Miracle-dz/UniFAR-FTUs huggingface dataset:
Race and Sex Differences in the Incidence and Prognostic Significance of Silent Myocardial Infarction in the Atherosclerosis Risk in Communities (ARIC) Study

Background— Race and sex differences in silent myocardial infarction (SMI) are not well established. Methods and Results— The analysis included 9498 participants from the Atherosclerosis Risk in Communities (ARIC) study who were free of cardiovascular disease at baseline (visit 1, 1987–1989). Incident SMI was defined as ECG evidence of MI without clinically documented MI (CMI) after the baseline until ARIC visit 4 (1996–1998). Coronary heart disease and all-cause deaths were ascertained starting from ARIC visit 4 until 2010. During a median follow-up of 8.9 years, 317 participants (3.3%) developed SMI and 386 (4.1%) developed CMI. The incidence rates of both SMI and CMI were higher in men (5.08 and 7.96 per 1000-person years, respectively) than in women (2.93 and 2.25 per 1000-person years, respectively; P<0.0001 for both). Blacks had a nonsignificantly higher rate of SMI than whites (4.45 versus 3.69 per 1000-person years; P=0.217), but whites had higher rate of CMI than blacks (5.04 versus 3.24 per 1000-person years; P=0.002). SMI and CMI (compared with no MI) were associated with increased risk of coronary heart disease death (hazard ratio, 3.06 [95% confidence interval, 1.88–4.99] and 4.74 [95% confidence interval, 3.26–6.90], respectively) and all-cause mortality (hazard ratio, 1.34 [95% confidence interval, 1.09–1.65] and 1.55 [95% confidence interval, 1.30–1.85], respectively). However, SMI and CMI were associated with increased mortality among both men and women, with potentially greater increased risk among women (interaction P=0.089 and 0.051, respectively). No significant interactions by race were detected. Conclusions— SMI represents >45% of incident MIs and is associated with poor prognosis. Race and sex differences in the incidence and prognostic significance of SMI exist that may warrant considering SMI in personalized assessments of coronary heart disease risk.
RECAST (Remote Ischemic Conditioning After Stroke Trial): A Pilot Randomized Placebo Controlled Phase II Trial in Acute Ischemic Stroke

Background and Purpose— Repeated episodes of limb ischemia and reperfusion (remote ischemic conditioning [RIC]) may improve outcome after acute stroke. Methods— We performed a pilot blinded placebo-controlled trial in patients with acute ischemic stroke, randomized 1:1 to receive 4 cycles of RIC within 24 hours of ictus. The primary outcome was tolerability and feasibility. Secondary outcomes included safety, clinical efficacy (day 90), putative biomarkers (pre- and post-intervention, day 4), and exploratory hemodynamic measures. Results— Twenty-six patients (13 RIC and 13 sham) were recruited 15.8 hours (SD 6.2) post-onset, age 76.2 years (SD 10.5), blood pressure 159/83 mm Hg (SD 25/11), and National Institutes of Health Stroke Scale (NIHSS) score 5 (interquartile range, 3.75–9.25). RIC was well tolerated with 49 out of 52 cycles completed in full. Three patients experienced vascular events in the sham group: 2 ischemic strokes and 2 myocardial infarcts versus none in the RIC group (P=0.076, log-rank test). Compared with sham, there was a significant decrease in day 90 NIHSS score in the RIC group, median NIHSS score 1 (interquartile range, 0.5–5) versus 3 (interquartile range, 2–9.5; P=0.04); RIC augmented plasma HSP27 (heat shock protein 27; P<0.05, repeated 2-way ANOVA) and phosphorylated HSP27 (P<0.001) but not plasma S100-&bgr;, matrix metalloproteinase-9, endocannabinoids, or arterial compliance. Conclusions— RIC after acute stroke is well tolerated and appears safe and feasible. RIC may improve neurological outcome, and protective mechanisms may be mediated through HSP27. A larger trial is warranted. Clinical Trial Registration— URL: http://www.isrctn. com. Unique identifier: ISRCTN86672015.
BMI Trends, Socioeconomic Status, and the Choice of Dataset

Objective:This study is a descriptive investigation of trends in BMI in the USA over time, across race/ethnicity, gender, and socioeconomic status (SES) groups, and across different datasets. Methods: The study analyzes micro-level data from three widely used cross-sectional US health datasets: the National Health and Nutrition Examination Survey (NHANES), the National Health Interview Survey (NHIS), and the Behavioral Risk Factor Surveillance System (BRFSS), from the 1970s to 2008. Consistent race/ethnicity and SES groups are constructed for all datasets. SES is measured by education and income. Focusing on adults aged 20–74 years, the study estimates BMI time trends, distributional shifts, and incremental associations (gradients) with SES. Results: SES-BMI gradients are consistently larger for women than for men, differ across race/ethnicity groups, and are similar across datasets. Trends in mean BMI are comparable across White, Black and Hispanic males, while Hispanic females range between White and Black females. Self-reported BMI in the NHANES differs markedly from self-reports in the NHIS and BRFSS. Conclusion: The NHANES, NHIS, and BRFSS provide similar evidence regarding BMI trends over time and across race/ethnicity, gender, and SES groups. Racial disparities in BMI remain after adjusting for SES and should be studied further.
Determining the Ideal Strategy for Ventilator-associated Pneumonia Prevention. Cost-Benefit Analysis.

RATIONALE Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection with high associated cost and poor patient outcomes. Many strategies for VAP reduction have been evaluated. However, the combination of strategies with the optimal cost-benefit ratio remains unknown. OBJECTIVES To determine the preferred VAP prevention strategy, both from the hospital and societal perspectives. METHODS A cost-benefit decision model with a Markov model was constructed. Baseline probability of VAP, death, reintubation, and discharge from the intensive care unit (ICU) alive were ascertained from clinical trial data. Model inputs were obtained from the medical literature and the U.S. Department of Labor; a device cost was obtained from the manufacturer. Sensitivity analyses were completed to test the robustness of model results. MEASUREMENTS AND MAIN RESULTS Overall least expensive strategy and the strategy with the best cost-benefit ratio, up to a willingness to pay threshold of $50,000-100,000 per case of VAP averted was sought. We examined a total of 120 unique combinations of VAP prevention strategies. The preferred strategy from the hospital perspective included subglottic suction endotracheal tubes, probiotics, and the Institute for Healthcare Improvement VAP Prevention Bundle. The preferred strategy from the point of view of society also included additional prevention measures (oral care with chlorhexidine and selective oral decontamination). No preferred strategies included silver endotracheal tubes or selective gut decontamination. CONCLUSIONS Despite their infrequent use, current data suggest that the use of prophylactic probiotics and subglottic endotracheal tubes are cost-effective for preventing VAP from the societal and hospital perspectives.
Vague Sets Security Measure for Steganographic System Based on High-Order Markov Model

Security measure is of great importance in both steganography and steganalysis. Considering that statistical feature perturbations caused by steganography in an image are always nondeterministic and that an image is considered nonstationary, in this paper, the steganography is regarded as a fuzzy process. Here a steganographic security measure is proposed. This security measure evaluates the similarity between two vague sets of cover images and stego images in terms of n-order Markov chain to capture the interpixel correlation. The new security measure has proven to have the properties of boundedness, commutativity, and unity. Furthermore, the security measures of zero order, first order, second order, third order, and so forth are obtained by adjusting the order value of n-order Markov chain. Experimental results indicate that the larger n is, the better the measuring ability of the proposed security measure will be. The proposed security measure is more sensitive than other security measures defined under a deterministic distribution model, when the embedding is low. It is expected to provide a helpful guidance for designing secure steganographic algorithms or reliable steganalytic methods.
Waardenburg syndrome in childhood deafness in Cameroon

Background. Waardenburg syndrome (WS) is a rare hereditary disorder essentially characterised by deafness and pigment disorders of the eyes, hair and skin. Methods. Between October 2010 and December 2011, we identified six patients with WS during an aetiological survey of 582 deaf participants recruited in schools for the deaf and ear, nose and throat outpatient clinics in seven of the ten regions of Cameroon. Two classic characteristics of WS were used as diagnostic criteria: deafness and pigmentation abnormalities (heterochromia iridis, white forelock and depigmented skin patches). In addition, to identify dystopia canthorum, a sign of WS type I, we calculated the W -index. Results. WS comprised 1% of the whole sample, 7% of the genetic cases, and 50% of the genetic syndromic cases. All patients with WS had severe to profound congenital sensorineural and symmetrical hearing loss with flat audiograms. They also had pigment disorders of the eyes and the skin. In the absence of dystopia canthorum, they were all classified as having WS type II. The pedigree was suggestive of autosomal dominant inheritance in two cases, and the four others seemed to be de novo cases. Conclusion. The results suggest that WS type II is the most common syndromic form of hearing loss among Cameroonians. This has implications for retrospective genetic counselling and hearing tests for earlier management in affected families.
Construcción de un vector de expresión derivado de virus adenoasociados para corregir in vitro el defecto genético de la enfermedad de Morquio A

Introduccion. La mucopolisacaridosis IV A (Morquio A) es una enfermedad de deposito lisosomico causada por la deficiencia en la actividad de la enzima N-acetil-galactosamina- 6-sulfato-sulfatasa que produce la acumulacion intralisosomica de queratan y condroitin-6-sulfato. Hasta el momento, su manejo es paliativo, por lo que las investigaciones se han enfocado en establecer una terapia que pueda aplicarse tempranamente y garantice la expresion estable de la enzima. En este sentido, la terapia genica se presenta como una de las potenciales alternativas terapeuticas para corregir el defecto genetico en la mucopolisacaridosis IV A. Objetivo. Construir vectores de expresion derivados de virus adenoasociados para corregir in vitro la deficiencia enzimatica en la mucopolisacaridosis IV A. Materiales y metodos. Se produjeron vectores derivados de virus adenoasociados que portaban el gen humano de la enzima N-acetil-galactosamina-6-sulfato-sulfatasa dirigido por el promotor temprano del citomegalovirus humano, empleando un sistema libre de adenovirus. Se transfectaron celulas HEK293 y fibroblastos humanos Morquio A con los virus recombinantes, y se determino la actividad enzimatica en el lisado celular a las 24 y 48 horas despues de la transfeccion. Resultados. Se obtuvieron virus adenoasociados recombinantes, libres de adenovirus, con titulos hasta de 2,08 x 1010 capsides/ml. Tanto en celulas HEK293 como en fibroblastos Morquio A transfectados, se obtuvieron actividades enzimaticas hasta de 3,05 nmoles/mg por hora, 48 horas despues de la transfeccion. Conclusion. Los virus recombinantes producidos expresaron in vitro la enzima GALNS en las celulas transfectadas. Estos resultados constituyen el paso inicial para el desarrollo de una terapia genica para la enfermedad de Morquio A empleando vectores derivados de virus adenoasociados.
Immunohistochemistry of the Skin

have presented a host of fungal, viral, and bacterial infections of the skin. In the last decade, immunohisto- chemistry has played an increasingly important role for routine diagnosis, prognosis, and research. The complexity of all skin disorders makes it imperative to understand IHC and the different dis- ciplines that are required by today's der- matopathologists. An entire book could be dedicated to this subject. This paper will attempt to give a small overview of the use of commonly used antibodies and phenotyping in the modern dermato- pathology laboratory. Antibodies Commonly Used
Propagation and bit error rate measurements within buildings in the millimeter wave band about 60 GHz

There is a significant interest in the millimetric waveband around 60 GHz for providing integrated personal communications for a wide range of digital services to mobile users and data terminals. Furthermore, with recent advances in GaAs technology, the use of 60 GHz in broadband short-range point-to-point links is also the subject of much investigation at the moment. A study of propagation and bit error rate within buildings using phase-locked oscillators at 60 GHz is reported. The measurements include envelope distribution, median received signal power versus distance, signal coverage, knife edge diffraction, and bit error rate using frequency-shift keying. <<ETX>>
Determinants of Risk for Venous and Arterial Thrombosis in Primary Antiphospholipid Syndrome and in Antiphospholipid Syndrome with Systemic Lupus Erythematosus

Objective. Antiphospholipid syndrome (APS) is characterized by thrombosis (venous and arterial) and pregnancy loss in conjunction with the lupus anticoagulant, IgG or IgM anticardiolipin, or IgG or IgM anti-ß2-glycoprotein I. In most series, only a minority of patients with antiphospholipid antibodies develop a clinical manifestation. Methods. A cross-sectional study of consecutive patients in the Hopkins Lupus Center was performed. Interviews were done and records were reviewed for the following variables: gender, ethnicity, hypertension, triglycerides, cholesterol, smoking, diabetes mellitus, homocysteine, cancer, hepatitis C, hormone replacement therapy/oral contraceptives, hereditary thrombophilia, anticardiolipin antibodies IgG, IgM and IgA, and lupus anticoagulant (LAC). Our aim was to identify risk factors associated with thrombosis and pregnancy loss in patients with antiphospholipid antibodies. Results. A total of 122 patients (84% female, 74% Caucasian) were studied. Patients were divided into 3 groups: primary APS, APS associated with systemic lupus erythematosus, and patients with systemic lupus erythematosus (SLE) with antiphospholipid antibodies but no thrombosis or pregnancy loss. Venous thrombosis was associated with high triglycerides (p = 0.001), hereditary thrombophilia (p = 0.02), anticardiolipin antibodies IgG > 40 (p = 0.04), and LAC (p = 0.012). Hypertriglyceridemia was associated with a 6.4-fold increase, hereditary thrombophilia with a 7.3-fold increase, and anticardiolipin IgG > 40 GPL with a 2.8-fold increase in the risk of venous thrombosis. Arterial thrombosis was associated with hypertension (p = 0.008) and elevated homocysteine (p = 0.044). Hypertension was associated with a 2.4-fold increase in the risk of arterial thrombosis. No correlations were found for pregnancy loss. Conclusion. The frequency of thrombosis and pregnancy loss is greater in APS associated with SLE than in primary APS. Risk factors differ for venous and arterial thrombosis in APS. Treatment of hypertension may be the most important intervention to reduce arterial thrombosis. Elevated triglycerides are a major associate of venous thrombosis, but the benefit of treatment is not known. Hereditary thrombophilia is an associate of venous but not arterial thrombosis, making it cost-effective to investigate only in venous thrombosis.
Benzo(a)pyrene Diol Epoxide-Induced Chromosome 9p21 Aberrations Are Associated with Increased Risk of Bladder Cancer

Purpose: Loss of chromosome 9p21 is one of the most frequent genomic alterations in bladder cancer. Alterations of 9p21 and p16 are also frequently seen in the epithelial cells of chronic smokers. We hypothesize that 9p21 is a molecular target of benzo(a)pyrene diol epoxide (BPDE), the metabolic product of tobacco carcinogen benzo(a)pyrene, and 9p21 BPDE sensitivity is a genetic susceptibility factor for bladder cancer. Material and Methods: In this case-control study of 203 bladder cancer cases and 198 matched healthy controls, we compared the frequencies of BPDE-induced 9p21 aberrations in cultured peripheral blood lymphocytes using fluorescent in situ hybridization and evaluated the association between 9p21 BPDE sensitivity and bladder cancer risk. Results: We found that BPDE-induced chromosome 9p21 aberrations were significantly higher in peripheral blood lymphocytes of bladder cancer cases (20.76 ± 6.97 per 1,000) than those of controls (16.58 ± 7.07 per 1,000; P < 0.0001). However, no difference was observed for CEP9, a control centromere locus on chromosome 9. Using the median aberration value in the controls as a cutoff point to dichotomize BPDE sensitivity and after adjustment by age, sex, ethnicity, and smoking status, 9p21 BPDE sensitivity was associated with a significantly increased risk of bladder cancer (odds ratio, 5.29; 95% confidence interval, 3.26-8.59), whereas the odds ratio for the CEP9 locus was 0.99 (95% confidence interval, 0.66-1.50). There was also a dose-response relationship between the 9p21 BPDE sensitivity and increased risk for bladder cancer. Conclusion: 9p21 may be a molecular target for BPDE damage in bladder cancer cases and 9p21 BPDE sensitivity may be a marker of bladder cancer susceptibility. (Cancer Epidemiol Biomarkers Prev 2008;17(9):2445–50)
Achieving Optimal Functional Outcomes in Community-Based Rehabilitation following Acquired Brain Injury: A Qualitative Investigation of Therapists' Perspectives

The aim of this study was to explore therapists' opinions about the rehabilitation approaches that they perceived contributed to positive outcomes for people with acquired brain injury in community-based rehabilitation settings in order to develop a set of practice principles for clinicians working in this area. Semi-structured interviews were conducted with eight Australian and three British therapists, with a mean of 5.2 years' experience of working with people with acquired brain injury in community-based rehabilitation settings. The interviews were analysed thematically. A summary of the themes was presented to a larger group of acquired brain injury service providers (n = 35) for validation. The participants emphasised the importance of environmental factors, such as collaboration with and inclusion of others in rehabilitation, especially those in the person's support network. Strategy use, client-centred goal setting, the provision of education and the development of a therapeutic relationship were identified as facilitators in community-based rehabilitation. Problems with self-awareness and motivation, drug and alcohol use, and behavioural difficulties were commonly identified barriers to optimal outcomes. The key practice principles derived from the findings were the need for community-based rehabilitation for people with acquired brain injury to be (1) environment focused and contextually appropriate, (2) collaborative and (3) goal directed and client centred.
The homocysteine pathway in human subfertility

textabstractSubfertility, defined as at least one year of unprotected intercourse with the same partner without conception, affects ten to fifteen percent of couples in the western world. Depending on the duration of the subfertility, a female factor is the dominant cause of subfertility in around 50%, a male factor in 20-26% and the cause is unexplained in 25-30%. In most couples, subfertility is of multifactorial origin and should therefore be considered as a complex disease. Whereas genetic causes are difficult to modulate, environmental and lifestyle factors implicated in reproduction are potentially amendable to curative or preventive measures. Worldwide, an increasing number of couples are treated by assisted reproductive technology (ART) to achieve pregnancy. Currently, the chance of achieving a clinical pregnancy is around 28-31% per started in vitro fertilization (IVF) cycle with or without intracytoplasmic sperm injection (ICSI) in the Netherlands. The advantage of the introduction of IVF and ICSI treatment is that it gives access to and information about the direct environment of the gametes and early developing embryo. On the other hand, IVF and ICSI treatment is introducing an artifactual endocrinologic milieu which may affect the quality of the embryo. Whether concentrations of nutrients and enzymes change due to ovarian hyperstimulation is unclear, but it has already been demonstrated that different ovarian stimulation regimens increase the rates of embryo aneuploidy.
Stat3 Contributes to Indoxyl Sulfate-Induced Inflammatory and Fibrotic Gene Expression and Cellular Senescence

Background/Aim: Increased phosphorylation (activation) of signal transducer and activator of transcription 3 (Stat3) on tyrosine 705 leads to renal fibrosis. Indoxyl sulfate, a uremic toxin, induces renal fibrosis through expression of transforming growth factor-β1 (TGF-β1) in proximal tubular cells. The present study aimed to determine whether Stat3 is involved in indoxyl sulfate-induced dysfunction of proximal tubular cells. Methods: Localization of phosphorylated Stat3 in the kidneys of normal, subtotally nephrectomized, and AST-120-treated subtotally nephrectomized rats was examined by immunohistochemistry. The effect of indoxyl sulfate on phosphorylation of Stat3 and the role of Stat3 on indoxyl sulfate-induced cellular effects were examined using human proximal tubular cells (HK-2 cells). Results: Subtotally nephrectomized rats showed increased immunostaining of phosphorylated Stat3 in the renal tubules compared with normal rats. Administration of AST-120, which reduces serum level of indoxyl sulfate, to subtotally nephrectomized rats reduced the immunostaining of phosphorylated Stat3 in the renal tubules. Indoxyl sulfate induced phosphorylation of Stat3 in HK-2 cells. Stat3 small interfering RNA suppressed indoxyl sulfate-induced expression of an inflammation marker gene (monocyte chemotactic protein-1), fibrosis marker genes (TGF-β1, α-smooth muscle actin) and a subunit of nuclear factor-ĸB (p65), and attenuated a cellular senescence marker, senescence-associated β-galactosidase activity. Conclusions: Stat3 is involved in indoxyl sulfate-induced inflammatory and fibrotic gene expression and cellular senescence in proximal tubular cells.
Microperimetry: a review of fundus related perimetry

Visual field assessment is a key part of optometry and ophthalmology practice. However, in people with non-central or unstable fixation, it is not possible to relate defects on a visual field map to a specific retinal location. Microperimetry (or fundus related perimetry) is a technique that images the retina during visual field testing, enabling a correlation to be made between visual function and retinal structure. In this article, the history of fundus related perimetry is reviewed. Three modern microperimeters (MP-1, OCT/SLO and MAIA) are described and their relative merits identified. Finally, the uses of microperimetry in optometric practice are discussed.