Miracle-dz/UniFAR-FTUs huggingface dataset:
Body composition and mortality after adult lung transplantation in the United States.

RATIONALE Obesity and underweight are contraindications to lung transplantation based on their associations with mortality in studies performed before implementation of the lung allocation score (LAS)-based organ allocation system in the United States Objectives: To determine the associations of body mass index (BMI) and plasma leptin levels with survival after lung transplantation. METHODS We used multivariable-adjusted regression models to examine associations between BMI and 1-year mortality in 9,073 adults who underwent lung transplantation in the United States between May 2005 and June 2011, and plasma leptin and mortality in 599 Lung Transplant Outcomes Group study participants. We measured body fat and skeletal muscle mass using whole-body dual X-ray absorptiometry in 142 adult lung transplant candidates. MEASUREMENTS AND MAIN RESULTS Adjusted mortality rates were similar among normal weight (BMI 18.5-24.9 kg/m(2)), overweight (BMI 25.0-29.9), and class I obese (BMI 30-34.9) transplant recipients. Underweight (BMI < 18.5) was associated with a 35% increased rate of death (95% confidence interval, 10-66%). Class II-III obesity (BMI ≥ 35 kg/m(2)) was associated with a nearly twofold increase in mortality (hazard ratio, 1.9; 95% confidence interval, 1.3-2.8). Higher leptin levels were associated with increased mortality after transplant surgery performed without cardiopulmonary bypass (P for interaction = 0.03). A BMI greater than or equal to 30 kg/m(2) was 26% sensitive and 97% specific for total body fat-defined obesity. CONCLUSIONS A BMI of 30.0-34.9 kg/m(2) is not associated with 1-year mortality after lung transplantation in the LAS era, perhaps because of its low sensitivity for obesity. The association between leptin and mortality suggests the need to validate alternative methods to measure obesity in candidates for lung transplantation. A BMI greater than or equal to 30 kg/m(2) may no longer contraindicate lung transplantation.
Health literacy demands of written health information materials: an assessment of cervical cancer prevention materials.

BACKGROUND Health literacy requires reading and writing skills as well as knowledge of health topics and health systems. Materials written at high reading levels with ambiguous, technical, or dense text, often place great comprehension demands on consumers with lower literacy skills. This study developed and used an instrument to analyze cervical cancer prevention materials for readability, comprehensibility, suitability, and message design. METHODS The Suitability Assessment of Materials (SAM) was amended for ease of use, inclusivity, and objectivity with the encouragement of the original developers. Other novel contributions were specifically related to "comprehensibility" (CAM). The resulting SAM + CAM was used to score 69 materials for content, literacy demand, numeric literacy, graphics, layout/typography, and learning stimulation variables. Expert reviewers provided content validation. Inter-rater reliability was "substantial" (kappa = .77). RESULTS The mean reading level of materials was 11th grade. Most materials (68%) scored as "adequate" for comprehensibility, suitability, and message design; health education brochures scored better than other materials. Only one-fifth were ranked "superior" for ease of use and comprehensibility. CONCLUSIONS Most written materials have a readability level that is too high and require improvement in ease of use and comprehensibility for the majority of readers.
Practical Interventions to Promote Circadian Adaptation to Permanent Night Shift Work: Study 4

Scheduled bright light and darkness can phase shift the circadian clocks of night workers for complete adaptation to a night work, day sleep schedule, but few night workers would want this because it would leave them out of phase with the diurnal world on days off. This is the final study in a series designed to produce a compromise circadian phase position for permanent night shift work in which the sleepiest circadian time is delayed out of the night work period and into the first half of the day sleep episode. The target compromise phase position was a dim light melatonin onset (DLMO) of 3:00, which puts the sleepiest circadian time at ~10:00. This was predicted to improve night shift alertness and performance while permitting sufficient daytime sleep after work as well as late-night sleep on days off. In a between-subjects design, 19 healthy subjects underwent 3 simulated night shifts (23:00-7:00), 2 days off, 4 more night shifts, and 2 more days off. Subjects “worked” in the lab and slept at home. Experimental subjects received four 15-min bright light pulses during each night shift, wore dark sunglasses when outside, slept in dark bedrooms at scheduled times, and received outdoor afternoon light exposure (“light brake”) to keep their rhythms from delaying too far. Control subjects remained in normal room light during night shifts, wore lighter sunglasses, and had unrestricted sleep and outdoor light exposure. The final DLMO of the experimental group was 3:22 ± 2.0 h, close to the target of 3:00, and later than the control group at 23:24 ± 3.8 h. Experimental subjects slept for nearly all the permitted time in bed. Some control subjects who slept late on weekends also reached the compromise phase position and obtained more daytime sleep. Subjects who phase delayed (whether in the experimental or control group) close to the target phase performed better during night shifts. A compromise circadian phase position improved performance during night shifts, allowed sufficient sleep during the daytime after night shifts and during the late nighttime on days off, and can be produced by inexpensive and feasible interventions.
The role of quality tools in assessing reliability of the Internet for health information

The Internet has made it possible for patients and their families to access vast quantities of information that previously would have been difficult for anyone but a physician or librarian to obtain. Health information websites, however, are recognised to differ widely in quality and reliability of their content. This has led to the development of various codes of conduct or quality rating tools to assess the quality of health websites. However, the validity and reliability of these quality tools and their applicability to different health websites also varies. In principle, rating tools should be available to consumers, require a limited number of elements to be assessed, be assessable in all elements, be readable and be able to gauge the readability and consistency of information provided from a patient's view point. This article reviews the literature on the trends of the Internet use for health and analyses various codes of conduct/ethics or ‘quality tools’ available to monitor the quality of health websites from a patient perspective.
Kinetics of Insulin-Mediated and Non-Insulin-Mediated Glucose Uptake in Humans

The kinetics of insulin-mediated glucose uptake (IMGU) and non-insulin-mediated glucose uptake (NIMGU) in humans have not been well defined. We used the glucose-clamp technique to measure rates of wholebody and leg muscle glucose uptake in six healthy lean men during hyperinsulinemia (∼460 pM) to study IMGU and during somatostatin-induced insulinopenia to study NIMGU at four glucose levels (4.5, 9,12, and 21 mM). To measure leg glucose uptake, the femoral artery and vein were catheterized, and blood flow was measured by thermodilution (leg glucose uptake = arteriovenous glucose difference [A-VG] × blood flow). With this approach, we found that, during hyperinsulinemia, both whole-body and leg glucose uptake increased in a curvilinear fashion at every glucose level, the highest glucose uptake values obtained being 139 ± 17 μmol · kg−1 · min−1 and 3656 ± 931 μmol · min−1 · leg−1, respectively. Leg blood flow increased twofold from 6.0 ± 1.7 to 11.7 ± 3.1 dl/min (P < 0.01) over the range of glucose and was correlated with whole-body glucose uptake (r = 0.55, P < 0.005). Leg muscle glucose extraction, independent of changes in blood flow, which is reflected by the A-VG, saturated over the range of glucose (1.28 ± 0.12, 2.22 ± 0.30, 2.92 ± 0.42, 3.02 ± 0.41 mM, NS between last 2 values) with a halfmaximal effective glucose concentration (EGS0) of 5.3 ± 0.4 mM. During insulinopenia, both whole-body and leg glucose uptake increased in a near-linear fashion; however, glucose uptake remained significantly lower than that seen with insulin stimulation, the highest glucose uptake values obtained being 22 ± 2 μmol · kg−1 · min−1 and 260 ± 34 μmol · min−1 · leg1, respectively. Leg blood flow was unchanged from the basal value (4.15 ± 0.63 dl/min) over the range of glucose studied, and A-VG increased at all glucose levels: 0.094 ± 0.010, 0.28 ± 0.03, 0.38 ± 0.04, and 0.59 ± 0.03 mM (P < 0.05 between any 2 consecutive values), with an EG50 of 10.0 ± 0.4 mM (P < 0.001 vs. IMGU). We conclude that 1) insulin increases the capacity for muscle A-VQ approximately fivefold; 2) muscle IMGU, independent of blood flow, displays an EG50 similar to the Km characteristic of the glucose-transport system (∼5–6 mM); 3) in contrast, NIMGU is a low-affinity glucoseuptake system; and 4) blood flow to insulin-sensitive tissue increases with insulin and glucose infusions and is an important determinant of the rate of in vivo glucose uptake.
Using positive deviance techniques to improve smoking cessation outcomes in New South Wales prison settings.

Average smoking prevalence among New South Wales (NSW) prisoners exceeds 72%. Most inmates have no intention to stop smoking in the short term, making management of prisonbased smoking cessation (Quit) programs difficult.1-3 The NSW Tobacco Action Plan identifies prisoners as a priority group for smoking cessation initiatives.4 The cost to Justice Health of structured smoking cessation programs is substantial – typically $400 per inmate, including cost of nicotine replacement therapy and weekly peer-support and counselling sessions. It is therefore important to explore less expensive ways to help smoker prisoners quit. Since 2006, the authors introduced positive deviance techniques5 to complement structured Quit programs in a NSW prison, highlighting positive exceptions (i.e. non-smokers and quitters) to smoking stereotypes in prison settings, and encouraging mainstream adoption of the success strategies of these ‘positive deviants’. Positive deviance is an ‘assets-based’, four-stage approach that focuses on using the resources already available among communities to promote health (see Table 1). 6 Over a 15-month review period, smoking prevalence fell by 20 percentage points in this prison, 70% of Quit participants were not smoking three months after the program started (compared with an average 52% success rate for other comparable Justice Health structured Quit programs between 2001-05). Eleven of 14 long-sentence prisoners who participated in the program remained abstinent for at least 12 months, compared with 16 out of 41 patients similarly followed-up at other sites. Furthermore, the documented number of smokers making efforts to quit smoking on their own in this centre by contacting clinic nurses during the review period was significantly higher than in the other sites where similar Quit programs were being undertaken. The recognition accorded positive deviants by Justice Health staff and their ‘no-smoking’ advocacy (e.g. during World No Tobacco Day activities) apparently also served to promote a smoking abstinence norm in this prison.
Stakeholder integration in service innovation - an exploratory case study in the healthcare industry

This paper explores the integration of internal and external stakeholders in service innovation. Building upon the co-creative paradigm, the resource and knowledge integration of stakeholders in dynamic and complex service systems is gaining importance. This case study analyses the practice of stakeholder integration in a service innovation project at a German provider for medical appliances. We show that stakeholder integration is realised in the modes of reactive integration for the majority of stakeholders, whereas mutual integration is realised with members of the organisation, only. Customers are integrated as reactive resources throughout the innovation process, also informally and indirectly. The evidence from this empirical study suggests that stakeholder integration in service systems creates interdependencies between stakeholders and implicates that indirect ways of stakeholder integration have to be taken into account for project and stakeholder management.
Clinical impact of defibrillation testing at the time of implantable cardioverter-defibrillator insertion.

BACKGROUND Ventricular fibrillation is routinely induced during implantable cardioverter-defibrillator insertion to assess defibrillator performance, but this strategy is experiencing a progressive decline. We aimed to assess the efficacy of defibrillator therapies and long-term outcome in a cohort of patients that underwent defibrillator implantation with and without defibrillation testing. METHODS Retrospective observational series of consecutive patients undergoing initial defibrillator insertion or generator replacement. We registered spontaneous ventricular arrhythmias incidence and therapy efficacy, and mortality. RESULTS A total of 545 patients underwent defibrillator implantation (111 with and 434 without defibrillation testing). After 19 (range 9-31) months of follow-up, the death rate per observation year (4% vs. 4%; p = 0.91) and the rate of patients with defibrillator-treated ventricular arrhythmic events per observation year (with test: 10% vs. without test: 12%; p = 0.46) were similar. The generalized estimating equations-adjusted first shock probability of success in patients with test (95%; CI 88-100%) vs. without test (98%; CI 96-100%; p = 0.42) and the proportion of successful antitachycardia therapies (with test: 87% vs. without test: 80%; p = 0.35) were similar between groups. There was no difference in the annualized rate of failed first shock per patient and per shocked patient between groups (5% vs. 4%; p = 0.94). CONCLUSIONS In this observational study, that included an unselected population of patients with a defibrillator, no difference was found in overall mortality, first shock efficacy and rate of failed shocks regardless of whether defibrillation testing was performed or not.
Particle acceleration in turbulence and weakly stochastic reconnection.

In this Letter we analyze the energy distribution evolution of test particles injected in three dimensional (3D) magnetohydrodynamic (MHD) simulations of different magnetic reconnection configurations. When considering a single Sweet-Parker topology, the particles accelerate predominantly through a first-order Fermi process, as predicted in and demonstrated numerically in . When turbulence is included within the current sheet, the acceleration rate is highly enhanced, because reconnection becomes fast and independent of resistivity and allows the formation of a thick volume filled with multiple simultaneously reconnecting magnetic fluxes. Charged particles trapped within this volume suffer several head-on scatterings with the contracting magnetic fluctuations, which significantly increase the acceleration rate and results in a first-order Fermi process. For comparison, we also tested acceleration in MHD turbulence, where particles suffer collisions with approaching and receding magnetic irregularities, resulting in a reduced acceleration rate. We argue that the dominant acceleration mechanism approaches a second order Fermi process in this case.
Plasticity of Myeloid Cells during Oral Barrier Wound Healing and the Development of Bisphosphonate-related Osteonecrosis of the Jaw*

Injury to the barrier tissue initiates a rapid distribution of myeloid immune cells from bone marrow, which guide sound wound healing. Bisphosphonates, a widely used anti-bone resorptive drug with minimal systemic side effects, have been linked to an abnormal wound healing in the oral barrier tissue leading to, in some cases, osteonecrosis of the jaw (ONJ). Here we report that the development of ONJ may involve abnormal phenotypic plasticity of Ly6G+/Gr1+ myeloid cells in the oral barrier tissue undergoing tooth extraction wound healing. A bolus intravenous zoledronate (ZOL) injection to female C57Bl/6 mice followed by maxillary first molar extraction resulted in the development of ONJ-like lesion during the second week of wound healing. The multiplex assay of dissociated oral barrier cells exhibited the secretion of cytokines and chemokines, which was significantly modulated in ZOL mice. Tooth extraction-induced distribution of Ly6G+/Gr1+ cells in the oral barrier tissue increased in ZOL mice at week 2. ONJ-like lesion in ZOL mice contained Ly6G+/Gr1+ cells with abnormal size and morphology as well as different flow cytometric staining intensity. When anti-Ly6G (Gr1) antibody was intraperitoneally injected for 5 days during the second week of tooth extraction, CD11b+GR1hi cells in bone marrow and Ly6G+ cells in the oral barrier tissue were depleted, and the development of ONJ-like lesion was significantly attenuated. This study suggests that local modulation of myeloid cell plasticity in the oral barrier tissue may provide the basis for pathogenesis and thus therapeutic as well as preventive strategy of ONJ.
A 9-shaped antenna for 5G applications

In this paper, Multiband 9-shaped microstrip patch antenna using epoxy substrate has been designed, simulated, and optimized to meet the best possible result using two simulation software: HFSS (High Frequency Structure Simulator) software and CST Microwave Studio software. Microstrip patch antennas are widely used because of their several advantages such as light weight, low volume, and low fabrication cost. The performance of the designed antenna was analyzed in term of bandwidth, gain, return loss, VSWR, and radiation pattern.
Correlation of clinical score, intrapleural pressure, cytologic findings of bronchoalveolar fluid, and histopathologic lesions of pulmonary tissue in horses with summer pasture-associated obstructive pulmonary disease.

OBJECTIVE To correlate clinical score, intrapleural pressure, cytologic findings of bronchoalveolar lavage fluid (BALF), and histologic lesions of pulmonary tissue in horses affected with summer pasture-associated obstructive pulmonary disease (SPAOPD). ANIMALS 8 adult horses affected with SPAOPD and 6 adult horses without evidence of respiratory tract disease. PROCEDURE Clinical score, change in intrapleural pressure (deltaPpl) during tidal breathing, results of cytologic examination and bacteriologic culture of BALF, and results of histologic examination of pulmonary parenchyma were evaluated. RESULTS Clinical scores for SPAOPD-affected horses (median, 5.75; range, 4.0 to 7.5) were significantly greater, compared with clinically normal horses (median, 2.0; range, 2.0 to 3.0). Cytologic examination of BALF from SPAOPD-affected horses revealed predominantly nondegenerate neutrophils. Histologic lesions were identified throughout pulmonary tissue and included severe accumulation of mucus and neutrophils within the small airways, metaplasia of bronchiolar goblet cells, and mild peribronchial infiltrate. Histologic examination of specimens collected via percutaneous biopsy was predictive of disease and corresponded to findings at postmortem examination. Clinical score and deltaPpl were highly correlated with mucus accumulation in the airways of affected horses. Peribronchial inflammatory infiltrate correlated with percentage of neutrophils in BALF of affected horses. CONCLUSIONS AND CLINICAL RELEVANCE Clinical scoring and deltaPpl provided valid estimates of disease severity. Findings from cytologic examination of BALF of SPAOPD-affected horses varied, although, in most instances, it was diagnostically useful. Severe mucus accumulation in the airways was the most remarkable histopathologic finding in SPAOPD-affected horses. Examination of biopsy specimens collected from pulmonary parenchyma was consistently useful in diagnosing SPAOPD.
Prooxidants open both the mitochondrial permeability transition pore and a low-conductance channel in the inner mitochondrial membrane.

Mitochondria can be induced by a variety of agents/conditions to undergo a permeability transition (MPT), which nonselectively increases the permeability of the inner membrane (i.m.) to small (<1500 Da) solutes. Prooxidants are generally considered to trigger the MPT, but some investigators suggest instead that prooxidants open a Ca(2+)-selective channel in the inner mitochondrial membrane and that the opening of this channel, when coupled with Ca(2+) cycling mediated by the Ca(2+) uniporter, leads ultimately to the observed increase in mitochondrial permeability [see, e.g., Schlegel et al. (1992) Biochem. J. 285, 65]. S. A. Novgorodov and T. I. Gudz [J. Bioenerg. Biomembr. (1996) 28, 139] propose that the i.m. contains a pore that, upon exposure to prooxidants, can open to two states, one of which conducts only H(+) and one of which is the classic MPT pore. Given the current interest in increased mitochondrial permeability as a factor in apoptotic cell death, it is important to determine whether i.m. permeability is regulated in one or multiple ways and, in the latter event, to characterize each regulatory mechanism in detail. This study examined the effects of the prooxidants diamide and t-butylhydroperoxide (t-BuOOH) on the permeability of isolated rat liver mitochondria. Under the experimental conditions used, t-BuOOH induced mitochondrial swelling only in the presence of exogenous Ca(2+) (>2 microM), whereas diamide was effective in its absence. In the absence of exogenous inorganic phosphate (P(i)), (1) both prooxidants caused a collapse of the membrane potential (DeltaPsi) that preceded the onset of mitochondrial swelling; (2) cyclosporin A eliminated the swelling induced by diamide and dramatically slowed that elicited by t-BuOOH, without altering prooxidant-induced depolarization; (3) collapse of DeltaPsi was associated with Ca(2+) efflux but not with efflux of glutathione; (4) neither Ca(2+) efflux nor DeltaPsi collapse was sensitive to ruthenium red; (5) collapse of DeltaPsi was accompanied by an increase in matrix pH; no stimulation of respiration was observed; (6) Sr(2+) was able to substitute for Ca(2+) in supporting t-BuOOH-induced i.m. depolarization, but not swelling; (7) in addition to being insensitive to CsA, the collapse of DeltaPsi was also resistant to trifluoperazine, spermine, and Mg(2+), all of which block the MPT; and (8) DeltaPsi was restored (and its collapse was inhibited) upon addition of dithiothreitol, ADP, ATP or EGTA. We suggest that these results indicate that prooxidants open two channels in the i.m. : the classic MPT and a low-conductance channel with clearly distinct properties. Opening of the low-conductance channel requires sulfhydryl group oxidation and the presence of a divalent cation; both Ca(2+) and Sr(2+) are effective. The channel permits the passage of cations, including Ca(2+), but not of protons. It is insensitive to inhibitors of the classic MPT.