Miracle-dz/UniFAR-FTUs huggingface dataset:
Clopidogrel and Neuraxial Block The Role of the PFA II and P 2 Y 12 Assays

To the Editor: We describe the usefulness of the PFA II and P2Y12 assays in determining the residual antiplatelet activity of clopidogrel when neuraxial block is planned. The patient was a 68-year-old man who sustained a left femoral neck fracture and was scheduled for a hemiarthroplasty of the left side of the hip. He had a history of failed intubation because of his ankylosing spondylitis and placement of 3 bare metal coronary artery stents. He has been taking 75 mg of clopidogrel and 81 mg of aspirin daily since stent placement. The clopidogrel and aspirin were stopped 5 days before the surgery, although the patient was administered aspirin on the day of the surgery. Physical examination showed severely limited range of motion of his neck. His platelet count was 235,000/KL. The PFA II result was 87 seconds (reference range, 41Y134 seconds). The P2Y12 assay showed 8% platelet inhibition and a platelet reaction unit (PRU) of 250 (reference range, 194Y 418). We performed spinal anesthesia with 12 mg of hyperbaric bupivacaine, which resulted in a sensory level of T4. He was brought to the post anesthesia care unit with a sensory level of T5, and there was complete sensory and motor recovery 3.5 hrs later. There was no bruising at the site of the spinal anesthesia, and the rest of his recovery was uneventful. The American Society of Regional Anesthesia consensus guidelines recommend the discontinuation of clopidogrel for 7 days before a neuraxial injection. There is a case report of a caudal steroid injection 5 days after discontinuation of the clopidogrel; no test of platelet activity was performed before the injection. In our patient, we performed a spinal anesthesia in view of the 8% platelet inhibition and a P2Y12 PRU that showed no residual antiplatelet activity of the clopidogrel. The numbers representing residual platelet reactivity (Q68 seconds for the PFA II and Q264 P2Y12 PRU for the P2Y12 assay) were determined in 1267 patients by comparing the 2 assays with the light transmission aggregation test, the standard test for the determination of antiplatelet activity of drugs. It was also noted that there was a better correlation of the P2Y12 assay with light transmission aggregation than the PFA test. The PFA test cost $154.00, whereas the P2Y12 assay costs $459.00. Another test, the platelet mapping portion in the thrombelastography, has been used, but limitations in its clinical usefulness have been noted. Our 1 case of an uneventful spinal anesthesia does not guarantee the safety of neuraxial injections 5 days after clopidogrel is stopped. If a neuraxial injection has to be performed before 7 days after clopidogrel is stopped, then either the PFA II or the P2Y12 assay, preferably the P2Y12 assay if available, should be considered to determine the residual antiplatelet activity of clopidogrel. Further studies are required to determine the clinical appropriateness of these tests.
Temperament and social behaviour at home and school among typically developing children and children with an intellectually disability.

BACKGROUND There has been limited research on differences in temperament between typically developing children and children with an intellectual disability (ID). Individual differences have generally been neglected in previous investigations of children with an ID. The present research investigated differences in temperament and social behaviour between typically developing children and children with an ID, in both home and school settings. METHODS Participants were 100 children (M = 10.7 years, SD = 0.88) from both regular and special education schools. Temperament was measured using the Emotionality, Activity, Sociability (EAS) Temperament Survey for Children (parental and teacher ratings), while social behaviour was measured using the School Social Behaviour Scales, Second Edition (SSBS-2) and the Home and Community Social Behaviour Scales (HCSBS). RESULTS There were minimal significant differences in temperament between the regular and special education groups. Children who attended regular schools had a significantly higher level of social competence and significantly lower level of antisocial behaviour both at home and school, when compared with children who attended special schools. CONCLUSIONS The difference in social behaviour between children attending regular and special schools was attributed to the difference in intellectual ability of the two groups, as well as contextual influences of regular or special school environments.
A preliminary randomized controlled study on the effectiveness of vestibular-specific neuromuscular training in children with hearing impairment

Objective: To determine the effectiveness of vestibular-specific neuromuscular training on motor skills, balance and health-related quality of life in children with hearing impairment. Design: Controlled, randomized, preliminary study. Setting: Rehabilitation school for children with hearing impairment. Subjects and intervention: Twenty-three children with mean age of 7.5–8.1 years with hearing impairment were randomized to either the intervention or the control group. Children in the experimental group (n = 11) participated in vestibular-specific neuromuscular training for six weeks and the children in the control group continued their regular activities followed at school. Outcome measures: Measurement of motor skills (Test of Gross Motor Development-2), postural control (Pediatric Reach Test, One Leg Standing Balance Test and postural sway meter) and health-related quality of life (PedsQL Generic Core Scale). Results: Following intervention, the scores of motor skills (Test of Gross Motor Development P = 0.02; throw for distance P = 0.042; kick for distance P = 0.08; jump for distance P = 0.001; 15-yard dash P = 0.001), postural control measures (Pediatric Reach Test P = 0.001; One Leg Standing Test P = 0.03; and anteroposterior sway (eyes open P = 0.007, eyes closed P = 0.03); mediolateral sway (eyes open P = 0.014, eyes closed P = 0.017) and health-related quality of life (P = 0.01) improved significantly in the experimental group and not in the control group. Conclusion: The findings of the study suggest that vestibular-specific neuromuscular training programme may improve the motor skills, balance and health-related quality of life in children with hearing impairment.
Condylar guidance: correlation between protrusive interocclusal record and panoramic radiographic image: a pilot study.

PURPOSE The purpose of this study was to compare the sagittal condylar angles set in the Hanau articulator by use of a method of obtaining an intraoral protrusive record to those angles found using a panoramic radiographic image. MATERIALS AND METHODS Ten patients, free of signs and symptoms of temporomandibular disorder and with intact dentition were selected. The dental stone casts of the subjects were mounted on a Hanau articulator with a springbow and poly(vinyl siloxane) interocclusal records. For all patients, the protrusive records were obtained when the mandible moved forward by approximately 6 mm. All procedures for recording, mounting, and setting were done in the same session. The condylar guidance angles obtained were tabulated. A panoramic radiographic image of each patient was made with the Frankfurt horizontal plane parallel to the floor of the mouth. Tracings of the radiographic images were made. The horizontal reference line was marked by joining the orbitale and porion. The most superior and most inferior points of the curvatures were identified. These two lines were connected by a straight line representing the mean curvature line. Angles made by the intersection of the mean curvature line and the horizontal reference line were measured. The results were subjected to statistical analysis with a significance level of p < 0.05. RESULTS The radiographic values were on average 4° greater than the values obtained by protrusive interocclusal record method. The mean condylar guidance angle between the right and left side by both the methods was not statistically significant. The comparison of mean condylar guidance angles between the right side of the protrusive record method and the right side of the panoramic radiographic method and the left side of the protrusive record method and the left side of the panoramic radiographic method (p= 0.071 and p= 0.057, respectively) were not statistically significant. CONCLUSION Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used in programming semi-adjustable articulators.
Anaemia in myelofibrosis: its value in prognosis

Summary. Forty‐four patients with myelofibrosis were investigated in our hospital in the period 1971–81. Their clinical, laboratory and radioisotope parameters were analysed. The direct correlation between plasma volume and splenic red cell pool has highlighted the role of the spleen in the dilutional anaemia seen in myelofibrosis. 52Fe quantitation enabled us to show that the bone marrow contributes relatively more to effective erythropoiesis than the extramedullary sites. The prognostic value of changes in plasma volume and bone marrow 52Fe activity has been demonstrated. We have shown that the Hb: reticulocyte relationship at diagnosis can be used to recognize probable stages of the disease and provides a useful prognostic determinant.
The Future of Journalism as a System, Profession and Culture: The Perception of Journalism Students

Currently, there is clear need for traditional journalism to redefi ne itself. The intention of this article is to portray the voices of future journalists in this quest. Therefore, Belgrade University journalism students were assigned to write down their contemplations about the journalism of tomorrow in essayistic form. In order to systematize their narratives, three theoretical understandings of journalism are introduced based on a literature review: journalism as a societal system, profession and culture. The essays were analyzed using quantitative and qualitative content and critical discourse analyses. The students’ anticipated changes in journalism understood as a system, profession and culture are discussed, with a special focus on language, in order to deconstruct how students evaluate the future of journalism. Furthermore, the article shows how students perceive their role in redefi ning journalism.
The distribution of 2-keto-3-deoxy-octonic acid in bacterial walls.

SUMMARY: A survey of the walls of over 80 bacterial species has been carried out using chromatographic and colorimetric techniques to demonstrate the presence of 2-keto-3-deoxy-octonic acid (KDO) and or sialic acid. In most Gram-negative bacteria KDO but not sialic acid was found in the wall, whereas the walls of Gram-positive bacteria contained neither compound.
ImprovedRadioimmunoassayfor CreatineKinaselsoenzymesin Plasma

We describe convenient and relatively rapid procedures for purifying creatine kinase isoenzymes MM, BB, and MB, and their use in an improved radioimmunoassay for creatine kinase isoenzymes in plasma. The modifications include use of: (a) BB with a specific activity of 400 kU/g, which can be labeled with a specific radioactivity of 20 Ci/g; (b) albumin-free purified MB as inhibitor; (c) antiserum to MB creatine kinase; and (d) a second-antibody technique that necessitatesonly a 15-mm incubation. The radioimmunoassay for MB has a sensitivity of 0.2 jigiL (80 mU/L) and a CV of <5%. Plasma MB average 22 (SD 12) ,. tgIL in 200 normal subjects: 24 (SD 12) /ig/L in 200 patients with chest pain without infarction: and 23 (SD 7) jig/L in 43 patients with renal disease, whether measured before or after dialysis. Peak values for plasma MB averaged 191 (SD 86) ,ig/L in 325 patients with documented myocardial infarction: BB was negligible. Extensive clinical experience indicates the radioimmunoassay to be suitably rapid, highly sensitive, and reliable as a diagnostic assay for MB in plasma.
The role of movement representation in episodic memory for actions: A study of patients with apraxia

In attempting to memorize a sentence about an action, such as “Pick up the glass,” performing the action (motor encoding) results in better memory performance than simply memorizing the words (verbal encoding). Such enhancement of memory is known as the enactment effect. Several theories have been proposed to explain this phenomenon using concepts such as physical motor information associated with speed, form, amplitude of movement and/or movement representations involved in movement imaging, knowledge on manipulating tools, and spatial relationships in the enactment effect. However, there have been no cognitive neuropsychological studies investigating whether the enactment effect is crucially influenced by physical motor information or movement representations. To clarify this issue, we compared healthy adult control participants with two different types of apraxia patients. One patient with left hemisphere lesions caused by cerebral infarction had a disability involving multiple movement representations. The other patient showed symptoms of corticobasal syndrome and was not able to benefit from feedback on the accuracy of her motor movements during enactment. Participants memorized action sentences via either verbal or motor encoding and responded to recall and recognition tests. Results indicated that the patient with the movement representation deficits exhibited worse memory performance than the other patient or control participants following both verbal and motor encoding. Although the enactment effect was present during recall in both patients, the effect was not observed for recognition in the patient with severe movement representation deficits. These results suggest that movement representations are involved in encoding episodic memories of action. Moreover, the role of movement representations appears to depend on the form of retrieval that is being used.
Long-term follow-up of a randomized, controlled clinical trial of three therapeutic strategies for multivessel stable coronary artery disease in women.

OBJECTIVES Coronary artery disease is the leading cause of death in women. The proposed treatments for women are similar to those for men. However, in women with multivessel stable coronary artery disease and normal left ventricular function, the best treatment is unknown. METHODS A post hoc analysis of the MASS II study with 10 years of follow-up, mean (standard deviation) 6.8 (3.7) years, enrolled between May 1995 and May 2000, evaluated 188 women with chronic stable multivessel coronary artery disease who underwent medical treatment, percutaneous coronary intervention or coronary artery bypass graft surgery. Primary end-points were incidence of total mortality, Q-wave myocardial infarction, or refractory angina. Data were analysed according to the intention-to-treat principle. RESULTS Women treated with percutaneous coronary intervention and medical treatment had more primary events than those treated with coronary artery bypass graft surgery, respectively, of 34, 44 and 22% (P = 0.003). Survival rates at 10 years were 72% for coronary artery bypass graft surgery, 72% for percutaneous coronary intervention and 56% for medical treatment (P = 0.156). For the composite end-point, Cox regression analysis adjusted for age, diabetes, hypertension, treatment allocation, prior myocardial infarction, smoking, number of vessels affected and total cholesterol, had a higher incidence of primary events with medical treatment than with coronary artery bypass graft surgery [hazard ratio (HR) = 2.38 (95% confidence interval (CI): 1.40-4.05); P = 0.001], a lower incidence with percutaneous coronary intervention than with medical treatment [HR = 0.60 (95% CI: 0.38-0.95); P = 0.031] but no differences between coronary artery bypass graft surgery and percutaneous coronary intervention. Regarding death, a protective effect was observed with percutaneous coronary intervention compared with medical treatment [HR = 0.44 (95% CI: 0.21-0.90); P = 0.025]. CONCLUSIONS Percutaneous coronary intervention and coronary artery bypass graft surgery compared with medical treatment had better results after 10 years of follow-up.
Liver Resection for Colorectal Cancer: Liver Metastases in the Aged

The purpose of this study was to determine the morbidity and mortality in elderly patients undergoing liver resections for metastatic colon cancer and compare them with those of a control group of younger patients. The charts of all patients undergoing liver resection for colon cancer were retrospectively reviewed. Patients less than 70 years of age (Group A) were compared with patients 70 years of age or older (Group B). Between 1971 and 1995, 167 liver resections were performed for metastatic colorectal cancer. Of these, 41 patients were in Group A and 126 patients were in Group B. The mean age of Group A was 74.5 years, and that of Group B was 57 years. American Society of Anesthesiologists (ASA) classification was similar for both groups (Groups A and B were 75.6% and 81.1% ASA class II, respectively). Anatomic resections were performed in 49 per cent and wedge resections in 51 per cent of patients in Group A, and 68 and 32 per cent in Group B, respectively. Estimated blood loss was slightly less for Group A (1575 vs 1973 cm3), as was operative time (4.0 vs 4.7 hours). In-hospital mortality rate was 7.3 per cent for Group A and 2.4 per cent for Group B. The major morbidity rates were 29 and 17.5 per cent, respectively. Intensive care unit care was necessary in 73 per cent (mean length of stay 3.9 days) for Group A and 62.6 per cent (mean length of stay 2.0 days) for Group B. The average length of hospitalization was 13.1 days for Group A and 16.6 days for Group B. The recurrence rates were similar for the two groups [56% (Group A) vs 66% (Group B)], but mean survival was longer for younger patients (22.9 vs 33.5 months). We conclude that liver resection for colorectal cancer liver metastases in properly selected patients older than 70 years of age can be performed with acceptable morbidity and mortality rates. The long-term survival for older patients is less than that for younger patients, but is still a significant length of time. Therefore, we conclude that age alone is not a contraindication to liver resection for colorectal cancer metastases in patients older than 70.
Transforming growth factor‐beta and fibroblast growth factor act synergistically to inhibit collagen II synthesis through a mechanism involving regulatory DNA sequences

Transforming growth factor‐beta (TGF‐β) and fibroblast growth factor (FGF) are two growth factors that will modulate chondrocyte growth and matrix synthesis. Here we report that these two growth factors act in a synergistic fashion to suppress the synthesis of type II collagen by embryonic chicken sternal chondrocytes. Treatment of chondrocytes with 20 ng/ml TGF‐β or 100 ng/ml FGF (acidic or basic) results in a 60–70% suppression of expression of the pro α1 chain of type II collagen. By comparison, when chondrocytes are exposed to a combination of 1 ng/ml TGF‐β and 10 ng/ml FGF, a complete suppression of type II collagen synthesis was observed. Epidermal growth factor (EGF), platelet‐derived growth factor (PDGF), or insulin‐like growth factor‐1 (IGF‐1) produce no suppression of synthesis either individually or in combination with TGF‐β. The decreased expression of the protein results from a decrease in the steady‐state level of the mRNA transcript coding for type II procollagen, as indicated by a northern analysis. Finally, chondrocytes transfected with a plasmid carrying the CAT gene driven by the collagen II promoter/enhancer sequence displayed high levels of CAT activity when cultured in control media, but treatment of the cells with a combination of the two growth factors resulted in a dramatic reduction of CAT activity, indicating diminished promoter activity. These results suggest that both TGF‐β and FGF can down‐regulate transcription of the collagen II gene through regulatory DNA sequences in the promoter and/or enhancer region. In addition, the finding of synergy suggests that these two growth factors may act through different pathways.
Facial Skin Smoothness as an Indicator of Perceived Trustworthiness and Related Traits

Facial texture has typically been studied as an umbrella phenomenon comprising several properties, such as skin tone and smoothness. Furthermore, texture has normally been addressed within complex models including also structural and dynamic properties and focusing on the extraction of perceptual dimensions from large numbers of physical and personality traits. It is yet unclear how individual facial textural properties affect the perception of individual physical and personality traits. We took a step in this direction by showing that the manipulation of a single facial textural property (skin smoothness) affected explicit evaluations of trustworthiness, competence, attractiveness, and health independently and in combination. Within the context of skin smoothness, our data also suggest a direct perceptual route for physical and an indirect perceptual route for personality traits.