Miracle-dz/UniFAR-FTUs huggingface dataset:
Use of botulinum toxin to improve upper limb spasticity and decrease subsequent carer burden in long-term care residents: a randomised controlled study.

Spasticity leads to decreased range of motion of joints, increased pain, spasm, functional disability, and contractures. Limb spasticity also increases the burden on carers in the provision of nursing and personal care. The use of botulinum toxin to treat spasticity has increased. It blocks acetylcholine release at the neuromuscular junction, thereby inhibiting muscle contraction and decreasing spastic muscle tone. Its antispastic effect usually lasts approximately 3 months. It is safe, with few (usually transient and localised) adverse effects. Since 2008, the American Academy of Neurology has recommended that botulinum neurotoxin be offered as a treatment option for spasticity in adults and children. Nonetheless, its effect on immobile infirmary patients has not been studied. This study aimed to evaluate the role of botulinum toxin A for treating upper limb spasticity in debilitated infirmary patients and the decrease in carer burden when given as a supplement to conventional physiotherapy and occupational therapy.
Influenza Immunization Disparities in Primary Care Offices—A Comparative Case Study

Without insight into the primary care environment, further improvements in influenza immunization rates are unlikely. We conducted a comparative case study of family medicine offices during the 2003 influenza immunization season. Practice 1 (P1) served an urban African American population, practice 2 (P2) served a suburban non-minority population, practice 3 (P3) served an urban Hispanic population. Influenza immunization rates among patients age 65 years and older in P1, P2, and P3 were 32%, 33%, and 67% by medical chart. Rates were highest in P3, where medical staff supported vaccination, promoted communication with patients and staff, and made use of systems to identify eligible patients. Characteristics that appear to affect influenza immunization in the primary care environment include the presence of a practice champion, issues of communication and collaboration, and the use of systems approaches. These data support the need for investigation of how these factors affect population level disparities.
Conversion of nucleotides sequences into genomic signals

An original tetrahedral representation of the Genetic Code (GC) that better describes its structure, degeneration and evolution trends is defined. The possibility to reduce the dimension of the representation by projecting the GC tetrahedron on an adequately oriented plane is also analyzed, leading to some equivalent complex representations of the GC. On these bases, optimal symbolic‐to‐digital mappings of the linear, nucleic acid strands into real or complex genomic signals are derived at nucleotide, codon and amino acid levels. By converting the sequences of nucleotides and polypeptides into digital genomic signals, this approach offers the possibility to use a large variety of signal processing methods for their handling and analysis. It is also shown that some essential features of the nucleotide sequences can be better extracted using this representation. Specifically, the paper reports for the first time the existence of a global helicoidal wrapping of the complex representations of the bases along DNA sequences, a large scale trend of genomic signals. New tools for genomic signal analysis, including the use of phase, aggregated phase, unwrapped phase, sequence path, stem representation of components’relative frequencies, as well as analysis of the transitions are introduced at the nucleotide, codon and amino acid levels, and in a multiresolution approach.
Small regulators, major consequences – Ca2+ and cholesterol at the endosome–ER interface

ABSTRACT The ER is the largest cellular compartment and a major storage site for lipids and ions. In recent years, much attention has focused on contacts between the ER and other organelles, and one particularly intimate relationship is that between the ER and the endosomal system. ER–endosome contacts intensify when endosomes mature, and the ER participates in endosomal processes, such as the termination of surface receptor signaling, multi-vesicular body formation, and transport and fusion events. Cholesterol and Ca2+ are transferred between the ER and endosomes, possibly acting as messengers for ER–endosome crosstalk. Here, we summarize different types of ER–endosomal communication and discuss membrane contact sites that might facilitate this crosstalk. We review the protein pairs that interact at the ER–endosome interface and find that many of these have a role in cholesterol exchange. We also summarize Ca2+ exchange between the ER and endosomes, and hypothesize that ER–endosome contacts integrate several cellular functions to guide endosomal maturation. We post the hypothesis that failure in ER–endosome contacts is an unrecognized but important contributor to diseases, such as Niemann–Pick type C disease, Alzheimer's disease and amyotrophic lateral sclerosis.
Risk factors for femoral fracture after canine press-fit cementless total hip arthroplasty.

OBJECTIVE To evaluate risk factors for femoral fracture after porous-coated cementless total hip arthroplasty (THA). STUDY DESIGN Case series. ANIMALS Dogs (n=74) that had cementless THA (n=84). METHODS Medical records of dogs from 2 referral hospitals were reviewed for occurrence of postoperative femoral fracture. Patient and operative (age, breed, sex, weight, and canal flare index [CFI], indication for arthroplasty, intraoperative fissure, cerclage usage, and implant sizes) factors were analyzed. Assessment of implant positioning and canal fill was performed on immediate postoperative radiographs. Femoral fractures (n=11) were evaluated and compared with 73 cases without fracture that met the inclusion criteria. RESULTS Mean (+/-SEM) age was 7.30+/-0.69 years for dogs with, and 4.77+/-0.37 years for dogs without femoral fracture. Age was positively associated with fracture (P=.022). Mean (+/-SEM) CFI was 1.80+/-0.09 for dogs with, and 1.98+/-0.04 for dogs without fracture. CFI was negatively associated with fracture (P=.045). Body weight, intraoperative fissure, cerclage use, implant size, position, and canal fill did not influence the occurrence of femoral fracture. CONCLUSIONS Older dogs and dogs with lower CFI may be at increased risk for femoral fracture after porous-coated cementless THA. CLINICAL RELEVANCE Risk factors exist for femoral fracture after cementless THA using porous-coated implants, and should be critically evaluated during the patient selection. These risks should be weighed against the benefits of the system, and measures to minimize femoral fracture in at-risk patients studied.
Genotype-based clinical manifestation and treatment of Chinese long QT syndrome patients with KCNQ1 mutations – R380S and W305L

Abstract Aim Most long QT syndrome patients are associated with genetic mutations. We aimed to investigate the clinical and biochemical characteristics and look for genotype-based preventive implications in Chinese long QT syndrome patients. Methods and results We identified two missense mutations of the KCNQ1 gene in two independent Chinese families, including a previously reported mutation R380S in the C-terminus and a novel mutation W305L in the P-loop domain of the Kv7.1 channel, respectively. The proband with R380S was an 11-year-old girl who suffered a prolonged corrected QT interval of 660 ms, recurrent syncope, and sudden cardiac death, whose father was an asymptomatic carrier. The mutation W305L was detected in a 36-year-old woman with long QT syndrome and her immediate family members including the proband’s younger sister with an unexplained syncope, her son, and her elder daughter without symptoms. Metoprolol appeared to be effective in preventing arrhythmias and syncope in long QT syndrome patients with mutation W305L. Both R380S and W305L mutations led to “loss-of-function” of the Kv7.1 channel accounting for the clinical phenotypes. Conclusions We first show two missense KCNQ1 mutations – R380S and W305L – in Chinese long QT syndrome patients, resulting in the loss of protein function. Mutation W305L in the P-loop domain of the Kv7.1 may derive a pronounced benefit from β-blocker therapy in symptomatic long QT syndrome patients, whereas mutation R380S located in the C-terminus may be associated with a high risk of sudden cardiac death.
Comparison of multiple auditory steady-state responses (80 versus 40 Hz) and slow cortical potentials for threshold estimation in hearing-impaired adults

This study evaluated the use of multiple auditory steady-state responses (ASSRs) and slow cortical potentials (SCPs) to estimate behavioural audiograms in adults for compensation cases. Two groups of 23 subjects were assessed using either 80 Hz or 40 Hz multiple simultaneous tones with carrier frequencies of 0.5, 1.0, 2.0, and 4.0 kHz. SCP thresholds for 0.5, 1.0, and 2.0 kHz were obtained for both groups. Mean evoked potential thresholds (dB HL) minus behavioural pure-tone thresholds (dB HL) difference scores were 5–17 dB for the 80 Hz group, 1–14 dB for the 40 Hz group, and 20–22 dB for the SCPs. Thresholds for 40 Hz ASSR were significantly closer to behavioural thresholds than were 80 Hz or SCP thresholds. SCP and 40 Hz ASSR audiogram estimates were obtained more quickly than the 80 Hz ASSR. Multiple 40 Hz ASSR is the method of choice for evoked potential threshold estimation in adults. Sumario Este estudio evaluó el uso de las respuestas auditivas múltiples de estado estable (ASSR) y de los potenciales corticales lentos (SCP) para estimar en casos de compensación, los audiogramas comportamentales de adultos. Se realizaron pruebas en dos grupos de 23 sujetos utilizando tonos múltiples simultáneos a 80 ó 40 Hz con frecuencias portadoras de 500, 1000, 2000 y 4000 Hz. Se obtuvieron umbrales SCP para 500, 1000 y 2000 Hz en ambos grupos. Los umbrales promedio de potenciales evocados (dBHL) menos las respuestas tonales comportamentales se ubicaron entre 5 y 17dB para el grupo de 80 Hz, de 1 a 40 dB para el grupo de 40 Hz y de 20 a 22 dB para los SCP. Los umbrales de las ASSR de 40 Hz estuvieron significativamente mas cercanos a los umbrales comportamentales que los de 80 Hz o los umbrales SCP. Los SCP y las ASSR-40 Hz se obtuvieron más rápido que las ASSR-80 Hz. Las ASSR múltiples de 40 Hz son el método de elección para la estimación de umbrales con potenciales evocados en adultos.
Emergence of Nonencapsulated and Encapsulated Non-b-Type Invasive Haemophilus influenzae Isolates in Portugal (1989-2001)

ABSTRACT Phenotypes and genetic relatedness of invasive Haemophilus influenzae strains were evaluated from 1989 through 2001. Among 119 isolates, multidrug resistance decreased (from 50 to 0%), the level of H. influenzae serotype b (Hib) strains declined (from 81 to 16%), the level of noncapsulated strains rose (from 19 to 80%), and the first invasive H. influenzae serotype f strain was described. This study documents changes in invasive H. influenzae infections in Portugal, i.e., the emergence of non-type-b strains that are genetically diverse and unrelated to Hib.
Oxygen cost of exercise hyperpnea: implications for performance.

We addressed two questions concerned with the metabolic cost and performance of respiratory muscles in healthy young subjects during exercise: 1) does exercise hyperpnea ever attain a "critical useful level"? and 2) is the work of breathing (WV) at maximum O2 uptake (VO2max) fatiguing to the respiratory muscles? During progressive exercise to maximum, we measured tidal expiratory flow-volume and transpulmonary pressure- (Ptp) volume loops. At rest, subjects mimicked their maximum and moderate exercise Ptp-volume loops, and we measured the O2 cost of the hyperpnea (VO2RM) and the length of time subjects could maintain reproduction of their maximum exercise loop. At maximum exercise, the O2 cost of ventilation (VE) averaged 10 +/- 0.7% of the VO2max. In subjects who used most of their maximum reserve for expiratory flow and for inspiratory muscle pressure development during maximum exercise, the VO2RM required 13-15% of VO2max. The O2 cost of increasing VE from one work rate to the next rose from 8% of the increase in total body VO2 (VO2T) during moderate exercise to 39 +/- 10% in the transition from heavy to maximum exercise; but in only one case of extreme hyperventilation, combined with a plateauing of the VO2T, did the increase in VO2RM equal the increase in VO2T. All subjects were able to voluntarily mimic maximum exercise WV for 3-10 times longer than the duration of the maximum exercise. We conclude that the O2 cost of exercise hyperpnea is a significant fraction of the total VO2max but is not sufficient to cause a critical level of "useful" hyperpnea to be achieved in healthy subjects. (ABSTRACT TRUNCATED AT 250 WORDS)
Kit-activating mutations in AML: Lessons from PU.1-induced murine erythroleukemia

In concert with its ligand, the stem cell factor (SCF), the receptor tyrosine kinase c-Kit acts as a key signaling molecule for a number of cell types, including hematopoietic stem cells, mast cells, melanocytes and germ cells. Gain of-function mutations in c-Kit have been described in a number of human cancers, including testicular germinomas, acute myeloid leukemia and gastrointestinal stromal tumors. Yet their contribution to neoplastic growth is incompletely understood. Now Kosmider et al report the acquisition of Kit mutations in 86% of late-stage eryhtroleukemias in Spi-1/PU-1 transgenic mice. Without Kit mutations, these mice suffer from a benign disease whose hallmark is erythropoietin-dependent expansion of undifferentiated red blood cell precursors. Newly acquired Kit mutations affect codon 814 or 818, and ectopic expression of these mutants in non-malignant pro-erythroblasts confers erythropoietin independence and tumorigenicity. Using tyrosine kinase inhibitors PP1, PP2, and imatinib mesylate (a.k.a. Gleevac®), the authors demonstrate that Kit mutations are important for the autonomous expansion of malignant cells via the MEK/Erk1/2 and PI3K/Akt pathways. These findings validate the notion that one differentiation-blocking (e.g., PU.1 activation) and one proliferative (e.g., c-Kit mutations) event are required for the development of frank leukemia.
Dual source coronary computed tomography angiography for detecting in-stent restenosis

Objective: To evaluate the performance of dual source CT coronary angiography (DSCT-CA) in the detection of in-stent restenosis (⩾50% luminal narrowing) in symptomatic patients referred for conventional angiography (CA). Design/patients: 100 patients (78 males, age 62 (SD 10)) with chest pain were prospectively evaluated after coronary stenting. DSCT-CA was performed before CA. Setting: Many patients undergo coronary artery stenting; availability of a non-invasive modality to detect in-stent restenosis would be desirable. Results: Average heart rate (HR) was 67 (SD 12) (range 46–106) bpm. There were 178 stented lesions. The interval between stenting and inclusion in the study was 35 (SD 41) (range 3–140) months. 39/100 (39%) patients had angiographically proven restenosis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of DSCT-CA, calculated in all stents, were 94%, 92%, 77% and 98%, respectively. Diagnostic performance at HR <70 bpm (n = 69; mean 58 bpm) was similar to that at HR ⩾70 bpm (n = 31; mean 78 bpm); diagnostic performance in single stents (n = 95) was similar to that in overlapping stents and bifurcations (n = 83). In stents ⩾3.5 mm (n = 78), sensitivity, specificity, PPV, NPV were 100%; in 3 mm stents (n = 59), sensitivity and NPV were 100%, specificity 97%, PPV 91%; in stents ⩽2.75 mm (n = 41), sensitivity was 84%, specificity 64%, PPV 52%, NPV 90%. Nine stents ⩽2.75 mm were uninterpretable. Specificity of DSCT-CA in stents ⩾3.5 mm was significantly higher than in stents ⩽2.75 mm (OR = 6.14; 99%CI: 1.52 to 9.79). Conclusion: DSCT-CA performs well in the detection of in-stent restenosis. Although DSCT-CA leads to frequent false positive findings in smaller stents (⩽2.75 mm), it reliably rules out in-stent restenosis irrespective of stent size.
The case for beta‐blockers as first‐line antihypertensive therapy

Reason for treatment In patients with asymptomatic high blood pressure, antihypertensive treatment is initiated for only one reason, to prevent the hypertensive sequelae of myocardial infarction, stroke and heart failure. Morbidity, mortality and surrogate endpoints Only diuretics and β-blockers have been shown to benefit hypertensive patients in terms of the hard endpoints morbidity and mortality. β-Blockers and diuretics are cheaper than newer drugs and thus represent good value for money. It is not acceptable to use drug effects on plasma lipids or insulin resistance as measures of the effects on coronary heart disease, since dihydropyridine calcium antagonists improve these parameters while significantly increasing coronary heart disease events in the acute and chronic ischaemic situation. Patient profiling Diuretics. Diuretics appear particularly suited to elderly hypertensives, especially those with isolated systolic hypertension, but they may increase cardiac events in younger and middle-aged diabetic and non-diabetic hypertensives. Angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors are undoubtedly valuable in the presence of left ventricular dysfunction, and possibly in the diabetic in maintaining good renal function. β-Blockers. β-Blockers are particularly well suited to younger and middle-aged hypertensives at all blood pressure levels, especially white males; where ischaemia and/or stress is a factor, β-blockers can significantly reduce the incidence of myocardial infarction and strokes. β-Blockers benefit elderly hypertensives by preventing strokes and may prevent coronary heart disease if prescribed with a diuretic.
Clopidogrel in ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention

Clopidogrel has become a mainstay in the management of acute coronary syndrome patients over the past decade, as well as an essential component of percutaneous coronary intervention (PCI) pharmacotherapy. Until recently, no prospective study has evaluated the effectiveness of clopidogrel in the setting of an ST-segment elevation myocardial infarction (STEMI). The majority of patients presenting with STEMI receive thrombolytic therapy (aspirin, heparin and a fibrinolytic agent) although many do not achieve or maintain adequate reperfusion of the infarct-related artery. The CLARITY (Clopidogrel as Adjunctive Reperfusion Therapy) study and the PCI–CLARITY substudy were designed to address whether a beneficial effect of clopidogrel, including a loading dose, would be attained among STEMI patients who were being treated with thrombolytic therapy and undergoing coronary angiography during the index hospitalisation. A total of 3491 patients who presented within 12 h after the onset of STEMI were randomly assigned to receive clopidogrel (300-mg loading dose followed by 75 mg daily) or placebo. Patients were scheduled to undergo coronary angiography after 48 h, and those who underwent PCI during the index hospitalisation formed the basis of PCI–CLARITY. This PCI cohort was followed for the combined end point of cardiovascular death, recurrent myocardial infarction and stroke for 30 days.
Application of a polarizable force field to calculations of relative protein–ligand binding affinities

An explicitly polarizable force field based exclusively on quantum data is applied to calculations of relative binding affinities of ligands to proteins. Five ligands, differing by replacement of an atom or functional group, in complexes with three serine proteases—trypsin, thrombin, and urokinase-type plasminogen activator—with available experimental binding data are used as test systems. A special protocol of thermodynamic integration was developed and used to provide sufficiently low levels of systematic error along with high numerical efficiency and statistical stability. The calculated results are in excellent quantitative (rmsd = 1.0 kcal/mol) and qualitative (R2 = 0.90) agreement with experimental data. The potential of the methodology to explain the observed differences in the ligand affinities is also demonstrated.
Optimal weighting of posteriors for audio-visual speech recognition

We investigate the fusion of audio and video a posteriori phonetic probabilities in a hybrid ANN/HMM audio-visual speech recognition system. Three basic conditions to the fusion process are stated and implemented in a linear and a geometric weighting scheme. These conditions are the assumption of conditional independence of the audio and video data and the contribution of only one of the two paths when the SNR is very high or very low, respectively. In the case of the geometric weighting a new weighting scheme is developed whereas the linear weighting follows the full combination approach as employed in multi-stream recognition. We compare these two new concepts in audio-visual recognition to a rather standard approach known from the literature. Recognition tests were performed in a continuous number recognition task on a single speaker database containing 1712 utterances with two different types of noise added.
Narrative in text, photo and video in social space

This purpose of this paper is to investigate the role played by different CMC for supporting young parents' reporting of everyday experiences about their baby's development with geographically separated families. “Reporting” in this study refers to narrative exercises using text, photo and video. Thus, the researcher wanted to see the differences or similarities between these media in reporting baby stories. The researcher followed Labov and Waletzky 's theory (LW) to understand narrative. This theory breaks narratives down into five distinctive building blocks: Orientation, Complication, Evaluation, Resolution and CODA. However in this paper we presented the result of Orientation only. It is the first and the main part of narrative. At the end of this paper, we identified the similarities and differences in narrative characteristics in Orientation (Who, Where, When and Why) displayed by text-based, picture-based and video-based CMC and their role in supporting young mothers' reporting everyday experiences with geographically separated families.
Are antenatal steroids beneficial to severely growth restricted fetuses?

Abstract Antenatal steroids (AS) have been shown to enhance fetal maturation in preterms and to improve outcome. The aim of this study was to evaluate the efficacy of AS in premature severely intrauterine growth restricted infants. The electronic data of 149 inborn, single infants born 24 to 31 6/7 weeks of GA and with a BW ≤ 3rd percentile were reviewed. Infants with congenital anomalies and syndromes were excluded. We compared the outcome of those who received 2 doses of AS (group A, 87 infants) with those who did not receive AS (group B, 62 infants). Sixty-eight infants in group A and 53 in group B were discharged home alive. AS did not improve the neonatal outcome, with the exception of a better cord pH and 5-min Apgar and we did not observe a significant difference in the Griffith’s test at 2 years of corrected age, although there was a trend to a higher incidence of severe global delay in the steroid group. In view of the potential cerebral and CVS risks associated with high circulating steroids, the indications for AS in such a population need to be re-evaluated.