Miracle-dz/UniFAR-FTUs huggingface dataset:
Primary Care Referral of Patients With Low Back Pain to Physical Therapy: Impact on Future Health Care Utilization and Costs

Study Design. A retrospective cohort. Objective. To describe physical therapy utilization following primary care consultation for low back pain (LBP) and evaluate associations between the timing and content of physical therapy and subsequent health care utilization and costs. Summary of Background Data. Primary care management of LBP is highly variable and the implications for subsequent costs are not well understood. The importance of referring patients from primary care to physical therapy has been debated, and information on how the timing and content of physical therapy impact subsequent costs and utilization is needed. Methods. Data were extracted from a national database of employer-sponsored health plans. A total of 32,070 patients with a new primary care LBP consultation were identified and categorized on the basis of the use of physical therapy within 90 days. Patients utilizing physical therapy were further categorized based on timing (early [within 14 d] or delayed)] and content (guideline adherent or nonadherent). LBP-related health care costs and utilization in the 18-months following primary care consultation were examined. Results. Physical therapy utilization was 7.0% with significant geographic variability. Early physical therapy timing was associated with decreased risk of advanced imaging (odds ratio [OR] = 0.34, 95% confidence interval [CI]: 0.29, 0.41), additional physician visits (OR = 0.26, 95% CI: 0.21, 0.32), surgery (OR = 0.45, 95% CI: 0.32, 0.64), injections (OR = 0.42, 95% CI: 0.32, 0.64), and opioid medications (OR = 0.78, 95% CI: 0.66, 0.93) compared with delayed physical therapy. Total medical costs for LBP were $2736.23 lower (95% CI: 1810.67, 3661.78) for patients receiving early physical therapy. Physical therapy content showed weaker associations with subsequent care. Conclusion. Early physical therapy following a new primary care consultation was associated with reduced risk of subsequent health care compared with delayed physical therapy. Further research is needed to clarify exactly which patients with LBP should be referred to physical therapy; however, if referral is to be made, delaying the initiation of physical therapy may increase risk for additional health care consumption and costs.
Molecular phylogeny of Fordini (Hemiptera: Aphididae: Pemphiginae) inferred from nuclear gene EF-1 α and mitochondrial gene COI

Abstract The tribe Fordini is a fascinating group because of its complicated life history, primary host specificity and gall-forming characteristic. Different species produce galls with different morphology on different parts of the host plants. The EF-1α-based, COI-based and combined sequences-based phylogenetic trees with three algorithms MP, ML and Bayes all strongly suggest that Fordini is a monophyletic group with two clades corresponding to two subtribes, Fordina and Melaphidina, each also monophyletic. Some important morphological characters and primary host plants of aphids were mapped onto the phylogenetic tree to analyse the division of subtribes and to uncover at which level the aphids correspond to their primary hosts, Pistacia and Rhus. Results suggest that the division of subtribes in Fordini is closely related to host selection of aphids. The evolution of gall morphology and the probable driving force behind it in this tribe were also discussed. The Fordini aphids seem to have evolved towards a better ability to manipulate their host plant, induce strong sinks and gain high reproductive success. Galls in this tribe evolved mainly along two directions to attain this goal: (i) by enlarging the gall from small bag to spherical, even big cauliflower-like, and changing the galls' location or forming two galls in their life cycle (Fordina); (ii) by moving the gall position from midrib, petiole of the leaflet, and eventually to the common petiole of the compound leaf (Melaphidina).
Genome-wide identification of Hami melon miRNAs with putative roles during fruit development

MicroRNAs represent a family of small endogenous, non-coding RNAs that play critical regulatory roles in plant growth, development, and environmental stress responses. Hami melon is famous for its attractive flavor and excellent nutritional value, however, the mechanisms underlying the fruit development and ripening remains largely unknown. Here, we performed small RNA sequencing to investigate the roles of miRNAs during Hami melon fruit development. Two batches of flesh samples were collected at four fruit development stages. Small RNA sequencing yielded a total of 54,553,424 raw reads from eight libraries. 113 conserved miRNAs belonging to 30 miRNA families and nine novel miRNAs comprising nine miRNA families were identified. The expression of 42 conserved miRNAs and three Hami melon-specific miRNAs significantly changed during fruit development. Furthermore, 484 and 124 melon genes were predicted as putative targets of 29 conserved and nine Hami melon-specific miRNA families, respectively. GO enrichment analysis were performed on target genes, “transcription, DNA-dependent”, “rRNA processing”, “oxidation reduction”, “signal transduction”, “regulation of transcription, DNA-dependent”, and “metabolic process” were the over-represented biological process terms. Cleavage sites of six target genes were validated using 5’ RACE. Our results present a comprehensive set of identification and characterization of Hami melon fruit miRNAs and their potential targets, which provide valuable basis towards understanding the regulatory mechanisms in programmed process of normal Hami fruit development and ripening. Specific miRNAs could be selected for further research and applications in breeding practices.
Fetal Lung Interstitial Tumor (FLIT): A Proposed Newly Recognized Lung Tumor of Infancy to Be Differentiated From Cystic Pleuropulmonary Blastoma and Other Developmental Pulmonary Lesions

The differential diagnosis of congenital lung lesions includes a variety of pulmonary malformations, and uncommon or rare neoplasms such as the pleuropulmonary blastoma (PPB) and congenital peribronchial myofibroblastic tumor (CPMT). Although most of the congenital lesions have a predominantly cystic appearance, the exceptions of a more solid process are the type 3 congenital cystic adenomatoid or pulmonary airway malformation (CCAM-CPAM) and the CPMT. The clinical and pathologic features of a unique solid or mixed solid/cystic lung mass composed of immature interstitial mesenchyme in association with irregular airspace-like structures mimicking abnormal incompletely developed lung are presented in this report of 10 infants (7 males, 3 females) whose tumor-like lesions were detected in the prenatal period to 3 months of age (median, 1-day old). A lobectomy was done in all 10 infants and 1 infant received adjuvant chemotherapy. One of the surgical resections occurred as an ex utero, antenatal procedure because of fetal ascites. There have been no reported recurrences in those patients with greater than 12 months of follow-up ranging from 15 to 182 months (9 cases). Because of the morphologic resemblance of this mass-like lesion to fetal lung at 20 to 24 weeks gestation (as though any further pulmonary development was arrested in these localized lesions), we are proposing the designation of fetal lung interstitial tumor (FLIT) whose pathogenetic relationship, if any, to type 1 (cystic) pleuropulmonary blastoma remains uncertain to date.
Oral Immunization with Recombinant Mycobacterium smegmatis Expressing the Outer Membrane Protein 26-Kilodalton Antigen Confers Prophylactic Protection against Helicobacter pylori Infection

ABSTRACT Helicobacter pylori infection is prevalent worldwide and results in chronic gastritis, which may lead to gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer. We have previously reported that oral immunization with recombinant Mycobacterium smegmatis expressing the H. pylori outer membrane protein 26-kilodalton (Omp26) antigen affords therapeutic protection against H. pylori infection in mice. In the present study, we investigated the prophylactic effects of this vaccine candidate on H. pylori challenge in mice. We found that oral immunization with recombinant Mycobacterium Omp26 significantly reduced H. pylori colonization in the stomach compared to inoculation with wild-type M. smegmatis in control mice. Six of the recombinant Mycobacterium-immunized mice (60%) were completely protected from H. pylori infection. The severity of H. pylori-associated chronic gastritis assessed histologically was significantly milder in mice vaccinated with recombinant Mycobacterium than in control animals. Mice immunized with recombinant Mycobacterium showed enhanced antigen-specific lymphocyte proliferation and antibody responses. Moreover, immunization with recombinant Mycobacterium resulted in an increased expression of interleukin-2 and gamma interferon in the stomach and spleen, as determined by reverse transcription-PCR analysis. Our results collectively suggest that vaccination with recombinant Mycobacterium Omp26 confers prophylactic protection against H. pylori infection. The inhibition of H. pylori colonization is associated with the induction of antigen-specific humoral and cell-mediated immune responses.
Current Spectrum of Cardiogenic Shock and Effect of Early Revascularization on Mortality Results of an International Registry

Background Cardiogenic shock remains the leading cause of death of patients hospitalized with acute myocardial infarction (MI). This study was conducted to examine (1) the current spectrum of cardiogenic shock, (2) the proportion of patients who are potential candidates for a trial of early revascularization, and (3) the apparent impact of early revascularization on mortality. Methods and Results Nineteen participating centers in the United States and Belgium prospectively registered all patients diagnosed with cardiogenic shock. Two hundred fifty-one patients were registered. The mean age was 67.5±11.7 years, and 43% were women. Acute mitral regurgitation or ventricular septal rupture was the cause of shock in 8%. Concurrent conditions contributing to the development of shock were noted in 5%, and 2% had isolated right ventricular shock. Among the remaining 214 patients, nonspecific findings on the ECG associated with “nontransmural” MI were seen in 14%. The median time to shock diagnosis after MI was 8 hours. The overall in-hospital mortality was 66%. Patients clinically selected to undergo cardiac catheterization were significantly younger and had a lower mortality than those not selected (51% versus 85%, P P P =.003), and had lower mortality (62% versus 73%, P =.077) than ineligible patients. Conclusions Patients diagnosed with cardiogenic shock complicating acute MI are a heterogeneous group. Those eligible for a trial of early revascularization tended to have lower mortality. Patients selected to undergo cardiac catheterization had lower mortality whether or not they were revascularized. Emergent PTCA and CABG are promising treatment modalities for cardiogenic shock, but biased case selection for treatment may confound the data. Whether PTCA and CABG reduce mortality and which patient subgroups benefit most remain to be determined in a randomized clinical trial.
Effects of guanidine inhibitors on mung bean mitochondria.

The effects of phenylethylbiguanidide, decamethylenediguanidide, and octylguanidine have been studied with mung bean hypocotyl mitochondria (Phaseolus aureus var. Jumbo) supplied with malate, reduced nicotinamide adenine dinucleotide, succinate, or ascorbate-tetramethyl-p-phenylenediamine as substrates. The guanidines act as energy transfer inhibitors, all three inhibiting all three phosphorylation sites. Phenylethylbiguanidide causes only partial inhibition even at relatively high concentrations. Decamethylenediguanidide inhibits about 70% of the malate respiration, 55% of the succinate respiration, and 35% of the ascorbate-tetramethyl-p-phenylenediamine respiration.Octylguanidine inhibits all three phosphorylation sites and the cyanide-insensitive respiration, but to differing extents and at different concentrations. Both states 3 and 4 are inhibited by octylguanidine. Inhibition of state 4 is preceded by an uncoupling action at lower concentrations of inhibitor, while inhibition of state 3 is influenced by the state of the mitochondria when the inhibitor is added. Application of the guanidine to state 4 mitochondria is more effective than application to mitochondria already in state 3.
Transanal Irrigation in the Treatment of Children With Intractable Functional Constipation

Objectives: The aim of the study was to assess the treatment efficacy of transanal irrigation and parental satisfaction in children with intractable functional constipation (FC) treated with Peristeen. Methods: Cross-sectional survey study among parents of children (age 0–18 years) treated with Peristeen for FC (based on the Rome III criteria). Anonymous questionnaires were sent out to parents via mail, these consisted of 25 self-developed, multiple-choice questions regarding the use of Peristeen, current gastrointestinal symptoms, adverse effects of Peristeen, concomitant medication use, and parental satisfaction. Results: Out of 91 invited families, 67 (74%) returned the questionnaire. In total, 84% of patients experienced fecal incontinence prior to treatment. Out of all children who still used Peristeen at the time of survey (n = 49), fecal incontinence had resolved completely in 41%, 12% experienced occasional episodes of fecal incontinence (<1 episode per week) and the remaining 47% still experienced episodes of fecal incontinence regularly (≥1 time per week). A total of 28 children (42%) experienced pain during rectal irrigation, especially during insertion of the catheter, inflating the balloon, or during irrigation. Overall, 86% of the parents were satisfied with the result of transanal irrigation and 67% reported that they would continue using transanal irrigation for the treatment of their child's symptoms. Conclusions: Transanal irrigation may be effective in the treatment of children with FC and renders a high parental satisfaction. Future prospective studies, preferably RCTs, are necessary to further evaluate this treatment option.
Self-Propagating, Molecular-Level Polymorphism in Alzheimer's ß-Amyloid Fibrils

Amyloid fibrils commonly exhibit multiple distinct morphologies in electron microscope and atomic force microscope images, often within a single image field. By using electron microscopy and solid-state nuclear magnetic resonance measurements on fibrils formed by the 40-residue β-amyloid peptide of Alzheimer's disease (Aβ1–40), we show that different fibril morphologies have different underlying molecular structures, that the predominant structure can be controlled by subtle variations in fibril growth conditions, and that both morphology and molecular structure are self-propagating when fibrils grow from preformed seeds. Different Aβ1–40 fibril morphologies also have significantly different toxicities in neuronal cell cultures. These results have implications for the mechanism of amyloid formation, the phenomenon of strains in prion diseases, the role of amyloid fibrils in amyloid diseases, and the development of amyloid-based nano-materials.
Forecasting the Indian Stock Market by Applying the Levenberg- Marquardt and Scaled Conjugate Training Algorithms in Neural Networks

The Indian stock market is experiencing fast growth and has peculiarities that differentiate it from many other stock markets, particularly those in developed markets. Given the potential size of this stock market and the growing importance of the Indian economy it seemed reasonable to look at what tools provide reasonably accurately stock prices forecast. It is of clear practical and theoretical relevance to determine which type of algorithm to use in order to try to forecast stock market trends. In recent times there has been an increasing interest in applying neural networks to such aim. In this article it is shown that a neural network using as an input the closing price in the previous day and two different learning algorithms produce accurate forecast. This simple but efficient approach generated a one day forecasting accuracy, measured as the mean value of 𝑅2 , of [0.9952, 0.9972] for the Levenberg-Marquardt training algorithm and [0.9965, 0.9970] for the Scaled Conjugate learning algorithm. These results were obtained using only 10 neurons in the neural network. Increasing the number of neurons to 500 did not improve the out of sample forecasting accuracy. It actually decreased, for both algorithms. It would seem that at least for the period of time analyzed, from 2010 to 2016, neural networks did a reasonably good job forecasting stock prices.
Management of China’s cross-border capital flows

ABSTRACT Since the turn of the century, especially since the global fiscal crisis in 2008, China’s process of capital account opening and RMB internationalization has begun to accelerate, and financial openness has improved significantly. However, due to the pressure of large-scale capital outflow over the last two years, the government has adopted a policy combination of exchange rate management, market intervention, and capital flow management. The liberalization and management of cross-border capital flow are closely linked. Based on current trends of China’s cross-border capital flows management, macro-management and micro-regulation should be distinguished in the future to construct a dual-pillar framework. In addition, cross-border capital flows management, especially capital controls, should be temporary measures. If used reasonably, they can buy some time for other reforms and adjustments.
Introducing security analysis in computer security courses through an electronic voting project

For courses in computer security, one of the more difficult skills to impart to the students is the ability to conduct methodical security analyses of computer systems. One must create a system that is sufficiently complex to generate non-trivial security issues while avoiding completely overwhelming the students. To that end, we have developed a new course project based on the design and evaluation of physical electronic voting systems, a problem area that is sufficiently complex, yet relatively easy to understand. In this paper, we will discuss the project with regards to higher level learning objectives (analysis, evaluation) as well as give observations and refinements made through offering the project over multiple years in an upper-division computer security course
Epithelial glucosphingolipid expression as a determinant of bacterial adherence and cytokine production

D-Threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol (PDMP) is a structural analog of ceramide that inhibits glucosylation of this molecule and thus of glucosphingolipid (GSL) expression by living cells. In this study, we used PDMP to slow the synthesis of the globoseries of GSLs (globo-GSLs) (derived from the precursor Gal alpha 1-4Gal beta 1-4Glc-ceramide) by cultured human kidney and large intestinal epithelial cells. The aim was to deplete the cells of receptors for P-fimbriated Escherichia coli and to examine the effects on the bacterially induced cytokine response. The mammalian cells (A498, HT-29, and Caco2) were cultured in the presence of PDMP in order to deplete them of GSLs. The cells were then subjected to GSL analysis or used to test bacterial adherence and cytokine production. The globo-GSLs were identified by thin-layer chromatography. Bacterial adherence was quantitated by microscopy, and interleukin-6 secretion was quantitated by the B9 bioassay. The interaction of bacteria with the globo-GSLs was studied by using E. coli strains and recombinant clones expressing P fimbriae. E. coli strains expressing type 1 fimbriae binding to mannose-containing glycoproteins were used as controls. PDMP treatment was found to reduce the content of the globo-GSLs in mammalian cells and the adherence of P-fimbriated E. coli to these cells. In contrast, PDMP treatment had no effect on the adherence of type 1-fimbriated E. coli or their activation of cytokine production by A498 cells. P-fimbriated E. coli elicited an interleukin-6 response in the A498 cells; this response was reduced after treatment with PDMP. The results emphasize the role of GSLs as receptors for P-fimbriated E. coli and for the cytokine response elicited by attaching bacteria.
Interventions for post-stroke fatigue.

BACKGROUND Fatigue after stroke is common and distressing to patients. The best way to treat this fatigue is uncertain. Theoretically, several different interventions may be of benefit. OBJECTIVES To determine whether any treatment for fatigue after stroke reduces the proportion of patients with fatigue, or fatigue severity, or both, and to determine the effect of treatment on health-related quality of life, disability, dependency and death, and whether such treatments are cost effective. SEARCH STRATEGY We searched the Cochrane Stroke Group Trials Register (last searched January 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2008), MEDLINE (1950 to February 2008), EMBASE (1980 to February 2008), CINAHL (1982 to February 2008), AMED (1985 to February 2008), PsycINFO (1967 to February 2008), Digital Dissertations (1861 to March 2008), PsycBITE (searched March 2008), PEDro (searched March 2008), and British Nursing Index (1985 to March 2008). We also searched four trials registries, scanned reference lists, performed citation tracking of included trials, and contacted experts. SELECTION CRITERIA The review author who performed the searches scrutinised all titles and abstracts, excluded irrelevant references, and obtained references for potentially relevant studies. A second review author independently scrutinised potentially relevant studies to determine whether they fulfilled inclusion criteria. We included randomised controlled trials of any intervention in patients with stroke where fatigue was a primary or secondary endpoint. DATA COLLECTION AND ANALYSIS The two review authors who scrutinised references independently extracted data. We performed a narrative review; we had intended to perform a meta-analysis but this was not possible as the interventions were too diverse for data to be combined. MAIN RESULTS We identified three trials. One randomised 83 patients with emotional disturbance after stroke to fluoxetine or placebo. After correcting for differences in fatigue severity at baseline, there was no significant difference in fatigue between groups at follow up. The second trial randomised 31 women with subarachnoid haemorrhage to tirilazad or placebo, of whom 18 were available for follow up. There was no difference in fatigue between the two groups. The third trial investigated a chronic disease self-management programme in 1150 patients with chronic diseases, of whom 125 had had a stroke. There was no difference in fatigue at follow up between the treatment and control in the subgroup with stroke. AUTHORS' CONCLUSIONS There is insufficient evidence available to guide the management of fatigue after stroke. Further trials are required.