Miracle-dz/UniFAR-FTUs huggingface dataset:
High-dose therapy improves progression-free survival and survival in relapsed follicular non-Hodgkin's lymphoma: results from the randomized European CUP trial.

PURPOSE To determine, in a randomized clinical trial, whether high-dose therapy (HDT) followed by autologous stem-cell transplantation is more effective than standard treatment with regard to progression-free survival (PFS) and overall survival (OS) in patients with relapsed follicular non-Hodgkin's lymphoma; and to assess the additional value of B-cell purging of the stem-cell graft with regards to PFS and OS. PATIENTS AND METHODS Patients received three cycles of chemotherapy. Responding patients with limited bone marrow infiltration were eligible for random assignment to three further cycles of chemotherapy (C), unpurged HDT (U), or purged HDT (P). RESULTS Between August 1993 and April 1997, 140 patients were registered from 36 centers internationally, and 89 were randomly assigned. Reasons for not randomizing included patient refusal, early progression, or death on induction therapy. With a 69-month median follow-up, the log-rank P value for PFS and OS were.0037 and.079, respectively. For PFS, the hazard ratios (95% CIs) for U versus C, P versus C, and P versus U were 0.33 (0.16 to 0.70), 0.38 (0.19 to 0.79), and 1.02 (0.51 to 2.05), respectively. The hazard ratio (95% CI) for C versus U + P was 0.30 (0.15 to 0.61). Hazard ratios (95% CIs) for OS were 0.43 (0.18 to 1.06), 0.43 (0.18 to 1.02), and 0.72 (0.32 to 1.63). For C versus U + P, the hazard ratio (95% CI) was 0.40 (0.18 to 0.89). Kaplan-Meier estimates (95% CIs) of 2-year PFS for C, U, and P were 26% (8% to 44%), 58% (37% to 79%), and 55% (34% to 75%), respectively. OS at 4 years for C, U, and P are 46% (25% to 67%), 71% (52% to 91%), and 77% (60% to 95%) respectively. CONCLUSION HDT significantly improves PFS and OS. There is no clear evidence of benefit through purging.
Recovery and Coherency-Control Protocols for Fast Intersystem Page Transfer and Fine-Granularity Locking in a Shared Disks Transaction Environment

llbstract This paper proposes schemes for fast page transfer between transaction system Instances In a shared disks (SD) environment where all the sharing Instances can read and modify the same data Fast page transfer improves transaction response time and concurrency because one or more disk I/OS are avoided while transferring a page from a system which modified it to another system which needs it. The proposed methods work with the steal and no-force buffer management policies, and fine-granularity (e.g., record) locking For each of the page-transfer schemes, we present both recovery and coherency-control protocols Updates can be made to a page by several systems before the page is written to disk. Many subtleties Involved in correctly recovering such a page in the face of single system or complex-wide failures are also discussed. Assuming that each system maintains its own log, some methods require a merged log for restart recovery while others don’t Our proposals should also apply to dlstrihuted. recoverable file systems and distributed virtual memory in the SD environment, and to the currently oopular client-server object-oriented DBMS environments where the clients cache data.
A fuzzy-based decision making procedure for machine selection problem

The selection of appropriate machines is one of the most critical decisions in the design and development of an efficient production environment. It is the fact that improper machine selection can result in quality, flexibility, productivity, etc., problems and negatively affect the overall performance and productivity of a manufacturing system. On the other hand, selecting the best machine among many alternatives is a multi-criteria decision making (MCDM) problem. In this paper, a fuzzy-based MCDM approach is used. For this aim, the fuzzy analytic network process (FANP) is used to determine weights of the criteria and preference ranking organization method for enrichment evaluations (PROMETHEE) is used to obtain final ranking of alternative machines. The proposed approach is applied for the selection of a CNC router machine (RM) to be purchased in an international company. In the problem addressed, there are four main criteria, namely cost, quality, flexibility and performance with the corresponding fourteen sub-criteria. The results for the case study indicate the best machine among six potential alternatives and provide different managerial insights for the decision makers.
Opsonization of encapsulated Cryptococcus neoformans by specific anticapsular antibody

Antisera prepared in rabbits against either whole encapsulated cells of Cryptococcus neoformans or purified cryptococcal polysaccharide were opsonic for the encapsulated yeast. The opsonic activity was removed by absorption with whole cryptococci and was inhibited by free polysaccharide. As little as 0.13 microgram of cryptococcal polysaccharide produced a 50% inhibition of opsonization. Various degrees of neutralization by polysaccharides from the four cryptococcal serotypes suggested that the opsonins were type specific. Fractionation of antiserum on Bio-Gel A-5m (Bio-Rad Laboratories) and diethylaminoethyl cellulose showed that the opsonins were antibodies of the immunoglobulin G class. These opsonizing antibodies did not require heat-labile serum components for optimal phagocytosis of the yeast. Inhibition studies using 2-deoxy-D-glucose demonstrated that ingestion of encapsulated cryptococci opsonized with anticapsular antibody was a 2-deoxy-D-glucose-inhibitable process. This result differed from similar studies with non-encapsulated cryptococci which showed that ingestion of non-encapsulated cryptococci opsonized with normal serum was not inhibited by 2-deoxy-D-glucose.
Fluid volume, lactate values, and mortality in sepsis patients with intermediate lactate values.

RATIONALE Patients with severe sepsis without shock or tissue hypoperfusion face substantial mortality; however, treatment guidelines are lacking. OBJECTIVES To evaluate the association between intravenous fluid resuscitation, lactate clearance, and mortality in patients with "intermediate" lactate values of 2 mmol/L or greater and less than 4 mmol/L. MEASUREMENTS AND MAIN RESULTS This was a retrospective study of 9,190 patients with sepsis with intermediate lactate values. Interval changes between index lactate values and those at 4, 8, and 12 hours were calculated with corresponding weight-based fluid volumes. Outcomes included lactate change and mortality. Repeat lactate tests were completed in 94.7% of patients within 12 hours. Hospital and 30-day mortality were 8.2 and 13.3%, respectively, for patients with lactate clearance; they were 18.7 and 24.7%, respectively, for those without lactate clearance. Each 10% increase in repeat lactate values was associated with a 9.4% (95% confidence interval [CI] = 7.8-11.1%) increase in the odds of hospital death. Within 4 hours, patients received 32 (± 18) ml/kg of fluid. Each 7.5 ml/kg increase was associated with a 1.3% (95% CI = 0.6-2.1%) decrease in repeat lactate. Across an unrestricted range, increased fluid was not associated with improved mortality. However, when limited to less than 45 ml/kg, additional fluid was associated with a trend toward improved survival (odds ratio = 0.92; 95% CI = 0.82-1.03) that was statistically significant among patients with highly concordant fluid records. CONCLUSIONS Early fluid administration, below 45 ml/kg, was associated with modest improvements in lactate clearance and potential improvements in mortality. Further study is needed to define treatment strategies in this prevalent and morbid group of patients with sepsis.
Sparse representation of LPC for analysis of stressed speech in lower dimensional subspace

This work explores a novel stressed speech recognition method based on sparse representation (SR) of vocal-tract system information, which is extracted using the linear prediction coefficients (LPCs). To accomplish this, the LPCs for neutral and stressed speech are linearly transformed with sparsity onto the common subspace, which consists of parameters of vocal-tract system of neutral condition to reduce the acoustic mismatch between them. The dictionary is created by employing the duration parameter of speech, which is modeled using the K-nearest-neighbour (K-NN) algorithm and is found to greatly reduce the acoustic variation in contrast to the K-SVD algorithm-based learned dictionary. Consequently, the synthesis of neutral and stressed speech using the projected LPCs constitutes the similar acoustic attributes. To further improve the system performance, the synthesized speech are projected onto the lower dimensional subspace. The low-rank projections derived using the synthesized neutral speech exploits linear discriminant analysis (LDA) and is explored by employing acoustic models based on Gaussian mixture model (GMM) as well as deep neural network (DNN). Speaker normalization is done using feature-space maximum-likelihood linear regression (fMLLR). Consistent improvements are noted for the proposed method in all the discussed cases.
Chikungunya Infection: An Emerging Rheumatism Among Travelers Returned From Indian Ocean Islands. Report of 47 Cases

A large chikungunya virus (CHIKV) outbreak emerged in 2005-2006 in the Indian Ocean islands, including Comoros, Mayotte, Mauritius, the Seychelles, and particularly in Reunion Island where 35% of 770,000 inhabitants were infected in 6 months. More recently, circulation of the virus has been documented in Madagascar and in India where CHIKV is spreading rapidly. CHIKV-infected visitors have returned home to nonendemic regions from these islands. We conducted a 14-month prospective observational study on the clinical aspects of CHIKV infection imported to Marseilles, France, in travelers returning from the Indian Ocean islands. A total of 47 patients have been diagnosed with imported CHIKV infection confirmed by serology, reverse transcription-polymerase chain reaction, and/or viral culture. At the early stage of the disease (within 10 days of the disease onset), fever was present in 45 of 47 patients. A rash was present in the first week in 25 cases. All patients suffered with arthritis. The most frequently affected joints were fingers, wrists, toes, and ankles. Eight patients were hospitalized during the acute stage, including 2 severe life-threatening cases. A total of 38 patients remained symptomatic after the tenth day with chronic peripheral rheumatism, characterized by severe joint pain and multiple tenosynovitis, with a dramatically limited ability to ambulate and carry out activities in daily life. Three patients were hospitalized at this stage for severe persistent handicap. Follow-up demonstrated slow improvement in joint pain and stiffness despite symptomatic treatment, mainly antiinflammatory and analgesic drugs. In the current series we describe 2 stages of the disease, an initial severe febrile and eruptive polyarthritis, followed by disabling peripheral rheumatism that can persist for months. We point out the possibility of transitory peripheral vascular disorders during the second stage and the occasional benefit of short-term corticosteroids. As CHIKV could spread throughout the world, all physicians should be prepared to encounter this arboviral infection.Abbreviations: CHIKV = chikungunya virus, MRI = magnetic resonance imaging, NSAIDs = nonsteroidal antiinflammatory drugs, RT-PCR = reverse transcription-polymerase chain reaction.
Antithrombin activity and outcomes in patients undergoing cardiac surgery with cardiopulmonary bypass

We recently reported prospective results from a cohort of patients scheduled for elective cardiac surgery with cardiopulmonary bypass (CPB) in which most baseline clinical parameters of patients and surgery outcomes failed to demonstrate relationships with post-CPB antithrombin (AT) activity. In this extension study, a larger sample size (250 patients) was analyzed following general linear models. Patients’ sociodemographic and pre-CPB clinical data as well as pre/post-CPB AT activity and outcomes were collected. There was a significant decrease of post-CPB AT activity (95.6 ± 13.7–64.6 ± 12.1%; P < 0.001). Univariate and multivariate analyses revealed that a decrease of approximately 1% post-CPB AT activity may be expected per 3 years increase in patient's age. Univariate analysis showed that post-CBP AT activity was inversely related to the need for transfusions, acute renal failure and occurrence of any complication (re-intervention, low cardiac output, arrhythmia, lung dysfunction, stroke, acute renal failure, mesenteric ischemia and re-hospitalization; P < 0.05). Multivariate analysis adjusted for age and pre-CPB AT did not show statistical significance. Odds ratio (OR) less than 1 was observed in most outcomes (0.8 on average), which suggested a reduction of the probability for an increase of 10% in post-CBP AT. Our results confirm the role of low postsurgery AT activity influencing outcomes in patients undergoing CPB.
Inhibition of peri-implant bone loss with the nonsteroidal anti-inflammatory drug flurbiprofen in beagle dogs. A preliminary study.

There is increasing interest in how pathways of tissue destruction around dental implants are similar as for teeth and how these pathways can be modulated to slow loss of supporting bone. The purposes of this study were to develop a short-term animal model to study the effect of the nonsteroidal anti-inflammatory drug flurbiprofen, on slowing the rate of induced peri-implant bone resorption. A total of 20 cylindrical titanium implants were placed in 2 beagle dogs using a low-trauma surgical technique. During the 3-month healing period without functional loading of the implants, daily oral hygiene was performed to maintain a Gingival Index of 0 to 0.5. At completion of the healing period, a baseline evaluation was performed which included the uptake of the bone-seeking radiopharmaceutical (BSRU) 99mtechnetium-tin-diphosphonate (99mTc-Sn-MDP) in peri-implant bone and standardized radiographs. Peri-implantitis was induced with 4-0 silk ligatures, cessation of oral hygiene and soft diet. One beagle was given 0.02 mg/kg of flurbiprofen by mouth; the other received a placebo. BSRU and radiographic height of bone were remeasured to calculate the rate of bone loss during the 60-day treatment period. The percent rate of bone loss during the study period was calculated from the radiographs using a computer-assisted method. The radiopharmaceutical uptake for the flurbiprofen-treated implants remained unchanged. However, BSRU for placebo-treated implants was significantly increased from baseline. (ABSTRACT TRUNCATED AT 250 WORDS)
ACL injury in football: a literature overview of the prevention programs.

BACKGROUND The ACL prevention programs are addressed to the control and/or modification of the so-called "modifiable risk factors". All these programs focus on different intervention strategies aimed to decrease the ACL injury risk, particularly in female athletes population. PURPOSE To furnish an overview of the most used ACL injury prevention program through a narrative review. CONCLUSION In literature there are many reports on prevention programs whose common denominator is the proper alignment of the lower limb joints and proper motor control during movements that are considered at risk for ACL integrity, as the landing phase after a jump. Nevertheless, some programs would appear more effective than others. In any cases a major problem remains the lack of sufficient compliance in respect of prevention programs. Finally, it is important to remember that the ethiology of ACL injuries is multifactorial. For this reason a prevention program able to prevent all the risk situations is utopian. STUDY DESIGN Narrative review.
Death rates from ischemic heart disease in women with a history of hypertension in pregnancy.

BACKGROUND Evidence about the influence of hypertension in pregnancy on later health and in particular the risk of cardiovascular disorders is conflicting, although a link has been suggested. In a population-based study with a long follow-up time the potential association between hypertension in pregnancy, preeclampsia and eclampsia with increased death rates from ischemic heart disease (IHD) was investigated. METHODS All 7543 case records at the main maternity hospital in Iceland during 1931-1947 were reviewed to identify women with hypertension in pregnancy, subdivided by parity and severity of disease into those with eclampsia, preeclampsia and hypertension alone. Information on those who had died was obtained from death certificates, supplemented by autopsy reports and hospital records. Death rates from IHD were compared to population data from public health and census reports during corresponding periods and between study groups. RESULTS Of 374 hypertensive women 177 had died. The death rate was slightly higher among women with any hypertension in pregnancy than in the reference population (RR = 1.20; 95% CI 1.01-1.42). About half of the increase was attributed to excess mortality from IHD with a relative risk of dying of 1.47 (95% CI 1.05-2.02). The relative risk of dying from IHD was significantly higher among eclamptic women (RR = 2.61; 95% CI 1.11-6.12) and those with preeclampsia (RR = 1.90; 95% CI 1.02-3.52) than those with hypertension alone. Parous women at the index pregnancy had a twofold higher risk of dying from IHD than primigravid women (RR = 2.05; 95% CI 1.19-3.55; p = 0.01). CONCLUSION There is an indication of increased death rates among women with a history of hypertension in pregnancy, where ischemic heart disease may be more common than in the general population.
The mRNA-bound proteome of the early fly embryo

Early embryogenesis is characterized by the maternal to zygotic transition (MZT), in which maternally deposited messenger RNAs are degraded while zygotic transcription begins. Before the MZT, post-transcriptional gene regulation by RNA-binding proteins (RBPs) is the dominant force in embryo patterning. We used two mRNA interactome capture methods to identify RBPs bound to polyadenylated transcripts within the first 2 h of Drosophila melanogaster embryogenesis. We identified a high-confidence set of 476 putative RBPs and confirmed RNA-binding activities for most of 24 tested candidates. Most proteins in the interactome are known RBPs or harbor canonical RBP features, but 99 exhibited previously uncharacterized RNA-binding activity. mRNA-bound RBPs and TFs exhibit distinct expression dynamics, in which the newly identified RBPs dominate the first 2 h of embryonic development. Integrating our resource with in situ hybridization data from existing databases showed that mRNAs encoding RBPs are enriched in posterior regions of the early embryo, suggesting their general importance in posterior patterning and germ cell maturation.
Ionizing Radiation Induces Apoptotic Signal Through Protein Kinase Cδ (delta) and Survival Signal Through Akt and Cyclic-Nucleotide Response Element-Binding Protein (CREB) in Jurkat T Cells

Although ionizing radiation induces a loss of proliferative capacity as well as cell death by apoptosis and necrosis, cells can oppose the damaging effects by activating survival signal pathways. Here we report the effect of 1.5- and 6-Gy doses of ionizing radiation on apoptotic protein kinase Cδ (PKCδ) and survival cyclic-nucleotide response element-binding protein (CREB) signal in Jurkat T cells. Cell cycle analysis, performed by flow cytometry, showed a significant G2M arrest 24 h after exposure to 6 Gy. This arrest was accompanied by dead cells, which increased in number up to 7 days, when cell viability was further reduced. The response was apparently promoted by caspase-3-mediated PKCδ activation, and thus apoptosis. Moreover, the presence of viable cells up to 7 days in samples exposed to 6 Gy is explained by Akt activation, which may influence the nuclear transcription factor CREB, leading to resistance to ionizing radiation. Thus, the knowledge of apoptotic and survival pathways activated in tumor cells may help in establishing specific therapies by combining selective inhibitors or stimulators of key signaling proteins with conventional chemotherapy, hormone therapy, and radiotherapy.
Absence of lipofuscin in motor neurons of SOD1-linked ALS mice

Significance This is the first report, to our knowledge, of the absence of lipofuscin, “aging pigment,” in a setting of motor neuron neurodegenerative disease, mutant SOD1-linked ALS. Although the initial hypothesis was that this must be due to a block in the autophagy/lysosome pathway, instead studies of autophagy markers and of ALS mice treated with chloroquine suggest the opposite, that there is hyperactivity of the autophagy/lysosome pathway, at least in part mediated through MTORC1. Lipofuscin, or aging pigment, is accreted as red autofluorescence in the lysosomes of motor neuron cell bodies in the ventral horn of WT mice by 3 mo of age. Strikingly, in two presymptomatic ALS mouse strains transgenic for mutant human Cu/Zn superoxide dismutase (SOD1), G85R SOD1YFP and G93A SOD1, little or no lipofuscin was detected in motor neuron cell bodies. Two markers of autophagy, sequestosome 1 (SQSTM1/p62) and microtubule-associated protein 1 light chain 3 (LC3), were examined in the motor neuron cell bodies of G85R SOD1YFP mice and found to be reduced relative to WT SOD1YFP transgenic mice. To elucidate whether the autophagy/lysosome pathway was either impaired or hyperactive in motor neurons, chloroquine was administered to 3-mo-old G85R SOD1YFP mice to block lysosomal hydrolysis. After 2 wk, lipofuscin was now observed in motor neurons, and SQSTM1 and LC3 levels approached those of WT SOD1YFP mice, suggesting that the autophagy/lysosome pathway is hyperactive in motor neurons of SOD1-linked ALS mice. This seems to be mediated at least in part through the mammalian target of rapamycin complex 1 (MTORC1) pathway, because levels of Ser757-phosphorylated Unc-51-like kinase 1 (ULK1), an MTORC1 target, were greatly reduced in the G85R SOD1YFP motor neurons, correspondent to an activated state of ULK1 that initiates autophagy.
Revisiting the total contact cast: maximizing off-loading by wound isolation.

Although the benefits of total contact casting for healing plantar neuropathic ulcers are consistent throughout a large body of available literature, the method of cast application varies (1–17). Cast structure at the ulcer site provides one major variance, i.e., should the cast create total contact with the entire plantar surface of the foot or should the wound be isolated? This article aims to resolve this issue by examining the differences in plantar pressure at the wound site between total contact casting using full contact with the plantar aspect of the foot and wound isolation. A total of 10 healthy adult subjects (aged 28 ± 13 years, height 1.81 ± 0.1 m, and weight 92.6 ± 18 kg) with focal areas of pressure (but no history of ulceration) under their metatarsal heads were recruited. For each subject, a region of interest (ROI) was selected to encompass areas of particularly high pressure. This study was approved by the Institutional Review Board of the Cleveland Clinic Foundation, and all subjects signed informed consent forms. A Pliance pressure-sensitive array (Novel) was fixed directly to the subject’s foot covering the ROI. The 16 × 16 sensor array had a sensor size of 19.36 mm2 and a sampling rate of 50 …