Miracle-dz/UniFAR-FTUs huggingface dataset:
FREQUENCY OF HOSPITAL ACQUIRED HYPONATREMIA IN A PEDIATRIC TERTIARY CARE SETTING.

BACKGROUND Hyponatremia is the most commonly encountered electrolyte disorder in children. In our country the epidemiology of hospital acquired hyponatremia has hardly ever been explored whereas the administration of hypotonic IV fluids is widely practiced here. Therefore we pioneered to conduct this study to determine the frequency of hospital acquired hyponatremia. METHODS This was a cross sectional study carried out at Aga Khan University Hospital, Karachi in paediatric ward and ICU over a period of 12 months. All children (>1 month and <15 years of age) admitted in paediatric units and on maintenance IV fluids who had serum sodium level measured on admission were included in the study and followed to identify patients who had a drop in serum sodium during hospitalization. Informed consent was taken from parents and collected data was recorded on a pro forma. RESULTS A total of 865 patients were enrolled in the study. Hyponatremia was recorded in 405 patients on admission (46.8%) while hospital acquired hyponatremia was documented in 240. children (27.7%). Out of these 142 (59.2%) were male and 98 (40.8%) were female. Mean age of children in hospital acquired hyponatremia group was 60.67 months. Severity of hospital acquired hyponatremia was recorded as mild in 191 (79.6%), moderate in 35 (14.6%) and severe in 14 (5.8%) children. Major disease categories included gastrointestinal disorder (30.4 %), respiratory illness (12.5%), oncological disease (16.3%), cardiovascular disease (11.7%), infectious disease (9.2%) and neurological illness (8.3%). CONCLUSION Hospital acquired hyponatremia is frequently encountered in our hospitalized children with majority of them receiving hypotonic IV solutions.
Salivary and serum myeloperoxidase in obstructive sleep apnea.

OBJECTIVE To assess the clinical utility of serum and saliva myeloperoxidase (MPO) and serum C-reactive protein (CRP) levels as markers of inflammation in obstructive sleep apnea (OSA). DESIGN Prospective, controlled, observational study. SETTING Snoring and respiratory sleep disorders centre at a tertiary hospital. METHODS This study included 32 OSA-diagnosed patients and 24 age- and gender-matched healthy subjects following endoscopic airway evaluation and polysomnography. MAIN OUTCOME MEASURES Saliva and serum MPO levels were analyzed by flow cytometry. Serum CRP levels were determined using a latex assay. The different groups were compared through parametric tests. Linear and logistic regression models using The Apnea-Hypopnea Index (AHI) as a dependent variable assessed the association of independent variables, including saliva and serum MPO levels, serum CRP levels, age, and body mass index (BMI). RESULTS Salivary MPO and serum CRP levels were significantly higher in the OSA group compared to controls (p < .0001, p = .0001). A moderate positive correlation was detected between saliva MPO and AHI, the oxygen desaturation index, and sleep efficiency (p = .0001, p = .0001, and p = .0002, respectively) by excluding potential confounding factors (age and BMI). Salivary MPO and BMI levels were associated with AHI in a linear regression model (p < .0001) and found to be concordant variables with the presence of OSA. CONCLUSION Increased salivary MPO levels in OSA subjects in this study support previously defined persistent local inflammation in these patients. Therefore, salivary MPO levels may be useful as oropharyngeal inflammatory markers in OSA patients.
Interleukin‐33 (IL‐33): A nuclear cytokine from the IL‐1 family

Interleukin‐33 (IL‐33) is a tissue‐derived nuclear cytokine from the IL‐1 family abundantly expressed in endothelial cells, epithelial cells and fibroblast‐like cells, both during homeostasis and inflammation. It functions as an alarm signal (alarmin) released upon cell injury or tissue damage to alert immune cells expressing the ST2 receptor (IL‐1RL1). The major targets of IL‐33 in vivo are tissue‐resident immune cells such as mast cells, group 2 innate lymphoid cells (ILC2s) and regulatory T cells (Tregs). Other cellular targets include T helper 2 (Th2) cells, eosinophils, basophils, dendritic cells, Th1 cells, CD8+ T cells, NK cells, iNKT cells, B cells, neutrophils and macrophages. IL‐33 is thus emerging as a crucial immune modulator with pleiotropic activities in type‐2, type‐1 and regulatory immune responses, and important roles in allergic, fibrotic, infectious, and chronic inflammatory diseases. The critical function of IL‐33/ST2 signaling in allergic inflammation is illustrated by the fact that IL33 and IL1RL1 are among the most highly replicated susceptibility loci for asthma. In this review, we highlight 15 years of discoveries on IL‐33 protein, including its molecular characteristics, nuclear localization, bioactive forms, cellular sources, mechanisms of release and regulation by proteases. Importantly, we emphasize data that have been validated using IL‐33‐deficient cells.
Functional effects of systemically administered agonists and antagonists of mu, delta, and kappa opioid receptor subtypes on body temperature in mice.

We have investigated the roles of peripheral and central mu, delta, and kappa opioid receptors and their subtypes in opioid-induced hypothermia in mice. Measuring rectal temperature after i.p. injection, opioid agonists [morphine, fentanyl, SNC80 ((+)-4-[(alphaR)-alpha-((2S,5R)-4-allyl-2,5-dimethyl-1-piperazinyl)3-methoybenzyl]-N,N-diethylbenzamide), U50,488H ((trans-(dl)-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)cyclohexyl]-benzeneacetamide), and loperamide)] were tested alone or with opioid antagonists [naloxone, beta-funaltrexamine, naloxonazine, naltrindole, 7-benzylidenenaltrexone (BNTX), naltriben, nor-binaltorphimine, 2-(3,4-dichlorophenyl)-N-methyl-N-[(1S)-1-(3-isothiocyanatophenyl)-2-(1-pyrrolidinyl)ethyl]acetamide (DIPPA), and methyl-naltrexone] given 15 min after the agonist. All agonists produced dose-related hypothermia, although at low doses, morphine and U50,488H produced hyperthermia. The effects of morphine and fentanyl were antagonized by naloxone and by the mu(1) antagonist naloxonazine. The delta(2) antagonist naltriben potentiated the hypothermic effect of mu agonists. SNC80-induced hypothermia was blocked by the delta antagonist naltrindole but not by the delta(1) antagonist BNTX. Depending on the dose, the delta(2) antagonist naltriben produced either a potentiation or an attenuation of the effect of SNC80. U50,488H-induced hypothermia was antagonized by the kappa antagonist nor-binaltorphimine but not by acute treatment with the irreversible kappa antagonist DIPPA. The peripherally acting opioid loperamide produced hypothermia that could be blocked by several mu-, delta-, or kappa-selective antagonists as well as the peripherally acting antagonist methyl-naltrexone. Methyl-naltrexone produced a weak potentiation of morphine-, fentanyl-, and U50,488H-induced hypothermia, whereas a significant attenuation of SNC80-induced hypothermia was observed. In conclusion, at high doses, morphine- and fentanyl-induced hypothermia may involve composite action on mu, kappa, and possibly delta opioid receptors after initial activation. In the mediation of delta opioid-induced hypothermia, no clear selectivity between the delta(1) and delta(2) subtypes was defined. The studies provide new evidence that maintenance of the initial effects of agonist/receptor activation vary with the agonist and the receptor. The existence of both central and peripheral components of opioid-induced hypothermia is also emphasized.
Investigation of the relationship between neutrophil-to-lymphocyte ratio and obstructive sleep apnoea syndrome.

Dear Editors, I came across a very interesting article published in your esteemed journal titled ‘Investigation of the relationship between neutrophil-to-lymphocyte ratio and obstructive sleep apnoea syndrome’ by Yenigun et al. The article is well written and I appreciate the effort put in by the authors. However, I am concerned about the authors’ conclusion and would like to express the same through your prestigious journal. The increase in inflammatory markers and its effect on cardiovascular morbidity in obstructive sleep apnoea has been known for quite some time. Neutrophil-to-lymphocyte ratio presents an exciting option for monitoring obstructive sleep apnoea patients because it is very simple to determine, and is not uncomfortable and cumbersome like polysomnography. However, a word of caution is advised, for multiple reasons. Firstly, neutrophil-to-lymphocyte ratio varies with patient age and body mass index, and will therefore vary from person to person. There are no standard cut-off values for neutrophil-to-lymphocyte ratio to determine whether it is abnormal or not. Without such standardisation, it is difficult to determine the significance of neutrophil-to-lymphocyte ratio in these patients. Secondly, although abnormal neutrophil-to-lymphocyte ratio in obstructive sleep apnoea has been proven in previous studies, there are many other common conditions, such as Bell’s palsy and even chronic tonsillitis, where the values of neutrophil-to-lymphocyte ratio can be deranged. As the neutrophil-to-lymphocyte ratio can be influenced by so many common conditions, its specificity for use as a diagnostic tool comes into doubt. Thirdly, although the authors have concluded that neutrophil-to-lymphocyte ratio correlates with the severity of obstructive sleep apnoea, it is not clear whether this relationship is linear or not. Only if the relationship is linear can it be used as a diagnostic tool for determining the severity of obstructive sleep apnoea. Another point which could have been evaluated is whether the neutrophil-to-lymphocyte ratio also depends on the duration of obstructive sleep apnoea and other co-morbid factors such as hypothyroidism. This can be done in future prospective trials. I would like to conclude by stating that we still have a long way to go before we can truly analyse the significance of neutrophil-to-lymphocyte ratio in obstructive sleep apnoea.
Operating Characteristics of the P&O Algorithm at High Perturbation Frequencies for Standalone PV Systems

The perturb and observe (P&O) algorithm is one of the most commonly utilized maximum power point tracking (MPPT) control schemes for photovoltaic (PV) generators. However, the operation of this algorithm at high perturbation frequencies, when the system response to MPPT perturbations is never allowed to settle, has not been given adequate attention in the literature. This paper characterizes system behavior in this mode of operation for standalone PV systems feeding resistive loads and motor-pump loads. Simulation and experimental results show that the P&O algorithm operating at a high perturbation frequency may offer higher energy utilization efficiency and better system performance, despite the resulting nonperiodic waveforms of the system.
Water may inhibit oxygen binding in hemoprotein models

Three distal imidazole pickets in a cytochrome c oxidase (CcO) model form a pocket hosting a cluster of water molecules. The cluster makes the ferrous heme low spin, and consequently the O2 binding slow. The nature of the rigid proximal imidazole tail favors a high spin/low spin cross-over. The O2 binding rate is enhanced either by removing the water, increasing the hydrophobicity of the gas binding pocket, or inserting a metal ion that coordinates to the 3 distal imidazole pickets.
Mycobacterium avium complex (MAC) Immune Reconstitution Syndrome (IRIS) With Reduced Susceptibility to Ethambutol in an HIV-Infected Patient

Objective: To describe a case of Mycobacterium avium complex (MAC) lymphadenitis complicated by immune reconstitution syndrome (IRIS) and reduced susceptibility to ethambutol. Case Summary: A 24-year-old man was diagnosed in October 2012 with advanced HIV infection upon hospitalization for multiple opportunistic infections (OIs). Within 5 months of starting antiretroviral therapy, the patient developed significant cervical lymphadenopathy concerning for MAC/IRIS. Acid-fast bacilli were detected in the primary lymph node biopsy smear, and culture results confirmed the presence of MAC. Susceptibility testing revealed an organism susceptible to azithromycin, with an elevated minimum inhibitory concentration (MIC) to ethambutol (8 µg/mL). Currently, there is no interpretation for an ethambutol MIC of 8 µg/mL for MAC. A review of the primary literature revealed the possibility of decreased ethambutol susceptibility when the MIC is above 1 µg/mL, and therefore, therapy was replaced by rifabutin in combination with azithromycin. Discussion: Current guidelines recommend a 2-drug regimen for the treatment of MAC, specifically a macrolide plus ethambutol. Guidelines also emphasize MAC susceptibility testing for macrolides only. Susceptibility results from this patient’s biopsy prompted an evaluation of the effectiveness of his antimycobacterial regimen. Conclusions: Reduced ethambutol susceptibility in this patient triggered a search of the primary literature that resulted in the decision to replace ethambutol with rifabutin. Additional clinical trials are needed to define susceptibility breakpoints for ethambutol and other antimycobacterial agents used for MAC infection treatment and to direct clinical decisions when elevated MICs to primary agents are identified.
Platelet size and kinetics in hereditary and acquired thrombocytopenia.

Abstract Measurements of platelet size and life-0 span were obtained to classify a variety of thrombocytopenic states. The mean size index in idiopathic thrombocytopenic purpura was significantly increased, whereas platelets in the Wiskott–Aldrich syndrome were small. The platelet defect in a family characterized by thrombocytopenia, sex-linked recessive inheritance, small platelet size and shortened platelet life-span closely resembled that of the Wiskott–Aldrich syndrome, but only mild eczema was present and immunologic abnormalities were absent. In a second family, thrombocytopenia was associated with increased platelet size suggesting a young cell population similar to idiopathic thrombocytopenic purpura. However, autologous platelet life-span was normal. Size measurements are thus useful in the classification of thrombocytopenias. Although in acquired conditions increased platelet size suggests a young platelet population, in hereditary disease platelet size is determined more by the nature of the in.
Supersites within superfolds. Binding site similarity in the absence of homology.

A method is presented to assess the significance of binding site similarities within superimposed protein three-dimensional (3D) structures and applied to all similar structures in the Protein Data Bank. For similarities between 3D structures lacking significant sequence similarity, the important distinction was made between remote homology (an ancient common ancestor) and analogy (likely convergence to a folding motif) according to the structural classification of proteins (SCOP) database. Supersites were defined as structural locations on groups of analogous proteins (i.e. superfolds) showing a statistically significant tendency to bind substrates despite little evidence of a common ancestor for the proteins considered. We identify three potentially new superfolds containing supersites: ferredoxin-like folds, four-helical bundles and double-stranded beta helices. In addition, the method quantifies binding site similarities within homologous proteins and previously identified supersites such as that found in the beta/alpha (TIM) barrels. For the nine superfolds, the accuracy of predictions of binding site locations is assessed. Implications for protein evolution, and the prediction of protein function either through fold recognition or tertiary structure comparison, are discussed.
Neurophysiological signs of rapidly emerging visual expertise for symbol strings

The current study examined whether the repeated visual presentation of novel, meaningless symbol strings triggers rapid changes in event related potentials (ERP). Adult participants performed three versions of a word and symbol string repetition detection task in the same experimental session. Analyses focussed on the occipito-temporal N1 (∼150 ms) known to reflect early word-specific processing and stimulus categorisation. While the N1 to words did not change, the occipito-temporal negativity to symbol strings increased over runs and converged with the word N1. Later (∼220 ms) more positive occipito-temporal amplitudes to repeated words in the third compared to the first run implied a repetition priming effect. This suggests that symbol string processing changed over time due to visual learning and increased perceptual expertise.
Filing, piling, and everything in between: The dynamics of E‐mail inbox management

Managing the constant flow of incoming messages is a daily challenge faced by knowledge workers who use technologies such as e‐mail and other digital communication tools. This study focuses on the most ubiquitous of these technologies, e‐mail, and unobtrusively explores the ongoing inbox‐management activities of thousands of users worldwide over a period of 8 months. The study describes the dynamics of these inboxes throughout the day and the week as users strive to handle incoming messages, read them, classify them, respond to them in a timely manner, and archive them for future reference, all while carrying out the daily tasks of knowledge workers. It then tests several hypotheses about the influence of specific inbox‐management behaviors in mitigating the causes of e‐mail overload, and proposes a continuous index that quantifies one of these inbox‐management behaviors. This inbox clearing index (ICI) expands on the widely cited trichotomous classification of users into frequent filers, spring cleaners, and no filers, as suggested by Whittaker and Sidner (1996). We propose that the ICI allows shifting the focus, from classifying users to characterizing a diversity of user behaviors and measuring the relationships between these behaviors and desired outcomes.
Evaluation of a new real-time PCR assay for detection of Mycoplasma pneumoniae in clinical specimens.

OBJECTIVE To establish and evaluate a real-time PCR assay to detect Mycoplasma pneumoniae (M.pneumoniae) in clinical specimens. METHODS By analysing the whole p1 gene sequence of 60 M.pneumoniae clinical isolates in Beijing of China, an optimized real-time PCR assay (MpP1) using p1 gene conserved region was designed. The specificity and sensitivity of this assay were evaluated and compared with other two reported assays (RepMp1 and Mp181) using 40 positive and 100 negative clinical specimens. RESULTS The detection limit of the new assay was 8.1 fg (about 1∼3CFU) M.pneumoniae DNA. The sensitivity of MpP1, RepMp1, and Mp181 assays appeared to be 100%, 100%, and 85%, respectively. CONCLUSION MpP1 assay is suitable for the detection of M.pneumoniae in Chinese clinical specimens.
Volumetric magnetic resonance imaging study of the brain in subjects with sex chromosome aneuploidies

OBJECTIVES Cognitive impairment has been reported in people with sex chromosome aneuploides (SCAs) and it has been proposed that the presence of an extra sex chromosome may have an adverse effect on neurodevelopment. This study examines the hypothesis with structural MRI of the brain. METHODS Thirty two subjects with SCA (XXX (n=12), XYY (n=10), and XXY (n=10)) from a birth cohort study were matched groupwise for age, parental social class, and height with normal controls (13 female, 26 male). Brain MRI , measurements of IQ, and a structured psychiatric interview were performed. RESULTS The XXX females and XXY males had significantly smaller whole brain volumes than controls of the same phenotypic sex (p=0.003 and p⩽0.05 respectively). The XXY group also had bilaterally enlarged lateral ventricles (p⩽0.05). No significant differences were found between the XYY group and controls. IQ scores in all SCA groups were lower than in the control groups. CONCLUSIONS The main result of reduced brain volumes in XXX and XXY subjects, but not in XYY subjects, indicates that the presence of a supernumerary X chromosome has a demonstrable effect on brain development.
Outcome of career expectancies and early professional burnout among newly qualified dentists.

OBJECTIVES To measure burnout development, outcome of expectations with regard to dental career and feelings of being unprepared for practice among newly graduated general dental practitioners. METHODS In 1997, 50 dentists were approached to fill in the Maslach Burnout Inventory, Dutch version (UBOS) and some additional variables between six months and one year after graduation at the Academic Centre for Dentistry Amsterdam (ACTA) (76% response). Six years later, in 2003, the same 50 dentists, plus another 60 who had graduated in the same period at ACTA, were approached (78% response). RESULTS Using Repeated Measures analysis, mean scores of dentists for whom two measurements were available on the three UBOS subscales (N=24) showed no statistically significant changes over six years on Emotional Exhaustion, Depersonalisation, or Personal Accomplishment. The same was true for group means of all in 1997 (N=33) compared with all in 2003 (N=82). However, according to manual criteria, varying percentages (7.2% - 24.4%) of dentists showed an unfavourable level on either one of the UBOS dimensions. Factors most frequently mentioned to be responsible for being unprepared for practice were: law and insurance matters (61.2%), practice organisation (56.6%) and staff management (55.2%). Most frequently reported factors that came out (much) worse than expected were: stressfulness of work (45.1%), and staff management (43.4%). CONCLUSIONS Burnout appears no threat for the average newly qualified dentist. However, some individuals report alarmingly high burnout scores at an early professional stage. Practice management is the professional aspect about which young professionals worry most. It is recommended that dental schools pay attention to practice management skills and the stressfulness of work in the curriculum. Also, longitudinal monitoring of dental students and newly qualified dentists on burnout development is strongly advocated.
BRCA1 does not paint the inactive X to localize XIST RNA but may contribute to broad changes in cancer that impact XIST and Xi heterochromatin

The BRCA1 tumor suppressor involved in breast and ovarian cancer is linked to several fundamental cell regulatory processes. Recently, it was reported that BRCA1 supports localization of XIST RNA to the inactive X chromosome (Xi) in women. The apparent cytological overlap between BRCA1 and XIST RNA across the Xi raised the possibility a direct role of BRCA1 in localizing XIST. We report here that BRCA1 does not paint the Xi or XIST territory, as do markers of Xi facultative heterochromatin. A smaller BRCA1 accumulation abuts Xi, although this is not exclusive to Xi. In BRCA1 depleted normal and tumor cells, or BRCA1 reconstituted cells, BRCA1 status does not closely correlate with XIST localization, however in a BRCA1 inducible system over‐expression correlated strongly with enhanced XIST expression. We confirm frequent loss of an Xi in tumor cells. In addition to mitotic loss of Xi, we find XIST RNA expression or localization frequently become compromised in cultured breast cancer cells, suggesting Xi heterochromatin may not be fully maintained. We demonstrate that complex epigenetic differences between tumor cell subpopulations can have striking effects on XIST transcription, accumulation, and localization, but this does not strictly correlate with BRCA1. Although BRCA1 can have indirect effects that impact XIST, our results do not indicate a direct and specific role in XIST RNA regulation. Rather, regulatory factors such as BRCA1 that have broad effects on chromatin or gene regulation can impact XIST RNA and the Xi. We provide preliminary evidence that this may occur as part of a wider failure of heterochromatin maintenance in some cancers. J. Cell. Biochem. 100: 835–850, 2007. © 2006 Wiley‐Liss, Inc.