Miracle-dz/UniFAR-FTUs huggingface dataset:
A national mandatory‐split liver policy: A report from the Italian experience

To implement split liver transplantation (SLT) a mandatory‐split policy has been adopted in Italy since August 2015: donors aged 18‐50 years at standard risk are offered for SLT, resulting in a left‐lateral segment (LLS) graft for children and an extended‐right graft (ERG) for adults. We aim to analyze the impact of the new mandatory‐split policy on liver transplantation (LT)‐waiting list and SLT outcomes, compared to old allocation policy. Between August 2015 and December 2016 out of 413 potentially “splittable” donors, 252 (61%) were proposed for SLT, of whom 53 (21%) donors were accepted for SLT whereas 101 (40.1%) were excluded because of donor characteristics and 98 (38.9%) for absence of suitable pediatric recipients. The SLT rate augmented from 6% to 8.4%. Children undergoing SLT increased from 49.3% to 65.8% (P = .009) and the pediatric LT‐waiting list time dropped (229 [10‐2121] vs 80 [12‐2503] days [P = .045]). The pediatric (4.5% vs 2.5% [P = .398]) and adult (9.7% to 5.2% [P < .001]) LT‐waiting list mortality reduced; SLT outcomes remained stable. Retransplantation (HR = 2.641, P = .035) and recipient weight >20 kg (HR = 5.113, P = .048) in LLS, and ischemic time >8 hours (HR = 2.475, P = .048) in ERG were identified as predictors of graft failure. A national mandatory‐split policy maximizes the SLT donor resources, whose selection criteria can be safely expanded, providing favorable impact on the pediatric LT‐waiting list and priority for adult sick LT candidates.
‘Getting used to’ hearing aids from the perspective of adult hearing-aid users

Abstract Objective: To describe getting used to hearing aids from the perspective of adult hearing-aid users. Design: Three focus group discussions were carried out. A topic guide and discussion exercises were used to elicit views on getting used to hearing aids. Discussion was audio recorded, transcribed verbatim, and subjected to qualitative content analysis. Study sample: Adult hearing aid users (n = 16). Results: Participants described getting used to hearing aids as a multi-factorial process which included adjusting to altered sensory input, practical matters such as cleaning and maintenance, and managing the psychosocial impact of hearing-aid use, such as on self-image. Users reported a process of discovering benefits and limitations of hearing aids leading to individual patterns of use that was relatively independent of input from audiologists. Conclusions: Getting used to hearing aids is a challenging multi-factorial process with both psychosocial and practical difficulties besides demands of adjusting to hearing-aid input.
Prognostic Impact of Angiotensin-Converting Enzyme Inhibitors and Receptor Blockers on Recurrent Ventricular Tachyarrhythmias and Implantable Cardioverter–Defibrillator Therapies

Abstract: This study sought to assess the prognostic impact of treatment with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) on recurrences of ventricular tachyarrhythmias in recipients of implantable cardioverter–defibrillators (ICD). Using a large retrospective registry including consecutive ICD recipients with documented episodes of ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2016, those patients treated with ACEi/ARB were compared with patients without. The primary prognostic endpoint was the first recurrence of ventricular tachyarrhythmias and related ICD therapies at 5 years. Multivariable Cox regression analyses were applied within the entire cohort, and thereafter, Kaplan–Meier analyses were performed in propensity-matched subgroups. A total of 592 consecutive ICD recipients were included (81% treated with ACEi/ARB and 19% without). Although ACEi/ARB was associated with no differences in overall recurrence of ventricular tachyarrhythmias, ACEi/ARB was associated with improved freedom from appropriate ICD therapy within multivariable Cox regressions (hazard ratio = 0.666; P = 0.043), especially in patients with index episodes of VF, left ventricular ejection fraction <35%, coronary artery disease, secondary preventive ICD, and glomerular filtration rate <45 mL/min/1.73 m2. In the propensity-matched subgroup, ACEi/ARB still prolonged freedom from appropriate ICD therapies (hazard ratio = 0.380; 95% confidence interval 0.193–0.747; P = 0.005). In conclusion, ACEi/ARB therapy was associated with improved freedom from appropriate ICD therapies.
Deaths Due to Physical Restraint

Almost Free From Restraints Doctors participating in the delivery of healthcare services in care homes have an important role with regard to defining the indication for protective measures, in the sense of freedom-restraining measures (FRM), not only in the context of urgent cases or the emergency setting. Those who know the legal strategies known as the Werdenfelser Weg (Werdenfels care pathway) may from a forensic-psychiatric perspective arrive at the hypothesis that shared responsibility with doctors is considered increasingly less important. The Bochum appeal to avoid FRM, launched on the 24th mental health court west, contains the following: “Freedom restraining measures are not unavoidable. Thanks to a joint initiative of the responsible court and authorities in the rural district Garmisch-Partenkirchen, the local care facility has become almost entirely free from using restraints within two years. ” A publication by the Freiburg Institute for Applied Social Sciences (AGP (Alter, Gesellschaft, Partizipation. Institut für angewandte Sozialforschung, Freiburg) provides the information that a study project entitled “Reducing freedom restraining measures,” funded by the Federal Ministry of Family Affairs, Senior Citizens, Women and Youth (German: Bundesministerium für Familie, Senioren, Frauen und Jugend), showed that during the study period, FRM were either not used at all in up to 20% of affected care home residents, or the duration of their use was restricted. Effective alternatives were developed and tested. However, even if in one in five care home residents, FRM can be avoided and substituted with alternative solutions, numerous care home residents will still require such measures for their own protection. It is therefore of the utmost importance to conduct these measures in a technically correct way, and that the treating physicians retain a technically advisory, evaluating function.
Annual Review of Cell and Developmental Biology Cell Sheet Morphogenesis : Dorsal Closure in Drosophila melanogaster as a Model System

Dorsal closure is a key process during Drosophila morphogenesis that models cell sheet movements in chordates, including neural tube closure, palate formation, and wound healing. Closure occurs midway through embryogenesis and entails circumferential elongation of lateral epidermal cell sheets that close a dorsal hole filled with amnioserosa cells. Signaling pathways regulate the function of cellular structures and processes, including Actomyosin and microtubule cytoskeletons, cell-cell/cell-matrix adhesion complexes, and endocytosis/vesicle trafficking. These orchestrate complex shape changes and movements that entail interactions between five distinct cell types. Genetic and laser perturbation studies establish that closure is robust, resilient, and the consequence of redundancy that contributes to four distinct biophysical processes: contraction of the amnioserosa, contraction of supracellular Actomyosin cables, elongation (stretching? ) of the lateral epidermis, and zipping together of two converging cell sheets. What triggers closure and what the emergent properties are that give rise to its extraordinary resilience and fidelity remain key, extant questions. 169 Click here to view this article's online features: • Download figures as PPT slides • Navigate linked references • Download citations • Explore related articles • Search keywords ANNUAL REVIEWS Further A nn u. R ev . C el l D ev . B io l. 20 17 . 3 3: 16 920 2. D ow nl oa de d fr om w w w . a nn ua lr ev ie w s. or g A cc es s pr ov id ed b y Sa m H ou st on S ta te U ni ve rs ity o n 10 /0 7/ 17 . F or p er so na l u se o nl y. CB33CH08-Kiehart ARI 5 September 2017 6:40
Review: New insights into optimizing chemical and 3D surface structures of carbon electrodes for neurotransmitter detection

The carbon-fiber microelectrode has been used for decades as a neurotransmitter sensor. Recently, new strategies have been developed for making carbon electrodes, including using carbon nanomaterials or pyrolyzing photoresist etched by nanolithography or 3D printing. This review summarizes how chemical and 3D surface structures of new carbon electrodes are optimized for neurotransmitter detection. There are effects of the chemical structure that are advantageous and nanomaterials are used ranging from carbon nanotube (CNT) to graphene to nanodiamond. Functionalization of these materials promotes surface oxide groups that adsorb dopamine and dopants introduce defect sites good for electron transfer. Polymer coatings such as poly(3,4-ethylenedioxythiophene) (PEDOT) or Nafion also enhance the selectivity, particularly for dopamine over ascorbic acid. Changing the 3D surface structure of an electrode increases current by adding more surface area. If the surface structure has roughness or pores on the micron scale, the electrode also acts as a thin layer cell, momentarily trapping the analyte for redox cycling. Vertically-aligned CNTs as well as lithographically-made or 3D printed pillar arrays act as thin layer cells, producing more reversible cyclic voltammograms. A better understanding of how chemical and surface structure affects electrochemistry enables rational design of electrodes. New carbon electrodes are being tested in vivo and strategies to reduce biofouling are being developed. Future studies should test the robustness for long term implantation, explore electrochemical properties of neurotransmitters beyond dopamine, and combine optimized chemical and physical structures for real-time monitoring of neurotransmitters.
Use of natural ingredients in Japanese quail diet and their effect on carcass and meat quality — A review

The present paper reviews the findings of different research studies on the effect of natural ingredients in the Japanese quail (Coturnix coturnix japonica) diet on carcass characteristics and meat quality. The results show a relationship between the type and concentration of ingredients used in diets and carcass characteristics and meat quality. The inclusion of medicinal herbs (thyme, black seed, and mint), plants (canola), seeds (chickpea), spices (cinnamon and coriander), worms (earthworms), bee products (propolis), phytochemicals (lycopene), and edible fungi (common mushrooms) in the diet improved carcass quality characteristics compared to the control diets (basal diets). The inclusion of medicinal herbs (spearmint and green tea), spices (cinnamon), vegetables (tomato), plants (verbena and canola), seeds (marijuana), and edible fungi (oyster mushrooms) improved meat quality. In conclusion, the use of ingredients of natural origin in the diet of Japanese quail improves carcass quality characteristics and meat quality.
Atrophy, oxidative switching and ultrastructural defects in skeletal muscle of the ataxia telangiectasia mouse model

ABSTRACT Ataxia telangiectasia is a rare, multi system disease caused by ATM kinase deficiency. Atm-knockout mice recapitulate premature aging, immunodeficiency, cancer predisposition, growth retardation and motor defects, but not cerebellar neurodegeneration and ataxia. We explored whether Atm loss is responsible for skeletal muscle defects by investigating myofiber morphology, oxidative/glycolytic activity, myocyte ultrastructural architecture and neuromuscular junctions. Atm-knockout mice showed reduced muscle and fiber size. Atrophy, protein synthesis impairment and a switch from glycolytic to oxidative fibers were detected, along with an increase of in expression of slow and fast myosin types (Myh7, and Myh2 and Myh4, respectively) in tibialis anterior and solei muscles isolated from Atm-knockout mice. Transmission electron microscopy of tibialis anterior revealed misalignments of Z-lines and sarcomeres and mitochondria abnormalities that were associated with an increase in reactive oxygen species. Moreover, neuromuscular junctions appeared larger and more complex than those in Atm wild-type mice, but with preserved presynaptic terminals. In conclusion, we report for the first time that Atm-knockout mice have clear morphological skeletal muscle defects that will be relevant for the investigation of the oxidative stress response, motor alteration and the interplay with peripheral nervous system in ataxia telangiectasia. Summary: A skeletal muscle defect is revealed as novel phenotype of Atm-knockout mice, which is relevant for ataxia telangiectasia disease studies and for the role of ATM in oxidative stress, atrophy and aging.
Biomarkers of ovarian reserve in childhood and adolescence: A systematic review

Certain medical disorders as well as their management may affect gonadal function. Recent advances in the management of these conditions accompanied by the availability and success of methods of fertility preservation has highlighted the need for assessment of ovarian reserve in childhood and adolescence. Serum anti‐Mullerian hormone (AMH) and antral follicle count are well established markers of ovarian reserve and serum inhibin has also been used. However, literature on reference ranges for ovarian reserve markers in this age‐group is relatively scarce. Thus, our aim was to evaluate published data to estimate reference values of ovarian reserve makers in childhood and adolescence.
Clinical Practice Guideline Summary for Clinicians: The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea

Clinical Practice Guideline Summary for Clinicians: The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea Martha E. Billings, Vidya Krishnan, George Su, Lucas M. Donovan, Sanjay R. Patel, David W. Hudgel, Amy M. Ahasic, Kevin C. Wilson, and Carey C. Thomson Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington; Division of Pulmonary, Critical Care and Sleep Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio; Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, San Francisco, California; Division of Pulmonary and Critical CareMedicine, University of Pittsburgh, Pittsburgh, Pennsylvania; University of Manitoba,Winnipeg, Manitoba, Canada; Section of Pulmonary and Critical Care Medicine, Department of Medicine, Norwalk Hospital and Western Connecticut Health Network, Norwalk, Connecticut; Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Division of Pulmonary and Critical Care, Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts; and Harvard Medical School, Boston, Massachusetts
Autonomic impairment of patients in coma with different Glasgow coma score assessed with heart rate variability

ABSTRACT Primary objective: The objective of this study is to assess the functional state of the autonomic nervous system in healthy individuals and in individuals in coma using measures of heart rate variability (HRV) and to evaluate its efficiency in predicting mortality. Design and Methods: Retrospective group comparison study of patients in coma classified into two subgroups, according to their Glasgow coma score, with a healthy control group. HRV indices were calculated from 7 min of artefact-free electrocardiograms using the Hilbert–Huang method in the spectral range 0.02–0.6 Hz. A special procedure was applied to avoid confounding factors. Stepwise multiple regression logistic analysis (SMLRA) and ROC analysis evaluated predictions. Results: Progressive reduction of HRV was confirmed and was associated with deepening of coma and a mortality score model that included three spectral HRV indices of absolute power values of very low, low and very high frequency bands (0.4-0.6 Hz). The SMLRA model showed sensitivity of 95.65%, specificity of 95.83%, positive predictive value of 95.65%, and overall efficiency of 95.74%. Conclusions: HRV is a reliable method to assess the integrity of the neural control of the caudal brainstem centres on the hearts of patients in coma and to predict patient mortality.
Effect of decompressive craniectomy on intracranial pressure and cerebrospinal compensation following traumatic brain injury.

OBJECTIVE Decompressive craniectomy is an advanced treatment option for intracranial pressure (ICP) control in patients with traumatic brain injury. The purpose of this study was to evaluate the effect of decompressive craniectomy on ICP and cerebrospinal compensation both within and beyond the first 24 hours of craniectomy. METHODS This study was a retrospective analysis of the physiological parameters from 27 moderately to severely head-injured patients who underwent decompressive craniectomy for progressive brain edema. Of these, 17 patients had undergone prospective digital recording of ICP with estimation of ICP waveform-derived indices. The pressure-volume compensatory reserve (RAP) index and the cerebrovascular pressure reactivity index (PRx) were used to assess those parameters. The values of parameters prior to and during the 72 hours after decompressive craniectomy were included in the analysis. RESULTS Decompressive craniectomy led to a sustained reduction in median (interquartile range) ICP values (21.2 mm Hg [18.7; 24.2 mm Hg] preoperatively compared with 15.7 mm Hg [12.3; 19.2 mm Hg] postoperatively; p = 0.01). A similar improvement was observed in RAP. A significantly lower mean arterial pressure (MAP) was needed after decompressive craniectomy to maintain optimum cerebral perfusion pressure (CPP) levels, compared with the preoperative period (99.5 mm Hg [96.2; 102.9 mm Hg] compared with 94.2 mm Hg [87.9; 98.9 mm Hg], respectively; p = 0.017). Following decompressive craniectomy, the PRx had positive values in all patients, suggesting acquired derangement in pressure reactivity. CONCLUSIONS In this study, decompressive craniectomy led to a sustained reduction in ICP and improvement in cerebral compliance. Lower MAP levels after decompressive craniectomy are likely to indicate a reduced intensity of treatment. Derangement in cerebrovascular pressure reactivity requires further studies to evaluate its significance and influence on outcome.
Long-term immune effects of high-level natural radiation on Yangjiang inhabitants in China

Abstract Purpose: Low dose radiation was found to perturb immune function or inflammatory reactions, which required further study. This study aimed to evaluate the health effects following long-term low dose radiation by detecting levels of peripheral blood lymphocyte subsets and serum cytokines of residents living in the Yangjiang High Background Radiation Area (HBRA). Materials and methods: Flow cytometry was used to detect peripheral blood T lymphocytes and its subsets (CD4+ T, CD8+ T lymphocyte) in 100 healthy female residents selected from HBRA and a Control Area (CA), respectively. Thirty cytokines or receptors and CRP levels were measured using antibody arrays in the 40 subjects described above. Subjects were chosen based on an age and BMI match between the two groups. Cytokine expression levels were then verified using ELISA methods. Result: In comparison to CA, CD8+ T lymphocyte numbers were significantly increased with cumulative dose following adjustment to age and BMI. Of the 30 selected targets, 22 indexes were measurable and inflammatory cytokines such as IFN-γ, IL-α, MCP-1, sIL-6R, EGFR, and CRP levels were observed to be significantly up-regulated with cumulative doses. ELISA results confirmed the cytokine array results and found CRP, MCP-1, and sIL-6R levels are linear with cumulative dose following adjustment to age and BMI. Conclusion: Immune function was found to be affected in humans exposed to long-term low dose radiation. Specifically, we observed an increase in CD8+T lymphocyte numbers and an up-regulation of inflammatory biomarkers, including IFN-γ, MCP-1, sIL-6R, EGFR, CRP.
Relationship Between Low‐Density Lipoprotein Cholesterol and Lipoprotein(a) Lowering in Response to PCSK9 Inhibition With Evolocumab

Background Beyond their potent LDL (low‐density lipoprotein) cholesterol (LDL‐C)–lowering efficacy (50–60%), PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors also reduce Lp(a) (lipoprotein[a]) levels by 25% to 30%, suggesting a 2:1 response ratio. We aimed to characterize the relationship between LDL‐C and Lp(a) lowering by evolocumab, a PCSK9 inhibitor, in a large clinical trial population and to determine the prevalence of concordant/discordant LDL‐C and Lp(a) responses to PCSK9 inhibition. Methods and Results Data were analyzed from 4 randomized, 12‐week, multicenter, phase 3 evolocumab trials. Patients with familial hypercholesterolemia, nonfamilial hypercholesterolemia, or statin intolerance participated in the trials. The main measure was the degree of concordance or discordance of LDL‐C and Lp(a) in response to PCSK9 inhibition; concordant response was defined as LDL‐C reduction >35% and Lp(a) reduction >10%. The study cohort comprised 895 patients (438 female; median age: 59.0 years [interquartile range: 51–66 years]). Baseline mean level of LDL‐C was 133.6 mg/dL (SE: 1.7) and median Lp(a) level was 46.4 mg/dL (interquartile range: 18.4–82.4 mg/dL). A discordant response was observed in 165 (19.7%) patients. With these cutoffs, the prevalence of discordance was higher when considering baseline Lp(a) concentrations >30 mg/dL (26.5%) or >50 mg/dL (28.6%). Conclusions We demonstrate high prevalence of discordance in LDL‐C and Lp(a) reduction in response to evolocumab, particularly when considering higher baseline Lp(a) concentrations, indicating the possibility of alternative pathways beyond LDLR (LDL receptor)–mediated clearance involved in Lp(a) reduction by evolocumab. Clinical Trial Registration URL: http://www.clinicaltrials. gov. Unique identifiers: NCT01763827, NCT01763866, NCT01763905, NCT01763918.
Ki-67 labeling index as a predictor of response to neoadjuvant chemotherapy in breast cancer

AIMS To investigate Ki-67 index with regard to its ability to predict achievement of pathologic complete response (pCR) to neoadjuvant chemotherapy (NACT) in breast cancer patient. MATERIAL AND METHODS It was a prospective observational study, conducted in Department of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Center (RGCIRC), New Delhi from February 2014 to March 2016. A total of 134 patients with Stage II/III breast cancer who underwent NACT followed by surgery at our center were enrolled and analyzed. Before starting the treatment, clinical, tumor-related and treatment-related factors were recorded. Response evaluation was done clinically and radiologically after completion of NACT and pathologically on the surgical specimen. We calculated Ki-67 cut-off of 35% to label it as high by area under Receiver operating characteristic curve analysis for prediction of pCR. RESULTS Clinical complete response (cCR) was observed in 35/134 (26.1%) patients while pCR was observed in 32/134 (23.9%) patients. On univariate analysis, higher grade (III), high Ki-67 index (>35%) and number of chemotherapy cycles (>3) were associated with better CCR rates. On multivariate analysis, number of chemotherapy cycles (>3) and high Ki-67 index (>35%) were independent predictive factors. For the predictive factors of pCR, univariate analysis showed grade (III), estrogen receptor/progesterone receptor negativity, HER-2 positivity, number of chemotherapy cycles (>3), TNBC and high Ki-67 index (>35%) to be associated with higher pCR rates. On multivariate analysis, Ki-67 index >35% and HER-2 positivity were the only independent predictive factors of pCR. CONCLUSIONS We suggest 35% as best cut-off for Ki-67 expression for predicting response to NACT and achievement of pCR. Validation of this cut-off is required in larger studies.