Miracle-dz/UniFAR-FTUs huggingface dataset:
Phenotypic heterogeneity and preclinical change in familial Alzheimer's disease

This thesis investigates relationships between clinical, neuroimaging and neuropathological features in autosomal dominant familial Alzheimer’s disease (FAD), with the aim of studying phenotypic heterogeneity and preclinical change. Chapters 1 and 2 introduce the background to the problem to be addressed in this thesis with an emphasis on current understanding of clinical and imaging changes in AD, and specifically in FAD. The FAD phenotype can be highly variable and, although it shares many clinical features with sporadic AD, it also possesses important differences. The clinical spectrum of FAD is first investigated, through analysis of all symptomatic cases studied at our research centre over the past twenty-five years (Chapter 3). Associations between phenotypic and pathological heterogeneity are then explored, with a study investigating genetic determinants of white matter hyperintensities and cerebral amyloid angiopathy (CAA) in FAD (Chapter 4). CAA is a common but variable feature of AD that appears to be an important factor in amyloid-modifying therapy and the term ‘ARIA’ has been coined to describe amyloid-related imaging abnormalities, thought to relate to vascular amyloid, that have been observed in a variety of amyloid-modifying therapy trials. Spontaneous changes of ARIA in FAD and the genetic risk factors that may provoke them are then described (Chapter 5). The recent launch of preclinical treatment trials for FAD necessitates better understanding of the trajectory of biomarker changes early in the disease. Observations from amyloid imaging studies, of presymptomatic amyloid deposition in the thalamus and striatum, motivated the final study, which examines changes in volume and diffusivity of these subcortical structures and their connecting white matter tracts in symptomatic and presymptomatic FAD mutation carriers (Chapter 6). Together, these studies demonstrate that exploring phenotypic heterogeneity and preclinical imaging changes can illuminate aspects of the underlying disease process, informing our understanding of FAD and potential effects of treatment.
Microbial Flora and Antibiotic Resistance in Odontogenic Abscesses in Upstate New York

Abscesses in the head and neck frequently have odontogenic sources. As bacterial pathogens and antibiotic resistance patterns may change over time and based on location, we describe the current common bacteria found in odontogenic abscesses, the prevalence of antibiotic resistance, and differences in each between pediatric and adult patients in Upstate New York. This is a retrospective review of patients who underwent drainage of odontogenic abscesses (n = 131) from 2002 to 2012 at an academic institution. The medical records were reviewed for results of abscess cultures, comorbidities, and drainage procedures. Polymicrobial sources were identified in 60.3% and monomicrobial in 33.6%. Overall, the most common bacteria were alpha hemolytic Streptococci (33.6%), Streptococcus milleri (32.1%), Prevotella (16.8%), and coagulase-negative Staphylococcus (14.5%). Candida and Morganella spp were more common in children than in adults. Overall, antibiotic resistance was observed in seven different pathogens. The most common antibiotic resistances were to clindamycin and erythromycin, which should be considered when deciding initial antibiotic therapy, especially in adult patients, who trended in this study toward having pathogens with higher rates of resistance.
Multidirectional instability of the shoulder (MDI) – focus on non-operative management

Abstract Background: The aetiology of multidirectional instability (MDI) is primarily laxity of the capsule and capsular thickenings. The other factors include dysfunction of dynamic stabilisers with loss of neuromuscular co-ordination, and altered neuromuscular control of activation patterns of rotator cuff muscles and scapular stabilisers. Methods: A literature search of the following databases, MEDLINE, CINAHL, EMBASE, Cochrane, AMED and Science direct was carried out. In addition, reference lists were hand searched for relevant papers. Seven studies qualified for inclusion and their methodological quality assessed with a risk of bias tool. A systematic review was done using narrative synthesis as there was not enough homogeneity in the studies to undertake a meta-analysis. Results: The studies were of low quality with a high risk of bias but showed consistent evidence that retraining neuromuscular control, proprioception and strengthening of dynamic stabilisers can compensate for deficit in static stabiliser function. About 60–100% success rate can be achieved with long-term compliance with the exercise programme being important for maintaining the results. Conclusions: Exercise-based therapy involving strengthening, proprioception and plyometric training is appropriate in the initial management of patients with MDI. The programme should be continued for about 6 months and maintained for the long term.
A study of algorithm animations on mobile devices

Compared to desktop PCs, mobile devices have several constraints such as restricted screen size and reduced interactivity. Hence, it is not clear if it is helpful to provide educational multimedia material for mobile media players. In this paper, we present a study of algorithm animations on mobile devices, i.e. an Apple iPod with video functionality. The results of our experiment indicate that despite limitations there is an actual learning effect and therefore mobile media players offer a potential to increase learning that deserves further investigation.
SUPPLEMENTARY LABORATORY INVESTIGATIONS OF MODERN PLASTIC-POLYMER FISHPLATES FOR RAIL JOINTS

Purpose. The authors’ goal is to determine the behavior of insulated rail joints with polymer-composite fishplates without glueing in the consideration of dynamic loadings regarding to own laboratory tests. In this paper they introduce the applied measurement opportunities. Methodology. Dynamic (fatigue) bending tests were performed by insulated rail joints assembled with plastic-polymer fishplates. The special laboratory measurements are related to digital picture/video measurement technique and assessment method executed by GOM hardware and software, as well as computer tomography according to laboratory bending tests. Findings. In previous papers the authors published the results of glued-insulated rail joints, in this period they continued their research with the investigation of rail joints with plastic-polymer fishplates without glueing. They tested two different types of rail fishplates made of plastic-polymer material. For the rail joints with fishplates but without glueing, the authors applied special measurement techniques by GOM products (Tritop, Aramis) that enable high precision digital measurement techniques with spectacular visualization results. The computer tomography records ensure the opportunity to be able to receive information about inner crackings and faults of plastic-polymer fishplates, with also high precision measurements. The assessment method has to be developed for these specific measurement methodologies to be able to compare the results and define scientific statements. Originality. Up to now any researcher and research group have been dealing with insulated rail joints with special plastic-polymer fishplates without glueing applied mentioned special techniques, no one determined the exact deterioration process of these joints, as well as the crack growing phenomenon in the cross section of the fishplates. Practical value. The research team of the authors had the possibility to see into the details of glass-fibre reinforced resin bonded plastic fishplates during laboratory tests, as well as they publish timely information in the consideration of their laboratory tests’ results. This result can be applied in railway engineering at all stages: design, construction, maintenance&operation in the future.
Systemic Arterial Blood Pressure during Exercise in Patients with Atherosclerosis Obliterans of the Lower Limbs

Systemic intraarterial blood pressure and heart rate have been measured during exercise on a foot ergometer in 13 patients suffering from unilateral intermittent claudication. Each limb was exercised separately for 5 min. Both systolic and diastolic blood pressure increased to significantly higher levels during exercise with the diseased limbs than during exercise with the nondiseased limbs. No significant difference was found in heart rate. After cessation of exercise the blood pressure and heart rate dropped abruptly. For the first 2 min of recovery the systolic blood pressure in the diseased limbs stayed higher than the pressure measured at rest immediately before exercise. Ten patients were also exercised for 2 or 3 min with arrested circulation. During this period no significant differences between the diseased and nondiseased limbs were found in relation to blood pressure or heart rate.
Optimum Design of Compact, Quiet, and Efficient Ventilation Fans

Axial ventilation fans are used to improve the air quality, remove contaminants, and to control the temperature and humidity in occupied areas. Ventilation fans are one of the most harmful sources of noise due to their close proximity to occupied areas and widespread use. The prolonged exposure to hazardous noise levels can lead to noiseinduced hearing loss. Consequently, there is a critical need to reduce noise levels from ventilation fans. Since fan noise scales with the 4-6th power of the fan tip speed, minimizing the fan tip speed and optimizing the duct geometry are effective methods to reduce fan noise. However, there is a tradeoff between reducing fan speed, noise and aerodynamic efficiency. To this end, a new innovative comprehensive optimum design methodology considering both aerodynamic efficiency and noise was formulated and implemented using a multi-objective genetic algorithm. The methodology incorporates a control vortex design approach that results in a spanwise chord and twist distribution of the blades that maximize the volumetric flow rate contribution of the outer radii, i.e. the axial flow velocity increases from the fan hub to the tip. The resulting blade geometry generates a given volumetric flow rate at the minimum fan tip speed. The fan design is complemented by the design of the optimum inlet duct geometry to maximize volumetric flow rate and minimize BL thickness for low noise generation. Good agreement with experimental results validates the design process. The present study also incorporates multi-element airfoils to further increase the aerodynamic characteristics of the fan blades and enable lower fan speeds and noise. Good agreement between experiments and predictions indicate that traditional blade element momentum methods can be implemented in conjunction with multi-element airfoil aerodynamic characteristics with good accuracy. A direct comparison of fans designed with single and multi-element airfoils has shown that fans designed with multi-element airfoils aerodynamically outperform single element airfoil fans. Optimum Design of Compact, Quiet, and Efficient Ventilation Fans
The health of healthcare: Emergency department physician well-being

Introduction: Physician health and well-being is an important issue that ultimately aff ects job performance. We compared the self-reported incidence of known medical issues, physical and mental health symptoms, and health behaviors of Emergency Physicians (EPs) with the general public in the United States. Methods: Questions selected from a national survey conducted by the Center for Disease Control (CDC) about public health trends were distributed to via Facebook to a private group of 12,917 EPs. Responses were compared between EPs and the general population using Chi-square tests of independence. Results: Our results demonstrated that EPs suff er less from chronic diseases, especially those related to the cardiopulmonary system; however, they suff er from a higher incidence of musculoskeletal pain and infectious disease complaints. EPs also exhibit higher rates of mental health symptoms, sleep-related complications, and alcohol consumption. Conclusions: Awareness, education, and advocacy may help improve physician health and ultimately job performance. Affi liations:
Utility of routine transesophageal echocardiography in patients with stroke or transient ischemic attack

Abstract In several series of patients with presumed stroke, transesophageal echocardiography (TEE) has seemed advantageous over transthoracic echocardiography (TTE) in that it improves detection of cardiac sources and can lead to changes in the methods of treatment. We hypothesized that the real-world application of TEE in our institution produced results at variance from those previously reported. Our study of 219 patients, referred for TEE for an indication of stroke or transient ischemic attack, found few relevant findings that would have indicated a new diagnosis or required a change in treatment. These results suggest that for most patients in whom TEE is ordered, either a TTE or no cardiac testing would suffice.
Role of MCRP in the clinical management and the pathophysiology of the acute coronary syndromes

Introduction: The rise in emergency department admissions for chest pain necessitates a quicker and more specific test for the different acute coronary syndromes. For a non-ST elevated myocardial infarction (NSTEMI) diagnosis, the current Gold Standard requires at least one cTn (cTn) value above the 99th percentile of a reference population across 12h of serial testing. Current research suggests serum levels of monomeric C-reactive protein (mCRP) and ultra-high-sensitive cTn assays may rule out NSTEMI more rapidly. Aims: To develop a novel immunoassay for mCRP for use on clinical samples to assess its diagnostic accuracy for NSTEMI. The Singulex Clarity and the Abbott iSTAT point of care hs-cTnI assays were assessed against the standard laboratory assay from Roche® Diagnostics hs-cTnT assay for NSTEMI diagnosis using non-kinetic (0h, 3h and max values) and kinetic (Δabsolute, %Δbaseline and %Δmean) values and in combination with H-FABP and ECG ischaemia. Methods: A competitive immunoassay for mCRP was optimised, which became an ELISA with a commercial anti-CRP detection antibody. Diagnostic tests calculated the clinical sensitivity, specificity, positive predictive value and negative predictive value for non-kinetic and kinetic values with the aim of creating the highest clinical sensitivity possible for NSTEMI rule out. Patients were grouped into 3 risk groups and cut-offs were optimised for each group. Predictor composites of 0h cTn, cTn deltas, ECG ischaemia and H-FABP were used for NSTEMI diagnosis and prediction of 3 different composite outcomes at 30 days. Cox regression assessed the assays’ and risk factors’ utility in 30-day MACE prediction. Results: The mCRP immunoassay was not sensitive enough for physiological mCRP concentrations (LoD 2 μg/ml) and the inter-assay imprecision was too great to be clinically useful. The Roche and Singulex assays showed 100% sensitivity and NPV for kinetic values in intermediate risk groups and predictor composites. The Singulex assay had 100% sensitivity for non-kinetic values also but the iSTAT assay did not perform well as a rule out diagnosis tool. Singulex Δabsolute and prior angina were independent predictors for 30-day MACE. Discussion: The mCRP immunoassay had problems because the antibody was not commercially produced, had to be used at high concentrations and therefore is not suitable for a competitive immunoassay. The Singulex assay could be used for early rule out but its variability could limit its clinical utility. The iSTAT assay is a useful tool for identifying high-risk patients quickly and all assays performed better when patients were split into risk groups by 0h cTn levels. Multi-faceted diagnostic tools are becoming more prominent for NSTEMI diagnosis and rule out.
Post Ischemic Stroke Complication: How Much Nursing Diagnosis are Confirms by Neurologist?

Background: Nursing role in post ischemic stroke is vulnerable by correct nursing recognition, due to limited study and evaluation of, this study was conducted. Material and method: It was a retrospective cross-sectional study that all patients admitted with a diagnosis of ischemic stroke in the Ayatollah Rouhani Hospital of Babol from 2015 to 2016. Data was analyzed by chi-square, t-test and coefficient, Kappa tests in spss21. Results: Of 300 ischemic stroke patients were studied, Distribution of sex was 154 (51.2%) female vs. 146 (48.5%) male, age range was 43-90 years with mean age of 65.8 ± 15.7 years. Pain in 107 patients (35.5%), depression in 101 patients (33.6) and fever in 94 patients (31.2) were the most common early complications of ischemic strokes. Coefficient was excellent agreement between the neurologist and nurses (yes 703 (84%), no 136(16%), Kappa=0.76). The highest amount of agreement was in relation to the diagnosis of pressure ulcer (accurate 70 (93%), misdiagnose 5 (7%), Kappa=0.83) and dysphasia (accurate 79 (91%), misdiagnose 8 (9%), Kappa = 0.84). Although the lowest rate of agreement was in relation to the diagnosis of CHF (accurate 4 (17%), misdiagnose 20(83%), Kappa=0.10). Conclusion: most common early complication was pain and the most accurate recognition by nurses was dysphagia and pressure ulcer. The total agreement between nurse and neurologist was favorable that nurses can play an important role to inform neurologist but continuous education to decrease misdiagnosis is recommended. It suggests a suitable feedback from neurologist to nurses. It can help nurses to analyzed how much it recognition was correct or need be more training. In relation to the incidence of stroke in Iran, a report from Babol northern of Iran, the incidence of stroke was 50 per hundred thousand populations [5,6]. In recent years, despite to all prophylactic measures to reduce the incidence of stroke by decreasing pert time, advances in diagnosis, medical care and treatment of patients, but the number of patients has been increased [7]. Post stroke complication include pressure ulcer, dysphasia, pain, respiratory infections, urinary tract infection, fever, depression deep vein thrombosis, pulmonary embolism, myocardial infarction and cardiac arrhythmias, Congestive heart failure, urinary retention and peptic ulcers. These complications have adverse effects on the physical and mental status of these patients and involve their on other hand have an economic burden to society [8]. Complications of stroke in the early days of hospitalized patients significantly increasing mortality rate [9]. Frequent assessment of neurological status, blood pressure, blood sugar and temperature control and identify early stroke complication is the key to success in the care of these patients [10].
Cervical Cancer Screening Knowledge and Behavior Among Female Undergraduate Students in a Nigerian University

Background: Cervical cancer is a highly preventable disease that affects women especially in developing countries. Over the years awareness and uptake of cervical cancer screening services have remained poor in developing countries. Lack of knowledge and poor attitude toward the disease and risk factors can affect screening practice and development of preventive behavior for cervical cancer. Aim: This study assessed the level of knowledge and barriers toward cervical cancer screening among female university students. Methods: We conducted a cross-sectional survey of 234 female students selected by stratified random sampling techniques at Ebonyi State University Abakaliki Nigeria. A pretested questionnaire was administered to assess knowledge, attitude and screening history. Data were analyzed with Epi info version 7.1. 4. Results: Participants' mean age was 22 years (SD=3). Majority of the respondents 79.5% have not heard of screening, 58.9% knew that it can be prevented, 78.5% have not heard about HPV vaccine and only 4.0% have had Papanicolaou test. Common barriers include lack of centers where such services are obtainable (88%) and fear of cancer being discovered (9%). Reported risk factors were multiple sexual partners (24.2%) and early onset of sexual intercourse (19.8%). A significant association was found between institutional and personal barriers and having a Papanicolaou test. Conclusion: Comprehensive education on cervical cancer screening in universities is critical in reducing the morbidity and mortality associated with cervical cancer. Few screening centers have also contributed to poor cervical screening uptake.
X10 and APGAS at Petascale

X10 is a high-performance, high-productivity programming language aimed at large-scale distributed and shared-memory parallel applications. It is based on the Asynchronous Partitioned Global Address Space (APGAS) programming model, supporting the same fine-grained concurrency mechanisms within and across shared-memory nodes. We demonstrate that X10 delivers solid performance at petascale by running (weak scaling) eight application kernels on an IBM Power--775 supercomputer utilizing up to 55,680 Power7 cores (for 1.7Pflop/s of theoretical peak performance). For the four HPC Class 2 Challenge benchmarks, X10 achieves 41% to 87% of the system’s potential at scale (as measured by IBM’s HPCC Class 1 optimized runs). We also implement K-Means, Smith-Waterman, Betweenness Centrality, and Unbalanced Tree Search (UTS) for geometric trees. Our UTS implementation is the first to scale to petaflop systems. We describe the advances in distributed termination detection, distributed load balancing, and use of high-performance interconnects that enable X10 to scale out to tens of thousands of cores. We discuss how this work is driving the evolution of the X10 language, core class libraries, and runtime systems.
Assessment of knowledge, attitude, and practice toward oral hygiene among governmental secondary school students in Debre Tabor Town, Amhara Region, North Central Ethiopia 2018: Institutional-based cross-sectional survey

Introduction: Oral health is significantly related to oral hygiene behaviors and their knowledge. Poor oral hygiene can have a profound effect on the quality of life. Oral hygiene practices are those measures taken to ensure that the mouth is clean. Oral hygiene practices are essential for the prevention of dental and other associated systemic diseases. The aim of this study is to determine the level of knowledge, attitude, and oral hygiene practices among secondary school students in Debre Tabor town, Amhara region, North Central Ethiopia 2018. Materials and Methods: An institution-based cross-sectional study was conducted among 422 systematically selected students using stratified random sampling technique from January 20 to 30, 2018. Data were collected using a pretested questionnaire on 422 selected students in three secondary schools found in Debre Tabor town. Variables collected included the frequency of brushing teeth and the use of toothpaste, knowledge of plaque, and students' perception of the importance of oral hygiene practices. The data were entered into Epi-Info version 3.5 and cleaned and analyzed using SPSS version 20. Results: A total of 422 patients participated in the study; among whom 216 (51.2%) were female students. The study revealed that 253 (60%) of the respondents had good knowledge with regard to oral hygiene, more than half 281 (66.6%) of the students had positive attitude toward oral hygiene, but their oral hygiene practices were still low that 260 (61.6%) of the students had poor oral hygiene practice. Conclusions: The study showed that more than half of the respondents had good knowledge and positive attitude toward oral hygiene to maintain proper oral health, but their practices toward oral hygiene were remain poor. The majority of students were aware that teachers and parents had not an important role to play in their oral hygiene. Establishment of oral health education programs in the school curriculum that will help a life-long oral hygiene practice in the school environment and at large in the community with the support of teachers and parents are crucial.