Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment of intermittent claudication with physical training, smoking cessation, pentoxifylline, or nafronyl: a meta-analysis.

BACKGROUND There is no consensus on the efficacy of physical training, smoking cessation, and pharmacological therapy (pentoxifylline or nafronyl oxalate) in the treatment of patients with intermittent claudication at Fontaine stage II of disease. METHODS A MEDLINE and manual search was used to identify relevant publications. Uncontrolled or retrospective studies, double reports, and trials without clinically meaningful outcomes were excluded. Included studies were graded level 1 (randomized and double- or assessor-blind), level 2 (open randomized), or level 3 (nonrandomized). Pain-free and total walking distance were the main outcomes considered; when feasible, end-of-treatment results were combined with appropriate meta-analytical procedures. RESULTS In 5 level 2 studies, physical training increased pain-free and total walking distance significantly (139.0 m [95% confidence interval {CI}, 31.0 to 246.9 m] and 179.1 m [95% CI, 60.2 to 298.1 m], respectively). In a level 3 study, smoking cessation resulted in a nonsignificant increase in total walking distance of 46.7 m (95% CI, -19.3 to 112.7 m). In 6 level 1 studies, pentoxifylline increased both pain-free and total walking distance by 21.0 m (95% CI, 0.7 to 41.3 m) and 43.8 m (95% CI, 14.1 to 73.6 m), respectively. In 4 level 1 trials, nafronyl significantly increased pain-free walking distance (58.6 m [95% CI, 30.4 to 86.8 m]) and total walking distance (71.2 m [95% CI, 13.3 to 129.0 m]). CONCLUSIONS Physical training increased pain-free and total walking distance in level 2 studies. Only level 3 studies support the usefulness of smoking cessation. In level 1 studies, pentoxifylline and nafronyl increased pain-free and total walking distance, but the average effects were relatively small.
Descemet Stripping and Automated Endothelial Keratoplasty (DSAEK) in Eyes With Failed Penetrating Keratoplasty

Purpose: To report our results of using Descemet stripping and automated endothelial keratoplasty (DSAEK) in eyes with failed penetrating keratoplasty (PK). Methods: An institutional review board-approved, prospective, surgical case series of 7 eyes of 7 consecutive patients undergoing DSAEK for graft failure after 1 or more PKs at 1 academic eye center. Results: The mean follow-up period was 13.3 months (range, 9-18 months). One eye suffered recurrent donor graft dislocation and elected to undergo repeat PK instead of repeat DSAEK. Of the remaining 6 patients, the average preoperative visual acuity (VA) was 20/851 compared with a best-corrected visual acuity (BCVA) of 20/65 postoperatively (P = 0.008). After DSAEK, 6 (100%) eyes showed improved BCVA, and 4 of 6 eyes (67%) achieved a BCVA of 20/40 or better. All 6 grafts remained clear at the last follow-up visit. Two eyes showed graft dislocation on the first postoperative day and underwent repositioning of the lenticule with good results. Two other eyes were diagnosed with primary iatrogenic graft failure within 1 week of DSAEK and underwent repeat DSAEK with new donor tissue with good results. One eye experienced acute graft rejection that was successfully treated with topical steroids. Conclusions: This pilot series of DSAEK in eyes with graft failure from previous PK shows favorable VA and graft clarity outcomes. The complications observed were similar to those observed for DSAEK for Fuchs dystrophy and pseudophakic bullous keratopathy and include graft dislocation, iatrogenic graft failure, and homograft rejection.
Neuropsychiatric aspects of progressive supranuclear palsy

Administering the Neuropsychiatric Inventory (NPI), we examined the behavioral symptoms of 22 patients with progressive supranuclear palsy (PSP), 50 patients with Alzheimer's disease, and 40 controls.PSP patients exhibited apathy (91%), disinhibition (36%), dysphoria (18%) and anxiety (18%), but rarely (<9%) irritability, abnormal motor behaviors, or agitation. Apathy in PSP was significantly associated with executive dysfunction. The presence of high apathy and low agitation and anxiety scale scores correctly identified the PSP patients 85% of the time. Evaluating the behavioral abnormalities of patients with neurodegenerative disorders will aid diagnosis and facilitate management. NEUROLOGY 1996;47: 1184-1189
A PRECEDE–PROCEED MODEL ON THE DETERMINANTS OF ADHERENCETO HIV TREATMENT: A PATH ANALYSIS EVIDENCE FROM INDONESIA

Objective: Adherence is increasingly recognized as an important determinant of successful HIV treatment (also called antiretroviral therapy [ART]). Poor adherence may cause ART failure and increase the risk of drug resistance. No prior studies have explained the reasons for poor adherence to ART among HIV-infected patients in Indonesia. This study aimed to investigate the determinants of adherence to ART among HIV-infected patients using precede–proceed model and path analysis.Methods: This was an analytic observational study with a cross-sectional design. The study was carried out at Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia, from January to March 2018. A total of 284 HIV-infected patients visiting Dr. Moewardi Hospital for ART was selected for this study by simple random sampling. The dependent variable was adherence to ART. The independent variables included adverse effect, patient knowledge, income, depression, trust in provider, ART supply by the government, family support, stigma, discrimination, distance, and travel expenditure. The data were collected by pre-tested questionnaire and analyzed by path analysis.Results: Adherence to ART was directly and positively affected by government supply of ART (b=2.10; 95% confidence interval (CI)=0.85–3.36; p<0.001), patient knowledge (b=1.70; 95% CI= 0.43–2.95; p=0.008), and trust in provider (b=2.14; 95% CI=−0.58–4.87; p = 0.123). Adherence was directly but negatively affected by adverse effect (b=−4.17; 95% CI=−6.87–−1.47 ; p=0.879), depression (b=−2.38; 95% CI=−4.15–−0.62 ; p=0.002), stigma (b=−4.10; 95% CI=−6.49–−1.71; p=0.008), and travel expenditure (b=−1.52; 95% CI=−2.68 to −0.36; p<0.001). Conclusion: Adherence is indirectly and positively affected by patient satisfaction, income, family support, but indirectly and negatively affected by discrimination and distance. This study concludes that government supply of ART, patient knowledge, and trust in provider, positively affect adherence to ART. Adverse effect, depression, stigma, and travel expenditure negatively affect adherence.
Projection Structure of the Atractyloside-inhibited Mitochondrial ADP/ATP Carrier of Saccharomyces cerevisiae*

ADP/ATP carriers in the inner mitochondrial membrane catalyze the exchange of cytosolic ADP for ATP synthesized in the mitochondrial matrix by ATP synthase and thereby replenish the eukaryotic cell with metabolic energy. The yeast ADP/ATP carrier (AAC3) was overexpressed, inhibited by atractyloside, purified, and reconstituted into two-dimensional crystals. Images of frozen hydrated crystals were recorded by electron microscopy, and a projection structure was calculated to 8-Å resolution. The AAC3 molecule has pseudo 3-fold symmetry in agreement with the 3-fold sequence repeats that are typical of members of the mitochondrial carrier family. The density distribution is consistent with a bundle of six transmembrane α-helices with two or three short α-helical extensions closing the central pore on the matrix side. The AAC3 molecules in the crystal are arranged in symmetrical homo-dimers, but the translocation pore for adenine nucleotides lies in the center of the molecule and not along the dyad axis of the dimer.
Optimisation de la prise en charge de la rectocolite hémorragique : de la théorie à la pratique

La rectocolite hemorragique (RCH) est une maladie inflammatoire chronique de l'intestin responsable d'un handicap et d'une alteration de la qualite de vie pouvant exposer les patients a des complications severes en depit des therapeutiques actuelles. L'objectif de cette these etait d'analyser les voies possibles d'amelioration de la prise en charge therapeutique des patients a partir de donnees experimentales et cliniques. Au niveau experimentale nous nous sommes interesses au mecanisme implique dans la regulation de l'expression de PPARγ, recepteur nucleaires aux proprietes anti-inflammatoires, primitivement diminuee au cours de la RCH et cible des 5-aminosalicyles. Il a ete montre que son expression etait d'une part sous le controle de la steroidogenese intraepitheliale, elle-meme sous controlee par LRH-1 et d'autre part que l'hypoxie epitheliale diminuait son expression via une sur-expression de miR-27a. Par ailleurs, les effets de l'hypoxie sur l'expression de PPARγ etaient inverses en presence de sildenafil. Sur le versant clinique, l'analyse d'une nouvelle strategie therapeutique ciblant la cicatrisation muqueuse, c'est a dire l'abrogation de l'inflammation colique macroscopique etait efficace et possible dans la pratique clinique. Cet objectif semble aujourd’hui fondamental pour diminue la morbi-mortalite induite par cette maladie. Enfin nous avons observe l'efficacite des anti-TNF dans le cas specifique de la rectite refractaire et l'importance de son utilisation prolongee pour eviter les rechutes de la maladie et l’obtention d’une remission prolongee.
Path Following of a Surface Vessel With Prescribed Performance in the Presence of Input Saturation and External Disturbances

This paper presents a path following controller of a surface vessel with a prescribed performance in the presence of input saturation and external disturbances. Based on the three degrees-of-freedom model of the surface vessel, the designed backstepping control scheme features three functional parts, namely, guidance, attitude control, and velocity control. To guarantee that the position errors are confined within the prescribed convergence rates and maximum overshoot, a performance constrained guidance law is formulated with an error transformed function. Command filters are incorporated in the control subsections to limit the magnitude of the virtual controls and simultaneously avoid arduous computations involving their time derivatives. Subsequently, auxiliary systems that are governed by smooth switching functions are developed in an unprecedented manner to compensate for the saturation constraints on actuators. Nonlinear disturbance observers are concurrently introduced to estimate the unknown external disturbances for increasing system's robustness. It is demonstrated that under the proposed control, the prescribed transient and steady tracking performance bounds are never violated, and all closed-loop signals remain uniformly ultimately bounded, despite the presence of input saturation and disturbances. Results from a comparative simulation study illustrate the effectiveness and advantages of the proposed method.
Evolution of VHL tumourigenesis in nerve root tissue

Haemangioblastomas are the key central nervous system manifestation of von Hippel–Lindau (VHL) disease, which is caused by germline mutation of the VHL gene. We have recently shown that ‘tumour‐free’ spinal cord from patients with VHL disease contains microscopic, poorly differentiated cellular aggregates in nerve root tissue, which we descriptively designated ‘mesenchymal tumourlets’. Here we have investigated spinal cord tissue affected by multiple tumours. We show that a small subset of mesenchymal tumourlets extends beyond the nerve root to form proliferative VHL‐deficient mesenchyme and frank haemangioblastoma. We thus demonstrate that tumourlets present potential, but true precursor material for haemangioblastoma. We further show that intraradicular tumourlets consist of scattered VHL‐deficient cells with activation of HIF‐2α and HIF‐dependent target proteins including CAIX and VEGF, and are associated with an extensive angiogenic response. In contrast, activation of HIF‐1α was only observed in the later stages of tumour progression. In addition, ultrastructural examination reveals gradual transition from poorly differentiated VHL‐deficient cells into vacuolated cells with a ‘stromal’ cell phenotype. The evolution of frank haemangioblastoma seems to involve multiple steps from a large pool of precursor lesions. Copyright © 2006 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Severity, chronicity, and timing of maternal depression and risk for adolescent offspring diagnoses in a community sample.

BACKGROUND Risk for depression and other disorders is known to be high among children of depressed mothers, but little is known about the parameters of severity, chronicity, and timing of depression and its effects on children. The study addresses these issues, disaggregating their overlapping effects. METHODS A sample of 816 women and their 15-year-old children in an Australian community were selected from a large birth cohort study to represent variation in maternal depression history during the child's first 10 years of life. Quantification of maternal depression severity and duration, and dates of occurrence, permitted analyses of youth depression and nondepressive disorders as a function of relative severity, chronicity, and timing of maternal depression. RESULTS Diagnosable depression in children as old as 15 years was twice as likely among offspring of depressed, as compared with never-depressed mothers. After controls for demographic factors, severity of maternal depression contributed more to children's risk for depression than did chronicity. Children exposed even to 1 to 2 months of maternal major depression, or to more than 12 months of mild depression had elevated risks of depression; however, chronicity of maternal depression was associated more with nondepressive outcomes than was severity. Timing of exposure did not differentially predict risk for the disorder in children when separated from confounding chronicity and severity parameters. CONCLUSIONS Even relatively brief maternal major depression, but more prolonged mild depression, predicted children's risk for depressive disorders by age 15 years in a community sample. Nondepressive outcomes were more complex to predict, which was due in part to difficulty dating disorder onset in relation to maternal depression. Exposure to maternal depression at any period in the first 10 years equally predicted youth depression if the mother was depressed only once. Further studies are needed to shed light on the mechanisms by which maternal depression has its effects.
Measure for Measure: How Well Do We Measure Micro-Level Conflict Intensity?

Rich measures of micro-level violent conflict intensity are key for successfully providing insight into the legacy of civil war. Yet, the debate on how exactly conflict intensity should be measured has just started. This paper aims to fuel this awakening debate. It is demonstrated how existing and widely available data - population census data - can provide the basis for a useful measure of micro-level conflict intensity: a fine Wartime Excess Mortality Index (WEMI). It is argued that the proposed measure is particularly well suited for studying the legacy of civil wars that are characterized by a large death toll and by different forms of violence. The measure is illustrated for the case of Rwanda and it is shown that, in a straightforward empirical application of the impact of armed conflict on schooling, the estimated impact varies widely across WEMI and a large set of alternative conflict intensity measures for Rwanda. While the conflict intensity measure proposed in this paper requires further study and one probably needs a combination of various methodologies, this finding suggests the need for a careful understanding of what underlies the different measures and methodologies in use.
Role of Gender and Genetic Variance in Plasminogen Activator Inhibitor-1 Secretion from Human Adipose Tissue

Summary Gender and the 4G/5G polymorphism in the plasminogen activator inhibitor 1 (PAI-1) gene are believed to play a role in the regulation of plasma PAI-1 activity. Adipose tissue has been found to be an important source of PAI-1. The possible influence of gender and the 4G/5G polymorphism in the PAI-1 gene on PAI-1 secretion from abdominal subcutaneous adipose tissue was investigated in 59 women and 32 men. The subjects were apparantly healthy, although they differed markedly inter-individually in body mass index (21-53 kg/m2). The 4G/5G polymorphism did not influence the adipose secretion rate of PAI-1 or plasma PAI-1 activity. There was no gender difference in the adipose secretion of PAI-1. In multiple regression, including body mass index (BMI), waist-to-hip ratio (WHR), plasma insulin and plasma triglycerides as the independent and adipose PAI-1 secretion as the dependent variable, only BMI and plasma triglycerides correlated independently with adipose PAI-1 secretion (r = 0.54, p <0.05; r = 0.51, p <0.05, respectively). Men had a two times higher plasma PAI-1 activity than women (p <0.05). This gender difference was mainly due to gender differences in WHR. In multiple regression analysis, BMI and WHR were identified to be independently correlated with plasma PAI-1 activity (r = 0.60, p <0.05; r = 0.52, p = 0.01, respectively). In conclusion, neither gender nor the 4G/5G polymorphism in the PAI-1 gene are associated with secretion of PAI-1 from abdominal subcutaneous adipose tissue.
Identifying Hotspots of Multidrug-Resistant Tuberculosis Transmission Using Spatial and Molecular Genetic Data.

BACKGROUND We aimed to identify and determine the etiology of "hotspots" of concentrated multidrug-resistant tuberculosis (MDR-tuberculosis) risk in Lima, Peru. METHODS From 2009 to 2012, we conducted a prospective cohort study among households of tuberculosis cases from 106 health center (HC) areas in Lima, Peru. All notified tuberculosis cases and their household contacts were followed for 1 year. Symptomatic individuals were screened by microscopy and culture; positive cultures were tested for drug susceptibility (DST) and genotyped by 24-loci mycobacterial interspersed repetitive units-variable-number tandem repeats (MIRU-VNTR). RESULTS 3286 individuals with culture-confirmed disease, DST, and 24-loci MIRU-VNTR were included in our analysis. Our analysis reveals: (1) heterogeneity in annual per-capita incidence of tuberculosis and MDR-tuberculosis by HC, with a rate of MDR-tuberculosis 89 times greater (95% confidence interval [CI], 54,185) in the most-affected versus the least-affected HC; (2) high risk for MDR-tuberculosis in a region spanning several HCs (odds ratio = 3.19, 95% CI, 2.33, 4.36); and (3) spatial aggregation of MDR-tuberculosis genotypes, suggesting localized transmission. CONCLUSIONS These findings reveal that localized transmission is an important driver of the epidemic of MDR-tuberculosis in Lima. Efforts to interrupt transmission may be most effective if targeted to this area of the city.
Inpatient rehabilitation outcomes in solid organ transplantation: Results of a unique partnership between the rehabilitation hospital and the multi-organ transplant unit in an acute hospital

Objective: To determine the outcomes in solid organ transplant recipients following inpatient rehabilitation, as a result of a unique partnership between the rehabilitation hospital and the multi-organ transplant program in an acute hospital. Design: Retrospective observational study. Setting: Community rehabilitation hospital affiliated with a university. Participants: A cohort of 173 organ transplant patients admitted consecutively over a four-year period (2004-2008) was compared to a cohort of all rehabilitation patients (n = 9762) admitted to the same inpatient rehab facility during the same period. Interventions: Inpatient rehab program to all participants. Main Outcome Measures: Length of hospital stay, Functional Independence Measure (FIMTM) change (admission-discharge), and rate of discharges to home. Results: Outcomes were measured using components of the FIMTM instrument, admission and discharge data. Chi-square and independent two-sample t-tests were used for statistical analysis. Compared to a general rehabilitation inpatient population, transplant rehabilitation inpatients had: more immediate (TM change (8.9 vs. 20.9, p TM efficiency (1.1 vs. 1.4, p < 0.001); and a higher rate of discharges to home in patients not readmitted to acute care (98.5% vs. 94.5% p < 0.001). Conclusion: Outcomes of rehabilitation in solid organ transplant patients are comparable but not identical to those in other patient groups. Inpatient rehabilitation for transplant patients is therefore fully justifiable and necessary. The ten times higher rate of transplant patient readmission to acute hospital must be communicated, facilitated, accepted and managed within a partnership strategy.
Towards a Trace-based Evaluation Model for Knowledge Acquisition and Training Resource Adaption

e-Assessment in an e-learning system is aimed at evaluating learners regarding their knowledge acquisition. Available assessment methods are usually used at the end of a training activity in order to state if a given learner has either passed or failed a training unit or level, based on the grading results obtained. Most of grading processes follow the SCORM norm in the matter (Scorm, 2006) and make use of duration and number of attempts to compute the scores. These information are valuable in grading but they can also be exploited to capture the learner bahaviour during a training activity, and then assess both learner knowledge acquisition and training resource quality in terms of adequacy. Therefore, we consider in this paper duration and number of attempts as modeled traces, upon which we build a theoretical model for automated evaluation of learnersâ knowledge acquisition evolution as a training activity progresses. The values obtained can be used to adapt training strategies and resources to improve both learnerâs knowledge level and e-learning platform quality.
Can a clinical decision rule decrease antibiotic use in viral meningitis?

revisit a prior study of children with meningeal signs who came to the emergency department at SophiaChildren’sHospital inRotterdam, theNetherlands, between 1988 and 1998. In the earlier study, the authors developed a prediction rule that identified 35% of patients with meningeal signs who did not require lumbar puncture. The study described in this issue seeks to extend that rule by incorporating cerebrospinal fluid (CSF) results with clinical findings to identify children from whom empiric antibiotic therapy can safely be withheld. It combines both a training set and a validation set from the earlier study to use as a new training set. The final rule is a clinical/blood laboratory test score detailed in the article’s “Methods” section combined with a CSF variable score best described in its footnote to Table 3; the treatment category can be found in Figure 1.
Development of DNA Based Active Macro–Materials for Biology and Medicine: A Review

Frank Xue Jiang1, Bernard Yurke2, Devendra Verma3, Michelle Previtera3, Rene Schloss3 and Noshir A. Langrana3 1Department of Chemical and Biological Engineering, Northwestern University, Evanston, IL 2Departments of Materials Science and Engineering and Electrical and Computer Engineering, Boise State University, Boise, Idaho 3Departments of Biomedical Engineering and Mechanical and Aerospace Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey USA