Miracle-dz/UniFAR-FTUs huggingface dataset:
Cytomegalovirus antibodies amongst immunocompromised (HIV) patients at Lagos University Teaching Hospital (LUTH) Idi - Araba, Lagos.

Background: CMV infection constitutes a real risk of pathogenecity in immunocompromised patient. HIV- infected patients who require transfusion are at high risk of developing symptomatic CMV infection when they are transfused with CMV-infected donor blood. This study intends to determine CMV infection risk in correlation with blood transfusion in a population of HIV- infected patients Methods: The study was carried out amongst clients attending HIV clinic at Lagos University Teaching Hospital (LUTH), who were recruited consecutively. Replacement blood donors of the hospital were recruited as controls. A total of 10mls of blood sample was collected per consenting participant. The serum obtained from 5ml of blood was assayed for CMV IgG/IgM using an enzyme- linked immunosorbent assay (ELISA) based Kit whilst full blood count and CD4 cell counts were also performed on the remaining 5mls. Results: A total of 129 HIV-infected were studied. All (100%) were IgG anti-CMV positive. 8 (6.6%) were IgM anti- CMV positive. This difference was found to be statistically significant P=0.004, (P<0.05). Of 122 replacement blood donor controls, 118 (96%) of them were IgG anti-CMV positive whilst 26 (19.5%) of 121 were IgM anti-CMV positive.The mean CD4+ cell count of HIV-infected patients was (234 ± 173.181). Previous history of blood transfusion did not affect CMV antibody positivity directly. Conclusion: The seroprevalence of CMV is very high in HIV-infected patients, which is comparable to the seroprevalence amongst the general population The use of leukoreduced blood units for anaemic HIV infected patients, is recommended. Keywords: Seroprevalence; CMV IgG/IgM; ELISA; healthy blood donors; HIV-infected patients. DOI: 10.3329/jom.v11i2. 5462 J MEDICINE 2010; 11 : 151-154
Structural and functional characterisation of a specific antidote for ticagrelor

Ticagrelor is a direct acting reversibly binding P2Y 12 antagonist and is widely used as an antiplatelet therapy for the prevention of cardiovascular events in acute coronary syndrome patients. However, antiplatelet therapy can be associated with an increased risk of bleeding. Here we present data on the identification, in vitro and in vivo pharmacology of a Fab antidote for ticagrelor. The Fab has a 20 pM affinity for ticagrelor, which is 100 times stronger than ticagrelor’s affinity for its target P2Y 12 . Despite ticagrelor’s structural similarities to adenosine, the Fab is highly specific and does not bind to adenosine, ATP, ADP or structurally related drugs. The antidote concentration-dependently neutralized the free fraction of ticagrelor and reversed its antiplatelet activity both in vitro in human platelet rich plasma and in vivo in mice. Finally, the antidote proved effective in normalizing ticagrelor dependent bleeding in a mouse model of acute surgery. This specific antidote for ticagrelor may prove a valuable agent for patients who require emergency procedures. naturally . Recently, specific antidotes for anticoagulants have been described and are undergoing clinical trials. These include a specific neutralising fragment antigen binding (Fab) designed to reverse the thrombin inhibitor dabigatran 10 , a recombinant catalytically inactive FXa which should reverse any of the FXa inhibitors 11 and a small molecule that can reverse the FXa inhibitors and dabigatran 12 . Here we report an antidote for ticagrelor, designed to be: (i) highly specific and neutralise both ticagrelor and ticagrelor’s active metabolite (TAM), which has similar P2Y 12 potency and is present at 30-40% of ticagrelor levels in the circulation of patients 13 and; (ii) have a half-life that is similar to that of ticagrelor and TAM in humans, which are 9.8 and 12.4 hours respectively 14 . A human Fab was selected as the most appropriate format for the antidote as this would confer the appropriate specificity and be expected to have a half-life of approximately 12 hours in patients. Here we describe the engineering and X-ray structure of the Fab MEDI2452 that binds and neutralises both ticagrelor and TAM, and reverses both the antiplatelet activity and drug induced bleeding in mouse models.
Use of a 23-hour emergency department observation unit for the management of patients with toxic exposures

Background A significant proportion of patients with toxic exposures presenting to the ED require admission. However, most will improve within 24 hours, and so could potentially be managed in a short-stay observation unit. We describe the management and outcomes of these patients in a 23-hour ED observation unit (EDOU). Methods A retrospective chart review of all patients with toxic exposures admitted to the EDOU in Singapore between 1 April 2013 and 31 March 2015 was performed. Patient demographics, exposure patterns, clinical presentation and interventions received were abstracted. The poisoning severity score (PSS) was retrospectively determined. Outcomes were length of stay and disposition. Results A total of 286 patients were analysed, of which 78.0% had intentional self-poisoning, 12.2% had bites/stings and 9.8% had unintentional or occupational toxic exposures. Analgesics (29.4%), sedatives (12.3%) and antidepressants (6.8%) were the most common drugs encountered. The majority of patients had a mild (68.9%) or moderate (15.4%) PSS, but 4.2% were graded as severe. Most patients with deliberate self-poisoning were reviewed by psychiatry (88.8%) and social services (74.9%). Most patients (92.0%) were medically cleared during their stay in EDOU, including all 12 with a severe PSS. Of these, 200 (69.9%) were discharged and 63 (22.0%) were transferred directly to a psychiatric unit. The median length of stay in the EDOU was 18 hours (IQR 13–23). Conclusion Most patients admitted to the EDOU were successfully managed and medically cleared within 23 hours, including those with a severe PSS. The EDOU appears to be a suitable alternative to inpatient admission for selected patients.
Collaborative Practice in Early Childhood Intervention From the Perspectives of Service Providers

Effective early childhood intervention (ECI) relies on collaboration among agencies, service providers, and families. Although previous literature has primarily focused on segments of collaboration within ECI service delivery, the actual process and how the adult stakeholders perceive and engage in collaborative practice have important implications for and effects on the service delivery system. This article investigates service providers' understanding of and reflections on their actual experiences of being engaged in collaborative service delivery. A survey approach was used to assess 75 service providers on their experience of collaborative ECI practice. The findings explain the practices and emphasize the value of working together with families to achieve effective collaborative ECI. Furthermore, the results show the value of working with families to be a significant predictor of service providers' satisfaction with provider–family collaboration, interagency collaboration, and their own time devoted to collaborative practice.
CMV reactivation drives posttransplant T-cell reconstitution and results in defects in the underlying TCRβ repertoire.

Although cytomegalovirus (CMV) reactivation has long been implicated in posttransplant immune dysfunction, the molecular mechanisms that drive this phenomenon remain undetermined. To address this, we combined multiparameter flow cytometric analysis and T-cell subpopulation sorting with high-throughput sequencing of the T-cell repertoire, to produce a thorough evaluation of the impact of CMV reactivation on T-cell reconstitution after unrelated-donor hematopoietic stem cell transplant. We observed that CMV reactivation drove a >50-fold specific expansion of Granzyme B(high)/CD28(low)/CD57(high)/CD8(+) effector memory T cells (Tem) and resulted in a linked contraction of all naive T cells, including CD31(+)/CD4(+) putative thymic emigrants. T-cell receptor β (TCRβ) deep sequencing revealed a striking contraction of CD8(+) Tem diversity due to CMV-specific clonal expansions in reactivating patients. In addition to querying the topography of the expanding CMV-specific T-cell clones, deep sequencing allowed us, for the first time, to exhaustively evaluate the underlying TCR repertoire. Our results reveal new evidence for significant defects in the underlying CD8 Tem TCR repertoire in patients who reactivate CMV, providing the first molecular evidence that, in addition to driving expansion of virus-specific cells, CMV reactivation has a detrimental impact on the integrity and heterogeneity of the rest of the T-cell repertoire. This trial was registered at www.clinicaltrials. gov as #NCT01012492.
Antioxidant Extracts from Acorns (Quercus ilex L.) Effectively Protect Ready-to-Eat (RTE) Chicken Patties Irrespective of Packaging Atmosphere.

This study evaluated the impact of a phenolic-rich acorn extract (200 ppm gallic acid equivalents) and the concentration of oxygen in the packaging system (low-oxygen modified atmosphere; 5% vs. normal-oxygen; 21%) on lipid and protein oxidation and consumers acceptance of the ready-to-eat chicken patties. Samples were subjected to cooking (electric oven, 170 °C/16 min), cold storage (14 d at 4 °C), and reheating (microwave, 600 mW/1 min). Samples treated with acorn extract kept thiobarbituric acid-reactive substances numbers and lipid-derived volatiles at basal levels throughout the whole processing irrespective of the oxygen concentration in the packaging atmosphere. Consistently, treated patties had lower protein carbonyls than control ones. The acorn extract also controlled color and texture deterioration during chilled storage and reheating and improved the color and odor acceptance of the products. Formulating with acorn extract is a feasible strategy to inhibit the oxidation-driven changes and preserve the quality of reheated samples as if there were freshly cooked. Compared to the effect of the antioxidant extract, the concentration of oxygen in the packaging system was negligible in terms of quality preservation.
Plasma Immunoreactive Calcitonin Levels in Pregnant Ewes and Their Lambs

A radioimmunoassay for ovine calcitonin (CT) using a porcine system and talcum powder separation has been developed. A guinea pig antiserum to partially purified porcine CT was highly specific for CT and was capable of detecting 5 pg of porcine CT. The antiserum cross-reacted significantly with sheep, bovine and horse CT but not with rat, rabbit, human and salmon CT. Plasma CT levels in the jugular vein of pregnant ewes were higher in the last 40 days of gestation than in control ewes. A calcium load given orally (10 mg/kg body weight) in newborn lambs did not change the plasma calcium level but increased the plasma CT concentration.
Characteristics of frequent attenders in an emergency department: analysis of 1-year attendance data

Background: There is a significant literature examining the reasons why patients attend emergency departments frequently. This body of work suggests that sociodemographic characteristics are important in understanding why patients re-attend, but it does not provide a definition of what frequent attendance means. This paper aims to identify personal and attendance factors associated with frequent attendance at an emergency department. Methods: One-year emergency department attendance data from a south-east London teaching hospital (2006–7) were analysed. The dataset was analysed at two levels: the individual patient level and the attendance level. Frequencies and cross-tabulations were produced to describe the dataset. Confidence intervals were calculated for both patient and attendance level data. Results: 82 812 patients made 117 187 attendances to the emergency department during 1 year. Each patient made an average of 1.4 attendances; 46% were repeat attendances. The analysis demonstrated differences in the personal and attendance profile of patients who attended the emergency department more frequently during the study period. A change in the patient profile first appeared at the fourth attendance and the change became more pronounced as attendances increased. Frequent attenders were more likely to be men (50.5% of single attendances; 69.5% of ⩾10 attendances), older (single attendance, mean age 32 years; ⩾10 attendances, mean age 45.6 years), to attend outside daytime hours (51.4% of single attendances; 69.2% of ⩾10 attendances) and to be triaged into the more serious categories (36.1% of single attendances; 54.3% of ⩾10 attendances). Conclusion: Where local services are being designed to divert frequent attenders, existing data sources can be a rich source of information to inform service design. For example, this analysis identifies older men at their fourth or more attendance as a potentially important group when examining frequent attendance at this particular hospital. It also identified a potential need for services outside normal surgery hours, although frequent attenders tend to be triaged into the more urgent categories.
Diabetes and liaison psychiatry: what about transition?

There are very few diabetes centres in the UK with a psychiatrist as part of the team ([Dalvi et al , 2008][1]). Our service in Leeds is one of those few and has been in existence since 1998. Prompted by the Dalvi 12-month case-note review describing a service in London (Chelsea and Westminster) ([
Trampolining injuries presenting to a children’s emergency department

Background: There has been an unprecedented surge in the popularity of trampolines in the UK and in the number of children attending emergency departments with associated injuries. Aim: To record the incidence, injury type and risk factors for children attending the emergency department of a busy suburban hospital with trampolining injuries. Methods: Between May and September 2008, all eligible patients had a proforma completed recording mechanism, time and type of injury, the number of children trampolining at the time of the injury and whether a supervising adult or safety net was present. Analgesia requirements, treatment and follow-up were recorded. Results: 131 children presented with trampolining injuries (1.5% of paediatric attendances). The average age was 8.8 years (range 1–16). 77 (59%) had no net present and 87 (66%) no supervising adult. 89 (68%) sustained injuries without actually falling from the trampoline and, on average, 2.6 people (range 1–7) were on the trampoline at the time of the injury. 81 (62%) required a radiograph and 40 (31%) were diagnosed with fractures. 18 (14%) required surgery and 28 (21%) were discharged with clinic follow-up. 18 (14%) sustained lacerations that required closure in the department. Conclusion: The enormous increase in trampoline sales has brought with it a significant increase in the injuries presenting to UK emergency departments. Safety information is given by manufacturers, retailers and local government authorities, but many parents fail to heed this advice. A combination of inadequate adult supervision, several people using a trampoline simultaneously and insufficient safety equipment seems inextricably linked with injury. Greater parental and public awareness is required regarding the potential dangers of what is perhaps unwittingly considered a light-hearted pastime.
“Maternal Devices”, Social Media and the Self-Management of Pregnancy, Mothering and Child Health

In recent years the smartphone has revolutionised lay people’s management of health and illness, particularly in regards to pregnancy and parenting. This article analyses smartphone applications, or apps, and social media platforms as mediating technologies which act as performative devices. These devices encourage particular enactments of subjectivity and technologies of the self which combine the expert patient ideal with ideologies of mothering. Some apps and social media can be disciplinary and invoke biological responsibility in various ways including the monitoring of specific behaviours via “push responsibilisation”. Apps claim to allow for greater convenience, connectivity, flexibility, efficiency, and what will be characterised in this article as the “tidbitisation” of information. This article suggests the ways in which health-conscious pregnant or maternal subjects are likely to view apps and social media sites as a means to improve and monitor their pregnancies, health, and their children’s development and health.
Socioeconomic differentials in contraceptive use and desire for more children in greater Freetown Sierra Leone.

The level of contraceptive use socioeconomic differentials in the level of use and the sources for contraception in Freetown Sierra Leone were examined. Despite having established the National Population Commission in 1974 Sierra Leone has not initiated a large-scale national family planning program designed to control population growth. In the absence of such a program the Planned Parenthood Association (PPA) of Sierra Leone has served as the main distributor of contraception. A household survey of 1841 women aged 12-49 who had at least 1 child younger than 5 was conducted. An overall contraceptive prevalence rate of 17% was found. The method most commonly used was the pill (62%) followed by the IUD (19%) and injectables (12%). Of the women interviewed 64% expressed desire for more children. Multiple regression analysis was used to estimate the effects of parity age education modern items owned and Islamic affiliation on the level of contraceptive use and desire for more children. The results revealed a positive correlation between contraceptive use and age and education and a negative correlation between contraceptive use and Islamic affiliation. Desire for more children however was negatively associated with age and parity and positively associated with Islamic religious affiliation. Significant differences were also found in contraceptive use and desire for more children among the different tribal groups. Among the women using contraception 50% of them obtained their supplies from the PPA 28% from a hospital or health center and 7% from a private store.
Platelet secretion paves the way

imaging and significantly longer follow-up could explain the higher incidence of ICH in this study. Despite the well-designed study, its retrospective nature creates inherent limitations. The enoxaparin cohort included patients who were deemed eligible for anticoagulation. Theoretically, providers’ clinical acumen could have identified cancer patients with a lower risk of ICH in whom enoxaparin increased to the level of patients whom providers considered ineligible for anticoagulation. Unfortunately, besides tumor type, the multivariable analysis did not identify other clinical factors to guide clinicians in the assessment of ICH risk. Additionally, only 60 patients with renal cell carcinoma and melanoma (20 treated with enoxaparin and 40 controls) were available; thus, firm conclusions in this high-risk cohort cannot be established. Recognizing these limitations, the data presented suggest that anticoagulation does not increase the risk of ICH in patients with brain metastasis. Replicating this analysis in larger data sets and including patients with brain metastases in prospective studies are warranted. Although oncologists often make the decisions regarding anticoagulation in cancer patients, hematologists are frequently consulted in scenarios involving a tenuous balance between bleeding and thrombosis. The results presented by Donato and colleagues suggest that cancer patients with brain metastasis have a wider fulcrum than expected to balance the risks of anticoagulation. This study further supports the statement from the 2014 American Society of Clinical Oncology Guidelines that brain metastases are not a contraindication to treatment of VTE with low-molecular-weight heparin. Conflict-of-interest disclosure: The author declares no competing financial interests. n
Standardised Tests: Wristwatch or Dipstick?

quality the SAT purports to measure. [Gladwell, 2001, p. 92] The biggest problem of all is that many states duck the consequences of high-stakes tests by selecting easy tests. A startling new study shows that many states have a long-standing tradition of setting basement-level education standards and misleading the public about student performance. [I]n many states students who perform brilliantly on state tests scored dismally on the federal National Assessment of Education Progress, which is currently the strongest, most well respected test in the country. [New York Times, 2006, p. 9] Not all states duck. Massachusetts state test results are close to federal results. But some states do. Oklahoma state test scores are forty-eight to sixty points higher than federal scores. Staardised tsts: w ristw atch or ditick? 9 Most alarming of all, the PACE [Policy Analysis for California Education] study fi nds that the gap between student reading performance on the state and federal test has actually grown wider over time—which suggests that claims of reading progress in many states are in fact phony. [New York
The Influence of Extracurricular Foodservice Work Experience on Culinary Graduate Industry Experience

This purpose of this article is to examine the influence of extracurricular foodservice work experience on the foodservice industry persistence of culinary graduates. The researcher used a survey methodology to obtain experiential data from culinary graduates. Post facto data from school records were used to enrich the survey data and provide an opportunity to observe the potential influence of extracurricular foodservice employment on in-school performance. A novel survey instrument was developed and validated through the use of expert reviewers, pilot testing, and internal consistency analysis. Participants in this study were graduates of a small, proprietary culinary school in a metropolitan area of Texas. Culinary graduates from the past five years and only graduates from one culinary program, the Associates of Applied Science in Culinary Arts (Culinary AAS), were used in the data analysis. The following hypotheses were addressed: H1: There is a statistically significant relationship between foodservice work experience obtained while attending culinary school and graduate career persistence in the foodservice industry. H0: There is not a statistically significant relationship between foodservice work experience obtained while attending culinary school and graduate career persistence in the foodservice industry. Moderate levels of extracurricular foodservice experience during school appeared to be a benefit to graduates. Industry persistence was higher for those graduates who worked prior to their in-school externship experience when compared to those who did not. Those students who had more robust extracurricular work experiences in the foodservice industry had higher industry persistence upon graduation. In-school performance for those students who worked in the foodservice industry while attending school was only slightly inferior to those who did not work prior to their externship experience. A decline in academic performance was observed when employment exceeded 30 hours per week. There was evidence of a synergistic effect between work and school that may alleviate the deleterious influence of extracurricular employment on academic performance. The results are of interest to culinary instructors and administrators who are seeking to strategically maximize graduate industry persistence and in-school academic performance. A limitation of this study was the reliance on survey data from former students. Examined in-school data metrics may also be influenced by other variables beyond the student's employment while attending school. Differences in school demographics, curricula, local foodservice employment opportunities, and the students themselves may influence the transferability of results to other settings. Generalization of the research method and results to other schools where students work, especially if the work is far removed from their career goals or degree focus, is not recommended.