Miracle-dz/UniFAR-FTUs huggingface dataset:
Infant position in neonates receiving mechanical ventilation.

BACKGROUND Several body positions other than standard supine position have been used in patients undergoing intensive care for reducing the incidence of pressure ulcers of the skin, contractures or ankylosis and for improving the patient's well being. In patients from different age groups undergoing mechanical ventilation (MV), it has been observed that particular positions such as prone position may improve some respiratory parameters. Benefits from these positions have not been clearly defined in Neonatology, a field where it is common that patients require mechanical ventilation sometimes during extended time periods. OBJECTIVES To assess the effects on both short and long-term outcomes of different positioning of newborn infants receiving MV. SEARCH STRATEGY Databases searched (up to January 2002) were the Oxford Database of Perinatal Trials, CINAHL, MEDLINE, EMBASE and Cochrane Controlled Trials Register (The Cochrane Library, Issue 1, 2002). Hand searches of proceedings of the Society for Pediatric Research from 1990 to January 2002 were used to identify unpublished studies. SELECTION CRITERIA Randomised or quasi randomised clinical trials comparing different positions in newborns receiving mechanical ventilation. DATA COLLECTION AND ANALYSIS Three independent and unblinded reviewers assessed the trials for inclusion in the review and extracted the data. Data were double-checked and entered into the Review Manager software. MAIN RESULTS Ten trials involving 164 infants were included in this review. Several positions were compared: prone vs. supine, prone vs. lateral right, lateral right vs. supine, lateral left vs. supine, lateral right vs. lateral left and good lung dependent vs. good lung uppermost. Apart from one of the two studies that compared lateral right vs. lateral left positions, all the included studies had a crossover design. Comparing prone vs. supine position, an increase in arterial P02 in the prone position of between 2.75 and 9.72 mm Hg (95%CI) was observed (one trial). When % hemoglobin oxygen saturation was measured with pulse oximetry, improvement in the prone position was from 1.17 to 4.36% (typical effect based on four trials). It was not possible to establish whether this effect remained once the intervention was stopped. Negative effects from the interventions were not described, although this issue was not studied enough. Effects of position on other outcomes were not statistically significant; however, these cannot be excluded considering the small numbers that were studied. REVIEWER'S CONCLUSIONS The prone position was found to slightly improve the oxygenation in neonates undergoing mechanical ventilation. However, we found no evidence concerning whether particular body positions during mechanical ventilation of the neonate are effective in producing sustained and clinically relevant improvements.
Quality of life trajectory in patients with advanced cancer during the last year of life.

INTRODUCTION Due to the high mortality of cancer a large number of patients pass a preterminal phase of their illness. Within this phase medical care aims at maintaining patients' quality of life (QOL) and reducing symptom burden. Our study investigated the patient-reported severity of QOL impairments during the last year of life, with a special focus on their course at the end of life. METHODS All patients with cancer receiving palliative care at Natters State Hospital (Austria) were considered as eligible for the study. QOL data were collected with the EORTC QLQ-C30 questionnaire as part of computerized patient-reported outcome monitoring (ePROM) within clinical routine. QOL was investigated longitudinally in regard to its course toward death as well as to changes in determinants of global QOL. RESULTS Eighty-five patients participated in the ePROM (255 assessments in total). Regarding trajectories, physical, role and cognitive functioning, fatigue and global QOL worsened sharply during the last 3 months of life. A steady decline was found for emotional functioning, pain, appetite loss and taste alterations. The impact of role functioning, sleep disturbances, and taste alterations on global QOL increased within the last 3 months of life. CONCLUSION Our results indicate that most aspects of QOL are considerably impaired in patients with advanced cancer. Furthermore, they highlight the importance of assessing QOL in general and taste alterations in particular within palliative care.
Characterization of Detergent‐Insoluble Complexes Containing the Familial Alzheimer’s Disease‐Associated Presenilins

Abstract: Many cases of early‐onset familial Alzheimer’s disease have been linked to mutations within two genes encoding the proteins presenilin‐1 and presenilin‐2. The presenilins are 48‐56‐kDa proteins that can be proteolytically cleaved to generate an N‐terminal fragment (∼25‐35 kDa) and a C‐terminal fragment (∼17‐20 kDa). The N‐ and C‐terminal fragments of presenilin‐1, but not full‐length presenilin‐1, were readily detected in both human and mouse cerebral cortex and in neuronal and glioma cell lines. In contrast, presenilin‐2 was detected almost exclusively in cerebral cortex as the full‐length molecule with a molecular mass of 56 kDa. The association of the presenilins with detergent‐insoluble, low‐density membrane microdomains, following the isolation of these structures from cerebral cortex by solubilization in Triton X‐100 and subsequent sucrose density gradient centrifugation, was also examined. A minor fraction (10%) of both the N‐ and C‐terminal fragments of presenilin‐1 was associated with the detergent‐insoluble, low‐density membrane microdomains, whereas a considerably larger proportion of full‐length presenilin‐2 was present in the same membrane microdomains. In addition, a significant proportion of full‐length presenilin‐2 was present in a high‐density, detergent‐insoluble cytoskeletal pellet enriched in β‐actin. The presence of the presenilins in detergent‐insoluble, low‐density membrane microdomains indicates a possible role for these specialized regions of the membrane in the lateral separation of Alzheimer’s disease‐associated proteins within the lipid bilayer and/or in the distinct functions of these proteins.
Phosphatidylinositol 3‐kinase

Currently, a central question in biology is how signals from the cell surface modulate intracellular processes. In recent years phosphoinositides have been shown to play a key role in signal transduction. Two phosphoinositide pathways have been characterized, to date. In the canonical phosphoinositide turnover pathway, activation of phosphatidylinositol‐specific phospholipase C results in the hydrolysis of phosphatidylinositol 4,5‐bisphospate and the generation of two second messengers, inositol 1,4,5‐trisphosphate and diacylglycerol. The 3‐phosphoinositide pathway involves protein‐tyrosine kinase‐mediated recruitment and activation of phosphatidylinositol 3‐kinase, resulting in the production of phosphatidylinositol 3,4‐bisphosphate and phosphatidylinositol 3,4,5‐trisphosphate. The 3‐phosphoinositides are not substrates of any known phospholipase C, are not components of the canonical phosphoinositide turnover pathway, and may themselves act as intracellular mediators. The 3‐phosphoinositide pathway has been implicated in growth factor‐dependent mitogenesis, membrane ruffling and glucose uptake. Furthermore the homology of the yeast vps34 with the mammalian phosphatidylinositol 3‐kinase has suggested a role for this pathway in vesicular trafficking.
Impact of Myeloperoxidase and NADPH-Oxidase Polymorphisms in Drug-Induced Agranulocytosis

Abstract: Therapy of the atypical antipsychotic drug clozapine is limited by a comparatively high incidence of agranulocytosis in 0.8% of patients. This severe side effect is possibly based on the clozapine-mediated stimulation of cytokines and soluble cytokine receptors release, followed by induction of granulocyte proliferation and induction of myeloperoxidase (MPO) and NADPH-oxidase. Because NADPH-oxidase/MPO may oxidize clozapine to highly reactive nitrenium ions, we investigated the role of hereditary polymorphisms in the NADPH oxidase/myeloperoxidase system in agranulocytosis patients who received clozapine (n = 49), ticlopidine (n = 11), and other drugs prior to the event. The low active MPO -436A allelic variant frequency was 22.2% in cases and 19.9% in controls, but AA carriers were overrepresented among cases compared with the sum of AG and GG-carriers (odds ratio 4.16, 95% confidence limits 0.86-20.3, P = 0.056). Particularly in clozapine-induced agranulocytosis, this finding was most pronounced (P = 0.04). In the CYBA gene, encoding the p22phox subunit of the NADPH-oxidase, 2 polymorphisms were investigated. C242T (His72Tyr) had an allele frequency of 31.9% and 32.2% (P = NS) and A640G in the 3′-UTR was less frequent in cases (48.7%) than controls (60.0%), odds ratio 0.63 (0.39-1.02), P = 0.048. CYBA 640GG-carriers were marginally less frequent in cases compared with controls (28.2% vs. 38.7%, P = 0.062). Sequencing the entire coding region of the NADPH subunit CYBB (gpS1phase) disclosed that CYBB is a highly conserved gene, which does not represent a risk factor for clozapine-induced agranulocytosis. The impact of the polymorphic myeloperoxidase, however, needs further verification to predict a patient's risk to develop drug-induced agranulocytosis.
Mode coupling of Schwarzschild perturbations: Ringdown frequencies

Within linearized perturbation theory, black holes decay to their final stationary state through the well-known spectrum of quasinormal modes. Here we numerically study whether nonlinearities change this picture. For that purpose we study the ringdown frequencies of gauge-invariant second-order gravitational perturbations induced by self-coupling of linearized perturbations of Schwarzschild black holes. We do so through high-accuracy simulations in the time domain of first and second-order Regge-Wheeler-Zerilli type equations, for a variety of initial data sets. We consider first-order even-parity (l = 2, m = ±2) perturbations and odd-parity (l = 2, m = 0) ones, and all the multipoles that they generate through self-coupling. For all of them and all the initial data sets considered we find that—in contrast to previous predictions in the literature—the numerical decay frequencies of second-order perturbations are the same ones of linearized theory, and we explain the observed behavior. This would indicate, in particular, that when modeling or searching for ringdown gravitational waves, appropriately including the standard quasinormal modes already takes into account nonlinear effects.
Some Physiognomic Aspects of Naming, or, Maluma and Takete Revisited

In an effort to understand some of the functional determinants of naming, Koehler's maluma-takete demonstration was examined in two studies, to see whether the matching of the nonsense words and nonsense figures could be accounted for on the basis of physiognomic similarity, as measured by the semantic differential. Matching was found to occur overwhelmingly in the expected direction, and the similarity of semantic differential locations of matched pairs was far greater than that of non-matched pairs. This held strikingly for “literal” scales (such as “Angular-Rounded”) but also held to a lesser extent for clearly “non-literal” scales (such as “Fresh-Stale”), indicating that physiognomic properties over and beyond simple literal description of the stimuli were involved. Study of the semantic differential locations of letters composing the nonsense words, and of ratings of the “fittingness” of the letters as names for the nonsense figures, showed that the physiognomic similarity presumably mediating the naming phenomenon may, at least in the Koehler demonstration, reside in the individual letters rather than in some emergent quality of the whole word. All in all, the study attempted to go beyond just checking whether a “fittingness” phenomenon occurs in naming, by exploring processes hypothesized to underlie the “fittingness. ” In at least some cases, physiognomic similarity may be the psychological process mediating naming.
Neonatal thyroid screening in a mild iodine deficiency endemic area in Iran.

BACKGROUND Evaluated serum thyroid-stimulating hormone (TSH), as an early index for diagnosis of neonatal hypothyroidism, indicates insufficient supply of thyroid hormones. OBJECTIVE The aim of the study was to estimate the incidence of neonatal hypothyroidism and assessment of iodine deficiency in the eastern part of Iran. SETTINGS AND DESIGN A cross-sectional study was conducted in a pilot screening. MATERIALS AND METHODS The measurement of blood TSH spotted on filter paper was performed by ELISA method in 59,436 neonates. TSH value equal to 5 mU/L was considered cut off point. The diagnosis of hypothyroidism in neonates with the blood TSH higher than the cut off point was based on clinical examinations and laboratory tests (serum TSH and T4). STATISTICAL ANALYSIS The groups were compared using chi-square and ANOVA tests. RESULTS In our study, the recall rate and incidence of hypothyroidism were 3.6% and 2 per 1000 neonates respectively. Based on the proposal made by WHO/UNICEF/ICCIDD, the results of our study showed a mild iodine deficiency in the area. CONCLUSIONS A comprehensive policy should be developed for control of iodine deficiency and treatment of hypothyroidism in the studied population and neighboring countries.
Semi-Empirical Stochastic Model of Aerosol Bolus Dispersion in the Human Lung

Aerosol bolus dispersion, that is, the broadening of an inhaled narrow aerosol bolus upon exhalation, was simulated by Monte Carlo methods using a stochastic, asymmetric morphometric model of the human lung. Physical mechanisms considered to contribute to bolus dispersion were () axial diffusion in conductive airways, approximated by effective diffusivities, () convective mixing at airway bifurcation sites, () differences in inspiratory and expiratory velocity profiles, () mixing with residual air in alveoli, and () inhomogeneous ventilation of the lung lobes due to asymmetric flow spitting at bifurcations and asymmetric and asynchronous filling of the five lung lobes. Theoretical predictions of the bolus dispersion model were compared to experimental data for 79 healthy volunteers, which provide detailed information on statistical bolus parameters (half-width, standard deviation, skewness, and mode shift) and total bolus deposition as a function of the depth of bolus penetration into the airway system. Predicted bolus dispersion and deposition data show excellent agreement with the published experimental data, suggesting that axial diffusion in conductive airways and convective mixing in alveoli, resulting in irreversible particle transport, are the major determinants of bolus dispersion. The variability and asymmetry of the branching airway network, leading to asymmetric flow splitting at airway bifurcations, greatly enhances the effect of irreversibility and the resulting dispersion of the inhaled bolus.
Stress-related reduction in personal mastery is associated with reduced immune cell β2-adrenergic receptor sensitivity

Background: A growing body of literature suggests that caregiving burden is associated with impaired immune system functioning, which may contribute to elevated morbidity and mortality risk among dementia caregivers. However, potential mechanisms linking these relationships are not well understood. The purpose of this study was to investigate whether stress-related experience of depressive symptoms and reductions in personal mastery were related to alterations in ß2-adrenergic receptor sensitivity. Methods: Spousal Alzheimer's caregivers (N = 106) completed measures assessing the extent to which they felt overloaded by their caregiving responsibilities, experienced depressive symptoms, and believed their life circumstances were under their control. We hypothesized that caregivers reporting elevated stress would report increased depressive symptoms and reduced mastery, which in turn would be associated with reduced ß2- adrenergic receptor sensitivity on peripheral blood mononuclear cells (PBMC), as assessed by in vitro isoproterenol stimulation. Results: Regression analyses indicated that overload was negatively associated with mastery (β = −0.36, p = 0.001) and receptor sensitivity (β = −0.24, p = 0.030), whereas mastery was positively associated with receptor sensitivity (β = 0.29, p = 0.005). Finally, the relationship between overload and receptor sensitivity diminshed upon simultaneous entry of mastery. Sobel's test confirmed that mastery significantly mediated some of the relationship between overload and receptor sensitivity (z = −2.02, p = 0.044). Conclusions: These results suggest that a reduced sense of mastery may help explain the association between caregiving burden and reduced immune cell ß2-receptor sensitivity.
Molecular Epidemiology of Rotaviruses in Nigeria: Detection of Unusual Strains with G2P[6] and G8P[1] Specificities

ABSTRACT During an epidemiological study on rotaviruses among diarrheic children in the northeastern and middle belt regions of Nigeria, the distribution of G and P types was investigated in 127 stool specimens. By PCR G typing, the G type of rotaviruses in 97 samples was identified. Interestingly, an unusual G8 type, as well as common G1, G2, and G3 types, was detected more frequently (31 of 112; 27.7%). Eleven samples contained multiple G types, and a G9 strain (Bulumkutu) was identified for one of the probable mixed infections. In PCR P typing, P[6] was detected most frequently, P[8] being the second most common type, while the P type of 73 samples could not be identified. One rotavirus strain with a G8 type specificity could be cultivated in cell culture, and the P type of this strain was found to be P[1], which is usually carried by bovine strains. When the combinations of G and P types were examined, the unusual strains G2P[6] and G8P[1] were often identified. Sequence analysis was performed for the VP7 gene of the G9 strain Bulumkutu and the VP4 and VP7 genes of G8P[1] strain HMG035. The VP7 sequence of the Nigerian serotype G9 was more closely related to that of a Brazilian strain than to those of other African strains. The VP7 and VP4 genes of G8P[1] strain HMG035 were found to be very similar to that of a Thai bovine strain A5, suggesting that bovine strains may have been transmitted directly to humans. These results highlight an unexpected diversity among rotavirus strains in Nigeria and emphasize the need for further serological and genetic surveys on more rotavirus strains in African countries, including Nigeria.
Severe acute pancreatitis admitted to intensive care unit: SOFA is superior to Ranson's criteria and APACHE II in determining prognosis.

BACKGROUND/AIMS Severe acute pancreatitis usually requires intensive management of cardiovascular, pulmonary, renal, and septic complications. Many scoring systems are used in determining the outcomes. The aim of the study was to evaluate the role of three scoring systems, i.e. Acute Physiology and Chronic Health Evaluation, Sequential Organ Failure Assessment, and modified Ranson's criteria, in predicting mortality rate in patients with severe acute pancreatitis as well as other factors influencingmortality in patients admitted to intensive care unit. MATERIALS AND METHODS Charts of 43 patients hospitalized in intensive care unit with severe acute pancreatitis were screened retrospectively. Four patients were excluded. Acute Physiology and Chronic Health Evaluation II, Sequential Organ Failure Assessment and modified Ranson's scores were calculated on admission, and Sequential Organ Failure Assessment score was recorded on weekly intervals during the intensive care unit stay. RESULTS Thirty-nine patients were included in the study (65% male, mean age: 61 years). The intensive care unit mortality was 64% and hospital mortality was 71%. Sequential Organ Failure Assessment scores correlated significantly with mortality. All patients with Sequential Organ Failure Assessment score ≥11 at any time during intensive care unit stay had higher mortality (80% sensitivity, 79% specificity, ROC=0,837). Although Acute Physiology and Chronic Health Evaluation II is used to estimate mortality prognosis, we could not find any statistically significant association between Acute Physiology and Chronic Health Evaluation II scores and mortality. CONCLUSION Various scoring systems are used to determine the prognosis of severe acute pancreatitis. In this group of patients, higher Sequential Organ Failure Assessment scores predict higher intensive care unit/hospital mortality.
Escherichia coli pyomyositis in an immunocompromised host.

BACKGROUND Pyomyositis due to Escherichia coli (E. coil) is rarely reported in immunocompromised patients with hematological malignancy. CASE REPORT We present a case report of a 34-year-old man who developed E. coli pyomyositis as a complication of acute myelogenous leukemia (AML). Magnetic resonance imaging (MRI) of the right hip suggested myofascial infection of the gluteal muscles, and a needle muscle aspiration grew E. coli phylogenetic group B2. The patient responded to intravenous piperacillin/tazobactam followed by prolonged oral levofloxacin. CONCLUSION Pyomyositis should be suspected in all immunocompromised patients complaining of muscle pain and may exhibit signs of localized muscle infection. Appropriate antibiotic therapy targeting fluoroquinolone-resistant E. coli should be considered for initial empiric therapy of pyomyositis in immunocompromised patients.
Prevalence in the Dutch Adult Population and a Meta-analysis of Signs and Symptoms of Temporomandibular Disorder

A nationwide survey of oral conditions, treatment needs, and attitudes toward dental health care in Dutch adults was carried out in 1986. One of the aims of the study was to assess the prevalence of signs and symptoms of temporomandibular disorder (TMD). A sample of 6577 persons (from 15 to 74 yr of age), stratified for gender, age, region, and socio-economic status, was contacted. Of this sample, 4496 persons participated in the behavioral part of the study, of whom 3526 were examined clinically. The TMD prevalence was based on (1) perceived signs and symptoms of TMD and (2) clinical examination of joint sounds, deviation, and pain on mandibular movements. A total of 21.5% of the Dutch adult population perceived some dysfunction, and 44.4% showed clinically assessed signs and symptoms of TMD. In nearly all age groups, the signs and symptoms of TMD appeared more in women than in men. Agreement between the results ofthe clinical examination and the anamnestic dysfunction index was significant (p < 0.0001); however, the Pearson's correlation coefficient was low (r = 0.29). The odds-value (risk-ratio) that subjects who perceived signs and symptoms of TMD would present with clinically assessed signs and symptoms of TMD was 2.3. The results of the survey were compared with results of a meta-analysis performed on 51 TMD prevalence studies. The analysis revealed (1) a perceived dysfunction rate of 30% and (2) a clinically assessed dysfunction of 44%, both based on compound samples of, respectively, over 15,000 (23 studies) and over 16,000 (22 studies) randomly selected subjects.