Miracle-dz/UniFAR-FTUs huggingface dataset:
Platelet function in lung cancer patients undergoing lobectomy

Abstract A growing interest concerns arterial thromboembolic disease in cancer patients. As platelets may be key players in this process, investigation of platelet aggregation in cancer patients is of importance. We aimed to investigate platelet aggregation in patients with lung cancer prior to surgery and during video-assisted thoracoscopic surgery (VATS) lobectomy compared with lobectomy performed through a thoracotomy. We included 93 patients (VATS + low molecular weight heparin (LMWH), n = 32; VATS no LMWH, n = 31; thoracotomy + LMWH, n = 30). Data obtained from 121 healthy individuals were used for comparison prior to surgery. Platelet aggregation was analysed by impedance aggregometry using adenosine diphosphate 6.5 μM (ADPtest) and collagen 3.2 μg/mL (COLtest) as agonists. Prior to surgery, platelet aggregation was significantly increased in both VATS-patients (ADPtest, p < .0001; COLtest, p = .0002) and patients undergoing thoracotomy (ADPtest, p < .0001; COLtest, p < .0001) compared with healthy individuals. Platelet aggregation did not differ between VATS-patients and thoracotomy patients prior to surgery (p-values >.11). At the first postoperative day, VATS-patients demonstrated significantly higher collagen-induced platelet aggregation than preoperatively (p = .001), but the increase in platelet aggregation did not differ significantly between VATS and thoracotomy patients (p-values ≥.24). At the second postoperative day, platelet aggregation was significantly reduced in thoracotomy patients compared with the preoperative level (ADPtest, p = .002; COLtest, p = .05). In conclusion, platelet aggregation was significantly increased in patients with primary lung cancer prior to surgery compared with healthy individuals. At the first postoperative day, platelet aggregation was significantly higher than the preoperative level in VATS-patients; however, this increase did not differ between patient groups.
Structure and severity of pharyngeal obstruction determine oral appliance efficacy in sleep apnoea

•Some patients with obstructive sleep apnoea (OSA) respond well to oral appliance therapy, whereas others do not for reasons that are unclear. •In the present study, we used gold‐standard measurements to demonstrate that patients with a posteriorly‐located tongue (natural sleep endoscopy) exhibit a preferential improvement in collapsibility (lowered critical closing pressure) with oral appliances. •We also show that patients with both posteriorly‐located tongue and less severe collapsibility (predicted responder phenotype) exhibit greater improvements in severity of obstructive sleep apnoea (i.e. reduction in event frequency by 83%, in contrast to 48% in predicted non‐responders). •The present study suggests that the structure and severity of pharyngeal obstruction determine the phenotype of sleep apnoea patients who benefit maximally from oral appliance efficacy.
What drives depression in empty nose syndrome? A Sinonasal Outcome Test-25 subdomain analysis.

BACKGROUND Empty nose syndrome (ENS) is a debilitating disorder characterised by paradoxical nasal obstruction after excessive surgical excision of nasal tissues. ENS negatively impacts the quality of life (QOL) and psychological status of patients. This study aimed to determine the associations among disease-specific QOL impairments and the severity of anxiety and depression before and after surgery in ENS patients. METHODS A total of 68 ENS patients were prospectively recruited and underwent submucosal Medpor implantation. QOL impairments and the severity of anxiety and depression were evaluated using the Sinonasal Outcome Test-25 (SNOT-25), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI) 1 day before and 6 months after surgery. RESULTS The BDI-II and BAI scores were significantly associated with the total score and ear/facial symptoms, psychological dysfunction, sleep dysfunction, and empty nose symptoms domains of the SNOT-25. Surgery improved disease-specific and psychological symptoms. Post-operative changes in the BDI-II score were correlated with changes in the total score and sleep dysfunction and empty nose symptoms domains of the SNOT-25. A SNOT-25 total score of greater than 60, sleep dysfunction domain score of greater than 18, and empty nose symptoms domain score of greater than 14 were good predictors of moderate-to-severe depression. CONCLUSIONS ENS symptoms are associated with psychological burden and could be good predictors of moderate-to-severe depression. Targeted symptom improvement could reduce the psychological burden.
Multistate outbreaks of Salmonella infections linked to imported Maradol papayas – United States, December 2016–September 2017

Abstract Foodborne salmonellosis causes approximately 1 million illnesses annually in the United States. In the summer of 2017, we investigated four multistate outbreaks of Salmonella infections associated with Maradol papayas imported from four Mexican farms. PulseNet initially identified a cluster of Salmonella Kiambu infections in June 2017, and early interviews identified papayas as an exposure of interest. Investigators from Maryland, Virginia and Food and Drug Administration (FDA) collected papayas for testing. Several strains of Salmonella were isolated from papayas sourced from Mexican Farm A, including Salmonella Agona, Gaminara, Kiambu, Thompson and Senftenberg. Traceback from two points of service associated with illness sub-clusters in two states identified Farm A as a common source of papayas, and three voluntary recalls of Farm A papayas were issued. FDA sampling isolated four additional Salmonella strains from papayas sourced from Mexican Farms B, C and D. In total, four outbreaks were identified, resulting in 244 cases with illness onset dates from 20 December 2016 to 20 September 2017. The sampling of papayas and the collaborative work of investigative partners were instrumental in identifying the source of these outbreaks and preventing additional illnesses. Evaluating epidemiological, laboratory and traceback evidence together during investigations is critical to solving and stopping outbreaks.
Levels of childhood traumatic experiences and dissociative symptoms in extremely obese patients with and without binge eating disorder

Abstract Background: It has been suggested that obese patients with binge eating disorder (BED) show higher levels of dissociation and childhood trauma. Aim: This study assesses childhood trauma history and dissociative symptoms in obese patients with BED compared to obese patients without BED. Methods: The 241 patients participating in the study had to meet obesity criteria. These patients were applicants for bariatric surgery and were consulted by a psychiatry service. Patients were separated into two groups that were accompanied by BED diagnoses according to structured clinical interviews administered according to the DSM-IV (SCID-I). Patients were assessed using the Dissociation Questionnaire (DIS-Q) and the Childhood Trauma Questionnaire (CTQ). The two groups of patients were compared. Results: A total of 75 (31.1%) of the 241 obese patients were diagnosed with BED. The study showed that obese patients with BED had higher dissociative scores than those without BED (p < .05). The results showed higher total scores and two different types of childhood trauma (physical abuse and emotional abuse) in BED patients compared to non-BED patients (p < .05). Conclusions: Clinicians should be fully aware of BED, dissociative symptoms and childhood traumatic experiences. These results show that, for at least a sub-group of obese patients, BED is associated with obesity and may be connected with dissociative symptoms and childhood physical abuse and emotional abuse.
Toxic Shock Syndrome Toxin 1-Producing Methicillin-Resistant Staphylococcus aureus of Clonal Complex 5, the New York/Japan Epidemic Clone, Causing a High Early-Mortality Rate in Patients with Bloodstream Infections

This study was performed to evaluate the clinical impacts of putative risk factors in patients with Staphylococcus aureus bloodstream infections (BSIs) through a prospective, multicenter, observational study. All 567 patients with S. aureus BSIs that occurred during a 1-year period in six general hospitals were included in this study. Host- and pathogen-related variables were investigated to determine risk factors for the early mortality of patients with S. aureus BSIs. ABSTRACT This study was performed to evaluate the clinical impacts of putative risk factors in patients with Staphylococcus aureus bloodstream infections (BSIs) through a prospective, multicenter, observational study. All 567 patients with S. aureus BSIs that occurred during a 1-year period in six general hospitals were included in this study. Host- and pathogen-related variables were investigated to determine risk factors for the early mortality of patients with S. aureus BSIs. The all-cause mortality rate was 15.0% (85/567) during the 4-week follow-up period from the initial blood culture, and 76.5% (65/85) of the mortality cases occurred within the first 2 weeks. One-quarter (26.8%, 152/567) of the S. aureus blood isolates carried the tst-1 gene, and most (86.2%, 131/152) of them were identified to be clonal complex 5 agr type 2 methicillin-resistant S. aureus (MRSA) strains harboring staphylococcal cassette chromosome mec type II, belonging to the New York/Japan epidemic clone. A multivariable logistic regression showed that the tst-1 positivity of the causative S. aureus isolates was associated with an increased 2-week mortality rate both in patients with S. aureus BSIs (adjusted odds ratio [aOR], 1.62; 95% confidence interval [CI], 0.90 to 2.88) and in patients with MRSA BSIs (aOR, 2.61; 95% CI, 1.19 to 6.03). Two host-related factors, an increased Pitt bacteremia score and advanced age, as well as a pathogen-related factor, carriage of tst-1 by causative MRSA isolates, were risk factors for 2-week mortality in patients with BSIs. Careful management of patients with BSIs caused by the New York/Japan epidemic clone is needed to improve clinical outcomes.
Characterization and treatment of landfill leachates by electro‐Fenton process: A case study in Algeria

The feasibility of the electro‐Fenton (EF) process to improve the biodegradability of Algerian leachates was examined, in order to prepare this kind of flux for conventional biological treatment. This work also included, for the first time in Algeria, the control and monitorization of a landfill—the “Hamici” landfill. Several physicochemical parameters were determined allowing its classification into an intermediate degradation phase, namely considering their alkaline pH (8.7), high ammonium concentration (3,120 mg/L), low content in heavy metals, and biodegradability (BOD5/COD = 0.22). The effects of important parameters such as current intensity, treatment time, and temperature on COD removal have been studied and optimized by using response surface analysis of a central composite design, where 91.1% of COD was removed with a treatment time of 285 min, a current intensity of 3 A, and a temperature of 20°C. A biodegradability test, which was performed on a solution electrolyzed with 120 min, 2 A, and 20°C, allowed to improve the leachates biodegradability from 0.2 to 0.42, with a removal rate of COD and TOC of 53.35% and 34.5%, respectively. However, the current efficiency declined from 137% to 76.6% when the current intensity was rise from 0.5 to 2 A. These results showed the relevance of EF process applied on raw intermediate leachates and its possible benefit in the Algiers leachates treatment processes. Thus, it was concluded that biological treatment can be combined with EF process for optimal mineralization of leachates with clear advantages in this studied location.
Comparison of the Effects of Milrinone, Sodium Nitroprusside, and Nitroglycerine for Induced Hypotension in Elderly Patients Undergoing Spine Surgery

Background: The use of induced hypotension is limited because of concerns about hypoperfusion to major organs in elderly patients. The aim of this study was to compare the effects of milrinone with those of other vasodilating hypotensive agents on induced hypotension in elderly patients undergoing spine surgery. Methods: In total, 60 patients older than 60 years who underwent lumbar fusion surgeries were randomized to groups M (milrinone), S (sodium nitroprusside), and N (nitroglycerine). The study drug was infused after perivertebral muscle retraction until complete interbody fusion occurred. The infusion dose was adjusted to achieve a fall of 30% in systolic blood pressure or mean blood pressure to 60 to 65 mm Hg. Intraoperative blood loss, grade of the surgical field, and urine output were recorded. Results: Intraoperative blood loss per fused spine level was 288.5±94.4 mL in group M, 399.8±60.3 mL in group S, and 367.0±122.5 mL in group N (P=0.002). The grade of the surgical field was similar among the 3 groups (P=0.439). Hourly urine output was 1.4±0.5 mL in group M, 0.7±0.3 mL in group S, and 0.9±0.4 mL in group N (P<0.001). Conclusions: The use of milrinone for induced hypotension led to less intraoperative blood loss and higher urine output than the use of sodium nitroprusside or nitroglycerine in elderly patients undergoing spine surgery.
THE ROLE OF MACROPHAGES IN EXERCISE AND INSULIN RESISTANCE IN HUMAN SKELETAL MUSCLE

OF DISSERTATION Muscle biopsies were taken at baseline, post eccentric exercise, post aerobic training, and after training followed by eccentric exercise from adults with different health status. In Cell Western analysis of pAkt/Akt ratio suggests that muscle cells isolated from baseline biopsies respond to insulin in a dose dependent manner that tracks with sensitivity to insulin of the host; however, this is uncoupled from glucose disposal in vitro. Nitrotyrosine (NY), a marker of free radical damage, was employed to assess the efficacy of the exercise paradigm. NY immunohistochemistry on muscle cross-sections revealed that eccentric exercise significantly increased damage in older (>55 years of age), but not middle aged ( 55 years age group, but not in the <55 years of age group. Following training, macrophages increased in response to eccentric exercise in middle aged and decreased in older subjects, showing a disconnect from NY damage. Macrophage phenotypes were assessed in these groups via the M1 marker CD11b, and the M2 marker, CD206. Two dominant populations of macrophages were identified, one of which co-expressed CD11b and CD206, and another which only expressed CD11b. These two populations of macrophages showed the same trends in expression in response to exercise observed with CD68, but did not achieve statistical significance. Bivariate analysis revealed that CD11b/CD206 macrophage densities were correlated with gene activities associated with fibrosis and angiogenesis, whereas CD11b macrophages correlated with gene activities associated with proteostasis and cellular turnover. Lastly, an in vitro model of skeletal muscle cell and macrophage integration was developed to study how macrophage phenotype influences insulin responsiveness. Data suggest that M1 macrophages inhibit insulin stimulated glucose disposal, whereas M2 macrophages enhance this response. Taken together these results suggest a functional distinction between inflammatory (M1) and alternative macrophages (M2) in exercise and insulin resistance that is altered with age.
ORLISTAT FAST DISINTEGRATING MINI-TABLETS FOR THE TREATMENT OF OBESITY; FORMULATION DEVELOPMENT AND EVALUATION

Article history Obesity is presently a global epidemic, which is associated with many major co-morbid disorders. Orlistat is used for the treatment of obesity. Fast disintegrating mini-tablets are compressed tablets of size up to 3mm that disintegrate rapidly and can be swallowed without water for better patient compliance. The objective of the present work is to develop the fast disintegrating Orlistat mini-tablets that can be administered whole as a unit dose sachet. Orlistat has a very less aqueous solubility, and to enhance the solubility and stability different methods were tried. In that, Orlistat β-cyclodextrin (1:2M) complex was found to be more feasible to prepare, 3mm mini-tablets each containing 6mg Orlistat, (20 mini-tablets for 120mg dose sachet). Nine formulation trials using novel co-processed excipients were done. No drug excipients interaction was found by the XRD and IR Spectrum. The optimized formulation (ORDT-9) mini-tablets were evaluated for weight variation, hardness, friability, drug content and wetting time, all the results were within the standard limits. The in vitro disintegration and dissolution tests results of the optimized formulation containing the 40% of ludiflash have shown to be disintegrating in 55 seconds and releasing the 86% of drug within 10 minutes. And in the comparative in-vitro dissolution study with the existing marketed product the optimized formulation (ORDT-9) was releasing three fold faster and complete drug was released in the 15 minutes. Hence, the developed fast disintegrating mini-tablets of Orlistat with enhanced dissolution rate could be a viable ready-to-use single dose sachet dosage form, for better patient compliance.
Comparison of risk models for mortality and cardiovascular events between machine learning and conventional logistic regression analysis

Aims Non-linear models by machine learning may identify different risk factors with different weighting in comparison to conventional linear models. Methods and results The analyses were performed in 15,933 patients included in the Shinken Database (SD) 2004–2014 (n = 22,022) for whom baseline data of blood sampling and ultrasound cardiogram and follow-up data at 2 years were available. Using non-linear models with machine learning software, 118 risk factors and their weighting of risk for all-cause mortality, heart failure (HF), acute coronary syndrome (ACS), ischemic stroke (IS), and intracranial hemorrhage (ICH) were identified, where the top two risk factors were albumin/hemoglobin, left ventricular ejection fraction/history of HF, history of ACS/anti-platelet use, history of IS/deceleration time, and history of ICH/warfarin use. The areas under the curve of the developed models for each event were 0.900, 0.912, 0.879, 0.758, and 0.753, respectively. Conclusion Here, we described our experience with the development of models for predicting cardiovascular prognosis by machine learning. Machine learning could identify risk predicting models with good predictive capability and good discrimination of the risk impact.
Active Body Pressure Relief System with Time-of-Flight Optical Pressure Sensors for Pressure Ulcer Prevention

A body pressure relief system was newly developed with optical pressure sensors for pressure ulcer prevention. Unlike a conventional alternating pressure air mattress (APAM), this system automatically regulates air flow into a body supporting mattress with adaptive inflation (or deflation) duration in response to the pressure level in order to reduce skin stress due to prolonged high pressures. The system continuously quantifies the body pressure distribution using time-of-flight (ToF) optical sensors. The proposed pressure sensor, a ToF optical sensor in the air-filled cell, measures changes in surface height of mattress when pressed under body weight, thereby indirectly indicating the interface pressure. Non-contact measurement of optical sensor usually improves the durability and repeatability of the system. The pressure sensor was successfully identified the 4 different-predefined postures, and quantitatively measured the body pressure distribution of them. Duty cycle of switches in solenoid valves was adjusted to 0–50% for pressure relief, which shows that the interface pressure was lower than 32 mmHg for pressure ulcer prevention.
Occupational hazards and radiation safety in veterinary practice including zoo veterinary practice in Australia

This thesis contains reviews and research on the occupational hazards of zoo veterinary practitioners in Australia. Although occupational hazards have long been recognised in the veterinary profession, little information is available on the number and magnitude of injuries to veterinarians in Australia, the United Kingdom or the United States. Apart from anecdotal accounts and some limited data, most of the available information is on occupational zoonoses, generally well recognized by veterinarians. Other occupational hazards to which veterinarians are exposed have received scant attention. The veterinary practitioner in a zoo environment has to treat a range of captive wild species which are much more unpredictable and dangerous than domesticated animals. A comprehensive study on occupational hazards sustained by veterinarians in zoological gardens has not been undertaken in Australia. Only one study had been undertaken in the US amongst zoo veterinarians, while comprehensive may not be able to be transposed to zoos in Australia as the species held in Australian zoos differ from those in the US. Personal communication with some senior veterinarians in the zoological gardens in Australia, have elicited further information on the prevalence of occupational hazards sustained by the zoo and wildlife park veterinarians. The prevalence of physical hazards including radiation, chemical and biological hazards reported by veterinary practitioners and the author's own experience as a veterinary practitioner, chairman of the safety committee, member of the animal ethics committee and manager, research in the zoological gardens in Perth, Western Australia have