Miracle-dz/UniFAR-FTUs huggingface dataset:
The Internal Brace for Midsubstance Achilles Ruptures

The efficient and effective function of the Achilles tendon is essential for normal gait and sporting performance. The optimal technique for the operative repair of the Achilles midsubstance rupture remains controversial. Suboptimal outcomes are common even after successful Achilles repair. Factors contributing to poor outcomes include a tenuous soft tissue envelope (leading to wound complications, peritendinous adhesions, and poor tendon healing,) as well as failure to maintain appropriate musculotendinous length, even after successful repair. We present a new technique using the InternalBrace (IB) and a modification of the Percutaneous Achilles Repair System (PARS; Arthrex Inc, Naples, FL), the Achilles Mid-Substance Speed Bridge Repair. This IB approach is knotless, respects the soft tissue envelope, and allows the appropriate musculotendinous length to be set intraoperatively. The IB principle enables direct fixation to bone allowing early mobilization while minimizing the risk of knot slippage, accelerating recovery, and allowing for restoration of normal function. Level of Evidence: Level V, expert opinion.
Chronic &mgr;-Opioid Receptor Stimulation Alters Cardiovascular Regulation in Humans: Differential Effects on Muscle Sympathetic and Heart Rate Responses to Arterial Hypotension

In opioid addicted patients, respiratory regulation adapts allowing intake of otherwise lethal dosages of opioids. In contrast, little is known about cardiovascular regulation during chronic opioid receptor stimulation. We previously demonstrated that chronic &mgr;-opioid receptor stimulation by methadone decreases resting muscle sympathetic activity (MSA). However, for short-term control of arterial blood pressure autonomic responses to arterial hypotension may be of greater importance. Accordingly, we tested the hypothesis that chronic opioid receptor stimulation attenuates muscle sympathetic and heart rate responses to arterial hypotension. Ten young patients (mean ± SD, 30 years ± 6) with a long history of mono-opioid addiction and under oral methadone substitution therapy (54 mg d−1 ± 31) for 12 months (±20) were studied. Peroneal MSA (microneurography) and heart rate responses to hypotensive challenges (sodium nitroprusside) were assessed in the awake state and compared with those of 10 matched healthy subjects. Effects of &mgr;-opioid receptor blockade by naloxone (12.4 mg i.v.) were determined during propofol anesthesia. Chronic &mgr;-opioid receptor stimulation markedly decreased the MSA response to hypotension (−0.5 units mm Hg−1 ± 0.2 vs. −2.0 ± 1.8; p = 0.01) compared with healthy subjects despite similar arterial blood pressure and heart rate at rest. In contrast, the heart rate response to hypotension did not differ between addicted patients (6 ms mm Hg−1 ± 2) and healthy subjects (7 ms mm Hg−1 ±4). Opioid receptor blockade during propofol anesthesia markedly increased the MSA response to hypotension even beyond awake values (−1.2 units mm Hg−1 ± 1.1; p = 0.02 vs. awake) while the heart rate response remained unchanged. Thus, chronic &mgr;-opioid receptor stimulation 1) results in uncompensated depression of cardiovascular sympathetic neural regulation, and 2) exerts differential effects on efferent sympathetic nerve activity to muscle and on heart rate control in response to arterial hypotension.
Selective phosphorylation of PKA targets after β-adrenergic receptor stimulation impairs myofilament function in Mybpc3-targeted HCM mouse model.

AIMS Hypertrophic cardiomyopathy (HCM) has been associated with reduced β-adrenergic receptor (β-AR) signalling, leading downstream to a low protein kinase A (PKA)-mediated phosphorylation. It remained undefined whether all PKA targets will be affected similarly by diminished β-AR signalling in HCM. We aimed to investigate the role of β-AR signalling on regulating myofilament and calcium handling in an HCM mouse model harbouring a gene mutation (G > A transition on the last nucleotide of exon 6) in Mybpc3 encoding cardiac myosin-binding protein C. METHODS AND RESULTS Cardiomyocyte contractile properties and phosphorylation state were measured in left ventricular permeabilized and intact cardiomyocytes isolated from heterozygous (HET) or homozygous (KI) Mybpc3-targeted knock-in mice. Significantly higher myofilament Ca²⁺sensitivity and passive tension were detected in KI mice, which were normalized after PKA treatment. Loaded intact cardiomyocyte force-sarcomere length relation was impaired in both HET and KI mice, suggesting a reduced length-dependent activation. Unloaded cardiomyocyte function revealed an impaired myofilament contractile response to isoprenaline (ISO) in KI, whereas the calcium-handling response to ISO was maintained. This disparity was explained by an attenuated increase in cardiac troponin I (cTnI) phosphorylation in KI, whereas the increase in phospholamban (PLN) phosphorylation was maintained to wild-type values. CONCLUSION These data provide evidence that in the KI HCM mouse model, β-AR stimulation leads to preferential PKA phosphorylation of PLN over cTnI, resulting in an impaired inotropic and lusitropic response.
Trends in Knowledge and Skill Expectations for New Human Factors Professionals

This study was a replicate of two prior studies on the knowledge and skill expectations for new human factors/ergonomics professionals in the current labor market. Five and four years have passed since new HF/E professionals and their employers were last surveyed. In the rapidly changing work domains it is important to track the changing expectations to detect trends and to continually revise academic curricula to better provide future HF/E professionals education that meets them. Both new professionals and their employers were surveyed for this study. The results are compared with the past surveys. In addition, the relevance of the new core competencies of the Board of Certification for Professional Ergonomics were examined against the workplace expectations.
Pengaruh Skeptisme, Pengalaman Auditor, dan Self Efficacy Terhadap Audit Judgement Pada Kantor Akuntan Publik di Medan

Judgment audit is a consideration made by public accountants in making an audit plan, and before issuing an opinion on the company's financial statements. The independent variables of this study are skepticism, auditor experience, and self efficacy. The dependent variable of this study is judgment audit. The purpose of this study is to examine and analyze the influence of skepticism, auditor experience, and self efficacy on judgment audits at the Public Accountant Office in Medan. This research uses descriptive quantitative research methods with the nature of research of causal relationships. The data were collected with questionnaires which were tested for validity and reliability before conducting the research. The test equipment used is normality test, multicollinearity test, and heteroscedasticity test. This study uses purposive sampling with a total of 90 respondents in the Public Accountant Office in Medan. The results of the study on the hypothesis indicate that skepticism, auditor experience, and self efficacy partially and simultaneously influence the judgment audit on the Public Accounting Firm in Medan. The conclusion of this study shows that skepticism, auditor experience, and self-efficacy have a positive and significant effect on judgment audits at the Public Accountant Office in Medan.Keywords: Skepticism, Auditor Experience, Self Efficacy, Audit Judgment
Importance of a Developmentally Regulated Pheromone Receptor of Cryptococcus neoformans for Virulence

ABSTRACT Cryptococcus neoformans is the etiologic agent of cryptococcosis. Two mating types exist in this fungus, MATα and MATa. The CPRa gene of C. neoformans is a MATa strain-specific gene and encodes a putative seven-transmembrane domain pheromone receptor. Unlike the other reported fungal pheromone receptors, CPRa shows functional diversity. Deletion of CPRa drastically affects mating efficiency but does not abolish mating. CPRa expression is developmentally regulated and is not affected by deletion of the transcriptional regulator STE12a. The expression of CPRa is markedly increased by shifting cultures from liquid to solid media. CPRa also plays a significant role in virulence. Δcpra cells produce smaller capsules in the brains of mice than the wild-type cells, and the mice infected with Δcpra survive significantly longer than those receiving the wild-type strain. Our results suggest that the MATa pheromone receptor of C. neoformans is not only required for mating but also important for survival and growth of the fungus in host tissue.
Endovascular Stenting of Obstructed Right Ventricle–to–Pulmonary Artery Conduits: A 15-Year Experience

Background— The optimal treatment for dysfunctional right ventricle–to–pulmonary artery (RV-PA) conduits is unknown. Limited follow-up data on stenting of RV-PA conduits have been reported. Methods and Results— Between 1990 and 2004, deployment of balloon-expandable bare stents was attempted in 242 obstructed RV-PA conduits in 221 patients (median age, 6.7 years). Acute hemodynamic changes after stenting included significantly decreased RV systolic pressure (89±18 to 65±20 mm Hg, P<0.001) and peak RV-PA gradient (59±19 to 27±14 mm Hg, P<0.001). There were no deaths, and, aside from 5 malpositioned stents requiring surgical removal, there were no serious procedural complications. During follow-up of 4.0±3.2 years, 9 patients died and 2 underwent heart transplantation, none related to catheterization or stent malfunction. During 155 follow-up catheterizations in 126 patients, the stent was redilated in 83 patients and additional stents were placed in 41. Stent fractures were diagnosed in 56 patients (43%) and associated with stent compression and substernal location but did not cause acute hemodynamic consequences. By Kaplan-Meier analysis, median freedom from conduit surgery after stenting was 2.7 years (3.9 years in patients >5 years), with younger age, homograft conduit, conduit diameter ≤10 mm, diagnosis other than tetralogy of Fallot, Genesis stent, higher prestent RV:aortic pressure ratio, and stent malposition associated with shorter freedom from surgery. Tricuspid regurgitation and RV function did not change between stent implantation and subsequent surgery. Conclusions— Conduit stenting is an effective interim treatment for RV-PA conduit obstruction and prolongs conduit lifespan in most patients. Stent fractures were common but not associated with significant complications or earlier conduit reoperation.
The roles of PCNA SUMOylation, Mms2‐Ubc13 and Rad5 in translesion DNA synthesis in Saccharomyces cerevisiae

Mms2, in concert with Ubc13 and Rad5, is responsible for polyubiquitination of replication processivity factor PCNA. This modification activates recombination‐like DNA damage‐avoidance mechanisms, which function in an error‐free manner. Cells deprived of Mms2, Ubc13 or Rad5 exhibit mutator phenotypes as a result of the channelling of premutational DNA lesions to often error‐prone translesion DNA synthesis (TLS). Here we show that Siz1‐mediated PCNA SUMOylation is required for the stimulation of this TLS, despite the presence of PCNA monoubiquitination. The stimulation of spontaneous mutagenesis by Siz1 in cells carrying rad5 and/or mms2 mutations is connected with the known role of PCNA SUMOylation in the inhibition of Rad52‐mediated recombination. However, following UV irradiation, Siz1 is engaged in additional, as yet undefined, mechanisms controlling genetic stability at the replication fork. We also demonstrate that in the absence of PCNA SUMOylation, Mms2‐Ubc13 and Rad5 may, independently of each other, function in the stimulation of TLS. Based on this finding and on an analysis of the epistatic relationships between SIZ1, MMS2 and RAD5, with respect to UV sensitivity, we conclude that PCNA SUMOylation is responsible for the functional differences between the Mms2 and Rad5 homologues of Saccharomyces cerevisiae and Schizosaccharomyces pombe.
Identification and antimicrobial resistance patterns of clinical isolates of Clostridium clostridioforme, Clostridium innocuum, and Clostridium ramosum compared with those of clinical isolates of Clostridium perfringens

Clostridium ramosum, C. innocuum, and C. clostridioforme are frequently isolated from clinical specimens including blood. Because of Gram stain variability, a lack of spores, and atypical colonial morphology, identification of these species is often difficult. Three anaerobe identification kits were evaluated for their abilities to identify these species. For comparison, 11 strains of C. perfringens were evaluated in parallel. By using profile numbers and codebooks, the correct genus and species were identified, as follows: with the RapID ANA II kit, 100% (20 of 20) of C. ramosum isolates, 24% (5 of 21) of C. innocuum isolates, and 50% (10 of 20) of C. clostridioforme isolates; with the AnIDent kit, 60% (12 of 20) of C. ramosum isolates, 28% (6 of 21) of C. innocuum isolates, and 90% (18 of 20) of C. clostridioforme isolates; with the ATB32A kit, 70% (14 of 20) of C. ramosum isolates, 0% (0 of 21) of C. innocuum isolates, and 40% (8 of 20) of C. clostridioforme isolates. Profile numbers that overlapped several species were obtained as follows: with the RapID ANA II kit, 0% of C. ramosum isolates, 76% of C. innocuum isolates, and 40% of C. clostridioforme isolates; with the AnIDent kit 40% of C. ramosum isolates, 62% of C. innocuum isolates, and 5% of C. clostridioforme isolates; with the ATB32A kit, 15% of C. ramosum isolates, 52% of C. innocuum isolates, and 25% of C. clostridioforme isolates. One strain of C. innocuum was misidentified by the AnIDent kit, and the remainder yielded profile numbers that were not listed in the codebooks. The MICs of 11 antimicrobial agents including penicillin G, metronidazole, clindamycin, cefoxitin, cefotetan, imipenem, meropenem, amoxicillin-clavulanate, ampicillin-sulbactam, piperacillin-tazobactam, and vancomycin were determined by the agar dilution method. All C. perfringens strains were susceptible to all antimicrobial agents tested. Various levels of resistance to cefoxitin, cefotetan, and penicillin G were noted with C. ramosum, C. clostridioforme, and C. innocuum. In addition, resistance to clindamycin was noted with C. ramosum (5%) and C. innocuum (10%). Most strains of C. innocuum were only moderately susceptible to vancomycin (MIC at which 90% of strains are inhibited, 4 micrograms/ml).
Audit Office Industry Diversity and Audit Quality

This study examines the association between the industry diversity of an audit office and audit quality, where industry diversity is the extent to which clients differ by industry classification. We find a negative association between industry diversity and audit quality that is robust to controlling for other audit office and client characteristics. We observe this association while holding the level of audit office specialization or expertise in a particular industry constant. The association is most apparent at the low end of the distribution of industry diversity, where audit offices with the least diverse client portfolios have the highest audit quality. We also find that the association exists for both small and large audit offices as well as both industry specialists and non-industry specialists. However, we do not observe the association when the office audits clusters of clients, where clusters are three or more clients in the same industry.
Gender-Specific Mental and Behavioral Outcomes among Physically Abused High-Risk Seventh-Grade Youths

Objective. Research has shown that physical abuse during childhood (early PA) is associated with various mental and behavioral problems in adolescence. However, there is little research on the differences in these associations by gender among youths residing in high-risk communities. This study investigated gender differences in the relationship between early PA and various internalizing (e.g., thoughts of suicide or victimization) and externalizing (e.g., perpetration of violence) behaviors. Methods. A cross-sectional study was conducted using survey data (collected in 2004) provided by 1,484 seventh-grade youths residing in a high-risk community (83% participated). Students were considered victims of early PA if they reported experiencing abuse prior to age 10 years. Prevalence ratios (PRs) were calculated to estimate the association between early PA and various outcomes (e.g., suicidality, victimization, violence, and illegal drug use), adjusting for race/ethnicity and other forms of abuse. Poisson regression with robust variance estimates was used to estimate the PRs and test for early PA-gender interaction. Results. Early PA was positively associated with suicidality, illegal drug use, and victimization with no significant differences by gender. The association between early PA and criminal behavior was significantly higher for females; the association between early PA and peer violence perpetration was significantly higher for males (interaction term PA*gender was significant at the p≤0.005 level). Conclusions. Young high-risk adolescents who experienced early PA may need counseling or other services (e.g., home visitation) to help prevent suicidality, victimization, violence perpetration, criminal behavior, and illegal drug use. Furthermore, male victims may need more attention in the area of violence prevention; female victims may need particular attention with regard to preventing criminal behavior.
Dynamic Vortex Drag

This thesis explores the concept of dynamic vortex drag resulting from Kelvin wave excitations on vortex cores in thin lms of super uid 4He. In this system, vortex drag is commonly accepted as a signi cant mechanism for the dissipation of third sound wave motion; however, current models implementing a static drag force have been unable to quantitatively explain anomalous third sound free decay results found in the literature. In this thesis, many possible manifestations of Kelvin wave agitation are explored and are shown to correct the de ciencies of existing static drag theories. It is therefore concluded that vortex drag in thin lms of super uid 4He is most likely a dynamic, and not a static, process. Acknowledgements: I would like to extend my gratitude to the Wesleyan University Physics Department for teaching me the physics that is at the backbone of this project and will underpin my development as a scientist in the years to come. In particular, I would like to thank Professor Fred Ellis for his support and encouragement in pursuing this project, his general academic and life advice during my time as an undergraduate, and his dedication towards encouraging an appreciation of dynamic climates in a southern Californian. I would also like to thank Professor Brian Stewart for inculcating an interest in sustainability, renewable energy, and broader energy/resource issues that I will carry with me throughout graduate school and the rest of my life. Additionally, I would like to thank the Wesleyan University Financial Aid Department for their generosity and thoughtfulness in my family's times of need.
Quinolone treatment for pediatric bacterial meningitis: a comparative study of trovafloxacin and ceftriaxone with or without vancomycin.

BACKGROUND Trovafloxacin is a new fluoroquinolone that exhibits good penetration into the central nervous system and excellent antimicrobial activity against common meningeal pathogens, including beta-lactam-resistant pneumococci. PURPOSE AND DESIGN A multicenter, randomized clinical trial was conducted in children with bacterial meningitis to compare the safety and efficacy of trovafloxacin with that of ceftriaxone with or without vancomycin therapy. RESULTS A total of 311 patients, ages 3 months to 12 years, were enrolled, of whom 203 were fully evaluable, 108 treated with trovafloxacin and 95 with the conventional regimen. Both groups were comparable with regard to baseline characteristics: age; cerebrospinal fluid findings; use of dexamethasone; history of seizures; and etiologic agents. No significant differences between trovafloxacin and the comparator, respectively, were detected in any of the following outcome measures: clinical success at 5 to 7 weeks after treatment (79% vs. 81%); deaths (2% vs. 3%); seizures after enrollment (22% vs. 21%); and severe sequelae (14% vs. 14%). Only 4 of 284 children developed joint abnormalities up to 6 months after treatment, 1 (0.9%) child received trovafloxacin and 3 (3.1%) received the comparator regimen. None of the evaluable patients experienced significant abnormalities of liver function during treatment. One nonevaluable patient who received trovafloxacin for 5 days and ceftriaxone for 11 days was readmitted to the hospital with hepatitis of unknown etiology 1 day after discharge. The episode resolved with liver function tests returning to normal within 2 months. CONCLUSIONS We conclude that trovafloxacin is an effective antibiotic for treatment of pediatric bacterial meningitis. These favorable results support further evaluation of fluoroquinolone therapy for children with meningitis or other serious bacterial infections.
Renal reserve during human pregnancy.

Pregnancy in healthy women is associated with increments in glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). We hypothesized that the hyperfiltration of normal pregnancy attenuates or exhausts renal reserve. In 21 healthy females studied serially in early and late pregnancy and then on average 15 wk postpartum, GFR and ERPF were determined by inulin and p-aminohippurate clearances, respectively, before and during either an amino acid infusion (Vamin 9; Kabi Pharmacia) (n = 14) or a control infusion of Hartman's solution (n = 7), both infused at 4 ml/min for 210 min. In early and late pregnancy, GFR increased significantly in response to amino acid infusion [from 137 +/- 29 to 162 +/- 35 ml/min (P < 0.001) and from 134 +/- 29 to 148 +/- 40 ml/min (P < 0.01), respectively], with the increments (18 and 10%, respectively) not significantly different from postpartum (non-pregnant) when GFR increased by 12% from 94 +/- 22 to 105 +/- 23 ml/min (P < 0.002). Amino acid infusion significantly increased ERPF from 874 +/- 188 to 980 +/- 215 ml/min in early pregnancy (P < 0.01), from 684 +/- 135 to 773 +/- 181 ml/min in late pregnancy (P < 0.01), and from 507 +/- 121 to 560 +/- 141 ml/min postpartum (P < 0.006), increments of 12, 13, and 10%, respectively. GFR did not change in response to control infusion. We conclude that, despite gestational increments in renal hemodynamics of > 40%, pregnancy does not attenuate the renal response to amino acid infusion.
The Electronic Marketing and Services Quality in Sports Clubs

The research aims to identify the availability of information database via websites in sport clubs, to identify research and development in e-marketing and to identify the availability of safety websites in sports clubs, to identify the marketing strategy of sport clubs,and to identify the quality of services in the sport clubs. The researchers had used descriptive approach. The research sample included the active members of Al Ahly and Zamalek Clubs (about 150 from Al-Ahly and 150 from Zamalek) and used the tools of data collection questionnaire. The results found a relationship between the availability of a database for marketing and quality services in sport clubs and the existence of a relationship between the research and development and quality of services, sports clubs and there is no relationship between the availability of safety, reliability and quality of services, sport clubs and the existence of the relationship between marketing strategy and the quality of services, sports club and the presence of the impact of electronic marketing on the quality of sport clubs.