Miracle-dz/UniFAR-FTUs huggingface dataset:
Successful resuscitation of a patient with ropivacaine‐induced asystole after axillary plexus block using lipid infusion *

Ropivacaine 1% 40 ml was mistakenly injected as part of an axillary plexus block in an 84‐year‐old woman. After 15 min the patient complained of dizziness and drowsiness and developed a generalised tonic‐clonic seizure followed by an asystolic cardiac arrest. After 10 min of unsuccessful cardiopulmonary resuscitation, a bolus of 100 ml of Intralipid 20% (2 ml.kg−1) was administered followed by a continuous infusion of 10 ml.min−1. After a total dose of 200 ml of Intralipid 20% had been given spontaneous electrical activity and cardiac output was restored. The patient recovered completely. We believe the cardiovascular collapse was secondary to ropivacaine absorption following the accidental overdose. This case shows that lipid infusion may have a beneficial role in cases of local anaesthetic toxicity when conventional resuscitation has been unsuccessful.
Infectious postoperative complications decrease long-term survival in patients undergoing curative surgery for colorectal cancer: a study of 12,075 patients.

OBJECTIVE We sought to characterize the effect of postoperative complications on long-term survival after colorectal cancer (CRC) resection. BACKGROUND The impact of early morbidity on long-term survival after curative-intent CRC surgery remains controversial. METHODS The Veterans Affairs Surgical Quality Improvement Program and Central Cancer Registry databases were linked to acquire perioperative and cancer-specific data for 12,075 patients undergoing resection for nonmetastatic CRC (1999-2009). Patients were categorized by presence of any complication within 30 days and by type of complication (noninfectious vs infectious). Univariate and multivariate survival analyses adjusted for patient, disease, and treatment factors were performed, excluding early deaths (<90 days). Subset analysis was performed to determine the specific impact of severe postoperative infections. RESULTS The overall morbidity and infectious complication rates were 27.8% and 22.5%, respectively. Patients with noninfectious postoperative complications were older, had lower preoperative serum albumin, had worse functional status, and had higher American Society of Anesthesiologists scores than patients with infectious complications and without complications (all P < 0.001). The presence of any complication was independently associated with decreased long-term survival [hazard ratio, 1.24; 95% confidence interval (1.15-1.34)]. Multivariate analysis by complication type demonstrated increased risk only with infectious complications [hazard ratio, 1.31; 95% confidence interval (1.21-1.42)]. Subset analysis demonstrated this effect predominantly in patients with severe infections [hazard ratio, 1.41; 95% confidence interval (1.15-1.73)]. CONCLUSIONS The presence of postoperative complications after CRC resection is associated with decreased long-term survival, independent of patient, disease, and treatment factors. The impact on long-term outcome is primarily driven by infectious complications, particularly severe postoperative infections.
Optimization of wireless sensor networks MAC protocols using machine learning; a survey

With the advent of Internet of Things IoT, it is expected that the growth of Wireless Sensor Networks WSN will increase exponentially as it provides a medium for IoT to sense the real-world environment. The increase on the number WSN nodes will result in deteriorating performance at Medium Access Control MAC layer. This paper provides a review on the recent applications of Machine Learning to improve the performance of MAC in WSN in terms of throughput, energy efficiency and latency.
Current and advancing treatments for metastatic colorectal cancer

Introduction: Colorectal cancer (CRC) is one of the leading causes of cancer deaths worldwide. Despite the introduction of several new drugs targeting the vascular endothelial growth factor or epidermal growth factor receptor (EGFR) signaling pathways, survival and disease control in metastatic CRC remains poor. Areas covered: Chemotherapy based on fluoropyrimidines and irinotecan or oxaliplatin has been the cornerstone of CRC standard of care for several decades. Optimal regimens are selected according to toxicity profiles and patient characteristics. The addition of targeted drugs inhibiting angiogenesis, notably bevacizumab, aflibercept and ramucirumab, has improved chemotherapy outcomes in metastatic CRC. Anti-EGFR agents, cetuximab and panitumumab, in combination with chemotherapy have also improved survival in patients with wild-type RAS tumors. In the refractory setting, there are emerging drugs such as regorafenib or TAS-102 that also have demonstrated impact on outcomes. Expert opinion: Drugs targeting signaling pathways involved in tumorigenesis improve patient outcomes over chemotherapy alone. Determining the most suitable combination and sequence should be carefully selected, with studies yet to provide a definitive solution to this unknown. Molecular mechanisms of colorectal cancer are at the forefront of research. Knowledge in this domain will help overcome resistance to therapies and introduce new drugs in the personalized CRC therapeutic scenario.
Prevalence of Arbovirus Infections among Pregnant Women at a Maternity Hospital School

Objective: Survey the prevalence of arbovirus infections among pregnant women provided with care at a maternity hospital school in Recife, Pernambuco, Brazil. Method: Descriptive, cross-sectional, retrospective, and quantitative study, carried out with data collected from the notification forms filled in during obstetric screening between August 2015 and July 2016. Results: Positive serology was found for arboviruses in 40.2% of the 103 suspected cases. Serology was not performed or it showed inconclusive results in 59.8% of the cases. Dengue fever occurred in 44% of the cases, chikungunya in 34%, and zika fever in 22%. Infections were more frequent among pregnant women over 20 years old, with low income and low schooling levels, living in Recife (48.5%) and Olinda, Pernambuco, Brazil (24.3%). The most frequently mentioned symptoms were arthralgia (94%), exanthema (82%), and fever (78%). Infections occurred within the first trimester of pregnancy (54.5%), 63.3% of the pregnant women had to be hospitalized, and 45.4% of them did not undergo morphological ultrasonography. Most babies were born full-term and they had adequate weight. The prevalence of microcephaly was 9.7% when considering cases of arbovirose and 62.5% when considering specific cases of zika fever. Conclusion: The prevalence and repercussions of arboviruses justify the consolidation of actions to fight Aedes aegypti, as well as the effective deployment of clinical protocols and recommendations aimed at the mother and child care.
Parity among the randomly amplified polymorphic DNA method, multilocus enzyme electrophoresis, and Southern blot hybridization with the moderately repetitive DNA probe Ca3 for fingerprinting Candida albicans

Randomly amplified polymorphic DNA (RAPD) analysis, multilocus enzyme electrophoresis (MLEE), and Southern blot hybridization with moderately repetitive DNA probes have emerged as effective fingerprinting methods for the infectious fungus Candida albicans. The three methods have been compared for their capacities to identify identical or highly related isolates, to cluster weakly related isolates, to discriminate between unrelated isolates, and to assess microevolution within a strain. By computing similarity coefficients between 29 isolates from three cities within the continental United States, strong concordance of the results is demonstrated for RAPD analysis, MLEE, and Southern blot hybridization with the moderately repetitive probe Ca3, and weaker concordance of the results is demonstrated for these three fingerprinting methods and Southern blot hybridization with the moderately repetitive probe CARE2. All methods were also demonstrated to be able to resolve microevolution within a strain, with the Ca3 probe exhibiting the greatest resolving power. The strong correlations demonstrated between polymorphic markers assessed by the four independent fingerprinting methods and the nonrandom association between loci demonstrated by RAPD analysis and MLEE provide evidence for strong linkage disequilibrium and a clonal population structure for C. albicans. In addition, a synapomorphic allele, Pep-3A, was found to be present in all members of one of the three clusters discriminated by RAPD analysis, MLEE, and Ca3 fingerprinting, supporting the concordance of the clustering capacities of the three methods, the robustness of the clusters, and the clonal nature of the clusters.
A modified new method for estimating smoking-attributable mortality in high-income countries

Preston, Glei, and Wilmoth (2010) recently proposed an innovative regression-based method to estimate smoking-attributable mortality in developed countries based on observed lung cancer death rates. Their estimates for females, however, differ appreciably from some published estimates. This article presents a modified version of the Preston, Glei, and Wilmoth method that includes an age-period interaction term in its model. This modified version produces improved estimates of smoking-attributable mortality that are consistent with results from a modified version of the Peto-Lopez indirect method.
A linkage study of the N‐methyl‐D‐aspartate receptor subunit gene loci and schizophrenia in southern African Bantu‐speaking families

Both direct and indirect evidence implicate excitatory amino acid neurotransmission in the aetiology of schizophrenia. The data are particularly suggestive for N-methyl-D-aspartate (NMDA) neurotransmission. Four of the six genes coding for subunits of the neuronal NMDA receptor have been mapped. We have studied segregation and allele sharing of markers in these four regions in a sample of southern African Bantu-speaking families multiply affected with DSM-III-R schizophrenia. This population was chosen because anthropological and linguistic data suggest that it has diverged from a small initial population within the past 1000 years, making shared genetic aetiology more likely. We find positive LOD score maxima of 0.876 at marker D9S1838 on chromosome 9q34.3 near the NMDARl central subunit gene, 0.758 at marker D17S784 on chromosome 17q25 near the NMDAR2C potentiating subunit gene, and 0.453 at marker D12S77 near the NMDAR2B gene on chromosome 12p12 when analysing affected samples only. Only the region of NMDAR2A, on chromosome 16p13, can be excluded in this population. There is evidence of increased allele sharing on chromosomes 9q34.3 and 17q25 using APM. Multipoint allele-sharing analysis using GENEHUNTER does not reject possible effects on chromosome 9q34.3, but does not support any involvement of chromosome 17q25. We propose that the NMDA receptor may be involved in the genetic predisposition to schizophrenia in this population through covariation in several of the subunits, which is consistent with the genetic models for the inheritance of the disease.
Effects of Polyurethane Coated Urea Supplement on In vitro Ruminal Fermentation, Ammonia Release Dynamics and Lactating Performance of Holstein Dairy Cows Fed a Steam-flaked Corn-based Diet

Three experiments were conducted to investigate the effects of polyurethane coated urea on in vitro ruminal fermentation, ammonia release dynamics and lactating performance of Holstein dairy cows fed a steam-flaked corn-based diet. In Exp. 1, a dual-flow continuous culture was run to investigate the effect of polyurethane coated urea on nutrient digestibility, rumen fermentation parameters and microbial efficiency. Three treatment diets with isonitrogenous contents (13.0% CP) were prepared: i) feed-grade urea (FGU) diet; ii) polyurethane coated urea (PCU) diet; and iii) isolated soy protein (ISP) diet. Each of the diets consisted of 40% steam-flaked corn meal, 58.5% forages and 1.5% different sources of nitrogen. PCU and FGU diets had significantly lower digestibility of NDF and ADF (p<0.01) than the ISP diet. Nitrogen source had no significant effect (p = 0.62) on CP digestibility. The microbial efficiency (expressed as grams of microbial N/kg organic matter truly digested (OMTD)) in vitro of the PCU diet (13.0 g N/kg OMTD) was significantly higher than the FGU diet (11.3 g N/kg OMTD), but comparable with the ISP diet (14.7 g N/kg OMTD). Exp. 2, an in vitro ruminal fermentation experiment, was conducted to determine the ammonia release dynamics during an 8 h ruminal fermentation. Three treatment diets were based on steam-flaked corn diets commonly fed to lactating cows in China, in which FGU, PCU or soybean meal (SBM) was added to provide 10% of total dietary N. In vitro NH 3 -N concentrations were lower (p<0.05) for the PCU diet than the FGU diet, but similar to that for the SBM diet at all time points. In Exp. 3, a lactation trial was performed using 24 lactating Holstein cows to compare the lactating performance and blood urea nitrogen (BUN) concentrations when cows were fed PCU, FGU and SBM diets. Cows consuming the PCU diet had approximately 12.8% more (p = 0.02) dietary dry matter intake than those consuming the FGU diet. Cows fed the PCU diet had higher milk protein content (3.16% vs. 2.94%) and lower milk urea nitrogen (MUN) concentration (13.0 mg/dl vs. 14.4 mg/dl) than those fed the FGU diet. Blood urea nitrogen (BUN) concentration was significantly lower for cows fed the PCU (16.7 mg/dl) and SBM (16.4 mg/dl) diets than the FGU (18.7 mg/dl) diet. Cows fed the PCU diet had less surplus ruminal N than those fed the FGU diet and produced a comparable lactation performance to the SBM diet, suggesting that polyurethane coated urea can partially substitute soybean meal in the dairy cow diet without impairing lactation performance.
Inhibition of tumorigenesis driven by different Wnt proteins requires blockade of distinct ligand-binding regions by LRP6 antibodies

Disregulated Wnt/β-catenin signaling has been linked to various human diseases, including cancers. Inhibitors of oncogenic Wnt signaling are likely to have a therapeutic effect in cancers. LRP5 and LRP6 are closely related membrane coreceptors for Wnt proteins. Using a phage-display library, we identified anti-LRP6 antibodies that either inhibit or enhance Wnt signaling. Two classes of LRP6 antagonistic antibodies were discovered: one class specifically inhibits Wnt proteins represented by Wnt1, whereas the second class specifically inhibits Wnt proteins represented by Wnt3a. Epitope-mapping experiments indicated that Wnt1 class-specific antibodies bind to the first propeller and Wnt3a class-specific antibodies bind to the third propeller of LRP6, suggesting that Wnt1- and Wnt3a-class proteins interact with distinct LRP6 propeller domains. This conclusion is further supported by the structural functional analysis of LRP5/6 and the finding that the Wnt antagonist Sclerostin interacts with the first propeller of LRP5/6 and preferentially inhibits the Wnt1-class proteins. We also show that Wnt1 or Wnt3a class-specific anti-LRP6 antibodies specifically block growth of MMTV-Wnt1 or MMTV-Wnt3 xenografts in vivo. Therapeutic application of these antibodies could be limited without knowing the type of Wnt proteins expressed in cancers. This is further complicated by our finding that bivalent LRP6 antibodies sensitize cells to the nonblocked class of Wnt proteins. The generation of a biparatopic LRP6 antibody blocks both Wnt1- and Wnt3a-mediated signaling without showing agonistic activity. Our studies provide insights into Wnt-induced LRP5/6 activation and show the potential utility of LRP6 antibodies in Wnt-driven cancer.
Impact of Thyroid Dysfunction on Serum Cystatin C, Serum Creatinine and Glomerular Filtration Rate

Impact of Thyroid Dysfunction on Serum Cystatin C, Serum Creatinine and Glomerular Filtration Rate Aim. The aim of this cross-sectional, prospective, randomized, longitudinal study was to asses serum cystatin C (Cys C) and creatinine concentrations and glomerular filtration rate (GFR) in thyroid dysfunction. Material and Methods. We have measured Cys C, creatinine and GFR using the 99mTc-DTPA technique in 35 patients (26 females and 9 males; 43 ± 11 years), 15 with newly diagnosed hyperthyroidism (TSH < 0.07 mIU/L, fT4 > 24 pmol/L) and 20 with newly diagnosed hypothyroidism (TSH > 4.5 mIU/L, fT4 < 9 pmol/L), at baseline and when they became euthyroid (TSH 0.4-4.5 mIU/L, fT4 9-24 pmol/L). The patients had no history of kidney disease and were subdivided into 2 groups: age (>50 and <50 years) and fT4 (40-100 pmol/L; >100 pmol/L) - hyperthyroid and TSH (4.5 - 48 mIU/L; > 48 mIU/L) - hypothyroid group. Thirty five age- and sex-matched normal subjects served as controls. Results. Increased creatinine levels in hypothyroid patients 115 ± 12 μmol/L decreased after treatment to 95 ± 14 μmol/L and reduced values in hyperthyroid patients 53.6 ± 12 μmol/L increased after treatement to 75.2 ± 14 μmol/L (p<0.05). Cys C ranged from 0.88 ± 0.7 mg/L before to 1.24 ± 0.5 mg/L after treatment in hypothyroid and 1.65 ± 0.5 mg/L before to 0.96 ± 0.5 mg/L after treatment in hyperthyroid patients (p<0.01). Hyperthyroid subjects exhibited significant increase in GFR ranging from 144.1 ± 18 mL/min before to 123.7 ± 24 mL/min after treatment. Hypothyroid group exhibited significant decrease in GFR ranging from 81.1 ± 28 mL/min before to 103.7 ± 24 mL/min after treatment (p<0.01). The significant difference between GFR values assessed by the isotope technique and values assessed by the serum markers indicates that further work needs to be performed to confirm which method is giving the true reflection of GFR in thyroid dysfunction.
Glutathione-independent maleylacetoacetate isomerase in gram-positive bacteria

Nocardia globerula CL1 produced a glutathione-independent maleylacetoacetate isomerase after growth on L-tyrosine. Partial purification of this isomerase demonstrated its independence of low-molecular-weight cofactors such as glutathione. Similar glutathione-independent maleylacetoacetate isomerases were present in three other gram-positive bacteria grown on tyrosine.
Maternal Toxicity With Continuous Nevirapine in Pregnancy: Results From PACTG 1022

Objective: To compare the safety of nelfinavir and nevirapine-based antiretroviral treatment in HIV–1-infected pregnant women. Methods: In Pediatric AIDS Clinical Trials Group Protocol 1022, 38 antiretroviral-naive pregnant women at 10–30 weeks' gestation were randomized to nelfinavir or nevirapine with zidovudine plus lamivudine. The study was suspended because of greater than expected toxicity and changes in nevirapine prescribing information. The incidence of treatment-limiting hepatic or cutaneous toxicity was compared between groups for all subjects and for the subset with CD4 cell counts greater than 250 cells/μL at study entry. Results: Toxicity was seen in 1 (5%) of 21 subjects randomized to nelfinavir and 5 (29%) of 17 subjects randomized to nevirapine (P = 0.07). Within the nevirapine group, 1 subject developed fulminant hepatic failure and died, and another developed Stevens-Johnson syndrome. The one adverse event associated with nelfinavir occurred in a subject with a CD4 cell count less than 250 cells/μL. All 5 events among subjects with a CD4 cell count greater than 250 cells/μL were associated with nevirapine (P = 0.04). Conclusions: Continuous nevirapine may be associated with increased toxicity among HIV-1-infected pregnant women with CD4 cell counts greater than 250 cells/μL, as has been observed in non-pregnant women.
The endotoxin binding and antioxidative properties of ceramic granules.

OBJECTIVE To investigate the possible antimicrobial activities and the detoxification (endotoxin binding and free radical scavenging) properties of Cerdak. METHOD In order to measure the antimicrobial activity of Cerdak, microorganisms were separately inoculated into nutrient agar in the presence of Cerdak, and growth was observed over 48 hours. Cerdak was incubated with 4000EU/ml endotoxin, and the residual endotoxin was determined over 24 hours. The decrease in the colour of ABTS and DPPH (inorganic free radicals) in the presence of Cerdak was colourimetrically monitored as a measure of Cerdax's free radical scavenging ability. DNA was exposed to hydrogen peroxide and ultraviolet irradiation in the presence and absence of Cerdak. The DNA strand break was then observed through electrophoresis. RESULTS While Cerdak had little or no antibacterial activities, it demonstrated a high water and endotoxin-binding capacity. It also protected DNA from damage by reactive oxygen species. CONCLUSION The detoxification properties of Cerdak could contribute to its healing abilities.
Cyclosporin-A-induced gingival overgrowth in renal transplant children.

Gingival overgrowth was assessed in renal transplant children, 19 boys and 13 girls, aged 2.5-18 yr, who had been on a cyclosporin-A (CsA)-based immunosuppressive regimen for at least 12 months. Data collected included number of posttransplant months, total CsA dose administered during the first 6 posttransplant months, oral dose and blood trough level of CsA on the day of examination, plaque accumulation (VPI%), gingival inflammation (GBI%), loss of attachment, and gingival overgrowth. Thirteen percent of the children exhibited gingival overgrowth characterized by one or more units with increased sulcus probing depth (> or = 4 mm), i.e. pseudopockets. The total amount of CsA administered during the first 6 posttransplant months was significantly higher in the children with gingival overgrowth than in those without. The study indicates that the development of CsA-induced gingival overgrowth is positively related to the total dose of the drug administered to the children during the first 6 posttransplant months.
How does rheumatoid arthritis affect corneal biomechanical properties ?

The aim of this study was to investigate the corneal alterations occurring in rheumatoid arthritis (RA) patients compared with healthy subjects and to define the presence of biomechanical alterations in cornea accompanying dry eye disease, the most common ocular manifestation of RA. Forty-seven RA patients and 40 control cases without any known systemic or ocular diseases were included in this prospective, cross-sectional study. All subjects underwent a complete ophthalmologic examination. For the diagnosis of dry eye disease; the symptoms were asked, Break up Time and Schirmer tests were applied. The Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, NY) was used to measure the biomechanical properties of the cornea. In RA group, 19 (40.4%) patients had the diagnosis of dry eye disease, but it was present in only one of the control cases (P=0.001). There was a significant difference between groups regarding the mean intraocular pressure (IOP) (P=0.04) but not the mean central corneal thickness values (P=0.56). Although there was not a statistically significant difference between RA group and control cases regarding corneal hysteresis and corneal resistance factor, IOPcc and IOPg were statistically significantly lower in RA group (P=0.03 and P=0.04, respectively). There is conflicting data in the literature about the effects of RA on the biomechanical properties of the cornea. Clinicians should be aware of these alterations since it may cause underestimated IOP readings in RA eyes. Larger prospective studies are warranted to determine the alterations on biomechanical properties of the cornea among RA patients, annually.