Miracle-dz/UniFAR-FTUs huggingface dataset:
Methotrexate and misoprostol teratogenicity: Further expansion of the clinical manifestations

We describe a boy who was exposed to misoprostol and methotrexate in the first trimester of gestation as a result of a failed medical abortion. He presented with severe growth retardation, skull defects, proptotic eyes, cleft palate, and severe micrognathia. There were bilateral defects of the upper and lower extremities, missing and hypoplastic ribs, and undescended testicles. He had clinical features of pulmonary hypoplasia with severe persistent pulmonary hypertension and remained ventilator‐dependent until he expired. An autopsy revealed brain anomalies consistent with arrhinencephaly. Methotrexate is frequently used in conjunction with misoprostol to induce medical abortion, an off‐label use as abortifacient. Both of these medications are well‐established teratogens and have an X classification during pregnancy. Data from eight patients who were exposed to both medications in the first trimester indicate a significant teratogenic risk to the developing fetus. Reported anomalies include growth retardation, absence or hypoplasia of the frontal bones, craniosynostosis, large fontanelle, ocular hypertelorism, short palpebral fissures, wide nasal bridge, malformed and low‐set ears, and micrognathia. Skeletal anomalies are frequent consisting of syndactyly, mesomelic shortening of the forearms, missing ribs, dislocated hips, and talipes equinovarus. The findings in our case are consistent with the pattern of abnormalities that have been reported in the literature. In addition, our patient had severe pulmonary hypoplasia and arrhinencephaly, anomalies that have not been described previously. This case adds to the documentation of the teratogenic effects of methotrexate and misoprostol on the developing fetus. © 2011 Wiley‐Liss, Inc.
Factors influencing human immunodeficiency virus type 1 transmission by blood transfusion. Transfusion Safety Study Group.

One hundred thirty-two recipients of blood components that retrospectively tested positive for antibody to human immunodeficiency virus type 1 (anti-HIV-1) were identified. Fourteen (11%) remained seronegative throughout follow-up. Donor and recipient characteristics that could have influenced transmission were examined. Attributes did not differ for infected and uninfected recipients. Peripheral blood mononuclear cells (PBMC) from uninfected recipients were HIV-1-negative by DNA amplification and culture but were susceptible to in vitro infection. Transmitting and nontransmitting donors at donation differed only for HIV-1 RNA positivity. By immunocapture reverse transcriptase-polymerase chain reaction, 6 of 11 transmitters and 0 of 11 nontransmitters tested RNA-positive (P = .02). A more sensitive quantitative RNA assay detected RNA in all donation sera, but median levels were higher in transmitting than nontransmitting sera (P = .01). Median CD4 cell counts were lower for transmitting than nontransmitting donors at enrollment (P = .02). Level of viremia is an important determinant of HIV infection by blood transfusion.
HPLC does not differentiate Mycobacterium paratuberculosis from Mycobacterium avium

HPLC, which is gaining its place as identification tool in mycobacteriology laboratories, has been proposed to distinguish Mycobacterium paratuberculosis from Mycobacterium avium. We had reported no significant difference between M. avium and M. paratuberculosis reference strain ATCC 19698. Because of the advantages offered by such a method, we enlarged our observations to include more isolates of M. paratuberculosis. Within the double cluster of peaks obtained by both M. avium and M. paratuberculosis, we could not find a consistent difference typical of M. paratuberculosis. Therefore, the present study confirmed that M. avium and M. paratuberculosis could not be distinguished by HPLC, raising doubts of a straightforward use of HPLC to identify M. paratuberculosis. # 1999 Elsevier Science B.V. All rights reserved.
Noise and cooling in electronics packages

The noise produced by cooling air passing through electronics packages arises from two sources. One source is the noise of the air-moving fan of either an axial or centrifugal type. This noise may have both tonal and random components and is strongly dependent on the way that the fan is placed in the unit and on how close its operation is to the design operating point. Often, this is the dominant noise source. The other source produces random noise due to the turbulent flow of air through the unit. Because the turbulent airflow is also responsible for heat transfer between the components and the air stream, we can regard this part of the noise as the irreducible noise due to cooling. If fan noise were eliminated, this part of the noise must remain. There is a relation, therefore, between the irreducible noise and the cooling of the unit. But the fan noise must also be considered. The relation between total airflow related noise and cooling requirements is developed in this paper for the irreducible noise.
Placebo-controlled evaluation of Ritalin side effects.

OBJECTIVE To address the frequency of side effects of Ritalin therapy in children with attention deficit hyperactivity disorder (ADHD) using the Barkeley Side Effects Questionnaire (BSEQ) in a clinical setting. DESIGN Randomized double-blind placebo-controlled cross-over trial. SETTING A large rural tertiary care clinic. PATIENTS 234 consecutive children aged 5 through 15 years who met the Diagnostic and Statistical Manual of Mental Disorders (3rd ed, revised) criteria for ADHD were enrolled. Of these children, 206 had sufficient side effects data for analysis. INTERVENTIONS 0.3 mg/kg per dose and 0.5 mg/kg per dose Ritalin compared to placebo in separate 2-week trials. Each treatment was given three times a day for 7 consecutive days. MEASUREMENTS AND MAIN RESULTS Parents, blinded to the treatment assignment, assessed side effects via the BSEQ at baseline and at the end of each of the 4 treatment weeks. Univariate odds ratios (OR) were used to describe the magnitude of differences in observed side effects between Ritalin and placebo weeks of the trial for each of the items on the BSEQ. The frequency of the following side effects significantly increased with Ritalin therapy: insomnia (OR = 3.13, 95% confidence interval [CI] = (1.80,5.42)), appetite disturbance (OR = 19.00, 95% CI = (9.18,39.31)), stomachache (OR = 7.00, 95% CI = (3.29, 14.89)), headache (OR = 5.29, 95% CI = (2.51,11.15)), and dizziness (OR = 7.50, 95% CI = (1.93,29.13)). The frequency of the following side effects significantly decreased with Ritalin therapy: staring and daydreaming (OR = 0.47, 95% CI = (0.27,0.84)), irritability (OR = 0.33, 95% CI = (0.18,0.61)), anxiety (OR = 0.42, 95% CI = (0.23,0.76)), and nailbiting (OR = 0.19, 95% CI = (0.07, 0.53)). The incidence rates of the remaining BSEQ items did not differ significantly between the Ritalin and placebo weeks of the trial. CONCLUSION The BSEQ proved to be clinically effective in tracking Ritalin side effects and should be incorporated into the routine evaluation and monitoring of ADHD patients for whom stimulants are prescribed.
Curvature based analysis of pulmonary nodules using thin-section CT images

Presents a method to characterize the internal structure of small pulmonary nodules through a curvature-based descriptor using thin-section CT images. The work is a first step toward the segmentation of the three-dimensional (3D) nodule images by using a 3D deformable surfaces approach. Secondly, a curvature-based representation of the pulmonary nodule is derived. Based on this representation, the pulmonary nodules are globally characterized through the shape spectra. This quantification emphasizes the difference between benign and malignant pulmonary nodules surroundings. Experiments on true 3D nodule images demonstrate good performance of our curvature based analysis technique.
Cardiac &bgr;-Adrenoceptor Changes in Monocrotaline-Treated Rats: Differences Between Membrane Preparations From Whole Ventricles and Isolated Ventricular Cardiomyocytes

In monocrotaline (MCT)-treated rats the &bgr;-adrenoceptor-G-protein-adenylyl cyclase system—determined in crude membrane preparations from whole ventricular tissue—was desensitized not only in right (RV) but also in left ventricles (LV). This study aimed to assess the specific contribution of cardiomyocytes to these &bgr;-adrenoceptor changes. Six-week-old male Wistar rats were treated with 60 mg/kg body weight MCT intraperitoneally; within 4–6 weeks, rats developed marked RV hypertrophy. Cardiomyocytes were isolated from RVs and LVs. In RV cardiomyocytes of MCT-treated rats, &bgr;-adrenoceptor density was significantly reduced whereas it was unaltered in LV cardiomyocytes. Reduction of RV cardiomyocyte &bgr;-adrenoceptors was due to a selective &bgr;1-adrenoceptor reduction. Isoprenaline (100 &mgr;M)–induced cAMP increase was significantly reduced in RV but not in LV cardiomyocytes of MCT-treated rats. G protein–coupled receptor kinase activity was increased in RV but not in LV cardiomyocytes. &agr;1-Adrenoceptor density and noradrenaline-induced increase in inositol phosphate formation were significantly reduced only in RV but not in LV cardiomyocytes from MCT-treated rats. It is concluded that in cardiomyocytes of MCT-treated rats, cardiac &bgr;-adrenoceptors and &agr;1-adrenoceptors are chamber-specifically desensitized only in the RV. Thus, changes in cardiac &bgr;-adrenoceptors determined in membrane preparations from whole tissue homogenates do not correctly reflect changes occurring in cardiomyocytes.
[Effects of exogenerous nucleotides on the apoptosis of intestinal epithelial cells IEC-6].

OBJECTIVE To investigate the effects of exogenous nucleotides on apoptosis of a normal rat small intestinal epithelial cell line, IEC-6. METHODS Cultured IEC-6 cells were treated by four kinds of monophosphate nucleotides and their mixture prepared according to their composition in human milk, then the cell apoptosis was determined by flow cytometry measurement, morphologic characterization, and electron-microscope observation. RESULTS IEC-6 cells treated with AMP or GMP showed a apotosis peak in flow cytometry measurement, but only AMP produce typical apoptosis characteristics in electron-microscope observation. Pyrimidine nucleotides (UMP and CMP)and nucleotides mixture could not induce apoptosis. However, UMP could significantly eliminate the apoptosis-inducing effects of AMP or GMP. CONCLUSION Purine nucleotides induce apoptosis of IEC-6, inducing effects of purine nucleotides. pyrimidine nucleotides UMP could abolish the apoptosis-inducing effects of purine nucleotides.
Tissue Composition of the Vaginal Wall in Women with Pelvic Organ Prolapse

Background/Aims: To determine the composition of the vaginal wall and to explore the connective tissue layer, muscularis and basement membrane in relation to the pathogenesis of pelvic organ prolapse (POP). Methods: We performed a histopathological study with respect to the composition of the vaginal wall of 33 patients and 9 controls. Tissue samples from the vaginal wall were analysed for collagens II and IV, desmin, elastin, fibronectin, smooth muscle actin (SMA) and transforming growth factor (TGF)-β1 using (immuno)histochemistry. Morphometric analyses were also performed. Results: Morphometric characteristics and expression of SMA, TGF-β1, elastin and collagen II were significantly altered in women with POP. Conclusion: Our results suggest that there could be an altered tissue composition of the vaginal wall in women with POP. SMA expression could play a role in the pathogenesis of POP. The alterations in elastin and TGF-β1 expression are likely a result of POP.
In-line filters in central venous catheters in a neonatal intensive care unit

Abstract Nosocomial sepsis remains an important cause of morbidity in neonatal intensive care units. Central venous catheters (CVCs) and parenteral nutrition (TPN) are major risk factors. In-line filters in the intravenous (IV) administration sets prevent the infusion of particles, which may reduce infectious complications. We randomized infants to in-line filter (for clear fluids and lipid emulsions) or no filter placement. Sepsis, nursing time and costs were assessed. IV sets without filters were changed every 24 h, IV-sets with filters every 96 h. Of 442 infants with a CVC, 228 were randomized to filter placement, 214 to no filter. No differences were found in clinical characteristics, CVC-use, and catheter days. Nosocomial sepsis occurred in 37 (16.2%) infants with filters, in 35 (16.3%) in the group without filter (NS). Nursing time to change the IV-administration sets was 4 min shorter in the filter-group (P<0.05). Costs of materials used were comparable. In conclusion, the incidence of sepsis when using filters was not reduced but the nursing time for changing the intravenous sets was reduced without a difference in costs.
EARLY PROSTHETIC COMPLICATIONS AFTER UNIPOLAR HEMIARTHROPLASTY

Background: In Australia, the most frequently used hemiarthroplasty prosthesis for the management of displaced intracapsular femoral neck fractures is the Uncemented Austin Moore (UAM). Despite concerns regarding poor functional outcomes and increased early revision rates associated with the UAM prosthesis, apprehension regarding the systemic side‐effects of polymethylmethacrylate cement implantation in the elderly patient continues to influence prosthesis selection. This study examines the incidence of early prosthesis related complications after UAM and Cemented Thompson (CT) hemiarthroplasty procedures for the management of femoral neck fractures.
Analysis of bacterial exopolysaccharides

Extracellular polysaccharides have been isolated from cultures of freshwater and marine bacteria originally isolated from material adhering to surfaces and underivatized hydrolysates have been analyzed by high‐performance liquid chromatography methods. A scheme has been developed whereby the uronic acids can be identified on strong anion‐exchange columns, while neutral monosaccharides can be separated and identified using aminobonded columns or cation‐exchange adsorbent loaded with a heavy metal ion. The methods permit rapid and accurate comparison of polysaccharides with differing chemotype. The strains studied show a range of different chemotypes, all containing a uronic acid and several neutral monosaccharides. Some of the polysaccharides isolated from marine bacteria possessed a very high acetyl content.
Antisettlement activity of synthetic analogues of polymeric 3-alkylpyridinium salts isolated from the sponge Reniera sarai

Based on the high, non-toxic and reversible antifouling activity of the polymeric 3-alkylpyridinium salts isolated from the sponge Reniera sarai, the anti-settlement activity and toxicity of a series of synthetic analogues has been studied. All the test compounds were less efficient than the natural polymers, suggesting that the high and reversible anti-macrofouling activity of the natural polymers could derive from their detergent-like properties. The values obtained for EC50sett. of inhibition of cyprid settlement and EC50imm. as naupliar toxicity for the synthetic compounds indicate that the presence of single or multiple charges in the structure is not relevant for the antifouling activity which, conversely, is favoured by increasing the length of the alkyl chain, or by the presence of uncharged pyridine units. The compound 1,8-di(3-pyridyl)octane was the most efficient (EC50sett.= 0.44 μg ml–1), although with a higher toxicity on naupliar stage of B. amphitrite than the natural polymers.
Accountants' perceptions regarding fraud detection and prevention methods

Purpose – The purpose of this study is to examine the extent to which accountants, internal auditors, and certified fraud examiners use fraud prevention and detection methods, and their perceptions regarding the effectiveness of these methods.Design/methodology/approach – A survey was administered to 86 accountants, internal auditors and certified fraud examiners.Findings – The results indicate that firewalls, virus and password protection, and internal control review and improvement are quite commonly used to combat fraud. However, discovery sampling, data mining, forensic accountants, and digital analysis software are not often used, despite receiving high ratings of effectiveness. In particular, organizational use of forensic accountants and digital analysis were the least often used of any anti‐fraud method but had the highest mean effectiveness ratings. The lack of use of these highly effective methods may be driven by lack of firm resources.Practical implications – Organizations should consider the .
Airborne endotoxin exposure and the development of airway antigen‐specific allergic responses

Repeated exposure of aerosolized antigen via respiratory tract can induce immunoglobulin (Ig) E isotype‐specific tolerance to this antigen. However, the atopic individuals often produce a higher titre of IgE in response to airborne environmental allergens. The mechanisms of this differential regulation of airway allergen‐specific immune responses are not fully understood. This study investigated the role of airborne endotoxin on the initiation of antigen‐specific airway allergic responses.
Research Report: A Reexamination of IT Investment and the Market Value of the Firm - An Event Study Methodology

Evaluating the effectiveness of Information Technology (IT) investments has always been an elusive but important goal of IS researchers. This study builds on a prior study that examined changes in the market value of the firm as reflected by the stock price in response to IT investment announcements. Data on stock prices were analyzed for 238 publicly traded companies. In addition to the stock price analysis, reaction of trading volume to the announcements was also examined to identify whether IT investment announcements affect investors' beliefs about IT value. Potentially confounding factors such as industry, size, and time lag effects were also analyzed. Size and time lag effects were found for all IT investment announcements. Reactions of price and volume were negatively related to firm size and became more positive over time. The positive excess return for smaller firms shows that smaller firms can leverage the lower price/performance ratio of new IT and reap greater rewards from IT investments than larger firms. Also, the result of time lag effect demonstrates that the stock market has recently begun to identify both tangible and intangible benefits of IT investments. For recent IT investment announcements, industry classification and firm size also affected the reactions of stock price to the announcements. This study provides optimism on the stock market reaction to IT investment announcements as well as further insight into the study of IT impacts on organizational performance.
Use of Integra in Complex Pediatric Wounds

The usefulness of Integra is well described in the adult reconstructive and burn literature. There is limited documentation of its utility in the pediatric plastic surgery population. We presented 8 cases referred to us for flap coverage that were treated using Integra. These cases describe difficult wounds resulting from trauma, and congenital abnormalities. The charts of all 8 cases were retrospectively reviewed. There were 5 females and 3 newborns. The average age at coverage with Integra was 4.6 years (range, 1 day–16 years). There were 4 traumatic wounds, 2 cases of cutis aplasia, 1 myelomeningocele, and 1 case of congenitally absent cranium. The average time to coverage was 8 days, and all trauma patients underwent at least 2 prior washout procedures. The average area covered was 43 cm2 (range, 6–100 cm2). At a mean follow-up of 14.25 months (range, 9–20 months), 7 patients' wounds had healed without need for further flap coverage. Only 1 patient required a skin graft over the Integra bed. There was 1 infection resulting in total dermal matrix loss and need for local flap reconstruction. One patient developed severe hypertrophic scarring requiring surgical revision. Integra is a reliable option in pediatric reconstruction, which may save a child the morbidity of a more extensive procedure.
Functional impairment severity is associated with health status among older persons with intellectual disability and cerebral palsy.

BACKGROUND Studies have noted high rates of specific health disorders in adults with cerebral palsy (CP). However, it remains unclear how growing older with a lifelong neuromotor physical disability confers risk for health outcomes in adults who have both intellectual disability (ID) and CP. AIM To assess the relationship between health status in older adults with ID either with or without coincident diagnoses of CP. METHOD Health status data were drawn from 1373 adults aged 33 to 79 years with ID living in small group homes in New York State. Their health status was defined by the presence of common health disorders. Of these, 177 subjects had coincident CP. Prevalence data for nine diseases representing different organ systems were obtained and compared in individuals with and without CP. A Severity of Functional Impairment Index (SFII) was developed based on subjects' capabilities in activities of daily living (ADLs) and mobility. Two logistic regression analyses were conducted to determine if CP diagnosis was an independent predictor of health disorder prevalence, or rather exerted effects similar to those without CP via severity of functional impairment as determined by SFII scores. In addition, older age, gender, and severity of intellectual disability were examined as predictors of health disorder prevalence in all study subjects. RESULTS Individuals with CP had higher frequencies in four out of the nine health disorders (overweight/obesity, gastroesophageal reflux, urinary tract infections and dysphagia). Analysis revealed a statistically significant association between SFII score and CP diagnosis. CP diagnosis alone was a statistically significant predictor for all of the above four common disorders; however, after adjustment for SFII score was included in health disorder models, only dysphagia showed an independent correlation with a CP diagnosis. CONCLUSION With the exception of dysphagia, impairment in ADLs and walking capabilities, and not CP diagnosis alone, accounted for disparities in specific diseases. Although the diagnosis of CP may be correlated with functional impairment, it alone may play a minor role in determining health trajectories in older persons with conjoint ID and CP.
Vandetanib and the management of advanced medullary thyroid cancer

Purpose of review Vandetanib is a small molecule tyrosine kinase inhibitor that has been recently approved as an ‘orphan drug’ for the treatment of patients with unresectable, locally advanced, or metastatic medullary thyroid cancer (MTC). Recent findings MTC is a neuroendocrine malignancy frequently associated with mutations to the RET proto-oncogene. Vandetanib selectively targets RET, vascular endothelial growth factor receptor-2, and epidermal growth factor receptor dependent signaling. Vandetanib has been shown to improve progression-free survival in patients with advanced MTC. In general, vandetanib is well tolerated, but QTc prolongation remains a potential concern demanding careful patient selection and monitoring. Summary Vandetanib has emerged as one of the more promising small molecule tyrosinse kinase inhibitors, providing durable rates of disease stabilization, with an acceptable adverse event profile in patients with advanced MTC.