Miracle-dz/UniFAR-FTUs huggingface dataset:
Higher Dose Dexamethasone Increases Early Postoperative Cognitive Dysfunction

Objective: To investigate the effects of intravenous administration of dexamethasone on early postoperative cognitive dysfunction (POCD). Methods: In this prospective randomized trial, 1000 patients with facial spasm undergoing microvascular decompression (MVD) were randomly assigned to receive normal sodium (Dex-0 group, n=333), dexamethasone 0.1 mg/kg (Dex-1 group, n=333), or dexamethasone 0.2 mg/kg (Dex-2 group, n=334). Exclusion criteria included: a history of neurologic or mental disease, renal failure, active liver disease, cardiac or pulmonary dysfunction, endocrine, metabolic, or peptic ulcer disease, a history of past surgery, <6 years of schooling, inability to complete neuropsychological testing, visual dysfunction, and auditory dysfunction. Patients were also excluded at any point if additional steroid was required. Propofol and sufentanil were administered for anesthetic induction, whereas propofol and remifentanil were given for maintenance of anesthesia. A battery of 9 neuropsychological tests was administered preoperatively and the on day 5 postoperatively. A postoperative deficit was defined as a postoperative decrement to preoperative score of >1SD on any test. Patients who experienced >2 deficits were considered to have experienced early POCD. Results: Nine hundred and fifty-four patients completed both preoperative and postoperative neuropsychological testing. Within the 3 groups: Dex-0 group, n=319; Dex-1 group, n=320 and Dex-2, n=315. POCD occurred in 71 patients (22.3%) in the Dex-0 group, in 66 patients (20.6%) in the Dex-1 group, and 99 patients (31.4%) in the Dex-2 group. POCD was significant among the 3 groups (P=0.003). Partitions of &khgr;2 method was applied for multiple comparisons showing that Dex-2 group was significantly different from Dex-1 and Dex-0 groups. Conclusions: Administration of higher dose of dexamethasone (0.2 mg/kg) increases the incidence of POCD in the early postoperative period after microvascular decompression under general anesthesia.
STUDY ON EFFECT OF CHEMICAL FERTILIZER AND VERMICOMPOST ON GROWTH OF CHILLI PEPPER PLANT ( CAPSICUM ANNUM )

Increase in application of inorganic fertilizers in agriculture has detoriated the soil quality. Vermicompost as a soil conditioner has been emerging as a potential end use for maintaining soil productivity. The paper examines the effect of chemical fertilizer and vermicompost on the growth of Capsicum annum crop. Initially analysis of soil was done in order to know its composition and lacking nutrients. Urea as chemical fertilizer was applied for the comparative study with vermicompost. Fertilizer at the rate of 0, 5, 10, 15 and 20% concentration was applied in the plot. Plant height, leaf length, number of leaves per plant, chlorophyll content in leaves, fresh weight, dry weight etc. were measured. Significant increase in plant height, leaf length and fruit yield of pepper plants was observed in plots treated with vermicompost. Maximum leaf chlorophyll content, 2.9% was estimated from the vermicomposting plot of 20%. Effective results were obtained after application of organic fertilizer as compared to the chemical fertilizer. Hence, in some fields if organic fertilizer applied at appropriate dose, it shows the potential to act as growth promoter for particular crop.
Image-guided thermal ablation might be a way to compensate for image deriving cancer overdiagnosis: Author reply

We thank Dr. Mauri for his interest in our study. We are happy to find that he generally supports our study [1] and we quite agree with his commentary. As mentioned, it remains to be determined when minimally invasive percutaneous treatments will play an important role in the management of patients with primary thyroid cancers. However, still we have some important issues. First, although our study presented favourable results in aged people with primary thyroid cancers [1], it must be strictly investigated whether these treatment modalities can play a similar role in younger people, serving as an alternative to active surveillance or surgery in the general population with primary thyroid cancers. Second, we have limited accuracy to detect lymph node metastasis [2,3]. It is important to carefully evaluate lymph node metastasis to identify best candidates for interventional therapy. To achieve this goal, better diagnostic criteria are needed to identify lymph node metastasis. However, interventional therapy for primary thyroid cancer may be beneficial, even if there are undetectable lymph node metastasis. Whether interventional therapy is beneficial or harmful to patients with lymph node metastasis is undetermined. Dr. Mauri commented the potential systemic effects of local tumour ablation, which could provide rationale for ablative therapy to the primary cancers. Finally, still we have issues of imaging criteria. We do not know which size criteria, as determined by imaging, are appropriate for interventional therapy. Cancer location may also be an important selection criterion; an example is the distance between cancer and thyroid capsule. In this regard, we clearly agree with Dr. Mauri’s comment that further well-designed studies are mandatory.
Intravenous Immunoglobulin (IVIG) in the Prevention of Implantation Failures

The recent spread of very sensitive P-hCG assays and assisted reproductive technologies has revealed how high the rate of very early and preclinical abortions This has made clear that implantation is the true limiting factor of human reproduction. Implantation necessarily implies a specific immunologic interaction between the embryo and the mother: many immune modifications have been claimed in recent literature to explain the tolerance of the fetal allograft . 3,4 This immune approach has given a theoretical basis to different therapeutic strategies for recurrent abortions involving either a partner or donor leukocyte active immuni~a t ion ’ . ~ or passive immunization by intravenous immunoglobulins (WIG)’ to prevent implantation failures. * This work, based on a previous preliminary investigation,’ aims to verify the effectiveness of IVIG treatment in the prevention of implantation failures in an open randomized comparative study versus placebo and to identify possible parameters predictive of conditions liable to be successfully treated by this protocol.
Pathology of Lacunar Ischemic Stroke in Humans—A Systematic Review

Twenty‐five percent of ischemic strokes are lacunar in type, but the cause remains unclear. Pathological descriptions of lacunar lesions are available but have not been systematically assessed. We therefore systematically summarized studies describing lacunar lesions by extracting data on the number of patients and lesions, clinical details, pathological methods, brain regions and/or vessels examined, and both parenchymal and vascular findings.
Prognostic features and treatment outcome in patients with nasopharyngeal carcinoma: an experience of 20 years.

BACKGROUND The best treatment of Nasopharyngeal Carcinoma (NPC) is still an open question. The purpose of this retrospective study was to determine risk factors that affect locoregional control and treatment outcome of NPC patients after radiotherapy, with or without chemotherapy. METHODS Between January 1976 and December 1996, 66 consecutive patients (stage I = 0; stage II = 13; stage III = 32; stage IV = 21) were given definitive radiotherapy at a single Institution. Concurrent or adjuvant chemotherapy was also given to 14 of them (21%). Multivariate analysis was performed to evaluate age, T stage, N stage, radiotherapy dose, histology, chemotherapy bone of skull erosions or cranial nerve palsies and base of skull involvement as prognostic factors of locoregional control and overall survival. RESULTS By the end of January 2000, after a median follow-up of 66 months and a minimal follow-up of 36 months, the event-free overall survival rate of 5 years was 48% and the overall survival 54%. Risk factor analysis revealed that radiotherapy dose, age and stage were the most important factors for overall survival of these patients. The 5 year overall survival was 89% for stage II and 49% for stage III-IV (p = 0.004), 62% for dose higher than 60 Gy and 20% for dose below 60 Gy (p = 0.007), 62% for age below 65 years and 36% for age higher than 65 years (p = 0.027). The concurrent or adjuvant chemotherapy did not have prognostic significance. CONCLUSIONS We confirm the need to determine the risk factors in patients with NPC. The choice of treatment, whether radiotherapy alone, at dose > 60 Gy, or radiotherapy plus chemotherapy, should be made after identification of patients with high risk disease, suitable for the combined modality.
Divergence of Angiogenic and Vascular Permeability Signaling by VEGF: Inhibition of Protein Kinase C Suppresses VEGF-Induced Angiogenesis, but Promotes VEGF-Induced, NO-Dependent Vascular Permeability

Vascular endothelial growth factor (VEGF) promotes angiogenesis by a variety of mechanisms including stimulation of endothelial cell proliferation and migration and increasing vascular permeability. Although its mitogenic activity is mediated primarily by the &bgr;2-isoforms of protein kinase C (PKC), little is known about the signaling pathways transducing its other physiological properties. Accordingly, we used a novel inhibitor molecule to examine the role of PKC isoforms &agr; and &bgr; in mediating VEGF-induced angiogenesis and vascular permeability. Because conventional inhibitors of PKC, such as staurosporine or calphostin C, also inhibit a variety of other protein kinases, we used a novel compound to specifically inhibit PKC. A myristoylated peptide, which mimics the pseudosubstrate motif of PKC-&agr; and -&bgr; subtypes, has been shown to be a highly selective and cell-permeable inhibitor of PKC. Blocking led, as expected, to abrogation of VEGF-induced endothelial cell proliferation in vitro. In vivo, VEGF-induced angiogenesis was impaired by myristoylated peptide. Surprisingly, selective inhibition of PKC induced vascular permeability in vivo via a NO-dependent mechanism. Moreover, PKC inhibition led to a 6.4-fold induction of NO synthase (NOS) activity in endothelial cells. Our findings demonstrate that activation of PKC is a major signaling pathway required for VEGF-induced proliferation and angiogenesis, whereas vascular permeability was enhanced by blocking PKC. Inhibition of calcium-dependent PKC by itself led to induction of NOS. Although NOS is a downstream target for VEGF-induced angiogenesis, its induction by PKC inhibition was not sufficient to promote neovascularization. These results reveal that angiogenesis and vascular permeability induced by VEGF are mediated by mechanisms which ultimately diverge.
Erythropoietic stimulating agents

Importance of the field: The synthesis of recombinant forms of erythropoietin, epoetin α, β and darbepoetin α, has represented a major achievement in anemia therapy. Areas covered in this review: This review analyzes the therapeutic options of existing erythropoietic stimulating agents (ESAs) in patients with cancer, renal and heart failure anemia and shows the main features of new ESAs under development. Peer-reviewed scientific literature and abstracts published during the last 10 years were reviewed. What the reader will gain: Randomized clinical trials carried out in patients with anemia associated with chronic renal disease or malignancies have consistently demonstrated that ESAs increase hemoglobin levels, reduce blood transfusion requirements and improve quality of life. However, in spite of the positive effects, treatment with ESAs, particularly in oncologic patients, is associated with an increased mortality and cardiovascular complications. These observations imply the absolute need for using ESAs in the context of currently available guidelines. Take home message: A razionalization in the clinical use of ESAs according to current guidelines is required to improve the benefits derived from therapy with these drugs. New ESAs are under development and their introduction in therapy could provide a significant improvement in anemia management.
OPTIMIZATION OF REGENERATION PROTOCOLS FOR WHEAT UNDER DROUGHT AND SALT STRESS

Responses of the wheat genotype ‘Faisalabad-2008’ to plant regeneration using immature embryos and in vitro drought and salt stress tolerance were investigated. For this study immature embryos 15 DAP (Days After Pollination) were used and after 6 weeks healthy calli were transferred to media containing variable concentrations of NaCl (0, 5, 10, and 15g/L) and drought stress intensities using PEG 6000 (0, 5, 10, 15 and 20% (w/v)). The findings suggested that the embryogenic capacity of callus depended on concentrations of exogenous hormones and the genetic makeup of the genotype. Faisalabad-2008 showed good callus induction and ability to proliferate and regenerate seedlings under drought and salt stress conditions. This study will serve as a guide line in future for in vitro screening of wheat varieties for their regeneration ability using indirect methods. Further establishment of in-vitro screening protocols for abiotic stress tolerance will facilitate screening of genotypes during early developmental stages.
Estimation of Lightning Incidence to Overhead Transmission Lines

General expressions for the estimation of lightning incidence to overhead transmission lines on the basis of electrogeometric and generic models are introduced, which consider, besides transmission-line geometry, lightning crest current distribution and, based on the recently proposed statistical model, interception probability distribution. An application to typical 115 kV up to 765 kV and large scale 500 kV and UHV overhead transmission lines is performed and the computed results, varying significantly among lightning attachment models, are validated through comparisons with field data from literature; the IEEE Std 1243 overestimates significantly lightning incidence to shield wires of large scale transmission lines. The expected annual number of lightning strikes to shield wires of transmission lines depends on lightning crest current distribution; this dependence, easily quantified with the aid of the introduced general expressions, is not considered by the relevant IEEE standard. Lightning incidence results are discussed in the context of the backflashover rate of overhead transmission lines.
Dopamine risk and paternal ADHD symptomatology associated with ADHD symptoms in four and a half-year-old boys

Objective This study examined the influence of allelic variation in two dopamine genes, the dopamine receptor D4 (DRD4) gene and the dopamine transporter D1 (DAT1) gene, and paternal attention-deficit hyperactivity disorder (ADHD) symptomatology on the level of ADHD symptoms in 96 four and a half-year-old boys. Method DNA was collected by means of a buccal swab and genotyped for DRD4 and DAT1. Mothers completed the Dupaul ADHD checklist on their sons. ADHD symptomatology ratings for fathers were based on a summed father self-reported and spouse-reported symptoms (Conners Adult ADHD Rating Scale). Results There were main effects for DAT1 and father symptomatology for the child Total ADHD and Hyperactivity–Impulsivity scores. The main effects for DRD4 were limited to the child Hyperactivity–Impulsivity scores. Child Inattentive scores were influenced only by father symptomatology. Interaction effects between DAT1 and DRD4 and between DAT1 and the father ADHD risk group were found for child Hyperactivity–Impulsivity scores. Boys with the highest level of symptomatology were those with the 10/10 DAT1 genotype and the DRD4-7 genotype or fathers with high symptomatology. Conclusion The findings of this study indicate that the risk for ADHD, particularly hyperactivity–impulsivity, is exacerbated in the presence of dopamine risk genes and paternal ADHD symptomatology. This study adds to the growing literature on the efficacy of including multiple genetic and environmental risk factors in studies related to the development of psychopathology.
Erythroderma associated with mixed lymphocyte endothelial cell interaction and Staphylococcus aureus infection

We report 11 consecutive cases of erythroderma, a high percentage of which were associated with the growth of Staphylococcus aureus in cultures from blood, joint fluid or skin. In biopsies from all the patients we found close morphological associations between lymphocytes and endothelial cells, with some of the lymphocytes showing features of blastoid transformation to T helper lymphocytes. In extreme cases, sheets of T cells, including T helper lymphocytes, formed a syncytium with endothelial cells in the dermis. Marked capillary proliferation was noted both on light and electron miroscopy. We suggest that erythroderma is precipitated by antigens such as protein A, a potent T cell mitogen present on the cell surface of Staphylococcus aureus, or by drugs, such as phenytoin. These antigens induce antigen presentation by individual endothelial cells, leading to T helper transformation and lymphocyte proliferation. Endothelial proliferation resulting from lymphocyte‐endothelial interaction results in the vascular proliferation associated with this syndrome.
Lower Limb Wrapping Prevents Hypotension, but Not Hypothermia or Shivering, After the Introduction of Epidural Anesthesia for Cesarean Delivery

The decrease of arterial blood pressure and body temperature after epidural or spinal anesthesia is thought to be the result of sympathetic block, which could cause pooling and redistribution of blood into the lower extremities. Studies have demonstrated that leg wrapping with elastic bandages may reduce the incidence of hypotension after spinal anesthesia. We tried to extend these previous observations to epidural anesthesia by testing the hypothesis that leg wrapping with elastic bandages should decrease the incidence of hypotension in patients receiving epidural anesthesia. Moreover, we evaluated the effect of this maneuver as regards hypothermia and shivering. Sixty parturients were randomly allocated to receive either leg wrapping with tight elastic bandages (leg-wrapped group) or not (control group) before anesthesia. Sublingual temperature was observed at five periods: baseline, immediately after epidural anesthesia, abdominal skin disinfection, skin incision, and delivery. Hypotension and shivering during the observation periods were also recorded. The incidence of hypotension was significantly less frequent (P =0.03) in the leg-wrapped group (23%) compared with the control group (50%). Shivering incidences were similar in both groups (70% versus 70%). Sublingual temperature decreased significantly (P < 0.001) throughout the procedure in each group. However, no differences were found between the two groups at each designated observation, even if compared by the magnitude of temperature decrease. We conclude that although leg wrapping with elastic bandages prevents maternal hypotension after epidural anesthesia, it does not reduce the incidence or magnitude of hypothermia or prevent shivering.
Permeability barrier disorder in Niemann-Pick disease: sphingomyelin-ceramide processing required for normal barrier homeostasis.

Prior studies have established the requirement for enzymatic hydrolysis of glucosylceramides to ceramide for epidermal barrier homeostasis. In this study, we asked whether sphingomyelin-derived ceramide, resulting from acid-sphingomyelinase activity, is also required for normal barrier function. We showed first, that a subset of Niemann-Pick patients with severe acid-sphingomyelinase deficiency (i.e., <2% residual activity) demonstrate abnormal permeability barrier homeostasis, i.e., delayed recovery kinetics following acute barrier disruption by cellophane tape-stripping. To obtain further mechanistic insights into the potential requirement for sphingomyelin-to-ceramide processing for the barrier, we next studied the role of acid-sphingomyelinase in hairless mouse skin. Murine epidermis contains abundant acid-sphingomyelinase activity (optimal pH 5.1-5.6). Two hours following acute barrier disruption by tape-stripping, acid-sphingomyelinase activity increases 1. 44-fold (p<0.008 versus vehicle-treated controls), an increase that is blocked by a single topical application of the acid-sphingomyelinase inhibitor, palmitoyldihydrosphingosine. Furthermore, both palmitoyldihydrosphingosine and desipramine, a chemically and mechanically unrelated acid-sphingomyelinase inhibitor, significantly delay barrier recovery both 2 and 4 h after acute barrier abrogation. Inhibitor application also causes both an increase in sphingomyelin content, and a reduction of normal extracellular lamellar membrane structures, in the stratum corneum. Both of the inhibitor-induced delays in barrier recovery can be overridden by co-applications of topical ceramide, demonstrating that an alteration of the ceramide-sphingomyelin ratio, rather than sphingomyelin accumulation, is likely responsible for the barrier abnormalities that occur with acid-sphingomyelinase deficiency. These studies demonstrate an important role for enzymatic processing of sphingomyelin-to-ceramide by acid-sphingomyelinase as a mechanism for generating a portion of the stratum corneum ceramides for permeability barrier homeostasis in mammalian skin.
Factors associated with discontinuation of antiretroviral therapy in HIV-infected patients with alcohol problems

Abstract Although mortality rates among HIV-infected populations have declined with the advent of combination antiretroviral therapy (ART), patients with substance use disorders have benefited less from these therapies. While adherence to ART has been well studied, less is known about factors associated with discontinuation of ART. The aim of this study is to investigate predictors of discontinuation of ART in HIV-infected patients with alcohol problems, focusing on their substance use and depressive symptoms. The study cohort (n=266) was prospectively assessed with biannual standardised interviews between 2001 and 2005. Four predictor variables (cocaine, heroin, heavy alcohol use and substantial depressive symptoms) were assessed six months prior to the outcome (ART discontinuation). Longitudinal logistic regression models examined the association between predictor variables and ART discontinuation adjusting for age, gender, race/ethnicity, homelessness, CD4, HIV RNA and HIV Symptom Index. Subjects were 77% male; 43% black; 22% homeless; 45% used cocaine; 20% used heroin; 29% had heavy alcohol use; and 40% had substantial depressive symptoms. Discontinuation occurred in 135 (17%) of the observations (n=743). In bivariate analyses, cocaine use, heroin use and depressive symptoms were significantly associated with ART discontinuation but heavy alcohol use was not. In the multivariable model, substantial depressive symptoms (adjusted odds ratio (AOR)=1.66; 95% confidence interval (CI): 1.04, 2.65) but not cocaine (AOR=1.28; 95%CI: 0.76, 2.16) or heroin use (AOR=1.27 95%CI: 0.66, 2.44), remained significantly associated with ART discontinuation. Among HIV-infected adults with alcohol problems, depressive symptoms, but not substance use, predicted subsequent ART discontinuation. Recognition and treatment of depressive symptoms in this population may result in better maintenance of ART and its associated clinical benefits.