Miracle-dz/UniFAR-FTUs huggingface dataset:
Optimising the treatment of hyperphosphatemia and vascular calcification in chronic kidney disease

Accelerated atherosclerosis and vascular calcifications (VC) play a central role in the pathogenesis of cardiovascular disease in chronic kidney disease (CKD) patients. Mineral metabolism disorders and increased serum calcium-phosphate product have been recently investigated as inducing factors of cardiovascular calcification. In fact, cardiovascular disease in renal failure appears greatly associated with bone metabolism alterations. Recently, the treatment of hyperphosphatemia in CKD patients changed from either calcium- or aluminium-based phosphate-binders to new free-calcium and aluminium phosphate binders, such as sevelamer hydrochloride and lanthanum carbonate. Therefore, control of serum phosphate in CKD patients becomes crucial in preventing increases in calcium-phosphate product, secondary hyperparathyroidism and ultimately VC.
Breath analysis in critically ill patients: potential and limitations

Breath tests are attractive since they are noninvasive and can be repeated frequently in the dynamically changing state of critically ill patients. Volatile organic compounds can be produced anywhere in the body and are transported via the bloodstream and exhaled through the lung. They can reflect physiologic or pathologic biochemical processes such as lipid peroxidation, liver disease, renal failure, allograft rejection, and dextrose or cholesterol metabolism. This review describes the diagnostic potential of endogenous organic volatile substances in the breath of critically ill patients. Since many of these patients require ventilatory support, aspects of breath analysis under mechanical ventilation will be addressed. Analytical procedures, problems concerning the physiologic meaning of breath markers and future developments will be discussed.
p53 mutations are confined to the comedo type ductal carcinoma in situ of the breast. Immunohistochemical and sequencing data.

BACKGROUND Mutations in the p53 tumor suppressor gene have been identified in breast and many other carcinomas. It is not clear, however, when these mutations occur during breast carcinogenesis. Overexpression of 53 protein has been reported in some ductal carcinoma in situ (DCIS) lesions. To further study the overexpression of p53 in DCIS of the breast and correlate these findings with changes at the molecular level, we performed p53 immunostaining and direct sequencing in noncomedo and comedo DCIS. EXPERIMENTAL DESIGN Archival blocks were obtained on cases of noncomedo DCIS, (including encysted, noninvasive papillary carcinoma) and comedo DCIS. Immunohistochemical staining with the p53 antibody DO7 was performed on all cases. Polymerase chain reaction (PCR) amplification of exons 5, 6, and 7 of the p53 gene was performed and the PCR products were directly sequenced. Four comedo DCIS cases that were p53 immunopositive were further screened for p53 mutations by PCR/single strand conformation polymorphism in exons 8 and 9 of the p53 gene. One of these cases showing a mobility shift was directly sequenced. RESULTS We examined 39 lesions including comedo DCIS (N = 12) and noncomedo DCIS (N = 27), the latter including 17 encysted noninvasive papillary carcinomas. Immunostaining with DO7 was positive in 4 of 12 comedo DCIS lesions (33%) while all noncomedo lesions including encysted noninvasive papillary carcinomas were negative. Direct sequencing of PCR products confirmed wild-type DNA in exons 5 and 6 in all noninvasive papillary carcinomas, 3 randomly selected noncomedo DCIS lesions, and 4 p53 antibody-positive comedo DCIS lesions. In these latter 4 cases, wild-type DNA sequences were preserved in exon 7 for all cases. A single case had a conformational shift in exon 8 within the four cases screened in exons 8 and 9. Direct DNA sequencing of this exon revealed a G to A point mutation resulting in an arginine-to-histidine substitution at codon 273 of the protein. CONCLUSIONS Our results suggest that mutant p53 protein accumulation in preinvasive lesions is limited to comedo (high grade) DCIS and that p53 positivity by immunohistochemistry does not correlate in all cases with specific p53 mutations in exons 5 to 9, the most highly conserved regions of this gene.
Unchanging public order policing in changing times in East Africa

This article offers a political analysis of the practices and motives of public order policing in Ethiopia and Uganda. It offers an explanation of the continuation of forceful tactics against political protest in a context of changing methods of information gathering, organisation and mobilisation by urban activists resulting from their access to internet and communication technology. It finds the two regimes, as anocracies, are caught between legally allowing protest and yet, conscious of their fragility, determined to crush opposition. For the latter approach, their militarist leaderships rely heavily on continued police violence. The paper concludes that failure of the police to adapt their public order policing to the new protest environment leaves them increasingly ineffective and unpopular. It is likely to provoke an escalation of violence and may both undermine the legitimacy of their regimes and reverse their attempts to open political space that justified their rebellions against former autocracies.
Effects of seated double-poling ergometer training on aerobic and mechanical power in individuals with spinal cord injury.

OBJECTIVE To determine whether regular interval training on a seated double-poling ergometer can increase physical capacity and safely improve performance towards maximal level in individuals with spinal cord injury. METHODS A total of 13 subjects with spinal cord injury (injury levels T5-L1) performed 30 sessions of seated double-poling ergometer training over a period of 10 weeks. Sub-maximal and maximal double-poling ergometer tests were performed before (test-retest) and after this training period. Oxygen uptake was measured using the Douglas Bag system. Three-dimensional kinematics were recorded using an optoelectronic system and piezoelectric force sensors were used to register force in both poles. RESULTS The mean intra-class correlation coefficient for test-retest values was 0.83 (standard deviation 0.11). After training significant improvements were observed in people with spinal cord injury in oxygen uptake (22.7%), ventilation (20.7%) and blood lactate level (22.0%) during maximal exertion exercises. Mean power per stroke and peak pole force increased by 15.4% and 23.7%, respectively. At sub-maximal level, significantly lower values were observed in ventilation (-12.8%) and blood lactate level (-25.0%). CONCLUSION Regular interval training on the seated double-poling ergometer was effective for individuals with spinal cord injury below T5 level in terms of improving aerobic capacity and upper-body power output. The training was safe and did not cause any overload symptoms.
Class-E Half-Wave Zero dv/dt Rectifiers for Inductive Power Transfer

This paper analyses and compares candidate zero dv/dt half-wave Class-E rectifier topologies for integration into multi-MHz inductive power transfer (IPT) systems. Furthermore, a hybrid Class-E topology comprising advantageous properties from all existing Class-E half-wave zero dv/dt rectifiers is analyzed for the first time. From the analysis, it is shown that the hybrid Class-E rectifier provides an extra degree of design freedom that enables optimal IPT operation over a wider range of operating conditions. Furthermore, it is shown that by designing both the hybrid and the current-driven rectifiers to operate below resonance provides a low deviation input reactance and inherent output voltage regulation with duty cycle allowing efficient IPT operation over wider dc load range than would otherwise be achieved. A set of case studies demonstrated the following performances: First, for a constant dc load resistance, a receiving end efficiency of 95% was achieved when utilizing the hybrid rectifier, with a tolerance in required input resistance of 2.4% over the tested output power range (50–200 W). Second, for a variable dc load in the range of 100–10%, the hybrid and current-driven rectifiers presented an input reactance deviation less than 2% of the impedance of the magnetizing inductance of the inductive link respectively and receiving end efficiencies greater than 90%. Third, for a constant current in the receiving coil, both the hybrid and the current-driven rectifier achieve inherent output voltage regulation in the order of 3% and 8% of the nominal value, respectively, for a variable dc load range from 100% to 10%.
Perioperative Fluid Management and Clinical Outcomes in Adults

The administration of IV fluid to avoid dehydration, maintain an effective circulating volume, and prevent inadequate tissue perfusion should be considered, along with the maintenance of sleep, pain relief, and muscular relaxation, a core element of the perioperative practice of anesthesia. Knowledge of the effects of different fluids has increased in recent years, and the choice of fluid type in a variety of clinical situations can now be rationally guided by an understanding of the physicochemical and biological properties of the various crystalloid and colloid solutions available. However, there are few useful clinical outcome data to guide this decision. Deciding how much fluid to give has historically been more controversial than choosing which fluid to use. A number of clinical studies support the notion that an approach based on administering fluids to achieve maximal left ventricular stroke volume (while avoiding excess fluid administration and consequent impairment of left ventricular performance) may improve outcomes. In this article, we review the available fluid types and strategies of fluid administration and discuss their relationship to clinical outcomes in adults.
Hormonal Prevention of Hereditary Breast Cancer

Women who carry a mutation in the BRCA1 or BRCA2 genes face a lifetime risk of developing breast cancer that approaches 80%. Among women with predisposing BRCA mutations, the risk of breast cancer is influenced by environmental factors and by modifying genes. Through the study of cohorts of female BRCA1 and BRCA2 carriers, several modifying factors have been identified. The risk of breast cancer is increased by early parity and is decreased by breast feeding, by oophorectomy, and by cigarette smoking. Many of the stragegies for breast cancer prevention involve estrogen deprivation and it is important to consider the acute and long‐term effects of induced menopause in young women at high risk for breast cancer. There are no data so far on whether hormonal replacement therapy is hazardous in carriers of BRCA mutations.
Selected Principals' Perceptions of the Importance of the National Policy Board for Educational Administration's Initially Recommended Foundational Areas of Learning for Principal Education

SELECTED PRINCIPALS' PERCEPTIONS OF THE IMPORTANCE OF THE NATIONAL POLICY BOARD FOR EDUCATIONAL ADMINISTRATION'S INITIALLY RECOMMENDED FOUNDATIONAL AREAS OF LEARNING FOR PRINCIPAL EDUCATION by Anthony Thomas Hussey This study was undertaken to determine selected principals' perceptions of the importance of the NPBEA’s initially recommended seven foundational areas of learning and associated topics to be included in doctoral programs for preservice preparation of principals. A secondary purpose of the study was to determine the amount of coverage of the foundational areas and associated topics in the preparation programs of the selected principals. National samples of U.S. public elementary and secondary school principals were surveyed over a 14 week period. Except for four topics, both groups of principals perceived the areas and topics to be important. Both groups perceived an additional eight topics to be less important than the other, topics. There was no significant difference between the elementary and secondary school principals' perceptions of the importance of the areas and topics. Except for two areas and one topic, both groups of principals did not perceive the seven foundational areas and associated topics to have been covered in their preparation programs. Both groups perceived an additional seven topics to have been covered more than the other areas and topics. Generally, the principals perceived the areas and topics to be important, but a corresponding high degree of coverage for the areas and topics in the principals' preparation programs had not been perceived. Conclusions of the study indicated the NPBEA had correctly identified a large number of topics that practicing principals perceive to be important and that should be included in one core curriculum for preparation of principals. Additionally, more detailed investigations should be completed to determine why principals perceive the topics concerned with demographic changes, organizational theory, and research to be of lower importance than the other NPBEA topics. In support of claims in the literature, preparation programs of both elementary and secondary school principals are not relevant and are inadequate in many instances because the programs do not cover to the required degree the NPBEA's foundational areas and associated topics that the principals perceive to be important. iii INSTITUTIONAL REVIEW BOARD This is to certify that the following study has been filed and approved by the Institutional Review Board of East Tennessee State University. Title of Grant or Project: Selected Principals1 Perception of the importance of _the National Policy Board.for Educational Administration1 s.Initially Recommended Foundational Areas of Learning for Principal Education Principal Investigator: Anthony T. Hussey Department: Educational Leadership and Policy Analysis Date Submitted: November 1989 Institutional Review Board Approval: u a . Anthony J.DeLucia, Ph.D. chairman, IRB
Pay-for-performance programs in family practices in the United Kingdom.

BACKGROUND In 2004, after a series of national initiatives associated with marked improvements in the quality of care, the National Health Service of the United Kingdom introduced a pay-for-performance contract for family practitioners. This contract increases existing income according to performance with respect to 146 quality indicators covering clinical care for 10 chronic diseases, organization of care, and patient experience. METHODS We analyzed data extracted automatically from clinical computing systems for 8105 family practices in England in the first year of the pay-for-performance program (April 2004 through March 2005), data from the U.K. Census, and data on characteristics of individual family practices. We examined the proportion of patients deemed eligible for a clinical quality indicator for whom the indicator was met (reported achievement) and the proportion of the total number of patients with a medical condition for whom a quality indicator was met (population achievement), and we used multiple regression analysis to determine the extent to which practices achieved high scores by classifying patients as ineligible for quality indicators (exception reporting). RESULTS The median reported achievement in the first year of the new contract was 83.4 percent (interquartile range, 78.2 to 87.0 percent). Sociodemographic characteristics of the patients (age and socioeconomic features) and practices (size of practice, number of patients per practitioner, age of practitioner, and whether the practitioner was medically educated in the United Kingdom) had moderate but significant effects on performance. Exception reporting by practices was not extensive (median rate, 6 percent), but it was the strongest predictor of achievement: a 1 percent increase in the rate of exception reporting was associated with a 0.31 percent increase in reported achievement. Exception reporting was high in a small number of practices: 1 percent of practices excluded more than 15 percent of patients. CONCLUSIONS English family practices attained high levels of achievement in the first year of the new pay-for-performance contract. A small number of practices appear to have achieved high scores by excluding large numbers of patients by exception reporting. More research is needed to determine whether these practices are excluding patients for sound clinical reasons or in order to increase income.
Seabird community structure in a coastal tropical environment: importance of natural factors and fish aggregating devices (FADs)

In tropical waters, productivity is low and seabirds only feed at the surface, often in association with sub-surface predators. We studied the distribution and abundance of seabirds in the coastal marine environment around Reunion Island, SW Indian Ocean, between February 2001 and October 2002. We investigated the distribution and abundance of birds at sea with respect to the effects of natural factors, such as bathymetry, distance to the shore, season and associations with sub- surface predatory schools, and the presence of anchored fish aggregating devices (FADs). A total of 13 572 birds of 15 species were observed, 8 of which were rare. Among the 7 abundant species, lesser noddies appeared to favour the shelf area. Barau's petrels and sooty terns were more abundant off- shore, and wedge-tailed shearwaters, Audubon's shearwaters, white-tailed tropicbirds and brown noddies were present over all habitats. When foraging, most species searched for prey solitarily or in very small groups. When feeding, they were generally in large multi-species flocks, especially when feeding events occurred in association with sub-surface predatory schools. Associations with surface- feeding schools of tunas, mainly skipjack, increased the abundance of most seabird species that fed on small fish or squids. The notable exception was for the white-tailed tropicbird, which was rarely found in association with sub-surface predators and, when associated, preferentially selected dolphin pods rather than tuna schools. Although they were often associated with tuna schools, lesser noddies were also strongly concentrated on the shelf, feeding on small pelagic schools. While the aggregat- ing power of FADs on pelagic fish has previously been demonstrated, the associations between schools of sub-surface predators and seabirds were not more frequent close to FADs. However, 2 seabird species were more abundant close to FADs when feeding, and 1 when foraging, suggesting that they may occasionally take advantage of the attractive power of FADs. Seasonal variations in the occurrence of associations indicated a turn-over of fish species that induced variations in the nature of the associations, with the greatest aggregating power of dolphin fish in spring during their peak of abundance in the vicinity of the island.
Granulosa cells regulate oocyte intracellular pH against acidosis in preantral follicles by multiple mechanisms

Mammalian oocytes grow within ovarian follicles in which the oocyte is coupled to surrounding granulosa cells by gap junctions. We report here that growing oocytes isolated from mouse preantral follicles are incapable of recovering from an experimentally induced acidosis, and that oocytes acquire the ability to manage acid loads by activating Na+/H+ exchange during growth. By contrast, granulosa cells from similar preantral follicles possess substantial Na+/H+ exchange capacity, which is attributable to the simultaneous action of two Na+/H+ exchanger isoforms: NHE1 and NHE3. Granulosa cells were also found to possess a V-type H+-ATPase that drives partial acidosis recovery when Na+/H+ exchange is inactivated. By monitoring intracellular pH (pHi) in small follicle-enclosed oocytes, we found that the oocyte has access to each of these acidosis-correcting activities, such that small follicle-enclosed oocytes readily recover from acidosis in a manner resembling granulosa cells. However, follicle-enclosed oocytes are unable to access these activities if gap-junction communication within the follicle is inhibited. Together, these experiments identify the NHE isoforms involved in regulating oocyte pHi, indicate that gap junctions allow granulosa cells to exogenously regulate oocyte pHi against acidosis until the oocyte has acquired endogenous pHi regulation, and reveal that granulosa cells possess multiple mechanisms for carrying out this function.
Tunnel morph model for time frequency bio-signal waveform processing

In this paper, we proposed a tunnel morph model for bio-signal waveform in measuring their similarity. Firstly, the formal specifications of bio-signal waveforms are given. And then, a series of model establishing related definitions are presented. These definitions contain waveform segmentation; waveforms distance measurement, and tunnel width computation. Moreover, on the base of the model, a similarity measuring strategy which takes the curve feature of bio-signal into account was presented. In the end, the strategy was compared with other similarity measurement methods by AECG (Ambulatory Electrocardiogram) waveform data. The data are adopted from MIT/BIH arrhythmia database. Experiment results show that the sensitivity and the positive predictivity of the strategy based on tunnel morph model are prior to other strategies.
Outmigration for coronary bypass surgery in an era of public dissemination of clinical outcomes.

BACKGROUND Since 1989, New York State has disseminated comparative information on outcomes of coronary bypass surgery to the public. It has been suggested that this program played a significant role in the 41% decrease in the risk-adjusted mortality rate between 1989 and 1992. We hypothesized that some high-risk patients had migrated out of state for surgery. METHODS AND RESULTS We reviewed 9442 isolated coronary bypass operations performed from 1989 through 1993 to assess referral patterns of case-mix and outcome. Expected and risk-adjusted mortality rates were computed using logistic regression models derived from the Cleveland Clinic and New York State databases. A mortality comparison was performed using the 1980 to 1988 time period as a historical control. Patients from New York (n=482) had a higher frequency of prior open heart surgery (44.0%) than patients from Ohio (n=6046) (21.5%, P<.001), other states (n=1923) (37.4%, P=.008), and other countries (n=991) (17.3%, P<.001). They were also more likely to be in NYHA functional class III or IV (47.6% versus Ohio 42.7%, P=.037; other states, 41.2%, P=.011; other countries, 34.1%, P=.001). The expected mortality rate was thus higher than among other referral cohorts. The observed 5.2% mortality rate among these patients was significantly greater than the 2.9%, 3.1%, and 1.4% mortality rates observed for patients from Ohio (P=.004), other states (P=.028), and other countries (P<.001). These differences in outcome were not apparent between 1980 and 1988 among referrals from within the United States. CONCLUSIONS Public dissemination of outcome data may have been associated with increased referral of high-risk patients from New York to an out-of-state regional medical center.