Miracle-dz/UniFAR-FTUs huggingface dataset:
Changes in Cervical Spine Range of Motion after Laminoplasty in Cervical Spondylotic Myelopathy

Study Design: A retrospective study. Objectives: This study examined the cervical range of motion (ROM) of cervical spondylotic myelopathy patients, before and after open door laminoplasty. Summary of Literature Review: Majority of the cases regarding the change of cervical range of motion after cervical laminoplasty showed decreased range of motion, and the results were diverse. Materials and Methods: Of the 487 patients, who underwent open door laminoplasty at our hospital from March 1997 to March 2008, 98 had been followed for at least 2 years and had cervical flexion-extension lateral x-rays. In all patients, open door laminoplasty involved at least three segments: three, four, and five segments in 11, 52, and 35 patients, respectively. In previous cases, fixation involved sutures using suture anchors. The lordosis or kyphosis between C2 and C7 was analyzed using cervical flexion-extension lateral radiographs before and 2 years after the operation. Results: The average patient age was 62.7 (range 32–82) years; 65 patients were male and 33 were female. From preoperatively to postoperatively, the average kyphosis of cervical flexion decreased from 10.7° to 7.8°, average lordosis decreased from 21.2° to 14.2°, and cervical ROM decreased from 31.9° to 22.0°, respectively (mean 9.9°, 31.0%). Conclusions: We could observe decreased cervical range of motion after cervical laminoplasty for cervical spondylotic myelopathic patients. Thus, the treatment to prevent the postoperative decrease of cervical range of motion and further study to find a new treatment are thought to be essential.
Differences in sperm storage and remating propensity between adult females of two morphotypes of the Anastrepha fraterculus (Diptera: Tephritidae) cryptic species complex

Abstract The South American fruit fly, Anastrepha fraterculus, is a complex of cryptic species composed of at least seven morphotypes. Some of them, such as the Peruvian and Brazilian 1 morphotypes (which include Argentinean populations), exhibit strong pre-copulatory isolation, yet it is possible to obtain heterotypic crosses when forcing copulation of adults under laboratory conditions. The cross involving Peruvian males and Argentinean females produces F1 offspring with reduced viability in terms of egg hatch. This low hatchability could be caused by a reduced amount of sperm transferred to and stored by females mated with heterotypic males, which in turn could affect their post-copulatory behaviour. To test these hypotheses, we investigated sperm transfer and female mating and remating behaviour for homotypic and heterotypic crosses between adults of two morphotypes (Brazilian 1 [Argentina] and Peruvian [Peru]) of the A. fraterculus cryptic species complex. As reported before, Argentinean males and females mated earlier in the day than the other three mating combinations. Peruvian females engaged in shorter copulation times than Argentinean females. Peruvian females tended to store smaller quantities of sperm than Argentinean females, and almost a half of the crosses involving Argentinean males and Peruvian females were unsuccessful (no sperm transfer). However, there was no evidence that the cross between Peruvian males and Argentinean females resulted in storage of a critically small amount of sperm (posing risk of sperm shortage). Argentinean females were more willing to remate than Peruvian females, irrespective of male morphotype, but latency to remating was not affected by male or female morphotype. This study shows that mating behaviour differs between some of the A. fraterculus complex morphotypes, with female but not male morphotype determining female likelihood to remate.
Seasonal trends, sampling plans and parasitoid complex of the Chinese wax scale, Ceroplastes sinensis Del Guercio (Hemiptera: Coccidae), in Mediterranean citrus groves

Abstract Seasonal trends and the parasitoid complex of Chinese wax scale (Ceroplastes sinensis) was studied from July 2010 to February 2013. Six commercial citrus groves located in northeastern Spain were sampled fortnightly. Chinese wax scale completed a single annual generation. Egg oviposition started in May and continued until mid-July. Egg hatching began in mid-June, and in the first quarter of August, the maximum percentage of hatched eggs was reached. In the same groves, the parasitoid species of C. sinensis were determined together with their seasonal trends, relative abundance and occurrence on C. sinensis. Four hymenoptera were found parasitizing C. sinensis, mainly on third instars and females: Coccophagus ceroplastae (Aphelinidae), Metaphycus helvolus (Encyrtidae), Scutellista caerulea (Pteromalidae) and Aprostocetus ceroplastae (Eulophidae). The most abundant species was A. ceroplastae, corresponding to 54% of the parasitoids emerged. Coccophagus ceroplastae and M. helvolus represented 19%, whereas S. caerulea comprised 8% of the total. This study is the first published record of C. ceroplastae in Spain and the first record of M. helvolus on C. sinensis in Spain. Concerning the economical thresholds normally used, sampling plans developed for the management of C. sinensis in citrus groves should target population densities of around 12–20% of invaded twigs, equivalent to 0.2–0.5 females per twig. The sample size necessary to achieve the desired integrated pest management precision is 90–160 twigs per grove for the enumerative plan and about 160–245 twigs per grove for the binomial plan.
Multi-character approach reveals a discordant pattern of phenotypic variation during ontogeny in Culex pipiens biotypes (Diptera: Culicidae)

Abstract Culex (Culex) pipiens s.l. (Diptera: Culicidae) comprises two distinct biotypes, pipiens (‘rural’) and molestus (‘urban’), both of which are thought to have differing capacities due to different host preferences. To better understand West Nile encephalitis epidemiology and improve risk assessment, local distinction between these forms is essential. This study assesses phenotypic variation at larval and adult stages of ‘urban’ and ‘rural’ biotypes of the species by complementary use of meristic, univariate and multivariate traits analyzed by traditional and geometric morphometrics. Third- and fourth-instar larvae from a broad area of the city of Novi Sad (Serbia) were collected and reared in the laboratory. After adult eclosion, the sex of each larva was recorded based on the sex of the corresponding adult. Examination of the association between variations of larval traits revealed contrasting variations regarding pecten spines vs. siphonal size and siphonal shape in the ‘rural’ biotype. Siphons of larvae collected in marshes and forest ecosystems outside urban areas were found to be the largest, but possessed the smallest number of pecten spines. In addition, statistically significant female-biased sexual dimorphism was observed in siphonal size, wing size and wing shape. Finally, we propose that an integrative approach is essential in delimitation of Cx. pipiens s.l. biotypes, since their differentiation was not possible based solely on larval and adult traits. Our findings shed light on the phenotypic plasticity important for population persistence in the changing environment of these medically important taxa.
New York City Panel on Climate Change 2015 Report Conclusions and Recommendations

Warmer temperatures are extremely likely,a and the frequency of heat waves is very likely to increase. Total annual precipitation will likely increase, and brief, intense rainstorms are very likely to increase. Sea level rise is very likely to accelerate as the century progresses. New York City’s sea level rise is projected to exceed the global average, increasing the risks posed to New York City’s coastal populations, infrastructure, and other built and natural assets.
New York City Panel on Climate Change 2015 Report Chapter 2: Sea Level Rise and Coastal Storms

New York City’s low-lying areas are home to a large population, critical infrastructure, and iconic natural, economic and cultural resources. These areas are currently exposed to coastal flooding by warmseason tropical storms such as Hurricane Sandya (Box 2.1) and cold-season nor’easters. Sea level rise increases the frequency and intensity of coastal flooding. For example, the 12 inches of sea level rise in New York City since 1900 may have expanded Hurricane Sandy’s flood area by approximately 25 square miles, flooding the homes of more than 80,000 additional peopleb in New York and New Jersey alone (Climate Central 2013, as reported in Miller et al., 2013; see also Chapter 3, NPCC, 2015). This chapter presents an overview of observed sea level rise and coastal storms for the New York metropolitan region, sea level rise projection methods and results, coastal storm projections, and recommendations for future research.
207 Arrhythmia Inducibility in a Novel Normotensive Rodent Model of Arrhythmia is not Related to Connexin 43 Quantity and Phosphorylation States – Determining the Contribution of Hypertension and ageing on the Myocardial Substrate

Introduction Hypertension and ageing are the commonest risk factors for atrial fibrillation (AF) and a significant cause of ventricular dysfunction, which may lead to arrhythmia. Putative factors in the remodelled substrate are connexin 43 (Cx43), the most abundant cardiac gap junction and fibrosis. The spontaneous hypertensive rat (SHR) has been demonstrated to have increased AF compared to a normotensive control species (Wistar Kyoto). However, the exact substrate changes remain elusive, as is a normotensive model of naturally occurring cardiac arrhythmia. Methods 40 Brown Norway (BN) and 40 SHR were aged simultaneously, with ex vivo Langendorff pacing protocols for atrial and ventricular arrhythmia performed at 3, 6, 9 and 12 months (n = 10 each group), which is the age at which SHRs develop spontaneous AF. Burst pacing was performed from right and left atria (RA/LA) from 150–30 ms in 10 ms decrements, then left ventricular (LV) apex extrastimulus pacing until ventricular effective refractory period was reached, or arrhythmia induced. Tissues were then divided and flash frozen for immunoblotting of Cx43. Electrophysiological data was recorded using a high-density microelectrode array placed on both RA and LA during atrial pacing and then RA and LV free wall during LV pacing. A subgroup (n = 4 each species) had non-invasive blood pressure recorded via tail-cuff plethysmography, echocardiography and implanted telemetry. Results BN mean systolic pressure was significantly lower than SHR with a lower LV mass on echo and heart weight to body weight ratio (p < 0.05 at all ages). Both sets of animals demonstrated equal atrial and ventricular inducibility ex vivo at all timepoints between species (see Figure 1) and occurrence of spontaneous AF and atrial tachycardia (AT) on in vivo telemetry (see Figure 2). Total atrial connexin 43 levels were no different between species at any age or when subdivided into arrhythmia +/- groups. However, there was a decrease in total ventricular Cx43 in both species between the 3, vs 9 and 3 vs 12 month groups, with an increase in the percentage dephosphorylated (P0) fraction in younger animals, despite a lower percentage of ventricular arrhythmia than older animals of the same species. Abstract 207 Figure 1 Abstract 207 Figure 2 Conclusions The novel findings of this study are as follows: 1. The Brown Norway rat is a novel small animal model of naturally occurring and provoked atria and ventricular arrhythmia, in addition to the recently described SHR. 2. The effects of age seem to be more potent on the arrhythmic substrate than hypertension. 3. The arrhythmia phenotype is not related to underlying Cx43 quantity or phosphorylation state. The mechanisms underlying the BN arrhythmia phenotype are undergoing continuing studies, specifically looking at fibrosis, Cx43 lateralisation and sodium channel expression.
Hepatic cannabinoid receptor-1 mediates diet-induced insulin resistance via inhibition of insulin signaling and clearance in mice.

BACKGROUND & AIMS Obesity-related insulin resistance contributes to cardiovascular disease. Cannabinoid receptor-1 (CB(1)) blockade improves insulin sensitivity in obese animals and people, suggesting endocannabinoid involvement. We explored the role of hepatic CB(1) in insulin resistance and inhibition of insulin signaling pathways. METHODS Wild-type mice and mice with disruption of CB(1) (CB(1)(-/-) mice) or with hepatocyte-specific deletion or transgenic overexpression of CB(1) were maintained on regular chow or a high-fat diet (HFD) to induce obesity and insulin resistance. Hyperinsulinemic-euglycemic clamp analysis was used to analyze the role of the liver and hepatic CB(1) in HFD-induced insulin resistance. The cellular mechanisms of insulin resistance were analyzed in mouse and human isolated hepatocytes using small interfering or short hairpin RNAs and lentiviral knockdown of gene expression. RESULTS The HFD induced hepatic insulin resistance in wild-type mice, but not in CB(1)(-/-) mice or mice with hepatocyte-specific deletion of CB(1). CB(1)(-/-) mice that overexpressed CB(1) specifically in hepatocytes became hyperinsulinemic as a result of reduced insulin clearance due to down-regulation of the insulin-degrading enzyme. However, they had increased hepatic glucose production due to increased glycogenolysis, indicating hepatic insulin resistance; this was further increased by the HFD. In mice with hepatocytes that express CB(1), the HFD or CB(1) activation induced the endoplasmic reticulum stress response via activation of the Bip-PERK-eIF2α protein translation pathway. In hepatocytes isolated from human or mouse liver, CB(1) activation caused endoplasmic reticulum stress-dependent suppression of insulin-induced phosphorylation of akt-2 via phosphorylation of IRS1 at serine-307 and by inducing the expression of the serine and threonine phosphatase Phlpp1. Expression of CB(1) was up-regulated in samples from patients with nonalcoholic fatty liver disease. CONCLUSIONS Endocannabinoids contribute to diet-induced insulin resistance in mice via hepatic CB(1)-mediated inhibition of insulin signaling and clearance.
Management of Pulmonary Disease in Patients with Cystic Fibrosis

Cystic fibrosis is the most common, life-shortening autosomal recessive disease, affecting approximately 1 in 3400 live births in the United States. Gastrointestinal and pulmonary manifestations are most common. With the introduction of pancreatic enzyme and vitamin supplementation, lung disease accounts for the vast majority of morbidity and mortality in patients with cystic fibrosis. The lungs of cystic fibrosis patients are essentially normal at birth but demonstrate evidence of airway inflammation and infection in early infancy. A vicious cycle of inflammation, infection and obstruction ultimately leads to destruction of airways, impairment of gas exchange and death. Current pharmacological management of pulmonary disease targets reducing airway obstruction, controlling infection and more recently, controlling inflammation. An increased recovery of unusual and highly resistant bacteria from patients with more advanced disease has been observed. Aggressive treatment of acute pulmonary exacerbations with combination antibiotic therapy for two to three weeks has shown pronounced beneficial effects. The routine use of prophylactic antistaphylococcal antibiotics is still controversial. Although current pharmacologic treatment is symptomatic, new agents are being developed and studied that target the underlying defect in the CFTR protein. This review focuses on current pharmacologic management of pulmonary disease in patients with cystic fibrosis and the role of new agents emerging for the treatment of this disease.
The use of pursed lips breathing in stable chronic obstructive pulmonary disease: a systematic review of the evidence

Abstract Objective: A systematic review was carried out to determine the evidence for teaching pursed lips breathing (PLB) to patients with stable chronic obstructive pulmonary disease (COPD). Exertional dyspnoea is the single most important factor limiting function for people with COPD and PLB is commonly advocated for its management. Method: A literature search of Medline, PEDro and CINAHL Plus was conducted. Articles were included if they studied the effects of PLB in stable COPD and excluded when proxy interventions or significant modifications of PLB were used. Where comparable data were available they were pooled using weighted means. Results: Eleven studies involving 226 participants were included; four of the studies were of moderate quality according to the grading of recommendations assessments, development and evaluation (GRADE) system; the remaining studies were of low quality. Although no high quality evidence was identified, the direction of effect for PLB was consistently towards benefit, with the exception of one low quality study. Moderate quality evidence demonstrates that in stable COPD pursed lips breathing increases oxygen saturation and tidal volume, reduces respiratory rate at rest and reduces time taken to recover to pre-exercise breathlessness levels. One RCT showed reduction in exertional dyspnoea and improvement in functional performance at 3 months. Additionally, the evidence suggests that not all patients with COPD respond equally to PLB: those with moderate to severe COPD are most likely to benefit. Conclusion: High quality studies are required to identify PLB responders from non-responders and to determine whether short-term effects translate into clinically significant benefit.
An Assessment of Emergency Department Throughput and Provider Satisfaction after the Implementation of a Scribe Program

Objectives. To assess the impact of a scribe program on an academic, tertiary care facility. Methods. A retrospective analysis of emergency department (ED) data, prior to and after scribe program implementation, was used to quantitatively assess the impact of the scribe program on measures of ED throughput. An electronic survey was distributed to all emergency medicine residents and advanced practice providers to qualitatively assess the impact of the scribe program on providers. Results. Several throughput time measures were significantly lower in the postscribe group, compared to prescribe implementation, including time to disposition. The left without being seen (LWBS) decrease was not statistically significant. A total of 30 providers responded to the survey. 100% of providers indicated scribes are a valuable addition to the department and they enjoy working with scribes. 90% of providers indicated scribes increase their workplace satisfaction and quality of life. Conclusions. Through evaluation of prescribe and postscribe implementation, the postscribe time period reflects many throughput improvements not present before scribes began. Scribe Program implementation led to improved ED throughput for discharged patients with further system-wide challenges needing to be addressed for admitted patients.
Prevalencia de asma, rinitis y eczema en escolares de la ciudad de Cuernavaca, México

Objetivo. La medicion del asma, la rinitis y el eczema ha sido motivo de controversia metodologica por la falta de uniformidad en los diagnosticos operacionales. Con el fin de probar la aplicabilidad de una metodologia estandarizada para comparaciones en tiempo y espacio se determino la prevalencia del asma y de otras enfermedades alergicas en una muestra aleatoria de escolares (n= 6 238) de 6 a 8 anos y de 11 a 14 anos residentes de Cuernavaca, Morelos, Mexico. Material y metodos. Se aplico la metodologia propuesta por el International Study of Asthma and Allergies in Childhood (ISAAC) para determinar la prevalencia y severidad del asma, la rinitis y el eczema. La informacion de prevalencia tanto actual como acumulada para dichos padecimientos se obtuvo a traves de un cuestionario estandarizado contestado por los padres de los ninos. Resultados. La prevalencia acumulada de asma por diagnostico medico y sibilancia fue de 5.8% (5.2-6.4) y 21.8% (20.7-22.9) respectivamente; la prevalencia de sibilancia en los ultimos 12 meses fue de 8.9% en el grupo de 6 a 8 anos contra 6.6% en el de 11 a 14 anos, p< 0.001. La prevalencia de diagnostico medico de rinitis fue de 4.9% (4.3-5.5). Con relacion a los sintomas tipicos de rinitis, en los ultimos 12 meses la prevalencia fue de 9.6% (6 a 8 anos) y de 10.1% (11 a 14 anos). La prevalencia de eczema por diagnostico medico fue de 4.1% (3.6-4.6). La prevalencia de sintomas de eczema en los ultimos 12 meses fue de 10.1% (6 a 8 anos) y de 10.6% (11 a 14 anos). Los sintomas severos de asma fueron significativamente mas prevalentes en el grupo de 6 a 8 anos y en los meses de otono. Conclusiones. La prevalencia de asma tanto por diagnostico medico como por sintomas resulta relativamente baja en relacion con otros estudios realizados con la misma metodologia. Se analizan las bondades del uso de una metodologia estandarizada.
Risk of melanoma and nonmelanoma skin cancer among patients with inflammatory bowel disease.

BACKGROUND & AIMS Patients with inflammatory bowel disease (IBD) are at risk for certain malignancies. We aimed to determine the risk of melanoma and nonmelanoma skin cancer (NMSC) in patients with IBD and how medications affect these risks. METHODS We performed retrospective cohort and nested case-control studies using administrative data from the LifeLink Health Plan Claims Database from 1997 to 2009. The cohort comprised 108,579 patients with IBD, and each was matched to 4 individuals without IBD. The risk of melanoma and NMSC was evaluated by incidence rate ratio (IRR) and by adjusted Cox proportional hazard ratio (HR) modeling. In nested case-control studies, patients with melanoma or NMSC were matched to 4 patients with IBD without melanoma or NMSC. Conditional logistic regression was used to determine associations between medications and both skin cancers. RESULTS In the cohort, IBD was associated with an increased incidence of melanoma (IRR, 1.29; 95% confidence interval [CI], 1.09-1.53). Risk was greatest among individuals with Crohn's disease (IRR, 1.45; 95% CI, 1.13-1.85; adjusted HR, 1.28; 95% CI, 1.00-1.64). The incidence of NMSC also increased among patients with IBD (IRR, 1.46; 95% CI, 1.40-1.53) and was greatest among those with CD (IRR, 1.64; 95% CI, 1.54-1.74). In the nested case-control studies, therapy with biologics increased the risk of melanoma (odds ratio [OR], 1.88; 95% CI, 1.08-3.29). Patients who had been treated with thiopurines had an increased risk of NMSC (OR, 1.85; 95% CI, 1.66-2.05). CONCLUSIONS Immunosuppression increases the risk of melanoma and NMSC among patients with IBD. The risk of melanoma is increased by use of biologics, and the risk of NMSC is increased by use of thiopurines. Patients with IBD should be counseled and monitored for skin cancer.
Vitamin B1 (thiamine) and dementia

The earliest and perhaps best example of an interaction between nutrition and dementia is related to thiamine (vitamin B1). Throughout the last century, research showed that thiamine deficiency is associated with neurological problems, including cognitive deficits and encephalopathy. Multiple similarities exist between classical thiamine deficiency and Alzheimer's disease (AD) in that both are associated with cognitive deficits and reductions in brain glucose metabolism. Thiamine‐dependent enzymes are critical components of glucose metabolism that are reduced in the brains of AD patients and by thiamine decline, and a decrease in their levels could account for the reduction in glucose metabolism. In preclinical models, reduced thiamine can drive AD‐like abnormalities, including memory deficits, neuritic plaques, and hyperphosphorylation of tau. Furthermore, excess thiamine diminishes AD‐like pathologies. In addition to dietary deficits, drugs or other manipulations that interfere with thiamine absorption can cause thiamine deficiency. Elucidating the reasons why the brains of AD patients are functionally thiamine deficient and determining the effects of thiamine restoration may provide critical information to help treat patients with AD.