Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparing CSF biomarkers and brain MRI in the diagnosis of sporadic Creutzfeldt-Jakob disease

SummaryWe assessed the diagnostic utility of 3 CSF biomarkers—14-3-3 protein, total tau (T-tau), and neuron-specific enolase (NSE)—from the same lumbar puncture to distinguish between participants with neuropathologically confirmed sporadic Creutzfeldt-Jakob disease (sCJD, n = 57) and controls with nonprion rapidly progressive dementia (npRPD, n = 41). Measures of diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value, as well as logistic regression and area under the receiver operator curve (AUC), were used to assess the ability of these CSF biomarkers, alone or concomitantly, to predict diagnosis. In a subcohort with available MRI (sCJD n = 57, npRPD = 32), we compared visual assessment of diffusion-weighted imaging MRI sequences to these CSF biomarkers. MRI was the best predictor, with an AUC of 0.97 (confidence interval [CI] 0.92–1.00) and a diagnostic accuracy of 97% (CI 90%–100%). Of the CSF biomarkers, T-tau had a higher diagnostic accuracy (79.6%) than 14-3-3 (70.4%, CI for difference 8.7%, 9.7%; p = 0.048) or NSE (71.4%, CI for difference 7.6%, 8.7%; p = 0.03).
Students' attitudes towards guidance and counseling services in public secondary schools in Nairobi Province

Youth, in contemporary times, are exposed to several conflicting, distracting, difficult and stressful situations. In the past, young people generally tended to rely on the advice, wisdom and judgement of their elders. In modem times, owing to their exposure to other cultural milieu, they are often tempted to imitate and emulate other modes and patterns of behaviour and transvestism. Such influence sometimes creates distressing problems of adjustment. They appear to be increasingly groping for a meaning in life consonant with their ideas and expectations and express themselves by resorting to drug and substance abuse and espousal of the hippie culture. In regard to all these issues, the youth is called upon to make choices from a welter of disconcerting alternatives, of which guidance and counselling is a major aspect. The main objective of this study was to investigate the attitude of students towards seeking guidance and counselling in public secondary schools in Nairobi Province, Kenya. The study analysed four issues, namely: attitude of students towards seeking guidance and counselling, difference in attitudes towards seeking guidance and counselling between boys and girls, difference in attitudes towards seeking guidance and counselling among students from different types of schools and common personal and academic problems that secondary school students experience. Literature was reviewed on guidance and counselling movement in Africa, the need for the students’ counselling and the problems they experience, the role of the teacher-counsellor as perceived by the students and review of studies carried out on attitudes of students towards guidance and
Biphasic Alterations in Expression and Subcellular Localization of MUC1 in Pancreatic Ductal Carcinogenesis in Syrian Hamsters

Objectives The aim of the present study was to characterize molecular targets for the prevention/diagnosis of pancreatic cancer using a chemically induced hamster pancreatic carcinogenesis model, in which background injuries to the parenchyma, for example, chronic pancreatitis or acinar atrophy, are limited. Methods Gene expression profiles in atypical hyperplasias were first investigated using a microarray technique. Immunohistochemical analyses of early lesions and invasive ductal carcinoma (IDC) were then conducted for MUC1, of which mRNA levels were prominent among the up-regulated genes, in contrast with the coexpression of epithelial-mesenchymal transition (EMT)-related proteins. Results Immunohistochemistry for MUC1 cytoplasmic domain (MUC1-CD), which was not detected in normal-like pancreatic ducts, was positive in the apical surfaces of the epithelia of hyperplasias with and without atypia and IDC areas with distinct tubular patterns. In contrast, cytoplasmic/nuclear positivity for MUC1-CD was observed in the invasive front of IDCs. The coexpression of EMT-related proteins, such as slug and vimentin, with cytoplasmic/nuclear MUC1-CD was also detected. Conclusions Alterations in the expression and subcellular localization of MUC1 represent a biphasic phenomenon, and the latter may be associated with EMT in pancreatic carcinogenesis in hamsters, which indicates that changes in MUC1 are important targets for pancreatic cancer prevention and chemotherapy.
The farm as an accounting laboratory: an essay on the history of accounting and agriculture

The shop, the factory, the office: these appear, to the popular imaginary, as natural sites for accounting, and for accountants. They are the places where accounting is usually said to be invented and practised, the places where accounting sustains business. The shop stands for commerce, which reportedly saw the emergence of double-entry bookkeeping in the so-called ‘commercial revolution’ of the early-modern times. The factory stands out as the chief target of management accounting from the nineteenth century and its ‘industrial revolution’. The office is where accounting clerks work, but also itself an object of productive accountability in the ‘service economy’ of the twentieth century.
Comparison of case fatality in south Asian and white patients after acute myocardial infarction: observational study

Abstract Objective: To compare mortality in south Asian (Indian, Pakistani, and Bangladeshi) and white patients in the six months after hospital admission for acute myocardial infarction. Design: Observational study. Setting: District general hospital in east London. Patients: 149 south Asian and 313 white patients aged <65 years admitted to the coronary care unit with acute myocardial infarction from 1 December 1988 to 31 December 1992. Main outcome measure: All cause mortality in the first six months after myocardial infarction. Results: The admission rate in the south Asians was estimated to be 2.04 times that in the white patients. Most aspects of treatment were similar in the two groups, except that a higher proportion of the south Asians received thrombolytic drugs (81.2% v 73.8%). After adjustment for age, sex, previous myocardial infarction, and treatment with thrombolysis or aspirin, or both, the south Asians had a poorer survival over the six months from myocardial infarction (hazard ratio 2.02 (95% confidence interval 1.14 to 3.56), P=0.018), but a substantially higher proportion were diabetic (38% v 11%, P<0.001), and additional adjustment for diabetes removed much of their excess risk (adjusted hazard ratio 1.26 (0.68 to 2.33), P=0.47). Conclusion: South Asian patients had a higher risk of admission with myocardial infarction and a higher risk of death over the ensuing six months than the white patients. The higher case fatality among the south Asians, largely attributable to diabetes, may contribute to the increased risk of death from coronary heart disease in south Asians living in Britain. Key messages This study shows that south Asians have high mortality in the first six months after a heart attack This may contribute to the high standardised mortality ratios for coronary disease in south Asians living in the Britain Diabetes may be an important contributor to this excess risk The high prevalence of diabetes and relatively poor prognosis after myocardial infarction in south Asian patients are important to consider in clinical management
Estimation of the regional burden of non-communicable diseases due to obesity and overweight in Markazi province, Iran, 2006-2007

Background and Objectives: Obesity and overweight are major determinants of health and quality of life. The World Health Organization (WHO) has always encouraged its member states to carry out studies on the attributable burden of these diseases at the national level, and use the study as the best guide to direct the health system policy. This study was thus undertaken in order to determine the regional burden of non-communicable diseases due to obesity and overweight. Setting and Design: Counterfactual analysis of the death registration data in Markazi province of Iran was carried out. Materials and Methods: We calculated the Years of Life Lost (YLL) according to the WHO's comparative risk assessment approach. Moreover, the attributable burden of obesity and overweight was determined by multiplying the impact fraction of risk factors with the YLL of major diseases, and the counterfactual analysis method was used. Results: A total of 7,176 deaths were registered contributing to 252,214 YLL, due to premature mortality. The total YLL due to premature mortality among females and males were 102,245 and 149,969 years, respectively. The most important causes of the YLL were associated with obesity and overweight in cardiovascular diseases for females, and overweight in cardiovascular diseases for males (12,826, 8,755 and 7,375 years, respectively). Conclusion: In this study, the importance and necessity of the recognition of overweight and obesity as the major risk factors for non-communicable diseases was shown. Hence, it is necessary to develop and apply comprehensive interventions to reduce the effect of overweight and obesity, especially in females.
Dysarthria in Friedreich’s Ataxia: A Perceptual Analysis

The aims of this study were to: (1) evaluate the perceptual speech dimensions, speech intelligibility and dysarthria severity of a group of individuals diagnosed with Friedreich’s ataxia (FRDA); (2) determine the presence of subgroups within FRDA dysarthria; (3) investigate the relationship between the speech outcome and the clinical factors of disease progression. The study included 38 individuals (21 female, 17 male) with a confirmed diagnosis of FRDA. A group of 20 non-neurologically impaired individuals served as controls. Perceptual analysis, investigating 30 different dimensions of speech, was conducted on a speech sample obtained from each participant. In addition, the Assessment of Intelligibility of Dysarthria Speech was administered. All FRDA participants presented with dysarthria with severities ranging from mild to moderate. Cluster analysis revealed 3 subgroups, the first presenting with mild dysarthric symptoms, the second with increased velopharyngeal involvement and the third characterized by increased laryngeal dysfunction. Dysarthria severity showed a significant correlation to disease duration but to no other clinical measure. The findings support the notion of subgroups in FRDA dysarthria, representing distinct impairments of the speech mechanism and perhaps reflective of differing evolutions beyond the cerebellum.
Application of a virtual reality prototype for pain relief of pediatric burn in Taiwan.

AIM This study examines the usability and effectiveness of virtual reality in reducing pain in wound-care procedures for pediatric burn patients in Taiwan. BACKGROUND Virtual reality has continuously gained prominence in the medical arena, for instance, the telepresence for surgery, the management of mental health disorders and pain control of the paediatric burn. Notwithstanding an increased application of virtual reality in the medical arena in North America, there have been no studies investigating its use for paediatric burn patients in Asia. METHODS This descriptive study has two phases: Phase I: the development of a virtual reality prototype. Phase II: the implementation of the prototype to discern its usability and efficacy with paediatric burn patients at a local hospital. RESULTS The findings suggest that a significant difference is found in the children's reported pain, with or without the virtual reality intervention, over the three phases: before, during and after the dressing change. However, less pain was noted in the intervention group during and after the dressing change. CONCLUSION Adding to the existing clinical value of virtual reality identifies the nature of and different children's responses to pain with the use of virtual reality. RELEVANCE TO CLINICAL PRACTICE This study is significant since it demonstrates a difference in the child's response to pain based on the nature of presence and distraction. Moreover, given the evidence that a decrease in anxiety was experienced after the dressing change with virtual reality intervention, timing of using the virtual reality intervention before the child develops conditioning anxiety and anticipated pain for the procedure would be of importance.
Model-based control on populations of air conditioners: Shaping aggregated power for demand side management

A population of thermostatically controlled devices such as air conditioners can be managed as a whole to reduce their load during a critical period or to participate in the electricity market. We present a model based on first principles for the power response of a population of air conditioners controlled by a common temperature set point change. We then develop a model-based controller for the aggregated power of the population. Our controller requires fine temperature set point resolution. For coarse resolution, as in ACs installed nowadays, we propose to divide the population into logical clusters and send different coarse-resolution signals to each cluster. Clustering achieves the same performance as using one global, high resolution, signal.
Cochlear Implantation in Postmeningitic Deafness

Purpose: The aim of this study is to evaluate long-term outcomes of cochlear implantation (CI) in patients with postmeningitic deafness. Methods: Twenty-seven patients with severe to profound hearing loss due to bacterial meningitis and received CI were the subjects of this study. Surgical findings and long-term audiological performances were evaluated. Speech perception and speech intelligibility of the implanted patients were evaluated with the categories of auditory performance–II (CAP-II) test and speech intelligibility rating (SIR) test, respectively. Results: Eighteen of the 27 patients had received full electrode insertion through the patent cochlear lumen. Remaining 9 patients had varying degrees of ossification throughout the cochlea and needed to be drilled to achieve partial electrode insertion. None of the patients exhibited surgical complication. Scores in both test batteries (CAP-II and SIR) were comparable between patients who received full or partial electrode insertion (P > 0.05). Conclusion: Cochlear implantation after postmeningitic deafness has favorable outcomes especially in long term. Although this type of inner ear pathology may require special considerations during surgery, it is a relatively safe procedure.
The expert experience in adopting the E-S-QUAL scale

This paper aims to identify and discuss some key conceptual and empirical issues that should be considered while adopting a generic scale, such as E-S-QUAL, to evaluate service quality. A collection of the 21 most relevant papers that have previously used the scale were retrieved from the leading databases. The authors involved in these papers were invited to share their experience in the use of the scale through a Delphi methodology. The experts agreed on many points related to the conceptualisation and empirical issues. Some of the most important points are the following: there was consensus that the ‘Fulfilment’ dimension is one of the prominent dimensions only for those websites that sell and deliver physical goods. Moreover, due to the high speed in the development of technology and telecommunication, the experts agreed that the Efficiency dimension must be updated. It was also agreed that the causes of instability in a number of dimensions are not only due to the service industry analysed but also due to the factors of such analysis methodology used across studies. The results of this study will increase the knowledge and the confidence that researchers and practitioners have when they use the scale in their subsequent studies.
Preventive pediatrics--new models of providing needed health services.

The risks to children's well-being are accelerating because, in part, of an increasingly porous social safety net. Pediatricians are being asked to bear an ever-increasing burden for helping children and families address a myriad of issues, and they have become the providers of last resort. As the distance between what we should do and what we can do as clinicians widens, so too does our frustration and willingness to consider addressing yet one more issue. We often retreat to the comfortable world of otitis media and immunizations and shut out the loud cacophony of the outside world and its effects on our families. We need a new model of care, based on an ecological approach to child health consistent with Bright Futures,40 which provides child health supervision guidelines. To meet these needs, some settings may develop models in which skilled professionals can provide advocacy services, parental health, parental mental health, and child development services in the context of pediatric practice. Although most practices or clinic programs will not have the space or resources to include all of these services, the development and implementation of any one of them will enrich the care of children and families. Other services such as legal aid, family literacy, and mental health may be available in the community and could be colocated in the pediatric setting as outreach efforts on the part of these programs or linked in a manner that ensures accessibility. Similar enhancements to primary-care programs for special groups of children at risk, including those who are homeless, drug exposed, in foster care, and born to teen-age mothers, are being developed in many communities. The cost of such services presents difficult obstacles. However, given the progressive growth of prepaid practices and competition among plans for patients, services such as those provided by a child development specialist might increase the attractiveness of the plan and allow recruitment of more families. Reducing cigarette smoking, preventing unwanted pregnancy, and reducing drug and alcohol use have potential cost-saving implications that will interest managed-care programs. On the other hand, health care plans may limit services if potential financial benefits are uncertain or acrue to another sector such as schools. For populations at risk, especially health-education collaboration of this type (whether funded and/or cofunded with funds from federal or state department of education budgets, Medicaid, managed-care contracts, tobacco tax revenues, and/or federal family planning funds) should be pursued. Most of the services we have described are, in fact, already available in most communities and/or health plans. Without new net costs, it may be possible to reallocate some or all of these services to the pediatric primary-care setting in a single-site, one-stop-shopping model. Redeploying services to the pediatric primary-care setting may increase accessibility to these important preventive services and improve the health and well-being of children and their parents.
Coexpression of CD40 and CD40 ligand in B‐cell lymphoma cells

CD40 ligand (CD40L) is involved in the T‐cell‐dependent regulation of B‐cell growth and survival and can rescue normal germinal centre B cells and several types of malignant B cells from apoptosis in vitro. We have previously reported that serum of patients with chronic lymphocytic leukaemia contained elevated levels of biologically active soluble CD40L (sCD40L). Whether an augmented CD40L pathway exists in patients with other types of B‐cell lymphoid malignancies and the source of native sCD40L in these patients is currently unknown. Using a sensitive ELISA assay, soluble CD40L (sCD40L) was detected in the sera of both healthy individuals and patients with haematological malignancies; however, its level was significantly elevated only in patients with B‐cell lymphomas (P < 0.0001). Several types of malignant B cells coexpressed CD40 and CD40L proteins, and CD40L mRNA was detected in purified resting malignant B cells. The dual expression of CD40 and CD40L in B cells and the presence of native sCD40L in human serum suggest that a direct T–B‐cell contact may not be required for CD40L delivery to B cells. This data raises the possibility that an autocrine cytokine loop involving CD40L may contribute to the growth regulation of benign and malignant B cells in vivo.
The Global Regulator CodY Regulates Toxin Gene Expression in Bacillus anthracis and Is Required for Full Virulence

ABSTRACT In gram-positive bacteria, CodY is an important regulator of genes whose expression changes upon nutrient limitation and acts as a repressor of virulence gene expression in some pathogenic species. Here, we report the role of CodY in Bacillus anthracis, the etiologic agent of anthrax. Disruption of codY completely abolished virulence in a toxinogenic, noncapsulated strain, indicating that the activity of CodY is required for full virulence of B. anthracis. Global transcriptome analysis of a codY mutant and the parental strain revealed extensive differences. These differences could reflect direct control for some genes, as suggested by the presence of CodY binding sequences in their promoter regions, or indirect effects via the CodY-dependent control of other regulatory proteins or metabolic rearrangements in the codY mutant strain. The differences included reduced expression of the anthrax toxin genes in the mutant strain, which was confirmed by lacZ reporter fusions and immunoblotting. The accumulation of the global virulence regulator AtxA protein was strongly reduced in the mutant strain. However, in agreement with the microarray data, expression of atxA, as measured using an atxA-lacZ transcriptional fusion and by assaying atxA mRNA, was not significantly affected in the codY mutant. An atxA-lacZ translational fusion was also unaffected. Overexpression of atxA restored toxin component synthesis in the codY mutant strain. These results suggest that CodY controls toxin gene expression by regulating AtxA accumulation posttranslationally.
The Role of Marketing Strategies in Successful Disruptive Technologies

A disruptive technology (DT) is defined as an emerging technology whose arrival in the marketplace signifies the eventual displacement of the dominant technology in that sector. A potential DT can also facilitate the creation of new markets previously untapped or unserved by the existing products/services to address the unmet need. The identification and commercial success of a potential DT lie in understanding the market in terms of consumer behavior, developing new products/services, and subsequently developing innovative marketing strategies to promote them effectively to the target market. The purpose of this paper is to propose a set of strategies that might aid an organization to successfully market a DT (or a DT-intensive product/service). The proposed strategies are subsequently prioritized based upon empirical studies to determine their relative criticality for successful launch and sustenance of such products/services. The contribution of this paper to the domain of high-technology marketing is two-fold. First, the research conducted is expected to further socialize the notion that DT is unique among the marketing practitioners. Second, the proposed strategies along with their relative criticality will provide a set of guidelines to the decision-makers in the field of technology and marketing to gain a better understanding of DT marketing, which is fast gaining ground in an ever-intensifying competitive marketplace.