Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of statins and beta-blocker therapy on mortality after coronary artery bypass graft surgery.

BACKGROUND We conducted a retrospective cohort study of patients after first-time isolated coronary artery bypass graft surgery (CABG) and assessed the impact of a discharge regimen including beta-blockers and statin therapy and their relationship to long-term all cause mortality and major adverse cardiovascular events (MACE). METHODS We identified patients age >18 years, undergoing first time isolated CABG from 1993 to 2005. Patients were identified using the Cardiovascular Information Registry (CVIR). We collected follow-up information at 30, 60, 90 days and yearly follow-up. The registry is approved for use in research by the institutional review broad. RESULTS We identified 5,205 patients who underwent single isolated CABG between January 1993 and December 2005. The mean age was 64.5±9.7 years and over 70% were male. There was a significant difference in the low density lipoproteins (LDL) concentration between those with or without statin medications (134±41.9 mg/dL) (no statin) vs. 126±44.8 mg/dL (with statin), P=0.001. A discharge regimen with statin therapy was associated with and overall reduction in 30 day, 1 year and long-term mortality. In addition, overall the triple ischemic endpoint of death, myocardial infarction (MI) and stroke was also significantly lower in the statin vs. no-statin group. In addition, statin and beta-blockers exerted synergistic effect on overall mortality outcomes short-term and in the long-term. We note that the predictors of overall death include no therapy with statin therapy and age [hazard ratios (HR) 1.1, 95% CI: 1.04-1.078, P<0.001] and presence of renal failure (HR 2.0, P=0.005). The estimated 11-year Kaplan Meier curves for mortality between the two groups starts to diverge immediately post discharge after single isolated CABG and continue to diverge through out the follow-up period. CONCLUSIONS A post-discharge regimen of statins independently reduces overall and 1 year mortality. These results confirm those of earlier studies within a contemporary surgical population and support the current clinical guidelines.
Multiple target sparse reconstruction in TWRI utilizing ghost's aspect dependence feature

In through-the-wall radar imaging (TWRI), the presence of multipath create ghost targets which can adversely affect the image reconstruction process. Unlike genuine targets, ghost positions are aspect dependent which means their position changes with the transceiver location. This paper proposes efficient ghost suppression method exploiting aspect dependence feature with compressive sensing. The signal model is generalized so that the effect of front wall reflection and target-to-target interactions are accommodated. The method does not require the knowledge of the reflecting geometry which makes the scheme more practical. Results show that the proposed methods can greatly suppress multipath ghosts and thus increases signal-to-clutter ratio.
Molecules in Crystals

Tercentenary Lecture delivered by Dr Dorothy F. R. S. , at 10.1 5 a.m. on Saturday 23 July 1960 at Beveridge Hall, University of London In this lecture I wish to describe the structures, as we see them today, of a number of very remarkable crystals. This is a subject that would certainly have interested the early Fellows of this Society and particularly Hooke and Boyle, both of whom carried out experiments on growing crystals, observed the shapes of their faces and speculated on the arrangement of corpuscles within them. In Micrographia, in 1664, Hooke drew pictures of alum, crystals side by side with sheets of globular bodies in hexagonal and cubic arrays, and commented ‘by these kinds of texture, or position of globular bodies, may you find out all the variety of regular shapes, into which the smooth surfaces of Alum are form’d . nor does it hold only in superficies, but in solidity also, for it’s obvious that a fourth Globule laid upon the third in this texture, composes a regular Tetrahedron, which is a very usual Figure of the Crystals of Alum’. Boyle imagined the integral parts of a body might have a variety of shapes, not only globular. Among the Qualifications that conduce to Fixity, he suggested would be ‘the ineptitude of the component corpuscles for avolation, by reason of their branchedness, irregular figures, crookedness, or other inconvenient shape, which intangles the particles among one another, and makes them difficult to be extricated’.
Domestic violence: the "rule of thumb": 2008 Western Trauma Association presidential address.

Domestic violence among women of child-bearing age has been estimated to be the leading cause of serious injury and the second-leading cause of injury and death in the United States. The rate of injury to women from battering was described as greater than that of motor vehicle crash and mugging combined. It is not a new problem to modern society, discussions of intimate partner violence date back centuries. The long-term sequelae, include health risks, posttraumatic stress disorder, depression, and the economic costs for health care, and the economic loss to victims are staggering. Despite the frequency and severity of domestic violence on its victims and our society, the response of the medical community to address the issue of domestic violence has been characterized as “slow and inconsistent. ”
Predicting Language Outcomes at 4 Years of Age: Findings From Early Language in Victoria Study

OBJECTIVE: To quantify the contributions of child, family, and environmental predictors to language ability at 4 years. METHODS: A longitudinal study was performed with a sample of 1910 infants recruited at 8 months in Melbourne, Australia. Predictors were child gender, prematurity, birth weight and order, multiple birth, socioeconomic status, maternal mental health, vocabulary, education, and age at child's birth, non–English-speaking background, and family history of speech/language difficulties. Outcomes were Clinical Evaluation of Language Fundamentals-Preschool, language scores, low language status (scores >1.25 SDs below the mean), and specific language impairment (SLI) (scores >1.25 SDs below the mean for children with normal nonverbal performance). RESULTS: A total of 1596 children provided outcome data. Twelve baseline predictors explained 18.9% and 20.9% of the variation in receptive and expressive scores, respectively, increasing to 23.6% and 30.4% with the addition of late talking status at age 2. A total of 20.6% of children (324 of 1573 children) met the criteria for low language status and 17.2% (251 of 1462 children) for SLI. Family history of speech/language problems and low maternal education levels and socioeconomic status predicted adverse language outcomes. The combined predictors discriminated only moderately between children with and without low language levels or SLIs (area under the curve: 0.72–0.76); this improved with the addition of late talking status (area under the curve: 0.78–0.84). CONCLUSIONS: Measures of social disadvantage helped explain more variation in outcomes at 4 years than at 2 years, but ability to predict low language status and SLI status remained limited.
COPD‐X Australian and New Zealand guidelines for the diagnosis and management of chronic obstructive pulmonary disease: 2017 update

Introduction: Chronic obstructive pulmonary disease (COPD) is characterised by persistent respiratory symptoms and chronic airflow limitation, and is associated with exacerbations and comorbidities. Advances in the management of COPD are updated quarterly in the national COPD guidelines, the COPD‐X plan, published by Lung Foundation Australia in conjunction with the Thoracic Society of Australia and New Zealand and available at http://copdx.org. au.
Estimation of State and Measurement Noise Covariance Matrices by Multi-Step Prediction

Abstract Estimation of noise covariance matrices for linear or nonlinear stochastic dynamic systems is treated. The novel off-line technique for estimation of the covariance matrices of the state and measurement noises is designed. The technique is based on the multi-step prediction error and on knowledge of the system initial condition and it takes an advantage of the well-known standard relations from the area of state estimation techniques and least square method. The theoretical results are illustrated in numerical examples.
Distributed multi-agent based approaches

The paper presents different approaches for building of multi-agent architectures for intelligent networks and applying of the multi-agent technologies to e-learning area. Here, three different multi-agent architectures are presented. In this approach, we discuss some basic problems related to the developing of multi-agent systems and their application. We will schematically apply our approach to the technological frame in an e-learning system.
Motion compensation in extremity cone-beam CT using a penalized image sharpness criterion

Cone-beam CT (CBCT) for musculoskeletal imaging would benefit from a method to reduce the effects of involuntary patient motion. In particular, the continuing improvement in spatial resolution of CBCT may enable tasks such as quantitative assessment of bone microarchitecture (0.1 mm–0.2 mm detail size), where even subtle, sub-mm motion blur might be detrimental. We propose a purely image based motion compensation method that requires no fiducials, tracking hardware or prior images. A statistical optimization algorithm (CMA-ES) is used to estimate a motion trajectory that optimizes an objective function consisting of an image sharpness criterion augmented by a regularization term that encourages smooth motion trajectories. The objective function is evaluated using a volume of interest (VOI, e.g. a single bone and surrounding area) where the motion can be assumed to be rigid. More complex motions can be addressed by using multiple VOIs. Gradient variance was found to be a suitable sharpness metric for this application. The performance of the compensation algorithm was evaluated in simulated and experimental CBCT data, and in a clinical dataset. Motion-induced artifacts and blurring were significantly reduced across a broad range of motion amplitudes, from 0.5 mm to 10 mm. Structure similarity index (SSIM) against a static volume was used in the simulation studies to quantify the performance of the motion compensation. In studies with translational motion, the SSIM improved from 0.86 before compensation to 0.97 after compensation for 0.5 mm motion, from 0.8 to 0.94 for 2 mm motion and from 0.52 to 0.87 for 10 mm motion (~70% increase). Similar reduction of artifacts was observed in a benchtop experiment with controlled translational motion of an anthropomorphic hand phantom, where SSIM (against a reconstruction of a static phantom) improved from 0.3 to 0.8 for 10 mm motion. Application to a clinical dataset of a lower extremity showed dramatic reduction of streaks and improvement in delineation of tissue boundaries and trabecular structures throughout the whole volume. The proposed method will support new applications of extremity CBCT in areas where patient motion may not be sufficiently managed by immobilization, such as imaging under load and quantitative assessment of subchondral bone architecture.
Acid Rain: China, United States, and a Remote Area

The composition of precipitation in China is highly influenced by fossil fuel combustion and agricultural and cultural practices. Compared to the eastern United States, precipitation in China generally has higher concentrations of sulfate, ammonium, and calcium. Wet deposition rates of sulfur in China are 7 to 130 times higher than those in a remote area in the Southern Hemisphere. In many areas of the world, significant ecological changes have occurred in ecosystems that have acid deposition rates substantially less than those currently existing in China.
La gestión de calidad total y la orientación al mercado: dos culturas de gestión clave para la competitividad de las empresas asturianas

El objetivo central de este trabajo es analizar el efecto combinado de la gestion de la calidad total y de la orientacion al mercado en el logro de ventajas competitivas. El estudio, que se basa en la informacion proporcionada por una muestra de empresas asturianas, analiza las practicas de GCT desde la perspectiva del modelo EFQM, referente inexcusable en el contexto europeo. Las evidencias empiricas obtenidas permiten confirmar que las empresas que adoptan simultaneamente ambas filosofias de gestion consiguen sistematicamente resultados superiores a los de su competencia. Con el objetivo de ofrecer lineas concretas de actuacion, el estudio tambien reflexiona sobre aquellos aspectos de la gestion desarrollados de modo insuficiente desde la perspectiva de la gestion de la calidad total y de la orientacion al mercado. Asi mismo, se incluyen las principales barreras para la puesta en practica de un programa de gestion de calidad total.
Sharing decision making about cardiac surgery: improving the quality of the decision to undergo or forego surgery.

Aortic valve replacement surgery is the only available treatment option able to improve survival in patients with symptomatic and severe aortic valve stenosis. Without surgical intervention, patients with symptomatic dyspnea and severe aortic valve stenosis have a median survival less than 2 years. In an ideal, patient-centered healthcare system, the decision whether to undergo risky yet potentially life-prolonging surgery should not only reflect judicious application of the evidence of safety and efficacy of the surgery, but it also should be consistent with the patient’s clinical and personal contexts, and their goals, values, and preferences for life and healthcare. Article see p 533 The report by Bach et al1 is the latest in their series of investigations to uncover why cardiac valve replacement surgery is underused among eligible candidates. In this report, they seek explanations among patient, clinician, and hospital-level characteristics and suggest the following hypothesis: clinicians, particularly cardiologists, are making apparently inconsistent judgments as to which patients should be referred to cardiac surgeons for consideration of aortic valve replacement. Among 191 patients with severe aortic valve stenosis who did not undergo cardiac surgery, a cardiologist evaluated 182 (95%), but referred only 57 (30%) to a cardiac surgeon. In this editorial, we will place this finding in the context of the evolving field of shared decision-making and suggest how this focus could improve the quality of care delivered to patients with valvular heart disease. Shared decision making is a 3-step process.2 The first step involves knowledge transfer. In its idealized form, shared decision making requires symmetrical and bidirectional exchange of information between patients and clinicians. This exchange aims to identify and distinguish the available options under consideration, including the option of no treatment. The other 2 steps require the patient and clinician to (1) actively engage in deliberating (ie, …
Consensus analysis of high-order linear swarm systems over random topologies

Consensus problems of discrete-time high-order linear swarm systems over random topologies are considered. Based on the relative information of neighboring agents, distributed dynamic consensus protocols are proposed. The state space decomposition method is applied to discrete-time high-order linear swarm systems, a necessary and sufficient condition for consensus over random topologies with probability 1 is given and the explicit expression of the consensus function is presented. Numerical simulations are shown to demonstrate theoretical results.
Formation control of quadrotors with extended feedback linearization based on consensus problem

This paper aims formation control of quadrotors with an extended feedback linearization technique. In the framework of an existing consensus problem, double integrators can achieve arbitrary shape of formation. The extended feedback linearization technique is able to convert the reference point of a quadrotor dynamics into four double integrators with respect to the position in the space and the yaw angle. In contrast to the traditional exact feedback linearization, the extended feedback linearization of the quadrotor does not require the jerk where the jerk is derivative of the acceleration and is difficult to measure or estimate. Numerical examples illustrate the reference points and the mass centers of the quadrotors achieve formation.
Biological Mechanisms in Palatogenesis and Cleft Palate

Clefts of the palate are common birth defects requiring extensive treatment. They appear to be caused by multiple genetic and environmental factors during palatogenesis. This may result in local changes in growth factors, extracellular matrix (ECM), and cell adhesion molecules. Several clefting factors have been implicated by studies in mouse models, while some of these have also been confirmed by genetic screening in humans. Here, we discuss several knockout mouse models to examine the role of specific genes in cleft formation. The cleft is ultimately caused by interference with shelf elevation, attachment, or fusion. Shelf elevation is brought about by mesenchymal proliferation and changes in the ECM induced by growth factors such as TGF-βs. Crucial ECM molecules are collagens, proteoglycans, and glycosaminoglycans. Shelf attachment depends on specific differentiation of the epithelium involving TGF-β3, sonic hedgehog, and WNT signaling, and correct expression of epithelial adhesion molecules such as E-cadherin. The final fusion requires epithelial apoptosis and epithelium-to-mesenchyme transformation regulated by TGF-β and WNT proteins. Other factors may interact with these signaling pathways and contribute to clefting. Normalization of the biological mechanisms regulating palatogenesis in susceptible fetuses is expected to contribute to cleft prevention.
A Framework for Providing Redundancy and Robustness in Key Management for IPsec Security Associations in a Mobile Ad-Hoc Environment

This research investigated key management in a Mobile Ad Hoc Network (MANET) environment. At the time this research began key management schemes provided limited functionality and low service availability in a highly partitioned ad hoc environment. The purpose of this research was to develop a framework that provides redundancy and robustness for Security Association (SA) establishment between pairs of nodes. The key contribution of this research is the Key Management System (KMS) framework and, more specifically, the unique way the various components are integrated to provide the various functionalities. The KMS overcomes the limitations of previous systems by (1) minimizing pre-configuration, (2) increasing service availability, (3) and increasing flexibility for new nodes joining the network. A behavior grading scheme provides the network with a system-wide view of the trustworthiness of nodes and enables the KMS to dynamically adjust its configuration according to its environment. The introduction of behavior grading allows nodes to be less dependent on strict identity verification. This KMS was simulated with Monte Carlo and NS2 simulations and was shown to interoperate with IP Security (IPsec) to enable the establishment of IPsec SAs. The simulations have proven the effectiveness of the system in providing service to the nodes in a highly partitioned environment.
Intraventricular Cerebrovascular Pathologies of Hydrocephalus and Managements

Cavernous malformations (CM), also called cavernous angiomas and cavernomas, are lowflow vascular malformations that constitute 5-13% of all central nervous system vascular malformations (Moriarity et al., 1999; Raychaudhuri et al., 2005). On the other hand, IVC are rare pathological entities, constituting 2,5-10.8% of cerebral CM (Kivelev et al., 2010). The first report of an IVC was published in 1905 by Finkelnburg. As to our knowledge, so far 102 IVCs have been summarized published cases in the literature (Table-1).
Flooding adds pathogenic Escherichia coli strains to the water sources in southern Khyber Pakhtunkhwa, Pakistan

Purpose: Seasonal rains in Pakistan result in heavy floods across the country, whereby faecal contaminants will be added to the water bodies and cause numerous food-borne outbreaks. The present study was aimed to determine the prevalence of diarrheagenic Escherichia coli (DEC) strains in the water sources. Materials and Methods: Two hundred water samples collected during (2011–2012) were processed for the isolation of E. coli (EC) strains. EC strains were further analysed for antibiotic susceptibility patterns, and pathogroups-specific virulence factors stx1, stx2, stx2c, eae, tir, hlyA, bfpA, estA and eltA were detected using multiplex polymerase chain reaction. Results: Thirty-three percent of the water samples were contaminated with EC pathotypes. Fifty percent (33/66) of the DEC pathotypes were identified as enterotoxigenic EC (ETEC). Seventy-two percent (13/18) of the enteropathogenic EC (EPEC) strains were identified as typical EPEC and 28% (5/18) as atypical EPEC. Eleven percent (7/66) of the Shiga toxin EC (STEC) isolates carried a combination of stx1 and stx2 genes. Summer was found as a peak season with 47% (31/66) for EC pathogroups' activities. Eighty-nine percent of the strains showed resistance against tetracycline. Conclusion: ETEC and EPEC are the primary causes of water contamination in southern regions of Khyber Pakhtunkhwa province, Pakistan. Firm adherence to the prescribed drugs can decrease trends in antibiotic resistance.
Vaccines against malaria – an update

Malaria vaccine discovery and development follow two principal strategies. Most subunit vaccines are designed to mimic naturally acquired immunity that develops over years upon continuous exposure to Plasmodium transmission. Experimental model vaccines, such as attenuated live parasites and transmission‐blocking antigens, induce immune responses superior to naturally acquired immunity. The promises and hurdles of the different tracks towards an effective and affordable vaccine against malaria are discussed.
Lymphocytic CD43 and CD45 bear sulfate residues potentially implicated in cell to cell interactions

CD43 is a major heavily glycosylated lymphocyte surface molecule. It has been shown to play an important role in lymphocyte activation and cell‐cell interactions. Here we demonstrate that in human activated lymphocytes and CEM T cells, CD43 is a sulfated molecule. We also observed that CD45, another lymphocyte surface glycoprotein, is a sulfated molecule. 35SO 42− incorporation would thus appear to be an appropriate labeling method for CD43 and CD45 visualization. Moreover, we show that the level of cell surface protein sulfation can modulate CD43‐mediated homotypic aggregation induced by CD43 monoclonal antibodies. It is well known that glycoprotein sulfation is required for various recognition phenomena. Since there are numerous potential sulfation sites on CD43 and CD45, these residues could play an important role in regulating cell‐cell interactions.
Social Network Sites for Medical Physicists

Social Network Sites (SNS) as a part of Web 2.0 gain increasing importance in social life. There are different types of SNS being more or less adapted to the requirements of professionals. For a selection of six SNS features and services were regarded in respect to the applicability in the professional life, using medical physicists as an example. Services as groups, calendar, literature services, and career functions prove to be of particular convenience. As all Web 2.0 services SNS depend on the contributions and operations of their users.