Miracle-dz/UniFAR-FTUs huggingface dataset:
Paediatric IOL implantation and postoperative refractive state: what role do study methodology and surgical technique play?

Evolution of surgical techniques has made paediatric primary intraocular lens (IOL) implantation more popular.1 As the comfort level of implanting younger children increases, postoperative target refraction accuracy and emmetropisation of refractive error have become important management problems. The normal neonatal eye is hyperopic, and over the first 18 months of life, axial elongation, lenticular change and corneal flattening move the focussing system towards emmetropia2 3 with axial elongation playing the primary role.4 While being sensitive to genetic factors,5 the globe axial elongation and resultant myopic shift seen in the first 2 years of life is thought to be an active process—emmetropisation—influenced by visual stimulus within a sensitive period. Evidence that emmetropisation is an active light dependent process, with the sensory component most likely in the retinal amacrine cells, comes from a large volume of animal model work.6–8 It is speculated that the effector component is controlled by the ocular matrix metalloproteinases (MMPs) which orchestrate posterior segment remodelling.8 The primary site of this motor arm is unclear and may be located at the posterior pole,9 or the area around the ciliary body.10 11 As with the normally developing eye, the primary effector of the myopic shift seen in pseudophakic children is globe axial elongation.12–14 However, the myopic shift is large,12 15 shows considerable variance12–21 (table 1) and is devoid of consistent correlation with either a child's preoperative axial length or the implanted IOL power.13 15 20 Age is the significant influencing factor, with younger children exhibiting larger and more unpredictable myopic shifts.12 15 18 20 View this table: Table 1 Reports on the myopic shift following intraocular lens implantation in infancy In this month's issue, Sminia et al (see page 547) compare the axial eye length growth of the two fellow eyes within one …
In vivo induction of apoptosis (programmed cell death) in mouse thymus by administration of lipopolysaccharide

In vivo administration of bacterial lipopolysaccharide to mice induced DNA fragmentation in the thymus. Fragmented DNA was confirmed by agarose gel electrophoresis and laser flow cytometry. DNA fragmentation was predominantly detected in the thymus of young mice, while it was undetectable in the spleen, bone marrow, and lymph nodes. DNA fragmentation in the thymus was roughly dependent on the dose of lipopolysaccharide injected and reached the peak about 18 h after the injection. The addition of lipopolysaccharide to in vitro cultures of thymocytes did not cause DNA fragmentation, suggesting that lipopolysaccharide was unable to induce apoptosis of thymocytes directly. The injection of lipopolysaccharide induced no significant DNA fragmentation in adrenalectomized mice. The injection of anti-tumor necrosis factor alpha antibody together with lipopolysaccharide partially inhibited the appearance of DNA fragmentation in the thymus. On the basis of the fact that DNA fragmentation is one of the characteristics typical in apoptotic cell death, it was suggested that lipopolysaccharide could induce apoptosis in the mouse thymus in vivo. This apoptosis in the thymus might be mediated mainly by the adrenal hormones, but it is likely that tumor necrosis factor alpha might also participate in it.
Relationships between the shedding of Coxiella burnetii, clinical signs and serological responses of 34 sheep

Two abortions associated with Coxiella burnetii occurred in a group of 34 pregnant ewes. The seroprevalence of C bumetii infection was studied by using an ELISA and the immunofluorescence (IF) assay was applied to the contents of vaginal swabs. In addition, a KCR assay, with primers based on a transposonlike repetitive region of the C bumetii genome (trans-PCR), was used for the highly sensitive and specific detection of C bumetii in vaginal swabs, milk and faeces. Of the 34 animals tested at parturition, eight (24 per cent) were positive by ELISA, 11 (32 per cent) were positive by IF, and 15 (44 per cent) were positive when the vaginal swab extract was subjected to the trans-PCR assay. C bumetii was therefore detected by PCR in the vaginal swabs of seven seronegative ewes. However, five weeks after lambing, 16 (47 per cent) of the animals tested were ELISA positive but only two animals (6 per cent) were positive by PCR. Among the ELISAand PCR-positive animals, eight (25 per cent) shed coxiella in their milk and six (18 per cent) did so in their faeces.
Letter by Dixon et al Regarding Article, "Watching Television and Risk of Mortality From Pulmonary Embolism Among Japanese Men and Women: The JACC Study (Japan Collaborative Cohort)".

We read with great interest the recent article by Shirakawa et al.1 In their prospective observational cohort study, they found that television time increased the risk of mortality from pulmonary embolism in those watching ≥2.5 hours per day. It is important to note that the risk doubled in those watching television for ≥5 hours per day. As the authors point out, these findings are consistent with those observed in the Nurse’s Health Study, …
Long-term Outcomes in Patients with Small Intestinal Strictures Secondary to Crohn's Disease After Double-balloon Endoscopy-assisted Balloon Dilation

Background:Crohn's disease (CD) strictures of the small intestine are a feared complication and difficult to treat because of difficulty gaining access to the stricture site. The development of double-balloon endoscopy (DBE) enabled access to the entire small intestine with interventional capabilities. The aim of this study was to assess the long-term outcomes in patients with small intestinal strictures secondary to CD after DBE-assisted endoscopic balloon dilation (EBD). Methods:In this retrospective cohort study, DBE-assisted EBD was performed in 85 consecutive patients with CD strictures of the small intestine from 2002 to 2014. Follow-up data were available for 85 patients for a mean of 41.9 months (range, 0–141), and clinical outcomes were assessed. Results:Overall, 321 DBE-assisted EBD sessions (473 procedures) were performed in 85 patients during the study period. Most CD strictures were de novo (97%). The surgery-free rate after initial DBE-assisted EBD was 87.3% at 1 year and 78.1% at 3 years. The presence of a fistula was significantly associated with the need for surgical intervention (hazard ratio = 5.50, 95% confidence interval: 2.16–14.0, P < 0.01). The surgery-free interval in patients with a fistula was significantly shorter than in patients without a fistula (P < 0.01, log-rank test). Conclusions:DBE-assisted EBD provides a favorable long-term outcome in patients with small intestinal CD-associated strictures. DBE-assisted EBD for CD strictures is a safe and effective treatment to avoid or postpone surgery over the long-term.
PD-L1 expression in tumor metastasis is different between uveal melanoma and cutaneous melanoma.

AIM To compare PD-L1 expression between metastatic uveal melanoma (MUM) and metastatic cutaneous melanoma (MCM). MATERIALS & METHODS A total of 295 MCM and 78 MUM specimens were analyzed for tumor cell PD-L1 expression. Additionally, 91 MCM and 45 MUM specimens were analyzed for PD-1 expression on tumor-infiltrating lymphocytes. RESULTS A total of 77/295 (26.1%) MCM specimens expressed PD-L1 as compared to 4/78 (5.1%) MUM specimens (p < 0.0001). PD-1 expression on tumor-infiltrating lymphocytes was greater in MCM (73.6%; 67/91) than in MUM (51.1%; 23/45), respectively (p = 0.009). CONCLUSION Significant differences exist in PD-L1 expression between MCM and MUM. The lower PD-L1 expression in MUM may provide a rationale for failure of PD-1 inhibitor therapy and suggests that immune evasion in this disease may occur via alternative mechanisms.
Association of Calponin with Desmin Intermediate Filaments*

Our previous immunoelectron microscopy studies of chicken gizzard smooth muscle cells showed that in certain areas the distribution of anti-calponin exhibits a high degree of overlap with β-actin, filamin, and in particular, desmin, suggesting that in situ a fraction of calponin may be associated with intermediate filaments of the cytoskeleton. In this work we further explore this idea by studying the interaction between calponin and desmin. We found that at physiological salt concentrations, calponin bound only weakly to synthetic desmin intermediate filaments. On the other hand, calponin bound strongly to nonfilamentous desmin tetramers and was incorporated into intermediate filaments when the two proteins were mixed in a buffer containing 6 m urea and dialyzed into a buffer containing 0.15 m NaCl. Anti-calponin was found to label a portion of intermediate filaments and dense bodies isolated from gizzard tissues. Our findings suggest that in chicken gizzard smooth muscle cells, calponin may be an integral component of desmin intermediate filaments in the vicinity of dense bodies. Since calponin is also known to bind actin, we hypothesize that one of the functions of calponin might be to bridge intermediate filaments with actin in dense bodies.
Impaired immune regulation in children and adolescents with hemophilia and thalassemia in Israel

The immune function was assessed in 22 children, adolescents and young adults with asymptomatic hemophilia, and 15 with thalassemia, in Israel. Five patients with hemophilia and two with thalassemia were found to be severely abnormal, having cutaneous anergy, very low T-helper cells, elevated T-suppressor cells, inverted T-helper/suppressor ratio, reduced response to mitogens and antigens, and nonfunctional NK cells. Four of the five hemophilia patients exhibited profound lymphopenia also. Decreased T-helper and mildly elevated T-suppressor cells with inverted T4/T8 ratio were observed in the hemophiliacs as a group. In the severe group, the reduction in T-helpers and T4/T8 ratio was more pronounced. The thalassemics as a group were found to have increased numbers of T-suppressor cells with decreased T-helper cells in those with intact spleen only. Both groups studied were found to have elevated IgG levels and low natural killer (NK) activity and normal response to mitogens. Cutaneous anergy was found to be a reliable indication for severe T-cell dysfunction and may serve as an early indication of impending AIDS. These results indicate that patients with hemophilia and with heavily hyper-transfused thalassemia may be at increased risk of AIDS as they approach adolescence.
Efficacy and tolerability of rituximab with or without PEGylated interferon alfa-2b plus ribavirin in severe hepatitis C virus-related vasculitis: a long-term followup study of thirty-two patients.

OBJECTIVE To report on the long-term followup of a cohort of patients with hepatitis C virus (HCV)-related vasculitis treated with rituximab with or without PEGylated interferon alfa-2b (PEG-IFN alfa-2b) plus ribavirin. METHODS The study group comprised 32 HCV RNA-positive patients with HCV-related vasculitis: 20 patients were treated with rituximab and PEG-IFN alfa-2b (9 of whom had not previously received antiviral treatment and 11 of whom had experienced disease resistance to or relapse with antiviral treatment), and 12 antiviral-intolerant patients were treated with rituximab alone. RESULTS Treatment with rituximab and PEG-IFN alfa-2b plus ribavirin induced a complete clinical response and a partial clinical response in 80% and 15% of patients, respectively, a complete immunologic response and a partial immunologic response in 67% and 33% of patients, respectively, and a sustained virologic response in 55% of patients. Treatment with rituximab alone induced a complete clinical response and a partial clinical response in 58% and 9% of patients, respectively, and a complete immunologic response and a partial immunologic response in 46% and 36% of patients, respectively. B cell depletion was achieved in 96% of patients, and B cell recovery began after a median delay of 12 months. After a mean+/-SD followup period of 23+/-12 months, 22% of patients experienced a clinical relapse, and 34% of patients experienced an immunologic relapse. All relapses were associated with the absence of virologic control, and 78% of relapses were associated with B cell recovery. Six patients were re-treated with rituximab. All 6 of these patients had a complete clinical response, 50% had a complete immunologic response, and 50% had a partial immunologic response. Rituximab was well tolerated overall. CONCLUSION Rituximab is an effective treatment of severe and/or refractory HCV-related vasculitis. Relapses were consistently associated with the absence of virologic control. The clinical and immunologic efficacy of rituximab after repeated infusion appeared to be the same as that observed after induction therapy.
LONG‐TERM OUTCOME OF PATIENTS TREATED WITH METHADONE MAINTENANCE *

The root causes of narcotic addiction are unknown. Contributory factorssuch as easy availability of drugs, peer group delinquency, broken families, and adolescent curiosity,-of course are statistically associated with addiction since they are correlated with exposure, but they d o not explain why, with apparently equal exposure, some persons become life-long addicts while others d o not. Why do many adolescents use narcotics a few times and then reject the habit, while a minority become chronic drug-dependent users? Why d o some of the persons who start with narcotics quit the drug after a few months of heavy use? How can some persons remain occasional users while others progress to intractable, life-destroying addiction with narcotic drugs dominating all other interests? Are the social, psychological and medical disabilities seen in chronic addicts the causes of addiction or d o they simply reflect the unhealthy life that addicts lead? How often can chronic addiction to narcotics be cured by a program that provides motivation and promotes social rehabilitation? Can success be predicted? The present study summarizes some statistics that seem relevant to these questions. The problem of addiction obviously goes deeper than the environment. If narcotic drugs serve only as a n escape from bad living conditions, a maintenance program should become unnecessary when the subjects have a job, a stable family and a sense of accomplishment. But experience teaches differently. Most persons with a long history of heroin use relapse after detoxification whether or not they had been rehabilitated. Their relapses might be ascribed to residual psychopathology, to the persistence of conditioned reflexes or t o some undefined metabolic disease-but these are only conjectures, and certainly not worth fighting about. The practical fact is that some heroin users can become permanently abstinent, while others relapse, even under the best conditions. How can we predict the outcome? One factor in prediction obviously is the duration of use. Even without treatment, most short-term users stop using narcotics and move to other interests. Time is selective. After the experimenters have left the field, we see the chronic users. When addiction has persisted for several years despite efforts a t dissuasion by punishment and treatment, the probability of a spontaneous remission becomes much less. It is this intractable group that we have treated in the methadone maintenance programs. They are the subjects of the present report. Approximately 82,000 addicts have been admitted to methadone maintenance programs in New York since the modality was formally defined in 1%5. All are listed in the files of the Community Treatment Foundation which has maintained
CAT: Building Couples to Early Detect Node Compromise Attack in Wireless Sensor Networks

Node compromise attack is a serious threat to the successful deployment of wireless sensor networks. It is a multiple-stage attack, which usually consists of three stages: physically capturing and compromising sensor nodes; redeploying the compromised nodes back to the sensor network; and compromised sensor nodes rejoining the network and launching attack. Over the last few years, much previous work has tackled the node compromise attack in the late stage, either in the second stage or in the third stage. As a result, the protection measures are often ineffective. In this paper, we will make the first effort on addressing the node compromise problem in the first stage, and present a new couple-based scheme to detect the node compromise attack in early stage. Specifically, after sensor nodes are deployed, they first build couples in ad hoc pattern. Then, the nodes within the same couple can monitor each other to detect any node compromise attempt. Extensive simulation results are given to demonstrate the high detection rate of the proposed scheme.
Single dose of secnidazole treatment against naturally occuring Giardia duodenalis infection in Sakiz lambs

Objective. The purposes of this study were to determine whether secnidazole administered at a single dose of 10 mg/kg, orally, lessens or eliminates Giardia cyst shedding, and to validate the benefit of secnidazole treatment on clinical signs and faecal consistency in lambs naturally infected with Giardia duodenalis. Materials and methods. To this extent weaned 12 weeks of age lambs were selected and randomly assigned into two groups based on placebo (group C, n=7 untreated control group) or treatment (group S, n=10 lambs treated with a single dose of secnidazole at 10 mg/kg). Results. On days 0 and 10, before and after treatment, respectively, reduction in cyst excretion was determined. The faecal consistency and general health were recorded at each sampling day. Conclusions. During the study there was a high (99.98%) reduction in cyst excretion in the secnidazol treatment group compared to the positive control group on day 10, resulting in a significant (p<0.001) reduction, making secnidazole highly effective treatment option.
Presynaptic calcium currents at voltage‐clamped excitor and inhibitor nerve terminals of crayfish.

1. A two‐electrode voltage clamp was used to record calcium currents from the excitatory and inhibitory nerve terminals that innervate the crayfish (Procambarus spp.) opener muscle. Other voltage‐dependent currents were blocked with tetrodotoxin, 3,4‐diaminopyridine, 4‐aminopyridine and tetraethylammonium. 2. The presynaptic calcium current at both excitatory and inhibitory synapses was blocked by cadmium and omega‐agatoxin IVA but was not affected by omega‐conotoxin GVIA, omega‐conotoxin MVIIC or nifedipine, suggesting that the calcium currents flow through P‐type calcium channels. 3. Current‐voltage (I‐V) relations at both excitatory and inhibitory synapses are similar, with current activation near ‐40 mV, peak current near ‐10 mV and current reversal at membrane potentials greater than +25 mV. I‐V relations were scaled along the current axis by partial calcium current blockade with cobalt, suggesting that series resistance and space‐clamp errors were small. 4. A subset of terminals on one muscle fibre was locally superfused with a physiological saline containing barium; the rest of the preparation was superfused with a physiological saline containing calcium channel antagonists. Under such conditions the characteristics of the I‐V relation were very similar to the I‐V relations recorded when the entire preparation was bathed in physiological levels of calcium, suggesting that the space clamp was adequate. 5. Calcium channel activation, as determined from tail current analyses, was similar when the entire preparation was bathed in physiological levels of calcium or if terminals on one muscle fibre were locally superfused with barium. 6. During a 30 ms depolarization, calcium currents inactivated to a greater extent in inhibitory than in excitatory terminals. The inactivation was of small magnitude (< 20%) and was eliminated by intracellular injection of the calcium chelator BAPTA, suggesting that the inactivation was calcium dependent. 7. These data show that biophysical and pharmacological properties of calcium currents at crayfish neuromuscular junctions resemble those found at stellate synapses in squid.
Capillary Refill Time in the Hands and Feet of Normal Newborn Infants

We measured capillary refill time (CRT) in a convenience sample of 137 healthy newborns between 1 and 120 hours of age and 36-42 weeks gestation in the well-baby nursery of a large community hospital. CRT was measured by applying moderate pressure to the dorsum of the right hand and right foot for 5 seconds. Pressure was released and the time for complete refilling of the blanched area noted. Each infant was studied only once. We also measured ambient temperature and the skin temperature of the dorsum of the hand and foot and tested interobserver agreement. Mean CRT was 4.23±1.47 s (SD) (range 1.63-8.78 s) in the hand and 4.64±1.41 s (range 2.15-9.94 s) in the foot (p=0.0001) and did not change significantly in the first 72 hours. CRT decreased with increasing temperature. Environmental temperature, axillary temperature, and temperature of the hand and foot were all significantly and indirectly related to CRT, the strongest relationship existing between CRT and the skin temperature of the hand (r=-0.59, 95% CI 0.69, 0.47 p<0.00001) and foot (r=-0.33, 95% CI 0.46, 0.16 p<0.0001). With triplicate measurements, there was a statistically significant, but clinically moderate, order effect, CRT decreasing with each successive measurement (p<0.0001). Interobserver agreement was fair, the correlation coefficient (r) ranged from 0.47 to 0.71. We conclude that CRT as measured in the hand or foot of a newborn infant in the first 5 days of life is a relatively subjective measurement with an endpoint that is not easy to define and a wide range of values in normal infants. It is influenced significantly by environmental, axillary, and skin temperatures. Since there is no accepted standard for measuring decreased perfusion in the newborn, it is impossible to document the clinical utility of CRT in this population. Further studies are necessary before CRT can be accepted as a useful measure of peripheral perfusion and circulatory status in the newborn infant.
Abdominal aortic aneurysm repair in octogenarians: myth or reality?

AIM We studied the thirty-day mortality and morbidity rate to assess the value of conventional open repair vs endovascular aortic repair (EVAR) in an elderly population presenting with a ruptured, symptomatic or asymptomatic abdominal aortic aneurysm (AAA) undergoing emergency, urgent or elective repair. METHODS During the period from January 2004 to May 2007, 329 consecutive patients were treated for AAA in our Department. Among these, 81 (24.6%) were aged >80 years (mean age 83.6, range 80-95 years). These older patients were divided into groups according to their clinical presentation: ruptured AAA group (rAAA) - 22 cases (4 emergency EVAR, 18 emergency open repair); symptomatic non-ruptured AAA group (sAAA) - 15 cases (11 urgent EVAR, 4 urgent open repair); asymptomatic AAA group (asAAA) - 44 cases (32 elective EVAR, 12 elective open repair). The main outcome measures were 30-day mortality and 30-day morbidity rate. RESULTS The mortality rate following open surgery vs EVAR was 66.6% vs 50% (P=NS) in the rAAA group, 25% vs 0% (P=NS) in the sAAA group, and 9% vs 3.2% (P=NS) in the asAAA group. When comparing postoperative morbidities in the octogenarians, 3 of the patients that received EVAR (6.4%) and 15 of those that received open repair (48.4%) had a severe complication (P<0.01). CONCLUSION The introduction of EVAR has considerably changed the balance of risks and benefits for AAA treatment. Our study confirms the high mortality rate for octogenarians with rAAA and haemodynamic instability, and supports the value of an active EVAR approach for octogenarians with AAA to prevent rupture. Moreover, the introduction of endovascular techniques as part of an overall treatment algorithm for ruptured AAAs appears to be potentially associated with improved outcomes in terms of mortality and morbidity as compared to open surgical repairs alone.