Miracle-dz/UniFAR-FTUs huggingface dataset:
Safety and efficacy of recombinant activated factor VII for refractory hemorrhage in pediatric patients on extracorporeal membrane oxygenation: a single center review

Background: Medically refractory hemorrhage in patients on ECMO (extracorporeal membrane oxygenation) support can have catastrophic complications. Recombinant-Activated Factor VII (rFVIIa; NovoSeven®) may provide lifesaving hemostasis; however, there are reports of catastrophic thrombosis related to its administration. Objective: This review attempts to add safety and efficacy data to existing literature regarding the use of rFVIIa for refractory hemorrhage in pediatric patients on ECMO support. Design/Methods: A retrospective chart review was performed for all pediatric patients on ECMO who received rFVIIa for refractory hemorrhage from 2004 to 2009. Data was extracted for each refractory bleeding event, including patient blood loss and transfused blood products in the 6 hours before the first dose, between rFVIIa doses and in the 6 hours after the final dose. For purposes of data collection, a hemorrhagic event was defined as new onset hemorrhage or a hemorrhage occurring at least 12 hours after the most recent dose of rFVIIa. Results: In total, seven patients aged 1 month to 15 years received rFVIIa for 14 different hemorrhagic events. There was no significant difference in blood loss or blood product transfusion associated with rFVIIa administration. There was one patient-related and one ECMO-related complication temporally associated with rFVIIa administration: decreased ECMO circuit oxygenator efficiency and the development of an intra-gastric clot requiring surgical evacuation. Conclusion: These data suggest limited efficacy for rFVIIa use for refractory hemorrhage in pediatric patients on ECMO support. There were two non-catastrophic complications temporally associated with its administration.
Towards a proactive therapy utilizing the modern spectrum of extracorporeal life support: a single-centre experience

Background: We describe a single-centre experience of extracorporeal life support (ELS) for patients with severe and refractory cardiogenic shock, refractory cardiac arrest and severe respiratory failure. Methods: Between September 2007 and September 2012, 56 intra-hospital and 10 inter-hospital adult patients were supported. Results: The median ELS duration was 3 (0.9 - 6) days in venoarterial and 9.2 (7.4 - 24.4) days in venovenous supported patients. At hospital discharge and follow-up (12 and 40 months), survival among the respiratory (venovenous) patients and cardiac (venoarterial) patients was 84% and 38%, respectively. Survival in severe refractory cardiogenic shock patients was related to early initiation of ELS (<8 hours of onset of failure). A delay in initiating venoarterial ELS (>8 hours) and increased pre-ELS pH and lactate levels were associated with death in all cardiomyopathy patients, independent of infarct size. Conclusions: Our results exemplify the benefits of ELS as a bridge to initial stabilization of critically ill patients. Potentially, the early application of ELS technology can lower mortality and morbidity in patients with a regressive pathology.
The politics of health information

Issues related to research in health and stress must be some of the most controversial, often leading to total rejection of all that is written. Thus, the title of this book is likely to attract attention, particularly when it is part of an established series and has a distinguished list of contributors. In a subject area where there is lack of clarity of definitions, the diversity of approach from different disciplines, the comprehensive reviews and detailed and extensive references in this book are most welcome. The two opening chapters reviewing the disciplinary perspectives-epidemiology and health psychologyprovide an excellent introduction. They will be of value to all who are interested in stress and illness. The rest of the book will be relevant mainly to those involved in research. The next three chapters on methodological issues, bias, research design, data analysis and evaluation are detailed and practical, and could well be regarded as required reading for those contemplating research in this field. The second part of the book is more specific and, although general issues may be inferred, will be most useful to those working in the selected topic areas-family and stress, social support, work environment, type A behaviour pattern and coping. While these chapters are valuable they give the appearance of an unrelated collection of papers, and this is not resolved by the final chapter. While this concluding chapter does reflect on past difficulties and present dilemmas and indicates future directions, I would have liked to see this expanded to make full use of the earlier contributions. While it is unrealistic to expect a synthesis of the disciplinary approaches, I would hope that in a future revision of this volume this final section could go some way to achieving this.
Low nonconvexity-rank bilinear matrix inequalities: algorithms and applications in robust controller and structure designs

A branch and bound (BB) algorithm for solving a general class of bilinear matrix inequality (BMI) problems is proposed. First, linear matrix inequality (LMI) constraints are incorporated into BMI constraints in a special way to take advantage of useful information on nonconvex terms. Then, the nonconvexity of the BMI is centralized in coupling constraints so that when the latter are omitted, we get a relaxed LMI problem for computing lower bounds. As in our previous developments, the branching is performed in a reduced dimensional space of complicating variables. This makes the approach practical even with a large dimension of overall variables. Applications of the algorithm to several test problems of robust control are discussed.
Successful Cognitive Aging in HIV: Potential Strategies for Treatment and Research

ABSTRACT Over the past decade, HIV has been transformed from a terminal to chronic disease. Physical and occupational therapists are seeing increasing numbers of patients/clients who are aging with HIV. Nearly half of the adults with HIV experience mild to severe cognitive deficits, which can interfere with everyday functioning such as driving and medication adherence. Such cognitive deficits become more severe with increasing age. Given that nearly half of those with HIV will be 50 or older by 2015, physical and occupational therapists must explore strategies to improve or maintain cognitive functioning and/or mitigate for cognitive loss in this clinical population. In this review article, promising strategies to support healthy cognitive aging in HIV, such as psychostimulants and treatment of mental health issues, are discussed. Following this, some ineffective strategies such as acetylcholinesterase inhibitors are described. Finally, novel but unsupported strategies such as transcranial stimulation are examined. Implications for treatment and research are provided.
Causes, prediction and prevention of back pain at work

Pain in the back and lower limbs due to lumbar disorders has a multifactorial etiology, and there is no clear relationship between the morbid pathological change observed and the symptoms experienced. Of the precipitating factors, unaccustomed heavy work, postural fatigue, and injury are common. "Back injury," however, embodies a variety of phenomena, few of which can readily be distinguished either in national statistical data or in previous epidemiologic studies. Thus the causal relationship between back pain and work is far from clear, a difficulty compounded by the prevalence of back symptoms in all groups of the population. There are few epidemiologically established methods for identifying people who are susceptible to a first attack of back pain, though, once back pain has been reported, recurrence may be predicted. Selection of the preventive approach depends on reliable information about the prevalence of back pain/discomfort, the back injury rate, sickness absence, etc; about accidents, work stoppages, job turnover, or any other pointers to the design of the workplace or work practices; and about the resulting losses of productivity and the costs of the remedy. Though the decisions are up to management, the quality of the information required is mainly an occupational health responsibility.
Sight Restoration Comes into Focus: Versions of Visual Prostheses

The first visual prosthetic is on the commercial stage now, and a variety of new retinal and cortical implants are in the wings. When it won the European stamp of approval last year, the Argus II became the first commercially available visual prosthesis. Now Second Sight Medical Products Inc. of Sylmar, California, the company behind the Argus II, hopes to receive approval to sell the device in the United States by late 2012. As the excitement over the Argus II continues at a fever pitch, other research groups are developing their own versions of visual prostheses, working to create the potential for restoring sight.
Propensity scores and M‐structures

In a recent issue of Statistics in Medicine, Ian Shrier [Statist. Med. 2008; 27(14):2740–2741] posed a question regarding the use of propensity scores [Biometrika 1983; 70(1):41–55]. He considered an ‘M‐structure’ illustrated by the directed acyclic graph (DAG) in Figure 1. In Figure 1, z is a binary exposure, r is a response of interest, x is a measured covariate, and u1 and u2 are two unmeasured covariates. Shrier stated that for the M‐structure, ‘. it remains unclear if the propensity method described by Rubin would introduce selection bias or not’. In the same issue, Donald Rubin [Statist. Med. 2002; 27(14):2741–2742] replied by clarifying several key points in the use of propensity scores. He did not, however, discuss the original question posed by Shrier. Given the popularity of both propensity score methods and graphical models, I think any confusion regarding the appropriateness of these methods deserves serious attention and I would therefore like to answer Shrier's question here. The short answer is that for the M‐structure, propensity score methods do indeed induce a bias. Below, I will clarify this statement. I will first briefly review the basic idea of propensity scores and then explain why the idea does not apply to the M‐structure. I will use a notation which is consistent with Rosenbaum and Rubin [Biometrika 1983; 70(1):41–55]. Copyright © 2009 John Wiley & Sons, Ltd.
Monitoramento auditivo na ototoxidade

Some pharmaceutical products are capable of damaging the human auditory system. Technological progress has provided numerous resources to monitor hearing but there still is some controversy regarding the selection of the most sensitive and specific tests. OBJECTIVE: to analyze audiological procedures used in the auditory monitoring of individuals exposed to ototoxic medication. METHODS: we searched the MEDLINE and LILACS literature databases, using terms pertinent to audiological monitoring, ototoxicity and cancer. The pertaining literature analysis identified two procedures often used worldwide for the early detection of auditory lesions induced by ototoxic pharmaceutical drugs: high-frequency audiometry and evoked otoacoustic emissions. Both allow early identification of hearing disorders before changes are seen in conventional pure-tone audiometry and, consequently, before speech understanding is compromised. CONCLUSION: we suggest a hearing monitoring protocol, considering the patients capability to respond to behavioral tests and monitoring timing (first test/follow up). For cancer patients, hearing monitoring should be performed in the patients treatment venue.
The \"Jaipur Foot\": India?s Most Popular Prosthetic for Amputees Is Not the Latest in Technology, but It's Still the Most Suitable Option for Many Patients Almost 50 Years after Its Development

It is 8 a.m. on a December morning in Jaipur, Rajasthan, India. The day has just begun at Bhagawan Mahavir Vikalanga Sahayata Samithi (BMVSS), a nonprofit organization dedicated to fitting the disabled with artificial limbs (Figure 1). Slowly, patients from across India and neighboring countries gather in the center? s front yard. By the end of the day, more than 35 people will make a long journey back to their homes and communities outfitted with a new prosthetic leg or arm that will promise them a more active and functional future. The entire treatment is free.
Negative Consequences of Low Energy Availability in Natural Male Bodybuilding: A Review.

Energy availability (EA) is a scientific concept describing how much energy is available for basic metabolic functions such as reproduction, immunity, and skeletal homeostasis. Carefully controlled studies on women have shown pathological effects of EA < 30 kcal/kg fat-free mass (FFM), and this state has been labeled low EA (LEA). Bodybuilding is a sport in which athletes compete to show muscular definition, symmetry, and low body fat (BF). The process of contest preparation in bodybuilding includes months of underfeeding, thus increasing the risk of LEA and its negative health consequences. As no well-controlled studies have been conducted in natural male bodybuilders on effects of LEA, the aim of this review was to summarize what can be extrapolated from previous relevant research findings in which EA can be calculated. The reviewed literature indicates that a prolonged EA < 25 kcal/kg FFM results in muscle loss, hormonal imbalances, psychological problems, and negatively affects the cardiovascular system when approaching the lower limits of BF (∼4%-5%) among males. Case studies on natural male bodybuilders who prepare for contest show muscle loss (>40% of total weight loss) with EA < 20 kcal/kg FFM, and in the study with the lowest observed BF (∼4 kg), major mood disturbance and hormonal imbalances co-occurred. Studies also underline the problem of BF overshoot during refeeding after extremes of LEA among males. A more tempered approach (EA > 25 kcal/kg FFM) might result in less muscle loss among natural male bodybuilders who prepare for contest, but more research is needed.
Fast and Slow Dietary Proteins

THERE ARE FATS THAT ARE good for your health (monounsaturated and polyunsaturated fats) and those that may be less healthy (saturated fats). In addition, there is a difference in how your body processes low-glycemic carbohydrates versus highglycemic carbohydrates. In a similar vein, dietary proteins are also not treated similarly by your body. The notion that all protein is created equally is certainly not supported by the preponderance of scientific evidence. In compelling research published in the Proceedings of the National Academy of Sciences, Boirie et al. (1) found that a 30-g feeding of casein protein versus whey protein had different effects on postprandial protein gain. Both whey and casein are proteins derived from milk. In essence, they showed that whey protein is absorbed very quickly, producing peak levels of amino acids at approximately 60–90 minutes after ingestion and then returning to baseline levels at approximately 3–4 hours postingestion. Casein, on the other hand, produced a much slower and less dramatic rise in amino acid levels, peaking at approximately 60–90 minutes but maintaining higher levels of amino acids (versus baseline) over the entire 7-hour time frame. Evidently, the differences in digestion and absorption translate into differences in protein metabolism. For instance, they discovered that whole-body protein breakdown was inhibited by 34% by casein ingestion but not by whey. However, whey protein ingestion stimulated protein synthesis by 68% while casein stimulated protein synthesis to a lesser extent (+31%). However, when they looked at the ‘net leucine balance’ over the 7-hour time period after ingestion, casein ingestion resulted in a significantly higher net balance (i.e., postfeeding protein deposition was greater). Apparently, a fast-absorbing protein such as whey stimulates protein synthesis tremendously but a large part of the protein is also oxidized (used as fuel). Thus, one might conclude from this single study that a single feeding of a ‘slow’ protein such as casein is superior for promoting protein accretion to a ‘fast’ protein such as whey when examined in healthy subjects over a 7-hour time frame. However, this same laboratory followed this study with a more in-depth investigation (2). They took 4 groups of 5 or 6 young men and had them consume a 30-gprotein meal. However, they were divided into 4 categories:
From science projects to the engineering bench

The CISSRS surgical LEGO robot competition gives high-school students hands-on experience. The CISSRS Surgical LEGO Robot Competition leverages the increasingly multidisciplinary field of surgical robotics and the versatile but easy to learn Mindstorms system to introduce participants to CIS by giving them hands-on experience in solving real-world, cutting-edge science and engineering challenges in a fun and exciting environment. Over the course of a "long" weekend, participants with little or no computer or engineering experience can learn the necessary skills to design, build, program, test, and demonstrate a robot that performs a realistically simulated surgery.
Muscle oxygenation asymmetry in ice speed skaters: not compensated by compression.

PURPOSE The current investigation assessed tissue oxygenation and local blood volume in both vastus lateralis muscles during 3000-m race simulations in elite speed skaters on ice and the effects of leg compression on physiological, perceptual, and performance measures. METHODS Ten (6 female) elite ice speed skaters completed 2 on-ice trials with and without leg compression. Tissue oxygenation and local blood volume in both vastus lateralis muscles were assessed with near-infrared spectroscopy. Continuous measures of oxygen uptake, ventilation, heart rate, and velocity were conducted throughout the race simulations, as well as blood lactate concentration and ratings of perceived exertion before and after the trials. In addition, lap times were assessed. RESULTS The investigation of tissue oxygenation in both vastus lateralis muscles revealed an asymmetry (P < .00; effect size = 1.81) throughout the 3000-m race simulation. The application of leg compression did not affect oxygenation asymmetry (smallest P = .99; largest effect size = 0.31) or local blood volume (P = .33; 0.95). Lap times (P = .88; 0.43), velocity (P = .24; 0.84), oxygen uptake (P = .79; 0.10), ventilation (P = .11; 0.59), heart rate (P = .21; 0.89), blood lactate concentration (P = .82; 0.59), and ratings of perceived exertion (P = .19; 1.01) were also unaffected by the different types of clothing. CONCLUSION Elite ice speed skaters show an asymmetry in tissue oxygenation of both vastus lateralis muscles during 3000-m events remaining during the long gliding phases along the straight sections of the track. Based on the data, the authors conclude that there are no performance-enhancing benefits from wearing leg compression under a normal racing suit.
Recovery and adaptation from repeated intermittent-sprint exercise.

PURPOSE This investigation aimed to ascertain a detailed physiological profile of recovery from intermittent-sprint exercise of athletes familiar with the exercise and to investigate if athletes receive a protective effect on markers of exercise-induced muscle damage (EIMD), inflammation, and oxidative stress after a repeated exposure to an identical bout of intermittent-sprint exercise. METHODS Eight well-trained male team-sport athletes of National League or English University Premier Division standard (mean ± SD age 23 ± 3 y, VO2max 54.8 ± 4.6 mL ·kg-1 · min-1) completed the Loughborough Intermittent Shuttle Test (LIST) on 2 occasions, separated by 14 d. Maximal isometric voluntary contraction (MIVC), countermovement jump (CMJ), creatine kinase (CK), C-reactive protein (CRP), interleukin-6 (IL-6), F2-isoprostanes, and muscle soreness (DOMS) were measured before and up to 72 h after the initial and repeated LISTs. RESULTS MIVC, CMJ, CK, IL-6, and DOMS all showed main effects for time (P < .05) after the LIST, indicating that EIMD was present. DOMS peaked at 24 h after LIST 1 (110 ± 53 mm), was attenuated after LIST 2 (56 ± 39 mm), and was the only dependent variable to demonstrate a reduction in the second bout (P = .008). All other markers indicated that EIMD did not differ between bouts. CONCLUSION Well-trained games players experienced EIMD after exposure to both exercise tests, despite being accustomed to the exercise type. This suggests that well-trained athletes receive a very limited protective effect from the first bout.
Should foam made with physiologic gases be the standard in sclerotherapy?

Objectives The aim of this paper is to look at the pros and cons of using physiologic gas to produce foam for use in sclerotherapy. With the expanding use of foam sclerotherapy, there have been increased reports of transient neurologic adverse events such as visual disturbance. Although rare, increased numbers of serious adverse events such as transient ischemic attacks (TIAs) and stroke have been described. These events are seen more often in patients who have migraine with aura and those with a right-to-left shunt. Methods A literature search of the databases Ovid and Google Scholar was performed for studies looking specifically at neurologic side effects associated with sclerotherapy and use of physiologic foams. Included studies were randomized controlled trials, meta-analyses, review articles, observational studies and case studies. Results Although physiologic gases have been shown in several studies to reduce the incidence of visual disturbance, increasing evidence from recent studies suggest endothelin, rather than gas bubbles to be the cause of these side effects. The cause of stroke and TIA has not been proven and occlusion of cerebral arterioles from gas emboli should still be considered. Many authors state that only good quality foam be injected and volumes should be kept low in an attempt to prevent these rare, but potentially serious events. Foam made with physiologic gases are more biocompatible compared to air-based foam and have been found to be at least as effective in sclerotherapy as foam made with room air. Conclusion The use of physiologic gases should be considered for those at increased risk of neurologic side effects such as migraineurs with aura and those with a known PFO. Additionally, as there are few disadvantages to the use of physiologic foam, the use of CO2 or CO2/O2 foam should be considered in all patients receiving foam sclerotherapy.
MoveIt! [ROS Topics]

R obots are increasingly finding applications in domains where they have to work in close proximity to humans. Industrial robotic applications are starting to examine the possibility of robots and humans as coworkers, sharing tasks and workspace. Autonomous robotic cars operating on crowded streets and freeways have to share space with pedestrians and cyclists in addition to other vehicles. Domestic robots, in particular mobile manipulation systems, will be confronted with cluttered, messy environments where obstacles exist at every corner, and people are continuously moving in and out of the workspace of the robots. Robots working in human environments clearly have to be aware of their surroundings andmust actively attempt to avoid collisions with humans and other obstacles. MoveIt! is a set of software packages integrated with the Robot Operating System (ROS) and designed specifically to provide such capabilities, especially for mobile manipulation. MoveIt! will allow robots to build up a representation of their environment using data fused from three-dimensional (3-D) and other sensors, generate motion plans that effectively and safely move the robot around in the environment, and execute the motion plans while constantly monitoring the environment for changes.