Miracle-dz/UniFAR-FTUs huggingface dataset:
Surgeon Awareness of Operating Room Supply Costs

Background: The extent to which surgeons understand costs associated with expensive operative procedures remains unclear. The goal of the study was to better understand surgeon cost awareness of operating room supplies and implants. Methods: This was a cross-sectional study of faculty (n = 24) and trainees (fellow and residents, n = 27) in the Department of Otolaryngology. Participants completed surveys to assess opinions on importance of cost and ease in accessing cost data and were asked to estimate the costs of operating room (OR) supplies and implants. Estimates within 20% of actual cost were considered correct. Analyses were stratified into faculty and trainee surgeons. Results: Cost estimates varied widely, with a low percentage of correct estimations (25% for faculty, 12% for trainees). Surgeons tended to underestimate the cost of high-cost items (55%) and overestimate the cost of low-cost items (77%). Attending surgeons were more accurate at correctly estimating costs within their own subspecialty (33% vs 16%, P < .001). Self-rated cost knowledge and years in practice did not correlate with cost accuracy (P < .05). Conclusions: A majority of surgeons were unable to correctly estimate the costs of items/implants used in their OR. An opportunity exists to improve the mechanisms by which cost data are fed back to physicians to help promote value-based decision making.
Cytoplasmic domain requirements for Frazzled-mediated attractive axon turning at the Drosophila midline

The conserved DCC ligand-receptor pair Netrin and Frazzled (Fra) has a well-established role in axon guidance. However, the specific sequence motifs required for orchestrating downstream signaling events are not well understood. Evidence from vertebrates suggests that P3 is important for transducing Netrin-mediated turning and outgrowth, whereas in C. elegans it was shown that the P1 and P2 conserved sequence motifs are required for a gain-of-function outgrowth response. Here, we demonstrate that Drosophila fra mutant embryos exhibit guidance defects in a specific subset of commissural axons and these defects can be rescued cell-autonomously by expressing wild-type Fra exclusively in these neurons. Furthermore, structure-function studies indicate that the conserved P3 motif (but not P1 or P2) is required for growth cone attraction at the Drosophila midline. Surprisingly, in contrast to vertebrate DCC, P3 does not mediate receptor self-association, and self-association is not sufficient to promote Fra-dependent attraction. We also show that in contrast to previous findings, the cytoplasmic domain of Fra is not required for axonal localization and that neuronal expression of a truncated Fra receptor lacking the entire cytoplasmic domain (FraΔC) results in dose-dependent defects in commissural axon guidance. These findings represent the first systematic dissection of the cytoplasmic domains required for Fra-mediated axon attraction in the context of full-length receptors in an intact organism and provide important insights into attractive axon guidance at the midline.
Propranolol in primary and secondary prophylaxis of variceal bleeding among cirrhotics in India: a hemodynamic evaluation

OBJECTIVE:In the present study, we attempted to complete the hemodynamic assessment of propranolol response in cirrhotics with esophageal varices at high risk of bleeding, in one sitting, so as to identify nonresponders at the earliest. Some noninvasive indicators of this response were also evaluated.METHODS:Hepatic venous pressure gradient (HVPG) was measured in 33 such cases (18 nonbleeders, 15 bleeders) before and 90 min after an oral dose of 80 mg propranolol, and reduction by ≥20% taken as responder.RESULTS:Twenty-two patients (66.67%) responded (HVPG reduction ≥26%), whereas 11 (33.33%) did not (HVPG reduction ≤6%). Postdrug HVPG between responders and nonresponders showed a significant difference (p < 0.001). Neither baseline HVPG (p > 0.1), baseline CI (p = 0.665), nor baseline stroke volume index (p > 0.1) could predict responder status. Difference of HVPG reduction (percent) between bleeders (21.49 ± 35.53) and nonbleeders (40.58 ± 23.95) approached, but did not reach, statistical significance (p = 0.076). However, logistic regression showed this difference to be significant (p = 0.026). Age of responders was found to be significantly lower than that of nonresponders (p≈ 0.05). During a follow-up of 9–38 months, only one of 22 responders (on propranolol) had an episode of variceal bleed. None in whom HVPG fell to ≤12 mm Hg bled.CONCLUSION:The study suggests that single-sitting hemodynamic assessment of acute response to high-dose oral propranolol clearly differentiates between responders and nonresponders. Moreover, it appears that prior history of variceal bleeding and old age negatively influences the effect of propranolol.
Differences in contractile behaviour between the soleus and medial gastrocnemius muscles during human walking

SUMMARY The functional roles of individual lower limb muscles during human walking may differ depending on walking speed or duration. In this study, 11 volunteers walked on a treadmill for 60 min at speeds corresponding to both optimal and 20% above optimal energetic cost of transport whilst oxygen consumption and medial gastrocnemius (MG) and soleus fascicle lengths were measured. Although energetic cost of transport was ∼12% higher at the faster speed, it remained constant over 60 min at both speeds, suggesting that humans can walk for prolonged periods at a range of speeds without compromising energetic efficiency. The fascicles of both muscles exhibited rather ‘isometric’ behaviour during the early to mid stance phase of walking, which appears to be independent of walking speed or movement efficiency. However, several functional differences were observed between muscles. MG exhibited time- and speed-dependent decreases in operating length, and shortened faster during the pushoff phase at the faster walking speed. Conversely, soleus exhibited consistent contractile behaviour regardless of walking speed or duration, and always shortened slower than MG during pushoff. Soleus appears to play a more important functional role than MG during walking. This may be especially true when walking for prolonged periods or at speeds above the most energetically efficient, where the force potential and thus the functional importance of MG appears to decline.
Evaluating the More Suitable ISM Frequency Band for IoT-Based Smart Grids: A Quantitative Study of 915 MHz vs. 2400 MHz

IoT has begun to be employed pervasively in industrial environments and critical infrastructures thanks to its positive impact on performance and efficiency. Among these environments, the Smart Grid (SG) excels as the perfect host for this technology, mainly due to its potential to become the motor of the rest of electrically-dependent infrastructures. To make this SG-oriented IoT cost-effective, most deployments employ unlicensed ISM bands, specifically the 2400 MHz one, due to its extended communication bandwidth in comparison with lower bands. This band has been extensively used for years by Wireless Sensor Networks (WSN) and Mobile Ad-hoc Networks (MANET), from which the IoT technologically inherits. However, this work questions and evaluates the suitability of such a “default” communication band in SG environments, compared with the 915 MHz ISM band. A comprehensive quantitative comparison of these bands has been accomplished in terms of: power consumption, average network delay, and packet reception rate. To allow such a study, a dual-band propagation model specifically designed for the SG has been derived, tested, and incorporated into the well-known TOSSIM simulator. Simulation results reveal that only in the absence of other 2400 MHz interfering devices (such as WiFi or Bluetooth) or in small networks, is the 2400 MHz band the best option. In any other case, SG-oriented IoT quantitatively perform better if operating in the 915 MHz band.
Principle of Local Conservation of Energy-Momentum

Starting with Einstein's theory of special relativity and the principle that whenever a celestial body or an elementary particle, subjected only to the fundamental forces of nature, undergoes a change in its kinetic energy then the mass-energy equivalent of that kinetic energy must be subtracted from the rest-mass of the body or particle, we derive explicit equations of motion for two falling bodies. In the resulting mathematical theory we find that there are no singularities and consequently no blackholes.
Role of Vif in Stability of the Human Immunodeficiency Virus Type 1 Core

ABSTRACT The Vif protein of human immunodeficiency virus type 1 (HIV-1) is important for virion infectivity. Previous studies have shown thatvif-defective virions exhibit structural abnormalities in the virus core and are defective in the ability to complete proviral DNA synthesis in acutely infected cells. We developed novel assays to assess the relative stability of the core in HIV-1 virions. Using these assays, we examined the role of Vif in the stability of the HIV-1 core. The integrity of the core was examined following virion permeabilization or removal of the lipid envelope and treatment with various triggers, including S100 cytosol, deoxynucleoside triphosphates, detergents, NaCl, and buffers of different pH to mimic aspects of the uncoating and disassembly process which occurs after virus entry but preceding or during reverse transcription.vif mutant cores were more sensitive to disruption by all triggers tested than wild-type cores, as determined by endogenous reverse transcriptase (RT) assays, biochemical analyses, and electron microscopy. RT and the p7 nucleocapsid protein were released more readily from vif mutant virions than from wild-type virions, suggesting that the internal nucleocapsid is less stably packaged in the absence of Vif. Purified cores could be isolated from wild-type but not vif mutant virions by sedimentation through detergent-treated gradients. These results demonstrate that Vif increases the stability of virion cores. This may permit efficient viral DNA synthesis by preventing premature degradation or disassembly of viral nucleoprotein complexes during early events after virus entry.
LIFE OUTCOMES AND SATISFACTION RATINGS OF MULTIHANDICAPPED ADULTS *

Ten and 20 year longitudinal data were collected on 180 multihandicapped adults. Subjects completed a 50‐item questionnaire which was divided into five sections: (a) living circumstances, (b) physical status, (c) social situation, (d) education, and (e) vocational training and employment. Respondents provided both outcome data and their satisfaction with those outcomes. The results indicated that most lived at home, were financially dependent and were not married. However, they reported that they were satisfied with these life outcomes and that they were very satisfied with their social activities. Few significant differences separated the age groups, suggesting that societal and legal changes over the last 20 years have had a limited impact. The variable most strongly related to life outcome and satisfaction with life outcome was functional status. In addition, perceived (self‐reported) functional skills were highly correlated with more objective clinical ratings of functional status.
Effect of creatine supplementation as a potential adjuvant therapy to exercise training in cardiac patients: a randomized controlled trial

Objective: To investigate the effect of oral creatine supplementation in conjunction with an exercise programme on physical fitness in patients with coronary artery disease or chronic heart failure. Design: Single centre double-blind randomized placebo controlled trial. Setting: Cardiac rehabilitation centre. Subjects and intervention: 70 (4 women) cardiac patients (age 57.5 (8.4) years) were randomized to a placebo (n = 37) or creatine (n = 33) treatment for three months. Combined aerobic endurance and resistance training (three sessions/ week) was performed during supplementation. Main Measures: Aerobic power was determined during graded bicycle testing, knee extensor peak isometric and isokinetic strength, endurance and recovery were assessed by an isokinetic dynamometer, and health related quality of life was evaluated with the SF-36 and MacNew Heart Disease questionnaires. In addition, blood samples were taken after an overnight fast and 24 hour urinary collection was performed. Results: At baseline there were no significant differences between both groups. We observed main time effects for aerobic power, muscle performance, health related quality of life, high density lipoprotein cholesterol and triglycerides (pre vs post; P<0.05 for all). However, changes after training were similar between placebo group and creatine group (P>0.05). Further, no detrimental effect on renal or liver function was observed nor were there any reports of side effects. Conclusion: Oral creatine supplementation in combination with exercise training does not exert any additional effect on the improvement in physical performance, health related quality of life, lipid profile in patients with coronary artery disease or chronic heart failure than exercise training alone.
The anti-cancer drug, phenoxodiol, kills primary myeloid and lymphoid leukemic blasts and rapidly proliferating T cells

The plasma electron transport system is a relatively newly-discovered potential target for anti-leukemia drugs. In this paper Herst and coworkers describe the effects of phenoxodiol, an inhibitor of this pathway on leukemia cell lines and primary as well as on resting and activated T cells. The ability of phenoxodiol to kill rapidly proliferating lymphocytes might make this drug a promising candidate for the treatment of pathologically-activated lymphocytes. Background The redox-active isoflavene anti-cancer drug, phenoxodiol, has previously been shown to inhibit plasma membrane electron transport and cell proliferation and promote apoptosis in a range of cancer cell lines and in anti-CD3/anti-CD28-activated murine splenocytes but not in non-transformed WI-38 cells and human umbilical vein endothelial cells. Design and Methods We determined the effects of phenoxodiol on plasma membrane electron transport, MTT responses and viability of activated and resting human T cells. In addition, we evaluated the effect of phenoxodiol on the viability of leukemic cell lines and primary myeloid and lymphoid leukemic blasts. Results We demonstrated that phenoxodiol inhibited plasma membrane electron transport and cell proliferation (IC50 46 μM and 5.4 μM, respectively) and promoted apoptosis of rapidly proliferating human T cells but did not affect resting T cells. Phenoxodiol also induced apoptosis in T cells stimulated in HLA-mismatched allogeneic mixed lymphocyte reactions. Conversely, non-proliferating T cells in the mixed lymphocyte reaction remained viable and could be restimulated in a third party mixed lymphocyte reaction, in the absence of phenoxodiol. In addition, we demonstrated that leukemic blasts from patients with primary acute myeloid leukemia (n=22) and acute lymphocytic leukemia (n=8) were sensitive to phenoxodiol. The lymphocytic leukemic blasts were more sensitive than the myeloid leukemic blasts to 10 μM phenoxodiol exposure for 24h (viability of 23±4% and 64±5%, respectively, p=0.0002). Conclusions The ability of phenoxodiol to kill rapidly proliferating lymphocytes makes this drug a promising candidate for the treatment of pathologically-activated lymphocytes such as those in acute lymphoid leukemia, or diseases driven by T-cell proliferation such as auto-immune diseases and graft-versus-host disease.
Acute myocardial infarction: assessment of left ventricular function with 16-detector row spiral CT versus MR imaging--study in pigs.

PURPOSE To assess global left ventricular (LV) function and regional wall motion with retrospective electrocardiographically gated 16-detector row computed tomography (CT) in comparison with magnetic resonance (MR) imaging. MATERIALS AND METHODS In 15 pigs (mean weight, 53.9 kg +/- 9.5 [standard deviation]), acute myocardial infarction was induced with balloon occlusion of the left anterior descending coronary artery after approval was obtained from the committee on animal affairs. Thereafter, multi-detector row CT and MR imaging were performed with standardized examination protocols. From manually drawn endocardial and epicardial contours, LV volumes, including mean ejection fraction, peak filling rate (PFR), peak ejection rate (PER), time to PER, and time from end systole to PFR, were calculated. Regional wall motion was assessed from cine loops with a 16-segment model of the left ventricle. LV function was analyzed by using Bland-Altman plots, Student t test, and Pearson correlation coefficient. Regional wall motion scores were compared with weighted kappa statistic. RESULTS LV volumes determined with multi-detector row CT correlated well with MR imaging results, with an ejection fraction of 46.1% +/- 6.5 for multi-detector row CT and 46.8% +/- 5.9 for MR imaging (r = 0.97). PER, PFR, time to PER, and time from end systole to PFR showed a wide range of scattering and significant differences between multi-detector row CT and MR imaging for PER and time from end systole to PFR (P < .05). Regional wall motion scores showed a very high level of agreement with a kappa value of 0.88. CONCLUSION Although 16-detector row CT allows reliable assessment of LV volumes and regional wall motion at rest, it is not suited for assessment of all functional parameters.
Expression of senescence-related genes in human corneal endothelial cells

Purpose To investigate the expression of p16INK4a, p21WAF1/CIP1, p27KIP1, and p53 in human corneal endothelial cell (HCEC) senescence ex vivo at various donor ages. Methods Residual corneal tissues obtained after penetrating keratoplasty were used in this study. Age, death-to-preservation interval, and preservation-to-surgery interval of the donors were recorded. Corneal endothelial cell survival and density were evaluated by trypan blue and alizarin red staining immediately after keratoplasty. Fresh frozen sections of donor corneas at various ages (18, 33, 54, and 68 years) were immunostained in situ. Total RNA extracted from age groups of 20, 30, 40, 50, and 60 years was evaluated by reverse-transcriptase polymerase chain reaction (PCR) to reveal the expression of the senescence-related genes, p16INK4a, p21WAF1/CIP1, p27KIP1, and p53, in HCECs. Total RNA extracted from 20-, 24-, 26-, 30-, 50-, 55-, 56-, and 60-year-old donor groups was subjected to real-time PCR analysis for measurement of gene expression. The results of the young (≤30 years) and the old (≥ 50 years) were compared by the unpaired t-test. Ex vivo senescence of HCECs from the donors at various ages (9, 17, 23, 57, 65, and 67 years) was observed by senescence-associated β-galactosidase activity (SA-β-Gal) staining at pH 6.0. Results The mean endothelial cell density of the donor corneas was 2,391.4±84.6 cells/mm2, and the survival rate of the endothelial cells was 84.4%±5.3%. Hematoxylin and eosin staining showed normal structures of the corneal epithelium, stroma, and endothelium. The expression and nuclear localization of p16INK4a, p21WAF1/CIP1, p27KIP1, and p53 in HCECs were confirmed by immunohistochemistry in situ. Reverse transcriptase PCR examination showed positive target bands of each gene at each age group. An age-related increase in p16INK4a expression was observed by real-time PCR (p=0.014). There was no significant difference in the expression levels of p21WAF1/CIP1, p27KIP1, and p53 between the young and old donors (p=0.875, 0.472, and 0.430, respectively). Strong SA-β-Gal activity was observed in the endothelial cells of the old donors while there was weak and little-to-no blue staining in the endothelia from the young. Conclusions The population of HCECs exhibiting senescence-like characteristics increases with age. p16INK4a, p21WAF1/CIP1, p27KIP1, and p53 are expressed in HCECs despite donor ages. The p16INK4a signal pathway might play a key role in the process of senescence in HCECs.
Modulation Theory for Self-Focusing in the Nonlinear Schrödinger–Helmholtz Equation

The nonlinear Schrödinger–Helmholtz (SH) equation in N space dimensions with 2σ nonlinear power was proposed as a regularization of the classic nonlinear Schrödinger (NLS) equation. It was shown that the SH equation has a larger regime of global existence and uniqueness of solutions compared with that of the classic NLS . In the limiting case where the Schrödinger–Helmholtz equation is viewed as a perturbed system of the classic NLS equation, we apply modulation theory to the classic critical case (σ = 1, N = 2) and show that the regularization prevents the formation of singularities of the NLS equation. Our theoretical results are supported by numerical simulations.
Fertility preservation and breast cancer: a review

Breast cancer is the most common malignancy in women, and its incidence increases with age, with the majority of patients diagnosed after menopause. However, in 15–25% of cases, patients are premenopausal at the time of diagnosis, and about 7% of them are below the age of 40. Therefore, a considerable amount of young women are diagnosed with breast cancer during their reproductive life. Within this group, most cancer cases require cytotoxic chemotherapy and/or hormone therapy, which are responsible for a decrease in the patients’ reproductive function, along with their age. The efficacy of such treatments, among other factors, has led to a high five-year-survival rate, which results in an increasing number of young women who survive breast cancer before having fulfilled their reproductive wishes, especially considering the current trend to delay pregnancy until the late 30s or early 40s in developed countries. The combination of these factors justifies the importance of fertility preservation and reproductive counselling at the time of breast cancer diagnosis in young women. A wide range of fertility preservation techniques has been developed, such as ovarian suppression, oocyte and embryo cryopreservation, immature oocyte retrieval and in vitro maturation, and ovarian tissue cryopreservation. Early counselling and referral of these patients to fertility specialists are fundamental factors in order to maximise their chances of pregnancy. This review aims to update the knowledge about the influence of breast cancer in fertility, the influence of pregnancy and fertility preservation techniques in breast cancer patients and assessment of ovarian reserve for a better treatment choice. A special section dedicated to BRCA-mutation carriers has been included because of their specific features. A comprehensive literature search has been conducted, including publications from the last five years.