Miracle-dz/UniFAR-FTUs huggingface dataset:
The Use of Prolonged Peripheral Neural Blockade After Lower Extremity Amputation: The Effect on Symptoms Associated with Phantom Limb Syndrome

BACKGROUND: Phantom limb syndrome (PLS) is common after limb amputations, involving up to 90% of amputees. Although many different therapies have been evaluated, none has been found to be highly effective. Therefore, we evaluated the efficacy of a prolonged perineural infusion of a high concentration of local anesthetic solution in preventing PLS. METHODS: A perineural catheter was placed immediately before or during surgery in 71 patients undergoing lower extremity amputation. A continuous infusion of 0.5% ropivacaine was started intraoperatively at 5 mL/h using an elastomeric (nonelectronic) pump, and continued for 4 to 83 days after surgery. PLS was evaluated on the first postoperative day and then 1, 2, 3, and 4 weeks, and 3, 6, 9, and 12 months after surgery. To evaluate the presence and severity of PLS while the patient was receiving the ropivacaine infusion, it was discontinued for 6 to 12 hours before each assessment period (i.e., until the sensation in the extremity returned). The severity of phantom limb and stump pain was assessed using a 5-point verbal rating scale (VRS), with 0 = no pain to 4 = intolerable pain, and “phantom” sensations were recorded as present or absent. If the VRS score was >1 or significant phantom sensations were present, the ropivacaine infusion was immediately restarted at 5 mL/h. If the VRS score remained at 0 to 1 and the patient had not experienced phantom sensations for 48 hours, the infusion was permanently discontinued and the catheter was removed. RESULTS: Median duration of the local anesthetic infusion was 30 days (95% confidence interval, 25–30 days). On postoperative day 1, 73% of the patients complained of severe-to-intolerable pain (visual analog scale >2). However, the incidence of severe-to-intolerable phantom limb pain was only 3% at the end of the 12-month evaluation period. At the end of the 12-month period, the percentage of patients with VRS pain scores were 0 = 84%, 1 = 10%, 2 = 3%, 3 = 3%, and 4 = none. However, phantom limb sensations were present in 39% of patients at the end of the 12-month evaluation period. All patients were able to manage the elastomeric catheter infusion system at home. CONCLUSION: Use of a prolonged postoperative perineural infusion of ropivacaine 0.5% seems to be an effective therapy for the treatment of phantom limb pain and sensations after lower extremity amputation.
How Broadcasting vs. Narrowcasting on Social Media Affects Memories

How do audiences impact the memories shared on social media? We find that sharing experience on social media can ironically decrease memory of shared experience and sharing with a small group attenuates sharer’s memories to a greater extent than sharing with a large group. This advantage is due to outsourcing memories to identifiable audiences and is diminished by enhancing the perceived heterogeneity of large group or decreasing the identifiability of small group.
Medical students' ability to care for lesbian, gay, bisexual, and transgendered patients.

BACKGROUND AND OBJECTIVES Our objective was to assess medical students' ability to care for lesbian, gay, bisexual, and transgender (LGBT) patients and to identify potential deficiencies in medical school curricula pertaining to this care. METHODS Between March 1 and April 15, 2004, third- and fourth-year medical students at a metropolitan medical school were sent an e-mail requesting participation in a confidential on-line survey of 64 quantitative questions designed to assess their ability to care for LGBT patients. RESULTS A total of 248 of 320 (77.5%) students responded. Medical students with greater clinical exposure to LGBT patients reported more frequent sexual history taking with LGBT patients, had more positive attitude scores, and possessed higher knowledge scores than students with little or no clinical exposure. Overall, on the 13-item attitude survey, the mean was 4.15 (5 = most positive, SD = .55, range 1.86-5.00), indicating a desire and willingness to provide health care to LGBT patients. The mean score on the 14-item knowledge test was 60% (SD = .12) correct. CONCLUSIONS Medical students with increased clinical exposure to LGBT patients tended to perform more comprehensive histories, hold more positive attitudes toward LGBT patients, and possess greater knowledge of LGBT health care concerns than students with little or no clinical exposure.
Outbreak of Infection with a Multiresistant Klebsiella pneumoniae Strain Associated with Contaminated Roll Boards in Operating Rooms

ABSTRACT An outbreak with a multiresistant Klebsiella pneumoniae (MRKP) strain among seven patients admitted to the adult intensive care unit (ICU) of a regional teaching hospital in The Netherlands was investigated. Epidemiologic investigations revealed a short delay between an operation and the acquisition of the MRKP strain. A case-control study comprising 7 cases and 14 controls was conducted to identify the risk factors associated with the acquisition of the MRKP strain. An operation at each of two operation rooms was strongly associated with the acquisition of the MRKP strain: odds ratio of 36 (95% confidence interval, 2.7 to 481.2; P = 0.003, Fisher exact two-tailed test). Cultures of environmental specimens of the operation rooms revealed contamination of the roll boards used to transport patients from the bed to the operation table with the MRKP strains. Molecular genotyping of the isolates revealed clonal similarity between the isolates of the seven cases, isolates from environmental specimen cultures, and in addition, an MRKP isolate from a repatriated ICU patient from earlier that year. The outbreak ended after cleaning and replacement of the roll boards in the operation rooms and implementation of additional barrier precautions for colonized or infected patients. It was concluded that two operation rooms played a significant role in the transmission of an MRKP strain between ICU patients during the presented outbreak.
Simulation of a planar PDMS micropump using in-contact, low-leakage check valves

We present a lumped-parameter dynamic model for a planar poly(dimethylsiloxane) (PDMS) micropump using in-contact, virtually zero-leakage check valves to provide critical insights into the dynamic characteristics of the planar micropump operation. The model features a single-plane microfluidic chamber sandwiched between two check valves, which allows for reliable operation and easy system integration. Theoretic equations have been developed based on the coupled interaction of the fluid flow and the structural motion, combined with external pneumatic actuation directly applied. Furthermore, we have resolved the equations analytically and analyzed the dynamic performance of this micropump. Systematic analysis using this model studied comprehensive factors including the motion of the actuated diaphragm, the applied pressure, and pumping chamber height. Compared with experimental characterization data, this model shows good agreement with the experimental results, demonstrating its utility as a useful tool for analyzing and designing the planar micropump.
Timing of follow-up after abnormal screening and diagnostic mammograms.

OBJECTIVE To evaluate woman-level characteristics associated with timing of follow-up after abnormal mammograms in an integrated healthcare system with an active breast health program. STUDY DESIGN Retrospective cohort study. METHODS The study included women aged 40-84 years who had an abnormal mammogram (20,060 screening and 3184 diagnostic) recommended for follow-up. We compared characteristics of women who received any follow-up evaluation within <7, 8 to 14, 15 to 21, and 22 to 180 days. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariate ordinal logistic regression. RESULTS The proportion of women seeking care within 7 days was 23% for screening and 69% for diagnostic mammograms. Characteristics associated with later follow-up (>8 days vs <7 days) after an abnormal screening mammogram included being older (OR=1.15; 95% CI, 1.04-1.26 [age 70-79 years]; OR=1.31; 95% CI, 1.14-1.51 [age 80+ years]), Asian (OR=1.18; 95% CI, 1.04-1.33), or having a college degree (OR=1.10; 95% CI, 1.01-1.19). Characteristics associated with earlier follow-up included family history of breast cancer (OR=0.93; 95% CI, 0.88-0.98), symptoms at time of mammogram (OR=0.79; 95% CI, 0.70-0.88), or extremely dense breasts (OR=0.82; 95% CI, 0.69-0.96). For diagnostic mammograms, symptoms at time of mammogram (OR=0.47; 95% CI, 0.39-0.56) and being obese (OR=0.79; 95% CI, 0.65-0.98) were associated with earlier follow-up. CONCLUSIONS Several woman-level characteristics were associated with timely follow-up after an abnormal screening exam, but only presence of symptoms and being obese was associated with timely follow-up after an abnormal diagnostic exam.
Changes to the quantity and processing of starchy foods in a Western diet can increase polysaccharides escaping digestion and improve in vitro fermentation variables

This study investigated how readily achievable changes to the quantity and processing of starchy foods in a typical Western diet: (1) were reflected in levels of resistant starch (RS) and NSP excreted from the small intestine; and (2) more favourable profiles of butyrate, NH3 and phenol production. Two diets, a low-starch diet (LSD) and a high-starch, low-fat diet (HSLFD) were compared. The LSD with 20 % total energy (%E) from starch was based on a ‘typical’ Australian diet, while the HSLFD (40 %E as starch) was the same Australian diet modified by an increased content of legumes, starchy foods and coarsely-ground cereals and by a reduced fat content. Four subjects with iliostomies consumed each diet for 2 d, with ileal effluent collection on the second day. On the HSLFD compared with the LSD, RS in ileal effluent increased from from 0·49 to 1·7 g/MJ per d (P < 0·005) while ileal NSP excretion increased from 2·0 to 3·3 g/MJ per d (P < 0·05). Ileal effluents obtained after each diet were incubated for 24 h in vitro with a human faecal innoculum. After fermentation, ileal effluent from the HSLFD produced more butyrate relative to other short-chain fatty acids (17·5 v. 15·8 molar %, P < 0·005) and less phenol (2·3 v. 5·7 mg/l, P < 0·05) and NH3 (20·3 v. 23·1 mmol/l, P < 0·005) than the LSD diet. The HSLFD also generated a lower pH (6·15 v. 6·27, P < 0·05). On a wt/wt basis, RS was 2·3-fold higher in the HSLFD effluent while NSP did not increase, suggesting that the change in RS largely contributed to the fermentation effects. Changes in in vitro variables when the HSLFD ileal effluent was ground before fermentation indicated the importance of physical structure in determining ileal excretion of RS. We conclude that: (1) readily achievable modifications to the amount and processing of starchy foods in an Australian diet would produce potential benefits for in vitro fermentation variables; and (2) the physical structure of grains and cereals is important in determining access by colonic bacteria to a carbohydrate substrate.
Determination of Serum Unbound Bilirubin for Prediction of Kernicterus in Low Birthweight infants

Serum unbound bilirubin concentrations (UBC) and serum total bilirubin concentrations (TBC) were measured serially in 138 low birthweight (LBW) infants treated with phototherapy for non‐hemolytic hyperbilirubinemia. We attempted to assign the suitable critical UBC levels for predicting bilirubin encephalopathy into two different birthweight groups: a very low birthweight (VLBW) group (birthweight < 1,500 g) and an LBW group (birthweight between 1,500 g and 2,499 g). Twelve infants were diagnosed as ‘at risk’ for kernicterus, of whom 11 had signs of acute bilirubin encephalopathy and exchange transfusion. One VLBW infant had neurological sequelae at a 3 year follow‐up, although exchange transfusion was not carried out because of low TBC.
The NAIP–NLRC4 inflammasome in innate immune detection of bacterial flagellin and type III secretion apparatus

Bacterial flagella and type III secretion system (T3SS) are evolutionarily related molecular transport machineries. Flagella mediate bacterial motility; the T3SS delivers virulence effectors to block host defenses. The inflammasome is a cytosolic multi‐protein complex that activates caspase‐1. Active caspase‐1 triggers interleukin‐1β (IL‐1β)/IL‐18 maturation and macrophage pyroptotic death to mount an inflammatory response. Central to the inflammasome is a pattern recognition receptor that activates caspase‐1 either directly or through an adapter protein. Studies in the past 10 years have established a NAIP–NLRC4 inflammasome, in which NAIPs are cytosolic receptors for bacterial flagellin and T3SS rod/needle proteins, while NLRC4 acts as an adapter for caspase‐1 activation. Given the wide presence of flagella and the T3SS in bacteria, the NAIP–NLRC4 inflammasome plays a critical role in anti‐bacteria defenses. Here, we review the discovery of the NAIP–NLRC4 inflammasome and further discuss recent advances related to its biochemical mechanism and biological function as well as its connection to human autoinflammatory disease.
Seroprevalence and anti‐HEV persistence in the general population of the Republic of San Marino

The prevalence of anti‐HEV was assessed in 2,233 subjects aged 20–79 years in the Republic of San Marino in the years 1990–1991. The sera were tested by ELISA and further confirmed by Western blot (WB) analysis. The overall anti‐HEV prevalence was 1.5%. A significant trend by age was observed. Anti‐HEV prevalence was 0.6% in subjects <30 years and 3.3% in those older than 70 years of age. Family size larger than four persons (OR = 3.8; 95% CI = 1.8–13.2) was the sole independent predictor of anti‐HEV positivity in the multivariate analysis. Anti‐HAV and anti‐HEV prevalences did not show a parallel trend by age. No association was found either between hepatitis E virus (HEV) or hepatitis C virus (HCV) infections. Follow‐up samples 5 years apart were available for 38 out of 54 (70%) anti‐HEV ELISA‐positive subjects. Eight out of 22 (37%) WB‐confirmed anti‐HEV–positive subjects were still anti‐HEV–positive after 5 years. However, anti‐HEV remained positive in all but two (75%) of the subjects with WB‐confirmed ELISA positivity value of S/CO ≥ 2 (cutoff 1.2), but in only 2 out of the 14 subjects (14%) with a WB‐con‐ firmed ELISA positivity value of S/CO < 2 (P < 0.005). None of the 16 subjects ELISA‐positive but not WB‐confirmed was anti‐HEV–positive 5 years apart. Therefore, only a relative proportion of subjects once infected with HEV maintain for at least 5 years anti‐HEV antibodies. J. Med. Virol. 58:49–53, 1999. © 1999 Wiley‐Liss, Inc.
Measurements and Simulations of Low Dark Count Rate Single Photon Avalanche Diode Device in a Low Voltage 180-nm CMOS Image Sensor Technology

This paper presents the key features of single photon avalanche diode (SPAD) devices fabricated in a low voltage commercial 180-nm CMOS image sensor technology exhibiting very low dark count rate (DCR). The measured DCR is <; 100 Hz at room temperature even for excess voltages above 2 V. The active junction of the SPAD measures 10 μm in diameter within a 24-μm test structure. The active region where Geiger avalanche occurs is determined by an implanted charge sheet. Edge avalanche is averted by utilizing a virtual guard ring, formed by the retrograde well profile. The design, measurements, and simulations of doping and electric field profiles that lead to such low DCR are reported and analyzed. The current-voltage characteristics and the temperature dependence of the breakdown voltage provide further, indirect evidence for the low DCR measured in the device. Thus, the key features of measured good SPADs are presented and are correlated with simulations that give physical insight on how to design high-performance SPADs.
Randomized comparison of aspirin and phenprocoumon for prevention of right-sided thromboembolic complications associated with transvenous defibrillation leads.

Death due to pulmonary embolism caused by thrombosis formation along a pacing wire has been reported in patients with antibradycardia pacemakers. The purpose of this prospective and randomized study was to evaluate the effects of prophylactically assigned aspirin (100 mg per day) or phenprocoumon (a coumarin derivative) on the incidence of right-sided thromboembolic complications associated with transvenous defibrillation leads. Multiplane transoesophageal echocardiography and pulmonary scintigraphy were performed in 62 consecutive patients immediately and 6 +/- 2 months after transvenous defibrillator implantation. Aspirin or phenprocoumon was administered to the patients in a randomized and parallel manner. By means of multiplane transoesophageal echocardiography and pulmonary scintigraphy no thromboembolic events were observed immediately after transvenous defibrillator implantation. After 6 +/- 2 months, however, multiplane transoesophageal echocardiography disclosed thrombi on the transvenous leads in 13 of 62 patients (21%) despite antithrombotic therapy. At the same time, pulmonary scintigraphy did not reveal any defects compatible with pulmonary embolism. Although thrombi occurred in only four patients treated with phenprocoumon, but in nine patients receiving aspirin, this difference was statistically insignificant. Other variables associated with the occurrence of thrombosis formation were not identified. One fatal intracranial haemorrhage occurred in the phenprocoumon group. (ABSTRACT TRUNCATED AT 250 WORDS)
Phytoremediation of Ni-contaminated soil by Salicornia iranica

ABSTRACT Although nickel (Ni) is useful and is used in various industries, it is one of the most usual and important sources of heavy metals pollutants in the world. In this study, Salicornia iranica was used in order to phytoremediate Ni-contaminated soil. Possible mechanisms of plant tolerance to Ni pollution and its detoxification were studied through using expression analysis of glutathione-S-transferase (GST) and measurement of involved key physiological components. The concentration of the chlorophylls a, b, total chlorophyll, and carotenoids were significantly decreased in 500 mg/kg Ni at 3, 24, 48 h, and 90 days after the treatment. Free proline significantly increased in the tissues. The absorption and concentration of Ni increased in tissues, so that Ni concentration at 50, 250, and 500 mg Ni/kg soil significantly increased to 2.5, 3.5, and 4.5 fold compared with the lowest Ni level respectively. In addition, the GST expression was significantly increased both in the 50 and 500 mg/kg Ni treatment. The highest concentration of Ni affected plant growth parameters such as the root and shoot lengths. Therefore, S. iranica is able to accumulate Ni and it can be used as an environmental biotechnological study for phytoremediation of Ni-polluted soils. Abbreviations: ABA: abscisic acid; ABRE: ABA-responsive element; As+3: arsenic; Cd2+: cadmium; ef1: elongation factor; FW: fresh weight; GSH: glutathione; GST: glutathione-S-transferase; GSTU: tau class GST; Hcl: hydrochloric acid; Hg2+: mercury; HgCl2: mercury(II) chloride; MYB: myeloblastosis viral oncogene homolog; Ni+2: nickel; Pb: lead; SiGSTU: Salicornia iranica GSTU; ZnSO4: zinc sulfate
The impact of compensatory measures on public support for carbon taxation: an experimental study in Sweden

ABSTRACT This study aims at better understanding how, and to what extent, perceptions of a policy instrument’s distributional effects impact on policy support, focusing on the case of CO2 taxes on petrol in Sweden. Through a large-scale (N = 5000) randomized survey experiment with a 2 × 3 factorial design, the extent to which perceptions of fairness determine attitudes to a suggested increase of the Swedish CO2 tax is explored. Furthermore, the study considers whether these effects change with the level of the suggested tax increase, as well as whether negative sentiments can be alleviated by combining it with a compensatory measure in the shape of a simultaneous income tax cut financed by the revenues from the tax increase. The results show that a higher tax increase is both viewed as more unfair and enjoys weaker support. Furthermore, compensatory measures can be a powerful policy design tool to increase perceptions of the policy as fair, but the effect of compensation on policy support is conditioned by the individual’s left–right ideological position. Whereas people self-identifying to the right react favourably to compensatory measures, people self-identifying to the left become less supportive of a tax increase when combined with a simultaneous cut in income taxes. Key policy insights Perceptions of fairness are highly important for explaining public support for climate policy tools, specifically CO2 taxes. Compensatory measures can be a powerful policy design tool to increase perceptions of the policy as less unfair. However, the effect of compensatory measures on policy support is conditioned by ideological position, and only successful among people to the ideological right. In contexts dominated by right-wing ideals, a combination of a tax and a compensatory scheme may be a successful route forward towards increased climate policy support. In left-oriented contexts the results imply that a CO2 tax without compensation seems more likely to increase support.
HIV Testing Among US High School Students and Young Adults

BACKGROUND: We assessed HIV testing trends among high school students and young adults. METHODS: We analyzed National Youth Risk Behavior Survey (YRBS) and Behavioral Risk Factor Surveillance System (BRFSS) data to assess HIV testing prevalence among high school students and young adults aged 18 to 24, respectively. Logistic regression models for each sample stratified by gender and race/ethnicity were estimated to assess trends in the percentages ever tested, with year as a continuous linear variable. We report absolute differences in HIV testing prevalence and model results for 2005–2013 (YRBS) and 2011–2013 (BRFSS). RESULTS: During the study periods, an average of 22% of high school students (17% of male and 27% of female students) who ever had sexual intercourse and 33% of young adults reported ever being tested for HIV. Among high school students, no change was detected in HIV testing prevalence during 2005–2013, regardless of gender or race/ethnicity. Among young adult males, an average of 27% had ever been tested, and no significant changes were detected overall or by race/ethnicity during 2011–2013. Significant decreases in testing prevalence were detected during 2011–2013 among young adult females overall (from 42.4% to 39.5%), young adult white females (from 37.2% to 33.9%), and young adult black females (from 68.9% to 59.9%). CONCLUSIONS: HIV testing prevalence was low among high school students and young adults. No increase in testing among young adult males and decreased testing among young adult black females is concerning given their higher risk of HIV infection.
Information communication technologies and environmental innovations in firms: joint adoptions and productivity effects

Information communication technology (ICT) and environmental innovation (EI) are relevant waves of the ongoing technological revolution. We study the complementarity in innovation adoption to test the research hypothesis that the higher the diffusion and intensity of usage of ICT and EI, the higher a firm's productivity performance might be. However, it is not certain that the use of different innovations stemming from different innovation paths generates higher productivity. To test our hypothesis, we use original survey data concerning manufacturing firms in Northeast Italy including detailed information on both ICT and EI. Empirical evidence shows that there are still wide margins to improve the integration between EI and ICT in order to exploit their potential benefits on productivity. The awareness of specific synergies seems to mainly characterise the heavy polluting firms that are subject to more stringent environmental constraints, while some trade-offs tend to emerge for the remaining firms.