Miracle-dz/UniFAR-FTUs huggingface dataset:
Intraperitoneal Instillation of Lidocaine Improves Postoperative Analgesia at Cesarean Delivery: A Randomized, Double-Blind, Placebo-Controlled Trial

BACKGROUND: Cesarean delivery is a commonly performed procedure worldwide. Despite improvements in balanced multimodal analgesia, there remains a proportion of women for whom postoperative pain relief and patient satisfaction are still inadequate. Intraperitoneal instillation of local anesthetic has been shown to be effective in reducing postoperative pain after abdominal surgery. We sought to investigate the effect of intraperitoneal instillation of lidocaine on postcesarean delivery pain as part of a multimodal analgesia regimen. METHODS: We studied women scheduled for elective cesarean delivery under spinal anesthesia. Spinal anesthesia was performed with 0.75% hyperbaric bupivacaine, fentanyl, and morphine. At the end of the cesarean delivery, immediately before parietal peritoneum or fascia closure, patients were randomized to receive either lidocaine (20 mL 2% lidocaine with epinephrine) or placebo (20 mL normal saline) instilled into the peritoneal cavity. The primary outcome was pain score on movement at 24 hours. Secondary outcomes were pain score at rest and on movement at 2, 24, and 48 hours; maternal satisfaction score; analgesic consumption; incidence of nausea, vomiting, and itching; and return of bowel function. RESULTS: Two hundred four women were recruited. Baseline characteristics were similar between the lidocaine and placebo groups. Pain scores at 24 hours postcesarean delivery on movement (parameter estimate 0.02 [95% confidence interval {CI} −0.14 to 0.18]; P = .823) and at rest (parameter estimate 0.00 [95% CI −0.32 to 0.33]; P = .986) were similar in both groups. Pain scores at 2 hours postcesarean delivery on movement (parameter estimate −0.58 [95% CI −0.90 to −0.26]; P = .001) and at rest (parameter estimate −1.00 [95% CI −1.57 to −0.43]; P = .001) were lower in the lidocaine group. Subgroup analysis of patients with peritoneum closure revealed significantly lower pain scores at 24 hours on movement (parameter estimate −0.33 [95% CI −0.64 to −0.03]; P = .032) in the lidocaine group. The number of women requesting postoperative opioids for breakthrough pain was significantly lower in the lidocaine group compared with that of the placebo (40 [40%] vs 61 [65%], respectively, relative risk 0.59 [95% CI 0.43–0.81]; P = 0.001). CONCLUSIONS: The use of intraperitoneal instillation of lidocaine improves early postoperative pain management after cesarean delivery. Furthermore, it reduces the number of women requesting systemic opioids in the immediate postpartum period. Women undergoing peritoneal closure may particularly benefit from this intervention.
OBSERVATIONAL SELECTION BIAS AFFECTING THE DETERMINATION OF THE EXTRAGALACTIC DISTANCE SCALE

▪ Abstract The influence of Malmquist bias on the studies of extragalactic distances is reviewed, with brief glimpses of the history from Kapteyn to Scott. Special attention is paid to two kinds of biases, for which the names Malmquist biases of the first and second kind are proposed. The essence of these biases and the situations where they occur are discussed. The bias of the first kind is related to the classical Malmquist bias (involving the “volume effect”), while the bias of the second kind appears when standard candles are observed at different (true) distances, whereby magnitude limit cuts away a part of the luminosity function. In particular, study of the latter bias in distance indicators such as Tully Fisher, available for large fundamental samples of galaxies, allows construction of an unbiased absolute distance scale in the local galaxy universe where approximate kinematic relative distances can be derived. Such investigations, using the method of normalized distances or of the Spaenhauer dia.
Threats to Moral Identity: Testing the Effects of Incentives and Consequences of One's Actions on Moral Cleansing

Individuals engage in moral cleansing, a compensatory process to reaffirm one's moral identity, when one's moral self-concept is threatened. However, too much moral cleansing can license individuals to engage in future unethical acts. This study examined the effects of incentives and consequences of one's actions on cheating behavior and moral cleansing. Results found that incentives and consequences interacted such that unethical thoughts were especially threatening, resulting in more moral cleansing, when large incentives to cheat were present and cheating explicitly harmed others. Implications are discussed in terms of ethics training, using incentives as motivators, and the depersonalized norms of science.
PREPARATION OF PLEUROPNEUMONIA-LIKE ORGANISMS FOR MICROSCOPIC STUDY

I This investigation was supported in part by research grants (E-2764 and E-2765) from the National Institute of Allergy and Infectious Diseases, U. S. Public Health Service. 2 Special Research Fellow, U. S. Public Health Service. with differential staining would aid in their identification. There are two basic methods currently being used for the preparaticn of PPLO colonies for microscopic study. One methcd uses a modified agar fixation technique (Klieneberger and Smiles, J. Hyg., 42, 110, 1942) and the other a direct, stained agar technique (Dienes, J. Infectious Diseases, 65, 24, 1939). Both methods have been used and reported by other investigators to have
Inhibition of Rat and Human Steroidogenesis by Triazole Antifungals

Environmental chemicals that alter steroid production could interfere with male reproductive development and function. Three agricultural antifungal triazoles that are known to modulate expression of cytochrome P450 (CYP) genes and enzymatic activities were tested for effects on steroidogenesis using rat in vivo (triadimefon), rat in vitro (myclobutanil and triadimefon), and human in vitro (myclobutanil, propiconazole, and triadimefon) model systems. Hormone production was measured in testis organ cultures from untreated adult and neonatal rats, following in vitro exposure to 1, 10, or 100 μM of myclobutanil or triadimefon. Myclobutanil and triadimefon reduced media levels of testosterone by 40–68% in the adult and neonatal testis culture, and altered steroid production in a manner that indicated CYP17-hydroxylase/17,20 lyase (CYP17A1) inhibition at the highest concentration tested. Rat to human comparison was explored using the H295R (human adrenal adenocarcinoma) cell line. Following 48 h exposure to myclobutanil, propiconazole, or triadimefon at 1, 3, 10, 30, or 100 μM, there was an overall decrease in estradiol, progesterone, and testosterone by all three triazoles. These data indicate that myclobutanil, propiconazole, and triadimefon are weak inhibitors of testosterone production in vitro. However, in vivo exposure of rats to triazoles resulted in increased serum and intra-testicular testosterone levels. This discordance could be due to higher concentrations of triazoles tested in vitro, and differences within an in vitro model system lacking hepatic metabolism and neuroendocrine control.
A unifying approach for surrogate marker validation based on Prentice's criteria

Part of the recent literature on the evaluation of surrogate endpoints starts from a multi‐trial approach which leads to a definition of validity in terms of the quality of both trial‐level and individual‐level association between a potential surrogate and a true endpoint, Buyse et al. These authors proposed their methodology based on the simplest cross‐sectional case in which both the surrogate and the true endpoint are continuous and normally distributed. Different variations to this theme have been implemented for binary responses, times to event, combinations of binary and continuous endpoints, etc. However, a drawback of this methodology is that different settings have led to different definitions to quantify the association at the individual‐level. In the longitudinal setting; Alonso et al. defined a class of canonical correlation functions that can be used to study surrogacy at the trial and individual‐level. In the present work, we propose a new approach to evaluate surrogacy in the repeated measurements framework, we also show the connection between this proposal and the previous ones reported in the literature. Finally, we extend this concept to the non‐normal case using the so‐called ‘likelihood reduction factor’ (LRF) a new validation measure based on some of the Prentice's criteria. We apply the previous methodology using data from two clinical studies in psychiatry and ophthalmology. Copyright © 2005 John Wiley & Sons, Ltd.
Thinking about Psychoanalytic Curricula: an Epistemological Perspective

The author discusses the role that curriculum development can play in preparing psychoanalytic candidates to understand the challenges created by theoretical pluralism in our field and by the growth of knowledge in neighboring disciplines. Curriculum design can be used to encourage the development of epistemological perspectives that can serve as organizing frameworks to help candidates think critically about psychoanalytic knowledge. It is possible to teach these complex matters in a way that students find accessible and useful. The author presents exemplars taken from the curriculum at the Columbia University Center for Psychoanalytic Training and Research in New York.
Quantitative analysis of cell-free DNA in ovarian cancer

The aim of the present study was to investigate the association between cell-free DNA (cf-DNA) levels and clinicopathological characteristics of patients with ovarian cancer using a branched DNA (bDNA) technique, and to determine the value of quantitative cf-DNA detection in assisting with the diagnosis of ovarian cancer. Serum specimens were collected from 36 patients with ovarian cancer on days 1, 3 and 7 following surgery, and additional serum samples were also collected from 22 benign ovarian tumor cases, and 19 healthy, non-cancerous ovaries. bDNA techniques were used to detect serum cf-DNA concentrations. All data were analyzed using SPSS version 18.0. The cf-DNA levels were significantly increased in the ovarian cancer group compared with those of the benign ovarian tumor group and healthy ovarian group (P<0.01). Furthermore, cf-DNA levels were significantly increased in stage III and IV ovarian cancer compared with those of stages I and II (P<0.01). In addition, cf-DNA levels were significantly increased on the first day post-surgery (P<0.01), and subsequently demonstrated a gradual decrease. In the ovarian cancer group, the area under the receiver operating characteristic curve of cf-DNA and the sensitivity were 0.917 and 88.9%, respectively, which was higher than those of cancer antigen 125 (0.724, 75%) and human epididymis protein 4 (0.743, 80.6%). There was a correlation between the levels of serum cf-DNA and the occurrence and development of ovarian cancer in the patients evaluated. bDNA techniques possessed higher sensitivity and specificity than other methods for the detection of serum cf-DNA in patients exhibiting ovarian cancer, and bDNA techniques are more useful for detecting cf-DNA than other factors. Thus, the present study demonstrated the potential value for the use of bDNA as an adjuvant diagnostic method for ovarian cancer.
The association of maternal social factors and antenatal care with cord serum zinc in full – term neonates

Zinc is a crucial micronutrient in early childhood survival and the development of innate and acquired immunity. The objective is to determine the relationship between of maternal social class and antenatal care to serum zinc level in newborns in a tertiary and a rural hospital. It is prospective study using questionnaires on consecutive mothers with normal pregnancy(excluding sepsis and chronic illneses) and cord serum level of Zinc estimation in newborns using flame atomic absorption spectrophotometry. There were 106 mothers and neonates; were made up of 57 females and 49 males. The ages of the mother ranged between 21 years to 39 years, with a mean of 26 years; while the gestational age of the neonates ranged between 30 weeks and 45 weeks with a mean of 37.3. The range of the serum Zinc was 0. 14μg/L – 0. 92μg/L, with a mean of 0. 64μg/L (SD=0.17) and median value of 0. 63μg/L. The social classes of the mothers were low 66, middle 23 and high 17 with mean neonatal serum zinc of 0. 62μg/L, 0. 68μg/L and 0. 72μg/L. The mean serum Zinc in 17/86 neonates of mothers with inadequate tetanus vaccination was 0. 53μg/L, (below the median value) compared to 0. 66μg/L in 89/106 neonates of mothers with complete vaccination. The serum zinc in the neonates of mothers 25years. Fever in pregnancy was seen in 31/106; with mean neonatal serum Zinc of 0. 63μg/L compared with those without fever 0. 65μg/L. There were 94 neonates with normal weight (>2.5kg) and 12 low birth weight ( Key word: neonates, serum zinc, maternal social classes, antenatal care, association
Human Milk Intake and Retinopathy of Prematurity in Extremely Low Birth Weight Infants

REFERENCES 1. Smith MJ, Ellenberg SS, Bell LM, Rubin DM. Media coverage of the measles-mumps-rubella vaccine and autism controversy and its relationship to MMR immunization rates in the United States. Pediatrics. 2008;121(4). Available at: www.pediatrics. org/ cgi/content/full/121/4/e836 2. Gellin BG, Maibach EW, Marcuse EK. Do parents understand immunizations? A national telephone survey. Pediatrics. 2000; 106(5):1097–1102 3. Salmon DA, Moulton LH, Omer SB, DeHart MP, Stokley S, Halsey NA. Factors associated with refusal of childhood vaccines among parents of school-aged children: a case-control study. Arch Pediatr Adolesc Med. 2005;159(5):470–476 4. Woo EJ, Ball R, Bostrom A, et al. Vaccine risk perception among reporters of autism after vaccination: Vaccine Adverse Event Reporting System 1990–2001. Am J Public Health. 2004;94(6): 990–995
Rivastigmine in the Treatment of Alzheimer’s Disease

Setting and participants. Patients aged 50 to 85 years who had mild to moderately severe AD were enrolled from 45 medical centers in Europe and North America. All study participants met criteria for Alzheimer’s type dementia as described in the DSM-IV [1] and criteria for probable AD from the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association [2]. Patients were excluded who were taking psychotropic or anticholinergic drugs, memory enhancers, insulin, or health food supplements.
Pesticide has asymmetric effects on two tadpole species across density gradient

Northern leopard frogs (Rana pipiens) have been disappearing throughout their range. The causes for extirpations have been elusive, although habitat alteration appears to be a major factor. Pesticides have been implicated in declines in western amphibians, but no mechanism has been identified. We tested the hypothesis that leopard frog tadpoles would be eliminated from insecticide‐exposed ponds when they were less abundant than a competitor (American toads, Bufo americanus) by manipulating toad and leopard frog density (16, 50, or 150 of each species) with or without the insecticide carbaryl. Insecticide exposure did not interact with density on either species, indicating that contaminant effects were similar despite drastic differences in competition. The survival of both species decreased with increasing conspecific density, but not heterospecific density. Leopard frogs produced more metamorphs at intermediate densities, whereas toads produced more metamorphs at high density. Leopard frog mass at and time to metamorphosis responded negatively to density. Carbaryl did not affect leopard frog survival but positively affected mass at and time to metamorphosis. In contrast, toad survival was reduced after exposure, but mass at metamorphosis was greater. Pesticide‐induced survival reductions may not affect population size if reductions are slight (as in toads, whose fitness may be compensated by increased mass). Management strategies aimed at ameliorating the effects of carbaryl in systems with these two species may not need to consider density. Environ. Toxicol. Chem. 2011; 30:650–658. © 2011 SETAC
Deficiency of beta1 integrins results in increased myocardial dysfunction after myocardial infarction.

OBJECTIVE To study the role of beta1 integrins in left ventricular (LV) remodelling after myocardial infarction (MI). METHODS AND RESULTS LV structural and functional alterations were determined in wild-type (WT) and beta1 integrin heterozygous knockout (hKO) mice one month after MI. MI increased beta1 integrin expression in both groups; however, the increase was lower in hKO. Infarct size was similar in WT and hKO mice, whereas lung wet weight to dry weight ratio was increased in the hKO-MI mice (5.17 (SE 0.13) v 4.60 (0.15) in WT-MI, p < 0.01). LV end systolic and end diastolic diameters were significantly higher and percentage fractional shortening was significantly lower in hKO-MI. The ratio of peak velocity of early LV filling (E wave) to that of the late LV filling (A wave) and the isovolumic relaxation time (IVRT) were increased in both MI groups but the increase in IVRT was significantly higher in hKO-MI group than in WT-MI mice. Langendorff perfusion analysis indicated reduced peak LV developed pressure and increased LV end diastolic pressure in both MI groups. The reduction in peak LV developed pressure (36.7 (2.2) v 53.4 (1.9) mm Hg, p < 0.05) and increase in LV end diastolic pressure was higher in hKO-MI than in WT-MI. Increase in fibrosis was not different between the two MI groups. The increase in myocyte circumference was higher in the hKO-MI group (p < 0.001 v WT-MI). The number of apoptotic myocytes was significantly higher in hKO-MI than in WT-MI mice (p < 0.005) three days after MI. The number of necrotic myocytes was not different between the two MI groups. CONCLUSION beta1 integrins are crucial in post-MI remodelling with effects on LV function, hypertrophy and apoptosis.
TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS

ABSTRACT. In 68 appropriate for gestational age (AGA) and 33 small for gestational age (SGA) infants, transepidermal water loss was studied during the first four weeks after birth. The method used to measure evaporation rate is based on measurement of the water vapour pressure gradient close to the skin surface. All measurements were made at an ambient humidity of 50% and with the infants calm and quiet. At all the investigated post‐natal ages in both AGA and SGA infants, an exponential relationship was found between transepidermal water loss (g/m2 h) and gestational age, this loss being much higher in the pre‐term infants than in those born at term. The transepidermal water loss was generally lower in SGA than in AGA infants during the first week of post‐natal life, irrespective of gestational age at birth. There was a gradual decrease in transepidermal water loss with increasing post‐natal age in both pre‐term AGA and pre‐term SGA infants. Three weeks after birth this water loss tended to be higher in pre‐term SGA infants than in pre‐term AGA infants of corresponding gestational age.
Influence of Phenethylbiguanide on Lactic, Pyruvic and Citric Acids in Diabetic Patients

The biochemical effects of the oral hypoglycemic agent DBI (phenformin, phenethylbiguanide) in experimental animals have included alterations in the metabolism of lactic acid as well as of glucose, DBI not only increases the glucose uptake of the rat diaphragm in vitro but also decreases the oxygen uptake and increases the lactic acid production of that tissue. Lactic acid production by the guinea pig liver slice is also increased by the addition of DBI. In the same animal an elevation of the blood lactic acid concentration has been observed after administration of the drug. Accordingly, it appeared of interest to determine whether or not lactic acid metabolism was also altered in diabetic patients who were given DBI. The present studies on diabetic patients have included an investigation of the effects of DBI on ( i ) the concentration of lactic acid in the fasting blood, (2) the twenty-four-hour urinary excretion of lactic acid, (3) the changes in the blood lactic acid concentration after the administration of glucose or fructose, potential precursors of lactate, and (4) the changes in the blood lactic acid concentration after sodium lactate administration. Since lactate is in equilibrium with pyruvate, changes in lactic acid cannot be properly interpreted without a knowledge of the associated pyruvic acid changes. Therefore, both pyruvic and lactic acid concentrations were measured in the blood and urine specimens. In addition, changes in the blood concentrations and urinary excretions of glucose and citric acid were studied.
Vastus medialis obliquus and vastus lateralis activity in open and closed kinetic chain exercises in patients with patellofemoral pain syndrome: an electromyographic study.

OBJECTIVES To evaluate the electromyographic activities of vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles in open and closed kinetic chain exercises in subjects with patellofemoral pain syndrome (PFPS). DESIGN Case-controlled study. SETTING Rehabilitation science center in a tertiary medical center. PARTICIPANTS Ten patients with bilateral knee pain diagnosed with PFPS and 10 healthy volunteers. INTERVENTIONS Subjects performed open kinetic chain exercise on an isokinetic dynamometer and closed kinetic chain exercise by squat-to-stand and stand-to-squat tasks. Surface electromyography was done for the VMO and VL muscles. MAIN OUTCOME MEASURES VMO/VL ratios were calculated after normalization of muscle activities. RESULTS The VMO/VL ratios of PFPS subjects were significantly lower than were those of unimpaired subjects during knee isokinetic closed kinetic chain exercises (p = .047). However, there was no statistical difference in VMO/VL ratio between subjects with and without PFPS during closed kinetic chain exercises (p = .623). Maximum VMO/VL ratio was obtained at 60 degrees knee flexion in closed kinetic chain exercise. CONCLUSION In closed kinetic chain exercises, more selective VMO activation can be obtained at 60 degrees knee flexion. Maximal VMO/VL ratio was observed at this knee flexion angle, and muscle contraction intensity was also greatest.
The use of an immunocytochemical double-labeling staining can display the distribution of Bcl-2/Ki-67 cells in endometrial adenocarcinomas as well as in normal endometrium.

BACKGROUND Endometrial adenocarcinoma is the most common gynecologic malignancy and is the fifth most frequently diagnosed cancer in women. The objective of the present study was to determine the expression of a proliferation marker, Ki-67 and an apoptosis inhibitor, Bcl-2, by double-label staining in endometrial adenocarcinomas and in normal endometrium samples, to evaluate the differences in the immunocytochemical expression of Ki-67 and Bcl-2, and finally to correlate the results with tumor grade and stage. METHODS This study was carried on 270 endometrial samples, collected during a 27 month period, freshly resected from women who underwent total abdominal hysterectomy. RESULTS Ki-67 and Bcl-2 expressions were studied by immunocytochemistry. Bcl-2 expression was strong and homogeneous in normal (proliferative, secretory and atrophic) endometrium and more frequent in low-grade endometrioid carcinomas. Completely negative staining of Bcl-2 was found to be strictly related to high-grade endometrioid carcinomas. Ki-67 expression was higher in patients with high-grade endometrioid carcinomas. Proliferative endometrium showed inconclusive Ki-67 expression levels and in the secretory endometrium Ki-67 positive cells were remarkably diminished and even disappeared. Completely negative staining of Ki-67 was found to be strictly related to atrophic endometrium. CONCLUSIONS Immunocytochemical double-label staining can be used to display the distribution of Bcl-2 and Ki-67 cells in endometrioid carcinomas as well as normal endometrium, and, in addition to cytomorphologic features, contributes to its accurate diagnosis.