Miracle-dz/UniFAR-FTUs huggingface dataset:
Ultrasound-Guided Femoral Nerve Blocks

Abstract Pediatric acute femur fractures are a relatively common major orthopedic injury seen in emergency departments. Providing adequate and safe analgesia is essential while patients await definitive management of these fractures. Opioid medications are typically used to treat fracture-associated pain but have well-known adverse effects including respiratory and central nervous system depression, pruritus, nausea, and allergic reactions. Dose titration of opioids in pediatric patients may be difficult and requires frequent nursing and physician reassessments. Regional anesthesia using ultrasound guidance has been proposed as a reliable and safe method to provide pain relief for this population and to decrease reliance on opioid medications. There is a growing body of literature on the utility and safety of ultrasound-guided femoral nerve blocks for pediatric patients in the acute care setting. This review article covers recent literature on point-of-care ultrasound-guided femoral nerve blocks for pediatric patients, with a discussion of the indications, sonographic anatomy, selection of anesthetics, nerve block technique, and complications. This review supplements the expert supervision and practice required to gain competency.
Periappendicular Abscess Presenting within an Inguinal Hernia

The presence of the appendix within an inguinal hernia is a rare finding. We present the case of an elderly woman who developed appendicitis within an inguinal hernia, complicated by a supervening periappendicular abscess. She was successfully treated with a combination of antibiotics and percutaneous drainage.
A deleterious gene-by-environment interaction imposed by calcium channel blockers in Marfan syndrome

Calcium channel blockers (CCBs) are prescribed to patients with Marfan syndrome for prophylaxis against aortic aneurysm progression, despite limited evidence for their efficacy and safety in the disorder. Unexpectedly, Marfan mice treated with CCBs show accelerated aneurysm expansion, rupture, and premature lethality. This effect is both extracellular signal-regulated kinase (ERK1/2) dependent and angiotensin-II type 1 receptor (AT1R) dependent. We have identified protein kinase C beta (PKCβ) as a critical mediator of this pathway and demonstrate that the PKCβ inhibitor enzastaurin, and the clinically available anti-hypertensive agent hydralazine, both normalize aortic growth in Marfan mice, in association with reduced PKCβ and ERK1/2 activation. Furthermore, patients with Marfan syndrome and other forms of inherited thoracic aortic aneurysm taking CCBs display increased risk of aortic dissection and need for aortic surgery, compared to patients on other antihypertensive agents. DOI: http://dx.doi. org/10.7554/eLife.08648. 001
Nerve fibre layer thinning in patients with preclinical retinopathy.

OBJECTIVE To compare retinal nerve fibre layer thickness (RNFLT) obtained by optical coherence tomography (OCT) between patients with preclinical diabetic retinopathy (DR) and healthy subjects. STUDY DESIGN Cross-sectional study. PARTICIPANTS Ninety-nine type I or II diabetic patients with no visible funduscopic retinal alteration and 77 healthy subjects were included in this study. METHODS All participants were evaluated for peripapillary RNFLT by Stratus OCT. In diabetic patients, levels of blood sugar and glycosylated hemoglobin were examined. RESULTS The mean RNFLT in diabetic patients and healthy subjects was significantly different (104.2 [SD 10.4] and 108.6 [SD 9.2] microm, respectively; p = 0.004). Compared with the healthy group, the RNFLT in the diabetic group was also significantly less in the superior quadrant and at the 5, 11, and 12 o'clock sectors (p = 0.04, 0.002, and 0.001, respectively). The average RNFLT in diabetic patients with preclinical DR showed a low correlation with fasting blood sugar level (p = 0.03). CONCLUSIONS The mean and superior quadrant peripapillary RNFLT was slightly less in diabetic patients without abnormal vascular manifestations than in healthy subjects. Furthermore, lower RNFLT values in patients with preclinical DR appears to be weakly associated with high levels of fasting blood sugar.
Prognostically significant cytotoxic T cell clones are stimulated after thalidomide therapy in patients with multiple myeloma

The expanded T cell clones are associated with a prolonged survival in patients with multiple myeloma. We sought to confirm this prognostic significance in a multicenter patient cohort and investigate the effect of thalidomide on clones and T regulatory cells (Tregs). Blood was collected from 120 patients enrolled in a Phase III trial of maintenance therapy ± thalidomide after autologous stem cell transplantation. TCR Vβ repertoire analysis identified T cell expansions in 48% of patients pre-transplant and 68% after 8-month maintenance. T cell expansions, previously shown to be clonal, were predominantly CD8 + (93%) and all 24 TCR Vβ families tested were represented. Thalidomide therapy was associated with a significant increase in the incidence of patients with multiple expansions (49% vs. 23%; χ2 = 6.8; p = 0.01). The presence of expansions regardless of therapy was associated with a significantly longer median progression free survival (PFS) (32.1 vs. 17.6 months; χ2 = 5.6; p = 0.02) and overall survival (OS) (χ2 = 3.9; p < 0.05). Median PFS in the thalidomide arm was 50.9 months for patients with expansions and 28.3 months for patients without expansions (χ2 = 19.4; p = 0.0002). Thalidomide did not appear to modulate Treg numbers. Expanded T cell clones are prognostically significant and have an impact on progression after thalidomide therapy in a proportion of patients.
Transmission electron microscopy study of domains in ferroelectrics

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Relational parametricity and units of measure

Type systems for programming languages with numeric types can be extended to support the checking of units of measure. Quantification over units then introduces a new kind of parametric polymorphism with a corresponding Reynolds-style representation independence principle: that the behaviour of programs is invariant under changes to the units used. We prove this 'dimensional invariance' result and describe four consequences. The first is that the type of an expression can be used to derive equations which describe its properties with respect to scaling (akin to Wadler's 'theorems for free' for System F). Secondly there are certain types which are inhabited only by trivial terms. For example, we prove that a fully polymorphic square root function cannot be written using just the usual arithmetic primitives. Thirdly we exhibit interesting isomorphisms between types and for first-order types relate these to the central theorem of classical dimensional analysis. Finally we suggest that for any expression whose behaviour is dimensionally invariant there exists some equivalent expression whose type reflects this behaviour, a consequence of which would be a full abstraction result for a model of the language.
Suspending the Right to an Education or Preserving It ?

Millions of students are suspended from public school each year in the United States. Critics argue that suspensions infringe upon a student’s right to an education, while schools insist that discipline is necessary to protect the educational rights of every student. Using a unique data set from North Carolina, I estimate an equilibrium model of student behavior, achievement, and suspension that captures the overall effect of out of school suspension. The results indicate that disruptive peer behavior negatively influences achievement and that suspensions deter students from misbehavior without harming student performance. Using the model, I evaluate two policies aimed at closing the racial gap in student discipline: rule based discipline codes and student integration. I show that while each of these policies closes the aggregate racial gap in suspension, they also have significant unintended effects on behavior and achievement.
The Middle Region of an HP1-binding Protein, HP1-BP74, Associates with Linker DNA at the Entry/Exit Site of Nucleosomal DNA*

In higher eukaryotic cells, DNA molecules are present as chromatin fibers, complexes of DNA with various types of proteins; chromatin fibers are highly condensed in metaphase chromosomes during mitosis. Although the formation of the metaphase chromosome structure is essential for the equal segregation of replicated chromosomal DNA into the daughter cells, the mechanism involved in the organization of metaphase chromosomes is poorly understood. To identify proteins involved in the formation and/or maintenance of metaphase chromosomes, we examined proteins that dissociated from isolated human metaphase chromosomes by 0.4 m NaCl treatment; this treatment led to significant chromosome decondensation, but the structure retained the core histones. One of the proteins identified, HP1-BP74 (heterochromatin protein 1-binding protein 74), composed of 553 amino acid residues, was further characterized. HP1-BP74 middle region (BP74Md), composed of 178 amino acid residues (Lys97–Lys274), formed a chromatosome-like structure with reconstituted mononucleosomes and protected the linker DNA from micrococcal nuclease digestion by ∼25 bp. The solution structure determined by NMR revealed that the globular domain (Met153–Thr237) located within BP74Md possesses a structure similar to that of the globular domain of linker histones, which underlies its nucleosome binding properties. Moreover, we confirmed that BP74Md and full-length HP1-BP74 directly binds to HP1 (heterochromatin protein 1) and identified the exact sites responsible for this interaction. Thus, we discovered that HP1-BP74 directly binds to HP1, and its middle region associates with linker DNA at the entry/exit site of nucleosomal DNA in vitro.
First- and Second-Line Targeted Systemic Therapy in Hepatocellular Carcinoma—An Update on Patient Selection and Response Evaluation

Advanced hepatocellular carcinoma (HCC) with vascular invasion and/or extrahepatic spread and preserved liver function, according to stage C of the Barcelona Clinic Liver Cancer (BCLC) classification, has a dismal prognosis. The multi-targeted tyrosine-kinase receptor inhibitor (TKI) sorafenib is the only proven active substance in systemic HCC therapy for first-line treatment. In this review, we summarize current aspects in patient selection and management of side effects, and provide an update on response evaluation during first-line sorafenib therapy. Since second-line treatment options have been improved with the successful completion of the RESORCE trial, demonstrating a survival benefit for second-line treatment with the TKI regorafenib, response monitoring during first-line therapy will be critical to deliver optimal systemic therapy in HCC. To this regard, specific side effects, in particular worsening of arterial hypertension and diarrhea, might suggest treatment response during first-line sorafenib therapy; however, clear predictive clinical markers, as well as laboratory test or serum markers, are not established. Assessment of radiologic response according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) is helpful to identify patients who do not benefit from sorafenib treatment.
Microstructure and Texture Evolution of Magnesium alloy after Shear Assisted Processing and Extrusion (ShAPETM)

Shear Assisted Processing and Extrusion (ShAPETM) is a novel procedure used for fabricating thin-walled magnesium tubing. The technique involves pressing a billet through a rotating sleeve, thus causing severe deformation in the metal as the tube forms. This study analyzes the microstructure and crystallographic texture of the alloy in three different states by using electron backscatter diffraction. Notable differences in grain size and texture were observed depending on the location examined within the extrusion. Wall thicknesses of 1.5 and 3.0 mm (0.06 and 0.12 in) were characterized showing that both the grain size and basal plane orientation changed significantly as a function of position through the wall thickness, with abrupt changes near the outside wall. This type of microstructural information can be used to tune the parameters of the forming process to obtain the desired properties.
A Slightly Low Hemoglobin Level Is Beneficially Associated with Arterial Stiffness in Japanese Community-Dwelling Women

Pulse wave velocity (PWV) is a simple and noninvasive method of measuring arterial stiffness for the assessment of cardiovascular disease in high-risk populations. This association may be further confounded by hemoglobin status, which is involved in the development of atherosclerosis. We randomly recruited 120 men and 223 women aged 69 ± 9 and 68 ± 7 years, respectively, during their annual health examination in a single community. Arterial stiffness was evaluated by brachial–ankle PWV (baPWV). The value of baPWV was different from men and women. In men, baPWV was not related to hemoglobin levels (r = 0.013, P = .886), but in women baPWV increased significantly and progressively with increased hemoglobin levels (r = 0.276, P < .001). Stepwise multiple regression analysis using the baPWV as objective variables, adjusted for confounding factors as explanatory variables, showed that only in women, hemoglobin levels (β = 0.165, P = .001) as well as age (β = 0.268, P < .001), body mass index (BMI; β = −0.165, P < .001), systolic blood pressure (SBP; β = 0.429, P < .001), prevalence of antihypertensive (β = 0.154, P = .002), heart rate (HR; β = 0.108, P = .017), and antilipidemic medication (β = 0.094, P = .036), and estimated glomerular filtration rate (eGFR; β = −0.147, P = .003) were significantly and independently associated with baPWV. Multivariate-adjusted baPWV was significantly higher in hemoglobin groups of ≥12.7 g/dL (Group-2, Group-4) than in the lowest hemoglobin group (10.0–12.6 g/dL; P = .032). A slightly low hemoglobin level was beneficially associated with arterial stiffness in community-dwelling women but not men.
Distributed Strain Sensing from Different Optical Fiber Configurations

Strain distributions were obtained from optical fibers arranged in three different configurations on transversely-loaded cantilevered beams. Traditional strain measurement sensors, such as strain gauges, are limited to measuring strain at discrete points on a structural member. However, distributed optical fibers can measure high spatial (<1 mm spacing) strain or temperature distributions. In this study, optical fibers in spiral, grid, and rosette configurations were bonded to aluminum cantilevered beams subjected to tip loads. Strain distributions from optical fiber sensors were measured using a swept wavelength coherent interferometric technique. The optical fiber strain measurements show good agreement with strain gauge measurements. The attributes of each sensor configuration are discussed.
Role of scrape cytology in the intraoperative diagnosis of tumor

Background: Rapid diagnosis of surgically removed specimens has created many controversies and a single completely reliable method has not yet been developed. Histopathology of a paraffin section remains the ultimate gold standard in tissue diagnosis. Frozen section is routinely used by the surgical pathology laboratories for intraoperative diagnosis. The use of either frozen section or cytological examination alone has an acceptable rate (93–97%) of correct diagnosis, with regard to interpretation of benign versus malignant. Aim: To evaluate the utility of scrape cytology for the rapid diagnosis of surgically removed tumors and its utilisation for learning cytopathology. Materials and Methods: 75 surgically removed specimens from various organs and systems were studied. Scrapings were taken from each specimen before formalin fixation and stained by modified rapid Papanicolaou staining. Results: Of the 75 cases studied, 73 could be correctly differentiated into benign and malignant tumors, with an accuracy rate of 97.3%. Conclusions: Intraoperative scrape cytology is useful for intraoperative diagnosis of tumor, where facilities for frozen section are not available. The skill and expertise developed by routinely practicing intraoperative cytology can be applied to the interpretation of fine needle aspirate smears. Thus, apart from its diagnostic role, intraoperative cytology can become a very useful learning tool in the field of cytopathology.
A path relinking-based scatter search for the resource-constrained project scheduling problem

Project scheduling has received growing attention from researchers in recent decades in order to recommend models and methods to tackle problems for real-size projects. In this paper, we consider the resource-constrained project scheduling problem (RCPSP), which consists of scheduling activities in order to minimise the project duration in presence of precedence and resource constraints. We propose a hybrid metaheuristic based on scatter search that involves forward-backward improvement and reversing the project network at each iteration of the search. A bidirectional path relinking method with a new move is used as a solution combination method and a new improvement procedure is proposed in the reference set update method. The proposed method is applied to the standard benchmark projects from the PSPLIB library. The computational results show that the proposed scatter search produces high-quality solutions in a reasonable computational time and is among the best performing metaheuristics.
Affective modulation of inspiratory motor drive.

The present study aimed to explore inspiratory motor drive as measured by inspiratory occlusion pressure (P100) during affective picture viewing. P100 is the decrease in mouth pressure that develops 100 ms after an inspiratory effort against a closed breathing circuit. The P100 is a measure of the "central respiratory drive. " Seventy-eight healthy women viewed four pictures series (160 s) varying in content: neutral, positive, threat, or pain. They also rated each picture series on pleasantness and arousal. An occlusion was applied at the onset of inspiration in 33% of the breaths. The threat and the pain picture series were associated with an increased P100 and were rated as most unpleasant and highest in arousal. We conclude that inspiratory motor drive is affectively modulated and is a measure of the respiratory response to threatful stimuli.
Comparative genomic analysis of Drechmeria coniospora reveals core and specific genetic requirements for fungal endoparisitism of nematodes

Drechmeria coniospora is an obligate fungal pathogen that infects nematodes via the adhesion of specialized spores to the host cuticle. D. coniospora is frequently found associated with Caenorhabditis elegans in environmental samples. It is used in the study of the nematode’s response to fungal infection. Full understanding of this bi-partite interaction requires knowledge of the pathogen’s genome, analysis of its gene expression program and a capacity for genetic engineering. The acquisition of all three is reported here. A phylogenetic analysis placed D. coniospora close to the truffle parasite Tolypocladium ophioglossoides, and Hirsutella minnesotensis, another nematophagous fungus. Ascomycete nematopathogenicity is polyphyletic; D. coniospora represents a branch that has not been molecularly characterized. A detailed in silico functional analysis, comparing D. coniospora to 11 fungal species, revealed genes and gene families potentially involved in virulence and showed it to be a highly specialized pathogen. A targeted comparison with nematophagous fungi highlighted D. coniospora-specific genes and a core set of genes associated with nematode parasitism. A comparative gene expression analysis of samples from fungal spores and mycelia, and infected C. elegans, gave a molecular view of the different stages of the D. coniospora lifecycle. Transformation of D. coniospora allowed targeted gene knock-out and the production of fungus that expresses fluorescent reporter genes. It also permitted the initial characterisation of a potential fungal counter-defensive strategy, involving interference PLOSGenetics | DOI:10.1371/journal.pgen. 1006017 May 6, 2016 1 / 41 a11111
Predictors of unsafe sex among HIV patients in Denmark: A population-based cohort study

Abstract Background: Sexual transmission continues to be the primary mode of human immunodeficiency virus (HIV) infection in Western Europe. We aimed to describe predictors of unsafe sex and reasons given for such behaviour. Methods: We performed a survey examining sexual risk behaviours and reasons for unsafe sex in a nationwide cohort of adult Danish HIV-1-positive patients. Differences in characteristics between those who practiced safe and unsafe sex were estimated by binary logistic regression. The fraction with detectable viral load was determined in the 2 groups, and reasons for unsafe sex were evaluated. Results: Of 812 eligible patients, a total of 275 (34%) had engaged in unsafe sex with an HIV-negative partner or a partner with unknown HIV status in the previous year. On multivariate analysis, men who have sex with men (MSM) was the only statistically significant risk factor associated with unsafe sex (odds ratio 3.24, 95% confidence interval 1.72–6.12). The main reason for practicing unsafe sex was that the partner did not wish to use a condom (53%). Conclusions: A high proportion of HIV-positive patients engage in unsafe sex, especially MSM. The reasons for unsafe sex are primarily linked to negotiation issues concerning condom use, including assumptions about the sexual partner's intent.
Folic Acid Improves Endothelial Function in Coronary Artery Disease via Mechanisms Largely Independent of Homocysteine Lowering

Background—Homocysteine is a risk factor for coronary artery disease (CAD), although a causal relation remains to be proven. The importance of determining direct causality rests in the fact that plasma homocysteine can be safely and inexpensively reduced by 25% with folic acid. This reduction is maximally achieved by doses of 0.4 mg/d. High-dose folic acid (5 mg/d) improves endothelial function in CAD, although the mechanism is controversial. It has been proposed that improvement occurs through reduction in total (tHcy) or free (non–protein bound) homocysteine (fHcy). We investigated the effects of folic acid on endothelial function before a change in homocysteine in patients with CAD. Methods and Results—A randomized, placebo-controlled study of folic acid (5 mg/d) for 6 weeks was undertaken in 33 patients. Endothelial function, assessed by flow-mediated dilatation (FMD), was measured before, at 2 and 4 hours after the first dose of folic acid, and after 6 weeks of treatment. Plasma folate increased markedly by 1 hour (200 compared with 25.8 nmol/L;P <0.001). FMD improved at 2 hours (83 compared with 47 &mgr;m;P <0.001) and was largely complete by 4 hours (101 compared with 51 &mgr;m;P <0.001). tHcy did not significantly differ acutely (4-hour tHcy, 9.56 compared with 9.79 &mgr;mol/L;P =NS). fHcy did not differ at 3 hours but was slightly reduced at 4 hours (1.55 compared with 1.78 &mgr;mol/L;P =0.02). FMD improvement did not correlate with reductions in either fHcy or tHcy at any time. Conclusions—These data suggest that folic acid improves endothelial function in CAD acutely by a mechanism largely independent of homocysteine.