Miracle-dz/UniFAR-FTUs huggingface dataset:
The Effects of Succinylcholine on Mouth Opening

Mouth opening and the resistance to opening developed by the muscles of mastication were measured in 63 children anesthetized with halothane and relaxed with succinylcholine, pancuronium, or vecuronium. Measurement of mouth opening, induced by a constant test force, was made when each patient was deeply anesthetized, as judged by clinical parameters. Succinylcholine, vecuronium, or pancuronium was then administered. The mouth opening measurement was repeated immediately after the loss of limb muscle twitch response and 45 s following the loss of twitch response. For the 24 patients receiving succinylcholine, there was a significant reduction in mean mouth opening (P < 0.0001) and a significant increase in jaw stiffness (P < 0.0001) immediately after limb relaxation. Forty-five seconds after full limb relaxation was attained, the mean mouth opening was still reduced (p < 0.0001) and the mean jaw stiffness was still increased (p < 0.0003) in the succinylcholine group. Patients receiving cither vecuronium or pancuronium did not show a significant change of mouth opening or jaw stiffness following limb relaxation. Three patients, who received succinylcholine, required several attempts at tracheal intubation due to increased resistance to mouth opening. Anesthesia and surgery proceeded in all patients. None of the patients developed malignant hyperthermia. In view of the fact that a reduction in mouth opening was a constant finding when succinylcholine was administered during halothane anesthesia, the assumption that isolated “masseter spasm” or jaw stiffness heralds malignant hyperthermia should be reconsidered.
Living Donor Liver Transplantation in Children: Surgical and Immunological Results in 250 Recipients at Université Catholique de Louvain

Objectives: To evaluate the outcome of pediatric living donor liver transplantation (LDLT) regarding portal vein (PV) reconstruction, ABO compatibility, and impact of maternal donation on graft acceptance. Background: LDLT and ABO-mismatched transplantation constitute feasible options to alleviate organ shortage in children. Vascular complications of portal hypoplasia in biliary atresia (BA) and acute rejection (AR) are still major concerns in this field. Methods: Data from 250 pediatric LDLT recipients, performed at Cliniques Universitaires Saint-Luc between July 1993 and June 2012, were collected retrospectively. Results were analyzed according to ABO matching and PV complications. Uni- and multivariate analyses were performed to study the impact of immunosuppression, sex matching, and maternal donation on AR rate. Results: Overall, the 10-year patient survival rate was 93.2%. Neither patient or graft loss nor vascular rejection, nor hemolysis, was encountered in the ABO nonidentical patients (n = 58), provided pretransplant levels of relevant isoagglutinins were below 1/16. In BA recipients, the rate of PV complications was lower after portoplasty (4.6%) than after truncal PV anastomosis (9.8%) and to jump graft interposition (26.9%; P = 0.027). In parental donation, maternal grafts were associated with higher 1-year AR-free survival (55.2%) than paternal grafts (39.8%; P = 0.041), but only in BA patients. Conclusions: LDLT, including ABO-mismatched transplantation, constitutes a safe and efficient therapy for liver failure in children. In BA patients with PV hypoplasia, portoplasty seems to constitute the best technique for PV reconstruction. Maternal donation might be a protective factor for AR.
Sources of variance in daily physical activity levels as measured by an accelerometer.

PURPOSE To examine sources of variance in objective measures of physical activity in a group of healthy adults (N = 92) participating in a physical activity measurement study. METHODS Physical activity was assessed for up to 21 consecutive days using the Computer Science Applications (CSA) accelerometer. Day-of-the-week effects were evaluated for activity counts (ct.min(-1). d(-1), ct.d(-1)) and time (min.d(-1)) spent in inactivity (0-499 ct), moderate-1 (500-1951 ct), and moderate-2-vigorous activity (> or =1952 ct). Random effects models were employed to estimate variance components for subject, day of the week, and residual error from which the number of days of assessment required to achieve 80% reliability were estimated. RESULTS Physical inactivity was lower on weekend days, and Saturday was the least inactive day of the week for both men and women. Inter-individual variation, or differences between subjects, was proportionally the largest source of variance (55-60% of total) in accelerometer counts and time spent in moderate to vigorous activity. Differences within subjects (intra-individual variation) accounted for 30-45% of the overall variance, and day-of-the-week effects accounted for 1-8%. For activity counts, and time spent in moderate to vigorous activity, at least 3-4 d of monitoring were required to achieve 80% reliability. Reliable measures of physical inactivity required at least 7 d of monitoring. CONCLUSION These findings provide insight for understanding the behavioral variability in the activity patterns of adults and suggest that reliable measures of activity behaviors require at least 7 d of monitoring.
Aberrant promoter methylation of PPP1R3C and EFHD1 in plasma of colorectal cancer patients

Aberrant DNA methylation is a common epigenetic alteration involved in colorectal cancer (CRC). In our previous study, we performed methylated DNA immunoprecipitation‐on‐chip analysis combined with gene re‐expression analysis by 5‐aza‐2′‐deoxycytidine treatment, to identify methylation genes in CRC genome widely. Among these genes, 12 genes showed aberrant hypermethylation frequently in >75% of 149 CRC samples but did not in normal samples. In this study, we aim to find out any of these methylation genes to be utilized for CRC detection using plasma DNA samples. Primers for methylation‐specific PCR and pyrosequencing were designed for seven of the 12 genes. Among them, PPP1R3C and EFHD1 were rarely hypermethylated in peripheral blood cells, but frequently hypermethylated in 24 CRC tissue samples and their corresponding plasma samples. In plasma samples, PPP1R3C was methylated in 81% (97/120) of CRC patients, but only in 19% (18/96) of noncancer patients (P = 6 × 10−20, Fisher's exact test). In combined analysis with EFHD1, both genes were methylated in 53% (64/120) of CRC patients, but only in 4% (4/96) of noncancer patients (P = 2 × 10−16), giving high specificity of 96%. At least one of the two genes was methylated in 90% (108/120) of CRC patients, and 36% (35/96) of control patients, giving high sensitivity of 90%. Compared with low sensitivity of carcinoembryonic antigen (17% at stage I, 40% at stage II) and CA19‐9 (0% at stage I, 13% at stage II) for early‐stage CRCs, sensitivity of aberrant methylation was significantly higher: PPP1R3C methylation at 92% (11/12) for stage I and 77% (23/30) for stage II, and methylation of at least one gene at 100% (12/12) for stage I and 87% (26/30) for stage II. PPP1R3C methylation or its combined use of EFHD1 methylation was highly positive in CRC plasma samples, and they might be useful in detection of CRC, especially for early‐stage CRCs.
Mindfulness-based cognitive therapy versus psycho-education for patients with major depression who did not achieve remission following antidepressant treatment: a preliminary analysis.

OBJECTIVES The objective of this study was to compare mindfulness-based cognitive therapy (MBCT) with a psycho-educational control group designed to be structurally equivalent to the MBCT program but excluding the claimed "active ingredient" of MBCT (i.e., mindfulness meditation practice) for the treatment of patients with major depression (MD). DESIGN This was a randomized controlled trial. LOCATION The study was conducted at the Institute of Psychiatry, University of Bologna, Italy. SUBJECTS Patients who had MD and who did not achieve remission following at least 8 weeks of antidepressant treatment were considered for inclusion. Eligible subjects were randomized to receive MBCT or psycho-education and were prospectively followed for 8 weeks. OUTCOME MEASURES MD severity was assessed with the Hamilton Rating Scale for Depression (HAMD). Measures of anxiety, mindfulness, and quality of life, as measured with the Beck Anxiety Inventory, Mindfulness Attention and Awareness Scale, and the Psychological General Well-being Index (PGWBI), respectively, were also included. All assessments were performed at baseline, 4 weeks, and 8 weeks. Changes of psychologic variables over the study period were analyzed by means of the repeated-measures analysis of variance. RESULTS Of 29 screened subjects, 16 received MBCT or psycho-education. Both HAMD and PGWBI scores improved to a significantly higher extent in the MBCT group than in the psycho-educational control group. CONCLUSIONS Although limited by a small sample size and the lack of follow-up measures, the results of this preliminary study suggest the superiority of MBCT over psycho-education for subjects who had MD and who did not achieve remission following antidepressant treatment.
Poor retention in early care increases risk of mortality in a Brazilian HIV-infected clinical cohort

ABSTRACT Retention in early HIV care has been associated with decreased mortality and improved viral suppression, however the consequences of poor retention in early care in Brazil remain unknown. We assessed the effect of poor retention on mortality in a Brazilian HIV-infected clinical cohort. The analysis included ART-naïve, HIV-infected adults linked to care at the Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz between 2000 and 2010, who did not become pregnant nor participate in a clinical trial during the first two years in care (early care). Poor retention in early care was defined as less than 3 out of 4 six-month intervals with a CD4 or HIV-1 RNA laboratory result during early care. Cox proportional hazards models were used to identify factors associated with mortality, and Kaplan–Meier plots were used to describe the survival probability for participants with poor retention versus good retention. Among 1054 participants with a median (interquartile range) follow-up time of 4.2 years (2.6, 6.3), 20% had poor retention in early care and 8% died. Poor retention in early care [adjusted hazard ratio (aHR) 3.09; 95% CI 1.65–5.79], AIDS defining illness (aHR 1.95; 95% CI 1.20–3.18) and lower education (aHR 2.33; 95% CI 1.45–3.75) were associated with increased mortality risk. Our findings highlight the importance of adopting strategies to improve retention in early HIV care.
[Gender differences in the social relations of students].

INTRODUCTION The aim of this study is to study gender differences in social network and social support among university students with a special view to social relations as a coping strategy for dealing with personal problems. MATERIAL AND METHODS A total of 1,126 (48%) medical, psychology and liberal arts students who initiated their studies in 2006 or 2007 participated in the study. Data derives from a student register and a questionnaire on social network and social support. RESULTS Approximately 85% of the students visit friends weekly, and about 40% spend time with their family weekly. Nearly half of the students have a partner. More female than male medical students have a partner when initiating their studies. More than 80% of the students have experienced mental health or social problems in the past, more female than male medical and liberal arts students. More than half of the male students handle their personal problems by themselves, whereas female students receive more social support. Significant gender differences in social support are mostly found among medical and liberal arts students. CONCLUSION The results suggest that male and female students use different coping strategies when dealing with social and mental health problems, and gender differences in social relations seem to be most widespread among medical and liberal arts students - why and how should be investigated further.
Prostate histoscanning in clinically localized biopsy proven prostate cancer: an accuracy study.

PURPOSE To assess the accuracy of prostate histoscanning (PHS) for spatial detection and localization of prostate cancer (PCa). PATIENTS AND METHODS Prospective, single center study from January to September 2012 was conducted. Inclusion criterion was biopsy confirmed PCa in patients scheduled for radical prostatectomy. In total, 98 patients were included in the study. Results of PHS were compared against whole-mount step sectioning by the Stanford technique. A lower limit of 0.1 cm(3) was used for PHS. A dedicated 12-sector form was used for spatial correlation. The urologist and pathologist were blinded for each other's results. Sensitivity, specificity, and receiver operating characteristic curves were calculated with a logistic regression model for covariates. RESULTS PHS performance for detection of PCa lesions ≥0.1 cm(3) had sensitivity of 60%, specificity of 66%, and area under the curve (AUC) of 0.63. Posterior and anterior sectors achieved sensitivity of 77%, specificity of 39%, and 28% and 84%, respectively. The model containing PHS positivity within a given sector reached sensitivity of 73.4%, specificity of 65.7%, and AUC of 0.75. In a ogistic regression model, the performance of PHS was affected by sector location, rectal distance, index, and total cancer volume (all P<0.0001) and bladder fullness (P=0.02). The best PHS accuracy was present in midposterior sectors. CONCLUSIONS PHS has a potential for clinical practice, especially if PHS positivity within given sectors is taken into account. A trained operator is important. More studies are necessary to test different detection limits in various clinical settings, such as targeted biopsies and image guided focal therapy.
Hereditary Macrothrombocytopenia and Pregnancy

Summary Introduction. Hereditary macrothrombocytopenias (HM) are a group of infrequent disorders characterized by hereditary giant platelets. Little has been published about the course of these diseases during pregnancy and delivery. Subjects and methods. Forty consecutive thrombocytopenic pregnant women were studied. Platelet count, mean platelet volume and blood smear examination were performed. Platelet antibodies were studied by immunofluorescence. Familial study, bleeding time, ultrastructural platelet examination, a von Willebrand disease screening and aggregation tests were carried out when HM was suspected. Results. Four cases of HM were diagnosed. Giant platelets were observed in all cases, with the typical ultrastructural pattern. Dohle-like cytoplasmic inclusions in granulocytes were observed in one case. Platelet antibodies were detected in only one case. No prophylactic measures to prevent haemorrhage were adopted, and all patients underwent vaginal deliveries. Haemorrhagic events were absent in both mothers and children. Conclusions. The prevalence of HM in pregnant trombocytopenic women is higher than assumed. Prophylactic treatment should be avoided in the absence of a history of haemorrhagic complications and obstetrical risk factors.
Current Concepts in Mucosal Immunity

Neutra, Marian R. Current Concepts in Mucosal Immunity. V. Role of M cells in transepithelial transport of antigens and pathogens to the mucosal immune system. Am. J. Physiol. 274 (Gastrointest. Liver Physiol. 37): G785–G791, 1998. —Specialized epithelial M cells, a phenotype that occurs only in the epithelium over organized lymphoid follicles, deliver samples of foreign material by transepithelial transport from the lumen to organized lymphoid tissues within the mucosa of the small and large intestines. Mounting evidence indicates that a complex interplay of mucosal lymphoid cells and luminal microorganisms with epithelial cells underlies differentiation of the M cell phenotype. The cellular and molecular features of M cells that promote adherence and transport of antigens and microorganisms are crucial for the design of mucosal vaccines and for understanding the strategies that pathogens use to exploit this pathway.
New scoring system of an interview for the diagnosis of benign paroxysmal positional vertigo

Abstract Conclusion This study investigated a novel instrument to diagnose benign paroxysmal positional vertigo (BPPV). Objective To develop a new scoring system of an interview for the diagnosis of BPPV. Methods The answers to questions on dizziness and/or vertigo (D/V) (571 patients) were analyzed and the questions for which the answers differed significantly between the patients with and without BPPV were selected. Results This study established an intensive questionnaire with a scoring system. It consists of the following questions: (1) Is rotary vertigo a characteristic of your D/V? (2) Is your D/V triggered when you roll your head over in a supine position? (3) Does your D/V disappear within 5 min? (4) Have you previously experienced hearing loss in one ear, or have you experienced hearing loss, tinnitus, or ear fullness with this D/V? One point each was given to an answer of ‘yes’ to questions (1) and (2). Two points were given to an answer of ‘yes’ to question (3). One point was subtracted upon an answer of ‘yes’ to question (4). When the total score was greater than two points, the patient was diagnosed with BPPV. The sensitivity of the diagnosis of BPPV by this scoring system was 81% and the specificity was 69%.
Blood-borne macrophage-neural cell interactions hitchhike on endosome networks for cell-based nanozyme brain delivery.

BACKGROUND Macrophage-carried nanoformulated catalase ('nanozyme') attenuates neuroinflammation and protects nigrostriatal neurons from 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine intoxication. This is facilitated by effective enzyme transfer from blood-borne macrophages to adjacent endothelial cells and neurons leading to the decomposition of reactive oxygen species. MATERIALS & METHODS We examined the intra- and inter-cellular trafficking mechanisms of nanozymes by confocal microscopy. Improved neuronal survival mediated by nanozyme-loaded macrophages was demonstrated by fluorescence-activated cell sorting. RESULTS In macrophages, nanozymes were internalized mainly by clathrin-mediated endocytosis then trafficked to recycling endosomes. The enzyme is subsequently released in exosomes facilitated by bridging conduits. Nanozyme transfer from macrophages to adjacent cells by endocytosis-independent mechanisms diffusing broadly throughout the recipient cells. In contrast, macrophage-free nanozymes were localized in lysosomes following endocytic entry. CONCLUSION Facilitated transfer of nanozyme from cell to cell can improve neuroprotection against oxidative stress commonly seen during neurodegenerative disease processes.
Time to return to work and surgeons' recommendations after carpal tunnel release.

BACKGROUND Time to return to work after carpal tunnel release is extremely variable suggesting that only a small proportion of total sick-leave is for medical reasons. AIMS To determine factors predicting a delayed return to work. METHODS Fifty consecutive employed patients undergoing carpal tunnel surgery were tested pre-operatively, and then at 1 month post-operatively using both questionnaires and objective testing. Further follow-up by telephone was carried out every 2 weeks up until 90 days. RESULTS Forty-nine of the 50 workers had returned to work by 3 months. Time to return to work was extremely variable ranging from 1 to 88 days in those who returned to work. Post-operative recommendations by the surgeon also varied widely from 1 to 36 days. The surgeons' recommendations were the strongest predictors of delayed return to work [odds ratio 30.5; 95% confidence interval (CI), 3.2-288], with physical work (odds ratio 27.7; 95% CI, 1.5-507) and lack of self-rated health (odds ratio 5.0; 95% CI, 1.11-100) adding significantly to the logistic regression model, which was highly predictive (area under the receiver-operator curve of 88%). Patient symptoms and objective findings of disability did not add significantly to a logistic regression model either predicting return to work or the surgeon's recommendations. CONCLUSIONS Our study suggests that workers will return to work in less than 3 weeks if recommended by the surgeon. A randomized controlled trial is warranted to determine if a higher proportion of workers returning in less than 3 weeks can be obtained by standardizing surgeons' recommendations.
Recreational Physical Activity and Leisure-Time Sitting in Relation to Postmenopausal Breast Cancer Risk

Epidemiologic evidence supports an inverse association between physical activity and postmenopausal breast cancer. Whether associations exist for moderate activities, such as walking, and whether associations differ by estrogen receptor (ER) status, body mass index (BMI, kg/m2), adult weight gain, or use of postmenopausal hormones (PMH) is unclear. The relation between time spent sitting and breast cancer also is unclear. Among 73,615 postmenopausal women in the American Cancer Society Cancer Prevention Study II Nutrition Cohort, 4,760 women were diagnosed with breast cancer between 1992 and 2009. Extended Cox regression was used to estimate multivariable-adjusted relative risks (RR) of breast cancer in relation to total recreational physical activity, walking, and leisure-time sitting. Differences in associations by ER status, BMI, weight gain, and PMH use were also evaluated. The most active women (those reporting >42 MET-hours/week physical activity) experienced 25% lower risk of breast cancer than the least active [0–<7 MET-hours/week; 95% confidence interval (CI), 0.63–0.89; Ptrend = 0.01]. Forty-seven percent of women reported walking as their only recreational activity; among these women, a 14% lower risk was observed for ≥7 hours/week relative to ≤3 hours/week of walking (95% CI, 0.75–0.98). Associations did not differ by ER status, BMI, weight gain, or PMH use. Sitting time was not associated with risk. These results support an inverse association between physical activity and postmenopausal breast cancer that does not differ by ER status, BMI, weight gain, or PMH use. The finding of a lower risk associated with ≥7 hours/week of walking may be of public health interest. Cancer Epidemiol Biomarkers Prev; 22(10); 1906–12. ©2013 AACR.
Are Biomarkers a Useful Aid in Smoking Cessation? A Review and Analysis of the Literature

Abstract Healthcare providers' ability to motivate people to try to quit smoking or to remain abstinent is limited. Even with our best treatments, most smokers relapse within 1 year. Therefore it is important that we constantly strive to develop and test new, effective smoking interventions. Providing feedback on one's biomarkers (eg, biological indices of smoking-related harm, harm exposure, or genetic susceptibility to disease) have been suggested as potentially useful for increasing smokers' motivation or ability to quit smoking. In fact, variations of this strategy are commonly incorporated into behavioral smoking-cessation interventions, but little empirical evidence has specifically addressed whether this approach is effective. In this article, the author reviews the theoretical rationale and empirical evidence regarding this practice. Although the preliminary evidence is promising, more research is needed to determine the efficacy of using biomarkers and the limits of the strategy's effectiveness. Future investigations should address these issues.