Miracle-dz/UniFAR-FTUs huggingface dataset:
Transcervical Intralesional Vasopressin Injection Compared With Placebo in Hysteroscopic Myomectomy: A Randomized Controlled Trial

OBJECTIVE: To evaluate the efficacy of transcervical intralesional vasopressin injection to submucous myoma in hysteroscopic myomectomy from 2011 to 2014. METHODS: This was a prospective, randomized, double-blind study in a single center. Forty premenopausal women with symptomatic submucous myoma requiring hysteroscopic myomectomy were randomized to transcervical intralesional vasopressin injection or placebo in a 4:4 ratio. The primary outcome was operative time. Secondary outcomes including fluid volumes, blood loss, and visual clarity were compared between the two groups. RESULTS: The median duration for myomectomy was 19.9 minutes (range 3.1–54.2 minutes) in the vasopressin group compared with 29.0 minutes (range 8.0–60.9 minutes) in the placebo group, a nonsignificant difference (P=.14). There were significant reductions in the median volume of fluid used (4,200 mL [range 1,300–21,000 mL] compared with 9,800 mL (range 1,500–23,000 mL; P=.004) and fluid intravasation (0 mL [range 0–3,100] compared with 300 mL [range –150–3,150 mL; P=.029) in the vasopressin group. The median intraoperative blood loss was reduced (5 mL [range 1–50 mL] compared with 20 mL [range 1–150 mL; P=.002). The operative surgeon rated that 95% of the vasopressin group had “minimal” bleeding compared with 36.8% in the placebo group. The surgical field (visual analog scale [VAS] 9 [range 2–10] compared with 6 [range 2–10; P<.001]; 0=worst visual clarity, 10=best visual clarity) and the effluent fluid (VAS 1 [range 0–7] compared with 4 [range 0–8; P<.001]; 0=clear, 10=unclear) were statistically significantly clearer in the vasopressin group. CONCLUSION: Transcervical intralesional vasopressin injection in hysteroscopic myomectomy did not reduce operative time but did reduce volume of inflow fluid, fluid intravasation, intraoperative blood loss, and improving visual clarity. CLINICAL TRIAL REGISTRATION: Centre for Clinical Research and Biostatistics, http://www.cct. cuhk.edu. hk/Registry/publictriallist.aspx, CUHK_CCT00291. LEVEL OF EVIDENCE: I
Creditor Rights and Debt Allocation within Multinationals Basak Akbel

We analyze the optimal debt structure of multinational corporations choosing between centralized or decentralized borrowing. We identify how this choice is affected by creditor rights and bankruptcy costs, taking into account managerial incentives and coinsurance considerations. We find that partially centralized borrowing structures are optimal with either weak or strong creditor rights. For intermediate levels of creditor rights fully decentralized (centralized) borrowing structures are optimal if managers have strong (weak) empire building tendencies. Decentralized borrowing is more attractive for companies focussing on short-term profitability. Credits are rather taken in countries with better creditor rights and more efficient insolvency systems. JEL classification: G32, F23
The rami communicantes in the rhesus monkey.

the limits of the thoraco-lumbar outflow in the defined as T 1/T 2-L 3/L 4, rarely L 5, and in man as T1-L 2. The observations fitted into the general pattern of the sympathetic system, described first in the dog and cat by Gaskell In the rami communicantes, however, the small medullated fibres are distributed more widely. only do they take part in the constitution of the white rami of the thoraco-lumbar region, but they are also found in almost all the grey rami, in those of the lower cervical and lower lumbar nerves. their grey rami; histological distinction grey and white rami are in their a pure grey or a pure white ramus is rarely seen. There are widely possible differences in the interpretation of the microscopical appearances of sympathetic rami. the number of myelinated fibres found in the rami of L3 and L4 to conclude that the thoraco-lumbar outflow extended in man as far down as the fourth lumbar segment. Further, a white ramus connected with the eighth cervical nerve bas been as an occasional finding Wrete and yet, in all examples that have been examined, its ventral spinal root is virtually devoid of the small myelinated fibres of the size constituting the thoraco-lumbar outflow.
Outpatient Lumbar Spine Decompression in 233 Patients 65 Years of Age or Older

Study Design. A retrospective review including patient follow-up on all lumbar decompression procedures by 1 of 2 surgeons. Objective. To evaluate the success of lumbar decompressions performed on an outpatient basis on patients 65 years of age or older. Summary of Background Data. The efficacy of decompression procedures on the lumbar spine is documented and is often performed on an outpatient basis. Few studies have evaluated these procedures in older adults, and none in a greater population of patients on an outpatient basis. Methods. A total of 1377 lumbar decompression procedures were performed from 1992 to 2001 by 2 surgeons, 263 of these on patients 65 years of age or older. A chart review was done on all procedures. Follow-ups occurred from June 2001 to August 2003 by an unbiased observer not involved in the surgical procedures. Results. A total of 30 (11.4%) of the 263 procedures were done with a hospital stay: 10 patients of 243 planned inpatient procedures (4.1%) were converted due to a complication. Of the 233 done on an outpatient basis, 4 (1.7%) had a complication. A total of 152 patients (57.8%) completed a questionnaire by phone or mail by an unbiased observer at least 18 months after surgery. A total of 97 of 134 patients (72.4%) said they would repeat the outpatient procedure, and 94 of 136 patients (69.1%) stated that their surgery's outcome was good or better. Conclusions. For the aged patient, surgical decompression of the lumbar spine can be performed on an outpatient basis safely and successfully.
Up-regulated expression and activation of the orphan chemokine receptor, CCRL2, in rheumatoid arthritis.

OBJECTIVE Rheumatoid arthritis (RA) is a chronic inflammatory condition characterized by a cellular influx and destruction of the joint architecture. Chemokines characteristically regulate leukocyte recruitment and activation. Chemokine (CC motif) receptor-like 2 (CCRL2) is an orphan receptor with homology to other CC chemokine receptors. We undertook this study to examine CCRL2 expression in RA, cytokine regulation of expression, and the source of a putative ligand in an attempt to determine the role of this receptor during inflammation. METHODS Expression of CCRL2 on joint-infiltrating leukocytes was examined by immunocytochemistry. In vitro studies evaluated CCRL2 expression in primary neutrophils using Northern and Western blotting and reverse transcriptase-polymerase chain reaction. HEK 293 cells expressing two splice variants of CCRL2 (HEK/CCRL2A or HEK/CCRL2B) were generated with a retroviral expression system, and their migration in response to fractions of synovial fluid (SF) from RA patients was examined using a 48-well chamber. RESULTS CCRL2 expression was observed on all infiltrating neutrophils and on some macrophages obtained from the SF of 5 RA patients. In vitro studies of primary neutrophils revealed that CCRL2 messenger RNA (mRNA) was rapidly up-regulated following stimulation with lipopolysaccharide (1 microg/ml) or tumor necrosis factor (5 ng/ml). The mRNA for both CCRL2A and CCRL2B were expressed in cytokine-stimulated neutrophils. Cells expressing either of these splice variants migrated in response to a fraction of RA SF. CONCLUSION CCRL2 expression is up-regulated on synovial neutrophils of RA patients. Inflammatory products present in the SF activate this receptor, indicating that CCRL2 is a functional receptor that may be involved in the pathogenesis of RA.
Effects of Inorganic Arsenic, Methylated Arsenicals, and Arsenobetaine on Atherosclerosis in the apoE−/− Mouse Model and the Role of As3mt-Mediated Methylation

Background: Arsenic is metabolized through a series of oxidative methylation reactions by arsenic (3) methyltransferase (As3MT) to yield methylated intermediates. Although arsenic exposure is known to increase the risk of atherosclerosis, the contribution of arsenic methylation and As3MT remains undefined. Objectives: Our objective was to define whether methylated arsenic intermediates were proatherogenic and whether arsenic biotransformation by As3MT was required for arsenic-enhanced atherosclerosis. Methods: We utilized the apoE−/− mouse model to compare atherosclerotic plaque size and composition after inorganic arsenic, methylated arsenical, or arsenobetaine exposure in drinking water. We also generated apoE−/−/As3mt−/− double knockout mice to test whether As3MT-mediated biotransformation was required for the proatherogenic effects of inorganic arsenite. Furthermore, As3MT expression and function were assessed in in vitro cultures of plaque-resident cells. Finally, bone marrow transplantation studies were performed to define the contribution of As3MT-mediated methylation in different cell types to the development of atherosclerosis after inorganic arsenic exposure. Results: We found that methylated arsenicals, but not arsenobetaine, are proatherogenic and that As3MT is required for arsenic to induce reactive oxygen species and promote atherosclerosis. Importantly, As3MT was expressed and functional in multiple plaque-resident cell types, and transplant studies indicated that As3MT is required in extrahepatic tissues to promote atherosclerosis. Conclusion: Taken together, our findings indicate that As3MT acts to promote cardiovascular toxicity of arsenic and suggest that human AS3MT SNPs that correlate with enzyme function could predict those most at risk to develop atherosclerosis among the millions that are exposed to arsenic. https://doi.org/10.1289/EHP806
Differential specificity for binding of retinoblastoma binding protein 2 to RB, p107, and TATA-binding protein

The growth suppressor activities of the RB and p107 products are believed to be mediated by the reversible binding of a heterogeneous family of cellular proteins to a conserved T/E1A pocket domain that is present within both proteins. To study the functional role of these interactions, we examined the properties of cellular retinoblastoma binding protein 2 (RBP2) binding to RB, p107, and the related TATA-binding protein (TBP) product. We observed that although RBP2 bound exclusively to the T/E1A pocket of p107, it could interact with RB through independent T/E1A and non-T/E1A domains and with TBP only through the non-T/E1A domain. Consistent with this observation, we found that a mutation within the Leu-X-Cys-X-Glu motif of RBP2 resulted in loss of ability to precipitate p107, while RB- and TBP-binding activities were retained. We located the non-T/E1A binding site of RBP2 on a 15-kDa fragment that is independent from the Leu-X-Cys-X-Glu motif and encodes binding activity for RB and TBP but does not interact with p107. Despite the presence of a non-T/E1A binding site, however, recombinant RBP2 retained the ability to preferentially precipitate active hypophosphorylated RB from whole-cell lysates. In addition, we found that cotransfection of RBP2 can reverse in vivo RB-mediated suppression of E2F activity. These findings confirm the differential binding specificities of the related RB, p107, and TBP proteins and support the presence of multifunctional domains on the nuclear RBP2 product which may allow complex interactions with the cellular transcription machinery.
The functional significance of scolex retraction and subsequent cyst formation in the cysticercoid larva of Hymenolepis microstoma

The cysticercoid type of larval development, involving the retraction of the scolex and the associated development of a cyst, is of widespread occurrence within cyclophyllidean cestodes, but previously its possible adaptive value has been unexplained. Scolex retraction in Hymenolepis microstoma is an active, muscular process which takes only about a minute to complete. Following its retraction the scolex develops adult structures. The cyst enclosing the scolex also differentiates further, involving the secretion of three layers of collagen fibres and the development of a myelin-like layer adjacent to the retracted scolex. The cells within the cyst, including the muscle, become condensed or are autolysed causing a decrease in thickness of the cyst and an increase in the proportion of fibrous tissue. The collagenous part of the cyst provides mechanical protection for the scolex during grinding by the teeth on entry into the mouse host. The myelin-like layer insulates the scolex from the low pH conditions of the stomach. Values of lower than pH 3·0 are lethal to newly excysted worms. The myelin-like layer loses its insulatory capacity following exposure to bile salts.
More Time or Better Tools? A Large-Scale Retrospective Comparison of Pedagogical Approaches to Teach Programming

Learning to program is a complex task, and the impact of different pedagogical approaches to teach this skill has been hard to measure. This study examined the performance data of seven cohorts of students (N = 1168) learning programming under three different pedagogical approaches. These pedagogical approaches varied either in the length of the introductory programming block of courses (two or three semesters) or in the programming tool used in the first semester (C language or the programming support tool Raptor). In addition, gender and initial course selection differences were investigated. Raw pass rates under the three pedagogical approaches were compared; they were also compared, controlling for initial ability levels, using a logistic regression. Results showed that a more extensive duration of the introductory block produced a higher pass rate in students, but changing the programming tool used did not. Raw gender differences were not statistically significant; admission phase differences were initially statistically different, but not once initial ability and pedagogical approach received had been accounted for. Findings are discussed in relation to existing literature.
Risk perception and smoking behavior in medically ill smokers: a prospective study.

AIMS To examine the influence of risk perception on intentions to quit smoking and post-treatment abstinence. DESIGN Prospective and longitudinal. SETTING United States. PARTICIPANTS A total of 237 adult smokers (mean age 56 years) receiving medical care from home health-care nurses. Participants did not have to want to quit smoking to participate, but received cessation counseling within the context of their medical care. MEASUREMENTS Three measures of risk perception were given pre- and post-treatment: perceived vulnerability, optimistic bias and precaution effectiveness. Smoking status was verified biochemically at end of treatment and at 2, 6 and 12 months later. FINDINGS Principal components analysis supported the theoretical discriminability of the risk perception measures, and intercorrelations provided evidence for concurrent and predictive validity. Elevated risk perception was associated with a variety of socio-demographic and psychosocial characteristics. Optimistic bias was associated significantly with older age and ethnic minority status. Smokers in pre-contemplation had lower perceived vulnerability and precaution effectiveness and greater optimistic bias than those in contemplation and preparation. Smokers in preparation had higher perceived vulnerability and lower optimistic bias than those in earlier stages. Change in perceived vulnerability predicted smoking cessation at follow-up. Optimistic bias predicted a lower likelihood of cessation and precaution effectiveness predicted a greater likelihood of smoking cessation, but only among those with a smoking-related illness. CONCLUSIONS In patients receiving medical care from home health-care nurses, change in perceived vulnerability to smoking-related disease is predictive of smoking cessation. In those with smoking-related illnesses, optimistic bias predicts continued smoking while precaution effectiveness predicts cessation.
Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations

Immunization against pertussis, influenza, and rubella reduces morbidity and mortality in pregnant women and their offspring. Health care professionals (HCPs) caring for women perinatally are uniquely placed to reduce maternal vaccine preventable diseases (VPDs). Despite guidelines recommending immunization during the perinatal period, maternal vaccine uptake remains low. This qualitative study explored the role of obstetricians, general practitioners, and midwives in maternal vaccine uptake. Semi-structured interviews (n = 15) were conducted with perinatal HCPs at a tertiary maternity hospital in South Australia. HCPs were asked to reflect on their knowledge, beliefs, and practice relating to immunization advice and vaccine provision. Interviews were transcribed and coded using thematic analysis. Data collection and analysis was an iterative process, with collection ceasing with theoretical saturation. Participants unanimously supported maternal vaccination as an effective way of reducing risk of disease in this vulnerable population, however only rubella immunity detection and immunization is embedded in routine care. Among these professionals, delegation of responsibility for maternal immunization was unclear and knowledge about maternal immunization was variable. Influenza and pertussis vaccine prevention measures were not included in standard pregnancy record documentation, information provision to patients was “ad hoc” and vaccinations not offered on-site. The key finding was that the incorporation of maternal vaccinations into standard care through a structured process is an important facilitator for immunization uptake. Incorporating vaccine preventable disease management measures into routine obstetric care including incorporation into the Pregnancy Record would facilitate HCPs in implementing recommendations. Rubella prevention provides a useful “template” for other vaccines.
Manipulation of selective cell adhesion and growth by surface charges of electrically polarized hydroxyapatite.

Adherence of cells to a surface, such as a biomaterial surface, can be significantly influenced by the surface charge on that material. The applicability of electrically charged hydroxyapatite ceramics to selective cell adhesion was examined, and we show that polarized hydroxyapatite has significant effects on cell growth and adhesion. The surface charge applied to polarized hydroxyapatite promotes (i) enhanced colony formation of osteoblast-like cells, (ii) activation of gap junctions, and (iii) specific orienting of neuroblastoma cells. These findings will be of great utility and have significance in applications of tissue engineering, for example, in potential treatments for osteoporosis.
Gab1 Is an Integrator of Cell Death versus Cell Survival Signals in Oxidative Stress

ABSTRACT Upon the addition of different growth factors and cytokines, the Gab1 docking protein is tyrosine phosphorylated and in turn activates different signaling pathways. On the basis of the large body of evidence concerning cross talk between the signaling pathways activated by growth factors and oxidative stress, we decided to investigate the role of Gab1 in oxidative injury. We stimulated wild-type mouse embryo fibroblasts (MEF) or MEF with a homozygous deletion of the Gab1 gene (−/− MEF) with H2O2. Our results show that Gab1 is phosphorylated in a dose- and time-dependent manner after H2O2 triggering. Gab1 then recruits molecules such as SHP2, phosphatidylinositol 3-kinase (PI3K), and Shc. Gab1 phosphorylation is sensitive to the Src family kinase inhibitor PP2. Furthermore, we demonstrate that Gab1 is required for H2O2-induced c-Jun N-terminal kinase (JNK) activation but not for ERK2 or p38 activation. Reconstitution of Gab1 in −/− MEF rescues JNK activation, and we find that this is dependent on the SHP2 binding site in Gab1. Cell viability assays reveal that Gab1 has a dual role in cell survival: a positive one through its interaction with PI3K and a negative one through its interaction with SHP2. This is the first report identifying Gab1 as a component in oxidative stress signaling and one that is required for JNK activation.
Antibiotic Prophylaxis following Implant-Based Breast Reconstruction: What Is the Evidence?

Background: Although data from other surgical disciplines do not support the use of prolonged postoperative prophylactic antibiotics, implant-based breast reconstruction is one area of plastic surgery where this may be warranted. The purpose of this study was to review the literature on antibiotic prophylaxis in prosthetic breast reconstruction, summarize findings, and provide recommendations. Methods: A literature review was performed to identify studies that compared different perioperative prophylactic antibiotic regimens with respect to infectious outcomes in prosthetic breast reconstruction. Results: Five studies and five systematic reviews were identified. One prospective randomized trial showed that a single preoperative dose was better than placebo, and another showed no difference between 24 hours versus until drain removal. Three studies were retrospective, one showing no difference between a single preoperative dose and prolonged antibiotic use, and two showing significant reduction in infectious complications with prolonged antibiotic use. One systematic review suggested an increased rate of infection with prolonged antibiotic use, and the other showed no difference between less than 24 hours and greater than 24 hours, but showed a reduction in infections compared to no treatment. Conclusions: The literature contains conflicting data regarding the optimal duration for perioperative antibiotic prophylaxis following prosthetic breast reconstruction. The authors’ opinion is that 24 hours of antibiotic prophylaxis is warranted. Further studies are needed. Patient-centered antibiotic prophylaxis based on a risk-assessment model may be a more effective alternative to the current indiscriminate model of surgical-site infection control.
Short-term Prediction of the Incidence of Congenital Rubella Syndrome

Objectives In Japan, a rubella outbreak occurred from early 2012 to late 2013, primarily among adult males aged 20–49 years. We conducted this study to predict the number of congenital rubella syndrome (CRS) cases in Japan in 2014. Methods The probability of CRS when a pregnant woman is infected with rubella depends on the gestational age of the fetus. The cumulative number of CRS cases was predicted by a formula based on the parameters from two studies conducted in the U.K. and the U.S., the reported cases of rubella among women 15–49 years of age, and the reports of CRS from 2011 to week 2 of 2014. Findings While the predicted number of cases of CRS based on parameters from the U.K. study demonstrated a biphasic curve, with a low peak around week 12 and a high peak around week 50 of 2013, the predicted number of CRS cases based on the U.S. study demonstrated a single peak around week 50 of 2013. The ex post evaluation indicated that the cumulative number of CRS cases in 2014 would be 19.1–29.3. Interpretation Our prediction of the number of CRS cases may be useful for the enhanced detection of this often under-reported syndrome.