Miracle-dz/UniFAR-FTUs huggingface dataset:
Assembling infrastructures and business models for service design and innovation

Most of the service innovation in e‐government initiatives has been initially focused on making a digital version of an equivalent physical service, followed by creating new services through either adopting new business models or overhauling existing infrastructures. The former approach uses variants of e‐commerce business models to drive service innovation whereas the latter entails changes to the backend for driving system efficiency and integration, which later serve for reorganising and improving service provision. Each approach presents a different way of assembling services, infrastructures, people and business models. The ramifications of each assemblage to service innovation are less understood. This paper seeks to examine the intended and unintended consequences of these two contrasting approaches inductively and deductively. Our findings show that a frontend approach enables quick improvements and enacts a variety of structures, with each structure inscribing a set of new path‐dependent routines in the infrastructures. In the backend approach it took longer to introduce new services. Yet the services were of a higher quality and required less modification in the long run. Quantitative analyses confirmed these findings. We attributed the alignment advantage of backend approach to better interdepartmental collaboration organised around a technology platform for system and service integration, concentrating resources on a coherent rather than a diverse set of business models. This approach realigns practices and routines and technology internally, whereas the explorative, diverse use of business models in the frontend approach for service innovation is less sustainable.
How normal are the hands of normal controls? A study with dedicated magnetic resonance imaging.

OBJECTIVE To investigate bone and soft tissue changes in the hands of normal subjects by MRI. METHODS Twenty-three normal volunteers (16 women) agreed to be examined. MRI of the hand was performed with a dedicated-extremity 0.2 Tesla device using gradient echo, spin echo and STIR sequences. Joint space width was measured in 16 different locations of the hand. Bone lesions, including bone oedema, ankylosis, and erosions, as well as the presence of tenosynovitis were investigated. RESULTS Reproducibility of measures of joint space width was relatively good with an intraclass correlation coefficient of 0.82 and 0.71 in the intra-observer and inter-observer evaluations, respectively. No age- or sex-related differences of joint space were observed. Reproducibility of the readings of bone oedema and tenosynovitis were optimal. Bone oedema and erosions were observed in 2/23 (8.7%) and in 6/23 (26.1%) subjects, respectively. Tenosynovitis of the extensor tendons was present in 1/23 subjects (4.3%), whereas tenosynovitis of the flexor tendons was seen in 4/23 (17.4%). CONCLUSION This study demonstrates that joint changes considered to be peculiar of arthritis can be found by MRI in a relevant percentage of healthy subjects. Our data suggest that a control group of healthy subjects should be included in MRI studies on the appearance of the wrist in disease.
Viability of Legionella pneumophila in Water Samples: A Comparison of Propidium Monoazide (PMA) Treatment on Membrane Filters and in Liquid

Legionella pneumophila is a ubiquitous microorganism widely distributed in aquatic environments and can cause Legionellosis in humans. A promising approach to detect viable cells in water samples involves the use of quantitative polymerase chain reaction (qPCR) in combination with photoactivatable DNA intercalator propidium monoazide (PMA). However, the PMA efficiency could be different depending on the experimental conditions used. The aim of this study was to compare two PMA exposure protocols: (A) directly on the membrane filter or (B) in liquid after filter washing. The overall PMA-induced qPCR means reductions in heat-killed L. pneumophila cells were 2.42 and 1.91 log units for exposure protocols A and B, respectively. A comparison between the results obtained reveals that filter exposure allows a higher PMA-qPCR signal reduction to be reached, mainly at low concentrations (p < 0.05). This confirms the potential use of this method to quantify L. pneumophila in water with low contamination.
Fine-scale thermal adaptation in a green turtle nesting population

The effect of climate warming on the reproductive success of ectothermic animals is currently a subject of major conservation concern. However, for many threatened species, we still know surprisingly little about the extent of naturally occurring adaptive variation in heat-tolerance. Here, we show that the thermal tolerances of green turtle (Chelonia mydas) embryos in a single, island-breeding population have diverged in response to the contrasting incubation temperatures of nesting beaches just a few kilometres apart. In natural nests and in a common-garden rearing experiment, the offspring of females nesting on a naturally hot (black sand) beach survived better and grew larger at hot incubation temperatures compared with the offspring of females nesting on a cooler (pale sand) beach nearby. These differences were owing to shallower thermal reaction norms in the hot beach population, rather than shifts in thermal optima, and could not be explained by egg-mediated maternal effects. Our results suggest that marine turtle nesting behaviour can drive adaptive differentiation at remarkably fine spatial scales, and have important implications for how we define conservation units for protection. In particular, previous studies may have underestimated the extent of adaptive structuring in marine turtle populations that may significantly affect their capacity to respond to environmental change.
The Influence of the Number of Cortices of Screw Purchase and Ankle Position in Weber C Ankle Fracture Fixation

Objectives: Biomechanical and clinical studies have shown that syndesmosis screws may be indicated in repairing Weber C ankle fractures. This study sought to determine the effect of the number of cortices of screw purchase and ankle position on syndesmosis width and tibiotalar rotation in Weber C ankle fracture fixation. Methods: Nine pairs of human cadaver legs were mechanically tested to determine syndesmosis width and tibiotalar rotation. This was done for intact specimens and after a Weber C injury was created and repaired with 3 and 4 cortices of purchase. Tests were performed for no axial load and for axial loads of 700 N with and without external torques of 1 and 5 Nm on the ankle. Torque-to-failure tests were also done for 4 cortices of fixation. Results: In comparison to baseline, the syndesmosis width was significantly decreased when the syndesmosis screw was inserted in plantarflexion with either 0 or 1 Nm of torque. Syndesmosis width significantly increased when the screw was inserted in dorsiflexion for 5 Nm of torque. For tibiotalar rotation, no statistical differences were detected for either plantarflexion or dorsiflexion when compared to baseline, except with axial load. Syndesmosis width was not affected by the number of cortices purchased by the syndesmosis screw. Failure torque and failure angle were also measured. Conclusions: Because no difference was seen between 3 or 4 cortices, it is the surgeon's choice in determining how many cortices of fixation are achieved.
Glucose Variability and Mortality in Patients Hospitalized With Acute Myocardial Infarction

Background— Mean blood glucose (BG) during acute myocardial infarction (AMI) is an important predictor of inpatient mortality but does not capture glucose variability (GV), which has been shown to be independently associated with mortality in critically ill patients. Whether GV is associated with in-hospital mortality during AMI, after accounting for mean BG, is unknown. Methods and Results— We analyzed 18 563 consecutive patients with AMI with ≥3 BGs in the first 48 hours admitted to 61 US hospitals from 2000 to 2008. Five different GV metrics were compared for their ability to predict in-hospital mortality (range, standard deviation, mean amplitude of glycemic excursions, mean absolute glucose change, and average daily risk range) using hierarchical logistic regression models that sequentially adjusted for mean BG, hypoglycemia (<70 mg/dL), and multiple patient characteristics. In unadjusted analyses, range and average daily risk range had the highest C-indices (0.620 for range, 0.635 for average daily risk range; both P<0.0001). Greater GV was associated with higher mortality for all metrics (eg, mortality was 3.8%, 5.5%, 7.1%, and 11.3% for increasing quartiles of range, P<0.0001); however, the association between GV and mortality for each metric was no longer significant after multivariable adjustment. In contrast, mean BG remained an important predictor of survival (P<0.001, all models). Conclusions— Although greater GV is associated with increased risk of in-hospital mortality in patients with AMI in unadjusted analyses, GV is no longer independently predictive after controlling for multiple patient factors, including mean BG. These findings suggest that GV does not provide additional prognostic value above and beyond already recognized risk factors for mortality during AMI.
Predicting the requirement for N-acetylcysteine in paracetamol poisoning from reported dose

Abstract Context. There is contention over whether reported dose correlates with toxicity in paracetamol poisoning and risk assessment is currently based on serum paracetamol concentration compared to a nomogram, irrespective of reported dose. Objective. To determine if reported dose predicts the need for N-acetylcysteine (NAC). Methods. Data were taken from paracetamol overdoses presenting to a tertiary toxicology service. Age, sex, reported dose, ingestion time, timed paracetamol concentrations between 4 and 16 h, hepatotoxicity (peak alanine transaminase > 1000 U/L) and treatment (single dose-activated charcoal [SDAC] and NAC) were analysed. Data were analysed within a repeated measures logistic regression framework using NONMEM (ver 7.2). The primary outcome was administration of NAC, which was determined based on a serum paracetamol concentration greater than the nomogram line. Result. : There were 1571 admissions in 1303 patients, with a median age of 27 years (12–96 years) and 1140 (73%) were females. The median dose was 10 g (1–100 g). The paracetamol concentration was above the nomogram line in 337 of 1571 (22%) patients. Patients presenting later (first paracetamol concentration between 7 and 16 h post-overdose) compared to those presenting earlier (4–7 h post-overdose) were more likely to have hepatotoxicity (5.5% vs. 0.4%; p < 0.0001), have a toxic paracetamol concentration (34% vs. 18%; p < 0.0001) and receive NAC (48% vs. 23%; p < 0.0001). SDAC reduced the probability of the paracetamol concentration being above the nomogram. Based on SDAC not being administered there was a 5% probability of requiring NAC at a dose of 6–9 g, a 10% chance of requiring NAC at a dose of 13–16 g, a 50% chance of requiring NAC at a dose of 30–34 g and a 90% chance for needing NAC at 48–50 g. Conclusion. Reported dose was a good predictor of a toxic paracetamol concentration and SDAC reduced the probability of the concentration being above the nomogram. These predictions may assist in determining which patients could be started on NAC immediately.
Ventricular anti-arrhythmic effects of heptanol in hypokalaemic, Langendorff-perfused mouse hearts

Ventricular arrhythmic and electrophysiological properties were examined during normokalaemia (5.2 mM [K+]), hypokalaemia (3 mM [K+]) or hypokalaemia in the presence of 0.1 or 2 mM heptanol in Langendorff-perfused mouse hearts. Left ventricular epicardial or endocardial monophasic action potential recordings were obtained during right ventricular pacing. Hypokalaemia induced ventricular premature beats (VPBs) in 5 of 7 and ventricular tachycardia (VT) in 6 of 7 hearts (P<0.01), prolonged action potential durations (APD90) from 36.2±1.7 to 55.7±2.0 msec (P<0.01) and shortened ventricular effective refractory periods (VERPs) from 44.5±4.0 to 28.9±3.8 msec (P<0.01) without altering conduction velocities (CVs) (0.17±0.01 m/sec, P>0.05), reducing excitation wavelengths (λ, CV × VERP) from 7.9±1.1 to 5.1±0.3 mm (P<0.05) while increasing critical intervals (CI, APD90-VERP) from −8.3±4.3 to 26.9±2.0 msec (P>0.001). Heptanol (0.1 mM) prevented VT, restored effective refractory period (ERP) to 45.2±2.9 msec without altering CV or APD, returning λ to control values (P>0.05) and CI to 8.4±3.8 msec (P<0.05). Heptanol (2 mM) prevented VPBs and VT, increased ERP to 67.7±7.6 msec (P<0.05), and reduced CV to 0.11±0.1 m/sec (P<0.001) without altering APD (P>0.05), returning λ and CI to control values (P>0.05). Anti-arrhythmic effects of heptanol during hypokalaemia were explicable by ERP changes, scaling λ and CI.
Myopathy in scleroderma and in other connective tissue diseases

Purpose of reviewThis review discusses the most updated literature of myopathy in scleroderma and other connective tissue diseases. Recent findingsIn the past year, studies have demonstrated that myopathy in scleroderma is associated with poor outcomes such as disability and mortality. In addition, muscle histopathology in scleroderma continues to reveal that it is a heterogeneous entity, and that necrosis and acute neurogenic atrophy may be a more prevalent histopathologic feature in muscle biopsies than previously reported. In other connective tissue diseases such as SLE, the onset of overlap myositis typically does not occur simultaneously as it does in scleroderma or rheumatoid arthritis. SummaryMyopathy in scleroderma is heterogeneous and given that it is associated with poor outcomes, it is imperative that optimal diagnostic strategies and therapies including a classification criterion be developed. In other connective tissue diseases, such as rheumatoid arthritis and systemic lupus erythematosus, myopathy is even more poorly defined and requires more robust studies to clarify both the clinical features and muscle histopathology in this group.
Pre-heated isentropic gas in groups of galaxies

We confirm that the standard assumption of isothermal, shock-heated gas in cluster potentials is unable to reproduce the observed X-ray luminosity- temperature relation of groups of galaxies. As an alternative, we construct a physically motivated model for the adiabatic collapse of pre-heated gas into an isothermal potential that improves upon the original work of Kaiser (1991). The luminosity and temperature of the gas is calculated, assuming an appropriate distribution of halo formation times and radiation due to both bremsstrahlung and recombination processes. This model successfully reproduces the slope and dispersion of the luminosity-temperature relation of galaxy groups. We also present calculations of the temperature and luminosity functions for galaxy groups under the prescription of this model. This model makes two strong predictions for haloes with total masses M<10^13 M_sun, which are not yet testable with current data: (1) the gas mass fraction will increase in direct proportion to the halo mass; (2) the gas temperature will be larger than the virial temperature of the mass. The second effect is strong enough that group masses determined from gas temperatures will be overestimated by about an order of magnitude if it is assumed that the gas temperature is the virial temperature. The entropy required to match observations can be obtained by heating the gas at the turnaround time, for example, to about 3 X 10^6 K at z=1, which is too high to be generated by a normal rate of supernova explosions. This model breaks down on the scale of low mass clusters, but this is an acceptable limitation, as we expect accretion shocks to contribute significantly to the entropy of the gas in such objects.
Variation of fish assemblages and species abundances in the upper Flint River shoals, Georgia

The Flint River, a major tributary of the Apalachicola drainage, is one of four rivers originating in the Piedmont of central Georgia. This study investigated relations between fish assemblages and habitat characteristics in shoals, one of the primary features of the upper mainstem. The study compared variation in fish assemblages and species abundances among shoals at two scales, the microhabitat and the reach. Shoals differed in terms of species assemblages, habitat composition, and species abundances. Habitat use by fishes was predicted by different variables at the microhabitat and reach scales. The predictive variables were depth, velocity, Podostemum coverage, bed sediment variables, and gradient. These findings should be useful for management decisions and in evaluating consequences of municipal water policy in the Flint headwaters. INDEX WORDS: fish assemblages, Flint River, shoals, Cyprinella callitaenia, Micropterus cataractae, Percina sp. VARIATION OF FISH ASSEMBLAGES AND SPECIES ABUNDANCES IN THE UPPER FLINT RIVER SHOALS, GEORGIA
A Primer on Strategic Games

This is a short introduction to the subject of strategic games. We focus on the concepts of best response, Nash equilibrium, strict and weak dominance, and mixed strategies, and study the relation between these concepts in the context of the iterated elimination of strategies. Also, we discuss some variants of the original definition of a strategic game. Finally, we introduce the basics of mechanism design and use pre-Bayesian games to explain it.
Methamphetamine-induced hyperthermia and dopaminergic neurotoxicity in mice: pharmacological profile of protective and nonprotective agents.

Neurotoxic doses of methamphetamine (METH) can cause hyperthermia in experimental animals. Damage sustained to dopaminergic nerve terminals by this stimulant can be reduced by environmental cooling or by pharmacological manipulation which attenuates the hyperthermia. Many pharmacological agents with very diverse actions protect against METH-induced neuropathology. Several of these compounds, as well as drugs which do not protect, were investigated to determine if there was a relationship between protection and METH-induced hyperthermia. Mice received METH with or without concurrent administration of other drugs and core (i.e., colonic) temperature was monitored during treatment. The animals were sacrificed > or = 5 days later and neostriatal tyrosine hydroxylase activity and dopamine were measured. Core temperature was significantly elevated (> or = 2 degrees C) in mice treated with doses of METH which produced > or = 90% losses in striatal dopamine but not in mice less severally affected (only 50% loss of dopamine). Concurrent treatment of mice with METH and pharmacological agents which protected partially or completely from METH-induced toxicity also prevented the hyperthermic response (i.e., dopamine receptor antagonists, fenfluramine, dizocilpine, alpha-methyl-p-tyrosine, phenytoin, aminooxyacetic acid and propranol). These findings are consistent with the hypothesis that the hyperthermia produced by METH contributes to its neuropathology. However, studies with reserpine, a compound which dramatically lowers core temperature, demonstrated that hyperthermia per se is not a requirement for METH-induced neurotoxicity. Although core temperature was elevated in reserpinized mice treated with METH as compared with reserpinized control mice, their temperatures remained significantly lower than in nonreserpinized control mice. However, the hypothermic state produced in the reserpinized mice did not provide protection from METH-induced toxicity. These data demonstrate that hyperthermia per se contributes to but is not solely responsible for the METH-induced neuropathology.
A Rapid and Sensitive Method to Measure the Functional Activity of Shiga Toxins in Human Serum

Shiga toxins (Stx) have a definite role in the development of hemolytic uremic syndrome in children with hemorrhagic colitis caused by pathogenic Stx-producing Escherichia coli (STEC) strains. The dramatic effects of these toxins on the microvasculature of different organs, particularly of the kidney, are well known, whereas there is no consensus on the mechanism by which Stx reach the endothelia of target organs and/or indirectly injure these body sites. We hereby describe a quick (4 h), radioactive, Raji cell-based method designed for the detection of Stx in human sera. The assay monitors the translation impairment induced by these powerful inhibitors of protein synthesis, which are identified properly by neutralizing their activity with specific monoclonal antibodies. By this method, we detected for the first time the functional activity of Stx in sera of STEC-infected patients during hemorrhagic colitis. Recent research has pointed to a dynamic process of Stx-induced renal intoxication in which concurrent and interactive steps are involved. Our rapid and specific method could be useful for studying the kinetics of Stx during the natural course of STEC infection and the interplay between Stx activity in serum and Stx presence in different blood fractions (neutrophils, monocytes, platelets, leukocyte-platelet aggregates, microvesicles, lipoproteins).
Infection control knowledge, attitudes, and practices among cystic fibrosis patients and their families

In 2003, the Cystic Fibrosis (CF) Foundation in the United States published evidence‐based infection control guidelines and distributed these to CF care centers. However, it is unclear how well the guidelines have been disseminated to patients and families, how well patients and families understand the principles of infection control, and what barriers they experience implementing the guidelines.
Voice and Touch Screen Based Direction and Speed Control of Wheel Chair for Physically Challenged Using Arduino

This paper is to describe an intelligent motorized wheel chair for handicapped person using voice and touch screen technology. It enables a disabled person to move around independently using a touch screen and a voice recognition application which is interfaced with motors through microcontroller. When we want to change the direction, the touch screen sensor is modeled to direct the user to required destination using direction keys on the screen and that values are given to microcontroller. Depending on the direction selected on the touch screen, microcontroller controls the wheel chair directions. This can also be controlled through simple voice commands using voice controller. The speech recognition system is easy to use programmable speech recognition circuit that is the system to be trained the words (or vocal utterances) the user wants the circuit to recognize. The speed controller works by varying the average voltage sent to the motor. This is done by switching the motors supply on and off very quickly using PWM technique. The methodology adopted is based on grouping a microcontroller with a speech recognition system and touch screen.
Optimal Meropenem Concentrations To Treat Multidrug-Resistant Pseudomonas aeruginosa Septic Shock

ABSTRACT A patient with septic shock due to extensively drug resistant (XDR) Pseudomonas aeruginosa was cured by optimizing the meropenem (MEM) regimen to obtain at least 40% of the time between two administrations in which drug levels were four times higher than the MIC of the pathogen. As the standard drug dose did not achieve these optimal concentrations, the MEM regimen was progressively increased up to 12 g/day (3 g every 6 h in a 3-h extended infusion), which eventually resulted in sepsis resolution. High MEM dosage may represent a valuable therapeutic option for infection due to multidrug-resistant (MDR) strains, and drug monitoring would allow rapid regimen adjustment in clinical practice.