Miracle-dz/UniFAR-FTUs huggingface dataset:
Intra- and postoperative application of Mitomycin C in the middle meatus reduces adhesions and antrostomy stenosis after FESS.

AIM Obstruction of the osteomeatal complex is the commonest anatomic finding in revision endoscopic sinus surgery. This study assesses the efficacy of topical mitomycin C in the middle meatus, intra- and postoperatively in the prevention of adhesion formation and restenosis of the maxillary sinus antrostomy. MATERIALS AND METHODS At the end of endoscopic surgery for chronic rhinosinusitis and four weeks postoperatively 30 patients received a pledget soaked with 1 ml of mitomycin C (0.5 mg/ml) in the middle meatus for 5 minutes while a pledget soaked in saline was placed in the contralateral side. Patients were assessed at least 6 months postoperatively by a blinded observer for the presence of synechiae and antrostomy stenosis. Medical records were reviewed for episodes of recurrent sinusitis. RESULTS Adhesions were observed in 8 patients. All adhesions rated as moderate to severe (4 patients) were observed in the control side (p = 0.043). Restenosis was observed in 2 sides treated with mitomycin C and in 9 control sides (p = 0.032). Recurrent symptoms of sinusitis occurred in three patients on the saline side. CONCLUSION Mitomycin C is safe and effective in the prevention of severe adhesions and antrostomy stenosis when applied twice, during surgery and the early postoperative period.
Impact of Continuous Quality Improvement Initiatives on Clinical Outcomes in Peritoneal Dialysis

♦ Objective: We evaluated the role of a quality improvement initiative in improving clinical outcomes in peritoneal dialysis (PD). ♦ Methods: In a retrospective analysis of 6 years of data from a hospital registry, the period between 1 July 2005 and 30 June 2008 (control group) provided baseline data from before implementation of systemic outcomes monitoring, and the period between 1 July 2008 and 30 June 2011 [continuous quality improvement (CQI) group] represented the time when a CQI program was in place. Peritonitis incidence, patient and technique survival, cardiovascular status, causes of death, and drop-out were compared between the groups. ♦ Results: In the 370 patients of the CQI group and the 249 patients of the control group, the predominant underlying kidney diseases were chronic glomerulonephritis and diabetic nephropathy. After implementation of the CQI initiative, the peritonitis rate declined to 1 episode in 77.25 patient-months from 1 episode in 22.86 patient-months. Ultrasound parameters of cardiac structure were generally unchanged in the CQI group, but significant increases in cardiothoracic ratio and interventricular septal thickness were observed in the control group (both p < 0.05). Patient survival at 1, 2, and 3 years was significantly higher in the CQI group (97.3%, 96.3%, and 96.3% respectively) than in the control group (92.6%, 82.4%, and 67.3% respectively, p < 0.001). Implementation of the CQI initiative also appeared to significantly improve technique survival rates: 95.6%, 92.6%, and 92.6% in the CQI group compared with 89.6%, 79.2%, and 76.8% in the control group (p < 0.001) after 1, 2, and 3 years respectively. ♦ Conclusion: Integration of a CQI process into a PD program can significantly improve the quality of therapy and its outcomes.
Adherence to emergency department discharge prescriptions.

OBJECTIVE Nonadherence to prescribed medication is associated with increased morbidity and mortality as well as the increased use of health services. The main objective of our study was to assess the incidence of prescription-filling and medication adherence in patients discharged from the emergency department (ED). METHODS This was a prospective, observational study carried out at a Canadian tertiary care ED with an annual census of 69 000. We enrolled a convenience sample of patients being discharged with a prescription. We queried a provincial prescription-dispensing database 2 weeks later to determine whether prescriptions had been filled. We used a standardized follow-up interview to assess adherence and whether or not the patient experienced an adverse drug-related event (ADRE) or an unplanned revisit to an ED or clinic. RESULTS Of the 301 patients who agreed to participate, follow-up was successful for 258 (85.7%). Fifty-one patients (19.8%, 95% confidence interval [CI] 15.4%-25.1%) failed to fill their discharge prescriptions and 104 (40.3%, 95% CI 34.5%-46.4%) did not adhere to 1 or more medications. Antibiotics were associated with a lower odds ratio (OR) of nonadherence (OR 0.21, 95% CI 0.08-0.52). There was a trend toward increasing nonadherence in patients who reported an ADRE (OR 1.84, 95% CI 0.98-3.48) or had 2 or more medications coprescribed (OR 1.71, 95% CI 0.95-3.09). There was also a trend toward a higher risk of a revisit to an ED or clinic in nonadherent patients (OR 1.75, 95% CI 0.94-3.25). CONCLUSION Approximately 4 in 10 patients discharged from the ED did not adhere to his or her prescribed medication. Our results suggest that patients who are prescribed antibiotics are more likely to be adherent, and that further evaluation of the associations between nonadherence, ADREs, the coprescription of 2 or more medications and the use of health services is warranted.
A Review of Antibiotic Use in Pregnancy

During pregnancy, untreated sexually transmitted or urinary tract infections are associated with significant morbidity, including low birth weight, preterm birth, and spontaneous abortion. Approximately one in four women will be prescribed an antibiotic during pregnancy, accounting for nearly 80% of prescription medications in pregnant women. Antibiotic exposures during pregnancy have been associated with both short‐term (e.g., congenital abnormalities) and long‐term effects (e.g., changes in gut microbiome, asthma, atopic dermatitis) in the newborn. However, it is estimated that only 10% of medications have sufficient data related to safe and effective use in pregnancy. Antibiotics such as beta‐lactams, vancomycin, nitrofurantoin, metronidazole, clindamycin, and fosfomycin are generally considered safe and effective in pregnancy. Fluoroquinolones and tetracyclines are generally avoided in pregnancy. Physiologic changes in pregnancy lead to an increase in glomerular filtration rate, increase in total body volume, and enhanced cardiac output. These changes may lead to pharmacokinetic alterations in antibiotics that require dose adjustment or careful monitoring and assessment.
Experimental assessment of shade-cloth covers on agricultural reservoirs for irrigation in south-eastern Spain

Agricultural water reservoirs (AWRs) are commonly used to guarantee water supply throughout the whole irrigation season in arid and semiarid areas. An important fraction of the total stored water is lost through evaporation, substantially decreasing overall irrigation efficiency. In this study, the effects of suspended shade cloth covers (SSCCs) on reducing evaporation and on the quality of the stored water have been experimentally assessed. To this aim, an AWR located in south-eastern Spain was monitored during two consecutive years. During the first year, the AWR remained uncovered, while during the second year it was covered with a black polyethylene SSCC. The evaporation rate, the water temperature profile and the driving meteorological variables determining evaporation were measured to assess the technical viability of the cover. Evaporation measurements for covered conditions were compared with estimations obtained from an openwater evaporation model which was validated during the first year of experimentation. A reduction close to 85% in the evaporation rate was found. To assess the effects on water quality, water samples and measurements with a multiparametric instrument were monthly collected during the two-year experimental period. Electrical conductivity, chlorophyll concentration and turbidity were measured using this equipment. Results indicate that the reduction in solar radiation (1% transmission through the cover) dramatically reduced the photosynthetic activity; hence algal bloom was highly limited. Finally, the main benefits and costs associated with the cover installation were identified in order to analyse economic viability under different scenarios representative of the current irrigated farming situation in south-eastern Spain. Additional key words: algae concentration; economic viability; electrical conductivity; evaporation; polyethylene meshes; water saving.
The Pharmacokinetics of Nebulized Nanocrystal Budesonide Suspension in Healthy Volunteers

Nanocrystal budesonide (nanobudesonide) is a suspension for nebulization in patients with steroid‐responsive pulmonary diseases such as asthma. The pharmacokinetics and safety of the product were compared to those of Pulmicort Respules. Sixteen healthy volunteers were administered nanobudesonide 0.5 and 1.0 mg, Pulmicort Respules 0.5 mg, andplacebo in a four‐way, randomizedcrossover design. All nebulized formulations were well tolerated, with no evidence of bronchospasm. Nebulization times were significantly shorter for nanobudesonide compared to Pulmicort Respules. Because of a low oral bioavailability, plasma concentration of budesonide is a good marker of lung‐delivered dose. The pharmacokinetics of nanobudesonide 0.5 and 1.0 mg were approximately dose proportional with respect to Cmax, AUC(0‐t), and AUC(0‐∞). Nanobudesonide 0.5 mg and Pulmicort Respules 0.5 mg exhibited similar AUCs, suggesting a similar extent of pulmonary absorption. A higher Cmax was noted with nanobudesonide 0.5 mg, and the tmax was significantly different, suggesting a more rapid rate of drug delivery of nanobudesonide 0.5 mg than Pulmicort Respules. In conclusion, nebulized nanobudesonide 0.5 mg was safe in healthy volunteers, with a similar extent of absorption as Pulmicort Respules.
Age- and Sex-Specific Thorax Finite Element Model Development and Simulation

Objective: The shape, size, bone density, and cortical thickness of the thoracic skeleton vary significantly with age and sex, which can affect the injury tolerance, especially in at-risk populations such as the elderly. Computational modeling has emerged as a powerful and versatile tool to assess injury risk. However, current computational models only represent certain ages and sexes in the population. The purpose of this study was to morph an existing finite element (FE) model of the thorax to depict thorax morphology for males and females of ages 30 and 70 years old (YO) and to investigate the effect on injury risk. Methods: Age- and sex-specific FE models were developed using thin-plate spline interpolation. In order to execute the thin-plate spline interpolation, homologous landmarks on the reference, target, and FE model are required. An image segmentation and registration algorithm was used to collect homologous rib and sternum landmark data from males and females aged 0–100 years. The Generalized Procrustes Analysis was applied to the homologous landmark data to quantify age- and sex-specific isolated shape changes in the thorax. The Global Human Body Models Consortium (GHBMC) 50th percentile male occupant model was morphed to create age- and sex-specific thoracic shape change models (scaled to a 50th percentile male size). To evaluate the thoracic response, 2 loading cases (frontal hub impact and lateral impact) were simulated to assess the importance of geometric and material property changes with age and sex. Results: Due to the geometric and material property changes with age and sex, there were observed differences in the response of the thorax in both the frontal and lateral impacts. Material property changes alone had little to no effect on the maximum thoracic force or the maximum percent compression. With age, the thorax becomes stiffer due to superior rotation of the ribs, which can result in increased bone strain that can increase the risk of fracture. For the 70-YO models, the simulations predicted a higher number of rib fractures in comparison to the 30-YO models. The male models experienced more superior rotation of the ribs in comparison to the female models, which resulted in a higher number of rib fractures for the males. Conclusion: In this study, age- and sex-specific thoracic models were developed and the biomechanical response was studied using frontal and lateral impact simulations. The development of these age- and sex-specific FE models of the thorax will lead to an improved understanding of the complex relationship between thoracic geometry, age, sex, and injury risk.
A Single Center Experience in Biological Therapy for the Treatment of Rheumatoid Arthritis in Saudi Arabia

Background: Biological therapy is indicated in the treatment of RA (Rheumatoid Arthritis) after failure of disease-modifying anti-rheumatic drugs (DMARDS) by the ACR/EULAR recommendations. The objective of the study is to describe the characteristics of Saudi patients at the initiation of biological therapy and to evaluate clinical effectiveness of this therapy measured by the disease activity score DAS 28. Methods: This was a retrospective cohort study of RA (rheumatoid arthritis) patients in King Fahad Hospital in Jeddah, Saudi Arabia from January 2005-July 2011. Data were collected from the medical records of all RA patients on biological therapy including: demographics, disease characteristics, comorbid illnesses and DAS 28 score over a period of 1 year. Results: 139 patients were studied (mean age 46 ± 13 years), of which 118 (84%) were females; mean duration of affliction with RA was 7.2 years ranging 1-45 years. Rheumatoid factor (RF) was positive in 88 patients (63.3%) and one or more comorbidities were present in 102 patients (73.3%). First choice of biological drug was ADA (Adalimumab) 44 patients (31.7%) and RTX (Rituximab) was the 2nd frequently prescribed biological drug. Mean DAS 28 activity at baseline was in ADA 41 patients (6.10 ± 1.62), ETA (Etarnercept) 29 patients (6.64 ± 1.42) and RTX 50 patients (6.7 ± 1.32). Moderate to good EULAR response was obtained in 74%, 85.7% and 53.3% at 6 months in ADA, ETA and RTX patients respectively. Moderate to good EULAR response was obtained in 61.8%, 86.6% and 72% in ADA, ETA AND RTX patients respectively at 1 year of treatment. Therapeutic effectiveness was comparable with the response rates in published observational trials. Conclusion: Our data demonstrate daily clinical practice in management of RA. The pattern of prescription is in agreement with the ACR/EULAR recommendations for initiation of biologicals in the treatment of RA.
Recent ARPES experiments on quasi-1D bulk materials and artificial structures

The spectroscopy of quasi-one-dimensional (1D) systems has been a subject of strong interest since the first experimental observations of unusual line shapes in the early 1990s. Angle-resolved photoemission (ARPES) measurements performed with increasing accuracy have greatly broadened our knowledge of the properties of bulk 1D materials and, more recently, of artificial 1D structures. They have yielded a direct view of 1D bands, of open Fermi surfaces, and of characteristic instabilities. They have also provided unique microscopic evidence for the non-conventional, non-Fermi-liquid, behavior predicted by theory, and for strong and singular interactions. Here we briefly review some of the remarkable experimental results obtained in the last decade.
Asbestos-related diseases of the lung and other organs: their epidemiology and implications for clinical practice.

1 From the Departments of Epidemiology and Health, and of Experimental Medicine, McGill University, and from the Department of Medicine, Royal Victoria Hospital, Montreal, Quebec, Canada. 2 Requests for reprints should l. >e addressed to Department of Epidemiology and Health, McGill University, 3775 University Street, Montreal, Quebec, Canada. 3 Associate of the Medical Research Council of Canada. Pathology Pathogenesis Clinical Features Radiographic Changes Lung Function Diagnosis Prognosis, Complications, and Medical Management
Outbreak of Mycobacterium Abscessus Infection After Soft Tissue Augmentation

BACKGROUND Illicit soft-tissue augmentation performed in New York City resulted in an outbreak of Mycobacterium abscessus infection in 2002. OBJECTIVE To report two cases of women who developed tender, subcutaneous nodules of the face and buttocks after illicit soft-tissue augmentation with a hyaluronic acid derivative. METHODS Two case reports are presented, and the literature is reviewed. RESULTS Empiric treatment with clarithromycin (for M. abscessus infection) and prednisone (for foreign body reaction) resulted in clearance of lesions. CONCLUSION Contaminated or impure material used for soft-tissue augmentation can result in a clustered outbreak of infection or foreign body reaction.
Restricting the Field of View: Perceptual and Performance Effects

Visual perception involves both the high acuity of foveal vision and the wide scope of overlapping peripheral information. The role of peripheral vision in competent performance of the adult visuomotor activities of walking, reaching, and forming a cognitive map of a room was examined using goggles which limited the scope of the normal field of view to 9°, 14°, 22°, or 60°. Each restriction of peripheral field information resulted in some perceptual and performance decrements, with the 9° and 14° restriction producing the most disturbance. In addition, bodily discomfort, dizziness, unsteadiness and disorientation, were reported as the subjects moved around with restricted fields of view.
Improving Remote Collaboration With Video Conferencing and Video Portals

The ability of employees to collaborate with remote colleagues is now essential for most large corporations and organizations. Decades of research have identified the conditions that must be present for remote collaboration to succeed. We present a set of studies of remote collaboration within a technology company (Google) that has not only met these conditions but gone beyond them by providing ubiquitous video conferencing (VC). We looked at how well remote collaboration can now work, whether travel is still required, and what impediments still remain. We found that several factors contributed to the success of remote collaboration. Visual real-time communication via VC is ubiquitous and easy to use, VC is integrated with calendar software, and most Google employees have laptops with VC capability. Collaborative tools such as Google Docs, e-mail, and instant messaging make working together, sharing information, and keeping in touch easy. Finally, there is a culture of trust and sharing within Google. We also found that initial face-to-face meetings remain crucial for enhancing subsequent remote interactions. There were two findings of particular interest. First, VC has completely replaced audio conferencing for internal company communications. Second, video portals (always-on video connections between two or more locations) have sprung up spontaneously throughout Google. We categorize their use into four different styles of interaction and describe how they can be effective not only in facilitating communication but also in providing presence and status information, helping to establish mutual trust and common ground, and preventing misunderstandings. Video portals reduce the behavioral costs of communication and for the first time allow tightly coupled remote work to succeed. Although there are some lingering problems in technology-mediated distributed meetings, a combination of a collaborative culture with appropriate infrastructure, software, and access to technology can radically narrow the gap between colocated and remote collaboration.
Synergistic Anticancer Potential of Dichloroacetate and Estradiol Analogue Exerting their Effect via ROS-JNK-Bcl-2-Mediated Signalling Pathways

Background: C9, a newly in silico-designed inhibitor of microtubule dynamics induces G2/M arrest culminating in apoptosis. Dichloroacetate (DCA) inhibits pyruvate dehydrogenase kinase, an enzyme that promotes pyruvate entry into mitochondria. The use of antitumor drugs targeting different cancer features can be a more effective way to overcome drug resistance. Methods: The influence of C9 (130 nM) + DCA (7.5 mM) on MCF-7 and MCF-12 cells was assessed via microscopy spectrophotometry global gene expression and flow cytometry assays. Results: An LDH assay showed that C9+DCA treatment decreased cell viability to 83.5% in MCF-7 cells when compared to the non-tumorigenic MCF-12A cells 92.4% (P < 0.05). C9- and C9+DCA treatment induced mitochondrial membrane potential depolarization in MCF-7 cells but not in MCF-12A cells (P < 0.05). The occurrence of apoptosis was associated with increased hypo- and hyper-phosphorylation of Bcl-2 Ser70 and caspase 7 activation. Kinase inhibition revealed sustained activation of the JNK pathway caused increased Bcl-2 protein Ser70 hypo-and hyper-phosphorylation. Elevated levels of DCF fluorescence was observed in DCA-, C9- and C9+DCA-exposed MCF-7 cells, but not in MCF-12A cells, indicating cytosolic H2O2/Fe2+ formation in treated tumorigenic cells. LC3-II expression was elevated in C9+DCA-treated cells in both cell lines, indicating that autophagy was also induced. Conclusions: Synergistic effects of C9+DCA were demonstrated on breast carcinoma and non-tumorigenic cells with selectivity towards the MCF-7 cells. Antimitotic compound C9 in combination with a glycolytic inhibitor dichloroacetate eradicates breast cancer cells through ROS-JNK-Bcl-2-mediated signalling pathways in vitro and it is argued that autophagy acts as protective mechanism in the treated cells before apoptosis occurs.
Egg Coat Proteins Activate Calcium Entry into Mouse Sperm via CATSPER Channels1

Abstract During mammalian fertilization, the contact between sperm and egg triggers increases in intracellular Ca2+ concentration ([Ca2++]i) in sperm. Voltage-gated Ca2+ channels (CaVs) are believed to mediate the initial phase of [Ca2+]i increases in sperm induced by egg coat (zona pellucida [ZP]) glycoproteins, while store depletion-activated Ca2+ entry is thought to mediate the sustained phase. Using patch-clamp recording and Ca2+ imaging, we show herein that CaV channel currents, while found in spermatogenic cells, are not detectable in epididymal sperm and are not essential for the ZP-induced [Ca2+]i changes. Instead, CATSPER channels localized in the distal portion of sperm (the principal piece) are required for the ZP-induced [Ca2+]i increases. Furthermore, the ZP-induced [Ca2+]i increase starts from the sperm tail and propagates toward the head.