Miracle-dz/UniFAR-FTUs huggingface dataset:
Pediatric Supratentorial Subdural Empyemas: A Retrospective Analysis of 65 Cases

Aim: Intracranial subdural empyemas (SDEs), the majority of which are supratentorial in location, are common neurosurgical emergencies in developing countries, especially in the pediatric age group. They result in significant morbidity and mortality despite improvements in neuroimaging, surgical techniques and antibiotic therapy. In the present study, we retrospectively analyze our experience with operated cases of intracranial supratentorial SDEs in the pediatric age group. Patients and Methods: 65 pediatric patients (age ≤18 years) with supratentorial SDEs were treated in our institute between January 1988 and May 2006, and the case records analyzed with respect to clinical, radiological, bacteriological and surgical complications and outcome data. Results: There was a slight male preponderance (55%), with mean age being 9.54 ± 6.43 years (range 3 months to 18 years). Otogenic source was the most common identifiable etiology, followed by postmeningitic and rhinogenic sources. The initial surgical intervention, burr holes (44 patients; 67.7%) and craniotomy (21 patients; 32.3%), varied with individual cases and surgeon preference. Initial craniotomy was associated with lesser repeat procedures, and slightly better clinical outcome. The majority (83.3%) of patients with significant residual requiring repeat surgery were found to have undergone burr hole evacuation initially. The mortality rate in the present series was 10.8%. Follow-up was available for 41 patients (70.7%) with an average follow-up of 10.4 months. 88% of patients showed good outcomes (Glasgow Outcome Scores of 4 or 5) at the latest follow-up. Conclusion: Pediatric supratentorial SDEs, although rapidly fatal if not identified promptly, can be effectively managed with early surgical drainage (preferably craniotomy), eradication of the source, and sensitive broad-spectrum antibiotics (i.v.) with good outcomes.
Acculturation and Expectations?

Abstract This article investigates different sources of generalised trust among ethnic Danes and non-Western immigrants together with the gap in trust levels across the two groups. New survey data from Denmark were utilised, and the variables included socioeconomic resources, interethnic contact, perceptions of institutional fairness, timespan in Denmark, national identification and language proficiency. The results showed that interethnic contact and institutional fairness matter less for immigrants than for Danes vis-à-vis trust and that these variables alone do not explain the trust gap. The results also showed that their interactions with ethnicity reduce the trust gap for respondents with little interethnic contact or negative perceptions of institutions. Share of lifespan spent in Denmark also correlated negatively with social trust for immigrants. The results are discussed as the reflection of dynamic acculturation and changing expectations rather than socialisation or distinctly personal experiences.
The effects of antiphospholipid antibodies obtained from women with SLE/APS and associated pregnancy loss on rat embryos and placental explants in culture

Recurrent fetal loss occurs in approximately 1% of women. Autoimmune causes have been suggested as a factor in some of these cases. High rates of intrauterine fetal growth retardation and increased incidence of prematurity is associated with systemic lupus erythematosus (SLE) and the antiphospholipid syndrome (APS). We found in previous studies that sera from SLE/APS patients when used as a culture medium for rat embryos were found to reduce embryonic growth and development, induce a high rate of embryonic anomalies and death and damage the yolk sac morphologicallyand functionally. In order to investigatethe direct effect of IgG purified from women with SLE/APS on the growth and viability of embryos, we cultured 11.5-day-old rat embryos in their yolk sacs in the presence of IgG purified from SLE/APS patients with recurrent pregnancy loss (RPL). The IgG affected directly the embryo and yolk sac, reducing their growth. The purified IgG positive for anticardiolipin/anti-DNA antibodies reduced yolk sac and embryonic growth more than sera negative for these antibodies but positive for antiphosphatydilserine and for antilaminin. Monoclonal antiphosphatydilserine reduced yolk sac growth but the embryos remained intact. Following the observed damage to the yolk sac we cultured human placental explants at 5.5-8 weeks of pregnancy in sera from SLE/APS patients for 96 hours and found that these sera reduced placental trophoblastic cell growth, reduced their proliferation rate and increased their rate of apoptosis. Successful treatment of the women resulted in a correction of the damage induced in the cultured rat embryos and in the cultured placental explants.
Scaffold Protein X11α Interacts with Kalirin-7 in Dendrites and Recruits It to Golgi Outposts*

Background: Kalirin-7 is a neuronal Rac1-GEF that regulates spine morphology. X11α is a PDZ scaffolding protein. Results: X11α binds kalirin-7 and modulates its localization to Golgi outposts, GEF activity, and spine morphology. Conclusion: X11α is a novel regulator of small GTPase signaling by recruitment to Golgi outposts. Significance: We identify a novel mechanism for regulation of neuronal GEF localization and function. Pyramidal neurons in the mammalian forebrain receive their synaptic inputs through their dendritic trees, and dendritic spines are the sites of most excitatory synapses. Dendritic spine structure is important for brain development and plasticity. Kalirin-7 is a guanine nucleotide-exchange factor for the small GTPase Rac1 and is a critical regulator of dendritic spine remodeling. The subcellular localization of kalirin-7 is thought to be important for regulating its function in neurons. A yeast two-hybrid screen has identified the adaptor protein X11α as an interacting partner of kalirin-7. Here, we show that kalirin-7 and X11α form a complex in the brain, and this interaction is mediated by the C terminus of kalirin-7. Kalirin-7 and X11α co-localize at excitatory synapses in cultured cortical neurons. Using time-lapse imaging of fluorescence recovery after photobleaching, we show that X11α is present in a mobile fraction of the postsynaptic density. X11α also localizes to Golgi outposts in dendrites, and its overexpression induces the removal of kalirin-7 from spines and accumulation of kalirin-7 in Golgi outposts. In addition, neurons overexpressing X11α displayed thinner spines. These data support a novel mechanism of regulation of kalirin-7 localization and function in dendrites, providing insight into signaling pathways underlying neuronal plasticity. Dissecting the molecular mechanisms of synaptic structural plasticity will improve our understanding of neuropsychiatric and neurodegenerative disorders, as kalirin-7 has been associated with schizophrenia and Alzheimer disease.
Laparoscopic Colorectal Surgery Is Associated With a Higher Intraoperative Complication Rate Than Open Surgery

Objectives:Laparoscopic colorectal resection is equivalent to open resection in a number of important areas. However, recent data have raised concern that intraoperative complications may be increased. We conducted a meta-analysis comparing intraoperative complication rates of laparoscopic and equivalent open colorectal resection. Data Sources:Cochrane Central Register of Controlled Trials, MEDLINE, and Embase databases were searched, as were relevant scientific meeting abstracts and reference lists of included articles. Review Methods:Randomized controlled trials (RCTs) evaluating laparoscopic versus open surgery for any colorectal indication were included. Exclusion criteria were: trials assessing hand-assisted resection, and trials that excluded conversions to open surgery. There were no restrictions on language. Data were entered on an intention-to-treat basis in prospectively designed tables with complications categorized per event as: total complications, haemorrhage, bowel injury, and solid organ injury. Corresponding authors were contacted if information was missing. The Cochrane Collaboration tool was used for assessing risk of bias, the PETO odds ratio method was used for meta-analysis. Results:Complete intraoperative complication data were obtained for 10 out of 30 included RCTs. Four thousand and fifty-five patients were analyzed; 2159 in the Laparoscopic Group and 1896 in the Open Group. There was a higher total intraoperative complication rate (OR 1.37, P = 0.010) and a higher rate of bowel injury in the Laparoscopic Group (OR 1.88, P = 0.020). There was no difference in the rate of intraoperative haemorrhage or solid organ injury. Conclusion:Laparoscopic colorectal resection is associated with a significantly higher intraoperative complication rate than equivalent open surgery.
Long-Term Bond Strength of Two Benzalkonium Chloride-Modified Adhesive Systems to Eroded Dentin

This study investigated the effect of benzalkonium chloride (BAC) modification of two adhesive systems on long-term bond strength to normal and artificially eroded dentin. A total of 128 extracted human molars were sectioned and the buccal and oral surfaces of each molar were ground until the dentin. One half was left untreated (normal dentin) while the other half underwent artificial erosion. Resin composite was bonded to the buccal or oral surface following treatment with Adper Scotchbond 1XT or OptiBond FL without or with 1% BAC incorporation. Shear bond strength (SBS) was measured after 24 h (100% humidity, 37°C) or 1 year (tap water, 37°C). SBS results were statistically analyzed (α = 0.05). SBS was significantly lower to artificially eroded dentin than to normal dentin (p < 0.001). Storage for 1 year had no effect on SBS to normal dentin but led to a significant decrease in SBS to artificially eroded dentin (p < 0.001). BAC incorporation decreased the 24 h SBS to normal dentin (p = 0.018), increased the 24 h SBS to eroded dentin (p = 0.001), and had no effect on the 1-year SBS for either substrate. Consequently, BAC incorporation did not improve bond durability.
Expanded Studies of the Pharmacokinetics and Clinical Effects of Multidose Sublingual Triazolam in Healthy Volunteers

Abstract Previous work described the pharmacokinetics and clinical effects of multidose sublingual triazolam (Halcion; Pharmacia & Upjohn Co, Kalamazoo, Mich). This laboratory study evaluated the hypothesis that incremental dosing of triazolam produces dose-dependent central nervous system depression that is profound and long lasting. Forty-nine healthy adults between the ages of 21 and 39 years, not receiving dental treatment, were randomly assigned to placebo (n = 12) or 1 of 3 triazolam groups (0.25-mg single dose, n = 12; 0.5 mg divided between 2 equal doses for 60 minutes, n = 12; or 0.75 mg divided among 3 doses for 90 minutes, n = 13). Plasma triazolam concentrations were determined. Bispectral index (BIS) and the Observer Assessment of Alertness/Sedation scale were used to assess sedation. Plasma triazolam concentrations increased with time in all subjects, with Tmax and Cmax both increasing dose dependently. Compared with placebo, all dosing paradigms produced dose-dependent BIS suppression and sedation. The single dose of 0.25 mg reached its peak BIS suppression at 90 (81 ± 7) minutes and sedation at 120 (3.6 ± 0.5) minutes and returned to baseline before 360 minutes. In contrast, incremental dosing of 0.5 and 0.75 mg produced profound and long-lasting BIS suppression and sedation that did not plateau until either 180 or 210 minutes as measured by the BIS index (67 ± 14 and 60 ± 16 at 0.5 and 0.75 mg, respectively) and 150 minutes as measured by the Observer Assessment of Alertness/Sedation scale (3.2 ± 1.0 and 2.7 ± 0.4 at 0.5 and 0.75 mg, respectively). These data more fully characterize the effects of incremental dosing with sublingual triazolam and provide additional insight for discharge safety recommendations.
Turbulent water coupling in shock wave lithotripsy

Previous studies have demonstrated that stone comminution decreases with increased pulse repetition frequency as a result of bubble proliferation in the cavitation field of a shock wave lithotripter (Pishchalnikov et al 2011 J. Acoust. Soc. Am. 130 EL87–93). If cavitation nuclei remain in the propagation path of successive lithotripter pulses, especially in the acoustic coupling cushion of the shock wave source, they will consume part of the incident wave energy, leading to reduced tensile pressure in the focal region and thus lower stone comminution efficiency. We introduce a method to remove cavitation nuclei from the coupling cushion between successive shock exposures using a jet of degassed water. As a result, pre-focal bubble nuclei lifetime quantified by B-mode ultrasound imaging was reduced from 7 to 0.3 s by a jet with an exit velocity of 62 cm s−1. Stone fragmentation (percent mass <2 mm) after 250 shocks delivered at 1 Hz was enhanced from 22 ± 6% to 33 ± 5% (p = 0.007) in water without interposing tissue mimicking materials. Stone fragmentation after 500 shocks delivered at 2 Hz was increased from 18 ± 6% to 28 ± 8% (p = 0.04) with an interposing tissue phantom of 8 cm thick. These results demonstrate the critical influence of cavitation bubbles in the coupling cushion on stone comminution and suggest a potential strategy to improve the efficacy of contemporary shock wave lithotripters.
Eurace Open: An agent-based multi-country model

The global economic and financial crises, whose genesis is often associated with the collapse of Lehman Brothers, had a pervasive impact on all the leading economies in the world. The place where it might have been more disruptive has been the European Union (EU), which revealed a structural fragility and inadequacy to tackle some of the main challenges ahead. In this paper we mainly focus on migration challenges, further integrations of a monetary union, spatial inequality, and sovereign debt crisis. To address the relevant issues, we use a multi-country model that is an extension of the Eurace agent-based model. We design a flexible modeling framework that can host many different countries. In this paper the model hosts four countries. It is designed as a monetary union of two countries with international labor market, international trade, and international financial market, and another two independent countries that are always identical to the union members and serve as control states. We found that when countries are identical it is always beneficial to join the union, however an excess of workers mobility can weaken the performance of the union and even create persistent inequality between countries. Moreover, the monetary policy of the union central bank can deteriorate if the difference between countries growth and in general it tends to overshoot the inflation target. When the two countries differ in productivity, the union on aggregate performs again better than the sum of the isolated countries counterparts. However, taking into account the welfare in both countries of the union, it is not always convenient to form the union. The performance of the union is strongly affected by the level of labor market frictions and the size of the productivity gap among countries. The real sovereign debt per capita in the union increases with low mobility frictions and high productivity gap. Stronger fiscal integration (fiscal transfers) reduces inequality between countries, allowing the low productivity country and, hence, the total union to sustain even with a higher mobility of workers.
Lewy body extracts from Parkinson disease brains trigger α‐synuclein pathology and neurodegeneration in mice and monkeys

Mounting evidence suggests that α‐synuclein, a major protein component of Lewy bodies (LB), may be responsible for initiating and spreading the pathological process in Parkinson disease (PD). Supporting this concept, intracerebral inoculation of synthetic recombinant α‐synuclein fibrils can trigger α‐synuclein pathology in mice. However, it remains uncertain whether the pathogenic effects of recombinant synthetic α‐synuclein may apply to PD‐linked pathological α‐synuclein and occur in species closer to humans.
Changes produced by external radiation in parameters influencing intestinal permeability and microparticle uptake in vitro

Purpose: To determine the interaction between X-irradiation and in vitro intestinal microparticle uptake through Caco-2 epithelial cells. Methods: Caco-2 cells were cultured on 3 μm porous membranes for 21 days, X-irradiated with 2 Gy or sham-irradiated, then incubated for 5 or 30 min and exposed apically for 30 min to 2 μm latex microparticles. Measurements included cell dimensions, from confocal microscope ‘optical slices’; transepithelial resistance (TER) for tight junction (TJ) permeability; particle aggregation; and particle numbers on (adsorbed), in (intraepithelial) and through (submembranous) the epithelium. Results: Irradiation alone reduced TJ permeability more than sham-treatment, more so 5 min than 30 min after treatment. Irradiated epithelia were more permeable to particles than the equivalent sham-irradiated or previously untreated (particle only) groups: the latter two were similar. Irradiation altered adsorbed particle numbers and increased submembranous counts: particle uptake correlated best with cell height. Conclusions: 2 Gy X-irradiation increased particle uptake and translocation through the epithelium. This correlated well with the TJ opening seen after particle exposure in irradiated samples and changes in cell morphology. New data on cell dimensions underlined the similarity in particle uptake between this in vitro epithelium and that in an in vivo model, highlighting the translational significance of the work.
Critical illness polyneuropathy and myopathy in patients with acute respiratory distress syndrome*

Objective:Critical illness polyneuropathy/myopathy (CIP/CIM) is frequently described in critically ill patients who survive severe sepsis. Clinically relevant paresis is major symptom of CIP/CIM. We aimed at determining risk factors and diagnostic value of electrophysiologic testing for CIP/CIM in patients with acute respiratory distress syndrome (ARDS). Design:Single-center, retrospective analysis, using charts. Setting:University medical center. Patients:Fifty consecutive ARDS patients in our intensive care unit. Interventions:Patient characteristics and clinical course were analyzed. All patients received early electrophysiologic testing. CIP/CIM was diagnosed by the presence of clinical relevant paresis. Measurements and Main Results:Clinically relevant paresis was confirmed in 27 ARDS patients (60%), whereas in 18 patients no paresis was determined (controls); five patients died before clinical assessment of paresis was feasible. Patients with paresis were older, had more days on mechanical ventilation, and had increased intensive care unit length of stay compared with controls. Patients who developed paresis had elevated daily peak blood glucose levels during 28 days of intensive care unit treatment: 166 (134, 200) mg/dL in CIP/CIM patients vs. 144 (132, 161) mg/dL in controls (median, quartiles). Twenty-five of 27 patients with paresis revealed reduced motor unit potentials, fibrillation potentials, or positive sharp waves on early electrophysiologic testing indicating CIP/CIM, whereas 16 of 18 control patients did not. Conclusions:In ARDS patients, paresis is a frequent complication causing prolonged mechanical ventilation and intensive care unit length of stay. An association between hyperglycemia and CIP/CIM has been found. However, since this is a retrospective survey, a causal relation is not clearly supported. In this study, the use of early electrophysiologic testing in ARDS patients was a valuable diagnostic tool for detecting CIP/CIM.
Predictors of Chronic Pelvic Pain in an Urban Population of Women With Symptoms and Signs of Pelvic Inflammatory Disease

Objective: The objective of this study was to assess the risk profile for chronic pelvic pain (CPP) after pelvic inflammatory disease (PID). Study: Multivariate logistic regression was used to assess risk factors for CPP in a longitudinal study of 780 predominately black, urban women with clinically suspected PID: complaints of acute pain (<30 days); a clinical finding of pelvic tenderness; and leukorrhea, mucopurulent cervicitis, or untreated gonococcal or chlamydial cervicitis. CPP was defined as pain reported at ≥2 consecutive interviews conducted every 3 to 4 months for 2 to 5 years. Results: Nonblack race (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.31–3.58), being married (OR, 2.06; 95% CI, 1.02–4.18), a low SF-36 mental health composite score (OR, 2.71; 95% CI, 1.69–4.34), ≥2 prior PID episodes (OR, 2.84; 95% CI, 1.07–7.54), and smoking (OR, 1.65; 95% CI, 1.01–2.71) independently predicted CPP. Histologic endometritis or evidence of endometrial Neisseria gonorrhoeae or Chlamydia trachomatis infection was negatively associated with CPP (OR, 0.69; 95% CI, 0.44–1.10). Conclusions: A range of demographic, clinical, historical, and behavioral factors predict CPP after PID.
Prevention of N-Methyl-N-Nitrosourea–Induced Breast Cancer by α-Fetoprotein (AFP)–Derived Peptide, a Peptide Derived from the Active Site of AFP

Purpose: α-Fetoprotein (AFP) is a protein of pregnancy associated with a decrease in lifetime risk of breast cancer in parous women. A synthetic, cyclic nonapeptide has been developed that mimics the antioncogenic active site of AFP. To test the hypothesis that the AFP-derived peptide (AFPep) can prevent breast cancer, the N-methyl-N-nitrosourea–induced breast cancer model was used in rats. Experimental Design: AFPep was given daily by injection beginning 10 days after N-methyl-N-nitrosourea treatment and continued for 23 days (a time designed to mimic pregnancy) or for other times to assess efficacy as a function of drug duration. Tumor incidence, multiplicity, and latency were noted as end points. At necropsy, pathology analysis of tumors and major organs were obtained. Results: AFPep prevented cancer in a dose-dependent fashion. Significantly longer mean tumor-free days (P < 0.02), lower tumor incidence (P = 0.004), and lower tumor multiplicity were observed for AFPep-treated groups. No evidence of host toxicity as measured by body weight, cage activity, fur texture, and organ weights (liver, uterus, heart, kidney, and spleen) were found in animals treated with AFPep. Mechanistic studies using transplantable human breast cancer xenografts showed that the peptide interfered with estrogen-dependent breast cancer growth inhibited the phosphorylation of the estrogen receptor and activated phosphorylation of p53. Conclusions: AFPep is a well-tolerated, mechanistically novel, chemopreventive agent in models of breast cancer and warrants further development for the prevention and treatment of this disease in humans.