Miracle-dz/UniFAR-FTUs huggingface dataset:
Malnutrition and the severity of lung disease in adults with pulmonary tuberculosis in Malawi.

SETTING Zomba Central Hospital, Zomba, Malawi. OBJECTIVE To examine the relationship between malnutrition and the severity of lung disease in human immunodeficiency virus (HIV) positive and negative adults with pulmonary tuberculosis (PTB). DESIGN Cross-sectional study. METHODS Chest radiographs and anthropometric measurements were obtained and bioelectrical impedance analysis was conducted in sputum-positive patients with pulmonary tuberculosis. Lung disease in chest radiographs was graded as normal, minimal, moderately advanced and far advanced according to a conventional classification system. RESULTS Among 319 adults with PTB with or without HIV co-infection, body mass index (BMI), fat mass and phase angle were independently associated with increasing severity of lung disease. Multiple logistic regression analyses showed that BMI, fat mass and phase angle were associated with increasing severity of lung disease among 236 HIV-positive adults, when adjusted for sex, age, and plasma HIV load. CONCLUSION The severity of lung disease in adults with PTB is associated with the extent of malnutrition, as reflected by BMI and body composition studies using bioelectrical impedance analysis.
Comparison of Blood-conservation Strategies in Cardiac Surgery Patients at High Risk for Bleeding

Background: Aprotinin and tranexamic acid are routinely used to reduce bleeding in cardiac surgery. There is a large difference in agent price and perhaps in efficacy. Methods: In a prospective, randomized, partially blinded study, 168 cardiac surgery patients at high risk for bleeding received either a full-dose aprotinin infusion, tranexamic acid (10-mg/kg load, 1-mg · kg−1 · h−1 infusion), tranexamic acid with pre–cardiopulmonary bypass autologous whole-blood collection (12.5% blood volume) and reinfusion after cardiopulmonary bypass (combined therapy), or saline infusion (placebo group). Results: There were complete data in 160 patients. The aprotinin (n = 40) and combined therapy (n = 32) groups (data are median [range]) had similar reductions in blood loss in the first 4 h in the intensive care unit (225 [40–761] and 163 [25–760] ml, respectively;P = 0.014), erythrocyte transfusion requirements in the first 24 h in the intensive care unit (0 [0–3] and 0 [0–3] U, respectively;P = 0.004), and durations of time from end of cardiopulmonary bypass to discharge from the operating room (92 [57–215] and 94 [37, 186] min, respectively;P = 0.01) compared with the placebo group (n = 43). Ten patients in the combined therapy group (30.3%) required transfusion of the autologous blood during cardiopulmonary bypass for anemia. Conclusions: The combination therapy of tranexamic acid and intraoperative autologous blood collection provided similar reduction in blood loss and transfusion requirements as aprotinin. Cost analyses revealed that combined therapy and tranexamic acid therapy were the least costly therapies.
Deep neuromuscular block reduces intra‐abdominal pressure requirements during laparoscopic cholecystectomy: a prospective observational study

Laparoscopic surgery causes specific post‐operative discomfort and intraoperative cardiovascular, pulmonary, and splanchnic changes. The CO2 pneumoperitoneum‐related intra‐abdominal pressure (IAP) remains one of the main drivers of these changes. We investigated the influence of deep neuromuscular blockade (NMB) on IAP and surgical conditions.
Oral cyclosporin‐A is effective treatment for untreated and also for previously immunosuppressed patients with severe bone marrow failure *

16 patients with transfusion‐dependent, life‐threatening bone marrow failure (14 with severe aplastic anaemia, 1 with systemic lupus erythematosus and 1 with pure red cell aplasia) were treated with cyclosporin‐A (Cy‐A) after either lack of response to conventional immunosuppression with antithymocyte‐globulin/high‐dose methylpred‐nisolone for 95 to 1190 days (median 186.5) (group I, 8 patients) or as a primary treatment due to ineligibility for conventional immunosuppression (group II, 8 pat.). Cyclosporin‐A was given orally to maintain trough levels of 200 to 300 ng/ml (RIA). In group I, 6 out of 8 patients responded 30 to 480 d (median 53) and are currently alive 627 to 1482 d (median 731) after initiation of Cy‐A, respectively. In 3 of the responders Cy‐A has been withdrawn, without relapse. In group II, 5 of 8 patients responded 26 to 170 d (median 63) and are currently alive 142 to 697 (median 420) d following initiation of Cy‐A, respectively. These data indicate a place for cyclosporin‐A in the management of patients with life‐threatening bone marrow failure in whom a) immunosuppressive therapy with antithymocyte‐globulin and high‐dose methylprednisolone had failed and b) who are not candidates for vigorous immunosuppression or bone marrow transplantation, for medical or other reasons.
Nuclear transfer in cattle using in vivo‐derived vs. in vitro‐produced donor embryos: Effect of developmental stage

To determine the best developmental stage of donor embryos for yielding the highest number of clones per embryo, we compared the efficiencies of nuclear transfer when using blastomeres from morulae or morulae at cavitation, or when using inner‐cell‐mass cells of blastocysts as nuclear donors. This comparison was done both on in vivo‐derived and in vitro‐produced donor embryos. In experiment 1, with in vivo‐derived donor embryos, nuclei from morulae at cavitation supported the development of nuclear transfer embryos to the blastocyst stage (36%) at a rate similar to that of nuclei from morulae (27%), blastomeres from morulae at cavitation being superior (P < 0.05) to inner‐cell‐mass cells from blastocysts (21%). The number of blastocysts per donor embryo was significantly (P < 0.05) higher when using nuclei from morulae at cavitation (15.7 ± 4.1) rather than nuclei from morulae (9.8 ± 5.5) or blastocysts (6.3 ± 3.3). With in vitro‐produced donor embryos (experiment 2), nuclei from morulae yielded slightly more blastocysts (32%) than nuclei from morulae at cavitation (29%), both stages being superior to nuclei from blastocysts (15% development to the blastocyst stage). Morulae at cavitation yielded a higher number of cloned blastocysts per donor embryo (11.5 ± 5.9) than did morulae (9.3 ± 3.2) and blastocysts (3.3 ± 1.4). Transfer of cloned embryos originating from in vivo‐derived morulae, morulae at cavitation, and blastocysts resulted in four pregnancies (10%), three pregnancies (7%), and one (17%) pregnancy on day 45. The corresponding numbers of calves born were 3 (4%), 3 (7%), and 0, respectively. After transfer of blastocysts derived from in vitro nuclear donor morulae (n = 16) and morulae at cavitation (n = 7), two (20%) and two (50%) recipients, respectively, were pregnant on day 45. However, transfer of seven cloned embryos from in vitro donor blastocysts to three recipients did not result in a pregnancy. Using in vitro‐produced donor embryos, calves were only obtained from morula‐stage donors (13%). Our results indicate that the developmental stage of donor embryos affects the efficiency of nuclear transfer, with morulae at cavitation yielding a high number of cloned blastocysts. © 1996 Wiley‐Liss, Inc.
Posttraumatic Psychiatric Disorders and Resilience in Healthcare Providers following a Disastrous Earthquake: An Interventional Study in Taiwan

Background Posttraumatic psychiatric disorders (PTPDs) are common in disaster workers; however, their incidence and resilience in healthcare providers (HCPs) following a disastrous earthquake are still unclear. Therefore, we conducted an interventional study to clarify this issue. Methods After a medical response to the scene of a collapsed huge building, we conducted an assessment of the HCPs using an immediate self-administered questionnaire and a follow-up questionnaire 1 month later. Psychological support after the operation was implemented. We performed analysis of the risk for PTPDs and comparison between immediate and follow-up questionnaires. Results The mean age (standard deviation) of the HCPs was 32.7 (5.2) years, with 33.5 (5.8) years for nurses and 32.4 (4.4) years for physicians. The proportion of females among the nurses and physicians was 94.3% and 12.5%, respectively. In total, 16.4% (11/67) of HCPs fit the criteria of PTPDs. Nurses had a trend of higher incidence than physicians. Female HCPs had a trend of higher incidence than male HCPs. After intervention, none of the HCPs reported PTPDs in the follow-up questionnaire (p < 0.05). Conclusion This study delineated that PTPDs were common in HCPs following medical response to an earthquake; however, the resilience was good after the early intervention.
Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders

Importance Chronic pain is common among the elderly and is associated with cognitive deficits in cross-sectional studies; the population-level association between chronic pain and longitudinal cognition is unknown. Objective To determine the population-level association between persistent pain, which may reflect chronic pain, and subsequent cognitive decline. Design, Setting, and Participants Cohort study with biennial interviews of 10 065 community-dwelling older adults in the nationally representative Health and Retirement Study who were 62 years or older in 2000 and answered pain and cognition questions in both 1998 and 2000. Data analysis was conducted between June 24 and October 31, 2016. Exposures “Persistent pain,” defined as a participant reporting that he or she was often troubled with moderate or severe pain in both the 1998 and 2000 interviews. Main Outcomes and Measures Coprimary outcomes were composite memory score and dementia probability, estimated by combining neuropsychological test results and informant and proxy interviews, which were tracked from 2000 through 2012. Linear mixed-effects models, with random slope and intercept for each participant, were used to estimate the association of persistent pain with slope of the subsequent cognitive trajectory, adjusting for demographic characteristics and comorbidities measures in 2000 and applying sampling weights to represent the 2000 US population. We hypothesized that persistent pain would predict accelerated memory decline and increased probability of dementia. To quantify the impact of persistent pain on functional independence, we combined our primary results with information on the association between memory and ability to manage medications and finances independently. Results Of the 10 065 eligible HRS sample members, 60% were female, and median baseline age was 73 years (interquartile range, 67-78 years). At baseline, persistent pain affected 10.9% of participants and was associated with worse depressive symptoms and more limitations in activities of daily living. After covariate adjustment, persistent pain was associated with 9.2% (95% CI, 2.8%-15.0%) more rapid memory decline compared with those without persistent pain. After 10 years, this accelerated memory decline implied a 15.9% higher relative risk of inability to manage medications and an 11.8% higher relative risk of inability to manage finances independently. Adjusted dementia probability increased 7.7% faster (95% CI, 0.55%-14.2%); after 10 years, this translates to an absolute 2.2% increase in dementia probability for those with persistent pain. Conclusions and Relevance Persistent pain was associated with accelerated memory decline and increased probability of dementia.
Human papillomavirus status in young patients with head and neck squamous cell carcinoma

The role of human papillomavirus (HPV) in head and neck squamous cell carcinoma (HNSCC) development has been recognized only in the last decade. Although younger patients develop HNSCC associated with HPV, the incidence in young patients has not been studied. Forty‐five young HNSCC patients (<40 years) were tested for HPV and the expression of p16ink4a and p53 in tumor biopsies. The presence of HPV was correlated with the absence and presence of alcohol and tobacco exposure. Paraffin‐embedded, archival biopsy materials from HNSCC of 45 patients younger than 40 years were analyzed. HPV subtypes were identified by PCR followed by genotyping. Expression of p16ink4a and p53 were determined by immunohistochemistry. Fourteen (31%) of the HNSCC specimens from 45 patients unequivocally exhibited HPV16 positivity. Sixty percentage of the oropharyngeal tumors and 5% of the oral cavity tumors were HPV16 positive. P16ink4a overexpression was detected in 93% of the HPV16‐positive tumors. None of the HPV16 tumors showed p53 overexpression. There was no association of HPV positivity with (lack of) exposure to alcohol and smoking. HPV association was not exclusively detected in nonsmoking, nondrinking young HNSCC patients. The presence of p16ink4a accumulation and the absence of p53 overexpression are good surrogate markers for HPV‐associated HNSCC.
The Effect of Biological Substrates on the Ultrafast Excited‐state Dynamics of Zinc Phthalocyanine Tetrasulfonate in Solution

Zinc phthalocyanine tetrasulfonate (ZnPcS4), a potential photosensitizer for photodynamic therapy (PDT), has been studied using femtosecond laser spectroscopy. The excited‐state dynamics in water have been found to be fast (<80 ps) and dominated by intermolecular aggregation. Since the proposed mechanism for PDT is energy transfer from the triplet excited state of the photosensitizer to triplet O2 creating singlet O2, the short lifetime is expected to be unfavorable for producing singlet O2. This leads to the suggestion that the presence of biological substrates may have an effect on the excited‐state dynamics. To test this hypothesis, the lifetimes of the ex‐cited states of ZnPcS4 have been directly measured in the presence of a model membrane, n‐hexadecyltrimethylammonium bromide (CTAB). The excited‐state dynamics of ZnPcS4 in buffer solutions and with human serum albumin (HSA) have also been measured. The presence of HSA and CTAB increases the excited‐state lifetime significantly relative to that observed in water. The longer lifetime of ZnPcS4 in CTAB (>1 ns) indicates that the micellar surface favors monomer formation. By increasing the excited‐state lifetime, the surface substantially in‐creases the photosensitizing potential of ZnPcS4.
Typing of prostate tissue by ultrasonic spectrum analysis

Prostate cancer is the highest-incidence cancer and second-leading cancer killer of men in the U.S. Diagnosis now relies virtually exclusively on core-needle biopsy, guided by transrectal ultrasound (TRUS). Because of the limitations of TRUS in detecting suspicious regions, biopsy often fails to sample cancer that is present or to determine that extracapsular cancer exists, which results in false-negative biopsies or inappropriate prostatectomies. Therefore, the authors conducted this study to investigate the use of spectrum analysis of radio frequency (RF) echo signals as a possible means of reducing the number of false-negative biopsies and inappropriate prostatectomies. This method utilizes databases of parameters derived from normalized power spectra of RF echo signals and histologically proven tissue types to determine ranges of parameter values associated with tissue types of interest. Typing an unknown tissue is performed by comparing the parameter values of the unknown to the value ranges of specific tissue types in the database. The authors' results provide encouraging preliminary discriminant-function distributions that suggest an excellent potential for differentiating cancerous from noncancerous prostate tissue far superior in terms of sensitivity and specificity than means now used to determine whether biopsy is required. In addition, the authors developed images using color to indicate the most likely tissue type throughout the tissue cross section as determined by comparisons with database parameter values. These images showed excellent correlation with histology.
Responsiveness of cultured septal and hippocampal neurons to ethanol and neurotrophic substances

Dissociated septal and hippocampal neurons from E18 fetal rats were cultured with varying concentrations of ethanol (0.6–2.4 g/dl) and in cultures containing ethanol plus nerve growth factor (NGF) or basic fibroblast growth factor (bFGF). These substances have been shown to provide neurotrophic support for these populations and to afford neuroprotection against certain toxic substances or conditions applied to some neuronal populations. Both the septal and hippocampal neurons responded to ethanol in a dosedependent manner. Survival of septal neurons was generally unaffected by initial ethanol concentrations of 0.6 and 1.2 g/dl but was considerably impaired by higher concentrations (1.8 and 2.4 g/dl), while neurite outgrowth was compromised by all ethanol concentrations except the lowest one applied. The hippocampal neurons survived ethanol concentrations up to 2.4 g/dl, although process extension was decreased in concentrations of 1.2 g/dl and higher. NGF or bFGF in the culture medium (in cultures without ethanol) did not affect neuronal survival or process outgrowth in either population, probably owing to the relatively high plating densities of the cultures. NGF did tend to have a moderate ameliorative effect on the ethanol neurotoxicity in the septal cultures, however, and was slightly effective in this regard in hippocampal cultures at intermediate ethanol concentrations (1.8 g/dl). High concentrations of ethanol (2.4 g/dl) reduced the proportion of cholinergic cells in the septal preparations by approximately 50%. This neuronal loss could be reversed by inclusion of high concentrations of NGF in the culture medium (100 ng/ml) but not by a lower concentration (20 ng/ml). bFGF provided some protection against ethanol cytotoxicity with respect to both populations. The implications of these results for studies of fetal alcohol effects are discussed, as well as their relation to prior reports of trophic factor neuroprotection. © 1994 Wiley‐Liss, Inc.
Patterns of hepatitis B prevalence and seroconversion in hemodialysis units from three continents: the DOPPS.

BACKGROUND Hepatitis B (HBV) historically has been a public health issue within hemodialysis units. This study estimates HBV prevalence and seroconversion rates across seven countries and investigates associations with facility level practice patterns. METHODS The study sample was from the Dialysis Outcomes and Practice Patterns Study (DOPPS), a cross-sectional, prospective, observational study of adult hemodialysis patients randomly selected from 308 dialysis facilities in France, Germany, Italy, Spain, the United Kingdom, Japan, and the United States. Logistic regression was used to model the odds ratio (OR) of HBV prevalence, and Cox regression was used to model time from entry into the study to HBV seroconversion. RESULTS In this sample, mean HBV facility prevalence was 3.0% with a median of 1.9%. The percentage of facilities with an HBV prevalence 0% to 5% was 78.5%. Adjusted HBV prevalence was higher in France, Germany, and Italy and lower in Japan and the United Kingdom. The majority of facilities (78.1%) had a seroconversion rate of 0 conversions per 100 patient-years. Presence of a protocol for HBV-infected patients was significantly associated with HBV seroconversion in the separate practice pattern model [risk ratio (RR) = 0.52, P = 0.03] and in the combined practice pattern model (RR = 0.44, P = 0.01). CONCLUSION There are differences in HBV prevalence and rate of seroconversion both at the country and the hemodialysis facility level. Presence of a protocol for HBV-infected patients was strongly and significantly associated with decreased risk for seroconversion. The observed variation suggests opportunities for improved HBV outcomes with further definition of optimal practice patterns at the facility level.
Corrosion at the marginal gap of implant-supported suprastructures and implant failure.

PURPOSE Late failure, which occurs after successful osseointegration, is usually attributed to prosthodontic determinants. Corrosion of metallic suprastructures and incorrectly handled materials are often primary causes of late implant failure. In this study, 6 implants whose failure was related to suprastructure metal corrosion and adjacent bone were investigated. MATERIALS AND METHODS Six implants as well as their suprastructures were analyzed for surface corrosion using light and scanning microscopy. Metal alloys and soldering compounds were analyzed using energy-dispersive x-ray analysis. Bone adhering to the implants was removed and analyzed for metal content using atom absorption spectroscopy. RESULTS Extensive corrosion lesions and areas of oxidation were detected on all 6 of the implants and inner crown surfaces. Bone tissue collected from 5 of the implants showed higher contents of metal ions in comparison to physiologic baseline values detected in healthy bone. DISCUSSION In spite of the high gold content of the suprastructure, corrosion occurred. Bonding oxides necessary for the process of fusing porcelain to gold will initiate corrosion. Apparently, once corrosion is initiated it rapidly progresses at the gap crevices, and toxic metal ions are released. These toxic ions diffuse into the peri-implant bone, causing bone structure breakdown and hastening osseodisintegration. CONCLUSION Biocompatible metals, alloys, and ceramics should be used for implant-supported suprastructures. It is also essential that gaps between the implant and its suprastructure be avoided by cementing the suprastructure or sealing the gap.
Renal Collecting Duct Epithelial Cells React to Pyelonephritis-Associated Escherichia coli by Activating Distinct TLR4-Dependent and -Independent Inflammatory Pathways1

TLR4 plays a central role in resistance to pyelonephritis caused by uropathogenic Escherichia coli (UPEC). It has been suggested that renal tubule epithelial cells expressing TLRs may play a key role in inflammatory disorders and in initiating host defenses. In this study we used an experimental mouse model of ascending urinary tract infection to show that UPEC isolates preferentially adhered to the apical surface of medullary collecting duct (MCD) intercalated cells. UPEC-infected C3H/HeJ (Lpsd) mice carrying an inactivating mutation of tlr4 failed to clear renal bacteria and exhibited a dramatic slump in proinflammatory mediators as compared with infected wild-type C3H/HeOuJ (Lpsn) mice. However, the level of expression of the leukocyte chemoattractants MIP-2 and TNF-α still remained greater in UPEC-infected than in naive C3H/HeJ (Lpsd) mice. Using primary cultures of microdissected Lpsn MCDs that expressed TLR4 and its accessory molecules MD2, MyD88, and CD14, we also show that UPECs stimulated both a TLR4-mediated, MyD88-dependent, TIR domain-containing adaptor-inducing IFN-β-independent pathway and a TLR4-independent pathway, leading to bipolarized secretion of MIP-2. Stimulation by UPECs of the TLR4-mediated pathway in Lpsn MCDs leads to the activation of NF-κB, and MAPK p38, ERK1/2, and JNK. In addition, UPECs stimulated TLR4-independent signaling by activating a TNF receptor-associated factor 2-apoptosis signal-regulatory kinase 1-JNK pathway. These findings demonstrate that epithelial collecting duct cells are actively involved in the initiation of an immune response via several distinct signaling pathways and suggest that intercalated cells play an active role in the recognition of UPECs colonizing the kidneys.