Miracle-dz/UniFAR-FTUs huggingface dataset:
The impact of spontaneous ventilation on non-operative lung injury in thoracic surgery: a randomized controlled rabbit model study

OBJECTIVES One-lung ventilation (OLV) with general anaesthesia may increase adverse effects after thoracic surgery, specifically ventilator-induced lung injury. Spontaneous ventilation (SV) has no mechanical ventilation process, thus, we established a rabbit model to assess non-operative lung injury between OLV and SV. METHODS Thirty-six rabbits were randomly divided into 6 groups: OLV and SV (0, 2 and 4 h). Blood gas analysis was performed after thoracic surgery. Lung tissue and bronchoalveolar lavage fluid were obtained from the non-operative lung. Pathological injury score in lung tissue and tumour necrosis factor α (TNF-α) level in bronchoalveolar lavage fluid using enzyme-linked immunosorbent assay were determined. Moreover, messenger RNA and protein of TNF-α in lung tissue were also determined by quantitative reverse transcriptase polymerase chain reaction and immunohistochemistry. RESULTS Compared with the OLV group, significantly higher partial pressure of carbon dioxide (47.78 ± 3.57 vs 38.95 ± 3.88 mmHg, P < 0.01) and partial pressure of oxygen (101.08 ± 13.1 vs 85.6 ± 11.07 mmHg, P < 0.01), as well as a significantly lower pathological injury score (6.83 ± 1.17 vs 8.83 ± 1.72, P < 0.05), TNF-α level in bronchoalveolar lavage fluid (290.32 ± 29.38 vs 368.43 ± 31.26 pg/ml, P < 0.01), TNF-α messenger RNA (6.31 ± 1.13 vs 8.6 ± 1.34, P < 0.01), immunostaining intensity in lung tissue were found at 4 h in the SV group. However, there are no significant differences between OLV and SV groups at 2 h (P > 0.05), except in TNF-α messenger RNA. CONCLUSIONS Based on this rabbit model, SV for thoracic surgery is not inferior to OLV in terms of lung injury. Considering our results, when performing time-consuming thoracic procedures under OLV, surgeons should more closely examine patients for non-operative lung injury postoperatively.
Boundary condition Analysis for Cuk, SEPIC and zeta Converters using Energy factor Concept

This paper aims to use the concept of energy factor and its associated concepts to analyze high-order converters, such as Cuk, Sepic and Zeta converters. The maximum variation of energy factor (MVEF) of high-order converters exhibits particular characteristic which is different from that of second order converters. To carry out the analysis based on MVEF, boundary conditions for the high-order converters should be restudied. There are new boundary conditions that are derived by analyzing the energy factor. Through the research in this paper, it can be concluded that the MVEF can reveal the amount of energy storage and impact the efficiency of high-order converters. Experimental results have confirmed that the MVEF and efficiency are correlated. MVEF can be a preferred index for DC-DC converters including high-order converters.
Medication-related clinical decision support alert overrides in inpatients

Objective To define the types and numbers of inpatient clinical decision support alerts, measure the frequency with which they are overridden, and describe providers' reasons for overriding them and the appropriateness of those reasons. Materials and Methods We conducted a cross-sectional study of medication-related clinical decision support alerts over a 3-year period at a 793-bed tertiary-care teaching institution. We measured the rate of alert overrides, the rate of overrides by alert type, the reasons cited for overrides, and the appropriateness of those reasons. Results Overall, 73.3% of patient allergy, drug-drug interaction, and duplicate drug alerts were overridden, though the rate of overrides varied by alert type (P < .0001). About 60% of overrides were appropriate, and that proportion also varied by alert type (P < .0001). Few overrides of renal- (2.2%) or age-based (26.4%) medication substitutions were appropriate, while most duplicate drug (98%), patient allergy (96.5%), and formulary substitution (82.5%) alerts were appropriate. Discussion Despite warnings of potential significant harm, certain categories of alert overrides were inappropriate >75% of the time. The vast majority of duplicate drug, patient allergy, and formulary substitution alerts were appropriate, suggesting that these categories of alerts might be good targets for refinement to reduce alert fatigue. Conclusion Almost three-quarters of alerts were overridden, and 40% of the overrides were not appropriate. Future research should optimize alert types and frequencies to increase their clinical relevance, reducing alert fatigue so that important alerts are not inappropriately overridden.
A Statistical Approach Reveals Designs for the Most Robust Stochastic Gene Oscillators

The engineering of transcriptional networks presents many challenges due to the inherent uncertainty in the system structure, changing cellular context and stochasticity in the governing dynamics. One approach to address these problems is to design and build systems that can function across a range of conditions; that is they are robust to uncertainty in their constituent components. Here we examine the parametric robustness landscape of transcriptional oscillators, which underlie many important processes such as circadian rhythms and the cell cycle, plus also serve as a model for the engineering of complex and emergent phenomena. The central questions that we address are: Can we build genetic oscillators that are more robust than those already constructed? Can we make genetic oscillators arbitrarily robust? These questions are technically challenging due to the large model and parameter spaces that must be efficiently explored. Here we use a measure of robustness that coincides with the Bayesian model evidence combined with an efficient Monte Carlo method to traverse model space and concentrate on regions of high robustness, which enables the accurate evaluation of the relative robustness of gene network models governed by stochastic dynamics. We report the most robust two and three gene oscillator systems, plus examine how the number of interactions, the presence of auto-regulation, and degradation of mRNA and protein affects the frequency, amplitude and robustness of transcriptional oscillators. We also find that there is a limit to parametric robustness, beyond which there is nothing to be gained by adding additional feedback. Importantly, we provide predictions on new oscillator systems that can be constructed to verify the theory and advance design and modelling approaches to systems and synthetic biology.
Speciation trajectories in recombining bacterial species

While speciation in eukaryotes is well-studied, a controversy over the nature of bacterial species due to recombination between distant strains continues. It is generally agreed that bacterial diversity can be classified into genetically and ecologically cohesive units, but what produces such variation is a topic of intensive research. Recombination may maintain coherent species of frequently recombining bacteria, but the emergence of distinct clusters within a recombining species, and the impact of habitat structure in this process are not well described, limiting our understanding of how new species are created. Here we present a model of bacterial evolution in overlapping habitat space. We show three different outcomes are possible for a pair of clusters, depending on the size of their habitat overlap: fast divergence with little interaction between the clusters, slow divergence with frequent recombination between the clusters, and stationary or near stationary population structure, where the clusters remain at an equilibrium distance for an indefinite time. We fit our model to two data sets. In Streptococcus pneumoniae, we find a genomically and ecologically distinct subset, held at a relatively constant genetic distance from the majority of the population through frequent recombination with it, while in Campylobacter jejuni, we find a minority population we predict will continue to diverge at a higher rate. This approach may predict and define speciation trajectories in multiple bacterial species.
Prevalence of Malnutrition in Hospitalized Patients: a Multicenter Cross-sectional Study

Background Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. Methods A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. Results The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). Conclusion Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Extracellular pH monitoring for use in closed-loop vagus nerve stimulation

Objective. Vagal nerve stimulation (VNS) has shown potential benefits for obesity treatment; however, current devices lack physiological feedback, which limit their efficacy. Changes in extracellular pH (pHe) have shown to be correlated with neural activity, but have traditionally been measured with glass microelectrodes, which limit their in vivo applicability. Approach. Iridium oxide has previously been shown to be sensitive to fluctuations in pH and is biocompatible. Iridium oxide microelectrodes were inserted into the subdiaphragmatic vagus nerve of anaesthetised rats. Introduction of the gut hormone cholecystokinin (CCK) or distension of the stomach was used to elicit vagal nerve activity. Main results. Iridium oxide microelectrodes have sufficient pH sensitivity to readily detect changes in pHe associated with both CCK and gastric distension. Furthermore, a custom-made Matlab script was able to use these changes in pHe to automatically trigger an implanted VNS device. Significance. This is the first study to show pHe changes in peripheral nerves in vivo. In addition, the demonstration that iridium oxide microelectrodes are sufficiently pH sensitive as to measure changes in pHe associated with physiological stimuli means they have the potential to be integrated into closed-loop neurostimulating devices.
The Manifold Fruits of Digitalization - Determining the Literal Value Behind

As digitalization is rewriting the rules of competition, companies need to adapt to external changes or they will be left behind. Indeed, digitalization bears a lot of economic potential and is undoubted to have tremendous impacts on the economy. Many companies already launched digital initiatives. However, most of them lack an understanding of the value digitalization can create. They often neither know the organizational value created, nor define accountability measures or specify targets. Therefore, as a first step this paper aims to provide clarity by relating digital benefits listed in literature and highlighting the underlying value drivers. Our results help companies to identify digital business value, but also lower the hurdles that prevent them from scaling up their digital
The effect of cisapride on total parenteral nutrition-associated cholestasis in rats.

BACKGROUND Cholestasis is a frequent problem in patients on total parenteral nutrition. Cisapride has a prokinetic effect on the biliary system, but its effect on hepatic excretory function is unknown. OBJECTIVES To study the effect of cisapride on TPN-induced cholestasis in a rat model. METHODS Bile flow and bile salt secretion rate were measured in rats given TPN. There were four groups of 8 to 13 animals each. After a one hour baseline period during which all four groups received i.v. saline infusion, two groups received a TPN solution for another 2 hours, while saline was infused in the two control groups. At the beginning of the second hour, 2 mg/kg cisapride was injected i.v. as a bolus into one experimental and one control group. Bile was collected from the common bile duct. RESULTS At the end of the third hour, TPN caused a significant reduction in bile flow (P < 0.02) and bile salt secretion rate (P < 0.001) (61.24 vs. 50.74 microliters/min/kg, and 1.173 vs. 0.799 mumol/min/kg, respectively). Addition of cisapride abolished the cholestatic effect of TPN. CONCLUSIONS Cisapride has a protective effect against TPN-associated cholestasis. This may have clinical significance, and further studies are warranted.
Impact of West African Monsoon convective transport and lightning NO x production upon the upper tropospheric composition: a multi-model study

Abstract. Within the African Monsoon Multidisciplinary Analysis (AMMA), we investigate the impact of nitrogen oxides produced by lightning (LiNOx) and convective transport during the West African Monsoon (WAM) upon the composition of the upper troposphere (UT) in the tropics. For this purpose, we have performed simulations with 4 state-of-the-art chemistry transport models involved within AMMA, namely MOCAGE, TM4, LMDz-INCA and p-TOMCAT. The model intercomparison is complemented with an evaluation of the simulations based on both spaceborne and airborne observations. The baseline simulations show important differences between the UT CO and O3 distributions simulated by each of the 4 models when compared to measurements from the MOZAIC program and fom the Aura/MLS spaceborne sensor. We show that such model discrepancies can be explained by differences in the convective transport parameterizations and, more particularly, the altitude reached by convective updrafts (ranging between ~200–125 hPa). Concerning UT O3, the models exhibit a good agreement with the main observed features. Nevertheless the majority of models simulate low O3 concentrations compared to both MOZAIC and Aura/MLS observations south of the equator, and rather high concentrations in the Northern Hemisphere. Sensitivity studies are performed to quantify the effect of deep convective transport and the influence of LiNOx production on the UT composition. These clearly indicate that the CO maxima and the elevated O3 concentrations south of the equator are due to convective uplift of air masses impacted by Southern African biomass burning, in agreement with previous studies. Moreover, during the WAM, LiNOx from Africa are responsible for the highest UT O3 enhancements (10–20 ppbv) over the tropical Atlantic between 10° S–20° N. Differences between models are primarily due to the performance of the parameterizations used to simulate lightning activity which are evaluated using spaceborne observations of flash frequency. Combined with comparisons of in-situ NO measurements we show that the models producing the highest amounts of LiNOx over Africa during the WAM (INCA and p-TOMCAT) capture observed NO profiles with the best accuracy, although they both overestimate lightning activity over the Sahel.
Adolescent and Parent Perspectives on Medical Decision-Making for Chronic Illness

Introduction: The objective of the study was to assess correlates of adolescent and parent perceptions of their involvement in medical decision-making (MDM). Method: Study participants included 28 pairs of pediatric patients with chronic rheumatologic illnesses and their parents presenting to an outpatient rheumatology clinic. Participants completed measures assessing perceptions of MDM involvement, health consciousness, and decisional conflict. Results: Adolescent health consciousness correlated positively with parent health consciousness and adolescent-valuing involvement. There was a significant positive correlation between adolescents-valuing involvement in medical decisions and perception of actual involvement. Adolescents who perceived themselves as more involved in their care reported less decisional conflict. Parents who wanted to participate in MDM reported greater actual involvement. Discussion: Adolescents who value participation in MDM reported higher levels of actual participation, suggesting their preferences may be considered by providers. Greater engagement in MDM was related to lower decisional conflict for adolescents, suggesting that including adolescents in the MDM process does not necessarily result in confusion or distress.
Ovine uterine space restriction causes dysregulation of the renin–angiotensin system in fetal kidneys

Abstract In ovine pregnancy, uterine space restriction (USR) resulting from decreased space for placental attachment caused intrauterine growth restriction and impaired nephrogenesis. The fetal kidney renin—angiotensin system (RAS) is involved in nephrogenesis, fluid balance, and iron deposition. Angiotensin II exerts its effects via multiple receptors: angiotensin II1-8 receptor type 1 (AT1R) and type 2 (AT2R), and angiotensin II1-7 Mas receptor (MASR). Objective: To test the hypothesis that ovine USR is associated with dysregulation of the fetal renal RAS. Methods: Multiparous pregnant ewes (n = 32), 16 with surgical bifurcated disconnection of one uterine horn to further reduce placental attachment sites, were studied. USR (n = 31) ovine fetuses were compared to nonspace restricted (NSR) singleton controls (n = 22) on gestational day (GD) 120 or GD130, term GD147. Fetal plasma was collected to evaluate plasma renin activity and iron indices. Fetal kidney AT1R, AT2R, and MASR proteins were assessed by Western immunoblotting and immunohistochemistry. Results: AT1R, AT2R, and MASR protein expression was higher in USR at GD130 than aged-matched NSR and USR at GD120, (P < 0.05 all). AT1R and AT2R localization was homogenous throughout proximal and distal tubules in both USR and NSR at both gestational dates. MASR localization was punctate throughout renal cortical structures including tubules and glomeruli in both USR and NSR, shifted to intranuclear at GD130. Plasma renin activity was inversely related to plasma osmolarity (P < 0.02) and was downregulated in USR at GD130 (P < 0.05). Conclusions: By late gestation, USR upregulated renal angiotensin receptor expression, an effect with potential functional implications. Summary Sentence Multifetal gestation-induced intrauterine growth restriction alters expression and localization of fetal renal angiotensin receptors and the associated relationships with fetal plasma chemistries.
Contemporary rates and outcomes of single- vs. dual-coil implantable cardioverter defibrillator lead implantation: data from the Israeli ICD Registry

Aims Dual-coil leads were traditionally considered standard of care due to lower defibrillation thresholds (DFT). Higher complication rates during extraction with parallel progression in implantable cardioverter defibrillator (ICD) technology raised questions on dual coil necessity. Prior substudies found no significant outcome difference between dual and single coils, although using higher rates of DFT testing then currently practiced. We evaluated the temporal trends in implantation rates of single- vs. dual-coil leads and determined the associated adverse clinical outcomes, using a contemporary nation-wide ICD registry. Methods and results Between July 2010 and March 2015, 6343 consecutive ICD (n = 3998) or CRT-D (n = 2345) implantation patients were prospectively enrolled in the Israeli ICD Registry. A follow-up of at least 1 year of 2285 patients was available for outcome analysis. The primary endpoint was all-cause mortality. Single-coil leads were implanted in 32% of our cohort, 36% among ICD recipients, and 26% among CRT-D recipients. Secondary prevention indication was associated with an increased rate of dual-coil implantation. A significant decline in dual-coil leads with reciprocal incline of single coils was observed, despite low rates of DFT testing (11.6%) during implantation, which also declined from 31 to 2%. In the multivariate Cox model analysis, dual- vs. single-coil lead implantation was not associated with an increased risk of mortality [hazard ratio (HR) = 1.23; P= 0.33], heart failure hospitalization (HR = 1.34; P=0.13), appropriate (HR = 1.25; P= 0.33), or inappropriate ICD therapy (HR = 2.07; P= 0.12). Conclusion Real-life rates of single-coil lead implantation are rising while adding no additional risk. These results of single-coil safety are reassuring and obtained, despite low and contemporary rates of DFT testing.
A unique clonal JAK 2 mutation leading to constitutive signalling causes polycythaemia

INSERM U362, Institut Gustave Roussy, Paris XI University, PR1, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France Laboratoire d’Hématologie, CHU Brest, 29609 Brest Cedex, France Laboratoire d’Hématologie, Hôtel Dieu, AP-HP, 75181 Paris Cedex 04, France Ludwig Institute for Cancer Research and Christian de Duve Institute of Cellular Pathology & MEXP Unit, Université Catholique de Louvain, Brussels B-1200, Belgium INSERM E0210, Hôpital Necker, 75743 Paris Cedex 15, France Laboratoire d’Hématologie, Institut Gustave Roussy, 94805 Villejuif Cedex, France Polyclinique d’Hématologie, Hôpital Saint Louis, AP-HP, 75475 Paris Cedex 10, France
Gate-induced vs. implanted body doping impact on Z2-FET DC operation

The impact of the gate-induced virtual and body implanted doping on the DC Z2-FET operation is analyzed under several gate-biasing scenarios. Results are compared with related architectures such as the Shockley and P-I-N diodes or the current-gate thyristor. Gate biasing turns out to be essential to observe the characteristic sharp switch of Z2-FET device.
Advanced characterization technique for the extraction of intrinsic effective mobility in ultra-thin-body strained SOI MOSFETs

An accurate method of extracting intrinsic effective mobility is proposed which considers the parasitic component and floating-body effects. The technique was verified with fabricated ultra-thin body (UTB) strained silicon-on-insulator (sSOI) MOSFETs. The accurate mobility values extracted using the newly proposed technique, were then comparatively analyzed. This novel method corrects the underestimation of mobility produced by the parasitic component and the overestimated mobility resulting from the floating-body effects.
Electronic Structures and Optoelectronic Properties of C/Ge-doped Silicon Nanotubes

The electronic structures and optoelectronic properties of C/Ge-doped single-walled armchair silicon nanotubes were determined by using first-principles calculations in the framework of density-functional theory. In particular, the calculated results indicate that both pure and C/Ge-doped silicon nanotubes display a direct band gap. The band gap is decreased firstly and then increased for the silicon nanotubes doped with C and Ge, respectively. Moreover, the upper of valence band is mainly contributed by the Si-3p states and the lower of conduction band is primarily occupied by the Si-3p states. The state dielectric constant is improved and the optical absorption shows a red-shifted for the C-doped silicon nanotubes, whereas the state dielectric constant is reduced and the optical absorption shows a blue-shifted for the Ge-doped silicon nanotubes. The results provide an useful theoretical guidance for the applications of single-walled armchair silicon nanotubes in optical detectors.