Miracle-dz/UniFAR-FTUs huggingface dataset:
Cataract surgery in patients with prior refractive surgery

As the number and types of keratorefractive procedures increase and as the baby boomer population moves into the “cataractous decades,” the number of patients requiring cataract surgery following refractive surgery grows larger each year. While technological advances in surgical instrumentation and intraocular lens (IOL) design allow us to perform cleaner, faster, and more reliable cataract extractions, the ultimate postoperative refraction depends primarily on calculations performed before surgery. Third-generation IOL formulas (eg, Haigis, Hoffer Q, Holladay 2, or SRK/T) provide outstanding accuracy when used for eyes with physiologic, prolate corneas. In addition, most instruments used today for measuring corneal curvature and power were designed before the era of refractive surgery. These formulas and instruments make assumptions about the anatomy and refractive properties of the cornea that are no longer valid following most keratorefractive procedures. These breakdowns in IOL calculation often result in a “refractive surprise” after cataract surgery, which may require subsequent surgical correction. This article examines recent publications of modeling studies of various methods for estimating effective K values for IOL calculation, cataract surgery case series following refractive surgery, new corneal topography technologies and methods for correcting “refractive surprises” postoperatively.
Mechanisms of Action for the Commonly Used Antiepileptic Drugs: Relevance to Antiepileptic Drug-Associated Neurobehavioral Adverse Effects

Antiepileptic drugs exert their anticonvulsant effects by interfering with brain processes that involve structures that are also involved in learning, memory, and emotional behavior. Thus, modulation of ion channels, neurotransmitters, second messengers, and other processes by antiepileptic drugs, although helpful in controlling seizures, can interfere with normal brain function in undesired ways. The specific mechanism(s) of action of an antiepileptic drug can increase the risk for particular types of adverse events. In this review, we examine the cognitive and behavioral effects of antiepileptic drugs in animal models. Although animal studies, in many respects, do not mimic clinical experience, the data suggest a connection between certain mechanisms of antiepileptic action and the occurrence of cognitive adverse effects. Specifically, antiepileptic drugs with traditional γ-aminobutyric acid (GABA)ergic mechanisms have the most detrimental effects on cognitive function, possibly because they impair attention. Conversely, drugs with the predominant effects at Na + channels appear to have minimal impact on cognition. Levetiracetam, with its nonconventional GABAergic and Ca2+ channel effects, has shown positive cognitive effects in animal studies. Antiglutamatergic drugs have the potential to be a double-edged sword: they can interfere with consolidation of learning and memory but can also provide neuroprotection in addition to their antiseizure effects. (J Child Neurol 2004;19(Suppl 1):S6-S14).
New estimates of down syndrome risks at chorionic villus sampling, amniocentesis, and livebirth in women of advanced maternal age from a uniquely defined population

Current measures of livebirth prevalence of Down syndrome are derived from data obtained up to 20 years ago, before the introduction of the prenatal diagnostic tests amniocentesis and chorionic villus sampling (CVS). For women aged 36–52 years, but who were not tested prenatally, we proposed to make a direct estimate of current livebirth prevalence of Down syndrome. We could also determine prevalence at the time of CVS and amniocentesis in women of the same age undergoing prenatal testing. Differences in these prevalences allow an estimation of the relative loss of Down syndrome during pregnancy. In Victoria, Australia, we identified 3041 women having CVS, 7504 having amniocentesis, and 13 139 having no test. Smoothed regression estimates of age‐specific livebirth prevalence were found to be higher than in the early studies. The estimate of spontaneous loss was 17 per cent between the time of CVS and amniocentesis, and 18 per cent after the time of amniocentesis. The latter figure is lower than previous estimates and may be explained by a greater likelihood of a Down syndrome fetus surviving to be liveborn, given the modern approach to early obstetric intervention. These current risk estimates of livebirth may be useful updates for genetic counselling, but perhaps more importantly, may be used as precise maternal age‐related risk figures, necessary in the design and implementation of prenatal screening programmes for Down syndrome.
Calcium and long‐term transmission damage following anoxia in dentate gyrus and CA1 regions of the rat hippocampal slice.

The mechanism of long‐term anoxic damage in brain tissue is investigated using the rat hippocampal slice as a model system. The effects of short durations of anoxia on subsequent transmission through two neural pathways are studied. 10 min of anoxia irreversibly abolishes transmission between the perforant path and the dentate granule cells while only 7 min of anoxia irreversibly abolishes transmission between the Schaeffer collaterals and the CA1 pyramidal cells. We examine the involvement of Ca2+ in this irreversible transmission damage and, also, the differential sensitivities of the dentate gyrus and CA1 regions. Substitution of a buffer containing 0 Ca2+ and 10 mM‐Mg2+ during the anoxic period substantially improves the recovery of synaptic transmission in both regions of the slice. Dentate gyrus transmission recovers completely after 20 min of anoxia and CA1 transmission survives 10 min of anoxia. These results suggest that Ca2+ influx during anoxia may be an important cause of the long‐term damage. The uptake of 45Ca2+ into the intracellular space of the slice is increased during anoxia. This effect is approximately twice as large in CA1 as in the dentate gyrus. Thus, in the dentate gyrus the calculated exchangeable pool of Ca2+ is increased 30% by anoxia and in the CA1 it is increased by 70%. Two incubating conditions which decrease the amount of 45Ca2+ uptake during anoxia protect transmission against long‐term damage. (a) Pre‐incubation of the slices with 25 mM‐creatine elevates tissue phosphocreatine and attenuates the fall in adenosine 5'‐triphosphate (ATP) during anoxia. This is associated with partial protection against transmission damage and an approximate 50% attenuation of the anoxic uptake of 45Ca2+. (b) Inclusion of 2 mM‐cobalt in the buffer reduces the normoxic uptake of 45Ca2+ so that the uptake during anoxia is no greater than normoxic uptake in the absence of cobalt. This is associated with a complete protection against long‐term transmission damage following 10 min of anoxia in the dentate gyrus. A kinetic analysis of the 45Ca2+ uptake shows that the anoxic uptake results primarily from inhibition of the unidirectional efflux of Ca2+ from the cells; there is no calculable increase in the undirectional influx. This suggests that anoxia increases Ca2+ uptake by inhibiting one or more Ca2+‐extrusion processes and not by opening depolarization‐sensitive Ca2+ channels. (ABSTRACT TRUNCATED AT 400 WORDS)
Lifestyle management to prevent and treat atrial fibrillation

ABSTRACT Introduction: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia with a one in four lifetime risk in adults over the age of forty. Traditionally, AF management has focused on the three pillars of rate control, rhythm control and appropriate anticoagulation to reduce stroke risk. More recently, the importance of cardiovascular risk factor management in AF has emerged as a fourth and essential pillar with improved patient outcomes. Areas covered: Here, we aim to summarize the current available evidence for the association between various modifiable risk factors and AF, and to identify optimal treatment targets to improve outcomes. Expert Commentary: Care for AF patients utilizing an integrated approach and aggressive lifestyle management may reduce the enormous burden of this arrhythmia.
Sole disorders in conventionally managed and organic dairy herds using different housing systems

Records of claw trimmings were analysed in seven organic and six conventional Danish herds (a total of 974 cows). The housing systems represented were tie stall systems, loose housing system with slatted floor (one organic herd), and deep litter systems (deep straw bedding). Occurrence of sole disorders was analysed separately for cows in first lactation and for cows in later lactations. Three different responses (acute haemorrhage, sole ulcer in one leg and sole ulcer in two or more legs) were analysed using three binomial logistic regression analyses for each group. Herd analysed as a fixed effect was a strong risk factor for all kinds of sole ulcer. Lactation stage was a risk factor for acute haemorrhage in both groups of cows, and for sole ulcer in first parity cows. In general, there was a strong positive association between the period 61–120 d post partum and the presence of sole disorders. Breed was associated with acute haemorrhage in cows in second and later parities, and sole ulcer in one leg only in first parity cows in an interaction with lactation stage in both conditions. Danish Friesian cows were strongly associated with sole disorder, although the combination of lactation stage from 61 to 120 d post partum in cows of other dual purpose breeds was positively associated with the presence of sole ulcer in one leg only in first parity cows. The time of year for claw trimming was a risk factor for acute haemorrhage in first parity cows, with the period from December to January most strongly associated with acute haemorrhage. Previous disease treatment was a risk factor for sole ulcer in two or more legs in second and later parities. Udder related disorders and disorders other than reproductive problems were positively associated with the occurrence of sole ulcer. Body weight at calving was associated with acute haemorrhage in cows in second and subsequent parities. Body weight lower than the mean herd level by >50 kg was negatively associated with acute haemorrhage.
Definition of an Amino-terminal Domain of the Human T-cell Leukemia Virus Type 1 Envelope Surface Unit That Extends the Fusogenic Range of an Ecotropic Murine Leukemia Virus*

Murine leukemia viruses (MuLV) and human T-cell leukemia viruses (HTLV) are phylogenetically highly divergent retroviruses with distinct envelope fusion properties. The MuLV envelope glycoprotein surface unit (SU) comprises a receptor-binding domain followed by a proline-rich region which modulates envelope conformational changes and fusogenicity. In contrast, the receptor-binding domain and SU organization of HTLV are undefined. Here, we describe an HTLV/MuLV envelope chimera in which the receptor-binding domain and proline-rich region of the ecotropic MuLV were replaced with the potentially corresponding domains of the HTLV-1 SU. This chimeric HTLV/MuLV envelope was processed, specifically interfered with HTLV-1 envelope-mediated fusion, and similar to MuLV envelopes, required cleavage of its cytoplasmic tail to exert significant fusogenic properties. Furthermore, the HTLV domain defined here broadened ecotropic MuLV envelope-induced fusion to human and simian cell lines.
Papillomas of the breast: factors associated with underestimation

The distinction between benign and malignant papilloma of the breast through percutaneous needle biopsy can be difficult because of limited samples; the underestimation rate can be up to 25%. The aim of this study is to identify clinical and histological factors associated with underestimation, invasive ductal carcinoma, or ductal in-situ carcinoma (DCIS) of the breast found in surgical specimens from papillary lesions. This may contribute toward selection of patients for a follow-up strategy without the need for surgical excision. From a database of 3563 patients, we identified 85 with intraductal papilloma between 2007 and 2013 who had undergone breast-imaging studies, percutaneous needle biopsy, and surgical resection of the lesion. Central papillomas normally present with a palpable mass, whereas peripheral papillomas generally do not have clinical manifestations (microcalcifications); both central and peripheral papillomas were related to atypical lesions, 13.5 and 15.4%, respectively. Among the 59 cases of central papillomas, there were four cases of underestimation, three DCIS and one invasive ductal carcinoma (6.8%). Among the 26 cases of peripheral papillomas, there was one case of DCIS (3.8%), with a total underestimation rate of 5.8%; all underestimated lesions measured more than 1 cm. The median size was 11 mm at mammography and 19 mm at ultrasound. Our data suggest that lesions less than 1 cm in size, without atypia and concordant imaging and clinical findings, may not require surgical resection.
Pharmacokinetics and acceptability of once- versus twice-daily lamivudine and abacavir in HIV type-1-infected Ugandan children in the ARROW Trial

Background No data on once-daily dosing of nucleoside analogues in African children currently exist. We compared the pharmacokinetics (PK) of once- versus twice-daily lamivudine and abacavir treatment using the World Health Organization recommended weight band dosing of scored adult tablets. Methods HIV type-1 (HIV-1)-infected Ugandan children aged 3–12 years receiving antiretroviral therapy that included lamivudine and abacavir twice daily (total 150+300 mg, 225+450 mg and 225/300+600 mg daily for 12–<20, 20–<25 and ≥25 kg, respectively) were enrolled in a crossover study. Plasma PK sampling (at 0, 1, 2, 4, 6, 8 and 12 h after observed morning intake) was performed for the twice-daily regimen at steady-state. Children were then switched to once-daily treatment with PK sampling repeated 4 weeks later (with an additional 24 h sample). Acceptability questionnaires were completed at both time points. Daily area under the curve (AUC0–24) and maximum concentrations (Cmax) were compared by geometric mean ratios (GMRs). Results A total of 41 HIV-1-infected children (median age of 7 years) and n=23, n=14 and n=4 in 12–<20, 20–<25 and ≥25 kg weight bands, respectively, were enrolled. Mean AUC0–24 was 13.0 and 12.0 mg•h/l for once- and twice-daily lamivudine (GMR 1.09, 90% confidence intervals [CI] 0.98–1.20) and 15.3 and 15.6 mg•h/l for once- and twice-daily abacavir (GMR 0.98, 90% CI 0.89–1.08), respectively, with no difference in 3–6 versus 7–12 year olds. Cmax was 76% (lamivudine) and 64% (abacavir) higher on once-daily regimens. For both children and caregivers, once-daily dosing of lamivudine plus abacavir was highly acceptable and strongly preferred over twice-daily. Conclusions In children aged 3–12 years, AUC0–24 of lamivudine and abacavir were bioequivalent on once-and twice-daily regimens. Once-daily dosing of abacavir and lamivudine could provide an alternative dosing strategy for HIV-1-infected children, with high acceptability and strong preference suggesting the potential for improved adherence.
Long-term acceptance of major histocompatibility complex mismatched cardiac allografts induced by CTLA4Ig plus donor-specific transfusion

Allograft rejection is a T cell-dependent process. Productive T cell activation by antigen requires antigen engagement of the T cell receptor as well as costimulatory signals delivered through other T cell surface molecules such as CD28. Engagement of CD28 by its natural ligand B7 can be blocked using a soluble recombinant fusion protein, CTLA4Ig. Administration of CTLA4Ig blocks antigen-specific immune responses in vitro and in vivo, and we have shown that treatment of rats with a 7-d course of CTLA4Ig at the time of transplantation leads to prolonged survival of cardiac allografts (median 30 d), although most grafts are eventually rejected. Here, we have explored additional strategies employing CTLA4Ig in order to achieve long-term allograft survival. Our data indicate that donor-specific transfusion (DST) plus CTLA4Ig can provide effective antigen-specific immunosuppression. When DST is administered at the time of transplantation followed by a single dose of CTLA4Ig 2 d later, all animals had long-term graft survival (> 60 d). These animals had delayed responses to donor-type skin transplants, compared with normal rejection responses to third-party skin transplants. Furthermore, donor-matched second cardiac allografts were well tolerated with minimal histologic evidence of rejection. These data indicate that peritransplant use of DST followed by subsequent treatment with CTLA4Ig can induce prolonged, often indefinite, cardiac allograft acceptance. These results may be clinically applicable for cadaveric organ and tissue transplantation in humans.
An Open Loop Phase Shifter and Frequency Synthesizer

This paper presents a new open-loop phase shifter and frequency synthesizer which can be implemented by small hardware. In the proposed method the differential square wave is converted to a differential ramp. Then the cross point of two ramps will be detected as the middle point of high or low duration which will be full-range recovered for 90deg shifting operation. Four phases in 10 MHz frequency can be generated by 3 mW power consumption and 60 mu times 60 mu area. All circuits have been simulated in 0.35 mu CMOS technology.
Work-related mesothelioma in Québec, 1967-1990.

Prior surveys of malignant mesothelioma in Québec have noted that almost all the excess in occupational exposure related mesothelioma was in the manufacture and industrial application of asbestos rather than in the mining and milling operations. To evaluate the current status of malignant pleural mesothelioma in the Québec workforce, we reviewed all cases of pleural mesothelioma seen and accepted by the Québec Workman's Compensation Board (CSST) for work related compensation of industrial disease. We identified 120 cases, 7 of whom were females. They were of an average age of 59 +/- 8.5 yrs (sd) (range 42-84); they were exposed to asbestos dust in the workplace for an average of 26 +/- 14.3 yrs (range 0.5-50). The cases were subdivided into 3 groups according to workplace asbestos exposures. There were 49 cases originating in the mines and mills of the Québec Eastern Township region (primary industry, group 1), 50 cases from the manufacture and industrial application sector (secondary industry, group 2), and 21 cases from industries where asbestos was not a major work material, often an "incidental" material (tertiary industry, group 3). Group 1 was of an average age of 62 +/- 8 years, exposed to asbestos dust 31 +/- 14 years and the distribution of exposure time was as follows: 15% cases with < or = 10 year-exposure and 77% > or = 25 year-exposure. In group 2, the age was significantly lower at 57 +/- 9 years; the exposure time was also significantly lower at 22 +/- 14 years, and the distribution of exposure time differed from the above (29% cases with < or = 10 year-exposure and 48% > or = 25 year-exposure). In group 3, the average age was 58 +/- 7 years, the exposure time was also significantly lower at 28 +/- 12 years and the distribution of exposure time differed from the above (33% cases with < or = 10 year-exposure and 62% > or = 25 year-exposure). Analyses of the yearly incidence of new cases in each group documented the general incremental trend in all groups, with the sharpest rises in group 3. In the mining towns of Thetford and Asbestos, the incidence of mesothelioma was proportional to the workforce, thus suggesting that the tremolite air contamination, which is 7.5 x higher in Thetford, may not be a significant determinant of the disease in these workers. (ABSTRACT TRUNCATED AT 400 WORDS)
Neisseria weaveri sp. nov. (formerly CDC group M-5), from dog bite wounds of humans.

The taxonomic relationships of strains belonging to Centers for Disease Control group M-5 were examined. Previous studies of rRNA cistron similarities placed this organism on the Neisseriaceae rRNA branch of rRNA superfamily III; the closest neighbors included the genus Neisseria and groups EF-4a and EF-4b. The group M-5 strains were characterized by a range of phenotypic tests, and their G + C contents and DNA-DNA relatedness levels were determined. In addition, a numerical taxonomic analysis of the whole-cell protein patterns (obtained by sodium dodecyl sulfate-polyacrylamide gel electrophoresis) of group M-5 and related taxa was performed. The strains studied included 45 group M-5 strains, the type strains of six Neisseria species or subspecies, three group EF-4a reference strains, and three group EF-4b reference strains plus the type strain of the phenotypically similar organism Oligella urethralis. Our results showed that the group M-5 strains were members of a homogeneous taxon distinct from phylogenetically closely related taxa. The genomic divergence as revealed by levels of rRNA cistron similarity and phenotypic characteristics indicate that group M-5 can be considered a new species of the genus Neisseria. We therefore propose the new species Neisseria weaveri, with NCTC 12742 (= CCUG 4007 = ISL775/91 = LMG 5135) as the type strain. N. weaveri strains are strictly aerobic, gram-negative, nonmotile, rod-shaped organisms which are catalase and oxidase positive, nonsaccharolytic, and able to grow on MacConkey agar and do not reduce nitrate but generally reduce nitrite. (ABSTRACT TRUNCATED AT 250 WORDS)
Hypotension Due to Meprobamate Overdose

had started to rise just before the transfusion. The effects on uric-acid excretion were certainly not the effects of the blood transfusion per se, since control observations were made on this same patient on the three days following his second transfusion (also of 2,500 ml. of fresh blood) in August, 1958. On this occasion the uric-acid excretion on the three days after transfusion was 573, 548, and 715 mg. /24 hours-that is, a greatly increased amount, sharply contrasted with the abrupt fall after the first transfusion (illustrated in the Chart). Further work is needed, particularly since there may be fallacies in relying on the results of uric-acid studies. It is remotely possible, for example, that accelerated uricolysis (Bien et al., 1956) could entirely explain the observations made in this patient. However, this would entail a rate of uricolysis exceeding 60% of the normal daily production-a rate which has not yet been shown to occur in human beings. The simplest explanation is that acute reduction in the rate of normal white-cell destruction was the first event, which, by tilting the balance in favour of the normal cell population, produced a temporary clinical and haematological remission.