Miracle-dz/UniFAR-FTUs huggingface dataset:
Prognostic Role of High-sensitivity Cardiac Troponin I and Soluble Suppression of Tumorigenicity-2 in Surgical Intensive Care Unit Patients Undergoing Non-cardiac Surgery

Background The prognostic utility of cardiac biomarkers, high-sensitivity cardiac troponin I (hs-cTnI) and soluble suppression of tumorigenicity-2 (sST2), in non-cardiac surgery is not well-defined. We evaluated hs-cTnI and sST2 as predictors of 30-day major adverse cardiac events (MACE) in patients admitted to the surgical intensive care unit (SICU) following major non-cardiac surgery. Methods hs-cTnI and sST2 concentrations were measured in 175 SICU patients immediately following surgery and for three days postoperatively. The results were analyzed in relation to 30-day MACE and were compared with the revised Goldman cardiac risk index (RCRI) score. Results Overall, 30-day MACE was observed in 16 (9.1%) patients. hs-cTnI and sST2 concentrations differed significantly between the two groups with and without 30-day MACE (P<0.05). The maximum concentration of sST2 was an independent predictor of 30-day MACE (odds ratio=1.016, P=0.008). The optimal cut-off values of hs-cTnI and sST2 for predicting 30-day MACE were 53.0 ng/L and 182.5 ng/mL, respectively. A combination of hs-cTnI and sST2 predicted 30-day MACE better than the RCRI score. Moreover, 30-day MACE was observed more frequently with increasing numbers of above-optimal cut-off hs-cTnI and sST2 values (P<0.0001). Reclassification analyses indicated that the addition of biomarkers to RCRI scores improved the prediction of 30-day MACE. Conclusions This study demonstrates the utility of hs-cTnI and sST2 in predicting 30-day MACE following non-cardiac surgery. Cardiac biomarkers would provide enhanced risk stratification in addition to clinical RCRI scores for patients undergoing major non-cardiac surgery.
The impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery

Background: Relevant discharge information about the use of analgesic medication and other strategies may help patients to manage their pain more effectively and prevent postoperative persistent pain. Aims: To examine patients’ pain characteristics, analgesic intake and the impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery. Concerns about pain and pain medication prior to surgery will also be described. Methods: From March 2012 to September 2013, 416 participants (23% women) were consecutively enrolled in a randomized controlled trial. The intervention group received usual care plus an educational booklet at discharge with supportive telephone follow-up on postoperative day 10, and the control group received only usual care. The primary outcome was worst pain intensity (The Brief Pain Inventory – Short Form). Data about pain characteristics and analgesic use were collected at 2 weeks and at 1, 3, 6 and 12 months post-surgery. General linear mixed models were used to determine between-group differences over time. Results: Twenty-nine percent of participants reported surgically related pain at rest and 9% reported moderate to severe pain at 12 months post-surgery. Many participants had concerns about pain and pain medication, and analgesic intake was insufficient post-discharge. No statistically significant differences between the groups were observed in terms of the outcome measures following surgery. Conclusion: Postoperative pain and inadequate analgesic use were problems for many participants regardless of group allocation, and the current intervention did not reduce worst pain intensity compared with control. Further examination of supportive follow-up monitoring and/or self-management strategies post-discharge is required.
Ablation of β1 integrin in mammary epithelium reveals a key role for integrin in glandular morphogenesis and differentiation

Integrin-mediated adhesion regulates the development and function of a range of tissues; however, little is known about its role in glandular epithelium. To assess the contribution of β1 integrin, we conditionally deleted its gene in luminal epithelia during different stages of mouse mammary gland development and in cultured primary mammary epithelia. Loss of β1 integrin in vivo resulted in impaired alveologenesis and lactation. Cultured β1 integrin–null cells displayed abnormal focal adhesion function and signal transduction and could not form or maintain polarized acini. In vivo, epithelial cells became detached from the extracellular matrix but remained associated with each other and did not undergo overt apoptosis. β1 integrin–null mammary epithelial cells did not differentiate in response to prolactin stimulation because of defective Stat5 activation. In mice where β1 integrin was deleted after the initiation of differentiation, fewer defects in alveolar morphology occurred, yet major deficiencies were also observed in milk protein and milk fat production and Stat5 activation, indicating a permissive role for β1 integrins in prolactin signaling. This study demonstrates that β1 integrin is critical for the alveolar morphogenesis of a glandular epithelium and for maintenance of its differentiated function. Moreover, it provides genetic evidence for the cooperation between integrin and cytokine signaling pathways.
Write-Once-Read-Many-Times Characteristic of InZnO Oxide Semiconductor

Write-once-read-many-times (WORM) characteristics of sol–gel InZnO (IZO) thin films are investigated in this paper. The Ag/IZO/n<sup>+</sup>-Si WORM memory exhibits a poor read disturb immunity. Although a postannealing process is capable of improving the performance due to formation of a thin interfacial Ag<sub>x</sub>O layer, the memory window is only <inline-formula> <tex-math notation="LaTeX">$5\times 10^{2}$ </tex-math></inline-formula> and the resistance in high resistance state degrades dramatically during read disturb testing. By replacing the Ag electrode with an Al electrode, without the postannealing process, the Al/IZO/n<sup>+</sup>-Si WORM memory shows a superior read disturb immunity and a large memory window of <inline-formula> <tex-math notation="LaTeX">$4 \times 10^{3}$ </tex-math></inline-formula>. The read endurance is over 10<sup>4</sup> cycles. X-ray diffraction, X-ray photoelectron spectroscopy, transmission electron microscopy, and energy dispersive spectroscopy were utilized to investigate the physical mechanisms of the WORM characteristics. The carrier conduction mechanisms were also explored.
Smoking patterns and chronic kidney disease in US Hispanics: Hispanic Community Health Study/Study of Latinos.

BACKGROUND Intermittent smoking is prevalent among Hispanics, but little is known about whether this smoking pattern associates with increased chronic kidney disease (CKD) risk in this population. The objective of the present study is to identify patterns of exposure associated with CKD in US Hispanics. METHODS We used cross-sectional data on 15 410 participants of the Hispanics Community Health Study/the Study of Latinos, a population-based study of individuals aged 18-74 years, recruited in 2008 to 2011 from four US field centers (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA). Smoking exposure was obtained through a questionnaire. CKD was defined by an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) or a urine albumin-to-creatinine ratio of ≥30 mg/g. RESULTS Approximately 14% of individuals were daily and 7% were intermittent smokers, and 16% were past smokers. There was a significant interaction between smoking status and pack-years of exposure (P = 0.0003). In adjusted models, there was an increased odds of CKD among daily, intermittent and past smokers by pack-years compared with never smokers. The association of intermittent smokers was significant at 10 pack-years [odds ratio (OR) = 1.38, 95% confidence intervals (CI) 1.06, 1.81], whereas for daily smokers this association was observed at 40 pack-years (OR = 1.43, 95% CI 1.09, 1.89). CONCLUSIONS Our findings of increased risk of CKD among Hispanics who are intermittent smokers support screening and smoking cessation interventions targeted to this population for the prevention of CKD. It also suggests novel mechanistic pathways for kidney toxicity that should be further explored in future studies.
Intra‐cluster correlation selection for cluster randomized trials

In this paper, we give focus to cluster randomized trials, also known as group randomized trials, which randomize clusters, or groups, of subjects to different trial arms, such as intervention or control. Outcomes from subjects within the same cluster tend to exhibit an exchangeable correlation measured by the intra‐cluster correlation coefficient (ICC). Our primary interest is to test if the intervention has an impact on the marginal mean of an outcome. Using recently developed methods, we propose how to select a working ICC structure with the goal of choosing the structure that results in the smallest standard errors for regression parameter estimates and thus the greatest power for this test. Specifically, we utilize small‐sample corrections for the estimation of the covariance matrix of regression parameter estimates. This matrix is incorporated within correlation selection criteria proposed in the generalized estimating equations literature to choose one of multiple working ICC structures under consideration. We demonstrate the potential power and utility of this approach when used in cluster randomized trial settings via a simulation study and application example, and we discuss practical considerations for its use in practice. Copyright © 2016 John Wiley & Sons, Ltd.
Review of the epidemiologic literature on residential exposure to perchloroethylene

Perchloroethylene is a solvent that is widely used for dry cleaning. There has been considerable interest in the toxicity of this chemical because of the potential for low-level exposure among a large portion of the US population. Although substantial epidemiologic literature exists on high-level occupational exposure to perchloroethylene, there are relatively few studies dealing with lower-level residential exposure. In the current paper, the author reviews this limited residential literature, with special emphasis on strengths, limitations, and consistency. Reviewed studies primarily address neurobehavioral, cancer, and reproductive endpoints. Most studies used an ecological or cross-sectional design, with exposure defined by either drinking-water contamination or proximity to dry cleaning. In general, reviewed studies were highly exploratory, with inconsistencies and potential for bias that detract from interpretation of study findings. The magnitudes of reported effects are frequently incompatible with the effects reported from much higher occupational and human-chamber exposures. Overall, few reliable conclusions can be drawn from this sparse and highly limited body of literature.
Ghost probiotics with a combined regimen: a novel therapeutic approach against the Zika virus, an emerging world threat

Abstract The Zika virus (ZIKV) used to be an obscure flavivirus closely related to dengue virus (DENV). Transmission of this epidemic pathogen occurs mainly via mosquitoes, but it is also capable of placental and sexual transmission. Although the characteristics of these viruses are well defined, infections are unpredictable in terms of disease severity, unusual clinical manifestations, unexpected methods of transmission, long-term persistence, and the development of new strains. Recently, ZIKV has gained huge medical attention following the large-scale epidemics around the world, and reported cases of congenital abnormalities associated with Zika virus infections which have created a public health emergency of international concern. Despite continuous research on ZIKV, no specific treatment or vaccine has been developed, excepting a preventive strategy for congenital ZIKV infection. Probiotics, known as GRAS, are bacteria that confer various health beneficial effects, and have been shown to be effective at curing a number of viral diseases by modulating the immune system. Furthermore, probiotic preparations consisting of dead cells and cellular metabolites, so-called “Ghost probiotics”, can also act as biological response modifiers. Here, we review available information on the epidemiology, transmission, and clinical features of ZIKV, and on treatment and prevention strategies. In addition, we emphasize the use of probiotics and plant-based natural remedies and describe their action mechanisms, and the green technologies for microbial conversion, which could contribute to the development of novel therapies that may reduce the pathogenicity of ZIKV. Accordingly, we draw attention to new findings, unanswered questions, unresolved issues, and controversies regarding ZIKV.
A framework for semantic link discovery over relational data

Discovering links between different data items in a single data source or across different data sources is a challenging problem faced by many information systems today. In particular, the recent Linking Open Data (LOD) community project has highlighted the paramount importance of establishing semantic links among web data sources. Currently, LOD sources provide billions of RDF triples, but only millions of links between data sources. Many of these data sources are published using tools that operate over relational data stored in a standard RDBMS. In this paper, we present a framework for discovery of semantic links from relational data. Our framework is based on declarative specification of linkage requirements by a user. We illustrate the use of our framework using several link discovery algorithms on a real world scenario. Our framework allows data publishers to easily find and publish high-quality links to other data sources, and therefore could significantly enhance the value of the data in the next generation of web.
Barriers against split-dose bowel preparation for colonoscopy

Objective Although split regimen is associated with higher adenoma detection and is recommended for elective colonoscopy, its adoption remains suboptimal. The identification of patient-related barriers may improve its implementation. Our aim was to assess patients' attitude towards split regimen and patient-related factors associated with its uptake. Design In a multicentre, prospective study, outpatients undergoing colonoscopy from 8:00 to 14:00 were given written instructions for 4 L polyethylene glycol bowel preparation, offering the choice between split-dose and day-before regimens and emphasising the superiority of split regimen on colonoscopy outcomes. Uptake of split regimen and association with patient-related factors were explored by a 20-item questionnaire. Results Of the 1447 patients (mean age 59.2±13.5 years, men 54.3%), 61.7% and 38.3% chose a split-dose and day-before regimens, respectively. A linear correlation was observed between time of colonoscopy appointments and split-dose uptake, from 27.3% in 8:00 patients to 96% in 14:00 patients (p<0.001, χ2 for linear trend). At multivariate analysis, colonoscopy appointment before 10:00 (OR 0.14, 95% CI 0.11 to 0.18), travel time to endoscopy service >1 h (OR 0.55, 95% CI 0.38 to 0.79), low education level (OR 0.72, 95% CI 0.54 to 0.96) and female gender (OR 0.74, 95% CI 0.58 to 0.95) were inversely correlated with the uptake of split-dose. Overall, the risk of travel interruption and faecal incontinence was slightly increased in split regimen patients (3.0% vs 1.4% and 1.5% vs 0.9%, respectively; p=NS). Split regimen was an independent predictor of adequate colon cleansing (OR 3.34, 95% CI 2.40 to 4.63) and polyp detection (OR 1.46, 95% CI 1.11 to 1.92). Conclusion Patient attitude towards split regimen is suboptimal, especially for early morning examinations. Interventions to improve patient compliance (ie, policies to reorganise colonoscopy timetable, educational initiatives for patient and healthcare providers) should be considered. Trial registration number NCT02287051; pre-result.
Aberrant localization of apoptosis protease activating factor-1 in lipid raft sub-domains of diffuse large B cell lymphomas

Resistance to chemotherapy remains a challenge in the clinical management of diffuse B cell lymphomas despite aggressive chemotherapy such as CHOP and monoclonal CD20. Here we provide evidence that the apoptosome adaptor protein, Apaf-1, is mislocalized in primary cells derived from patients with diffuse large B cell lymphomas (DLBCL). Whereas, the total expression of Apaf-1 did not change, its sub-cellular localization was significantly different in DLBCL, compared to T cell lymphomas as well as cells derived from reactive lymphadenopathy biopsies. As expected, Apaf-1 was detected in the cytosolic fractions of non-B cell lymphomas and non-cancerous tissues; however, in B cell derived lymphomas the protein was detected in membrane raft sub-domains rather than the cytosol. Disruption of lipid raft structures resulted in the redistribution of Apaf-1 to the cytosol and restored apoptosis sensitivity of DLBCL. Furthermore, we identified novel small molecule compounds that target DLBCL by promoting Apaf-1 release form lipid rafts via mechanisms that involve an increase in intracellular reactive oxygen species production. Taken together, our results implicate Apaf-1 mislocalization as a potential diagnostic and prognostic marker for DLBCL, and provide a novel therapeutic strategy for circumventing the drug refractory nature of this sub-class of B cell lymphoma.
Effect of Substrate on Memristive Switching of Pr0.7Ca0.3MnO3

Perovskite manganite Pr0.7Ca0. 3MnO3 (PCMO) thin film nanostructures were grown on different substrates by chemical solution deposition to investigate its electrical switching properties. Planar structures consisting of Ag/Pr0.7Ca0. 3MnO3/Ag grown on SiO2, Si (100), LaAlO3 (100) and MgO (100) were characterized by grazing incidence X-ray diffraction, atomic force microscopy and electrical measurements. In each case, single PCMO phase formation and smooth surface morphology was confirmed by XRD and AFM, respectively. Four terminal current voltage characteristics of Ag/PCMO/Ag planar geometry exhibited a sharp transition from a low resistance state (LRS) to a high resistance state (HRS) with a high resistance switching ratios of the order of 950 for PCMO films grown on quartz was estimated at room temperature. High resistance switching ratios were found to depend on the substrate, suggesting a role of lattice mismatch for resistance switching. We have observed that higher mismatch lead to better resistance switching in this compound. The observed conduction characteristics provide direct evidence of substrate strain induce resistance switching in the Pr0.7Ca0. 3MnO3.
Dietary protein intake and chronic kidney disease

Purpose of review High-protein intake may lead to increased intraglomerular pressure and glomerular hyperfiltration. This can cause damage to glomerular structure leading to or aggravating chronic kidney disease (CKD). Hence, a low-protein diet (LPD) of 0.6–0.8 g/kg/day is often recommended for the management of CKD. We reviewed the effect of protein intake on incidence and progression of CKD and the role of LPD in the CKD management. Recent findings Actual dietary protein consumption in CKD patients remains substantially higher than the recommendations for LPD. Notwithstanding the inconclusive results of the ‘Modification of Diet in Renal Disease’ (MDRD) study, the largest randomized controlled trial to examine protein restriction in CKD, several prior and subsequent studies and meta-analyses appear to support the role of LPD on retarding progression of CKD and delaying initiation of maintenance dialysis therapy. LPD can also be used to control metabolic derangements in CKD. Supplemented LPD with essential amino acids or their ketoanalogs may be used for incremental transition to dialysis especially on nondialysis days. The LPD management in lieu of dialysis therapy can reduce costs, enhance psychological adaptation, and preserve residual renal function upon transition to dialysis. Adherence and adequate protein and energy intake should be ensured to avoid protein-energy wasting. Summary A balanced and individualized dietary approach based on LPD should be elaborated with periodic dietitian counseling and surveillance to optimize management of CKD, to assure adequate protein and energy intake, and to avoid or correct protein-energy wasting.
Decentralizing Government and Decentering Gender: Lessons from Local Government Reform in South Africa

Localization and decentralization are frequently presented as good for women. However, the reality is not so clear cut. Local government is the tier that is closest to people, but relationships, structures, and processes of local governance can limit both the space for women’s participation and the policy potential for addressing gender issues. The experience of democratic reform in South Africa is invariably held up as an example of good practice in advancing gender equity in governance. Critically drawing on this experience, the article points out some of the paradoxes for women and gender equity that arise from decentralization strategies and governance at the local level.
Polarised epithelial monolayers of the gastric mucosa reveal insights into mucosal homeostasis and defence against infection

Objective Helicobacter pylori causes life-long colonisation of the gastric mucosa, leading to chronic inflammation with increased risk of gastric cancer. Research on the pathogenesis of this infection would strongly benefit from an authentic human in vitro model. Design Antrum-derived gastric glands from surgery specimens served to establish polarised epithelial monolayers via a transient air–liquid interface culture stage to study cross-talk with H. pylori and the adjacent stroma. Results The resulting ‘mucosoid cultures’, so named because they recapitulate key characteristics of the gastric mucosa, represent normal stem cell-driven cultures that can be passaged for months. These highly polarised columnar epithelial layers encompass the various gastric antral cell types and secrete mucus at the apical surface. By default, they differentiate towards a foveolar, MUC5AC-producing phenotype, whereas Wnt signalling stimulates proliferation of MUC6-producing cells and preserves stemness—reminiscent of the gland base. Stromal cells from the lamina propria secrete Wnt inhibitors, antagonising stem-cell niche signalling and inducing differentiation. On infection with H. pylori, a strong inflammatory response is induced preferentially in the undifferentiated basal cell phenotype. Infection of cultures for several weeks produces foci of viable bacteria and a persistent inflammatory condition, while the secreted mucus establishes a barrier that only few bacteria manage to overcome. Conclusion Gastric mucosoid cultures faithfully reproduce the features of normal human gastric epithelium, enabling new approaches for investigating the interaction of H. pylori with the epithelial surface and the cross-talk with the basolateral stromal compartment. Our observations provide striking insights in the regulatory circuits of inflammation and defence.