Miracle-dz/UniFAR-FTUs huggingface dataset:
Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood.

BACKGROUND Cardiotoxicity is a recognized complication of doxorubicin therapy, but the long-term effects of doxorubicin are not well documented. We therefore assessed the cardiac status of 115 children who had been treated for acute lymphoblastic leukemia with doxorubicin 1 to 15 years earlier in whom the disease was in continuous remission. METHODS Eighteen patients received one dose of doxorubicin (45 mg per square meter of body-surface area), and 97 received multiple doses totaling 228 to 550 mg per square meter (median, 360). The median interval between the end of treatment and the cardiac evaluation was 6.4 years. Our evaluation consisted of a history, 24-hour ambulatory electrocardiographic recording, exercise testing, and echocardiography. RESULTS Fifty-seven percent of the patients had abnormalities of left ventricular afterload (measured as end-systolic wall stress) or contractility (measured as the stress-velocity index). The cumulative dose of doxorubicin was the most significant predictor of abnormal cardiac function (P less than 0.002). Seventeen percent of patients who received one dose of doxorubicin had slightly elevated age-adjusted afterload, and none had decreased contractility. In contrast, 65 percent of patients who received at least 228 mg of doxorubicin per square meter had increased afterload (59 percent of patients), decreased contractility (23 percent), or both. Increased afterload was due to reduced ventricular wall thickness, not to hypertension or ventricular dilatation. In multivariate analyses restricted to patients who received at least 228 mg of doxorubicin per square meter, the only significant predictive factors were a higher cumulative dose (P = 0.01), which predicted decreased contractility, and an age of less than four years at treatment (P = 0.003), which predicted increased afterload. Afterload increased progressively in 24 of 34 patients evaluated serially (71 percent). Reported symptoms correlated poorly with indexes of exercise tolerance or ventricular function. Eleven patients had congestive heart failure within one year of treatment with doxorubicin; five of them had recurrent heart failure 3.7 to 10.3 years after completing doxorubicin treatment, and two required heart transplantation. No patient had late heart failure as a new event. CONCLUSIONS Doxorubicin therapy in childhood impairs myocardial growth in a dose-related fashion and results in a progressive increase in left ventricular afterload sometimes accompanied by reduced contractility. We hypothesize that the loss of myocytes during doxorubicin therapy in childhood might result in inadequate left ventricular mass and clinically important heart disease in later years.
Ultrasound-Guided Thoracic Paravertebral Blockade: A Retrospective Study of the Incidence of Complications

BACKGROUND:The benefits of thoracic paravertebral block (TPVB) have been demonstrated for patients undergoing surgery for breast cancer. However, pleural puncture resulting in pneumothorax is a serious complication associated with traditional approaches using guidance from anatomic landmarks and nerve stimulation and may contribute to the low utilization of this block. An ultrasound-guided technique has the potential to reduce complications by providing direct visualization of the paravertebral space during needle manipulation. We evaluated the complications using a single-injection, transverse, in-plane ultrasound-guided technique for paravertebral blockade in patients undergoing mastectomy with immediate reconstruction for breast cancer treatment or prophylaxis. METHODS:Data from all patients who underwent TPVB between January 1, 2010, and December 3, 2013, at Massachusetts General Hospital was prospectively recorded in a computerized database. All blocks were placed for postoperative analgesia after unilateral or bilateral mastectomy with immediate breast reconstruction. Medical records were retrospectively reviewed for any patient who developed complications including accidental pleural puncture, symptomatic pneumothorax, hypotension, or bradycardia, as well as signs and symptoms of toxicity or effects of local anesthetic outside of the paravertebral space. RESULTS:Eight hundred fifty-six patients underwent a total of 1427 thoracic paravertebral injections (285 unilateral and 571 bilateral TPVB). There were 6 complications (0.70%; 99.2% confidence interval, 0.17%–1.86%) including symptomatic bradycardia and hypotension (n = 3), vasovagal episode (n = 1), and evidence of possible local anesthetic toxicity (n = 2). There was no incidence of suspected accidental pleural puncture or symptomatic pneumothorax identified in our study population. CONCLUSIONS:The routine use of a single-injection, transverse, in-plane ultrasound-guided technique for TPVB in patients undergoing mastectomy with immediate breast reconstruction is associated with very few complications.
The salience of the body: transition in sexual self-identity for women living with multiple sclerosis.

AIM The purpose of this paper is to outline understandings about the construction of sexuality and the impact of a changing body for women living with multiple sclerosis (MS). We suggest that the process of transition towards incorporating the experience of chronic illness into one's life is influenced by the (re)construction of self-identity. DESIGN AND METHODS A participatory action process guided the research. The women joined the authors for five group sessions that totalled 15 hours of contact time. In addition, we offered women the opportunity for one-to-one interviews at home. Nine women volunteered to participate. This allowed us to gain additional in-depth data about individual experiences. The interpretive framework was guided by the self-identity literature. When reading the transcripts we questioned: What is going on here? What does this say about the construction of self? What does this say about the construction of identity? What influence does the body have in the construction of self-identity? Analysis was collaborative (with the women) and the resultant emerging construction of sexuality is shared in this paper. Data generated during one-to-one interviews are privileged and we include two accounts from women who live with MS. The women's stories focus on sexuality, however, within this sexual context, we observed shifts in self-identity which we contend may shape the illness transition experience. FINDINGS The rationale for privileging only two accounts is to expand understanding of Ordinariness and Extraordinariness with particular focus on the salience of the body in the 'sexual' lives of the women. Self-identity was shaped by how they felt about themselves as sexual beings, how they experienced their body, how they felt about sexual activities and by the way others reacted to them. Importantly, we view the women's sense of self, identity and the relationship to the body and find that shifts in self identity shape the woman's transition towards Ordinariness. CONCLUSIONS This exploration of illness experiences is a reminder that our bodies are vehicles for our sense of self and identity. Cultural, educational, social, religious and family contexts all impact on women's capacity to shape the consequences of illness and the choices available to them. Facilitating women towards an awareness of the choices available in order to sustain or reclaim self may in turn expedite transition towards Ordinariness so that illness may become a part of their life.
Isolation and biochemical characterisation of monomeric and dimeric photosystem II complexes from spinach and their relevance to the organisation of photosystem II in vivo.

Membranes enriched in photosystem II were isolated from spinach and further solubilised using n-octyl beta-D-glucopyranoside (OctGlc) and n-dodecyl beta-D-maltoside (DodGlc2). The OctGlc preparation had high rates of oxygen evolution and when subjected to size-exclusion HPLC and sucrose density gradient centrifugation, in the presence of DodGlc2, separated into dimeric (430 kDa), monomeric (236 kDa) photosystem II cores and a fraction containing photosystem II light-harvesting complex (Lhcb) proteins. The dimeric core fraction was more stable, contained higher levels of chlorophyll, beta-carotene and plastoquinone per photosystem II reaction centre and had a higher oxygen-evolving activity than the monomeric cores. Their subunit composition was similar (CP43, CP47, D1, D2, cytochrome b 559 and several lower-molecular-mass components) except that the level of 33-kDa extrinsic protein was lower in the monomeric fraction. Direct solubilisation of photosystem-II-enriched membranes with DodGlc2, followed by sucrose density gradient centrifugation, yielded a super complex (700 kDa) containing the dimeric form of the photosystem II core and Lhcb proteins: Lhcb1, Lhcb2, Lhcb4 (CP29), and Lhcb5 (CP26). Like the dimeric and monomeric photosystem II core complexes, the photosystem II-LHCII complex had lost the 23-kDa and 17-kDa extrinsic proteins, but maintained the 33-kDa protein and the ability to evolve oxygen. It is suggested, with a proposed model, that the isolated photosystem II-LHCII super complex represents an in vivo organisation that can sometimes form a lattice in granal membranes of the type detected by freeze-etch electron microscopy [Seibert, M. , DeWit, M. & Staehelin, L. A. (1987) J. Cell Biol. 105, 2257-2265].
Corpus callosum in patients with obsessive-compulsive disorder: diffusion-tensor imaging study.

PURPOSE To prospectively examine microstructural white matter abnormalities in the corpus callosum (CC) of patients with obsessive-compulsive disorder (OCD), as compared with control subjects, and to investigate the relationship between diffusion-tensor (DT) imaging measures of the CC region and clinical symptoms of OCD. MATERIALS AND METHODS Institutional review board approval was obtained, and each participant--or the participant's parent(s)--provided written informed consent. Sixteen patients with OCD (seven male, nine female; mean age, 28.7 years +/- 9.8 [standard deviation]) and 16 matched healthy volunteers (control subjects) (seven male, nine female; mean age, 29.9 years +/- 9.0) were examined. Mean diffusivity and fractional anisotropy (FA) were measured in five subdivisions of the CC. The paired t test was performed to compare the mean diffusivity or the FA in CC regions between the patients with OCD and the control subjects. RESULTS There were no significant differences (rostrum, P = .15; genu, P = .88; rostral body, P = .12; isthmus, P = .77; splenium, P = .88) in mean diffusivity between the patients with OCD and the healthy volunteers. A significant reduction in FA was observed in the rostrum of the CC in patients with OCD compared with the rostral FA in the control subjects (P < .001). Higher FA in only the rostrum correlated significantly with lower Yale-Brown obsessive-compulsive scale score (r = -0.72, P = .002). CONCLUSION Study results support the widely held view that the orbital prefrontal region is involved in the pathophysiology of OCD and indicate that the orbitofrontal circuit influences symptom severity in patients with OCD.
Advantages of Intrathecal Nalbuphine, Compared with Intrathecal Morphine, After Cesarean Delivery: An Evaluation of Postoperative Analgesia and Adverse Effects

We performed a prospective, randomized, double-blinded, multicenter study to compare the analgesic efficacy and adverse effects of intrathecal nalbuphine, at three different doses, and intrathecal morphine for postoperative pain relief after cesarean deliveries. Ninety healthy patients at full term who were scheduled for elective cesarean delivery with spinal anesthesia were enrolled in the study. They received 10 mg of hyperbaric bupivacaine 0.5% with either morphine 0.2 mg (Group 1), nalbuphine 0.2 mg (Group 2), nalbuphine 0.8 mg (Group 3), or nalbuphine 1.6 mg (Group 4). Only patients in Groups 1 and 2 reported pain during surgery. Postoperative analgesia lasted significantly longer in the morphine group, compared with the nalbuphine groups (P < 0.0001). In the nalbuphine groups, postoperative analgesia lasted longest with the 0.8-mg dose. The additional increase to 1.6 mg did not increase efficacy. The incidence of pruritus was significantly higher in Group 1 (11 of 22), compared with Group 2 (0 of 22, P < 0.0002), Group 3 (0 of 23, P < 0.0001), and Group 4 (3 of 20, P < 0.02). Postoperative nausea and vomiting were more frequent in Group 1 (5 of 22), compared with Group 2 (0 of 22, P < 0.05), Group 3 (0 of 23, P < 0.05), and Group 4 (3 of 23, not significant). There was no maternal or newborn respiratory depression. Neonatal conditions (Apgar scores and umbilical vein and artery blood gas values) were similar for all groups. This study suggests that intrathecal nalbuphine 0.8 mg provides good intraoperative and early postoperative analgesia without side effects. However, only morphine provides long-lasting analgesia. Implications Small doses of intrathecal nalbuphine produce fewer adverse effects, such as pruritus and postoperative nausea and vomiting, compared with intrathecal morphine. This may allow earlier discharge of patients from the recovery room.
Ayurvedic gender differences revisited.

Dear Editor: In an article recently published in this journal, a finite genopsycho-somatotyping model, which combined Ayurvedic genomics, constitutional psychology, and endocrinology, was proposed in males. In them, the high rate of muscle growth and leadership characteristics are considered to be part of the ‘‘andrus’’ constitution due to the androgen effects. Since androgen and testes do not represent the female characteristics, we consider that such a model must be adjusted to current findings since women behave differently than the model proposed. Even though androgens are commonly seen as the ‘‘male’’ hormones and estrogens are considered to be the ‘‘female’’ hormones, they participate in a complex interplay in both sexes. Interestingly enough, estrogens are produced from androgens in both sexes. Moreover, testosterone, a wellknown hormone involved in male dominance, is considered an unlikely candidate for biologic underpinning of dominance motivation in females. Instead of this, a positive association between estradiol and dominance motivation was found in women. Furthermore, levels of circulating androgens are positively associated with body mass index. Such correlation has been found only in women with polycystic ovary syndrome or with simple obesity. Moreover, high circulating levels of dehydroepiandrosterone sulphate, the sulphate ester of the androgen precursor dehydroepiandrosterone, does correlate with truncal fat in women but not in men. The aforementioned hormone actions strongly support the concept that gender differences have to be considered from now on in the mesomorphic or andrus (pitta) basic constitution discussed elsewhere. Also, the constitutional model referred to as ‘‘andrus’’ for males should be referred as ‘‘estrus’’ in females. Likewise, the associated organ to the latter somatotype should be the ovaries, since they constitute the main place of estrogen synthesis in premenopausal nonpregnant women. Therefore, the genopsycho-somatotyping model for humans must consider the effects of hormone-to-hormone differences as well as their interaction, as a key point in male and female alternative and complementary psychophysiology in order to better understand the human mind–body–spirit homeostasis.
The Effect of Delocalized Plans on the Maintainability of Spreadsheets A Controlled Experiment

Spreadsheets are widely used in industry. Companies take important decisions based on information coming from spreadsheets. But, spreadsheets also suffer from typical software maintenance issues. Previous research shows that they contain code smells, lack documentation and testing, have a long live span and during this life span are transferred multiple times from one user to another. To obtain a better understanding of how the maintainability of spreadsheets can be improved, we focus in this paper on spreadsheet comprehension. We analyze the relation between the organization of formulas in a spreadsheet and its maintainability. To that end, we conduct a controlled experiment with 107 spreadsheet users, divided into two groups. One group receives a model where the formals are organized in such a way that all related components are grouped closely together, the other group receives a model where the components are spread far and wide in the spreadsheet. All subjects have to perform the same set of comprehension tasks on their spreadsheet. The results indicate that the way formulas are organized, indeed influences the performance of the subjects in their ability to comprehend and adapt the spreadsheet. Especially for the comprehension tasks, the subjects performed better on the model were the data was grouped closely together. For the adaptation tasks, we found that the way the formulas were constructed influenced the performance of the subjects more than the organization of the formulas itself.
Advanced Modeling and Accurate Characterization of a 16 Gb/s Memory Interface

As the input/output (I/O) data rate increases to several gigabits per second, determining the performance of high-speed interfaces using conventional simulation and measurement techniques is becoming very challenging. The models of the interconnects have to be broadband and accurate to represent high frequency and second-order effects such as frequency dependence of dielectric losses and surface roughness. The large and small signal behaviors of the transmitter and receiver circuitries have to be correctly represented in link analysis. In addition, the system simulation needs to properly capture the interactions between the circuits and interconnect subsystems to optimize the overall system. However, determining the values of the critical link parameters and their correlations can be complicated. Some of the key parameters are not deterministic and some cannot be observed directly. A combined modeling and measurement approach is indispensable to determine the performance of high-speed links. This paper presents the modeling and characterization techniques employed in the design and verification of a 16 Gb/s bidirectional asymmetrical memory interface. Direct frequency and time-domain methods as well as indirect techniques based on bit-error-rate testing are used to model and determine important link parameters. Complex de-embedding procedures are utilized to extract parameters from externally observed data. On-chip measurements are also used to complement off-chip instrumentation and accurately measure the true performance of the link. The modeling and characterization of prototypes are also discussed and model-to-hardware correlations are presented at component and system levels. Based on both simulation and measurement results, the behavioral model of the complete system is constructed and statistical simulation technique is used to predict the yield and performance at low bit error rate.
Incentives for Sharing in P2P Networks

A dust seal for a material conveyor belt and material chute includes an elongated body of a polygonal configuration. The body includes an axial bore defined within the body and extending the length thereof. An attachment device is included for securing the dust seal at a point upstream of the chute and on the belt to allow gravity and friction developed between the moving belt and the dust seal to move the dust seal to a position adjacent the chute so as to provide a seal to prevent the escape of material from around the chute.
FAST DISINTEGRATING COMBINATION TABLETS OF OMEPRAZOLE AND DOMPERIDONE

The aim of this study was to prepare fast disintegrating combination tablets of Omeprazole and Domperidone by using pertinent disintegrant. The tablets were prepared using mannitol as diluent and sodium saccharin as sweetening agent along with three different levels of disintegrant. The superdisintegrant used in this study were Kollidon CL, Ac-Di-Sol and SSG. The tablets were evaluated for weight variation, hardness, friability, wetting time, water absorption ratio, disintegration time (DT) and dissolution study. Using the same excipients, the tablets were prepared by direct compression and were evaluated in the similar way. Drug content was estimated by using HPLC method and also assay of sample was compared with standard drugs (Omeprazole and Domperidone). Omeprazole and Domperidone were well resolved and the retention times were around 9.01 and 6.2 respectively. From the results obtained, it can be concluded that the tablet formulation prepared with 4.76% Ac-Di-Sol (internally cross linked form of sodium carboxymethylcellulose) ie. 10 mg showed Disintegration time of 15 seconds in vitro. Also the hardness, friability, dissolution rate and assay of prepared tablets (batch F7) were found to be acceptable according to standard limits.
Immunohistochemical expression of interleukin‐4, ‐6, ‐8, and ‐12 in inflammatory cells in surrounding invasive front of oral squamous cell carcinoma

Cytokines play important roles in the diverse interactions between tumor microenvironment and malignant cells. This study evaluated the association of interleukin (IL)‐4, ‐6, ‐8, and ‐12 expressions and clinicopathologic parameters of 35 primary oral squamous cell carcinomas (OSCCs).
Nucleotide sequence of thymidine kinase gene of sequential acyclovir‐resistant herpes simplex virus type 1 isolates recovered from a child with Wiskott–Aldrich syndrome: Evidence for reactivation of acyclovir‐resistant herpes simplex virus

Recurrent acyclovir (ACV)‐resistant (ACV‐r) herpes simplex virus type 1 (HSV‐1) infections occurred in a patient with Wiskott–Aldrich syndrome, an X‐linked recessive immunodeficiency syndrome composed of three clinical characteristics of immunodeficiency, thrombocytopenia, and an eczematous dermatitis. The patient had severe and recurrent ACV‐r herpes simplex and was treated with vidarabine in a satisfactory manner from 1993 to 1997. During the 4‐year observation period, two ACV‐sensitive (ACV‐s) HSV‐1 isolates and five ACV‐r HSV‐1 isolates were recovered. The nucleotide sequence of the thymidine kinase (TK) gene from these sequential ACV‐r isolates was compared with the ACV‐s isolates. A single nucleotide deletion of cytosine (C) from homopolymer stretch of four C residues between nucleotide 1061 and 1064 of the open reading frame was found in all ACV‐r isolates. No other differences were observed in the TK nucleotide sequence between ACV‐s and ACV‐r isolates. The TK nucleotide sequences of the two ACV‐s isolates were identical to each other and those of the five ACV‐r isolates were identical to one another. These results suggest that the ACV‐r HSV‐1 might have derived from the ACV‐s strain in the patient body and that TK‐associated ACV‐r HSV‐1 can reactivate from latency. J. Med. Virol. 58:387–393, 1999. © 1999 Wiley‐Liss, Inc.
Symptoms and Signs of Sciatica and Their Relation to the Localization of the Lumbar Disc Herniation

Neurologic symptoms and signs in patients with sciatica were prospectively studied and compared with myelographic and operative findings in 403 cases with lumbar disc herniation as the cause of sciatica with special reference to accuracy of the clinical level diagnosis. Fifty-six percent of the herniations at L4–5. However, pain projection into the first sacral distribution was most common. Neurologic symptoms and signs of involvement of a single root were present in 239 cases and of two roots in 154 cases in L4–5 and L5S1 herniations. Pain projection into the fifth lumbar distribution was a very important symptom for Identification of clinical findings of the fifth lumbar root involvement gave a level diagnostic accuracy comparable with myelography, while pain projection into the first sacral distribution was less reliable especially in cases with signs of two roots. The neurologic picture of high herniations was completely unreliable. Lumbar myelography or computer tomography is recommended as a routine preoperatlve study.