Miracle-dz/UniFAR-FTUs huggingface dataset:
Totally laparoscopic feeding jejunostomy – a technique modification

In oncological patients with upper gastrointestinal tract tumours, dysphagia and cachexy necessitate gastrostomy or jejunostomy as the only options of enteral access for long-term feeding. In this article the authors describe a modified technique of laparoscopic feeding jejunostomy applied during the staging laparoscopy. A 48-year-old male patient with gastroesophageal junction tumour and a 68-year-old male patient with oesophageal tumour were operated on using the described technique. Exploratory laparoscopy was performed. Then the feeding jejunostomy was made using a Cystofix® TUR catheter. The jejunum was fixed to the abdominal wall with four 2.0 Novafil™ transabdominal stitches. Two additional sutures were placed caudally about 4 cm and 8 cm from the jejunostomy, aiming at prevention of jejunal torsion. Total operating time was 45 min. There was no blood loss. There were no intraoperative complications. The only adverse event was one jejunostomy wound infection that responded well to oral antibiotics. There were no mortalities. The described technique has most of the benefits of laparoscopic feeding jejunostomy with some steps added from the open operation making the procedure easier to perform as part of a staging operation with a relatively short additional operating time. The proposed transabdominal stitches make the technique easier to apply. Two additional ‘anti-torsion sutures’ prevent postoperative volvulus. Use of the Cystofix catheter allows easy introduction of the catheter into the peritoneal cavity and the jejunal lumen, providing a good seal at the same time. Further studies on larger groups of patients are required to assess long-term outcomes of the proposed modified technique.
The carbon and nitrogen ecophysiologies of two endemic tropical orchids mirrors those of their temperate relatives and the local environment

Orchids are one of the most widely distributed plant families. However, current research on the ecophysiology of terrestrial orchids is biased towards temperate species. Thus, it is currently unknown whether tropical terrestrial orchids belong to similar trophic guilds as their temperate relatives. To examine the ecophysiologies of two tropical terrestrial orchids, I analysed the carbon and nitrogen stable isotope compositions and nitrogen concentrations of the Hawaiian endemics Anoectochilus sandvicensis and Liparis hawaiensis. I compared these values with those of surrounding vegetation and their temperate relatives. I found that A. sandvicensis was consistently enriched in the heavy isotope of nitrogen (15N) and had higher nitrogen (N) concentrations than surrounding vegetation, and these values were even higher than those of its temperate relatives. Carbon stable isotope composition among populations of A. sandvicensis varied by island. These results point to local environment and evolutionary history determining the ecophysiology of this species. Whereas L.hawaiensis was also enriched in 15N and had on average higher N concentrations than surrounding vegetation, these values were not significantly different from temperate relatives, indicating that evolutionary history may be a stronger predictor of this orchid species' ecophysiology than environment. I suggest that both Hawaiian species are potentially partially mycoheterotrophic.
Self-Management of Type 2 Diabetes among African Americans in the Arkansas Delta: A Strengths Perspective in Social-cultural Context

This qualitative study explored underlying factors influencing the promotion of type 2 diabetes (T2D) self-management among adult African Americans diagnosed with T2D in the Arkansas Delta. Our narrative approach gathered insights in the participants’ own voices and placed their T2D self-management experiences in social-cultural-historical contexts. Using purposive sampling, 31 participants (16 women and 15 men) were selected and interviewed. The participants showed low awareness of T2D’s chronic nature because of its asymptomatic or nonspecific symptoms. They interpreted medically prescribed dietary and physical exercise guidelines as impractical and culturally irrelevant for them. Medication non-adherence was due to inadequate knowledge and awareness of T2D as a chronic disease, and suspicion and mistrust of the formal medical system. To develop culturally-targeted interventions to advance self-management outcomes, we must understand from and with African Americans the strengths of social-cultural contexts in which they live and make their health behavior choices. Engaging African Americans diagnosed with T2D in community-based programs may be a promising approach.
Localized Retroprocessing as a Model of Intron Loss in the Plant Mitochondrial Genome

Loss of introns in plant mitochondrial genes is commonly explained by retroprocessing. Under this model, an mRNA is reverse transcribed and integrated back into the genome, simultaneously affecting the contents of introns and edited sites. To evaluate the extent to which retroprocessing explains intron loss, we analyzed patterns of intron content and predicted RNA editing for whole mitochondrial genomes of 30 species in the monocot order Alismatales. In this group, we found an unusually high degree of variation in the intron content, even expanding the hitherto known variation among angiosperms. Some species have lost some two-third of the cis-spliced introns. We found a strong correlation between intron content and editing frequency, and detected 27 events in which intron loss is consistent with the presence of nucleotides in an edited state, supporting retroprocessing. However, we also detected seven cases of intron loss not readily being explained by retroprocession. Our analyses are also not consistent with the entire length of a fully processed cDNA copy being integrated into the genome, but instead indicate that retroprocessing usually occurs for only part of the gene. In some cases, several rounds of retroprocessing may explain intron loss in genes completely devoid of introns. A number of taxa retroprocessing seem to be very common and a possibly ongoing process. It affects the entire mitochondrial genome.
Assembly of body wall muscle and muscle cell attachment structures in Caenorhabditis elegans

C. Elegans has four muscle quadrants that are used for locomotion. Contraction is converted to locomotion because muscle cells are anchored to the cuticle (the outer covering of the worm) by a specialized basement membrane and hemidesmosome structures in the hypodermis (a cellular syncytium that covers the worm and secretes the cuticle). To study muscle assembly, we have used antibodies to determine the spatial and temporal distribution of muscle and attachment structure components in wild-type and mutant C. elegans embryos. Myofibrillar components are first observed diffusely distributed in the muscle cells, and are expressed in some dividing cells. Later, the components accumulate at the membrane adjacent to the hypodermis where the sarcomeres will form, showing that the cells have become polarized. Assembly of muscle attachment structures is spatially and temporally coordinated with muscle assembly suggesting that important developmental signals may be passed between muscle and hypodermal cells. Analysis of embryos homozygous for mutations that affect muscle assembly show that muscle components closer to the membrane than the affected protein assemble quite well, while those further from the membrane do not. Our results suggest a model where lattice assembly is initiated at the membrane and the spatial organization of the structural elements of the muscle is dictated by membrane proximal events, not by the filament components themselves.
Harvesting organizational knowledge and innovation practices: An empirical examination of their effects on operations strategy

Purpose – The purpose of this paper is to examine the impact of organizational knowledge and innovation practices on the outcomes of operations strategy.Design/methodology/approach – The study employs a survey‐based method to test a theoretically grounded set of hypotheses using regression techniques.Findings – The results indicate that cost, quality, delivery and flexibility outcomes are influenced by specific organizational knowledge and innovation practices. Also, the findings show that innovation performance mediate the relationship between knowledge practices and operations strategy.Practical implications – Acquiring knowledge is not enough. Managers need to facilitate dynamics of knowledge sharing and utilization to cultivate a better level of technical and administrative innovation performance, which in turn will result in favourable operations strategy outcomes.Originality/value – The paper is one of the first studies that highlight knowledge and innovation practices in relation to operations stra.
Identifying High-alert Medications in a University Hospital by Applying Data From the Medication Error Reporting System

Objectives To facilitate safe use of high-alert medications, lists of medications posing higher risks for medication errors (MEs) and harmful effects have been compiled. These lists can be general or reflect clinical practices in specific settings. Less common has been to compile a hospital-specific list applying data from the organization’s ME reporting system. Our objective was to demonstrate a method for compiling such a high-alert medication list in a university hospital. Methods Of the eighteen 136 MEs reported during 2007 to 2013, ME reports with medications coded as a contributing factor to the incident were included (n = 249). The involved medications were identified and compared with the hospital’s drug consumption and Institute for Safe Medication Practice’s List of High-Alert Medications. The report narratives of MEs with most reported and high-alert medications (120 reports) were qualitatively content analyzed. Results The included 249 reports concerned 280 medications, of which 33% were classified as high-alert medications by the Institute for Safe Medication Practice. The most common therapeutic groups were antibacterials for systemic use (13%), psycholeptics (10%), analgesics (9%), and antithrombotic agents (9%). The most common high-alert medications were oxycodone (5%), enoxaparin (3%), and noradrenaline (3%). Serious patient harm (3%) was related to cefuroxime, enoxaparin, ibuprofen, midazolam, propofol, and warfarin. A half of the MEs were related to parenteral preparations. The qualitative content analysis revealed the key process safety risks of the most reported and high-alert medications. Conclusions The method is applicable for compiling a hospital-specific high-alert medication list and related analysis of key process safety risks contributing to MEs.
Translocation portals for the substrates and products of a viral transcription complex: the bluetongue virus core

The bluetongue virus core is a molecular machine that simultaneously and repeatedly transcribes mRNA from 10 segments of viral double‐stranded RNA, packaged in a liquid crystalline array. To determine how the logistical problems of transcription within a sealed shell are solved, core crystals were soaked with various ligands and analysed by X‐ray crystallography. Mg2+ ions produce a slight expansion of the capsid around the 5‐fold axes. Oligonucleotide soaks demonstrate that the 5‐fold pore, opened up by this expansion, is the exit site for mRNA, whilst nucleotide soaks pinpoint a separate binding site that appears to be a selective channel for the entry and exit of substrates and by‐products. Finally, nucleotides also bind to the outer core layer, providing a substrate sink.
High precision frequency calibration of N I lines in the XUV domain

With the use of a narrowband and tunable extreme ultraviolet laser source transition frequencies in the spectrum of neutral atomic nitrogen were measured for transitions originating from the (2p3)4S3/2 ground state to 12 levels in the 2p23d and 2p24s configurations in the wavelength range 95.1–96.5 nm. The present laboratory calibrations, performed at an absolute accuracy of 0.005 cm−1 or 5 × 10−8, should be useful for comparison with nitrogen absorption features observed in quasars for assessment of possible temporal variation of the fine structure constant. Simultaneous recordings of spectra for both 14N and 15N yield accurate values for transition isotope shifts, which reveal large specific-mass shifts almost to the extent of cancelling the isotope shifts.
Groundwater quality and human health risk assessment related to groundwater consumption in An Giang province, Viet Nam

Groundwater is one of the main sources for water supply for domestic use, irrigation, aquaculture and industry in Mekong Delta. With rapidly increasing in human population, groundwater becomes more important for social and economic activities. This study evaluated the quality of groundwater using data from the eight monitoring wells over the period of 2009 - 2016. Human health risk was assessed for the population consuming groundwater contaminated with arsenic. The findings indicated that groundwater wells in An Giang province were contaminated with microorganisms. The total dissolved solids (TDS) and hardness in Phu Tan (PT) and Cho Moi (CM) wells were significant higher than the national technical regulations on groundwater quality (QCVN 09-MT:2015/BTNMT). In addition, groundwater wells in some small islands of An Giang were seriously contaminated with organic matters and arsenic. The mean arsenic concentration was up to 0.55 ± 1.21 mg/L. Estimation of carcinogenic risk for human population showed that the cancer risks ranged from medium (8.66 x 10-4) to high (8.26 x 10-2) for both children and adults. Alternative water supply sources should be offered for the population at risk. Besides, regular health check is essential for local people in the arsenic contaminated groundwater. Nước ngầm là một trong những nguồn cung cấp nước chính cho sinh hoạt, tưới tiêu, nuôi trồng thủy sản và công nghiệp ở Đồng bằng sông Cửu Long. Cùng với sự gia tăng dân số, nước ngầm ngày càng đóng vai trò quan trọng hơn trong các hoạt động phát triển kinh tế - xã hội. Nghiên cứu đã tiến hành đánh giá diễn biến chất lượng nước ngầm thông qua số liệu của tám giếng quan trắc trong giai đoạn từ năm 2009 – 2016. Kết hợp với đánh giá rủi ro sức khỏe của người dân khi sử dụng nước ngầm chứa arsenic. Kết quả nghiên cứu cho thấy các giếng nước ngầm ở tỉnh An Giang đã bị nhiễm vi sinh. Tổng chất rắn hòa tan (TDS) và độ cứng ở trạm Phú Tân và Chợ Mới phân tích được cao hơn quy chuẩn cho phép (QCVN 09-MT:2015/BTNMT). Các giếng nước ngầm ở một số khu vực cù lao của tỉnh An Giang đã bị ô nhiễm hữu cơ và arsenic nghiêm trọng. Nồng độ arsenic trong nước ngầm có thể dao động lên đến 0.55 ± 1.21 mg/L. Rủi ro ung thư ở hai đối tượng người lớn và trẻ em khi sử dụng nước ngầm nhiễm arsenic dao động từ trung bình (8 người trong 1.000 người) tới cao (8 người trong 100 người). Cung cấp nguồn nước thay thế là giải pháp khả thi để giảm rủi ro sức khỏe cho con người trong trường hợp này. Ngoài ra, người dân địa phương cần được khám sức khỏe thường xuyên để kịp thời phát hiện và sớm điều trị bệnh.
Erdös distance problem in vector spaces over finite fields

We study the Erdos/Falconer distance problem in vector spaces over finite fields. Let be a finite field with elements and take , . We develop a Fourier analytic machinery, analogous to that developed by Mattila in the continuous case, for the study of distance sets in to provide estimates for minimum cardinality of the distance set in terms of the cardinality of . Bounds for Gauss and Kloosterman sums play an important role in the proof.
Allelic variant in CTLA4 alters T cell phosphorylation patterns

Little is known regarding the functional effects of common autoimmune susceptibility variants on human immune cells. The SNP CT60 (rs3087243; A/G) located in the 3′ UTR of the CTLA4 gene has been associated with autoimmune diseases. We examined a cohort of healthy individuals stratified by genotypes at CTLA4 to gain insight into the functional effects of allelic variation on T cell signaling. Using phospho-site-specific mAbs, we tested the hypothesis that the CT60 genotype at CTLA4 is associated with altered T cell antigen receptor (TCR) signaling in naive and/or memory T cells. By normalizing for the extent of the initial TCR signaling event at CD3ζ, we observed that the relative responsiveness to TCR stimulation as assessed by phosphorylation levels of downstream signaling molecules was altered in naive (CD4+CD45RAhigh) and memory (CD4+CD45RAlow) T cells obtained from individuals with the disease-susceptibility allele at CTLA4. Thus, allelic variation associated with autoimmune disease can alter the signaling threshold of CD4+ T cells. These experiments provide a rational approach for the dissection of T cell-susceptibility genes in autoimmune diseases.
Changes in Muscle Activity and Kinematics of Highly Trained Cyclists During Fatigue

Muscle fatigue may alter kinematics and contribute to repetitive strain injuries. This study quantified how both localized muscle fatigue and movement kinematics change over time during exhaustive cycling. Seven highly trained cyclists rode a stationary bicycle ergometer at 100% of their maximum oxygen consumption ( VO2 max) until voluntary exhaustion. Cycling kinematics and electromyography (EMG) activity from select lower extremity muscles were recorded. Cross-correlations were computed to quantify how EMG median frequencies (MDFs) changed with changes in movement kinematics. All athletes maintained both cadence and power output for ~ 90% of the trial duration. Significant sustained muscle fatigue occurred in 18 of 28 muscles tested, most prominently in the biceps femoris (p = 0.020) and gastrocnemius ( p = 0.018). Kinematics and MDF both fluctuated nonmonotonically as subjects fatigued. Changes in MDF significantly preceded changes in mean trunk lean ( p = 0.009) and hip angles (p = 0.025), and trunk lean range of motion (p = 0.029). Fluctuations in MDF were positively correlated with fluctuations in mean trunk lean (p = 0.009 ) and knee splay angles (p = 0.011), and with trunk lean (p = 0.002) and ankle (p = 0.001) range of motion. These results therefore establish a direct link between changes in muscle fatigue state and subsequent changes in movement kinematics during cycling.
Downlink and Uplink Decoupling: A disruptive architectural design for 5G networks

Cell association in cellular networks has traditionally been based on the downlink received signal power only, despite the fact that uplink and downlink transmission powers and interference levels differed significantly. This approach was adequate in homogeneous networks with macro base stations all having similar transmission power levels. However, with the growth of heterogeneous networks where there is a big disparity in the transmit power of the different base station types, this approach is highly inefficient. In this paper, we study the notion of Downlink and Uplink Decoupling (DUDe) where the downlink cell association is based on the downlink received power while the uplink is based on the pathloss. We present the motivation and assess the gains of this 5G design approach with simulations that are based on Vodafone's LTE field trial network in a dense urban area, employing a high resolution ray-tracing pathloss prediction and realistic traffic maps based on live network measurements.
Genome-Wide Copy Number Analysis Uncovers a New HSCR Gene: NRG3

Hirschsprung disease (HSCR) is a congenital disorder characterized by aganglionosis of the distal intestine. To assess the contribution of copy number variants (CNVs) to HSCR, we analysed the data generated from our previous genome-wide association study on HSCR patients, whereby we identified NRG1 as a new HSCR susceptibility locus. Analysis of 129 Chinese patients and 331 ethnically matched controls showed that HSCR patients have a greater burden of rare CNVs (p = 1.50×10−5), particularly for those encompassing genes (p = 5.00×10−6). Our study identified 246 rare-genic CNVs exclusive to patients. Among those, we detected a NRG3 deletion (p = 1.64×10−3). Subsequent follow-up (96 additional patients and 220 controls) on NRG3 revealed 9 deletions (combined p = 3.36×10−5) and 2 de novo duplications among patients and two deletions among controls. Importantly, NRG3 is a paralog of NRG1. Stratification of patients by presence/absence of HSCR–associated syndromes showed that while syndromic–HSCR patients carried significantly longer CNVs than the non-syndromic or controls (p = 1.50×10−5), non-syndromic patients were enriched in CNV number when compared to controls (p = 4.00×10−6) or the syndromic counterpart. Our results suggest a role for NRG3 in HSCR etiology and provide insights into the relative contribution of structural variants in both syndromic and non-syndromic HSCR. This would be the first genome-wide catalog of copy number variants identified in HSCR.
MyD88-Deficient Mice Display a Profound Loss in Resistance to Mycobacterium tuberculosis Associated with Partially Impaired Th1 Cytokine and Nitric Oxide Synthase 2 Expression

ABSTRACT Mycobacterium tuberculosis possesses agonists for several Toll-like receptors (TLRs), yet mice with single TLR deletions are resistant to acute tuberculosis. MyD88−/− mice were used to examine whether TLRs play any role in protection against aerogenic M. tuberculosis H37Rv infection. MyD88−/− mice failed to control mycobacterial replication and rapidly succumbed. Moreover, expressions of interleukin 12, tumor necrosis factor alpha, gamma interferon, and nitric oxide synthase 2 were markedly decreased in the knockout animals. These results argue that resistance to M. tuberculosis must depend on MyD88-dependent signals mediated by an as-yet-undetermined TLR or a combination of TLRs.
Intercultural communication through the eyes of patients: experiences and preferences

Objectives To explore patients’ preferences and experiences regarding intercultural communication which could influence the development of intercultural patient-centred communication training. Methods This qualitative study is based on interviews with non-native patients. Thirty non-native patients were interviewed between September and December 2015 about their preferences and experiences regarding communication with a native Dutch doctor. Fourteen interviews were established with an interpreter. The semi-structured interviews took place in Amsterdam. They were focused on generic and intercultural communication skills of doctors. Relevant fragments were coded by two researchers and analysed by the research team by means of thematic network analysis. Informed consent and ethical approval was obtained beforehand. Results All patients preferred a doctor with a professional patient-centred attitude regardless of the doctor’s background. Patients mentioned mainly generic communication aspects, such as listening, as important skills and seemed to be aware of their own responsibility in participating in a consultation. Being treated as a unique person and not as a disease was also frequently mentioned. Unfamiliarity with the Dutch healthcare system influenced the experienced communication negatively. However, a language barrier was considered the most important problem, which would become less pressing once a doctor-patient relation was established. Conclusions Remarkably, patients in this study had no preference regarding the ethnic background of the doctor. Generic communication was experienced as important as specific intercultural communication, which underlines the marginal distinction between these two. A close link between intercultural communication and patient-centred communication was reflected in the expressed preference ‘to be treated as a person’.