Miracle-dz/UniFAR-FTUs huggingface dataset:
Influence of hydatidiform mole follow-up setting on postmolar gestational trophoblastic neoplasia outcomes: a cohort study.

OBJECTIVE To assess the influence of hydatidiform mole (HM) management setting (reference center versus other institutions) on gestational trophoblastic neoplasia (GTN) outcomes. METHODS This cohort study included 270 HM patients attending Botucatu Trophoblastic Diseases Center (BTDC, São Paulo State University, Brazil) between January 1990 and December 2009 (204 undergoing evacuation and entire postmolar follow-up at BTDC and 66 from other institutions [OIs]). GTN characteristics and outcomes were analyzed and compared according to HM management setting. The confounding variables assessed included age, gravidity, parity, number of abortions and HM type (complete or partial). Postmolar GTN outcomes were compared using Mann-Whitney's test, chi2 test or Fisher's exact test. RESULTS Postmolar GTN occurred in 34 (34/204 = 16.7%) BTDC patients and in 27 (27/66 = 40.9%) of those initially treated in other institutions. BTDC patients showed lower metastasis rate (5.8% vs. 48%, p = 0.003) and lower median FIGO (2002) score (2.00 [1.00, 3.00] vs. 4.00 [2.00, 7.00], p = 0.003]. Multiagent chemotherapy to treat postmolar GTN was required in 2 BTDC cases (5.9%) and in 8 OI cases (29.6%) (p = 0.017). Median time interval between molar evacuation and chemotherapy onset was shorter among BTDC patients (7.0 [6.0, 10.0] vs. 10.0 [7.0, 16.0], p = 0.040). CONCLUSION BTDC patients showed GTN characteristics indicative of better prognosis. This underscores the importance of GTD specialist centers.
Transmission of Retroviruses from Seronegative Donors by Transfusion during Cardiac Surgery

OBJECTIVE To evaluate the effectiveness of serologic testing of blood donors for human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus types I and II (HTLV-I/II) infections and to estimate the risk for transmission of HIV-1 and HTLV-I/II by transfusion of seronegative blood from screened donors. DESIGN A prospective multicenter cohort study of cardiac surgery patients who received multiple transfusions between 1985 and 1991. SETTING Cardiac surgery services of three large tertiary care hospitals. PATIENTS The study included 11,532 patients in three hospitals who had cardiovascular surgery. MEASUREMENTS Incident HIV-1 and HTLV-I or HTLV-II infection. RESULTS We detected two new HIV-1 infections among patients transfused with 120,312 units of blood components from seronegative donors. In each case a donor was detected on follow-up who had seroconverted since the donation. The HIV-1 infection rate was 0.0017% with an upper limit of the 95% CI of 0.0053%. Before donor screening for HTLV-I, transfusion of 51,026 units resulted in two HTLV-I infections (0.0039%) and four HTLV-II infections (0.0078%). After HTLV-I screening was instituted, one recipient was infected with HTLV-II among participants exposed to 69,272 units, a rate of 0.0014%. A corresponding HTLV-I/II-infected donor was found for this patient. CONCLUSION Serologic screening of donors for antibodies to HIV-1 and HTLV-I coupled with exclusion of donors from groups having a relatively high risk for infection has led to a low incidence of transfusion-transmitted HIV-1 and HTLV-I/II infection in the United States. A small risk remains, however, despite these measures. We estimate the residual risk for HIV-1 and HTLV-II infection from transfusion of screened blood during the time of this study to be about 1 in 60,000 units.
Quality of life among children with cleft lips and palates : a critical review of measurement instruments

Background: Multidisciplinary teams that treat patients with cleft lips and palates seek to promote quality of life (QoL) in this population. In this study, we aim to identify instruments in the literature that can be used to assess comprehensive aspects of QoL (related to functionality, aesthetics, and outcomes) for this population. Methods: We searched li­terature­on­PubMed­published­between­2001­and­2011­for­specific­instruments­used­to­ evaluate QoL among cleft lip and palate patients using the following keywords: quality of life & oral cleft, quality of life & craniofacial deformities, quality of life & oral cleft speech, voice related quality of life. Results:­We­identified­457­papers­related­to­the­subject­and­ evaluated­the­following­specific­pediatric­instruments­for­assessing­QoL­among­cleft­lip­ and palate patients: Quality of Life Instrument – Craniofacial Surgery (YQOL-CS), Youth Quality of Life Instrument-Facial Differences (YQOL-FD), Child Oral Health Quality of Life Questionnaire (COHQOL), Child Oral Health Impact Profile (COHIP), Pediatric Voice Outcome Surgery (PVOS) and Pediatric Voice-Related Quality of Life Survey (PVRQOL). Conclusions: No pediatric QoL instrument exists in the current literature that comprehensively evaluates children with cleft lips and palates, including aspects related to aesthetics, conceptual and perceptual consequences, and functionality (chewing and respiratory systems, and vocal resonance) associated with this important congenital craniofacial anomaly.
Challenges and Strategies of Instrument Translation

The often-cited back translation procedure used for the translation of research instruments has not been consistently described in cross-cultural literature. Translation errors resulting in conceptually dissimilar instruments can compromise comparisons of cross-cultural health initiatives. This report describes a five-step translation procedure and equivalence and reliability testing process used to develop the High School Questionnaire: Profile of Experiences (HSQ) in Mandarin. Each step of the translation process provided additional information and detected discrepancies between the English and Mandarin versions of the HSQ. Issues related to grammatical translation, cultural usage and experience, syntax, and concept interpretation were exposed by the translation process. The procedures used in this 18-month study were rigorous enough to create an instrument that was both linguistically appropriate and culturally relevant.
How to implement an acute pain service.

To implement a successful acute pain service the following factors are the most important for success: anaesthesiologist-supervised pain nurses and an ongoing educational programme for patients and all health personnel involved in the care of surgical patients. The benefits in increased patient satisfaction and improved outcome after surgery will far outweigh the costs of running an acute pain service that raises standards of pain management throughout the hospital. Optimal use of basic pharmacological analgesia will improve relief of post-operative pain for most surgical patients. More advanced approaches, such as well-tailored epidural analgesia, are needed to relieve severe dynamic pain (e.g. when coughing). This may reduce markedly risks of complications in patients at high risk of developing post-operative respiratory infections and cardiac ischaemic events. More aggressive methods for post-operative pain management need robust routines that will discover the early symptoms and signs of potentially serious complications. High preparedness must be present for swift and correct handling of the rare but potentially catastrophic complications of bleeding and infection in the spinal canal. Chronic pain is common after surgery. Better acute pain relief may reduce this distressing long-term complication of surgery. Research into the long-term effects of optimal neuraxial analgesia and drugs that dampen glutamatergic hyperphenomena (hyperalgesia/allodynia) are urgently needed to verify whether these approaches can reduce the problem of intractable chronic post-operative pain.
Assessment of Borrowers' Delinquency and Default Behaviors in Online P2P Lending: A Two-stage Model

Online peer-to-peer (P2P) lending grows remarkably in recent years. Supported by a unique P2P lending dataset, this study empirically investigated the determinants of delinquency and default behaviors of borrowers with a two-stage probability model. The results suggested that special collection actions could help reduce bad debt. Historical repayment performance of borrowers indicated by many factors would have significant impact on both delinquency and default. If the required repayment due date was during weekend, borrowers were less likely to be delinquent and default. But the effects were opposite for other holiday-related factors. The results by latent class model also demonstrated two types of borrowers, 35% of which were found to be of higher credit and quality. The determinants of delinquency and default affect somewhat differently between the two segments of borrowers. As one of earliest empirical studies on delinquency in P2P lending, this study offers several implications for research and practice.
Holographic Method for Reconstruction of Random Rough Surface

A holographic principle for computer reconstruction of random rough surface (RRS) and determination of the surface parameters is used. The random function describing the surface is expanded in a Fourier series. The scattering from the RRS light field is approximated as a field, obtained as result of diffraction from sinusoidal gratings. The mixed field (obtained from the mixing of the diffracted field and the field of the laser beam) carries information about the phase of each sinusoidal grating. Sections of the diffracted and mixing fields are correspondingly registered by photodiode array. The first, the second and the third diffraction orders from each grating are taken into account for the surface reconstruction. The statistical distribution and the autocorrelation function of the surface height fluctuation are calculated. The surface parameters of mean roughness, root mean square and correlation length are determined. The studied surface, having a Gaussian statistic, is measured from the work of Daintyet al.Talystep profilometer. The values of the above-mentioned surface parameters calculated in Daintyet al.are in good agreement with those obtained in the present work.
Ultrasonographic and radiographic results from a two-year controlled trial of immediate or one-year-delayed addition of infliximab to ongoing methotrexate therapy in patients with erosive early rheumatoid arthritis.

OBJECTIVE To compare the impact of immediate and delayed introduction of anti-tumor necrosis factor therapy on inflammation and structural damage in methotrexate (MTX)-treated patients with early rheumatoid arthritis (RA). METHODS Twenty-four patients with erosive early RA (duration < 3 years) who were receiving MTX were randomized to receive infliximab 5 mg/kg or placebo infusions at weeks 0, 2, and 6, and then every 8 weeks through week 46. Beginning at week 54 and thereafter, all patients received infliximab 5 mg/kg. Metacarpophalangeal joints were scanned using high-frequency ultrasonography and power Doppler imaging. Radiographs were evaluated using the modified Sharp/van der Heijde scoring system. RESULTS From baseline to week 54, total synovial thickness was significantly improved in the infliximab + MTX group compared with the placebo + MTX group (median reduction 95.8% versus 37.5%; P = 0.005), as was the total color Doppler area (CDA; vascularity assessment) (median reduction 100% and 47.1%, respectively; P = 0.025). From week 0 to week 110, no significant between-group difference was observed in the change from baseline for total synovial thickening or the total CDA. At week 54, greater progression in the Sharp/van der Heijde score was apparent in patients receiving placebo + MTX compared with those receiving infliximab + MTX. Although radiographic progression in the placebo + MTX group was greatly reduced in the second year (after initiation of infliximab therapy), marked differences were observed between the infliximab + MTX group (median change in the Sharp/van der Heijde score 4.0) and the placebo + MTX group (median change 14.5) from baseline to week 110 (P = 0.076). CONCLUSION The results indicate that the efficacy of 2 years of combination therapy with infliximab + MTX for inhibiting cumulative structural damage was superior to that of 1 year of treatment with MTX alone followed by the addition of infliximab.
Efficacy, safety, and adherence with a twice-daily combination lamivudine/zidovudine tablet formulation, plus a protease inhibitor, in HIV infection

ObjectiveA randomized, open-label, multicenter study to establish clinical equivalence (non-inferiority) of a regimen employing a lamivudine 150 mg/zidovudine 300 mg combination tablet, administered twice daily, plus a marketed protease inhibitor, compared with a conventional regimen of 150 mg lamivudine twice daily, 600 mg zidovudine daily, and a protease inhibitor, in antiretroviral-experienced patients infected with HIV-1. PatientsAdults who were seropositive for HIV-1 infection with plasma HIV-1 RNA levels < 10 000 copies/ml (Roche Amplicor polymerase chain reaction assay, lower limit of quantitation (LLOQ) 400 copies/ml) and CD4+ cell counts ⩾ 300 × 106/l). All patients had been receiving the conventional lamivudine/zidovudine/protease inhibitor regimen for ⩾ 10 weeks immediately prior to the study. InterventionPatients were randomized to the conventional regimen (n = 113) or combination tablet regimen (n = 110) for 16 weeks. The primary study endpoint was treatment failure, defined as an increase in HIV-1 RNA ⩾ 0.5 log10 above baseline in patients with viral load > LLOQ at randomization and as HIV-1 RNA increasing to ⩾ 1250 copies/ml in patients with viral load < LLOQ at randomization. ResultsThe combination tablet regimen was associated with a 3.5% greater success rate than the conventional regimen (96.4 versus 92.9%), with four and eight patients failing treatment due to increases in HIV-1 RNA levels, respectively. The lower limit of the associated confidence interval for the difference was −2.4%, which was well within the −10% margin predefined as clinically unimportant. This establishes the clinical equivalence (non-inferiority) of the combination tablet regimen to the conventional regimens regarding virologic response. The combination tablet and conventional regimens were similar with respect to percentage of patients maintaining HIV-1 RNA levels < LLOQ at the end of study or improving from baseline to undetectability (94 versus 91%;P = 0.063), overall incidence of drug-related adverse events (21 versus 19%) (P = 0.868), and mean area under the curve for CD4+ cell counts [treatment difference, 5.9 cells (95% confidence interval, −15.8 to 27.6 × 106 cells/l)]. A self-reported adherence questionnaire indicated that patients in the combination tablet group were less likely to miss doses of nucleoside analogue medication at weeks 8 (P = 0.007) and 16 (P = 0.046). ConclusionsThe combination lamivudine/zidovudine tablet/protease inhibitor regimen is clinically equivalent (non-inferior) to the conventional regimen with respect to virologic response and may offer adherence advantages.
The role of smartphone usage types , emotional intelligence , social stress , self-regulation , age , and gender

The present study investigates the role of process and social oriented smartphone usage, emotional intelligence, social stress, self-regulation, gender, and age in relation to habitual and addictive smartphone behavior. We conducted an online survey among 386 respondents. The results revealed that habitual smartphone use is an important contributor to addictive smartphone behavior. Process related smartphone use is a strong determinant for both developing habitual and addictive smartphone behavior. People who extensively use their smartphones for social purposes develop smartphone habits faster, which in turn might lead to addictive smartphone behavior. We did not find an influence of emotional intelligence on habitual or addictive smartphone behavior, while social stress positively influences addictive smartphone behavior, and a failure of self-regulation seems to cause a higher risk of addictive smartphone behavior. Finally, men experience less social stress than women, and use their smartphones less for social purposes. The result is that women have a higher chance in developing habitual or addictive smartphone behavior. Age negatively affects process and social usage, and social stress. There is a positive effect on self-regulation. Older people are therefore less likely to develop habitual or addictive smartphone behaviors. 2015 Published by Elsevier Ltd.
DIRECT MEASUREMENT OF INTERSTELLAR EXTINCTION TOWARD YOUNG STARS USING ATOMIC HYDROGEN Lyα ABSORPTION

Interstellar reddening corrections are necessary to reconstruct the intrinsic spectral energy distributions (SEDs) of accreting protostellar systems. The stellar SED determines the heating and chemical processes that can occur in circumstellar disks. Measurement of neutral hydrogen absorption against broad Lyα emission profiles in young stars can be used to obtain the total H i column density (N(H i)) along the line of sight. We measure N(H i) with new and archival ultraviolet observations from the Hubble Space Telescope (HST) of 31 classical T Tauri and Herbig Ae/Be stars. The H i column densities range from log10(N(H i)) ≈19.6–21.1, with corresponding visual extinctions of AV =0.02–0.72 mag, assuming an RV of 3.1. We find that the majority of the H i absorption along the line of sight likely comes from interstellar rather than circumstellar material. Extinctions derived from new HST blue-optical spectral analyses, previous IR and optical measurements, and new X-ray column densities on average overestimate the interstellar extinction toward young stars compared to the N(H i) values by ∼0.6 mag. We discuss possible explanations for this discrepancy in the context of a protoplanetary disk geometry.
Health technology diffusion in developing countries: a case study of CT scanners in Brazil.

BACKGROUND The development of products and services for health care systems is one of the most important phenomena to have occurred in the field of health care over the last 50 years. It generates significant commercial, medical and social results. Although much has been done to understand how health technologies are adopted and regulated in developed countries, little attention has been paid to the situation in low- and middle-income countries (LMICs). Here we examine the institutional environment in which decisions are made regarding the adoption of expensive medical devices into the Brazilian health care system. METHODS We used a case study strategy to address our research question. The empirical work relied on in-depth interviews (N = 16) with representatives of a wide range of actors and stakeholders that participate in the process of diffusion of CT (computerized tomography) scanners in Brazil, including manufacturers, health care organizations, medical specialty societies, health insurance companies, regulatory agencies and the Ministry of Health. RESULTS The adoption of CT scanners is not determined by health policy makers or third-party payers of public and private sectors. Instead, decisions are primarily made by administrators of individual hospitals and clinics, strongly influenced by both physicians and sales representatives of the medical industry who act as change agents. Because this process is not properly regulated by public authorities, health care organizations are free to decide whether, when and how they will adopt a particular technology. CONCLUSIONS Our study identifies problems in how health care systems in LMICs adopt new, expensive medical technologies, and suggests that a set of innovative approaches and policy instruments are needed in order to balance the institutional and professional desire to practise a modern and expensive medicine in a context of health inequalities and basic health needs.
Differential MRI patterns of brain atrophy in double or single transgenic mice for APP and/or SOD

Clinical magnetic resonance imaging (MRI) offers a noninvasive diagnostic tool for neurodegenerative diseases. MRI was performed on mice to investigate a relationship between brain atrophy and overexpression of two genes involved in such diseases, SOD1 (superoxide dismutase) and APP (amyloid precursor protein), which have been associated with pathogenesis of Alzheimer's disease or Down syndrome. Additionaly, we investigated how life span and growth rate were affected by genetic background. T2‐weighted MRI made possible the measurement of the volume of brain regions of interest in living transgenic mice that overexpress normal APP, SOD1, or both. The most pronounced alterations in gray matter volume were observed in 1‐year‐old double APP/SOD1 transgenic mice. Hippocampus, entorhinal, and cingulate cortex volumes were decreased by 8% to 25%. In contrast, mice homozygous for SOD1 exhibited atrophy specifically in cortex regions (cingulate, retrosplenial, and temporoparietal cortex), but no significant modification was found in the hippocampus region. None of these alterations was seen in single APP transgenics. However, the life span of these mice was significantly shortened. SOD1 overexpression prevented APP toxicity with regard to premature death, especially in double APP/SOD1 transgenic animals homozygous for SOD1, and increase in life span was significantly correlated to SOD1 activity. In conclusion, overexpression of both APP and SOD1, in contrast to single APP transgenics, produced a robust effect on brain anatomy but did not impair growth or life span. Consequences of genotype alterations on brain atrophy may be dissociated from their effect on life span. © 2008 Wiley‐Liss, Inc.
Production and Characterization of Monoclonal Antibodies against Aflatoxin B1

In this article, we embarked on production of mouse monoclonal antibodies against aflatoxin B1 which is the most commonly occurring fungal toxin in food and feed products. After immunization and fusion with myloma cells, two stable clones (A218 and B319) were selected. Isotyping showed that these monoclonal antibodies (mAbs) were IgG2b with kappa light chains. The affinity of A218 and B319 clons were 5×1011 M−1 and 6×109 M−1, respectively. Competitive indirect ELISA results indicated these mAbs had complete (100%) cross-reaction with four major types of aflatoxins: B1, B2, G1, and G2. These mAbs could be used for immunoassay measurement of aflatoxins with high affinity and low detection limits.
Local uptake of 14C‐labeled acetate and butyrate in rat brain in vivo during spreading cortical depression

Spreading depression severely disrupts ion homeostasis, causes sensory neglect and motor impairment, and is associated with stroke and migraine. Glucose utilization (CMRglc) and lactate production rise during spreading depression, but the metabolic changes in different brain cell types are unknown. Uptake of 14C‐labeled compounds known to be preferentially metabolized by the glial tricarboxylic acid cycle was, therefore, examined during unilateral KCl‐induced spreading cortical depression in conscious, normoxic rats. [14C]Metabolites derived from [14C]butyrate in K+‐treated tissue rose 21% compared to that of untreated contralateral control cortex, whereas incorporation of H14CO3 into metabolites in K+‐treated tissue was reduced to 86% of control. Autoradiographic analysis showed that laminar labeling of cerebral cortex by both 14C‐labeled acetate and butyrate was elevated heterogeneously throughout cortex by an average of 23%; the increase was greatest (∼40%) in tissue adjacent to the K+ application site. Local uptake of acetate, butyrate, and deoxyglucose showed similar patterns, and monocarboxylic acid uptake was highest in the structures in which apparent loss of labeled metabolites of [6‐14C]glucose was greatest. Enhancement of net uptake of acetate and butyrate in cerebral cortex during spreading depression is tentatively ascribed to increased astrocyte metabolism. © 2001 Wiley‐Liss, Inc.