Miracle-dz/UniFAR-FTUs huggingface dataset:
Use of immunohistochemical techniques to investigate museum specimens of neurological disease

Museum Specimens are a valuable resource both for teaching and research but have generally been used to show the gross morphology. The aim of this dissertation is to determine if modern neuropathological techniques, such as histology and immunohistochemistry, can be applied successfully in museum specimens that have been preserved for periods in excess of 50 years. It may be expected that many factors could affect the quality of histological material retrieved from museum specimens. These include the age of the specimen, type and length of fixation/preservation, storage conditions, patient information and post-mortem period. It is important to understand how preservation methods had changed over time, and therefore, the complex history of “potting” is reviewed. The process of selecting specimens for this study is described and an investigation into the characteristics of mounting solutions is presented. The major part of the dissertation concerns the development of ways in which to apply modern histological techniques to museum specimens. It is shown that post-fixation in formaldehyde 10% and an adjustment of the eosin stain solution to a pH ranging between 4.8 and 5.0 are especially important in older tissues. Satisfactory immunohistochemistry staining was obtained using EnVision + (Dako) system, a HRP labeled polymer, with anti-neurofilament antibody (Dako). Nevertheless, successful results were only achieved with cryostat sections, as they appeared to produce better immunohistochemistry staining when compared to formalin-fixed paraffin-embedded (FFPE) sections, suggesting that processing in organic solvents and high temperatures of molten paraffin alters the conformation of the antigen hampering immunohistochemistry detection. A detailed study of three cases from 1953, 1954 and 1955 confirms that modern techniques (including immunohistochemistry) can be used in aged tissue to the point where they are useful diagnostically. This study shows that with careful adjustment to protocols it is possible to achieve remarkably high quality histological results in tissues that have been preserved for many years. It confirms that specimens in museums represent a valuable resource for teaching and research at an ultrastructural level.
Red coloration varies with dietary carotenoid access and nutritional condition in kittiwakes

ABSTRACT Carotenoid-based ornaments are common signaling features in animals. Although the mechanisms that link color-based signals to individual condition is key to understanding the evolution and function of these ornaments, they are most often poorly known. Several hypotheses have been posited. They include: (i) the role of foraging abilities on carotenoid acquisition and thereby carotenoid-based ornaments, and (ii) the role of internal processes linked to individual quality on the allocation and conversion of carotenoids in integuments. Here, we tested the influence of dietary carotenoid access versus internal process on gape coloration in black-legged kittiwakes (Rissa tridactyla). This seabird displays a vibrant red gape, whose coloration varies with individual quality in males and is due to the deposition of red ketocarotenoids, such as astaxanthin. We decreased hydroxycarotenoid and ketocarotenoid levels in plasma, but increased efficiency in internal processes linked to nutritional condition, by supplementing breeding males with capelin, a natural energy-rich fish prey. We found that, despite having lower carotenoid levels in plasma, supplemented birds developed redder coloration than control birds, but only in the year when dietary levels of astaxanthin in the natural diet were low. In contrast, in the astaxanthin-rich year, supplemented males had a less-red gape than unsupplemented birds. These results suggest that inter-individual differences in internal processes may be sufficient to maintain the honesty of gape coloration under conditions of low dietary astaxanthin levels. Nonetheless, when inter-individual variations in dietary astaxanthin levels are elevated (such as in the crustacean-rich year), carotenoid access seems a more limiting factor to the expression of gape coloration than internal processes. Therefore, our study revealed a complex mechanism of gape color production in kittiwakes, and suggests that the main factor maintaining the condition dependency of this ornaments may vary with environmental conditions and diet composition. Summary: The main mechanism limiting the full expression of carotenoid-based color signals varies with environmental conditions in a red-colored seabird.
Matrix Discriminant Analysis Evidenced Surface-Lithium as an Important Factor to Increase the Hydrolytic Saccharification of Sugarcane Bagasse

Statistical evidence pointing to the very soft change in the ionic composition on the surface of the sugar cane bagasse is crucial to improve yields of sugars by hydrolytic saccharification. Removal of Li+ by pretreatments exposing -OH sites was the most important factor related to the increase of saccharification yields using enzyme cocktails. Steam Explosion and Microwave:H2SO4 pretreatments produced unrelated structural changes, but similar ionic distribution patterns. Both increased the saccharification yield 1.74-fold. NaOH produced structural changes related to Steam Explosion, but released surface-bounded Li+ obtaining 2.04-fold more reducing sugars than the control. In turn, the higher amounts in relative concentration and periodic structures of Li+ on the surface observed in the control or after the pretreatment with Ethanol:DMSO:Ammonium Oxalate, blocked -OH and O− available for ionic sputtering. These changes correlated to 1.90-fold decrease in saccharification yields. Li+ was an activator in solution, but its presence and distribution pattern on the substrate was prejudicial to the saccharification. Apparently, it acts as a phase-dependent modulator of enzyme activity. Therefore, no correlations were found between structural changes and the efficiency of the enzymatic cocktail used. However, there were correlations between the Li+ distribution patterns and the enzymatic activities that should to be shown.
Factors Affecting Empathy with Patient among Healthcare Provider Students: A Structural Equation Modeling Study

ABSTRACT Context In medicine and health care, empathy is a very important component of relationship between a physician or healthcare provider and patients. Aims This study was designed to investigate the factors affecting empathy with patient among healthcare provider students using structural equation model. Settings and design Cross-sectional study Materials and methods It was a cross-sectional study to examine the conceptual model based on JSE-HPS. Three hundred ninety-eight students of School of Nursing and Midwifery, Mashhad University of Medical Sciences, Iran participated in the study. They were selected by quota-stratified sampling. The data were collected by JSE-HPS. Statistical analysis used To examine the conceptual model, and SEM was used for ordinal data using WLSMV in Mplus 6. Results Findings indicated proper model fit so that “perspective-taking” had a positive effect on “compassionate care”. “Compassionate care” had a positive effect on “standing in patient's shoes”. Conclusion The results of this study can improve students’ empathic relationships with patients. The “perspective-taking”, “compassionate care” and “standing in patient's shoes” must be emphasized in training programs for medical students providing healthcare in order to familiarize them with the importance of empathy and its role in care. Key messages Empathy is truly the heart of the relationship, Perspective-Taking, Compassionate Care, and Standing in Patient's Shoes can be taken into account to improve the empathy and establish empathic relationships with patients. Proper environment is expected for improving the disease consequences by establishing empathic relationships. How to cite this article Karimi FZ, Abdollahi M. Factors Affecting Empathy with Patient among Healthcare Provider Students: A Structural Equation Modeling Study. Indian J Crit Care Med 2019;23(9):396–399.
A control region near the fibroblast growth factor 23 gene mediates response to phosphate, 1,25(OH)2D3 and LPS in vivo.

Fibroblast growth factor 23 (FGF23) is a bone-derived hormone involved in the control of phosphate (P) homeostasis and vitamin D metabolism. Despite advances, however, molecular details of this gene's regulation remain uncertain. In this report, we created mouse strains in which four epigenetically-marked FGF23 regulatory regions were individually deleted from the mouse genome using CRISPR/Cas9 gene-editing technology and the consequences of these mutations then assessed on Fgf23 expression and regulation in vivo. An initial analysis confirmed that bone expression of Fgf23 and circulating intact FGF23 (iFGF23) were strongly influenced by both chronic dietary P treatment and acute injection of 1,25(OH)2D3. Further analysis, however, revealed that bone Fgf23 expression and iFGF23 could be rapidly upregulated by dietary P within 3 and 6 h, respectively; this acute upregulation was lost in the FGF23-PKO mouse containing an Fgf23 proximal enhancer deletion but not in the additional enhancer deleted mice. Interestingly, prolonged dietary P treatment over several days led to normalization of FGF23 levels in the FGF23-PKO mouse, suggesting added complexity associated with P regulation of FGF23. Treatment with 1,25(OH)2D3 also revealed a similar loss of Fgf23 induction and blood iFGF23 levels in this mouse. Finally, normal lipopolysaccharide (LPS) induction of Fgf23 expression was also compromised in the FGF23-PKO mouse, a result that together with our previous report, indicates that the action of LPS on Fgf23 expression is mediated by both proximal and distal Fgf23 enhancers. These in vivo data provide key functional insight into the genomic enhancers through which Fgf23 expression is mediated.
Occupational Classification (ISCO-88): Concepts, Methods, Reliability, Validity and Cross-National Comparability

This paper considers a range of topics concerned with the statistical application of an occupational classification, focusing in particular upon the use of the international standard, ISCO-88. Following a brief presentation of the conceptual basis of ISCO-88 and on methods of collecting and coding occupational information, evidence is presented on the reliability and validity of occupationally classified data. The paper reviews progress on the implementation of ISCO-88 on a global basis and presents an assessment of the likely comparability between countries of occupational data based upon ISCO-88. From the evidence available it appears that ISCO-88 has successfully superseded ISCO-68 and, in many countries, has become the model for a new national classification even where a national classification of occupations previously existed. However, occupational classification remains a difficult process, subject to a fairly low level of reliability. In addition to problems of reliability .
Simple, Low Cost, and Efficient Design of a PC-based DC Motor Drive

In industrial applications, requiring variable speed and load characteristics, the DC motor is the attractive piece of equipment; due to its ease of controllability. Pulse-width modulation (PWM) or duty-cycle variation methods are commonly used in speed control of DC motors. A simple, low cost, and efficient design for a control circuit uses the PWM to adjust the average voltage fed the DC motor is proposed in this paper. The objective of this paper is to illustrate how the DC motor's speed could be controlled using a 555 timer. This timer works like a changeable pulse width generator. The pulse width can be changed via relays to add or remove resistors in the timer circuit. Using relays enable the proposed circuit to drive higher-power motors. The designed circuit controls the speed of a Permanent Magnet PM DC motor by means of the parallel port of a PC; therefore, the user will be able to control the speed of the DC motor. C++ computer program is used to run the motor at four levels of speed. An interface circuit is used to connect the motor to the parallel port. PC based control software is chosen to get simplicity and ease of implementation.
Knowledge of alcohol-disease links and socio-demographic factors as predictors of support for alcohol-related policies among university students in Botswana

Abstract Background: Worldwide, harmful alcohol use is causally related to about 60 diseases and is linked to about 3.3 million deaths annually. Yet, awareness of alcohol-disease links is low. Objective: This study aims to assess socio-demographic characteristics and knowledge of alcohol-disease links as predictors of support for alcohol-related policies. Methods: A survey of 615 university students (age = 19.8; SD = 1.6; 18–25) in Botswana assessed alcohol use and knowledge of alcohol-disease links as predictors of support for alcohol-related policies. T-tests and regression analyses were performed to estimate differences and predictors. Results: Forty per cent of respondents (n = 245) use alcohol, 38% (n = 93) of whom were hazardous users. Awareness of alcohol-disease links was low for diabetes (39%) and cancer (41%) but high for liver cirrhosis (89%) and injuries (87%). Female gender (relative to male) (β = 0.19, 95% CI: 0.11, 0.27), harmful alcohol use (β = −0.49, 95% CI: −0.56, −0.42), higher maternal education (β = 0.11, 95% CI: 0.02, 0.18), and more knowledge of alcohol-disease links (β = 0.13, 95% CI: 0.05, 0.21) predicted support for policies. Conclusions: Awareness of alcohol-disease links was low. Support for policies was predicted by being female (relative to male), reporting no harmful alcohol use, having more educated mothers, and knowledge of alcohol-disease links. Improving awareness of alcohol-disease links could be an effective intervention to increase support for alcohol-related policies.
Total Versus Near-total Thyroidectomy in Graves Disease: Results of the Randomized Controlled Multicenter TONIG-trial.

BACKGROUND Previous data suggest that the incidence of hypoparathyroidism after surgery for Graves disease (GD) is lower after subtotal thyroidectomy compared to total thyroidectomy (TT). The present study evaluated the incidence of postoperative hypoparathyroidism after near-total (NTT) versus TT in GD. METHODS/DESIGN In a multicenter prospective randomized controlled clinical trial, patients with GD were randomized intraoperatively to NTT or TT. Primary endpoint was the incidence of transient postoperative hypoparathyroidism. Secondary endpoints were permanent hypoparathyroidism, transient recurrent laryngeal nerve palsy (RLNP), reoperations for bleeding, inadvertently removed parathyroid glands, and recurrent hyperthyroidism after 12 months. RESULTS Eighteen centers randomized 205 patients to either TT (n = 102) or NTT (n = 103) within 16 months. According to intention-to-treat postoperative transient hypoparathyroidism occurred in 19% (20/103) patients after NTT and in 21% (21 of 102) patients after TT (P = 0.84), which persisted >6 months in 2% and 5% of the NTT and TT groups (P = 0.34). The rates of parathyroid autotransplantation (NTT 24% vs TT 28%, P = 0.50) and transient RLNP (NTT 3% vs TT 4%, P = 0.35) was similar in both groups. The rate of reoperations for bleeding tended to be higher in the NTT group (3% vs 0%, P = 0.07) and the rate of inadvertently removed parathyroid glands was significantly higher after NTT (13% vs 3%, P = 0.01). An existing endocrine orbitopathy improved in 35% and 24% after NTT and TT (P = 0.61). Recurrent disease occurred in only 1 patient after TT (P = 0.34). CONCLUSION NTT for GD is not superior to TT regarding transient postoperative hypoparathyroidism.
Clinical and Forensic Importance of S100β Protein for Prediction of Outcome and Evaluation of Medical Care in Mild to Moderate Head Injuries

The incidence of minor and mild to moderate traumatic brain injuries (TBI) have increased in the recent years, mainly at the expense of grave and moderate to severe injuries. The protein S100β is a sensitive biomarker to head injury. The aim of this study is to investigate importance of S100β protein as a new biomarker yielding a more informative diagnostic and prognostic technique to be added to the working protocols of dealing with TBIs. Fifty one patients with mild or moderate head injury were included in this study. Sociodemographic data, clinical data and computerized tomography (CT) findings were recorded in addition to measuring serum S100β levels within 6 hours after trauma. There was a significant increase of S100β levels in non survivors compared with survivors (P <0.001). There was a significant negative correlation between the levels of S100β and survival period in cases that died (r = -0.887, P <0.001). The protein S100β had a good predictive power for mortality (AUC = 0.803, cut off value > 1.205 ug/L, sensitivity = 100%, specificity = 54.55%). Adding S100β levels to Glasgow coma score and CT scan findings increased the accuracy of prediction of outcome from 64.7% to 82.4%. However, there were no significant differences in S100β levels as regards categories of severity or types of CT findings. It could be concluded that S100β serum level is a good predictor of outcome in cases of mild and moderate head injuries and its use is recommended both in clinical guidelines and in forensic practice.
Cluster‐Randomized, Crossover Trial of Head Positioning in Acute Stroke

BACKGROUND The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. We wanted to determine whether outcomes in patients with acute ischemic stroke could be improved by positioning the patient to be lying flat (i.e., fully supine with the back horizontal and the face upwards) during treatment to increase cerebral perfusion. METHODS In a pragmatic, cluster‐randomized, crossover trial conducted in nine countries, we assigned 11,093 patients with acute stroke (85% of the strokes were ischemic) to receive care in either a lying‐flat position or a sitting‐up position with the head elevated to at least 30 degrees, according to the randomization assignment of the hospital to which they were admitted; the designated position was initiated soon after hospital admission and was maintained for 24 hours. The primary outcome was degree of disability at 90 days, as assessed with the use of the modified Rankin scale (scores range from 0 to 6, with higher scores indicating greater disability and a score of 6 indicating death). RESULTS The median interval between the onset of stroke symptoms and the initiation of the assigned position was 14 hours (interquartile range, 5 to 35). Patients in the lying‐flat group were less likely than patients in the sitting‐up group to maintain the position for 24 hours (87% vs. 95%, P<0.001). In a proportional‐odds model, there was no significant shift in the distribution of 90‐day disability outcomes on the global modified Rankin scale between patients in the lying‐flat group and patients in the sitting‐up group (unadjusted odds ratio for a difference in the distribution of scores on the modified Rankin scale in the lying‐flat group, 1.01; 95% confidence interval, 0.92 to 1.10; P=0.84). Mortality within 90 days was 7.3% among the patients in the lying‐flat group and 7.4% among the patients in the sitting‐up group (P=0.83). There were no significant between‐group differences in the rates of serious adverse events, including pneumonia. CONCLUSIONS Disability outcomes after acute stroke did not differ significantly between patients assigned to a lying‐flat position for 24 hours and patients assigned to a sitting‐up position with the head elevated to at least 30 degrees for 24 hours. (Funded by the National Health and Medical Research Council of Australia; HeadPoST ClinicalTrials.gov number, NCT02162017.)
Efficacy and safety of repetitive transcranial magnetic stimulation for generalised anxiety disorder: A meta-analysis

Background Pharmacological and conventional non-pharmacological treatments are only moderately effective in treating generalised anxiety disorder (GAD). Recently, repetitive transcranial magnetic stimulation (rTMS) has attracted interest because of its potential therapeutic value. Aim To investigate the efficacy and safety of rTMS treatment for GAD. Methods Literature studies published in English or Chinese were screened in 10 electronic databases up to 5 December 2018. The included studies’ bias risk was assessed using Cochrane risk of bias assessment tool. Meta-analysis was performed to compute the standardised mean difference (SMD) and risk ratio (RR) along with its 95% CIs through using RevMan V.5. 3. Heterogeneity was inspected by I2 and the χ2 test. We performed subgroup analysis and meta-regression to investigate heterogeneity. We used funnel plot to assess publication bias. We used the GRADE approach to assess the whole quality of evidence. Results Twenty-one studies, with a total sample size of 1481, were analysed. The risk of bias in most studies included is moderate, the majority of which are lacking of blinding methods of treatment allocation. The treatment had beneficial effects in the rTMS group compared with the control group in mean anxiety score (SMD=−0.68; 95% CI −0.89 to −0.46). None of the 21 studies included here reported severe adverse events. As for dropout rates, there are no statistically significant differences between the two groups (RR 1.14, 95% CI 0.72 to 1.82) or adverse events (RR 0.95, 95% CI 0.77 to 1.18). No particular influence on the heterogeneity of any variable was observed. The risk of publication bias was low. According to the GRADE approach, the evidence levels of primary outcome (treatment effects) and secondary outcomes (acceptability and safety) were rated as ‘medium’. Conclusion The use of rTMS combined with medication treatment may have a significant positive anti-anxiety effect on patients with GAD. However, we should interpret the results cautiously due to the relatively high heterogeneity of the meta-analysis. Future high-quality clinical trials are needed to confirm our results.
Treatment of infections of the lumbar spine with single-staged posterior instrumentation, disc debridement and interbody fusion with titanium cages

1 Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany 2 Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy 3 Krankenhaus der Augustinerinnen Klinik für Orthopädie,Spezielle Orthopädische Chirurgie, Jakobstraße 27 – 31 50678 Köln, Germany