Miracle-dz/UniFAR-FTUs huggingface dataset:
Traumatic flail chest injuries and the benefits of epidural analgesia

Introduction: Many poly-trauma patients sustain chest wall injuries. Flail chest is considered one of the uncommon injuries that may happen in traumatized patients and may increase morbidity and mortality in polytrauma patients. Pulmonary contusion, mechanical ventilation, pneumonia, sepsis and poor pain control are expected to be common complications in patients sustaining chest wall injuries. We hypothesize that the use of epidural analgesia can lead to improved clinical outcomes in this group of patients. Methodology: A retrospective study conducted for the years 2008 – 2013 for patients admitted to a level 1 trauma center (Figure 1). Patients were diagnosed with flail chest by clinical exam and imaging. Trauma registry was queried to study modalities of pain control; especially the use of epidural. We divided the patients to two groups; those who had received epidural analgesia and those who did not have epidural analgesia. A logistic regression model was developed to identify independent predictors of 30 days in hospital mortality. Results: 180 patients had flail chest; with a mean age was 57.4 years. There were 74.4% males. There were 43.3% who had a chest tube, 23.8% who developed pneumonia and 6.7% who had tracheostomy. 79 patients (44.4%) had epidural analgesia. ISS was 26.19 for patients with epidural analgesia and 30 for patients without epidural (p-value 0.02). The mean Hospital length of stay (LOS) was 18.46 days and the 30 days mortality was 3% for the epidural group V.S 10% for the non-epidural group (p-value 0.058). Logistic regression analysis for 30-day mortality revealed a significant association in the group with epidural analgesia for Age, ISS score, Hospital LOS and pneumonia. Conclusion: Epidural analgesia as pain control for patients with flail chest is understudied. This study demonstrates a significant statistical reduction in mortality with the use of epidural in patients diagnosed with flail chest sustained in a trauma setting. There was a significant statistical difference in ISS scores between both groups. This difference can be attributed to head injuries and other complications that may restrict the use of epidural analgesia. Further randomized studies are needed to evaluate the superior efficiency of epidural analgesia over standard pain control modalities in flail chest in trauma patients. Correspondence to: Alhadhrami B, MD, Royal Hospital, Muscat, Oman, E-mail: drbader85@hotmail.com
Homologous globin cell-free transcription system with comparison of heterologous factors

Mouse erythroleukemia (MEL) cells provide a useful model system to examine the regulation of globin gene expression. MEL cells ordinarily do not express globin genes, but in the presence of inducers, such as dimethyl sulfoxide or hexamethylene bisacetamide, they mimic erythroid differentiation. We have developed a cell-free transcription system from uninduced MEL cells to determine the requirements for mRNA synthesis. The MEL system directs accurate transcription of adenovirus type 2 major late DNA and mouse betamaj-globin with an efficiency comparable to those of HeLa and KB cell extracts. Using the procedure of Matsui et al. (T. Matsui, J. Segall, P.A. Weil, and R.G. Roeder, J. Biol. Chem. 255:11992-11996, 1980), we have isolated three active fractions from both MEL and HeLa cell extracts which are required for accurate transcription and have shown that equivalent fractions from MEL and HeLa cell extracts are interchangeable. Our findings suggest that the components required for initiation of transcription are similar in different cell types, at least to the extent that they can be assayed in these in vitro systems.
Redefining the Role of Langerhans Cells As Immune Regulators within the Skin

Langerhans cells (LC) are a unique population of tissue-resident macrophages that form a network of cells across the epidermis of the skin, but which have the ability to migrate from the epidermis to draining lymph nodes (LN). Their location at the skin barrier suggests a key role as immune sentinels. However, despite decades of research, the role of LC in skin immunity is unclear; ablation of LC results in neither fatal susceptibility to skin infection nor overt autoimmunity due to lack of immune regulation. Our understanding of immune processes has traditionally been centered on secondary lymphoid organs as sites of lymphocyte priming and differentiation, which is exemplified by LC, initially defined as a paradigm for tissue dendritic cells that migrate to draining LN on maturation. But, more recently, an awareness of the importance of the tissue environment in shaping effector immunity has emerged. In this mini-review, we discuss whether our lack of understanding of LC function stems from our lymph node-centric view of these cells, and question whether a focus on LC as immune regulators in situ in the skin may reveal clearer answers about their function in cutaneous immunology.
Speed-dependent treadmill training is effective to improve gait and balance performance in patients with sub-acute stroke.

OBJECTIVE To compare the effects of speed-dependent treadmill training on gait and balance performance in patients with sub-acute stroke. DESIGN Single-blinded randomized controlled trial. SUBJECTS A total of 26 patients with sub-acute stroke were randomly assigned to experimental (n = 13) and control (n = 13) groups. METHODS Subjects in the experimental group underwent short interval walking trials with stepwise increases in treadmill speed (speed-dependent treadmill training), following the principles of sprint training. Control subjects received gait training on the treadmill at a steady speed. Gait speed, stride length, cadence, and Berg's Balance Score were recorded and analysed before and after the 10 training sessions. RESULTS Results of 2-way repeated measures analysis of variance showed significant group×time interactions for gait speed and stride length (p < 0.05). Within each subject group there were improvements in all gait parameters and Berg’s Balance Score after the training programme. In addition, the experimental group showed significantly larger increases in gait speed (mean 0.15 m/s, 95% confidence interval 0.04–0.26) and stride length (mean 0.16 m, 95% confidence interval 0.02–0.30) than the control subjects. CONCLUSION Speed-dependent treadmill training in patients with sub-acute stroke resulted in larger gains in gait speed and stride length compared with steady speed. The positive findings provide evidence for clinical practice of speed-dependent treadmill training in enhancing gait function after stroke.
Developmental pattern of ventricular atrial natriuretic peptide (ANP) expression in chronically hypoxic rats as an indicator of the hypertrophic process.

Atrial natriuretic peptide (ANP) is a natriuretic, diuretic and vasodilatory peptide normally synthesized and secreted by the atria of the adult mammalian heart. Synthesis of ANP in the ventricle has also been demonstrated in the fetus and neonate. In the adult, ventricular ANP is expressed under pathological conditions such as hypertension and congestive heart failure. The purpose of the present study was to analyse the spatial and temporal development of ANP expression in the right ventricle of the rat heart during the onset, establishment, and recovery from hypoxia-induced pulmonary hypertension and right ventricular hypertrophy (RVH). Significant RVH and immunoreactive ANP (ir-ANP) were detected in the right ventricles of hypoxic rats after only 3 days of exposure and continued to increase with the duration of hypoxia through 21 days. The presence of ir-ANP became apparent in the left ventricle as well as the right after 14 days of hypoxic exposure. Twenty-one days of normoxia following 21 days of hypoxia reduced RVH and ir-ANP to the levels seen at 3 days. Light microscopic immunohistochemistry demonstrated initial focal concentrations of ir-ANP in cardiomyocytes near the junction of the right ventricular free wall and the septum, as well as surrounding isolated blood vessels in the right ventricular wall, after 3 days of exposure. With increasing duration of hypoxic exposure, these immunoreactive areas enlarged to encompass the entire right ventricular wall and right half of the septum by 14 days. While many right ventricular cardiomyocytes were intensely stained at the light level, electron microscopic immunocytochemistry revealed only a sparse number of ANP-positive secretory granules. In immunohistochemical studies with an anti-clathrin antibody, there was a homogeneous staining pattern for clathrin in cardiomyocytes from the hypertrophied right ventricles. This pattern was not typical of the staining observed in other secretory cells which typically exhibit a perinuclear localization of clathrin. The alterations in ultrastructural immunocytochemistry for ANP suggest that ventricular ANP synthesis differs from atrial synthesis of this peptide. The differences in clathrin staining indicate that its expression may also be related to the hypertrophic adaptation of ventricular cardiomyocytes. Our results suggest that ventricular ANP expression in the adult rat is a dynamic event which is regulated by stress in the ventricular wall. The initial sites of ventricular ANP expression may represent zones of maximum tension in the ventricular wall following increased workload. To our knowledge this is the first study to demonstrate topographical changes in ventricular ANP expression in response to the development and reversal of cardiac hypertrophy. (ABSTRACT TRUNCATED AT 400 WORDS)
Linear Order as Higher-Level Decision: Information Structure in Strategic and Tactical Generation

We propose a multilingual approach to characterizing word order at the clause level as a means to realize information structure. We illustrate the problem with three languages which differ in the degree of word order freedom they exhibit: Czech, a free word order language in which word order variation is pragmatically determined; English, a fixed word order language in which word order is primarily grammatically determined; and German, a language which is between Czech and English on the scale of word order freedom. Our work is theoretically rooted in previous work on information structuring and word order in the Prague School framework as well as on the systemic-functional notion of Theme. The approach we present has been implemented in KPML.
No detectable resistance to tenofovir disoproxil fumarate in HBeAg+ and HBeAg− patients with chronic hepatitis B after 8 years of treatment

A major hurdle in the long‐term treatment of chronic hepatitis B (CHB) patients is to maintain viral suppression in the absence of drug resistance. To date, no evidence of resistance to tenofovir disoproxil fumarate (TDF) has been observed. A cumulative evaluation of CHB patients who qualified for resistance surveillance over 8 years of TDF treatment was conducted. Patients in studies GS‐US‐174‐0102 (HBeAg−) and GS‐US‐174‐0103 (HBeAg+) were randomized 2:1 to receive TDF or adefovir dipivoxil (ADV) for 48 weeks followed by open‐label TDF through year 8. Population sequencing of HBV pol/RT was attempted for all TDF‐treated patients at baseline and, annually if viremic, at discontinuation, or with addition of emtricitabine. Overall, 88/641 (13.7%) patients qualified for sequence analysis at one or more time points. The percentage of patients qualifying for sequence analysis declined over time, from 9 to 11% in years 1‐2 to <4% over years 3‐8. Forty‐one episodes of virologic breakthrough (VB) occurred throughout the study, with most (n=29, 70%) associated with nonadherence to study medication. Fifty‐nine per cent of VB patients with an opportunity to resuppress HBV achieved HBV DNA resuppression. A minority of patients who qualified for sequencing had polymorphic (41/165, 24.8%) or conserved (17/165, 10.3%) site changes in pol/RT, with six patients developing lamivudine and/or ADV resistance‐associated mutations. No accumulation of conserved site changes was detected. The long‐term treatment of CHB with TDF monotherapy maintains effective suppression of HBV DNA through 8 years, with no evidence of TDF resistance or accumulation of conserved site changes.
A search based Sudoku solver

Sudoku is a popular puzzle. In this paper we detail constrain t s tisfaction search algorithms used to solve Sudoku problems. We sho w that a good value ordering heuristic helps solving problems. We also show tha t Limited Discrepancy search is a good alternative to the traditional Forward Checking algorithm. We have also found a phase transition for 25x25 Sudoku.
Car: a cytoplasmic sensor responsible for arginine chemotaxis in the archaeon Halobacterium salinarum

A new metabolic signaling pathway for arginine, both a chemoeffector and a fermentative energy source, is described for Halobacterium salinarum. Systematic screening of 80+ potentially chemotactic compounds with two behavioral assays identified leucine, isoleucine, valine, methionine, cysteine, arginine and several peptides as strong chemoattractants. Deletion analysis of a number of potential halobacterial transducer genes led to the identification of Car, a specific cytoplasmic arginine transducer which lacks transmembrane helices and was biochemically shown to be localized in the cytoplasm. Flow assays were used to show specific adaptive responses to arginine and ornithine in wild‐type but not Δcar cells, demonstrating the role of Car in sensing arginine. The signaling pathway from external arginine to the flagellar motor of the cell involves an arginine:ornithine antiporter which was quantitatively characterized for its transport kinetics and inhibitors. By compiling the chemotactic behavior, the adaptive responses and the characteristics of the arginine:ornithine antiporter to arginine and its analogs, we now understand how the combination of arginine uptake and its metabolic conversion is required to build an effective sensing system. In both bacteria and the archaea this is the first chemoeffector molecule of a soluble methylatable transducer to be identified.
GATA3-Driven Th2 Responses Inhibit TGF-β1–Induced FOXP3 Expression and the Formation of Regulatory T Cells

Transcription factors act in concert to induce lineage commitment towards Th1, Th2, or T regulatory (Treg) cells, and their counter-regulatory mechanisms were shown to be critical for polarization between Th1 and Th2 phenotypes. FOXP3 is an essential transcription factor for natural, thymus-derived (nTreg) and inducible Treg (iTreg) commitment; however, the mechanisms regulating its expression are as yet unknown. We describe a mechanism controlling iTreg polarization, which is overruled by the Th2 differentiation pathway. We demonstrated that interleukin 4 (IL-4) present at the time of T cell priming inhibits FOXP3. This inhibitory mechanism was also confirmed in Th2 cells and in T cells of transgenic mice overexpressing GATA-3 in T cells, which are shown to be deficient in transforming growth factor (TGF)-β–mediated FOXP3 induction. This inhibition is mediated by direct binding of GATA3 to the FOXP3 promoter, which represses its transactivation process. Therefore, this study provides a new understanding of tolerance development, controlled by a type 2 immune response. IL-4 treatment in mice reduces iTreg cell frequency, highlighting that therapeutic approaches that target IL-4 or GATA3 might provide new preventive strategies facilitating tolerance induction particularly in Th2-mediated diseases, such as allergy.
Exploitation of Empty Palm Fruit Bunch for the Generation of Electricity

Electricity is very important for the growth and economy of a country. Biomass wastes such as waste from oil palm plantation companies can be harnessed for this purpose since they are usually abundant in nature. The aim of this study is to evaluate the utilization of empty palm fruit bunch for the generation of electricity. The empty fruit bunch (EFB) was used in firing a steam turbine plant (boiler) for the generation of electricity. The power plant that was used in this research is owned by PRESCO Nigeria Limited located in Ikpoba-Okha local government area of Edo state. 1.7 MW of electricity was generated by burning empty fruit bunch (EFB) at a rate of 896 kg/h when the steam boiler was used. This value was compared with the traditional power plant fired using methane gas which produces 4.5MW. This value (1.7 MW) shows that EFB is a very good alternative for firing a boiler plant, power generation and elimination of wastes.
A 92.6 % tuning range VCO utilizing simultaneously controlling of transformers and MOS varactors in 0.13 µm CMOS technology

A novel resonant circuit consisting of transformer-based variable inductors and MOS varactors is proposed to implement an ultra-wideband voltage-controlled-oscillator (VCO). The VCO is designed and fabricated using 0.13 µm CMOS, and fully evaluated on wafer. The VCO IC exhibits a frequency tuning range as high as 92.6 % spanning from 1.2 GHz to 3.27 GHz. The measured phase noise of −120 dBc/Hz at 1 MHz offset from the 3.1 GHz carrier is obtained.
Handoff Performance in Wireless Mobile Networks with Unreliable Fading Channel

Handoff is an indispensable operation in wireless networks to guarantee continuous, effective, and resilient services during a mobile station (MS) mobility. Handoff counting, handoff rate, and handoff probability are important metrics to characterize the handoff performance. Handoff counting defines the number of handoff operations during an active call connection. Handoff rate specifies the expected number of handoff operations during an active call, or equivalently, the average handoff counting. Handoff probability refers to the probability that an MS will perform a handoff before call completion. In the literature, the fading channel is not incorporated in deriving these metrics. In addition, the teletraffic parameters are usually simplified into exponentially distributed variables for the sake of analytical tractability. In this paper, we derive the formulas for these metrics over Rayleigh fading. In particular, the results can demonstrate the explicit relationship between the handoff metrics and the physical layer characteristics, e.g., carrier frequency, maximum Doppler frequency, and fade margin. Furthermore, the formulas are developed with the generalized teletraffic parameters. Numerical examples are presented to demonstrate the impact of physical layer on the handoff metrics. The techniques and the results are significant for both deploying practical wireless networks and evaluating the system resilience over an unreliable radio channel.
Energy Balance of Triathletes during an Ultra-Endurance Event

The nutritional strategy during an ultra-endurance triathlon (UET) is one of the main concerns of athletes competing in such events. The purpose of this study is to provide a proper characterization of the energy and fluid intake during real competition in male triathletes during a complete UET and to estimate the energy expenditure (EE) and the fluid balance through the race. Methods: Eleven triathletes performed a UET. All food and drinks ingested during the race were weighed and recorded in order to assess the energy intake (EI) during the race. The EE was estimated from heart rate (HR) recordings during the race, using the individual HR-oxygen uptake (Vo2) regressions developed from three incremental tests on the 50-m swimming pool, cycle ergometer, and running treadmill. Additionally, body mass (BM), total body water (TBW) and intracellular (ICW) and extracellular water (ECW) were assessed before and after the race using a multifrequency bioimpedance device (BIA). Results: Mean competition time and HR was 755 ± 69 min and 137 ± 6 beats/min, respectively. Mean EI was 3643 ± 1219 kcal and the estimated EE was 11,009 ± 664 kcal. Consequently, athletes showed an energy deficit of 7365 ± 1286 kcal (66.9% ± 11.7%). BM decreased significantly after the race and significant losses of TBW were found. Such losses were more related to a reduction of extracellular fluids than intracellular fluids. Conclusions: Our results confirm the high energy demands of UET races, which are not compensated by nutrient and fluid intake, resulting in a large energy deficit.
Has the ozone hole contributed to increased Antarctic sea ice extent?

Since the 1970s sea ice extent has decreased dramatically in the Northern Hemisphere and increased slightly in the Southern Hemisphere, a difference that is potentially explained by ozone depletion in the Southern Hemisphere stratosphere. In this study we consider the impact of stratospheric ozone depletion on Antarctic sea ice extent using a climate model forced with observed stratospheric ozone depletion from 1979 to 2005. Contrary to expectations, our model simulates a year‐round decrease in Antarctic sea ice due to stratospheric ozone depletion. The largest percentage sea ice decrease in our model occurs in the austral summer near the coast of Antarctica, due to a mechanism involving offshore Ekman sea ice transport. The largest absolute decrease is simulated in the austral winter away from the coast of Antarctica, in response to an ocean warming that is consistent with a poleward shift of the large‐scale pattern of sea surface temperature. Our model results strongly suggest that processes not linked to stratospheric ozone depletion must be invoked to explain the observed increase in Antarctic sea ice extent.
Bargaining failures and merger policy ∗

We study approval rules in a model where horizontal merger proposals arise endogenously as the outcome of negotiations among the firms in the industry. We make two main points. First, relatively ineffi cient merger proposals succeed with positive probability. That is, the negotiation process may result in a particular merger agreement despite the existence of an alternative one that would generate higher profits and higher consumer surplus. Second, the antitrust authority should optimally commit to an approval rule that is more stringent for all mergers than the optimal ex-post rule.
Examining the relationship between age at first marriage, education and the timing of marital dissolution in Ghana.

"This study utilizes the family-life course perspective with survival tables and proportional hazard rate analysis to examine the timing patterns of marital dissolution in Ghana at various durations of marriage. Using data from the Ghana Fertility Survey (GFS) 1979/1980, this study has found evidence to support research from western industrial countries that young age at marriage compared to the cultural norm increases the probability of divorce. It is found that for those with no education, divorce rates are not affected by age at marriage, while for those with some education, later marriage leads to lower dissolution rates. "