Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of Third-Degree and Fourth-Degree Laceration Rates as Quality Indicators

OBJECTIVE: To examine the patterns and predictors of third-degree and fourth-degree laceration in women undergoing vaginal delivery. METHODS: We identified a population-based cohort of women in the United States who underwent a vaginal delivery between 1998 and 2010 using the Nationwide Inpatient Sample. Multivariable log-linear regression models were developed to account for patient, obstetric, and hospital factors related to lacerations. Between-hospital variability of laceration rates was calculated using generalized log-linear mixed models. RESULTS: Among 7,096,056 women who underwent vaginal delivery in 3,070 hospitals, 3.3% (n=232,762) had a third-degree laceration and 1.1% (n=76,347) had a fourth-degree laceration. In an adjusted model for fourth-degree lacerations, important risk factors included shoulder dystocia and forceps and vacuum deliveries with and without episiotomy. Other demographic, obstetric, medical, and hospital variables, although statistically significant, were not major determinants of lacerations. Risk factors in a multivariable model for third-degree lacerations were similar to those in the fourth-degree model. Regression analysis of hospital rates (n=3,070) of lacerations demonstrated limited between-hospital variation. CONCLUSION: Risk of third-degree and fourth-degree laceration was most strongly related to operative delivery and shoulder dystocia. Between-hospital variation was limited. Given these findings and that the most modifiable practice related to lacerations would be reduction in operative vaginal deliveries (and a possible increase in cesarean delivery), third-degree and fourth-degree laceration rates may be a quality metric of limited utility. LEVEL OF EVIDENCE: II
Monitoring antiproliferative responses to kinase inhibitor therapy in mice with 3'-deoxy-3'-18F-fluorothymidine PET.

UNLABELLED The aim of this study was to evaluate, whether PET with (18)F-FDG and 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) may be used to monitor noninvasively the antiproliferative effects of tyrosine kinase inhibitors. METHODS Using a high-resolution small animal scanner, we measured the effect of the ErbB-selective kinase inhibitor PKI-166 on the (18)F-FDG and (18)F-FLT uptake of ErbB1-overexpressing A431 xenograft tumors. RESULTS Treatment with PKI-166 markedly lowered tumor (18)F-FLT uptake within 48 h of drug exposure; within 1 wk (18)F-FLT uptake decreased by 79%. (18)F-FLT uptake by the xenografts significantly correlated with the tumor proliferation index as determined by proliferating cell nuclear antigen staining (r = 0.71). Changes in (18)F-FLT uptake did not reflect inhibition of ErbB kinase activity itself but, rather, the effects of kinase inhibition on tumor cell proliferation. Tumor (18)F-FDG uptake generally paralleled the changes seen for (18)F-FLT. However, the baseline signal was significantly lower than that for (18)F-FLT. CONCLUSION These results indicate that (18)F-FLT PET provides noninvasive, quantitative, and repeatable measurements of tumor cell proliferation during treatment with ErbB kinase inhibitors and provide a rationale for the use this technology in clinical trials of kinase inhibitors.
Fingerprints indexing algorithms based on multiple characteristics

Fingerprint identification in large databases is a leading concern preoccupation problem since biometrics still the most reliable and secure means of identification systems. Hence the need to find an accurate and relevant system of research and identification. In this paper we present the different approaches of fingerprints indexing algorithms that have proven satisfactory results in the field, evaluated on large databases provided by FVC.
Detection of endotoxin in the plasma of patients with gram-negative bacterial sepsis by the Limulus amoebocyte lysate assay

A total of 120 Limulus amoebocyte lysate (LAL) determinations were made on plasma obtained from normal, healthy human blood donors. Results demonstrated a mean endotoxin level in blood of 0.02 to 1.57 pg/ml. The amount of Escherichia coli endotoxin added to human plasma samples can be quantitated by both nephelometry and turbidimetry. Endotoxin-spiked samples were shown to be significantly different from unspiked samples. When plasma samples were collected from 45 patients hospitalized at three centers, a strong association was demonstrated between a positive Limulus amoebocyte lysate assay and a septic condition. Sensitivity, specificity, and false-positive and false-negative rates for the Limulus amoebocyte lysate assay as a diagnostic test for gram-negative bacteremia were estimated.
Undergraduate student expectations of role requirements and pedagogic relationships in a business school : a psychological contract approach

Ongoing research has identified a potential disconnect in academic and pedagogic expectation between academic staff and students. At the same time a context of higher tuition fees and changing student expectations renders this relationship even more important to the success of higher education institutions. This research investigated the sources of student expectations for the pedagogic relationship, the alignment between staff and student expectations and the potential impact of expectation fulfilment and frustration on the student experience. The study used the Psychological Contract as a theoretical framework, responding to recent calls for the further use of psychological contracts in education. The author has taught business in both secondary and university contexts for a number of years. This experience informed the phenomenological positioning of the thesis, its focus, its location in a large post -’92 business school, its mixed methods and an analytical method (template analysis) which has enabled both anticipated and emergent themes to be explored. Data was collected from a sample of students at regular intervals throughout their first year of study and from staff. Both exploratory statistical analysis of survey data and template analysis of interviews suggested that staff and students’ initial expectations broadly concur. However the practical implications of such notions as ‘independent learning’ develop significantly over the first year and it is contended that pre-entry expectations are significantly influenced by students’ experience of the pedagogic relationship at tertiary education level. The initial pedagogic psychological contract changes significantly over the first year as post entry experiences (or the ‘reality shock’) reshapes and reconfigures their expectations. The research developed a series of recommendations to both secondary schools and universities to improve the management of expectations.
Welfare, Austerity and Social Citizenship in the UK

Viewed within their historical context, recent cuts to public social spending and increasingly governmental welfare reforms reflect and beget a shift in the praxis of social citizenship in the UK. This review article demonstrates how greater conceptual attention to the constitutive features of social citizenship can help clarify some of the claims made about its relation to austerity and welfare reform within the existing literature. Through schematic consideration of the emerging evidence, this article suggests that welfare austerity is undermining the ‘effectiveness’, ‘inalienability’ and ‘universality’ of social citizenship in the UK.
Determinants of contraceptive availability at medical facilities in the department of veterans affairs

AbstractOBJECTIVE: To describe the variation in provision of hormonal and intrauterine contraception among Veterans Affairs (VA) facilities. DESIGN: Key informant, cross-sectional survey of 166 VA medical facilities. Data from public use data sets and VA administrative databases were linked to facility data to further characterize their contextual environments. PARTICIPANTS: All VA hospital-based and affiliated community-based outpatient clinics delivering services to at least 400 unique women during fiscal year 2000. MEASUREMENTS: Onsite availability of hormonal contraceptive prescription and intrauterine device (IUD) placement. RESULTS: Ninety-seven percent of facilities offered onsite prescription and management of hormonal contraception whereas 63% offered placement of IUDs. After adjusting for facility caseload of reproductive-aged women, 3 organizational factors were independently associated with onsite IUD placement: (1) onsite gynecologist (adjusted odds ratio [OR], 20.35; 95% confidence interval [CI], 7.02 to 58.74; P<.001); (2) hospital-based in contrast to community-based practice (adjusted OR, 5.49; 95% CI, 1.16 to 26.10; P=.03); and (3) availability of a clinician providing women’s health training to other clinicians (adjusted OR, 3.40; 95% CI 1.19 to 9.76; P=.02). CONCLUSIONS: VA’s provision of hormonal and intrauterine contraception is in accordance with community standards, although onsite availability is not universal. Although contraception is a crucial component of a woman’s health maintenance, her ability to obtain certain contraceptives from the facility where she obtains her primary care is largely influenced by the availability of a gynecologist. Further research is needed to determine how fragmentation of women’s care into reproductive and nonreproductive services impacts access to contraception and the incidence of unintended pregnancy.
A comparison of off- and on-pump beating-heart coronary artery bypass surgery on long-term cardiovascular events

Summary Objective Our aim was to compare short-term outcomes and long-term major adverse cardiovascular event (MACE)-free survival and independent predictors of long-term MACE after off-pump (OPCAB) versus on-pump beating-heart (ONBHCAB) coronary artery bypass grafting (CABG). Methods We retrospectively reviewed data of all consecutive patients who underwent elective CABG, performed by the same surgeon, from January 2003 to October 2009. A propensity score analysis was carried out to adjust for baseline characteristics and a total of 398 patients were included: ONBHCAB (n = 181), OPCAB (n = 217). Results OPCAB was associated with significantly shorter ventilation times (p < 0.001), intensive care unit stay (p < 0.001) and hospital stay (p < 0.001). The total blood loss was significantly more in the ONBHCAB group (p < 0.001), and accordingly, the number of transfused blood units was significantly lower in the OPCAB group (p < 0.001). Incidence of peri-operative renal complications were significantly higher in the ONBHCAB group (p = 0.004). The OPCAB group showed significantly lower long-term MACE-free survival (p = 0.029). The mean number of transfused blood units was the only independent predictor of MACE (HR: 1.218, 95% CI: 1.089–1.361; p = 0.001). Conclusion OPCAB provided better long-term MACE-free survival compared with ONBHCAB. Fewer units of blood transfused following OPCAB surgery may have been the main reason for this result.
Unique Pathology in Simian Immunodeficiency Virus-Infected Rapid Progressor Macaques Is Consistent with a Pathogenesis Distinct from That of Classical AIDS

ABSTRACT Simian immunodeficiency virus (SIV) infection of macaques and human immunodeficiency virus type 1 (HIV-1) infection of humans result in variable but generally fatal disease outcomes. Most SIV-infected macaques progress to AIDS over a period of 1 to 3 years, in the face of robust SIV-specific immune responses (conventional progressors [CP]). A small number of SIV-inoculated macaques mount transient immune responses and progress rapidly to AIDS (rapid progressors [RP]). We speculated that the underlying pathogenic mechanisms may differ between RP and CP macaques. We compared the pathological lesions, virus loads, and distribution of virus and target cells in SIVsmE660- or SIVsmE543-infected RP and CP rhesus macaques at terminal disease. RP macaques developed a wasting syndrome characterized by severe SIV enteropathy in the absence of opportunistic infections. In contrast, opportunistic infections were commonly observed in CP macaques. RP and CP macaques showed distinct patterns of CD4+ T-cell depletion, with a selective loss of memory cells in RP macaques and a generalized (naive and memory) CD4 depletion in CP macaques. In situ hybridization demonstrated higher levels of virus expression in lymphoid tissues (P < 0.001) of RP macaques and a broader distribution to include many nonlymphoid tissues. Finally, SIV was preferentially expressed in macrophages in RP macaques whereas the primary target cells in CP macaques were T lymphocytes at end stage disease. These data suggest distinct pathogenic mechanisms leading to the deaths of these two groups of animals, with CP macaques being more representative of HIV-induced AIDS in humans.
LFA-1 Expression on Target Cells Promotes Human Immunodeficiency Virus Type 1 Infection and Transmission

ABSTRACT While CD4 and the chemokine receptors are the principal receptors for human immunodeficiency virus (HIV), other cellular proteins, such as LFA-1, are also involved in HIV infection. LFA-1 and its ligands, ICAM-1, ICAM-2, and ICAM-3, can be expressed on the cells infected by HIV, as well as on the HIV virions themselves. To examine the role of LFA-1 expressed on target cells in HIV infection, Jurkat-derived Jβ2. 7 T-cell lines that express either wild-type LFA-1, a constitutively active mutant LFA-1, or no LFA-1 were used. The presence of wild-type LFA-1 enhanced the initial processes of HIV infection, as well as the subsequent replication and transmission from cell to cell. In contrast, the constitutively active LFA-1 mutant failed to promote virus replication and spread, even though this mutant could help HIV enter cells and establish the initial infection. This study clearly demonstrates the contribution of LFA-1 in the different stages of HIV infection. Moreover, not only is LFA-1 expression important for initial HIV-cell interaction, subsequent replication, and transmission, but its activity must also be properly regulated.
Development of morphology and function of neonatal mouse ventricular myocytes cultured on a hyaluronan‐based polymer scaffold

In recent years cardiac tissue engineering has emerged as a promising field aimed at developing suitable techniques to repair the infarcted myocardium with a combination of cells, biomaterials, and regulative factors. In particular it could stand for an alternative strategy to simple in situ cellular implantation. In the present study our purpose was to analyze the interaction between a hyaluronan‐based mesh (HYALONECT®) and neonatal murine ventricular myocytes (NMVMs). Specifically, we investigated morphological and functional characteristics of cardiomyocytes cultured on HYALONECT® in view of its employment in heart repair. Both living and fixed cells analysis was performed on in toto scaffolds with confocal microscopy. NMVMs adhesion on HYALONECT® was studied by tracking sarcomeric α‐actinin immunofluorescence staining. The structural features of NMVMs adherent onto HYALONECT® were investigated at 24, 48, 72 h, and 7 days of culture by immunofluorescence for sarcomeric α‐actinin and connexin‐43. We observed a progressive morphological organization of the cells inside the biopolymer, with both clear sarcomeric arrangement along the scaffold fibers and gap junctions development between adjacent cells. Finally, in vivo intracellular calcium measurements performed using calcium fluorimetric confocal imaging revealed the presence of spontaneous calcium transients and contractile activity of NMVMs adherent onto HYALONECT® up to 48 h from seeding, indicating a progressive differentiation of the cells toward the adult phenotype. In conclusion, our results demonstrate that HYALONECT® allowed NMVMs to adhere to the fibers and to develop functional properties, displaying suitable features as a scaffold to perform heart tissue engineering. J. Cell. Biochem. 113: 800–807, 2012. © 2011 Wiley Periodicals, Inc.
Isolation and characterization of Tn917lac-generated competence mutants of Bacillus subtilis

We isolated 28 mutants of Bacillus subtilis deficient in the development of competence by using the transposon Tn917lacZ as a mutagen. The mutant strains were poorly transformable with plasmid and chromosomal DNAs but were normally transducible and exhibited wild-type resistance to DNA-damaging agents. The mutations were genetically mapped, and the mutants were characterized with respect to their abilities to bind and take up radiolabeled DNA. All were defective in uptake, and some failed to bind significant amounts of DNA. The abilities of the mutant strains to resolve into two buoyant density classes on Renografin gradients were studied. Most resolved normally, but several banded in Renografin only at the buoyant density of noncompetent cells. The genetic mapping studies and the other analyses suggested that the mutations define a minimum of seven distinct com genes.
Destabilization of transthyretin by pathogenic mutations in the DE loop

Transthyretin single‐amino‐acid variants are responsible for familial amyloidotic polyneuropathy, in which transthyretin variants accumulate extracellularly in the form of fibrillar aggregates. We studied the structural stabilities of four transthyretin variants (L58H, L58R, T59K, and E61K), in which a positively charged amino acid is introduced in a loop region between the D‐ and E‐strands. In addition to being located in the DE‐loop, L58 and T59 are involved in the core of the transthyretin monomer. The L58H, L58R, and T59K substitutions destabilized transthyretin more than the E61K mutation did, indicating that transthyretin is substantially destabilized by the substitution of residues located in both the DE‐loop and the monomer core. By utilizing hydrogen‐deuterium exchange and nuclear magnetic resonance, we demonstrated that residues in the G‐strand and the loop between the A‐ and B‐strands were destabilized by these pathogenic mutations in the DE loop. At the quaternary structural level, the DE‐loop mutations destabilized the dimer–dimer contact area, which may lead to transient dissociation into a dimer. Our results suggest that the destabilization of the dimer–dimer interface and the monomer core is important for the amyloidogenesis of transthyretin. Proteins 2007. © 2006 Wiley‐Liss, Inc.
Transmission and Control of Methicillin-Resistant Staphylococcus aureus in a Skilled Nursing Facility

Abstract Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly frequent in both acute care facilities (ACFs) and skilled nursing facilities (SNFs). Admissions to SNFs from ACFs with endemic MRSA are one likely source of infection in SNFs. The occurrence of MRSA in SNFs and the relative roles of ACFs and SNFs in MRSA transmission have not been well characterized. We conducted an epidemiologic investigation in an SNF reporting a high incidence of MRSA cases and found that the prevalence of MRSA exceeded that reported in acute care settings. Fifteen (9.1%) of the 164 residents were colonized or infected with MRSA. Risk factors for MRSA identified through a prevalence case-control study were nasogastric intubation (odds ratio = 5.5; 95% confidence interval = 1.2, 26.4), antibiotic therapy (OR= 3.9; CI = 1.2, 13.0), and hospitalization in an acute care facility within the previous six months (OR = 2.9; CI = 0.9, 9.7). During a three-month period, 6 of 100 new admissions were MRSA-positive; all positive patients were from ACFs. Five new cases also emerged from previously MRSA-negative residents. SNF residents are often discharged to ACFs. Transmission of MRSA within the SNF and the transfer of patients to ACFs increases the reservoir of potentially infective patients and the potential for MRSA infections in ACFs. Modest control measures, including targeted surveillance culturing and cohorting of colonized residents, may minimize MRSA transmission in the SNF and decrease the reservoir of MRSA in the community.
Exploration and Selection of Intralimb Coordination Patterns in 3-Month-Old Infants

Abstract Through the exploration of their own capacities and the selection of adaptive responses, infants learn new motor solutions. Using a conjugate reinforcement mobile procedure, previous researchers have repeatedly shown that infants increase their leg kick frequency to control a mobile that is connected to their ankles. That traditional experimental design allows multiple motor solutions to the task and therefore provides limited information about the infants' capacity to explore and select specific motor solutions. The author designed a new experimental procedure to study infants' capacity to discover and adopt specific motor solutions. The new, constraining mobile reinforcement procedure requires a specific motor response and therefore the development of a more finely tuned perception—action map than has previously been experimentally demonstrated. To gain reinforcement from the mobile, infants had to produce a coordinated hip and knee extension within the same leg. The results from the 13 infant participants showed that they were capable of increasing their frequency of coordinated movements to make the mobile move. Those results suggest that infants at the age of 89–106 days are sensitive to intralimb coordination task requirements and are capable of mapping their own limb dynamics to the environmental information.
Static inflation and deflation pressure–volume curves from excised lungs of marine mammals

SUMMARY Excised lungs from eight marine mammal species [harp seal (Pagophilus groenlandicus), harbor seal (Phoca vitulina), gray seal (Halichoerus grypush), Atlantic white-sided dolphin (Lagenorhynchus acutus), common dolphin (Delphinus delphis), Risso's dolphin (Grampus griseus), long-finned pilot whale (Globicephala melas) and harbor porpoise (Phocoena phocoena)] were used to determine the minimum air volume of the relaxed lung (MAV, N=15), the elastic properties (pressure–volume curves, N=24) of the respiratory system and the total lung capacity (TLC). Our data indicate that mass-specific TLC (sTLC, l kg–1) does not differ between species or groups (odontocete vs phocid) and agree with that estimated (TLCest) from body mass (Mb) by applying the equation: TLCest=0.135 Mb0.92. Measured MAV was on average 7% of TLC, with a range from 0 to 16%. The pressure–volume curves were similar among species on inflation but diverged during deflation in phocids in comparison with odontocetes. These differences provide a structural basis for observed species differences in the depth at which lungs collapse and gas exchange ceases.
Direct Comparison of (±) 3,4-Methylenedioxymethamphetamine (“Ecstasy”) Disposition and Metabolism in Squirrel Monkeys and Humans

The present study compared the disposition and metabolism of the recreational drug (±) 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) in squirrel monkeys and humans because the squirrel monkey has been extensively studied for MDMA neurotoxicity. A newly developed liquid chromatography-mass spectrometric procedure for simultaneous measurement of MDMA, 3,4-dihydroxymethamphetamine, 4-hydroxy-3-methoxymethamphetamine, and 3,4-methylenedioxyamphetamine was employed. In both humans and squirrel monkeys, a within-subject design permitted testing of different doses in the same subjects. Humans and squirrel monkeys were found to metabolize MDMA in similar, but not identical, pathways and proportions. In particular, amounts of 3,4-dihydroxymethamphetamine (after conjugate cleavage) and 3,4-methylenedioxyamphetamine were similar in the 2 species, but formation of 4-hydroxy-3-methoxymethamphetamine was greater in squirrel monkeys than in humans. Both species demonstrated nonlinear MDMA pharmacokinetics at comparable plasma MDMA concentrations (125-150 ng/mL and above). The elimination half-life of MDMA was considerably shorter in squirrel monkeys than in humans (2-3 versus 6-9 hours). In both species, there was substantial individual variability. These results suggest that the squirrel monkey may be a useful model for predicting outcomes of MDMA exposure in humans, although this will also depend on the degree to which MDMA pharmacodynamics in the squirrel monkey parallels that in humans.