Miracle-dz/UniFAR-FTUs huggingface dataset:
Machine Perfusion Preservation Improves Renal Allograft Survival

Machine perfusion (MP) has been used as the kidney preservation method in our center for over 10 years. The first, small (n = 74) prospective, single‐blinded randomized study comparing MP and Cold Storage (CS) showed that the incidence of delayed graft function was higher after CS. There have been no reports in the literature on the effect of storage modality on long‐term function of renal allografts. This paper presents an analysis of long‐term results of renal transplantation in 415 patients operated on between 1994 and 1999. Of those, 227 kidneys were MP‐stored prior to KTx. The control group consisted of 188 CS kidney transplants. Kidneys were not randomized to MP or to CS. Donor demographics, medical and biochemical data, cold ischemia time, HLA match and recipient data were collected. Standard triple‐drug immunosuppression was administered to both groups. Mortality, graft survival and incidence of return to hemodialysis treatment were analyzed. Despite longer cold ischemia time and poorer donor hemodynamics in MP group, 5‐year Kaplan‐Meier graft survival was better in MP‐stored than in CS‐stored kidneys (68.2% vs. 54.2%, p = 0.02). Conclusion: In this nonrandomized analysis, kidney storage by MP improved graft survival and reduced the number of patients who returned to dialysis.
Gastrointestinal motor function in patients with portal hypertension.

BACKGROUND Existing data on gastric emptying and small-intestinal transit rates in portal-hypertensive patients are scarce and contradictory, and so far, the motor function of the colon has not been assessed in these patients. In this study we evaluated the propulsive effect of all main segments of the gastrointestinal tract in patients with well-characterized portal hypertension. METHODS Eight patients with a postsinusoidal hepatic pressure gradient of at least 13 mmHg and eight age- and sex-matched healthy controls participated in the study. Gastric emptying, small-intestinal transit, and colonic transit rates were evaluated in all subjects by means of a gamma camera technique. The technique was also used to measure the frequency of antral contractions. RESULTS No difference was observed in gastric mean emptying time or small-intestinal mean transit time of liquid and solid markers between patients and controls. After 24 h, however, the geometric center of the liquid marker had a more caudal localization in the colon of the patient group than in the controls (P = 0.04); that is, the patients had a faster colonic transit. No difference was found in the frequency of antral contractions 45 min after the test meal between patients and controls. CONCLUSIONS These data suggest that the colonic transit is often accelerated in patients with portal hypertension, whereas the motor function of the stomach and the small intestine is unaffected.
Hepatic artery thrombosis following orthotopic liver transplantation: A 10‐year experience from a single centre in the United Kingdom

Hepatic artery thrombosis (HAT) occurs in 3–9% of all liver transplants and acute graft loss is a possible sequelae. We present our experience in the management of HAT over a 10‐year period. Prospectively collected data from April 1994 to April 2004 were analyzed. There were 1,257 liver transplants, 669 males, median age 51 (16–73) years. There were 61 (4.9%) cases of HAT. Early HAT occurred in 21 (1.8%). Thirty six had graft dysfunction, 11 required a regraft, and 14 died. Positive CMV serology in the donor, cold ischemia time, duration of operation, transfusions of more than 6 units of blood, and 15 units of plasma, an aortic conduit for arterial reconstruction, Roux‐en‐Y biliary reconstructions, regrafts and relaparotomy were associated with HAT. At multivariate analysis, type of biliary anastomosis was the only significant factor associated with HAT. Split or reduced liver graft were not risk factors for HAT. Number of hepatic arteries requiring multiple arterial anastomosis was not a risk for HAT. HAT resulted in a reduction in overall survival post liver transplantation. The incidence of HAT was 4.9%; with 1.8% early HAT and HAT impacted on survival. Surgical technique was not an aetiological factor for HAT. In conclusion, while a Roux‐en‐Y biliary reconstruction was an independent risk factor for HAT, cold ischemia and operative times, the use of blood and plasma and the use of aortic conduits in arterial reconstruction were associated with HAT. Regrafts and reoperation were also identified risk factors. Liver Transpl 12:146–151, 2006. © 2005 AASLD.
Quantitative comparison of intestinal invasion of zoonotic serotypes of Salmonella enterica in poultry

The aim of the present study was to compare the invasion of selected zoonotic Salmonella serotypes of poultry in an in vivo chicken intestinal loop model and also in vitro in epithelial cell cultures. Invasion was measured relative to a reference strain, Salmonella Typhimurium 4/74 inv H201::Tn phoA . Two serotypes demonstrated intracellular log 10 counts that differed significantly from all other serotypes tested: Salmonella Enteritidis PT4 being 1.5 log 10 colony forming units (CFU) (31-fold) higher, and Salmonella Tennessee being 0.7 log 10 CFU (fivefold) lower than the reference strain ( P h 0.0001). A group of serotypes, which can be vertically transmitted, showed significantly higher intracellular counts (fourfold to eightfold) than the reference strain. The group included S. Typhimurium 4/74, S. Typhimurium DT104 (poultry and porcine isolates), S. Enteritidis PT1, S. Enteritidis PT6, S. Enteritidis PT8, and Salmonella Berta. The serotypes Salmonella Hadar, Salmonella Virchow, S. 4,12:b:-, S. Typhimurium DT41, and Salmonella Infantis, most of which are considered horizontally transmitted, did not show significantly different intracellular counts from the reference strain. Results from the cell culture invasion studies agreed with the in vivo data, with the exception of S. Berta and the poultry isolate of S. Typhimurium DT104.
Citrulline Level Is a Potent Indicator of Acute Rejection in the Long Term Following Pediatric Intestinal/Multivisceral Transplantation

Citrulline has been advocated as a marker for acute cellular rejection (ACR) in intestinal transplantation; however, its significance as a forewarning in the long‐term follow‐up remains unknown. This study aimed to investigate the association between citrulline levels and the grading of ACR to establish a cutoff point that accurately predicts ACR beyond 3 months posttransplant in the pediatric patient population. During a 16‐year period (1995–2011), a total of 13 499 citrulline samples were prospectively collected from 111 consecutive pediatric intestinal/multivisceral transplant recipients: 2155 were obtained concurrently with intestinal biopsies. There were 185 ACR episodes observed among 74/111 (67%) patients (median follow‐up: 4.4 years). Citrulline levels were inversely proportional to the severity of ACR. Negative predictive values for any type of ACR (cutoff, 20 μmol/L) and moderate/severe ACR (cutoff, 10 μmol/L) were 95% and 99%, respectively. When patients were divided according to graft size, diagnostic accuracy using the same cutoff was identical. Similarly, subgroup analysis by the timing of citrulline measurement prior to biopsy varying from 1 to 7 days demonstrated comparable results. Citrulline is a potent indicator as a danger signal for ACR, being an exclusionary, noninvasive biomarker with excellent negative predictive values in the long term after pediatric intestinal/multivisceral transplant.
Timing of Glottic Closure during Swallowing: A Combined Electromyographic and Endoscopic Analysis

Objectives: We performed a case series to enhance our understanding of the coupling between neuromuscular events and glottic closure. Methods: We performed combined flexible video laryngoscopy and electromyography in 4 healthy human subjects. Hooked-wire electrodes were placed in the superior pharyngeal constrictor, longitudinal pharyngeal, cricopharyngeus, thyroarytenoid, genioglossus, suprahyoid, and posterior cricoarytenoid muscles. A flexible endoscope tip was positioned in the oropharyngeal-hypopharyngeal region. The subjects performed multiple trials each of 10-mL normal and super-supraglottic liquid swallows. Results: Arytenoid movement consistently preceded full glottic closure and was associated with cessation of activity of the posterior cricoarytenoid muscle. In 89% of normal swallows, the glottis was partially open in the video frame before bolus passage. The maximum amount of thyroarytenoid electromyographic activity occurred during endoscopic white-out. When subjects executed a super-supraglottic swallow, early thyroarytenoid activity coincided with arytenoid contact. Conclusions: The initial medialization of the arytenoids is due to a decrease in motor tone of the posterior cricoarytenoid muscle. Full glottic closure typically occurs late in the process of swallowing, with activation of the thyroarytenoid muscle. Shifting of arytenoid medialization and glottic closure earlier in the super-supraglottic swallow indicates that glottic closure is under significant voluntary control.
Serum Thyroxine and Triiodothyronine Concentrations in Rats Receiving Lithium Carbonate

Circulating thyroxine (T4) and triiodothyronine (T3) concentrations in rats were determined after various periods of lithium administration in diet. No significant change in serum T4 and T3 levels was observed after ten days of lithium treatment. However, lithium treatment for one month, two months and four months showed a significant decrease in serum T4 and T3 levels indicating the adverse effect of chronic lithium intake.
Obesity prevention at the point of purchase

The point of purchase is when people may make poor and impulsive decisions about what and how much to buy and consume. Because point of purchase strategies frequently work through non‐cognitive processes, people are often unable to recognize and resist them. Because people lack insight into how marketing practices interfere with their ability to routinely eat healthy, balanced diets, public health entities should protect consumers from potentially harmful point of purchase strategies. We describe four point of purchase policy options including standardized portion sizes; standards for meals that are sold as a bundle, e.g. ‘combo meals’; placement and marketing restrictions on highly processed low‐nutrient foods; and explicit warning labels. Adoption of such policies could contribute significantly to the prevention of obesity and diet‐related chronic diseases. We also discuss how the policies could be implemented, along with who might favour or oppose them. Many of the policies can be implemented locally, while preserving consumer choice. © 2016 World Obesity
Factors Predicting 2 Years of Remission and Low Disease Activity in Rheumatoid Arthritis Patients Treated with TNF-inhibitors.

BACKGROUND The goals of treatment for rheumatoid arthritis (RA) are remission and low disease activity (LDA). However, many patients do not reach or maintain these targets with regard to disease control. OBJECTIVES To identify predictive factors of remission/LDA in a cohort of RA patients who started treatment with first line tumor necrosis factor-inhibitors (TNF-i). METHODS We included 308 RA patients treated with first line TNF-i for 2 years to evaluate remission/LDA based on the 28-joint disease activity score (DAS28). Predictive factors considered for achievement of remission/LDA were: gender, age at the time of TNF-i treatment, early arthritis, baseline C-reactive protein (CRP) and erythrocyte sedimentation rate levels, RF/anti-citrullinated protein antibody positivity, good/moderate European League Against Rheumatism response at 6 months, co-morbidities, and concomitant disease modifying antirheumatic drugs (DMARDs). Intention to treat, receiver operating characteristic curve, and univariate and multivariate analyses by logistic regression were performed. RESULTS Positive predictors of remission/LDA in both the univariate and the multivariate analyses were: male gender, age at the time of TNF-i treatment ≤ 54 years, negative baseline CRP, and concomitant DMARDs. The presence of any co-morbidity resulted to be a negative predictor of remission/LDA in both the univariate and the multivariate analyses. CONCLUSIONS Demographic and clinical features were identified as reliable predictors of both the achievement and the maintenance of treatment targets in a cohort of RA patients treated for 2 years with first line TNF-i.
Prognostic Significance of the DNA-Index in Liver Transplantation for Hepatocellular Carcinoma in Cirrhosis

Objective:This study was conducted to evaluate the prognostic significance of the tumor DNA index in patients receiving liver transplantation for hepatocellular carcinoma (HCC) in cirrhosis. Background:In patients suffering from HCC in cirrhosis, the current selection for liver transplantation does not optimally achieve the goal to simultaneously maximize the number of viable transplant candidates and reject the smallest number of those who could have benefited. This is the first report on the prognostic significance of the tumor DNA index. Patients and Methods:From 1988 to 2007, liver transplantation for HCC in cirrhosis was performed in 246 consecutive patients. The DNA-index was determined by Feulgen staining and semiautomatical image analysis. Interpretation of DNA histograms followed the recommendations outlined in the European Society for Analytical Cellular Pathology consensus report on diagnostic DNA image cytometry. Results:A DNA-index ≤1.5 was detected in the HCC of 159 patients (65%). Five- and 10-year post-transplant survival rates in this group were 86% and 80%, respectively. The DNA-index exceeded 1.5 in 87 patients (35%). These patients had 5- and 10-year survival rates of 27% and 6%, respectively, which were significantly lower than in the DNA-index ≤1.5 group (P < 0.0001). On univariate analysis, DNA-index, vascular invasion, fulfillment of the Milan criteria, and histopathological grading were prognostic parameters. In the multivariate analysis, only DNA-index (odds ratio: 11.9; 95% confidence interval: 7.1–20.0; P < 0.0001) and vascular infiltration (odds ratio: 1.7; 95% confidence interval: 1.1–2.6; P < 0.01) were identified as prognostic variables. Conclusion:This is the first study to describe the DNA-index as a strong prognostic indicator after liver transplantation for HCC in cirrhosis. At this time, determination of the DNA-index is likely to be the most promising diagnostic tool in the selection of transplant candidates.
The Use of Noninvasive Positive Pressure Ventilation following Pediatric Tonsillectomy

Objective To determine the risks of bleeding and other complications in pediatric patients who require noninvasive positive pressure ventilation (PPV) in the immediate posttonsillectomy period. Study Design Case series with chart review. Setting Single tertiary pediatric hospital. Subjects and Methods Sixty-nine patients who had undergone tonsillectomy from July 2007 through December 2013 and required postoperative PPV were reviewed. Data collected included age, sex, medical history, preoperative polysomnogram parameters, length of use and type of noninvasive ventilatory support, and postoperative complications. Bleeding rate was calculated. Results Sixty-nine children met inclusion criteria for the study. Most had comorbid conditions. The mean age of these patients was 6.4 years. The postoperative bleeding rate of children who required operative intervention for control was 5.97%. Patients did not experience other complications. Conclusion This is the largest study in the literature investigating bleeding in pediatric patients undergoing tonsillectomy who required postoperative noninvasive PPV. Some hesitation may exist in using this form of ventilation when open pharyngeal wounds are exposed to pressure, but this study suggests that it can be used as a suitable alternative to invasive ventilation.
The relationship between ethos, learning habits and educational outcomes of English Church of England secondary schools and academies

This thesis represents my reflective journey to explore the relationship between ethos, learning habits and educational outcomes of Church of England secondary schools and academies. Leaders of Church schools often suggest that their Christian ethoses contribute to their favourable outcomes although they offer limited evidence to support this. Using published inspection reports for Church schools I argue that it is possible to find a statistically significant relationship between an aggregated score for ethos and an aggregated score for educational outcomes. Focusing on one school with a particularly strong match as a case-study, and drawing on the work of Jeynes (2003) in the United States, I argue that there is a perception amongst the stakeholders of this school that its Christian ethos contributes to success through cultivating the learning habits of diligence, resilience and compliance. Further, I argue that the values, theology and actions of the headteacher have contributed significantly to this ethos and these related learning habits. In proposing these findings I argue that my role as a self-professing Christian and serving Church school headteacher provided me with a unique experience to obtain this data grounded in my own story. Through personal biographies and further enquiry, I suggest that these learning habits may be applicable not only to the case-study school but to all successful Church schools. Finally, in arriving at all these findings, I maintain that the employment of a range of methodologies throughout this thesis enabled me to illuminate the different dimensions of the relationship between ethos, learning habits and outcomes in Church schools. In an age when there is evidence of growing opposition to all ‘faith’ schools, I suggest that the findings from this study provide important insights into the relationship between ethos, learning habits and outcomes, not only of Church schools but other schools too.
Taste sensation following cochlear implantation surgery

Abstract Objectives The chorda tympani nerve (CTN) is at risk of damage during cochlear implantation, especially during posterior tympanotomy. The aim of this study was, therefore, to elicit the risk of taste disorders following cochlear implantation surgery involving a mastoidectomy and a posterior tympanotomy approach. Method Twenty-six patients underwent a taste test before, 3 days after, and 6 weeks after cochlear implantation surgery. The taste sensations – sweet, sour, salt and bitter – were determined. Patients’ self-ratings of taste function were also obtained. In addition, the surgeons provided information concerning the intraoperative status of the CTN. Results In total, 19.2% (5 of 26) of the patients had postoperative taste dysfunction, as measured either subjectively or objectively or both. One of these five individuals had taste disturbance as assessed by both subjective and objective measures; in another, it was merely reported subjectively. Three patients were subjectively asymptomatic but the postoperative taste test revealed a dysfunction. Sixteen percent of the patients in whom the CTN was reported to be preserved intraoperatively had a postoperative taste dysfunction. Although the CTN was rerouted in five patients, only two of them (40%) had transient gustatory dysfunction. In two of those patients with postoperative taste dysfunction, the CTN was not intraoperatively exposed (being protected by bone) despite these individuals’ experiencing postoperative taste problems. The recovery rate was 100% at 6 weeks after surgery. Conclusion Our study indicates that cochlear implantation entails only a minimal risk of taste dysfunction and that this is chiefly a transient problem.
Relations between symptom severity, illness perceptions, visceral sensitivity, coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness

Abstract Irritable Bowel Syndrome (IBS) is a common condition affecting around 10–20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org. au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ2 (8) = 11.91, p = . 16, χ2/N = 1.49, CFI > . 98, TLI > . 96, SRMR < . 05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = –.28, p < .001; β = –.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.
Effectiveness and tolerability of a homoeopathic remedy compared with conventional therapy for mild viral infections

Treatments for mild viral infections are usually directed at providing symptomatic relief. The effectiveness of the homoeopathic remedy Gripp‐Heel® was compared with that of conventional treatments in a prospective, observational cohort study in 485 patients with mild viral infections and symptoms such as fever, headache, muscle pain, cough or sore throat. Practitioners specialised in homoeopathy or conventional treatment, or practised both to similar extents. As evaluated by the practitioners, the homoeopathic therapy was effective to similar or greater degree than the conventional therapies: 67.9% of patients were considered asymptomatic at the end of Gripp‐Heel® therapy vs. 47.9% of patients in the control group. Practitioners judged homoeopathic treatments as ‘successful’ in 78.1% of cases vs. 52.2% for conventional therapies. Tolerability and compliance were good in both treatment groups, with the verdict ‘very good’ given for 88.9% of patients in the homoeopathic group vs. 38.8% in the conventional treatment group.