Miracle-dz/UniFAR-FTUs huggingface dataset:
Early Tracheal Extubation after Coronary Artery Bypass Graft Surgery Reduces Costs and Improves Resource Use: A Prospective, Randomized, Controlled Trial

Background Economics has caused the trend of early tracheal extubation after cardiac surgery, yet no prospective randomized study has directly validated that early tracheal extubation anesthetic management decreases costs when compared with late extubation after cardiac surgery. Methods This prospective, randomized, controlled clinical trial was designed to evaluate the cost savings of early (1-6 h) versus late tracheal extubation (12-22 h) in patients after coronary artery bypass graft (CABG) surgery. The total cost for the services provided for each patient was determined for both the early and late groups from hospital admission to discharge home. All costs applicable to each of the services were classified into direct variables, direct fixed costs, and overhead (an indirect cost). Physician fees and heart catheterization costs were included. The total service cost was the sum of unit workload and overhead costs. Results One hundred patients having elective CABG who were younger than 75 yr were studied. Including all complications, early extubation (n = 50) significantly reduced cardiovascular intensive care unit (CVICU) costs by 53% (P < 0.026) and the total CABG surgery cost by 25% (P <0.019) when compared with late extubation (n = 50). Forty-one patients (82%) in each group were tracheally extubated within the defined period. In the early extubation group, the actual departmental cost savings in CVICU nursing and supplies was 23% (P < 0.005), in ward nursing and supplies was 11% (P < 0.05), and in respiratory therapy was 12% (P <0.05). The total cost savings per patient having CABG was 9% (P < 0.001). Further cost savings using discharge criteria were 51% for CVICU nursing and supplies (Pt < 0.001), 9% for ward nursing and supplies (P <0.05), and 29% for respiratory therapy (P < 0.001), for a total cost savings per patient of 13% (P < 0.001). Early extubation also reduced elective case cancellations (P < 0.002) without any increase in the number of postoperative complications and readmissions. Conclusions Early tracheal extubation anesthetic management reduces total costs per CABG surgery by 25%, predominantly in nursing and in CVICU costs. Early extubation reduces CVICU and hospital length of stay but does not increase the rate or costs of complications when compared with patients in the late extubation group. It shifts the high CVICU costs to the lower ward costs. Early extubation also improves resource use after cardiac surgery when compared with late extubation.
From Open Data to Open Analyses—New Opportunities for Environmental Applications?

In this study, we explore the potential of open and accessible data in combination with interactive cloud-processing capabilities for applications in environmental monitoring and policies. During the last few years, the amount of open Earth observation and open national data has increased substantially. In parallel, access to analysis capabilities for such data has improved. The search and extraction of data from larger Earth observations archives and the processing of larger amounts of data have hitherto been an obstacle for many potential users. With the availability of new cloud solutions such as Google Earth Engine, NASA Earth Exchange, or ESA Cloud Toolbox, accessing and processing of large datasets have become easier for a wider range of users. In this communication, we briefly summarize these recent trends and illustrate their potential by four application showcases from terrestrial and aquatic environmental monitoring. We accessed and processed data from US and European Earth observation satellite archives with Google Earth Engine. As a complement, we also used open Swedish national data and open source desktop tools. We hope that our positive user experiences can encourage other environmental data users to further explore the new opportunities for easy access to open data and cloud-based processing capabilities.
Central visual field progression in normal-tension glaucoma patients with autonomic dysfunction.

PURPOSE To investigate the characteristics of visual field (VF) progression in normal-tension glaucoma (NTG) patients with autonomic dysfunction. METHODS Forty-eight NTG eyes with more than seven VF tests during at least 5 years of follow-up were analyzed retrospectively. All participants were referred to rheumatology, where they were subjected to heart-rate variability assessment. Patients were classified into the lowest and highest heart-rate variability groups according to the SD value of the qualified normal-to-normal intervals of the heart-rate-variability assessment. The VF was divided into central and peripheral regions and further classified into superior and inferior regions. Groups in the lowest and highest heart-rate variability groups were compared in terms of rates of change in the mean thresholds of each designated region by using a linear mixed model. Potential clinical factors associated with central VF progression were also investigated. RESULTS The baseline VF showed similar stages of glaucoma damage between the lowest and highest heart-rate variability groups. The mean global rate of VF changes was similar between the two groups. Only the rate of VF changes in the central and superior central regions were significantly different between the lowest heart-rate variability group (-1.16 dB/year in the central region and -1.48 dB/year in the superior central region) and highest heart-rate variability group (-0.52 dB/year in the central region and -0.64 dB/year in the superior central region). Baseline VF pattern SD (β = -1.160, P = 0.008), migraine (β = 1.380, P = 0.040), orthostatic hypotension (β = 1.146, P = 0.023), and lower heart-rate variability (β = -1.516, P = 0.010) were significantly associated with central VF progression. CONCLUSIONS NTG patients with lower heart-rate variability, which reflects autonomic dysfunction with sympathetic predominance, presented faster rate of central VF progression than patients with higher heart-rate variability. Intraocular pressure-independent risk factors, such as migraine, orthostatic hypotension, and autonomic dysfunction, were related to central VF progression.
Studies on Fibrinogen Fractions Isolated from Human Plasma by Precipitation with Cold Ether

Mackay, Maycock, Silk and Combridge (1965) have shown that human fibrinogen preparations isolated by cold ether from freshly collected plasma (fraction HAHG, rich in Factor VIII), or from outdated plasma (fraction ETF), generate, when incubated at 37°C. , traces of kinin (2–30 μmg. of bradykinin per ml. of fraction in 60 minutes). Activation of the plasminogen in the two fractions enhances the kinin formation in HAHG (30–117 μmg./ml. per 60 minutes), but not in ETF. Longer incubation did not increase the kinin yield.
Postoperative Morphine Use and Hyperalgesia Are Reduced by Preoperative but Not Intraoperative Epidural Analgesia: Implications for Preemptive Analgesia and the Prevention of Central Sensitization

Background The aim of this study was to evaluate the postoperative morphine-sparing effects and reduction in pain and secondary mechanical hyperalgesia after preincisional or postincisional epidural administration of a local anesthetic and an opioid compared with a sham epidural control. Methods Patients undergoing major gynecologic surgery by laparotomy were randomly assigned to three groups and studied in a double-blinded manner. Group 1 received epidural lidocaine and fentanyl before incision and epidural saline 40 min after incision. Group 2 received epidural saline before incision and epidural lidocaine and fentanyl 40 min after incision. Group 3 received a sham epidural control (with saline injected into a catheter taped to the back) before and 40 min after incision. All patients underwent surgery with general anesthesia. Results One hundred forty-one patients completed the study (group 1, n = 45; group 2, n = 49; group 3, n = 47). Cumulative patient-controlled analgesia morphine consumption at 48 h was significantly lower (P = 0.04) in group 1 (89.8 ± 43.3 mg) than group 3 (112.5 ± 71.5 mg) but not group 2 (95.4 ± 60.2 mg), although the hourly rate of morphine consumption between 24 and 48 h after surgery was significantly lower (P < 0.0009) in group 1 (1.25 ± 0.02 mg/h) than group 2 (1.41 ± 0.02 mg/h). Twenty-four hours after surgery, the visual analog scale pain score on movement was significantly less intense (P = 0.005) in group 1 (4.9 ± 2.2 cm) than group 3 (6.0 ± 2.6 cm) but not group 2 (5.3 ± 2.5 cm), and the von Frey pain threshold near the wound was significantly higher (P = 0.03) in group 1 (6.4 ± 0.6 log mg) than in group 3 (6.1 ± 0.8 log mg) but not group 2 (6.2 ± 0.7 log mg). Conclusions Preincisional administration of epidural lidocaine and fentanyl was associated with a significantly lower rate of morphine use, lower cumulative morphine consumption, and reduced hyperalgesia compared with a sham epidural condition. These results highlight the importance of including a standard treatment control group to avoid the problems of interpretation that arise when two-group studies of preemptive analgesia (preincisional vs. postsurgery) fail to find the anticipated effects.
Jogging the Cogs: Trauma-Focused Art Therapy and Cognitive Behavioral Therapy with Sexually Abused Children

Art therapy in conjunction with cognitive behavioral therapy reduces symptoms and enhances the potential for positive outcomes for sexually abused children in trauma-focused treatment. This article presents a treatment model that utilizes specific art therapy interventions to facilitate treatment, based on research on the effectiveness of combined art therapy and cognitive behavior therapy (Pifalo, 2001, 2006).
Recall-precision trade-off: A derivation

The inexact nature of document retrieval gives rise to a fundamental recall precision trade-off: generally, recall improves at the expense of precision, or precision improves at the expense of recall. This trade-off is borne out empirically and has qualitatively intuitive explanations. In this article, we explore this relationship mathematically to explain it further. We see that the recall-precision trade-off hinges on a deceleration in the proportion of relevant documents which are retrieved, successively, over time. Further, we examine several mathematical functions sharing this property and conclude that the equation that best models recall as a function of time is the logarithm of a quadratic function. Our conclusion meets the following requirements: the function we derive predicts non-decreasing recall over time until the last relevant document is retrieved (regardless of the density of relevant documents in the collection) without imposing any artificial restrictions on either what percentage of the collection would need to be examined to achieve perfect recall or what the level of precision would be at that time. Other models examined fail to meet one or more of these criteria. © 1989 John Wiley & Sons, Inc.
Increase in number of intrafusal muscle fibres during the development of muscle spindles in the rat.

The morphogenesis of muscle spindles in rat lower hindlimb muscles has been investigated using the electron microscope. The earliest detectable spindles are seen in the 19.5-day foetus and consist of a single myotube bearing simple nerve terminals of the large primary afferent axon from the nearby unmyelinated spindle nerve trunk. The capsule forms by an extension of the perineural epithelium of the supplying nerve fasciculus, and is confined initially to the innervated zone. Myonuclei accumulate in this region, so that the first intrafusal muscle fibre to develop is a nuclear-bag fibre. Myoblasts, that are present within the axial bundle throughout its development, fuse to form a smaller, less-differentiated myotube by the 20-day foetal stage. This matures in close association with the initial fibre, and by birth (21-22 days gestation) has formed the smaller intermediate bag fibre that has been identified histochemically and ultrastructurally in the adult. Nuclear-chain fibres develop in the same way; myoblasts fuse to form satellite myotubes that mature in apposition to one or more of the other fibres, lying within a common basement membrane. By the 4-day postnatal stage the full adult complement of 4 intrafusal muscle fibres is present, although the ultrastructural and histochemical variations, seen in the adult, are not present. The fusimotor innervation begins to arrive by birth, but is not fully established until the 3rd postnatal week, when the ultrastructural and histo chemical maturation of the axial bundle is complete. The maturation of the capsule and periaxial space occurs at the same time. It is suggested that the sequential development of the intrafusal fibres is a reflection of the decreasing morphogenetic effect of the afferent innervation, whereas the role of the fusimotor innervation is in ultra- structural and histochemical differentiation.
Intravenous glomus tumor of the forearm

An intravenous glomus tumor occurring in a forearm vein is reported. The patient had a painful subcutaneous mass which was completely excised. This mass was a neoplasm which expanded the lumen of a vein and extended throughout its wall into the surrounding subcutaneous fat. The neoplasm consisted of sheets of rounded cells with a capillary stroma. The neoplastic cells were closely apposed to the capillary vessels and were positive for vimentin, smooth muscle actin and muscle specific actin. The cells were negative for desmin, factor VIII‐related antigen, epithelial membrane antigen, cytokeratins, S‐100 protein and chromogranin. This is the 2nd reported case of intravenous glomus tumor of the forearm. This unusual presentation may be due to intravascular extension by a cutaneous glomus tumor. The potential for intravascular growth by glomus tumor should be recognized by surgeons, dermatologists and pathologists.
Interaction Between ICOS‐B7RP1 and B7‐CD28 Costimulatory Pathways in Alloimmune Responses In Vivo

The B7‐CD28 pathway is one of the foremost costimulatory pathways involved in T‐cell activation. Recently, a number of additional costimulatory pathways have been described and preliminary data suggest that they play important roles in alloimmunity. However, the interactions between these different pathways are not well understood. We studied the effect of targeting ICOS ligand, B7RP1, in a rat cardiac transplant model, with and without concomitant blockade of the B7 pathway using CTLA4Ig. In a fully mismatched WF to LEW vascularized cardiac allograft model, without therapy, grafts were acutely rejected (MST 10.8 ± 1.6 days). Early (day of transplant) B7RP1 blockade with ICOSIg alone had little effect on graft survival and rather than being additive with B7 blockade, ICOSIg abrogated the prolonged graft survival induced by CTLA4Ig treatment. By contrast, delayed (day 2 post‐transplant) blockade of B7RP1 did not have such an effect. These findings were not related to cytokine deviation but may be in part related to the pattern of down‐regulation of B7.2 expression following early B7RP1 blockade. This is the first report describing the complex interactions between ICOS‐B7RP1 and B7‐CD28 costimulatory pathways in alloimmunity in vivo.
Development of a dosage strategy in patients receiving enoxaparin by continuous intravenous infusion using modelling and simulation.

AIM To develop an appropriate dosing strategy for continuous intravenous infusions (CII) of enoxaparin by minimizing the percentage of steady-state anti-Xa concentration (C(ss)) outside the therapeutic range of 0.5-1.2 IU ml(-1). METHODS A nonlinear mixed effects model was developed with NONMEM for 48 adult patients who received CII of enoxaparin with infusion durations that ranged from 8 to 894 h at rates between 100 and 1600 IU h(-1). Three hundred and sixty-three anti-Xa concentration measurements were available from patients who received CII. These were combined with 309 anti-Xa concentrations from 35 patients who received subcutaneous enoxaparin. The effects of age, body size, height, sex, creatinine clearance (CrCL) and patient location [intensive care unit (ICU) or general medical unit] on pharmacokinetic (PK) parameters were evaluated. Monte Carlo simulations were used to (i) evaluate covariate effects on C(ss) and (ii) compare the impact of different infusion rates on predicted C(ss). The best dose was selected based on the highest probability that the C(ss) achieved would lie within the therapeutic range. RESULTS A two-compartment linear model with additive and proportional residual error for general medical unit patients and only a proportional error for patients in ICU provided the best description of the data. Both CrCL and weight were found to affect significantly clearance and volume of distribution of the central compartment, respectively. Simulations suggested that the best doses for patients in the ICU setting were 50 IU kg(-1) per 12 h (4.2 IU kg(-1) h(-1)) if CrCL < 30 ml min(-1); 60 IU kg(-1) per 12 h (5.0 IU kg(-1) h(-1)) if CrCL was 30-50 ml min(-1); and 70 IU kg(-1) per 12 h (5.8 IU kg(-1) h(-1)) if CrCL > 50 ml min(-1). The best doses for patients in the general medical unit were 60 IU kg(-1) per 12 h (5.0 IU kg(-1) h(-1)) if CrCL < 30 ml min(-1); 70 IU kg(-1) per 12 h (5.8 IU kg(-1) h(-1)) if CrCL was 30-50 ml min(-1); and 100 IU kg(-1) per 12 h (8.3 IU kg(-1) h(-1)) if CrCL > 50 ml min(-1). These best doses were selected based on providing the lowest equal probability of either being above or below the therapeutic range and the highest probability that the C(ss) achieved would lie within the therapeutic range. CONCLUSIONS The dose of enoxaparin should be individualized to the patients' renal function and weight. There is some evidence to support slightly lower doses of CII enoxaparin in patients in the ICU setting.
Maternal embryonic leucine zipper kinase transcript abundance correlates with malignancy grade in human astrocytomas

We have performed cDNA microarray analyses to identify gene expression differences between highly invasive glioblastoma multiforme (GBM) and typically benign pilocytic astrocytomas (PA). Despite the significant clinical and pathological differences between the 2 tumor types, only 63 genes were found to exhibit 2‐fold or greater overexpression in GBM as compared to PA. Forty percent of these genes are related to the regulation of the cell cycle and mitosis. QT‐PCR validation of 6 overexpressed genes: MELK, AUKB, ASPM, PRC1, IL13RA2 and KIAA0101 confirmed at least a 5‐fold increase in the average expression levels in GBM. Maternal embryonic leucine zipper kinase (MELK) exhibited the most statistically significant difference. A more detailed investigation of MELK expression was undertaken to study its oncogenic relevance. In the examination of more than 100 tumors of the central nervous system, we found progressively higher expression of MELK with astrocytoma grade and a noteworthy uniformity of high level expression in GBM. Similar level of overexpression was also observed in medulloblastoma. We found neither gene promoter hypomethylation nor amplification to be a factor in MELK expression, but were able to demonstrate that MELK knockdown in malignant astrocytoma cell lines caused a reduction in proliferation and anchorage‐independent growth in in vitro assays. Our results indicate that GBM and PA differ by the expression of surprisingly few genes. Among them, MELK correlated with malignancy grade in astrocytomas and represents a therapeutic target for the management of the most frequent brain tumors in adult and children. © 2007 Wiley‐Liss, Inc.
Direct fitness benefits of delayed dispersal in the cooperatively breeding red wolf (Canis rufus)

The existence of cooperative breeding in diverse animal taxa has inspired much interest in what nonbreeding helpers gain from participation in rearing nondescendent young. A major theoretical explanation for this phenomenon has revolved around the notion of inclusive fitness, where delayed dispersers in a family-based group gain indirect fitness benefits by fostering the viability of close relatives. There is potential, however, for direct fitness benefits in delayed dispersal itself. We explored the relationship between delayed dispersal and lifetime fitness in a reintroduced population of the cooperatively breeding red wolf, Canis rufus, which exhibits delayed dispersal but few opportunities to breed in the natal pack. We present evidence that male wolves that delayed dispersal to later ages had lower mortality risk from natural and anthropogenic sources combined and increased probability of becoming reproductive in their lifetimes. Furthermore, delayed dispersal did not result in delayed age at first reproduction. For females, however, the relative costs and benefits of delaying dispersal to later ages were more complex. In general, we provide evidence that there are direct fitness benefits to delaying dispersal in red wolves even in the absence of reproductive opportunities in the natal pack. Thus, we lend support to the hypothesis that direct fitness benefits may in themselves be sufficient to facilitate the evolution of delayed dispersal requisite to cooperatively breeding social systems. Copyright 2011, Oxford University Press.
CONSTRUCTION OF MICROSATELLITE LINKAGE MAP AND DETECTION OF SEGREGATION DISTORTION IN INDICA RICE (ORYZA SATIVA L.)

High density molecular linkage map is a prerequisite to identify the quantitative traits loci. Construction of linkage maps, using mapping populations derived from two major subspecies: indica and japonica in rice, have been reported. However, limited work was conducted in indica subspecies. Present studies focused to construct a molecular map based on indica × indica (Shaheen Basmati × Pokkali) derived F2 mapping population. The detected microsatellite polymorphism was only 50.64% between parental cultivars. A total of 107 microsatellite markers were employed to amplify 108 loci, distributed throughout the genome. The marker data of 190 individuals was recorded for map construction. Most of the markers were found co-dominant, where as eight markers exhibited dominance in favor of Shaheen Basmati alleles and four in favor of Pokkali alleles. Detected segregation distortion was 7.47%, which was significantly low than previous studies. MapMaker was used to construct the linkage groups. The map spanned 1753.9 cM (Kosambi function) with microsatellite markers on 12 rice chromosomes and an average distance of 16.2 cM between markers. This map contained a greater and least percentage of markers on linkage group 3 and 12, respectively. Maximum common interval size (MCIS) analysis revealed that present map (indica × indica) covered the rice genome 98% of previous investigation (japonica × indica). Because of diverse background of parental cultivars, low segregation distortion and high genome coverage, revealed that molecular linkage map would be used as marker framework to investigate the genetics of important agronomic traits in indica rice.
Characteristics of L‐Carnitine Transport in Cultured Human Hepatoma HLF Cells

The recently cloned organic cation transporter, OCTN2, isolated as a homologue of OCTN1, has been shown to be of physiological importance in the renal tubular re‐absorption of filtered L‐carnitine as a high‐affinity Na+ carnitine transporter in man. Although the mutation of the OCTN2 gene has been proved to be directly related to primary carnitine deficiency, there is little information about the L‐carnitine transport system in the liver. In this study, the characteristics of L‐carnitine transport into hepatocytes were studied by use of cultured human hepatoma HLF cells, which expressed OCTN2 mRNA to a greater extent than OCTN1 mRNA.