Miracle-dz/UniFAR-FTUs huggingface dataset:
Warfarin monitoring economic evaluation of point of care self-monitoring compared to clinic settings

Abstract Objective: To determine the cost-effectiveness of home-based point-of-care self-monitoring compared to clinic-based care for patients managed on long-term warfarin medication. Current evidence is inconsistent; results should reduce uncertainty and inform service delivery. Methods: A Markov model compared self-testing and self-management, using point-of-care devices to usual care in patients with atrial fibrillation and mechanical heart valves. The primary clinical end-points were stroke and mortality avoided; costs and utilities were associated with these events. The costs of warfarin monitoring were included in the model. Results: Over 10 years, self-monitoring saved £1187 per person compared to usual care. Patients who self-monitored had notably fewer strokes and deaths. The results were sensitive to life-years gained and cost of the device. If the NHS purchased the device, financial break-even was achieved at the end of the second year; if the patient bought the device the NHS saved money every year. If 10% of the current 950,000 patients switched to point-of-care devices for 10 years, the NHS could save over £112million. Limitations: Clinical studies had a relatively short duration and only data on composite end-points were reported. Conclusions: With training, self-testing and self-management are safe, reliable, and cost-effective for a sizable proportion of patients receiving long-term warfarin. Compared to clinic-based services, self-monitoring offers the NHS the potential to make cost savings and release bed-days by reducing the number of strokes experienced by these high-risk patients.
Balancing efficacy and safety in the TRITON-TIMI 38 trial

The TRITON-TIMI 38 study tested the hypothesis that prasugrel compared with clopidogrel is more efficacious in prevention of ischaemic events in patients undergoing percutaneous coronary intervention (PCI) for either ST-elevation myocardial infarction or for non-ST-elevation acute coronary syndromes. In a double-blind design, 13 608 patients were randomly assigned to receive prasugrel or clopidogrel. During 15-month follow-up, prasugrel compared with clopidogrel significantly reduced the incidence of the primary endpoint, the composite of the rate of cardiovascular death, myocardial infarction, or stroke from 12.1 to 9.9% (hazard ratio: 0.81; P < 0.001). Significant benefit of prasugrel was found during the first 3 days (hazard ratio: 0.82; P = 0.01) and from day 4 to the end of the study (hazard ratio: 0.8; P = 0.003). Of the patients treated with prasugrel, 2.4% experienced at least one TIMI major haemorrhage unrelated to coronary artery bypass graft, compared with 1.8% treated with clopidogrel (hazard ratio: 1.32; P = 0.03). Thus, in the entire study group, the balance of efficacy and safety was in favour of prasugrel with an absolute 2.2% reduction in the primary efficacy endpoint by prasugrel when compared with clopidogrel that was opposed by an only 0.6% increase in major haemorrhage. In conclusion, in patients with acute coronary syndromes undergoing PCI prasugrel significantly reduced the incidence of ischaemic events, both in the acute and long term. Prasugrel was associated with an increased risk of bleeding. In the entire cohort, the superior efficacy of prasugrel outweighed the increased risk of bleeding.
Prevalence and antibiotic susceptibility of uropathogens among patients attending University of Abuja Teaching Hospital, Gwagwalada, Abuja

A urinary tract infection (UTI) is a condition where one or more structures in the urinary tract become infected by the presence and growth of microorganisms that overcome the structures strong natural defenses. This study reports the examination of bacterial organisms implicated in urinary tract infections among 180 patients suspected to have UTI that attended University of Abuja Teaching Hospital (UATH), Gwagwalada, Abuja for a period of 3 months and the antibiotic susceptibility patterns of the bacterial isolates. First morning mid stream urine sample cultures were done by the calibrated loop technique delivering 0.002 ml of urine plated on Cystine Lactose Electrolyte Deficient (CLED) agar and blood agar medium for isolation of uropathogens which were further analyzed for drug susceptibility by disk diffusion method. Result showed that 104 (57.78%) patients had urinary tract infection. The uropathogens isolated were Escherichia coli as the most abundant (43.27%) followed by Staphylococcus aureus (35.57%), Klebsiella species (11.54%), Proteus species (5.77%) and Pseudomonas species (3.85%) as the least occurring. In vitro antibiotic susceptibility test revealed that the Gram negative bacteria were most sensitive to quinolones (ofloxacin and levofloxacin), gentamycin and nalixidic acid while the Gram positive isolates were sensitive to erythromycin, chloramphenicol and quinolones (ofloxacin and levofloxacin). The most effective drug in both cases was the quinolones– ofloxacin (78.32%) and levofloxacin (76.98%), while the least sensitivity pattern was observed with ampicillin (14.29%).
Cell Signaling : Proteins , Pathways and Mechanisms Activation of mTORC 1 by leucine is potentiated by branched-chain amino acids and even more so by essential amino acids following resistance exercise

Marcus Moberg, William Apró, Björn Ekblom, Gerrit van Hall, Hans-Christer Holmberg, and Eva Blomstrand Åstrand Laboratory, Swedish School of Sport and Health Sciences, Stockholm, Sweden; Clinical Metabolomics Core Facility, Rigshopitalet and Department of Biomedical Sciences, Rigshospitalet, University of Copenhagen, Copenhagen Denmark; Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden; and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
Haemodiafiltration Does Not Reduce the Frequency of Intradialytic Hypotensive Episodes when Compared to Cooled High-Flux Haemodialysis

Introduction: Intradialytic hypotension remains the commonest complication of outpatient haemodialysis (HD) treatments. On-line haemodiafiltration (HDF) has been reported to reduce the frequency of intradialytic hypotension. We introduced on-line HDF into our satellite dialysis program, and prospectively audited the effect of HDF on cardiovascular stability. Methods: 34 patients’ dialysis schedules (Tuesday/Thursday/Saturday) were converted to online post-dilutional HDF, and 44 patients’ dialysis schedules (Monday/Wednesday/Friday) remained on high-flux HD. Blood pressure and intra-treatment complications were monitored prospectively for 12 months. Results: There was no significant change in pre-treatment mean arterial blood pressure in the HDF group during the 12 months of the study (pre-treatment 113.7 ± 0.7 mm Hg vs. 109.3 ± 2.8 after 12 months), or for the HD cohort (113.9 ± 2.7 vs. 117.9 ± 2.6). However, the frequency of intradialytic hypotensive episodes was greater for the HDF cohort: 25.9 versus 16.5% in the HD cohort, p = 0.0116. During HDF, on average >16 litres of substitution fluid was used and the median temperature was 36°C (35°C–36°C), higher than the dialysate in the HD cohort which was 35°C (35°C–36°C), p < 0.05. Conclusion: In this study, HDF did not improve blood pressure control or reduce the frequency of intradialytic hypotensive episodes compared to high-flux HD using cooled dialysate.
Glaucoma awareness and perceptions of risk among African-Caribbeans in Birmingham, UK

Among black people, primary open-angle glaucoma is a major cause of irreversible blindness that is avoidable with early detection and treatment. This paper presents an account of a qualitative investigation, based on a phenomenological approach, into glaucoma awareness based on semi-structured interviews and focus groups with 48 African– Caribbean participants who were not receiving treatment from a hospital eye service. Data were analysed using manual and computerised methods to identify six themes: ‘knowledge of glaucoma’, ‘glaucoma risk perception and heuristics’, ‘images of blindness’, ‘health accounts’, ‘glaucoma risk perception’ and protection motivation theory and ‘cultural context and individual differences’. Findings showed that while participants held positive attitudes to health promotion in general, these did not incorporate eye health. Factors such as family histories, where available, were very important in helping individuals to understand that glaucoma might affect them, and in what ways this might happen. Attitudes to blindness tended to reflect the notion of the blind person as a victim. The idea of taking action to prevent this happening hinged upon participants’ perceptions of the credibility of both the source and the nature of the information they had received about glaucoma. It is anticipated that this study will help practitioners to understand the health beliefs of African–Caribbean patients with this condition and to assist in recruitment to further research on glaucoma pathogenesis and clinical outcomes in the African–Caribbean eye.
VMO-VL reflex latency difference in osteoarthritic knees and controls

It was hypothesized that onset of reflex electromyographic (EMG) activity of vastus medialis oblique (VMO) was delayed relative to that of vastus lateralis (VL) in patients with osteoarthritis (OA) of the knee compared to controls. Three subject groups were tested: young asymptomatics (n=20), mean (±SD) 31.1±7.9 years; older asymptomatics (n=17), 56.7±8.6 years; and symptomatic OA knee patients, diagnosed by an orthopaedic surgeon (n=16), 65.9±7.8 years. The patellar tendon reflex latencies of VMO and VL were measured using surface EMG, and the reflex latency difference (RLD) between the two muscles was calculated for each subject. Mean RLD values were 0.75±1.17, 1.05±1.06 and 1.27±0.81 ms for young asymptomatics, older asymptomatics and OA knee patients respectively, indicating that on average VMO was activated after VL in all groups. However, analysis of variance showed that these RLD values were not significantly different between the groups, F(2,50)=1.140, p=0.33. The results demonstrate that the onset of reflex VMO EMG activity relative to VL is not delayed in OA knee patients compared to controls. This has important implications for rehabilitation programmes aimed at developing preferential activation of VMO compared to VL in OA knee.
A clinico-pathological report of canine ehrlichiosis in a Doberman pinscher.

Introduction presented in the TVCSC (Teaching and Veterinary Clinical Complex) Mhow with the history of anorexia Canine Ehrlichiosis is also known as canine and weight loss since last 10 days. On clinical rickettsiosis, canine hemorrhagic fever, canine typhus, examination the dog was found to be dull and tracker dog disease, and tropical canine pancytopenia. emaciated together with edema of hind limbs. The It is a tick-borne disease (important is Rhipicephalus o rectal temperature was recorded to be 105 C.The sanguineus, the brown dog tick) usually caused by the Condition suggested of blood protozoan infection. organism Ehrlichia canis. The Ehrlichiae are a group Blood was collected and sent for detailed hematoof small, gram-negative, pleiomorphic, obligate logical and blood protozoan examination to the intracellular cocci that infect different blood cells in Department of Veterinary Pathology. various animal species and in human (Lauren et Hematological Observations: The blood was al.,2003). Though it is primarily the pathogen of subjected for TLC, DLC TEC, Hb and Total Platelet animals but the zoonotic potential has also been Count. The blood picture revealed macrocytic hyporeported. Humans can become infected by E. canis and chromic anemia along with increased number of other species after tick exposure (Ettinger and hypersegmented neutrophills. There was marked Feldman, 2000). Even though the zoonotic role of leucopenia (4500/ul) which indicated bone marrow dogs as a reservoir for human infection has never been suppression. The monocytes, were increased in shown to be a threat, it is still a great concern for many number and in their cytoplasm membrane bound canine patients. Veterinarians play a major role in the basophilic round to oval bodies were present (Fig 1). prevention, diagnosis and treatment of ehrlichia Platelet Count, Hb, TEC and PCV were consiinfections in dogs. There is a very fine line for creating derably reduced to the value of 1,50,000ul, 6.0g/dl, awareness of tick-borne diseases without generating 12 4.8×10 /L and 25% respectively. Erythrocyte indices panic and concern in the pet-owning public. as calculated were found to be MCH 12.5pg, MCHC Case History and Observations 24 grams/dl and MCV 52.08 fl. Albumin was 4.0g/dl
Low levels of mannose-binding lectin at admission increase the risk of adverse neurological outcome in preterm infants: a 1-year follow-up study

Abstract Objective: The aim of this study was to explore the association between serum levels of mannose-binding lectin (MBL) at admission and neurodevelopmental outcomes in a group of Chinese preterm infants, observed prospectively, until 1-year of corrected age (CA). Methods: All preterm infants used in this study were received from the neonatal intensive care unit (NICU) of our Hospital between 1 January 2012 and 31 August 2013. Serum levels of MBL and clinical data were obtained at the time of admission. The influence of MBL levels on neurological outcome was assessed by logistic regression analysis. Clinical follow-up was performed at 1 year. Results: The study cohort consisted of 175 neonates at baseline and 105 finished the 1-year follow-up. The mean serum MBL levels at the time of admission were significantly lower in children with adverse neurological outcomes as compared with children with no adverse [0.53 (SD = 0.09) μg/ml versus 0.80 (SD = 0.17) μg/ml, respectively; t = 8.342, p < 0.0001]. In multivariate analysis, there was an increased risk of adverse neurological outcomes associated with MBL ≤ 0.68 μg/ml [odds ratios (OR) = 12.11, 95% confidence interval (CI): 2.31–30.32; p < 0.0001] after adjusting for possible factors. Conclusion: Preterm infants who had low levels of MBL at admission are exposed to an increased risk of adverse neurological outcomes.
Evaluation of Common Structural Brain Changes in Aging and Alzheimer Disease with the Use of an MRI-Based Brain Atrophy and Lesion Index: A Comparison Between T1WI and T2WI at 1.5T and 3T

This study assesses the usefulness of a set of established structural findings in Alzheimer disease with various MRI sequences at 2 different field strengths in 127 subjects. Scores of atrophy and lesion burden were reliable across sequences and unit strength and were lowest in individuals with cognitive impairment, higher in those with Alzheimer disease, and also correlated with age, cognitive performance, and amyloid-β test. Although the results were slightly better at 3T, the authors concluded that even at 1.5T scores were reliable. BACKGROUND AND PURPOSE: The Brain Atrophy and Lesion Index combines several common, aging-related structural brain changes and has been validated for high-field MR imaging. In this study, we evaluated measurement properties of the Brain Atrophy and Lesion Index by use of T1WI and T2WI at 1.5T and 3T MR imaging to comprehensively assess the usefulness of the lower field-strength testing. MATERIALS AND METHODS: Data were obtained from the Alzheimer's Disease Neuroimaging Initiative. Images of subjects (n = 127) who had T1WI and T2WI at both 3T and 1.5T on the same day were evaluated, applying the Brain Atrophy and Lesion Index rating. Criterion and construct validity and interrater agreement were tested for each field strength and image type. RESULTS: Regarding reliability, the intraclass correlation coefficients for the Brain Atrophy and Lesion Index score were consistently high (>0.81) across image type and field strength. Regarding construct validity, the Brain Atrophy and Lesion Index score differed among diagnostic groups, being lowest in people without cognitive impairment and highest in those with Alzheimer disease (F > 5.14; P < .007). Brain Atrophy and Lesion Index scores correlated with age (r > 0.37, P < .001) and cognitive performance (r > 0.38, P < .001) and were associated with positive amyloid-β test (F > 3.96, P < .050). The T1WI and T2WI Brain Atrophy and Lesion Index scores were correlated (r > 0.93, P < .001), with the T2WI scores slightly greater than the T1WI scores (F > 4.25, P < .041). Regarding criterion validation of the 1.5T images, the 1.5T scores were highly correlated with the 3T Brain Atrophy and Lesion Index scores (r > 0.93, P < .001). CONCLUSIONS: The higher field and T2WI more sensitively detect subtle changes in the deep white matter and perivascular spaces in particular. Even so, 1.5T Brain Atrophy and Lesion Index scores are similar to those obtained by use of 3T images. The Brain Atrophy and Lesion Index may have use in quantifying the impact of dementia on brain structures.
Analysis of Senescence-Related Differentiation Potentials and Gene Expression Profiles in Human Dental Pulp Stem Cells

Introduction: Dental pulp stem cell (DPSC)-mediated dental pulp regeneration is considered a promising method for the treatment of deep caries with pulpitis. However, mesenchymal stem cell (MSC) senescence is an adverse factor from the perspective of cell-based therapies. In this study, we investigated the characteristics and expression profiles of DPSCs from young and old donors. Methods: DPSCs from young and old donors were cultured in differentiation medium, and their differentiation potentials were assessed. Long noncoding RNA (LncRNA) microarray assays and a bioinformatic analysis were performed to investigate differences in LncRNA and mRNA expression profiles between DPSCs from young and old donors. Results: We found that DPSCs from young donors exhibited more powerful proliferation ability and greater osteogenic and adipogenic differentiation potentials than DPSCs from old donors. In DPSCs from young donors, numerous LncRNAs were significantly up- (n = 389) or down-regulated (n = 172) compared to DPSCs from old donors. Furthermore, 304 mRNAs were differentially expressed, including 247 up-regulated genes and 57 down-regulated genes in DPSCs from young donors. The bioinformatic analysis identified that several pathways may be associated with DPSC characteristics, such as those involved in the cell cycle and RNA transport, and revealed nuclear transcription factor Y subunit β, general transcription factor IIB, and nuclear receptor subfamily 3 group C member 1 as core regulatory factors and FR249114, FR299091, and ENST00000450004 as core LncRNAs. Conclusions: Our results indicated that senescence impaired the proliferation and differentiation potentials of DPSCs and that donor age is an important factor that affects their use for tooth regeneration. We also provide insight into the mechanisms responsible for senescence in DPSCs.
A comprehensive review of swallowing difficulties and dysphagia associated with antipsychotics in adults

ABSTRACT Introduction: This is a comprehensive review of antipsychotic (AP)-induced dysphagia and its complications: choking and pneumonia. Areas covered: Four PubMed searches were completed in 2018. The limited literature includes: 1) 45 case reports of AP-induced dysphagia with pharmacological mechanisms, 2) a systematic review of APs as a risk factor for dysphagia, 3) reviews suggesting adult patients with intellectual disability (ID) and dementia are prone to dysphagia (APs are a risk factor among multiple others), 4) studies of the increased risk of choking in patients with mental illness (APs are a contributing factor), 5) naturalistic pneumonia studies suggesting that pneumonia may contribute to AP-increased death in dementia, and 6) naturalistic studies suggesting that pneumonia may be a major cause of morbidity and mortality in clozapine patients. Expert commentary: The 2005 Food and Drug Administration requirement that package inserts warn of AP-induced dysphagia jumpstarted this area, but current studies are limited by: 1) its naturalistic nature, 2) the lack of dysphagia studies of patients with IDs and dementia on APs, and 3) the assumed indirect association between dysphagia with choking and pneumonia. Future clozapine studies on pneumonia, if they lead to a package insert warning, may have high potential to save lives.
Phthalate exposure in pregnant women and the influence of exposure to environmental tobacco smoke

Abstract Background: Phthalates have been blended in various compositions as plasticizers worldwide for a variety of purposes, and there are more and more polymers in the packaging of tobacco. Methods: We investigated phthalate exposure in pregnant women to explore the influence of exposure to environmental tobacco smoke (ETS). In 2013, a total of 620 pregnant women in 30 counties (district) of Zhejiang Province were selected by probability proportionate to size sampling method, and they were interviewed for the sociodemographic characteristic, lifestyle characteristics, and 77 of them were selected by random and agreed to provide a urine sample. GC/MS method was used to determine the concentration of phthalate in urine including DMP, DEP, DIBP, DBP, BMPP, DPP, DHXP, BBP, HEP, BNBP, DCHP, DEHP, DOP, DNP, MMP, MEP, MBP, MEHP, ans MBzP. The distribution characteristics of the levels of phthalate between pregnant women with or without exposure to ETS were described, and logistic regression analysis was used to analyze the association between the phthalate levels and influencing factors. Results: We found that there was significant difference between pregnant women with or without exposure to ETS on DIBP, DBP, DNP (Z = 2.192, 2.172, 2356; p = .028, .030, .018). In multifactors analysis, we found that higher level concentration of DIBP (OR= 3.895, 95% = 1.12–13.546), DBP (OR = 5.25, 95% = 1.4–19.692), DPP (OR = 16.5, 95% = 1.058–250.176), DNP (OR = 8.00, 95% = 1.85–34.604) were associated by exposure to ETS. Conclusions: Pregnant women with or without exposure to ETS were associated with urinary DIBP, DBP, DPP, and DNP. Exposure to ETS may increase the urinary phthalate levels among pregnant women.