Miracle-dz/UniFAR-FTUs huggingface dataset:
A model for predicting gastrostomy tube placement in patients undergoing surgery for upper aerodigestive tract lesions.

IMPORTANCE Identifying high-risk patients in the preoperative period can allow physicians to optimize nutritional status early for better outcomes after head and neck cancer resections. OBJECTIVE To develop a model to predict preoperatively the need for gastrostomy tube (G-tube) placement in patients undergoing surgery of the upper aerodigestive tract. DESIGN, SETTING, AND PARTICIPANTS This retrospective medical record review included all adult patients diagnosed with head and neck cancers who underwent tumor resection from 2007 through 2012 at Wake Forest Baptist Health, a level 1 tertiary care center. Records were screened for patient demographics, tumor characteristics, surgical treatment type, and postoperative placement of G-tube. A total of 743 patients underwent resection of head and neck tumors. Of these, 203 were excluded for prior G-tube placement, prior head and neck resection, G-tube placement for chemoradiotherapy, and resection for solely nodal disease, leaving 540 patients for analysis. MAIN OUTCOMES AND MEASURES Placement of postoperative G-tube. RESULTS Of the 540 included patients, 23% required G-tube placement. The following variables were significant and independent predictors of G-tube placement: preoperative irradiation (odds ratio [OR], 4.1; 95% CI, 2.4-6.9; P < .001), supracricoid laryngectomy (OR, 26.0; 95% CI, 4.9-142.9; P < .001), tracheostomy tube placement (OR, 2.6; 95% CI, 1.5-4.4; P < .001), clinical node stage N0 vs N2 (OR, 2.4; 95% CI, 1.4-4.2; P = .01), clinical node stage N1 vs N2 (OR, 1.6; 95% CI, 0.8-3.3; P = .01), preoperative weight loss (OR, 2.0; 95% CI, 1.2-3.2; P = .004), dysphagia (OR, 2.0; 95% CI, 1.2-3.2; P = .005), reconstruction type (OR, 1.9; 95% CI, 1.1-2.9; P = .02), and tumor stage (OR, 1.8; 95% CI, 1.1-2.9; P = .03). A predictive model was developed based on these variables. In the validation analysis, we found that the average predicted score for patients who received G-tubes was statistically different than the score for the patients who did not receive G-tubes (P = .01). CONCLUSIONS AND RELEVANCE We present a validated and comprehensive model for preoperatively predicting the need for G-tube placement in patients undergoing surgery of the upper aerodigestive tract. Early enteral access in high-risk patients may prevent complications in postoperative healing and improve overall outcomes, including quality of life.
Prioritizing patients for Community Rehabilitation Services: do clinicians agree on triage decisions?

Objective: To evaluate agreement between independent clinician raters using a triage protocol to prioritize referrals for occupational therapy and physiotherapy within a community rehabilitation program. Design: The priority category allocated to consecutive referrals by one of six clinicians in the referral office was compared with a second rating made by an independent occupational therapist, blinded to the initial priority rating. Setting: A centralized referral office staffed by allied health and nursing professionals designed as a single point of access for sub acute and ambulatory services within a large metropolitan health network. Participants: 214 referrals for adults requiring community based occupational therapy or physiotherapy rehabilitation for orthopaedic, neurological or other conditions (such as falls or cardio-respiratory conditions). Main Measure: Agreement (weighted kappa = κw) between the two ratings. Results: Overall agreement was moderate (κw = 0.60), but disagreement occurred in 30% of cases. Professional discipline of the raters did not affect agreement. Agreement varied between diagnostic subgroups, with significantly lower agreement for referrals for rehabilitation following elective orthopaedic surgery (κw = 0.25) than the other categories combined. Differences in agreement were observed between the four triage categories, with the lowest observed agreement in the most urgent category. Conclusions: Clinicians in a centralized model of triage showed only moderate agreement when making decisions about client priority for community rehabilitation for occupational therapy and physiotherapy.
Molecular mediators of tumor angiogenesis: Enhanced expression and activation of vascular endothelial growth factor receptor KDR in primary breast cancer

The progression of breast cancer growth and its ability to metastasize are associated with the process of angiogenesis. In this study, we examined the protein expression of vascular endothelial growth factor (VEGF) and its specific and functional receptor KDR in human breast tissue. We investigated a total of 13 mammary carcinomas, 3 fibroadenomas, 5 specimens with fibrocystic breast disease as well as normal (adjacent to malignant) breast tissue using immunohistochemistry and Western blot analysis. In all carcinomas examined, functional KDR protein was present independent of tumor type, tumor stage and histological grade as demonstrated by tyrosine phosphorylation analysis of KDR. When malignant tissues were compared with their neighboring non‐neoplastic regions, activated KDR was found to be expressed to a much higher extent within the malignant tissue samples. In fibroadenomas, KDR was barely detectable, whereas in fibrocystic breast disease KDR expression was variable. Immunostaining of KDR was localized to endothelium and epithelium of mammary ducts in malignant and benign breast tissue, while VEGF immunoreactivity was primarily found in the endothelium and also in tumor cells and macrophages. Our data demonstrate that KDR activation is enhanced in breast cancer in vivo and emphasize the functional role of VEGF and KDR in the development of malignant breast disease. Int. J. Cancer (Pred. Oncol.) 84:293–298, 1999. © 1999 Wiley‐Liss, Inc.
Examining store atmosphere appraisals using parallel approaches from the aesthetics literature

ABSTRACT Drawing on the aesthetics literature, this study examines how typicality, novelty, unity and variety help to explain consumers’ aesthetic pleasure and approach/avoidance behaviours. Comparisons are made between consumers’ perceptions of actual store designs in a recently remodelled fashion store and that of an older, established store prototype owned by the same retailer. The research findings establish how novelty, typicality and variety confer aesthetic pleasure and approach behaviours in-store atmosphere appraisals contexts where there is a limited introduction of novelty, with one established prototype. The findings also suggest that moderation effects explain that consumers who place a greater value on the importance of design evaluate the novelty and aesthetic pleasure association differently compared to consumers with less design value orientation.
Can Contrarian Strategies Improve Momentum Profits

This paper investigates whether investors can exploit the contrarian cycle to improve the profitability of momentum strategies. We conjecture that the momentum strategies implemented in the early stage of price reversal (MSES) are more profitable than those implemented in the late stage of price reversal (MSLS). Our empirical results show that while MSES records significant positive returns, the profits from MSLS are not significant. There is a continuation of momentum profits in MSES up to 60 months, but not in MSLS. The overall evidence indicates that we can improve the profits of momentum strategies if we also consider past long-term performance.
Levels of terbinafine in plasma, stratum corneum, dermis-epidermis (without stratum corneum), sebum, hair and nails during and after 250 mg terbinafine orally once per day for four weeks.

The distribution of terbinafine in stratum corneum dermis-epidermis (without stratum corneum), sebum, hair, nails and plasma was studied in human male volunteers during and after 250 mg orally once daily for 28 days. The highest concentration was seen in sebum, 56.07 micrograms/g, after 14 days of therapy. The concentration was still 1.0 microgram/g 44 days after stop of medication. In stratum corneum the highest concentration, 14.4 micrograms/g, was seen 1 day after the last day of therapy, and it was 2.1 micrograms/g 44 days after stop of medication. The concentrations in hair and nails were lower with a maximum of 2.36 and 0.39 micrograms/g respectively, 1 day after stop of therapy, and still 0.21 microgram/g in hair and 0.09 microgram/g in nails 55 days after the last day of medication. With the exception of nails, all other tissue levels were at all times above the plasma concentrations. For nails, tissue levels exceeded that of plasma as early as 1 day after stop of medication, and this difference continued to increase until the last day of tissue sampling, 55 days after the last tablet. These results indicate that terbinafine is delivered to the stratum corneum through sebum and to a minor extent by direct diffusion through dermis-epidermis. Probably short-term therapy with terbinafine may be effective in the treatment of several dermatomycoses, due to the strong binding of terbinafine to stratum corneum for a long time after stop of medication. (ABSTRACT TRUNCATED AT 250 WORDS)
Risk assessment of preeclampsia in advanced maternal age by uterine arteries Doppler at 17-21 weeks of gestation.

OBJECTIVE To assess the risk of preeclampsia development in elderly gravidarum by uterine arteries Doppler at 17-21 weeks' gestation. MATERIAL AND METHOD Pulsatility index (PI) of the uterine arteries was measured by color Doppler transabdominal sonography in 298 elderly gravida women at 17-21 weeks of gestation. The criterion for abnormal results was PI > 95th percentile of each gestational age and/or the presence of bilateral notches. The major end point was preeclampsia. RESULTS Ten woman (3.4%) developed preeclampsia. Two hundred and eighty-four women (95.3%) had a normal Doppler flow of uterine arteries (PI < or =95th percentile of each gestational age), and 14 woman (4.7%) had abnormal Doppler flow of uterine arteries. The sensitivity, specificity, and positive and negative predictive values for detecting preeclampsia were 20%, 95.8%, 14.3%, and 97.2%, respectively. CONCLUSION Women with mean PI > 95th of each gestational age have a high risk of developing preeclampsia. With the high negative predictive value, this test may be useful to minimize unnecessary interventions.
Benefit of the measurement of mesorectal extension in patients with pT3N1-2 rectal cancer without pre-operative chemoradiotherapy: Post-operative treatment strategy

A treatment strategy based on the distance of mesorectal extension (DME) for pT3N1-2 rectal cancer patients without pre-operative chemoradiotherapy has not yet been defined. The present study aimed to describe the benefit of the measurement of mesorectal extension in stratifying treatment for pT3N1-2 rectal cancer patients. Data from 512 patients with pT3N1-2 rectal cancer undergoing curative surgery at 28 institutes were analyzed in this study. DME was measured histologically, and the optimal prognostic cut-off point of the DME was determined using Cox regression analyses. Survival was calculated using the Kaplan-Meier method. The patients were subdivided into two groups based on the optimal prognostic cut-off point: DME ≤4 mm and DME >4 mm. The DME was found to be a powerful independent risk factor for predicting distant and local recurrences. The recurrence-free 5-year survival rates of patients with DME >4 mm were significantly poorer for Stages IIIB (53.3%; p=0.0015; HR, 1.76; 95% CI, 1.233–2.501) and IIIC (32.9%; p=0.0095; HR, 1.64; 95% CI, 1.119–2.407) than for patients with DME ≤4 mm (69.7 and 50.4%, respectively). The cancer-specific survival rates of patients with DME >4 mm were also significantly worse than those with DME ≤4 mm. A value of 4 mm provides the best cut-off point for subdividing the mesorectal extension to predict oncologic outcomes. Measurement of mesorectal extension appears to be of benefit in stratifying patients for post-operative adjuvant treatments.
Factors influencing the pursuit of personal learning goals in MOOCs

ABSTRACT MOOCs are promising opportunities for lifelong learning, but as promising as these learning opportunities seem, many learners do not succeed in pursuing their personal learning goals. Barriers to learning are the main reason for not finishing the intended (parts of the) MOOCs. This study addressed the question whether the factors age, gender, educational level, and online learning experience affect barriers faced while learning in MOOCs. The results show that it is challenging to combine work and family life with lifelong (online) learning activities, especially for learners in their early adulthood and mid-life. However, more experience with online learning positively affects individuals’ ability to cope with these challenges. Also, learners with a lower educational level may experience a lack of knowledge or difficulties with the course content. These findings may serve as input to inform potentially vulnerable learners about these issues and support them in successfully achieving their personal learning goals.
Triple Loss of Function of Protein Phosphatases Type 2C Leads to Partial Constitutive Response to Endogenous Abscisic Acid1[C][W][OA]

The phytohormone abscisic acid (ABA) is a key regulator of plant growth and development as well as plant responses to situations of decreased water availability. Protein phosphatases type 2C (PP2Cs) from group A, which includes the ABI1/HAB1 and PP2CA branches, are key negative regulators of ABA signaling. Specifically, HAB1, ABI1, ABI2, and PP2CA have been shown to affect both seed and vegetative responses to ABA. To further understand their contribution to ABA signaling and to unravel possible genetic interactions and functional redundancy among them, we have generated different combinations of double and triple mutants impaired in these PP2Cs. Interestingly, hab1-1pp2ca-1 and abi1-2pp2ca-1 double mutants showed reduced water loss and enhanced resistance to drought stress, which further supports the role of PP2CA in vegetative responses to ABA. Two triple hab1-1abi1-2abi2-2 and hab1-1abi1-2pp2ca-1 mutants were generated, which showed an extreme response to exogenous ABA, impaired growth, and partial constitutive response to endogenous ABA. Thus, transcriptomic analysis revealed a partial up-regulation/down-regulation of a subset of ABA-responsive genes in both triple mutants in the absence of exogenous ABA. Comparison of ABA responses in the different pp2c mutants showed that a progressive increase in ABA sensitivity could be obtained through combined inactivation of these PP2Cs. These results indicate that ABA response is finely tuned by the integrated action of these genes, which is required to prevent a constitutive response to endogenous ABA that might have a deleterious effect on growth and development in the absence of environmental stress.
Bacterial ureases: structure, regulation of expression and role in pathogenesis

The nickel metalloenzyme urease catalyses the hydrolysis of urea to ammonia and carbamate, and thus generates the preferred nitrogen source of many organisms. When produced by bacterial pathogens in either the urinary tract or the gastroduodenal region, urease acts as a virulence factor. At both sites of infection urease is known to enhance the survival of the infecting bacteria. Ammonia resulting from the action of urease is believed to increase the pH of the environment to one more favourable for growth, and to injure the surrounding epithelial cells. In addition, in the urinary tract urease activity can result in the formation of urinary calculi. Bacterial urease gene clusters contain from seven to nine genes depending upon the species. These genes encode the urease structural subunits and accessory polypeptides involved in the biosynthesis of the nickel metallocentre. So far, three distinct mechanisms of urease gene expression have been described for ureolytic bacteria. Some species constitutively produce urease; some species produce urease only if urea is present in the growth medium; and some species produce urease only during nitrogen‐limiting growth conditions. For either the urea‐inducible genes or the nitrogen‐regulated genes transcription appears to be positively regulated. In the nitrogen‐regulated systems, urease gene expression requires Nac (nitrogen assimilation control), a member of the LysR family of transcriptional activators. Urea dependent expression of urease requires UreR (urease regulator), a member of the AraC family of transcriptional activators. An evolutionary tree for urease genes of eight bacterial species is proposed.
Redundant Roles for Sox7 and Sox18 in Arteriovenous Specification in Zebrafish

The specification of arteries and veins is an essential process in establishing and maintaining a functional blood vessel system. Incorrect arteriovenous specification disrupts embryonic development but has also been diagnosed in human syndromes such as hypotrichosis-lymphedema-telangiectasia, characterized by defects in blood and lymphatic vessels and associated with mutations in SOX18. Here we characterize the role of sox7 and sox18 during zebrafish vasculogenesis. Sox7 and sox18 are specifically expressed in the developing vasculature, and simultaneous loss of their function results in a severe loss of the arterial identity of the presumptive aorta which instead expresses venous markers, followed by dramatic arteriovenous shunt formations. Our study identifies members of the Sox family as key factors in specifying arteriovenous identity and will help to better understand hypotrichosis-lymphedema-telangiectasia and other diseases.
Selected sociocultural correlates of physical activity among African-American adults

Objective. Previous studies have identified several factors to be associated with physical activity (PA) among African-Americans, e.g., demographic and health-related characteristics. Formative studies suggest a link between sociocultural factors and PA among ethnic minorities; yet, it is unclear whether these factors play a role in PA among African-Americans. This paper explores the association of selected sociocultural characteristics with self-reported PA by gender among African-American adults, taking into account demographic and health-related characteristics. Design. Data from the baseline survey of a colorectal cancer communication intervention trial were used. Participants included 446 African-American men and women, aged 45–75 years. Self-report data were collected on demographics, health-related characteristics, selected sociocultural constructs (e.g., ethnic identity, religiosity, collectivism, and medical mistrust), and PA. PA was categorized as meeting or not meeting recommended levels; recommended levels were defined as participating in vigorous PA for 20 minutes/day for at least three days/week or moderate PA for 30 minutes/day for at least five days/week or a minimum of 600 MET-minutes/week in at least five days. Chi-square and multivariate logistic regression models were used to characterize the association between the selected sociocultural constructs and PA among men and women, after adjusting for demographic and health-related characteristics. Results. Most participants reported some PA but only 59% were found to be meeting recommended levels. Univariate analyses revealed that high collectivist attitudes were associated with meeting recommended PA (OR=1.74), particularly for women (OR=1.81). In multivariate analyses, high collectivist attitudes were significantly associated with meeting PA recommendations among men (OR=1.87); while high religiosity and high collectivism were significant among women (OR=1.87 and 1.85, respectively). Conclusions. Few of the selected sociocultural characteristics were found to be associated with meeting recommended PA levels. Further study is needed to understand the association of these characteristics with PA among African-Americans.
Conducting Wall Hall Thrusters

A unique configuration of the magnetic field and channel geometry near the wall of Hall thrusters, called magnetic shielding, has recently demonstrated the ability to significantly reduce the erosion of the boron nitride (BN) walls and extend the life of Hall thrusters by orders of magnitude. The ability of magnetic shielding to minimize interactions between the plasma and the discharge chamber walls in regions where erosion typically occurs has for the first time enabled the replacement of insulating walls with conducting materials without loss in Hall thruster performance. It is important to note that this is not a thruster with anode layer (TAL) where the walls are at or near cathode potential, but is a Hall thruster configuration where the walls are near the anode potential. The BN rings in the 6-kW H6 Hall thruster were replaced with graphite that self-biased to near the anode potential during operation. The thruster efficiency remained over 60% (within 2% of the baseline BN configuration) with a small decrease in thrust and increase in Isp typical of magnetically shielded Hall thrusters. The graphite wall temperatures decreased significantly compared with both shielded and unshielded BN configurations, leading to the potential for higher power operation. Eliminating ceramic walls makes it simpler and less expensive to fabricate a thruster to survive launch loads, and the graphite discharge chamber radiates more efficiently, which increases the power capability of the thruster compared with conventional Hall thruster designs.
Ca2+ responses in enteric glia are mediated by connexin-43 hemichannels and modulate colonic transit in mice.

BACKGROUND & AIMS In the enteric nervous system, neurotransmitters initiate changes in calcium (Ca(2+) responses) in glia, but it is not clear how this process affects intestinal function. We investigated whether Ca(2+)-mediated responses in enteric glia are required to maintain gastrointestinal function. METHODS We used in situ Ca(2+) imaging to monitor glial Ca(2+) responses, which were manipulated with pharmacologic agents or via glia-specific disruption of the gene encoding connexin-43 (Cx43) (hGFAP::CreER(T2+/-)/Cx43(f/f) mice). Gastrointestinal function was assessed based on pellet output, total gut transit, colonic bead expulsion, and muscle tension recordings. Proteins were localized and quantified by immunohistochemistry, immunoblot, and reverse transcription polymerase chain reaction analyses. RESULTS Ca(2+) responses in enteric glia of mice were mediated by Cx43 hemichannels. Cx43 immunoreactivity was confined to enteric glia within the myenteric plexus of the mouse colon; the Cx43 inhibitors carbenoxolone and 43Gap26 inhibited the ability of enteric glia to propagate Ca(2+) responses. In vivo attenuation of Ca(2+) responses in the enteric glial network slowed gut transit overall and delayed colonic transit--these changes are also observed during normal aging. Altered motility with increasing age was associated with reduced glial Ca(2+)-mediated responses and changes in glial expression of Cx43 messenger RNA and protein. CONCLUSIONS Ca(2+)-mediated responses in enteric glia regulate gastrointestinal function in mice. Altered intercellular signaling between enteric glia and neurons might contribute to motility disorders.
Protocols for communication and governance of risks

The aim of this paper is to explain the need to organize the development of standard protocols for communication about major public risks. Tragic events, such as inadequate earthquake preparedness or great unnecessary losses of life due to public misunderstandings underline the importance of such protocols to protect the public and support confidence in government and experts. The required contents of such protocols are suggested in outline. It is concluded that the need is urgent internationally to organize the development of standard protocol paradigms, one for scientificprofessional analysts and another for authorities' communications to the public.