Miracle-dz/UniFAR-FTUs huggingface dataset:
Benzodiazepines - Effects on Human Performance and Behavior.

There exist a large number of drugs belonging to the benzodiazepine family. These include the 1,4-benzodiazepines such as diazepam, temazepam and oxazepam, the often more potent diazolo- and triazolo-groups represented by alprazolam, midazolam, triazolam etc. These drugs represent a large range of potencies from submilligram doses to over 100 mg and a range of polarities. Consequently, blood or plasma concentrations associated with prescribed use range from sub-nanogram per mL to near-microgram per mL. Their medical use varies, but they are predominantly used as hypnotics and sedatives. Some members are also used in the treatment of post-traumatic stress and obsessive-compulsive disorders, alcohol withdrawal, muscle spasm, and seizures. Recreationally, drug users favor these drugs to reduce the symptoms of withdrawal and unpleasant effects of heroin and cocaine. They are also commonly used as "date-rape" drugs to render a victim incapable of resisting an attack. Benzodiazepines elicit a large number of physiological and psychological responses in humans that often can lead to significant behavioral changes and adverse effects on skills required for safe driving. These include reduced lane control, increased reaction times, reduced hand-eye coordination and cognitive impairment. Impairment can exceed that seen with 0.05 g% ethanol. In high doses benzodiazepines can cause persons to exhibit classical features of CNS-depressant drugs such as nystagmus, ataxia, slurred speech, and impaired divided attention skills. As one would expect with hypnotics and sedatives, any sleep deprivation, or situations involving monotonous driving can lead to a reduced ability to concentrate and maintain vigilance. Adverse effects on REM and NREM sleep patterns will exacerbate fatigue-related components to driving. Persons with sleep abnormalities, e.g., sleep apnea, may be more likely to be affected by benzodiazepines than those with normal sleep patterns. Ethanol and narcotic analgesics also affect sleep patterns and may compound any CNS-depressant effects associated with the use of benzodiazepines.
Prevalence of Anemia in the First Trimester of Pregnancy in Rural Population of Krishna District in Andhra Pradesh

Anaemia in pregnancy is an important health problem in India. Anaemia among pregnant women includes increased risk of low birth weight, maternal mortality and morbidity. The objective of this study was to estimate the prevalence of anaemia which helps in planning our maternal health programme. A hospital based, cross-sectional study was conducted among 104 pregnant women, in their first trimester to assess the prevalence of anaemia in rural Krishna. The study was carried out at Dr PSIMS & RF Hospital , Chinnavutapalli. Only those who visited the hospital were enrolled in the study. Lablife H3D Premier automated haematology analyser was used for estimation of haemoglobin, MCV and MCH. Anaemia was classified as per the World Health Organization (WHO) grading criteria as mild 10 -11 gms%, moderate 7 to 9.9 gms % and severe below 7 gms %. The present study revealed that 93.26 % of pregnant women were anaemic and their mean Hb was 10.37 ± 0.94 g/dl, mean MCV was 72.65 ± 6.53 fl and their mean MCH was 26.75 ± 2.75 pg. Among them, 73.07% had mild anaemia, 20.19 % had moderate anaemic & none had severe anaemia. In Mild anaemia, the mean Hb was 10.78 ± 0.5 g/dl while in moderate anaemia, the mean Hb was 8.94± 0.625g/dl . Anaemia in 1st trimester of pregnancy was endemic and microcytic, hypochromic anaemia is most common in this region.
Effectiveness and safety of long-term antidepressant treatment in bipolar disorder.

OBJECTIVE We sought to review research on use of antidepressants for long-term treatment of bipolar depression. METHOD We conducted a computerized literature search of the MEDLINE, HealthStar, Current Contents, PsychInfo, and National Library of Medicine databases to identify studies involving antidepressant, anticonvulsant, or lithium use in bipolar disorder or manic-depressive illness published from 1966 through 2000. RESULTS Only 7 blinded, controlled trials of long-term antidepressant treatment in bipolar disorders were found. The available information is not adequate to support the safety or effectiveness of long-term antidepressant treatment for bipolar depression, with or without mood-stabilizing cotherapy. CONCLUSION Antidepressant treatment of bipolar depression is extraordinarily understudied. Controlled trials comparing specific antidepressants, particularly to compare mood-stabilizing agents given alone and combined with an antidepressant, are needed.
Ruptured emphysematous infectious aortitis after endoprothesis placement.

An 80-year-old man presented to the emergency department with persistent fever, retrosternal pain and cold sweating for 1 week. He had undergone endovascular aortic stent repair of a thoracic aortic aneurysm 3 months ago. On examination, his body temperature was 38.6°C, heart rate was 99 bpm and blood pressure was 98/60 mm Hg. Laboratory studies revealed leukocytosis with elevated C-reactive protein of 19.6 mg/dl. A radiograph of the chest …
Reproductive History and Risk of Multiple Sclerosis

Background: It has been suggested that reproductive factors may be involved in the etiology of multiple sclerosis (MS). We studied associations of reproductive history with MS risk in a population-based setting. Methods: Using national databases, we established a cohort comprising 4.4 million Danish men and women born between 1935 and 1989 and alive in 1968 or later. We obtained information about their live-born children, pregnancy losses, pregnancy complications, and infertility diagnoses. MS cases in the cohort were identified through 2004 in the Danish Register of Multiple Sclerosis. Associations between reproductive factors and MS risk were evaluated using rate ratios (RRs) obtained in log-linear Poisson regression analysis. Results: MS was diagnosed in 6332 women and 3426 men. In both sexes, parents had a lower risk of MS compared with childless persons (in women, RR = 0.76 [95% confidence interval = 0.71–0.82]; in men, 0.89 [0.80–0.98]). RRs were inversely associated with number of children, age at first childbirth, and proximity in time since most recent birth. Among women, MS risk was unrelated to histories of pregnancy loss, pregnancy complications, or infertility. A supplementary analysis in which the date of MS diagnosis was backdated by 5 years to address the possibility of reverse causality did not confirm a protective effect of parenthood (in women, 0.95 [0.88–1.03]; in men, 1.08 [0.98–1.20]). Conclusions: Similar findings in women and men argue against a biologic role of pregnancy in the etiology of MS. Moreover, the observed differences in childbearing patterns were restricted to the 5 years before MS diagnosis, suggesting that reverse causality (ie, reduced reproductive activity in persons with yet-undiagnosed MS) might explain the observed associations.
Use of Neuromuscular Electrostimulation in the Treatment of Dysphagia in Patients with Multiple Sclerosis

Objectives: We explored the possible effects of neuromuscular electrostimulation on the swallowing function of patients with multiple sclerosis and swallowing problems. Methods: Twenty-five patients (average age, 53.1 years; SD, 9.8 years) with multiple sclerosis and swallowing problems were treated for 3 weeks with 2 sessions per week of neuromuscular electrostimulation. The average time since the onset of multiple sclerosis was 16.5 years (SD, 10.2 years). Seventeen patients were examined with transnasal flexible endoscopy 1 week before treatment and 1 week after treatment. Results: After treatment, a significant decrease in pooling of saliva in the pyriform sinuses was seen in 6 patients (p = 0.03), and significantly less aspiration during swallowing of thin liquids (p < 0.01) was seen in 9 patients. Overall, the 25 patients reported that their swallowing had improved (p < 0.01), and in 20% of the patients, it had become less strenuous. No adverse effects of the treatment were reported. Conclusions: Our study showed that the treatment of swallowing problems with neuromuscular electrostimulation in patients with multiple sclerosis in this sample was successful in the reduction of pooling of saliva and in the reduction of aspiration.
The Role for Tunneled Indwelling Pleural Catheters in Patients With Persistent Benign Chylothorax

Background:Utilization of tunneled indwelling pleural catheters (TIPCs) for persistent pleural effusions is increasingly more common; however, the presence of chylothorax is generally considered a contraindication for utilization of a TIPC due to concerns regarding potential nutritional, immunologic and hemodynamic complications. Therefore, in this study, a cohort of patients with persistent benign chylothorax managed with TIPCs is described. Methods:A retrospective analysis of patients with persistent benign chylothorax managed with a TIPC at the study center between January 1, 2008, and March 1, 2012, was completed. Extracted data included patient characteristics, chylothorax etiologies, prior interventions, outcomes and complications. Results:Eleven patients (14 hemithoraces) had persistent benign chylothorax treated with placement of a TIPC during the inclusion time frame. Etiology of the chylothorax was nontraumatic in 8 of the 11 patients, with the remaining 3 secondary to thoracic surgery. Pleurodesis was achieved in 9 of the 14 hemithoraces, with a median time to pleurodesis of 176 days. All procedures were well tolerated, and no immediate periprocedural complications were reported. One serious complication was encountered in the form of a postoperative pulmonary embolism after replacement of an occluded TIPC, resulting in the patient’s death. Two patients had transient occlusions of their TIPCs successfully treated with intracatheter thrombolytic therapy. No significant adverse nutritional, hemodynamic or immunologic outcomes were reported during follow-up for any included patient. Conclusions:Utilization of a TIPC for the management of persistent benign chylothorax should be considered early because pleurodesis may be frequently and safely achieved in this patient population.
1 Performance Investigation of Multi-tier Web Applications in Xen Virtualized Environment

Server virtualization comforts deployment of Internet services and enables cloud service providers to improve resource utilization, fault tolerance, and energy efficiency by consolidating virtual servers within a shared environment. Although deploying services in virtualized environment brings benefits to service providers in terms of service agility, functionality, and reusability in comparison to traditional architecture, overhead of mediating hypervisor and contention amongst hosted virtual machines to possess virtualized resources can adversely affect the performance of applications in virtualized environments. In this paper, we provide a detailed profiling-based performance investigation of Web application in Xen virtualized environment to recognize the major sources of performance degradation of Web application in Xen. Our experimental results indicate that the main cause of the performance degradation of a single Web application in Xen is higher CPU utilization not higher disk utilization of the system; detailed profiling of the performance events occurred at the system-level identifies the most CPU consuming and the highest L3 cache miss functions of Xen and Dom0 kernels that contribute the most to this performance degradation. Additionally, the experiments show that by increasing the number of cores in Xen environment, the number of L3 cache misses occurred at the system decreases significantly which leads to response time improvement of the Web application in Xen. Moreover, the results demonstrate that when multiple Web applications are running in a Xen consolidated environment, not only the high CPU utilization but also the high disk utilization causes the performance degradation. The dramatic increase of L3 cache misses of the system is another cause of this performance degradation. The functions of Xen and Dom0 kernels that handle I/O operations of domains have the most contribution to this considerable increase of L3 cache misses.
The association between NFKB 194 ins / del ATTG polymorphism and non-small cell lung cancer risk in a Chinese Han population

This study aimed to clarify the influence of a common insertion/deletion polymorphism (-94ins/del ATTG, rs28362491) in the Nuclear factor-κB1 (NFKB1) promoter on non-small cell lung cancer (NSCLC) susceptibility. We genotyped the NFKB1 -94ins/del ATTG polymorphism by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and assessed the association with NSCLC risk, clinicopathological parameters in a case-control study of 421 cases and 425 controls. Heterozygous (ID) genotype disclosed a statistically significantly increased risk of developing NSCLC (OR = 1.57, 95% CI 1.13-2.19, P = 0.007). Homozygous (II) genotype also showed an increased risk of NSCLC (OR = 1.87, 95% CI 1.27-2.75, P = 0.001). Statistically significant difference was observed when the patients and controls were compared according to ID + II versus DD (OR = 2.01, 95% CI 1.472.76, P<0.001). The I allele was significantly higher in the NSCLC cases compared to the controls (52.9% versus 45.1%). The I allele was significantly associated with NSCLC risk (OR = 1.37, 95% CI 1.12-1.65, P = 0.001). There was a significantly higher frequency of ID + II genotypes observed in smokers, compared to non-smokers (OR = 1.99, 95% CI 1.22-3.24, P = 0.005) and in patients with stage III + IV, compared to stage I + II (OR = 2.16, 95% CI 1.343.49, P = 0.002). This study suggested that NFKB1 -94ins/del ATTG polymorphism was significantly associated with NSCLC risk in Chinese Han population.
Iron‐sulphur clusters and the problem with oxygen

During the first billion years of life on the Earth, the environment was anaerobic. Iron and sulphur were plentiful, and they were recruited in the formation of iron‐sulphur (Fe‐S) clusters within ancient proteins. These clusters provided many enzymes with the ability to transfer electrons; to others they offered a cationic feature that tightly bound oxyanionic and nitrogenous metabolites. Still others acquired a crystallizing surface around which polypeptide could fold to establish a three‐dimensional structure. However, the subsequent oxygenation of the Earth's atmosphere by photosynthetic organisms created a threat to cluster‐dependent proteins that still has not been fully resolved. By oxidizing environmental iron, oxygen limits its bioavailability, requiring that organisms employ complex schemes with which to satisfy their iron requirement. More directly, oxygen species convert exposed Fe‐S clusters to unstable forms that quickly decompose. Some microbes responded to this dilemma by retreating to anaerobic habitats. Others abandoned the use of low‐potential electron‐transfer pathways, which rely upon the least stable cluster enzymes, and developed antioxidant strategies to protect the remainder. These adjustments were only partially successful: largely because of their reliance upon Fe‐S clusters, aerobes remain vulnerable to iron restriction and oxidative stress, features that higher organisms exploit in defending themselves against bacterial pathogens. Thus, the history of Fe‐S clusters is an unusual one that has profoundly shaped contemporary microbial ecology.
Evaluation of aviation-based safety team training in a hospital in The Netherlands.

PURPOSE The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program's content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient safety, but little is known about how it affects safety culture. DESIGN/METHODOLOGY/APPROACH Pre- and post-assessments of the hospitals' safety culture was based on interviews with ophthalmologists, anesthesiologists, residents, nurses, and support staff. Interim observations were made at training sessions and in daily hospital practice. FINDINGS The program consisted of safety audits of processes and (team) activities, interactive classroom training sessions by aviation experts, a flight simulator session, and video recording of team activities with subsequent feedback. Medical professionals considered aviation experts inspiring role models and respected their non-hierarchical external perspective and focus on medical-technical issues. The post-assessment showed that ophthalmologists and other hospital staff had become increasingly aware of safety issues. The multidisciplinary approach promoted social (team) orientation that replaced the former functionally-oriented culture. The number of reported near-incidents greatly increased; the number of wrong-side surgeries stabilized to a minimum after an initial substantial reduction. RESEARCH LIMITATIONS/IMPLICATIONS The study was observational and the hospital's variety of efforts to improve safety culture prevented us from establishing a causal relation between improvement and any one specific intervention. ORIGINALITY/VALUE Aviation-based TRM training can be a useful to stimulate safety culture in hospitals. Safety and quality improvements are not single treatment interventions but complex socio-technical interventions. A multidisciplinary system approach and focus on "team" instead of "profession" seems both necessary and difficult in hospital care.
Computerized tomography assessment of cranial and mid-facial fractures in patients following road traffic accident in South-West Nigeria.

BACKGROUND Globally, the most common cause of cranio-facial fractures is road traffic accident (RTA) with computerized tomography (CT) scan as the gold standard in the diagnosis of patients with cranial and facial fractures. The purpose of this study is to assess the pattern of cranial and facial fractures on CT in head injured patients following RTA. MATERIALS AND METHODS Using CT, detailed analyses of 236 patients with head injury following RTA were performed between 2006 and 2008, Data recorded included cause of injury, age and gender distribution, cranial and mid-facial fractures sustained, associated intracranial and soft tissue injury and the types of vehicular accident. RESULTS The peak age of the patients was between 30 and 39 years. RTA was more common in males than females. Motor-vehicle was the most common cause of RTA in the present study (66.9%). More passengers were involved in the motor vehicle (87.3%) and motorcycle (52.0%) accidents than their corresponding drivers, and they were predominantly males. Majority of the patients involved in pedestrian road traffic accident (PRTA) were motor vehicle victims (93.3%). There were more patients with cranial (59.8%) than mid-facial fractures (40.2%). Majority of the patients had temporal bone cranial fracture (31.1%) and combined or mixed type of mid-facial fractures (41.3%). Intracranial bleeding (31.7%) was the most common associated intracranial finding. CONCLUSION RTAs continue to be a menace and are the main cause of craniofacial injury in Nigeria. This pattern of etiologic factors is in accordance with data from most developing countries. Special attention should be paid to reinforcement of legislation and enactment of laws aimed at the reduction of head injury and provision for easy access to CT for the head injured patient.
Follow up studies during the first five years of life: a pervasive assessment of neurological function.

indeed, it is not easy to be accurate in an account of anything, however simple. Zoologists often disagree in their descriptions of the curve of a shell, or the plumage of a bird, though they may lay their specimen on the table, and examine it at their leisure; how much greater becomes the likelihood of an error in the description of things which must be in many parts observed from a distance, or under unfavourable circumstances of light and shade; and of which many of the distinctive features have been worr. away by time. I believe few people have an idea of the cost of truth in these things; of the expenditure of time necessary to make sure of the simplest facts, and of the strange way in which separate observations will sometimes falsify each other, incapable of reconcilement, owing to some imperceptible inadvertency. '
Clinical suspicion, management and outcome of intrapartum foetal distress in a public hospital with limited advanced foetal surveillance

Abstract Objectives: To determine the basis for the clinical suspicion of foetal distress, the instituted managements and delivery outcome in a tertiary hospital in sub-Saharan Africa with limited capability for advanced foetal monitoring. Methods: It is a 3-year retrospective analysis of all the obstetrics cases with intrapartum foetal distress. Results: There were 301 cases reviewed. The birth asphyxia incidence rate was 233/1000 live births and the perinatal death rate was 47/1000 live births. Suspicion of foetal distress was premised on the presence of persistent tachycardia or bradycardia during intermittent auscultation. Main resuscitative measures were left lateral repositioning of patient, fast saline infusion, intranasal oxygen administration and discontinuation of oxytocin infusion, if any. Only 124 (41.2%) of all the cases had delivery achieved within 2 h of diagnosis. Mean decision-delivery interval by caesarean section was 2.93 ± 2.05 h. Socio-demographic factors (p= 0.001) and pregnancy risk category (p = 0.002) influenced incidence of birth asphyxia. Conclusion: To reduce subsisting high perinatal morbidity and mortality in sub-Saharan Africa, it is best that at the least referral hospitals should have advanced facilities for foetal monitoring and shortened surgical intervention time.
A PHYLOGENETIC STUDY OF POLLINATOR CONSERVATISM AMONG SEXUALLY DECEPTIVE ORCHIDS

Abstract Orchids of the genus Chiloglottis are pollinated through the sexual deception of male wasps mainly from the genus Neozeleboria (Tiphiidae: Thynninae). The orchids mimic both the appearance and sex pheromones of wingless female thynnines but provide no reward to the deceived males. Despite the asymmetry of this interaction, strong pollinator specificity is typical. Such plant-pollinator interactions would seem to be relatively flexible in the plant's adaptive response to variation in the local pollinator resource. However, we present DNA sequence data on both orchids and wasps that demonstrate a pattern of pollinator conservatism operating at a range of taxonomic levels. Sequence data from the wasps indicate 15 of 16 Chiloglottis pollinators are closely related members of one clade of Thynninae. A pattern of congruence between orchid and wasp phylogenies is also demonstrated below the generic level, such that related orchids tend to use related thynnine wasps as specific pollinators. Comparative physiological data on the wasp responses to the floral scents of two Chiloglottis species and one outgroup, Arthrochilus, indicate similar attractive volatile chemicals are used by related orchid taxa. By extension, we infer a similarity of sex pheromone signals among related thynnines. Thus, the conservative pattern of pollinator change in sexually deceptive orchids may reflect phylogenetic patterns in the sex pheromones of their pollinators. Corresponding Editor: J. Conner