Miracle-dz/UniFAR-FTUs huggingface dataset:
Preoperative assessment of resectability of hepatic hilar cholangiocarcinoma: combined CT and cholangiography with revised criteria.

PURPOSE To retrospectively assess the accuracy of combined multiphasic computed tomography (CT) and direct cholangiography for evaluation of the resectability of hilar cholangiocarcinoma, on the basis of revised criteria for unresectability, by using surgery as the reference standard. MATERIALS AND METHODS Institutional review board approval was obtained, and informed consent was waived. From 1998 to 2003, 55 patients (37 men, 18 women; mean age +/- standard deviation, 59 years +/- 12) with surgically proved hilar cholangiocarcinomas who underwent preoperative CT (single-detector row CT, n = 26; multi-detector row CT, n = 29) and cholangiography were included for study. The authors' revised criteria for unresectable tumor were contralateral hepatic artery invasion; main or contralateral portal vein invasion longer than 2 cm; biliary extension to the contralateral secondary confluence, farther than 2 cm from hepatic hilum; enlarged lymph nodes at the celiac, portacaval, and paraaortic area; and other ancillary findings. Tumor resectability based on these parameters was determined at imaging by two radiologists in consensus. Mann-Whitney U test and weighted kappa coefficient of agreement were used for accuracy determination. RESULTS For depiction of portal vein invasion (in 26 patients), CT yielded an accuracy of 85.5%. Arterial invasion was found at surgery in 19 patients, with CT providing an accuracy of 92.7%. For prediction of node involvement (15 patients, 27%), CT yielded an accuracy of 83.6%. The extent of ductal involvement could be accurately predicted in 46 patients (84%) (weighted kappa = 0.767). In 30 of 42 patients with disease classified as resectable according to revised criteria, disease was found to be resectable at surgery (71.4% positive predictive value). In 11 of 13 patients with disease classified as unresectable according to revised criteria, unresectable disease was confirmed (84.6% negative predictive value). Overall accuracy of resectability was 74.5%. CONCLUSION Combined interpretation of CT and direct cholangiographic images by using our revised criteria resulted in overall accuracy of 74.5% for prediction of resectability for hilar cholangiocarcinoma.
Manganese enhancement in non‐CNS organs

Manganese‐enhanced magnetic resonance imaging (MEMRI) is a novel imaging technique capable of monitoring calcium influx, in vivo. Manganese (Mn2+) ions, similar to calcium ions (Ca2+), are taken up by activated cells where their paramagnetic properties afford signal enhancement in T1‐weighted MRI methodologies. In this study we have assessed Mn2+ distribution in mice using magnetization‐prepared rapid gradient echo (MP‐RAGE) based MRI, by measuring changes in T1–effective relaxation times (T1‐eff), effective R1‐relaxation rates (R1‐eff) and signal intensity (SI) profiles over time. The manganese concentration in the tissue was also determined using inductively coupled plasma atomic emission spectrometry (ICP‐AES). Our results show a strong positive correlation between infused dose of MnCl2 and the tissue manganese concentration. Furthermore, we demonstrate a linear relationship between R1‐eff and tissue manganese concentration and tissue‐specific Mn2+ distribution in murine tissues following dose‐dependent Mn2+ administration. This data provides an optimized MnCl2 dose regimen for an MP‐RAGE based sequence protocol for specific target organs and presents a potential 3D MRI technique for in vivo imaging of Ca2+ entry during Ca2+‐dependent processes in a wide range of tissues. Copyright © 2010 John Wiley & Sons, Ltd.
Input tracking of Lipschitz nonlinear systems using input-state-stability approach

A simple approach based on input to state stability (ISS) criterion for input tracking and stabilisation of a Lipschitz nonlinear system is being proposed. The controller design is carried out in a linear matrix inequality (LMI) framework. The resulting controller, if feasible, tracks the input reference signal and also provides stability to the system. The designed closed loop system is robust against parametric norm bound uncertainty.
The World Federation of Socleties of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders, Part II: Treatment of Mania

Identical to the preceding guidelines of this series, these practice guidelines for the biological, mainly pharmacological treatment of acute bipolar mania were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of acute mania. The data used for these guidelines have been extracted from a MEDLINE and EMBASE search, from recent proceedings of key conferences, and from various national and international treatment guidelines. Their scientific rigor was categorised into four levels of evidence (A-D). As these guidelines are intended for clinical use, the scientific evidence was finally not only graded, but has also been commented by the experts of the task force to ensure practicability.
Identification of Sources of Phoenix Aerosol by Positive Matrix Factorization

ABSTRACT Chemical composition data for fine and coarse particles collected in Phoenix, AZ, were analyzed using positive matrix factorization (PMF). The objective was to identify the possible aerosol sources at the sampling site. PMF uses estimates of the error in the data to provide optimum data point scaling and permits a better treatment of missing and below-detection-limit values. It also applies nonnegativity constraints to the factors. Two sets of fine particle samples were collected by different samplers. Each of the resulting fine particle data sets was analyzed separately. For each fine particle data set, eight factors were obtained, identified as (1) biomass burning characterized by high concentrations of organic carbon (OC), elemental carbon (EC), and K; (2) wood burning with high concentrations of Na, K, OC, and EC; (3) motor vehicles with high concentrations of OC and EC; (4) nonferrous smelting process characterized by Cu, Zn, As, and Pb; (5) heavy-duty diesel characterized by high EC, OC, and Mn; (6) sea-salt factor dominated by Na and Cl; (7) soil with high values for Al, Si, Ca, Ti, and Fe; and (8) secondary aerosol with SO4 -2 and OC that may represent coal-fired power plant emissions. For the coarse particle samples, a five-factor model gave source profiles that are attributed to be (1) sea salt, (2) soil, (3) Fe source/motor vehicle, (4) construction (high Ca), and (5) coal-fired power plant. Regression of the PM mass against the factor scores was performed to estimate the mass contributions of the resolved sources. The major sources for the fine particles were motor vehicles, vegetation burning factors (biomass and wood burning), and coal-fired power plants. These sources contributed most of the fine aerosol mass by emitting carbonaceous particles, and they have higher contributions in winter. For the coarse particles, the major source contributions were soil and construction (high Ca). These sources also peaked in winter.
Effects of gender on the pharmacokinetics of drugs secreted by the renal organic anions transport systems in the rat.

The importance of considering sex differences in drug handling studies was admitted recently. The present work evaluates the sex influences on the pharmacokinetics of para-aminohippuric acid (PAH), the reference substance for the renal organic anion transports systems, and furosemide (FS), a standard loop diuretic which is also a substrate for this transport system. Female rats displayed a lower PAH and FS systemic clearance, and a lower value of the elimination rate microconstant from the central compartment for both drugs. These results may be explained by the diminution of the renal clearance of both PAH and FS observed in females. In summary, sex modifies the pharmacokinetics of organic anions. Although additional experimental work must be done to bridge the gap between studies using animals and humans, the reported experimental observations may have potentially important pharmacological implications. So, caution must be exercised in administering drugs like organic anions to females.
Persuasive Populism? Estimating the Effect of Populist Messages on Political Cynicism

Many European countries have seen a growth of populism in recent years. Extant research shows that populist parties are increasingly successful, and that populist messages appear more frequently in the media. This raises the question to what extent populist messages affect public opinion. The aim of this study is to assess whether populist messages fuel political cynicism by arguing that an arrogant, selfish and complacent political elite does not listen to what ordinary people find important. Moreover, it assesses whether populist messages affect only those already favourably predisposed towards populist parties, or whether it affects citizens across the board. The results of a survey experiment, conducted in the Netherlands, suggests that individuals who are exposed to populist messages are indeed more cynical afterwards than individuals who are exposed to a very similar, but more ‘neutrally formulated’ message. However, the effects seem to be restricted to supporters of populist parties.
Selective inhibition of Erwinia amylovora by the herbicidally active germination‐arrest factor (GAF) produced by Pseudomonas bacteria

Aims: The germination‐arrest factor (GAF) produced by Pseudomonas fluorescens WH6, and identified as 4‐formylaminooxyvinylglycine, specifically inhibits the germination of a wide range of grassy weeds. This study was undertaken to determine whether GAF has antimicrobial activity in addition to its inhibitory effects on grass seed germination.
Assessing Market Distortions Affecting Poverty Reduction Efforts On Smallholder Tobacco Production in Tanzania

This study attempts to analyse the efficiency of production, the degree of distortion in the markets and the pattern of incentives for smallholder tobacco growers in Songea, Tanzania. A survey was conducted on a sample of tobacco growers in Songea district, and secondary data collected from key organisations in the industry. A Policy Analysis Matrix (PAM) of the tobacco production and marketing system was constructed so as to determine the private and social profitability of the system, distortions in the markets and the efficiency of resource use in the pursuit of maximizing income. Since PAM is a static model, a sensitivity analysis to explore the effect of potential changes in various factors that influence profitability of the enterprise was also conducted. The analysis revealed that although tobacco production is potentially a profitable enterprise relative to the international market, smallholders are paid less than the actual value of their product. The overall effect is a net taxation of tobacco production at the farm level. Thus the existing marketing arrangements have made it appear uncompetitive with low resource allocation efficiency. There is a net disincentive to produce the crop. In the absence of distortions, smallholder farmers in the region would have realised more to their average annual income from tobacco production alone. These findings reveal the importance of the crop in poverty reduction efforts, and the significant effects of market distortions. Sensitivity analysis indicated that an increase in producer prices resulted into a sharp increase in producer incentives and smallholders will be more protected with profits realised in excess of normal returns to domestic resources increasing. With a decrease in the parity price of the product, indicators depict that production of the crop becomes undesirable from the social point of view. However, efficiency indicators were insensitive to an increase in parity prices of tradable inputs implying that tobacco production will still be a desirable enterprise from the social point of view. The study concludes that although liberalization opened up markets by formally allowing private leaf dealers to invest in marketing of tobacco, operational arrangements have not provided adequate incentives to tobacco growers in terms of pre-harvest services and marketing efficiency in general. Many problems have been noted which indicated gross inefficiency in the entire production and marketing system. These problems alter costs and revenues in the input/output markets and prevent realization of potential income gains by tobacco growers. Intervention is, therefore, necessary in the operation of liberalized markets to increase incentives and comparative advantage in costs, revenues and efficiency of resource use.
The Role of Visceral Protein Markers in Protein Calorie Malnutrition

Abstract Despite substantial evidence of the crucial role protein calorie malnutrition (PCM) plays in the occurrence of complications, increased length of stay, and cost of care in hospitalized populations, no standard approach for screening and monitoring the nutritional status of patients initially and throughout admission currently exists. Recognizing that there is a growing public and professional recognition of the importance of malnutrition, a large patient population (30–55%) at risk for PCM, and an even larger population experiencing declining nutritional status during hospitalization, this study examined the feasibility of a full-scale study to assess the value of two biochemical markers, transthyretin and albumin, for detecting and monitoring PCM in hospitalized patients. It was demonstrated that these two markers do provide important information predictive of outcomes for those they identify at risk for PCM. The patients who entered the study with or developed low transthyretin and albumin experienced poorer health outcomes and higher costs of care. Their discharge occurred in an early phase of recovery, with significant implications for after-discharge care. The full-scale study must consider severity of illness and other confounders during randomization and, preferably, be conducted in institutions that currently do not use transthyretin for nutrition assessment.
An overview of recent findings of the Stanley Foundation Bipolar Network (Part I).

AIM AND METHODS Selected recent findings of the Stanley Foundation Bipolar Network are briefly reviewed and their clinical implications discussed. RESULTS Daily prospective ratings on the NIMH-LCM indicate a high degree of residual depressive morbidity (three times that of hypomania or mania) despite active psychopharmacological treatment with a variety of modalities including mood stabilizers, antidepressants, and benzodiazepines, as well as antipsychotics as necessary. The rates of switching into brief to full hypomania or mania during the use of antidepressants is described, and new data suggesting the potential utility of continuing antidepressants in the small group of patients showing an initial acute and persistent response is noted. Bipolar patients with a history of major environmental adversities in childhood have a more severe course of illness and an increased incidence of suicide attempts compared with those without. Preliminary open data suggest useful antidepressant effects of the atypical antipsychotic quetiapine, while a double-blind randomized controlled study failed to show efficacy of omega-3 fatty acids (6 g of eicosapentaenoic acid compared with placebo for 4 months) in the treatment of either acute depression or rapid cycling. The high prevalence of overweight and increased incidence of antithyroid antibodies in patients with bipolar illness is highlighted. CONCLUSIONS Together, these findings suggest a very high degree of comorbidity and treatment resistance in outpatients with bipolar illness treated in academic settings and the need to develop not only new treatment approaches, but also much earlier illness recognition, diagnosis, and intervention in an attempt to reverse or prevent this illness burden.
Regeneration of Entorhino-dentate Projections in Organotypic Slice Cultures: Mode of Axonal Regrowth and Effects of Growth Factors

Explants of Embryonic Day 18 (E18) rat entorhinal cortex were cocultured with Postnatal Day 6 mouse hippocampal slices to study CNS regeneration in vitro. The present report describes a double-labeling paradigm for quantitative analysis of the type of new growth seen in immature cultures. Entorhinal projection neurons in living static cocultures were retrogradely labeled with DiI or Texas red-dextran at 6 days in vitro and with dextran-FITC at 13 days. An intervening lesion to the entorhinodentate pathway was made at 8 days by replacing the hippocampal slices with fresh ones. About one-third of the new efferent entorhinal projections labeled with the second tracer could be characterized as true regeneration of axons from previously projecting entorhinal neurons by virtue of their being double labeled. The remaining two-thirds comprised new, late-arriving axons from previously nonprojecting cells. Earlier studies have shown that rat entorhinal axons will reinnervate hippocampal slices only if the lesions are made before 2-3 weeks in culture, equivalent to a postnatal age of 11-18 days. In a second series of experiments we tested whether treatment with trophic factors could overcome this age-related failure of regeneration characteristic of mature preparations. E18 explants were lesioned after 4 weeks in vitro and grown for a further 2 weeks in medium supplemented with either Schwann cell conditioned medium or acidic fibroblast growth factor plus heparin. A significant increase in outgrowth was seen in both cases, although the effects of each factor were not additive when they were applied in combination. These results show that our model of CNS lesions in vitro can be used to assess the effectiveness of growth factors in ameliorating the decline in regenerative ability with increasing developmental age.
An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease.

BACKGROUND Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. PURPOSE The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. METHODS An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. RESULTS We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. CONCLUSIONS Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem. Strategies for early detection and specific treatments for this condition are also needed.
Low mortality rate in 97 consecutive pancreaticoduodenectomies: the experience of a group.

CONTEXT Pancreaticoduodenectomy is the procedure of choice for resectable cancer of the periampullary region. These tumors account for 4% of deaths from cancer, being referred to as one of the lowest survival rates at 5 years. Surgery remains a complex procedure with substantial morbidity and mortality. Despite reports of up to 30% mortality rates, in centers of excellence it have been identified as less than 5%. Recent studies show that pancreaticojejunostomy represents the "Achilles' heel" of the procedure. OBJECTIVE To evaluate the post-operative 30 days morbidity and mortality rates. METHODS Retrospective analysis of 97 consecutive resected patients between July, 2000 and December, 2012. All patients were managed by the same group, and data were obtained from specific database service. The main objective was to evaluate the 30-day mortality rate, but we also studied data of surgical specimen, need for vascular resection and postoperative complications (gastric stasis, pancreatic fistula, pneumonia and reoperation rate). RESULTS Thirty-day mortality rate was 2.1% (two patients). Complete resection with no microscopic residual tumor was obtained in 93.8% of patients, and in 67.3% of cases pathology did not detected metastatic nodes. Among postoperative complications were reported 6% of prolonged gastric stasis, 10.3% of pneumonia, 10.3% of pancreatic fistula and 1% of infection in the drain pathway. Two patients underwent reoperation due to bleeding and infected hematoma caused by pancreatic fistula, and another for intestinal obstruction because of adhesions at postoperative day 12. CONCLUSIONS The pancreaticoduodenectomy as treatment procedure for periampullary cancers has a low morbidity and mortality rate in services with experience in Hepato-Pancreato-Biliary surgery, remaining as first-line treatment in resectable patients.
Higher frequency of p53 gene mutations in diffuse large B‐cell lymphoma with MALT component

p53 gene mutation is not a frequent event in the tumorigenesis of lymphomas and the expression of p53 protein is independent of p53 gene mutations. The present study aimed to investigate mutations in the p53 gene in a series of extranodal B‐cell lymphomas, and its association with p53 protein expression. A total of 52 cases were graded histologically into Grade 1, Grade 2 and Grade 3 tumors and p53 protein expression was detected using immunohistochemistry. Mutations in the p53 gene were analyzed using polymerase chain reaction single‐strand conformation polymorphism (PCR‐SSCP) and mobility shifts were confirmed by direct sequencing. The tumors comprised 26 (50%) Grade 1, 9 (17%) Grade 2 and 15 (29%) Grade 3. A high proportion of Grade 2 (25%) tumors expressed p53 protein (P = 0.051) and carried p53 gene mutation (33%) (P = 0.218). However, p53 protein expression was not associated with p53 gene mutations (P = 0.057). Transversion mutations (88%) were more frequently detected than transition mutations (12%). The present study revealed that p53 gene mutations and p53 protein expression occurred in higher frequencies in Grade 2 tumors, which may be of pathogenetic importance. The high frequency of transversion mutations may reflect the influence of an etiological agent in the tumorigenesis of mucosa‐associated lymphoid tissue (MALT lymphoma).