glycoprotein ES‐62 promotes a murine dendritic cell (DC) phenotype that induces T helper type 2 (Th2) responses. We now show that, in addition to directly priming Th2 responses, ES‐62 can act to dampen down the pro‐inflammatory DC responses elicited by lipopolysaccharide. Furthermore, we also demonstrate that murine DCs and macrophages derived ex vivo from bone marrow cells exposed in vivo to ES‐62 by release from osmotic pumps are hyporesponsive to subsequent stimulation with lipopolysaccharide. These effects can be largely mimicked by exposure to the PC moiety of ES‐62 conjugated to an irrelevant protein. The data we provide are, as far as we aware, the first to show that a defined pathogen product can modulate the developmental pathway of bone marrow cells of the immune system in vivo. Such a finding could have important implications for the use of pathogen products or their derivatives for immunotherapy.
Flow cytometry crossmatching as a predictor of acute rejection in sensitized recipients of cadaveric renal transplants

Flow cytometry crossmatching (FCXM) was developed as a more sensitive assay than the standard complement‐dependent cytotoxicity crossmatch (CDCXM) for the detection of anti‐donor antibodies, that mediate hyperacute rejection and graft loss in the early post‐transplant period in renal transplant recipients. The role of FCXM in predicting long‐term clinical outcome in renal allograft recipients is unclear. This study examines the role of FCXM in predicting long‐term clinical outcome in highly sensitized recipients of cadaveric renal transplants. All patients (n=100) with peak panel reactive antibody (PRA) levels>30%, who received cadaveric renal transplants between 1/1/’90 and 12/31/’95 at our institution, were divided into FCXM+ and FCXM− groups. The incidence of acute rejection was determined for each group during the first yr after transplant. Graft survival rates at 1, 2, and 3 yr, and creatinine levels were also compared between groups. FCXM+ patients experienced a higher incidence of acute rejection during the first yr after transplant (69 vs. 45%), and a higher percentage of FCXM+ patients had more than one episode of acute rejection during the first yr after transplant (34 vs. 8%) when compared to FCXM− patients. There was no statistically significant difference in 1‐, 2‐, or 3‐yr graft survival between FCXM+ and FCXM− patients (76 vs. 83, 62 vs. 80, 62 vs. 72%, respectively). These results suggest that sensitized FCXM+ cadaveric renal transplant recipients have a higher incidence of acute rejection episodes in the first yr after transplant. Given the association of multiple rejection episodes with poor long‐term allograft survival, FCXM may be a useful predictor of long‐term clinical outcome in this sub‐group of renal transplant recipients.
Occupational noise exposure and noise-induced hearing loss are associated with work-related injuries leading to admission to hospital

Objective This study focuses on work-related injuries that required admission to hospital in a population of male workers exposed to occupational noise (≥80 dBA) which some displayed a hearing loss due to their exposure. Methods The study population count 46 550 male workers, 1670 (3.6%) of whom incurred at least one work-related injury requiring admission to hospital within a period of 5 years following hearing tests conducted between 1987 and 2005. The noise exposure and hearing loss-related data were gathered during occupational noise-induced hearing loss (NIHL) screening. The hospital data were used to identify all members of the study population who were admitted, and the reason for admission. Finally, access to the death-related data made it possible to identify participants who died during the course of the study. Cox proportional hazards model taking into account hearing status, noise levels, age and cumulative duration of noise exposure at the time of the hearing test established the risk of work-related injuries leading to admission to hospital. Results For each dB of hearing loss, a statistically significant risk increase was observed (HR=1.01 dB 95% CI 1.006 to 1.01). An association (HR=2.36 95% CI 2.01 to 2.77) was also found between working in an occupational ambient noise ≥100 dBA and the risk of injury. Conclusions From a safety perspective, this issue is highly relevant; especially when workers are exposed to intense ambient noise and NIHL.
Development and validation of the Experiential Avoidance in Caregiving Questionnaire (EACQ)

Objective: Providing care to a relative with dementia is associated with negative health consequences. Experiential avoidance has been found to be related to caregivers’ distress. However, no specific measure of experiential avoidance in the caregiving context is available. The aim of this study is to develop and present the psychometric properties of the Experiential Avoidance in Caregiving Questionnaire (EACQ). Method: Face-to-face interviews were conducted with 263 dementia family caregivers (mean age = 61.37; SD = 14.84; 78.3% female). In addition to the EACQ, the Action and Acceptance Questionnaire (AAQ) was used. Depression, anxiety, alexithymia, cognitive fusion, dysfunctional thoughts about caregiving, and mean arterial pressure were also measured.Results: Using principal component analysis, three factors were retained that explained 44.75% of the variance. These factors were labeled: (1) Active Avoidant Behaviors; (2) Intolerance of Negative Thoughts and Emotions Towards the Relative; and (3) Apprehension Concerning Negative Internal Experiences Related to Caregiving. Acceptable reliability indexes (Cronbach's alpha) were found for each factor (.63 for factor 1; .71 for factor 2; and .60 for factor 3) and the total scale (α = .70). Significant positive associations were found between the global scale and anxiety, dysfunctional thoughts, alexithymia and the AAQ.Conclusion: The EACQ shows acceptable psychometric properties and may be a useful tool for clinical assessment and therapeutic work with caregivers.
Secure VANET from vampire attack using LEACH protocol

In modern years we see some growth in technology and for better traffic control on road with these some technologies the moving vehicle can do the better communication in Ad-hoc network which developed a new kind of technology like Vehicular Ad-hoc Network(VANET). VANET provides wireless communication with vehicle to road side unit. VANET can perform the communication between V2V, V2I, I2I. VANET developed an advanced traffic signaling system. To avoid various attack on VANET it provides authentication to every nodes and block the unauthorized nodes. But when nodes are communicate each other on that time for secure data transmission of data clustering is required on that network which is arrange in periodic and dynamic form and selected one cluster head in which they has some features like routing depletion affects the path and resource depletion affects the power, bandwidth and energy consumption which is known as Vampire attack for prevention of this attack use the technique like LEACH protocol(Low Energy Adaptive Clustering Hierarchy). Vampire attack drain the battery power from nodes while transferring data from one node to another.
The role of duplex-doppler ultrasonography in the diagnosis of renal dysfunction and hepatorenal syndrome in patients with liver cirrhosis.

BACKGROUND/AIMS Kidney dysfunction commonly develops in patients with liver cirrhosis. Renal failure develops due to renal vascular constriction and can be present weeks or even months before clinical signs or increased levels of blood urea nitrogen or serum creatinine concentrations become detectible. The objective of this study was to analyze the value of renal interlobar arterial resistance index, measured by duplex-Doppler ultrasonography for detecting early impairment of renal function in patients with liver cirrhosis and its possible use in detecting a subgroup of patients with a higher risk of developing hepatorenal syndrome. METHODOLOGY The patients were divided into three groups: patients with liver cirrhosis and normal renal function (n=31), patients with liver cirrhosis and renal failure but without hepatorenal syndrome criteria (n=9), and patients with hepatorenal syndrome (n=6). The interlobar arterial resistance index was estimated with duplex Doppler ultrasonography, and liver and renal function tests were measured in all patients. RESULTS The average value of interlobar arterial resistance index in patients with hepatorenal syndrome (0.74+/-0.01) was statistically significantly higher than interlobar arterial resistance index values measured in liver cirrhosis patients without the signs of azotemia (0.65+/-0.03) or in those with liver cirrhosis and kidney dysfunction, but without hepatorenal syndrome (0.67+/-0.01). In all patients with hepatorenal syndrome the value of interlobar arterial resistance index was over 0.70. In the group of patients with liver cirrhosis and kidney dysfunction, but without hepatorenal syndrome, interlobar arterial resistance index was below 0.70 in seven, whereas in the remaining two interlobar arterial resistance index was above 0.70. In those patients renal dysfunction displayed a progressive form and hepatorenal syndrome developed. CONCLUSIONS Duplex-Doppler ultrasound of intralobar arteries is a simple, effective and non-invasive method which enables the early detection of renal hemodynamic disturbances in patients with liver cirrhosis even before renal dysfunction becomes clinically evident. It also makes possible the identification of a subgroup of patients with liver cirrhosis who are at higher risks for developing hepatorenal syndrome.