Miracle-dz/UniFAR-FTUs huggingface dataset:
Institutional clinical trial accrual volume and survival of patients with head and neck cancer.

PURPOSE National Comprehensive Cancer Network guidelines recommend patients with head and neck cancer (HNC) receive treatment at centers with expertise, but whether provider experience affects survival is unknown. PATIENTS AND METHODS The effect of institutional experience on overall survival (OS) in patients with stage III or IV HNC was investigated within a randomized trial of the Radiation Therapy Oncology Group (RTOG 0129), which compared cisplatin concurrent with standard versus accelerated fractionation radiotherapy. As a surrogate for experience, institutions were classified as historically low- (HLACs) or high-accruing centers (HHACs) based on accrual to 21 RTOG HNC trials (1997 to 2002). The effect of accrual volume on OS was estimated by Cox proportional hazards models. RESULTS Median RTOG accrual (1997 to 2002) at HLACs was four versus 65 patients at HHACs. Analysis included 471 patients in RTOG 0129 (2002 to 2005) with known human papillomavirus and smoking status. Patients at HLACs versus HHACs had better performance status (0: 62% v 52%; P = .04) and lower T stage (T4: 26.5% v 35.3%; P = .002) but were otherwise similar. Radiotherapy protocol deviations were higher at HLACs versus HHACs (18% v 6%; P < .001). When compared with HHACs, patients at HLACs had worse OS (5 years: 51.0% v 69.1%; P = .002). Treatment at HLACs was associated with increased death risk of 91% (hazard ratio [HR], 1.91; 95% CI, 1.37 to 2.65) after adjustment for prognostic factors and 72% (HR, 1.72; 95% CI, 1.23 to 2.40) after radiotherapy compliance adjustment. CONCLUSION OS is worse for patients with HNC treated at HLACs versus HHACs to cooperative group trials after accounting for radiotherapy protocol deviations. Institutional experience substantially influences survival in locally advanced HNC.
Feasibility and predictors of early discharge after percutaneous edge-to-edge mitral valve repair

Background Percutaneous edge-to-edge mitral valve repair (PMVR) recently emerged as an effective treatment modality for patients with severe mitral regurgitation (MR). Length of postprocedural hospital stay may represent a modifiable cost associated with percutaneous treatment. We looked at feasibility, predictors and safety of early discharge (ED), defined as hospital discharge within 72 hours, in patients undergoing PMVR. Methods and results Consecutive patients treated with MitraClip from October 2008 to December 2015 were analysed. Primary outcomes of interest were cardiovascular and non-cardiovascular mortality, rehospitalisation for heart failure and major adverse events at 30 days and 90 days. A total of 269 patients were included. Of these, 115 patients were early discharged (ED group). Rates of ED increased from 25.9% for the biennium 2008–2009 to 59.1% in 2014–2015 (p<0.001 for trend). In a penalised logistic regression model, male gender (OR=2.13, 95% CI 1.17 to 3.95) and procedural year (OR=2.13, 95% CI 1.51 to 3.11) were associated with higher probability of ED. Conversely, atrial fibrillation (OR=0.48, 95% CI 0.27 to 0.85), any Mitral Valve Academic Research Consortium bleeding (OR=0.07, 95% CI 0.01 to 0.60), log-transformed N-terminal pro-brain natriuretic peptide levels (OR=0.79, 95% CI 0.63 to 0.99) and postimplant MR grade (OR=0.60, 95% CI 0.37 to 0.94) conferred a lower likelihood of ED. In propensity score-weighted analyses, overall survival, freedom from heart failure and major adverse events at 30 days and 90 days were not different in ED and non-ED groups (all weighted log-rank p value>0.05). Conclusions In selected patients undergoing PMVR, ED may be feasible and safe.
Addressing the Challenges of Adherence

Summary: Adherence to antiretroviral therapy is a crucial determinant of treatment success. Studies have unequivocally demonstrated the close association between adherence and plasma HIV RNA levels, CD4 cell counts, and mortality in patients with HIV infection and disease. Adherence levels of ≥95% are required to maintain virologic suppression. However, actual adherence rates are often far lower; most studies show that 40% to 60% of patients are <90% adherent. Adherence also tends to decrease over time. Patients offer a range of reasons for nonadherence, but the most frequently cited one is simply that they forget; other reasons include being away from home, being busy, or experiencing a change in daily routine. Additional barriers to adherence include psychiatric disorders, such as depression or substance use, uncertainty about the effectiveness of treatment and the consequences of poor adherence, regimen complexity, and treatment side effects. Several strategies can be employed in the effort to support patients’ adherence, and all members of the multidisciplinary team should ideally employ these strategies in combination. Efforts should be made to educate and motivate patients, simplify treatment regimens and tailor them to individual lifestyles, prepare for and manage side effects, and address the concrete issues that may be a barrier to adherence. Recruiting an adherence monitor, providing memory aids to medication taking, and anticipating course corrections can also help patients achieve the adherence rates needed for successful treatment of HIV infection and disease.
Trends in Severe Maternal Morbidity After Assisted Reproductive Technology in the United States, 2008–2012

OBJECTIVE: To examine trends in severe maternal morbidity from 2008 to 2012 in delivery and postpartum hospitalizations among pregnancies conceived with or without assisted reproductive technology (ART). METHODS: In this retrospective cohort study, deliveries were identified in the 2008–2012 Truven Health MarketScan Commercial Claims and Encounters Databases. Severe maternal morbidity was identified using International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes and Current Procedural Terminology codes. Rate of severe maternal morbidity was calculated for ART and non-ART pregnancies. We performed multivariable logistic regression, controlling for maternal characteristics, and calculated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for severe morbidity. Additionally, a propensity score analysis was performed between ART and non-ART deliveries. RESULTS: Of 1,016,618 deliveries, 14,761 (1.5%) were identified as pregnancies conceived with ART. Blood transfusion was the most common severe morbidity indicator for ART and non-ART pregnancies. For every 10,000 singleton deliveries, there were 273 ART deliveries or postpartum hospitalizations with severe maternal morbidity compared with 126 for non-ART (P<.001). For ART singleton deliveries, the rate of severe morbidity decreased from 369 per 10,000 deliveries in 2008 to 219 per 10,000 deliveries in 2012 (P=.025). Odds of severe morbidity were increased for ART compared with non-ART singletons (adjusted OR 1.84, 95% CI 1.63–2.08). Among multiple gestations, there was no significant difference between ART and non-ART pregnancies (rate of severe morbidity for ART 604/10,000 and non-ART 539/10,000 deliveries, P=.089; adjusted OR 1.04, 95% CI 0.91–1.20). Propensity score matching agreed with these results. CONCLUSION: Singleton pregnancies conceived with ART are at increased risk for severe maternal morbidity; however, the rate has been decreasing since 2008. Multiple gestations have increased risk regardless of ART status.
A Computational Study of Nasal Spray Deposition Pattern in Four Ethnic Groups.

BACKGROUND Very little is known about the role of nasal morphology due to ethnic variation on particle deposition pattern in the sinonasal cavity. This preliminary study utilizes computational fluid dynamics (CFD) modeling to investigate sinonasal airway morphology and deposition patterns of intranasal sprayed particles in the nose and sinuses of individuals from four different ethnic groups: African American (Black); Asian; Caucasian; and Latin American. METHODS Sixteen subjects (four from each ethnic group) with "normal" sinus protocol computed tomography (CT) were selected for CFD analysis. Three-dimensional reconstruction of each subject's sinonasal cavity was created from their personal CT images. CFD simulations were carried out in ANSYS Fluent(™) in two phases: airflow phase was done by numerically solving the Navier-Stokes equations for steady state laminar inhalation; and particle dispersed phase was solved by tracking injected (sprayed) particles through the calculated airflow field. A total of 10,000 particle streams were released from each nostril, 1000 particles per diameter ranging from 5 μm to 50 μm, with size increments of 5 μm. RESULTS As reported in the literature, Caucasians (5.31 ± 0.42 cm(-1)) and Latin Americans (5.16 ± 0.40cm(-1)) had the highest surface area to volume ratio, while African Americans had highest nasal index (95.91 ± 2.22). Nasal resistance (NR) was highest among Caucasians (0.046 ± 0.008 Pa.s/mL) and Asians (0.042 ± 0.016Pa.s/mL). Asians and African Americans had the most regions with particle deposition for small (5 μm-15 μm) and large (20 μm-50 μm) particle sizes, respectively. Asians and Latin Americans individuals had the most consistent regional particle deposition pattern in the main nasal cavities within their respective ethnic groups. CONCLUSIONS Preliminary results from these ethnic groups investigated showed that Caucasians and Latin Americans had the least patent nasal cavity. Furthermore, Caucasians and African Americans had the lowest inter-subject consistency in regional particle deposition pattern; this may be due to greater inter-subject variability in their respective nasal vestibule morphology.
Detection of anti‐D in D– recipients transfused with D+ red blood cells

BACKGROUND: The D antigen is highly immunogenic, requiring only a small quantity of transfused red blood cells (RBCs) to cause alloimmunization in D– immunocompetent recipients. The relatively low sensitization rate in oncology patients transfused with D+ platelets is well documented. A study of the alloimmunization rate of primarily nononcology D– recipients transfused with D+ RBCs was undertaken.
A Short Literary History of the United States

Introduction 1. Discovery narratives 2. Colonial literature 3. Literature of the Early Republic 4. Transcendentalism 5. American Renaissance 6. Gilded Age-Realism 7. Modernism 8. Postmodernism 9. Ethnic Voices 10. Literary theory in the United States Glossary Suggested further reading Author and title index Subject index
Gender-specific changes in well-being in older people with coronary heart disease: evidence from the English Longitudinal Study of Ageing

Objectives: The objective of this study is to investigate gender-specific trajectories in well-being among older people with coronary heart disease (CHD) and to compare them with those of healthy people. Method: The study included a sample of 4496 participants from the first three waves of the English Longitudinal Study of Ageing (2002–2003 to 2006–2007). We measured well-being using quality of life (CASP-19; ‘control’, ‘autonomy’, ‘pleasure’ and ‘self-realization’) and depressive caseness (three or more symptoms on the CESD-8; Centre for Epidemiologic Study Depression scale). Results: After adjustment, at two– and four–years follow-ups, women had three points higher quality of life than men (p < 0.001). When looking at each quality of life's domain we found that women reported higher scores of autonomy compared to men. The gender difference in the probability of having depressive caseness reduced to 7 percentage points at four-year follow-up from 13 percentage points in the previous occasions. Men's quality of life declined progressively over time by 3 points (p < 0.001) (equivalent to the effect of having diabetes) but no changes in prevalence of depressive caseness were found. Women's quality of life only declined after four-year follow-up by less than 2 points (p < 0.001), while in the same period their probability of reporting depressive caseness reduced by 6 percentage points (p < 0.001). Conclusion: Women had better quality of life than men in the two and four years following a CHD event, and were not more likely than men to report depressive caseness in the long term. Men's quality of life deteriorated progressively over time, among women it did not deteriorate in the first two years following a CHD event; women had a long-term improvement in depressive caseness.
Crystal structures of pristine and oxidatively processed lignin peroxidase expressed in Escherichia coli and of the W171F variant that eliminates the redox active tryptophan 171. Implications for the reaction mechanism.

The heme enzyme lignin peroxidase (LiP) from the white rot fungus Phanerochaete chrysosporium contains a solvent exposed redox active tryptophan residue (Trp171) that carries a unique hydroxy group stereo-specifically attached to its C(beta) atom. A Trp171Phe mutant has no activity at all towards the substrate veratryl alcohol. The mechanism of veratryl alcohol oxidation involving beta-hydroxy-Trp171 is largely unknown. Here, we present the first crystal structures of LiP isozyme H8 at high resolution in its pristine non-hydroxylated form, of the C(beta)-hydroxylated form, and of the Trp171Phe mutant using recombinantly expressed and refolded protein produced from Escherichia coli. As a consequence, all structures are unglycosylated. Structural changes in response to the mutation are marginal and allow us to attribute the complete lack of activity exclusively to the absence of the redox active indole side-chain. The origin of the stereospecificity of the Trp171 hydroxylation can be explained on structural grounds. A reaction mechanism involving Trp171 is proposed and the possible function of the modification is discussed. Another important result regarding the ongoing debate on the co-ordination state of the heme iron in the resting state is that the iron is six co-ordinate in all cases the data being collected at room temperature. The mean distance from the iron to the distal water ligand is 2.18(+/-0.08) A. The radical scavenger orcinol was found to decrease radiation damage to the crystals, during data collection at room temperature.
Effect of environmental conditions on tear dynamics in soft contact lens wearers.

PURPOSE Dry eye symptoms are often associated with soft contact lens (SCL) wear and may be affected by environmental conditions. This study was conducted to determine the effects of temperature and humidity on the tear film in SCL wearers. METHODS All 11 enrolled subjects were males (mean age, 23.5 +/- 5.2 [SD] years), and all wore SCL daily. They were exposed in different sessions to four different conditions in an environmental chamber with the air temperature (AT) and relative humidity (RH) set at 5 degrees C/10% (AT/RH), 15 degrees C/20%, 25 degrees C/40%, or 35 degrees C/50%. Two different types of hydrogel SCL (SCL-a and SCL-b; water content 72.0% and 37.5%, respectively) were used. The meniscus tear volume was determined on a video meniscometer by measuring the tear meniscus radius (TMR) with and without SCL. The tear interference patterns on the contact lens (TIPCL) were classified into five grades (the higher the grade, the thinner the film). Using a video interferometer, the non-invasive tear film breakup time (NIBUT) was recorded with and without SCLs; ocular dryness was also scored with and without SCLs. RESULTS Under the environmental conditions examined, there were no significant differences in the TMR without or with SCL, regardless of their type. As AT and RH decreased, there was a significant increase in the TIPCL grade (CL-a: P = 0.042; CL-b: P = 0.002), a significant decrease in NIBUT (CL-a: P = 0.004; CL-b: P = 0.001), and a significant increase in the dryness score (without SCL P = 0.023; with CL-a P = 0.009; with CL-b P = 0.003). The dryness scores were higher with CL-a than CL-b (P = 0.011 at 15 degrees C/20%). Under identical experimental conditions, we observed no significant change in NIBUT in the absence of an SCL. CONCLUSIONS AT and RH apparently had no effect on the tear volume in the presence of SCLs. As AT and RH decreased, the tear film on the SCL became thinner, NIBUT became shorter, and dryness increased. Dryness was more pronounced in eyes with SCL of the higher water content.
Epidural bupivacaine with sufentanil or fentanyl during labour: a randomized, double-blind study

Background and objective: Epidural analgesia with bupivacaine plus either sufentanil or fentanyl is widely used during labour, but it is not clear which opioid is to be preferred. The study compared these opioids at equianalgesic doses in terms of analgesia, onset time and side-effects. Methods: Ninety females in active labour were entered into the randomized, double-blind trial. A test dose of bupivacaine was given into the epidural space. Parturients in Group S received sufentanil 8 mL as a bolus dose, followed by an infusion at a rate of 5 mL h−1 of a mixture containing sufentanil 1 μg mL−1 and bupivacaine 1 mg mL−1. Patients in Group F received fentanyl 8 mL as a bolus, followed by an infusion at 5 mL h−1 of a solution containing fentanyl 3.5 μg mL−1 and bupivacaine 1 mg mL−1. Additional boluses of 5 mL were of the relevant solution were given if necessary. Results: In a ratio of 1.0:3.5 (sufentanil 1 μg versus fentanyl 3.5 μg), both groups reported the same analgesia with the same onset time. The onset time to obtain 50% of the initial visual analogue score was 10 and 11 min for Groups S and F, respectively. Mean visual analogue scores in Groups S and F respectively declined from 77 and 82 before epidural blockade, to 29 and 27 during the first stage of labour, and to 69 and 59 respectively during the second stage. Overall satisfaction among parturients was high (98 and 96%), particularly during the first stage (98 and 98%), and also to a large degree during the second stage of labour (74 and 79%). Furthermore, only a few extra bolus doses were required (mean 0.9 and 1.2, Groups S and F, respectively). All the females could stand on their own, and almost all (81% Group S; 79% Group F) could walk 20 m without help. There were no serious adverse effects. Moderate side-effects occurred equally often with the possible exception of less nausea and vomiting in the fentanyl group. Conclusions: Epidural analgesia for ambulatory parturients with bupivacaine plus either sufentanil or fentanyl (ratio 1.0:3.5) provides good analgesia with a low frequency of modest side-effects. No clinical differences were found between the opioids.
Effect of surgical periodontal treatment associated to antimicrobial photodynamic therapy on chronic periodontitis: A randomized controlled clinical trial

AIM This randomized controlled clinical trial evaluated the effects of an adjunctive single application of antimicrobial photodynamic therapy (aPDT) in Surgical Periodontal Treatment (ST) in patients with severe chronic periodontitis (SCP). MATERIAL AND METHODS In a split-mouth design, 20 patients with SCP were treated with aPDT+ST (Test Group, TG) or ST only (Control Group, CG). aPDT was applied in a single episode, using a diode laser and a phenothiazine photosensitizer. All patients were monitored until 90 days after surgical therapy. Levels of 40 subgingival species were measured by checkerboard DNA-DNA hybridization at baseline, 60 and 150 days. Clinical and microbiological parameters were evaluated. RESULTS In deep periodontal pockets depth (PPD ≥5 mm), Test Group presented a significantly higher decrease in PPD than Control Group at 90 days after surgical therapy (p < .05). Test Group also demonstrated significantly less periodontal pathogens of red complex (Treponema denticola) (p < .05). CONCLUSION A single episode of aPDT used in adjunct to open flap debridement of the root surface in the surgical treatment of SCP: i) significantly improved clinical periodontal parameters; ii) eliminates periodontal pathogens of the red complex more effectively (NCT02734784).
On a Changing Perspective Illusion within Vermeer's The Music Lesson

The effect of line of sight on the perception of spatial configuration has been investigated in a well-known painting (The Music Lesson by Vermeer) and in two control patterns. In experiment 1, subjects indicated the perceived inclination of two major contours which defined the sidewall—floor and backwall—floor joints in (i) a projected image of the painting, (ii) a three-line representation of the major spatial elements of the painting, and (iii) a three-dimensional wire model of these same contours, when standing in each of eighteen positions on a line running parallel to the surface of the screen. Results indicated a significant change in the perception of the sidewall—floor, but not of the backwall—floor contour, as viewing angle changed, in both the painting and the three-line representation. However, the angular setting in the latter case was significantly less than when the painting was used, ie subjects underestimated the depicted inclination. Settings for the wire model did not deviate with viewing angle and reflected geometrically correct adjustments. In experiment 2, the results of experiment 1 were confirmed using enantiomorphs. These findings are discussed in the light of other view-dependent illusions in paintings.
Thermal symmetry of skin temperature: normative data of normal subjects in Taiwan.

BACKGROUND The aims of this study were (a) to establish normative data of thermal symmetry (left vs. right) in normal subjects; (b) to compare the skin temperature in various regions between young and old people in Taiwan and between male and female. METHODS The skin surface of 57 healthy volunteers (aged 24 to 80 yr) was divided into 25 areas and measured by an infrared thermography (Avionics TVS-2000, Japan). The average temperatures of these 25 regions were compared: (a) left vs. right side, (b) young (< or = 60 yr, n = 37) vs. old (> 60 yr, n = 20), and (c) male vs. female. Student's t-test was used to assess means between both groups. RESULTS The neck carried the highest skin temperature (31.9 degrees C +/- 0.6; mean +/- SD) of the body in comparison with the toes that had the lowest one (27.5 degrees C +/- 2.0). The side-to-side temperature differences were subtle, which did not exceed 0.5 degrees C. The average skin temperature of elderly was slightly lower than that of young subjects in 11 out of 25 areas (p < 0.05), especially the distal parts of extremities. Elderly female had lower skin temperature in various truncal areas as compared with their counterpart. However, the skin temperature was higher in the distal extremity (p < 0.05). CONCLUSIONS The thermoregulatory system is substantially symmetrical. The result of this study offered valuable normative database on skin thermal symmetry in normal population of Taiwan, and may be useful as a diagnostic aid in patients with various states of disorders associated with autonomic dysfunctions.