Miracle-dz/UniFAR-FTUs huggingface dataset:
[Change of labor duration:a systematic analysis].

OBJECTIVE To evaluate the labor duration of healthy primiparas in the past 20 years compared with Friedman labor curve. METHODS Published observational studies about labor duration in primiparas with singleton vertex presentation were searched in PubMed, EMBase, Cochrane library, CNKI, VIP and Wanfang database. The Cochrane Collaboration's RevMan 5.1 software was used for meta-analysis. RESULTS Eleven literatures involving 4534 primiparas were included, which were eligible for the criteria to investigate the labor duration. Meta-analysis showed that the length of active phase was significantly different between what was showed in primiparas in the past 20 years and Friedman labor curve [P = 0.01, weighted mean difference (WMD) = 1.61, 95%CI: 0.38 to 2.83], and significant differences were also found in the second stage duration (P = 0.0006, WMD = -0.20, 95%CI: -0.31 to -0.09). CONCLUSIONS Compared with Friedman labor curve, active phase length of healthy primiparas in the past 20 years was significantly longer and second stage length was shorter. Reassessing labor curve of healthy primiparas is required for more scientific guidance and less unnecessary interventions.
Embryonic and early postnatal abnormalities contributing to the development of hippocampal malformations in a rodent model of dysplasia

While there are many recent examples of single gene deletions that lead to defects in cortical development, most human cases of cortical disorganization can be attributed to a combination of environmental and genetic factors. Elucidating the cellular or developmental basis of teratogenic exposures in experimental animals is an important approach to understanding how environmental insults at particular developmental junctures can lead to complex brain malformations. Rats with prenatal exposure to methylazoxymethanol (MAM) reproduce many anatomical features seen in epilepsy patients. Previous studies have shown that heterotopic clusters of neocortically derived neurons exhibit hyperexcitable firing activity and may be a source of heightened seizure susceptibility; however, the events that lead to the formation of these abnormal cell clusters is unclear. Here we used a panel of molecular markers and birthdating studies to show that in MAM‐exposed rats the abnormal cell clusters (heterotopia) first appear postnatally in the hippocampus (P1–2) and that their appearance is preceded by a distinct sequence of perturbations in neocortical development: 1) disruption of the radial glial scaffolding with premature astroglial differentiation, and 2) thickening of the marginal zone with redistribution of Cajal‐Retzius neurons to deeper layers. These initial events are followed by disruption of the cortical plate and appearance of subventricular zone nodules. Finally, we observed the erosion of neocortical subventricular zone nodules into the hippocampus around parturition followed by migration of nodules to hippocampus. We conclude that prenatal MAM exposure disrupts critical developmental processes and prenatal neocortical structures, ultimately resulting in neocortical disorganization and hippocampal malformations. J. Comp. Neurol. 495:133–148, 2006. © 2006 Wiley‐Liss, Inc.
Which factors determine the optimal pedaling rate in sprint cycling?

INTRODUCTION Mechanical power output in sprint cycling depends on pedaling rate, with an optimum at around 130 revolutions per minute (rpm). In this study, the question is addressed if this optimal pedaling rate can be understood from a Hill-type description of muscular dynamics. In particular, it is investigated how 1) the power-velocity relationship that follows from Hill's force-velocity relationship and 2) activation dynamics (from the perspective of which the optimal pedaling rate is near-zero) affect the optimal pedaling rate. METHODS A forward dynamics modeling/simulation approach is adopted in this study. The skeletal model is a 2D linkage of rigid segments; it is actuated by eight Hill-type "muscles. " Input of the model is the neural stimulation of the muscles, output is the resulting movement and variables dependent thereupon, such as pedal forces. For a wide range of isokinetic pedaling rates, the neural stimulation is optimized with respect to the average mechanical power output. RESULTS Correspondence between experimental data and simulation results regarding 1) the (pedaling-rate dependent) muscle phasing, 2) pedal forces, and 3) the power-pedaling rate relationship is good. At the optimal pedaling rate predicted by the model (120 rpm), muscles contract at velocities well below those that maximize their power output. Finally, when a model is considered that lacks activation dynamics, it is found that both the optimal pedaling rate and the maximal power output increase substantially. DISCUSSION From the results pertaining to the standard model, it is concluded that the optimal pedaling rate is not uniquely specified by the power-velocity relationship of muscle, as suggested in literature. From the results pertaining to the model lacking activation dynamics, it follows that activation dynamics plays a surprisingly large role in determining the optimal pedaling rate. It is concluded that the pedaling rate that maximizes mechanical power output in sprint cycling follows from the interaction between activation dynamics and Hill's power-velocity relationship.
Registration of protocols for observational research is unnecessary and would do more harm than good

Being an epidemiologist means always having to say you're sorry. Epidemiology has constantly been criticised for the problems of lack of randomisation of exposures, misclassification of exposures and outcomes, and inadequate control of confounding.1 Nevertheless, epidemiologists continue to make important scientific discoveries, ranging from Snow's work on cholera2 to the discovery of tobacco smoking3 and asbestos4 as major causes of lung cancer, through to more recent discoveries such as the link between human papillomavirus (HPV) and cervical cancer.5 All of these discoveries took decades to become accepted, but eventually successful public health interventions followed. We must be doing something right. Of course, we can also get things wrong, and there are many examples of findings which hit the headlines but were not replicated when further studies were carried out.6 It is therefore not surprising that the public may be sceptical of epidemiological findings.6 Perhaps the problem is not that epidemiology is more prone to error than other sciences (basic researchers, for example geneticists, probably get things wrong at least as often, and often hype up their findings even more than we do), but that our mistakes may be more likely to be highlighted by the media. Examples include studies of β carotene and cardiovascular disease, hormone replacement therapy, vitamin E and vitamin C intake in relation to cardiovascular disease, and fibre intake in relation to colon cancer.7 However, these examples of ‘epidemiological failures’ primarily involve studies of lifestyle factors (particularly diet). These are notoriously difficult to investigate, since the exposed group (eg, those with high β carotene levels in their diets) will often be markedly different from the non-exposed group as regards other lifestyle factors. Ironically, some areas of epidemiological research are less prone to error, but these are often areas in …
Primary Central Nervous System Lymphoma: A Critical Review of the Role of Surgery for Resection.

BACKGROUND Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that carry a poor prognosis, with most patients suffering recurrence. Progress has been made in the treatment of this pathology, notably with the widespread use of systemic high dose methotrexate. However, unlike most other malignant CNS neoplasms, surgery for cytoreduction is not routinely performed for this disease, mainly as a result of negative experiences decades ago. Since these studies were published, the availability of intraoperative monitoring, MR imaging and neuro-navigation as well as surgical adjuncts such as fluorescence- guided resection have greatly improved the safety of intracranial procedures. More recent data is suggestive of a potential survival benefit for resection of single PCNSL lesions when patients are subsequently treated with modern regimen high-dose methotrexate, yet this evidence is limited, and should be interpreted conservatively. METHODS AND FINDINGS A systematic review of the literature was performed to identify trials evaluating surgical options for the treatment of PCNSL. CONCLUSION In this review, we provide a critical overview of the evidence favoring and discouraging resection for PCNSL. This literature suffers from several biases and limitations that must be considered in the context of the extrapolation of this literature into clinical decision-making.
The Impact of Interest in School on Educational Success in Portugal

Notwithstanding increased educational expenditure, Portugal continues to record poor educational outcomes. Underlining the weak expenditure-educational success link, a large body of work in educational economics displays that there is a tenuous relationship between a range of school inputs and cognitive achievement. Among others, the inability to establish a clear link between inputs and success has been attributed to the difficulty of controlling for unobserved attributes such as ability, motivation and interest. Against this background, and inspired by a large body of work in educational psychology which explicitly measures constructs such as educational motivation and interest, this paper examines whether a child’s interest in school has any bearing on educational success after controlling for the kinds of variables typically used in educational economics analyses. We rely on two data sets collected in Portugal in 1998 and 2001 and examine the interest-educational success link using both cross-section and panel data. Our estimates suggest that after controlling for time-invariant unobservable traits and for the simultaneous determination of interest and achievement, there is little support for the idea that prior interest in school has a bearing on future educational success.
Serum Elastase 1 in Clinical Practice

Using radioimmunoassay, we tested serum elastase 1 (El), an enzyme secreted only from the pancreas, in 200 subjects as follows: 39 healthy subjects as controls, 56 patients with diseases of the digestive tract, 66 patients with hepatobiliary diseases, and 39 patients with pancreatic diseases. The serum El showed high specificity and proved very useful in the diagnosis of acute pancreatitis. However it was not useful in diagnosis of clinically silent chronic pancreatitis, nor in its functional evaluation. On the other hand, it was found to be a valuable guide in revealing a concomitant pancreatic pathology during hepatobiliary diseases. Further investigation is needed of the behavior of El in patients who have undergone a total pancreatectomy, where the enzyme remains measurable, and in those with an ileocolic disease in an acute phase where El is increased in many patients.
Melatonin‐induced autophagy protects against human prion protein‐mediated neurotoxicity

Abstract: Melatonin has neuroprotective effects in the models of neurodegenerative disease including Alzheimer’s and Parkinson’s disease. Several studies have shown that melatonin prevents neurodegeneration by regulation of mitochondrial function. However, the protective action of melatonin has not been reported in prion disease. We investigated the influence of melatonin on prion‐mediated neurotoxicity. Melatonin rescued neuronal cells from PrP(106–126)‐induced neurotoxicity by prevention of mitochondrial dysfunction. Moreover, the protective effect of melatonin against mitochondrial dysfunction was related with autophagy activation. Melatonin‐treated cells were dose‐dependently increased in LC3‐II, an autophagy marker. Melatonin‐induced autophagy prevented a PrP(106–126)‐induced reduction in mitochondrial potential and translocation of Bax to the mitochondria and cytochrome c release. On the other hand, downregulation of autophagy protein 5 with Atg5 siRNA or the autophagy blocker 3‐methyladenine prevented the melatonin‐mediated neuroprotective effects. This is the first report demonstrating that treatment with melatonin appears to protect against prion‐mediated neurotoxicity and that the neuroprotection is induced by melatonin‐mediated autophagy signals. The results of this study suggest that regulation of melatonin is a therapeutic strategy for prion peptide‐induced apoptosis.
EFFECT OF COLLATAPE ® COLLAGEN WOUND DRESSING ALONE AND COMBINED WITH INGENIOS ® SYNTHETIC BONE GRAFT ON THE SOCKET HEALING IN

Introduction: Socket preservation enhances healing and reduces bone loss during healing of extraction socket. Objectives: To assess the effect of bio-absorbable collagen wound dressing (CollaTape®; Zimmer) on the of healing of extraction sockets in rabbits when applied alone and combined with IngeniOs Beta tricalcium phosphate (β-TCP) synthetic bone particles. Materials and methods: Sixteen rabbits were included in this study in which lower left first premolars were extracted and then divided into three groups including: Control group (4 animals) in which the sockets were left for normal healing, Collatape group (the sockets were closed with CollaTape collagen wound dressing alone) and IngeniOs β-TCP group (6 animals) in which the sockets were filled with synthetic bone particles and were closed with CollaTape collagen wound dressing. Euthanasia were done 2 and 6 weeks respectively. Socket healing was examined and evaluated histologically and analyzed histomorphometrically. Results: At 2 weeks of healing, it was observed in all groups that the sockets were filled with newly formed woven bone. The percentage of newly formed bone was lowest in control group followed by Collatape group while β-TCP group showed highest values. At 6 weeks healing period, the socket entrance was sealed with compact bone and the rest of the socket was filled with trabecular bone. β-TCP group showed the highest values of the percentage of the formed bone. Conclusions: It was confirmed that IngeniOs β-TCP enhances bone formation during socket healing and could be used for socket preservation
Escherichia coli Peritonitis in Peritoneal Dialysis: The Prevalence, Antibiotic Resistance and Clinical Outcomes in a South China Dialysis Center

♦ Introduction: Escherichia coli (E. coli) peritonitis is a frequent, serious complication of peritoneal dialysis (PD). The extended-spectrum β-lactamase (ESBL)-producing E. coli peritonitis is associated with poorer prognosis and its incidence has been on continuous increase during the last decades. However, the clinical course and outcomes of E. coli peritonitis remain largely unclear. ♦ Methods: All of the E. coli peritonitis episodes that occurred in our dialysis unit from 2006 to 2011 were reviewed. The polymicrobial episodes were excluded. ♦ Results: In total, ninety episodes of monomicrobial E. coli peritonitis occurred in 68 individuals, corresponding to a rate of 0.027 episodes per patient-year. E. coli was the leading cause (59.2%) of monomicrobial gram-negative peritonitis. ESBL-producing strains accounted for 35.5% of E. coli peritonitis. The complete cure rate and treatment failure rate of E. coli peritonitis were 77.8% and 10.0% respectively. Patients with preceding peritonitis had a higher risk of ESBL production as compared to those without peritonitis history [odds ratio (OR): 5.286; 95% confidence interval (CI): 2.018 - 13.843; p = 0.001]. The risk of treatment failure was significantly increased when the patient had a baseline score of Charlson Comorbidity Index (CCI) above 3 (OR: 6.155; 95% CI: 1.198 - 31.612; p = 0.03), or had diabetes mellitus (OR: 8.457; 95% CI: 1.838 - 38.91; p = 0.006), or hypoalbuminemia (≤ 30g/l) on admission (OR: 13.714; 95% CI: 1.602 - 117.428; p = 0.01). Prolonging the treatment course from 2 to 3 weeks or more reduced the risk of relapse and repeat significantly (p < 0.05). ♦ Conclusions: E. coli peritonitis remains a common complication of PD. The clinical outcomes of E. coli peritonitis are relatively favorable despite the high ESBL rate. A history of peritonitis is associated with increased risk for ESBL development. The severity of baseline comorbidities, the presence of diabetes mellitus and hypoalbuminemia at admission are associated with poor outcomes.
Theories of Tax Competition

A central message of the tax competition literature is that independent governments engage in wasteful competition for scarce capital through reductions in tax rates and public expenditure levels. This paper discusses many of the contributions to this literature, ranging from early demonstrations of wasteful tax competition to more recent contributions that identify efficiencyenhancing roles for competition among governments. Such roles involve considerations not present in earlier models, including imperfectly-competitive market structures, government commitment problems, and political economy considerations.
Serum Cholesterol in Patients with Obsessive Compulsive Disorder during Treatment with Behavior Therapy and SSRI or Placebo

Objective: Patients with panic disorder are reported to have elevated cholesterol levels. There is also some evidence that cholesterol elevation is not so much a specific condition in panic disorder but is generally associated with anxiety. So far, there is little data on cholesterol levels in patients with obsessive compulsive disorders (OCD) which is also classified as anxiety disorder. Method: Thirty-three patients with OCD participated in the study. Serum cholesterol was measured as pretreatment and at the end of a ten-week treatment-period. All patients received behavior therapy and, in a double-blind fashion, fluvoxamine or placebo. Severity of OCD was assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results: Pretreatment cholesterol values of OCD patients were compared with cholesterol levels of thirty panic disorder patients and thirty normal controls. OCD patients had elevated cholesterol levels comparable with those of panic disorder patients. Cholesterol levels decreased significantly from pre- to posttreatment. OCD patients with high cholesterol levels (≥ 240 mg/dl, n = 7) could make best use of the treatment whereas patients with desirable cholesterol levels (< 200 mg/dl, n = 11) did not change their cholesterol during treatment. Conclusions: Our data support the assumption that not only panic disorder but also other anxiety disorders, e.g., obsessive compulsive disorders, may be associated with serum cholesterol elevations. Effective treatment (behavior therapy and/or treatment with a selective serotonin reuptake inhibitor [SSRI]) seems to decrease cholesterol levels, especially in patients with pathological cholesterol elevations.
Acarbose and metabolic control in patients with type 2 diabetes with newly initiated insulin therapy

Aim: This study was designed to investigate the effect of acarbose in patients with type 2 diabetes with newly initiated insulin treatment who had previously been insufficiently controlled with oral antihyperglycaemic agents [haemoglobin A1c (HbA1c) ≥ 8%].
Managing the safety of inhaled corticosteroids in COPD and the risk of pneumonia

Introduction: Inhaled corticosteroids (ICS) are known to increase the risk of pneumonia in patients with chronic obstructive pulmonary disease. To estimate the association between ICS and pneumonia among users of ICS relative to non-ICS users and to examine whether this risk is dose related, class related and what’s its association with the pneumonia-mortality or overall mortality. Areas covered: Through a comprehensive literature search of MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials.gov from inception to February 2015, we identified randomized controlled trials of ICS therapy lasting at least 6 months. We conducted meta-analyses to generate summary estimates comparing ICS with non-ICS treatment on the risk of pneumonia. Expert opinion: ICS alone or in combination with long-acting β-agonists are associated with an increased risk of pneumonia but have no effect on pneumonia related mortality. It is important to identify those patients to benefit the most from ICS, as those with frequent exacerbations, a severe airway obstruction, a positive bronchodilator test or a sputum eosinophilia despite treatment.
Relationship between Altered Platelet Morphological Parameters and Retinopathy in Patients with Type 2 Diabetes Mellitus

Purpose. To investigate whether platelet morphology or function is altered in patients with diabetic retinopathy (DR). Methods. This prospective study enrolled 85 healthy controls (HCs) (group 1) and 262 patients with Type 2 diabetes mellitus (T2DM). Patients were subclassified into three groups according to ocular findings: no DR (group 2; n = 88); nonproliferative DR (group 3; n = 88), and proliferative DR (group 4; n = 86). Mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (PLCR), plateletcrit (PCT) values, and platelet count were measured in the studied groups. Results. MPV, PDW, and PLCR levels were significantly altered in groups 2–4 compared with HCs (p < 0.05, p < 0.05, p < 0.05). Compared with group 2, both DR groups had higher MPV and PDW levels, with a significant difference between groups 2 and 4 for both MPV (p = 0.036) and PDW (p = 0.006). PLCR correlated with retinopathy stage, but no significant difference was found between the DR groups. Platelet count and PCT values were not significantly different between the groups (p > 0.05). Conclusion. Our findings suggest an association between mean platelet indices (MPI) (i.e., MPV, PDW, and PLCR) and DR stage. Therefore, MPI could be a beneficial prognostic marker of DR in patients with T2DM.
Comparison between von Willebrand Factor (VWF) and VWF Antigen II in Normal Individuals and Patients with von Willebrand Disease

Summary Von Willebrand disease is characterised by a quantitative (type 1) or qualitative (type 2) decrease in von Willebrand factor (vWF) a multimeric glycoprotein involved in primary haemostasis. The propep-tide of von Willebrand, also named vWF antigen II (vWF:AgII), is released from platelets and endothelial cells and circulates in plasma as a glycoprotein of 100 kD. In the present study, we attempted to determine whether vWF:AgII level may provide information on the synthesis of vWF, specially in patients with von Willebrand disease (vWD). To elucidate that point, we developed an ELISA and quantify the vWF:AgII in normal individuals and in various vWD patients. The propeptide molar concentration was found to be 5nM as compared to 31 nM for mature vWF. In normal individuals, the level of vWF:AgII was significantly decreased in females from O and A blood groups. In type 2 vWD patients the level of plasma vWF:AgII appears normal in the patients with normal level of platelet vWF. In type 2 B vWD characterised by increased affinity of mature vWF for platelet glyco-protein Ib, the vWF:Ag II in contrast to the vWF antigen (vWF:Ag) was not decreased. In type 2A vWD patients the level of vWF:AgII was decreased in patients with absence of high molecular weight vWF in platelets and plasma but normal in patients with increased sensitivity to proteolysis. Finally, in type 1 vWD, some studied patients have a parallel decrease in vWF:AgII and vWF:Ag whereas in others, the vWF:Ag levels were much more affected than corresponding vWF:AgII levels, as observed in some type 2 vWD patients. Thus, in contrast to that already described, the plasma vWF:AgII level cannot discriminate type 1 from type 2 vWD patients. We conclude that the vWF:AgII measurement provides additional information on the mechanisms responsible for vWD and might also contribute to the classification of vWD patients.