Miracle-dz/UniFAR-FTUs huggingface dataset:
The Development of Tracheal Intubation Proficiency Outside the Operating Suite During Pediatric Critical Care Medicine Fellowship Training: A Retrospective Cohort Study Using Cumulative Sum Analysis

Objective: Tracheal intubation is a core technical skill for pediatric critical care medicine fellows. Limited data exist to describe current pediatric critical care medicine fellow tracheal intubation skill acquisition through the training. We hypothesized that both overall and first-attempt tracheal intubation success rates by pediatric critical care medicine fellows improve over the course of training. Design: Retrospective cohort study at a single large academic children’s hospital. Materials and Methods: The National Emergency Airway Registry for Children database and local QI database were merged for all tracheal intubations outside the Operating Suite by pediatric critical care medicine fellows from July 2011 to January 2015. Primary outcomes were tracheal intubation overall success (regardless of number of attempts) and first attempt success. Patient-level covariates were adjusted in multivariate analysis. Learning curves for each fellow were constructed by cumulative sum analysis. Results: A total of 730 tracheal intubation courses performed by 33 fellows were included in the analysis. The unadjusted overall and first attempt success rates were 87% and 80% during the first 3 months of fellowship, respectively, and 95% and 73%, respectively, during the past 3 months of fellowship. Overall success, but not first attempt success, improved during fellowship training (odds ratio for each 3 months, 1.08; 95% CI, 1.01–1.17; p = 0.037) after adjusting for patient-level covariates. Large variance in fellow’s tracheal intubation proficiency outside the operating suite was demonstrated with a median number of tracheal intubation equal to 26 (range, 19–54) to achieve a 90% overall success rate. All fellows who completed 3 years of training during the study period achieved an acceptable 90% overall tracheal intubation success rate. Conclusions: Tracheal intubation overall success improved significantly during the course of fellowship; however, the tracheal intubation first attempt success rates did not. Large variance existed in individual tracheal intubation performance over time. Further investigations on a larger scale across different training programs are necessary to clarify intensity and duration of the training to achieve tracheal intubation procedural competency.
Use of rice husk ash as filler in natural rubber vulcanizates: In comparison with other commercial fillers

Rice husk ash is mainly composed of silica and carbon black remaining from incomplete combustion. Both silica and carbon black have long been recognized as the main reinforcing fillers used in the rubber industry to enhance certain properties of rubber vulcanizates, such as modulus and tensile strength. In this study, two grades of rice husk ash (low- and high-carbon contents) were used as filler in natural rubber. Comparison was made of the reinforcing effect between rice husk ashes and other commercial fillers such as talcum, china clay, calcium carbonate, silica, and carbon black. Fourier transform infrared spectroscopy (FTIR) analysis was employed to study the presence of functional groups on the ash surface. The effect of silane coupling agent, bis(3-triethoxysilylpropyl)tetrasulfane (Si-69), on the properties of ash-filled vulcanizates was also investigated. It was found that both grades of rice husk ash provide inferior mechanical properties (tensile strength, modulus, hardness, abrasion resistance, and tear strength) in comparison with reinforcing fillers such as silica and carbon black. However, the mechanical properties of the vulcanizates filled with rice husk ash are comparable to those filled with inert fillers. The addition of silane-coupling agent has little effect on the properties of the ash-filled vulcanizates. This is simply due to the lack of silanol groups on the ash surface. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 83: 2485–2493, 2002
Matrix metalloproteinase‐7 as a marker of metastasis and predictor of poor survival in bladder cancer

Matrix metalloproteinases (MMPs) play an important role in tumor progression and metastasis. Here, we investigated the prognostic relevance of MMP‐7 in urinary bladder cancer. MMP‐7 gene expression was measured in tissue samples of 101 patients using quantitative real‐time PCR. Circulating MMP‐7 serum levels of 98 individuals (79 patients and 19 controls) were analyzed by enzyme‐linked immunosorbent assay. The results were compared with the clinical follow‐up data, performing Kaplan–Meier log‐rank test as well as univariate and multivariate Cox analysis. In representative cases, immunohistochemical analysis for MMP‐7 was performed. We detected significantly elevated MMP‐7 levels both in tissue and serum samples of patients with metastatic disease (P = 0.001 and P = 0.002). Multivariate analysis revealed that high MMP‐7 tissue expression and serum concentration are stage‐ and grade‐independent predictors of both metastasis‐free (hazard ratio [HR] = 3.80, 95% confidence interval [CI], 1.29–11.23, P = 0.016, and HR = 2.53, 95% CI, 1.01–6.37, P = 0.048) and disease‐specific survival (HR = 1.89, 95% CI, 1.00–3.55, P = 0.050 and HR = 1.95, 95% CI, 1.03–3.71, P = 0.041). Based on these findings, we conclude that MMP‐7 is a promising marker to detect present and to predict future metastasis. Serum MMP‐7 analysis provides information about the risk of metastasis before surgery which could help to optimize therapeutic procedures. Furthermore, high MMP‐7 tissue and/or serum levels could identify patients most likely to benefit from early adjuvant chemotherapy.
The Cytoplasmic Domain of the Hyaluronan Receptor for Endocytosis (HARE) Contains Multiple Endocytic Motifs Targeting Coated Pit-mediated Internalization*

The hyaluronic acid (HA) receptor for endocytosis (HARE) is the primary scavenger receptor for HA and chondroitin sulfates in mammals. The two human isoforms of HARE (full-length 315-kDa and a 190-kDa proteolytic cleavage product), which are type I single-pass membrane proteins, are highly expressed in sinusoidal endothelial cells of lymph nodes, liver, and spleen. Their identical HARE cytoplasmic domains contain four candidate AP-2/clathrin-mediated endocytic signaling motifs as follows: YSYFRI2485, FQHF2495, NPLY2519, and DPF2534 (315-HARE numbering). Stably transfected cells expressing 190-HARE(ΔYSYFRI), 190-HARE(ΔFQHF), or 190-HARE(ΔNPLY) (lacking Motifs 1, 2, or 3) had decreased 125I-HA endocytosis rates of ∼49, ∼39, and ∼56%, respectively (relative to wild type). In contrast, 190-HARE(ΔDPF) cells (lacking Motif 4) showed no change in HA endocytic rate. Deletions of motifs 1 and 2 or of 1, 2, and 4 decreased the rate of HA endocytosis by only ∼41%. Endocytosis was ∼95% decreased in mutants lacking all four motifs. Cells expressing a 190-HARE(Y2519A) mutant of the NPLY motif retained 85–90% of wild type endocytosis, whereas this mutation in the triple motif deletant decreased endocytosis to ∼7% of wild type. Tyr in NPLY2519 is thus important for endocytosis. All HARE mutants showed similar HA binding and degradation of the internalized HA, indicating that altering endocytic motifs did not affect ectodomain binding of HA or targeting of internalized HA to lysosomes. We conclude that, although NPLY may be the most important motif, it functions together with two other endocytic motifs; thus three signal sequences (YSYFRI, FQHF, and NPLY) provide redundancy to mediate coated pit targeting and endocytosis of HARE.
Tannin-Based Carbon Foams for Electromagnetic Applications

Broadband dielectric analysis of tannin-based carbon foams produced at nine different densities, ranging from 0.036 to 0.114 g/cm3, was carried out in wide frequency (20 Hz-35 GHz) and temperature (25-500 K) ranges. Both dielectric constant and electrical conductivity of carbon foams in quasi-static regime, at 129 Hz, were high (more than 106 and close to 70 S/m, respectively), and increased with carbon foams density according to power laws. Significant electromagnetic interference shielding efficiency (EMI SE) was found at microwave (MW) frequencies for all produced samples. The highest value of electromagnetic attenuation at the level of 20 dB for 2-mm thick sample was observed for the foam having the highest density and the lowest mean cell size. For thicker samples (4 mm and 1 cm), EMI SE reached 39 and 73 dB, respectively. On cooling, dc conductivity decreased with temperature according to Mott's law but foams still remained opaque to the MW radiation. MW performances of carbon foams reported here, along with other valuable properties such as “green” origin, low price, lightness, chemical inertness, thermal stability and high conductivity, open new routes for producing effective EMI shields from tannin-based carbonaceous porous structures.
Serum Lipid Levels and the Risk of Venous Thrombosis

Objective—Lipids, through effects on the coagulation and fibrinolytic systems, may contribute to the development of venous thrombosis. This association has been investigated in a few studies, with conflicting results. Methods and Results—We conducted a population-based, case-control study at a health maintenance organization in Washington State, to assess the association of serum lipid levels with the risk of venous thrombosis. Cases were 477 postmenopausal women with a first venous thrombosis during January 1995 through December 2001. Control subjects (1986) were a random sample of postmenopausal women. Medical records, computerized pharmacy databases, and a cancer registry served to collect data on lipid levels and risk factors for thrombosis. Total cholesterol levels were not associated with venous thrombosis. Only high HDL cholesterol levels were associated with a decreased risk of venous thrombosis after adjustment for hospitalization, malignancy, height and weight, postmenopausal hormone therapy, and vascular disease (for high-density lipoprotein [HDL] cholesterol levels >1.79 mmol/L versus those <1.79 mmol/L; odds ratio [OR], 0.71; 95% confidence interval [CI], 0.52 to 0.97). In contrast, elevated triglyceride levels were associated with an increased risk (OR, 2.13; 95% CI, 1.34 to 3.37) for women with triglyceride levels >1.05 mmol/L compared with women with lower levels. Conclusion—Elevated triglyceride levels were associated with a doubling of risk of venous thrombosis in postmenopausal women, whereas elevated HDL cholesterol levels were associated with a decreased risk.
Spectrotemporal Response Properties of Core Auditory Cortex Neurons in Awake Monkey

So far, most studies of core auditory cortex (AC) have characterized the spectral and temporal tuning properties of cells in non-awake, anesthetized preparations. As experiments in awake animals are scarce, we here used dynamic spectral-temporal broadband ripples to study the properties of the spectrotemporal receptive fields (STRFs) of AC cells in awake monkeys. We show that AC neurons were typically most sensitive to low ripple densities (spectral) and low velocities (temporal), and that most cells were not selective for a particular spectrotemporal sweep direction. A substantial proportion of neurons preferred amplitude-modulated sounds (at zero ripple density) to dynamic ripples (at non-zero densities). The vast majority (>93%) of modulation transfer functions were separable with respect to spectral and temporal modulations, indicating that time and spectrum are independently processed in AC neurons. We also analyzed the linear predictability of AC responses to natural vocalizations on the basis of the STRF. We discuss our findings in the light of results obtained from the monkey midbrain inferior colliculus by comparing the spectrotemporal tuning properties and linear predictability of these two important auditory stages.
Corrigendum to “Discounted Stochastic Games With No Stationary Nash Equilibrium: Two Examples”

Levy (2013) presented examples of discounted stochastic games that do not have stationary equilibria. The second named author has pointed out that one of these examples is incorrect. In addition to describing the details of this error, this note presents a new example by the first named author that succeeds in demonstrating that discounted stochastic games with absolutely continuous transitions can fail to have stationary equilibria.
Extending the MR‐Egger method for multivariable Mendelian randomization to correct for both measured and unmeasured pleiotropy

Methods have been developed for Mendelian randomization that can obtain consistent causal estimates while relaxing the instrumental variable assumptions. These include multivariable Mendelian randomization, in which a genetic variant may be associated with multiple risk factors so long as any association with the outcome is via the measured risk factors (measured pleiotropy), and the MR‐Egger (Mendelian randomization‐Egger) method, in which a genetic variant may be directly associated with the outcome not via the risk factor of interest, so long as the direct effects of the variants on the outcome are uncorrelated with their associations with the risk factor (unmeasured pleiotropy). In this paper, we extend the MR‐Egger method to a multivariable setting to correct for both measured and unmeasured pleiotropy. We show, through theoretical arguments and a simulation study, that the multivariable MR‐Egger method has advantages over its univariable counterpart in terms of plausibility of the assumption needed for consistent causal estimation and power to detect a causal effect when this assumption is satisfied. The methods are compared in an applied analysis to investigate the causal effect of high‐density lipoprotein cholesterol on coronary heart disease risk. The multivariable MR‐Egger method will be useful to analyse high‐dimensional data in situations where the risk factors are highly related and it is difficult to find genetic variants specifically associated with the risk factor of interest (multivariable by design), and as a sensitivity analysis when the genetic variants are known to have pleiotropic effects on measured risk factors.
Dismantling the Myth of ‘ ‘ Autoanticoagulation ’ ’ in Cirrhosis : An Old Dogma Dies Hard

Autophagy is a cellular catabolic process that relies on the cooperation of autophagosomes and lysosomes. During starvation, the cell expands both compartments to enhance degradation processes. We found that starvation activates a transcriptional program that controls major steps of the autophagic pathway, including autophagosome formation, autophagosomelysosome fusion, and substrate degradation. The transcription factor EB (TFEB), a master gene for lysosomal biogenesis, coordinated this program by driving expression of autophagy and lysosomal genes. Nuclear localization and activity of TFEB were regulated by serine phosphorylation mediated by the extracellular signal-regulated kinase 2, whose activity was tuned by the levels of extracellular nutrients. Thus, a mitogen-activated protein kinase-dependent mechanism regulates autophagy by controlling the biogenesis and partnership of two distinct cellular organelles.
The bone marrow functionally contributes to liver fibrosis.

BACKGROUND & AIMS Bone marrow (BM) cells may transdifferentiate into or fuse with organ parenchymal cells. BM therapy shows promise in murine models of cirrhosis, and clinical trials of bone marrow stem cell therapy for organ healing are underway. However, the BM may contribute to scar-forming myofibroblasts in various organs including the liver. We have studied this axis of regeneration and scarring in murine models of cirrhosis, including an assessment of the temporal and functional contribution of the BM-derived myofibroblasts. METHODS Female mice were lethally irradiated and received male BM transplants. Carbon tetrachloride or thioacetamide was used to induce cirrhosis. BM-derived cells were tracked through in situ hybridization for the Y chromosome. BM transplants from 2 strains of transgenic mice were used to detect intrahepatic collagen production. RESULTS In the cirrhotic liver, the contribution of BM to parenchymal regeneration was minor (0.6%); by contrast, the BM contributed significantly to hepatic stellate cell (68%) and myofibroblast (70%) populations. These BM-derived cells were found to be active for collagen type 1 transcription in 2 independent assays and could influence the fibrotic response to organ injury. These BM-derived myofibroblasts did not occur through cell fusion between BM-derived cells and indigenous hepatic cells but, instead, originated largely from the BM's mesenchymal stem cells. CONCLUSIONS The BM contributes functionally and significantly to liver fibrosis and is a potential therapeutic target in liver fibrosis. Clinical trials of BM cell therapy for liver regeneration should be vigilant for the possibility of enhanced organ fibrosis.
Elevated α-synuclein mRNA levels in individual UV-laser-microdissected dopaminergic substantia nigra neurons in idiopathic Parkinson's disease

The presynaptic protein α-synuclein is involved in several neurodegenerative diseases, including Parkinson's disease (PD). In rare familial forms of PD, causal mutations (PARK1) as well as multiplications (PARK4) of the α-synuclein gene have been identified. In sporadic, idiopathic PD, abnormal accumulation and deposition of α-synuclein might also cause degeneration of dopaminergic midbrain neurons, the clinically most relevant neuronal population in PD. Thus, cell-specific quantification of α-synuclein expression-levels in dopaminergic neurons from idiopathic PD patients in comparison to controls would provide essential information about contributions of α-synuclein to the etiology of PD. However, a number of previous studies addressing this question at the tissue-level yielded varying results regarding α-synuclein expression. To increase specificity, we developed a cell-specific approach for mRNA quantification that also took into account the important issue of variable RNA integrities of the individual human postmortem brain samples. We demonstrate that PCR –amplicon size can confound quantitative gene-expression analysis, in particular of partly degraded RNA. By combining optimized UV-laser microdissection- and quantitative RT–PCR-techniques with suitable PCR assays, we detected significantly elevated α-synuclein mRNA levels in individual, surviving neuromelanin- and tyrosine hydroxylase-positive substantia nigra dopaminergic neurons from idiopathic PD brains compared to controls. These results strengthen the pathophysiologic role of transcriptional dysregulation of the α-synuclein gene in sporadic PD.
Understanding the High Temperature Corrosion Behavior of Modified 13%Cr Martenistic OCTG

Recent efforts by manufacturers of OCTG have led to the development of several new grades of modified or `supermartensitic` tubulars. The main feature of these products is improved corrosion performance at high temperatures (above 13O C), i.e. in conditions which standard 13Cr, based on type 420 chemistry, corrodes at a rate too high to permit its use. In order to study these new materials, laboratory corrosion tests have been conducted, in conditions in which the standard 13Cr (API 5CT L80) suffers severe corrosion. The H{sub 2}S partial pressure in these tests was in the range 0.01---0.1 bar (1--10 kPa). It was found that the general corrosion rate of the modified alloy was approximately one-tenth of that of the standard 13Cr, and the pitting rate was reduced by a factor of 3--4. Observation of the samples after test revealed the presence of colored interference films on the modified materials, whereas the standard 13Cr was different in having a corrosion product on its surface. This was less adherent and protective than the film on the modified martensitics. Electrochemical testing has confirmed that the corrosion behavior of the modified martensitics falls between that of the standard 13Cr (which tends to corrode generally) andmore » that of 22Cr duplex in the same conditions (which is fully passive). « less
Regular Synthesis and Sufficiency Conditions for Optimality

We propose a definition of "regular synthesis" that is more general than those suggested by other authors such as Boltyanskii [SIAM J. Control Optim, 4 (1966), pp. 326--361] and Brunovský [Math. Slovaca, 28 (1978), pp. 81--100], and an even more general notion of "regular presynthesis. " We give a complete proof of the corresponding sufficiency theorem, a slightly weaker version of which had been stated in an earlier article, with only a rough outline of the proof. We illustrate the strength of our result by showing that the optimal synthesis for the famous Fuller problem satisfies our hypotheses. We also compare our concept of synthesis with the simpler notion of a "family of solutions of the closed-loop equation arising from an optimal feedback law," and show by means of examples why the latter is inadequate, and why the difficulty cannot be resolved by using other concepts of solution---such as Filippov solutions, or the limits of sample-and-hold solutions recently proposed as feedback solutions by Clarke et al. [IEEE Trans. Automat. Control, 42 (1997), pp. 1394--1407]---for equations with a non-Lipschitz and possibly discontinuous right-hand side.
Traveling Wave Solutions of a Mathematical Model for Tumor Encapsulation

The formation of a capsule of dense, fibrous extracellular matrix around a solid tumor is a key prognostic indicator in a wide range of cancers. However, the cellular mechanisms underlying capsule formation remain unclear. One hypothesized mechanism is the "expansive growth hypothesis," which suggests that a capsule may form by the rearrangement of existing extracellular matrix, without new matrix production. A mathematical model was recently proposed to study the implications of this hypothesis [Perumpanani, Sherratt, and Norbury, Nonlinearity, 10 (1997), pp. 1599--1614]. The model consists of conservation equations for tumor cells and extracellular matrix and exhibits traveling wave solutions in which a pulse of extracellular matrix, corresponding to a capsule, moves in parallel with the advancing front of the tumor. In this paper the author presents a detailed study of traveling wave behavior in the model, deriving conditions for the existence of traveling waves and their key properties. Numerical meth.
Predilection of the macular region to high incidence of choroidal neovascularization after intense laser photocoagulation in the monkey.

OBJECTIVE To determine the key factors for creating a high incidence model of choroidal neovascularization (CNV) in the monkey. METHODS Intense laser photocoagulation was performed in 8 eyes of 4 monkeys using krypton red and green-yellow and Alcon frequency-doubled diode ophthalmic lasers. Eight to 13 lesions were delivered to an area between the temporal vascular arcades in each eye. Development of CNV was monitored by fluorescein angiography at 2 and 4 weeks after laser treatment, and the results were correlated with histological analysis. RESULTS A much higher incidence of CNV occurred in the macular region, which refers to an anatomic area equivalent to a mean +/- SD 2.5 +/- 0.4 times the horizontal diameter of the optic disc in the fundus. Regardless of the type of ophthalmic laser used, 72% of lesions developed fluorescein leakage within the macula, compared with 12% outside the macula (P<.001). By histological analysis, 89% of lesions developed microscopic CNV within the macula vs 22% outside the macula (P<.001). CONCLUSION The macular region is predisposed to creation of laser-induced CNV in the monkey.Clinical Relevance The predilection of the macular region to a high incidence of laser-induced CNV may account for the high recurrence rate of subfoveal CNV after laser treatment in humans.