Miracle-dz/UniFAR-FTUs huggingface dataset:
Influence of Fluid Infusion Associated with High-volume Blood Loss on Plasma Propofol Concentrations

BackgroundIt is common clinical practice to use fluid infusion to manage high-volume blood loss until a blood transfusion is performed. The authors investigated the influence of fluid infusion associated with blood loss on the pseudo-steady state propofol concentration. MethodsTwenty-seven swine were assigned to a lactated Ringer’s solution group, a hydroxyethyl starch group, or a threefold lactated Ringer’s solution group (n = 9 in each group). After 180 min of steady state infusion of propofol at a rate of 2 mg · kg−1 · h−1, hemorrhage and infusion were induced by stepwise bleeding followed by fluid infusion every 30 min. In each of the first two steps, 400 ml blood was collected; thereafter, 200 ml was collected at each step. Just after each bleeding step, fluid infusion was rapidly performed using a volume of lactated Ringer’s solution or hydroxyethyl starch equivalent to the blood withdrawn, or a threefold volume of lactated Ringer’s solution. Hemodynamic parameters and the plasma propofol concentration were recorded at each step. ResultsAlthough the plasma propofol concentration in the lactated Ringer’s solution group increased with hemorrhage and infusion, it decreased in both the hydroxyethyl starch and the threefold lactated Ringer’s solution groups. The propofol concentration in the hydroxyethyl starch group could be expressed by the following equation: Plasma Propofol Concentration Decrease (%) = 0.80 × Hematocrit Decrease (%) (r2 = 0.83, P < 0.0001). ConclusionsWhen high-volume blood loss is managed by isovolemic hemodilution, the plasma propofol concentration during continuous propofol infusion decreases linearly with the hematocrit decrease.
Optimized Coverage and Efficient Load Balancing Algorithm for WSNs-A Survey

— Major challenge in field of wireless sensor networks (WSN) is to provide full coverage of a sensing field and connectivity of relaying nodes. Many applications—such as object tracking, healthcare, natural environment protection and battlefield intrusion detection —requires the full coverage at any time. Load balancing aims to optimize resource use, maximize throughput, minimize response time, and avoid overload of any single resource. In this paper we are over viewing techniques which are used in WSN for load balancing. The maximum cover tree (MCT) difficulty is to construct several connected cover trees and difficult in Nondeterministic Polynomial (NP)-Complete problem, Ant colony based scheduling Algorithm (ACB-SA) can used to solve the efficient coverage problem but it has time delay as drawback, And Temperature aware Algorithms that seek to save energy but the implementation is complex. In order to mitigate limitations above, Novel maximum connected load-balancing cover tree (MCLCT) algorithm is proposed and it is composed by two sub strategies: a coverage-optimizing recursive (COR) heuristic and a probabilistic load-balancing (PLB) method. This Algorithm provides the better coverage and connectivity among others which is presented as a result of this survey. Simulation results show the output in terms of energy efficiency and connectivity maintenance.
Effect of decrease in heart rate variability on the diagnostic accuracy of 64-MDCT coronary angiography.

OBJECTIVE The purpose of this study was to evaluate the effect of average heart rate and heart rate variability on the diagnostic accuracy of 64-MDCT in the assessment of coronary artery stenosis. SUBJECTS AND METHODS CT and invasive coronary angiography were performed on 114 patients (mean age, 62 years) referred for known coronary artery disease (n = 26), atypical chest pain (n = 58), and presurgical exclusion of coronary artery disease before abdominal aortic (n = 14) or cardiac valve (n = 16) surgery. The population was divided into two groups depending on median average heart rate (60.0 beats/min) and median heart rate variability (2.7 beats/min) during scanning. Heart rate variability was calculated as SD from the mean heart rate. Two blinded observers using a 4-point scale independently assessed the quality of images of each coronary artery segment and classified each segment as being stenosed (luminal diameter narrowing > 50%) or not. Invasive coronary angiography was used as the reference standard. RESULTS In 71 (62.3%) of the patients, 241 significant coronary artery stenoses were identified with invasive coronary angiography. In 11 (9.7%) of the patients, 1.6% (26/1,672) of the segments were not evaluable with CT. Overall sensitivity, specificity, and positive and negative predictive values in a patient-based analysis were 97%, 81%, 90%, and 95%, respectively. Image quality was better (p < 0.05) in the low average heart rate group than in the high average heart rate group, but diagnostic accuracy was comparable for the two groups. In contrast, image quality and diagnostic accuracy were significantly better (p < 0.01) among patients in the low heart rate variability group than in the high heart rate variability group. CONCLUSION Lower heart rate variability is associated with higher diagnostic accuracy of 64-MDCT coronary angiography.
Effects of Interleukin-11 on the Hematopoietic Action of Granulocyte Colony-stimulating Factor

Summary Interleukin-11 (IL-11, CAS 145941-26-0) is a cytokine that ameliorates thrombocytopenia induced by chemotherapy. Granulocyte colony-stimulating factor (G-CSF) is frequently used clinically as an adjuvant therapy to ameliorate neutropenia. In this study, it has been investigated whether IL-11 influences the hematopoietic action of G-CSF in vitro. IL-11 alone did not stimulate CFU-Meg colony formation in the absence of interleukin-3 (IL-3), but did in the presence of IL-3. However, IL-11 alone stimulated the formation of CFU-E, BFU-E and CFU-GM colonies, which were further enhanced by IL-3. G-CSF alone stimulated in a concentration dependent manner colony formation of CFU-GM and CFU-E, but not BFU-E or CFU-Meg. The addition of IL-11 enhanced the stimulatory effect of G-CSF on CFU-GM colony formation, and enabled G-CSF to stimulate colony formation of BFU-E, but not CFU-E. The addition of IL-3 further enhanced the stimulatory effect of G-CSF on CFU-E, BFU-E, and CFU-GM colony formation. However, G-CSF was unable to stimulate CFU-Meg colony formation for any of the cytokine combinations tested. These studies demonstrate that IL-11 has significant stimulatory effects on G-CSF-induced CFU-GM colony formation, suggesting that the therapeutic combination of the two growth factors could be beneficial for the treatment of myelosuppression induced by chemotherapy.
Human Imaging With Photon Counting–Based Computed Tomography at Clinical Dose Levels: Contrast-to-Noise Ratio and Cadaver Studies

ObjectivesThe purpose of this work was to measure and compare the iodine contrast-to-noise ratio (CNR) between a commercial energy-integrating detector (EID) computed tomography (CT) system and a photon-counting detector (PCD) CT scanner capable of human imaging at clinical dose rates, as well as to determine clinical feasibility using human cadavers. Materials and MethodsA research dual-source PCD-CT scanner was used, where the “A” tube/detector subsystem used an EID and the “B” tube/detector subsystem used a PCD. Iodine CNR was measured in 4 anthropomorphic phantoms, simulating 4 patient sizes, at 4 tube potential settings. After biospecimen committee approval, PCD scans were performed on a fresh-frozen human head and a whole-body cadaver using clinical dose rates. Scans were repeated using the EID and identical parameters, and qualitative side-by-side comparisons were performed. ResultsFor the same photon fluence, phantom measurements demonstrated a mean increase in CNR of 11%, 23%, 31%, 38% for the PCD system, relative to the EID system, at 80, 100, 120, and 140 kV, respectively. Photon-counting detector CT additionally provided energy-selective imaging, where low- and high-energy images reflected the energy dependence of the iodine signal. Photon-counting detector images of cadaveric anatomy demonstrated decreased beam hardening and calcium blooming in the high-energy bin images and increased contrast in the low-energy bins images relative to the EID images. Threshold-based PCD images were qualitatively deemed equivalent in other aspects. ConclusionsThe evaluated research PCD-CT system was capable of clinical levels of image quality at clinical dose rates. It further provided improved CNR relative to state-of-the-art EID-CT. The energy-selective bin images provide further opportunity for dual-energy and multienergy analyses.
Course and prognosis of chronic progressive multiple sclerosis: Results of an epidemiological study

ABSTRACT‐ In studies on the natural course of multiple sclerosis (MS), several forms of the disease are distinguished. The most important are the relapsing remitting and the chronic progressive forms. The relationship between these remains unclear. In a prospective epidemiological survey we studied the course of MS using the year in which the chronic‐progressive phase started as a landmark. The reliability of this “year of progression” was examined in an observer agreement study. Data were acquired from 342 patients. Progression of the handicap was most rapid in case of a secondary progressive course, female sex, high relapse rate in the preceding remitting phase and “year of progression” at a higher age. Survival after the “year of progression” was lowest in the secondary progressive group. Determining the “year of progression” seems to be significant for the prognosis.
Baseline depressive symptoms predict poor substance use outcome following adolescent residential treatment.

OBJECTIVE To characterize baseline depressive symptoms among substance-abusing adolescents and determine their association with post residential treatment substance use outcomes. METHOD In total, 153 adolescents (mean age 6.6 years, +/- 0.11) entering residential treatment were assessed at intake and at 3, 6, 9, and 12 months. Beck Depression Inventory (BDI) and Global Appraisal of Individual Needs were administered to assess depression, other risk factors, and substance use. A regression model was developed with 10 risk factors including BDI scores of >/=11 versus <11 to predict the outcome measure mean percentage of days in the past 90 days with any (nonnicotine) substance use. RESULTS At intake, 55% had BDI scores of >/=11. A baseline BDI score of >/=11 was significantly associated with greater mean percentage of days of substance use (27.5 +/- 3.8% versus 15.4 +/- 4.0% days, p <.01) across 1-year follow-up. Two other factors were significant: length of drug career >2 years and having an opioid use disorder. CONCLUSIONS Results from this prospective study, although preliminary, suggest the association of depressive symptoms with poorer substance outcomes and the utility of the BDI as a prognostic tool. They highlight the need for interventions targeting co-occurring depressive symptoms that may improve adolescent substance treatment outcomes.
Microvasculature alters the dispersion properties of shear waves – a multi‐frequency MR elastography study

Magnetic Resonance Elastography (MRE) uses macroscopic shear wave propagation to quantify mechanical properties of soft tissues. Micro‐obstacles are capable of affecting the macroscopic dispersion properties of shear waves. Since disease or therapy can change the mechanical integrity and organization of vascular structures, MRE should be able to sense these changes if blood vessels represent a source for wave scattering. To verify this, MRE was performed to quantify alteration of the shear wave speed cs due to the presence of vascular outgrowths using an aortic ring model. Eighteen fragments of rat aorta included in a Matrigel matrix (n=6 without outgrowths, n=6 with a radial outgrowth extent of ~600µm and n=6 with ~850µm) were imaged using a 7 Tesla MR scanner (Bruker, PharmaScan). High resolution anatomical images were acquired in addition to multi‐frequency MRE (ν = 100, 115, 125, 135 and 150 Hz). Average cs was measured within a ring of ~900µm thickness encompassing the aorta and were normalized to cs0 of the corresponding Matrigel. The frequency dependence was fit to the power law model cs ~νy. After scanning, optical microscopy was performed to visualize outgrowths. Results demonstrated that in presence of vascular outgrowths (1) normalized cs significantly increased for the three highest frequencies (Kruskal‐Wallis test, P = 0.0002 at 125 Hz and P = 0.002 at 135 Hz and P = 0.003 at 150 Hz) but not for the two lowest (Kruskal‐Wallis test, P = 0.63 at 100 Hz and P = 0.87 at 115 Hz), and (2) normalized cs followed a power law behavior not seen in absence of vascular outgrowths (ANOVA test, P < 0.0001). These results showed that vascular outgrowths acted as micro‐obstacles altering the dispersion relationships of propagating shear waves and that MRE could provide valuable information about microvascular changes. Copyright © 2015 John Wiley & Sons, Ltd.
PACU PTH Facilitates Safe Outpatient Total Thyroidectomy

Objective. To determine if a serum parathyroid hormone (PTH)–based discharge algorithm can be used to safely facilitate outpatient total thyroidectomy. Study Design. Case series with chart review of consecutive total and completion thyroidectomies performed by the senior author from March 2008 to November 2009. Setting. An academic tertiary care center. Subjects and Methods. At the authors’ institution, patients undergoing total or completion thyroidectomy are subject to a same-day discharge algorithm that incorporates postanesthesia care unit rapid PTH as the major discharge criterion. Patients with PTH >30 pg/mL are eligible for same-day discharge without supplementation, patients with PTH between 20 and 30 pg/mL are eligible for discharge but receive calcium supplementation, and patients with PTH <20 pg/mL are observed overnight (23 hours) with calcium and vitamin D supplementation. Results. One hundred eighty patients (mean age, 48.9 years; 83.3% female) underwent total (77.2%) or completion (22.7%) thyroidectomy with or without node dissection. Forty-two percent were performed with minimally invasive video-assisted (MIVA) technique. Seventy-six percent (137/180) of patients had a PTH >20 pg/mL, meeting the PTH discharge criterion. Sixty-nine percent (95/137) of eligible patients were discharged on the same day (53.1% of total). Ten percent of discharge-eligible patients were admitted due to drain placement. Of the 95 patients undergoing outpatient surgery, none were admitted, seen, or called for symptoms of hypocalcemia in the postoperative period. All 180 patients were eucalcemic at postoperative day (POD) 7 and POD 30 office visits. No patients were hypoparathyroid at POD 30. No significant difference in postoperative hypoparathyroidism existed between completion versus total thyroidectomy (11.1% vs 22.2%, P = .28) or MIVA versus standard technique (P = .37). Conclusion. A PTH-based discharge algorithm can safely facilitate outpatient total or completion thyroidectomy, with minimal risk of clinically significant outpatient hypocalcemia.
Overcoming Barriers to Access and Utilization of Hospice and Palliative Care Services in African-American Communities

While there is ample evidence to support the need for hospice and palliative care services for African Americans, only 8% of patients who utilize those services are from African-American communities. The underutilization of end-of-life and palliative care can be attributed to several barriers to service access including incompatibility between hospice philosophy and African-American religious, spiritual, and cultural beliefs; health care disparities; distrust of the medical establishment; physician influence; financial disincentives, and hospice admission criteria. Suggestions for dismantling barriers to care access include developing culturally competent professionals in the health and human services, expanding the philosophy of hospice to include spiritual advisors from client communities, and funding national initiatives to promote improved access to health care at all stages in the life cycle of members of all underserved communities.
Elevated prostate specific antigen and reduced 10-year survival among a cohort of Danish men consecutively referred from primary care to an urological department during 2005–2006

Abstract It remains unclear whether total prostate specific antigen (tPSA) or complex PSA (cPSA) has the best diagnostic performance. Additionally, the utility of percentage free PSA (%fPSA) is still debated. Our objectives were to compare the diagnostic performances of tPSA, cPSA, and %fPSA among patients referred from GP to an Urological Specialist and to investigate prognostic factors and survival in the cohort. A total of 1261 consecutive male patients without previously known prostate cancer (PCa) were referred to the same Department of Urology during June 2005 to August 2006. Some 299 patients were diagnosed with PCa and 962 patients were found without PCa. Among the PCa patients, the median age, tPSA, cPSA, and %fPSA levels were 70.8 years, 13.4 μg/L, 10.8 μg/L, and 12.6%. For patients without PCa the results were 67.5 years, 2.5 μg/L, 1.9 μg/L, and 24.9%. The sensitivity, specificity, PVpos, PVneg, and efficiency of tPSA and cPSA were overlapping (p > .05). In the tPSA interval >4 μg/L – ≤20 μg/L, %fPSA excluded PCa with a PVneg of 72.4%; 38.5% of PCa patients had a tPSA concentration >20 μg/L at the time of referral and these patients had a reduced 10-year survival as compared to patients with tPSA concentrations ≤20 μg/L. In conclusion, tPSA and cPSA showed similar diagnostic performances. %fPSA provided additional diagnostic information at tPSA concentrations >4 μg – ≤20 μg/L. The high percentage of patients with tPSA concentrations >20 μg/L indicate delayed use of tPSA resulting in advanced disease at presentation and reduced patient survival.
Tumor necrosis factor- (cid:1) stimulates gastric epithelial cell proliferation

Tumor necrosis factor- (cid:1) stimulates gastric epithelial cell proliferation. Am J Physiol Gastrointest Liver Physiol ajpgi.00093. 2004. —TNF- (cid:1) is a cytokine produced during gastric mucosal injury. We examined whether TNF- (cid:1) could promote mucosal repair by stimulation of epithelial cell proliferation and explored further the underlying mechanisms in a rat gastric mucosal epithelial cell line (RGM-1). TNF- (cid:1) treatment (1–10 ng/ml) for 12 or 24 h signiﬁcantly increased cell proliferation but did not induce apoptosis in RGM-1 cells. TNF- (cid:1) treatment signiﬁcantly increased cytosolic phospholipase A 2 and cyclooxygenase-2 (COX-2) protein expression and PGE 2 level but did not affect the protein levels of EGF, basic ﬁbroblast growth factor, and COX-1 in RGM-1 cells. The mRNA of TNF receptor (TNF-R) 2 but not of TNF-R1 was also increased. the effect of TNF- (cid:1) cell proliferation, with a signiﬁcant decrease in cellular COX-2 expression and PGE 2 level. A selective COX-2 inhibitor 3-(3-ﬂuorophenyl)-4-[4-(methylsulfonyl)phenyl]-5,5-dimethyl- 5 H-furan-2-one (DFU) by itself had no effect on basal cell proliferation but signiﬁcantly reduced the stimulatory effect of TNF- (cid:1) on RMG-1 cells. Combination of dexamethasone and DFU did not produce an additive effect. PGE 2 signiﬁcantly reversed the de- pressive action of dexamethasone on cell proliferation. These results suggest that TNF- (cid:1) plays a regulatory role in epithelial cell repair in the gastric mucosa via the TNF- (cid:1) receptor and activation of the arachidonic acid/PG pathway.
Imaging Proteolysis by Living Human Glioma Cells

Abstract Degradation of basement membrane is an essential step for tumor invasion. In order to study degradation in real time as well as localize the site of proteolysis, we have established an assay with living human cancer cells in which we image cleavage of quenchedfluorescent basement membrane type IV collagen (DQcollagen IV). Accumulation of fluorescent products is imaged with a confocal microscope and localized by optically sectioning both the cells and the matrix on which they are growing. For the studies described here, we seeded U87 human glioma cells as either monolayers or spheroids on a 3-dimensional gelatin matrix in which DQcollagen IV had been embedded. As early as 24 hours after plating as monolayers, U87 cells were present throughout the 3- dimensional matrix. Cells at all levels had accumulated fluorescent degradation products of DQcollagen IV intracellularly within vesicles. Similar observations were made for U87 spheroids and the individual cells migrating from the spheroids into the gelatin matrix. Both the migrating cells and those within the spheroid contained fluorescent degradation products of DQcollagen IV intracellularly within vesicles. Thus, glioma cells like breast cancer cells are able to degrade type IV collagen intracellularly, suggesting that this is an important pathway for matrix degradation.
Long-term steroid treatment and growth: a study in steroid-dependent nephrotic syndrome

Objective High-dose steroid therapy in children is known to impair growth. What is unknown is the level of steroid therapy at which children continue to grow normally. This study was designed to deduce a dosage of prednisolone compatible with normal growth. Patients and design The growth of 41 children (age 1.92–13.2 years) with steroid-dependent nephrotic syndrome (SDNS) was studied using recordings from clinic visits over the course of their follow-up at Great Ormond Street Hospital (study period range 1.38–8.43 years, mean 4.2 years, total 172 years). The height standard deviation score (SDS) and the SDS velocity between clinics were calculated, and compared to the contemporary dose of prednisolone (converted to an equivalent daily dose when on an alternate day regime). Results The mean dose of prednisolone was 0.44 mg/ kg/day (range 0.06–1.45 mg/kg/day). The mean change in height SDS velocity over the course of recording was −0.02 SDS/year (boys −0.14 SDS/year, girls +0.16 SDS/year). Overall, there was no negative effect on growth seen at doses of prednisolone of less than 0.75 mg/kg/day. At doses higher than 0.75 mg/kg/day, there was a small decline in height SDS velocity (−0.14 SDS/ year). Conclusions Overall, prednisolone treatment in these children was not shown to adversely affect their height SDS. This was true even at doses of prednisolone up to 0.5–0.75 mg/kg/day. There was some decline in height SDS seen during periods of higher steroid use (over 0.75 mg/kg/day), but periods on lower doses allowed for adequate catch up growth.