Miracle-dz/UniFAR-FTUs huggingface dataset:
Nutritional and Inflammatory Markers in the Prediction of Mortality in Chinese Hemodialysis Patients

Background/Aims: The prevalence ofcardiovascular disease and mortality rate is relatively low in Chinese dialysis patients. This study aimed to evaluate the predictive value of nutritional and inflammatory markers in Chinese hemodialysis patients. Methods: A total of 158 patients (70 men and 88 women, age 59.9 ± 13.2 years) were studied. Nutritional and inflammatory markers, including subjective global assessment (SGA), insulin-like growth factor-1, albumin, tumor necrosis factor-α, interleukin (IL)-1β, IL-6, serum amyloid A (SAA), and C-reactive protein (CRP), were measured. These patients were followed up until April 2004 (36 months) to determine the incidence and causes of death. Results: SGA (p = 0.001), IL-1β (p = 0.032), SAA (p = 0.031), IL-6 (p = 0.001) and CRP (p < 0.001) were found to be significant predictors of mortality. After adjusting with age, sex, diabetes, coronary artery disease, Kt/Vurea, and duration on dialysis, CRP (odds ratio = 4.58; p = 0.038) and SGA (odds ratio = 6.57; p = 0.004) remained the independent predictors of mortality. The adjusted mortality rate was highest for patients with a high CRP level and malnutrition (assessed by SGA). Conclusions: SGA and CRP levels are the most significant predictors of mortality in Chinese dialysis patients. Chinese dialysis patients with a high CRP level tend to be at higher risk of mortality only if they are malnourished.
Double blind comparison of three hearing aid circuits with new hearing aid users

This study was a double blind comparison of three types of hearing aid circuits: Class A linear peak clipping, Class D compression limiting and K-Amp TM wide dynamic range compression. Subjective ratings, speech perception tests, real ear measurements and questionnaire data were obtained from a group of 17 new hearing aid users with mild to moderate sensorineural hearing loss. The results indicate a similar performance for all three circuits. We saw no evidence of performance degradation due to saturation distortion, even in the presence of high levels of speech and noise. Our primary conclusions include recommending K-Amps TM to new hearing aid users with mild to moderate hearing loss, mostly on the basis of battery life, while cautioning about the use of compression knee-point controls and recognizing that Class A and Class D amplifiers are virtually equivalent in every performance measurement.
Effects of Prevalence and Test Diagnosticity upon Clinical Judgments of Probability

The process of revising diagnostic probabilities was studied to examine the relative influence of prior probability and test diagnosticity at various levels of clinical experience. The aims were to show changes with increasing seniority, to explore the effects of perceived seriousness of a disease, and to demonstrate systematic biases in handling probabilistic information. To these ends, 4 case vignettes were presented to 169 medical students in the three final years of the medical course and 25 residents. The data presented included the prior probabilities of two diseases and the true positive fraction of a single clinical manifestation of the rarer disease. Results showed a slightly increasing reliance on prior probability with increasing experience. The less experienced seemed most influenced by test results and by perceived seriousness of the disease. In some vignettes judgment seemed to depend on representativeness. In others, the most plausible explanation of the diagnostic choice would have been availability. Marked case-to-case variation was noted for individuals and there was a general lack of systematic biases. Revision of diagnostic opinion often depended on preconceived notions, and prior probabilities tended to be ignored. These are clear indications for teaching the basics of decision theory to medical students and early post-graduates.
Isolation of aerobic and anaerobic bacteria from suspected enterotoxaemia cases in lambs

Ninety cases of clinically diagnosed enterotoxemia infection in lambs at AL-Hamdaniya region where studied for isolation of aerobic and anaerobic bacterial causes, faecal samples were collected from all suspected cases during January- June 2008, the results show that 41.6% of the isolates were Cl. perfringens as pure single isolates, while mixed infection of Cl. perfringens with each of Enterococci and staphylococcus in percentage of 26.04%, 20.83% respectively, also mixed infection of Cl. septicum with each of Staphylococcus and E.coli were isolated at the percentage of 5.2%, 6.25% respectively. Highest bacterial isolation was from the faecal samples collected during April. McIntosh jar method show isolation of pure culture of anaerobic bacteria (Cl. perfringens), while Candle jar method show detection of 56 isolates in mixed cultures of aerobic and anaerobic bacteria.
Cancer Pain and Analgesia

Pain ranges in prevalence from 14–100% among cancer patients and occurs in 50–70% of those in active treatment. Cancer pain may result from direct invasion of tumor into nerves, bones, soft tissue, ligaments, and fascia, and may induce visceral pain through distension and obstruction. Cancer pain is multifaceted. Clinicians may describe cancer pain as acute, chronic, nociceptive (somatic), visceral, or neuropathic. Despite implementation of the WHO guidelines, reports of undertreatment of cancer pain persist in various clinical settings and in spite of decades of work to reduce unnecessary discomfort. Substantial obstacles to adequate pain relief with opioids include specific concerns of patients themselves, their family members, physicians, nurses, and the healthcare system. The WHO analgesic ladder serves as the mainstay of treatment for the relief of cancer pain in concert with tumoricidal, surgical, interventional, radiotherapeutic, psychological, and rehabilitative modalities. This multidimensional approach offers the greatest potential for maximizing analgesia and minimizing adverse effects. Primary therapies are directed at the source of the cancer pain and may enhance a patient's function, longevity, and comfort. Adjuvant therapies include nonopioids that confer analgesic effects in certain medical conditions but primarily treat conditions that do not involve pain. Nonopioid medications (over‐the‐counter agents) are useful in the management of mild to moderate pain, and their continuation through step 3 of the WHO ladder is an option after weighing a drug's risks and benefits in individual patients. Symptomatic treatment of severe cancer pain should begin with an opioid, regardless of the mechanism of the pain. They are very effective analgesics, titrate easily, and offer a favorable risk/benefit ratio. Cancer pain remains inadequately controlled despite the diagnostic and therapeutic means of ensuring that patients feel comfortable during their illness. Therefore, all practitioners need to make control of cancer pain a professional duty, even if they can only use the most basic and least expensive analgesic medications, such as morphine, codeine, and acetaminophen, to reduce human suffering.
The Frontal Systems Behaviour Scale (FrSBe) as a predictor of community integration following a traumatic brain injury

Primary objective: This study examined the relationships between the Frontal Systems Behaviour Scale (FrSBe), neuropsychological tests and community integration outcomes among individuals with a history of TBI. Methods: Seventy-six individuals with a history of TBI were consecutively recruited from patients seen in a Neuropsychology clinic in an academic healthcare setting. Participants completed neuropsychological tests, the FrSBe and the Community Integration Questionnaire (CIQ) as part of a standard clinical neuropsychological evaluation. Results: The FrSBe was a significant predictor of community integration (CIQ) outcomes. Specifically, poorer executive functioning (FrSBe Executive Functioning) predicted lower CIQ Total Scores, while increased apathy (FrSBe Apathy) was associated with reduced CIQ Productivity. Regarding neuropsychological tests, only Delayed Memory remained as a predictor: higher scores were associated with enhanced CIQ Total Scores and CIQ Social Integration. Finally, female gender was associated with superior CIQ Total Scores, CIQ Home Integration and CIQ Productivity. Conclusions: While neuropsychological tests of executive functioning failed to add predictive power to models of community integration following TBI with this sample, the FrSBe, a measure of behavioural manifestations of frontal lobe dysfunction, did predict these important functional outcomes. This suggests that use of the FrSBe may enhance the ecological validity of information gathered during a clinical neuropsychological assessment.
Carbon dynamics and budget in a Miscanthus sinensis grassland in Japan

We investigated the carbon dynamics and budget in a grassland of Miscanthus sinensis, which is widely distributed in Japan, over a 2-year period (2000–2001). Plant biomass began to increase from May and peaked in September, then decreased towards the end of the growing season (October). Soil respiration rates also exhibited seasonal fluctuations that reflected seasonal changes in soil temperature and root respiration. The contribution of root respiration to total soil respiration was 22–41% in spring and summer, but increased to 52–53% in September. To determine the net ecosystem production (carbon budget), we estimated annual net primary production, soil respiration, and root respiration. Net primary production was 1207 and 1140 g C m−2 in 2000 and 2001, respectively. Annual soil respiration was 1387 g C m−2 in 2000 and 1408 g C m−2 in 2001; root respiration was 649 and 695 g C m−2 in 2000 and 2001, respectively. Moreover, some of the carbon fixed as net production (457–459 g C m−2) is removed by mowing in autumn in this grassland. Therefore, the annual carbon budget was estimated to be −56 g C m−2 in 2000 and − 100 g C m−2 in 2001. These results suggest that the Miscanthus sinensis grassland in Japan can act as a source of CO2.
ACUTE PANCREATITIS: MODELS, MARKERS, AND MEDIATORS

Acute pancreatitis has an incidence of approximately 40 cases per year per 100,000 adults. Although usually self-limiting, 10% to 20% of afflicted patients will progress to severe pancreatitis. The mortality rate among patients with severe pancreatitis may approach 30% when they progress to multisystem organ failure. The development of acute pancreatitis illustrates the requirement for understanding the basic mechanisms of disease progression to drive the exploration of therapeutic options. The pathogenesis of acute pancreatitis involves the interplay of local and systemic immune responses that are often difficult to characterize, particularly when results from animal models are used as a foundation for human trials. Experimental studies suggest that the prognosis for acute pancreatitis depends upon the degree of pancreatic necrosis and the intensity of multisystem organ failure generated by the systemic inflammatory response. This suggests an intricate balance between localized tissue damage with proinflammatory cytokine production and a systemic, anti-inflammatory response that restricts the inappropriate movement of proinflammatory agents into the circulation. The critical players of this interaction include the proinflammatory cytokines IL-1β, TNF-α, IL-6, IL-8, and platelet activating factor (PAF). The anti-inflammatory cytokines IL-10, as well as TNF-soluble receptors and IL-1 receptor antagonist, have also been shown to be intimately involved in the inflammatory response to acute pancreatitis. Other compounds implicated in disease pathogenesis in experimental models include complement, bradykinin, nitric oxide, reactive oxygen intermediates, substance P, and higher polyamines. Several of these mediators have been documented to be present at increased concentrations in the plasma of patients with severe, acute pancreatitis. Preclinical work has shown that some of these mediators are markers for disease activity, whereas other inflammatory components may actually drive the disease process as important mediators. Implication of such mediators suggests that interruption or blunting of an inappropriate immune response has the potential to improve outcome. Although the manipulations of specific mediators in animal models may be promising, they may not transition well to the human clinical setting. However, continued reliance on experimental animal models of acute pancreatitis may be necessary to determine the underlying causes of disease. Full understanding of these basic mechanisms involves determining not only which mediators are present, but also closely documenting the kinetics of their appearance. Measurement of the inflammatory response may also serve to identify diagnostic markers for the presence of acute pancreatitis and provide insight into prognosis. Understanding the models, documenting the markers, and deciphering the mediators have the potential to improve treatment of acute pancreatitis.
Quality of Life and Symptoms of Anxiety and Depression of Patients Receiving Cancer Chemotherapy: Longitudinal Study

The overall survival gain of cancer chemotherapy is estimated to be small, and some claim that it rarely improves quality of life (QOL). The purpose of this population-based study was to describe QOL and symptoms of anxiety and depression, over time, in a group of Icelandic cancer patients receiving chemotherapy. Quality of life was measured with the Icelandic version of Cancer Rehabilitation Evaluation System, Short Form (CARES-SF), and symptoms of anxiety and depression, with the Icelandic version of Hospital Anxiety and Depression Scale (HADS). Enrolled into the study were 144 patients, 90 women and 54 men; mean (SD) age was 55 (12.1) years. Although QOL was found relatively good during the period of chemotherapy, it was significantly worse after 3 and 6 months compared to baseline. Quality of life was found worst in the sexual and physical domains. At all time points, a significant association was found between symptoms of anxiety and depression and QOL with those reporting symptoms of either anxiety or depression experiencing worse QOL. The good QOL found during the period of chemotherapy is a positive finding. The results, however, call for an intense assessment, over time, of physical symptoms, anxiety, and depression, as well as sexuality issues.
Hspa4l-Deficient Mice Display Increased Incidence of Male Infertility and Hydronephrosis Development

ABSTRACT The Hspa4l gene, also known as Apg1 or Osp94, belongs to the HSP110 heat shock gene family, which includes three genes encoding highly conserved proteins. This study shows that Hspa4l is expressed ubiquitously and predominantly in the testis. The protein is highly expressed in spermatogenic cells, from late pachytene spermatocytes to postmeiotic spermatids. In the kidney, the protein is restricted to cortical segments of distal tubules. To study the physiological role of this gene in vivo, we generated mice deficient in Hspa4l by gene targeting. Hspa4l-deficient mice were born at expected ratios and appeared healthy. However, approximately 42% of Hspa4l−/− male mice suffered from fertility defects. Whereas the seminiferous tubules of Hspa4l−/− testes contained all stages of germ cells, the number of mature sperm in the epididymis and sperm motility were drastically reduced. The reduction of the sperm count was due to the elimination of a significant number of developing germ cells via apoptosis. No defects in fertility were observed in female mutants. In addition, 12% of null mutant mice developed hydronephrosis. Concentrations of plasma and urine electrolytes in Hspa4l−/− mice were similar to wild-type values, suggesting that the renal function was not impaired. However, Hspa4l−/− animals were preferentially susceptible to osmotic stress. These results provide evidence that Hspa4l is required for normal spermatogenesis and suggest that Hspa4l plays a role in osmotolerance.
Potential of in situ hybridization for early diagnosis of productive cytomegalovirus infection

In situ hybridization with a probe specific for immediate-early genes was used for detection of cytomegalovirus (CMV) transcripts in peripheral blood mononuclear cells, and the potential use of this technique as a diagnostic tool was assessed. The results were compared with those obtained with conventional assay systems. In 8 of 18 continually observed patients who developed a productive CMV infection, a high number of hybridization-positive cells were observed 1 to 2 weeks before the conventional tests yielded positive results. Thus, quantitative evaluation of hybridization results provided an early and specific marker for beginning CMV infection or reactivation. In three cases, quantitative in situ hybridization assays provided the only laboratory marker indicating CMV infection or reactivation. It was also found that a probe specific for immediate-early genes was superior to a probe specific for late genes for diagnosis of productive infections.
[Treatment of severe idiopathic cold-agglutinin diseases using interferon-alpha 2b].

Cold agglutinin disease is an immunohemolytic anemia in which the autoantibody directly agglutinates human red blood cells below body temperature, maximally at 0 to 5 degrees C. The disease is considered to occur in primary (idiopathic) or secondary forms. The secondary form is noticed in the setting of infections (e.g. Mycoplasma pneumoniae, infectious mononucleosis), or patients with lymphoproliferative disorders. Affected patients show varying clinical presentation ranging from mild to serious hemolytic anemia, episodic hemoglobinuria, acrocyanosis, or other peripheral vaso-occlusive events which are all occasioned by cold exposure. In mild chronic cold agglutinin disease preventing cold exposure usually suffices to avoid disease exacerbation. However, treatment of severe disease is difficult. Splenectomy or glucocorticoids are generally disappointing, but exceptions have been reported. Treatment with alkylating agents, as for example chlorambucil or cyclophosphamide, may be effective in some patients. However, late effects, and in particular their carcinogenic potential when used as long-term treatment, must be born in mind. We report on a 59-year-old woman with severe cold agglutinin disease who was at first treated successfully with chlorambucil and prednisone. Based on in vitro evidence, primary cold agglutinin disease can be considered as a low grade malignant lymphoproliferative disorder in which interferon-alpha has been shown to be an effective therapeutic agent, at least in forms such as hairy cell leukemia. We therefore switched therapy to interferon-alpha 2b (three million units/m2 body surface area subcutaneously three times weekly). 18 months after treatment initiation there was no remission, but improvement of clinical and laboratory signs of the disease was noted. (ABSTRACT TRUNCATED AT 250 WORDS)
Pseudodominant inheritance of goitrous congenital hypothyroidism caused by TPO mutations: molecular and in silico studies.

CONTEXT AND OBJECTIVE Most cases of goitrous congenital hypothyroidism (CH) from thyroid dyshormonogenesis 1) follow a recessive mode of inheritance and 2) are due to mutations in the thyroid peroxidase gene (TPO). We report the genetic mechanism underlying the apparently dominant inheritance of goitrous CH in a nonconsanguineous family of French Canadian origin. DESIGN, SETTING, AND PARTICIPANTS Two brothers identified by newborn TSH screening had severe hypothyroidism and a goiter with increased (99m)Tc uptake. The mother was euthyroid, but the father and two paternal uncles had also been diagnosed with goitrous CH. After having excluded PAX8 gene mutations, we hypothesized that the underlying defect could be TPO mutations. RESULTS Both compound heterozygous siblings had inherited a mutant TPO allele carried by their mother (c.1496delC; p.Pro499Argfs2X), and from their father, one brother had inherited a missense mutation (c.1978C-->G; p.Gln660Glu) and the other an insertion (c.1955insT; p.Phe653Valfs15X). The thyroid gland of one uncle who is a compound heterozygote for TPO mutations (p.Phe653Valfs15X/p.Gln660Glu) was removed because of concurrent multiple endocrine neoplasia type 2A. Immunohistochemistry revealed normal TPO staining, implying that Gln660Glu TPO is expressed properly. Modeling of this mutant in silico suggests that its three-dimensional structure is conserved, whereas the electrostatic binding energy between the Gln660Glu TPO and its heme group becomes repulsive. CONCLUSION We report a pedigree presenting with pseudodominant goitrous CH due to segregation of three different TPO mutations. Although goitrous CH generally follows a recessive mode of inheritance, the high frequency of TPO mutations carriers may lead to pseudodominant inheritance.
Epidural Morphine Provides Postoperative Pain Relief in Peripheral Vascular and Orthopedic Surgical Patients: A Dose—Response Study

&NA; A randomized double‐blind study compared the dose‐response relationship of epidural morphine for postoperative pain relief in two groups of patients whose surgical procedures would result in either moderate (femoral‐popliteal bypass) or severe (total knee replacement) postoperative pain. Preservative‐ free morphine sulphate in doses of 0, 2, 5, or 10 mg in a volume of 10 ml saline were administered via lumbar epidural catheters. The epidural morphine was administered 1 hr after the last dose of intraoperative local epidural anesthetic in an effort to achieve a pain‐free postoperative course. A significant relationship existed between the dose of epi‐ dural morphine and both time to first required pain medication and 24‐hr weighted pain score. Five mg epidural morphine provided significant improvement in postoperative analgesia compared with the control in both groups. Further enhancement of analgesia occurred with 10 mg; however, late respiratory depression, demonstrated by an increased resting PaCO2 10 hr after administration, was seen only with the 10‐mg dose in both surgical groups. Minor complications such as nausea, vomiting, pruritus, and urinary retention were uncommon and did not appear to be related to dose. We found that 5 mg epidural morphine provided long‐lasting postoperative analgesia without serious adverse effects after peripheral vascular and orthopedic surgery.
Kaon Pair Production in Proton-Proton Collisions

The differential and total cross sections for kaon pair production in the pp -> ppK(+)K(-) reaction have been measured at three beam energies of 2.65, 2.70, and 2.83 GeV using the ANKE magnetic spectrometer at the COSY-Julich accelerator. These near-threshold data are separated into pairs arising from the decay of the phi-meson and the remainder. For the non-phi selection, the ratio of the differential cross sections in terms of the K(-)p and K(+)p invariant masses is strongly peaked toward low masses. This effect can be described quantitatively by using a simple ansatz for the K(-)p final state interaction, where it is seen that the data are sensitive to the magnitude of an effective K(-)p scattering length. When allowance is made for a small number of phi events where the K- rescatters from the proton, the phi region is equally well described at all three energies. A very similar phenomenon is discovered in the ratio of the cross sections as functions of the K(-)pp and K(+)pp invariant masses and the identical final state interaction model is also very successful here. The world data on the energy dependence of the non-phi total cross section is also reproduced, except possibly for the results closest to threshold.