Miracle-dz/UniFAR-FTUs huggingface dataset:
Imaging of the Corneal Subbasal Whorl-like Nerve Plexus: More Accurate Depiction of the Extent of Corneal Nerve Damage in Patients With Diabetes.

PURPOSE To show that noninvasive in vivo corneal confocal microscopy (IVCM) can make more accurate imaging of the corneal subbasal nerve plexus possible. This diagnostic technique monitors the status of diabetic peripheral neuropathy. However, it is difficult to accurately confirm the corneal area captured by IVCM, which can induce measurement errors. Because the whorl-like characteristic pattern of the corneal subbasal nerve plexus is in the inferocentral cornea, we evaluated whether IVCM images of the whorl-like patterns can accurately evaluate the corneal nerve fibers in diabetic neuropathy. METHODS Forty-seven patients with diabetes (DM group) and 21 healthy control subjects underwent IVCM examination to compare the characteristics of the corneal subbasal nerve plexus around the central cornea (conventional method) and the whorl-like pattern in the inferocentral cornea (study method). We measured the total corneal nerve fiber and branch length (CNFL). RESULTS The total CNFL were significantly shorter in the DM group than in the control group and tended to decrease with progression of diabetic retinopathy, nephropathy, neuropathy, and decreased corneal sensation. There was a significant positive correlation between the CNFL values obtained with the conventional method and those obtained with the study method. The coefficient of variation of the CNFL values in the study method was significantly smaller than in the conventional method. CONCLUSIONS Our findings indicated that IVCM measurements of the whorl-like patterns may accurately define the extent of corneal nerve damage in order to monitor diabetic peripheral neuropathy.
Monitoring peripheral blood CD4+ adenosine triphosphate activity in a liver transplant cohort: Insight into the interplay between hepatitis C virus infection and cellular immunity

Peripheral blood CD4+ adenosine triphosphate [ATP (ng/mL)] release [ImmuKnow Immune Cell Function Assay (ATP)] correlates to immunoreactivity. We hypothesized that ATP levels could provide insight into hepatitis C virus (HCV) infection and recurrent liver disease in liver transplantation (LT). We studied our center's LT cohort, in which ATP levels had been measured off protocol from February 2005 through July 2006. Of the 280 LTs performed since 1993, 114 (58.2%) fit the selection criteria, with a mean age of 49 ± 10 years. LT (alone/combination) indications included HCV (58%), alcoholic liver disease (41%), hepatocellular carcinoma (16%), and other (33%). Four hundred seventy‐seven ATP levels were obtained: 3 (1‐17) per patient 25 months (4 days to 19 years) from the time from transplantation. Final diagnoses were normal allograft function (n = 166, 35%), recurrent disease (n = 199, 42%), septic event (n = 34, 7%), other (n = 51, 11%), and undetermined (n = 27, 6%). Two hundred eighty‐one ATP levels were obtained [3 (1‐18) per patient] in 66 HCV(+) patients. Forty‐five (68%) developed biopsy‐proven recurrent liver disease [188/281 (67%) ATP levels]. The median ATP level (ng/mL) was 162 (1‐761); it was lower in HCV(+) patients (151 ± 109) versus HCV(−) patients (211 ± 139; P < 0.0001). ATP ranges in HCV(+) patients were stable from the time from transplantation. In HCV(−) patients, ATP ranges were initially high and eventually decreased to HCV(+) levels (P = 0.01). Immunosuppressant levels were low in 62% of HCV(−) patients versus 38% of HCV(+) patients (P = 0.04). In HCV(+) patients, ATP was lower in disease recurrence (139 ± 97) versus none (181 ± 141; P = 0.01) with similar immunosuppression, and ATP decreased with grade (P = 0.05) but not stage. Time from transplantation, aspartate aminotransferase/alanine aminotransferase >1, and low ATP were independently associated with recurrent HCV. In conclusion, after LT, global cellular immune function appears depressed at baseline in HCV(+) patients versus HCV(−) patients and more so in HCV(+) recurrent disease. Liver Transpl 14:1313–1322, 2008. © 2008 AASLD.
Determination of Thermal Conductivity and Porosity of Building Stone from Ultrasonic Velocity Measurements

Ultrasonic velocity measurement, a non-destructive and easy method to apply in both field and laboratory conditions, has increasingly been conducted to determine the physical properties of rock materials. This paper presents an experimental study of the measurement of P-wave velocity, thermal conductivity and porosity of several types of sedimentary, metamorphic, and magmatic rocks. The aim of this study is to predict the rocks properties including their thermal conductivity and porosity using P-wave velocity. For this purpose, the physical properties are determined in the laboratory to obtain correlations between P-wave velocity and physical properties. Consequently, good linear relationships are found between all the determined physical properties and the P-wave velocity measurements.
A comprehensive study of the distressing experiences and support needs of parents of children with intractable cancer.

OBJECTIVE The primary endpoints of this study were: (1) to explore the distressing experiences of parents of patients with intractable pediatric cancer in Japan from disclosure of poor prognosis to the present and (2) to explore support they regarded as necessary. METHODS A multi-center questionnaire survey was conducted that included 135 bereaved parents of patients with pediatric cancer in Japan. RESULTS The top five distressing experiences shared by over half of the bereaved parents were: 'Realize that the child's disease was getting worse' (96.7%), 'Witness the child's suffering' (96.7%), 'Make many decisions on the basis that the child will die in the not-so-distant future' (83.6%), 'Feel anxious and nervous about the child's acute deterioration' (82.0%) and 'Realize that there was nothing that I could do for the child' (78.7%). The top five support regarded as necessary were: 'Visit the room and speak to the sick child every day' (90.2%), 'Provide up-to-date information' (80.3%), 'Sufficiently explain the disadvantages of each treatment option' (80.3%), 'Show a never-give-up attitude until the end' (78.7%) and 'Make arrangements to allow the sick child to spend time with his/her siblings' (73.8%). CONCLUSIONS This study identified the common distressing experiences of parents and the support regarded as necessary by them. To provide efficient support with limited manpower in pediatric setting, healthcare professionals should recognize these tasks as high priorities when engage parents of intractable pediatric cancer patients.
T cell-depleted hla-haploidentical stem cell transplantation in thalassemia young patients

The cure for thalassemia involves correcting the genetic defect in a hematopoietic stem cell that results in reduced or absent β-globin synthesis and an excess of α-globin dimers. Intracellular precipitation and accumulation of α- dimers results in ineffective erythropoiesis and hemolytic anemia. Replacing the abnormal thalassemic marrow with allogeneic normal or heterozygous stem cells carrying the functional gene restores appropriate β-globin chain synthesis.
Sequence and properties of mecA, a negative regulator of genetic competence in Bacillus subtilis

The development of competence in Bacillus subtilis is regulated by growth conditions and several regulatory genes. In complex media competence development is poor, and there is little or no expression of late competence genes, mec mutations permit competence development and late competence gene expression in complex media, and bypass the requirements for many of the competence regulatory genes. In this paper we describe the cloning and characterization of mecA. The mecA gene product acts negatively in the development of competence. Null mutations in mecA allowed expression of a late competence gene comG, under conditions where it is not normally expressed, including in complex media and in cells mutant for several competence regulatory genes. Overexpression of MecA from a multicopy plasmid resulted in inhibition of comG transcription. The DNA sequence of mecA was determined and the predicted gene product showed no significant similarity to any protein in the database. Expression of a mecA–lacZ translational fusion was constitutive during growth and did not vary significantly in the different media tested. The rote of mec A in competence development and other stationary phase phenomena is discussed.
Interaction circuit design and RF behavior of a 236 GHz gyrotron for DEMO

The Demonstration Fusion Power Reactor (DEMO) to follow ITER by 2050 demands high frequency (>230 GHz), high power (in the range from 1 MW to 2 MW) gyrotrons as RF sources for electron cyclotron resonance heating and current drive (ECRH&CD). In the frame of the EUROfusion programme at KIT, the designs of conventional-cavity type and coaxial-cavity type DEMO-compatible gyrotrons are under investigation. In this presentation, the physical design of the interaction circuit of a 236 GHz conventional cavity gyrotron and its RF behavior are presented. The simulation results show a stable single mode RF output power without serious mode competition.
The clinical analgesic efficacy of buprenorphine

Based on in vitro assays and select animal models, buprenorphine is commonly called a ‘partial agonist’. An implication is that it should produce less analgesic effect in humans than so‐called ‘full agonists’ such as morphine or fentanyl. However, buprenorphine has a multimechanistic pharmacology, and thus partial agonism at a specific receptor is not particularly relevant to its overall analgesic action. We review published clinical trials that directly compared the magnitude of buprenorphine's analgesic effect to analgesics commonly considered full agonists.
Nodal Anaplastic Large-Cell Lymphoma ALK-1− with CD30+ Cutaneous Lymphoproliferation Treated with Mistletoe: Spontaneous Remission or Treatment Response?

Abstract A 12-year old girl presented with general weakness and weight loss, a localised cervical lymph node enlargement and cutaneous lesions compatible with lymphomatoid papulosis (LyP). Biopsies from lymph node and skin revealed a histological diagnosis of nodal large cell ALK-1− anaplastic lymphoma (ALCL) with a synchronous CD30+ cutaneous lymphoproliferation consistent with lymphomatoid papulosis (LyP). The girl was treated with mistletoe (MT) as monotherapy. Within 1 week after initiation of MT-treatment the skin lesions and lymph node enlargement improved. Under continuing MT-therapy 30 months after diagnosis the patient is still in complete remission. It is not possible to know whether this was a rare case of spontaneous remission of the nodal and skin-manifestations of this CD30+ T-cell lymphoproliferation or whether the observed effect was a specific therapeutic response to MT-treatment.
Glucocorticoids Induce Proteasome C3 Subunit Expression in L6 Muscle Cells by Opposing the Suppression of Its Transcription by NF-κB*

Muscle wasting in catabolic conditions results from activation of the ubiquitin-proteasome proteolytic pathway by a process that requires glucocorticoids and is generally associated with increased levels of mRNAs encoding components of this proteolytic system. In L6 muscle cells, dexamethasone stimulates proteolysis and increases the amount of the proteasome C3 subunit protein by augmenting its transcription. Transfection studies with human C3 promoter-luciferase reporter genes and electrophoretic mobility shift assays revealed that a NF-κB·protein complex containing Rel A is abundant in L6 muscle cell nuclei. Glucocorticoids stimulate C3 subunit expression by antagonizing the interaction of this NF-κB protein with an NF-κB response element in the C3 subunit promoter region. Dexamethasone also increased the cytosolic amounts of the NF-κB p65 subunit and the IκBα inhibitor proteins in L6 cells. Incubation of L6 cells with a cytokine mixture not only increased the amount of activated NF-κB but also decreased C3 promoter activity and lowered endogenous C3 subunit mRNA. Thus, NF-κB is a repressor of C3 proteasome subunit transcription in muscle cells, and glucocorticoids stimulate C3 subunit expression by opposing this suppressor action.
Holistic Issues in the Preoperative Period

The good physician knows his patients through and through, and his knowledge is bought dearly. Time, sympathy, and understanding must be lavishly dispensed, but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine. One of the essential qualitities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient. Dr. Francis Weld Peabody, lecture to Harvard medical students, 1927
Limited usefulness of non-invasive coronary angiography with 16-detector multislice computer tomography at a community hospital

Objectives. To evaluate the usefulness of coronary angiography by 16-detector multislice spiral computed tomography (MSCT) in community hospital outpatients. Design. MSCT was performed at the community hospital in 157 of 218 consecutive outpatients with suspected significant coronary disease, before referral for invasive coronary angiography. Results. 101 patients had interpretable MSCT angiograms (64 men, age 62±10 years, calcium score 373±678, heart rate 56±7 beats/min, beta-blocker used by 91%). Coronary stenoses >50% were identified by invasive angiography in 49 patients. Only 79% of all segments could be assessed by MSCT due to heavy coronary calcification (12%) and blurred images (9%) in the remaining. By interpreting non-assessable segments as negative results 79 patients were correctly classified by MSCT. Sensitivity, specificity, positive and negative predictive values at patient level was 82%, 75%, 75% and 81%. By interpreting non-assessable segments as positive findings, the corresponding values were 100%, 29%, 57% and 100%, with correct diagnoses in 63% of patients. Conclusions. Limited diagnostic accuracy, non-interpretable scans and radiation exposure restrict the usefulness of coronary MSCT in a community hospital setting.
STUDIES OF GLYCOGEN METABOLISM IN LIVER GLYCOGEN DISEASE (VON GIERKE'S DISEASE): SIX CASES WITH SIMILAR METABOLIC ABNORMALITIES AND RESPONSES TO GLUCAGON.

Glycogen disease of the liver (von Gierke's disease) is a rare and incompletely understood disorder of childhood. It is characterized by defective breakdown of liver glycogen to glucose. In most cases, excessive liver glycogen deposition occurs, reaching levels as high as 14 to 17 per cent of the wet liver weight (1, 2). Major clinical manifestations include hepatomegaly; fasting hypoglycemia, acidosis and ketosis; delayed growth and development, and increased morbidity with even minor infections. The most severely affected children have usually died during infancy. Histologic studies of autopsy or biopsy specimens of liver reveal essentially normal architecture, but hepatic cells contain excessive amounts of glycogen and often, fat. The glycogen is usually normal in structure (3) and can be broken down to glucose by homogenates of normal animal or human liver (2, 4, 5). Spontaneous breakdown of glycogen during in vitro incubation of liver tissue from affected children is deficient (2, 4, 6). The currently accepted pathways of liver glycogen metabolism are summarized in Figure 1. It was formerly believed that glycogen was synthesized through the action of phosphorylase, the same enzyme that catalyzes its breakdown. However, it is now agreed that this reaction, which occurs readily in vitro, is not an important one in vivo (7), and that glycogen synthesis probably proceeds through the uridine-diphosphoglucose pathway described by Leloir and Cardini (8). Glycogen breakdown is mediated by phosphorylase
The GFDL CM3 Coupled Climate Model: Characteristics of the Ocean and Sea Ice Simulations

AbstractThis paper documents time mean simulation characteristics from the ocean and sea ice components in a new coupled climate model developed at the NOAA Geophysical Fluid Dynamics Laboratory (GFDL). The GFDL Climate Model version 3 (CM3) is formulated with effectively the same ocean and sea ice components as the earlier CM2.1 yet with extensive developments made to the atmosphere and land model components. Both CM2.1 and CM3 show stable mean climate indices, such as large-scale circulation and sea surface temperatures (SSTs). There are notable improvements in the CM3 climate simulation relative to CM2.1, including a modified SST bias pattern and reduced biases in the Arctic sea ice cover. The authors anticipate SST differences between CM2.1 and CM3 in lower latitudes through analysis of the atmospheric fluxes at the ocean surface in corresponding Atmospheric Model Intercomparison Project (AMIP) simulations. In contrast, SST changes in the high latitudes are dominated by ocean and sea ice effects absen.
Functional and Molecular Expression of Epithelial Sodium Channels in Cultured Human Endolymphatic Sac Epithelial Cells

Hypothesis: Epithelial sodium channels are expressed in cultured human endolymphatic sac (ES) epithelial (HESE) cells and epithelial sodium channel (ENaC) expression is suppressed by interleukin 1&bgr;. Background: The ES is part of the membranous labyrinth in the inner ear that plays an important role in maintaining homeostasis of the endolymphatic fluid system. However, the exact mechanism of fluid volume regulation is not yet known. Methods: The ES specimens were harvested during acoustic neuroma surgery (n = 13) using the translabyrinthine approach and were subcultured with high-epidermal growth factor (25 ng/mL) media. Results: The serially passaged HESE cells differentiated into a monolayer of confluent cells and some of the cultured cells had features of mitochondria-rich cells. Reverse transcription-polymerase chain reaction revealed that ENaC subunits are expressed in the cultured HESE cells. We also confirmed the presence of an ENaC-dependent short-circuit current in the cultured HESE cells. Interestingly, ENaC mRNA expression and ENaC-dependent current decreased after treatment with interleukin 1&bgr; (10 nmol/L for 24 h). Conclusion: These findings suggest that ENaC plays an important role in fluid absorption in the human ES and that its function may be altered during inflammatory conditions.
Is it worth inducing labour in women with a previous caesarean delivery?

The aim of this study was to determine the outcome of labour induction following a previous caesarean section. A total of 43 cases were identified; 23 out of those (53.5%) achieved vaginal delivery. The remaining 20 cases (46.5%) had a repeat caesarean. A total of 25 women had ≥ 1 previous vaginal deliveries and in the remaining 18, the previous caesarean was the only pregnancy carried before the current pregnancy. Out of the 23 women who successfully delivered vaginally, 16 cases (69.6%) had a history of ≥ 1 previous vaginal delivery, while no such history was reported in the remaining seven cases (30.4%). The indications for a repeat caesarean were failed induction of labour in five cases (25%); fetal distress in seven cases (35%); failure-to-progress in eight cases (40%). Only one case (2.3%) of uterine rupture was reported. In conclusion, labour induction following a previous caesarean section is an effective and safe intervention. Vaginal delivery can be anticipated in the majority of these women. This study emphasises the need for thorough counselling of these women regarding benefits and risks of induction of labour, and also highlights the necessity of shared patient–doctor decision-making.
The spatial analysis of spectral data: Extracting the neglected data

Remotely sensed data are a key input to GIS-based spatial decision support systems for land cover and land use application areas. One of the major sources of error in the input of processed remotely sensed data to GIS is in the process of classification. Particularly important is the degradation of the data from the interval to nominal level of measurement. This is less significant in cultural landscapes where boundaries predominate, but it becomes an important source of error in natural, and disturbed natural, environments where gradients exist. Use of the Gi * local statistic as an alternative approach to processing remotely sensed data proved very successful, replicating the level of discrimination achieved by conventional classification and field labelling in a much shorter time, whilst avoiding the errors associated with conversion of the data from the interval to nominal level of measurement.
Maternal assessment of neonatal jaundice after hospital discharge.

OBJECTIVE To determine whether mothers can accurately assess the presence and severity of jaundice in their newborns, both visually and with an icterometer, after hospital discharge. STUDY DESIGN Mothers were taught how to examine their infants for jaundice by determining the extent of caudal progression of jaundice and by using an Ingram icterometer. The mothers documented the examinations for 7 days after discharge. Home health nurses examined the babies for jaundice after discharge and obtained serum bilirubin levels. POPULATION Mothers of infants cared for in the normal newborn nursery of a 340-bed community hospital. OUTCOMES MEASURED Maternal assessment of the presence of jaundice and its caudal progression. RESULTS Jaundice extending below the nipple line had a positive predictive value of 55% and a negative predictive value of 86% for identifying infants with bilirubin levels of = 12 mg/dL. Icterometer readings of = 2.5 had a positive predictive value of 44% and a negative predictive value of 87% for identifying infants with bilirubin levels of = 12 mg/dL. The 3 infants with bilirubin levels = 17 mg/dL were recognized by their mothers as having jaundice below the nipple line and had icterometer readings of = 2.5. CONCLUSIONS Further study is needed to determine the optimum method of parental education about newborn jaundice. However, maternal use of the Ingram icterometer and determination of jaundice in relation to the infant's nipple line are both potentially useful methods of assessing jaundice after hospital discharge.
[Functional capacity evaluation of nursing professionals].

OBJECTIVE To evaluate the functional capacity of nursing staff in a hospital complex and its association with individual and work characteristics. METHODS A cross-sectional comprising 885 subjects was carried out. A standardized self-administered questionnaire was used to calculate a work capacity index based on information regarding occupation, morbidity, demographic and socioeconomic data. Odds ratios and their respective 95% confidence intervals were estimated using the Chi-square test. A multiple logistic model was used for testing the associations and adjusted odds ratios were obtained. RESULTS The study population included primarily women (87.3%), aged between 35 and 68 years (43+/-6.3 on average), who worked as nursing aides, technical-level professionals and nurses in seven hospital units that integrate the hospital complex. Work capacity was considered good in over 80% of the staff. Statistical analyses showed that those with higher schooling (OR=0.4; CI=0.2-1.0; p=0.05 and adjOR= 0.4; CI: 0.2-1.0; p=0.04) and who exercise and have some physical activity (OR=0.5; CI: 0.3-0.9; p=0.02 and adjOR: 0.5; CI: 0.3-0.9, p=0.02) are more likely to have good work capacity. Those with reduced work capacity were found to have a high prevalence of musculoskeletal diseases. CONCLUSIONS The company's worker health program should include guidance and follow-up of nursing staff regarding their physical and leisure activities aiming at promoting good work capacity as well as implementing preventive measures against musculoskeletal diseases.