Miracle-dz/UniFAR-FTUs huggingface dataset:
What is the effect of combining artesunate and praziquantel in the treatment of Schistosoma mansoni infections?

Summary A group of 110 individuals with Schistosoma mansoni infection was investigated. Patients were allocated to one of three treatment groups and given artesunate or praziquantel alone or both in combination. Combined artesunate–praziquantel significantly increased the number of individuals cured at 5 weeks post‐treatment, but at 12 weeks was only better than artesunate alone and at 24 weeks there was no statistically significant difference between the three groups. Egg count reduction rate was similar to the rate obtained with praziquantel used alone.
Left ventricular hypertrophy in aortic valve stenosis: friend or foe?

revision. 11 12 There are several mechanisms by which excessive LVH may be related to the outcome of patients with AS. It has been shown that left ventricular systolic function declines as hypertrophy develops, increasing the risk of heart failure. 6 Due to afterload dependence, systolic chamber function may be difficult to quantify in the presence of AS. As left ventricular volumes become smaller due to concentric remodelling, stroke volume is reduced, sometimes leading to the ‘paradoxical low-flow AS’ phenomenon. 13 Despite normal ejection fraction, patients with this condition show higher values of concentric remodelling and smaller ventricles than their normal-flow counterparts. In paradoxical low-flow AS, reduced output is believed to result in the combination of systolic and diastolic dysfunction. Under stress situations, the heart may fail to provide adequate output, and patients with paradoxical low-flow AS show an adverse prognosis, particularly if they do not undergo valve replacement. 14
Metaprogramming GPUs with Sh

Shading, as part of the creation of realistic computer-generated images, is currently bringing major advances to computer graphics, with important practical applications in computer game design and animation. Shaders are a more sophisticated way of making 3D objects look more realistic. While most shaders are created using proprietary shading languages, Sh, a new open-source system, simplifies the shader programming process by making it part of the C++ language. This book introduces Sh and describes how to program a GPU using C++ to implement both basic and advanced shading techniques. Readers of this book will be able to start writing advanced, modular shaders using Sh within a day!
Decrease in serum LDL cholesterol with microcrystalline chitosan.

Peroral microcrystalline chitosan (MCCh; 3 capsules, each 400 mg b.i.d.) or placebo was given for 8 weeks in a double-blind manner to 51 healthy obese women just before routine hospital and home meals. Weight records, serum lipids (total, LDL and HDL cholesterol, triglycerides) and safety laboratory parameters were monitored before the trial and at 4, 6 and 8 weeks of treatment. In a subgroup of subjects with a body mass index > or = 30 who had not changed their eating habits, serum LDL cholesterol decreased 0.57 +/- 0.72 mmol/l (n = ll) at 4 weeks in the MCCh group and 0.10 +/- 0.60 mmol/l (n = 14) in the placebo group (p < 0.05). At 8 weeks, LDL cholesterol reduction was 0.48 +/- 0.91 mmol/l in the MCCh group and 0.26 +/- 0.57 mmol/l in the placebo group (p > 0.1). In all subjects, the reduction in LDL cholesterol at 4 weeks was 0.48 +/- 0.72 mmol/l (n = 24) in MCCh subjects and 0.18 +/- 0.58 mmol/l (n = 27) in placebo subjects (p = 0.057), and 0.52 +/- 0.69 mmol/l and 0.31 +/- 0.63 mmol/l, respectively, at 8 weeks (p > 0.1). MCCh did not significantly alter serum total and HDL cholesterol (p > 0.1), but slightly increased serum triglycerides compared to placebo (p = 0.015-0.06). No reductions in weight were observed in any treatment group. Chitosan was well tolerated and no serious adverse events or changes in safety laboratory parameters were noted including serum fat-soluble vitamins A and E, and serum Fe++ and transferrin.
Participatory Epidemiology Of Cattle Diseases among the Fulani Pastoralists in Bacita Market, Edu Local Government Area, Kwara State, North-central Nigeria

The Fulani pastoralists are the custodians of 90% of the Nigerian cattle population and represent a significant component of the Nigerian economy. Participatory epidemiology involves the systematic use of participatory approaches and methods to improve the understanding of diseases and provide options for control. We used focus group meeting, disease impact scoring, seasonal calendar and triangulation as participatory epidemiology methods to identify the most important cattle diseases that Fulani pastoralists encounter in Kwara state, North-central Nigeria. Eight diseases/symptoms were collectively identified by the Fulani pastoralists during the focus group meeting and disease impact scoring exercise as most important affecting their cattle. These are: leptospirosis ( Gabi-Gabi), FMD (Chabo), fasciolosis (Hanta), trypanosomiasis (Samore), haematuria (Taki), tick infestation (Duce), brucellosis (Kwanejie) and ear infection (Kune); local names in parentheses. The seasonal calendar created by the pastoralists described variations in disease occurrence and rainfall pattern over four seasons of the year. When rainfall patterns were compared with the state annual rainfall pattern, there were obvious differences in the early rainy and early dry seasons. This could be because pastoralists recognize the seasons from the amount of rainfall, rather than the calendar date. Participatory epidemiology techniques were effective in gathering information from Nigerian Fulani Pastoralists that might inform control policy for livestock diseases.
Comparison of pyogenic liver abscesses caused by hypermucoviscous Klebsiella pneumoniae and non-Klebsiella pneumoniae pathogens in Beijing: A retrospective analysis

Objective To perform a retrospective comparison of the clinical and radiological features of Klebsiella pneumoniae (KP)-associated and non-KP-associated pyogenic liver abscesses (PLA) in Chinese patients. Methods Patients with confirmed diagnoses of bacterial liver abscess at three Beijing hospitals were enrolled. Clinical isolates from liver abscesses were used to determine serology and expression of hypermucoviscosity genes. Basic clinical, ultrasonographic (US) and computed tomography (CT) data were recorded and compared between patients with KP- and non-KP-associated PLA. Results A total of 101 (77.10%) and 30 (22.90%) cases were due to KP and non-KP pathogens, respectively. Compared with the non-KP cohort, the KP cohort demonstrated a significantly higher incidence of underlying diabetes mellitus, and more gas-forming abscesses, as demonstrated by US and CT examinations. Prior abdominal surgery or chemoradiation therapy was significantly associated with non-KP cases. The non-KP group had a higher chance of a clear edge, compared with the KP group, on pre-contrast CT images. Conclusion KP and non-KP-associated PLA have distinctive risk factors and unique US and CT features, in Chinese patients.
Randomized Multicenter Placebo-Controlled Trial of Omega-3 Fatty Acids for the Control of Aromatase Inhibitor-Induced Musculoskeletal Pain: SWOG S0927.

PURPOSE Musculoskeletal symptoms are the most common adverse effects of aromatase inhibitors (AIs) and can result in decreased quality of life and discontinuation of therapy. Omega-3 fatty acids (O3-FAs) can be effective in decreasing arthralgia resulting from rheumatologic conditions and reducing serum triglycerides. PATIENTS AND METHODS Women with early-stage breast cancer receiving an AI who had a worst joint pain/stiffness score ≥ 5 of 10 using the Brief Pain Inventory-Short Form (BPI-SF) were randomly assigned to receive either O3-FAs 3.3 g or placebo (soybean/corn oil) daily for 24 weeks. Clinically significant change was defined as ≥ 2-point drop from baseline. Patients also completed quality-of-life (Functional Assessment of Cancer Therapy-Endocrine Symptoms) and additional pain/stiffness assessments at baseline and weeks 6, 12, and 24. Serial fasting blood was collected for lipid analysis. RESULTS Among 262 patients registered, 249 were evaluable, with 122 women in the O3-FA arm and 127 in the placebo arm. Compared with baseline, the mean observed BPI-SF score decreased by 1.74 points at 12 weeks and 2.22 points at 24 weeks with O3-FAs and by 1.49 and 1.81 points, respectively, with placebo. In a linear regression adjusting for the baseline score, osteoarthritis, and taxane use, adjusted 12-week BPI-SF scores did not differ by arm (P = .58). Triglyceride levels decreased in patients receiving O3-FA treatment and remained the same for those receiving placebo (P = .01). No between-group differences were seen for HDL, LDL, or C-reactive protein. CONCLUSION We found a substantial (> 50%) and sustained improvement in AI arthralgia for both O3-FAs and placebo but found no meaningful difference between the groups.
Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience.

CONTEXT Our experience with laparoscopic pancreatic resection began in 2001. During initial experience, laparoscopy was reserved for selected cases. With increasing experience more complex laparoscopic procedures such as central pancreatectomy and pancreatoduodenectomies were performed. OBJECTIVES The aim of this paper is to review our personal experience with laparoscopic pancreatic resection over 11-year period. METHODS All patients who underwent laparoscopic pancreatic resection from 2001 through 2012 were reviewed. Preoperative data included age, gender, and indication for surgery. Intraoperative variables included operative time, bleeding, blood transfusion. Diagnosis, tumor size, margin status were determined from final pathology reports. RESULTS Since 2001, 96 patients underwent laparoscopic pancreatectomy. Median age was 55 years old. 60 patients were female and 36 male. Of these, 88 (91.6%) were performed totally laparoscopic; 4 (4.2%) needed hand-assistance, 1 robotic assistance. Three patients were converted. Four patients needed blood transfusion. Operative time varied according type of operation. Mortality was nil but morbidity was high, mainly due to pancreatic fistula (28.1%). Sixty-one patients underwent distal pancreatectomy, 18 underwent pancreatic enucleation, 7 pylorus-preserving pancreatoduodenectomies, 5 uncinate process resection, 3 central and 2 total pancreatectomies. CONCLUSIONS Laparoscopic resection of the pancreas is a reality. Pancreas sparing techniques, such as enucleation, resection of uncinate process and central pancreatectomy, should be used to avoid exocrine and/or endocrine insufficiency that could be detrimental to the patient's quality of life. Laparoscopic pancreatoduodenectomy is a safe operation but should be performed in specialized centers by highly skilled laparoscopic surgeons.
Detection of candidaemia in high risk patients: Can yield of blood cultures be improved by blind subculture?

Rapid detection of candidaemia is crucial for timely antifungal chemotherapy. However, the sensitivity of automated blood culture (BC) systems has been questioned. Blind subculture might increase detection rate and possibly also reduce time to detection of candidaemia. This retrospective study aimed to evaluate the efficacy of blind subcultures in patients deemed at high risk of candidaemia. BCs were processed by the BacT/Alert BC system, and during a 5-y period (1998–2003) subculture on the third d of incubation was performed for patients selected by clinical and microbiological assessment. A total of 79,165 BCs were drawn during the study period. 2154 BCs from 285 patients were selected for subculture. 103 (4.8%) BCs from 52 patients were yeast positive; 71 were detected positive prior to the planned subculture, 25 were positive on subculture, and 7 were negative on subculture, but became positive during further incubation. The 25 BCs positive on subculture originated from 14 patients, 11 of whom had already been diagnosed with candidaemia during the previous 14 d. Thus, a primary diagnosis of candidaemia was obtained by subculture in only 3 (1.1%) of the 285 patients selected. In conclusion, in our clinical setting blind subculture did not materially increase the detection of candidaemia, but helped to document persistent infection in a subset of cases.
Tolerability, safety and efficacy of conventional amphotericin B administered by 24-hour infusion to lung transplant recipients.

BACKGROUND Fungal infections cause serious morbidity and mortality in lung transplant recipients. Expensive lipid formulations of amphotericin B (AmB) are generally used because of fear of adverse effects due to concomitant cyclosporine A and other nephrotoxic drugs. However, a 24-hour dosing regimen of AmB may be well tolerated even in these patients. METHODS In an open pilot study 6 out of 94 lung transplant recipients with invasive or semi-invasive bronchopulmonary azole-resistant candidal infections (3 paraspilosis, 2 glabrata, 1 krusei) were treated for 40 (17-73) days by 24-hour continuous infusions of AmB 1 mg/kg. Additionally, patients received at least 1000 ml of 0.9% saline intravenously per day. Beside cyclosporine A at serum trough levels of 240 (195-273) microg/l, five patients additionally received aminoglycosides for at least 2 weeks, and 4 were treated with ganciclovir. RESULTS Calculated creatinine clearance decreased from 57 (43-73) ml/min to a nadir of 35 (28-39) and recovered to 52 (33-60) after cessation of therapy. One patient needed temporary haemofiltration for 7 days after 30 days of AmB, most probably because of the use of contrast media in conjunction with furosemide and hypovolaemia. Besides three episodes of mild hypokalaemia no other side effects attributable to AmB were recorded. While in one case an asymptomatic candidal colonisation persisted for 10 months, the other 5 were cured from their infection. CONCLUSION These preliminary data show that conventional AmB administered by 24-hour infusion is well tolerated, safe, and efficacious in lung transplant recipients receiving cyclosporine A and other nephrotoxic substances.
Purification and partial characterization of outer membrane proteins P5 and P6 from Haemophilus influenzae type b

The major outer membrane proteins of Haemophilus influenzae type b (Hib), designated P5 and P6 (R.S. Munson, Jr., J.L. Shenep, S.J. Barenkamp, and D.M. Granoff, J. Clin. Invest. 72:677-684, 1983), were purified to homogeneity and partially characterized. P5 was insoluble in octylglucoside-NaCl and could be extracted with 1% sodium dodecyl sulfate (SDS) in 20 mM phosphate (pH 7.5). Solubilized P5 was further purified on hydroxylapatite in 0.1% SDS. The purified protein had an apparent molecular weight of 27,000 as determined by SDS-polyacrylamide gel electrophoresis after sample preparation at room temperature. The protein migrated with an apparent molecular weight of 35,000 after heating for 30 min at 100 degrees C in the presence of 10% beta-mercaptoethanol (beta ME). Rabbit antisera prepared against the purified preparation immunoprecipitated solubilized protein P5 but had no protective activity in the infant rat bacteremic model. The SDS-insoluble residue was further extracted with 1% SDS-0.5 M NaCl-0.1% beta ME at 37 degrees C. A single outer membrane protein, designated P6, with an apparent molecular weight of 16,000, remained insoluble under these conditions. Antiserum prepared against this insoluble fraction contained antibodies which, after removal of anti-lipopolysaccharide antibody, immunoprecipitated P6 and protected infant rats challenged with Hib. Protein P6 could be released from the insoluble cell wall in the presence of SDS-NaCl-beta ME at 60 degrees C. Thus, proteins P5 and P6 could be purified from the cell envelope of Hib. Based on the results from infant rat passive protection experiments, antigens in the P6-cell wall fraction merit further investigation as possible vaccine components. In contrast, epitopes on protein P5 did not appear to elicit protective antibody.
Pelvic and reproductive structures in placoderms (stem gnathostomes)

Newly discovered pelvic and reproductive structures within placoderms, representing some of the most crownward members of the gnathostome stem group and the most basal jawed vertebrates, challenge established ideas on the origin of the pelvic girdle and reproductive complexity. Here we critically review previous descriptions of the pelvic structures in placoderms and reinterpret the morphology of the pelvic region within the arthrodires and ptyctodonts, in particular the position of the pelvic fin and the relationship of the male clasper to the pelvic girdle. Absence of clear articular surfaces on the clasper and girdle in the Arthrodira, along with evidence from the Ptyctodontida, suggest that these are separate structures along the body. We describe similarities between the pectoral and pelvic girdles and claspers, for example, all these have both dermal and perichondral (cartilaginous) components. Claspers in placoderms and chondrichthyans develop in very different ways; in sharks, claspers develop from the pelvic fin while the claspers in placoderms develop separately, suggesting that their independent development involved a posterior extension of the ‘competent stripes’ for fin development previously limited to the region between the paired pectoral and pelvic fins. Within this expanded zone, we suggest that clasper position relative to the pelvic fins was determined by genes responsible for limb position. Information on early gnathostome reproductive processes is preserved in both the Ptyctodontida and Arthrodira, including the presence of multiple embryos in pregnant females, embryos of differing sizes and of different sexes (e.g. male claspers preserved in some embyros). By comparison with chondrichthyans, these observations suggest more complex reproductive strategies in placoderms than previously appreciated.
Genetic Polymorphisms and Haplotype Structure of the Organic Cation Transporter 1 Gene in the Zulu Population of South Africa

Organic cation transporter (OCT) 1could influence an individual’s response to various treatments and increase their susceptibility to diseases. Genotypic and allelic frequencies of nineteen non-synonymous and one intronic Single Nucleotide Polymorphism (SNP) from the OCT1 gene were determined in 101 unrelated healthy Zulu participants, using a SNaPshot multiplex assay. Minor allele frequencies (MAF) were compared to representative populations of Africa, Asia and Europe, from Ensembl. MAFs for S14F, V519F, rs622342 and P341L were 2.0%, 6.0%, 6.0% and 1.0%, respectively. Sixteen of nineteen investigated non-synonymous SNPs were monomorphic. No study participant harbored variant alleles for S189L, G220V, P283L, G401S, M420V, M440I, G465R, I542V, R61C, R287G, C88S, A306T, A413V, I421F, C436F and V501E. Haplotype, CGTCGCCGCGCAAGAGGTGA, was most frequently observed (81.23%). Further investigations are encouraged to evaluate potential roles these SNPs could play in the therapeutic efficacy of clinically important drugs and in the development of various diseases in the Zulu population. Keywords—OCT1, PCR, SNaPshot assay, Zulu population.
Elevated levels of MIC‐1/GDF15 in the cerebrospinal fluid of patients are associated with glioblastoma and worse outcome

For patients with brain tumors identification of diagnostic and prognostic markers in easy accessible biological material, such as plasma or cerebrospinal fluid (CSF), would greatly facilitate patient management. MIC‐1/GDF15 (growth differentiation factor 15) is a secreted protein of the TGF‐beta superfamily and emerged as a candidate marker exhibiting increasing mRNA expression during malignant progression of glioma. Determination of MIC‐1/GDF15 protein levels by ELISA in the CSF of a cohort of 94 patients with intracranial tumors including gliomas, meningioma and metastasis revealed significantly increased concentrations in glioblastoma patients (median, 229 pg/ml) when compared with control cohort of patients treated for non‐neoplastic diseases (median below limit of detection of 156 pg/ml, p < 0.0001, Mann–Whitney test). However, plasma MIC‐1/GDF15 levels were not elevated in the matching plasma samples from these patients. Most interestingly, patients with glioblastoma and increased CSF MIC‐1/GDF15 had a shorter survival (p = 0.007, log‐rank test). In conclusion, MIC‐1/GDF15 protein measured in the CSF may have diagnostic and prognostic value in patients with intracranial tumors. © 2009 UICC
The Social Context of Recovery

The findings of Stein et al.’s two-month longitudinal study regarding reactions, impairment and help-seeking following the terrorist attacks of September 11th, 2001, compel further exploration of the ways in which communal social functioning and individual social networking may serve either to reintegrate and reconnect community members or to pose complex challenges to the recovery process. Our commentary reflects our experience providing crisis intervention and disaster mental health services in the District of Columbia in the aftermath of September 11th, 2001, the anthrax contaminations of October, 2001, and the sniper shootings of October, 2002. For the District of Columbia, the impact of these tragedies must be considered in a social context whose characteristics include vast economic and educational disparity and chronic neighborhood violence. Social capital theory describes the phenomenon of bonding of like groups—social bonding that occurs at the family, neighborhood, and close friend level and among people who share demographic characteristics (Cullen and Whiteford 2001). These likenesses may create an “affinity group,” which we define as the phenomenon in which commonalities afford a mutually felt sense of belonging and may inform the interpretation of events for those within the group. Social capital theory also posits that bonding networks are key in information dissemination and the establishment of social and cultural norms. Thus, the concepts of bonding and affinity are determinants of trust that suggest mechanisms that should not be overlooked by preparedness planners and in the crafting of recovery interventions. With initial evidence of substantial distress in the New York City area following the September 11th attacks, Wave 2 of Stein et al.’s study (60-days post-event) found acute and localized distress to have substantially abated and to have become more evenly distributed across both rural and urban regions of the country. This study lends credibility to evidence of what the field has broadly termed the “new normal. ” While initial shock and distress levels have subsided, there remains persistent, widespread distress that, while not diagnostically significant, is significant in terms of social functioning and adaptation (North and Pfefferbaum 2002). Psychiatry 67(2) Summer 2004 158