Miracle-dz/UniFAR-FTUs huggingface dataset:
Conservation of Resources: Indications for Intensive Care Monitoring After Upper Airway Surgery on Patients With Obstructive Sleep Apnea

Although significant complications can result after upper airway surgery for obstructive sleep apnea (OSA), there is a lack of consensus regarding the most appropriate level of monitoring in the perioperative period. A retrospective analysis was performed on the operative records of 109 adult patients who underwent 125 surgical procedures from January 1, 1991, to May 31, 1996, with particular emphasis on complications that would have mandated intensive care monitoring and management. Airway complications occurred in one patient (0.8%), who became obstructed immediately after surgery; he responded to naloxone and suctioning. Five other patients (4%) suffered oxygen desaturation to levels below 90% (none fell below 80%, and in only one case was it below the lowest preoperative oxygen saturation level). Cardiac complications, primarily significant hypertension, were the most common adverse events. Four (3.2%) bleeding complications were encountered; all occurred after discharge from the hospital. Routine postoperative intensive care monitoring for all adult patients undergoing upper airway surgery for OSA is unnecessary. Although high‐risk patients cannot always be identified preoperatively, significant complications generally emerge within 2 hours after surgery. Therefore a decision regarding the level of postoperative monitoring needed may be made with confidence during the period of time that the patient is in the recovery room.
Relapse rates in chronic hepatitis B naïve patients after discontinuation of antiviral therapy with entecavir

Registration studies show entecavir (ETV) to be effective and safe in NUC‐naïve patients with chronic hepatitis B, but relapse rates after treatment discontinuation have not been well established. Relapse rates and predictors of relapse were evaluated in naïve HBeAg‐positive and HBeAg‐negative patients treated with ETV. Treatment duration was defined according to international guidelines. Virological relapse was defined as reappearance in serum of hepatitis B virus (HBV) DNA to >2000 IU/mL after discontinuation of treatment. A hundred and sixty‐nine consecutive patients were treated for a median 181 weeks. 61% were HBeAg positive, 23% had cirrhosis, and mean HBV DNA level was 6.88 ± 1.74 log10 IU/mL. Ninety‐two per cent became HBV DNA negative; 71% of HBeAg+ve patients became HBeAg negative and 68% anti‐HBe positive; 14% became HBsAg negative and 13% anti‐HBs positive. At the end of the study, 36 patients discontinued treatment: one due to breakthrough associated with resistant variants and 35 (20%) due to sustained virological response; 33 of these patients developed HBeAg seroconversion and 18 HBsAg seroconversion. Median off‐treatment time was 69 weeks. Nine patients (26%), all HBeAg positive at baseline, developed virological relapse after a median 48 weeks off‐treatment, 3 of them showed HBeAg reversion and 4 lost anti‐HBe. No patient with HBsAg seroconversion relapsed. HBeAg clearance after week 48 of treatment was associated with an increase risk of relapse. After ETV discontinuation, HBsAg seroconversion was maintained in 100% of the patients, HBeAg seroconversion maintained in 90%, and virological relapse rate was 24%.
Stability analysis of interconnected power systems coupled with market dynamics

Summary form only given as follows. The use of market mechanisms to determine generation dispatch, and the natural tendency to seek improved economic efficiency through rapid market updates, raises a critical issue. As the frequency of market-based dispatch updates increases, there will inevitably be interaction between the dynamics of markets determining the generator dispatch commands, and the physical response of generators and network interconnections. This paper examines questions of stability in such coupled systems by means of numeric tests using various market update models, (including detailed generator/turbine/governor dynamics) for the New England 39 bus test system. The results highlight the nature of potential instabilities and show the interaction modes between physical and market quantities through eigenanalysis. Understanding of potential modes of instability in such coupled systems is crucial both for designing suitable rules for power markets and for designing physical generator controls that are compatible with market-based dispatch.
Kicker Magnet System of the RCS in J-PARC

Kicker magnets are installed in the extraction section of the RCS (Rapid Cycling Synchrotron) in J-PARC (Japan Proton Accelerator Research Complex) facility. They extract a 3 GeV proton beam and inject it into a downstream beam transport line at a repetition rate of 25 Hz. The power supply is mainly composed of the charging unit, the pulse forming network, and thyratrons as switching device. The maximum charging voltage is 80 kV. The kicker magnet is a distributed (transmission line) twin-C type. The circuit parameters are designed to have the 10 Omega characteristic impedance. The magnets are installed in vacuum chambers to prevent voltage breakdown. In order to accept 1 MW beam power, strict conditions are imposed on the kicker system. In the first part of this paper, we give an outline of the RCS extraction kicker system. Next, we report the specifications and performance of the power source and magnet. In addition, we report the measurements of the vacuum performance and magnetic field
Characteristic Analysis of Interior Permanent-Magnet Synchronous Motor in Electrohydraulic Power Steering Systems

This paper presents design and analysis results of a 2.6-kW interior permanent-magnet synchronous motor developed for an electrohydraulic power steering system. The motor was designed by using the proposed equivalent magnetic circuit model in consideration with a core loss. To analyze motor characteristics by using the equivalent magnetic circuit model, inductance and iron-loss resistance, which are affected critically by magnetic saturation, are obtained by using finite-element analysis. Finally, motor characteristics such as armature current, torque, and efficiency are calculated by the equivalent magnetic circuit model and verified by experimental results.
Acute Watery Diarrhea as the Initial Presenting Feature of a Pheochromocytoma in an 84-Year-Old Female Patient

We report the case of an 84-year-old woman who was initially admitted to the emergency room of our institution for frank dehydration caused by acute and severe secretory diarrheas along with acidosis and hypokalemia. After extensive gastrointestinal investigations, the etiology of the diarrhea remained unclear. Because clinical symptoms and ionogram parameters worsened, despite intravenous fluids and electrolyte replacement, an abdominal CT scan was performed and unexpectedly revealed a 4.5-cm mass in the right adrenal gland. Several separate 24-hour urine catecholamines were shown to be highly elevated. The diagnosis of pheochromocytoma was confirmed by MIBG scintigraphy and MRI. Before the admission, the patient never experienced symptoms suggestive of pheochromocytoma, except dry mouth and fear of impending death on several occasions. After 2 weeks, the diarrhea stopped abruptly and spontaneously without specific medication but after adequate rehydration. The patient subsequently underwent surgical removal of the adrenal medullary mass. Postoperatively, urinary catecholamines returned to normal values. Immunohistochemical study of the tumor confirmed the diagnosis of pheochromocytoma and revealed the presence of VIP-positive cells organized as islets in scattered areas of the tissue. This case illustrates the protean mode of presentation of pheochromocytoma, as well as the ability of medullary neural crest-derived cells to produce various neuropeptides potentially responsible for a large variety of symptoms.
PGC-1α, SIRT1 and AMPK, an energy sensing network that controls energy expenditure

Purpose of review Peroxisome proliferator-activated receptor gamma coactivator-1-α (PGC-1α) has been extensively described as a master regulator of mitochondrial biogenesis. However, PGC-1α activity is not constant and can be finely tuned in response to different metabolic situations. From this point of view, PGC-1α could be described as a mediator of the transcriptional outputs triggered by metabolic sensors, providing the idea that these sensors, together with PGC-1α, might be weaving a network controlling cellular energy expenditure. In this review, we will focus on how disorders such as type 2 diabetes and the metabolic syndrome might be related to an abnormal and improper function of this network. Recent findings Two metabolic sensors, AMP-activated protein kinase (AMPK) and SIRT1 have been described to directly affect PGC-1α activity through phosphorylation and deacetylation, respectively. Although the physiological relevance of these modifications and their molecular consequences are still largely unknown, recent insight from different in-vivo transgenic models clearly suggests that AMPK, SIRT1 and PGC-1α might act as an orchestrated network to improve metabolic fitness. Summary Metabolic sensors such as AMPK and SIRT1, gatekeepers of the activity of the master regulator of mitochondria, PGC-1α, are vital links in a regulatory network for metabolic homeostasis. Together, these players explain many of the beneficial effects of physical activity and dietary interventions in our battle against type 2 diabetes and related metabolic disorders. Hence, understanding the mechanisms by which they act could guide us to identify and improve preventive and therapeutic strategies for metabolic diseases.
Polarization in Alcohol Consumption among Icelandic Adolescents, 1995–2003

Aims Alcohol use among Icelandic adolescents has declined substantially in the last decade. This paper evaluates the source of this decline by examining changes in the frequency and quantity of adolescent alcohol consumption in the period 1995–2003. Data and Methods The total population of 10th grade (15–16-year-olds) students in Iceland was surveyed in 1995, 1999 and 2003 as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Results The total volume of alcohol consumed by 15–16-year-old students declined by 15% between 1995 and 2003. This decline can be traced to an increasing number of abstainers. Among adolescent alcohol consumers drinking was more frequent and the total volume of alcohol they consumed increased by 19% between 1995 and 2003. Conclusion Declining alcohol use among Icelandic adolescents is due to fewer alcohol consumers and cannot be traced to less consumption by active drinkers. Adolescents who consume alcohol regularly have increased their consumption in this period.
[Predictive value of NT-pro-BNP for the non-cardiologist. A study on 573 hospitalized patients with cardiovascular disease].

BACKGROUND B-type natriuretic peptides are excellent markers of cardiac function and are strong prognostic parameters in patients with coronary heart disease and heart failure. We examined the diagnostic and prognostic value of natriuretic peptides in a heterogeneous group of patients of a cardiological university hospital. METHODS NT-pro-BNP was assessed in 573 inpatients (66 % male, median age 66 years) and association with demographic and cardiological parameters, in-hospital course as well as the combined endpoint of death, heart failure hospitalization and stroke was analyzed during a median follow-up time of 1117 days. RESULTS NT-pro-BNP was significantly associated with age, diastolic blood pressure, renal function, previous myocardial infarction, arterial occlusive disease, atrial fibrillation, NYHA class and left-ventricular dysfunction. Differentiation of distinct cardiac diseases by NT-pro-BNP was not possible. NT-pro-BNP identified patients with a length of hospital stay of more than 12 days with a sensitivity of 88,2 % and a negative predictive value of 97 %. Supramedian NT-pro-BNP values (> 300 pg/ml) indicated a relative risk for the combined endpoint of 7,5 (95 % CI 4,1 - 13,8) compared to inframedian NT-pro-BNP values. Prognostic value of NT-pro-BNP was independent of and stronger than demographic and cardiological risk markers. CONCLUSION NT-pro-BNP is a strong and independent predictor of in-hospital course and long-term outcome in inpatients with cardiovascular disease. NT-pro-BNP assessment allows a risk-adapted patient management for non-cardiologists.
Treatment of Calcified Insertional Achilles Tendinopathy by the Posterior Midline Approach.

The present study investigated the clinical outcomes of the posterior midline approach in the treatment of 34 patients with significantly calcified insertional Achilles tendinopathy. The posterior midline approach was applied for the surgical treatment of 34 patients with chronic significantly calcified insertional Achilles tendinopathy after failed conservative treatment. Gastrocnemius recession was performed simultaneously for patients with gastrocnemius contracture. The Fowler-Philip angle and parallel pitch lines were measured before surgery, and the visual analog scale, Tegner score, and Victorian Institute of Sport tendon study group score were recorded before and after surgery. The mean follow-up period was 45.2 ± 17.7 (range 24 to 84) months. After surgery, the visual analog scale score had decreased notably, and the Tegner score and Victorian Institute of Sport tendon study group score had increased significantly. The posterior midline approach can achieve satisfactory outcomes in the treatment of significantly calcified insertional Achilles tendinopathy, and gastrocnemius recession (Strayer procedure) should be performed for patients with gastrocnemius contracture to improve the surgical outcome.
Bi-directional dc-dc converter for fuel cell generation system

Fuel cell (FC) has slow response characteristic for load variation. In this paper, bi-directional dc-dc converter for FC generation system is proposed to improve load response characteristic. The bi-directional converter interfaces the low voltage battery to the inverter dc link of FC generation system. When power flows from the low voltage side (battery: 48 V) to the high voltage side (dc link: 380 V), the circuit works in discharge operation (boost mode) to power the high voltage side load; otherwise, it works in charge operation (buck mode) to charge the low voltage side battery. A simple voltage clamp branch is used to limit transient voltage across the current-fed full bridge and realize zero-voltage-switching (ZVS) during discharge operation. A soft switched, isolated bi-directional dc-dc converter has been developed for FC generation system, in which the 48 V battery for the system accessory loads is also used to start up the FCs and to charge the energy consumed on operating of FC generation system.
When invaders meet locally adapted types: rapid moulding of hybrid zones between sculpins (Cottus, Pisces) in the Rhine system

Hybrid zones are commonly studied to dissect the processes that drive divergence among lineages, which have incomplete barriers of reproduction. Most hybrid zones have existed for an extended time making inferences on the initial mode of formation difficult. It is a priori unclear how fast a nascent hybrid zone would form as a response to endogenous and exogenous factors. We have studied several hybrid zones between two lineages of sculpins (Cottus spp.), which emerged due to a recent range expansion of one of the lineages along the river Rhine in the early 1990s. Applying a dense sampling across two contact areas and using a highly informative set of 45 microsatellite markers we found pronounced genetic structure. Steep genetic clines suggest that strong selective forces have shaped the respective hybrid zones from the beginning. We find that the zones are coupled to ecological transitions from small streams to larger rivers. The width of these zones is much smaller than estimates of annual individual dispersal distances, as estimated outside of the hybrid zones. The pattern is apparently not strongly affected by pre‐ or postzygotic reproductive isolation because numerous backcross hybrids occur within the zones. This suggests that strong natural selection acts against immigrant genotypes. The study exemplifies how local adaptation can play a key role in preventing admixture in dependence of the ecological context.
Security primitives (PUF and TRNG) with STT-MRAM

The rapid development of low power, high density, high performance SoCs has pushed the embedded memories to their limits and opened the field to the development of emerging memory technologies. The Spin-Transfer-Torque Magnetic Random Access Memory (STT-MRAM) has emerged as a promising choice for embedded memories due to its reduced read/write latency and high CMOS integration capability. Inner properties of STT-MRAMs make them suitable for the implementation of basic security primitives such Physically Unclonable Functions (PUFs) and True Random Number Generators (TRNGs). PUFs are emerging primitives used to implement low-cost device authentication and secure secret key generation. On the other hand, TRNGs generate random numbers from a physical process. We will show how it is possible to exploit (i) the high variability affecting the electrical resistance of the magnetic device to build a robust, unclonable and unpredictable PUF, and (ii) the stochastic nature of the write operation in the magnetic device to generate randomly distributed numbers.
Uric Acid Induces Cognitive Dysfunction through Hippocampal Inflammation in Rodents and Humans

Uric acid (UA) is a purine metabolite that in most mammals is degraded by the hepatic enzyme uricase to allantoin. Epidemiological studies have shown that an elevated UA level predicts the development of cognition and memory deficits; however, there is no direct evidence of this relationship, and the underlying mechanism is largely undefined. Here, we show that a high-UA diet triggers the expression of proinflammatory cytokines, activates the Toll-like receptor 4 (TLR4)/nuclear factor (NF)-κB pathway, and increases gliosis in the hippocampus of Wistar rats. We, subsequently, identify a specific inhibitor of NF-κB, BAY11-7085, and show that stereotactic injections of the inhibitor markedly ameliorate UA-induced hippocampal inflammation and memory deficits in C57BL/6 mice. We also found that NF-κB is activated in the primary cultured hippocampal cells after UA administration. Additionally, C57BL/6 mice that lack TLR4 are substantially protected against UA-induced cognitive dysfunction, possibly due to a decrease in inflammatory gene expression in the hippocampus. Importantly, magnetic resonance imaging confirms that hyperuricemia in rats and humans is associated with gliosis in the hippocampus. Together, these results suggest that UA can cause hippocampal inflammation via the TLR4/NF-κB pathway, resulting in cognitive dysfunction. Our findings provide a potential therapeutic strategy for counteracting UA-induced neurodegeneration. SIGNIFICANCE STATEMENT This work demonstrates that a high-uric acid (UA) diet triggers the expression of proinflammatory cytokines, activates the Toll-like receptor 4 (TLR4)/nuclear factor (NF)-κB pathway, and increases gliosis in the hippocampus of Wistar rats. Inhibition of the NF-κB signaling pathway markedly ameliorates UA-induced hippocampal inflammation and cognitive dysfunction in C57BL/6 mice. TLR4-knock-out mice are substantially protected against UA-induced cognitive dysfunction, possibly due to a decrease in inflammatory gene expression in the hippocampus. Moreover, magnetic resonance imaging confirms that hyperuricemia in rats and humans are associated with gliosis in the hippocampus. Together, this study suggests that there is an important link between UA-induced cognitive dysfunction and hippocampal inflammation in rodents and humans, which may have remarkable implications in the treatment of UA-induced neurodegeneration.
Molecular Cloning and Characterization of a Novel Human G-protein-coupled Receptor, EDG7, for Lysophosphatidic Acid*

Lysophosphatidic acid (LPA), together with sphingosine 1-phosphate, is a bioactive lipid mediator that acts on G-protein-coupled receptors to evoke multiple cellular responses, including Ca2+ mobilization, modulation of adenylyl cyclase, and mitogen-activated protein (MAP) kinase activation. In this study, we isolated a human cDNA encoding a novel G-protein-coupled receptor, designated EDG7, and characterized it as a cellular receptor for LPA. The amino acid sequence of the EDG7 protein is 53.7 and 48.8% identical to those of the human functional LPA receptors EDG2 and EDG4, respectively, previously identified. LPA (oleoyl) but not other lysophospholipids induced an increase in the [Ca2+] i of EDG7-overexpressing Sf9 cells. Other LPA receptors, EDG4 but not EDG2, transduced the Ca2+response by LPA when expressed in Sf9 cells. LPAs with an unsaturated fatty acid but not with a saturated fatty acid induced an increase in the [Ca2+] i of EDG7-expressing Sf9 cells, whereas LPAs with both saturated and unsaturated fatty acids elicited a Ca2+ response in Sf9 cells expressing EDG4. In EDG7- or EDG4-expressing Sf9 cells, LPA stimulated forskolin-induced increase in intracellular cAMP levels, which was not observed in EDG2-expressing cells. In PC12 cells, EDG4 but not EDG2 or EDG7 mediated the activation of MAP kinase by LPA. Neither the EDG7- nor EDG4-transduced Ca2+ response or cAMP accumulation was inhibited by pertussis toxin. In conclusion, the present study demonstrates that EDG7, a new member of the EDG family of G-protein-coupled receptors, is a specific LPA receptor that shows distinct properties from known cloned LPA receptors in ligand specificities, Ca2+ response, modulation of adenylyl cyclase, and MAP kinase activation.
Dexmedetomidine vs midazolam for premedication of pediatric patients undergoing anesthesia

Background: Dexmedetomidine, an α2‐receptor agonist, provides sedation, analgesia, and anxiolytic effects, and these properties make it a potentially useful anesthetic premedication. In this study, we compared the effects of intranasal dexmedetomidine and midazolam on mask induction and preoperative sedation in pediatric patients.
Risks of stroke and mortality associated with suboptimal anticoagulation in atrial fibrillation patients

Summary Atrial fibrillation (AF) carries an increased risk of ischaemic stroke, and oral anticoagulation with warfarin can reduce this risk. The objective of this study was to evaluate the association between time in therapeutic International Normalised Ratio (INR) range when receiving warfarin and the risk of stroke and mortality. The study cohort included AF patients aged 40 years and older included in the UK General Practice Research Database. For patients treated with warfarin we computed the percentage of follow-up time spent within therapeutic range. Cox regression was used to assess the association between INR and outcomes while controlling for patient demographics, health status and concomitant medication. The study population included 27,458 warfarintreated (with at least 3 INR measurements) and 10,449 patients not treated with antithrombotic therapy. Overall the warfarin users spent 63% of their time within therapeutic range (TTR). This percentage did not vary substantially by age, sex and CHA2DS2-VASc score. Patients who spent at least 70% of time within therapeutic range had a 79% reduced risk of stroke compared to patients with ≤30% of time in range (adjusted relative rate of 0.21; 95% confidence interval 0.18–0.25). Mortality rates were also significantly lower with at least 70% of time spent within therapeutic range. In conclusion, good anticoagulation control was associated with a reduction in the risk of stroke.