Miracle-dz/UniFAR-FTUs huggingface dataset:
An unusual evolution of the systemic capillary leak syndrome.

A 33-year-old black male, was referred to our department in 1981 for the following symptoms consistent with typical SCLS: several episodes of shock with generalized oedema; diffuse pain; and transient anuria. A monoclonal gammapathy of undetermined significance (MGUS) was discovered at that time. Three years later, he had minimal proteinuria (monoclonal component). Femoral artery superficialization was performed to obtain a permanent and easy vascular access, and the patient was treated during subsequent crises by colloid or gelatin fluids. Prevention of these crises was attempted unsuccessfully with corticosteroids, theophylline, cyclophosphamide, cyclosporin A, plasma exchanges, and naftazone. Beginning in 1986, transient diabetes mellitus occurred during the crises. Because of the presumably auto-immune mechanism common to both the SCLS and the episodes of diabetes mellitus, the patient began treatment with intravenous polyvalent immunoglobulins. These reduced the intensity of his crises, with only abdominal pain, moderate hypotension and weight gain. In 1991, the patient developed permanent diabetes mellitus and, beginning in 1999, diabetic retinopathy, progressive neuropathy and nephropathy. In May 2000, the patient had acute renal failure and persistent proteinuria, and a renal biopsy was performed. Optical examination showed osmotic nephrosis-like lesions in the podocytes and most tubules, but no amyloidosis. On immunofluorescence, some polyclonal depositions were seen in glomeruli as well as tubular basement membranes. Electronmicroscopy showed basal thickening, without fibrillar or granular deposition, and mesangial expansion, suggesting an early dia betic nephropathy. The patient recovered renal function after this episode. However, he presented more frequent crises, weight loss, thoracic pain and, finally, worsening cardiac function. A pericardial effusion was drained. Pericardial biopsy showed no amyloidosis despite evidence revealed by echocardiography. A bone marrow aspiration showed 80% abnormal plasmocytes, confirming the diagnosis of myeloma. M-component serum level was 18 gul. Humeral lacunae were seen on an X-ray. Cutaneous and salivary biopsies revealed AL amyloidosis. In April 2001, treatment was begun with melphalan and prednisone. However, the patient died after two treatment courses from cardiac and hepatic amyloidosis.
A novel colonic anastomosis technique involving fixed polyglycolic acid mesh.

BACKGROUND Polyglycolic acid mesh (PAM) reinforcement of colonic anastomoses were evaluated. METHODS Twenty female albino rabbits were divided into two groups. Each rabbit underwent segmental colonic resection with single-layer anastomosis. In one group of rabbits, PAM of length equal to the circumference of the anastomosis was applied. Rabbits were sacrificed on postoperative day 10 and peritoneal adhesions, anastomosis burst pressure, and anastomosis histopathological characteristics were evaluated. RESULTS The average burst pressure for the control and PAM groups was 149±15.95 mmHgand 224±124.5 mmHg, respectively (p=0.578). All control anastomoses burst, whereas only five (50%) PAM anastomoses burst (p<0.03). There was no anastomotic leakage in the control group, whereas three PAM group anastomoses leaked (p=0.210). The collagen fiber density and amount of neovascularization were lower in the PAM than the control group (p=0.001 and p=0.002, respectively). The average peritoneal adhesion value was 1.6±0.51 in the control group and 2.9±0.31 in the PAM group (p<0.0001). CONCLUSION The new fixed PAM-reinforced anastomosis technique resulted in an increased risk of anastomosis leakage and peritoneal adhesion, but also higher in non-burst anastomoses.
Osteochondral Autograft Transplantation in the Porcine Knee

Background Knee articular cartilage defects are not an uncommon problem. Because articular cartilage is limited in its ability to heal, these defects are difficult to manage. Hypothesis Osteochondral autografts will provide less of a cavitary defect and more viable hyaline articular cartilage than will control knees. Study Design Controlled laboratory study. Methods Osteochondral autografts were grossly and microscopically evaluated in the porcine knee and compared with a control at 6 weeks, 3 months, and 6 months. In 18 porcine specimens, a 1-stage surgical procedure was performed to harvest an osteochondral graft from a nonweightbearing articular cartilage surface, and the graft was transplanted into a defect created in the weightbearing region of the medial femoral condyle. In the opposite control knee, a similar defect was created in the medial femoral condyle; an osteochondral transplant was not performed. Six pigs each were sacrificed at 6 weeks, 3 months, and 6 months. Results Gross inspection of the control knees showed a cavitary defect. The defect grossly decreased in size with fibrous ingrowth seen on microscopic analysis. An increasing amount of fibrous tissue and fibrocartilage was present at the 3 time periods. Gross inspection of the graft knee showed a healed osteochondral plug with no obvious displacement, cavitary defects, or surrounding necrotic tissue at each time interval. Microscopic analysis revealed the graft knee contained viable hyaline cartilage and healed viable subchondral bone. At all time intervals, 75% to 100% of the hyaline cartilage was viable in all specimens. In 6-month specimens, bridging cartilage at the autograft-host junction was incomplete in 50%, partial in 33%, and complete in 17%. Conclusion Osteochondral autografts in the porcine knee resulted in viable hyaline cartilage for up to 6 months; there was inconsistent bridging hyaline cartilage at the periphery. Grafts appeared to heal into existing subchondral bone without displacement or evidence of necrosis. Clinical Relevance This type of osteochondral transplant can be used as a reliable reconstructive alternative for osteochondral defects.
Head to head: The role of academic competition in undergraduate anatomical education

Competition is a key element in many educational games and is often adopted by educators in an effort to motivate and excite their students. Yet, the use of academic competition in educational institutions remains the subject of much debate. Opponents argue that academic competition causes an increase in student anxiety and divides their attention. However, if the contexts of academic competition are defined, could the inclusion of a game‐like competition in a university course be a viable and beneficial method of engaging students? Students (n = 67) were recruited from an undergraduate human anatomy course at Western University. Using a crossover design, students were exposed to a competitive tournament either at the time of their first term test or second term test. The anatomical knowledge of participating students was assessed prior to the start of the study using a baseline anatomy test. Following treatment with an online competitive anatomy tournament, student's term test grades and final course grades were analyzed. Both the second term test scores (F(2,64) = 3.743, P = 0.029) and overall course grades (F(2,64) = 3.356, P = 0.041) were found to be significantly different (P < 0.05) for individuals in the competitive group when compared to their non‐competing peers. As suggested by the literature where organized competition in the classroom correlates to improved academic performance, this study uncovered significant results pertaining to increased academic performance resulting from participating in tournament‐based competition. In light of these positive results, further exploration of the effects of academic competition on student performance across age brackets and disciplines is warranted. Anat Sci Educ 8: 404–412. © 2014 American Association of Anatomists.
Blind source separation of non-stationary sources using second-order statistics

The question addressed in this paper is whether and under which conditions blind source separation is possible using only second-order statistics. It is well known that for stationary, i.i. d. sources the answer is negative due to the inherent unitary matrix ambiguity of the output second order information. It is shown however that if the sources' power is allowed to vary with time, unique identifiability is guaranteed without resorting to higher order statistics. In many applications the sources' power does change with time (e.g., speech or fading communication signals), and therefore the result has practical relevance. A novel second order source separation method is proposed based on a generalized eigenvalue decomposition of appropriate correlation matrices and the identifiability conditions are investigated. Asymptotic performance results for the output SIR are developed.
Dosing strategies and optimization of targeted therapy in advanced renal cell carcinoma

Within the past decade, treatment options for metastatic renal cell carcinoma have expanded dramatically. Currently, seven targeted agents are approved for use in metastatic renal cell carcinoma and have superseded the use of parenteral cytokine therapy with interleukin-2 or interferon, the former standards of care for metastatic renal cell carcinoma. Targeted agents include inhibitors of the vascular endothelial growth factor pathway (i.e. sorafenib, sunitinib, pazopanib, axitinib, and bevacizumab) and inhibitors of the mammalian target of rapamycin pathway (i.e. temsirolimus and everolimus). These newer therapies have been shown to improve progression-free survival compared with previous approaches. Because most of these targeted agents are taken orally, responsibility for dose administration has shifted to patients, which might result in variable adherence. Additionally, with new treatments for metastatic renal cell carcinoma comes the challenge of selecting dosing schemes that maximize therapeutic benefit and minimize adverse events. Much of the information related to the effectiveness of dose modifications for targeted therapies in metastatic renal cell carcinoma has been gathered from clinical studies that have strict inclusion and exclusion criteria, which might not translate directly to real-world patient populations. This review discusses the impact of dose adherence on the effectiveness of targeted agents to treat metastatic renal cell carcinoma, assesses the literature regarding the effectiveness of approved dosing strategies, and provides a summary of alternative dosing strategies.
The Yeast Plasma Membrane Protein Alr1 Controls Mg2+ Homeostasis and Is Subject to Mg2+-dependent Control of Its Synthesis and Degradation*

The Saccharomyces cerevisiae ALR1(YOL130w) gene product Alr1p is the first known candidate for a Mg2+ transport system in eukaryotic cells and is distantly related to the bacterial CorA Mg2+ transporter family. Here we provide the first experimental evidence for the location of Alr1p in the yeast plasma membrane and for the tight control of its expression and turnover by Mg2+. Using well characterizednpi1 and end3 mutants deficient in the endocytic pathway, we demonstrate that Alr1 protein turnover is dependent on ubiquitination and endocytosis. Furthermore, cells lacking the vacuolar protease Pep4p accumulated Alr1p in the vacuole. Mutants lacking Alr1p (Δalr1) showed a 60% reduction of total intracellular Mg2+ compared with the wild type and failed to grow in standard media. When starved of Mg2+, mutant and wild-type cells had similar low levels of intracellular Mg2+; but upon addition of Mg2+, wild-type cells replenished the intracellular Mg2+ pool within a few hours, whereasΔalr1 mutant cells did not. Expression of the bacterial Mg2+ transporter CorA in the yeastΔalr1 mutant partially restored growth in standard media. The results are discussed in terms of Alr1p being a plasma membrane transporter with high selectivity for Mg2+.
Interleukin-27 augments the inhibitory effects of sorafenib on bladder cancer cells

Both sorafenib and interleukin-27 (IL-27) are antineoplastic drugs. This study aimed to investigate the synergistic effect of these two drugs on bladder cancer cells. HTB-9 and T24 cells were stimulated with IL-27 (50 ng/mL), sorafenib (2 μM) or the synergistic action of these two drugs. The cells without treatment acted as control. Cell proliferation, apoptosis and invasion were measured by bromodeoxyuridine assay, flow cytometry and modified Boyden chamber, respectively. Simultaneously, both modified Boyden chamber and scratch assay were used to assess cell migration. Finally, the phosphorylation levels of key kinases in the Akt/mechanistic target of rapamycin (mTOR)/mitogen-activated protein kinase (MAPK) pathway, and expression levels of matrix metalloproteinase (MMP)-2 and MMP-9 were detected by western blot analysis. Stimulation with IL-27 or sorafenib repressed proliferation, migration and invasion but promoted apoptosis, and the effects were all enhanced by the combination of these two drugs in HTB-9 cells. The effect of the combined treatment on bladder cancer cells was verified in T24 cells. Additionally, the phosphorylation levels of AKT, mTOR and MAPK as well as the expression levels of MMP-2 and MMP-9 were all decreased by a single treatment of IL-27 or sorafenib, and further decreased by the combined treatment of these two drugs. The combination of IL-27 and sorafenib inhibited proliferation, migration and invasion and promoted apoptosis of bladder cancer cells compared with mono-drug treatment. Additionally, the AKT/mTOR/MAPK pathway might be implicated in the functional effects by down-regulations of MMP-2 and MMP-9.
Concurrent and Short-Term Prospective Relations among Neurocognitive Functioning, Coping, and Depressive Symptoms in Youth

The present short-term longitudinal study examined the concurrent and prospective relations among executive functioning (i.e., working memory and cognitive flexibility), coping (primary and secondary control coping), and depressive symptoms in children. Participants were 192 children between 9 and 15 years old (M age = 12.36 years, SD = 1.77) recruited from the community. Youth were individually administered neuropsychological measures of executive functioning and intelligence and completed self-report measures of executive dysfunction, coping, and depressive symptoms in small groups; the latter two measures were completed again 4 months later (Time 2 [T2]). Linear regression analyses were used to examine direct associations among executive functions, coping, and depressive symptoms, and a bootstrapping procedure was used to test indirect effects of executive functioning on depressive symptoms through coping. Significant prospective relations were found between working memory measured at Time 1 (T1) and both primary and secondary control coping measured at T2, controlling for T1 coping. T1 cognitive flexibility significantly predicted T2 secondary control coping, controlling for T1 coping. Working memory deficits significantly predicted increases in depressive symptoms 4 months later, controlling for T1 depressive symptoms. Bootstrap analyses revealed that primary and secondary control coping each partially mediated the relation between working memory and depressive symptoms; secondary control coping partially mediated the relation between cognitive flexibility and depressive symptoms. Coping may be one pathway through which deficits in executive functioning contribute to children's symptoms of depression.
Molecular characterization of a large Borrelia burgdorferi motility operon which is initiated by a consensus sigma70 promoter

A large motility operon, referred to as the flgB operon, was identified, characterized, and mapped at 310 to 320 kb on the linear chromosome of the spirochete Borrelia burgdorferi. This is the first report that a sigma70-like promoter rather than a sigma28-like promoter is involved in the transcription of a major motility operon in bacteria. From these results in conjunction with results from a previous study (Y. Ge and N. W. Charon, Gene, in press), we have identified 26 genes in this operon that are relevant to motility and flagellar synthesis. With few exceptions, the gene order and deduced gene products were most similar to those of other spirochetes and Bacillus subtilis. Primer extension analysis indicated that transcription initiated from a conserved sigma70-like promoter immediately upstream of flgB; this promoter mapped within the heat-shock-induced protease gene hslU. Reverse transcriptase PCR analysis indicated that a single transcript of 21 kb initiated at this promoter and extended through flgE and (with our previous results) onto the putative motility gene flbE. The flgB promoter element had strong activity in both Escherichia coli and Salmonella typhimurium. As expected, a mutant of S. typhimurium with an inactivated flagellum-specific sigma28 factor did not affect the function of this promoter. Western blot analysis indicated that B. burgdorferi recombinant FliG and FliI were antigenically similar to those of E. coli and other spirochetes. Although complementation of E. coli or S. typhimurium fliG or fliI mutants with the B. burgdorferi genes was unsuccessful, B. burgdorferi recombinant FliI completely inhibited flagellar synthesis and motility of wild-type E. coli and S. typhimurium. These results show that spirochete motility genes can influence flagellar synthesis in other species of bacteria. Finally, Western blot analysis with sera from infected humans and animals indicated a weak or nondetectable response to recombinant FliG and FliI. These results indicate that these antigens are not favorable candidate reagents to be used in the diagnosis of Lyme disease.
Spousal Differences In Marital Satisfaction During Transition to Parenthood

Ninety-six couples were assessed to determine the contributions of sex role attitudes, marital equity, perceived father involvement, and infant temperament to satisfaction during transition to parenthood. Both parents reported a significant decline in marital satisfaction from 3 months prebirth to 3 months postbirth. Mothers' evaluations of their postbirth marital relationships were positively influenced by more nontraditional sex role attitudes and greater father involvement in infant care, and negatively influenced by marital inequity and a more temperamentally active infant. Fathers' postbirth marital satisfaction was more negatively influenced by marital inequity than mothers’. Other factors did not contribute to fathers' marital assessment. Results suggest that a mother's perception of marital satisfaction after parenthood is more complex than a father's, and that equity is a greater consideration for men than for women during the transition to parenthood.
The influence of chronotype and intelligence on academic achievement in primary school is mediated by conscientiousness, midpoint of sleep and motivation

Individuals differ in their timing of sleep (bed times, rise times) and in their preference for morning or evening hours. Previous work focused on the relationship between academic achievement and these variables in secondary school students. The main aim of the study is to investigate the relationship between chronotype and academic achievement in 10-year-old children (n = 1125) attending 4th grade of primary school. They filled a cognitive test (Culture Fair Intelligence Test, CFT 20-R) and questions about rise times and bed times, academic achievement, conscientiousness and motivation. We used the “scales for the assessment of learning and performance motivation” (SELLMO; Skalen zur Erfassung der Lern- und Leistungsmotivation for motivation), the short version of the Five-Factor Personality Inventory Children (FFPI-C) to measure conscientiousness, and the Composite Scale of Morningness (CSM) to assess morningness–eveningness. Mean CSM score was 37.84 ± 6.66, midpoint of sleep was 1:36 ± 00:25 and average sleep duration (time in bed) was 10:15 ± 0:48. Morningness orientation was positively related to intelligence, conscientiousness and learning objectives. Eveningness orientation was related to avoidance performance objectives and work avoidance. Early midpoint of sleep, conscientiousness and intelligence were associated with better grades. The multivariate model showed that intelligence was the strongest predictor of good grades. Conscientiousness, motivation, younger age and an earlier midpoint of sleep were positively related to good grades. This is the first study in primary school pupils, and it shows that the relationship between evening orientation and academic achievement is already prevalent at this age even when controlling for important predictors of achievement.
Pharmacokinetics of Levobupivacaine (2.5 mg/kg) After Caudal Administration in Children Younger Than 3 Years

BACKGROUND: Caudal administration of levobupivacaine (2.5 mg/kg) in children is used frequently in some hospitals. However, no reports of levobupivacaine concentrations have been published with this dosing scheme. We report the results of a study on the pharmacokinetics of levobupivacaine (2.5 mg/kg) after caudal administration in children younger than 3 yr. METHODS: Ten children, aged 1–36 mo and scheduled for subumbilical surgery were studied under sevoflurane anesthesia. After caudal injection of 0.25% levobupivacaine (2.5 mg/kg), serial venous blood samples were taken for 3 h to measure total plasma concentration levels of levobupivacaine. Median (range) levobupivacaine Cmax and Tmax measured were 1.48 (0.62–2.40) &mgr;g/mL and 37 (10–60) min. The highest individual Cmax was observed in a 1-mo-old infant 30 min after caudal block. CONCLUSIONS: The highest Cmax reached in this study was close to the toxic threshold of adult patients. Although no adverse events have been reported, care must be taken, especially in small infants, after caudal administration of levobupivacaine (2.5 mg/kg).