Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Utility of Botulinum Toxin in the Treatment of Cerebral Palsy: Comprehensive Review

The physical properties, mechanism of action, and clinical evidence supporting the use of botulinum toxin in the management of spasticity in cerebral palsy are discussed. Assessment methods, patient selection criteria, and methodology for preparation and administration of botulinum toxin are discussed in detail and a treatment algorithm based on the cumulative experience of the author is provided. Botulinum toxin type A is well tolerated, safe, and effective in the treatment of patients with spastic cerebral palsy. Appropriate patient selection is imperative. Treatment goals need to be well defined and tailored to the individual patient's needs. Growth and development is a continuous and evolving process, necessitating the constant reassessment of the patient and modification of future treatment goals. The ultimate success of management in cerebral palsy is dependent on the development of a comprehensive spasticity team with complementing skills who, together, can significantly improve the quality of life of these patients. (J Child Neurol 2001;16:37-46).
Toward Patients’ Motion Intention Recognition: Dynamics Modeling and Identification of iLeg—An LLRR Under Motion Constraints

In order to implement model-based recognition of human motion intention, dynamics modeling and identification of a lower limb rehabilitation robot named iLeg is investigated. Due to the relatively strong motion constraints, the traditional identification methods become insufficient for iLeg in three aspects: (1) the coupling factors among joints have not been considered in the traditional joint friction models, which makes the structural error and the torque estimation errors relatively large; (2) because of the small and complicated feasible region caused by the motion constraints, the traditional initialization strategy, for searching the valid initial solutions of the optimization problem for the exciting trajectories, becomes very inefficient; and (3) the condition number of the observation matrix, calculated from the preliminary dynamic model and the associated optimized exciting trajectory, is too large for the identification, and, however, further reduction of the condition number has not been considered in the literature. Therefore, corresponding contributions are presented to overcome the limitation. First, the coupling factors among joints are considered in the joint friction model by using the Palmgren empirical formulation and a polynomial fitting method. Then, an indirectly generating strategy is designed, by which the valid initial solutions of the optimization problem can be found with good efficiency. Moreover, a recursive optimization method based on the optimization of the dynamic model and the exciting trajectories, is proposed to further reduce the condition number. Finally, the performance of the proposed methods is demonstrated by several experiments.
A Model for Planning Optimal Follow-up for Outpatients on Warfarin Anticoagulation

Patients taking warfarin for long-term anticoagulation require frequent clinic visits to monitor the prothrombin time ratio (PTR), a measure of blood clotting. A dynamic stochastic model using nonlinear optimization was developed to select follow-up visit intervals that minimize the overall costs of patient care. Assuming that fluctuations in a patient's PTR behave as a random diffusion process, future PTR fluctuations are unknown, except as revealed by past PTRs. To determine the incidence and costs of complications in relation to PTR, the authors reviewed the charts of 216 patients who had 719 patient-years of follow-up with 695 trivial, significant, life-threatening, or fatal complications. They modeled the relationship between costs of complications and deviation of the PTR from the therapeutic target as a fourth-order convex polynomial. The model is used to compute the interval to the next follow-up visit to minimize accumulated potential costs. Variables in the optimization are the cost of a mon itoring visit and the expected costs of complications. The latter are derived from the current PTR, the variability of the patient's past PTR values, the number of past PTRs available, and the target PTR for the patient. No attempt is made to predict the level of the next PTR or suggest adjustments in the warfarin dose. Shorter follow-up is recommended for patients who have histories of large fluctuations in past PTRs and for patients with few prior PTR determinabons. As visits accumulate, the patient's degree of variability can be estimated more accurately and visit intervals adjusted accordingly The scheduling method balances costs to the health care system of monitoring each patient against the expected costs of complications. This approach has the potential to reduce the number of monitoring visits necessary for safe management of anticoagulated patients with stable PTRs and to improve control among unstable patients. Key words: warfarin; anticoagulation, ambulatory care; follow-up studies; stochastic processes. (Med Decis Making 1992;12:132-141)
Vaginal Intraepithelial Neoplasia: Biologic Aspects and Management

&NA; A review of 59 consecutive cases of vaginal intraepithelial neoplasia seen in a colposcopy clinic between 1971 and 1984 was made. All patients presented with an abnormal Papanicolaou smear, and diagnosis was confirmed by colposcopically directed biopsy. The patients ranged in age from 23 to 72 years, with a mean age of 49. Fourteen (24%) patients were less than 40 years of age. A previous hysterectomy had been performed in 68% of patients, 42.5% of these being for benign disease. Forty‐two patients (71%) had evidence of multicentric neoplasia of the lower genital tract, and 30 (51%) had been treated previously for cervical neoplasia. Twenty‐nine lesions were multifocal and 52 (88%) were located in the upper third of the vagina. The results of the different modes of treatment were reviewed. Surgical extirpation gave the best results. The local ablative techniques used, ie, electrocautery and CO2 laser, were associated with failure rates of 25 and 50%, respectively. Three patients developed invasive carcinoma of the vagina after treatment. (Obstet Gynecol 68:333, 1986)
Acupuncture for Depression: Exploring Model Validity and the Related Issue of Credibility in the Context of Designing a Pragmatic Trial

Introduction: Evaluating care that is not credible to its practitioners or patients will result in a gap between evidence and practice and the potential value, or harm, of the intervention may be underestimated. Our aim was to develop a pragmatic trial that would have better model validity and credibility than trials to date in this clinical area. Methods: In‐depth interviews; a nominal consensus technique and five arm pilot trial conducted in UK primary care using counseling and usual general practitioner (GP) care as comparisons for acupuncture. Findings: Patients with long standing, severe illness that had not responded, or partially responded to conventional treatments may be interested in using acupuncture and participating in a trial. Using a database method to recruit, pilot trial patients were mostly severely depressed (87.5%); chronically ill (60% with 3+ previous episodes), with high levels of comorbidity, and medication use. Acupuncture was as credible to pilot trial participants as usual GP care and more credible than counseling: most patients (62.5%) preferred to be allocated to acupuncture, rating it more highly at baseline than counseling or usual GP care as potentially able to benefit their depression (P = 0.002). Disparities were identified in the working models of acupuncturists and counselors that suggest inherent differences between interventions in terms of the process and intended potential outcomes of therapy, as well as the interaction between patients and therapists. Conclusion: The Medical Research Council (MRC) framework with its phased, mixed method approach has helped to develop research that has better model validity than trials to date in this field. The next phase of research will need to involve acupuncture and counseling practitioners to help researchers to develop realistic and credible care packages for a full‐scale trial, where patients are likely to be severely and chronically ill.
Comparison of antioxidant defence parameters in colostrum and milk between Berrichon du Cher ewes and Uhrusk ewes

The aim of the study was to evaluate the profile of antioxidant parameters in ewes' colostrum and milk in relation to breed during 5 d post partum. Total antioxidant capacity (TAC) was analysed and the activity of the enzymic antioxidants, glutathione peroxidase (GSH-Px) and glutathione transferase (GSH-Tr), as well as the concentration of the non-enzymic antioxidants, vitamin C, vitamin A and β-carotene, were measured. Samples were collected from healthy animals belonging to two ewe breeds: Berrichon du Cher (n=15) and Uhrusk (n=15) kept in the Podlasie Province (Poland). Colostrum was sampled directly after parturition, as well as after 12, 24 and 48 h later and milk was sampled 5 d after parturition. Colostrum and milk for the evaluation of all parameters except for vitamin A and β-carotene were centrifuged, and the supernatant was used for further analysis. Spectrophotometric methods were used for biochemical measurements. The results showed dynamic changes of antioxidative parameters within the time period examined. TAC values and GSH-Px activity increased significantly during the experiment. GSH-Tr activity showed a similar tendency in Uhrusk ewes but an opposite relationship in Berrichon du Cher. Concentrations of examined vitamins followed the increasing trends noticed in the activities of antioxidative enzymes. Moreover, differences between breeds in the evaluated parameters were detected; these differences were not unequivocal however. The results are also a source of not previously published physiological antioxidant profile in colostrum and milk of ewes over the post-partum period.
Urinary incontinence in community dwelling elderly: are there sex differences in help-seeking behaviour?

Objective – To assess sex differences in disorder- and patient-specific factors influencing help-seeking behaviour by independently living elderly people with urinary incontinence. Design – Qualitative and quantitative analyses of the collected data. Setting – Patients from nine family practices involved in the Nijmegen Monitoring Project. Subjects – Independently living elderly aged 60 or over. MAIN outcome measures – The study population consisted of participants in a study on the prevalence of incontinence among elderly people. Independently living elderly people aged 60 or over from nine family practices with uncomplicated urinary incontinence were interviewed at home using a disorder-specific questionnaire and open-ended questions. Results – In total, 56 men and 314 women were interviewed. Half of them had sought help from a general practitioner. Men sought help from their GP when they had less severe incontinence than women. Help-seeking behaviour in women was related to the duration of symptoms (odds ratio 3.66, 95% CI 1.44–9.39), the presence of incontinence-related symptoms such as constant feeling of vaginal pressure and pain in the lower abdomen (odds ratio 2.69, 95% CI 1.52–4.76) and the severity of incontinence (odds ratio 1.69, 95% CI 0.99–2.88). In men help-seeking was related to the distress experienced in daily life (odds ratio 7.10, 95% CI 1.15–43.91). Most men and women who did not seek help consider their incontinence as not being serious enough, or they had inappropriate beliefs such as that “incontinence is age-related” and “there is nothing that can be done about incontinence”. Conclusion – Help-seeking in women is determined by the duration of the symptoms, the presence of concomitant complaints and the severity of incontinence. In men help-seeking behaviour is mostly related to the distress experienced in daily life. In men and women the most important reasons for not seeking help are that they consider the incontinence not serious enough and that they believe that there are no treatment options available.
Enhancing infant attachment security: An examination of treatment efficacy and differential susceptibility

Abstract This randomized controlled trial examined (a) the efficacy of a brief intervention designed to increase the rate of secure infant attachment, (b) the differential susceptibility hypothesis, and (c) whether maternal attachment styles moderated the expected Treatment × Irritability interaction in predicting infant attachment outcomes. Although there was no main effect of treatment, a significant Treatment × Irritability interaction revealed intervention effects for the highly irritable infants only, thus supporting one of two predictions of the differential susceptibility hypothesis: highly irritable infants would have disproportionately better outcomes than moderately irritable infants in better conditions (i.e., with intervention). When separate analyses were conducted with maternal attachment styles, we found significant three-way interactions among treatment, irritability, and each of the examined maternal attachment style dimensions (i.e., secure–fearful and dismissing–preoccupied). Specifically, with more secure mothers, beneficial effects of intervention emerged for highly irritable infants. For more dismissing mothers, the results revealed support for both predictions of the differential susceptibility hypothesis: highly irritable infants, compared to moderately irritable infants, were both more likely to be secure with intervention and less likely to be secure when in the control group. It is interesting that, for more preoccupied mothers, a treatment effect emerged only for moderately irritable infants. We discuss the implications of these findings for the differential susceptibility hypothesis as well as for early intervention.
Operating bioreactors for microbial exopolysaccharide production

There is considerable interest in exploiting the novel physical and biological properties of microbial exopolysaccharides in industry and medicine. For economic and scientific reasons, large scale production under carefully monitored and controlled conditions is required. Producing exopolysaccharides in industrial fermenters poses several complex bioengineering and microbiological challenges relating primarily to the very high viscosities of such culture media, which are often exacerbated by the producing organism’s morphology. What these problems are, and the strategies for dealing with them are discussed critically in this review, using pullulan, curdlan, xanthan, and fungal β-glucans as examples of industrially produced microbial exopolysaccharides. The role of fermenter configuration in their production is also examined.
ON ULAM APPROXIMATION OF THE ISOLATED SPECTRUM AND EIGENFUNCTIONS OF HYPERBOLIC MAPS

Perron-Frobenius operators and their eigendecompositions are increasingly being used as tools of global analysis for higher dimensional systems. The numerical computation of large, isolated eigenvalues and their corresponding eigenfunctions can reveal important persistent structures such as almost-invariant sets, however, often little can be said rigorously about such calculations. We attempt to explain some of the numerically observed behaviour by constructing a hyperbolic map with a Perron-Frobenius operator whose eigendecomposition is representative of numerical calculations for hyperbolic systems. We explicitly construct an eigenfunction associated with an isolated eigenvalue and prove that a special form of Ulam's method well approximates the isolated spectrum and eigenfunctions of this map.
Modeling, Analysis and Comparative of Down Sampling based Clamping SV PWM for Cascaded and Diode Clamped Multilevel Inverter fed Induction Motor Drive

This paper presents investigation and performance analysis of novel down sampling based clamping SV PWM technique for diode and cascaded Multi-level Invereter fed to Induction motor drive. A novel down sampling based clamping SVPWM has developed by adding triangular off set to sinusoidal fundamental waveform is modified by down sampling the reference wave by order of 10 so this technique is called clamping space vector pulse width modulation techniques such as PD, POD and APOD. so as to shift the lower order harmonics to higher order side. This novel carrier is compared with the offset injected space vector reference waveform to generate the required PWM pulses to the inverter. To analyze the performance of the proposed PWM technique it is implemented on seven level diode and cascaded Multi-level Inverter using Matlab/Simulink software tool for output line, phase voltage, currents, speed, torque and Total harmonic distortion analysis.
Multifractal Analysis of Sleep EEG Dynamics in Humans

The aim of this study is to investigate the possibility that human sleep EEGs can be characterized by a multifractal spectrum using wavelet transform modulus maxima (WTMM). We used sleep EEGs taken from healthy subjects during the four stages of sleep and REM sleep. Our findings showed that the dynamics in human sleep EEGs could be adequately described by a set of scales and characterized by multifractals. We performed multivariate discriminate analysis to evaluate the use of multifractal features for classification. The multivariate discriminate analysis using within-groups covariance matrices for all sleep stages yielded a total error rate of 41.8%. In conclusion, multifractal formalism, based on the WTMM, appears to be a good tool for characterizing dynamics in sleep EEGs
Fungal Diversity in Deep-Sea Hydrothermal Ecosystems

ABSTRACT Deep-sea hydrothermal ecosystems are considered oases of life in oceans. Since the discovery of these ecosystems in the late 1970s, many endemic species of Bacteria, Archaea, and other organisms, such as annelids and crabs, have been described. Considerable knowledge has been acquired about the diversity of (micro)organisms in these ecosystems, but the diversity of fungi has not been studied to date. These organisms are considered key organisms in terrestrial ecosystems because of their ecological functions and especially their ability to degrade organic matter. The lack of knowledge about them in the sea reflects the widely held belief that fungi are terrestrial organisms. The first inventory of such organisms in deep-sea hydrothermal environments was obtained in this study. Fungal diversity was investigated by analyzing the small-subunit rRNA gene sequences amplified by culture-independent PCR using DNA extracts from hydrothermal samples and from a culture collection that was established. Our work revealed an unsuspected diversity of species in three of the five fungal phyla. We found a new branch of Chytridiomycota forming an ancient evolutionary lineage. Many of the species identified are unknown, even at higher taxonomic levels in the Chytridiomycota, Ascomycota, and Basidiomycota. This work opens the way to new studies of the diversity, ecology, and physiology of fungi in oceans and might stimulate new prospecting for biomolecules. From an evolutionary point of view, the diversification of fungi in the oceans can no longer be ignored.
Positive body image and young women’s health: Implications for sun protection, cancer screening, weight loss and alcohol consumption behaviours

This study examined the link between positive body image and a range of health behaviours. Participants were 256 women who completed an online questionnaire measuring body appreciation, body dissatisfaction, sun protection, cancer screening, seeking medical attention, weight-loss behaviour and alcohol and tobacco consumption. Results indicated that body appreciation was positively related to sun protection, skin screening and seeking medical attention and negatively related to weight-loss behaviour. Body appreciation explained unique variance, over and above body dissatisfaction, in sun protection, skin screening and weight-loss behaviour. These results have implications for interventions to improve adherence to health behaviours.
A Rapid and Inexpensive Method for Anticipating Severe Toxicity to Fluorouracil and Fluorouracil-based Chemotherapy

Dihydropyrimidine dehydrogenase (DPD) deficiency leads to dramatic overexposure to fluorouracil (5-FU), resulting in a potentially lethal outcome in patients treated with standard doses. The aim of this study was to validate, in a routine clinical setting, a simple and rapid method to determine the DPD status in a subset of cancer patients, all presenting with life-threatening toxicities following 5-FU or capecitabine intake. In this study, 80 out of 615 patients (13%) suffered severe toxicities, including 5 lethal ones (0.8%), during or after chemotherapy with a fluoropyrimidine drug. Patients with severe toxicities were treated with 5-FU (76 patients) or capecitabine-containing protocols (4 patients). Simplified uracil to di-hydrouracil (U/UH2) ratio determination in plasma was retrospectively performed in these 80 patients, as a surrogate marker of DPD activity. When possible, 5-FU Css determination was performed, and screenings for the canonical IVS14+1G>A mutation were systematically carried out. Comparison of the U/UH2 ratios with a reference, non-toxic population, showed abnormal values suggesting impaired DPD activity in 57 out of the 80 toxic patients (71%) included in this study, and in 4 out of 5 patients (80%) with a fatal outcome. Similarly, drug exposures up to 15 times higher than the range observed in the non-toxic population were also observed. Importantly, no IVS14+1G>A mutation was found in these patients, including those displaying the most severe or lethal toxicities. These data warrant systematic detection of DPD-deficient patients prior to fluoropyrimidine administration, including when oral capecitabine (Xeloda) is scheduled. Finally, the simplified methodology presented here proved to be a low cost and rapid way to identify routinely patients at risk of toxicity with 5-FU or capecitabine.
HIV Pathogenesis: Knowledge Gained after Two Decades of Research

Great progress has been made in our understanding of HIV since its initial discovery about 20 years ago. The ability of HIV to infect CD4+ lymphocytes and a wide variety of other cells in the body is appreciated, as is its role in immunologic, gastrointestinal, and brain disorders. HIV enters cells via the CD4 molecule, chemokine co-receptors (CXCR4, CCR5), and other cell-surface proteins. Several accessory virus-associated genes (e.g., Rev, Tat, Nef) have uncovered unique pathways that can also be observed in normal cells. Recently, the discovery of natural cellular resistant factors (APOBEC3G and TRIM5a) has provided avenues for novel antiviral therapies. Studies of long-term survivors have given insight into immune responses that control HIV and can prevent infection. Neutralizing antibodies and CD8+ cell cytotoxic responses, as well as plasmacytoid dendritic cells and CD8+ cell non-cytotoxic antiviral responses, are adaptive and innate immune activities mediating this anti-HIV effect. HIV vaccine studies have indicated that conventional approaches do not work against this integrated intracellular parasite. While much has been learned about HIV, more details are needed about its infection cycle and its pathologic effects in the body. The past 20 years have yielded important information on HIV/AIDS that should lead to effective anti-HIV therapies and a vaccine.