Miracle-dz/UniFAR-FTUs huggingface dataset:
Hemostatic techniques reduce hospital stay following multilevel posterior cervical spine surgery.

BACKGROUND Despite meticulous hemostasis, persistent postoperative drain output following posterior cervical spine procedures often necessitates a prolonged length of hospital stay. We sought to determine if thrombin-soaked absorbable gelatin compressed sponge can decrease postoperative drain output and the length of hospital stay after multilevel posterior cervical spine surgery. METHODS We performed a retrospective analysis of forty-three pairs of patients who had undergone either posterior cervical decompression and/or fusion of three or more levels by the same surgeon. The patients were matched according to intraoperative blood loss, age, sex, and number of involved levels. Control patients were managed between 2004 and 2007, whereas study patients were managed between 2008 and 2011. The only variable between the study and control groups was that, in the study group, absorbable gelatin compressed sponge was soaked in thrombin and applied over the exposed spine before wound closure. A subfascial drain was used in all patients. Total drain output, time for the drainage to decrease to <30 mL per eight-hour shift (at which point the drain was discontinued), the length of stay, the number of readmissions, and postoperative complications were analyzed. RESULTS Total drain output averaged 93 mL in the study group and 204 mL in the control group (p < 0.0001). The average time for the drainage to decrease to <30 mL per eight-hour shift was 2.5 shifts in the study group and 4.4 shifts in the control group (p < 0.0001). Length of stay averaged 1.3 days (cumulative total, fifty-seven days) in the study group and 2.2 days (cumulative total, ninety-five days) in the control group (p < 0.0001). Persistent drain output was the primary reason preventing discharge on the first postoperative day. There were no infections, epidural hematomas, or readmissions within thirty days of discharge in either group. No patient developed adverse reactions attributable to the thrombin-soaked absorbable gelatin compressed sponge. CONCLUSIONS Application of thrombin-soaked absorbable gelatin compressed sponge at the end of multilevel posterior cervical spinal surgery significantly decreased postoperative drain output and consequent hospital stay. LEVEL OF EVIDENCE Therapeutic Level III.
Immunomodulation Mechanisms in Disease and in the Surgical Patient

Modulation of the immune system plays a critical role in management of health and disease processes within humans. The importance of the immune system stems from the need to eliminate and modulate both pathogenic and nonpathogenic micro-organisms that could hinder the body’s ability to maintain homeostasis. In addition to a functional host immune system, the presence of a microbiome of nonpathogenic bacteria is necessary to maintain a proper symbiotic effect. Of the 35 trillion cells in the human body, half originate from a human line and half from a microbial line (Sender et al., 2016). In this issue of the journal, Ostrov and Amsterdam comprehensively review the role of such microbiota in the progression and development of several rheumatologic diseases (Ostrov and Amsterdam, 2017). The most common microbial floras in human gut are phyla Firmicutes and bacteroides. When these bacteria are recognized by the Toll-like receptors within human cells, the immune responses are modulated and excessive levels of inflammation are prevented. In addition to the direct involvement of the microbiome in the pathophysiology of the rheumatic disease, medications used to treat rheumatic diseases were found to be metabolized differentially by various bacterial floras within the gastrointestinal tract. Perioperative modulation of the immune system occurs after all surgical procedures. Both surgery and anesthesia have been postulated to contribute to these immunomodulatory effects. It has been well documented that after the inadequate resection of a cancer, the rate of progression is accelerated. Moreover, the risk of bacterial infections increases postoperatively, while the symptoms from a viral infection are mitigated due to a switch in the immune response from the Th-1 to the Th-2 response. The former immune response is directed toward eradicating and clearing bacterial loads and the latter response is geared toward viral infections and tumor-related immunity. Systems biology after surgical stress identified interferon regulatory factor 3 as the negative regulator of Toll like receptors (TLR) signaling that subsequently leads to anti-inflammatory reaction (Ishikawa 2009). It should be noted that the surgical stress response, potential perioperative transfusion of blood products which is known suppressor of the immune system, and the whole cadre of anesthetic agents have similar immunomodulatory effects. In this issue, Knight’s group provides a detailed review on the effects of anesthesia on major phases of innate immunity including recognition, recruitment, response, and resolution (Sedghi et al., 2017). According to this review, the initial proinflammatory response “prep of the battle field” led by activation of tumor necrosis factor alpha (TNF-α)
The rostromedial tegmental nucleus and alcohol addiction

The neurobiological mechanisms underlying alcohol addiction remain obscure. It is generally accepted that alcohol's addictive property is associated with its ability to increase the activity of dopaminergic (DA) neurons in the ventral tegmental area (VTA) in the brain. These neurons are under the powerful control of synaptic inputs. Thus, the synaptic regulation of DA neurons is a key initial step in reward mechanisms leading to alcohol addiction. DA neurons receive major GABAergic afferents. Some drugs of abuse, such as opioids, stimulate VTA-DA neurons through suppression of GABAergic transmission-that is by disinhibition. Emerging evidence indicates that the rostromedial tegmental nucleus (RMTg), a recently defined structure with dense Mu-opioid receptor (MOR) immunoreactivity, is a major GABAergic afferent to DA neurons, and a key structure in MOR-dependent regulation of DA neurons [1]. Substantial evidence associates the endogenous opioid system with the development and maintenance of alcoholism [2]. Alcohol alters the activity of endogenous opioid peptides, including biosynthesis, release, and degradation, as well as binding to opioid receptors, and these alterations may modulate many of the alcohol-related behaviors, including drinking and conditioned place preference (CPP). Blocking MORs with naltrexone, an opioid antagonist significantly decreases alcohol intake in preclinical settings and in humans with inconstant efficacy. However, the underlying mechanisms connecting MOR expressing RMTg neurons with alcohol drinking behavior remain obscure. In an attempt to address this issue, in a recent study[3], we measured alcohol related behaviors after lesioning the RMTg with a special pharmacological agent, dermorphin-saporin (DS). Dermorphin is a potent MOR agonist, causing MOR internalization upon binding[4], whereas saporin is a ribosome-inactivating cytotoxin [5]. Microinjection of DS into the RMTg substantially reduced the number of RMTg cells. Importantly, the rats that received DS injection elevated their alcohol intake and preference compared to those that received an injection of blank saporin (BS), which did not cause neuronal damage. Based on these results, and the evidence from previous rodent studies suggesting that alcohol's aversive effects limit voluntary intake, we propose that MOR-expressing GABAergic neurons in the RMTg may be an important structure of alcohol aversion. Conversely, given that alcohol's euphoric effect encourages drinking, which may be normally constrained by these neurons; hence the ablation of these neurons makes drinking more rewarding. To test these hypotheses, we conduced a conditioned place preference (CPP) experiment, and found that rats spent more time in the chamber where they received intraperitoneal injections of alcohol (2g/kg), implying that alcohol gave …
Hyperprolactinemia and hypothyroidism following cytotoxic therapy for central nervous system malignancies.

Endocrinologic dysfunction including hyperprolactinemia and hypothyroidism are recognized complications of irradiation to the hypothalamic-pituitary axis or thyroid gland in the course of treating CNS malignancies. However, the frequency of these adverse effects in both short- and long-term survivors may be underestimated. Sixty-five patients treated in the University of Rochester Cancer Center since 1968 with radiation with or without BCNU chemotherapy for CNS tumors not involving the hypothalamic-pituitary axis were evaluated for thyroid, prolactin, and gonadal disturbances regardless of clinical symptomatology. Prolactin values were elevated in 19 of 47 patients (40%). For males and females treated with greater than 55 Gy, abnormal values were present in nine of 11 (82%) and seven of 14 (50%), respectively. For males and females treated with less than or equal to 55 Gy, two of nine (22%) and one of 13 (8%), respectively, were abnormal (P = .0001). Six of six patients who also received BCNU chemotherapy were hyperprolactinemic, as compared with six of ten (60%) who did not receive BCNU. Seven of eight females with elevated prolactin levels had menstruation abnormalities, and five of seven adult males noted a decrease in libido. Mild abnormalities in testosterone concentration were found in three of nine men evaluated, all of whom had normal gonadotropins. Of 47 patients who did not receive irradiation to the spinal axis (and thus the thyroid gland), ten (21%) had a decreased thyroxin (T4) value. Only one of these patients had an elevated thyroid-stimulating hormone (TSH) value. Of 32 patients who received greater than 55 Gy, ten (31%) had a low T4, compared with zero of 15 who received less than or equal to 55 Gy (P = .0001). Four of eight patients (50%) who also received BCNU had low T4 values, as compared with three of 14 (21%) who did not receive BCNU. Of 15 patients who were treated with 4 to 10 MV photon irradiation to the spinal axis, five patients (33%) had elevated TSH values. The mean spinal axis dose in these patients was 33 Gy. Two euthyroid children in this group manifested the early onset of puberty. The complex of endocrinologic abnormalities observed in several patients receiving only cranial irradiation, that is elevated prolactin, decreased thyroid, and gonadal hormone secretion in the presence of otherwise normal pituitary hormone levels, suggests a radiation-induced insult to the hypothalamic regulation of pituitary function.
Managers' perception of potential impact of knowledge management in the workplace: Case study

This paper is an exploratory research that reviews how organization managers perceive knowledge management (KM), and practice across all levels of their firms. The paper posits that KM consists of enablers such as top management commitment and knowledge structure that are critical to the success of a knowledge-based organization. The study was stimulated firstly, the recognition of shifting businesses from production-based to a knowledge-based economy, secondly the emergence of the needs for knowledge managers, as well as learning organization. The paper also addresses all top management leaders (levels of decision making) in the study. The study is conducted in Abu Dhabi, Al-ain, United Arab Emirates (UAE), and the study represents all firms according to ‘’ The Chamber of Commerce Directory’’. Based on the sample of 112 firms, finding reveal that managers’ perception in these firms was a key barrier for achieving success and positive performance. Findings reveal that although business growth and a large market size were seen to motivate firms locally, perceiveness of the potential KM effectiveness to increase efficiency of the organization was lagging behind, and therefore understanding KM was a barrier.
LEISURE TIME MANAGEMENT IN MARMARA UNIVERSITY AND KİLİS 7 ARALIK UNIVERSITY STUDENTS TRAINING IN SPORTS SCIENCES

This sport science research in an undergraduate Faculty of Marmara University Sports Science and Kilis 7 Aralik University of Physical Education and Sports School students of “Leisure Management” ideas are evaluated. Free time management scale; Wei-Ching Wang et al. (2011) and Akgul and Karakucuk (2015) by adapting to Turkish by making validity and reliability study consists of 15 items and 4 sub-dimensions. 285 students from Marmara University Faculty of Sport Sciences and Kilis 7 Aralik University School of Physical Education and Sports participated in the study. In data analysis, d escriptive statistics, t-test, ANOVA test were used. As a result of the statistical analysis, it was seen that the majority of the participants consisted of Marmara University students, while in the departments, there was a larger number of male students. In the other findings, it was understood that there was more participation in the 18-20 age group, they were single in marital status and they were more in the 1st class and they participated in their activities in leisure time 2-3 days a week. While there was a significant difference between the total scale scores of the participants and the variables of the universities, it was found that there was no significant difference in gender, marital status variables. There was a significant difference between the scale sub-dimensions and the activities of universities, age, leisure time and classes. As a result, it is understood that leisure time is better managed in metropolitan cities and that students who are studying in the field of sports should be directed to leisure time activities.
On the Relationship between Two Fatigue-Life Models

The relationship between two fatigue life distributions, namely the Birnbaum-Saunders and the Inverse Gaussian, is further investigated. An intimate connection exists between the two models, viz, the Birnbaum-Saunders is a mixture of two probability distributions: 1) an Inverse Gaussian random variable, and 2) the reciprocal of an Inverse Gaussian random variable. Advantages and disadvantages of the two distributions are discussed. The arguments favour the Birnbaum-Saunders distribution from a stochastic modeling point of view, whereas the Inverse Gaussian distribution seems to be the more attractive of the two with respect to statistical analysis and analysis of censored data.
Foot and Ankle Infections: Diagnosis and Management

Abstract Infections of the foot are a common source of morbidity, disability, and potential limb loss. A large proportion of lower extremity infections occurs in the setting of diabetic neuropathy, with or without circulatory compromise, and are potentially preventable with regular surveillance. Adequate diagnosis and treatment of foot infections can be challenging. Successful treatment is dependent on factors such as etiology; vascular, neurologic, and immune status; and the identity of the offending organism.
Comparison of SOS MOSFET's Equivalent Circuit Parameters Extracted From $LCR$ Meter and VNA Measurement

In this paper, we critically compare two techniques for the parametrization of silicon-on-sapphire MOSFETs' high-frequency small-signal equivalent circuit and discuss the scalability of high-frequency equivalent circuit parameters. We demonstrate that the same values of the high-frequency circuit elements are obtained from both the vector network analyzer and the low-frequency LCR measurements. We show that this holds even when majority carriers in the isolated body of the transistor are not in the equilibrium state, implying that the equivalence does not depend on quasi-static response of the carriers.
Efficacy of entacapone and pramipexole in treating non-motor symptoms of Parkinson’s disease: a prospective randomized controlled trial

Background and objective: Individuals with Parkinson’s disease exhibit a variety of non-motor symptoms that can negatively impact quality of life. Although both entacapone and pramipexole can be used to treat Parkinson’s disease via modulation of dopamine metabolism, the ways in which these treatments differ in terms of their effects on the non-motor symptoms of Parkinson’s disease are unknown. Participants and methods: This prospective, randomized, controlled trial will be conducted in the Geriatric Hospital of Hainan, Haikou, China. A total of 388 patients with idiopathic Parkinson’s disease will be randomly assigned to receive entacapone (n = 194) or pramipexole (n = 194). This study was approved by the Ethics Committee of the Geriatric Hospital of Hainan, China on August 30, 2013 (approval number: S2013-038-01) on August 30, 2013. Written informed consent regarding the study protocol and surgical procedure will be obtained from all participants. Results: The primary outcome measure will be the rate of improvement of non-motor symptoms 3 weeks after treatment. Secondary outcome measures will be soluble interleukin-2 receptor and homocysteine levels in serum, which reflect inflammation, and adverse events before and 3 weeks after treatment. Our self-controlled pilot study involving 100 patients showed that incidences of autonomic neurological symptoms such as postural hypotension, urinary urgency, urinary frequency, sexual dysfunction, dry mouth, and salivation, psychiatric symptoms such as cognitive dysfunction, hallucination, depression, and anxiety, and sensory abnormalities such as spasm, pain, and restless leg syndrome were remarkably reduced. Meanwhile, levels of serum soluble interleukin-2 receptor and homocysteine had noticeably decreased after treatment with entacapone and pramipexole. Conclusion: This trial will confirm the efficacy of entacapone and pramipexole in the treatment of non-motor symptoms of Parkinson’s disease. We hope that our findings will provide direction for future clinical treatment of non-motor symptoms of Parkinson’s disease, leading to improved patient quality of life. Trial registration: This study was registered with the Chinese Clinical Trial Registry on April 15, 2019 (registration number: ChiCTR1900022534). Protocol version is 1.0.
Diabetes and the labor market: the community-wide economic cost in the Lower Rio Grande Valley.

Economic analyses of diabetes and diabetes treatment and prevention are increasingly common (1–11). The cost of illness studies divide costs into direct and indirect components (12,13). Indirect costs are typically those associated with limited employment-related productivity (14–18). Direct costs usually include hospital and other medical costs (19–25). While these approaches have merit at the national level, they are less applicable at the community level for two reasons. First, lost income due to diabetes translates into substantially reduced local spending for everyone in communities where the prevalence of diabetes is high. For example, in a community with high diabetes-related unemployment, income reductions related to diabetes translate into less local spending, leading to layoffs and reduced expenditures. Second, the economy of the local community partially benefits from medical expenditures, which are largely inflows from outside the community but spent locally. In this study, we use an alternative method to assess the local economic impact of diabetes: input-output analysis. We focus on a largely Mexican-American community with a 25% type 2 diabetes prevalence rate, the Lower Rio Grande Valley (LRGV) of South Texas (26). We intend to show that the standard practice of including local medical care costs is not necessary to highlight …
Bioenergy Production via Microbial Conversion of Residual Oil to Natural Gas

ABSTRACT World requirements for fossil energy are expected to grow by more than 50% within the next 25 years, despite advances in alternative technologies. Since conventional production methods retrieve only about one-third of the oil in place, either large new fields or innovative strategies for recovering energy resources from existing fields are needed to meet the burgeoning demand. The anaerobic biodegradation of n-alkanes to methane gas has now been documented in a few studies, and it was speculated that this process might be useful for recovering energy from existing petroleum reservoirs. We found that residual oil entrained in a marginal sandstone reservoir core could be converted to methane, a key component of natural gas, by an oil-degrading methanogenic consortium. Methane production required inoculation, and rates ranged from 0.15 to 0.40 μmol/day/g core (or 11 to 31 μmol/day/g oil), with yields of up to 3 mmol CH4/g residual oil. Concomitant alterations in the hydrocarbon profile of the oil-bearing core revealed that alkanes were preferentially metabolized. The consortium was found to produce comparable amounts of methane in the absence or presence of sulfate as an alternate electron acceptor. Cloning and sequencing exercises revealed that the inoculum comprised sulfate-reducing, syntrophic, and fermentative bacteria acting in concert with aceticlastic and hydrogenotrophic methanogens. Collectively, the cells generated methane from a variety of petroliferous rocks. Such microbe-based methane production holds promise for producing a clean-burning and efficient form of energy from underutilized hydrocarbon-bearing resources.
Benefit/risk assessment for breast cancer chemoprevention with raloxifene or tamoxifen for women age 50 years or older.

PURPOSE The Study of Tamoxifen and Raloxifene (STAR) demonstrated that raloxifene was as effective as tamoxifen in reducing the risk of invasive breast cancer (IBC) in postmenopausal women and had lower risks of thromboembolic events, endometrial cancer, and cataracts but had a nonstatistically significant higher risk of noninvasive breast cancer. There is a need to summarize the risks and benefits of these agents. PATIENTS AND METHODS Baseline incidence rates of IBC and other health outcomes, absent raloxifene and tamoxifen, were estimated from breast cancer chemoprevention trials; the Surveillance, Epidemiology and End Results Program; and the Women's Health Initiative. Effects of raloxifene and tamoxifen were estimated from STAR and the Breast Cancer Prevention Trial. We assigned weights to health outcomes to calculate the net benefit from raloxifene compared with placebo and tamoxifen compared with placebo. RESULTS Risks and benefits of treatment with raloxifene or tamoxifen depend on age, race, breast cancer risk, and history of hysterectomy. Over a 5-year period, postmenopausal women with an intact uterus had a better benefit/risk index for raloxifene than for tamoxifen. For postmenopausal women without a uterus, the benefit/risk ratio was similar. The benefits and risks of raloxifene and tamoxifen are described in tables that can help identify groups of women for whom the benefits outweigh the risks. CONCLUSION We developed a benefit/risk index to quantify benefits from chemoprevention with tamoxifen or raloxifene. This index can complement clinical evaluation in deciding whether to initiate chemoprevention and in comparing the benefits and risks of raloxifene versus tamoxifen.
A Novel Recursive Feature Subset Selection Algorithm

Univariate filter methods, which rank single genes according to how well they each separate the classes, are widely used for gene ranking in the field of microarray analysis of gene expression datasets. These methods rank all of the genes by considering all of the samples; however some of these samples may never be classified correctly by adding new genes and these methods keep adding redundant genes covering only some parts of the space and finally the returned subset of genes may never cover the space perfectly. In this paper we introduce a new gene subset selection approach which aims to add genes covering the space which has not been covered by already selected genes in a recursive fashion. Our approach leads to significant improvement on many different benchmark datasets. Keywords-gene selection; filter methods; gene expression; microarray; ranking functions.