Miracle-dz/UniFAR-FTUs huggingface dataset:
Cost effectiveness of proton therapy compared with photon therapy in the management of pediatric medulloblastoma

Proton therapy has been a hotly contested issue in both scientific publications and lay media. Proponents cite the modality's ability to spare healthy tissue, but critics claim the benefit gained from its use does not validate its cost compared with photon therapy. The objective of this study was to evaluate the cost effectiveness of proton therapy versus photon therapy in the management of pediatric medulloblastoma.
[Cellular immune response in tuberculosis: analysis of T-lymphocytes and their subsets, B-lymphocytes and natural cytotoxic cells in different tuberculosis states and body fluids].

BACKGROUND The immune response to Mycobacterium tuberculosis is primarily mediated by T lymphocytes. In this study an investigation was made of T lymphocytes and their subsets, B lymphocytes and natural cytotoxic cells (Natural Killer, NK) in blood and organic fluids in different tuberculosis conditions. METHODS Patients with localized pulmonary tuberculosis (LPT, n = 12), extensive pulmonary tuberculosis (EPT, n = 24), pleural tuberculosis (PLE, n = 14), disseminated tuberculosis (DIS, n = 10), recent Mantoux converters (MAN, n = 15) and healthy subjects (CON, n = 19) were studied. HIV+ and immunosuppressed patients were excluded. Total lymphocytes and T subsets (CD3, CD4, CD8, TCR alpha beta and gamma delta), B (CD19) and NK cells (CD56) in blood and pleural fluid (n = 7) and ascitic fluid (n = 3) were determined. RESULTS An increase was observed in total lymphocytes and all T subsets (CD3, CD4, CD8, alpha beta and gamma delta) in MAN group compared with CON group (p < 0.05 for all determinations). A progressive lymphopenia of total lymphocytes and CD4 was observed with more extensive disease, particularly in the DIS group (p < 0.05). No differences were observed between groups regarding B lymphocytes and NK cells. In pleural effusions and ascitic exudates an accumulation of T lymphocytes, mainly CD4, was observed, with no increase in gamma delta T lymphocytes. CONCLUSIONS 1) In patients with recent tuberculosis infection T lymphocytosis (total and subsets) occurs. 2) In the absence of HIV infection, a progressive lymphopenia occurs, particularly CD4, with extending disease. 3) In tuberculous pleural effusions and ascitic exudates and accumulation of CD4 T lymphocytes occurs, but not TCR gamma delta lymphocytes.
Meta-analysis of erythrocyte polyunsaturated fatty acid biostatus in bipolar disorder.

OBJECTIVES Dietary deficiency in polyunsaturated fatty acids (PUFAs), including the omega-3 fatty acids eicosapentaenoic acid (EPA; 20:5n-3) and docosahexaenoic acid (DHA; 22:6n-3), and excesses in omega-6 fatty acids, including linoleic acid (LA; 18:2n-6) and arachidonic acid (AA; 20:4n-6), may be associated with the pathophysiology of bipolar disorder. In an effort to provide clarification regarding the relationship between PUFA biostatus and bipolar disorder, this meta-analysis investigated studies comparing erythrocyte (red blood cell) membrane PUFA composition in patients with bipolar disorder and healthy controls. METHODS A meta-analysis was performed on case-control studies comparing erythrocyte PUFA (EPA, DHA, LA and AA) levels in patients with bipolar I disorder and healthy controls. Standardized effect sizes were calculated and combined using a random effects model. RESULTS Six eligible case-control studies comprising n = 118 bipolar I patients and n = 147 healthy controls were included in the analysis. Compared with healthy controls, patients with bipolar I disorder exhibited robust erythrocyte DHA deficits (p = 0.0008) and there was a trend for lower EPA (p = 0.086). There were no significant differences in LA (p = 0.42) or AA (p = 0.64). CONCLUSIONS Bipolar I disorder is associated with robust erythrocyte DHA deficits. These findings add to a growing body of evidence implicating omega-3 PUFA deficiency in the pathophysiology of bipolar disorder.
Primary Nerve Repair for Obstetrical Brachial Plexus Injury: A Meta-Analysis

Background: Nerve repair may be effective in improving function following obstetrical brachial plexus injury. No previous review has directly compared nerve repair to nonoperative management for similar patients, and no previous analysis has been adequately powered to determine whether nerve repair reduces impairment. Methods: Electronic databases were searched (MEDLINE, Embase, CINAHL, and Cochrane Central). Eligible studies were randomized controlled trials, observational studies, and case series (n > 9); included patients younger than 2 years undergoing nerve repair or nonoperative management of obstetrical brachial plexus injury; and reported functional impairment. Two reviewers independently screened articles using objective a priori criteria. Bias was assessed for each study. Overall quality of evidence was evaluated for each outcome. Results: Among nine cohort studies including 222 patients, nerve repair significantly reduced functional impairment compared with nonoperative management (relative risk, 0.58; 95 percent CI, 0.43 to 0.79; p < 0.001; I2 = 0 percent; absolute risk reduction, 19 percent; number needed to treat, six). Findings are consistent with comparison of similar patients from case series. With operative management, no deaths were reported; major adverse events were reported in 1.5 percent, and minor adverse events were reported in 5.0 percent of cases. Among demographic (all severities) samples managed nonoperatively, residual impairment remains in 27 percent (19 to 36 percent). Conclusions: Nerve repair reduces functional impairment in obstetrical brachial plexus injury. Nonoperative management in patients with a deficit at 3 months of age leads to a high proportion of functional impairment. Mortality is not a common risk of modern pediatric microsurgical nerve repair. Residual impairment with nonoperative management is underestimated in the reported literature. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Maternal low protein diet restricted to the preimplantation period induces a gender‐specific change on hepatic gene expression in rat fetuses

It has been shown previously that maternal low protein diet (LPD) throughout rat gestation altered hepatic gene expression and enzyme activities in offspring. Here, we investigate the effect of maternal LPD (9% casein vs. 18% control) exclusively during the preimplantation period (switched diet group) or provided throughout gestation on hepatic gene expression in day 20 fetuses. Using quantitative competitive PCR, we found that switched diet induced a two‐fold increase (P = 0.008) in hepatic gene expression of phosphoenolpyruvate carboxykinase (PEPCK, a rate limiting enzyme for gluconeogenesis) in male fetuses and a 17% increase (P = 0.005) in 11β‐hydroxysteroid dehydrogenase type 1 (11β‐HSD1, acts primarily as a reductase to produce active glucocorticoid) in female liver compared with control fetuses. Maternal LPD administered throughout gestation increased 11β‐HSD1 expression in male fetal liver by 27% (P = 0.042) compared with controls. However, maternal LPD fed for either period did not affect fetal hepatic insulin receptor (IR), glucocorticoid receptor (GR), glycogen synthase (GS) nor placental glucose transporter 1 (Glut1) and 3 (Glut3) transcript levels. The alteration in fetal hepatic gene expression could not be attributed specifically to known regulators including insulin or glucose concentrations in fetal blood nor alteration in cAMP in fetal liver, although a combination of these regulatory factors may be responsible. Fetal hepatic glycogen level was unaffected by maternal diet. The present findings show that the long term potential of the preimplantation embryo is sensitive to maternal LPD such that basal levels of hepatic gene expression in day 20 fetuses are altered in a gender‐specific manner. Mol. Reprod. Dev. 74: 48–56, 2007. © 2006 Wiley‐Liss, Inc.
Diversity and abundance of phyllosphere bacteria are linked to insect herbivory

Simultaneous or sequential attack by herbivores and microbes is common in plants. Many seed plants exhibit a defence trade‐off against chewing herbivorous insects and leaf‐colonizing (‘phyllosphere’) bacteria, which arises from cross‐talk between the phytohormones jasmonic acid (JA, induced by many herbivores) and salicylic acid (SA, induced by many bacteria). This cross‐talk may promote reciprocal susceptibility in plants between phyllosphere bacteria and insect herbivores. In a population of native bittercress (Cardamine cordifolia, Brassicaceae), we tested whether simulating prior damage with JA or SA treatment induced resistance or susceptibility (respectively) to chewing herbivores. In parallel, we conducted culture‐dependent surveys of phyllosphere bacteria to test the hypothesis that damage by chewing herbivores correlates positively with bacterial abundance in leaves. Finally, we tested whether bacterial infection induced susceptibility to herbivory by a major chewing herbivore of bittercress, Scaptomyza nigrita (Drosophilidae). Overall, our results suggest that reciprocal susceptibility to herbivory and microbial attack occurs in bittercress. We found that JA treatment reduced and SA treatment increased S. nigrita herbivory in bittercress in the field. Bacterial abundance was higher in herbivore‐damaged vs. undamaged leaves (especially Pseudomonas syringae). However, Pedobacter spp. and Pseudomonas fluorescens infections were negatively associated with herbivory. Experimental Pseudomonas spp. infections increased S. nigrita herbivory in bittercress. Thus, plant defence signalling trade‐offs can have important ecological consequences in nature that may be reflected in a positive correlation between herbivory and phyllosphere bacterial abundance and diversity. Importantly, the strength and direction of this association varies within and among prevalent bacterial groups.
An Interview Study of Patient and Caregiver Perspectives on Advance Care Planning in ESRD.

BACKGROUND Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, it can be an emotionally charged process for patients with kidney disease and their caregivers. This study aimed to describe the perspectives and attitudes of patients with end-stage renal disease (ESRD) and their caregivers toward ACP. STUDY DESIGN Qualitative study. SETTING & PARTICIPANTS Patients with ESRD (n=24) and their caregivers (n=15) aged 36 to 91 years at various stages of ACP ("not commenced," "in progress," or "completed") from 3 renal services. METHODOLOGY Semistructured interviews. ANALYTICAL APPROACH Transcripts were analyzed using thematic analysis. RESULTS 5 major themes were identified: articulating core values (avoiding futile and undignified treatment, reevaluating terms of dialysis, framing a life worth living, and refusing to be a burden), confronting conversations (signifying death and defeat, accepting inevitable death, and alleviating existential tension), negotiating mutual understanding (broaching taboos and assisting conflicted caregivers), challenging patient autonomy (family pressures to continue dialysis, grief diminishing caregivers' capacity, and leveraging support), and decisional disempowerment (lacking medical transparency and disappointment with clinical disinterest). LIMITATIONS Only English-speaking patients/caregivers participated in the interview. CONCLUSIONS ACP provides patients with ESRD and their caregivers a conduit for accepting and planning for impending death and to express treatment preferences based on self-dignity and value of living. However, ACP can be considered taboo, may require caregivers to overcome personal and decisional conflict, and may be complex if patients and caregivers are unable to accept the reality of the patient's illness. We suggest that ACP facilitators and clinicians make ACP more acceptable and less confrontational to patients and caregivers and that strategies be put in place to support caregivers who may be experiencing overwhelming grief or who have conflicting goals, particularly when they are called on to make end-of-life decisions.
WOOD PROPERTY MAPS SHOWING WOOD VARIABILITY IN MATURE LONGLEAF PINE: DOES GETTING OLD CHANGE JUVENILE TENDENCIES?

Established illustrations of juvenile wood in pines depict a central core of wood, varying little by diameter or cambial age, to be nested within mature wood tapering to the upper portion of the stem; alternative illustrations show greater complexity in attributing variability within this central core of wood to its proximity to the crown and/or the maturity of the tree when the wood was formed. The present study addresses the degree to which different representations of juvenile wood are applicable to a sampling of 70-yr-old longleaf pine (Pinus palustris Mill.) trees. Wood property maps were derived from X-ray densitometry data gathered from tree disks taken at every 61 cm along each tree bole. Unique to the wood property maps herein is that the two cardinal directions of the data (north and south) were preserved, thus providing true full-stem profiles. Compared with maps reported for younger southern pines, the central core of low-density wood extending the length of the tree boles was noticeably wider at the midheight than at the lower and higher relative heights. Another difference was that the higher ring specific gravity (SG) values, particularly at the lower heights, did not extend all the way to the wood closest to the bark. Narrower ring width and higher ring SG values above the 3Q height, normally being wood features associated with higher wood quality, can be attributed to the maturity of the study trees. Altogether, the wood property maps and data comparisons were consistent with an alternative juvenile wood illustration proposing that all the wood at the base of the tree, comprised of juvenile corewood and juvenile outerwood, as being different from the majority of the tree wood, upward from a one-quarter relative height.
The Dyke Marsh Preserve Ecosystem

For over a century, Dyke marsh along the Potomac River just south of Alexandria, VA, has been a favorite site for natural history studies. Despite earlier attempts at diking to create agricultural land and dredging for sand and gravel, the remaining marsh represents the last major tidal freshwater wetland on the upper Potomac River, and is now owned and maintained by the National Park Service as the Dyke Marsh Preserve. In the present paper historical data on physical properties and biota are compared and contrasted with more recent biological investigations to show functioning ecosystem components, interrelationships among the flora and fauna, and documented changes in biotic communities over the years. As a haven for migratory waterfowl and shorebirds, unique plant communities, and large, dynamic insect and vertebrate populations, the Preserve is constantly threatened by river pollution, nearby large-scale development projects, and bridge construction. The long-term stability of this unique Preserve depends largely on the vigilance of the Park Service, concerned citizens, and environmental groups to ensure the preservation of this valuable functioning ecosystem.
Employing Internet of Things in Education: Justifications, areas, challenges

Internet of things is a new phenomenon to employ the Internet in various applications of life, and became a reality for the future is not yet complete and did not form the basis of the solid start of the upcoming, which will bring technology to humanity, are we ready for it? The paper seeks to explore the phenomenon of Internet objects and their applications in working life in general and in education in particular, and the paper tries to clarify the following points:  The Internet means things and their characteristics and areas of application  Justifications that call for the need to take advantage of Internet technology in the field of education  Areas in which Internet objects can be used to develop the services and activities of educational institutions  The challenges facing the use of Internet stuff in the field of education.
Plastic bowing fracture of the femur in a child.

J. B. , a 5-year-old white male, was involved in a motor vehicle accident. When admitted to the emergency room, he complained of pain in his left midthigh. Physical examination detected no deformity, but mild tenderness was elicited over the midshaft of the left femur. Radiographs revealed anterior bowing of the left femur (figs. 1A and 1B) without cortical disruption. The right femur was normal (fig. 1C). Several hours after the accident, the patient was free of symptoms and used his left leg readily. The patient remained free of symptoms or disability when seen in a clinic visit 3 days later. Radiographs were unchanged, but a bone scan 7 days after the trauma (fig2A) revealed increased activity at the site of bowing. Radiographs 3 weeks after the accident showed no evidence of periosteal new bone formation. However, 6 months later remodeling was seen on the concave surface of the femur (fig. 2B).
DEMOGRAPHIC AND EVOLUTIONARY IMPACTS OF NATIVE AND INVASIVE INSECT HERBIVORES ON CIRSIUM CANESCENS

Invasive species have the potential to alter trade-offs leading to selection in the populations they invade. Here we quantify the demographic and selective effects of herbivory by native insects and the introduced floral feeder Rhinocyllus conicus on Platte thistle (Cirsium canescens), a sparse monocarpic thistle endemic to North America. Rhin- ocyllus first invaded the Platte thistle population in 1993. Since then, its numbers have increased exponentially, while the Platte thistle population size has decreased. Data from 11 years were analyzed to determine how demographic rates varied with plant size and damage by native insects and Rhinocyllus. Individual growth, survival, flowering proba- bility, and seed set were all size dependent. Damage to vegetative structures did not influence demographic rates; damage to flower heads did because Platte thistle is seed limited. These analyses were used to parameterize a series of integral projection models (IPMs) that investigated the effects of floral herbivory on the population growth rate l, equilibrium population size, and the evolutionary stable (ES) flowering strategy. The IPMs showed that native insects have significant impact on the equilibrium population size and l, but not the ES flowering strategy, because they use the flowers of different-sized plants indiscrimi- nately. In contrast, Rhinocyllus has the potential to drive Platte thistle extinct. Rhinocyllus preferentially fed and oviposited on the flowers of larger plants and therefore selected for a reduction in flowering size. However, as the thistle population went into decline, this pattern reversed. Thus, selection imposed by an invader may be complex and will reflect behavioral interactions between herbivore and host, as well as demographic changes in the host population.
Psychological treatments of binge eating disorder.

CONTEXT Interpersonal psychotherapy (IPT) is an effective specialty treatment for binge eating disorder (BED). Behavioral weight loss treatment (BWL) and guided self-help based on cognitive behavior therapy (CBTgsh) have both resulted in short-term reductions in binge eating in obese patients with BED. OBJECTIVE To test whether patients with BED require specialty therapy beyond BWL and whether IPT is more effective than either BWL or CBTgsh in patients with a high negative affect during a 2-year follow-up. DESIGN Randomized, active control efficacy trial. SETTING University outpatient clinics. PARTICIPANTS Two hundred five women and men with a body mass index between 27 and 45 who met DSM-IV criteria for BED. Intervention Twenty sessions of IPT or BWL or 10 sessions of CBTgsh during 6 months. MAIN OUTCOME MEASURES Binge eating assessed by the Eating Disorder Examination. RESULTS At 2-year follow-up, both IPT and CBTgsh resulted in greater remission from binge eating than BWL (P < .05; odds ratios: BWL vs CBTgsh, 2.3; BWL vs IPT, 2.6; and CBTgsh vs IPT, 1.2). Self-esteem (P < .05) and global Eating Disorder Examination (P < .05) scores were moderators of treatment outcome. The odds ratios for low and high global Eating Disorder Examination scores were 2.8 for BWL, 2.9 for CBTgsh, and 0.73 for IPT; for self-esteem, they were 2.4 for BWL, 1.9 for CBTgsh, and 0.9 for IPT. CONCLUSIONS Interpersonal psychotherapy and CBTgsh are significantly more effective than BWL in eliminating binge eating after 2 years. Guided self-help based on cognitive behavior therapy is a first-line treatment option for most patients with BED, with IPT (or full cognitive behavior therapy) used for patients with low self-esteem and high eating disorder psychopathology. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00060762.
Weighing Vietnamese Children: How Accurate are Child Weights Adjusted for Estimates of Clothing Weight?

Children who are weighed for growth monitoring are frequently clothed, especially in the cold weather. Health workers commonly estimate and subtract the weight of these clothes, but the accuracy of these estimates is unknown. We assessed the accuracy of child weights adjusted for estimated clothing typical of hot, cold, and extremely cold ambient temperatures. Trained field workers weighed a sample of 212 children 6 to 42 months old from the ViSION project, adjusted the weights using a job aid describing the weights of common clothing by season and age, and then weighed the clothing to calculate the actual clothing and child weights. Fieldworker estimates of the weight of the clothing that children wore during weighing were remarkably good. In nearly all cases (207 of 212; 97.7%), the difference between the estimated and actual clothing weight was less than the precision of the child scales (± 50 g), and most (181 of 212; 84.5%) were within 25 g. Thus, the calculated child weights were, in fact, equivalent to the actual child weights. Using simulations, we found that improperly accounting for clothing weight can overestimate weight-for-age by 0.1 to 0.4 Z score. Accurate weights are possible, even under adverse conditions. Our training methods, clothing album, and job aid might benefit nutrition research and programming in Viet Nam as well as settings with colder climates.
Modified Split Extensor Hallucis Longus Tendon Transfer for Correction of Hallux Varus

The most common cause of hallux varus is iatrogenic following correction of hallux valgusY In flexible deformities that are passively correctable, the abductor hallucis tendon,' extensor hallucis brevis (EHB) tendon. " and extensor hallucis longus (EHL) tendon-" have been used to correct this deformity. Jonnsondescribed a technique using a split EHL tendon transfer to correct iatrogenic hallux varus. In this technique, the lateral half of the EHL tendon is released from its insertion distally and transferred from proximal to distal under the intermetatarsalligament between the first and second metatarsal heads. The tendon transfer is secured into a bony tunnel in the plantar lateral aspect of the base of the proximal phalanx. This functions as a dynamic tendon transfer to correct the hallux varus. Clinically, when tension is applied distally to the lateral portion of the EHL tendon, this tension is also transferred to the remaining functional medial half of the EHL tendon and may alter its function.
Exposure Fusion

We propose a technique for fusing a bracketed exposure sequence into a high quality image, without converting to HDR first. Skipping the physically-based HDR assembly step simplifies the acquisition pipeline. This avoids camera response curve calibration and is computationally efficient. It also allows for including flash images in the sequence. Our technique blends multiple exposures, guided by simple quality measures like saturation and contrast. This is done in a multiresolution fashion to account for the brightness variation in the sequence. The resulting image quality is comparable to existing tone mapping operators.