Miracle-dz/UniFAR-FTUs huggingface dataset:
Intraoperative injection of bupivacaine‐adrenaline close to the fascia reduces morphine requirements after cesarean section: a randomized controlled trial

Objective. The purpose of this study was to investigate whether a single injection of bupivacaine with adrenaline close to the fascia could decrease opiate consumption and pain in patients undergoing cesarean section in spinal anesthesia. Design. Randomized double‐blind controlled study. Settings. Karolinska University Hospital, Huddinge, Sweden. Population. 260 women scheduled for elective cesarean section were enrolled in the study. Methods. The treatment group (n= 130) received 40 mL bupivacaine (2.5 mg/mL) with adrenaline (5 μg/mL) (Marcain® adrenalin) and the control group (n= 130) received 40 mL saline solution (0.9%), which was, in both groups, injected close to the fascia before closure of the wound. Main outcome measures. Morphine consumption and mean resting pain intensity numerical rating scale at 12 and 24 hours were the primary outcome variables. Other assessments for pain as well as mobilization parameters were considered secondary. Results. Morphine requirements were significantly less in the bupivacaine group, 19.0 mg/woman, compared with 24.0 mg/woman in the placebo group, during the first 12 postoperative hours. During this time period there was also a trend towards a difference between groups in mean pain intensity, but significant only during the first six hours. Over the whole first postoperative 24 hours, there were no differences in either morphine requirement or pain intensity between groups. Conclusions. A single injection of bupivacaine with adrenaline in the surgical wound decreases the need for morphine requirements for the first 12 postoperative hours and contributes to safe and effective pain management in women undergoing cesarean section.
Neurobehavioral, cellular, and molecular consequences of single and multiple mild blast exposure

Mild traumatic brain injury, caused by the exposure to single or repeated blast overpressure, is a principal concern due to its pathological complexity and neurobehavioral similarities with posttraumatic stress disorder. In this study, we exposed rats to a single or multiple (five total; administered on consecutive days) mild blasts, assessed their behavior at 1 and 16 days postinjury) and performed histological and protein analyses of brains and plasma at an early (2 h) and a late (22 days) termination time point. One day postinjury, multiple‐injured (MI) rats showed the least general locomotion and the most depression‐ and anxiety‐related behaviors among the experimental groups; there were no such differences at 16 days. However, at the later time point, both injured groups displayed elevated levels of select protein biomarkers. Histology showed significantly increased numbers of TUNEL+ (terminal‐deoxy‐transferase‐mediated dUTP nick‐end labeling)‐positive cells in the dorsal and ventral hippocampus (DHC and VHC) of both injured groups as early as 2 h after injury. At 22 days, the increase was limited to the VHC of MI animals. Our findings suggest that the exposure to mild blast overpressure triggers early hippocampal cell death as well as neuronal, glial, and vascular damage that likely contribute to significant, albeit transient increases in depression‐ and anxiety‐related behaviors. However, the severity of the observed pathological changes in MI rats failed to support the hypothesized cumulative effect of repeated injury. We infer that at this blast frequency, a potential conditioning phenomenon counteracts with and reduces the extent of subsequent damage in MI rats.
Major psychoses with mixed psychotic and mood symptoms: are mixed psychoses associated with different neurobiological markers?

Objective: Evidence related to overlapping clinical and genetic risk factors in schizophrenia and bipolar disorder (BD) have raised concerns about the validity of ‘Kraepelinian dichotomy’. As controversies mainly arise in mixed psychoses that occupy the intermediate zone between schizophrenia and BD, investigating neurobiological markers of mixed psychoses may be relevant to understanding the nature of psychotic disorders.
Quality control of next‐generation sequencing library through an integrative digital microfluidic platform

We have developed an automated quality control (QC) platform for next‐generation sequencing (NGS) library characterization by integrating a droplet‐based digital microfluidic (DMF) system with a capillary‐based reagent delivery unit and a quantitative CE module. Using an in‐plane capillary–DMF interface, a prepared sample droplet was actuated into position between the ground electrode and the inlet of the separation capillary to complete the circuit for an electrokinetic injection. Using a DNA ladder as an internal standard, the CE module with a compact LIF detector was capable of detecting dsDNA in the range of 5–100 pg/μL, suitable for the amount of DNA required by the Illumina Genome Analyzer sequencing platform. This DMF‐CE platform consumes tenfold less sample volume than the current Agilent BioAnalyzer QC technique, preserving precious sample while providing necessary sensitivity and accuracy for optimal sequencing performance. The ability of this microfluidic system to validate NGS library preparation was demonstrated by examining the effects of limited‐cycle PCR amplification on the size distribution and the yield of Illumina‐compatible libraries, demonstrating that as few as ten cycles of PCR bias the size distribution of the library toward undesirable larger fragments.
Emotion recognition and marital satisfaction in stroke

Deficits in the comprehension of facial and prosodic expressions are commonly associated with right hemisphere stroke. However, little is known regarding the impact of these disorders on social relations. We examined facial and prosodic processing, mood, and marital satisfaction in 12 right hemisphere damaged (RHD) stroke patients and nine controls. Results revealed significant impairments in the comprehension of facial expressions and prosody among RHD stroke patients. Nonparametric correlations in the RHD group showed significant associations between marital satisfaction and facial affect discrimination and matching, and nonaffective prosody discrimination. We conclude that deficits in the recognition of nonverbal expressions are associated with reduced relationship satisfaction.
Costs and Resource Utilization for Diagnosis and Treatment During the Initial Year in a European Inflammatory Bowel Disease Inception Cohort: An ECCO-EpiCom Study

Background:No direct comparison of health care cost in patients with inflammatory bowel disease across the European continent exists. The aim of this study was to assess the costs of investigations and treatment for diagnostics and during the first year after diagnosis in Europe. Methods:The EpiCom cohort is a prospective population-based inception cohort of unselected inflammatory bowel disease patients from 31 Western and Eastern European centers. Patients were followed every third month from diagnosis, and clinical data regarding treatment and investigations were collected. Costs were calculated in euros (&OV0556;) using the Danish Health Costs Register. Results:One thousand three hundred sixty-seven patients were followed, 710 with ulcerative colitis, 509 with Crohn's disease, and 148 with inflammatory bowel disease unclassified. Total expenditure for the cohort was &OV0556;5,408,174 (investigations: &OV0556;2,042,990 [38%], surgery: &OV0556;1,427,648 [26%], biologicals: &OV0556;781,089 [14%], and standard treatment: &OV0556;1,156,520 [22%)]). Mean crude expenditure per patient in Western Europe (Eastern Europe) with Crohn's disease: investigations &OV0556;1803 (&OV0556;2160) (P = 0.44), surgery &OV0556;11,489 (&OV0556;13,973) (P = 0.14), standard treatment &OV0556;1027 (&OV0556;824) (P = 0.51), and biologicals &OV0556;7376 (&OV0556;8307) (P = 0.31). Mean crude expenditure per patient in Western Europe (Eastern Europe) with ulcerative colitis: investigations &OV0556;1189 (&OV0556;1518) (P < 0.01), surgery &OV0556;18,414 (&OV0556;12,395) (P = 0.18), standard treatment &OV0556;896 (&OV0556;798) (P < 0.05), and biologicals &OV0556;5681 (&OV0556;72) (P = 0.51). Conclusions:In this population-based unselected cohort, costs during the first year of disease were mainly incurred by investigative procedures and surgeries. However, biologicals accounted for >15% of costs. Long-term follow-up of the cohort is needed to assess the cost-effectiveness of biological agents.
Sexual Dysfunction in Inflammatory Bowel Disease

Abstract:Sexual health is a broad term that encompasses a variety of functions including sexual thoughts, desire, arousal, intercourse, orgasm, and the impact of body image. Sexual dysfunction in individuals with inflammatory bowel disease is multifactorial including the impact of psychosocial factors, disease activity, medical therapies, surgical interventions, body image perceptions and changes, hypogonadism, and pelvic floor disorders. Providers caring for patients with inflammatory bowel disease should be cognizant of these concerns and develop management plans and techniques for earlier diagnosis and treatment.
Combinatorial Effects of Diet and Genetics on Inflammatory Bowel Disease Pathogenesis

Abstract:Inflammatory bowel disease (IBD) encompasses a group of disorders affecting the gastrointestinal tract characterized by acute and chronic inflammation. These are complex and multifactorial disorders that arise in part from a genetic predisposition. However, the increasing incidence of IBD in developing countries suggests that environmental factors, such as diet, are also critical components of disease susceptibility. Evidence suggests that consumption of a Western diet, enriched with saturated fat, refined carbohydrates, and food additives, is associated with increased IBD risk. Dietary components, such as omega-6 fatty acids, long-chain fatty acids, protein, and digestible carbohydrates, may contribute to IBD pathogenesis through altering intestinal microbiota, increasing intestinal permeability, and promoting inflammation; whereas omega-3 fatty acids, medium chain triglycerides, and nondigestible carbohydrates improve these parameters and intestinal health. However, the limited amount of prospective studies, small sample sizes, and the heterogeneity of disease subtype result in inconsistencies between studies and difficulty in conclusively determining the specific effects of diet on intestinal homeostasis. There are no standard clinical dietary recommendations for patients with IBD. However, exclusionary diet interventions have shown some efficacy in relieving symptoms or inducing remission, suggesting more research is needed to fully understand how diet influences disease behavior or combines with other IBD risk factors to promote disease. This review focuses on the associations of various dietary components and IBD risk in clinical studies and genetically susceptible IBD models.
Liposomal nanotransporter for targeted binding based on nucleic acid anchor system

Microfluidic techniques have been developed intensively in recent years due to lower reagent consumption, faster analysis, and possibility of the integration of several analytical detectors into one chip. Electrochemical detectors are preferred in microfluidic systems, whereas liposomes can be used for amplification of the electrochemical signals. The aim of this study was to design a nanodevice for targeted anchoring of liposome as transport device. In this study, liposome with encapsulated Zn(II) was prepared. Further, gold nanoparticles were anchored onto the liposome surface allowing binding of thiol moiety‐modified molecules (DNA). For targeted capturing of the transport device, DNA loops were used. DNA loops were represented by paramagnetic microparticles with oligo(DT)25 chain, on which a connecting DNA was bound. Capturing of transport device was subsequently done by hybridization to the loop. The individual steps were analyzed by electrochemistry and UV/Vis spectrometry. For detection of Zn(II) encapsulated in liposome, a microfluidic system was used. The study succeeded in demonstrating that liposome is suitable for the transport of Zn(II) and nucleic acids. Such transporter may be used for targeted binding using DNA anchor system.
Factors predictive of ten‐year mortality in severe anorexia nervosa patients

Huas C, Caille A, Godart N, Foulon C, Pham‐Scottez A, Divac S, Dechartres A, Lavoisy G, Guelfi JD, Rouillon F, Falissard B. Factors predictive of ten‐year mortality in severe anorexia nervosa patients.
Fungal Signature in the Gut Microbiota of Pediatric Patients With Inflammatory Bowel Disease

Background:Inflammatory bowel disease (IBD) involves dysregulation of mucosal immunity in response to environmental factors such as the gut microbiota. The bacterial microbiota is often altered in IBD, but the connection to disease is not fully clarified and gut fungi have recently been suggested to play a role as well. In this study, we compared microbes from all 3 domains of life—bacteria, archaea, and eukaryota—in pediatric patients with IBD and healthy controls. Methods:A stool sample was collected from patients with IBD (n = 32) or healthy control subjects (n = 90), and bacterial, archaeal, and fungal communities were characterized by deep sequencing of rRNA gene segments specific to each domain. Results:Patients with IBD (Crohn's disease or ulcerative colitis) had lower bacterial diversity and distinctive fungal communities. Two lineages annotating as Candida were significantly more abundant in patients with IBD (P = 0.0034 and P = 0.00038, respectively), whereas a lineage annotating as Cladosporium was more abundant in healthy subjects (P = 0.0025). There were no statistically significant differences in archaea, which were rare in pediatric samples compared with those from adults. Conclusions:Pediatric IBD is associated with reduced diversity in both fungal and bacterial gut microbiota. Specific Candida taxa were found to be increased in abundance in the IBD samples. These data emphasize the potential importance of fungal microbiota signatures as biomarkers of pediatric IBD, supporting their possible role in disease pathogenesis.
Translating assessments of the film of daily life into person‐tailored feedback interventions in depression

In a clinical overview – recently published in the Acta Psychiatrica Scandinavica – Palmier-Claus et al. (1) advocate the use of ESM (experience sampling) in clinical practice. ESM has the power to uncover subtle and fine-grained patterns of affect and behaviour in the flow of daily life with relevance to relapse and recovery in depression (2, 3). Despite the recent rise in new mobile health interventions (4, 5), no study has yet tried to translate the film of daily life – as acquired with ESM – into person-tailored feedback on relevant patterns of emotions and behaviour in depression. We report on a first, ongoing study in which depressed patients collect ESM data over a 6-week period and receive weekly verbal and graphical feedback on daily life contexts (social context, current activities, physical activity etc.) in relation to their momentary emotional responses. Also, they receive feedback on changes in relevant emotional and behavioural patterns over time (Fig. 1). The aim is to give patients more insight into functional and dysfunctional behaviours in daily life. For example, they could learn in which contexts they will experience most positive emotions. This may help patients to translate the black box of their depressive experience into manageable pieces of daily life behaviour that they can influence. In this study, patients are randomized into an experimental group, a pseudo-experimental group (ESM data collection, but no feedback) and a control group. Applying ESM in clinical practice, although theoretically attractive, may have practical limitations. Continuous mood tracking is likely intensive, especially for depressed patients, who are characterized by low levels of motivation and energy. Therefore, the tolerability and desirability from the perspective of patients need to be examined. We present preliminary results of participants in the above-described study on the use of an ESM electronic monitoring device (the PsyMate ) and the ESM-generated feedback (Table 1). The sample consisted of 22 participants (12 male, 55%), of whom one was excluded from further analysis. Severity of depression as assessed by the Hamilton Depression Rating Scale (HDRS) during the initial screening ranged from 8 to 26 (M = 15.8, SD = 4.3), indicating mild-to-moderate major depression. Results showed that participants were not troubled (scale: 1–7) by the length of the questionnaire at each beep (M = 2.1) or by the sound the PsyMate produced when it beeped (M = 2.4). The number of beeps per day was experienced as somewhat distressing (M = 3.4) and to some extent questions appeared difficult or not always very clear (M = 3.1). Participants rated the comprehensibility of the verbal, graphical and written feedback as good (M = 5.6; M = 6.0; M = 5.6 Not at all 1 2 3 4 5 6 7 Much Positive emotions Household activities On the way Work/study Doing nothing or resting Passive relaxation activity Active relaxation activity Positive emotions per activity
Momentary assessment technology as a tool to help patients with depression help themselves

Wichers M, Simons CJP, Kramer IMA, Hartmann JA, Lothmann C, Myin‐Germeys I, van Bemmel AL, Peeters F, Delespaul P, van Os J. Momentary assessment technology as a tool to help patients with depression help themselves.
Exploring the effect of the apolipoprotein E (APOE) gene on executive function, working memory, and processing speed during the early recovery period following traumatic brain injury

ABSTRACT Introduction: There is evidence that the e4 allele of the apolipoprotein E (APOE) gene is detrimental to cognitive function, but results from traumatic brain injury (TBI) populations are mixed. A possible explanation is that APOEe2 carriers have routinely been incorporated into APOEe4 and non-e4 groups, despite APOEe2 being proposed to have an ameliorative effect. Our primary aim was to investigate the influence of APOEe4 on cognitive impairment during early recovery following TBI, excluding the potential confound of APOEe2 possession. A secondary objective was to explore whether APOEe4 displays more pronounced effects in moderate to severe TBI and to consider the potential postinjury protective influence of the APOEe2 allele. Method: Participants who recently sustained a TBI (posttraumatic amnesia > 5 minutes) were assessed on measures of information processing speed, executive function, and working memory upon remission of posttraumatic amnesia. APOE genotype was determined by buccal saliva DNA extraction (APOEe4 n = 37, APOEe3 n = 92, APOEe2 n = 13). Results: Stepwise multiple regressions were performed to compare APOEe4 carriers to APOEe3 homozygotes, with injury severity, age, and estimated premorbid IQ included in the first step. This model was found to significantly predict performance on all tasks, accounting for 17.3–24.3% of the variance. When APOEe4 status was added for the second step, there were no significant changes on any tasks (additional variance <1%). The effect of APOEe4 in moderate to severe TBI and the effect of APOEe2 were explored by analysis of covariance (ANCOVA), with no significant effects revealed. Conclusions: It is unlikely that APOE genotype influences cognitive function in the initial recovery period following TBI, regardless of injury severity. However, a more nuanced and long-term exploration of the effect of APOE genotype in the TBI population is warranted.
Debate: Should Nurses Have a Larger Role in the Outpatient Dialysis Setting Than They Currently Do?

The facts are very clear: the nephrologist work force is shrinking, while the end stage renal disease (ESRD) population is growing at a rate of about 10% each year and is composed of older and sicker patients. American medical students are not flocking to clinical nephrology as a career choice. Furthermore, the government seems to be a major player in deciding the fate of foreign medical graduates and foreigners completing their fellowships in the United States. In clinical nephrology, our backs are up against the wall, but fortunately there are competent practitioners available to ease the problem. Advanced practice nurses have the clinical skills and judgment to superbly complement a collaborative approach in the care of patients with renal dysfunction. In 1997, the Renal Physicians Association (RPA), the American Society of Nephrology (ASN), and the American Nephrology Nurses Association (ANNA) convened a work group to explore the areas of commonality between nephrologists and advanced practice nurses in nephrology, specifically nurse practitioners (NP) and clinical nurse specialists (CNS). Representatives of these professional organizations reviewed the education, credentials, clinical responsibilities, and reimbursement standards of these two groups of providers. In 1998, all three organizations endorsed or approved the final position paper entitledRPA, ASN, and ANNA Joint Position Paper on Collaboration Between Nephrologists and Advanced Practice Nurses ( ee Appendix). The nephrology community should embrace this historic effort and move forward in its adoption and implementation.
Cognitive screening in substance users: Diagnostic accuracies of the Mini-Mental State Examination, Addenbrooke’s Cognitive Examination–Revised, and Montreal Cognitive Assessment

ABSTRACT Introduction: Despite the considerable prevalence of cognitive impairment in substance-using populations, there has been little investigation of the utility of cognitive screening measures within this context. In the present study the accuracy of three cognitive screening measures in this population was examined—the Mini-Mental State Examination (MMSE), the Addenbrooke’s Cognitive Examination–Revised (ACE–R), and the Montreal Cognitive Assessment (MoCA). Method: A sample of 30 treatment-seeking substance users and 20 healthy individuals living in the community were administered the screening measures and a neuropsychological battery (NPB). Agreement of classification of cognitive impairment by the screening measures and NPB was examined. Results: Results indicated that the ACE–R and MoCA had good discriminative ability in detection of cognitive impairment, with areas under the receiver-operating characteristic (ROC) curve of . 85 (95% confidence interval, CI [.75. .94] and .84 (95% CI [.71, .93]) respectively. The MMSE had fair discriminative ability (.78, 95% CI [.65, .93]). The optimal cut-score for the ACE–R was 93 (impairment = score of 92 or less), at which it correctly classified 89% of individuals as cognitively impaired or intact, while the optimal cut-score for the MoCA was <26 or <27 depending on preference for either specificity or sensitivity. The optimal cut-score for the MMSE was <29; however, this had low sensitivity despite good specificity. Conclusions: These findings suggest that the MoCA and ACE–R are both valid and time-efficient screening tools to detect cognitive impairment in the context of substance use.