Miracle-dz/UniFAR-FTUs huggingface dataset:
EFFECT OF ACIDOSIS AND ALKALOSIS UPON CAPACITY FOR WORK.

The composition of arterial blood in exercise varies with the intensity of the exertion. In moderate work, percentage saturation of hemoglobin, alkaline reserve and hydrogen ion concentration remain constant or nearly so while the proportion of hemoglobin in blood and of protein in serum increase from 5 to 10 per cent. When exercise is carried on to exhaustion there is little or no further increase in concentration of blood proteins but lactic acid concentration may increase to 11 m.Eq. per liter and carbonic acid capacity2 may decrease in nearly reciprocal fashion. There may be a decrease in arterial pH. of 0.3 which means a liberation of base bound by protein. Work cannot be continued if lactic acid concentration much exceeds 10 m.Eq. per liter of blood. In circulatory diseases the description cannot be given in such precise fashion. The capacity for oxygen transport to the tissues is diminished, the composition of the blood in rest is variable, and it has been suggested by Eppinger and his associates and by Pilcher, Clark and Harrison (1930) that the buffering power of the blood and tissues is diminished in congestive heart failure. In view of the complications associated with exercising a sick man we have established acidosis in a normal man (H. D.) by ammonium chloride administration and have studied his performance while normal while in acidosis and while in -the alkalosis subsequent to withdrawing ammonium chloride. The composition of urine and the respiratory changes in rest have been described by Dennig, Dill and Talbott (1929).
A retrospective analysis of failed spinal anesthetic attempts in a community hospital.

Since the introduction of spinal anesthesia more than 85 years ago, there have been numerous periods of enthusiasm and condemnation associated with ever changing attitudes to and concepts of spinal anesthesia (1). With increased understanding of the physiology and pharmacology of spinal anesthesia, it is now established as one of the most useful forms of anesthesia, providing excellent analgesia and relaxation, with documented safety and relative ease of administration. However, Levy et al. (2) recently reported a 17% incidence of failure of spinal anesthetics in a university teaching hospital. Clinical reports describing inability to induce spinal anesthesia, the incidence of inadequate spinal anesthesia and factors associated with spinal failure are limited. The purpose of this retrospective study was to determine the incidence and factors associated with failed spinal anesthetics as seen in a community hospital.
Split‐liver transplantation in the high‐MELD adult patient: are we being too cautious?

The fear that patients with high‐mathematical model for end stage liver disease (MELD) score may not be suitable candidates for segmental grafts because of their need for greater liver mass has continued to push the transplant community toward the use of whole LT (WLT) in preference to split LT (SLT). In order to define the outcome of segmental liver transplantation in a better manner in high‐MELD patients (score ≥26), we queried the UNOS registry for graft and patient survival results according to MELD score in adult patients receiving WLT and SLT in the United States from the inception of MELD allocation (February 27, 2002) through March 9, 2007. A total of 316 adult patients received a SLT as compared with 20 778 WLTs. Patient and graft survival rates at 6 and 12 months were comparable for all MELD ranges, including the ‘high‐MELD’ recipients (e.g. at MELD score 31–35, patients’ and grafts’ survival rates at 12 months was 87.5% in SLT group vs. 84.4% and 76.7% in WLT group respectively). The results even at higher MELD scores (i.e. >35) were more than acceptable. In conclusion, patient and graft survival rates for SLT in high‐MELD adult patients are comparable to the same for WLT.
Experience with a Novel Efalizumab‐Based Immunosuppressive Regimen to Facilitate Single Donor Islet Cell Transplantation

Islet transplantation is an experimental therapy for selected patients with type 1 diabetes (T1DM). It remains limited by immunosuppressive drug toxicity, progressive loss of insulin independence, allosensitization and the need for multiple islet donors. We describe our experience with an efalizumab‐based immunosuppressive regimen as compared to the prevailing standard regimen, the Edmonton protocol. Twelve patients with T1DM received islet transplants: eight were treated with the Edmonton protocol; four were treated with daclizumab induction, a 6‐month course of tacrolimus, and maintenance with efalizumab and mycophenolate mofetil. The primary endpoint was insulin independence after one islet infusion. Only two Edmonton protocol treated patients achieved the primary endpoint; six required islets from multiple donors, and all experienced leukopenia, mouth ulcers, anemia, diarrhea and hypertransaminasemia. Four became allosensitized. All patients treated with the efalizumab‐based regimen achieved insulin independence with normal hemoglobin A1c after a single islet cell infusion and remained insulin independent while on efalizumab. These patients experienced significantly fewer side effects and none became allosensitized. Trial continuation was terminated by withdrawal of efalizumab from the market. These data suggest that this efalizumab‐based regimen prevents islet rejection, is well tolerated, and allows for single donor islet transplantation.
Dental throat packs and airway protection

A 60-year-old man weighing 70 kg with mild angina on exertion and no respiratory problems was intubated and his lungs ventilated for lower limb vascular surgery. Hand ventilation was with a Bain circuit in the anaesthetic room, and ventilation of the chest appeared to be normal. After the transfer to the operating table, the tracheal tube was connected to an Oxford ventilator set a t a tidal volume of 700ml with a frequency of 10 breathsmin-’. The inflation pressure was noted to be low and plateauing at 8cmH,O and this was not significantly altered by a temporary increase in the tidal volume to 850ml. A Wrights respirometer showed the expiratory volume to be 450 ml and hence a leak was sought. There was an audible hiss during the latter half of inspiration in the region of the tracheal tube, which was not corrected by the addition of further air to the cuff or by a visual check and tightening of the connections between the circuit and the tracheal tube. The catheter mount, angle piece, sampling set and tracheal tube were then changed. A quieter hiss was still audible, with an inflation pressure of 13 cmH20, with good expansion of the patient’s chest and an expiratory tidal volume of 700 ml. Testing of the items that had been changed by immersion in a bucket of water whilst connected to a breathing circuit demonstrated an obvious leak from the connector for the end-tidal C 0 2 monitor, also called the sampling set. The site of the leak was at the point of passage of the pilot tube into the connector (Fig. I ) . The replacement connector was also leaking from the same site, although to a much lesser extent. This was demonstrated by placing some lubricating jelly over the pilot tube entrance site. An identical connector from an adjacent operating theatre was also noted to have a small leak. The connectors in question are made by Datex Instrumentation Corporation, Helsinki, Finland, and bore the following markings ‘Safe and sure, pac date 02.05. 1991, 85212-3’. This batch was withdrawn from use from our Fig. 1.
Comparison of the Efficacies of Three Fluoroquinolone Antimicrobial Agents, Given as Continuous or Pulsed-Water Medication, against Escherichia coli Infection in Chickens

ABSTRACT This study compared the efficacy of continuous or pulsed-water medication with enrofloxacin, danofloxacin, and sarafloxacin in eight groups of 90 chicks each by using an infectious bronchitis virus-Escherichia coli model of colisepticemia. The model produced lesions of typical those occurring in birds with severe colisepticemia; for the infected, nonmedicated birds the mortality was 43.5% and the morbidity was 89%, 17.8% of birds had severe lesions, and the birds had a mean air sac lesion score of 2.58. This experiment showed that continuous dosing and pulsed dosing are clinically equivalent. However, for all fluoroquinolones studied, there was a trend for the continuously mediated birds to have lower mortality and less severe disease than birds receiving pulsed doses. Compared with infected, nonmedicated controls, only birds continuously medicated with enrofloxacin had a significantly lower morbidity (32%), and only birds medicated with enrofloxacin and danofloxacin (continuous and pulsed treatments) had significantly lower mortality (6.7 and 11.0% and 16.8 and 19.2% for continuous and pulsed treatments with enrofloxacin and danofloxacin, respectively). A significantly lower proportion of birds only in the groups medicated with enrofloxacin had severe lesions (for birds receiving continuous and pulsed treatments, 2.2 and 6.7%, respectively). Birds medicated with any of the three fluoroquinolones (continuous and pulsed treatments) except pulsed-water treatment with sarafloxacin had significantly reduced mean air sac lesion scores compared with the scores for nonmedicated birds (air sac lesion scores, 0.60 and 0.83, 1.38 and 1.63, and 1.80 and 2.05 for birds receiving continuous and pulsed treatments with enrofloxacin, danofloxacin, and sarafloxacin, respectively). The performance of the birds that survived the challenge or that recovered after receiving medication was not compromised compared to the performance of noninfected birds. Enrofloxacin was more efficacious than either danofloxacin or sarafloxacin for the treatment of colisepticemia in chickens by medication in drinking water. Similarly, danofloxacin appeared to be more effective than sarafloxacin in treating colisepticemia.
Regulation of SRC-3 (pCIP/ACTR/AIB-1/RAC-3/TRAM-1) Coactivator Activity by IκB Kinase

ABSTRACT In the past few years, many nuclear receptor coactivators have been identified and shown to be an integral part of receptor action. The most frequently studied of these coactivators are members of the steroid receptor coactivator (SRC) family, SRC-1, TIF2/GRIP1/SRC-2, and pCIP/ACTR/AIB-1/RAC-3/TRAM-1/SRC-3. In this report, we describe the biochemical purification of SRC-1 and SRC-3 protein complexes and the subsequent identification of their associated proteins by mass spectrometry. Surprisingly, we found association of SRC-3, but not SRC-1, with the IκB kinase (IKK). IKK is known to be responsible for the degradation of IκB and the subsequent activation of NF-κB. Since NF-κB plays a key role in host immunity and inflammatory responses, we therefore investigated the significance of the SRC-3-IKK complex. We demonstrated that SRC-3 was able to enhance NF-κB-mediated gene expression in concert with IKK. In addition, we showed that SRC-3 was phosphorylated by the IKK complex in vitro. Furthermore, elevated SRC-3 phosphorylation in vivo and translocation of SRC-3 from cytoplasm to nucleus in response to tumor necrosis factor alpha occurred in cells, suggesting control of subcellular localization of SRC-3 by phosphorylation. Finally, the hypothesis that SRC-3 is involved in NF-κB-mediated gene expression is further supported by the reduced expression of interferon regulatory factor 1, a well-known NF-κB target gene, in the spleens of SRC-3 null mutant mice. Taken together, our results not only reveal the IKK-mediated phosphorylation of SRC-3 to be a regulated event that plays an important role but also substantiate the role of SRC-3 in multiple signaling pathways.
Hypoxia‐inducible factor 1‐alpha does not regulate osteoclastogenesis but enhances bone resorption activity via prolyl‐4‐hydroxylase 2

Osteogenic–angiogenic coupling is promoted by the hypoxia‐inducible factor 1‐alpha (HIF‐1α) transcription factor, provoking interest in HIF activation as a therapeutic strategy to improve osteoblast mineralization and treat pathological osteolysis. However, HIF also enhances the bone‐resorbing activity of mature osteoclasts. It is therefore essential to determine the full effect(s) of HIF on both the formation and the bone‐resorbing function of osteoclasts in order to understand how they might respond to such a strategy. Expression of HIF‐1α mRNA and protein increased during osteoclast differentiation from CD14+ monocytic precursors, additionally inducing expression of the HIF‐regulated glycolytic enzymes. However, HIF‐1α siRNA only moderately affected osteoclast differentiation, accelerating fusion of precursor cells. HIF induction by inhibition of the regulatory prolyl‐4‐hydroxylase (PHD) enzymes reduced osteoclastogenesis, but was confirmed to enhance bone resorption by mature osteoclasts. Phd2+/− murine osteoclasts also exhibited enhanced bone resorption, associated with increased expression of resorption‐associated Acp5, in comparison with wild‐type cells from littermate controls. Phd3−/− bone marrow precursors displayed accelerated early fusion, mirroring results with HIF‐1α siRNA. In vivo, Phd2+/− and Phd3−/− mice exhibited reduced trabecular bone mass, associated with reduced mineralization by Phd2+/− osteoblasts. These data indicate that HIF predominantly functions as a regulator of osteoclast‐mediated bone resorption, with little effect on osteoclast differentiation. Inhibition of HIF might therefore represent an alternative strategy to treat diseases characterized by pathological levels of osteolysis. © 2017 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
DETERMINANTS OF INTELLECTUAL CAPITAL DISCLOSURE PRACTICES OF INDIAN COMPANIES

Numerous academicians, business professionals, and consultants identified 'intellectual assets/capital' as the main factor of value creation in the present knowledge economy. Companies especially in the service sectors require maximum amount of this type of capital to maintain their existence in the competitive market, whereas empirical results show that companies disclose lesser amount of intellectual capital related information in the annual reports. In this study, we examine the factors that determine the proportion of intellectual capital disclosure in the annual reports. For the purpose of the study 30 Indian knowledge-intensive companies (software, pharmaceuticals, and finance) are selected (on the basis of highest market capitalisation) for the period 2009-2012. Content analysis of annual reports is done to prepare intellectual capital disclosure (ICD) index and efficiency of intellectual capital is measured through VAIC. Multiple regression analysis is applied to examine the relationship between dependent and independent variables. Empirical results show that audit committee's size, age, and firm size have positive relation with intellectual capital disclosure but VAIC, profitability, and leverage have negative relationship with intellectual capital disclosure. This negative association between intellectual capital efficiency and disclosure suggests that intellectually efficient companies disclose less information in the financial statement for fear of losing competitive advantage. The present study is the first study in the Indian context that examines the determinant(s) of intellectual capital disclosure. However, this study is confined to 30 Indian knowledge companies for the period 2009-2012.
Co‐localization of multiple ErbB receptors in stratified epithelium of oral squamous cell carcinoma

The expression of all four ErbB receptors was compared by immunohistochemistry, using receptor‐specific polyclonal antisera, in 32 invasive, 11 in situ carcinomas, six benign lesions, and 22 samples of histologically normal mucosa adjacent to specimens of carcinoma originating from oral cavity epithelium. Among invasive and in situ carcinoma, EGFR expression was the most prevalent (in 29/32 and 8/11 cases, respectively) followed by ErbB2 (17/32 and 2/11) and ErbB4 (9/32 and 1/10), while ErbB3 was only detected in invasive tumours (12/32). Specific patterns included invasive tumours with expression of EGFR (8/32) or ErbB4 (1/32) alone, as well as different receptor combinations (EGFR+ErbB2, EGFR+ErbB4, EGFR+ErbB2+ErbB3, EGFR+ErbB2+ErbB4, and all four receptors). Simultaneous expression of three or four ErbB receptors correlated with tumour invasion (p=2.2×10−4) and localized in the intermediate epithelial cell layer of well and moderately differentiated tumours. No other significant correlation with clinico‐pathological features was noticed. Some benign lesions and histologically normal mucosa adjacent to carcinomas showed weak immunostaining of EGFR (10/28), ErbB2 (4/28) or ErbB4 (3/28). By comparison, overexpression, as indicated by increased staining intensity, was observed in invasive tumours for EGFR (18/32), ErbB2 (8/32), ErbB4 (3/32), and ErbB3 (3/32). Statistical evaluation demonstrated a significant association of EGFR or ErbB2 overexpression with invasive carcinoma when compared with benign lesions and apparently normal epithelium (p=5.2×10−7 and p=5×10−3, respectively). Tumour‐specific overexpression of ErbB receptors and their co‐expression, most frequently involving EGFR and ErbB2, in the same cell layer of neoplastic epithelium, implicate receptor heterodimers in the pathogenesis of oral squamous carcinoma. Copyright © 2001 John Wiley & Sons, Ltd.
The synergy between endoscopic assistance and extraoral approach in subcondylar fracture repair: a report of 13 cases.

BACKGROUND We aimed to present the primary experience of one surgeon with a new surgical technique performed on the first 13 cases and to evaluate outcomes following an extraoral endoscopic approach to subcondylar fractures. METHODS Fifteen subcondylar fractures in 13 patients, who were treated at Ondokuz Mayis University Hospital between January 2010 and June 2011, were included in this study. Patients were operated on using either endoscopic or open approach. RESULTS Rigid plate fixation was completed endoscopically using extraoral approach in nine fractures, while six fractures were plated by conversion to a full-open approach. In all six fractures that could not be fixed endoscopically, the proximal fragments were medially displaced, whereas seven of nine fractures that were successfully fixed endoscopically were laterally displaced. CONCLUSION An extraoral endoscopic approach for subcondylar fractures is feasible and can be carried out with decreased morbidity. This approach is recommended for those with limited experience in endoscopy to treat low laterally displaced subcondylar fractures as their initial cases.
Long-term clinical outcomes following coronary stenting.

BACKGROUND Clinical trials of drug-eluting stents (DES) vs bare metal stents (BMS) report a reduced need for target lesion revascularization with no difference in death or myocardial infarction. However, these trials selectively enrolled patients with lower risk, single-vessel coronary artery disease (CAD) and limited the follow-up period to 1 year or less. Thus, it is not known how these short-term results apply to patients with higher risk, multivessel CAD seen in community practice settings. The objective of this study was to compare the long-term clinical outcomes of patients receiving DES vs BMS in a clinical practice setting. METHODS Patients from the Duke Databank for Cardiovascular Disease undergoing their initial revascularization with DES or BMS from January 1, 2000, through July 31, 2005, were included in the study population. Propensity scores and inverse probability weighted estimators were used to adjust for treatment group imbalances. RESULTS The study population included 1501 patients who received DES and 3165 who received BMS. After adjustment, DES reduced target vessel revascularization (TVR) rates at 6, 12, and 24 months compared with BMS (24-month rates: DES, 6.6%; BMS, 16.3%; difference, -9.7%; 95% confidence interval [CI], -11.7% to -7.7%; P < .001). The TVR benefit for DES increased among patients with multivessel CAD (1-vessel CAD: -8.3%; 95% CI, -10.9% to -5.8%; P < .001; 2-vessel CAD: -9.7%; 95% CI, -3.6% to -5.8%; P < .001; 3-vessel CAD: -16.2%; 95% CI, -25.2% to -7.2%; P < .001). However, in the overall cohort there were no statistically significant differences in the composite of death or myocardial infarction. CONCLUSIONS Patients receiving DES vs BMS in a clinical practice setting have lower TVR rates, albeit with less absolute benefit than those observed in clinical trials. Patients with multivessel vs single-vessel disease experience a greater reduction in TVR.
Faecal incontinence and health related quality of life in inflammatory bowel disease patients: Findings from a tertiary care center in South Asia.

AIM To analyze the frequency and severity of faecal incontinence (FI) and its effect on the quality of life (QOL) in inflammatory bowel disease (IBD) patients. METHODS All patients who attended surgical and medical gastroenterology outpatient clinics in a tertiary care center with an established diagnosis of either ulcerative colitis (UC) or Crohn's disease (CD) over a period of 10 mo were included in this study. Before enrollment into the study, the patients were explained about the study and informed consent was obtained. The patients with unidentified colitis were excluded. The data on demographics, disease characteristics, FI (Vaizey score), and quality of life (IBD-Q) were collected. Data were analyzed using SPSS version 21. RESULTS There were 184 patients (women = 101, 54.9%; UC = 153, 83.2%) with a female preponderance for UC (male/female ratio = 1:1.5) and a male preponderance for CD (male/female = 2:1). Forty-eight (26%) patients reported symptoms of FI. Among the patients with FI, 70.8% were women (n = 34) and 29.2% were men (n = 14) with an average age of 52.7 years (range, 20-78 years). Average age of onset of FI was 48.6 (range, 22-74) years. Ten percent (n = 5) reported regular FI. Incontinence to flatus was seen in 33.3% (n = 16), to liquid faeces in 56.2% (n = 27), to solid faeces in 6.2% (n = 3) and to all three in 4.1% (n = 2). Twenty-one percent (n = 10) complained of disruption of their physical and social activity. There was no association between FI and type of IBD. Significant associations were found between FI and age (P = 0.005) and gender (P < 0.001). QOL in our cohort of patients was significantly affected by FI. CONCLUSION In our study, nearly a quarter of patients reported FI. There was a significant correlation between FI and QOL. Therefore, enquiring about FI in IBD patients can lead to identification of this debilitating condition. This will enable early referral for continence care in this group of patients.