Miracle-dz/UniFAR-FTUs huggingface dataset:
Percutaneous Peritoneal Dialysis Catheter Insertion by a Nephrologist: A New, Simple, and Safe Technique

♦ Background: Insertion of the peritoneal dialysis (PD) catheter by a nephrologist has been encouraged by several studies. The ultimate goal is to provide safe, timely, and effective catheter insertion without an unduly long wait time or delay. The success of PD depends partly on the ease of catheter insertion. We developed a new technique for percutaneous PD catheter insertion by nephrologists. Our new technique, in addition to being easy, proved to be safe and to eliminate the need for the peel-away sheath. ♦ Methods: Data were collected prospectively on all patients having a PD catheter inserted by a nephrologist using our new technique (40 catheters in 38 patients). All catheters were evaluated for infectious and mechanical complications. ♦ Results: The mean duration of the procedure from skin sterilization to the end of insertion was 24 ± 3 minutes. No bowel perforation or serious hemorrhage was recorded. Poor initial drainage was recorded in 12.5% of the catheters (n = 5) during the 4 weeks after insertion. The incidence of early exit-site leakage was 2.5% (1 catheter). Episodes of exit-site infection occurred in 5.0% and 12.5% of catheters (within 1 month and by the end of study period respectively). Two episodes of peritonitis were reported by the end of the 12-month period. Catheter survival was 95.0% and 87.5% at 6 months and 12 months respectively. ♦ Conclusions: Percutaneous bedside placement of PD catheters using our new technique is safe and carries less morbidity in terms of bowel perforation, catheter-related infection, and exit-site leak. In addition, our new technique appears to have a high success rate and to offer considerable savings in terms of operating time.
ETHENE AND OTHER BIOMARKERS OF OXIDATIVE STRESS IN HYPERTENSIVE DISORDERS OF PREGNANCY

Objective: An increase in reactive oxygen species (ROS) and lipid peroxides and a comprised antioxidant status has been implicated in the pathophysiology of severe preeclampsia. This study investigates whether oxidative stress and impaired antioxidant systems also contribute to milder forms of hypertensive disorders in pregnancy. Furthermore, ethene in exhaled air, a noninvasive measure for oxidative stress, was evaluated and compared with two other more established biomarkers. Methods: Ethene in exhaled air, plasma protein carbonyls, and the ratio of free glutathione/oxidized glutathione (GSHfree/GSHox) as markers for oxidative stress as well as the antioxidants vitamins C and E, uric acid, glutathione, and the oxygen radical absorbance capacity (ORAC) in plasma were measured in 30 healthy nonpregnant, 14 normal pregnant, 9 women with pregnancy-induced hypertension (PIH), and 14 preeclamptic women. Pregnant participants were measured during pregnancy and after delivery. Results: Women suffering from PIH and preeclampsia showed higher levels of the antioxidants vitamin E and uric acid, and lower levels of vitamin C compared with normal pregnant and nonpregnant women. All markers for oxidative stress were comparable between groups. Ethene levels showed a positive correlation with protein carbonyls but no correlation could be demonstrated with the free glutathione/oxidised glutathione ratio. Conclusions: PIH and preeclampsia are associated with minor alterations in antioxidant levels without signs of oxidative stress. Detection of ethene in exhaled air seems a promising noninvasive method to study lipid peroxidation but further research in more severe preeclampsia is needed.
Unbalanced Power in Four-Wire Systems and Its Reactive Compensation

Unbalanced power of three-phase stationary linear loads with a neutral conductor, supplied with sinusoidal symmetrical voltages and its reactive compensation, is the subject of this paper. A novel power equation of such loads is developed. The suggested power equation is based on the decomposition of the load current into Current Physical Components (CPC). This paper shows that all powers can be expressed in terms of the load parameters and this creates fundamentals for design of balancing reactive compensators capable of improving the power factor to unity. A reactive balancing compensator is composed, in general, of two compensators in the Δ and Y configuration. This paper presents a method of calculation of LC parameters of such a compensator using the CPC-based power theory.
Regulation of plant immune receptor accumulation through translational repression by a glycine-tyrosine-phenylalanine (GYF) domain protein

Plant immunity is tightly regulated to ensure proper defense against surrounding microbial pathogens without triggering autoimmunity, which negatively impacts plant growth and development. Immune receptor levels are intricately controlled by RNA processing and post-translational modification events, such as ubiquitination. It remains unknown whether, and if yes, how, plant immune receptor homeostasis is regulated at the translational level. From a mutant, snc1-enhancing (muse) forward genetic screen, we identified MUSE11/EXA1, which negatively regulates nucleotide-binding leucine-rich repeat (NLR) receptor mediated defence. EXA1 contains an evolutionarily conserved glycine-tyrosine-phenylalanine (GYF) domain that binds proline-rich sequences. Genetic and biochemical analysis revealed that loss of EXA1 leads to heightened NLR accumulation and enhanced resistance against virulent pathogens. EXA1 also associates with eIF4E initiation factors and the ribosome complex, likely contributing to the proper translation of target proteins. In summary, our study reveals a previously unknown mechanism of regulating NLR homeostasis through translational repression by a GYF protein. DOI: http://dx.doi. org/10.7554/eLife.23684. 001
Dentate gyrus and hilus transection blocks seizure propagation and granule cell dispersion in a mouse model for mesial temporal lobe epilepsy

Epilepsy‐associated changes of the anatomical organization of the dentate gyrus and hilus may play a critical role in the initiation and propagation of seizures in mesial temporal lobe epilepsy (MTLE). This study evaluated the role of longitudinal projections in the propagation of hippocampal paroxysmal discharges (HPD) in dorsal hippocampus by performing a selective transection in a mouse model for MTLE obtained by a single unilateral intrahippocampal injection of kainic acid (KA). Full transections of the dentate gyrus and hilus were performed in the transverse axis at 22 days after KA injection when spontaneous HPD were fully developed. They: (i) significantly reduced the occurrence of HPD; (ii) increased their duration at the KA injection site; (iii) abolished their spread along the longitudinal axis of the hippocampal formation and; (iv) limited granule cell dispersion (GCD) of the dentate gyrus posterior to the transection. These data suggest that: (i) longitudinal projections through the dentate gyrus and hilus are involved in HPD spread; (ii) distant hippocampal circuits participate in the generation and cessation of HPD and; (iii) GCD requires continuous HPD to develop, even when seizures are established. Our data reveal a critical role for longitudinal projections in the generation and spread of hippocampal seizures. © 2010 Wiley‐Liss, Inc.
Participation of the human p53 3′UTR in translational repression and activation following γ‐irradiation

p53 protein levels have been shown to increase in a number of cells after treatment with genotoxic agents through a post‐transcriptional mechanism. In γ‐irradiated human cells, the accumulation of p53 protein is accompanied by an increase in the association of p53 mRNA with large polysomes without any change in the level of p53 mRNA. This redistribution of p53 mRNA on polysomes in response to irradiation is consistent with enhanced translational activity of p53 mRNA. We demonstrate that a region of the p53 3′‐untranslated region (3′UTR) inhibits translation of a chimeric reporter mRNA in vivo. Induced elevation of reporter activity after γ‐irradiation was seen in cells expressing chimeric reporter–p53 3′UTR transcripts. These data taken together demonstrate translational control of p53 gene expression after γ‐irradiation and denote a previously unsuspected and novel role for the p53 3′UTR in controlling translation.
Ectopic Pregnancy in Korle Bu Teaching Hospital, Ghana: A Three-Year Review

A retrospective study of ectopic pregnancies seen in Korle Bu Teaching Hospital from January 1991 to December 1993 was conducted. The incidence was 39.5/1000 deliveries; patients with ectopic were not of lower parity than those with normal pregnancies. The incidence of historical predisposing factors was 11.08%, although findings at operation indicated a much higher incidence of previous pelvic inflammatory disease (PID). Dizziness/fainting and abdominal distension were more frequent than has been reported elsewhere. This was due to a very high incidence of ruptured ectopic pregnancies (98.1%) with mean volume of haemoperitoneum of 1.37 1. 16.3% of patients were misdiagnosed initially. The second commonest site of tubal pregnancy, after the ampullary region, was cornual. The case fatality rate was 27.9/1000, with more than half of the deaths occurring before or soon after arrival in hospital. In order to reduce the incidence of ruptured ectopic pregnancies we suggest, among other measures, that appropriate diagnostic facilities be provided.
Doctors' and nurses' perceptions of ethical problems in end-of-life decisions.

AIMS To identify and compare doctors' and nurses' perceptions of ethical problems. Rationale. Ethical problems are a source of tension for health professionals. Misunderstandings or conflicts may result from differing perceptions of ethical problems. If true collaboration is to be achieved, it is important to understand the perspectives of others, particularly when difficult end-of-life decisions must be made. METHODS In this qualitative study a total of seven doctors and 14 nurses working in acute care adult medical-surgical areas, including intensive care, were asked to describe ethical problems that they frequently encounter in practice. Interviews were taped and transcribed. Thematic analysis followed. RESULTS All participants experienced ethical problems around decision making at the end of life. The core problem for both doctors and nurses was witnessing suffering, which engendered a moral obligation to reduce that suffering. Uncertainty about the best course of action for the patient and family was a source of moral distress. Competing values, hierarchical processes, scarce resources, and communication emerged as common themes. The key difference between the groups was that doctors are responsible for making decisions and nurses must live with these decisions. Each group, therefore, asked different questions when encountering and interpreting sources of moral distress. CONCLUSIONS It was concluded that observed differences between doctors and nurses were a function of the professional role played by each rather than differences in ethical reasoning or moral motivation. Although this was a small qualitative study on one institution, and may not be generalizable, results suggest that doctors and nurses need to engage in moral discourse to understand and support the ethical burden carried by the other. Administrators should provide opportunities for discourse to help staff reduce moral distress and generate creative strategies for dealing with this.
Nucleotide-Binding Oligomerization Domain 2 Contributes to Limiting Growth of Mycobacterium abscessus in the Lung of Mice by Regulating Cytokines and Nitric Oxide Production

Mycobacterium abscessus is a prominent cause of pulmonary infection in immunosuppressed patients and those with cystic fibrosis. Nucleotide-binding oligomerization domain (NOD) 2 is a cytosolic receptor which senses a bacterial peptidoglycan component, muramyl dipeptide (MDP). Although nucleotide-binding oligomerization domain 2 (NOD2) contributes to protect host against various microbial infections, it is still unclear whether NOD2 is essential to regulate host immune responses against M. abscessus infection. In this study, we sought to clarify the role of NOD2 and the underlying mechanism in host defense against M. abscessus infection. Mice were infected intranasally with M. abscessus and sacrificed at indicated time points. Bacterial survival, cytokines production, and pathology in the lungs were determined. Bone marrow-derived macrophages were used to clarify cellular mechanism of NOD2-mediated immune response. Bacterial clearance was impaired, and pathology was more severe in the lungs of NOD2-deficient mice compared with the wild-type mice. In macrophages, NOD2-mediated activation of p38 and JNK were required for production of proinflammatory cytokines and nitric oxide (NO) and expression of iNOS in response to M. abscessus. NO was critical for limiting intracellular growth of the pathogen. Intranasal administration of MDP reduced in vivo bacterial replication and thus improved lung pathology in M. abscessus-infected mice. This study offers important new insights into the potential roles of the NOD2 in initiating and potentiating innate immune response against M. abscessus pulmonary infection.
Control of In Vitro Immune Responses by Regulatory Oligodeoxynucleotides through Inhibition of pIII Promoter Directed Expression of MHC Class II Transactivator in Human Primary Monocytes

Ag presentation is a key step in the initiation of adaptive immune responses that depends on the expression of MHC Ags and costimulatory molecules. Immune-enhancing CpG and non-CPG oligodeoxynucleotides (ODNs) stimulate Ag presentation by stimulating the expression of these molecules and by promoting dendritic cell maturation. In this report, we identify immunoregulatory orthophosphorothioate non-CpG molecules, referred to as regulatory ODNs (rODNs), by their ability to inhibit allogeneic monocyte-stimulated T cell responses and down-regulate HLA-DR in human primary monocytes. The rODNs promoted the survival of macrophages and were able to activate IL-8 secretion through a chloroquine-resistant pathway. Messenger RNAs for HLA-DR α and β and the MHC CIITA were reduced by rODNs but not by stimulatory CpG ODN2006 and non-CpG ODN2006a. CIITA transcription in monocytes was controlled primarily by promoter III and not by promoter I or IV. rODNs blocked promoter III-directed transcription of CIITA in these cells. Under conditions that induced dendritic cell differentiation, rODNs also reduced HLA-DR expression. The activity of rODNs is phosphorothioate chemistry and G stretch dependent but TLR9 independent. G tetrads were detected by circular dichroism in active rODNs and associated with high m.w. multimers on nondenaturing gels. Heat treatment of rODNs disrupted G tetrads, the high m.w. aggregates, and the HLA-DR inhibitory activity of the ODNs. The inhibition of immune responses by regulatory oligodeoxynucleotides may be useful for the treatment of immune-mediated disorders including autoimmune diseases and graft rejection.
Continuous infusion of N‐acetylcysteine reduces liver warm ischaemia–reperfusion injury

N‐acetylcysteine (NAC) may modulate the initial phase (less than 2 h) of liver warm ischaemia–reperfusion (IR) injury but its effect on the late phase remains unclear. The present study investigated the role of NAC during the early and late phases in a rabbit lobar IR model.
Functional topography of serotonergic systems supports the Deakin/Graeff hypothesis of anxiety and affective disorders

Over 20 years ago, Deakin and Graeff hypothesized about the role of different serotonergic pathways in controlling the behavioral and physiologic responses to aversive stimuli, and how compromise of these pathways could lead to specific symptoms of anxiety and affective disorders. A growing body of evidence suggests these serotonergic pathways arise from topographically organized subpopulations of serotonergic neurons located in the dorsal and median raphe nuclei. We argue that serotonergic neurons in the dorsal/caudal parts of the dorsal raphe nucleus project to forebrain limbic regions involved in stress/conflict anxiety-related processes, which may be relevant for anxiety and affective disorders. Serotonergic neurons in the “lateral wings” of the dorsal raphe nucleus provide inhibitory control over structures controlling fight-or-flight responses. Dysfunction of this pathway could be relevant for panic disorder. Finally, serotonergic neurons in the median raphe nucleus, and the developmentally and functionally-related interfascicular part of the dorsal raphe nucleus, give rise to forebrain limbic projections that are involved in tolerance and coping with aversive stimuli, which could be important for affective disorders like depression. Elucidating the mechanisms through which stress activates these topographically and functionally distinct serotonergic pathways, and how dysfunction of these pathways leads to symptoms of neuropsychiatric disorders, may lead to the development of novel approaches to both the prevention and treatment of anxiety and affective disorders.
Expression of the human glycine receptor alpha 1 subunit in Xenopus oocytes: apparent affinities of agonists increase at high receptor density.

The inhibitory glycine receptor (GlyR) is a ligand‐gated chloride channel, which mediates post‐synaptic inhibition in spinal cord and other brain regions. Heterologous expression of the ligand binding alpha subunits of the GlyR generates functional agonist‐gated chloride channels that mimic most of the pharmacological properties of the receptor in vivo. Here, nuclear injection into Xenopus oocytes of a human alpha 1 subunit cDNA, engineered for efficient expression, was used to create GlyR channels over a wide density range, resulting in whole‐cell glycine currents of 10 nA to 25 microA. Notably, the pharmacology of these channels changed at high expression levels, with the appearance of a novel receptor subpopulation of 5‐ to 6‐fold higher apparent agonist affinity at current values > 4 microA. The low‐affinity receptors were readily blocked by nM concentrations of the competitive antagonist strychnine, whereas the high‐affinity receptors were more resistant to antagonism by this alkaloid. Picrotoxinin, a chloride channel blocker, inhibited both GlyR populations with equal potency. Our data suggest that receptor interactions, occurring at high receptor density, modify the agonist response of the GlyR. This phenomenon may contribute to neurotransmitter efficacy at fast synapses.
Factors influencing cognitive functioning following mild traumatic brain injury in OIF/OEF burn patients.

OBJECTIVE To examine the relationship between mild traumatic brain injury (mTBI), psychiatric conditions, pain medications, and injury severity on cognitive functioning in service members admitted to a burn unit. We hypothesize that psychiatric co-morbidity and pain medications will have a stronger relationship with cognitive dysfunction than mTBI diagnosis in this population. METHOD Retrospective review of clinical evaluations (n=194) completed between September 2005 - October 2007 on service members with burn injuries secondary to explosive munitions. Evaluations were completed during the acute stage of recovery (mean=7.87 weeks). mTBI diagnosis (n=50) was made through a clinical interview using ACRM criteria. Exclusion criteria included duration of posttraumatic amnesia > 24 hours (n=10); and inability to complete neurocognitive measures due to severe bimanual burns and/or amputations (n=17). Cognitive functioning was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). RESULTS Subjects who sustained mTBI demonstrated significantly greater difficulty on the RBANS visuospatial and attention/processing speed indices. A hierarchical linear regression, using mTBI diagnosis, psychiatric diagnosis, time since injury, presence of pain medications, and measures of trauma severity as predictive factors, found that mTBI diagnosis had a significant, but small unique effect on cognitive functioning. Contrary to our hypothesis, psychiatric co-morbidity was not shown to have a significant effect on this population of acutely injured service members. CONCLUSIONS While the relationship between severe TBI and cognitive functioning is well established, the relationship between mTBI and its effects on cognitive and behavioral abilities is less clear. The current study demonstrates that mTBI and analgesic medications have a small effect neurocognitive functioning in this population. Continued examination of this relationship is warranted.
Frequency of intron 1 and 22 inversions of factor VIII gene in Mexican patients with severe hemophilia A

Hemophilia A (HA) is one of the most common inherited bleeding disorders caused by FVIII gene mutations. Inversion of intron 22 (inv22) originates 50% of cases of severe HA and is a major risk factor for inhibitor development. Inversion of intron 1 (inv1) has been reported to occur in 2–3% of severe HA patients. We studied both inversions to determine their frequencies in Mexican patients with severe HA and to compare these data with other HA populations. The inv22 was evaluated as a risk factor for FVIII inhibitor development in severe HA patients. We studied 44 patients from 31 severe HA families for the detection of inv22 and 94 patients from 65 families to detect inv1. We used the subcycling long‐distance PCR to detect inv22 and rapid PCR in duplex reactions to detect inv1. We found a frequency of 45% for the inv22 and no inv1‐positive patients (0%). These frequencies were not statistically different from other populations, although haplotype analyses of FVIII gene and telomeric regions should be incorporated to explore population‐specific variation of inv1 frequencies. Inv22‐positive patients showed 1.88X higher risk for developing inhibitors with respect to patients carrying other severe mutations; however, this OR value was not significant. Our findings confirm inv22 as a hot‐spot for severe HA and evidence the low frequency of inv1 in a Mexican population. The non‐significant risk for developing inhibitors among inv22‐positive patients agrees with the variety of genetic and non‐genetic factors involved in such a complication. Am. J. Hematol. , 2007. © 2007 Wiley‐Liss, Inc.
Etoposide, doxorubicin, and cisplatin chemotherapy for advanced gastric adenocarcinoma: results of a phase II trial.

PURPOSE A phase II study of etoposide, doxorubicin, and cisplatin (EAP) therapy in patients with advanced gastric carcinoma was performed in an attempt to confirm encouraging results reported by German investigators using an identical EAP regimen. PATIENTS AND METHODS Thirty-six consecutive, previously untreated patients with surgically unresectable, measurable gastric carcinoma were treated every 28 days with etoposide (120 mg/m2, days 4, 5, and 6), doxorubicin (20 mg/m2, days 1 and 7), and cisplatin (40 mg/m2, days 2 and 8). A total of 108 courses of treatment was given. RESULTS Therapy was associated with myelosuppression (median granulocyte nadir, 239/microL; median platelet nadir, 81,000/microL), which reached its maximum 14 days after the start of therapy and necessitated hospitalization after 24 of 108 (22%) treatment courses. Four of 36 (11%) patients died of treatment-related toxicity: three from sepsis and one from hemorrhage. Objective responses were observed in 12 of 36 (33%) patients; three (8%) patients experienced a clinical complete response. The median time to progression was 4 months for all 36 patients and 8 months for the 12 responding patients. Of the 13 patients with localized but unresectable disease, five subsequently underwent surgical resection; only one of these five was rendered disease-free. CONCLUSION The EAP regimen is highly toxic and results in response rates and survival times no better than those of more easily tolerated treatment programs.