Miracle-dz/UniFAR-FTUs huggingface dataset:
Denervated Stomach as an Esophageal Substitute Recovers Intraluminal Acidity With Time

ObjectiveTo determine whether the denervated stomach as an esophageal substitute recovers normal intraluminal acidity with time. Summary Background DataBilateral truncal vagotomy to the stomach as an esophageal substitute reduces both gastric acid production and antral motility, but a spontaneous motor recovery process takes place over years. MethodsIntraluminal gastric pH and bile were monitored during a 24-hour period 1 to 195 months after transthoracic elevation of the stomach as esophageal replacement in 91 and 76 patients, respectively. Nine patients underwent a second gastric pH monitoring after a 3-year period. The percentages of time that the gastric pH was less than 2 and bile absorbance exceeded 0.25 were calculated in reference to values from 25 healthy volunteers. Eighty-nine upper gastrointestinal endoscopies were performed in 83 patients. Patients were divided into three groups depending on length of follow-up: group 1, less than 1 year; group 2, 1 to 3 years; group 3, more than 3 years. ResultsThe prevalence of a normal gastric pH profile was 32.3% in group 1, 81.5% in group 2, and 97.6% in group 3. The percentage of time that the gastric pH was less than 2 increased from group 1 (27.3%) to group 2 (56.1%) and group 3 (70.5%), parallel to an increase in the prevalence of cervical heartburn and esophagitis. The percentage of time that the gastric pH was less than 2 increased from 28.7% to 81.2% in the nine patients investigated twice. Exposure of the gastric mucosa to bile was 12.8% in patients with a high gastric pH profile versus 19.3% in those with normal acidity. In the esophageal remnant in six patients, Barrett’s metaplasia developed, intestinal (n = 2) or gastric (n = 4) in type. ConclusionsEarly after vagotomy, intraluminal gastric acidity is reduced in two thirds of patients, but the stomach recovers a normal intraluminal pH profile with time, so that in more than one third of patients, disabling cervical heartburn and esophagitis develop. The potential for the development of Barrett’s metaplasia in the esophageal remnant brings into question the use of the stomach as an esophageal substitute in benign and early neoplastic disease.
Use of Highly Encapsulated Streptococcus pneumoniae Strains in a Flow-Cytometric Assay for Assessment of the Phagocytic Capacity of Serotype-Specific Antibodies

ABSTRACT A phagocytosis assay for Streptococcus pneumoniae based on flow cytometry (FACS) with human polymorphonuclear cells and human complement was developed for the study of human vaccination antisera. Human prevaccination sera already contain high levels of C-polysaccharide (C-PS) antibodies, which are not protective in humans but which might give false positive results in a flow-cytometry-based assay. Cultures of S. pneumoniae grown to log phase on three consecutive days, followed by heat inactivation, yielded stable and highly encapsulated strains for serotypes 6A, 6B, 14, 19F, and 23F. As a result, only serotype-specific antibodies were able to facilitate phagocytosis of these strains, whereas no phagocytosis was observed with antibodies against C-PS or pneumococcal surface proteins. No, or weak, phagocytosis was observed with human prevaccination sera, whereas in general, postvaccination antisera facilitated phagocytosis. A highly significant correlation was observed between enzyme-linked immunosorbent assay titers and FACS phagocytosis titers (r = 0.98, P < 0.001) for serotype 23F pneumococci with human vaccination antisera. For all serotypes, interassay variation was below 10%. Major advantages of this assay over the classical killing assay are that (i) limited amounts of sera are required (10 μl per titration curve), (ii) 600 samples can be processed in one day by one person, and (iii) cells can be fixed and measurement of the samples can be performed up to 1 week later.
Desensitization of Myofilaments to Ca2+ as a Therapeutic Target for Hypertrophic Cardiomyopathy With Mutations in Thin Filament Proteins

Background—Hypertrophic cardiomyopathy (HCM) is a common genetic disorder caused mainly by mutations in sarcomeric proteins and is characterized by maladaptive myocardial hypertrophy, diastolic heart failure, increased myofilament Ca2+ sensitivity, and high susceptibility to sudden death. We tested the following hypothesis: correction of the increased myofilament sensitivity can delay or prevent the development of the HCM phenotype. Methods and Results—We used an HCM mouse model with an E180G mutation in &agr;-tropomyosin (Tm180) that demonstrates increased myofilament Ca2+ sensitivity, severe hypertrophy, and diastolic dysfunction. To test our hypothesis, we reduced myofilament Ca2+ sensitivity in Tm180 mice by generating a double transgenic mouse line. We crossed Tm180 mice with mice expressing a pseudophosphorylated cardiac troponin I (S23D and S24D; TnI-PP). TnI-PP mice demonstrated a reduced myofilament Ca2+ sensitivity compared with wild-type mice. The development of pathological hypertrophy did not occur in mice expressing both Tm180 and TnI-PP. Left ventricle performance was improved in double transgenic compared with their Tm180 littermates, which express wild-type cardiac troponin I. Hearts of double transgenic mice demonstrated no changes in expression of phospholamban and sarcoplasmic reticulum Ca2+ ATPase, increased levels of phospholamban and troponin T phosphorylation, and reduced phosphorylation of TnI compared with Tm180 mice. Moreover, expression of TnI-PP in Tm180 hearts inhibited modifications in the activity of extracellular signal-regulated kinase and zinc finger-containing transcription factor GATA in Tm180 hearts. Conclusions—Our data strongly indicate that reduction of myofilament sensitivity to Ca2+ and associated correction of abnormal relaxation can delay or prevent development of HCM and should be considered as a therapeutic target for HCM.
Achieving Glycemic Control in Type 2 Diabetes: A Practical Guide for Clinicians on Oral Hypoglycemics

Type 2 diabetes mellitus has reached epidemic proportions in the United States. Cardiovascular morbidity and mortality are particularly high in this patient population. Improved glucose control, especially early in the course of diabetes, can slow or prevent complications, preserve β-cell function, and improve long-term outcomes. Within the last decade, new treatments and glycemic goals have created an opportunity to better manage this prevalent, chronic disease. Defects of insulin resistance and deficiency leading to type 2 diabetes can now be directly targeted with available therapies. In addition to diet and exercise, oral treatment options have been broadened, with both insulin secretagogues and insulin sensitizers. These advances in treatment options make glycemic control an obtainable target, and therefore should improve overall morbidity and mortality for patients. This paper will review currently available oral therapies, with a focus on the unique attributes of the insulin sensitizers for patients with type 2 diabetes.
A New Direction for Cardiac Regeneration Therapy: Application of Synergistically Acting Epicardium-Derived Cells and Cardiomyocyte Progenitor Cells

Background—Adult human epicardium-derived cells (EPDCs), transplanted into the infarcted heart, are known to improve cardiac function, mainly through paracrine protection of the surrounding tissue. We hypothesized that this effect might be further improved if these supportive EPDCs were combined with cells that could possibly supply the ischemic heart with new cardiomyocytes. Therefore, we transplanted EPDCs together with cardiomyocyte progenitor cells that can generate mature cardiomyocytes in vitro. Methods and Results—EPDCs and cardiomyocyte progenitor cells were isolated from human adult atrial appendages, expanded in culture, and transplanted separately or together into the infarcted mouse myocardium (total cell number, 4×105). Cardiac function was determined 6 weeks later (9.4T MRI). Coculturing increased proliferation rate and production of several growth factors, indicating a mutual effect. Cotransplantation resulted in further improvement of cardiac function compared with single cell-type recipients (P<0.05), which themselves demonstrated better function than vehicle-injected controls (P<0.05). However, in contrast to our hypothesis, no graft-derived cardiomyocytes were observed within the 6-week survival, supporting that not only EPDCs but also cardiomyocyte progenitor cells acted in a paracrine manner. Because injected cell number and degree of engraftment were similar between groups, the additional functional improvement in the cotransplantation group cannot be explained by an increased amount of secreted factors but rather by an altered type of secretion. Conclusion—EPDCs and cardiomyocyte progenitor cells synergistically improve cardiac function after myocardial infarction, probably instigated by complementary paracrine actions. Our results demonstrate for the first time that synergistically acting cells hold great promise for future clinical regeneration therapy.
Immunoglobulin M predominance in cutaneous lupus erythematosus

Background: Direct immunofluorescence (DIF) is a valuable tool in the diagnosis of cutaneous lupus erythematosus (LE). Our goal was to characterize the most frequent immune reactants in the skin biopsies of cutaneous LE and identify the most common immunofluorescence staining patterns.
End-of-life decision making in 42 patients with amyotrophic lateral sclerosis.

OBJECTIVE To determine when end-of-life issues were discussed with patients afflicted with amyotrophic lateral sclerosis (ALS). METHODS This was a retrospective analysis of ALS patients referred to the neuromuscular clinic at Georgetown University Hospital. Patients were seen by a pulmonologist and a neurologist at the initial diagnosis or referral, and every 2-3 months thereafter. End-of-life discussions were addressed at each visit. Other variables recorded included the amount of time afflicted with ALS, serial pulmonary function test results, and the subjective level of bulbar dysfunction. RESULTS We saw 43 patients (age range 39-94 y) between June 1999 and September 2004. One patient was on a ventilator at the initial visit, and was therefore excluded from the study. Discussion about the patients' end-of-life care preferences were initiated at the first pulmonary visit with 40 patients. With 2 patients, end-of-life decisions were discussed at the second office visit. Twenty-five patients chose do-not-resuscitate and do-not-intubate (DNR/DNI) orders after the initial end-of-life discussion with the pulmonologist. Five other patients chose DNR/DNI orders during subsequent clinic visits. Four patients were still undecided at their last clinic visit. Six patients were lost to follow-up before a decision was made. Two patients requested full ventilatory support. Both the forced vital capacity and the level of bulbar dysfunction were not statistically different between the patients who chose DNR/DNI and the patients who were either undecided or requested full ventilatory support. CONCLUSIONS Decisions about end-of-life care are often delayed in patients with ALS. These patients' final decisions seem to be independent of their level of respiratory insufficiency or bulbar function, and most related to the physician addressing end-of-life care decisions in a timely manner.
Arabidopsis Myosin XI: A Motor Rules the Tracks1[C][W][OPEN]

A myosin triple knockout mutant has altered cytoskeletal organization and single filament turnover. Plant cell expansion relies on intracellular trafficking of vesicles and macromolecules, which requires myosin motors and a dynamic actin network. Arabidopsis (Arabidopsis thaliana) myosin XI powers the motility of diverse cellular organelles, including endoplasmic reticulum, Golgi, endomembrane vesicles, peroxisomes, and mitochondria. Several recent studies show that there are changes in actin organization and dynamics in myosin xi mutants, indicating that motors influence the molecular tracks they use for transport. However, the mechanism by which actin organization and dynamics are regulated by myosin XI awaits further detailed investigation. Here, using high spatiotemporal imaging of living cells, we quantitatively assessed the architecture and dynamic behavior of cortical actin arrays in a mutant with three Myosin XI (XI-1, XI-2, and XI-K) genes knocked out (xi3KO). In addition to apparent reduction of organ and cell size, the mutant showed less dense and more bundled actin filament arrays in epidermal cells. Furthermore, the overall actin dynamicity was significantly inhibited in the xi3KO mutant. Because cytoskeletal remodeling is contributed mainly by filament assembly/disassembly and translocation/buckling, we also examined the dynamic behavior of individual actin filaments. We found that the xi3KO mutant had significantly decreased actin turnover, with a 2-fold reduction in filament severing frequency. Moreover, quantitative analysis of filament shape change over time revealed that myosin XI generates the force for buckling and straightening of both single actin filaments and actin bundles. Thus, our data provide genetic evidence that three Arabidopsis class XI myosins contribute to actin remodeling by stimulating turnover and generating the force for filament shape change.
Power and Administration

T HERE is no more forlorn spectacle in the administrative world than an agency and a program possessed of statutory life, armed with executive orders, sustained in the courts, yet stricken with paralysis and deprived of power. An object of contempt to its enemies and of despair to its friends. The lifeblood of administration is power. Its attainment, maintenance, increase, dissipation, and loss are subjects the practitioner and student can ill afford to neglect. Loss of realism and failure are almost certain conse-
Public service motivation and job satisfaction as predictors of organizational citizenship behaviour

This study aims to analyze the relationship of variables of public service motivation, job satisfaction and Organizational Citizenship Behaviour. Inferential statistics using simultaneous equation model is used to test the hypothesis. Samples as many as 51 people were taken randomly from a population of 71 people. The results show that in public service motivation and job satisfaction (both simultaneously and partially) have a positive and significant impact on Organizational Citizenship Behaviour.
UC Updatable Non-Hiding Committed Database with Efficient Zero-Knowledge Proofs

We define an ideal functionality FNHCD and a protocol ΠNHCD for an updatable non-hiding committed database (NHCD). NHCD is described as the task of storing a database into a suitable data structure that allows you to efficiently prove in zero-knowledge (ZK) that a value is stored in the database at a certain position. The database is non-hiding because both prover and verifier know its content. It is committed in the sense that only ZK proofs about position-value pairs that are actually stored are possible. It is updatable because its contents can be modified dynamically throughout the protocol execution. The NHCD task is used implicitly as building block of privacy-preserving protocols for e-commerce, smart billing and access control. In those protocols, this task is intertwined with others. Our functionality FNHCD allows us to study constructions for this task in isolation. Furthermore, it allows us to improve modularity in protocol design, by using FNHCD as building block of those protocols along with functionalities for other tasks. Our construction ΠNHCD uses a non-hiding vector commitment (VC) scheme as building block. Thanks to the efficiency properties of non-hiding VC schemes, ΠNHCD provides ZK proofs whose computation cost (after initialization) and whose size are both independent of the database size. Therefore, ΠNHCD is suitable for large databases. Moreover, the database can be updated dynamically and
Predicting Inflation: Portfolio Erosion or Collapse?

What is the probability of high inflation; how high, when? These questions are important to all investors since even the 2% level to which we are accustomed will cut an investor’s portfolio by over 17% during a decade. This 2% level is the target of the Federal Reserve, along with near 0% interest rates, for a risk free rate of -2%. This guarantees portfolio erosion absent risk-taking, which could result in even lower returns if the risks of loss are realized. An AARP article characterizes this as The War On Savers. Higher inflation is possible, at 4% or more, with even worse effects. There are heated debates about the probability and timing of high inflation, but our review of the extensive literature reveals no reliable way to predict its onset or extent. Expert opinion predicts inflation best, but it has failed to predict the onset or extent of inflation, and past inflation predicts the experts’ estimates as well as the experts predict future inflation. Debt levels are very high, and inflation is one of the possibilities for deleveraging. The Japanese have proved that high debt can exist without inflation for at least a decade or two, at least in their particular circumstances. Our high debt levels are partly due to the housing collapse. We propose months of unsold housing inventory as an indicator likely to decline before a sustained housing rally, and shelter is both the largest single component of inflation and affects consumer wealth and psychology. We also propose that portfolio erosion through 2% inflation is likely to continue for the present, and that much higher inflation is unlikely until the economy strengthens, but that it remains a risk until deleveraging has occurred by some other means. We suggest monitoring banks’ Federal Reserve deposit levels, which are reported weekly, as another barometer of inflation risk. A portfolio invested in traditional liquid assets – stocks, bonds, and cash – is unlikely to weather high inflation intact; the extent of the damage to each of these asset categories varies widely among inflationary periods and is volatile within these periods.
Differences between female and male patients with familial rheumatoid arthritis

OBJECTIVE To determine whether there are genetic differences between female and male patients with familial rheumatoid arthritis (RA). METHODS 45 men and 119 women from 78 families with RA who all had at least one first degree relative with RA were compared. HLA-DRB1 alleles were analysed, including DRB1*04 subtypes and associations of DRB1*04 haplotypes with DQB1*0301 or DQB1*0302 alleles, the age of the patients at disease onset, the presence of rheumatoid factor (RF), joint erosions, and rheumatoid nodules. RESULTS HLA-DRB1*13 allele (the subtype allele of DR6, reported to be protective against the development of RA) was found in 14/119 (12%) of female but in none of the male patients (p=0.036). The HLA-DR4 allele was found slightly more often in men than women patients with familial RA (31/45 (69%)v 75/119 (63%), NS). Men were also more often RF positive than women (44/45 (98%) v98/117 (84%); p=0.031). On the other hand, the mean age at onset of RA was significantly lower in the female group (40.4 years) than in men (46.6 years, p=0.0044). CONCLUSION The results indicate that there is stronger genetic background in familial male than female patients with RA in the genetic susceptibility defined by the studied HLA antigens. However, the earlier age of onset of the disease in female group and the increased proportion of women with RA indicate that there are additional sex related predisposing factors enhanced in familial cases.
Low thermal resistance high-speed top-emitting 980-nm VCSELs

Increasing copper plated heatsink radii from 0 to 4 mum greater than the mesa in vertical-cavity surface-emitting lasers (VCSELs) reduced the measured thermal resistance for a range of device sizes to values 50% lower than previously reported over a range of device sizes. For a 9-mum diameter oxide aperture, the larger heatsink increases output power and bandwidth by 131% and 40%, respectively. The lasers exhibit a 3-dB modulation frequency bandwidth up to 9.8 GHz at 10.5 kA/cm2. The functional dependence of thermal resistance on oxide aperture diameter indicates the importance of lateral heat flow to mesa sidewalls
Chaotic scattering around black holes

It is shown that the scattering of a charged test particle by a system of four extreme Reissner-Nordtröm black holes is chaotic in some cases. This is the third manifestation of chaos in the motion of test particles in general relativistic backgrounds: chaotic bounded orbits and fractal basin boundaries were previously known. 04.25. -g,04.40. Nr,04.70. Bw,95.10. Fh Typeset using REVTEX 1
Transformations? Skilled Change Agents Influencing Organisational Sustainability Culture

Abstract Training employees in sustainability knowledge and skills is considered a vital element in creating a sustainability culture within an organisation. Yet, the particular types of training programs that are effective for this task are still relatively unknown. This case study describes an innovative workplace training program using a ‘head, hands, heart and feet’ learning framework to create skilled change agents among employees, in order to influence organisational sustainability culture. Utilising a dialogic inquiry methodology (Most Significant Change), as well as Mezirow's phases of transformative learning and Schein's organisational culture framework, this study considers the training program's impact on both participants and organisational sustainability culture. While transformative learning impacts for participants were identified, questions remain as to the overall impact of the program on the organisation's sustainability culture. Considering training participants as ‘seeds of influence’ as opposed to wholly responsible for organisational culture might provide new perspectives to these questions.
Current Management of Aneurysmal Subarachnoid Hemorrhage Guidelines from the Canadian Neurosurgical Society

ABSTRACT: Published medical evidence pertaining to the management of aneurysmal subarachnoid hemorrhage (SAH) was critically reviewed in order to prepare practice guidelines for this condition. SAH should be considered as a possible cause of all sudden and/or unusual headaches, and every attempt should be made to recognize mild SAHs, as they are still frequently misdiagnosed. The first test for SAH is computed tomography (CT), followed by lumbar puncture when the CT is negative for intracranial bleeding (the case in only several per cent of patients within 24 hours of aneurysm bleeding). Urgent cerebral angiography is necessary to detect the underlying cerebral aneurysm. The advantage of rapid diagnosis of SAH followed by early aneurysm repair is minimizing the risk of catastrophic aneurysm rebleeding. Early surgery for aneurysm repair is often possible and is recommended, unless the aneurysm location or size renders it technically difficult to expose in clot-laden subarachnoid cisterns beneath an acutely swollen brain. Aneurysm ablation is optimally accomplished with open microsurgery and clipping of the aneurysm neck, although other options include proximal parent artery occlusion, “trapping” of the aneurysmal segment of the artery, and embolization of thrombogenic materials (e.g., platinum “microcoils”) directly into the aneurysm dome using endovascular techniques. Neurological outcome following SAH is also optimized through the prevention of secondary SAH complications, and further management specific for ruptured cerebral aneurysms can include anticonvulsants, neuroprotectants, and various agents and techniques to prevent or reverse delayed-onset cerebral vasospasm. All patients with aneurysmal SAH should be treated with the calcium antagonist nimodipine, and in certain circumstances patients should receive anticonvulsants. Induced arterial hypertension, hypervolemia and in some instances percutaneous balloon angioplasty are recommended to reverse vasospasm causing symptomatic cerebral ischemia prior to cerebral infarction.