Miracle-dz/UniFAR-FTUs huggingface dataset:
Inhalational Versus Intravenous Anesthetic Conditioning for Subarachnoid Hemorrhage–Induced Delayed Cerebral Ischemia

Background: Inhalational anesthetics were associated with reduced incidence of angiographic vasospasm and delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH). Whether intravenous anesthetics provide similar level of protection is not known. Methods: Anesthetic data were collected retrospectively for patients with SAH who received general anesthesia for aneurysm repair between January 1, 2014 and May 31, 2018, at 2 academic centers in the United States (one employing primarily inhalational and the other primarily intravenous anesthesia with propofol). We compared the outcomes of angiographic vasospasm, DCI, and neurological outcome (measured by disposition at hospital discharge), between the 2 sites, adjusting for potential confounders. Results: We compared 179 patients with SAH receiving inhalational anesthetics at one institution to 206 patients with SAH receiving intravenous anesthetics at the second institution. The rates of angiographic vasospasm between inhalational versus intravenous anesthetic groups were 32% versus 52% (odds ratio, 0.49 [CI, 0.32–0.75]; P=0.001) and DCI were 21% versus 40% (odds ratio, 0.47 [CI, 0.29–0.74]; P=0.001), adjusting for imbalances between sites/groups, Hunt-Hess and Fisher grades, type of aneurysm treatment, and American Society of Anesthesiology status. No impact of anesthetics on neurological outcome at time of discharge was noted with rates of good discharge outcome between inhalational versus intravenous anesthetic groups at (78% versus 72%, P=0.23). ConclusionS: Our data suggest that those who received inhalational versus intravenous anesthetic for ruptured aneurysm repair had significant protection against SAH-induced angiographic vasospasm and DCI. Although we cannot fully disentangle site-specific versus anesthetic effects in this comparative study, these results, when coupled with preclinical data demonstrating a similar protective effect of inhalational anesthetics on vasospasm and DCI, suggest that inhalational anesthetics may be preferable for patients with SAH undergoing aneurysm repair. Additional investigations examining the effect of inhalational anesthetics on other SAH outcomes such as early brain injury and long-term neurological outcomes are warranted.
Prevalence and Severity of Dental Caries and Fluorosis in 8 Year-old Children With or Without Fluoride Supplementation

One of the most effective and studied measures in the prevention of caries is the use of fluoride, which has the property to reduce their incidence and severity. In Chile, 75 % of the population receives it the drinking water. In 1984, WHO recommended the use of milk as an alternative vehicle. In Chile, the Fluoridated School Feeding Program (FSFP) was introduced in 1994, using this alternative in rural areas without fluoride in water. The objective of the study was to compare prevalence and severity of dental caries and dental fluorosis in 8-year-old children of four state schools: two with fluoride supplementation in drinking water or milk and two without any fluoride program. Epidemiological, descriptive, comparative, observational and cross-sectional study with a sample of 140 8-year-old children, with no systemic diseases and who had lived in the same place since birth: 50 schoolchildren from an area with fluoridated water; 40 from an area with fluoridated milk and 50 from a zone without supplementation of F. The percentage of caries-free children was obtained with the methodology described by the WHO, for severity the dmft and DMFT indexes were used. To quantify the prevalence and severity of dental fluorosis, Dean Index was used. 38 % of the children were caries-free in the community with fluoridated water (CFW); 0 % in the community with fluoridated milk (FSFP) and 10 % in the community with no fluoride program established (CNF). The difference between CFW with CNF is statistically significant (p<0.05). The prevalence of fluorosis is significantly higher for CFW (48.8 %) than FSFP (35 %) and CNF (16 %). Conclusion: The contribution of fluoride in drinking water causes a decrease in the prevalence and severity of dental caries in children of 8 years of age, and an increase in the prevalence of dental fluorosis.
International Medullary Thyroid Carcinoma Grading System: A Validated Grading System for Medullary Thyroid Carcinoma

PURPOSE Medullary thyroid carcinoma (MTC) is an aggressive neuroendocrine tumor (NET) arising from the calcitonin-producing C cells. Unlike other NETs, there is no widely accepted pathologic grading scheme. In 2020, two groups separately developed slightly different schemes (the Memorial Sloan Kettering Cancer Center and Sydney grade) on the basis of proliferative activity (mitotic index and/or Ki67 proliferative index) and tumor necrosis. Building on this work, we sought to unify and validate an internationally accepted grading scheme for MTC. PATIENTS AND METHODS Tumor tissue from 327 patients with MTC from five centers across the United States, Europe, and Australia were reviewed for mitotic activity, Ki67 proliferative index, and necrosis using uniform criteria and blinded to other clinicopathologic features. After reviewing different cutoffs, a two-tiered consensus grading system was developed. High-grade MTCs were defined as tumors with at least one of the following features: mitotic index ≥ 5 per 2 mm2, Ki67 proliferative index ≥ 5%, or tumor necrosis. RESULTS Eighty-one (24.8%) MTCs were high-grade using this scheme. In multivariate analysis, these patients demonstrated decreased overall (hazard ratio [HR] = 11.490; 95% CI, 3.118 to 32.333; P < .001), disease-specific (HR = 8.491; 95% CI, 1.461 to 49.327; P = .017), distant metastasis-free (HR = 2.489; 95% CI, 1.178 to 5.261; P = .017), and locoregional recurrence-free (HR = 2.114; 95% CI, 1.065 to 4.193; P = .032) survivals. This prognostic power was maintained in subgroup analyses of cohorts from each of the five centers. CONCLUSION This simple two-tiered international grading system is a powerful predictor of adverse outcomes in MTC. As it is based solely on morphologic assessment in conjunction with Ki67 immunohistochemistry, it brings the grading of MTCs in line with other NETs and can be readily applied in routine practice. We therefore recommend grading of MTCs on the basis of mitotic count, Ki67 proliferative index, and tumor necrosis. In this study, the authors proposed and validated a two-tiered international medullary thyroid carcinoma grading system (IMTCGS) using a multicentric retrospective cohort from five centers across the USA, Europe, and Australia. High grade MTC has at least one of the following three features: mitotic index≥5 per 2 mm2, Ki67 proliferative index ≥5%, and/or tumor necrosis
Fuel Formulation Effects on Diesel Fuel Injection, Combustion, Emissions and Emission Control

This paper describes work under a U.S. DOE sponsored Ultra Clean Fuels project entitled ''Ultra Clean Fuels from Natural Gas,'' Cooperative Agreement No. DE-FC26-01NT41098. In this study we have examined the incremental benefits of moving from low sulfur diesel fuel and ultra low sulfur diesel fuel to an ultra clean fuel, Fischer-Tropsch diesel fuel produced from natural gas. Blending with biodiesel, B100, was also considered. The impact of fuel formulation on fuel injection timing, bulk modulus of compressibility, in-cylinder combustion processes, gaseous and particulate emissions, DPF regeneration temperature and urea-SCR NOx control has been examined. The primary test engine is a 5.9L Cummins ISB, which has been instrumented for in-cylinder combustion analysis and in-cylinder visualization with an engine videoscope. A single-cylinder engine has also been used to examine in detail the impacts of fuel formulation on injection timing in a pump-line-nozzle fueling system, to assist in the interpretation of results from the ISB engine.
CCR4 is a prognostic biomarker and correlated with immune infiltrates in head and neck squamous cell carcinoma

Background Increased evidence has indicated that the tumour microenvironment plays an essential in the development, treatment and prognosis of head and neck squamous cell carcinoma (HNSC). Recent studies have indicated CC chemokine receptor 4 (CCR4) plays an essential role in tumor invasion and other adverse biological behavior. This study used data from the Cancer Genome Atlas (TCGA) database to explore the role of CCR4 in HNSC and its clinical significance. Methods The gene expression and clinical data of HNSC patients in the TCGA database were extracted. Gene Expression Profiling Interactive Analysis (GEPIA) was used to analyze the expression of CCR4 in tumor and non-tumor tissue. Kaplan-Meier survival analysis was used to analyze the relationship between CCR4 expression and overall survival rate (OS), disease-specific survival (DSS), and progression-free interval (PFI) in HNSC. A logistic regression model was used to analyze the relationships between various clinical factors and CCR4 expression. Gene Set Enrichment Analysis (GSEA) was used to explore the potential role of CCR4 in HNSC. Additionally, we explored the relationship between CCR4 and immune infiltration. Results The expression of CCR4 in HNSC was not significantly different from that in normal tissue. The expression level of CCR4 in wild-type TP53 was higher than that in mutant TP53. Cox regression analysis showed the expression level of CCR4 was related to the patient's tumor grade and Tumor-Node-Metastasis (TNM) stage. CCR4 expression level is an independent prognostic factor. CCR4 is positively correlated with immune infiltration and immune checkpoints expression levels. The results of GSEA revealed that the high CCR4 expression group genes were enriched in allograft rejection, inflammatory response, IL-6/JAK/STAT3 signaling, interferon gamma response, and KRAS signaling up. Low CCR4 expression group genes were enriched in oxidative phosphorylation, MYC targets v1, DNA repair, reactive oxygen species pathway, and P53 pathway. Further, our study indicated CCR4 can also predict the prognosis of radiotherapy patients. Conclusions Our study found that CCR4 was a prognostic marker related to HNSC immune infiltration, and patients with high expression of CCR4 had a better prognosis.
Royal gene therapy at a royal cost.

Hemophilia is an X-linked disease that affects 400000 people worldwide, of whom 15% have hemophilia B caused by deficiency of factor IX (FIX), which affected the offspring of Queen Victoria, the most famous carrier. In those with severe deficiency (,1% factor IX activity), the disease is characterized by spontaneous and traumatic bleeding, primarily into joints, which leads to chronic arthropathy, disability, and pain. Current management requires factor infusion several times weekly to prevent bleeding episodes (prophylaxis) and early, intense treatment of acute breakthrough bleeding. Unfortunately, the invasiveness of several times weekly IV therapy deters compliance, and the high cost deprives those in resource-poor settings of life-saving treatment.
Slurry Seeding Cover Crops

Suarez, Edwin A. M.S., Purdue University, May 2013. Slurry Seeding Cover Crops. Major Professor: Eileen J. Kladivko. Cover crops improve soil quality through increased organic matter, biological activity, aggregate stability, water infiltration, and nutrient cycling. Slurry seeding, the coapplication of cover crop seed and swine (Sus domesticus) manure, is a new practice that saves fuel, time and labor. High salinity and/or ammonia, among other components in swine manure, may reduce cover crop seed germination and limit the use of slurry seeding. Ten cover crop species were evaluated to compare the effects of swine manure components on cover crop seed germination. Seed germination percentages and rates were affected by swine manure but not by equivalent salinity levels established with Sodium Chloride. Thus, the salinity component of swine manure is not likely a large contributor to the negative effects of manure on the germination of some cover crop seeds. Pre-soaking seeds in solution had an effect on germination of cover crops, and thus a mixing period of ≤1hr is suggested for the practice. Nitrogen ammoniacal gaseous forms resulting from volatilization after manure applications had an inhibitory effect on germination of cover crop seeds and may be the driving factor reducing germination. Anaerobic like conditions also reduced germination. A rainfall event within the first week after slurry seeding may be critical in order to achieve a good establishment of the crop.
Understanding the Knowledge Needs of Designers During Design Process in Industry

Product success is substantially influenced by satisfaction of knowledge needs of designers, and many tools and methods have been proposed to support these needs. However, adoption of these methods in industry is minimal. This may be due to an inadequate understanding of the knowledge needs of designers in industry. This research attempts to develop a better understanding of these needs by undertaking descriptive studies in an industry. We propose a taxonomy of knowledge, and evaluate this by analyzing the questions asked by the designers involved in the study during their interactions. Using the taxonomy, we converted the questions asked into a generic form. The generic questions provide an understanding about what knowledge must be captured during design, and what its structure should be.
Design and Fabrication of Complex-Shaped Ceramic Bone Implants via 3D Printing Based on Laser Stereolithography

3D printing allows the fabrication of ceramic implants, making a personalized approach to patients’ treatment a reality. In this work, we have tested the applicability of the Function Representation (FRep) method for geometric simulation of implants with complex cellular microstructure. For this study, we have built several parametric 3D models of 4 mm diameter cylindrical bone implant specimens of four different types of cellular structure. The 9.5 mm long implants are designed to fill hole defects in the trabecular bone. Specimens of designed ceramic implants were fabricated at a Ceramaker 900 stereolithographic 3D printer, using a commercial 3D Mix alumina (Al2O3) ceramic paste. Then, a single-axis compression test was performed on fabricated specimens. According to the test results, the maximum load for tested specimens constituted from 93.0 to 817.5 N, depending on the size of the unit cell and the thickness of the ribs. This demonstrates the possibility of fabricating implants for a wide range of loads, making the choice of the right structure for each patient much easier.
VIBRATION STUDIES OF TSING MA SUSPENSION BRIDGE

This paper focuses on the development of a three-dimensional dynamic finite element model for the Tsing Ma Bridge, the understanding of the main features of modal vibrations, and the comparison with the measured natural frequencies and mode shapes. Of particular interest are the interactions between vibrational modes, between the main and side spans, and between cables, deck, and towers. As done by Abdel-Ghaffar (1978) for the San Pedro-Terminal Island Bridge, Buckland et al. (1979) for the Golden Gate Bridge, and Kumarasena et al. (1989) for the Deer Isle Bridge, the combination of numerical modeling and full-scale measurement provides a comprehensive understanding of behavior and properties of the Tsing Ma Bridge.
Impact of Damper Stiffness and Damper Support Stiffness on the Efficiency of a Linear Viscous Damper in Controlling Stay Cable Vibrations

Accurate prediction of optimum damper size and its corresponding maximum attainable modal damping ratio is essential for the design of a linear viscous damper to control cable vibrations on cable-stayed bridges. The stiffness within the damper and the damper support would affect both the required damper size and the resulting equivalent modal damping ratio of the damped cable and thus influence the damper efficiency. An experimental study on a cable-damper system is conducted to investigate the individual and the combined effects of damper stiffness and damper support stiffness on the performance of a linear viscous damper. A finite-element model of the corresponding cable-damper system is developed to verify the experimental results and further study these two parameters within the typical ranges of cable and damper properties used on real bridges. Results show that higher damper stiffness and/or lower damper support stiffness would have an adverse impact on damper performance. Increasing the stiffness of a damper and/or its support would result in a larger optimum damper size. However, the maximum attainable damping ratio would decrease with larger damper stiffness but increase if the support is more rigid. To facilitate practical design, a set of asymptotic relationships has been proposed, of which the optimum damper size and the maximum achievable damping ratio are expressed concisely as functions of nondimensional damper properties in terms of its location, stiffness, and support stiffness. Design examples are given to illustrate the various applications of the proposed refined damper design tool.
Using discrete event simulation to assess obstacle location accuracy in the REMUS unmanned underwater vehicle

Abstract : Navy personnel use the REMUS unmanned underwater vehicle to search for submerged objects. Navigation inaccuracies lead to errors in predicting the location of objects and thus result in increased search times for Explosive Ordnance Disposal (EOD) teams searching for the object post-mission. This thesis explores contributions to navigation inaccuracy using Discrete Event Simulation (DES) to model the vehicle's navigation system and operational performance. The DES produced for this thesis uses the JAVA-based Simkit package to simulate the navigation system in REMUS. The model considers factors affecting accuracy, such as compass error, the effect of current, transducer drop error, transducer positioning effects, and ping interval. Mines can be placed at specific locations or generated randomly. Three types of vehicles are considered in this thesis. First, a simple vehicle that navigates by Dead Reckoning is analyzed. Second, a more complex vehicle that navigates using Long-Baseline (LBL) is analyzed. Third, the vehicle is simulated to move through an area of interest in a sweeping pattern that is populated by 10 mines, each of which is randomly positioned. Data from the last vehicle are used to build three analytic models that the operator can use to improve performance. First, the probability of detection is modeled by a logit regression. Second, given that detection has occurred, the mean location offset is modeled by a linear regression. Third, the distribution of errors is shown to follow an exponential distribution. These three models enable operators to explore the impact of various inputs prior to programming the vehicle, thus allowing them to choose the best combination of vehicle parameters that minimize the offset error between the reported and actual locations. (18 tables, 33 figures, 17 refs.)
The effectiveness of Bupivacaine as a pre-emptivepudendal block among patients undergoing vaginal surgeries: meta-analysis of randomized controlled trials

Background: Pre-emptive analgesia using pudendal nerve block (PNB) with bupivacaine is commonly used in clinical practice during pelvic floor and vaginal surgeries. However, its effectiveness is unclear. To update the evidence base we summarised short- and intermediate-term outcomes of pre-emptive analgesia using pudendal nerve block with bupivacaine as an approach in the management of pelvic floor and vaginal surgeries. Methods: We searched the CENTRAL, PubMed, ClinicalTrials.gov, google scholar and Open Grey from inception until April 2019. The citation lists of relevant papers were also searched. Randomized controlled trials (RCTs) of women who underwent perineal, pelvic floor or vaginal surgeries and received pre-emptive analgesia using a pudendal nerve block were included. Two authors independently screened and selected eligible trials as well as performed data extraction and quality assessment. Disagreements were resolved via consensus and an adjudicator was involved when consensus was not achieved. Data was narratively synthesized, when possible, data was pooled in RevMan 5 using random effects model. Results: Four RCTs with a total of 349 participants were eligible for inclusion. We found evidence of small effect for improvement in post-operative pain scores; requirements for opioids, SMD: -0.89 (95% CI: -1.19, -0.59) and non-steroidal anti-inflammatories SMD -1.04 (95% CI: -1.64, -0.43) in favour of the PNB versus control group. The risk ratio for adverse effects 0.42 (95% CI: 0.18, 0.99) favoured PNB. There was no significant difference between groups for length of hospital stay, MD: -0.82 (95% CI: -5.34, 3.69) and return to normal activity. Conclusion:We found inconclusive evidence that pre-emptive pudendal block using bupivacaine may improve postoperative pain and recovery in perineal, pelvic floor or vaginal surgeries. However, due to the scant and poor quality of evidence included in this systematic review, well-designed and adequately powered RCTs that adhere to reporting guidelines and evaluate key outcomes are needed to inform clinical guidelines on the use of pre-emptive pudendal block. Key words:pre-emptive analgesia, bupivacaine, pudendal nerve block, vaginal surgery, pelvic organ prolapse, systematic review, meta-analysis
The Effects of Display Type and Spatial Ability on Performance During a Virtual Reality Simulation

Abstract : The purpose of this study was to investigate the effects of display type and spatial ability level on performance during three trials of a virtual reality (VR) simulation. Seventy-six Air Force Reserve Officer Training Corps cadets were identified as having high or low spatial ability level. Subjects used either a helmet mounted display or a standard computer monitor to perform a VR simulation. The study examined the effects of display type, spatial ability, and number of trials on simulation performance, performance strategy, discomfort level, display characteristics and attitude. Results indicated that subjects with high spatial ability performed significantly better on the simulation than subjects with low spatial ability. Performance results revealed a significant interaction between spatial ability level and trial. Separate analyses for each spatial ability group showed that the performance of high spatial ability subjects improved significantly from trial to trial. The performance of low spatial ability subjects did not significantly improve over time. There were no significant performance differences between subjects that wore the head mounted display versus subjects that did the simulation on a standard computer monitor. Results for performance strategy suggested that high spatial ability subjects used more effective strategies during the simulation than low spatial ability subjects. Exploratory data analysis indicated that performance strategy was a stronger predictor of performance than spatial ability. Discomfort survey results indicated that subjects who used the head mounted display reported significantly higher levels of cold sweating and difficulty focusing than subjects who used the standard computer monitor. Head mounted display subjects also rated display resolution significantly lower than computer monitor subjects. High spatial ability subjects benefited significantly more from practice than low spatial ability subjects.