Miracle-dz/UniFAR-FTUs huggingface dataset:
Seeing double: the low carb diet

A 38 year old white Scottish man with mild learning difficulties (able to read and write but not to maintain employment) presented with a three day history of diplopia and agitation, after seven days of presumed viral gastroenteritis. On admission, he was agitated, mildly confused, tachycardic (115 beats/min, regular) and tachypnoeic (18 breaths/min). There were no chest signs or peripheral oedema. He had complete bilateral sixth cranial nerve palsies and horizontal nystagmus, with dilated, slowly reacting pupils. Limb movements were clumsy, with moderate cerebellar signs and dysdiadochokinesis, but no tremor. He was clinically jaundiced. Electrocardiography showed inferolateral T wave inversion. His heart size was at the upper limit of normal on chest radiography. On specific questioning, he gave a history of lifelong avoidance of alcohol, but of 34 kg weight loss over the preceding three months. This information was corroborated by his parents and practice nurse. At an initial weight of 127 kg (body mass index 42.4), he had received “healthy eating” advice from his practice nurse, who described him as her “star patient. ” His weight had rapidly fallen—from 123 kg at four weeks, to 110 kg at eight weeks, 104 kg at 11 weeks, and finally 93 kg (body mass index 31) on admission. More recently, pursuing greater weight loss, he had eliminated all bread, cereals, and fats, on a diet considered “starvation” by his parents, without nutritional supplements. ### 1 What is the most likely diagnosis? #### Short answer Concurrent agitation and cerebellar signs suggest Wernicke’s encephalopathy as the most likely …
Economic costs of benign prostatic hyperplasia in the private sector.

PURPOSE Several studies document the impact of benign prostatic hyperplasia (BPH) in working, aged men. Direct medical costs related to BPH treatment are largely borne by employees through higher premiums. However, indirect costs related to lost work are primarily borne by the employer. In this study we used claims data and absentee records from large employers to estimate the costs associated with BPH in working age males. MATERIALS AND METHODS We used 2 data sources to examine direct and indirect costs associated with BPH in a privately insured, nonelderly population. Multivariate regression models were used to predict spending for persons with and without a medical claim for BPH, controlling for relevant covariates. Data on work loss were linked to medical claims to estimate work loss related to treatment for BPH. RESULTS Mean annual expenditures were 4,193 dollars for men without a medical claim for BPH. In contrast, annual spending was 5,729 dollars for men with a claim for BPH. Thus, the incremental cost associated with a diagnosis of BPH was 1,536 dollars yearly. Overall the average employee with the condition missed 7.3 hours of work yearly related to BPH with approximately 10% reporting some work loss related to a health care encounter for BPH. CONCLUSIONS Treatment of men with BPH places a significant burden on employees and their employers through direct medical costs as well as through lost work time. Direct and indirect costs to the private sector related to BPH treatment are estimated to be 3.9 billion dollars.
Short chain fatty acids in the human colon.

The human colon contains a luxuriant mixed culture of bacteria, probably at least 175 g. The special property of these bacteria is their metabolism, which is in the main strictly anaerobic, the end-products being primarily the short chain, or volatile, fatty acids, acetic, propionic, and butyric acid. These are the principal known anions in the colon but, although this has often becni rcported,' little thought has been given to the possible implications.
European Concerted Action on Anticoagulation (ECAA): International Normalized Ratio Variability of CoaguChek and TAS Point-of-Care Testing Whole Blood Prothrombin Time Monitors

Summary The object was to assess the variability in displayed International Normalised Ratio (INR) between monitors of the same manufacture using whole blood samples from the same subjects. Two brands of monitor, CoaguChek Mini and the TAS PT-NC were tested. 14 instruments of each brand were tested on the same day at the same laboratory by the same operator using identical blood samples to avoid between-centre differences in samples and operator technique. Whole blood samples from two normal donors and four coumarintreated patients were tested to assess between-instrument variability of INR. Results have been coded. There was a much wider dispersion of INR on Brand B than on Brand A. One Brand A instrument failed to give a result with one of the two whole blood samples from one patient. One Brand B monitor gave an aberrant result with one of the samples from a normal subject. On both brands of monitor, INR variability appeared to be due mainly to duplication differences rather than between-instrument variability on both normal and coumarin whole blood samples.
Childhood sexual abuse and risk behaviors among men at high risk for HIV infection.

OBJECTIVES This study examined the association between unwanted sexual activity during childhood and risky behaviors among a sample of predominantly African American and Hispanic men. METHODS Data were obtained from baseline interviews completed by 2676 men enrolled in a multisite HIV prevention trial. RESULTS Approximately 25% of the men reported unwanted or uninvited sexual activity before 13 years of age, with Hispanic men more likely than African American men to report unwanted sexual activity during childhood. Men with a history of unwanted sexual activity during childhood were more likely to report unwanted sexual activity since age 13, the buying and selling of sex, problems with alcohol, and drug use. Men who reported unwanted sexual activity during childhood also reported a significantly greater frequency of unprotected sexual acts and more partners. CONCLUSIONS Among men at high risk for HIV infection, unwanted sexual activity during childhood is more widespread than previously described and can increase the risk of participating in harmful health practices during adulthood, including risky sexual behaviors.
Efficacy and safety of lapatinib as first-line therapy for ErbB2-amplified locally advanced or metastatic breast cancer.

PURPOSE This study (EGF20009) assessed the efficacy and tolerability of two lapatinib administration schedules as first-line monotherapy in women with ErbB2-amplified locally advanced or metastatic breast cancer. PATIENTS AND METHODS Patients with ErbB2-amplified, locally advanced or metastatic breast cancer previously untreated in the metastatic setting were randomly assigned to one of two lapatinib dose cohorts and received either 1,500 mg once daily or 500 mg twice daily. Clinical response was assessed at weeks 8 and 12 and every 12 weeks thereafter. RESULTS A total of 138 patients were treated with lapatinib for a median of 17.6 weeks. The overall response rate (complete response [CR] plus partial response [PR]) was 24% in the intent-to-treat population, and 31% of patients derived clinical benefit (CR, PR, or stable disease for >or= 24 weeks). The median time to response was 7.9 weeks, and the progression-free survival rates at 4 and 6 months were 63% and 43%, respectively. The most common lapatinib-related adverse events (AEs) were diarrhea, rash, pruritus, and nausea, and these events were primarily grade 1 or 2. There were no significant differences in clinical activity or the AE profile between the dosing schedules. CONCLUSION Lapatinib demonstrated clinical activity and was well tolerated as first-line therapy in ErbB2-amplified locally advanced or metastatic breast cancer. This study supports further evaluation of lapatinib in first-line and early-stage ErbB2-overexpressing breast cancer.
Nuclear factor-κB signaling contributes to severe, but not moderate, angiotensin II-induced left ventricular remodeling

Objective The transcription factor nuclear factor-kappaB (NF-κB) has been implicated in cardiomyocyte hypertrophy in vitro as well as in vivo; however, it is unknown if activation of NF-κB plays a mandatory role in the hypertrophic process. Here we characterize the importance of NF-κB signaling in moderate and severe left ventricular (LV) hypertrophy in rats with chronic pressure overload induced by angiotensin II (Ang II) infusion. Methods and results Electrophoretic mobility shift assay analysis revealed that Ang II infusion (2.5 μg/kg per min) for 6 days increased LV NF-κB/DNA-binding activity in a biphasic manner in Sprague–Dawley rats. Pyrrolidine dithiocarbamate (PDTC) (100 mg/kg per day), an NF-κB inhibitor, abolished Ang II-induced NF-κB activation and concomitant increase in tumor necrosis factor-α gene expression, while activator protein-1/DNA binding was not affected. Inhibition of NF-κB signaling for 6 days significantly attenuated Ang II-induced increases in LV/body weight ratio, LV mean wall thickness and cardiomyocyte cross-sectional area, without compromising LV systolic function. Moreover, PDTC abolished Ang II-induced cardiomyocyte apoptosis and interstitial fibrosis, and attenuated the gene expression of type I collagen. In contrast, a moderate LV hypertrophy induced by Ang II at a lower dose (0.5 μg/kg per min) was not associated with a significant activation of NF-κB, and PDTC treatment had no effect on the hypertrophic indices. Conclusion Our in-vivo data indicate a critical role of NF-κB signaling in the advanced stage of the remodeling process, whereas development of moderate LV hypertrophy is not dependent on NF-κB activation.
Adaptive decentralized control of robot manipulators driven by current-fed induction motors

In this paper, an adaptive decentralized control scheme with a rotor-flux observer is proposed for the tracking control of robot manipulators actuated by current-fed induction motors. To cope with all parametric uncertainties in the electromechanical systems, an adaptive law is designed so that all the signals of closed-loop systems are bounded, and the tracking errors in position, velocity and rotor fluxes converge to a residual set.
Double knockout of pendrin and Na-Cl cotransporter (NCC) causes severe salt wasting, volume depletion, and renal failure

The Na-Cl cotransporter (NCC), which is the target of inhibition by thiazides, is located in close proximity to the chloride-absorbing transporter pendrin in the kidney distal nephron. Single deletion of pendrin or NCC does not cause salt wasting or excessive diuresis under basal conditions, raising the possibility that these transporters are predominantly active during salt depletion or in response to excess aldosterone. We hypothesized that pendrin and NCC compensate for loss of function of the other under basal conditions, thereby masking the role that each plays in salt absorption. To test our hypothesis, we generated pendrin/NCC double knockout (KO) mice by crossing pendrin KO mice with NCC KO mice. Pendrin/NCC double KO mice displayed severe salt wasting and sharp increase in urine output under basal conditions. As a result, animals developed profound volume depletion, renal failure, and metabolic alkalosis without hypokalemia, which were all corrected with salt replacement. We propose that the combined inhibition of pendrin and NCC can provide a strong diuretic regimen without causing hypokalemia for patients with fluid overload, including patients with congestive heart failure, nephrotic syndrome, diuretic resistance, or generalized edema.
Borg/Septin Interactions and the Assembly of Mammalian Septin Heterodimers, Trimers, and Filaments*

Septins constitute a family of guanine nucleotide-binding proteins that were first discovered in the yeastSaccharomyces cerevisiae but are also present in many other eukaryotes. In yeast they congregate at the bud neck and are required for cell division. Their function in metazoan cells is uncertain, but they have been implicated in exocytosis and cytokinesis. Septins have been purified from cells as hetero-oligomeric filaments, but their mechanism of assembly is unknown. Further studies have been limited by the difficulty in expressing functional septin proteins in bacteria. We now show that stable, soluble septin heterodimers can be produced by co-expression from bicistronic vectors in bacteria and that the co-expression of three septins results in their assembly into filaments. Pre-assembled dimers and trimers bind guanine nucleotide and show a slow GTPase activity. The assembly of a heterodimer from monomers in vitro is accompanied by GTP hydrolysis. Borg3, a downstream effector of the Cdc42 GTPase, binds specifically to a septin heterodimer composed of Sept6 and Sept7 and to the Sept2/6/7 trimer, but not to septin monomers or to other heterodimers. Septins associate through their C-terminal coiled-coil domains, and Borg3 appears to recognize the interface between these domains in Sept6 and Sept7.
Inter-batch contamination and potential sources of vancomycin-resistant Enterococcus faecium on broiler farms

1. Vancomycin-resistant Enterococcus faecium (VREfm) has recently spread among Swedish broiler farms. The objectives were to investigate VREfm persistence within barns between flocks, and to determine whether day-old chicks, feed or forklift trucks used for loading crates could be identified as a means of transmission. 2. Faeces were collected for selective culture from 12 farms (9 culture-positive, 3 culture-negative as determined by prior monitoring), and samples were collected from the barn environment before and after cleaning and disinfection, from forklift tyres, hatcheries and feed. 3. VREfm was isolated only from previously known VREfm-positive farms. The proportions of culture-positive environmental samples were 75% (9 out of 9 farms) prior to and 31% (7 out of 9 farms) after cleaning/disinfection. Five out of 6 samples from forklift tyres were culture-positive. No VREfm were isolated from feed or hatcheries. The majority of 27 vanA gene positive isolates showed similar banding patterns by SmaI restriction digestion and pulse-field gel electrophoresis. No consistent differences were observed regarding management between VREfm-positive and negative farms. 4. We conclude that VREfm contaminates barns and remains present between flocks. Forklift trucks are one possible means of transmission between farms.
Rifabutin absorption in the gut unaltered by concomitant administration of didanosine in AIDS patients

Didanosine (ddI) is currently used in the management of patients infected by the human immunodeficiency virus. Rifabutin (RBT) is being extensively used for prophylaxis against Mycobacterium avium complex (MAC) infections. Due to its acid-labile characteristics, ddI must be administered with a buffer. Recent reports have indicated that absorption of ketoconazole, ciprofloxacin, and dapsone, etc., in the gut is altered by concomitant ddI dosing. We have assessed whether concomitant dosing of ddI as antiretroviral therapy modifies RBT absorption in the gut, its steady-state pharmacokinetics, and/or safety in 15 patients with AIDS. Of the 15 patients enrolled, 12 completed the study and 3 receiving 600 mg of RBT with concomitant ddI administration withdrew prematurely from the study. Steady-state RBT pharmacokinetics were assessed on day 13 (ddI plus RBT) and day 16 (RBT alone). The ddI doses (adjusted for body weight) were 167 to 375 mg twice daily, while RBT was administered as a single 300- or 600-mg daily dose. No statistically significant (P > 0.05) differences were seen in RBT absorption parameter estimates between days 13 and 16: maximum concentration in plasma (Cmax; 511 +/- 341 ng/ml versus 525 +/- 254 ng/ml) and the time at which Cmax was observed (3.0 versus 2.5 h). The mean RBT estimates for area under the concentration-time curve from 0 to 24 h (AUC(0-tau)) (5,650 versus 5,023 ng x h/ml) and for oral clearance (1.28 versus 1.18 liter/h/kg) on both study days were also similar. Assessment based on urinary recovery of RBT (3.1 versus 3.7 mg) and its predominant deacetyl metabolite, LM565 (1.6 versus 1.4 mg), showed no apparent effect of ddI. The fraction of the RBT dose converted to LM565, as suggested by the ratio of AUC of the metabolite to AUC of the parent drug, was also unaltered (0.15 versus 0.12). A ratio analysis (day 13/day 16) of the RBT pharmacokinetic estimates showed that the 95% confidence intervals for all parameters were inclusive of one. Furthermore, the brief interruption of ddI therapy over this short study period at steady state produced no clinically significant changes in body weight, hematology, and renal and pancreatic functions. Therefore, concomitant administration of ddI appears not to affect RBT absorption in the gut and its disposition or safety in patients with AIDS.
Design of a flexible PPG signal processing wireless device

In this paper, the design of a flexible PPG signal processing wireless device is presented. The printed circuit board design is based on a flexible substrate, i.e., Flexible Print Circuit Board (FPCB). The main purpose is to improve the existing PPG signal detection of the wearable device. The different detection positions by different users often limit the accuracy of the calculation results. By means of a flexible mechanism, it can guide the user to find the most suitable detection position. Due to various molds for different users' finger sizes, the product cost can be reduced by FPCB. The aesthetic design of the products can also be achieved easier.
ENTROPY GENERATION IN BOUNDARY LAYER FLOW OF A MICRO POLAR FLUID OVER A STRETCHING SHEET EMBEDDED IN A HIGHLY ABSORBING MEDIUM

An analytical study of entropy generation in steady boundary layer flow, heat and mass transfer characteristic of 2D convective flow of a micro polar fluid over a stretching sheet embedded through a highly absorbing medium is performed. The governing equations are continuity, momentum boundary layer, micro rotation, and energy takes into account of Rosseland approximation for thermal radiation sources are solved analytically. The governing system of partial differential equations is first transformed into a system of non-linear ordinary differential equations using similarity transformation. The transformed equations are non-linear coupled differential equations which are then linearized by quasi-linearization method and solved very efficiently by the Homotopy analysis method. The special case of the first branch (K = 0, classical Newtonian fluid) is compared with the existing numerical results of stretching flow in good agreement. In addition, favorable comparisons with previously published work on various special cases of the problem are obtained. The effects of various physical parameters of entropy generation are presented graphically and in tabular form.
Convergence of service, policy, and science toward consumer-driven mental health care.

BACKGROUND A common theme is emerging in sentinel reports on the United States health care system. Consumer relevance and demands on service systems and practices are influencing how mental health care is delivered and how systems will be shaped in the future. AIMS OF THE STUDY The present report seeks to assemble a confluence of consumer-driven themes from noteworthy reports on the state of the mental health system in the U.S. It also explores innovative efforts, promising practices, collaborative efforts, as well as identification of barriers to consumer-directed care, with possible solutions. METHOD The report reviews the relevant public mental health policy and data used in published work. RESULTS The findings indicate an increasing public and private interest in promoting consumer-driven care, even though historical systems of care predominate, and often create, barriers to wide-spread redesign of a consumer-centered mental health care system. Innovative consumer-driven practices are increasing as quality, choice, and self-determination become integral parts of a redesigned U.S. mental health care system. DISCUSSION AND LIMITATIONS The use of consumer-driven approaches in mental health is limited at best. These programs challenge industry norms and traditional practices. Limitations include the need for additional and thorough evaluations of effectiveness (cost and clinical) and replicability of consumer-directed programs. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE Consumer-driven services indicate that mental health consumers are expecting to be more participative in their mental health care. This expectation will influence how traditional mental health services and providers become more consumer-centric and meet the demand. IMPLICATIONS FOR HEALTH POLICIES Public and private interest in consumer-driven health care range from creating cost-conscious consumers to individualized control of recovery. The health care sector should seek to invest more resources in the provision of consumer-driven health care programs. The results of this study have implications and are informative for other countries where consumer-directed care is delivered in either the private or public health care systems. IMPLICATIONS FOR FURTHER RESEARCH More research is needed to obtain further evidence on the use of consumer-driven services and their overall effectiveness.
Canada's Physical Activity Guide: Examining Print-Based Material for Motivating Physical Activity in the Workplace

The authors conducted a secondary analysis on 202 adults from the Physical Activity Workplace Study. The aim of this analysis was to examine demographic characteristics associated with reading Canada's Physical Activity Guide (CPAG), being motivated by the guide, and whether participants in the Physical Activity Workplace Study who read the CPAG increased their physical activity levels over 1 year. Results revealed that less than 50% of participants read the full version of CPAG, and less than 10% were motivated by it. The CPAG also appears to be more appealing to and effective for women than for men. Although the CPAG had some influence in increasing mild physical activity levels in a workplace sample, there was also a decrease in physical activity levels among some members of the group. Overall, the effectiveness of CPAG was not substantial, and the findings of this analysis could help guide future targeted intervention materials and programs.
Many-Sorted Coalgebraic Modal Logic: a Model-theoretic Study

This paper gives a semantical underpinning for a many- sorted modal logic associated with certain dynamical systems, like tran- sition systems, automata or classes in object-oriented languages. These systems will be described as coalgebras of so-called polynomial func- tors, built up from constants and identities, using products, coproducts and powersets. The semantical account involves Boolean algebras with operators indexed by polynomial functors, called MBAOs, for Many- sorted Boolean Algebras with Operators, combining standard (categor- ical) models of modal logic and of many-sorted predicate logic. In this setting we will see Lindenbaum MBAO models as initial objects, and canonical coalgebraic models of maximally consistent sets of formulas as nal objects. They will be used to (re)prove completeness results, and Hennessey{Milner style characterisation results for the modal logic, rst established by Roiger. Mathematics Subject Classication. 03G05, 03G30, 06E25.