Miracle-dz/UniFAR-FTUs huggingface dataset:
Efficacy of the 2-staged procedure in the management of cholesteatoma.

OBJECTIVE To demonstrate the efficacy of intact canal wall procedure coupled with a second-stage exploration for the treatment of cholesteatoma. DESIGN Retrospective case study of patients with cholesteatomas treated with staged surgical extirpation. A minimum of 6 months' postoperative follow-up time was required for inclusion into the study. SETTING Tertiary academic referral center. Patients A total of 35 adult and pediatric patients, ranging from 9 to 65 years of age, who underwent 2-stage procedures for removal of cholesteatomas. INTERVENTIONS Two-stage procedures, separated by 6 months, performed with posterior tympanotomy approaches. MAIN OUTCOME MEASURES The presence or absence of cholesteatoma on second-stage look and the subsequent surgical treatment for recurrent cholesteatoma. The overall hearing results after the completion of the 2-staged procedure were calculated. RESULTS Disease was controlled in 26 (74%) of the patients. Residual and/or recurrent cholesteatomas were found in 9 (26%) of the patients during the second-stage operation. Of these patients, 5 (14% of the total group) ultimately required conversion to canal-wall-down procedure. Average hearing gain at the completion of the second-stage procedure was 9 dB. CONCLUSIONS A planned 2-stage procedure that uses the posterior tympanotomy approach for the control of cholesteatoma is an effective technique. This approach offers significant potential for hearing preservation and restoration.
A Behavioral Investigation Of Supplier Differentiation In The Market For Audit Services

The degree of competition within the public accounting profession has received increasing attention from researchers and practitioners in recent years, stimulated first by the Metcalf Staff Report (U.S. Senate [1976]) and later by the Cohen Commission Report (AICPA [1978]). The former argued that there was insufficient competition, whereas the latter believed it to be excessive. In order for competition to exist, there must be a basis for differentiating the services of different CPA firms. However, in its final report, the Cohen Commission stated its belief that there is little or no product differentiation in the audit profession: "Public accounting firms go to considerable lengths to develop superior services for their clients, but there is little effective product differentiation from the viewpoint of the present buyer of the service, that is, the management of the corporation A 'clean opinion' obtained from one reputable firm is about as valuable to the competent, honest financial manager as one from another reputable firm" (AICPA [1978, p. 111]). The purpose of our study was to determine whether this assertion accurately describes the market for audit services. To do so we used multidimensional scaling to examine bankers' comparisons and ratings of Big Eight CPA firms. More specifically, our study addressed two
Quasi-periodic oscillations in superfluid magnetars

We study the time-evolution of axisymmetric oscillations of superfluid magnetars with a poloidal magnetic field and an elastic crust, working in Newtonian gravity. Extending earlier models, we study the effects of composition gradients and entrainment on the magneto-elastic wave spectrum and on the potential identification of the observed quasi periodic oscillations (QPOs). We use two-fluid polytropic equations of state to construct our stellar models, which mimic realistic composition gradient configurations. The basic features of the axial axisymmetric spectrum of normal fluid stars are reproduced by our results and in addition we find several magneto-elastic waves with a mixed character. In the core, these oscillations mimic the shear mode pattern of the crust as a result of the strong dynamical coupling between these two regions. Incorporating the most recent entrainment configurations in our models, we find that they have a double effect on the spectrum: the magnetic oscillations of the core have a frequency enhancement, while the mixed magneto-elastic waves originating in the crust are moved towards the frequencies of the single-fluid case. The distribution of lower-frequency magneto-elastic oscillations for our models is qualitatively similar to the observed magnetar QPOs with $\nu < 155 $Hz. \emph{In particular, some of these QPOs could represent mixed magneto-elastic oscillations with frequencies not greatly different from the crustal modes of an unmagnetised star. } We find that many QPOs could even be accounted for using a model with a relatively weak polar field of $B_{p} \simeq 3\cdot 10^{14}$G, because of the superfluid enhancement of magnetic oscillations. Finally, we discuss the possible identification of 625 and 1837~Hz QPOs either with non-axisymmetric modes or with high-frequency axisymmetric QPOs excited by crustal mode overtones.
Diagnostic value of periodic complexes in Creutzfeldt–Jakob disease

In 1996, our group published objective electroencephalogram (EEG) criteria to define periodic sharp‐wave complexes (PSWCs) suggestive for Creutzfeldt–Jakob disease (CJD). These criteria have since then been strictly applied in all cases reported to us as possible CJD in the course of the German CJD surveillance study. Furthermore, EEG analysis of the records was performed without any additional information on complementary clinical and laboratory data. In this study, we investigated sensitivity, specificity, and the predictive values of these EEG criteria exclusively in cases in which autopsy confirmed (n = 150) or excluded (n = 56) CJD. EEG criteria were positive in 64% (n = 96) of the CJD cases and falsely positive in 9% (n = 5) of other dementias. The resulting figures for sensitivity, specificity, and positive and negative predictive values were 64%, 91%, 95%, and 49%, respectively. In the falsely positive cases, Alzheimer's disease (n = 4) and vascular dementia (n = 1) were the underlying diseases. However, only in one of these five cases both clinical and EEG data would have led to the false‐positive result to diagnose probable CJD. These data prove the high diagnostic value of our objective EEG criteria in CJD. Ann Neurol 2004
The Effect of Chronic Clonidine Administration on Salivary Glands and Caries in the Rat

Clonidine is a widely prescribed, centrally acting antihypertensive with proposed pharmacologic mechanisms of stimulation of central postsynaptic α2–adrenergic receptors and agonist activity at presynaptic α2–adrenergic receptors, interfering with peripheral regulation of norepinephrine and acetylcholine release. Both of these mechanisms are capable of adversely influencing salivary output and composition, potentially leaving an individual with increased caries risk. The purpose of the present study was to determine the effect of chronic administration of clonidine on saliva, salivary glands, and caries in rats. Sprague–Dawley rat pups were infected with Streptococcus sobrinus, given Diet 2000 and 10% sucrose water ad libitum, and either desalivated, or treated with clonidine HCl (125 or 250 μg/kg administered daily for 28 days by means of osmotic minipumps), or assigned as controls. There were no statistical differences in stimulated parotid or submandibular gland salivary output or sublingual gland weights among the groups. The weight of the submandibular glands as a percent of total body weight was significantly decreased in animals that received clonidine when compared with controls. Sulcal caries scores in both clonidine groups and smooth surface caries scores in the high clonidine group were increased when compared with control animals. Positive control animals (desalivated) had significantly higher caries scores than all other groups. These data show that chronic administration of clonidine significantly decreases submandibular gland weight and increases susceptibility to dental caries.
Temperature dependence of the thermopower and its variation of the Au atomic contact

We performed simultaneous measurements of the thermopower, and conductance of Au atomic contacts during the self-breaking process under temperature control. During the whole measurement temperature regime (290–330 K), the thermopower randomly fluctuated from positive to negative in sign, and the average thermopower was negligibly small with respect to the variation of the thermopower of the contact. Meanwhile, the standard deviation of the thermoelectric voltage increased linearly with the temperature difference across the contacts. Above 320 K, we observed a decrease in the standard deviation of thermopower, which suggested a decrease in the density of defects near the contacts. The linear increase in the standard deviation of the thermoelectric voltage, and the decrease in the standard deviation of the thermopower above 320 K, indicate that the standard deviation of thermopower provides insight into the thermopower of an individual Au atomic contact and the atomic structure of Au atomic contacts, such as crystallinity and the distribution of defects near the contacts.
Rumination as a Mediator between Childhood Trauma and Adulthood Depression/Anxiety in Non-clinical Participants

Objective: Although there is strong evidence that childhood trauma is associated with the development of depression and anxiety, relatively few studies have explored potential mediating factors for this relationship. The present study aimed to evaluate the mediating role of rumination in the link between childhood trauma and mood status such as depression, anxiety and affective lability. Materials and Methods: Two hundred and seven non-clinical participants completed the Childhood Trauma Questionnaire, the Ruminative Response Scale, the Beck Depression Inventory, the State Anxiety Inventory, and the Affective Lability Scale. Structural equation modeling was used to evaluate the results. Results: Our results supported that rumination is a meaningful mediator between childhood trauma and depression/anxiety in non-clinical participants. The mediation model indicated that childhood trauma and its subtypes are linked to depression and anxiety through three subtypes of rumination, thereby supporting a significant indirect relationship (Standardized coefficient [SC] = 0.56, p < 0.001 for the path from trauma to rumination; SC = 0.67, p < 0.001, from rumination to mood). The direct relationship between childhood trauma and mood symptoms was also significant in a model including rumination (SC = 0.68, p < 0.001). The mediation effect of rumination in the relationship between childhood trauma and mood was more predominant in female participants. Conclusions: The present study found that rumination mediates the influence of childhood trauma on the development of mood symptoms in non-clinical participants. Childhood trauma appears to be a critical determinant for developing symptoms of depression and anxiety.
Dexamethasone induces irreversible G1 arrest and death of a human lymphoid cell line

Growth of a human leukemic T‐cell line (CEM C7) in 10−6 M dexamethasone results in inhibition of growth and rapid loss of cell viability after a delay of approximately 18 to 24 hours. Analysis of dexamethasonetreated cells by flow‐microfluorometry showed that they were arrested in the G1 phase of the cell cycle. Loss of cell viability began at the same time as G1 accumulation was first detectable, and 20% of all cells were found to be blocked in G1 at this time suggesting that loss of viability and G1 arrest were coincident events. Half‐maximal and maximal effects on both viability and G1 arrest after 48 hours in steroid were nearly identical with respect to steroid concentration and corresponded to half‐maximal and full occupancy of glucocorticoid specific receptor by hormone, consistent with a glucocorticoid receptor mediated mechanism for both phenomena. Most non‐viable cells were arrested in G1, and accumulation of cells in G1 was irreversible; removal of steroid in the presence of colcemid did not result in a decreased fraction of G1 cells. Furthermore, dexamethasone treatment did not protect cells against the effects of 33258 Hoechstamplified killing of bromodeoxyuridine substituted cells exposed to light. These results show that dexamethasone arrests these leukemic cells in G1 and strongly suggest that dexamethasone‐treated cells are killed upon entry into G1.
The Impact of the Auditor Selection Process and Audit Committee Appointment Power on Investment Recommendations

After the recent financial crisis, regulatory bodies proposed alternative auditor selection processes to enhance auditor independence such as mandatory audit firm rotation or mandatory tendering (i.e., rotation which allows for the current auditor to be reappointed). However, these alternative selection processes may not be effective if management has substantial influence over auditor appointment decisions. We posit that disclosures of high appointment power of the audit committee will enhance the perceived effectiveness of rotation and tendering, thus, increasing investment recommendations. In an experimental study involving 118 experienced investment professionals, we examine the impact of the auditor selection process (mandatory rotation, mandatory tendering, and voluntary selection) and the appointment power of the audit committee (high, low) on investment recommendations. We find that audit committee appointment power affects investment recommendations only when a possible auditor change is anticipated (i.e., in the case of rotation and tendering), but not when the auditor selection is voluntary. Further, rotation and tendering lead to a higher recommended investment likelihood than voluntary selection, but only when an audit committee has high appointment power. In all, the findings underscore that investors do not view auditor selection processes in isolation of a company’s internal corporate governance mechanisms.
Ingestion of a Marked Bacterial Pathogen of Cotton Conclusively Demonstrates Feeding by First Instar Southern Green Stink Bug (Hemiptera: Pentatomidae)

ABSTRACT Long-held dogma dictates that first instars of Nezara viridula (L.) do not feed, yet recent observations of stylet activity within a food source suggest otherwise. As a cosmopolitan pest of cotton and other high-value cash crops, confirmation of feeding by first instars may ultimately influence the knowledge on biology and management strategies for this pest. To determine whether first instars feed, newly hatched nymphs were provided sterile green beans (control) or beans infected with a rifam-picin-resistant marked bacterial pathogen (Pantoea agglomerans (Ewing and Fife)) of cotton. Insects were exposed to beans for 2 d, and feeding was confirmed based on detection of marked bacteria ingested by the insect. Normal bacterial flora was detected in all insects; however, control insects did not possess the marked bacteria. Of the first instars surviving on infected beans, ≈65% possessed the marked bacteria internally. Furthermore, the frequency of insects with marked bacteria was higher in insects collected directly from the bean surface than those that were off the bean at time of collection. Densities of innate and marked bacteria were comparable (both ranging from 101 to 103), suggesting that the marked bacteria did not exclude preexisting bacterial flora. Marked bacteria were also detected in a subset of second instars, indicating marked bacteria were retained through the molting process after ingesting bacteria as first instars. Our findings conclusively demonstrate feeding by first instars and redefine the long-held perspective of nonfeeding by first instars. These findings may necessitate changes to crop protection strategies against feeding and vectoring of plant pathogens by N. viridula.
N-Terminal Proteolysis of Full-Length Mutant Huntingtin in an Inducible PC12 Cell Model of Huntington’s Disease

Proteolytic cleavage of mutant huntingtin may play a key role in the pathogenesis of Huntington’s disease; however the steps in huntingtin proteolysis are not fully understood. Huntingtin was shown to be cleaved by caspases and calpains within a region between 460-600 amino acids from the N-terminus. Two smaller N-terminal fragments produced by unknown protease have been previously described as cp-A and cp-B. To further investigate the huntingtin proteolytic pathway, we used an inducible PC12 cell model expressing full-length huntingtin with either normal or expanded polyglutamine. This cell model recapitulates several steps of huntingtin proteolysis: proteolysis mediated by caspases within the region previously mapped for caspase cleavage, and cleavage generating two novel N-terminal fragments (cp-1 approximately 90-105 residues long and cp-2 extending beyond 115-129 epitope of huntingtin). Interestingly, the deletion of amino acids 105-114 (mapped previously as a cleavage site for cp-A) failed to affect the production of cp-1 or cp-2. Therefore, we conclude that these new fragments are distinct from previously described cp-A and cp-B. We demonstrate that cp-1 and cp-2 fragments are produced and accumulate within nuclear and cytoplasmic inclusions prior to huntingtin-induced cell toxicity, and these fragments can be formed by caspase-independent proteolytic cleavage of huntingtin in PC12 cells. In addition, inhibition of calpains leads to decreased subsequent degradation of cp-1 and cp-2 fragments, and accelerated formation of inclusions. Further delineation of huntingtin cleavage events may lead to novel therapeutic targets for HD.
Abiraterone plus Prednisone in Metastatic, Castration‐Sensitive Prostate Cancer

Background Abiraterone acetate, a drug that blocks endogenous androgen synthesis, plus prednisone is indicated for metastatic castration‐resistant prostate cancer. We evaluated the clinical benefit of abiraterone acetate plus prednisone with androgen‐deprivation therapy in patients with newly diagnosed, metastatic, castration‐sensitive prostate cancer. Methods In this double‐blind, placebo‐controlled, phase 3 trial, we randomly assigned 1199 patients to receive either androgen‐deprivation therapy plus abiraterone acetate (1000 mg daily, given once daily as four 250‐mg tablets) plus prednisone (5 mg daily) (the abiraterone group) or androgen‐deprivation therapy plus dual placebos (the placebo group). The two primary end points were overall survival and radiographic progression‐free survival. Results After a median follow‐up of 30.4 months at a planned interim analysis (after 406 patients had died), the median overall survival was significantly longer in the abiraterone group than in the placebo group (not reached vs. 34.7 months) (hazard ratio for death, 0.62; 95% confidence interval [CI], 0.51 to 0.76; P<0.001). The median length of radiographic progression‐free survival was 33.0 months in the abiraterone group and 14.8 months in the placebo group (hazard ratio for disease progression or death, 0.47; 95% CI, 0.39 to 0.55; P<0.001). Significantly better outcomes in all secondary end points were observed in the abiraterone group, including the time until pain progression, next subsequent therapy for prostate cancer, initiation of chemotherapy, and prostate‐specific antigen progression (P<0.001 for all comparisons), along with next symptomatic skeletal events (P=0.009). These findings led to the unanimous recommendation by the independent data and safety monitoring committee that the trial be unblinded and crossover be allowed for patients in the placebo group to receive abiraterone. Rates of grade 3 hypertension and hypokalemia were higher in the abiraterone group. Conclusions The addition of abiraterone acetate and prednisone to androgen‐deprivation therapy significantly increased overall survival and radiographic progression‐free survival in men with newly diagnosed, metastatic, castration‐sensitive prostate cancer. (Funded by Janssen Research and Development; LATITUDE ClinicalTrials.gov number, NCT01715285.)
Interest in Nutrition and Local Food Systems among Food-Insecure Households in an Appalachian Community

ABSTRACT Appalachian Kentucky has high levels of food insecurity and related health problems, such as obesity. Countermeasures based on local food systems have been suggested to address this issue, but for communities to implement these community-based interventions effectively, it is necessary to understand the perceptions of the food-insecure households they aim to serve. In this study, the primary food preparer in 259 households in Berea, Kentucky, completed a survey as part of a community food assessment. Households were identified as relatively more food secure (FS) or food insecure (FI) on the basis of their responses, and bivariate analysis was performed between relative food security status and other measures. The results indicate significantly different (P < .05) perceptions between FS and FI households regarding the role of convenience, location, and price in determining their food choices. Despite these differences, both groups placed equally high importance on nutrition and local produce, and FI households were also significantly more interested than FS households in activities such as cooking clubs and work exchange for free local food. These findings have implications for the development of programs and policies to combat food insecurity.
Effect of Multiple Daily Insulin Injections on the Course of Diabetic Retinopathy

Forty-two diabetic patients on insulin once a day in the early stage of diabetic retinopathy were randomly assigned to one of two kinds of insulin regimen, i.e., single or multiple daily injections. Retinal changes were quantitatively estimated by counting the microaneurysms (MAs) observed on fluorescein angiograms at the posterior pole of the more diseased eye. Baseline characteristics of the two groups were not significantly different. These included duration of diabetes, age at diagnosis, daily dose of insulin, amount of urinary sugar excreted in 24 hours, fasting blood sugar (FBS), and number of MAs. During the follow-up (mean duration of three years) the mean yearly progression in the number of MAs was significantly less in the multiple-than in the single-injection groups: 1.8 ± 0.7 versus 7.2 ± 1.9 (p < 0.01; nonparametric test: p < 0.02). Final values were, respectively, MAs: 15.2 ± 4.9; 33.0 ± 7.9; glycosuria (gm./24 hrs): 20.6 ± 2.5; 27.5 ± 4.3; FBS (mg./100 ml.): 154 ± 15; 195 ± 11. P values comparing the two groups were <0.02, <0.02, and <0.05. Thus, in this clinical trial, made under routine treatment conditions, the use of divided daily insulin injections was effective in improving diabetic control and delaying retinal changes.
An Hourly Variation in Zoo Visitor Interest: Measurement and Significance for Animal Welfare Research

A methodological difficulty facing welfare research on nonhuman animals in the zoo is the large number of uncontrolled variables due to variation within and between study sites. Zoo visitors act as uncontrolled variables, with number, density, size, and behavior constantly changing. This is worrisome because previous research linked visitor variables to animal behavioral changes indicative of stress. There are implications for research design: Studies not accounting for visitors' effect on animal welfare risk confounding (visitor) variables distorting their findings. Zoos need methods to measure and minimize effects of visitor behavior and to ensure that there are no hidden variables in research models. This article identifies a previously unreported variable—hourly variation (decrease) in visitor interest—that may impinge on animal welfare and validates a methodology for measuring it. That visitor interest wanes across the course of the day has important implications for animal welfare management; visitor effects on animal welfare are likely to occur, or intensify, during the morning or in earlier visits when visitor interest is greatest. This article discusses this issue and possible solutions to reduce visitor effects on animal well-being.