Miracle-dz/UniFAR-FTUs huggingface dataset:
Post-operative delirium after hip fracture treatment - a review of the current literature

Delirium is a common accompaniment of physical illness in old age, affecting approximately one out of five of those admitted to medical wards, the number being higher for elderly with fractured femurs. Although its existence has long been recognized its exact pathophysiology has not yet been fully elucidated. The present article presents up-to-date information concerning the etiology, pathophysiology, prevention and treatment of the post-operative delirium after hip-fracture treatment. The fact that its diagnosis remains mainly clinical requiring a high index of suspicion, both from nursing and medical staff, results in important under-recognition of the syndrome. Delirium is a medical emergency and if not promptly and urgently treated, or even better prevented, may have serious consequences for the patient and the family members. Proper measures for its prevention and treatment result in shorter hospital stay of the patients, less financial cost and better surgical outcome and rehabilitation of the elderly patient.
Silk/Cotton/Scoured Silk Core Twin Spun Yams

A technique is described for producing a spun silk/cotton/scoured silk continuous filament composite yam by using the spun silk ring spinning frame. This novel com posite yam is called "core twin spun" yam. The tensile and compression properties of a few other yams with different structures are discussed. The core twin spun com bination yam may be useful in developing and designing new materials for the spun silk fabrics.
Recent advances and current state of immunotherapy in systemic lupus erythematosus

ABSTRACT Introduction: Systemic lupus erythematosus (SLE) is an autoimmune syndrome that poses significant challenges in diagnosis and treatment. Dysregulated innate and adaptive immune systems are involved in its pathogenesis. A plethora of novel immunotherapies have been developed for the treatment of SLE but many have failed early clinical trials. Areas covered: This review summarizes immunotherapies under recent development with relevance to the targeted cellular or soluble factors involved in the pathogenesis of SLE. Expert opinion: SLE is a complicated disease with much heterogeneity. Novel immunotherapies with different mechanisms of action that are currently under development include biologic agents targeting co-stimulatory molecules, cytokines or their receptors and signaling molecules and B cells, cell-based therapy and peptide therapy. Together with good scientific rationale and advanced biological engineering techniques, optimization of clinical trial design, patient selection and disease outcome measures are essential to demonstrate the clinical efficacy and safety of these agents.
The role of everolimus in liver transplantation

During the last 5 decades, liver transplantation has witnessed rapid development in terms of both technical and pharmacologic advances. Since their discovery, calcineurin inhibitors (CNIs) have remained the standard of care for immunosuppression therapy in liver transplantation, improving both patient and graft survival. However, adverse events, particularly posttransplant nephrotoxicity, associated with long-term CNI use have necessitated the development of alternate treatment approaches. These include combination therapy with a CNI and the inosine monophosphate dehydrogenase inhibitor mycophenolic acid and use of mammalian target of rapamycin (mTOR) inhibitors. Everolimus, a 40-O-(2-hydroxyethyl) derivative of mTOR inhibitor sirolimus, has a distinct pharmacokinetic profile. Several studies have assessed the role of everolimus in liver transplant recipients in combination with CNI reduction or as a CNI withdrawal strategy. The efficacy of everolimus-based immunosuppressive therapy has been demonstrated in both de novo and maintenance liver transplant recipients. A pivotal study in 719 de novo liver transplant recipients formed the basis of the recent approval of everolimus in combination with steroids and reduced-dose tacrolimus in liver transplantation. In this study, everolimus introduced at 30 days posttransplantation in combination with reduced-dose tacrolimus (exposure reduced by 39%) showed comparable efficacy (composite efficacy failure rate of treated biopsy-proven acute rejection, graft loss, or death) and achieved superior renal function as early as month 1 and maintained it over 2 years versus standard exposure tacrolimus. This review provides an overview of the efficacy and safety of everolimus-based regimens in liver transplantation in the de novo and maintenance settings, as well as in special populations such as patients with hepatocellular carcinoma recurrence, hepatitis C virus-positive patients, and pediatric transplant recipients. We also provide an overview of ongoing studies and discuss potential expansion of the role for everolimus in these settings.
Experimental investigation of non-linear constitutive behavior of PZT piezoceramics

The uni-axial non-linear large signal behavior of PIC 151 soft PZT ceramics was experimentally investigated under a pure electric field, a pure compressive stress and combined electromechanical loading conditions, respectively. Polarisation and strain vs. E field hysteresis loops were observed under a pure cyclic electric field load. The corresponding strain vs. polarisation (S - P) curves also exhibited a significant hysteresis. The material response was found to depend on the loading rate and amplitude of the applied E field. A higher loading rate resulted in a smaller coercive field. Ageing effects caused the remnant polarisation and strain to decrease with time after removing the E field load. As subjected to a pure compressive stress load, the material exhibited non-linear stress-strain behavior. In addition, a non-linear depolarisation curve was observed for the pre-poled specimen. Permanent changes of polarisation and strain induced by the mechanical load could be brought back to their initial values by a subsequent application of an electric field to repolarise the material. Loading rate dependence was also found in the non-linear stress - strain behavior. When being subjected to a constant load, this material exhibited significant time-dependent effects. Polarisation and strain exhibited creep-like behavior with the passage of the external load hold time. Most pronounced time-dependent effects were observed as the load was close to the coercive field or the coercive stress. Polarisation and strain versus electric field hysteresis loops were measured under various levels of a preload compressive stress. It turned out that the superimposed compression load reduced the remnant polarisation, decreased the coercive field and also had a significant impact on the dielectric and piezoelectric properties. High field dielectric permittivity and piezoelectric coefficients were found to be enhanced by the compressive preload within a small range. The improved performance was accompanied by an unfavorable larger hysteresis, which was attributed to larger extrinsic contribution due to more non-180° domain switching induced by the prestress. The effects of a bias electric field on the non-linear stress - strain and stress - depolarisation response were also studied. The non-linear curves were effectively closed upon application of an electric field parallel to the pre-poling direction. Larger stresses were needed to initiate and forward the ferroelastic domain switching. The inverse of this trend occurred when the specimen was subjected to a bias electric field anti-parallel to the pre-poling direction.
Potential Red-Flag Identification of Colorectal Adenomas with Wide-Field Fluorescence Molecular Endoscopy

Adenoma miss rates in colonoscopy are unacceptably high, especially for sessile serrated adenomas / polyps (SSA/Ps) and in high-risk populations, such as patients with Lynch syndrome. Detection rates may be improved by fluorescence molecular endoscopy (FME), which allows morphological visualization of lesions with high-definition white-light imaging as well as fluorescence-guided identification of lesions with a specific molecular marker. In a clinical proof-of-principal study, we investigated FME for colorectal adenoma detection, using a fluorescently labelled antibody (bevacizumab-800CW) against vascular endothelial growth factor A (VEGFA), which is highly upregulated in colorectal adenomas. Methods: Patients with familial adenomatous polyposis (n = 17), received an intravenous injection with 4.5, 10 or 25 mg of bevacizumab-800CW. Three days later, they received NIR-FME. Results: VEGFA-targeted NIR-FME detected colorectal adenomas at all doses. Best results were achieved in the highest (25 mg) cohort, which even detected small adenomas (<3 mm). Spectroscopy analyses of freshly excised specimen demonstrated the highest adenoma-to-normal ratio of 1.84 for the 25 mg cohort, with a calculated median tracer concentration in adenomas of 6.43 nmol/mL. Ex vivo signal analyses demonstrated NIR fluorescence within the dysplastic areas of the adenomas. Conclusion: These results suggest that NIR-FME is clinically feasible as a real-time, red-flag technique for detection of colorectal adenomas.
Impact of a Partial Smoke-Free Legislation on Myocardial Infarction Incidence, Mortality and Case-Fatality in a Population-Based Registry: The REGICOR Study

Background and Objective Coronary heart disease (CHD) is the leading cause of death, and smoking its strongest modifiable risk factor. Our aim was to determine the impact of the Spanish 2006 partial smoke-free legislation on acute myocardial infarction (AMI) incidence, hospitalization and mortality rates, and 28-day case-fatality in Girona, Spain. Methods Using a population-based registry (the REGICOR Study), we compared population incidence, hospitalization, and mortality rates, and 28-day case-fatality in the pre- and post-ban periods (2002–2005 and 2006–2008, respectively) by binomial regression analysis adjusted for confounding factors. We also analyzed the ban's impact on the outcomes of interest using the AMI definitions of the American Heart Association (AHA)/European Society of Cardiology (ESC) and the World Health Organization (WHO)-Monitoring trends and determinants in cardiovascular diseases (MONICA). Results In the post-ban period, AMI incidence and mortality rates significantly decreased (relative risk [RR] = 0.89; 95% confidence interval [CI] = 0.81–0.97 and RR = 0.82; 95% CI = 0.71–0.94, respectively). Incidence and mortality rates decreased in both sexes, especially in women, and in people aged 65–74 years. Former and non-smokers (passive smokers) showed diminished incidence rates. Implementation of the ban was not associated with AMI case-fatality. Models tended to be more significant with the WHO-MONICA than with the AHA/ESC definition. Conclusions The 2006 Spanish partial smoke-free legislation was associated with a decrease in population AMI incidence and mortality, particularly in women, in people aged 65–74 years, and in passive smokers. These results clarify the association between AMI mortality and the enactment of a partial smoke-free legislation and reinforce the effectiveness of smoking regulations in preventing CHD.
High porosity electrospun scaffolds for small diameter vascular graft applications

Porosity, pore size and pore interconnectivity have been shown to be critical factors for cellular infiltration into vascular grafts. While electrospinning has been shown to produce many promising characteristics for the fabrication of vascular graft scaffolds, it has yet to create sufficient porosity for transmural endothelial in-growth. This study was aimed at using dual electrospinning with sacrificial fibre extraction to produce scaffolds with controllable porosity characteristics while maintaining sufficient structural strength to resist deformation during implantation. Scaffolds were subsequently covalently grafted with heparin, a known anti-coagulant with growth-factor binding properties. Poly(ethylene oxide) (PEO) and Pellethane R © (PU) were spun simultaneously and subsequently PEO was selectively extracted to create additional void space within the fibrous structure. Low, medium and high porosity scaffolds (76%±0.2%, 83%±0.5% and 90%±1.0% respectively) along with their heparinized versions were analysed in vitro for pore size, porosity, fibre morphology and mechanical properties; and in vivo for cellular infiltration, vascularisation, collagen deposition and inflammation subcutaneously in male Wistar rats (7,14 and 28 days, n = 6). The tensile strength (σt = −44P + 41 MPa, r=0.96) and elastic modulus (E = −9.2P + 9.0 MPa, r=0.97) of the constructs decreased linearly with increasing porosity (P ) (post PEO removal) and the heparinization process resulted in decreased strength (8.4±4.9MPa to 2.2±1.1 MPa, p<0.02) but slightly increased stiffness (9.0±0.6 MPa to 9.7±1.2 MPa, p<0.001) when compared to non-heparinized scaffolds (100% PU). Calculated compliance values increased with increases in sacrificial fibre fraction (Cd[PU ] = −0.078FFPU + 10.3 %/100mmHg, r = 0.72, p<0.001 and Cd[PU+Hep] = −0.038FFPU + 6.93 %/100mmHg, r = 0.45, p<0.05) and closely matched the compliance values of the human popliteal artery reported in literature. Average pore-size for low, medium and high porosity scaffolds was 4.0±2. 3μm, 9.9±4. 2μm and 11.1±5. 5μm (p<0.0001). Heparinization resulted in increased fibre diameter (3.6±1.1μm vs 1.8±0.8μm, p<0.0001) but did not influence pore-size (p>0.66). Cellular infiltration for low, medium and high porosity scaffolds reached 33±7%, 77±20% and 98±1% of scaffold width respectively by day 28 of implantation (p<0001); hepariniza-
Device Array Layout Synthesis With Nonlinear Gradient Compensation for a High-Accuracy Current-Steering DAC

Mismatches caused by random and systematic variations among identical designed devices usually dominate the performance of analog circuits, where the former can be controlled by increasing area, while the latter should be tackled by careful layout design. Most of existing studies propose analog placement methodologies with the common centroid constraint to mitigate the linear systematic gradient effect. However, nonlinear gradient error compensation should also be addressed for circuits requiring high performance. This paper presents a current source placement algorithm considering quadratic (second order) gradient error for a high-accuracy current-steering digital-to-analog converter to pursue excellent linearity. A new switching scheme and a submatrix swapping technique are proposed to maximize quadratic gradient compensation, and a simulated annealing-based matrix perturbation algorithm is also proposed to directly minimize integral nonlinearity (INL). In addition, to tackle the extremely high complexity of current source interconnections, we model the routing instance as a branch assignment problem and propose an optimal greedy-based algorithm, which is inspired by the well-known left-edge algorithm. The experimental results show an order of magnitude reduction in INL compared to a state-of-the-art nonlinear gradient-aware current source placement approach and better dynamic performance in post-layout simulation.
Nanofat Grafting for Scar Treatment and Skin Quality Improvement

Background: Fat grafting has been gaining attention in tissue augmentation over the past decade, not only for lipofilling, but also for its observed regenerative properties and overall skin texture improvement. Objectives: The aim of this study was to analyze the effect of nanofat grafting on scars, wrinkles, and skin discolorations in our clinic. Methods: Nanofat was prepared by a standard emulsification and filtration protocol. The resulting liquid was injected intradermally or directly into the scar tissue. Skin quality was evaluated based on a scoring system, and patient satisfaction was documented. Three physicians compared and analyzed standardized pre‐ and posttreatment photographs in respect to general improvement of skin aesthetics. Results: Fifty‐two patients were treated with nanofat from November 2013 to April 2016. The mean (± standard deviation) posttreatment follow up was 155 ± 49 days and average volume of harvested fat amounted to 165 cc. The primary harvesting areas were the abdomen and flanks, and the injected volume of nanofat ranged from 1 to 25 mL (mean, 4.6 mL). A total of 40 scars (76% of all patient defects) were effectively treated as well as 6 patients with wrinkles, and 6 patients with discoloration. Posttreatment clinical evaluations showed a marked improvement of scar quality and a high patient satisfaction. The results in our clinic showed that nanofat grafting softened the scars, made discolorations less pronounced, and wrinkles appeared less prominent. Conclusions: Nanofat grafting has been shown to have beneficial effects in the treatment of scars, wrinkles, and skin discolorations. Level of Evidence: 4: Figure. No Caption available.
WSMeter: A Performance Evaluation Methodology for Google's Production Warehouse-Scale Computers

Evaluating the comprehensive performance of a warehouse-scale computer (WSC) has been a long-standing challenge. Traditional load-testing benchmarks become ineffective because they cannot accurately reproduce the behavior of thousands of distinct jobs co-located on a WSC. We therefore evaluate WSCs using actual job behaviors in live production environments. From our experience of developing multiple generations of WSCs, we identify two major challenges of this approach: 1) the lack of a holistic metric that incorporates thousands of jobs and summarizes the performance, and 2) the high costs and risks of conducting an evaluation in a live environment. To address these challenges, we propose WSMeter, a cost-effective methodology to accurately evaluate a WSC's performance using a live production environment. We first define a new metric which accurately represents a WSC's overall performance, taking a wide variety of unevenly distributed jobs into account. We then propose a model to statistically embrace the performance variance inherent in WSCs, to conduct an evaluation with minimal costs and risks. We present three real-world use cases to prove the effectiveness of WSMeter. In the first two cases, WSMeter accurately discerns 7% and 1% performance improvements from WSC upgrades using only 0.9% and 6.6% of the machines in the WSCs, respectively. We emphasize that naive statistical comparisons incur much higher evaluation costs (> 4 times) and sometimes even fail to distinguish subtle differences. The third case shows that a cloud customer hosting two services on our WSC quantifies the performance benefits of software optimization (+9.3%) with minimal overheads (2.3% of the service capacity).
Elastic and frictional properties of graphene

We describe studies of the elastic properties and frictional characteristics of graphene samples of varying thickness using an atomic force microscope. For tensile testing, graphene is suspended over micron‐sized circular holes and indented by atomic force microscope (AFM) tips. Fitting of the force‐displacement curves yields the prestress and elastic stiffness, while comparison of the breaking force to simulation gives the ultimate strength, which is the highest measured for any material. Experiments on samples with 1–3 atomic layers yield similar values for the intrinsic stiffness and strength of a single sheet, but also reveal differences in mechanical behavior with thickness. The frictional force between an AFM tip and graphene decreases with thickness for samples from 1 to 4 layers, and does not depend on the presence of a substrate. High‐resolution friction force imaging in stick‐slip mode shows the same trend, and allows direct imaging of the crystal lattice.
Assessment of tissue fibrosis in skin biopsies from patients with systemic sclerosis employing confocal laser scanning microscopy: an objective outcome measure for clinical trials?

OBJECTIVES To obtain an objective, unbiased assessment of skin fibrosis in patients with SSc for use in clinical trials of SSc disease-modifying therapeutics. METHODS Skin biopsies from the dorsal forearm of six patients with diffuse SSc and six healthy controls, and skin biopsies from the forearm of one patient with diffuse SSc before and following 1 year treatment with mycophenolate mofetil were analysed by confocal laser scanning microscopy (CLSM) with specific antibodies against collagen types I and III or fibronectin. The integrated density of fluorescence (IDF) was calculated employing National Institutes of Health-ImageJ software in at least four different fields per biopsy spanning the full dermal thickness. RESULTS The intensities of collagen types I and III and fibronectin IDF were 174, 147 and 139% higher in SSc skin than in normal skin, respectively. All differences were statistically significant. The sum of the IDF values obtained for the three proteins yielded a comprehensive fibrosis score. The average fibrosis score for the six SSc samples was 28.3 x 10(6) compared with 18.6 x 10(6) for the six normal skin samples (P < 0.0001). Comparison of skin biopsies obtained from the same SSc patient before treatment and after 12 months of treatment with mycophenolate mofetil showed a reduction of 39% in total fibrosis score after treatment. CONCLUSIONS CLSM followed by quantitative image analysis provides an objective and unbiased assessment of skin fibrosis in SSc and could be a useful end-point for clinical trials with disease-modifying agents to monitor the response or progression of the disease.
Phosphorylation of p65 Is Required for Zinc Oxide Nanoparticle–Induced Interleukin 8 Expression in Human Bronchial Epithelial Cells

Background Exposure to zinc oxide (ZnO) in environmental and occupational settings causes acute pulmonary responses through the induction of proinflammatory mediators such as interleukin-8 (IL-8). Objective We investigated the effect of ZnO nanoparticles on IL-8 expression and the underlying mechanisms in human bronchial epithelial cells. Methods We determined IL-8 mRNA and protein expression in primary human bronchial epithelial cells and the BEAS-2B human bronchial epithelial cell line using reverse-transcriptase polymerase chain reaction and the enzyme-linked immunosorbent assay, respectively. Transcriptional activity of IL-8 promoter and nuclear factor kappa B (NFκB) in ZnO-treated BEAS-2B cells was measured using transient gene transfection of the luciferase reporter construct with or without p65 constructs. Phosphorylation and degradation of IκBα, an inhibitor of NF-κB, and phosphorylation of p65 were detected using immunoblotting. Binding of p65 to the IL-8 promoter was examined using the chromatin immunoprecipitation assay. Results ZnO exposure (2–8 μg/mL) increased IL-8 mRNA and protein expression. Inhibition of transcription with actinomycin D blocked ZnO-induced IL-8 expression, which was consistent with the observation that ZnO exposure increased IL-8 promoter reporter activity. Further study demonstrated that the κB-binding site in the IL-8 promoter was required for ZnO-induced IL-8 transcriptional activation. ZnO stimulation modestly elevated IκBα phosphorylation and degradation. Moreover, ZnO exposure also increased the binding of p65 to the IL-8 promoter and p65 phosphorylation at serines 276 and 536. Overexpression of p65 constructs mutated at serines 276 or 536 significantly reduced ZnO-induced increase in IL-8 promoter reporter activity. Conclusion p65 phosphorylation and IκBα phosphorylation and degradation are the primary mechanisms involved in ZnO nanoparticle-induced IL-8 expression in human bronchial epithelial cells.