Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparative evaluation of microdiscectomy only, autograft fusion, polymethylmethacrylate interposition, and threaded titanium cage fusion for treatment of single-level cervical disc disease: a prospective randomized study in 125 patients.

OBJECT The need for interbody fusion or stabilization after anterior cervical microdiscectomy is still debated. The objectives of this prospective randomized study were 1) to examine whether combined interbody fusion and stabilization is more beneficial than microdiscectomy only (MDO) and 2) if fusion is found to be more beneficial than MDO, to determine which is the best method of fusion by comparing the results achieved using autologous bone graft (ABG), polymethylmethacrylate (PMMA) interposition, and threaded titanium cage (TTC). METHODS A total of 125 patients with a single-level cervical disc disease were included in this prospective study. All patients were randomized and assigned to one of the four following groups: Group 1 (33 patients), MDO; Group 2 (30 patients), microdiscectomy followed by ABG; Group 3 (26 patients), microdiscectomy followed by injection of PMMA; and Group 4 (36 patients), microdiscectomy followed by placement of a TTC. Clinical outcome according to Odom criteria was summarized as 1) excellent and good or 2) satisfactory and poor. One-year follow-up examination was performed in 123 patients. Patients in the TTC group experienced a significantly better outcome 6 months after surgery (92% excellent and good results) compared with those in the MDO and ABG groups (72.7 and 66.6% excellent and good results, respectively). Twelve months after surgery there was still a significant difference in outcomes between the TTC group (94.4% excellent and good results) and the MDO group (75.5% excellent and good results). Outcome in patients treated with PMMA was comparable with that in those treated with TCC after 6 (91.6%) and 12 months (87.5%), but no segmental fusion was achieved. Differences compared with MDO and ABG were, however, not significant, which may be related to the smaller number of patients in the PMMA group. CONCLUSIONS Interbody cage-assisted fusion yields a significantly better short- and intermediate-term outcome than MDO in terms of return to work, radicular pain, Odom criteria, and earlier fusion. In addition, the advantages of interbody cages over ABG fusion included better results in terms of return to work, Odom criteria, and earlier fusion after 6 months. These results suggest that interbody cage-assisted fusion is a promising therapeutic option in patients with single-level disc disease. Polymethylmethacrylate seems to be a good alternative to interbody cage fusion but is hindered by the absence of immediate fusion.
Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study

Objective To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. Methods A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from ‘traditional’ rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Results Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=−0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56–0.77) for all years. Conclusions Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators.
Clinical Implications of Electrocardiographic Left Ventricular Strain and Hypertrophy in Asymptomatic Patients With Aortic Stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis Study

Background— The prognostic impact of ECG left ventricular strain and left ventricular hypertrophy (LVH) in asymptomatic aortic stenosis is not well described. Methods and Results— Data were obtained in asymptomatic patients randomized to simvastatin/ezetimibe combination versus placebo in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Primary end point was the first of myocardial infarction, nonhemorrhagic stroke, heart failure, aortic valve replacement, or cardiovascular death. The predictive value of ECG left ventricular strain (defined as T-wave inversion in leads V4 through V6) and LVH, assessed by Sokolow-Lyon voltage criteria (RV5–6+SV1 ≥35 mV) and Cornell voltage-duration criteria {[RaVL+SV3+(6 mV in women)]×QRS duration ≥2440 mV · ms}, was evaluated by adjustment for other prognostic covariates. A total of 1533 patients were followed for 4.3±0.8 years (6592 patient-years of follow-up), and 627 cardiovascular events occurred. ECG strain was present in 340 patients (23.6%), with LVH by Sokolow-Lyon voltage in 260 (17.1%) and by Cornell voltage-duration product in 220 (14.6%). In multivariable analyses, ECG left ventricular strain was associated with 3.1-fold higher risk of in-study myocardial infarction (95% confidence interval, 1.4–6.8; P=0.004). Similarly, ECG LVH by both criteria predicted, compared with no ECG LVH, 5.8-fold higher risk of heart failure (95% confidence interval, 2.0–16.8), 2.0-fold higher risk of aortic valve replacement (95% confidence interval, 1.3–3.1; both P=0.001), and 2.5-fold higher risk of a combined end point of myocardial infarction, heart failure, or cardiovascular death (95% confidence interval, 1.3–4.9; P=0.008). Conclusions— ECG left ventricular strain and LVH were independently predictive of poor prognosis in patients with asymptomatic aortic stenosis. Clinical Trial Registration— http://www.clinicaltrials. gov. Unique identifier: NCT00092677.
A novel image interpolation method using the bilateral filter

In general, since the noise deteriorates the interpolation performance in digital images, it is effective to employ denoising prior to the interpolation. In this paper, we propose a novel interpolation framework in which denoising and image sharpening methods are embedded. In the proposed framework, the image is first decomposed using the bilateral filter into the detail and base layers which represent the small and large scale features, respectively. The detail layer is adaptively smoothed to suppress the noise before interpolation and an edge-preserving interpolation method is applied to both layers. Finally, the high resolution image is obtained by combining the base and detail layers. Experimental results show that the proposed algorithm outperforms the conventional methods while suppressing blurring and jagging.
Does Competition Policy Implementation Affect the Intensity of Competition ? *

Although many transition and developing economies have established competition offices, there is yet little systematic evidence about implementation experience and its impact on intensity of economywide competition. This paper aims to fill this gap in the literature in two ways. First, it provides an overview of progress in implementation based on a major survey directed to both competition agencies and legal experts in the area of competition policy implemented over a ten year period from 1995 to 2005. It then examines the main policy and structural determinants of the intensity of competition at the enterprise level across transition economies, presenting new evidence using three rounds of an enterprise-level survey implemented in 1999, 2002 and 2005 by the EBRD and the World Bank. The key findings are summarized as follows. At the country level, an important finding is that competition policy implementation is significantly and positively correlated with the intensity of competition, a result which holds robustly from all the three rounds of the enterprise level surveys and to the introduction of other policy-level controls and alternative specifications of the basic model. On the contrary, privatization is either not significantly or is negatively correlated to the intensity of competition, confirming that privatization, in the absence of the development of adequate market supporting institutions, does not lead to a more competitive environment.
The prevalence of hearing impairment and associated risk factors: the Beaver Dam Offspring Study.

OBJECTIVE To estimate the prevalence of hearing impairment (HI) and evaluate the cross-sectional associations of environmental and cardiovascular disease risk factors and HI in middle-aged adults. DESIGN Data were collected as part of the Beaver Dam Offspring Study, an epidemiological cohort study of aging. Hearing impairment was defined as a pure-tone average (0.5, 1.0, 2.0, and 4.0 kHz) greater than 25 db hearing level in either ear. Word recognition in competing message (WRCM) was measured using the Northwestern University No. 6 word list. Questionnaire information about behaviors, environmental factors, and medical history was also collected. PARTICIPANTS The participants (N = 3285) were offspring of participants of the population-based Epidemiology of Hearing Loss Study and ranged in age from 21 to 84 years (mean age, 49 years). RESULTS The prevalence of HI was 14.1%, and the mean (SD) WRCM score was 64% (15%). In a multivariate model, after age, sex, education, and occupational noise were controlled for, a history of ear surgery (odds ratio [OR], 4.11; 95% confidence interval [CI], 2.37-7.15), a larger central retinal venular equivalent (OR, 1.77; 95% CI, 1.20-2.60 [fourth quartile vs first quartile]), and a higher hematocrit percentage (OR, 0.77; 95% CI, 0.63-0.95 [per 5%]) were independently associated with HI. Factors associated with lower WRCM scores were similar but also included mean intima-media thickness (mean difference, -0.63%; 95% CI, -1.06% to -0.19%; P = .005 [per 0.1 mm]) and statin use (mean difference, -2.09%; 95% CI, -3.58% to -0.60%; P = .005). CONCLUSIONS Hearing impairment is a common condition in middle-aged adults. Cardiovascular disease risk factors may be important correlates of age-related auditory dysfunction.
There are stable individual differences in performance variability, both from moment to moment and from day to day

Individual differences in decision speed have been regarded as direct reflections of a “primitiv” functional neurophysiological characteristic, which affects performance on all cognitive tasks and so may be regarded as the “biological basis of intelligence”, or of age-related changes in mental abilities. More detailed analyses show that variability within an experimental session (WSV) is a stable individual difference characteristic and that mean choice reaction times (CRTs) are gross summary statistics that reflect variability, rather than maximum speed of performance. A total of 98 people aged from 60 to 80 years completed 36 weekly sessions on six different letter categorization tasks. After effects of practice and of circadian variability had been eliminated, individuals with lower scores on the Cattell Culture Fair intelligence test had slower CRTs and greater WSV on all tasks. A simulation study showed that the greater WSVs of low Cattell scorers led directly to the significantly greater variability of their mean CRTs from session to session. However because CRTs on tasks co-varied from session to session it was apparent that, besides being affected by WSV, individuals’ between-session variabilities (BSVs) also vary because of state changes that affect their performance from day to day. It seems that both variability in performance from trial to trial during a session and variability in average performance from day to day are correlated, stable, individual difference characteristics that vary inversely with intelligence test performance. Methodological consequences of these results for interpretations of age-related cognitive changes, for variability between as well as within individuals, for individual differences in decision speed, and for circadian variability in performance are discussed.
Maintaining the integrity of older patients in long-term institutions: relatives' perceptions.

AIM To study relatives' views on how the integrity of older patients is maintained in long-term institutions in Finland. BACKGROUND aintaining patient integrity is considered a key prerequisite for good quality care and treatment and a characteristic of ethical care. Institutionalization, dependence on others and vulnerability may all threaten the integrity of the older patient and, in this sense, pose ethical problems. DESIGN/METHODS The data for this descriptive and explorative survey were collected by questionnaires from 213 relatives of older patients in four long-term institutions in Finland. The response rate was 78%. Data were analysed using statistical methods. RESULTS Relatives rated the maintenance of patient integrity quite highly. The highest ratings were recorded for the maintenance of physical integrity and the lowest to the maintenance of psychological integrity. The main source of problems were patients' and/or relatives' wishes concerning elimination. There were also shortcomings in the provision of intimacy. Relatives who thought that admission to the long-term institution had been problematic, either for the patient or for themselves, felt that patient integrity was poorly maintained. CONCLUSION The findings highlight the importance of nurses' efforts in long-term care facilities to preserve the integrity of patients and to maintain close contact and cooperation with relatives. Although relatives generally were quite pleased with how patient integrity was maintained, the results also provide evidence on problems that may threaten patient integrity. RELEVANCE TO CLINICAL PRACTICE Greater emphasis should be placed on the need for cooperation between older patients, their relatives and nursing staff, especially before admission to long-term care. Furthermore, increased efforts are needed in maintaining the integrity of older patients and in reducing ethically problematic situations.
Pretreatment serum hepatitis C virus RNA levels and hepatitis C virus genotype are the main and independent prognostic factors of sustained response to interferon alfa therapy in chronic hepatitis C

The aim of the study was to determine the respective influence of pretreatment serum hepatitis C virus (HCV) RNA levels and HCV genotype on the response to interferon (IFN) alfa in patients with chronic hepatitis C. We retrospectively studied 141 patients with chronic hepatitis C included in two consecutive controlled trials of IFN alfa. A sustained response was observed in 28, a response followed by relapse in 43, and no response in 70 patients. Pretreatment serum HCV RNA quantitation with the branched DNA (bDNA) assay and HCV genotyping with reverse hybridization assay (LiPA) were performed in all patients. Seventy‐four percent of the patients had detectable serum HCV RNA (43%, 77% and 84%) in the three groups of patients with sustained response, relapse, and no response, respectively (P = .005). Mean serum HCV RNA level were 1.4 ± 6 × 106, 4.8 ± 6 × 106, and 3.9 ± 5 × 106 genomes/mL in patients with sustained response, response and relapse, and no response, respectively (P < .01). Genotype 1b was found in 7%, 47%, and 46% of the patients in the three response groups, respectively. By univariate analysis, age, source, and duration of HCV infection, serum HCV RNA levels, and HCV genotypes were significantly different in the three response groups. By multivariate analysis, the only independent factors associated with sustained response were low serum HCV RNA levels and HCV genotype other than 1b. Pretreatment serum HCV RNA levels and HCV genotype are the main and independent factors associated with sustained response to IFN therapy. (HEPATOLOGY 1995; 22:1050–1056.).
Electrodynamic Heart Model Construction and ECG Simulation

Summary Objectives: In this paper, we present a unified electrodynamic heart model that permits simulations of the body surface potentials generated by the heart in motion. The inclusion of motion in the heart model significantly improves the accuracy of the simulated body surface potentials and therefore also the 12-lead ECG. Methods: The key step is to construct an electromechanical heart model. The cardiac excitation propagation is simulated by an electrical heart model, and the resulting cardiac active forces are used to calculate the ventricular wall motion based on a mechanical model. The source-field point relative position changes during heart systole and diastole. These can be obtained, and then used to calculate body surface ECG based on the electrical heart-torso model. Results: An electromechanical biventricular heart model is constructed and a standard 12-lead ECG is simulated. Compared with a simulated ECG based on the static electrical heart model, the simulated ECG based on the dynamic heart model is more accordant with a clinically recorded ECG, especially for the ST segment and T wave of a V1-V6 lead ECG. For slight-degree myocardial ischemia ECG simulation, the ST segment and T wave changes can be observed from the simulated ECG based on a dynamic heart model, while the ST segment and T wave of simulated ECG based on a static heart model is almost unchanged when compared with a normal ECG. Conclusions: This study confirms the importance of the mechanical factor in the ECG simulation. The dynamic heart model could provide more accurate ECG simulation, especially for myocardial ischemia or infarction simulation, since the main ECG changes occur at the ST segment and T wave, which correspond with cardiac systole and diastole phases.
Identifiability and global estimability tools for dynamical systems

The identifiability and estimability properties of dynamical systems have been extensively studied in the literature. However, such approaches often focus on the sensitivity of system trajectories to perturbations in parameter values about some nominal parameter value. Relying on parameter sensitivity to assess parameter estimability can be misleading because the neighbourhood over which the sensitivity equations provide a good approximation of parameter influence can be very small. In this work, a complimentary notion of asymptotic sensitivity is defined. The asymptotic sensitivity is a measure of how much parameter values can be perturbed from their nominal value without affecting the number or type of steady state points available to the system. Such a notion is especially useful for systems that allow multiple steady states with different qualitative behaviour or where the asymptotic behaviour of the system is much better characterized than state trajectories. An efficient computational scheme for computing asymptotic sensitivity is presented. The proposed computational scheme is applied to a simple bioreactor system.
Anti-JC virus antibody prevalence in a multinational multiple sclerosis cohort

JC virus (JCV) is an opportunistic virus known to cause progressive multifocal leukoencephalopathy. Anti-JC virus (Anti-JCV) antibody prevalence in a large, geographically diverse, multi-national multiple sclerosis (MS) cohort was compared in a cross-sectional study. Overall, anti-JCV antibody prevalence was 57.6%. Anti-JCV antibody prevalence in MS patients ranged from approximately 47% to 68% across these countries: Norway, 47.4%; Denmark, 52.6%; Israel, 56.6%; France, 57.6%; Italy, 58.3%; Sweden, 59.0%; Germany, 59.1%; Austria, 66.7% and Turkey, 67.7%. Prevalence increased with age (from 49.5% in patients < 30 years of age to 66.5% in patients ≥ 60 years of age; p < 0.0001 comparing all age categories), was lower in females than in males (55.8% versus 61.9%; p < 0.0001) and was not affected by prior immunosuppressant or natalizumab use.
In vitro evaluation of the internalization and toxicological profile of silica nanoparticles and submicroparticles for the design of dermal drug delivery strategies

The use of colloidal silica nanoparticles and sub‐microparticles (SiPs) have been considered a very interesting strategy for drug delivery applications. In the present study, we have focused our attention on the suitability of these nanomaterials as potential carriers for dermal drug delivery, thus studying their toxicological profile in vitro, cellular uptake and intracellular localization in both human keratinocytes (K17) and human dermal fibroblasts (HDF) as a function of their particle size (SiPs of 20, 70, 200 and 500 nm). Full characterization of these aspects enabled us to observe a strong cell‐type dependency in terms of cytotoxicity and cell internalization, whereas particle size was only relevant for ultra‐small SiPs (20 nm), being the most toxic SiPs. For 70, 200 and 500 nm SiPs, the differences in uptake and intracellular trafficking determined the different toxicological profiles in K17 and HDF. In addition, these characteristics can further define different drug delivery strategies. Hence, phagocytosis has been identified as the main internalization mechanism for K17, and caveolae‐mediated endocytosis for HDF. This relevant information led us to conclude that fibroblasts would be optimal targets for delivering delicate therapeutic molecules such as proteins or genetic material using SiPs while maintaining a low toxicity profile, whereas keratinocytes could enable accelerated drug release therapies based on SiPs.
ReviewGenomic Rearrangements and Gene Copy-Number Alterations as a Cause of Nervous System Disorders

Genomic disorders are a group of human genetic diseases caused by genomic rearrangements resulting in copy-number variation (CNV) affecting a dosagesensitive gene or genes critical for normal development or maintenance. These disorders represent a wide range of clinically distinct entities but include many diseases affecting nervous system function. Herein, we review selected neurodevelopmental, neurodegenerative,andpsychiatricdisorderseitherknown or suggested to be caused by genomic rearrangement and CNV. Further, we emphasize the cause-and-effect relationship between gene CNV and complex disease traits. We also discuss the prevalence and heritability of CNV, the correlation between CNV and higher-order genomearchitecture, and theheritabilityofpersonality, behavioral, and psychiatric traits. We speculate that CNV could underlie a significant proportion of normal human variation including differences in cognitive, behavioral, and psychological features.