Miracle-dz/UniFAR-FTUs huggingface dataset:
A change in the management of intractable obstetrical hemorrhage over 15 years in a tertiary care center

Context: Peripartum hysterectomy was the gold standard to save a woman with persistent obstetrical bleeding, but compromised the menstrual and reproductive functions. Bilateral internal iliac artery ligation (BIAL) is a potentially effective, fertility preserving means of controlling pelvic hemorrhage, but with surgical and anesthetic risks and low success. Angiographic embolization has the potential to arrest severe pelvic hemorrhage without removing the uterus and without hazarding general anesthesia in a hemodynamically unstable patient. Aims: The aim of this study is to discuss change in the management of intractable obstetrical hemorrhage from removing to conserving the uterus over 15 years. Settings and Design: A retrospective analysis of 122 cases of intractable obstetrical hemorrhage over a period of 15 years (January 1997 to December 2011) was done. We started uterine artery embolization (UAE) in 2007 for obstetrical hemorrhage. The patients were analyzed for maternal characteristics, indications, treatment modality, maternal morbidity, and mortality. Statistical Analysis Used: Descriptive. Results: We analyzed 12,055 deliveries, (6029 cesarean sections; 6026 vaginal deliveries). One hundred and twenty-two cases of intractable obstetrical hemorrhage were managed with obstetrical hysterectomies in 63, UAE in 53 cases and BIAL in six cases. During the period between 1997 and 2006 intractable obstetrical hemorrhage was managed by hysterectomy/internal iliac artery ligation. The last 5 years of the study period had 80 patients with intractable obstetrical hemorrhage, 53 patients underwent arterial embolization and 35 had a hysterectomy and two had internal artery ligation. There was no mortality and significantly less morbidity in embolization group in our study. Conclusions: Embolization should be tried in patients with intractable obstetrical hemorrhage before proceeding for surgical intervention.
Changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal-directed hemodynamic optimization at admission to ICU and the relation to outcome.

OBJECTIVE To evaluate the changes in tissue perfusion parameters in dogs with severe sepsis/septic shock in response to goal-directed hemodynamic optimization in the ICU and their relation to outcome. DESIGN Prospective observational study. SETTING ICU of a veterinary university medical center. ANIMALS Thirty dogs with severe sepsis or septic shock caused by pyometra who underwent surgery and were admitted to the ICU. MEASUREMENTS AND MAIN RESULTS Severe sepsis was defined as the presence of sepsis and sepsis-induced dysfunction of one or more organs. Septic shock was defined as the presence of severe sepsis plus hypotension not reversed with fluid resuscitation. After the presumptive diagnosis of sepsis secondary to pyometra, blood samples were collected and clinical findings were recorded. Volume resuscitation with 0.9% saline solution and antimicrobial therapy were initiated. Following abdominal ultrasonography and confirmation of increased uterine volume, dogs underwent corrective surgery. After surgery, the animals were admitted to the ICU, where resuscitation was guided by the clinical parameters, central venous oxygen saturation (ScvO(2)), lactate, and base deficit. Between survivors and nonsurvivors it was observed that the ScvO(2), lactate, and base deficit on ICU admission were each related independently to death (P = 0.001, P = 0.030, and P < 0.001, respectively). ScvO(2) and base deficit were found to be the best discriminators between survivors and nonsurvivors as assessed via receiver operator characteristic curve analysis. CONCLUSION Our study suggests that ScvO(2) and base deficit are useful in predicting the prognosis of dogs with severe sepsis and septic shock; animals with a higher ScvO(2) and lower base deficit at admission to the ICU have a lower probability of death.
Susceptibility Pattern of Enterococci at Tertiary Care Hospital

The study was aimed to characterize enterococci from various clinical specimens, to determine the antimicrobial susceptibility pattern, and to explore the association between virulence factors and antimicrobial resistance. A total of 283 clinical enterococcal isolates were speciated and subjected to antimicrobial susceptibility testing. Virulence factors (hemolysin, gelatinase, and biofilm production) were detected phenotypically. Of the 283 enterococci isolated, 12 species were identified; predominant species were Enterococcus faecalis (82.33%). High-level gentamicin (HLG) and vancomycin resistance were observed among 55.57% and 6.01% of enteroccal isolates, respectively. All vancomycin-resistant enterococci (VREs) were E. faecalis and had VanA phenotype and genotype. Hemolysin, gelatinase, and biofilm production were seen in 15.90%, 12.36%, and 13.43% of enterococcal isolates, respectively. Vancomycin and HLG resistance were observed in 0.35% and 61.86% of the enterococcal isolates producing virulence factors. Isolates resistant to HLG but susceptible to vancomycin expressed more virulent factors. Further research is required to reveal the complex interplay between drug resistance and virulence factors.
Self-organizing sensor networks for integrated target surveillance

Self-organization is critical for a distributed wireless sensor network due to the spontaneous and random deployment of a large number of sensor nodes over a remote area. Such a network is often characterized by its abilities to form an organizational structure without much centralized intervention. An important design goal for a smart sensor network is to be able have an energy-efficient, self-organized configuration of sensor nodes that can scan, detect, and track targets of interest in a distributed manner. In this paper, we propose a novel self-organization protocol and describe other relevant, indigenous building blocks that can be combined to build integrated surveillance applications for self-organized sensor networks. Experiments in both simulated and real-world platforms indicate that this protocol can be useful for tracking targets that follow a predictable course
Obsessive compulsive disorder and basal ganglia dysfunction

There is increasing evidence that selective basal ganglia dysfunction underlies obsessive-compulsive disorder (OCD). Recent neuroanatomical, neuropharmacological, and behavioural studies indicate a complex perceptual and cognitive role for the basal ganglia in addition to their more well-accepted motor functions. In addition, obsessive-compulsive symptoms in certain syndromes and in individual cases with basal ganglia disease, response to psychosurgery, and new antiobsessional drugs and recent brain-imaging studies all support such a model. OCD may represent the inappropriate triggering of genetically stored and learned behaviours by the striatum as the primary cause of OCD.
Dynamic Adaptation to Resource Scarcity and Backstop Availability: Theory and Application to Groundwater

In this paper we analyse the optimal management of a renewable resource (groundwater) with stock-dependent extraction cost and a backstop substitute, facing two-sector linear demands. Application to the Kiti region in Cyprus demonstrates the model’s performance and is used to test for the difference between optimal and myopic behaviour. It is found that the presence of a backstop resource diminishes the importance of optimal dynamic behaviour, whereas in the absence of backstop the optimal control solution yields a value for social welfare significantly larger than the myopic policy.
Opportunistic virus DNA levels after pediatric stem cell transplantation: serostatus matching, anti‐thymocyte globulin, and total body irradiation are additive risk factors

C. Kullberg‐Lindh, K. Mellgren, V. Friman, A. Fasth, H. Ascher, S. Nilsson, M. Lindh. Opportunistic virus DNA levels after pediatric stem cell transplantation: serostatus matching, anti‐thymocyte globulin, and total body irradiation are additive risk factors. Transpl Infect Dis 2011: 13: 122–130. All rights reserved
Prevention of Retinochoroiditis in Congenital Toxoplasmosis: Europe Versus South America

Congenital toxoplasmosis is suspected when seroconversion occurs in a pregnant woman, and it is confirmed by one or more biologic tests (polymerase chain reaction on amniotic fluid or neonatal serodiagnosis). The methods used are diagnostic in more than 95% of cases at birth and in 100% of cases by the age of 9 months. Ocular lesions represent the most frequent complication of congenital toxoplasmosis, independent of any treatment. The risk of toxoplasmic retinochoroiditis is highly unpredictable, however, mainly because the pathophysiology is poorly understood. By school age, 10% to 20% of children with congenital toxoplasmosis have one or more retinochoroidal lesions, but more than 90% of them have normal vision in both eyes; bilateral blindness is very rare. This article focuses on the controversy surrounding the effectiveness of screening and treatment for children with congenital toxoplasmosis.
Reformulación conversacional en adultos mayores

El presente trabajo tiene como objetivo determinar los tipos de actividades de reformulacion conversacional que aparecen en conversaciones en adultos mayores con diferentes niveles de desempeno cognitivo: normales y trastorno cognitivo leve, a partir de una tarea de construccion de un discurso narrativo-argumentativo. Desde una perspectiva de investigacion cualitativa, se obtuvo un corpus de 4 entrevistas, que fue codificado con la ayuda del software ATLAS.ti lo que permitio la generacion de conceptos y el desarrollo de explicaciones a partir de los datos, los que fueron contrastados con el marco teorico disponible. Los resultados indicaron que los hablantes realizaron actividades de auto-reformulacion auto-iniciada, auto-reformulacion iniciada por otro y hetero-reformulacion derivada del auto-inicio. Las dos primeras se redujeron en los hablantes identificados con trastorno cognitivo leve, mientras que el ultimo tipo de actividad fue el mas frecuente y dominante en la conversacion. Los hablantes con trastorno cognitivo leve realizaron reformulaciones que no corregian o adecuaban el discurso, por lo que no cumplieron con la finalidad de la reparacion.
Serum‐induced membrane depolarization in quiescent fibroblasts: activation of a chloride conductance through the G protein‐coupled LPA receptor.

Serum stimulation of quiescent fibroblasts leads to a dramatic depolarization of the plasma membrane; however, the identity of the active serum factor(s) and the underlying mechanism are unknown. We find that this serum activity is attributable to albumin‐bound lysophosphatidic acid (LPA) acting on its own G protein‐coupled receptor, and that membrane depolarization is due to activation of an anion conductance mediating Cl‐ efflux. This depolarizing Cl‐ current can also be activated by thrombin and neuropeptide receptors; it is distinct from volume‐regulated Cl‐ currents. Activation of the Cl‐ current consistently follows stimulation of phospholipase C and coincides with remodelling of the actin cytoskeleton, which is regulated by the Ras‐related GTPase Rho. However, the response is not due to Ca2+/protein kinase C signalling and requires neither Rho nor Ras activation. The results indicate that in quiescent fibroblasts, LPA and other G protein‐coupled receptor agonists evoke membrane depolarization by activating a new type of Cl‐ channel through a signalling pathway that is closely associated with phosphoinositide hydrolysis, yet independent of known second messengers.
PTPN11 Mutations in Noonan syndrome type I: detection of recurrent mutations in exons 3 and 13

We surveyed 16 subjects with the clinical diagnosis of Noonan Syndrome (NS1) from 12 families and their relevant family members for mutations in PTPN11/SHP2 using direct DNA sequencing. We found three different mutations among five families. Two unrelated subjects shared the same de novo missense substitution in exon 13 (S502T); an additional two unrelated families had a mutation in exon 3 (Y63C); and one subject had the amino acid substitution Y62D, also in exon 3. None of the three mutations were present in ethnically matched controls. In the mature protein model, the exon 3 mutants and the exon 13 mutant amino acids cluster at the interface between the N′ SH2 domain and the phosphatase catalytic domain. Six of eight subjects with PTPN11/SHP2 mutations had pulmonary valve stenosis while no mutations were identified in those subjects (N = 4) with hypertrophic cardiomyopathy. An additional four subjects with possible Noonan syndrome were evaluated, but no mutations in PTPN11/SHP2 were identified. These results confirm that mutations in PTPN11/SHP2 underlie a common form of Noonan syndrome, and that the disease exhibits both allelic and locus heterogeneity. The observation of recurrent mutations supports the hypothesis that a special class of gain‐of‐function mutations in SHP2 give rise to Noonan syndrome. Hum Mutat 20:298–304, 2002. © 2002 Wiley‐Liss, Inc.
Refilling medications through an online patient portal: consistent improvements in adherence across racial/ethnic groups

OBJECTIVE Online patient portals are being widely implemented; however, no studies have examined whether portals influence health behaviors or outcomes similarly across patient racial/ethnic subgroups. We evaluated longitudinal changes in statin adherence to determine whether racial/ethnic minorities initiating use of the online refill function in patient portals had similar changes over time compared with Whites. METHODS We examined a retrospective cohort of diabetes patients who were existing patient portal users. The primary exposure was initiating online refill use (either exclusively for all statin refills or occasionally for some refills), compared with using the portal for other tasks (eg, exchanging secure messages with providers). The primary outcome was change in statin adherence, measured as the percentage of time a patient was without a supply of statins. Adjusted generalized estimating equation models controlled for race/ethnicity as a primary interaction term. RESULTS Fifty-eight percent of patient portal users were white, and all racial/ethnic minority groups had poorer baseline statin adherence compared with Whites. In adjusted difference-in-difference models, statin adherence improved significantly over time among patients who exclusively refilled prescriptions online, even after comparing changes over time with other portal users (4% absolute decrease in percentage of time without medication). This improvement was statistically similar across all racial/ethnic groups. DISCUSSION Patient portals may encourage or improve key health behaviors, such as medication adherence, for engaged patients, but further research will likely be required to reduce underlying racial/ethnic differences in adherence. CONCLUSION In a well-controlled examination of diabetes patients' behavior when using a new online feature for their healthcare management, patient portals were linked to better medication adherence across all racial/ethnic groups.
Comparison between clinical and videofluoroscopic evaluation of swallowing in children with suspected dysphagia.

PURPOSE To verify the accuracy of clinical evaluation compared with videofluoroscopic swallowing studies in the detection of isolated laryngeal penetration and laryngeal aspiration in children with suspected dysphagia; to identify clinical signs and symptoms associated with isolated laryngeal penetration and laryngeal aspiration; and to determine the sensitivity and specificity of the clinical signs and symptoms identified. METHODS Retrospective analysis of data from clinical and videofluoroscopic evaluations carried out in 55 children from 1 month to 7 years and 11 months old. For clinical assessment, the Protocol for Clinical Assessment of Pediatric Dysphagia was used. The sensitivity, specificity, and positive and negative predictive values of clinical evaluation were analyzed. For statistical analysis, the Fisher's exact and χ2 tests were used. RESULTS Clinical evaluation showed, in general, a sensitivity of 86% and a specificity of 32%. For isolated laryngeal penetration, clinical evaluation showed a sensitivity of 88%. For laryngeal aspiration, clinical evaluation showed a sensitivity of 86%. However, the specificity values were low for both alterations. There was no association between clinical evaluation and videofluoroscopic findings. Choking was the only clinical sign associated with isolated laryngeal penetration thin fluid and showed a sensitivity of 53% and a specificity of 77%. CONCLUSIONS Clinical evaluation was sensible to detect isolated laryngeal penetration and laryngeal aspiration in children with suspected dysphagia. However, it showed a low specificity. Choking was the only clinical sign associated with isolated laryngeal penetration of thin fluid. More prospective studies are needed to confirm these findings in this population.
Inhibitor of human C3 associated with preparations of C3 dissociated from C3-zymosan complex.

Incubation of human serum with zymosan at 37°C, followed by removal of the zymosan residue by centrifugation, resulted in C3-zymosan complex. The C3-zymosan complex could be dissociated and C3 recovered in the eluate. Preparations of dissociated C3 did not contain the hemolytically active component of complement, C1 esterase, or fibrinolytic or caseinolytic activity. Addition of dissociated C3 to EAC142 blocked the formation of EAC1423 or EAC14235 by partially purified C3,C5. The effect of the inhibitor was not limited to intermediate complexes, it also blocked the hemolytic activity of serum was restored by adding C2, but not C3. A positive immune adherence test was obtained by treating EAC142 with dissociated C3. The data are discussed in relation to an hypothesis that the inhibitor in preparations of dissociated C3 is C3, which is hemolytically inactive, but participates in immune adherence and has greater affinity for SAC2 than the C3 molecule possessing functional integrity.
A central limit theorem and a law of the iterated logarithm for the Biggins martingale of the supercritical branching random walk

Abstract Let (W n (θ)) n∈ℕ0 be the Biggins martingale associated with a supercritical branching random walk, and denote by W_∞(θ) its limit. Assuming essentially that the martingale (W n (2θ)) n∈ℕ0 is uniformly integrable and that var W 1(θ) is finite, we prove a functional central limit theorem for the tail process (W ∞(θ)-W n+r (θ)) r∈ℕ0 and a law of the iterated logarithm for W ∞(θ)-W n (θ) as n→∞.
"Everything goes into or out of the iPad": the iPad, information scraps and personal information management

Personal information management (PIM) is of considerable interest to the information science community. Traditionally the domain of paper, desktop computers and laptops, we have seen the widespread introduction of tablet computers in PIM. In this paper we discuss the findings of the first stage of a multi year study into the emergent role of tablets in PIM with a particular focus on information and knowledge workers. We discuss a set of observations on how the use of tablet computers affects PIM and how it fits into the process of collecting and managing information. In particular, heavy tablet users appear to be supplanting paper with tablets for the purposes of micronote taking. A major finding detailed in the paper is an unexpected increase in the use of paper by heavy tablet users.
A Placebo-Controlled, Double-Blind, Cross-Over Trial of Flunarizine in Common Migraine

After four weeks of medication-free baseline observation, 29 patients with common migraine randomly received flunarizine (10 mg daily) or placebo for a 16-week period. After four weeks wash-out they crossed treatments for another 16 weeks; 27 patients completed the trial. Compared with placebo, flunarizine significantly reduced the frequency of migraine attacks and the derived headache indices, but the duration and severity of single attacks remained unchanged (Mann-Whitney U-test). The effect of flunarizine increased during the 16-week treatment period and during the last four weeks the number of migraine attacks was reduced to 50% compared to the wash-out period. The only side-effect of flunarizine was mild daytime sedation in three patients. It is concluded that flunarizine is a valuable new prophylactic agent for common migraine.
Plus strand strong‐stop DNA transfer in yeast Ty retrotransposons

The yeast Ty1 LTR retrotransposon replicates by reverse transcription and integration; the process shows many similarities to the retroviral life cycle. However, we show that plus strand strong‐stop DNA transfer in yeast Ty1 elements differs from the analogous retroviral process. By analysis of the native structure of the Ty1 primer binding site and by a series of manipulations of this region and assessment of the effects on retrotransposition, we show that primer binding site inheritance is not from the tRNA primer, which is inconsistent with classical retroviral models. This unusual inheritance pattern holds even when the Ty1 primer binding site is lengthened in order to be more retrovirus‐like. Finally, the distantly related Ty3 element has an inheritance pattern like Ty1, indicating evolutionary conservation of the alternative pathway used by Ty1. Based on these results we arrive at a plus strand primer recycling model that explains Ty1 plus strand strong‐stop DNA transfer and inheritance patterns in the primer binding site.
Release of von Willebrand Factor after Venous Occlusion – The Importance of Standardization of Venous Occlusion Tests

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Similar Representations of Emotions Across Faces and Voices

Emotions are a vital component of social communication, carried across a range of modalities and via different perceptual signals such as specific muscle contractions in the face and in the upper respiratory system. Previous studies have found that emotion recognition impairments after brain damage depend on the modality of presentation: recognition from faces may be impaired whereas recognition from voices remains preserved, and vice versa. On the other hand, there is also evidence for shared neural activation during emotion processing in both modalities. In a behavioral study, we investigated whether there are shared representations in the recognition of emotions from faces and voices. We used a within-subjects design in which participants rated the intensity of facial expressions and nonverbal vocalizations for each of the 6 basic emotion labels. For each participant and each modality, we then computed a representation matrix with the intensity ratings of each emotion. These matrices allowed us to examine the patterns of confusions between emotions and to characterize the representations of emotions within each modality. We then compared the representations across modalities by computing the correlations of the representation matrices across faces and voices. We found highly correlated matrices across modalities, which suggest similar representations of emotions across faces and voices. We also showed that these results could not be explained by commonalities between low-level visual and acoustic properties of the stimuli. We thus propose that there are similar or shared coding mechanisms for emotions which may act independently of modality, despite their distinct perceptual inputs.