Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical validation of electromyography and acceleromyography as sensors for muscle relaxation

Background and objective: The aim of this study was to determine which of two clinically applied methods, electromyography or acceleromyography, was less affected by external disturbances, had a higher sensitivity and which would provide the better input signal for closed loop control of muscle relaxation. Methods: In 14 adult patients, anaesthesia was induced with intravenous opioids and propofol. The response of the thumb to ulnar nerve stimulation was recorded on the same arm. Mivacurium was used for neuromuscular blockade. Under stable conditions of relaxation, the infusion‐rate was decreased and the effects of turning the hand were investigated. Results: Electromyography and acceleromyography both reflected the change of the infusion rate (P = 0.015 and P < 0.001, respectively). Electromyography was significantly less affected by the hand‐turn (P = 0.008) than acceleromyography. While zero counts were detected with acceleromyography, electromyography could still detect at least one count in 51.1%. Conclusions: Electromyography is more reliable for use in daily practice as it is less influenced by external disturbances than acceleromyography.
EVALUATION OF THE BOD POD AND LEG‐TO‐LEG BIOELECTRICAL IMPEDANCE ANALYSIS FOR ESTIMATING PERCENT BODY FAT IN NATIONAL COLLEGIATE ATHLETIC ASSOCIATION DIVISION III COLLEGIATE WRESTLERS

The purpose of this study was to compare percent body fat (%BF) estimated by air displacement plethysmography (ADP) and legto-leg bioelectrical impedance analysis (LBIA) with hydrostatic weighing (HW) in a group (n 5 25) of NCAA Division III collegiate wrestlers. Body composition was assessed during the pre-season wrestling weight certification program (WCP) using the NCAA approved methods (HW, 3-site skinfold [SF], and ADP) and LBIA, which is currently an unaccepted method of assessment. A urine specific gravity less than 1.020, measured by refractometry, was required before all testing. Each subject had all of the assessments performed on the same day. LBIA measurements (Athletic mode) were determined using a Tanita body fat analyzer (model TBF-300A). Hydrostatic weighing, corrected for residual lung volume, was used as the criterion measurement. The %BF data (mean ± SD) were LBIA (12.3 ± 4.6), ADP (13.8 ± 6.3), SF (14.2 ± 5.3), and HW (14.5 ± 6.0). %BF estimated by LBIA was significantly (p < 0.01) smaller than HW and SF. There were no significant differences in body density or %BF estimated by ADP, SF, and HW. All methods showed significant correlations (r = 0.80–0.96; p < 0.01) with HW. The standard errors of estimate (SEE) for %BF were 1.68, 1.87, and 3.60%; pure errors (PE) were 1.88, 1.94, and 4.16% (ADP, SF, and LBIA, respectively). Bland-Atman plots for %BF demonstrated no systematic bias for ADP, SF, and LBIA when compared with HW. These preliminary findings support the use of ADP and SF for estimating %BF during the NCAA WCP in Division III wrestlers. LBIA, which consistently underestimated %BF, is not supported by these data as a valid assessment method for this athletic group.
Failure of transradial approach during coronary interventions: Anatomic considerations

The anatomy of the radial artery has yet to be systematically studied from the perspective of using it as a route for catheter access. We prospectively performed angiography of the arteries of the upper limb to delineate the anatomic features of the radial artery as a way to determine the feasibility of using it as a route for coronary intervention. We studied 2,211 consecutive patients submitted to transradial cardiac catheterization. In all patients, an angiography of the upper limb arteries was performed before and after procedure. Radial puncture was successful in 98.9% of patients. At angiography, anatomic variations of upper limb arteries were noted in 505 patients (22.8%) and included tortuous configurations (3.8%), stenosis (1.7%), hypoplasias (7.7%), radioulnar loop (0.8%), abnormal origin of the radial artery (8.3%), and lusoria subclavian artery (0.45%). Overall procedural success by transradial approach was 97.5%. Patients with anatomic variations of radial artery had a significantly lower puncture (96.2% vs 99.7%, P < 0.0001) and procedural (93.1% vs 98.8%, P < 0.0001) success. The procedure was successfully performed by radial approach in 98.8% of patients with tortuous configurations, 91.9% of radial stenosis, 93.9% of hypoplastic radial artery, 83.3% of radioulnar loop, 96.7% of radial axillary origin, and 60% of lusoria subclavian artery setting. Anatomic variations of the radial artery are not rare. However, they do not represent an important limitation in transradial approach if they are well documented previously. © 2006 Wiley‐Liss. , Inc.
Metastatic breast cancer masquerading as primary gastric cancer: case report and review of the literature.

CASE REPORT An 84-year-old woman on postmenopausal hormone replacement therapy (HRT) had an abnormal screening mammogram of the left breast. The patient underwent an ultrasound-guided core biopsy confirming a diagnosis of invasive breast cancer. HRT was discontinued, and she underwent a lumpectomy with sentinel lymph node mapping. Pathology revealed a 0.9-cm, well-differentiated, lobular carcinoma (Figure 1) with 33 of 36 sampled axillary lymph nodes demonstrating cancer, including several with extracapsular extension. The cancer was estrogen receptor (ER) and progesterone receptor (PR) positive and Her2 negative by immunohistochemistry (IHC) and chromogenic silver in situ hybridization (SISH). The patient received 6 cycles of adjuvant chemotherapy with docetaxel and cyclophosphamide, followed by postlumpectomy radiation therapy and then aromatase inhibitor antiestrogen therapy with anastrozole. She also was enrolled in a clinical study in which she was randomized to either denosumab, a monoclonal antibody to the RANK (receptor activator of nuclear factor -B) ligand that inhibits osteoclasts, or placebo. The primary end point was to delay or prevent relapse of breast cancer to the bone. As part of the study, the patient underwent annual computed tomographic (CT) scans of the chest, abdomen and pelvis, and bone. Approximately 2.5 years after the breast surgery, the patient began experiencing dysphagia. She saw a gastroenterologist who performed an esophagogastroduodenoscopy (EGD). A tumor along the lesser curvature of the stomach was biopsied, with pathology from another lab showing poorly differentiated signet ring–type adenocarcinoma (Figure 2), consistent with a gastric primary and negative for Helicobacter pylori. Repeat CT scans, which were obtained 5 months after the previous study-mandated scans, showed a new 1.7-cm proximal stomach mass but no other abnormalities. The patient underwent a laparotomy with the intention of performing a partial gastrectomy and regional lymph node dissection, but aggressive surgery was aborted because of visible, unresectable omental disease. The clinical impression was that the patient had regionally metastatic, unresectable gastric cancer. Omental biopsies were sent to pathology (Figure 3). Given the patient’s history of breast cancer, a panel of immunostains was performed to confirm tissue of origin. The omental biopsy specimen was positive for the highly breast cancer–specific gross cystic disease fluid protein (GCDFP)-15 (Figure 4), as well as cytokeratin (CK)-7 and estrogen receptor (ER), and was focally positive for mammaglobin and negative for CK20, TTF-1, and CDX-2. The EGD specimen was obtained from the outside lab and reanalyzed by IHC and was also positive for GCDFP-15 (Figure 5), CK7, and ER and
Exploring and Evaluating Patient Safety Culture in a Community-Based Primary Care Setting

Supplemental digital content is available in the text. Objectives The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents’ profession was examined. Methods A cross-sectional study was conducted by administering the SCOPE–Primary Care questionnaire in two home care service organizations. Results In total, 1875 valid questionnaires were returned from 2930 employees, representing a response rate of 64%. The highest mean patient safety culture score was found for “organizational learning” (mean [SD] = 3.81 [0.53]), followed by “support and fellowship” (mean [SD] = 3.76 [0.61]), “open communication and learning from error” (mean [SD] = 3.73 [0.64]), and “patient safety management” (mean [SD] = 3.71 [0.60]). The lowest mean scores were found for “handover and teamwork” (mean [SD] = 3.28 [0.58]) and “adequate procedures and working conditions” (mean [SD] = 3.30 [0.56]). Moreover, managers/supervisors scored significantly higher on the dimensions “open communication and learning from error,” “adequate procedures and working conditions,” “patient safety management,” “support and fellowship,” and “organizational learning” than clinical and nonclinical staff. Conclusions In conclusion, organizational learning is perceived as most positive. However, large gaps remain in the continuity of care as “handover and teamwork” is perceived as the most negative safety culture dimension. With knowledge of the current patient safety culture, organizations can redesign processes or implement improvement strategies to avoid patient safety incidents and patient harm in the future.
Stop It Now! A Pilot Study Into the Limits and Benefits of a Free Helpline Preventing Child Sexual Abuse

Stop It Now! aims to prevent child sexual abuse using a free anonymous helpline. It provides information, advice, and guidance to anyone concerned about child sexual abuse. It targets people who have sexually abused children or who are worried that they might do so. This article presents findings from a pilot study on the operation and outcomes of the helplines in the United Kingdom and the Netherlands. The findings underline the strength of the public health approach to prevention efforts. More specifically, benefits reported by helpline users are shown to correspond with the aims of the helplines. A number of factors were reported by users that helped them modify their own or others’ actions to minimize risk of abuse. However, a challenge that remains is ensuring that helplines are accessible to those most in need. Recommendations are included to further expand the effect of Stop It Now! in reducing CSA.
Buffalo milk composition, processing factors, whey constituents recovery and yield in manufacturing Mozzarella cheese

The beginning of buffalo breeding (Bubalus bubalis) in Brazil occurred around the year 1980 in various regions of the country (Bernardes, 2007). Since the 90s, there has been an increase in the number of industries manufacturing products derived from buffalo milk in Brazil, which are responsible for using most of the milk produced. Two major factors that contribute to the interest in buffalo milk processing are the peculiar characteristics of the raw material in terms of composition, which surpasses solid content and yield when compared to bovine milk characteristics (Teixeira et al., 2005; Tonhati et al., 2008; Rangel et al., 2011).
Repeating through the insula: evidence from two consecutive strokes

Mixed transcortical aphasia is a very rare syndrome characterized by intact repetition, despite severe impairment in all other language modalities. In some cases, however, preservation of repetition is accompanied by intact reading. We report the case of a left-handed man who, after a subcortical stroke in the left hemisphere, showed the typical features of mixed transcortical aphasia with spared repetition and reading. After 10 days, a second stroke, involving the anterior insula and adjacent white matter bundles, markedly deteriorated repetition while his reading abilities recovered. By comparing features of repetition and reading before and after the second stroke, we provide evidence for the existence of a modular organization of language abilities, pointing to the primary role of the insula and surrounding white matter in phonological processing.
Universal screening for domestic violence in a department of obstetrics and gynaecology: a patient and carer perspective

BEN NATAN M. , BEN ARI G. , BADER T. & HALLAK M. (2011) Universal screening for domestic violence in a department of obstetrics and gynaecology: a patient and carer perspective. International Nursing Review59, 108–114 Aim: This study aimed to examine the effect of knowledge, department routine, and attitudes of physicians and nurses on the identification of female victims of domestic violence in Israel, as well as the patients' attitudes regarding the screening process. Background: Every seventh woman in Israel is reported to have been victimized by her intimate partner at least once in her lifetime. Routine screening for intimate partner violence is endorsed by the Ministry of Health in Israel; however screening rates in healthcare settings remain low. Methods: Correlative, cross-sectional design was utilized based on a sample of 100 physicians and nurses from an obstetrics and gynaecology department in a central Israel hospital and a stratified simple random sampling to recruit 100 former female patients. Findings: Both medical and nursing staffs were reluctant to screen women for domestic violence, although the patients interviewed for the study claimed that screening is crucial for preventing domestic violence. Past experience with assessing violence and intention to screen were the most significant predictors of screening behaviour. Several factors impede screening by medical and nursing staff, although it is legally mandated. Discussion: Nurses' and physicians' screening of women about domestic violence is a fundamental intervention with implications for health care in general and basic human rights in particular; however attitudes and beliefs must also be considered. Conclusions: Screening women about domestic violence is an intervention not usually implemented by physicians and nurses. Understanding barriers to screening may help form feasible policies for improving the quality of services offered to women.
Research on the Clinical Usefulness of the Rorschach: 1. The Diagnosis of Schizophrenia

Research on the use of the Rorschach in the diagnosis of schizophrenia is reviewed. The analysis of this research (from that done by Rorschach to the most recent) indicates that schizophrenics do not respond in any unique fashion to any particular determinant or any particular card. The research also indicates that the computation of percentages and ratios, no matter how complex, does not facilitate the identification of a schizophrenic process. What the research does demonstrate is that schizophrenia, in its overt as well as latent and borderline forms, is detectable on the Rorschach through an analysis of the patient's thinking. The thinking of the schizophrenic reveals highly personal, illogical, and bizarre associations to the blots. This analysis of thinking is not accomplished through assessment of the formal properties of the blots, e.g., the analysis of response to color, movement, shading, the color-to-movement ratio, or form level (low form level proves to be a function of psychoticism, not schizophrenia, per se) but more in terms of the phenomenology of the responses.
Generation of Campylobacter fetus S‐layer protein diversity utilizes a single promoter on an invertible DNA segment

Wild‐type strains of Campylobacter fetus contain a monomolecular array of surface layer proteins (SLPs) and vary the antigenicity of the predominant SLP expressed. Reciprocal recombination events among the eight genomic SLP gene cassettes, which encode 97‐ to 149 kDa SLPs, permit this variation. To explore whether SLP expression utilizes a single promoter, we created mutant bacterial strains using insertional mutagenesis by rescue of a marker from plasmids. Experimental analysis of the mutants created clearly indicates that SLP expression solely utilizes the single sapA promoter, and that for variation C. fetus uses a mechanism of DNA rearrangement involving inversion of a 6.2 kb segment of DNA containing this promoter. This DNA inversion positions the sapA promoter immediately upstream of one of two oppositely oriented SLP gene cassettes, leading to its expression. Additionally, a second mechanism of DNA rearrangement occurs to replace at least one of the two SLP gene cassettes bracketing the invertible element. As previously reported promoter inversions in prokaryotes, yeasts and viruses involve alternate expression of at most two structural genes, the ability of C. fetus to use this phenomenon to express one of multiple cassettes is novel.
A cytosine methyltransferase converts 5-methylcytosine in DNA to thymine.

Sites of cytosine methylation are known to be hot spots for C.G to T.A mutations in a number of systems, including human cells. Traditionally, spontaneous hydrolytic deamination of 5-methylcytosine to thymine has been invoked as the cause of this phenomenon. We show here that a bacterial cytosine methyltransferase can convert 5-methylcytosine in DNA to thymine and that this reaction creates a mutational hot spot at a site of DNA methylation. The reaction is fairly insensitive to the methyl donor in the reaction, S-adenosylmethionine. In many cancers, the most frequent class of mutations is C to T changes within CG dinucleotides of the tumor suppressor gene p53. Because of the similarities of the reaction mechanisms of mammalian and bacterial enzymes and the physiology of the cancer cells, this reaction is expected to contribute to mutations at CG dinucleotides in precancerous cells.
Liver involvement during HCV infection in chronic lymphoproliferative diseases.

Sir, we have read with interest the paper Evaluation of hepatitis B and C infection in patients with non Hodgkin’s lymphoma (NHL) and without liver disease, by Musolino et al., which confirms the close relationship between HCV infection and NHL, at least in Italy. Indeed, their data are in agreement with those of other italian groups spreading all over the country that have shown a high prevalence of HCV infection in patients with B-cell lymphomas, especially immunocytomas and Waldenstrom macroglobulinemia (WM). In their paper the authors suggest that HCV may chronically infect NHL patients without producing liver damage. This is a rather surprising statement, since up to now there is no evidence that HCV can cause an active infection without liver involvement. We have investigated clinical, histological and virologic findings in a series of 38 patients affected by B-cell chronic lymphoproliferative disorders: 19 low grade lymphomas (ten of which with an IgM monoclonal component), 10 high grade lymphomas, 3 chronic lymphocytic leukemias and 6 IgM monoclonal gammapathies. Ten patients (26%) had anti-HCV antibodies detectable in their serum by third generation Elisa assay, and in all of them the confirmatory test (Riba III) was positive. Viral mRNA was detected by a PCR technique in the serum of 7 of them (Table 1). Thus in a series of patients residing in another Italian region (Lazio) we have confirmed the high prevalence of HCV contact in patients with B-cell chronic lymphoproliferative diseases. Only one of the positive patients had received bloob proucts. serum transaminases were normal. Serum transaminases were elevated in one patients, slightly elevated in four and normal in five (Table 1). In all ten patients we performed a liver biopsy. Histology documented cirrhosis in one patient, chronic hepatitis in 6, steatosis in 2, infiltration by NHL in 3 and normal structure in one (Table 1). In 5 out of 7 patients with histological findings of hepatitis serum transaminases were normal. Thus, it is apparent that a liver involvement
Long-term Results of a Phase I/II Study of High-Dose Thoracic Radiotherapy With Concomitant Cisplatin and Etoposide in Limited Stage Small-Cell Lung Cancer

This report presents the results from a Mayo Clinic initiated phase I/II study exploring a potentially more aggressive local and systemic approach for treatment of limited-stage small-cell lung cancer (LSSCLC). Five patients with LSSCLC received three cycles of induction cyclophosphamide, etoposide, and infusion cisplatin chemotherapy. This was followed by accelerated hyperfractionated thoracic radiotherapy (AHFTRT) consisting of 30 Gy given as 1.5-Gy fractions twice daily with a 2-week break and then the AHFTRT was repeated. The AHFTRT was given concomitantly with daily oral etoposide and daily intravenous cisplatin. Prophylactic cranial radiation was delivered with the AHFTRT. After completion of the AHFTRT, patients received 4 cycles of oral etoposide maintenance chemotherapy. Follow-up of patients was continued until death or a minimum of 42 months. Three patients had severe toxic responses. No patients completed the entire protocol because of toxicity or progression during treatment. Three patients completed the majority of the protocol except for the four cycles of maintenance etoposide. Four of five patients achieved a complete response. There were two recurrences within the irradiated field, and distant metastases developed in four patients. Acute nonlymphocytic leukemia developed in one patient, who died 2 months later. No patient completed the entire protocol, because of toxicity or progression; therefore, this protocol cannot be recommended for the treatment of LSSCLC.