Miracle-dz/UniFAR-FTUs huggingface dataset:
Reliability of Waveform Analysis as an Adjunct to Loss of Resistance for Thoracic Epidural Blocks

Background The epidural space is most commonly identified with loss of resistance (LOR). Although sensitive, LOR lacks specificity, as cysts in interspinous ligaments, gaps in ligamentum flavum, paravertebral muscles, thoracic paravertebral spaces, and intermuscular planes can yield nonepidural LOR. Epidural waveform analysis (EWA) provides a simple confirmatory adjunct for LOR. When the needle is correctly positioned inside the epidural space, measurement of the pressure at its tip results in a pulsatile waveform. In this observational study, we set out to assess the sensitivity, specificity, as well as positive and negative predictive values of EWA for thoracic epidural blocks. Methods We enrolled a convenience sample of 160 patients undergoing thoracic epidural blocks for thoracic surgery, abdominal surgery, or rib fractures. The choice of patient position (sitting or lateral decubitus), approach (midline or paramedian), and LOR medium (air or normal saline) was left to the operator (attending anesthesiologist, fellow, or resident). After obtaining a satisfactory LOR, the operator injected 5 mL of normal saline through the epidural needle. A sterile tubing, connected to a pressure transducer, was attached to the needle to measure the pressure at the needle tip. A 4-mL bolus of lidocaine 2% with epinephrine 5 &mgr;g/mL was then administered and, after 10 minutes, the patient was assessed for sensory blockade to ice. Results The failure rate (incorrect identification of the epidural space with LOR) was 23.1%. Of these 37 failed epidural blocks, 27 provided no sensory anesthesia at 10 minutes. In 10 subjects, the operator was unable to thread the catheter through the needle. When compared with the ice test, the sensitivity, specificity, and positive and negative predictive values of EWA were 91.1%, 83.8%, 94.9%, and 73.8%, respectively. Conclusions Epidural waveform analysis (with pressure transduction through the needle) provides a simple adjunct to LOR for thoracic epidural blocks. Although its use was devoid of complications, further confirmatory studies are required before its routine implementation in clinical practice.
Pharmacogenomic study of side-effects for antidepressant treatment options in STAR*D

Background Understanding individual differences in susceptibility to antidepressant therapy side-effects is essential to optimize the treatment of depression. Method We performed genome-wide association studies (GWAS) to search for genetic variation affecting the susceptibility to side-effects. The analysis sample consisted of 1439 depression patients, successfully genotyped for 421K single nucleotide polymorphisms (SNPs), from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Outcomes included four indicators of side-effects: general side-effect burden, sexual side-effects, dizziness and vision/hearing-related side-effects. Our criterion for genome-wide significance was a prespecified threshold ensuring that, on average, only 10% of the significant findings are false discoveries. Results Thirty-four SNPs satisfied this criterion. The top finding indicated that 10 SNPs in SACM1L mediated the effects of bupropion on sexual side-effects (p=4.98×10−7, q=0.023). Suggestive findings were also found for SNPs in MAGI2, DTWD1, WDFY4 and CHL1. Conclusions Although our findings require replication and functional validation, this study demonstrates the potential of GWAS to discover genes and pathways that could mediate adverse effects of antidepressant medication.
Increased platelet count and leucocyte–platelet complex formation in acute symptomatic compared with asymptomatic severe carotid stenosis

Objective: The risk of stroke in patients with recently symptomatic carotid stenosis is considerably higher than in patients with asymptomatic stenosis. In the present study it was hypothesised that excessive platelet activation might partly contribute to this difference. Methods: A full blood count was done and whole blood flow cytometry used to measure platelet surface expression of CD62P, CD63, and PAC1 binding and the percentage of leucocyte–platelet complexes in patients with acute (0–21 days, n = 19) and convalescent (79–365 days) symptomatic (n = 16) and asymptomatic (n = 16) severe (⩾70%) carotid stenosis. Most patients were treated with aspirin (37.5–300 mg daily) although alternative antithrombotic regimens were more commonly used in the symptomatic group. Results: The mean platelet count was higher in patients with acute and convalescent symptomatic compared with asymptomatic carotid stenosis. There were no significant differences in the median percentage expression of CD62P and CD63, or PAC1 binding between the acute or convalescent symptomatic and asymptomatic patients. The median percentages of neutrophil–platelet (p = 0.004), monocyte–platelet (p = 0.046), and lymphocyte–platelet complexes (p = 0.02) were higher in acute symptomatic than in asymptomatic patients. In patients on aspirin monotherapy, the percentages of neutrophil–platelet and monocyte–platelet complexes (p = 0.03) were higher in acute symptomatic (n = 11) than asymptomatic patients (n = 14). In the convalescent phase, the median percentages of all leucocyte–platelet complexes in the symptomatic group dropped to levels similar to those found in the asymptomatic group. Conclusion: Increased platelet count and leucocyte–platelet complex formation may contribute to the early excess risk of stroke in patients with recently symptomatic carotid stenosis.
Infliximab in patients with primary Sjögren's syndrome: a pilot study.

OBJECTIVE Tumor necrosis factor alpha (TNFalpha) is a proinflammatory cytokine involved in the pathogenesis of Sjögren's syndrome (SS), and blockade of TNFalpha may reduce the activity of the disease. The purpose of this study was to evaluate the safety and potential efficacy of infliximab, a chimeric human-mouse anti-TNFalpha monoclonal antibody, in patients with active primary SS. METHODS This was a single-center, open-label pilot study. Sixteen patients with active primary SS received 3 infusions of infliximab (3 mg/kg) at 0, 2, and 6 weeks. Standard clinical assessment, complete ophthalmologic testing, and functional evaluation of salivary flow were performed at baseline and at weeks 2, 6, 10, and 14. RESULTS All patients completed the study. There was statistically significant improvement in all clinical and functional parameters, including global assessments (patient's global assessment, patient's assessment of pain and fatigue, physician's global assessment), erythrocyte sedimentation rate, salivary flow rate, the Schirmer I test, tender joint count, fatigue score, and dry eyes and dry mouth. This clinical benefit was observed at week 2 and was maintained throughout the study and the 2-month followup period. The treatment was well tolerated in all patients, and no significant adverse events were seen. No lupus-like syndrome was observed, and no anti-double-stranded DNA antibodies were observed that were attributable to infliximab therapy. CONCLUSION In patients with active primary SS, a loading-dose regimen of 3 infusions of infliximab provided a fast and significant clinical benefit without major adverse reactions. It was possible to maintain statistically significant improvement for up to 8 weeks after the third infusion.
Correlation between clinical success and apical dye penetration.

AIM This study was undertaken to examine whether a correlation exists between apical dye penetration and the clinical performance of root fillings. METHODOLOGY Apical dye penetration into 116 roots of human teeth that had been root-filled at least 6 months prior to extraction was tested in vitro using a vacuum technique and by measuring the length of dye penetration. Endodontic treatment was classified as clinically successful or unsuccessful and results for these groups were compared using analysis of variance and the Student's t-test. Positive and negative controls were used to test the experimental system. RESULTS All controls performed as expected. Dye penetrated significantly further in unsuccessful cases although the raw data suggested little difference. Overall, dye penetrated 99.5% of the specimens, indicating that the presence of dye in the canal is a poor indicator of whether the technique or material will succeed. However, the extent of dye penetration may be related to the clinical outcome. CONCLUSIONS Clinically placed root canal fillings do not provide an apical seal that prevents fluid penetration. The outcome of treatment cannot be predicted from the results of apical dye leakage studies.
Lung function in older humans: the contribution of body composition, physical activity and smoking

An allometric model was used to determine the important factors related to the decline in forced expiratory volume (FEV1.0) across ages 55-86 years in independently living men and women. Measurements were available from a randomized sample of 181 men and 203 women residing in London, Ontario, Canada. The effects of height, age, sex, adiposity, fat free mass (FFM), grip strength and physical activity (PA) on FEV1.0 were assessed using an allometric model to test the hypothesis that sex differences in lung function would be due in part to sex-related differences in the aforementioned variables and would therefore be eliminated by our analysis. The following model was linearized and parameters were identified using standard multiple regression: FEV1.0 = heightβ1·FFMβ2 ·grip strengthβ3 ·PAβ4 ·exp (β0 + β5age + β6sex + β7smoking + β8%body fat)·∈. Results indicate that the amount of FFM and heavy intensity physical activity participated in by the elderly may be more important in influencing forced expiratory function than previously recognized. In addition, results from this study have confirmed the importance of age and height in the prediction of FEV1.0 and demonstrated a negative effect of smoking on lung function. Individuals with a greater FFM and physical activity level tended to be associated with an above average lung function performance. The cross-sectional rate of decline in FEV1.0 determined from our model was ≈12% per decade.
Iterative MIMO Subspace Detection Based on Parallel Interference Cancellation

In this paper, a novel iterative MIMO subspace detection method is proposed to approach the maximum-likelihood (ML) receiver performance while keeping the computational complexity scalable for MIMO systems with large number of transmit and receive antennas. By dividing the signal detection problem for a large MIMO system into subspaces with smaller size, the complexity of applying a per-subspace ML receiver is much lower while near ML performance may still be achieved in combination with an iterative parallel interference cancellation unit. It is shown that, for equal number of transmit and receive antennas, the complexity of the proposed method is cubic with the number of transmit antennas. A flexible complexity#x002F;performance trade-off can be obtained by varying the subspace size. Even for small subspace dimensions, close to ML performance can be achieved, resulting in low complexity. The performance of this method is assessed in terms of bit error rate and achievable mutual information, and compared to conventional MIMO detection methods using the zero-forcing (ZF) or minimum mean squared error (MMSE) criterion, as well as the successive interference cancellation (SIC) approach. Furthermore, the convergence behavior of this iterative detection method is analyzed using a new variant of the EXIT-Chart based on the mutual information of equivalent hard output channels, i.e., a binary symmetric channel (BSC) model.
Highly hydrophobic and partially conductive polydimethylsiloxane surface produced by direct fluorination and subsequent annealing

Highly hydrophobic materials are of interest in many scientific and technological areas. To improve surface properties of polydimethylsiloxane (PDMS), PDMS sheets were surface fluorinated in a laboratory vessel using a F2/N2 mixture with 12.5% F2 by volume at about 55 °C under 0.1 MPa for different times of 15, 30, and 60min. Surface wettability and surface energy were evaluated by contact angle measurements and surface energy calculations, and surface electrical properties were investigated by measurements of surface conductivity and surface potential decay. These results show that direct fluorination produced a highly hydrophobic and partially conductive PDMS surface with low surface energy, which had little correlation with fluorination time in the investigated range of 15 to 60 min. Moreover, annealing of the surface fluorinated PDMS sheets at 150 °C for 60 min caused a further increase in surface hydrophobicity, while reduced surface conduction of the fluorinated PDMS sheets. Attenuated total reflection infrared analyses and scanning electron microscope surface and cross-section observations reveal substantial changes in physicochemical characteristics of the sheet surface layers due to direct fluorination. The high hydrophobicity or low surface energy is attributed to the changes in chemical composition and structure of the surface layers and in their surface roughness. The partial conductivity of the fluorinated PDMS surfaces is a result of the competition between the compositional change and the structural change.
Local Binary Pattern Approach for Fast Block Based Motion Estimation

With the rapid growth of video services on smartphones such as video conferencing, video telephone and WebTV, implementation of video compression on mobile terminal becomes extremely important. However, the low computation capability of mobile devices becomes a bottleneck which calls for low complexity techniques for video coding. This work presents two set of algorithms for reducing the complexity of motion estimation. Binary motion estimation techniques using one-bit and two-bit transforms reduce the computational complexity of matching error criterion, however sometimes generate inaccurate motion vectors. The first set includes two neighborhood matching based algorithms which attempt to reduce computations to only a fraction of other methods. Simulation results demonstrate that full search local binary pattern (FS-LBP) algorithm reconstruct visually more accurate frames compared to full search algorithm (FSA). Its reduced complexity LBP (RC-LBP) version decreases computations significantly to only a fraction of the other methods while maintaining acceptable performance. The second set introduces edge detection approach for partial distortion elimination based on binary patterns. Spiral partial distortion elimination (SpiralPDE) has been proposed in literature which matches the pixel-to-pixel distortion in a predefined manner. Since, the contribution of all the pixels to the distortion function is different, therefore, it is important to analyze and extract these cardinal pixels. The proposed algorithms are called lossless fast full search partial distortion elimination ME based on local binary patterns (PLBP) and lossy edge-detection pixel decimation technique based on local binary patterns (ELBP). PLBP reduces the matching complexity by matching more contributable pixels early by identifying the most diverse pixels in a local neighborhood. ELBP captures the most representative pixels in a block in order of contribution to the distortion function by evaluating whether the individual pixels belong to the edge or background. Experimental results demonstrate substantial reduction in computational complexity of ELBP with only a marginal loss in prediction quality. iii
The Impact of Net Migrant Remittance on Economic Growth: Evidence from Nigeria

The growing impact of remittance in the economic well-being of the in Sub-Sahara Africa, most especially Nigerians cannot be ignored. This can better be appreciated in term of large number of Nigerians living and working abroad and with the resultant incomes that are being sent back home. This development has necessitated the need to examine the impact of net remittance on economic growth, having taken into consideration the cost of transferring the remittances. The study employs the use of seemingly unrelated regression (SUR) analysis and Error Correction Model. The result does establish a significant relationship between net remittance and economic growth, but at individual level, it provides immediate income for different households. But the impact of Remittance can only be more meaningful and contribute to economic growth of Nigeria, only if financial institutions are well organized and be made more competitive to provide remittance services at reduced cost, so that funds can be remitted through official channels.
Gay, Lesbian and Straight Education Network (GLSEN)

Building on his advocacy efforts for glbtq students, Jennings next decided to create a cohesive network of teachers, parents, and other members of the community for the purpose of ending homophobic and heterosexist biases in schools. Based in Boston, GLSEN was first staffed by volunteers. However, its impact was quickly felt; in 1993 the organization was instrumental in leading Massachusetts to become the first state in the country to prohibit discrimination against public school students based on sexual orientation.
Anti-Receptor for Advanced Glycation End Products Therapies as Novel Treatment for Abdominal Aortic Aneurysm

Objective:Rupture of abdominal aortic aneurysms (AAA) is a devastating event potentially preventable by therapies that inhibit growth of small aneurysms. Receptor of advanced glycation end products (RAGE) has been implicated in age related diseases including atherosclerosis and Alzheimer. Consequently, we explored whether RAGE may also contribute to the formation of AAAs. Results:Implicating a role for RAGE in AAA, we found the expression of RAGE and its ligand AGE were highly elevated in human aneurysm specimens as compared with normal aortic tissue. In a mouse model of AAA, RAGE gene deletion (knockout) dramatically reduced the incidence of AAA to 1/3 of control (AAAs in 75.0% of controls vs. 25.0% knockouts). Moreover, aortic diameter was markedly reduced in RAGE knockout animals versus controls. As to mechanism, we found that RAGE was coexpressed in AAA macrophages with MMP-9, a promoter of matrix degradation, which is known to induce AAA. In vitro, AGE induced the production of MMP-9 in macrophages in a dose-dependent manner while blocking RAGE signaling with a soluble AGE inhibitor prevented MMP-9 expression. In vivo, RAGE gene deficiency eliminated MMP-9 activity that was prevalent in aneurismal wall of the wild-type mice. Conclusions:RAGE promotes the development of AAA by inducing MMP-9 expression. Blocking RAGE in a mouse aneurysm model has a dramatic inhibitory effect on the formation of aneurysms. These data suggest that larger animal and eventually human trials should be designed to test oral RAGE inhibitors and their potential to prevent progression of small aneurysms.
Disappointing Interobserver Agreement Among Radiologists for a Classifying Diagnosis of Pancreatic Cysts Using Magnetic Resonance Imaging

Objectives To assess the degree of interobserver agreement of MRI in the diagnostic assessment of pancreatic cysts (PCs). Methods Magnetic resonance imaging sets of images of 62 patients with PCs (32 with histological confirmation and 30 with clinical diagnosis) were reviewed by 4 experienced radiologists. Features scored included septations, nodules, solid components, pancreatic duct communication, and wall thickening (>2 mm). Radiologists were asked whether they considered the PC mucinous and if the PC was suspicious for malignancy. Furthermore, they had to choose a classifying diagnosis. Intraclass correlation coefficient (ICC) was used to measure agreement within the group. Results Interobserver agreement for septations and nodules was fair (ICC, 0.36 and 0.23, respectively). Agreement for the presence of solid components was fair (ICC, 0.23), agreement for communication with the pancreatic duct was moderate (ICC, 0.53), and agreement for wall thickening was moderate (ICC, 0.44). There was fair agreement for the discrimination between mucinous and nonmucinous PC (ICC, 0.36). Agreement was fair (ICC, 0.26) for a classifying diagnosis and fair for the presence of malignant features (ICC, 0.33). Conclusions Interobserver agreement was poor to moderate for individual PC features, and there was fair agreement for a classifying diagnosis. Magnetic resonance imaging morphology alone did not allow for a reliable discrimination between different types of PC.
Independent evolution of knuckle-walking in African apes shows that humans did not evolve from a knuckle-walking ancestor

Despite decades of debate, it remains unclear whether human bipedalism evolved from a terrestrial knuckle-walking ancestor or from a more generalized, arboreal ape ancestor. Proponents of the knuckle-walking hypothesis focused on the wrist and hand to find morphological evidence of this behavior in the human fossil record. These studies, however, have not examined variation or development of purported knuckle-walking features in apes or other primates, data that are critical to resolution of this long-standing debate. Here we present novel data on the frequency and development of putative knuckle-walking features of the wrist in apes and monkeys. We use these data to test the hypothesis that all knuckle-walking apes share similar anatomical features and that these features can be used to reliably infer locomotor behavior in our extinct ancestors. Contrary to previous expectations, features long-assumed to indicate knuckle-walking behavior are not found in all African apes, show different developmental patterns across species, and are found in nonknuckle-walking primates as well. However, variation among African ape wrist morphology can be clearly explained if we accept the likely independent evolution of 2 fundamentally different biomechanical modes of knuckle-walking: an extended wrist posture in an arboreal environment (Pan) versus a neutral, columnar hand posture in a terrestrial environment (Gorilla). The presence of purported knuckle-walking features in the hominin wrist can thus be viewed as evidence of arboreality, not terrestriality, and provide evidence that human bipedalism evolved from a more arboreal ancestor occupying the ecological niche common to all living apes.
Employers Need to Invest to Strengthen Performance Management

Performance management (PM) has become the whipping boy for HR. There are few defenders. The media now focuses on companies that have abandoned traditional approaches. Even the Society for Human Resource Management (SHRM) reflects the criticism. The first feature article in the April issue of HR Magazine is, “Is It Time to Put Performance Review on a PIP? ” (A PIP, of course, is a performance improvement plan.) Performance management has been a problem for decades. The article quotes the VP for Adobe Systems, Donna Morris—a company that abandoned the traditional approach—who highlighted the core problem, “So many of the processes and functions in HR are practices that were adopted in a different era. ” She’s correct, of course; the widely used practices continue to resemble those used a generation ago. But my purpose here is to discuss why PM is an essential process and the strategies to avoid the problems and make it a valuable activity. Central to the argument is that this should not be treated as an HR function. The obvious fact is that HR is not involved in the day-to-day management of performance. It is strictly the responsibility of line managers and supervisors. HR carries the towels and the water bottles.