Miracle-dz/UniFAR-FTUs huggingface dataset:
Pharmacokinetic Interaction between Maraviroc and Fosamprenavir-Ritonavir: an Open-Label, Fixed-Sequence Study in Healthy Subjects

ABSTRACT This open-label, fixed-sequence, phase 1 study evaluated the pharmacokinetic interaction between maraviroc (MVC) and ritonavir-boosted fosamprenavir (FPV/r) in healthy subjects. In period 1, subjects received 300 mg of MVC twice daily (BID; cohort 1) or once daily (QD; cohort 2) for 5 days. In period 2, cohort 1 subjects received 700/100 mg of FPV/r BID alone on days 1 to 10 and then FPV/r at 700/100 mg BID plus MVC at 300 mg BID on days 11 to 20; cohort 2 subjects received FPV/r at 1,400/100 mg QD alone on days 1 to 10 and then FPV/r at 1,400/100 mg QD plus MVC at 300 mg QD on days 11 to 20. Pharmacokinetic parameters, assessed on day 5 of period 1 and on days 10 and 20 of period 2, included the maximum plasma concentration (Cmax), the concentration at end of dosing interval (Cτ), and the area under the curve over dosing interval (AUCτ). Safety and tolerability were also assessed. MVC geometric mean AUCτ, Cmax, and Cτ were increased by 149, 52, and 374%, respectively, after BID dosing with FPV/r, and by 126, 45, and 80%, respectively, after QD dosing. Amprenavir (the active form of the prodrug fosamprenavir) and ritonavir exposures were decreased in the presence of MVC with amprenavir AUCτ, Cmax, and Cτ decreased by 34 to 36% in the presence of FPV/r plus maraviroc BID and by 15 to 30% with FPV/r plus MVC QD both compared to FPV/r alone. The overall all-causality adverse-event (AE) incidence rate was 96.4%; all AEs were of mild or moderate severity. Commonly reported treatment-related AEs (>20% of patients overall) included diarrhea, fatigue, abdominal discomfort, headache, and nausea. No serious AEs or deaths occurred. In summary, maraviroc exposure increased in the presence of FPV/r, whereas MVC coadministration decreased amprenavir and ritonavir exposures. MVC dosed at 300 mg BID with FPV/r is not recommended due to concerns of lower amprenavir exposures; however, no dose adjustment is warranted with MVC at 150 mg BID in combination with FPV/r based on the available clinical data. MVC plus FPV/r was generally well tolerated; no new safety signals were detected.
The Presence of Leukocytes in Ex Vivo Assays Significantly Increases the 50-Percent Inhibitory Concentrations of Artesunate and Chloroquine against Plasmodium vivax and Plasmodium falciparum

ABSTRACT Plasmodium species ex vivo sensitivity assay protocols differ in the requirement for leukocyte removal before culturing. This study shows that the presence of leukocytes significantly increases the 50% inhibitory concentration (IC50) of P. vivax and P. falciparum to artesunate and chloroquine relative to results with the paired leukocyte-free treatment. Although leukocyte removal is not an essential requirement for the conduct of ex vivo assays, its use has important implications for the interpretation of temporal and spatial antimalarial sensitivity data.
Evaluation of a Telehealth Service for COPD and HF patients: Clinical outcome and patients’ perceptions

NHS Croydon Health Services and NHS Croydon Clinical Commissioning Group have been providing telehealth services for the past 36 months. The aim of this study was to measure the impact of telehealth when implemented as a service within a standard patient care pathway. To measure the clinical outcomes, the number of A&E visits and hospital admissions, recorded on the NHS Secondary Uses Service database, were compared before and after the implementation of the telehealth service. The number of all events despite its cause and the number of events related to the patients’ diagnosed condition were collected. To elicit patients’ perceptions about the telehealth service, a cross sectional survey of patients registered on the triage manager database was used to explore their perceptions, concerns and general satisfaction with the telehealth service via a 4 point likert scale questionnaire. The data of 48 patients were collected and telehealth reduced the number of both A&E and hospital admission due to all causes by 13% (P = 0.42) and 22% (P = 0.048), respectively. When only the events directly related to the patient’s diagnosed condition were considered, a reduction by 36% (P = 0.03) and 28% (P = 0.02) was recorded for A&E visits and hospital admission respectively. 27 patients consented to participate in the survey. Overall, patients were very satisfied with telehealth services. Patients agreed that telehealth had improved their health, it was a convenient form of health care delivery for them and they were more involved in the decisions about their care or treatment. In addition, since being on telehealth, patients’ confidence in managing their health increased from somewhat confident to confident. Telehealth, when provided as a service within a standard care pathway, seems to decrease hospital admissions and A&E visits. Good patient satisfaction suggests that the current service is accepted and it could be further expanded to include a larger number of patients.
Novel Staphylococcal Cassette Chromosome mec Type, Tentatively Designated Type VIII, Harboring Class A mec and Type 4 ccr Gene Complexes in a Canadian Epidemic Strain of Methicillin-Resistant Staphylococcus aureus

ABSTRACT Staphylococcal cassette chromosome mec (SCCmec) is a mobile genetic element characterized by flanking terminal direct and, in most cases, inverted repeat sequences, the mec and ccr gene complexes, and their surrounding DNA regions. Unique combinations of the mec and ccr gene complexes generate various SCCmec types. Six SCCmec types have been reported to date. We describe here a novel SCCmec type identified in a Canadian methicillin-resistant Staphylococcus aureus (MRSA) epidemic strain. MRSA clinical isolates were screened for known SCCmec types by multiplex and conventional PCR methods. Three phenotypically and genotypically identical MRSA clinical isolates with a pulsotype identical to CMRSA9 were identified locally and found to be nontypeable by available SCCmec typing schemes. Complete sequencing of the SCCmec element revealed a nucleotide fragment of 32,168 bp integrated at an identical chromosomal integration site (attBscc) at the 3′ end of the orfX gene. The nucleotide sequences at the chromosome-SCCmec junction regions were typical of other SCCmec types, but the element harbored a unique combination of class A mec and type 4 ccr gene complexes. Sequence recombination analysis suggested that this unique SCCmec type may be derived from homologous recombination between the previously described SCCRP62A of S. epidermidis strain RP62A and SCC composite island of S. epidermidis ATCC 12228, respectively, or via recombination of other staphylococcal strains that carry the same or similar mobile cassettes. We identified a previously undescribed type of SCCmec from isolate C10682, tentatively designated type VIII, and we provide compelling evidence supporting the ability of SCC elements to transfer horizontally or undergo recombination to generate new SCCmec types.
Randomized controlled equivalence trial comparing videoconference and in person delivery of cognitive processing therapy for PTSD

Introduction In an effort to improve access to and utilization of health care, the Veterans Health Administration (VHA) continues to investigate the effectiveness of video-teleconferencing (VTC) technologies for service delivery. While previous research focused on the efficacy of VTC treatment for post-traumatic stress disorder (PTSD) in Vietnam era veterans, few studies have evaluated the efficacy of this modality and treatment for the Iraq/Afghanistan era veterans. The aim of this randomized clinical trial was to evaluate equivalence between in person and VTC psychotherapy for PTSD in this newer cohort. Methods Veterans of the Iraq/Afghanistan conflict from two VHA hospitals in the United States were recruited and randomized to receive cognitive processing therapy (CPT) for PTSD either in person (IP) or over VTC. Clinician-administered and self-report measures were collected before, during, and after treatment. Results A trend was observed which suggested that CPT over VTC may be equivalent to the treatment delivered in person, as suggested by previous studies. Regardless of treatment, veterans who received the intervention in both conditions reported significant decreases on post-treatment measures. Discussion This study highlighted research and clinical challenges in providing services to the newest veteran generation in general as well as unique challenges with VTC. One complicating factor to the statistical power of this study was a treatment dropout rate twice the original estimate. Factors that could have influenced this high dropout rate are explored.
Clinical Characteristics and Treatment Outcomes of Patients with Acquired Macrolide-Resistant Mycobacterium abscessus Lung Disease

ABSTRACT Macrolide antibiotics are mainstays in the treatment of lung disease due to the Mycobacterium abscessus complex. Although previous studies have reported development of acquired macrolide resistance in this species, limited data are available on the outcomes of lung disease due to macrolide-resistant Mycobacterium abscessus subsp. abscessus. This study evaluated the clinical features, treatment outcomes, and molecular characteristics of macrolide-resistant isolates of M. abscessus subsp. abscessus. We performed a retrospective review of medical records and genetic analysis of clinical isolates from 13 patients who had acquired macrolide-resistant M. abscessus subsp. abscessus lung disease between November 2006 and March 2016. Eleven (85%) patients had the nodular bronchiectatic form of the disease, and two (15%) patients had the fibrocavitary form. When acquired macrolide resistance was detected, 10 (77%) patients were on antibiotic therapy for M. abscessus subsp. abscessus, and three (23%) patients were on therapy for lung disease due to other nontuberculous mycobacteria. The median treatment duration after detecting resistance was 24.0 months (interquartile range, 16.0 to 43.0 months). Treatment outcomes were poor, and final sputum culture conversion was achieved in only one (8%) patient, after resectional surgery. All 13 clinical isolates demonstrated point mutations at position 2058 (n = 10) or 2059 (n = 3) of the 23S rRNA gene, which resulted in acquired macrolide resistance. This study indicates that treatment outcomes are very poor after the development of acquired macrolide resistance in patients with M. abscessus subsp. abscessus lung disease. Thus, more effective measures are needed to prevent development and effectively treat macrolide-resistant M. abscessus subsp. abscessus lung disease.
Automated News Reading: Stock Price Prediction Based on Financial News Using Context-Specific Features

We examine whether stock price effects can be automatically predicted analyzing unstructured textual information in financial news. Accordingly, we enhance existing text mining methods to evaluate the information content of financial news as an instrument for investment decisions. The main contribution of this paper is the usage of more expressive features to represent text and the employment of market feedback as part of our word selection process. In our study, we show that a robust Feature Selection allows lifting classification accuracies significantly above previous approaches when combined with complex feature types. That is because our approach allows selecting semantically relevant features and thus, reduces the problem of over-fitting when applying a machine learning approach. The methodology can be transferred to any other application area providing textual information and corresponding effect data.
The use of telehealth services to facilitate audiological management for children: A scoping review and content analysis

Approximately 32 million children globally present with disabling hearing loss. Despite evidence describing the negative consequences of hearing loss, there is still a lack of hearing screening programmes in South Africa. Audiologists have been exploring the use of information and communication technologies (tele-audiology) to provide services to children and it is currently being evaluated to determine its feasibility. Aims We aim to describe tele-audiology services conducted to facilitate audiological management for children in both the rural and urban context and to determine the strengths, challenges and clinical implications of such services. Methods A scoping review was conducted by searching for peer-reviewed publications from five databases. Inclusion criteria and search strategies were outlined. Results Of the 23 studies that met the inclusion criteria, reliability of automated testing was comparable to conventional testing; however, these studies were based primarily on screening programmes. Eight (35%) of the 23 papers were concordance studies evaluating feasibility and validity of tele-audiology systems when compared with conventional testing, while one study (4%) evaluated a tele-audiology service. A further four studies (17%) evaluated the feasibility of introducing telehealth methods to evaluate middle ear pathology. Tele-auditory brainstem response was investigated in three studies (13%) and another five (22%) used smartphone and/or iPad technology to screen hearing. Only two studies (9%) evaluated the feasibility of providing intervention through telehealth methods. All included studies demonstrated improved access to and coverage of rural areas. Services such as video otoscopy and synchronous (online) hearing testing in remote areas were successfully implemented. Challenges included lack of diagnostic studies, inadequate training of staff and the need to standardize protocols and procedures in order to ensure that tele-audiology services are provided in a standardized and valid manner. Conclusion Tele-audiology services are feasible and can be useful in identifying auditory pathology for children in rural and remote areas.
Diversification of Web Search Results through Social Interest Mining

Traditional information retrieval techniques mainly focus on improving the relevance of result documents retrieved by a query. In most informational (or exploratory) search tasks, formulated queries may often fail to precisely capture users' real intents, and consequently retrieved results may not adequately satisfy their information needs. However, if the retrieved results were diverse in nature, some results would likely be able to meet the user's information need. In this paper, we present a novel search results diversification technique that integrates social interest mined from query logs with a probabilistic model based on query-URL bipartite graphs. A query can retrieve relevant and diverse results by incorporating the social interest, discovered through kernel principle component analysis on the related queries and URLs, with random walk on the bipartite graph. We have conducted a set of experiments to validate this technique and the results show that this technique outperforms existing results diversification techniques in terms of both the relevance and the diversity of result documents retrieved by a query.
Power Control in AC Isolated Microgrids With Renewable Energy Sources and Energy Storage Systems

This paper presents a new strategy to control the generated power from energy sources existing in autonomous and isolated microgrids. In this particular study, the power system consists of a power electronic converter supplied by a battery bank, which is used to form the ac grid (grid former converter), an energy source based on a wind turbine with its respective power electronic converter (grid supplier converter), and the power consumers (loads). The main objective of this proposed strategy is to control the state of charge of the battery bank limiting the voltage on its terminals by controlling the power generated by the energy sources. This is done without using dump loads or any physical communication among the power electronic converters or the individual energy source controllers. The electrical frequency of the microgrid is used to inform the power sources and their respective converters about the amount of power that they need to generate in order to maintain the battery-bank charging voltage below or equal its maximum allowable limit. Experimental results are presented to show the feasibility of the proposed control strategy.
Characteristic Analysis and Verification of the Magnetic-Field-Modulated Brushless Double-Rotor Machine

The magnetic-field-modulated brushless double-rotor machine (MFM-BDRM), composed of the stator, the modulating ring rotor, and the permanent-magnet (PM) rotor, is a new power-split device for hybrid electric vehicles (HEVs). Compared with traditional double-rotor machines (DRMs), the MFM-BDRM shows more complicated electromechanical energy conversion relations, due to its special operating principle-the magnetic field modulation principle. To analyze the speed relation in the MFM-BDRM, a diagrammatized method is proposed. It shows that the speeds of stator magnetic field, modulating ring rotor, and PM rotor present a collinear speed characteristic. On this basis, the torque relations of stator, modulating ring rotor, and PM rotor are investigated from the view of a conservative lossless system. Then, a lever-balanced torque map is proposed to analyze their torque characteristic. It shows that the torques of stator, modulating ring rotor, and PM rotor can be calculated by the lever balance principle. The power flow map is further proposed to analyze the power flow characteristic among three ports. In addition, comparison of the MFM-BDRM and the planetary gear shows that the MFM-BDRM can be totally equivalent to an electrical machine and a planetary gear, making it gain a great advantage particularly when the MFM-BDRM is used in HEVs. The electromagnetic performance of MFM-BDRM is investigated by a finite-element method, which shows that the MFM-BDRM has advantages of fine sinusoidal back electromotive force and low torque fluctuation. Finally, the speed and torque analysis and FE results are verified by experiment.
Maximum power point tracking strategy for large-scale wind generation systems considering wind turbine dynamics

Summary form only given. Under the global trend of renewable energy development, various advanced techniques such as forecasting algorithm, intelligent computation, and optimal control are expected to make the complex and uncertain renewable energy system stable and profitable in the near future. This paper presents a new control strategy for large-scale wind energy conversion systems (WECSs) to achieve a balance between power output maximization and operating cost minimization. First, an Intelligent Maximum Power Point Tracking (IMPPT) algorithm is proposed such that short-term wind speed prediction, wind turbine dynamics, and MPPT are collectively considered to improve system efficiency. Then, in view of a spatial and temporal distribution of wind speed disturbances, a box uncertain set is embedded in the forecasted wind speed, which is likely more realistic for practicing engineers. Next, IMPPT and box uncertainties are applied to the WECS control strategy, which is formulated as a min-max optimization problem and efficiently solved with semi-definite programming (SDP). Finally, a comparison with the conventional MPPT control method demonstrates that the proposed approach can obtain a higher efficiency, which validates this research work.
Population Pharmacokinetic and Pharmacodynamic Modeling of Amodiaquine and Desethylamodiaquine in Women with Plasmodium vivax Malaria during and after Pregnancy

ABSTRACT Amodiaquine is effective for the treatment of Plasmodium vivax malaria, but there is little information on the pharmacokinetic and pharmacodynamic properties of amodiaquine in pregnant women with malaria. This study evaluated the population pharmacokinetic and pharmacodynamic properties of amodiaquine and its biologically active metabolite, desethylamodiaquine, in pregnant women with P. vivax infection and again after delivery. Twenty-seven pregnant women infected with P. vivax malaria on the Thai-Myanmar border were treated with amodiaquine monotherapy (10 mg/kg/day) once daily for 3 days. Nineteen women, with and without P. vivax infections, returned to receive the same amodiaquine dose postpartum. Nonlinear mixed-effects modeling was used to evaluate the population pharmacokinetic and pharmacodynamic properties of amodiaquine and desethylamodiaquine. Amodiaquine plasma concentrations were described accurately by lagged first-order absorption with a two-compartment disposition model followed by a three-compartment disposition of desethylamodiaquine under the assumption of complete in vivo conversion. Body weight was implemented as an allometric function on all clearance and volume parameters. Amodiaquine clearance decreased linearly with age, and absorption lag time was reduced in pregnant patients. Recurrent malaria infections in pregnant women were modeled with a time-to-event model consisting of a constant-hazard function with an inhibitory effect of desethylamodiaquine. Amodiaquine treatment reduced the risk of recurrent infections from 22.2% to 7.4% at day 35. In conclusion, pregnancy did not have a clinically relevant impact on the pharmacokinetic properties of amodiaquine or desethylamodiaquine. No dose adjustments are required in pregnancy.
Arthroscopic Release of the Stiff Elbow

Recent technologic advances in elbow arthroscopy have expanded its indications for the management of elbow joint stiffness. One of these expanded indications is the treatment of elbow joint contracture from a variety of causes, including posttraumatic, congenital, and atraumatic. Most intra-articular and some extra-articular elbow stiffness may be successfully treated with arthroscopy. With the recent emphasis on minimally invasive surgery, treating elbow joint stiffness arthroscopically has become increasingly viable. This article focuses on management of intra-articular causes of elbow stiffness and reviews the indications, techniques, and results for arthroscopic management of elbow contracture.
Social Aspects in Technology Acceptance: Theory Integration and Development

The success of many new technologies and technology-based applications relies heavily on considering social factors. Contemporary models for technology acceptance either neglect social aspects or cover them in a superficial way. In our study we develop a better understanding of social aspects in technology adoption. We analyze and combine items related to social influence from the Unified Theory of Acceptance and Use of Technology and the Model of Adoption of Technology in Households and develop a new research model. While testing this model using quantitative data (n=501), one derived construct appears to be weak. Hence, we introduce new items, provide a second round of data collection (n=682), and develop an improved research model, which is validated by the new data. Here, all constructs work as intended. Our second model has a higher coefficient of determination than the first one. We show that Social Externalities is the most influential social factor towards technology acceptance and provide the corresponding items for future research.
Apple peel jejunal atresia: Successful management of a rare case

Apple peel jejunal atresia is a rare congenital anomaly. This condition presents at birth as an intestinal obstruction, is diagnosed by X-rays and confirmed by laparatomy. Resection of the dilated proximal intestine and primary anastomosis is the treatment, but has a poor prognosis. We report here a rare form of atresia with apple peel deformity and its successful management.