Miracle-dz/UniFAR-FTUs huggingface dataset:
Novel oral anticoagulant management issues for the stroke clinician

Background Four nonvitamin K antagonist oral anticoagulants (NOACs) are approved for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). Aims In this review, we assemble available evidence for the best management of ischemic and hemorrhagic stroke patients in the context of NOAC use. Summary of review NOACs provide predictable anticoagulation with fixed dosages. The direct thrombin inhibitor dabigatran and direct factor Xa inhibitors apixaban, edoxaban, and rivaroxaban are all noninferior to warfarin for the prevention of ischemic stroke and systemic embolism and are associated with reduced incidence of intracranial hemorrhage. While these agents offer treatment options for NVAF patients, they also present challenges specific to the clinician managing cerebrovascular disease patients. Conclusions We summarize available evidence and current approaches to the initiation, dosing, monitoring and potential reversal of NOACs in stroke patients.
An Information Highway To the Auditory Nerve

Cochlear implants are the most successful examples to date of a class of biomedical devices called neural prostheses. Neural prosthetics is based on the not ion that sensory and motor dysfunction can be corrected by using electronic components to replace missing or damaged elements of the nervous system; reviewed in Loeb (1989). Perhaps the main challenge is the design of the interface whereby information is passed between the electronic and the neural circuitry. In the case of a sensory prosthesis such as the cochlear implant, the level of performance achieved by the patient is directly related to the rate at which information can be processed and transmitted electronically and decoded successfully by the nervous system. One appealing way to explain the somewhat arcane field of information technology is to employ the metaphor of a highway with data streaming in various lanes at various rates. In this article, I use this metaphor to explain the principles of operation and current challenges of cochlear implant technology.
Economic burden of informal care attributable to stroke among those aged 65 years or older in China

Stroke is a leading cause of disability in China, frequently resulting in the need for informal care. No information, however, is available on costs of informal care associated with stroke, required to understand the true cost of stroke in China. Using the 2011 China Health and Retirement Longitudinal Study, we identified 4447 respondents aged ≥65 years suitable for analyses, including 184 stroke survivors. We estimated the economic burden of informal care associated with stroke using a two-part model. The monthly number of hours of informal caregiving associated with stroke was 29.2 h/stroke survivor, and the average annual cost of informal care associated with stroke was 10,612 RMB per stroke survivor. The findings stress the necessity of proper interventions to prevent stroke and will be useful for estimating the economic burden of stroke.
Natural Antiulcerogenic Agents: An Overview

Extensive use of certain drugs, changes in lifestyles and food habits, as well as stress factors in modern human lives have led to an exponential increase in the incidence of gastric ulceration. The ideal anti-ulcer drug with less side effects and recurrence, and affordability has so far remains elusive, providing avenues for innovation, especially with phytochemicals. This review furnishes extensive information on the earlier works carried out in this area and rationalizes the mode of action of them, citing limitations of the previous studies. The primary aim was to cover different classes of potent natural compounds that have impressive gastro-protective property against various ulcerogens (except Helicobacter pylori infection), and are available in large quantities from the natural sorces. A few examples of synthetic congeners have also been included to highlight the type of innovation that may be required for developing new drugs.
Molecular Characterization of Methicillin-Susceptible Staphylococcus aureus Clinical Isolates in the United States, 2004 to 2010

ABSTRACT While much is known about the geographic distribution of different clonal types of methicillin-resistant Staphylococcus aureus (MRSA), few studies have assessed the molecular epidemiology of methicillin-susceptible S. aureus (MSSA), despite its continued clinical importance. In each U.S. Census region, reference laboratories collected successive MSSA isolates from patients with invasive or superficial staphylococcal infections for use in the Tigecycline Evaluation and Surveillance Trial. All isolates from the periods of 2004 to 2005 and 2009 to 2010 underwent antimicrobial susceptibility testing and characterization of their staphylococcal protein A (spa) type. Of the 708 isolates analyzed, 274 spa types were identified and divided into 15 genetic clusters. The most common clones were spa t002 (n = 63, 8.9%) and t008 (n = 56, 7.9%). While the distribution of the predominant spa types did not differ by U.S. Census region or time period, spa t008 was nearly twice as common in community skin and soft tissue infections than in nosocomial bloodstream infections (11.1% versus 5.6%, respectively; P = 0.008). Despite such differences, both community and nosocomial settings had diverse staphylococcal clonal types representing all major spa clusters. In contrast to those of MRSA, MSSA infectious isolates show wide genetic diversity without clear geographical or temporal clustering. Notably, the prevalent MSSA strains (spa t002 and spa t008) are analogous to the predominant MRSA clones, further demonstrating the importance of both lineages.
Developing workable research methods: lessons from a pilot study with vulnerable participants and complex assessments

Following acute stroke, deterioration in nutritional status and weight loss is common; few studies have investigated this, perhaps due to difficulties with recruitment and completion of complex assessments with stroke patients. This study reports the feasibility of a study protocol to determine predictors of nutritional intake in stroke patients. The aim of the study was to test the feasibility of a protocol to measure taste and smell function, and explore links with dietary intake following stroke. Patients were recruited from one Acute Stroke Unit in 2007/8. Data were collected at three time-points and entailed standardised validated assessments of taste and smell function, diet, appetite and mood state. Recruitment of this vulnerable population to a demanding assessment schedule was challenging. Of a cohort of 166 admissions, six were recruited and complete data collected from four participants. Slow recruitment was largely due to exacting inclusion criteria and rapid hospital discharge. Those who completed all assessments reported the schedule as tolerable and acceptable. This study illustrated the difficulties of recruiting this vulnerable population. Identification of reasons for slow recruitment facilitated development of measures to address them. It was possible to format a complex and lengthy assessment schedule to be acceptable to vulnerable participants.
Voltage Unbalance Reduction in Low Voltage Feeders by Dynamic Switching of Residential Customers Among Three Phases

To dynamically reduce voltage unbalance (VU) along low voltage distribution feeders, a distributed intelligent residential load transfer scheme is proposed. In this scheme, residential loads are transferred from one phase to another to minimize VU along the feeder. The central controller, installed at the distribution transformer, observes the power consumption in each house and determines the house(s) to be transferred from an initially connected phase to another. The transfer is carried out by the help of a static transfer switch, with a three-phase input and a single-phase output connection, through which each house is supplied. The steady-state and dynamic performances of the proposed load transfer scheme are investigated by MATLAB analyses and PSCAD/EMTDC simulations.
Job stress as a preventable upstream determinant of common mental disorders: A review for practitioners and policy-makers

Abstract There is growing recognition of the important role of mental health in the workforce and in the workplace. At the same time, there has been a rapid growth of studies linking job stress and other psychosocial working conditions to common mental disorders, and a corresponding increase in public concern media attention to job stress and its impact upon worker health and well-being. This article provides a summary of the relevant scientific and medical literature on this topic for practitioners and policy-makers. It presents a primer on job stress concepts, an overview of the evidence linking job stress and common mental disorders, a summary of the intervention research on ways to prevent and control job stress, and a discussion of the strengths and weakness of the evidence base. We conclude that there is strong evidence linking job stress and common mental disorders, and that it is a substantial problem on the population level. On a positive note, however, the job stress intervention evidence also shows that the problem is preventable and can be effectively addressed by a combination of work- and worker-directed intervention.
Complications of endovascular treatment for acute ischemic stroke: Prevention and management

Endovascular mechanical thrombectomy (MT) for the treatment of acute stroke due to large vessel occlusion has evolved significantly with the publication of multiple positive thrombectomy trials. MT is now a recommended treatment for acute ischemic stroke. Mechanical thrombectomy is associated with a number of intra-procedural or post-operative complications, which need to be minimized and effectively managed to maximize the benefits of thrombectomy. Procedural complications include: access-site problems (vessel/nerve injury, access-site hematoma and groin infection); device-related complications (vasospasm, arterial perforation and dissection, device detachment/misplacement); symptomatic intracerebral hemorrhage; subarachnoid hemorrhage; embolization to new or target vessel territory. Other complications include: anesthetic/contrast-related, post-operative hemorrhage, extra-cranial hemorrhage and pseudoaneurysm. Some complications are life-threatening and many lead to increased length of stay in intensive care and stroke units. Complications increase costs and delay the commencement of rehabilitation. Some may be preventable; the impact of others can be minimized with early detection and appropriate management. Both neurointerventionists and stroke specialists need to be aware of the risk factors, strategies for prevention, and management of these complications. With the increasing use of mechanical thrombectomy for the treatment of acute ischemic stroke, incidence and outcome of complications will need to be carefully monitored by stroke teams. In this narrative review, we examine the frequency of complications of MT in the treatment of acute ischemic stroke with an emphasis on periprocedural complications. Overall, from recent randomized controlled trials, the risk of complications with sequelae for patient from mechanical thrombectomy is ∼15%. We discuss the management of complications and identify areas with limited evidence, which need further research. Search strategy and selection criteria Relevant evidence was found by searches of Medline and Cochrane Library, reference list, cross-referencing and main journal content pages. Search terms included “brain ischemia”, “acute ischemic stroke”, “cerebral infarction” AND “mechanical thrombectomy”, “endovascular therapy”, “endovascular treatment”, “endovascular embolectomy”, “intra-arterial” AND “randomized controlled trial”, “non-randomised trials”, “observational studies” AND “complications”, “procedural complications”, “peri-procedural complications”, “device-related complications”, “management”, “treatment”, “outcome”. The search included only human studies, and was limited to studies published in English between January 2014 and November 2016. The final reference list was selected on the basis of relevance to the topics covered in the Review. Guidelines for management of acute ischaemic stroke by the American Heart Association, the European Stroke Organisation, multi-disciplinary guidelines and the National Institute for Health and Care Excellence (NICE) were also reviewed.
pfmdr1 Amplification Associated with Clinical Resistance to Mefloquine in West Africa: Implications for Efficacy of Artemisinin Combination Therapies

ABSTRACT We describe here a clinical failure in the treatment with mefloquine of acute falciparum malaria contracted in Africa and associated with in vitro mefloquine resistance and pfmdr1 copy number amplification. This case raises the question of the presence and the evolution of this genotype in Africa, which is also known to alter the susceptibility to artemisinin combination therapy (ACT).
Password authentication based on public-key distribution cryptosystem

A password authentication mechanism based on the public-key distribution cryptosystem is proposed. The scheme uses an authentication table to replace the traditional password file. With this scheme, even if the authentication table is comprised, the system security is preserved. The user's password is effectively bound to the user's identification in a timely, efficient, and simple manner. <<ETX>>
A feasibility and performance study of dependency inference (database design)

The feasibility of inferring functional dependencies from an example relation is investigated. The problem occurs in the context of automatic database design, when a tool is needed to assist the database designer in the process of specifying logical dependencies. The complexity of the dependency inference problem is inherently exponential. However, algorithms could be developed that perform well when the input relation has certain characteristics. Two such algorithms for dependency inference are implemented and optimized. An extensive set of experiments is presented, in which dependencies were inferred from example relations with different cardinalities, number of attributes, and degree of normalization. It is concluded that for practical example relations, an adequate implementation of a dependence inference function leads to acceptable interactive response times. <<ETX>>
Relatedness of Human and Animal Clostridium difficile PCR Ribotype 078 Isolates Determined on the Basis of Multilocus Variable-Number Tandem-Repeat Analysis and Tetracycline Resistance

ABSTRACT Totals of 102 and 56 Clostridium difficile type 078 strains of human and porcine origins, respectively, from four European countries were investigated by an optimized multilocus variable-number tandem-repeat analysis (MLVA) and for tetracycline susceptibility. Eighty-five percent of all isolates were genetically related, irrespective of human or porcine origin. Human strains were significantly more resistant to tetracycline than porcine strains. All tetracycline-resistant strains contained the Tn916-like transposon harboring the tet(M) gene. We conclude that strains from human and porcine origins are genetically related, irrespective of the country of origin. This may reflect a lack of diversity and/or common source.
Evaluation of Mycobacterial Interspersed Repetitive-Unit-Variable-Number Tandem-Repeat Analysis and Spoligotyping for Genotyping of Mycobacterium bovis Isolates and a Comparison with Restriction Fragment Length Polymorphism Typing

ABSTRACT Common strain typing methods for differentiation of Mycobacterium bovis isolates include restriction endonuclease analysis (REA), restriction fragment length polymorphism (RFLP) analysis, spoligotyping, and, more recently, mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing. MIRU-VNTR typing and spoligotyping were evaluated in this study, and these typing methods were compared with RFLP typing. A total of 386 M. bovis isolates from cattle, badgers, and deer in the Republic of Ireland that had previously been typed by IS6110, polymorphic GC-rich sequence (PGRS), and direct-repeat (DR) RFLP were included in the study. Spoligotyping and analysis of six VNTR loci (QUB 11a, QUB 11b, ETR A, 4052, MIRU 26, and 1895) were performed on the samples. RFLP analysis was the method that gave the greatest differentiation of strains, with a Hunter-Gaston discriminatory index (HGDI) of 0.927; the HGDI recorded for MIRU-VNTR typing was marginally lower at 0.918, and spoligotyping was the least discriminatory method, with an HGDI of 0.7. Spoligotype SB0140 represented approximately 50% of the isolates. Within the group of isolates represented by SB0140, there was a much lower level of concordance between RFLP and MIRU-VNTR typing than for groups represented by other spoligotypes. A combination of spoligotyping and MIRU-VNTR typing offered advantages over MIRU-VNTR typing alone. In a combined spoligotyping and MIRU-VNTR typing protocol, the number of VNTR loci could be reduced to four (QUB 11a, QUB 11b, ETR A, and 4052) while maintaining a high level of strain differentiation.
Maintenance of materialized views of sampling queries

The authors discuss materialized views of random sampling queries of a relational database. They show how to maintain such views in the presence of insertions, deletions, and updates of the base relations. The basic idea is to reuse the maximal portion of the original sample when constructing the updated sample. The results are based on a synthesis of view update techniques and sampling algorithms. It is demonstrated that maintenance of materialized sample views may be substantially cheaper than resampling. <<ETX>>
Evaluation of a Modified Carbapenem Inactivation Method for Detection of Carbapenemases in Pseudomonas aeruginosa

aDepartment of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada bProvincial Laboratory for Public Health, Alberta Health Services Laboratory Services, Calgary, Alberta, Canada cNational Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada dDepartment of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
Audiological Assessment of Older Adults

Boys Town National Institute, Omaha, Nebraska The evaluation of elderly adults is a challenge to audiologists. Many older people have significant hearing losses, some of which may be medically treatable. They also may have communication problems, which in many cases may be helped by amplification and communication training. In addition, they may also have communication problems totally unrelated to hearing loss. The evaluation strategies that an audiologist uses for older adults should be based on an understanding of the probable underlying etiological factors of the hearing loss, communication deficits caused by the loss, and other nonauditory deficits. Moreover, it is important to remember that the term "elderly" refers to a very heterogenous population. Initially, we will discuss audiological testing as it applies to older adults who can perform standard audiological tests with no procedural modifications. Later, we will discuss the importance of assessment techniques to accommodate individuals who have additional deficits that may not be related to hearing acuity. Because most older adults have some degree of medically untreatable hearing loss, there is a tendency for physicians and audiologists to perform perfunctory evaluations on these patients. Although it may be extremely difficult, if not impossible, to separate losses caused from physiological degeneration secondary to aging from other causative factors, such as noise exposure, genetic influences, ototoxic substances, and systemic disorders (such as hypertension, cardiovascular disease, renal disease, and diabetes) and their treatments, audiologists and physicians should be aware that factors other than aging could be contributing to older people's hearing losses. For example, Rosen, Olin, and Rosen (1970) and Spencer (1973) found that hearing loss due to hypertension can be alleviated by a change in diet, and Shea (1975) reported that excessive salt intake, excessive smoking, and diabetes may be related to a fluctuating sensorineural hearing loss. Also, noise ex-
Sequence Variation within the P1 Gene of Mycoplasma pneumoniae

With interest, we have read the article by Zhao et al. ([4][1]), who describe the sequence of the P1 gene from 60 Mycoplasma pneumoniae strains. In their paper, the authors claim to have found novel sequence variants of the P1 gene. However, after comparison of these sequences with published P1
Use of a Prequalification Panel for Rapid Scale-Up of High-Throughput HIV Viral Load Testing

ABSTRACT Increased access to antiretroviral drugs expands needs for viral load (VL) testing. South Africa's National Health Laboratory Service responded to demands by implementing two testing platforms in 17 laboratories within 8 months. An industry partner's collaboration, training programs, and method verification with a VL prequalification panel ensured testing quality and rapid implementation.
Analysis of rewarming curves in Raynaud’s phenomenon of various aetiologies

This study investigated whether a modified Cold Provocation Test could distinguish between 86 normal subjects and 31 patients with Raynaud’s phenomenon or 59 with hand arm vibration syndrome (HAVS). Of the HAVS subjects, 56 were seen for medical reports as they were involved in litigation. Their assessments were done in a different location but the same protocol was used. A standardised cold stress was used to reduce the finger temperature to 15°C or less without inducing reflex hyperaemia. This test had acceptable repeatability for subjects without HAVS with an intra-class correlation of 0.7. Baseline temperature, temperature rise in the first 30 seconds and the time taken to rewarm by 5°C were measured. Patients with Raynaud’s phenomenon and HAVS had cooler hands than controls. HAVS patients rewarmed most in the first 30 seconds. Patients with Raynaud’s phenomenon take longer to rewarm by 5°C than controls or those with HAVS (P<0.001). A baseline difference of >7.5°C between the temperature of the digit and that of the room is unlikely to occur in patients with Raynaud’s phenomenon or HAVS. A temperature gain of ≥2.2°C in the first 30 seconds on rewarming combined with a low baseline temperature strongly suggests HAVS. This modified cold provocation test may differentiate between patients with Raynaud’s phenomenon, HAVS and controls but this observation requires independent verification in subjects not involved in litigation and tested in the same facility.
Design and evaluation of disk scheduling policies for high-demand multimedia servers

We propose and evaluate techniques to manage disk storage systems for multimedia document servers with constrained I/O resources. We also evaluate the requirements for the main memory to maintain desired levels of quality of presentation (QoP) for multiple users. This is achieved by attempting to minimize the number of tardy frames in end-to-end delivery of multimedia data. Inter-media and intra-media temporal synchronization at the user-interaction level are essential concerns for multimedia servers. Scheduling of multimedia frames has direct impact on both intra-stream and inter-stream multimedia synchronization. In order to effect such synchronization, we propose several O(n log n+mn) heuristics to schedule multimedia frames between the disks and destination memories of the multimedia systems, where m is the number of logical I/O channels and n is the number of frames of multimedia data. We study the performance of these heuristics via simulations and show the tradeoffs between the system resources and QoP parameters.