Miracle-dz/UniFAR-FTUs huggingface dataset:
Surgical Therapy for Chronic Obstructive Pulmonary Disease

Many patients with severe chronic obstructive pulmonary disease (COPD) experience incapacitating breathlessness and exercise limitation. Multiple surgical techniques have been utilized to achieve resection of giant, localized bullae with documented short-term beneﬁt in pulmonary function and dyspnea in highly selected patients. The poorest long-term outcome has been noted in those with greater degrees of emphysema in the remaining lung, greater underlying chronic bronchitis, and a bulla occupying less than one third of the hemithorax, particularly if compressed normal lung is not evident. Lung volume reduction surgery (LVRS) in the absence of giant bullae has become more widely accepted in selected patients. Bilateral LVRS procedures appear to result in greater short-term improvement than unilateral LVRS, whereas physiological beneﬁts appear similar with video-assisted thoracoscopy (VATS) or median sternotomy (MS) techniques. Improvement in dyspnea and health status after LVRS has been documented and appears to be better preserved over longer-term follow-up than physiological improvement. Clear direction has been provided in identifying optimal candidates for bilateral LVRS; patients with a postbronchodilator forced expiratory volume in 1 second (FEV 1 ) (cid:1) 20% predicted and a diffusing capacity for carbon monoxide (DL CO ) (cid:1) 20% predicted or homogeneous emphysema exhibit a much higher mortality with LVRS than with medical management. Patients with upper-lobe predominant emphysema and a low postrehabilitation exercise tolerance exhibited a decreased risk of mortality after LVRS. Patients with non–upper lobe predominant emphysema on high-resolution computed tomography (HRCT) and a high postrehabilitation exercise capacity exhibit an increased risk of death after LVRS. Patients with upper lobe predominant emphysema and a high postrehabilitation exercise capacity or patients with non–upper lobe predominant emphysema and a low postrehabilitation exercise capacity do not have a survival advantage or disadvantage, whereas
Pulmonary Blastomycosis

Blastomycosis is a rare but important fungal infection diagnosed primarily in the south central and midwestern United States but also in the American and Canadian borders of the Great Lakes. Epidemics of infection related to point-source exposure include patients of all ages and both sexes, but endemic cases are usually in young to middle-aged adults, with more men than women reported. Pneumonia is the most common manifestation and the lung is almost always the organ initially infected. The lung manifestations range from illness that mimics acute bacterial pneumonia to chronic, destructive lung disease appearing like tuberculosis or lung cancer. Extrapulmonary disease can occur with or without concomitant lung disease. In descending order, cutaneous, osseous, prostatic, and central nervous system involvements are the most frequent manifestations of extrapulmonary blastomycosis. Amphotericin B is curative, but, because of toxicity, oral azole agents have replaced amphotericin B as therapy for less than over-whelming blastomycosis. Itraconazole is now considered to be the agent of choice with ﬂuconazole, voriconazole, and posaconazole having a role in selected patients. In a patient with life-threatening or central nervous system blastomycosis amphotericin B should be given, at least initially.
Emerging Facade of Menopausal Hormone Therapy

Menopausal hormone therapy (HT) has been around for 70 years, and in the 1980s and 1990s was considered a universal panacea for women’s problems from midlife onward. However, this concept was challenged by the results of the Women’s Health Initiative (WHI) and the Million Women Study (MWS) that were ﬁrst published in 2002 and 2003. Since the publication of these studies, prescriptions of HT have markedly declined and there have been many media scares. An unfortunate sequel was an extrapolation of the observations from women in their 50s and older to those with early ovarian failure. This article discusses the WHI and the MWS with a focus on differences between HT regimens including doses, formulations, and routes, timing, and duration of HT. It addresses practical issues such as strategies for stopping HT, and discusses bioidentical hormones. The specialist knowledge now required to deliver post-reproductive health service has led to considerations that menopause management should be now the responsibility of a specialist and not a general gynecologist.
Autoimmunity – A View From 1975

This issue of Seminars in Thrombosis and Hemostasis concerns autoantibodies that inhibit blood coagulation factors. One of the next issues will deal with autoantibodies to blood platelets. The student of blood clotting may be puzzled by the occurrence of antibodies to constituents of the same body. But the immunologist is no less intrigued by the mystery of how the body generally avoids producing autoantibodies. This presentation will review some current concepts of antibody formation with particular emphasis on the manner by which the body defends itself against the ill effects of autoimmunity
Gonadotropin-Releasing Hormone Neuronal Migration

Neurons that synthesize and secrete the decapeptide gonadotropin-releasing hormone-1 (GnRH-1) to control the reproductive axis originate in the olfactory placode/vomeronasal organ of the olfactory system of mammals and migrate along vomeronasal nerves to the cribriform plate, which marks the boundary between the peripheral olfactory system and the forebrain. Migrating GnRH-1 neurons follow a branch of the vomeronasal nerve caudally into the hypothalamus, where they extend processes to the median eminence and halt their migration. The release of GnRH-1 into the capillaries of the median eminence starts the cascade that activates pituitary gonadotropin (luteinizing hormone and follicle-stimulating hormone) production and secretion. Failure of these neurons to complete their migration results in failure of the reproductive axis. In some cases, failed migration is linked to the loss of the sense of smell (anosmia). The mechanisms that regulate migration of GnRH-1 neurons along this complex pathway are incompletely understood. Recent studies have revealed an important role for a series of strategically located soluble factors that regulate different aspects of GnRH-1 neuron migration at speciﬁc locations along their migratory route. This review focuses on the different mechanisms used by these factors to regulate migration of GnRH-1 neurons.
MYH9-Related Platelet Disorders

Myosin heavy chain 9 (MYH9)-related platelet disorders belong to the group of inherited thrombocytopenias. The MYH9 gene encodes the nonmuscle myosin heavy chain IIA (NMMHC-IIA), a cytoskeletal contractile protein. Several mutations in the MYH9 gene lead to premature release of platelets from the bone marrow, macro-thrombocytopenia, and cytoplasmic inclusion bodies within leukocytes. Four overlapping syndromes, known as May-Hegglin anomaly, Epstein syndrome, Fechtner syndrome, and Sebastian platelet syndrome, describe different clinical manifestations of MYH9 gene mutations. Macrothrombocytopenia is present in all affected individuals, whereas only some develop additional clinical manifestations such as renal failure, hearing loss, and presenile cataracts. The bleeding tendency is usually moderate, with menorrhagia and easy bruising being most frequent. The biggest risk for the individual is inappropriate treatment due to misdiagnosis of chronic autoimmune thrombocytopenia. To date, 31 mutations of the MYH9 gene leading to macrothrombocytopenia have been identiﬁed, of which the upstream mutations up to amino acid (cid:1) 1400 are more likely associated with syndromic manifestations than the downstream mutations. This review provides a short history of MYH9-related disorders, summarizes the clinical and laboratory characteristics, describes a diagnostic algorithm, presents recent results of animal models, and discusses aspects of therapeutic management.
The ICF and Dementia

The World Health Organization’s International Classiﬁcation of Functioning, Disability and Health (ICF) is a framework for describing and classifying an individual’s health and health-related states. The purpose of this article is to discuss the relevance of the ICF to cogni-tive-communication disorders of dementia, in particular those of Alzheimer disease. These disorders are described according to the Functioning and Disability, and the Contextual Factors parts of the ICF, with a focus on assessment, coding and classiﬁcation, intervention, and outcome measurement.
Trophinin, Tastin, and Bystin: A Complex Mediating Unique Attachment Between Trophoblastic and Endometrial Epithelial Cells at Their Respective Apical Cell Membranes

— Embryo implantation is a complex process consisting of multiple cross-talks between maternal and embryonic cells. Defining the mechanisms underlying implantation at molecular level is challenging task in reproductive biology. In order to identify molecules involved in cellular interactions between trophoblastic and endometrial epithelial cells, we have established two human cell lines, trophoblastic HT-H and endometrial epithelial SNG-M. These two cell types exhibit cell adhesion at their respective apical cell membranes. Mole cules involved in this unique cell adhesion were identified by expression complementary DNA cloning and were named trophinin, tastin, and bystin. Trophinin is a membrane pro tein thought to have self-binding activity and thus mediates homophilic cell adhesion. Tastin and bystin are cytoplasmic proteins required for trophinin to exhibit cell adhesion activity. Trophinin is strongly expressed in trophectoderm of monkey blastocysts. In human endo metrium, trophinin is expressed for a limited period in the luminal epithelium at the time ex pected for implantation. In human placenta, trophinin, tastin, and bystin are strongly ex pressed in trophoblast and endometrium at the uteroplacental interface at an early stage in pregnancy. All these molecules disappear from the human placenta in the second trimester. The unique expression pattern and cell adhesion activity exhibited by trophinin, tastin, and bystin suggest strongly the involvement of these molecules in the initial attachment of blas tocyst to uterus.
A spatial variant of the Gaussian mixture of regressions model

In this study the nite mixture of multivariate Gaussian distributions is discussed in detail including the derivation of maximum likelihood estimators, a discussion on identi ability of mixture components as well as a discussion on the singularities typically occurring during the estimation process. Examples demonstrate the application of the nite mixture of univariate and bivariate Gaussian distributions. The nite mixture of multivariate Gaussian regressions is discussed including the derivation of maximum likelihood estimators. An example is used to demonstrate the application of the mixture of regressions model. Two methods of calculating the coe cient of determination for measuring model performance are introduced. The application of nite mixtures of Gaussian distributions and regressions to image segmentation problems is examined. The traditional nite mixture models however, have a shortcoming in that commonality of location of observations (pixels) is not taken into account when clustering the data. In literature, this shortcoming is addressed by including a Markov random eld prior for the mixing probabilities and the present study discusses this theoretical development. The resulting nite spatial variant mixture of Gaussian regressions model is de ned and its application is demonstrated in a simulated example. It was found that the spatial variant mixture of Gaussian regressions delivered accurate spatial clustering results and simultaneously accurately estimated the component model parameters. This study contributes an application of the spatial variant mixture of Gaussian regressions model in the agricultural context: maize yields in the Free State are modelled as a function of precipitation, type of maize and season; GPS coordinates linked to the observations provide the location information. A simple linear regression and traditional mixture of Gaussian regressions model were tted for comparative purposes and the latter identi ed three distinct clusters without accounting for location information. It was found that the application of the spatial variant mixture of regressions model resulted in spatially distinct and informative clusters, especially with respect to the type of maize covariate. However, the estimated component regression models for this data set were quite similar. The investigated data set was not perfectly suited for the spatial variant mixture of regressions model application and possible solutions were proposed to improve the model results in future studies. A key learning from the present study is that the e ectiveness of the spatial variant mixture of regressions model is dependent on the clear and distinguishable spatial dependencies in the underlying data set when it is applied to map-type data.
Clinical Services and the Regulatory Environment: An Overview

Most clinicians have difﬁculty participating in the political process. Patients/clients come ﬁrst, and there is often little time to pursue information about the political and regulatory processes affecting clinical practice. Yet, such activity is imperative if speech-language pathologists and other practitioners want to achieve individual and collective professional goals and ensure sufﬁcient funding for services to consumers. This article is an overview of politics, health-care policy, and regulation. Deﬁnitions are presented, and concepts regarding how politics become policy are cast in the familiar structure-process-outcome triad. Four types of regulation are discussed, and current regulatory initiatives are explained from the perspective of policy-makers. The discussion concludes by applying these concepts to issues and behaviors of speciﬁc interest to speech-language pathologists and sets the stage for the other articles in this publication.
Assessing the Emergence of Grammar in Toddlers at Risk for Specific Language Impairment

The purpose of this article is to identify areas of grammatical development that can be incorporated into risk-factor assessment models for toddlers between the ages of 2 and 3. A simple framework is presented for conceptualizing three early grammatical accomplishments: the acquisition of an initial verb lexicon, production of early sentence types, and the onset of tense marking. Strategies for using parent-report instruments and structure-speciﬁc language sampling to assess these areas in a time-efﬁcient manner are provided.
Stability Analysis for Homogeneous Hybrid Systems With Delays

The stability problem is studied for hybrid systems with delays in this paper. Based on Lyapunov–Razumikhin approach, a novel theorem is presented for such system with the characteristic of homogeneity so that the system is globally preasymptotically stable. In particular, under the homogeneous assumption, we are able to obtain some rather weak conditions compared with general nonhomogeneous hybrid systems in this paper. Finally, two illustrative numerical examples are presented to demonstrate the applicability and the effectiveness of our theorems.
Discrete Maximum Principle in One-Dimensional Heat Equation

The maximum principle plays key role in the theory and application of a wide class of real linear partial differential equations. In this paper, we introduce ‘Maximum principle and its discrete version’ for the study of second-order parabolic equations, especially for the one-dimensional heat equation. We also give a short introduction of formation of grid as well as finite difference schemes and a short prove of the ‘Discrete Maximum principle’ by using different schemes of heat equation. Journal of Advanced College of Engineering and Management , Vol. 2, 2016, Page: 5-10
A REM-active basal ganglia circuit that regulates anxiety

REM sleep has been hypothesized to promote emotional resilience, but any neuronal circuits mediating this have not been identified. We find that in mice, somatostatin (Som) neurons in the entopeduncular nucleus (EPSom)/internal globus pallidus are predominantly active selectively during REM sleep. This unique REM activity is necessary and sufficient for maintaining normal REM sleep. Inhibiting or exciting EPSom neurons reduced or increased REM sleep duration, respectively. Activation of the sole downstream target of EPSom neurons, Vglut2 cells in the lateral habenula (LHb), increased sleep via the ventral tegmental area (VTA). A simple chemogenetic scheme to periodically inhibit the LHb over 4 days selectively removed a significant amount of cumulative REM sleep. Chronic REM reduction correlated with mice becoming anxious and more sensitive to aversive stimuli. Therefore, we suggest that REM sleep, in part generated by the EP→LHb→VTA circuit identified here, could contribute to stabilizing reactions to habitual aversive stimuli.
Neural population dynamics reveal that motor-targeted intraspinal microstimulation preferentially depresses nociceptive transmission in spinal cord injury-related neuropathic pain

The purpose of this study is to determine whether intraspinal microstimulation (ISMS) intended to enhance voluntary motor output after spinal cord injury (SCI) modulates neural population-level spinal responsiveness to nociceptive sensory feedback. The study was conducted in vivo in three cohorts of rats: neurologically intact, chronic SCI without behavioral signs of neuropathic pain, and chronic SCI with SCI-related neuropathic pain (SCI-NP). Nociceptive sensory feedback was induced by application of graded mechanical pressure to the plantar surface of the hindpaw before, during, and after periods of sub-motor threshold ISMS delivered within the motor pools of the L5 spinal segment. Neural population-level responsiveness to nociceptive feedback was recorded throughout the dorso-ventral extent of the L5 spinal segment using dense multi-channel microelectrode arrays. Whereas motor-targeted ISMS reduced nociceptive transmission across electrodes in neurologically intact animals both during and following stimulation, it was not associated with altered nociceptive transmission in rats with SCI that lacked behavioral signs of neuropathic pain. Surprisingly, nociceptive transmission was reduced both during and following motor-targeted ISMS in rats with SCI-NP, and to an extent comparable to that of neurologically intact animals. The mechanisms underlying the differential anti-nociceptive effects of motor-targeted ISMS are unclear, although they may be related to differences in the intrinsic active membrane properties of spinal neurons across the cohorts. Nevertheless, the results of this study support the notion that it may be possible to purposefully engineer spinal stimulation-based therapies that afford multi-modal rehabilitation benefits, and specifically that it may be possible to do so for the individuals most in need – i.e., those with SCI-related movement impairments and SCI-NP.
Thromboembolic Complications in Pediatric Hematologic Malignancies

Thromboembolism (TE) is an uncommon entity in childhood. Overall 25% of children with thrombosis and more than 40% of children with central venous line (CVL) –related TE enrolled on the Canadian Pediatric Thrombophilia Registry had underlying diagnosis of cancer. However, so far there are very little data describing the epidemiology of TE in children with cancer. Most of the available information in this area originates mainly from retrospective and some prospective observational cohort studies conducted in children with acute lymphoblastic leukemia (ALL). Although ALL has been the most common cancer reported in association with thrombosis in children, available data from small studies indicate that TE is equally common in children with acute myeloid leukemia and lymphoma. TE in association with leukemia and lymphoma seems to be a multifactorial entity. Potential risk factors include increased thrombin generation related to leukemia, age of the patients, use of CVL, chemotherapy including aspar-aginase and corticosteroids, infections, and inherited prothrombotic state. Management of TE in a child with cancer presents a unique challenge in terms of balancing risk versus beneﬁt. Conservative therapy could lead to clot extension and risks of additional morbidity or mortality; however, chemotherapy-related thrombocytopenia and coagulopathy increase the risk of bleeding complications. In summary, TE is a frequent and serious complication in children with hematologic malignancies. More prospective studies are required to deﬁne the epidemiology, pathogenesis, and management of TE in children with hematologic malignancies.
Cystic Fibrosis in an Adolescent Being Evaluated for Primary Sclerosing Cholangitis

CASE HISTORY A 16-year-old white female with a history of hypothyroidism was referred for evaluation of persistent elevation of serum aminotransferases. She initially presented with mild elevation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), which was noted 1 year prior to referral with blood work for a history of hypothyroidism and secondary amenorrhea. Initial AST was 107 U/L (normal, 2 to 35 U/L) and ALT was 93 (normal, 2 to 40 U/L). These abnormalities persisted for the next 18 months (AST, 62 to 107 U/L; ALT, 73 to 93 U/L). There was no history of jaundice, abdominal pain, exposure to viral hepatitis, surgery, transfusion, or liver disease in the family. In addition there was no history of chronic medication use except for levothyroxine. The only notable medical history was the hypothyroidism. Review of systems revealed amenorrhea most likely associated with the hypothyroidism. She continued to be otherwise asymptomatic. On examination she appeared well with no dysmorphic features. Her weight was between the 50th and 75th percentile and her height was between the 75th and 90th percentile for her age. She had no scleral icterus. Her thyroid was not palpable. Her cardiac and pulmonary examinations were unremarkable. Her abdomen was soft, nontender, and nondistended, with no masses. Her liver was at the costal margin with an unremarkable span and her spleen tip was just palpable. Her neurological exam was normal. She was Tanner stage 5. At presentation her blood tests revealed white blood cell count (WBC) of 8.1 10/mL, hemoglobin of 14.3 g/dL, and platelet count of 182 10/mL. Her AST was 107 U/L (normal, 2 to 35 U/L) and ALT 93 U/L (normal, 2 to 40 U/L); total bilirubin was 0.6 mg/dL (normal, 0.2 -1.3 mg/dL), alkaline phosphatase was 348 U/L (normal, 60 to 350 U/L); gammaglutamyltransferase was 84 U/L (normal, 2 to 60 U/L), and hepatitis B surface antibody was reactive; hepatitis B surface antigen was nonreactive; and hepatitis C antibody negative. Tissue transglutaminase was negative, ceruloplasmin was 22 mg/dL (normal, 22 to 50 mg/dL), total serum immunoglobulin G (IgG) was 1980 mg/dL (normal, 694 to 1618 mg/dL); IgA was 131 mg/dL (normal, 81 to 463 mg/dL); IgM was 128 mg/dL (normal, 48 to 271 mg/dL); smooth muscle antibody was positive at a titer of 1:20. Initial antinuclear antibody analysis was equivocal and repeat was negative, liver kidney microsomal antibody was negative, and a-1-antitrysin level was 161 mg/dL (normal, 83 to 199 mg/dL). One and one half years after her initial presentation, her WBC decreased to 4.4 10/mL and her platelets were 143 10/mL
Existence, Asymptotic Behavior and Uniqueness for Large Solutions to Δu = eq(x)u

Abstract In this paper we consider existence, asymptotic behavior near the boundary and uniqueness for solutions to Δu = eq(x)u in a bounded smooth domain Ω with the boundary condition u(x) → + ∞ as dist(x, ∂Ω) → 0. The exponent q(x) is assumed to be a Hölder continuous function which is either positive on ∂Ω or is positive in a neighborhood of ∂Ω maybe vanishing on ∂Ω. When dealing with nonnegative exponents q we are allowing nonempty interior regions Ω0 ⊂ Ω where q vanishes. Changing sign exponents q will be also considered.