Miracle-dz/UniFAR-FTUs huggingface dataset:
The Vanishment of an Intramedullary High-Signal Intensity Lesion at the Craniocervical Junction After Surgical Treatment: A Case Report of the Presyrinx State

Study Design. A case report of the presyrinx state at the craniocervical junction with vanishment of an intramedullary high-signal lesion followed by decompression and fixation. Objective. To report the reversible change of an intramedullary high-signal lesion on T2-weighted MRI as a presyrinx state. Summary of Backgroud Data. The pathology of a T2-weighted high-signal intensity area in the spinal cord has not yet been described in detail. The case presented here showed the vanishment of this lesion after the surgical procedure, which implies that some high-signal intensity lesions might be reversible as a presyrinx state. Methods. A 75-year-old man presented with severe cervical myelopathy. Neurologic findings and observations on various images indicated compression myelopathy due to both a pseudotumor at the craniocervical junction and spondylosis at C3–C4 disc level due to Klippel-Feil syndrome. The most obvious finding was a vast high-signal intensity lesion at the craniocervical junction, which was speculated to be a syringomyelia before surgery. Results. The MRI at 1 month after surgical treatment (occipito-spinal fusion with the decompression by enlargement of foramen magnum) revealed complete vanishment of the vast high intensity lesion at the craniocervical junction, which remained undetected at the 2 years and 8 months follow-up and corresponded with improvement in the clinical symptoms of myelopathy. Conclusion. The vanishment of these signal changes on MRI after surgery was interpreted as a presyrinx state, demonstrating this reversible pathology in the spinal cord.
Sibling donor and recipient immune modulation with atorvastatin for the prophylaxis of acute graft-versus-host disease.

PURPOSE Graft-versus-host disease (GVHD) is major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Atorvastatin is a potent immunomodulatory agent that holds promise as a novel and safe agent for acute GVHD prophylaxis. PATIENTS AND METHODS We conducted a phase II trial to evaluate the safety and efficacy of atorvastatin administration for GVHD prophylaxis in both adult donors and recipients of matched sibling allogeneic HCT. Atorvastatin (40 mg per day orally) was administered to sibling donors, starting 14 to 28 days before the anticipated first day of stem-cell collection. In HCT recipients (n = 30), GVHD prophylaxis consisted of tacrolimus, short-course methotrexate, and atorvastatin (40 mg per day orally). RESULTS Atorvastatin administration in healthy donors and recipients was not associated with any grade 3 to 4 adverse events. Cumulative incidence rates of grade 2 to 4 acute GVHD at days +100 and +180 were 3.3% (95% CI, 0.2% to 14.8%) and 11.1% (95% CI, 2.7% to 26.4%), respectively. One-year cumulative incidence of chronic GVHD was 52.3% (95% CI, 27.6% to 72.1%). Viral and fungal infections were infrequent. One-year cumulative incidences of nonrelapse mortality and relapse were 9.8% (95% CI, 1.4% to 28%) and 25.4% (95% CI, 10.9% to 42.9%), respectively. One-year overall survival and progression-free survival were 74% (95% CI, 58% to 96%) and 65% (95% CI, 48% to 87%), respectively. Compared with baseline, atorvastatin administration in sibling donors was associated with a trend toward increased mean plasma interleukin-10 concentrations (5.6 v 7.1 pg/mL; P = .06). CONCLUSION A novel two-pronged strategy of atorvastatin administration in both donors and recipients of matched sibling allogeneic HCT seems to be a feasible, safe, and potentially effective strategy to prevent acute GVHD.
WSN02-5: A Power-Controlled Rate-Adaptive MAC Protocol to Support Differentiated Service in Wireless Ad Hoc Networks

To provide differentiated service is one of important issues in the design of wireless ad hoc networks. Traditionally, the provisioning of the differentiated service to different types of traffic streams is mainly supported at the medium access control layer with strict priority scheduling or weighted priority scheduling. In this paper, we propose a novel solution, named as Power-Controlled Rate-Adaptive medium access control (PCRA-MAC) scheme, to provide differentiated service by cross-layer consideration and design. The PCRA-MAC scheme exploits the features of multi-rate and power adjustable wireless transceiver system to achieve different transmission rates to support differentiated service. To the best of our knowledge, the PCRA-MAC scheme is the first and the only MAC scheme that generates different transmission rates for different types of traffic by tuning transmission power. Simulation experiments have proved that the PCRA-MAC scheme can effectively supports differentiated service in the wireless ad hoc networks.
The Cornified Cell Envelope: Loricrin and Transglutaminases

The cornified cell envelope (CE) of terminally differentiated human epidermis is a complex structure consisting of several defined protein constituents. The CE is the most insoluble component of the epidermis due to crosslinking by disulfide bonds as well as isodipeptide bonds that are formed by the action of transglutaminases (TGases). We have recently determined that loricrin is the major component of CE. We now have isolated and characterized its gene and showed that it has a simple structure with a single intron. We also show that the loricrin gene maps to position 1q21, which, coincidentally, is similar to the location of the profilaggrin and involucrin genes. Human loricrin in 26 kDa and consists of three long glycine‐serine‐cysteine rich sequence domains that contain quasi‐repeating peptides and which form the novel glycine loop motif. These are interspersed by lysine + glutamine rich domains involved in isodipeptide crosslinks. The glycine loops are thought to be involved in organization of epidermal proteins and maintenance of the flexibility of the epidermis. By use of PCR analyses, we have found that human loricrin consists of two allelic size variants, due to sequence variations in the second glycine loop domain only, and these variants segregate in the human population by normal Mendelian mechanisms. Futhermore, there are multiple sequence variants within these two size class alleles due to various deletions of 12 bp (4 amino acids) in the major loop of this glycine loop domain. In order to study the expression and role of TGases in the formation of CE, we have isolated and sequenced cDNA and genomic clones encoding the TGasel enzyme. The deduced complete sequence has 816 amino acid residues of 90 kDa. It shares 49–53% sequence homology with the other TGases of known sequence but has unique sequences in its amino‐ and carboxyltermini. The TGM1 gene has been isolated and characterized. It is 14.1 kbp long, contains 15 exons and is similar in structure to other TGase genes. It was located to chromosome position 14q11. It will now be possible to further study the regulation of the expression of the loricrin and TGase1 gene systems in normal and abnormally keratinizing epidermis.
Pediatric Tracheostomy: A Changing Procedure?

In 1982, the experience with tracheostomy at The Children's Hospital of Philadelphia was reported for 1971 through 1980. We have now reviewed 450 cases for the period from 1981 through 1992, and compared the characteristics of these cases with those in the previous review. Long-term follow-up was available on 83% of cases, and the median follow-up was 2.96 years. Patients received a tracheostomy for airway obstruction (38%), chronic ventilation (53%), or multiple indications (9%). The mean duration of tracheotomy (adjusted for death and loss to follow-up) was 2.13 years. The tracheostomy-related mortality was 0.5%, and the non–tracheostomy-related mortality was 22%. Nineteen percent of patients had complications in the first postoperative week, and 58% had 1 or more late complications. In comparison with the previous study from our institution, there was a great increase in long-term tracheostomy and a continuing trend away from tracheostomy for short-term airway management. Better monitoring and improvements in parental teaching may have contributed to a decrease in tracheostomy-related mortality.
Figure-8 Strap Application: Immediate Alteration of Pectoralis Minor Length and Scapular Alignment During Arm-Lifting Exercise in Participants With Forward Shoulder Posture.

CONTEXT Scapular bracing can correct scapular kinematics and restore normal scapular-muscle activity. However, there is little evidence to support the beneficial effects of a figure-8 strap, a type of scapular bracing, on muscle length, scapular alignment, and muscle activity during arm-lifting exercise. OBJECTIVE To investigate the immediate effect of a figure-8 strap on pectoralis minor length, scapular alignment, and scapular upward-rotator-muscle activity. DESIGN Cross-sectional study. SETTING Research laboratory. PARTICIPANTS Fifteen male participants (age 22.1 ± 1.9 y, weight 68.2 ± 5.7 kg, height 176.2 ± 3.3 cm) with forward shoulder posture (FSP) were examined for pectoralis minor length and scapular alignment with and without the application of a figure-8 strap. MAIN OUTCOME MEASURES Pectoralis minor length was measured using the Pectoralis Minor Index (PMI), scapular alignment was measured with FSP, and upper trapezius, lower trapezius, and serratus anterior muscle activity were measured using surface electromyography while participants performed an arm-lifting exercise. Data collected with and without applying a figure-8 strap were compared using a paired t-test. RESULTS Applying a figure-8 strap significantly decreased the PMI (P = .005) and scapular anterior tilting (P = .000). There were no differences in the muscle activity of the upper trapezius (P = .784), lower trapezius (P = .241), and serratus anterior muscles (P = .639). CONCLUSIONS A figure-8 strap resulted in positive changes in pectoralis minor length and scapular alignment. The results support its use as a treatment aid in managing pectoralis minor length and scapular alignment during arm-lifting exercises.
The ESHRE multicentre trial on the treatment of unexplained infertility: a preliminary report. European Society of Human Reproduction and Embryology.

Nineteen European fertility centres participated in a controlled randomized trial aimed at comparing the effectiveness of five methods for the treatment of unexplained infertility. Each centre was invited to employ two of the five treatments being investigated, and the treatment allocated to individual patients was then decided by randomization. The treatments were superovulation alone, and superovulation together with one of the following procedures: intra-uterine insemination (IUI), intra-peritoneal insemination (IPI), gamete intra-Fallopian transfer (GIFT), in-vitro fertilization (IVF). All the patients admitted to the study had experienced greater than 36 months infertility prior to the start of the trial, and only patients less than 38 years of age were included in the investigation. Further, the study was confined to patients with normal Fallopian tubes, and where there was evidence of spontaneous ovulation. Yet another prerequisite for inclusion in the study was that the male partner was 'normal' as regards fertility. Due to unavoidable practical difficulties, the experimental design eventually obtained was severely unbalanced. Nevertheless, objective statistical comparisons were possible among the five treatments, using non-orthogonal analyses of variance. By the completion of the trial 444 patients had been treated in a total of 649 cycles. There was some statistical evidence that the pregnancy rate obtained from superovulation alone was inferior to that obtained by using superovulation together with one of the methods of assisted conception. (ABSTRACT TRUNCATED AT 250 WORDS)
PRECEDENT: A randomized phase II trial comparing EC145 and pegylated liposomal doxorubicin (PLD) in combination, versus PLD alone, in subjects with platinum-resistant ovarian cancer.

LBA5012b Background: EC145, a conjugate of folic acid and desacetylvinblastine hydrazide binds with high affinity to the folate receptor (FR), found on > 90% of epithelial ovarian cancers. This abstract reports interim data on an international randomized, phase II study of EC145 + PLD compared with PLD alone, in women with platinum-resistant ovarian cancer. An independent Data Safety Monitoring Board (DSMB) has conducted a prespecified interim analysis on PFS and safety with results reported herein. METHODS Women ≥ 18 with ECOG PS of 0-2 and ≤ 2 prior systemic cytotoxic regimens were randomized to receive EC145 (2.5 mg IV weeks 1 and 3) + PLD (50 mg/m2 IBW IV q 28 days) or PLD (50 mg/m2 IBW IV q 28 days) alone until progression or death. RESULTS The interim analysis occurred after the 46th event out of a planned study total of 95 progressions or deaths. Demographic characteristics at screening such as age, cancer type, residual tumor after debulking, prior therapy, CA-125 and time from diagnosis were balanced between arms. RECIST mean sum tumor length was longer for the combination arm (122.7 mm vs. 81.3 mm). There was no statistical difference between study arms with regard to total adverse events, serious adverse events, or the number of subjects reporting at least one treatment-emergent drug-related serious adverse event resulting in discontinuation. The Table displays the results of the interim analysis of PFS. At the interim, there is also a trend toward benefit in overall survival for the combination arm with HR = 0.425 (p value of 0.064). CONCLUSIONS Results indicate a greater than doubling in median PFS for women with platinum-resistant ovarian cancer receiving EC145 and PLD over those receiving PLD alone. These interim data suggest that EC145 and PLD is the first combination to show a statistically significant delay in progression-free survival over standard therapy in women with platinum-resistant ovarian cancer. [Table: see text] [Table: see text].
The cGMP/PKG pathway as a common mediator of cardioprotection: translatability and mechanism

Cardiomyocyte cell death occurring during myocardial reperfusion (reperfusion injury) contributes to final infarct size after transient coronary occlusion. Different interrelated mechanisms of reperfusion injury have been identified, including alterations in cytosolic Ca2+ handling, sarcoplasmic reticulum‐mediated Ca2+ oscillations and hypercontracture, proteolysis secondary to calpain activation and mitochondrial permeability transition. All these mechanisms occur during the initial minutes of reperfusion and are inhibited by intracellular acidosis. The cGMP/PKG pathway modulates the rate of recovery of intracellular pH, but has also direct effect on Ca2+ oscillations and mitochondrial permeability transition. The cGMP/PKG pathway is depressed in cardiomyocytes by ischaemia/reperfusion and preserved by ischaemic postconditioning, which importantly contributes to postconditioning protection. The present article reviews the mechanisms and consequences of the effect of ischaemic postconditioning on the cGMP/PKG pathway, the different pharmacological strategies aimed to stimulate it during myocardial reperfusion and the evidence, limitations and promise of translation of these strategies to the clinical practice. Overall, the preclinical and clinical evidence suggests that modulation of the cGMP/PKG pathway may be a therapeutic target in the context of myocardial infarction.
Clearly defining pediatric massive transfusion: Cutting through the fog and friction with combat data

BACKGROUND Massive transfusion (MT) in pediatric patients remains poorly defined. Using the largest existing registry of transfused pediatric trauma patients, we sought a data-driven MT threshold. METHODS The Department of Defense Trauma Registry was queried from 2001 to 2013 for pediatric trauma patients (<18 years). Burns, drowning, isolated head injury, and missing Injury Severity Score (ISS) were excluded. MT was evaluated as a weight-based volume of all blood products transfused in the first 24 hours. Mortality at 24 hours and in the hospital was calculated for increasing transfusion volumes. Sensitivity and specificity curves for predicting mortality were used to identify an optimal MT threshold. Patients above and below this threshold (MT+ and MT−, respectively) were compared. RESULTS The Department of Defense Trauma Registry yielded 4,990 combat-injured pediatric trauma patients, of whom 1,113 were transfused and constituted the study cohort. Sensitivity and specificity for 24-hour and in-hospital mortality were optimal at 40.1-mL/kg and 38.6-mL/kg total blood products in the first 24 hours, respectively. With the use of a pragmatic threshold of 40 mL/kg, patients were divided into MT+ (n = 443) and MT− (n = 670). MT+ patients were more often in shock (68.1% vs. 47.0%, p < 0.001), hypothermic (13.0% vs. 3.4%, p < 0.001), coagulopathic (45.0% vs. 29.6%, p < 0.001), and thrombocytopenic (10.6% vs. 5.0%, p = 0.002) on presentation. MT+ patients had a higher ISS, more mechanical ventilator days, and longer intensive care unit and hospital stay. MT+ was independently associated with an increased 24-hour mortality (odds ratio, 2.50; 95% confidence interval, 1.28–4.88; p = 0.007) and in-hospital mortality (odds ratio, 2.58; 95% confidence interval, 1.70–3.92; p < 0.001). CONCLUSION Based on this large cohort of transfused combat-injured pediatric patients, a threshold of 40 mL/kg of all blood products given at any time in the first 24 hours reliably identifies critically injured children at high risk for early and in-hospital death. This evidence-based definition will provide a consistent framework for future research and protocol development in pediatric resuscitation. LEVEL OF EVIDENCE Diagnostic study, level II. Prognostic/epidemiologic study, level III.
Inverse relationship between matrix remodeling and lipid metabolism during osteoarthritis progression in the STR/Ort mouse.

OBJECTIVE The biologic changes associated with osteoarthritis (OA) are incompletely understood. The aim of this study was to elucidate the molecular mechanisms underlying OA progression in an STR/Ort murine model of spontaneous disease. METHODS Global patterns of gene expression were assessed using microarray analysis of articular cartilage/subchondral bone from the tibial plateaus of STR/Ort mice at 3, 9, and 12 months of age. The age-dependent severity of osteophyte formation and extent of cartilage damage were determined in the corresponding femurs using microfocal computed tomography and the Mankin histologic scoring system. Pathway analysis was used to identify the functions of genes associated with OA progression, and changes in gene expression were confirmed using immunohistochemistry. RESULTS Six hundred twenty-one genes were associated with both osteophyte formation and cartilage damage in the STR/Ort joints. Genes involved in the development/function of connective tissue and in lipid metabolism were most significantly enriched and regulated during disease progression. Genes directly interacting with peroxisome proliferator-activated receptor alpha (PPARalpha)/PPARgamma were down-regulated, whereas those genes involved with connective tissue remodeling were up-regulated during disease progression. Associations of down-regulation of myotubularin-related phosphatase 1 (a phosphoinositide 3-phosphatase involved in lipid signaling) and up-regulation of biglycan (a member of the small leucine-rich protein family known to modulate osteoblast differentiation and matrix mineralization) with OA progression were confirmed by immunohistochemistry. CONCLUSION Since adipogenesis and osteogenesis are inversely related in the developing skeletal tissue, these results suggest that a shift in the differentiation of mesenchymal cells from adipogenesis toward osteogenesis is a component of the OA pathophysiologic processes occurring in the tibial plateau joints of STR/Ort mice.
Tympanic Membrane Perforation

A hole in the eardrum (tympanic membrane perforation) is a common consequence of ear injury or infections. They can be repaired surgically to improve hearing and to prevent complications. What causes a perforation in the eardrum? With recurrent ear infections, the eardrum (tympanic membrane) may become " scarred ". Scar tissue generally has less blood supply than normal tissue. As such, it is less resistant to infection and eventually, a point may come that the eardrum, when faced with the stress of an abscess, dissolves away, leaving a hole in the eardrum. The eardrum may also become perforated by foreign objects (Q-tips, bobby pins) or by trauma, such as a slap to the ear. Although many traumatic perforations heal spontaneously, many require repair. Perforations may also occur following extrusion of pressure equalization tubes placed to prevent recurrent middle ear infections. Chronic Eustachian tube problems cause negative middle ear pressures that can retract and thin the eardrum so much that it stops working as a sound collector and threatens to form cholesteatoma (see the sections titled " Otitis media " and " Cholesteatoma "). In these cases, the collapsed sections of eardrum are removed surgically and repaired using methods described below. What are the consequences of a perforated eardrum? A hole in the eardrum leads to hearing loss because the eardrum no longer has the surface area to collect all of the sound coming into the ear. The size of the hearing loss is related to the size of the perforation. It is not unusual for a small perforation that causes little hearing loss to go unnoticed by the patient. An ear with a hole in the eardrum is more likely to become infected because it is not protected from repeated water entry. Moisture evaporating from the exposed linings of the middle ear also tends to humidify the ear canal and creates a good environment for bacteria and fungi to grow. Excessive humidity in the ear canal with recurrent infection is a common problem for hearing aid users. The hearing aid acts as a plug that keeps the ear from drying out, and promotes an environment for infection. In some cases, skin from the outer surface of the eardrum will migrate into the middle ear through a perforation and accumulate. This accumulation invariably results in infection which will not stop until the infected skin is removed. The skin can erode hearing …
Towards multi-core parallel fuzzy tree mining

Fuzzy tree mining has been recently introduced in order to extract frequent subtrees from databases of labeled trees. It has many applications, especially for handling semi-structured data (e.g., XML). In this framework, soft approaches have been proposed, also known as fuzzy tree mining. They allow the methods to better recognize patterns that are embedded in the database, even if the patterns are only partially present. However, such soft methods have to cope with the problem of remaining scalable on huge volumes of data, regarding both time and memory consumption. It is thus interesting to take advantage of the new generations of computers with multi-core architectures. We thus propose an original method for parallelizing fuzzy tree mining. This paper presents our approach and discusses the main problems addressed and solutions proposed, based on the experimental results.