Miracle-dz/UniFAR-FTUs huggingface dataset:
Buprenorphine for postoperative analgesia: Axillary brachial plexus block versus intramuscular administration in a placebo-controlled trial

Background and Aims: Peripheral administration of opioids has been suggested for prolongation of regional analgesia. This prospective, randomized, double-blind placebo-controlled study was undertaken to compare the effect of regional (axillary brachial plexus block [ABPB]) versus intramuscular (IM) buprenorphine (2 μg/kg) in adults. Material and Methods: Seventy-five adults undergoing upper limb surgery received ABPB with local anaesthetic (15 ml 0.5% bupivacaine, 15 ml 2% lignocaine with adrenaline 1:200,000, 9 ml normal saline [NS]). In addition, regional group RB (n = 25) received buprenorphine 2 μg/kg in ABPB and 1 ml NS IM. Systemic Group SB (n = 25) received 1 ml NS in ABPB and buprenorphine 2 μg/kg IM. Group C (n = 25) received 1 ml NS in ABPB and IM. Onset, duration of sensory and motor block, hemodynamic parameters, sedation score, pain scores using visual analog scale, duration of postoperative analgesia, rescue analgesic (RA) requirement, adverse events, and patient satisfaction were noted. Results: Demographics, onset and duration of sensory, motor block were similar. RB group had longest duration of analgesia (20.61 ± 1.33 h) compared to SB (10.91 ± 0.90 h) and control group (5.86 ± 0.57 h) (P < 0.05 RB vs. SB/C and SB vs. C). RA requirement was highest in the control group and least in RB group (P = 0.000 RB vs. SB/C and SB vs. C). SB group had a maximum number of side effects (P = 0.041, SB vs. RB/C). Patient satisfaction was highest with group RB (P < 0.05 RB vs. SB/C, and P = 0.06 SB vs. C). Conclusion: Buprenorphine 2 μg/kg in axillary plexus block provides significantly prolonged analgesia with less RA requirement and greater patient satisfaction compared to IM administration. This is highly suggestive of action on peripheral opioid receptors.
Vitamin A decreases the incidence and severity of nitrofen-induced congenital diaphragmatic hernia in rats

BERNARD THÉBAUD,1,2 DICK TIBBOEL,3 CAROLINE RAMBAUD,4 JEAN-CHRISTOPHE MERCIER,5 JACQUES R. BOURBON,6 A. TUAN DINH-XUAN,2 AND STEPHEN L. ARCHER7 1Réanimation Néonatale and 4Service d’Anatomo-Pathologie, Hôpital Antoine Béclère, 92141 Clamart; 2Service de Physiologie, Hôpital Cochin, Université René Descartes, 75679 Paris Cedex 14; 5Réanimation Pédiatrique, Hôpital Robert Debré, 75019 Paris; 6Institut National de la Sante et de la Recherche Médicale Unité 319, Université Paris 7, 75251 Paris, France; 3Pediatric Surgery, Sophia Children’s Hospital, 3015 Rotterdam, The Netherlands; and 7Cardiology Division, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada T6G 2B7
Hemorrhage from cerebral cavernous malformations: a systematic pooled analysis.

OBJECTIVE The aim of this paper is to define an overall cavernous malformation (CM) hemorrhage rate and risk factors for hemorrhage. METHODS The authors performed a systematic, pooled analysis via the PubMed database through October 2015 using the terms "cavernoma," "cavernous malformation," "natural history," "bleeding," and "hemorrhage. " English-language studies providing annual rates and/or risk factors for CM hemorrhage were included. Data extraction, performed independently by the authors, included demographic data, hemorrhage rates, and hemorrhage risk factors. RESULTS Across 12 natural history studies with 1610 patients, the mean age at presentation was 42.7 years old and 52% of patients (95% CI 49%-55%) were female. Presentation modality was seizure in 30% (95% CI 25%-35%), hemorrhage in 26% (95% CI 17%-37%), incidental in 17% (95% CI 9%-31%), and focal deficits only in 16% of cases (95% CI 11%-23%). CM location was lobar in 66% (95% CI 61%-70%), brainstem in 18% (95% CI 13%-24%), deep supratentorial in 8% (95% CI 6%-10%), and cerebellar in 8% (95% CI 5%-11%). Pooling 7 studies that did not assume CM presence since birth, the annual hemorrhage rate was 2.5% per patient-year over 5081.2 patient-years of follow-up (95% CI 1.3%-5.1%). Pooling hazard ratios across 5 studies that evaluated hemorrhage risk factors, prior CM hemorrhage was a significant risk factor for hemorrhage (HR 3.73, 95% CI 1.26-11.1; p = 0.02) while younger age, female sex, deep location, size, multiplicity, and associated developmental venous anomalies (DVAs) were not. CONCLUSIONS Although limited by the heterogeneity of incorporated reports and selection bias, this study found prior hemorrhage to be a significant risk factor for CM bleeding, while age, sex, CM location, size, multiplicity, and associated DVAs were not. Future natural history studies should compound annual hemorrhage rate with prospective seizure and nonhemorrhagic neurological deficit rates.
Ivory Osteoma of the Craniofacial Skeleton

The authors describe the clinical presentation, investigation, and surgical management of two cases of benign ivory osteoma of the craniofacial skeleton. In the first case, a bony mass located over the frontal region had become a cosmetic burden to the patient, and she requested removal with minimal morbidity. Accordingly, an endoscopic procedure, with minimal access incisions located behind the hairline, was devised. In the second case, the patient, a Jehovah's Witness, presented with a long history of slowly enlarging bony masses over the maxilla and in the pterygopalatine space. She finally requested surgical intervention when the symptoms of pain related to fifth nerve compression at the foramen ovale became intolerable. Key aspects of the preoperative and perioperative management strategies used to avoid blood transfusion are detailed, as is the surgical approach, which included a bicoronal scalp flap with temporary removal of the zygomatic arch and the coronoid process. Finally, the etiology, histology, and natural history of ivory osteomas are discussed.
Effects of autonomic balance and fluid and electrolyte changes on cardiac function in infarcted rats: A serial study of sexual dimorphism

Premenopausal women are known to show lower incidence of cardiovascular disease than men. During myocardial infarction (MI), homeostatic responses are activated, including the sympathetic autonomic nervous system and the rennin–angiotensin–aldosterone system, which is related to the fluid and electrolyte balance, both aiming to maintain cardiac output. This study sought to perform a serial evaluation of sexual dimorphism in cardiac autonomic control and fluid and electrolyte balance during the development of MI‐induced heart failure in rats. Experimental MI was induced in male (M) and female (F) adult (7–9 weeks of age) Wistar rats. The animals were placed in metabolic cages to assess fluid intake and urine volume 1 and 4 weeks after inducing MI (male myocardial infarction (MMI) and female myocardial infarction (FMI) groups). They subsequently underwent echocardiographic evaluation and spectral analysis of heart rate variability. After completing each protocol, the animals were killed for postmortem evaluation and histology. The MMI group showed earlier and more intense cardiac morphological and functional changes than the FMI group, although the extent of MI did not differ between groups (P > 0.05). The MMI group showed higher sympathetic modulation and sodium and water retention than the FMI group (P < 0.05), which may partly explain both the echocardiographic and pathological findings. Females subjected to infarction seem to show attenuation of sympathetic modulation, more favourable fluid and electrolyte balances, and better preserved cardiac function compared to males subjected to the same infarction model.
From ad hoc to strategic ecosystem management: the “Three‐Layer Ecosystem Strategy Model” (TeLESM)

Recently, business ecosystems have been recognized as one of the most interesting phenomenon in software engineering research. Companies experience a paradigm shift where product development and innovation is moving outside the boundaries of the firm and where networks of stakeholders join forces to co‐create value. While there is prominent research focusing on the managerial perspective of business ecosystems, few studies provide strategic guidance for how to intentionally manage the different ecosystems that companies operate in. Therefore, and on the basis of multicase study research, we provide empirical evidence on the challenges that software‐intensive companies experience in relation to the different types of business ecosystems they operate in. We conduct a “state‐of‐the‐art” literature review to identify strategies that are used to manage ecosystem engagements, and we develop a conceptual model in which we identify strategies for managing the innovation ecosystem, the differentiating ecosystem, and the commoditizing ecosystem. By categorising the different strategies in relation to the different types of ecosystems for which they are valid, the “three‐layer ecosystem strategy model” provides comprehensive support for strategy selection. We validate the use of the identified strategies in 6 software‐intensive case companies, and we provide empirical insights on the “relevance” and the “desired use” of these strategies as experienced by the case companies.
Effect of adrenaline on basal and ovine corticotrophin-releasing factor-stimulated ACTH secretion in man.

Six normal male subjects were given, in single blind random order on six separate occasions, i.v. bolus doses of synthetic ovine corticotrophin-releasing factor-41 (oCRF-41; 25 and 50 micrograms) with and without adrenaline (3 micrograms/min) i.v. for 150 min, the adrenaline infusions alone and saline placebo. The adrenaline infusions resulted in plasma adrenaline concentrations of 4.33 +/- 0.82 (S.E.M.) nmol/l and were associated with an increase in blood glucose, heart rate and systolic blood pressure and a reduction of diastolic blood pressure. Despite these evident biological effects at several sites, there was no stimulation of plasma ACTH or cortisol by adrenaline in comparison with the effect of saline, and no enhancement of the stimulatory effect of either dose of oCRF-41 on ACTH or cortisol secretion. The ACTH response to 50 micrograms oCRF-41 was greater than that to 25 micrograms, indicating that the 25 micrograms dose of oCRF-41 was submaximal and capable of further enhancement. As the plasma adrenaline concentrations during the adrenaline infusions reached the upper limit of the physiological range of plasma adrenaline in man, yet failed to enhance the ACTH or cortisol responses to a submaximal dose of oCRF-41, we conclude that circulating adrenaline neither exerts a direct stimulatory effect on pituitary corticotrophs nor enhances the effect of CRF under physiological circumstances. The adrenaline infusions attenuated the ACTH and cortisol responses to oCRF-41 and were associated with a transient reduction of basal concentrations of both hormones.
Consumer Receptiveness to Non-Traditional Roles for Community Pharmacists

Abstract Healthcare is in a state of transition as providers are seeking to redefine their roles to accommodate marketplace pressures. The focus of this study was to examine consumer interest in receiving a portion of their healthcare services from community pharmacists. Overall, while consumers see value in pharmacists' services directly related to their medications, they may not be thinking of pharmacists in broader healthcare roles. If so, a strong marketing program will be needed to educate consumers on the qualifications of pharmacists and how there is value in the services they could provide.
Cost-effective treatment modalities for reducing morbidity associated with chronic kidney disease

Chronic kidney disease (CKD) is a worldwide health problem with increasing prevalence and incidence. Guidelines suggest that early referral to a nephrologist to manage advanced stage (4+) patients with CKD is an effective treatment strategy, with earlier stage patients best managed through primary care physicians. Should patients with CKD progress to total kidney failure, several therapies are available that vary widely in costs. Kidney transplantation offers the lowest costs and highest quality of life, followed in ascending order of costs by peritoneal dialysis, home hemodialysis and facility-based hemodialysis. Earlier detection of CKD may prevent progression to kidney failure, and accurate risk prediction of end-stage kidney failure may improve clinical planning, outcomes and resource allocation.
Tissue-Type Plasminogen Activator Deficiency Exacerbates Arthritis1

Fibrin deposition, cell migration, and tissue remodeling are key components in the lesions of inflammatory joint diseases, such as rheumatoid arthritis. The plasminogen activators (PAs), namely, tissue-type PA (t-PA) and urokinase PA, are implicated in these aspects of an inflammatory response, although their precise roles are yet to be defined. We therefore used gene-deficient mice to explore their role in a two-stage arthritis model involving intraarticular methylated BSA injection, followed by systemic IL-1 treatment. We report in this study that both t-PA and urokinase PA are protective for the mild arthritis induced by intraarticular methylated BSA injection alone, since absence of either of them exacerbates the response; following s.c. IL-1 injection, t-PA−/− mice had particularly severe disease. Fibrin deposition appeared to parallel disease severity under the various conditions, suggesting that PA-mediated fibrinolysis may be normally playing a protective role in inflammatory joint disease.
A Molecular Mechanism for Human T-cell Leukemia Virus Latency and Tax Transactivation (*)

The human T-cell leukemia virus type I (HTLV-I) is the causative agent of an aggressive T-cell malignancy in humans. While the virus appears to maintain a state of latency in most infected cells, high level virion production is an essential step in the HTLV-I life cycle. The virally-encoded Tax protein, a potent activator of gene expression, is believed to control the switch from latency to replication. Tax stimulation of HTLV-I transcription is mediated through cellular activating transcription factor/cAMP response element binding proteins, which bind the three 21-base pair (bp) repeat viral enhancer elements. In this report, we show that viral latency may result from a highly unstable interaction between CREB and the HTLV-I 21-bp repeats, resulting in rapid dissociation of CREB from the viral promoter. In the presence Tax, the dissociation rate of CREB from a 21-bp repeat element is decreased. This stabilization is highly specific, requiring the amino-terminal region of CREB and appropriate 21-bp repeat sequences. We suggest that Tax stabilization of CREB binding to the viral promoter leads to an increase in gene expression, possibly providing the switch from latency to high level replication of the virus.
Diagnostic efficiency of borderline personality disorder criteria in hospitalized adolescents: comparison with hospitalized adults.

OBJECTIVE The authors examined the diagnostic efficiency of borderline personality disorder criteria in adolescent inpatients. For comparison, diagnostic efficiency of borderline personality disorder criteria was also examined in a group of concurrently recruited adult inpatients. METHOD Adolescents (N=123) and adults (N=106) were reliably assessed with the Personality Disorder Examination, a semistructured diagnostic interview for DSM-III-R personality disorders. Sixty-five adolescents and 50 adults met diagnostic criteria for borderline personality disorder. Conditional probabilities were calculated to determine which borderline personality disorder criteria were most efficient as inclusion criteria and as exclusion criteria. Adolescents and adults were analyzed separately, and the results were compared. RESULTS There were no significant differences between groups with regard to the base rates of the borderline personality disorder diagnosis nor for any borderline personality disorder criterion. The best inclusion criterion for the adolescents was abandonment fears, though for the adults all symptoms were approximately equivalent in this regard. The most efficient exclusion criterion was uncontrolled anger for the adolescents and impulsiveness for the adults. CONCLUSIONS In hospitalized patients, borderline personality disorder and its symptoms appear to be as frequent for adolescents as for adults. Despite these surface similarities between groups with respect to symptom patterns, several differences were found at the level of the diagnostic efficiency for individual borderline personality disorder criteria. These differences may shed light on the nature of borderline psychopathology during adolescence.
Obesity and the lung: 4 · Obesity and asthma

Over the past 30 years there has been an epidemic of both obesity and asthma in the western world. A large body of robust epidemiological data has linked obesity with the development and severity of asthma in both children and adults and weight reduction with improvements in asthma severity and symptoms. However, it remains unsettled whether this relationship is causal or confounded by some other factor(s) as mechanistic and physiological studies have produced heterogeneous and at times conflicting findings. This review examines the clinical and epidemiological relationship between obesity and asthma and the purported mechanisms that may link these two processes together.
The Immoral Assumption Effect

Jumping to negative conclusions about other people’s traits is judged as morally bad by many people. Despite this, across six experiments (total N = 2,151), we find that multiple types of moral evaluations—even evaluations related to open-mindedness, tolerance, and compassion—play a causal role in these potentially pernicious trait assumptions. Our results also indicate that moralization affects negative—but not positive—trait assumptions, and that the effect of morality on negative assumptions cannot be explained merely by people’s general (nonmoral) preferences or other factors that distinguish moral and nonmoral traits, such as controllability or desirability. Together, these results suggest that one of the more destructive human tendencies—making negative assumptions about others—can be caused by the better angels of our nature.
Tamoxifen: A Protein Kinase C Inhibitor to Treat Mania A Systematic Review and Meta-Analysis of Randomized, Placebo-Controlled Trials

Objective The aim of this study was to conduct a systematic review of literature to retrieve all randomized controlled trials that evaluated the efficacy of tamoxifen on manic mood episodes and meta-analyze their quantitative results. Methods Four electronic databases were systematically searched from their inception to March 2014: PubMed, Cochrane Library (Cochrane Central Register of Controlled Trials), Scopus, and PsychINFO. Pooled difference in means of changes in mania scores and pooled odds ratio of treatment response (for tamoxifen monotherapy) were calculated as the main effect size. A random effects model was used to pool the data across studies. Quantitative syntheses were expressed by forest plots. Results Five randomized controlled trials (3 adjunct trials and 2 monotherapy trials) were included. Regarding adjunct tamoxifen, the standardized difference in mean of mania score changes in tamoxifen arm as compared with control arm was 0.669 (95% confidence interval [CI], 0.15–1.189; P = 0.012). Regarding monotherapy, the pooled difference in means of mania score changes in the tamoxifen arm as compared with the placebo arm was 22.09 (95% CI, 20.98–23.192; P < 0.000000001). Pooled odds ratio of response to treatment was 15.36 (95% CI, 2.99–78.73; P = 0.001) in the tamoxifen group as compared with the placebo group. Conclusions Tamoxifen can be considered an effective treatment for manic bipolar patients. Making a conclusion regarding the efficacy and safety for longer periods warrants further studies with a larger sample size and longer follow-up duration.
NK Cells Cause Liver Injury and Facilitate the Induction of T Cell-Mediated Immunity to a Viral Liver Infection1

NK cells are a relatively rare cell population in peripheral lymphoid organs but are abundant in the liver, raising questions as to their function in immune responses to infections of this organ. To investigate this, cell-mediated immunity to viral liver infection induced by a type 5, replication-defective, adenovirus was examined. It is shown that NK cells in the absence of T cells cause hepatocyte apoptosis in virus-infected livers associated with an increase in liver enzymes in the serum. Concomitantly, NK cells induce production of IFN-γ, inhibitable by their elimination before infection. NK cells are shown to be necessary for optimal priming of virus-specific T cells, assessed by delayed-type hypersensitivity response and CTL activity, consistent with their ability to secrete IFN-γ. The conclusion is drawn that NK cells mediate two important functions in the liver: they induce cell death in the infected organ and concomitantly stimulate the induction of T cell-mediated immunity by release of IFN-γ.
Inhibition of Adenosine Deaminase Attenuates Inflammation in Experimental Colitis

Adenosine modulates the immune system and inhibits inflammation via reduction of cytokine biosynthesis and neutrophil functions. Drugs able to prevent adenosine catabolism could represent an innovative strategy to treat inflammatory bowel disorders. In this study, the effects of 4-amino-2-(2-hydroxy-1-decyl)pyrazole[3,4-d]pyrimidine (APP; novel adenosine deaminase inhibitor), erythro-9-(2-hydroxy-3-nonyl)adenine hydrochloride (EHNA; standard adenosine deaminase inhibitor), and dexamethasone were tested in rats with colitis induced by 2,4-dinitrobenzenesulfonic acid (DNBS). DNBS-treated animals received APP (5, 15, or 45 μmol/kg), EHNA (10, 30, or 90 μmol/kg), or dexamethasone (0.25 μmol/kg) i.p. for 7 days starting 1 day before colitis induction. DNBS caused bowel inflammation associated with decrease in food intake and body weight. Animals treated with APP or EHNA, but not dexamethasone, displayed greater food intake and weight gain than inflamed rats. Colitis induced increment in spleen weight, which was counteracted by all test drugs. DNBS administration was followed by macroscopic and microscopic inflammatory colonic alterations, which were ameliorated by APP, EHNA, or dexamethasone. In DNBS-treated rats, colonic myeloperoxidase, malondialdehyde, and tumor necrosis factor (TNF)-α levels as well as plasma TNF-α and interleukin-6 were increased. All test drugs lowered these phlogistic indexes. Inflamed colonic tissues displayed an increment of inducible nitric-oxide synthase mRNA, which was unaffected by APP or EHNA, but reduced by dexamethasone. Cyclooxygenase-2 expression was unaffected by DNBS or test drugs. These findings indicate that 1) inhibition of adenosine deaminase results in a significant attenuation of intestinal inflammation and 2) the novel compound APP is more effective than EHNA in reducing systemic and intestinal inflammatory alterations.
New Concepts on the Mode of Action of Hormones

The final stage in the study ofa hormone and its activity, if indeed the word "final" can ever be applied in physiology, is the elucidation ofthe mechanism ofits action. AU must entail enzyme systems, probably systems of which as yet we know nothing. Can a steroid function, for instance, as a coenzyme? How can the utilization of potassium, or calcium, be influenced by traces ofsubstances? The future of hormone research will thus be in large part bound up with the advances in general biochemistry and physiology___ As yet it must be said, that this aspect of the work is scarcely begun. Nevertheless, the accumulation of knowledge now available means that much progress along these lines is now possible.