Miracle-dz/UniFAR-FTUs huggingface dataset:
A clinicopathological study of Alport syndrome and detection of type IV collagen chains in Alport patients.

OBJECTIVE To summarize the clinical and pathological findings of Alport syndrome (AS), detect the distribution of type IV collagen within basement membrane of patients with AS and evaluate the diagnostic value of indirect immunofluorescence (iIF) study of type IV collagen in AS. METHODS Fourteen patients belonging to 12 families were collected from January 1990 to June 1996. The clinical examinations include biochemical examination, audiometry and ocular examination. IIF technique was used to detect the location of chains of type IV collagen in 6 renal and 5 skin specimens from 8 Alport patients. RESULTS Among fourteen patients, 11 were male and 3 female (mean age 29.4 years). Microscopic hematuria was found in 13 patients, and recurrent gross hematuria in 7. All had proteinuria. Three patients presented nephrotic syndrome. Slowly progressive renal failure occurred in 10 of 11 males (11-39 years) and 1 female (40 years). Sensorineural deafness was observed in 9 patients particularly high frequency sound. Anterior lenticonus were presented in 2. Five families transmitted as X-linked dominant (XD) trait and 3 autosomal dominant, 3 autosomal recessive inheritance. In 7 renal biopsies, the findings by light microscopy mostly revealed focal and segmental sclerosis glomerulonephritis (4/7). The results of IF were negative in 4. Ultrastructural studies showed variable thickening, thinning of glomerular basement membrane (GBM) in 7 specimens with lamellation and basket wearing of GBM in 1. Using the iIF technique, the alpha 3, 4, 5 (IV) chains were observed to be absent within both GBM and EBM of 4 male XD-AS patients. Six patients were treated with hemodialysis, 2/6 with transplantation. CONCLUSION Alport syndrome (AS) is a heterogeneous hereditary disease characterized by progressive hematuric nephritis with or without sensorineural hearing loss and ocular defects. Ultrastructural alterations of GBM are helpful to the diagnosis of AS. IIF study suggests that type IV collagen in basement membrane of AS was abnormal and iIF study of type IV collagen chains distribution is useful for confirming the diagnosis of AS.
Population-based study of delays in carotid imaging and surgery and the risk of recurrent stroke

Background: Benefit from carotid endarterectomy is greatest when performed within 2 weeks of a presenting TIA or stroke and decreases rapidly thereafter. Objective: To determine the delays to carotid imaging and endarterectomy in Oxfordshire, UK, and the consequences for the effectiveness of stroke prevention. Methods: All patients undergoing carotid imaging for ischemic retinal or cerebral TIA or stroke were identified in two populations: the population of Oxfordshire, UK (n = 680,772), from April 1, 2002, to March 31, 2003, and the Oxford Vascular Study (OXVASC) subpopulation (n = 92,000) from April 1, 2002, to March 31, 2004. The times from presenting event to referral, scanning, and endarterectomy (Oxfordshire population) and the risk of stroke prior to endarterectomy in patients with ≥50% symptomatic carotid stenosis (OXVASC population) were determined. Results: Among 853 patients who had carotid imaging in the Oxfordshire population, median (interquartile range) times from presenting event to referral, scanning, and endarterectomy were 9 (3 to 30), 33 (12 to 62), and 100 (59 to 137) days. Eighty-five patients were found to have 50 to 99% symptomatic stenosis, of whom 49 had endarterectomy. Only 3 (6%) had surgery within 2 weeks of their presenting event and only 21 (43%) within 12 weeks. The risk of stroke prior to endarterectomy in the OXVASC subpopulation with ≥50% stenosis was 21% (8 to 34%) at 2 weeks and 32% (17 to 47%) at 12 weeks, in half of which strokes were disabling or fatal. Conclusion: Delays to carotid imaging and endarterectomy after TIA or stroke in the United Kingdom are similar to those reported in several other countries and are associated with very high risks of otherwise preventable early recurrent stroke.
Beyond mandatory use: Probing the affordances of social media for formal learning in the voluntary context

The integration of social media in formal education has received consistent interest in the recent decade. While most studies have focused on the mandatory use of social media as pedagogical tools, less explored is the context in which students voluntarily choose and use social media to supplement their formal learning. In this study, we employ an affordance approach to exploring the resources in social media that students perceive and use voluntarily for formal learning. Drawing on a qualitative study using focus groups of university students, we identified ten categories of social media affordances for learning in the voluntary context: association, editability, immediacy, interactivity, manageability, modality, persistence, scalability, searchability, and visibility. The affordances mentioned most frequently by students were visibility, persistence, and interactivity. These identified affordances encompass the major resources offered by social media for learning in the voluntary context, and provide insights into understanding, evaluating, and guiding social media adoption in formal education as well as lifelong learning. This paper concludes by presenting limitations and implications for research and practice.
Economic burden of occupational injury and illness in the United States.

CONTEXT The allocation of scarce health care resources requires a knowledge of disease costs. Whereas many studies of a variety of diseases are available, few focus on job-related injuries and illnesses. This article provides estimates of the national costs of occupational injury and illness among civilians in the United States for 2007. METHODS This study provides estimates of both the incidence of fatal and nonfatal injuries and nonfatal illnesses and the prevalence of fatal diseases as well as both medical and indirect (productivity) costs. To generate the estimates, I combined primary and secondary data sources with parameters from the literature and model assumptions. My primary sources were injury, disease, employment, and inflation data from the U.S. Bureau of Labor Statistics (BLS) and the Centers for Disease Control and Prevention (CDC) as well as costs data from the National Council on Compensation Insurance and the Healthcare Cost and Utilization Project. My secondary sources were the National Academy of Social Insurance, literature estimates of Attributable Fractions (AF) of diseases with occupational components, and national estimates for all health care costs. Critical model assumptions were applied to the underreporting of injuries, wage-replacement rates, and AFs. Total costs were calculated by multiplying the number of cases by the average cost per case. A sensitivity analysis tested for the effects of the most consequential assumptions. Numerous improvements over earlier studies included reliance on BLS data for government workers and ten specific cancer sites rather than only one broad cancer category. FINDINGS The number of fatal and nonfatal injuries in 2007 was estimated to be more than 5,600 and almost 8,559,000, respectively, at a cost of $6 billion and $186 billion. The number of fatal and nonfatal illnesses was estimated at more than 53,000 and nearly 427,000, respectively, with cost estimates of $46 billion and $12 billion. For injuries and diseases combined, medical cost estimates were $67 billion (27% of the total), and indirect costs were almost $183 billion (73%). Injuries comprised 77 percent of the total, and diseases accounted for 23 percent. The total estimated costs were approximately $250 billion, compared with the inflation-adjusted cost of $217 billion for 1992. CONCLUSIONS The medical and indirect costs of occupational injuries and illnesses are sizable, at least as large as the cost of cancer. Workers' compensation covers less than 25 percent of these costs, so all members of society share the burden. The contributions of job-related injuries and illnesses to the overall cost of medical care and ill health are greater than generally assumed.
Diabetes Mellitus: A Risk Factor for Ischemic Stroke in a Large Biracial Population

Background and Purpose— We previously reported increased incidence of ischemic stroke among both blacks and whites with diabetes mellitus, especially in those aged <55 years. With rising prevalence of diabetes mellitus in the past decade, we revisit the impact of diabetes mellitus on stroke incidence in the same population (≈1.3 million) 5 and 10 years later. Methods— This is a population-based study. First ischemic strokes among black and white residents of the 5-county Greater Cincinnati/Northern Kentucky region, aged ≥20 years, for periods 7/1993 to 6/1994, 1999, and 2005, were included in this analysis. Incidence rates were adjusted for sex, race, and age, as appropriate, to the 2000 US population. Results— History of diabetes mellitus among first ischemic strokes was reported for 493/1709 (28%) in 1993/1994, 522/1778 (29%) in 1999, and 544/1680 (33%) in 2005. Risk ratios (95% confidence interval) for rates of stroke in those with versus without diabetes mellitus for blacks reduced significantly from 5.6 in 1993/1994 to 3.2 in 2005; for whites the risk ratio remained stable at 3.8 in 1993/1994 and 2005. However, risk ratios varied with age, with an overall 5- to 14-fold increased risk observed in those aged 20 to 65 years. Conclusions— Those with diabetes mellitus remain at greatly increased risk for stroke at all ages, especially <65 years, regardless of race. The rates and risk ratios for 1999 and 2005, although similar to those previously reported for the mid-1990s, take on increased significance, given the epidemic of diabetes mellitus and metabolic syndrome throughout the US and the world.
Differences in ATP Generation Via Glycolysis and Oxidative Phosphorylation and Relationships with Sperm Motility in Mouse Species*

Background: Sperm from mouse species may produce ATP through glycolysis or respiration. Results: Sperm with high respiration/glycolysis ratio and high reliance on respiration produce more ATP and swim faster. Conclusion: The usage ratio of ATP production pathways defines sperm motility in mouse species. Significance: Sperm metabolism in mice has evolved ways to produce faster sperm. Mouse sperm produce enough ATP to sustain motility by anaerobic glycolysis and respiration. However, previous studies indicated that an active glycolytic pathway is required to achieve normal sperm function and identified glycolysis as the main source of ATP to fuel the motility of mouse sperm. All the available evidence has been gathered from the studies performed using the laboratory mouse. However, comparative studies of closely related mouse species have revealed a wide range of variation in sperm motility and ATP production and that the laboratory mouse has comparatively low values in these traits. In this study, we compared the relative reliance on the usage of glycolysis or oxidative phosphorylation as ATP sources for sperm motility between mouse species that exhibit significantly different sperm performance parameters. We found that the sperm of species with higher oxygen consumption/lactate excretion rate ratios were able to produce higher amounts of ATP, achieving higher swimming velocities. Additionally, we show that the species with higher respiration/glycolysis ratios have a higher degree of dependence upon active oxidative phosphorylation. Moreover, we characterize for the first time two mouse species in which sperm depend on functional oxidative phosphorylation to achieve normal performance. Finally, we discuss that sexual selection could promote adaptations in sperm energetic metabolism tending to increase the usage of a more efficient pathway for the generation of ATP (and faster sperm).
Convolutional Discriminative Feature Learning for Induction Motor Fault Diagnosis

A convolutional discriminative feature learning method is presented for induction motor fault diagnosis. The approach firstly utilizes back-propagation (BP)-based neural network to learn local filters capturing discriminative information. Then, a feed-forward convolutional pooling architecture is built to extract final features through these local filters. Due to the discriminative learning of BP-based neural network, the learned local filters can discover potential discriminative patterns. Also, the convolutional pooling architecture is able to derive invariant and robust features. Therefore, the proposed method can learn robust and discriminative representation from the raw sensory data of induction motors in an efficient and automatic way. Finally, the learned representations are fed into support vector machine classifier to identify six different fault conditions. Experiments performed on a machine fault simulator indicate that compared with the current state-of-the-art methods, the proposed method shows significant performance gains, and it is effective and efficient for induction motor fault diagnosis.
Pharmacokinetics of Efavirenz When Co‐administered With Rifampin in TB/HIV Co‐infected Patients: Pharmacogenetic Effect of CYP2B6 Variation

The goal of this study was to determine the effect of CYP2B6 genetic variation on the steady‐state pharmacokinetics of efavirenz (600 mg/d) in TB/HIV co‐infected patients receiving concomitant rifampin, a potent CYP inducer. In the 26 patients studied, CYP2B6 c.516GG, GT, and TT genotype frequencies were 0.27, 0.50, and 0.23, respectively. Mean plasma efavirenz area under the curve was significantly higher in patients with CYP2B6 c.516TT than in those with GT (107 vs 27.6 μg·h/mL, P < .0001) or GG genotype (107 vs 23.0 μg·h/mL, P < .0001). Apparent oral clearance (CL/F) was significantly lower in patients with CYP2B6 c.516TT than in those with GT genotype (2.1 vs 8.4 mL/min/kg, P < 0.0001) and GG genotype (2.1 vs 9.9 mL/min/kg, P < .0001). No differences in efavirenz exposure or CL/F existed between patients with CYP2B6 c.516GT and GG genotypes. Our results indicate that CYP2B6 c.516TT genotype can be used to identify efavirenz poor metabolizers in patients co‐treated with rifampin.
KynR, a Lrp/AsnC-Type Transcriptional Regulator, Directly Controls the Kynurenine Pathway in Pseudomonas aeruginosa

ABSTRACT The opportunistic pathogen Pseudomonas aeruginosa can utilize a variety of carbon sources and produces many secondary metabolites to help survive harsh environments. P. aeruginosa is part of a small group of bacteria that use the kynurenine pathway to catabolize tryptophan. Through the kynurenine pathway, tryptophan is broken down into anthranilate, which is further degraded into tricarboxylic acid cycle intermediates or utilized to make numerous aromatic compounds, including the Pseudomonas quinolone signal (PQS). We have previously shown that the kynurenine pathway is a critical source of anthranilate for PQS synthesis and that the kynurenine pathway genes (kynA and kynBU) are upregulated in the presence of kynurenine. A putative Lrp/AsnC-type transcriptional regulator (gene PA2082, here called kynR), is divergently transcribed from the kynBU operon and is highly conserved in Gram-negative bacteria that harbor the kynurenine pathway. We show that a mutation in kynR renders P. aeruginosa unable to utilize l-tryptophan as a sole carbon source and decreases PQS production. In addition, we found that the increase of kynA and kynB transcriptional activity in response to kynurenine was completely abolished in a kynR mutant, further indicating that KynR mediates the kynurenine-dependent expression of the kynurenine pathway genes. Finally, we found that purified KynR specifically bound the kynA promoter in the presence of kynurenine and bound the kynB promoter in the absence or presence of kynurenine. Taken together, our data show that KynR directly regulates the kynurenine pathway genes.
Importance of psychotic features to long-term course in major depressive disorder.

OBJECTIVE Most efforts to describe the prognostic significance of psychotic features in depression have been limited to single assessments 1 year or less after the initial evaluation. However, the various biological and treatment response differences between patients with psychotic and nonpsychotic depression suggest that prognostic differences may be very long-term. METHOD The 787 patients described here entered the study as they sought treatment at one of five academic medical centers; they had either RDC major depressive disorder or schizo-affective depression (other than the mainly schizophrenic subtype) and completed at least 6 months of follow-up. Of these, 144 (18.3%) had psychotic depression as defined here. Patients provided follow-up interviews at 6-month intervals for 5 years and annually thereafter; 98 of those with psychotic depression and 434 of those with non-psychotic depression were followed for 10 years. RESULTS Those who began follow-up with psychotic depression had fewer weeks with minimal symptoms in each of the 10 years of follow-up and reported more psychosocial impairment at both 5 and 10 years. Both the index episode and the first recurrence of psychotic depression lasted longer than nonpsychotic episodes, but nonpsychotic episodes among previously psychotic individuals were relatively brief. Intervals between episodes were significantly shorter for patients who had ever been psychotic. CONCLUSIONS Together with evidence that psychotic features are highly recurrent, these data show 1) that psychotic features denote a lifetime illness of greater severity and 2) that within individuals, psychotic features may emerge in only the more severe episodes.
Decreases in dengue transmission may act to increase the incidence of dengue hemorrhagic fever

Dengue hemorrhagic fever (DHF) is a potentially fatal manifestation of an infection with the mosquito-borne dengue virus. Because of the social and economic costs of DHF, many countries in Asia and South America have initiated public health measures aimed at vector control. Despite these measures, DHF incidence rates do not appear to be declining. The effectiveness of vector control in reducing dengue transmissibility has thereby been questioned. Here, we revisit this conclusion using epidemiological data from Thailand. We first show, with age incidence data, that dengue transmission rates have fallen since 1981; surprisingly, however, these declines are not associated with decreases in DHF incidence. Instead, district-level analyses indicate a nonmonotonic relationship between the basic reproductive number R0 and DHF incidence. To understand this relationship, we formulated three mathematical models, which differ in their assumptions of transient between-serotype cross-protection. Unlike the first two models, the previously unconsidered third model with clinical cross-protection can reproduce this nonmonotonic relationship. Simulation of this model with nonstationary R0 reproduces several previously unexplained patterns of dengue dynamics, including a transition from a ≈2-year cycle to a ≈4-year cycle and a transient trough in DHF incidence in provinces with rapid R0 declines. These results imply that DHF incidence can be effectively controlled with a sufficiently large reduction in R0 but that moderate reductions may be counterproductive. More broadly, these results show that assuming parameter stationarity in systems with approximate stationarity in disease incidence is unjustified and may result in missed opportunities to understand the drivers of disease variability.
Assessing the potential for natural recovery and coral restoration techniques for enhancing coral habitat in Jamaica

The reduced biodiversity of Caribbean coral reefs has been attributed to disturbances of various types. Many of the once abundant coral species have disappeared from Jamaican coral reefs with algae taking their place resulting in a less attractive reef habit with fewer fish which has affected the Jamaican economy. The mortality of Acropora species has been a particularly important driving force in shaping the transition. The abundance of Acropora spat settling in the Caribbean are lower than other coral families and much lower than on South Pacific reefs. A natural recovery through sexual reproduction is unlikely in the next decade. The long-term survival of remnant A. cervicornis populations is threatened unless successful sexual reproduction is restored. This study seeks to assess methods of restoring A. cervicornis populations by creating pockets of greater reef health around surviving populations. Experi- mental transplants using several techniques are underway to develop a suitable technology for restoring A. cervicornis populations in Jamaica. In one technique the mean survivorship ranged from 4% - 78% after 55 weeks. Mortality associated with damselfish (Stegastes) and fireworms (Hermodice carunculata) were observed. By increasing coral habitat bio mass and complexity we can increase the abundance of fish populations which will result in greater fish catches for subsistence fishers. As well, more coral and fish biodiversity improves the attractiveness of the reef community for divers and snorkelers making Jamaica a more appealing destination for tourists.
Assessment of Hospital Emergency Management in the Beijing Area

Abstract Introduction: In recent years, the number of public health emergencies has increased. Improving hospital emergency management is an important challenge. Objective: This is a pilot study intended to assess hospital emergency management in the Beijing area, make recommendations to government health authorities and hospital managers, and offer references for similar studies. Methods: This was an observational, cross-sectional survey. Forty-five hospitals in the Beijing area were selected randomly. A self-administered questionnaire was used as a data collection tool. It comprised of three sections: (1) Section A was the introduction; (2) Section B asked for the respondent's personal information; and (3) Section C comprised the major part of the questionnaire and was intended to gather information regarding the hospital's general emergency management situation. Results: The survey response rate was 44%, accounting for 29% of total hospitals that the study targeted. No hospital had an established emergency management department or full-time staff for emergency management. A total of 15–45% of the hospitals had established a hospital emergency management committee, performed a vulnerability analysis, or evaluated emergency management regularly. Twenty-five percent of respondents thought that the local government health authority had established an integrated hospital incident command system. A total of 40%–55% of hospitals contracted with outside institutions for supplements, backup of key functional systems and professional support. Conclusions: After the occurrence of the 2003 severe acute respiratory syndrome (SARS) epidemic, Chinese hospital managers took many measures to improve hospital resilience. However, most of these efforts lacked the guidance of theories, concepts, principles, and methods. An integrated, standardized, operational hospital emergency management model has not been established. Although the survey response rate was relatively low, some clues for further study were discovered, and suggestions to the health authority for hospital emergency management improvement were revealed.