Miracle-dz/UniFAR-FTUs huggingface dataset:
Laparoscopic adrenalectomy for adrenal malignancy: a preliminary report comparing the short-term outcomes with open adrenalectomy.

BACKGROUND The laparoscopic approach to adrenal malignancy remains a topic of debate. METHODS A retrospective analysis of patients who had an open or laparoscopic adrenalectomy for malignancy at a tertiary care center from 1995 to 2005 were included in this study. RESULTS Twenty-six cases were identified: 19 women and 7 men with a median age of 48 years (range, 20-81) underwent 12 open (8 adrenocortical carcinoma [ACC] and 4 metastases) and 14 laparoscopic adrenalectomies (5 ACC, 8 metastases, and 1 lymphoma). Conversion to open surgery was required in 1 laparoscopic case (7%). Cases with obvious invasion to adjacent organs were not approached laparoscopically. There was no difference in age, sex, American Society of Anesthesiologists status or diagnosis between the two groups, but patients in the laparoscopic group had a higher body mass index. Two patients required splenectomies for splenic tears in the open group. There was no difference in operative time between the two groups, but estimated blood loss (200 vs. 550 mL; P = 0.01) and hospital stay (2 vs. 7 days; P = 0.005) were less in the laparoscopic group. The size of tumors removed by open surgery was larger than by laparoscopy (8 vs. 4 cm; P = 0.003). No locoregional recurrences are reported so far in the laparoscopic group. CONCLUSIONS Laparoscopic adrenalectomy is both feasible and safe for some malignant tumors of the adrenal gland in experienced hands. However, it cannot be applied to all cases. Careful selection, preoperative staging, and respect for oncologic principles are important considerations in choosing laparoscopic surgery for primary and secondary adrenal malignancy. Short-term outcomes are better when the laparoscopic approach is possible. Confirmation and long-term results with further studies are required.
The burden of illness associated with psoriasis: cost of treatment with systemic therapy and phototherapy in the US

SUMMARY Objective: To evaluate utilization and direct healthcare expenditures among psoriasis patients treated with systemic therapy and phototherapy in the United States. Design: Cohort study using retrospective administrative medical claims. Patients: Psoriasis patients treated with systemic therapy and phototherapy, as well as a matched cohort of non-psoriasis patients. All patients were covered by employer-sponsored insurance between 1 April 1996 and 31 December 2000. Main outcome measures: Estimated risk of hospitalization and total annual healthcare expenditures overall and by comorbidity status were compared for persons with psoriasis using systemic therapy or phototherapy and persons without psoriasis. Annualized utilization rates for hospitalizations, and use of emergency department, outpatient physician, outpatient laboratory, and outpatient pharmaceutical services were also compared across the two cohorts. Results: Seventeen percent of psoriasis patients were treated with systemic therapy or phototherapy. Patients with comorbid anemia, carcinoma, diabetes, depression, GI disorders, hepatotoxicity, hypertension, and nephrotoxicity had significantly higher expenditures than non-psoriasis patients with the same comorbidities ( p ≤ 0.05). Elevated risk of hospitalization also contributed to higher expenditures in patients treated with systemic therapy or phototherapy. Limitations of this study include those inherent in using claims data such as dependence on diagnosis coding, the fact that psoriasis severity cannot be determined directly from claims data, confounding comorbidities, and the fact that only direct healthcare expenditures were considered in this analysis. Conclusion: Psoriasis patients treated with systemic therapies/phototherapies have significantly more comorbidities and higher mean total healthcare expenditures compared to non-psoriasis patients. Psoriasis patients with selected comorbidities have significantly higher mean total healthcare expenditures compared to non-psoriasis persons with the same comorbidities.
Global revascularization: the role of the cardiologist

There are compelling reasons for cardiologists to undertake a more global approach to patients with peripheral vascular diseases: atherosclerosis is a 'systemic' disease frequently causing both coronary and peripheral vascular problems in the same patient; coronary artery disease is the most common cause of morbidity and mortality in patients with peripheral vascular disease; and peripheral vascular disease negatively impacts the management of angina pectoris and congestive heart failure. There are four major areas of special interest to the cardiologist: (1) iliac arteries (vascular access), (2) renal arteries (hypertension and volume overload), (3) subclavian arteries (coronary steal with a left internal mammary artery [LIMA] graft), and (4) carotid arteries (stroke). coronary angioplasty are transferable to the peripheral vasculature. However, an understanding of the natural history of peripheral disease, patient and lesion selection criteria, and knowledge of other treatment alternatives are essential to performing these procedures safely and effectively. Appropriate preparation and training, and a team approach, including an experienced vascular surgeon, are both desirable and necessary before interventional cardiologists who are inexperienced in the treatment of peripheral vascular disease attempt percutaneous peripheral angioplasty. There are inherent advantages for patients when the cardiologist performing the procedure is also a clinician. Judgments regarding the indications, timing, and risk/benefit ratio of procedures are enhanced by a long-term relationship between physician and patient. Finally, in view of the increased incidence of coronary artery disease in patients with atherosclerotic peripheral Technical skills necessary to perform vascular disease, the participation of a cardiologist in their care seems appropriate. (Int J Cardiovasc Intervent 2000; 3: 71 79)
Optimization of effective inventory control and management in manufacturing industries : case study of Flour Mills Company Calabar, Nigeria

For various manufacturing industries in Nigeria, inventory remains the prevalent asset on the balance sheet at any given time; therefore, there is the need for it to be properly managed. The researcher identifies some of the challenges hindering effective inventory management and control using Flour Mills Company as a case study. Although, effectiveness was seen in this research as the ability to achieve stated inventory levels, judge in terms of financial measures like inventory turnover. And for any company to claim to be effective, it inventory management decisions made by management must be ascertained and certified. The key source of information gathering which the research employed was the used of primary data through a well structured questionnaires and personal interviews. The data so obtain was analyse through qualitative technique, using descriptive statistics method by quantifying the level of frequency and determining the percentages of respondents and weighted mean scores. This method was considered more appropriate and convenient by the author because it helps to establish the objectives of the research. The results has help to proffer solution to the problem of lead time of delivery or delay in supply of goods or material, the interruption in production and stock out of goods or materials during production and problem of when to order and how much to order as it affects manufacturing industries in Nigeria. Conclusions were drawn and recommendations was made for the best practices that will ensure effective inventory control of stock and customers satisfaction and retention in both public and private industries in Nigeria.
Evaluating the Implementation of Expert Committee Recommendations for Obesity Assessment

The increasing prevalence of childhood overweight/obesity and their associated morbidities are well established, yet rates of diagnosis and screening for related conditions by clinicians are low. Expert Committee recommendations were released in 2007 to facilitate management of pediatric overweight/obesity. From well-child visits to a Massachusetts multisite group practice, we randomly selected 1 visit per child in 2006 (n = 56 374) and in 2008 (n = 69 681) and used electronic health record data to identify children with incident overweight or obesity (BMI ≥ 85th percentile) and ascertained whether clinicians assigned relevant ICD-9 (International Classification of Diseases, Ninth Revision) codes and ordered laboratory tests recommended for children ≥10 years old. In the year following the release of recommendations, a large majority of children 2 to 17 years old with a BMI ≥85th percentile lack diagnosis codes for overweight/obesity and recommended laboratory orders for assessment of obesity-related comorbidities for children 10 years and older, suggesting the need to augment current approaches to increase uptake of guidelines.
Survivin Expression in Breast Carcinoma: Correlation With Apoptosis and Prognosis

BackgroundSurvivin is a novel inhibitor of apoptosis commonly detected in tissues during fetal development and in cancer, but not usually in normal tissues. It has been suggested that the expression of this protein may be of prognostic significance in gastric, colorectal, and bladder carcinomas. We assessed survivin expression in breast carcinomas correlating results with expression of other antiapoptotic (bcl-2, bcl-x) and proapoptotic (bax) markers, with prognostic parameters, and with prognosis. DesignParaffin-embedded sections of 37 breast carcinomas were immunostained for survivin, bcl-2, bcl-x, and bax. Expression was evaluated in normal breast tissue and carcinoma, nuclei and cytoplasm, as intensity (0 to 3+), and percentage of positive cells. ResultsSurvivin expression was noted in 30 (81%) of breast carcinomas, and in normal breast tissue, in nuclei, and cytoplasm. There was a significant correlation (P=0.022) between survivin and bcl-x expression; survivin and bcl-x tended to correlate with overall survival (P=0.072 and 0.075, respectively), but not with disease-free survival (P=0.19 and 0.18, respectively). There was no correlation of survivin with bcl-2 or bax expression, or with other prognostic parameters (age, tumor size, histologic type, histologic grade, nodal status, and tumor stage) (P>0.05). ConclusionThe majority (81%) of breast carcinomas show survivin expression which correlates with bcl-x, another antiapoptotic marker, and both markers tend to correlate with prognosis.
Variation in Individuals' Post-Adoption Behaviors: Use of Information Systems

Information Systems (IS) offers many advantages to organizations, however, research suggests that most users underutilize IS in organizations. To further leverage an IS, it requires users to vary, over time, how an IS is incorporated into their work practices. Using the Generalized Darwinism framework and drawing insights from a case study and survey findings, this paper introduces and conceptualizes the notion of 'Variation' (i.e. changes) in IS use, and investigates factors that facilitate variations. Intrinsic motivation, domain-related kn owledge and feedback quality were shown to play a role in supporting and predicting the extent of variations, for both the case study and survey findings. Perceived resources, while playing a role in the case study was not significant in the survey findings. This study responds to calls for greater attention to changes in IS use and provides insights for practitioners on ways to encourage change in individuals' use of IS.
Inhibition of Cyclooxygenase-2 Gene Expression by p53*

Oncogenes enhance the expression of cyclooxygenase (Cox)-2, but interactions between tumor suppressor genes and Cox-2 have not been studied. In the present work, we have compared the levels of Cox-2 and the production of prostaglandin E2 in mouse embryo fibroblasts that do not express any p53 ((10)1) versus the same cell line ((10.1)Val5) engineered to overexpress wild-type (wt) p53 at 32 °C or mutant p53 at 39 °C. Cells expressing wt p53 showed about a 10-fold decrease in synthesis of prostaglandin E2 compared with those expressing mutant p53. Levels of Cox-2 protein and mRNA were markedly suppressed by wt p53 but not by mutant p53. Nuclear run-offs revealed decreased rates of Cox-2 transcription in cells expressing wt p53. The activity of the Cox-2 promoter was reduced by 85% in cells expressing wt p53 but was reduced only by 30% in cells expressing mutant p53 compared with cells null for p53. The effect of p53 on the suppression of Cox-2 promoter activity was localized to the first 40 base pairs 5′ from the transcription start site. Electrophoretic mobility shift assay revealed that p53 competed with TATA-binding protein for binding to mouseCox-2 or human Cox-2 promoter extending from −50 to +52 base pairs. The results of this study suggest that interactions between p53 and Cox-2 could be important for understanding why levels of Cox-2 are undetectable in normal cells and increased in many tumors.
OTO-104: A Sustained-Release Dexamethasone Hydrogel for the Treatment of Otic Disorders

Hypothesis: To investigate whether OTO-104, a poloxamer-based hydrogel containing micronized dexamethasone for intratympanic delivery, can provide long-lasting inner ear exposure and be well tolerated. Methods: OTO-104 was administered intratympanically to guinea pigs and sheep, and its pharmacokinetic and toxicity profiles were examined. Results: After a single intratympanic injection of OTO-104 (from 0.6% to 20%, w/w), significant and prolonged exposure to dexamethasone in the inner ear was observed. Increasing the concentration of OTO-104 resulted in higher perilymph drug levels as well as a more prolonged duration of exposure. At the highest dose, therapeutic perilymph levels of dexamethasone could be sustained over 3 months in guinea pigs and more than 1 month in sheep. A toxicologic evaluation was conducted, including assessments of middle and inner ear function and physiology, as well as appraisal of local and systemic toxicity. A small and transient shift in hearing threshold was observed, most probably conductive in nature. No significant histologic changes in middle or inner ear tissues were noted. Although macroscopically mild erythema/inflammation was documented in a subset of guinea pigs treated with 20% OTO-104, the nature and the severity of these changes were not different between the poloxamer vehicle, saline, and 20% OTO-104 groups. No evidence of acute dermal toxicity, delayed hypersensitivity, or systemic adverse effects was found. Conclusion: OTO-104 is a novel proprietary therapeutic delivery system that can achieve prolonged, sustained release of dexamethasone within the inner ear fluids. The administration of this clinical candidate formulation via intratympanic injection is expected to be well tolerated both locally and systemically.
Dynamics of Distant Moons of Asteroids

Abstract We introduce a new analytic method for treating the orbital motions of objects about asteroids and planets. For an asteroid following a circular path around the Sun, we rewrite Jacobi's integral of the motion in terms of the orbital elements relative to the asteroid. This procedure is similar to the derivation of Tisserand's Constant, but here we make the approximation that the satellite is bound to the asteroid rather than far from it. In addition, we retain high order terms that Tisserand ignored and make no assumptions about the relative masses of the asteroid and its satellite. We then average our expression over one circuit of the binary asteroid about its center of mass and obtain the “Generalized Tisserand Constant. ” We use the Generalized Tisserand Constant to elucidate properties of distant orbits and test our predictions against numerical integrations. In particular, we show analytically that planar prograde orbits are elongated along the Sun–asteroid line, that planar retrograde orbits extend furthest perpendicular to the Sun–asteroid line, and that retrograde orbits are more stable than prograde ones. Our formalism can be extended (i) to three dimensions and (ii) to apply to faint dusty rings around planets by including the effects of planetary oblateness, radiation pressure, and the electromagnetic force from a rotating dipolar magnetic field.
PRESERVATIVE-FREE TRIAMCINOLONE ACETONIDE INJECTABLE SUSPENSION VERSUS “TRADITIONAL” TRIAMCINOLONE PREPARATIONS: Impact of Aggregate Size on Retinal Biocompatibility

Purpose: To evaluate the biocompatibility of the three currently most commonly used triamcinolone acetonide (TA) preparations on retinal cells. Methods: Preservative containing KL (Kenalog-40; Bristol-Myers Squibb, Princeton, NJ), compounded preservative-free triamcinolone acetonide (PFTA; compounded from Volon A; Dermapharm, Vienna, Austria), and preservative-free triamcinolone acetonide injectable suspension (TRIESENCE; Alcon, Inc, Fort Worth, TX) (0.01–1 mg/mL) were either added directly on top or separated by a Boyden chamber filter or by a layer of vitreous to confluent cell cultures of retinal pigment epithelial cells (ARPE19) or retinal ganglion cells (RGC5). The distribution pattern of the TA crystals was assessed microscopically. Cell viability was assessed using MTT-ELISA and Live/Dead-Assay. Results: Sedimentation of triamcinolone acetonide injectable suspension, KL, or PFTA caused a pronounced decrease in cell viability. Cytotoxicity was most pronounced when triamcinolone acetonide injectable suspension and PFTA were used. Without direct sedimentation of TA crystals on top of the cells, none of the three formulations were cytotoxic. Triamcinolone acetonide injectable suspension showed the largest and most dense TA crystal aggregates on top of the cells. Conclusion: Retinal cytotoxicity of TA seems only to occur when there is intimate contact of TA crystals with the cellular membrane. Cytotoxicity depends on the number and size of TA crystal aggregates—with larger conglomerates being more harmful. Of the TA formulations tested, triamcinolone acetonide injectable suspension had the strongest tendency to form large TA crystal conglomerates and to gravitate downward.
Occurrence of Soil- and Tick-Borne Fungi and Related Virulence Tests for Pathogenicity to Ixodes scapularis (Acari: Ixodidae)

ABSTRACT Ixodes scapularis Say, the blacklegged tick, vectors Borrelia burgdorferi Johnson et al. 1984, the bacterium that causes Lyme disease, the most important vector-borne disease in the United States. Efforts to reduce I. scapularis populations are shifting toward the development of biological control methods. Currently, only a few entomopathogenic fungal species are considered virulent to ticks. We hypothesized that these species may not represent the most abundant local taxa that would be pathogenic to ticks in situ. To identify potential entomopathogenic fungi at a study site in Westchester County, New York, we sampled soils and ticks, extracted and amplified the internal transcribed spacer region of nuclear ribosomal DNA (nrDNA), and compared sequences with those in GenBank. Over three sampling periods from June 2007 to May 2008, 70 fungal taxa were isolated and identified from soils (48 taxa) and ticks (27 taxa; 5 taxa were found both in soil and on ticks) collected in this study, encompassing species in 25 different genera. In laboratory bioassays, 15 fungal taxa were found to be significantly virulent, although none of these were previously considered common pathogens of I. scapularis. Two species, Hypocrea lixii Patouillard 1891 and Penicillium soppii K. M. Zalessky 1927, were tested in field trials by spraying suspensions on forested plots. Mean tick mortality was 71% after treatment with H. lixii, 58% after treatment with P. soppii, and 32% in the control plots. The complete diversity of entomopathogenic fungal species at this site is yet to be defined, but, in general, such fungi appear to be more common in forest habitats where I. scapularis resides than previously thought. Examination of intact fungal communities can provide information that serves as the foundation for site-specific biocontrol programs.
Children's aggression following competition and exposure to an aggressive model.

Aggressive behavior was studied in 96 5- and 6-year-old children who observed either an aggressive or a nonaggressive adult model. Subsequent to viewing the model each child either succeeded or failed in competitive games or engaged in noncompetitive play. Results based on observation of free-play behavior were: (a) participation in competitive games increased aggression, and the predicted group ordering for aggressiveness (failure, success, no competition) was obtained in 3 of the 4 possible comparisons; (b) exposure to the aggressive model increased girls' but not boys' aggressiveness; (c) boys were more aggressive than girls, but only after witnessing the nonaggressive model. Boys and girls exposed to modeled aggression were equally aggressive. The present study investigated the effects of (a) experimentally manipulated success and failure in competitive games, and (b) exposure to modeled aggression upon children's aggressive behavior. Both competition and observation of an aggressive model are believed to promote aggressive behavior but by somewhat different mechanisms. Berkowitz (1962) has suggested that competition constitutes a frustrating situation which generates anger and which frequently results in aggressive behavior. As in other frustrating situations, strength of the anger generated in competition should be a function of (a) drive strength, as determined by the importance of the outcome in terms of potential reward or punishment; and (b) the
Sub-Tenon's Block: The Effect of Hyaluronidase on Speed of Onset and Block Quality

The role of hyaluronidase on the onset time and quality of single quadrant sub-Tenon's block was studied in a prospective, randomized, double-blind controlled manner. One hundred and twenty consecutive patients undergoing cataract surgery under local anaesthesia received a sub-Tenon's block with either of two local anaesthetic solutions. One consisted of 2% plain lignocaine 3 ml with 0.5% plain bupivacaine 2 ml. The other consisted of 2% lignocaine 1 ml containing 150 IU per ml of hyaluronidase with 2% plain lignocaine 2 ml and 0.5% plain bupivacaine 2 ml. The development of akinesia and the resulting block quality were assessed. Akinesia scores were lower at all time intervals and were significantly lower (P<0.05) up to 9 minutes after block in the hyaluronidase group. However, block quality as assessed by the surgeon was not significantly different between the groups. The addition of 150 IU hyaluronidase significantly speeds up the onset of surgical anaesthesia produced by a sub-Tenon's block.