Miracle-dz/UniFAR-FTUs huggingface dataset:
Prediction of bacteremia in the emergency department: an external validation of a clinical decision rule

Objective The objective of this study was to validate a previously published clinical decision rule for predicting a positive blood culture in emergency department (ED) patients with suspected infection on the basis of major and minor criteria and a total score (Shapiro et al., J Emerg Med, 2008; 35:255–264). Methods This is a retrospective matched cohort study of adult ED patients with blood cultures obtained from 1 January 2011 through to 31 December 2011. ED patients with blood culture-confirmed bacteremia were matched 1 : 3 with patients with negative cultures. The outcome was ‘true bacteremia’. Data on clinical history, comorbid illnesses, physical observations, and laboratory tests were used to evaluate the application of the clinical decision rule. We report the sensitivity, specificity, and area under the curve. Results Among 1526 patients, 105 (6.9%) patients were classified with true bacteremia. The sensitivity of the prediction rule was 94% (95% confidence interval, 88–98%) and the specificity was 48% (95% confidence interval, 42–53%). The area under the receiver-operating characteristics curve was 0.83. Conclusion The clinical decision rule performed well in our ED setting and is likely to be a useful supplement to clinical judgment.
Medical cost analysis of family psychoeducation for schizophrenia

Abstract Family psychoeducation has been shown to prevent the relapse of schizophrenia. However, whether medical costs are reduced by this approach remains uncertain. The subjects were patients with schizophrenia who lived with high‐expressed emotion (EE) families and were at high risk of relapse. A total of 30 patients whose families underwent psychoeducation and intensive family sessions or psychoeducation and subsequent support were regarded as the psychoeducation group. A high‐EE group without family psychoeducation made up of 24 patients was used as a control group. The mean outpatient medical cost, duration of hospitalization, inpatient medical cost, and total medical cost during the follow‐up period were compared between the psychoeducation group and the control group. The mean inpatient medical cost was ¥270 000 in the psychoeducation group and ¥470 000 in the control group. The mean total medical costs were ¥500 000 in the psychoeducation group and ¥710 000 in the control group. The cost in the psychoeducation group was significantly lower than the control group by Mann–Whitney U‐test. The proportion of patients with a total medical cost greater than the median value was 23% in the psychoeducation group and 54% in the control group with a significant difference. The medical cost can be reduced in the psychoeducation group compared with the control group due to the prevention of re‐hospitalization by family psychoeducation.
An extraordinary degree of structural specificity is required in neural phospholipids for optimal brain function: n‐6 docosapentaenoic acid substitution for docosahexaenoic acid leads to a loss in spatial task performance

This study was conducted to determine whether provision of preformed dietary docosapentaenoic acid (DPAn‐6) can replace docosahexaenoic acid (DHA) for brain function as assessed by spatial task performance. A newly modified artificial rearing method was employed to generate n‐3 fatty acid‐deficient rats. Newborn pups were separated from their mothers at 2 days of age and given artificial rat milk containing linoleic acid (LA), or LA supplemented with 1% DHA (DHA), 1% DPAn‐6 (DPA) or 1% DHA plus 0.4% DPAn‐6 (DHA/DPA). The animals were then weaned onto similar pelleted diets. At adulthood, behavioural tasks were administered and then the brains were collected for fatty acid analysis. The LA and DPA groups showed a lower (63–65%) brain DHA than the dam‐reared, DHA and DHA/DPA groups and this loss was largely compensated for by an increase in brain DPAn‐6. The brain fatty acid composition in the DPA group was the same as that in the LA group at adulthood. In the Morris water maze, the LA and DPA groups exhibited a longer escape latency than the dam‐reared and DHA groups and had a defect in spatial retention. In conclusion, DPAn‐6 could not replace DHA for brain function, indicating a highly specific structural requirement for DHA.
Proliferating cell nuclear antigen (PCNA) in relation to ras, c‐erbB‐2, p53, clinico‐pathological variables and prognosis in colorectal adenocarcinoma

Proliferating cell nuclear antigen (PCNA) expression was studied by immunohistochemistry on paraffin‐embedded sections of 293 primary colorectal adenocarcinomas and 56 corresponding lymph node metastases. PCNA‐positive expression was detected in <25% of tumour cells in 172 (59%) cases and in >25% in 121 (41%) cases. PCNA accumulation was related to over‐expression of c‐erbB‐2 and p53 and tended to be increased in cases with ras over‐expression. PCNA expression was identical in primary and corresponding metastases. No significant relationship was observed between PCNA expression and prognosis and other clinico‐pathological variables, including grade of differentiation, growth pattern, Duke's stage, site, age or sex. We conclude that PCNA expression may be related to alterations of oncoproteins but that PCNA itself could not provide additional information for the development of metastasis and prognosis in colorectal adenocarcinoma. © 1996 Wiley‐Liss, Inc.
Current Outcomes of the Norwood Operation in Patients With Single-Ventricle Malformations Other Than Hypoplastic Left Heart Syndrome

Background: Subsequent to increased experience with the Norwood operation in children with hypoplastic left heart syndrome (HLHS), its application has expanded to allow palliation of single-ventricle (SV) malformations other than HLHS. We describe current palliation outcomes in this group of SV patients. Methods: Between 2002 and 2012, 65 of the 303 Norwood operations were performed in non-HLHS SV patients. Competing risk analysis modeled events after Norwood and after subsequent Glenn and examined risk factors affecting outcomes. Results: Competing risk analysis showed that one year following Norwood, 24% of patients had died or received transplantation, 72% had undergone Glenn, and 4% were alive awaiting Glenn/Kawashima. Five years following Glenn, 9% of patients had died, 68% had undergone Fontan, and 23% were alive awaiting Fontan. Overall seven-year survival following Norwood was 68%. On multivariable analysis, mortality risk factors were unplanned cardiac reoperation (hazard ratio [HR]: 4.0 [1.5-10.6], P = .006), right dominant ventricle morphology (HR: 3.3 [1.3-8.3], P = .012), and postoperative extracorporeal membrane oxygenation (HR: 3.1 [1.1-9.0], P = .035). Conclusions: Operative death and interstage mortality continue to be problematic following Norwood palliation for non-HLHS SV variants. Outcomes seem comparable to those reported for HLHS, however they are influenced by underlying pathology; children with dominant left ventricle morphology (tricuspid atresia and double inlet left ventricle) have superior survival compared to those with dominant right ventricle morphology (mitral atresia, unbalanced atrioventricular septal defect, and most patients with atrial isomerism). Unplanned reoperations for technical imperfections diminish survival. Large multicenter studies might be warranted to better identify high-risk patients and provide guidance toward improving their survival.
Grumose or foamy spheroid bodies involving astrocytes in the human brain

Grumose or foamy spheroid bodies (GFSB), which correspond to the classical pathological description, ‘grumose degeneration’, are described. By light microscopy, GFSB are faintly eosinophilic and spheroidal structures with a foamy appearance in haematoxylin and eosin stains; they vary from 10 to 50 μm in diameter and contain amorphous debris‐like material. Some GFSB, however, contain a varying amount of eosinophilic grumose aggregates, some of which are randomly stained with periodic acid Schiff (PAS), Schmorl, Berlin blue, Grimelius or silver methods. The Gallyas stain, on the other hand, usually stains the contents of GFSB black or brown. Immunohistochemically, most GFSB are ubiquitin‐positive. Characteristically glial fibrillary acidic protein is associated with some GFSB giving a foamy appearance. Ultrastructurally, GFSB consist of dense bodies of various sizes and configuration. Glial fihrillary bundles and astrocytic punclate adhesions are occasionally observed associated with GFSB. Anatomically, GFSB are observed preferentially in the rostroventral parts of both the substantia nigra pars reticulata and the globus pallidus in a number of human neurodegenerative diseases and aged brains. GFSB, however, appear outside the above regions in various circumstances such as trauma, infarction and astrocytomas. In conclusion, GFSB are ubiquitinated structures closely related to astrocytes in their formation and with a preferred location in the deep regions of the basal ganglia.
Positional Relationship of Ethmoidal Foramens With Reference to the Nasion and Its Significance in Orbital Surgery

Purpose:The aim of the study was to elucidate the positional relationship of the ethmoidal foramens (EFs) with reference to the nasion to facilitate prediction of the exact location of EFs, the optic canal (OC), and the frontoethmoidal suture (FS), and thereby avoid complications during complex surgery involving the medial wall of the orbit. Materials and Methods:One hundred two intact orbits of 57 embalmed cadavers were dissected in this observational anatomic study. Nasion’ (N’) was defined as the intersection point of the medial orbit margin with the horizontal line through the nasion, and this was used as a reference point. N’-OC was defined as the straight line joining N’ and OC. The locations of the anterior ethmoidal foramen (AEF), posterior ethmoidal foramen (PEF), and OC were determined with reference to N’. The vertical distances from N’-OC to EFs and to FS were also determined. Results:The N’-AEF, AEF-PEF, and PEF-OC distances were 18.4, 15.3, and 8.3 mm, respectively. Vertically, AEF and PEF were situated at 0.2 mm below and 0.4 mm above N’-OC, respectively. At the same reference points, N’-OC was situated at 0.4 and 0.6 mm above FS, respectively. Conclusions:N’, AEF, PEF, and OC were considered to be situated on the same straight line, and N’-OC could be regarded as coinciding with FS. This means that N’ is an easily identifiable and reliable landmark for identifying EFs, OC, and FS. Our navigational parameters with reference to N’ will help surgeons to enhance the safety of orbital surgery.
TAK1‐binding protein 2 facilitates ubiquitination of TRAF6 and assembly of TRAF6 with IKK in the IL‐1 signaling pathway

TAK1 mitogen‐activated protein kinase kinase kinase participates in the Interleukin‐1 (IL‐1) signaling pathway by mediating activation of JNK, p38, and NF‐κB. TAK1‐binding protein 2 (TAB2) was previously identified as an adaptor that links TAK1 to an upstream signaling intermediate, tumor necrosis factor receptor‐associated factor 6 (TRAF6). Recently, ubiquitination of TRAF6 was shown to play an essential role in the activation of TAK1. However, the mechanism by which IL‐1 induces TRAF6 ubiquitination remains to be elucidated. Here we report that TAB2 functions to facilitate TRAF6 ubiquitination and thereby mediates IL‐1‐induced cellular events. A conserved ubiquitin binding domain in TAB2, the CUE domain, is important for this function. We also found that TAB2 promotes the assembly of TRAF6 with a downstream kinase, IκB kinase (IKK). These results show that TAB2 acts as a multifunctional signaling molecule, facilitating both IL‐1‐dependent TRAF6 ubiquitination and assembly of the IL‐1 signaling complex.
Historical Development of the Dopamine Hypothesis of Schizophrenia

This review examines the history of discoveries that contributed to development of the dopamine hypothesis of schizophrenia. The origin of the hypothesis is traced to the recognition that neuroleptic drugs interfere with brain dopamine function. This insight was derived from two distinct lines of research. The first line originated from the discovery in 1956 that reserpine depletes brain serotonin. This finding resulted in a sequence of studies that led to the discovery that brain dopamine is involved in neuroleptic-induced extrapyramidal motor disturbances. The second line of research was aimed at determining the mechanism of action of psychomotor stimulants. This research produced evidence that stimulants directly or indirectly activate brain dopamine receptors. Because nonreserpine neuroleptics such as chlorpromazine block stimulant-induced movement, these findings suggested that neuroleptics were dopamine antagonists. Most previous accounts of the development of the dopamine hypothesis of schizophrenia emphasize the first line of research and ignore the second.
Ciliopathy‐associated IQCB1/NPHP5 protein is required for mouse photoreceptor outer segment formation

Null mutations in the human IQCB1/NPHP5 (nephrocystin‐5) gene that encodes NPHP5 are the most frequent cause of Senior‐Løken syndrome, a ciliopathy that is characterized by Leber congenital amaurosis and nephronophthisis. We generated germline Nphp5‐knockout mice by placing a b‐Geo gene trap in intron 4, thereby truncating NPHP5 at Leu87 and removing all known functional domains. At eye opening, Nphp5‐/‐ mice exhibited absence of scotopic and photopic electroretinogram responses, a phenotype that resembles Leber congenital amaurosis. Outer segment transmembrane protein accumulation in Nphp5‐/‐ endoplasmic reticulum was evident as early as postnatal day (P)6. EGFP‐CETN2, a centrosome and transition zone marker, identified basal bodies in Nphp5‐/‐ photoreceptors, but without fully developed transition zones. Ultrastructure of P6 and 10 Nphp5‐/‐ photoreceptors revealed aberrant transition zones of reduced diameter. Nphp5‐/‐ photoreceptor degeneration was complete at 1 mo of age but was delayed significantly in Nphp5‐/‐;Nrl‐/‐ (cone only) retina. Nphp5‐/‐ mouse embryonic fibroblast developed normal cilia, and Nphp5‐/‐ kidney histology at 1 yr of age showed no significant pathology. Results establish that nephrocystin‐5 is essential for photoreceptor outer segment formation but is dispensable for kidney and mouse embryonic fibroblast ciliary formation. —Ronquillo, C. C. , Hanke‐Gogokhia, C. , Revelo, M. P., Frederick, J. M. , Jiang, L. , Baehr, W. Ciliopathy‐associated IQCB1/NPHP5 protein is required for mouse photoreceptor outer segment formation. FASEB J. 30, 3400–3412 (2016). www.fasebj. org
Anti‐mitogenic effects of β‐agonists and PGE2 on airway smooth muscle are PKA dependent

Inhaled β‐agonists are effective airway smooth muscle (ASM)‐relaxing agents that help reverse bronchoconstriction in asthma, but their ability to affect the aberrant ASM growth that also occurs with asthma is poorly understood. β‐Agonists exhibit PKA‐dependent antimitogenic effects in several cell types. However, recent studies suggest that Epac, and not PKA, mediates the antimitogenic effect of cAMP in both ASM and fibroblasts. This study aims to clarify the roleof PKA in mediating the effect of GS‐coupled receptors on human ASM growth. Pretreatmentof ASM cultures with β‐agonists albuterol, isoproterenol, or salmeterol (100 nM to 10 µM) caused a significant (‐25–30%) inhibition of EGF‐stimulated ASM thymi‐dine incorporation and cell proliferation, whereas a much greater inhibition was observed from pretreatment with PGE2 (75–80%). However, all agents were ineffective in cells expressing GFP chimeras of either PKI (a PKA inhibitor) or a mutant PKA regulatory subunit relative to the control cells expressing GFP. The antimitogenic efficacy of PGE2 in inhibiting control cultures was associated with greater ability to stimulate sustained PKA activation and greater inhibition of late‐phase promitogenic p42/p44 and PI3K activities. These findings suggest that therapeutic approaches enabling superior PKA activation in ASM will be most efficacious in deterring ASM growth. —Yan, H. , Deshpande, D. A. , Misior, A. M. , Miles, M. C. , Saxena, H. , Riemer, E. C. , Pascual, R. M. , Panettieri, R. A. , Penn. R. B. Anti‐mitogenic effects of β‐agonists and PGE2 on airway smooth muscle are PKA dependent. FASEB J. 25, 389–397 (2011). www.fasebj. org
El comercio entre los países BRICS

El acronimo BRICS (Brasil, Rusia, India, China, Sudafrica) usado originalmente para identificar economias emergentes con grandes dimensiones geografica y demografica se esta convirtiendo en la practica en una categoria de analisis. Esos paises han pasado a ser considerados de modo distinto, sendo vistos no mas solo como 'otros paises en desarrollo', sino como candidatos a jugar un rol de creciente importancia en el escenario mundial. Algunos analistas hacen referencia frecuente al conjunto de los paises BRICS como probable locomotora del crecimiento mundial en las proximas decadas. El argumento es por veces entendido como la anticipacion de una actuacion en grupo de esos cinco paises. Para que ello sea verdad falta todavia un grado minimo de interaccion entre esas economias, y en moldes distintos de lo que se ha registrado hasta aqui. A lo mejor en el futuro proximo parece mas sensato esperar actuaciones mas decisivas por parte de esas economias en sus respectivas areas geograficas de influencia.
Advances in organ preservation for transplantation

Organ transplantation provides the best available therapy for a myriad of medical conditions, including end‐stage renal disease, hepatic failure and type I diabetes mellitus. The current clinical reality is, however, that there is a significant shortage of organs available for transplantation with respect to the number of patients on organ waiting lists. As such, methods to increase organ supply have been instituted, including improved donor management, organ procurement and preservation strategies, living organ donation, transplantation education and the increased utilization of donation after circulatory death and expanded criteria donors. In particular, especially over the last decade, we have witnessed a significant change in the way donor organs are preserved, away from static cold storage methods to more dynamic techniques centred on machine perfusion (MP). This review highlights the current state and future of organ preservation for transplantation, focusing on both abdominal and thoracic organs. In particular, we focus on MP preservation of renal, hepatic, pancreatic, cardiac and lung allografts, also noting relevant advances in Australasia. MP of organs after procurement holds considerable promise, and has the potential to significantly improve graft viability and function post‐transplantation, especially in donors in whom acceptance criteria have been expanded.
A Systematic Review of Motor and Cognitive Outcomes After Early Surgery for Congenital Heart Disease

CONTEXT: Brain injury is the most common long-term complication of congenital heart disease requiring surgery during infancy. It is clear that the youngest patients undergoing cardiac surgery, primarily neonates and young infants, are at the greatest risk for brain injury. Developmental anomalies sustained early in life have lifelong repercussions. OBJECTIVE: We conducted a systematic review to examine longitudinal studies of cognitive and/or motor outcome after cardiac surgery during early infancy. METHODS: Electronic searches were performed in Medline, the Cumulative Index to Nursing and Allied Health Literature (Cinahl), and Embase (1998–2008). The search strategy yielded 327 articles, of which 65 were reviewed. Eight cohorts provided prospective data regarding the cognitive and/or motor outcome of infants who had undergone surgery for congenital heart disease before 6 months of age. Two authors, Ms Snookes and Dr Gunn, independently extracted data and presented results according to 3 subgroups for age of follow-up: early development (1 to <3 years); preschool age (3–5 years); and school age (>5 to 17 years). Weighted analysis was undertaken to pool the results of studies when appropriate. RESULTS: All of the identified studies reported results of the Bayley Scales of Infant Development for children younger than the age of 3. Outcome data as reported by the Bayley Scales were combined for infants assessed at 1 year of age, revealing a weighted mean Mental Development Index of 90.3 (95% confidence interval: 88.9–91.6) and Psychomotor Development Index of 78.1 (95% confidence interval: 76.4–79.7). Additional analysis was limited by a lack of data at preschool and school age. CONCLUSIONS: With this review we identified a limited number of prospective studies that systematically addressed outcome in patients at the highest risk. These studies consistently revealed cognitive and motor delay in children after cardiac surgery during early infancy. Additional investigation is required to ascertain the consequences of such impairment during later childhood and into adult life.
Pharmacologic Response to a Diagnosis of Late-Life Depression: A Population Study in Quebec

Objective: To identify predictors of receiving psychoactive medication and receiving recommended first-line pharmacotherapy in individuals with newly diagnosed late-life depression. Methods: We undertook a retrospective database cohort study of 5258 beneficiaries of the Quebec provincial health insurance plan between 1999 and 2002. Subjects were aged 65 to 84 years and diagnosed with depression by primary care physicians or psychiatrists between October 2000 and March 2001; they had no depression diagnosis in the previous year. We defined receipt of psychoactive medication as having a pharmacy claim in the year following the depression diagnosis. We determined receipt of recommended first-line pharmacotherapy from the first psychoactive medication dispensed following diagnosis and defined it accordingly; we defined first-line pharmacotherapy according to the 2001 Canadian Psychiatric Association guidelines. We used multivariate generalized estimating equations models to identify the determinants of the 2 outcomes. Results: A total of 4421 (84.1%) patients received psychoactive medication following diagnosis; 2623 (59.3%) patients had not received antidepressants in the previous year. Of these, 1310 (49.9%) received recommended first-line pharmacotherapy. Independent predictors of receiving psychoactive medication were female sex, depression not otherwise specified (NOS), increasing comorbidity, and living in rural areas. Independent predictors of receiving recommended first-line pharmacotherapy were male sex, depression NOS, receiving medication in the month following diagnosis, and having the same physician diagnosing and treating the patient. Conclusion: Male sex and continuity of care predicted that patients had the recommended medication dispensed.