Miracle-dz/UniFAR-FTUs huggingface dataset:
Surgical results of decompressive craniectomy in very young children: A level one trauma centre experience from India

Abstract Introduction: Literature remains sparse regarding decompressive craniectomy (DC) in traumatic brain injury (TBI) in very young children. This study analysed the indications, complications and outcome of young children undergoing DC for TBI at our institute. Study design: Retrospective. Observations: The total number of patients was 71. Mean age was 1.6 years. Mean duration from injury to surgery was 11.9 hours (range = 3–80 hours). Around 50% had severe head injury. Intracranial pressure (ICP) monitoring was done in 33 patients. Mean ICP was 22.2 mm Hg (range = 9–50 mm Hg). The threshold ICP for surgery was 15 mm Hg. Perioperative mortality was 50% each for severe TBI (18/36) and diffuse cerebral edema (7/14), and 58% for infants (4/7). Ninety per cent of expired patients had ICP > 20 mm Hg. Mean follow-up duration was 19.6 months (range = 2–42 months). Except one, all survivors had good-to-excellent outcomes (Glasgow outcome scale extended; GOS-E = 7–8). Conclusions: Decompressive craniectomy offers a survival advantage in almost 50% of young children with severe TBI and should be used judiciously. The highest mortality was within the 1st week of surgery. The cut-off limit of 20 mm Hg for surgical decompression might not be applicable to young children and a low threshold ICP needs to be considered. Factors associated with increased mortality are high opening ICP (>20 mm Hg), GCS <8, diffuse cerebral oedema and infant age group. Timing of DC remains crucial. Further prospective studies are necessary to optimize the timing and ICP limit for surgical decompression.
Long‐Term Outcomes Among Participants in the WEGENT Trial of Remission‐Maintenance Therapy for Granulomatosis With Polyangiitis (Wegener's) or Microscopic Polyangiitis

Findings from the WEGENT trial and other short‐term studies have suggested that azathioprine (AZA) or methotrexate (MTX) could effectively maintain remission of granulomatosis with polyangiitis (Wegener's) (GPA) or microscopic polyangiitis (MPA). This study was undertaken to examine whether differences in rates of relapse or adverse events would appear after discontinuation of these 2 maintenance regimens, when assessed over a longer followup period.
Health insurance in India: what do we know and why is ethnographic research needed

ABSTRACT The percentage of India's national budget allocated to the health sector remains one of the lowest in the world, and healthcare expenditures are largely out-of-pocket (OOP). Currently, efforts are being made to expand health insurance coverage as one means of addressing health disparity and reducing catastrophic health costs. In this review, we document reasons for rising interest in health insurance and summarize the country's history of insurance projects to date. We note that most of these projects focus on in-patient hospital costs, not the larger burden of out-patient costs. We briefly highlight some of the more popular forms that government, private, and community-based insurance schemes have taken and the results of quantitative research conducted to assess their reach and cost-effectiveness. We argue that ethnographic case studies could add much to existing health service and policy research, and provide a better understanding of the life cycle and impact of insurance programs on both insurance holders and healthcare providers. Drawing on preliminary fieldwork in South India and recognizing the need for a broad-based implementation science perspective (studying up, down and sideways), we identify six key topics demanding more in-depth research, among others: (1) public awareness and understanding of insurance; (2) misunderstanding of insurance and how this influences health care utilization; (3) differences in behavior patterns in cash and cashless insurance systems; (4) impact of insurance on quality of care and doctor-patient relations; (5) (mis)trust in health insurance schemes; and (6) health insurance coverage of chronic illnesses, rehabilitation and OOP expenses.
Nutritional and anti-nutritional composition of velvet bean: an under-utilized food legume in South India

Four accessions of the under-utilized legume, velvet bean (Mucuna pruriens var. utilis (Wall. ex Wight) Bak. ex Burck), collected from three different locations of Western Ghats, South India were analysed for proximate composition, mineral profiles, the protein fractions, amino acid profiles of total seed protein, in vitro protein digestibility and certain anti-nutritional factors to determine their potential as an alternative source to alleviate protein-energy-malnutrition among the people of South India. The major findings of the study were as follows: crude protein ranged from 20.2-29.3%, crude lipid 6.3-7.4%, total dietary fibre 8.7-10.5%, ash 3.3-5.5% and carbohydrates 49.9-61.2%. The energy level of the seed (1562-1597 kJ 100 g -1 DM) was comparable with commonly consumed Indian pulses. Mineral profiles, viz. sodium, potassium, calcium, magnesium, phosphorus, iron, copper, zinc and manganese ranged from 43.1-150.1, 778.1-1846.0, 393.4-717.7, 174.9-387.6, 98.4-592.1, 10.8-15.0, 0.9-2.2, 5.0-10.9, 3.9-4.3 mg 100 -1 seed flour, respectively. The data on seed protein fractions revealed that the globulins constitute the major bulk of the seed protein as in most legumes. Profiles of amino acids of total seed proteins detected in the present study revealed that they contain relatively higher levels of all essential amino acids except threonine, leucine and lysine in black-coloured seed coat accessions and phenylalanine and tyrosine in white-coloured seed coat accession compared with the FAO/WHO (1991) requirement pattern. The in vitro protein digestibility of the legumes under study ranged from 72.4-76.9%. Anti-nutritional substances like total free phenolics, tannins, L-DOPA, trypsin inhibitor activity and phytohaemagglutinating activity also were investigated. The detected anti-nutritional factors probably have little nutritional significance if the beans are properly processed.
Mutational spectrum and deep intronic variants in the factor VIII gene of haemophilia A patients

Summary Haemophilia A (HA) is caused by a broad spectrum of different mutation types in the factor VIII gene (F8). In our patient cohort of more than 2600 HA patients as well as in other published studies, the most frequent cause are missense mutations in different F8 exons or the recurrent intron 22 inversion. Some exons and several specific nucleotide positions represent hot spots for point mutations in the examined cohort. About 4 % of cases remain without mutation after routine HA diagnostic methods including inversion PCRs, Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA). Deep intronic mutations cannot be detected by current standard HA diagnostics but have been reported for several genetic disorders. However, next generation sequencing (NGS) of the whole genomic sequence of the F8 gene allows to identify deep intronic variants. Conclusion: In general, NGS provides an effective approach to screen for different HA causing mutation types in the F8 gene.
Mouse genetic locus Lps influences susceptibility to Neisseria meningitidis infection

We surveyed a number of inbred mouse strains for susceptibility to meningococcemia. Mice of all strains became bacteremic after intraperitoneal injection of a serogroup C, serotype 2a human disease isolate, but the strains differed in levels of bacteremia, indicating influences of the host genome on susceptibility. There was no significant correlation between level of bacteremia and differences at major histocompatibility or immunoglobulin loci; the Salmonella susceptibility locus, Ity; the complement C5 locus, Hc; the antibody response locus, xid; or the transferrin locus, Trf. However, the Lps locus, which influences a range of host cellular responses to endotoxin and affects susceptibility to Salmonella typhimurium, did influence susceptibility to meningococcemia. There were significant differences in levels of bacteremia between C3H/HeJ (Lpsd) mice and each of the other strains (all Lpsn). We confirmed the association of the Lpsd genotype with susceptibility by using coisogenic strains from two widely separated mouse lineages: C3H and B10. Lpsd mice experienced a 1,000-fold proliferation of bacteria and were bacteremic for days before clearing the infection. In contrast, Lpsn mice cleared the bacteremia in less than 1 day. There was no difference in meningococcal growth in vitro in serum from C3H/HeJ and coisogenic C3H/HeN (Lpsn) mice, suggesting that the Lps-related difference in susceptibility may involve a cellular response.
Platelet‐activating factor secreted by DDAVP‐treated monocytes mediates von willebrand factor release from endothelial cells

We have previously shown that although DDAVP (1‐deamino‐8‐D‐arginine vasopressin), a synthetic analogue of the natural hormone arginine vasopressin, does not directly promote release of vWf from human umbilical vein endothelial cells (ECs), enhanced release does occur when ECs were exposed to either monocytes or to supernatants recovered from DDAVP‐treated monocytes. In the present study, we have found that exposure of monocytes to DDAVP did not increase secretion of interleukins (IL)‐1β, IL‐6, IL‐8, tumor necrosis factor (TNF‐α), growth factors G‐CSF (granulocyte‐), GM‐CSF (granulocyte, monocyte‐colony stimulating factor), prostaglandins (PG) E2, PGF2α, or PGI2 or purine nucleotides such as ATP and ADP. However, increased levels of platelet‐activating factor (PAF) were secreted by DDAVP‐treated monocytes in a time‐ and dose‐dependent manner that positively correlated with the enhancement in vWf release from ECs. Moreover, this effect could also be elicited when lipid extracts of these supernatants or purified PAF were added directly to ECs. This response could be inhibited with (±)‐trans‐2,5‐Bis(3,4,5‐trimethoxyphenyl)‐1,3‐dioxolane, a specific PAF receptor antagonist, when the ECs were exposed to supernatants from DDAVP‐treated monocytes or to pure PAF. The present data indicate that enhanced secretion of PAF from monocytes is one mechanism whereby DDAVP can provoke release of vWf from ECs. © 1993 Wiley‐Liss, Inc.
Psychotropic Drug Use before, during, and after Pregnancy: A Population-Based Study in a Canadian Cohort (2001-2013)

Objective: To describe the extent of increase in use and the rate of continuation versus discontinuation of psychotropic agents before, during, and after pregnancy. Methods: Rates of psychotropic use (antidepressants, anxiolytic/sedative-hypnotics, antiepileptics, antipsychotics, lithium, stimulants) among women with a hospital-recorded pregnancy outcome were assessed using databases at the Manitoba Centre for Health Policy. Rate of use was defined as ≥1 prescription over the total number of pregnancies in the 3-12 months before pregnancy, 0-3 months before pregnancy, during pregnancy, or 3 months after pregnancy. Continued use was defined as ≥2 prescriptions with gap ≤14 days. Poisson regression was used to analyze trends. Results: Over the study period, a psychotropic drug was used before, during, or after pregnancy in 41,923 of 224,762 pregnancies. From 2001 to 2013, psychotropic use increased 1.5-fold from 11.1% to 16.2% (p < 0.0001) in the 3-12 months before pregnancy, 1.6-fold from 6.4% to 10.5% (p < 0.0001) in the 3 months before pregnancy, 1.8-fold from 3.3% to 6.0% (p < 0.0001) during pregnancy, and 1.5-fold from 6.2% to 9.5% (p < 0.0001) in the 3 months postpartum. Among the 13,579 women who received at least 1 psychotropic agent in the 3 months prior to pregnancy, 38.5% stopped the agent prior to pregnancy and only 10.3% continued use throughout pregnancy. Continued use throughout pregnancy was higher (56.9%) among the 6693 women who received at least 2 prescriptions for a psychotropic agent and were at least 80% adherent in the 3 months prior to pregnancy. Conclusion: The use of psychotropic agents increased over 12 years. The safety of continuing versus discontinuing these agents during pregnancy remains uncertain, but we observed a decrease in psychotropic drug use during the pregnancy period.
Optimal sampling frequency in recording of resistance training exercises

Abstract The purpose of this study was to analyse the raw lifting speed collected during four different resistance training exercises to assess the optimal sampling frequency. Eight physically active participants performed sets of Squat Jumps, Countermovement Jumps, Squats and Bench Presses at a maximal lifting speed. A linear encoder was used to measure the instantaneous speed at a 200 Hz sampling rate. Subsequently, the power spectrum of the signal was computed by evaluating its Discrete Fourier Transform. The sampling frequency needed to reconstruct the signals with an error of less than 0.1% was f99.9 = 11.615 ± 2.680 Hz for the exercise exhibiting the largest bandwidth, with the absolute highest individual value being 17.467 Hz. There was no difference between sets in any of the exercises. Using the closest integer sampling frequency value (25 Hz) yielded a reconstruction of the signal up to 99.975 ± 0.025% of its total in the worst case. In conclusion, a sampling rate of 25 Hz or above is more than adequate to record raw speed data and compute power during resistance training exercises, even under the most extreme circumstances during explosive exercises. Higher sampling frequencies provide no increase in the recording precision and may instead have adverse effects on the overall data quality.
The effects of stimulus distribution form during trace conditioning

Three experiments examined the effect of distribution form of the trace interval on trace conditioning. In Experiments 1 and 2, two groups of rats were conditioned to a fixed-duration conditioned stimulus (CS) in a trace interval procedure; rats in Group Fix received a fixed-duration trace interval, whereas for rats in Group Var the trace interval was of variable duration. Responding during the CS was higher in Group Var than in Group Fix, whereas during the trace interval this difference in responding reversed—Group Fix showed higher response rates than Group Var. Experiment 3 examined whether the greater response rate observed during the CS in Group Var was due to a performance effect or the acquisition of greater associative strength by the CS. Following trace conditioning, the rats from Experiment 1 underwent a second phase of delay conditioning with the same CS; a 5-s auditory stimulus was presented in compound with the last 5 s of the 15-s CS, and the unconditioned stimulus (US) was delivered at the offset of the CSs. On test with the auditory stimulus alone, subjects in Group Var showed lower response rates during the auditory stimulus than subjects in Group Fix. We interpreted these findings as evidence that the superior responding in Group Var during the CS was a result of it acquiring greater associative strength than in Group Fix.
Etiology and clinical profile of patients with Cushing's syndrome: A single center experience

Background: There is little published literature on the profile of patients with Cushing's syndrome (CS) from India. The aim of this study was to compile data of CS patients treated at this hospital. Materials and Methods: Patients referred to the endocrine services of this hospital for diagnosis/treatment of CS from January 1985 to July 2012 were the subjects for this study. All patients had detailed medical history, physical examination and biochemical and hormonal assays (which changed with availability of tests and changing views). Assays for plasma adrenocorticotropic hormone (ACTH) (late 90s), salivary cortisol estimation, IJV sampling for ACTH and corticotrophin releasing hormone stimulation tests were added on later. Imaging included computed tomography (CT), magnetic resonance imaging (since the late 80's) and 68Ga DOTA-TOC/FDG PET-CT (2008). Results: Three hundred sixty-four patients (250 females, 114 males, age 6 months to 65 years, mean 28 years + 12 years) were diagnosed to have CS during this period. Two hundred and ninety-three patients (80.5%) were ACTH dependent (CD 215, ectopic ACTH syndrome 22, occult ACTH source 56) while 71 (19.5%) were ACTH independent (adrenal carcinoma 36, adenoma 30, primary pigmented nodular adrenal disease 4, AIMAH 1). Pituitary macro adenoma was seen in 14% of the CD cases. The most common presenting complaints were hypertension and diabetes mellitus. A total of 63% patients complained of weight gain while 15% had lost weight. Myopathy, infections, skeletal fractures and psychiatric problems were the other common observations in our patients. Conclusion: The clinical spectrum was broad. CD was the most common cause for CS.
Gauging the likelihood of stable cavitation from ultrasound contrast agents

The mechanical index (MI) was formulated to gauge the likelihood of adverse bioeffects from inertial cavitation. However, the MI formulation did not consider bubble activity from stable cavitation. This type of bubble activity can be readily nucleated from ultrasound contrast agents (UCAs) and has the potential to promote beneficial bioeffects. Here, the presence of stable cavitation is determined numerically by tracking the onset of subharmonic oscillations within a population of bubbles for frequencies up to 7 MHz and peak rarefactional pressures up to 3 MPa. In addition, the acoustic pressure rupture threshold of an UCA population was determined using the Marmottant model. The threshold for subharmonic emissions of optimally sized bubbles was found to be lower than the inertial cavitation threshold for all frequencies studied. The rupture thresholds of optimally sized UCAs were found to be lower than the threshold for subharmonic emissions for either single cycle or steady state acoustic excitations. Because the thresholds of both subharmonic emissions and UCA rupture are linearly dependent on frequency, an index of the form ICAV = Pr/f (where Pr is the peak rarefactional pressure in MPa and f is the frequency in MHz) was derived to gauge the likelihood of subharmonic emissions due to stable cavitation activity nucleated from UCAs.
Growth-Related and Antennular Amputation-Induced Changes in the Olfactory Centers of Crayfish Brain

Freshwater crayfish increase in size throughout their lives, and this growth is accompanied by an increase in the length of the appendages and number of mechanoreceptive and chemoreceptive sensilla on them. We find that in the Australian freshwater crayfishCherax destructor, neuropil volumes of the olfactory centers increase linearly with body size over the entire size range of animals found in their natural habitat. The number of cell somata of two groups of interneurons associated with the olfactory centers (projection neurons and small local neurons) also increases linearly with the size of the animals. In contrast, axon counts of interneurons that represent a nonolfactory input to the olfactory centers show that these reach a total number in the very early adult stages that then remains constant regardless of the size of the animal. Only the axon diameter of these interneurons increases linearly with body size. Amputation of the antennule and olfactory sensilla reduces the number of projection and local interneurons on the amputated side. No change in the size of the olfactory centers occurs on the unamputated side. Amputation of the olfactory receptor neurons in crayfish therefore leads not only to a degeneration of the receptor cell endings in the olfactory lobe but also to a trans-synaptic response in which the number of higher order neurons decreases. Reconstitution of the antennule and olfactory receptor neurons in small adult crayfish is accompanied by the reestablishment of the normal number of interneurons and neuropil volume in the olfactory centers.
Meeting at the Crossroads: Myanmar Migrants and Their Use of Thai Health Care Services

This study assesses the use of health services among cross-border migrants from Myanmar who are now living in Kanchanaburi Province, western Thailand. The migrants comprise three main ethnic groups, namely the Burmese, Karen and Mon, most of whom have no formal education and are agricultural workers. Results indicate that although the migrants can access government health facilities, they are still more likely to buy drugs or use herbal medicines for treating themselves when they have minor illnesses, while the Thais are more likely to seek medical care from government facilities. The main difficulties for migrants in accessing health services are their legal status, financial constraints, and an inability to speak Thai. Moreover, health beliefs also determine the health-seeking behaviors of migrants, particularly among the Karen who believe in spirits and herbal medicine, while very few of the Burmese and the Mon do so. This leads to the conclusion that ethnicity is an important determinant of the utilization of health services by migrants from Myanmar in Kanchanaburi.
Examining the Impact of Consumer Innovativeness and Innovative Restaurant Image in Upscale Restaurants

Long-term customer retention in the upscale restaurant industry requires successful management of postconsumption service evaluations. The purpose of this research is to identify drivers of price fairness and postconsumption behavioral intentions within the context of upscale/fine dining restaurant patronage. Specifically, this study identifies the dual roles of consumer innovation and restaurant image as drivers of price fairness and behavioral intentions. Based on a review of the literature, a construct nomology was proposed. The model was then tested using data collected from a sample of upscale restaurant patrons residing in the United States. Results of a structural equation analysis suggest, for innovative consumers, the perception that a restaurant is likewise innovative results in increased perceptions of price fairness and positive postconsumption behavioral intention. Innovative customers, grateful to the restaurant for having their needs for novelty satisfied, were more likely to perceive prices as fair and were more likely to report positive behavioral intentions. The academic and managerial implications of these findings are considered.
GSK3β regulates gluconeogenic gene expression through HNF4α and FOXO1

Hepatic gluconeogenesis is important for the maintenance of blood glucose homeostasis under fasting condition. Hepatocyte nuclear factor 4α (HNF4α) and FOXO1 transcription factors have implicated in this process through transcriptional regulation of glucose-6-phosphatase (G6Pase) and phosphoenolpyruvate carboxykinase (PEPCK), which are rate-limiting enzymes in gluconeogenesis. In this study, we demonstrate that glycogen synthase kinase 3β (GSK3β) regulates the expression of gluconeogenic genes through HNF4α and FOXO1. Silencing of GSK3β leads to reduction in the expression of gluconeogenic genes, including G6Pase, PEPCK, and peroxisome proliferator-activated receptor γ coactivator-1α. We show that GSK3β directly binds to both HNF4α and FOXO1. Inhibition of GSK3 by SB-216763 abolishes HNF4α-mediated activation of G6Pase promoter. We also found that overexpression of GSK3β potentiates G6Pase promoter activation by FOXO1 in a manner dependent on its kinase activity. Treatment of SB-216763 diminishes FOXO1-mediated activation of G6Pase promoter. Taken together, these results reveal a previously unrecognized mechanism for the regulation of gluconeogenic gene expression.