Miracle-dz/UniFAR-FTUs huggingface dataset:
The Role of Antibiotic Prophylaxis in Prevention of Wound Infection After Lichtenstein Open Mesh Repair of Primary Inguinal Hernia: A Multicenter Double-Blind Randomized Controlled Trial

Objective:To determine whether the use of prophylactic antibiotics is effective in the prevention of postoperative wound infection after Lichtenstein open mesh inguinal hernia repair. Summary Background Data:A recent Cochrane meta-analysis (2003) concluded that “antibiotic prophylaxis for elective inguinal hernia repair cannot be firmly recommended or discarded. ” Methods:Patients with a primary inguinal hernia scheduled for Lichtenstein repair were randomized to a preoperative single dose of 1.5 g intravenous cephalosporin or a placebo. Patients with recurrent hernias, immunosuppressive diseases, or allergies for the given antibiotic were excluded. Infection was defined using the Centers for Disease Control and Prevention criteria. Results:We included 1040 patients in the study between November 1998 and May 2003. According to the intention-to-treat principle, 1008 patients were analyzed. There were 8 infections (1.6%) in the antibiotic prophylaxis group and 9 (1.8%) in the placebo group (P = 0.82). There was 1 deep infection in the antibiotic prophylaxis group and 2 in the placebo group (P = 0.57). Statistical analysis showed an absolute risk reduction of 0.19% (95% confidence interval, −1.78%–1.40%) and a number needed to treat of 520 for the total number of infections. For deep infection, the absolute risk reduction is 0.20% (95% confidence interval, −0.87%–0.48%) with a number needed to treat of 508. Conclusions:A low percentage (1.7%) of wound infection after Lichtenstein open mesh inguinal (primary) hernia repair was found, and there was no difference between the antibiotic prophylaxis or placebo group. The results show that, in Lichtenstein inguinal primary hernia repair, antibiotic prophylaxis is not indicated in low-risk patients.
Prevalence, awareness, treatment and control of hypertension in Portugal: the PAP study

Background The objective of this study was to estimate the prevalence and distribution of hypertension and to determine the status of hypertension awareness, treatment and control in the Portuguese adult population. Methods This study was conducted in 2003, and a multistage cluster sampling method was used to select a national representative sample. A total of 5023 adults, age 18–90 years, were examined. Three blood pressure measurements were obtained by trained observers using an OMROM M4-I sphygmomanometer after a 5-min sitting rest. Information on the history of hypertension and the use of antihypertensive medications was obtained by use of a standard questionnaire. Results Hypertension was defined as a mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, or the use of antihypertensive medications. Overall, 42.1% of the Portuguese adult population aged 18–90 years, representing 3 311 830 people, had hypertension. The age-specific prevalence of hypertension in the three age groups studied — younger than 35 years, 35–64 years old and older than 64 years — was 26.2, 54.7 and 79% in men and 12.4, 41.1 and 78.7% in women, respectively. Among hypertensive patients, only 46.1% were aware of their high blood pressure, 39.0% were taking antihypertensive medication and 11.2% achieved blood pressure control (< 140/90 mmHg). Conclusions Our results indicate that hypertension is highly prevalent in Portugal. The percentages of those with hypertension that are aware, treated and controlled are unacceptably low. These results underscore the urgent need to develop national strategies to improve prevention, detection and treatment of hypertension in Portugal.
Advocacy coalitions, beliefs and climate change policy in the United States

The Advocacy Coalition Framework (ACF) asserts that disagreement over policy core beliefs divides organizations into competing coalitions. We apply Discourse Network Analysis to 1,410 statements in the Wall Street Journal, New York Times and USA Today to investigate what kinds of beliefs contribute to coalition formation in the climate change policy debate in the news media in the United States. We find that the beliefs concerning the reality of anthropogenic climate change, the importance of ecology over economy and desirability of governmental regulation divide organizations into three advocacy coalitions: the economy, ecology and science coalitions. Policy preferences such as cap and trade do not; they find support across coalition lines. Based on these findings, we suggest that ACF theory could be clarified to better account for how beliefs concerning policy instruments contribute to coalition formation. In some policy domains, policy instruments are where opposing coalitions find agreement. In others, they are more divisive.
Predicting Health Care Utilization Among Latinos

There are two competing research explanations to account for Latinos’ underutilization of health services relative to non-Latino Whites in the United States. One hypothesis examines the impact of health locus of control (HLOC) beliefs, while the other focuses on the role of access factors on health care use. To date, the relative strength of HLOC beliefs in explaining Latinos’ use of health care services in the context of access factors is inconclusive. This study, therefore, tests and compares both explanations. We analyzed data from the 2007 Pew Hispanic Healthcare Survey, a nationally representative survey of 4,013 Latino adults. HLOC beliefs had a statistically significant but weak impact on health care use after accounting for access factors. Having continuous health insurance coverage and a usual place of care to go when sick or in need of health advice were much more influential in predicting health care use than HLOC beliefs. This study suggests that disparities in health care service use among Latinos are much more an issue of access than it is an issue of HLOC beliefs. Implications for public health research and intervention efforts that aim to reduce health disparities in health care use are discussed.
Effects of Mutagenic and Chain-Terminating Nucleotide Analogs on Enzymes Isolated from Hepatitis C Virus Strains of Various Genotypes

ABSTRACT The development of effective therapies for hepatitis C virus (HCV) must take into account genetic variation among HCV strains. Response rates to interferon-based treatments, including the current preferred treatment of pegylated alpha interferon administered with ribavirin, are genotype specific. Of the numerous HCV inhibitors currently in development as antiviral drugs, nucleoside analogs that target the conserved NS5B active site seem to be quite effective against diverse HCV strains. To test this hypothesis, we examined the effects of a panel of nucleotide analogs, including ribavirin triphosphate (RTP) and several chain-terminating nucleoside triphosphates, on the activities of purified HCV NS5B polymerases derived from genotype 1a, 1b, and 2a strains. Unlike the genotype-specific effects on NS5B activity reported previously for nonnucleoside inhibitors (F. Pauwels, W. Mostmans, L. M. Quirynen, L. van der Helm, C. W. Boutton, A. S. Rueff, E. Cleiren, P. Raboisson, D. Surleraux, O. Nyanguile, and K. A. Simmen, J. Virol. 81:6909-6919, 2007), only minor differences in inhibition were observed among the various genotypes; thus, nucleoside analogs that are current drug candidates may be more promising for treatment of a broader variety of HCV strains. We also examined the effects of RTP on the HCV NS3 helicase/ATPase. As with the polymerase, only minor differences were observed among 1a-, 1b-, and 2a-derived enzymes. RTP did not inhibit the rate of NS3 helicase-catalyzed DNA unwinding but served instead as a substrate to fuel unwinding. NS3 added to RNA synthesis reactions relieved inhibition of the polymerase by RTP, presumably due to RTP hydrolysis. These results suggest that NS3 can limit the incorporation of ribavirin into viral RNA, thus reducing its inhibitory or mutagenic effects.
Histopathologic Features of the Acetabular Labrum in Femoroacetabular Impingement

This paper summarizes clinical and histopathologic findings derived from 25 patients who had surgery for symptomatic femoroacetabular impingement. We explored if observed pathologic features were consistent with hypothesized mechanisms of injury, if severity of osteoarthritis and labral degeneration were associated, and if labral refixation would present an alternative. Clinically, all patients presented with limited range of motion at the hip attributable to pain and a positive impingement test. Magnetic resonance arthrography and surgical observations showed degenerated or ruptured labra or both in the anterior and/or superior regions of the acetabular rim (24 of 25 specimens) which correlated with pain provocation, limited range of motion, and anatomic deformities. Histologically, labra were mostly hyperplastic with disorganized cystic matrices. No inflammation was observed. Spatial distribution of degenerated labral matrices was not different for the two femoroacetabular impingement mechanisms. Labral degeneration and severity of osteoarthritis observed on radiographs did not correlate. In patients having only joint debridement, the labral matrix at the tip, near its vascular supply, was normal. Femoroacetabular impingement is a gentle chronic irritation of the labra located at the site of rupture that elicits a degenerative reaction. In early stages of the disease, the labral tip is not involved, providing the possibility of labral refixation after resection of the degenerated portion.
Endovascular embolization is applicable for large and giant intracranial aneurysms: experience in one center with long-term angiographic follow-up

Background Endovascular treatment of large and giant intracranial aneurysms and long-term results of angiographic follow-up of these aneurysms treated endovascularly are not known currently. Purpose To investigate the outcome of endovascular treatment of large and giant aneurysms and the long-term angiographic follow-up results. Material and Methods A retrospective analysis of all patients with endovascular treatment of large and giant aneurysms between 1998 and 2009 was performed. There were 90 large or giant aneurysms treated with coiling alone, stent-assisted coiling, covered-stent deployment, or parent artery occlusion (PAO) in 88 patients (female/male, 54/34; age range, 23–92 years; mean age, 56 years). Results Immediately after the initial endovascular embolization procedure, complete occlusion was achieved in 56.7%, near complete occlusion in 37.8%, and incomplete occlusion in 5.5%. The total periprocedural complication rate excluding subarachnoid hemorrhage (SAH)-induced vasospasm was 10.2% with a mortality rate of 2.3%. Follow-up angiography was performed in all of the aneurysms with the longest follow-up duration of 131 months. Among 38 aneurysms initially treated with coiling alone and 17 initially treated with stent-assisted coiling, 22 (57.9%) and four (23.5%) recurred, respectively, during follow-up. No recurrence occurred in aneurysms initially treated with covered-stent deployment or PAO. Aneurysm recurrence was predominantly seen in older and female patients, in larger aneurysms, and in aneurysms treated with coiling alone. Twenty-three aneurysms were successfully retreated endovascularly. Conclusion Endovascular intervention with coiling alone or stent-assisted coiling for large and giant cerebral aneurysms is not very effective, while covered stents are more promising. Better endovascular devices are needed to obtain more secure closure.
A functional mammalian target of rapamycin complex 1 signaling is indispensable for c‐Myc‐driven hepatocarcinogenesis

Amplification and/or activation of the c‐Myc proto‐oncogene is one of the leading genetic events along hepatocarcinogenesis. The oncogenic potential of c‐Myc has been proven experimentally by the finding that its overexpression in the mouse liver triggers tumor formation. However, the molecular mechanism whereby c‐Myc exerts its oncogenic activity in the liver remains poorly understood. Here, we demonstrate that the mammalian target of rapamycin complex 1 (mTORC1) cascade is activated and necessary for c‐Myc‐dependent hepatocarcinogenesis. Specifically, we found that ablation of Raptor, the unique member of mTORC1, strongly inhibits c‐Myc liver tumor formation. Also, the p70 ribosomal S6 kinase/ribosomal protein S6 and eukaryotic translation initiation factor 4E‐binding protein 1/eukaryotic translation initiation factor 4E signaling cascades downstream of mTORC1 are required for c‐Myc‐driven tumorigenesis. Intriguingly, microarray expression analysis revealed up‐regulation of multiple amino acid transporters, including solute carrier family 1 member A5 (SLC1A5) and SLC7A6, leading to robust uptake of amino acids, including glutamine, into c‐Myc tumor cells. Subsequent functional studies showed that amino acids are critical for activation of mTORC1 as their inhibition suppressed mTORC1 in c‐Myc tumor cells. In human hepatocellular carcinoma specimens, levels of c‐Myc directly correlate with those of mTORC1 activation as well as of SLC1A5 and SLC7A6. Conclusion: Our current study indicates that an intact mTORC1 axis is required for c‐Myc‐driven hepatocarcinogenesis; thus, targeting the mTOR pathway or amino acid transporters may be an effective and novel therapeutic option for the treatment of hepatocellular carcinoma with activated c‐Myc signaling. (Hepatology 2017;66:167–181).
Does Gonadotropin-Releasing Hormone in the Cerebrospinal Fluid Modulate Luteinizing Hormone Release?

The function of gonadotropin-releasing hormone (GnRH) in the cerebrospinal fluid (CSF) is unknown. This study on ovariectomized ewes investigated whether CSF-GnRH has a role in modulating luteinizing hormone (LH) secretion either through an ultrashort-loop feedback system to affect GnRH secretion or to directly act on the pituitary gland after entering the hypothalamo-hypophysial portal system. In the first experiment, a 3-hour continuous infusion of exogenous GnRH (700 or 7 pg/min; n = 8) was administered into the third ventricle through a permanent indwelling cannula. Jugular LH concentrations were measured as an estimate of the activity of the GnRH ‘pulse generator’. To assess the potential for a direct involvement of CSF-GnRH in pituitary stimulation of LH secretion, ewes were also implanted with a cannula to collect hypophysial portal blood. In a first investigation, radioactive (2 × 106 cpm 125I-GnRH; n = 3) GnRH was injected into the third ventricle, and the amount of radioactivity present in the portal and jugular blood after the injection measured. In a second investigation, cold GnRH was infused (400 pg/min; n = 3) into the third ventricle for 2 h, and portal and jugular blood collected for the determination of GnRH and LH concentrations, respectively. In the first experiment, neither rate of infusion of GnRH into the third ventricle had any effect on the mean interpulse interval, nadir, pulse amplitude or circulating level of systemic LH, suggesting that CSF-GnRH is not a component of an ultrashort-loop feedback system for GnRH. Furthermore, in the second experiment, despite extremely low levels of radioactivity (maximum: 120 cpm/ml) being detected in hypophysial portal blood (which may not have been intact decapeptide), in the second part of this experiment, no radioimmunoassayable GnRH associated with the period of infusion could be measured. These data demonstate in ewes that little, if any, CSF-GnRH reaches the hypophysial portal blood, and this compartment of GnRH does not, thus, directly affect the pituitary gland. The present study strongly suggests, therefore, that CSF-GnRH does not modulate LH secretion. Whether this compartment of GnRH is involved in sexual behavior remains to be established.
Enhanced synaptic excitation–inhibition ratio in hippocampal interneurons of rats with temporal lobe epilepsy

A common feature of all epileptic syndromes is the repetitive occurrence of pathological patterns of synchronous neuronal activity, usually combined with increased neuronal discharge rates. Inhibitory interneurons of the hippocampal formation control both neuronal synchronization as well as the global level of activity and are therefore of crucial importance for epilepsy. Recent evidence suggests that changes in synaptic inhibition during temporal lobe epilepsy are rather specific, resulting from selective death or alteration of interneurons in specific hippocampal layers. Hence, epilepsy‐induced changes have to be analysed separately for different types of interneurons. Here, we focused on GABAergic neurons located at the border between stratum radiatum and stratum lacunosum‐moleculare of hippocampal area CA1 (SRL interneurons), which are included in feedforward inhibitory circuits. In chronically epileptic rats at 6–8 months after pilocarpine‐induced status epilepticus, frequencies of spontaneous and miniature inhibitory postsynaptic currents were reduced, yielding an almost three‐fold increase in excitation–inhibition ratio. Consistently, action potential frequency of SRL interneurons was about two‐fold enhanced. Morphological alterations of the interneurons indicate that these functional changes were accompanied by remodelling of the local network, probably resulting in a loss of functional inhibitory synapses without conceivable cell death. Our data indicate a strong increase in activity of interneurons in dendritic layers of the chronically epileptic CA1 region. This alteration may enhance feedforward inhibition and rhythmogenesis and – together with specific changes in other interneurons – contribute to seizure susceptibility and pathological synchronization.
Electronically-controllable floating inductor using OMA with enhanced input dynamic range

Recently a new formulation for realizing a floating inductance (FI) using an OMA (operational mirrored amplifier), which takes into account the dominant pole of the op-amp employed in the OMA, without requiring any external capacitor was proposed. The proposition, however, suffered from a limited input-dynamic-range of operation owing to limited open-loop signal handling capability of the op-amp used. In this paper we propose an improved FI formulation with increased input signal handling capability. The electronically controllable floating inductance feature of the resulting circuit has been shown by replacing all the building blocks of the FI formulation by their CMOS counterparts. The workability of the proposed FI has been demonstrated by PSPICE simulations.
Color measurements as quality criteria for clinical shade matching of porcelain crowns.

STATEMENT OF PROBLEM The ability of a dentist to select and communicate an acceptable shade match to a dental laboratory may be the most important factor in esthetic restorative dentistry. PURPOSE The purpose of this study was to evaluate the use of instrumental color measurement in clinical shade matching of porcelain-fused-to-metal (PFM) and all-porcelain crowns. The relative effects of clinical and laboratory factors related to shade matching for PFM and all-porcelain crowns were also evaluated. MATERIALS AND METHOD Forty patients treatment planned to receive PFM or all-porcelain crowns made up the study population. The patients were randomly divided into two groups for shade selection: conventional visual assessment and photocolorimetric analysis. At the preparation appointment, a photograph was taken of the target tooth along with four shade guide tabs selected by the two visual observers. The crown was fabricated by either visual selection or by the lowest E* values determined from the photographs and a spectrophotometer. The same dental laboratory fabricated all 40 restorations. At the cementation appointment, clinical criteria were used to evaluate anatomy/contour, surface texture, and the amount of glaze as it relates to color perception before the restoration was cemented. RESULTS The mean E* between the reference tooth before preparation and the crown before cementation in the visual assessment group was 10.49 (+/- 14.6), whereas the mean E* in the photocolorimetric group was 8.99 (+/- 5.7). Analysis of data showed that the observers and the colorimetric technique were perfect (E* = 0) 41% of the time and varied (E* = 0.1 or higher) 59% of the time. Data collected further showed no significant difference or correlation between shade selection methods and the evaluated clinical criteria. CONCLUSIONS These results provide evidence that there is no significant difference in shade selection using the conventional visual assessment by two experienced clinicians or the photocolorimetric technique. CLINICAL SIGNIFICANCE The use of photocolorimetric analysis in shade selection can serve as a reliable alternative to conventional visual shade selection. This method is useful for clinicians who have difficulty with shade selection.
Fibronectin Induces Endothelial Cell Migration through β1 Integrin and Src-dependent Phosphorylation of Fibroblast Growth Factor Receptor-1 at Tyrosines 653/654 and 766*

Background: Both matrix and growth factors regulate endothelial cell chemotaxis. Results: The matrix protein fibronectin can activate fibroblast growth factor receptor-1 (FGFR1) through β1 integrin and Src, which requires tyrosines 653/654 and 766 on FGFR1, thereby leading to cell migration. Conclusion: Fibronectin induces cell migration through FGFR1 transactivation. Significance: This work highlights mechanisms by which the extracellular matrix regulates cell behavior through transactivation of receptor tyrosine kinases. The extracellular matrix microenvironment regulates cell phenotype and function. One mechanism by which this is achieved is the transactivation of receptor tyrosine kinases by specific matrix molecules. Here, we demonstrate that the provisional matrix protein, fibronectin (FN), activates fibroblast growth factor (FGF) receptor-1 (FGFR1) independent of FGF ligand in liver endothelial cells. FN activation of FGFR1 requires β1 integrin, as evidenced by neutralizing antibody and siRNA-based studies. Complementary genetic and pharmacologic approaches identify that the non-receptor tyrosine kinase Src is required for FN transactivation of FGFR1. Whereas FGF ligand-induced phosphorylation of FGFR1 preferentially activates ERK, FN-induced phosphorylation of FGFR1 preferentially activates AKT, indicating differential downstream signaling of FGFR1 in response to alternate stimuli. Mutation analysis of known tyrosine residues of FGFR1 reveals that tyrosine 653/654 and 766 residues are required for FN-FGFR1 activation of AKT and chemotaxis. Thus, our study mechanistically dissects a new signaling pathway by which FN achieves endothelial cell chemotaxis, demonstrates how differential phosphorylation profiles of FGFR1 can achieve alternate downstream signals, and, more broadly, highlights the diversity of mechanisms by which the extracellular matrix microenvironment regulates cell behavior through transactivation of receptor tyrosine kinases.
Value of Freight Travel-Time Savings

The monetary value of travel time savings in freight transport can be used to include travel-time benefits in cost-benefit analysis and to compute generalized travel costs in traffic forecasting models. Several methods have been used to attach a monetary value to freight travel-time savings, including revealed and stated preference methods. In this chapter, an overview of these methods and of the main numerical outcomes is given, as well as an example of a recent application.