Miracle-dz/UniFAR-FTUs huggingface dataset:
Significance of arterial hypotension after resuscitation from cardiac arrest*

Objective:Expert guidelines advocate hemodynamic optimization after return of spontaneous circulation (ROSC) from cardiac arrest despite a lack of empirical data on prevalence of post-ROSC hemodynamic abnormalities and their relationship with outcome. Our objective was to determine whether post-ROSC arterial hypotension predicts outcome among postcardiac arrest patients who survive to intensive care unit admission. Design:Cohort study utilizing the Project IMPACT database (intensive care unit admissions from 120 U.S. hospitals) from 2001–2005. Setting:One hundred twenty intensive care units. Patients:Inclusion criteria were: 1) age ≥18 yrs; 2) nontrauma; and 3) received cardiopulmonary resuscitation before intensive care unit arrival. Interventions:None. Measurements and Main Results:Subjects were divided into two groups: 1) Hypotension Present—one or more documented systolic blood pressure <90 mm Hg within 1 hr of intensive care unit arrival; or 2) Hypotension Absent—all systolic blood pressure ≥90 mm Hg. The primary outcome was in-hospital mortality. The secondary outcome was functional status at hospital discharge among survivors. A total of 8736 subjects met the inclusion criteria. Overall mortality was 50%. Post-ROSC hypotension was present in 47% and was associated with significantly higher rates of mortality (65% vs. 37%) and diminished discharge functional status among survivors (49% vs. 38%), p < . 001 for both. On multivariable analysis, post-ROSC hypotension had an odds ratio for death of 2.7 (95% confidence interval, 2.5–3.0). Conclusions:Half of postcardiac arrest patients who survive to intensive care unit admission die in the hospital. Post-ROSC hypotension is common, is a predictor of in-hospital death, and is associated with diminished functional status among survivors. These associations indicate that arterial hypotension after ROSC may represent a potentially treatable target to improve outcomes from cardiac arrest.
Color of bulk‐fill composite resin restorative materials

OBJECTIVE To evaluate the color stability of novel bulk-fill composite resins. MATERIALS AND METHODS Color measurements of a nanohybrid composite resin (Z550) and 3 bulk-fill composite resins (BLK, AFX, XTF; n = 45) were performed before polymerization. After polymerization, color measurements were repeated and specimens were immersed in distilled water or red wine, or coffee. Color change [CIEDE2000 (ΔE00 )] was calculated after 24 h, 1 and 3 weeks. Data were analyzed with Kruskal-Wallis, Mann-Whitney U and Wilcoxon tests (α = 0.05). RESULTS Color changes observed after polymerization were significant for all groups. Color changes observed in distilled water for Z550 and AFX were significant. Color changes after stored in red wine and coffee were significant for all groups. Bulk-fill composite resin color change increased over time for all groups in red wine and coffee (P < .05). CONCLUSION Polymerization significantly changed the color of nanohybrid composite resin and bulk-fill composite resins. AFX had the highest color change in distilled water. The color of tested bulk-fill composite resins significantly changed after immersion in beverages and over time. Color change observed with the nanohybrid composite resin after 1 week was stable. CLINICAL SIGNIFICANCE Clinicians should keep in mind that tested composite resins may change color when exposed to water and significantly change color immediately after they are polymerized. In addition, the color change continues over time should the patient is a coffee and/or red wine consumer.
Novel multi-coil resonator design for wireless power transfer through reinforced concrete structure with rebar array

The wireless power transfer (WPT) has many advantages such as convenience of energy transfer and high reliability of system. Therefore, WPT system is widely applied to IT devices, electric vehicle, and industrial application by using concrete structure. However, when is applied to reinforced concrete structure, there is a severe problem that it has very low efficiency for power transfer, which results in high power loss due to interference of the internal rebar array. In other words, although the conventional WPT system has high efficiency under air condition, it has low transfer efficiency under reinforced concrete structure with rebar array. To overcome this problem, this paper proposes a new multi-coil resonator design. It uses main one coil and intermediate 4 coils. The main coil boosts coupling coefficient and the intermediate 4 coils boost self-inductance and a few coupling coefficients. As a result, high coupling coefficient leads to high WPT efficiency. Moreover, the proposed resonator design enables intermediate 4 coils to avoid interference of the rebar array. Therefore, the proposed new multi-coil resonator design for WPT system has high efficiency under reinforced concrete structure with rebar array. To confirm the operation, features, and validity of the proposed resonator designs, a laboratory WPT system with 3.3V/10W is built and tested.
The value of the PedsQLTM in assessing quality of life in survivors of childhood cancer.

AIMS To determine differences in ratings of quality of life (QOL) depending on respondent (mother or child) and implications for the validity of measures of QOL, and interpretation of scores. METHOD Forty-five survivors of acute lymphoblastic leukaemia (ALL) and 23 survivors of central nervous system (CNS) tumours and their mothers completed a generic measure of QOL: the Pediatric Quality of Life Inventory Version 4.0 (PedsQL 4.0; Varni et al., 2001). RESULTS Although correlations between mother and survivor ratings were largely moderate to good, further analyses showed that mothers reported QOL to be worse than survivors. Both mothers and survivors rated physical health worse than psychological health, and survivors of a CNS tumour had poorer QOL than survivors of ALL. Although survivors of ALL reported reasonably good physical health, their psychosocial health was more adversely affected. CONCLUSIONS Implications for further use of the PedsQL 4.0 in the clinical or research context are discussed. Incidental findings highlight some limitations of the PedsQL 4.0 for work with this population.
Sustained induction of epithelial to mesenchymal transition activates DNA methylation of genes silenced in basal-like breast cancers

The active acquisition of epigenetic changes is a poorly understood but important process in development, differentiation, and disease. Our work has shown that repression of the p16/pRb pathway in human epithelial cells, a condition common to stem cells and many tumor cells, induces dynamic epigenetic remodeling resulting in the targeted methylation of a selected group of CpG islands. We hypothesized that cells in this epigenetically plastic state could be programmed by the microenvironment to acquire epigenetic changes associated with tumorigenesis. Here, we describe an in vitro model system where epigenetically plastic cells were placed in an environment that induced epithelial to mesenchymal transition (EMT) and led to a program of acquired de novo DNA methylation at targeted sites. In this model, we found that repression of E-cadherin transcription preceded the subsequent acquisition of methylated CpG sites. Furthermore, the induction of EMT was accompanied by de novo methylation of several other gene promoters, including those of the estrogen receptor and Twist. These data demonstrate that signals from the microenvironment can induce phenotypic and gene expression changes associated with targeted de novo epigenetic alterations important in tumor progression, and that these alterations occur through a deterministic, rather than stochastic, mechanism. Given the dynamic epigenetic reprogramming that occurs in these cells, DNA methylation profiles observed in human tumors may reflect the history of environmental exposures during the genesis of a tumor.
Effects of Cleft Width and Veau Type on Incidence of Palatal Fistula and Velopharyngeal Insufficiency After Cleft Palate Repair

BackgroundPostoperative fistulae and velopharyngeal insufficiency (VPI) are 2 important complications after cleft palate repair. The effects of preoperative cleft width on outcomes after cleft palate repair have been rarely studied. MethodsA retrospective review of all patients undergoing primary cleft palatoplasty by a single surgeon between 2004 and 2011 was performed. Primary outcomes were palatal fistula and VPI, defined as the need for corrective surgery after failing conservative speech-language therapy. Logistic regression analysis was performed to identify factors associated with the primary outcomes. ResultsOne hundred seventy-seven patients (84 men and 93 women) were identified. Median age at repair was 10 months with median follow-up of 3.80 years. Preoperative cleft width was 10 mm or less for 72 (41%) patients, 11 to 14 mm for 54 (30%) patients, and 15 mm or greater for 51 (29%) patients. Palatal fistula was observed in 8 (4.5%) patients, but required surgical repair in only 2 (1.1%). Fistula was overall associated with Veau IV classification (odds ratio, 8.13; P < 0.01) but not with cleft width. Velopharyngeal insufficiency needing surgical intervention occurred in 9 patients (7.38% of patients older than 4 years) and was associated with increasing cleft width (odds ratio, 1.29; P = 0.011). Outcomes were similar for patients undergoing surgery in the earlier and later halves of the study. ConclusionsThis retrospective review is one of the first from the United States to explore the associations between measured cleft width and outcomes after palatoplasty. Overall rates of palatal fistula and VPI were low, corroborating previous studies showing good outcomes with the 2-flap palatoplasty. After adjusting for multiple variables including Veau type, cleft width was associated with higher VPI rates but not with fistula formation. Cleft width is a unique preoperative factor that should be considered and studied as a potential predictor of outcomes.
Joint Factor Analysis of the Children's Depression Inventory and the Revised Children's Manifest Anxiety Scale

Used a joint factor analysis with the Children's Depression Inventory (CDI; Kovacs, 1980/81, 1992) and Revised Children's Manifest Anxiety Scale (RCMAS; C. R. Reynolds & Richmond, 1978, 1985) to identify items that uniquely measured depression and anxiety. Data from 750 youngsters in Grades 4 through 7 were analyzed using principal-axis factoring with an oblique rotation. Salient factors were identified using guidelines provide by Gorsuch (1997). Item overlap and the large negative affectivity component across instruments were evident. Items that overlapped or had nonsalient loadings were eliminated. The sample was randomly split into 2 groups of 375 and analyses were repeated. Results indicated that a unique 9-item depression factor composed largely of items representing a negative view of oneself existed. In addition, a unique 7-item anxiety factor emerged that consisted of items reflecting worry. The validity of these abbreviated scales was explored using a separate sample of 131 students in Grades 4 through 9. The abbreviated scales were correlated with scales of positive and negative affect consistent with predictions. Findings suggest exploring alternative scoring strategies for the CDI and RCMAS to eliminate problems associated with overlapping items.
Organization and polarity of actin filament networks in cells: implications for the mechanism of myosin-based cell motility.

Force arising from myosin activity drives a number of different types of motility in eukaryotic cells. Outside of muscle tissue, the precise mechanism of myosin-based cell motility is for the most part theoretical. A large part of the problem is that, aside from cell surface features such as lamellipodia and microvilli, relatively little is known about the structural organization of potential actin substrates for myosin in non-muscle motile cells. Several groups [Cramer, Siebert and Mitchison (1997) J. Cell Biol. 136, 1287-1305; Guild, Connelly, Shaw and Tilney (1997) J. Cell Biol. 138, 783-797; Svitkina, Verkhovsky, McQuade and Borisy (1997) J. Cell Biol. 139, 397-415] have begun to address this issue by determining actin organization throughout entire non-muscle motile cells. These studies reveal that a single motile cell comprises up to four distinct structural groups of actin organization, distinguished by differences in actin filament polarity: alternating, uniform, mixed or graded. The relative abundance and spatial location in cells of a particular actin organization varies with cell type. The existence in non-muscle motile cells of alternating-polarity actin filament bundles, the organization of muscle sarcomeres, provides direct structural evidence that some forms of motility in non-muscle cells are based on sarcomeric contraction, a recurring theory in the literature since the early days of muscle research. In this scenario, as in muscle sarcomeres, myosin generates isometric force, which is ideally suited to driving symmetrical types of motility, e.g. healing of circular wounds in coherent groups of cells. In contrast, uniform-polarity actin filament bundles and oriented meshworks in cells allow oriented movement of myosin, potentially over relatively long distances. In this simple 'transport-based' scenario, the direction in which myosin generates force is inherently polarized, and is well placed for driving asymmetrical or polarized types of motility, e.g. as expected for long-range transport of membrane organelles. In the more complex situation of cell locomotion, the predominant actin organization detected in locomoting fish keratocytes and locomoting primary heart fibroblasts excludes sarcomeric contraction force from having a major role in pulling these cell types forward during locomotion. Instead Svitkina et al. propose that 'dynamic network contraction' of a weakly adherent uniform-polarity actin filament meshwork is the basis of keratocyte locomotion. For fibroblast locomotion, however, Cramer et al. prefer a transport mechanism based on graded-polarity actin filament bundles.
LIN-12/Notch trafficking and regulation of DSL ligand activity during vulval induction in Caenorhabditis elegans

A novel mode of crosstalk between the EGFR-Ras-MAPK and LIN-12/Notch pathways occurs during the patterning of a row of vulval precursor cells (VPCs) in Caenorhabditis elegans: activation of the EGFR-Ras-MAPK pathway in the central VPC promotes endocytosis and degradation of LIN-12 protein. LIN-12 downregulation in the central VPC is a prerequisite for the activity of the lateral signal, which activates LIN-12 in neighboring VPCs. Here we characterize cis-acting targeting sequences in the LIN-12 intracellular domain and find that in addition to a di-leucine motif, serine/threonine residues are important for internalization and lysine residues are important for post-internalization trafficking and degradation. We also identify two trans-acting factors that are required for post-internalization trafficking and degradation: ALX-1, a homolog of yeast Bro1p and mammalian Alix and the WWP-1/Su(dx)/Itch ubiquitin ligase. By examining the effects of mutated forms of LIN-12 and reduced wwp-1 or alx-1 activity on subcellular localization and activity of LIN-12, we provide evidence that the lateral signal-inhibiting activity of LIN-12 resides in the extracellular domain and occurs at the apical surface of the VPCs.
Adipose tissue recruitment of leukocytes

Purpose of review In December of 2003, two seminal articles describing the presence of macrophages in obese adipose tissue were published. These adipose tissue macrophages (ATMs) are inflammatory and promote local and systemic insulin resistance. Due to the continuing rise in obesity around the world, understanding how these ATMs contribute to metabolic disorders is of much interest. Recent findings Chemokines have been extensively studied for their role in ATM recruitment. Deficiency or antagonism of chemokine receptors that interact with multiple chemokine ligands reduces ATM accumulation. ATMs are now defined as either classically (M1) or alternatively (M2) activated. Peroxisome proliferator-activated receptor activation and adiponectin promote an M2-polarized state resulting in improved insulin sensitivity. Finally, recent studies have provided evidence that T lymphocytes, natural killer T cells, mast cells, and B cells also enter adipose tissue and may interact with macrophages and adipocytes. Summary Literature published during the past year has shown that macrophage recruitment to adipose tissue is only one of the important mediators of obesity-related insulin resistance. The phenotype of ATMs and recruitment of other immune cells to the adipose tissue play key roles in the overall contribution of adipose tissue to systemic metabolic outcomes of obesity.
Diagnostic management of suspected metastatic thyroid carcinoma: clinical value of octreotide scintigraphy in patients with negative high-dose radioiodine scans.

OBJECTIVES Somatostatin receptor scintigraphy (SRS) with (111)In-octreotide has been suggested as a potential tool for the detection of recurrent or metastatic differentiated thyroid cancer when no radioiodine uptake can be demonstrated in tumour sites. However, there is no consensus concerning the performance and clinical impact of this examination in such instances. DESIGN AND METHODS A prospective study was undertaken to evaluate SRS in 43 patients (18 men, 25 women) with papillary (n=20), follicular (n=9), insular (n=6) and oncocytic (n=8) thyroid carcinomas with elevated serum thyroglobulin (Tg) levels and no detected radioiodine uptake. RESULTS Evaluation criteria were interpreted in terms of an assumed presence of tumoural tissue. Sensitivity of SRS was 51%, clearly lower than that of conventional imaging procedures, and of positron emission tomography using [(18)F]-2-fluoro-2-deoxy-d-glucose, performed in a subset of 27 patients. In addition, we observed two false-positive foci of uptake of octreotide that corresponded to inflammatory pulmonary sites. The sensitivity was higher in patients with Tg levels greater than 50 microg/l (76%) for detecting mediastinal lesions (93%), and in patients with oncocytic cancer (88%). Finally, SRS changed treatment strategy in four patients. CONCLUSION In differentiated thyroid cancer, SRS is a moderately sensitive method for the detection of lesions unable to concentrate iodine and appears useful only in patients with very high Tg levels or in oncocytic cancer.
Biological and Physicochemical Wastewater Treatment Processes Reduce the Prevalence of Virulent Escherichia coli

ABSTRACT Effluents discharged from wastewater treatment plants are possible sources of pathogenic bacteria, including Escherichia coli, in the freshwater environment, and determining the possible selection of pathogens is important. This study evaluated the impact of activated sludge and physicochemical wastewater treatment processes on the prevalence of potentially virulent E. coli. A total of 719 E. coli isolates collected from four municipal plants in Québec before and after treatment were characterized by using a customized DNA microarray to determine the impact of treatment processes on the frequency of specific pathotypes and virulence genes. The percentages of potentially pathogenic E. coli isolates in the plant influents varied between 26 and 51%, and in the effluents, the percentages were 14 to 31%, for a reduction observed at all plants ranging between 14 and 45%. Pathotypes associated with extraintestinal pathogenic E. coli (ExPEC) were the most abundant at three of the four plants and represented 24% of all isolates, while intestinal pathogenic E. coli pathotypes (IPEC) represented 10% of the isolates. At the plant where ExPEC isolates were not the most abundant, a large number of isolates were classified as both ExPEC and IPEC; overall, 6% of the isolates were classified in both groups, with the majority being from the same plant. The reduction of the proportion of pathogenic E. coli could not be explained by the preferential loss of one virulence gene or one type of virulence factor; however, the quinolone resistance gene (qnrS) appears to enhance the loss of virulence genes, suggesting a mechanism involving the loss of pathogenicity islands.
Managing governance reform in the public sector

Corporate governance is the latest in a long list changes associated with New Public Management reforms which have been introduced into the public sector in Australia. Despite the wealth of research into change, a review of the literature shows that there is very little that takes into account the combination of the numerous factors involved in change, and still less those that characterise change in the public sector. This paper addresses this gap. Two hundred and thirty two chief executive and senior managers employed in all Australian state government departments were surveyed using a structured questionnaire. Factor analyses confirmed that political/cultural and rational/scientific factors proposed in a model influenced the adoption and operation of change management programs to introduce governance reforms.
Open Versus Arthroscopic Ankle Arthrodesis: A Comparison of Subsequent Procedures in a Large Database.

Arthroscopic and open ankle arthrodesis have been compared in very few studies, and no consensus has been reached regarding the incidence of postoperative revision surgery associated with each technique. The purpose of the present study was to compare these 2 approaches for the incidence of postsurgical operations. Patients who had undergone either arthroscopic or open ankle arthrodesis were identified between January 2005 to December 2011 in the PearlDiver(™) database using a predetermined algorithm and searched for the following postsurgical operations: revision ankle arthrodesis, midfoot arthrodesis, and hindfoot arthrodesis. In the current database, 7322 cases were performed with an open technique and 1152 arthroscopically. The incidence of revision arthrodesis was not significantly different statistically between the 2 techniques. However, the incidence of subsequent adjacent joint arthrodesis was greater for the open cohort (5.6% versus 2.6%; odds ratio 2.17, 95% confidence interval 1.49 to 3.16). In the open cohort, the incidence of hindfoot arthrodesis was greater than the incidence of midfoot arthrodesis (3.9% versus 1.6%, odds ratio 2.43, 95% confidence interval 1.95 to 3.01). The results showed that although open ankle arthrodesis is more commonly performed, it is associated with a greater incidence of subsequent adjacent joint arthrodesis specifically in the hindfoot.