Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving Conventional Recovery With Enhanced Recovery in Minimally Invasive Surgery for Rectal Cancer

BACKGROUND: Enhanced recovery pathways have been shown to decrease the length of hospital stay in patients undergoing colorectal surgery. Few reports have studied patients undergoing minimally invasive surgery for rectal cancer. OBJECTIVE: Our aim was to review our experience in minimally invasive rectal cancer surgery. We report short-term outcomes and evaluate the potential advantages of the enhanced recovery protocol compared with our less intensive conventional pathway. DESIGN: This is a consecutive retrospective study of all minimally invasive rectal cancers treated from February 2005 to December 2011. Multivariable logistic regression models were constructed to identify factors contributing to a short length of stay. SETTINGS: This study was performed at Mayo Clinic, Rochester, Minnesota, between 2005 and 2011. PATIENTS: A total of 346 patients were retrospectively reviewed. Seventy-eight patients were managed under the enhanced recovery pathway. Patients underwent either laparoscopic-, robotic-, or hand-assisted laparoscopic surgery for rectal cancer. INTERVENTIONS: All patients followed either a standardized conventional pathway or an enhanced recovery pathway for perioperative care. MAIN OUTCOME MEASURES: The primary outcome was the length of stay. Secondary outcomes were postoperative complications and 30-day readmissions. RESULTS: Hospital stay was significantly decreased for patients who underwent minimally invasive surgery for rectal cancer and were managed with an enhanced recovery protocol, 4.1 days, vs 6.1 days for the conventional pathway (95% CI, −2.9 to −1.2 days; p < 0.0001). Rates of complications were similar between the 2 groups. Factors associated with shorter length of stay included the enhanced recovery protocol and laparoscopic or robotic surgery compared with hand-assisted laparoscopic surgery. LIMITATIONS: This was a retrospective study at a single institution. Additional limitations include the comparison with historical controls and the potential for selection bias. CONCLUSION: The enhanced recovery pathway is associated with a significantly decreased length of hospital stay after minimally invasive surgery for rectal cancer in this series. Decreased hospital stay was achieved without affecting short-term outcomes.
Thermal behavior of ethylene/1-octene copolymer fractions at high temperatures: Effect of hexyl branch content

In this work, the effect of hexyl branch content on thermal behavior of a fractionated ethylene/1-octene copolymer with emphasis on high temperatures was investigated. The ethylene/1-octene copolymer was carefully fractionated to different fractions with homogenous hexyl branch (HB) content by preparative temperature rising elution fractionation (P-TREF) method. The P-TREF fractions were thermally analyzed via differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and evolved gas analysis (EGA). The P-TREF profile showed a short chain branch distribution (SCBD) of around 1.24. A linear relationship between P-TREF elution temperature (ET) and methylene sequence length (MSL) was presented. The DSC curves exhibited a monolithically increase in melting temperature (Tm) as well as crystallization temperature (Tc) by decreasing short chain branch (SCB) content. The calculated values of lamellae thickness suggested a linear function of SCB content and Tm. The TGA studies of P-TREF fractions depicted a two-stage thermal degradation behavior: pre-degradation and main degradation stages. Tmax for both pre-degradation and main degradation stages was increased for fractions with less hexyl branch content. As an interesting point the pre-degradation stage was found more intensified for more linear fractions. The concentration of main products was found to be affected by the content of hexyl branches using Py-GC-MS.
Corporate Social Responsibility: Institutional Behavior Differences in Extractive Industry

The developed countries’ institutional research undertaken on corporate social responsibilities (CSR) have shown a positive relationship between accessibility of financial related assets and CSR. Contentions that we classified as the Institutional Difference Hypothesis (IDH) drawn from the institutional writing, on the other hand, propose that institutional contrasts amid of developing and the developed economies are prone to result in diverse CSR propositions. Incorporating the rationale of IDH with understanding of knowledge from slack resource theory, we contend that there exists a negative relationship between fiscal resources accessibility and CSR investments for mining companies in Ghana, a sub-Saharan African developing economy. We utilize a well-protected data from the Ghana Investment Promotion Center (GIPC), Ghana Stock Exchange (GSE) and Ghana Chamber of mines (GCM) and find that Return on Ordinary Share, Return on Sales, and Net Profit were reliably connected with lower CSR disbursements. We highlight the ramifications of our discoveries for academics’ examination and corporate practitioners.
The fate at mid-term follow-up of the on-pump vs. off-pump coronary artery bypass grafting surgery

Aims To evaluate the fate of on-pump coronary artery bypass grafting (ON-pump CABG) vs. off-pump coronary artery bypass grafting (OP-CABG) surgery at mid-term follow-up. Methods From January 2008 to December 2010, 369 patients underwent surgical myocardial revascularization by means of OP-CABG techniques (n = 166) or with ON-pump CABG (n = 203). Data of the two groups of patients were retrospectively analyzed. Results As compared with OP-CABG, in the ON-pump CABG patients, mean value of Logistic EuroSCORE (8.1 ± 7.8% vs. 6.2 ± 5.9%, P = 0.04), more extended coronary disease (2.7 ± 0.5 vs. 2.5 ± 0.7 diseased vessels/patient, P < 0.001) consequently requiring greater number of grafts/patient (2.9 ± 0.9 vs. 2.3 ± 0.9, P < 0.0001), and emergency surgery (12 vs. 6%, P = 0.03) were more frequently observed. Operative mortality was 1.9% in ON-pump CABG vs. 1.2% in OP-CABG (P = 0.6) and incidence of stroke 2.46 vs. 1.81% (P = 0.7). The incidence of stroke was reduced at 1.2% when OP-CABG PAS-Port ‘clamp-less’ technique was used. Intraoperatively, costs per patient were higher for OP-CABG vs. ON-pump CABG (1.930,00 +1.050,00 &OV0556;, if PAS-port system was included, vs. 1.060,00 &OV0556; for ON-pump surgery). ICU stay (1.9 ± 1.0 days vs. 1.4 ± 0.7 days) and total postoperative in-hospital stay (5.3 ± 3.3 days vs. 5.5 ± 3.5 days) were similar in both groups. At 4 years, survival (91 ± 13% in the ON-pump CABG vs. 84 ± 19% in the OP-CABG), freedom from major adverse cardiac events (composite end-point of all-cause death, myocardial infarction, and repeat coronary revascularization of the target lesion) (82 ± 9% vs. 76 ± 14%), and major adverse cardiac and cerebrovascular events (80 ± 11% vs. 72 ± 16%) were not significantly different. Freedom from late cardiac death was slightly significant higher after ON-pump CABG (98 ± 4% vs. 90 ± 10%, P = 0.05). Conclusion Mid-term freedom from composite end-points is similar after ON-pump CABG and OP-CABG. Freedom from cardiac death appears to be better after ON-pump CABG. OP-CABG needs for more expensive surgical technique. OP-CABG performed by an experienced surgical team using ‘clamp-less’ techniques can be an effective strategy in reducing postoperative stroke.
Risk Factors for Ovarian Cancers With and Without Microsatellite Instability

Objective In a population-based sample of epithelial ovarian cancers, the objective of this study was to evaluate the association between microsatellite instability (MSI) status and the following factors: (1) ovarian cancer risk factors and (2) the distribution of the specific histologic subtypes. Patients and Methods Participants were drawn from 3 population-based studies of primary epithelial ovarian cancer; tumor DNA was analyzed using 5 standardized microsatellite markers to assess the MSI status. Patients were divided into 3 groups (MSI-high, MSI-low, and MSI-stable) according to the National Cancer Institute criteria. We compared the prevalence of specific known risk and protective factors among the 3 subgroups, including body mass index, smoking history, parity, BRCA1 and BRCA2 mutation status, past oral contraceptive use, and tubal ligation. Similarly, we compared the distribution of the histologic subtypes among the 3 subgroups. Results A total of 917 ovarian cancer patients were included. One hundred twenty-seven cases of cancer (13.8%) were MSI-high. Subgroup analyses according to smoking, body mass index, parity, past oral contraceptive use, and past tubal ligation did not reveal any statistically significant differences among the groups. Among the 29 patients with BRCA1 mutations, 20.7% had MSI-high cancers compared with 5.9% among 17 patients with BRCA2 mutations. The proportions of different ovarian cancer histologies among the various MSI subgroups were similar. Conclusions The prevalence of risk and protective factors among ovarian cancer patients is similar for cancers with and without MSI. The distributions of MSI do not differ significantly among ovarian cancers with different histologies. Ovarian cancer patients with BRCA1 mutations had a 21% rate of MSI-high tumors compared with 6% among patients with BRCA2 mutations, but this difference was not statistically significant.
Treatment of Polycythaemia Rubra Vera*

the supporting and the supported categories within a population, and with the increasing disparity between the number of mouths to be fed and the available food resources of the world, the problem that the bouche inutile creates gains in importance. In this country within the National Health Service it is already being found that the existing facilities cannot cope with newly discovered and enlarging needs. The authorities concerned are being forced to give serious consideration to the construction of a calculus of priorities. Great, therefore, becomes the need for the provision of the means whereby greater and more detailed knowledge concerning the variety and the needs of the public for those services can be secured. The changing age-structure and the changing pattern of morbidity are prominent among the factors that are creating the demand for the expansion of medical and hospital services at a time when the financial resources of the nation are strained. It is to be remembered that in their beginning the medical services were encouraged because it was thought that such medical intervention would prove itself to be a sound business proposition. It would certainly seem that the reasons for the encouragement of medical research and of the practice of preventive and of curative medicine have changed. though not completely, since then. It would be difficult to maintain that the medical care of the old, permanently disabled by chronic illness, or of the idiot and imbecile beyond all human aid is economically desirable. Such matters are not to be considered in economic terms, for moral principles are involved. They do not create difficulties within the medical profession, for this is governed by an explicitly stated code; but they do constitute problems of profound difficulty and complexity for society as a whole. There is to be discerned a growing interest in such matters as the sterilization of the unfit and euthanasia, which can be regarded as an indication that the gravity of the problem is becoming recognized and that the search for a possible solution has begun. I refer to this matter only to attract your attention to the possibility that in the future the social ethic may come to be in conflict with the ethic that at the moment prevails within the profession of medicine.
Maternal and Fetal Determinants of Neonatal Body Composition

Background: Body composition in early life influences the development of obesity during childhood and beyond. It is, therefore, important to adequately determine neonatal body composition. Fetal growth and maternal factors might influence neonatal fat mass percentage (FM%), independent of birth weight. Methods: In 194 healthy neonates, we investigated neonatal body composition, measured by air-displacement plethysmography (PEAPOD), and its associations with estimated fetal weight (EFW), neonatal anthropometric data, maternal preconceptional body mass index (BMI) and maternal weight gain during pregnancy. Results: There was a large variation in neonatal FM%, even in case of a similar birth weight, corrected for gender and gestational age. Neonatal FM% was associated with EFW at 30 and 36 weeks of gestation and with catch-up in weight between 30 and 36 weeks of gestation, but not with EFW at 20 weeks (p < 0.01, p < 0.01 and p = 0.64, respectively). Neonatal FM% was also associated with preconceptional BMI of the mother (p < 0.01). There was no correlation with maternal weight gain. Conclusion: Our study shows that term neonates have a large variation in FM%. Neonatal FM% is associated with EFW at 30 and 36 weeks, catch-up in weight between 30 and 36 weeks of gestation and preconceptional BMI of the mother.
Impact of admission blood glucose level on outcomes in community-acquired pneumonia in older adults

Background Community-acquired pneumonia (CAP) is a common cause of morbidity and mortality in older adults. Although diabetes mellitus is a risk factor for pneumonia, the clinical impact of blood glucose level at the time of admission is not clear. Our goal was to examine the association between admission hyperglycemia and subsequent mortality, length of stay, and readmission outcomes in older adults with CAP. Methods A retrospective observational study was conducted using hospital data for community-acquired pneumonia admissions in 857 persons from January 1, 2008 to December 31, 2010. We examined the effects of admission glucose level on mortality, length of stay, and 30 day readmission, adjusted for demographic factors and comorbidity. Results The mean age of the sample was 64 years, and 51% of the subjects were female. Inpatient mortality occurred in 4.6% and the median length of stay was 5 days (interquartile range 3–9 days). Readmission within 30 days occurred in 17%. We found little impact of first glucose measures on in-hospital mortality (P = 0.94), length of stay (P = 0.95), and 30-day readmission (P = 0.56). Subjects 65 years and older trended towards higher in-hospital mortality. Older age, cancer, heart failure, and cirrhosis were associated with adverse outcomes. Conclusion Glucose level upon admission for community-acquired pneumonia was not associated with adverse outcomes within 30 days in older adults.
The Communication Complexity of Gap Hamming Distance

In the gap Hamming distance problem, two parties must determine whether their respective strings x; y2f0; 1g n are at Hamming distance less than n=2 p n or greater than n=2+ p n: In a recent tour de force, Chakrabarti and Regev (2010) proved the long- conjectured W(n) lower bound on the randomized communication complexity of this problem. In follow-up work, Vidick (2010) discovered a simpler proof. We contribute a new proof, which is simpler yet and a page-and-a-half long.
Emerging Concepts in TCR Specificity: Rationalizing and (Maybe) Predicting Outcomes

T cell specificity emerges from a myriad of processes, ranging from the biological pathways that control T cell signaling to the structural and physical mechanisms that influence how TCRs bind peptides and MHC proteins. Of these processes, the binding specificity of the TCR is a key component. However, TCR specificity is enigmatic: TCRs are at once specific but also cross-reactive. Although long appreciated, this duality continues to puzzle immunologists and has implications for the development of TCR-based therapeutics. In this review, we discuss TCR specificity, emphasizing results that have emerged from structural and physical studies of TCR binding. We show how the TCR specificity/cross-reactivity duality can be rationalized from structural and biophysical principles. There is excellent agreement between predictions from these principles and classic predictions about the scope of TCR cross-reactivity. We demonstrate how these same principles can also explain amino acid preferences in immunogenic epitopes and highlight opportunities for structural considerations in predictive immunology.
Flexural fatigue analysis of steel fibre reinforced concrete

This paper presents the experimental investigation carried on Steel Fiber Reinforced Concrete (SFRC) subjected to repeated loading. The SFRC beam specimen of size 500mm x 100mm x 100mmcontaining mixed steel fibers of size 50mm x 2mm x 0.6mm and 0. 5mmΦ× 30mm in different proportions were tested under two point flexural fatigue load at a frequency of 2Hz at various stress levels. The readings obtained from the flexural fatigue test were used to plot S-N diagram and also to perform statistical analysis using two parameter Weibull distributions.
Association between female sex, IL28B genotype, but also DQB1*0301 allele and the outcome of acute hepatitis C virus infection

We thank Grebely et al. for their recent InC study confirming that the IL28B genotype and female sex are associated with the spontaneous clearance of hepatitis C virus (HCV). However, we and others showed that spontaneous HCV resolution is associated with another genetic factor more than 10 years ago. This factor is the DQB1*0301 allele of the major histocompatibility complex class II. The IL28B genotype was shown to be the most important factor associated with a sustained virologic response to pegylatedinterferon ribavirin therapy and also with the spontaneous outcome of HCV infection. However, the study showing that genetic variations in IL28B is associated with spontaneous clearance of HCV focused on a single nucleotide polymorphism and was not a genome-wide association study (GWAS). A new multicenter collaborative study on 919 North American and European subjects whose HCV was resolved spontaneously was conducted to explain the conflicting results. It was shown that IL28B rs12979860 and DQB1*0301 rs4272729 alleles were independently associated with the spontaneous resolution of HCV. Surprisingly, these results are not discussed by Grebely et al. The InC study is important because the authors confirmed prospectively the well-known IL28B polymorphism and reported that being a female is also associated with the clearance of an acute HCV infection. Our previous cohort studies also found this statistically significant association with female sex (P< 0.004), but it was not an independent factor in multivariate analysis. We also reported that viral genotype plays no role in spontaneous resolution of HCV infection. We are disappointed that the InC study did not test the DQB1*0301 allele in each subject. It is technically easy to do so and not costly. We believe that they would have found that this host factor is also associated with spontaneous HCV resolution. We suggest that female sex will not be an independent predictor of spontaneous HCV clearance when both these genetic factors are included in a multivariate analysis. LAURENT ALRIC, PH.D., M.D. DELPHINE BONNET, M.D. MARYLISE FORT, M.D. Internal Medicine Digestive Department Purpan Hospital UMR152, IRD Toulouse III University, Toulouse, France Immunology Unit Rangueil Hospital, Toulouse, France
Flat feet in children.

24 hours after the onset of continuous chest pain are given thrombolytic treatment. Patients with ST depression or deep T wave inversion are at first treated for unstable angina with heparin, aspirin, nitrates, and ri blockers. If chest pain persists after two hours and electrocardiographic changes show no tendency to resolve myocardial infarction is assumed and streptokinase infusion started. Early resolution of electro-cardiographic changes, on the other hand, is taken to indicate reversible ischaemia requiring no additional treatment. No patient with a normal electrocardiogram receives thrombo-lytic treatment. I Reimer KA, Jennings RB. The wavefront phenomenon" ofttvocardial ischemic cell death. 2. Transmural progression of necrosis within the framework of ischemic bcd sizc mvocardium at risk) and collateral flow. Lab Invest 1979;40:633-44. 2 Huev BL, Gheorghiade M, Crampton RS, et al. Actute non-Q wasve myocardial infarction associatcd with earlv ST segment elevation: evidence for spontaneous coronary reperftusioni and itmplica-tions for thrombolytic trials.
Radiation Potential of Extremely Low Frequency (ELF) Magnetic Field to Increase Tobacco Production

ELF magnetic field has many advantages, in addition to being a non-ionizing radiation, it is also able to penetrate almost any material. Several research results prove that exposure to ELF magnetic field can trigger the growth of tomato plants Ranti (Sari et al, 2015) and large chili plants (Handoko et al, 2017). The underlying mechanism for this is that exposure to ELF magnets can increase intracellular calcium, which can lead to increased cell proliferation. Excess magnetic field ELF is expected to be an alternative solution to the problems faced by tobacco farmers, which is the decline of the production of tobacco. Simple and inexpensive solutions need to be sought. Therefore, this study proves the effect of ELF magnetic field on increasing the leaf mass of tobacco. The sample of this research is tobacco seed exposed to ELF magnetic field after soaked in water for 24 hours. The variations in the intensity of the ELF magnetic field used in this study were 300μT, 500μT and 700μT and variations of 45 minutes and 60 minutes of exposure time. The results of One Way Anova analysis of this research data proves that exposure to the ELF magnetic field significantly increases the wet mass of leaf tobacco production. The highest wet mass of tobacco leaf was obtained in the group exposed to the magnetic field ELF 500μT for 60 minutes. In conclusion, that exposure to ELF magnetic field has an effect on increasing wet mass of leaf tobacco production. Extremely Low Frequency, Leaf Mass, Length of Exposure
Altered expression of vesicular monoamine transporter 2 in epileptic patients and experimental rats

In the central nervous system (CNS), vesicular monoamine transporter 2 (VMAT2) transports cytoplasmic monoamines such as dopamine into synaptic vesicles for storage and subsequent exocytotic release. Recent studies have provided direct evidence for VMAT2‐regulated monoamine neurotransmitter involvement in the neurophysiological activities of neurological disease. This study investigated the expression pattern of VMAT2 in patients with temporal lobe epilepsy (TLE) and in a rat model of epilepsy. We assessed the expression of VMAT2 in the temporal neocortex in 24 TLE patients using western blotting and quantitative real time PCR (qRT‐PCR) analyses. These results showed that VMAT2 expression dynamically decreased in TLE patients when compared with the control subjects (n = 12). And that VMAT2 protein transiently increased in acute stages (1 day and 3 days) after epileptic seizures in pilocarpine‐treated rats; however, it clearly decreased after spontaneous recurrent seizures (7 days, 21 days, and 60 days after seizures). In addition, double immunofluorescence and immunohistochemical labeling studies performed in patient and experimental animal tissue revealed that VMAT2 protein was mainly expressed in the cytoplasm and in the axons of neurons but not glial cells in the hippocampus and temporal lobe cortex. These data suggested that the abnormal expression of VMAT2 mRNA and protein in epileptic brain tissue may contribute to vulnerability toward epilepsy‐related psychiatric disorders and cognitive impairment. Synapse 67:415–426, 2013. © 2013 Wiley Periodicals, Inc.