Miracle-dz/UniFAR-FTUs huggingface dataset:
Ultrastructure of liver progenitor/oval cells in children with nonalcoholic steatohepatitis.

PURPOSE Very interesting reports have appeared lately on the role of liver progenitor/oval cells in the morphogenesis and development of nonalcoholic steatohepatits (NASH) in adult patients and experimental animals. However, no literature data concerning pediatric patients have been available. Therefore, the purpose of the study was to evaluate the ultrastructure of the population of liver progenitor/oval cells in the biopsy material from children with previously clinocopathologically diagnosed NASH. MATERIAL/METHODS Electron-microscopic examinations were conducted on fresh tissue samples collected from 10 children with NASH (aged 2-14 years), which were fixed with a solution of 2% paraformaldehyde and 2.5% glutaraldehyde in 0.1 M cacodylate buffer. RESULTS Ultrastructural examinations of the liver progenitor/oval cells in children with NASH show a quite prominent number of these cells, especially their two types, hepatic progenitor cells (HPCs) and intermediate hepatocyte-like cells (IHCs), with intermediate bile-like cells being the least frequent. They were found to occur single or in clusters of two, seldom of three, and frequently in the areas of advanced liver fibrosis or close to them. Many times, these cells were accompanied by hepatocytes showing a varying degree of death, to total cell disintegration. Interesting was the presence of activated nonparenchymal liver cells, i.e. Kupffer cells/macrophages and hepatic stellate cells, frequently found to adhere to the hepatic oval cells. CONCLUSIONS The current study suggests a marked involvement of the population of liver progenitor/oval cells, mainly HPCs and IHCs, in the development of nonalcoholic steatohepatitis in pediatric patients, especially in fibrosis progression.
Predictive models for subtypes of autism spectrum disorder based on single-nucleotide polymorphisms and magnetic resonance imaging.

PURPOSE Autism spectrum disorder (ASD) is a neurodevelopmental disorder, of which Asperger syndrome and high-functioning autism are subtypes. Our goal is: 1) to determine whether a diagnostic model based on single-nucleotide polymorphisms (SNPs), brain regional thickness measurements, or brain regional volume measurements can distinguish Asperger syndrome from high-functioning autism; and 2) to compare the SNP, thickness, and volume-based diagnostic models. MATERIAL AND METHODS Our study included 18 children with ASD: 13 subjects with high-functioning autism and 5 subjects with Asperger syndrome. For each child, we obtained 25 SNPs for 8 ASD-related genes; we also computed regional cortical thicknesses and volumes for 66 brain structures, based on structural magnetic resonance (MR) examination. To generate diagnostic models, we employed five machine-learning techniques: decision stump, alternating decision trees, multi-class alternating decision trees, logistic model trees, and support vector machines. RESULTS For SNP-based classification, three decision-tree-based models performed better than the other two machine-learning models. The performance metrics for three decision-tree-based models were similar: decision stump was modestly better than the other two methods, with accuracy = 90%, sensitivity = 0.95 and specificity = 0.75. All thickness and volume-based diagnostic models performed poorly. The SNP-based diagnostic models were superior to those based on thickness and volume. For SNP-based classification, rs878960 in GABRB3 (gamma-aminobutyric acid A receptor, beta 3) was selected by all tree-based models. CONCLUSION Our analysis demonstrated that SNP-based classification was more accurate than morphometry-based classification in ASD subtype classification. Also, we found that one SNP--rs878960 in GABRB3--distinguishes Asperger syndrome from high-functioning autism.
Transformation of UML class diagram to internal java domain-specific language

Abstract - the article addresses the existing problems found in the area of Domain-Specific Languages (DSLs). Being a widely adopted programming technique, DSL grammar creation process still lacks desirable traceability and automation. The paper proposes a sequential model transformation process based on Model-Driven Architecture concepts as one of the potential solutions to stated problem. One of the main results of the research work is the implementation of prototype of the full-cycle model transformation chain starting from the UML domainmodel and ending with internal Java-based DSL grammar implementation.
Emergency lung transplantation contributes to knock down mortality on the waiting list

peutic optimization of CPB through the combination of different procedures that reduce inflammatory response and oxidative stress. This approach proved effective in improving the clinical outcome. It is also well recognized that aortic cross-clamp time plays a relevant role. In their preliminary study with a sutureless implantable aortic bioprosthesis (Perceval S valve, Sorin, Saluggia, Italy), Flameng et al. [6] have recently obtained a very short aortic cross-clamp time (18 ± 6 min). In the experience at our centre with the Perceval bioprosthesis (67 valve implantations), we had an aortic cross-clamp time of 37.2 ± 12.7 min in 43 high-risk patients, a much shorter cross-clamp time than that reported by Dimarakis et al. (median 84 min, range 68–143 min), despite similar EuroSCORE values (logistic EuroSCORE 20 ± 11.2). Notably, 10 out of the 43 patients required combined surgery (5 coronary artery bypass grafting, 1 ventricular septal defect closure, 2 catheter ablation of atrial fibrillation, 1 ascending aorta replacement and 1 tricuspid valvuloplasty). Whether the reduction in implantation time will also result in improved outcome remains to be defined. In our opinion, however, such a remarkable reduction in blood contact time during CPB should be considered within the multidisciplinary and open debate about protection strategies in high-risk patients undergoing aortic surgery. REFERENCES
Exploring Older Adult Care Transitions From Hospital to Home: A Participatory Action Research Project

ABSTRACT Using a participatory action research approach, community-based older adult service providers and university researchers partnered to explore older adult care transitions through the health care system, specifically from a hospital stay to home with rehabilitative services. Qualitative findings of transitioning home from both older adult and service provider perspective included three major themes: social support, communication, and adjusting to home and planning for the community. In addition, resources developed through the project are discussed with implications to practice.
Risk assessment for acute myocardial infarction patients using artificial neural networks

The purpose of the study was to develop a clinical score for risk assessment to determine the profile of every patient with acute myocardial infarction (MI). A cohort of 1,318 consecutive patients with a first MI admitted to four referral teaching hospitals (one with tertiary facilities) were followed up for 6 months after admission. To classify patients an artificial neural network (ANN), called a multilayer perceptron was used with the backpropagation learning algorithm. This method is used to analyse a collection of simple clinical markers. The model has achieved high values of sensitivity and specificity in the classification of the patients, training both in the training cohort (91.58% sensitivity, 79.37% specificity), and the validation cohort (88.46% sensitivity, 78.09% specificity). The use of simple clinical variables allows ANNs to give a reliable prediction of risk for in-hospital and 6 month mortality.
Pneumococcal 13-valent conjugate vaccine administration after inferior response to pneumococcal vaccine.

BACKGROUND The pneumococcal vaccine, a nonconjugated vaccine, may be used to evaluate the integrity of the humoral immune system. Those patients with an inferior response to a nonconjugated vaccine may be vaccinated with a conjugated vaccine, which elicits both a B- and T-cell response. OBJECTIVE We evaluated the immunogenicity of a conjugated vaccine in patients with inferior responses to a nonconjugated vaccine. METHODS This was an institutional review board approved retrospective study that involved 22 patients with suspected specific antibody deficiency who received a nonconjugated vaccine, followed by a conjugated vaccine. Patients with an inferior response had <70% response in pneumococcal serotypes (1.3 μg/mL, with at least a two to fourfold increase), whereas protective responses were those with a >70% response. These patients were subsequently administered a conjugated vaccine at various time intervals (1-36 months), and titers were evaluated 4-6 weeks later. RESULTS A protective response was found in 6 of 22 patients (average age, 62.2 years) after conjugated vaccine administration. Half of the responders were vaccinated <12 months after nonconjugated vaccine administration. The majority of the nonresponders (n = 16) received a conjugated vaccine <12 months after a nonconjugated vaccine. Of the nonresponders, 10 received a conjugated vaccine <12 months after a nonconjugated vaccine and did not mount a protective response. Other associated immunologic findings included hypogammaglobulinemia (n = 6), low immunoglobulin G1 (IgG1) levels (n = 5), and low IgG2 levels (n = 6). CONCLUSION The majority of the patients with an inferior response to a nonconjugated vaccine also had an inferior response to a conjugated vaccine. Conjugated vaccine administration time did not affect the response rate. Analysis of the data demonstrated that patients with suspected specific antibody deficiency may not benefit from a conjugated vaccine, which suggested a defect that may affect more than pure antibody responses. Also, the majority of patients with IgG2 deficiency mounted an inadequate response to Pneumococcal 13-valent conjugate vaccine.
Income-related differences in mortality among people with diabetes mellitus

Background: Mortality has declined substantially among people with diabetes mellitus over the last decade. Whether all income groups have benefited equally, however, is unclear. We examined the impact of income on mortality trends among people with diabetes. Methods: In this population-based, retrospective cohort study, we compared changes in mortality from Apr. 1, 1994, to Mar. 31, 2005, by neighbourhood income strata among people with diabetes aged 30 years or more in the province of Ontario, Canada. Results: Overall, the annual age- and sex-adjusted mortality declined, from 4.05% in 1994/95 (95% confidence interval [CI] 3.98%–4.11%) to 2.69% in 2005/06 (95% CI 2.66%–2.73%). The decrease was significantly greater in the highest income group (by 36%) than in the lowest income group (by 31%; p < 0.001). This trend was most pronounced in the younger group (age 30–64 years): the mortality rate ratio widened by more than 40% between the lowest and highest income groups, from 1.12 to 1.59 among women and from 1.14 to 1.60 among men. Income had a much smaller effect on mortality trends in the older group, whose drug costs are subsidized: the income-related difference rose by only 0.9% over the study period. Interpretation: Mortality declined overall among people with diabetes from 1994 to 2005; however, the decrease was substantially greater in the highest income group than in the lowest, particularly among those aged 30–64 years. These findings illustrate the increasing impact of income on the health of people with diabetes even in a publicly funded health care setting. Further studies are needed to explore factors responsible for these income-related differences in mortality.
Inter-rater reliability of the Frenchay Activities Index in patients with stroke and their carers

Objective: To measure the inter-rater reliability of the interview-administered version of the Frenchay Activities Index (FAI). Design: Comparison of FAI score on the same person when administered by two raters (mean time between interviews 15.2 days). Subjects: Fifty-nine Oxfordshire residents who either had had a stroke (n = 35) or were the main carer (n = 24). Results: The 95% limits of agreement for the FAI totals were –9.9 to +8.4. The kappa statistic for nine of the 15 items showed a good level of agreement between the two research interviews (0.64–0.80). The other six items showed fair or moderate strength of agreement (0.26–0.52). Three items showed significant differences between the two raters p < 0.05 (Wilcoxon's sign paired rank sum test). The mean difference between the total scores was –0.76 (95% confidence interval from –1.98 to 0.46). Spearman's rho correlation coefficient for FAI totals of rater B against A was r(59) = 0.93 (p < 0.001). Conclusion: The FAI is a reliable tool for measuring outcome following stroke. Suggestions are made to strengthen the reliability, and consequently the validity of the measure.
The Effect of Educating Self-Care Behaviors to Patients With Heart Failure in Hospitals of Zahedan

Background: Heart failure is a chronic disease in the elderly. Self-care education has a significant role in preventing the disease, its progress, and complications. Objectives: The present study aimed to assess the effect of training on self-care behaviors among patients with heart failure in hospitals of Zahedan City in 2012. Materials and Methods: The present study had a quasi-experimental interventional design with control group, and was conducted in CCU and post-CCU wards in hospitals affiliated to Zahedan University of Medical Sciences in 2012. There were 140 hospitalized patients in two equal groups of case (70 people) and control (70 people). The case group received an educational package including a pamphlet, an educational CD, and educational footage for their cell phone. After one month, they took the posttest. The data were analyzed by SPSS statistical software ver. 18. Results: After training, the mean scores of awareness, attitude and practice among patients in the case group were respectively 8.93 ± 2.32, 47.69 ± 2.21, and 66.04 ± 3.44 (P < 0.0001). The mean score difference of attitude in the intervention group was 17.78 ± 7.0, and 3.30 ± 6.85 in the control. The mean score difference of practice in the intervention group was 26.57 ± 6.37, and 2.08 ± 7.16in the control group (P < 0.0001). Conclusion: The results of the present study showed that self-care behaviors in patients with heart failure were influenced by awareness, and their practice improved with increasing their knowledge. Therefore, it is recommended to give an educational pamphlet video to patients with heart failure.
Impurity Knight shift in quantum dot Josephson junctions

Spectroscopy of a Josephson junction device with an embedded quantum dot reveals the presence of a contribution to level splitting in external magnetic field that is proportional to \cos\phicosϕ, where \phiϕ is the gauge-invariant phase difference across the junction. To elucidate the origin of this unanticipated effect, we systematically study the Zeeman splitting of spinful subgap states in the superconducting Anderson impurity model. The magnitude of the splitting is renormalized by the exchange interaction between the local moment and the continuum of Bogoliubov quasiparticles in a variant of the Knight shift phenomenon. The leading term in the shift is linear in the hybridisation strength \GammaΓ (quadratic in electron hopping), while the subleading term is quadratic in \GammaΓ (quartic in electron hopping) and depends on \phiϕ due to spin-polarization-dependent corrections to the Josephson energy of the device. The amplitude of the \phiϕ-dependent part is largest for experimentally relevant parameters beyond the perturbative regime where it is investigated using numerical renormalization group calculations. Such magnetic-field-tunable coupling between the quantum dot spin and the Josephson current could find wide use in superconducting spintronics.
Efficacy Evaluation of a Pollen Blocker Cream against Dust-Mite Allergy: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Crossover Trial

Objective To further evaluate the efficacy and safety of a pollen blocker cream against dust-mite allergy. Methods A multicenter, randomized, double-blind, placebo-controlled, crossover trial was conducted in a Chinese population. Patients diagnosed with perennial allergic rhinitis, sensitive to dust-mite allergy including Dermatophagoides farinae and Dermatophagoides pteronyssinus were randomly allocated to receive a pollen blocker cream or placebo, which was applied and spread evenly to the lower internal nose region three times daily for a total of 30 days. The primary outcome measurements for efficacy were total nasal symptom score (TNSS) and individual nasal symptom score (iNSS). Adverse events were also monitored. Results After application of a pollen blocker, the mean TNSS decreased from 23.1 to 13.8, the decrease of the pollen blocker group (9.3) was highly significant compared with the placebo group (5.2; p < 0.001). Similarly, the decreases in iNSSs (rhinorrhea, congestion, sneezing, and itching) between the pollen blocker group and the placebo group were also significant (p < 0.05). In addition, in adults, the pollen blocker led to a remarkably significant decrease in TNSS (9.5) compared with placebo (5.4; p < 0.001); in children, the pollen blocker led to a significant decrease in TNSS (8.6) compared with placebo (4.8; p < 0.05). No statistical difference was found in the incidence of adverse events between the two groups (p > 0.05), and no severe systematic reactions were observed. Conclusion Pollen Blocker is a safe and effective alternative to the drugs for treatment of AR, especially for Chinese people allergic to dust-mite allergy.
The use of skeletal traction in the treatment of severe primary Dupuytren’s disease

In 13 patients (18 fingers) we used two types of external fixator as progressive static splints for the preoperative correction of the deformities of severe Dupuytren’s disease before conventional fasciectomy. The duration of treatment was from one to four weeks. At a mean follow-up of 18 months the mean total fixed flexion deficit had been reduced from 138° to 39° and the mean proximal interphalangeal joint contracture from 80° to 29°. The mean total active range of movement had increased from 123° to 175°. These preliminary results are promising, but continued follow-up is needed since recurrence is common.
Fertility decline in North-Central Namibia: an assessment of fertility in the period 1960-2000 based on parish registers.

This study examines fertility decline in North-Central Namibia in the period 1960-2000. A Scandinavian-type parish-register system, established in the beginning of 20th Century and still in use, provided register-based data for fertility analysis. Fertility decline began in 1980, was rapid in the 1980s, levelled off in the early 1990s, started again in 1994 and continued until the year 2000. Fertility declined in every age group, except among the 15-19 year olds, whose fertility increased. Cohort fertility started to decline among the 1940-44 birth cohort. During the 1980s, fertility decline was associated with increasing age at first marriage and declining marital fertility, connected to e.g. the War of Independence. During the 1990s, an increase in both the use of contraceptives and HIV-prevalence contributed to the fertility decline.
Cost-effectiveness of second-line antihyperglycemic therapy in patients with type 2 diabetes mellitus inadequately controlled on metformin

Background: Metformin is widely accepted as first-line pharmacotherapy for patients with type 2 diabetes mellitus when glycemic control cannot be achieved by lifestyle interventions alone. However, uncertainty exists regarding the optimal second-line therapy for patients whose diabetes is inadequately controlled by metformin monotherapy. Increased use of newer, more costly agents, along with the rising incidence of type 2 diabetes, carries significant budgetary implications for health care systems. We conducted this analysis to determine the relative costs, benefits and cost-effectiveness of options for second-line treatment of type 2 diabetes. Methods: We used the United Kingdom Prospective Diabetes Study Outcomes Model to forecast diabetes-related complications, quality-adjusted life-years and costs of alternative second-line therapies available in Canada for adults with type 2 diabetes inadequately controlled by metformin. We obtained clinical data from a systematic review and mixed treatment comparison meta-analysis, and we obtained information on costs and utilities from published sources. We performed extensive sensitivity analyses to test the robustness of results to variation in inputs and assumptions. Results: Sulphonylureas, when added to metformin, were associated with the most favourable cost-effectiveness estimate, with an incremental cost of $12 757 per quality-adjusted life-year gained, relative to continued metformin monotherapy. Treatment with other agents, including thiazolidinediones and dipeptidyl peptidase-4 inhibitors, had unfavourable cost-effectiveness estimates compared with sulphonylureas. These results were robust to extensive sensitivity analyses. Interpretation: For most patients with type 2 diabetes that is inadequately controlled with metformin monotherapy, the addition of a sulphonylurea represents the most cost-effective second-line therapy.
Incidence of bleeding from gastroduodenal ulcers in patients with end-stage renal disease receiving hemodialysis

Background: Few large population-based studies have compared the incidence of bleeding of gastroduodenal ulcers between patients with and without end-stage renal disease. We investigated the association between ulcer bleeding and end-stage renal disease in patients receiving hemodialysis, and we sought to identify risk factors for ulcer bleeding. Methods: We performed a nationwide seven-year population study using data from the National Health Insurance Research Database in Taiwan. We identified 36 474 patients with end-stage renal disease who were receiving hemodialysis, 6320 patients with chronic kidney disease and 36 034 controls matched for age, sex and medication use. We performed log-rank testing to analyze differences in survival time without ulcer bleeding among the three groups. We performed Cox proportional hazard regressions to evaluate the risk factors for ulcer bleeding among the three groups and to identify risk factors in patients receiving hemodialysis. Results: Patients receiving hemodialysis and those with chronic kidney disease had a significantly higher incidence of ulcer bleeding than controls had (p < 0.001). Hemodialysis (hazard ratio [HR] 5.24, 95% confidence interval [CI] 4.67–5.86) and chronic kidney disease (HR 1.95, 95% CI 1.62–2.35) were independently associated with an increased risk of ulcer bleeding. Diabetes mellitus, coronary artery disease, cirrhosis and use of nonsteroidal anti-inflammatory drugs were risk factors for ulcer bleeding in patients with end-stage renal disease who were receiving hemodialysis Interpretation: Patients with end-stage renal disease who are receiving hemodialysis had a high risk of ulcer bleeding. Diabetes mellitus, coronary artery disease, cirrhosis and the use of nonsteroidal anti-inflammatory drugs were important risk factors for ulcer bleeding in these patients.