Miracle-dz/UniFAR-FTUs huggingface dataset:
Population Pharmacokinetics and Pharmacodynamics of Doripenem in Obese, Hospitalized Patients

Background: Doripenem population pharmacokinetics and dosing recommendations are limited in obesity. Objective: To evaluate the population pharmacokinetics and pharmacodynamics of doripenem in obese patients. Methods: Hospitalized adults with a body mass index (BMI) ≥ 40 kg/m2 or total body weight (TBW) ≥45.5 kg over their ideal body weight received doripenem 500 mg every 8 hours, infused over 1 hour. Population pharmacokinetic analyses were performed using NONMEM, and Monte Carlo simulations were performed for 5 intermittent and prolonged infusion dosing regimens to calculate probability of target attainment (PTA) at 40% and 100% fT>MIC (free drug concentrations above the minimum inhibitory concentration). Results: A total of 20 patients were studied: 10 in an intensive care unit (ICU) and 10 in a non-ICU. A 2-compartment model with first-order elimination best described the serum concentration-time data. Doripenem clearance (CL) was significantly associated with creatinine CL (CRCL), volume of the central compartment with TBW and ICU residence, and volume of the peripheral compartment with TBW (P < 0.05). Using 40% fT>MIC, PTA was >90% for all simulated dosing regimens at MICs ≤2 mg/L. Using 100% fT>MIC, prolonged infusions of 1 g every 6 hours and 2 g every 8 hours achieved >90% PTA at MICs ≤2 mg/L. Conclusions: CRCL, ICU residence, and TBW are significantly associated with doripenem pharmacokinetics. Currently approved dosing regimens provide adequate pharmacodynamic exposures at 40% fT>MIC for susceptible bacteria in obese patients. However, prolonged infusions of larger doses are needed if a higher pharmacodynamic target is desired.
Peroxynitrite affects Ca2+ influx through voltage‐dependent calcium channels

The effect of peroxynitrite (OONO−) on voltage‐dependent Ca2+ channels (VDCCs) was examined by measuring [45Ca2+] influx into mouse cerebral cortical neurones. OONO− time‐ and dose‐dependently increased [45Ca2+] influx and this increase was abolished by manganese (III) tetrakis (4‐benzoic acid) porphyrin, a scavenger for OONO−. Inhibition of cyclic GMP (cGMP) formation did not alter the OONO−‐induced [45Ca2+] influx. OONO−, as well as 30 mm KCl, significantly increased fluorescence intensity of cell‐associated bis‐(1,3‐dibutylbarbituric acid) trimethine oxonol (bis‐oxonol). Tetrodotoxin and membrane stabilizers such as lidocaine dose‐dependently suppressed OONO−‐induced [45Ca2+] influx. Although each of 1 µm nifedipine and 1 µmω‐agatoxin VIA (ω‐ATX) significantly inhibited the OONO−‐induced [45Ca2+] influx and the concomitant presence of these agents completely abolished the influx, 1 µmω‐conotoxin GVIA (ω‐CTX) showed no effect on the influx. On the other hand, OONO− itself reduced 30 mm KCl‐induced [45Ca2+] influx to the level of [45Ca2+] influx induced by OONO− alone, and the magnitude of this reduction was as same as that of KCl‐induced [45Ca2+] influx by ω‐CTX. These results indicate that OONO− increases [45Ca2+] influx into the neurones through opening P/Q‐ and L‐type VDCCs subsequent to depolarization, and inhibits the influx through N‐type VDCCs.
An experimental study of postoperative tumor metastases. I. Growth of pulmonary metastases following total removal of primary leg tumor

ULTIPLE distant metastases sometimes a p M pear and grow rapidly after operations designed to extirpate primary cancers. This Occurrence is most common after amputation of an extremity in which there is osteogenic sarcoma, but rapid growth of metastases is not infrequent after surgical removal of other tumors. Despite lack of proof, there is a suggestion that surgical procedures may precipitate dissemination and growth of tumor in these instances. I t is the purpose of t h i s study to evaluate the effect of removal of a malignant neoplasm on the growth of its distant metastases.
Injection nerve palsy

Objective: To study the clinical profile and outcome of surgery for injection nerve palsies. Materials and Methods: This is a retrospective study of patients with INP who were treated at our institute during May 2000 to May 2009. Clinical, electroneuromyography (ENMG), and operative findings were noted. Intraoperative nerve action potential monitoring was not used in any case. Outcome of patients who were followed was reviewed. Results: INP comprised 92 (11%) of 837 nerve injury patients. Seventy one patients were children less than 16 years. The nerves involved were sciatic in 80 patients, radial in 8, and others in four. Fifty seven patients had power, grade 0/5. ENMG studies revealed absent compound muscle action potential in 64 and absent sensory nerve action potential in 67 patients. Thirty nine (42.3%) of 92 patients underwent surgery. The mean duration since injury in these patients was 5.2 months (3 months to 11 months). All underwent neurolysis. Only 18 patients who underwent surgery had a follow up of more than 3 months. Ten (55.5%) patients had good or fair outcome after surgery. Except for grade of motor deficit prior to surgery, none of the variables were found to significantly affect the outcome. Conclusion: The outcome of INP is generally good and many patients recover spontaneously. The outcome of surgery is dependent on preoperative motor power.
Prevalence of Capillaria philippinensis in diarrheic patients using the small subunit ribosomal DNA ( ssurDNA ) gene

C. philippinensis is a parasite of the small intestine that causes a severe enteropathy and at times death in cases of delayed diagnosis or inappropriate treatment. This study aims to detect the molecular prevalence of C. philippinensis among diarrheic patients at Beni-Suef, Egypt. Stool samples were collected from 121 diarrheic patients and subjected to copro-parasitological examination and copro-nested PCR (nPCR) assays using small subunit ribosomal DNA (ssurDNA) gene. C. philippinensis was detected microscopically in diarrheic stool samples of 7 (5.8%) cases and PCR product of Capillaria was detected in 14 samples (11.6%), all positive samples by microscopy were detected by PCR. Durations of diarrhea and number of motions/day were correlated with the infection. Recurrence and severity of diarrhea, borborgymi, lower limb edema and presence of charcot Leyden crystals in stool were significantly associated with capillariasis (p value=0.0001, 0.0001, 0.006, 0.0001, 0.0001 respectively). Detection of capillariasis using nPCR targeting ssurDNA gene is a specific and accurate method and can identify infection avoiding the delay in management and possible complications.
Advances in the management of organophosphate poisoning

Organophosphate (OP) poisoning is commonly encountered in agricultural communities. The mainstay of therapy in OP poisoning is the use of atropine. However, several other therapies have been evaluated. Although oxime has been the most studied antidote, results in humans have been disappointing and limited by the lack of well-designed, prospective, randomised controlled trials. The key factor in determining outcomes in OP poisoning appears to be the timing of antidote administration. Other adjuvants, such as magnesium, fresh frozen plasma and haemoperfusion appear promising, and need to be explored further. A multi-faceted approach may be the answer to improving outcomes in OP poisoning. This review evaluates the advances in OP management over the last 20 years.
Imaging utilization in the era of the hospitalist.

OBJECTIVE We sought to determine whether hospitalists specifically reduce inpatient radiologic testing and radiology costs, which to our knowledge has not previously been studied. We examined the number of radiologic studies ordered, total cost of radiology utilization, cost per patient, mean length of stay, and readmission rates for hospitalists and nonhospitalists across the top-10 discharge diagnosis related groups for hospitalists from October 2000 to September 2001. CONCLUSION We found no decreases in the utilization of radiology resources by hospitalists. Given the increasing volume and importance of radiology in clinical decision making, there will be increased pressure to justify the costs of these studies. We believe that more data should be collected about the use of radiology resources.
Distributed consensus tracking of multi-agent systems with nonlinear dynamics under a reference leader

This paper investigates the distributed consensus tracking problem for multi-agent systems with Lipschitz-type dynamics under a reference leader. It is assumed that the leader state information is only available to a subset of followers, while the bounded reference input of the leader’s is unavailable to any follower. To achieve consensus tracking, a class of discontinuous protocols based on the relative information between the neighbouring agents are proposed. Furthermore, as extensions of the former result, the robust and adaptive consensus tracking problems are studied for the case where there exist parameter uncertainties and external disturbances in the network. Finally, the effectiveness of the theoretical result is demonstrated through a network of single-link manipulators.
Monitoring the Effectiveness of Hospital Cleaning Practices by Use of an Adenosine Triphosphate Bioluminescence Assay

Objective. To evaluate the usefulness of an adenosine triphosphate (ATP) bioluminescence assay for assessing the efficacy of daily hospital cleaning practices. Design. A 2-phase prospective intervention study. Setting. A university-affiliated community teaching hospital. Methods. During phase I of our study, 5 high-touch surfaces in 20 patient rooms were sampled before and after daily cleaning. Moistened swabs were used to sample these surfaces and were then plated onto routine and selective media, and aerobic colony counts were determined after 48 hours of incubation. Specialized ATP swabs were used to sample the same high-touch surfaces in the 20 patient rooms and were then placed in luminometers, and the amount of ATP present was expressed as relative light units. During phase II of our study, after in-service housekeeper educational sessions were given, the housekeepers were told in advance when ATP readings would be taken before and after cleaning. Results. During phase I, the colony counts revealed that the 5 high-touch surfaces were often not cleaned adequately. After cleaning, 24 (24%) of the 100 surface samples were still contaminated with methicillin-resistant Staphylococcus aureus, and 16 (16%) of the 100 surface samples still yielded vancomycin-resistant enterococci. ATP readings (expressed as relative light units) revealed that only bathroom grab bars and toilet seats were significantly cleaner after daily cleaning than before. During phase II, a total of 1,013 ATP readings were obtained before and after daily cleaning in 105 rooms. The median relative light unit was significantly lower (ie, surfaces were cleaner) after cleaning than before cleaning for all 5 high-touch surfaces. Conclusions. Suboptimal cleaning practices were documented by determining aerobic colony counts and by use of an ATP bioluminescence assay. ATP readings provided quantitative evidence of improved cleanliness of high-touch surfaces after the implementation of an intervention program.
Electron Transport Pathway for a Streptomyces Cytochrome P450

Streptomyces and other bacterial actinomycete species produce many important natural products, including the majority of known antibiotics, and cytochrome P450 (P450) enzymes catalyze important biosynthetic steps. Relatively few electron transport pathways to P450s have been characterized in bacteria, particularly streptomycete species. One of the 18 P450s in Streptomyces coelicolor A3(2), P450 105D5, was found to bind fatty acids tightly and form hydroxylated products when electrons were delivered from heterologous systems. The six ferredoxin (Fdx) and four flavoprotein Fdx reductase (FDR) proteins coded by genes in S. coelicolor were expressed in Escherichia coli, purified, and used to characterize the electron transfer pathway. Of the many possibilities, the primary pathway was NADH → FDR1 → Fdx4 → P450 105D5. The genes coding for FDR1, Fdx4, and P450 105D5 are located close together in the S. coelicolor genome. Several fatty acids examined were substrates, including those found in S. coelicolor extracts, and all yielded several products. Mass spectra of the products of lauric acid imply the 8-, 9-, 10-, and 11-hydroxy derivatives. Hydroxylated fatty acids were also detected in vivo in S. coelicolor. Rates of electron transfer between the proteins were measured; all steps were faster than overall hydroxylation and consistent with rates of NADH oxidation. Substrate binding, product release, and oxygen binding were relatively fast in the catalytic cycle; high kinetic deuterium isotope effects for all four lauric acid hydroxylations indicated that the rate of C–H bond breaking is rate-limiting in every case. Thus, an electron transfer pathway to a functional Streptomyces P450 has been established.
Clinical and Pathological Comparison of Pyogenic and Amoebic Liver Abscesses

BACKGROUND: Pyogenic and amoebic liver abscesses are rare, potentially lethal conditions. In this study, we aimed to examine the clinical and pathological differences between them. METHODS: Patients with confirmed liver abscesses were divided into two groups: the pyogenic (n = 47) and amoebic group (n = 21), which were analyzed for differences in clinical and laboratory findings. RESULTS: Amoebic liver abscesses presented most frequently in young adults (14 - 30 years; 71%), whereas pyogenic liver abscesses were most commonly observed in adults 41 - 50 years (49%). Indirect hemagglutination test revealed a 100% positive response in the amoebic group, whereas 68% of the pyogenic group presented with blood/pus culture. Multiple abscesses were observed in 66% and 24% of patients in the pyogenic and amoebic group, respectively. CONCLUSIONS: Pyogenic abscesses were commonly observed in older patients, and were associated with features such as markedly deranged liver function test, higher prothrombin time, and multiple abscesses, compared to amoebic abscess. Early and improved diagnoses and differentiation between the two conditions, followed by the correct treatment, can help prevent serious complications and lead to an overall improved mortality rate.
Body Image, Food Addiction, Depression, and Body Mass Index in University Students

ABSTRACT The relationship between body image, depression, food addiction and body mass index (BMI) and differences in these variables due to gender and field of education have not been studied extensively. This study was conducted on a total of 793 university students (20.19 ± 1.90 years). The Beck Depression Inventory, Yale Food Addiction, and Body Image Scale were used. It was determined that body image scores of females and individuals enrolled in health sciences programs were lower compared to those of males and those enrolled in the social sciences. There was a negative relationship between body image and depression and food addiction scores. There was a positive relationship between food addiction and depression scores, in addition to a positive relationship between food addiction and BMI.
Application of an Acellular Dermal Matrix Allograft (AlloDerm) for Treatmentof Localized Gingival Recession Defect: A Case Report with One-year Follow-up

Generalized or localized gingival recession can be caused by periodontal disease, improper flossing, aggressive tooth brushing, incorrect occlusal relationships, and dominant roots. Gingival recession remains one of the main esthetic concern for the patient. Various procedures have been employed for the management of gingival recessions. The present case report employs the use of an Acellular Dermal Matrix Allograft (Alloderm®) to increase the width of attached gingival.
Performance of the ACG Case-Mix System in Two Canadian Provinces

Background.While the adjusted clinical group (ACG) system has been extensively validated in the United States, its use in other developed nations has been limited. This article examines the performance of the system in 2 Canadian provinces and assesses the extent to which ACGs can account for same-year and next-year health care expenditures. Methods.The study population included all residents of Manitoba and British Columbia who were continuously enrolled in the provincial health plans from April 1, 1995, to March 31, 1997. ACGs were assigned through diagnoses from fee-for-service physician claims and hospital separation records. “Physician” costs were calculated from the fee-for-service tariffs, and for Manitobans, “total” costs were also computed by combining physician and hospital costs. Linear regression was used to examine the ability of the ACG system to explain variation in individual costs (truncated at the 99th percentile). Results.The British Columbia and Manitoba data were generally acceptable, with fewer than 2% rejected diagnoses. Higher costs were associated with both the accumulation of morbidities and their relative severity. For physician costs, the ACG system explained ∼50% and ∼25% of the variation in same-year and next-year truncated costs, respectively. For total costs, the system explained ∼40% and ∼14% of these respective costs. Conclusions.The application of ACGs in Canada is feasible using existing data. The ability of the ACG system to explain variation in costs is similar to that found in US health systems. While application of ACGs in Canada shows promise, further research is required to examine how closely they reflect population morbidity burdens and health care needs.
Analysing farmland rental rates using Bayesian geoadditive quantile regression

Empirical studies on farmland rental rates so far have predominantly concentrated on modelling conditional means using spatial autoregressive models. While these models only focus on the central tendency of the response variable, quantile regression provides more detailed insight by modelling different points of the conditional distribution as a function of covariates. Based on data from the German agricultural census, this article contributes to the agricultural economics literature by modelling conditional quantiles of farmland rental rates semi-parametrically using Bayesian geoadditive quantile regression. Our results stress the importance of using semi-parametric regression models, as several covariates influence rental rates in an explicit non-linear way. Moreover, our analysis allows us to uncover potential heterogeneities of the estimated effects across the conditional distribution of rental rates. By explicitly modelling and visually presenting the spatial effects, we also provide additional insight into the spatial structure of German farmland rental rates.
Screening for platelet function disorders with Multiplate and platelet function analyzer

Abstract Light transmission aggregation (LTA) is the gold standard for the diagnosis of platelet function disorders (PFDs), but it is time-consuming and limited to specialized laboratories. Whole-blood impedance aggregometry (Multiplate) and platelet function analyzer (PFA) may be used as rapid screening tools to exclude PFDs. The aim of this study is to assess the diagnostic performance of Multiplate and PFA for PFDs, as detected by LTA.Data from preoperative patients, patients referred to the hematologist for bleeding evaluation, and patients with a diagnosed bleeding disorder were used. PFDs were defined as ≥2 abnormal LTA curves. Diagnostic performance of Multiplate and PFA for detecting PFDs was expressed as sensitivity and specificity. The ability of Multiplate agonists and PFA kits to detect corresponding LTA curve abnormalities was expressed as area under the receiver operating characteristic curve. Prevalence of PFDs was 16/335 (4.8%) in preoperative patients, 10/54 (18.5%) in referred patients, and 3/25 (12%) in patients with a diagnosed bleeding disorder. In preoperative and referred patients, the sensitivity of Multiplate and PFA for detecting mild PFDs varied between 0% and 40% and AUCs for detecting corresponding LTA curve abnormalities were close to 0.50. In patients with a diagnosed bleeding disorder, both assays could detect Glanzmann thrombasthenia (GT) with sensitivity of 100% and AUCs of 0.70–1.00. Multiplate and PFA cannot discriminate between preoperative and referred patients with and without mild PFDs, meaning that they cannot be used as screening tests to rule out mild PFDs in these populations. Both Multiplate and PFA can detect GT in previously diagnosed patients.
Broken bones and fractures - an audit of patients' perceptions.

INTRODUCTION 'Have I got a fracture or a break doctor? ' remains a commonly posed question in fracture clinics, suggesting that patients frequently feel a 'fracture' and a 'break' are two separate entities. This apparent misconception amongst fracture clinic patients may result in confusion and occasionally anger that doctors appear to have inconsistent views on the severity of their injury. Compliance and outcome of patient care can also be affected by poor communication. PATIENTS AND METHODS Our questionnaire-based study was conducted in two stages. The initial objective was to establish whether this misconception surrounding the words 'fracture' and 'break' is commonly held amongst our out-patient trauma patients. The second stage of the audit was to determine whether a patient information leaflet on fractures/broken bones could help reduce this misconception. RESULTS The preliminary audit involving 50 new patients attending our fracture clinic showed that 84% thought there was a difference between a 'fracture' and a 'break', with 68% believing a 'break' to be worse than a 'fracture'. Following the introduction of an information leaflet, a re-audit of 61 new patients took place. This time 67% felt there was a difference between a 'fracture' and a 'break', with 65% believing a 'break' to be worse than a 'fracture'. Only 21% had read the supplied information leaflet, and 69% of those still believed there was a difference between a 'fracture' and a 'break'. CONCLUSIONS The majority of patients believed that there was a difference between a 'fracture' and a 'break'. Access to information leaflets did not appear to alter this misconception. Verbal communication and explanation may be more beneficial and practical than visual aids and leaflets in overcoming this problem.