Miracle-dz/UniFAR-FTUs huggingface dataset:
Malignant renal tumours in adults in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.

BACKGROUND Malignant renal tumour is the third commonest urological tumour after prostate and bladder cancer. It is however the urological tumour with the highest mortality/incidence ratio. OBJECTIVE To review the frequency, mode of presentation and histological pattern of patients with malignant renal tumours in Nnamdi Azikiwe University Teaching Hospital. METHOD A 7 year retrospective review of all our renal tumour folders in theinstitution. RESULTS 19 patients qualified for the study with a male/female ratio of 1:2.8 and a mean age of 52.6 +/- 15.8 years. The peak age was in the seventh decade. Most patient present late (78.9%). Renal cell cancer was the commonest tumour type with the commonest mode of presentation being abdominal mass and pain. CONCLUSION Malignant renal tumours present very ate in our environment and patients hesitate in accepting available treatment option which is surgery. There is need for increased patient awareness and high index of suspicion by the clinician, particularly during imaging procedures, as this would significantly enhance the early detection of these patients.
The outcomes of palliative care day services: A systematic review

This systematic review evaluates the evidence underpinning the provision of palliative day care services (PDS) to determine whether such services have a measurable effect on attendees’ wellbeing. The majority of studies reviewed were qualitative and elicited individual perceptions of the benefits PDS. Although it was difficult to determine the quality of many studies, it would appear that attendance at PDS had a positive impact on attendees’ quality of life. Fewer studies utilized validated outcome measures to determine the effect of PDS on attendees’ wellbeing and small sample sizes combined with high attrition rates influenced the significance of some the results. However little quantitative evidence was offered to prove that PDS had an impact on attendees’ quality of life or wellbeing. The review concludes that dying people find attending PDS a valuable experience that allows them to engage with others and to be supported in a restorative environment. However, further well-powered empirical studies are required to provide quality evidence to determine whether or not attendance at PDS does indeed have a positive impact on the wellbeing of attendees.
A 35-year longitudinal assessment of cognition and midlife depression symptoms: the Vietnam Era Twin Study of Aging.

OBJECTIVE To determine whether early adult cognitive ability is a risk factor for depressive symptoms in midlife and how genetic and environmental influences explain the association and to examine cross-sectional relationships between depressive symptoms and specific cognitive abilities at midlife. DESIGN A 35-year longitudinal and cross-sectional twin study of cognitive aging. SETTING Large multicenter study in the United States. PARTICIPANTS One thousand two hundred thirty-seven male twins aged 51 to 60 years. MEASUREMENTS At the age of 20 years and midlife, participants completed the same version of a general cognitive ability test (Armed Forces Qualification Test [AFQT]). Midlife testing included an extensive neurocognitive protocol assessing processing speed, verbal memory, visual-spatial memory, working memory, executive function, and visual-spatial ability. Participants completed the Center for Epidemiologic Studies Depression Scale before cognitive testing and provided health and life style information during a medical history interview. RESULTS Lower age 20 AFQT scores predicted higher levels of depressive symptoms at age 55 years (r = -0.16,p <0.001). In bivariate twin modeling, 77% of the correlation between early cognitive ability and midlife depressive symptoms was due to shared genetic influences. Controlling for current age, age 20 AFQT, and nonindependence ofobservations, depressive symptoms were associated with worse midlife AFQT scores and poorer performance in all cognitive domains except verbal memory. CONCLUSION Results suggest that low cognitive ability is a risk factor for depressive symptoms; this association is partly due to shared genetic influences. Crosssectional analyses indicate that the association between depressive symptoms and performance is not linked to specific cognitive domains.
Endogenous sex hormones and prostate cancer: a collaborative analysis of 18 prospective studies.

BACKGROUND Sex hormones in serum have been hypothesized to influence the risk of prostate cancer. We performed a collaborative analysis of the existing worldwide epidemiologic data to examine these associations in a uniform manner and to provide more precise estimates of risks. METHODS Data on serum concentrations of sex hormones from 18 prospective studies that included 3886 men with incident prostate cancer and 6438 control subjects were pooled by the Endogenous Hormones and Prostate Cancer Collaborative Group. Relative risks (RRs) of prostate cancer by fifths of serum hormone concentration were estimated by use of conditional logistic regression with stratification by study, age at recruitment, and year of recruitment. All statistical tests were two-sided. RESULTS No associations were found between the risk of prostate cancer and serum concentrations of testosterone, calculated free testosterone, dihydrotestosterone, dehydroepiandrosterone sulfate, androstenedione, androstanediol glucuronide, estradiol, or calculated free estradiol. The serum concentration of sex hormone-binding globulin was modestly inversely associated with prostate cancer risk (RR in the highest vs lowest fifth = 0.86, 95% confidence interval = 0.75 to 0.98; P(trend) = . 01). There was no statistical evidence of heterogeneity among studies, and adjustment for potential confounders made little difference to the risk estimates. CONCLUSIONS In this collaborative analysis of the worldwide data on endogenous hormones and prostate cancer risk, serum concentrations of sex hormones were not associated with the risk of prostate cancer.
The osmotic link between hypoglycaemia and hypovolaemia

Objective. Hypoglycaemia is regularly accompanied by hypovolaemia. To suggest a mechanism for this phenomenon, we reviewed data from eight studies conducted by our group and examined the circumstances under which rebound hypoglycaemia develops after intravenous infusion of glucose solutions. Material and methods. Forty healthy volunteers and 40 patients received a total of 122 infusions of glucose solutions at different rates, volumes and concentrations. Plasma glucose and the haemodilution were measured repeatedly during and for at least 2 h after the infusions ended. Glucose kinetics was calculated using a one‐compartment turnover model and the plasma volume expansion was estimated from changes in Hb. Results. A strong linear correlation was found between the glucose level and the plasma volume expansion in all series of experiments (p<0.001). After infusion, there was a risk of hypoglycaemia and hypovolaemia developing in healthy volunteers with a high glucose clearance and when infusing glucose solutions of higher concentrations than 2.5 %. Few and mild hypoglycaemic events occurred in patients with insulin resistance, such as in diabetics and in those undergoing surgery. The immediate linear relationship between hypoglycaemia and hypovolaemia suggests an osmotic link between the two parameters. More specifically, infused fluid accompanies glucose during uptake into the cells, while volume expansion by the same fluid has already elicited an effective diuretic response. Conclusion. Hypovolaemia is a consequence of hypoglycaemia after intravenous infusion of glucose solution and is caused by the osmotic translocation of fluid from the extracellular to the intracellular fluid space that occurs despite effective renal elimination.
Functional Characterization of Borrelia spielmanii Outer Surface Proteins That Interact with Distinct Members of the Human Factor H Protein Family and with Plasminogen

ABSTRACT Acquisition of complement regulator factor H (CFH) and factor H-like protein 1 (CFHL1) from human serum enables Borrelia spielmanii, one of the etiological agents of Lyme disease, to evade complement-mediated killing by the human host. Up to three distinct complement regulator-acquiring surface proteins (CRASPs) may be expressed by serum-resistant B. spielmanii, each exhibiting an affinity for CFH and/or CFHL1. Here, we describe the functional characterization of the 15-kDa CRASPs of B. spielmanii, members of the polymorphic Erp (OspE/F-related) protein family, that bind two distinct host complement regulators, CFH and factor H-related protein 1 (CFHR1), but not CFHL1. CFH bound to the B. spielmanii CRASPs maintained cofactor activity for factor I-mediated C3b inactivation. Three naturally occurring alleles of this protein bound CFH and CFHR1 while a fourth natural allele could not. Comparative sequence analysis of these protein alleles identified a single amino acid, histidine-79, as playing a significant role in CFH/CFHR1 binding, with substitution by an arginine completely abrogating ligand binding. The mutation of His-79 to Arg did not inhibit binding of plasminogen, another known ligand of this group of borrelial outer-surface proteins.
High prevalence of gastroesophageal reflux in children after lung transplantation

Bronchiolitis obliterans and its clinical correlate bronchiolitis obliterans syndrome (BOS) are a major cause of morbidity and mortality following lung transplantation. Gastroesophageal reflux disease (GERD) may be a contributing factor for the development of BOS. Since 2002, all recipients of lung and heart‐lung transplantation at our institution have been routinely investigated for GERD. In this observational study, we report on the prevalence of GERD in this population, including all pediatric patients undergoing single (SLTx) or double (DLTx) lung transplantation or heart‐lung (HLTx) transplantation from January 2003–May 2004. GERD was assessed 3–6 months after transplantation by 24‐hr pH testing. The fraction time (Ft) with a pH < 4 within a 24‐hr period was recorded. Spirometry data, episodes of confirmed acute rejection, and demographic data were also collected. Ten transplant operations were performed: 4 DLTx, 1 SLTx, and 5 HLTx. Nine patients had cystic fibrosis. One patient had end‐stage pulmonary disease secondary to chronic aspiration pneumonia and postadenovirus lung damage. Of 10 patients tested, 2 had severe GERD (Ft > 20%), 5 had moderate GERD (Ft 10–20%), 2 had mild GERD (Ft 5–10%), and 1 had no GERD. The only patient in this group with no GERD had a Nissen fundoplication pretransplant. All study patients were asymptomatic for GERD. All patients with episodes of rejection had moderate to severe GERD posttransplant. There was no association between severity of GERD and peak spirometry results posttransplant. Moderate to severe GERD is common following lung transplantation in children. © 2005 Wiley‐Liss, Inc.
Airborne chemicals cause respiratory symptoms in individuals with contact allergy

Exposure to fragrance chemicals causes various eye and airway symptoms. Individuals with perfume contact allergy report these symptoms more frequently than individuals with nickel allergy or no contact allergies. However, the associations between contact allergy and respiratory symptoms elicited by airborne chemicals other than perfumes are unclear. The study aimed to investigate the association between eye and airway symptoms elicited by airborne chemicals (other than perfumes) and contact allergy in a population‐based sample. A questionnaire on respiratory symptoms was posted, in 2002, to 1189 individuals who participated in 1997/1998 in a Danish population‐based study of allergic diseases. Questions about eye and airway symptoms elicited by different airborne chemicals and airborne proteins were included in the questionnaire. Data from the questionnaire were compared with data on patch testing and prick testing. Having at least 1 positive patch test (adjusted odds ratio 1.7, 95% CI 1.2–2.5) was associated with the symptoms, and the odds ratio increased with the number of positive patch tests (P‐value for test for trend <0.05). Bronchial hyperreactivity, female sex and psychological vulnerability were independently associated with symptoms, but no association was found between prick test reactivity to proteins and the symptoms elicited by airborne chemicals.
The Impact of ‘Boss’ Candidates and Local Political Machines on Elections in Ukraine

Abstract The business sector has strongly influenced Ukrainian electoral campaigns since the founding post-communist elections. This article investigates the role of influential, local business-sector candidates, whom we label ‘boss’ candidates, in illicit campaign activities, using unique biographical, electoral, and crowd-sourced data from the 2012 parliamentary elections. The analysis shows that higher levels of competition among candidates with ‘boss’ characteristics are associated with elevated reports of voter manipulation, specifically vote buying. The findings add to extant research on election integrity in Eastern Europe and Eurasia, presenting quantitative empirical evidence that is consistent with narratives about Ukrainian electoral corruption.
Glenohumeral joint reaction forces increase with critical shoulder angles representative of osteoarthritis—A biomechanical analysis

Osteoarthritis (OA) of the glenohumeral joint constitutes the most frequent indication for nontraumatic shoulder joint replacement. Recently, a small critical shoulder angle (CSA) was found to be associated with a high prevalence of OA. This study aims to verify the hypothesis that a small CSA leads to higher glenohumeral joint reaction forces during activities of daily living than a normal CSA. A shoulder simulator with simulated deltoid (DLT), supraspinatus (SSP), infraspinatus/teres minor (ISP/TM), and subscapularis (SSC) musculotendinous units was constructed. The DLT wrapping on the humerus was simulated using a pulley that could be horizontally adjusted to simulate the 28° CSA found in OA or the 33° CSA found in disease‐free shoulders. Over a range of motion between 6° and 82° of thoracohumeral abduction joint forces were measured using a six‐axis load cell. An OA‐associated CSA yielded higher net joint reaction forces than a normal CSA over the entire range of motion. The maximum difference of 26.4 N (8.5%) was found at 55° of thoracohumeral abduction. Our model thus suggests that a CSA typical for OA predisposes the glenohumeral joint to higher joint reaction forces and could plausibly play a role in joint overloading and development of OA. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1047–1052, 2016.
Haemophilus influenzae type b carriage and immunity four years after receiving the Haemophilus influenzae oligosaccharide‐CRM197 (HbOC) conjugate vaccine

Late in 1991, before the implementation of a national immunization program against Haemophilus influenzae type b (Hib) in the United Kingdom, we performed a 4-year follow-up of 120 children who in 1987 had been enrolled in an immunogenicity trial in which 60 of them (vaccinees) received an Hib conjugate vaccine (HbOC) at the same time as diphtheria-tetanus toxoid-pertussis vaccine at the ages of 3, 5 and 9 months. Sixty others (controls) received only diphtheria-tetanus toxoid-pertussis vaccine at the same ages and were not subsequently immunized against Hib. We investigated Hib pharyngeal colonization using the antiserum agar method and the concentrations of serum IgG antibody to the type b capsule by enzyme-linked immunosorbent assay. At 4 years of age the Hib colonization rates in vaccinees and controls were 8% (5 of 60) and 5% (3 of 60), respectively. The children colonized with Hib had greater serum anti-capsular IgG concentrations than did noncolonized children (P < 0.001), and colonized vaccinees tended to have higher concentrations than colonized controls (P = 0.053). Regardless of Hib colonization status vaccinees had greater antibody concentrations than controls (P < 0.001). Forty-nine percent of vaccinees had an antibody concentration >1 Mg/ml. There was an inverse relationship between the Hib colony count on culture and the serum IgG
Study of Ranging System Using Pseudo-Random Continuous Wave Signal

Pseudo-random signal has potential value as ranging system’s signal since it has noise-like character, excellent autocorrelation and large time bandwidth character. The theory of the ranging system based on pseudo-random signal and how system works will be introduced in detail in this paper. We learned that the quality of signal generated by pseudo-random signal generator is very good through observing frequency domain chart, autocorrelation chart and time domain chart of signal. Quite accurate result can be got through dealing with experiment dates. It turned out that pseudo-random signal can be applied efficiently in ranging system and accuracy is quite high in field experiment. DOI : http://dx.doi. org/10.11591/telkomnika.v12i3. 4458 Full Text: PDF
Neurodevelopmental Functioning in HIV-Infected Infants and Young Children Before and After the Introduction of Protease Inhibitor–Based Highly Active Antiretroviral Therapy

OBJECTIVES. The purpose of this work was to examine the effects of HIV infection and the impact of highly active antiretroviral treatment with protease inhibitors on neurodevelopmental functioning during the first 3 years of life. PATIENTS AND METHODS. Pediatric AIDS Clinical Trials Group 219/219C is a longitudinal cohort study that has enrolled HIV-infected (HIV+) and HIV-exposed but uninfected (HIV−) infants and children since 1993. Longitudinal profiles of neurodevelopmental functioning as measured by the Bayley Scales of Infant Development were compared by HIV-infection status before and after the availability of highly active antiretroviral therapy with a protease inhibitor and within infants with Bayley tests available before and after initiating protease inhibitor therapy. RESULTS. In the pre–protease inhibitor era, mean mental and motor scores in HIV+ (n = 54) infants <1 year of age were significantly lower than those among HIV− infants (n = 221) and remained lower up to 2 years of age. After protease inhibitors became available, mean mental and motor functioning of HIV+ infants (n = 91) <1 year of age were still significantly lower than those of HIV− infants (n = 838). However, against a background of declining scores among the HIV− infants, there was evidence of limited improvement in the HIV+ infants relative to their uninfected peers. Among infants who had Bayley II evaluations before and after starting a protease inhibitor, there was a trend to improved mental and motor scores after initiation of protease inhibitor therapy. CONCLUSIONS. The suppression of systemic viral replication and subsequent substantial improvements in survival and immunologic status brought about by highly active antiretroviral therapy have been followed by limited improvements in neurodevelopmental functioning in young children. Additional longitudinal research is needed to better understand the role of antiretroviral therapy as well as the impact of genetic and environmental factors on neurodevelopmental functioning in children affected by HIV.
On high‐ and low‐affinity agonist sites in GABAA receptors

GABAA receptors are activated via low‐affinity binding sites for the agonists GABA or muscimol. Evidence has been provided that the amino acid residueα1F64 located at the β2(+)/α1(–) subunit interface forms part of this binding site. In radioactive ligand binding studies the agonist [3H]muscimol has been found to interact with the receptor via a high‐affinity binding site. This site has been interpreted as a conformational variant of the low‐affinity site. Alternatively, the high‐affinity binding site has been located to the α1(+)/β2(–) interface and the homologous residue to α1F64, β2Y62 has been proposed to constitute an important part of this site. Here we investigated the effect of the point mutation α1F64L and the homologous mutation β2Y62L on agonist and antagonist binding and functional properties in α1β2γ2 GABAA receptors. While the mutation in the α1 subunit had drastic consequences on all studied properties, including desensitization, the mutation in the β2 subunit had little consequence. Our observations are relevant for the relative location of high‐ and low‐affinity agonist sites in GABAA receptors.
A qualitative study of HIV testing and referral practices of private hospital doctors treating patients with TB in Chennai, India.

OBJECTIVE In India, 50%-80% of patients with tuberculosis (TB) seek private care. This study set out to explore HIV testing and referral practices of private hospital doctors treating patients with TB. METHODS Interviews were conducted with private hospital doctors (n = 15). Interviews covered HIV testing, linking HIV-positive patients with TB to HIV care, and coordination of care for co-infected patients. RESULTS Doctors did not routinely refer patients with TB to government HIV testing facilities as per national policy guidance. If deemed appropriate, then testing was conducted privately. Testing was more common when a facility guideline mandated testing or a public-private initiative for TB management was in place. Otherwise, testing was based on doctors' judgement. Patients accustomed to private care who could not afford treatment were reportedly reluctant to shift to public facilities. A lack of communication between public and private doctors was found to undermine co-management. CONCLUSIONS In this sample, private provider practices were influenced by both the social and the health systems contexts in which they operated. An understanding of patient perceptions of HIV, private doctors concerns for retaining patients, and the contrasting philosophies of private medicine versus public health objectives was found to be critical to explain HIV testing and referral behaviours. The government has proposed to scale up HIV testing and treatment among patients with TB, yet operationalising this will require engagement with the realities of a large, diverse private sector. It will also require considering what role government policies can have on shaping private practice and how to potentially integrate public and private care.
Severe Refractory Hypercalcaemia in HTLV-1 Infection

In hypercalcaemia, exclusion of common causes such as hyperparathyroidism or disseminated malignancy is straight-forward. Matters become more difficult when no obvious cause can be found. A rare cause of refractory hypercalcaemia is adult T-cell leukaemia/lymphoma (ATLL) induced by human T-cell leukaemia virus type-1 (HTLV-1).
Anthropometric measures: poor predictors of body fat in children with moderate to severe cerebral palsy

Aim This purpose of our study was to assess and compare anthropometric measures of adiposity and direct measurement of percentage body fat by dual emission X‐ray absorptiometry (DXA) in children with cerebral palsy (CP). We also compared our results in children with CP with results from a national sample of typically developing children from the National Health and Nutrition Examination Survey.