Miracle-dz/UniFAR-FTUs huggingface dataset:
High-risk carotid endarterectomy: fact or fiction.

OBJECTIVE It has been proposed that patients whose conditions do not meet North American Symptomatic Carotid Endarterectomy Trial inclusion criteria or have anatomic risk factors constitute a "high-risk" group for carotid endarterectomy (CEA) and might be candidates for primary carotid angioplasty stenting. Our objective was to review a consecutive series of isolated CEAs, identify the number of such patients at high risk, and determine whether their operations were associated with increased complication rate. METHODS Consecutive isolated CEAs performed between June 1996 and June 2001 were reviewed. High-risk comorbidities included: age 80 years or more (n = 80), New York Heart Association class III/IV angina (n = 16), Canadian class III/IV heart failure (n = 4), myocardial infarct 6 months or less (n = 11), steroid-dependent or oxygen-dependent pulmonary disease (n = 4), and creatinine level of 3 or more (n = 13). Anatomic high risk was defined by: contralateral occlusion (n = 66), lesion above C(2) or requirement of digastric division (n = 53), reoperation (n = 29), and neck radiation (n = 3). Statistical analysis was with chi(2) analysis. RESULTS Of 788 patients reviewed, 228 (29%) were classified as high risk by one or more of the previous criteria (63% comorbidity, 28% anatomy, 9% both). Presence of preoperative neurologic symptoms and postoperative results were similar across all patient groups. The total stroke and death rate was 1.1% for all the patients. Six patients had postoperative strokes (0.8%), and three patients died of myocardial infarcts (0.4%). The stroke and death rate was 1.3% in the high-risk group as compared with 1.1% in the normal-risk group (P =.51). CONCLUSION The concept of the high-risk CEA must be critically reexamined. Although 29% of patients for CEA were high risk as defined by others, we found no evidence that this influenced the results after CEA. Patients with significant medical comorbidities, contralateral carotid occlusion, and high carotid lesions can undergo operation without increased complications. If a high-risk group exists, it is small and restricted to reoperation or radiated neck (4% in this series). With this possible exception, carotid angioplasty stenting should be restricted to randomized clinical trials.
Greater access to healthy food outlets in the home and school environment is associated with better dietary quality in young children

Abstract Objective To explore associations between dietary quality and access to different types of food outlets around both home and school in primary school-aged children. Design Cross-sectional observational study. Setting Hampshire, UK. Subjects Children (n 1173) in the Southampton Women’s Survey underwent dietary assessment at age 6 years by FFQ and a standardised diet quality score was calculated. An activity space around each child’s home and school was created using ArcGIS. Cross-sectional observational food outlet data were overlaid to derive four food environment measures: counts of supermarkets, healthy specialty stores (e.g. greengrocers), fast-food outlets and total number of outlets, and a relative measure representing healthy outlets (supermarkets and specialty stores) as a proportion of total retail and fast-food outlets. Results In univariate multilevel linear regression analyses, better diet score was associated with exposure to greater number of healthy specialty stores (β=0·025 sd/store: 95 % CI 0·007, 0·044) and greater exposure to healthy outlets relative to all outlets in children’s activity spaces (β=0·068 sd/10 % increase in healthy outlets as a proportion of total outlets, 95 % CI 0·018, 0·117). After adjustment for mothers’ educational qualification and level of home neighbourhood deprivation, the relationship between diet and healthy specialty stores remained robust (P=0·002) while the relationship with the relative measure weakened (P=0·095). Greater exposure to supermarkets and fast-food outlets was associated with better diet only in the adjusted models (P=0·017 and P=0·014, respectively). Conclusions The results strengthen the argument for local authorities to increase the number of healthy food outlets to which young children are exposed.
An adaptable framework for distributed and parallel applications

Complex applications need powerful computers to achieve results in a valid time. However, such machines are very expensive and not always available. An alternative is the adoption of several simple, less powerful, and less expensive computers, which triggers the need for an adaptable framework that would support parallel and distributed execution in several environments and with different communication protocols. By executing in a heterogeneous environment, the user benefits from a higher number of machines. The framework we propose allows switching from a heterogeneous to a more specialized executing environment, if or when it is available. It supports both newcomers who can use existing default implementations to more quickly create applications of their own, and experienced programmers who, besides using existing framework abstractions and implementations, can also implement some parts to increase performance. In fact, the main objective is supporting researches, being acceptable to loose some performance when compared to a tailored, and harder to implement solution, still having a better performance when compared to a nonparallel approach.
Twodi ¡ erentmechanismsofampicillin resistanceoperating in strainsofVibrio choleraeO 1 independentof resistancegenes

Twodi¡erentmechanismsofampicillin resistanceoperating in strainsofVibrio choleraeO1independentof resistancegenes Dong Tu Nguyen, Tuan Cuong Ngo, Huy Hoang Tran, Thi Phuong Lan Nguyen, Binh Minh Nguyen, Kouichi Morita & Masahiko Ehara Department of Bacteriology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Department of Virology, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki, Japan; Department of Microbiology and Immunology, Pasteur Institute HCMC, Ho Chi Minh, Vietnam; and Department of Bacteriology, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki, Japan
Link performance prediction methods for cooperative relaying in wireless networks

Next generation wireless networks are likely to include cooperative relaying in their design. The performance of certain cooperation schemes in realistic scenarios should be evaluated by system level simulations (SLS). Moreover, the link adaptation (LA) and radio resource management become more complex, since cooperation schemes involve transmissions on more than one link and joint processing at the receiver. Both LA and SLS require quality metrics of the composite cooperative links, which capture the performance of the transmission scheme. This paper proposes performance prediction methods which rely on mutual information based metrics for two cooperation schemes which use one relay. Simulations show that, yet simple, these methods are accurate in predicting the coded block error rate (BLER).
Cognitive-behavioural therapy for anxiety in dementia: pilot randomised controlled trial.

BACKGROUND Anxiety is common and problematic in dementia, yet there is a lack of effective treatments. AIMS To develop a cognitive-behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial. METHOD A ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT plus treatment as usual (TAU) (n = 25) or TAU (n = 25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months. RESULTS At 15 weeks, there was an adjusted difference in anxiety (using the Rating Anxiety in Dementia scale) of (-3.10, 95% CI -6.55 to 0.34) for CBT compared with TAU, which just fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (-5.37, 95% CI -9.50 to -1.25). Improvements remained significant at 6 months. CBT was cost neutral. CONCLUSIONS CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.
The Bent Hawaiian-Emperor Hotspot Track: Inheriting the Mantle Wind

Bends in volcanic hotspot lineaments, best represented by the large elbow in the Hawaiian-Emperor chain, were thought to directly record changes in plate motion. Several lines of geophysical inquiry now suggest that a change in the locus of upwelling in the mantle induced by mantle dynamics causes bends in hotspot tracks. Inverse modeling suggests that although deep flow near the core-mantle boundary may have played a role in the Hawaiian-Emperor bend, capture of a plume by a ridge, followed by changes in sub-Pacific mantle flow, can better explain the observations. Thus, hotspot tracks can reveal patterns of past mantle circulation.
Building a circle with squares: A polar phase shifter based on cartesian methods

A phase shifter with polar output has been implemented with techniques commonly used for quadrature phase shifters. The hybrid approach employs dual-path programmable gain amplifiers and polyphase filters as cascaded quadrature phase shifter stages. Each stage is implemented using active components as well as differential RC filters which consume less area than the typical LC low-pass/high-pass approach. 5-bit phase resolution has been implemented. A 4-bit linear PGA follows the phase shifter chain for antenna tapering. The RFIC employing LNA and balancing devices has been been designed in a 0.25 µm SiGe BiCMOS technology which guarantees a low cost solution for medium scale integration such as in phased arrays. According to simulation results, a very homogeneous distribution of phase/gain states can be expected over a wide bandwidth. Achieved gain and noise figure in the band of interest (2.9 GHz . 3.1 GHz) exhibit 25.9 dB and 11.6 dB, respectively, with a power consumption of 114mW.
Does the hiring of chief risk officers align with the COSO/ISO enterprise risk management frameworks?

Purpose - There are two main industry-sanctioned enterprise risk management (ERM) models, that is, COSO Design/methodology/approach - The proxy for ERM implementation is the hiring of a Chief Risk Officer (CRO). The research data come from a sample of 122 US firms that issued a press release following the hiring of a CRO between 2010 and 2014. The press releases were retrieved and aggregated through content analysis in LexisNexis Academic. Findings - The results reveal that many ERM implementations are occurring at the firm/entity level, and with the exception of reporting, firms consider ERM to be a strategic firm resource capable of improving business operations and compliance initiatives. Originality/value - There is a dearth of research studies specifically investigating whether ERM programs adopted by firms are aligned with the specification of
Automatic blood vessel localization in small field of view eye images

Localizing blood vessels in eye images is a crucial step in the automated and objective diagnosis of eye diseases. Most previous research has focused on extracting the centerlines of vessels in large field of view images. However, for diagnosing diseases of the optic disk region, like glaucoma, small field of view images have to be analyzed. One needs to identify not only the centerlines, but also vessel widths, which vary widely in these images. We present an automatic technique for localizing vessels in small field of view images using multi-scale matched filters. We also estimate local vessel properties - width and orientation - along the length of each vessel. Furthermore, we explicitly account for highlights on thick vessels - central reflexes - which are ignored in many previous works. Qualitative and quantitative results demonstrate the efficacy of our method - e.g. vessel centers are localized with RMS and median errors of 2.11 and 1 pixels, respectively in 700×700 images.
Recent developments in the HIV neuropathies.

PURPOSE OF REVIEW With the introduction of highly active antiretroviral therapy peripheral neuropathies have become the most common neurological complications in HIV infection. The frequency and spectrum of these neuropathies are changing, as the various toxic and immune factors are modified by new treatment strategies. Recent studies have provided a better understanding of the risk factors, markers and relevant pathogenic mechanisms, and a thorough review of these is critical for an improved understanding of this important and increasingly common complication. RECENT FINDINGS The combined use of dideoxynucleosides, in association with immune-mediated mechanisms triggered by HIV infection, are critical in the development of distal sensory polyneuropathy. Valuable markers of neuropathy such as intraepidermal nerve fiber density from skin biopsies have been validated and promise to be a valuable tool in the detection and monitoring of distal sensory polyneuropathy. Markers of virological activity have also been associated with the severity of neuropathic pain in distal sensory polyneuropathy. In some instances, the enhanced viral suppression from antiretroviral agents may actually improve or decrease the frequency of certain types of neuropathy. New evidence supports mitochondrial toxicity as a principal mechanism for dideoxynucleoside-associated sensory neuropathy, and questions arise about enhanced risk with pre-existing mitochondrial defects. Confirmed treatments are limited to the reduction of symptoms, with a need for the further investigation of corrective therapies. SUMMARY Increased and improved surveillance for HIV-associated neuropathy will allow earlier interventions to improve quality of life and prevent severe toxicities. A better understanding of the prevailing mechanisms will allow for more effective interventions.
Estimation of Geographic Variation in Human Papillomavirus Vaccine Uptake in Men and Women: An Online Survey Using Facebook Recruitment

Background Federally funded surveys of human papillomavirus (HPV) vaccine uptake are important for pinpointing geographically based health disparities. Although national and state level data are available, local (ie, county and postal code level) data are not due to small sample sizes, confidentiality concerns, and cost. Local level HPV vaccine uptake data may be feasible to obtain by targeting specific geographic areas through social media advertising and recruitment strategies, in combination with online surveys. Objective Our goal was to use Facebook-based recruitment and online surveys to estimate local variation in HPV vaccine uptake among young men and women in Minnesota. Methods From November 2012 to January 2013, men and women were recruited via a targeted Facebook advertisement campaign to complete an online survey about HPV vaccination practices. The Facebook advertisements were targeted to recruit men and women by location (25 mile radius of Minneapolis, Minnesota, United States), age (18-30 years), and language (English). Results Of the 2079 men and women who responded to the Facebook advertisements and visited the study website, 1003 (48.2%) enrolled in the study and completed the survey. The average advertising cost per completed survey was US $1.36. Among those who reported their postal code, 90.6% (881/972) of the participants lived within the previously defined geographic study area. Receipt of 1 dose or more of HPV vaccine was reported by 65.6% women (351/535), and 13.0% (45/347) of men. These results differ from previously reported Minnesota state level estimates (53.8% for young women and 20.8% for young men) and from national estimates (34.5% for women and 2.3% for men). Conclusions This study shows that recruiting a representative sample of young men and women based on county and postal code location to complete a survey on HPV vaccination uptake via the Internet is a cost-effective and feasible strategy. This study also highlights the need for local estimates to assess the variation in HPV vaccine uptake, as these estimates differ considerably from those obtained using survey data that are aggregated to the state or federal level.
Clinical Strategies to Address Patients' Concerns in Osteoporosis Management with Bisphosphonates

Abstract Approximately 44 million Americans either have, or are at risk of developing, osteoporosis, a disease associated with an increased risk of fracture and, consequently, morbidity and mortality. Osteoporosis affects 20% to 30% of postmenopausal women, and resulting fractures pose a major economic burden, with estimated annual direct costs ranging from $17 billion to $19 billion. Hip fractures account for the majority of costs (˜60%) because they often require costly long-term follow-up care in addition to the direct costs of initial treatment. Screening, diagnosis, and disease management are of paramount importance when treating patients at risk for osteoporosis. The National Osteoporosis Foundation recommends that all postmenopausal women be evaluated for osteoporosis risk factors and that all women aged ≥ 65 years undergo bone mineral density testing. Once the primary care physician has identified a patient at risk for osteoporosis-related fracture, the physician must decide whether and how to treat the patient (ie, nonpharmacologic or pharmacologic options). Bisphosphonates are the first-line pharmacologic treatment for women aged ≥ 50 years with postmenopausal osteoporosis. Bisphosphonates—which have a favorable safety and tolerability profile in clinical trials—have shown efficacy in reducing fractures. However, achieved real-world effectiveness is very much dependent on good treatment adherence by the patient. Media attention to rare adverse events has motivated some patients to deliberate nonadherence. Physicians should screen patients for contraindications and adverse event risk factors, educate them on the risks of fracture and benefits and risks of treatment, and monitor them during therapy. To assist primary care physicians in clinical decision making for women at risk for or with confirmed osteoporosis, this article presents a review of the guidelines for the diagnosis and treatment of postmenopausal osteoporosis, recent long-term efficacy data for extended-interval bisphosphonates, recent safety concerns with bisphosphonates, and lastly, suggests strategies for improving bisphosphonate adherence and patient outcomes.
Liver pathology in compound heterozygous patients for hemochromatosis mutations.

BACKGROUND While hepatic pathology of homozygous carriers of the C282Y mutation of the HFE haemochromatosis gene is well defined, the impact of the C282Y/H63D compound heterozygous carrier state is unknown. AIMS To evaluate the range of hepatic pathology in C282Y/H63D compound heterozygous patients. PATIENTS 25 C282Y/H63D compound heterozygous patients with and without known underlying liver disease underwent liver biopsies for evaluation or abnormal liver tests. Eleven cadaveric liver donors with HFE wild type served as controls. METHODS Mutations in the HFE gene were detected by polyacrylamide gel electrophoresis (PAGE) separation of digested polymerase chain reaction (PCR)-amplificates. The extent of light microscopic changes of liver architecture were studied on haematoxylin, eosin (H. E.) stains. In addition, the extent and the distribution of iron deposition was graded on Prussian blue-stained sections and hepatic iron was quantified by atom absorption spectroscopy. Serum ferritin concentration and the transferrin saturation index were measured using routine laboratory methods. RESULTS Patients without underlying liver disease (n = 15): Hepatic inflammation was seen in only 8% but fibrosis was found in 36% of compound heterozygous patients. Eighty six percent of those patients had stainable iron predominantly found in Rappaport's zone 1 and 2, but all had a liver iron-index < 1.9. Transferrin saturation was found elevated in 36% of compound heterozygous patients. Patients with liver fibrosis showed significantly higher ferritin levels than patients without liver fibrosis (1110 ng/mL versus 307 ng/mL, p < 0.05). Patients with underlying disease (n = 10): In compound heterozygous patients, 77% had hepatic inflammation and 88% fibrosis. Stainable iron (44%) was less frequently found than in patients without underlying liver disease. Hepatic iron-index in patients with underlying liver disease was always below 1.17; transferrin saturation was elevated in only 22% of the compound heterozygous patients. Histologic hepatic iron-index was significantly lower in patients with underlying disease (median 0.047) as compared to patients without underlying liver disease (median 0.274, P < 0.05). CONCLUSIONS The underlying liver disease determines the extent of hepatic pathology seen in livers of compound heterozygous patients. However, considerable histologic fibrosis can also be found in compound heterozygous patients without underlying liver disease.
Comorbidity and survival disparities among black and white patients with breast cancer.

CONTEXT Reasons for the shorter survival of black breast cancer patients compared with their white counterparts are not completely understood. OBJECTIVE To evaluate the role of comorbidity in this racial disparity among breast cancer patients. DESIGN, SETTING, AND PATIENTS Historical cohort from the Henry Ford Health System (a large comprehensive health system in Detroit, Mich) followed up for a median of 10 years. Patients (n = 906) included 264 black (29.1%) and 642 white (70.9%) women diagnosed as having breast cancer between 1985 and 1990. Detailed comorbidity data (268 comorbidities) and study data were abstracted from medical records and institutional, Surveillance, Epidemiology, and End Results, and Michigan State registries. Associations were analyzed with logistic and Cox regression. MAIN OUTCOME MEASURES Breast cancer recurrence/progression and survival to death from all, breast cancer, and competing (non-breast cancer) causes. RESULTS Of blacks, 64 (24.9%) died of breast cancer and 95 (37.0%) died of competing causes. Comparable data for whites were 115 (18.3%) and 202 (32.1%). Blacks had worse all-cause survival (hazard ratio [HR], 1.34; 95% confidence interval [CI], 1.11-1.62), breast cancer-specific survival (HR, 1.47; 95% CI, 1.08-2.00), and competing-causes survival (HR, 1.27; 95% CI, 1.00-1.63). A total of 77 adverse comorbidities were associated with reduced survival. Adverse comorbidity count was associated with all-cause (adjusted HR, 1.29; 95% CI, 1.19-1.40) and competing-causes survival but was not associated with recurrence/progression or breast cancer-specific survival. At least 1 adverse comorbidity was observed in 221 (86.0%) blacks and 407 (65.7%) whites (odds ratio, 3.20; 95% CI, 2.17-4.72). Comparisons of unadjusted and comorbidity-adjusted HRs indicated that adverse comorbidity explained 49.1% of all-cause and 76.7% of competing-causes survival disparity. Diabetes and hypertension were particularly important in explaining disparity. CONCLUSIONS More black breast cancer patients die of competing causes than of breast cancer. Effective control of comorbidity in black breast cancer patients should help improve life expectancy and lead to a reduction in survival disparities.