Miracle-dz/UniFAR-FTUs huggingface dataset:
Tetralogy of Fallot repair: optimal z-score use for transannular patch insertion.

OBJECTIVES Transannular patching is used to relieve significant pulmonary annular stenosis during tetralogy of Fallot repair. Although recent literature has focused on the deleterious effects of pulmonary regurgitation, inadequate relief of stenosis may increase postoperative mortality and the re-intervention rate. Patching criteria based on pulmonary annular z-scores are ambiguous because of the use of varied z-score data sets. This study aimed to generate data that could be used to optimize z-score use for patch insertion. METHODS A retrospective review was made of medical records of patients who had a valve-sparing repair of tetralogy of Fallot between 1 January 2000 and 31 December 2010. In a selected group in which the residual gradient was confined to the pulmonary valve, the post-repair peak pressure gradient was determined by trans-thoracic echocardiography and was correlated with the intra-operative pulmonary valve annulus (PVA) diameter z-score. Regression analysis was used to examine this relationship. RESULTS Data from 46 patients with valve-sparing repair were reviewed; the median age and median weight were 6.5 months and 6.6 kg, respectively; the 30-day mortality was 2.2%. Analysis of these data implies that 25% of the time, all patients with a PVA z-score of -1.3 would have a PVA gradient ≥30 mmHg. CONCLUSIONS Criteria that recommend a transannular patch insertion only when the PVA diameter z-score is significantly smaller than -1.3 (e.g. -3) may result in a significant number of patients with an unacceptable post-repair PVA gradient.
Medical Information on the Internet: A Tool for Measuring Consumer Perception of Quality Aspects

Background Most of adult Internet users have searched for health information on the Internet. The Internet has become one of the most important sources for health information and treatment advice. In most cases, the information found is not verified with a medical doctor, but judged by the “online-diagnosers” independently. Facing this situation, public health authorities raise concern over the quality of medical information laypersons can find on the Internet. Objective The objective of the study was aimed at developing a measure to evaluate the credibility of websites that offer medical advice and information. The measure was tested in a quasi-experimental study on two sleeping-disorder websites of different quality. Methods There were 45 survey items for rating the credibility of websites that were tested in a quasi-experimental study with a random assignment of 454 participants to either a high- or a low-quality website exposure. Using principal component analysis, the original items were reduced to 13 and sorted into the factors: trustworthiness, textual deficits of the content, interferences (external links on the Web site), and advertisements. The first two factors focus more on the provided content itself, while the other two describe the embedding of the content into the website. The 45 survey items had been designed previously using exploratory observations and literature research. Results The final scale showed adequate power and reliability for all factors. The loadings of the principal component analysis ranged satisfactorily (.644 to .854). Significant differences at P<. 001 were found between the low- and high-quality groups. Advertisements on the website were rated as disturbing in both experimental conditions, meaning that they do not differentiate between good and bad information. Conclusions The scale reliably distinguished high- and low-quality of medical advice given on websites.
Central Nervous System Complications in Children Receiving Chemotherapy or Hematopoietic Stem Cell Transplantation

Therapy-related neurotoxicity greatly affects possibility of survival and quality of life of pediatric patients treated for cancer. Central nervous system (CNS) involvement is heterogeneous, varying from very mild and transient symptoms to extremely severe and debilitating, or even lethal syndromes. In this review, we will discuss the broad scenario of CNS complications and toxicities occurring during the treatment of pediatric patients receiving both chemotherapies and hematopoietic stem cell transplantation. Different types of complications are reviewed ranging from therapy related to cerebrovascular with a specific focus on neuroradiologic and clinical features.
Rapid short-term cooling following the Chicxulub impact at the Cretaceous–Paleogene boundary

Significance Here, for the first time (to our knowledge), we are able to demonstrate unambiguously that the impact at the Cretaceous–Paleogene boundary (K–Pg, ∼66 Mya) was followed by a so-called “impact winter. ” This impact winter was the result of the injection of large amounts of dust and aerosols into the stratosphere and significantly reduced incoming solar radiation for decades. Therefore, this phase will have been a key contributory element in the extinctions of many biological clades, including the dinosaurs. The K–Pg boundary impact presents a unique event in Earth history because it caused global change at an unparalleled rate. This detailed portrayal of the environmental consequences of the K–Pg impact and aftermath aids in our understanding of truly rapid climate change. The mass extinction at the Cretaceous–Paleogene boundary, ∼66 Ma, is thought to be caused by the impact of an asteroid at Chicxulub, present-day Mexico. Although the precise mechanisms that led to this mass extinction remain enigmatic, most postulated scenarios involve a short-lived global cooling, a so-called “impact winter” phase. Here we document a major decline in sea surface temperature during the first months to decades following the impact event, using TEX86 paleothermometry of sediments from the Brazos River section, Texas. We interpret this cold spell to reflect, to our knowledge, the first direct evidence for the effects of the formation of dust and aerosols by the impact and their injection in the stratosphere, blocking incoming solar radiation. This impact winter was likely a major driver of mass extinction because of the resulting global decimation of marine and continental photosynthesis.
Deletion of Flagellin’s Hypervariable Region Abrogates Antibody-Mediated Neutralization and Systemic Activation of TLR5-Dependent Immunity1

TLRs trigger immunity by detecting microbe-associated molecular patterns (MAMPs). Flagellin is a unique MAMP because it harbors 1) an antigenic hypervariable region and 2) a conserved domain involved in TLR5-dependent systemic and mucosal proinflammatory and adjuvant activities. In this study, the contribution of the flagellin domains in TLR5 activation was investigated. We showed that TLR5 signaling can be neutralized in vivo by flagellin-specific Abs, which target the conserved domain. However, deletions of flagellin’s hypervariable region abrogated the protein’s intrinsic ability to trigger the production of neutralizing Abs. The fact that MAMP-specific Abs block TLR-mediated responses shows that this type of neutralization is a novel mechanism for down-regulating innate immunity. The stimulation of mucosal innate immunity and adjuvancy to foreign Ag was not altered by the hypervariable domain deletions. In contrast, this domain is essential to trigger systemic innate immunity, suggesting that there are distinct mechanisms for TLR5 activation in systemic and mucosal compartments. In summary, specific MAMP determinants control the production of neutralizing Abs and the compartmentalization of innate responses.
Racial and Social Class Differences in How Parents Respond to Inadequate Achievement: Consequences for Children's Future Achievement.

OBJECTIVE Despite numerous studies on parental involvement in children's academic schooling, there is a dearth of knowledge on how parents respond specifically to inadequate academic performance. This study examines whether 1) racial differences exist in parenting philosophy for addressing inadequate achievement, 2) social class has implications for parenting philosophy, and 3) parents' philosophies are consequential for children's academic achievement. METHODS Using data from the Child Development Supplement (N=1041) to the Panel Study of Income Dynamics, we sort parents into two categories-those whose parenting repertoires for addressing poor achievement include punitive responses and those whose repertoires do not. We then determine whether racial differences exist between these categories and how various responses within the aforementioned categories are related to students' academic achievement. RESULTS The findings show that white and black parents have markedly different philosophies on how to respond to inadequate performance, and these differences appear to impact children's achievement in dramatically different ways. CONCLUSION Educators and policy makers should pay particular attention to how parents respond to inadequate achievement as imploring parents of inadequately performing students to be more involved without providing them with some guidance might exacerbate the problem.
enBudget: A Run-Time Adaptive Predictive Energy-Budgeting scheme for energy-aware Motion Estimation in H.264/MPEG-4 AVC video encoder

The limited energy resources in portable multimedia devices require the reduction of encoding complexity. The complex Motion Estimation (ME) scheme of H.264/MPEG-4 AVC accounts for a major part of the encoder energy. In this paper we present a Run-Time Adaptive Predictive Energy Budgeting (enBudget) scheme for energy-aware ME that predicts the energy budget for different video frames and different Macroblocks (MBs) in an adaptive manner considering the run-time changing scenarios of available energy, video frame characteristics, and user-defined coding constraints while keeping a good video quality. It assigns different Energy-Quality Classes to different video frames and fine-tunes at MB level depending upon the predictive energy quota in order to cope with above-mentioned run-time unpredictable scenarios. Compared to UMHexagonS, EPZS, and FastME, our enBudget scheme for energy-aware ME achieves an energy saving of up to 93%, 90%, 88% (average 88%, 77%, 66%), respectively. It suffers from an average Peak Signal to Noise Ratio (PSNR) loss of 0.29 dB compared to Full Search. We also demonstrate that enBudget is equally beneficial to various other state-of-the-art fast adaptive MEs (e.g.). We have evaluated our scheme for ASIC and various FPGAs.
Renin inhibition by soyasaponin I: a potent native anti-hypertensive compound

One way to control hypertension is inactivation of the Renin- Angiotensin- Aldosterone System (RAAS). Inhibition of renin as a rate-limiting step of this system is an effective way to stop up RAAS. It has been proved that soyasaponin I, an herbal compound obtained from soybeans, has anti-hypertensive effect via renin inhibition, so it has the potential of being an anti-hypertensive drug. Herein, some theoretical approaches such as Docking Simulation, Molecular Dynamics (MD) Simulation and MMPBSA analysis have been used to study how soyasaponin I inhibits renin at the structural level. The results of docking simulation and hydrogen bond pattern show that this ligand is able to bind to the active site of renin and a region near the active site. Results of MD simulation for renin – soyasaponin I complexes confirm that soyasaponin I binds to the active site of renin and has inhibition effect on it via competing with the substrate. Besides, according to MMPBSA analysis, the binding free energy for renin – soyasaponin I complex is −42.61 kcal/mol when it binds to the active site. Comparing to the peptide obtained from angiotensinogen, ΔG = −74.96 kcal/mol, it may inferred that although binding of soyasaponin I to the active site of renin does not have a complete competition with the substrate, it might attenuate the formation of renin – angiotensinogen complex and have partial non-competitive effect. The results of this survey might be helpful to design partial non – competitive renin inhibitors with pharmaceutical capability.
Intrinsic, Extrinsic, and Integrative Orientations of French Canadian Learners of English.

The present study had two purposes: (a) to replicate previous research on intrinsic and extrinsic motivation for language learning in French Canadian students of English, and (b) to consider the relations between intrinsic and extrinsic motivation and the integrative orientation. Quebecois university students (N = 59) in a summer English immersion course completed a questionnaire addressing their reasons for language learning, perceptions of autonomy and competence, effort expended in language learning, determination to pursue English studies, and course achievement. The results of correlational analyses supported the predicted relations between theoretical antecedents and consequences of intrinsic and extrinsic orientations. The integrative orientation correlated most strongly with the intrinsic orientation. The results are discussed in terms of the implications of these orientations for language learning outcomes.
Long-Term Frequency Gradients During Persistent Atrial Fibrillation in Sheep Are Associated With Stable Sources in the Left Atrium

Background— Dominant frequencies (DFs) of activation are higher in the atria of patients with persistent than paroxysmal atrial fibrillation (AF), and left atrial (LA)-to-right atrial (RA) DF gradients have been identified in both. However, whether such gradients are maintained as long-term persistent AF is established remains unexplored. We aimed at determining in vivo the time course in atrial DF values from paroxysmal to persistent AF in sheep and testing the hypothesis that an LA-to-RA DF difference is associated with LA drivers in persistent AF. Methods and Results— AF was induced using RA tachypacing (n=8). Electrograms were obtained weekly from an RA lead and an implantable loop recorder implanted near the LA. DFs were determined for 5-second-long electrograms (QRST subtracted) during AF in vivo and in ex vivo optical mapping. Underlying structural changes were compared with weight-matched controls (n=4). After the first AF episode, DF increased gradually during a 2-week period (7±0.21 to 9.92±0.31 Hz; n=6; P<0.05). During 9 to 24 weeks of AF, the DF values on the implantable loop recorder were higher than the RA (10.6±0.08 versus 9.3±0.1 Hz, respectively; n=7; P<0.0001). Subsequent optical mapping confirmed a DF gradient from posterior LA-to-RA (9.1±1.0 to 6.9±0.9 Hz; P<0.05) and demonstrated patterns of activation compatible with drifting rotors in the posterior LA. Persistent AF sheep showed significant enlargement of the posterior LA compared with controls. Conclusions— In the sheep, transition from paroxysmal to persistent AF shows continuous LA-to-RA DF gradients in vivo together with enlargement of the posterior LA, which harbors the highest frequency domains and patterns of activation compatible with drifting rotors.
Eosinophilic esophagitis in children following cardiac transplantation: Association with post‐transplant lymphoproliferative disorder and other transplant outcomes

Although cardiac transplantation is life‐saving, morbidities from immunosuppression are significant. EoE is a complication of calcineurin inhibitors following liver transplant causing feeding intolerance, weight loss, vomiting, and dysphagia. There are limited reports of EoE following heart transplantation. We performed a retrospective single‐center review of pediatric cardiac transplant patients from 2000 to 2010. A case–control analysis of patients with and without EoE was performed evaluating heart transplantation outcomes such as rates of rejection, CAV, PTLD, and graft loss. Eighty‐six transplants were performed in 84 patients; 34 (40%) underwent diagnostic endoscopy, and 10 (12%) had EoE. Median time to diagnosis of EoE was 3.7 yr (IQR: 2.0–5.2). There were no differences in demographics or use of induction medications between patients with or without EoE. Patients with EoE had fewer episodes of treated rejection (1.0 vs. 2.5; p = 0.04). Four of 10 (40%) EoE patients had PTLD compared with only 2/24 (8%) of those without EoE (p = 0.048; OR 7.33 [95% CI: 1.1–50.2]). There were no differences in CAV or graft loss between groups. EoE should be considered as a cause of GI symptoms in children after cardiac transplantation and may be associated with fewer rejection episodes and increased rates of PTLD, thus representing a marker of over‐immunosuppression.
The envirome and the connectome: exploring the structural noise in the human brain associated with socioeconomic deprivation

Complex cognitive functions are widely recognized to be the result of a number of brain regions working together as large-scale networks. Recently, complex network analysis has been used to characterize various structural properties of the large-scale network organization of the brain. For example, the human brain has been found to have a modular architecture i.e., regions within the network form communities (modules) with more connections between regions within the community compared to regions outside it. The aim of this study was to examine the modular and overlapping modular architecture of the brain networks using complex network analysis. We also examined the association between neighborhood level deprivation and brain network structure—modularity and gray nodes. We compared network structure derived from anatomical MRI scans of 42 middle-aged neurologically healthy men from the least (LD) and the most deprived (MD) neighborhoods of Glasgow with their corresponding random networks. Cortical morphological covariance networks were constructed from the cortical thickness derived from the MRI scans of the brain. For a given modularity threshold, networks derived from the MD group showed similar number of modules compared to their corresponding random networks, while networks derived from the LD group had more modules compared to their corresponding random networks. The MD group also had fewer gray nodes—a measure of overlapping modular structure. These results suggest that apparent structural difference in brain networks may be driven by differences in cortical thicknesses between groups. This demonstrates a structural organization that is consistent with a system that is less robust and less efficient in information processing. These findings provide some evidence of the relationship between socioeconomic deprivation and brain network topology.
Bumetanide As a Candidate Treatment for Behavioral Problems in Tuberous Sclerosis Complex

Background Recent studies indicate excitatory GABA action in and around tubers in patients with tuberous sclerosis complex (TSC). This may contribute to recurrent seizures and behavioral problems that may be treated by agents that enhance GABAergic transmission by influencing chloride regulation. Case presentation Here, we used the chloride transporter antagonist bumetanide to treat a female adolescent TSC patient with refractory seizures, sensory hyper-reactivity, and a variety of repetitive and compulsive behaviors. Methods To evaluate the effect of bumetanide on behavior, auditory sensory processing, and hyperexcitability, we obtained questionnaire data, event-related potentials (ERP), and resting state EEG at baseline, after 3 and 6 months of treatment and after 1 month washout period. Discussion Six months of treatment resulted in a marked improvement in all relevant behavioral domains, as was substantiated by the parent questionnaires. In addition, resting-state electroencephalography and ERP suggested a favorable effect of bumetanide on hyperexcitability and sensory processing. These findings encourage further studies of bumetanide on neuropsychiatric outcome in TSC.
Elevated plasma matrix metalloproteinase-9 protein and its gene polymorphism in patients with community-acquired pneumonia

Abstract Background: The purpose here was to detect the association among plasma matrix metalloproteinase-9 (MMP-9) concentration, single nucleotide polymorphisms (SNPs) of MMP-9 gene and community-acquired pneumonia (CAP). Methods: The enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were, respectively used to measure the plasma MMP-9 level and its gene polymorphisms. Results: The level of plasma of MMP-9 was elevated in patients with CAP as compared to that of normal controls and decreased significantly after treatment. Plasma MMP-9 concentration was significantly correlated with white blood cell (WBC) and neutrophil counts in patients with CAP. No significant difference was found in the genotypes distribution of MMP-9 SNPs, rs3918242, rs17576 or rs2274756, between patients with CAP and normal controls. Plasma MMP-9 concentration was not associated with MMP-9 polymorphism. When the cut-off level of the plasma MMP-9 concentration was set to be 105.02 ng/mL, the odds ratio of plasma MMP-9 for CAP risk was 9.86 (95% confident interval: 4.27–22.75). Plasma MMP-9 level may act as a prediction marker for CAP. Conclusions: Elevated plasma MMP-9 could be a biological marker for the diagnosis and be a new strategy for target therapy of community-acquired pneumonia.
Exploiting reuse locality on inclusive shared last-level caches

Optimization of the replacement policy used for Shared Last-Level Cache (SLLC) management in a Chip-MultiProcessor (CMP) is critical for avoiding off-chip accesses. Temporal locality, while being exploited by first levels of private cache memories, is only slightly exhibited by the stream of references arriving at the SLLC. Thus, traditional replacement algorithms based on recency are bad choices for governing SLLC replacement. Recent proposals involve SLLC replacement policies that attempt to exploit reuse either by segmenting the replacement list or improving the rereference interval prediction. On the other hand, inclusive SLLCs are commonplace in the CMP market, but the interaction between replacement policy and the enforcement of inclusion has barely been discussed. After analyzing that interaction, this article introduces two simple replacement policies exploiting reuse locality and targeting inclusive SLLCs: Least Recently Reused (LRR) and Not Recently Reused (NRR). NRR has the same implementation cost as NRU, and LRR only adds one bit per line to the LRU cost. After considering reuse locality and its interaction with the invalidations induced by inclusion, the proposals are evaluated by simulating multiprogrammed workloads in an 8-core system with two private cache levels and an SLLC. LRR outperforms LRU by 4.5% (performing better in 97 out of 100 mixes) and NRR outperforms NRU by 4.2% (performing better in 99 out of 100 mixes). We also show that our mechanisms outperform rereference interval prediction, a recently proposed SLLC replacement policy and that similar conclusions can be drawn by varying the associativity or the SLLC size.