Miracle-dz/UniFAR-FTUs huggingface dataset:
Renal Sympathetic Denervation as an Adjunct to Catheter Ablation for the Treatment of Ventricular Electrical Storm in the Setting of Acute Myocardial Infarction

We present a case of ventricular storm (VS) in a patient with acute ST‐elevation myocardial infarction (STEMI). After initial successful thrombus extraction and percutaneous coronary intervention (PCI) of the proximal left anterior descending (LAD) coronary artery, a 63‐year‐old male patient showed recurrent monomorphic ventricular tachycardia (VT) and fibrillation (VF) episodes refractory to antiarrhythmic drug therapy. After initial successful VT ablation, fast VT and VF episodes remained an evident problem despite maximum antiarrhythmic drug therapy. Due to an increasing instability, renal sympathetic denervation (RDN) was performed. ICD interrogation and 24‐hour Holter monitoring excluded recurrent episodes of VT or VF at a 6‐month follow‐up (FU) after discharge. This case highlights that RDN was effective and safely performed in a hemodynamically unstable patient with VS after STEMI and adjunct catheter ablation. RDN may open a new avenue for an adjunctive interventional bailout treatment of such highly challenging patients.
Elevated expression of inducible nitric oxide synthase and inflammatory cytokines in the alveolar macrophages after esophagectomy

Objective To evaluate the role of inducible nitric oxide (NO) synthase (iNOS) and inflammatory cytokines in alveolar macrophages (AMs) after esophagectomy in the pathogenesis of acute lung injury. Design Prospective, exploratory, open-labeled clinical study. Setting Intensive care unit and operating room in a university hospital. Patients Thirteen patients receiving esophagectomy with carcinoma of the esophagus (postesophagectomy group), ten patients just before the surgery (preoperation group), and seven patients receiving surgery less invasive than esophagectomy (other surgery group) were selected. Interventions Bronchoalveolar lavage fluid (BALF) and blood samples were obtained from study groups. Measurements and Main Results The AMs in the BALF collected from each group were stained immunohistochemically with antibodies against iNOS, interleukin (IL)-6, and IL-8. The intensities of these expressions were determined by semiquantitative cytofluorometric system. NOx (NO2−+NO3−), IL-6, and IL-8 levels in the BALF and plasma were measured concurrently. The expressional intensities of iNOS, IL-6, and IL-8 in AMs obtained from the postesophagectomy group were maximal 24 hrs after the skin incision and significantly more evident than those from other groups. The IL-6, IL-8, and NOx levels in BALF and IL-6 and IL-8 levels in plasma in the postesophagectomy patients were also elevated. The intensities of iNOS and inflammatory cytokines expressions in AMs were closely related to postoperative respiratory failure. Conclusions The activation of topical alveolar macrophages may be involved in the pathogenesis of pulmonary complications in the postoperative period after esophagectomy.
Kinetics of promoter Pol II on Hsp70 reveal stable pausing and key insights into its regulation

The kinetics with which promoter-proximal paused Pol II undergoes premature termination versus productive elongation is key to understanding mechanisms of metazoan transcription regulation. To assess the fate of paused Pol II, Lis and colleagues measured the stability of paused Pol II at the Drosophila Hsp70 locus through a combination of optical studies and biochemical analysis. Heat shock drastically increases elongating Pol II without decreasing termination, indicating that regulation acts at the step of paused Pol II entry to productive elongation.
Blood Cell Activation: New Perspectives from Ultrastructural Morphometry

The new computerized approaches for image analysis available for a few years permit, in an excellent and detailed way, monitoring cellular structural modifications during activation processes. Here, we presented morphometric data obtained on blood cells (platelets, monocytes, and PMN cells) after in vitro activation and under in vivo conditions related to atherosclerosis studied by means of electron microscopy. Area and perimeter form factors, nucleus to cytoplasma area ratio, and the surface density of platelet plasma membrane openings of SCCS presented significant differences compared with the respective significant differences compared with the respective controls. Ultrastructural markers of blood cell activation were revealed by the computerized morphometry applied on ultrastructural images.
Transferability of macrolide, lincomycin, and streptogramin resistances between group A, B, and D streptococci, Streptococcus pneumoniae, and Staphylococcus aureus

The transferability of plasmid pRI405 between various streptococci of groups A, B, and D, Streptococcus pneumoniae, and Staphylococcus aureus is described. pRI405 originated from Streptococcus faecalis and encodes for resistance to macrolides, lincomycin, and streptogramin B (MLS resistance). The host range of the well-documented streptococcal plasmid pAM beta 1 was found to be similar to that of pRI405. Cleavage with restriction enzymes suggests that pRI405 belongs to a related family of MLS resistance plasmids.
The Pasinetti paradox in neoclassi-cal and more general models

A machine for transferring adhesive labels from both sides of a single carrier strip to two separate streams of product items on a continuous basis. A pair of spaced continuously rotating vacuum wheels come in contact with opposite sides of the carrier strip, the carrier strip passing around a loop-forming roller adjacent each vacuum wheel to bring the label in contact with the vacuum wheel. Each vacuum wheel has holes around the periphery thereof, a vacuum being applied through the openings in a stationary sector of the vacuum wheel. As each label comes in contact with the associated vacuum wheel, it is pulled off by the vacuum and transported through the sector angle to a release point, where it is transferred to the surface of a product item.
Safety, efficacy and determinants of effectiveness of antimalarial drugs during pregnancy: implications for prevention programmes in Plasmodium falciparum‐endemic sub‐Saharan Africa

Plasmodium falciparum malaria in pregnancy poses substantial risk to a pregnant woman and her neonate through anaemia and low birth weight (LBW), respectively, and is responsible for up to 35% of preventable LBW in malaria‐endemic areas. Chemoprophylaxis or intermittent preventive treatment (IPT) with an effective antimalarial can ameliorate the adverse effects of malaria during pregnancy. Current guidelines from the WHO recommend that women in highly malarious areas receive IPT with an effective antimalarial. Two central considerations in evaluating drugs for use during pregnancy are safety for the mother and her foetus and effectiveness, which is determined by efficacy, cost, availability, deliverability and acceptability of the drug. These factors may be scored and potential drugs or drug combinations ranked in order of potential effectiveness for use in prevention programmes. The seven most promising regimens are all IPT, primarily because they are more easily delivered and less expensive than chemoprophylaxis. Currently, IPT with sulphadoxine–pyrimethamine (SP) is more likely to have the best overall effectiveness in preventing adverse outcomes associated with malaria in pregnancy. Its low cost, wide availability, easy deliverability and acceptability make it the clear choice in countries where efficacy of the drug remains good. For countries where resistance to SP is rising or already high, amodiaquine (alone or in combination with SP or artesunate) artesunate + SP, chlorproguanil–dapsone (with and without artesunate) and artemether–lumefantrine require urgent evaluation for use in pregnancy.
Population pharmacokinetics and Bayesian estimation of tacrolimus exposure in paediatric liver transplant recipients.

AIMS The objectives of this study were to develop a population pharmacokinetic (PopPK) model for tacrolimus in paediatric liver transplant patients and determine optimal sampling strategies to estimate tacrolimus exposure accurately. METHODS Twelve hour intensive pharmacokinetic profiles from 30 patients (age 0.4-18.4 years) receiving tacrolimus orally were analysed. The PopPK model explored the following covariates: weight, age, sex, type of transplant, age of liver donor, liver function tests, albumin, haematocrit, drug interactions, drug formulation and time post-transplantation. Optimal sampling strategies were developed and validated with jackknife. RESULTS A two-compartment model with first-order absorption and elimination and lag time described the data. Weight was included on all pharmacokinetic parameters. Typical apparent clearance and central volume of distribution were 12.1 l h(-1) and 31.3 l, respectively. The PopPK approach led to the development of optimal sampling strategies, which allowed estimation of tacrolimus pharmacokinetics and area under the concentration–time curve (AUC) on the basis of practical sampling schedules (three or four sampling times within 4 h) with clinically acceptable prediction error limit. The mean bias and precision of the Bayesian vs. reference (trapezoidal) AUCs ranged from -2.8 to -1.9% and from 7.4 to 12.5%, respectively. CONCLUSIONS The PopPK of tacrolimus and empirical Bayesian estimates represent an accurate and convenient method to predict tacrolimus AUC(0-12) in paediatric liver transplant recipients, despite high between-subject variability in pharmacokinetics and patient demographics. The developed optimal sampling strategies will allow the undertaking of prospective trials to define the tacrolimus AUC-based therapeutic window and dosing guidelines in this population.
Neural correlates of quantity processing of numeral classifiers.

OBJECTIVE Classifiers play an important role in describing the quantity information of objects. Few studies have been conducted to investigate the brain organization for quantity processing of classifiers. In the current study, we investigated whether activation of numeral classifiers was specific to the bilateral inferior parietal areas, which are believed to process numerical magnitude. METHOD Using functional MRI, we explored the neural correlates of numeral classifiers, as compared with those of numbers, dot arrays, and nonquantity words (i.e., tool nouns). RESULTS Our results showed that numeral classifiers and tool nouns elicited greater activation in the left inferior frontal lobule and left middle temporal gyrus than did numbers and dot arrays, but numbers and dot arrays had greater activation in the middle frontal gyrus, precuneus, and the superior and inferior parietal lobule in the right hemisphere. No differences were found between numeral classifiers and tool nouns. CONCLUSION The results suggest that quantity processing of numeral classifiers is independent of that of numbers and dot arrays, supporting the notation-dependent hypothesis of quantity processing.
Convergence of two global transcriptional regulators on nitrogen induction of the stress‐acclimation gene nblA in the cyanobacterium Synechococcus sp. PCC 7942

Cyanobacteria respond to environmental stress conditions by degrading their phycobilisomes, the light harvesting complexes for photosynthesis. The expression of nblA, a key gene in this process, is controlled by the response regulator NblR in Synechococcus sp. PCC 7942. Here we show that, under nitrogen stress, nblA is also regulated by NtcA, the global regulator for nitrogen control. NtcA activation of nblA was found to be nitrogen‐specific and did not take place under sulphur stress. Transcripts from the two major transcription start points (tsp) for the nblA gene were induced in response to nitrogen and sulphur starvation. The most active one (tspII) required both NblR and NtcA to induce full nblA expression under nitrogen starvation. NblR and NtcA bound in vitro to a DNA fragment from the nblA promoter region, suggesting that, under nitrogen stress, both NblR and NtcA activate the main regulated promoter (PnblA‐2) by direct DNA‐binding. The structure of PnblA‐2 differs from that of the canonical NtcA‐activated promoter and it is therefore proposed to represent a novel type of NtcA‐dependent promoter. We analysed expression patterns from ntcA and selected NtcA targets in NtcA–, NblR– and wild‐type strains, and discuss data suggesting further interrelations between phycobilisome degradation and nitrogen assimilation regulatory pathways.
Migrating Legacy Systems: Gateways, Interfaces, and the Incremental Approach

Many businesses are burdened by legacy ISs--existing systems that contain valuable data but lack the power or the agility to meet current organizational requirements. Since such systems are by nature resistant to modification, the only way an enterprise can gain full use of the data within one is to move to a completely new IS--ideally, one that won't become a legacy itself in a few years. This book discusses the challenges and provides a framework for a workable system migration, based on incremental modifications that allow the manager to control cost and risk. Focusing on data migration, the authors outline key techniques for transforming a legacy IS into a flexible system that meets current needs and is adaptable to unpredictable future changes. Because designing, developing, testing, and deploying a new system all at once would be extremely risky, the authors advocate a step-by-step strategy that migrates the system to a decomposable target environment while the current IS remains completely operational. Their flexible 11-step method allows any IS to be migrated incrementally, using gateways to access data reliably and accurately without any downtime. Because each company's IS is as unique as its business strategy, the authors focus on the choices and pitfalls that may be encountered in an IS migration. Drawing on over 45 years of collective IS experience, they illustrate their work with two complete case studies of migration projects they worked on themselves. Their versatile solution is effective for any migration, including those to a client/server environment using relational DBMSs and 4GLs. Features a special survey of migration tools by Jennifer Schmidt. Note: the authors would be very interested in receiving a brief report on any successful legacy IS migration project using their methodology or any other, or of significant problems encountered in a migration attempt. As such projects take years, success can apply to the first significant increment.
Sixteen-detector row CT of abdomen and pelvis: study for optimization of Z-axis modulation technique performed in 153 patients.

PURPOSE To retrospectively determine the optimal noise indexes required to obtain diagnostically acceptable computed tomographic (CT) images of the abdomen and pelvis with z-axis modulation. MATERIALS AND METHODS Ninety-five patients underwent 16-section multi-detector row CT of the abdomen and pelvis with z-axis modulation at noise indexes of 10.5, 11.0, 11.5, and 12.0 HU with 10-380 mA. Subsequently, 58 patients were scanned at noise indexes of 12.5 and 15.0 HU with 75-380 mA. The weights of all subjects were recorded, and transverse and anteroposterior diameters were measured. The CT images were evaluated for abnormalities and graded for image quality in terms of noise and diagnostic acceptability by using a five-point scale. Objective noise in the liver parenchyma was measured, and the tube current was recorded at each section in all 153 patients. Statistical analyses were performed to determine the appropriate noise index and to assess the effect of patient weight and abdominal diameters on image noise and diagnostic acceptability at different noise indexes. Tube current-time products (in milliampere seconds) at various noise indexes were compared with those at CT previously performed without z-axis modulation. RESULTS No significant difference in subjective image noise or diagnostic acceptability was found at noise indexes of 10.5-15.0 HU (P =.14), and objective noise was significantly inferior only at a noise index of 15.0 HU (P =.009). Compared with CT scanning at a 10.5-HU noise index, CT scanning at 12.5- and 15.0-HU noise indexes yielded, respectively, 10.0% and 41.3% reductions in radiation exposure. Patient weight and abdominal diameters affected subjective image quality. CONCLUSION Use of a 15.0-HU noise index at 75-380 mA results in acceptable subjective image noise and diagnostic acceptability but significantly greater objective image noise at routine abdominal-pelvic CT. For greater image quality demands, a noise index of 12.5 HU results in acceptable image quality and a 19.6% reduction in radiation exposure.
When three is not a crowd: a Crossregulation Model of the dynamics and repertoire selection of regulatory CD4+ T cells

Summary: Regulatory CD4+ T cells, enriched in the CD25 pool of healthy individuals, mediate natural tolerance and prevent autoimmune diseases. Despite their fundamental and potential clinical significance, regulatory T (TR) cells have not yet been incorporated in a coherent theory of the immune system. This article reviews experimental evidence and theoretical arguments supporting a model of TR cell dynamics, uncovering some of its most relevant biological implications. According to this model, the persistence and expansion of TR cell populations depend strictly on specific interactions they make with antigen‐presenting cells (APCs) and conventional effector T (TE) cells. This three‐partner crossregulation imposes that TR cells feed on the specific autoimmune activities they suppress, with implications ranging from their interactions with other cells to their repertoire selection in the periphery and in the thymus, and to the relationship between these cells and the innate immune system. These implications stem from the basic prediction that the peripheral dynamics sort the CD4+ T‐cell repertoire into two subsets: a less diverse set of small clones of autoreactive effector and regulatory cells that regulate each other’s growth, and a more diverse set of barely autoreactive TE cell clones, whose expansion is limited only by APC availability. It is argued that such partitioning of the repertoire sets the ground for self–non‐self discrimination.
Cloud computing in higher education: A snapshot of software as a service

Cloud Computing increases the flexibility and access of educational users to a wide range of educational resources. This includes access to infrastructure, software, hardware, and platform at any time in any place provided there is internet access. The users of cloud computing in higher educational institutions include students, lecturers, administrative staff, faculty staff, developers, programmers and researchers. Among the different cloud service models, software as a service (SaaS) is the most common service model used by higher educational institutions. As a result, the effect of SaaS on education can be serious and can impact education either positively or negatively. In this paper, we explore the use of SaaS in South African higher educational institutions with the intention to determine whether SaaS is a viable option for higher educational institutions. This paper also aims to identify the benefits and limitations of SaaS in higher educational institutions.
Role of sialic acid in prediction of diabetic nephropathy

Background: Diabetic nephropathy is a major microvascular complication of diabetes mellitus and the most common cause of end stage renal disease worldwide. It has been proposed that inflammatory process seems to play an important role in the development of diabetes and its late complications. Serum sialic acid, an acute phase reactant and acute phase reactants are considered as the indicators of microvascular angiopathy. Microalbuminuria is a predictor of incipient nephropathy in diabetic patients. Aim: The study was undertaken to evaluate serum sialic acid and microalbuminuria levels and to assess the correlation of serum sialic acid and microalbuminuria in diabetic nephropathy patients. Method: The diabetic subjects were divided into two groups. Group I - 120 patients with diabetes mellitus with early stage of nephropathy based on urinary albumin excretion per day and Group II - 120 newly diagnosed or known diabetics on treatment but without any complication. The age and sex matched 120 controls were selected from the healthy persons from same region. Both the cases and controls were selected by a simple random method. Blood samples were analyzed for fasting and post prandial blood sugar, blood urea, serum creatinine, serum sialic acid, glycated hemoglobin (HbA1c) and urine sample for microalbumin levels and systolic, diastolic blood pressure was recorded in both cases and controls. Result: Serum sialic acid levels were found to be significantly increased in diabetes with or without nephropathy compared to controls. Urinary microalbumin in diabetic nephropathy patients was significantly higher compared with diabetics and healthy individuals. In diabetes without any complications, serum sialic acid level had no statistically significant positive correlation with serum urea, creatinine and urinary microalbumin but in diabetes with nephropathy, serum sialic acid level statistically was well correlated with serum urea, creatinine and urinary microalbumin. Conclusion: Elevated serum sialic acid and urinary microalbumin levels are strongly associated with the presence of nephropathy. Serum sialic acid may be a predictor of renal dysfunction in diabetic nephropathy.
Effect of alternative chest compression techniques in infant and child on rescuer performance*

Objective: Current chest compression (CC) guidelines for an infant recommend a two-finger (TF) technique with lone rescuer and a two- thumb (TT) technique with two rescuers, and for a child either an one hand (OH) or a two hand (TH) technique with one or two rescuers. The effect of a 30:2 compression:ventilation ratio using these techniques on CC quality and rescuer fatigue is unknown. We hypothesized that during lone rescuer CC, TT technique, in infant and TH in child achieve better compression depth (CD) without additional rescuer fatigue compared with TF and OH, respectively. Design: Randomized observational study. Setting: University-affiliated pediatric hospital. Subjects: Adult healthcare providers certified in basic life support or pediatric advanced life support. Interventions: Laerdal baby advanced life support trainer and Resusci junior manikin were modified to digitally record CD, compression pressure (CP) and compression rate. Sixteen subjects were randomized to each of the four techniques to perform 5 minutes of lone rescuer 30:2 compression:ventilation cardiopulmonary resuscitation. Rescuer heart rate (HR) and respiratory rate were recorded continuously and the recovery time interval for HR/respiratory rate to return to baseline was determined. Subjects were blinded to data recording. Groups were compared using two-sample, two-sided Student’s t tests. Measurements and Main Results: Two-thumb technique generated significantly higher CD and peak CP compared with TF (p < 0.001); there was no significant difference between OH vs. TH. TF showed decay of CD and CP over time compared with TT. Compression rate (per minute) and actual compressions delivered were not significantly different between groups. No significant differences in fatigue and recovery time were observed, except the TT group had greater increase in the rescuer’s HR (bpm) from baseline compared with TF group (p = 0.04). Conclusions: Two-thumb compression provides higher CD and CP compared with TF without any evidence of decay in quality and additional rescuer fatigue over 5 minutes. There was no significant difference in child CC quality or rescuer fatigue between OH and TH. Two-thumb technique is preferred for infant CC and our data support the current guidelines for child CC.