Miracle-dz/UniFAR-FTUs huggingface dataset:
Premedication before elective breast surgery, a comparison between ketobemidone and midazolam

One hundred female patients scheduled for elective breast surgery (mean age 60 ± 11 years) were randomly assigned to receive one of two premedications: ketobemidone (Ketogan®) 1‐1.5 ml or midazolam 4–5 mg, intramuscularly. The effects on preoperative anxiety and postoperative emetic sequelae were studied. All patients were anaesthetised with thiopentone, fentanyl and atracurium, and ventilated with a mixture of nitrous oxide in oxygen with supplementary isoflurane. Sixty‐nine percent of the midazolam‐ and 50% of the ketobemidone‐premedicated patients experienced a reduction in anxiety. Midazolam was found to be more effective than ketobemidone in reducing anxiety among more tense patients ‐ those with a VAS grading before premedication of 2 or more (P<0.05). Midazolam‐premedicated patients were also assessed by observers as being more relaxed (P<0.05). No difference was seen in the frequency of emetic sequelae: 20 patients in the midazolam group and 14 patients in the ketobemidone group vomited once or more during the 24‐h observation period. There was no difference between the two groups in time until an analgetic was required. In conclusion, midazolam seemed more effective in reducing preoperative anxiety than ketobemidone without any negative effects on postoperative emesis or time until an analgetic was required.
The use of rapid parathyroid hormone assay in predicting postoperative hypocalcemia after total or completion thyroidectomy.

PURPOSE To evaluate the rapid parathyroid hormone assay (rPTH) as a perioperative tool in predicting postoperative symptomatic hypocalcemia following thyroidectomy. METHODS We conducted a prospective study of 69 patients undergoing total or completion thyroidectomy. Rapid PTH levels were obtained preoperatively, intraoperatively, and postoperatively upon arrival in the postanesthesia care unit (PACU). All patients were closely monitored postoperatively for the development of symptomatic or asymptomatic hypocalcemia. RESULTS Of 60 patients (25%) undergoing thyroidectomy, 15 developed hypocalcemia, 7 (11.7%) were symptomatic, and 8 (13.3%) asymptomatic. An intraoperative rPTH level less than 12 pg/mL was 71% sensitive and 95% specific for predicting postoperative symptomatic hypocalcemia, whereas a PACU rPTH level less than 12 pg/mL was 100% sensitive and 92% specific. A greater than 75% decline in preoperative rPTH level when measured intraoperatively was 71% sensitive and 86% specific, whereas a greater than 75% decline in rPTH level in the PACU was 100% sensitive and 88% specific for predicting symptomatic hypocalcemia. CONCLUSIONS The rPTH assay is a highly accurate and effective tool for predicting symptomatic hypocalcemia immediately after thyroidectomy. Routine utilization of this assay is recommended, because it will allow safe and timely discharge of normocalcemic patients and the early identification of patients requiring treatment of postthyroidectomy hypocalcemia.
Unsedated ultrathin upper endoscopy is better than conventional endoscopy in routine outpatient gastroenterology practice: a randomized trial.

AIM to compare the feasibility and patients' tolerance of esophagogastroduodenoscopy (EGD) using a thin endoscope with those of conventional oral EGD and to determine the optimal route of introduction of small-caliber endoscopes. METHODS One hundred and sixty outpatients referred for diagnostic EGD were randomly allocated to 3 groups: conventional (C)-EGD (9.8 mm in diameter), transnasal (TN)-EGD and transoral (TO)-EGD (5.9 mm in diameter). Pre-EGD anxiety was measured using a 100-mm visual analogue scale (VAS). After EGD, patients and endoscopists completed a questionnaire on the pain, nausea, choking, overall discomfort, and quality of the examination either using VAS or answering some questions. The duration of EGD was timed. Blood oxygen saturation (SaO2) and heart rate (HR) were monitored during EGD. RESULTS Twenty-one patients refused to participate in the study. The 3 groups were well-matched for age, gender, experience with EGD, and anxiety. EGD was completed in 91.1% (41/45), 97.5% (40/41), and 96.2% (51/53) of cases in TN-EGD, TO-EGD, and C-EGD groups, respectively. TN-EGD lasted longer (3.11 +/- 1.60 min) than TO-EGD (2.25 +/- 1.45 min) and C-EGD (2.49 +/- 1.64 min) (P<0.05). The overall tolerance was higher (P<0.05) and the overall discomfort was lower (P<0.05) in TN-EGD group than in C-EGD group. EGD was tolerated "better than expected" in 73.2% of patients in TN-EGD group and 55% and 39.2% of patients in TO-EGD and C-EGD groups, respectively (P<0.05). Endoscopy was tolerated "worst than expected" in 4.9% of patients in TN-EGD group and 17.5% and 23.5% of patients in TO-EGD and C-EGD groups, respectively (P<0.05). TN-EGD caused mild epistaxis in one case. The ability to insufflate air, wash the lens, and suction of the thin endoscope were lower than those of conventional instrument (P<0.001). All biopsies performed were adequate for histological assessment. CONCLUSION Diagnostic TN-EGD is better tolerated than C-EGD. Narrow-diameter endoscope has a level of diagnostic accuracy comparable to that of conventional gastroscope, even though some technical characteristics of these instruments should be improved. Transnasal EGD with narrow-diameter endoscope should be proposed to all patients undergoing diagnostic EGD.
Medical exposures in youth and the frequency of narcolepsy with cataplexy: a population‐based case–control study in genetically predisposed people

Epidemiological observations suggest that exposures in youth may trigger narcolepsy in genetically predisposed individuals. In this population‐based case–control study, we sought to identify all prevalent cases of narcolepsy with cataplexy aged 18–50 years as of 1 July 2001, in King County, Washington. The 45 eligible cases who were DQB1*0602‐positive were compared with 95 controls with this allele, identified through random‐digit dialing and buccal smears. Cases and controls were interviewed in person about physician‐diagnosed infectious and non‐infectious illnesses, immunizations, head trauma and parasomnias or psychiatric problems during youth. Narcolepsy with cataplexy was more frequent in African‐Americans and in poorer households. Adjusting for these factors, the condition was 5.4‐fold more common [95% confidence interval (CI) = 1.5–19.1] among people reporting a physician‐diagnosed strep throat before the age of 21 years. No other significant associations with childhood diseases, immunizations or head trauma were found. However, prevalence was increased 16.3‐fold (95% CI = 6.1–44.1) in subjects who reported having had ‘night terrors’. Strep throat may be related to narcolepsy with cataplexy in genetically susceptible individuals. The association with night terrors could simply reflect early symptoms of narcolepsy, or they could be a prodromal sign of disturbed sleep physiology.
Polyploidy enhances the occupation of heterogeneous environments through hydraulic related trade-offs in Atriplex canescens (Chenopodiaceae).

Plant hydraulic characteristics were studied in diploid, tetraploid and hexaploid cytotypes of Atriplex canescens (Chenopodiaceae) to investigate the potential physiological basis underlying the intraspecific habitat differentiation among plants of different ploidy levels. Populations of A. canescens from different habitats of the Chihuahuan Desert (New Mexico, USA) were analyzed using flow cytometry to determine ploidy levels. Traits related to xylem water transport efficiency and safety against drought-induced hydraulic failure were measured in both stems and leaves. At the stem level, cytotypes of higher ploidy showed consistently lower leaf-specific hydraulic conductivity but greater resistance to drought-induced loss of hydraulic conductivity. At the leaf level, comparisons in hydraulics between cytotypes did not show a consistent pattern, but exhibited high plasticity to proximal environmental conditions related to soil water availability. The results suggest that a trade-off between stem hydraulic efficiency and safety across ploidy levels underlies niche differentiation among different cytotypes of A. canescens. Polyploidization may have been facilitated by environmental heterogeneity related to water availability, and variation in water-related physiology found in the present study suggests an important functional basis for the niche differentiation and coexistence of A. canescens cytotypes in desert environments.
Pandemic H1N12009 influenza and HIV: a review of natural history, management and vaccine immunogenicity

Purpose of review The 2009 pandemic HIN1 influenza strain (H1N12009) produced more severe disease and increased risk for mortality. As an at-risk population for more severe influenza illness, particular concern regarding HIV patients triggered a focused effort to evaluate disease burden and vaccine efficacy in these populations. Recent findings As with other immune-compromised individuals, most HIV-infected individuals recovered without major consequence. Although HIV infection was assumed to be a risk factor for more severe disease and death, the published literature does not indicate this to be so. Neuraminadase inhibitors were well tolerated by this population and there was no evidence of clinically significant pharmacokinetic interactions with antiretroviral therapy. Immunogenicity was increased with H1N12009 vaccine compared to the historical results of nonpandemic vaccines and optimized by the use of adjuvants. Booster dosing was also of benefit. H1N12009 vaccine was generally well tolerated without evidence of detrimental effect on HIV status. Summary The worse case scenario was not realized for H1N12009 in the general population or in those with HIV. Immunization with adjuvant represents a key measure to protect this population from H1N12009 and other future novel influenza strains.
Computation of negative corona inception field strength in the coaxial cylindrical electrode arrangement under variable air density

Corona discharge has attracted much interest among researchers as it has a lot of applications in industry and a number of effects on power systems. In the coaxial cylindrical electrode arrangement in air, simulating many practical applications, corona inception depends on the electric field strength around the inner conductor and on atmospheric conditions. In the present study a computational method for the estimation of the negative corona inception field strength in the coaxial cylindrical electrode arrangement under variable air density is presented. The method is based on streamer theory, involves Hartmann's expression for the effective ionization coefficient and considers the effect of the space charge field on avalanche growth. The computed negative corona inception field strength is in good agreement with literature experimental data for an avalanche number varying with the product of relative air density and inner conductor radius. Streamer formation occurs rather through a multi-avalanche process, assisted by subsidiary avalanches owing to secondary ionization processes at the cathode and in air. Peek's empirical formula for estimating corona inception field strength in the coaxial cylindrical electrode arrangement in air agrees satisfactorily with literature experimental data referring to negative corona inception.
[Quantitative measurement of axial rigidity, functional status and health-related quality of life in patients with Parkinson's disease].

INTRODUCTION Rigidity is a cardinal symptom of Parkinson's disease (PD). Clinically, rigidity is usually assessed by passively flexing and extending a patient's limb. Few studies have assessed rigidity in trunk muscles in PD patients. AIMS To develop an objective measurement to quantify trunk rigidity in PD patients, and to examine its relationship with disease severity using the Hoehn and Yahr staging score (HY) and the Unified Parkinson's Disease Rating Scale III (UPDRS-III), disease duration, functional status with the Schwab & England activities of daily living scale and health related quality of life (HRQoL) was assessed with the European Quality of Life-5 Dimensions and Parkinson's Disease Questionnaire-39 items (PDQ-39). PATIENTS AND METHODS An isokinetic dynamometer Biodex System 3 was employed to assess trunk rigidity in 36 PD patients. Passive trunk flexion and extension at 3 angular velocities, 30 degrees/s, 45 degrees/s and 60 degrees /s were applied and resistive torques were recorded as trunk flexor and extensors rigidity. RESULTS Significant correlations between trunk flexors-extensors tone and HY staging score, UPDRS-III, disease duration and functional status at 30 degrees/s, 45 degrees/s and 60 degrees/s were obtained. Trunk rigidity was correlated with the HRQoL assessed with the PDQ-39. CONCLUSIONS Our results suggest that the 30 degrees/s, 45 degrees/s and 60 degrees/s angular velocities of this objective method was valid to assess trunk rigidity and was correlated with disease severity, disease duration, functional status and HRQoL in PD patients.
Investigation of the maternal and cord plasma levels of IL-1 beta, TNF-alpha and VEGF in early membrane rupture

Abstract Objective: Recent studies indicate a relationship between early membrane rupture (EMR) and proinflammatory cytokines like tumor necrosis factor (TNF) and interleukin (IL) and angiogenic factors like vascular endothelial growth factor (VEGF). In this study, we aimed to investigate the relationship between EMR and maternal and cord blood plasma levels of TNF-alpha, IL-1 beta and VEGF. Methods: This prospective, cross-sectional study was conducted with 85 pregnant women. The patients were divided into four groups as Group I (term EMR group, n = 21), Group II (preterm EMR group, n = 23), Group III (preterm non-EMR group, n = 19) and Group IV (term non-EMR group, n = 22). Plasma levels were assayed with ELISA method. Results: IL-1 beta levels were significantly lower, but TNF-alpha levels were significantly higher in maternal and cord plasma of EMR participants compared to non-EMR participants. There was no significant difference for VEGF levels. Cord plasma TNF-alpha levels were significantly higher than maternal plasma levels in EMR participants and cord plasma. VEGF levels were significantly higher than maternal levels in all participants. Conclusions: Higher TNF-alpha levels in our EMR participants indicate an inflammatory process during EMR. Higher cord plasma VEGF levels may point out placental or fetal production. Further studies conducted with expanded populations are needed to discuss our results.
A Legionella pneumophila-translocated substrate that is required for growth within macrophages and protection from host cell death

Legionella pneumophila requires the Dot/Icm protein translocation system to replicate within host cells as a critical component of Legionnaire's pneumonia. None of the known individual substrates of the translocator have been shown to be essential for intracellular replication. We demonstrate here that mutants lacking the Dot/Icm substrate SdhA were severely impaired for intracellular growth within mouse bone marrow macrophages, with the defect absolute in triple mutants lacking sdhA and its two paralogs. The defect caused by the absence of the sdhA family was less severe during growth within Dictyostelium discoideum amoebae, indicating that the requirement for SdhA shows cell-type specificity. Macrophages harboring the L. pneumophila sdhA mutant showed increased nuclear degradation, mitochondrial disruption, membrane permeability, and caspase activation, indicating a role for SdhA in preventing host cell death. Defective intracellular growth of the sdhA− mutant could be partially suppressed by the action of caspase inhibitors, but caspase-independent cell death pathways eventually aborted replication of the mutant.
Clinical significance of multidrug resistance and P‐glycoprotein expression in patients with gastric carcinoma

Twenty‐four fresh tumors of gastric carcinoma were assessed by flow cytometric detection of P‐glycoprotein (P‐gp) using monoclonal antibody C219. Eight patients were P‐gp positive. Differentiated gastric carcinomas contained significantly higher concentrations of P‐gp positive. Incidence of P‐gp positive was high in advanced stage. In 16 cases estimated chemosensitivity was test assessed by thymidine incorporation assay (TIA). Seven of nine multidrug‐resistant cases according to TIA were P‐gp positive and all of seven nonmultidrug resistant cases were P‐gp negative. Expression of P‐gp and multidrug resistance were closely correlated (P < 0.01). Also, in 89 patients with operable gastric carcinoma, the relation between in vitro chemosensitivity test (TIA) and their clinicopathologic features as well as their survival lengths were studied. Thirty‐one of 89 specimens from gastric carcinoma patients were multidrug resistant according to TIA. Patients in the multidrug‐resistant group had a significantly poorer cumulative survival rate than those who were not multidrug resistant (P < .05). The multivariate analysis showed that multidrug resistance is a useful indicator of prognosis (P < 0.1). We suggest that multidrug‐resistant cases or P‐gp‐positive cases of gastric carcinoma are highly malignant, and these determinations are clinically useful. © 1995 Wiley‐Liss, Inc.
Ecological evidence that affect and perceptions of drink effects depend on alcohol expectancies.

AIMS (1) To compare affective changes over drinking and non-drinking days among frequent drinkers and (2) to evaluate whether drinkers' expectations influence affective changes and perceived pleasure and relief from drinking. DESIGN Observational study involving ecological momentary assessments collected via electronic diaries during the course of 3 weeks. SETTING Drinkers' usual settings in Columbia, MO, USA. PARTICIPANTS A total of 400 adult, frequent drinkers, aged 18-70 years. MEASUREMENTS Ecological assessments included morning reports, pre-drinking random prompts, user-initiated first-drink reports and device-prompted follow-ups over drinking episodes. Participants rated positive (enthusiastic, excited, happy) and negative (distressed, sad) affect and perceived pleasure and relief from drinking in real time. A self-report questionnaire completed at baseline evaluated expectancies for enhanced sociability and tension reduction from drinking. FINDINGS Relative to affective changes over non-drinking days, positive affect increased prior to drinking [95% confidence interval (CI) = 0.004, 0.023], and at first drink (95% CI = 0.238, 0.317), whereas negative affect decreased prior to drinking (95% CI = - 0.007, 0.000) and at first drink (95% CI = - 0.154, - 0.098). Sociability expectancies augmented increases in positive affect prior to drinking (95% CI = 0.009, 0.027) and at first drink (95% CI = 0.017, 0.169). Sociability expectancies also enhanced perceived pleasure from first drinks (95% CI = 0.046, 0.318). Tension-reduction expectancies attenuated decreases in negative affect at first drink (95% CI = - 0.133, - 0.029), but augmented perceived relief from first drinks (95% CI = 0.001, 0.304). CONCLUSIONS Although theoretical models tend to focus on negative affective outcomes of drinking, changes in positive affect prior to drinking and early in drinking episodes are important for maintaining drinking behavior. Frequent drinkers' expectations for enhanced sociability or tension reduction from drinking influence their affective experiences over drinking days and perceptions of pleasure and relief from drinking.
Verification of Synchronous Machine Modeling in Stability Studies: Comparative Tests of Digital and Physical Scale Model Power System Simulations

The adequacy of digital models of synchronous machines in conventional transient stability programs has been of continuing interest and concern to engineers involved in system planning and operating studies. To verify the adequacy of such models a comparative test approach is taken by running a series of tests on the AEP Transient Stability Program and on the MIT Physical Scale Model facility which closely approximates actual system dynamic performance characteristics. The paper summarizes the results of these studies and shows good correlation between the two simulations. Also, the results confirm the findings of others that existing models and associated parameters may need to be improved for certain types of dynamic performance studies and operating conditions.
Novel Technique for Repair of Severed Peripheral Nerves in Rats Using Polyurea Crosslinked Silica Aerogel Scaffold

ABSTRACT Purpose/Aim: To design, synthesize, and test in vivo an aerogel-based top-open peripheral nerve scaffold to simultaneously support and guide multiple completely severed peripheral nerves in a rat model. Also, to explore options for immobilizing severed nerves on the aerogel material without the use of sutures resulting in reduced surgical time. Materials and Method: A novel material and approach was developed for the reattachment of severed peripheral nerves. Nerve confinement and alignment in this case relies on the surface properties of a lightweight, highly porous, polyurea crosslinked silica aerogel scaffold. The distal and proximal ends of completely transected nerve terminals were positioned inside prefabricated “top-open” corrugated channels that cradled approximately two thirds of the circumference of the nerve trunk and connectivity of the severed nerves was evaluated using sciatic function index (SFI) technique for five months post-surgery on 10 female Sprague–Dawley rats then compared with the gold standard for peripheral nerve repair. The interaction of nerves with the surface of the scaffold was investigated also. Results and Conclusion: Multichannel aerogel-based nerve support scaffold showed similar SFI recovery trend as the case suture repair technique. Usage of an adhesion-promoting coating reduced the friction between the nerve and the scaffold leading to slippage and lack of attachment between nerve and surface. The aerogel scaffold used in this study did not collapse under pressure during the incubation period and allowed for a rapid and non-invasive peripheral nerve repair approach without the demands of microsurgery on both time and surgical expertise. This technique may allow for simultaneous repair and reconnection of multiple severed nerves particularly relevant to nerve branching sites.
Preventing pregnancy: a girls' issue. Seventeen-year-old Swedish boys' perceptions on abortion, reproduction and use of contraception

Objective To gain deeper understanding of how teenage males view abortion, adolescent fatherhood, sexual behavior, and use of contraception. Method We conducted six focus-group interviews with 17-year-old boys (n = 40). The interviews were tape-recorded, transcribed verbatim, and analyzed using manifest content analysis. Results Adolescent fatherhood was considered to be a catastrophe and abortion a moral dilemma. Most participants agreed that the unrestricted right to decide on abortion rests upon the girl, but some were frustrated by not having any legal right to influence the decision. Contraceptive failure was viewed as common and mainly due to the influence of alcohol or in relation to unplanned sex. Boys perceived girls as having a greater responsibility in avoiding pregnancy, and they often put a blind trust in the girls' use of hormonal contraceptives or initiation of emergency contraception. Several groups had insufficient knowledge about fetal development and other aspects of reproduction. Many were unsatisfied with the sex education they had received at school, but still considered it to be an important counterweight to other sources of information concerning sex, such as pornography. Conclusion Equal responsibility among boys and girls regarding reproductive issues is still a challenge, but nevertheless an important key to the prevention of unwanted pregnancies.