Miracle-dz/UniFAR-FTUs huggingface dataset:
Assessment of Common Interventions and Perceived Barriers to Pressure Ulcer Prevention in Southwest Nigeria

PURPOSE: We examined the interventions used by nurses to prevent pressure ulcers in 3 hospitals in south west Nigeria and perceived barriers to effective nursing pressure ulcer prevention interventions. SUBJECTS AND SETTINGS: One hundred ninety-three nurses were purposively selected from neurological, orthopedic, intensive care, and accident and emergency units of participating hospitals. Study sites were 3 teaching hospitals in south west Nigeria (Lagos State University Teaching Hospital, Lagos; University College Hospital, Ibadan; and Obafemi Awolowo Teaching Hospital Ile–Ife). METHODS: Data were collected via a structured questionnaire designed for this study. It included 3 sections: demographic information, practices used for pressure ulcer prevention, and perceived barriers to prevention. Sections of the questionnaire that queried interventions and perceived barriers to pressure ulcer prevention were evaluated for face and content validity. Reliability was evaluated via internal consistency; the split half reliability was 0.82. RESULTS: Similar practices regarding pressure ulcer prevention were found across the 3 hospitals. The most commonly used intervention was patient repositioning every 2 hours; the least used intervention was completion of a validated pressure ulcer risk scale. Nurses described using interventions that have not proved effective for pressure ulcer prevention such as massaging bony prominences and application of talcum powder. Nurses identified 2 principal factors that act as barriers to successful prevention of pressure ulcers: inadequate manpower and inadequate supply of linens on the wards. CONCLUSION: Nurses use a combination of evidence-based interventions, along with interventions that have not proved effective for pressure ulcer prevention. We recommend development of national standards for pressure ulcer prevention in Nigeria that are based on current best evidence and consistent with current international guidelines.
Acidosis inhibits oxidative phosphorylation in contracting human skeletal muscle in vivo

This study tested the hypothesis that acidic pH inhibits oxidative ATP supply during exercise in hand (first dorsal interosseus, FDI) and lower limb (leg anterior compartment, LEG) muscles. We measured oxidative flux and estimated mitochondrial capacity using the changes in creatine phosphate concentration ([PCr]) and pH as detected by 31P magnetic resonance (MR) spectroscopy during isometric exercise and recovery. The highest oxidative ATP flux in sustained exercise was about half the estimated mitochondrial capacity in the LEG (0.38 ± 0.06 vs. 0.90 ± 0.14 mm ATP s−1, respectively), but at the estimated capacity in the FDI (0.61 ± 0.05 vs. 0.61 ± 0.09 mm ATP s−1, respectively). During sustained exercise at a higher contraction rate, intracellular acidosis (pH < 6.88) prevented a rise in oxidative flux in the LEG and FDI despite significantly increased [ADP]. We tested whether oxidative flux could increase above that achieved in sustained exercise by raising [ADP] (> 0.24 mm) and avoiding acidosis using burst exercise. This exercise raised oxidative flux (0.69 ± 0.05 mm ATP s−1) to nearly twice that found with sustained exercise in the LEG and matched (0.65 ± 0.11 mm ATP s−1) the near maximal flux seen during sustained exercise in the FDI. Thus both muscles reached their highest oxidative fluxes in the absence of acidosis. These results show that acidosis inhibits oxidative phosphorylation in vivo and can limit ATP supply in exercising muscle to below the mitochondrial capacity.
An agent simulator meets the enron for communication network analysis

Agent-based modeling, simulation, and network analysis approaches is one of the emergent techniques among soft computing literature. This paper presents an agent-based model for analyzing the characteristics of peer-to-peer human communication networks. We focus on the process of the collapse of Enron Corporation, which is an interesting topic among the business management domain. The Enron email dataset is available for the analysis. The simulation results are compared with the Enron email dataset in the following meanings: (i) the degrees of the communication networks and contents information and (ii) the changes of network structures among the major events. The investigation suggests that the agent-based model is beneficial to uncover the characteristics of implicit communication mechanisms of the firm.
Imaging via widefield surface plasmon resonance microscope for studying bone cell interactions with micropatterned ECM proteins

The widefield surface plasmon resonance microscope has recently been used to monitor label free antibody/antigen binding events and focal contacts in HaCaT cells at high special resolutions. Thus the aim of this study was to examine MG63 bone cell attachment and alignment to microcontact printed extracellular matrix proteins. Collagen, fibronectin and laminin were stamp patterned onto glass slides using templates consisting of 5‐, 10‐, 25‐, 50‐ and 100‐μm‐wide repeat grating. MG63 bone cells were seeded at 50 000 cells per 25 cm2 and cell alignment was determined from micrographs taken at time‐points 2, 5 and 18 h after cell seeding. Cells on the fibronectin pattern attached and elongated at early stages after seeding. In the case of collagen and laminin, cells did not adhere readily and appeared more rounded until 18 h after seeding. This indicated MG63 cells attach mostly via fibronectin specific integrins. The cells aligned well on the fibronectin‐patterned cover slips especially to the 50‐ and 100‐μm‐wide patterns, although in this case cells did not position themselves in the middle of each fibronectin‐coated region, but instead aligned to the small features associated with the edges of the fibronectin‐coated regions. Patterned and un‐patterned cells also had quite different morphologies. The un‐patterned cells had a more rounded morphology and lengths of 25 to 35 μm, whereas patterned cells elongated in the direction of the pattern and had lengths of 50–70 μm. The widefield surface plasmon resonance imaging indicated that cells on un‐patterned surfaces had a rounded morphology in which the focal contacts were evenly distributed around the periphery of the cell. However, MG63 bone cells on fibronectin‐patterned substrates organized most of their focal contacts along the periphery of the cell distal to the edge of the fibronectin patterns. This suggests that the interaction between the cell and the edge of the pattern induces a reorganization of focal contacts such that the region of the cell guided by the edge of the fibronectin pattern is relatively loosely coupled to the cell culture substrate, but the region of the cell positioned away from that edge is quite tightly coupled to the fibronectin‐coated region of the culture substrate. This in turn suggests that guidance is not necessarily associated with enhanced cell substrate coupling along the guidance cue, but may be more associated with a decreased coupling at the guidance cue. Such an arrangement may influence cytoplasmic streaming and as such modulate cell extension. Verification of this finding is required; as such a response to a guidance cue is quite unexpected because it is believed that cells cluster their focal contacts along a guidance cue.
Hypertension in the Elderly: Prevalence and Health Seeking Behavior

Background: Non-communicable diseases (NCDs) are major contributors of morbidity and mortality in the elderly. Estimating the prevalence of hypertension and studying the health seeking behavior is important. Aim: This study was designed to estimate the prevalence of hypertension and understand the health seeking behavior among the elderly in rural Puducherry, south India. Materials and Methods: A total of 211 elderly from a rural community were selected by systematic random sampling. Blood pressure (BP) was measured. Socio-demographic characteristics and health seeking behavior were assessed by interviews. Results: Prevalence of hypertension among study participants was 40.5%. Prevalence of hypertension among elderly male subjects was 39.2% and in female subjects was 40.8%. About 62% (53 out of 85 hypertensives) were already aware of their hypertensive status. About 54.7% (29) were diagnosed at government health facilities either at primary health centers (PHCs) or a government hospital. Conclusion: Burden of hypertension among the elderly is high in rural areas. Strategies to detect and treat hypertension in the elderly have to be implemented early.
Analysis of the cardiac repolarization period using the KL transform: applications on the ST-T database

The ST-T segment of the surface ECG reflects cardiac repolarization, and is quite sensitive to a number of pathological conditions. ST-T changes generally affect the entire waveshape, and are inadequately characterized by single features such as depression of the ST segment. Metrics which represent overall waveshape should provide more sensitive indicators of ST-T wave abnormalities. This study presents a Karhunen-Loeve Transform (KLT) technique for the analysis of the ST-T waveform. This technique recovers maximum information from a minimum number of parameters for a given set of waveforms. The training data yielded a KL basis set which concentrates 90% of the ST-T signal energy in the first four coefficients. The KL technique was used to analyze the ST-T complexes in the ESC ST-T database. KL coefficients were plotted as a function of time, and were effective in detection of transient ischemic episodes. Twenty percent of the records showed bursts of periodic ischemia suggesting local vascular instability. <<ETX>>
Merkel cell carcinoma of the eyelid: management and prognosis.

IMPORTANCE The literature on Merkel cell carcinoma (MCC) of the eyelid remains scarce, and there has yet to be a study using the most up-to-date TNM staging system for this rare but aggressive tumor. OBJECTIVE To analyze the TNM stage, management, and outcomes of patients with MCC of the eyelid. DESIGN, SETTING, AND PARTICIPANTS Retrospective case series of 21 patients from 5 tertiary referral centers in the United Kingdom and Australia with primary MCC of the eyelid presenting at a median age of 77 years, with median follow-up of 54 months. Tumors were staged according to the American Joint Committee on Cancer, 7th edition, TNM criteria for eyelid carcinoma and MCC. MAIN OUTCOMES AND MEASURES TNM stage, treatment modalities, and clinical outcome. RESULTS The eyelid carcinoma TNM stages were T2aN0M0 for 5 patients, T2bN0M0 for 7 patients, T3aN0M0 for 4 patients, T3bN0M0 for 3 patients, T2bN1M0 for 1 patient, and T3aN1M0 for 1 patient. The MCC TNM stages were T1N0M0 for 12 patients, T2N0M0 for 7 patients, T1N1M0 for 1 patient, and T2N1M0 for 1 patient. One patient had a sentinel lymph node biopsy, and 8 patients underwent head/neck imaging. Eighteen patients underwent a wide local excision, 12 with a paraffin section and 6 with a frozen section. Two patients underwent Mohs surgery, 1 of whom required an orbital exenteration. Twelve patients (57%) received adjuvant radiotherapy, and 2 patients received chemotherapy. The local recurrence rate was 10%, the regional nodal recurrence rate was 10%, and the distant metastatic recurrence rate was 19%. The lowest T category tumor metastasizing to both regional nodes and distant locations was a T2a (eyelid TNM)/T1 (Merkel TNM) tumor measuring 8 mm. Two patients with T3a (eyelid TNM)/T2 (Merkel TNM) tumors died of metastatic MCC. CONCLUSIONS AND RELEVANCE The majority of patients with MCC of the eyelid present with localized eyelid disease of T category T2 (eyelid TNM)/T1 (Merkel TNM). A wide local excision with margin control remains the mainstay of treatment, whereas the use of radiotherapy is institution specific. Tumors with a low T category are associated with regional nodal and distant metastatic disease. It may therefore be reasonable to consider a sentinel lymph node biopsy or strict regional lymph node surveillance for all MCCs of the eyelid, regardless of T category or size.
Extracranial stereotactic radioablation: results of a phase I study in medically inoperable stage I non-small cell lung cancer.

INTRODUCTION Surgical resection is standard therapy for patients with stage I non-small cell lung cancer (NSCLC), however, many patients are medically inoperable. We set out to investigate a new therapy akin to brain radiosurgery called extracranial stereotactic radioablation (ESR) in a phase I trial. PATIENTS AND METHODS Eligible patients included those with clinically staged T1 or T2 (tumor size, < or = 7 cm) N0M0 biopsy confirmed NSCLC. All patients had comorbid medical problems that precluded thoracotomy. The median age was 75 years, and the median Karnofsky performance status was 80. ESR was administered in three separate fractions over 2 weeks. Three to five patients were treated within each dose cohort starting at 800 cGy per fraction (total, 2,400 cGy) followed by successive dose escalations of 200 cGy per fraction (total increase per cohort, 600 cGy). Waiting periods occurred between dose cohorts to observe toxicity. Patients with T1 vs T2 tumors underwent separate independent dose escalations. RESULTS A total of 37 patients were enrolled since February 2000. One patient experienced grade 3 pneumonitis, and another patient had grade 3 hypoxia. For the entire population, there was no appreciable decline in cardiopulmonary function as measured by symptoms, physical examination, need for oxygen supplementation, pulmonary function testing, arterial blood gas determinations, or regular chest imaging. Both T-stage groups ultimately reached and tolerated 2,000 cGy per fraction for three fractions (total, 6,000 cGy). The maximum tolerated dose for this therapy in either T-stage group has yet to be reached. Tumors responded to treatment in 87% of patients (complete response, 27%). After a median follow-up period of 15.2 months, six patients experienced local failure, all of whom had received doses of < 1,800 cGy per fraction. CONCLUSIONS Very high radiation dose treatments were tolerated in this population of medically inoperable patients with stage I NSCLC using ESR techniques.
Psychiatric diagnoses in children with alopecia areata.

OBJECTIVE To identify psychiatric diagnoses in a sample of 12 children with alopecia areata (AA), to assess the possible relationship between life stressors and AA and to correlate any consistent physical findings to psychiatric data. METHOD Twelve children with AA completed systematic psychiatric evaluations. The assessments included structured and semistructured interviews, rating scales, and parent checklists. Children had previously undergone immunological and endocrinological blood testing. RESULTS Seven of the 12 subjects met criteria for anxiety disorders (including simple phobia) on structured interviews. An additional subject met criteria for dysthymia. Self-esteem measures indicated a high positive self-concept, and rating scales measuring anxiety and depression were within normal limits. No significant difference was found between mean number of positive or negative life events of children with AA compared with a normative sample. CONCLUSIONS Although structured interviews revealed a higher than expected rate of anxiety or depressive disorders in this small clinical sample, self-report rating scales and semistructured interviews did not support the conclusion that significant psychopathology was present.
Significance of T helper 17 immunity in transplantation

Purpose of reviewThe aim of this review is to provide an overview of significance of T helper 17 (Th17) immunity in acute, chronic and antibody-mediated allograft rejection. The role of Th17 immunity in development of de-novo autoimmunity following transplantation is outlined. It will also consider the impact of Th17 immunity on transplantation tolerance. Potential therapies to target Th17 immunity are discussed. Recent findingsInterleukin17 (IL-17) is produced by a wide variety of immune and non-immune cells in response to injury. IL-17 production by tubular epithelial cells in response to complement activation in acute antibody-mediated rejection may perpetuate immune injury. Th17-dependent de-novo autoimmunity contributes to chronic allograft rejection. Targeting IL-17 not only inhibits Th17 immunity but also attenuates Th1 immunity by affecting the initial recruitment of immune cells to sites of inflammation and modulates innate and adaptive immune responses that ultimately lead to tissue destruction. SummaryTh17 immunity is now beginning to be appreciated as a set of responses mediated not only by CD4 Th17 cells but a variety of immune cells and a plethora of cytokines that collaborate to mediate immune disorders, including transplant rejection. Development and contribution of de-novo autoimmunity to chronic rejection is increasingly appreciated. The developmental plasticity of Tregs and Th17 cells is a major hurdle to Treg-based cellular therapies for transplantation. Several biologics targeting Th17 immunity are under evaluation for autoimmune disease. It remains to be determined whether these can be used in transplantation to improve outcomes.
Identification of coronin‐1a as a novel antibody target for clinically isolated syndrome and multiple sclerosis

Recently, we identified the mimotope UH‐CIS6 as a novel candidate antibody target for clinically isolated syndrome (CIS) and relapsing‐remitting (RR) multiple sclerosis (MS). The purpose of this study was to further validate UH‐CIS6 as an antibody target for CIS and MS and to identify the in vivo antibody target of UH‐CIS6. First, a UH‐CIS6 peptide ELISA was optimized. Next, we investigated the antibody response toward UH‐CIS6 in cerebrospinal fluid (CSF) from patients with CIS (n = 20), MS (n = 43) and other neurological diseases (n = 42). Immunoprecipitation of anti‐UH‐CIS6 antibodies on a normal human brain lysate was performed to identify the in vivo antibody target of UH‐CIS6. The cellular expression of an in vivo candidate target was investigated by immunohistochemistry using MS brain tissue sections. Antibody reactivity toward UH‐CIS6 was detected in a significantly increased proportion of CSF samples from CIS and RR‐MS patients as compared with neurological controls (p = 0.046). We identified and confirmed coronin‐1a as the in vivo antibody target for UH‐CIS6. Furthermore, coronin‐1a was expressed by T cells and macrophages in an active MS lesion. Together, these results demonstrate that coronin‐1a is a novel antibody target for CIS and MS.
Radial versus femoral access for rescue percutaneous coronary intervention with adjuvant glycoprotein IIb/IIIa inhibitor use.

BACKGROUND The transradial approach has not been evaluated for "rescue" percutaneous coronary intervention (PCI) with glycoprotein (GP) IIb/IIIa inhibitor following failed thrombolysis. OBJECTIVES To compare the safety and procedural outcomes of the transradial and transfemoral approaches to rescue PCI. METHODS Rescue PCI cases with adjuvant GP IIb/IIIa inhibitor performed at two centres were reviewed retrospectively, and the bleeding rates, equipment use and procedure times for the femoral and the radial approach were compared. RESULTS Radial access was attempted in 47 of 111 cases (42%) and crossover to femoral access was required in two cases (4%). Major bleeding occurred in three patients in the radial group (6%) and in 12 patients in the femoral group (19%; P=0.06). Radial access was associated with less access site-related major bleeding (0% versus 9%; P=0.04) and fewer transfusions (4% versus 19%; P=0.02). After excluding patients with intra-aortic balloon pump, this difference was no longer statistically significant (4% versus 8%; P=0.7). Fluoroscopy times and contrast use were similar, and the time to first balloon inflation was slightly longer with radial access (33 min versus 30 min; P=0.07). CONCLUSIONS In selected patients, the transradial approach for rescue PCI is safe and effective. The present findings warrant further study in a prospective, randomized trial.
Manipulation of prothrombin concentration improves response to high‐dose factor VIIa in a cell‐based model of haemophilia

Clinical reports suggest that treatment regimens employing both activated prothrombin complex concentrates (aPCCs) and recombinant activated factor VII (rFVIIa) may control the bleeding in patients with haemophilia who fail to respond to either agent alone. We hypothesised that increased concentrations of prothrombin, as may be observed after the infusion of aPCCs, favourably influence parameters of thrombin generation in haemophilia treated with high‐dose rFVIIa. We examined the effect of varied prothrombin and rFVIIa concentrations on thrombin generation in a model of haemophilia. At all concentrations of rFVIIa, increased prothrombin concentrations led to increases in the peak and rate of thrombin generation. In assays with the highest concentrations of prothrombin and rFVIIa, peak thrombin actually equalled that measured in the model of normal haemostasis. The significant impact of prothrombin concentration on the effect of rFVIIa in vitro may explain the improved haemostasis reported with concurrent use of aPCCs and rFVIIa. These results imply that persons with plasma prothrombin levels at either end of the ‘normal’ range could have significantly different responses to similar rFVIIa doses. Furthermore, these results suggest that increasing plasma prothrombin concentration prior to rFVIIa administration may offer advantages over the use of rFVIIa alone in the treatment of haemophilic bleeding.
A Collaborative Calibration Study of Reference Materials for Thromboplastins

Summary In a collaborative study of ten laboratories performed mainly within the framework of the BCR (the European Community Bureau of Reference), five thromboplastins were calibrated against the WHO (World Health Organisation) primary international reference preparation 67/40. Of these five thromboplastins, three were BCR reference materials (BCT/099, OBT/79 and RBT/79) and two were WHO secondary international reference preparations (68/434 and 70/178). Human brain tissue type is represented by 67/40 and BCT/099; bovine type by 68/434 and OBT/79, and rabbit type by 70/178 and RBT/79. The calibration relations are expressed in terms of a linear relationship between the logarithms of the prothrombin times, measured in seconds.