Miracle-dz/UniFAR-FTUs huggingface dataset:
Complex Feeding Decisions

Objective: Where swallowing difficulties are chronic or progressive, or a patient is palliative, tube feeding is often not deemed appropriate. Instead, patients continue to eat and drink despite the risks of pneumonia and death. There is currently little evidence to guide clinical practice in this field often termed “risk feeding. ” This qualitative study investigated staff, patient, and family member perceptions of risk feeding practices in one New Zealand hospital. Method: Twenty-nine staff members and six patients and/or their family were interviewed. Results: Thematic analysis revealed four global themes: supporting practice, communication, complexity of feeding decisions, and patient and family-centered care. Staff described limited education and organizational policy around risk feeding decisions. Communication was considered a major factor in the success. Conclusion: Feeding decisions are complex in the hospital environment. The themes identified in this study provide a foundation for hospital guideline development and implementation.
Tropism-Modification Strategies for Targeted Gene Delivery Using Adenoviral Vectors

Achieving high efficiency, targeted gene delivery with adenoviral vectors is a long-standing goal in the field of clinical gene therapy. To achieve this, platform vectors must combine efficient retargeting strategies with detargeting modifications to ablate native receptor binding (i.e. CAR/integrins/heparan sulfate proteoglycans) and “bridging” interactions. “Bridging” interactions refer to coagulation factor binding, namely coagulation factor X (FX), which bridges hepatocyte transduction in vivo through engagement with surface expressed heparan sulfate proteoglycans (HSPGs). These interactions can contribute to the off-target sequestration of Ad5 in the liver and its characteristic dose-limiting hepatotoxicity, thereby significantly limiting the in vivo targeting efficiency and clinical potential of Ad5-based therapeutics. To date, various approaches to retargeting adenoviruses (Ad) have been described. These include genetic modification strategies to incorporate peptide ligands (within fiber knob domain, fiber shaft, penton base, pIX or hexon), pseudotyping of capsid proteins to include whole fiber substitutions or fiber knob chimeras, pseudotyping with non-human Ad species or with capsid proteins derived from other viral families, hexon hypervariable region (HVR) substitutions and adapter-based conjugation/crosslinking of scFv, growth factors or monoclonal antibodies directed against surface-expressed target antigens. In order to maximize retargeting, strategies which permit detargeting from undesirable interactions between the Ad capsid and components of the circulatory system (e.g. coagulation factors, erythrocytes, pre-existing neutralizing antibodies), can be employed simultaneously. Detargeting can be achieved by genetic ablation of native receptor-binding determinants, ablation of “bridging interactions” such as those which occur between the hexon of Ad5 and coagulation factor X (FX), or alternatively, through the use of polymer-coated “stealth” vectors which avoid these interactions. Simultaneous retargeting and detargeting can be achieved by combining multiple genetic and/or chemical modifications.
On the skew-bounded minimum-buffer routing tree problem

Bounding the load capacitance at gate outputs is a standard element in today's electrical correctness methodologies for high-speed digital very large scale integration design. Bounds on load caps improve coupling-noise immunity, reduce degradation of signal transition edges, and reduce delay uncertainty due to coupling noise (Kahng et al. 1998). For clock and test distribution, an additional design requirement is bounding the buffer skew, i.e., the difference between the maximum and the minimum number of buffers over all of the source-to-sink paths in the routing tree, since buffer skew is one of the main factors affecting delay skew (Tellez and Sarrafzadeh 1997). In this paper, we consider algorithms for buffering a given tree with the minimum number of buffers under given load cap and buffer skew constraints. We show that the greedy algorithm proposed by Tellez and Sarrafzadeh is suboptimal for nonzero buffer-skew bounds and give examples showing that no bottom-up greedy algorithm can achieve optimality. The main contribution of the paper is an optimal dynamic programming algorithm for the problem. Experiments on test cases extracted from recent industrial designs show that the dynamic programming algorithm has practical running time and saves up to 37.5% of the buffers inserted by Tellez and Sarrafzadeh's algorithm.
A New Paradigm for the Treatment of Secondary Hyperparathyroidism

The global rise in chronic kidney disease makes secondary hyperparathyroidism (SHPT) a growing medical concern. Conventional therapies for treating SHPT are limited and include calcium-based and calcium-free phosphate binders for reducing serum phosphorus and vitamin D or its analogues for simultaneous stimulation of calcium absorption and suppression of parathyroid hormone (PTH) gene expression. Control of SHPT using these therapies has typically been poor. Recent studies have demonstrated that use of calcimimetics that reduce PTH secretion by increasing the sensitivity of the parathyroid gland calcium-sensing receptor to circulating calcium allow improved control of serum PTH, calcium, phosphorus and calcium–phosphorus product. This review describes experimental data and the clinical rationale supporting novel strategies for the integration of calcimimetics with conventional therapies to improve control of SHPT.
Use of the Foot Abduction Orthosis Following Ponseti Casts: Is It Essential?

The purpose of this study was to evaluate the need for the use of a foot abduction orthosis (FAO) in the treatment of idiopathic clubfeet using the Ponseti technique. Forty-four idiopathic clubfeet were treated with casting using the Ponseti method followed by FAO application. Compliance was defined as full-time FAO use for 3 months and part-time use subsequently. Noncompliance was failure to fulfill the criteria during the first 9 months after casting. Feet were rated according to the Dimeglio and Pirani scoring systems at initial presentation, at the time of FAO application, and at 6 to 9 months of follow-up. At the time of application, no significant differences in scores were found between the groups. At follow-up, the compliant group's scores were significantly (P < 0.01) better than those of the noncompliant group. From the time of application to follow-up, for the compliant group, the Dimeglio scores improved significantly (P = 0.005). For the noncompliant group, the Dimeglio scores deteriorated significantly (P = 0.001). The feet of patients compliant with FAO use remained better corrected than the feet of those patients who were not compliant. Proper use of FAO is essential for successful application of the Ponseti technique.
Rules Rule! Brain Activity Dissociates the Representations of Stimulus Contingencies with Varying Levels of Complexity

The significance of stimuli is linked not only to their nature but also to the sequential structure in which they are embedded, which gives rise to contingency rules. Humans have an extraordinary ability to extract and exploit these rules, as exemplified by the role of grammar and syntax in language. To study the brain representations of contingency rules, we recorded ERPs and event-related optical signal (EROS; which uses near-infrared light to measure the optical changes associated with neuronal responses). We used sequences of high- and low-frequency tones varying according to three contingency rules, which were orthogonally manipulated and differed in processing requirements: A Single Repetition rule required only template matching, a Local Probability rule required relating a stimulus to its context, and a Global Probability rule could be derived through template matching or with reference to the global sequence context. ERP activity at 200–300 msec was related to the Single Repetition and Global Probability rules (reflecting access to representations based on template matching), whereas longer-latency activity (300-450 msec) was related to the Local Probability and Global Probability rules (reflecting access to representations incorporating contextual information). EROS responses with corresponding latencies indicated that the earlier activity involved the superior temporal gyrus, whereas later responses involved a fronto-parietal network. This suggests that the brain can simultaneously hold different models of stimulus contingencies at different levels of the information processing system according to their processing requirements, as indicated by the latency and location of the corresponding brain activity.
Multimedia streaming via TCP: an analytic performance study

TCP is widely used in commercial media streaming systems, with recent measurement studies indicating that a significant fraction of Internet streaming media is currently delivered over HTTP/TCP. These observations motivate us to develop analytic performance models to systematically investigate the performance of TCP for both live and stored media streaming. We validate our models via <i>ns</i> simulations and experiments conducted over the Internet. Our models provide guidelines indicating the circumstances under which TCP streaming leads to satisfactory performance, showing, for example, that TCP generally provides good streaming performance when the achievable TCP throughput is roughly twice the media bitrate, with only a few seconds of startup delay.
STAT3 links IL-22 signaling in intestinal epithelial cells to mucosal wound healing

Signal transducer and activator of transcription (STAT) 3 is a pleiotropic transcription factor with important functions in cytokine signaling in a variety of tissues. However, the role of STAT3 in the intestinal epithelium is not well understood. We demonstrate that development of colonic inflammation is associated with the induction of STAT3 activity in intestinal epithelial cells (IECs). Studies in genetically engineered mice showed that epithelial STAT3 activation in dextran sodium sulfate colitis is dependent on interleukin (IL)-22 rather than IL-6. IL-22 was secreted by colonic CD11c+ cells in response to Toll-like receptor stimulation. Conditional knockout mice with an IEC-specific deletion of STAT3 activity were highly susceptible to experimental colitis, indicating that epithelial STAT3 regulates gut homeostasis. STAT3IEC-KO mice, upon induction of colitis, showed a striking defect of epithelial restitution. Gene chip analysis indicated that STAT3 regulates the cellular stress response, apoptosis, and pathways associated with wound healing in IECs. Consistently, both IL-22 and epithelial STAT3 were found to be important in wound-healing experiments in vivo. In summary, our data suggest that intestinal epithelial STAT3 activation regulates immune homeostasis in the gut by promoting IL-22–dependent mucosal wound healing.
Comparative Evaluation of the Four most commonly used Pediatric Liquid Formulations in Ahmedabad City: An in vitro Study

Introduction: This study was conducted to assess the cario­ genic potential of pediatric liquid medicaments (PLMs) of Allopathic, Homeopathic, Ayurvedic, and Unani formulations specifically in Ahmedabad. Materials and methods: Four commonly used PLMs were selected based on a survey. Thirty-nine exfoliated deciduous teeth samples were placed in selected PLM for 1 minute, 10 minutes, and 8 hours and observed under scanning electron microscope to check the erosive potential. Their endogenous pH, calcium dissolution potential, viscosity, and type and amount of sugar were checked. Results: In all the four groups, a specific type of enamel prism pattern was seen in all the samples irrespective of magnification and immersion time. However, the degree of erosion increases with the increase in immersion time. All the four syrups were acidic in nature. Lowest pH (3.73) and highest calcium disso­ lution (7.106) were seen in Saduri®. Viscosity was higher with Benadryl® mainly due to high sugar content (36.10), especially glucose (27.21). Conclusion: All the PLMs used in this study showed an erosive effect on the primary enamel surface though major effect was seen with Saduri®. Clinical significance: With respect to this study, Unani medi­ cations are most cariogenic for the teeth among all the four types of medications in children.
Sex Differences in the Contributions of Visceral and Total Body Fat to Blood Pressure in Adolescence

Excess body fat deposited viscerally rather than elsewhere in the body is associated with higher risk for hypertension; this relationship is stronger in men than in women. Here we investigated whether similar sex dimorphism exists already in adolescence. A population-based sample of adolescent boys (n=237) and girls (n=262), age 12 to 18 years, was studied. Total body fat (TBF) was assessed with multifrequency bioelectrical impedance, and visceral fat (VF) was quantified with MRI. Blood pressure (BP) was measured beat by beat during an hour-long protocol, including supine, standing, sitting, mental stress, and poststress sections. Multivariate mixed-model analysis was used to assess the relative contributions of TBF and VF to BP during these sections. In boys, BP was strongly positively associated with VF (P<0.0001), whereas it was less strongly and negatively associated with TBF (P=0.004); these relationships did not substantially vary during the protocol. In contrast, in girls, BP was strongly positively associated with TBF (P=0.0006), whereas it was not associated with VF (P=0.08); the relationship with TBF varied during the protocol and was most apparent during mental stress (TBF*section interaction: P=0.002). Furthermore, when waist circumference was included in multivariate models instead of VF, it was not associated with BP in either sex; this indicates that waist circumference may not be an appropriate surrogate for VF. Thus, in adolescence, adiposity-related BP elevation is driven mainly by visceral fat in males and by fat deposited elsewhere in females. This dimorphism suggests sex-specific mechanisms of obesity-induced hypertension and the need for sex-specific criteria of its prevention.
On the Distribution of Indefinite Quadratic Forms in Gaussian Random Variables

In this work, we propose a unified approach to evaluating the CDF and PDF of indefinite quadratic forms in Gaussian random variables. Such a quantity appears in many applications in communications, signal processing, information theory, and adaptive filtering. For example, this quantity appears in the mean-square-error (MSE) analysis of the normalized least-mean-square (NLMS) adaptive algorithm, and SINR associated with each beam in beam forming applications. The trick of the proposed approach is to replace inequalities that appear in the CDF calculation with unit step functions and to use complex integral representation of the the unit step function. Complex integration allows us then to evaluate the CDF in closed form for the zero mean case and as a single dimensional integral for the non-zero mean case. Utilizing the saddle point technique allows us to closely approximate such integrals in non zero mean case. We demonstrate how our approach can be extended to other scenarios such as the joint distribution of quadratic forms and ratios of such forms, and to characterize quadratic forms in isotropic distributed random variables. We also evaluate the outage probability in multiuser beamforming using our approach to provide an application of indefinite forms in communications.
Detecting Novel Associations in Large Data Sets

A statistical method reveals relationships among variables in complex data sets. Identifying interesting relationships between pairs of variables in large data sets is increasingly important. Here, we present a measure of dependence for two-variable relationships: the maximal information coefficient (MIC). MIC captures a wide range of associations both functional and not, and for functional relationships provides a score that roughly equals the coefficient of determination (R2) of the data relative to the regression function. MIC belongs to a larger class of maximal information-based nonparametric exploration (MINE) statistics for identifying and classifying relationships. We apply MIC and MINE to data sets in global health, gene expression, major-league baseball, and the human gut microbiota and identify known and novel relationships.
Analytical Framework for Preliminary Planning of Very High-Speed Digital Subscriber Line Access Networks

In this paper, we introduce an analytical framework for the performance evaluation of the VDSL2-based access systems. It allows for the obtaining of approximations of the achievable bit rate per user, taking into account several factors, such as the bit-loading limitation per sub-carrier; interference scenario, including the number and positions of the active interferers along the cable; crosstalk statistics; and vectoring. A closed-form expression for the maximum sub-carrier frequency that can be loaded with the maximum number of allowed bits is also presented. Formulas are obtained assuming log-normal statistics for the signal-to-interference-plus-noise ratio (SINR) per sub-carrier. The validity of the proposed formulas has been assessed by computer calculations. A very good agreement between the exact and the approximated bit rates has been obtained. The framework can be used for preliminary design of VDSL2 systems in terms of the bit rate coverage, as well as to analyze performance of other access technologies such as ADSL and G.fast.
A Complex Molecular Interplay of Auxin and Ethylene Signaling Pathways Is Involved in Arabidopsis Growth Promotion by Burkholderia phytofirmans PsJN

Modulation of phytohormones homeostasis is one of the proposed mechanisms to explain plant growth promotion induced by beneficial rhizobacteria (PGPR). However, there is still limited knowledge about the molecular signals and pathways underlying these beneficial interactions. Even less is known concerning the interplay between phytohormones in plants inoculated with PGPR. Auxin and ethylene are crucial hormones in the control of plant growth and development, and recent studies report an important and complex crosstalk between them in the regulation of different plant developmental processes. The objective of this work was to study the role of both hormones in the growth promotion of Arabidopsis thaliana plants induced by the well-known PGPR Burkholderia phytofirmans PsJN. For this, the spatiotemporal expression patterns of several genes related to auxin biosynthesis, perception and response and ethylene biosynthesis were studied, finding that most of these genes showed specific transcriptional regulations after inoculation in roots and shoots. PsJN-growth promotion was not observed in Arabidopsis mutants with an impaired ethylene (ein2-1) or auxin (axr1–5) signaling. Even, PsJN did not promote growth in an ethylene overproducer (eto2), indicating that a fine regulation of both hormones signaling and homeostasis is necessary to induce growth of the aerial and root tissues. Auxin polar transport is also involved in growth promotion, since PsJN did not promote primary root growth in the pin2 mutant or under chemical inhibition of transport in wild type plants. Finally, a key role for ethylene biosynthesis was found in the PsJN-mediated increase in root hair number. These results not only give new insights of PGPR regulation of plant growth but also are also useful to understand key aspects of Arabidopsis growth control.
Endovascular repair of abdominal aortic aneurysm : a single-center results analysis *

Objective: To evaluate immediate and mid-term outcomes in a series of patients submitted to endovascular repair of infrarenal abdominal aortic aneurysm in a reference center for cardiovascular medicine. Materials and Methods: The present retrospective study included a series of patients treated in the period from January 2009 to July 2010, and evaluated demographic characteristics, technical success, therapeutic success, morbimortality, immediate complications and perioperative reintervention rate in a one-year follow-up. Results: The authors evaluated 102 consecutive patients with a mean age of 72 ± 9 years (79% were men). Technical success was observed in 97.1% of cases, and therapeutic success, in 81%. Perioperative mortality was 0.9% and one-year mortality rate was 7.8%. Reintervention was necessary in 18.8% of the patients during follow-up. Conclusion: The outcomes observed in the present study justify performing such a procedure in patients with suitable anatomy.
A Neural Mechanism of Strategic Social Choice under Sanction-Induced Norm Compliance1,2,3

Abstract In recent years, much has been learned about the representation of subjective value in simple, nonstrategic choices. However, a large fraction of our daily decisions are embedded in social interactions in which value guided decisions require balancing benefits for self against consequences imposed by others in response to our choices. Yet, despite their ubiquity, much less is known about how value computation takes place in strategic social contexts that include the possibility of retribution for norm violations. Here, we used functional magnetic resonance imaging (fMRI) to show that when human subjects face such a context connectivity increases between the temporoparietal junction (TPJ), implicated in the representation of other peoples’ thoughts and intentions, and regions of ventromedial prefrontal cortex (vmPFC) that are associated with value computation. In contrast, we find no increase in connectivity between these regions in social nonstrategic cases where decision-makers are immune from retributive monetary punishments from a human partner. Moreover, there was also no increase in TPJ-vmPFC connectivity when the potential punishment was performed by a computer programmed to punish fairness norm violations in the same manner as a human would. Thus, TPJ-vmPFC connectivity is not simply a function of the social or norm enforcing nature of the decision, but rather occurs specifically in situations where subjects make decisions in a social context and strategically consider putative consequences imposed by others.