Miracle-dz/UniFAR-FTUs huggingface dataset:
CONCURRENT COMPARISON OF OUTCOMES OF PRIMARY ANGIOPLASTY AND OF STENT PLACEMENT IN HIGH‐RISK PATIENTS WITH SYMPTOMATIC INTRACRANIAL STENOSIS

OBJECTIVETo compare the long-term outcomes of treatment of symptomatic intracranial stenosis using primary angioplasty or stent placement. Both primary angioplasty and stent placement have been proposed as treatment modalities, but long-term outcome comparisons are not available. METHODSWe determined rates of technical success and rates of major stroke, second procedure, or death in patients with symptomatic intracranial stenosis (≥70% in severity and/or medication failure). Pre- and posttreatment angiographic stenosis was measured by independent reviewers. Angioplasty was used preferentially in patients with more technically challenging lesions. Kaplan-Meier analysis was used to determine the rate of major stroke–free survival and major stroke– or repeat procedure–free survival between the two treatment modalities over periods of 12 and 24 months. Cox proportional hazards analysis was used to determine the differential risk of major stroke or death after either angioplasty or stent placement. RESULTSTwenty-two patients (mean age, 62 ± 13 yr) were treated with primary angioplasty and 22 patients (mean age, 58 ±14 yr) with stent placement. The mean stenosis (±standard deviation) decreased from 76 ± 13% to 28 ± 18% in the primary angioplasty–treated and from 68 ± 9% to 17 ± 13% in the stent-treated group. There was no difference in time to major stroke or death (log-rank statistic, 0.44; P = 0.5), and time to major stroke, repeat procedure, or death (log-rank statistic, 0.78; P = 0.4) between the two treatment groups. At 12 months, major stroke–free survival was 95% (± standard error of 4%) for the stent-treated patients and 93% (± standard error of 7%) for the angioplasty-treated patients. There was no significant difference in the risk of major stroke or death between angioplasty and stent placement (P = 0.996) using Cox proportional hazards analysis after adjusting for age, gender, race/ethnicity, presence of hyperlipidemia, qualifying event, preprocedure stenosis, and target vessel. CONCLUSIONThe results of primary angioplasty and primary stent placement were comparable at intermediate follow-up examination after the procedure. The results highlight the need for carefully designed, randomized clinical trials to determine the precise value of stent placement in the intracranial circulation.
Parisi-Sourlas supergravity

A manifestly diffeomorphism invariant exact renormalization group requires extra diffeomorphism invariant ultraviolet regularisation at some effective cutoff scale Λ. This motivates construction of a ‘Parisi-Sourlas’ supergravity, in analogy with the gauge theory case, where the superpartner fields have the wrong spin-statistics such that they can become Pauli–Villars regulator fields after spontaneous symmetry breaking. We show that in contrast to gauge theory, the free theory around flat space is already non-trivial and in a sense already displays some spontaneous symmetry breaking. We show that the fluctuating fields form multiplets whose mass matrices imply that the fields propagate into each other not only with the expected 1/p 2 but also through propagators with improved ultraviolet properties, namely 1/p 4 and 1/p 6, despite the fact that the action contains a maximum of two space-time derivatives.
Pattern and outcome of admissions in the medical wards of a tertiary health center in a rural community of Ekiti State, Nigeria.

OBJECTIVE To determine the pattern and outcome of medical admissions as well as the basic demographic characteristics in medical wards of a tertiary health center located in a rural area. Materials and Methods : A retrospective analysis of medical wards admissions of the Federal Medical Centre, Ido-Ekiti, Ekiti State, southwest Nigeria, between January 2009 and December 2011. Data obtained was analyzed using SPSS Version 16 software. RESULT The total number of patients admitted during the period was 1519, age ranged from 16 to 120 years, with a mean of 56.1 + 18.8 years. There were 823 (54.3%) males and 696 (45.7%) females in a ratio of 1.2:1.0; the highest number of age group admitted was the elderly. Disorders of the cardiovascular system topped the admission list (32.1%) in general, and noncommunicable diseases were also predominant (68.4%) on the admission list compared with communicable diseases (31.6%). The most common cause of death was cardiovascular diseases (33.0%). CONCLUSION Male gender and elderly aged groups were predominant on admission. Noncommunicable diseases were of higher proportion on admission than communicable diseases. The most common cause of death was cardiovascular diseases of which stroke topped the list.
Facial nerve grafts: from cerebellopontine angle and beyond.

OBJECTIVES To review the outcomes from facial nerve cable grafting in a variety of pathologic conditions and to determine the possible causes of poor facial function after facial nerve grafting. STUDY DESIGN A retrospective review of patients undergoing facial nerve grafts through a neurotologic procedure. SETTING This study was performed at a university-based tertiary referral center. PATIENTS All 27 patients undergoing a neurotologic procedure that required a facial nerve graft from 1982 to 1997 were reviewed. Fourteen patients had grafts from the facial nerve stump at the brainstem. INTERVENTIONS All patients had facial nerve function determined by the senior neurotologist and through use of historical data and photographs. MAIN OUTCOME MEASURE A facial nerve repair recovery score was developed for facial nerve transection and repair. The House-Brackmann scale was found to be inappropriate for transected and repaired nerves. RESULTS Facial function was found in 23/25 (92%) patients with at least 8 months follow-up. Statistical analysis revealed no significant correlation between graft length and recovery score. Patients who had the nerve grafted to a site distal to the meatal foramen had a mean outcome that was nearly one grade level better than those with an anastomosis proximal to the meatal foramen (i.e., at the brainstem), but this did not reach statistical significance. CONCLUSIONS Facial nerve grafting is an effective way of restoring facial motor function. A new facial recovery grading scale is proposed for repaired or grafted facial nerves.
Internet-based mental health programs: a powerful tool in the rural medical kit.

OBJECTIVE To discuss, using two case examples, the potential utility of Internet-based depression information and automated therapy programs in rural regions. DESIGN Systematic review of evaluations of two Australian web-based mental health programs: MoodGYM and BluePages Depression Information. SETTING Community, school, university. PARTICIPANTS A total of 12 papers and reports derived from nine separate studies of MoodGYM and BluePages involving sample sizes ranging from 78 to 19 607 people. OUTCOME MEASURES Depressive symptoms, anxiety symptoms, dysfunctional thoughts, depression literacy, stigma, help seeking and cost-effectiveness. RESULTS Internet-based applications were effective in reducing depressive symptoms and stigmatising attitudes to depression and in improving depression literacy. School-based programs also showed promise in decreasing depressive symptoms. CONCLUSIONS Depression self-help and information programs can be delivered effectively by means of the Internet. As accessibility of face-to-face mental health services in rural areas is poor and as there is a strong culture of self-reliance and preference for self-managing health problems among rural residents, the Internet might offer an important platform for the delivery of help for depression in rural regions. Consideration should be given to developing programs tailored to rural settings and future research should evaluate the efficacy and effectiveness of such programs in rural settings.
Right colon interposition in corrosive esophageal long segment stricture: our local experience.

BACKGROUND Aim of our study is to highlight technical details in pedicled right colon interposition locally in cases of long segment corrosive esophageal stricture. Lesion results from cicatrization of burns wound inflicted by chemicals. Restoration of swallowing is of paramount importance. MATERIALS AND METHODS It was a retrospective study involving adult and adolescent patients who had surgery because of corrosive esophageal stricture between January 2001 and December 2010. Hospital records were reviewed for age, sex, radiological findings, detail of anesthesia, operative procedure, and follow up. The steps which included mobilization of colon with intact marginal blood supply, safeguarding the middle colic artery that forms the pedicle, and doing three anastomoses that were leak proof were ascertained. RESULT There were 12 males (70.5%) and six females (29.4%) and age ranged from 14 to 45 years. Caustic soda caused the problem among 10 (58.8%) patients while liquid acid battery was involved in three (17.6%) patients. The rest were distributed equally between native concoction and unknown substance. All were done under general anesthesia and mean duration of the procedure was 306.8 ± 54.6 min with an average intra operative blood loss of 823.1 ± 428.5 m. Sixteen (94.1%) had successful pedicle isolation and 15 (82.3%) patients had neither dysphagia nor reflux at follow-up. CONCLUSION Securing a pedicled right colon based on middle colic artery was a critical step. This surgical technique should be used to restore swallowing among patients with long segment esophageal stricture.
Disclosing the diagnosis of pediatric HIV infection: mothers' views.

ISSUES AND PURPOSE The stigma of HIV infection creates barriers to disclosure. The purpose of this study was to identify to whom biological and foster mothers disclose the diagnosis of HIV infection, discuss their rationale, and describe the recipient's reactions. DESIGN AND METHODS A descriptive, qualitative study included biological (n = 9) and foster (n = 11) mothers of children with HIV infection. RESULTS Three themes emerged from the data: Telling for support, determining who should know, and telling children. These themes were present for both biological and foster mothers. PRACTICE IMPLICATIONS It is important for nurses to realize that parental disclosure of the diagnosis of HIV infection is a long-term, age-appropriate process that will take place over many discussions and time, and should have the support of the interdisciplinary team. Additional psychological support also should be available.
Perfusion Measurement in Brain Gliomas with Intravoxel Incoherent Motion MRI

BACKGROUND AND PURPOSE: Intravoxel incoherent motion MRI has been proposed as an alternative method to measure brain perfusion. Our aim was to evaluate the utility of intravoxel incoherent motion perfusion parameters (the perfusion fraction, the pseudodiffusion coefficient, and the flow-related parameter) to differentiate high- and low-grade brain gliomas. MATERIALS AND METHODS: The intravoxel incoherent motion perfusion parameters were assessed in 21 brain gliomas (16 high-grade, 5 low-grade). Images were acquired by using a Stejskal-Tanner diffusion pulse sequence, with 16 values of b (0–900 s/mm2) in 3 orthogonal directions on 3T systems equipped with 32 multichannel receiver head coils. The intravoxel incoherent motion perfusion parameters were derived by fitting the intravoxel incoherent motion biexponential model. Regions of interest were drawn in regions of maximum intravoxel incoherent motion perfusion fraction and contralateral control regions. Statistical significance was assessed by using the Student t test. In addition, regions of interest were drawn around all whole tumors and were evaluated with the help of histograms. RESULTS: In the regions of maximum perfusion fraction, perfusion fraction was significantly higher in the high-grade group (0.127 ± 0.031) than in the low-grade group (0.084 ± 0.016, P < .001) and in the contralateral control region (0.061 ± 0.011, P < .001). No statistically significant difference was observed for the pseudodiffusion coefficient. The perfusion fraction correlated moderately with dynamic susceptibility contrast relative CBV (r = 0.59). The histograms of the perfusion fraction showed a “heavy-tailed” distribution for high-grade but not low-grade gliomas. CONCLUSIONS: The intravoxel incoherent motion perfusion fraction is helpful for differentiating high- from low-grade brain gliomas.
Compliance of primary care doctors with asthma guidelines and related education programs: the employment factor.

BACKGROUND Primary care physicians' adherence to accepted asthma guidelines is necessary for the proper care of asthma patients. OBJECTIVES To investigate the compliance of primary care physicians with clinical guidelines for asthma treatment and their participation in related educational programs, and to evaluate the influence of their employment status. METHODS A questionnaire was administered to a random sample of 1,000 primary care practitioners (pediatricians and family physicians) in Israel. RESULTS The response rate was 64%. Of the physicians who participated, 473 (75%) had read and consulted the guidelines but only 192 (29%) had participated in an educational program on asthma management in the last 12 months. The younger the responding physician (fewer years in practice), the more likely his/her attendance in such a program (p < 0.0001). After consulting the guidelines 189 physicians (40%) had modified their treatment strategies. Significantly more self-employed than salaried physicians had read the guidelines and participated in educational programs; physicians who were both self-employed and salaried fell somewhere between these groups. This trend was not influenced by the number of years in practice. CONCLUSIONS All primary care physicians should update their knowledge more often. The publication of guidelines on asthma must be followed by their proper dissemination and utilization. Our study suggests that major efforts should be directed at the population of employed physicians.
Separate components of emotional go/no-go performance relate to autism versus attention symptoms in children with autism.

OBJECTIVE The present investigation examined whether higher functioning children with autism would demonstrate impaired response inhibition performance in an emotional go/no-go task, and whether severity of attention-deficit/hyperactivity disorder (ADHD) or autism symptoms correlated with performance. METHOD Forty-four children (21 meeting criteria for autism; 23 typically developing controls [TDCs]) completed an emotional go/no-go task in which an emotional facial expression (angry, fearful, happy, or sad) was the go stimulus and a neutral facial expression was the no-go stimulus, and vice versa. RESULTS The autism group was faster than the TDC group on all emotional go trials. Moreover, the children in the autism group who had the fastest reaction times on emotional go trials were rated as having the greatest number of symptoms (Autism Diagnostic Observation Schedule Social + Communication score), even after accounting for the association with ADHD symptoms. The autism group also made more impulsive responses (i.e., lower d', more false alarms) than the TDC group on all trials. As d' decreased or false alarms increased, so did ADHD symptoms. Hyperactivity/impulsivity symptoms were significantly correlated with false alarms, but inattention symptoms were not. There was not a significant relationship between no-go false alarms and autism symptoms; even after partialing out associations with autism symptoms, the significant correlation between ADHD symptoms and no-go false alarms remained. CONCLUSION The present findings support a comorbidity model that argues for shared and independent risk factors, because ADHD and autism symptoms related to independent aspects of emotional go/no-go performance.
The Influence of Research Compensation Options on Practice-based Research Network (PBRN) Physician Participation: A North Texas (NorTex) PBRN Study

Objective: To study the effect of two compensation approaches, continuing medical education (CME) credits (5 hours) or monetary ($150), on the participation rate of a physician needs assessment study. Methods: Physicians representing family medicine, internal medicine, pediatric, and geriatrics specialties, and practicing in ambulatory primary care clinics affiliated with the North Texas Primary Care (NorTex) PBRN clinics, were recruited to complete a survey relevant to their subspecialty and to conduct a self-audit/abstraction of five medical records. Physicians were recruited from four health care systems, and the recruiting methods varied by system. Study outcome was the rate of study completion by type of incentive. Results: One hundred five of 211 (49.8%) physicians approached to participate gave consent and 84 (39.8%) completed the study. There was no difference in the number of physicians randomly assigned to monetary compared with CME compensation for giving consent to participate (adjusted odds ratio = 1.42, confidence interval = 0.69, 2.93). However, physicians in the monetary compensation group were more likely to complete the study after giving consent (adjusted odds ratio = 4.70, confidence interval = 1.25, 17.58). This monetary effect was also significant from the perspective of all physicians approached initially (adjusted odds ratio = 2.78, confidence interval = 1.16, 6.67). Discussion: This study suggests that future PBRN investigators should receive monetary compensation for the opportunity cost of adding research activities to their already busy practices. This compensation may be especially vital for PBRNs to complete more ambitious projects requiring a significant time commitment from the participating physicians.
Balance performance and self-perceived handicap among dizzy patients in primary health care

Objective. To study the diagnostic panorama at a primary health care centre where the physiotherapist is specialized in dizziness. To study balance measures of dizzy patients as well as measures of self-perceived handicap and to analyse whether these measures correlate. Design. Retrospective study of computerized medical records. Setting. A primary health care centre in Malmö, Sweden. Subjects. A total of 119 patients with dizziness, 73 women and 46 men, aged from 22 to 90 years.Main outcome measures. Diagnoses according to specified criteria. Four balance measures: tandem standing, standing on one leg, walking in a figure of eight, and walking heel to toe on a line. The Dizziness Handicap Inventory (DHI). Results. Six different groups of diagnoses were found: multisensory dizziness, peripheral vestibular disorder, dizziness as a symptom caused by whiplash-associated disorder, unspecific dizziness, phobic postural vertigo, and dizziness of cervical origin. The group with multisensory dizziness performed poorer on the balance measures than the other groups. The group with phobic postural vertigo had the highest total scores on DHI, while the vestibular group had the lowest total score. Subjects over 65 years old had more disturbances in balance, but a lower level of self-perceived handicap, than subjects aged 65 or younger. DHI did not correlate with any of the balance measures. Conclusions. Self-perceived handicap, measured with DHI, and disturbed balance measured with clinical methods, do not necessarily correlate. Elderly patients with dizziness seem to have more disturbances in balance than younger patients but a lower level of self-perceived handicap.
A Nine-Residue Synthetic Propeptide Enhances Secretion Efficiency of Heterologous Proteins inLactococcus lactis

ABSTRACT Lactococcus lactis, a gram-positive organism widely used in the food industry, is a potential candidate for the secretion of biologically useful proteins. We examined the secretion efficiency and capacity of L. lactis by using the Staphylococcus aureus nuclease (Nuc) as a heterologous model protein. When expressed in L. lactis from an efficient lactococcal promoter and its native signal peptide, only ∼60% of total Nuc was present in a secreted form at ∼5 mg per liter. The remaining 40% was found in a cell-associated precursor form. The secretion efficiency was reduced further to ∼30% by the deletion of 17 residues of the Nuc native propeptide (resulting in NucT). We identified a modification which improved secretion efficiency of both native Nuc and NucT. A 9-residue synthetic propeptide, LEISSTCDA, which adds two negative charges at the +2 and +8 positions, was fused immediately after the signal peptide cleavage site. In the case of Nuc, secretion efficiency was increased to ∼80% by LEISSTCDA insertion without altering the signal peptide cleavage site, and the yield was increased two- to fourfold (up to ∼20 mg per liter). The improvement of NucT secretion efficiency was even more marked and rose from 30 to 90%. Similarly, the secretion efficiency of a third protein, the α-amylase ofBacillus stearothermophilus, was also improved by LEISSTCDA. These data indicate that the LEISSTCDA synthetic propeptide improves secretion of different heterologous proteins in L. lactis.
Dose‐dependent effects of an immune challenge at both ultimate and proximate levels in Drosophila melanogaster

Immune responses are highly dynamic. The magnitude and efficiency of an immune response to a pathogen can change markedly across individuals, and such changes may be influenced by variance in a range of intrinsic (e.g. age, genotype, sex) and external (e.g. abiotic stress, pathogen identity, strain) factors. Life history theory predicts that up‐regulation of the immune system will come at a physiological cost, and studies have confirmed that increased investment in immunity can reduce reproductive output and survival. Furthermore, males and females often have divergent reproductive strategies, and this might drive the evolution of sex‐specific life history trade‐offs involving immunity, and sexual dimorphism in immune responses per se. Here, we employ an experiment design to elucidate dose‐dependent and sex‐specific responses to exposure to a nonpathogenic immune elicitor at two scales – the ‘ultimate’ life history and the underlying ‘proximate’ immune level in Drosophila melanogaster. We found dose‐dependent effects of immune challenges on both male and female components of reproductive success, but not on survival, as well as a response in antimicrobial activity. These results indicate that even in the absence of the direct pathogenic effects that are associated with actual disease, individual life histories respond to a perceived immune challenge – but with the magnitude of this response being contingent on the initial dose of exposure. Furthermore, the results indicate that immune responses at the ultimate life history level may indeed reflect underlying processes that occur at the proximate level.
College students' uses and perceptions of social networking sites for health and wellness information

Introduction. This study explores college students' use of social networking sites for health and wellness information and their perceptions of this use. Method. Thirty-eight college students were interviewed. Analysis. The interview transcripts were analysed using the qualitative content analysis method. Results. Those who had experience using social networking sites for health information used the platform mainly to check health updates of a loved one, find lifestyle information and ask about treatments for mild conditions. Overall, participants were sceptical about the quality of information, concerned about the lack of medical knowledge of their friends or peers and wary about possible social risks and invasion of privacy. Based on the results, a model of users' acceptance of social networking sites for health and wellness information was proposed and implications for designing social platforms to better support health inquiries were discussed. Conclusions. Using social networking sites for health and wellness information is not a popular behaviour among college students in this study and social networking sites seem not to be a well-perceived platform for health and wellness information.