Miracle-dz/UniFAR-FTUs huggingface dataset:
Role of Echocardiography in Bariatric Surgery: Preoperative Assessment of Non- Cardiopathic Morbidly Obese Patients

Introduction: Morbidly obese patients are at risk of cardiovascular events and their optimal assessment before surgery is controversial. The aim of this study was to analyze the value of transthoracic echocardiography to detect structural and functional cardiac alterations and as a predictor of cardiovascular morbidity both in the operative period and in the immediate postoperative period in high risk but non-cardiopathic patients undergoing bariatric surgery. Material and Methods: A transthoracic echocardiography was routinely performed in non-cardiopathic patients with OSA and/or hypertension treated with two or more drugs. Eighty seven patients aged 48.5 ± 9 years, BMI of 45.9 ± 7 kg/m were studied. Cardiovascular risk factors, the anesthetic monitoring and the cardiovascular complications were evaluated. Results: An abnormal indexed left ventricular mass (LVMi) was observed in 12.6 % of patients, septum hypertrophy in 24%. Diastolic dysfunction (DD) was diagnosed in 32.7% of subjects (74% with a mild alteration). No significant differences were found in the echocardiography findings in patients with severe obesity (BMI > 50 kg/m2) compared with the rest of the subjects. In the linear regression analysis age (β=0.256, P=0.021) was found to be the main determinant of LVMi (R2 for the model= 0.314). Regarding intraoperative monitorization, two patients required special measures due to surgical complications and one patient suffered from a cardiovascular complication but in neither case did the echocardiografic findings prompt a change in the anesthesic management. Conclusions: The echocardiographic alterations found in a Mediterranean population of non-cardiopathic morbidly obese patients as candidates for bariatric surgery, were low. The echocardiographic findings did not change the anesthetic management of these patients and the cardiovascular events observed in the operative and immediate postoperative period were very scarce. This indicates that this test is not useful when routinely performed.
Pacific Asia Conference on Information Systems ( PACIS ) 2014 WHY DO THEY RESIST ? EXAMINING THE SALIENT FACTORS OF PHYSICIANS ’ IT ADOPTION BEHAVIOUR

The IT landscape in German hospitals is characterized by great heterogeneity. While IT-systems directly supporting medical diagnosis generally show high adoption rates, acceptance of process supporting systems, such as systems supporting the documentation processes, is often not as originally envisioned when the system was implemented. This research analyzes physicians’ perceptions towards adopting a digital archive system, which is currently not used as originally intended by the IT-department. Based on the Unified Theory of Acceptance and Use of Technology (UTAUT) extended with findings of an extensive review of the literature a research model is develop and tested with an in-depth case study at a large teaching hospital in Germany. The findings identify effort-related outcome expectations amongst the most relevant factors for physicians’ IT adoption behaviour. This contrasts prior research where -if at allweak impact of effort expectancy on physicians’ behavioural intention has been identified. Further findings show that, although physicians report high computer self-efficacy, training is absolutely crucial to facilitate system usage, as study objects were frequently unaware of the systems’ capabilities.
Review of the Current Status of Intra-Arterial Thrombolysis for Treating Acute Cerebral Infarction: a Retrospective Analysis of the Data from Multiple Centers in Korea

Objective The purpose of the study was to review the current status of intra-arterial (IA) thrombolysis in Korea by conducting a retrospective analysis of the data from multiple domestic centers. Materials and Methods The radiologists at each participating institution were asked to fill out case report forms on all patients who had undergone IA recanalization due to acute anterior circulation ischemia. These forms included clinical, imaging and procedure-related information. A central reader analyzed the CT/MR and angiographic results. The rates of successful recanalization, hemorrhagic transformation and functional outcome were obtained. The univariate analyses were performed together with the multivariate analysis. Results We analyzed the data from 163 patients, and they had been treated at seven institutes. The initial imaging modalities were CT for 46 patients (28%), MR for 63 (39%), and both for 54 (33%). Various mechanical treatment methods were applied together in 50% of the patients. Radiologically significant hemorrhage was noted in 20/155 patients (13%). We found various factors that influenced the recanalization rate and the occurrence of significant hemorrhagic transformations. The favorable outcome rate, reported as modified Rankin Scale ≤ 2, was 40%, and the mortality rate was 11%. The factors that predicted a poor functional outcome were old age (p = 0.01), initially severe neurological symptoms (p < 0.0001), MR findings of a wide distribution of lesions (p = 0.001), involvement of the basal ganglia (p = 0.01), performance of procedures after working hours (p = 0.01), failure of recanalization (p = 0.003), contrast extravasation after the procedure (p = 0.007) and significant hemorrhagic transformation (p = 0.002). The subsequent multivariate analysis failed to show any statistically significant variable. Conclusion There was a trend toward increased dependency on MR imaging during the initial evaluation and increased usage of combined pharmacologic/mechanical thrombolysis. The imaging and clinical outcome results of this study were comparable to those of the previous major thrombolytic trials.
Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review

Introduction Dental practitioners are exposed to different occupational hazards during the course of their professional activity, such as physical, chemical, biological, ergonomic factors. The ergonomic hazards, caused by strained posture and prolonged repetitive movements, can induce musculoskeletal disorders. It occurs in 54–93% of dental professionals and involve the spine, shoulder and hand-wrist tract. Through a systematic review of international literature, we analyzed specific ergonomic risk factors and preventive measures of musculoskeletal disorders in professional dental activity. Methods This systematic review is coherent with the PRISMA statement. The scientific research on the major online databases was based on the following keywords: dentist, prevention, ergonomic, dentistry, musculoskeletal, neck pain, posture, ergonomics, work and occupational. The studies included in this review focus on disorders related to ergonomics and on the most effective preventive measures to be adopted. No restrictions were applied for language or publication type. We excluded reports not related to ergonomic prevention in dentistry, reports of minor academic significance, editorial articles, individual contributions, and studies published in scientific conferences. Results Online research indicated 4188 references: PubMed (2919), Scopus (1257) e Cochrane Library (12). We excluded 3012 of these, because they were unrelated to ergonomics theme and 187 due to duplication. From the remaining 989 studies, 960 papers did not meet inclusion criteria and they were excluded. Therefore, we analyzed 29 articles, including 16 narrative reviews and 13 original article. The main risk factor for the development of musculoskeletal disorders found in our analysis is static posture adopted during work, highlighted in 87.5% of reviews and 84% of original articles. With regard to preventive measures, 75% of the reviews highlighted the importance of stretching after each working session and at the end of the working day, while 61.5% of the original articles emphasized the use of modern and ergonomic instruments. Discussion This review showed that static postures are strongly responsible in the etiology of musculoskeletal disorders. The awkward postures more frequently identified among dental professionals are: extreme forward-head and neck flexion; trunk inclination and rotation towards one side; lifting one or both shoulders; increased curvature of the thoracic vertebral column; incorrect positioning of the lower limbs with thigh-leg angle of less than 90°. It is really important to use of a modern workstation with appropriate ergonomic supports. Among the preventive ergonomic measures, literature has widely recognized the role of physical activity and of a neutral and balanced posture. The present review has some limits: a large part of the selected studies did not have a high methodological quality score and an inadequate statistical analysis.
Gravitational wave burst signal from core collapse of rotating stars

We present results from detailed general relativistic simulations of stellar core collapse to a proto-neutron star, using two different microphysical nonzero-temperature nuclear equations of state as well as an approximate description of deleptonization during the collapse phase. Investigating a wide variety of rotation rates and profiles as well as masses of the progenitor stars and both equations of state, we confirm in this very general setup the recent finding that a generic gravitational wave burst signal is associated with core bounce, already known as type I in the literature. The previously suggested type II (or “multiple-bounce”) waveform morphology does not occur. Despite this reduction to a single waveform type, we demonstrate that it is still possible to constrain the progenitor and postbounce rotation based on a combination of the maximum signal amplitude and the peak frequency of the emitted gravitational wave burst. Our models include to sufficient accuracy the currently known necessary physics for the collapse and bounce phase of core-collapse supernovae, yielding accurate and reliable gravitational wave signal templates for gravitational wave data analysis. In addition, we assess the possibility of nonaxisymmetric instabilities in rotating nascent proto-neutron stars. We find strong evidence that in an iron core-collapse event the postbounce core cannot reach sufficiently rapid rotation to become subject to a classical bar-mode instability. However, many of our postbounce core models exhibit sufficiently rapid and differential rotation to become subject to the recently discovered dynamical instability at low rotation rates.
The Lymphatic Territories of the Upper Limb: Anatomical Study and Clinical Implications

Background: Current understanding of the pattern of lymph channels is largely dependent on the anatomical studies of Sappey performed in the nineteenth century, when mercury was injected into human cadavers and the lymphatics were dissected. These studies have not been repeated because the use of mercury is now prohibited as a result of its toxicity. The aim of this study was to reappraise the gross lymphatic anatomy and lymph node connections using a radiologic technique. A period of 3 years was required for development of a new method. Methods: The definitive technique used hydrogen peroxide to identify lymphatic vessels and to inflate them. The individual channels were injected with a radiopaque lead oxide mixture and recorded on x-ray film. Each channel was dissected meticulously under the surgical microscope and its course examined in relation to the regional lymph nodes. This method was then applied to 14 human cadaver upper limbs obtained from 10 different cadavers. Results: The authors found that the superficial lymphatic vessels course within the subcutaneous fat in close proximity to the main subcutaneous veins. Communication between the superficial and the deep lymphatic systems was not identified in these studies. Conclusions: Most lymph vessels were seen to flow into one main (sentry) lymph node in the axillary region; however, some of the lymph vessels ran along the posterior forearm, bypassing the “sentry” node to reach other smaller nodes.
Adaptation of terminal to base station assignment to terminal activities and rain event in Broadband Fixed Wireless Access systems

In point-multipoint systems the signal to interference plus noise ratio highly depends on the assignment of terminal stations (TS) to base stations (BS). The Broadband Fixed Wireless Access (BFWA) systems operate at high carrier frequencies, i.e. microwave domain. In this frequency range wave propagation is highly influenced by precipitation, especially rain. Applying site diversity can mitigate rain attenuation effects, when downlink signal level decreases below a threshold, terminal station can be assigned to an other base station, though in point-multipoint systems this base station re-assignment can raise uplink interferences at other terminals. Present contribution provides a special diversity method which adopts genetic algorithm to dynamically optimize TS-BS assignments in BFWA service area from interference point of view. Efficiency of applying various objective functions are compared considering different aspects.
Simocyclinone D8, an Inhibitor of DNA Gyrase with a Novel Mode of Action

ABSTRACT We have characterized the interaction of a new class of antibiotics, simocyclinones, with bacterial DNA gyrase. Even though their structures include an aminocoumarin moiety, a key feature of novobiocin, coumermycin A1, and clorobiocin, which also target gyrase, simocyclinones behave strikingly differently from these compounds. Simocyclinone D8 is a potent inhibitor of gyrase supercoiling, with a 50% inhibitory concentration lower than that of novobiocin. However, it does not competitively inhibit the DNA-independent ATPase reaction of GyrB, which is characteristic of other aminocoumarins. Simocyclinone D8 also inhibits DNA relaxation by gyrase but does not stimulate cleavage complex formation, unlike quinolones, the other major class of gyrase inhibitors; instead, it abrogates both Ca2+- and quinolone-induced cleavage complex formation. Binding studies suggest that simocyclinone D8 interacts with the N-terminal domain of GyrA. Taken together, our results demonstrate that simocyclinones inhibit an early step of the gyrase catalytic cycle by preventing binding of the enzyme to DNA. This is a novel mechanism for a gyrase inhibitor and presents new possibilities for antibacterial drug development.
Isolating the Effect of Day-Count Conventions on the Market Value of Interest Rate Swaps

Day-count conventions are a ubiquitous but often overlooked aspect of interest-bearing investments. While many market traded securities have adopted fixed or standard conventions, over-the-counter agreements such as interest rate swaps can and do use a wide variety of conventions, and many investors may not be aware of the effects of this choice on their future cash flows. Here, we show that the choice of day-count convention can have a surprisingly large effect on the market value of swap agreements. We highlight the importance of matching day-count conventions on obligations and accompanying swap agreements, and demonstrate various factors which influence the magnitude of day-count convention effects. As interest rate swaps are very common amongst municipal and other institutional investors, we urge investors to thoroughly understand these and other `fine print' terms in any potential agreements. In particular, we highlight the ability of financial intermediaries to effectively increase their fees substantially through their choice of day-count conventions.
Cluster Mergers, Core Oscillations, and Cold Fronts

We use numerical simulations with hydrodynamics to demonstrate that a class of cold fronts in galaxy clusters can be attributed to oscillations of the dark matter distribution. The oscillations are initiated by the off-axis passage of a low-mass substructure. From the simulations, we derive three observable morphological features indicative of oscillations: (1) the existence of compressed isophotes, (2) the regions of compression must be alternate (opposite and staggered) and lie on an axis passing through the center of the cluster, and (3) the gradient of each compression region must pass through the center of the cluster. Four of six clusters reported in the literature have cold front morphologies consistent with the presence of oscillations. The clusters with oscillations are A496, A1795, A2142, and RX J1720.1+2638. Galaxy clusters A2256 and A3667 are not consistent, so the cold fronts are interpreted as group remnants. The oscillations may be able to provide sufficient energy to solve the cooling flow problem and, importantly, provide it over an extended duration.
Progesterone receptor status significantly improves outcome prediction over estrogen receptor status alone for adjuvant endocrine therapy in two large breast cancer databases.

PURPOSE To determine whether progesterone receptor (PgR) status provides additional value to estrogen receptor (ER) status and improves prediction of benefit from endocrine treatment among patients with primary breast cancer. PATIENTS AND METHODS Clinical outcomes of patients in two large databases were analyzed as a function of steroid receptor status. The first database (PP), contained 3,739 patients who did not receive any systemic adjuvant therapy and 1,688 patients who received adjuvant endocrine therapy but no chemotherapy. The second database (SPORE), contained 10,444 patients who received adjuvant endocrine therapy but no chemotherapy. Biochemical ER and PgR assays were identically performed in two different central laboratories. RESULTS In univariate and multivariate analyses, the prognostic significance of PgR status among systemically untreated patients is modest. Among endocrine-treated patients, however, multivariate analyses, including lymph-node involvement, tumor size, and age, demonstrate that PgR status is independently associated with disease-free and overall survival. For recurrence, the reduction in relative risk (RR) was 25% for ER-positive/PgR-negative patients and 53% for ER-positive/PgR-positive patients, compared with ER-negative/PgR-negative patients (P <.0001, PP patients). Patients with ER-positive/PgR-negative tumors have a reduction in RR of death of 30% (SPORE patients) and 38% (PP patients), compared with patients with ER-negative/PgR-negative tumors (P <.0001). For ER-positive/PgR-positive tumors, the reduction of the risk of death was greater than 46% in SPORE patients and 58% in PP patients, indicating that ER-positive/PgR-positive patients derive more benefit from endocrine therapy (P <.0001). CONCLUSION When accurately measured, PgR status is an independent predictive factor for benefit from adjuvant endocrine therapy. Therefore, PgR status should be taken into account when discussing RR reductions expected from endocrine treatment with individual patients.
Safety and Efficacy of Controlled‐Release Oxycodone: A Systematic Literature Review

Prescriptions for controlled‐release oxycodone, a narcotic analgesic, recently contributed to a dramatic increase in pharmacy costs for a large private insurance company. To determine whether this agent offered clinical benefits over other available drugs that would justify its significantly greater cost, a systematic review of 16 clinical trials was undertaken. The review suggested that immediate‐release and controlled‐release preparations of oxycodone have similar efficacy and comparable side effect profiles. Controlled‐release oxycodone has the advantage of less frequent dosing than immediate‐release oxycodone; however, other agents may be dosed infrequently at much lower costs. For patients requiring a controlled‐release opioid treatment, controlled‐release morphine and methadone should be considered because they appear to be as effective as oxycodone and cost considerably less. Controlled‐release oxycodone may be appropriate for some patients, particularly if they cannot tolerate other controlled‐release or long‐acting opioid analgesics.
Mechanisms of the effectiveness of lipid nanoparticle formulations loaded with anti-tubercular drugs combinations toward overcoming drug bioavailability in tuberculosis

Abstract Dual-drug-loaded lipid nanoparticle formulations (LNFs) namely solid lipid nanoparticles (SLNs) and nanostructured lipid carrier (are also solid lipid nanoparticles- a new generation of traditional SLNs) were developed and delivered to differentiated THP-1 cells. Developed LNFs have smooth and spherical surface morphology and nano range in size. In vitro drugs release profiles from these LNFs were slow and sustained. Particles were well co-localised in a different compartment (lysosome and endosome) of polarised macrophage by using suitable pH-dependent and antibody-mediated trafficking probe. Majority of the LNFs were also capable of existing in phago-lysosomal complex and able to effectively co-localise with the different cellular compartment of THP-1. The journey of the lipid carrier started through the formation of coated vesicle on differentiated macrophage surface, will further followed to idetify the efficient delivery of nano carrierat lysosomal and endosomal compartment in a sub cellular level of specific cell population. Comparative oral in vivo pharmacokinetic study revealed that nanostructured lipid carrier enhanced the pharmacokinetic profile compared to solid lipid nanoparticles and overall inclined the relative bioavailability by many folds. Cumulative results suggest that nanostructured lipid carrier could be an effective, alternative and promising lipid-mediated oral drug delivery approach than solid lipid nanoparticles.