Miracle-dz/UniFAR-FTUs huggingface dataset:
Congenital Syphilis: An Economic Evaluation of a Prevention Program in China

Background: Until now there has been no data to show the effectiveness or benefits of screening for syphilis in gravidas in China. This study was to assess the effectiveness of a program preventing mother-to-child-transmission of syphilis and to reveal factors impacting the benefit. Methods: A cohort of 159,017 gravidas were screened for syphilis by serologic methods and infected individuals were treated with 3 injections of 2.4 million units of benzathine penicillin in Shenzhen in 2005. The pregnancy outcomes were compared for this cost-effectiveness analysis in 2 scenarios, intervention with screening and treatment versus no intervention. Results: Eight hundred twenty-seven pregnant women (0.52%) were diagnosed with syphilis and treated subsequently. Of these, 200 gestations ended in miscarriage. Four babies were diagnosed with congenital syphilis; 25 neonates with low birth weight; 1 died after birth. The total cost was $636,748. On average, every $770 identified 1 infected mother. Every $4391 prevented 1 congenital syphilis; every $5135 prevented 1 low birth weight; and every $7075 prevented 1 death. One disability adjusted life year could be saved by $215. In total the program reached a benefit to cost ratio of 21.76. Sensitivity analyses revealed that this ratio was mainly impacted by the prevalence of syphilis in pregnant women and the rate of miscarriage. Conclusions: Screening for antenatal syphilis combined with intervening during gestation is highly effective in China. Reducing the percentage of spontaneous/induced abortion would be one of the most effective methods of further increasing the benefits of this screening.
Quality of management of oral anticoagulation as assessed by time in therapeutic INR range in elderly and younger patients with low mean years of formal education: a prospective cohort study.

BACKGROUND despite the overwhelming evidence of its effectiveness, oral anticoagulation continues to be underused in the elderly, presumably due to physicians' misconceptions when estimating bleeding risk and ability to comply with treatment. OBJECTIVE to investigate the quality of anticoagulation control among deprived elderly and younger patients. DESIGN prospective observational study. SETTING a public anticoagulation clinic in a developing country. SUBJECTS all adult patients on intended long-term (>90 days) oral anticoagulation. We studied 171 patients (79 elderly and 92 non-elderly) with a mean follow-up of 273 ± 84.9 days. METHODS the main outcome measure was the quality of anticoagulation management as measured by the time in therapeutic (TTR) international normalised ratio (INR) range. Elderly patients (≥60 years) were compared with younger patients with respect to the educational level and co-morbidities. RESULTS the mean number of years of formal education was 4.37 ± 3.2 years. The mean TTR was 62.50 ± 17.9% in non-elderly and 62.10 ± 16.6% in elderly (P = 0.862) subjects, despite the higher prevalence of co-morbidities in the latter group: heart failure (46.3 versus 28.6%, P = 0.042), diabetes mellitus (22.8 versus 8.7%, P = 0.011), renal failure (estimated glomerular filtration rate <50 ml/min: 38.0 versus 7.1%, P < 0.001) and polypharmacy (84.8 versus 58.7%, P < 0.001). Fifty elderly and 84 non-elderly subjects require little or no assistance in taking medications. Among them, the elderly had lower educational levels (3.42 ± 2.5 versus 5.55 ± 3.4 years of formal education, P < 0.001) and higher rates of cognitive impairment (34.0 versus 13.1%, P = 0.004), but a similar mean TTR (62.46 ± 16.1 versus 63.02 ± 17.8%, P = 0.856). The oldest (≥75 years) patients did as well as those aged ≤50 years (mean TTR: 62.54 ± 16.0 versus 62.23 ± 16.4%, respectively, P = 0.98). CONCLUSIONS good-quality management of oral anticoagulation is achievable in deprived populations attending an anticoagulation clinic. Elderly patients may experience similar quality of anticoagulation despite having higher levels of co-morbidities and polypharmacy. These results add evidence to the safety of such therapeutic interventions in the elderly.
Discrepancies in information provided to primary care physicians by patients with and without dementia: the Steel Valley Seniors Survey.

OBJECTIVE The objective of this study was to examine associations between discrepancies in health information provided to primary care providers and severity of impairment in older patients with and without dementia. METHODS This study included brief assessment and medical record review of 1,107 patients with a mean (standard deviation) age of 76.3 (6.6) years (range: 65-100 years) in seven small-town primary care practices. In 358 patients, detailed in-home assessment included demographics; dementia by Clinical Dementia Rating (CDR) scale; and frequencies of memory complaints, falls, and inadvertent medication nonadherence determined from medical records and standardized in-home research assessments. Main outcome variables were trends in discrepancies between chart reviews and research assessments. Main explanatory variable was CDR box total scores. RESULTS Proportions of patients reporting memory complaints and falls, and evidence of inadvertent nonadherence, in the charts and by research assessment increased with CDR. Discrepancies between medical record and research assessment, were also associated with CDR, showing linear trends for memory complaints and inadvertent nonadherence and a quadratic trend for falls. CONCLUSION Memory complaints, falls, and inadvertent medication nonadherence increase with dementia severity. The levels of discrepancy between information patients provided to their physicians and information they provided in response to detailed, standardized assessments, also varied with dementia severity. Physicians should be alert to the possibility of receiving unreliable health information from even mildly demented patients, whether or not dementia has been detected.
Thermal Design Optimization for Strip-Fin Heat Sinks with a Ducted Air Flow

An effective method for performing the thermal optimization of strip-fin heat sinks with a ducted air flow under constraints of pressure drop, mass, and space limitations has been successfully developed. The thermal and hydrodynamic models for strip-fin heat sinks have been developed. The design of experiments approach is performed to explore the relationships between design variables and responses with the minimal number of experimental runs. A statistical method for sensitivity analysis of the design factors, including the size of heat sink footprint, conductivity of sink base, thickness of sink base, stream wise and span wise fin pitch, fin thickness, fin length, fin height, and upstream air velocity, is performed to determine the key factors that are critical to the design; and a response surface methodology is then applied to establish regression models for the thermal resistance and pressure drop in terms of the design factors with an central composite design. Diagnostic analysis of the residuals from the regression model may reveal errors that were not in Gaussian distribution, which is one of the most important assumptions of experimental analysis; in the case of this work, a log-transformation is applied to make the response variance closer to the normal distribution. Furthermore, to screen out the insignificant model terms for the better modeling accuracy, the statistical skill, F-test, is applied. By employing the gradient-based numerical optimization technique, a series of constrained optimal designs have been efficiently performed
Sodium channel antagonists for the treatment of migraine

Introduction: Migraine has a strong social impact, influencing both quality of life and work productivity. Therapeutic approach of migraine consists of a multimodal program of pharmacotherapy and behavioral therapy in order to reduce the risk of chronification. Indications for the use of preventive therapy are three or more attacks per month, significant disability, attack duration that is > 90 min. Areas covered: In this review, studies conducted on sodium channel antagonists for the prophylaxis of migraine are selected using the International Classification of Headache Disorders (ICHD)-I and -II diagnostic criteria for migraine and are open-label and placebo-controlled studies. Expert opinion: Several sodium channel antagonists, such as valproic acid, topiramate, lamotrigine, zonisamide, carbamazepine and oxcarbazepine, are widely used in migraine although without similar level of efficacy. Among these antiepileptic drugs, valproic acid and topiramate seem to be more effective in migraine, as reported in the majority of controlled studies. In spite of their high efficacy rate, important side effects should be always monitored, especially depression, cognitive functions, weight gain, sleepiness and dizziness. The usefulness of this class drug will be dramatically improved by using ongoing data on individual pharmacogenomics profile.
Topology optimization for three-dimensional electromagnetic waves using an edge element-based finite-element method

This paper develops a topology optimization procedure for three-dimensional electromagnetic waves with an edge element-based finite-element method. In contrast to the two-dimensional case, three-dimensional electromagnetic waves must include an additional divergence-free condition for the field variables. The edge element-based finite-element method is used to both discretize the wave equations and enforce the divergence-free condition. For wave propagation described in terms of the magnetic field in the widely used class of non-magnetic materials, the divergence-free condition is imposed on the magnetic field. This naturally leads to a nodal topology optimization method. When wave propagation is described using the electric field, the divergence-free condition must be imposed on the electric displacement. In this case, the material in the design domain is assumed to be piecewise homogeneous to impose the divergence-free condition on the electric field. This results in an element-wise topology optimization algorithm. The topology optimization problems are regularized using a Helmholtz filter and a threshold projection method and are analysed using a continuous adjoint method. In order to ensure the applicability of the filter in the element-wise topology optimization version, a regularization method is presented to project the nodal into an element-wise physical density variable.
Use of molecular techniques to study microbial diversity in the skin: Chronic wounds reevaluated

The skin is colonized by an array of microorganisms which form its natural microflora. Disruption to the normal barrier function of the skin (due to trauma or disease) may result in invasion of the dermis by opportunistic bacteria. To date, these organisms, which may contribute to the chronicity of skin wounds, have been analyzed solely by culture methods. It is increasingly realized that standard culture methods of analysis do not accurately reflect the full diversity of complex microflora. This review discusses the limitations of traditional culture approaches and reviews recent advances in molecular microbiological techniques which facilitate a more comprehensive characterization of the microflora within clinical samples. The currently available technologies and techniques are described, as is their use in clinical practice and their potential for diagnostic screening. Chronic venous ulceration of the lower limbs is an important skin disorder in which the microflora invading the dermal tissues contribute to the observed delayed healing. Using chronic leg ulcers as a working example, we show how strict culture and molecular microbiological techniques may be employed, for the first time in combination, to definitively characterize the invading microbial community of the dermis.
Strength indices of the proximal femur and shaft in prepubertal female gymnasts.

INTRODUCTION/PURPOSE The role of impact loading activity on bone mass is well established; however, there are little data on the effects of exercise on bone geometry and indices of bone strength. The primary purpose of this study was to compare indices of bone strength at the proximal femur (PF) between elite premenarcheal gymnasts (N= 30) and age-matched controls (N= 30). METHODS Structural properties of the proximal femur were derived from the hip analyses program and included measurement of subperiosteal width, endosteal diameter, cross-sectional area, bone mineral density, cross-section moment of inertia (CSMI), and section modulus (Z). These parameters were measured for two regions of the PF: the narrow neck (NN), and the shaft (S). In addition, a strength index (S-SI) was calculated at the shaft by dividing the Z at the shaft by the femur length. A secondary purpose was to compare bone mineral content (BMC) values at the total body, lumbar spine, and three sites at the PF (neck, trochanter, and total) between the groups. All dependent values were compared adjusting for height and weight using an ANCOVA procedure and for relative lean body mass. RESULTS The gymnasts had significantly greater size-adjusted strength indices (CSMI, Z, and SI) at the NN and S. Gymnasts also had significantly greater size-adjusted BMC at all sites investigated. However, these differences disappeared when adjusted for relative lean body mass. CONCLUSION When adjusted for body size, gymnasts had significantly greater indices of both axial strength and bending strength at the NN region of the PF and S, as well as a greater bone SI at the femoral shaft. These differences may be related to greater relative lean body mass attained in gymnastics training.
[Clinical and pathological analysis of 114 patients with postoperative wound infections by M. abscessus].

OBJECTIVE To evaluate the pathological findings of postoperative wound infections by M. abscessus. METHODS Proven sources of infections in 114 patients with postoperative wound infections were contaminated instrument disinfection liquid. According to the wound exudates cultivation and bacteriologic identification, the pathogen of postoperative infections was proved M. abscessus. Pathological features of postoperative wound infections were analyzed retrospectively. RESULTS The postoperative wound infections in 114 cases involved cutaneous and subcutaneous tissue 95(83.3%), deep muscular tissue 21(18.4%), local lymph nodes 13(11.4%) and visceral organ, peritoneum and mesentery 3(2.6%). The main pathological appearances were granulomatous lesions and nonspecific chronic pyogenic inflammations. The granulomatous lesions include pyogenic tuberculosis-like granuloma, atypical tuberculosis-like granuloma and tuberculosis-like granuloma. The three types of granuloma could be seen in the same case and the percentage of three types was 75.4%, 28.1%, 59.6% respectively. 38 cases (33.3%) were showed red mycobacterium at acid-fast stain. CONCLUSIONS The pathological appearances of most postoperative wound infections by M. abscessus were more or less different from those of tuberculosis. Awareness of the pathologic features of the postoperative wound M. abscessus infections will facilitate the diagnosis so that appropriate therapy may be initiated before the disease is far advanced and prevent infection dissemination.
Control of Tobacco mosaic virus Movement Protein Fate by CELL-DIVISION-CYCLE Protein481[W][OA]

Like many other viruses, Tobacco mosaic virus replicates in association with the endoplasmic reticulum (ER) and exploits this membrane network for intercellular spread through plasmodesmata (PD), a process depending on virus-encoded movement protein (MP). The movement process involves interactions of MP with the ER and the cytoskeleton as well as its targeting to PD. Later in the infection cycle, the MP further accumulates and localizes to ER-associated inclusions, the viral factories, and along microtubules before it is finally degraded. Although these patterns of MP accumulation have been described in great detail, the underlying mechanisms that control MP fate and function during infection are not known. Here, we identify CELL-DIVISION-CYCLE protein48 (CDC48), a conserved chaperone controlling protein fate in yeast (Saccharomyces cerevisiae) and animal cells by extracting protein substrates from membranes or complexes, as a cellular factor regulating MP accumulation patterns in plant cells. We demonstrate that Arabidopsis (Arabidopsis thaliana) CDC48 is induced upon infection, interacts with MP in ER inclusions dependent on the MP N terminus, and promotes degradation of the protein. We further provide evidence that CDC48 extracts MP from ER inclusions to the cytosol, where it subsequently accumulates on and stabilizes microtubules. We show that virus movement is impaired upon overexpression of CDC48, suggesting that CDC48 further functions in controlling virus movement by removal of MP from the ER transport pathway and by promoting interference of MP with microtubule dynamics. CDC48 acts also in response to other proteins expressed in the ER, thus suggesting a general role of CDC48 in ER membrane maintenance upon ER stress.
Cold‐induced calcium elevation triggers DNA fragmentation in immature pig oocytes

Fluo‐4 loaded immature oocytes were cooled from 30°C to various lower temperatures between 20 and 10°C and changes in intracellular calcium (Ca2+) levels were measured. Pig oocytes cooled to 14°C exhibited a clear biphasic Ca2+ rise. Lower temperatures produced similar responses, while higher temperatures did not exert any effect. The Ca2+ response appeared to rely on ryanodine dependent stores as removal of extracellular Ca2+ and intracytoplasmic injection of heparin did not modify cold‐induced Ca2+ elevation, while procaine or ruthenium red virtually eliminated the response. Confocal analysis of subcellular Ca2+ distribution during cooling revealed that the ion rises sharply within the nucleus. As Ca2+ imbalance may activate nuclear endonucleases, DNA integrity of cooled pig oocytes was evaluated by TUNEL and comet assays. Most cooled oocytes showed clear signs of DNA fragmentation. Oocytes injected with 1,2‐bis(2‐aminophenoxy)ethane‐N,N,N′,N′‐tetracetic acid tetrapotassium salt (BAPTA), a Ca2+ chelator, maintained their DNA integrity thus confirming that intracellular Ca2+ is involved in triggering DNA fragmentation. The protective effect exerted by ruthenium red and/or procaine further confirmed this hypothesis. These data show that a moderate and transient cooling is sufficient to cause an intracellular Ca2+ rise that leads to DNA damage. The addition of inhibitors of ryanodine dependent Ca2+ stores may represent a valuable protective treatment to reduce chilling injuries. Mol. Reprod. Dev. 65: 289–297, 2003. © 2003 Wiley‐Liss, Inc.
H−/L∞ fault detection observer for discrete-time Takagi-Sugeno fuzzy systems

In this paper, an H<inf>−</inf>/L<inf>∞</inf> fault detection observer is proposed for discrete-time Takagi-Sugeno (T-S) fuzzy systems. The main contribution of this paper lies as, first, the finite frequency H<inf>−</inf> index is used to measure the worst-case fault sensitivity. Second, unlike the common H<inf>−</inf>/H<inf>∞</inf> fault detection observer, this paper uses L<inf>∞</inf> norm to measure the worst effect of disturbance on residual instead of H<inf>∞</inf> norm. Besides, a residual evaluation is synthesized based on the Lnorm to achieve an efficient fault detection despite of the disturbance occurrence. Besides, sufficient conditions of the observer design are derived based on piecewise Lyapunov functions. The effectiveness of the proposed method is demonstrated by numerical simulations.
Distinct Ca2+ and Sr2+ Binding Properties of Synaptotagmins

Ca2+-dependent neurotransmitter release consists of at least two components: a major fast component that is insensitive to Sr2+ and a minor slow component that is potentiated by Sr2+ (Goda, Y., and Stevens, C. F.(1994) Proc. Natl. Acad. U. S. A. 91, 12942-12946). These results suggest that at least two Ca2+ sensors act in synaptic vesicle fusion with distinct Ca2+ and Sr2+ binding properties. We have now investigated the relative Ca2+ and Sr2+ binding activities of synaptotagmins to evaluate their potential roles as Ca2+ sensors for the fast and slow components. Our results demonstrate that the first C2 domains of synaptotagmins I, II, III, V, and VII have very similar Ca2+ requirements for phospholipid binding (range of EC50 = 2.6 μM to 5.0 μM), but distinct Sr2+ requirements (EC50 range = 23 μM to 133 μM); synaptotagmins I and II had the lowest Sr2+ affinity, and synaptotagmin III the highest Sr2+ affinity. Purified synaptotagmin I from bovine brain exhibited similar properties as its recombinant first C2 domain, suggesting that the first C2 domain fully accounts for its Ca2+-dependent phospholipid binding properties. Sr2+ was unable to trigger syntaxin binding by synaptotagmin I at all concentrations tested, whereas it was effective for synaptotagmin III. These results suggest that different C2 domains have distinct Sr2+ binding properties. They support the hypothesis that synaptotagmins localized on the same vesicle perform distinct functions, with synaptotagmins I and II serving as candidate Ca2+ sensors for the fast component in release and synaptotagmin III for the slow component.
Simultaneous Quantification of Multiple Urinary Naphthalene Metabolites by Liquid Chromatography Tandem Mass Spectrometry

Naphthalene is an environmental toxicant to which humans are exposed. Naphthalene causes dose-dependent cytotoxicity to murine airway epithelial cells but a link between exposure and human pulmonary disease has not been established. Naphthalene toxicity in rodents depends on P450 metabolism. Subsequent biotransformation results in urinary elimination of several conjugated metabolites. Glucuronide and sulfate conjugates of naphthols have been used as markers of naphthalene exposure but, as the current studies demonstrate, these assays provide a limited view of the range of metabolites generated from the parent hydrocarbon. Here, we present a liquid chromatography tandem mass spectrometry method for measurement of the glucuronide and sulfate conjugates of 1-naphthol as well as the mercapturic acids and N-acetyl glutathione conjugates from naphthalene epoxide. Standard curves were linear over 2 log orders. On column detection limits varied from 0.91 to 3.4 ng; limits of quantitation from 1.8 to 6.4 ng. The accuracy of measurement of spiked urine standards was -13.1 to + 5.2% of target and intra-day and inter-day variability averaged 7.2 (± 4.5) and 6.8 (± 5.0) %, respectively. Application of the method to urine collected from mice exposed to naphthalene at 15 ppm (4 hrs) showed that glutathione-derived metabolites accounted for 60-70% of the total measured metabolites and sulfate and glucuronide conjugates were eliminated in equal amounts. The method is robust and directly measures several major naphthalene metabolites including those derived from glutathione conjugation of naphthalene epoxide. The assays do not require enzymatic deconjugation, extraction or derivatization thus simplifying sample work up.
Interaction of low frequency magnetic fields with thin 3D sheets of combined resistive and magnetic properties

The subject of this paper is numerical modelling of thin 3D sheets with combined resistive and magnetic properties, exposed by low frequency magnetic fields. Incorporating reduction of thickness of sheet into Maxwell equations leads to approximate boundary conditions, written for tangential electric and magnetic fields of free space. These fields are represented only by vector potential, which is calculated based on single and double layer currents, located on the interface surface. Resulting equations are solved via Method of Moments. Numerical simulations are compared with semi-analytic solutions for thin plate and for spherical shell, as well as with measurement data. As an application, radiation from supply cable in the presence of metallic surface and shield is considered.