Miracle-dz/UniFAR-FTUs huggingface dataset:
Adjuvant intra-arterial hepatic fotemustine for high-risk uveal melanoma patients

Uveal melanoma metastases occur most commonly in the liver. Given the 50% mortality rate in patients at high risk of developing liver metastases, we tested an adjuvant intra-arterial hepatic (i.a.h.) chemotherapy with fotemustine after proton beam irradiation of the primary tumour. We treated 22 high-risk patients with adjuvant i.a. h. fotemustine. Planned treatment duration was 6 months, starting with four weekly doses of 100 mg/m2, and after a 5-week rest, repeated every 3 weeks. The survival of this patient group was compared with that of a 3 : 1 matched control group randomly selected from our institutional database. Half of the patients experienced ≥grade 3 hepatotoxicity (one patient developing cholangitis 8 years later). Catheter-related complications occurred in 18%. With a median follow-up of 4.6 years for the fotemustine group and 8.5 years for the control group, median overall survival was 9 years [95% confidence interval (CI) 2.2–12.7] and 7.4 years (95% CI 5.4–12.7; P=0.5), respectively, with 5-year survival rates of 75 and 56%. Treatment with adjuvant i.a. h. fotemustine is feasible. However, toxicities are important. Although our data suggest a survival benefit, it was not statistically significant. Confirming such a benefit would require a large, internationally coordinated, prospective randomized trial.
Duration of breast feeding and arterial distensibility in early adult life: population based study

Abstract Objectives: To test the hypothesis that duration of breast feeding is related to changes in vascular function relevant to the development of cardiovascular disease. Design: Population based observational study. Setting: Cambridge. Participants: 331 adults (171 women, 160 men) aged between 20 and 28 years, born in Cambridge Maternity Hospital. Main outcome measures: Distensibility of brachial artery, type and duration of infant feeding, current lipid profile, and other cardiovascular risk factors. Results: The longer the period of breast feeding the less distensible the artery wall in early adult life, with no sex differences (regression coefficient = —3.93 μm/month, 95% confidence interval —7.29 to —0.57, P=0.02). However, in those breast fed for less than four months, arterial distensibility was not significantly reduced compared with an exclusively formula fed group. The vascular changes observed were not explained by alterations in plasma cholesterol concentration in adult life. Conclusions: Breast feeding in infancy is related to reduced arterial function 20 years later. These data should not alter current recommendations in favour of breast feeding, which has several benefits for infant health. Further work is needed, however, to explore the optimal duration of breast feeding in relation to cardiovascular outcomes.
The Impact of Iodine Status on the Recall Rate of the Screening Program for Congenital Hypothyroidism: Findings from Two National Studies in Iran

Back ground: Iodine deficiency is one of the important factors in increasing the recall rate in congenital hypothyroidism (CH) screening programs. The present study assessed whether the iodine status of the general population may predict the recall rate or vice versa. Methods: In the current national study, among 1,382,229 live births delivered between March 2010 and March 2011, 1,288,237 neonates were screened for detecting CH by TSH (thyroid stimulating hormone) measurement via heel prick sampling. Simultaneously, a total of 11,280 school-aged children, aged 7–8 years, were selected using random multi-cluster sampling for measurement of urinary iodine. Results: A negative correlation was found between median urinary iodine (MUI) and the recall rate (r = −0.33, p = 0.03). No correlation was found between MUIC (median urinary iodine concentration) and the incidence rate of CH. Linear regression analysis showed a 0.1% increase in the recall rate for a one unit decrease in MUIC (β = −0.11, 95% CI: −0.2, −0.1, p = 0.03). MUIC, at a cut-off point of 144.7 µg/L, was predictive for a recall rate < 3% (p = 0.05). Conclusion: Frequencies of TSH ≥ 5 mU/L may be a more sensitive indicator for iodine status during pregnancy rather than in the general population. As higher recall rates reflect inadequate iodine nutrition, sufficient iodine supplementation is needed to reduce the recall rate in such communities.
Plasma from rheumatoid arthritis patients promotes pro-atherogenic cholesterol transport gene expression in THP-1 human macrophages

Immunologic derangements in rheumatoid arthritis (RA) patients likely contribute to premature atherosclerotic cardiovascular disease (CVD). Traditional CVD risk factors do not reliably identify at-risk RA patients, probably because disease-associated mechanisms are not taken into account. The purpose of this study was to determine whether plasma from subjects with RA exhibits atheroma-promoting properties leading to disruption of cholesterol homeostasis in human monocytes/macrophages. Twenty-one healthy controls (HC) and 22 RA patients were enrolled in an IRB approved study at Winthrop University Hospital. Naïve THP-1 macrophages were exposed to plasma from each HC and RA patient. Following incubation, RNA and protein were isolated. QRT-PCR and Western blotting techniques were then used to measure expression of proteins responsible for cholesterol efflux (ATP binding cassette transporter (ABC)A1, ABCG1, 27-hydroxylase) and cholesterol uptake (CD36, ScR-A1, lectin oxidized low density lipoprotein receptor (LOX)-1, CXCL16). To confirm the pro-atherogenic effects of RA plasma on macrophages, foam cell formation was quantified. Results showed that RA plasma downregulates cholesterol efflux proteins and upregulates scavenger receptors CD36, LOX1 and CXCL16. These pro-atherogenic changes in gene expression in the presence of RA plasma are associated with augmented lipid accumulation and foam cell formation by THP-1 macrophages. RA plasma induces macrophage cholesterol overload. Demonstration of disrupted cholesterol homeostasis mediated by RA plasma provides further evidence of the involvement of the immune system in atherogenesis. Our data suggest that chronic exposure to RA plasma adversely affects the capacity of monocytes/macrophages in the arterial wall to metabolize cholesterol and maintain lipid homeostasis, thereby contributing to the development of premature atherosclerosis.
Managing Medicare's HIV caseload in the era of suppressive therapy.

OBJECTIVES The 1996 introduction of antiretroviral medications changed Medicare's role in providing HIV care. We analyzed Medicare's patient database in an effort to document the new HIV therapies' effects on expenditures and outcomes. METHODS We examined the medical billing records of a 5% national Medicare sample from 1997 through 2003. The cohort was stratified by year and categorized by age, race/ethnicity, gender, and Medicare status. Population summaries were categorized according to presence of major chronic diseases and HIV-related conditions. RESULTS The number of Medicare beneficiaries with HIV increased from 42520 in 1997 to 76500 in 2003, whereas mortality among this group fell by 35%. HIV-associated infections declined by as much as 43% (mycoses). Heart and liver disease and diabetes increased by more than 50%. Adjusted annual per person Medicare expenditures fell 28%; expenditures were 49% higher for Blacks than for Whites. CONCLUSIONS Improved HIV medical management has led to fewer deaths and has shifted treatment toward chronic care. However, successful management is complicated by conditions that have not been historically linked to HIV and whose effects vary according to race/ethnicity.
A key role of GARP in the immune suppressive tumor microenvironment

In melanoma patients, one of the main reasons for tumor immune escape and therapy failure is the immunosuppressive tumor microenvironment. Herein, suppressive immune cells and inhibitory factors secreted by the tumor itself play a central role. In the present study we show that the Treg activation marker GARP (glycoprotein A repetitions predominant), known to induce peripheral tolerance in a TGF-β dependent way, is also expressed on human primary melanoma. Interestingly, membrane bound GARP is shed from the surface of both, activated Treg and melanoma cells, and, in its soluble form (sGARP), not only induces peripheral Treg but also a tumor associated (M2) macrophage phenotype. Notably, proliferation of cytotoxic T cells and their effector function is inhibited in the presence of sGARP. GARP expression on Treg and melanoma cells is significantly decreased in the presence of agents such as IFN-α, thus explaining at least in part a novel mechanism of action of this adjuvant therapy. In conclusion, GARP in its soluble and membrane bound form contributes to peripheral tolerance in a multipronged way, potentiates the immunosuppressive tumor microenvironment and thus acts as a negative regulator in melanoma patients. Therefore, it may qualify as a promising target and a new checkpoint for cancer immunotherapy.
The Limits to Collaboration Across Four of the Most Innovative UK Industries

This study demonstrates the importance and limits to external knowledge collaboration across different geographical dimensions and the most innovative UK industries(knowledge-intensive business services (KIBS), high-tech manufacturing, information and communication technologies (ICT), creative industries). Traditionally, this issue has presented a challenge for the geography of innovation, external knowledge sourcing and open innovation literatures, in terms of first identifying the phenomenon and second measuring it. We propose and estimate a structural model that estimates the knowledge production function with innovation inputs and outputs at the firm level. Our sample includes 19,510 observations and 17,859 firms, mainly from the UK Innovation Survey and the Business Registry. We demonstrate that external collaboration may bestow a significant advantage for innovation developed by the firm and in collaboration with other businesses, but there are limits to collaboration. They are likely to be better offset by firms in knowledge-intense sectors (KIS), while they remain consistent across collaboration with partners across four geographical regions. Our findings call for further research on innovation and revision of national and regional innovation policies.
A novel, implicit treatment for language comprehension processes in right hemisphere brain damage: Phase I data

Background: This manuscript reports the initial phase of testing for a novel, “Contextual constraint” treatment, designed to stimulate inefficient language comprehension processes in adults with right hemisphere brain damage (RHD). Two versions of treatment were developed to target two normal comprehension processes that have broad relevance for discourse comprehension and that are often disrupted by RHD: coarse semantic coding and suppression. The development of the treatment was informed by two well-documented strengths of the RHD population. The first is consistently better performance on assessments that are implicit, or nearly so, than on explicit, metalinguistic measures of language and cognitive processing. The second is improved performance when given linguistic context that moderately-to-strongly biases an intended meaning. Treatment consisted of providing brief context sentences to prestimulate, or constrain, intended interpretations. Participants made no explicit associations or judgments about the constraint sentences; rather, these contexts served only as implicit primes. Aims: This Phase I treatment study aimed to determine the effects of a novel, implicit, Contextual Constraint treatment in adults with RHD whose coarse coding or suppression processes were inefficient. Treatment was hypothesized to speed coarse coding or suppression function in these individuals. Methods & Procedures: Three adults with RHD participated in this study, one (P1) with a coarse coding deficit and two (P2, P3) with suppression deficits. Probe tasks were adapted from prior studies of coarse coding and suppression in RHD. The dependent measure was the percentage of responses that met predetermined response time criteria. When pre-treatment baseline performance was stable, treatment was initiated. There were two levels of contextual constraint, Strong and Moderate, and treatment for each item began with the provision of the Strong constraint context. Outcomes & Results: Treatment-contingent gains were evident after brief periods of treatment, for P1 on two treatment lists, and for P2. P3 made slower but still substantial gains. Maintenance of gains was evident for P1, the only participant for whom it was measured. Conclusions: This Phase I treatment study documents the potential for considerable gains from an implicit, Contextual constraint treatment. If replicated, this approach to treatment may hold promise for individuals who do poorly with effortful, metalinguistic treatment tasks, or for whom it is desirable to minimize errors during treatment. The real test of this treatment's benefit will come from later phase studies of study, which will test broad-based generalization to various aspects of discourse comprehension.
Delayed Changes in Growth Factor Gene Expression during Slow Remyelination in the CNS of Aged Rats

In this study we have examined whether the slower rate of CNS remyelination that occurs with age is associated with a change in growth factor expression patterns, an association that would provide further support for a causal relationship between growth factors and remyelination. Using quantitative in situ hybridization we have shown that there are differences in IGF-I, TGF-beta 1, and PDGF-A mRNA expression during remyelination of lysolecithin-induced demyelination in the spinal cord of young adult and old adult rats. IGF-I and TGF-beta1 mRNA expression in old rats had a delayed and lower peak expression compared to young rats. The initial increase in PDGF-A mRNA expression was delayed in old rats compared to young rats, but after 5 days both age groups had similar patterns of expression, as was the expression pattern of FGF-2 mRNA at all survival times. In neither age group were increases in CNTF, NT-3, or GGF-2 mRNA expression detected. An analysis of the macrophage response using oligonucleotide probes for scavenger receptor-B mRNA indicated that differences in the macrophage response in young and old animals was the likely cause of the age related change in IGF-I and TGF-beta 1 mRNA expression patterns. On the basis of these data we suggest a model of remyelination in which PDGF is involved in the initial phase of oligodendrocyte progenitor recruitment, while IGF-I and TGF-beta 1 trigger the differentiation of the recruited cells into myelinating oligodendrocytes.
Adequate Health Literacy Is Associated With Higher Heart Failure Knowledge and Self-care Confidence in Hospitalized Patients

Heart failure (HF) patients with inadequate health literacy are at increased risk for poor self-care and negative health outcomes such as hospital readmission. The purpose of the present study was to examine the prevalence of inadequate health literacy, the reliability of the Dutch HF Knowledge Scale (DHFKS) and the Self-care of Heart Failure Index (SCHFI), and the differences in HF knowledge, HF self-care, and 30-day readmission rate by health literacy level among patients hospitalized with HF. The convenience sample included adults (n = 95) admitted to a large, urban, teaching hospital whose primary diagnosis was HF. Measures included the Short Test of Functional Health Literacy in Adults, the DHFKS, the SCHFI, and readmission at 30 days after discharge. The sample was 59 ± 14 years in age, 51% male, and 67% African American; 35% had less than a high school education, 35% were employed, 73% lived with someone who helps with their HF care, and 16% were readmitted within 30 days of index admission. Health literacy was inadequate for 42%, marginal for 19%, and adequate for 39%. Reliability of the DHFKS and SCHFI scales was comparable to prior reports. Mean knowledge score was 11.43 ± 2.26; SCHFI subscale scores were 56.82 ± 17.12 for maintenance, 63.64 ± 18.29 for management, and 65.02 ± 16.34 for confidence. Those with adequate health literacy were younger and had higher education level, HF knowledge scores, and HF self-care confidence compared with those with marginal or inadequate health literacy. Self-care maintenance and management scores and 30-day readmission rate did not differ by health literacy level. These findings demonstrate the high prevalence of inadequate and marginal health literacy and that health literacy is an important consideration in promoting HF knowledge and confidence in self-care behaviors, particularly among older adults and those with less than a high school education.
Remapping the Somatosensory Cortex after Stroke: Insight from Imaging the Synapse to Network

Together, thousands of neurons with similar function make up topographically oriented sensory cortex maps that represent contralateral body parts. Although this is an accepted model for the adult cortex, whether these same rules hold after stroke-induced damage is unclear. After stroke, sensory representations damaged by stroke remap onto nearby surviving neurons. Here, we review the process of sensory remapping after stroke at multiple levels ranging from the initial damage to synapses, to their rewiring and function in intact sensory circuits. We introduce a new approach using in vivo 2-photon calcium imaging to determine how the response properties of individual somatosensory cortex neurons are altered during remapping. One month after forelimb-area stroke, normally highly limb-selective neurons in surviving peri-infarct areas exhibit remarkable flexibility and begin to process sensory stimuli from multiple limbs as remapping proceeds. Two months after stroke, neurons within remapped regions develop a stronger response preference. Thus, remapping is initiated by surviving neurons adopting new roles in addition to their usual function. Later in recovery, these remapped forelimb-responsive neurons become more selective, but their new topographical representation may encroach on map territories of neurons that process sensory stimuli from other body parts. Neurons responding to multiple limbs may reflect a transitory phase in the progression from their involvement in one sensorimotor function to a new function that replaces processing lost due to stroke.
Results of the Household Finance and Consumption Survey in Latvia

This paper presents an overview of the main results of the Household Finance and Consumption Survey in Latvia, which was conducted in 2014 and collected responses from 2 814 individuals (1 202 households). Unique data on household wealth, including their assets and liabilities, as well as income and consumption were gathered. The data this survey collects are representative of the population, and the survey is to be carried out regularly to study aggregate and distributional changes in household budgets, wealth components and inequality over time. The survey results show that households in Latvia, in comparison with those in the euro area, have much higher ownership rates of the most important household asset – the main residence (76% vs. 61% respectively). However, the median value of this asset and of total assets is markedly lower than in the euro area. On the liabilities side, only one third of Latvian households have outstanding debt – one of the lowest readings among euro area countries. Taking all components of a household balance sheet together, the median net wealth of households in Latvia is 14 200 euro, which is more than seven times smaller than that of euro area households. While the largest net wealth holdings in the euro area are owned by the households where the reference person is at a pre-retirement age, it is the young households (especially the group aged 35–44) in Latvia that own the largest amounts of net wealth and earn the highest median income.
The Temporal Pattern of Mortality Responses to Air Pollution: A Multicity Assessment of Mortality Displacement

Although the association between particulate matter and mortality or morbidity is generally accepted, controversy remains about the importance of the association. If it is due solely to the deaths of frail individuals, which are brought forward by only a brief period of time, the public health implications of the association are fewer than if there is an increase in the number of deaths. Recently, other research has addressed the mortality displacement issue in single-city analysis. We analyzed this issue with a distributed lag model in a multicity hierarchic modeling approach, within the Air Pollution and Health: A European Approach (APHEA-2) study. We fit a Poisson regression model and a polynomial distributed lag model with up to 40 days of delay in each city. In the second stage we combined the city-specific results. We found that the overall effect of particulate matter less than 10 &mgr;M in aerodynamic diameter (PM10) per 10 &mgr;g/m3 for the fourth-degree distributed lag model is a 1.61% increase in daily deaths (95% CI = 1.02–2.20), whereas the mean of PM10 on the same day and the previous day is associated with only a 0.70% increase in deaths (95% CI = 0.43–0.97). This result is unchanged using an unconstrained distributed lag model. Our study confirms that the effects observed in daily time-series studies are not due primarily to short-term mortality displacement. The effect size estimate for airborne particles more than doubles when we consider longer-term effects, which has important implications for risk assessment.
Staging the hepatic fibrosis on CT images: Optimizing the slice thickness and texture features

Texture features are useful in analyzing the hepatic fibrosis on CT images, however properly selecting features and slice thickness is still uncertain. In this paper, five types of slice thickness and 15 features extracted from co-occurrence matrix are investigated to select the optimal parameters. Each combination will be checked by using SVM (Support Vector machine) with leave-one-case-out method. 149 cases including 6 grades of hepatic fibrosis are acquired by CT scanner and divided into two groups: normal & mild fibrosis vs severe fibrosis & typical cirrhosis. Iteration test on all of the subsets indicates that 5 to 7 features with slice thickness of 1.25mm is the optimal combination with relative higher accuracy in classification of fibrosis.
Making Impact in the Health-care Sector with Outsourced Information Technology Services: An Interview with Day Veerlapati, President and CEO, Seven Seas Technologies Inc, Chesterfield, USA

This interview provides insights into technology and management of IT outsourcing service providers. It identifies the advantages that global delivery centers offer firms in the outsourcing sector. The interview highlights the key emerging information technologies for future and their emerging roles in the health-care sector, such as artificial intelligence, internet of things (IOT), cloud computing and blockchain, and emphasizes the importance of data management. It finally offers key requirements that senior IT executives need to possess to sustain their top talents. Day Veerlapati is the President and CEO of Seven Seas Technologies, Inc (S2Tech). Prior to launching S2Tech, he has held IT positions at several leading firms, including Union Pacific Technologies. He holds a Master of Information Management from Washington University and M.Tech in Industrial Engineering from IIT Khadagpur.