Miracle-dz/UniFAR-FTUs huggingface dataset:
Warming before and after epidural block before general anaesthesia for major abdominal surgery prevents perioperative hypothermia: A randomised controlled trial

BACKGROUND Epidural analgesia (EDA) is known to be an independent risk factor for perioperative hypothermia and its many known adverse effects. Combined general and epidural anaesthesia decreases intraoperative core temperature more rapidly than general anaesthesia alone. Hence, adequate warming procedures are needed for these patients. OBJECTIVE We evaluated the effects of active skin-surface warming before and/or after initiation of EDA during general anaesthesia as a procedure to prevent perioperative hypothermia. DESIGN A randomised controlled trial. SETTING Department of Anaesthesiology in a general hospital in Germany from January 2013 until August 2014. PATIENTS After obtaining written informed consent, we included 99 adult patients undergoing elective major abdominal surgery under combined general anaesthesia and EDA with an expected duration of surgery of at least 120 min. Patients were excluded if they were under 18 years of age, classified as American Society of Anesthesiologists’ physical status 4 or higher or if patients refused EDA. INTERVENTIONS Patients were randomly assigned to one of three groups and received either only passive insulation, 15 min of active air-forced warming after EDA and before induction of general anaesthesia, or two periods, each of 15 min, of active air-forced warming before and after EDA. Core and skin temperatures were measured at several time points throughout the study. MAIN OUTCOME MEASURES The primary outcome measure was the incidence of hypothermia on arrival in the ICU. The secondary outcome measure was the incidence of postoperative shivering. In addition, the perioperative change in body core temperature was recorded. RESULTS Without prewarming (n = 32), 72% of patients became hypothermic (<36°C) at the end of anaesthesia. Fifteen minutes of warming after insertion of the epidural catheter and before initiation of general anaesthesia reduced the incidence of postoperative hypothermia to 6% (n = 33). After two periods of 15 min of warming before and after insertion of the epidural catheter, no patient became hypothermic (n = 34). Prewarming in either ‘warming’ group prevents the initial temperature drop which was observed in the control group. CONCLUSION Warming for 15 min before and after initiation of EDA in patients receiving combined anaesthesia is effective in preventing postoperative hypothermia. TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov (identifier: NCT01795482).
Novel sequence variants in the TMC1 gene in Pakistani families with autosomal recessive hearing impairment

Though many hearing impairment genes have been identified, only a few of these genes have been screened in population studies. For this study, 168 Pakistani families with autosomal recessive hearing impairment not due to mutations in the GJB2 (Cx26) gene underwent a genome scan. Two‐point and multipoint parametric linkage analyses were carried out. Twelve families had two‐point or multipoint LOD scores of 1.4 or greater within the transmembrane cochlear expressed gene 1 (TMC1) region and were subjected to further screening with direct DNA sequencing. Five novel putatively functional non‐synonymous sequence variants, c.830A>G (p.Y277C), c.1114G>A (p.V372M), c.1334G>A (p.R445H), c.2004T>G (p.S668R), and c.2035G>A (p.E679K), were found to segregate within seven families, but were not observed in 234 Pakistani control chromosomes. The variants c.830A>G (p.Y277C), c.1114G>A (p.V372M), and c.1334G>A (p.R445H) occurred at highly conserved regions and were predicted to lie within hydrophobic transmembrane domains, while non‐synonymous variants c.2004T>G (p.S668R) and c.2035G>A (p.E679K) occurred in extracellular regions that were not highly conserved. There is evidence that the c.2004T>G (p.S668R) variant may have occurred at a phosphorylation site. One family has the known splice site mutation c.536 ‐8T>A. The prevalence of non‐syndromic hearing impairment due to TMC1 in this Pakistani population is 4.4% (95%CI: 1.9, 8.6%). The TMC1 protein might have an important function in K+ channels of inner hair cells, which would be consistent with the hypothetical structure of protein domains in which sequence variants were identified. © 2005 Wiley‐Liss, Inc.
Integrating 'English as a Foreign Language' in Austrian primary schools : contextual and participant perspectives

Government guidelines in Austria specify that first and second year primary school pupils (age 6-8 years old) should receive their first teaching of a foreign language integrated into the syllabus subjects. The present study, embedded in the theoretical framework of social constructivist learning and socio-cultural language learning theories, investigated the actual classroom practices of Austrian primary school teachers during the integration of English into the lessons. The main research question ‘How is English as a foreign language taught in the first two years of Austrian primary schools? ' required consideration of both the context and the participants and aligned three perspectives: context, teachers and pupils. From the contextual perspective, government legislation and guidance, teacher training institutions, and school management are significant. They influence some aspects of the individual teachers’ competences and attitudes, which in turn affect her or his teaching goals, lesson planning, time allocated to English and other subjects, and choice of classroom activities. The other key participants are the children themselves and their perspective on English learning in the classroom. Setting out to observe foreign language teaching/learning in Austrian primary schools, the study actually identified a number of disparities in processes and perceptions, and raised questions about how English integration is translated into effective classroom practice. Set in the framework of qualitative mixed methods study design, with data drawn from a combination of case study ethnographic classroom observations, a small scale survey, interviews with academics and teachers, pupil picture questionnaires, documentary evidence and innovative qualitative data elicitation methods adapted to young children, the findings of this study reveal that there is a mismatch between government expectations, teacher training, school policies, and actual teaching practice.
Coumadin and aspirin in prevention of recurrence after transluminal coronary angioplasty: a randomized study.

To determine the influence of adjunctive treatment with coumadin or aspirin on recurrence rate after percutaneous transluminal coronary angioplasty (PTCA), 248 patients in whom PTCA was assessed to be a primary success were randomized to either 325 mm aspirin daily or to coumadin treatment sufficient to maintain a prothrombin time 2 to 2.5 times the control value. The follow-up protocol included stress testing and coronary angiographic examinations 3 to 6 months after PTCA. All patients were followed for at least 9 months. Of the 122 patients randomized to coumadin 44 (36%) had recurrent stenoses as opposed to 34/126 (27%) of patients on aspirin, a difference that did not reach statistical significance at the . 05 level. However, patients with at least a 6 month history of angina demonstrated a significantly different response to adjunctive treatment in that 19/43 (44%) of coumadin patients as compared with 10/48 (21%) of aspirin patients had recurrent stenoses (p less than .05). Thus, coumadin was not shown to be more effective than aspirin as adjunctive treatment after PTCA, while aspirin was shown to be superior to coumadin in patients with a longer history of angina.
The Medstone fixed, mobile, and modular configurations: impact on efficacy.

PURPOSE To evaluate the efficacy of three lithotripter configurations that utilize the Medstone STS treatment head. PATIENTS AND METHODS From 1999 through 2002, 13,131 patients were treated with the Medstone STS fixedsite unit (STS-FIX; 52%), the mobile coach-transportable unit (STS-MOB; 26%), or the modular operating-room unit (STS-T; 22%). All units were staffed by a rotating schedule of the same ten SWL-certified radiological technicians. The treating urologists reported follow-up that included plain abdominal radiography to document stone-free rate (no residual fragments) and the need for auxiliary procedures or re-treatment. An efficiency quotient (EQ) was calculated for each unit. RESULTS The overall stone-free rate for the STS-FIX, STS-MOB, and the STS-T was 59%, 62%, and 65%, respectively. The STS-FIX had the lowest stone-free rate for lower-pole stones (48%) and stones 21 mm to 30 mm (30%) compared with the STS-MOB (57% and 62%, respectively) and the STS-T (59% and 54%, respectively). However, the STS-FIX had a higher stone-free rate in the middle ureter (86%) than the STS-T (67%) and STS-MOB (65%). The STS-FIX required more post-SWL procedures overall (12%) than the STSMOB (4%) and STS-T (5%). The re-treatment rates for the STS-FIX, STS-MOB, and STS-T were 7%, 6%, and 6%, respectively. The STS-T had the highest overall EQ (59) followed by the STS-MOB (56) and the STSFIX (50). CONCLUSIONS New configurations of the STS lithotripter have a significant positive impact on efficacy compared with the original fixed machine. Availability of real-time fluoroscopy with the STS-T may impact the higher EQ of this machine.
Delirium Assessment Tools for Use in Critically Ill Adults: A Psychometric Analysis and Systematic Review

Background Delirium is highly prevalent in critically ill patients. Its detection with valid tools is crucial. Objective To analyze the development and psychometric properties of delirium assessment tools for critically ill adults. Methods Databases were searched to identify relevant studies. Inclusion criteria were English language, publication before January 2015, 30 or more patients, and patient population of critically ill adults (>18 years old). Search terms were delirium, scales, critically ill patients, adult, validity, and reliability. Thirty‐six manuscripts were identified, encompassing 5 delirium assessment tools (Confusion Assessment Method for the Intensive Care Unit (CAM‐ICU), Cognitive Test for Delirium, Delirium Detection Score, Intensive Care Delirium Screening Checklist (ICDSC), and Nursing Delirium Screening Scale). Two independent reviewers analyzed the psychometric properties of these tools by using a standardized scoring system (range, 0‐20) to assess the tool development process, reliability, validity, feasibility, and implementation of each tool. Results Psychometric properties were very good for the CAM‐ICU (19.6) and the ICDSC (19.2), moderate for the Nursing Delirium Screening Scale (13.6), low for the Delirium Detection Score (11.2), and very low for the Cognitive Test for Delirium (8.2). Conclusions The results indicate that the CAM‐ICU and the ICDSC are the most valid and reliable delirium assessment tools for critically ill adults. Additional studies are needed to further validate these tools in critically ill patients with neurological disorders and those at various levels of sedation or consciousness.
POPULATION AND COLONY GENETIC STRUCTURE OF THE PRIMITIVE TERMITE MASTOTERMES DARWINIENSIS

Abstract The termite Mastotermes darwiniensis is the sole extant member of its family and occupies the basal position in the phylogeny of the eusocial order Isoptera. In this study, we investigated the micro- and macrogeographic genetic structure of M. darwiniensis in its native range in Australia. A total of 1591 workers were sampled from 136 infested trees in 24 locales. Each locale was separated by 2–350 km, and these locales were found within two broader geographic regions approximately 1500 km apart. The multilocus genotypes of all termites were assayed at six polymorphic microsatellite loci. The genetic data indicated that colonies typically fed on multiple trees within locales and extended over linear distances of up to 320 m. Single colonies were frequently headed by multiple reproductives. Workers were highly related (r = 0.40) and substantially inbred (f = 0.10). Thus, M. darwiniensis colonies are characterized by the input of alleles from multiple reproductives, which sometimes engage in consanguineous matings. Our analyses of population genetic structure above the level of the colony indicated that locales and regions were significantly differentiated (θlocale = 0.50, θregion = 0.37). Moreover, locales showed a pattern of genetic isolation by distance within regions. Thus, M. darwiniensis populations display restricted gene flow over moderate geographic distances. We suggest that the genetic patterns displayed by M. darwiniensis result primarily from selective pressures acting to maintain high relatedness among colonymates while allowing colonies to grow rapidly and dominate local habitats. Corresponding Editor: S. Edwards
Analysing the motivations of Japanese international sports-fan tourists

ABSTRACT Research question: The number of sports fans travelling internationally to attend sporting events as spectators is increasing every year. Understanding their behaviour is important for sports marketers, including sports organisations, travel companies and government tourist organisations. Numerous studies have examined motivations either from the perspective of sports fans or from that of tourists, but there has so far been little research on sports tourism. The aim of the current study is to develop two scales, one for sports fans and another for tourists, with initial motivation factors derived from previously published scales for both groups. The study also considers the activity and motivations of Japanese sports tourists as an increasingly important sub-segment of the international sports tourism market. Research methods: Data were collected from Japanese general tourists (N = 3773). Of those surveyed, 9% (N = 338) had watched sports in foreign countries. Motivation scales were developed using factor analysis and independent t-tests. Results and findings: A Tourist Motivation Scale (Escape, Nature, Shopping and Gourmet Dining) and a Sports Fan Motivation Scale (Socialisation, Achievement, Relaxation in Sports and Enjoy High Level of Games) were developed. Then, the mean scores were compared by gender, active sports participation, and for two major spectator sports: professional soccer in Europe (England Premier League, Spanish Liga BBVA, Italian Seria A, and so on) and Major League Baseball in USA. Implications: The research presents practical implications for stakeholders in the market for international sports tourists. In particular, marketers should consider different strategies when targeting male and female sports tourists, and consider segmentation of sports tourists between purely spectators and those that participate in sports. The latter are motivated by greater detail in information about the sports they watch.
Human cytomegalovirus pp65 lower matrix protein: a humoral immunogen for systemic lupus erythematosus patients and autoantibody accelerator for NZB/W F1 mice

Both the infection of human cytomegalovirus (HCMV) and the immunization of its recombinant glycoprotein (gB) in mice have been known to induce autoimmunity, resulting in symptoms similar to those of human systemic lupus erythematosus (SLE). Research has also found that the murine cytomegalovirus (MCMV)‐specific monoclonal antibody (mAb) is able to react with a human U1‐70K‐like autoantigen. To investigate HCMV involvement in autoimmunity, we analysed the humoral responses to HCMV by autoimmune patients and normal adults. Our studies show unambiguously that sera from SLE patients exhibited an elevated IgG titre to HCMV when compared with those observed in controls and other connective tissue disease (CTD) patients (P < 0·001). The IgM titres to HCMV and IgG to HBV were evaluated, and no significant differences were noted among all testing groups. In addition to initiating T cell activity, as reported by many investigators, we found that the HCMV pp65 antigen (also known as lower matrix protein) was able to induce humoral responses in SLE patients. Immunoblot assays showed that 82·56% of sera from SLE patients reacted with the HCMV pp65 antigen, but only 11·11%, 23·53% and 31·17% of patients from normal control, rheumatoid arthritis (RA) and CTD patients, respectively, reacted to it. Unlike HCMV pp65, HCMV pp150 induced B cell activity in most collected sera (92·22%‐98·04%). Finally, female NZB/W F1 mice immunized with plasmids encoding HCMV pp65 open reading frame (pcDNApp65) developed an early onset of autoantibody activity and more severe glomerulonephritis. Thus, we conclude that the HCMV pp65 antigen triggers humoral immunity in SLE patients and autoimmune‐prone mice and that it could very well exacerbate the autoimmune responses in susceptible animals.
Protective effects of leucine on redox status and mitochondrial-related gene abundance in the jejunum of intrauterine growth-retarded piglets during early weaning period

ABSTRACT The aim of this study was to investigate the effects of dietary supplementation with 0.35% l-leucine on redox status and gene abundance relating to mitochondrial biogenesis and function in the jejunum of intrauterine growth-retarded (IUGR) piglets during early weaning period. According to a 2 × 2 factorial arrangement, 16 IUGR and 16 normal body weight (NBW) piglets were fed a basal diet without l-leucine supplementation or a basal diet plus 0.35% l-leucine supplementation from the age of 14 to 35 d. The results showed that compared with NBW piglets, IUGR piglets had a lower (p < 0.05) jejunal DNA concentration, a reduced (p < 0.05) manganese superoxide dismutase (MnSOD) and total antioxidant capability (T-AOC) activities and mitochondrial DNA content in the jejunum. Leucine supplementation increased (p < 0.05) MnSOD and T-AOC activities and decreased (p < 0.05) the malondialdehyde content in the jejunum of IUGR piglets. The mRNA gene abundance of nuclear respiratory factor-1 (NRF1), mitochondrial transcription factor A (TFAM), ATP synthase (ATPs), cytochrome c oxidase V (CcOX V), cytochrome c and glucokinase in the jejunum of IUGR piglets was reduced (p < 0.05) compared with NBW piglets. However, NRF1, peroxisome proliferation-activated receptor gamma coactivator-1 alpha, TFAM, ATPs and CcOX I mRNA gene abundance in the jejunum of IUGR piglets were increased (p < 0.05) by diets supplemented with leucine. These data indicate that leucine supplementation has therapeutic potential for attenuating intestinal oxidative stress and mitochondrial dysfunction in IUGR piglets during the early period of life via increasing enzyme activities and up-regulating mRNA gene abundance.
Validation of cytochrome P450 time-dependent inhibition assays: a two-time point IC50 shift approach facilitates kinact assay design

Recent guidance from the US Food and Drug Administration (USFDA) has advocated testing of time-dependent inhibition of cytochrome P450 (CYP), which can be addressed by performing IC50 shift as well as KI/kinact determinations. Direct (IC50, Ki) and time-dependent inhibition (IC50 shift, KI/kinact) assays were validated in human liver microsomes with liquid chromatography-tandem mass spectrometry (LC/MS/MS) analysis for the following enzyme/substrate/inhibitor combinations: CYP1A2/phenacetin/alpha-naphthoflavone/furafylline, CYP2C8/amodiaquine/montelukast/gemfibrozil-1-O-β-glucuronide, CYP2C9/diclofenac/sulfaphenazole/tienilic acid, CYP2C19/S-mephenytoin/S-benzylnirvanol/S-fluoxetine, CYP2D6/dextromethorphan/quinidine/paroxetine, and CYP3A4/midazolam/testosterone/ketoconazole/azamulin/verapamil/diltiazem. IC50 shift assays were performed with two pre-incubation time points (10 and 30 min) to facilitate kinact assay design. Data obtained show good agreement with literature values. For rapid acting inhibitors, such as azamulin/CYP3A4 and tienilic acid/CYP2C9, the IC50 shifts were similar at both time points suggesting a short maximum pre-incubation time with closely spaced time points for the KI/kinact assay. Slow acting inhibitors (such as verapamil/CYP3A4 or S-fluoxetine/CYP2C19) showed an increase in IC50 shift between 10 and 30 min suggesting a longer maximum pre-incubation time with wider spacing of time points for KI/kinact. The two-time point IC50 shift experiment proved to be an excellent method for the selection of appropriate KI/kinact assay parameters and is suitable for the routine analysis of P450 inhibition by drug candidates.
Oxidative Cell Injury as a Predictor of Endometriosis Progression

Background: There is increasing evidence that oxidative stress is one of the key factors for progression of endometriosis. In this prospective controlled trial, we measured 6 different biomarkers of oxidative stress targeting protein, lipid, and DNA to quantify the severity and progression of endometriosis and establish a diagnostic marker for the disease. Methods: A total of 62 consecutive patients were identified and enrolled in this study. After exclusion criteria, 44 patients were allocated to 3 groups: stage I/II (n = 14), stage III/IV (n = 16), and a control group (n = 14). The levels of 8-hydroxy-2-deoxyguanosine (8-OHdG), 8-oxoguanine DNA glycosylase (OGG1), protein carbonyl (PC), lipid peroxidation (LPO), reactive oxygen species (ROS), and total antioxidant capacity (TAC) were accessed in peritoneal fluid and tissue. Results: Significantly higher levels of 8-OHdG and PC were seen in patients with endometriosis, in addition OGG1 expression was found to be significantly lower in patients with endometriosis (P < .001, P = .001, P = .033, respectively); ROS, TAC, and LPO were similar in stages I/II, stages III/IV, and control group. A predictive model was built using multivariable analyses and receiver–operating characteristics curves. The ability to predict and distinguish between patients without endometriosis, stage I/II endometriosis, and stage III/IV was very high. This model was highly discriminatory and had a concordance index of 0.87. Conclusion: In this cohort, higher DNA damage and lower DNA repair activity was related to endometriosis progression. Our results indicate that oxidative stress as a biomarker of cell injury can be used as a reliable quantitative test of endometriosis severity.
A Study of Heavy Rainfall Events during the Great Midwest Flood of 1993

Abstract A synoptic–dynamic climatology was constructed using all 24-h 2-in. (50.8 mm) or greater rainfall events in nine states affected by heavy rains and flooding from June through September 1993 using 6- or 12-h gridded analyses from the Regional Data Assimilation System and geostationary satellite imagery. Each of the 85 events was assigned a category (0–4) based on the areal coverage of the 3-in. (76.2 mm) or greater observed precipitation isohyet. A variety of meteorological fields and rules of thumb used by forecasters at the Hydrometeorological Prediction Center are investigated that may help identify the most likely location and scale of a convective precipitation event. The heaviest rain usually fell to the north (downwind) of the axis of highest 850-mb winds and moisture flux in an area of 850-mb warm temperature and equivalent potential temperature advection. The rainfall maximum also usually occurred to the north or northeast of the axis of highest 850-mb equivalent potential temperature. Th.