Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of fentanyl administration on respiratory system compliance in infants

ObjectiveTo determine if the analgesic doses of fentanyl used in a pediatric intensive care unit (ICU) setting adversely affect dynamic total respiratory system compliance in awake, intubated infants. DesignProspective case-control study. SettingPediatric and pediatric cardiac ICUs of a tertiary university hospital. PatientsThirteen awake and mechanically ventilated children <6 months of age. InterventionsMeasurements of dynamic total respiratory system compliance were obtained during steady-state conditions for 6 mins and continued for 10 mins after the rapid, intravenous administration of 4 μg/kg of fentanyl. No patient had received a narcotic, benzodiazepine, or muscle relaxant within the previous 4 hrs. Measurements and Main ResultsAfter fentanyl administration, dynamic total respiratory system compliance was unchanged in three patients, improved in nine patients, and deteriorated in one patient. The mean value for the entire group increased from 0.76 mL/cm H2O/kg before infusion to 0.82 mL/cm H2O/kg after infusion p < . 02), representing a 9.6% increase. None of the patients showed oxygen desaturation as assessed by continuous pulse oximeter, or episodes of chest wall rigidity. ConclusionsThis work corroborates our clinical impression that rapid infusions of fentanyl at the dose tested in small infants do not adversely affect dynamic total respiratory system compliance. To the contrary, the sedating and analgesic effects may improve synchronous breathing and decrease voluntary muscle tone, resulting in improved dynamic total respiratory system compliance.
Comparative effects of permanent biventricular and right-univentricular pacing in heart failure patients with chronic atrial fibrillation.

BACKGROUND One third of chronic heart failure patients have major intraventricular conduction and uncoordinated ventricular contraction. Non-controlled studies suggest that biventricular pacing may improve haemodynamics and well-being by reducing ventricular asynchrony. The aim of this trial was to assess the clinical efficacy and safety of this new therapy in patients with chronic atrial fibrillation. METHODS Fifty nine NYHA class III patients with left ventricular systolic dysfunction, chronic atrial fibrillation, slow ventricular rate necessitating permanent ventricular pacing, and a wide QRS complex (paced width >or=200 ms), were implanted with transvenous biventricular-VVIR pacemakers. This single-blind, randomized, controlled, crossover study compared the patients' parameters, as monitored during two 3-month treatment periods of conventional right-univentricular vs biventricular pacing. The primary end-point was the 6-min walked distance, secondary end-points were peak oxygen uptake, quality-of-life, hospitalizations, patients' preferred study period and mortality. RESULTS Because of a higher than expected drop-out rate (42%), only 37 patients completed both crossover phases. In the intention-to-treat analysis, we did not observe a significant difference. However, in the patients with effective therapy the mean walked distance increased by 9.3% with biventricular pacing (374+/-108 vs 342+/-103 m in univentricular;P =0.05). Peak oxygen uptake increased by 13% (P=0.04). Hospitalizations decreased by 70% and 85% of the patients preferred the biventricular pacing period (P<0.001). CONCLUSION As compared with conventional VVIR pacing, effective biventricular pacing seems to improve exercise tolerance in NYHA class III heart failure patients with chronic atrial fibrillation and wide paced-QRS complexes. Further randomized controlled studies are required to definitively validate this therapy in such patients.
Advocacy coalitions in Brazilian higher education: the role of the main stakeholders in shaping the new social contract for Brazilian higher education

This paper explores the dynamics of coalition building that unifies different stakeholders inside the Brazilian policy system related to higher education using the conceptual framework of the advocacy coalitions as proposed by Sabatier and collaborators. It discusses how “democratic governance” was established as a core value inside some of the coalitions and how it has been converted into a policy taboo (Tannenwald, 1999) against which no “respectable” domestic actor may fight, no matter what international bench marking says. It also explores the constraints this framework has imposed over the development of new policy instruments in the
Structural analysis of the major immediate early gene of human cytomegalovirus

The most abundant species of human cytomegalovirus (Towne) immediate early polysome-associated RNA originates from a region of ca. 2.8 kilobases (0.739 to 0.755 map units) within the XbaI-E DNA fragment. These sequences code for a 1.95-kilobase mRNA and are referred to as immediate early coding region one (M. F. Stinski, D. R. Thomsen, R. M. Stenberg, and L. C. Goldstein, J. Virol. 46:1-14, 1983). We have utilized the nuclease mapping technique of Berk and Sharp (A. J. Berk and P. A. Sharp, Cell 12:721-732, 1977) to examine this gene in detail. Cloned fragments of human cytomegalovirus DNA, either labeled with 32P in vivo or end labeled in vitro at the 5' or 3' termini, were hybridized to immediate early polysome-associated RNA. The hybrids were treated with single-strand-specific nuclease and subjected to electrophoresis in either neutral or denaturing gels. The major transcript was shown to be a spliced molecule containing a 3' terminal exon of 1,341 nucleotides. Upstream of the major body of the mRNA are three small exon sequences of 185, 88, and 121 nucleotides. The sequence of the exons as well as the locations of the intron-exon splice junctions were determined. Based on the DNA sequence, the viral mRNA molecule has one open reading frame which begins within the second exon and extends for 491 amino acid residues. The predicted molecular weight of the polypeptide originating from this region was estimated to be 64,000. It is hypothesized that this viral gene codes for the major regulatory protein controlling transcription of the viral genome at early times. The properties of the viral gene and its protein product are discussed.
The "V3" domain is a determinant of simian immunodeficiency virus cell tropism

Thirty-one different mutant forms of simian immunodeficiency virus (SIVmac) were created with changes in the region of env corresponding to the V3 domain of HIV-1. Sixteen of these mutants had one amino acid change, 12 had two changes, two had three changes, and one had four changes in the SIVmac "V3" loop. The ability of the mutant viruses to replicate in CEMx174 cells, rhesus monkey peripheral blood mononuclear cells, and rhesus monkey alveolar macrophages was investigated. Ten of the mutant viruses replicated with approximately wild-type kinetics in all three cell types. Of the 31 mutants, 22 were able to replicate in one or more of the cell types. Thus, this region of SIVmac gp120 is quite tolerant to change. Nine of the mutants replicated poorly or not at all in any of the cells tested. The lack of replication competence of some of the mutants was associated with inefficient proteolytic processing of the gp160 precursor. Some mutations had dramatic differential effects in different cell types. For example, changing P to S at position 321 and M to I at position 325 drastically reduced replication in macrophages and CEMx174 cells but had no effect on replication in peripheral blood mononuclear cells. Mutants with altered tropism were blocked at an early stage that includes virus entry into cells. Thus, sequences in SIVmac that correspond to V3 in HIV-1 can affect virus entry and cell tropism in a manner analogous to that of HIV-1 V3.
Advances in antiplatelet treatment for acute coronary syndromes

Context Recent publications of TRITON-TIMI (prasugrel) as well as PLATO (ticagrelor) have introduced new and potent antiplatelet agents, but at the same time have left clinicians with multiple choices without clear directions regarding the most appropriate use of these agents. Objective 1. To review the randomized controlled trial evidence examining the role of the three antiplatelet gents in acute coronary syndromes is presented. 2. To provide recommendations for the practicing physician for their optimal use in clinical practice. Data Sources CURE, TRITON-TIMI 38 and PLATO trials. Study Selection Large randomized placebo controlled trials of dual antiplatelet therapy in acute coronary syndromes. Data Extraction From original trials. Results and Conclusions Both prasugrel and ticagrelor are potent antiplatelet agents with improved ischaemic benefits in comparison with clopidogrel. The improved benefit, however, comes at the price of increased bleeding. As such, careful patient selection and balancing of benefit-risk is warranted to optimise their use in clinical practice.
Critical Limb Ischemia: A Practical Up-To-Date Review

Critical limb ischemia (CLI) is the most advanced form of peripheral artery disease. It is associated with significant morbidity and mortality and high management costs. It carries a high risk of amputation and local infection. Moreover, cardiovascular complications remain a major concern. Although it is a well-known entity and new technological and therapeutic advances have been made, this condition remains poorly addressed, with significantly heterogeneous management, especially in nonexperienced centers. This review, from a third-level dedicated inpatient and outpatient cardioangiology structure, aims to provide an updated summary on the topic of CLI of its complexity, encompassing epidemiological, social, economical and, in particular, diagnostic/imaging issues, together with potential therapeutic strategies (medical, endovascular, and surgical), including the evaluation of cardiovascular risk factors, the diagnosis, and treatment together with prognostic stratification.
Human Masseter Muscle Fibers From the Elderly Express Less Neonatal Myosin Than Those of Young Adults

In contrast to limb muscles where neonatal myosin (MyHC‐neo) is present only shortly after birth, adult masseter muscles contain a substantial portion of MyHC‐neo, which is coexpressed with mature MyHC isoforms. Changes in the numerical and area proportion of muscle fibers containing MyHC‐neo in masseter muscle with aging could be expected, based on previously reported findings that (i) developmental MyHC‐containing muscle fibers exhibit lower shortening velocities compared to fibers with exclusively fast MyHC isoforms and (ii) transformation toward faster phenotype occurs in elderly compared to young masseter muscle. In this study, we detected MyHC isoforms in the anterior superficial part of the human masseter muscle in a sufficiently large sample of young, middle‐aged, and elderly subjects to reveal age‐related changes in the coexpression of MyHC‐neo with adult MyHC isoforms. MyHC isoforms were visualized with immunoperoxidase method and the results were presented by (i) the area proportion of fibers containing particular MyHC isoforms and (ii) the numerical proportion of fiber types defined by MyHC‐1, ‐2a, ‐2x, and ‐neonatal isoform expression from a successive transverse sections. We found a lower numerical and area proportion of fibers expressing MyHC‐neo as well as a lower area proportion of fibers containing MyHC‐1 in elderly than in young subjects. We conclude that the diminished expression of MyHC‐neo with age could point to a lower regeneration capacity of masseter muscle in the elderly. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc.
Letter from the Co-Presidents

Over the last decade, the scholarly interest on migration policies has increased exponentially. A significant part of research has focused on case studies (e.g. Délano 2011) or comparative case studies (e.g. Lafleur 2011) while other researchers have compiled migration policy datasets with the goal of constructing indices quantitatively and allowing large-n comparisons (e.g. Gamlen 2006; Vink and Bauböck 2013; Ruhs 2013). This research note deals primarily with the latter kind of effort, not with the main aim of summarizing them (for that, see Scipioni and Urso 2017) or of assessing their quality (for that see for instance Helbling et al. 2013; Goodman 2015; Koopmans 2013; Ellermann 2013). Our goal in this paper is rather to propose concrete paths to move our field forward by reflecting on the information that is still missing in the current and past efforts of data collection and proposing new standards of transparency for the collection of data on migration policy to allow our field to flourish with both scientific rigor and a collaborative spirit.
A Randomized, Placebo-controlled Study of Fentanyl Buccal Tablet for Breakthrough Pain in Opioid-treated Patients With Cancer

ObjectivesCancer-related breakthrough pain (BTP) is typically managed with a short-acting oral opioid, taken as needed during a fixed-schedule opioid regimen. The conventional approach may not provide the onset of analgesia required for BTP for many patients, because the onset of analgesia with short-acting opioids lags behind the time course of the majority of episodes of BTP. The fentanyl buccal tablet (FBT) employs a novel delivery system that enhances the rate and extent of absorption of fentanyl through the buccal mucosa. This double-blind, randomized, placebo-controlled study evaluated the efficacy, safety, and tolerability of FBT in opioid-treated patients with cancer-related BTP. MethodsAfter an open-label titration (N=123) to identify an effective FBT dose to treat BTP episodes, 77 patients were randomly assigned to 1 of 18 prespecified dose sequences of 10 tablets (7 FBT and 3 placebo). Pain intensity, pain relief (PR), and global performance of the medication were recorded at regular time intervals between 15 and 60 minutes. Pain intensity differences (PID), the summed PID (SPID), and summed total PR were calculated. The SPID at 30 minutes (SPID30) was the primary efficacy variable. Adverse events were reported. ResultsSixty-five percent (80/123) of patients were titrated to an effective dose. The mean (SE) SPID30 for FBT was 3.0±0.12 versus 1.8±0.18 for placebo (P<0.0001). Measures of PR, PID, SPID, summed total PR, and patient ratings of global performance of medication significantly favored FBT over placebo at all time points. Adverse events were typical of opioid drugs. Poor oral tolerability was noted in 2 patients. ConclusionsFBT is efficacious and safe in the treatment of cancer-related BTP.
Effect of inhibition of the Na+/H+ exchanger with cariporide on left ventricular function in acute coronary syndromes: results from the echocardiographic substudy of the GUARDIAN trial.

OBJECTIVE To evaluate the effects of inhibition of the Na+/H+ exchanger (NHE) on regional left ventricular dysfunction in patients with a non-ST elevation acute coronary syndrome (ACS) BACKGROUND: NHE inhibition protects against myocardial necrosis and stunning in ischemia-reperfusion models. METHODS AND RESULTS In a substudy of the GUARd During Ischemia Against Necrosis (GUARDIAN) trial, 141 patients with an ACS and wall motion abnormalities on a baseline echocardiogram underwent repeated studies after 48 h and 36 days to determine the extent of early and late recovery of ventricular function. Patients were randomized to cariporide 20 mg, 80 mg or 120 mg intravenously three times per day or placebo for two to seven days. The wall motion score index improved from baseline to day 36 by 0.13+/-0.21, 0.16+/-0.34 and 0.15+/-0.28, respectively, in the cariporide groups, and by 0.10+/-0.16 with placebo (P=0.57). From baseline to 48 h, the wall motion score index decreased by 0.04+/-0.16, 0.08+/-0.20 and 0.03+/-0.22, respectively, for the cariporide groups and by 0.03+/-0.11 with placebo (P=0.09); the number of abnormal chords (centreline method) decreased by 11.2+/-24.0, 9.5+/-24.3 and 8.1+/-27.9, respectively, in the cariporide groups compared with an increase of 0.6+/-20.0 with placebo (P=NS). CONCLUSION No significant benefit of NHE inhibition could be detected in ACS patients in the GUARDIAN trial.
Transforming Growth Factor β1 Expression and Activation Is Increased in the Alcoholic Rat Lung

Alcohol abuse increases the incidence of acute respiratory distress syndrome more than threefold in patients with septic shock. We have shown that chronic ethanol ingestion in a rat model impairs alveolar epithelial barrier function and enhances lung injury during sepsis. We speculated that transforming growth factor β1 (TGFβ1), a pluripotent cytokine implicated in models of epithelial barrier disruption and lung injury, could mediate alveolar epithelial injury in the alcoholic lung. We report that chronic ethanol ingestion (6 weeks) in rats increased both TGFβ1 mRNA and protein tissue expression (p < 0.05), but alone did not induce the release of TGFβ1 into the alveolar space. However, during endotoxemia, ethanol-fed rats released fivefold more TGFβ1 protein (by ELISA, p < 0.05) into the alveolar space than control-fed rats. Furthermore, lung lavage fluid from endotoxemic, ethanol-fed rats had more biologically active TGFβ1 protein than control-fed rats (p < 0.05), as reflected by anti-TGFβ1 antibody-inh.
FRICTO Analysis: A Framework For Making Capital Structure And Financing Decisions

In a seminal paper, Nobel Laureates Modigliani and Miller (1958) advanced the proposition that, based upon several simplifying assumptions, capital structure has no effect on the value of the firm. However, recognizing the impact of taxes, bankruptcy, agency costs, and asymmetric information, capital structure theory has evolved to acknowledge the real world that the use of debt does affect the value of the firm. Modern theories of capital structure can be classified into at least two categories: "static tradeoff models" and the "pecking order hypothesis. " Static tradeoff models imply an optimal debt-equity mix that is determined by a tradeoff between the benefits and costs of debt (e.g., balancing the tax and leverage advantages of debt against the risk of bankruptcy and agency costs). However, as argued by Myers (1998), although "the (static tradeoff) theory may sound right to financial economists, and business people will give it lip service if asked . it may be a weak guide to average behavior. It is not much help in understanding any given firm's decisions. " The pecking order hypothesis implies a hierarchy in raising funds, in which internal financing (retained earnings) is preferred to external financing and, if the firm obtains external financing, debt is preferred to equity. This empirically motivated hypothesis, which has been theoretically supported on the basis of asymmetric information by Myers and Majluf (1984), is consistent with Donaldson's (1961) observation that firms prefer internal financing and have an aversion to issuing common stock. In a survey of the chief financial officers of Fortune 500 companies in the United
Transcriptional analysis, translational analysis, and sequence of the kilA-tellurite resistance region of plasmid RK2Ter

The tellurite resistance (Ter) determinant of the IncP alpha plasmid RK2Ter, a variant of RK2 (also called RP4), is located between the kilA and korA genes involved in plasmid replication control. Transcriptional and translational fusions were constructed between the gene for beta-galactosidase and the kilA and Ter genes by using the transpositional phage mini-Mu. These fusions indicated that the Ter genes are transcribed in the same direction as kilA and that transcription and translation of the cloned kilA gene are occurring and may not be lethal to the bacterial cell even in the absence of korA. The nucleotide sequence of this region was determined, and three open reading frames (ORFs) were identified. The first ORF codes for KilA, a 28-kDa hydrophilic protein. The second ORF, telA, codes for a hydrophilic protein of 42 kDa. The third ORF, telB, codes for a hydrophobic protein of 32 kDa. This protein appears to be located in the inner membrane of the bacterial cell, since fusions of TelB to alkaline phosphatase were obtained by using TnphoA. All three proteins were detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis after overproduction using the T7 RNA polymerase/promoter system. The same three proteins were produced when Tes and Ter derivatives of RP4 were expressed in an in vitro transcription-translation system. A single Ser-to-Cys missense mutation in telB was found to be responsible for mutation of RK2 to Ter.
Variable Resource Dispatch Through Do-Not-Exceed Limit

Due to the variability of renewable resources, the ISO tries to identify do-not-exceed (DNE) limits, which are the maximum renewable generation ranges that the power system can accommodate without sacrificing system reliability. The problem is formulated as an optimization problem whose objective is to find the largest operating ranges of variable resources such that the system remains feasible under any generation realizations within the range. Computing the DNE limits can be conceptually translated into finding the largest uncertain set of a robust optimization problem. Depending on the assumptions on how the system responds to the uncertainty of renewable resources, three alternative approaches are developed to convert the nonstandard robust optimization problem into linear programming, bilinear programming and two-stage robust optimization problems, respectively. Although the linear programming problem is easier to solve as compared to the other two alternatives, its resulting DNE limits are the most conservative. Therefore, the trade-off needs to be considered when deciding which approach is the most appropriate in real-time operation. A 5-bus system and the ISO New England power system are used to test the proposed approaches.
Horizontal Transfer of Tetracycline Resistance among Chlamydia spp. In Vitro

ABSTRACT There are no examples of stable tetracycline resistance in clinical strains of Chlamydia trachomatis. However, the swine pathogen Chlamydia suis is commonly tetracycline resistant, both in America and in Europe. In tested U.S. strains, this resistance is mediated by a genomic island carrying a tet(C) allele. In the present study, the ability of C. suis to mobilize tet(C) into other chlamydial species was examined. Differently antibiotic resistant strains of C. suis, C. trachomatis, and Chlamydia muridarum were used in coculture experiments to select for multiply antibiotic resistant progeny. Coinfection of mammalian cells with a naturally occurring tetracycline-resistant strain of C. suis and a C. muridarum or C. trachomatis strain containing selected mutations encoding rifampin (rifampicin) or ofloxacin resistance readily produced doubly resistant recombinant clones that demonstrated the acquisition of tetracycline resistance. The resistance phenotype in the progeny from a C. trachomatis L2/oflR-C. suis R19/tetR cross resulted from integration of a 40-kb fragment into a single ribosomal operon of a recipient, leading to a merodiploid structure containing three rRNA operons. In contrast, a cross between C. suis R19/tetR and C. muridarum MoPn/oflR led to a classical double-crossover event transferring 99 kb of DNA from C. suis R19/tetR into C. muridarum MoPn/oflR. Tetracycline resistance was also transferred to recent clinical strains of C. trachomatis. Successful crosses were not obtained when a rifampin-resistant Chlamydophila caviae strain was used as a recipient for crosses with C. suis or C. trachomatis. These findings provide a platform for further exploration of the biology of horizontal gene transfer in Chlamydia while bringing to light potential public health concerns generated by the possibility of acquisition of tetracycline resistance by human chlamydial pathogens.