Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of prognosis in patients with respiratory failure requiring venovenous extracorporeal membrane oxygenation (ECMO).

PURPOSE In this study, we analyzed the respiratory status and the prognosis of patients, including adults with acute respiratory failure requiring venovenous extracorporeal membrane oxygenation (VV ECMO) to maintain respiratory status. We then evaluated the differences between patients who could be removed from VV ECMO and those who could not. PATIENTS AND METHODS From January 2003 to December 2008, eleven patients in our hospital required VV ECMO for severe acute respiratory failure. All 11 had severe acute respiratory distress syndrome. The age of the patients was 52 ± 24 (range; 8-86) years, and the male/female ratio was 8/3. The acute physiology and chronic health evaluation II (APACHE II) score, ECMO flow, and respiratory parameters, such as PaO2/FiO2 (P/F ratio), pulmonary compliance, and Lung Injury Score (LIS) before and after the introduction of ECMO, were compared among patients in whom ECMO could or could not be removed. RESULTS ECMO could be removed from six patients (55%, group A), but in five (45%, group B) could not. The duration of ECMO support was significantly shorter in group A than in group B (111 ± 68 hr vs. 380 ± 233 hr, p = 0.011). The pre-ECMO ventilator time was shorter in group A than in group B. Significant differences were found between the two groups in the P/F ratio and LIS from pre-ECMO introduction to 72 hours after. ECMO flow in group A could be weaned for 48 hours after introduction, significantly different compared with group B. CONCLUSION The early introduction of ECMO may be desirable if the causes of respiratory failure are recoverable. It is presumed that VV ECMO removal will be difficult if the ECMO flow cannot be weaned within 48 hours after ECMO introduction in patients with severe respiratory failure.
Possible Garcinia cambogia-Induced Mania With Psychosis: A Case Report

Garcinia cambogia is a Southeast Asian fruit becoming increasingly popular as a weight management supplement. Hydroxycitric acid (HCA) is the primary active ingredient which demonstrates serotonergic- and muscarinic-enhancing properties via inhibition of selective serotonin reuptake and acetylcholinesterase. We report a young adult female with no history of bipolar disorder who developed mania and psychosis approximately 1 week following initiation of G cambogia and the Cleanse and Detox™ dietary supplement manufactured by Apex Vitality Health. She presented with a predominantly expansive mood, psychomotor agitation, disorganized and pressured speech, flight of ideas, grandiosity, delusions, and auditory hallucinations. Following discontinuation of G cambogia and the initiation of lithium and quetiapine, the patient experienced rapid and progressive mood stabilization and was discharged after 8 days. Seven previous case reports associating (hypo)mania and/or psychosis with G cambogia consumption have been published. The chronology of mania and/or psychosis onset may appear between 1 and 8 weeks following initiation of G cambogia. Psychiatric symptoms have resolved with G cambogia discontinuation in some instances and may not require chronic pharmacotherapy. Our report should encourage further research and case reports regarding this adverse event and the reconciliation of complete herbal supplement use at clinic visits and hospital admissions.
A high proportion of Vibrio cholerae strains isolated from children with diarrhoea in Bangkok, Thailand are multiple antibiotic resistant and belong to heterogenous non-O1, non-O139 O-serotypes

Results of a surveillance on cholera conducted with patients seen at the Children Hospital in Bangkok, Thailand from August 1993 to July 1995 are presented. Annually, isolation rates for Vibrio cholerae varied between 1·7 and 4·4% of patients with diarrhoea. V. cholerae O1 serotype Ogawa accounted for between 31 and 47% of patients cultured positive for V. cholerae, whereas the O139 serotype dominated in early 1994 after which it disappeared. Non-O1, non-O139 strains were isolated at similar rates as serotype O1 in 1993 and 1994, but accounted for 69% of V. cholerae culture positive specimens in 1995. However, the annual proportion of the isolation of non-O1, non-O139 strains showed little variation and remained low between 1·0 and 1·3%. Serotyping of 69 epidemiological unrelated non-O1, non-O139 strains produced 37 different O-serotypes. BglI ribotyping of serotypes containing more than two strains demonstrated a high degree of heterogeneity within and between serotypes, except seven serotype O37 strains which showed an identical ribotype suggesting clonality. None of the 69 strains hybridized with a cholera toxin probe and only two strains hybridized with a heat-stable enterotoxin probe. Susceptibility testing to 12 antibiotics showed that 40 of 69 (58%) non-O1, non-O139 strains were resistant to colistin, streptomycin and sulphisoxazole and 28 of 69 (41%) were multiple antibiotic resistant (MAR; [ges ]4 antibiotics). Although 26 of 69 (38%) strains contained one or more plasmids, the plasmids were of low molecular weights and did not seem to encode antibiotic resistance. The results of the present study showed that a high proportion of heterogenous MAR V. cholerae non-O1, non-O139 strains were isolated from children at the hospital. With reference to the emergence of V. cholerae O139 in 1992, we suggest that non-O1, non-O139 strains should be monitored carefully to detect new serotypes with a possible epidemic potential, but also to determine the development and mechanism of antibiotic resistance.
Mechanisms of Reinforcement Learning and Decision Making in the Primate Dorsolateral Prefrontal Cortex

Abstract: To a first approximation, decision making is a process of optimization in which the decision maker tries to maximize the desirability of the outcomes resulting from chosen actions. Estimates of desirability are referred to as utilities or value functions, and they must be continually revised through experience according to the discrepancies between the predicted and obtained rewards. Reinforcement learning theory prescribes various algorithms for updating value functions and can parsimoniously account for the results of numerous behavioral, neurophysiological, and imaging studies in humans and other primates. In this article, we first discuss relative merits of various decision‐making tasks used in neurophysiological studies of decision making in nonhuman primates. We then focus on how reinforcement learning theory can shed new light on the function of the primate dorsolateral prefrontal cortex. Similar to the findings from other brain areas, such as cingulate cortex and basal ganglia, activity in the dorsolateral prefrontal cortex often signals the value of expected reward and actual outcome. Thus, the dorsolateral prefrontal cortex is likely to be a part of the broader network involved in adaptive decision making. In addition, reward‐related activity in the dorsolateral prefrontal cortex is influenced by the animal's choices and other contextual information, and therefore may provide a neural substrate by which the animals can flexibly modify their decision‐making strategies according to the demands of specific tasks.
Gender differences in Working Capital Management amongst Small Business Owners in Uganda

The purpose of this study is to examine gender differences on the effect of individual attributes on working capital management amongst small business owners. Based on a sample of 360 owner-managers of small businesses in the central business district of Kampala, the results show as follows. There are significant gender differences in perceived usefulness and attitude. Secondly, males and females do not statistically differ in terms of impulsivity. Thirdly, perceived usefulness significantly influences working capital management for females but not males. Fourthly, attitude significantly influences working capital management for males but not females. Lastly, the effect of impulsivity on working capital management is stronger for females than males. However, paucity of studies on the input perspective of working capital management limited crossvalidation of the findings with previous research. Future studies should be conducted to confirm the results. At policy level, understanding gender differences on the effect of the identified driving forces should be of interest to practitioners and policy makers in their effort to enhance small business management through developing appropriate gendered policies. This study contributes to the dearth of evidence of working capital management literature by investigating the effect of individual attributes as opposed to the conventional financial ratios.
Intimate Partner Violence: Variations in Perpetrators and Treatment Allocation

The division of batterers into subtypes is hardly ever used, neither to describe the type of perpetrator nor to indicate in the clinical decision-making process what treatment should be offered. In this study, a sample of male perpetrators of intimate partner violence (IPV) who had been advised to seek treatment at a community-based Dutch forensic psychiatric facility (N = 110), either voluntarily or mandatorily, have been divided into four subtypes based on a model reported by Holtzworth-Munroe and Stuart (1994). The four subtypes are Family-Only (FO), Borderline-Dysphoric (BD), Generally Violent Antisocial (GVA), and Low-Level Antisocial (LLA). The aim of the study was to identify the subtypes and to compare the different groups on descriptive dimensions and treatment allocation. In the first part of the study, aside from identifying the batterer subtypes, important differences between the subtypes were encountered in the nature of the violence (structural vs. incidental). The characteristics of the BD subtype were found to be similar to the model except for the psychopathological dimension. Differences in allocation of treatment types between batterer subtypes were not substantial raising questions about the correspondence between typological subtypes and the judgment of clinicians. These results do suggest that more attention should be paid to the heterogeneity of the batterer population, which could improve treatment and advance our understanding of IPV.
Sex-Biased miRNA Expression in Atlantic Halibut (Hippoglossus hippoglossus) Brain and Gonads

The role of miRNA in fish sexual development is not elucidated yet. We profiled miRNAs in gonads and brains of Atlantic halibut using SOLiD sequencing technology. We found tissue- and sexually dimorphic expression of several miRNAs, including miR-29a, miR-34, miR-143, miR-145, miR-202-3p, miR-451, and miR-2188. miR-9 and miR-202 were abundant in brain and gonads, respectively. In the next step, we selected some miRNAs showing differential expression patterns between sexes and performed RT-qPCR on 3 age groups: juveniles, 3-year-, and 5-year-olds. In brains, miR-451 was significantly down-regulated in juveniles compared to adults. let-7a, miR-143, and miR-202-3p were up-regulated in gonads of mature males compared to immature females at the same age. We investigated the effect of suppressing aromatase cytochrome P450 enzyme on miRNA expression at the onset of sex differentiation through masculinization with Fadrozole or 17-α-methyltestosterone. We found significant differences in miRNA expression between masculinized individuals and untreated controls. miR-202-3p was significantly down-regulated in female juveniles compared to male juveniles. The expression levels of let-7a and miR-451 were restored after termination of the masculinization treatment. Our data give a first insight into miRNA involvement in sexual development in teleosts.
Histopathological Changes of Inner Retina, Optic Disc, and Optic Nerve in Rabbit with Advanced Retinitis Pigmentosa

ABSTRACT We observed the histopathological changes of retinal ganglion cells (RGCs), optic disc, and optic nerve in rabbit with advanced retinitis pigmentosa (RP). Wild-type (WT) and rhodopsin transgenic (Tg) of RP rabbits were used at age 24 months. Light and electron microscopy were used to observe the retina, optic disc, and optic nerve. RGCs were also confirmed by immunofluorescent staining with a TUJ-1 monoclonal antibody. In addition to the rod and cone degeneration, we observed the astrocyte infiltration of the optic disc due to the damage of small RGCs and nerve fibres and atrophy of small optic nerve fibres. They subsequently lead to the optic disc excavation and atrophy of the optic nerve. Consequently, our histopathological study clarified that not only the outer retina but also the inner retina, the optic disc, and the optic nerve were also affected in the late stages of RP rabbit.
Topotecan, an active drug in the second-line treatment of epithelial ovarian cancer: results of a large European phase II study.

PURPOSE Topotecan is a topoisomerase I inhibitor with preclinical activity against various tumor types. We conducted a large multicenter phase II study with topotecan in ovarian cancer in patients who had failed to respond to one prior cisplatin-based chemotherapeutic regimen. PATIENTS AND METHODS Topotecan 1.5 mg/m2/d was administered intravenously by 30-minute infusion for 5 days repeated every 3 weeks. As the cisplatin-free interval relates to response in subsequent treatment, patients were stratified in subgroups, ie, cisplatin-refractory, cisplatin-resistant, and cisplatin-sensitive. RESULTS One-hundred eleven patients entered the study. Nineteen patients were considered to be ineligible; 92 patients were assessable for response. A total of 552 courses were given (median, four per patient; range, one to 17). The major toxicities were leukocytopenia and neutropenia, which were grade 3 to 4 in 54.2% and 69.1% of courses, respectively, but with only 4.3% of these being grade 4 neutropenia plus fever or infectious complications. Prophylactic granulocyte colony-stimulating factor (G-CSF) was given in 20.5% of courses to maintain dose-intensity. Other relatively frequent side effects were alopecia (82%), nausea (36.4%), and vomiting (17.5%). The overall response rate was 16.3%, with one complete response (CR) and 14 partial responses (PRs). In the cisplatin-refractory, cisplatin-resistant, and cisplatin-sensitive strata, the response rates were 5.9%, 17.8%, and 26.7%, respectively. The median duration of time of documented response was 21.7 weeks (range, 4.6 to 41.9). CONCLUSION Topotecan in a daily-times-five schedule is an effective regimen as second-line treatment in ovarian cancer. Further investigations of topotecan in ovarian cancer, including first-line use and combination with other active agents, are indicated.
Incremental costs for reduction of air pollution from ships: a case study on North European emission control area

ABSTRACT In addition to sulphur oxides control, the North and the Baltic Seas have recently been designated as nitrogen oxides control area. Amidst ongoing developments in energy markets and international trade, shipowners have to develop cost-efficient strategies to comply with the new regulation. This study creates and tests a model calculating the incremental costs of abating NOx and SOx emissions under MARPOL Annex VI regulations for the following methods: SCR, HAM and internal engine modifications, marine gas oil, wet scrubbers, and liquefied natural gas propulsion. The model is tested empirically on a broad sample of 244 ships from the Swedish Commercial Fleet database for different operating contexts and fuel prices. Individual ship emission reductions and incremental abatement costs are calculated and the results are presented for the entire studied sample and per ship type class. The study also explores the sensitivity of the chosen abatement methods to cost determinants and to main engine time operation under the light of economic performance and cost-efficiency. The results of the study aim to contribute to company abatement strategy.
Evaluation of glutathione S-transferase P1 (GSTP1) Ile105Val polymorphism and susceptibility to type 2 diabetes mellitus, a meta-analysis

It is well established that type 2 diabetes mellitus (T2DM) is associated with oxidative stress and glutathione S-transferases (GSTs) protect cells against oxidative stress. The missense substitution Ile105Val (rs1695) of the glutathione S-transferase P1 (GSTP1, OMIM: 134660) results from an A/G base substitution at nucleotide 313. Many studies have evaluated the correlation between the rs1695 polymorphism and T2DM, but the results remain inconclusive. The aim of the present meta-analysis was to investigate the association between GSTP1 Ile105Val polymorphism and the susceptibility risk of T2DM. Eligible studies (published before August 2017) were identified in several databases. The heterogeneity between studies was evaluated with the chi-square based Q test and the I2 test. The strengths of the association were assessed by pooled odds ratios (ORs) and the corresponding 95 % confidence interval (95 % CI) using either a fixed or random-effects models. Eighteen studies documenting a total of 2595 T2DM cases and 2888 controls were included in this meta-analysis. In the overall analysis there was no significant association between the rs1695 polymorphism and the risk of T2DM. The subgroup analyses stratified by ethnicity, publication year and sample size did not reveal significant association between the study polymorphism and the risk of T2DM and any sources contributing to the substantial heterogeneity between studies. The present meta-analysis suggested that there was significant heterogeneity between studies. Considering some limi tations of our meta-analysis, further large-scale studies should be done to reach a more comprehensive understanding.
The role of arterial and venous pressure for volume regulation of an organ enclosed in a rigid compartment with application to the injured brain

Background: Treatment of increased intracranial pressure often includes an active change in arterial and venous pressure, sometimes with draining of cerebrospinal fluid. We evaluated tissue and perfusion pressure during corresponding interventions in an organ enclosed in a rigid compartment with capillaries permeable for electrolytes and impaired autoregulation, conditions comparable to those present in the injured brain.
Ossification patterns of the tympanic facial canal in the human fetus and neonate

Dehiscences in the bony facial canal are comparatively common in the human adult. The highest incidence occurs in the tympanic segment of the facial nerve near the region of the oval window. Thirty‐three fetal temporal bones, ranging from 16 to 40 weeks' gestation, and four from 1, 2, 4 and 12 weeks' postpartum neonates, were studied to evaluate the normal patterns of ossification of the fallopian canal of the tympanic facial nerve segment in the human. The tympanic facial nerve segment elongates threefold during this period (from 1 mm to 3 mm). The ossification starts at 21 weeks' gestation anteriorly from apical otic ossification centers and at 26 weeks from canalicular ossification centers near the stapedius muscle. The ossification proceeds in an anterior‐to‐posterior direction as two periosteal shelves of bone surround the facial nerve. The superior periosteal bony ledge contributes 75% of the circumference of the fallopian canal. The anterior ossification center forms over 83% of the fallopian canal length. The two centers fuse post partum near the region of the oval window. The anatomic location of the facial nerve, nerve branching, and neural vasculature precede ossification. In 80% of the paired temporal bones, this ossification pattern appears to be symmetrical. The patterns and incidence of bony dehiscences within the tympanic fallopian canal segment can be explained by these observations. This study demonstrates that fallopian canal dehiscences are not congenital anomalies, but variations of normal developmental anatomic processes.
Landholding size and farmers’ access to credit and its utilisation in Pakistan

ABSTRACT This article reports on a study that aimed to investigate the differences in access to, and utilisation of, agricultural credit among subsistence farmers in Pakistan. Primary data were collected from 87 randomly selected subsistence farmers. Results show that subsistence farmers with more land had greater access and utilisation, and that education, experience, type of farmer, and landholding size were significant factors influencing access to credit. As subsistence farmers with the least land were the most disadvantaged, there is a need for revamping the credit policy to protect their interests. Moreover, simplifying the existing complex procedures involved in securing agricultural credit is highly recommended.
Benign paroxysmal positioning vertigo in multiple sclerosis: diagnosis, pathophysiology and therapeutic techniques

Objective: To report on the most common causes of vertigo in patients with multiple sclerosis (MS) and emphasize appro priate diagnostic techniques and treatment interventions. Background: True vertigo is estimated to occur in about 20% of MS patients. Lesions within the vestibular nuclei and in the root entry zone of cranial nerve VIII represent the most common locations where demyelinating activity can provoke vertigo in patients with MS. However, other causes of vertigo should be explored in MS patients in order to avoid unnecessar y treatment with corticosteroids and vestibular suppressants. Recently, we reviewed our four-year experience with new onset vertigo in our university-based MS population and found that benign paroxysmal positioning vertigo (BPPV) to be the most common cause. A ll patients diagnosed with BPPV were treated successfully with particle repositioning maneuvers. The remaining patients were treated with conventional therapies appro priate for the specific diagnosis. Conclusions: Empiric treatments with corticosteroids and/or vestibular suppressants should not be employed until all MS patients undergo a careful bedside examination, which includes diagnostic positional and, if indicated, particle repositioning maneuvers. Here we emphasize the pathophysiology of BPPV and illustrate the proper techniques for the diagnostic and therapeutic maneuvers.
Magnetization transfer magnetic resonance imaging and clinical changes in patients with relapsing-remitting multiple sclerosis.

BACKGROUND Magnetization transfer (MT) magnetic resonance imaging (MRI) can provide in vivo quantitative estimates of microscopic tissue damage in normal-appearing white matter (NAWM) and gray matter (GM) from patients with multiple sclerosis (MS). OBJECTIVE To determine whether a one-time MT MRI can provide markers of short-term disease evolution in patients with relapsing-remitting MS. DESIGN Eighteen-month observational study. SETTING Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele. PATIENTS Twenty-two patients with untreated relapsing-remitting MS. MAIN OUTCOME MEASURES Relapse rate; disability according to the Expanded Disability Status Scale (EDSS); dual-echo, 2-dimensional gradient echo with and without a saturation MT pulse and T1-weighted MRIs of the brain; and MT ratio (MTR) histograms for NAWM and GM. RESULTS During the study period, 13 patients (59%) experienced 25 relapses. The median EDSS score was 1.25 (range, 0-3.5) at study entry and 1.75 (range, 0-3) at study exit. Significant, although moderate, correlations were found between average GM MTR values at baseline and EDSS changes during the study period (r = -0.44; P = .04). A trend was observed for the correlation between NAWM MTR values at baseline and the EDSS changes throughout 18 months (r = -0.42; P = .05). For the relation between EDSS changes and baseline GM MTR, the slope of the regression line was -0.5 (95% confidence interval, -1.0 to 0.0), indicating that a decrease in the baseline GM MTR of 1% predicted an increase in the EDSS score of 0.5 point throughout the 18 months. CONCLUSION This study indicates that a "snapshot" MT MRI assessment detects subtle brain tissue changes that are associated with short-term disability accumulation in patients with relapsing-remitting MS.