Miracle-dz/UniFAR-FTUs huggingface dataset:
Anaesthetic management and outcomes after noncardiac surgery in patients with hypoplastic left heart syndrome: a retrospective review

Context Noncardiac surgery in patients with hypoplastic left heart syndrome has been associated with significant morbidity and mortality in case reports and small series. Objective A retrospective study to review the anaesthetic care and outcomes of patients with hypoplastic left heart syndrome undergoing noncardiac surgery. Design The medical records of patients undergoing anaesthesia for noncardiac surgery were reviewed, including anaesthesiology records, operative notes, admission history, physical examination records and discharge summaries. Data were collected on patient characteristics, co-morbidities, surgical procedure, anaesthetic and monitoring techniques, intraoperative and postoperative complications and admission status. Setting A tertiary medical centre with a high volume of congenital heart disease. Participants Seventy-three procedures performed in 40 patients with hypoplastic left heart syndrome undergoing noncardiac surgery between July 2002 and May 2008. Results Thirty-three procedures were performed on an outpatient basis without invasive monitoring or complications. Adverse events occurred in 11 (15%) cases, including cardiovascular and respiratory instability, airway obstruction and postoperative stridor, with 13 (18%) patients admitted to the ICU postoperatively. Conclusion Given the high incidence of adverse events in this patient population, it is imperative that perioperative care be individualised based on the presence of known risk factors such as the stage of palliation, residual cardiac disease and severity of planned surgery.
Promoting development and use of systematic reviews in a developing country.

INTRODUCTION One major barrier to develop health systems is the limited capacity for conducting research and implementation of research findings. We assessed the views of researchers, decision makers and research policy makers on how the development and usage of evidence from systematic reviews can be promoted in a country with limited resources. METHODS We surveyed 131 participants in six systematic review workshops for their views on important items influencing the production and usage of systematic reviews in a developing country. They were also asked to propose interventions to deal with potential barriers. We analysed the quantitative data using multidimensional scaling methods, and the qualitative data using content analysis approach. RESULTS We identified seven clusters of items that contribute to the promotion of conducting and using systematic reviews. For each cluster a set of interventions are proposed that health care decision makers and research policy makers may use for promoting conduct and use of systematic reviews. The clusters are 'importance for policy makers', 'access to international research', 'priority and support for systematic reviews', 'competency and willingness of researchers to conduct reviews', 'importance for end-users', 'quality of local primary research' and 'visibility and access to local research'. DISCUSSION The proposed interventions focus on national level initiatives for making the systematic reviews 'wanted' and improving the capacity to conduct research. Our findings emphasize the essential role of policy makers for promoting systematic reviews. They demonstrate that many barriers stem from the lower quality of and lack of access to primary research originating from developing countries.
Evidence for a Great Medieval Earthquake (~1100 A.D.) in the Central Himalayas, Nepal

The Himalayan orogen has produced three thrust earthquakes with moment magnitude (Mw) 7.8 to 8.5 during the past century, yet no surface ruptures associated with these great earthquakes have been documented. Here, we present paleoseismic evidence from east central Nepal that, since ∼700 A.D., a single earthquake ruptured the Frontal Thrust fault at ∼1100 A.D., with a surface displacement of ∼17 (+5/–3) meters and a lateral extent and size that could have exceeded 240 kilometers and ∼Mw 8.8, respectively. Ruptures associated with Mw <8.2 events would contribute to the frontal Himalayas folding but would stop before reaching the surface. These findings could require substantial modifications to current regional seismic hazard models.
Endoplasmic reticulum stress is induced and modulated by enterovirus 71

Picornavirus infection alters the endoplasmic reticulum (ER) membrane but it is unclear whether this induces ER stress. Infection of rhabdomyosarcoma cells with enterovirus 71 (EV71), a picornavirus, caused overexpression of the ER‐resident chaperone proteins, BiP and calreticulin, and phosphorylation of eIF2α, but infection with UV‐inactivated virus did not, indicating that ER stress was induced by viral replication and not by viral attachment or entry. Silencing (si)RNA knockdown demonstrated that phosphorylation of eIF2α was dependent on PKR: eIF2α phosphorylation was reduced by siPKR but not by siPERK. We provided evidence showing that PERK is upstream of PKR and is thus able to negatively regulate the PKR‐eIF2α pathway. Pulse‐chase experiments revealed that EV71 infection inhibited translation and activation of ATF6. Expression of BiP at the protein level was activated by a virus‐dependent, ATF6‐independent mechanism. EV71 upregulated XBP1 mRNA level, but neither IRE1‐mediated XBP1 splicing nor its active spliced protein was detected, and its downstream gene, EDEM, was not activated. Epigenetic BiP overexpression alleviated EV71‐induced ER stress and reduced viral protein expression and replication. Our results suggest that EV71 infection induces ER stress but modifies the outcome to assist viral replication.
A scoring system based on the expression of six surface molecules allows the identification of three prognostic risk groups in B‐cell chronic lymphocytic leukemia

We have previously identified 12 surface antigens whose differential expression represented the signature of B‐cell chronic lymphocytic leukemia (B‐CLL) subsets with different prognosis. In the present study, expression data for these antigens, as determined in 137 B‐CLL cases, all with survivals, were utilized to devise a comprehensive immunophenotypic scoring system of prognostic relevance for B‐CLL patients. In particular, univariate z score was employed to identify the markers with greater prognostic impact, while maximally selected log‐rank statistics were chosen to define the optimal cut‐off points capable to split patients into two groups with different survivals. A weighted immunophenotypic scoring system was developed by integrating results from these analyses. Six antigens were selected: three positive prognosticators (CD62L, CD54, CD49c) and three negative prognosticators (CD49d, CD38, CD79b), with cut‐off values ranging from 30% to 50% of positive cells. By weighing the expression of each marker according to its statistical power, a complete scoring system, with point values comprised between 0 (complete absence of phenotypic conditions associated with good prognosis) and 9 (all the phenotypic conditions associated with good prognosis fulfilled), allowed to split the whole set of B‐CLL patients, into three distinctive prognostic groups (P = 4.78 × 10−11) with high‐ (score 0–3), intermediate‐ (score 4–6), and low‐ (score 7–9) risk of death. The three risk groups showed different distribution of cases as for Rai's stages, IgVH mutations, and ZAP‐70 expression. The proposed immunophenotypic scoring system may be an additional useful tool in routine diagnostic/prognostic procedures for B‐CLL. J. Cell. Physiol. 207: 354–363, 2006. © 2005 Wiley‐Liss, Inc.
Why do macaroni penguins choose shallow body angles that result in longer descent and ascent durations?

SUMMARY It is generally assumed that air-breathing aquatic animals always choose the shortest route to minimize duration for transit between the surface and foraging depth in order to maximize the proportion of time spent foraging. However, empirical data indicate that the body angles of some diving animals are rarely vertical during descent and ascent. Why do they choose shallower body angles that result in longer descent and ascent durations? To investigate this question, we attached acceleration data loggers to eight female macaroni penguins, breeding on the Kerguelen Islands (48°45′–50°00′S, 68°45′–70°58′E; South Indian Ocean), to record depth, two-dimensional acceleration (stroke cycle frequency and body angle) and temperature. We investigated how they controlled body angle and allocated their submerged time. The instrumented females performed multiple dives (N=6952) with a mean dive depth for each bird ranging from 24.5±28.5 m to 56.4±75.1 m. Mean body angles during descent and ascent were not vertical. There was large variation in mean descent and ascent angles for a given dive depth, which, in turn, caused large variation in descent and ascent duration. Body angles were significantly correlated with time spent at the bottom-phase of the dive. Birds that spent long periods at the bottom exhibited steep body angles during ascent and subsequent descent. By contrast, they adopted shallow body angles after they had short or no bottom phases. Our results suggest that macaroni penguins stay at the bottom longer after encountering a good prey patch and then travel to the surface at steep body angles. If they do not encounter prey, they discontinue the dive, without staying at the bottom, ascend at shallow body angles and descend at shallow body angles in a subsequent dive. A shallow body angle can increase the horizontal distance covered during a dive, contributing to the move into a more profitable area in the following dive. During the ascent, in particular, macaroni penguins stopped beating their flippers. The buoyantly gliding penguins can move horizontally with minimum stroking effort before reaching the surface.
Endoplasmic reticulum Ca2+ depletion activates XBP1 and controls terminal differentiation in keratinocytes and epidermis

Background Endoplasmic reticulum (ER) Ca2+ depletion, previously shown to signal pathological stress responses, has more recently been found also to trigger homeostatic physiological processes such as differentiation. In keratinocytes and epidermis, terminal differentiation and barrier repair require physiological apoptosis and differentiation, as evidenced by protein synthesis, caspase 14 expression, lipid secretion and stratum corneum (SC) formation.
THE EFFECT OF INTRAHIPPOCAMPAL KAINIC ACID INJECTIONS AND SURGICAL LESIONS ON NEUROTRANSMITTERS IN HIPPOCAMPUS AND SEPTUM

Local injection of kainic acid (2 μg) was accompanied by destruction of intrinsic neurons in the dorsal part of hippocampus. The lesion was accompanied by a 75% reduction in glutamate decarboxylase activity, a 60% reduction in the high affinity uptake of l‐glutamate, a 40‐60% reduction in the endogeneous levels of aspartate, glutamate and GABA and no changes in the activities of choline acetyltransferase or aromatic amino acid decarboxylase in the dorsal hippocampus. Unilateral destruction of neurons in the dorsal hippocampus was followed by a 20‐40% reduction in the high affinity uptake of glutamate in lateral, but not in medial septum, on both sides. There was no reduction in choline acetyltransferase, glutamate decarboxylase or aromatic amino acid decarboxylase activities in the lateral or medial part of the septum. Transection of fimbria and superior fornix was accompanied by a severe reduction in choline acetyltransferase and aromatic amino acid decarboxylase activity in hippocampus, in the high affinity uptake of glutamate and in the endogenous level of glutamate in the lateral septum. The results are consistent with the concept that in the hippocampus kainic acid destroys intrinsic neurons and not afferent fibres. It seems therefore that all GABAergic fibres in the hippocampus belong to intrinsic neurons whereas glutamergic and aspartergic neurons belong partly to local neurons. The connection from the hippocampus to the lateral septum probably uses glutamate as a transmitter.
Drivers' behaviour at roundabouts in Riyadh

As is the case in many cities, roundabouts are used extensively in Riyadh. However, instead of improving safety, driving through roundabouts in Riyadh can be a dangerous experience as many drivers do not follow regulations. Unfortunately, no official statistics exist on accidents or violations at roundabouts and no studies have been done to assess this problem. A field study to collect data on drivers' behaviour at five roundabouts in Riyadh was done and a questionnaire was randomly distributed to drivers to explore this issue. Results showed that the percentage of drivers breaching at least one traffic regulation is approximately 90% of all drivers driving through these roundabouts, with leaving without flashing and entering the roundabout without giving way being the most frequent violation types. Questionnaire results from 384 respondents showed that there is a lack of information among most drivers on roundabout driving regulations and that driver training and licensing process does not include enough information related to this matter. Finally, practical suggestions as how to tackle this issue in terms of education, training and policing are given.
Maternal Outcome in Eclampsia with Low Dose Magnesium Sulphate Therapy

Eclampsia is defined as the development of seizures that cannot be attributed to other causes and/or unexplained coma associated with signs of pre-eclampsia during pregnancy, labor or within 7 days of delivery(1). There has been some debate regarding the choice of anti-convulsant agents but this controversy has been resolved once for all by The Eclampsia Trial Collaborative Group Study and Cochrane review which concluded that magnesium sulphate was safer and better than phenytoin, diazepam and lytic cocktail. It has advantage of being having lower cost, ease of administration, rapid onset of action, less sedation and has easily available antidote (calcium gluconate) (2,3). The World Health Organisation has also recommended magnesium sulphate as the most effective, safe and low cost drug for the treatment of eclampsia (4). Pritchard Regimen has been the gold standard since the original article describing it was published (5). However, high toxicity has been a major concern particularly when recipient are of small built. Many authors have suggested that the dose of magnesium sulphate should be limited in women who are known to be or appear to be small. Women in India, Introduction Abstract The crosssectional study was undertaken to evaluate maternal outcomes with low dose magnesium sulphate therapy in patients admitted with and those who developed eclampsia after admission. The study included 123 eclampsia patients. The patients were subjected to low dose magnesium sulphate therapy as first loading dose of 4 gm intravenous diluted in 20 cc of 5% dextrose, slower over 15-20 minutes, followed by maintenance dose of 2 gm intravenously similarly diluted 3 hourly till 24 hours after delivery or after last convulsion, whichever was later.Toxicity of magnesium sulphate was assessed before each dose in the form of deep tendon reflexes, urine output (30 ml/hour) and respiratory rate (16/minute). Termination of pregnancy was undertaken in all cases of eclampsia. Delivery was expedited in the form of induction/ augmentation of labor or LSCS depending upon assessment of each case. Over a period of one year of study, there were 16213 deliveries and 123 cases of eclampsia making an incidence of 0.76%. Among 81 patients who had antepartum/intrapartum eclampsia, 59 (72.83%) delivered vaginally spontaneously, 3 (3.70%) had assisted vaginal deliveries and 19 (23.45%) patients underwent LSCS. There was only one maternal death with maternal mortality rate of 0.81%. Only 8 (6.50%) patients developed respiratory tract infection, 6 (4.87%) patients developed PPH, 2 (1.62%) patients developed cerebrovascular accident, 7 (5.69%) patients developed abruption placenta. No treatment failure was seen and only 1 (0.81%) patient had fit recurrence. Majority of the patients (60.16%) had hospital stay of less than 6 days. No case of magnesium sulphate toxicity was reported. Thus, low dose magnesium sulphate therapy is as effective as high dose standard regimen with favourable maternal outcome.
Dynamics of a body with internal moving masses in the presence of dry friction

Dynamics of a rigid body moving along a plane and carrying internal movable masses is analyzed. The body is subjected by dry friction forces obeying Coulomb's law. The motion is controlled by internal masses that have two degrees of freedom relative to the body. It is shown that, under certain conditions, the body can be transferred from an initial position to any prescribed terminal position in the plane.
The rate of clinically significant plain radiograph misinterpretation by faculty in an emergency medicine residency program.

OBJECTIVE To estimate the rate of clinically significant discrepancies between radiograph interpretations by attending radiologists and emergency medicine (EM) faculty in 2 academic EDs, using a unique scoring system. METHODS A retrospective comparison of radiographic agreement between EM and radiology faculty members was performed. All plain films initially interpreted by EM faculty or by EM residents with immediate reinterpretation by EM faculty were subsequently reviewed by attending radiologists. All discrepancies between these readings were reported to the ED on the following day for review by an EM faculty member (usually different from the initial EM faculty reader) who determined the need for treatment or follow-up changes. A secondary chart review by a quality assurance faculty member determined whether radiographic findings not noted on the x-ray log were present on the ED record All discrepancies from February to June 1994 were reviewed. A severity score was assigned based on the following criteria. Q-0: There was no change in treatment or follow-up; or the initial interpretation by EM faculty was validated by repeat or additional views. Q-1: Discrepancy is minor. Q-2: Discrepancy is significant, with potential for injury or bad outcome. Q-3: Discrepancy is significant, with actual injury or bad outcome. RESULTS Of 14,046 radiographic studies eligible for enrollment, there were 134 discrepancies (0.95%). Only 28 cases (0.2%) were found to be clinically significant. Of these, 25 were scored Q-1, 3 were scored Q-2, and 0 were scored Q-3. These clinically significant discrepancy rates were highest for the finger, skull, elbow, hand, and lumbar spine. CONCLUSION Emergency medicine faculty provide highly accurate rates of plain radiograph interpretation, particularly when adjusted for clinical significance and actual impact on patient care.
Cortical Evoked Potentials and Extraversion

&NA; Stimulus intensity modulation was studied in extraverts and introverts. Auditory evoked potentials were recorded in 29 subjects and visual evoked potentials in 55. In both sensory modalities, extraverts showed considerably larger amplitudes of the late components of the evoked potentials, suggesting that they were more “open” to stimuli than introverts. In this way, extraverts' responses to simple stimuli could be seen as similar to their interchange with the complex stimuli of the social world.
MITOCHONDRIAL ISCHEMIA-REPERFUSION INJURY OF THE TRANSPLANTED RAT HEART: IMPROVED PROTECTION BY PRESERVATION VERSUS CARDIOPLEGIC SOLUTIONS

Cold ischemia time and preservation of organs are limited by I/R injury leading to primary nonfunction of the graft. In a rat heart transplant model, we compared cardioplegic St Thomas (ST) to histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin preservation solutions in terms of contractile function, and mitochondrial respiratory and enzymatic defects after prolonged cold ischemia and reperfusion. Contractile function was scored after transplantation and 24 h of reperfusion. Mitochondrial function was investigated by high-resolution respirometry of permeabilized myocardial fibers. Graft performance in terms of contractile function declined with the duration of cold storage. Recovery was significantly improved after 10 h of cold storage in HTK compared with ST (cardiac scores, 3.3 ± 0.5 and 1.8 ± 0.8, respectively). Tissue lactate dehydrogenase was better preserved in HTK than ST. Increase of tissue water content (edema) was less pronounced in HTK than ST (3.33 ± 0.14 and 3.73 ± 0.21 mg/mg dry weight, respectively). Similar cardiac scores (2.6 ± 0.9 and 2.9 ± 1.2, respectively) and mitochondrial respiratory parameters were obtained after preservation in HTK and University of Wisconsin. Decline in contractile function of individual grafts correlated well with loss of mitochondrial respiratory capacity, whereas citrate synthase activity remained largely preserved, indicating specific damage of respiratory complexes. Our data provide evidence for the superiority of preservation solutions versus a cardioplegic solution for prolonged cold storage of the heart. The correlation of graft performance and mitochondrial function indicates the potential of high-resolution respirometry for quantitative assessment of myocardial injury upon cold I/R, providing a basis for diagnostic approaches and evaluation of improved preservation solutions for heart transplantation.Abbreviations-ADP-adenosine diphosphate; CIR-cold I/R; GSH-glutathione; HTK-histidine-tryptophan-ketoglutarate solution; TMPD-N,N,N',N'-tetramethyl-p-phenylenediamine dihydrochloride; ST-St Thomas solution; UW-University of Wisconsin solution
Population Structure Mediates Sexual Conflict in Water Striders

When water striders can disperse among groups, females select for reduced male aggression. Sexual conflict occurs when males and females act against each others’ interest, typically resulting in selection favoring harmful males. We performed laboratory experiments on sexual conflict that both confined individuals in isolated groups, which prevents selection acting counter to this conflict, and provided more naturalistic multigroup population structures. We show that in water striders, aggressive male mating behavior was strongly favored within groups but not favored in a multigroup population when individuals can freely disperse among groups. These observations explain the persistence of less-aggressive males within natural populations.