Miracle-dz/UniFAR-FTUs huggingface dataset:
Survey of intrathecal opioid usage in the UK

Background and objective: Intrathecal opioids are now used routinely in the UK for intra‐ and postoperative analgesia. The opioids of choice have altered over recent years and the dosage regimens used can vary between institutions. Concerns over safety have been reduced probably because much lower doses of opioids are now being used. This survey explored the practice of intrathecal opioid usage in the UK. Methods: We sent a questionnaire survey to 270 anaesthetic departments and received 199 replies, a response rate of 73.7%. Results: Intrathecal opioids were used in 175 (88.4%) departments. Of these departments, 107 (61.1%) had local guidelines or protocols in place. Opioids such as diamorphine (used in 136 (78.2%) of departments) and fentanyl (129 (74.1%)) with a shorter duration of action are now more commonly used than morphine (37 (21.3%)) for intrathecal analgesia. In 96 (54.5%) departments, patients were nursed on regular surgical wards following administration of spinal opioids. Conclusions: The use of low‐dose lipophilic intrathecal opioids for postoperative analgesia is widespread in the UK. Patients are commonly nursed in low‐dependency post‐anaesthetic care areas. The low incidence of adverse events reported by the respondents along with the popularity of the technique suggests that low‐dose spinal opioid administration is safe.
Resonance Raman based skin carotenoid measurements in newborns and infants

We describe Resonance Raman based skin carotenoid measurements in newborns and infants. Skin‐ and serum carotenoid levels correlate with high statistical significance in healthy newborns and infants, and with reduced accuracy also in prematurely born infants, who in general feature very low carotenoid levels and thin transparent skin giving rise to large background absorption effects. Skin carotenoid levels can be easily compared among subjects and/or tracked in longitudinal studies with the highly molecule‐specific Raman method. It therefore holds promise as a rapid, non‐invasive, carotenoid antioxidant assessment method for newborns and infants in the field of pediatrics. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Urinary Soluble CD163 in Active Renal Vasculitis.

A specific biomarker that can separate active renal vasculitis from other causes of renal dysfunction is lacking, with a kidney biopsy often being required. Soluble CD163 (sCD163), shed by monocytes and macrophages, has been reported as a potential biomarker in diseases associated with excessive macrophage activation. Thus, we hypothesized that urinary sCD163 shed by crescent macrophages correlates with active glomerular inflammation. We detected sCD163 in rat urine early in the disease course of experimental vasculitis. Moreover, microdissected glomeruli from patients with small vessel vasculitis (SVV) had markedly higher levels of CD163 mRNA than did those from patients with lupus nephritis, diabetic nephropathy, or nephrotic syndrome. Both glomeruli and interstitium of patients with SVV strongly expressed CD163 protein. In 479 individuals, including patients with SVV, disease controls, and healthy controls, serum levels of sCD163 did not differ between the groups. However, in an inception cohort, including 177 patients with SVV, patients with active renal vasculitis had markedly higher urinary sCD163 levels than did patients in remission, disease controls, or healthy controls. Analyses in both internal and external validation cohorts confirmed these results. Setting a derived optimum cutoff for urinary sCD163 of 0.3 ng/mmol creatinine for detection of active renal vasculitis resulted in a sensitivity of 83%, specificity of 96%, and a positive likelihood ratio of 20.8. These data indicate that urinary sCD163 level associates very tightly with active renal vasculitis, and assessing this level may be a noninvasive method for diagnosing renal flare in the setting of a known diagnosis of SVV.
A yeast-based assay identifies drugs active against human mitochondrial disorders

Due to the lack of relevant animal models, development of effective treatments for human mitochondrial diseases has been limited. Here we establish a rapid, yeast-based assay to screen for drugs active against human inherited mitochondrial diseases affecting ATP synthase, in particular NARP (neuropathy, ataxia, and retinitis pigmentosa) syndrome. This method is based on the conservation of mitochondrial function from yeast to human, on the unique ability of yeast to survive without production of ATP by oxidative phosphorylation, and on the amenability of the yeast mitochondrial genome to site-directed mutagenesis. Our method identifies chlorhexidine by screening a chemical library and oleate through a candidate approach. We show that these molecules rescue a number of phenotypes resulting from mutations affecting ATP synthase in yeast. These compounds are also active on human cybrid cells derived from NARP patients. These results validate our method as an effective high-throughput screening approach to identify drugs active in the treatment of human ATP synthase disorders and suggest that this type of method could be applied to other mitochondrial diseases.
The Linkage Between Knowledge Management Practices and Company Performance: Empirical Evidence

Purpose: This study explores the linkage between Knowledge management practices and company performance. Keeping in view the theoretical and empirical importance, the present study examines the predicting linkage of Knowledge management practices (sharing of best practices and building of consistent process, continues employee learning, effective management of knowledge, innovative culture development, and management of core competencies) with company performance. Methodology: The study was carried out on purposively selected sample of 412 employees at different managerial positions. They were administered questionnaires including Knowledge Management Practices and company performance. Data was operated by using SPSS version 20.Correlation and regression analysis was done to establish the relationship between various Knowledge management practices and company performance. Findings: Results of this study illustrated that all selected Knowledge management were positively related to company performance. Based on the findings, and management of core competencies was the strongest predictor of company performance, followed by innovative culture development, effective management of knowledge and sharing of best practices and building of consistent process, continues employee learning. Research limitations/implications: The paper focuses on examining the perceptual impacts of Knowledge management (KM) practices on company performance. The interpretation of results should be taken with caution.
Epidemic Typhoid in Vietnam: Molecular Typing of Multiple-Antibiotic-Resistant Salmonella enterica Serotype Typhi from Four Outbreaks

ABSTRACT Multidrug-resistant Salmonella enterica serotype Typhi isolates from four outbreaks of typhoid fever in southern Vietnam between 1993 and 1997 were compared. Pulsed-field gel electrophoresis, bacteriophage and plasmid typing, and antibiotic susceptibilities showed that independent outbreaks of multidrug-resistant typhoid fever in southern Vietnam are caused by single bacterial strains. However, different outbreaks do not derive from the clonal expansion of a single multidrug-resistant serotype Typhi strain.
Adjuvant modulation of the immune responses and the outcome of infection with Chlamydia pneumoniae

Immunization with different adjuvants resulted in antithetic outcomes of infection with Chlamydia pneumoniae. Immunization with the outer major protein‐2 from C. pneumoniae (OMP‐2) emulsified in Freund's complete adjuvant (FCA) thus increased the susceptibility of mice to infection with the bacteria. The detrimental effect was not observed upon inoculation of irrelevant antigens or major outer membrane protein (MOMP) in FCA, but was also observed after immunization with FCA–chlamydial heat shock protein‐60 (HSP‐60). The harmful effect of FCA‐OMP‐2 depended on the presence of both CD4+ and CD8+ cells and was mediated by IL‐10, as shown using gene‐ablated mice. The increased susceptibility to infection caused by FCA‐OMP‐2 immunization was long‐lasting and observed in mice infected 4 months after the last dose of immunogen. In contrast, partial protection against C. pneumoniae was observed when FCA was replaced with oligodeoxynucleotides containing immunostimulatory CpG motifs mixed with Freund's incomplete adjuvant (FIA‐IS‐CpG). These polar outcomes of infection related to the cytokine pattern: antigen‐stimulated spleen cells from FCA‐OMP‐2‐immunized mice showed higher IL‐10/IFN‐γ ratios than FIA‐IS‐CpG‐OMP‐2‐immunized animals. In agreement, sera from FCA‐OMP‐2 showed higher anti‐OMP‐2 IgG1/IgG2a ratios than FIA‐IS‐CpG‐OMP‐2‐immunized animals. Finally, OMP‐2 also generated a protective response when delivered by a eukaryotic expression vector in tandem with CTLA4, a procedure that targeted OMP‐2 to antigen‐presenting cells.
Results of Arthroscopic Revision Anterior Shoulder Reconstruction

Background Recurrent instability after surgical stabilization of the shoulder is uncommon. Although results of open revision stabilization procedures have been reported, only 3 studies have evaluated the outcome of arthroscopic revision surgery. Purpose To analyze results of arthroscopic revision anterior shoulder reconstruction at the authors’ institution. Study Design Case series; Level of evidence, 4. Methods Chart review identified 18 shoulders that had arthroscopic revision anterior shoulder reconstruction at the Southern California Orthopedic Institute between November 4, 1997, and May 14, 2002. Anterior reconstruction of the shoulder was performed using suture anchors and nonabsorbable sutures. In most patients, posterior capsular plication was also performed; in 1 patient, closure of the rotator interval was performed. Sixteen shoulders in 15 patients were examined and 1 patient who required revision surgery was interviewed at a mean of 38 months (range, 24-67 months) after arthroscopic revision anterior shoulder reconstruction. The patient population consisted of 13 men and 3 women whose age at surgery was between 17 and 55 years (mean, 30 years; SD, 11.9 years). Patient satisfaction, the Simple Shoulder Test, and the Rowe scale were used to measure outcome. Results Prior surgeries included 10 arthroscopic procedures in 9 shoulders and 10 open procedures in 8 shoulders. In this study group, 1 patient dislocated his shoulder 4 months after arthroscopic revision anterior shoulder reconstruction during an altercation and subsequently underwent a Bristow procedure. Of the remaining cases, none of the 16 shoulders had recurrence of dislocation or subluxation; all 15 patients were satisfied with their revision surgeries. Among this group, the Simple Shoulder Test responses improved from 8.3 yes responses to 11.3 after arthroscopic revision anterior shoulder reconstruction (P < .05). Using the Rowe scale, there were 9 excellent, 4 good, and 3 fair results. Mean Rowe score at follow-up was 83.8 (range, 55-100; SD, 14.7) for these 16 shoulders. Conclusion In this series, 94% of shoulders were stable after arthroscopic revision anterior shoulder reconstruction, and there were a high number of good and excellent outcomes. Results suggest arthroscopic revision anterior shoulder reconstruction using suture anchors is a viable treatment alternative for patients with failed anterior shoulder reconstructions.
Literatura e formação do pedagogo: caminhos que (ainda) não se cruzam

Este artigo apresenta investigacao sobre o ensino de literatura nos cursos de Pedagogia do Brasil. Toma como corpus os Projetos Pedagogicos, as Estruturas Curriculares de Cursos de Pedagogia de universidades federais. Provem de uma pesquisa de doutorado em Educacao que se realiza na Universidade Federal do Rio Grande do Norte – UFRN. Adota a abordagem de investigacao qualitativa descritiva. Selecionou-se 27 (vinte e sete) universidades federais, uma para cada estado da federacao, e foi feito um levantamento das disciplinas de literatura ofertadas no Curso de Pedagogia presencial. Considera que a literatura e fundamental para a formacao humana e essencial para a formacao do pedagogo. Dados iniciais indicam a ausencia da literatura nos Cursos de formacao do pedagogo.
Detection of human chromosomal abnormalities using a new technique combining 4′,6‐diamidino‐2‐phenyl‐indole staining and image analysis

Chromosomal abnormalities are associated with a variety of diseases. We have developed a new technique for detecting chromosomal abnormalities, and the technique combines conventional 4′,6‐diamidino‐2‐phenyl‐indole staining (DAPI) with image analysis. The image analysis consists of two simple steps: deconvolution and three‐dimensional reconstruction. The technique has been reported for analyzing plant chromosomes but has not been applied to analyze human chromosomes yet. To test the technique, we analyzed five translocations: 46,XX,t(3;21)(12;18), 46,XX,t(11;22), 46,XY,t(7;22), 46,XY,t(11;18), and 46,XY,t(3;7). The results showed that the karyotype of the 46,XX,t(3;21)(12;18) was 46,XX,t(3;21)(q11.1;p13),t(12;18) (q21.2;q23), and the karyotypes of the 46,XX,t(11;22), 46,XY,t(7;22), 46,XY,t(11;18), and 46,XY,t(3;7) were 46,XX,t(11;22)(q23;q12.1); 46,XY,t(7;22)(q32;q13.2); 46,XY,t(11;18)(q13.3;q23), and 46,XY,t(3;7)(q22.1;p13), respectively. The identity of derivative chromosomes involved in the translocations was verified by chromosome painting as well as FISH analyses with centromere probes. The new technique has two advantages: the procedure is simple and convenient, and the results are accurate. The technique has the potential to be used in cytogenetic studies and clinical diagnosis of human diseases in the future.
Performance Analysis of IEEE 802.15.6 MAC Protocol in Beacon Mode with Superframes

Wireless Body Area Networks (WBANs) are becoming increasingly important to solve the issue of health care. IEEE 802.15. 6 is a wireless communication standard for WBANs, aiming to provide a real-time and continuous monitoring. In this paper, we present our development of a modified Markov Chain model and a backoff model, in which most features such as user priorities, contention windows, modulation and coding schemes (MCSs), and frozen states are taken into account. Then we calculate the normalized throughput and average access delay of IEEE 802.15. 6 networks under saturation and ideal channel conditions. We make an evaluation of network performances by comparing with IEEE 802.15. 4 and the results validate that IEEE 802.15. 6 networks can provide high quality of service (QoS) for nodes with high priorities.
Chronic hydralazine treatment alters the acute pressure-natriuresis curve in young spontaneously hypertensive rats.

The pressure-natriuresis relationship was studied in anesthetized, 7- to 9-week-old control spontaneously hypertensive rats (SHR) and in SHR that had been treated with hydralazine (20 mg.kg-1.day-1 in drinking water) starting at 4-5 weeks of age. To minimize reflex changes in kidney function during changes in renal artery pressure, neural and hormonal influences on the kidney were fixed by surgical renal denervation, adrenalectomy, and infusion of a hormone cocktail (330 microL.kg-1.mikn-1) containing high levels of aldosterone, arginine vasopressin, hydrocortisone, and norepinephrine dissolved in 0.9% NaCl containing 1% albumin. Changes in renal function were measured using standard clearance techniques, while renal artery pressure was varied between 136 +/- 1 and 186 +/- 2 mmHg (1 mmHg = 133.32 Pa) in control SHR (n = 10) and between 113 +/- 1 and 162 +/- 2 mmHg in treated SHR (n = 11). Mean arterial pressure (+/- SE) under Inactin anesthesia was 172 +/- 3 mmHg in control SHR and 146 +/- 3 mmHg in treated SHR (p less than 0.05). Where renal artery pressure overlapped between groups, there were no significant differences in glomerular filtration rate. Renal blood flow was also similar in both groups, although at 160 mmHg blood flow was slightly but significantly reduced in treated SHR. Urine flow and total and fractional sodium excretion increased similarly with increases in renal artery pressure in both groups, but the pressure-natriuresis curve in hydralazine-treated SHR was displaced to the left along the pressure axis. The data indicate that chronic administration of hydralazine in young SHR enhances fractional sodium excretion, suggesting that tubular reabsorption of sodium is decreased by hydralazine.
A study of early pregnancy factor activity in preimplantation.

PROBLEM AND METHOD Early pregnancy factor (EPF), an Immunosuppressive substance, which appears in pregnant women's sera 48 h after fertilization, is a kind of pregnancy-specific protein. To determine whether the EPF activity could be a super early indicator of pregnancy, we used rosette inhibition assay to detect EPF activity in the sera, collected from 70 women 2-7 days after ovulation intending to conceive monitored by ultrasonography. Simultaneously we selected 40 non-pregnant sera and 12 early-pregnant sera as negative control and positive control, respectively. RESULTS The results of this study demonstrated that EPF activity is detected in 35 women's sera out of 70 women within 2-7 days after ovulation, and 28 women out of the 35 were pregnant, which was known by follow-up, and 7 were not pregnant, possibly due to either false positive results or embryo loss because of preimplantation failure, thus causing no pregnancy. The other 35 out of 70 had no EPF activity and 34 of them were not pregnant, which was known by follow-up, but one case became pregnant, which was false negative result. Our study showed that diagnosis of the super early pregnancy could be made by detecting EPF activity in maternal serum within the time of preimplantation. The accuracy of pregnancy diagnosis by this method is 88.6%, with a false negative rate of 3.4% and a false positive rate of 17.1%. The beta-HCG level was measured from the above 70 women's sera in order to contrast EPF activity. All of the sera collected 2-6 days following ovulation indicated that there were lower beta-HCG values in very early pregnancy (> or = a5 mIU/ml). On the seventh day after ovulation, EPF activity was detected in 11 out of 15 sera with only 2 of them with a b-HCG level that reached or slightly surpassed that of the early pregnancy diagnosis (5 mIU/ml and 5.4 mIU/ml, respectively). This demonstrated that beta-HCG is not the earliest signal of pregnancy; otherwise the EPF activity is one that appears 2-6 days earlier than beta-HCG appears. We measured the progesterone level of the 48 sera from the 70 collected above within 2-7 days postovulation and found most of them reached the level of progesterone in the luteal phase (7.5-98.3 nmol/L). This indicated that ovulation had taken place in these women, which was in accordance with observations by ultrasonography. CONCLUSIONS Our study showed that diagnosis (of 88.6%) of super early pregnancy could be made with an accuracy of 88.6% by detecting EPF activity in maternal serum within 2-days after ovulation. This offers a basis for pregnancy diagnosis for the women who attempt to terminate their pregnancy safely or who conceive unexpectedly, and it contributes to family-planning.
Some insight on censored cost estimators

Censored survival data analysis has been studied for many years. Yet, the analysis of censored mark variables, such as medical cost, quality‐adjusted lifetime, and repeated events, faces a unique challenge that makes standard survival analysis techniques invalid. Because of the ‘informative’ censorship imbedded in censored mark variables, the use of the Kaplan–Meier (Journal of the American Statistical Association 1958; 53:457–481) estimator, as an example, will produce biased estimates. Innovative estimators have been developed in the past decade in order to handle this issue. Even though consistent estimators have been proposed, the formulations and interpretations of some estimators are less intuitive to practitioners. On the other hand, more intuitive estimators have been proposed, but their mathematical properties have not been established. In this paper, we prove the analytic identity between some estimators (a statistically motivated estimator and an intuitive estimator) for censored cost data. Efron (1967) made similar investigation for censored survival data (between the Kaplan–Meier estimator and the redistribute‐to‐the‐right algorithm). Therefore, we view our study as an extension of Efron's work to informatively censored data so that our findings could be applied to other marked variables. Copyright © 2011 John Wiley & Sons, Ltd.
Implementation of the patient self-determination act in a hospital setting. An initial evaluation.

BACKGROUND The Patient Self-Determination Act aims to enhance patient awareness of advance directives by requiring health-care institutions to ask patients whether they have advance directives and to inform patients of their rights to prepare these documents. We investigated the following: (1) compliance of the hospital staff with implementing this act, (2) the effects of this act on the extent to which patients discuss and prepare advance directives, and (3) variables that might influence patient discussions on advance planning and preparation of advance directives. METHODS We surveyed 219 patients from a university hospital that implemented a nurse-dependent advance directive program. We also conducted a telephone interview with 57% of these patients at least 6 months after hospital discharge. RESULTS Nurses asked 70% of the patients about the existence of an advance directive and of these patients, only 57% remembered the inquiry. Only 57% of the patients received the brochure on advance directives and of these patients, only 55% read the brochure. Only 2% of the patients requested to receive additional information on advance directives. Less than one quarter of the patients had discussions on advance planning while in the hospital and of those patients who were contacted within 6 months after hospital discharge, 39% had discussions on advance planning and 15% prepared an advance directive. Race was an independent predictor for hospital discussions, and educational level was an independent predictor for discussions and preparation of advance directives after hospital discharge. CONCLUSIONS To enhance the effectiveness of a nurse-dependent advance directive program, hospitals may need (1) to strengthen the quality of the patient-nurse encounter in which the issue of advance directives is raised to more effectively promote patient interest, discussions, and preparation of advance directives and (2) to account for the social diversity of their patient population.
LMP1 Immunohistochemistry in Non-Hodgkin’s Lymphoma of Sudanese Cases

Back ground: Non-Hodgkin’s lymphoma (NHL) with its different subtypes is strongly related to Epstein Bar virus (EBV) infection mainly Burkitt’s lymphoma in Africa. Studies proved the role of EBV in tumor-genesis and linked it to prognosis and therapy of patients. Objectives: To determine the frequency of EBV in non-Hodgkin lymphomas using EBV latent membrane protein 1 (EBV-LMP1) immunohistochemical stain. Methods: This cross-sectional study was conducted at radio-isotope centre of Khartoum (2012-2014). A total of 75 cases of non-Hodgkin lymphoma paraffin embedded sections were stained for EBV LMP1 antibody. Data were analyzed by SPSS 16 and statistical cross linking of the results of immune staining with other data was done. Results: Out of 75 patients of non Hodgkin’s lymphoma (74.7%) were males. EBV-LMP1 Immune-staining was positive in (17.3%) with predominance of Burkitt’s lymphoma (33.3%), followed by diffuse large B cell lymphoma (17.9%). Conclusion: Burkitt’s lymphoma expressed the highest percentage of non-Hodgkin’s lymphoma positive cases (46.2%) out of the total (17.3%) positive cases. Different methods need to be used in studying Burkitt’s lymphoma expression of EBV and its effects on the treatment and prognosis of cases.