Miracle-dz/UniFAR-FTUs huggingface dataset:
Prognostic Factors of Thymectomy in Patients with Myasthenia gravis: A Cohort of 132 Patients

Objective: To identify the response to thymectomy and the factors associated with a poor response, a nested case-control study was performed on 132 patients with an established diagnosis of myasthenia gravis who had had a thymectomy between 1987 and 1997 and had been followed up for at least 3 years. Methods: In order to assess the response to thymectomy, the following two points were taken into account: (a) the dose of pyridostigmine and other drugs (steroids, azathioprine) that the patient took before and after thymectomy, and (b) the Osserman classification before and after thymectomy. The patients were divided into 4 groups: (1) patients in remission; (2) patients with improvement; (3) patients with no change, and (4) patients who were worse. Results: 91 patients had a good response (69%) and 41 patients had a poor response (31%). The response by groups was as follows: 50 patients were found to be in remission; 41 patients had improved; 34 patients had no changes, and 7 got worse. Being more than 60 years old was associated with a poor prognosis (odds ratio 4.6, CI 1.11–20.32, p 0.01). The patients who had the disease for more than 3 years (odds ratio 2.97, CI 0.79–5.39, p 0.09) had a tendency towards a bad prognosis even though there was no statistical significance, and for those who had it for more than 4 years (odds ratio 2.58, CI 0.89–0.96, p 0.02) the bad prognosis was statistically significant. The patients who had the disease for more than 3 years between diagnosis and thymectomy (odds ratio 2.02, CI 0.69–5.90, p 0.15) and those with it for more than 4 years (odds ratio 2.53, CI 0.83–7.7, p 0.06) had a tendency towards a poor prognosis even though there was no statistical significance. In addition, having Osserman I was associated with a bad prognosis. Referring to the pathological findings, patients with thymoma (odds ratio 3.51, CI 0.43–31.5, p 0.15) and those with thymic atrophy (odds ratio 2.19, CI 0.93–5.16, p 0.04) had a poor prognosis. Finally, the use of steroids before thymectomy (odds ratio 2.26, CI 0.99–5.18, p 0.03) was associated with a worse prognosis. Conclusions: The response to thymectomy was high (69%). The variables that had the most prognostic importance were age and the Osserman stage. Other variables of poor prognosis were: high doses of pyridostigmine and use of steroids before surgery; the total duration of the disease and the duration of the disease between diagnosis and the surgical procedure; history of previous thymectomy; use of plasmapheresis after surgery, and the discovery of thymic atrophy and thymoma in the histopathological result.
Recovery in Antarctic benthos after iceberg disturbance: trends in benthic composition, abundance and growth forms

The response of an Antarctic benthic community to iceberg disturbance was investi- gated using underwater photographs (1 m 2 each) on the SE Weddell Sea shelf. This study: (1) char- acterises composition, coverage, number of patches and area of sessile benthic fauna, (2) describes faunal heterogeneity using MDS ordination and identifies 'structural taxa' of each recovery stage, and (3) analyses changes of growth-form patterns during Antarctic recovery. We observed changes in the space occupation of benthic organisms along the recolonisation stages. Uncovered sediment characterised the early stages ranging from 98 to 91% of the coverage. The later stages showed high (70.5%) and intermediate (52.5%) values of benthic coverage, where demosponges, bryozoans and ascidians exhibited a high number of patches and taxa. Several 'structural species' were identified among the stages, and information is provided on their coverage, number of patches and area. Over- all, maximum areas of patches increased as recovery proceeded. Early stages were characterised by the presence of pioneer taxa, which only partly covered the bottom sediment but were locally abun- dant (e.g. the bryozoan Cellarinella spp. and the gorgonian Primnosis antarctica with a maximum coverage of 13 and 3%, and 51 and 30 patches m -2 , respectively). Soft bush-like bryozoans, sheet-like sabellid polychaetes, and tree-like sponges, gorgonians, bryozoans and ascidians were the first colonisers. Mound-like sponges and ascidians as well as tree-like organisms with a long lifespan and different reproductive strategies defined the late stages. We conclude by comparing the selected 'structural species' and relating their life-history traits to differences in distribution in the course of Antarctic recovery.
Does knowledge , knowledge sources and reasoning skills affect the accuracy of nursing diagnoses ?

Background. This paper is a report of a study to what the effect is on the accuracy of nursing diagnoses of knowledge sources, such as handbooks an assessment format and a predefined record structure for diagnoses documentation and what the influence is of knowledge, disposition toward critical thinking and reasoning skills on the accuracy of nursing diagnoses. Knowledge sources may support nurses in deriving diagnoses. Nurses’ disposition towards critical thinking and reasoning skills is also thought to influence the accuracy of nursing diagnoses. Method. A randomised factorial design was used in 2008-2009 to determine the effect of knowledge sources. We used the following instruments to assess the influence of ready knowledge, dispositions, and reasoning skills on the accuracy of diagnoses: (1) knowledge inventory, (2) California Critical Thinking Disposition Inventory, and (3) Health Science Reasoning Test. Qualified nurses (n=249) were randomly assigned to one of four factorial groups, and were instructed to derive diagnoses based on an assessment interview with a simulated patient/actor. Results. The use of a predefined record structure resulted in a significantly higher accuracy of nursing diagnoses. A regression analysis reveals that almost half of the variance of diagnoses accuracy is explained by the use of a predefined record structure, nurse age and reasoning skills deduction and analysis. Conclusions. Improving nurses’ disposition towards critical thinking and nurses’ reasoning skills, and the use of a predefined record structure improves accuracy of nursing diagnoses.
THE RELATION OF CIRCULATING ANTIPNEUMOCOCCAL IMMUNE SUBSTANCES TO THE COURSE OF LOBAR PNEUMONIA III. INJECTED IMMUNE SUBSTANCES (ANTIPNEUMOCOCCUS SERUM, TYPES I AND II).

In the consideration of this phase of the subject more attention will be given to certain objective changes occurring after the introduction of immune serum than to mortality. Our series of cases is far too small to permit any conclusions concerning the influence of serum therapy on the outcome of the disease. Mortality percentages will be taken into account in the discussion of the reports of other workers. We wish to present the data which we have secured from a study of the effect of immune serum, chiefly Type I, on the spread of the pneumonic lesion, bacteremia, the duration of the disease and resolution of the consolidated lung.
Parkinson disease: systemic and orofacial manifestations, medical and dental management.

BACKGROUND More than 1.5 million Americans have Parkinson disease (PD), and this figure is expected to rise as the population ages. However, the dental literature offers little information about the illness. TYPES OF STUDIES REVIEWED The authors conducted a MEDLINE search using the key terms "Parkinson's disease," "medical management" and "dentistry. " They selected contemporaneous articles published in peer-reviewed journals and gave preference to articles reporting randomized controlled trials. RESULTS PD is a progressive neurodegenerative disorder caused by loss of dopaminergic and nondopaminergic neurons in the brain. These deficits result in tremor, slowness of movement, rigidity, postural instability and autonomic and behavioral dysfunction. Treatment consists of administering medications that replace dopamine, stimulate dopamine receptors and modulate other neurotransmitter systems. CLINICAL IMPLICATIONS Oral health may decline because of tremors, muscle rigidity and cognitive deficits. The dentist should consult with the patient's physician to establish the patient's competence to provide informed consent and to determine the presence of comorbid illnesses. Scheduling short morning appointments that begin 90 minutes after administration of PD medication enhances the patient's ability to cooperate with care. Inclination of the dental chair at 45 degrees, placement of a bite prop, use of a rubber dam and high-volume oral evacuation enhance airway protection. To avoid adverse drug interactions with levodopa and entacapone, the dentist should limit administration of local anesthetic agents to three cartridges of 2 percent lidocaine with 1:100,000 epinephrine per half hour, and patients receiving selegiline should not be given agents containing epinephrine or levonordefrin. The dentist should instruct the patient and the caregiver in good oral hygiene techniques.
Lack of long-term beta-cell glucotoxicity in vitro in pancreatic islets isolated from two mouse strains (C57BL/6J; C57BL/KsJ) with different sensitivities of the beta-cells to hyperglycaemia in vivo.

Previous studies have shown that 4 weeks after syngeneic transplantation of a suboptimal number of islets into either C57BL/6J (BL/6J) or C57BL/KsJ (BL/KsJ) diabetic mice there is an impaired insulin secretion by the perfused grafts. After normalization of the blood glucose level with a second islet graft, the BL/6J strain showed restored insulin secretion whilst that of the BL/KsJ strain remained impaired. The aim of the present work was to study the effects of glucose on the in-vitro function of islet beta-cells from these two mouse strains, with different sensitivities of their beta-cells to glucose in vivo. Isolated pancreatic islets from each strain were kept for 1 week in tissue culture at 5.6, 11, 28 or 56 mmol glucose/l and were subsequently analysed with regard to insulin release, (pro)-insulin and total protein biosynthesis, insulin, DNA and insulin mRNA contents and glucose metabolism. Islets from both strains cultured at 28 or 56 mmol glucose/l showed an increased accumulation of insulin in the culture medium and an enhanced glucose-stimulated insulin release compared with corresponding control islets cultured at 11 mmol glucose/l. After culture at either 5.6 or 56 mmol/l, rates of (pro)insulin biosynthesis were decreased in BL/KsJ islets in short-term incubations at 17 mmol glucose/l, whereas islets cultured at 56 mmol glucose/l showed a marked increase at 1.7 mmol glucose/l. In BL/6J islets, the (pro)insulin biosynthesis rates were similar to those of the BL/KsJ islets with one exception, namely that no decrease was observed at 56 mmol glucose/l. Islets of both strains showed a decreased insulin content after culture with 56 mmol glucose/l. (ABSTRACT TRUNCATED AT 250 WORDS)
Rivaroxaban and false positive lupus anticoagulant testing

Dear Sirs, Antiphospholipid syndrome (APS) is diagnosed when arterial or venous thrombosis, or recurrent miscarriage, is associated with the presence of antiphospholipid antibodies. The antiphospholipid antibody must be persistent (present in two separate blood samples taken more than 12 weeks apart) (1). The laboratory tests should use screening, mixing and confirmation stages, and more than one test system should be used due to the heterogeneity of lupus anticoagulants. Accurate detection of lupus anticoagulant (LA) in patients on anticoagulant therapy is difficult. For instance, the coagulation defect induced by vitamin K antagonists (VKAs) leads to prolongation of all phospholipid-dependent clotting times. Similarly, treatment (or contamination of the sample) with unfractionated heparin (UFH) prolongs the clotting time of all phospholipid-dependent tests. Low-molecular-weight heparin (LMWH) does not usually lead to a significant prolongation of these tests, but this does sometimes occur depending on the brand of LMWH (2, 3). Although various procedures are described to overcome the effect of warfarin and heparin on these tests, in most instances it is best to postpone laboratory diagnosis until treatment with these agents has ceased (2, 3). Less information is available on the newer anticoagulants and interference with LA testing. Studies have demonstrated that direct thrombin inhibitors can lead to both false positive and false negative dilute Russell Viper Venom ratios (dRVVs) (4, 5). Correspondence to: Eileen Merriman Haematology Department, Monash Medical Centre Clayton, Victoria, Australia Tel. : +61 450011998, Fax: +61 3 95946587 E-mail: eileen.merriman@southernhealth.org. au
Monitoring disease activity in juvenile dermatomyositis: the role of von Willebrand factor and muscle enzymes.

OBJECTIVE To assess the usefulness of serial measurement of plasma von Willebrand factor (vWF) and serum levels of muscle enzymes in the detection and prediction of flares of disease activity in children with juvenile dermatomyositis (JDM). METHODS Retrospective study of serial measurements of vWF and muscle enzymes in 16 patients with JDM followed for 540 patient-months. Charts were reviewed by an investigator blinded to laboratory results, and disease flare was defined as 2 of worsening function, increasing weakness, increasing muscle enzymes, increasing medication requirements. RESULTS vWF was increased on at least one occasion in all but 2 patients with levels up to 4.9 IU/ml (normal 0.5 to 1.5). Laboratory evaluations were available in 23/29 disease flares. The sensitivity (0.85) and specificity (0.45) of vWF to detect disease flare were not better than that of LDH or AST even when muscle enzyme levels were excluded from flare definition. CK and ALT were not significantly associated with disease flare. The risk of flare increased 3-fold after a > 20% increase in AST levels, but vWF did not reliably predict disease flare. CONCLUSION Although vWF is associated with disease flares, it does not seem to offer more information than enzyme measurements. LDH and AST were most useful in the detection of a flare, while AST was the only test capable of predicting it.
EVALUATION OF BONE RESORPTION IN MALE PATIENTS WITH BILHARZIAL PERIPORTAL HEPATIC FIBROSIS

Objective: To evaluate bone resorption and bone mineral metabolism in male patients suffering from bilharzial periportal hepatic fibrosis by assessment of liver function tests and factors that regulate bone resorption and formation and correlate these factors to bone mineral density assessing bone mineral metabolism. Methodology: This study was carried out on 50 male patients suffering from bilharzial periportal hepatic fibrosis; their mean age was 38.6 ±8.14. Also 40 age matched healthy males were included in this study as a control group. Both patients and control groups were subjected to the following investigations (parathyroid hormone (PTH), testosterone , vitamin D3 (1-25 hydroxycholecalciferol) , serum calcium and phosphorus , total alkaline phosphatase and liver function tests including (SGOT, SGPT, total protein, albumin, total and direct bilirubin) in addition to dual energy X-ray absorbtiometry (DEXA) and abdominal ultrasonography. Results: patients suffering from bilharzial periportal hepatic fibrosis showed highly significant reduction of serum testosterone and bone mineral density (BMD) in comparison to control group (p<0.001) and the testosterone is highly correlated with BMD (p<0.001) parathyroid hormone, vitamin D3, serum calcium and phosphorus showed non significant difference between both studied groups (p>0.05) and not correlated with BMD (p>0.05). However, liver function tests Bone Resorption in Periportal Hepatic Fibrosis Hassieb et al. 640 were significantly higher in patients than control group (p<0.01). Conclusion: Our results demonstrate that the liver is an important organ responsible for bone integrity and any chronic liver disease like bilharzial periportal liver fibrosis can directly affect the bone and causing osteoporosis which indicated by diminished BMD and this osteoporosis was accompanied with gonadal dysfunction indicated by reduced testosterone so it is called (Andropausal osteoporosis).
Identification of srv, a PrfA-Like Regulator of Group A Streptococcus That Influences Virulence

ABSTRACT We have identified a Crp/Fnr-like transcriptional regulator of Streptococcus pyogenes that when inactivated attenuates virulence. The gene, named srv for streptococcal regulator of virulence, encodes a 240-amino-acid protein with 53% amino acid similarity to PrfA, a transcriptional activator of virulence in Listeria monocytogenes.
Short and long term outcome of percutaneous coronary intervention with drug eluting stent and bare metal stent in patients with chronic kidney disease.

AIM Coronary artery disease represents the most important cause of mortality and morbidity in chronic kidney disease (CKD). Despite continuous improvements in percutaneous coronary intervention (PCI), CKD is still associated with more adverse events after PCI. We performed a retrospective study to compare bare metal stents (BMS) versus drug eluting stents (DES) in CKD. METHODS We included consecutively all patients undergoing PCI at our Centre from July 2002 to December 2005 with CKD, defined as creatinine clearance <60 mL/min. Patients who received only DES were compared to those who received only BMS. The primary end-point was the long-term rate of major adverse cardiac events (MACE, i.e. the composite of death, myocardial infarction and repeat revascularization). RESULTS We included a total of 219 patients with CKD out of a total of 2354 patients, with 164 receiving BMS and 55 DES. After a mean follow up of 48 months, the MACE rate was significantly higher in BMS group (71% versus 38%, P<0.001). A similarly increased risk with BMS was found for death (45% versus 17%, P<0.001), whereas the rates for repeat coronary revascularization, myocardial infarction and stent thrombosis were not significantly different. Multivariable analysis showed that BMS vs. DES implantation was not statistically significant associated with MACE, death, myocardial infarction, rePTCA or stent thrombosis. CONCLUSION Compared with BMS, use of DES in patients with CKD is safe and effective in reducing adverse outcomes. However, differences found between groups in clinical end-point could be ascribed to selection bias and confounding factors.
Meiosis-specific double-strand DNA breaks at the HIS4 recombination hot spot in the yeast Saccharomyces cerevisiae: control in cis and trans

The region of Saccharomyces cerevisiae chromosome III located between the 5' end of the HIS4 gene and the 3' end of the adjacent BIK1 gene has a very high level of meiotic recombination. In wild-type strains, a meiosis-specific double-strand DNA break occurs in the hot spot region. This break is absent in strains in which the transcription factors Rap1p, Bas1p, and Bas2p cannot bind to the region upstream of HIS4. In strains with levels of recombination that are higher than those of the wild type, the break is found at elevated levels. The linear relationship between hot spot activity and the frequency of double-strand DNA breaks suggests that these lesions are responsible for initiating recombination at the HIS4 recombination hot spot.
Newly Synthesized Cholecystokinin in Subcellular Fractions of the Rat Brain

Abstract: The subcellular localization of in vivo synthesized cholecystokinin (CCK) in different parts of the rat brain was studied after intracisternal pulse injections of [35S]methionine. The rats were decapitated 1 h after the injection, and the brain was divided into cortex, hippocampus and remainder. Subcellular fractions were obtained according to Whittaker's method. De novo synthesized CCK in the crude mitochondrial‐synaptosomal fraction, P2, and in the purified synaptosomal fraction was demonstrated by affinity chromatography, using antibodies specific for the COOH‐terminal sequence of CCK. By subsequent gel chromatography two molecular forms of labelled CCK occurred, with elution constants, Kav, of 1.1 (corresponding to the COOH‐terminal octapeptide) and of 1.40 (a component which may correspond to the COOH‐terminal tet‐rapeptide amide, CCK‐4). The findings support the idea that the small molecular forms are the transmitter forms of CCK.
Glutathione as a Mediator of the In Vitro Cytotoxicity of a Green Tea Polyphenol Extract

ABSTRACT The 24-hr cytotoxicities of a green tea polyphenol (GTP) extract to cell lines derived from the human oral cavity were assessed using the neutral red (NR) assay. The sequence of sensitivity was carcinoma HSC-2 cells > immortalized gingival GT1 fibroblasts > normal gingival HGF-2 fibroblasts. The GTP extract generated hydrogen peroxide (H2O2) in cell culture medium and in phosphate buffer, albeit to a lesser extent. A 3-hr exposure to the GTP extract lowered the intracellular glutathione (GSH) content of the HSC-2 cells, but stimulated that of the GT1 and HGF-2 fibroblasts. The cytotoxicity of a 4-hr exposure of the GTP extract to the HSC-2 and GT1, but not to the HGF-2, cells was lessened in the presence of 2.5 mM GSH. Conversely, a 0.5 hr preexposure to the glutathione depleter, 1-chloro-2-dinotrobenzene (CDNB) at 25 μM, potentiated the 24-hr cytotoxicity of the GTP extract to the HSC-2 and GT1, but not to the HGF-2, cells. Using a cell-free system, it was shown that the GTP extract quickly depleted GSH, with depletion greatly enhanced at an alkaline pH, thus, correlating with the enhanced generation of H2O2 by the GTP extract observed at alkaline pH. Apparently, a mode of cytotoxicity of the GTP extract, in particular to the carcinoma HSC-2 cells, was to induce oxidative stress, as noted by the generation of H2O2, the depletion of intracellular GSH, the protection afforded by extracellular GSH, and cell hypersensitivity after pretreatment with CDNB.
Report from the Secretary General.

Executive summary This report seeks to identify policies for the effective promotion of science, technology and engineering for innovation and capacity-building in education and research, as part of the wider enabling policy framework to meet the Millennium Development Goals contained in the Millennium Declaration. Though there is wide consensus that technological innovation is a driver and critical source of sustainable economic growth in the new millennium, many developing countries have yet to benefit from the promises of science, technology and innovation (STI). Harnessing knowledge for development requires putting science, technology and innovation at the centre of national development strategies. In particular, STI policies can provide special working conditions for science and technology talent and institute reward structures to promote research directed at addressing national and regional development challenges. The promotion of research and development can be complemented by the commercialization of scientific and technological research for addressing developmental challenges and creating employment. Venture capital can supplement loans and microfinance as a form of financial and mentorship support needed to catalyse promising enterprises. Developing countries can augment regional STI capacity-building networks with other developing countries that share common development challenges in other regions of the world. Finally, innovation may require that society embrace change, creativity and learning. Without an innovation-friendly culture, STI capacity-building mechanisms may not deliver the returns that innovation promises the developing world.