Miracle-dz/UniFAR-FTUs huggingface dataset:
Medical residents' perspectives on discussions of advanced directives: can prior experience affect how they approach patients?

INTRODUCTION Resident physicians are inadequately taught how to communicate with patients about end-of-life decision making. Their beliefs about resuscitation and prior experiences with end-of-life care may impact the manner in which they approach patients. OBJECTIVE To explore residents' perceptions of end-of-life discussions, determine the features they find most important, and discern the challenges they face in this process. METHODS Internal medicine residents were surveyed about their experiences discussing resuscitation with patients including perceptions of patient understanding, outcomes of resuscitation, and regret about attempting to resuscitate patients. They were asked what features of these discussions are most important and which are the most challenging. Qualitative content analysis was used to examine the responses to open-ended questions. RESULTS Fifty-five residents completed the survey. Residents reported rarely feeling satisfied with the results of these discussions and disagreed with the decision for resuscitation numerous times. They perceive that few patients and families understand resuscitation. In their description of important features, they focus on the content of the discussion rather than the process, with the most common responses centering on a description of resuscitation. In contrast, the greatest challenge they identify is dealing with the emotional aspects of the discussion. CONCLUSIONS Residents report internal conflict about their experiences discussing resuscitation with patients. Their approach to these discussions focuses on resuscitation itself with less attention paid to processes that might improve patient decision making. The challenges they describe may be overcome with improved education about end-of-life communication.
Brain Angiotensin-Converting Enzyme Type 2 Shedding Contributes to the Development of Neurogenic Hypertension

Rationale: Overactivity of the brain renin–angiotensin system is a major contributor to neurogenic hypertension. Although overexpression of angiotensin-converting enzyme type 2 (ACE2) has been shown to be beneficial in reducing hypertension by transforming angiotensin II into angiotensin-(1–7), several groups have reported decreased brain ACE2 expression and activity during the development of hypertension. Objective: We hypothesized that ADAM17-mediated ACE2 shedding results in decreased membrane-bound ACE2 in the brain, thus promoting the development of neurogenic hypertension. Methods and Results: To test this hypothesis, we used the deoxycorticosterone acetate–salt model of neurogenic hypertension in nontransgenic and syn-hACE2 mice overexpressing ACE2 in neurons. Deoxycorticosterone acetate–salt treatment in nontransgenic mice led to significant increases in blood pressure, hypothalamic angiotensin II levels, inflammation, impaired baroreflex sensitivity, and autonomic dysfunction, as well as decreased hypothalamic ACE2 activity and expression, although these changes were blunted or prevented in syn-hACE2 mice. In addition, reduction of ACE2 expression and activity in the brain paralleled an increase in ACE2 activity in the cerebrospinal fluid of nontransgenic mice after deoxycorticosterone acetate–salt treatment and were accompanied by enhanced ADAM17 expression and activity in the hypothalamus. Chronic knockdown of ADAM17 in the brain blunted the development of hypertension and restored ACE2 activity and baroreflex function. Conclusions: Our data provide the first evidence that ADAM17-mediated shedding impairs brain ACE2 compensatory activity, thus contributing to the development of neurogenic hypertension.
Refining temporal criteria to classify collaborative systems

This paper presents a critical analysis of classification criteria for collaborative systems, and a more refined proposal for their reformulation. The analysis highlights the multiplicity of definitions and uses of the same set of classification terms which denote time relationships in collaborative systems. We observe that authors, when characterizing collaborative systems, use concepts without giving an exact definition of them, and other authors use terms in an ambiguous way, as if they were synonyms, when in fact they are not. This situation encourages the revision and reformulation of the conflictive terms. Specifically, the real-time, concurrent and synchronous concepts are analysed, and we apply them in different areas of this technology, resulting in the reformulation of the criteria. In many cases the resulting criteria are truly new due to the fact that their meanings, apart from being more precise, are different from those already used by some authors. The refining of criteria contributes to the organization and placement of the classification concepts, and helps in the formation of a useful vocabulary in order to better characterize collaborative systems.
Telomerase activity and telomere length in patients with acute promyelocytic leukemia: indicative of proliferative activity, disease progression, and overall survival.

BACKGROUND The progressive shortening of telomeres and the activation of telomerase have been considered to be one of the key mechanisms in cellular immortalization and tumor progression. PATIENTS AND METHODS About 300 sequential samples were collected from 40 patients during the course of acute promyelocytic leukemia (APL) disease. Telomerase activity (TA) and terminal restriction fragment (TRF) length were assessed by TRAP and Southern blot analyses, respectively. PML-retinoic acid receptor alpha (RARa)/glucose-6-phosphate dehydrogenase transcripts were quantified by real-time PCR. RESULTS About 90% of the patients had a significant reduction in telomere length (TL) relative to the control (median 3.5 versus 11.37 kbp; P < 0.001). A significant positive correlation between TL and PML-RARa expression was found (P = 0.001). Telomerase was activated in all patients; however, TA level was significantly higher in the group of relapsed patients than patient with newly diagnosed. The group of patients with shortened TRF and elevated TA had a significantly poorer overall survival. CONCLUSIONS The shortened TL and elevated TA in APL patients are mainly indicative of extensive proliferative activity and they correlate with disease progression and relapse; thus, they may serve as prognostic factors for a subset of APL patients with more aggressive disease and poor outcome, those who may not respond favorably to arsenic therapy.
Lexicographically Optimal Rate Control for Video Coding with MPEG Buffer Constraints

In this paper, we address the problem of allocating bits among pictures in an MPEG video coder to equalize the visual quality of the coded pictures, while meeting buffer and channel constraints imposed by a Video Buffer Verifier. We address this problem within a framework consisting of 1) a bit production model for the input pictures, 2) a novel lexicographic criterion for optimality, and 3) a set of bit-rate constraints imposed by the transmission channel and Video Buffer Verifier. Using this framework, we analyze the bit allocation problem for both constant and variable bit rate operation. The analysis results in a set of simple necessary and sufficient conditions for optimality that leads to efficient algorithms.
Unpacking social interaction that make us adore: on the aesthetics of mobile phones as fashion items

We report on a study of fashionable people"s expressions of opinions on mobile phones in online fashion media, such as blogs and magazines. First, the study contributes to our understanding of the role of pragmatic philosophy, which is now dominating HCI both as a guide for design and as a guide when looking at social practices, in outlining the role of aesthetics in experience design. Fashion practices diverge from this theory, since here aesthetic appearances can be visual, ambiguous and incomplete although it still provides a lot of meanings for people. We argue that our findings should influence the discussion in HCI to consider a less theoretically oriented aesthetic approach, where instead empirical studies get at the forefront. Second, the study provides valuable insight on how we should design mobile experiences to attract more attention from people interested in fashion. Mobile phones, and their services, can for example be designed to relate to the visual appearance of the dressed outfit, or ensemble of a person.
Animals and Environments: Resisting Schisms in Comparative Physiology and Biochemistry

The articles in this volume are a product of the enthusiasm shown by delegates to meet in a remote corner of southern Africa and to discuss comparative physiology and biochemistry in their wider interpretation and future course. This collection reflects a small but long‐standing commitment to fostering the engagement of biological research with African issues and colleagues. Comparative physiology and biochemistry are evolving, but in this we must guard against fractionation of effort and purpose. Increasingly available molecular methods are seductive in encouraging work on model species and in employing these species in place of more appropriate comparative models. Concomitantly, the comparative approach is reaching out beyond the individual organism and organism‐organism interactions to establish underlying principles at ecosystem and landscape levels. The integration of molecular methods into comparative studies will require judicious selection and use of such skills if it is to be achieved without abandoning nonmodel species. The physiological and metabolic bases of ecosystem and evolutionary approaches must be underpinned by relevant data, requiring comparative researchers to accommodate colleagues contributing this specialist knowledge. These articles report distinct symposia, prefaced by a plenary paper. While each paper is itself a review of an entire symposium, they all exhibit a common theme, that comparative physiology and biochemistry are about interactions. It is our hope that the Comparative Physiology and Biology in Africa meetings will continue to facilitate special interactions between the people who make this happen.
Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary.
Intercellular Bridges as Protoplasmic Anastomoses between Smooth Muscle Cells

In electron microscopic studies, protoplasmic anastomoses were found to occur between smooth muscle cells in the gastrointestinal tracts of rats. The protoplasmic connections are apparently cylindrical in form and contain cytoplasm having a density similar to that of the cellular regions connected. The membranes enclosing the cytoplasmic connections are continuous with the membranes of the connected cells. These connecting structures have been called intercellular bridges, which is adequately descriptive if emphasis is placed on the interpretation that they represent protoplasmic anastomoses. To emphasize this, the term may be modified; i.e., anastomotic intercellular bridges. In some cellular connections, transverse diffuse lines are seen. These may be interpreted as either disintegrating or reforming plasma membranes which is consistent with the concept that protoplasmic continuity is transitory. Since the animals were dissected under hypothermia, reduction of muscular activity by the chilling may have helped to preserve the structure of existing anastomotic intercellular bridges. The intercellular protoplasmic anastomoses may play a role in the conduction of action potentials from one smooth muscle cell to another.
Different Hemispheric Roles in Recognition of Happy Expressions

The emotional expression of the face provides an important social signal that allows humans to make inferences about other people's state of mind. However, the underlying brain mechanisms are complex and still not completely understood. Using magnetoencephalography (MEG), we analyzed the spatiotemporal structure of regional electrical brain activity in human adults during a categorization task (faces or hands) and an emotion discrimination task (happy faces or neutral faces). Brain regions that are specifically important for different aspects of processing emotional facial expressions showed interesting hemispheric dominance patterns. The dorsal brain regions showed a right predominance when participants paid attention to facial expressions: The right parietofrontal regions, including the somatosensory, motor/premotor, and inferior frontal cortices showed significantly increased activation in the emotion discrimination task, compared to in the categorization task, in latencies of 350 to 550 ms, while no activation was found in their left hemispheric counterparts. Furthermore, a left predominance of the ventral brain regions was shown for happy faces, compared to neutral faces, in latencies of 350 to 550 ms within the emotion discrimination task. Thus, the present data suggest that the right and left hemispheres play different roles in the recognition of facial expressions depending on cognitive context.
Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications.

CONTEXT Euthyroid women with autoimmune thyroid disease show impairment of thyroid function during gestation and seem to suffer from a higher rate of obstetrical complications. OBJECTIVE We sought to determine whether these women suffer from a higher rate of obstetrical complications and whether levothyroxine (LT(4)) treatment exerts beneficial effects. DESIGN This was a prospective study. SETTING The study was conducted in the Department of Obstetrics and Gynecology. PATIENTS A total of 984 pregnant women were studied from November 2002 to October 2004; 11.7% were thyroid peroxidase antibody positive (TPOAb(+)). INTERVENTION TPOAb(+) patients were divided into two groups: group A (n = 57) was treated with LT(4), and group B (n = 58) was not treated. The 869 TPOAb(-) patients (group C) served as a normal population control group. MAIN OUTCOME MEASURES Rates of obstetrical complications in treated and untreated groups were measured. RESULTS At baseline, TPOAb(+) had higher TSH compared with TPOAb(-); TSH remained higher in group B compared with groups A and C throughout gestation. Free T(4) values were lower in group B than groups A and C after 30 wk and after parturition. Groups A and C showed a similar miscarriage rate (3.5 and 2.4%, respectively), which was lower than group B (13.8%) [P < 0.05; relative risk (RR), 1.72; 95% confidence interval (CI), 1.13-2.25; and P < 0.01; RR = 4.95; 95% CI = 2.59-9.48, respectively]. Group B displayed a 22.4% rate of premature deliveries, which was higher than group A (7%) (P < 0.05; RR = 1.66; 95% CI = 1.18-2.34) and group C (8.2%) (P < 0.01; RR = 12.18; 95% CI = 7.93-18.7). CONCLUSIONS Euthyroid pregnant women who are positive for TPOAb develop impaired thyroid function, which is associated with an increased risk of miscarriage and premature deliveries. Substitutive treatment with LT(4) is able to lower the chance of miscarriage and premature delivery.
Polyacrylamide Based Breathable Coating for Cotton Fabric

Breathable coatings based on polyacrylamide on cotton fabrics have been developed. The coatings show high water vapor permeability, while providing desirable protection against air and liquid water-penetration. These polyacrylamide based coatings were obtained by coating the fabric with polyacrylamide solution (4%), containing citric acid as a crosslinker (5–50 mol%), and sodium hypophosphite (0.3%) as a catalyst, followed by drying at 90 C and curing at 150 C. The curing reaction leads to formation of crosslinks among the polymer chains as well as between the polymer and the cotton fabric. The integrity of the crosslinked polyacrylamide coating was observed to be good. The resistance, to hydrostatic head for double and triple-coated samples, with cross-linker concentration of 50 and 20 mol% was found to be in the range of 800–1280 mm, while the air-permeability values reduced drastically by two orders of magnitude, compared to the control fabric. The water vapor transmission rate (WVTR) values for these samples were found to be excellent with only 5–23% reduction compared to the values shown by control cotton fabric. The mechanism of the reaction leading to the formation of crosslinks has been evaluated using FTIR and NMR spectroscopy.
A Front-End Execution Architecture for High Energy Efficiency

Smart phones and tablets have recently become widespread and dominant in the computer market. Users require that these mobile devices provide a high-quality experience and an even higher performance. Hence, major developers adopt out-of-order superscalar processors as application processors. However, these processors consume much more energy than in-order superscalar processors, because a large amount of energy is consumed by the hardware for dynamic instruction scheduling. We propose a Front-end Execution Architecture (FXA). FXA has two execution units: an out-of-order execution unit (OXU) and an in-order execution unit (IXU). The OXU is the execution core of a common out-of-order superscalar processor. In contrast, the IXU comprises functional units and a bypass network only. The IXU is placed at the processor front end and executes instructions without scheduling. Fetched instructions are first fed to the IXU, and the instructions that are already ready or become ready to execute by the resolution of their dependencies through operand bypassing in the IXU are executed in-order. Not ready instructions go through the IXU as a NOP, thereby, its pipeline is not stalled, and instructions keep flowing. The not-ready instructions are then dispatched to the OXU, and are executed out-of-order. The IXU does not include dynamic scheduling logic, and its energy consumption is consequently small. Evaluation results show that FXA can execute over 50% of instructions using IXU, thereby making it possible to shrink the energy-consuming OXU without incurring performance degradation. As a result, FXA achieves both a high performance and low energy consumption. We evaluated FXA compared with conventional out-of-order/in-order superscalar processors after ARM big. LITTLE architecture. The results show that FXA achieves performance improvements of 67% at the maximum and 7.4% on geometric mean in SPECCPU INT 2006 benchmark suite relative to a conventional superscalar processor (big), while reducing the energy consumption by 86% at the issue queue and 17% in the whole processor. The performance/energy ratio (the inverse of the energy-delay product) of FXA is 25% higher than that of a conventional superscalar processor (big) and 27% higher than that of a conventional in-order superscalar processor (LITTLE).
Firm Heterogeneity and Export Participation: A New Asian Tiger Perspective

This paper investigates the relationship between firm heterogeneity and a firm's decision to export, using the annual survey of Thai manufacturing firms from 2001 to 2004. A significant contribution of this paper is that we are, for the first time, able to break down FDI by country of origin to observe whether the behavior of MNEs differs by region of origin. We find that entry sunk costs and firm characteristics are important factors in explaining a firm's decision to export. Another important determinant is the ownership structure of the firm, with foreign owned firms having a higher probability of exporting than domestically owned firms although this differs across country of ownership with potentially important policy implications. Export platform FDI is used to explain the behavior of foreign firms that invest in Thailand. Using three measures of total factor productivity, we also find that highly productive firms self-select into the export market. The implication for governments of developing countries is the need to think carefully about how and to whom they target their inward FDI policies as a means of growth. The heterogeneous behavior of multinationals from different nations means that policies targeting specific regions or countries may be preferable to general tax concessions or the implementation of special economic zones that are open to all.
Mouse Stbd1 is N-myristoylated and affects ER–mitochondria association and mitochondrial morphology

ABSTRACT Starch binding domain-containing protein 1 (Stbd1) is a carbohydrate-binding protein that has been proposed to be a selective autophagy receptor for glycogen. Here, we show that mouse Stbd1 is a transmembrane endoplasmic reticulum (ER)-resident protein with the capacity to induce the formation of organized ER structures in HeLa cells. In addition to bulk ER, Stbd1 was found to localize to mitochondria-associated membranes (MAMs), which represent regions of close apposition between the ER and mitochondria. We demonstrate that N-myristoylation and binding of Stbd1 to glycogen act as major determinants of its subcellular targeting. Moreover, overexpression of non-myristoylated Stbd1 enhanced the association between ER and mitochondria, and further induced prominent mitochondrial fragmentation and clustering. Conversely, shRNA-mediated Stbd1 silencing resulted in an increase in the spacing between ER and mitochondria, and an altered morphology of the mitochondrial network, suggesting elevated fusion and interconnectivity of mitochondria. Our data unravel the molecular mechanism underlying Stbd1 subcellular targeting, support and expand its proposed function as a selective autophagy receptor for glycogen and uncover a new role for the protein in the physical association between ER and mitochondria. Highlighted Article: The glycogen-binding protein Stbd1 is N-myristoylated and targeted to ER–mitochondria contact sites. Stbd1 loss- or gain-of-function affects ER–mitochondria association and mitochondrial morphology.