Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevention of Hypotension by a Single 5-mg Dose of Ephedrine During Small-Dose Spinal Anesthesia in Prehydrated Cesarean Delivery Patients

To evaluate the effectiveness of prophylactic ephedrine for the prevention of hypotension associated with spinal anesthesia, 50 parturients undergoing cesarean delivery received either ephedrine 5 mg or saline IV in a double-blinded fashion immediately after the induction of spinal anesthesia. Spinal anesthesia was performed with hyperbaric bupivacaine 6.6 mg combined with sufentanil 3.3 &mgr;g as part of a combined spinal-epidural technique. All patients received 1000 mL of lactated Ringer’s solution and 500 mL of hydroxyethylstarch 6% before the spinal injection. Additional ephedrine boluses (5 mg) were administered IV when the systolic blood pressure or heart rate decreased by more than 30% from baseline values, when systolic blood pressure became <100 mm Hg, or when patients complained of nausea or feeling faint. The height of the block was equal in the groups; however, more patients in the placebo group were found to develop hypotension (58% vs 25%, P < 0.05). Only 2 (8%) patients in the ephedrine group developed hypotension with systolic blood pressure values <90 mm Hg, whereas 10 patients (42%) in the saline group experienced hypotension of this severity (P < 0.05). In addition, there was a higher incidence of nausea in the placebo-treated patients. The total amount of ephedrine administered did not differ between groups. These findings suggest that the incidence and severity of hypotension are significantly reduced by the IV administration of a prophylactic dose of 5 mg ephedrine in patients receiving small-dose spinal anesthesia for cesarean delivery. Implications Ephedrine is the drug most often used to correct hypotension during spinal anesthesia for cesarean delivery in healthy patients. A single IV dose of 5 mg decreases the occurrence and limits the severity of hypotension in prehydrated subjects receiving a small-dose spinal local anesthetic-opioid combination.
Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California.

OBJECTIVES --To determine the extent to which interinstitutional variations in length of stay are explained by differences in patient characteristics and to determine whether patients in hospitals with shorter lengths of stay had worse outcomes. DESIGN --We reviewed patients' medical records and surveyed patients between 3 and 12 months after hospital discharge using a questionnaire. SETTING --Six teaching hospitals in California and Massachusetts. PATIENTS --A cohort of 2484 selected patients who had been hospitalized for acute myocardial infarction or to rule out acute myocardial infarction, coronary artery bypass graft surgery, total hip replacement, cholecystectomy, or transurethral prostatectomy. Between 73% and 84% of the patients with each condition completed a follow-up questionnaire. OUTCOME MEASURES --In-hospital complications, deaths, length of stay, functional status after hospital discharge, readmission, and patient satisfaction with hospital care were analyzed. RESULTS --Significant interinstitutional differences in length of stay were noted for all conditions except rule-out acute myocardial infarction. Statistical adjustment for case-mix differences accounted for most of the interinstitutional differences in length of stay for total hip replacement but explained little of the differences in the other conditions. When we controlled statistically for other predictors, length of stay did not have a significant impact on deaths, functional status after hospital discharge, the probability of readmission, or patient satisfaction with hospital care. CONCLUSION --More research is needed to determine the medical practices that are related to variations in lengths of stay. Routinely available outcome data may help preserve quality in the face of efforts to decrease costs by effecting more standardized practices of care.
The Multidimensional Inventory of Black Identity: Its Use With Euro-American, Latino, and Native American Undergraduates

Abstract This study examined the reliability and validity of scores from the Multidimensional Inventory of Black Identity with 550 Euro-American, 112 Latino, and 41 Native American undergraduates. Data for the Centrality, Private Regard, and Public Regard scales indicate that these scores have construct validity. Scores have acceptable Cronbach alpha internal consistency reliabilities across the 3 groups.
Differences of Urease Activity and Expression of Associated Genes According to Gastric Topography

Background: We hypothesize that pH difference between acid‐secreting corpus and non‐secreting antrum might influence the activity of H. pylori’s urease and/or related genes. We therefore measured urease activity and the expression of amiE whose encoded protein that hydrolyzes short‐chain amides to produce ammonia.
Transcutaneous ultrasonographic evaluation of gastric distension with fluid in horses.

OBJECTIVE To develop a transcutaneous ultrasonography (TUS) method for measuring the location of the stomach during various levels of fluid distension and evaluate any correlation between gastric fluid distension and stomach position. ANIMALS 6 adult horses. PROCEDURES Known volumes of water were administered in 2 trials. In trial 1, the stomach was evaluated prior to and after the administration of 2, 4, and 6 L of water. In trial 2, the stomach was evaluated after administration of 6, 8, 10, and 12 L of water. The TUS was performed at the 7th through 16th left intercostal spaces (ICSs). For each volume of water, an image was captured at the most dorsal point in each ICS where the dorsolateral aspect of the stomach wall was viewed. The distance between this point and a horizontal line drawn on the skin at the level of the elbow joint was measured. The measurements at all ICSs were used to estimate the gastric wall height at ICS 12, which was subsequently evaluated for statistical association with volume administered. RESULTS Significant correlation between the estimated height of the stomach wall at ICS 12 and the volume of fluid administered was detected. A regression equation to estimate gastric fluid volume when initial values for gastric wall height (cm) at ICS 12 and fluid volume (L) are known was developed. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that use of TUS for gastric fluid volume estimation is a potentially useful technique.
Prevalence of Occult Hepatitis B and Hepatitis C Virus Infections in Turkish Hemodialysis Patients

Background and Objective. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are important causes of morbidity and mortality in maintenance hemodialysis patients. Although their exact prevalence is not known, HBV and HCV viral infections and occult viral hepatitis are frequent in these patients. This study aimed to determine the prevalence of occult HBV and HCV infections in maintenance hemodialysis patients. Materials and Methods. One hundred and eighty-eight end-stage renal disease patients on maintenance hemodialysis (100 male, mean age 49±29 [16–80] years, and mean duration of hemodialysis 98±66 [12–228] months) were enrolled in this study. Serological markers for HBV and HCV were determined with immunoenzymatic assay (ELISA) by using commercial diagnostic kits (Access and BioRad, Beckman-Coulter). HCV-RNA (Cobas Amplicor HCV kit) and HBV-DNA (Artus GmbH HBV kit) were determined quantitatively by polymerase chain reaction. Results. Among the patients screened, 25 (13.3%) had HBV infection alone and 38 (20.2%) had HCV infection alone, while seven (3.7%) had dual infection of both viruses. Serological markers for occult hepatitis B and occult hepatitis C were positive in five (2.7%) and nine (4.8%) of the patients, respectively. Isolated anti-HBc was positive in 12 (6.4%) of all patients, three (7.9%) of the patients with anti-HCV and two (40%) of the patients with occult hepatitis B. Isolated anti-HBc positivity was more frequent in patients with occult hepatitis B than in those without (40% [2/5] vs. 5.5% [10/183], p=0.002). None of the patients with HCV had occult hepatitis B. Conclusions. Both occult and non-occult forms of HCV infection are more prevalent than HBV infection in hemodialysis patients. Especially the patients with isolated anti-HBc positivity should be tested for probable occult hepatitis B infection.
The influence of weather on the frequency of secondary post-tonsillectomy haemorrhage

The aim of this study was to determine whether certain weather variables influence the secondary post-tonsillectomy haemorrhage rate and to examine the influence of a change in these variables on secondary haemorrhage. This was a prospective study carried out in a tertiary referral institution. All patients undergoing bilateral tonsillectomy over a one-year period were included. Local weather data, including daily temperature (max/min), relative humidity and water vapour pressure, were acquired. All patients readmitted to our department with secondary post-tonsillectomy haemorrhage were recorded. Of 346 patients undergoing tonsillectomy, 32 developed secondary haemorrhage (9.2 per cent). A significant negative correlation was found between secondary haemorrhage rate and the average monthly temperature (max/min) and water vapour pressure (Pearson’s correlation = −0.8) (p ≤ 0.002). These results suggest that performing tonsillectomy in warmer weather when the water vapour pressure is higher may reduce the secondary haemorrhage rate.
Clinico-pathological correlations in 127 patients in 11 large pedigrees, segregating one of three heterozygous mutations in the COL4A3/ COL4A4 genes associated with familial haematuria and significant late progression to proteinuria and chronic kidney disease from focal segmental glomerulosclerosis.

BACKGROUND Heterozygous mutations in the COL4A3/ COL4A4 genes are currently thought to be responsible for familial benign microscopic haematuria and maintenance of normal long-term kidney function. METHODS We report on 11 large Cypriot pedigrees with three such mutations. A total of 236 at-risk family members were genetically studied, and 127 (53.8%) carried a heterozygous mutation. Clinico-pathological correlations were available in all of these patients. Renal biopsies in 21 of these patients all showed various stages of focal, segmental glomerulosclerosis (FSGS). Thirteen of these biopsies were also studied with EM and showed thinning of the glomerular basement membrane. RESULTS Mutation G1334E (COL4A3) was found in six pedigrees, mutation G871C (COL4A3) in four and mutation 3854delG (COL4A4) in one pedigree. Clinical and laboratory correlations in all 127 mutation carriers (MC) showed that microscopic haematuria was the only urinary finding in patients under age 30. The prevalence of 'haematuria alone' fell to 66% between 31 and 50 years, to 30% between 51 and 70 and to 23% over age 71. Proteinuria with CRF developed on top of haematuria in 8% of all MC between 31 and 50 years, to 25% between 51 and 70 years and to 50% over 71 years. Altogether 18 of these 127 MC (14%) developed ESRD at a mean age of 60 years. Two members with different mutations married, and two of their children inherited both mutations and developed adolescent, autosomal recessive Alport syndrome (ATS), confirming that these mutations are pathogenic. CONCLUSIONS Our data confirm for the first time a definite association of heterozygous COL4A3/COL4A4 mutations with familial microscopic haematuria, thin basement membrane nephropathy and the late development of familial proteinuria, CRF, and ESRD, due to FSGS, indicating that the term 'benign familial haematuria' is a misnomer, at least in this cohort. A strong hypothesis for a causal relationship between these mutations and FSGS is also made. Benign familial haematuria may not be so benign as commonly thought.
The Nellcor N‐101 pulse oximeter

The accuracy of the Nellcor N‐101 pulse oximeter has been evaluated in adult patients receiving general anaesthesia or intensive care. Readings obtained noninvasively with this instrument were compared with measurements made on arterial blood using a Radiometer OSM2 oximeter. The pulse oximeter was easy to use and within the range tested (70–100 percent saturation of haemoglobin with oxygen) the readings were within I digit of the values obtained by in vitro measurement.
In Vivo Assembly of the Proteasomal Complexes, Implications for Antigen Processing (*)

The multicatalytic and multisubunit proteasomal complexes have been implicated in the processing of antigens to peptides presented by class I major histocompatibility complex molecules. Two structural complexes of this proteinase, 20 S and 26 S proteasomes, have been isolated from cells. By analyzing in vivo assembly of the proteasomal complexes we show that the 20 S proteasomal complexes are irreversibly assembled via 15 S assembly intermediates containing unprocessed β-type subunits. The 20 S proteasomes further associate reversibly with proteasome activators PA28 or pre-existing ATPase complexes to form 26 S proteasomal complexes. Our findings that not all of the 20 S proteasomal complexes are assembled into 26 S proteasomal complexes within cells and that all of PA28 and ATPase complexes are associated with 20 S proteasomes strongly suggest that all proteasomal complexes coexist within cells. We further demonstrate that 26 S proteasomal complexes are predominantly present in the cytoplasm and a significant portion of the 20 S proteasomal complexes is associated with the endoplasmic reticulum membrane. Taken together, our findings suggest that depending upon their associated regulatory components, 26 S and 20 S-PA28 proteasomal complexes serve different housekeeping functions within the cells, while they degrade antigens in a cooperative manner in antigen processing.
Difficult and failed intubation in 3430 obstetric general anaesthetics*

A retrospective audit was performed of all obstetric general anaesthetics in our hospital over an 8 year period to determine the incidence of difficult and failed intubation. Data was collected from a number of sources to ensure accuracy. A total of 3430 rapid sequence anaesthetics were given. None of the patients had a failed or oesophageal intubation (95% CI, 0–1:1143). There were 23 difficult intubations (95% CI, 1:238–1:100). This was anticipated in nine cases, requiring awake fibreoptic intubation in three cases. Consultants or specialist registrars were involved in the management of all cases. We attribute the low incidence of airway complications to the above average rate of general anaesthesia in our hospital, senior cover and specialised anaesthetic operating department assistants.
Immunolocalization of HIV envelope gp120 in HIV encephalitis with dementia

Numerous studies have shown that the HIV envelope glycoprotein, gp120, is a potent neurotoxin. However, its role in the pathogenesis of HIV dementia had been questioned due to the lack of demonstration of its presence in vivo. We now demonstrate conclusively the presence of gp120 by immunohistochemistry in the brain of patients with HIV encephalitis who also had dementia. A highly specific anti-gp120 polyclonal sera was used on formalin fixed tissue. Gp120 staining cells were predominantly perivascular and included macrophages, microglia and multinucleated giant cells. These studies provide an important missing link for the role of gp120 in the neuropathogenesis of HIV infection. ISSN 0269-9370
The Global Problems of Child Malnutrition and Mortality in Different World Regions

Abstract The study of child mortality occupies a special place in the field of demographic research, since it represents the negative component of population growth. Also, the world food problem has become a familiar topic since the end of the World War II. The idea that population growth will sometime in the future outrun food supplies and universal starvation occurs. This study deals with what happened in global and regional variations regarding the child malnutrition and mortality rates. The main objective of the study is to explain and to explore the effect of the social, demographic, economic and health factors on child malnutrition and mortality rates among different regions in the globe. The study includes ten regions of the whole world compared to other studies that covered only one or two regions. Data were collected from various sources. The sample involved 191 countries. These countries divided by regions of world as following. East Southern Africa, West Africa, East Asia and Pacific, South Asia, Eastern Europe and Central Asia, Europe, Middle East, North Africa, North America, and South America. The results of descriptive analysis show that the highest mean rate of child malnutrition was found in South Asia region (57 children per 100), while the smallest mean rate was found in Europe region (just 1 child per 100). In West Africa region, the average of child mortality rate per 1000, 172 children, was the highest among all regions in the world, while in Europe was found to be 14 children per 1000. The results of correlation coefficients reveal that there were positive associations between illiteracy rate, unemployment, poverty, fertility rate, family size, food consumption, maternal mortality rate, population per physician, and child malnutrition and mortality in the whole world regions. Some regions have strong significant associations, such as Sub-Saharan Africa, Asia, and Americas, and other were non-significant association, such as Europe, Middle East, and North Africa. The results suggest that there were negative associations between GNP, household income, protein consumption, and child malnutrition and mortality in all world regions except Europe and Central Asia regions.
Classification of Bug Injected and Fixed Changes Using a Text Discriminator

Approaches to detect fault-prone modules have been studied for a long time. As one of these approaches, the authors proposed a technique using a text filtering technique. They assume that bugs relate to words and context that are contained in a software module. The technique treats a module as text information. Based on the dictionary which was learned by classifying modules which induce bugs, the bug inducing probability over a target module is calculated, and it judges whether the given module is a fault-prone module. The predictive granularity of this technique is a module. In this study, the authors aimed at prediction with the finer granularity of the portion that induces a bug. Specifically, they tried to predict bug-inducing changes by using source code differences of bug inducing changes and previous changes and a text filtering technique. Similarly, the authors tried to predict bug fixing by using source code differences of bug fixing changes and previous changes and a text filtering technique. To show the effectiveness of the approach, the authors conducted two experiments and compared their approach with fault-prone filtering by applying it to two open source projects, and obtained higher accuracy. Classification of Bug Injected and Fixed Changes Using a Text Discriminator
High-Grade Osteosarcoma of the Extremity: Differences Between Localized and Metastatic Tumors at Presentation

Background In osteosarcoma, as in other tumors, the presence of metastases at presentation is generally considered a consequence of late diagnosis. To verify this, the authors investigated whether there was a relationship between the stage of the disease at presentation and several clinical and pathologic characteristics, including the interval between the onset of first symptoms or signs and the final diagnosis. Patients and Methods One thousand seventy-one patients with high-grade osteosarcoma of the extremity were observed between 1980 and 1999. Of these, 891 had a localized tumor and 180 had metastases at the time of diagnosis. Results Compared with patients with localized disease, patients with detectable metastases at the time of diagnosis had higher serum levels of alkaline phosphatase, larger primary lesions, and tumors often located in the femur and humerus. In terms of time to diagnosis, the interval between the onset of first symptoms and the final diagnosis was significantly shorter in patients with metastases than in patients with localized tumor. This surprising finding probably reflects a more rapid growth of the tumor. Conclusions These results suggest a different biologic phenotype and aggressiveness of the tumor in a subgroup of patients and that the stage of the disease at presentation depends more on the properties of these tumors than on late diagnosis.
Validity of field expedient devices to assess core temperature during exercise in the cold.

INTRODUCTION Exposure to cold environments affects human performance and physiological function. Major medical organizations recommend rectal temperature (TREC) to evaluate core body temperature (TcORE) during exercise in the cold; however, other field expedient devices claim to measure TCORE. The purpose of this study was to determine if field expedient devices provide valid measures of TcRE during rest and exercise in the cold. METHODS Participants included 13 men and 12 women (age = 24 +/- 3 yr, height = 170.7 +/- 10.6 cm, mass = 73.4 +/- 16.7 kg, body fat = 18 +/- 7%) who reported being healthy and at least recreationally active. During 150 min of cold exposure, subjects sequentially rested for 30 min, cycled for 90 min (heart rate = 120-140 bpm), and rested for an additional 30 min. Investigators compared aural (T(AUR)), expensive axillary (T(AXLe)), inexpensive axillary (T(AXLi)), forehead (T(FOR)), gastrointestinal (T(GI)), expensive oral (T(ORLe)), inexpensive oral (T(ORLi)), and temporal (T(TEM)) temperatures to T(REc) every 15 min. Researchers used mean difference between each device and T(REC) (i.e., mean bias) as the primary criterion for validity. RESULTS T(AUR), T(AXLe), T(AXLi), T(FOR), TORLe, T(ORLi), and TTEM provided significantly lower measures compared to T(REC) and fell below our validity criterion. T(GI) significantly exceeded T(REC) at three of eleven time points, but no significant difference existed between mean T(REC) and T(GI) across time. Only T(GI) achieved our validity criterion and compared favorably to T(REC). CONCLUSION T(GI) offers a valid measurement with which to assess T(CORE) during rest and exercise in the cold; athletic trainers, mountain rescuers, and military medical personnel should avoid other field expedient devices in similar conditions.