Miracle-dz/UniFAR-FTUs huggingface dataset:
From the Human Spine to Hyperredundant Robots: The ERMIS Mechanism

Mechatronics are occasionally inspired by nature for joint designs in order to exploit the advantages of the biological ones in terms of mobility and articulation. Within this context and based upon the human spine for structure and actuation, the authors will present a novel hyperredundant mechanism, named ERMIS. The muscle-skeletal system of the human trunk will be described and modelled, and the elements that are being replicated by the mechanical analog will be analysed. It will be shown that the vertebrae-intervertebral disk arrangement can be emulated by a spherical-type configuration, the proposed Disk-Ball-Disk joint. Furthermore, the muscle actuation system is being recreated by a system of wires and pulleys. The relevant kinematic models will be developed, and both simulation and experimental data to evaluate its operation will be demonstrated.
Cardio-Oncology Programs Strive to Balance Cancer Care With Heart Health.

For many diseases, therapeutic advances have improved patient survival, but with prolonged life comes an increased likelihood of experiencing long-term adverse effects of treatment. For cancer survivors, it may be years after completing chemotherapy or radiation before problems are detected, with the most worrisome being secondary cancers and cardiovascular damage. In light of the increased potential that a cancer survivor of today will become the heart disease patient of tomorrow, many hospitals and research groups are dedicating multidisciplinary programs and subspecialties focused on cardio-oncology, with the goal of balancing the benefits of cancer treatments against the risks of adverse cardiovascular effects. “The concept of cancer drug cardiotoxicity is not new actually, but cardio-oncology has emerged as a new field for two simple reasons,” said Javid J. Moslehi, MD, an Assistant Professor of Medicine and the Director of the Cardio-Oncology Program at Vanderbilt School of Medicine in Nashville, TN. “First, there has been an explosion of new cancer therapies, some of which adversely affect the cardiovascular system, and second, survival of cancer patients makes cardiovascular issues relevant. ” The heart is especially vulnerable to cancer treatments because cardiac cells do not divide and have minimal ability to heal, despite being very active. They are also very responsive to stress and, because they rely heavily on cell-cell communication, disruptions can negatively impact the heart in a significant way. Some anticancer agents primarily affect cardiac …
Efectos de un programa de Ai Chi acuático en pacientes con fibromialgia. Estudio piloto

Introduccion. La fibromialgia es un trastorno reumatico que presenta sintomatologia fisica, psicologica y social. El objetivo del presente estudio es analizar los beneficios de un programa de Ai Chi en el medio acuatico sobre la calidad de vida, depresion y dolor en pacientes con fibromialgia. Pacientes y metodos. Se realizo un estudio experimental con 20 pacientes diagnosticadas de fibromialgia de dos localidades distintas. Las dimensiones del estudio fueron la capacidad funcional (Fibromyalgia Impact Questionnaire), la valoracion del dolor (escala analogica visual) y la salud fisica y mental (Short Form-36). Las evaluaciones se llevaron a cabo en el momento basal y al finalizar las 20 sesiones. Resultados. Finalizadas las diez semanas de tratamiento, se obtuvieron diferencias significativas (p < 0,05) en practicamente todas las variables valoradas. Conclusion. Un programa de Ai Chi en el medio acuatico contribuye a mejorar la salud fisica y mental, el dolor y la calidad de vida de pacientes con fibromialgia.
Serum Procalcitonin and C-reactive Protein Level as an Early Diagnostic Marker of Bacterial Meningitis in the Emergency Department

Purpose: Immediate identification of bacterial meningitis (BM) is essential in the emergency department. However, diagnosis of BM from analysis of cerebrospinal fluid has low sensitivity. The goal of this study was to determine the ability of serum procalcitonin (PCT) and C-reactive protein (CRP) for differentiation between BM and non-BM in adult patients. Methods: This retrospective cohort study, which was conducted from Jan 1 2008 to Sep 3
Discussion: Diagnostic issues in early-stage disease

At present, several modalities exist for the preoperative staging of rectal lesions, including computed tomography (CT), body coil or endorectal coil magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS) done by rigid or flexible probes, and positron emission tomography (PET). Staging accuracy for CT ranges from 53% to 94% for T-stage accuracy and from 54% to 70% for N-stage accuracy. Improved CT accuracy is observed at higher disease stages. Body coil MRI has shown T- and N-stage accuracy ranging from 59% to 95% and 39% to 95%, respectively. Endorectal coil MRI has shown improved T- and N-stage accuracy, with rates of 66% to 91% and 72% to 79%, respectively. The development of phased-array MRI, combining high spatial resolution with a larger field of view, offers promise to improve on these rates. EUS, considered the current gold standard, has shown T-stage accuracy ranging from 75% to 95%, with N-stage accuracy ranging from 65% to 80%. Flexible EUS probes have the advantage of being able to access and sample iliac nodes. Recent studies also suggest that three-dimensional EUS may provide greater accuracy than conventional two-dimensional EUS. Limited studies exist on the use of PET in primary tumor staging. PET may upstage disease in 8% to 24% of patients and has also been used in posttreatment restaging and surveillance. Postradiation edema, necrosis, and fibrosis seem to decrease restaging accuracy in all modalities. This article reviews the current literature about the staging accuracy of the various modalities and suggests a staging algorithm for rectal cancer.
Evaluation of Intervention Strategies for Idiopathic Diarrhea in Commercial Turkey Brooding Houses

SUMMARY In 3 separate commercial turkey brooder houses, we compared the effects of selected probiotic bacteria or antibiotics on performance of poults within a complex that was routinely experiencing mild idiopathic diarrhea and stunting. In all experiments, treatments of probiotic cultures or antibiotics were administered in the water. Poults were tagged and placed into individual pens (20 per pen, 4 replicate pens per treatment) within the brooding house, and performance was evaluated by body weight or body weight gain. In the first experiment, poults receiving 1 of 2 probiotic cultures weighed significantly more than nontreated or antibiotic-treated poults. In the second experiment, there were no significant differences among any of the groups. A third experiment was performed during a clinically significant Salmonella seftenburg infection. In this experiment, poults receiving antibiotics followed by a probiotic culture had significantly higher weight gain than nontreated or probiotic-treated poults.
The polymorphism of G protein ß3 subunit C825T and cancer risk: A Meta-analysis

Aims: In previous studies, G protein β3 subunit (GNB3) C825T polymorphism was reported to have association with various cancers. However, the results were inconclusive, this meta-analysis was performed to investigate the association between GNB3 gene polymorphism C825T and cancer risk. Methods: A comprehensive search in PubMed database was conducted for studies by March, 2014. Meta-analysis was performed using the STATA 11.0 software. Cancer risk associated with GNB3 C825T was estimated by pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). Results: Nine independent studies including 2246 cancers and 3851 controls were included in our meta-analysis. Our results indicated that GNB3 C825T was not associated with the risk of cancer for alleles T vs C [odd ratio (OR) = 1.03, 95% confidence interval (95%CI): 0.95–1.12], TT vs CC (OR = 1.10, 95%CI: 0.91-1.33), CT vs CC
Pneumopathie interstitielle aiguë fatale sous docetaxel: à propos d'un cas et revue de la littérature

Le docetaxel est un agent de chimiothérapie appartenant à la famille des taxanes. Ce médicament est largement utilisé dans le traitement des cancers. La pneumopathie intestitielle est une toxicité rare mais redoutable du fait d'un risque de mortalité élevé. On rapporte un cas d'une patiente atteinte d'un cancer du sein qui a présenté une pneumopathie interstitielle aigue fatale à la suite d'une chimiothérapie adjuvante par docetaxel. Le clinicien doit être conscient de ce risque et doit le considérer comme un diagnostique différentiel en cas de symptômes respiratoire chez un patient recevant du docetaxel.
A Novel Time Series Prediction Approach Based on a Hybridization of Least Squares Support Vector Regression and Swarm Intelligence

This research aims at establishing a novel hybrid artificial intelligence (AI) approach, named as firefly-tuned least squares support vector regression for time series prediction (FLSVRTSP). The proposed model utilizes the least squares support vector regression (LS-SVR) as a supervised learning technique to generalize the mapping function between input and output of time series data. In order to optimize the LS-SVR's tuning parameters, the FLSVRTSP incorporates the firefly algorithm (FA) as the search engine. Consequently, the newly construction model can learn from historical data and carry out prediction autonomously without any prior knowledge in parameter setting. Experimental results and comparison have demonstrated that the FLSVRTSP has achieved a significant improvement in forecasting accuracy when predicting both artificial and real-world time series data. Hence, the proposed hybrid approach is a promising alternative for assisting decision-makers to better cope with time series prediction.
Is CRP a reliable diagnostic tool for infective exacerbations of COPD

CRP, a marker of infection and inflammation, is often used to help type COPD exacerbations as infective or non-infective and so decide need for sputum cultures and antibiotics. This is more so if other signs of infection e.g. fever, sputum purulence are absent. Bacterial growth from sputum reflects infection or colonisation and can greatly alter immediate and long-term management of COPD patients. We looked at how predictive CRP levels are of bacterial growth from sputum culture in patients admitted to a district hospital with COPD exacerbations. We posed 2 questions: 1. Is there a difference in CRP between positive and negative sputum groups? 2. Is a particular CRP level predictive of positive sputum culture? METHOD We cross-referenced positive sputum cultures from 2008 to 2010 with discharges from the same time coded with keywords “COPD”, “exacerbation”. Only patients with CRP levels and sputum sent within 24 hours of admission were included. RESULTS We found 122 cases: 79 male, 43 female, mean age 70.8 years. 67 / 122 had positive sputum cultures. Though the sputum positive CRP mean was higher, we found no significant difference between the groups: mean CRP for sputum positives was 89.6 (CI 62.4 - 116.7) and for sputum negatives 70.6 (CI 49.1 - 92.1); P = 0.29. With CRP at 100 as a screen, sensitivity for positive sputum was 28.4%, specificity 72.7%, positive predictive value (PPV) 55.9% and negative predictive value (NPV) 45.5%. With a CRP of 50, sensitivity was 50%, specificity 58.2%, PPV 58.9% and NPV 49.2%. CONCLUSION We contend that CRP is not a reliable predictor of sputum positivity in COPD exacerbations and so there must be more reliance on clinical findings to decide need for sputum cultures and antibiotics.
Quality Analysis of OpenStreetMap Data Based on Application Needs

Abstract More volunteered geographic information is becoming available; if this information is to be exploited, its quality must be known. This study evaluates the quality of OpenStreetMap data with respect to its “fitness for use” (i.e., its suitability for a certain application), specifically pedestrian navigation. The quality of the data is determined by comparing simulated routes on two networks; one data set is from OSM, and the other is the German topographic data set, ATKIS. Both accessibility and length of routes are used as quality criteria. The two data sets are tested using three different test scenarios in Germany.
Can P Wave Parameters Obtained from 12-Lead Surface Electrocardiogram be a Predictor for Atrial Fibrillation in Patients Who Have Structural Heart Disease?

This study was planned to investigate the parameters detecting risk of developing atrial fibril lation (AF) in patients with sinus rhythm with structural heart disease. Forty-five patients with AF and 37 patients without AF but with structural heart disease (Group I) were included in this study. Thirty-eight patients (Group II) had successfully undergone medically or electri cally cardioversion after transesophageal echocardiography. The restoration of sinus rhythm could not be achieved in 7 patients who were excluded from this study. After providing sinus rhythm, amiodarone was given orally to the patients to prevent recurrences. Left ventricular ejection fraction (LVEF) was calculated and left atrial diameter (LAD) was measured by echocardiography in group I and in group II after cardioversion. A 12-lead electrocardiography (ECG) was simultaneously obtained from all the patients. In these ECG recordings, maximum P wave duration (P max), minimum P wave duration (P min), and P wave dispersion (P disper sion) were calculated. P dispersion was expressed as "P max-P min." Also, the highest P wave voltage is expressed as P amplitude maximum (P amp max), the lowest P wave as P amplitude minimum (P amp min), and P amplitude dispersion (P amp dispersion) was calculated as the difference of both. In univariate analysis, P max, P dispersion, P amp max, P amp dispersion, LAD, LVEF, and old age were significant predictors of chronic AF (p < 0.001, p < 0.01, p < 0.01, p < 0.01, p = 0.003, p = 0.02, and p = 0.01, respectively). However, in multivariate analysis, P max and LAD were independent predictors of chronic AF in patients with structural heart disease (r = 0.39, p < 0.05; r = 0.34; p < 0.05, respectively). In conclusion, in estimating the risk of devel oping chronic AF, P max and LAD are predictive parameters in patients with sinus rhythm with structural heart disease.
FERTILITY IN WOMEN WITH TURNERS SYNDROME CASE REPORT AND REVIEW OF LITERATURE

A successful pregnancy in a woman with Turner's syndrome with a 45, X/46,XX karyotype is described. The literature contains reports of a total of nine pregnancies in seven women with a 45,X karyotype and 56 pregnancies in 23 women with mosaicism and a 45,X cell line, as well as a 46,XX and/or 47,XXX cell line. Fifteen of the latter 56 pregnancies ended in spontaneous abortion (27 per cent), and four ended in the delivery of a stillborn child; 12 of the 37 liveborn infants (32 per cent) had a physical or mental abnormality, and 8 (22 per cent) had a chromosome abnormality. Three had Down's syndrome, and five had a 45,X cell line. Due to the relatively high (8 per cent) incidence of Down's syndrome among liveborn infants of women with Turner's syndrome, amniocentesis for fetal karyotyping should be advised.
Inmunogenicidad, inocuidad y eficacia de una vacuna tetravalente obtenida por recombinación genética de rotavirus aislados de monos rhesus y seres humanos en Belém, Brasil

Se evaluo la inocuidad, inmunogenicidad y eficacia de una vacuna tetravalente obtenida por recombinacion genetica de rotavirus aislados de monos rhesus y seres humanos (RRV-TV) (4 x 10(4) unidades formadoras de placas por dosis) en un ensayo prospectivo, aleatorio, a doble ciego y controlado con placebo que se efectuo con 540 lactantes brasilenos. Se administraron dosis de vacuna o de placebo a la edad de 1, 3 y 5 meses. No se observaron diferencias significativas en la frecuencia de diarrea o vomito en los bebes de ninguno de los dos grupos despues de administrar la dosis correspondiente. De 2 a 3% de los vacunados tuvieron fiebre baja los dias tercero a quinto despues de recibir la primera dosis, pero no despues de las dosis segunda o tercera. Se observo una respuesta de anticuerpos del tipo IgA al rotavirus aislado de monos rhesus (RRV) en 58% de los vacunados y en 33% de quienes recibieron placebo. La respuesta de anticuerpos neutralizantes a cada serotipo no paso de 20% cuando se determino con la prueba de reduccion de focos de fluorescencia, pero fue superior a 40% al medirse con la prueba de neutralizacion a base de reduccion de placas. Se presentaron 91 casos de diarrea causada por rotavirus entre los ninos que recibieron las tres dosis (de vacuna o de placebo) durante un seguimiento de 2 anos, 36 de ellos en los ninos vacunados. La eficacia general de la vacuna fue de 8% (P = 0,005) contra toda clase de diarrea y de 35% (P = 0,03) contra la diarrea causada por rotavirus. La proteccion durante el primer ano de seguimiento, cuando predomino el rotavirus G del serotipo 1, fue de 57% (P = 0,008), pero se redujo a 12% en el segundo ano. Se obtuvieron resultados similares al restringir el analisis a episodios en que el rotavirus fue el unico agente patogeno identificado. Se observo en la vacuna una mayor tendencia a proteger contra casos de enfermedad con un promedio de seis o mas deposiciones diarias. Estos resultados son lo suficientemente alentadores para justificar que en paises en desarrollo se hagan otros estudios de esta vacuna con una dosis mayor para tratar de mejorar su inmunogenicidad y eficacia.
Effects of combination lipid therapy in the management of patients with type 2 diabetes mellitus in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.

The evidence base demonstrating that statins reduce major events, including in people with diabetes mellitus,1 is arguably as robust as for any cardiovascular therapy. However, many individuals still experience end points despite the use of statins (the Figure). This “residual risk,” which is much higher in people with coexistent cardiovascular disease, is probably most appropriately expressed in absolute terms, acknowledging the development of atherosclerosis over decades rather than the duration of trials and its multifactorial causation. However, the residual risk provides the rationale for testing other lipid-modifying therapies in combination with statins. Figure. Vascular event rates, risk reduction, and residual risk despite statin use in major randomized controlled trials of statins in people with diabetes mellitus. CVD indicates cardiovascular disease; RRR, relative risk reduction; and ARR, absolute risk reduction. People with diabetes mellitus have both qualitative and quantitative lipid changes. They include increased levels of triglycerides, small dense low-density lipoprotein (LDL) particles, and apolipoprotein B, as well as a decrease in levels of high-density lipoprotein (HDL) cholesterol. Fibrates, which are peroxisome proliferator receptor-α agonists, not only reduce triglyceride levels and possibly LDL cholesterol and chylomicron remnants and elevate HDL cholesterol but also are anti-inflammatory. The major beneficial effect of statins is to decrease LDL cholesterol. However, lower levels of HDL cholesterol and possibly increasing levels of triglycerides still denote elevated risk in those taking statins,2,3 even when LDL cholesterol levels are very low,2 and particularly in those with diabetes mellitus.3 The hypothesis tested was whether, on a background of simvastatin 20 to 40 mg, major vascular events were reduced by fenofibrate, dosed according to baseline glomerular filtration rate.4 Overall, among 5518 subjects (mean age, 62 years; 31% female; …
Medical Utilization and Cost in Patients with Overlap Syndrome of Chronic Obstructive Pulmonary Disease and Asthma

Abstract Background: Little information is available regarding medical utilization and cost in patients with overlap syndrome of chronic obstructive pulmonary disease (COPD) and asthma. The purpose of this study is to analyze medical utilization and cost in patients with overlap syndrome and to compare them to COPD patients without asthma. Methods: Using the 2009 Korean National Health Insurance (NHI) database, COPD patients were identified. Medical utilization and costs were also analyzed. Results: Of a total of 185,147 patients identified with COPD, 101,004 patients were classified with overlap syndrome of COPD and asthma and 84,143 patients with COPD without asthma. In 2009, the percentages of emergency room visits, admissions, and intensive care unit admissions were 14.6%, 30.5%, and 0.5%, respectively, in the patients with overlap syndrome group and 5.0%, 14.1%, and 0.2%, respectively, in the COPD patients without asthma group (p < 0.05 for all comparisons). The cost of medical utilization was 790 ± 71 US dollars per person and 3,373 ± 4,628 dollars per person for outpatient and inpatient services, respectively, in the patients with overlap syndrome and 413 ± 512 and 3,010 ± 5,013, respectively, in the COPD patients without asthma (p < 0.05 for all comparisons). Multiple linear regression showed that age, sex, overlap syndrome, hospitalization in the last year, low socioeconomic status, and type of hospital use were significant factors affecting medical utilization and cost. Conclusions: In patients with overlap syndrome, both medical utilization and cost were higher than in COPD patients without asthma.
Early High-Frequency Oscillatory Ventilation in Pediatric Acute Respiratory Failure. A Propensity Score Analysis.

RATIONALE The use of high-frequency oscillatory ventilation (HFOV) for acute respiratory failure in children is prevalent despite the lack of efficacy data. OBJECTIVES To compare the outcomes of patients with acute respiratory failure managed with HFOV within 24-48 hours of endotracheal intubation with those receiving conventional mechanical ventilation (CMV) and/or late HFOV. METHODS This is a secondary analysis of data from the RESTORE (Randomized Evaluation of Sedation Titration for Respiratory Failure) study, a prospective cluster randomized clinical trial conducted between 2009 and 2013 in 31 U.S. pediatric intensive care units. Propensity score analysis, including degree of hypoxia in the model, compared the duration of mechanical ventilation and mortality of patients treated with early HFOV matched with those treated with CMV/late HFOV. MEASUREMENTS AND MAIN RESULTS Among 2,449 subjects enrolled in RESTORE, 353 patients (14%) were ever supported on HFOV, of which 210 (59%) had HFOV initiated within 24-48 hours of intubation. The propensity score model predicting the probability of receiving early HFOV included 1,064 patients (181 early HFOV vs. 883 CMV/late HFOV) with significant hypoxia (oxygenation index ≥ 8). The degree of hypoxia was the most significant contributor to the propensity score model. After adjusting for risk category, early HFOV use was associated with a longer duration of mechanical ventilation (hazard ratio, 0.75; 95% confidence interval, 0.64-0.89; P = 0.001) but not with mortality (odds ratio, 1.28; 95% confidence interval, 0.92-1.79; P = 0.15) compared with CMV/late HFOV. CONCLUSIONS In adjusted models including important oxygenation variables, early HFOV was associated with a longer duration of mechanical ventilation. These analyses make supporting the current approach to HFOV less convincing.