Miracle-dz/UniFAR-FTUs huggingface dataset:
Technical standards and practice guidelines: should we? Why now? Why SNIS?

SNIS continues to develop and update practice guidelines for the delivery of NeuroInterventional care. This constant project represents a major societal undertaking. On occasion, it has bound our society to other medical groups. However, articulating what we believe to be “the correct” guidelines, at times places us at odds with others over critical issues. Why make this effort? Is it worth it? In 2001, SNIS (then ASITN) published its first guidelines on NeuroInterventional therapies including aneurysms, arteriovenous malformations, head and neck tumors, epistaxis and acute ischemic stroke.1 2 3 4 5 6 7 8 These guidelines helped to define the “state-of-the-art” and served as a foundation for future clinical and technical advancement. Other specialty societies as exampled by the American Society of Interventional Pain Physicians have embraced standards and guidelines and worked to involve their membership in the process by educating them in the method of evidence-based medicine (EBM). 9 10 11 12 13 14 15 The Institute of Medicine defines clinical guidelines as “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances”. 16 Such guidelines are statements developed and designed to assist both patient and provider in decision-making about the clinical circumstance that they may encounter. Where possible, clinical practice guidelines are statements of best practice that should be based on outcomes data of the treatments we employ. In 1989, Congress mandated the creation of the Agency for Healthcare Policy and Research. This agency was given broad responsibility for supporting research, data development and related activities. At the same time, the National Academy of Sciences published a document indicating that guidelines are expected to enhance the quality, appropriateness, and effectiveness of healthcare services. While such conclusions might appear to be self-evident, one could argue that these goals have not been …
Regional metabolic changes in the hippocampus and posterior cingulate area detected with 3-Tesla magnetic resonance spectroscopy in patients with mild cognitive impairment and alzheimer disease

Background: Magnetic resonance spectroscopy (MRS) plays an important role in early diagnosis of Alzheimer disease (AD). There are many reports on MRS studies among individuals with AD and mild cognitive impairment (MCI). However, very few studies have compared spectroscopic data of different limbic regions among AD and MCI subjects. Purpose: To compare metabolite changes of different regions in the brain of AD and MCI patients by using 3.0T short-echo-time MRS. Material and Methods: Metabolite ratios in the hippocampus and posterior cingulate area were compared in a group of patients with AD (n=16), MCI (n=16), and normal subjects as a control group (n=16). Clinical neuropsychological tests were measured in all subjects. Results: In the hippocampus, there were significant differences in N-acetylaspartate (NAA)/creatine (Cr), myo-inositol (mI)/Cr, and mI/NAA ratios among the three groups. However, there were no significant differences in choline (Cho)/Cr ratio among the three groups. In the posterior cingulate area, there were no significant differences in the NAA/Cr, Cho/Cr, and mI/Cr ratios among the three groups. However, there were significant differences in mI/NAA ratio between patients with AD and the control group, and between the AD and MCI groups. In addition, there was significant correlation between mI/NAA ratio and Mini Mental Status Exam (MMSE) score in subjects with AD and MCI. Conclusion: The study reveals that the elevation of mI/NAA ratio in the hippocampus is more significant than that in the posterior cingulate area, which corresponds to the pathologic procession of AD. The ratios of mI/NAA in the hippocampus and in the posterior cingulate area together provide valuable discrimination among the three groups (AD, MCI, and controls). There is a significant correlation between mI/NAA ratio and cognitive decline.
PANSS Syndromes and Quality of Life in Schizophrenia

Background: Results from factor analysis studies have suggested that a five-dimensional structure appears to be a better representation of the psychopathological data of the PANSS. The purpose of this study was the detailed investigation of the association of schizophrenia syndromes and single symptoms with quality of life (QOL) in acute and remitted patients. The leading hypotheses were: (1) affective symptoms, especially depression and anxiety, are mostly associated with QOL longitudinally and (2) in the acute phase, QOL is also associated with positive schizophrenia symptoms. Methods: For the present study, schizophrenia and schizophreniform patients were studied on admission, at the end of the acute phase and 6 months after hospitalization. Psychopathology was measured using the PANSS syndromes, QOL was assessed using disease-specific (SWN) and generic (MLDL, EDLQ) scales. Results: Eighty-four patients entered the study and were assessed during the acute phase taking into account their history and actual treatment. Results revealed anxiety as the most important symptom and depression as the most important syndrome associated with different areas of QOL during and after hospitalization. Also cognitive and negative symptoms were associated with different QOL domains, but both positive symptom clusters showed no substantial association with QOL. Conclusions: Results of this longitudinal study investigating psychopathology and QOL in schizophrenia provide further support for the need to consider the psychopathological state and treatment setting when measuring QOL in schizophrenia and the need for a differential analysis of schizophrenia symptoms and QOL in the acute, mid-term and long-term phase. Anxiety reduction should be a critical goal of treatment in order to prevent further QOL impairment.
Threshold-based insulin-pump interruption for reduction of hypoglycemia.

BACKGROUND The threshold-suspend feature of sensor-augmented insulin pumps is designed to minimize the risk of hypoglycemia by interrupting insulin delivery at a preset sensor glucose value. We evaluated sensor-augmented insulin-pump therapy with and without the threshold-suspend feature in patients with nocturnal hypoglycemia. METHODS We randomly assigned patients with type 1 diabetes and documented nocturnal hypoglycemia to receive sensor-augmented insulin-pump therapy with or without the threshold-suspend feature for 3 months. The primary safety outcome was the change in the glycated hemoglobin level. The primary efficacy outcome was the area under the curve (AUC) for nocturnal hypoglycemic events. Two-hour threshold-suspend events were analyzed with respect to subsequent sensor glucose values. RESULTS A total of 247 patients were randomly assigned to receive sensor-augmented insulin-pump therapy with the threshold-suspend feature (threshold-suspend group, 121 patients) or standard sensor-augmented insulin-pump therapy (control group, 126 patients). The changes in glycated hemoglobin values were similar in the two groups. The mean AUC for nocturnal hypoglycemic events was 37.5% lower in the threshold-suspend group than in the control group (980 ± 1200 mg per deciliter [54.4 ± 66.6 mmol per liter] × minutes vs. 1568 ± 1995 mg per deciliter [87.0 ± 110.7 mmol per liter] × minutes, P<0.001). Nocturnal hypoglycemic events occurred 31.8% less frequently in the threshold-suspend group than in the control group (1.5 ± 1.0 vs. 2.2 ± 1.3 per patient-week, P<0.001). The percentages of nocturnal sensor glucose values of less than 50 mg per deciliter (2.8 mmol per liter), 50 to less than 60 mg per deciliter (3.3 mmol per liter), and 60 to less than 70 mg per deciliter (3.9 mmol per liter) were significantly reduced in the threshold-suspend group (P<0.001 for each range). After 1438 instances at night in which the pump was stopped for 2 hours, the mean sensor glucose value was 92.6 ± 40.7 mg per deciliter (5.1 ± 2.3 mmol per liter). Four patients (all in the control group) had a severe hypoglycemic event; no patients had diabetic ketoacidosis. CONCLUSIONS This study showed that over a 3-month period the use of sensor-augmented insulin-pump therapy with the threshold-suspend feature reduced nocturnal hypoglycemia, without increasing glycated hemoglobin values. (Funded by Medtronic MiniMed; ASPIRE ClinicalTrials.gov number, NCT01497938.).
Collection and fuzzy estimation of truth labels in glial tumour segmentation studies

In this work, we propose a novel behavioural comparison strategy specifically oriented to accuracy assessment in MRI glial tumour segmentation studies. A salient aspect of the proposed strategy is the use of the fuzzy set framework in modelling visual inspection and interpretation processes. In particular, a reference estimation strategy based on fuzzy connectedness principles is designed to merge individual labels and produce a common segmentation. The estimation is based exclusively on highly reliable partial information provided by experts. Interaction is then drastically limited compared with a complete manual tracing, leaving the estimation of the complete segmentation to the fuzzy connectedness method. A set of experiments was conceived and conducted to evaluate the contribution of the solutions proposed in the process of truth label collection and reference data estimation. A comparison analysis was also developed to see whether our method could constitute a worthy alternative to well-known and state-of-the-art solutions.
Spatiotemporal Instability of Femtosecond Pulses in Graded-Index Multimode Fibers

We study the spatiotemporal instability generated by a universal unstable attractor in normal dispersion graded-index multimode fiber for femtosecond pulses for the first time. Experimentally observed spatiotemporal instability sidebands are 91-THz detuned from the pump wavelength of 800 nm. Detailed analysis carried out numerically by employing coupled-mode pulse propagation model. Numerically obtained results are well-aligned with experimental observations. Spatial evolution of the total field and spatiotemporal instability sidebands is calculated numerically, and for the input pulses of 200-fs duration, formation and evolution of spatiotemporal instability are shown in both spatial and temporal domains. Our results present the unique features of spatiotemporal instability, such as remarkable frequency shift with inherited beam shape of instability sidebands.
Physicochemical Characterization and Dissolution Study of Solid Dispersions of Lovastatin with Polyethylene Glycol 4000 and Polyvinylpyrrolidone K30

Solid dispersions in water-soluble carriers have attracted considerable interest as a means of improving the dissolution rate, and hence possibly bioavailability, of a range of hydrophobic drugs. The aim of the present study was to improve the solubility and dissolution rate of a poorly water-soluble drug, Lovastatin, by a solid dispersion technique. Solid dispersions were prepared by using polyethylene glycol 4000 (PEG 4000) and polyvinylpyrrolidone K30 (PVP K30) in different drug-to‐carrier ratios. Dispersions with PEG 4000 were prepared by fusion-cooling and solvent evaporation, whereas dispersions containing PVP K30 were prepared by solvent evaporation technique. These new formulations were characterized in the liquid state by phase solubility studies and in the solid state by differential scanning calorimetry, X-ray powder diffraction, and FT-IR spectroscopy. The aqueous solubility of Lovastatin was favored by the presence of both polymers. The negative values of the Gibbs free energy and enthalpy of transfer explained the spontaneous transfer from pure water to the aqueous polymer environment. Solid-state characterization indicated Lovastatin was present as amorphous material and entrapped in polymer matrix. In contrast to the very slow dissolution rate of pure Lovastatin, the dispersion of the drug in the polymers considerably enhanced the dissolution rate. This can be attributed to improved wettability and dispersibility, as well as decrease of the crystalline and increase of the amorphous fraction of the drug. Solid dispersion prepared with PVP showed the highest improvement in wettability and dissolution rate of Lovastatin. Even physical mixture of Lovastatin prepared with both polymers also showed better dissolution profile than that of pure Lovastatin. Tablets containing solid dispersion prepared with PEG and PVP showed significant improvement in the release profile of Lovastatin compared with tablets containing Lovastatin without PEG or PVP.
Pulse amplification characteristics of a CW pumped Erbium-Doped Fiber Amplifier

We present experimental investigation of pulse amplification characteristics of an Erbium-Doped Fiber Amplifier (EDFA). Gain saturation of the EDFA pumped by a CW laser is precisely measured for input pulse widths from 100ns to 100μs. Pulse width dependence of the saturation power is discussed by applying a simple three-level model to erbium ions.
PP13 mRNA Expression in Trophoblasts From Preeclamptic Placentas

To assess the role of placental protein 13 (PP13) in the pathogenesis of preeclampsia, the messenger RNA expression of PP13 was investigated in the trophoblasts from first and third trimester placenta. First, syncytiotrophoblasts and extravillous trophoblasts were separated from frozen section of third trimester placenta obtained from pregnant women with and without preeclampsia by laser microdissection. The PP13 levels of syncytiotrophoblasts were significantly higher than those of extravillous trophoblasts. The expression levels in syncytiotrophoblasts from the preeclampsia were significantly lower than those from normal. Next, the PP13 expression was assessed in trophoblasts from residual samples of chorionic villus sampling at 11 weeks of gestation, who subsequently developed preeclampsia. The levels in the preeclampsia group were significantly lower than those of normal cases. These findings indicate that an alteration in the PP13-messenger RNA expression in the trophoblasts may be associated with the pathogenesis of preeclampsia.
Preoperative dobutamine stress echocardiography versus cardiac arteriography for risk assessment prior to renal transplantation

Abstract Because coronary artery disease is the leading cause of death in patients with end-stage renal disease, we prospectively studied the prognostic value of dobutamine stress echocardiography (DSE) compared to coronary angiography (CA) as an evaluative tool. Thirty-three patients at high risk for coronary artery disease were selected from a cohort of 133 renal transplant candidates and underwent both DSE and CA. In this study, the value of DSE was found to exist in its strong negative predictive value (92 %). A negative DSE coupled with a negative clinical cardiac evaluation was found to practicably exclude the necessity for CA. DSE can thus serve as a non-invasive, low cost screening test.
The problem of the sex offender.

From my brief survey it is clear that the whole problem of the sex offender is a most complicated one and involves many fields. All attempts at better diagnosis, treatment, and prevention will require many years of cooperative research by scientists from many different fields. There is no one over-all way of attacking the problem. Rather one must attack individual facets. It is possible to pose a series of specific questions to which there is reason to believe we can get specific answers. By setting up more and more of these researches, which will attack limited phases of the problem, and by securing answers to such phases, we can hope to be able eventually to throw these answers together and by combining them obtain a solution to this problem.
Histologic types of lung cancer among uranium miners

A panel of pathologists classified 121 cases of lung cancer from American uranium miners by cell type, and 138 cases of cancer in non‐miners. Undifferentiated carcinomas showed a higher incidence with increasing radiation exposure and age and cigarette matched controls. At high radiation exposures, the WHO 2B cell type accounted for more than half the total. An average of 15.9 years elapsed from the beginning of mining to development of cancer. It was longest among the highly exposed men and was shortest among men with small cell, undifferentiated carcinoma who had less than 700 Work Level Months exposure. In all age and cigarette groups, radiation exposure increased the small cell, undifferentiated, but decreased the epidermoid tumors. Age showed an increase in epidermoid carcinoma. Undifferentiated small cell types were slightly increased among the lowest exposure groups. These increases and an excess of these cell types among South African gold miners seem to establish a trend.
Non‐infectious skin disease in Indigenous Australians

The burden of non‐infectious skin disease in the Indigenous Australian population has not been previously examined. This study considers the published data on the epidemiology and clinical features of a number of non‐infectious skin diseases in Indigenous Australians. It also outlines hypotheses for the possible differences in the prevalence of such diseases in this group compared with the general Australian population. There is a paucity of literature on the topic but, from the material available, Indigenous Australians appear to have a reduced prevalence of psoriasis, type 1 hypersensitivity reactions and skin cancer but increased rates of lupus erythematosus, kava dermopathy and vitamin D deficiency when compared to the non‐Indigenous Australian population. This article profiles the prevalence and presentation of non‐infectious skin diseases in the Indigenous Australian population to synthesise our limited knowledge and highlight deficiencies in our understanding.
Comparison of Task Specific Exercises and Mirror Therapy to Improve Upper Limb Function in Subacute Stroke Patients

Stroke is the leading cause of long-term disability. Approximately 70% to 80% of people sustaining a stroke have upper limb (UL) impairment. Improving use of the affected UL is important however, because difficulty in using this UL in daily tasks has been associated with reduced quality of life. Additional effects of combining mirror therapy (MT) with Task Specific Exercises (TSE) to improve UL function post-stroke are unknown. Hence, primary objective of this study was to find out the effectiveness of combined TSE and MT interventions in sub-acute stroke patients to improve UL function and secondary objective was to compare the effectiveness of combined TSE and MT interventions with TSE alone and MT alone. Thirty-seven stroke patients were divided into 3 groups; Group A received TSE, Group B received MT and Group C received TSE as well as MT. Outcome measures were Action Research Arm Test, Fugl-Meyer Assessment and Voluntary Control Grading. All 3 groups showed statistically significant improvement on outcome measures but Group C improved more than the other 2 groups. Conclusion: TSE and MT interventions should be combined altogether in the treatment of sub-acute stroke patients to improve UL function.
Infratrochlear nerve block for a new infratrochlear neuralgia

Dear Sir, Painful cranial neuropathies are a group of entities causing pain in the distribution of one particular nerve (1,2). Some of them are well characterized while others have been identified only very recently. Apart from first-division trigeminal neuralgia, several neuropathies affecting the terminal branches of the trigeminal nerve may involve the orbital and periorbital area, including supraorbital/supratrochlear neuralgia (3), infraorbital neuralgia (4) and lacrimal neuralgia (5). Pareja et al. have recently described infratrochlear neuralgia in seven patients presenting with paroxysmal pain in the internal angle of the orbit (6). In each patient, the pain appeared in one of three different locations within the territory supplied by the infratrochlear nerve, namely, the medial half of the palpebra superior, the caruncula lacrimalis and the lateral aspect of the radix nasi. Although most of the patients (six out of seven) were treated with oral drugs, we advocate anaesthetic blockades as a safe and effective treatment for this condition. We aim to present a new case of infratrochlear neuralgia, as well as the result of the anaesthetic blockade of the infratrochlear nerve. A 46-year-old woman with prior history of migraine without aura came to our office complaining of a new type of pain. She had paroxysms of pressing pain in the internal angle of the right orbit and the medial half of the right palpebra superior. The episodes roughly lasted 2minutes and they ranged from mild (3 out of 10) to moderate (7 out 10) in intensity. She had been experiencing such a pain for 1 year with an average frequency of once per week. The patient could not identify any trigger. Between the paroxysms, she felt pain within the symptomatic area when gently touching it. Sensory examination demonstrated the presence of hyperesthesia and allodynia in the painful area. In addition, palpation of the medial edge of the right orbit just above the caruncula lacrimalis was extremely painful. This area matched the point where the infrathrochlear nerve emerges from the orbit. The pain evoked upon palpation did not increase with vertical eye movements. All ancillary tests, including routine blood tests, immunological screening and brain and orbital magnetic resonance imaging, were normal. Considering infratrochlear neuralgia as the most reasonable diagnosis, we performed an anaesthetic
Practical experience of dissolved gas in transformer oil for the detection of incipient faults

Although the association between dissolved gas analysis (DGA) in transformer oil and incipient faults is well established, interpretations for this association are not. There are different approaches to the interpretation of DGA results, some standards use individual gas limits while others use key gases or ratios (such as Rogers). Different with numerous publications on the subject presented about DGA interpretation techniques that are available for the detection of incipient faults, this paper has addressed how we meet the challenges in real cases and introduce experience learnt in implementing DGA diagnostic approaches to "look after" each fault-specific transformer. Some key learning points are (1) when properly applied, DGA signature is powerful for detecting a wide range of incipient faults in transformers and assisting in determination when to remove the transformer from service for repair or replacement; (2) Knowledge of transformer design strength and weakness together with information of historic operation and maintenance enable the results of DGA to be interpreted correctly; and (3) Utilizing these practical experience allow the user to manage the risk of failure and discount the need for replacement.
Data mining applications in power systems — Case-studies and future trends

Presently power system operation produces huge volumes of data that is still treated in a very limited way. Knowledge discovery and machine learning can make use of these data resulting in relevant knowledge with very positive impact. In the context of competitive electricity markets these data is of even higher value making clear the trend to make data mining techniques application in power systems more relevant. This paper presents two cases based on real data, showing the importance of the use of data mining for supporting demand response and for supporting player strategic behavior.