Miracle-dz/UniFAR-FTUs huggingface dataset:
Complications of Bioglue postsurgery for aortic dissections and aortic valve replacement

Aims Bioglue is an adhesive used during cardiovascular surgery to improve hemostasis perioperatively and to strengthen and reinforce vascular anastomoses. It has also been used to ‘seal’ the false lumen in patients presenting with acute aortic dissections. Herein, we examine the complications of Bioglue, which may lead to redo sternotomy in selected patients. Methods A review of pathology records at our institution from 2002 to 2010 found 4 cases of excised aortic tissue and/or aortic valves with previous Bioglue® use at initial operation. Excised tissues and valves were examined, looking for the presence of Bioglue®, inflammatory cells (acute, chronic, macrophage and giant cells) and micro-organisms. Patient demographics were also reviewed and recorded. Results We identified four cases of Bioglue use found at redo surgery, after the formation of pseudoaneurysm (n=3) and aortic stenosis (n=1). Mean interval to redo surgery was 2.28 + 0.32 years (range 2-2.6 years). Pseudoaneurysm formation was thought to be caused by an inflammatory reaction to the Bioglue® itself in two cases, while one case found no such reaction. One patient with previous aortic valve replacement had large annular abscesses filled with necrotic debris surrounding the prosthesis and pannus found on the sewing cuff, comprised of Bioglue® itself. Conclusions The mechanisms leading to these complications include mechanical strain, inflammation and tissue necrosis. The judicious use of Bioglue® when clinically indicated, and close follow-up of these patients with serial imaging, remain an integral part of avoiding future complications.
Current rapid tranquillisation documents in the UK: a review of the drugs recommended, their routes of administration and clinical parameters influencing their use

Background Despite not being underpinned by a strong evidence base, rapid tranquillisation is frequently the intervention of choice for dealing with violent and aggressive behaviour in psychiatric hospitals. This is the second of a two-part review of recommendations set out in UK trusts' adult rapid tranquillisation documents. In this article we focus on the drugs recommended, their routes of administration and clinical parameters influencing their use. Method A review of adult rapid tranquillisation documents currently in use in NHS or HSC trusts providing adult mental health services in the UK. Results A total of 45 rapid tranquillisation documents met the inclusion criteria and were examined. Sixteen drugs were recommended, via four separate routes of administration. Beyond the use of oral and IM lorazepam, haloperidol and olanzapine there was no consensus as to which drugs should be used for rapid tranquillisation in adults. Eleven clinical decision-making parameters were identified that influenced the selection of drugs for IM administration. However, the wide variation and sometimes absence of advice surrounding these parameters was concerning. Conclusions and implications for clinical practice The results of this review demonstrate that there is a need to rationalise rapid tranquillisation and develop consensus guidelines that allow for evidence based decision-making tools.
Predicting Growth in Child Abuse and Neglect Reports in Urban, Suburban, and Rural Counties

This study analyzes the different effects of demographic, social, and economic factors on the number of child abuse and neglect reports in 18 urban, suburban, and rural California counties over a 6-year period. Some of the findings demonstrate that in urban and rural counties, the number of arrests for narcotics and dangerous drugs in particular is positively linked to the number of child abuse and neglect reports. The findings can aid in the process of sharpening allocation methods for child welfare services and in determining where public efforts should be directed in order to reduce the incidence of child abuse and neglect.
Characteristics of auditory brainstem response latencies in children with autism spectrum disorders

Abstract Background: Hypersensitivity to loud sounds is commonly noticed in children with autism spectrum disorders. Objective and methods: This was a cross-sectional study that included 50 children, ages ranging from 1.5 to 3.33 years, divided into a study group of 25 autistic children with normal hearing and a control group of 25 normal hearing healthy children. The aim of this research was to the assess any abnormality in the loudness growth function objectively using auditory brainstem response (ABR), as well as to detect any ABR abnormalities in normal hearing autistic children with delayed language development. Results: Forty-four percent of normal hearing autistic children showed a lower threshold compared to healthy controls. They also showed significantly delayed wave III, but within-normal wave V, and consequently a longer inter-peak interval (IPI): I–III and shorter IPI: III–V, reflecting retro-cochlear dysfunction that may be related to their difficulty in communication. The mean slope of wave V latency intensity curve did not differ between autism and their controls, reflecting normal loudness growth. Male autistic children showed statistically significant longer latencies of wave V than females except at high intensities, but there was no statistically significant difference between them with regard to the mean slope of wave V latency intensity curve. Conclusion: Autistic children with normal hearing showed a within-normal loudness growth indicating that their abnormal reactions to sounds may either be phonophobia, an efferent system affection or a more central pathology that needs further evaluation. They also showed a retro-cochlear dysfunction that may be related to their difficulty in communication.
More than a quarter of India's youngsters have premarital sex

A quarter to a third of India's young people indulge in premarital sex, a new study conducted by the National Institute of Health and Family Welfare and suppressed by India's health ministry, has said. The study, coordinated by V K Tewari, surveyed premarital sexuality and unmet contraceptive needs among school and college students, young working men and women, and young people aged 15–24 years living in slums in Delhi and Lucknow. It concludes that premarital sex varies from 17% among schoolchildren to …
Human ERV3-1 env protein expression in various human tissues and tumours

Human endogenous retrovirus group 3 member 1 (ERV3-1) has been implicated in the pathogenesis of several human diseases, including tumours. The gene expression profiles of ERV3-1 could provide us with important insights into the pathogenic relationship between ERV3-1 and cancer. Several studies have explored the mRNA expression profiles of ERV3-1 in normal and cancer tissues.1–6 Although the importance of ERV3-1 has been demonstrated in human tissues and cancers, few studies have investigated the expression pattern of ERV3-1 protein in human tissues and tumours. Here, we analysed the expression pattern of ERV3-1 viral envelope (env) protein in adult human organs and in tumours using a tissue microarray. We also compared the expression of ERV3-1 between normal and tumour tissues to study the relationship between ERV3-1 and tumour formation. Tissue microarray slides were purchased from SuperBioChips (SuperBioChips Laboratories, Seoul, Korea). Around 60 patients’ normal or tumour surgical specimens were put on individual tissue microarray slides. The normal tissue and tumours were obtained from patient surgical specimens and no clinical information except for the age and gender of each patient was available for the obtained tissues. For immunohistochemical analysis, tissue microarray slides were immunostained with rabbit polyclonal antibody to ERV3-1 (1:500 dilution; ab116723, Abcam, Cambridge, Massachusetts, USA) and stained using the Dako EnVision System (DAKO, Carpinteria, California, USA). Background staining was measured by the immunostaining of all slides without primary antibody or rabbit immunoglobulin G (IgG), and also confirmed antibody specificity by western blot analysis (figure 1). For protein expression assessment, staining intensity was scored as negative (−), weak (+), moderate (++), and strong (+++). The focal intensity of …
Enteral nutritional therapy in septic patients in the intensive care unit: compliance with nutritional guidelines for critically ill patients

Objective Evaluate the compliance of septic patients' nutritional management with enteral nutrition guidelines for critically ill patients. Methods Prospective cohort study with 92 septic patients, age ≥18 years, hospitalized in an intensive care unit, under enteral nutrition, evaluated according to enteral nutrition guidelines for critically ill patients, compliance with caloric and protein goals, and reasons for not starting enteral nutrition early or for discontinuing it. Prognostic scores, length of intensive care unit stay, clinical progression, and nutritional status were also analyzed. Results The patients had a mean age of 63.4±15.1 years, were predominantly male, were diagnosed predominantly with septic shock (56.5%), had a mean intensive care unit stay of 11 (7.2 to 18.0) days, had 8.2±4.2 SOFA and 24.1±9.6 APACHE II scores, and had 39.1% mortality. Enteral nutrition was initiated early in 63% of patients. Approximately 50% met the caloric and protein goals on the third day of intensive care unit stay, a percentage that decreased to 30% at day 7. Reasons for the late start of enteral nutrition included gastrointestinal tract complications (35.3%) and hemodynamic instability (32.3%). Clinical procedures were the most frequent reason to discontinue enteral nutrition (44.1%). There was no association between compliance with the guidelines and nutritional status, length of intensive care unit stay, severity, or progression. Conclusion Although the number of septic patients under early enteral nutrition was significant, caloric and protein goals at day 3 of intensive care unit stay were met by only half of them, a percentage that decreased at day 7.
Allergic contact dermatitis to para‐phenylenediamine

Exposure to hair dye is the most frequent route of sensitisation to para‐phenylenediamine (PPD), a common contact allergen. International studies have examined the profile of PPD, but Australian‐sourced information is lacking. Patients are often dissatisfied with advice to stop dyeing their hair. This study examines patients' characteristics, patch test results and outcomes of PPD allergy from a single Australian centre, through a retrospective analysis of patch test data from 2006 to 2013 at the Liverpool Hospital Dermatology Department. It reviews the science of hair dye allergy, examines alternative hair dyes and investigates strategies for hair dyeing. Of 584 patients, 11 were allergic to PPD. Our PPD allergy prevalence rate of 2% is at the lower end of international reported rates. About half these patients also react to para‐toluenediamine (PTD). Affected patients experience a significant lifestyle disturbance. In all, 78% tried alternative hair dyes after the patch test diagnosis and more than half continued to dye their hair. Alternative non‐PPD hair dyes are available but the marketplace can be confusing. Although some patients are able to tolerate alternative hair dyes, caution is needed as the risk of developing an allergy to other hair dye ingredients, especially PTD, is high.
Modeling and characterization of the system-level Power Delivery Network for a dual-core ARM Cortex-A57 cluster in 28nm CMOS

Power delivery is a well-known challenge for high-end microprocessor systems. Comparatively, mobile computing platforms typically consume order-of-magnitude lower currents, but economic and volume constraints limit the quality of the Power Delivery Network. In addition, the trend towards GHz+ operating frequencies and the ubiquity of low-power techniques such as clock-gating and power-gating, make these systems susceptible to pathological AC transients. Consequently, mobile computing systems are ultimately limited by power-delivery. In this paper, we present the system-level Power Delivery Network (PDN) modeling, analysis and measurement results on a dual-core 64bit ARM Cortex-A57 compute cluster in 28nm CMOS. We present a comprehensive analysis of the PDN by characterizing the individual contribution of each constituent i.e. the PCB, package and the die. We present frequency- and time-domain simulation results and correlate that with measurement (both on-chip and off-chip). Our results demonstrate how complex software and micro-architectural interactions can trigger PDN resonances that ultimately lead to system failure.
Cobas 4800 HPV detection in the cervical, vaginal and urine samples of women with high-grade CIN before and after treatment

Aims To assess the performance of a clinically validated human papillomavirus (HPV) test (the Cobas 4800 HPV test) in urine and self-taken vaginal specimens within a colposcopy population and to assess HPV prevalence before and after treatment across the different biospecimens. Methods A total of 100 women attending a colposcopy clinic provided three biospecimens (a clinician-taken liquid-based cytology sample (LBC), a self-taken vaginal sample and a urine sample) for HPV testing. HPV prevalence and concordance was compared across the biospecimens and clinical performance relative to the detection of cervical intraepithelial neoplasia (CIN)2+ and CIN3+ was assessed. A total of 39 women retuned at 6 months for a post-treatment follow-up appointment, and HPV concordance in all biospecimens was measured relative to their original HPV status. Results 65 cases of CIN2+ were detected in the baseline population; sensitivity for CIN2+ was 92% (82 to 97) for the vaginal and the LBC sample and 80.0 (68% to 88%) for the urine sample. In the follow-up (post treatment) population, women were twice as likely to be HPV positive in their urine or vaginal sample compared with the equivalent LBC sample. Conclusions Vaginal and LBC samples showed very similar performance for the detection of CIN2+ in this population using the Cobas HPV test; further validation of these findings in screening contexts will be of value. Self-taken samples may have less utility in a ‘test of cure’ setting—given the higher prevalence of HPV relative to LBC.
Eruption on the dorsal hand

A 62-year-old man presented with a 3-week history of a painful enlarging lesion over the dorsum of his left hand. There was no associated fever, night sweats, weight loss or bowel symptoms. On examination, there was a large pustular plaque with haemorrhagic bullae with central ulceration and circumferential erythema over the dorsum of the left hand (Fig. 1a). There was also an oedematous erythematous papule overlying the right wrist (Fig. 1b). Blood testing revealed a raised erythrocyte sedimentation rate of 28 but a normal full blood count. Renal and liver function were normal. He received a 2-week course of empirical oral antibiotics (co-amoxiclav) for a suspected bacterial soft tissue infection. Given the lack of clinical improvement, bacterial resistance to the initial antibiotics was suspected and he was admitted and treated with an antibiotic regime consisting of i.v. teicoplanin, oral ciprofloxacin and oral clindamycin. Despite 3 days of i.v. therapy there was no resolution of the lesion.
The microbiome and atopic eczema: More than skin deep

Discoveries in the defective molecular composition of the epidermal barrier, such as the epidermal protein filaggrin, in those with atopic eczema (or atopic dermatitis [AD]) have proved crucial in understanding this disease, but its aetiology remains to be fully elucidated. The epidermal barrier is just one interface between the microbial world and our immune system. Recent advances in molecular technology have demonstrated for the first time the true scale of the normal human microbiome and changes seen in disease states. In this review article we discuss the role of the human microbiome in the aetiology and maintenance of AD. The role of Staphylococcus aureus within the skin microbiome is examined, in addition to the role of other bacteria and fungi, identified using novel culture‐independent methods. The significant contribution of the gut microbiome and its manipulation via probiotic use is also reviewed. We emphasise that the microbiome of separate systems, including the gut, has a significant role to play in the manifestation of this cutaneous disorder. To date, there has been a lack of studies investigating whether changes to the lung microbiome may play a role in AD. An early interaction between the microbiome and immune system via multiple routes (skin–gut–lung) could feasibly affect the risk of a subsequent development of atopic diseases. When making management decisions for AD patients, clinicians must be mindful of the role of the microbiome.
Next-generation sequencing in the genomic profiling of synchronous colonic carcinomas: comment on Li et al (2015)

Colorectal cancer (CRC) occurs as multiple, either synchronous or metachronous, neoplasms in 2–5% of the patients.1 Their onset may reflect either independent primaries or a metastatic spread from an original single neoplastic site. A careful pathological workup in order to clarify the origin of multiple colonic tumours is crucial to guide treatment. However, in some instances this distinction is challenging, requiring an accurate characterisation of the individual tumours, as exemplified by the case reported by Li et al . 2 Indeed, in this study, two synchronous CRCs shared similar histology, immunohistochemical features and even the same microsatellite instability profile; thus, a lymphovascular metastatic spread was considered the most likely underlying mechanism. Though, KRAS testing, performed by real-time PCR using Taqman probes, detected a mutation in only one tumour. This demonstration of a distinct clonal origin of the two neoplasms led to a combined drug treatment suitable for both lesions. While in this case, simply testing for KRAS was sufficient to clarify the distinct nature of …
Intestinal parasitic infections in renal transplant recipients

The impact of intestinal parasitic infection in renal transplant recipients requires careful consideration in the developing world. However, there have been very few studies addressing this issue in Iran. This study was conducted to determine the prevalence of intestinal parasitic infections in renal transplant recipients in Iran. Stool specimens from renal transplant recipients and control groups were obtained between June 2006 and January 2007. The samples screened for intestinal parasitic infections using direct smear, formalin-ether sedimentation, Sheather's flotation and modified Ziehl-Neelsen staining methods. Out of 150 renal transplant recipients, 33.3% (50), and out of 225 control group, 20% (45) were infected with one or more type of intestinal parasites. The parasites detected among patients included Entamoeba coli (10.6%), Endolimax nana (8.7%), Giardia lamblia (7.4%), Blastocystis spp. (4.7%), Iodamoeba butschlii (0.7%), Chilomastix mesnili (0.7%) and Ascaris lumbricoides (0.7%). Multiple infections were more common among renal transplant recipients group (p < 0.05). This study highlights the importance of testing for intestinal parasites among Iranian renal transplant recipients. Routine examinations of stool samples for parasites would significantly benefit the renal transplant recipients by contributing to reduce severe infections.
Decreased Platelet Free Magnesium with Increased Free Calcium in Mild Essential Hypertension

Intracellular free magnesium and calcium concentrations of platelets from 21 mild essential hypertensive patients and 8 normotensive individuals were measured using mag-fura2, a recently developed fluorescent indicator, and fura2, respectively. Compared with normotensives, intracellular free magnesium concentration was significantly decreased (0.32±0.10 vs. 0.50±0.15mmol/l, mean±SD, p<0.001) and intracellular free calcium concentration was significantly increased (40.2±9.0 vs. 21.7±11.8 nmol/l, p<0.001) in the hypertensives. In all subjects, mean blood pressure correlated negatively with intracellular free magnesium (r=-0.57, p<0.001) and positively with intracellular free calcium (r=0.48, p<0.02). Furthermore, intracellular free magnesium correlated negatively with intracellular free calcium. In contrast, serum and intraerythrocyte magnesium concentrations did not differ between the two groups. These results suggest that the decreased intracellular free magnesium of platelets concomitant with the increased intracellular free calcium may participate in the pathophysiology of essential hypertension. (Hypertens Res 1992; 15: 105-110)
Health services research methods

Health services research methods , N Black, J Brazier, F Fitzpatrick, B Reeves, eds, pp xii + 268. BMJ Books, London, 1998. £30 (£28 to BMA members), paperback. ISBN 1 85996 271 8. ★★★★ This book provides a detailed description and assessment of all aspects of health services research. The first two sections describe how health and disease can be measured and the types of study designs available to test new interventions and technologies. Examples of topics included …
Assessment of the family function perception and social support levels of mothers of children with Down syndrome.

Objective: The purpose of this study was to evaluate the family function perception and social support levels of mothers of the children with Down syndrome. Methods: This descriptive study was conducted in seven private education and rehabilitation centers affiliated to three District National Education Directorates in city centers between 15 March 2012 and 28 February 2013. The study was conducted with mothers of 63 children with Down syndrome, who accepted to participate in the study, without using the method of sample group selection. The data were collected using the Questionnaire, Family Evaluation Scale, and Multidimentional scale of the perceived social scale. Percentiles, means, Kruskal-Wallis test, Mann-Whitney U test and correlation analysis were used to assess the data. Results: Evaluating the relation between the perception of the family functions and the perceived social support; it was determined that regarding family function perception of mothers, there was a significant inverse relation between their scores of subscales “Problem Solving”, “Communication”, “Roles”, “General Functions” and their total score. There was similar relation between their scores of social support dimensions of “Perceived from Family, Friend and a Significant Other” and their total social support score.Besides, there were significant inverse correlations between scores of the “Affective Involvement” and “Behavioral Control” subscales of the perception of family functions and scores of the social support dimension of “perceived from the family, a significant other” and total score. Conclusion: The results revealed that mothers of the children with Down syndrome fulfill their family functions, while the mothers having higher levels of social support carry out the family functions more effectively.