Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of self‐management training in Type 2 diabetes: a randomized, prospective trial

Aims The efficacy of three education programmes for Type 2 diabetic patients was tested in a randomized trial. A didactic‐oriented training programme (treatment A) was compared with a self‐management‐oriented programme delivered in group sessions (treatment B). The latter programme was compared with a more individualized approach (treatment C).
Contribution of Thymidylate Synthase to Gemcitabine Therapy for Advanced Pancreatic Cancer

Objectives: Thymidylate synthase (TS) inhibitors activate human equilibrative nucleoside transporter 1. We evaluated the contribution of TS expression to determine a treatment method providing an effect from gemcitabine (GEM). Methods: The expression of 5-fluorouracil (5-FU) and GEM metabolic factors (5-FU: TS, dihydropyrimidine dehydrogenase, orotate phosphoribosyltransferase; GEM: human equilibrative nucleoside transporter 1, deoxycytidine kinase, cytidine deaminase, 5&vprime;-nucleotidase) were studied in 7 pancreatic cancer cell lines by Western blotting, and drug resistance was evaluated by 3-[4,5-dimethylthiazol]-2,5-dephenyl tetrazolium bromide assay. The expression of 5-FU factors was observed immunohistochemically in resected pancreatic cancer specimens. Results: Gemcitabine concentrations that inhibited colony formation by 50% correlated with TS protein expression (P = 0.0169). With a 5-FU non-growth-inhibiting dose, GEM concentrations that inhibited colony formation by 50% were significantly reduced by one fourth to one tenth. Knockout of TS expression by small interfering RNA decreased resistance to GEM in the cell lines (P = 0.0019). Immunohistochemically, TS expression related to disease-free survival time of patients treated with GEM (P = 0.0224). A high expression of 5-FU factors was detected: orotate phosphoribosyltransferase: differentiated cases (P = 0.0137), lower T factor (P = 0.0411); dihydropyrimidine dehydrogenase: nerve invasion (P = 0.0188), lymph node recurrence (P = 0.0253); TS, positive N factor (P = 0.0061). Conclusions: The expression of TS provides an alternative source of substrate for DNA synthesis and positively correlates with GEM resistance and shortened patient survival. Abbreviations: GEM - gemcitabine, 5-FU - 5-fluorouracil, TS - thymidylate synthase, DPD - dihydropyrimidine dehydrogenase, OPRT - orotate phosphoribosyltransferase, hENT1 - human equilibrative nucleoside transporter 1
Pull-In Analysis of Torsional Scanners Actuated by Electrostatic Vertical Combdrives

This paper presents pull-in analysis of torsional MEMS scanners actuated by electrostatic vertical combdrives with general comb gap arrangements and cross sections. The analysis is based on a 2-DOF actuator with a single voltage control. Three failure modes of the scanners are identified as in-plane twist, transversal motion, and out-of-plane twist. For each failure mode, analytical expressions of pull-in deflection are obtained by applying 2D analytical capacitance models to the derived pull-in equations. From these, the dominant pull-in mechanism is shown to be in-plane twist for scanners with high-aspect-ratio torsional springs. The analytical calculations for both symmetric and asymmetric capacitances are shown to be in good agreement with simulation results. The optimum scanner design is achieved when the pull-in deflection matches the capacitance maximum angle. The condition can be expressed in terms of the ratio of the comb thickness to the comb gap, which is smaller than the typical aspect ratio of deep reactive ion etching. The optimum tradeoff between the maximum deflection angle and the number of movable combs is achieved by adjusting the overlap of the movable and fixed combs and the distance of the comb sets from the axis of the rotation.
Medical management of Crohn's disease

Introduction: The medical approach to Crohn's disease has been modified in recent years thanks to the introduction of new therapies, like biologics. Also, well-designed studies and systematic reviews have allowed better evaluation of the role of old drugs like steroids and immunosuppressors. This review aims to evaluate the recent evidence on the medical approach to Crohn's disease in the different settings of the disease. Areas covered: Randomized controlled trials and meta-analyses were included in the review. The research on all the studies discussed was based on the Cochrane Library, Medline and Embase, using the following medical subject headings: Crohn's disease, clinical trial, therapy, 5-aminosalicylicacid, steroid, budesonide, immunosuppressant, anti-meta-analysis TNF and biologics. Expert opinion: In a mild active inflammatory ileocecal disease, budesonide is considered the best approach. The efficacy of aminosalicylates is limited, but a trial that has recently compared aminosalicylates and budesonide has shown that the two drugs are comparable. In a mild colonic disease, sulfasalazine, antibiotics and steroids are effective but the evidence for antibiotics is less clear. The maintenance of remission in this setting is debatable, but sulfasalazine seems the better choice. In a moderate severe ileal and colonic disease, steroids are the best therapy to induce remission. Once remission is reached, immunosuppressors remain today the better choice to maintain the remission. Anti-TNF therapy is indicated in patients intolerant or not responding to steroids and immunosuppressors and in fistulizing Crohn's disease. Early therapy with biologics may be considered in patients with severe disease.
Commentary on “Dissociation in Trauma: A New Definition and Comparison with Previous Formulations” by Nijenhuis and Van der Hart

I have often argued that the construct of dissociation lacks clarity and that the term dissociation is widely used without consideration for its varied meanings and implications. I agree that more precise and explicit definitions of dissociation are essential if we are to move forward in this field, and therefore I applaud Professors Nijenhuis and Van der Hart’s efforts in this regard. There is much that I like about this article, which is a welcome extension of the theory of structural dissociation of the personality, one of the most interesting and insightful approaches in this area. There are also aspects of the article that I regard less favorably or that, for me, require clarification. Like the authors, I believe it is crucial to distinguish between the processes of dissociation and the symptoms that result from those processes. We also agree that different processes may be responsible for the various symptoms that compose the “domain” of dissociation (Cardeña, 1994). In particular, we agree on the need to distinguish between symptoms that are characterized by an altered state of consciousness and those that relate more to the dissociation of mental subsystems (Brown, 2002a, 2002b, 2004, 2005, 2006; Holmes et al., 2005). Unlike Nijenhuis and Van der Hart, however, I am less convinced that conditions characterized solely by alterations in consciousness (e.g., depersonalization disorder) should be excluded from the domain. Although there is a conceptual logic to this view, such altered states of consciousness are regarded as paradigmatic dissociative phenomena by many both within and outside the field (witness the popularity of the “peritraumatic dissociation” concept, for example). For this reason, I believe
Incidence and epidemiological features of dengue in Sabah, Malaysia

In South East Asia, dengue epidemics have increased in size and geographical distribution in recent years. We examined the spatiotemporal distribution and epidemiological characteristics of reported dengue cases in the predominantly rural state of Sabah, in Malaysian Borneo–an area where sylvatic and urban circulation of pathogens are known to intersect. Using a public health data set of routinely notified dengue cases in Sabah between 2010 and 2016, we described demographic and entomological risk factors, both before and after a 2014 change in the clinical case definition for the disease. Annual dengue incidence rates were spatially variable over the 7-year study period from 2010–2016 (state-wide mean annual incidence of 21 cases/100,000 people; range 5-42/100,000), but were highest in rural localities in the western districts of the state (Kuala Penyu, Nabawan, Tenom and Kota Marudu). Eastern districts exhibited lower overall dengue rates, although a high proportion of severe (haemorrhagic) dengue cases (44%) were focused in Sandakan and Tawau. Dengue incidence was highest for those aged between 10 and 29 years (24/100,000), and was slightly higher for males compared to females. Available vector surveillance data indicated that during large outbreaks in 2015 and 2016 the mosquito Aedes albopictus was more prevalent in both urban and rural households (House Index of 64%) than Ae. aegypti (15%). Demographic patterns remained unchanged both before and after the dengue case definition was changed; however, in the years following the change, reported case numbers increased substantially. Overall, these findings suggest that dengue outbreaks in Sabah are increasing in both urban and rural settings. Future studies to better understand the drivers of risk in specific age groups, genders and geographic locations, and to test the potential role of Ae. albopictus in transmission, may help target dengue prevention and control efforts.
[The value of epidemiologic studies of ski injuries].

The Garmisch-Partenkirchen experience--15,513 skiing injuries between 1972 and 1990--was compared to the results of an inquiry into the skiing injuries among 565 persons of the medical profession, that were active skiers over an average of 18 years. The parameter injuries per 1000 skiing days was calculated from the outpatient clinic data as well as from all skiing injuries that had happened in the interview group and those that required surgical treatment. The mean value of 2.7 injuries/1000 skiing days--corrected for the number of patients--from the literature and the clinical data with 2.1 is comparable to the 1.8 injuries/1000 skiing days (injuries that required surgical treatment) but stands sharply against the 4.2 arising from the total number of injuries in the inquiry group. --Thus, every epidemiological study clearly underestimates the actual rate of skiing injuries. This fact may be defined as the "bypass-effect". The comparison between clinical setting and inquiry allowed for a quantification: Depending on the type of injury and the study design, a true prevalence of skiing injuries that is between 10% and 200% higher than the published data has to be expected. --Descriptive, not controlled epidemiologic studies on skiing injuries are justified and give valid trends on which therapeutic and prophylactic measures can be based--but exclusively under the following prerequisite conditions: 1. a standardized study protocol; 2. an observation.
Attitudes of Icelandic young people toward sexual and reproductive health services.

CONTEXT Iceland has higher levels of fertility among both adult women and adolescents than many other western European countries. There is a need to make sexual and reproductive health services more accessible to teenagers in Iceland. METHODS A descriptive, cross-sectional national postal survey was conducted in 1996 to explore the attitudes of 2,500 young people aged 17-20 toward sexual and reproductive health services in Iceland and to determine which factors might be of importance for the development of such services. RESULTS Icelandic adolescents want specialized sexual and reproductive health services offered within a broad-based service setting. Half of them would prefer to have these services located in a sexual and reproductive health clinic, and about one-third want such services to be located in community health centers. Having services that are free, that are anonymous and that do not require an appointment are important to teenagers who live in Reykjavik, but proximity and equal access to services are more highly valued by adolescents who live outside Reykjavik. Characteristics that young women, in particular, value include close proximity to services, access to a comfortable environment, a friendly staff, absolute confidentiality, and the ability to come with a friend and to have enough time for discussion. Adolescents who have already used contraceptive services mentioned that they need enough time for discussion and that they value high-quality client-provider interaction. CONCLUSIONS The attitudes of adolescents should be considered when specialized sexual and reproductive health services are developed for young people in Iceland. Specialized services that respond to the unique concerns of adolescents may increase their utilization of contraceptive methods and other reproductive health services.
Systematic Profiling of Poly(A)+ Transcripts Modulated by Core 3’ End Processing and Splicing Factors Reveals Regulatory Rules of Alternative Cleavage and Polyadenylation

Alternative cleavage and polyadenylation (APA) results in mRNA isoforms containing different 3’ untranslated regions (3’UTRs) and/or coding sequences. How core cleavage/polyadenylation (C/P) factors regulate APA is not well understood. Using siRNA knockdown coupled with deep sequencing, we found that several C/P factors can play significant roles in 3’UTR-APA. Whereas Pcf11 and Fip1 enhance usage of proximal poly(A) sites (pAs), CFI-25/68, PABPN1 and PABPC1 promote usage of distal pAs. Strong cis element biases were found for pAs regulated by CFI-25/68 or Fip1, and the distance between pAs plays an important role in APA regulation. In addition, intronic pAs are substantially regulated by splicing factors, with U1 mostly inhibiting C/P events in introns near the 5’ end of gene and U2 suppressing those in introns with features for efficient splicing. Furthermore, PABPN1 inhibits expression of transcripts with pAs near the transcription start site (TSS), a property possibly related to its role in RNA degradation. Finally, we found that groups of APA events regulated by C/P factors are also modulated in cell differentiation and development with distinct trends. Together, our results support an APA code where an APA event in a given cellular context is regulated by a number of parameters, including relative location to the TSS, splicing context, distance between competing pAs, surrounding cis elements and concentrations of core C/P factors.
Ensemble-Kalman-Filter-Based Power System Harmonic Estimation

The growing use of power-electronics-based components and nonlinear loads is increasing the presence of harmonics in power system signals. In this scenario, proper estimation of such harmonics is intended to maintain power quality and improved operation of the system. It is also desirable that the estimation technique should be computationally efficient while being accurate. From this viewpoint, this paper proposes a nonlinear state estimation technique based on ensemble Kalman filtering for estimation of harmonics, interharmonics, and subharmonics, all using a single framework and at a time, from distorted power system signal. The proposed technique is computationally efficient compared to conventional Kalman filtering leading to less computational cost and hardware requirement. It is observed from both simulation and experimental studies that the proposed ensemble Kalman filter (KF) approach to estimation of harmonics, interharmonics, and subharmonics in a distorted power system signal exhibits superior estimation performance in terms of tracking time and accuracy as compared to performances of some of the existing techniques such as recursive least square, recursive least mean square, and KF algorithms. The proposed technique is also found to be robust and gives accurate estimates even in the presence of amplitude variations in the measured signal.
The influence of NF‐κB signal‐transduction pathways on the murine inner ear by acoustic overstimulation

Nuclear factor‐kappa B (NF‐κB) comprises a family of inducible transcription factors that serve as important regulators of the host immune and inflammatory responses. The NF‐κB signals are activated via the canonical and/or noncanonical pathways in response to diverse stimuli. The excessive action of NF‐κB signal‐transduction pathways frequently causes self‐injurious phenomena such as allergic diseases, vascular disorders, and ischemia–reperfusion neuronal damage. In the inner ear, the role of NF‐κB has not been clarified because the activated NF‐κB signals potentially induce both cytoprotective and cytotoxic target genes after ototoxic stimulation. In the present study, we investigated the response of NF‐κB in both the canonical and noncanonical pathways to acoustic overstimulation (117 dB/SPL/2 hr) and followed the change of inflammatory factors (inducible nitric oxide synthase [iNOS], intracellular adhesion molecule‐1 [ICAM‐1], and vascular cell adhesion molecule‐1 [VCAM‐1]) in the cochlear lateral wall (CLW) and the rest of cochlea (RoC). By means of immunohistochemistry combined with confocal microscopy and reverse transcriptase–polymerase chain reaction techniques, we found the response of NF‐κB family members (NF‐κB1, 2, RelA, and RelB) at the transcription level. After the NF‐κB signaling, the inflammatory factors were significantly increased in the CLW and the RoC. Additionally, at the protein level, the prominent expression of adhesion molecules (ICAM‐1 and VCAM‐1) was observed in the tissue around the capillaries in the stria vascularis. These results show that acoustic overstimulation causes the NF‐κB signaling to overexpress the inflammatory factors in the inner ear, and the up‐regulation of the adhesion molecules (ICAM‐1 and VCAM‐1) and iNOS potentially influence the hemodynamics and the cellular integrity in the stria vascularis. © 2009 Wiley‐Liss, Inc.
Placement of observations for the efficient estimation of a psychometric function.

Psychometric functions for different psychophysical tasks describe the relationship between physical stimuli and subjects' responses. Although a psychometric function is of considerable value, characterizing the function is time consuming and, hence, is not carried out routinely in psychophysical experiments. A principal reason for the lack of efficiency in characterizing the psychometric function is the use of unimodal (e.g., Gaussian and uniform) sampling methods. As an alternative, a multimodal four-point sampling method is proposed. A psychometric function is then fitted to the four data points (each with several trials) to estimate the threshold and slope parameters of the psychometric function. Results from three examples demonstrate that a 60% savings in data-collection time can be achieved.
Modélisation d'évolution de profil utilisateur en recherche d'information personnalisée

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Coagulation and Fibrinolytic Profile of Paediatric Patients Undergoing Cardiopulmonary Bypass

Summary The haemostatic system and the use of heparin during cardiopulmonary bypass (CPB) have been studied extensively in adults but not in children. Results from adult trials cannot be extrapolated to children because of age-dependent physiologic differences in haemostasis. We studied 22 consecutive paediatric patients who underwent CPB at The Hospital for Sick Children, Toronto. Fibrinogen, factors II, V, VII, VIII, IX, XI, XII, prekallikrein, protein C, protein S, antithrombin (AT), heparin cofactor II, α2-macroglobulin, plasminogen, α2-antiplas- min, tissue plasminogen activator (tPA), plasminogen activator inhibitor, thrombin-AT complexes (TAT), D-dimer, heparin (by both anti-factor Xa assay and protamine titration) and activated clotting time (ACT) were assayed perioperatively. The timing of the sampling was: pre heparin, post heparin, after initiation of CPB, during hypothermia, post hypothermia, post protamine reversal and 24 h post CPB. Plasma concentrations of all haemostatic proteins decreased by an average of 56% immediately following the initiation of CPB due to haemodilution. During CPB, the majority of procoagulants, inhibitors and some components of the fibrinolytic system (plasminogen, α2AP) remained stable. However, plasma concentrations of TAT and D-dimers increased during CPB showing that significant activation of the coagulation and fibrinolytic systems occurred. Mechanisms responsible for the activation of haemostasis are likely complex. However, low plasma concentrations of heparin (<2.0 units/ml in 45% of patients) during CPB were likely a major contributing etiology. ACT values showed a poor correlation (r = 0.38) with heparin concentrations likely due to concurrent haemodilution of haemostatic factors, activation of haemostatic system, hypothermia and activation of platelets. In conclusion, CPB in paediatric patients causes global decreases of components of the coagulation and fibrinolytic systems, primarily by haemodilution and secondarily by consumption.
Vibrational Braille code display with MEMS-Based hydraulic diplacement amplification mechanism

We demonstrate an efficient vibrational Braille code display with large-displacement MEMS actuator arrays. The large displacement is realized by hydraulic displacement amplification mechanisms (HDAM). Static and dynamic characteristics of HDAM were investigated and 18- and 11-fold amplification were achieved in static and dynamic (at 70 Hz) actuation, respectively. We applied actuator arrays consisting of HDAM and piezoelectric actuators to Braille code display. Owing to the characteristics of finger tactile receptors being more sensitive to vibrational stimuli than static ones and the natural frequency of HDAM, vibrational actuation at 70 Hz, which required a low voltage of 30V for subjects to detect the code, were more efficient than static actuation, which required 65V, and vibrational actuation at other frequencies.
Crimp morphology in the ovine anterior cruciate ligament

While the crimp morphology in ligaments and tendons has been described in detail in the literature, its relative distribution within the tissue has not been studied, especially in relation to the complex multi‐bundle arrangement as is found in the anterior cruciate ligament (ACL). In this study, the crimp morphology of the ovine ACL was examined topologically and with respect to its double‐bundle structure. The crimp morphologies were compared with the knee in three knee positions, namely stance, maximum extension and maximum flexion. As a control, the crimp morphology of the ACL free from its bony attachments was determined. In the control samples, the anterior‐medial (AM) bundle contained a combination of coarse and fine crimp, whereas the posterior‐lateral (PL) bundle manifested only a coarse crimp. Using the extent of crimp loss observed when subjecting the knee to the respective positions, and comparing with the controls, the crimp morphologies show that the AM bundle of the ACL is most active in the stance position, whereas for the maximum extension and flexion positions the PL bundle is most active. We propose that these differences in crimp morphologies have relevance to ACL design and function.