Miracle-dz/UniFAR-FTUs huggingface dataset:
Reference values for urinary neutrophil gelatinase-associated lipocalin (NGAL) in pediatric age measured with a fully automated chemiluminescent platform

Abstract Background: Neutrophil gelatinase-associated lipocalin (NGAL) has been suggested as the most promising biomarker of acute kidney injury. However, there are no reliable data on analytical sensitivity and reference limits of urinary NGAL (uNGAL) assay in pediatric age. The aim of the present study is to evaluate the analytical sensitivity and the reference range of uNGAL measured in urine specimens of pediatric age with the fully automated platform ARCHITECT® i1000. Methods: A total of 333 urine samples were collected from 25 healthy newborns (16 males and 9 females; age 1–4 days) and 308 children (150 males and 147 females; mean age 80.7 months, range 0.63–248 months) and assayed for uNGAL by two different Italian centers (Department of Laboratory Medicine of the Fondazione Toscana G. Monasterio of Pisa and Massa and the Clinical Pathology Laboratory Unit of Istituto Giannina Gaslini of Genova). Results: The calculated limits of blank (LOB) and detection (LOD) values were 0.5 ng/mL and 0.95 ng/mL, respectively. The distribution of uNGAL values approximated a log-normal distribution (median 5.2 ng/mL, interquartile range 2.5–12.8 ng/mL, 99th percentile 117.6 ng/mL). uNGAL values of the 25 neonates were significantly higher than those of 308 children (neonates: mean 44.2 ng/mL, median 30.3 ng/mL, range 5.2–137.4 ng/mL; children: mean 10.2 ng/mL, median 4.6 ng/mL, range 0.2–146.7 ng/mL; p<0.0001). Conclusions: uNGAL assay shows a good analytical sensitivity and imprecision, which allows the measurement of uNGAL values around the cut-off value (i.e., 117.6 ng/mL) with an imprecision <5 CV%. The distribution of uNGAL values in pediatric age approximates a log-normal distribution, with values which are higher in neonates compared to children.
Ventriculostomy-related infections: The performance of different definitions for diagnosing infection

Introduction. Comparison of rates of ventriculostomy-related infections (VRIs) across institutions is difficult due to the lack of a standard definition. We sought to review published definitions of VRI and apply them to a test cohort to determine the degree of variability in VRI diagnosis. Materials and methods. We conducted a PubMed search for definitions of VRI using the search strings “ventriculostomy-related infection” and “ventriculostomy-associated infection. ” We applied these definitions to a test cohort of 18 positive cerebrospinal fluid (CSF) cultures taken from ventriculostomies at two institutions to compare the frequency of infection using each definition. Results. We found 16 unique definitions of VRI. When the definitions were applied to the test cohort, the frequency of infection ranged from 22 to 94% (median 61% with interquartile range (IQR) 56–74%). The concordance between VRI diagnosis and treatment with VRI-directed antibiotics for at least seven days ranged from 56 to 89% (median: 72%, IQR: 71–78%). Conclusions. The myriad of definitions in the literature produce widely different frequencies of infection. In order to compare rates of VRI between institutions for the purposes of qualitative metrics and research, a consistent definition of VRI is needed.
Aerobic Testing and Training for Persons with Multiple Sclerosis: A Review with Clinical Recommendations

Purpose: In this article, we review the evidence for aerobic training in persons with multiple sclerosis (MS). The effects of aerobic training on enhancing cardiovascular fitness, muscle strength, and health-related quality of life (HRQOL) and reducing risk factors for cardiovascular disease are summarized. Clinical considerations and recommendations for aerobic testing and training are also presented. Summary of Key Points: Persons with MS may limit their participation in physical activity, predisposing them to deconditioning and additional disability, previously attributed to the disease process itself. However, individuals with mild to moderate levels of disability who participate in aerobic training can improve aerobic fitness, muscle strength, and HRQOL and reduce the risk factors for cardiovascular disease. Aerobic testing and training are safe for these patients provided that they are adequately screened and managed for fatigue, dysautonomia, and thermosensitivity. These historical concerns should not preclude active participation in aerobic training as current evidence suggests that the benefits outweigh the risks. Conclusion: To minimize activity limitations and participation restrictions and enhance physical and psychosocial well-being, aerobic exercise should be promoted and included in the overall management plan of clients with MS.
A combined index of cardiac biomarkers as a risk factor for early cardiovascular mortality in hemodialysis patients

Abstract Background: Cardiac biomarkers, including cardiac troponin-I (cTn-I) and N-terminal pro brain natriuretic peptide (NT-proBNP) have been associated with poor outcome in hemodialysis (HD) patients. The present study was designed to evaluate these biomarkers as biological risk factors for early and late mortality in HD patients. In addition, a multimarker approach including inflammatory index was performed in order to improve the cardiovascular risk assessment of these patients. Methods: cTnI, NT-proBNP and C-reactive protein (CRP) were measured at baseline (October through November 2002) in 130 HD patients [median age 69.0 (23.4–87.7) years old, 76 females, 54 males]. Patients were followed during 8 years. Adjusted hazard ratios (HRs) of death and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. Results: During the follow-up, 82 patients died, mainly from cardiac cause (63.4%). Elevated cTnI, NT-proBNP or CRP were all associated with increased early (death within 2 years of follow-up) but not late mortality. Moreover, the combination of all parameters (CRP ≥10.51 mg/L and cTnI ≥0.037 µg/L and NT-proBNP ≥10,204 pg/mL) dramatically increased the short-term mortality especially the cardiovascular mortality (HR 8.58, 95% CI 1.59–46.2; p=0.0007). Conclusions: A combined index of cardiovascular risk factors could provide supplementary risk stratification in HD patients for early cardiovascular mortality, strongly supporting the annual routine determination of these biomarkers.
Plasma volume shifts during multiday racing

*Corresponding author: Chris J. Gore, PhD, FACSM, Head of Physiology, Australian Institute of Sport, PO Box 176 Belconnen ACT 2616, Australia, E-mail: chris.gore@ausport.gov. au Chris J. Gore: Flinders University of South Australia, Bedford Park, Australia Jakob Morkeberg: Bispebjerg Hospital, Copenhagen, Denmark Walter Schmidt: University of Bayreuth, Bayreuth, Germany Laura Anne Garvican: Australian Institute of Sport, Canberra, Australia; and University of Canberra, Canberra, Australia Nicole Fellman: Universit é d ’ Auvergne, CHU de Clermont-Ferrand, Clermont-Ferrand, France
Outcome of tube thoracostomy in paediatric non-traumatic pleural fluid collections

Objective: Management of pleural fluid collection not due to trauma increases workload of the paediatric thoracic surgeons, while delay or inappropriate treatment worsens the prognosis of the disease. This study aimed at assessing the outcome of therapeutic tube thoracostomy in non-traumatic paediatric pleural fluid collections and identifying factors responsible for treatment failure with tube thoracostomy. Design: Prospective analysis of socio-demographic characteristics, clinical features, clinical diagnosis, radiological diagnosis, and bacteriological diagnosis including bacteria cultured with sensitivity pattern, also treatment offered including tube thoracostomy with duration of tube thoracostomy and length of hospitalisation, indication for additional surgical procedure with type, and outcome of treatment of 30 paediatric patients with non-traumatic pleural fluid collection. Results: Thirty paediatric patients with various causes of non-traumatic pleural fluid collection in 34 pleural spaces were analysed. Their ages ranged between six months and 16 years (mean = 6.5 years) and M:F ratio of 2:1. Pleural effusion and empyema thoracis accounted for 46% and 40% with staphylococcus aureus and streptococcus pneumoniae cultured in 10% each and a high negative culture rate of 46%, which was higher with age. The parents of 40% of the patients belonged to social class 3. Success rate of tube thoracostomy was 86% in unilateral cases, 50% in bilateral cases and 81% in all cases. Alternative treatment with thoracotomy and decortications gave a success rate of 100%. Conclusion: Thoracotomy with decortication is superior to tube thoracostomy in paediatric non-traumatic pleural fluid collection and should be chosen as the primary treatment option when there is bilateral disease, chronicity, loculated effusion, thickened pleural membranes or trapped lung.
Happiness and Associated Demographic Factors among Medical Students of Mazandaran University of Medical Sciences, 2010

Background and purpose: Happiness is comprised of at least three components: emotional, social and cognitive. The emotional aspect results in positive expressions, the social aspect leads to expanded positive relationships with others and cognitive component creates a thinking which optimistically interprets daily events. This study evaluated the level of happiness and some influencing factors in medical students of Mazandaran University of Medical Sciences. Materials and methods: This descriptive cross-sectional study was done in all medical students (n= 356) who were consent to fill the questionnaire. The "Oxford Happiness Questionnaire" with a demographic questionnaire were completed by the students. The scores were analyzed by calculating mean scores of different groups and t-test and ANOVA using SPSS ver.17. Results: From the total of 356 medical students 208 handed the questionnaires. The mean score of happiness of medical students was 41.23. The mean score of happiness was significantly high (42.87) among students of medicine aged 18-22 years while it was lower (38.79) among those aged 22-31 years (P= 0.027). The mean score of happiness for medical students with physical disease was (35.06) which was lower than that of the healthy students (41.9) (P= 0.039). Findings from the study of five inventory factors showed different levels of self-esteem among male and female students of medicine (P= 0.005). Conclusion: The findings showed no relationship between sex, marital status, residential status and happiness among medical students but age and physical health influenced their level of happiness.
Lack of association between the TNFα G −308 A promoter polymorphism and periodontal disease

Background: Immunorelevant gene polymorphisms might influence the susceptibility for periodontal disease. The present study assessed the frequency of a promoter polymorphism (−308G-to-A) of the tumour necrosis factor (TNF)α gene in patients with periodontitis and controls. Methods: Eighty-one patients with generalized chronic periodontitis and 80 healthy controls were genotyped for the −308 polymorphism of the TNFα gene by PCR amplification and subsequent restriction fragment length polymorphism analysis. The diagnosis of chronic periodontitis was made for each subject on basis of standardized clinical and radiographic criteria. Results: In patients with peridontitis and controls, the frequency of the TNFα−308 A allele was comparable (19.1% [31/162] versus 13.8% [22/160]; p=0.193). Conclusion: The present study revealed no association between the −308 TNFα gene polymorphism and periodontal disease.
Anterior pituitary dysfunction in moderate-to-severe chronic traumatic brain injury patients and the influence on functional outcome

Objective: The objective of this study is to determine the prevalence of anterior pituitary dysfunction in moderate-to-severe chronic traumatic brain injury (TBI) patients. The investigation of a relationship between pituitary hormonal status and body mass index (BMI) in TBI patients by observing changes in BMI was conducted as well as an assessment of whether there is a difference in functional outcome related to anterior pituitary dysfunction in TBI patients. Methods: Forty-five TBI patients and 30 normal controls underwent a series of standard endocrine tests for anterior pituitary hormone function. It was studied whether changes in BMI correlated with anterior pituitary hormone levels. This study also compared changes in mini-mental state examination (K-MMSE) and functional independence measure (FIM) scores between patients in the hormone-sufficient and -deficient groups. Results: Anterior pituitary dysfunction was found in 31.1% of TBI patients. Changes in BMI statistically correlated with IGF-1 and basal cortisol levels. A meaningful difference was found between the hormone-sufficient and -deficient groups in light of the K-MMSE and FIM score gains. Conclusions: These findings strongly suggest that patients who suffer head trauma should be routinely tested for anterior pituitary hormone deficiency.
Recreational physical activities among children with a history of severe traumatic brain injury

Objective: To describe leisure time physical activity (LTPA) and physical capabilities such as balance, muscle strength and walking performance and to evaluate the associations between physical capabilities and LTPA among children post-traumatic brain injury (TBI) as compared to a peer group of typically-developed (TD) controls. Participants: Convenience sample of 15 children, 1.5–7 years post-severe TBI and 15 age- and sex-matched controls. Main outcome measures: LTPA by the Godin and Shephard (G&S) questionnaire. Balance tests—the Timed Up and Go test (TUG) and functional reach test (FRT). Maximal isometric strength was assessed by using a hand-held dynamometer; walking dynamics were recorded by an electronic mat and the 6 minute walk test and energy expenditure index (EEI). Perceived exertion was rated by the OMNI scale. Results: Children post-severe TBI participate significantly less in LTPA as compared to TD controls (p < 0.01). Walking performance was comparable between groups except for step length which was significantly shorter among children post-TBI. Hip extensor strength and balance performance were significantly lower among children post-TBI. Balance performance was positively associated with LTPA. Conclusions: This study suggests that attention should be directed towards improving balance performance as part of the training repertoire of children and adolescents with post-severe TBI. The efficacy of such a training programme, in particular its contribution to LTPA participation, should then be further assessed.
S100B blood level measurement to exclude cerebral lesions after minor head injury: the multicenter STIC-S100 French study

Abstract Background: S100B protein measurement in blood is proposed to exclude the presence of computed tomography (CT) lesions after minor head injury (MHI). We aimed to validate S100B as an accurate and valuable screening tool for MHI diagnosis in a large multicenter study, as well as: 1) to evaluate whether a second S100B blood level determination 3 h after the first one would be informative; 2) to compare the bioclinical performances of the two commercially available automated methods of measurement of S100B for the screening of patients. Methods: Four thousand and thirty MHI subjects were enrolled in a prospective observational multicenter study; results for serum S100B measurement determined within 3 h after the clinical event (H0) then at H3 were compared to that of cranial CT scans performed with 6 h following the presentation to emergency department. Both the Diasorin and the Roche Diagnostics assays were systematically performed. Results: Cerebral lesions on CT scan were identified with sensitivity and negative-predictive value (NPV) of 96.3% and 99.4% (Diasorin, 1 dissonant case), and of 100% and 100% (Roche Diagnostics, no dissonant case). Sensitivity and NPV at H3 appeared lower than those at H0, due to the rapid decrease in S100B levels. Conclusions: Serum S100B level on admission of patients with MHI is an accurate and useful screening tool to exclude intracranial lesions. Performing a second late S100B level determination is not informative. The two automated immunoassays appear usable in a similar manner, although the two methods are not interchangeable.
Proposed chronic cerebrospinal venous insufficiency criteria do not predict multiple sclerosis risk or severity

It is still unclear whether chronic cerebrospinal venous insufficiency (CCSVI) is associated with multiple sclerosis (MS), because substantial methodological differences have been claimed by Zamboni to account for the lack of results of other groups. Furthermore, the potential role of venous malformations in influencing MS severity has not been fully explored. This information is particularly relevant, because uncontrolled surgical procedures are increasingly offered to MS patients to treat their venous stenoses.
Longitudinal study of the diffusion tensor imaging properties of the corpus callosum in acute and chronic diffuse axonal injury

Background: Magnetic resonance diffusion tensor imaging (MR-DTI) is used increasingly to detect diffuse axonal injury (DAI) after traumatic brain injury (TBI). Primary objective: The primary objective was to investigate the changes in the diffusion properties of the corpus callosum in the acute phase and 6 months after TBI and to examine the correlation between DTI parameters and clinical outcome. Research design: Longitudinal prospective study. Methods and procedures: MR-DTI was performed in eight patients with suspected DAI within 11 days and at 6 months post-injury. Six controls were also examined. Fractional anisotropy (FA), trace and parallel and perpendicular diffusivity of the corpus callosum were analysed. The main outcome was the extended Glasgow Outcome Scale score, assessed at 6 months. Main outcomes and results: A significant reduction in FA in the corpus callosum was seen in the acute phase in patients compared with the healthy controls. There was no significant change in the parallel or perpendicular eigenvalues or trace. At 6 months, a significant reduction in FA and a significant increase in trace and perpendicular eigenvalues were noticed compared with controls. Conclusions: The diffusion properties of the corpus callosum correlated with clinical outcome in this longitudinal investigation.
A histopathological study of ovarian neoplasms in children in a tertiary hospital of northern Nigeria.

BACKGROUND Information concerning the frequency and pattern of ovarian tumours in children is scant, more so in northern Nigeria. In view of this, we reviewed ovarian biopsies obtained from children in Zaria over a 25-year period. MATERIALS AND METHODS Ovarian tumours occurring in 48 patients of age 15 years and below were reviewed and classified using the current World Health Organization (WHO) histological classification of ovarian tumours. RESULTS Ovarian tumours in children accounted for 8.6% of all cases of tumours seen in all age groups over the period. Among all the malignant tumours seen in this period, 32% occurred in children, and Burkitt's lymphoma accounted for 31.2% of these. Germ cell tumours accounted for 58.0% while epithelial tumours had a frequency of 2.1%. CONCLUSION Burkitt's lymphoma is the most common childhood ovarian tumour in Zaria, northern Nigeria.
Immediate effect of short duration of slow deep breathing on heart rate variability in healthy adults

Background: Various types of breathing exercises have various effects on autonomic nervous system like fast breathing increases sympathetic tone and slow breathing increases parasympathetic tone. But these changes are seen when those exercises are done for long duration. Heart rate variability (HRV) reveals the autonomic status very effectively. So took up the study to know the effects of short duration (5 min) of slow deep breathing on heart rate variability. Aims & Objective: To study the HRV Before and after five minutes of slow deep breathing in healthy adults. Materials and Methods: 20 healthy adults aged between 30 to 40 years and not practicing any kind of breathing exercises or yoga were involved in the study. Using powerlab, AD Instrument polyrite, HRV was calculated by recording ECG in Lead II for five minutes. Then the participants were made to slow deep breathe for 5 minutes, again HRV was calculated. The time domain parameters of HRV studied were Standard deviation of all normal-to-normal intervals in milliseconds (SDNN) and Root Mean Square Successive Difference in milliseconds (RMSSD). The frequency domain parameters studied were low frequency in normalized units (LF nu), high frequency in normalized units (HFnu) and the ratio of LF to HF (LF/HF ratio). Data was analysed by paired t test. Results: Heart rate did not show much of variation. There was significant increase in LFnu (46.91±14.51, 60.79±17.29 and p 0.009), decrease in HFnu (43.56±17.59, 30.17±13.52 and p 0.002), increase in LF/HF ratio (1.43±0.84, 3.06±3.22 and p 0.03). SDNN and RMSSD did not show significant change. Conclusion: Effect of slow deep breathing for a short duration of five minutes in healthy adults who are not practicing any kind of breathing exercise or yoga is shift of the cardiac sympathovagal balance towards the sympathetic predominance.
Effectiveness of physical therapy for improving gait and balance in individuals with traumatic brain injury: A systematic review

Primary objective: The purpose of this review was to investigate the efficacy or effectiveness of non-aerobic exercise interventions to improve balance and gait in functionally mild-to-moderate individuals with TBI (those who demonstrate the ability or capacity to ambulate) and to provide evidence-based guidelines for clinical practice. Methods: The authors searched eight databases for papers including exercise interventions to improve gait and balance post-TBI. Twenty papers fully met inclusion criteria. The quality of studies was determined by the Physiotherapy Evidence Database (PEDro) scale and strength by Sackett's Levels of Evidence. Results: This study found limited evidence of the positive effects of balance, gait or the combination of both interventions in TBI rehabilitation. Most studies included small sample sizes with heterogeneous groups and the interventions were variable and lacked standardization. The outcome measures were variable and low in quality. Conclusions: The state of evidence for gait and balance interventions in patients with mild-to-moderate TBI is surprisingly poor. Greater consideration and conformity in the choice of outcome measures and attention in the design and standardization treatment approaches are essential in future research to advance practice.