Miracle-dz/UniFAR-FTUs huggingface dataset:
Hearing results of intratympanic steroid treatment of endolymphatic hydrops

Objectives/Hypothesis: This study evaluated the effectiveness of a single application of steroids to the open middle ear in improving short‐term hearing in patients with Meniere's disease and cochlear hydrops. Study Design: Retrospective study in which each patient's pretreatment hearing served as the control compared with posttreatment hearing. Methods: Patients were treated with a single application of dexamethasone, 8 mg, in hyaluronan. Following tympanotomy and lysis of round window adhesions, steroids were placed in the round window niche with absorbable gelatin sponge and the remainder of the middle ear was then filled with the steroid solution. Systemic steroids were not administered. Audiograms were performed within 1 month before surgery and at least 1 month after surgery. Results: Between September 1996 and July 1997, 21 ears in 19 patients underwent intratympanic steroid treatment. The criterion for hearing change was a 10‐dB or greater change in pure‐tone average (PTA), or a 15% change in speech discrimination score (SDS). Of the 15 ears meeting inclusion criteria for this study, five (33%) demonstrated hearing improvement and three (20%) demonstrated hearing deterioration. Maximum improvement was a 38‐dB improvement in PTA and a 32% improvement in SDS. Conclusion: A single application of intratympanic dexamethasone/hyaluronan solution directly to the round window did not produce dramatic short‐term hearing improvement in patients with endolymphatic hydrops. Although the theoretical basis for intratympanic steroid treatment of endolymphatic hydrops is appealing, we urge close evaluation of the results of specific protocols of intratympanic steroid administration before widespread utilization of this treatment. The choice of steroid, route of administration, frequency of application, and need for simultaneous systemic administration require standardization to adequately assess the efficacy of this treatment. Laryngoscope, 108:1682–1685, 1998
Efficacy and Safety of Donepezil 23 mg versus Donepezil 10 mg for Moderate-to-Severe Alzheimer’s Disease: A Subgroup Analysis in Patients Already Taking or Not Taking Concomitant Memantine

Background/Aims: A large multicenter trial of donepezil 23 mg/day versus donepezil 10 mg/day for moderate-to-severe Alzheimer’s disease allowed patients taking concomitant memantine. We evaluated the efficacy/safety of donepezil 23 and 10 mg/day in this trial, with respect to concomitant memantine use. Methods: Prespecified analysis of data from a 24-week, randomized, double-blind trial. Patients were randomized to donepezil doses (23 vs. 10 mg/day) and stratified by concomitant memantine use (yes or no). Efficacy and safety were assessed for each donepezil dose in subgroups taking or not taking concomitant memantine. Results: At week 24, donepezil 23 mg/day provided significant cognitive benefits over 10 mg/day (p < 0.01) on the Severe Impairment Battery, with or without concomitant memantine (ANCOVA adjusted for baseline score, country and treatment). The higher dose showed no benefit on the global function, Mini-Mental State Examination or activities of daily living measures in either memantine subgroup. Rates of treatment-emergent adverse events (AEs) were higher for donepezil 23 mg/day with memantine (80.7%) than 23 mg/day without memantine (69.7%) or 10 mg/day with/without memantine (66.7/62.0%); across all treatment groups, most events were mild/moderate in severity. Individual rates of serious AEs were low (<1.0%), regardless of concomitant memantine use. Conclusion: In this population, concomitant memantine use did not alter the response profile of donepezil 23 vs. 10 mg/day. Donepezil 23 mg was generally safe and well tolerated among patients receiving donepezil alone and among patients receiving a combination of donepezil and memantine therapy.
Web accessibility standards and disability: developing critical perspectives on accessibility

Abstract Purpose: Currently, dominant web accessibility standards do not respect disability as a complex and culturally contingent interaction; recognizing that disability is a variable, contrary and political power relation, rather than a biological limit. Against this background there is clear scope to broaden the ways in which accessibility standards are understood, developed and applied. Methods: Commentary. Results: The values that shape and are shaped by legislation promote universal, statistical and automated approaches to web accessibility. This results in web accessibility standards conveying powerful norms fixing the relationship between technology and disability, irrespective of geographical, social, technological or cultural diversity. Conclusions: Web accessibility standards are designed to enact universal principles; however, they express partial and biopolitical understandings of the relation between disability and technology. These values can be limiting, and potentially counter-productive, for example, for the majority of disabled people in the “Global South” where different contexts constitute different disabilities and different experiences of web access. To create more robust, accessible outcomes for disabled people, research and standards practice should diversify to embrace more interactional accounts of disability in different settings. Implications for Rehabilitation Creating accessible experiences is an essential aspect of rehabilitation. Web standards promote universal accessibility as a property of an online resource or service. This undervalues the importance of the user’s intentions, expertize, their context, and the complex social and cultural nature of disability. Standardized, universal approaches to web accessibility may lead to counterproductive outcomes for disabled people whose impairments and circumstances do not meet Western disability and accessibility norms. Accessible experiences for rehabilitation can be enhanced through an additional focus on holistic approaches to accessibility blending digital and physical solutions, the use of BS 8878 and mixed-method approaches to accessibility benchmarking. Web standards and accessibility conformance should be considered together with user input and the recognition and development of local accessibility and rehabilitation expertize.
Introduction of Virulence Markers in PB2 of Pandemic Swine-Origin Influenza Virus Does Not Result in Enhanced Virulence or Transmission

ABSTRACT In the first 6 months of the H1N1 swine-origin influenza virus (S-OIV) pandemic, the vast majority of infections were relatively mild. It has been postulated that mutations in the viral genome could result in more virulent viruses, leading to a more severe pandemic. Mutations E627K and D701N in the PB2 protein have previously been identified as determinants of avian and pandemic influenza virus virulence in mammals. These mutations were absent in S-OIVs detected early in the 2009 pandemic. Here, using reverse genetics, mutations E627K, D701N, and E677G were introduced into the prototype S-OIV A/Netherlands/602/2009, and their effects on virus replication, virulence, and transmission were investigated. Mutations E627K and D701N caused increased reporter gene expression driven by the S-OIV polymerase complex. None of the three mutations affected virus replication in vitro. The mutations had no major impact on virus replication in the respiratory tracts of mice and ferrets or on pathogenesis. All three mutant viruses were transmitted via aerosols or respiratory droplets in ferrets. Thus, the impact of key known virulence markers in PB2 in the context of current S-OIVs was surprisingly small. This study does not exclude the possibility of emergence of S-OIVs with other virulence-associated mutations in the future. We conclude that surveillance studies aimed at detecting S-OIVs with increased virulence or transmission should not rely solely on virulence markers identified in the past but should include detailed characterization of virus phenotypes, guided by genetic signatures of viruses detected in severe cases of disease in humans.
Transduction of the light message: from the photon to the optic nerve

Summary— Retinal transduction consists of the conversion of a physical stimulus, light, into an electrophysiological signal. This conversion takes place in several stages. First of all, at the photoreceptor level, via a sequence of molecular activations and deactivations, the detection of light results in an hyperpolarization of the cell membrane. This initial electrical signal is then relayed onto the functional cells of the retina. The bipolar cells are the first associated neurons, responding to the light stimulus by either hyperpolarization (OFF), or depolarization (ON). The second associated neurons are the ganglion cells where the ON‐OFF duality also operates and whose fibers make up the optic nerve. In coloured photopic vision, the photoreceptor — bipolar cell — ganglion cell circuit is direct. For the cone‐bipolar cell transmission, horizontal cells delimit excitatory (center) and inhibitory (surround) zones at the origin of the receptive field. In scotopic vision, however, i) there is only a single class of bipolar cells, that depolarize in response to light, and ii) the bipolar‐ganglion cell connection is not direct. Here, the All amacrine cells are responsible for the inhibition of the OFF ganglion cells directly connected to them or for the excitation of the ON ganglion cells via ON bipolar cells of the cone circuit. Finally, in mesopic vision, the sensory message originates in rods, and is subsequently relayed by the cone circuit via gap junctions between photoreceptors.
Evidence for prescribing exercise as therapy in chronic disease

Considerable knowledge has accumulated in recent decades concerning the significance of physical activity in the treatment of a number of diseases, including diseases that do not primarily manifest as disorders of the locomotive apparatus. In this review we present the evidence for prescribing exercise therapy in the treatment of metabolic syndrome‐related disorders (insulin resistance, type 2 diabetes, dyslipidemia, hypertension, obesity), heart and pulmonary diseases (chronic obstructive pulmonary disease, coronary heart disease, chronic heart failure, intermittent claudication), muscle, bone and joint diseases (osteoarthritis, rheumatoid arthritis, osteoporosis, fibromyalgia, chronic fatigue syndrome) and cancer, depression, asthma and type 1 diabetes. For each disease, we review the effect of exercise therapy on disease pathogenesis, on symptoms specific to the diagnosis, on physical fitness or strength and on quality of life. The possible mechanisms of action are briefly examined and the principles for prescribing exercise therapy are discussed, focusing on the type and amount of exercise and possible contraindications.
Questioning a Class Effect: Does ACE Inhibitor Tissue Penetration Influence the Degree of Fibrinolytic Balance Alteration following an Acute Myocardial Infarction?

There is a common belief in a class effect among angiotensin‐converting enzyme (ACE) inhibitors. This is unsubstantiated for acute myocardial infarction (AMI). Because vascular tissue is a source of the endogenous fibrinolytic markers, and ACE inhibition in vascular tissue favorably influences the fibrinolytic system, the authors hypothesized that a high‐tissue‐penetrating ACE inhibitor would provide a more favorable reduction in plasminogen activator inhibitor‐1 (PAI‐1) and an increase in tissue plasminogen activator (t‐PA) after AMI compared to a low‐tissue‐penetrating ACE inhibitor. In a randomized open‐label trial, patients received the high‐tissue‐penetrating quinapril (n = 15) or low‐tissue‐penetrating enalapril (n = 15) immediately following an AMI. PAI‐1 and t‐PA antigen (ng/mL) were measured at baseline and through 14 days of treatment. There was no difference in baseline PAI‐1 or t‐PA antigen between treatments. PAI‐1 antigen trended toward being lower with quinapril versus enalapril on day 1 (24.44 ± 14.96 vs. 36.94 ± 19.49, respectively, p = 0.059) and was significantly lower on day 3 (17.32 ±9.57 vs. 27.49 ± 9.61, respectively, p = 0.009). Analysis of PAI‐1 antigen over time by two‐factor ANOVA with replication found significantly lower concentrations of PAI‐1 antigen over the entire treatment period with quinapril versus enalapril (p < 0.003). This investigation of ACE inhibitor tissue‐penetrating influence on markers of reinfarction risk suggests there may be a greater early reduction in PAI‐1 with a more highly tissue‐penetrating ACE inhibitor.
Laboratory and field comparisons of insecticides to reduce infestation of Drosophila suzukii in berry crops.

BACKGROUND The spotted wing Drosophila, Drosophila suzukii (Matsumura, 1931) (Diptera: Drosophilidae), is an invasive pest of small-fruit crops. Unlike most other Drosophila, this insect is able to oviposit into and damage ripe and ripening fruit, making it unmarketable. Because this is a new pest in the United States, it is necessary to identify registered insecticides to manage this insect effectively in conventional and organic production systems. RESULTS The present laboratory bioassays and field trials identified a number of insecticides representing various modes of action that are effective in controlling D. suzukii. Products that performed well in the laboratory bioassay also performed well in the field, indicating that screening of new chemistries in the laboratory is a worthy exercise. Field application of pyrethoids, organophosphates or spinosyns provided 5-14 days of residual control of D. suzukii. The efficacy of the neonicotinoids as adulticides was not satisfactory compared with the other contact-mode-of-action chemistries. Based on the zero tolerance by the small-fruit industry and the individual effects mentioned above, neonicotinoids are not currently recommended for D. suzukii management. CONCLUSIONS There are effective insecticides registered for controlling D. suzukii infestations in susceptible small-fruit crops.
Can PRISM predict length of PICU stay? An analysis of 2000 cases

PRISM is claimed to score disease severity which has attributed an impact on length of PICU stay (LOS). Primary objective: To determine the impact of PRISM on LOS, and evaluate an Artificial Neural Network's (ANN) performance to estimate LOS from PRISM item patterns. Research design and methods: Retrospectively we performed correlation and regression analyses on routinely scored PRISM data of all consecutive admissions to our level-III PICU from 1994 to 1999 (n > 2000) with individual LOS. In addition, an ANN was trained on the chronologically first 75% of those data (inputs, PRISM items + age + sex; output, LOS). The ANN's performance was tested on the remaining most recent 25% of the data sets. Main results: The Spearman and Pearson coefficients of correlation between PRISM and LOS were 0.2 (p < 0.001) and 0.08 (p = 0.0003), the latter being slighly higher when LOS was logarithmically transformed. Pearson's coefficient of correlation between ANN derived LOS estimate and actual LOS was 0.21 (p < 0.001) (LOS logarithmically transformed: 0.34; p < 0.001) in the independent validation sample. Conclusions: The ANN with its intrinsic ability to detect non-linear correlation, and to relate specific item patterns to LOS, outperformed linear statistics but was still disappointing in estimating individual LOS. It might be speculated that therapeutic intervention modulates the natural course of the disease thus counteracting both disease severity as initially scored by PRISM, and LOS. This being true, the inverse of the correlation between PRISM (or PRISM based LOS estimate) and LOS might be a candidate indicator of quality of care.
Fuentes del Crecimiento y Comportamiento de la Productividad Total de Factores en Chile

El objetivo de este trabajo es descomponer el crecimiento economico de Chile, a partir de la contribucion del capital, trabajo, y productividad total de factores (PTF), y estudiar los determinantes que explican el comportamiento de la PTF en Chile desde 1960 y hasta la fecha. Nuestros resultados indican que la contribucion de la PTF al crecimiento difiere significativamente entre distintos periodos. Durante 1961-1973 domina la contribucion del capital, durante 1974-1989 el trabajo, y durante 1990-2003 la PTF. La evidencia sobre los determinantes de la PTF sugiere que, ademas de factores ciclicos el crecimiento de la PTF refleja los efectos de la estabilizacion macroeconomica y de las reformas estructurales. Destaca la interaccion de ambos factores en el comportamiento de la PTF. La evidencia sugiere que bajo condiciones de alta (baja) inestabilidad macroeconomica, el impacto de una reforma estructural sobre la PTF es menor (mayor). Analogamente ocurre con los esfuerzos de estabilizacion macro.
Parent and child contributions to diagnosis of mental disorder: are both informants always necessary?

OBJECTIVE To examine the unique cases contributed by parent and child informants to diagnostic classification, with the goal of identifying those diagnoses for which either or both informants are needed. METHOD The authors examined survey data from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, a 4-community epidemiology survey of 9- to 17-year-old children and their parents. Parent-child dyads (1,285 pairs) were independently interviewed by lay persons with the Diagnostic Interview Schedule for Children; a subset of these pairs (n = 247) were also interviewed by clinicians. Agreement between parents and children was examined with respect to levels of impairment, need for/use of services, and clinicians' diagnoses. RESULTS Parents and children rarely agreed on the presence of diagnostic conditions, regardless of diagnostic type. Nonetheless, most child-only- and parent-only-identified diagnoses were similarly related to impairment and clinical validation, with 2 exceptions: child-only-identified attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). CONCLUSIONS Overall findings suggest that most "discrepant" diagnoses (those reported by one but not the other informant) reflect meaningful clinical conditions. In some instances, however, diagnoses reported by one but not the other informant should be treated with caution, as they may not reflect the full diagnostic condition (e.g., possibly child-only-identified ADHD or ODD). Further research is needed to determine the salience of child-only- or parent-only-reported cases.
New vitamin D analogs.

BACKGROUND 1,25-(OH)2D3 (calcitriol) controls parathyroid gland growth and suppresses the synthesis and secretion of parathyroid hormone. Because of this, 1,25-(OH)2D3 has been used successfully for the treatment of secondary hyperparathyroidism, which almost always accompanies renal failure. However, the potent effect of 1,25-(OH)2D3 on intestinal calcium and phosphorus absorption and bone mineral mobilization often leads to the development of hypercalcemia and hyperphosphatemia precluding 1,25-(OH)2D3 therapy. METHODS This has led to the development of vitamin D analogs that retain the suppressive action on PTH and parathyroid gland growth, but that have less calcemic and phosphatemic activity. Currently, two analogs, 19-nor-1,25-(OH)2D2 and 1,alpha(OH)D2, are being used for the treatment of secondary hyperparathyroidism in the United States, and two are being used in Japan, 22-oxa-calcitriol and 1,25-(OH)2-26,27F6 D3. RESULTS All four analogs suppressed PTH, but had less calcemic and phosphatemic activity than 1,25-(OH)2D3. In rats, 19-nor-1,25-(OH)2D2 has been shown to be less calcemic and phosphatemic compared to 1,alpha(OH)D2. CONCLUSION Therapeutic doses of 19-nor-1,25-(OH)2D2 could produce a lower Ca x P product compared to 1,alpha(OH)D2, which could be an important consideration in patient treatment. Further studies are necessary to define these differences and to understand the mechanisms behind the differential actions of vitamin D analogs.
Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder.

OBJECTIVE Studies have reported that countries with high rates of fish oil consumption have low rates of depressive disorder. The authors studied a specific omega-3 fatty acid, the ethyl ester of eicosapentaenoic acid (E-EPA), as an adjunct to treatment for depressive episodes occurring in patients with recurrent unipolar depressive disorder who were receiving maintenance antidepressant therapy. METHOD Twenty patients with a current diagnosis of major depressive disorder participated in a 4-week, parallel-group, double-blind addition of either placebo or E-EPA to ongoing antidepressant therapy. Seventeen of the patients were women, and three were men. RESULTS Highly significant benefits of the addition of the omega-3 fatty acid compared with placebo were found by week 3 of treatment. CONCLUSIONS It is not possible to distinguish whether E-EPA augments antidepressant action in the manner of lithium or has independent antidepressant properties of its own.
The clinical course of neuromyelitis optica (Devic’s syndrome)

Objectives: To evaluate the spectrum of neuromyelitis optica (NMO), including characteristics of the index events (optic neuritis [ON]) and myelitis), neuroimaging, CSF, and serologic studies, and to evaluate the long-term course. Methods: Review of 71 patients with NMO evaluated at the Mayo Clinic between 1950 and 1997. Results: NMO was either monophasic or relapsing. Patients with a monophasic course (n = 23) usually presented with rapidly sequential index events (median 5 days) with moderate recovery. Most with a relapsing course (n = 48) had an extended interval between index events (median 166 days) followed within 3 years by clusters of severe relapses isolated to the optic nerves and spinal cord. Most relapsing patients developed severe disability in a stepwise manner, and one-third died because of respiratory failure. Features of NMO distinct from “typical” MS included >50 cells/mm3 in CSF (often polymorphonuclear), normal initial brain MRI, and lesions extending over three or more vertebral segments on spinal cord MRI. Conclusions: Clinical, laboratory, and imaging features generally distinguish neuromyelitis optica from MS. Patients with relapsing optic neuritis and myelitis may have neuromyelitis optica rather than MS. Patients with a relapsing course of neuromyelitis optica have a poor prognosis and frequently develop respiratory failure during attacks of cervical myelitis.
A Brief Analysis on Differences of Risk Assessment Between Smart Grid and Traditional Power Grid

Smart grid is the next generation power grid development trend. Discuss the smart grid risk assessment system and risk control measurement using the latest self-healing concept in smart grid is of great importance. The paper first reviews the traditional power grid risk assessment development course, then analyzes and compares the differences of risk assessment process between smart grid and traditional power grid. The differences includes much system uncertainty due to renewable resources involvement, more surge between micro grid and the main power grid, and more customer joint into the risk assessment process as the work is set to be highly concerned issue about the utility and infrastructure energy security as well as national security. The future work on risk assessment of smart grid is very complex system work. As the initial stage of smart grid, there is still much more work remains to be carried out in the future.