Miracle-dz/UniFAR-FTUs huggingface dataset:
Ultrasound-guided multilevel paravertebral block versus local anesthesia for medical thoracoscopy

Background: Local anesthetic infiltration for medical thoracoscopy has an analgesic properties for short duration. Single injection thoracic paravertebral block (PVB) provides limited analgesia. Purpose: Comparison between thoracic PVB performed at two or three levels with local infiltration for anesthetic adequacy in adult medical thoracoscopy as a primary outcome and postthoracoscopic analgesia and pulmonary function as secondary outcomes for adult medical thoracoscopy. Patients and Methods: Prospective randomized control study included 63 adult patients with exudative pleural effusion randomly divided into three groups of 21 patients: 3-level PVB, 2-level PVB group, and local infiltration group. Patients with contraindications to regional anesthesia or uncontrolled comorbidities were excluded from the study. Pain visual analog scale and spirometry were used for comparison as anesthetic adequacy in adult medical thoracoscopy as a primary outcome besides prolonged analgesia and improved pulmonary function as secondary outcomes. Results: The anesthetic adequacy was 95.3% in 3-level PVB group, 81% in 2-level PVB group, and 71.5% in local infiltration group. The mean sensory level was 1 ± 0.8 and 1 ± 0.6 segment above and 0.8 ± 0.6 and 0.7 ± 0.7 segment below the injected level in 3-level PVB group and 2-level PVB, respectively. VAS was statistically significant higher in local infiltration compared to the other two groups immediately postthoracoscopic and 1 h after. Two-hour postthoracoscopy, significant increase in forced vital capacity values in the three groups compared to their basal values whereas forced expiratory volume at 1 s (FEV1) only in both PVB groups. Conclusion: Unilateral 3-level TPVB was superior to 2-level TPVB and LA infiltration for anesthetic adequacy for patients undergoing medical thoracoscopy. Moreover, US-guided TPVB was followed by higher FEV1 values and lower pain scores during the next 12 h postthoracoscopy in comparison to local infiltration, so 3-level TPVB is an effective and relatively safe anesthetic technique for adult patients undergoing medical thoracoscopy which may replace local anesthesia.
Intraoperative embolism and hip arthroplasty: intraoperative transesophageal echocardiographic study

Objectives Cardiopulmonary complications are well known in orthopaedic surgery. The aim of the present study was to evaluate the relevance and the origin of embolization, to correlate the event with the procedure and to establish the clinical relevance of this phenomenon. Methods We performed transesophageal echocardiography (TEE) on 40 patients during total hip arthroplasty, 19 males and 21 females, average age 66 years, with a negative medical history for heart and lung diseases, who underwent an operation for hip prosthesis (22 patients) or surgery for medial fracture (18 patients). Of these, 22 patients received a cemented prosthesis and 18 patients received an uncemented one. Results During the placement of the acetabular and femoral components, and during the relocation of the hip joint, a snow flurry appearing in the right heart was followed by several highly echogenic and mobile emboli of various sizes. Conclusions Our data suggest that the presence of emboli detected by TEE in the right heart and pulmonary artery appears to derive principally from the reaming of the femoral canal and the placement of the femoral stem, particularly during the placement of cemented prostheses. However, the passage of embolic material had no adverse sequelae. For these reasons routine, intraoperative TEE cannot be recommended in orthopaedic surgery
Synapse-Assembly Proteins Maintain Synaptic Vesicle Cluster Stability and Regulate Synaptic Vesicle Transport in Caenorhabditis elegans

The functional integrity of neurons requires the bidirectional active transport of synaptic vesicles (SVs) in axons. The kinesin motor KIF1A transports SVs from somas to stable SV clusters at synapses, while dynein moves them in the opposite direction. However, it is unclear how SV transport is regulated and how SVs at clusters interact with motor proteins. We addressed these questions by isolating a rare temperature-sensitive allele of Caenorhabditis elegans unc-104 (KIF1A) that allowed us to manipulate SV levels in axons and dendrites. Growth at 20° and 14° resulted in locomotion rates that were ∼3 and 50% of wild type, respectively, with similar effects on axonal SV levels. Corresponding with the loss of SVs from axons, mutants grown at 14° and 20° showed a 10- and 24-fold dynein-dependent accumulation of SVs in their dendrites. Mutants grown at 14° and switched to 25° showed an abrupt irreversible 50% decrease in locomotion and a 50% loss of SVs from the synaptic region 12-hr post-shift, with no further decreases at later time points, suggesting that the remaining clustered SVs are stable and resistant to retrograde removal by dynein. The data further showed that the synapse-assembly proteins SYD-1, SYD-2, and SAD-1 protected SV clusters from degradation by motor proteins. In syd-1, syd-2, and sad-1 mutants, SVs accumulate in an UNC-104-dependent manner in the distal axon region that normally lacks SVs. In addition to their roles in SV cluster stability, all three proteins also regulate SV transport.
MUCH ADO ABOUT FUNCTIONAL ENDOSCOPIC SINUS SURGERY

Background: Reported success rates in endoscopic sinus surgery vary from 74 to 97%. However, the methods of evaluation and the functional endoscopic sinus surgery (FESS) techniques are not standard in these series. In our practice, some patients failed to attend the 3‐monthly follow up claiming all was well. With this experience, the aim of this study is to document a standard minimal technique with minimal follow up, which may be applicable to selected patients.
Estimation of gestational age during the first trimester by real‐time measurement of fetal crown‐rump length and biparietal diameter

A series of 237 patients in the first trimester of pregnancy were examined to derive normal growth curves for fetal crown‐rump length (CRL) and biparietal diameter (BPD) using sector scanner real‐time ultrasound equipment. Conventional B‐scan CRL measurements were obtained from 50 of these patients: In 41 (82%), the values fell within a range ± 5 mm of those of real‐time. Another group of 97 patients between 7 and 13 wk of gestation was then examined in a blind trial to confirm the accuracy of real‐time measurements in estimating gestational age. An estimate was made in 95% of cases to within 4.6 days with CRL and to within 5 days with BPD. A similar comparison was made with both of these dimensions using a comparative nomogram, giving a prediction within 3.9 days in 957percnt; of cases. This method is now used routinely.
The New Brunswick Declaration on Research Ethics, Integrity, and Governance

Despite their growth and extension of power, overworked ethics review committees are limping along. Many have commented on the structural problems of the regime: the inability of ethics committees to make consistent decisions [1,2] the inability of ethics committees, despite their local strength, to effect any necessary policy changes, and the long periods of abeyance for national agencies to bring about essential amendments in ethics codes. Other scholars (some are listed in endnote 2) have found other weaknesses in the system. Finally, The costs are astronomical [3,4].
Wideband High Stability MEMS-Based AC Voltage References

This paper presents the high level of stability of voltage references operated in alternating current (ac) and based on the pull-in effect in split-finger microelectromechanical systems (MEMS). It shows results of both electrical and mechanical characterizations, as well as the development of optimized readout electronics. The new aspects in this paper are related to the new architecture of the MEMS allowing minimizing the effect of leakage capacitances on the stability of the voltage reference and avoiding compensating any “built-in voltage” generated at metal–semiconductor interfaces. Hence, the voltage stability of MEMS devices, designed to serve as ac voltage standards ranging from 2 to 14 V, has been measured over more than 150 h with a relative deviation from the mean value not exceeding <formula formulatype="inline"><tex Notation="TeX">$1 \times 10^{-6}$</tex></formula> ( <formula formulatype="inline"><tex Notation="TeX">$1\sigma$</tex></formula> standard deviation) at 100 kHz. The temperature dependence of these devices has been found ten times smaller than those previously reported. In addition, MEMS-based references are theoretically independent of frequency beyond the mechanical resonant frequency. The frequency stability has been successfully tested between 40 and 300 kHz.
Comparison of two anoxia models in rainbow trout cells by a 2‐DE and MS/MS‐based proteome approach

In the literature, a variety of ways have been used to obtain anoxia, and most often results are compared between studies without taking into consideration how anoxia has been obtained. Here, we provide a comprehensive study of two types of anoxia, using a proteomics approach to compare changes in protein expression. The two investigated situations were 30 min of chemical anoxia (10 mM NaN3) followed by reoxygenation overnight (CR) and 2 h of N2‐induced anoxia (achieved by flushing with N2) followed by reoxygenation overnight (NR), after which samples were resolved by 2‐DE. Forty‐five protein spots changed their abundance in response to CR and 35 protein spots changed their abundance in response to NR, but only six proteins changed their abundance in response to both stimuli. By the means of MS/MS, 40 protein spots were identified including proteins involved in processes like cell protection and protein synthesis. It was also revealed that the level of a number of keratins was down‐regulated. This study therefore provides a valuable comparison of two different anoxia models and shows that great care should be taken when comparing the effects of anoxia in studies that have used different types and durations of anoxia.
Using LTE in Unlicensed Bands: Potential Benefits and Coexistence Issues

Using LTE in unlicensed bands will allow operators to access additional spectrum to meet the increasing demand for mobile services. In this article, we provide an overview of the different approaches currently being considered for LTE operation in unlicensed bands and their interaction with WiFi networks. In summary, LTE-Unlicensed with carrier sense adaptive transmission is likely to be available in the short term, but cannot be used in all regions due to regulatory restrictions. License assisted access is intended for use more widely, so it will include listen-before-talk and other features required to conform with, for example, European and Japanese regulations. However, this will require changes to the LTE standards, so license assisted access is likely to take longer to deploy. In addition to describing the trade-offs between these approaches, we also discuss the issue of fair coexistence with existing unlicensed band users, especially WiFi devices.
Does weaning influence growth and health up to 18 months?

Background: National and international recommendations for the age of introducing solid foods (weaning) are founded on insufficient evidence and little is known about the short and medium term consequences associated with early or late weaning. Aims and Methods: Data from over 1600 infants from five prospective randomised trials conducted in the UK between 1993 and 1997 were used to determine the influence of weaning ⩽12 weeks or >12 weeks on growth and health outcomes (diarrhoea and vomiting, lower respiratory chest infections, atopy, sleep patterns) up to 18 months post-term, in term appropriate for gestational age (AGA), term small for gestational age (SGA), and preterm infants. Results: Term infants weaned ⩽12 weeks were heavier at 12 weeks of age than those weaned after 12 weeks, but showed slower gain in weight, length, and head circumference between 12 weeks and 18 months than those weaned after 12 weeks; by 18 months, there were no significant differences in size between the two groups. A similar pattern was seen in preterm infants. Breast fed term infants were more likely to be sleeping though the night at 9 months if they were weaned before 12 weeks. No weaning effects or interactions were observed for health outcomes. Conclusions: We found little evidence that weaning before or after 12 weeks influences health outcomes up to 18 months. Early weaned infants were larger at 12 weeks than later weaned infants but the growth trajectories of the two groups “converged” by 18 months. These findings do not exclude the later emergence of programmed effects of weaning practices.
Choroidal abnormalities in café‐au‐lait syndromes: a new differential diagnostic tool?

The best known café‐au‐lait syndrome is neurofibromatosis type 1 (NF1). Legius syndrome (LS) is another, rarer syndrome with café‐au‐lait macules (CALMs). In young patients their clinical picture is often indistinguishable. We investigated the presence of choroidal abnormalities in syndromes with CALMs as a candidate tool for a more efficient diagnosis.
Transmembrane Potential Polarization, Calcium Influx, and Receptor Conformational State Modulate the Sensitivity of the Imidacloprid-Insensitive Neuronal Insect Nicotinic Acetylcholine Receptor to Neonicotinoid Insecticides

Neonicotinoid insecticides act selectively on insect nicotinic acetylcholine receptors (nAChRs). Recent studies revealed that their efficiency was altered by the phosphorylation/dephosphorylation process and the intracellular signaling pathway involved in the regulation of nAChRs. Using whole-cell patch-clamp electrophysiology adapted for dissociated cockroach dorsal unpaired median (DUM) neurons, we demonstrated that intracellular factors involved in the regulation of nAChR function modulated neonicotinoid sensitivity. DUM neurons were known to express two α-bungarotoxin-insensitive nAChR subtypes: nAChR1 and nAChR2. Whereas nAChR1 was sensitive to imidacloprid, nAChR2 was insensitive to this insecticide. Here, we demonstrated that, like nicotine, acetamiprid and clothianidin, other types of neonicotinoid insecticides, acted as agonists on the nAChR2 subtype. Using acetamiprid, we revealed that both steady-state depolarization and hyperpolarization affected nAChR2 sensitivity. The measurement of the input membrane resistance indicated that change in the acetamiprid-induced agonist activity was related to the receptor conformational state. Using cadmium chloride, ω-conotoxin GVIA, and (R,S)-(3,4-dihydro-6,7-dimethoxy-isoquinoline-1-yl)-2-phenyl-N,N-di-acetamide (LOE 908), we found that inhibition of calcium influx through high voltage-activated calcium channels and transient receptor potential γ (TRPγ) activated by both depolarization and hyperpolarization increased nAChR2 sensitivity to acetamiprid. Finally, using N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride (W7), forskolin, and cAMP, we demonstrated that adenylyl cyclase sensitive to the calcium/calmodulin complex regulated internal cAMP concentration, which in turn modulated TRPγ function and nAChR2 sensitivity to acetamiprid. Similar TRPγ-induced modulatory effects were also obtained when clothianidin was tested. These findings bring insights into the signaling pathway modulating neonicotinoid efficiency and open novel strategies for optimizing insect pest control.
Yamase-derived Gap Winds Off the Western Hokkaido Coasts and Their Effects on Sea Surface Temperature Fields

Suttu, which is located in the western Hokkaido, is known to be the 4th strongest windy place in Japan, where topographical gaps efficiently develop strong winds. These gap winds over the ocean and their effects on sea surface temperature (SST) fields are investigated by scatterometer- and synthetic aperture radar (SAR)-observed wind fields and the Advanced Very High Resolution Radiometer (AVHRR)-derived SST data. The SAR wind field observed by a wide-swath ScanSAR mode reveals a series of wind jet/wake patterns, which correspond to upstream land topography. The strong jets extend offshore over 100 km. It is found by several SAR-derived wind fields that these gap winds develop under the condition of upstream easterly winds. The easterly winds are common in spring and summer, which are known as the Yamase phenomena in northern Japan. Low/high SST patterns, which correspond to the jet/wake, are frequently observed off the western Hokkaido coasts in summertime. We create a composite image of the SST spatial anomalies for windy days, based on in situ wind measurements in Suttu. The composite image shows well-defined local SST cooling/warming stripes along general wind jet/wake regions. These are probably induced by the difference of the diurnal warming amplitude.
Serglycin secreted by leukocytes is efficiently eliminated from the circulation by sinusoidal scavenger endothelial cells in the liver

This study was undertaken to determine the fate of the circulating chondroitin sulfate proteoglycan serglycin. The human monocytic cell line THP‐1 was cultured under serum‐free conditions in the presence of [35S]sulfate. The conditioned medium was harvested and S‐macromolecules were purified by Q‐Sepharose anion‐exchange chromatography and Superose 6 gel chromatography. After labeling with 12I, the purified material was treated with chondroitinase ABC and subjected to sodium dodecyl sulfate polyacrylamide gel electrophoresis. A major band with mr of approximately 14 kDa appeared, consistent with the core protein of serglycin. The identity of the proteoglycan was confirmed by amino‐terminal amino acid sequencing. Purified serglycin, labeled either with [35S]sulfate or 125I and fluorescein isothiocyanate, was injected intravenously into rats. The blood content of radiolabeled serglycin fell by 50% from 1 to 2.4 min after injection, indicating an initial t 1/2 of 1.4 min or shorter. Approximately 90% of the recovered radioactivity was localized in the liver, 5% in the blood, and 5% altogether in urine, kidneys, and spleen about 30 min after injection. Isolation of liver cells at the same time point showed that 70% of the radioactivity was taken up by the sinusoidal scavenger endothelial cells, and 23 and 7% by the hepatocytes and Kupffer cells, respectively. When excess amounts of unlabeled hyaluronan was co‐injected with radiolabeled serglycin, the elimination of serglycin was significantly inhibited, indicating that the hyaluronan receptor on the sinusoidal scavenger endothelial cells is responsible for the elimination of serglycin. J. Leukoc. Biol. 67: 183–188; 2000.
Combining Household Income and Asset Data to Identify Livelihood Strategies and Their Dynamics

ABSTRACT Current approaches to identifying and describing rural livelihood strategies, and household movements between strategies over time, in developing countries are imprecise. Here we: (i) present a new statistical quantitative approach combining income and asset data to identify household activity choice variables, characterise livelihood strategy clusters, and analyse movements between strategies, and (ii) apply the approach using an environmentally-augmented three-wave household (n = 427) level panel dataset from Nepal. Combining income and asset data provides a better understanding of livelihood strategies and household movements between strategies over time than using only income or asset data. Most households changed livelihood strategy at least once over the two three-year periods. A common pathway out of poverty included an intermediate step during which households accumulate assets through farming, petty trading, and migratory work.
Aortic wall thickness in patients with ascending aortic aneurysm versus acute aortic dissection.

OBJECTIVES Recent studies have shown that aortic diameter alone is an insufficient parameter to identify patients at risk for aortic dissection. The aim of this study was to determine the value of the ratio of aortic diameter to medial wall thickness as a new marker of risk. METHODS We obtained data from 181 patients with an ascending aortic aneurysm (n = 94) or an acute type A aortic dissection (n = 87), surgically treated at our institution (1996-2012). Measurements of the maximum aortic diameter and the medial wall thickness were conducted by retrospective review of preoperative imaging studies and histological specimens, respectively. RESULTS Nearly 60% of the dissection patients had aortic diameters smaller than 50 mm. There was a significant negative linear correlation between medial wall thickness and aortic diameter (P = 0.01) in the dissection group only. Among patients with aortic diameters above 50 mm, dissection patients had significantly thinner aortic media (P = 0.04). Among patients with a mildly dilated aorta (>45 mm), the aortic diameter to medial wall thickness ratio was significantly higher in the dissection group (P = 0.04). CONCLUSIONS Among patients with a dilatation of the ascending aorta of more than 45 and 49 mm, patients experiencing aortic dissection have a significantly higher aortic diameter to wall thickness ratio and a thinner aortic media, respectively. In the subset of patients with mild aortic dilatation, wall thickness might in the future serve as an additional parameter to help identify those patients who would benefit from prophylactic aortic surgery.
Prevalence of Jumper's Knee among Elite Athletes from Different Sports: A Cross-sectional Study

Background The prevalence of jumper's knee across different sports has not been examined, and it is not known if there is a gender difference. Data from surgical case series indicate that there may be a high prevalence in sports with high speed and power demands. Hypothesis The aim of this study was to estimate the prevalence of jumper's knee in different sports among female and male athletes and to correlate the prevalence to the loading characteristics of the extensor mechanism in these sports. Study Design Cross-sectional study; Level of evidence, 4. Methods The authors examined approximately 50 Norwegian male and female athletes at the national elite level from each of the following 9 sports: athletics (male athletes: high jump, 100- and 200-m sprint), basketball (male athletes), ice hockey (male athletes), volleyball (male athletes), orienteering (male athletes), road cycling (male athletes), soccer (male and female athletes), team handball (male and female athletes), and wrestling (male athletes). The examination included an interview on individual characteristics (weight, age, height, and training background), a clinical examination, and self-recorded Victorian Institute of Sport Assessment score from 0 (worst) to 100 (best). Results The overall prevalence of current jumper's knee was 14.2% (87 of 613 athletes), with a significant difference between sports with different performance characteristics (range, 0%-45%). In addition, 51 athletes (8%) reported previous symptoms. The prevalence of current symptoms was highest in volleyball (44.6% ± 6.6%) and basketball (31.9% ± 6.8%), whereas there were no cases in cycling or orienteering. The prevalence of current jumper's knee was lower among women (5.6% ± 2.2%) compared with men (13.5% ± 3.0%; χ2 test, P =. 042). The duration of symptoms among athletes with current jumper's knee (n = 87) was 32 ± 25 (standard deviation) months, with a Victorian Institute of Sport Assessment score of 64 ± 19. Conclusion The prevalence of jumper's knee is high in sports characterized by high demands on speed and power for the leg extensors. The symptoms are often serious, resulting in long-standing impairment of athletic performance.
“Dodgy 6As”: Differentiating Pneumococcal Serotype 6C from 6A by Use of the Quellung Reaction

The Quellung reaction has long been the standard method for pneumococcal serotyping ([7][1]); however, the new serotype 6C is reportedly indistinguishable from serotype 6A using this method ([8][2]). We report an anomalous Quellung reaction associated with serotype 6C, which may aid in diagnostic