Miracle-dz/UniFAR-FTUs huggingface dataset:
The rational clinical examination. Does this patient have strep throat?

CONTEXT Sore throat is a common complaint, and identifying patients with group A beta-hemolytic streptococcal pharyngitis (strep throat) is an important task for clinicians. Previous reviews have not systematically reviewed and synthesized the evidence. OBJECTIVE To review the precision and accuracy of the clinical examination in diagnosing strep throat. DATA SOURCE MEDLINE search for articles about diagnosis of strep throat using history-taking and physical examination. STUDY SELECTION Large blinded, prospective studies (having > or =300 patients with sore throat) reporting history and physical examination data and using throat culture as the reference standard were included. Of 917 articles identified by the search, 9 met all inclusion criteria. DATA EXTRACTION Pairs of authors independently reviewed each article and used consensus to resolve discrepancies. DATA SYNTHESIS The most useful findings for evaluating the likelihood of strep throat are presence of tonsillar exudate, pharyngeal exudate, or exposure to strep throat infection in the previous 2 weeks (positive likelihood ratios, 3.4, 2.1, and 1.9, respectively) and the absence of tender anterior cervical nodes, tonsillar enlargement, or exudate (negative likelihood ratios, 0.60, 0.63, and 0.74, respectively). No individual element of history-taking or physical examination is accurate enough by itself to rule in or rule out strep throat. Three validated clinical prediction rules are described for adult and pediatric populations. CONCLUSIONS While no single element of history-taking or physical examination is sufficiently accurate to exclude or diagnose strep throat, a well-validated clinical prediction rule can be useful and can help physicians make more informed use of rapid antigen tests and throat cultures.
PARANEOPLASTIC DISORDERS

IN recent years, there has been increasing recognition that many patients suffering from malignant disease also have disturbances of body metabolism, which are not explained by the anatomical situation of the tumour or its metastases. From this category are also excluded those tumours of endocrine origin which continue to secrete hormones. Therefore, disorders such as virilism from androgen-secreting tumours of testis or ovary, carcinoma of the thyroid with thyrotoxicosis, hypertension with phreochromocytoma, peptic ulceration with gastrin-secreting islet-cell tumours of the pancreas, etc., will not be discussed.
A self-healing framework for general software systems

Modern systems must guarantee high reliability, availability, and efficiency. Their complexity, exacerbated by the dynamic integration with other systems, the use of thirdparty services and the various different environments where they run, challenges development practices, tools and testing techniques. Testing cannot identify and remove all possible faults, thus faulty conditions may escape verification and validation activities and manifest themselves only after the system deployment. To cope with those failures, researchers have proposed the concept of self-healing systems. Such systems have the ability to examine their failures and to automatically take corrective actions. The idea is to create software systems that can integrate the knowledge that is needed to compensate for the effects of their imperfections. This knowledge is usually codified into the systems in the form of redundancy. Redundancy can be deliberately added into the systems as part of the design and the development process, as it occurs for many fault tolerance techniques. Although this kind of redundancy is widely applied, especially for safety-critical systems, it is however generally expensive to be used for common use software systems. We have some evidence that modern software systems are characterized by a different type of redundancy, which is not deliberately introduced but is naturally present due to the modern modular software design. We call it intrinsic redundancy. This thesis proposes a way to use the intrinsic redundancy of software systems to increase their reliability at a low cost. We first study the nature of the intrinsic redundancy to demonstrate that it actually exists. We then propose a way to express and encode such redundancy and an approach, Java Automatic Workaround, to exploit it automatically and at runtime to avoid system failures. Fundamentally, the Java Automatic Workaround approach replaces some failing operations with other alternative operations that are semantically equivalent in terms of the expected results and in the developer’s intent, but that they might have some syntactic difference that can ultimately overcome the failure. We qualitatively discuss the reasons of the presence of the intrinsic redundancy and we quantitatively study four large libraries to show that such redundancy is indeed a characteristic of modern software systems. We then develop the approach into a prototype and we evaluate it with four open source applications. Our studies show that the approach effectively exploits the intrinsic redundancy in avoiding failures automatically and at runtime.
Location-dependent query processing: Where we are and where we are heading

The continuous development of wireless networks and mobile devices has motivated an intense research in mobile data services. Some of these services provide the user with context-aware information. Specifically, location-based services and location-dependent queries have attracted a lot of interest. In this article, the existing literature in the field of location-dependent query processing is reviewed. The technological context (mobile computing) and support middleware (such as moving object databases and data stream technology) are described, location-based services and location-dependent queries are defined and classified, and different query processing approaches are reviewed and compared.
Comments on the CASIA version 1.0 Iris Data Set

We note that the images in the CASIA version 1.0 iris data set have been edited so that the pupil area is replaced by a circular region of uniform intensity. We recommend that this data set no longer be used in iris biometrics research unless there is a compelling reason that takes into account the nature of the images. In addition, based on our experience with the iris challenge evaluation (ICE) 2005 technology development project, we make recommendations for reporting results of iris recognition experiments.
Recovering the Evolution Stable Part Using an ECGM Algorithm: Is There a Tunnel in Mozilla?

Analyzing the evolutionary history of the design of Object-Oriented Software is an important and difficult task where matching algorithms play a fundamental role. In this paper, we investigate the applicability of an error-correcting graph matching (ECGM) algorithm to object-oriented software evolution. By means of a case study, we report evidence of ECGM applicability in studying the Mozilla class diagram evolution. We collected 144 Mozilla snapshots over the past six years, reverse-engineered class diagrams and recovered traceability links between subsequent class diagrams. Our algorithm allows us to identify evolving classes that maintain a stable structure of relations(associations, inheritances and aggregations) with other classes and thus likely constitute the backbone of Mozilla.
Pathophysiology of genetic deficiency in tissue kallikrein activity in mouse and man

Summary Study of mice rendered deficient in tissue kallikrein (TK) by gene inactivation and human subjects partially deficient in TK activity as consequence of an active site mutation has allowed recognising the physiological role of TK and its peptide products kinins in arterial function and in vasodilatation, in both species. TK appears as the major kinin forming enzyme in arteries, heart and kidney. Non-kinin mediated actions of TK may occur in epithelial cells in the renal tubule. In basal condition, TK deficiency induces mild defective phenotypes in the cardiovascular system and the kidney. However, in pathological situations where TK synthesis is typically increased and kinins are produced, TK deficiency has major, deleterious consequences. This has been well documented experimentally for cardiac ischaemia, diabetes renal disease, peripheral ischaemia and aldosterone-salt induced hypertension. These conditions are all aggravated by TK deficiency. The beneficial effect of ACE/kininase II inhibitors or angiotensin II AT1 receptor antagonists in cardiac ischaemia is abolished in TK-deficient mice, suggesting a prominent role for TK and kinins in the cardioprotective action of these drugs. Based on findings made in TK-deficient mice and additional evidence obtained by pharmacological or genetic inactivation of kinin receptors, development of novel therapeutic approaches relying on kinin receptor agonism may be warranted.
Preliminary experiments toward automatic generation of new TTS voices from recorded speech alone

To generate a new concatenative text-to-speech (TTS) voice from recordings of a human’s voice, not only recordings but also additional information such as the transcriptions, prosodic labels, and the phonemic alignments are necessary. Since some of the information depends on the speaking style of the narrator, these types of information need to be manually added by listening to the recordings, which is costly and time consuming. To tackle this problem, we have been working on a totally train-able TTS system every component of which, including the text processing module, can be automatically trained from a speech corpus. In this paper, we reﬁne the framework and propose several submodules to collect all of the linguistic and acoustic information necessary for generating a TTS voice from the recorded speech. Though completely automatic generation of a new voice is not yet possible, we report progress in the submodules by showing experimental results.
Cellular Signaling Underlying Atrial Tachycardia Remodeling of L-type Calcium Current

Atrial tachycardia (AT) downregulates L-type Ca2+ current (ICaL) and causes atrial fibrillation–promoting electric remodeling. This study assessed potential underlying signal transduction. Cultured adult canine atrial cardiomyocytes were paced at 0, 1, or 3 Hz (P0, P1, P3) for up to 24 hours. Cellular tachypacing (P3) mimicked effects of in vivo AT: decreased ICaL and transient outward current (Ito), unchanged ICaT, IKr, and IKs, and reduced action potential duration (APD). ICaL was unchanged in P3 at 2 and 8 hours but decreased by 55±6% at 24 hours. Tachypacing caused Ca2+i accumulation in P3 cells at 2 to 8 hours, but, by 24 hours, Ca2+i returned to baseline. Cav1.2 mRNA expression was not altered at 2 hours but decreased significantly at 8 and 24 hours (32±4% and 48±4%, respectively) and protein expression was decreased (47±8%) at 24 hours only. Suppressing Ca2+i increases during tachypacing with the ICaL blocker nimodipine or the Ca2+ chelator BAPTA-AM prevented ICaL downregulation. Calcineurin activity increased in P3 at 2 and 8 hours, respectively, returning to baseline at 24 hours. Nuclear factor of activated T cells (NFAT) nuclear translocation was enhanced in P3 cells. Ca2+-dependent signaling was probed with inhibitors of Ca2+/calmodulin (W-7), calcineurin (FK-506), and NFAT (INCA6): each prevented ICaL downregulation. Significant APD reductions (≈30%) at 24 hours in P3 cells were prevented by nimodipine, BAPTA-AM, W-7, or FK-506. Thus, rapid atrial cardiomyocyte activation causes Ca2+ loading, which activates the Ca2+-dependent calmodulin–calcineurin–NFAT system to cause transcriptional downregulation of ICaL, restoring Ca2+i to normal at the cost of APD reduction. These studies elucidate for the first time the molecular feedback mechanisms underlying arrhythmogenic AT remodeling.
Meat Quality and Storage Characteristics of Pork Loin Marinated in Grape Pomace

This study investigated the meat quality and storage characteristics of pork loin marinated in grape pomace powder during different storage periods. The experimental design included six treatments : pork loin containing only 100% water (Control, C); pork loin containing a combination of 20% grape pomace and 80% water (T1); pork loin containing a combination of 40% grape pomace and 60% water (T2); pork loin containing a combination of 0.5% grape pomace powder and 95.5% water (T3); pork loin containing a combination of 1.0% grape pomace powder and 99.0% water (T4); and pork loin containing a combination of 2.0% grape pomace powder and 98.0% water (T5). The pork loins aged by grape pomace and grape pomace powder showed decreased crude protein, crude fat, crude ash, pH, redness, and yellowness values; however, their moisture, lightness, and shear force increased significantly. During cold storage, marination with grape pomace and grape pomace powder reduced the 2-thiobarbituric acid value, volatile basic nitrogen value, and total microbial count in pork loin. Thus, marination with grape pomace and grape pomace powder improved the meat quality and storage characteristics, and could be used to improve storage stability of pork loin.
Identifying clinical criteria to predict Type 1 diabetes, as defined by absolute insulin deficiency: a systematic review protocol

Introduction Management of a patient's diabetes is entirely dependent upon the type of diabetes they are deemed to have. Patients with Type 1 diabetes are insulin deficient so require multiple daily insulin injections, whereas patients with Type 2 diabetes still have some endogenous insulin production so insulin treatment is only required when diet and tablets do not establish good glycaemic control. Despite the importance of a correct diagnosis, classification of diabetes is based on aetiology and relies on clinical judgement. There are no clinical guidelines on how to determine whether a patient has Type 1 or Type 2 diabetes. We aim to systematically review the literature to derive evidence-based clinical criteria for the classification of the major subtypes of diabetes. Methods and analysis We will perform a systematic review of diagnostic accuracy studies to establish clinical criteria that predict the subsequent development of absolute insulin deficiency seen in Type 1 diabetes. Insulin deficiency will be determined by reference standard C-peptide concentrations. Synthesis of criteria identified will be undertaken using hierarchical summary receiver operating characteristic curves. Ethics and dissemination As this is a systematic review, there will be no ethical issues. We will disseminate results by writing up the final systematic review and synthesis for publication in a peer-reviewed journal and will present at national and international diabetes-related meetings.
Inhibitory effects of 4-vinylbenzaldehyde and 4-vinylbenzoic acid on the activity of mushroom tyrosinase

Tyrosinase (EC 1.14.18.1) catalyzes both the hydroxylation of tyrosine into o-diphenols and the oxidation of o-diphenols into o-quinones which form brown or black pigments. Here, the inhibitory effects of 4-vinylbenzaldehyde and 4-vinylbenzoic acid on the activity of mushroom tyrosinase have been investigated. The results showed that both 4-vinylbenzaldehyde and 4-vinylbenzoic acid could inhibit both monophenolase activity and diphenolase activity of the enzyme. For the monophenolase activity, 4-vinylbenzoic acid could lengthen the lag time, but 4-vinylbenzaldehyde could not. Both 4-vinylbenzaldehyde and 4-vinylbenzoic acid decreased the steady-state activity, and the IC50 values were estimated as 93 μM and 3.0 mM for monophenolase activity, respectively. For the diphenolase activity, the inhibitory capacity of 4-vinylbenzaldehyde was stronger than that of 4-vinylbenzoic acid, and the IC50 values were estimated as 23 μM and 0.33 mM, respectively. Kinetic analyses showed that inhibition by both compounds was reversible and their mechanisms were mixed-II type; their inhibition constants were also determined and compared.
Rotational twisted string actuator with linearized output: Mathematical model and experimental evaluation

Twisted string actuator is a compliant, light, and mechanically simple module. The actuation principle is based on the contraction of the strings, where a low torque - high speed dc motor is capable of providing high forces. Such actuators are very light, quiet, compliant, mechanically simple and provide a possibility to move motors away from the actu- ating joint. Implementation of these actuators can drastically decrease the weight and size of certain robotic systems such as exoskeletons, manipulators and humanoid robots. However, these actuators have disadvantages such nonlinear transmission ratio, which is found as a ratio between the angle of twisting of the strings and their resulting contraction. In this paper, we propose a linearized output transmission mechanism with rotational motion as an output which incorporates a twisted string actuator. The designed mechanism allows to linearize the relationships between the input and output displacements and forces. The proposed design has been validated theoretically and evaluated through a series of experiments and simulations. A detailed analysis of the performance of the proposed mechanism is presented in this paper.
Functional outcome of precontoured locking compression plate fixation of tibial plateau fractures in adults

Tibial plateau fractures are one of the commonest intra articular fractures. These injuries encompass many varied fracture configuration that involve medial, lateral or both tibial plateau with varied degree of compression and articular displacements. Articular reconstruction and stable fixation of tibial plateau fractures and its various subtypes continue to represent a surgical challenge. Only few trials have studied results following angular stable plate fixation. In our prospective longitudinal study of 20 subjects with follow up of six months using Rasmussens knee scoring system found a statistically significant difference in the functional outcome with the use of angle stable locking compression plate.
Comparison of the morphine-sparing effect of intraoperative dexmedetomidine with and without loading dose following general anesthesia in multiple-fracture patients

Abstract Intraoperative dexmedetomidine (DEX) with or without loading dose both promote morphine-sparing effect in patient-controlled analgesia on postoperative acute pain. However, the contribution of the loading dose to this effect is largely unknown, especially in long-lasting surgeries. The present study was designed to investigate the role of a loading dose of DEX in this morphine-sparing effect in multiple-fracture patients following general anesthesia. Eighty-six patients scheduled multiple-fracture surgeries under general anesthesia were allocated into 3 groups which were maintained with propofol/remifentanil/Ringer solution (PRR), propofol/remifentanil/DEX with (PRDw), or without (PRDo) DEX loading dose before induction, respectively. Time to first morphine request and 24-hour morphine consumption was monitored. Pain intensity was evaluated with visual analog scale. During the first 24 hours following surgery, patients in the PRDw/o group showed increased time to first request of postoperative morphine and decreased total morphine consumption as compared with PRR patients. There was no significant difference with respect to these parameters between patients from the PRDw and PRDo groups. More patients from the PRDw groups experienced intraoperative bradycardia when compared to those from the PRR or PRDo group. This randomized controlled trial indicates that the morphine-sparing effect of intraoperative DEX was not affected by a loading dose in long-time surgeries.
Release of antioxidant components from tomatoes determined by an in vitro digestion method

Tomatoes are an important source of antioxidant compounds, such as lycopene, phenolics and ascorbic acid. The main objective of this study was to determine the accessibility (availability for absorption) of the antioxidant compounds (total phenolics, total flavonoids, lycopene, ascorbic acid) and the antioxidant activity in fresh tomatoes of three cultivars (Excell, Tradiro and Flavourine) grown in New Zealand. The tomatoes were subjected to an in vitro digestion method, in which the pH, temperature, enzymes and chemical conditions were maintained according to human gastrointestinal conditions. The results showed that a high amount of the total phenolics and total flavonoids (71–77%) were released from tomatoes during digestion. However, only 3.2–4.5% of the total lycopene was released. No ascorbic acid could be detected after completion of in vitro digestion, probably due to degradation. After completion of digestion, the in vitro digestion extracts were found to have 45–50% antioxidant activity compared with the total antioxidant activity of fresh tomatoes (as measured by the 2,2′-azinobis (3-ethylbenzothiazoline-6-sulfonic acid diammonium salt radical decolourization assay). This study shows that the antioxidant components of tomatoes were affected by the in vitro digestion conditions depending on the type of compound. This in vitro digestion method gives an estimate of the release of antioxidant components in tomato, which may predict their in vivo behaviour.
Preliminary study on the effects of bar placement on the thorax after the nuss procedure for pectus excavatum using bone scintigraphy.

AIM Bone scintigraphy was performed to elucidate the effects of the Nuss procedure for pectus excavatum on the bony thorax. METHODS Eight boys and 6 girls (5 - 24 years of age) underwent bone scintigraphy, using (99m)Tc-HMDP. Eleven patients were studied 5 to 21 days after the Nuss procedure; 6 were studied 20 to 24 months after the operation before bar removal. Three of 14 were studied twice after the Nuss procedure and before bar removal. RESULTS In the early postoperative phase, RI accumulation was found at the sternum and ribs in only 1 of 6 patients under 9 years of age, whereas in all 5 older patients, RI had accumulated at the sternum. Scintigrams before bar removal revealed, regardless of age, hot spots at the lateral ribs in contact with the bar and at the costochondral junctions where the bar passed through the intercostal spaces. Furthermore, chest roentgenograms showed the deformed lateral ribs in contact with the bar. CONCLUSIONS The Nuss procedure creates minute fractures at the sternum and the ribs, especially in older patients. The bar deforms the ribs and restrains the growth of the thorax. Furthermore, it constantly rubs against the ribs and can therefore cause late complications. Bone scintigraphy may determine the appropriate timing for bar removal.
Metabolic crosstalk between choline/1-carbon metabolism and energy homeostasis

Abstract There are multiple identified mechanisms involved in energy metabolism, insulin resistance and adiposity, but there are here-to-fore unsuspected metabolic factors that also influence these processes. Studies in animal models suggest important links between choline/1-carbon metabolism and energy homeostasis. Rodents fed choline deficient diets become hypermetabolic. Mice with deletions in one of several different genes of choline metabolism have phenotypes that include increased metabolic rate, decreased body fat/lean mass ratio, increased insulin sensitivity, decreased ATP production by mitochondria, or decreased weight gain on a high fat diet. In addition, farmers have recognized that the addition of a metabolite of choline (betaine) to cattle and swine feed reduces body fat/lean mass ratio. Choline dietary intake in humans varies over a >three-fold range, and genetic variation exists that modifies individual requirements for this nutrient. Although there are some epidemiologic studies in humans suggesting a link between choline/1-carbon metabolism and energy metabolism, there have been no controlled studies in humans that were specifically designed to examine this relationship.