Miracle-dz/UniFAR-FTUs huggingface dataset:
La part de Chlamydia pneumoniae dans l’athérosclérose et les exacerbations de bronchopneumopathie chronique obstructive et d’asthme

Chlamydia pneumoniae infection has been often associated with several chronic diseases including asthma and chronic obstructive pulmonary diseases (COPD). The spectrum of Chlamydia pneumoniae infection has been expanded to the association with coronary heart disease (CHD). In Morocco, the implication of Chlamydia pneumoniae infection in these pathologies is unknown. The aim of our study was to determine the relationship between infection with Chlamydia pneumoniae and respiratory pathology and atherosclerosis. The patients were from two departments (department of respiratory disease and of cardiology), and presented exacerbation of COPD and asthma or atherosclerosis. The mean age was 45 years a with a 1.7 sex ratio for the first population and 61 years with a 1.4 sex ratio for the second population. Serological diagnosis of Chlamydia pneumoniae infection has been determined by microimmunofluorescence (MIF). All samples were tested for anti-Chlamydia pneumoniae IgG, IgA and IgM. In the first group, we found 42 % positive for IgG, 11 % for IgA, and no case for IgM. In the second group the presence of anti-Chlamydia pneumoniae IgG was observed in 67.5 % cases, IgA in 16.5 % cases and IgM in 2 % cases, 14 % of patients had negative serology for IgA, IgG, and IgM. Our results are in accord to those reported by other studies. According to these results, it seems that a certain degree of association exists between Chlamydia pneumoniae infection and exacerbation of COPD, asthma and atherosclerosis which should be of importance on a therapeutic point of view.
Consolidative Radiotherapy for Limited Metastatic Non–Small-Cell Lung Cancer: A Phase 2 Randomized Clinical Trial

Importance Patterns-of-failure studies suggest that in metastatic non–small-cell lung cancer (NSCLC) sites of gross disease at presentation are the first to progress when treated with chemotherapy. This knowledge has led to increased adoption of local ablative radiation therapy in patients with stage IV NSCLC, though prospective randomized evidence is limited. Objective To determine if intervening with noninvasive stereotactic ablative radiotherapy (SAbR) prior to maintenance chemotherapy in patients with non–progressive limited metastatic NSCLC after induction therapy led to significant improvements in progression-free survival (PFS). Design, Setting, and Participants This is a single-institution randomized phase 2 study of maintenance chemotherapy alone vs SAbR followed by maintenance chemotherapy for patients with limited metastatic NSCLC (primary plus up to 5 metastatic sites) whose tumors did not possess EGFR-targetable or ALK-targetable mutations but did achieve a partial response or stable disease after induction chemotherapy. Interventions Maintenance chemotherapy or SAbR to all sites of gross disease (including SAbR or hypofractionated radiation to the primary) followed by maintenance chemotherapy. Main Outcomes and Measures The primary end point was PFS; secondary end points included toxic effects, local and distant tumor control, patterns of failure, and overall survival. Results A total of 29 patients (9 women and 20 men) were enrolled; 14 patients (median [range] age, 63.5 [51.0-78.0] years) were allocated to the SAbR-plus-maintenance chemotherapy arm, and 15 patients (median [range] age, 70.0 [51.0-79.0] years) were allocated to the maintenance chemotherapy–alone arm. The trial was stopped to accrual early after an interim analysis found a significant improvement in PFS in the SAbR-plus-maintenance chemotherapy arm of 9.7 months vs 3.5 months in the maintenance chemotherapy–alone arm (P = .01). Toxic effects were similar in both arms. There were no in-field failures with fewer overall recurrences in the SAbR arm while those patients receiving maintenance therapy alone had progression at existing sites of disease and distantly. Conclusions and Relevance Consolidative SAbR prior to maintenance chemotherapy appeared beneficial, nearly tripling PFS in patients with limited metastatic NSCLC compared with maintenance chemotherapy alone, with no difference in toxic effects. The irradiation prevented local failures in original disease, the most likely sites of first recurrence. Furthermore, PFS for patients with limited metastatic disease appeared similar to those patients with a greater metastatic burden, further arguing for the potential benefits of local therapy in limited metastatic settings. Trial Registration clinicaltrials.gov Identifier: NCT02045446
Identification of a class of hybrid systems

This paper deals with the problem of on-line identification of a class of single-input single-output time-invariant hybrid plant which can operate under bounded disturbances and/or unmodelled dynamics. The hybrid plant dealt with is composed of two subsystems one being of continuous-time type while the other is digital. An input–output model is first designed involving filtered signals for the hybrid plant from an initial state-space description. Such a model is simultaneously driven by the standard continuous-time input plus an extra signal. The extra input is composed for all time of a signal which involves the contribution of the input and output over a finite number of previous sampling instants plus a signal which involves the contribution of the weighted integral of the continuous-time input on a set of preceding sampling intervals. The above last driving signal is due to the existing couplings between the continuous-time and digital substates of the hybrid plant. A relative adaptation dead zone is used in the parameter estimation scheme whose role is the robust adaptive stabilization under uncertainties and bounded noise. The parametrical identification is asymptotically achieved in the absence of noise and unmodelled dynamics provided that the plant is controllable and exponentially stable and that the input satisfies astandard condition of persistence of excitation.
Setting accessibility preferences about learning objects within adaptive elearning systems: User experience and organizational aspects

Higher and further education providers are facing the challenge of supporting the interaction needs of an increasing number of students who feature accessibility preferences to use both elearning contents and services. In the next future, we can expect that, within adaptive elearning systems, both automatic and manual procedures will interoperate to elicit users' interaction needs for ensuring accessibility. In this paper, we report findings from the user experience with the self‐assessment of interaction needs, as part of a content personalization system, which tackles possible mismatches in the interaction between the user and the learning objects. All stakeholders involved in providing this service along with intended user groups (students with visual, auditory or mobility impairments, and without impairments) participated in the evaluation with over 100 users described in this paper. From the evaluation, results follow that our approach allows students to self‐assess and report adequately their interaction preferences. Furthermore, the paper describes findings of interest and open issues about how massive online courses may address the accessibility needs of an increasing number of elearning users.
Timing properties of LuAP:Ce studied with large area avalanche photodiodes

Prompted by recent interest in PET scanners equipped with LuAP:Ce (LuAlO/sub 3/:Ce) scintillators read by avalanche photodiodes we have measured timing properties of this scintillating material with Large Area Avalanche Photodiodes (LAAPD) from Advanced Photonix Inc. (API). We have obtained time resolution of 1.16/spl plusmn/0.06 ns for 511 keV peak from a (22)Na source with energy threshold set at 400 keV, and 580/spl plusmn/35 ps for /sup 60/Co source with energy threshold set at 1 MeV. The dependence of time resolution on LAAPD gain was measured showing improved timing at gains over 200, but at the cost of higher excess noise. Comparing time resolution of LuAP:Ce and LSO:Ce measured with LAAPD and photomultipliers we discuss the dependence of timing properties on light output and decay time of these scintillators.
Tratamiento fisioterapéutico grupal en la enfermedad de Parkinson. Physiotherapy group- treatment in Parkinson’s disease

La Enfermedad de Parkinson primaria, es una afeccion cronica que en el transcurso de su evolucion, produce incapacidades molestas a los que la padecen, a pesar del bienestar demostrado por las drogas antiParkisonianas. Ultimamente se han aplicado nuevos procederes terapeuticos, como el autotrasplante de medula suprarrenal, los trasplantes de sustancia nigra fetal y la subtalamotomia estereotaxica; pero con ciertas limitaciones en cuanto a la edad, disponibilidad y estado general del paciente. En base a esto y la gran incidencia de la enfermedad en nuestro medio se decidio aplicar un esquema fisioterapeutico de grupo en 50 pacientes provenientes de la consulta especializada y analizar evolutivamente los sintomas cardinales de la enfermedad en periodos de 1, 3, y 6 meses de tratamiento rehabilitador Concluyendo que la fisioterapia de grupo, aunque fisiopatologicamente no elimina la dolencia, si produce mejorias evidentes de sus sintomas e incapacidades, resaltando ademas la gran ayuda que pudiera brindar el medico de la familia en el tratamiento rehabilitador sistematico para la compensacion y satisfaccion de estos enfermos. DeCS: ENFERMEDAD DE PARKINSON / rehabilitacion, MEDICO DE FAMILIA, REHABILITACION / metodos ABSTRACT Primary Parkinson's Disease is a chronic disease that produces uncomfortable disabilities to those people who suffer from the entity during its evolution; in spite of the wellbeing antiparkisonism drugs produce new therapeutic procedures such as: autochthonous-adrenal medulla-graft, fetal substancia nigra transplantations and stereotaxic subthalmamotomy are established but having some limitations according to age, availability and patient's general condition. Based on all these aspects and the high percentage of parkisonism-incidence a Group Physical therapy of 50 patients selected from specialty consultation was created aimed at analysing the most significant symptoms of the disease; as well as its progression in periods of 1, 3 and 6 months under rehabilitation treatment, concluding that Group-Physical Therapy (although the entity is not pathophysiologically eliminated) relieves symptoms and improves capacities, playing family physician and important role in the systematic rehabilitation treatment to compensate and satisfy these patients. DeCS : PARKINSON'S DISEASE/rehabilitation, FAMILY PHYSICIAN/rehabilitation/procedures.
Fertility Intention and Family Planning use Among People Living with HIV/AIDS (PLHIV) on Follow up Care Western Shoa Zone, Anti Retroviral Treatment (ART) Unit, Oromia, Ethiopia

HIV positive individuals may or may not have intention to have children. They could also have different degrees of utilization and demand for family planning. The desire of HIV infected persons to have children in the future has significant implication for the transmission of HIV to their sexual partners or newborns. So, this study contributes a lot for program planner or other interested group. The study was designed to determine the fertility desire and contraceptive utilization among People Living with HIV on ART follow up care in western Shoa Zone. A cross sectional institution based study design supplemented by qualitative in-depth interview was done between December to May 2012. The study was conducted in western Shoa Zone (three Hospital; Ambo, Gedo and Gindeberet hospital), western Ethiopia. The study population were all People Living with HIV who had at list one visit to the selected ART units and age group 15- 49 for women and 15-59 for men and the sample size taken was 462 and data were analyzed by spss version 16 computer software. Those who desire to have child are those who have no child, married and whose partners have desire to have children (P< 0.01). Those who were using family planning were educated (secondary and post-secondary education), married, having three or more children and having knowledge on Mother to Child Transmission of HIV (P<0.05). This study indicates that Couples or individuals in need of children should be supported by availing adequate information on the Prevention of Mother to Child Transmission of HIV in line with the country's HIV prevention and control plan and strategy since high number of participants are in need of children.
Exploratory analysis of the effect of intravitreal ranibizumab or triamcinolone on worsening of diabetic retinopathy in a randomized clinical trial.

IMPORTANCE The standard care for proliferative diabetic retinopathy (PDR) usually is panretinal photocoagulation, an inherently destructive treatment that can cause iatrogenic vision loss. Therefore, evaluating the effects of therapies for diabetic macular edema on development or worsening of PDR might lead to new therapies for PDR. OBJECTIVE To evaluate the effects of intravitreal ranibizumab or triamcinolone acetonide, administered to treat diabetic macular edema, on worsening of diabetic retinopathy. DESIGN Exploratory analysis was performed on worsening of retinopathy, defined as 1 or more of the following: (1) worsening from no PDR to PDR, (2) worsening of 2 or more severity levels on reading center assessment of fundus photographs in eyes without PDR at baseline, (3) having panretinal photocoagulation, (4) experiencing vitreous hemorrhage, or (5) undergoing vitrectomy for the treatment of PDR. SETTING Community- and university-based ophthalmology practices. PARTICIPANTS Individuals with central-involved diabetic macular edema causing visual acuity impairment. INTERVENTIONS Eyes were assigned randomly to sham with prompt focal/grid laser, 0.5 mg of intravitreal ranibizumab with prompt or deferred (≥24 weeks) laser, or 4 mg of intravitreal triamcinolone acetonide with prompt laser. MAIN OUTCOMES AND MEASURES Three-year cumulative probabilities for retinopathy worsening. RESULTS For eyes without PDR at baseline, the 3-year cumulative probabilities for retinopathy worsening (P value comparison with sham with prompt laser) were 23% using sham with prompt laser, 18% with ranibizumab with prompt laser (P = .25), 7% with ranibizumab with deferred laser (P = .001), and 37% with triamcinolone with prompt laser (P = .10). For eyes with PDR at baseline, the 3-year cumulative probabilities for retinopathy worsening were 40%, 21% (P = .05), 18% (P = .02), and 12% (P < .001), respectively. CONCLUSIONS AND RELEVANCE Intravitreal ranibizumab appears to be associated with a reduced risk of diabetic retinopathy worsening in eyes with or without PDR. Intravitreal triamcinolone also appears to be associated with a reduced risk of PDR worsening. These findings suggest that use of these drugs to prevent worsening of diabetic retinopathy may be feasible. Given the exploratory nature of these analyses, the risk of endophthalmitis following intravitreal injections, and the fact that intravitreal triamcinolone can cause cataract or glaucoma, use of these treatments to reduce the rates of worsening of retinopathy, with or without PDR, does not seem warranted at this time.
A direct approach for approximate optimal control of integro-differential equations based on homotopy analysis and parametrization method

This paper contributes a suitable hybrid iterative scheme for solving optimal control problems governed by integro-differential equations. The technique is based upon homotopy analysis and parametrization methods. Comparison of the obtained results of the proposed method with other methods shows that the method is reliable and capable of providing analytic treatment for solving such equations. Convergence analysis is presented. Some illustrative examples are given to demonstrate the accuracy of the proposed method.
A Model-Based Cluster Analysis of Maternal Emotion Regulation and Relations to Parenting Behavior.

In a diverse community sample of mothers (N = 108) and their preschool-aged children (Mage = 3.50 years), this study conducted person-oriented analyses of maternal emotion regulation (ER) based on a multimethod assessment incorporating physiological, observational, and self-report indicators. A model-based cluster analysis was applied to five indicators of maternal ER: maternal self-report, observed negative affect in a parent-child interaction, baseline respiratory sinus arrhythmia (RSA), and RSA suppression across two laboratory tasks. Model-based cluster analyses revealed four maternal ER profiles, including a group of mothers with average ER functioning, characterized by socioeconomic advantage and more positive parenting behavior. A dysregulated cluster demonstrated the greatest challenges with parenting and dyadic interactions. Two clusters of intermediate dysregulation were also identified. Implications for assessment and applications to parenting interventions are discussed.
Simvastatin induces osteogenic differentiation in human amniotic fluid mesenchymal stem cells (AFMSC)

Amniotic fluid is a complex mixture composed of water, salts and different cells types derived from embryo exfoliation. Some of these cells present similar characteristics to mesenchymal stem cells as adherent properties, typical surface antigens and differentiation capacity. These cells are called amniotic fluid‐derived mesenchymal stem cells (AFMSCs) and are easily obtained by amniocentesis, propagated in culture and differentiated in several cell types with specific inductions. In this study, we observe the ability of simvastatin, a 3‐HMG‐CoA reductase inhibitor, to induce AFSMCs osteogenic differentiation. When AFSMCs were incubated with medium containing simvastatin, it was observed morphological changes, calcium deposits formation confirmed by Alizarin Red stain. Differentiated cells also expressed typical osteogenic genes, as osteopontin and osteocalcin. In conclusion, simvastatin could be used as an optional osteogenic induction agent for amniotic fluid‐derived mesenchymal stem cells.
In vivo expression of human T-lymphotropic virus type 1 basic leucine-zipper protein generates specific CD8+ and CD4+ T-lymphocyte responses that correlate with clinical outcome.

BACKGROUND The roles of the human T-lymphotropic virus type 1 (HTLV-1) basic leucine zipper (HBZ) gene are not clearly understood. We examined CD8+ and CD4+ T cell responses to HBZ and compared these with Tax responses. METHOD Interferon (IFN)-γ and interleukin (IL)-2-secreting T cells were detected by enzyme-linked immunosorbent spot (ELISpot) assays of freshly isolated peripheral blood mononuclear cells (PBMCs) stimulated with synthetic HBZ or Tax peptides. Ten patients with HTLV-1-associated myelopathy (HAM) and 20 asymptomatic HTLV-1 carriers (ACs), (10 high, 10 low viral load). RESULTS Of 30 study participants, 17 had detectable HBZ-specific CD4+ T cells and 12 had HBZ-specific CD8+ T cell responses. Detection of Tax-specific CD4+ T cells (IL-2- or IFN-γ-secreting) did not differ by disease status, but Tax-specific CD8+ T cell responses were more commonly detected in patients with HAM. HBZ-specific CD4+ or CD8+ T cells were less likely to be detected than Tax-specific T cells. IL-2-secreting Tax-specific CD8+ T cells, and IFN-γ-secreting Tax-specific CD4+ T cells were associated with HAM. Low viral load, asymptomatic HTLV-1 carriage was associated with IL-2-secreting CD8+ T cells specific for HBZ. CONCLUSION HBZ protein is expressed in vivo in patients with HAM and in ACs. Our results are consistent with the idea that the T cell response to HBZ plays an important part in restricting HTLV-1 viral load.
Madhouse: A Tragic Tale of Megalomania and Modern Medicine

Madhouse reveals a long-suppressed medical scandal, shocking in its brutality and sobering in its implications. It shows how a leading American psychiatrist of the early twentieth century came to believe that mental illnesses were a purely biological phenomenon, the product of chronic infections that poisoned the brain. Convinced that he had uncovered the single source of psychosis, Henry Cotton, superintendent of the Trenton State Hospital, New Jersey, launched a ruthless campaign to "eliminate the perils of pus infection". Teeth were pulled, tonsils excised, stomachs, spleens, colons, uteruses were all sacrificed in an extraordinary assault on "focal sepsis". Many patients did not survive Cotton's surgeries; thousands more were left mangled and maimed. Cotton's work was controversial, yet none of his colleagues questioned his experimental practices. Adolf Meyer, still regarded as the greatest American psychiatrist of the first half of the twentieth century, suppressed criticism of Cotton. The British medical establishment lionized him as 'a new Lister', and subsequent historians and psychiatrists have ignored events that questioned their favourite narratives of scientific and humanitarian progress In a remarkable feat of historical detective work, Andrew Scull exposes the full, frightening story of madness among the mad-doctors. Drawing on a wealth of documents and interviews, he reconstructs in vivid detail a nightmarish, cautionary chapter in modern psychiatry when professionals failed to police themselves. 'a tour de force of investigative reporting and a provocative case study of megalomania, junk science and cronyism vs. the Hippocratic Oath. It's also a fast-paced medical thriller. ' Sylvia Nasar, author of A Beautiful Mind 'The most impressive piece of narrative psychiatric history I have ever read. ' William F. Bynum, Wellcome Centre for the History of Medicine.
Epidemiologic inference from the distribution of tuberculosis cases in households in Lima, Peru.

BACKGROUND Tuberculosis (TB) often occurs among household contacts of people with active TB. It is unclear whether clustering of cases represents household transmission or shared household risk factors for TB. METHODS We used cross-sectional data from 764 households in Lima, Peru, to estimate the relative contributions of household and community transmission, the average time between cases, and the immunity afforded by a previous TB infection. RESULTS The distribution of cases per household suggests that almost 7 of 10 nonindex household cases were infected in the community rather than in the household. The average interval between household cases was 3.5 years. We observed a saturation effect in the number of cases per household and estimated that protective immunity conferred up to 35% reduction in the risk of disease. CONCLUSIONS Cross-sectional household data can elucidate the natural history and transmission dynamics of TB. In this high-incidence setting, we found that the majority of cases were attributable to community transmission and that household contacts of case patients derive some immunity from household exposures. Screening of household contacts may be an effective method of detecting new TB cases if carried out over several years.