Miracle-dz/UniFAR-FTUs huggingface dataset:
Should Low Central Venous Pressure Be Maintained during Liver Transplantation

Low central venous pressure, which indirectly reflects free hepatic venous pressure, is maintained during hepatic resection surgery to reduce intraoperative blood loss by facilitating hepatic venous outflow. However, whether the low central venous pressure protocol established for non-transplant hepatobiliary surgery should be generalized to liver transplantation is controversial because patients with cirrhosis have decreased portal and hepatic venous blood flow and vulnerability to renal failure. However, consistent with observations from hepatic resection surgeries, lowering central venous pressure during the preanhepatic phase significantly reduces blood loss and transfusion volume. Conversely, inherent study limitations and different study designs have yielded different results in terms of renal dysfunction. Although hepatic venous outflow promoted by lowering blood volume seems to facilitate a liver graft to accommodate portal blood flow increased by portal hypertension-induced splanchnic vasodilatation, the association between low central venous pressure and reduced incidence of portal hyperperfusion injury has not been demonstrated. Stroke volume variation predicts fluid responsiveness better than central venous pressure, but it has not been associated with a greater clinical benefit than central venous pressure to date. Therefore, the safety of maintaining low central venous pressure during liver transplantation has not been verified, and further randomized controlled studies are warranted to establish a fluid management protocol for each phase of liver transplantation to reduce intraoperative blood loss and transfusion rate, thereby maintaining liver graft viability. In conclusion, low central venous pressure reduces intraoperative blood loss but does not guarantee renoprotection or graft protection.
Postoperative Hypoparathyroidism and the Viability of the Parathyroid Glands During Thyroidectomy

Objectives To prevent hypoparathyroidism after thyroidectomy, preservation of the parathyroid glands and their vascularity are essential. The aim of this study was to determine the association between postoperative parathyroid function and the viability of the parathyroid glands during thyroidectomy. Methods We prospectively analyzed 111 patients who underwent total thyroidectomy and in whom all 4 parathyroid glands were preserved in situ during the operation. The surgeons scored the viability of each parathyroid gland from 0 (normal) to 3 (severely compromised viability) based on its gross appearance and vascularity intraoperatively. The index of parathyroid viability score (IPVS) was defined as the sum of the viability scores of the 4 parathyroid glands. We evaluated the relationship between postoperative parathyroid function and IPVS. Results Transient hypoparathyroidism occurred in 25 patients (22.5%), and permanent hypoparathyroidism in 4 patients (3.6%). The IPVS were significantly different in the three groups: 2.87±1.46 in the normal group, 3.68±1.41 in the transient hypoparathyroidism group and 7.50±1.00 in the permanent hypoparathyroidism group. The rates of transient hypoparathyroidism were 13.6% in patients with IPVS 0–2, 23.8% in patients with IPVS 3–4, and 42.9% in patients with IPVS 5–6. All the patients with IPVS of 7 or more had permanent hypoparathyroidism. Conclusion IPVS is correlated with the incidence of hypoparathyroidism. It could be a good quantitative indicator of the probability of hypoparathyroidism after thyroidectomy.
Low-Dose Heparin Retention in Temporary Hemodialysis Double-Lumen Catheter Does Not Increase Catheter Occlusion and Might Reduce Risk of Bleeding

Background: The objective of this study was to assess the impact of heparin concentration retained in temporary double-lumen catheters on bleeding risk. Methods: Activated partial thromboplastin time (aPTT) was measured in patients hemodialyzed via double-lumen catheters. Heparin solutions of 5,000 U/ml (group 1, n = 95) and 1,000 U/ml (group 2, n = 89) were randomly retained in catheters after placement and each hemodialysis (HD) session. Blood transfusion, bleeding episodes, and changes of hematocrit were recorded. Results: The aPTT at the beginning of HD or 10 min after heparin lock was significantly prolonged, which was more prominent in the 5,000 U/ml group, whereas the aPTT declined to baseline values at the end of HD or before the next dialysis session in both groups. Infection and occlusion rates were similar in both groups. More patients suffered from major bleeding and prominent decline of hematocrit in the 5,000 U/ml group. Conclusions: Low-dose heparin (1,000 U/ml) retention in double-lumen catheters for temporary HD maintains comparable catheter patency and might reduce the bleeding risk.
A Modular Multilevel DC–DC Converter Topology With a Wide Range of Output Voltage

To solve some problems caused by the ac control method used for the existing modular multilevel dc–dc converter (MMDC), this paper has proposed a new MMDC topology with a wide range of output voltage by means of dc control. By reconstructing the submodule structure, the converter has a power branch and an auxiliary balance branch, which are used to transmit dc power and balance the capacitor voltage, respectively. Both dc analysis and control method are adopted to establish a mathematical model so as to deduce the mathematical relationships between the key electrical parameters. Moreover, what have been done include analyzing the self-balancing principle of the capacitor voltage and the mechanism of the auxiliary balance branch, calculating the related parameters of the capacitor voltage fluctuation, and presenting a dc closed-loop control strategy based on a small-signal model. The analyses of the steady and dynamic states in combination with simulation and experiment show that the proposed converter can stably operate in the mode of dc control, with a large adjustable range of output voltage, a small fluctuation in voltage of the capacitor, and the ability of the inductor to suppress the spike of the auxiliary balance current effectively so as to reduce the impact on the device.
Effects of ulinastatin on renal ischemia-reperfusion injury in rats.

AIM To investigate the effect and possible mechanism of ulinastatin on renal ischemia-reperfusion injury in rats. METHODS Male Sprague-Dawley rats were subjected to 45-min bilateral renal ischemia, treated with intravenously 12,500 U ulinastatin at 30 min prior to ischemia and at the beginning of reperfusion, compared with a nontreated group without ulinastatin and a sham-operation group without bilateral renal ischemia. After 0 h, 2 h, 6 h, 12 h, and 24 h of reperfusion, serum creatinine and blood urea nitrogen were measured for the assessment of renal function, renal sections were used for histologic grading of renal injury, for immunohistochemical localization of Bcl-2 and heat shock protein 70. Renal ultrastructure was observed through a transmission electron microscope. RESULTS Ulinastatin significantly reduced the increase in blood urea nitrogen and creatinine produced by renal ischemia-reperfusion, suggesting an improvement in renal function. Ulinastatin reduced the histologic evidence of renal damage associated with ischemia-reperfusion and accompanied with an up-regulation in the expression of Bcl-2 protein, but it had no significant effect on the expression of HSP 70. Ulinastatin also significantly reduced kidney ultrastructure damage caused by renal ischemia-reperfusion. CONCLUSION The protease inhibitor, ulinastatin, reduced the renal dysfunction and injury associated with ischemia-reperfusion of the kidney. The protective effect of ulinastatin might be associated with the up-regulation of Bcl-2 expression and the effect on membrane fragility.
Quantification of anatomical variation at the atlanto‐occipital articulation: morphometric resolution of commingled human remains within the repatriation documentation process

Within many institutional collections are skeletal and mummified human remains representing a part of our species’ adaptation and evolution to various biocultural environments. Archaeologically recovered individuals come from deep into our past, and possess information that provides insight into population history, genetics, diet, health and other questions relevant to all living peoples. Academic concerns have been raised regarding the reinterment of these collections due to the rise of the international repatriation movement, the passage of various laws and implementation of institutional policies. While all potential research questions cannot be anticipated, the proactive documentation of collections is one way to ensure primary data are maintained for future study. This paper explores developments in digitization technology that allow the archive of virtual copies of human remains, and an example of how anatomical and archaeological collections can be digitized towards pragmatic research goals. The anatomical variability of the human atlanto‐occipital (AO) articular surfaces was studied using non‐metric categorical shape, 2D measurement and 3D morphometric analyses to provide reference standards for the reassociation of individuals from commingled skeletal remains, such as found in some archaeological sites or forensic investigations including mass grave or mass disaster recovery scenes. Results suggest that qualitative shape observations and caliper‐derived measurements of the articulating AO condyles tend to display significant sexual dimorphism and biological ancestry‐related size and shape differences. Variables derived from a scanned 3D mesh, such as condylar angle and articular surface curvature, quantify biomechanical variation and display a stronger congruency within individuals. It is recommended that a two‐stage approach involving initial screening and identification of possible reassociation candidates is accomplished with a linear osteometric approach, followed by 3D laser scanning of the candidate joint surfaces for morphometric analyses to confirm reassociations when destructive DNA typing is not allowed or otherwise impractical due to cost or other resource restrictions.
Local Ramsey theory: an abstract approach

Given a topological Ramsey space (R,≤,r) , we extend the notion of semiselective coideal to sets H⊆R and study conditions for H that will enable us to make the structure (R,H,≤,r) a Ramsey space (not necessarily topological) and also study forcing notions related to H which will satisfy abstract versions of interesting properties of the corresponding forcing notions in the realm of Ellentuck's space (cf. ). This extends results from to the most general context of topological Ramsey spaces. As applications, we prove that for every topological Ramsey space R , under suitable large cardinal hypotheses every semiselective ultrafilter U⊆R is generic over L(R) ; and that given a semiselective coideal H⊆R , every definable subset of R is H ‐Ramsey. This generalizes the corresponding results for the case when R is equal to Ellentuck's space (cf. ).
Compromised Cerebrovascular Regulation and Cerebral Oxygenation in Pulmonary Arterial Hypertension

Background Functional cerebrovascular regulatory mechanisms are important for maintaining constant cerebral blood flow and oxygen supply in heathy individuals and are altered in heart failure. We aim to examine whether pulmonary arterial hypertension (PAH) is associated with abnormal cerebrovascular regulation and lower cerebral oxygenation and their physiological and clinical consequences. Methods and Results Resting mean flow velocity in the middle cerebral artery mean flow velocity in the middle cerebral artery (MCAvmean); transcranial Doppler), cerebral pressure‐flow relationship (assessed at rest and during squat‐stand maneuvers; analyzed using transfer function analysis), cerebrovascular reactivity to CO 2, and central chemoreflex were assessed in 11 patients with PAH and 11 matched healthy controls. Both groups also completed an incremental ramp exercise protocol until exhaustion, during which MCAvmean, mean arterial pressure, cardiac output (photoplethysmography), end‐tidal partial pressure of CO 2, and cerebral oxygenation (near‐infrared spectroscopy) were measured. Patients were characterized by a significant decrease in resting MCAvmean (P<0.01) and higher transfer function gain at rest and during squat‐stand maneuvers (both P<0.05). Cerebrovascular reactivity to CO 2 was reduced (P=0.03), whereas central chemoreceptor sensitivity was increased in PAH (P<0.01), the latter correlating with increased resting ventilation (R 2=0.47; P<0.05) and the exercise ventilation/CO2 production slope (V˙E/V˙CO2 slope; R 2=0.62; P<0.05) during exercise for patients. Exercise‐induced increases in MCAvmean were limited in PAH (P<0.05). Reduced MCAvmean contributed to impaired cerebral oxygen delivery and oxygenation (both P<0.05), the latter correlating with exercise capacity in patients with PAH (R 2=0.52; P=0.01). Conclusions These findings provide comprehensive evidence for physiologically and clinically relevant impairments in cerebral hemodynamic regulation and oxygenation in PAH.
Comparison of CapriPure® and Percoll® density gradients for sperm separation of frozen-thawed goat spermatozoa

Frozen-thawed semen from six Boer bucks was pooled and used to compare the recently available commercial product CapriPure with Percoll for sperm quality. Sperm quality parameters such as sperm motility, concentration, membrane integrity (PI/CFDA), acrosome integrity (FITC-PNA) and mitochondrial activity (JC-1) were evaluated before and after sperm processing using CapriPure and Percoll density gradients. There was a significant reduction (P < 0.05) in the percentage of spermatozoa with intact acrosomes following Percoll gradient centrifugation. However, there was a significant increase in the percentage of spermatozoa with high mitochondrial membrane potential in both CapriPure (P < 0.01) and Percoll (P < 0.05) density gradient centrifugation methods. The samples selected using the CapriPure gradient achieved higher numerical values of membrane integrity, acrosome integrity as well as high mitochondrial membrane potential and showed a tendency for improvement of sperm parameters compared with the Percoll gradient, suggesting that CapriPure is a good alternative to Percoll for goat sperm separation. However, further studies are needed to assess the fertilizing capacity of spermatozoa following the use of the CapriPure gradient.
The Effect of 40-m Repeated Sprint Training on Maximum Sprinting Speed, Repeated Sprint Speed Endurance, Vertical Jump, and Aerobic Capacity in Young Elite Male Soccer Players

Tønnessen, E, Shalfawi, SAI, Haugen, T, and Enoksen, E. The effect of 40-m repeated sprint training on maximum sprinting speed, repeated sprint speed endurance, vertical jump, and aerobic capacity in young elite male soccer players J Strength Cond Res 25(9): 2364-2370, 2011—The purpose of this study was to examine the effect of 10 weeks' 40-m repeated sprint training program that does not involve strength training on sprinting speed and repeated sprint speed on young elite soccer players. Twenty young well-trained elite male soccer players of age (±SD) 16.4 (±0.9) years, body mass 67.2 (±9.1) kg, and stature 176.3 (±7.4) cm volunteered to participate in this study. All participants were tested on 40-m running speed, 10 × 40-m repeated sprint speed, 20-m acceleration speed, 20-m top speed, countermovement jump (CMJ), and aerobic endurance (beep test). Participants were divided into training group (TG) (n = 10) and control group (CG) (n = 10). The study was conducted in the precompetition phase of the training program for the participants and ended 13 weeks before the start of the season; the duration of the precompetition period was 26 weeks. The TG followed a Periodized repeated sprint training program once a week. The training program consisted of running 40 m with different intensities and duration from week to week. Within-group results indicate that TG had a statistically marked improvement in their performance from pre to posttest in 40-m maximum sprint (−0.06 seconds), 10 × 40-m repeated sprint speed (−0.12 seconds), 20- to 40-m top speed (−0.05 seconds), and CMJ (2.7 cm). The CG showed only a statistically notable improvement from pre to posttest in 10 × 40-m repeated sprint speed (−0.06 seconds). Between-group differences showed a statistically marked improvement for the TG over the CG in 10 × 40-m repeated sprint speed (−0.07 seconds) and 20- to 40-m top speed (−0.05 seconds), but the effect of the improvement was moderate. The results further indicate that a weekly training with repeated sprint gave a moderate but not statistically marked improvement in 40-m sprinting, CMJ, and beep test. The results of this study indicate that the repeated sprint program had a positive effect on several of the parameters tested. However, because the sample size in this study is 20 participants, the results are valid only for those who took part in this study. Therefore, we advice to use repeated sprint training similar to the one in this study only in periods where the players have no speed training included in their program. Furthermore, the participants in this study should probably trained strength, however, benefits were observed even without strength training is most likely to be caused by the training specificity.
Sequencing Treatment in BRAFV600 Mutant Melanoma: Anti-PD-1 Before and After BRAF Inhibition

Novel agents targeting immune checkpoint molecules or mutated BRAF are active therapeutic options for patients with BRAFV600-mutant melanoma. However, the most effective first-line treatment and the optimal sequencing of these agents have not been well characterized. To explore this, we retrospectively assessed 114 patients from 4 centers with advanced, BRAFV600-mutant melanoma who received anti-programmed cell death-1 (PD-1)/PD-L1 antibodies. We evaluated clinical outcomes, including objective response rate (ORR), overall survival (OS), and progression-free survival (PFS) to initial and subsequent therapies in patients that received anti-PD-1 first (n=56) versus those that received BRAF±MEK inhibitors (BRAFi) first (n=58). Median OS was similar between these groups (27.5 vs. 40.3 mo, P=0.71). Patients who progressed on anti-PD-1 during the study timeframe had worse outcomes after starting subsequent BRAFi than those who had not received prior anti-PD-1 (median PFS 5 vs. 7.4 mo, median OS 10.6 vs. 40.3 mo). Similarly, patients who previously progressed on BRAFi had seemingly inferior outcomes after starting anti-PD-1 compared with those without prior BRAFi, including ORR (25% vs. 41%), median PFS (2.8 vs. 10.6 mo) and median OS (8.2 vs. 27.6 mo). Notably, patients who benefited >6 months from BRAFi had superior ORR to subsequent anti-PD-1 compared with those with more rapid progression (<6 mo) on BRAFi (34% vs. 15%, P=0.04). We conclude that either BRAFi or anti-PD-1 may be effective regardless of treatment sequence in patients with BRAFV600-mutant melanoma, but clinical outcomes to front-line therapy are superior. In addition, we suggest a shared “responder phenotype” between BRAFi and anti-PD-1.
Evaluation of the SNAP CPL and Spec CPL canine pancreatic lipase tests for acute pancreatitis in dogs presenting with clinical signs of acute abdominal disease

Canine acute pancreatitis (AP) is commonly encountered in veterinary clinical practice. Acute pancreatitis can occur on its own as a primary disease or can be secondary to other diseases. Early recognition and appropriate management of dogs with AP can be hampered by difficulty in not only diagnosing the disease, but also differentiating primary versus secondary pancreatitis. Failure to recognise that AP is actually the result of another underlying disease may lead to inappropriate management of the patient. This is especially important in critically ill dogs that present to an emergency service. Historically, catalytic assays have been used to diagnose AP but the tests have shown poor reliability. These tests have largely been criticised for lack of sensitivity and specificity, as pancreatic enzyme activity may not solely represent pancreatic leakage. Recently, a laboratory-based canine specific pancreatic lipase test (Spec cPL®) has been developed to aid diagnosis of AP, which is specific to the detection of pancreatic lipase leakage. To date, there are few studies evaluating the Spec cPL®, but it was developed in the hope it would provide a more definitive diagnosis of AP. Questions have been raised as to its accuracy as a diagnostic test, and it still does not differentiate between primary and secondary pancreatitis. An in-house canine pancreatic lipase test (SNAP® cPL) has also become available to clinicians. The manufacturer has reported very good agreement between the Spec cPL® and SNAP® cPL, using recombinant canine pancreatic lipase (cPL), but this is yet to be tested clinically. The first aim of this study therefore was to measure agreement between these two tests in dogs presenting with clinical signs of acute abdominal disease. The second aim was to determine the degree of agreement (if any) between a clinical diagnosis of primary AP and increased cPL concentration, as measured by the above two tests. The third aim was to establish the sensitivity and specificity for these tests in dogs with clinically diagnosed primary AP. The results of this study demonstrated that the SNAP® cPL and Spec cPL® tests had good agreement with each other for the entire cohort of dogs. However, there was poor agreement between each of these tests and a clinical diagnosis of pancreatitis. While sensitivity did not differ markedly from previous reports on Spec cPL®, specificity results were much lower. Therefore, it appears that these tests can detect the presence of cPL but cannot be used in isolation to diagnose primary pancreatitis.
Meibomian Gland Dysfunction in Cranial Nerve VII Palsy

Purpose: To examine clinical findings on meibomian gland dysfunction (MGD) in patients with unilateral cranial nerve VII (CN VII) palsy. Methods: This prospective observational study included 35 patients with unilateral CN VII palsy. The following features were compared between the affected and the unaffected sides: incidence of eyelid abnormalities (irregular eyelid margin, vascular engorgement, and plugged meibomian gland orifices), Marx line score, meibom expression score, area and density scores for corneal fluorescein staining, Schirmer test I (without topical anesthesia), and tear break-up time. Results: The affected side demonstrated significantly higher incidences of vascular engorgement (p = 0.004) and plugged meibomian gland orifices (p < 0.001) than the unaffected side. The incidence of an irregular eyelid margin was similar for both sides (p = 0.168). The scores for the Marx line (p < 0.001), meibom expression (p < 0.001), area (p = 0.034), and density (p = 0.026) were significantly higher for the affected side than for the unaffected side. The affected side showed a significantly higher Schirmer value than the unaffected side (p = 0.030). Tear break-up time was significantly shorter on the affected side than on the unaffected side (p = 0.023). Conclusions: MGD was more markedly demonstrated on the affected side in patients with unilateral CN VII palsy.