Miracle-dz/UniFAR-FTUs huggingface dataset:
Geomapping of chlamydia and gonorrhoea in Birmingham.

OBJECTIVE To investigate if the core population hypothesis is applicable to patients with genital chlamydia infections. DESIGN Retrospective cross sectional study. SETTING Two genitourinary medicine (GUM) clinics in the city of Birmingham and eight adjacent clinics. SUBJECTS All patients with chlamydia (n = 665) or gonorrhoea (n = 584) attending between 1 October 1995 and 30 September 1996 with a postcode within the Birmingham health district. Controls were 727 patients seen in the same period with no infection. METHODS Postcodes were used to calculate population prevalence rates per 100,000 aged 15-65 in the 39 wards of the city and to estimate the socioeconomic status using the Super Profile (SP). Ethnic specific rates were also calculated. Data were obtained on gonorrhoea and chlamydia isolation from all the major laboratories of the city over the same time period. RESULTS GUM clinic attenders accounted for 67.6% and 82.5% of all chlamydia and gonorrhoea isolates reported by the laboratories and that were available for our epidemiological analysis. Both infections were more common in men and in black ethnic groups. However, patients with gonorrhoea only infection were more likely to be of black ethnicity than those with chlamydia only infection (p = 0.0001) and to have different SP distribution (p = 0.0001). On logistic regression age < 20 years, male sex, black ethnicity, and living in neighbourhoods with SP J ("have nots") were predictive of both infections compared with controls. Overall chlamydia and gonorrhoea prevalence rates were 129 and 98.4 per 10(5) respectively. Corresponding rates for whites was 64.7 and 37.2 and for black ethnic groups 1105 and 1183 per 10(5) of each ethnic group. Eight adjacent wards accounted for 41% of the chlamydia and 66.5% of the gonorrhoea. CONCLUSION In a large urban setting patients attending GUM clinics with chlamydia belong to core population groups with similar, but not identical, sociodemographic characteristics to patients with gonorrhoea infection.
Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative.

BACKGROUND Proton pump inhibitor (PPI) medications have been inconsistently shown to be associated with osteoporotic fractures. We examined the association of PPI use with bone outcomes (fracture, bone mineral density [BMD]). METHODS This prospective analysis included 161 806 postmenopausal women 50 to 79 years old, without history of hip fracture, enrolled in the Women's Health Initiative (WHI) Observational Study and Clinical Trials with a mean (SD) follow-up of 7.8 (1.6) years. Analyses were conducted for 130 487 women with complete information. Medication information was taken directly from drug containers during in-person interviews (baseline, year 3). The main outcome measures were self-reported fractures (hip [adjudicated], clinical spine, forearm or wrist, and total fractures) and for a subsample (3 densitometry sites), 3-year change in BMD. RESULTS During 1 005 126 person-years of follow-up, 1500 hip fractures, 4881 forearm or wrist fractures, 2315 clinical spine fractures, and 21 247 total fractures occurred. The multivariate-adjusted hazard ratios for current PPI use were 1.00 (95% confidence interval [CI], 0.71-1.40) for hip fracture, 1.47 (95% CI, 1.18-1.82) for clinical spine fracture, 1.26 (95% CI, 1.05-1.51) for forearm or wrist fracture, and 1.25 (95% CI, 1.15-1.36) for total fractures. The BMD measurements did not vary between PPI users and nonusers at baseline. Use of PPIs was associated with only a marginal effect on 3-year BMD change at the hip (P = .05) but not at other sites. CONCLUSION Use of PPIs was not associated with hip fractures but was modestly associated with clinical spine, forearm or wrist, and total fractures.
Reducing Liver Transplant Length of Stay: A Lean Six Sigma Approach

Context Organ transplant centers are under increasing scrutiny to maintain outcomes while controlling cost in a challenging population of patients. Throughout health care and transplant specifically, length of stay is used as a benchmark for both quality and resource utilization. Objective To decrease our length of stay for liver transplant by using Lean Six Sigma methods. Design The Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) method was used to systematically analyze our process from transplant listing to hospital discharge after transplant, identifying many factors affecting length of stay. Patients or Other Participants Adult, single-organ, primary liver transplant recipients between July 2008 and June 2012 were included in the study. Recipients with living donors or fulminant liver failure were excluded. Intervention(s) Multiple interventions, including a clinical pathway and enhanced communication, were implemented. Main Outcome Measure(s) Length of stay after liver transplant and readmission after liver transplant. Results Median length of stay decreased significantly from 11 days before the intervention to 8 days after the intervention. Readmission rate did not change throughout the study. The improved length of stay was maintained for 24 months after the study. Conclusion Using a Lean Six Sigma approach, we were able to significantly decrease the length of stay of liver transplant patients. These results brought our center's outcomes in accordance with our goal and industry benchmark of 8 days. Clear expectations, improved teamwork, and a multidisciplinary clinical pathway were key elements in achieving and maintaining these gains.
Localization of GABAA receptor subunits alpha 1, alpha 3, beta 1, beta 2/3, gamma 1, and gamma 2 in the salamander retina.

Electrophysiological studies have demonstrated that gamma-aminobutyric acid receptors type A (GABA(A)) mediate important information processing in the retinas of salamander and other vertebrates. The pharmacology and physiology of GABA(A) receptors depend on their subunit composition. We studied the localization of GABA(A) receptor subunit isoforms alpha(1), alpha(3), beta(1), beta(2/3) (antibody BD-17 and 62-3G1), gamma(1), and gamma(2) in salamander retina with immunocytochemical methods. All three beta-subunit antibodies labeled similarly in the outer retina, especially the inner segments and synaptic terminals of rod photoreceptors (identified with protein kinase C). Somatic labeling was observed in cell bodies of some horizontal cells, bipolar cells, amacrine cells, and cells in the ganglion cell layer (GCL). Puncta were present throughout the inner plexiform layer (IPL) for beta(1) and 62-3G1, but not for BD-17. alpha(1)-immunoreactivity (IR) stained a population of presumed OFF rod-dominated bipolar cells, including dendrites, soma, and axon terminals in the distal IPL. A subtype of GABAergic amacrine cell also expressed alpha(1)-IR, with puncta sparsely distributed at the distal and proximal margins of the IPL. Both the OPL and IPL were labeled throughout for alpha(3)-IR, as opposed to the narrow distribution of alpha(1)-IR in the IPL, suggesting that the two alpha-subunits are localized at different synaptic sites. Punctate gamma(1)-IR was observed in the OPL and IPL, whereas gamma(2) was most prominent in cone photoreceptors (identified with calbindin), including the terminal telodendria, in cell bodies of some horizontal cells, amacrine cells, cells in the GCL, and less intensely in the IPL. In addition, several subunits were present in Müller cells. The differential labeling suggests the existence of GABA(A) receptor subtypes with different subunit compositions that mediate multiple GABAergic functions in salamander retina.
Chemopreventive effect of carvacrol on 1,2-dimethylhydrazine induced experimental colon carcinogenesis.

PURPOSE Colorectal cancer (CRC) is a leading cause for cancer-related death and its prevention is of great importance throughout the world. Chemoprevention offers a novel approach to control the incidence of colon cancer. The present study was performed to evaluate the efficacy of carvacrol supplementation on colonic aberrant crypt foci (ACF), lipid peroxidation, and antioxidant defense system in 1,2-dimethylhydrazine (DMH)-induced colon carcinogenesis in male Wistar rats. MATERIALS AND METHODS The rats were randomly divided into six groups. Group 1, control rats received modified pellet diet; Group 2 rats received modified pellet diet along with carvacrol (80 mg/kg b.wt/day); Groups 3-6 received subcutaneous injection of DMH (20 mg/kg b.wt), once a week for the first 4 weeks; in addition Groups 4-6 received carvacrol at three different doses of 20, 40, and 80 mg/kg b.wt/day for 16 weeks. RESULTS Our result suggest that increased tumor incidence and increased number of ACF, increased bacterial enzymes accompanied by a decrease in the colonic lipid peroxidation, glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) activities were observed in DMH-treated rats. Administration of carvacrol to DMH-treated rats significantly decreased the tumor incidence and the number of ACF and bacterial enzymes with enhancement of colonic lipid peroxidation, GPx, SOD, and CAT activities. CONCLUSION The results of this study suggest that carvacrol at a dose of 40 mg/kg b.wt showed a significant beneficial effect against chemically-induced colon carcinogenesis in rats.
Kinetic changes of oxidative stress and selenium status in plasma and tissues following burn injury in selenium-deficient and selenium-supplemented rats.

BACKGROUND This study investigates the relationship between the burn-induced oxidative stress and the selenium status. METHODS The rats were fed with a selenium-adequate diet or a selenium-depleted diet for 5 weeks, before a third-degree thermal injury was applied to the animals. One group of selenium-depleted animals received injections of sodium selenite after the injury. The selenium status and the oxidative stress parameters were measured for 5 days. RESULTS The selenium-deficient diet leads to oxidative stress with a high stimulation of the superoxide dismutase activity. After the burn injury, the oxidative stress appears important because the initial selenium status is already impaired and, in all animals, the selenium levels and the antioxidant seleno-dependent glutathione peroxidase (GPx) activity decrease in the plasma and the tissues. A treatment with daily selenium injections is efficient in normalizing selenium levels and restores the GPx activity, but fails to counteract the initial oxidative damages induced by the selenium-deficient diet. CONCLUSIONS The selenium status before the burn injury is a modulating factor of the burn-induced oxidative stress. A single selenium supplement is not sufficient to counteract these oxidative damages and henceforth combined antioxidant supplementations should be investigated to improve the early treatment of the burn patients.
A non-local rheology for granular flows across yield conditions

The rheology of dense granular flows is studied numerically in a shear cell controlled at constant pressure and shear stress, confined between two granular shear flows. We show that a liquid state can be achieved even far below the yield stress, whose flow can be described with the same rheology as above the yield stress. A non-local constitutive relation is derived from dimensional analysis through a gradient expansion and calibrated using the spatial relaxation of velocity profiles observed under homogeneous stresses. Both for frictional and frictionless grains, the relaxation length is found to diverge as the inverse square-root of the distance to the yield point, on both sides of that point.
Thoracoscopic minimally invasive surgery for non-small cell lung cancer in patients with chronic obstructive pulmonary disease.

OBJECTIVE To determine the incidence of peri-operative complications in non-small cell lung cancer (NSCLC) patients with co-existent chronic obstructive pulmonary disease (COPD) who undergo lung resection via traditional and minimally invasive techniques. METHODS A retrospective analysis was conducted of 152 NSCLC patients with COPD who underwent thoracoscopic minimally invasive surgery. Particular attention is given to the relationship between disease severity or surgical approach and the incidence of complications. RESULTS THE PREVALENCE OF RESPIRATORY AND CARDIAC COMPLICATIONS WAS SIGNIFICANTLY HIGHER IN PATIENTS WITH SEVERE/EXTREMELY SEVERE COPD THAN THOSE WITH MILD TO MODERATE COPD (RESPIRATORY COMPICATIONS: 37.3% vs. 20.4%, P=0.022; cardiac complications: 16.9% vs. 6.5%, P=0.040). Patients who underwent complete-video assisted thoracoscopic surgery (c-VATS) had a significantly lower overall morbidity of adverse reactions than those who had undergone VATS major resection (26.3% vs. 42.1%, P=0.044). Among patients with severe/extremely severe COPD, there was no significant difference in the incidence of any complication between the lobectomy group and wedge resection group (38.8% vs. 70.0%, P=0.072). Overall, the occurrence of adverse reactions was significantly lower in patients who underwent c-VATS than in those who had undergone VATS major resection surgery (34.2% vs. 61.9%, P=0.038). CONCLUSIONS VATS techniques are suitable for COPD patients and are demonstrated here to lower the incidence of post-operative complications when compared with more invasive approaches.
Behavior of Sister Copies of Mini-F Plasmid after Synchronized Plasmid Replication in Escherichia coli Cells

ABSTRACT To clarify whether sister copies of mini-F plasmid are immediately separated from each other after replication, we analyzed the behavior of sister mini-F copies after synchronized replication of mini-F. Sister copies of mini-F were separated immediately or shortly after replication, in contrast to sister oriC copies of the Escherichia coli chromosome.
Microvascular vasopressin effects during endotoxin shock in the rat.

We have demonstrated decreased microvascular sensitivity to norepinephrine during endotoxin shock possibly related to reduced sympathetic receptor activity (Baker et al.: Circ Shock 12:165-176, 1984). The response to other vascular controls such as arginine vasopressin (AVP) may also be altered. Reactivity of the left cremaster muscle microvessels of pentobarbital anesthetized Wistar rats was studied using videomicroscopy and videodensitometry. Femoral arterial pressure (Pm), dose response curves of vessel diameters to topical arginine vasopressin (10(-15) to 10(-6) M), FITC-albumin mean transit times, and plasma velocities were obtained. Escherichia coli endotoxin (6 mg/kg i.v., LD100) was infused over a 1-hr period. Parameter measurements were repeated at 30 min and 90 min post-endotoxin. Both Pm and plasma velocities progressively decreased. Arteriolar constriction and the mean transit times of FITC-labeled albumin progressively increased. The threshold dose for AVP averaged 10(-9) M at control and decreased to 10(-14) M post-endotoxin. Venular diameters were not altered by AVP. The AVP antagonist did not alter the microvascular diameter response to endotoxin but did block the responses to topical and endogenous AVP since arterial pressure and flow velocity decreased at a significantly greater rate than in rats without antagonist. Plasma AVP levels were significantly increased by endotoxin. Reduced alpha adrenergic sensitivity may unmask the responsiveness to AVP or increase the sensitivity of AVP receptors. Increased endogenous AVP may require a smaller exogenous concentration of AVP for constriction.
Pathology Associated with Optical Coherence Tomography Macular Bending due to either Dome-Shaped Macula or Inferior Staphyloma in Myopic Patients

Purpose: To evaluate the prevalence of and describe the pathology associated with macular bending (MB) defined as a smooth macular elevation found in optical coherence tomography (OCT) of patients with high myopia related to either dome-shaped macula (DSM) or the border of an inferior staphyloma. Procedures: We reviewed the 330 files of all highly myopic patients in our database that had had an OCT performed in the last 5 years. Main outcome measures were MB prevalence and its associated pathology. Results: Sixty-eight eyes from 45 patients (13.63%) presented MB; 23 bilateral, 40 in a posterior pole or macular staphyloma and 21 in an inferior staphyloma. Eighteen eyes presented choroidal neovascularization (CNV), 7 subretinal fluid without CNV, 11 retinoschisis and 3 a macular hole which had been stable for years. No differences were found in the rate of complications between patients with DSM or inferior staphyloma. Conclusions: MB is not an uncommon clinical feature. Associated pathology prevalence in MB was elevated and similar in posterior and inferior staphylomas.
Premature Labor, Part I: Risk Assessment, Etiologic Factors, And Diagnosis

Background: This paper, the first of a two-part series on premature labor, reviews the recent literature on the causes of and risk factors for preterm labor and methods of diagnosis. Methods: A review of the literature on risk determination and diagnosis of preterm labor was conducted by searching MEDLINE files from 1983 to the present, using the key terms “preterm labor,” “premature labor,” “preterm labor and infection,” and “uterine monitoring. ” Additional references were accessed by cross-referencing the bibliographies of the articles obtained through this search. Results and Conclusions: Risk factors for preterm labor, which include items related to the pregnant woman’s demographic characteristics, history, daily habits, and current pregnancy, have been combined into scoring systems commonly used by clinicians and researchers to single out women at risk for preterm delivery. When such systems are tested in obstetric populations, results show variable success in predicting preterm labor or birth. These inconsistent results could be due, in part, to important factors that have often been omitted from scoring systems, such as chemical abuse, poor nutrition, little social support, demanding work, multiple sexual partners, past or current sexually transmitted diseases, and other gynecologic infections. Women who are considered high risk for preterm labor can benefit from participating in preterm birth prevention programs that incorporate home monitoring, patient education regarding the signs and symptoms of preterm labor, frequent contacts with health professionals, and cervical examinations.
Angiomyolipoma with minimal fat: can it be differentiated from clear cell renal cell carcinoma by using standard MR techniques?

PURPOSE To retrospectively assess whether magnetic resonance (MR) imaging with opposed-phase and in-phase gradient-echo (GRE) sequences and MR feature analysis can differentiate angiomyolipomas (AMLs) that contain minimal fat from clear cell renal cell carcinomas (RCCs), with particular emphasis on small (<3-cm) masses. MATERIALS AND METHODS Institutional review board approval and a waiver of informed consent were obtained for this HIPAA-compliant study. MR images from 108 pathologically proved renal masses (88 clear cell RCCs and 20 minimal fat AMLs from 64 men and 44 women) at two academic institutions were evaluated. The signal intensity (SI) of each renal mass and spleen on opposed-phase and in-phase GRE images was used to calculate an SI index and tumor-to-spleen SI ratio. Two radiologists who were blinded to the pathologic results independently assessed the subjective presence of intravoxel fat (ie, decreased SI on opposed-phase images compared with that on in-phase images), SI on T1-weighted and T2-weighted images, cystic degeneration, necrosis, hemorrhage, retroperitoneal collaterals, and renal vein thrombosis. Results were analyzed by using the Wilcoxon rank sum test, two-tailed Fisher exact test, and multivariate logistic regression analysis for all renal masses and for small masses. A P value of less than . 05 was considered to indicate a statistically significant difference. RESULTS There were no differences between minimal fat AMLs and clear cell RCCs for the SI index (8.05%±14.46 vs 14.99%±19.9; P=.146) or tumor-to-spleen ratio (-8.96%±16.6 and -15.8%±22.4; P=.227) when all masses or small masses were analyzed. Diagnostic accuracy (area under receiver operating characteristic curve) for the SI index and tumor-to-spleen ratio was 0.59. Intratumoral necrosis and larger size were predictive of clear cell RCC (P<.001) for all lesions, whereas low SI (relative to renal parenchyma SI) on T2-weighted images, smaller size, and female sex correlated with minimal fat AML (P<.001) for all lesions. CONCLUSION The diagnostic accuracy of opposed-phase and in-phase GRE MR imaging for the differentiation of minimal fat AML and clear cell RCC is poor. In this cohort, low SI on T2-weighted images relative to renal parenchyma and small size suggested minimal fat AML, whereas intratumoral necrosis and large size argued against this diagnosis.
Sleep and 24 hour body temperatures: a comparison in young men, naturally cycling women and women taking hormonal contraceptives

1 Body temperature has a circadian rhythm, and in women with ovulatory cycles, also a menstrual rhythm. Body temperature and sleep are believed to be closely coupled, but the influence on their relationship of gender, menstrual cycle phase and female reproductive hormones is unresolved. 2 We investigated sleep and 24 h rectal temperatures in eight women with normal menstrual cycles in their mid‐follicular and mid‐luteal phases, and in eight young women taking a steady dose of oral progestin and ethinyl oestradiol (hormonal contraceptive), and compared their sleep and body temperatures with that of eight young men, sleeping in identical conditions. All subjects maintained their habitual daytime schedules. 3 Rectal temperatures were elevated throughout 24 h in the luteal phase compared with the follicular phase in the naturally cycling women, consistent with a raised thermoregulatory set‐point. Rectal temperatures in the women taking hormonal contraceptives were similar to those of the naturally cycling women in the luteal phase. 4 Gender influenced body temperature: the naturally cycling women and the women taking hormonal contraceptives attained their nocturnal minimum body temperatures earlier than the men, and the naturally cycling women had blunted nocturnal body temperature drops compared with the men. 5 Sleep architecture was essentially unaffected by either menstrual cycle phase or gender. The women taking hormonal contraceptives had less slow wave sleep (SWS), however, than the naturally cycling women. 6 Gender, menstrual cycle phase and hormonal contraceptives significantly influenced body temperature, but had only minor consequences for sleep, in the young men and women in our study.