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"user": "Identify and return all the text visible in this image.",
"assistant": "A case report on generalized pemphigus vulgaris treated with rituximab\n\nJagdish Jadavbhai Sakhiya\u00b9*, Dhruv Jagdish Sakhiya\u00b9, Jashmine Mukeshbhai Gandhi\u00b9, Feral Ravi Daruwala\u00b2\n\nAbstract\n\nBackground: Pemphigus vulgaris has an obscure etiology; the presence of autoantibodies is coherent with an autoimmune disease. Rituximab, a monoclonal antibody that specifically targets the CD20 antigen of B lymphocytes, has arisen as a novel treatment approach for pemphigus vulgaris.\n\nCase presentation: A 39-year-old male patient presented with a three-month history of mouth ulcers, poor oral hygiene accompanied with heavy tobacco smoking and alcohol consumption. He was diagnosed with pemphigus vulgaris. The disease gradually progressed to involve other body parts. The patient had shown partial improvement after conventional therapy (oral cefuroxime, oral prednisolone with azathioprine) and was later on successfully treated with rituximab. After 90 days of follow-up, no future recurrence was observed.\n\nConclusion: With this case, the authors would like to aware other clinicians of the potential use of rituximab in treating pemphigus vulgaris, especially when the conventional therapy fails.\n\nKeywords: Autoantibodies; Pemphigus, Rituximab, Oral Hygiene, Ulceration, Tobacco Smoking, Alcohol consumption, India\n\nBackground\n\nThe term pemphigus implies a group of autoimmune, mucocutaneous blistering diseases, in which the keratinocyte antigens are the target of the autoantibodies, prompting acantholysis and the formation of blisters. Main variants of pemphigus include pemphigus vulgaris (PV) and pemphigus foliaceus (PF). PV is the most common subtype and represents well over 80% of cases. As being a serious and potentially life-threatening condition, early treatment is of utmost importance [1]. The advent of corticosteroids in the amelioration of pemphigus has dramatically changed the outlook of this perpetually disastrous disease; thus, corticosteroids have become the cornerstone of pemphigus therapy. One case reported favorable outcomes with combined therapy of high-dose corticosteroids and other immunosuppressants. However, such a high dose of corticosteroids can cause serious adverse events such as several metabolic problems, global reduction of immune system efficacy, antecedent risk of serious infections, and mortality [2]. To overcome these long-term events, Pasricha and Gupta introduced dexamethasone cyclophosphamide pulse (DCP) therapy in 1984 [3]. Later on, DCP and oral corticosteroids with or without adjuvant immunosuppressants (azathioprine, cyclophosphamide, mycophenolate mofetil, and cyclosporine) have emerged as the backbone of pemphigus treatment, however, they are associated with the high death rate in pemphigus [4]. With these conventional treatments, some patients fail to improve or some have contraindications for their usage, or some encounter relapse. Hence, advanced research has continuously been going on for finding newer molecules in pemphigus. In 2001, Heizmann et al. [5] first used rituximab for the therapy of autoimmune bullous diseases. He reported a case of paraneoplastic pemphigus favorably managed with rituximab, since then there was a drastic development in the pemphigus treatment era. Rituximab chimeric monoclonal antibody selectively acts on the CD20 expressing B cells, which are known to secrete auto-antibodies targeting the epidermal desmogleins (DSG). It has been used nearly in one million patients for treating lymphoma worldwide. Recently, rituximab has been approved for rheumatoid arthritis that is unresponsive..."
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"user": "Write the contents of the text shown in the photo.",
"assistant": "INTRODUCTION\n\nThe structural strength of arteries is governed by reinforcing collagen fibres present in the vessel wall. Although healthy vessels are capable of fibre remodelling, unhealthy fibre remodelling patterns may be associated with disease [1]. A greater understanding of the remodelling of these fibres may provide greater insight into arteries at risk of disease and how arterial repair may be induced.\n\nSmall angle light scattering (SALS) is a technique which has previously been used to determine the structure of thin, highly organised tissue structures, such as bovine pericardium and porcine aortic valve tissue [2].\n\nThe aim of the present study is to design and develop a fully automated SALS system capable of determining the changes in arterial fibre architecture in response to strain.\n\nMATERIALS AND METHODS\n\nAn in-house SALS system has been developed making use of an unpolarised 5mW HeNe laser (\u03bb = 632.8 nm) and two focusing lenses in order to pass light through a tissue sample held in an automated sample positioner. The sample positioner incorporates two stepper motors controlled by LabVIEW to allow movement of the sample in the x and y plane with a resolution of 5 \u00b5m. The sample is interrogated sequentially in 250 x 250 \u00b5m regions. The resulting scattered light pattern is recorded by a CMOS camera and analysed through a custom Matlab code to determine predominant collagen fibre directions.\n\nTo validate the system, testing was conducted on test plates with known printed configurations. Once validated, SALS testing was carried out on flat porcine carotid artery wall sections fixed at different stretch ratios. Carotid artery samples were fixed and processed using a standard histological tissue sectioning protocol. Validation of the results was achieved through histological staining of the sections.\n\nRESULTS\n\nFigure 1 displays the collagen fibre directions in an unstretched carotid artery section, as predicted by SALS, overlaid on picrosirius red stained histological images. Figure 1b shows the reorganisation of the constituent collagen fibres under circumferential stretch (\u03bb=1.25).\n\nCollagen fibre patterns in the artery were also obtained through the thickness of the artery wall using SALS, for both strained and unstrained configurations.\n\nDISCUSSION\n\nResults shown in Figure 1 highlight the dependence of fibre orientation on the levels of stretch experienced by the artery wall. A clear realignment of collagen fibres in the direction of loading is visible from Figure 1a and 1b. Although these results are widely known and shown in literature, this is the first time they have been resolved through SALS.\n\nAlthough SALS is limited to thin samples, time consuming staining protocols are not required for fibre characterisation. The speed, accuracy and ease of use of this system make it a powerful system for providing insights into the response of arterial tissue to load.\n\nFuture work aims to fully identify load induced tissue changes in healthy and diseased arterial tissue using SALS.\n\nREFERENCES\n\n[1] Creane et al., Biomech Model Mechanobiol., 10: 831-843, 2011\n[2] Billiar, K., and Sacks, M., J. Biomech. 30: 753\u2013756, 1997\n\nACKNOWLEDGEMENTS\n\nThis research was part funded by Science Foundation Ireland (SFI/13/ERC/B2775) and the Irish Research Council (GOIPG/2014/515)."
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3
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|
[
{
"user": "Can you recognize and transcribe the writing in the picture?",
"assistant": "The parametric equations for a projectile with constant gravity $g$:\n\n\\[\nx = v_0 t \\cos \\theta + x_0\n\\]\n\n\\[\ny = -\\frac{1}{2} gt^2 + v_0 t \\sin \\theta + y_0\n\\]\n\nex. A shell is fired from ground level with an initial speed of 768 ft/sec. at an angle of 30\u00b0. Find:\n\n1. $\\vec{r}(t)$\n2. the maximum altitude attained\n3. the range of the shell\n4. the speed on impact\n5. the horizontal distance when $y = 2240$ ft."
}
]
|
OlmOCR
|
4
|
[
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|
[
{
"user": "List all the words visible in this document image.",
"assistant": "Do: An electron in a TV tube is beamed horizontally at a speed of $5 \\times 10^6$ m/sec. toward the face of the tube 40 cm away. To determine how far the electron drops before it hits, which equation would be used?\n\n\\begin{enumerate}\n\\item $y = -4.9t^2$\n\\item $y = -4.9t^2 - 5 \\times 10^6 t$\n\\item $5 \\times 10^6 t = 4$\n\\item $5 \\times 10^6 t = 40$\n\\end{enumerate}"
}
]
|
OlmOCR
|
5
|
[
{
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|
[
{
"user": "List all the words visible in this document image.",
"assistant": "Figure A.4 - Graphical view of the workflow generated by the software Taverna. In fact, the file is in Scufl language. Inputs, outputs and services in green (also called processor in Taverna) are described and organized. However this scheme is simplified. Indeed, it does not display the port..."
}
]
|
OlmOCR
|
6
|
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"user": "Transcribe everything printed or written in the image.",
"assistant": "Software functionality: SepINRIA has different functionality which can be loaded from a single main window:\n\n- **Lesion Segmentation Edition:** Manual or semi-automatic segmentation of MS lesions (e.g. a segmentation realized by an expert). Segmentations can be saved and visualized in 2D or 3D. Lesion number and lesion volume can be computed and print.\n\n- **Automatic Lesion Segmentation:** Automatic segmentation of MS lesions from four MRI sequences (Dual Spin Echo T2-PD, T1, T2-FLAIR).\n\n- **Images or Segmentation Comparison:** Quantitative comparisons of two images registered to assess evolution and comparison between a segmentation (e.g. automatic segmentation) and a segmentation of reference (segmentation of an expert): by computation of the difference image or by visualizing them in the same window (side to side or image fusion).\n\n- **Brain Atrophy Evaluation:** Manual and automatic evaluation of the brain atrophy. Linear measurements computation of the brain, lateral ventricle and third ventricle width are available in the manual mode. And evolution of the BPF in function of the exam dates can be perform in the automatic mode.\n\n### 4.2 Structure based on C++\n\nThis section describes concisely dependencies of the software and also its structure by providing a simplify UML scheme of the code architecture.\n\n#### 4.2.1 Software dependencies\n\nSepINRIA is based on several C++ libraries (*C.f.* Figure 4.2). ITK\\(^2\\) and MIPS\\(^3\\) contain both image processing tools. The first one can be downloaded on Internet and is especially used for image conversion. Whereas the second one is inner to the Asclepios team (algorithms presented in chapter 3 can be found in this library).\n\n\n\nThe display is supported by the libraries VTK\\(^4\\) and vtkINRIA3D\\(^5\\) (*C.f.* Figure A.1) while the user graphical interface is based on wxWidgets\\(^6\\). Finally, the general framework (structure\n\n---\n\n\\(^2\\)ITK: [http://www.itk.org/](http://www.itk.org/)\n\n\\(^3\\)MIPS: [http://www-sop.inria.fr/asclepios/software.php](http://www-sop.inria.fr/asclepios/software.php)\n\n\\(^4\\)VTK: [http://www.vtk.org/](http://www.vtk.org/)\n\n\\(^5\\)vtkINRIA3D: [http://www-sop.inria.fr/asclepios/software.php](http://www-sop.inria.fr/asclepios/software.php)\n\n\\(^6\\)wxWidgets: [http://www.wxwidgets.org/](http://www.wxwidgets.org/)"
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OlmOCR
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7
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[
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"user": "Identify and return all the text visible in this image.",
"assistant": "The Arab Family in Kuwait: Size and Structure (1)\n\nRecent studies dealing with family status in the Arab world are few and sometimes contradictory. While some researchers, such as Dr. Madeeha Naser (1972), assume that 75% of Iraqi families belong to the extended type grouping three generations living under one roof (2), Dr. Sana Khawli's investigation, condensed in Al-Raida (no. 9, vol. II, p. 15), leads her to conclude that the Arab family is evolving into a non-isolated nuclear family.\n\nSome researchers adopt a middle course by recognizing the existence of differences between country and town regarding family type and affirming that the extended family exists in a larger proportion in the country than in town and city. Good, another sociologist, asserts that for economic and other reasons, the extended family has not been the rule in Arab countries. Peterson says that demographic factors have prevented the extensive spread of the extended family in Egypt and that the large family of six members or more formed 40% of Egyptian families since the beginning of the twentieth century.\n\nA study prepared by Dr. Fahd al-Thaqeb aims to show that even if economic and demographic conditions should favor the spread of the extended family, as is the case in Kuwait, this family type is bound to remain a minority.\n\nThis study is based on statistics derived from interviews between 1965 and 1970 with a random sample of Kuwaiti families representing various social levels.\n\nFamily Size\n\nBetween 1965 and 1970, the majority of families in Kuwait were made up of six or more members per family. This proportion decreased among university graduates from 67.4% in 1965 to 56.9% in 1970. The data reveal that the number of family members tends to decrease in proportion with the cultural, economic and social status of the family.\n\nFor example, while 33% of family heads with secondary education have limited the number of their families to five or less, only 12% of illiterate family heads have adhered to this number.\n\nLarge-sized families are characteristic of higher middle and lower middle classes. Small-sized families of 1-5 members exist at the rate of 38% in less privileged classes, while 72% of the lower middle class are made up of eight or more each.\n\nFamily Structure\n\nThree family types have been singled out: the nuclear, the quasi-extended and the extended family. The first comprises the parents and children; the third includes two or more families living in the same house, joined by blood ties. The quasi-extended family is a small sized extended family.\n\nIn Kuwait, the nuclear family forms 59.2%, the quasi-extended 18.4%, and the extended family 22.4%.\n\nThe size of the family is not a sound indicator of its type, though it may have some connection with it. It was found that only 26% of the nuclear families interviewed were made up of six members each, while 70% of them had 6-12 members per unit.\n\nThe study has shown that the nuclear family, while it is not the ideal type, is most common among urban, educated, young people and among the middle class. This type is less common in lower and lower middle class. About 31% of families of the lower class are quasi-extended while in the upper socio-economic group, the quasi-extended type reaches only 15%.\n\nThe proportion of the extended family type is higher among illiterate groups: 30% for illiterate against 17% for university people.\n\nAge of Respondents\n\nThe family type differed according to the age of people interviewed. Around 50% of the young lived in nuclear families. Many of them lived in quasi-nuclear ones and did not break communication with their relatives. The ages of 65% of nuclear family people ranged between 30 and 39 years, while the highest proportion of the extended family type existed among those who were 50 years of age or above.\n\nConclusion\n\nThe majority of f
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OlmOCR
|
8
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"user": "Output the exact text from the provided image.",
"assistant": "Univariate logistic regression analysis was performed, applying 24 baseline demographics and disease characteristics. Significant (p<0.1) variables in univariate were included in multivariate models. Last, multivariate models were selected based on model fit statistics (Akaike information criterion and $r^2$) and clinical significance. Adjusted OR and 95% CIs for selected baseline variables were calculated.\n\n**RESULTS**\n\nOverall, 334 patients were randomised to treatment and received adalimumab+MTX (n=171) or MTX alone (n=163), and 148 (86.5%) and 128 (78.5%) patients completed the double-blind portion of the study, respectively (figure 1). Demographics and baseline characteristics were well matched between treatment groups (table 1). The mean RA disease duration was 0.3 years, and the majority of patients had \u22651 erosion at baseline and high disease activity. The mean MTX dose during the 26-week study was $6.2 \\pm 0.8$ mg/week in the adalimumab+MTX group and $6.6 \\pm 0.6$ mg/week in the MTX alone group (p<0.001). After 26 weeks of treatment, 34.5% (59/171) of adalimumab+MTX patients were receiving MTX 8 mg/week versus 65.0% (106/163) of MTX alone patients (p<0.001).\n\n**Radiographic progression**\n\nTreatment with adalimumab+MTX significantly inhibited radiographic progression (figure 2A) at week 26 versus MTX alone (mean change\u00b1SD, $1.5 \\pm 6.1$ vs $2.4 \\pm 3.2$, respectively; p<0.001). Results were confirmed by an LE analysis (figure 2A). Changes in radiographic progression during 26 weeks of treatment were also assessed by a cumulative probability plot of $\\Delta mTSS$ (figure 2B). Fewer adalimumab+MTX patients exhibited radiographic progression ($\\Delta mTSS>0.5$), with 62.0% (106/171) of patients showing no radiographic progression versus 35.4% (57/161) of MTX alone patients (p<0.001). Furthermore, only 14.0% (24/171) of adalimumab+MTX patients exhibited clinically relevant radiographic progression ($\\Delta mTSS>3$) versus 37.3% (60/161) of MTX alone patients (p<0.001). In addition, a significantly higher percentage of adalimumab+MTX patients did not experience worsening ($\\leq 0.5$) in erosion score (73.7% (126/171)) versus MTX alone patients (42.2% (68/161); p<0.001). In patients who lacked baseline erosive damage, the continued absence of erosions was reported in more adalimumab+MTX patients versus MTX alone patients (9/9 vs 2/6 patients, respectively; p=0.01).\n\n**Clinical response**\n\nA significantly higher percentage of adalimumab+MTX patients achieved ACR responses versus MTX alone patients at each assessment (figure 3A\u2013C). Significant differences between treatment groups, observed as early as week 2, were maintained through week 26. At week 26, a significantly larger percentage of adalimumab+MTX patients versus MTX alone patients achieved ACR20, ACR50 and ACR70 (figure 3A\u2013C) and ACR90 (12.9% vs 5.5%; p=0.02) responses. Significant differences in favour of adalimumab+MTX were also observed from week 2 to 26 for DAS28-ESR, DAS28-CRP, SDAI and CDAI (see online supplementary figure 1A\u2013D). A larger percentage of adalimumab+MTX patients than MTX alone patients demonstrated good or moderate European League Against Rheumatism responses (figure 3D) and were in states of low disease activity or remission after 26 weeks of treatment (figure 3E). Furthermore, a significantly larger percentage of adalimumab+MTX patients versus MTX alone patients satisfied Boolean remission criteria (19.3% vs 8.6%, p=0.007). Adalimumab+MTX achieved a 1.8- to 2.2-fold increase in the percentage of patients achieving clinical remission, across all definitions of clinical remission evaluated, versus MTX alone.\n\nA significantly larger decrease from baseline in mean HAQ-DI score, indicative of an improvement in physical function, was observed for adalimumab+MTX patients versus MTX alone patients at week 26 ($-0.6 \\pm 0.6$
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OlmOCR
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9
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"assistant": "longitudinal study of patients with rheumatoid arthritis. *Arthritis Rheum* 1995;38:44\u20138.\n\n22 Fries JF, Spitz P, Kraines RG, et al. Measurement of patient outcome in arthritis. *Arthritis Rheum* 1980;23:137\u201345.\n\n23 Smolen JS, Breedveld FC, Schiff MH, et al. A simplified disease activity index for rheumatoid arthritis for use in clinical practice. *Rheumatology (Oxford)* 2003;42:244\u201357.\n\n24 Aletaha D, Nell VPK, Stamm T, et al. Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. *Arthritis Res Ther* 2005;7:R796\u2013806.\n\n25 van Gestel AM, Prevoo MLL, van \u2019t Hof MA, et al. Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis. Comparison with the preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism criteria. *Arthritis Rheum* 1996;39:34\u201340.\n\n26 Wells G, Becker J-C, Teng J, et al. Validation of the 28-joint Disease Activity Score (DAS28) and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis, and comparison with the DAS28 based on erythrocyte sedimentation rate. *Ann Rheum Dis* 2009;68:954\u201360.\n\n27 Felson DT, Smolen JS, Wells G, et al. American College of Rheumatology/European League Against Rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials. *Ann Rheum Dis* 2011;70:404\u201313.\n\n28 Aletaha D, Smolen J. The Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI): a review of their usefulness and validity in rheumatoid arthritis. *Clin Exp Rheumatol* 2005;23(5 suppl 39):S100\u20138."
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OlmOCR
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10
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|
[
{
"user": "Can you recognize and transcribe the writing in the picture?",
"assistant": "Local transportation for the participating teams shall be the responsibility of the participating institutions."
}
]
|
OlmOCR
|