Miracle-dz/UniFAR-FTUs huggingface dataset:
Obstetric outcome following epidural analgesia with bupivacaine‐adrenaline 0.25% or bupivacaine 0.125% with sufentanil ‐ a prospective randomized controlled study in 1000 parturients

Background: Epidural analgesia (EDA) is the most efficient method for pain relief during labour, but there is still a debate as to whether it interferes with the normal process of delivery. Some authors argue that the incidence of instrumental deliveries, Caesarean section, malrotation and protracted labour is increased in parturients receiving EDA.
Journal of Occupational Medicine and Toxicology Sweat Rate and Sodium Loss during Work in the Heat

Objective: Significant and poorly documented electrolyte losses result from prolonged sweating. This study aimed to quantify likely sodium losses during work in heat. Methods: Male subjects exercised in an environmental chamber on two consecutive days in both winter and summer. Sweat collecting devices were attached to the upper arms and legs. Results: Sweat rates were higher and sodium concentrations were lower in the summer (acclimatised) than the winter (unacclimatised) trials. Sweat sodium concentration was reduced on the second day in summer but not winter. Regional differences were found in both seasons. Conclusion: The difference between days in summer probably reflects short-term acclimation. The difference between seasons reflects acclimatisation. The data predict average sodium (Na) losses over a work shift of 4.8–6 g, equivalent to 10–15 g salt (NaCl). Losses are potentially greater in unacclimatised individuals. Fluid and electrolyte losses resulting from prolonged sweating must be replaced to prevent imbalance in body fluids, however guidelines for this replacement are often conflicting. This study provides important information for occupational health practitioners by quantifying the likely sodium losses over a work shift and providing recommendations for replacement.
Luciferase fragment complementation imaging in preclinical cancer studies

The luciferase fragment complementation assay (LFCA) enables molecular events to be non-invasively imaged in live cells in vitro and in vivo in a comparatively cheap and safe manner. It is a development of previous enzyme complementation assays in which reporter genes are split into two, individually enzymatically inactive, fragments that are able to complement one another upon interaction. This complementation can be used to externally visualize cellular activities. In recent years, the number of studies which have used LFCAs to probe questions relevant to cancer have increased, and this review summarizes the most significant and interesting of these. In particular, it focuses on work conducted on the epidermal growth factor, nuclear and chemokine receptor families, and intracellular signaling pathways, including IP3, cAMP, Akt, cMyc, NRF2 and Rho GTPases. LFCAs which have been developed to image DNA methylation and detect RNA transcripts are also discussed.
Utilization of tests for Lyme disease antibody at a university hospital

We performed a retrospective study on patients who had a positive screening antibody test result for antibody to Borrelia burgdorferi to determine the clinical indicators used by physicians to order this test. Eighty-two evaluable patients who were screen positive (indirect enzyme-linked immunosorbent assay) between August 1991 and March 1993 were included. Additional tests, isotype-specific capture immunoglobulin enzyme immunoassay and Western blot (immunoblot) analysis (immunoglobulin G), were performed on positive samples. Of 82 patients with a positive screening test result, 54 (66%) had no serologic evidence of Lyme disease on the basis of additional testing (positive predictive value, 34%). Only 28 of 82 patients (34%) had clinical indicators suggestive of Lyme disease. Antibody screening tests may provide misleading information if they are not accompanied by more specific assays. Inappropriate testing of patients without indications of Lyme disease is frequently performed, and the ordering practices of physicians should be reassessed.
Plants under Climatic Stress: I. Low Temperature, High Light Effects on Photosynthesis.

Photosynthetic rates of both C(4)- and C(3)-pathway plants grown at 25 C were measured before and during a period of chilling stress at 10 C, and then again at 25 C following various periods at 10 C. When temperatures are first lowered photosynthetic rates drop immediately, then undergo a further reduction which is quite rapid in species such as Sorghum, maize, and Pennisetum; slower in soybean; and very slow in Paspalum and ryegrass. Visible light causes progressive permanent damage to the photosynthetic capacity of leaves during this period of lowered photosynthesis. The extent of damage increases with light intensity and the length of time leaves are held at 10 C but varies greatly between species, being roughly correlated with the extent to which chilling initially and subsequently lowers photosynthesis. Three days of chilling (10 C) at 170 w.m(-2) reduces the photosynthetic capacity of youngest-mature Paspalum leaves only 30 to 40% while Sorghum leaves are essentially inoperative when returned to 25 C after the same stress. Root temperature has a substantial rapid effect on photosynthesis of soybean and little immediate effect on Sorghum. Photosynthesis of stress-intolerant species (Sorghum) is reduced only slightly more than that of semitolerant species (Paspalum) when temperatures are lowered at mid-photo-period, but to a far greater extent if temperatures are reduced at the commencement of a photoperiod.
Brain swelling and death in children with cerebral malaria.

BACKGROUND Case fatality rates among African children with cerebral malaria remain in the range of 15 to 25%. The key pathogenetic processes and causes of death are unknown, but a combination of clinical observations and pathological findings suggests that increased brain volume leading to raised intracranial pressure may play a role. Magnetic resonance imaging (MRI) became available in Malawi in 2009, and we used it to investigate the role of brain swelling in the pathogenesis of fatal cerebral malaria in African children. METHODS We enrolled children who met a stringent definition of cerebral malaria (one that included the presence of retinopathy), characterized them in detail clinically, and obtained MRI scans on admission and daily thereafter while coma persisted. RESULTS Of 348 children admitted with cerebral malaria (as defined by the World Health Organization), 168 met the inclusion criteria, underwent all investigations, and were included in the analysis. A total of 25 children (15%) died, 21 of whom (84%) had evidence of severe brain swelling on MRI at admission. In contrast, evidence of severe brain swelling was seen on MRI in 39 of 143 survivors (27%). Serial MRI scans showed evidence of decreasing brain volume in the survivors who had had brain swelling initially. CONCLUSIONS Increased brain volume was seen in children who died from cerebral malaria but was uncommon in those who did not die from the disease, a finding that suggests that raised intracranial pressure may contribute to a fatal outcome. The natural history indicates that increased intracranial pressure is transient in survivors. (Funded by the National Institutes of Health and Wellcome Trust U.K.).
Teacher professional development and its effects on reading instruction

TEACHER PROFESSIONAL DEVELOPMENT AND ITS EFFECTS ON READING INSTRUCTION by Kristen Lea Suarez May 2011 The world of education is an ever-evolving profession. We, as a society, have learned so much about education and how we can better benefit our students. Students depend on education to equip them with the tools needed to become successful. This dissertation addresses the need for and adequacy of today’s teacher professional development in Reading instruction and how that training can translate into more meaningful classroom education. The writer surveyed elementary Reading teachers in grades 3-6 from two school districts in southern Mississippi to determine their perceptions concerning various elements of the professional development training they received during the 2009-2010 school year. The writer also collected data about how much professional development these teachers attended, how much information from the training they actually used for their classroom instruction, and whether or not they received follow-up training for help on implementation of strategies after the initial professional development session had ended. Using Language Arts standardized test scores for the 2009-2010 school year in the state of Mississippi, the writer compared test scores with how many teachers actually utilized information from professional development training for
Irritancy testing of sodium laurate and other anionic detergents using an open exposure model

The irritant potency of soap (sodium laurate, LAU) as opposed to other anionic detergents is not uniformly agreed upon. The aim of the study was to compare the irritancy of sodium laurate with that of sodium laurylsulphate (SLS), sodium cocoyl isethionate and disodium lauryl 3‐ethoxysulphosuc‐cinate by means of a 4‐day repeated open exposure model in order to achieve a more realistic mimicry of daily practice.
Human-Mediated Marine Dispersal Influences the Population Structure of Aedes aegypti in the Philippine Archipelago

Background Dengue virus (DENV) is an extraordinary health burden on global scale, but still lacks effective vaccine. The Philippines is endemic for dengue fever, but massive employment of insecticides favored the development of resistance mutations in its major vector, Aedes aegypti. Alternative vector control strategies consist in releasing artificially modified mosquitos in the wild, but knowledge on their dispersal ability is necessary for a successful implementation. Despite being documented that Ae. aegypti can be passively transported for long distances, no study to date has been aimed at understanding whether human marine transportation can substantially shape the migration patterns of this mosquito. With thousands of islands connected by a dense network of ships, the Philippines is an ideal environment to fill this knowledge gap. Methodology/principal findings Larvae of Ae. aegypti from 15 seaports in seven major islands of central-western Philippines were collected and genotyped at seven microsatellite loci. Low genetic structure and considerable gene flow was found in the area. Univariate and multivariate regression analyses suggested that anthropic factors (specifically the amount of processed cargo and human population density) can explain the observed population structure, while geographical distance was not correlated. Interestingly, cargo shipments seem to be more efficient than passenger ships in transporting Ae. aegypti. Bayesian clustering confirmed that Ae. aegypti from busy ports are more genetically similar, while populations from idle ports are relatively structured, regardless of the geographical distance that separates them. Conclusions/significance The results confirmed the pivotal role of marine human-mediated long-range dispersal in determining the population structure of Ae. aegypti. Hopefully corroborated by further research, the present findings could assist the design of more effective vector control strategies.
The spider does not always win the fight for attention: Disengagement from threat is modulated by goal set

Stimulus-driven preferential attention to threat can be modulated by goal-driven attention. However, it remains unclear how this goal-driven modulation affects specific attentional components implied in threat interference. We hypothesise that goal-driven modulation most strongly impacts delayed disengagement from threat. A spatial cueing task was used that disentangles delayed disengagement from attentional capture by tightly manipulating the locus of attention at the time of target onset. Different top-down goals were induced by instructing participants to identify bird/fish targets (Experiment 1) or spider/cat targets (Experiment 2) among animal non-targets. Delayed disengagement from a non-target spider was observed only when the spider was part of the target set, not when it was task-irrelevant. This corroborates evidence that threat stimuli do not necessarily override goal-driven attentional control and that extended processing of threatening distractors is not obligatory.
Fluoxetine in early poststroke depression: a double-blind placebo-controlled study.

BACKGROUND AND PURPOSE Early poststroke depression (PSD) is a frequent and specific entity that impairs the rehabilitation and functional recovery of hemiplegic patients. This trial was designed to study the efficacy and tolerance of fluoxetine (FLX) in the treatment of early PSD. METHODS This was a multicenter, double-blind, placebo-controlled study. Recent hemiplegic patients (<3 months) suffering from major depressive disorder (determined by International Classification of Diseases, 10th Revision, and Montgomery-Asberg Depression Rating Scale [MADRS] >19) were randomized to receive either 20 mg/d fluoxetine (FLX) or placebo for 6 weeks. Patients were evaluated by use of the Motricity Index, Mini-Mental State Examination, Functional Independence Measure, and MADRS. Statistical analysis was performed by using an intent-to-treat approach comparing the 2 groups at day 0 (baseline) and days 15, 30, and 45 (end point). RESULTS Of 121 patients screened, 31 were included in the study, 16 in the FLX group and 15 in the placebo group. There were no significant differences in baseline characteristics among the 2 groups. The FLX-treated patients compared with placebo-treated patients demonstrated significant improvement in mean MADRS scores at end point (11.8+/-6. 7 [mean+/-SD] versus 18.7+/-10.0, respectively; P=0.05). FLX-treated patients compared with placebo-treated patients also demonstrated greater response rate (62.5% versus 33.3%, respectively) and greater mean decrease of MADRS (16.6 versus 8.4, respectively; P=0.02). There were no differences in motor, cognitive, or functional improvement and no significant side effects after FLX treatment, except for a patient with a moderate and transient increase of transaminases. CONCLUSIONS FLX is an efficacious and well-tolerated treatment for early PSD. Further research is needed to evaluate the efficacy and safety of long-term treatment in this population.
Designing the Interface of Rich Internet Applications

In this paper we present a novel approach for designing the interface of rich internet applications. Our approach uses the Abstract Data Views (ADV) design model which allows to express at a high level of abstraction the structure and behaviors of the user interface. Additionally, by using advanced techniques for separation of concerns it allows to create complex interfaces as oblivious compositions of simple interface atoms. Using a simple illustrative example we present the rationale of our approach, its core stages and how it is integrated into the Object Oriented Hypermedia Design Method (OOHDM). Some implementation issues are finally analyzed.
The use of evidence-based medicine in the practice of consultant physicians. Results of a questionnaire survey.

BACKGROUND Information is lacking about the extent to which Australasian physicians apply methods of evidence-based medicine (EBM) in routine practice. AIMS To assess the frequency and predictors of use of EBM methods in a sample of consultant physicians in adult medicine. METHODS Self-administered questionnaires were distributed to a convenience sample of 545 physicians from October 1998 to January 1999. RESULTS One hundred and eleven questionnaires were returned (20% response rate). Ninety-eight (88%) respondents formulated five or less clinical questions per week; 69 (62%) undertook five or more evidence searches per week, the majority as MEDLINE searches involving therapeutic topics. Respondents identified insufficient time (74%), limited search skills (41%), and limited access to evidence (43%) as search impediments. In determining evidence quality, 37% frequently relied on global impressions, while 22% frequently applied explicit critical appraisal (p=0.008). Efficiency of literature searches was rated on average as good/very good by 18%, fair by 52% and poor by 30%. As a result of EBM, 47% frequently had confidence in pre-existing decisions increased, 39% gained improved knowledge, and 5% altered clinical decisions. Frequently encountered inhibitors to changing practice were personal conservatism (40%), organisational constraints (40%), and interdisciplinary tensions (39%). Perceived weaknesses of EBM included: limited applicability to individual patients (26%); evidence deficiencies (25%); and too time consuming (13%). In making EBM more attractive, one third requested reliable evidence sources at the point of care. CONCLUSIONS The application of EBM to routine practice by physicians is constrained by deficient EBM skills, limited access to evidence, lack of time, and cognitive and environmental factors. Targeted education in EBM and systems that quickly deliver high-quality evidence at the point of care are needed in realising the full potential of EBM to improve care.
Emergency laparotomy in octogenarians: A 5-year study of morbidity and mortality.

AIM To determine the morbidity and mortality associated with emergency laparotomy for a clinically acute abdomen in patients aged ≥ 80 years. METHODS In this retrospective audit, octogenarians undergoing emergency laparotomy between 1st January 2005 and 1(st) January 2010 were identified using the Galaxy Theatre System. Patients undergoing abdominal surgery through groin crease incisions or Lanz or Gridiron incisions were excluded. Also simple appendectomies were excluded. All patients were aged 80 years or more at the time of their surgery. Data were obtained using casenote review with a standardised proforma to determine patient age, American Society of Anesthesiologists (ASA) grade, indications for surgery, early (within 30 d) and late (after 30 d) complications, mortality and length of stay. Data were inserted into a Microsoft Excel spreadsheet and analysed. RESULTS One hundred patients were identified from the database (Galaxy) as having undergone emergency laparotomy. Of those, 55 underwent the procedure for intestinal procedures and 37 for secondary peritonitis. There was a 2:1 female predominance; average age 85 and ASA grade 3. Bowel resection was required in 51 out of the 100 patients and 22 (43%) died. Other procedures included appendicectomy, adhesiolysis, repair of AAA graft leak and colostomies for the pathological process resulting in an acute abdomen. Twelve of 100 patients (12%) suffered intra-operative complications, including splenic and bowel-serosal tears. Seventy patients (70%) had postoperative complications including myocardial infarction, wound infection, haematoma and sepsis. Overall mortality was 45/100 patients (45%). The major causes of death were sepsis (19/45 patients, 42%), underlying cancer (13/45 patients, 29%); with others including bowel obstruction (2/45 patients, 4%), myocardial and intestinal ischaemia and dementia. CONCLUSION Emergency laparotomy in octogenarians carries a significant morbidity and mortality. In particular, surgery requiring bowel resection has higher mortality than without resection.
Diagnostic Value of Salivary Cortisol in Children with Abnormal Adrenal Cortex Functions

Aims: It has been shown that the free cortisol level in saliva may reflect plasma free cortisol. The measurement of cortisol in saliva is a simple method, and as such it is important in the pediatric age group. In this research, the diagnostic value of measurement of salivary cortisol (SC) measurement was examined in adrenal insufficiency (AI). Methods: Fifty-one patients, mean age 10.8 ± 4.29, who were investigated for possible AI, were included. Basal cortisol levels were below 18 µg/dl. Adrenal function was determined by low-dose ACTH test. During the test, samples for SC were obtained simultaneously with serum samples (at 0–10–20–30–40 min). Results: Mean basal serum cortisol level was 8.21 ± 4.10 µg/dl (mean ± SD). Basal SC was correlated to basal serum cortisol (r = 0.64, p < 0.001). A cut-off of 0.94 µg/dl for SC differentiated adrenal insufficient subjects from normals with a sensitivity and specificity of 80 and 77%, respectively. A peak SC less than 0.62 µg/dl defined AI with a specificity of 100%; however, sensitivity was 44%. Conclusion: Measurement of SC may be used in the evaluation of AI. It is well-correlated to serum cortisol. Peak SC in low-dose ACTH test can be used to differentiate patients with AI in the initial evaluation of individuals with suspected AI.
Social and dynamic graph-based scalable routing protocol in a DTN network

In this paper we consider the DTN routing problem in networks where the links between nodes are not stable, but tend to change over time. In these cases, the classical algorithms are not adequate, so new protocols are needed to deliver the highest number of messages, trying to limit the amount of messages transmitted in the network. We propose a new algorithm, S-Grasp, whose foundations are found in other works already presented in the literature, but in some cases it improves their performances. Finally we will show, through simulations, that although the success rate is close to the optimal value, the number of retransmissions is reduced by at least 50% compared to that of other analyzed algorithms.
Mipomersen, an Antisense Oligonucleotide to Apolipoprotein B-100, Reduces Lipoprotein(a) in Various Populations With Hypercholesterolemia: Results of 4 Phase III Trials

Objective— Lp(a) is an independent, causal, genetic risk factor for cardiovascular disease and aortic stenosis. Current pharmacological lipid-lowering therapies do not optimally lower Lp(a), particularly in patients with familial hypercholesterolemia (FH). Approach and Results— In 4 phase III trials, 382 patients on maximally tolerated lipid-lowering therapy were randomized 2:1 to weekly subcutaneous mipomersen 200 mg (n=256) or placebo (n=126) for 26 weeks. Populations included homozygous FH, heterozygous FH with concomitant coronary artery disease (CAD), severe hypercholesterolemia, and hypercholesterolemia at high risk for CAD. Lp(a) was measured 8× between baseline and week 28 inclusive. Of the 382 patients, 57% and 44% had baseline Lp(a) levels >30 and >50 mg/dL, respectively. In the pooled analysis, the mean percent decrease (median, interquartile range in Lp(a) at 28 weeks was significantly greater in the mipomersen group compared with placebo (−26.4 [−42.8, −5.4] versus −0.0 [−10.7, 15.3]; P<0.001). In the mipomersen group in patients with Lp(a) levels >30 or >50 mg/dL, attainment of Lp(a) values ⩽30 or ⩽50 mg/dL was most frequent in homozygous FH and severe hypercholesterolemia patients. In the combined groups, modest correlations were present between percent change in apolipoprotein B-100 and Lp(a) (r=0.43; P<0.001) and low-density lipoprotein cholesterol and Lp(a) (r=0.36; P<0.001) plasma levels. Conclusions— Mipomersen consistently and effectively reduced Lp(a) levels in patients with a variety of lipid abnormalities and cardiovascular risk. Modest correlations were present between apolipoprotein B-100 and Lp(a) lowering but the mechanistic relevance mediating Lp(a) reduction is currently unknown.
Dexamethasone in adults with bacterial meningitis.

Background: Even when bacterial meningitis is diagnosed and treated promptly, it causes significant morbidity and mortality in adults. Dexamethasone, which lessens cerebrospinal inflammation, has been shown to reduce the incidence of hearing loss in children with meningitis caused by Haemophilus influenzae type b and possibly Streptococcus pneumoniae. To date, strong evidence to support the use of steroids in adults with bacterial meningitis has been lacking.