Miracle-dz/UniFAR-FTUs huggingface dataset:
Craniectomies décompressives chez l'enfant traumatisé crânien : facteurs pronostiques et suivi au long terme

Introduction : Le traumatisme crânien grave (TCG) constitue la premiere cause de mortalite et de handicap severe chez les jeunes et represente donc un probleme majeur de sante publique. Les TCG representeraient environ 3 % des traumatismes crâniens. Ces lesions cerebrales sont le plus souvent diffuses et conduisent a des deficiences multiples, notamment motrices, cognitives et comportementales. Le pronostic de ces patients traumatises crâniens depend donc de la gravite des lesions initiales mais aussi de l’efficacite des therapies mises en œuvre pour prevenir ou, du moins, limiter les lesions secondaires. L’escalade des therapeutiques medicamenteuses pour lutter contre l’hypertension intracrânienne (HTIC) chez l’enfant traumatise crânien est bien codifiee. Cependant, la place de la craniectomie, elle, n’est toujours pas definie avec un niveau de preuve scientifique correct. Objectif : Evaluer le pronostic neurologique au long terme des enfants ayant eu un traumatisme crânien grave ayant necessite une craniectomie decompressive et identifier des facteurs pronostiques. Materiel et methodes : Nous avons realise une etude retrospective multicentrique nationale dans 10 centres en France. Nous avons analyse 150 dossiers de patients pediatriques ayant ete victimes d’un traumatisme crânien et traites par craniectomie decompressive entre 2006 et 2016. Notre critere d’evaluation principal etait le score de KOSCHI. Les patients presentant un score ≥ 4, etaient consideres comme ayant eu une evolution neurologique favorable. Nous nous sommes interesses aux donnees cliniques, radiologiques et au monitorage cerebral afin d’identifier si certaines avaient une valeur pronostique. Les analyses statistiques ont ete effectuees en utilisant le logiciel XLSTAT® et la limite de significativite a ete fixee a p = 0,05. Resultats : 58 % des patients avaient une evolution consideree comme favorable, 24 % avaient une evolution consideree comme neurologiquement defavorable et la mortalite etait de 16%. Les variables pre operatoires statistiquement associees a un mauvais devenir neurologique etaient l’âge, le GCS initial, une anomalie pupillaire a la prise en charge initiale et/ou a l’arrivee en reanimation, une PIC maximale avant chirurgie ≥30 mm Hg, le score de Rotterdam, un shift des structures medianes > 5mm au scanner. Le taux de complications chirurgicales etait de 10%. Conclusion : Etant donne l’esperance de vie des enfants, il est important de les traiter de maniere appropriee et agressive. La place de la craniectomie decompressive dans l’arsenal therapeutique doit etre reconsideree, d’autant plus que, chez l’enfant, le taux de complications est faible.
Guidelines for Adult Stroke Rehabilitation and Recovery.

Purpose—The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods—Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council’s Scientific Statement Oversight Committee and the AHA’s Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results—Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness Guidelines for Adult Stroke Rehabilitation and Recovery A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
EFFECT OF COSTUS PICTUS D. DON. ON PEPSIN ENZYME

Objective: Pepsin has a close resemblance with HIV-protease in proteolytic activity as both of them belong to same aspartate enzyme family. Hence in the present study, pepsin was used as a substitute for HIV-protease. Pepsin assay could be used for preliminary screening of natural products for probable HIV-protease inhibitory activity. Therefore the objective of present study was to prepare 4 extracts namely, Fresh-Aqueous, FreshHydroalcoholic (HA), Dry-Aqueous and Dry-Hydroalcoholic (HA) from fresh as well as air dried leaves of Costus pictus D. Don. and to evaluate their effect on pepsin enzyme. Methods: Pepsin assay was carried out using hemoglobin as a substrate. Further, the antioxidant activity of extracts was monitored using DPPH assay, whereas, phenolic content was estimated using Folin-Ciocalteu reagent. Results: All the extracts showed potent inhibitory effect against pepsin enzyme, wherein Fresh-HA revealed the highest inhibitory activity (93.49%) followed by Dry-HA (88.11%). The highest antioxidant potential was exhibited by Dry-HA extract (IC 50 = 1.03mg/ml). Conclusion: The present study suggests that C. pictus might be useful as a HIV protease inhibitor. The inhibitory activity could be attributed to phenolic content of the extracts.
Decentralized detection in resource-limited sensor network architectures

We consider the problem of decentralized binary detection in a network consisting of a large number of nodes arranged as a tree of bounded height. We show that the error probability decays exponentially fast with the number of nodes under both a NeymanPearson criterion and a Bayesian criterion, and provide bounds for the optimal error exponent. Furthermore, we show that under the Neyman-Pearson criterion, the optimal error exponent is often the same as that corresponding to a parallel configuration, implying that a large network can be designed to operate efficiently without significantly affecting the detection performance. We provide sufficient, as well as necessary, conditions for this to happen. For those networks satisfying the sufficient conditions, we propose a simple strategy that nearly achieves the optimal error exponent, and in which all non-leaf nodes need only send 1-bit messages. We also investigate the impact of node failures and unreliable communications on the detection performance. Node failures are modeled by a Galton-Watson branching process, and binary symmetric channels are assumed for the case of unreliable communications. We characterize the asymptotically optimal detection performance, develop simple strategies that nearly achieve the optimal performance, and compare the performance of the two types of networks. Our results suggest that in a large scale sensor network, it is more important to ensure that nodes can communicate reliably with each other (e.g., by boosting the transmission power) than to ensure that nodes are robust to failures. In the case of networks with unbounded height, we establish the validity of a long-standing conjecture regarding the sub-exponential decay of Bayesian detection error probabilities in a tandem network. We also provide bounds for the error probability, and show that under the additional assumption of bounded Kullback-Leibler divergences, the error probability is Ω(e−cn d ), for all d > 1/2, with c being a positive constant. Furthermore, the bound Ω(e−c(log n) d ), for all d > 1, holds under an additional mild condition on the distributions. This latter bound is shown to be tight. Moreover, for the Neyman-Pearson case, we establish that if the sensors act myopically, the Type II error probabilities also decay at a sub-exponential rate.
Mucosal Tolerance and Immunity: Regulating the Development of Allergic Disease and Asthma

Allergic diseases and asthma are characterized by eosinophilic inflammation induced by Th2 lymphocytes. However, the immunological events and the molecular and cellular mechanisms that protect against and regulate these pathological immune responses are poorly understood. In this review, we discuss the role of immunological tolerance, regulatory T cells, and dendritic cells (DCs) in these protective processes. In addition, we discuss factors like the maturation state of DCs, source and effect of Il-10 production as well as specific combinations of costimulatory molecules in the antigen-presenting cell: T cell synapse, which determine whether tolerance or immunity develops in the respiratory mucosa in response to inhaled allergen.
Multicenter Phase II Study of Lapatinib in Patients with Brain Metastases from HER2-Positive Breast Cancer

Purpose: Brain metastases develop in one third of patients with advanced HER2+ breast cancer. Effective therapy for patients with central nervous system (CNS) progression after cranial radiation is extremely limited and represents a major clinical challenge. Lapatinib, an epidermal growth factor receptor/HER2 inhibitor, was associated with regressions of CNS lesions in a small phase 2 trial. The current study was done to further evaluate the CNS activity of lapatinib. The study was later amended to allow patients who progressed on lapatinib the option of receiving lapatinib plus capecitabine. Experimental Design: Eligible patients had HER2+ breast cancer, progressive brain metastases, prior trastuzumab, and cranial radiotherapy. The primary end point was CNS objective response, defined as ≥50% volumetric reduction of CNS lesion(s) in the absence of increasing steroid use, progressive neurologic signs and symptoms, or progressive extra-CNS disease. Results: Two-hundred and forty-two patients entered the study. CNS objective responses to lapatinib were observed in 6% of patients. In an exploratory analysis, 21% of patients experienced a ≥20% volumetric reduction in their CNS lesions. An association was observed between volumetric reduction and improvement in progression-free survival and neurologic signs and symptoms. Of the 50 evaluable patients who entered the lapatinib plus capecitabine extension, 20% experienced a CNS objective response and 40% experienced a ≥20% volumetric reduction in their CNS lesions. Conclusions: This study confirms the modest CNS antitumor activity of lapatinib. Additional responses were observed with the combination of lapatinib and capecitabine. Further studies of lapatinib-based regimens for CNS metastases from HER2+ breast cancer are warranted.
On systems containing Aristotle's thesis

“Apart from merits or defects of PA1, however, its existence demonstrates the feasibility of a new approach to the logic of propositions involving the principle of subjunctive contrariety. We thus have good reason to investigate the effect this principle, and a concept of conditionality compatible with it, might exert if introduced into standard quantification theory, into set theory, into modal logic and into epistemology and the philosophy of science. ”
Peri-tumoral leakage during intra-tumoral convection-enhanced delivery has implications for efficacy of peri-tumoral infusion before removal of tumor

Abstract In cases of malignant brain tumors, infiltrating tumor cells that exist at the tumor-surrounding brain tissue always escape from cytoreductive surgery and, protected by blood-brain barrier (BBB), survive the adjuvant chemoradiotherapy, eventually leading to tumor recurrence. Local interstitial delivery of chemotherapeutic agents is a promising strategy to target these cells. During our effort to develop effective drug delivery methods by intra-tumoral infusion of chemotherapeutic agents, we found consistent pattern of leakage from the tumor. Here we describe our findings and propose promising strategy to cover the brain tissue surrounding the tumor with therapeutic agents by means of convection-enhanced delivery. First, the intracranial tumor isograft model was used to define patterns of leakage from tumor mass after intra-tumoral infusion of the chemotherapeutic agents. Liposomal doxorubicin, although first distributed inside the tumor, distributed diffusely into the surrounding normal brain once the leakage happen. Trypan blue dye was used to evaluate the distribution pattern of peri-tumoral infusions. When infused intra- or peri-tumorally, infusates distributed robustly into the tumor border. Subsequently, volume of distributions with different infusion scheduling; including intra-tumoral infusion, peri-tumoral infusion after tumor resection, peri-tumoral infusion without tumor removal with or without systemic infusion of steroids, were compared with Evans-blue dye. Peri-tumoral infusion without tumor removal resulted in maximum volume of distribution. Prior use of steroids further increased the volume of distribution. Local interstitial drug delivery targeting tumor surrounding brain tissue before tumor removal should be more effective when targeting the invading cells.
Intuitionistic fuzzy random variables

Intuitionistic fuzzy set is an extension of traditional fuzzy set, which is considered to be more flexible and applicable than traditional fuzzy set as deal with some uncertain and fuzzy problems. In this paper, some properties of intuitionistic fuzzy set are discussed, intuitionistic fuzzy random variables are first introduced, the expected value of intuitionistic fuzzy random variables is defined, and then the law of large numbers of intuitionistic fuzzy random variables are given.
Land Reform as a Counterinsurgency Policy: Evidence from Colombia

Can targeted land reform reduce levels of civil war conflict by mitigating the factors that contribute to rural rebellion? This paper uses new micro-level data on land reform and insurgency at the municipal level from Colombia from 1988-2000, a country with high rates of land inequality and informal land ownership, to test whether land reform undercut subsequent guerrilla activity. The reform had two distinct aspects. Politically powerful large landholders blocked most large-scale reform, which resulted primarily in an enduring, low-intensity and geographically dispersed reform that spurred low levels of insurgent activity. Larger-scale reforms were only implemented in areas that threatened serious violence and had the potential to harm elite interests, and in these limited areas reform reduced guerrilla activity. This suggests that while land reform can be an effective counterinsurgency policy, it may be politically difficult to implement at a sufficient scale because it threatens the status quo.
Human skin penetration of gold nanoparticles through intact and damaged skin

Abstract Gold nanoparticles (AuNPs) are produced for many applications but there is a lack of available data on their skin absorption. Experiments were performed using the Franz diffusion cell method with intact and damaged human skin. A physiological solution was used as receiving phase and 0.5 mL (1st exp) and 1.5 mL (2nd exp) of a solution containing 100 mgL-1 of AuNPs (15 and 45 μg cm-2, respectively) was applied as donor phase to the outer surface of the skin for 24 h. Skin absorption was dose dependent. Mean gold content of 214.0 ± 43.7 ng cm-2 and 187.7 ± 50.2 ng cm-2 were found in the receiving solutions of cells where the AuNPs solution was applied in higher concentration on intact skin (8 Franz cells) and on damaged skin (8 Franz cells), respectively. Twenty-four hours gold flux permeation was 7.8 ± 2.0 ng cm-2 h-1 and 7.1 ± 2.5 ng cm-2 h-1 in intact and damaged skin, respectively, with a lag time less than 1 hour. Transmission Electron Microscope analysis on skin samples and chemical analysis using Inductively Coupled Plasma-Mass Spectrometry demonstrated the presence of AuNPs into epidermis and dermis. This study showed that AuNPs are able to penetrate the human skin in an in vitro diffusion cell system.
Fatigue Life Assessment Method for Prestressed Concrete Sleepers

Concrete sleepers are one of the most important applications of a railway track system. Researchers have previously studied the impact load characteristics and ultimate load carrying capacity of a prestressed sleeper but research on the fatigue life of prestressed concrete sleepers is limited. Prestressed concrete sleeper fatigue damage is mainly due to the accumulation of defects, caused by the repeated load of wheel-rail interaction. Fatigue load, fatigue characteristics and the existing design methods of prestressed concrete sleeper are summarized in this paper. The commonly used fatigue assessment methods of concrete structures are also evaluated. Based on the results of former research result, this article presents a convenient fatigue life assessment method for a prestressed concrete sleeper, and contrasts with the test results. The insight information gained can be used to evaluate the service performance and predict the fatigue life of the concrete sleeper, as well providing design flexibility and broadening the design principle. The outcome of this study may also improve the rail track maintenance and inspection criteria, in order to establish an appropriate track condition monitoring network in practice.
Drugs for treating uncomplicated malaria in pregnant women.

BACKGROUND Women are more vulnerable to malaria during pregnancy, and malaria infection may have adverse consequences for the fetus. Identifying safe and effective treatments is important. OBJECTIVES To compare the effects of drug regimens for treating uncomplicated falciparum malaria in pregnant women. SEARCH STRATEGY We searched the Cochrane Infectious Diseases Group Specialized Register (May 2005), Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to May 2005), EMBASE (1974 to May 2005), LILACS (May 2005), reference lists, and conference abstracts. We also contacted researchers in the field, organizations, and pharmaceutical companies. SELECTION CRITERIA Randomized and quasi-randomized controlled trials of antimalarial drugs for treating uncomplicated malaria in pregnant women. DATA COLLECTION AND ANALYSIS Both authors assessed trial eligibility and methodological quality, and extracted data. We performed a quantitative analysis only where we could combine the data. We combined dichotomous data using relative risk (RR) with 95% confidence intervals (CI). MAIN RESULTS Six trials (513 participants) met the inclusion criteria. Two were quasi-randomized, and none described allocation concealment. Data were scarce for the primary outcome, treatment failure. One trial compared artesunate plus mefloquine with quinine and reported fewer treatment failures at day 63 with the combination (RR 0.09, 95% CI 0.02 to 0.38; 106 participants). AUTHORS' CONCLUSIONS There is insufficient reliable research on malaria treatment options in pregnancy.
Microchimérisme et prédiction des complications de la grossesse chez les femmes primigestes

Objectif de l’etude : Comparer la quantite de microchimerisme fœtal dans les serums de femmes primigestes a 12 semaines d’amenorrhee avec ou non une grossesse pathologique. Montrer que la presence elevee de microchimerisme fœtal permettrait d’anticiper des 12 semaines d’amenorrhee la survenue d’une pre-eclampsie chez la femme, une Restriction de Croissance Intra-Uterine (RCIU) ou un Petit poids pour l’Age Gestationnel (PAG) chez le nouveau-ne. Materiel et methode : Selection de serum de femmes primigestes ayant eu un garcon ou une fille et dont la grossesse fut normale ou pathologique (pre-eclampsie, hypertension arterielle, nouveau-ne avec un RCIU ou un PAG). Quantification du taux d’ADN circulant total par Polymerase Chaine Reaction (PCR) du gene de la β-globine (gene sur le chromosome 11 autosomal) et masculin via le gene Sex-determining Region of Y chromosome (SRY) (gene du chromosome Y) dans quatre groupes de serum. Correlation des quantites de microchimerisme avec les marqueurs seriques du premier trimestre et les donnees cliniques de la grossesse et de l’accouchement. Resultats : Le microchimerisme fœtal masculin est plus important chez les femmes ayant eu une grossesse pathologique. L’analyse montre que la presence de quantites elevees de microchimerisme masculin a une bonne valeur predictive du caractere pathologique de la grossesse (p<0.0001). Dans l’etude cette valeur predictive est meilleure que celle evaluee par les taux de Pregnancy-Associated Plasma Protein-A (PAPP-A) et Beta-Hormone Chorionique Gonadotrope (β-HCG). Le microchimerisme masculin est egalement predictif d’un petit poids a la naissance. Conclusion : La quantification du microchimerisme fœtal est un moyen predictif de la pre-eclampsie et/ou du RCIU et/ou du PAG. Son utilisation comme facteur predictif necessite une standardisation du protocole de detection et quantification. Il serait interessant d’inserer les valeurs de microchimerisme dans un score avec les antecedents de la patiente et divers marqueurs seriques, pour identifier les femmes a haut risque de pre-eclampsie afin de mettre en place un traitement preventif.
Association of carotid intima-media thickness with the presence and severity of coronary artery disease.

OBJECTIVE To examine, prospectively, whether the intima-media thickness (IMT) of the common carotid artery and the overlying plaque predicts the presence and severity of coronary artery events. METHODS Two hundred and one consecutive patients (100 men and 101 women), who had recently undergone coronary angiography in Tabriz University of Medical Sciences, were enrolled in the study carried out from May 2004 to May 2005. Measurements of IMT were performed by ultrasound, while blood pressure, blood sugar and cholesterol levels were recorded. RESULTS The mean IMT of the common carotid artery was significantly higher in patients with coronary artery disease (CAD) compared with non-CAD patients, as well as in patients with significant CAD compared to non-significant CAD in both genders. The same was observed for the plaque area. Clinical systolic blood pressure, clinical diastolic blood pressure, low-density lipoprotein and high-density lipoprotein cholesterol did not significantly differ between the 3 groups. Fasting blood sugar was higher in the non-significant CAD patients. CONCLUSION The IMT of the common carotid artery is a clinically valuable parameter in the non-invasive diagnosis of non-significant CAD, as well as significant coronary artery lesions.