Miracle-dz/UniFAR-FTUs huggingface dataset:
Fetal cardiac surgery.

Elucidation of the mechanisms of placental dysfunction after bypass and the negative effects of fetal stress (Fig 9) has allowed these issues to be addressed effectively using indomethacin and appropriate fetal anesthesia. The effective management of these two major problems has made a dramatic difference in the ability of fetal animals to survive surgical intervention and extracorporeal circulation. Characterization of various aspects of placental vascular hemodynamics using the isolated placental preparation also has added new insights into the behavior of the placental vasculature during extracorporeal circulation. These insights have been and will continue to be extremely useful in designing the ideal method of fetal extracorporeal circulatory support. In spite of these advances, further work remains before clinical application of these techniques can be applied reliably. Ideally, a specific blocker of the mediators of the placental response to cardiac bypass should be available before clinical studies are undertaken. Indomethacin, although quite effective, may have secondary effects on other vascular beds that would be potentially detrimental. Also, although the fetal stress response can be blocked adequately using fetal total spinal anesthesia, with a dramatic improvement in cardiovascular stability, this technique of anesthesia not only would be cumbersome, but also would be potentially dangerous in the human fetus. High-dose narcotic anesthesia has been shown to be very effective in neonates and infants undergoing cardiac procedures, with respect to both blockage of the stress response and maintenance of cardiac function. This technique also may be applicable in the human fetus as an effective method of blocking the stress response without causing myocardial depression or affecting peripheral vascular resistances. Unfortunately, sheep do not possess opiate receptors and, therefore, are not an appropriate model for testing narcotic anesthesia in the fetus. Future studies in the primate model using high-dose narcotic anesthesia could provide important information regarding this problem. Also, the ideal circuitry for fetal extracorporeal support has not been determined with certainty. Although a simplified circuit without an oxygenator is possible if the placenta is used as the oxygenator, this method has the disadvantages of high flow rates and placental stimulation. Extracorporeal circulation with the inclusion of an artificial oxygenator requires a somewhat more complex circuit; however, more manageable flow rates and less stimulation of placental vasculature are possible with this technique (Fig 10). All forms of fetal intervention for cardiovascular disease require an extensive understanding of the fetal pathophysiologic responses to intervention, whether the intervention involves open techniques that necessitate extracorporeal circulatory support or closed interventional techniques. (ABSTRACT TRUNCATED AT 400 WORDS)
Three-Phase Cross-Cloud Federation Model: The Cloud SSO Authentication

Cloud federation aims to cost-effective assets and resources optimization among heterogeneous environments where clouds can cooperate together with the goal of obtaining unbounded computation resources, hence new business opportunities. This paper describes an architecture for the federation establishment, where clouds that need external resources ask to federated clouds the renting of extra physical resources. Our architecture introduces a new module named Cross-Cloud Federation Manager including three agents (Discovery, Match-making and Authentication). In this work, we specifically focus on the authentication agent, which is responsible for a secure federation. To address such problem we propose a technical solution based on the IdP/SP model along with the SAML technology.
Ovarian Cancer Research in the Post Genomic Era — Challenges and Opportunities

The field of ovarian cancer research is undergoing major re-examination. Pathologists are defining the disease in new terms, and—having observed discrepancies in its actual cell(s) and tissue(s) of origin—are asking whether or not ovarian cancer truly represents one disease or a complex group of diseases. Further complexity was unveiled after sequencing a large number of high-grade serous ovarian cancer tumor samples (the most frequent ovarian cancer histotype). The experiments uncovered the existence of at least four different molecular subtypes, which standard pathological assessment cannot determine. These discoveries propelled a need for designing novel model systems to study the disease and to develop therapies tailored to the molecular genetics of the tumor. Though there has been no major breakthrough as regards overall patient survival of ovarian cancer in the last 50 years, this chapter summarizes the many challenges and fascinating opportunities scientists face in altering the fatal course of this disease.
Stability of Galactic Gas Disks and the Formation of Massive Clusters

We study gravitational instabilities in disks, with special attention to the most massive clumps that form because they are expected to be the progenitors of globular-type clusters. The maximum unstable mass is set by rotation and depends only on the surface density and orbital frequency of the disk. We propose that the formation of massive clusters is related to this largest scale in galaxies not stabilized by rotation. Using data from the literature, we predict that globular-like clusters can form in nuclear starburst disks and protogalactic disks but not in typical spiral galaxies, in agreement with observations.
The Psychology of the Child

* Introduction The Sensori-Motor Level * Sensori-motor Intelligence * The Construction of Reality * The Cognitive Aspect of Sensori-motor Reactions * The Affective Aspect of Sensori-motor Reactions The Development of Perception * Perceptual Consistencies and Perceptual Causality * Field Effects * The Perceptual Activities * Perceptions, Concepts, and Operations The Semiotic or Symbolic Function * The Semiotic Function and Imitation * Symbolic Play * Drawing * Mental Images * Memory and the Structure of Image-Memories * Language The Concrete Operations of Thought and Interpersonal Relations * The Three Levels in the Transition from Action to Operation * The Genesis of the Concrete Operations * Representation of the Universe: Causality and Chance * Social and Affective Interactions * Moral Feelings and Judgments * Conclusion The Preadolescent and the Propositional Operations * Formal Thought and the Combinatorial System * The Two Reversibilities * The Formal Operatory Schemes * The Induction of Laws and the Dissociation of Factors * The Affective Transformations * Conclusion: Factors in Mental Development
Spectral and Temporal Measures in Hybrid Cochlear Implant Users: On the Mechanism of Electroacoustic Hearing Benefits

Objective Compare auditory performance of Hybrid and standard cochlear implant users with psychoacoustic measures of spectral and temporal sensitivity and correlate with measures of clinical benefit. Study Design Cross-sectional study. Setting Tertiary academic medical center. Patients Hybrid cochlear implant users between 12 and 33 months after implantation. Hybrid recipients had preservation of low-frequency hearing. Interventions Administration of psychoacoustic, music perception, and speech reception in noise tests. Main Outcome Measures Performance on spectral-ripple discrimination, temporal modulation detection, Schroeder-phase discrimination, Clinical Assessment of Music Perception, and speech reception in steady-state noise tests. Results Clinical Assessment of Music Perception pitch performance at 262 Hz was significantly better in Hybrid users compared with standard implant controls. There was a near significant difference on speech reception in steady-state noise. Surprisingly, neither Schroeder-phase discrimination at 2 frequencies nor temporal modulation detection thresholds across a range of frequencies revealed any advantage in Hybrid users. This contrasts with spectral-ripple measures that were significantly better in the Hybrid group. The spectral-ripple advantage was preserved even when using only residual hearing. Conclusion These preliminary data confirm existing data demonstrating that residual low-frequency acoustic hearing is advantageous for pitch perception. Results also suggest that clinical benefits enjoyed by Hybrid recipients are due to improved spectral discrimination provided by the residual hearing. No evidence indicated that residual hearing provided temporal information beyond that provided by electric stimulation.
The Application of Activity Theory to Explain Collaborative Technology Use in Healthcare: The Case of a Chemotherapy Ordering System

Today cancer is one of the leading causes of death. Treating cancer requires the administration of chemotherapy, however, this is a complex and complicated process which requires the collaboration of many individuals. In many hospitals hand-based systems are used which can also cause further problems especially with regard to errors. This study focusses on the implementation of a computerised chemotherapy system. Further, based on Activity Theory the chemotherapy administration process is framed as an activity system so that contradictions can be uncovered. In doing so, the study proffers activity theory as a robust and rich lens in which to analyse all the critical success aspects of the implementation process so that a successful assimilation of the solution into practice may ensue.
Maternal Deprivation Effect on the Infant’s Neural Stress Markers Is Reversed by Tactile Stimulation and Feeding But Not by Suppressing Corticosterone

After 24 hr of maternal deprivation, significant elevations in ACTH and the naturally occurring glucocorticoid corticosterone (CORT) are observed during the stress-hyporesponsive period. The deprived pups also showed in the paraventricular nucleus (PVN) a marked increase of stress-induced c-fos mRNA and a reduction of corticotropin-releasing hormone (CRH) and glucocorticoid receptor (GR) mRNA; in hippocampal CA1, a reduction of the mineralocorticoid receptor (MR) and GR was observed. Here, we examined whether these changes are reversed by (1) preventing the elevations of CORT characteristic for the 11-d-old deprived pups by administering the synthetic glucocorticoid dexamethasone (DEX); or (2) reinstating some aspects of maternal behavior. The pups were either (1) left undisturbed, (2) stroked, or (3) stroked and episodically fed by cheek cannulation. At postnatal day 12, peripheral and neural stress markers were measured. Nondeprived animals served as controls. Experiment 1 demonstrates that although CORT was kept low by DEX, the central effects on CORT receptors, CRH, and c-fos mRNA were still present, except for MR in hippocampal CA1. Experiment 2 shows that stroking alone prevented the stress-induced rise in ACTH andc-fos mRNA and in the reduction in CRH and MR mRNA. In pups that were fed and stroked, CORT and GR mRNA resembled nondeprived controls. In conclusion, the changes in peripheral endocrine responses and in the brain cannot be attributed to the effect of elevated CORT concentrations, which are characteristic of the maternally deprived neonate. However, reinstating some components of the dams’ nurturing behavior can reverse the effects evoked by maternal deprivation.
Modality Switching Costs Emerge in Concept Creation as Well as Retrieval

Theories of embodied cognition hold that the conceptual system uses perceptual simulations for the purposes of representation. A strong prediction is that perceptual phenomena should emerge in conceptual processing, and, in support, previous research has shown that switching modalities from one trial to the next incurs a processing cost during conceptual tasks. However, to date, such research has been limited by its reliance on the retrieval of familiar concepts. We therefore examined concept creation by asking participants to interpret modality-specific compound phrases (i.e., conceptual combinations). Results show that modality switching costs emerge during the creation of new conceptual entities: People are slower to simulate a novel concept (e.g., auditory jingling onion) when their attention has already been engaged by a different modality in simulating a familiar concept (e.g., visual shiny penny). Furthermore, these costs cannot be accounted for by linguistic factors alone. Rather, our findings support the embodied view that concept creation, as well as retrieval, requires situated perceptual simulation.
Near Surface Swimming of Salmonella Typhimurium Explains Target-Site Selection and Cooperative Invasion

Targeting of permissive entry sites is crucial for bacterial infection. The targeting mechanisms are incompletely understood. We have analyzed target-site selection by S. Typhimurium. This enteropathogenic bacterium employs adhesins (e.g. fim) and the type III secretion system 1 (TTSS-1) for host cell binding, the triggering of ruffles and invasion. Typically, S. Typhimurium invasion is focused on a subset of cells and multiple bacteria invade via the same ruffle. It has remained unclear how this is achieved. We have studied target-site selection in tissue culture by time lapse microscopy, movement pattern analysis and modeling. Flagellar motility (but not chemotaxis) was required for reaching the host cell surface in vitro. Subsequently, physical forces trapped the pathogen for ∼1.5–3 s in “near surface swimming”. This increased the local pathogen density and facilitated “scanning” of the host surface topology. We observed transient TTSS-1 and fim-independent “stopping” and irreversible TTSS-1-mediated docking, in particular at sites of prominent topology, i.e. the base of rounded-up cells and membrane ruffles. Our data indicate that target site selection and the cooperative infection of membrane ruffles are attributable to near surface swimming. This mechanism might be of general importance for understanding infection by flagellated bacteria.
Three Versus Seven-Day Treatment of Asymptomatic Bacteriuria in Pregnant Women: A Pilot Investigation

Objective: To compare 3-day vs 7-day antimicrobial treatment for asymptomatic bacteriuria in pregnant women in a pilot study. Methods: Pregnant women with asymptomatic bacteriuria (100,000 cfu/mL) were randomized to 3-day or 7-day nitrofurantoin treatment. Exclusion criteria included symptomatic bacteriuria at enrollment, previously treated bacteriuria in the current pregnancy, underlying renal disorders, antibiotic use within one week prior to initial culture or treatment, bacterial resistance to nitrofurantoin, or other contraindications to nitrofurantoin. Urine test of cure (TOC) was performed 2-4 weeks after initiation of treatment. Subjects with persistent bacteriuria received an additional 7-day treatment course with an antimicrobial agent based on uropathogen sensitivities and selected at the physician's discretion. Following delivery, antenatal, perinatal, and neonatal data were reviewed. Statistical analyses were performed using t-test, Chi- square, and Fisher exact where appropriate. Analysis was based on intent-to-treat. Results: Forty-four of 60 patients had complete prenatal and delivery records. Twenty-four patients (54.5%) were randomized to 3-day treatment and 20 patients (45.5%) to 7-day treatment. Six (25%) patients in the 3-day group had persistent bacteriuria at TOC, compared to 2 (10%) patients in the 7-day group (p=0.19). There were no statistical differences between the groups in maternal age, gestational age at enrollment, mode of delivery, birth weight, NICU admissions, or the incidence of recurrent urinary tract infections or pyelonephritis. Conclusion: Based on our small sample group, 3-day nitrofurantoin treatment had statistically comparable outcomes to 7- day treatment for asymptomatic bacteriuria in pregnant patients, yet 3-day-treated women were 2.5 times more likely to have persistent bacteriuria than 7-day-treated women. The possibility of a beta error exists. In light of recent data which indicates that 1-day nitrofurantoin therapy is less effective than 7-day treatment in pregnant women, we recommend 7-day treatment for ASB.
Antiretroviral therapy initiation and adherence in rural South Africa: community health workers’ perspectives on barriers and facilitators

ABSTRACT South Africa has the largest global HIV/AIDS epidemic, but barriers along the HIV care continuum prevent patients from initiating and adhering to antiretroviral therapy (ART). To qualitatively explore reasons for poor ART initiation and adherence rates from the unique perspective of community health workers (CHWs), we conducted focus groups during May–August 2014 with 21 CHWs in rural Msinga, KwaZulu-Natal. Interviews were audio-recorded, transcribed, and translated from Zulu into English. Hybrid deductive and inductive analytical methods were applied to identify emergent themes. Multiple psychosocial, socioeconomic, and socio-medical barriers acted at the level of the individual, social network, broader community, and healthcare environment to simultaneously hinder initiation of and adherence to ART. Key themes included insufficient patient education and social support, patient dissatisfaction with healthcare services, socioeconomic factors, and tension between ART and alternative medicine. Fear of lifelong therapy thwarted initiation whereas substance abuse principally impeded adherence. In conclusion, HIV/AIDS management requires patient counselling and support extending beyond initial diagnosis. Treating HIV/AIDS as a chronic rather than acute infectious disease is key to improving ART initiation and long-term adherence. Public health strategies include expanding CHWs' roles to strengthen healthcare services, provide longitudinal patient support, and foster collaboration with alternative medicine providers.
Nonlinear System Identification by Gustafson–Kessel Fuzzy Clustering and Supervised Local Model Network Learning for the Drug Absorption Spectra Process

This paper deals with the problem of fuzzy nonlinear model identification in the framework of a local model network (LMN). A new iterative identification approach is proposed, where supervised and unsupervised learning are combined to optimize the structure of the LMN. For the purpose of fitting the cluster-centers to the process nonlinearity, the Gustafsson-Kessel (GK) fuzzy clustering, i.e., unsupervised learning, is applied. In combination with the LMN learning procedure, a new incremental method to define the number and the initial locations of the cluster centers for the GK clustering algorithm is proposed. Each data cluster corresponds to a local region of the process and is modeled with a local linear model. Since the validity functions are calculated from the fuzzy covariance matrices of the clusters, they are highly adaptable and thus the process can be described with a very sparse amount of local models, i.e., with a parsimonious LMN model. The proposed method for constructing the LMN is finally tested on a drug absorption spectral process and compared to two other methods, namely, Lolimot and Hilomot. The comparison between the experimental results when using each method shows the usefulness of the proposed identification algorithm.
Cutting Edge: IL-4 Receptor Expression by Non-Bone Marrow-Derived Cells Is Required to Expel Gastrointestinal Nematode Parasites1

Expulsion of two gastrointestinal nematode parasites, Nippostrongylus brasiliensis and Trichinella spiralis, is similar in that both require IL-4Rα expression, but different in that T cells and mast cells are required for IL-4-induced expulsion of T. spiralis but not N. brasiliensis. To examine the role of IL-4Rα signaling in immunity to these parasites, we studied worm expulsion in chimeric mice that selectively expressed IL-4Rα on bone marrow-derived or non-bone marrow-derived cells. N. brasiliensis was expelled by mice that expressed IL-4Rα only on non-bone marrow-derived cells, but not by mice that expressed IL-4Rα only on bone marrow-derived cells. Although T. spiralis expulsion required IL-4Rα expression by both bone marrow- and non-bone marrow-derived cells, IL-4 stimulation eliminated the requirement for IL-4Rα expression by bone marrow-derived cells. Thus, direct IL-4Rα signaling of nonimmune gastrointestinal cells may be generally required to induce worm expulsion, even when mast cell and T cell responses are also required.
Technologies of Gender: Essays on Theory, Film and Fiction

"Technologies of Gender builds a bridge between the fashionable orthodoxies of academic theory (Lacan, Foucault, Derrida, et al.) and the frequently-marginalized contributions of feminist theory. In sum, de Lauretis has written a book that should be required reading for every feminist in need of theoretical ammunition and for every theorist in need of feminist enlightenment. " B. Ruby Rich. ". sets philosophical ideas humming. she has much to say. " Cineaste"I can think of no other work that pushes the debate on the female subject forward with such passion and intellectual rigor. " SubStanceThis book addresses the question of gender in poststructuralist theoretical discourse, postmodern fiction, and women s cinema. It examines the construction of gender both as representation and as self-representation in relation to several kinds of texts and argues that feminism is producing a radical rewriting, as well as a rereading, of the dominant forms of Western culture. "
Influence of Temperature on the Mechanical Properties of Cardiac Muscle

The influence of temperature on contractile performance, total myocardial stiffness, and the elastic and viscous components of stiffness was studied in intact hearts (dog) and isolated cardiac muscle (cat). In 12 dogs on whole-heart bypass, stiffness (ΔP/ΔV) was determined by inducing sinusoidal 0.5-ml volume changes in paced, isovolumically contracting left ventricles and measuring the resultant pressure changes (ΔP). In eight cat papillary muscles contracting isometrically at Lmax, stiffness (ΔT/ΔL) was similarly determined from the changes in tension and length during sinusoidal length changes of 0.25% L max. Total stiffness was linearly related to ventricular pressure or muscular tension during both contraction and rest. As the temperature rose from 33° to 40°C in vivo and from 22° to 40°C in vitro, the slopes of the stiffness-pressure and stiffness-tension relationships and the intercept of the latter declined; therefore, stiffness is inversely related to temperature. Since both preparations responded as linear second-order systems, stiffness could be separated into its elastic and viscous components. The moduli of both components varied in the same direction as total stiffness during temperature changes; however, the viscous component was more sensitive to the influence of temperature.