Miracle-dz/UniFAR-FTUs huggingface dataset:
POSTOPERATIVE ANALGESIA WITH TRANSDERMAL DICLOFENAC VERSUS INTRAMUSCULAR DICLOFENAC - A COMPARATIVE STUDY

BACKGROUND: The search for an ideal drug for postoperative analgesia is ongoing. Diclofenac is commonly used drug for this purpose in different routes. AIMS: To compare the efficacy of transdermal diclofenac with intramuscular diclofenac for postoperative analgesia. SETTINGS AND DESIGN: This prospective comparative study was conducted in the department of anaesthesiology in a medical college & general hospital. METHODS AND MATERIALS: The study subjects were 200 patients of both sexes between 18-50 years of age who were scheduled for elective laparoscopic, gynaecological & orthopaedic surgeries on limb. They divided into two groups. Group I received intramuscular injection of diclofenac sodium (75mg) & Group II received transdermal diclofenac diethylamine patch (200mg per 75 sq.cm) postoperatively. The outcome measures were pain intesity, changes in vital parameters, requirment for rescue analgesia & adverse effects. STATISTICAL ANALYSIS: Parametric data were analysed by using student t-test (unpaired). Non parametric data were analysed by using test of association (chi-square test). RESULTS: The mean pain score was significantly high in intramuscular diclofenac group (Group I) in laparoscopic & gynaecological surgeries (P = 0.002). Though the mean pain score was different among two groups in orthopaedic surgeries it was not statistically significant (P = 0.377). There were no significant differences in vital parameters & adverse reactions in between two groups. The requirment of rescue anlgesia was significantly more in intramuscular diclofenac group (Group I). CONCLUSIONS: Transdermal diclofenac is more effective in reducing the intensity of postoperative pain following laparoscopic & gynaecological surgeries but the effect is similar to intramuscular
A cell‐free expression and purification process for rapid production of protein biologics

Cell‐free protein synthesis has emerged as a powerful technology for rapid and efficient protein production. Cell‐free methods are also amenable to automation and such systems have been extensively used for high‐throughput protein production and screening; however, current fluidic systems are not adequate for manufacturing protein biopharmaceuticals. In this work, we report on the initial development of a fluidic process for rapid end‐to‐end production of recombinant protein biologics. This process incorporates a bioreactor module that can be used with eukaryotic or prokaryotic lysates that are programmed for combined transcription/translation of an engineered DNA template encoding for specific protein targets. Purification of the cell‐free expressed product occurs through a series of protein separation modules that are configurable for process‐specific isolation of different proteins. Using this approach, we demonstrate production of two bioactive human protein therapeutics, erythropoietin and granulocyte‐macrophage colony‐stimulating factor, in yeast and bacterial extracts, respectively, each within 24 hours. This process is flexible, scalable and amenable to automation for rapid production at the point‐of‐need of proteins with significant pharmaceutical, medical, or biotechnological value.
Optimal model‐based design of the twin‐column CaptureSMB process improves capacity utilization and productivity in protein A affinity capture

Multi‐column chromatographic processes have recently been developed for protein A affinity chromatography to efficiently capture monoclonal antibodies from cell culture supernatant. In this work, the novel twin‐column CaptureSMB process was compared to a batch capture process with dual loading flow rate to identify performance gains. As a case study, the isolation of a monoclonal antibody with the Amsphere JWT‐203 protein A resin was investigated. Using model based optimization, both processes were optimized and compared over a wide range of operating conditions. A trade‐off between productivity and capacity utilization was found, and the resulting pareto‐curves showed that CaptureSMB dominates batch, except at very low productivity values. With a feed titer of 1.2 mg mL−1, CaptureSMB could reach a productivity of up to 19.5 mg mL−1 h−1 experimentally, while maintaining relatively high capacity utilization of 63.8%. On the other hand, at maximum capacity utilization of 95.5%, a productivity of 10.2 mg mL−1 h−1 could be reached. This corresponds to a performance improvement with respect batch operation of about 25% in capacity utilization and 40% in productivity, for given yield and purity. CaptureSMB therefore offers a greatly increased performance over batch capture.
Lipid production of microalga Chlorella sorokiniana CY1 is improved by light source arrangement, bioreactor operation mode and deep‐sea water supplements

Microalgae‐based biodiesel has been recognized as a sustainable and promising alternative to fossil diesel. High lipid productivity of microalgae is required for economic production of biodiesel from microalgae. This study was undertaken to enhance the growth and oil accumulation of an indigenous microalga Chlorella sorokiniana CY1 by applying engineering strategies using deep‐sea water as the medium. First, the microalga was cultivated using LED as the immersed light source, and the results showed that the immersed LED could effectively enhance the oil/lipid content and final microalgal biomass concentration to 53.8% and 2.5 g/l, respectively. Next, the semi‐batch photobioreactor operation with deep‐sea water was shown to improve lipid content and microalgal growth over those from using batch and continuous cultures under similar operating conditions. The optimal replacement ratio was 50%, resulting in an oil/lipid content and final biomass concentration of 61.5% and 2.8 g/l, respectively. A long‐term semi‐batch culture utilizing 50%‐replaced medium was carried out for four runs. The final biomass concentration and lipid productivity were 2.5 g/L and 112.2 mg/L/d, respectively. The fatty acid composition of the microalgal lipids was predominant by palmitic acid, stearic acid, oleic acid and linoleic acid, and this lipid quality is suitable for biodiesel production. This demonstrates that optimizing light source arrangement, bioreactor operation and deep‐sea water supplements could effectively promote the lipid production of C. sorokiniana CY1 for the applications in microalgae‐based biodiesel industry.
Inactivation of GDP‐fucose transporter gene (Slc35c1) in CHO cells by ZFNs, TALENs and CRISPR‐Cas9 for production of fucose‐free antibodies

Removal of core fucose from N‐glycans attached to human IgG1 significantly enhances its affinity for the receptor FcγRIII and thereby dramatically improves its antibody‐dependent cellular cytotoxicity activity. While previous works have shown that inactivation of fucosyltransferase 8 results in mutants capable of producing fucose‐free antibodies, we report here the use of genome editing techniques, namely ZFNs, TALENs and the CRISPR‐Cas9, to inactivate the GDP‐fucose transporter (SLC35C1) in Chinese hamster ovary (CHO) cells. A FACS approach coupled with a fucose‐specific lectin was developed to rapidly isolate SLC35C1‐deficient cells. Mass spectrometry analysis showed that both EPO‐Fc produced in mutants arising from CHO‐K1 and anti‐Her2 antibody produced in mutants arising from a pre‐existing antibody‐producing CHO‐HER line lacked core fucose. Lack of functional SLC35C1 in these cells does not affect cell growth or antibody productivity. Our data demonstrate that inactivating Slc35c1 gene represents an alternative approach to generate CHO cells for production of fucose‐free antibodies.
Using a Measure of Person-Perception Skills to Identify Outstanding Home Care Workers

This study involved university-community collaboration with an international home care company for the purpose of developing a tool to identify talented caregivers. Tested was the hypothesis that workers' ability to provide care in person-centered ways would be positively associated with their ability to describe others in complex ways—that is, their person-perception skills. Company coordinators functioning as supervisors used an innovative 10-item instrument to screen 554 home health aides for their person centeredness. The most and least person-centered workers were evaluated for their person-perception skills. Person centeredness was positively associated with the complexity of home care workers' descriptions of others.
BRAF Mutations in Papillary Thyroid Carcinoma: Diagnostic Role, Prognostic Implications, and a Guide for Clinical Management

Thyroid carcinoma is the most common endocrine malignancy, and papillary thyroid carcinoma (PTC) comprises almost 80% of all thyroid cancers. The incidence of PTC is increasing, and it may pose both diagnostic and clinical dilemmas, especially in those cases where morphology alone is insufficient to provide a definitive answer. Recent progress in the discovery of molecular alterations in PTC, and availability of molecular techniques enabling their detection in surgical and cytologic samples have resulted in an explosion in the literature, documenting the utility of molecular testing for diagnosis and prognostication of patients with suspected PTC. Out of several genetic mutations known to occur in PTC, BRAF V600E mutation is the most common and appears to be the most helpful in improving the accuracy of cytomorphological analysis of thyroid fine-needle aspiration samples, particularly of samples with indeterminate cytology. Furthermore, BRAF mutation also helps in the prognostication of these tumors, serving as a marker of more aggressive PTC. Herein, we provide an illustration of diagnostic usefulness of BRAF mutation detection in thyroid fine-needle aspiration samples, and discuss the diagnostic and prognostic role of this mutation.
Exogenous ochronosis in melasma: A study from South India

Background: Exogenous ochronosis (EO) can be associated with the prolonged application of hydroquinone (HQ) used for the treatment of melasma. Histopathological examination is required for a definite diagnosis. Dermoscopy can be used to avoid unnecessary biopsies from the face. Aims and Objectives: The aim was to characterize the clinical profile of melasma, to elicit the dermoscopic features of melasma and EO if any, and to histopathologically confirm any suspected cases of EO. Materials and Methods: This was a descriptive study spanning October 2011 to June 2013. With informed consent, a detailed history and examination was carried out along with details of skin lightening creams used if any. This was followed by cutaneous examination and dermoscopic evaluation. In those who had lesions suspicious of EO, consent for 3 mm punch biopsy was obtained and the samples were studied using hematoxylin and eosin stain for banana-shaped ochre colored fibers. Results: In 104 (94 females, 10 males), the mean age at onset and duration of melasma was 36.6 and 4.14 years, respectively. Past history of treatment for melasma was present in 30.8% patients. The most common clinical type of melasma was malar (51.9%). EO was suspected in five patients. In suspected cases, brown-blue globules were noted in addition to melasma features dermoscopically. Telangiectasias were noted in 37.5% of patients. Histopathological confirmation of EO was obtained in only one out of four patients who gave consent for biopsy. Conclusion: The frequency of EO in our study was found to be 0.9%. The incidence of EO in Indian population appears to be quite low, which might be due to under reporting, lack of awareness, irregular and infrequent use of HQ or population based difference in prevalence.
Early Surgical Stabilization of Flail Chest With Locked Plate Fixation

Objectives: To compare the results of surgical stabilization with locked plating to nonoperative care of flail chest injuries. Design: Retrospective case–control study. Setting: Level II trauma center. Patients/Participants: From January 2005 to January 2010, 22 patients with flail chest treated with locked plate fixation were compared with a matched cohort of 28 nonoperatively managed patients at our institution. Intervention: Open reduction internal fixation of rib fractures with 2.7-mm locking reconstruction plates. Main Outcome Measurements: Demographic data, such as age, sex, injury severity score, number of fractures, and lung contusion severity, were recorded. Intensive care unit data concerning length of stay (LOS), tracheostomy, and ventilator days were noted. Operative data, such as time to OR, operative time, and estimated blood loss, were recorded. Hospital data, including total hospital LOS, need for reintubation, and home oxygen requirements, were documented. Results: Average follow-up period of operatively managed patients was 17.84 ± 4.51 months, with a range of 13–22 months. No case of hardware failure, hardware prominence, wound infection, or nonunion was reported. Operatively treated patients had shorter intensive care unit stays (7.59 vs. 9.68 days, P = 0.018), decreased ventilator requirements (4.14 vs. 9.68 days, P = 0.007), shorter hospital LOS (11.9 vs. 19.0 days, P = 0.006), fewer tracheostomies (4.55% vs. 39.29%, P = 0.042), less pneumonia (4.55% vs. 25%, P = 0.047), less need for reintubation (4.55% vs. 17.86%, P = 0.34), and decreased home oxygen requirements (4.55% vs. 17.86%, P = 0.034). Conclusions: This study demonstrates the potential benefits of surgical stabilization of flail chest with locked plate fixation. When compared with case-matched controls, operatively managed patients demonstrated improved clinical outcomes. Locked plate fixation seems to be safe as no complications associated with hardware failure, plate prominence, wound infection, or nonunion were noted.
Design and development of a mobile exercise application for home care aides and older adult medicaid home and community-based clients

ABSTRACT We describe a community-engaged approach with Medicaid home and community-based services (HCBS), home care aide (HCA), client, and physical therapist stakeholders to develop a mobile application (app) exercise intervention through focus groups and interviews. Participants desired a short exercise program with modification capabilities, goal setting, and mechanisms to track progress. Concerns regarding participation were training needs and feasibility within usual care services. Technological preferences were for simple, easy-to-use, and engaging content. The app was piloted with HCA-client dyads (n = 5) to refine the intervention and evaluate content. Engaging stakeholders in intervention development provides valuable user-feedback on both desired exercise program contents and mobile technology preferences for HCBS recipients.
Unique Challenges of Transgender Aging: Implications From the Literature

Transgender elders are both underserved and understudied. Neither the etiology nor prevalence of transgender is well understood. Because sex, gender, and sexuality are at the very core of individual identity, it is difficult to dislodge one's ideas and feelings about them. Unlike biological sex and sexual orientation, gender has several aspects: gender identity, gender expression, and gender classification. A discussion of the terminology of transgender is presented, and the issues facing aging transgender individuals are identified. Although the challenges of adequate healthcare, social support, and legal obstacles are faced by many elderly individuals, the way they are presented and managed are unique to this often invisible group.
Biomechanical Testing of Pin Configurations in Supracondylar Humeral Fractures: The Effect of Medial Column Comminution

Objectives: We measured biomechanical stability in simulated supracondylar humeral fractures fixed with each of 6 pin configurations, 2 with associated medial comminution, and developed a technique for reproducible pin placement and divergence. Methods: A transverse supracondylar osteotomy was performed on 36 biomechanical humerus models. Of these, 24 (4 groups of 6 specimens each) were fixed with pins in 1 of 4 lateral entry configurations. The remaining 12 (2 groups of 6 specimens each) had a 30-degree medial wedge removed from the distal humerus and were fixed with 1 of 2 configurations. Half of each group was tested under axial rotation and the other half under varus bending. The distal humerus was divided into 4 equal regions from lateral to medial (1–4). Lateral entry pins were inserted through regions 1–3, whereas the medial pin was inserted through region 4. Results: Without comminution, 3 widely spaced, divergent lateral entry pins resulted in higher torsional stiffness (0.36 Nm/degree) than 2 pins in adjacent regions (P < 0.055), but similar to 2 pins in nonadjacent regions (P = 0.57). Three lateral entry pins had higher bending stiffness (79.6 N/mm) than 2 pins, which ranged from 46.7 N/mm (P < 0.01) to 62.5 N/mm (P = 0.21). With comminution, adding a third medial entry pin increased torsional stiffness (0.13–0.24 Nm/degree, P < 0.01) and increased bending stiffness (38.7–44.7 N/mm, P = 0.10). Conclusions: For fractures without medial column comminution, fixation using 3 lateral entry pins may provide the greatest combination of torsional and bending stiffness. With medial comminution, adding a third medial pin increased torsional stiffness (P < 0.01) and bending stiffness (P = 0.10).
Reported Coping Strategies and Depressive Symptoms Among African American and White Residents of Congregate Housing

Chronic health conditions and living in congregate housing, both stressors and losses, are risk factors for late life depressive symptoms. We examined self-reported coping strategies and their associations with depressive symptoms among residents of congregate living facilities. Despite demographic differences between the African American and the White participants, reported coping for the 2 groups was similar, though more African Americans reported spiritual coping. Participants who reported coping through either positive attitude and adaptations or activity participation had fewer depressive symptoms, after controlling for demographics, health, functioning, and other types of coping.
Can Cultural Values Help Explain the Positive Aspects of Caregiving Among Chinese American Caregivers?

This study used an adaptation of the caregivers' stress model to examine the positive aspects of caregiving with 113 Chinese American family caregivers who provided care to their elderly relatives. The hierarchical multiple regression analysis indicated that combination of caregiver background characteristics, stressors, and cultural values had direct effects on positive aspects of caregiving. Unlike previous studies in which cultural values were not measured, this study found that cultural values helped explain positive aspects of caregiving. Specifically, cultural values, caregiver's health, and caregiver's age predicted positive aspects of caregiving. Service implications are discussed based upon the findings.
Paradise Lost: Older Cuban American Exiles’ Ambiguous Loss of Leaving the Homeland

To explore the experience of leaving Cuba, 2 Cuban American émigrés interviewed 20 Cuban exiles aged 65 or older, who left Cuba between 1959 and 1971. The interviews were conducted in New York and New Jersey using a phenomenological approach (Moutsakas, 1994). Themes included feeling betrayed by the Revolution, the inevitability of leaving, the expectation of a temporary refuge, and longing and idealizing the past. The psychological presence that participants expressed, along with an endless sense of loss, resonates with ambiguous loss theory (Boss, 2006)—themes that have yet to be explored in the literature and that have research and practice implications.
Mental health literacy and eating disorders: What do women with bulimic eating disorders think and know about bulimia nervosa and its treatment?

Background and Aims: Attitudes and beliefs concerning the eating disorder bulimia nervosa (BN) were examined in a community sample of women (n = 158) with BN-type eating disorders. Method: A vignette was presented describing a fictional person meeting diagnostic criteria for BN. Participants gave their opinions on a range of issues concerning the nature and treatment of the problem described. Results: Most participants believed that BN would be difficult to treat and that relapse would be likely, were initial treatment successful. Primary care practitioners, psychologists, counsellors and close friends were perceived as helpful in the treatment of BN by the vast majority of participants. Lifestyle changes, including taking vitamins and minerals, were also highly regarded, whereas participants were ambivalent about the benefits of psychiatrists and antipathetic towards the use of prescription medication. Most participants believed that BN is common among women in the community and many had occasionally or often thought that it “might not be too bad” to have such a problem. Low self-esteem was considered the most likely cause of BN. Conclusions: Beliefs and attitudes likely to be conducive to low or inappropriate treatment seeking exist among women with BN-type eating disorders in the community. Poor “mental health literacy” therefore needs to be addressed in early intervention programs for these disorders. Health professionals need to be aware of patients' belief systems and their potential effects on treatment-seeking and adherence to treatment.
War Leaves an Enduring Legacy in Combatants’ Lives

The memory of combat experience endures in World War II veterans. As veterans age, traumatic memory that previously may have been suppressed in the busyness of family and everyday life can re-emerge. Combat stress may affect not only the veterans, but also those people closely associated with them. Interviews were conducted with World War II veteran aircrew, wives, children, grandchildren, siblings, and friends to examine the impact of combat experience on the veterans and the family across the life course from the perspectives of the various participants. The combat experience significantly affected the life course of most.
Active Muscle Trigger Points as Sign of Sensitization in Chronic Primary Headaches

Objective: To describe the differences in the presence of trigger points [TrPs] in neck and shoulder muscles that elicit referred pain to the head between nummular headache [NH], chronic tension-type headache [CTTH], and healthy controls [HNC]. Methods: Ten NH [i.e., head pain exclusively felt in a small rounded or elliptical area of the head, not attributed to another disorder], 10 CTTH, and 10 HNC participated. The upper trapezius, sternocleidomastoid, and temporalis muscles were bilaterally examined by an assessor blinded to the subjects' condition for the presence of muscle TrPs as follows: hyperirritable spot within a taut band, local twitch response, and referred pain with palpation. TrPs were considered active if the referred pain reproduced the pattern and features of spontaneous headache attacks. Results: The number of TrPs was significantly higher [P < 0.001] in the CTTH group [mean: 4.4, standard deviation [SD]: 1.7] as compared to both NH [mean: 0.9, SD: 0.7] and HNC groups [mean: 1.2, SD: 0.6], but not significantly different between NH and HNC [P = 0.8]. Active TrPs were only found in the CTTH group [P < 0001]. Latent TrPs were more conspicuous in both temporalis muscles within the CTTH group [P < 0.05], but not significantly different for the remaining muscles [P = 0.6]. Differences in the distribution of TrPs were significantly different between CTTH and both NH and HNC groups [P < 0.01], but not between the two last groups [P = 0.7]. Conclusions: The absence of active TrPs could be clinically useful to distinguish NH, a peripheral primary headache, from CTTH, a central primary headache.