Miracle-dz/UniFAR-FTUs huggingface dataset:
Diagnosis, Management, and Outcome of Aortitis at a Single Center

Background: Aortitis is a rare condition with inflammatory or infectious etiology that can be difficult to diagnose due to the highly variable clinical presentation and nonspecific symptoms. However, current literature on the diagnosis, management, and prognosis of aortitis is extremely scarce. Methods: We retrospectively reviewed all patients’ charts who were diagnosed with giant cell arteritis, Takayasu arteritis, or noninfectious aortitis presenting at a single center between January 1, 2009, and April 17, 2015. Data collected included demographics, medical history, comorbidities, laboratory and imaging data, management, and outcome. Results: Among the included 15 patients presenting with aortitis at our center, 53% were diagnosed with Takayasu arteritis, 33% with idiopathic inflammatory aortitis, and 13% with giant cell arteritis. All patients received steroid treatment, 67% received adjunctive immunosuppressants or immunomodulators, and 33% underwent interventional procedures. Based on clinical presentation and laboratory and imaging findings at the last follow-up visit for each patient, 67% showed improvement, 27% had no change in disease activity, and 7% had a progression of the disease. Conclusions: Takayasu arteritis was found to be more common than idiopathic inflammatory aortitis and giant cell arteritis among our 15 cases diagnosed with aortitis. All patients received medical therapy and 33% received interventional procedures, leading to 67% improvement of disease activity or related complications. This article also offers a comprehensive review of the diagnosis, management, and outcome of aortitis, supplementing the very limited literature on this disease.
Meaningful Components of Exercise and Active Recreation for Spinal Cord Injuries

This qualitative study used focus groups to identify meaningful components of exercise and active recreation (E/AR) related to consistent participation for those with spinal cord injury (SCI). Transcripts from each focus group were analyzed with classical content analysis, grounded theory coding, and meaning condensation using the International Classification of Function, Disability and Health (ICF). Variables within each of the ICF domains (body structures and functions, activities/participation, and environment) were indicated as meaningful components leading to increased participation, independence, and reasons why people consistently participated in E/AR. Occupational therapists can utilize these components to implement therapeutic intervisions, which provide clients with a sense of purpose and being, thus improving outcomes in meaningful occupations.
Access point selection and auction-based scheduling in uplink MU-MIMO WLANs

We study the uplink multi-user multiple-input multiple-output (UL MU-MIMO) channel in a wireless local area network (WLAN) with multiple access points (APs) and multiple stations (STAs). APs are allocated with different orthogonal frequency-division multiplexing (OFDM) subcarriers. Each AP has multiple antennas and applies zero-forcing successive interference cancellation (ZF-SIC) as in [1] for spatial multiplexing in its own MU-MIMO channel. STAs arrive and depart dynamically. The joint AP selection and STA scheduling problem is modeled as an auction game. STAs perform AP selection to maximize their utility, which is a function of the expected rate, the valuation and the price charged by APs. APs schedule STAs to maximize the social welfare and set price to ensure truthful revelation of STAs' valuation. The auction is conducted in a distributed fashion and requires subtle information exchange. Shown by the simulation, the proposed mechanism has superior performance in respect of social welfare, throughput and load balancing.
Structural Behavior of Precast Lightweight Foam Concrete Sandwich Panel with Double Shear Truss Connectors under Flexural Load

This paper presents the structural behaviour of precast lightweight foam concrete sandwich panel (PFLP) under flexure, studied experimentally and theoretically. Four (4) full scale specimens with a double shear steel connector of 6 mm diameter and steel reinforcement of 9 mm diameter were cast and tested. The panel’s structural behavior was studied in the context of its ultimate flexure load, crack pattern, load-deflection profile, and efficiency of shear connectors. Results showed that the ultimate flexure load obtained from the experiment is influenced by the panel’s compressive strength and thickness. The crack pattern recorded in each panel showed the emergence of initial cracks at the midspan which later spread toward the left and right zones of the slab. The theoretical ultimate load for fully composite and noncomposite panels was obtained from the classical equations. All panel specimens were found to behave in a partially composite manner. Panels PLFP-3 and PLFP-4 with higher compressive strength and total thickness managed to obtain a higher degree of compositeness which is 30 and 32.6 percent, respectively.
A Model for Evaluating Collaborative Health Care Programs for Children With Special Needs

As health care professionals are being challenged to become more collaborative with and accountable to parents and managed care organizations in the provision of diagnostic and treatment services, the development of more systematic and responsive procedures for program evaluation are needed. This article reviews the general issues related to program evaluation and the unique concerns related to evaluating collaborative disciplinary health care programs. A model for evaluating collaborative disciplinary programs for children with special health care needs is described. A comprehensive review system is used to evaluate process components of the program (productivity, utilization, accountability, continuity, and coordination). Questionnaires, interviews, and chart reviews are utilized to evaluate outcome variables, including consumer satisfaction, medical outcomes, and psychosocial outcomes. Implications for improving future evaluation efforts and clinical practice are discussed.
Solution Path for Pin-SVM Classifiers With Positive and Negative $\tau $ Values

Applying the pinball loss in a support vector machine (SVM) classifier results in pin-SVM. The pinball loss is characterized by a parameter <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula>. Its value is related to the quantile level and different <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula> values are suitable for different problems. In this paper, we establish an algorithm to find the entire solution path for pin-SVM with different <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula> values. This algorithm is based on the fact that the optimal solution to pin-SVM is continuous and piecewise linear with respect to <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula>. We also show that the nonnegativity constraint on <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula> is not necessary, i.e., <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula> can be extended to negative values. First, in some applications, a negative <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula> leads to better accuracy. Second, <inline-formula> <tex-math notation="LaTeX">$\tau = -1$ </tex-math></inline-formula> corresponds to a simple solution that links SVM and the classical kernel rule. The solution for <inline-formula> <tex-math notation="LaTeX">$\tau = -1$ </tex-math></inline-formula> can be obtained directly and then be used as a starting point of the solution path. The proposed method efficiently traverses <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula> values through the solution path, and then achieves good performance by a suitable <inline-formula> <tex-math notation="LaTeX">$\tau $ </tex-math></inline-formula>. In particular, <inline-formula> <tex-math notation="LaTeX">$\tau = 0$ </tex-math></inline-formula> corresponds to C-SVM, meaning that the traversal algorithm can output a result at least as good as C-SVM with respect to validation error.
Decentralized heuristic access policy design for two cognitive secondary users under a primary Type-I HARQ process

In this paper, decentralized heuristic access policies are designed for two secondary users (SUs) in an underlay cognitive radio network in which the PU employs Type-I Hybrid ARQ. Exploiting the redundancy in PU retransmissions, each SU receiver applies interference cancellation (IC) to remove a successfully decoded PU message in the subsequent PU retransmissions. There is no central control unit and we consider two different scenarios. In the first scenario, each SU transmitter only knows the PU message knowledge state of its corresponding SU receiver. In the second scenario, the SU transmitters are unaware of any PU message knowledge states at the SU receivers. We design access policies in both offline and online modes, where in an online mode each SU can learn from its own local information. Using heuristic approaches for the considered scenarios, decentralized access policies are proposed to maximize the average sum throughput of SUs under a PU throughput degradation constraint. The results also show that heuristic access policies using the online mode have a performance gain close to that obtained using the offline mode, while providing increased robustness and flexibility.
Murine Neonates Infected with Yersinia enterocolitica Develop Rapid and Robust Proinflammatory Responses in Intestinal Lymphoid Tissues

ABSTRACT Neonatal animals are generally very susceptible to infection with bacterial pathogens. However, we recently reported that neonatal mice are highly resistant to orogastric infection with Yersinia enterocolitica. Here, we show that proinflammatory responses greatly exceeding those in adults arise very rapidly in the mesenteric lymph nodes (MLN) of neonates. High-level induction of proinflammatory gene expression occurred in the neonatal MLN as early as 18 h postinfection. Marked innate phagocyte recruitment was subsequently detected at 24 h postinfection. Enzyme-linked immunosorbent spot assay (ELISPOT) analyses indicated that enhanced inflammation in neonatal MLN is contributed to, in part, by an increased frequency of proinflammatory cytokine-secreting cells. Moreover, both CD11b+ and CD11b− cell populations appeared to play a role in proinflammatory gene expression. The level of inflammation in neonatal MLN was also dependent on key bacterial components. Y. enterocolitica lacking the virulence plasmid failed to induce innate phagocyte recruitment. In contrast, tumor necrosis factor alpha (TNF-α) protein expression and neutrophil recruitment were strikingly higher in neonatal MLN after infection with a yopP-deficient strain than with wild-type Y. enterocolitica, whereas only modest increases occurred in adults. This hyperinflammatory response was associated with greater colonization of the spleen and higher mortality in neonates, while there was no difference in mortality among adults. This model highlights the dynamic levels of inflammation in the intestinal lymphoid tissues and reveals the protective (wild-type strain) versus harmful (yopP-deficient strain) consequences of inflammation in neonates. Moreover, these results reveal that the neonatal intestinal lymphoid tissues have great potential to rapidly mobilize innate components in response to infection with bacterial enteropathogens.
Auditory Dysfunction in a Patient with Subcortical and Insular Involvement

Data presented in part at the 1988 Annual Meeting of the American Speech Language Hearing Association, Boston, MA. There are many behavioral and electrophysiological tests available that help provide comprehensive audiological assessment. However, the challenge lies in selecting the most effective measures to evaluate and quantify each patient's unique auditory difficulties. These measures must have high sensitivity and specificity for peripheral and central auditory lesions as it is often difficult to differentiate these problems based on symptoms alone. Complaints of difficulty hearing in noise and localization of sound, tinnitus, and unilateral ear symptoms may be present with both peripheral and central involvement. The first tests by Bocca et al. (1954) of central auditory function were based on similar complaints in persons with unilateral temporal lobe lesions and normal pure tone audiograms. They recognized that the pure tone audiogram did not explain the persons' reported difficulties of subjective differences in the quality and clarity of speech in the ear contralateral to their temporal lobe tumor. Therefore, Bocca and his associates designed measures to decrease the redundancy of the auditory signal and therefore stress the auditory system to a greater degree. Although a review of auditory complaints alone does not differentiate peripheral and central auditory dysfunction, it does heighten the clinician's "index of suspicion. " Completing a comprehensive case history is therefore the first, and in some instances the most valuable, step in identifying auditory dysfunction. Careful questioning of the patient may reveal specific auditory difficulties that may not be present on routine pure-tone audiometry. Deficits in the central auditory system are of particular concern in such cases because pure-tone and traditional speech recognition scores may be normal even though the patient reports significant auditory difficulties. In some instances, patients initially may not report hearing loss, but do have a history of documented central nervous system involvement. However, further questioning of the patient may heighten their awareness of subtle hearing problems they may have overlooked. In other cases of central nervous system lesions, patients may
$k$ -Times Markov Sampling for SVMC

Support vector machine (SVM) is one of the most widely used learning algorithms for classification problems. Although SVM has good performance in practical applications, it has high algorithmic complexity as the size of training samples is large. In this paper, we introduce SVM classification (SVMC) algorithm based on <inline-formula> <tex-math notation="LaTeX">$k$ </tex-math></inline-formula>-times Markov sampling and present the numerical studies on the learning performance of SVMC with <inline-formula> <tex-math notation="LaTeX">$k$ </tex-math></inline-formula>-times Markov sampling for benchmark data sets. The experimental results show that the SVMC algorithm with <inline-formula> <tex-math notation="LaTeX">$k$ </tex-math></inline-formula>-times Markov sampling not only have smaller misclassification rates, less time of sampling and training, but also the obtained classifier is more sparse compared with the classical SVMC and the previously known SVMC algorithm based on Markov sampling. We also give some discussions on the performance of SVMC with <inline-formula> <tex-math notation="LaTeX">$k$ </tex-math></inline-formula>-times Markov sampling for the case of unbalanced training samples and large-scale training samples.
The Type IV Secretion System Effector Protein CirA Stimulates the GTPase Activity of RhoA and Is Required for Virulence in a Mouse Model of Coxiella burnetii Infection

ABSTRACT Coxiella burnetii, the etiological agent of Q fever in humans, is an intracellular pathogen that replicates in an acidified parasitophorous vacuole derived from host lysosomes. Generation of this replicative compartment requires effectors delivered into the host cell by the Dot/Icm type IVb secretion system. Several effectors crucial for C. burnetii intracellular replication have been identified, but the host pathways coopted by these essential effectors are poorly defined, and very little is known about how spacious vacuoles are formed and maintained. Here we demonstrate that the essential type IVb effector, CirA, stimulates GTPase activity of RhoA. Overexpression of CirA in mammalian cells results in cell rounding and stress fiber disruption, a phenotype that is rescued by overexpression of wild-type or constitutively active RhoA. Unlike other effector proteins that subvert Rho GTPases to modulate uptake, CirA is the first effector identified that is dispensable for uptake and instead recruits Rho GTPase to promote biogenesis of the bacterial vacuole. Collectively our results highlight the importance of CirA in coopting host Rho GTPases for establishment of Coxiella burnetii infection and virulence in mammalian cell culture and mouse models of infection.
Psychosocial Impact of Poverty on Antiretroviral Nonadherence Among HIV-TB Coinfected Patients in Lima, Peru

Objective . Tuberculosis and HIV coinfection poses unique clinical and psychosocial complexities that can impact nonadherence to highly active antiretroviral treatment (HAART). Methods. This was a prospective case series to identify risk factors for HAART nonadherence among 43 patients with HIV and tuberculosis (TB) in Lima, Peru. Nonadherence was defined by patient self-report. Results. The median initial CD4 and HIV viral load were 63 and 159,000, respectively. Patients had received a median of 6.1 months of ART. Univariable analysis found low social support, substance use, and depression to be associated with nonadherence. In multivariable analysis, low social support was associated with nonadherence. Conclusions. In the authors' urban cohort of HIV-TB coinfected individuals in Lima, Peru, substance use, depression, and lack of social support were key barriers to adherence. These findings suggest that adherence interventions may be unsuccessful unless they target the underlying psychosocial challenges faced by patients living with TB and AIDS.
Borrelia burgdorferi RNA Induces Type I and III Interferons via Toll-Like Receptor 7 and Contributes to Production of NF-κB-Dependent Cytokines

ABSTRACT Borrelia burgdorferi elicits a potent cytokine response through activation of multiple signaling receptors on innate immune cells. Spirochetal lipoproteins initiate expression of NF-κB-dependent cytokines primarily via TLR2, whereas type I interferon (IFN) production is induced through the endosomal receptors TLR7 and TLR9 in human dendritic cells and TLR8 in monocytes. We demonstrate that DNA and RNA are the B. burgdorferi components that initiate a type I IFN response by human peripheral blood mononuclear cells (PBMCs). IFN-α protein and transcripts for IRF7, MX1, and OAS1 were induced by endosomal delivery of B. burgdorferi DNA, RNA, or whole-cell lysate, but not by lysate that had been treated with DNase and RNase. Induction of IFN-α and IFN-λ1, a type III IFN, by B. burgdorferi RNA or live spirochetes required TLR7-dependent signaling and correlated with significantly enhanced transcription and expression of IRF7 but not IRF3. Induction of type I and type III IFNs by B. burgdorferi RNA could be completely abrogated by a TLR7 inhibitor, IRS661. In addition to type I and type III IFNs, B. burgdorferi RNA contributed to the production of the NF-κB-dependent cytokines, IFN-γ, interleukin-10 (IL-10), IL-1β, IL-6, and tumor necrosis factor alpha (TNF-α), by human PBMCs. Collectively, these data indicate that TLR7-dependent recognition of RNA is pivotal for IFN-α and IFN-λ1 production by human PBMCs, and that RNA-initiated signaling contributes to full potentiation of the cytokine response generated during B. burgdorferi infection.
Medical Marijuana in HIV-Positive Patients: What Do We Know?

On November 4, 2008, our state passed the Michigan Medical Marijuana Act (MMMA), which allows the medical use of marijuana for certain conditions and/or constellation of symptoms. This article will (1) review the current evidence that medical marijuana is useful for certain chronic conditions, particularly pain and wasting syndromes experienced by HIV-positive people; (2) discuss the adverse effects of marijuana; (3) summarize the new Michigan law and the challenges it poses for physicians, and (4) review the experience in California where medical marijuana has been legal since 1996.
A Mycobacterium tuberculosis Rpf Double-Knockout Strain Exhibits Profound Defects in Reactivation from Chronic Tuberculosis and Innate Immunity Phenotypes

ABSTRACT Resuscitation-promoting factors (Rpfs), apparent peptidoglycan hydrolases, have been implicated in the reactivation of dormant bacteria. We previously demonstrated that deletion of rpfB impaired reactivation of Mycobacterium tuberculosis in a mouse model. Because M. tuberculosis encodes five Rpf paralogues, redundant functions among the family members might obscure rpf single-knockout phenotypes. A series of rpf double knockouts were therefore generated. One double mutant, ΔrpfAB, exhibited several striking phenotypes. Consistent with the proposed cell wall-modifying function of Rpfs, ΔrpfAB exhibited an altered colony morphology. Although ΔrpfAB grew comparably to the parental strain in axenic culture, in vivo it exhibited deficiency in reactivation induced in C57BL/6 mice by the administration of nitric oxide synthase inhibitor (aminoguanidine) or by CD4+ T-cell depletion. Notably, the reactivation deficiency of ΔrpfAB was more severe than that of ΔrpfB in aminoguanidine-treated mice. A similar deficiency was observed in ΔrpfAB reactivation from a drug-induced apparently sterile state in infected NOS2−/− mice upon cessation of antimycobacterial therapy. Secondly, ΔrpfAB showed a persistence defect not seen with the ΔrpfB or ΔrpfA single mutants. Interestingly, ΔrpfAB exhibited impaired growth in primary mouse macrophages and induced higher levels of the proinflammatory cytokines tumor necrosis factor alpha and interleukin 6. Simultaneous reintroduction of rpfA and rpfB into the double-knockout strain complemented the colony morphology and macrophage cytokine secretion phenotypes. Phenotypes related to cell wall composition and macrophage responses suggest that M. tuberculosis Rpfs may influence the outcome of reactivation, in part, by modulating innate immune responses to the bacterium.
Cryptococcus gattii Infection Dampens Th1 and Th17 Responses by Attenuating Dendritic Cell Function and Pulmonary Chemokine Expression in the Immunocompetent Hosts

ABSTRACT Cryptococcal infections are primarily caused by two related fungal species: Cryptococcus neoformans and Cryptococcus gattii. It is well known that C. neoformans generally affects immunocompromised hosts; however, C. gattii infection can cause diseases in not only immunocompromised hosts but also immunocompetent individuals. While recent studies suggest that C. gattii infection could dampen pulmonary neutrophil recruitment and inflammatory cytokine production in immunocompetent hosts, the impact of C. gattii infection on the development of their adaptive T helper cell immune response has not been addressed. Here, we report that C. neoformans infection with highly virulent and less virulent strains preferentially induced pulmonary Th1 and Th17 immune responses in the host, respectively. However, fewer pulmonary Th1 and Th17 cells could be detected in mice infected with C. gattii strains. Notably, dendritic cells (DC) in mice infected with C. gattii expressed much lower levels of surface MHC-II and Il12 or Il23 transcripts and failed to induce effective Th1 and Th17 differentiation in vitro. Furthermore, the expression levels of Ip10 and Cxcl9 transcripts, encoding Th1-attracting chemokines, were significantly reduced in the lungs of mice infected with the highly virulent C. gattii strain. Thus, our data suggest that C. gattii infection dampens the DC-mediated effective Th1/Th17 immune responses and downregulates the pulmonary chemokine expression, thus resulting in the inability to mount protective immunity in immunocompetent hosts.