Miracle-dz/UniFAR-FTUs huggingface dataset:
Performance of DWI as a Rapid Unenhanced Technique for Detecting Mammographically Occult Breast Cancer in Elevated-Risk Women With Dense Breasts.

OBJECTIVE The objective of our study was to evaluate the performance of DWI to detect mammographically occult breast cancer in elevated-risk women with dense breasts. MATERIALS AND METHODS We retrospectively reviewed all women who underwent screening breast MRI at our institution from January 2007 through May 2013. We created a case-control cohort composed of 48 subjects with mammographically dense breasts: 24 with mammographically occult cancer detected on MRI and 24 healthy women with negative MRI findings who were matched to the subjects with breast cancer patients for age, breast density, and MRI protocol. The contrast-to-noise ratio (CNR), apparent diffusion coefficient (ADC), and conspicuity score (range, 1-5) were assessed on DWI for all malignancies. Lesions and normal tissue were compared using the Wilcoxon signed rank test; associations with clinical characteristics were evaluated using the Mann-Whitney U test. Three experienced breast imagers who were blinded to medical records and contrast-enhanced MRI findings independently evaluated the unenhanced MRI scans of the 48 women for the presence of cancer. RESULTS Mammographically occult breast cancers (invasive carcinoma, n = 16; ductal carcinoma in situ, n = 8) in women with dense breasts typically exhibited higher signal intensity on DWI than normal parenchyma (median CNR of cancers, 1.4; median conspicuity score of cancers, 4) and a lower ADC (median, 1.31 vs 1.79 × 10(-3) mm(2)/s, respectively) (p < 0.0001). The conspicuity score, CNR, and ADC were not associated with patient age, menopausal status, lesion size, morphologic type, or histology (p > 0.05). Average reader performance using unenhanced MRI was 45% sensitivity, 91% specificity, 62% positive predictive value, and 83% negative predictive value. CONCLUSION In elevated-risk women with dense breasts, DWI can reveal cancers in addition to those detected on mammography alone with a low false-positive rate; these results suggest that DWI may have potential as a rapid supplemental screening tool.
Visual-Sensitive Epilepsies: Classification and Review

ABSTRACT: Photosensitivity, photosensitive seizures, and photosensitive epilepsy are discussed. The International League against Epilepsy has suggested the term “visual-sensitive” replace “photosensitive”. Visual-sensitive seizures may be more common than is realized. A classification for visual-sensitive epilepsies is presented. Chromosomal and DNA testing may help to refine the classification further. A standardized approach for neurophysiologic testing, such as that proposed by European experts, is recommended. These steps should promote evidenced-based management for this group of disorders.
From Busyware to Stableware

The integrated engineering of complex systems depends on, among other things, the supply of reliable, cost effective, stable components. However, as pointed out earlier by H.W. Lawson (1998), unnecessary complexity abounds in today's computer and communication structures, including the platforms that host many complex, often critical systems. Thus, even if an organization accurately designs, develops, and supports reliable, cost effective, nonplatform components, deploying them in an unstable platform will counteract even the most stringent engineering and management efforts. The system will be no stronger than its weakest components (R. Colwell, 1998,). Societal burdens are already here. A recent example is the Windows NT error that caused the Yorktown, an Aegis guided missile cruiser, to be disabled. The Yorktown could not perform its mission and had to be towed into port. An otherwise well engineered system failed because of a platform bug. There are likely many platform related failures in a variety of critical application domains that are never made public. A concerted (hopefully industry driven) effort must be made to move toward the stable integrated platform solutions that Colwell indicates. This requires a transformation from what the author calls busyware to stableware.
Clinical and Immunological Follow-Up of Pemphigus Patients on Adjuvant Treatment with Immunoadsorption or Rituximab

Background: Pemphigus vulgaris (PV) is a life-threatening autoimmune blistering skin disease which is associated with pathogenic IgG autoantibodies against desmogleins (Dsg) 1 and 3. Novel therapeutic strategies such as immunoadsorption (IA) or the anti-CD20 antibody rituximab (Rtx) hold promise to be effective in severe or recalcitrant PV. Patients and Methods: In the present retrospective study, 6 patients with extensive cutaneous PV were subjected to adjuvant IA treatment while 5 patients with severe mucosal PV received adjuvant Rtx treatment. Results: Within 6 months, IA and Rtx induced excellent clinical responses which were associated with a significant reduction of prednisolone doses and a decrease in anti-Dsg-specific IgG. Over a 12-month period, 3 IA-treated patients required additional adjuvant drugs while all of the PV patients on Rtx had no or only minimal residual symptoms. Conclusion: The relative therapeutic (long-term) efficacy of IA and Rtx in cutaneous versus mucosal PV needs to be evaluated in a prospective study.
Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn's disease: the CLASSIC-I trial.

BACKGROUND & AIMS Tumor necrosis factor blockade has been shown to be an effective treatment strategy in Crohn's disease (CD). Adalimumab is a human immunoglobulin G1 (IgG(1)) monoclonal antibody targeting tumor necrosis factor (TNF). A randomized, double-blind, placebo-controlled, dose-ranging trial was performed to evaluate the efficacy of adalimumab induction therapy in patients with CD. METHODS A total of 299 patients with moderate to severe CD naive to anti-TNF therapy were randomized to receive subcutaneous injections at weeks 0 and 2 with adalimumab 40 mg/20 mg, 80 mg/40 mg, or 160 mg/80 mg or placebo. The primary endpoint was demonstration of a significant difference in the rates of remission at week 4 (defined as a Crohn's Disease Activity Index score <150 points) among the 80 mg/40 mg, 160 mg/80 mg, and placebo groups. RESULTS The rates of remission at week 4 in the adalimumab 40 mg/20 mg, 80 mg/40 mg, and 160 mg/80 mg groups were 18% (P = .36), 24% (P = .06), and 36% (P = .001), respectively, and 12% in the placebo group. Adverse events occurred at similar frequencies in all 4 treatment groups except injection site reactions, which were more common in adalimumab-treated patients. CONCLUSIONS Adalimumab was superior to placebo for induction of remission in patients with moderate to severe Crohn's disease naive to anti-TNF therapy. The optimal induction dosing regimen for adalimumab in this study was 160 mg at week 0 followed by 80 mg at week 2. Adalimumab was well tolerated.
Combinations of Polyclonal or Monoclonal Antibodies to Proteins of the Outer Membranes of the Two Infectious Forms of Vaccinia Virus Protect Mice against a Lethal Respiratory Challenge

ABSTRACT Previous studies demonstrated that antibodies to live vaccinia virus infection are needed for optimal protection against orthopoxvirus infection. The present report is the first to compare the protective abilities of individual and combinations of specific polyclonal and monoclonal antibodies that target proteins of the intracellular (IMV) and extracellular (EV) forms of vaccinia virus. The antibodies were directed to one IMV membrane protein, L1, and to two outer EV membrane proteins, A33 and B5. In vitro studies showed that the antibodies to L1 neutralized IMV and that the antibodies to A33 and B5 prevented the spread of EV in liquid medium. Prophylactic administration of individual antibodies to BALB/c mice partially protected them against disease following intranasal challenge with lethal doses of vaccinia virus. Combinations of antibodies, particularly anti-L1 and -A33 or -L1 and -B5, provided enhanced protection when administered 1 day before or 2 days after challenge. Furthermore, the protection was superior to that achieved with pooled immune gamma globulin from human volunteers inoculated with live vaccinia virus. In addition, single injections of anti-L1 plus anti-A33 antibodies greatly delayed the deaths of severe combined immunodeficiency mice challenged with vaccinia virus. These studies suggest that antibodies to two or three viral membrane proteins optimally derived from the outer membranes of IMV and EV, may be beneficial for prophylaxis or therapy of orthopoxvirus infections.
So close, so different: geothermal flux shapes divergent soil microbial communities at neighbouring sites

This study is focused on the (micro)biogeochemical features of two close geothermal sites (FAV1 and FAV2), both selected at the main exhalative area of Pantelleria Island, Italy. A previous biogeochemical survey revealed high CH4 consumption and the presence of a diverse community of methanotrophs at FAV2 site, whereas the close site FAV1 was apparently devoid of methanotrophs and recorded no CH4 consumption. Next‐Generation Sequencing (NGS) techniques were applied to describe the bacterial and archaeal communities which have been linked to the physicochemical conditions and the geothermal sources of energy available at the two sites. Both sites are dominated by Bacteria and host a negligible component of ammonia‐oxidizing Archaea (phylum Thaumarchaeota). The FAV2 bacterial community is characterized by an extraordinary diversity of methanotrophs, with 40% of the sequences assigned to Methylocaldum, Methylobacter (Gammaproteobacteria) and Bejerickia (Alphaproteobacteria); conversely, a community of thermo‐acidophilic chemolithotrophs (Acidithiobacillus, Nitrosococcus) or putative chemolithotrophs (Ktedonobacter) dominates the FAV1 community, in the absence of methanotrophs. Since physical andchemical factors of FAV1, such as temperature and pH, cannot be considered limiting for methanotrophy, it is hypothesized that the main limiting factor for methanotrophs could be high NH4+ concentration. At the same time, abundant availability of NH4+ and other high energy electron donors and acceptors determined by the hydrothermal flux in this site create more energetically favourable conditions for chemolithotrophs that outcompete methanotrophs in non‐nitrogen‐limited soils.
A novel sliding mode guidance law without line-of-sight angular rate information accounting for autopilot lag

ABSTRACT This paper proposes a new composite guidance law to intercept manoeuvring targets without line-of-sight (LOS) angular rate information in the presence of autopilot lag. The presented formulation is obtained via a combination of homogeneous theory and sliding mode control approach. Different from some existing observers, the proposed homogeneous observer can estimate the lumped uncertainty and the LOS angular rate in an integrated manner. To reject the mismatched lumped uncertainty in the integrated guidance and autopilot system, a sliding surface, which consists of the system states and the estimated states, is proposed and a robust guidance law is then synthesised. Stability analysis shows that the LOS angular rate can be stabilised in a small region around zero asymptotically and the upper bound can be lowered by appropriate parameter choice. Numerical simulations with some comparisons are carried out to demonstrate the superiority of the proposed method.
Utilization of Cesarean Sections: Comparing Hospitals in Indiana

number of citizens will soon have access to health insurance and healthcare. However, it is uncertain if this reform will be able to reduce costs and improve quality. The states will soon change the focus of their health policies from protecting the uninsured to guaranteeing high-quality care at lower costs. Initiatives like the Commonwealth Fund’s State Scorecard on Health System Performance will gain prominence, challenging states to avoid unnecessary care, control costs, and promote healthy lives. The public call for more transparency and accountability in the healthcare system will also present a challenge for states. Growing evidence suggests that healthcare in the U.S. does not perform with the highest standards of quality, and that it ranks low compared with other developed countries [1,2]. Providers now face more requirements to submit performance data, and more organizations are releasing provider quality ratings to the public. One of these initiatives, supported by the U.S. Department of Health and Human Services (DHHS), is the Hospital Compare website. Hospital Compare reports hospital quality measures based on processes and outcomes for many care services. However, because the majority of the data comes from Medicare claims and enrollment, Hospital Compare does not encompass services that are common to a broader spectrum of the population. Despite the clear need for more accountability, two problems threaten the improvement of quality through public disclosure. First, the methodologies to assess quality have limitations. Different public quality reports produce conflicting ratings due to lack of homogeneity in methodologies, data source, and sample selection [3,4]. A hospital may look good under one methodology and bad under another. The lack of validation makes it difficult to discern which rating is right, and, more importantly, makes quality assessment questionable. Quality assessment is connected to patient decisions and providers’ reputation and income. Therefore, conflicting metho dologies will reduce stakeholders’ confidence in public ratings, risking its effectiveness as a vehicle to improve healthcare quality. The second problem is the effectiveness of public disclosure. Several studies question the patient’s capability to use and influence healthcare quality data. With only 12% of Americans proficient in health literacy [5], disclosing information about quality hardly empowers the average patient to choose a provider based on performance. Most patients remain unaware of publicly available quality information. Those who are aware of the available reports may not understand the information [6,7]. Although patients value the disclosure of quality information, they still rely on informal sources, such as family and friends. When it comes to choosing a healthcare provider, the evidence shows that quality plays a small role in the final decision [6]. CENTER FOR HEALTH POLICY MARCH 2011 R E S E A R C H F O R A H E A L T H I E R I N D I A N A
Improvement of transmission loss of a double panel by using active control with a virtual modal mass

In this article, modal feedback control is proposed to reduce the sound transmission through finite double panels using lead zirconate titanate ceramic sensors and actuators bonded to the structure. Active control allows adding virtual modal damping and mass to the structure by the use of modal velocities and accelerations. In a first step, the equations describing the structure, the actuators, the acoustic excitation, and the acoustic radiation are detailed. Next, the state space formulation of the smart structure is presented. In a second step, the implementation of active control is illustrated through the use of numerical examples. Finally, simulations are performed using two actuators, allowing five modes to be controlled. The transmission loss factors of the controlled and uncontrolled structure are shown as a function of the required command voltage. These results are also compared with those achieved using other vibroacoustic control techniques.
Simulating within-vector generation of the malaria parasite diversity

Plasmodium falciparum, the most virulent human malaria parasite, undergoes asexual reproduction within the human host, but reproduces sexually within its vector host, the Anopheles mosquito. Consequently, the mosquito stage of the parasite life cycle provides an opportunity to create genetically novel parasites in multiply-infected mosquitoes, potentially increasing parasite population diversity. Despite the important implications for disease transmission and malaria control, a quantitative mapping of how parasite diversity entering a mosquito relates to diversity of the parasite exiting, has not been undertaken. To examine the role that vector biology plays in modulating parasite diversity, we develop a two-part model framework that estimates the diversity as a consequence of different bottlenecks and expansion events occurring during the vector-stage of the parasite life cycle. For the underlying framework, we develop the first stochastic model of within-vector P. falciparum parasite dynamics and go on to simulate the dynamics of two parasite subpopulations, emulating multiply infected mosquitoes. We show that incorporating stochasticity is essential to capture the extensive variation in parasite dynamics, particularly in the presence of multiple parasites. In particular, unlike deterministic models, which always predict the most fit parasites to produce the most sporozoites, we find that occasionally only parasites with lower fitness survive to the sporozoite stage. This has important implications for onward transmission. The second part of our framework includes a model of sequence diversity generation resulting from recombination and reassortment between parasites within a mosquito. Our two-part model framework shows that bottlenecks entering the oocyst stage decrease parasite diversity from what is present in the initial gametocyte population in a mosquito’s blood meal. However, diversity increases with the possibility for recombination and proliferation in the formation of sporozoites. Furthermore, when we begin with two parasite subpopulations in the initial gametocyte population, the probability of transmitting more than two unique parasites from mosquito to human is over 50% for a wide range of initial gametocyte densities.
The oral glucose tolerance test, revisited.

Hyperglycaemia is necessary for the diagnosis of diabetes. For more than 35 years there has been a spirited controversy about the diagnostic criteria for Type 2 diabetes, in particular about the oral glucose tolerance test (OGTT). In a 1975 paper Marvin Siperstein referred to the OGTT as ‘a pitfall in the diagnosis of diabetes mellitus’. Now the controversy has returned in the wake of the 1997 recommendations by the American Diabetes Association to exclude this test from routine diagnostic and screening efforts. This discussion has expanded beyond the best method to determine the level of glycaemia that defines diabetes, and now embraces questions of the best glucose level to predict an increased risk of future diabetes or future cardiovascular disease. The paper by Qiao et al. in this issue is one of several recent publications that re-examine the OGTT question. The history of the OGTT is instructive. By the 1960s it was recognized that a fasting glucose test would miss many persons who had obvious diabetes when their glucose was measured after a test meal. This led to the development of at least six different recommendations for oral glucose loads ranging from 50 to 100 g without regard to body size, or based on ideal body weight or body surface. Most of these early tests for diabetes required both 1 and 2 h post-challenge blood draws, and the level of glycaemia required for a diagnosis of diabetes varied depending on the protocol. Only one of these early protocols included a fasting blood glucose, and this protocol (with the diagnosis of diabetes based on a point score) required four blood tests, one at 0, 1, 2 and 3 h after an OGTT. Several reasons for not testing post-challenge glycaemia were recognized early, including the poor reproducibility of post-challenge (compared to fasting) glucose levels and the striking effect of age on post-challenge (compared to fasting) glucose. In fact, the high prevalence of diabetes in older adults when the diagnosis was based on post-challenge glucose led to a reluctance to accept the OGTT — on the grounds that so many people could not possibly
Successful vaginal delivery in a patient with extreme thrombotic thrombocytopenic purpura at term

of epidural analgesia with 0.5% lignocaine and 75 mg of fentanyl did not provide adequate analgesia she was given a spinal anaesthetic for the repair. On the first postnatal day, her urine output was 900 ml in 24 h. Her blood pressure was elevated at 150/90 mmHg with no evidence of proteinuria. Blood investigations revealed an elevated creatinine at 163 mmol/l (normal 60–120 mmol/l). Coagulation studies and liver function tests were normal. A renal scan revealed bilateral mild hydronephrosis. She was reviewed by a urologist who advised conservative management and avoidance of NSAIDs. Her renal function returned to normal on the 3rd postnatal day and she was discharged from hospital in good condition on the 5th postnatal day. At her 6-week postnatal visit, she was well with no detectable problems.
MSS4, a Phosphatidylinositol-4-phosphate 5-Kinase Required for Organization of the Actin Cytoskeleton in Saccharomyces cerevisiae *

The Saccharomyces cerevisiae protein MSS4 is essential and homologous to mammalian phosphatidylinositol-4-phosphate (PI(4)P) 5-kinases. Here, we demonstrate that MSS4 is a lipid kinase. MSS4 has dual substrate specificity in vitro, converting PI(4)P to PI(4,5)P2 and to a lesser extent PI(3)P to PI(3,4)P2; no activity was detected with PI or PI(5)P as a substrate. Cells overexpressing MSS4 contain an elevated level specifically of PI(4,5)P2, whereas mss4mutant cells have only approximately 10% of the normal amount of this phosphorylated phosphoinositide. Furthermore, cells lacking MSS4 are unable to form actin cables and to properly localize their actin cytoskeleton during polarized cell growth. Overexpression ofRHO2, encoding a Rho-type GTPase involved in regulation of the actin cytoskeleton, restores growth and polarized distribution of actin in an mss4 mutant. These results suggest that MSS4 is the major PI(4)P 5-kinase in yeast and provide a link between phosphoinositide metabolism and organization of the actin cytoskeletonin vivo.
Expression of both Bacillus subtilis threonyl-tRNA synthetase genes is autogenously regulated

The "housekeeping" threonyl-tRNA synthetase gene (thrS) of Bacillus subtilis is shown to be transcribed in vivo and in vitro from a single promoter. In vitro, 85% of all messages transcribed from the thrS promoter are terminated at a strong factor-independent terminator localized upstream of the thrS Shine-Dalgarno sequence, within the 305-nucleotide-long leader region. Overexpression of thrS represses transcriptional and translational thrS-lacZ fusions to a similar extent, suggesting that thrS is autoregulated at the transcriptional level. We show that autogenous control does not act at the level of transcription initiation but involves antitermination of the transcription mechanism. thrZ, the second threonyl-tRNA synthetase gene, is also autogenously regulated. However, the ability of the ThrS synthetase to repress thrS as well as thrZ expression is much greater than that of the ThrZ synthetase.
Effect of tumbling time and injection rate on the processing characteristics, tenderness and color of pork Biceps femoris muscle.

The effect of tumbling time (0-9 hours) on quality characteristics of cooked pork meat processed with 30% and 40% injection level was investigated. The properties of injected and tumbled meat were determined by measuring processing characteristics (tumbling yield, cooked yield, expressed moisture), color and textural characteristics (shear force, texture profile analysis). The increase of the tumbling time up to 9 hours favorably affected hydration properties and increased the cooked yield. It also decreased the shear force and hardness of the samples. None of the techniques utilized did affect the chromatic components (p>0.05) of the samples, however there were differences between samples regarding the injection rate.