Miracle-dz/UniFAR-FTUs huggingface dataset:
Pathologic findings from the national surgical adjuvant project for breast cancers (protocol no. 4) X. Discriminants for tenth year treatment failure

A search for prognostic discriminants of treatment failure in the tenth postmastectomy year was undertaken in 614 patients enrolled in protocol no. 4 of the National Surgical Adjuvant Project for Breast Cancers treated by radical mastectomy. Exploratory analyses of 38 pathologic and 6 clinical features disclosed 16 and 13 variables significantly related to nodal status and treatment failure, respectively. However, multivariate analyses with life tables adjusted or controlled for nodal status revealed that patients whose tumors measured <2 cm had a more favorable clinical course. All of the characteristics were also explored when patients were stratified according to numbers of nodal metastases, the most significant prognostic discriminant for disease‐free survival in the tenth year. A germinal center predominance lymph node pattern and high histologic grade according to our conventional grading method were observed to adversely influence disease‐free survival in patients with negative nodes. A strong trend in this manner was also observed with tumors ⩾2 cm and types 3 and 5 scar cancers. Histologic grade and tumor size were significantly recognized as discriminatory in patients with 4+ nodes but no factors were significantly observed in the group of patients with 1 to 3 positive nodes. A possible explanation for this inconsistency is discussed. For the most part, these factors were also encountered by us previously at the 5‐year postoperative period. Only the presence of 13+ nodal metastases and types 3 and 5 scar cancers and cancers without scar appeared to discriminate success or failure between the fifth and tenth year. It is therefore concluded that nodal category, germinal center predominance, histologic grade, and tumor size, in the contexts noted, represent strong prognostic discriminants exerting a rather constant influence on disease‐free survival at least to the tenth postmastectomy period. The prognostic value of categorizing those patients with 4+ positive nodes into subgroups with 4 to 6, 7 to 12 and 13+ is reaffirmed. The actual disease‐free survival of patients in the tenth year was not strikingly different from that observed previously by us at 5 years in this cohort.
Transcranial magnetic stimulation: normal values of magnetic motor evoked potentials in 84 normal horses and influence of height, weight, age and sex.

REASONS FOR PERFORMING STUDY Cervical spinal cord dysfunction is a common problem in equine medicine and the currently available tests give no objective information about the functionality of the nervous tracts. Therefore, transcranial magnetic stimulation (TMS) was performed in 84 healthy horses of different height in order to have an objective measure for the integrity of the descending motor tracts in normal horses. OBJECTIVES To obtain reference values for onset latency and peak-to-peak amplitude of magnetic motor evoked potentials (MMEPs) and to evaluate the possible effect of height, age and gender on the neurophysiological measures. METHODS All horses were sedated and stimulated transcranially by using a magnetic coil placed on the forehead. The stimulator triggered the sweep of an electromyogram machine that recorded MMEPs bilaterally from needle electrodes in the extensor carpi radialis and cranial tibial muscles. In that way, it was possible to measure latency between stimulus and onset of response. RESULTS A significant difference was found between recordings made in the fore- and hindlimbs; MMEPs recorded in the front legs had a shorter onset latency and higher peak-to-peak amplitude. Mean +/- s.d. normal values for onset latency of 19.32 +/- 2.50 and 30.54 +/- 5.28 msecs and peak-to-peak amplitude values of 9.54 +/- 3.73 and 6.62 +/- 3.62 mV were obtained for extensor carpi radialis and cranial tibial muscles, respectively. The left-to-right difference in onset latency and peak-to-peak amplitude was not significant. In the same horse, differences up to 0.82 and 1.53 msecs for the extensor carpi radialis and cranial tibial muscles, respectively, lie within the 95% confidence limit and are considered normal. In contrast to onset latency, peak-to-peak amplitude showed a very large intra- and interindividual variability, even in the same muscle. To reduce the variability and predict normal values of new individual cases, influence of height, weight, age and sex on the MMEPs were determined. No significant effects of sex were observed on onset latency and peak-to-peak amplitude. The age of the horse had only a small but significant effect on peak-to-peak amplitude, with larger responses in older horses. Height at the withers and weight of the horse, parameters that strongly correlate with the size of the horse, had an important significant influence on onset latency but not on peak-to-peak amplitude. The age of the horse and height at the withers were used to predict peak-to-peak amplitude and onset latency, respectively, in normal horses. CONCLUSIONS AND POTENTIAL RELEVANCE TMS is an excellent addition to the few tools we have for noninvasive imaging of the equine nervous system. Magnetically evoked potentials are highly reproducible and recent advances suggest that the applications of TMS in horses will continue to grow rapidly.
Biomechanics, energetics and coordination during extreme swimming intensity: effect of performance level

ABSTRACT The present study aimed to examine how high- and low-speed swimmers organise biomechanical, energetic and coordinative factors throughout extreme intensity swim. Sixteen swimmers (eight high- and eight low-speed) performed, in free condition, 100-m front crawl at maximal intensity and 25, 50 and 75-m bouts (at same pace as the previous 100-m), and 100-m maximal front crawl on the measuring active drag system (MAD-system). A 3D dual-media optoelectronic system was used to assess speed, stroke frequency, stroke length, propelling efficiency and index of coordination (IdC), with power assessed by MAD-system and energy cost by quantifying oxygen consumption plus blood lactate. Both groups presented a similar profile in speed, power output, stroke frequency, stroke length, propelling efficiency and energy cost along the effort, while a distinct coordination profile was observed (F(3, 42) = 3.59, P = 0.04). Speed, power, stroke frequency and propelling efficiency (not significant, only a tendency) were higher in high-speed swimmers, while stroke length and energy cost were similar between groups. Performing at extreme intensity led better level swimmers to achieve superior speed due to higher power and propelling efficiency, with consequent ability to swim at higher stroke frequencies. This imposes specific constraints, resulting in a distinct IdC magnitude and profile between groups.
The Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 11. What next?

Abstract Background and aims: Longstanding uncertainty surrounds the selection of surgical protocols for unilateral cleft lip and palate (UCLP), and randomised trials have only occasionally been performed. The Scandcleft Project consists of three trials initiated in 1997. The results at age 5 have been published in the series of reports that precede this manuscript, which aims to distill some of the issues that future trialists may need to address. Method: The shared experience of this group of trials is reviewed with reference to the current literature on trial management and, more specifically, trials of surgical technique and timing. Results: The main discussion points relate to the challenges associated with research bureaucracy, learning curve, individuality of skill, and ethics. Conclusions: Compliance with current regulatory requirements for clinical trials and recruitment rates for cleft sub-types represent substantial challenges. Mastery of new surgical techniques prior to trials raises important ethical issues, although recent reports in the wider surgical literature suggest that learning may be hastened with the assistance of anonymised peer review ratings of intraoperative performance. The three Scandcleft Trials succeeded in meeting the planned recruitment targets, and completed follow-up with remarkably high retention rates (99.3%). The design of the study required the majority of participating surgeons to master a new technique and, although overall outcomes were comparable with those in the literature, the associated learning curve increased postoperative complications in two of the trials. Trial registration: ISRCTN29932826.
The Impact of Rapid Response Team on Outcome of Patients Transferred From the Ward to the ICU: A Single-Center Study*

Objectives:To determine the impact of rapid response team implementation on the outcome of patients transferred from the regular hospital ward and nonward locations to the ICU. Design:Retrospective before–after cohort study. Setting:The study was performed in two ICUs, one surgical and one medical, of a tertiary medical center. Patients:We included 4,890 patients transferred from the hospital ward to two ICUs and 15,855 patients admitted from nonward locations. Interventions:None. Measurements and Main Results:Data on each patient were abstracted from the Acute Physiology and Chronic Health Evaluation III and the administrative hospital and rapid response team databases. The study period was divided into pre–rapid response team and rapid response team. A 24/7 critical care consult service and cardiac arrest teams were available for ward patient care during both periods. A total of 20,745 patients were admitted to the two study ICUs, of whom 4,890 were from the ward (2,466 and 2,424 during the pre–rapid response team and rapid response team periods, respectively). The first ICU day severity of illness was higher for the pre–rapid response team period. A multiple logistic regression model that included predicted mortality as a covariate suggested that availability of rapid response team was associated with an increased risk of hospital death in patients transferred to the ICU from the regular ward, odds ratio (95% CI) of 1.273 (1.089–1.490). For the nonward patients, the availability of rapid response team was similarly associated with increased risk of death. The ICU length of stay was shorter during the rapid response team period both in ward transfer and in nonward transfer patients. Conclusions:Rapid response team implementation is associated with increased numbers of ICU admissions and rates, and transfer from the ward of less severely ill patients. However, rapid response team implementation did not improve the severity-of-illness-adjusted outcome of patients transferred from the ward. Implementation of rapid response team in an institution with a 24/7 ICU consult service may have unforeseen costs without obvious benefit. Our findings highlight that institutions should evaluate the impact of rapid response team on patient outcome and make modifications specific to their practices.
Detecting sexual conflict and sexually antagonistic coevolution

We begin by providing an operational definition of sexual conflict that applies to both inter- and intralocus conflict. Using this definition, we examine a series of simple coevolutionary models to elucidate fruitful approaches for detecting interlocus sexual conflict and resultant sexually antagonistic coevolution. We then use published empirical examples to illustrate the utility of these approaches. Three relevant attributes emerge. First, the dynamics of sexually antagonistic coevolution may obscure the conflict itself. Second, competing models of inter-sexual coevolution may yield similar population patterns near equilibria. Third, a variety of evolutionary forces underlying competing models may be acting simultaneously near equilibria. One main conclusion is that studies of emergent patterns in extant populations (e.g. studies of population and/or female fitness) are unlikely to allow us to distinguish among competing coevolutionary models. Instead, we need more research aimed at identifying the forces of selection acting on shared traits and sexually antagonistic traits. More specifically, we need a greater number of functional studies of female traits as well as studies of the consequences of both male and female traits for female fitness. A mix of selection and manipulative studies on these is likely the most promising route.
Estrogen–Growth Factor Interactions and Their Contributions to Neurological Disorders

Estrogen has diverse and powerful effects in the brain, including actions on neurons, glia, and the vasculature. It is not surprising, therefore, that there are many changes in the female brain as serum estradiol levels rise and fall during the normal ovarian cycle. At times of life when estradiol levels change dramatically, such as puberty, postpartum, or menopause, there also are dramatic changes in the central nervous system. Changes that occur because of fluctuations in serum estrogen levels are potentially relevant to neurological disorders because symptoms often vary with the time of the ovarian cycle. Moreover, neurological disorders (eg, seizures and migraine) often increase in frequency in women when estradiol levels change. In this review, the contribution of 2 growth factors targeted by estrogen, the neurotrophin brain‐derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF), will be discussed. Estrogen‐sensitive response elements are present on the genes for both BDNF and VEGF, and they are potent modulators of neuronal, glial, and vascular function, making them logical candidates to mediate the multitude of effects of estrogen. In addition, BDNF induces neuropeptide Y, which has diverse actions that are relevant to estrogen action and to the same neurological disorders.
Circularly polarized tag antenna on an AMC substrate for wearable UHF RFID applications

This paper presents a circularly polarized tag on an AMC to achieve longer read range for UHF RFID on-body applications. In the conference paper, two asymmetrically orthogonal cross-dipoles printed on FR4 substrate are combined to generate a degenerate mode for circularly polarization. A symmetric T-matching transformer is employed to conjugate matching with a Monza 4 microchip. The body effect is very significant as the tag is designed for on-body applications. An artificial magnetic conductor (AMC) is placed on the back plane of the cross-dipole tag in order to insulate the influence from a human body. The tag with the AMC can increase antenna gain and achieve over 15 m read range as it is pasted on the human body.
Maturation of Human Cortical Auditory Function: Differences Between Normal‐Hearing Children and Children with Cochlear Implants

Objective: We investigated maturation of cortical auditory function in normal‐hearing children and in children who receive stimulation of their auditory system through a cochlear implant. Design: As a measure of cortical auditory function, auditory evoked responses(AERs) were recorded from normal‐hearing children and adults as well as from children and adults fitted with a cochlear implant. Morphological and latency changes for evoked responses recorded at electrode Cz are reported. Results: For normal‐hearing children, there is a gradual evolution of AER features that extends through adolescence, with P1 latency becoming adult‐like in the late teens. Latency changes for P1 occur at the same rate for implanted children, but the overall maturation sequence is delayed. By extrapolation from the existing data, the age at which P1 latency becomes adult‐like is delayed by approximately 5 yr for the implanted population. Other typical features of the AER, namely N1 and P2, are either delayed in developing or absent in the implanted children. Conclusions: These preliminary findings suggest both similarities and differences in cortical auditory maturation for normal‐hearing and implanted children. For implanted children, the 5 yr delay for maturation of P1 latency roughly corresponds to the average 4.5 yr interval between the onset of deafness and the time of implantation. These findings suggest that during the period of deafness, maturation of cortical auditory function does not progress. However, some, if not all, maturational processes resume after stimulation is reintroduced.
Characterization of NarJ, a System-specific Chaperone Required for Nitrate Reductase Biogenesis in Escherichia coli *

The narGHJI operon encodes the three subunits, α, β, and γ, of the respiratory nitrate reductase complex in Escherichia coli. A fourth open reading frame of the operon encodes a putative protein, NarJ, which is not present in purified nitrate reductase, but is required for biogenesis of the membrane-bound complex. NarJ was identified with a T7 expression system and was produced at significantly less than stoichiometric levels relative to the three enzyme subunits. A functional His-tagged NarJ fusion protein was overexpressed from a multicopy plasmid, purified by Ni2+ affinity chromatography, and characterized. Western blot analysis with antibodies raised against the fusion protein demonstrated that NarJ remained in the cytosol after assembly of the active membrane complex. The cytosolic αβ complex accumulated in anarJ insertion mutant was rapidly degraded after induction, but was stabilized by NarJ expressed from a multicopy plasmid. Overproduction of the His-tagged NarJ fusion protein in the same mutant led to the formation of an αβ·NarJ complex, which was resolved by Ni2+ affinity chromatography. The NarJ protein therefore has the properties of a system-specific (private) chaperone that reacts directly with and modifies the properties of the cytosolic αβ subunit complex, but remains in the cytoplasm after the assembly of the active αβγ complex in the membrane.
‘Biologic endoscopy’: optimization of upper aerodigestive tract cancer evaluation

Purpose of reviewEndoscopy is the first-line examination and most reliable way to get precise bidimensional assessment of the superficial extent of a squamous cell cancer arising within the upper aerodigestive tract (UADT). Its role as the cornerstone at each diagnostic step in the evaluation of head and neck cancer patients, in both treatment and follow-up, cannot be overemphasized. A number of technological improvements have been introduced to enhance conventional white light endoscopy of the UADT, in order to provide deeper insight into the specific biological properties of observed lesions. The purpose of this review is to summarize the most recent trends in ‘biologic endoscopy’ techniques. Recent findingsStarting from the use of toluidine blue up to the most recent light-based detection systems such as autofluorescence and narrow band imaging, researchers have devoted substantial efforts to the identification of specific biological properties of neoplastic tissues that can be targeted by new endoscopic tools. These aids attempt to assist the surgeon in achieving a more reliable distinction between normal and neoplastic or precancerous mucosa, within a wide range of inflammatory and iatrogenic modifications. SummaryEven though direct comparison of the efficacy of these techniques is seldom feasible due to their site-specific application, different advantages and disadvantages, economic considerations, and limited diffusion in daily practice, it is nevertheless clear that the future of endoscopy of the UADT will be strongly influenced by these new technologies.
Predicting Difficult Laparoscopic Cholecystectomy Based on Clinicoradiological Assessment.

INTRODUCTION Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic cholelithiasis. However, of all Laparoscopic cholecystectomies, 1-13% requires conversion to an open for various reasons. Thus, for surgeons it would be helpful to establish criteria that would predict difficult laparoscopic cholecystectomy and conversion preoperatively. But there is no clear consensus among the laparoscopic surgeons regarding the parameters predicting the difficult dissection and conversion to open cholecystectomy. AIM To assess the clinical and radiological parameters for predicting the difficult laparoscopic cholecystectomy and its conversion. MATERIALS AND METHODS This was a prospective study conducted from October 2010 to October 2014. Total of 180 patients meeting the inclusion criteria undergoing LC were included in the study. Four parameters were assessed to predict the difficult LC. These parameters were: 1) Gallbladder wall thickness; 2) Pericholecystic fluid collection; 3) Number of attacks; 4) Total leucocyte count. The statistical analysis was done using Z-test. RESULTS Out of 180 patients included in this study 126 (70%) were easy, 44 (24.44%) were difficult and 3 (5.56%) patients required conversion to open cholecystectomy. The overall conversion rate was 5.6%. The TLC>11000, more than 2 previous attacks of cholecystitis, GB wall thickness of >3mm and Pericholecystic collection were all statistically significant for predicting the difficult LC and its conversion. CONCLUSION The difficult laparoscopic cholecystectomy and conversion to open surgery can be predicted preoperatively based on number of previous attacks of cholecystitis, WBC count, Gall bladder wall thickness and Pericholecystic collection.
[Human multi-route exposure assessment of lead and cadmium for Korean volunteers].

OBJECTIVES We wanted to evaluate the main route of exposure to lead and cadmium for the general population in Korea by using multi-route and multi-media exposure assessment METHODS Samples of air at the homes, samples of the food and water and peripheral blood samples were collected from thirty volunteers living in Seoul (the metropolitan area), Yong-in (the suburban area) and Ansan (the industrial area) in 2001. Graphite furnace atomic absorption spectrometric methods were used for the determination of the Pb and Cd levels in the air, food, water and blood samples. RESULTS The average intake of lead through the air, drinking water and food were 5.06 microg/day (26.3%), 0.002 microg /day (0.1%), and 16.4 microg/day (73.6%), respectively. The average intake of cadmium through the air, drinking water and food were 0.082 microg/day (0.9%), 0.001 microg/day (0.007%), and 12.61 microg/day (99.0%), respectively. The blood lead level was statistically higher in the male subjects than in the female subjects (3.39 and 2.22 microg/dl, respectively), and only gender was a significant variable on the multiple regression analysis for blood lead. CONCLUSIONS This study showed that the intake of lead and cadmium through food was the major route of exposure. A policy to reduce the pollutants according to the exposure routes should be established. However, more studies will be needed to support these data for the general population.
Advances in glaucoma therapeutics

Glaucoma is a major cause of irreversible blindness in the world. The prevalence of glaucomatous loss in vision will continue to grow as our populations age. Ocular hypertension is a major risk factor for the development of glaucoma and current glaucoma therapy is directed at lowering intraocular pressure. Several new ocular hypotensive agents have been introduced in the past several years providing a variety of treatment options. In addition, various classes of neuroprotective agents demonstrating activity in a wide variety of animal models have been proposed as potential new glaucoma therapeutics. Although these approaches will slow the progression of vision loss, they do not directly intervene in the disease process(es). Advances have been made attempting to understand the pathogenic pathways involved in glaucomatous damage to the eye and in methods to clinically measure glaucoma damage. An increased understanding of the pathophysiology of glaucoma will lead to the development of new therapeutic agents that intervene and perhaps even reverse glaucomatous damage to the eye. There also is a need to develop new methods to clinically measure glaucoma damage because, currently, considerable damage occurs before glaucoma is diagnosed and glaucoma remains underdiagnosed in the general population.