Miracle-dz/UniFAR-FTUs huggingface dataset:
Lateral Column Lengthening by Calcaneal Osteotomy

The surgical treatment of adult acquired flatfoot deformity secondary to posterior tibial tendon dysfunction is controversial, especially for the stage 2 posterior tibial tendon dysfunction in which the deformity is still flexible. It has been widely recognized that isolated soft tissue procedures do not provide stable correction of the deformity, which often progresses and becomes painful. For this reason, bony osteotomies have been combined with tendon transfers and ligament reconstruction in an attempt to give long-lasting correction of both pain and deformity. Lateral calcaneal lengthening osteotomy, as originally described by Evans in child flatfoot, was found to restore the medial longitudinal arch and to correct forefoot abduction, thus allowing to minimize the strain and to reach a successful function of the medial ligament reconstruction and tendon transfers. The closer the osteotomy of the calcaneus is to the calcaneocuboid joint, the more likely the anterior calcaneus becomes unstable, which, in turn, may provoke incongruency and pressure increase at the calcaneocuboid joint. This article describes the author's preferred more posteriorly located calcaneal osteotomy along the anterior border of the posterior subtalar facet.
A Study on the Characteristics of Phonation Threshold Pressure and Phonation Threshold Airflow of Patients with Functional Voice Disorder

This study attempted to investigate the characteristics of Phonation Threshold Pressure and Phonation Threshold Airflow of Patients who have Functional voice disorder. 50 subjects participated in study (32 subjects were patients who had functional voice disorders and 20 subjects were normal adults). The PAS (Phonatory aerodynamic system, model 6600, KAY electronics, Inc.) was used to measure the data and to do the analysis. Data from the Phonation Threshold Pressure was measured using voicing efficiency of the PAS protocol. Data from the Phonation Threshold Airflow was measured using Maximum Sustained Phonation of the PAS protocol. Those were used because of the ease of phonation. The results of this study showed that the differences in Phonation Threshold Pressure and Phonation Threshold Airflow between patients who had functional voice disorder and normal adults could be significant index. Patients who had functional voice disorder showed more higher figures than normal adults. These results suggest that Phonation Threshold Pressure and Phonation Threshold Airflow are very useful in diagnosing the voice disorder. The measured data also provided useful information for diagnosing patients with vocal fold diseases.
Fatigue, mood and quality of life improve in MS patients after progressive resistance training

Fatigue occurs in the majority of multiple sclerosis patients and therapeutic possibilities are few. Fatigue, mood and quality of life were studied in patients with multiple sclerosis following progressive resistance training leading to improvement of muscular strength and functional capacity. Fatigue (Fatigue Severity Scale, FSS), mood (Major Depression Inventory, MDI) and quality of life (physical and mental component scores, PCS and MCS, of SF36) were scored at start, end and follow-up of a randomized controlled clinical trial of 12 weeks of progressive resistance training in moderately disabled (Expanded Disability Status Scale, EDSS: 3—5.5) multiple sclerosis patients including a Control group (n = 15) and an Exercise group (n = 16). Fatigue (FSS > 4) was present in all patients. Scores of FSS, MDI, PCS—SF36 and MCS—SF36 were comparable at start of study in the two groups. Fatigue improved during exercise by —0.6 (95% confidence interval (CI) —1.4 to 0.4) a.u. vs. 0.1 (95% CI —0.4 to 0.6) a.u. in controls (p = 0.04), mood improved by —2.4 (95% CI —4.1 to 0.7) a.u. vs. 1.1 (—1.2 to 3.4) a.u. in controls (p = 0.01) and quality of life (PCS—SF36) improved by 3.5 (95% CI 1.4—5.7) a.u. vs. —1.0 (95% CI —3.4—1.4) a.u. in controls (p = 0.01). The beneficial effect of progressive resistance training on all scores was maintained at follow-up after further 12 weeks. Fatigue, mood and quality of life all improved following progressive resistance training, the beneficial effect being maintained for at least 12 weeks after end of intervention.
Intramuscular interferon beta-1a therapy in patients with relapsing-remitting multiple sclerosis: a 15-year follow-up study

Disease-modifying drugs are initiated early and continued for years in patients with multiple sclerosis. Long-term tolerability and impact are not known. The objective of this study was to evaluate long-term tolerability of intramuscular interferon beta-1a and effects on disability and quality of life. Patients were evaluated an average of 15 years after randomization into a placebo-controlled, double-blind trial of intramuscular interferon beta-1a for relapsing multiple sclerosis. Patient-reported Expanded Disability Status Scale, the Short Form-36, a visual analog scale of self-care independence, and a living situation questionnaire were administered. Status was ascertained in 79% (136/172) of eligible patients. Analysis focused on 122 living patients. Despite open-label, non-standardized treatment after the 2-year clinical trial, 46% (n= 56) of the patients remained on intramuscular interferon beta-1a. Expanded Disability Status Scale scores were correlated highly with Short Form-36 subcategories and visual analog scale scores. Patients currently using intramuscular interferon beta-1a had a significantly lower mean Expanded Disability Status Scale score (p= 0.011), less progression to Expanded Disability Status Scale milestones, significantly better scores on the physical component of the Short Form-36 (p< 0.0001), and reported better general health and greater independence. We conclude that patients continuing to use intramuscular interferon beta-1a had less disability and better quality of life compared with patients not currently using intramuscular interferon beta-1a 15 years after randomization into a clinical trial.
Drug Efflux by a Small Multidrug Resistance Protein Is Inhibited by a Transmembrane Peptide

ABSTRACT Drug-resistant bacteria use several families of membrane-embedded transporters to remove antibiotics from the cell. One such family is the small multidrug resistance proteins (SMRs) that, because of their relatively small size (ca. 110 residues with four transmembrane [TM] helices), must form (at least) dimers to efflux drugs. Here, we use a Lys-tagged synthetic peptide with exactly the same sequence as TM4 of the full-length SMR Hsmr from Halobacterium salinarum [TM4 sequence: AcA(Sar)3-VAGVVGLALIVAGVVVLNVAS-KKK (Sar = N-methylglycine)] to compete with and disrupt the native TM4-TM4 interactions believed to constitute the locus of Hsmr dimerization. Using a cellular efflux assay of the fluorescent SMR substrate ethidium bromide, we determined that bacterial cells containing Hsmr are able to remove cellular ethidium via first-order exponential decay with a rate constant (k) of 10.1 × 10−3 ± 0.7 × 10−3 s−1. Upon treatment of the cells with the TM4 peptide, we observed a saturable ∼60% decrease in the efflux rate constant to 3.7 × 10−3 ± 0.2 × 10−3 s−1. In corresponding experiments with control peptides, including scrambled sequences and a sequence with d-chirality, a decrease in ethidium efflux either was not observed or was marginal, likely from nonspecific effects. The designed peptides did not evoke bacterial lysis, indicating that they act via the α-helicity and membrane insertion propensities of the native TM4 helix. Our overall results suggest that this approach could conceivably be used to design hydrophobic peptides for disruption of key TM-TM interactions of membrane proteins and represent a valuable route to the discovery of new therapeutics.
Early changes on electroencephalography in natalizumab-associated progressive multifocal leucoencephalopathy

Progressive multifocal leucoencephalopathy has become a growing concern in natalizumab-treated multiple sclerosis patients. Here, we describe a 35-year-old patient who was treated with 34 infusions of natalizumab before complaining about visual deterioration. MRI was non-diagnostic and JC virus testing initially was negative. Electroencephalography showed severe slowing of the right hemisphere, and neuropsychological testing revealed right frontal and temporal deficits. The diagnosis of progressive multifocal leucoencephalopathy was established 2 months later by typical MRI presentation and detection of JC virus DNA in the cerebrospinal fluid. Functional neurological deficits may precede imaging features and should prompt early consideration of progressive multifocal leucoencephalopathy.
Linear and Nonlinear Control Techniques for a Three-Phase Three-Level NPC Boost Rectifier

This paper deals with three control techniques for a three-phase three-level neutral-point-clamped (NPC) boost rectifier to study their relative performance. Linear, nonlinear, and nonlinear model reference adaptive control (MRAC) methods are developed to control power factor (PF) and regulate output and neutral point voltages. These controllers are designed in Simulink and implemented in real time using the DS1104 DSP of dSPACE for validation on a 1.2-kW prototype of an NPC boost rectifier operating at 1.92 kHz. The performance of boost converter with three control methods has been investigated respectively in steady state in terms of line-current harmonic distortion, efficiency, and PF and during transients such as load steps, utility disturbances, reactive power control, and dc-bus voltage tracking behavior. The linear PI controllers are characterized by reduced complexity but poor performance, whereas the nonlinear control technique has improved the converter performance significantly, while nonlinear MRAC exhibits much better performance in a wide operating range
$H^infty$Control of the Neutral Point in Four-Wire Three-Phase DC&#8211;AC Converters

Inverters used as the interface for a distributed generator in a three-phase four-wire system sometimes operate with a large neutral current because of unbalanced loads and single-phase (possibly nonlinear) loads. Voltage balance within the dc-link of the inverter is important for proper operation of the inverter, and the neutral current is a significant disturbance to this. It is preferable to use fast acting control rather than dissipative balancing or large-valued capacitors. This paper develops a linear model of an actively balanced split dc-link and applies Hinfin control design to provide high-bandwidth robust control. The approach is developed for a conventional two-level inverter, but it remains valid (without change) for a three-level neutral-point clamped inverter. The controller achieves very small deviations of the neutral point (better than 0.5 in 800 V) from the midpoint of the dc source despite the large neutral current (32 ARMS). The controller design is described and verified first in a PSCAD simulation and second in experimental testing of a 30-kW 415-V (line) inverter
Modeling, Identification, and Compensation of Stick-Slip Friction

The paper presents a novel approach for stick-slip friction modeling. The adaptive friction compensator, which uses this modified model guarantees the convergence of the tracking error to a small residual set and at the same time the algorithm can easily be implemented on standard industrial controller architectures. The model clearly distinguishes the low and the high-velocity regimes. Accordingly, at low velocities the adaptive laws in the friction compensator tune only the parameters which characterizes the low-speed friction behavior (Striebeck friction) and at the high-speed regime the adaptive laws modify only the parameters which characterize the high-speed friction behavior (Coulomb and viscous friction terms). An off-line identification method for the friction model parameters is also presented. Experimental results are provided to show the performances of the proposed friction modeling and compensation method
ZVS Combined Three-Level Converter—A Topology Suitable for High Input Voltage With Wide Range Applications

A novel zero-voltage-switching (ZVS) combined three-level (TL) converter is proposed in this paper. It is essentially a hybrid combination of a half-bridge TL section and a full-bridge section. The main advantages of the proposed converter are given as follows: the voltage stress of all the switches is ensured to be only half of the input voltage; the secondary rectified voltage is very close to the output voltage, so the high-frequency content is very low, leading to a reduced output filter requirement; the voltage stress of the rectifier diodes is also reduced; and the switches can achieve ZVS with the use of the leakage inductances of the transformers and the intrinsic capacitors of the switches. This paper describes the operating principles and design procedures for the proposed converter. Experimental results from a 1080 W prototype converter operating at 100 kHz are presented to validate the theoretical analysis and demonstrate the performance of the proposed converter
Body Fragmentation: Native American Community Members’ Views on Specimen Disposition in Biomedical/Genetics Research

Background: Genetics research is controversial in Native American communities, and the disposition and ownership of biological specimens are central issues. Within Native communities, there is considerable variety in tribal members’ views. This article reports the results from an ethnographic study conducted with a Native American community in the southwestern United States. The purpose of this study was to examine the relationship (past and present) between the tribe and biomedical/genetics research. Methods: Qualitative interviews were conducted with 53 members of a Native American community. Interviewees were purposively recruited to include an approximately equal number of past research participants and nonparticipants, as well as individuals with and without diabetes. Tribal members were also asked whether they identified as a “traditional person,” an emic category used in the community. Results: Tribal members’ views on specimen disposition were linked with their identification as a traditional or nontraditional person. Individuals identifying as traditional people were more likely to believe that biological specimens should be returned at the end of a study and should not be used after the research participant's death, and that they were the property of the individual who provided them. These perspectives were related to broader concerns about fragmentation of the body-self. Conclusions: Through gaining an understanding of the cultural logic related to specimen disposition, researchers may be able to work more effectively with Native American communities on developing procedures for genetics studies. The process of informed consent and other study procedures can be adapted to be culturally respectful of Native American communities.
Efficacy of Daptomycin against Bacillus anthracis in a Murine Model of Anthrax Spore Inhalation

ABSTRACT Daptomycin demonstrated in vitro (MIC90, 4 μg/ml) and in vivo activities against Bacillus anthracis. Twice-daily treatment with a dose of 50 mg/kg of body weight was begun 24 h after challenge and continued for 14 or 21 days; results were compared to those for controls treated with phosphate-buffered saline or ciprofloxacin. Day 43 survival rates were 6/10 mice for the 14-day and 9/10 mice for the 21-day treatment groups, compared to survival with ciprofloxacin: 8/10 and 9/10 mice, respectively. Culture results from tissues removed at the termination of the experiment were negative.
In Vitro Susceptibility of Global Surveillance Isolates of Pseudomonas aeruginosa to Ceftazidime-Avibactam (INFORM 2012 to 2014)

ABSTRACT Broth microdilution antimicrobial susceptibility testing was performed for ceftazidime-avibactam and comparator agents against 7,062 clinical isolates of Pseudomonas aeruginosa collected from 2012 to 2014 in four geographic regions (Europe, Asia/South Pacific, Latin America, Middle East/Africa) as part of the International Network for Optimal Resistance Monitoring (INFORM) global surveillance program. The majority of isolates were susceptible to ceftazidime-avibactam, with the proportions susceptible differing marginally across the four regions (MIC90, 8 to 16 μg/ml; 88.7 to 93.2% susceptible), in contrast to lower susceptibilities to the following comparator β-lactam agents: ceftazidime (MIC90, 32 to 64 μg/ml; 71.5 to 80.8% susceptible), meropenem (MIC90, >8 μg/ml; 64.9 to 77.4% susceptible), and piperacillin-tazobactam (MIC90, >128 μg/ml; 62.3 to 71.3% susceptible). Compared to the overall population, susceptibility to ceftazidime-avibactam of isolates that were nonsusceptible to ceftazidime (n = 1,627) was reduced to between 56.8% (Middle East/Africa; MIC90, 64 μg/ml) and 68.9% (Asia/South Pacific; MIC90, 128 μg/ml), but these percentages were higher than susceptibilities to other β-lactam agents (0 to 44% susceptible, depending on region and agent; meropenem MIC90, >8 μg/ml; 26.5 to 43.9% susceptible). For this subset of isolates, susceptibilities to amikacin (MIC90, >32 μg/ml; 53.2 to 80.0% susceptible) and colistin (MIC90, 1 μg/ml; 98.5 to 99.5% susceptible) were comparable to or higher than that of ceftazidime-avibactam. A similar observation was made with isolates that were nonsusceptible to meropenem (n = 1,926), with susceptibility to ceftazidime-avibactam between 67.8% (Middle East/Africa; MIC90, 64 μg/ml) and 74.2% (Europe; MIC90, 32 μg/ml) but again with reduced susceptibility to comparators except for amikacin (MIC90, >32 μg/ml; 56.8 to 78.7% susceptible) and colistin (MIC90, 1 μg/ml; 98.9 to 99.3% susceptible). Of the 8% of isolates not susceptible to ceftazidime-avibactam, the nonsusceptibility of half could be explained by their possession of genes encoding metallo-β-lactamases. The data reported here are consistent with results from other country-specific and regional surveillance studies and show that ceftazidime-avibactam demonstrates in vitro activity against globally collected clinical isolates of P. aeruginosa, including isolates that are resistant to ceftazidime and meropenem.
-308 G > A of TNF-α gene promoter decreases the risk of multiple sclerosis: a meta-analysis

Background: Environmental and genetic factors are thought to be involved in the pathogenesis of multiple sclerosis (MS). Polymorphisms of tumor necrosis factor (TNF)-α −308 were implicated in MS risk in several case–control association studies. However, the studies have shown inconsistent results. Objectives: To address the association of G/A polymorphisms of TNF-α −308 with MS risk by meta-analysis. Methods: Thirteen studies were included. Pooled odds ratios (ORs) together with 95% confidence intervals (CIs) were calculated. Results: A total of 1870 cases and 2769 controls were included in the meta-analysis. The pooled result indicated that −308 A allele is significantly associated with reduced risk of MS compared with −308 G allele (A vs. G, p = 0.022). The same pattern of the result was also obtained in the contrasts of AA + GA vs. GG (p = 0.008) and GA vs. GG (p = 0.007). For AA vs. GG or AA vs. GA + GG, no significant association was detected most likely caused by very low frequency or non-availability of homozygote genotype AA for all of the studies. Conclusions: TNF-α −308 A allele is associated with reduced risk of MS.
Efficacy of Usual and High Doses of Daptomycin in Combination with Rifampin versus Alternative Therapies in Experimental Foreign-Body Infection by Methicillin-Resistant Staphylococcus aureus

ABSTRACT The treatment of prosthetic joint infections caused by methicillin-resistant Staphylococcus aureus (MRSA) continues to be a challenge for the clinician. The aim of this study was to evaluate the efficacies of daptomycin at usual and high doses (equivalent to 6 and 10 mg/kg of body weight/day, respectively, in humans) and in combination with rifampin and to compare the activities to those of conventional anti-MRSA therapies. We used MRSA strain HUSA 304, with the following MICs and minimal bactericidal concentrations (MBCs), respectively: daptomycin, 1 μg/ml and 4 μg/ml; vancomycin, 2 μg/ml and 4 μg/ml; linezolid, 2 μg/ml and >32 μg/ml; and rifampin, 0.03 μg/ml and 0.5 μg/ml. In time-kill curves, only daptomycin and its combinations with rifampin achieved a bactericidal effect in log and stationary phases. For in vivo studies, we used a rat foreign-body infection model. Therapy was administered for 7 days with daptomycin at 100 mg/kg/day and 45/mg/kg/day, vancomycin at 50 mg/kg/12 h, rifampin at 25 mg/kg/12 h, and linezolid at 35 mg/kg/12 h, and each antibiotic was also combined with rifampin. Among monotherapies, daptomycin at 100 mg/kg/day and rifampin performed better than vancomycin and linezolid. In combination with rifampin, both dosages of daptomycin were significantly better than all other combinations, but daptomycin at 100 mg/kg/day plus rifampin achieved better cure rates at day 11 (P < 0.05) than daptomycin at 45 mg/kg/day plus rifampin. Resistant strains were found in monotherapies with rifampin and daptomycin at 45 mg/kg/day. In conclusion, daptomycin at high doses was the most effective monotherapy and also improved the efficacy of the combination with rifampin against foreign-body infections by MRSA. Clinical studies should confirm whether this combination may be considered the first-line treatment for foreign-body infections by MRSA in humans.
Pharmacokinetics of Daptomycin in a Patient with Severe Renal Failure Not Receiving Dialysis

The pharmacokinetics of daptomycin has been described in patients with normal renal function ([1][1], [2][2]) or under hemodialysis ([3][3]) but not in patients with severe impaired renal function who are not receiving hemodialysis. A 48-year-old, 60-kg woman was treated within our institution for
Fmt Bypass in Pseudomonas aeruginosa Causes Induction of MexXY Efflux Pump Expression

ABSTRACT The intrinsic resistance of P. aeruginosa PAO1 to the peptide deformylase inhibitor (PDF-I) LBM415 was mediated by the MexAB-OprM and MexXY-OprM efflux pumps, the latter of which was strongly induced by LBM415. Single-step exposure of PAO1 deleted for mexAB-oprM (therefore lacking both MexAB-OprM and MexXY-OprM functions) to PDF-Is selected for nfxB mutants, which express the MexCD-OprJ efflux pump, indicating that these compounds are also substrates for this pump. Selection of resistant mutants by use of levels of LBM415 greater than that accommodated by efflux yielded two additional groups of mutations, in the methionyl-tRNAfmet formyltransferase (fmt) and folD genes. Both mechanisms are known to impose an in vitro growth deficit (also observed here), presumably due to impairment of protein synthesis. We surmised that this inherent impairment of protein synthesis would upregulate expression of mexXY in a fashion similar to upregulation by LBM415 or by ribosome inhibitory compounds. Transcriptional profiling and/or mexX::lux promoter fusion analysis revealed that fmt and folD mutants were strongly upregulated for mexXY and another gene known to be required for upregulation of the pump, PA5471. Complementation of the fmt mutation in trans reversed this constitutive expression. This supports the notion that MexXY has a natural physiological function responding to impairment of ribosome function or protein synthesis and that fmt mutation (Fmt bypass) and folD mutation generate the intracellular mexXY-inducing signal.