Miracle-dz/UniFAR-FTUs huggingface dataset:
Proton Pump Inhibitors Versus Solitary Lifestyle Modification in Management of Laryngopharyngeal Reflux and Evaluating Who is at Risk: Scenario in a Developing Country

Background Laryngopharyngeal reflux disease can present with a varied symptomatology because of the involvement of multiple sub-sites of the upper aero-digestive tract. It is a very common disease to be encountered in routine practice by both medical and ENT personnel. Its association with multiple pathologies including malignancy warrants an early diagnosis and management. The lack of cost effective and non-invasive tests constitutes a major hurdle in its early management. Objectives 1. To define the “at risk” population, prone to developing laryngopharyngeal reflux. 2. To formulate major and minor risk factors for the clinical diagnosis of patients with laryngopharyngeal reflux. 3. To evaluate the efficacy of lifestyle management alone as a treatment option. 4. To formulate a treatment protocol for the management of patients and to prevent recurrence. Study Design We performed a prospective analysis of 234 patients diagnosed with laryngopharyngeal reflux. Patients were randomized into study and control groups based on the treatment protocol, using a computer generated randomization table and were single blinded to the type of therapy received. A complete analysis of the possible risk factors, symptoms, and signs was performed with statistical analysis. Results and Conclusion The data has helped us define the “at risk” population and formulate the criteria to diagnose cases of laryngopharyngeal reflux, clinically. The results emphasize the non-requirement of invasive or costly investigations for all patients and indicate the probable protocol to be followed prior to considering further investigation. The role of long term proton pump inhibitor treatment along with lifestyle modification in the initial phase of treatment, as mentioned in the literature, was re-confirmed by our study. However, in addition to the initial treatment, the study establishes the need for continuing lifestyle modification further for at least six months after the cessation of proton pump inhibitor therapy to prevent early recurrence of symptoms.
The effect of symptom-controlling medication on gait outcomes in people with multiple sclerosis: a systematic review

Abstract Purpose: To synthesise and critically appraise randomised controlled trials examining the effect of symptom-controlling medication on gait outcomes in people with multiple sclerosis (MS). Method: The literature search examined five databases (Medline, Embase, AMED, Cochrane (CENTRAL), and CINAHL until the end of November 2016. Eligible studies included medication to address symptoms associated with MS and an objective gait outcome measure. Two reviewers independently extracted data and assessed study quality using structured data extraction forms and the PEDro scale. Results: From 249 papers identified, 13 papers met inclusion criteria, examining three medications. Fampridine was found to significantly increase gait speed, but only in those people who responded to medication, which was less than half (pooled mean: 39%). Ten milligrams of fampridine twice daily significantly improves gait endurance. No definitive conclusions can be made about the efficacy of cannabinoid medication due to conflicting results across three studies. A single study of baclofen did not provide evidence to support the use of this medication to improve gait. Conclusions: Limited evidence is available to guide gait symptom control for people with MS. Further research that includes three-dimensional gait analysis, patient perceived measures of gait dysfunction and explores combined efficacy of other modalities on gait is needed. Implications for Rehabilitation Gait disturbance is a common and disabling symptom of multiple sclerosis. Fampridine and cannabis medication may increase gait speed, baclofen does not. Fampridine can be used to improve gait endurance. Future research should include both quantitative and qualitative outcome measures of gait and investigate the combined efficacy of pharmacological and non-pharmacological interventions to assist clinicians to maximise gait improvements.
Labor Supply Effects of State Maternity Leave Legislation

25% of all employed US mothers of newborns are on either paid or unpaid leave. The proportion of new mothers which is employed but not at work shrinks rapidly as the child ages so that virtually all mothers return to actual work in the formal labor force within four months of giving birth. Beginning in 1986 twelve states have passed maternity leave statutes guaranteeing recent mothers the right to return to a job held in pregnancy after an unpaid leave. One of US President Clintons first official acts upon assuming office was to sign into law the federal Family Leave Act providing for unpaid maternity leaves. The authors develop an economic model to accommodate their theory that both employment and leave will increase with the passage of maternity leave legislation but the direction of the legislations effect upon work is ambiguous. Their theory is tested with data from the 1980 and 1990 censuses. Study results are sensitive to the controls for state and year effects and the controls for the characteristics of sampled women. The estimates provide some evidence that maternity leave statutes increased leave but had insignificant positive effects upon employment and work.
Sickle cell disease and implementation science: A partnership to accelerate advances

Sickle cell disease (SCD) results in end organ damage and a shortened lifespan. Both the pathophysiology of the disease and the social determinants of health affect patient outcomes. Randomized controlled trials have been completed among this population and resulted in medical advances; however, the gestation of these advances and the lack of penetrance into clinical practice have limited advancements in clinical improvements for many people with SCD. We discuss the role of implementation science in SCD and highlight the need for this science to shorten the length of time to implement evidence‐based care for more people with SCD.
Treprostinil-based therapy in the treatment of moderate-to-severe pulmonary arterial hypertension: long-term efficacy and combination with bosentan.

BACKGROUND Treprostinil, a long-acting prostacyclin analog, diminished the symptoms of pulmonary arterial hypertension (PAH) in controlled 12-week clinical efficacy studies. This retrospective, single-center, open-label study was designed to assess the efficacy of long-term, subcutaneously administered, treprostinil-based therapy alone or in combination with bosentan for the treatment of moderate-to-severe PAH. METHODS Thirty-eight patients with pulmonary hypertension treated with subcutaneous treprostinil were followed up for a mean (+/-SD) duration of 984+/-468 days (range, 165 to 1,847 days). Oral bosentan was added to the treprostinil regimen if patients remained in New York Heart Association (NYHA) functional class III or II with intolerable prostacyclin side effects that limited therapy. Hemodynamic studies, Borg dyspnea score evaluations, 6-min walk (6MW) tests, and NYHA functional class determinations were performed at approximately 6-month intervals. RESULTS Mean pulmonary artery pressure decreased from 59.7 to 50.5 mm Hg (p<0.001). Significant and sustained improvement in 6MW distance (p=0.022) and Borg dyspnea score (p=0.023) were observed. At the final observation, the mean dose of treprostinil was 37.8 ng/kg/min (range, 7.5 to 115 ng/kg/min). At baseline, 5% of patients were in NYHA functional class 2 or lower vs 58% at the last follow-up. Bosentan was added to the regimens of 19 patients. In those patients, significant additional improvement occurred in the pulmonary arterial pressure (p<0.001), 6MW distance (p=0.001), and Borg dyspnea scale (p=0.020) compared to baseline. CONCLUSIONS Long-term treatment with subcutaneous treprostinil-based therapy improved functional parameters and hemodynamics in patients with moderate-to-severe PAH. In patients requiring combination therapy, the addition of oral bosentan to treprostinil-based therapy was safe, well-tolerated, and associated with further clinical improvements.
Are All Manikins Created Equal? A Pilot Study of Simulator Upper Airway Anatomic Fidelity

This study evaluates the anatomic fidelity of several commercially available pediatric and adult manikins, including airway task trainers, which could be used in aerodigestive procedure training. Twenty-three experienced otolaryngologists assessed the aerodigestive anatomy of 5 adult and 5 pediatric manikins in a passive state, using rigid and flexible endoscopy. Anatomic fidelity was rated on a 5-point scale for the following: nasal cavity, nasopharynx, oral cavity, oropharynx, larynx, trachea, esophagus, and neck. Mean scores and standard deviations were tabulated for each manikin at each anatomic site. Ratings by survey participants demonstrated variation in the anatomic fidelity of the aerodigestive tract in a range of manikins. Radar chart display of the results allows comparison of manikin fidelity by anatomic site. Differences in scores may allow instructors to select manikins with the best anatomic fidelity for specific educational purposes, and they may contribute to recommendations to improve future manikin design.
A Discourse Analysis: One Caregiver’s Voice in End-of-Life Care

Informal family caregivers make a significant contribution to the U.S. health care system, and the need for caregivers will likely increase. Gaining deeper insights into the caregiver experience will provide essential knowledge needed to support the future caregiver workforce delivering care. Discourse analysis is a viable approach in analyzing textual caregiver data that focuses on the end-of-life caregiving experience. The purpose of this study was to conduct an in-depth discourse analytic examination of 13 hours of caregiver interview data, which reveal the multiplicity of shifting stances and perceptions of one caregiver in the midst of end-of-life care, specifically with regard to his perceptions of self (caregiver) and other (care recipient). By isolating a specific but limited set of reference terms used throughout the discourse, we gained systematic glimpses into the mind and perceptions of this single caregiver in relation to his role as caregiver for his terminally ill wife.
Elevated Expression of the NLRP3 Inflammasome and Its Correlation with Disease Activity in Adult-onset Still Disease

Objective. The dysregulation of the NLRP3 (NLR containing a pyrin domain) inflammasome is involved in autoinflammatory diseases. Adult-onset Still disease (AOSD) is regarded as an autoinflammatory disease. However, the pathogenic involvement of NLRP3 inflammasome in AOSD remains unclear and NLRP3 activators in AOSD are currently unknown. Methods. The mRNA expression of NLRP3 inflammasome signaling in peripheral blood mononuclear cells (PBMC) from 34 patients with AOSD and 14 healthy subjects was determined using quantitative-PCR (qPCR). The changes in mRNA and protein levels of NLRP3 inflammasome signaling in PBMC treated with the potential activator [imiquimod (IMQ)] or inhibitor of NLRP3 were evaluated using qPCR and immunoblotting, respectively. The supernatant levels of interleukin (IL)-1β and IL-18 were determined by ELISA. Results. Significantly higher mRNA levels of NLRP3 inflammasome signaling were observed in patients with AOSD compared with healthy controls. NLRP3 expressions were positively correlated with disease activity in patients with AOSD. IMQ (an effective Toll-like receptor 7 ligand; 10 µg/ml and 25 µg/ml) stimulation of PBMC from patients with AOSD induced dose-dependent increases of mRNA expression of NLRP3 (mean ± standard error of the mean, 2.06 ± 0.46 and 6.05 ± 1.84, respectively), caspase-1 (1.81 ± 0.23 and 4.25 ± 0.48), IL-1β (5.68 ± 1.51 and 12.13 ± 3.71), and IL-18 (2.32 ± 0.37 and 4.81 ± 0.51) compared with controls (all p < 0.005). IMQ stimulation of PBMC from patients similarly induced greater increases in protein expressions of NLRP3 inflammasome compared with controls. The protein expressions of NLRP3, IL-1β, and IL-18 on PBMC significantly decreased after treatment with NLRP3 inhibitor in patients with AOSD. Conclusion. Increased expression of NLRP3 inflammasome and its positive correlation with disease activity in AOSD suggest its involvement in disease pathogenesis. IMQ upregulated expressions of NLRP3 inflammasome signaling, and IMQ might be an activator of NLRP3 inflammasome in AOSD.
Novel CH1:CL interfaces that enhance correct light chain pairing in heterodimeric bispecific antibodies

Abstract Targeting two unique antigens with a single bispecific antibody is an attractive approach with potential broad therapeutic applicability. However, the production of heterodimeric bispecific antibodies (bsAbs) presents a challenge, requiring the co-expression and accurate pairing of two distinct heavy and light chain units. Several undesirable by-products can be formed in the production process, including heavy chain homodimers and non-cognate light chain pairings. Although additional downstream purification methods exist, they are often time consuming and restrict practical large-scale production. In this study, we identify and validate novel Fab interface mutations that increase cognate light chain pairing efficiencies within heterodimeric bsAbs. Importantly, the variable domains remain unaltered as interface mutations were restricted to the CH1 and CL domains. We performed several biochemical assays to demonstrate that the novel engineered interfaces do not adversely impact bispecific antibody expression, stability, affinity and biological function. The designs reported here can easily be applied in a generic manner to use existing antibodies as building blocks for bsAbs which will help to accelerate the identification and production of next generation bispecific antibody therapeutics.
Motor reflex responses elicited by cutaneous stimulation in the regenerating nerve of man: Axon reflex or ephaptic response?

In 57 of 60 nerves (29 median and 31 ulnar) sutured at the wrist, forearm and arm, we recorded motor responses in thenar or hypothenar muscles by electrical stimulation of the corresponding fingers. Recordings were made at different times during the process of regeneration, ranging from 3 months up to 11 years. The responses showed a constant shape and latency to every stimulation (simple or repetitive). The latency was shorter the more distal the level of injury and the greater the elapsed time from the reinnervation. The point of „reflexion”︁ of the responses is at or very near the line of nerve suture. The electrophysiological behavior of the responses fits well with either the criterion of axon reflex or ephaptic response. We discuss both possibilities and conclude that it is not possible, with the electrophysiological technique that we used, to distinguish between an axon reflex and an ephaptic response.
Special Educators' Perspectives of Aligning Individual Education Program Goals of Students with Severe Disabilities with the General Education Curriculum

Special Educators’ Perspectives of Aligning Individual Education Program Goals of Students with Severe Disabilities with the General Education Curriculum Kristi Noel Tonga Department of Counseling Psychology and Special Education Master of Science Aligning Individual Education Program (IEP) goals of students with severe disabilities with the general education curriculum is required by the Individuals with Disabilities Education Improvement Act of 2004 (IDEIA). This study sought to determine the perspectives of special educators regarding this requirement. Special educators from three school districts participated in focus groups to offer their perspectives in aligning IEP goals with the general education curriculum. The researchers also sought the special educators’ perspectives with regards to providing access to the general education curriculum. The study found that special educators are striving to align IEP goals through the use of general education classes, the extended core, and portfolios. The main approaches to providing access to the core curriculum were general education classes, peer tutors, and adapted curriculum.
Rural labor migration, characteristics, and employment patterns

Continued industrialization in China and increase in its agricultural productivity imply that surplus rural workers will to be attracted into non-agricultural production activities and, consequently, will have the opportunity to increase their off-farm income. Studying the structure of the rural labor force and its characteristics is important for evaluating its migration potential into non-agricultural sectors. This study examines the rural labor market in China exclusively based on China's first national agricultural census. We analyzed the demographic characteristics of the rural labor force and their association with the type of employment, place of work, and labor migration. Furthermore, we investigated demographic distributions of rural labor force and attempted to capture their relation with the distribution of other resources especially land availability or land constraints. We finally applied a generalized polytomous logit technique to analyze the patterns of rural labor employment and forecast rural migration. In this framework, we related rural labor migration with demographic characteristics, types of occupation, place of work, geographic characteristics, and various economic development indicators.
[Arterial hypertension and obesity in Ilha do Governador-Rio de Janeiro].

PURPOSE To investigate the association between hypertension and obesity and also their prevalence in the adult population from Ilha do Governador-Rio de Janeiro. METHODS It is a domiciliar inquiry, with a probalistic cluster sample in two stages. We interviewed 1272 adult residents in the selected households. Social-demographic information, anthropometric measures, habits related to smoking, physical activities and blood pressure were registered. RESULTS The prevalence of hypertension-systolic pressure > or = 160mmHg or diastolic pressure > or = 95mmHg or anti-hypertensive treatment at the moment of the interview, was 24.9% whereas the prevalence of obesity-body mass index (BMI) > or = 27kg/m2 was 28.4%. The prevalence of hypertension increased 2.4 fold from the lowest (< 25kg/m2) to the highest (> or = 30kg/m2) band of BMI. It was observed an association between hypertension and obesity that persisted after adjusting for sex, age, skin color, smoking, physical activity and level of education. Interaction of obesity with sex, age and skin color was found. The association between hypertension and obesity was stronger for men, for the youngest and also for the white people. CONCLUSION The results point out the necessary of actions to prevent and control the occurrence of both hypertension and obesity, mainly at younger ages, to decrease the rates of cardiovascular diseases.
Bilateral White Matter Diffusion Changes Persist after Epilepsy Surgery

Summary: Purpose: Bilateral white matter diffusion tensor imaging (DTI) abnormalities have been reported in patients with temporal lobe epilepsy (TLE) and unilateral mesial temporal sclerosis (MTS), but it is unknown whether these are functional or structural changes. We performed a longitudinal study in patients with unilateral MTS who were seizure‐free for 1 year after surgery to determine whether the observed presurgical white matter diffusion abnormalities were reversible.
Dealing with Long-Lived Data in High Performance Storage Systems

Long-term reliability and manageability of high-end storage systems for scientific computing will become an increasingly important issue as disk-based storage systems grow to handle petabytes and, eventually, exabytes of data. Storage systems cannot simply be upgraded by replacing them; instead, they must grow over time. Managing and replacing the thousands of individual devices that make up such a system, marshaling the trillions of files stored in the system, and ensuring the security of the data they contain will pose significant challenges that must be solved to ensure that data stored in the system today can be found and used in 25 years.
A smoother for attitude estimation using inertial and magnetic sensors

A smoother is proposed for an attitude estimation problem, where attitude is estimated using inertial and magnetic sensors. A smoother can provide better results when an off-line processing is allowed. A quaternion is used to represent attitude. An indirect Kalman filter is used as a forward and backward filter. In the smoother, the final attitude quaternion is computed using the averaging algorithm of quaternions, which can be computed from a simple optimization problem.
Teacher professional growth plans: A case study of the Chilliwack school district

Recently there has been renewed interest in the field for developing school leaders with the knowledge, skills and abilities for the supervision of instruction and teacher evaluation. Supervision and evaluation are two distinct aspects of educational administration, requiring different skills, knowledge, and actions from school leaders as well as the development of different relationships between administrators and teachers. The focus of this research is teacher professional growth plans, a non-evaluative program involving administrators and teachers. The question that is posed in the research asks educators to give their perceptions on the leadership factors that promote the development of teacher growth plans. This was a qualitative study, using a case-study approach. The case involved teachers and administrators in one school district who were involved in the development of teacher professional growth plans between 2002 and 2004. All teachers who had developed a growth plan during that time period and all administrators were surveyed. Interviews were conducted involving twenty educators. The teacher professional growth plan guide was reviewed and individual teacher growth plan documents were analysed for coherence. Hodgkinson's dimensions of leadership were used to construct the statements for the survey and to formulate the questions for the interviews. The dimensions of leadership included: consideration, situation, production