Miracle-dz/UniFAR-FTUs huggingface dataset:
Traumatic cardiac arrest: Should advanced life support be initiated?

BACKGROUND Several studies recommend not initiating advanced life support in traumatic cardiac arrest (TCA), mainly owing to the poor prognosis in several series that have been published. This study aimed to analyze the survival of the TCA in our series and to determine which factors are more frequently associated with recovery of spontaneous circulation (ROSC) and complete neurologic recovery (CNR). METHODS This is a cohort study (2006–2009) of treatment benefits. RESULTS A total of 167 TCAs were analyzed. ROSC was obtained in 49.1%, and 6.6% achieved a CNR. Survival rate by age groups was 23.1% in children, 5.7% in adults, and 3.7% in the elderly (p < 0.05). There was no significant difference in ROSC according to which type of ambulance arrived first, but if the advanced ambulance first, 9.41% achieved a CNR, whereas only 3.7% if the basic ambulance first. We found significant differences between the response time and survival with a CNR (response time was 6.9 minutes for those who achieved a CNR and 9.2 minutes for those who died). Of the patients, 67.5% were in asystole, 25.9% in pulseless electrical activity (PEA), and 6.6% in VF. ROSC was achieved in 90.9% of VFs, 60.5% of PEAs, and 40.2% of those in asystole (p < 0.05), and CNR was achieved in 36.4% of VFs, 7% of PEAs, and 2.7% of those in asystole (p < 0.05). The mean (SD) quantity of fluid replacement was greater in ROSC (1,188.8 [786.7] mL of crystalloids and 487.7 [688.9] mL of colloids) than in those without ROSC (890.4 [622.4] mL of crystalloids and 184.2 [359.3] mL of colloids) (p < 0.05). CONCLUSION In our series, 6.6% of the patients survived with a CNR. Our data allow us to state beyond any doubt that advanced life support should be initiated in TCA patients regardless of the initial rhythm, especially in children and those with VF or PEA as the initial rhythm and that a rapid response time and aggressive fluid replacement are the keys to the survival of these patients. LEVEL OF EVIDENCE Therapeutic study, level IV; epidemiologic study, level III.
A Qualitative Study on the Experiences of Young Adults With Eating Disorders Transferring From Pediatric to Adult Care

The study’s objective was to identify systemic facilitators and barriers of transferring young adults (ages 17–21) with eating disorders from pediatric to adult health and mental health services. Qualitative interviews were conducted and three themes emerged: (a) difficulties navigating care during the transfer period; (b) challenges achieving and maintaining recovery due to systemic barriers after the transfer of care;and (c) recommendations for facilitating the transfer between systems of care. From the perspective of young adults with eating disorders our study shows that the transition to adult care services may be improved with increased coordination, communication, and collaborative partnerships between pediatric and adult providers.
Location of CD4+ T Cell Priming Regulates the Differentiation of Th1 and Th17 Cells and Their Contribution to Arthritis

Th cytokines IFN-γ and IL-17 are linked to the development of autoimmune disease. In models of rheumatoid arthritis, that is, proteoglycan (PG)-induced arthritis, IFN-γ is required, whereas in collagen-induced arthritis, IL-17 is necessary for development of arthritis. In this study we show that the route of immunization determines the requirement for either IFN-γ or IL-17 in arthritis. Intraperitoneal immunization with PG induces a CD4+ T cell IFN-γ response with little IL-17 in the spleen and peripheral lymph nodes. However, s.c. immunization induces both an IFN-γ and an IL-17 CD4+ T cell response in spleen and lymph nodes. The failure to induce a CD4+ T cell IL-17 response after i.p. immunization is associated with T cell priming, as naive T cells activated in vitro were fully capable of producing IL-17. Moreover, PG-induced arthritis is converted from an IFN-γ to an IL-17–mediated disease by altering the route of immunization from i.p. to s.c. The histological appearance of joint inflammation (cellular inflammation and bone erosion) is similar in the i.p. versus s.c. immunized mice despite the presence of CD4+ T cells producing IL-17 in joint tissues only after s.c. immunization. These data indicate a critical role for the site of initial T cell priming and the Th cytokines required for susceptibility to arthritis. Our findings suggest that T cell activation at different anatomical sites in rheumatoid arthritis patients may skew the T cells toward production of either IFN-γ or IL-17.
The safety of cannabinoids for the treatment of multiple sclerosis

The evidence for the therapeutic efficacy of cannabinoids in the treatment of multiple sclerosis (MS) is increasing but is not as yet convincing. Although several trials have reported no significant effect, the majority of the evidence which supports a beneficial effect on spasticity and pain is based on subjective measurements in trials where unblinding was likely to be a problem. The available clinical trial data suggest that the adverse side effects associated with using cannabis-based medicinal extracts (CBMEs) are generally mild, such as dry mouth, dizziness, somnolence, nausea and intoxication, and in no case did toxicity develop. However, most of these trials were run over a period of months and it is possible that other adverse side effects, not seen in these short-term studies, could develop with long-term use. Despite the evidence that cannabinoids can disrupt cognitive function and promote depression, on the basis of current data, such adverse effects seem unlikely to be associated with the use of CBMEs. Likewise, there is no evidence to suggest that their effects on balance and motor control, or immune function, may be clinically significant. There is, however, reason to be concerned about the use of therapeutic cannabinoids by people predisposed to psychosis and by pregnant women, given the increasing evidence of their adverse effects on the fetus. In conclusion, given the modest therapeutic effects of cannabinoids demonstrated so far, and the risk of long-term adverse side effects, there is reason to be cautious about their use in the treatment of MS.
Direct excitatory interactions between spinal motoneurones of the cat.

1. Ninety‐seven spinal motoneurones were identified by their antidromic invasion following stimulation of the muscle nerve and submitted to a series of four tests to reveal a possible direct excitation between motoneurones. 2. Threshold differentiation, refractoriness, hyperpolarization and collision revealed antidromically induced depolarizations in fourteen of the ninety‐seven tested motoneurones. 3. The parameters of the antidromically induced depolarizations indicate a short latency, a low amplitude and independence with regard to the membrane polarization. 4. It is concluded that the antidromically induced depolarizations reached the impaled motoneurone via a route other than its own axon. 5. The mechanism may involve either electrotonic interactions between neighbouring motoneurones or excitatory recurrent collaterals between synergist motoneurones.
Indicators of suboptimal biologic therapy over time in patients with ulcerative colitis and Crohn's disease in the United States

This study assessed the occurrence of indicators for suboptimal biologic therapy among ulcerative colitis (UC) and Crohn’s disease (CD) patients over time in the United States (US). Data from a large US claims database (2005–2013) were used to retrospectively identify patients with diagnosed with either UC or CD who were new biologic users. Indicators of suboptimal biologic therapy included: dose escalation during the maintenance phase, discontinuation of the initial biologic, switch to another biologic within 90 days following the last day of supply of the initial biologic, augmentation with a non-biologic systemic therapy, UC- or CD-related surgery, UC- or CD-related urgent care, and development of fistula (for CD only). Kaplan-Meier analyses were used. A total of 1,699 UC and 4,569 CD patients were included. Among UC patients, 51.1% and 90.9% experienced ≥1 indicator of suboptimal biologic therapy within 6 months and 36 months of biologic therapy initiation, respectively. Among CD patients, 54.3% and 91.4% experienced ≥1 indicator of suboptimal biologic therapy within 6 and 36 months of biologic therapy initiation, respectively. For both UC and CD patients, the most frequent indicators of suboptimal biologic therapy were discontinuation, dose escalation and augmentation. In conclusion, this study found that the occurrence of suboptimal biologic therapy is common among patients with UC and CD, with approximately 90% of patients experiencing at least one indicator of suboptimal biologic therapy within 36 months of biologic treatment initiation.
Effect of food and gastric acidity on absorption of orally administered ketoconazole.

Effects of food and gastric acidity on the bioavailability of ketoconazole tablets were investigated in 12 volunteers using a six-treatment, randomized, Latin-square crossover design. All volunteers received all treatments, as follows: (A) ketoconazole 200 mg administered after a fast; (B) ketoconazole 200 mg with a standardized high-fat meal; (C) ketoconazole 200 mg with a standardized high-carbohydrate meal; (D) ketoconazole 200 mg after pretreatment with glutamic acid hydrochloride 680 mg as capsules; (E) ketoconazole 200 mg in a simulated achlorhydric state induced with cimetidine and sodium bicarbonate; and (F) ketoconazole 200 mg administered with glutamic acid hydrochloride in a simulated achlorhydric state. Ketoconazole concentrations were measured by high-performance liquid chromatography in plasma samples drawn immediately before and at various times over 24 hours after drug administration. Bioavailability variables, including natural logarithm transformation for area under the concentration-time curve (AUC), were subjected to analysis of variance followed by Duncan's Multiple Range testing. Treatments B and C significantly prolonged the times required to achieve the peak plasma ketoconazole concentration, and treatment C also significantly reduced the peak plasma ketoconazole concentration (Cmax) compared with treatment A. There was a trend toward increased AUC values with treatment B and decreased AUC values with treatment C. Treatment D produced a higher Cmax compared with treatment A, and treatment E produced large, significant reductions in Cmax and AUC values compared with treatment A. Treatment F significantly increased AUC values and Cmax compared with treatment E. (ABSTRACT TRUNCATED AT 250 WORDS)
Grupos estratégicos en las franquicias españolas

2001, se realizaron por medio de esta for-mula mas del 7% de las ventas del comer-cio minorista (1) a traves de unas 700marcas (2). Ademas, la tendencia es cre-ciente, dado que esta cifra aun se hallamuy lejos de las de otros paises, comoEEUU, donde supone mas de un 30% deestas ventas (Shane y Spell, 1998). Este estudio se refiere a la llamada fran-quicia de negocio, en la que se transmiteun concepto de negocio completo a losfranquiciados, pero existe otra categoria,denominada franquicia de producto. Las
Evidence that multiple proteases of Bacillus subtilis can degrade fibrin and fibrinogen.

Fibrinolytic enzyme produced by Bacillus spp. are known to possess an unique property to degrade fibrin blood clots. Fibrinolytic enzyme such as nattokinase has commercial applications as a therapeutic agents and functional food formulation. In this study, we report an interesting characteristic feature of Bacillus subtilis BR21, a native isolate for its ability to produce multiple proteases that exclusively acts on fibrin and fibrinogen. The crude enzyme preparation was made from the culture grown in soybean powder supplemented Luria Bertani broth. The culture filtrate was found to contain proteases, that could collectively degrade fibrin and fibrinogen effectively. Zymogram indicated presence of six fibrinolytic proteases and these degraded all the four peptide chains of fibrin rapidly. However, only Aα, Bβ chains of fibrinogen were highly susceptible to the enzymes. Activity inhibition by PMSF and EDTA indicated the presence of serine and metallo proteases. Fibrinolytic and fibrinogenolytic activities, specifically the ability to degrade γ-γ′ dimer of fibrin, promises its potential as both therapeutic and prophylactic agents, for thrombosis related disorders as this remains undegraded in such conditions. The fibrinolytic ability of multiple proteases together may help in developing cheaper and effective orally administrable thrombolytic preparations.
Experimental studies on myocardial contractility and hemodynamics in extrasystoles.

Extrasystoles with a fully compensated pause were experimentally induced in dogs for analysis of their effects on myocardial contractility and hemodynam-ics. The first postextrasystolic beat showed improved hemodynamic measurements exceeding the respective values of the pre-extrasystolic beat of the basic rhythm, making some compensation for extrasystole-induced depression of hemodynamics, which was progressively enhanced as the coupling time be-came shorter. The coupling time, the site of origin, and even the frequency of the extrasystole did not affect the rate of compensation, which averaged 60%. It was confirmed that hemodynamics in extrasystoles was mainly affected by two independent factors; the blood volume in the ventricle at the onset of ventricular contraction with the resultant STARLING'S effect, and ventricular contractility for individual beats, the latter of which depends upon myocardial contractility and the sequence of ventricular contraction. Postextrasystolic potentiation was regarded as the positive inotropic effect of the premature activation on the myocardium in postextrasystolic beats.
Transcriptomics-assisted quantitative trait locus fine mapping for the rapid identification of a nodulin 26-like intrinsic protein gene regulating boron efficiency in allotetraploid rapeseed.

Allotetraploid rapeseed (Brassica napus L., An An Cn Cn , 2n = 4x = 38) is extraordinarily susceptible to boron (B) deficiency, a ubiquitous problem causing severe losses in seed yield. The breeding of B-efficient rapeseed germ plasm is a cost-effective and environmentally friendly strategy for the agricultural industry; however, genes regulating B efficiency in allotetraploid rapeseed have not yet been isolated. In this research, quantitative trait locus (QTL) fine mapping and digital gene expression (DGE) profiling were combined to identify the candidate genes underlying the major-effect QTL qBEC-A3a, which regulates B efficiency. Comparative phenotype analyses of the near-isogenic lines (NILs) indicated that qBEC-A3a plays a significant role in improving B efficiency under B deficiency. Exploiting QTL fine mapping and DGE analyses revealed a nodulin 26-like intrinsic protein (NIP) gene, which encodes a likely boric acid channel. The gene co-expression network for putative B transporters also highlighted its central role in the efficiency of B uptake. An integration of whole-genome re-sequencing (WGS) with bulked segregant analysis (BSA) authenticated the emerging availability of QTL-seq for the QTL analyses in allotetraploid rapeseed. Transcriptomics-assisted QTL mapping and comparative genomics provided novel insights into the rapid identification of quantitative trait genes (QTGs) in plant species with complex genomes.
Hydrogenkwadaphnin Induces Monocytic Differentiation and Enhances Retinoic Acid-mediated Granulocytic Differentiation in NB 4 Cell Line

Recently, we have reported that 3-hydrogenkwadaphnin (3-HK), a diterpene ester isolated from Dendrostellera lessertii (Thymealeaceae), is very effective against leukemia cell lines without any detectable effects on normal cells (Moosavi et al., 2005b). In this study, we report that 3-HK induces G1 cell-cycle arrest, differentiation and apoptosis in APL NB4 cell line. Indeed, the drug between 24 to 96 h induced 7-65% growth inhibition of NB4 cells. Cell viability was also decreased by 2-55% between 24 to 96 h treatments with the drug, respectively. These effects of the drug were also dose-dependent. According to flow cytomtry results, 3-HK (15 nM) induced a significant G1-arrest up to 24 h which was consequently followed with appearance of sub-G1 peak at 72 to 96 h. Hoechst 33258 staining and DNA fragmentation assays confirmed the occurrence of apoptosis among the treated cells. On the other hand, NBT reducing assay, Wright-Giemsa staining, phagocytic activity and expression of cell surface markers (CD11b and CD14) confirmed that the inhibition of proliferation is associated with differentiation especially toward macrophage-like morphology. Interestingly, 3-HK at 5 and 10 nM enhanced the effects of all-trans retinoic acid (ATRA) in NB4 cells. Based on these results, 3-HK might become an ideal candidate for treatment of APL patients pending full exploration of its biological functions.
Adenoviral VEGF‐A gene transfer induces angiogenesis and promotes bone formation in healing osseous tissues

Vascular endothelial growth factor (VEGF) is a key regulator of angiogenesis. VEGF has been safely and efficiently applied to stimulate neovascularization in ischemic tissues in atherosclerotic patients. VEGF has an important role in bone repair by promoting angiogenesis and by stimulating major skeletal cell populations, chondrocytes, osteoblasts and osteoclasts.
What’s New in Traumatic Brain Injury: Update on Tracking, Monitoring and Treatment

Traumatic brain injury (TBI), defined as an alteration in brain functions caused by an external force, is responsible for high morbidity and mortality around the world. It is important to identify and treat TBI victims as early as possible. Tracking and monitoring TBI with neuroimaging technologies, including functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), positron emission tomography (PET), and high definition fiber tracking (HDFT) show increasing sensitivity and specificity. Classical electrophysiological monitoring, together with newly established brain-on-chip, cerebral microdialysis techniques, both benefit TBI. First generation molecular biomarkers, based on genomic and proteomic changes following TBI, have proven effective and economical. It is conceivable that TBI-specific biomarkers will be developed with the combination of systems biology and bioinformation strategies. Advances in treatment of TBI include stem cell-based and nanotechnology-based therapy, physical and pharmaceutical interventions and also new use in TBI for approved drugs which all present favorable promise in preventing and reversing TBI.
Global CLF stabilization of Systems with Point-dissipative Free Dynamics via Admissible Controls: Chaos Control of a Chua's System

The aim of this paper is to address the global asymptotic stabilization (GAS) of the class of affine control systems which are open-loop point-dissipatives (have compact global attractors), that include some chaotic systems (e.g. Lorenz, Chen, smooth Chua), via admissible (bounded and regular) feedback controls. The existence of the global attractor for the free dynamics, whose overestimation is achieved by a Lyapunov function V(x), allows us to use V(x) as a basis to obtain a control Lyapunov function (CLF) in order to apply our control design method (entailed from Artstein and Sontag's CLF-stabilization approach) developed for the GAS of affine control systems via admissible feedback controls. We illustrate the results with the chaos control of a smooth (cubic) Chua's system via admissible feedback controls.
The Component of Gaze Selection/Control in the Development of Visual Acuity in Children

Visual acuity was tested for 180 eyes of 90 children in four age groups using three types of test charts. Subjects read the same 10 high-contrast letters in Snellen (line) format, as isolated-letter flash cards, and as repeat-letter flash cards. Group mean line and group mean isolated-letter acuity showed similar progressive improvements with age. A subgroup of 24 of 50 eyes of 4- to 5-year-olds (15 of 25 subjects) and 3 of 50 eyes of 6- to 7-year-old (2 of 25 subjects) had low Snellen acuity. Of this low-acuity subgroup of 27 eyes, 10 scored above average for their age group on the repeat-letter chart. We concluded that abnormal lateral interactions were not the explanation for the immaturity of Snellen acuity in these 10 eyes. We suggest that an important factor in the low acuities of these 10 eyes is delayed development of the selection and/or control of gaze direction. Some eyes with excellent Snellen acuity showed high crowding. For example, there were five such eyes in the oldest group. We suggest that the excellent acuities of at least two of these eyes are limited by minor inaccuracies in gaze selection and/or control rather than by lateral interaction.
HTA decision support system for sustainable business continuity management in hospitals. The case of surgical activity at the University Hospital in Florence.

BACKGROUND A fundamental element of the social and safety function of a health structure is the need to guarantee continuity of clinical activity through the continuity of technology. OBJECTIVE This paper aims to design a Decision Support System (DSS) for medical technology evaluations based on the use of Key Performance Indicators (KPI) in order to provide a multi-disciplinary valuation of a technology in a health structure. METHODS The methodology used in planning the DSS followed the following key steps: the definition of relevant KPIs, the development of a database to calculate the KPIs, the calculation of the defined KPIs and the resulting study report. Finally, the clinical and economic validation of the system was conducted though a case study of Business Continuity applied in the operating department of the Florence University Hospital AOU Careggi in Italy. RESULTS A web-based support system was designed for HTA in health structures. The case study enabled Business Continuity Management (BCM) to be implemented in a hospital department in relation to aspects of a single technology and the specific clinical process. Finally, an economic analysis of the procedure was carried out. CONCLUSIONS The system is useful for decision makers in that it precisely defines which equipment to include in the BCM procedure, using a scale analysis of the specific clinical process in which the equipment is used. In addition, the economic analysis shows how the cost of the procedure is completely covered by the indirect costs which would result from the expenses incurred from a broken device, hence showing the complete auto-sustainability of the methodology.
State Classification of Time-Nonhomogeneous Markov Chains and Average Reward Optimization of Multi-Chains

In a discrete time nonhomogeneous Markov chain (TNHMC), the states spaces, transition probabilities, and reward functions at different times may be different. In this paper, with the confluencity previously introduced, we show that the states of a TNHMC can be classified into the branching states and a number of classes of confluent states (versus the transient and recurrent states in the time homogeneous case). The optimization of average reward in TNHMC's consisting of a single confluent class (uni-chain) have been addressed in a previous paper by the author. In this paper, we show that with confluencity and the state classification and under some bound conditions, we can obtain the necessary and sufficient conditions for optimal policies of the average reward of TNHMCs consisting of multiple confluent classes (multi-chains). Just like in the uni-chain TNHMC case, the sufficient condition does not need to hold in any “zero frequently visited” time sequence. This “under-selectivity” makes the problem not amenable to dynamic programming. A direct comparison based approach is used to prove the results. The results enhance our understanding of state classification and performance optimization with the notion of confluencity.