Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of Preoperatively Continued Aspirin Use on Early and Mid-Term Outcomes in Off-Pump Coronary Bypass Surgery: A Propensity Score-Matched Study of 1418 Patients

Background To date, effect of preoperatively continued aspirin administration in off-pump coronary artery bypass grafting (CABG) is less known. We aimed to assess the effect of preoperatively continued aspirin use on early and mid-term outcomes in patients receiving off-pump CABG. Methods From October 2009 to September 2013 at the Fuwai Hospital, 709 preoperative aspirin users were matched with unique 709 nonaspirin users using propensity score matching to obtain risk-adjusted outcome comparisons between the two groups. Early outcomes were in-hospital death, stroke, intra- and post-operative blood loss, reoperation for bleeding and blood product transfusion. Major adverse cardiac events (death, myocardial infarction or repeat revascularization), angina recurrence and cardiogenic readmission were considered as mid-term endpoints. Results There were no significant differences among the groups in baseline characteristics after propensity score matching. The median intraoperative blood loss (600 ml versus 450 ml, P = 0.56), median postoperative blood loss (800 ml versus 790 ml, P = 0.60), blood transfusion requirements (25.1% versus 24.4%, P = 0.76) and composite outcome of in-hospital death, stroke and reoperation for bleeding (2.8% versus 1.6%, P = 0.10) were similar in aspirin and nonaspirin use group. At about 4 years follow-up, no significant difference was observed among the aspirin and nonaspirin use group in major adverse cardiac events free survival estimates (95.7% versus 91.5%, P = 0.23) and freedom from cardiogenic readmission (88.5% versus 85.3%, P = 0.77) whereas the angina recurrence free survival rates was 83.7% and 73.9% in the aspirin and nonaspirin use group respectively (P = 0.02), with odd ratio for preoperative aspirin estimated at 0.71 (95% confidence interval, 0.49-1.04, P = 0.08). Conclusions Preoperatively continued aspirin use was not associated with increased risk of intra- and post-operative blood loss, blood transfusion requirements and composite outcome of in-hospital death, stroke and reoperation for bleeding in off-pump CABG. Preoperative aspirin use tended to decrease the hazard of mid-term angina recurrence.
Conditions for tangent plane continuity over recursively generated B-spline surfaces

The continuity properties of recursively generated B-spline surfaces over an arbitrary topology have been related to the eigenproperties of the local subdivision transformation. In this paper a discrete Fourier transform technique is employed to derive these eigenproperties for a general choice of subdivision weightings. Conditions on these weightings are identified for tangent plane continuity at the extraordinary points and a geometric interpretation is given.
Examining possible effects of seawater pH decline on foraminiferal stable isotopes during the Paleocene‐Eocene Thermal Maximum

[1] A large body of paleoceanographic data for the Paleocene-Eocene Thermal Maximum (PETM) is based on foraminiferal stable carbon and oxygen isotope composition (δ13C and δ18O). However, the proxy records could be biased due to a “pH effect” on stable isotopes during times when the ocean became more acidic, as has been demonstrated for modern planktonic foraminifera. In this paper, we calculate the possible ranges of the pH effect on δ13C and δ18O during the PETM based on the relative pH decline (ΔpH) from the preperturbation steady state simulated by a carbon cycle model and the empirical relationships obtained from culture experiments with planktonic foraminifera. The model is configured with Eocene paleogeography and simulates ΔpH for surface, intermediate, and deep water in the major ocean basins in response to various carbon input scenarios (2000 to 5000 Pg C). For an array of scenarios, the modeled ΔpH of the surface ocean ranges from 0.1 to 0.28 units. This suggests that δ13C of planktonic foraminifera may be increased by up to 2.1‰ and δ18O may be increased by up to 0.7‰ (corresponding to over 3°C error in paleotemperature estimate). Under conditions in which the model best simulates the global CaCO3 dissolution pattern, we find marked differences in the deep-sea ΔpH between the Atlantic (−0.4) and Pacific oceans (−0.1). This would imply that the magnitude of the negative δ13C and δ18O excursions of benthic foraminifera in the Atlantic Ocean was dampened by up to 2.8‰ and 0.9‰ at maximum, respectively, relative to a constant pH scenario.
Impact of Noncommunicable Disease Multimorbidity on Healthcare Utilisation and Out-Of-Pocket Expenditures in Middle-Income Countries: Cross Sectional Analysis

Background The burden of non-communicable disease (NCDs) has grown rapidly in low- and middle-income countries (LMICs), where populations are ageing, with rising prevalence of multimorbidity (more than two co-existing chronic conditions) that will significantly increase pressure on already stretched health systems. We assess the impact of NCD multimorbidity on healthcare utilisation and out-of-pocket expenditures in six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Methods Secondary analyses of cross-sectional data from adult participants (>18 years) in the WHO Study on Global Ageing and Adult Health (SAGE) 2007–2010. We used multiple logistic regression to determine socio-demographic correlates of multimorbidity. Association between the number of NCDs and healthcare utilisation as well as out-of-pocket spending was assessed using logistic, negative binominal and log-linear models. Results The prevalence of multimorbidity in the adult population varied from 3∙9% in Ghana to 33∙6% in Russia. Number of visits to doctors in primary and secondary care rose substantially for persons with increasing numbers of co-existing NCDs. Multimorbidity was associated with more outpatient visits in China (coefficient for number of NCD = 0∙56, 95% CI = 0∙46, 0∙66), a higher likelihood of being hospitalised in India (AOR = 1∙59, 95% CI = 1∙45, 1∙75), higher out-of-pocket expenditures for outpatient visits in India and China, and higher expenditures for hospital visits in Russia. Medicines constituted the largest proportion of out-of-pocket expenditures in persons with multimorbidity (88∙3% for outpatient, 55∙9% for inpatient visit in China) in most countries. Conclusion Multimorbidity is associated with higher levels of healthcare utilisation and greater financial burden for individuals in middle-income countries. Our study supports the WHO call for universal health insurance and health service coverage in LMICs, particularly for vulnerable groups such as the elderly with multimorbidity.
The Lidköping Accident Prevention Programme--a community approach to preventing childhood injuries in Sweden.

OBJECTIVES: In Sweden about 100 children 0-14 years die from accidental injuries every year, roughly 40 girls and 60 boys. To reduce this burden the Safe Community concept was developed in Falköping, Sweden in 1975. Several years later a second programme was initiated in Lidköping. The objectives of this paper are to describe the programme in Lidköping and to relate it to changes in injury occurrence. SETTING: The Lidköping Accident Prevention Programme (LAPP) was compared with four bordering municipalities and to the whole of Skaraborg County. METHODS: The programme included five elements: surveillance, provision of information, training, supervision, and environmental improvements. Process evaluation was based mainly on notes and reports made by the health planners, combined with newspaper clippings and interviews with key people. Outcome evaluation was based on information from the hospital discharge registry. RESULTS: In Lidköping there was an on average annual decrease in injuries leading to hospital admissions from 1983 to 1991 of 2.4% for boys and 2.1% for girls compared with a smaller decline in one comparison area and an increase in the other. CONCLUSION: Because the yearly injury numbers are small there is a great variation from year to year. However, comparisons over the nine year study period with the four border municipalities and the whole of Skaraborg County strengthen the impression that the programme has had a positive effect. The findings support the proposition that the decrease in the incidence of childhood injuries after 1984 could be attributed to the intervention of the LAPP. Nevertheless, several difficulties in drawing firm conclusions from community based studies are acknowledged and discussed.
An Example: Perception of Average Size Perceptually Averaging in a Continuous Visual World: Extracting Statistical Summary Representations over Time

It is natural to think about visual perception in terms of the processing of individual elements, such as features, objects, and scenes. In real-world visual experience, however, it is also useful to summarize the distribution of information averaged across many such elements. For example, suppose you are picking apples at an orchard. In choosing a tree, it is not sufficient to evaluate the size and ripeness of a single apple, and it may not be feasible to evaluate each apple on every tree. Instead, it is most useful to summarize each candidate tree—for example, in terms of the average size and ripeness of its apples. Such averaging can be done numerically (for a review, see Pol-lard, 1984), but here we are interested in the possibility that these types of ensemble features, which we call statistical summary representations (SSRs), can be extracted efficiently in the course of visual processing. In fact, the visual system seems able to extract SSRs—with surprising speed and accuracy— over many different dimensions of visual scenes, including size 2008). The visual system can even extract higher-level properties , such as the average emotion of a group of faces The phenomenon of size averaging has spurred a considerable amount of recent research. For example, when faced with a display of discs of varying sizes, observers are able to accurately report their average size, even while unable to judge whether particular individual sizes were present (Ariely, 2001). This phenomenon also works as a striking demonstration: This task can sound daunting, but it is surprisingly easy to simply see the average. This ability is even more fascinating given that it persists when the display is presented very briefly (down to 50 ms), and with considerable variation in the Abstract Beyond processing individual features and objects, the visual system can also efficiently summarize scenes—for example, allowing observers to perceive the average size of a group of objects. Extraction of such statistical summary representations (SSRs) is fast and accurate, but researchers do not yet have a clear picture of the circumstances in which they operate. Previous studies have always used discrete input—either spatial arrays of shapes or temporal sequences of shapes presented one at a time. Real-world environments, in contrast, are intrinsically continuous and dynamic. We investigated the ability to compute average size in displays of objects (or sometimes a single object) that changed continuously, expanding and contracting over time. The results …
Influence of inhibitory control on planning abilities in children with mild intellectual disability

With regard to the fact that the tendency toward unsophisticated strategies is often related to difficulties with basic components of executive functions, the aim of this research was to determine the relation between planning abilities and inhibitory control in children with mild intellectual disability (MID). The sample included 56 children with idiopathic MID (IQ 50-69, M=61.13, SD=7.14), of both genders (26/46.3% of girls), between 9.11 and 14.03 years of age (M=11.61; SD=1.29). Go no Go Task and Day/Night Stroop Task were used for the assessment of inhibitory control (delayed response to the agreed signal, conflict provoking motor responses, and inhibition of arrogant verbal responses), while Tower of London Test (ToL) was used for the assessment of planning abilities. Multivariate analysis of covariance (MANCOVA), paired samples t-test, Pearson's correlation, and partial correlation coefficients were used in statistical analysis of the results. The results showed that the mistakes in Response delay set of Go-no-Go task were the only significant factor of primary Total move score variable (ToL). The influence of the ability to delay motor activity, assessed by Response delay set, on all ToL variables was statistically significant (p=0.003). The results lead to a conclusion that, during the processes of planning and executing activities, children with MID primarily rely on simple inhibitory mechanisms.
Characteristics of an Albumin Cobalt Binding Test for assessment of acute coronary syndrome patients: a multicenter study.

BACKGROUND The ability of the N-terminal region of human albumin to bind cobalt is diminished by myocardial ischemia. The characteristics of an assay based on albumin cobalt binding were assessed in suspected acute coronary syndrome patients and in a control reference population. The ability of the Albumin Cobalt Binding (ACB) Test measurement at presentation to predict troponin-positive or -negative results 6-24 h later was also examined. METHODS We enrolled 256 acute coronary syndrome patients at four medical centers. Blood specimens were collected at presentation and then 6-24 h later. The dichotomous decision limit and performance characteristics of the ACB Test for predicting troponin-positive or -negative status 6 h-24 h later were determined using ROC curve analysis. Results for 32 patients could not be used because the time of onset of ischemia appeared to have been >3 h before presentation or was uncertain. The reference interval was determined by parametric analysis to estimate the upper 95th percentile of a reference population (n = 109) of ostensibly healthy individuals. RESULTS Increased cTnI was found in 35 of 224 patients. The ROC curve area for the ACB Test was 0.78 [95% confidence interval (CI), 0.70-0.86]. At the optimum decision point of 75 units/mL, the sensitivity and specificity of the ACB Test were 83% (95% CI, 66-93%) and 69% (95% CI, 62-76%). The negative predictive value was 96% (95% CI, 91-98%), and the positive predictive value was 33% (95% CI, 24-44%). The within-run CV of the ACB Test was 7.3%. Results for the reference population were normally distributed; the one-sided parametric 95th percentile was 80.2 units/mL. CONCLUSIONS This exploratory study suggests that the ACB Test has high negative predictive value and sensitivity in the presentation sample for predicting troponin-negative or -positive results 6-24 h later.
Horizontal Acquisition of a Multidrug-Resistance Module (R-type ASSuT) Is Responsible for the Monophasic Phenotype in a Widespread Clone of Salmonella Serovar 4,[5],12:i:-

Salmonella enterica serovar 4,[5],12:i:- is a monophasic variant of S. Typhimurium incapable of expressing the second-phase flagellar antigen (fljAB operon), and it is recognized to be one of the most prevalent serovars causing human infections. A clonal lineage characterized by phage type DT193, PulseNet PFGE profile STYMXB.0131 and multidrug resistance to ampicillin, streptomycin, sulphonamides and tetracycline (R-type ASSuT) is commonly circulating in Europe. In this study we determined the deletions affecting the fljAB operon and the resistance region responsible for the R-type ASSuT in a strain of Salmonella enterica serovar 4,5,12:i:- DT193/STYMXB.0131, through an approach based on PCRs and Southern blot hybridization of genomic DNA. Using a set of nine specific PCRs, the prevalence of the resistance region was assessed in a collection of 144 S. enterica serovar 4,[5],12:i:-/ASSuT/STYMXB.0131 strains isolated from Germany, Switzerland and Italy. A 28 kb-region is embedded between the loci STM2759 and iroB, replacing the DNA located in between, including the fljAB operon. It encompasses the genes blaTEM−1, strA-strB, sul2 and tet(B) responsible for the R-type ASSuT together with genes involved in plasmid replication and orfs of unknown function characteristically located on IncH1 plasmids. Its location and internal structure is fairly conserved in S. enterica serovar 4,[5],12:i:-/ASSuT/STYMXB.0131 strains regardless of the isolation source or country. Hence, in the S. enterica serovar 4,[5],12:i:-/ASSuT/STYMXB.0131 clonal lineage widespread in Germany, Switzerland and Italy, a resistance region derived from IncH1 plasmids has replaced the chromosomal region encoding the second flagellar phase and is an example of the stabilization of new plasmid-derived genetic material due to integration into the bacterial chromosome.
A domain‐specific modeling approach to realizing user‐centric communication

Advances in communication devices and technologies are dramatically expanding our communication capabilities and enabling a wide range of multimedia communication applications. The current approach to develop communication‐intensive applications results in products that are fragmented, inflexible, and incapable of responding to changing end‐users' communication needs. These limitations have resulted in the need for a new development approach of building communication applications that are driven by end‐users and that support the dynamic nature of communication‐based collaboration. To address this need, the Communication Virtual Machine (CVM) technology has been developed to support rapid specification and automatic realization of user‐centric communication applications based on a domain‐specific modeling approach. The CVM technology consists of a domain‐specific modeling language (DSML), the Communication Modeling Language (CML), that is used to create communication models, and a semantic rich platform, the CVM, that realized the created communication models. In this paper, we report on our experiences of applying a systematic approach to engineering CML and the synthesis of CML models in CVM. Based on a feature model describing the taxonomy of the user‐centric communication domain in a network independent manner, we develop the meta‐model of CML and its different concrete syntaxes. We also present a behavioral specification (dynamic semantics) of CML that enables the dynamic synthesis of user‐centric communication models into an executable form called communication control script. We validated the CML semantics using Kermeta, a meta‐programming environment for engineering DSMLs, and evaluated the practicality of our approach using a CVM prototype and a set of experiments. Copyright © 2011 John Wiley & Sons, Ltd.
Heme Deficiency in Alzheimer's Disease: A Possible Connection to Porphyria

Mechanisms that cause Alzheimer's disease (AD), an invariably fatal neurodegenerative disease, are unknown. Important recent data indicate that neuronal heme deficiency may contribute to AD pathogenesis. If true, factors that contribute to the intracellular heme deficiency could potentially alter the course of AD. The porphyrias are metabolic disorders characterized by enzyme deficiencies in the heme biosynthetic pathway. We hypothesize that AD may differ significantly in individuals possessing the genetic trait for an acute hepatic porphyria. We elaborate on this hypothesis and briefly review the characteristics of the acute hepatic porphyrias that may be relevant to AD. We note the proximity of genes encoding enzymes of the heme biosynthesis pathway to genetic loci linked to sporadic, late-onset AD. In addition, we suggest that identification of individuals carrying the genetic trait for acute porphyria may provide a unique resource for investigating AD pathogenesis and inform treatment and management decisions.
Autophagy in Cancer Stem Cells: A Potential Link Between Chemoresistance, Recurrence, and Metastasis

Abstract Cancer cells require an uninterrupted nutritional supply for maintaining their proliferative needs and this high demand in concurrence with inadequate supply of blood and nutrition induces stress in these cells. These cells utilize various strategies like high glycolytic flux, redox signaling, and modulation of autophagy to avoid cell death and overcome nutritional deficiency. Autophagy allows the cell to generate ATP and other essential biochemical building blocks necessary under such adverse conditions. It is emerging as a decisive process in the development and progression of pathophysiological conditions that are associated with increased cancer risk. However, the precise role of autophagy in tumorigenesis is still debatable. Autophagy is a novel cytoprotective process to augment tumor cell survival under nutrient or growth factor starvation, metabolic stress, and hypoxia. The tumor hypoxic environment may provide site for the enrichment/expansion of the cancer stem cells (CSCs) and successive rapid tumor progression. CSCs are characteristically resistant to conventional anticancer therapy, which may contribute to treatment failure and tumor relapse. CSCs have the potential to regenerate for an indefinite period, which can impel tumor metastatic invasion. From last decade, preclinical research has focused on the diversity in CSC content within tumors that could affect their chemo- or radio-sensitivity by impeding with mechanisms of DNA repair and cell cycle progression. The aim of this review is predominantly directed on the recent developments in the CSCs during cancer treatment, role of autophagy in maintenance of CSC populations and their implications in the development of promising new cancer treatment options in future.
UV Excess Measures of Accretion onto Young Very Low Mass Stars and Brown Dwarfs

Low-resolution spectra from 3000 to 9000 Å of young low-mass stars and brown dwarfs were obtained with LRIS on Keck I. The excess UV and optical emission arising in the Balmer and Paschen continua yields mass accretion rates ranging from 2 × 10−12 to 10−8 M☉ yr−1. These results are compared with HST STIS spectra of roughly solar-mass accretors with accretion rates that range from 2 × 10−10 to 5 × 10−8 M☉ yr−1. The weak photospheric emission from M dwarfs at <4000 Å leads to a higher contrast between the accretion and photospheric emission relative to higher mass counterparts. The mass accretion rates measured here are systematically ~4-7 times larger than those from Hα emission line profiles, with a difference that is consistent with but unlikely to be explained by the uncertainty in both methods. The accretion luminosity correlates well with many line luminosities, including high Balmer and many He I lines. Correlations of the accretion rate with Hα 10% width and line fluxes show a large amount of scatter. Our results and previous accretion rate measurements suggest that Ṁ ∝ M1.87 ± 0.26 for accretors in the Taurus molecular cloud.