Miracle-dz/UniFAR-FTUs huggingface dataset:
Of Tattooed Rabbits, Parturients, and Neuraxial Blocks

First, we highlight that the aim of this technique is to direct the needle caudally to access the proximal infraclavicular space. Thus, the point of administration of local anesthetic is performed at the first portion of the axillary artery. However, this approach involves an ultrasound “dark zone” generated by the clavicle acoustic shadow. This incident, in our opinion, is a serious concern because it hinders the visualization of the tip of the needle. Regarding this fact, we would like to recall the similitude with the recently published technique by our group named “costoclavicular block. ” In our view, a better tracing of the entire needle can be obtained with our approach. In the retroclavicular block, also named posterior approach to infraclavicular brachial plexus by Hebbard and Royse, the axillary vessels and cords are identified in the paramedial sagittal plane. Thereafter, a “palpation” of the supraclavicular fossa is performed and the needle insertion point is determined at a point “sufficiently posterior to the clavicle,” medial or over the trapezius muscle. Maintaining a strict alignment between the ultrasound beam and the insertion point, the block is completed with the perivascular injection of local anesthetic posterior to the axillary artery. In our opinion, the aforementioned approach corresponds, with enough similarity, to the classical approach described by Winnie and Collins in the article “The Subclavian Perivascular Technique of Brachial Plexus Anesthesia. ” In Winnie's report, there is a description of the palpation along the interscalene groove until the subclavian artery is located. Immediately after, the needle insertion point is determined above the palpating finger in a directly caudal direction. Following this direction, the needle is aimed dorsally tangential to the artery until “the click” of the needle penetrating the sheath is felt. Only a short distance beyond, a single hand paresthesia is observed, thus confirming the correct positioning of the needle in the perivascular space. In our extensive experience during the era of nerve stimulation, motor response was found in a median distance of 2 to 4 cm to the skin, reaching the infraclavicular or retroclavicular space rather than the supraclavicular space. In this letter, we intend to honor Dr. Alon P. Winnie and his “subclavian perivascular technique,” which was the pioneering work leading to many subsequent approaches to the brachial plexus. In the ultrasound era, it is crucial—and we must be certain not to forget history. We recall Dr. Winnie's words in his book, “Those who don't remember the past are condemned to relive it. ”
What effects might anti-TNFα treatment be expected to have on cardiovascular morbidity and mortality in rheumatoid arthritis? A review of the role of TNFα in cardiovascular pathophysiology

Patients with rheumatoid arthritis (RA) have an increased burden of atherosclerotic cardiovascular disease which cannot be explained by an increased prevalence of traditional cardiovascular risk factors alone. Atherosclerosis is now being viewed as an inflammatory condition and the cumulative inflammation experienced in RA may contribute to accelerated atherosclerosis. It has been hypothesised that treatment with anti-tumour necrosis factor (TNF) α in RA may reduce both intra-articular inflammation and the inflammation associated with atherosclerosis. Thus, TNFα blockade may reduce the cardiovascular morbidity and mortality associated with RA. This review examines the pathophysiological role of TNFα in atherosclerosis and the evidence to date that anti-TNFα treatment modifies this process in RA.
Analysis of Reconfiguration Strategies Based On Petri Nets Models and Optimization Techniques

The concept of flexible manufacturing system (FMS) has been initially introduced to enable the production of different types of parts at the same time. But dependable requirements and especially the necessity to continue to produce in spite of the breakdown of a plant component lead to exploit the flexibility to reconfigure the plant. Nowadays, the challenge for researchers and industrials is thus to build reconfigurable manufacturing systems (RMS). A RMS must be able to adapt its configuration in real-time depending on production objectives and available resources. In this paper, we introduce the concept of reconfiguration process that defines the different steps to determine the actions needed to put the system in a state compatible with production resumption. Our approach expresses the reconfiguration process as a Petri net reachability problem instance. Our proposition consists in reusing the initial models developed for control purposes and to adapt them to model the potential reconfiguration actions (alternatives routes, start and stop of resources, feasible operating sequences). We define then a target marking - not necessarily entirely known - corresponding to the specification of a family of desired system states. Then we search for the firing sequences that bring the system from an initial marking to the desired objective marking. This problem is solved using mathematical programming techniques, allowing to optimize criteria corresponding to the relevance of the reconfiguration
Safety of immunomodulators and biologics for the treatment of inflammatory bowel disease during pregnancy and breast‐feeding

&NA;The aim of this article is to critically review available data regarding the safety of immunomodulators and biological therapies during pregnancy and breast‐feeding in women with inflammatory bowel disease. Methotrexate and thalidomide can cause congenital anomalies and are contraindicated during pregnancy (and breast‐feeding). Although thiopurines have a Food and Drug Administration (FDA) rating D, available data suggest that these drugs are safe and well tolerated during pregnancy. Although traditionally women receiving azathioprine or mercaptopurine have been discouraged from breast‐feeding because of theoretical potential risks, it seems that these drugs may be safe in this scenario. Treatment with cyclosporine for steroid‐refractory ulcerative colitis (UC) during pregnancy can be considered safe and effective, and the use of this drug should be considered in cases of severe UC as a means of avoiding urgent surgery. Breast‐feeding is contraindicated for patients receiving cyclosporine. Biological therapies appear to be safe in pregnancy, as no increased risk of malformations has been demonstrated. Therefore, the limited clinical results available suggest that the benefits of infliximab and adalimumab in attaining response and maintaining remission in pregnant patients might outweigh the theoretical risks of drug exposure to the fetus. Stopping therapy in the third trimester may be considered, as it seems that transplacental transfer of infliximab is low prior to this. Certolizumab differs from infliximab and adalimumab in that it is a Fab fragment of an antitumor necrosis factor alpha monoclonal antibody, and therefore it may not be necessary to stop certolizumab in the third trimester. The use of infliximab is probably compatible with breast‐feeding. (Inflamm Bowel Dis 2009;)
Speed and Cardiac Recovery Variables Predict the Probability of Elimination in Equine Endurance Events

Nearly 50% of the horses participating in endurance events are eliminated at a veterinary examination (a vet gate). Detecting unfit horses before a health problem occurs and treatment is required is a challenge for veterinarians but is essential for improving equine welfare. We hypothesized that it would be possible to detect unfit horses earlier in the event by measuring heart rate recovery variables. Hence, the objective of the present study was to compute logistic regressions of heart rate, cardiac recovery time and average speed data recorded at the previous vet gate (n-1) and thus predict the probability of elimination during successive phases (n and following) in endurance events. Speed and heart rate data were extracted from an electronic database of endurance events (80–160 km in length) organized in four countries. Overall, 39% of the horses that started an event were eliminated—mostly due to lameness (64%) or metabolic disorders (15%). For each vet gate, logistic regressions of explanatory variables (average speed, cardiac recovery time and heart rate measured at the previous vet gate) and categorical variables (age and/or event distance) were computed to estimate the probability of elimination. The predictive logistic regressions for vet gates 2 to 5 correctly classified between 62% and 86% of the eliminated horses. The robustness of these results was confirmed by high areas under the receiving operating characteristic curves (0.68–0.84). Overall, a horse has a 70% chance of being eliminated at the next gate if its cardiac recovery time is longer than 11 min at vet gate 1 or 2, or longer than 13 min at vet gates 3 or 4. Heart rate recovery and average speed variables measured at the previous vet gate(s) enabled us to predict elimination at the following vet gate. These variables should be checked at each veterinary examination, in order to detect unfit horses as early as possible. Our predictive method may help to improve equine welfare and ethical considerations in endurance events.
The knowledge-attitude dissociation in geriatric education: can it be overcome?

INTRODUCTION A knowledge-attitude dissociation often exists in geriatrics where knowledge but not attitudes towards elderly patients improve with education. This study aims to determine whether a holistic education programme incorporating multiple educational strategies such as early exposure, ageing simulation and small group teaching results in improving geriatrics knowledge and attitudes among medical students. MATERIALS AND METHODS We administered the 18-item University of California Los Angeles (UCLA) Geriatric Knowledge Test (GKT) and the Singapore-modified 16-item UCLA Geriatric Attitudes Test (GAT) to 2nd year students of the old curriculum in 2009 (baseline reference cohort, n = 254), and before and after the new module to students of the new curriculum in 2010 (intervention cohort, n = 261), both at the same time of the year. RESULTS At baseline, between the baseline reference and intervention cohort, there was no difference in knowledge (UCLA-GKT Score: 31.6 vs 33.5, P = 0.207) but attitudes of the intervention group were worse than the baseline reference group (UCLA-GAT Score: 3.53 vs 3.43, P = 0.003). The new module improved both the geriatric knowledge (UCLA-GKT Score: 34.0 vs 46.0, P <0.001) and attitudes (UCLA-GAT Score: 3.43 vs 3.50, P <0.001) of the intervention cohort. CONCLUSION A geriatric education module incorporating sound educational strategies improved both geriatric knowledge and attitudes among medical students.
Genome‐wide analysis of primary plasma cell leukemia identifies recurrent imbalances associated with changes in transcriptional profiles

Primary plasma cell leukemia (pPCL) is a rare, yet aggressive form of de novo plasma cell tumor, distinct from secondary PCL (sPCL) which represents a leukemic transformation of pre‐existing multiple myeloma (MM). Herein, we performed a comprehensive molecular analysis of a prospective series of pPCLs by means of FISH, single nucleotide polymorphism (SNP) array and gene expression profiling (GEP). IGH@ translocations were identified in 87% of pPCL cases, with prevalence of t(11;14) (40%) and t(14;16) (30.5%), whereas the most frequent numerical alterations involved 1p (38%), 1q (48%), 6q (29%), 8p (42%), 13q (74%), 14q (71%), 16q (53%), and 17p (35%). We identified a minimal biallelic deletion (1.5 Mb) in 8p21.2 encompassing the PPP2R2A gene, belonging to a family of putative tumor suppressors and found to be significantly down‐regulated in deleted cases. Mutations of TP53 were identified in four cases, all but one associated with a monoallelic deletion of the gene, whereas activating mutations of the BRAF oncogene occurred in one case and were absent in N‐ and K‐RAS. To evaluate the influence of allelic imbalances in transcriptional expression we performed an integrated genomic analysis with GEP data, showing a significant dosage effect of genes involved in transcription, translation, methyltransferase activity, apoptosis as well as Wnt and NF‐kB signaling pathways. Overall, we provide a compendium of genomic alterations in a prospective series of pPCLs which may contribute to improve our understanding of the pathogenesis of this aggressive form of plasma cell dyscrasia and the mechanisms of tumor progression in MM. Am. J. Hematol. 2013. © 2012 Wiley Periodicals, Inc.
Prognostic Value of Procalcitonin, CRP, Serum Amyloid A, Lactate and IL-6 Markers in Liver Transplant Patients Admitted to ED with Suspected Infection.

BACKGROUND/AIM Infections are one of the most important causes of mortality and morbidity after liver transplantation as in all transplantations. Infectious complications are known to be among the preventable causes with appropriate diagnosis and treatment. So early prediction of the risk of infections will provide an effective approach to determine the local antimicrobial resistance and prevention of specific risk factors. The aim of this study was to deterimne whether specific markers are useful or not to deterimne a suspected infection in patients that have undergone liver transplantation. PATIENTS AND METHODS The study included 65 patients with liver transplantation admitted to emergency room with suspicion of infection. These patient's CRP, procalsitonin (PCT), lactate, SAA and IL-6 levels were initially measured in the emergency department. The patients were classified to three categories according to culture results; culture-negative, culture-positive and control group. Studying parameters were investigated according to whether the culture was positive or negative in these patients. RESULTS CRP, PCT, lactate, SAA and IL-6 levels were significanlty high in patients with suspected infeciton when compared to the control group (p<0.05). CRP, PCT and IL-6 levels were higher in the culture-positive group than in the culture-negative group and there was a significant variation (p<0.05). When suspecting an infection evaluating the parameters CRP, PCT and IL-6 was very meaningfull (p<0.05). CONCLUSION We can use CRP, PCT, lactate, SAA and IL-6 parameters to identify presence of infection at the liver transplantation patients admitted to the emergency department with suspected infection. If CRP, PCT and IL-6 levels are significantly high we can guess the patient's positive culture.
Early signs of brain infarction at CT: observer reliability and outcome after thrombolytic treatment--systematic review.

PURPOSE To review systematically all reported early computed tomographic (CT) signs in acute ischemic stroke to determine interobserver agreement and the relationship between early CT signs and patient outcome with or without thrombolysis. MATERIALS AND METHODS A systematic review of the literature was conducted by using Cochrane Stroke Group methodology to identify studies published between 1990 and 2003 that were performed to assess interobserver agreement about early signs of infarction on CT scans obtained within 6 hours after onset of stroke symptoms and determine the relation of early signs of infarction to clinical outcome, including any interactive effect of thrombolysis. Interobserver agreement was measured with the kappa statistic, sensitivity, and specificity. The relation of early signs to clinical outcome with or without thrombolysis was assessed with calculated odds ratios and 95% confidence intervals. RESULTS In 15 studies of interobserver agreement (median of 30 CT scans and six raters), the prevalence of all early infarction signs was 61% +/- 21 (standard deviation). Interobserver agreement (kappa statistics) ranged from 0.14 to 0.78 for any early infarction sign. The mean sensitivity and specificity for detection of early infarction signs with CT were 66% (range, 20%-87%) and 87% (range, 56%-100%), respectively. Experience improved detection, but knowledge of symptoms did not. In 15 studies of early infarction signs and outcome (including seven thrombolysis trials) in 3468 patients, any early infarction sign increased the risk of poor outcome (odds ratio, 3.11; 95% confidence interval: 2.77, 3.49). Two studies that sought interaction between early infarction signs and thrombolysis found no evidence that thrombolysis given in the presence of early infarction signs resulted in worse outcome than that due to early signs alone. CONCLUSION Further work is required to determine which signs are most reliably detected, whether scoring systems help to improve detection, and whether any early infarction sign should influence decisions concerning thrombolysis.
Concept of a Domain Repository for Industrial Automation

Reuse approaches like domain engineering are increasingly shifted from software to system engineering. This results in new challenges to be faced by domain repositories, in which the reusable artifacts are stored. This paper describes the specific requirements for domain repositories for industrial automation systems and proposes a possibility to structure domain repository contents. The results of this paper are expected to be particularly interesting for researchers and practitioners in the area of industrial automation systems, since the proposed concept can be used in diverse industrial automation domains.
Human recombination rates are increased around accelerated conserved regions - evidence for continued selection?

MOTIVATION We hypothesized that recombination rates might be increased at genetic loci that are subject to more intense selection. Here, we test this hypothesis by using a recently published set of accelerated conserved regions and fine-scale recombination rate estimates provided by the HapMap project. RESULTS We observed that fine-scale recombination rates are increased around conserved noncoding regions that show accelerated evolution in human or chimp, as compared to noncoding regions showing accelerated evolution in mouse and those being conserved between human and fugu. Recombination rates around hominid accelerated conserved regions (ACRs) are furthermore increased as compared to exonic regions. On the other hand, GC-content is reduced around ACRs, excluding a major confounding influence of GC-content on the observed variation in recombination rate. CONCLUSION Our observations indicate that selection intensity could be an important determinant of local recombination rate variation and that continued positive selection might act at many ACR loci. Alternatively, a confounding factor needs to be found that causes a congruent signal in recombination rate estimates based on human polymorphism data and in the comparative genomic data. Researchers who consider the explanation involving selection as more likely may expect more common functional sequence variants at ACRs in genetic association studies.
Damage signals in the insect immune response

Insects and mammals share an ancient innate immune system comprising both humoral and cellular responses. The insect immune system consists of the fat body, which secretes effector molecules into the hemolymph and several classes of hemocytes, which reside in the hemolymph and of protective border epithelia. Key features of wound- and immune responses are shared between insect and mammalian immune systems including the mode of activation by commonly shared microbial (non-self) patterns and the recognition of these patterns by dedicated receptors. It is unclear how metazoan parasites in insects, which lack these shared motifs, are recognized. Research in recent years has demonstrated that during entry into the insect host, many eukaryotic pathogens leave traces that alert potential hosts of the damage they have aﬄicted. In accordance with terminology used in the mammalian immune systems, these signals have been dubbed danger- or damage-associated signals. Damage signals are necessary byproducts generated during entering hosts either by mechanical or proteolytic damage. Here, we briefly review the current stage of knowledge on how wound closure and wound healing during mechanical damage is regulated and how damage-related signals contribute to these processes. We also discuss how sensors of proteolytic activity induce insect innate immune responses. Strikingly damage-associated signals are also released from cells that have aberrant growth, including tumor cells. These signals may induce apoptosis in the damaged cells, the recruitment of immune cells to the aberrant tissue and even activate humoral responses. Thus, this ensures the removal of aberrant cells and compensatory proliferation to replace lost tissue. Several of these pathways may have been co-opted from wound healing and developmental processes.
Extraction of effective elastic coefficients from a coupled structural electrostatic simulation of a MEMS switch

This paper investigates several methods for the extraction of effective elastic coefficients for integrated micro-electro-mechanical switches, to be used eventually in compact macromodels of these devices. The methods are based on the numerical results obtained from the coupled mechanical-electrostatic finite element (FE) simulation of the device. The best method found is based on a cubic least square approximation of the force-displacement characteristic extracted from the FE simulation. For this method, the relative error of the pull-in voltage is less than 0.5 % with respect to the reference value obtained from the FE simulation. The algorithm of this method is described in detail.
Strain-Rate-Dependent Deformation Behavior of Carbon-Black-Filled Rubber under Monotonic and Cyclic Straining

The constitutive equation of rubber is derived by employing a nonaffine molecular chain network model for an elastic deformation behavior and the reptation theory for a viscoelastic deformation behavior. The results reveal the roles of the individual springs and dashpot, and the strain rate dependence of materials and disentanglement of molecular chains in the monotonic and cyclic deformation behaviors, particularly softening and hysteresis loss, that is, the Mullins effect, occurring in stress-stretch curves under cyclic deformation processes.
Wildtype p53-specific Antibody and T-Cell Responses in Cancer Patients

Mutation in the p53 gene based on single amino acid substitutions is a frequent event in human cancer. Accumulated mutant p53 protein is released to antigen presenting cells of the immune system and anti-p53 immune responses even against wt p53 is induced and observed in a number of human cancer patients. Detection of antibodies against wt p53 protein has been used as a diagnostic and prognostic marker and discovery of new T-cell epitopes has enabled design of cancer vaccination protocols with promising results. Here, we identified wt p53-specific antibodies in various cancer patients and identified a broad range of responses against wt p53 protein and 15-mer peptides using a novel print array technology. Likewise, using bioinformatic tools in silico, we identified CD8+ T-cell specificity or reactivity against HLA-A*02:01 binding peptides wt p53(65–73), wt p53(187–197), and wt p53(264–272) in breast cancer patients and against HLA-A*01:01 binding peptide wt p53(226–234) and HLA-B*07:02 binding peptide wt p53(74–82) in renal cell cancer and breast cancer patients, respectively. Finally, we analyzed antibody and T-cell responses against wt p53 15-mer peptides in patients with metastatic renal cell carcinoma who were alive with no evidence of disease after a follow-up period of minimum 5 years after treatment with IL-2±IFN-&agr;±histamine containing immunotherapy to identify novel epitopes for use in immunotherapy and for potential response biomarkers. However, none of the wt p53 reactivity observed justified use of 15-mer or was related to survival in this rare patient population.