Miracle-dz/UniFAR-FTUs huggingface dataset:
Acellular Dermal Matrix in Irradiated Tissue Expander/Implant–Based Breast Reconstruction: Evidence-Based Review

Background: The benefits of acellular dermal matrix for breast reconstruction have been well described. However, its clinical impact for breast reconstruction in the setting of radiation therapy has not been well reported. Methods: The MEDLINE and EMBASE databases were reviewed for articles published between January of 2005 and February of 2012 on breast reconstruction using acellular dermal matrix in the setting of radiation therapy. The authors also reviewed their institutional experience of consecutive patients who met these criteria between January of 2008 and October of 2011. Results: Thirteen articles were identified for review: three animal studies on acellular dermal matrix and 10 with level III evidence of its use in humans. The 10 clinical studies included 246 irradiated patients. The M. D. Anderson experience included 30 irradiated acellular dermal matrix patients for a total of 276 irradiated patients evaluated in this review. Use of acellular dermal matrix in implant-based breast reconstruction in the setting of radiation therapy did not predispose to higher infection or overall complication rates or prevent bioprosthetic mesh incorporation. However, the rate of mesh incorporation may be slowed. Its use allowed for increased intraoperative saline fill volumes, which improved aesthetic outcomes and allowed patients to awake from surgery with a formed breast. Conclusions: Use of acellular dermal matrix for implant-based breast reconstruction does not appear to increase or decrease the risk of complications, but it might provide psychological and aesthetic benefits. Multicenter or single-center randomized controlled trials that provide high-quality, level I evidence are warranted.
Improving the Blue Response and Efficiency of Multicrystalline Silicon Solar Cells by Surface Nanotexturing

Reducing surface reflectance by surface roughening is critical to improve the efficiency of all kinds of solar cells. In this letter, nanotexturing based on reactive ion etching (RIE) was adopted to increase the blue response and conversion efficiency of multicrystalline silicon (mc-Si) solar cells. After antireflection film deposition, the reflectivity at 400 nm remarkably decreases from 27.76% for acid-textured wafer to 4.46% for RIE-textured wafer. The average conversion efficiency of industrial wafer-scale (15.6 cm × 15.6 cm) mc-Si solar cells increased from 18.10% to 18.72%. This letter presents an effective strategy to improve the efficiency of industrial mc-Si solar cells.
Nutrition in the Cancer Patient: A Review

Effects of cancer on nutrition Many patients with cancer are malnourished (Soukop & Calman 1979, Brennan 1981). However, deterioration in nutritional status occurs late in the progress of cancers at certain sites, e.g. the breast (Whittaker & Clark 1971, Stein et al. 1976, Kopersztych et al. 1976) but at all stages in patients with gastrointestinal cancer (Jubert et al. 1977, Bolton et al. 1975). Weight loss with decrease in body fat and wastage of muscles occurs to a varying degree, and biochemical evidence of multiple vitamin deficiencies has been reported. Superficially, the clinical condition resembles the results of simple food deprivation. However, the derangements in metabolism are often complex and some patients show an elevated resting energy expenditure (Warnold et al. 1978, Bozzetti et al. 1980), disturbance of carbohydrate metabolism (Lundholm et al. 1978, 1982) and generally a failure to adapt to a reduced food intake which is characteristic of cachexia. The aetiology of cachexia is not really understood. It has been suggested (Theologides 1979) that certain tumours produce peptides or other small molecules, the so-called 'toxohormones', which cause metabolic disturbances in host tissue cells with an increase in energy expenditure and the release of amino acids and peptides which can be utilized by tumour tissues (Waterhouse & Kemperman 1971, Holroyde et al. 1975). Experimental evidence in support of this mechanism has been provided (McAllister et al. 1976, Calman et al. 1977).
Modification of gold surface by grafting of poly(ethylene glycol) for reduction in protein adsorption and platelet adhesion

Gold surfaces were first treated in an alkanethiol solution to form self-assembled monolayers (SAMs). The thiolated Au surface was then subjected to Ar plasma pretreatment, followed by air exposure and UV-induced graft polymerization of poly(ethylene glycol) methacrylate (PEGMA) macromonomer. In comparison with the 3-mercaptopropionic acid-2-ethylhexyl ester (MPAEE) SAM, the (3-mercaptoproply)trimethoxysilane (MPTMS) SAM on Au exhibited higher stability under the conditions of Ar plasma pretreatment. The graft concentration of the PEGMA polymer on SAMmodified Au surface increased with increasing PEGMA macromonomer concentration and UV-graft polymerization time. The modified-Au surfaces were characterized by X-ray spectroscopy (XPS), atomic force microscopy (AFM), and water contact angle measurement. The Au surface with a high concentration of grafted PEGMA polymer could completely repel protein adsorption and platelet adhesion.
Design of a transformer-less grid connected hybrid photovoltaic and wind energy system

This paper presents a transformer-less grid-tie hybrid photovoltaic and wind energy system. The proposed hybrid system consists of a wind turbine, a Permanent Magnet Synchronous Machine (PMSM), a three phase diode bridge rectifier, an wind-side converter, Photovoltaic (PV) array, a dc-dc converter, a grid interface inverter and a T-LCL filter. The power extracted from hybrid wind-solar power system is transferred to the grid interface inverter by using a new dc-dc converter topology which is a fusion of CUK and SEPIC converters. This new topology lets the two sources to supply the load individually or simultaneously depending on the availability of the energy sources and keeps common dc voltage constant. As the suggested method is entirely transformer-less, it astonishingly reduces Total Harmonic Distortion (THD) less than 0.5%, minimizes the size of the system and provides efficiency up to 97%. The proposed design is mathematically modeled which is simulated via PSIM software and finally the results are presented to confirm the effectiveness of this hybrid system.
The Immunoglobulin (IgG) Antibody Response to OspA and OspB Correlates with Severe and Prolonged Lyme Arthritis and the IgG Response to P35 Correlates with Mild and Brief Arthritis

ABSTRACT In an effort to implicate immune responses to specificBorrelia burgdorferi proteins that may have a role in chronic Lyme arthritis, we studied the natural history of the antibody response to B. burgdorferi in serial serum samples from 25 patients monitored throughout the course of Lyme disease. In these patients, the immunoglobulin G (IgM) and IgG antibody responses to 10 recombinant B. burgdorferi proteins, determined during early infection, early arthritis, and maximal arthritis, were correlated with the severity and duration of maximal arthritis. The earliest responses were usually to outer surface protein C (OspC), P35, P37, and P41; reactivity with OspE, OspF, P39, and P93 often developed weeks later; and months to years later, 64% of patients had responses to OspA and OspB. During early infection and early arthritis, the levels of IgG antibody to P35 correlated inversely with the subsequent severity or duration of maximal arthritis. In contrast, during periods of maximal arthritis, the levels of IgG antibody to OspA and OspB, especially to a C-terminal epitope of OspA, correlated directly with the severity and duration of arthritis. Thus, the higher the IgG antibody response to P35 earlier in the infection, the milder and briefer the subsequent arthritis, whereas during maximal arthritis, the higher the IgG response to OspA and OspB, the more severe and prolonged the arthritis.
Management of real‐time streaming data Grid services

We discuss our message‐based approach to managing real‐time data streams and building higher level services to produce and consume them. Our messaging system acts as a substrate that can be used to provide qualities of service to various streaming applications ranging from audio–video collaboration systems to sensor Grids. The messaging substrates are composed of distributed, hierarchically arranged message broker networks. Services such as filters are deployed along the edges of the network. We discuss the role of management systems for both broker networks and filter services: broker network topologies must be created and maintained, and distributed filters must be arranged in appropriate sequences. These managed broker networks may be applied to a wide range of problems. We discuss applications to audio–video collaboration in some detail and also describe applications to streaming Global Positioning System data streams. These provide specific application filters that can transform and republish message streams to the broker system. Copyright © 2006 John Wiley & Sons, Ltd.
A fluid of multidimensional objects.

This paper contains a variational formulation of the theory of a perfect fluid composed of multidimensional objects in space-time of arbitrary dimension; a nonstandard variational principle is based on the discussion of the Noether identity related to covariance of the Lagrangian under the action of diffeomorphisms of space-time. The initial-value problem and the boundary conditions are considered.
An immunologic model in laboratory animals for the study of Neisseria gonorrhoeae.

The controlled in vivo testing of gonococcal antigens, which in the past has been limited by the absence of a suitable model in laboratory animals, is important to the development of an effective immunizing agent for gonorrhea. Experimental infections with Neisseria gonorrhoeae have been recently reported, however, in four species of laboratory animals: rabbits, guinea pigs, hamsters, and mice. When the infection in each of these species was considered and the potential use of the species as a laboratory model was evaluated, the guinea pig was found to be the most satisfactory species for study of the immune mechanism of gonococcal infections. Both active and serum-mediated passive immunity were demonstrated in the guinea pig model. Research on gonorrhea, currently the most frequently reported infectious disease in the United States, has been handicapped by lack of a suitable model in laboratory animals. The first confirmed animal infections with Neisseria gonorrhoeae were reported by Miller [1], who succeeded in isolating a strain of gonococcus that was lethal for mice when injected ip. This isolate proved difficult to maintain, since it required frequent blind passages in mice to remain virulent. Miller also reported the ocular infection of rabbits by the direct inoculation of gonococci into the anterior chamber [1], but because of the discomfort to the animal and
The relative roles of DNA damage induced by UVA irradiation in human cells

UVA light (320-400 nm) represents approximately 95% of the total solar UV radiation that reaches the Earth’s surface. UVA light induces oxidative stress and the formation of DNA photoproducts in skin cells. These photoproducts such as pyrimidine dimers (cyclobutane pyrimidine dimers, CPDs, and pyrimidine (6-4) pyrimidone photoproducts, 6-4PPs) are removed by nucleotide excision repair (NER). In this repair pathway, the XPA protein is recruited to the damage removal site; therefore, cells deficient in this protein are unable to repair the photoproducts. The aim of this study was to investigate the involvement of oxidative stress and the formation of DNA photoproducts in UVA-induced cell death. In fact, similar levels of oxidative stress and oxidised bases were detected in XP-A and NER-proficient cells exposed to UVA light. Interestingly, CPDs were detected in both cell lines; however, 6-4PPs were detected only in DNA repair-deficient cells. XP-A cells were also observed to be significantly more sensitive to UVA light compared to NER-proficient cells, with an increased induction of apoptosis, while necrosis was similarly observed in both cell lines. The induction of apoptosis and necrosis in XP-A cells using adenovirus-mediated transduction of specific photolyases was investigated and we confirm that both types of photoproducts are the primary lesions responsible for inducing cell death in XP-A cells and may trigger the skin-damaging effects of UVA light, particularly skin ageing and carcinogenesis.
Newer drugs and earlier treatment: impact on lifetime cost of care for HIV-infected adults

Objective:To determine the component costs of care to optimize treatment with limited resources. Design:We used the Cost-Effectiveness of Preventing AIDS Complications Model of HIV disease and treatment to project life expectancy and both undiscounted and discounted lifetime costs (2010 &OV0556;). Methods:We determined medical resource utilization among HIV-infected adults followed from 1998 to 2005 in northern France. Monthly HIV costs were stratified by CD4 cell count. Costs of CD4, HIV RNA and genotype tests and antiretroviral therapy (ART) were derived from published literature. Model inputs from national data included mean age 38 years, mean initial CD4 cell count 372 cells/&mgr;l, ART initiation at CD4 cell counts less than 350 cells/&mgr;l, and ART regimen costs ranging from &OV0556;760 to 2570 per month. Results:The model projected a mean undiscounted life expectancy of 26.5 years and a lifetime undiscounted cost of &OV0556;535 000/patient (&OV0556;320 700 discounted); 73% of costs were ART related. When patients presented to care with mean CD4 cell counts of 510 cells/&mgr;l and initiated ART at CD4 cell counts less than 500 cells/&mgr;l or HIV RNA more than 100 000 copies/ml, life expectancy was 27.4 years and costs increased 1–2%, to &OV0556;546 700 (&OV0556;324 500 discounted). When we assumed introducing generic drugs would result in a 50% decline in first-line ART costs, lifetime costs decreased 4–6%, to &OV0556;514 200 (&OV0556;302 800 discounted). Conclusion:As HIV disease is treated earlier with more efficacious drugs, survival and thus costs of care will continue to increase. The availability in high-income countries of widely used antiretroviral drugs in generic form could reduce these costs.
Intralesional targeted alpha therapy for metastatic melanoma

This paper reports the development and application of intralesional targeted alpha therapy (TAT) for melanoma, being the first part of a program to establish a new systemic therapy. Rationale Labelling the benign targeting vector 9.2. 27 with 213Bi forms the alpha-immunoconjugate (AIC), which is highly cytotoxic to targeted melanoma cells. Objective To investigate the safety and efficacy of intralesional AIC in patients with metastatic skin melanoma. Findings 16 melanoma patients were recruited. All the patients were positive to the monoclonal antibody 9.2. 27. AIC doses from 50 to 450 ? Ci injected into lesions of different sizes resulted in massive cell death, as observed by the presence of tumour debris. The AIC was very effective in delivering a high dose to the tumour while sparing other tissues. There were no significant changes in blood proteins and electrolytes. There was no evidence of a human-antimouse-antibody reaction. Evidence of significant decline in serum marker melanoma-inhibitory-activity protein (MIA) at 2 weeks post-TAT was observed. Conclusions Intralesional TAT for melanoma was found to be quite safe up to 450 ? Ci, and efficacious at a dose of 200 ? Ci. MIA, apoptosis and ki67 proliferation marker tests all indicated that TAT is a promising therapy for the control of inoperable secondary melanoma or primary ocular melanoma.
Meta-Analysis of Clinical Trials with Copolymer 1 in Multiple Sclerosis

Glatiramer acetate (copolymer 1) was licensed in the USA in 1996 for the treatment of relapsing-remitting multiple sclerosis. In order to assess its efficacy, a meta-analysis of all randomized controlled trials was performed. Two double-blind studies, accounting for a total number of 299 patients, contribute to this analysis. Patients undergoing the treatment have decreased probability of relapse at 12 months (OR 0.17, 95% CI 0.05–0.51, p = 0.002) and of unsustained progression of disability at 24 and 35 months (OR 0.57, 95% CI 0.34–0.95, p = 0.031, and OR 0.50, 95% CI 0.28–0.90, p = 0.019). These data suggest that glatiramer acetate represents an alternative to interferon treatment in relapsing-remitting multiple sclerosis. However, further evidence of efficacy is required to justify its use in clinical practice.
HEAT TRANSFER ON MHD CONVECTIVE FLOW OF HEAT GENERATING/ABSORBING SECOND GRADE FLUID THROUGH POROUS MEDIUM IN A ROTATING PARALLEL PLATES

In this paper, we have considered the heat transfer on the unsteady hydro magnetic convective flow of an incompressible viscous electrically conducting heat generating/ absorbing second grade fluid through porous medium in a rotating parallel plate channel under the influence of uniform transfer magnetic field normal to the channel. The momentum equation for the flow is governed by the Brinkman's model. The analytical solutions for the velocity and temperature distributions are obtained by making use of regular perturbation technique and computationally discussed with reference to flow parameters through the graphs. The skin friction and Nusselt number are also evaluated analytically and computationally discussed with reference to pertinent parameters in detail.
The Soluble Interleukin‐2 Receptor Predicts Mortality in Older Hospitalized Men

BACKGROUND: There is an inverse relationship between the soluble interleukin‐2 receptor (sIL‐2R) and serum albumin, cholesterol, transferrin, prealbumin, and hemoglobin. Inasmuch as low serum albumin and cholesterol have been associated with excess mortality, we hypothesized that elevated sIL‐2R would predict mortality in older adults.
Reducing antibiotic use in children: a randomized trial in 12 practices.

OBJECTIVE To test whether an educational outreach intervention for families and physicians, based on the Centers for Disease Control and Prevention (CDC) principles of judicious antibiotic use, decreases antimicrobial drug prescribing for children younger than 6 years old. Setting. Twelve practices affiliated with 2 managed care organizations (MCOs) in eastern Massachusetts and northwest Washington State. Patients. All enrolled children younger than 6 years old. METHODS Practices stratified by MCO and size were randomized to intervention or control groups. The intervention included 2 meetings of the practice with a physician peer leader, using CDC-endorsed summaries of judicious prescribing recommendations; feedback on previous prescribing rates were also provided. Parents were mailed a CDC brochure on antibiotic use, and supporting materials were displayed in waiting rooms. Automated enrollment, ambulatory visit, and pharmacy claims were used to determine rates of antibiotic courses dispensed (antibiotics/person-year) during baseline (1996-1997) and intervention (1997-1998) years. The primary analysis (for children 3 to <36 months and 36 to <72 months) assessed the impact of the intervention among children during the intervention year, controlling for covariates including patient age and baseline prescription rate. Confirmatory analyses at the practice level were also performed. RESULTS The practices cared for 14 468 and 13 460 children in the 2 study years, respectively; 8815 children contributed data in both years. Sixty-two percent of antibiotic courses were dispensed for otitis media, 6.5% for pharyngitis, 6.3% for sinusitis, and 9.2% for colds and bronchitis. Antibiotic dispensing for children 3 to <36 months old decreased 0.41 antibiotics per person-year (18.6%) in intervention compared with 0.33 (11.5%) in control practices. Among children 36 to <72 months old, the rate decreased by 0.21 antibiotics per person-year (15%) in intervention and 0.17 (9.8%) in control practices. Multivariate analysis showed an adjusted intervention effect of 16% in the younger and 12% in the older age groups. The direction and approximate magnitude of effect were confirmed in practice-level analyses. CONCLUSIONS A limited simultaneous educational outreach intervention for parents and providers reduced antibiotic use among children in primary care practices, even in the setting of substantial secular trends toward decreased prescribing. Future efforts to promote judicious prescribing should continue to build on growing public awareness of antibiotic overuse.
Angiopoietin‐2 is increased in severe sepsis: Correlation with inflammatory mediators

Objective: Angiopoietin (Ang)‐2 is an endothelium‐specific growth factor, regulated by proinflammatory stimuli, that destabilizes vascular endothelium and increases vascular leakage; consequently, Ang‐2 may contribute to sepsis pathophysiology. We have studied 1) serum Ang‐2 levels in critically‐ill patients and investigated potential relationships with inflammatory mediators and indices of disease severity and 2) the effect of sepsis‐related inflammatory mediators on Ang‐2 production by lung endothelium in vitro. Design: Prospective clinical study followed by cell culture studies. Setting: General intensive care unit and research laboratory of a university hospital. Subjects: Human and bovine lung microvascular endothelial cells and 61 patients (32 men). Patients were grouped according to their septic stage as having: no systemic inflammatory response syndrome (n = 6), systemic inflammatory response syndrome (n = 8), sepsis (n = 16), severe sepsis (n = 18), and septic shock (n = 13). Interventions: Cells were exposed to lipopolysaccharide, tumor necrosis factor‐&agr;, and interleukin‐6. Measurements and Main Results: Patients’ serum Ang‐2 levels were significantly increased in severe sepsis as compared with patients with no systemic inflammatory response syndrome or sepsis (p < .05 by analysis of variance). Positive linear relationships were observed with: serum tumor necrosis factor‐&agr; (rs = 0.654, p < .001), serum interleukin‐6 (rs = 0.464, p < .001), Acute Physiology and Chronic Health Evaluation II score (rs = 0.387, p < .001), and Sequential Organ Failure Assessment score (rs = 0.428, p < .001). Multiple regression analysis revealed that serum Ang‐2 is mostly related to serum tumor necrosis factor‐&agr; and severe sepsis. Treatment of human lung microvascular endothelial cells with all mediators resulted in a concentration‐dependent Ang‐2 reduction. Treatment of bovine lung microvascular endothelial cells with lipopolysaccharide and tumor necrosis factor‐&agr; increased Ang‐2 release, and interleukin‐6 reduced basal Ang‐2 levels. Conclusions: First, patients’ serum Ang‐2 levels are increased during severe sepsis and associated with disease severity. The strong relationship of serum Ang‐2 with serum tumor necrosis factor‐&agr; suggests that the latter may participate in the regulation of Ang‐2 production in sepsis. Second, inflammatory mediators reduce Ang‐2 release from human lung microvascular endothelial cells, implying that this vascular bed may not be the source of increased Ang‐2 in human sepsis.