Miracle-dz/UniFAR-FTUs huggingface dataset:
Closed-Loop Quantitative Verification of Rate-Adaptive Pacemakers

Rate-adaptive pacemakers are cardiac devices able to automatically adjust the pacing rate in patients with chronotropic incompetence, i.e., whose heart is unable to provide an adequate rate at increasing levels of physical, mental, or emotional activity. These devices work by processing data from physiological sensors in order to detect the patient’s activity and update the pacing rate accordingly. Rate adaptation parameters depend on many patient-specific factors, and effective personalization of such treatments can only be achieved through extensive exercise testing, which is normally intolerable for a cardiac patient. In this work, we introduce a data-driven and model-based approach for the automated verification of rate-adaptive pacemakers and formal analysis of personalized treatments. To this purpose, we develop a novel dual-sensor pacemaker model where the adaptive rate is computed by blending information from an accelerometer, and a metabolic sensor based on the QT interval. Our approach enables personalization through the estimation of heart model parameters from patient data (electrocardiogram), and closed-loop analysis through the online generation of synthetic, model-based QT intervals and acceleration signals. In addition to personalization, we also support the derivation of models able to account for the varied characteristics of a virtual patient population, thus enabling safety verification of the device. To capture the probabilistic and nonlinear dynamics of the heart, we define a probabilistic extension of timed I/O automata with data and employ statistical model checking for quantitative verification of rate modulation. We evaluate our rate-adaptive pacemaker design on three subjects and a pool of virtual patients, demonstrating the potential of our approach to provide rigorous, quantitative insights into the closed-loop behavior of the device under different exercise levels and heart conditions.
Achilles tendon pain intensity and level of neovascularization in athletes as determined by color Doppler ultrasound

The cause of pain in Achilles tendinopathy is thought to be related to the presence of neovascularization in the tendon as seen on color Doppler ultrasound. Asymptomatic pathology has been observed in patellar tendons of elite athletes. The purpose of this study was to examine the prevalence of Achilles tendon pain and the characteristics of Achilles tendons in a young athletic population. Sixty‐four varsity athletes underwent color Doppler ultrasound imaging to determine tendon thickness, presence of degeneration and neovascularization. The presence of swelling and tenderness was determined, and Achilles tendon pain was rated on three visual analogue scales (VAS) (pain during exercise, pain at rest, pain during daily activities) as well as on the VISA‐A scale. Tendon symptoms were not related to the presence of neovascularization. There was a low prevalence of Achilles tendinopathy, tenderness, and neovascularization in this population. Neovascularization was seen in both a painful and a non‐painful tendon.
Use of Intraoral Miniplates to Control Postoperative Occlusion After High Condylectomy for the Treatment of Condylar Hyperplasia

AbstractMandibular condylar hyperplasia is a rare disorder, characterized by unilateral mandibular overgrowth with overeruption of the dentition on the affected side. Although the etiology is unclear, multiple surgical techniques have been described to correct the associated mandibular bone, occlusal, and soft tissue deformities. Often a condylectomy, to arrest mandibular growth, is combined with various orthognathic procedures to restore occlusion and facial harmony. Here we report our technique of isolated high condylectomy with simultaneous intraoral placement of maxillary and mandibular miniplates. Each plate has an intraoral extension that allows our orthodontists to develop vertical force vectors to intrude the maxillary and mandibular molar segments. Using this combined surgical and orthodontic technique, we were able to postoperatively control the occlusal cant, restore the dental midline, improve facial aesthetics, and resolve the patient’s contralateral temporomandibular joint dysfunction without concomitant orthognathic surgery. As a result of our findings, we are currently using, and would recommend, this technique for patients requiring surgical-orthodontic intervention for other conditions.
What is the role of noninvasive ventilation in cystic fibrosis?

Purpose of review The use of noninvasive ventilatory support in patients with cystic fibrosis (CF) has increased exponentially over the past 2 decades. This review examines the current knowledge and considers potential future directions for use of noninvasive ventilation in CF patients. Recent findings Noninvasive ventilation was originally reported as a bridge to transplantation in CF patients with severe respiratory failure but is now used as a long-term treatment modality for patients with respiratory failure independent of transplant status. In 2013 to 2014, over 400 publications on noninvasive ventilation demonstrate its increasing clinical application, however only seven reference CF. Recent technological advances and potential benefits to CF patients are considered. Summary The role of noninvasive ventilation in CF patients in chronic respiratory failure is established, but future prospective studies are needed to determine further indications and optimal timing of this intervention. Developments in both ventilator and interface design may enhance the efficacy of ventilation in CF patients but require careful individualized assessment and regular review. The implications on treatment burden and quality of life in CF also need to be studied.
Heritability and seasonal variability of vitamin D concentrations in male twins.

BACKGROUND Serum 25-hydroxyvitamin D [25(OH)D] concentrations can be affected by several environmental and individual factors. It is not clear to what extent genetic influences play a role in determining vitamin D status. Thus far, studies on the heritability of vitamin D have provided conflicting results. OBJECTIVE We estimated the heritability of vitamin D concentrations and the effect of season on heritability estimates. DESIGN We measured serum 25(OH)D concentrations in 510 middle-aged, male twins (310 monozygotic and 200 dizygotic twins) selected from the Vietnam Era Twin Registry. Generalized estimating equations were used to test the association between 25(OH)D and other study factors. Structural equation modeling was used to estimate the heritability of 25(OH)D. RESULTS The twins' mean (±SD) age was 55 ± 2.8 y. The mean (±SD) 25(OH)D concentration was 38.4 ± 23.3 ng/mL with a substantial seasonal variation (a 6.1-ng/mL lower value during the winter than during the summer, P = 0.003). Approximately 70% of the variation in 25(OH)D concentrations during the winter was explained by genetic factors. However, in the summer, 25(OH)D concentrations were not heritable. During the summer, 53% of the variation in 25(OH)D concentrations was due to shared environmental factors, and 47% of the variation in 25(OH)D concentrations was due to unique environmental factors. CONCLUSIONS Serum 25(OH)D concentrations are highly heritable during the winter season only. In the summer, environmental conditions (eg, sun exposure) prevail over genetic backgrounds in determining serum 25(OH)D concentrations. This trial was registered at clinicaltrials.gov as NCT00017836.
Prevalence of melanoma clinically resembling seborrheic keratosis: analysis of 9204 cases.

OBJECTIVE To estimate the prevalence of melanoma clinically mimicking seborrheic keratosis. DESIGN Retrospective review of cases submitted for histological examination with a clinical diagnosis of seborrheic keratosis or with a differential diagnosis that included seborrheic keratosis. SETTING A tertiary medical care center-based dermatopathology laboratory serving academic dermatology clinics that have a busy pigmented lesion clinic. MATERIALS AND METHODS A total of 9204 consecutive pathology reports containing a diagnosis of seborrheic keratosis in the clinical information field were identified between the years 1992 and 2001 through a computer database search. Reports with a final histological diagnosis of melanoma were selected for further review and clinicopathological analysis. MAIN OUTCOME MEASURE Histological diagnosis, which was correlated with the preoperative clinical diagnosis. RESULTS Melanoma was identified in 61 cases (0.66%) submitted for histological examination with a clinical diagnosis that included seborrheic keratosis. Melanoma was in the clinical differential diagnosis of 31 cases (51%). The remaining lesions had a differential diagnosis of seborrheic keratosis vs melanocytic nevus (17 cases, 28%), basal cell carcinoma (7 cases, 12%), or a squamous proliferation (3 cases, 5%). In 3 cases (5%), seborrheic keratosis was the only clinical diagnosis. All histological types of melanoma were represented. CONCLUSIONS Our results confirm that melanoma can mimic seborrheic keratosis. These data strongly support the current policy of submitting for histological examination all specimens that have been removed from patients.
Alcohol screening in young persons attending a sexually transmitted disease clinic

AbstractOBJECTIVE: To compare the ability of 3 brief alcohol screens (Alcohol Use Disorders Identification Test [AUDIT], CRAFFT, and CAGE) to identify adolescents and young adults with a current alcohol use disorder (AUD) and to determine whether there are gender-based or race-based differences in screening performance. DESIGN, PARTICIPANTS, AND SETTING: Cross-sectional study of 358 young persons (55% males; 49% blacks; age range, 15–24 years; mean age, 20.6 years) who were attending an urban clinic for sexually transmitted diseases and reported alcohol use during the past year. MEASUREMENTS: Receiver operating characteristic (ROC) curve analysis was used to determine the ability of the 3 screens to discriminate between participants with and without AUDs detected in the Structured Clinical Interview for DSM-IV (SCID). RESULTS: One third (33%) of participants met Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria for a current AUD (24% with alcohol abuse and 9% with alcohol dependence). The AUDIT performed best at a cut score of 9 (sensitivity, 0.76; specificity, 0.79), CRAFFT at a cut score of 2 (sensitivity, 0.94; specificity, 0.33), and CAGE at a cut score of 1 (sensitivity, 0.69; specificity, 0.63). The AUDIT had the best overall performance (area under the curve [AUC], 0.84), followed closely by CRAFFT (AUC, 0.79) and then CAGE (AUC, 0.70). Performance of screens did not differ by gender. The AUDIT performed slightly better in whites than blacks, but no race-based differences were observed for the CAGE or CRAFFT. CONCLUSIONS: Clinicians should use the AUDIT or CRAFFT, rather than the CAGE, to screen young persons for AUDs. The AUDIT performs best, but its length may limit its utility in this setting. The CRAFFT is a suitable alternative, with excellent sensitivity and no gender-based or race-based differences.
Genotyping for cytokine polymorphisms in a Northern Ivory Coast population reveals a high frequency of the heterozygote genotypes for the TNF‐α‐308G/A SNP

Cytokine polymorphisms influence the outcomes of parasitic diseases and vary among populations because of their different evolutionary histories and selective pressures imposed by host–pathogen interactions. In this frame, we investigated the frequencies of TNF‐α (‐308G/A), TGF‐β1 (codon 10C/T, codon 25C/G) and IL‐10 (‐1082A/G) SNPs in 133 individuals from Ouangolodougou, a rural village in Northern Ivory Coast, where malaria and other parasitic diseases are endemic. The SNPs alleles were determined by ARMS‐PCR methodology. Allele frequencies of the SNPs investigated were as follows: IL 10 ‐1082G = 0.741 and ‐1082A = 0.259; TGF‐β1 Codon 10 C = 0.835 and T = 0.165; TGF‐β1 Codon 25 G = 0.782 and C = 0.218. For the TNF‐α gene, we found high frequencies of the ‐308A allele (0.305) and heterozygote genotypes (0.594), with a consequent deviation from the Hardy–Weinberg equilibrium. The high heterozygosity at the TNF‐α locus suggests a possible selective advantage of the heterozygote genomes, associated with intermediate levels of TNF‐α expression, against the infectious agents endemic in Western Africa.
Human endothelium: endovascular biopsy and molecular analysis.

PURPOSE To develop a safe and reproducible method for harvesting viable vascular endothelium to analyze gene expression at sites of vascular lesions. MATERIALS AND METHODS Coaxial curved stainless-steel guide wires were used to obtain samples of endothelial cells from large arteries and veins in 29 patients undergoing routine endovascular procedures. Three immunocytochemical markers were used to identify cells as endothelial. Cellular viability was evaluated in terms of cell membrane integrity, energy-dependent uptake of acetylated low-density lipoprotein, and cellular response to lipopolysaccharide. Single-cell reverse transcription polymerase chain reaction (PCR) and immunocytochemistry were used to study endothelial gene expression. RESULTS Cells with endothelial morphology and immunoreactivity for von Willebrand factor, thrombomodulin, and angiotensin-converting enzyme were consistently obtained from iliac and carotid arteries and large veins (average yield [+/- standard error] from 26 iliac arteries, 262 endothelial cells +/- 45, 20%-30% of which were viable). These cells displayed induction of E-selection messenger RNA at PCR after exposure to lipopolysaccharide. Expression of vascular cell adhesion molecule 1 transcripts in endothelial cells increased with patient age (P < .01), whereas expression of intercellular adhesion molecule 1 did not. CONCLUSION Viable endothelium can be obtained during routine angiography. Immunocytochemical and reverse transcription PCR analyses of these cells allowed determination of transcripts and proteins expressed by endothelium at sites of vascular lesions. Such information could aid in understanding mechanisms of vascular diseases and in clinical decision making.
Reperfusion at reduced flow rates enhances postischemic contractile recovery of perfused heart.

The effects of reperfusion at reduced flow rates on postischemic cardiac contractile function were examined in perfused rat hearts. Isolated hearts were subjected to 35-min ischemia followed by reperfusion at the preischemic flow rate (9.0 ml.g-1.min-1; ordinary flow rate) or at reduced flow rates (0.9-8.1 ml.g-1.min-1). Reperfusion at ordinary flow rate did not generate any left ventricular developed pressure (LVDP), whereas reperfusion at reduced flow rates (0.9-7.2 ml.g-1.min-1) elicited 13-57% of initial contractile force at reperfusion's end; optimal recovery occurred at 3.6 ml.g-1.min-1 (reduced flow rate). Reduced flow rate reperfusion attenuated ischemia-reperfusion-induced increase in left ventricular end-diastolic pressure (LVEDP) and perfusion pressure (PP), alteration in tissue Na+, K+, Ca2+, and Mg2+, release of creatine kinase and ATP metabolites, and development of triphenyltetrazolium chloride-unstained areas. Enhanced postischemic LVDP recovery was inversely related to higher coronary PP at the initial stage (4 min) of reperfusion (r = -0.763). The benefit of reduced flow rate reperfusion could not be attributed to rate of calcium delivery to the heart, formation of oxygen free radicals in myocardium, endothelium-dependent coronary artery dilation, or LVDEP reduction. Enhancement of postischemic LVDP recovery was associated with attenuation of ischemia-reperfusion-induced increases in myocardial sodium and calcium; failure of postischemic LVDP recovery was accompanied by an increase. Reduction in sodium and calcium overload may underlie the beneficial effects of reduced flow rate reperfusion in ischemic-reperfused heart.
Characterization of a light-responding trans-activator responsible for differentially controlling reaction center and light-harvesting-I gene expression in Rhodobacter capsulatus

The purple nonsulfur photosynthetic bacterium Rhodobacter capsulatus regulates synthesis of its photosystem in response to two environmental stimuli, oxygen tension and light intensity. Here we describe the identification and characterization of the trans-acting regulatory gene hvrA, which we show is involved in differentially controlling reaction center and light-harvesting gene expression in response to alterations in light intensity. An hvrA mutant strain is shown to lack the capability to trans-activate light-harvesting-I and reaction center gene expression but retain normal light-harvesting-II and photopigment regulation, in response to a reduction in light intensity. As a consequence of altered expression, hvrA mutant strains exhibit reduced photosynthetic growth capabilities under dim-light conditions. The results of this study and additional studies indicate that regulated synthesis of the photosystem involves complex sets of overlapping regulatory circuits that differentially control photosystem gene expression in response to environmental stimuli such as oxygen tension and light intensity.
Flexible and Stretchable Brush-Painted Wearable Antenna on a Three-Dimensional (3-D) Printed Substrate

This letter presents the proof-of-concept of the fabrication and performance analysis of a flexible and stretchable wearable antenna on a three-dimensional (3-D) printed substrate. It presents the details of the 3-D printing of the substrate, brush-painting of the antenna, as well as the simulation and measurement results of the antenna. In addition, the bending test is done to check the limitation of the manufacturing method. The results show that the stretchable silver conductive paste achieves a 1.7 × 104 S/m conductivity. The fabricated antenna shows measured impedance bandwidth of 990 MHz (1.94–2.93 GHz) with a peak gain of −7.2 dB at 2.45 GHz. Moreover, the antenna shows excellent wireless performance even when bent. Based on the results, the presented approach can be used for the manufacturing of wearable antennas and wireless on-body applications.
Validating the balanced scorecard framework for nonprofit organisations: an empirical study involving Australasian healthcare

In this paper, we theorise and empirically validate the nonprofit version of the balanced scorecard (BSC) using Australasian nonprofit healthcare organisations (NPHOs) as the sampling frame. We used 232 valid responses (collected via a questionnaire that captures the conceptual domain of the 9 constructs of our model) to test our hypotheses using partial-least-squares-based structural equation modelling (PLSBSEM). Our study brings clarity to the nonprofit BSC as we explain how organisational Mission drives the Strategy (which in turn drives the system) to achieve the stakeholder (Client, People, and the Donors) outcomes, en route the application of our mixed method research to generate rich data to plug other gaps in the BSC, such as omission of people (as a key stakeholder group) and inadequate explication of the financial perspective, in a nonprofit context. Our hypotheses (which are ground in the literature) were supported by the data and we discussed the implications of the findings from a theoretical and practical standpoint to guide future research. Our study is the first to undertake the development of a PM framework specific to Australasian NPHOs (to a level that it can be readily used by the practitioners). Our findings are analytically generalisable across NPHOs in the UK and other similar regions/countries.
Automated tools for manipulating files in a distributed environment with RSYNC

It is well known that the primary objective of a world wide business organization is to find a way to improve the delivery of services and facilities for business interactions. Advancements in information and communication technologies especially in the field of networking can be utilized to enhance the co-ordination and enforcement policies of such organizations. The information needed by an organization agency usually involves collecting information that has been captured or owned by other cooperating agencies which are usually situated in geographically separate locations. Sharing of such information typically involves manual requests which could at times be slow and may be subjected to other administrative procedures. With the use of distributed file technologies supported by sound information sharing policies, disparate information from a myriad of geographically separate organization resources could be collected and distributed as if the information is residing on the requestor's own repository. This paper suggests a framework for file distribution in an environment where files from different geographically separate resources can be shared by the cooperating agencies. The proposed algorithm performs replication on several servers, and updates the servers when data manipulation occurs. In addition, the algorithm can reduce the transfer time for huge files significantly by using Wrapper RSYNC between two replica servers. The experimental results reveal that the proposed algorithm reduces the overall file transfer time up to 55% and improves the fault tolerance by 20%.
Perinatal Transmission and Viral Evolution of Hepatitis C Virus Quasispecies in Infants Coinfected With HIV

Objectives:Three HIV/hepatitis C virus (HCV)-coinfected children and the mothers of 2 were studied to examine the nature of perinatal HCV infection in HIV-coinfected infants and to assess the evolution of viral quasispecies thereafter. Sequences of the hypervariable region in the N terminus of the E2/NS1 region (HVR-1) of the children and their mothers were compared. HCV quasispecies changes in the infants were tracked over several years. Methods:Sequence similarity comparisons and phylogenetic trees were derived from cDNA of plasma isolates. Quantitation of plasma HCV and HIV was performed in the children, as well as CD4 T-cell percentage and liver transaminases. Results:Phylogenetic analysis of the mother-child pairs suggested that transmission of multiple dominant and nondominant variants identified in the mother were seen. HCV diversification in the children was seen as early as 2 months of life. The child with the best immune status and HIV control demonstrated the most diversification throughout. Conclusion:Multiples HCV variants transmitted from mother to child and their early changes in the child may be related to maternal antibody. Variation after the 1st year of life may reflect immunologic pressure from the child. There was no trend suggesting that the presence or absence of selective immunologic pressure affected HCV load or liver transaminase values.