Miracle-dz/UniFAR-FTUs huggingface dataset:
Thoracic and Lumbar Epidural Analgesia via the Caudal Approach Using Electrical Stimulation Guidance in Pediatric Patients: A Review of 289 Patients

BackgroundNerve stimulation guidance (Tsui test) has been reported to be an effective alternative to radiographic imaging for proper catheter placement. The purpose of this study was to examine the success rate and complications of continuous caudal epidural analgesia since the implementation of routine use of the Tsui test at the authors’ institution. MethodsThe authors examined prospectively collected data in their pediatric pain service database from 289 children who had attempted caudal placement of a lumbar or thoracic catheter between 1999 and 2002. ResultsIn five patients (aged 5 months–1.6 yr), the catheter did not thread to the desired level and was abandoned in the operating room (technical success rate, 98.2%). Of the remaining 284 patients, the overall analgesic success rate of all caudal route epidural analgesia procedures was 84.9%. There was no significant difference in adequate pain control (success) in infants (aged 1 day–1 yr) versus older children (aged younger than 1 yr). The most common adverse effects were pruritus (26.1%) and nausea and vomiting (16.9%). Of the patients in our study, 57.7% had urinary catheters in situ; of those who did not have a catheter placed, 20.8% experienced urinary retention. The incidence of respiratory depression was 4.2%, but the administration of naloxone for severe respiratory depression was never necessary. Three percent of catheters were removed because of suspected contamination, but no epidural abscesses or systemic infection were noted. ConclusionsThe results of this study suggest that epidural catheter placement via the caudal approach using the Tsui test is an effective and reasonable alternative to direct lumbar and thoracic epidural analgesia in pediatric patients.
Comparing the experiential and psychosocial dimensions of chronic pain in african americans and Caucasians: findings from a national community sample.

OBJECTIVES To ascertain whether non-Hispanic African American and Caucasian chronic pain sufferers differ or converge in their self-reports of pain experience and pain adjustment. RESEARCH DESIGN A telephone survey of U.S. English-speaking adults selected via random-digit dialing procedures and constrained to locate persons with chronic pain within selected gender by age groupings. SUBJECTS A national sample of 2,407 participants contained a total of 214 non-Hispanic African Americans. A sample of 214 non-Hispanic Caucasians was randomly selected from the larger set of 1,935 Caucasian participants to serve as a comparison group for the present study. MEASURES Participants provided responses to interviewer questions that assessed pain experience (severity, interference, and emotional burden) and psychosocial outcomes (coping, attitudes and beliefs, catastrophizing, social support and hindrance, pain's interference with daily life activities, treatment status, and medication taking). RESULTS Although African American and Caucasian adults with chronic pain did not differ significantly in pain severity, interference, emotional burden, or current treatment status, multivariate analyses revealed differences in several domains of psychosocial functioning. Compared to Caucasians, African Americans reported greater pain-related interference with daily living, deficiencies in coping, and counterproductive attitudes and beliefs. African Americans also reported greater impatience and insensitivity from the most important person in their lives. CONCLUSIONS Psychosocial dimensions of chronic pain differed between community-residing African American and Caucasian adults surveyed as part of a national sample.
Long-term outcome of idiopathic hypogonadotropic hypogonadism

Purpose of reviewThis review focuses on the presentation, treatment and long-term outcomes of men with idiopathic hypogonadotropic hypogonadism (IHH). Recent findingsThe traditional view that IHH is a simple monogenic disorder has now been revised, with some cases having an oliogenic basis involving mutations in more than one locus in each affected individual. The majority of IHH men respond well to induction of spermatogenesis with gonadotropins or pulsatile gonadotropin-releasing hormone. Favourable prognostic factors include larger testicular size, prior gonadotropin therapy, no previous androgen therapy, absence of cryptorchidism and pretreatment inhibin B levels more than 60 pg/ml. Genetic factors influence response to therapy and patients with KAL1 mutations tend to have less favourable outcomes as they may have defects in multiple levels of the hypothalamic-pituitary-gonadal axis.Androgen replacement is warranted in all IHH patients after usual chronological age of puberty, and poor treatment compliance is associated with lower bone mineral density and higher fat mass. However, 10% of patients display sustained reversal so a brief treatment interruption should be considered. SummaryIHH is a heterogeneous disorder. The complex genetics and interaction with environmental factors likely underlie the variable expressivity of the reproductive and nonreproductive phenotypes. The demonstration of reversibility, the impact of inadequate testosterone replacement and the good response to induction of spermatogenesis confirm the need for specialist care and long-term follow-up.
Overview of In-Orbit Radiation Induced Spacecraft Anomalies

Spacecraft anomalies due to radiation effects on electronic devices have been known since the very beginning of the space era. Today they represent a major part of on-board anomalies, mission outages, and unexpected workload on ground controllers of operational systems. This text will first describe a few known cases of cumulative or transient effects in Earth or planetary environments. Then, it will discuss investigation methodology, and issues such as the statistical aspects of probabilistic anomalies in the assessment of cause to effects relationships, and the necessity of multi-field experts in group root cause analysis, from radiation effects, to satellite fault determination, to identification and reconfiguration strategy. A focus on some practical cases of anomaly analyses will be made.
IL-15 suppresses colitis-associated colon carcinogenesis by inducing antitumor immunity

IL-15 regulates the development, survival, and proliferation of multiple innate and adaptive immune cells and plays a dual role, inducing both tumor cell growth and antitumor immunity. However, the role of IL-15 in inflammation-induced cancer remains unclear. To explore this, we have compared the colon carcinoma burden of Il15−/− and Il15rα−/− mice with wild type (WT) mice after induction of colitis-associated colon carcinogenesis utilizing the AOM/DSS model. Compared to WT mice, Il15−/− but not Il15rα−/− mice showed reduced survival, along with higher tumor incidence, colon weight, and tumor size. This suggests that low affinity IL-15 signaling via the shared IL-2Rβ/γc decreases the risk for developing colitis-associated cancer. CD11c-Il15 mice, in which IL-15 expression is reconstituted in Il15−/− mice under the control of the CD11c-promoter, showed that selective reconstitution of IL-15 in antigen-presenting cells restored the CD8+ T and NK cell compartments, serum levels of IFNγ, G-CSF, IL-10, and CXCL1 and reduced tumor burden. After demonstrating IL-15 expression in human colorectal cancer (CRC) cells in situ, we investigated the role of this cytokine in the modulation of key colonic oncogenic pathways in the tumor. While these pathways were found to be unaltered in the absence of IL-15, tumor transcriptome analysis showed that the loss of IL-15 upregulates key inflammatory mediators associated with colon cancer progression, such as IL-1β, IL-22, IL-23, Cxcl5, and Spp1. These findings provide evidence that IL-15 suppresses colitis-associated colon carcinogenesis through regulation of antitumor cytotoxicity, and modulation of the inflammatory tumor micromilieu.
Nurses' Awareness about Principles of Airway Suctioning.

INTRODUCTION Airway suctioning is one of the most common interventions for patients with respiratory disorders and having adequate knowledge in implementing this technique is quite crucial for nurses. AIM To assess the nurses' awareness about principles of airway suctioning. MATERIALS AND METHODS This study was a cross-sectional study done on 85 staff nurses' in Vali-Asr hospital. Sampling was based on census data collection. A researcher made questionnaire was used for assessment of nurses' awareness about the principles of airway suctioning. The validity and reliability (Cronbach's alpha=0.78) of the questionnaire have been examined and proved. The level of nurses' awareness about airway suctioning was measured based on the questionnaire that includes demographic and specialty information in the form of eight questions of 3-selection-item. The maximum and minimum score of knowledge ranged between 0-8. The data obtained was statistically analysed using SPSS software Version 16.0 and was analysed using descriptive statistics and Pearson correlation coefficient. RESULTS The results reveal that the nurses' awareness about principles of airway suctioning was average. There was a significant association between knowledge and gender of nurses (p<0.05) which reveals that the awareness of women about the principles of airway suctioning was more than men. CONCLUSION The results indicate that nurses' awareness of airway suctioning technique was in an average state. Considering the importance of this technique and the effects this technique has on the patients' haemodynamic status, we recommend in-service courses.
Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021.

BACKGROUND Few studies have explored the role of the National Health Expenditure and macroeconomics on the utilization of total joint replacement. The economic downturn has raised questions about the sustainability of growth for total joint replacement in the future. Previous projections of total joint replacement demand in the United States were based on data up to 2003 using a statistical methodology that neglected macroeconomic factors, such as the National Health Expenditure. METHODS Data from the Nationwide Inpatient Sample (1993 to 2010) were used with United States Census and National Health Expenditure data to quantify historical trends in total joint replacement rates, including the two economic downturns in the 2000s. Primary and revision hip and knee arthroplasty were identified using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. Projections in total joint replacement were estimated using a regression model incorporating the growth in population and rate of arthroplasties from 1993 to 2010 as a function of age, sex, race, and census region using the National Health Expenditure as the independent variable. The regression model was used in conjunction with government projections of National Health Expenditure from 2011 to 2021 to estimate future arthroplasty rates in subpopulations of the United States and to derive national estimates. RESULTS The growth trend for the incidence of joint arthroplasty, for the overall United States population as well as for the United States workforce, was insensitive to economic downturns. From 2009 to 2010, the total number of procedures increased by 6.0% for primary total hip arthroplasty, 6.1% for primary total knee arthroplasty, 10.8% for revision total hip arthroplasty, and 13.5% for revision total knee arthroplasty. The National Health Expenditure model projections for primary hip replacement in 2020 were higher than a previously projected model, whereas the current model estimates for total knee arthroplasty were lower. CONCLUSIONS Economic downturns in the 2000s did not substantially influence the national growth trends for hip and knee arthroplasty in the United States. These latest updated projections provide a basis for surgeons, hospitals, payers, and policy makers to plan for the future demand for total joint replacement surgery.
Chimpanzee dendritic cells with potent immunostimulatory function can be propagated from peripheral blood

We have established dendritic cell (DC) cultures from chimpanzee peripheral blood mononuclear cells (PBMC) by using recombinant human (rh) granulocyte–macrophage colony‐stimulating factor (GM‐CSF) and rh interleukin‐4 (IL‐4) and demonstrate that these cells have all the characteristics of DC as described for other species. We consistently can obtain 1×107 DC per 100 ml of blood, a yield of 5% DC as compared to 0.1 to 0.5% DC reported in fresh human PBMC. The cultured DC have a varied morphology with typical cytoplasmic extensions. Phenotypically, the blood‐derived DC lack expression of most lineage antigens, but express CD83, an antigen specifically expressed on human blood DC. Chimpanzee DC express very high levels of major histocompatability complex class II antigens, adhesion and costimulatory molecules. Consistent with this phenotype of a powerful antigen‐presenting cell, chimpanzee DC generate allogeneic mixed leukocyte responses 15 to 20 times more potent than that elicited by macrophages, Epstein–Barr virus‐transformed lymphoblasts and fresh PBMC. In addition, chimpanzee DC very efficiently present tetanus toxoid to PBMC‐derived CD4+ T cells as compared to macrophages and PBMC. The DC generated by culturing chimpanzee PBMC with rhGM‐CSF and rhIL‐4 thus closely resemble human blood‐derived DC propagated in the same manner. This technology provides a powerful animal model with which to apply DC to clinical studies with relevance to human disease. In particular, chimpanzee DC can be tested as immunotherapeutic agents for cancer, and be studied in relation to the pathogenesis of human immunodeficiency virus (HIV) infection.
Novel Role of Y1 Receptors in the Coordinated Regulation of Bone and Energy Homeostasis*

The importance of neuropeptide Y (NPY) and Y2 receptors in the regulation of bone and energy homeostasis has recently been demonstrated. However, the contributions of the other Y receptors are less clear. Here we show that Y1 receptors are expressed on osteoblastic cells. Moreover, bone and adipose tissue mass are elevated in Y1-/- mice with a generalized increase in bone formation on cortical and cancellous surfaces. Importantly, the inhibitory effects of NPY on bone marrow stromal cells in vitro are absent in cells derived from Y1-/- mice, indicating a direct action of NPY on bone cells via this Y receptor. Interestingly, in contrast to Y2 receptor or germ line Y1 receptor deletion, conditional deletion of hypothalamic Y1 receptors in adult mice did not alter bone homeostasis, food intake, or adiposity. Furthermore, deletion of both Y1 and Y2 receptors did not produce additive effects in bone or adiposity. Thus Y1 receptor pathways act powerfully to inhibit bone production and adiposity by nonhypothalamic pathways, with potentially direct effects on bone tissue through a single pathway with Y2 receptors.
Runx2 isoform I controls a panel of proinvasive genes driving aggressiveness of papillary thyroid carcinomas.

CONTEXT The ability of tumor cells to invade adjacent tissues is governed by a complicated network of molecular signals, most of which have not yet been identified. In a recent work, we reported that the transcriptional regulator Id1 contributes to thyroid cancer progression by powering the invasion capacity of tumor cells. OBJECTIVE The intent of this work was to further investigate the biology of invasive thyroid tumors, through the analysis of the molecular interactions existing between Id1 and some of its target genes and through the characterization of the function of these factors in the progression of thyroid tumors. RESULTS We showed that Id1 controls the expression of the Runx2 isoform I and that this transcription factor plays a central role in mediating the Id1 proinvasive function in thyroid tumor cells. We demonstrated that Runx2 regulates proliferation, migration, and invasiveness by activating a panel of genes involved in matrix degradation and cellular invasion, which we previously identified as Id1 target genes in thyroid tumor cells. Finally, we show that Runx2 is strongly expressed in metastatic human thyroid tumors both at the primary site and in metastases. CONCLUSION Overall, our experiments demonstrate the existence of a previously unknown molecular axis that controls thyroid tumor invasiveness by altering the ability of tumor cells to interact with the surrounding microenvironment. These factors could prove to be valuable markers that permit early diagnosis of aggressive thyroid tumors.
Relation of left ventricular end-diastolic pressure and N-terminal pro-brain natriuretic peptide level with left atrial deformation parameters.

AIMS It has been shown that speckle-tracking echocardiography (STE) is a feasible and reproducible method to assess left atrial (LA) function. The relationship between left ventricular end-diastolic pressure (LVEDP) and brain natriuretic peptide (BNP) with LA deformation parameters has not been studied comprehensively. Therefore, we propose to investigate the effects of invasively obtained LVEDP and BNP level on LA deformation parameters assessed by STE and to show the relationship between them. METHODS AND RESULTS The study population consisted of 62 patients who underwent cardiac catheterization. LVEDP was obtained with a fluid-filled catheter. All patients underwent standard two-dimensional echocardiography. In STE analysis for LA, the peak LA strain at the end of the ventricular systole (LAs-strain) and the LA strain with LA contraction (LAa-strain) were obtained. N-terminal pro-BNP (NT-pro-BNP) levels were measured. The univariate correlation analysis demonstrated that the LAs-strain and LAa-strain had good inverse correlation with LVEDP, and the LAs-strain and LAa-strain only had a moderate correlation with NT-pro-BNP. The area under the receiver-operating characteristic curve of the LAs-strain was 0.96 (0.86-0.99, P < 0.001), and for the LAa-strain, the area was 0.88 (0.74-0.96, P < 0.001) to predict increased LVEDP. A multiple regression analysis demonstrated that the LAs-strain, LAV(max), and LV ejection fraction were independent predictors of increased LVEDP among the covariates examined; however, the LAa-strain and LV mass index were not independent predictors. A borderline statistical significance was found for NT-pro-BNP. CONCLUSION LAs-strain more closely related with LVEDP and NT-pro-BNP level than LAa-strain. LAs-strain thus might be used clinically to predict increased LVEDP.
Ocular biometry in preterm infants: implications for estimation of retinal illuminance.

PURPOSE Retinal illuminance varies with stimulus luminance, pupil size, eye size, and transmissivity of the ocular media. There are few published data to inform estimates of retinal illuminance in early infancy, and no concurrent studies of pupil size and ocular length have been described. The goals were to document simultaneously the measured ocular parameters in growing preterm infants and to estimate the potential errors associated with using either stimulus luminance or troland value as a proxy for retinal illuminance in this population. METHODS Ocular biometry including diameters of the eye, vitreous chamber depth (VCD) and dilated pupil diameter was performed on 111 occasions in 33 preterm infants aged between 30 and 55 weeks' postmenstrual age. RESULTS Eye size increased rapidly between 30 and 55 postmenstrual weeks and was comparable to that of term-born infants. The ratio of dilated pupil area to VCD(2) was highly variable. Retinal illuminance of the infant eye compared with adult eyes was underestimated by both stimulus luminance and troland values. CONCLUSIONS Stimulus luminance and troland values cannot be used to infer retinal illuminance when comparing eyes of markedly differing sizes or transmissivities. Error in estimating retinal illuminance in prematurely born infants is inevitable because of uncertainty regarding media transmissivity, but this discrepancy can be minimized by using directly measured pupil diameter and data presented herein for eye size in this population.
Adenosine kinase as a target for therapeutic antisense strategies in epilepsy

Purpose: Given the high incidence of refractory epilepsy, novel therapeutic approaches and concepts are urgently needed. To date, viral‐mediated delivery and endogenous expression of antisense sequences as a strategy to prevent seizures have received little attention in epilepsy therapy development efforts. Here we validate adenosine kinase (ADK), the astrocyte‐based key negative regulator of the brain’s endogenous anticonvulsant adenosine, as a potential therapeutic target for antisense‐mediated seizure suppression.
Loss of Outer Membrane Proteins without Inhibition of Lipid Export in an Escherichia coli YaeT Mutant*

Escherichia coli yaeT encodes an essential, conserved outer membrane (OM) protein that is an ortholog of Neisseria meningitidis Omp85. Conflicting data with N. meningitidis indicate that Omp85 functions either in assembly of OM proteins or in export of OM lipids. The role of YaeT in E. coli was investigated with a new temperature-sensitive mutant harboring nine amino acid substitutions. The mutant stops growing after 60 min at 44 °C. After 30 min at 44 °C, incorporation of [35S]methionine into newly synthesized OM proteins is selectively inhibited. Synthesis and export of OM phospholipids and lipopolysaccharide are not impaired. OM protein levels are low, even at 30 °C, and the buoyant density of the OM is correspondingly lower. By Western blotting, we show that levels of the major OM protein OmpA are lower in the mutant in whole cells, membranes, and the growth medium. SecA functions as a multicopy suppressor of the temperature-sensitive phenotype and partially restores OM proteins. Our data are consistent with a critical role for YaeT in OM protein assembly in E. coli.
Low bit rate image compression core for onboard space applications

This paper presents low-cost, purpose optimized discrete wavelet transform-based image compressors for future spacecrafts and microsatellites. The hardware solution proposed here exploits a modified set partitioning in hierarchical trees algorithm and ensures that appropriate reconstructed image qualities can be achieved also for compression ratios over 100:1. Several implementations are presented varying the parallelism level and the tile size. Obtained results demonstrate that, using a parallel implementation operating on a 64 /spl times/ 64 size tile, a maximum data rate of about 18 Mpixels/s can be sustained. In this case, only 4500 slices and 24 BlockRAMs of a XILINX Virtex II device are required.