Miracle-dz/UniFAR-FTUs huggingface dataset:
Autonomic Nervous System Activity as Risk Predictor in the Medical Emergency Department: A Prospective Cohort Study

Objectives: To evaluate heart rate deceleration capacity, an electrocardiogram-based marker of autonomic nervous system activity, as risk predictor in a medical emergency department and to test its incremental predictive value to the modified early warning score. Design: Prospective cohort study. Setting: Medical emergency department of a large university hospital. Patients: Five thousand seven hundred thirty consecutive patients of either sex in sinus rhythm, who were admitted to the medical emergency department of the University of Tübingen, Germany, between November 2010 and March 2012. Interventions: None. Measurements and Main Results: Deceleration capacity of heart rate was calculated within the first minutes after emergency department admission. The modified early warning score was assessed from respiratory rate, heart rate, systolic blood pressure, body temperature, and level of consciousness as previously described. Primary endpoint was intrahospital mortality; secondary endpoints included transfer to the ICU as well as 30-day and 180-day mortality. One hundred forty-two patients (2.5%) reached the primary endpoint. Deceleration capacity was highly significantly lower in nonsurvivors than survivors (2.9 ± 2.1 ms vs 5.6 ± 2.9 ms; p < 0.001) and yielded an area under the receiver-operator characteristic curve of 0.780 (95% CI, 0.745–0.813). The modified early warning score model yielded an area under the receiver-operator characteristic curve of 0.706 (0.667–0.750). Implementing deceleration capacity into the modified early warning score model led to a highly significant increase of the area under the receiver-operator characteristic curve to 0.804 (0.770–0.835; p < 0.001 for difference). Deceleration capacity was also a highly significant predictor of 30-day and 180-day mortality as well as transfer to the ICU. Conclusions: Deceleration capacity is a strong and independent predictor of short-term mortality among patients admitted to a medical emergency department.
Contralateral motor rootlets and ipsilateral nerve transfers in brachial plexus reconstruction.

OBJECT The goal of this study was to evaluate outcomes in patients with brachial plexus avulsion injuries who underwent contralateral motor rootlet and ipsilateral nerve transfers to reconstruct shoulder abduction/external rotation and elbow flexion. METHODS Within 6 months after the injury, 24 patients with a mean age of 21 years underwent surgery in which the contralateral C-7 motor rootlet was transferred to the suprascapular nerve by using sural nerve grafts. The biceps motor branch or the musculocutaneous nerve was repaired either by an ulnar nerve fascicular transfer or by transfer of the 11th cranial nerve or the phrenic nerve. The mean recovery in abduction was 90 degrees and 92 degrees in external rotation. In cases of total palsy, only two patients recovered external rotation and in those cases mean external rotation was 70 degrees. Elbow flexion was achieved in all cases. In cases of ulnar nerve transfer, the muscle scores were M5 in one patient, M4 in six patients, and M3+ in five patients. Elbow flexion repair involving the use of the 11th cranial nerve resulted in a score of M3+ in five patients and M4 in two patients. After surgery involving the phrenic nerve, two patients received a score of M3 + and two a score of M4. Results were clearly better in patients with partial lesions and in those who were shorter than 170 cm (p < 0.01). The length of the graft used in motor rootlet transfers affected only the recovery of external rotation. There was no permanent injury at the donor sites. CONCLUSIONS Motor rootlet transfer represents a reliable and potent neurotizer that allows the reconstruction of abduction and external rotation in partial injuries.
PG490 (Triptolide) Cooperates with Tumor Necrosis Factor-α to Induce Apoptosis in Tumor Cells*

Progress in the treatment of solid tumors has been slow and sporadic. The efficacy of conventional chemotherapy in solid tumors is limited because tumors frequently have mutations in the p53 gene. Also, chemotherapy only kills rapidly dividing cells. Members of the tumor necrosis factor (TNF) family, however, induce apoptosis regardless of the p53 phenotype. Unfortunately, the cytotoxicity of TNF-α is limited by its activation of NF-κB and activation of NF-κB is proinflammatory. We have identified a compound called PG490, that is composed of purified triptolide, which induces apoptosis in tumor cells and sensitizes tumor cells to TNF-α-induced apoptosis. PG490 potently inhibited TNF-α-induced activation of NF-κB. PG490 also blocked TNF-α-mediated induction of c-IAP2 (hiap-1) and c-IAP1 (hiap-2), members of the inhibitor of apoptosis (IAP) family. Interestingly, PG490 did not block DNA binding of NF-κB, but it blocked transactivation of NF-κB. Our identification of a compound that blocks TNF-α-induced activation of NF-κB may enhance the cytotoxicity of TNF-α on tumors in vivo and limit its proinflammatory effects.
A User-Centric QoS Model for Wireless Home Networks

We propose a model for adaptive QoS management that dynamically adjusts application priorities based on user requirements. Unlike traditional QoS approaches that always give multimedia applications a pre-determined high priority due to their strict latency and loss requirements, the proposed model classifies traffic based on user preferences, thus, ensuring a certain level of quality regardless of the application requirements. Additionally, the model employs usability rules to detect and penalize concurrent use of conflicting applications in order to make fair use of the available bandwidth. The example of possible implementation of the model based on 802.11e standard demonstrates effectiveness of the proposed model with respect to the typical QoS schemes.
17β-Hydroxysteroid Dehydrogenase Type 1, 2, 3, and 4 Expression and Enzyme Activity in Human Anterior Pituitary Adenomas

17Beta-hydroxysteroid dehydrogenase (17betaHSD) isoforms reversibly catalyze the final step in the formation of estradiol (E2) from estrone (E1) and the formation of testosterone from androstenedione. We have investigated 17betaHSD type 1, 2, 3, and 4 gene expression and 17betaHSD estrogenic activity in human anterior pituitary adenomas. 17BetaHSD messenger ribonucleic acid (mRNA) expression was studied by RT-PCR in 42 pituitary tumors and 3 normal pituitaries, 17betaHSD activity was studied in 11 tumors and 17betaHSD type 1 was immunolocalized in vitro in 6 tumors. 17BetaHSD type 1 gene expression was detected in 34 of 42 adenomas in all tumor subtypes; 17betaHSD type 2 mRNA was detected in 18 of 42 adenomas, but not in prolactinomas; 17betaHSD type 3 mRNA was detected in 12 of 42 adenomas, but not in corticotropinomas; 17betaHSD type 4 was expressed in 20 of 42 adenomas by all adenoma subtypes. Reversible 17betaHSD activity was found in 9 of 11 adenomas, and 17betaHSD type 1 immunopositivity was cytoplasmically distributed in all 6 adenomas in vitro. All 4 17betaHSD isoforms are variably expressed in human anterior pituitary adenomas, which also show 17betaHSD enzyme activity, suggesting that 17betaHSD may play an important role in regulating the local cellular levels of estradiol.
[Study on the mechanisms of diarrhea induced by a new anticancer camptothecin derivative, irinotecan hydrochloride (CPT-11), in rats].

We investigated the mechanisms of CPT-11-induced diarrhea. 1) CPT-11 (80 mg/kg, i.v.) induced watery diarrhea within 1 hr after dosing in saline-loaded (10 ml/kg, p.o.) rats. This was partially inhibited by subcutaneous injection of atropine (1 mg/kg) or ondansetron (1 mg/kg) and almost completely inhibited by a combination of atropine and ondansetron or by clonidine (0.3 mg/kg) or morphine (10 mg/kg) alone. 2) CPT-11 at the same dose reduced intestinal fluid absorption, which was blocked by the anti-diarrheal agents mentioned above. Intraluminal injection of CPT-11 (20 mg/2 ml) inhibited fluid absorption and induced fluid secretion. 3) CPT-11, 60 mg/kg, by single intravenous injection induced fewer enzymological and histological changes in the small intestine than 5-FU at 270 mg/kg, while 4 consecutive dosings of CPT-11 induced delayed diarrhea (days 5-7) associated with disruption of intestinal integrity. Co-administration with anti-diarrheal agents, except for ondansetron, protected against watery diarrhea appearing within 1 hr after CPT-11 on days 3 and 4, but worsened delayed diarrhea. These results suggest that single injection of higher doses of CPT-11 causes watery diarrhea at an acute phase at least partly by reducing fluid absorption or increasing secretion, and that while conventional anti-diarrheal agents protect against watery diarrhea, their co-administration in repeated CPT-11 administration has no ameliorative effect on CPT-11-induced delayed diarrhea.
Survival in Very Preterm Infants: An International Comparison of 10 National Neonatal Networks

In this article, we compare the survival of very preterm infants in 10 national neonatal networks, showing marked differences in survival and age at death. OBJECTIVES: To compare survival rates and age at death among very preterm infants in 10 national and regional neonatal networks. METHODS: A cohort study of very preterm infants, born between 24 and 29 weeks’ gestation and weighing <1500 g, admitted to participating neonatal units between 2007 and 2013 in the International Network for Evaluating Outcomes of Neonates. Survival was compared by using standardized ratios (SRs) comparing survival in each network to the survival estimate of the whole population. RESULTS: Network populations differed with respect to rates of cesarean birth, exposure to antenatal steroids and birth in nontertiary hospitals. Network SRs for survival were highest in Japan (SR: 1.10; 99% confidence interval: 1.08–1.13) and lowest in Spain (SR: 0.88; 99% confidence interval: 0.85–0.90). The overall survival differed from 78% to 93% among networks, the difference being highest at 24 weeks’ gestation (range 35%–84%). Survival rates increased and differences between networks diminished with increasing gestational age (GA) (range 92%–98% at 29 weeks’ gestation); yet, relative differences in survival followed a similar pattern at all GAs. The median age at death varied from 4 days to 13 days across networks. CONCLUSIONS: The network ranking of survival rates for very preterm infants remained largely unchanged as GA increased; however, survival rates showed marked variations at lower GAs. The median age at death also varied among networks. These findings warrant further assessment of the representativeness of the study populations, organization of perinatal services, national guidelines, philosophy of care at extreme GAs, and resources used for decision-making.
Comparison of pre- and post-operational multifocal electroretinograms of retinal detachment.

OBJECTIVES To explore the changes of multifocal electroretinograms (mfERG) before and after retinal detachment surgery and to evaluate its clinical significance. METHODS Twenty-three patients (23 eyes) with rhegmatogenous retinal detachment underwent mfERG before and after surgery. The latencies and average response densities of N(1)-wave and P(1)-wave of mfERGs in detached areas, attached areas, fovea and the entire tested area were compared before and after surgery. RESULTS Preoperatively, the average response densities of N(1)-wave and P(1)-wave in the detached area were significantly smaller than those in attached areas (t = 3.68, t = 4.26, P < 0.01), and the latencies of N(1)-wave and P(1)-wave in detached areas were significantly longer than those in attached areas (t = 3.07, t = 3.89, P < 0.01). Postoperatively, the average response densities of N(1)-wave and P(1)-wave in detached areas, fovea and the entire tested area increased, and there were significant differences pre- and postoperatively (P < 0.05). However, the latencies of N(1)-wave and P(1)-wave before and after surgery showed no significant differences (P > 0.05). CONCLUSIONS The mfERG is a useful tool to evaluate the recovery of posterior retinal function after retinal detachment surgery. The response density is a more sensitive index than latency to evaluate retinal function of retinal detachment.
Efficacy of Antibodies against the N-Terminal of Pseudomonas aeruginosa Flagellin for Treating Infections in a Murine Burn Wound Model

Background: In an era of increasing drug resistance, immunotherapy is a desirable treatment against Pseudomonas aeruginosa infections. The flagellum, which is an important pseudomonal virulence factor, was targeted for immunotherapy. The aim of the study was to evaluate the efficacy of polyclonal immunotherapy targeted against the N-terminal of flagellin (anti-N′-fla-b) for treating severe P. aeruginosa infection in a murine burn wound model. Methods: Groups of 12 mice were infected (subeschar) with P. aeruginosa strain PA01, and were treated either with systemic anti-N′-fla-b immunoglobulin G (IgG), nonspecific IgG, or imipenem. The control groups included mice with burn alone, mice with untreated infected burn, and mice without burn infected with P. aeruginosa. Three separate regimens were examined: prophylaxis (preinfection), therapeutic (postinfection), and combined. The efficacy of anti-N′-fla-b was evaluated by monitoring the mortality and morbidity (relative weight loss) during a period of 2 weeks. Results: Anti-N′-fla-b IgG immunotherapy significantly decreased the mortality rate of infected burned mice followed by severe P. aeruginosa infection. The mortality rate in the anti-N′-fla-b–treated groups ranged from 0 to 17 percent compared with 58 to 83 percent in nontreated groups infected with 2 to 5 × 106 colony-forming units of P. aeruginosa (p < 0.05). The mortality rate in the anti-N′-fla-b–treated groups was similar to that of groups treated with imipenem. The three tested regimens yielded similar results. Morbidity paralleled survival results. Histopathologic examination revealed an earlier reepithelialization of the infected wound in the anti-N′-fla-b–treated mice compared with untreated mice. Conclusion: Immunotherapy with anti-N′-fla-b IgG, given either as prophylaxis or therapeutically, effectively reduced mortality and morbidity and improved wound healing in a severely P. aeruginosa–infected murine burn model.
Nitrogen-Doped Unusually Superwetting, Thermally Insulating and Elastic Graphene Aerogel for Efficient Solar Steam Generation.

By removing the oxygen-containing functional groups, thermal treatment in inert gas has been widely reported to improve the hydrophobicity of carbon materials. However, this work reports a contrary phenomenon for nitrogen doped graphene aerogel (NGA). As the temperature of thermal treatment increases from 200 ºC to 1000 ºC, NGA becomes more and more hydrophilic and the superwetting property maintains for weeks in air. To uncover this unusual phenomenon, the effect of nitrogen-doping is studied through both experiment and MD simulation. The effect of air exposure and air humidity are further investigated in detail to illustrate the whole physical picture clearly. The superwetting behavior is attributed to the preferential adsorption of water molecules to the nitrogen doped sites, which significantly inhibits airborne hydrocarbon adsorption. In combination with the excellent properties including mechanical elasticity, high light absorption, and good thermal insulation, an efficient photothermal and solar steam generation performance is demonstrated by using NGA-600 as the photothermal material, presenting a high energy conversion efficiency of 86.2% and good recycling stability.
The effect of ruminal escape protein and ambient temperature on the efficiency of utilization of metabolizable energy by lambs.

Forty-eight crossbred lambs (22.5 +/- 2.6 kg average BW) of equal numbers from both sexes were used to observe the effect of protein supplement (none, canola meal, or fish meal) and temperature (21 +/- 1.8 degrees C or 4.7 +/- 1.7 degrees C) on growth and energetic efficiency in a 2 x 3 x 2 factorial experiment. Twelve lambs were slaughtered at the onset of the trial to determine initial body composition. The remaining 36 were fed diets consisting of 50% concentrate and 50% straw at DMI of 77 and 83 g/kg.75 daily in the warm and cold, respectively, for an 85-d period. Daily gains of the control lambs and of those supplemented with canola and fish meal were 80, 94, and 101 g/d, respectively; however, no differences in efficiency of live weight gain could be detected. Apparent digestibilities of DM, GE, OM, and fiber were decreased (P < .05) in response to the cold. Methane production was increased (P < .01) in the cold. Metabolizable energy intake was not increased by exposure to cold, even though DMI was higher (P < .1) in the cold. Cold-treated lambs retained less (P < .01) total energy as well as less (P = .02) fat energy as determined by comparative slaughter. Supplementation with protein increased (P < .05) energy retained as protein; however, it did not affect total energy retained or energetic efficiency. Energy retention estimated from the calorimetry-balance technique was 30 to 80% greater than that estimated from the comparative slaughter technique. It was concluded that methane production in lambs with short fleece was increased when the temperature was reduced from 21 to 5 degrees C and that energetic efficiency was not affected by the concentration or type of protein in the diet.
Cultural measures associated with sexual risk behaviors among Latino youth in Southern California: a longitudinal study.

CONTEXT Cultural variables have been associated with sexual risk behaviors among Latino youth, but findings across studies are inconsistent. METHODS A longitudinal study of acculturation patterns followed Latino youth in Southern California from 2005 to 2012. Data from 995 participants were used in logistic and ordered regression analyses to test whether cultural variables measured in high school were associated with sexual risk behaviors in emerging adulthood, and whether gender moderated these associations. RESULTS The cultural value of respect for parents was negatively associated with participants' odds of reporting an earlier age at sexual debut (odds ratio, 0.8) and condom nonuse at most recent sexual intercourse (0.8). A measure of acculturation reflecting U.S. cultural practices was positively associated with the likelihood of being sexually experienced (1.2), having concurrent sexual partners (1.5) and, among males only, having a greater number of sexual partners (1.3). Second- and later-generation immigrant youth had lower odds of not using a condom at most recent sexual intercourse than first-generation youth (0.6 and 0.5, respectively). Strength of endorsement of Latino cultural practices was negatively associated with females' lifetime number of partners (0.8), but positively associated with males' (1.4). CONCLUSIONS The cultural measures associated with Latino youths' sexual behaviors differed across outcomes and by gender. Further understanding of these associations and their underlying mechanisms may help inform the development of culturally sensitive sexual health interventions.
Pharmacologic studies of norepinephrine, acetylcholine and related compounds on neurons in Deiters' nucleus and the cerebellum.

Using multibarreled electrodes, the effects of electrophoretically applied norepinephrine (NE) and acetylcholine (ACh) were studied on the lateral vestibular nucleus (NVL) neurons in cats. In contrast to most neurons in other parts of the mammalian brain, these neurons responded to NE with excitation so far as they were sensitive to the substance. This excitation was not blocked by N-(2-chloroethyl)-dibenzylamine hydrochloride or phentolamine, but was blocked by dichloroisopropylarterenol. Isopropylarterenol, however, had no effect upon NVL neurons. ACh also excited NVL neurons and this excitation was blocked by atropine. In the cerebellum, NE exerted excitatory effects upon neurons in the flocculus while it depressed the firing of cells in the neocerebellum. The possible physiologic roles of NE and ACh excitation are discussed.
Harmful Delayed Effects of Exogenous Isolation Enzymes on Isolated Human Islets: Relevance to Clinical Transplantation

The isolation process exposes human pancreatic islets to exogenous isolation enzymes. Exposure to these enzymes, as a result of intraductal injection in the pancreas or simple contact of islets with enzyme components, causes internalization into the islet cells of enzymes and their by‐products. Human islets exposed to Liberase‐HI exhibit a decreased insulin secretory ability that correlates with the time of exposure. This phenomenon is paralleled by increased expression of adhesion molecules (CD106 and CD62p) and activation of apoptotic pathways (Bax and Bcl‐2) in islet cells. Increased functional impairment is also observed after islet transplantation in diabetic immunodeficient mice. Experimental exposure of islet grafts to exogenous isolation enzymes causes intense inflammation (CD11b positive cells) at the transplant site and it was associated with sickness behavior and eventually death of mouse recipients. The extent of these adverse effects likely deceives the standard qualitative protocols currently in use to assess islet quality in vitro. Reducing the secondary effects of exogenous isolation enzymes on isolated human islets may be crucial to enhance the quality of islets as tissue grafts.
Medical and psychiatric symptoms in women with childhood sexual abuse.

&NA; Although there is increasing awareness of the short‐term psychological and social adaptations to childhood sexual abuse, little is known about the long‐term effects of such abuse, particularly its effect on subsequent medical utilization and the experience and reporting of physical symptoms. We re‐analyzed data from a previous study of 100 women scheduled for diagnostic laparoscopy (50 for chronic pain, 50 for tubal ligation or infertility evaluation) who received structured, physician‐administered psychiatric and sexual abuse interviews. Women were regrouped by severity of childhood sexual abuse, and we compared the groups with respect to lifetime psychiatric diagnoses and medically unexplained symptom patterns. Unadjusted odds ratios showed that risk for lifetime diagnoses of major depression, panic disorder, phobia, somatization disorder and drug abuse, and current diagnoses of major depression and somatoform pain disorder were significantly higher in the severely abused group compared with women with no abuse or less severe abuse. Logistic regression analysis demonstrated that number of somatization symptoms, lifetime panic disorder and drug dependence were predictive of a prior history of severe childhood sexual abuse. Psychiatric disorders and medical symptoms, particularly chronic pelvic pain, are common in women with histories of severe childhood sexual abuse. Clinicians should inquire about childhood sexual and physical abuse experiences in patients with multiple medical and psychiatric symptoms, particularly patients with chronic pelvic pain.