Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of fentanyl–bupivacaine or midazolam–bupivacaine mixtures with plain bupivacaine for caudal anaesthesia in children

Summary Background: The aim of this study was to evaluate the intensity and effectiveness of 0.75 ml·kg−1 bupivacaine 0.25% with the addition of fentanyl or midazolam for caudal block in children undergoing inguinal herniorrhaphy.
The Reduction of Serum B‐Lymphocyte Activating Factor levels following Quinacrine Add‐On Therapy in Systemic Lupus Erythematosus

B‐Lymphocyte‐activating factor (BAFF/BLyS) is a survival factor for B cells, belonging to the tumor necrosis ligand super family. Serum BAFF levels have been found to be elevated in patients with systemic lupus erythematosus (SLE). Neutralization of BAFF activity was suggested as an additional therapeutic approach in SLE. To determine the effect of add‐on Quinacrine (Qn) treatment on serum BAFF levels and the effect of this treatment on SLE disease activity index (SLEDAI), antidsDNA and anticardiolipin (aCL) antibody levels, we treated 29 stable SLE patients, who were maintained on prednisolone and hydroxychloroquine and in some on azathioprine (AZT), with additional Qn (100 mg/d) with an aim to further reduce disease activity. SLEDAI, antidsDNA, aCL antibodies and serum BAFF levels were assessed before and 3 months after the addition of Qn. Three months following Qn initiation, a reduction in SLEDAI was noticed in 19/29 patients (mean 8.8 ± 2.3 to 3.3 ± 1.5, P = 0.009), followed by reduction or discontinuation of prednisolone in all patients and the discontinuation of AZT in five patients. Serum BAFF levels were significantly reduced in 8/12 patients (mean 6.3 ± 0.5 to 3.0 ± 0.56 ng/ml P = 0.0001). This reduction was found in correlation with a decrease in aCL titres. However, the decrease in SLEDAI scores and antidsDNA antibody titres was unrelated to the decrease in serum BAFF or aCL levels. We conclude that the addition of Qn to previous therapeutic regimens in active SLE is beneficial and seems to reduce SLEDAI scores, serum BAFF and aCL levels and therefore should be considered in many of our SLE patients before aggressive treatments are given.
Predicting Intention to Adopt Interorganizational Linkages: An Institutional Perspective

This study used institutional theory as a lens to understand the factors that enable the adoption of interorganizational systems. It posits that mimetic, coercive, and normative pressures existing in an institutionalized environment could influence organizational predisposition toward an information technology-based interorganizational linkage. Survey-based research was carried out to test this theory. Following questionnaire development, validation, and pretest with a pilot study, data were collected from the CEO, the CFO, and the CIO to measure the institutional pressures they faced and their intentions to adopt financial electronic data interchange (FEDI). A firm-level structural model was developed based on the CEO's, the CFO's, and the CIO's data. LISREL and PLS were used for testing the measurement and structural models respectively. Results showed that all three institutional pressures-mimetic pressures, coercive pressures, and normative pressures-had a significant influence on organizational intention to adopt FEDI. Except for perceived extent of adoption among suppliers, all other subconstructs were significant in the model. These results provide strong support for institutional-based variables as predictors of adoption intention for interorganizational linkages. These findings indicate that organizations are embedded in institutional networks and call for greater attention to be directed at understanding institutional pressures when investigating information technology innovations adoption.
Balloon catheter disruption of middle cerebral artery thrombus in conjunction with thrombolysis for the treatment of acute middle cerebral artery embolism.

BACKGROUND AND PURPOSE The goal of this study was to prospectively assess the feasibility, safety, and efficacy of balloon disruption of the middle cerebral artery (MCA) by using a deflated balloon catheter combined with an intra-arterial thrombolysis for the treatment of acute ischemic stroke. MATERIALS AND METHODS Seven consecutive patients with clinical findings of acute major-vessel stroke met our criteria and underwent balloon disruption of an MCA thrombus with a deflated balloon catheter. The balloon disruption was performed with a low-profile microballoon catheter. The microballoon was inflated in the distal carotid artery and then deflated and advanced just distal to the occlusion site in the MCA. Thereafter, an intra-arterial thrombolysis of the MCA was applied. The maximum time from the onset of symptoms to the start of treatment and maximum dosage of urokinase was 6 hours and 600,000 U. The outcome was classified as good for a modified Rankin Scale (mRS) score of 0 or 1, moderate for a score of 2 or 3, and poor for a score of 4 or 5. RESULTS Complete recanalization was achieved in 5 patients and partial recanalization in 3. Three patients recovered to an mRS score of 0 or 1; 3, to scores of 2 or 3; and 1, to a score of 4. No patients died. There was no major intracerebral hemorrhage. CONCLUSIONS The penetration of the MCA with a deflated balloon catheter combined with an intra-arterial thrombolysis may be a safe and effective treatment for acute ischemic stroke.
Histamine regulates autoreactive T cell activation and adhesiveness in inflamed brain microcirculation

Histamine may contribute to the pathology of MS and its animal model EAE. We explored the effects of histamine and specific HR agonists on activation and migratory capacity of myelin‐autoreactive T cells. We show that histamine in vitro inhibits proliferation and IFN‐γ production of mouse T cells activated against PLP139–151. These effects were mimicked by the H1R agonist HTMT and the H2R agonist dimaprit and were associated with reduced activation of ERK½ kinase and with increased levels of cell cycle inhibitor p27Kip‐1, both involved in T cell proliferation and anergy. H1R and H2R agonists reduced spontaneous and chemokine‐induced adhesion of autoreactive T cells to ICAM‐1 in vitro and blocked firm adhesion of these cells in inflamed brain microcirculation in vivo. Thus histamine, through H1R and H2R, inhibits activation of myelin‐autoreactive T cells and their ability to traffic through the inflamed BBB. Strategies aimed at interfering with the histamine axis might have relevance in the therapy of autoimmune disease of the CNS.
Efficient Enzymatic Hydrolysis of Bamboo by Pretreatment with Steam Explosion and Alkaline Peroxide

A combination of steam explosion (SE) and alkaline peroxide (AP) used to pretreat bamboo was investigated. Steam explosion at 224 °C for 4 min was applied to bamboo, and the pretreated bamboo was delignified by alkaline peroxide. Enzymatic hydrolysis was compared in the pretreated samples. Steam pretreatment led to remarkable hemicellulose solubilization (63.2%). Lignin solubilization (93.1%) was achieved by alkaline peroxide treatment of steam-pretreated bamboo at 80 °C for 1 h in 0.88% (v/v) H2O2, whereas only 33.4% of lignin was solubilized when using raw bamboo. Pretreatment methods resulted in a low degree of polymerization and increased hydrolysis of cellulose. A maximum glucose yield of 90.5% was achieved with a combined steam explosion and alkaline peroxide pretreatment. The surface structure of treated bamboo and the adsorption of enzyme on the substrate were characterized by X-ray photoelectron spectroscopy. Delignification decreased enzyme adsorption and increased enzymatic conversion. SEM analyses indicated that SE-AP pretreatment disrupted lignin networks and exposed crystalline cellulose in bamboo more effectively than SE or AP pretreatment alone.
Belief Disagreements and Collateral Constraints

Belief disagreements have been suggested as a major contributing factor to the recent financial crisis. This paper theoretically evaluates this hypothesis. I assume that optimists have limited wealth and take on leverage in order to take positions in line with their beliefs. To have a significant effect on asset prices, they need to borrow from traders with pessimistic beliefs using loans collateralized by the asset itself. Since pessimists do not value the collateral as much as optimists do, they are reluctant to lend, which provides an endogenous constraint on optimist's ability to borrow and to influence asset prices. I demonstrate that the tightness of this constraint depends on the nature of belief disagreements. Optimism concerning the probability of downside states has no or little effect on asset prices because these types of optimism are disciplined by this constraint. Instead, optimism concerning the relative probability of upside states could have significant effects on asset prices. This asymmetric disciplining effect is robust to allowing for short selling because pessimists that borrow the asset face a similar endogenous constraint. These results emphasize that what investors disagree about matters for asset prices, to a greater extent than the level of disagreements. When richer contracts are available, insurance contracts (similar to credit default swaps) endogenously emerge to facilitate betting. Richer contracts moderate the effect of belief disagreements on asset prices because the medium of betting shifts from buying (or shorting) the asset to trading alternative contracts.
Modulation of &ggr;-Aminobutyric Acid Type A Receptor–mediated Spontaneous Inhibitory Postsynaptic Currents in Auditory Cortex by Midazolam and Isoflurane

Background: Anesthetic agents that target &ggr;-aminobutyric acid type A (GABAA) receptors modulate cortical auditory evoked responses in vivo, but the cellular targets involved are unidentified. Also, for agents with multiple protein targets, the relative contribution of modulation of GABAA receptors to effects on cortical physiology is unclear. The authors compared effects of the GABAA receptor–specific drug midazolam with the volatile anesthetic isoflurane on spontaneous inhibitory postsynaptic currents (sIPSCs) in pyramidal cells of auditory cortex. Methods: Whole cell recordings were obtained in murine brain slices at 34°C. GABAA sIPSCs were isolated by blocking ionotropic glutamate receptors. Effects of midazolam and isoflurane on time course, amplitude, and frequency of sIPSCs were measured. Results: The authors detected no effect of midazolam at 0.01 &mgr;m on sIPSCs, whereas midazolam at 0.1 and 1 &mgr;m prolonged the decay of sIPSCs by approximately 25 and 70%, respectively. Isoflurane at 0.1, 0.25, and 0.5 mm prolonged sIPSCs by approximately 45, 150, and 240%, respectively. No drug-specific effects were observed on rise time or frequency of sIPSCs. Isoflurane at 0.5 mm caused a significant decrease in sIPSC amplitude. Conclusions: The dose dependence of isoflurane effects on GABAA sIPSCs in pyramidal cells is consistent with effects on auditory evoked response in vivo. By contrast, comparable effects of midazolam on GABAA sIPSCs arise at concentrations exceeding those currently thought to be achieved in vivo, suggesting that the cellular targets of midazolam reside elsewhere in the thalamocortical circuit or that the concentration of midazolam reached in the brain is higher than currently believed.
Hospital Nurses’ Perceptions of Respect and Organizational Justice

Objective: To test an exploratory model of the antecedents and consequences of nurses’ perceptions of respect in hospitals. Background: Although nurses in hospital settings often state that they do not receive the respect they deserve for their contribution to patient care, there is little empirical research on this phenomenon. Interactional organizational justice theory framed the analysis. Methods: A random sample of 285 staff nurses from Ontario teaching hospitals completed measures of interactional justice, structural empower-ment, perceived respect, work pressures, emotional exhaustion, and work effectiveness. Results: More than half of the nurses felt that managers did not show concern or deal with them in a sensitive and truthful manner regarding decisions affecting their jobs. The strongest predictors of perceptions of respect were interactional organizational justice, followed by structural empowerment and job stress resulting from lack of recognition, poor interpersonal relationships and heavy workload. Consequences of nurses’ feelings of respect included greater job satisfaction, trust in management, and lower emotional exhaustion, as well as higher nurse ratings of quality of care and perceived staffing adequacy. Conclusions: A positive organizational environment increases nurses’ perceptions of respect, resulting in positive outcomes for both the nurse and the organization.
Tracheostomy for Ventilator Dependence in the Elderly Patient: A Preliminary Report

With advances in medical technology and increasing numbers of elderly patients surviving acute intensive care unit admissions, otolaryngologic consultation regarding tracheostomy for ventilator-dependent patients is expected to continue increasing. However, established treatment guidelines and defined outcomes in terms of health status, quality of life, and medical costs are lacking in this emotionally delicate setting. A retrospective case review of the outcomes of 19 elderly patients who underwent tracheostomy for ventilator dependence revealed that 14 had died within 40 days of surgery. The high number of deaths—which were caused by multiple organ failure, sepsis, and/or cardiopulmonary arrest—so soon after tracheostomy demands the implementation of outcomes research. In this article, we introduce outcomes analysis as a means of assessing the utility of tracheostomy for ventilator dependence in the elderly and to advocate the establishment of a multidisciplinary palliative-care unit for this group of patients.
Effectiveness of psychotherapy for personality disorders.

OBJECTIVE The authors examined the evidence for the effectiveness of psychotherapy for personality disorders in psychotherapy outcome studies. METHOD Fifteen studies were located that reported data on pretreatment-to-posttreatment effects and/or recovery at follow-up, including three randomized, controlled treatment trials, three randomized comparisons of active treatments, and nine uncontrolled observational studies. They included psychodynamic/interpersonal, cognitive behavior, mixed, and supportive therapies. RESULTS All studies reported improvement in personality disorders with psychotherapy. The mean pre-post effect sizes within treatments were large: 1.11 for self-report measures and 1.29 for observational measures. Among the three randomized, controlled treatment trials, active psychotherapy was more effective than no treatment according to self-report measures. In four studies, a mean of 52% of patients remaining in therapy recovered--defined as no longer meeting the full criteria for personality disorder--after a mean of 1.3 years of treatment. A heuristic model based on these findings estimated that 25.8% of personality disorder patients recovered per year of therapy, a rate sevenfold larger than that in a published model of the natural history of borderline personality disorder (3.7% recovered per year, with recovery of 50% of patients requiring 10.5 years of naturalistic follow-up). CONCLUSIONS Psychotherapy is an effective treatment for personality disorders and may be associated with up to a sevenfold faster rate of recovery in comparison with the natural history of disorders. Future studies should examine specific therapies for specific personality disorders, using more uniform assessment of core pathology and outcome.
The Efficient Catabolism of Thrombin-Protease Nexin 1 Complexes Is a Synergistic Mechanism That Requires Both the LDL Receptor-related Protein and Cell Surface Heparins*

Protease nexin 1 (PN1) is a serine protease inhibitor (SERPIN) that acts as a suicide substrate for thrombin (Th) and urokinase-type plasminogen activator (uPA). PN1 forms 1:1 stoichiometric complexes with these proteases, which are then rapidly bound, internalized, and degraded. The low density lipoprotein receptor-related protein (LRP) is the receptor responsible for the internalization of protease-PN1 complexes. However, we found that the LRP is not significantly involved in the initial cell surface binding of thrombin-PN1, leading us to investigate what cellular component was responsible for this initial interaction. Since Th-PN1 complexes retain a high-affinity for heparin after complex formation, unlike several of the other SERPINs, we tested the possibility that cell surface heparins were involved in initial complex binding. Soluble heparin was found to be a potent inhibitor of the binding of Th-PN1 to the cell surface and greatly facilitated the dissociation of Th-PN1 complexes pre-bound in the absence of soluble heparin. To ascertain the role of cell surface heparins, further studies were done using complexes of thrombin and PN1(K7E), a variant of PN1 in which the heparin binding site was rendered non-functional. When added at equal initial concentrations of complexes, Th-PN1(K7E) was catabolized 5- to 10-fold less efficiently than Th-PN1, a direct result of the greatly diminished initial binding of the Th-PN1(K7E) complexes. These data demonstrate the sizable contribution of cell surface heparins to Thrombin-PN1 complex binding and support a model in which these heparins act to concentrate the complexes at the cell surface facilitating their subsequent LRP-dependent endocytosis.
Optimizing return via locations to reduce mode conversion in connector pin fields

Differential wiring is prevalent in high-speed signaling, because it provides better immunity and reduced emissions over single-ended transmission structures. These advantages are diminished when the transmitter pollutes the signal with common mode signals and when discontinuities in the channel convert some fraction of the differential mode signal to common mode. This paper focuses on the channel discontinuities, specifically the arrangement of signal and return vias. Genetic algorithms and a fast via solver are used to optimize return positions to minimize the mode conversion. Case studies of open-area via transitions are presented, as well as a pin array conforming to a common high-speed connector footprint.
The Role of Learning Strategies in Second Language Acquisition

Abstract : This paper describes a study of learning strategies used by high school students who were effective or ineffective in learning English as a second language. Think aloud data were collected during listening tasks that varied in familiarity and difficulty. Failure of students to appear for sessions was such that results were analyzed only from five effective listeners who attended three sessions and from three ineffective listeners who attended one session. The primary results were that effective listeners used self-monitoring and elaboration strategies significantly more often than did ineffective listeners during session one. Also, effective listeners were found to use the inferencing strategy twice as often as ineffective listeners, although this effect failed to reach significance because of the small sample size. However, effective listeners were found to significantly increase their use of imagery and elaboration from session one to session three. Altogether, these results are consistent with the theory suggesting that the use of strategies, especially metacognitive ones, is a major distinguishing characteristic of effective listeners.
Laparoscopic adrenalectomy: lessons learned from 306 cases.

INTRODUCTION Laparoscopic adrenalectomy has become the standard of care for the surgical treatment of benign adrenal pathology. We present the following case series documenting our experience in refinement of this approach. PAIENTS AND METHODS Analysis of patient records identified those in whom laparoscopic adrenalectomy was performed from January 1997 through February 2010. Study variables included indications, operative time, blood loss, length of hospital stay, histopathological evaluation, and complications. RESULTS Laparoscopic adrenalectomy was performed in 306 patients using the transperitoneal lateral approach. No major operative complications were noted, and postoperative complications included a pulmonary embolism and 2 cases of pneumonia. Conversion to the open approach was necessitated in two cases. The median operative time was 95±29 minutes (range, 45-145 minutes). Estimated blood loss was 60 mL (range, 30-150 mL). The mean size of the removed gland was 5.9±1.6 cm (range, 3-13 cm). The mean size of the tumor was 5±2 cm (range, 0.5-12 cm). The median hospitalization was 4±3.7 days (range, 2-22 days). Adrenal pathology included adenoma (n=164), pheochromocytoma (n=79), hyperplasia (n=35), metastatic carcinoma (n=22), cyst (n=9), myelolipoma (n=9), hemangioma (n=3), ganglioneuroma (n=3), and melanoma (n=2). CONCLUSION Laparoscopic adrenalectomy is a safe and feasible approach to adrenal pathology, providing the patients with all the benefits of minimally invasive surgery.
INTELLIGENCE OBSERVATION AMMAN ARAB UNIVERSITY VARIANCE UPON STUDENT ’ S POINT OF VIEW

his study was conducted on a sample of students from Amman Arab University, and was the study sample (65) students were chosen at random from a community (150) students, the study used a tool questionnaire to measure the variables, the answer to the first question, that the Amman Arab University Students results to all aspects of intelligence scored an average level for all areas of intelligence, either the results of the second question refers to the absence of differences related to gender in most areas with the exception of a difference in the areas of intelligence and musical intelligence existential difference was in favor of females, while the school year variable there was no statistically significant in most of the differences areas except the existence of differences in self-intelligence was the difference for the benefit of students per year and the third and fourth, compared to the students of the first and second year, and the results suggest the answer to the third question that there is a statistically significant relationship between the level of multiple intelligence and rates of cumulative students were positive relationship. The study recommends further research and studies on the different stages of learning.
Virulence in bacteriophage Mu: a case of trans‐dominant proteolysis by the Escherichia coli Clp serine protease.

The importance of proteases in gene regulation is well documented in both prokaryotic and eukaryotic systems. Here we describe the first example of genetic regulation controlled by the Escherichia coli Clp ATP‐dependent serine protease. Virulent mutants of bacteriophage Mu, which carry a particular mutation in their repressor gene (vir mutation), successfully infect Mu lysogens and induce the resident Mu prophage. We show that the mutated repressors have an abnormally short half‐life due to an increased susceptibility to Clp‐dependent degradation. This susceptibility is communicated to the wild type repressor present in the same cell, which provides the Muvir phages with their trans‐dominant phenotype. To our knowledge this is the first case where the instability of a mutant protein is shown to trigger the degradation of its wild type parent.