Miracle-dz/UniFAR-FTUs huggingface dataset:
Spinal Myxopapillary Ependymoma: Neurological Deterioration in Patients Treated With Surgery

Study Design. A retrospective multicenter study of series of 20 patients with myxopapillary ependymomas, which underwent surgery. Objective. To evaluate the postoperative outcomes of patients surgically treated for spinal myxopapillary ependymoma. Neurologic deterioration after tumor resection is discussed in terms of the tumor encapsulation. Summary of Background Data. Myxopapillary ependymomas occur most commonly in the cauda equina and/or conus medullaris region. Most series published in the literature have covered postoperative tumor recurrence and role of adjuvant radiotherapy. Few contradistinctive studies in postoperative neurological deficit were reviewed from the standpoints of MRI and histopathologic findings. Methods. A total of 20 patients were recruited and charts, MRI, intraoperative findings, and pathologic findings were reviewed. The follow-up period ranged from 2 to 12 years (median, 72.9 months). The surgical procedures were defined as gross total removal, piecemeal total removal, and subtotal removal. Postoperative radiotherapy was given in 3 patients in whom removal had been subtotal. Results. Gross total removal was achieved in 14 patients, piecemeal gross total and subtotal removal in 3 patients each. Neurologic deterioration after surgery was seen in 5 patients, all of which were unencapsulated tumors consisting of piecemeal gross total removal in 2 patients and subtotal removal in 3 patients. Recovery of postoperative bladder dysfunction remained unchanged in 2 patients. There were no tumor recurrence and progression of the remaining tumors. Unencapsulated tumors were more frequently seen in heterogeneously enhanced tumors on MRI than in homogenously enhanced tumors with significant difference. Conclusion. In the unencapsulated ependymomas, tumor separation and manipulation of the surrounding neural tissue caused neurologic injury. The heterogeneously enhanced ependymoma not only should be evaluated and treated meticulously, but also surgeons should not stick to total removal in infiltrated and adhering tumors as subtotally resected tumors with postoperative radiotherapy have not always recurred.
Stability of factor VIII concentrates after reconstitution

Adjusted‐dose continuous infusion of factor VIII (FVIII) has recently been shown to reduce the doses of the factor in patients undergoing surgery by 50‐75%. The main limitation of this method has been the instability of factor concentrates. All manufacturers are recommending infusion of the concentrate within hours after reconstitution. We studied the stability of 15 different lyophillzed F VIII products. Reconstituted samples were stored for periods of 4, 24, and 72 hr and 1, 2, 3, and 4 weeks at temperatures of WC, 20‐23°C, and 37°C in their original glass containers and in plastic tubes and then frozen. Assays were performed in duplicate, using a one‐stage clotting method and a chromoge nlc assay for F VIII, wlth all samples from a single concentrate In the same run. Activation of the coagulation factor occurred In some concentrates, more often at 44°C than at 20‐23°C or 3PC. The stability of all products was substantially better than that declared by the manufacturers. Several concentrates maintained factor activities above 80% of baseline for the entlre period of 4 weeks at 44°C or at 20‐23°C. The results demonstrate that many of the F VIII concentrates may be used for continuous infusion. © 1994 Wiley‐Liss, Inc.
Retrospective Comparison of Clinical Characteristics and In-Hospital Outcomes among Diabetic and Non-Diabetic Adults with Acute Pyelonephritis.

INTRODUCTION Acute Pyelonephritis (APN) is a common infection in community. Diabetes Mellitus (DM) may have different effect on clinical characteristics and outcomes of APN compared to non-diabetic individuals. AIM To compare clinical characteristics and assess outcomes of APN patients with and without DM. MATERIALS AND METHODS A retrospective analysis of 122 patients with DM (n=61) and without DM (n=61) was conducted at a single, private, urban set-up from Gujarat, India. Clinical symptoms, laboratory investigations, antibiotics treatment and outcomes in terms of mortality and prolonged hospitalization (10 days and above) were compared in two groups. RESULTS Mean age was significantly higher in diabetics than non-diabetics (55.2±12.5 vs 41.5±17.3, p<0.0001) and females were proportionally higher in both groups (65.6% Vs 62.3%, p=0.706). Fever was most frequent symptom (83.6% Vs 90.2%, p=0.283) followed by nausea/vomiting (50.8% Vs 63.9%, p=0.143), dysuria (66.7% Vs 74.4%, p=0.433) and flank pain (8.2 Vs 13.1, p=0.379). Backache/back pain (47.5% Vs 29.5%, p=0.041) and Chronic Kidney Disease (CKD) (63.9% Vs 45.9%, p=0.045) were significantly higher in diabetics than non-diabetics. Mean hospital stay did not vary significantly in two groups (7.0±3.2 Vs 6.50±2.9, p=0.346) but proportion of patients with longer hospital stay was higher in DM (16.4% Vs 8.2%). Elevated white cell count, erythrocyte sedimentation rate, C-reactive protein, serum creatinine and presence of red cell in urine (> 5/ high power field [hpf]) did not vary significantly in two groups. Cephalosporin-beta-lactamase inhibitor (Cefaperazone-Sulbactam/Cefepime-Tazobactam) was the most prescribed antibiotic in both the groups. No deaths were observed in any group during this evaluation period. Only raised ESR (>30 mm/hr) {Odds Ratio (OR): 1.58, 95% Confidence Interval (CI) 1.36-1.82, p=0.004} and presence of CKD (OR: 1.71, 95% CI 1.30-2.25, p=0.008) were found to be the significant predictors of prolonged hospitalization in overall population. CONCLUSION APN in diabetic and non-diabetic patients has similar clinical characteristics. Impact of diabetes on clinical outcomes of mortality and prolonged hospitalization warrants further investigation in a large, randomized, prospective trial.
Resampling and Distribution of the Product Methods for Testing Indirect Effects in Complex Models

Recent advances in testing mediation have found that certain resampling methods and tests based on the mathematical distribution of 2 normal random variables substantially outperform the traditional z test. However, these studies have primarily focused only on models with a single mediator and 2 component paths. To address this limitation, a simulation was conducted to evaluate these alternative methods in a more complex path model with multiple mediators and indirect paths with 2 and 3 paths. Methods for testing contrasts of 2 effects were evaluated also. The simulation included 1 exogenous independent variable, 3 mediators and 2 outcomes and varied sample size, number of paths in the mediated effects, test used to evaluate effects, effect sizes for each path, and the value of the contrast. Confidence intervals were used to evaluate the power and Type I error rate of each method, and were examined for coverage and bias. The bias-corrected bootstrap had the least biased confidence intervals, greatest power to detect nonzero effects and contrasts, and the most accurate overall Type I error. All tests had less power to detect 3-path effects and more inaccurate Type I error compared to 2-path effects. Confidence intervals were biased for mediated effects, as found in previous studies. Results for contrasts did not vary greatly by test, although resampling approaches had somewhat greater power and might be preferable because of ease of use and flexibility.
Efavirenz-Associated QT Prolongation and Torsade de Pointes Arrhythmia

OBJECTIVE: To report a case of acquired long QT syndrome that, after exclusion of all other possible causes, was probably related to therapy with efavirenz, a novel nonnucleoside reverse transcriptase inhibitor. CASE SUMMARY: This patient presented with recurrent syncope and polymorphic ventricular tachycardia, which was treated with overdrive ventricular pacing and was eliminated by discontinuation of the offending drug. DISCUSSION: This is the first reported case of QT prolongation and severe ventricular arrhythmia associated with the use of efavirenz. The temporal relationship between the initiation of treatment and the onset of electrocardiographic abnormalities, the absence of other apparent precipitating factors, as well as the normalization of QT interval and the resolution of the arrhythmia after discontinuation of the drug, strongly suggest a causal relationship between efavirenz and this adverse clinical event. CONCLUSIONS: Our case shows that any new pharmaceutical compound introduced in clinical practice may potentially result in QT prolongation and life-threatening arrhythmia.
Competition and Organizational Change ∗

We develop a model in which competitive pressure is a catalyst for organizational change. In our model, commitment to a narrow business strategy is valuable because workers need to coordinate their efforts to build a strategy-specific capability. We show that a monopolist may not be able to commit to a focused business strategy. However, introducing competition can make commitment credible, thus leading to organizational change and greater operating efficiency. Our model sheds light on a number of questions in the intersection between the strategic management literature and the organizational economics literature, including the importance of leadership styles, the existence of X-inefficiencies, and the interactions between strategic positioning and organizational capabilities.
Load sharing of decentralized-controlled multiple mobile robots handling a single object

In this paper, we propose a decentralized control algorithm of multiple robots handling a single object in coordination. Different from our previous control algorithm the external force applied to the object, including the inertia force, is shared equally by all of the robots. The proposed control algorithm is experimentally applied to three mobile robots, each of which has one degree of freedom. The experimental results illustrate the validity of the proposed control system.
How to deal with a crying patient? A study from a primary care setting in Croatia, using the ‘critical incident technique’

Abstract Background: Expression of strong emotions by patients is not a rare event in medical practice, however, there are few studies describing general practitioner (GP) communication with a crying patient. Objective: The aim of this study was to describe GP behaviour with a patient who cries in a family practice setting. Methods: A semi-qualitative study was conducted on 127 Croatian GP trainees, 83.5% female, and 16.5% male. The study method used was the ‘critical incident technique. ’ GP trainees described their recent experience with patients who cried in front of them. Textual data were explored inductively using content analysis to generate categories and explanations. Results: All 127 (100.0%) GP trainees initially let patients cry, giving them verbal (81.9%) and/or nonverbal support (25.9%). GP trainees (69.3%) encouraged their patients to verbalize and to describe the problem. Most GP trainees (87.4%) tried to establish mutual problem understanding. Approximately half of the GP trainees (55.1%) made a joint management plan. A minor group (14.2%) tried to maintain contact with the patient by arranging follow-up appointments. The vast majority of GP trainees shared their patient's emotion of sadness (92.9%). Some GP trainees were caught unaware or unprepared for patient's crying and reacted awkwardly (4.7%), some were indifferent (3.9%) or even felt guilty (3.1%). Conclusion: GP trainees’ patterns of communication with crying patients can be described in five steps: (a) let the patient cry; (b) verbalization of emotions and facilitation to express the problem; (c) mutual understanding and solution finding; (d) evaluation—maintaining contact; and (e) personal experience of great emotional effort.
The use of psychiatric services by young adults who came to Sweden as teenage refugees: a national cohort study

Aims. To investigate the patterns of use of different forms of psychiatric care in refugees who settled in Sweden as teenagers. Method. Cox proportional hazards models were used to estimate the use of different forms of psychiatric care from 2009 to 2012 in a population of 35 457 refugees, aged from 20 to 36, who had settled in Sweden as teenagers between 1989 and 2004. These findings were compared with 1.26 million peers from the same birth cohorts in the general Swedish population. Results. Unaccompanied and accompanied refugees were more likely to experience compulsory admission to a psychiatric hospital compared with the native Swedish population, with hazard ratios (HRs) of 2.76 (1.86–4.10) and 1.89 (1.53–2.34), respectively, as well as psychiatric inpatient care, with HRs of 1.62 (1.34–1.94) and 1.37 (1.25–1.50). Outpatient care visits by the young refugees were similar to the native Swedish population. The longer the refugees had residency in Sweden, the more they used outpatient psychiatric care. Refugees born in the Horn of Africa and Iran were most likely to undergo compulsory admission, with HRs of 3.98 (2.12–7.46) and 3.07 (1.52–6.19), respectively. They were also the groups who were most likely to receive inpatient care, with HRs of 1.55 (1.17–2.06) and 1.84 (1.37–2.47), respectively. Our results also indicated that the use of psychiatric care services increased with the level of education in the refugee population, while the opposite was true for the native Swedish population. In fact, the risks of compulsory admissions were particularly higher among refugees who had received a secondary education, compared with native Swedish residents, with HRs of 4.72 (3.06–7.29) for unaccompanied refugees and 2.04 (1.51–2.73) for accompanied refugees. Conclusions. Young refugees received more psychiatric inpatient care than the native Swedish population, with the highest rates seen in refugees who were not accompanied by their parents. The discrepancy between the use of inpatient and outpatient care by young refugees suggests that there are barriers to outpatient care, but we did note that living in Sweden longer increased the use of outpatient services. Further research is needed to clarify the role that education levels among Sweden's refugee populations have on their mental health and health-seeking behaviour.
The lateral amygdaloid nucleus: sensory interface of the amygdala in fear conditioning

Previous work has implicated projections from the acoustic thalamus to the amygdala in the classical conditioning of emotional responses to auditory stimuli. The purpose of the present studies was to determine whether the lateral amygdaloid nucleus (AL), which is a major subcortical target of projections from the acoustic thalamus, might be the sensory interface of the amygdala in emotional conditioning. Lesions were placed in AL of rats and the effects on emotional conditioning were examined. Lesions of AL, but not lesions of the striatum above or the cortex adjacent to the AL, interfered with emotional conditioning. Lesions that only partially destroyed AL or lesions placed too ventrally that completely missed AL had no effect. AL lesions did not affect the responses elicited following nonassociative (random) training. AL is thus an essential link in the circuitry through which auditory stimuli are endowed with affective properties and may function as the sensory interface of the amygdala during emotional learning.
Physicochemical and antimicrobial properties of copaiba oil: implications on product quality control.

BACKGROUND The copaiba oil is a common natural product used in cosmetic industry and as a nutraceutical product. However, lack of quality control and scarce knowledge about its antimicrobial activity is a point of concern. The proposal of this study was to investigate the physicochemical properties and the antimicrobial activity of five commercial brands of copaiba oil. METHODS Acidity and ester index, refractory index, solubility in alcohol, and thin layer chromatography were performed to verify the physicochemical properties of five commercial copaiba oils sold in local pharmacies. Ultra performance liquid chromatography coupled with diode-array detection and electrospray ionization quadrupole time-of-flight mass spectrometry (UPLC-DAD/ESI-Q-TOF-MS) was used to investigate diterpene acids while the volatile compounds were analysed by gas chromatography-mass spectrometry (GC-MS). Antibacterial and antifungal activities were also evaluated by agar diffusion technique; and minimal inhibitory concentration and maximal bactericidal concentration were defined for each sample and bacteria. RESULTS The physical-chemical analysis revealed heterogeneity between all samples analysed. The A1 sample showed characteristics of copaiba oil and was mainly composed by hydrocarbon sesquiterpenes (29.95% β-bisabolene, 25.65% Z-α-bergamotene and 10.27% β-cariophyllene). Among diterpene acids, the UPLCDAD/ESI-Q-TOF-MS data are compatible with presence of copalic and/or kolavenic acid (m/z 305 [M + H]+). Candida albicans was sensitive to almost all samples at high concentration and Saccaromyces. Cerevisiae showed sensitivity to A1 sample at 100 mg/mL. Although variable, all samples showed antibacterial activity. Significant activity was seen for A3 (19.0 ±0 and 15.6 ±0.5 mm), A4 (16.6 ±0.5 and 15.6 ±0 mm), and A5 (17.1 ±0 and 17.1 ±0 mm) on Staphylococcus saprophyticus and S. aureus, respectively. All samples were active against Klebsiella pneumoniae showing ≥15 mm diameter halo inhibition; and only A2 was active against Eschirichia coli. Phytopatogens tested revealed resistance of Ralstonia solanacearum CGH12 to all samples and susceptibility of Xcv 112 strain of Xanthomonas campestris pv campestris to almost all samples. MIC and MMC showed bacteriostatic effect against clinical interest bacteria and bactericidal effect against phytopatogens. CONCLUSIONS The results from physicochemical analysis reinforce the fact that it is imperative to include simple conventional methods in the analysis of oil products. The analysis of copaiba oil gives safe products and purity which ensure products with quality. Also, since copaiba oil is an over-the-counter product the results indicate that pharmacosurveillance must be improved by the governmental regulation agency to avoid microorganism resistance selection and to achieve better international quality products.
A Therapeutic Strategy for Metastatic Malignant Fibrous Histiocytoma Through Mesenchymal Stromal Cell-Mediated TRAIL Production

Objective:To overcome the therapeutic limitations of malignant fibrous histiocytoma (MFH), we evaluated human adipose tissue-derived mesenchymal stromal cells (MSCs) that secrete tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on metastatic MFH. Background:MFH is a highly malignant and metastatic type of sarcoma but surgical removal is the only effective method for treating MFH. MSCs are easily transduced to express a high level of transgene and can migrate toward cancer. For this reason, MSCs are a promising candidate for metastatic MFH therapies. Methods:In vitro sustainability of MSC-TRAIL against MFH-ino was analyzed by apoptosis assay. For preclinical study, anti-MFH effects of MSC-TRAILs were validated in murine models for local tumorigenesis and metastasis. Furthermore, a time-interval metastasis model of MFH was applied to confirm antimetastatic ability of MSC-TRAIL for preestablished metastatic MFH. Results:We found that MFH-ino is highly susceptible to recombinant TRAIL and MSC-TRAIL, which selectively induce apoptosis via caspase-8 activation in vitro. Moreover, not only MFH-ino but xenograft explants were also significantly inhibited by MSC-TRAIL in local tumorigenesis. In particular, the metastatic ability of MFH-ino was considerably reduced by MSC-TRAIL in metastasis murine model, particularly for preestablished metastatic MFH. Conclusions:These results suggest that MSC-TRAIL is sufficiently effective in inhibiting MFH-ino metastasis and the application using MSC-TRAIL could be extended to other sarcomas and recurrent metastatic cancers for cell-mediated cancer therapy.
Depression and Diabetes in Iranian Patients: A Comparative Study

Objective: The aim of the present study was determine the rate of depression in people with diabetes in an Iranian population. Method: A hospital-based prospective study with a comparison group was conducted in Firozgar Teaching Hospital in Tehran, Iran. The condition of depression and relationship to diabetes was assessed among 375 individuals (206 people with diabetes and 169 without diabetes) who consecutively presented for this prospective study. Results: Of the total participation, 206 (54.9%) had diabetes (type 1=66 and type 2=140). Female made up 63.7% (n = 239). The mean age of entire study was 47.2 years (SD = 16.3 range, 15–87 years). Major depression was present among 71.8% of this sample with diabetes (both types; type 1 and type 2). Depression was more prevalent among women with diabetes than men (Adjusted OR=2.1 (95% CI 1.4–3.2)). Of the 375 participants, 135 (36%) had BID scores lower than 11 and 240 (64%) had BDI scores indicating moderate to severe depression (> 16). Conclusions: Diabetes appears to increase the risk of developing depression; therefore early detection and treatment intervention provide the best protective mechanisms available against the effects of depression on diabetes outcomes, and a psychological service provision for people with diabetes is needed.
Long Term Process-Based Morphological Modelling of Pocket Beaches

The applicability of the open source model XBeach was tested for pocket beaches in this paper. First, schematized model setups have been used to assess the performance of XBeach qualitatively. It was found that adjustments of the initial bed were required to obtain the expected hydrodynamic conditions. The default sediment advection calibration factors had to be increased to obtain the expected morphological response of the pockets (stationair: 0.15, surfbeat: 0.30). The results have shown that the surfbeat mode outperforms the stationary mode based on a qualitative assessment. It was furthermore found that wave-current interaction produced unreliable results and should be avoided when modelling pocket beaches using XBeach. Non-hydrostatic simulations produced significantly more sedimentation behind the headlands due to the inclusion of diffraction. This mode was found to produce unexpected erosion at the upper shoreface however, indicating the inapplicability of the sediment transport formulas in non-hydrostatic simulations. Expansion of the classic pocket beach into two adjacent pocket beaches showed that these systems have to be treated as a complete system if interactions between these pockets are expected (separated by a salient). It was found that an individual assessment is adequate if a tombolo separates the pockets. Second, the morphological developments between the year 2000 and 2015 at Tanjong Beach (Singapore) were modelled using XBeach. For the modelled bed level changes, which were compared to bathymetric measurements, a ‘Good’ Mean-Squared Error Skill Score of 0.31 was found. In the prepared model, the obtained sediment advection calibration factors from the first part were used and model calibration was not performed. Based on the schematizations and the case study performed in this study, XBeach was found to be applicable for long term process-based modelling of pocket beaches.