Miracle-dz/UniFAR-FTUs huggingface dataset:
A 5‐year audit of haemodialysis access

This is a review of our experience with vascular access procedures over a 5‐year period at Derriford Hospital, Plymouth, UK. The aims of the study were to examine the outcome of vascular access procedures and factors influencing access survival. Between April 1995 and March 2000, 151 patients who underwent 221 vascular access procedures were studied. Of these, 136 had autogenous arteriovenous fistulae, whereas 85 had prosthetic AV grafts (41% in the thigh). The overall primary failure rate was 21% whereas the 1‐ and 5‐year cumulative access survival rates were 60 and 41%, respectively. Thigh grafts have a mean survival of 36 months compared with 32 months for prosthetic upper limb and 43 months for autogenous fistulae. Age, diabetes and predialysis status did not significantly influence access survival. Thrombosis was responsible for access failure in 62 cases (28%). Avoiding subclavian vein canulation and performing vessel mapping prior to access placement should reduce the risk of access failure due to outflow obstruction.
Age at menarche and menopause is not associated with two common genetic variants in the methylenetetrahydrofolate reductase (MTHFR) gene

ABSTRACT Objectives The study aimed at investigating the independent and the combined effects of the two common genetic variants in the methylenetetrahydrofolate reductase (MTHFR) gene, 677C > T and 1298A > C, and their interaction with lifestyle factors on timing of menarche and natural menopause. Methods Postmenopausal women (N = 792) were assessed for the association of the two genetic variants with age at menarche (AM). A subsample of 578 of them who had a natural menopause were further investigated for the association of the two genetic variants with age at natural menopause (ANM). Genotyping was done by means of the TaqMan® allelic discrimination method. The effect of genetic variants and of lifestyle factors on AM and ANM were calculated by linear regression models. Results The study revealed no association between the individual or combined effects of the two genetic variants and AM or ANM. The genetic variant 677C > T showed a significant interaction effect with duration of breastfeeding on ANM (p = 0.047). Conclusion We were unable to replicate previous findings suggesting that the MTHFR gene influences the onset of menarche and natural menopause. The interaction effect between the 677C >T genetic variant and duration of breastfeeding on the timing of natural menopause requires further investigation.
Bayesian Clustering for Unsupervised Estimation of Surface and Texture Models

A method of calculating the maximum-likelihood clustering for the unsupervised estimation of polynomial models for the data in images of smooth surfaces or for range data for such surfaces is presented. An image or a depth map of a region of smooth 3-D surface is modeled as a polynomial plus white noise. A region of physically meaningful textured-image such as the image of foliage, grass, or road in outdoor scenes or conductor or lintburn on a thick-film substrate is modeled as a colored Gaussian-Markov random field (MRF) with a polynomial mean-value function. Unsupervised-model parameter-estimation is accomplished by determining the segmentation and model parameter values that maximize the likelihood of the data or a more general Bayesian performance functional. Agglomerative clustering is used for this purpose. >
A putative role for platelet-derived growth factor in angiogenesis and neuroprotection after ischemic stroke in humans.

BACKGROUND AND PURPOSE Growth factors control two important processes in infarcted tissue, ie, angiogenesis and gliosis. We recently reported that transforming growth factor-beta1 (TGF-beta1) might be involved in angiogenesis after ischemic stroke in humans; here we present data of an extensive study on platelet-derived growth factor (PDGF) and its receptors. METHODS We studied brain samples from patients who suffered from ischemic stroke for the expression of mRNA encoding PDGF-A, PDGF-B, and PDGF receptors (PDGF-R). Proteins were examined by Western blotting and immunohistochemistry using the antibodies to PDGF-AB, PDGF-BB, PDGF-R alpha, and PDGF-R beta. RESULTS At the mRNA level, PDGF-A and PDGF-B were expressed mainly in neurons in penumbra. PDGF-R mRNA was strongly expressed in some astrocytes but mainly in type III/IV neurons in infarct and penumbra. The least expression was seen in the contralateral hemisphere (P<.001). In contrast, both PDGF-AB and PDGF-BB immunoreactive products were present in most cell types: PDGF-R alpha and PDGF-R beta mainly on neurons, and PDGF-R beta on some endothelial cells, with less staining of all the isoforms in the contralateral hemisphere. On Western blots, PDGF-AB and -BB were expressed more within white matter than gray matter of infarct/penumbra, whereas both isoforms of receptor were expressed mainly in gray matter compared with contralateral hemisphere. There was no or very weak expression of the receptor in white matter. CONCLUSIONS PDGF proteins are highly expressed in white matter, suggesting that PDGF may exert its function in white matter participating either in regeneration of damaged axons or in glial scar formation. PDGF-BB and its receptor expressed on microvessel endothelial cells might be involved in angiogenesis after stroke. Thus, PDGF is likely to be angiogenic and neuroprotective in stroke.
Clinical findings for a group of infants and young children with auditory neuropathy.

OBJECTIVE To examine the prevalence of auditory neuropathy in a group of infants at risk for hearing impairment and to present an overview of the clinical findings for affected children. DESIGN Results for 20 subjects who showed repeatable cochlear microphonic potentials in the absence of click-evoked auditory brain stem responses are included in this study. Behavioral and steady state evoked potential thresholds were established in each case. Where possible, otoacoustic emission and speech perception results (unaided and aided) also were obtained. RESULTS One in 433 (0.23%) of the children in our series had evidence of auditory neuropathy. The audiometric findings for these subjects varied significantly, with behavioral thresholds ranging from normal to profound levels. Discrimination skills were also variable. Approximately half of the subjects showed little understanding, or even awareness, of speech inputs in both the unaided and aided conditions. There were, however, a number of children who could score at significant levels on speech discrimination tasks and who benefited from the provision of amplification. CONCLUSION The results suggest that auditory neuropathy is more common in the infant population than previously suspected. The effects of neuropathy on auditory function appear to be idiosyncratic, producing significant variations in both the detection and discrimination of auditory signals. As such, the management of children with this disorder must allow for individual differences.
Photon antibunching in pulsed squeezed light generated via parametric amplification.

We have measured the intensity correlation of pulsed squeezed light generated by a degenerate optical parametric amplifier seeding weak coherent input signal. When the signal was deamplified, the correlation showed antibunching and the probability distribution of the photon number was sub-Poissonian, both of these being nonclassical properties of light.
Transcription Factors Stat3 and Stat5b Are Present in Rat Liver Nuclei Late in an Acute Phase Response and Bind Interleukin-6 Response Elements (*)

Proteins binding at the interleukin-6 response element of the rat α2 macroglobulin gene were purified by a combination of chromatographic procedures including binding site-specific DNA-affinity chromatography as the principal step. Three polypeptides of 92, 91, and 86 kDa were enriched approximately 6,300-fold from nuclei of rat livers excised 12 h after the induction of an experimental acute phase response. Amino acid sequence analysis identified the 86- and 91-kDa species as two forms of the transcription factor Stat3 and the 92-kDa species as the factor Stat5b. This identification was confirmed by gel mobility shift-supershift experiments using specific antisera for Stat3 and Stat5. Unexpectedly, activated Stat5 was also detected in the nuclei of untreated control rats. cDNA clones representing Stat3 and two isoforms of Stat5b were isolated from a cDNA library prepared with mRNA from rat livers excised at the peak of an experimental acute phase response. Full-length Stat5b, predicted from cDNA, consisted of 786 amino acids, while the variant Stat5bΔ40C lacked 41 amino acids at the COOH terminus. The amino acid sequence of rat Stat5b showed 26.7% overall identity with rat Stat3, 87.3% with sheep Stat5a, 92.5% with murine Stat5a, and 98.7% with murine Stat5b.
Could Beta blockade improve outcome after injury by modulating inflammatory profiles?

BACKGROUND Cardioprotection with beta-receptor antagonists improves outcome in high risk patients undergoing elective surgery. Recent trials have demonstrated an association between beta blocker (BB) use and improved outcomes after injury. The mechanisms through which BB result in improved outcomes remain poorly elucidated. In vitro evidence supports that BB modulates the postinjury inflammatory response. The purpose of this study was to examine the effects of BB on inflammatory profiles in injured patients at increased risk for heart disease. METHODS A pseudo-randomized, controlled trial of injured patients over 55 admitted to the intensive care unit was conducted. Patients were randomized to receive continuous BB or standard of care. Patients with a reported history of prehospital BB use were enrolled into an observational arm of the trial, continued on BB, and analyzed with the continuous BB group. Plasma interleukin (IL)-6 and IL-1beta levels were measured by enzyme-linked immunosorbent assay at baseline and day 1, 2, and 4 after BB initiation. Cytokine data were log transformed for normality assumptions. Repeated measures analysis of variance was used to test for within-group differences in cytokine levels over time. RESULTS Forty-two patients were enrolled. Seventeen patients were randomized to the control group and 25 patients received continuous BB (10 randomized/15 observational). There was no difference in gender, age, prior history of heart disease, or admission heart rate, systolic blood pressure or initial base deficit between groups. Baseline levels of IL-6 and IL-1beta did not differ between groups. Levels of IL-6, but not IL-1beta, decreased over time in patients receiving BB (p = 0.04), whereas levels in controls remained unchanged (p = 0.27). There were no BB related complications. CONCLUSIONS Use of BB decreases serum IL-6 levels over time in injured patients at risk for heart disease. This may contribute to improved outcomes noted in trauma patients receiving BB. Additionally, BB use in this population of patients is safe after endpoints of resuscitation have been met.
Family history of breast cancer. Impact on the disease experience.

PURPOSE Family history is the most prominent risk factor, besides advanced age, for the incidence of breast cancer among women. This study investigates differences in the experiences of women in the detection, diagnosis, and treatment of early-stage disease. The purpose of this research is to obtain a more comprehensive understanding of the impact of family history on the overall illness experience. DESCRIPTION OF STUDY Self-report retrospective data obtained from in-depth interviews with a convenience sample of 179 women who had recently received a diagnosis of nonrecurrent stage 0 to IIIA breast cancer are used to compare the experiences of women with and without a family history of breast cancer (FHOBC). The authors examine differences in screening behavior, method of detection, diagnostic processes, treatment decision making, and therapy receipt, and they report the results of bivariate analyses. RESULTS The results suggest that women with FHOBC have a different disease experience than those without an affected relative. Women with FHOBC were more likely than their counterparts to comply with screening guidelines, to seek more timely care, to consult with specialists, to be influenced by the experiences of others, to feel comfortable with treatment decisions, and to receive adjuvant therapy. CLINICAL IMPLICATIONS Healthcare providers should be aware that compliance with mammography and therapy guidelines may vary with FHOBC. Because the better health-related behavior reported by women with affected relatives suggests that they may have higher perceived risk, physicians should be sensitive to potentially elevated levels of anxiety, provide accurate information about relative risk, put patient concerns in the proper perspective, and include family members in treatment discussions. Alternatively, women without an FHOBC appear to have less favorable screening, detection, diagnosis, and treatment decision-making behavior. Because family doctors play an important role in the care of these patients, they may need to provide special education and counseling regarding the importance of adherence to screening guidelines, recognition of relevant symptoms, initiation of timely examinations, consultation with cancer specialists, and compliance with treatment recommendations.
The basis for the chemopreventive action of resveratrol.

The polyphenolic phytoalexin resveratrol (3,5,4'- trihydroxy-trans-stilbene) is produced, perhaps primarily, as a natural fungicide by more than 70 plant species, and can be found in high to moderate quantities in various foods including grapes, peanuts and wine. Recent in vitro and a limited number of in vivo studies have documented that physiological concentrations of resveratrol can modulate multiple molecular pathways thought to be associated with the development and progression of cardiovascular disease and cancer, among them phase II drug metabolizing, cyclooxygenase, lipid metabolizing, nitric oxide, DNA-synthesis, inflammation, cell survival, cell death and cell division cycle pathways. Work on the mechanisms underlying the cytostatic activities, which appear to affect all dividing tissues, and the cytotoxic activities of the compound, which seem to preferentially target tumor cells, has produced some controversial and, at times, seemingly conflicting results. The present review attempts to integrate some of the established biochemical activities of resveratrol into a common framework of function in an attempt to understand precisely how the compound affects cell proliferation and survival.
Study of quinalphos (an environmental oestrogenic insecticide) formulation (Ekalux 25 E.C.)‐induced damage of the testicular tissues and antioxidant defence systems in Sprague‐Dawley albino rats

The effect of quinalphos (O‐O‐diethyl‐O‐[quinoxalinyl‐(2)‐thionophosphate]), an environmental oestrogenic organophosphorus insecticide pollutant, was studied on Sprague‐Dawley albino rats at doses of 250 and 500 μg kg−1 body wt. i.p. for 3, 8 and 15 days, respectively. After the treatment with quinalphos there was an increase in the lipid peroxides (as measured by manoldialdehyde production) and a decrease in the total lipid content for the testicular membrane. The effects were more pronounced at the low doses than at the higher doses, indicating that some physiological defence mechanisms were in operation at higher doses. The free‐radical‐scavenging enzymes (superoxide dismutase, catalase and glutathione peroxidase) showed significantly higher activity at high dose in comparison to their activities at low‐dose treatment. Glutathione content was gradually reduced after quinalphos treatment, both in low and high doses. Histomorphohological studies showed that after the low‐dose treatment shrinkage of the tubular diameter and testicular atrophy leading to degenerative changes in the germinal epithelium were observed. But at high dose, gradual recovery of various germ cell layers and significant expansion of seminiferous tubules of Sprague‐Dawley rat testes were found; the latter is generally believed to be a useful index of testicular activity through the hypothalamo–hypophyseal–gonadal axis. The present study indicates that quinalphos caused damage and degeneration of the testicular tissues due to free‐radical‐mediated lipid peroxidation at low doses. We have also demonstrated that, in response to the damage, an endogenous antioxidant enzyme defence system became operative at the higher dose of treatment. Copyright © 2000 John Wiley & Sons, Ltd.
Follicular lymphoma: today’s treatments and tomorrow’s targets

Over the past two decades, the incidence of follicular lymphoma has increased. Contemporary treatments include combinations of chemotherapy and monoclonal antibodies, radioimmunotherapy, new targeted agents and stem-cell transplantation. Prognostic tools are becoming more important in helping clinicians and patients decide on the most appropriate therapeutic regimens. Gene expression profiling and biomarkers are promising additions to this armamentarium. When patients do require therapy, the addition of rituximab to chemotherapy seems to improve remission duration and may improve overall survival. Radioimmunotherapy capitalises on the capacity to target radiation directly to malignant cells, and is currently approved for the treatment of relapsed/refractory follicular lymphoma. Further investigation is needed to clarify the role of stem-cell transplantation in follicular lymphoma. Only well-designed clinical trials can provide answers to the many questions that remain regarding the optimal treatment and sequence of treatments for patients with follicular lymphoma.
Respiratory syncytial virus circulation in seven countries with Global Disease Detection Regional Centers.

BACKGROUND Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in young children globally, with the highest burden in low- and middle-income countries where the association between RSV activity and climate remains unclear. METHODS Monthly laboratory-confirmed RSV cases and associations with climate data were assessed for respiratory surveillance sites in tropical and subtropical areas (Bangladesh, China, Egypt, Guatemala, Kenya, South Africa, and Thailand) during 2004-2012. Average monthly minimum and maximum temperatures, relative humidity, and precipitation were calculated using daily local weather data from the US National Climatic Data Center. RESULTS RSV circulated with 1-2 epidemic periods each year in site areas. RSV seasonal timing and duration were generally consistent within country from year to year. Associations between RSV and weather varied across years and geographic locations. RSV usually peaked in climates with high annual precipitation (Bangladesh, Guatemala, and Thailand) during wet months, whereas RSV peaked during cooler months in moderately hot (China) and arid (Egypt) regions. In South Africa, RSV peaked in autumn, whereas no associations with seasonal weather trends were observed in Kenya. CONCLUSIONS Further understanding of RSV seasonality in developing countries and various climate regions will be important to better understand the epidemiology of RSV and for timing the use of future RSV vaccines and immunoprophylaxis in low- and middle-income countries.
Treatment of severe drooling with botulinum toxin in amyotrophic lateral sclerosis and Parkinson's disease: Efficacy and possible mechanisms

Abstract Objective. Drooling in neurodegenerative diseases is associated with social impediment. Previous treatments of drooling have little effect or are effective but with severe side effects. Therefore, there is a need to test new methods such as the use of botulinum toxin type A (BTX-A). Material and methods. This open, prospective study deals with treatment of drooling in 12 patients with amyotrophic lateral sclerosis and three with Parkinson's disease. Injections of BTX-A (Botox) were given into the parotid (25–40 units) and submandibular (15–30 units) glands with ultrasonographic guidance. After BTX-A treatment, the patients were followed for 2 months with evaluations every second week by means of self-assessed rating scales for drooling intensity, discomfort and treatment effect, and determination of unstimulated whole saliva (UWS) flow rate, and inorganic and organic UWS composition. The treatment was repeated up to four times, but seven patients dropped out shortly after the first treatment due to marked worsening of their disease-related condition. Results. Drooling and flow were reduced (P < 0.05) 2 weeks after treatment, without side-effects. The maximal reductions during the observation period were 40% for drooling and 30% for flow. There was a systematic variation in flow during the observation period, with an initial decrease and then an increase followed by a second decrease. Amylase activity and total protein concentration generally increased with decreasing flow (P ≤ 0.03). Conclusion. Inhibition of acetylcholine release from postganglionic parasympathetic nerve endings by injection of BTX-A into salivary glands seemed useful for secondary sialorrhoea, although cyclic variations in flow may occur, possibly due to transitory sprouting and regeneration.
Clinical characteristics of Burkitt's lymphoma seen in Kenyan patients.

OBJECTIVE To document the clinical features of Burkitt's lymphoma (BL) in the study population. DESIGN Retrospective and prospective documentation of clinical details using a standard clinical assessment model. SETTING Kenyatta National Hospital and all the seven provincial hospitals in Kenya. SUBJECTS The study involved all cases with tissue proven diagnosis of Burkitt's lymphoma during the study period of ten years. MAIN OUTCOME MEASURES For each BL case, the following were docummented age, sex, geographical (province) area, complaints, physical examination, investigation result findings. RESULTS This study documented 961 children and 44 adults with Burkitt's lymphoma. Male to female ratio was 1.5:1 in children and 1:1 in adults. All the eight provinces in Kenya had cases of BL and of the 44 tribes 22 were represented. The study showed that BL is a rapidly growing tumour with peak duration of 4 weeks and main complaint was swelling. The major sites involved were Jaw 51.6%, abdomen 25%, combined jaw and abdomen 13.8% and other sites 9.6%. In adults, involved sites were jaw 4.5%, abdomen 43.2%, combined jaw and abdomen 25% and other sites 27.3%. CNS disease demonstrated in 39%, bone marrow 25% while abnormal liver function tests were 18% and abnormal kidney functions 20%. Involved sites in children, jaw peaked at three years 66.7% and abdomen at 14 years 66.7% while in adults abdominal presentation was dominant at all ages. Furthermore jaw were 55% males verses 16% females. Stage at presentation; A 35.2%. B 31.1%, C 31% and D 2.7%. Adult cases had stage D 75% and C 25% but no stage A and B. Adult cases showed HIV 59% positive, mostly over 25 and peaking at 34 years of age with 67.6% males and 42.4% females. HIV BL cases had disseminated disease with lymph nodes, scalp, bone marrow involvement and pancytopenia as major features. CONCLUSION The clinical features are protean and BL is a rapidly progressive disease, presenting with swelling, majority in the jaw and abdomen in childhood and young adults. Age, sex and geographical (province) appear to influence the primary site of the disease. Also BL is a differential in many clinical presentations in this childhood setting.