Miracle-dz/UniFAR-FTUs huggingface dataset:
Post operative synovial sepsis following endoscopic surgery: Increased risk associated with the carpal sheath.

REASONS FOR PERFORMING STUDY The overall rate of sepsis following endoscopic surgery of synovial structures has not previously been documented. Clinical observation has led to the conjecture that tendon sheaths, in particular the carpal flexor tendon sheath, are more prone to post operative synovial sepsis than other synovial structures. OBJECTIVES To document and investigate the rate of post operative synovial sepsis following elective endoscopic surgery. STUDY DESIGN Retrospective case series. METHODS The medical records of horses that underwent arthroscopy, tenoscopy or bursoscopy at Donnington Grove Veterinary Surgery between January 1999 and July 2012 were reviewed. The signalment, anatomical structure involved, use of electrosurgery, tourniquet or motorised resector, presence of a fracture, whether surgery was performed with the horse standing or under general anaesthesia and the number of structures examined were recorded. Multivariable logistic regression was used to test the association between the selected variables and synovial sepsis. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. Level of significance was P<0.05. RESULTS There were 1670 horses that underwent endoscopic surgery of 3159 synovial structures: 2517 joints, 583 tendon sheaths and 59 bursae. There were 16 cases of post operative sepsis in 16 horses; therefore, the infection rate was one per 100 horses or 5 per 1000 procedures. Carpal sheath tenoscopy was associated with an OR of developing post operative synovial sepsis of 14.9 (95% CI 4.8-45.9, P<0.001) compared to other synovial structures. Tendon sheath endoscopy had an OR of developing post operative synovial sepsis of 5.21 (95% CI 1.24-21.91, P<0.02) compared to other synovial structures. CONCLUSION Surgeons should be aware that tendon sheaths and the carpal sheath in particular appear to have higher odds of developing sepsis following endoscopic surgery.
Ability-Based Balancing Using the Gross Motor Function Measure in Exergaming for Youth with Cerebral Palsy.

OBJECTIVE To test if the gross motor function measure (GMFM) could be used to improve game balancing allowing youth with cerebral palsy (CP) with different physical abilities to play a cycling-based exercise videogame together. Our secondary objective determined if exergaming with the GMFM Ability-Based algorithm was enjoyable. MATERIALS AND METHODS Eight youth with CP, 8-14 years of age, GMFM scores between 25.2% and 87.4% (evenly distributed between Gross Motor Function Classification System levels II and III), competed against each other in head-to-head races, totaling 28 unique race dyads. Dyads raced three times, each with a different method of minimizing the distance between participants (three balancing algorithms). This was a prospective repeated measures intervention trial with randomized and blinded algorithm assignment. The GMFM Ability-Based algorithm was developed using a least squares linear regression between the players' GMFM score and cycling cadence. Our primary outcome was dyad spread or average distance between players. The GMFM Ability-based algorithm was compared with a control algorithm (No-Balancing), and an idealized algorithm (one-speed-for-all [OSFA]). After each race, participants were asked "Was that game fun? " and "Was that game fair? " using a five-point Likert scale. RESULTS Participants pedaled quickly enough to elevate their heart rate to an average of 120 ± 8 beats per minute while playing. Dyad spread was lower when using GMFM Ability-Based balancing (4.6 ± 4.2) compared with No-Balancing (11.9 ± 6.8) (P < 0.001). When using OSFA balancing, dyad spread was (1.6 ± 0.9), lower than both GMFM Ability-Based (P = 0.006) and No-Balancing (P < 0.001). Cycling cadence positively correlated to GMFM, equal to 0.58 (GMFM) +33.29 (R2adj= 0.662, P = 0.004). Participants rated the games a median score 4/5 for both questions: "was that game fun? " and "was that game fair? " CONCLUSION The GMFM Ability-Based balancing decreased dyad spread while requiring participants to pedal quickly, facilitating interaction and physical activity.
Natural killer cell licensing in mice with inducible expression of MHC class I

Significance Natural killer (NK) cells undergo a licensing (or education) process through interactions with their MHC class I-specific receptors and self-MHC class I to become functionally competent. Previously it was not possible to study the acute consequences of these interactions. We developed transgenic mice to induce MHC class I acutely in an otherwise MHC class I-deficient environment. In these mice, acute NK cell licensing is dependent on interactions between NK-cell receptors and other hematopoietic cells; the acute process did not appear to induce detectable differences in the licensed NK cells themselves. Mouse natural killer (NK) cells acquire effector function by an education process termed “licensing” mediated by inhibitory Ly49 receptors which recognize self-MHC class I. Ly49 receptors can bind to MHC class I on targets (in trans) and also to MHC class I on the NK-cell surface (in cis). Which of these interactions regulates NK-cell licensing is not yet clear. Moreover, there are no clear phenotypic differences between licensed and unlicensed NK cells, perhaps because of the previously limited ability to study NK cells with synchronized licensing. Here, we produced MHC class I-deficient mice with inducible MHC class I consisting of a single-chain trimer (SCT), ovalbumin peptide-β2 microgloblin-H2Kb (SCT-Kb). Only NK cells with a Ly49 receptor with specificity for SCT-Kb were licensed after MHC class I induction. NK cells were localized consistently in red pulp of the spleen during induced NK-cell licensing, and there were no differences in maturation or activation markers on recently licensed NK cells. Although MHC class I-deficient NK cells were licensed in hosts following SCT-Kb induction, NK cells were not licensed after induced SCT-Kb expression on NK cells themselves in MHC class I-deficient hosts. Furthermore, hematopoietic cells with induced SCT-Kb licensed NK cells more efficiently than stromal cells. These data indicate that trans interaction with MHC class I on hematopoietic cells regulates NK-cell licensing, which is not associated with other obvious phenotypic changes.
Adoption and Utilization of Commercial Software Packages: Exploring Utilization Equilibria, Transitions, Triggers, and Tracks

Researchers and managers are beginning to realize that the full advantages of information technologies are not likely to be realized unless both the information technology and the organizational context are adapted during implementation. This highlights the importance of understanding and managing the relationship between information technology and organizational change. This study takes a new look at an old concept: information system utilization. A theoretical framework grounded in the punctuated equilibrium model contends that the mutual adaptation of commercial software packages and organizational processes follows a discontinuous change pattern where stable periods of utilization are occasionally disturbed by internal and external change triggers. Qualitative data gathered from interviews with software vendor personnel and a representative sample of users provide preliminary support for the existence of utilization equilibrium states. The evidence suggests that, when significant changes occur in the appropriation of technology, the users, or the organization context, the existing equilibrium state is disturbed. Following a temporary transition state characterized by redefinition of the technology and/or its context, the changes are incorporated into altered work processes, and a new equilibrium state develops. Various factors associated with the creation, maintenance, and disruption of equilibrium states are identified. Managers and users can enhance and prolong the useful life of software packages by paying careful attention to implementation efforts that heavily influence initial utilization equilibrium, identifying periods of equilibrium and transition, and managing the internal and external change triggers that influence transitions between equilibrium states.
Enhancing the safety of critically ill patients by reducing urinary and central venous catheter-related infections.

This article is based in part on work performed by the University of California, San Francisco–Stanford University Evidence-Based Practice Center under contract to the Agency for Healthcare Research and Quality (Contract No. 290-97-0013). Dr. Saint is supported by a Career Development Award from the Health Services Research and Development Service of the Department of Veterans Affairs. Part of this work was also supported by NIH HL51856 from the NHLBI (M.A.M.).
Intramyocellular lipids form an important substrate source during moderate intensity exercise in endurance‐trained males in a fasted state

Both stable isotope methodology and fluorescence microscopy were applied to define the use of intramuscular triglyceride (IMTG) stores as a substrate source during exercise on a whole‐body as well as on a fibre type‐specific intramyocellular level in trained male cyclists. Following an overnight fast, eight subjects were studied at rest, during 120 min of moderate intensity exercise (60 % maximal oxygen uptake capacity (V̇O2,max)) and 120 min of post‐exercise recovery. Continuous infusions of [U‐13C]palmitate and [6,6‐2H2]glucose were administered at rest and during subsequent exercise to quantify whole‐body plasma free fatty acid (FFA) and glucose oxidation rates and the contribution of other fat sources (sum of muscle‐ plus lipoprotein‐derived TG) and muscle glycogen to total energy expenditure. Fibre type‐specific intramyocellular lipid content was determined in muscle biopsy samples collected before, immediately after and 2 h after exercise. At rest, fat oxidation provided 66 ± 5 % of total energy expenditure, with FFA and other fat sources contributing 48 ± 6 and 17 ± 3 %, respectively. FFA oxidation rates increased during exercise, and correlated well with the change in plasma FFA concentrations. Both the use of other fat sources and muscle glycogen declined with the duration of exercise, whereas plasma glucose production and utilisation increased (P < 0.001). On average, FFA, other fat sources, plasma glucose and muscle glycogen contributed 28 ± 3, 15 ± 2, 12 ± 1 and 45 ± 4 % to total energy expenditure during exercise, respectively. Fluorescence microscopy revealed a 62 ± 7 % net decline in muscle lipid content following exercise in the type I fibres only, with no subsequent change during recovery. We conclude that IMTG stores form an important substrate source during moderate intensity exercise in endurance‐trained male athletes following an overnight fast, with the oxidation rate of muscle‐ plus lipoprotein‐derived TG being decreased with the duration of exercise.
Simultaneous measurements of particle number size distributions at ground level and 260 m on a meteorological tower in urban Beijing, China

Abstract. Despite extensive studies into the characterization of particle number size distributions at ground level, real-time measurements above the urban canopy in the megacity of Beijing have never been performed to date. Here we conducted the first simultaneous measurements of size-resolved particle number concentrations at ground level and 260 m in urban Beijing from 22 August to 30 September. Our results showed overall similar temporal variations in number size distributions between ground level and 260 m, yet periods with significant differences were also observed. Particularly, accumulation-mode particles were highly correlated (r2 = 0. 85) at the two heights, while Aitken-mode particles presented more differences. Detailed analysis suggests that the vertical differences in number concentrations strongly depended on particle size, and particles with a mobility diameter between 100 and 200 nm generally showed higher concentrations at higher altitudes. Particle growth rates and condensation sinks were also calculated, which were 3.2 and 3.6 nm h−1, and 2.8 × 10−2 and 2.9 × 10−2 s−1, at ground level and 260 m, respectively. By linking particle growth with aerosol composition, we found that organics appeared to play an important role in the early stage of the growth (09:00–12:00 LT) while sulfate was also important during the later period. Positive matrix factorization of size-resolved number concentrations identified three common sources at ground level and 260 m, including a factor associated with new particle formation and growth events (NPEs), and two secondary factors that represent photochemical processing and regional transport. Cooking emission was found to have a large contribution to small particles and showed much higher concentration at ground level than 260 m in the evening. These results imply that investigation of NPEs at ground level in megacities needs to consider the influences of local cooking emissions. The impacts of regional emission controls on particle number concentrations were also illustrated. Our results showed that regional emission controls have a dominant impact on accumulation-mode particles by decreasing gas precursors and particulate matter loadings, and hence suppressing particle growth. In contrast, the influences on Aitken particles were much smaller due to the enhanced new particle formation (NPF) events.
8.4 A 0.33V/-40°C process/temperature closed-loop compensation SoC embedding all-digital clock multiplier and DC-DC converter exploiting FDSOI 28nm back-gate biasing

A 32b SoC is designed in 28nm FDSOI to operate in either an energy-efficiency (EE) mode, at 0.45V, or low-leakage (LL) mode, at 0.33V, with process-temperature compensation. At near threshold, it overcomes low transistor current at negative temperatures, the need for an extra digital supply IO, and the clocking power costs faced by the internet-of-things (IoT) and wearable systems. The system includes: 1) an all-digital single-supply open-loop clock multiplier achieving 1.51 pJ/cycle; 2) a 0.33V/0.45V dual-mode switched-network-capacitor DC-DC down converter from a 1.1V logic supply, reaching 75% conversion efficiency in both modes; 3) a closed-loop low-invasiveness timing monitoring system dynamically compensating device centering and temperature changes, enabling constant frequency operation down to -40°C at 20MHz (1MHz) in EE (LL) mode. The system fully exploits forward body bias (FBB) available in 28nm UTBB FDSOI with LVT transistors.
Autologous Peripheral Blood Stem Cell Transplantation in Tumor‐stage Mycosis Fungoides: Predictors of Disease‐free Survival

Abstract: Nine patients with mycosis fungoides (age range 27–67) underwent autologous peripheral blood stem cell transplantation (PBSCT). All patients had tumor‐stage disease, and four had lymph node involvement. Eight patients exhibited a peripheral blood T cell clone using PCR/SSCP analysis of the TCR gamma gene, six prior to harvest and two at the time of harvest. Mobilization of CD34+ stem cells was achieved with etoposide and G‐CSF. Harvested cells were positively selected for CD34. After negative selection for CD4 and CD8, only two samples became PCR negative. Conditioning prior to reinfusion of stem cells was achieved with various combinations of total skin electron beam (TSEB), total body irradiation (TBI), and chemotherapy, depending upon the patient's prior exposure to radiotherapy. One patient failed to engraft and died of candidal septicemia 15 days posttransplant. The other eight patients achieved complete remission, but this was short‐lived in four (median disease‐free survival [DFS] = 2 months) and prolonged in three (median DFS 11 months). Those with a short DFS were distinguished by rapid tumor onset prior to transplant but not by stage at transplant. Loss of a detectable T cell clone after manipulation of the harvest did not discriminate between the two groups, but rapid relapsers had been subjected to a greater degree of T cell depletion, possibly indicating a compromised cytotoxic response post‐PBSCT. The median survival of the cohort is four years from tumor onset, 15 months from PBSCT, and 27 months from the date a peripheral blood clone was first detected in the presence of tumor‐stage disease. Rapid relapse was associated with poor overall survival. Our data demonstrate the value of PBSCT for inducing remission in tumor‐stage mycosis fungoides. Reinfusion of neoplastic cells could be avoided by harvesting stem cells at an earlier stage in the disease process, preferably before a T cell clone is detectable in the peripheral blood. Alternatively T cell depletion should be restricted to the CD4 subset.
Potential interactions between VSC HVDC and STATCOM

This paper analyses the dynamic behaviour of a power system with both FACTS and VSC HVDC, in particular, possible potential interactions between a STATCOM and a VSC in a point-to-point HVDC link. The investigation considers different STATCOM locations and VSC control strategies. A generic linearized mathematic model is firstly developed, where a combined method involving relative gain array (RGA) and modal analysis is applied to identify the interactions within the plant model and the outer controllers. The interactions identified are further analysed by creating a set of scenarios integrating both the STATCOM and VSC HVDC into a dynamic equivalent realistic AC system. Results show a collaborative operation between the STATCOM and the closely located VSC with reasonably tuned controllers.
Breast Cancer Subtypes in Patients Aged 70 Years and Older

ABSTRACT Recurrence and survival pattern in breast cancer (bc) patients (pts) ≥ 70 years subcategorized according to subtype and age are still an area of uncertainty. Tumor characteristics, patient demographics, therapies applied, and recurrence pattern were compared between luminal A (LA), luminal B (LB), Her2/neu overexpressing (Her+) and triple-negative (TN) bc subtypes and the age subcategories 70–74, 75–79, ≥80 years. Based on univariate Cox-regression-analyses distant-disease-free-survival (DDFS) differed significantly for bc subtypes (p = 0.0002), notably for Her+ vs. LA (p = 0.0014), TN vs. LA (p < 0.001), and TN vs. LB (p = 0.0086). Not age, but Her+ and TN represented prognostic factors for DDFS.
Paternal postpartum depression: How can nurses begin to help?

Abstract Men’s emotional health can be overlooked during their partner’s pregnancy and throughout the first postpartum year. Postpartum depression, once expected only in new mothers, is now estimated to occur in 4–25% of new fathers as well. The incidence of paternal postpartum depression is greater in couples where maternal postpartum depression is also present. Paternal postpartum depression can be difficult to assess. New fathers may seem more angry and anxious than sad. And yet, depression is present. When left untreated, paternal postpartum depression limits men’s capacity to provide emotional support to their partners and children. This article reviews the incidence and prevalence of paternal postpartum depression, comments on tools to measure the disorder, identifies paternal behaviors that may indicate depression, examines the effects of parental depression on families and discusses what nurses can do to begin to help.
Detection of excessive bronchoconstriction in asthma.

Airway hyperresponsiveness is easily assessed by measuring the concentration or dose of an inhaled agonist that produces a defined response, e.g., PC20 or PD20. However, this measure does not assess excessive bronchoconstriction. We report the results of analyzing bronchial dose-response curves by measuring percent fall in vital capacity (delta FVC%) as the response rather than the PC20. In our analysis, delta FVC% was measured at the PC20, and therefore it was the dependent variable, whereas the concentration of agonist was the independent variable, in contrast to the usual bronchoprovocation tests in which the response is the independent variable and the dose is the dependent variable. We reasoned that a dose-dependent increase in gas trapping with histamine would detect excessive bronchoconstriction as a decrease in FVC; in contrast, PC20 measures only the ease of bronchoconstriction. In 10 patients with mild asthma the reproducibility of delta FVC% when FEV1 fell by 20%, i.e., at the PC20 concentration of histamine, taken from a greater than 6-s FVC on an otherwise standard histamine challenge test was comparable to that of PC20. In 10 healthy asymptomatic subjects there were only trivial falls (0.3%) in FVC to as much as 16 mg/ml histamine. In a retrospective study of 146 patients with mild asthma, the delta FVC% was normally distributed (13.2 +/- 5.5 SD%) and did not correlate with the number of beta 2-agonist prescriptions or the PC20, but it did correlate with the number of prescriptions written per month for oral prednisone (r = 0.55, p < 0.02). We conclude that delta FVC% when FEV1 falls by 20% is a safe method of detecting excessive bronchoconstriction, and it reveals that different asthmatics react in fundamentally different ways to the same agonist. This may be useful in detecting the asthmatic at risk for serious disease.
Developmental changes in the expression of Leishmania chagasi gp63 and heat shock protein in a human macrophage cell line

The ability of the protozoan Leishmania chagasi to infect a vertebrate host depends on its ability to survive intracellularly in a mammalian macrophage. Novel patterns of gene expression are probably important for conversion from the extracellular promastigote to the obligate intracellular amastigote parasite form. We found that the human macrophage-like cell line U937 provided an in vitro model of phagocytosis of L. chagasi promastigotes and intracellular conversion to amastigotes, allowing examination of parasite protein and RNA expression. The Leishmania surface protease gp63 assumed three isoforms during stage conversion, and a 64-kDa form of gp63 not present in promastigotes became the most prominent form in amastigotes. gp63 RNAs derived from the three different classes of msp genes (mspS, mspL, and mspC) were also differentially expressed. Infectious promastigotes contained mRNAs from mspS and mspC genes, whereas converting parasites expressed only mspL and mspC mRNAs. Sequence analysis of clones from an amastigote cDNA library confirmed the presence of gp63 mRNAs only from mspL and mspC class genes in tissue-derived amastigotes. Finally, 24 h after phagocytosis, there was a transient increase in the level of hsp70 and hsp90 proteins that subsequently decreased to baseline; this increase was not due to heat shock alone. We conclude that a unique pattern of selected L. chagasi proteins and RNAs is induced following phagocytosis by macrophages.