Miracle-dz/UniFAR-FTUs huggingface dataset:
Influence of the frequency of Er:YAG laser on the bond strength of dental enamel.

OBJECTIVE The present study had the aim of evaluating the influence of different frequencies of the Er:YAG laser on adhesive resistance of enamel and one restorative system. BACKGROUND DATA There have been no reports of studies assessing the influence of the pulse frequency variation of the Er:YAG laser on adhesive resistance of the enamel/resin interface. MATERIALS AND METHODS Fifty surfaces of enamel from extracted human third molars were planed and divided into five groups at random. Enamel surface treatment was realized by the Er:YAG laser at 80-mJ power and 1-, 2-, 3-, and 4-Hz pulse frequencies, followed by etching. For the control group, only acid conditioning with 37% phosphoric acid for 15 sec was used. The Single Bond/Filtek Z250 system was chosen for the fabrication of the specimens, which were stored in 100% relative humidity for 24 h, at 37 degrees C. The specimens were submitted to tensile resistance tests using a Universal Testing Machine (50 Kgf and 0.5 mm/min). RESULTS The mean values in MPa were 1 Hz, 25.58 (+/-6.16); 2 Hz, 25.58 (+/-3.79); 3 Hz, 21.34 (+/-3.78); 4 Hz, 21.17 (+/-3.13); and phosphoric acid only, 22.44 (+/-7.0). Data were submitted to statistical analysis using ANOVA, and there was no significant difference in tensile resistance between the studied groups. CONCLUSION The results suggest that the Er:YAG laser, with 80-mJ power associated with acid conditioning at 1-, 2-, 3-, and 4-Hz frequencies, did not present significant improvement in tensile bonding of enamel, as compared to acid conditioning only.
Methods for a longitudinal quantitative outcome with a multivariate Gaussian distribution multi‐dimensionally censored by therapeutic intervention

In longitudinal studies, a quantitative outcome (such as blood pressure) may be altered during follow‐up by the administration of a non‐randomized, non‐trial intervention (such as anti‐hypertensive medication) that may seriously bias the study results. Current methods mainly address this issue for cross‐sectional studies. For longitudinal data, the current methods are either restricted to a specific longitudinal data structure or are valid only under special circumstances. We propose two new methods for estimation of covariate effects on the underlying (untreated) general longitudinal outcomes: a single imputation method employing a modified expectation–maximization (EM)‐type algorithm and a multiple imputation (MI) method utilizing a modified Monte Carlo EM‐MI algorithm. Each method can be implemented as one‐step, two‐step, and full‐iteration algorithms. They combine the advantages of the current statistical methods while reducing their restrictive assumptions and generalizing them to realistic scenarios. The proposed methods replace intractable numerical integration of a multi‐dimensionally censored MVN posterior distribution with a simplified, sufficiently accurate approximation. It is particularly attractive when outcomes reach a plateau after intervention due to various reasons. Methods are studied via simulation and applied to data from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study of treatment for type 1 diabetes. Methods proved to be robust to high dimensions, large amounts of censored data, low within‐subject correlation, and when subjects receive non‐trial intervention to treat the underlying condition only (with high Y), or for treatment in the majority of subjects (with high Y) in combination with prevention for a small fraction of subjects (with normal Y). Copyright © 2013 John Wiley & Sons, Ltd.
Why has EU macroeconomic governance become more supranational?

Abstract While much of the literature on the Euro crisis has highlighted the intergovernmental features of the European Union response, it appears that in strategic areas, such as macroeconomic policy or banking regulation, supranational institutions have seen their discretionary powers significantly enhanced and that they have played an instrumental role in bringing about such a change. This is all the more remarkable considering the decline in support for integration among governments and the public. This article explains this paradox by the dramatic character of the crisis and the deep mistrust that existed between European states at the time. It also suggests that the process could be hard to reconcile with attempts at ‘politicizing’ EU public policy.
Estimating the costs of intensity-modulated and 3-dimensional conformal radiotherapy in Ontario.

BACKGROUND Radiotherapy is a common treatment for many cancers, but up-to-date estimates of the costs of radiotherapy are lacking. In the present study, we estimated the unit costs of intensity-modulated radiotherapy (imrt) and 3-dimensional conformal radiotherapy (3D-crt) in Ontario. METHODS An activity-based costing model was developed to estimate the costs of imrt and 3D-crt in prostate cancer. It included the costs of equipment, staff, and supporting infrastructure. The framework was subsequently adapted to estimate the costs of radiotherapy in breast cancer and head-and-neck cancer. We also tested various scenarios by varying the program maturity and the use of volumetric modulated arc therapy (vmat) alongside imrt. RESULTS From the perspective of the health care system, treating prostate cancer with imrt and 3D-crt respectively cost $12,834 and $12,453 per patient. The cost of radiotherapy ranged from $5,270 to $14,155 and was sensitive to analytic perspective, radiation technique, and disease site. Cases of head-and-neck cancer were the most costly, being driven by treatment complexity and fractions per treatment. Although imrt was more costly than 3D-crt, its cost will likely decline over time as programs mature and vmat is incorporated. CONCLUSIONS Our costing model can be modified to estimate the costs of 3D-crt and imrt for various disease sites and settings. The results demonstrate the important role of capital costs in studies of radiotherapy cost from a health system perspective, which our model can accommodate. In addition, our study established the need for future analyses of imrt cost to consider how vmat affects time consumption.
Cerebrospinal fluid C3 and C4 indexes in immunological disorders of the central nervous system

Objectives– Validation of cerebrospinal fluid (CSF) indexes as a measure for intrathecal C3 and C4 production. Examination of their role in differential diagnosis of immunological disorders of the central nervous system (CNS). Material and methods– Correlative study in controls (low back pain without disk herniation) between the CSF/serum ratio (Q) for albumin, and Q C3 and Q C4. Comparative study of C3 and C4 indexes in patients with CNS dysfunction due to relapsing–remitting (RR) multiple sclerosis (MS), secondary progressive (SP) MS, systemic lupus erythematosus (SLE), and human immunodeficiency virus (HIV) infection. Results– Strong and statistically highly significant correlations between Q albumin and Q C3 (r=0.89, P=0.0001), and Q C4 (r=0.68, P=0.0001). In MS patients decreased mean values for serum (RR, SP) and CSF (RR) C3, and increased C3 index mean value (RR, SP). In CNS SLE increase of mean C3 and C4 index values. In CNS HIV increase of mean C3 and C4 index values, and CSF C3 and C4 concentrations. Most individual index values were within the reference range. Conclusion– CSF index is a valid tool to detect intrathecal C3 or C4 production. C3 or C4 index contributes little to the differential diagnosis of immunological CNS disorders. C3 might play a pathogenic role in various immunological CNS disorders.
Accuracy of primary care and hospital-based physicians' predictions of elderly outpatients' treatment preferences with and without advance directives.

BACKGROUND Past research has documented that primary care physicians and family members are often inaccurate when making substituted judgments for patients without advance directives (ADs). This study compared the accuracy of substituted judgments made by primary care physicians, hospital-based physicians, and family surrogates on behalf of elderly outpatients and examined the effectiveness of ADs in improving the accuracy of these judgments. PARTICIPANTS AND METHODS Participants were 24 primary care physicians of 82 elderly outpatients, 17 emergency and critical care physicians who had no prior experience with the patients, and a baseline comparison group of family surrogates. The primary outcome was accuracy of physicians' predictions of patients' preferences for 4 life-sustaining treatments in 9 hypothetical illness scenarios. Physicians made substituted judgments after being provided with no patient AD, patient's value-based AD, or patient's scenario-based AD. RESULTS Family surrogates' judgments were more accurate than physicians'. Hospital-based physicians making predictions without ADs had the lowest accuracy. Primary care physicians' accuracy was not improved by either AD. Accuracy and confidence in predictions of hospital-based physicians was significantly improved for some scenarios using a scenario-based AD. CONCLUSIONS Although ADs do not improve the accuracy of substituted judgments for primary care physicians or family surrogates, they increase the accuracy of hospital-based physicians. Primary care physicians are withdrawing from hospital-based care in growing numbers, and emergency medicine and critical care specialists most often are involved in decisions about whether to begin life-sustaining treatments. If ADs can help these physicians better understand patients' preferences, patient autonomy more likely will be preserved when patients become incapacitated.
Vibro-acoustic stimulation does not alter the duration of high and low fetal heart rate variability episodes

To study the effect of vibro-acoustic stimulation on high and low fetal heart rate (FHR) variability episodes. Prospective control study, in 21 high risk pregnancies between 32 to 39 weeks gestation. FHR pattern was recorded with cardiotocograph (CTG). After 5 min low FHR variability a vibro-acoustic stimulator was activated in contact with or above the maternal abdomen (sham) on a random basis on two consecutive days, and CTG was continued to obtain a complete high and low FHR variability cycle. Complete high and low FHR variability cycles were obtained in 12 patients with mean recording time of 129.5 minutes (range 69-185 min). The mean baseline FHR increased by 32.5 +/- 9.4 bpm after contact vibro-acoustic stimulation, but remained unchanged after sham stimulation. Mean duration of high FHR variability was 56.6 +/- 32.9 min and 47.3 +/- 23.7 min, respectively, and mean duration of the consecutive low FHR variability episode was similar after contact and sham stimulation. The complete cycles were 71.1 +/- 34.7 min and 66.2 +/- 21.2 min, respectively. Vibro-acoustic stimulation induced an abrupt change from low to high FHR variability, but the complete cycle of high and low FHR variability was not altered, when compared with the corresponding cycle following sham stimulation on the same fetus.
Increased Expression of Tight Junctions in ARPE-19 Cells Under Endoplasmic Reticulum Stress

Purpose: To investigate the effects of endoplasmic reticulum (ER) stress on the tight junctions of the retinal pigment epithelial (RPE) cells in vitro. Materials and Methods: ER stress was induced in cultured ARPE-19 cells, a human RPE cell line, by exposure to tunicamycin (TM) or to thapsigargin (TG). After 6, 12, 24 and 48 hours of exposure, the expressions of GRP78/Bip (Bip), C/EBP-homologous protein (CHOP), vascular endothelial growth factor (VEGF), zonula occludens (ZO)-1, occludin and claudin-1 were determined by real-time RT-PCR. Immunoblot analysis and/or immunohistochemistry for proteins of tight junctions and ER stress markers, viz., Bip, activating transcription factor (ATF) 6, CHOP, and caspase-4, were performed at 48 hours after the exposure. Enzyme-linked immunosorbent assay was used to determine the concentration of VEGF165. Transepithelial electrical resistance (TER) of the ARPE-19 cells was determined to measure the permeability. Results: The expressions of the mRNAs and/or proteins of Bip, CHOP, ATF6 and caspase-4 were significantly increased in ARPE-19 cells under ER stress induced by TM and TG. The mRNAs of VEGF were also increased by both TM and TG. However, the concentration of VEGF165 was not significantly increased after 48 hours exposure to TM and TG compared to that of the control in the apical chamber medium. The proteins and mRNAs of occludin and claudin-1 were significantly increased by TM and TG, and that of ZO-1 was significantly increased by TG. Immunohistochemistry showed that the staining of ZO-1, occludin and claudin-1 under ER stress was stronger than that of the control. A significant increase of TER was observed after exposure to TM and TG. Conclusions: The increased expressions of tight junction molecules by TM− or TG-exposed ARPE-19 cells indicate that ER stress can alter the function of RPE cells and may be involved in the pathogenesis of age-related macular degeneration.
Event-triggered sliding mode control for a class of nonlinear systems

ABSTRACT Event-triggering strategy is one of the real-time control implementation techniques which aims at achieving minimum resource utilisation while ensuring the satisfactory performance of the closed-loop system. In this paper, we address the problem of robust stabilisation for a class of nonlinear systems subject to external disturbances using sliding mode control (SMC) by event-triggering scheme. An event-triggering scheme is developed for SMC to ensure the sliding trajectory remains confined in the vicinity of sliding manifold. The event-triggered SMC brings the sliding mode in the system and thus the steady-state trajectories of the system also remain bounded within a predesigned region in the presence of disturbances. The design of event parameters is also given considering the practical constraints on control execution. We show that the next triggering instant is larger than its immediate past triggering instant by a given positive constant. The analysis is also presented with taking delay into account in the control updates. An upper bound for delay is calculated to ensure stability of the system. It is shown that with delay steady-state bound of the system is increased than that of the case without delay. However, the system trajectories remain bounded in the case of delay, so stability is ensured. The performance of this event-triggered SMC is demonstrated through a numerical simulation.
Influence of hydraulic retention time and plant species on performance of mesocosm subsurface constructed wetlands during municipal wastewater treatment in super-arid areas

ABSTRACT A constructed wetland (CW) in arid areas requires special knowledge given the particular climatic conditions. Among other aspects, the Hydraulic Retention Time (HRT) and plant species may be two important design parameters in hyper- and super-arid areas. Therefore, the study aimed to evaluate the influence of both variables in the application of CW in super-arid areas. Two HRT, 3.5 d and 7 d, and plant species classified by their origin: (a) native, Festuca Orthopylla, Cortaderia atacamensis and Schoenoplectus americanus, and (b) foreign, Cyperus papyrus, were evaluated in four Mesocosm Constructed Wetlands (MCW) operated in a super-arid area. The results showed that the HRT significantly increased (α < 0.05) in more than 10% the removal efficiency of nitrogen and phosphorus forms (TN, NH4+-N, TP, PO4−3-P). These results were the same for the two groups of plants assessed. Moreover, Cyperus papyrus significantly increased (α < 0.05) above 30% the removal efficiency, but only for nitrogen and phosphorus forms. MCW with this plant species showed a water loss above 25% and significantly increased (α < 0.05) the Electrical Conductivity (EC) of effluents. MCW planted with Schoenoplectus americanus showed water losses of around 25% for the both HRT evaluated, and its influence was not significant (α > 0.05) on the EC of the effluents. These results suggest that Schoenoplectus americanus would be an ideal candidate species for use in CW with subsurface flow in super-arid areas, with HRT varying between 3.5 d and 7 d.
Corporate Governance, Ownership Structure, and Credit Ratings of Hospitality Firms

This study examines interrelated connections of corporate governance, ownership structure, and credit ratings. From the agency relationship perspective, the study analyzes this multiple association by accounting for firm-specific and ownership characteristics for the period between 1990 and 2007. In this context, logistic functions are used in regression models to predict the probable outcomes of these multiple relationships. Primary findings of this study revealed that hospitality firms with higher anti-takeover provisions (less shareholder power) enjoy higher credit ratings. Findings also revealed high coefficients of Gompers, Ishii, and Metrick (2003) index (the GIM index), suggesting that hospitality firms have strong governance provisions, reduced agency conflicts, and higher chances of getting better credit ratings.
Excisional treatment in women with cervical adenocarcinoma in situ (AIS): a prospective randomised controlled non-inferiority trial to compare AIS persistence/recurrence after loop electrosurgical excision procedure with cold knife cone biopsy: protocol for a pilot study

Introduction Adenocarcinoma in situ (AIS) of the uterine cervix is the precursor to invasive endocervical adenocarcinoma. An excisional biopsy such as a cold knife cone biopsy (CKC) should be performed to exclude invasive adenocarcinoma. Loop electrosurgical excision procedure (LEEP) is an alternative modality to CKC but is controversial in AIS. There is a perception that there is a greater likelihood of incomplete excision of AIS with LEEP because the depth of excised tissue tends to be smaller and the tissue margins may show thermal artefact which can interfere with pathology assessment. In the USA, guidelines recommend that any treatment modality can be used to excise AIS, provided that the specimen remains intact with interpretable margins. However, there are no high-quality studies comparing LEEP with CKC and well-designed prospective studies are needed. If such a study were to show that LEEP was non-inferior to CKC for the outcomes of post-treatment persistence, recurrence and adenocarcinoma, LEEP could be recommended as an appropriate treatment option for AIS in selected patients. This would benefit women because, unlike CKC, LEEP does not require general anaesthesia and may be associated with reduced morbidity. Methods and analysis The proposed exploratory study is a parallel group trial with an allocation ratio of 2:1 in favour of the intervention (LEEP: CKC). Participants are women aged ≥18 to ≤45 years diagnosed with AIS on cervical screening and/or colposcopically directed biopsy in Australia and New Zealand, who are to receive excisional treatment in a tertiary level centre. Ethics and dissemination Ethical approval for the study has been granted by the St John of God Healthcare Human Research Ethics Committee (reference number #1137). Results from the study will be presented at conferences and published in a peer-reviewed scientific journal. Registration ANZCTR registration number ACTRN12617000132347 https://www.anzctr. org.au/Trial/Registration/TrialReview.aspx? id=372173&isReview=true
How valid are isotopic measurements of fatty acid oxidation?

These studies were performed 1) to compare two isotopic methods (3H2O and 14CO2 production) of measuring free fatty acid (FFA) oxidation; 2) to determine whether isotopic estimates of fatty acid oxidation during hypoinsulinemia are plausible when compared with those obtained using indirect calorimetry; and 3) to examine whether the delay between the exit of [14C]FFA from plasma and the appearance of 14CO2 in breath is accounted for solely by bicarbonate kinetics. Studies in 11 healthy volunteers revealed that [14C]- and [3H]FFA tracers provide similar estimates of FFA turnover and oxidation. Isotopic estimates of fatty acid oxidation were less than those of indirect calorimetry under basal conditions but equaled or exceeded indirect calorimetry estimates after 3 h of acute hypoinsulinemia (somatostatin induced). After stopping tracer infusions, the half-life of plasma [14C]FFA was 3.7 +/- 0.1 min. The half-life of 14CO2 decay from [14C]bicarbonate was 37 +/- 1 min, and the half-life of 14CO2 decay after discontinuation of [14C]FFA infusion was 141 +/- 10 min. Intracellular preoxidative fatty acid pools (possibly triglycerides) most probably account for the marked delay between the exit of FFA tracers from plasma and the appearance of isotopic markers of oxidation in measurable spaces. This delay can result in erroneous estimates of "FFA oxidation. " We conclude that tracer measurements of FFA oxidation are invalid under most circumstances.
Intravenous Versus Oral Iron Supplementation for the Treatment of Anemia in CKD: An Updated Systematic Review and Meta-analysis.

BACKGROUND Iron supplementation is crucial for the treatment of anemia of chronic kidney disease (CKD). Although intravenous (IV) iron is preferred for patients with CKD receiving dialysis (CKD stage 5D), the method of iron replacement for patients with CKD stages 3 to 5 is controversial. STUDY DESIGN Systematic review and meta-analysis. A search was performed until October 2015 of MEDLINE, Cochrane Library, conference proceedings in nephrology, and reference lists of included trials. SETTING & POPULATION Patients with CKD stages 3 to 5 or 5D. SELECTION CRITERIA FOR STUDIES All randomized controlled trials, regardless of publication status or language. INTERVENTION IV versus oral iron supplementation. OUTCOMES The primary outcome was defined as percentage of patients reaching an elevation in hemoglobin (Hb) concentration > 1g/dL. Secondary end points included percentage of patients who reached Hb levels > 11g/dL, absolute Hb concentration, change in Hb concentration, transferrin saturation, ferritin levels, erythropoiesis-stimulating agents and blood transfusion requirement, and quality of life. Safety analysis included all-cause mortality and serious and all adverse events. RESULTS 24 trials were identified, 13 including 2,369 patients with CKD stages 3 to 5 and 11 including 818 patients with CKD stage 5D. Patients treated with IV iron were more likely to reach an Hb response > 1g/dL (risk ratios [RRs] of 1.61 [95% CI, 1.39-1.87] for CKD stages 3-5 and 2.14 [95% CI, 1.68-2.72] for CKD stage 5D). Safety analysis showed similar rates of mortality and serious and any adverse effects. IV iron replacement was associated with higher risk for hypotension (RR, 3.71; 95% CI, 1.74-7.94) and fewer gastrointestinal adverse events (RR, 0.43; 95% CI, 0.28-0.67). LIMITATIONS Significant heterogeneity between trials; follow-up was usually limited to 3 months. CONCLUSIONS Our results agree with current recommendations for IV iron replacement for patients with CKD stage 5D and support increased use of IV iron for patients with CKD stages 3 to 5.