Miracle-dz/UniFAR-FTUs huggingface dataset:
Avoiding the Pitfalls of EEG Interpretation in Childhood Epilepsy

Summary: The accurate interpretation of the electroencephalogram (EEG) of infants and children being evaluated for suspected epilepsy is based on the appreciation of normal and expected age‐dependent characteristics, an awareness of the significance of both epileptiform and non‐epileptiform activity, and the correlation of epileptiform abnormalities with clinical findings. Avoiding the pitfalls of pediatric EEG interpretation include the recognition of such normal EEG features in wakefulness as posterior slow waves of youth, mu rhythm, and lambda waves. In addition, the understanding of age‐dependent characteristics of EEG state‐changes is essential, such as: monorhythmic and paroxysmal hypnagogic hypersyn‐chrony, special features of vertex transients and sleep spindles, positive occipital sharp transients, initial arousal responses and post‐arousal hypersynchrony. The EEG response to activation procedures such as hyper‐ventilation and photic stimulation may also be a source of confusion. Patterns of uncertain diagnostic significance also may be present in children, including 14‐and 6‐Hz bursts and rhythmic temporal theta bursts of drowsiness (the so‐called psychomotor variant). Some nonepilepti‐form EEG abnormalities may also be misinterpreted as epileptiform. The determination of the clinical significance of spike foci and generalized abortive spike‐and‐wave may pose more of a problem as a potential pitfall than the identification by visual analysis of these interic‐tal discharges. Another problem posed to the electroen‐cephalographer is the determination of the EEG response to antiepileptic drug therapy including effect on spike foci, generalized spike‐and‐wave and electrical seizure activity, and effect on background activity. The recognition of the differences between the EEG of children and adults will provide the basis for more accurate interpretation and assist the electroencephalographer in avoiding the identification of normal, age‐dependent features as epileptiform.
Working Conditions and Exposure to Dust and Bioaerosols in Sisal Processing Factories in Tanzania

Information was collected on working conditions and personal exposures to dust, bacteria, and fungi in sisal fiber processing factories in Tanzania to identify health hazards and possible needs for preventive measures. Walkthrough surveys were performed in the brushing and decorticating departments of six sisal factories. The number of departments showing adequate scores for ergonomics and work organization, physical working environment, and occupational health items were determined. Personal thoracic dust samples were collected during sisal processing and analyzed for concentration of dust (n = 24) and for fungi and bacteria (n = 32). In both departments, most items considered to be a prerequisite for a good working environment were either missing or inadequate. Ergonomic and physical hazards were observed. Repetitive strenuous tasks, awkward work postures, and high noise levels were found. Visible dust and inadequate ventilation were seen in the brushing departments, and wet floors were observed in the decortication departments. Personal protective equipment was hardly used. The arithmetic mean exposure of sisal processors was 1.2 mg thoracic dust/m3, 43 × 106 bacteria/ m3, and 2.35 × 106 fungal spores/m3. The highest exposure levels were measured in the decortication departments when machines were cleaned of waste. Significant differences were found for mean thoracic dust exposure and bacteria counts between the brushing and decortication departments and the security guards. Within individual departments, there were no significant differences in exposures between the different work tasks. A linear mixed effect model of thoracic dust including department as fixed effect explained 65% of the between-worker variability for thoracic dust exposure. The study shows that workers in sisal processing in Tanzania are exposed to bioaerosols, and suitable control measures should be implemented. More exposure studies are needed in this type of industry.
Information Seeking Related to Clinical Trial Enrollment

To understand what motivates people to attend to information about clinical trial enrollment, this study applies the risk information seeking and processing model (RISP) to explore potential differences in multichannel information seeking between (a) the general population and (b) cancer patients and their caregivers. The unique context of clinical trial enrollment grants this research an opportunity to study the RISP model in relation to a risk issue with varying relevance to the two samples as well as to investigate the role of emotion on information seeking. Key results suggested that risk perception and negative emotions had opposite effects on information seeking across the two samples; however, optimistic feelings had the most consistent, positive effects on seeking from all three types of information sources: interpersonal, traditional media, and online. These findings suggest important theoretical and practical implications in relation to promoting information seeking related to clinical trial enrollment among the general population as well as among specific patient groups.
Surgical prognosis in hindbrain related syringomyelia

Objectives – The recommended operative treatment against hindbrain related syringomyelia is suboccipital decompression. The aim of the study was to define prognostic factors for surgical outcome in this disease. Material and methods – Between 1990 and 1997, 31 patients with hindbrain related syringomyelia were treated. All patients underwent craniovertebral decompression by suboccipital craniectomy and laminectomy of C1 or C1 and C2, respectively. Additionally, in nearly half of the cases, the tonsils were treated by bipolar coagulation. Mean post‐operative observation period was 35 months including clinical and radiological (MRI) examination. Results – Neither there was correlation between clinical outcome and age nor correlation between clinical outcome and duration of preoperative symptoms. There was good correlation between clinical outcome and result of post‐operative MRI: 63% of patients with a sufficient post‐operative MRI demonstrated a significant clinical improvement, whereby only 17% of patients with insufficient MRI did so (P < 0.05). None of the patients with coagulation of the tonsils showed clinical improvement. In contrast, 77% of patients without tonsillar manipulation demonstrated clinical improvement (P < 0.01). Additionally, 88% of the patients with dorsal‐tenting duraplasty experienced neurological improvement (P < 0.01), too. Conclusions – The results give evidence for the prognostic importance of creating an adequate artificial cisterna magna. Dorsal‐tenting of the duraplasty is an advantageous means against scarring and adhesions, whereby intradural applications such as extensive bipolar coagulation of the cerebellar tonsils should be avoided.
Overcoming drug resistance in multi-drug resistant cancers and microorganisms

Resistance development against multiple drugs is a common feature among many pathogens—including bacteria such as Pseudomonas aeruginosa, viruses, and parasites—and also among cancers. The reasons are two-fold. Most commonly-used rationally-designed small molecule drugs or monoclonal antibodies, as well as antibiotics, strongly inhibit a key single step in the growth and proliferation of the pathogen or cancer cells. The disease agents quickly change or switch off this single target, or activate the efflux mechanisms to pump out the drug, thereby becoming resistant to the drug. A second problem is the way drugs are designed. The pharmaceutical industry chooses to use, by high-throughput screening, compounds that are maximally inhibitory to the key single step in the growth of the pathogen or cancer, thereby promoting selective pressure. An ideal drug would be one that inhibits multiple steps in the disease progression pathways with less stringency in these steps. Low levels of inhibition at multiple steps provide cumulative strong inhibitory effect, but little incentives or ability on the part of the pathogen/cancer to develop resistance. Such intelligent drug design involving multiple less stringent inhibitory steps is beyond the scope of the drug industry and requires evolutionary wisdom commonly possessed by bacteria. This review surveys assessments of the current clinical situation with regard to drug resistance in P. aeruginosa, and examines tools currently employed to limit this trend. We then provide a conceptual framework in which we explore the similarities between multi-drug resistance in pathogens and in cancers. We summarize promising work on anti-cancer drugs derived from the evolutionary wisdom of bacteria such as P. aeruginosa, and how such strategies can be the basis for how to look for candidate protein/peptide antibiotic drugs from bioengineered bugs. Such multi-domain proteins, unlike diffusible antibiotics, are not diffusible because of their large size and are often released only on contact with the perceived competitor. Thus, multi-domain proteins are missed during traditional methods of looking for growth zone inhibition of susceptible bacteria as demonstrated by antibiotics, but may represent the weapons of the future in the fights against both drug-resistant cancers and pathogens such as P. aeruginosa.
Biologic Therapy for the Treatment of Giant Cell Arteritis

Abstract Giant cell arteritis (GCA), a vasculitis of the medium and large arteries, is traditionally managed with glucocorticoids. However, the side effects of chronic glucocorticoid use and the occurrence of refractory cases warrant the consideration of steroid-sparing agents, including biologic agents. Interleukin-6 (IL-6) inhibition shows the most promise as biologic therapy for refractory cases of GCA, but data to support the use of other existing biologic agents are currently lacking. A better understanding of the pathogenesis of GCA as well as clinical trials investigating both existing and emerging biologic agents is needed to expand therapeutic options for the treatment of GCA.
Neuronal differentiation of the early embryonic auditory hindbrain of the chicken in primary culture

Neurons in the auditory hindbrain pathway of the chicken are physiologically and morphologically highly specialized. It remains unclear to what extent independent differentiation vs. activity‐dependent mechanisms determines the development of this system. To address this question we established a primary culture system of the early auditory hindbrain neurons. Primary cultures of neurons from nucleus magnocellularis and nucleus laminaris were prepared from embryonic day 6.5 chicken. These cells developed in culture under serum‐free conditions for up to 15 days. Immunocytochemical staining and whole‐cell patch recordings were used to characterize the development of the neurons. A stable expression of the calcium‐binding protein calretinin, which serves as a characteristic marker of the auditory pathway, was found at all stages. A voltage‐gated potassium channel (Kv3.1b) with a specific function in the auditory system was also expressed after about 1 week in culture. Electrophysiological recordings showed a general maturation of the neuronal phenotype as reflected by an increase in the mean resting membrane potential, a decrease in the mean input resistance as well as a maturation of action potential parameters. Four groups of neurons that generate action potentials could be distinguished. One of these showed the phasic firing pattern of auditory brainstem neurons known from slice preparations. In older cultures we demonstrated functional synaptogenesis in vitro by recording postsynaptic activity elicited by extracellular stimulation and styryl dye loading of vesicles. Thus, isolated neurons from the auditory region of the avian brainstem differentiate to specific neuronal subtypes and autonomously develop synaptic connections in vitro.
Anodal Transcranial Direct Current Stimulation Transiently Improves Contrast Sensitivity and Normalizes Visual Cortex Activation in Individuals With Amblyopia

Background. Amblyopia is a neurodevelopmental disorder of vision that is associated with abnormal patterns of neural inhibition within the visual cortex. This disorder is often considered to be untreatable in adulthood because of insufficient visual cortex plasticity. There is increasing evidence that interventions that target inhibitory interactions within the visual cortex, including certain types of noninvasive brain stimulation, can improve visual function in adults with amblyopia. Objective. We tested the hypothesis that anodal transcranial direct current stimulation (a-tDCS) would improve visual function in adults with amblyopia by enhancing the neural response to inputs from the amblyopic eye. Methods. Thirteen adults with amblyopia participated and contrast sensitivity in the amblyopic and fellow fixing eye was assessed before, during and after a-tDCS or cathodal tDCS (c-tDCS). Five participants also completed a functional magnetic resonance imaging (fMRI) study designed to investigate the effect of a-tDCS on the blood oxygen level–dependent response within the visual cortex to inputs from the amblyopic versus the fellow fixing eye. Results. A subgroup of 8/13 participants showed a transient improvement in amblyopic eye contrast sensitivity for at least 30 minutes after a-tDCS. fMRI measurements indicated that the characteristic cortical response asymmetry in amblyopes, which favors the fellow eye, was reduced by a-tDCS. Conclusions. These preliminary results suggest that a-tDCS deserves further investigation as a potential tool to enhance amblyopia treatment outcomes in adults.
Functional integration of hepatocytes derived from human mesenchymal stem cells into mouse livers

Aims: At present, clinical success of hepatocyte transplantation as an alternative to whole liver transplantation is hampered by the limited availability of suitable donor organs for the isolation of transplantable hepatocytes. Hence, novel cell sources are required to deliver hepatocytes of adequate quality for clinical use. Mesenchymal stem cells (MSCs) from human bone marrow may have the potential to differentiate into hepatocytes in vitro and in vivo. Methods: Isolated MSCs were selected by density gradient centrifugation and plastic adherence, differentiated in the presence of human hepatocyte growth medium and transplanted in immunodeficient Pfp/Rag2 mice. Results: Here, we demonstrate that human MSCs gain in vitro the characteristic morphology and function of hepatocytes in response to specified growth factors. Specifically, preconditioned MSCs store glycogen, synthesise urea and feature the active hepatocyte-specific gene promoter of phosphoenolpyruvate carboxykinase (PCK1). After transplantation into livers of immunodeficient mice, preconditioned MSCs engraft predominantly in the periportal portion of the liver lobule. In situ, the cells continue to store glycogen and express PCK1, connexin32, albumin and the human hepatocyte-specific antigen HepPar1, indicating that the transplanted cells retain prominent qualities of hepatocytes after their regional integration. Conclusion: MSCs derived from human bone marrow may serve as a novel source for the propagation of hepatocyte-like cells suitable for cell therapy in liver diseases.
Systematic review and meta-analysis of endoscopic ablative treatment of Barrett's esophagus.

BACKGROUND Barrett's esophagus (BE) is the main risk factor for esophageal adenocarcinoma. Its therapeutic approach is controversial and surgical treatment in the presence of high-grade intraepithelial neoplasia may be indicated. Endoscopic approach is an alternative with lower mortality and morbidity rates and favorable results. OBJECTIVE To define the best option, according to literature, to treat Barrett's Esophagus. MATERIALS AND METHODS DESIGN Systematic review of PUBMED, EMBASE, LILACS, and Cochrane Library databases was conducted and articles of randomized, controlled studies on BE endoscopic ablative treatment were selected. The systematic review through PUBMED retrieved results with higher evidence level and available recommendation grade regarding BE ablative therapy. Nine articles on randomized, controlled studies classified as A or B according to the Oxford table were selected. Cryotherapy, laser, photodynamic therapy (PDT), multipolar electrocoagulation (MPEC), and ablation through argon plasma coagulation (APC) and radiofrequency were considered ablation therapies. PATIENTS 649 patients from 10 different studies were analysed. RESULTS PDT was found to present an increase in treatment failure compared with APC, NNH = -7. BE ablation through MPEC or APC was found to have similar risk for treatment failure in meta-analysis. PDT associated with proton pump inhibitor (PPI) is beneficial for BE ablation regarding PPI use alone, NNT = 2.Radiofrequency with PPI is an efficient method to reduce risk of treatment failure, NNT = 1. CONCLUSIONS There are no studies demonstrating the benefit of indicating cryotherapy or laser therapy for BE endoscopic approach. APC ablation was found to have superior efficacy compared with PDT and ablation through APC and MPEC was found to present effective, similar results. Radiofrequency is the most recent approach requiring comparative studies for indication.
The Effects of Recombinant Human Erythropoietin and Tamoxifen on Growth and Angiogenesis of Mammary Tumor in Sprague-Dawley Rat

Problem statement: Erythropoietin receptor (EPOR) has been detected in breast cancer cells and speculated to be involved in cancer growth, viability and angiogenesis. This has risen suspicious that EPO administration may enhance the severity of cancer. Approach: This study was undertaken to determine the effects of rHuEPO, Tamoxifen and their combination on the growth and angiogenesis of mammary tumor. Female Sprague-Dawley rats were induced to develop mammary tumor through xenograft technique by inoculating 6x105 LCM 2388 cells. Results: Recombinant human erythropoietin, Tamoxifen and Tamoxifen-rHuEPO combination were administered weekly for four weeks and size of tumors was measured weekly. Blood was also collected weekly and serum separated and subjected to ELISA for Matrix Metalloproteinases 2 (MMP-2) and Vascular Endothelial Growth Factor (VEGF), quantification. The animals were sacrificed at the end of experiment and tumor masses excised for histopathological analysis. Results showed no significance difference in the growth of mammary tumor of rats that received rHuEPO compared to the control rats. Interestingly, the combination of rHuEPO and Tamoxifen produced approximately 90% tumor regression from the initial size compared to Tamoxifen alone which showed 70% tumor regression. Quantification of serum angiogenic factors, MMP2 and VEGF of rHuEPO treatment group showed lower concentrations than the control group. Conclusion/Recommendations: Among all groups, Tamoxifen-treated group showed the lowest concentration of the angiogenic factors. The mitotic index of the tumor from all groups were observed to be at low frequency (G1). In conclusion, rHuEPO did not produce any significant promoting effect either on tumor growth, angiogenesis or tumor cell proliferation.
Shortcut detection of the vanB gene cluster in enterococci by a duplex real‐time PCR assay

Aim: To develop a robust, simple and rapid method for detection of vanB in enterococci. Methods: A real‐time duplex PCR assay for the simultaneous detection of Enterococcus faecium and vanB resistance genotype in enterococci was developed in conjunction with a simple method for DNA extraction. The assay was tested on 130 fresh plate cultures of clinical isolates of enterococci and other Gram‐positive bacteria. Results: Forty‐eight isolates of vanB E. faecium from 32 different patients and three isolates of vanB E. faecalis were detected within 1 hour. All isolates of E. faecium were identified correctly. Conclusion: This simple method for the detection of resistance mediated by vanB is a potentially useful method that is suitable for use in the diagnostic microbiology laboratory.
Memory by subarachnoid regional anesthesia.

To the Editor:—In their statistically elegant study of lower limb phantom posture during induction of spinal anesthesia, Dr. Isaacson et al. have rejected the concept that phantoms adopt an archetypal position of orthopedic rest. Instead, they have reverted to a plastic model determined by limb posture during the onset of anesthetic blockade. Unfortunately, in their study, the authors chose an experimental protocol of proprioceptive acuity that was unlikely to guarantee reliable phantom development within the restricted 10-min period of their observations. In our earlier study of 169 clinically successful limb blocks, we reported that phantoms only began to occur approximately 10 min after injection. A much longer period usually was required before subjective phantoms became sufficiently intense and stable to be reportable in three-dimensional coordinates for all joint postures of the shoulder, elbow, wrist, and hand. The following incidences or “yield” of measurable subjective phantom postures were recorded after a significantly longer maturation period of 30–45 min from the time of completing the regional anesthetic procedure:
Nursing morale: predictive variables among a sample of registered nurses in Australia.

AIM This study investigates the determinants of morale among Registered Nurses in Queensland, Australia. BACKGROUND In light of the public discussions on the issues facing the future of nursing, it is critical to understand the factors that influence morale. METHODS A 160-question instrument sought information from Registered Nurses on their perceptions of 'self', work and morale. A response rate of 41% was achieved (n = 343) from a convenience sample of three acute hospitals. RESULTS Following binary logistic regression modelling for organizational morale, significant relationships were found with patient care provision and team interaction. Binary logistic regression modelling for personal morale revealed positive relationships with team interaction, consultation, professional recognition and lower levels of patient abuse. CONCLUSION The results point to a number of organizational and professional issues that can be considered by health care administrators and policy makers to develop workplaces that have a positive impact on the morale of nurses.
STUDY OF NANOSECOND ND: YAG 213 nm LASER ABLATION OF EXTRA HEAVY CRUDE OIL BY INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY

The Laser-Extra Heavy Crude Oil interaction was studied using a nanosecond Nd:YAG 213 nm laser coupled to an ICP-MS. For this study, ~2.7 g Extra Heavy Crude Oil was mixed with ~3 mL xylene and 0,3 g organic multielemental solution containing 100 µg g-1 of Ag, Al, Ba, Cd, Cr, Cu, Mg, Mn, Mo, Ni, Pb, Sn, Ti, V, and Zn, xylene was left to evaporate at 90 °C and multielemental samples were obtained and analyzed by LA-ICPMS. Laser parameters, such as, ablation gas flow, sample scanning speed, spot size, fluence and focus position were optimized and RSD (n = 8) from 3% to 5% for the net signal of 63 Cu, 95 Mo, 60 Ni and 66 Zn and from 0.9% to 3.3% for the ratios Ni/Mo and Cu/Zn were obtained. Elemental fractionation was observed with both Zn and Cd when fluence was varied. Nevertheless, evidence is not enough to explain results as a consequence of high volatility or high ionization potential (PI) of these elements. Ablation craters obtained show signs of more pronounced thermal processes at higher fluences. Elemental fractionation was also observed in the ICP due to mass load effect. Isotopic ratios 95 Mo/ 112 Cd, 63 Cu/ 66 Zn y 27 Al/ 24 Mg, which have different ionization potential (1.89; 1.68 and 1.66 eV, respectively expressed as PIdenominator - PInumerator) increase when mass load is increase. On the other hand, 60 Ni/ 63 Cu ratio (0.09 eV difference) remains constant. These results indicate that the plasma ionization temperature decreases when mass load is increased affecting those elements with high ionization potential.