Miracle-dz/UniFAR-FTUs huggingface dataset:
Deliberate hypotension induced by labetalol with halothane, enflurane or isoflurane for middle‐ear surgery

The feasibility of using labetalol, an alpha‐ and beta‐adrenergic blocking agent, as a hypotensive agent in combination with inhalation anaesthetics (halothane, enflurane or isoflurane) was studied in 23 adult patients undergoing middle‐ear surgery. The mean arterial pressure was decreased from 86 ± 5 (s.e. mean) mmHg to 52 ± 1 mmHg (11.5 ± 0.7 to 6.9 ± 0.1 kPa) for 98 ± 10 min in the halothane (H) group, from 79 ± 5 to 53 ± 1 mmHg (10.5 ± 0.7 to 7.1 ± 0.1 kPa) for 129 ± 11 min in the enflurane (E) group, and from 80 ± 4 to 49 ± 11 mmHg (10.7 ± 0.5 to 6.5 ± 0.1 kPa) for 135 ± 15 min in the isoflurane (I) group. The mean H concentration during hypotension in the inspiratory gas was 0.7 ± 0.1 vol%, the mean E concentration 1.6 ± 0.2 vol%, and the mean I concentration 1.0 ± 0.1 vol%. In addition, the patients received fentanyl and d‐tubocurarine. The initial dose of labetalol for lowering blood pressure was similar, 0.52 – 0.59 mg/kg, in all the groups. During hypotension, the heart rate was stable without tachy‐ or bradycardia. The operating conditions regarding bleeding were estimated in a double‐blind manner, and did not differ significantly between the groups. During hypotension, the serum creatinine concentration rose significantly in all groups from the values before hypotension and returned postoperatively to the initial level in the other groups, except the isoflurane group. After hypotension there was no rebound phenomenon in either blood pressure or heart rate. These results indicate that labetalol induces easily adjustable hypotension without compensatory tachycardia and rebound hypertension.
Expressive behavior in Parkinson's disease as a function of interview context.

OBJECTIVE Parkinson's disease affects the ability to express motivation through face, body, and voice; contextual factors may facilitate or inhibit expressive behavior. The purpose of this study was to determine whether qualities of the interview context are associated with client motivational behavior in Parkinson's disease. METHOD Men and women with Parkinson's disease (N = 106) discussed 2 topics (enjoyable activity vs. frustrating activity) during an assessment with a female or male interviewer. From videotaped clips, displays of 4 categories of motivation and 12 verbal and 18 nonverbal, behavioral patterns were rated. RESULTS During the discussion of enjoyable activities, participants used more positive words, smiled more, and were more facially expressive. Participants were less talkative about their negative feelings and appeared to be more apathetic with the same-gender interviewer. CONCLUSION Occupational therapy practitioners should vary the emotional tone of their questions to improve the validity of motivation assessments.
Patient adherence to ischemic heart disease treatment.

Introduction: The effectiveness of the treatment of chronic diseases depends on the participation of the patient, influenced by different sociocultural factors, which are not fully recognized by the treatment routine. Objective: To search for some of these factors that hinder or facilitate adherence to treatment and use of healthcare resources, approaching patients with ischemic heart disease. Method: A cross-sectional study was conducted using face-to-face interviews. We applied semi-structured questionnaires to 347 individuals and recorded 141 interviews for qualitative analysis. Descriptors were selected to identify eight categories of analyses. The quantitative data were submitted to descriptive analysis of frequency. Results: Only 2% had good medication adherence according to score on Morisky questionnaire. About 23% bought statins; the others obtained statin in the public health institution. Thirty-six speeches were selected and classified according to the following categories: knowledge about disease and medication, difficulty of acquisition, self management of treatment, difficulties of access to health services, side effect of statins, caregiver support, transportation to health services and concerns about the disease progression. However, it was noticed that about 1/3 of the care outside the research institution can be characterized as an attempt to bring rationalization to the health system. Conclusion: The improved adherence to chronic treatment of ischemic heart disease depends on the establishment of effective flows for referral and counter-referral from one care unit to another, relevant information and clarification of the questions for the patients and the attention of health professionals to the many social and cultural factors involved in treatment adherence. New research should be focused on educational groups by integrated multidisciplinary teams in order to share treatment decisions, thereby increasing the patient's commitment to his own health.
Market Integration from Measurement to Economic Analysis: A Survey of the Recent Literature

This paper surveys the literature on market integration. It builds on a previous survey on the integration of European markets (Federico 2012), extending the discussion to integration of markets in Asia and across oceans, and dealing also with the literature on causes and effects of integration. It argues that a lot of progress has been made, but still we are far from a comprehensive view of the issue. The most pressing needs are the definition of an implementable method to assess gains from integration and the collection of new data, most notably on products and areas other than cereals in Europe and on trade costs.
A phase II study of sunitinib in patients with recurrent epithelial ovarian and primary peritoneal carcinoma: an NCIC Clinical Trials Group Study.

PURPOSE Sunitinib is a multitargeted receptor tyrosine kinase inhibitor. We conducted a two-stage phase II study to evaluate the objective response rate of oral sunitinib in recurrent epithelial ovarian cancer. PATIENTS AND METHODS Eligibility required measurable disease and one or two prior chemotherapies, at least one platinum based. Platinum-sensitive or -resistant disease was allowed. Initial dose schedule was sunitinib 50 mg daily, 4 of 6 weeks. Observation of fluid accumulations during off-treatment periods resulted in adoption of continuous 37.5 mg daily dosing in the second stage of accrual. RESULTS Of 30 eligible patients, most had serous histology (67%), were platinum sensitive (73%) and had two prior chemotherapies (60%). One partial response (3.3%) and three CA125 responses (10%) were observed, all in platinum-sensitive patients using intermittent dosing. Sixteen (53%) had stable disease. Five had >30% decrease in measurable disease. Overall median progression-free survival was 4.1 months. Common adverse events included fatigue, gastrointestinal symptoms, hand-foot syndrome and hypertension. No gastrointestinal perforation occurred. CONCLUSIONS Single-agent sunitinib has modest activity in recurrent platinum-sensitive ovarian cancer, but only at the 50 mg intermittent dose schedule, suggesting that dose and schedule may be vital considerations in further evaluation of sunitinib in this cancer setting.
Postnatal development of alkaline phosphatase activity correlates with the maturation of neurotransmission in the cerebral cortex

We have shown previously that the tissue nonspecific alkaline phosphatase (TNAP) is selectively expressed in the synaptic cleft of sensory cortical areas in adult mammals and, by using sensory deprivation, that TNAP activity depends on thalamocortical activity. We further analyzed this structural functional relationship by comparing the developmental pattern of TNAP activity to the maturation of the thalamocortical afferents in the primate brain (Callithrix jacchus). Cortical expression of alkaline phosphatase (AP) activity reflects the sequential maturation of the modality‐specific sensory areas. Within the visual cortex, the regional and laminar distribution of AP correlates with the differential maturation of the magno‐ and parvocellular streams. AP activity, which is transiently expressed in the white matter, exhibits a complementary distributional pattern with myelin staining. Ultrastructural analysis revealed that AP activity is localized exclusively to the myelin‐free axonal segments, including the node of Ranvier. It was also found that AP activity is gradually expressed in parallel with the maturation of synaptic contacts in the neuropile. These data suggest the involvement of AP, in addition to neurotransmitter synthesis previously suggested in the adult, in synaptic stabilization and in myelin pattern formation and put forward a role of AP in cortical plasticity and brain disorders. J. Comp. Neurol. 486:179–196, 2005. © 2005 Wiley‐Liss, Inc.
The Determination of Peroxidase in Amniotic Fluid

Analyzing dial peroxidase activity in amniotic fluid is extremely simple, requiring only 1 ½ minutes of incubation at room temperature and a spectrophotometer. Peroxidase, clearly detectable at as early as 17 necks' gestation in the amniotic fluid, increases 100-fold by term. The increase follows a predictable rising curve and can be used to estimate the fetal age. Maturation of the fetal salivary gland is most probably (be source of rising amniotic fluid peroxidase levels. Samples from complicated pregnancies arc lower than normal. do not increase as rapidly, and probably can be bracketed into their own ranges for gestational age evaluation.
Effects of isotonic crystalloid resuscitation on fluid compartments in hemorrhaged rats.

Redistribution of fluid after isotonic crystalloid resuscitation from hemorrhage may result not only in interstitial edema but also in cellular edema. We measured the extent to which shock and resuscitation altered fluid compartments in different organs. Nephrectomized, anesthetized rats were randomly divided into a Control group (n = 10) and a Hemorrhage plus Resuscitation group (H/R, n = 10). Rats were subjected to 60 min hemorrhagic hypotension (50 mmHg) followed by a 60 min resuscitation period with . 9% NaCl infused as needed to maintain mean arterial pressure at 80% of baseline. A 2 h 51Cr-EDTA distribution space was used to estimate extracellular fluid volume (ECFV) and a 5 min 125I-albumin distribution space was used to measure plasma volume (PV). After euthanasia, total tissue water was measured by wet/dry weight analysis and interstitial fluid volume (ISFV) and cell water were calculated for selected organs. Resuscitation volume was two times the shed blood volume, but resulted in a PV equal to that of the Controls. There were no significant differences in whole animal ECFV or ISFV, although the mean values in the H/R group were greater than that of the Control group. The mean values for total tissue water for each tissue in the H/R group were larger than the respective means of the Control tissues but was significantly greater for only the heart (3639 +/- 56 microL/g vs. 3493 +/- 24 microL/g, mean +/- S.E., p < .05). In all H/R tissues, mean values for ISFV were also larger; this difference was significant for only the liver and small intestines (744 +/- 62 vs. 518 +/- 29 microL/g and 1117 +/- 155 vs. 706 +/- 58 microL/g, respectively). Heart cell water was significantly larger in H/R than Controls (2900 +/- 60 microL/g vs. 2738 +/- 27 microL/g). These data suggest that resuscitation of hemorrhage using isotonic crystalloid normalizes overall PV and ECFV but also causes interstitial expansion in selected gut tissues and cellular edema in the heart.
Relatives' attitudes towards medico-legal investigation and forensic autopsy: a study from South Delhi

Relatives of deceased persons on whose bodies a medico-legal autopsy had been performed at the All India Institute of Medical Sciences, New Delhi, India were personally asked to complete a questionnaire. The aim of study was to determine surviving family members' attitudes towards medico-legal investigation and forensic autopsy. The majority of the relatives showed a positive attitude towards forensic autopsy but were not aware of the detailed procedure of the autopsy. They wanted sufficient information to be provided before the autopsy. They showed a great interest in autopsy results i.e. the cause of death. It was concluded that sufficient relevant explanations given before the autopsy improves the relatives' acceptance and helps alleviate the suffering of the bereaved. The experience and opinions of relatives may help an autopsy surgeon in more effective management of medico-legal cases.
Predictors of the failure of treatment with chloroquine in children with acute, uncomplicated, Plasmodium falciparum malaria, in an area with high and increasing incidences of chloroquine resistance

Abstract Resistance to chloroquine (CQ) in Plasmodium falciparum has reached unacceptably high levels in many endemic countries. The pre-treatment factors that identify the children who are at risk of treatment failure after being given CQ were evaluated in 385 children with acute, uncomplicated, Plasmodium falciparum malaria. These children each took part in one of six antimalarial drug trials conducted, between July 1996 and July 2004, in a hyper-endemic area of south–western Nigeria. Following treatment with CQ, 149 (39%) of the children failed treatment by day 7 or 14. In a multivariate analysis, an age of 7 years [giving an adjusted odds ratio (AOR) of 2.17, with a 95% confidence interval (CI) of 1.19–3.85; P=0.01], an asexual parasitaemia of 100,000/μl (AOR = 2.17; CI = 1.08–4.35; P=0.03), the presence of gametocytaemia (AOR = 2.08; CI = 1.14–3.85; P=0.02) and enrolment >4 years after commencement of the study (i.e. after 2000; AOR = 2.13; CI = 1.3–4.0; P=0.003) were found to be independent predictors at presentation of the subsequent failure of treatment with CQ. Compared with the other children, those who failed to clear their parasitaemias within 3 days and those who still had fever 1–2 days after commencing treatment were more likely to be treatment failures. Together, these findings may have implications for malaria-control efforts in all areas of sub-Saharan Africa where treatment of malaria depends almost entirely on antimalarial monotherapy.
An Empirical Analysis of the Scottish Housing Market by Property Type

This paper studies house price dynamics of the different property types in Scotland. We find evidence of i) breakpoints around the recent financial crisis in three property types (flats, terraced, semi-detached) and in the average house prices, ii) volatility clustering in the detached house prices, with the CGARCH being the optimal volatility model, iii) negative impact of the unemployment and interest rates on house prices irrespective of the property type and positive effect of the CPI in the prices of the detached, terraced and average houses. Our results have significant implications for appropriate economic policy selection and investment management.
Improving Visual Communication for EIT-Based Lung Research

EIT (Electrical Impedance Tomography) is a novel imaging method visualizing impedance changes in the thorax mainly influenced by breathing and heart beating. Unfortunately, this technique has a poor image resolution. To improve the quality of EIT images, computer scientists and medical researchers are working together on the image reconstruction process of the data. As their background is different, there exist difficulties in the communication while assessing data and images. We provide a visualization of the thorax containing CT (Computer Tomography) and EIT images closing this gap. It is 3D, multimodal, semiabstract and suitable for both groups, and shows a rendered thorax volume with an embedded 2D EIT movie. The EIT image reconstruction contains several computational intermediate stages which are used to improve the volume rendering transfer function. Additionally, isosurfaces show context structures to understand spatial coherences more easily. The visualization is designed to be interactive and remove visual clutter to provide a direct view to the lung, which is the focus of interest. The results show that our visualization is able to give a basis for discussion for medical researchers as well as for computer scientists. Phenomena that have been discovered during long discussions are easier to detect. Furthermore it is possible to obtain new knowledge and address questions in terms of EIT.
Procedural sedation and analgesia in a large UK Emergency Department: factors associated with complications

Background The aim of this study was to investigate the delivery of procedural sedation and analgesia (PSA) in an urban teaching hospital Emergency Department (ED) over a 2-year period, and identify factors associated with complications. Methods Consecutive ED patients requiring PSA were prospectively enrolled onto the Registry of Emergency Procedural Sedation. Data collected included: patient and procedural characteristics; process times; physiological parameters; agents; sedation depth; and composition of staff team and complications. Multivariable binary logistic regression was used to identify factors associated with an increased risk of complications. Results 1402 patents required PSA during the study period. 1345 (95.9%) underwent orthopaedic manipulations. 597 (42.6%) received moderate sedation. 401 (28.6%) were sedated to deeper levels. Complications occurred in 49 (3.5%) cases. Deeper levels of sedation and the procedure occurring overnight were identified as risk factors for complications. Procedure type, patient age, grade of doctor and choice of drug were not found to be associated with an increased risk of complications. Conclusions Procedural sedation and analgesia by Emergency Physicians is safe and effective; however, complications do happen. Complications are more likely at deeper levels of sedation and at night. Emergency Physicians must have the necessary skills and equipment to deal with such complications when they arise. EDs must be adequately staffed with trained clinicians 24 h a day to provide PSA.
Rapid in vivo detection of rat spinal cord injury with double‐diffusion‐encoded magnetic resonance spectroscopy

Diffusion‐weighted imaging is a common experimental tool for evaluating spinal cord injury (SCI), yet it suffers from complications that decrease its clinical effectiveness. The most commonly used technique, diffusion tensor imaging (DTI), is often confounded by effects of edema accompanying acute SCI, limiting its sensitivity to the important functional status marker of axonal integrity. The purpose of this study is to introduce a novel diffusion‐acquisition method with the goal of overcoming these limitations.
Vancomycin‐resistant enterococci at a large university hospital in Denmark

Enterococci are part of the normal human fecal flora and also part of the fecal flora of many animals. Vancomycin‐and ampicillin‐resistant enterococci give rise to infections that may virtually be untreatable with antibiotics. Antibiotic use in humans is a risk factor for development or selection of vancomycin‐resistant enterococci. In animals the related glycopeptide avoparcin is used, especially in poultry, as a food additive to promote growth. Selective pressures for vancomycin‐resistant enterococci are high in Denmark with the production of 105 million poultry and the use of 24,000 kg avoparcin per year. The possible impact on vancomycin resistance among human isolates of enterococci remains to be defined. Furthermore, there has been a 3‐fold increase in vancomycin usage during the last 5 years at our hospital, from 2.4 to 7 kg/year. We examined 91 stool specimens from 67 patients in risk units at our hospital. Using a selective medium (KAA agar), 17 strains of Enterococcus faecium grew on the selective medium and 3 (18%) were vancomycin‐resistant (MIC>256 mg/l). Using PCR and an internal probe, vanA was found in the vancomycin‐resistant enterococci. No association between vancomycin therapy and carriage of VRE was demonstrated in these patients.
Reciprocal Relations Between Teacher–Child Conflict and Aggressive Behavior in Kindergarten: A Three-Wave Longitudinal Study

In recent developmental theorizing, it has been hypothesized that teacher–child conflict and children's externalizing behavior affect one another reciprocally over time. However, the relation between teacher–child conflict and externalizing behavior has been mainly studied from a unidirectional point of view. Therefore, this study aimed to test the hypothesis of bidirectionality by means of a cross-lagged longitudinal design with kindergarten teacher reports on core variables at 3 measurement occasions in 1 year. Structural equation modeling with data of 148 kindergartners provided evidence for the hypothesis of bidirectionality. Specifically, results supported a transactional sequence in which children's aggressive behavior at the beginning of kindergarten led to increases in teacher–child conflict midyear, which in turn led to an increase of aggressive behavior at the end of the kindergarten school year.
Are diagnostic testing and admission rates higher in non-English-speaking versus English-speaking patients in the emergency department?

STUDY OBJECTIVE To determine whether non-English-speaking patients who present to an emergency department have more diagnostic tests ordered, higher admission rate, and longer length of stay in the ED than English-speaking patients for 2 common complaints, chest pain and abdominal pain. METHODS This prospective, comparative, observational study was conducted at a public hospital ED. The study group was composed of 324 patients (172 non-English-speaking and 152 English-speaking) presenting with nontraumatic abdominal pain (148) or chest pain (176). The main outcome measures were admission rates, length of stay in the ED, and diagnostic test and procedure ordering. RESULTS The mean age for the total sample was 45.8+/-15.5 years (range 14 to 87 years); 45.4% (147/324) of the patients were male. For the non-English-speaking patients, the language distribution was Spanish (31.0%), other (9.0%), Cantonese (5.9%), Hindi (2.5%), Mien (1.5%), Arabic (1.9%), Russian (0.9%), Mandarin (0.6%), and Korean (0.3%). The admission rate was 37.8% for English-speaking patients versus 42.8% for non-English-speaking patients in the total sample (mean difference in proportions 5%, 95% confidence interval [CI] -6% to 16%; 34.2% for English-speaking versus 9.1% for non-English-speaking patients presenting with abdominal pain, mean difference in proportions 5%, 95% CI -11% to 21%) and 40.9% for English-speaking versus 45.8% for non-English-speaking patients presenting with chest pain (mean difference in proportions 5%, 95% CI -10% to 20%). Power was 80% to detect a 15% difference in admission rates at an alpha value of.05. There was no statistically significant difference in ordering of diagnostic tests between the non-English-speaking and English-speaking patients with chest pain. Non-English-speaking patients with abdominal pain had 5 tests ordered more often than English-speaking patients. The mean difference in proportions (with 95% CIs) for these tests were CBC count 18.4% (5.1% to 31.7%), serum electrolytes 17.9% (3.8% to 31. 9%), urinalysis 20.0% (4.5% to 35.6%), ECG 23.4% (8.6% to 38.2%), and abdominal computed tomographic scan 10.9% (1.0% to 20.8%). There was no statistically significant difference between English-speaking and non-English-speaking patients for ED length of stay in the total sample (mean difference 29.8, 95% CI -37.5 to 97.1 minutes; for the abdominal pain subgroup, mean difference 19.5, 95% CI -74.6 to 113.5 minutes; and for the chest pain subgroup, mean difference 37.9, 95% CI -58.0 to 133.8 minutes). CONCLUSION Significantly more tests are ordered for non-English-speaking patients with abdominal pain in the ED, including 3 times as many abdominal computed tomographic scans. There is no increase in test ordering with non-English-speaking patients with complaints of chest pain in the ED. When comparing English-speaking and non-English-speaking patients, there were no statistically significant differences in admission rates or length of stay in the ED.