Miracle-dz/UniFAR-FTUs huggingface dataset:
Laparoscopic repair of giant diaphragmatic hernias: evolving technical aspects and outcomes.

BACKGROUND Laparoscopic repair of giant diaphragmatic hernias (GDH) can be challenging, especially when partial or complete volvulus of the herniated stomach is encountered. OBJECTIVES To review our experience with laparoscopic repair of GDH, emphasizing preoperative investigation, technical aspects, and outcome. METHODS We conducted a retrospective review of patients operated on for GDH who were diagnosed when at least half the stomach was found in the mediastinum at surgery. Technical aspects and surgical outcomes were evaluated. RESULTS Fifty patients underwent laparoscopic GDH repair during an 8 year period. Four patients admitted with acute symptomatic volvulus of the stomach were initially treated by endoscopic decompression followed by surgery during the same admission. Two cases were converted to open surgery. Initial surgery was successful in 45 patients; 3 had an immediate recurrence, 1 was reoperated for dysphagia during the same admission, and 1 had a mediastinal abscess. During long-term follow-up, six patients required reoperation for recurrent hernias. Another four patients had asymptomatic partial herniation of the stomach. The main reason for failure was incomplete reduction of the hernia sac, especially the posterior component. No correlation was found between the type of repair and surgical failure. Most patients who did not undergo an anti-reflux procedure had postoperative reflux unrelated to their preoperative workup. CONCLUSIONS Laparoscopic repair of GDH is challenging, but practical and safe. It should be the treatment of choice for this potentially life-threatening condition. Careful attention to pitfalls, such as the posterior element of the sac, and routine performance of an anti-reflux procedure are crucial.
Listen to the noise: noise is beneficial for cognitive performance in ADHD.

BACKGROUND Noise is typically conceived of as being detrimental to cognitive performance. However, given the mechanism of stochastic resonance, a certain amount of noise can benefit performance. We investigate cognitive performance in noisy environments in relation to a neurocomputational model of attention deficit hyperactivity disorder (ADHD) and dopamine. The Moderate Brain Arousal model (MBA; Sikström & Söderlund, 2007) suggests that dopamine levels modulate how much noise is required for optimal cognitive performance. We experimentally examine how ADHD and control children respond to different encoding conditions, providing different levels of environmental stimulation. METHODS Participants carried out self-performed mini tasks (SPT), as a high memory performance task, and a verbal task (VT), as a low memory task. These tasks were performed in the presence, or absence, of auditory white noise. RESULTS Noise exerted a positive effect on cognitive performance for the ADHD group and deteriorated performance for the control group, indicating that ADHD subjects need more noise than controls for optimal cognitive performance. CONCLUSIONS The positive effect of white noise is explained by the phenomenon of stochastic resonance (SR), i.e., the phenomenon that moderate noise facilitates cognitive performance. The MBA model suggests that noise in the environment, introduces internal noise into the neural system through the perceptual system. This noise induces SR in the neurotransmitter systems and makes this noise beneficial for cognitive performance. In particular, the peak of the SR curve depends on the dopamine level, so that participants with low dopamine levels (ADHD) require more noise for optimal cognitive performance compared to controls.
Raman microspectroscopy reveals long‐term extracellular activity of chlamydiae

The phylum Chlamydiae consists exclusively of obligate intracellular bacteria. Some of them are formidable pathogens of humans, while others occur as symbionts of amoebae. These genetically intractable bacteria possess a developmental cycle consisting of replicative reticulate bodies and infectious elementary bodies, which are believed to be physiologically inactive. Confocal Raman microspectroscopy was applied to differentiate between reticulate bodies and elementary bodies of Protochlamydia amoebophila and to demonstrate in situ the labelling of this amoeba symbiont after addition of isotope‐labelled phenylalanine. Unexpectedly, uptake of this amino acid was also observed for both developmental stages for up to 3 weeks, if incubated extracellularly with labelled phenylalanine, and P. amoebophila remained infective during this period. Furthermore, P. amoebophila energizes its membrane and performs protein synthesis outside of its host. Importantly, amino acid uptake and protein synthesis after extended extracellular incubation could also be demonstrated for the human pathogen Chlamydia trachomatis, which synthesizes stress‐related proteins under these conditions as shown by 2‐D gel electrophoresis and MALDI‐TOF/TOF mass spectrometry. These findings change our perception of chlamydial biology and reveal that host‐free analyses possess a previously not recognized potential for direct experimental access to these elusive microorganisms.
Two-Dimensional Echocardiography Estimates of Fetal Ventricular Mass throughout Gestation

Background: Two-dimensional (2D) ultrasound quality has improved in recent years. Quantification of cardiac dimensions is important to screen and monitor certain fetal conditions. We assessed the feasibility and reproducibility of fetal ventricular measures using 2D echocardiography, reported normal ranges in our cohort, and compared estimates to other modalities. Methods: Mass and end-diastolic volume were estimated by manual contouring in the four-chamber view using TomTec Image Arena 4.6 in end diastole. Nomograms were created from smoothed centiles of measures, constructed using fractional polynomials after log transformation. The results were compared to those of previous studies using other modalities. Results: A total of 294 scans from 146 fetuses from 15+0 to 41+6 weeks of gestation were included. Seven percent of scans were unanalysable and intraobserver variability was good (intraclass correlation coefficients for left and right ventricular mass 0.97 [0.87-0.99] and 0.99 [0.95-1.0], respectively). Mass and volume increased exponentially, showing good agreement with 3D mass estimates up to 28 weeks of gestation, after which our measurements were in better agreement with neonatal cardiac magnetic resonance imaging. There was good agreement with 4D volume estimates for the left ventricle. Conclusion: Current state-of-the-art 2D echocardiography platforms provide accurate, feasible, and reproducible fetal ventricular measures across gestation, and in certain circumstances may be the modality of choice.
Predicting surgical exploration in renal trauma: Assessment and modification of an established nomogram

BACKGROUND This study aimed to externally validate a previously described nomogram that predicts the need for renal exploration in the trauma setting. METHODS The predicted probability of nephrectomy was manually calculated using prospectively collected data from consecutive patients with renal trauma who presented to our institution between May 2001 and January 2010. To assess nomogram performance, receiver operating characteristic curves against the observed exploration rate were generated, and areas under the curve were calculated. Calibration curves were generated to assess performance across the range of predicted probabilities. Logistic regression modeling was used to determine clinical factors predicting exploration in a contemporary setting, and a nomogram was derived and internally validated using bootstrapping. RESULTS The established nomogram was applied to the 320 patients who presented during the 9-year period. The global performance of the established nomogram was very high, with an area under the curve of 0.95. However, the model performance was poor for higher predicted probabilities, thus lacking predictive ability in the population where the model has the greatest potential utility. A clinical tool was generated to better predict trauma nephrectomy in our contemporary population, using platelet transfusion within the first 24 hours, blood urea nitrogen, hemoglobin, and heart rate on admission. The global accuracy for the new model was similar to the previous nomogram, but it was significantly better calibrated for patients with higher probabilities of nephrectomy, with good predictive accuracy even in patients with Grade 5 injuries. CONCLUSION Older nomogram fails to accurately predict renal exploration in high-grade injuries in the contemporary setting. A new nomogram that more accurately predicts the need for exploration is presented. LEVEL OF EVIDENCE Therapeutic study, level IV; prognostic study, level III.
Ultimate intrinsic signal‐to‐noise ratio for parallel MRI: Electromagnetic field considerations

A method is described for establishing an upper bound on the spatial encoding capabilities of coil arrays in parallel MRI. Ultimate intrinsic signal‐to‐noise ratio (SNR), independent of any particular conductor arrangement, is calculated by expressing arbitrary coil sensitivities in terms of a complete set of basis functions that satisfy Maxwell's equations within the sample and performing parallel imaging reconstructions using these basis functions. The dependence of the ultimate intrinsic SNR on a variety of experimental conditions is explored and a physically intuitive explanation for the observed behavior is provided based on a comparison between the electromagnetic wavelength and the distance between aliasing points. Imaging at high field strength, with correspondingly short wavelength, is shown to offer advantages for parallel imaging beyond those already expected due to the larger available spin polarization. One‐dimensional undersampling of k‐space yields a steep drop in attainable SNR for more than a 5‐fold reduction of scan time, while 2D undersampling permits access to much higher degrees of acceleration. Increased tissue conductivity decreases baseline SNR, but improves parallel imaging performance. A procedure is also provided for generating the optimal coil sensitivity pattern for a given acceleration, which will serve as a useful guide for future coil designs. Magn Reson Med 50:1018–1030, 2003. © 2003 Wiley‐Liss, Inc.
Reduction in levels of plasma vascular endothelial growth factor-A and improvement in hydrocele patients by targeting endosymbiotic Wolbachia sp. in Wuchereria bancrofti with doxycycline.

The treatment for hydrocele is expensive, invasive surgery-hydrocelectomy. A drug that could prevent or improve this condition could replace or supplement hydrocelectomy. In Ghana, 42 hydrocele patients participated in a double-blind, placebo-controlled trial of a six-week regimen of doxycycline, 200 mg/day. Four months after doxycycline treatment, patients received 150 mug/kg of ivermectin and 400 mg of albendazole, which is used for mass chemotherapy in this area. Patients were monitored for levels of Wolbachia sp. , microfilaremia, antigenemia, plasma levels of vascular endothelial growth factor-A (VEGF-A) and stage/size of the hydrocele. Wolbachia sp. loads/microfilaria, microfilaremia, and antigenemia were significantly reduced in the doxycycline-treated patients compared with the placebo group. The mean plasma levels of VEGF-A were decreased significantly in the doxycycline-treated patients who had active infection. This finding preceded the reduction of the stage of hydrocele. A six-week regimen of doxycycline treatment against filariasis showed amelioration of pathologic conditions of hydrocele patients with active infection.
The Inhibitory Effects of Purple Sweet Potato Color on Hepatic Inflammation Is Associated with Restoration of NAD+ Levels and Attenuation of NLRP3 Inflammasome Activation in High-Fat-Diet-Treated Mice

Purple sweet potato color (PSPC), a class of naturally occurring anthocyanins, exhibits beneficial effects on metabolic syndrome. Sustained inflammation plays a crucial role in the pathogenesis of metabolic syndrome. Here we explored the effects of PSPC on high-fat diet (HFD)-induced hepatic inflammation and the mechanisms underlying these effects. Mice were divided into four groups: Control group, HFD group, HFD + PSPC group, and PSPC group. PSPC was administered by daily oral gavage at doses of 700 mg/kg/day for 20 weeks. Nicotinamide riboside (NR) was used to increase NAD+ levels. Our results showed that PSPC effectively ameliorated obesity and liver injuries in HFD-fed mice. Moreover, PSPC notably blocked hepatic oxidative stress in HFD-treated mice. Furthermore, PSPC dramatically restored NAD+ level to abate endoplasmic reticulum stress (ER stress) in HFD-treated mouse livers, which was confirmed by NR treatment. Consequently, PSPC remarkably suppressed the nuclear factor-κB (NF-κB) p65 nuclear translocation and nucleotide oligomerization domain protein1/2 (NOD1/2) signaling in HFD-treated mouse livers. Thereby, PSPC markedly diminished the NLR family, pyrin domain containing 3 (NLRP3) inflammasome activation, ultimately lowering the expressions of inflammation-related genes in HFD-treated mouse livers. In summary, PSPC protected against HFD-induced hepatic inflammation by boosting NAD+ level to inhibit NLRP3 inflammasome activation.
Impact of inflammatory markers on cardiovascular mortality in patients with metabolic syndrome

Background Recent investigations suggest the inclusion of inflammatory markers in the definition of the metabolic syndrome (MS). The aim of this study was to address the role of C-reactive protein, fibrinogen, interleukin-6 (IL-6) and IL-18 (IL-18) on cardiovascular prognosis in accordance to MS. Methods A total of 1263 patients with documented coronary artery disease were prospectively included. We defined MS (MS yes: N = 533, 42.2%) as the presence of at least three of the following criteria: triglycerides ≥ 150 mg/dl; low high-density lipoprotein cholesterol (men: < 40 mg/dl women: < 50 mg/dl); body mass index greater than 30 kg/m2; blood pressure ≥ 130/85 mmHg; fasting glucose ≥ 100 mg/dl. In addition, we determined C-reactive protein, fibrinogen, IL-6 and IL-18 levels. Results Follow-up data (median 6.1 years) were available for 1257 patients (99.5%). 139 patients (11.1%) died from cardiovascular causes. Cardiovascular mortality was related to MS (MS yes: 15.1% versus MS no: 8.1%, P < 0.0001) and was further increased by elevation of each inflammatory marker. To address whether elevation of inflammatory markers provides additional prognostic information, a subgroup analysis was performed including patients with MS. In a multivariate-adjusted model including all four inflammatory markers, only IL-18 could be identified as an independent predictor of cardiovascular mortality. Conclusion The measurement of inflammatory markers, especially IL-18, adds important prognostic information with regard to the long-term prognosis of patients with MS.
Optimal diversification, stochastic dominance, and sampling error

Purpose - The purpose of this paper is to contribute to the literature in three ways: first, the authors investigate the impact of the sampling errors on optimal portfolio weights and on financial investment decision. Second, the authors advance a comparative analysis between various domestic and international diversification strategies to define a stochastic optimal choice. Third, the authors propose a new methodology combining the re-sampling method, stochastic optimization algorithm, and nonparametric stochastic dominance (SD) approach to analyze a stochastic optimal portfolio choice for risk-averse American investors who care about benefits of domestic diversification relative to international diversification. The authors propose a new portfolio optimization model involving SD constraints on the portfolio return rate. The authors define a portfolio with return dominating the benchmark portfolio return in the second-order stochastic dominance (SSD) and having maximum expected return. The authors combine re-sampling procedure and stochastic optimization to establish more flexibility in the investment decision rule. Design/methodology/approach - The authors apply the re-sampling procedure to consider the sampling error in the optimization process. The authors try to resolve the problem of the stochastic optimal investment strategy choice using the nonparametric SD test by Linton Findings - First, the authors find that reducing sampling error increases the dominance relationships between different portfolios, which, in turn, alters portfolio investment decisions. Though international diversification is preferred in some cases, the study’s results show that for risk-averse US investors, in general, there is no difference between the diversification strategies; this implies that there is no increase in the expected utility of international diversification for the period before and after the 2007-2008 financial crisis. Nevertheless, the authors find that stochastic diversification in domestic, global, and Europe, Australasia, and Far East markets delivers better risk returns for the US risk averters during the crisis period. Originality/value - The originality of the idea in this paper is to introduce a new methodology combining the concept of portfolio re-sampling, stochastic portfolio optimization with SSD constraints, and the nonparametric SD test by Linton
Predicting stock market movement: An evolutionary approach

Social Networks are becoming very popular sources of all kind of data. They allow a wide range of users to interact, socialize and express spontaneous opinions. The overwhelming amount of exchanged data on businesses, companies and governments make it possible to perform predictions and discover trends in many domains. In this paper we propose a new prediction model for the stock market movement problem based on collective classification. The model is using a number of public mood states as inputs to predict Up and Down movement of stock market. The proposed approach to build such a model is simultaneously promoting performance and interpretability. By interpretability, we mean the ability of a model to explain its predictions. A particular implementation of our approach is based on Ant Colony Optimization algorithm and customized for individual Bayesian classifiers. Our approach is validated with data collected from social media on the stock of a prestigious company. Promising results of our approach are compared with four alternative prediction methods namely, bagging, Adaboost, best expert, and expert trained on all the available data.
Nm23 ‘anti‐metastatic’ gene product expression in colorectal carcinoma

Nm23 is a putative metastasis suppressor gene and alterations in this gene have been reported in colorectal carcinomas suggestive of a role for nm23 in the dissemination of these tumours. In this study we used an affinity purified polyclonal antibody, ab‐11, on formalin‐fixed, paraffin‐embedded sections of colorectai carcinomas from 46 patients in a three‐stage avidin–biotin complex immunoperoxidase technique. Follow‐up of these patients was until time of death or for 5 years, with a mean time of 31·2 months. Two observers scored the staining results from 1 to 3 according to the proportion of tumour cells positive. The association of nm23 staining with survival, sex, age, vascular invasion, and Dukes' stage was determined using Cox's regression model. The association of death from colorectal cancer and nm23 status reached marginal significance in this study (P = 0.0417). Moreover, there is some suggestion of a protective effect from nm23 as the relative risk of dying from colorectal cancer for each increment of nm23 positivity is 0·573 (95 per cent confidence limits 0·34–0·98).
Effect of platelet rich fibrin and beta tricalcium phosphate on bone healing. A histological study in pigs.

PURPOSE To investigate the effect of platelet rich fibrin (PRF) and beta tricalcium phosphate (β-TCP), alone or in combination, on bone regeneration in pig tibial defects. METHODS Four standardized defects were prepared in both tibias of three adult male pigs. The first defect was left unfilled as a control; the others were grafted with either PRF, β-TCP or PRF mixed with β-TCP. All animals were sacrificed on the 12th postoperative week and the tibial bones were removed, histologic sections were prepared and the experimental sites were examined microscopically and stereologically. RESULTS Histologic and stereologic examination revealed more new bone formation in the defects filled with PRF mixed β-TCP than in the defects grafted with either β-TCP or PRF alone. CONCLUSION The platelet rich fibrin and beta tricalcium phosphate combination effectively induces new bone formation.
Potential role of CagA in the inhibition of T cell reactivity in Helicobacter pylori infections.

The pathogenicity of chronic gastroduodenal diseases is very often related to Helicobacter pylori infections. Most H. pylori strains carry the cagA gene encoding an immunodominant 120- to 128-kDa protein which is considered a virulence marker. The majority of CagA-positive H. pylori isolates also produce a 95-kDa protein cytotoxin (VacA) causing vacuolation and degradation of mammalian cells. In our previous study we have shown that live H. pylori bacteria and their sonicates inhibit PHA-driven proliferation of human T lymphocytes. The H. pylori CagA and VacA proteins were suspected of a paralyzing effect of H. pylori on T cell proliferation. In this report, by using isogenic H. pylori mutant strains defective in CagA and VacA proteins, we determined that CagA is responsible for the inhibition of PHA-induced proliferation of T cells.
Relationship Between Organizational Culture and Organizational Effectiveness - A Study of Nurses in Taiwan

UNLABELLED Organizational culture refers to the beliefs and values that have existed in an organization for a long time, and to the beliefs of the staff and the foreseen value of their work that will influence their attitudes and behavior. It is therefore essential to understand the relationship between organizational cultures and organizational effectiveness. METHODS A cross-sectional study was undertaken that focused on hospital nurses in Taiwan. Data was collected using a structured questionnaire; 900 questionnaires were distributed and 473 valid questionnaires were returned. RESULTS Organizational cultures were significantly (positively) correlated with organizational effectiveness (p<0.001). CONCLUSIONS When the interaction between the leadership and employees is good, the latter will make a greater contribution to team communication and will also be encouraged to accomplish the mission and objectives assigned by the organization, thereby enhancing organizational effectiveness.