Miracle-dz/UniFAR-FTUs huggingface dataset:
Accuracy of real‐time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: A pilot study

Real‐time shear wave elastography (SWE) is a novel, noninvasive method to assess liver fibrosis by measuring liver stiffness. This single‐center study was conducted to assess the accuracy of SWE in patients with chronic hepatitis C (CHC), in comparison with transient elastography (TE), by using liver biopsy (LB) as the reference standard. Consecutive patients with CHC scheduled for LB by referring physicians were studied. One hundred and twenty‐one patients met inclusion criteria. On the same day, real‐time SWE using the ultrasound (US) system, Aixplorer (SuperSonic Imagine S.A., Aix‐en‐Provence, France), TE using FibroScan (Echosens, Paris, France), and US‐assisted LB were consecutively performed. Fibrosis was staged according to the METAVIR scoring system. Analyses of receiver operating characteristic (ROC) curve were performed to calculate optimal area under the ROC curve (AUROC) for F0‐F1 versus F2‐F4, F0‐ F2 versus F3‐F4, and F0‐F3 versus F4 for both real‐time SWE and TE. Liver stiffness values increased in parallel with degree of liver fibrosis, both with SWE and TE. AUROCs were 0.92 (95% confidence interval [CI]: 0.85‐0.96) for SWE and 0.84 (95% CI: 0.76‐0.90) for TE (P = 0.002), 0.98 (95% CI: 0.94‐1.00) for SWE and 0.96 (95% CI: 0.90‐0.99) for TE (P = 0.14), and 0.98 (95% CI: 0.93‐1.00) for SWE and 0.96 (95% CI: 0.91‐0.99) for TE (P = 0.48), when comparing F0‐F1 versus F2‐ F4, F0‐ F2 versus F3‐F4, and F0 ‐F3 versus F4, respectively. Conclusion: The results of this study show that real‐time SWE is more accurate than TE in assessing significant fibrosis (≥F2). With respect to TE, SWE has the advantage of imaging liver stiffness in real time while guided by a B‐mode image. Thus, the region of measurement can be guided with both anatomical and tissue stiffness information. (HEPATOLOGY 2012;56:2125–2133)
Simulator study of young driver's instinctive response of lower extremity to a collision

ABSTRACT Objective: A driver's instinctive response of the lower extremity in braking movement consists of two parts, including reaction time and braking reaction behavior. It is critical to consider these two components when conducting studies concerning driver's brake movement intention and injury analysis. The purposes of this study were to investigate the driver reaction time to an oncoming collision and muscle activation of lower extremity muscles at the collision moment. The ultimate goal is to provide data that aid in both the optimization of intervention time of an active safety system and the improvement of precise protection performance of a passive safety system. Method: A simulated collision scene was constructed in a driving simulator, and 40 young volunteers (20 male and 20 female) were recruited for tests. Vehicle control parameters and electromyography characteristics of eight muscles of the lower extremity were recorded. The driver reaction time was divided into pre-motor time (PMT) and muscle activation time (MAT). Muscle activation level (ACOL) at the collision moment was calculated and analysed. Results: PMT was shortest for the tibialis anterior (TA) muscle (243∼317 ms for male and 278∼438 ms for female). Average MAT of the TA ranged from 28-55 ms. ACOL was large (5∼31% for male and 5∼23% for female) at 50 km/h, but small (<12%) at 100 km/h. ACOL of the gluteus maximus was smallest (<3%) in the 25 and 100 km/h tests. ACOL of RF of men was significantly smaller than that of women at different speeds. Conclusions: Ankle dorsiflexion is firstly activated at the beginning of the emergency brake motion. Males showed stronger reaction ability than females, as suggested by male's shorter PMT. The detection of driver's brake intention is upwards of 55ms sooner after introducing the electromyography. Muscle activation of the lower extremity is an important factor for 50 km/h collision injury analysis. For higher speed collisions, this might not be a major factor. The activations of certain muscles may be ignored for crash injury analysis at certain speeds, such as gluteus maximus at 25 or 100 km/h. Furthermore, the activation of certain muscles should be differentiated between males and females during injury analysis.
Functional characterization of UvrD helicases from Haemophilus influenzae and Helicobacter pylori

Haemophilus influenzae and Helicobacter pylori are major bacterial pathogens that face high levels of genotoxic stress within their host. UvrD, a ubiquitous bacterial helicase that plays important roles in multiple DNA metabolic pathways, is essential for genome stability and might, therefore, be crucial in bacterial physiology and pathogenesis. In this study, the functional characterization of UvrD helicase from Haemophilus influenzae and Helicobacter pylori is reported. UvrD from Haemophilus influenzae (HiUvrD) and Helicobacter pylori (HpUvrD) exhibit strong single‐stranded DNA‐specific ATPase and 3′–5′ helicase activities. Mutation of highly conserved arginine (R288) in HiUvrD and glutamate (E206) in HpUvrD abrogated their activities. Both the proteins were able to bind and unwind a variety of DNA structures including duplexes with strand discontinuities and branches, three‐ and four‐way junctions that underpin their role in DNA replication, repair and recombination. HiUvrD required a minimum of 12 nucleotides, whereas HpUvrD preferred 20 or more nucleotides of 3′‐single‐stranded DNA tail for efficient unwinding of duplex DNA. Interestingly, HpUvrD was able to hydrolyze and utilize GTP for its helicase activity although not as effectively as ATP, which has not been reported to date for UvrD characterized from other organisms. HiUvrD and HpUvrD were found to exist predominantly as monomers in solution together with multimeric forms. Noticeably, deletion of distal C‐terminal 48 amino acid residues disrupted the oligomerization of HiUvrD, whereas deletion of 63 amino acids from C‐terminus of HpUvrD had no effect on its oligomerization. This study presents the characteristic features and comparative analysis of Haemophilus influenzae and Helicobacter pylori UvrD, and constitutes the basis for understanding the role of UvrD in the biology and virulence of these pathogens.
Predictors of health care provider anticipatory guidance provision for older drivers

ABSTRACT Objective: The objective of this study was to determine the frequency of health care provider (HCP) driving safety/cessation-related anticipatory guidance provision and predictors of driving safety-related anticipatory guidance provision by HCPs. Methods: HCPs in several central/upper Midwest states were surveyed about frequency of anticipatory guidance provision (n = 265). Results: More than half of HCPs stated that they frequently or always provide driving safety/cessation-related anticipatory guidance to patients aged 85 or older, 38.7% provided this guidance to patients aged 75 to 84, and 13.7% to patients aged 65 to 74. Predictors of driving safety/cessation-related anticipatory guidance provision differed by patient age. For patients aged 65–74, HCP personal experience with a motor vehicle crash (either the HCP themselves or a friend/family member) was significant in predicting anticipatory guidance provision. However, for patients aged 75 and older, significant predictors included HCP rural practice, HCP age, and percentage of HCP patients who were older adults. Conclusion: HCP counseling provision related to driving issues differs by patient age and several HCP characteristics, including HCP rurality, age, and personal experience with motor vehicle crashes. Because aging results in physical and mental changes that affect driving and can be identified by HCPs, HCPs are in a position to counsel patients on the potential impacts of aging on the act of driving. Future research should examine the reasons for the differences in anticipatory guidance provision found in this study.
Scavenger receptor a restrains T‐cell activation and protects against concanavalin A‐induced hepatic injury

Negative feedback immune mechanisms are essential for maintenance of hepatic homeostasis and prevention of immune‐mediated liver injury. We show here that scavenger receptor A (SRA/CD204), a pattern recognition molecule, is highly up‐regulated in the livers of patients with autoimmune or viral hepatitis, and of mice during concanavalin A (Con A)‐induced hepatitis (CIH). Strikingly, genetic SRA ablation strongly sensitizes mice to Con A‐induced liver injury. SRA loss, increased mortality and liver pathology correlate with excessive production of IFN‐γ and heightened activation of T cells. Increased liver expression of SRA primarily occurs in mobilized hepatic myeloid cells during CIH, including CD11b+Gr‐1+ cells. Mechanistic studies establish that SRA on these cells functions as a negative regulator limiting T‐cell activity and cytokine production. SRA‐mediated protection from CIH is further validated by adoptive transfer of SRA+ hepatic mononuclear cells or administration of a lentivirus‐expressing SRA, which effectively ameliorates Con A‐induced hepatic injury. Also, CIH and clinical hepatitis are associated with increased levels of soluble SRA. This soluble SRA displays a direct T‐cell inhibitory effect and is capable of mitigating Con A‐induced liver pathology. Conclusion: Our findings demonstrate an unexpected role of SRA in attenuation of Con A‐induced, T‐cell‐mediated hepatic injury. We propose that SRA serves as an important negative feedback mechanism in liver immune homeostasis, and may be exploited for therapeutic treatment of inflammatory liver diseases. (HEPATOLOGY 2013)
A robust estimation of the effects of motorcycle autonomous emergency braking (MAEB) based on in-depth crashes in Australia

ABSTRACT Objective: Autonomous emergency braking (AEB) is a safety system that detects imminent forward collisions and reacts by slowing down the host vehicle without any action from the driver. AEB effectiveness in avoiding and mitigating real-world crashes has recently been demonstrated. Research suggests that a translation of AEB to powered 2-wheelers could also be beneficial. Previous studies have estimated the effects of a motorcycle AEB system (MAEB) via computer simulations. Though effects of MAEB were computed for motorcycle crashes derived from in-depth crash investigation, there may be some inaccuracies due to limitations of postcrash investigation (e.g., inaccuracies in preimpact velocity of the motorcycle). Furthermore, ideal MAEB technology was assumed, which may lead to overestimation of the benefits. This study sought to evaluate the sensitivity of the simulations to variations in reconstructed crash cases and the capacity of the MAEB system in order to provide a more robust estimation of MAEB effects. Methods: First, a comprehensive classification of accidents was used to identify scenarios in which MAEB was likely to apply, and representative crash cases from those available for this study were populated for each crash scenario. Second, 100 variant cases were generated by randomly varying a set of simulation parameters with given normal distributions around the baseline values. Variants reflected uncertainties in the original data. Third, the effects of MAEB were estimated in terms of the difference in the impact speed of the host motorcycle with and without the system via computer simulations of each variant case. Simulations were repeated assuming both an idealized and a realistic MAEB system. For each crash case, the results in the baseline case and in the variants were compared. A total of 36 crash cases representing 11 common crash scenarios were selected from 3 Australian in-depth data sets: 12 cases from New South Wales, 13 cases from Victoria, and 11 cases from South Australia. Results: The reduction in impact speed elicited by MAEB in the baseline cases ranged from 2.8 to 10.0 km/h. The baseline cases over- or underestimated the mean impact speed reduction of the variant cases by up to 20%. Constraints imposed by simulating more realistic capabilities for an MAEB system produced a decrease in the estimated impact speed reduction of up to 14% (mean 5%) compared to an idealized system. Conclusions: The small difference between the baseline and variant case results demonstrates that the potential effects of MAEB computed from the cases described in in-depth crash reports are typically a good approximation, despite limitations of postcrash investigation. Furthermore, given that MAEB intervenes very close to the point of impact, limitations of the currently available technologies were not found to have a dramatic influence on the effects of the system.
Validation of terminal peptide of procollagen III for the detection and assessment of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease

Liver biopsy is the reference standard for the detection of nonalcoholic steatohepatitis (NASH) within nonalcoholic fatty liver disease (NAFLD). The aim of this study was to identify a biomarker of NASH in patients without significant fibrosis. In all, 172 patients from two centers with biopsy‐proven NAFLD were included in this study. Eighty‐four patients from a single center were included as a derivation cohort and 88 patients from a second center were included as a validation cohort. Serum samples were tested for candidate markers of fibrosis and inflammation alongside hematological and biochemical markers. Among patients without advanced fibrosis, terminal peptide of procollagen III (PIIINP) was the only marker found to be associated with a histological diagnosis of NASH in both cohorts. PIIINP also correlated with the total NAFLD activity score (NAS) and its constituent components (P < 0.001). Area under receiver operating characteristic curve (AUROC) for PIIINP in discriminating between NASH and simple steatosis (SS) was 0.77‐0.82 in patients with F0‐2 fibrosis and 0.82‐0.84 in patients with F0‐3 fibrosis. PIIINP was elevated in patients with advanced fibrosis, the overwhelming majority of whom had NASH. When incorporating patients with all degrees of fibrosis from both cohorts, PIIINP was able to discriminate between patients with SS and those with NASH or advanced fibrosis with AUROC 0.85‐0.87. Conclusion: PIIINP discriminates between SS and NASH or advanced fibrosis. The use of a single biomarker in this context will be of clinical utility in detecting the minority of patients with NAFLD who have NASH or advanced fibrosis related to NASH. (HEPATOLOGY 2013)
Effect of an Exercise Program on Quality of Life of Women with Fibromyalgia

Abstract The purpose of this study was to examine the effect of a 10-week/20-session exercise program on quality of life (QOL) of women with fibromyalgia (FM). Thirty-two women with FM participated in one of the following groups: hospital-based group (G) (n = 10); home-based group (H) (n = 10); non-exercising control group (C) (n = 12). The hospital-based exercise program was conducted twice per week, and the home-based group participants followed the videotaped exercise program and maintained a detailed exercise log. The measures used assessed the participants' subjective and objective quality of life. Twenty-one women met all the completion requirements for the study. The baseline age (years) means were: C = 43.50 (n = 8), G = 51.78 (n = 9), H = 56 (n = 4). Data were analyzed using a one-way ANOVA. Over the ten-week period, significant improvements were made in the Range of Motion and in the Fibromyalgia Impact Questionnaire scores of the two exercise groups. However, the Tender Point Count and Tender Point Severity scores did not show any significant improvements. We conclude that the Fibromyalgia Exercise Program was effective in improving QOL of women with FM with minimal post exercise discomfort.
The Value of Staff Nurse Involvement in Decision Making

OBJECTIVES: The objectives of this study were to explore the perceptions of hospital-based staff nurses regarding their involvement in decision making and to gain an understanding of the ways nurses would like to be involved in decision making. BACKGROUND: How nurses want to be involved and the extent to which hospital-based staff nurses are involved in formal and informal structures for decision making remain unknown. METHODS: Stratified cluster random sampling was used to identify hospitals to participate in the study. Staff nurses and chief nursing officers (CNOs) from 10 hospitals in Colorado were invited to participate in this qualitative descriptive study informed by grounded theory. Focus groups with staff nurses and individual interviews with CNOs were also conducted. RESULTS: Safe quality patient care was threaded throughout discussions among the staff nurses and CNOs. CONCLUSIONS: Staff nurses viewed involvement in decision making through the lens of an egalitarian process, whereas administration viewed involvement as soliciting input but making decisions unilaterally.
The postbinding activity of scavenger receptor class B type I mediates initiation of hepatitis C virus infection and viral dissemination

Scavenger receptor class B type I (SR‐BI) is a high‐density lipoprotein (HDL) receptor highly expressed in the liver and modulating HDL metabolism. Hepatitis C virus (HCV) is able to directly interact with SR‐BI and requires this receptor to efficiently enter into hepatocytes to establish productive infection. A complex interplay between lipoproteins, SR‐BI and HCV envelope glycoproteins has been reported to take place during this process. SR‐BI has been demonstrated to act during binding and postbinding steps of HCV entry. Although the SR‐BI determinants involved in HCV binding have been partially characterized, the postbinding function of SR‐BI remains largely unknown. To uncover the mechanistic role of SR‐BI in viral initiation and dissemination, we generated a novel class of anti–SR‐BI monoclonal antibodies that interfere with postbinding steps during the HCV entry process without interfering with HCV particle binding to the target cell surface. Using the novel class of antibodies and cell lines expressing murine and human SR‐BI, we demonstrate that the postbinding function of SR‐BI is of key impact for both initiation of HCV infection and viral dissemination. Interestingly, this postbinding function of SR‐BI appears to be unrelated to HDL interaction but to be directly linked to its lipid transfer function. Conclusion: Taken together, our results uncover a crucial role of the SR‐BI postbinding function for initiation and maintenance of viral HCV infection that does not require receptor‐E2/HDL interactions. The dissection of the molecular mechanisms of SR‐BI–mediated HCV entry opens a novel perspective for the design of entry inhibitors interfering specifically with the proviral function of SR‐BI. (HEPATOLOGY 2013)
Investigation of polyuria and polydipsia

Abstract The causes of polyuria and polydipsia in childhood can be subdivided into three groups; cranial diabetes insipidus, nephrogenic diabetes insipidus and primary polydipsia. A detailed history and examination alone may suggest an underlying explanation for the child's symptoms but a range of baseline and then more extensive investigations are usually required before a diagnosis can be reached. These investigations are not without risk to the patient and it is of paramount importance that they are conducted safely and in a logical manner. In a small number of cases referral to a specialist centre will be required.
Educational Service Quality in Zanjan University of Medical Sciences from Students' Point of View.

This study aims at evaluating perceived service quality in Zanjan University of Medical Sciences (ZUMS). Thisstudy was cross-sectional and authors surveyed educational services at ZUMS. Through stratified random sampling,384 students were selected and an adapted SERVQUAL instrument was used for data collection. Data analysis wasperformed by using SPSS 11.5. The results indicated that there were the negative mean score of quality gap in alldimensions of the service quality. Overall services quality mean was (-1.6±.78). The highest and lowest differencesof mean scores between students' expectations and perceptions were in the responsiveness and (-1.83±1.01) andreliability ((-1.33±.79) dimensions respectively. Paired t-test showed the significant statistical differences betweenstudents' expectations and perceptions (ρ < <0.001) in all dimensions of the service quality. Thus, improvementactions are felt in all domains of the educational service quality; Students rated the responsiveness as the mostimportant dimension of service quality in ZUMS.
Questionário de freqüência de consumo alimentar e recordatório de 24 horas: aspectos metodológicos para avaliação da ingestão de lipídeos

The correct assessment of lipid intake through dietary questionnaires is interesting in population studies since lipids are involved in the development and prevention of coronary artery diseases. Food intake questionnaires consist of indirect methods of assessing the nutritional status and are subject to errors inherent to the individual and the study methodology. It is essential that such methods, especially the food frequency be validated for the studied population. Among the main mistakes that involve the assessment of lipid intake are intrapersonal variability which can be minimized by increasing the number of analyzed recalls and by statistical techniques. Biomarkers are used increasingly to estimate long term food intake and play an important role in the correct assessment of the real lipid intake. In this context, this study aims to discuss methodological aspects in estimating lipid intake by the population. The aspects associated with assessment errors of food intake and the use of food frequency questionnaire and 24-hour recall, the importance of studies using biomarkers and the use of dietary questionnaires to estimate lipid intake are discussed.