Miracle-dz/UniFAR-FTUs huggingface dataset:
The Role of Obesity in Spontaneous Temporal Bone Encephaloceles and CSF Leak

Objective Temporal bone encephaloceles and cerebrospinal fluid (CSF) otorrhea can lead to life-threatening sequelae such as meningitis and cerebritis. Obesity has been associated with spontaneous CSF leaks. We wished to determine if there were differences in the body mass index (BMI) of patients with spontaneous temporal bone encephaloceles/CSF leaks and nonspontaneous temporal bone encephaloceles/CSF leaks to help determine if obesity may be associated with their development. Study Design Single institution retrospective comparison. Methods Demographic and clinical information was obtained from 20 patients treated for surgically confirmed temporal bone dehiscence leading to encephalocele and/or CSF otorrhea. Statistical analysis was performed on patients with spontaneous and nonspontaneous encephaloceles/CSF leaks to determine if there were differences in the degree of obesity between these groups. Results Temporal bone dehiscence was spontaneous in 11 patients, related to chronic infection in 4 patients, posttraumatic in 3 patients, postsurgical in 1 patient, and because of massive hydrocephalus in a final patient. The average BMI for patients with spontaneous encephalocele was 33.4 kg/m2. The average BMI for patients with nonspontaneous encephaloceles was 27.0 kg/m2. This difference was statistically significant (p = 0.02). Conclusion Although several previous studies have demonstrated an association of obesity with spontaneous encephaloceles or CSF leaks, this study is one of the first to demonstrate a statistically significant increase in BMI for patients with spontaneous encephaloceles and CSF leaks as compared with patients developing them for other reasons. This suggests a potential etiologic role of obesity in the development of spontaneous encephaloceles and CSF leaks. Level of Evidence: 4.
Evidence for Early Loading of Osseointegrated Implants for Bone Conduction at 4 Weeks

Introduction The purpose of our study was to directly measure the stability of the abutment using resonance frequency analysis (RFA) and to report on the change in stability over time for implants loaded 4 weeks postoperatively. Materials and Methods The principle behind RFA is to obtain a numerical value relating to stability. The Osstell RFA recording device measures the resonance in a magnetic field of a 1 cm commercially manufactured attachment (SmartPeg) that is screwed onto the bone conduction device abutment. RFA measurements were obtained at surgery, 1, 4, and 16 weeks after implant surgery. The degree of movement (vibration) is inversely proportional to the stability of the abutment, and a numerical figure, the implant stability quotient (ISQ), is derived. Patients were fitted with the new Cochlear Bone-Anchored Hearing Aid (BAHA) BI300 series implant using a 1-stage procedure and loaded 4 weeks postoperatively. Results Prospectively 68 consecutive patients were recruited with a male to female ratio of 23:45. Nineteen patients had bilateral BAHA devices fitted, giving a total of 88 implants. The average ISQ change (delta) for the cohort gives a value of 0 at time of surgery. The change in ISQ at 1 week was −0.10 (95% confidence interval [CI], 0.74), at 4 weeks was 1.21 (95% CI, 0.59), and at 16 weeks was 1.60 (95% CI, 0.77). Discussion Successful early loading of the BAHA sound processor has been achieved. RFA provides a reliable means of assessing stability for loading and measuring implant stability in the longer term. These data support the evidence for early loading at 4 weeks with good clinical safety.
Living in Kinship Care: A Child-Centred View

Jane Aldgate describes findings from a Scottish research study on kinship care. Her article is drawn from a commissioned study which informed a government review of children looked after by local authorities in Scotland in 2006. The article presents the perspectives of the 30 children in the study on living in kinship care. It explores children's understanding of the reasons for their placements and their views on the future, as well as on the roles and tasks of social workers. Children speak of both the negative and positive challenges of living in kinship care, including maintaining contact with parents and siblings. Children's everyday lives, including experiences of school, peers and activities are recounted. The article ends by describing the Scottish Government's new policy for improving services for children in kinship care.
Sewage sludge treatment using microwave-enhanced advanced oxidation process

A microwave-enhanced advanced oxidation process using hydrogen peroxide (MW/H2O2-AOP) was used for the release of nutrients and the destruction of solids from secondary municipal sewage sludge in this study. Using a computer statistical software package for designing experiments and for data analyses, four factors including microwave heating temperature, heating time, hydrogen peroxide dosage, and sludge solids content were examined. Experiments were performed at sludge solids content of 0.5, 1.5 and 2.5%, heating temperature of 80, 100 and 120°C, heating time of 1.5, 3 and 9 minutes, and hydrogen peroxide dosage of 0, 1 and 2 wt %, respectively. Overall, the maximum solubilization of nutrients was obtained at 2.5% of total solids content, 2 wt % of hydrogen peroxide, 5 min. of microwave heating and at 120°C. The most significant factor for the solubilization of nutrients using the microwave enhanced advanced oxidation process was the initial sludge concentration. Hydrogen peroxide dosage was also a very significant factor. The maximum yield occurred at an extended heating period of five minutes in this study. Nevertheless, the results indicated that the nutrient release and disintegration of solids were also very substantial over heating periods of 1.5 and 3 minutes. Even with a heating period of 1.5 minutes, the yield was estimated to be about 70% that of the 5 minute heating.
Ketosis and diabetic ketoacidosis in response to SGLT2 inhibitors: Basic mechanisms and therapeutic perspectives

Inhibitors of the sodium‐glucose cotransporter SGLT2 are a new class of antihyperglycemic drugs that have been approved for the treatment of type 2 diabetes mellitus (T2DM). These drugs inhibit glucose reabsorption in the proximal tubules of the kidney thereby enhancing glucosuria and lowering blood glucose levels. Additional consequences and benefits include a reduction in body weight, uric acid levels, and blood pressure. Moreover, SGLT2 inhibition can have protective effects on the kidney and cardiovascular system in patients with T2DM and high cardiovascular risk. However, a potential side effect that has been reported with SGLT2 inhibitors in patients with T2DM and particularly during off‐label use in patients with type 1 diabetes is diabetic ketoacidosis. The US Food and Drug Administration recently warned that SGLT2 inhibitors may result in euglycemic ketoacidosis. Here, we review the basic metabolism of ketone bodies, the triggers of diabetic ketoacidosis, and potential mechanisms by which SGLT2 inhibitors may facilitate the development of ketosis or ketoacidosis. This provides the rationale for measures to lower the risk. We discuss the role of the kidney and potential links to renal gluconeogenesis and uric acid handling. Moreover, we outline potential beneficial effects of modestly elevated ketone body levels on organ function that may have therapeutic relevance for the observed beneficial effects of SGLT2 inhibitors on the kidney and cardiovascular system.
Transoral robotic surgery: development and challenges

: The da Vinci Surgical robot has been marketed since 1999; it was originally designed for aiding complex laparoscopic operations and cardiac operations. By the mid-2000s, otolar-yngologists had been attempting to deploy the surgical robot for endoscopic minimally invasive operations in the upper aerodigestive tract. The development went through a mannequin model, canine model, and cadaver model and finally cumulated to human Phase I trial. The operation was dubbed transoral robotic surgery (TORS). Subsequently, multicenter trials in the United States had proved the safety and oncological efficacy of using the surgical robot for resection of early cancers in the upper aerodigestive tract. In 2009, the US Food and Drug Administration granted license for the da Vinci surgical robot to be used for resection of benign tumors and early cancers in the oropharynx, larynx, and hypopharynx. TORS has also developed for surgery in the anterior skull base and nasopharynx, as well as in setting of flaps for reconstruction in the upper aerodigestive tract. This article will review the development of TORS, the current limitations
Dialysis patients treated with Epoetin alfa show improved anemia symptoms: A new analysis of the Canadian Erythropoietin Study Group trial

The health‐related quality of life (HRQOL) claims in the current Epoetin alfa label are based on the reanalyses of the exercise and physical function data from the Canadian Erythropoietin Study Group trial. The reanalysis was done to comply with the Food and Drug Administration's requirement of using statistical methods that are currently standard in evaluating clinical trial data. Presented here are HRQOL results associated with anemia. The Canadian Erythropoietin Study Group trial was a multicenter, double blind, randomized, placebo‐controlled trial evaluating the effects of Epoetin alfa on HRQOL in anemic hemodialysis patients. A total of 118 patients who were 18–75 years old, on hemodialysis for >3 months, who had a hemoglobin <9.0 g/dL, and did not have coronary artery disease or diabetes mellitus, were randomized to either receive placebo (n=40), or receive intravenous Epoetin alfa to achieve a target hemoglobin of 9.5–11.0 g/dL (n=40) or a target of 11.5–13.0 g/dL (n=38). Patients were followed for 6 months. The two Epoetin alfa‐treatment groups were combined for all analyses performed. This post hoc analysis was conducted using an intent‐to‐treat repeated measures mixed model analysis of variance using Bonferroni's multiplicity correction. The Epoetin alfa‐treated group showed a statistically significant improvement in the Kidney Disease Questionnaire symptom of fatigue in comparison with placebo. Additionally, the change in hemoglobin at 2 months was correlated with change in fatigue, energy, shortness of breath, and weakness, but had minimal effect on depression. These analyses confirm previously reported results, which indicate that treating hemodialysis patients with an erythropoiesis‐stimulating agent improves HRQOL.
The role of obstetric factors in postpartum depression

Abstract A large sample of primiparous women was screened for postpartum depression and for depression occurring before childbirth. Obstetric risk data, rated on the Peripartum Events Scale (O'Hara etal., 1986, 1991), were analysed for women identified as having suffered from depression, and for a control group. Obstetric risk was unrelated to the occurrence of postpartum depression in the population as a whole; but in women with a previous history of depressive disorder obstetric risk (delivery by forceps or Caesarean section) was significantly related to the occurrence of postpartum depression. This finding did not arise as a consequence of a previous psychiatric history predisposing women to higher obstetric risk. The results suggest that it may be profitable to institute routine antenatal recording of information concerning psychiatric history. This would enable additional support to be directed to women experiencing difficult deliveries who may be particularly vulnerable to postnatal depression.
The experiences of nurses returning to work after childbirth: ‘making a difference’

Aims To gain a better understanding of the experiences of nurses returning to work following childbirth and make recommendations for staff retention. Background Shortages of registered nurses have led managers and Government to consider ways of improving retention of staff. Following childbirth, nurses are one group of people who may potentially be lost to the workforce. Mothers who do return to work may experience role strain associated with their multiple roles. Method Using a qualitative approach data were obtained through semi-structured interviews with five nurses returning to work after childbirth in a central London intensive care and cardiac unit. The interviews were taped, transcribed and then analysed using a grounded theory approach. Findings (Re-)negotiation at home and work was used to cope with multiple roles. Five themes emerged: continuing career pathways, coping mechanisms, self-perception, division of labour, and relationships with partners. Conclusions Implications for nurse retention are highlighted. Recommendations to promote flexible and family friendly work practices are discussed in relation to the UK Government's publication ‘Making a Difference’.
Determination of Ct values for chlorine of resistant enteroviruses

Information on the required chlorine dose or Ct value (concentration of free chlorine multiplied by contact time) is limited to only a few enteroviruses. In this study the Ct values of some of the reported more chlorine resistant enteroviruses were determined. The Efficiency Hom Model was used to predict the times for 2, 3. and 4 –log inactivation of echovirus 1 and 12, coxsackievirus B5 and poliovirus type 1 at pH 7.5 and 9 at 5°C. Coxsackievirus B5 was the most resistant to chlorine with a Ct requirement of 11.5 mg× min/L at pH 7.5 at 5°C compared to polio with a Ct of 5.3 mg× min/L under the same conditions. All the viruses were more resistant than polio 1 at pH 9.0.
Integrins and dystroglycan regulate astrocyte wound healing: The integrin β1 subunit is necessary for process extension and orienting the microtubular network

Monolayers of astrocytes in culture respond to a scrape wound by orienting towards the wound and extending processes that will repair it. We show here that they also upregulate the expression of extracellular matrix (ECM) proteins, laminin, and chondroitin sulfated proteoglycan, that are deposited in astrocytic scars in vivo. We have previously shown that the major functional ECM receptors on astrocytes are dystroglycan (DG) plus integrins α1β1, α5β1, α6β1, and αvβ3. Consistent with this, laminin fragments that activate α1β1 integrin, α6β1 integrin, and DG all contribute to attachment. During astrocyte attachment, or process extension, integrins and DG are found at the leading edge of the lammelipodium, though they change in distribution with the extent of attachment and the α and β subunits of DG can be spatially uncoupled. Functionally, inhibitory antibodies to DG and integrin α1β1 or the RGD peptide all inhibit process extension, showing that ligand engagement of integrins and DG contribute to process extension. Astrocytes differentiated from DG or β1 null ES cells respond very differently to wounding. The former fail to extend process and cell polarization is disrupted partially. However, β1 null astrocytes not only fail to extend processes perpendicular to the wound, but cell polarization is completely disrupted and cells migrate randomly into the wound. We conclude that integrins are essential for astrocyte polarity. © 2008 Wiley Periodicals, Inc. Develop Neurobiol 2008
N-Methyl-D-Aspartate Receptor-Mediated Chronic Pain: New Approaches to Fibromyalgia Syndrome Etiology and Therapy

Objectives: Fibromyalgia syndrome [FMS], a poorly understood form of chronic pain, is under-diagnosed and under-treated. It is possible that stress-induced disturbances of endocrine and neurological systems underlie the ultimate expression of FMS. One of these systems, involving the N-Methyl-D-Aspartate [NMDA] receptor, is implicated in FMS as it is in other chronic pain conditions. Therefore, the objective of this review is to provide evidence for targeting the NMDA receptor for FMS pharmacotherapy and discuss its significance to FMS pain. Findings: Major barriers to effective management of FMS pain are the fact that there are no discrete objectifiable physical findings, psychological stress is often thought to be the sole explanation, and the pathophysiology of FMS pain remains unclear. Yet, an impressive body of evidence suggests that FMS pain is likely due to central sensitization. Given its role in central pain perception and processing, the NMDA receptor represents a possible lynchpin in the pathogenesis of chronic pain in FMS. Conclusions: We propose that the very centrality of NMDA receptors in chronic pain makes them an ideal target for pharmacotherapy in FMS. Reports of recent clinical trials using newer low-affinity NMDA receptor antagonists have shown analgesic affects in chronic pain states other than FMS. These new compounds represent novel avenues of research into the management of chronic pain.
Distribution of progesterone receptor immunoreactivity in the midbrain and hindbrain of postnatal rats

Nuclear steroid hormone receptors are powerful transcription factors and therefore have the potential to influence and regulate fundamental processes of neural development. The expression of progesterone receptors (PR) has been described in the developing forebrain of rats and mice, and the mammalian brain may be exposed to significant amounts of progesterone, either from maternal sources and/or de novo synthesis of progesterone from cholesterol within the brain. The present study examined the distribution of PR immunoreactive (PRir) cells within the midbrain and hindbrain of postnatal rats. The results demonstrate that PR is transiently expressed within the first 2 weeks of life in specific motor, sensory and reticular core nuclei as well as within midbrain dopaminergic cell groups such as the substantia nigra and the ventral tegmental area. Additionally, robust PRir was observed in cells of the lower rhombic lip, a transient structure giving rise to precerebellar nuclei. These results suggest that progestins and progesterone receptors may play a fundamental role in the postnatal development of numerous midbrain and hindbrain nuclei, including some areas implicated in human disorders. Additionally, these findings contribute to the increasing evidence that steroid hormones and their receptors influence neural development in a wide range of brain areas, including many not typically associated with reproduction or neuroendocrine function. © 2008 Wiley Periodicals, Inc. Develop Neurobiol, 2008
Part A : Toxic / Hazardous Substances and Environmental Engineering

Applicability of poorly crystalline aluminum oxide for adsorption of arsenate Youn-Jong Park a , Jae-Kyu Yang b , Seung-Mok Lee c & Sang-Il Choi a a Department of Environmental Engineering , Kwangwoon University , Seoul, Korea b Division of General Education , Kwangwoon University , Seoul, Korea c Department of Environment Engineering , Kwandong University , Gangneung, Korea Published online: 23 Sep 2011.
Age‐dependent differential expression of genes involved in steroid signalling pathway in the brain of protandrous black porgy, Acanthopagrus schlegeli

The mechanisms underlying brain sex differentiation in animals are poorly understood. In the present study, using black porgy, Acanthopagrus schlegeli, as primary experimental model, we investigated the temporal expression patterns of receptors for androgen (ar) and estrogen (esr1 and esr2a) in the brain during posthatching ages and analyzed them against the timing of gonadal germ cell development. We hypothesized that endogenous estrogens naturally masculinize the brain of black porgy. The expression of sex steroid receptors was studied in relation to a wider suite of other related genes (nr5a2, nr0b1, star, and cyp19a1b) to provide some insight into the monomale sex differentiation pattern observed in this species. Our results revealed a highly significant increase in esr1 together with the increase in esr2a at 120 dph (days posthatching), suggesting a significant role for esr in sex differentiation in this species. Temporal expression patterns of nr5a2, nr0b1, star, sex steroid receptors, and cyp19a1b in the brain provided evidence for their physiological roles in the monomale sex differentiation in this species. The expression of nr5a2, star, ar, esr1, esr2a, and cyp19a1b increased at 120 dph, a period when brain sex differentiation probably occurs in this species. The study also suggests that neurosteroidogenesis in black porgy may be regulated by both nr5a2‐dependent and nr5a2‐independent mechanisms. The results demonstrated striking differences in the abundance of the gene transcripts in discrete brain region throughout ontogeny. In addition, the sex steroid hormone levels and aromatase activity in brain at different developmental states and the changes in the gene expression patterns in response to aromatase inhibitor treatment are also discussed. © 2009 Wiley Periodicals, Inc. Develop Neurobiol, 2009
Timing and duration of developmental nicotine exposure contribute to attenuation of the tadpole hypercapnic neuroventilatory response

The ability for air‐breathing vertebrates to adjust ventilation in response to increased CO2 (hypercapnia) is fundamental to maintaining pH homeostasis. Developmental nicotine exposure has been shown to impair tadpole neuroventilatory responses to hypercapnia following 8–12 weeks of exposure. It is not clear, however, to what extent the timing of exposure during development and/or the duration over which the exposure takes place contribute to this impairment. Here, tadpoles were exposed to 30 μg/L of nicotine for 3‐ or 10‐week durations, either early or late in tadpole development. Correlates of tadpole lung neuroventilation were monitored during normocapnic (1.5% CO2) and hypercapnic (5% CO2) conditions of isolated brainstems. Preparations derived from early metamorphic tadpoles failed to increase lung neuroventilation in response to hypercapnia whether they had been exposed to nicotine for 3 or 10 weeks. Preparations derived from late metamorphic tadpoles failed to respond to hypercapnia after being exposed to nicotine for 10 weeks. These results suggest that both the developmental timing and duration of exposure are important when considering nicotine's effect on the hypercapnic neuroventilatory response. © 2009 Wiley Periodicals, Inc. Develop Neurobiol 2009
Obesity Prevention and National Food Security: A Food Systems Approach

Interventions that cultivate sustainable food systems to promote health, prevent obesity, and improve food security have the potential for many large-scale and long-lasting benefits including improvements in social, environmental, health, and economic outcomes. We briefly summarize findings from previous research examining associations between obesity and food insecurity and discuss the need for greater synergy between food insecurity initiatives and national obesity prevention public health goals in the United States. The common ground between these two nutrition-related public health issues is explored, and the transformation needed in research and advocacy communities around the shared goal of improving population health through individual, environmental, and policy level changes to promote healthy sustainable food systems is discussed. We propose an ecological framework to simultaneously consider food insecurity and obesity that identifies levers for change to promote sustainable food systems to improve food security and prevent obesity.