Miracle-dz/UniFAR-FTUs huggingface dataset:
Direct nipple ureteroneocystostomy in adults with primary obstructed megaureter.

PURPOSE We evaluated the results of direct nipple ureteroneocystostomy technique in adults with primary obstructed megaureter. MATERIALS AND METHODS Five patients with a mean age of 32.5 years had a total of 6 primary obstructed megaureters with complaints of flank pain. Two patients were female and 3 were male. In patient 1 disease was bilateral, in 3 it was on the right side and in 1 it was on the left side. In male patient 1 a thick walled right ureter could be directly inserted into the bladder without eversion or tapering. The left nipple was created with spatulation. In 2 cases the ureters were thin walled (2 mm or less) and the nipples were created without spatulation. In the other 2 cases the nipples were created following spatulation since the ureteral walls were thicker (2 to 3 mm). RESULTS Mean followup was 36 months. Flank pain complaints resolved in the postoperative period. Early postoperative Whitaker tests revealed nonobstructed renal units. At later followup visits excretory urograms and/or ultrasound showed partially resolved hydroureteronephrosis. CONCLUSIONS Ease of application, a high success rate and no need to taper or plicate the ureter, or prepare a submucosal tunnel might be the reasons to consider the direct nipple technique for megaureters of different etiologies.
Infections in Acute Older Stroke Inpatients Undergoing Rehabilitation

Objective The present study compares the incidence of various infections among patients in acute and rehabilitation wards and examines the risk factors and pathogens involved in rehabilitation ward infections. Design The study included 341 acute stroke patients (age, ≥65 yrs). The assessment of risk factors was done by comparison of patients with or without infection, urinary tract infection, and pneumonia. Possible precipitating factors in each comparison were included in the statistical analysis. Results Ninety-five (27.9%) patients experienced infections, and the most common type in the rehabilitation ward was urinary tract infection. The frequency of incidence of pneumonia in the rehabilitation ward (6.7%) was significantly lower than in the acute ward (23.8%) (P < 0.001). Patients with infection had a longer rehabilitation ward stay compared with those without infection (30.9 vs. 18.8 days, P = 0.002). A postvoid residual urine volume greater than 50 ml (odds ratio, 2.314; 95% CI, 1.204–4.448, P = 0.012) was found to be the most important risk factor for infection. Conclusions Infection may prolong the length of stay in acute stroke patients in a rehabilitation ward. The present study provides important information for clinicians to help identify risk factors for infection.
CDC Cardiosphere Derived Cell VRD Ventricular Restraint Device PTCA Percutaneous Transluminal Coronary Angioplasty Graphical

The spectrum of ischemic cardiomyopathy, encompassing acute myocardial infarction to congestive heart failure is a significant clinical issue in the modern era. This group of diseases is an enormous source of morbidity and mortality and underlies significant healthcare costs worldwide. Cardiac regenerative therapy, whereby pro-regenerative cells, drugs or growth factors are administered to damaged and ischemic myocardium has demonstrated significant potential, especially preclinically. While some of these strategies have demonstrated a measure of success in clinical trials, tangible clinical translation has been slow. To date, the majority of clinical studies and a significant number of preclinical studies have utilised relatively simple delivery methods for regenerative therapeutics, such as simple systemic administration or local injection in saline carrier vehicles. Here, we review cardiac regenerative strategies with a particular focus on advanced delivery concepts as a potential means to enhance treatment efficacy and tolerability and ultimately, clinical translation. These include (i) delivery of therapeutic agents in biomaterial carriers, (ii) nanoparticulate encapsulation, (iii) multimodal therapeutic strategies and (iv) localised, minimally invasive delivery via percutaneous transcatheter systems.
SCREENING AND MOLECULAR CHARACTERIZATION OF WHITE ROT FUNGI CAPABLE OF LACCASE PRODUCTION AND DYE DECOLOURIZATION

This study describes the isolation of white rot fungi, their molecular characterization and screening for their ability to produce laccase and decolourize the synthetic dyes. Twenty two white rot fungi were isolated from the collected fruiting bodies and screened for their ability to produce laccase. Of these, ten isolates were laccase producers. Among the laccase producing fungi, three isolates namely LCJ155, LCJ164 and LCJ169 were also efficient in synthetic dye decolourization. The three promising isolates were identified by conventional and molecular methods. Fungal DNA was extracted, ITS-rDNA amplified by PCR, and ITS regions were sequenced. Based on the molecular characterization, the novel laccase producing isolates was identified as Pleurotus floridanus LCJ155 (Accession no. KF373566), Leucocoprinus cretaceus LCJ164 (Accession no. KF383135) and Agaricus sp. LCJ169 (Accession no. KF383136). The three isolates LCJ155, LCJ164 and LCJ169 can therefore be used in developing an eco-friendly technology for bioremediation of the dye containing effluents from dyestuff industries.
Gene expression changes in the retina following optic nerve transection.

PURPOSE To obtain and analyze the gene expression profiles of the retina following optic nerve transection (ONT). METHODS An axotomy animal model was generated by taking a cross section of the optic nerve with care not to damage the adjacent blood supply. The extent of cell loss was evaluated by counting cells in the ganglion cell layer (GCL) of flat-mounted retinas stained with cresyl violet. Gene expression profiles of control and ONT retinas were analyzed with Agilent's rat oligo microarray slides. Differentially expressed genes were identified from three independent experiments and clustered based on their functions with expression analysis systematic explorer software. Real-time quantitative and semiquantitative RT-PCR were used to validate changes in gene expression levels. RESULTS Gene expression changes in axotomized retinas were analyzed with rat oligo microarray slides containing 22,575 oligonucleotide probes that represent over 20,000 genes and expressed sequence tags (ESTs). The expression of 493 genes was increased more than 1.5 fold, including 85 that were upregulated more than 2 fold, and the expression of 113 genes was decreased 1.5 fold or more, including 21 that were downregulated more than 2 fold. Differentially expressed genes were clustered based on their functions. Several novel genes expressed in the GCL have been identified and their expression patterns in different tissues were analyzed. Among the genes differentially regulated in retinas with induced retinal ganglion cell (RGC) death, we have identified 13 genes that are mapped to known glaucoma loci and can be considered for mutation screening in patients with inherited forms of glaucoma. CONCLUSIONS The gene expression profiles of the ONT retinas can be used to identify RGC-expressed genes, which may be essential for the morphological and physiological characteristics of RGCs. The results of this study can also be used to evaluate the molecular changes taking place in the retina in response to RGC loss.
Auditory Neuropathy: An Update

Objectives: To describe the round window electrocochleography (RWECochG) and electric auditory brainstem responses (EABR) in ears affected by auditory neuropathy (AN), and to determine if these electrophysiological tests can predict the outcome following cochlear implant surgery. Methods: A longitudinal study of all pediatric cochlear implant patients between 1994 and 2005 was undertaken. Speech perception outcomes after cochlear implantation and electrophysiological data were collected prospectively and analyzed. Some otoacoustic emissions (OAE) data were collected retrospectively during the neonatal period. All subjects were tested using round window electrocochleography (RWEcochG), auditory brainstem responses (ABR), and implant-evoked electric auditory brainstem responses (EABR). The auditory neuropathy (AN) group consisted of 39 children (78 ears) which had present OAE and absent or grossly abnormal ABR (a broad N1 component only). Results: All 78 ears from the 39 AN children showed large cochlear microphonics (CM) and an abnormal positive potential (APP) using RW ECochG. A further 21 children showed large CM and APP but had not been tested for OAE. In total, 60 children were discovered to have APP among 435 pediatric patients who received a cochlear implant. Electrically evoked ABR (EABR) from the implanted ear were normal in 45 and abnormal in 15. 46 age matched patients without large CM and APP were used as a control group. Two year postimplant scores (Melbourne categories) were: 6.27 (APP and normal EABR), 2.25 (APP and abnormal EABR) and 5.37 (control group). Mann-Whitney U Test for nonparametric data was used to test for significant difference at significance level p < 0.005 (two tailed). The APP ears which provided normal EABR had significantly better outcomes after cochlear implantation than APP ears which had abnormal EABR. Furthermore, the APP ears which provided normal EABR performed significantly better after cochlear implant surgery than the control group of patients with no OAE, appropriate ABR results and normal EABR. Conclusions: Ears affected by AN provide large CM and APP on RW ECochG. The presence of normal EABR may indicate a significantly better outcome after cochlear implant surgery than for those APP ears which had abnormal or absent EABR. Based on these findings it is suggested that the presence of APP and/ or OAE in 75% of the ears which have absent or abnormal ABR may not indicate a pathological condition affecting the auditory nerve or synapse but only survival of outer hair cells despite extensive loss of inner hair cells.
Perception of Active and Passive Turning in Parkinson Disease

Background. Many individuals with Parkinson disease (PD) experience difficulty with turning, yet little is known about the reasons for this difficulty. Objective. The authors sought to determine whether individuals with PD can use visual, vestibular, and proprioceptive cues to estimate how far they have turned. Methods. Fifteen PD subjects and 11 controls performed active and passive turns to the left and right, with and without vision, with amplitudes of 90, 180, 270, and 360 degrees. For active conditions, subjects were told the direction and amplitude of the desired turn and then attempted to turn in place the specified amount via actively stepping. For passive conditions, subjects were told that the disc they stood on would turn and they were to press a button when they had traveled the specified amplitude. Results. There were no differences between PD and control groups in any of the conditions, suggesting that those with PD effectively used sensory cues available in the different conditions to accurately judge distance turned. The authors found no apparent deficits in the visual, vestibular, or proprioceptive systems or in integration of these senses for performance of the turning task tested. Conclusions. Turning difficulties associated with PD may more likely relate to motor or sensorimotor integration deficits than to pure sensory or sensory integration deficits. Generalizability of the study may be limited by the fact that subjects were tested at a single velocity for passive rotations, were on medication, and had relatively mild PD (primarily H&Y 2).
Prognostication of diffuse large B-cell lymphoma in the rituximab era

Predicting the prognosis of patients diagnosed with diffuse large B-cell lymphoma (DLBCL) has been a moving target over the last several years. While earlier prognostic models relied mainly on such clinical variables as age, stage of disease, and performance status, it has become evident from gene-expression microarray studies that DLBCL is a heterogeneous disease in terms of molecular pathogenesis and cell of origin. Despite providing considerable insight into disease biology, these techniques are not widely available and are, at least at present, not applicable to routine clinical practice. Furthermore, older prognostic models need to be revalidated and modified as improved therapeutic options become available. In this review, we discuss pertinent studies on individual biomarkers and pattern-based biomarker models, with an emphasis on markers evaluated in patients treated with rituximab-containing chemotherapy. We also discuss recent and ongoing therapeutic trials using drugs that target molecular markers and pathways involved in the pathogenesis of DLBCL or those that adversely influence prognosis. The ultimate goal of these efforts is to refine prognostication of DLBCL using widely available, reproducible, and consistently predictive biomarker models applicable to currently used chemoimmunotherapy, and to create a pathophysiologically based framework for the rational design of individually tailored therapy.
Regional differences in outcomes for hospitalized injured patients.

BACKGROUND Our goal was to use a hospital population-based data set that was a sample of all injured patients admitted to a hospital in the United States to develop universal measures of outcome and processes of care. METHODS Patients with a primary discharge diagnosis of injury (ICD-9 800 to 959) in the HCUP/Nationwide Inpatient Sample for the years 1995 to 2000 were used to estimate the annual number of hospitalized injured patients. Using census data, we calculated age- and sex- adjusted average annual incidence rates for four census regions in the United States: Northeast, Midwest, South and West. Outcomes measured were annual rates per million populations of hospitalization rate, death rate, and potentially ineffective care (PIC) rate defined as >28 days of hospitalization ending in death. Length of stay (LOS) was calculated as total number of days annually hospitalized for injury for census regions per million populations. RESULTS Incidence rates per million populations and 95% confidence intervals for rate of hospitalizations for injury were: Northeast, 5596 (5338-5853); Midwest, 5516 (5316-5716); South, 5639 (5410-5869); West, 5307 (5071-5543). Incidence rates per million populations and 95% confidence intervals for rate of in-hospital deaths were: Northeast, 129 (119-139); Midwest, 131 (122-139); South, 141 (129-152); West, 114 (106-123). Incidence rates per million populations and 95% confidence intervals for rate of PIC were: Northeast, 11 (10-13); Midwest, 5 (4-5); South, 6 (5-7); West, 4 (3-4). Incidence rates per million populations and 95% confidence intervals for hospital days were: Northeast, 34 (32-36); Midwest, 30 (28-31); South, 30 (29-32); West, 26 (24-27). CONCLUSION Regional differences in outcomes and processes of care for hospitalized injured patients exist and may be influenced by hospital characteristics and region of the country. Research to identify the factors that cause these hospital and regional variations is needed. These observations suggest that to develop a uniform standard for quality of care, it will be essential to have valid and robust hospital population-based measures.
Anxiety Sensitivity and Reactivity to Asthma-Like Sensations Among Young Adults With Asthma

Anxiety sensitivity, particularly the physical concerns domain, is associated with more problematic asthma symptoms and greater functional limitations. It has been theorized that anxiety sensitivity fosters greater reactivity to asthma-related physical sensations; however, this theory has yet to be empirically tested. Thus, the present investigation sought to examine the role of anxiety sensitivity–physical concerns in terms of affective and physical reactivity to asthma-like symptoms. Participants were 101 undergraduates with asthma (76.2% female, Mage = 19.69 years, SD = 3.77 years, range = 18-49 years) who completed self-report measures and a straw-breathing task. Results indicated that after controlling for the effects of gender, asthma control (i.e., how well one’s asthma symptoms are managed or controlled), and negative affectivity, greater levels of anxiety sensitivity–physical concerns significantly predicted greater anxiety (4.7% unique variance) and asthma symptoms (6.9% unique variance) and lower levels of lung function (4.4% unique variance) after the straw-breathing task. These findings suggest that individuals with asthma who are fearful of physiological arousal are a particularly “at-risk” population for poor asthma outcomes because of this greater reactivity and could benefit from interventions targeting anxiety sensitivity.
Programme-related stressors among part-time undergraduate nursing students.

AIM The aim of this paper is to report a study exploring the perceived stressors identified by a group of 70 students who undertook a part-time degree at one Irish university. BACKGROUND In the literature on stress, part-time nursing students who are undertaking continuing education programmes appear to have received little attention. Stress amongst nurses is evident within the nursing literature but little information is available on the specific stressors that affect Registered Nurses who undertake further academic study. Anecdotally, students attending part-time programmes while working full-time report high levels of stress. METHOD Quantitative methods were used. While many instruments exist to measure overall stress, this study aimed to explore student's perceptions of specific stressors associated with academic study. We used a questionnaire developed from the literature on the topic. RESULTS Factors related to writing assignments at degree level, fulfilling personal needs and academic demands, were perceived as major stressors by these students. Factors of little concern were financial issues and attendance on the programme. Individual items receiving highest mean scores were: trying to balance work commitments and the required study (mean 3.89, sd = 1) and the prospect of the final examination (mean 3.86, sd = 1). This study was limited by the use of convenience sampling and self-report methods. Larger studies are required to support the findings. In addition, student stress was not observed or measured. CONCLUSION Those involved in the delivery of nurse education programmes to part-time students need to consider the impact of the workload on student welfare, and to prepare students for demands of the programme.
Genetics of resistance in a non-beta-lactamase-producing gonococcus with relatively high-level penicillin resistance

A penicillin-resistant (Penr) non-penicillinase-producing Neisseria gonorrhoeae strain responsible for an outbreak affecting 199 persons in Durham, N.C. , in 1983 was studied to determine the genetic basis of its unusually high-level (MIC, 2.0 micrograms/ml) Penr. Plasmid screening of the strain revealed no plasmids other than the 2.6-megadalton cryptic plasmid. Penr was found to be partially due to mutations genotypically and phenotypically similar to the previously characterized chromosomal loci penA, mtr, and penB. Resistance loci from the epidemic donor strain were transformed into susceptible recipients FA19 and F62 in a stepwise fashion; the combination of the three loci resulted in moderate levels of penicillin resistance (MIC, 0.5 micrograms/ml), but donor levels of resistance were not obtainable in either recipient, for uncertain reasons. Occurrence of an antibiotic-susceptible (env) mutation in a clinical isolate of the Penr epidemic strain also was documented.
Six months later: The effect of Hurricane Katrina on health care for persons living with HIV/AIDS in New Orleans

Abstract Nearly 13,000 Louisiana residents with HIV/AIDS were estimated to be living in areas affected by Hurricane Katrina. Although minimal general outpatient primary care services were available within a few weeks following the hurricane in New Orleans, access to antiretroviral medications was an early problem. The largest HIV care provider, the Medical Center of Louisiana at New Orleans HIV Outpatient Program (HOP), was able to assist in obtaining medications mid-October and opened an HIV clinic the first week of November in a temporary location. Services have slowly expanded in the five months since the HOP clinic opened but remain limited. Six months following the hurricane, microbiologic studies are still unable to be performed in clinic and uninsured patients must travel at least 70 miles for subspecialty care. The authors suggest recommendations for disaster planning for other centers caring for persons with HIV/AIDS based on the New Orleans experience.
Possibilities for Inter-Destination Collaboration in Tourism in the Case of Opatija and Portorož: A Managerial Perspective

Intense competition among tourist destinations raises interest in inter-destination collaboration as a tool for developing innovative inter-destination products. The study presented in this paper examined the motives, barriers and expected outcomes of inter-destination collaboration in two Mediterranean tourist destinations – Opatija and Portorož – that are recognised as good mutual substitutes for tourists. Twenty management-level representatives of tourism or tourism-related organisations in Opatija and Portorož were interviewed to evaluate how they perceived inter-destination collaboration. The study revealed that inter-destination collaboration is recognised as an important tool for bridging the tourism destination products that are designed internally in order to develop inter-destination products. The study also revealed the motives for inter-destination collaboration based on the destinations’ complementarity, collaboration barriers based on the destinations’ similarities as well as differences and outcomes that are expected from inter-destination collaboration that bridges the tourism products developed separately in each destination. Participants expressed positive attitudes towards an innovative tourist offer and arrangements for the new and distant markets aiming to overcome the seasonality and upgrade the quality of destination products. Furthermore, the findings indicated that inter-destination collaboration might be successfully employed between destinations with poor intra-destination collaboration that are close substitutes. Practical implications of the results are discussed and further research is considered.