Miracle-dz/UniFAR-FTUs huggingface dataset:
MRI-Guided Ventricular Tachycardia Ablation: Integration of Late Gadolinium-Enhanced 3D Scar in Patients With Implantable Cardioverter-Defibrillators

Background— Substrate-guided ablation of ventricular tachycardia (VT) in patients with implanted cardioverter-defibrillators (ICDs) relies on voltage mapping to define the scar and border zone. An integrated 3D scar reconstruction from late gadolinium enhancement (LGE) MRI could facilitate VT ablations. Methods and Results— Twenty-two patients with ICD underwent contrast-enhanced cardiac MRI with a specific absorption rate of <2.0 W/kg before VT ablation. Device interrogation demonstrated unchanged ICD parameters immediately before, after, or at 68±21 days follow-up (P>0.05). ICD imaging artifacts were most prominent in the anterior wall and allowed full and partial assessment of LGE in 9±4 and 12±3 of 17 segments, respectively. In 14 patients with LGE, a 3D scar model was reconstructed and successfully registered with the clinical mapping system (accuracy, 3.9±1.8 mm). Using receiver operating characteristic curves, bipolar and unipolar voltages of 1.49 and 4.46 mV correlated best with endocardial MRI scar. Scar visualization allowed the elimination of falsely low voltage recordings (suboptimal catheter contact) in 4.1±1.9% of <1.5-mV mapping points. Display of scar border zone allowed identification of excellent pace mapping sites, with only limited voltage mapping in 64% of patients. Viable endocardium of >2 mm resulted in >1.5-mV voltage recordings despite up to 63% transmural midmyocardial scar successfully ablated with MRI guidance. All successful ablation sites demonstrated LGE (transmurality, 68±26%) and were located within 10 mm of transition zones to 0% to 25% scar in 71%. Conclusions— Contrast-enhanced cardiac MRI can be safely performed in selected patients with ICDs and allows the integration of detailed 3D scar maps into clinical mapping systems, providing supplementary anatomic guidance to facilitate substrate-guided VT ablations.
Surveillance of microbiological contamination and correct use of protective lead garments.

BACKGROUND Healthcare associated infections are an important threat of Public Health. Several studies investigated the possible role played by the hospital environment in the transmission of nosocomial pathogens. In addition to the "classic" nosocomial surfaces, some researches focused their attention on "alternative" surfaces. Little is known about the protective lead garments used in operating rooms. STUDY DESIGN This study was conducted in three phases to investigate the microbiological contamination and the normal use of these garments. In the first step, we administered a questionnaire to know the frequency and the type of sanitation. Then, in the second step, we conducted the microbiological samplings and, finally, in the third step, we carried out a surveillance on the use of these garments during the surgical procedures. METHODS In the first step, we administered the questionnaire through direct interview. For microbiological sampling we used sterile swabs, the normal growth media and the API Identification System (bioMérieux). RESULTS The study showed that the garments are sanitized only in 66.7% of the cases with a non-defined frequency. Moreover, a bacterial contamination was found on 88 garments with a positivity of 80.7% and the units with the higher rate of contamination were Urology, Orthopedics, Neuroradiology and Intensive Cardiac Care. Finally, 100% of the surgical team members wore sterile disposable shirts above the protective lead garments while this was never true for the rest of the nursing and anaesthesia team. CONCLUSIONS To prevent the contamination of these garments, it is important to develop appropriate sanitation procedures and to store them in special cabinets also subjected to sanitation. Finally, it is necessary to focus on the correct use of the protective lead garments.
Mean Well to Do Good? Volunteer Motivation Re-Examined

The provision of social services in most developed countries has become more and more difficult to ensure, and many states rely increasingly on volunteer work. What motivates volunteers is, however, still a relatively under-researched topic. At the theoretical level, there is a consensus that pro-social behaviour is, at least in parts, motivated by altruism, the function of which, however, remains contested. In some recent studies, social psychologists have identified functional categories of volunteering, according to the concept of attitude functions, for volunteer motivation and found evidence that people were more likely to express a willingness to volunteer if they were confronted with persuasive messages according to their volunteer function. Empirical studies relying on volunteer surveys face, however, problems of self-selection. To overcome these problems, we carried out a online experiment to test volunteer motivation in participants and tested the congruence of participants' motivation and their response to persuasive messages according to these attitude functions. The results suggests that there is a systematic interaction between these elements. * Department of Political Science, University of Zurich (Switzerland), email: haefliger@ipz.uzh. ch ‡ Departement de science politique, Faculte des sciences economiques et sociales; Universite de Geneve; 40 Bd du Pont d’Arve; 1211 Geneve 4; Switzerland; phone ++41 22 379 83 78; email: simon.hug@unige.ch This research has been supported by the Swiss National Science Foundation (Grant Nr. 10117733/1). The authors would like to thank Line Rennwald for her translation work, Sven Akeret. MarieChristine Maier as well as the Service de Presse of the University of Geneva for their help in procuring addresses for our online-experiments.
Homeowner association boards of directors' leadership competencies in Fairfax, Virginia

The purpose of this qualitative, four-round modified online Delphi technique study was to identify leadership competencies necessary for homeowner association board leadership and to develop a profile of competencies that may contribute to the development of a model of effectiveness. The research focused on homeowner associations in Fairfax County, Virginia. The panel consisted of homeowner association experts and included homeowner association attorneys, community managers, and board members who had at least 3 years of experience in homeowner associations. Panel members were required to be associated with a homeowner association in Fairfax County, Virginia, at the time of the study and hold one of the eight certifications awarded by Community Associations Institute. The findings contain the panel’s most preferred homeowner association board leadership competencies and the top 10 factors that might contribute to a model of homeowner association board of director effectiveness.
Bile acids and gut peptide secretion after bariatric surgery: A 1‐year prospective randomized pilot trial

Increased delivery of bile acid salts (BA) to distal L‐cells and altered TGR5 receptor activation may contribute to the early and substantial increases in gut peptide secretion seen after bariatric surgery. To further elucidate a potential role of BA in the secretion of GLP‐1 and PYY, we analyzed plasma BA concentrations in 14 morbidly obese patients undergoing gastric bypass or sleeve gastrectomy in a prospective, randomized 1‐year trial.
The PD‐1 pathway in tolerance and autoimmunity

Summary: Regulatory T cells (Tregs) and the PD‐1: PD‐ligand (PD‐L) pathway are both critical to terminating immune responses. Elimination of either can result in the breakdown of tolerance and the development of autoimmunity. The PD‐1: PD‐L pathway can thwart self‐reactive T cells and protect against autoimmunity in many ways. In this review, we highlight how PD‐1 and its ligands defend against potentially pathogenic self‐reactive effector T cells by simultaneously harnessing two mechanisms of peripheral tolerance: (i) the promotion of Treg development and function and (ii) the direct inhibition of potentially pathogenic self‐reactive T cells that have escaped into the periphery. Treg cells induced by the PD‐1 pathway may also assist in maintaining immune homeostasis, keeping the threshold for T‐cell activation high enough to safeguard against autoimmunity. PD‐L1 expression on non‐hematopoietic cells as well as hematopoietic cells endows PD‐L1 with the capacity to promote Treg development and enhance Treg function in lymphoid organs and tissues that are targets of autoimmune attack. At sites where transforming growth factor‐β is present (e.g. sites of immune privilege or inflammation), PD‐L1 may promote the de novo generation of Tregs. When considering the consequences of uncontrolled immunity, it would be therapeutically advantageous to manipulate Treg development and sustain Treg function. Thus, this review also discusses how the PD‐1 pathway regulates a number of autoimmune diseases and the therapeutic potential of PD‐1: PD‐L modulation.
Periprosthetic joint infection increases the risk of one-year mortality.

BACKGROUND Periprosthetic joint infection continues to potentially complicate an otherwise successful joint replacement. The treatment of this infection often requires multiple surgical procedures associated with increased complications and morbidity. This study examined the relationship between periprosthetic joint infection and mortality and aimed to determine the effect of periprosthetic joint infection on mortality and any predictors of mortality in patients with periprosthetic joint infection. METHODS Four hundred and thirty-six patients with at least one surgical intervention secondary to confirmed periprosthetic joint infection were compared with 2342 patients undergoing revision arthroplasty for aseptic failure. The incidence of mortality at thirty days, ninety days, one year, two years, and five years after surgery was assessed. Multivariate analysis was used to assess periprosthetic joint infection as an independent predictor of mortality. In the periprosthetic joint infection population, variables investigated as potential risk factors for mortality were evaluated. RESULTS Mortality was significantly greater (p < 0.001) in patients with periprosthetic joint infection compared with those undergoing aseptic revision arthroplasty at ninety days (3.7% versus 0.8%), one year (10.6% versus 2.0%), two years (13.6% versus 3.9%), and five years (25.9% versus 12.9%). After controlling for age, sex, ethnicity, number of procedures, involved joint, body mass index, and Charlson Comorbidity Index, revision arthroplasty for periprosthetic joint infection was associated with a fivefold increase in mortality compared with revision arthroplasty for aseptic failures. In the periprosthetic joint infection population, independent predictors of mortality included increasing age, higher Charlson Comorbidity Index, history of stroke, polymicrobial infections, and cardiac disease. CONCLUSIONS Although it is well known that periprosthetic joint infection is a devastating complication that severely limits joint function and is consistently difficult to eradicate, surgeons must also be cognizant of the systemic impact of periprosthetic joint infection and its major influence on fatal outcome in patients.
Professional Development and the Adoption and Implementation of New Innovations: Do Teacher Concerns Matter? 6(5)

Although the trend today is leaning toward including teachers in the decision-making process, policymakers have historically tended to design professional development activities based on skills and knowledge they assume teachers need, rather than allowing teachers to identify their needs and concerns when designing new programs. Research suggests that successful implementation of new programs depends on teachers’ participation and comfort level. Concerns theory reports that at the early stages of an innovation, teachers’ concerns tend to be more personal. As personal concerns are resolved, teachers tend to be more concerned about the application (task and the impact of the innovation). This study examines the importance of taking teacher concerns into consideration when planning professional development activities for new innovations using a sample of seventy-nine teachers from two rural school districts in Ohio who elected to participate in a two-week training session on SchoolNet computers and networking applications. The Stages of Concern Questionnaire (SoCQ), teachers’ weekly reflections, and journal responses provided the data. Results suggest that as teachers became more familiar with SchoolNet technology, there was a shift in concerns from personal to task and impact concerns.
Risk preferences are not time preferences: balancing on a budget line: comment

In a recent experimental study of intertemporal risky decision making, Andreoni and Sprenger (2012) find that subjects exhibit a preference for intertemporal diversification, which is inconsistent with discounted expected utility theory. It was claimed that their results are also at odds with models involving probability weighting, such as rank-dependent utility and cumulative prospect theory. Here we demonstrate, however, that rank-dependent probability weighting explains intertemporal diversification if decision makers care about portfolio risk. Moreover, we provide a unified account of all of Andreoni and Sprenger's key findings.
The Risk-Averting Game of Transport Public-Private Partnership

With both the demand for mobility and nationwide fiscal stress increasing, governments at all levels are interested in public-private partnerships as a way to introduce private investment to the public transport infrastructure. Although transport PPPs offer great promise, their complexity entails unusual risks for the investment environment, the project, and the partnership itself. Adopting the lens of game theory, this article traces the evolution of the State Route 91 Express Lanes (91EL) PPP over the past two decades and analyzes the risk-averting behavior of the players in the transport PPP game. The odyssey of 91EL demonstrates that managing transport PPPs requires understanding of the nature of the game, recognition of sectoral differences, the skill to concert divergent interests, willingness to change and learn, and the courage to take risks and explore practical solutions in an erratic political and economic environment.
Insulin-Like Growth Factor I Promotes Maturation and Inhibits Apoptosis of Immature Cord Blood Monocyte–Derived Dendritic Cells through MEK and PI 3-Kinase Pathways

IGF-I has profound effects on the immune system. We previously reported that IGF-I promoted cord blood (CB)-naïve T-cell maturation and now show that IGF-I promoted maturation of CB monocyte–derived dendritic cells (DC) with up-regulation of CD83, CD86, CD40, and major histocompatibility complex (MHC) class II molecules, and down-regulation of mannose receptor. Furthermore, IGF-I inhibited apoptosis of CB DC and increased the production of tumor necrosis factor α (TNF-α). These effects were blocked by specific mitogen-activated protein kinase kinase (MEK) inhibitor (PD98059) and phosphoinositol 3-kinase inhibitor (LY294002). PD98059 partially inhibited the IGF-I–induced up-regulation of MHC class II. In contrast, LY294002 was additive in the IGF-I–induced up-regulation of MHC class II. Moreover, LY294002 significantly increased the percentage of late apoptotic cells in CB. These results imply the involvement of different pathways for the differential regulation of co-stimulatory molecule expression and apoptosis. The addition of anti–TNF-α did not neutralize the effects of IGF-I on CB DC maturation and apoptosis. On the contrary, neutralizing TNF-α significantly increased the IGF-I–induced up-regulation of CD83 and CD40. We conclude that IGF-I has maturation and survival effects on CB DC. These effects are mediated through both MEK and PI 3-kinase pathways but not through the IGF-I induction of TNF-α production by the DC.
Quantitative Analysis of Isolation Area and Rhythm Outcome in Patients With Paroxysmal Atrial Fibrillation After Circumferential Pulmonary Vein Antrum Isolation Using the Pace-and-Ablate Technique

Background— We sought to determine the relationship between the size of the left atrial isolated surface area (ISA) after pulmonary vein antrum isolation for paroxysmal atrial fibrillation (AF) and rhythm outcome during a 12-month follow-up. Methods and Results— One hundred one consecutive patients with paroxysmal AF (mean age, 59±11 years; median [range] AF history, 36 [24–96] months; mean left atrial size, 42±6 mm) were enrolled. The ISA was defined as the ratio of the total isolated antral surface area excluding the pulmonary veins to the sum of the total isolated antral surface area and the left atrial posterior wall surface area, while considering the individual characteristics of antral anatomy. All surface areas were assessed using the NavX system. Patients were divided into 4 groups according to ISA (group I: <50%; group II: 50 to <60%; group III: 60 to <70%; group IV: ≥70%). The average ISA for all patients was 59.2±11.6%. Subgroup analysis showed that ISA was 42.8±4.2% in group I (n=23), 54.2±3.0% in group II (n=23), 64.3±3.0% in group III (n=33), and 73.9±3.6% in group IV (n=22). After a 12-month follow-up period, 70% of patients in group I, 78% in group II, 97% in group III, and 100% in group IV were free from AF and atrial macroreentrant tachycardia. There was a significant difference between groups I and III, I and IV, II and III, and II and IV but not groups I and II and groups III and IV (log-rank test P=0.024, 0.016, 0.037, 0.044, 0.584, and 0.500, respectively). Receiver operating characteristic curve analysis yielded an optimal cutoff value of 55% for ISA. Conclusions— After 12 months, a larger ISA was associated with a significantly lower AF and macroreentrant tachycardia recurrence rate. ISA≥55% may thus serve as a predictor for long-term success after pulmonary vein antrum isolation.
Repopulation of oligodendrocyte progenitor cell‐depleted tissue in a model of chronic demyelination

Some, but not all, chronically demyelinated multiple sclerosis (MS) lesions are depleted of oligodendrocyte progenitor cells (OPCs) suggesting that OPCs are destroyed during the process of demyelination and some factor impedes OPC repopulation of the depleted tissue. The chronically demyelinated axons in MS lie in an astrocytic environment and it has been proposed that this might impede entry of OPCs into such regions. By depleting a short length of spinal cord of its OPCs using 40 Gy of X‐irradiation in both normal rats and rats with progressive myelin loss accompanied by an astrocytosis (taiep rats), we investigated whether such changes affect the ability of OPCs to repopulate OPC‐depleted tissue. In both taiep and normal rats, the rate of repopulation decreases with age, but no difference was detected in the rate at which OPCs repopulated normally myelinated and chronically demyelinated and astrocytosed tissue. This indicates that, if the astrocytic environment of the taiep central nervous system (CNS) is comparable to that found in MS lesions, then the presence of chronically demyelinated axons and astrocytosis in chronic MS lesions does not represent a barrier to repopulation of the tissue by OPCs. However, similar to the situation in the normal adult rodent CNS, the rate of repopulation by endogenous OPCs in aged taiep rats is very slow, approximately 0.2 mm per week.
Crl, a Low Temperature-induced Protein in Escherichia coli That Binds Directly to the Stationary Phase σ Subunit of RNA Polymerase*

The alternative sigma factor σS (RpoS) of Escherichia coli RNA polymerase regulates the expression of stationary phase and stress-response genes. σS is also required for the transcription of the cryptic genes csgBA that encode the subunits of the curli proteins. The expression of the csgBA genes is regulated in response to a multitude of physiological signals. In stationary phase, these genes are transcribed by the σS factor, and expression of the operon is enhanced by the small protein Crl. It has been shown that Crl stimulates the activity of σS, leading to an increased transcription rate of a subset of genes of the rpoS regulon in stationary phase. However, the underlying molecular mechanism has remained elusive. We show here that Crl interacts directly with σS and that this interaction promotes binding of the σS holoenzyme (EσS) to the csgBA promoter. Expression of Crl is increased during the transition from growing to stationary phase. Crl accumulates in stationary phase cells at low temperature (30 °C) but not at 37 °C. We therefore propose that Crl is a second thermosensor, besides DsrA, controlling σS activity.
Periacetabular Limb Salvage for Malignant Bone Tumours

Purpose. To evaluate treatment outcomes in primary malignant periacetabular bone tumour removal and limb salvage with or without bone-graft reconstruction. Methods. A total of 13 patients were treated for malignant periacetabular bone tumours at Siriraj Hospital, Bangkok, Thailand. The diagnoses were chondrosarcoma (n=8), Ewing's sarcoma (n=2), osteosarcoma (n=1), well-differentiated osteosarcoma (n=1), and malignant giant cell tumour (n=1). 11 patients did not undergo reconstruction following tumour resection; 2 patients received fibular bone grafts bridging the periacetabulum to the remaining sacrum. Adjuvant chemotherapy was administered for high-grade malignant tumours, and postoperative radiation therapy was performed on patients with a closed surgical margin. Results. At a mean follow-up of 24.3 months (range, 8.9–43.9 months), 9 patients remained disease-free, 3 had died of the disease, and one was alive with disease. According to the Musculoskeletal Tumor Society classification system, the mean functional analysis at final follow-up was 68.7%. Patients who underwent internal hemipelvectomy experienced a subsequent leg-length discrepancy ranging from 3 to 10 cm. Four patients had complications (one each for deep wound infection, skin necrosis, seroma, and vascular spasms) and were successfully treated with multiple debridements and appropriate antibiotics. Three patients had local recurrences; one required a classic hemipelvectomy. Conclusion. Malignant periacetabular tumours are difficult to manage. Functional results of our patients with no reconstruction or with bone-graft bridging were fair. Patients undergoing internal hemipelvectomy may experience leg-length discrepancies, which can be balanced with shoe lifts.
Duct‐acinar‐islet cell tumor of the pancreas

A case of a rare pancreatic tumor, duct‐acinar‐islet cell tumor is presented. The tumor was incidentally found in the pancreatic body on computed tomography of a 21 year old male suffering from mumps. It was well demarcated from surrounding pancreas, and spherical in shape, measured 2.5 cm in diameter. Histologic and immunohistochemical examinations showed the tumor to consist of three distinct cell populations: duct, acinar and islet cells. Small cell nests consisting of these cellular components, either solely of one cell type or mixed of the three cell types, were separated by broad desmoplastic stroma. Islet (endocrine) cells, which were most predominant, were arranged in a tra‐becular pattern or small cell nests. Most of them were positive for glucagon, and a few cells expressed insulin, somatostatin, serotonin or pancreatic polypeptide. These cells were distributed randomly within the cell nests. Ducts, some of which contained goblet cells, were found among the endocrine cell nests. Duct‐islet complexes were also observed. The acinar cells were the least conspicuous component. They expressed pancreatic α‐amylase. An electron microscopic examination revealed duct cells with intercellular attachments and interdigitations, endocrine cells containing secretory granules, and acinar cells with zymogen granules. No definite evidence suggesting malignancy could be obtained.