Miracle-dz/UniFAR-FTUs huggingface dataset:
Continuation of medically necessary platelet aggregation inhibitors - acetylsalicylic acid and clopidogrel - during surgery for spinal degenerative disorders: Results in 100 patients

Background: Patients undergoing spinal surgery while under anticoagulation therapy are at risk of developing bleeding complications, even though lower incidences have been reported for joint arthroplasty surgery. There is a gap in the medical literature examining the incidence of postoperative spinal bleeding in patients who were under anticoagulation medication at the time of surgery. Methods: We prospectively followed a consecutive cohort of 100 patients (58 male, 42 female) undergoing spinal surgery. The average patient age was 48.7 years and the minimum follow up time was 12 months. Diagnosis was lumbar spinal stenosis in 20, herniated lumbar discs in 63, degenerative cervical disc disease in 3, and cervical disc herniation in 14 cases. In our study, platelet aggregation inhibitors (clopidogrel and/or acetylsalicylic acid) were given for the treatment of cardiovascular and cerebrovascular thrombotic events, to reduce risk of stroke in patients who have had transient ischemia of the brain or acute coronary syndrome, and as secondary prevention of atherosclerotic events (fatal or nonfatal myocardial infarction (MI). A cessation of anticoagulants (acetylsalicylic acid or clopidogrel) in our patients in the peri- and postoperative period was contraindicated. Results: Sixty-three patients were on both clopidogrel and acetylsalicylic acid and 37 on acetylsalicylic acid only. None of the patients suffered any postoperative bleeding complication. Three patients suffered postoperative wound dehiscence and one patient had an infection that required reoperation. Conclusion: The question of whether preoperative platelet aggregation inhibitors must be stopped before elective spinal surgery has never been answered in the literature. In our prospective series, we have found no increase in the risk of postoperative spinal bleeding with the use of clopidogrel or acetylsalicylic acid. This finding suggests that spine surgery can be done without stopping anticoagulation. Lacking specific guidelines, each patient should be treated on an individual basis, and the potential benefits of anticoagulation should be compared with the potential risks (risk–benefit ratio).
Identification of regB, a gene required for optimal exotoxin A yields in Pseudomonas aeruginosa

The yield of exotoxin A from Pseudomonas aeruginosa has been shown to be strain‐dependent. Exotoxin A production requires the presence of the positive regulatory gene, regA. We cloned the regA genetic locus from the prototypical P. aeruginosa strain PAO1 and examined its ability to influence exotoxin A yields compared to the same region cloned from the hyper‐toxin‐producing strain, PA103. The P. aeruginosa regA mutant strain, PA103‐29, containing the PAO1 regA locus in trans produced approximately five to seven times less extracellular exotoxin A than PA103‐29 containing the regA locus cloned from the hyper‐toxigenic strain, PA103. Nucleotide sequence analysis of the PAO1 regA locus revealed several differences, the most striking of which was the absence of a second open reading frame that was present in the analogous PA103 DNA. In addition, an amino acid substitution was found at position 144 of RegA (Thr in PAO1 and Ala in PA103). Recombinant molecules were constructed to test the contribution of each of these changes in nucleotide sequence on extracellular exotoxin A yields. The amino acid substitution in the PAO1 RegA protein was found not to affect overall exotoxin A yields. In contrast, the presence of the second open reading frame immediately downstream of the PA103 regA gene was found to influence extracellular exotoxin A yields. This open reading frame encodes a gene which we call regB. Nucleotide sequence analysis indicates that regB is 228 nucleotides in length and encodes a protein of 7527 Daltons. Our data suggest that regB is required for optimal exotoxin A production and its absence in strain PAO1 partially accounts for the difference in yield of extracellular exotoxin A between P. aeruginosa strains PAO1 and PA103.
Practical polar code construction over parallel channels

Channel polarisation results are extended to the case of communications over parallel channels, where the channel state information is known to both the encoder and decoder. Given a set of parallel binary-input discrete memoryless channels (B-DMCs), by performing the channel polarising transformation over independent copies of these component channels, we obtain a second set of synthesised binary-input channels. Similar to the single-channel case, we prove that as the size of the transformation goes infinity, some of the resulting channels tend to completely noised, and the others tend to noise-free, where the fraction of the latter approaches the average symmetric capacity of the underlying component channels. For finite-length polar coding over parallel channels, performance is found to be relied heavily on the specific channelmapping scheme. To avoid exhaustive searching, an empirically good scheme that is called equal-capacity partition channel mapping is proposed and numerical results show that the proposed scheme significantly outperforms random mapping. Further, utilising the above results, a polar coding method for arbitrary code length is proposed, which has potential applications in practical systems.
Both under-nutrition and obesity increase morbidity following liver transplantation.

Malnutrition is common in patients awaiting liver transplantation and may contribute to operative and post-operative mortality, although this is controversial. We assessed the pre-operative nutritional status of 87 patients and the impact this had on mortality and morbidity following liver transplantation for chronic liver disease. Thirty six per cent of patients had more than 10% loss of body weight prior to transplantation. Nutritional depletion, considered present if triceps skin fold thickness or mid-arm muscle circumference were < 5th percentile, was present in 17% and 15% of the total group respectively. Patients whose pre-operative body weights were < 90% of their ideal body weight (IBW) had a longer hospital stay (p = 0.001) and required longer post-operative ventilatory support (p = 0.033). This group also required significantly more treatment with intravenous antibiotics (p = 0.001) suggesting an increased incidence of infective complications. Patients who were obese pre-operatively (body mass index > 30Kg/m2) also required a longer period in high dependency (p = 0.0003). No individual nutritional variable correlated with mortality. In the Irish population undergoing liver transplantation, we found a relatively low prevalence of malnutrition in comparison with other studies. Both under- nutrition and obesity significantly affected morbidity and length of hospital stay post-transplant, although no individual nutritional variable predicted survival post transplant.
Abnormal distribution of inositol 1,4,5‐trisphosphate receptors in human muscle can be related to altered calcium signals and gene expression in Duchenne dystrophy‐derived cells

Inositol 1,4,5‐trisphosphate (IP3) receptors (IP3Rs) drive calcium signals involved in skeletal muscle excitation‐transcription coupling and plasticity; IP3R subtype distribution and downstream events evoked by their activation have not been studied in human muscle nor has their possible alteration in Duchenne muscular dystrophy (DMD). We studied the expression and localization of IP3R subtypes in normal and DMD human muscle and in normal (RCMH) and dystrophic (RCDMD) human muscle cell lines. In normal muscle, both type 1 IP3Rs (IP3R1) and type 2 IP3Rs (IP3R2) show a higher expression in type II fibers, whereas type 3 IP3Rs (IP3R3) show uniform distribution. In DMD biopsies, all fibers display a homogeneous IP3R2 label, whereas 24 ± 7% of type II fibers have lost the IP3R1 label. RCDMD cells show 5‐fold overexpression of IP3R2 and down‐regulation of IP3R3 compared with RCMH cells. A tetanic stimulus induces IP3‐dependent slow Ca2+ transients significantly larger and faster in RCDMD cells than in RCMH cells as well as significant ERK1/2 phosphorylation in normal but not in dystrophic cells. Excitation‐driven gene expression was different among cell lines; 44 common genes were repressed in RCMH cells and expressed in RCDMD cells or vice versa. IP3‐dependent Ca2+ release may play a significant role in DMD pathophysiology. —Cárdenas, C. , Juretić, N. , Bevilacqua, J. A. , García, I. E. , Figueroa, R. , Hartley, R. , Taratuto, A. L. , Gejman, R. , Riveros, N. , Molgó, J., Jaimovich, E. Abnormal distribution of inositol 1,4,5‐trisphosphate receptors in human muscle can be related to altered calcium signals and gene expression in Duchenne dystrophy‐derived cells. FASEB J. 24, 3210–3221 (2010). www.fasebj. org
Genomic Abnormalities Acquired in the Blastic Transformation of Splenic Marginal Zone B-cell Lymphoma

Among 20 cases of typical splenic marginal zone lymphoma (SMZL), two cases had blastic transformation. The genetic mechanisms underlying the morphologic transformation were investigated by comparing genetic changes in initial and blastic phases. A complex karyotype including trisomy of 3q and genomic gain of 17q22-q24 was seen in both cases at diagnosis. However, the extra copy of 3q was lost during the transformation process in both tumors. Additionally, the Karpas 1718 cell line, which was derived from a patient with transformed SMZL and carried a trisomy of 3q, also evidenced the spontaneous loss of the extra 3q during the culturing process. Other acquired abnormalities observed exclusively in the transformation phase included amplification and/or translocation of bands 7p22-q22 and 19p13. These findings suggest that the loss of +3q and the acquisition of other genomic imbalances may represent unique markers for the transformation process of SMZL. We hypothesize that the trisomy of 3q may correlate with the indolent nature of SMZL, and that the loss of this acquired abnormality leads to or accompanies the development of blastic tumors.
Interleukin‐23 Mediates the Intestinal Response to Microbial β‐1,3‐Glucan and the Development of Spondyloarthritis Pathology in SKG Mice

Spondyloarthritides (SpA) occur in 1% of the population and include ankylosing spondylitis (AS) and arthropathy of inflammatory bowel disease (IBD), with characteristic spondylitis, arthritis, enthesitis, and IBD. Genetic studies implicate interleukin‐23 (IL‐23) receptor signaling in the development of SpA and IBD, and IL‐23 overexpression in mice is sufficient for enthesitis, driven by entheseal‐resident T cells. However, in genetically prone individuals, it is not clear where IL‐23 is produced and how it drives the SpA syndrome, including IBD or subclinical gut inflammation of AS. Moreover, it is unclear why specific tissue involvement varies between patients with SpA. We undertook this study to determine the location of IL‐23 production and its role in SpA pathogenesis in BALB/c ZAP‐70W163C–mutant (SKG) mice injected intraperitoneally with β‐1,3‐glucan (curdlan).
Correlation Between Pre-Employment Screening X-Ray Finding of Spondylolysis and Sickness Absenteeism Due to Low Back Pain Among Policemen of the Israeli Police Force

Study Design. A historical prospective case/control study of the significance and correlation between pre-employment findings of L5-S1 spondylolysis and sickness absenteeism due to low back pain among police officers. Objectives. Examining the importance of pre-employment lumbar spine radiographs as a prediction of work absenteeism. Summary of Background Data. Spondylolysis is a defect in the pars interarticularis. Its etiology remains controversial, it is a common condition among young athletes, and it carries genetic predisposition. Although described mostly as an incidental radiographic finding in the adult population, spondylolysis is implicated as a contributing factor to low back pain, although the cause-and-effect relation is not clear. Methods. One hundred and sixty-nine police officers with L5-S1 spondylolysis were identified out of 3988 examined. Incidence density of sickness absenteeism due to low back pain was calculated for the patients and the controls. The Cox’s proportional hazard model was used for comparison between the two groups, controlling for possible confounding variables. Results. Similar incidence of sickness absenteeism due to low back pain was found among the patients and controls. The total duration of sickness absenteeism, however, was 2.7 times higher in the spondylolysis group than the controls. Prevalence of spondylolysis is origin specific, denoting genetic predisposition to this condition. Total sickness absenteeism not related to low back pain was not significantly different between the two study groups. Conclusions. There is low predictive value of pre-employment lumbar spine radiograph as a screening tool predicting sickness absenteeism due to low back pain. Spondylolysis, however, may increase the duration of sickness absenteeism in patients with low back pain.
What Aspects of Rural Life Contribute to Rural‐Urban Health Disparities in Older Adults? Evidence From a National Survey

PURPOSE Rural-urban health disparities are well-documented and particularly problematic for older adults. However, determining which specific aspects of rural or urban living initiate these disparities remains unclear. The purpose of this study was to assess associations between place-based characteristics of rural-urban status and health among adults age 65+. METHODS Data from the 2012 Behavioral Risk Factor Surveillance System were geographically linked to place-based characteristics from the American Community Survey. Self-reported health (SRH), obesity, and health checkup within the last year were modeled against rural-urban status (distance to nearest metropolitan area, population size, population density, percent urban, Urban Influence Codes [UIC], Rural-Urban Continuum Codes [RUCC], and Rural-Urban Commuting Area [RUCA]) using generalized linear models, accounting for covariates and complex sampling, overall, and stratified by area-level income. FINDINGS In general, increasing urbanicity was associated with a reduction in negative SRH for all 7 measures of rural-urban status. For low-income counties, this association held for all measures and characteristics of rural-urban status except population density. However, for high-income counties, the association was reversed-respondents living in areas of increasing urbanicity were more likely to report negative SRH for 4 of the 7 measures (RUCC, UIC, RUCA, and percent urban). Findings were mixed for the outcome of obesity, where rural areas had higher levels, except in low-income counties, where the association between rurality and obesity was reversed (OR 1.033, 95%CI: 1.002-1.064). CONCLUSION These results suggest that rural-urban status is both a continuum and multidimensional. Distinct elements of rural-urban status may influence health in nuanced ways that require additional exploration in future studies.
NB87 induction protocol for stage 4 neuroblastoma in children over 1 year of age: a report from the French Society of Pediatric Oncology.

PURPOSE NB87 was designed to test the efficacy of a short, non cross-resistant, induction protocol for unselected patients over 1 year of age with stage 4 neuroblastoma. A secondary objective was to compare in a randomized study the toxicity of two modalities of cisplatin administration. PATIENTS AND METHODS A total of 183 patients received two cycles of alternating sequences: cyclophosphamide 300 mg/m2/d on days 1 to 5, vincristine 1.5 mg/m2/d on days 1 and 5, and doxorubicin 60 mg/m2/d on day 5 (CADO); and cisplatin 40 mg/m2/d and etoposide 100 mg/m2/d on days 1 to 5 (CVP), followed by surgery of the primary tumor (126 patients). Ninety-one were randomized to receive cisplatin either as bolus (BO; n = 48) or continuous infusion (CI; n = 43). International Neuroblastoma Staging System (INSS) and Response Criteria (INRC) were used with emphasis on skeletal evaluation by meta-iodobenzylguanidine (MIBG). RESULTS Hematotoxicity was predominant, with a higher incidence of neutropenia (P = .01) for CADO and of thrombocytopenia for CVP (P < .001). Severe infections, as well as nonhematologic toxicities, occurred more often after the first sequence. Gastrointestinal complications were predominant during both courses of CVP. The toxic death rate, including surgery, was 3%. Complete remissions (CRs) were less frequent on MIBG (45%) compared with marrow (66%) or other metastases (61%). Combining all metastatic sites resulted in a 39% CR rate. After surgery, the final CR rate was 42%. Nephrotoxicity was minimal in both arms (92% normal clearance for CI v 82% for BO). Hearing loss greater than 40 dB at 6,000 to 8,000 Hz was reported equally in both arms (n = 6 for CI v n = 5 for BO). CONCLUSION Intensified chemotherapy using CADO/CVP increases CR rates despite a shorter induction duration. However, the rate of MIBG normalization remains unsatisfactory and could be raised through the dose-intensive use of agents such as cyclophosphamide.
The Effect of Bispectral Index Monitoring on Long-Term Survival in the B-Aware Trial

BACKGROUND: When anesthesia is titrated using bispectral index (BIS) monitoring, patients generally receive lower doses of hypnotic drugs. Intraoperative hypotension and organ toxicity might be avoided if lower doses of anesthetics are administered, but whether this translates into a reduction in serious morbidity or mortality remains controversial. The B-Aware Trial randomly allocated 2463 patients at high risk of awareness to BIS-guided anesthesia or routine care. We tested the hypothesis that the risks of death, myocardial infarction (MI), and stroke would be lower in patients allocated to BIS-guided management than in those allocated to routine care. METHODS: The medical records of all patients who had not died within 30 days of surgery were reviewed. The date and cause of death and occurrence of MI or stroke were recorded. A telephone interview was then conducted with all surviving patients. The primary end point of the study was survival. RESULTS: The median follow-up time was 4.1 (range: 0–6.5) years. Five hundred forty-eight patients (22.2%) had died since the index surgery, 220 patients (8.9%) had an MI, and 115 patients (4.7%) had a stroke. The risk of death in BIS patients was not significantly different than in routine care patients (hazard ratio = 0.86 [95% confidence interval {CI}: 0.72–1.01]; P = 0.07). However, propensity score analysis indicated that the hazard ratio for death in patients who recorded BIS values <40 for >5 min compared with other BIS-monitored patients was 1.41 (95% CI: 1.02–1.95; P = 0.039). In addition, the odds ratios for MI in patients who recorded BIS values <40 for >5 min compared with other BIS-monitored patients was 1.94 (95% CI: 1.12–3.35; P = 0.02) and the odds ratio for stroke was 3.23 (95% CI: 1.29–8.07; P = 0.01). CONCLUSIONS: Monitoring with BIS and absence of BIS values <40 for >5 min were associated with improved survival and reduced morbidity in patients enrolled in the B-Aware Trial.
A characterization of r-valued functions monotonic in an order based on regularity

In this paper, we focus on r-valued functions for treating ambiguities. These functions are defined as r-valued functions monotonic in an order (denoted by <) which is a natural extension of the Kleene's regularity in his ternary logic. The order < is suitable for treating ambiguities. The functions were first introduced in Mukaidono (1986), and the authors have clarified some of their interesting mathematical properties. In this paper, we will show two different necessary and sufficient condition for an r-valued function to be monotonic in <. Next, we will discuss functions monotonic in < whose information loss are the minimal and the maximal. Then, we will give the representations of these two types of functions.
Ovarian‐Steroid Modulation of Locus Coeruleus Activity in Female Rats: Involvement in Luteinising Hormone Regulation

The noradrenergic nucleus locus coeruleus (LC) has been reported to regulate luteinising hormone (LH) secretion in female rats. Both oestrogen and progestin receptors have been demonstrated in LC neurones, suggesting that these cells are possibly responsive to variations in circulating levels of ovarian steroids. We therefore evaluated changes in the activity of LC neurones during the oestrous cycle and after ovarian‐steroid treatment in ovariectomised (OVX) rats, as determined by immunoreactivity to Fos‐related antigens (FRA), which comprises all of the known members of the Fos family. Effects of ovarian steroids on the firing rate of LC neurones were also determined in a slice preparation. The number of FRA/tyrosine hydroxylase (TH)‐immunoreactive (ir) neurones in the LC increased from 14.00–16.00 h on pro‐oestrus, coinciding with the onset of the LH surge and rise in plasma progesterone. FRA immunoreactivity was unaltered during dioestrus. Oestradiol‐treated OVX rats (OVX+E) displayed marked reduction in FRA/TH‐ir neurones in LC compared to oil‐treated OVX rats. Accordingly, oestradiol superfusion significantly reduced the spontaneous firing rate of LC neurones in slices from OVX rats. Compared to OVX+E, oestradiol‐treated rats injected with progesterone at 08.00 h (OVX+EP) exhibited higher number of FRA/TH‐ir neurones in the LC at 10.00 h and 16.00 h, and great amplification of the LH surge. Bath application of progesterone significantly increased the spontaneous firing rate of OVX+E LC neurones. Our data suggest that ovarian steroids may physiologically modulate the activity of LC neurones in females, with possible implications for LH secretion. Moreover, oestradiol and progesterone appear to exert opposite and complementary effects (i.e. whereas oestradiol inhibits, progesterone, after oestradiol priming, stimulates LC activity).
Glucagon-CREB/CRTC2 Signaling Cascade Regulates Hepatic BMAL1 Protein*

Background: The role of glucagon in regulation of hepatic circadian clock is unclear. Results: Glucagon-CREB/CRTC2 signaling axis plays an important role in regulation of hepatic Bmal1 expression. Conclusion: We find that the temporal signals of fasting and refeeding hormones regulate the transcription of Bmal1 in the liver. Significance: We identify a novel transcriptional pathway that links glucagon/insulin metabolic cues and circadian clock. Energy metabolism follows a diurnal pattern responding to the cycles of light and food exposures. Although food availability is a potent synchronizer of peripheral circadian clock in mammals, the underlying mechanism remains elusive. Here, we found that the temporal signals of fasting and refeeding hormones regulate the transcription of Bmal1, a key transcription activator of molecular clock, in the liver. During fasting, glucagon, a major fasting hormone, activates CREB/CRTC2 transcriptional complex that is recruited to Bmal1 promoter to induce its expression. Furthermore, we showed that CRTC2 is required for basal transcriptional regulation of Bmal1 by experiments using either adenovirus-mediated CRTC2 RNAi knockdown or primary Crtc2 null hepatocytes. On the other hand, insulin suppresses fasting-induced Bmal1 expression by inhibiting CRTC2 activity after refeeding. Taken together, our results indicate CRTC2 as a key component of the circadian oscillator that integrates the mammalian clock and energy metabolism.