Miracle-dz/UniFAR-FTUs huggingface dataset:
Community acquired pneumonia in Port Harcourt Rivers State of Nigeria.

BACKGROUND Community acquired pneumonia (CAP) is a major cause of death world wide. Knowledge of the likely pathogens and their sensitivity/resistance pattern can help in the choice of antibiotic therapy and improve outcome. OBJECTIVE To identify the seasonal variation; age and sex distribution; bacteriology; antimicrobial sensitivity pattern of isolates; haematological data; radiology and clinicaloutcome of community-acquired pneumonia (CAP) in adult patients admitted to hospital in Port Harcourt, Nigeria. DESIGN Prospective study. SETTING University of Port Harcourt Teaching Hospital, and Braithwaite Memorial Hospital, Port Harcourt, Rivers State. PATIENTS Adults admitted to the hospitals with CAP between 1 May 2002, and 30 April 2003. INTERVENTIONS A diagnostic strategy using regular collection of sputum samples for gram stain, bacteriological culture and chest radiography were done. Blood cultures were done in severe cases. Antibiotic sensitivity testing was done on the positive cultures. RESULTS During a 12 month period, 54 patients aged 16 to 82 years (mean 38.1 years) were evaluated. A total of 944 medical admissions were seen during the same period. This gives a prevalence rate of 5.7%. Twenty six classes of bacteria were isolated from the sputum of 23 patients (yield, 42.6%). Streptococcus pneumoniae, the most common pathogen, was isolated in nine cases (34.6%), followed by Klebsiella pneumoniae which was present in eight (30.8%). Other isolates included, Escherichia coli, four cases (15.4%), Pseudomonas aeruginosa, three cases (11.5%), and Staphylococcus aureus, two cases (7.7%). The commonest radiological pattern was lobar consolidation (49.9%) with no Distinct pattern associated with any conventional bacterial pathogen. The isolates showed good sensitivity to the newer and more expensive antibiotics (quinolines and cephalosporines) with marked resistance to the older and cheaper ones. However, clinical responses to benzyl penicillin and gentamycin were found to be good. Out of 54 patients evaluated, four (7.4%) died. CONCLUSION Streptococcus pneumoniae and Klebsiella were common aetiological organisms of CAP in Port Harcourt. Treatment of CAP with benzyl penicillin remains an appropriate first line choice in this environment while the more expensive quinolines and cephalosporines can be used as backups.
[Study on the relationship between single-nucleotide polymorphisms in IL-6, IL-10 genes and HBV-related hepatocellular carcinoma].

OBJECTIVE To investigate the association between single nucleotide polymorphisms (SNPs) in cytokine IL-6, IL-10 genes and HBV-related hepatocellular carcinoma (HCC). METHODS A hospital-based case-control study was conducted in 381 cases with HBV-related HCC, 340 HBsAg carriers and 359 non-tumor controls. Genotypes of -572 site of IL-6 gene and -819, -592 sites of IL-10 gene were determined by real-time polymorphism chain reaction. Unconditional logistic regression was used to estimate the odds ratios (ORs) and 95 confidence intervals (CIs). RESULTS For the G/C alleles of -572 loci on IL-6 gene, there were significant differences between the three groups (P < 0.05). Compared with CC genotype, GG genotype increased the risk of HBV infection (OR = 2.171, 95%CI: 1.068 - 4.415), but did not seem to be associated with HCC. For the alleles of -819 and -592 site of IL-10 gene, there were significant differences between the three groups (P < 0.05). Compared with CC genotype, TT genotype increased the risks of both HCC (OR = 2.791, 95%CI: 1.326 - 5.874), and HCC in HBsAg carriers (OR = 3.522, 95%CI: 1.707 - 7.266). When compared with CC genotype on -592 site, the AA genotype reduced the risk of both HCC (OR = 0.389, 95%CI: 0.173 - 0.875), and HCC in HBsAg carriers (OR = 0.336, 95%CI: 0.154 - 0.734). CONCLUSION The SNPs in -572 site of IL-6 gene might be associated with the risk of HBV infection. The SNPs in -819 site of IL-10 gene increased the risk of HCC, but -592 site of IL-10 gene decreased the risk of HCC.
Possible Mode of Antidepressive Action of Imipramine

Imipramine augmented and prolonged methamphetamine-induced increases in the rate of responding of rats working for "rewarding" hypothalamic and midbrain stimulation. In contrast, chlorpromazine antagonized the effects of methamphetamine on self-stimulation. These opposite psychopharmacological effects are consistent with the different clinical effects of these drugs and suggest a mechanism for the antidepressive action of imipramine.
Organised vs. spontaneous pap‐smear screening for cervical cancer: A case‐control study

To compare the effect of organised pap‐smear screening for cervical cancer with that of the spontaneous one on the incidence of invasive cervical cancer, we performed a case‐control study within the catchment area of the Helsinki University Hospital (Helsinki, Finland). The study material consisted of 179 incident cases of invasive cervical cancer and 1,507 population controls. Data on lifetime pap smears before the year of the cancer diagnosis were collected using a self‐administered questionnaire. The questionnaire information was obtained for 82% of the cases and 73% of the controls. The main outcome measure was relative risk of invasive cervical cancer among those with history of organised or spontaneous screening compared with risk among those with no history of screening for cervical cancer, measured as odds ratios (OR) with 95% confidence intervals (CI) and computed with logistic regression. Odds ratio of invasive cervical cancer among those who participated in the organised screening programme was 0.38 (CI 0.26–0.56) whereas any lifetime spontaneous pap smear had an OR value of 0.82 (CI 0.53–1.26), in terms of unit risk for those not subjected to any screening and adjusted for age and the other type of the screening activity. Our results indicate that the substantial decrease in the incidence of and mortality due to cervical cancer in Finland is mainly due to the organised mass‐screening. Int. J. Cancer 83:55–58,1999. © 1999 Wiley‐Liss, Inc.
SUICIDE AND PSYCHIATRIC CARE IN THE AGING.

A cumulative psychiatric case register to which all psychiatric experience for residents of a geographic area is routinely reported can facilitate unique investigation into the epidemiology of suicide. For example, the register provides an accurate mechanism for learning which of the persons who suicide had psychiatric contact. It is, thus, a method for obtaining data recorded prior to the event. The case records may provide further insight into the natural history of mental disorders leading to suicide and, thus, enhance predictability of potential suicide. Suicides who had previous psychiatric contact can be compared to those without such contact to determine features unique to each group. Persons who attempt suicide also can be followed prospectively through the register to study their subsequent psychiatric care and changing risk of suicide with the passage of time. In addition, the entire psychiatric register population can be followed indefinitely
Relaxation induced by ferritin and ferritin‐like magnetic particles: The role of proton exchange

Proton T1 and T2 in solutions of ferritin and fercayl (a ferritin‐like iron‐dextran particle) solutions were measured, over a wide range of various parameters (Bo, temperature, interecho‐time and pH). The window of the previously referred linear dependence of 1/T2 on the static field was increased, up to 500 MHz, and the independence of T2 on the echo time was confirmed. Correlation times were extracted from T1 nuclear magnetic relaxation dispersion profiles. In the pH range studied, no strong variation of the relaxivities of ferritin solutions was noticed. Fercayl, which, unlike ferritin, remains stable under large pH variations, is characterized by strongly pH‐dependent relaxation rates. This feature is interpreted as due to the effect of proton exchange in the water relaxation process. Outer sphere theory, which ignores proton binding, is shown to be unable to describe the relaxation of ferritin and ferritin‐like particles solutions, first because it predicts a quadratic rate dependence on Bo, but also because it severely underestimates the relaxation rate. Explaining relaxation induced by ferritin and ferritin‐like particle solutions will likely require a model that accounts for proton binding. Magn Reson Med 43:237–243, 2000. © 2000 Wiley‐Liss, Inc.
Vasorelaxant Properties of n-3 Polyunsaturated Fatty Acids in Aortas from Spontaneously Hypertensive and Normotensive Rats

Background: Dietary consumption of fish, rich in n-3 polyunsaturated fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), has been shown to reduce blood pressure in both animal studies and clinical trials. Although the antihypertensive mechanisms are not known, the blood-pressure-lowering effect of n-3 polyunsaturated fatty acids may be partially attributed to their vasorelaxant properties. Methods: Aortic rings, with and without endothelium, from Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR), 16–17 weeks old, were suspended in tissue baths and isometric tension was measured. Concentration-response curves were generated for DHA and EPA (1–100 μmol/l) in norepinephrine-contracted rings. Blood pressure was measured using the tail-cuff method and aortic media thickness was determined. Results: Blood pressure was significantly increased in SHR (n = 10; 194 ± 4.4 mmHg) compared with WKY (n = 10; 124 ± 1.2 mmHg, P ≤ 0.0001). DHA (1–100μmol/l) relaxed aortic rings from WKY (-3.3 ± 0.7 to −13 ± 2.3%, P ≤ 0.001) and from SHR (-6.5 ± 1.8 to −22.9 ± 4%, P ≤ 0.01) in a concentration-dependent manner. EPA (1–100μmol/l) evoked greater relaxation in SHR (−10.1 ± 2.0 to-33 ± 3.9%, P <0.01) than in WKY (−2.9 ± 1.1 to −18.3 ± 2.1%, P <0.01) aortic rings. The relaxant effect of DHA in both WKY and SHR and of EPA in WKY were not dependent on an intact endothelium. However, EPA (1–10μmol/l) induced greater responses in intact SHR rings (−10.1 ± 2.0 to −14.5 ± 3.1%) than in de-endothelialized SHR rings (0 to −2.1 ± 1.7%, P = 0.001). Conclusion: The direct relaxant effects of n-3 fatty acids as seen in WKY and SHR may contribute, in part, toward the blood-pressure-lowering effect of dietary fish and fish-oil supplementation.
The electrocardiogram of the Beagle dog: reference values and effect of sex, genetic strain, body position and heart rate

The aim of the study was to establish a database for electrocardiographic parameters of Beagle dogs used for toxicological studies and to evaluate the influence of supplier, sex, heart rate (HR) and body position for electrocardiogram (ECG) recording on ECG parameters. Peripheral ECG leads were recorded from 934 female and 946 male dogs from Marshall Farms and 27 females and 30 males from Harlan, either standing on a table or restrained in a hammock. HR, RR, PQ and QT intervals, P and QRS duration and P-wave amplitude were measured. There were no major differences between sexes for ECG parameters. The axis of the heart was shifted to the left when the animals were restrained in a hammock compared to when they were standing on a table. The PQ interval was higher (about 9%) in Harlan than in Marshall dogs. HR was negatively correlated with QT (coefficient of linear correlation: r = −0.61 to −0.74), which emphasizes the need for a formula correcting QT interval for HR when interpreting changes in QT interval. HR was also negatively correlated with PQ intervals (r = −0.26 to −0.11), whereas a positive correlation was found between HR and the amplitude of the P wave (r = 0.21–0.34). The level of the respiratory sinus arrhythmia (SA) was quantified by calculating the ratio of maximum to minimum RR interval measured over a 10 s period. This ratio was negatively correlated with HR (r = −0.49 to −0.33). Therefore, at high HRs, SA was less marked than at low HRs, but it did not completely disappear. Analysis of beat-to-beat variation indicated that QT and PQ intervals and the amplitude of P wave fluctuated over time and the degree of this variability was positively correlated with the level of SA. In conclusion, we have established reference values for the duration and/or amplitude of some ECG parameters both in terms of means and variability over the recording period, and we have evaluated the influence of body position, genetic strain and HR on the ECG parameters. These data can be used as baseline for the interpretation of the ECG of Beagle dogs.
ELASTIN FIBERS IN SCAR TISSUE

Scar tissue, obtained from humans, was stained for elastin fibers by a new staining method. Elastin fibers were noted at sites where they must have been formed de novo. The morphology and the distribution of elastin in various types of scars are described. Practically no elastin was found in keloids.
Natalizumab strongly suppresses cortical pathology in relapsing–remitting multiple sclerosis

Background: Since cortical pathology has been indicated to play a relevant role in the physical and cognitive disability of multiple sclerosis (MS) patients, this study aims to analyze the efficacy of natalizumab in slowing down its progression. Methods: A total of 120 relapsing–remitting MS patients completed a 2-year prospective study: 35 received natalizumab, 50 received interferon beta-1a or glatiramer acetate (immunomodulatory agents - IMA) and 35 remained untreated. Forty healthy subjects constituted the reference population. Clinical and magnetic resonance imaging (MRI) evaluations (including cortical lesions and atrophy) were performed at baseline and after 2 years. Results: Natalizumab significantly reduced accumulation of new cortical lesions (0.2±0.6,range 0–3) compared to immunomodulatory agents (1.3±1.1 togli spazio, range 1–6, p=0.001) and no treatment (2.9±1.5, range 1–8, p<0.001). The percentage of patients with new cortical lesions was also lower in natalizumab-treated patients (20%) compared to IMA-treated and untreated patients (68.0% and 74.2%; p<0.001 for both comparisons). Furthermore, the progression of cortical atrophy was significantly reduced by natalizumab (% change=1.7%) compared to IMA (3.7%, p=0.003) and no therapy (4.6%, p<0.001). Finally, a greater percentage (51.4%) of natalizumab-treated patients remained disease-free (no clinical or MRI evidence of disease activity or progression) compared to IMA-treated (18%, p=0.001) and untreated patients (5.7%, p<0.001). Conclusions: Natalizumab treatment significantly decreases cortical lesion accumulation and cortical atrophy progression in severe relapsing–remitting MS. While supporting the inflammatory origin of cortical lesions, our results highlight the significant impact of natalizumab on cortical pathology.
Central line-associated bloodstream infection prevention

Purpose of review This review summarizes recent literature regarding the prevention of central line-associated bloodstream infection (CLABSI). Recent findings CLABSI rates in United States ICUs reported to the National Healthcare Safety Network (NHSN) have decreased dramatically in recent years. This has been achieved largely through a multifaceted approach and a focus on evidence-based best practices for central line insertion. More recent studies suggest an added benefit from implementation of evidence-based best practices for central line maintenance. Recent investigations also focus on CLABSI prevention among pediatric patients and in the non-ICU setting, in which a significant proportion of central line-days and CLABSI occur. A recent meta-analysis supports the practice of daily chlorhexidine gluconate (CHG) bathing in the ICU population for CLABSI prevention. Investigation continues regarding the most effective way to implement and sustain CLABSI prevention practices, including ways to best address and improve the culture of safety in healthcare. Summary Recent literature on CLABSI prevention shows that a multifaceted approach to improving central line insertion and maintenance practices results in decreased CLABSI rates in both the ICU and non-ICU settings. More data are needed to develop appropriate benchmarks and prevention strategies specific to the non-ICU setting, in which a significant proportion of central line-days and CLABSI occur.
Does progesterone supplementation improve pregnancy rates in clomiphene citrate and intrauterine insemination treatment cycles?

Abstract Aim: To investigate the effect of empiric use of luteal phase progesterone supplementation to improve endometrial receptivity in women undergoing treatment with clomiphene citrate in combination with intrauterine insemination (CC-IUI). Design: Retrospective cohort analysis. Setting: University fertility center. Patients: 426 CC-IUI cycles from 292 patients with unexplained infertility. Interventions: Patients were treated with micronized intravaginal progesterone 100 mg twice daily beginning approximately three days after CC-IUI. Main outcome measure(s): Clinical pregnancy per initiated cycle as defined by presence of fetal heart rate on ultrasound. Results: Clinical pregnancy rate was higher in patients receiving luteal phase support compared to patients not receiving luteal phase support (odds ratio: 2.04; 95% confidence interval: 1.01–4.14) after adjusting for all factors in the analysis using a multivariate logistic regression model. Age at the start of the cycle, BMI and CC dose were not shown to have an effect on clinical pregnancy rates. Patients with endometrial lining (EML) thickness 6–8 mm and >8 mm had increased clinical pregnancy rates compared to EML <6 mm independent of luteal phase progesterone use. Patients who appear to receive the greatest benefit of progesterone supplementation are in the 6–8 mm EML cohort. Conclusions: Luteal phase progesterone supplementation in CC-IUI cycles can improve endometrial receptivity as judged by the improved clinical pregnancy rates as the primary outcome.
Characterization of aquifer heterogeneity using transient hydraulic tomography

Hydraulic tomography is a cost‐effective technique for characterizing the heterogeneity of hydraulic parameters in the subsurface. During hydraulic tomography surveys a large number of hydraulic heads (i.e., aquifer responses) are collected from a series of pumping or injection tests in an aquifer. These responses are then used to interpret the spatial distribution of hydraulic parameters of the aquifer using inverse modeling. In this study, we developed an efficient sequential successive linear estimator (SSLE) for interpreting data from transient hydraulic tomography to estimate three‐dimensional hydraulic conductivity and specific storage fields of aquifers. We first explored this estimator for transient hydraulic tomography in a hypothetical one‐dimensional aquifer. Results show that during a pumping test, transient heads are highly correlated with specific storage at early time but with hydraulic conductivity at late time. Therefore reliable estimates of both hydraulic conductivity and specific storage must exploit the head data at both early and late times. Our study also shows that the transient heads are highly correlated over time, implying only infrequent head measurements are needed during the estimation. Applying this sampling strategy to a well‐posed problem, we show that our SSLE can produce accurate estimates of both hydraulic conductivity and specific storage fields. The benefit of hydraulic tomography for ill‐posed problems is then demonstrated. Finally, to affirm the robustness of our SSLE approach, we apply the SSLE approach to a hypothetical three‐dimensional heterogeneous aquifer.
INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR SURGICAL REPAIR OF MYOPIC MACULAR HOLES

Purpose: To present the anatomical and functional results of vitrectomy with the “inverted internal limiting membrane flap technique” in myopic macular holes without retinal detachment. Methods: A prospective interventional study of 19 myopic eyes with a spherical equivalent >−6 diopters with macular holes in 18 consecutive patients. Preoperative and postoperative visual acuity and spectral domain optical coherence tomography images were evaluated. The main outcome measure was visual outcome and macular hole closure rate. Results: Mean visual acuity improved from 1.2 logMAR to 0.56 logMAR. We confirmed the closure of the macular hole with spectral domain optical coherence tomography in all cases. The closure of the macular hole began in the inner retinal layers, and the architecture gradually filled with tissue. Photoreceptor and external limiting membrane defects improved during the first 12 months after surgery. Conclusion: Vitrectomy with the inverted internal limiting membrane flap technique may be an effective addition to surgical options for treating myopic macular holes. Spectral domain optical coherence tomography images confirm that the process of foveal architectural repair after this surgery continues over at least a 12-month period.
Six-year outcomes of antivascular endothelial growth factor monotherapy for polypoidal choroidal vasculopathy

Objective To evaluate the 6-year outcomes of anti-VEGF (vascular endothelial growth factor) monotherapy for polypoidal choroidal vasculopathy (PCV). Methods The charts of 66 eyes of 66 patients with newly diagnosed, symptomatic, treatment-naive PCV were reviewed retrospectively. All patients were treated with 0.5 mg intravitreal ranibizumab (IVR) injections for 3 months followed by as-needed reinjections based on monthly examinations until 3 years after the first IVR injection. Thereafter, anti-VEGF monotherapy was continued for another 3 years. Results The mean best-corrected visual acuity (BCVA) improved significantly (p=0.001) 3 months after the first IVR injection (0.24±0.30 logarithm of the minimum angle of resolution (logMAR) VA; 20/35 Snellen VA) compared with the baseline BCVA (0.34±0.37 logMAR VA; 20/44 Snellen VA). However, the improved VA returned to 0.32±0.39 logMAR unit (20/42 Snellen VA), which was not significantly different at 3 years. This level was maintained to the end of 6 years (0.36±0.37 logMAR unit; 20/46 Snellen VA). The mean numbers of anti-VEGF injections administered annually during 6 years were 5.6±2.4 (including the initial three monthly injections), 3.3±2.2, 3.3±2.9, 3.6±3.2, 3.5±2.9 and 3.3±2.7, respectively. The mean total number of injections during 6 years was 21.5±10.1. Conclusions The results emphasised the efficacy of anti-VEGF therapy for preserving vision and the limitations of anti-VEGF therapy in that continuous treatment is required over an extended follow-up period.
Resolving Tensions in Hub-and-Spoke Networks of the Enterprise Application Software Industry - An Exploratory Case Study

Enterprise application software (EAS) is often developed organizationally distributed in hub-and-spoke networks. From a theoretical point of view the specific structure of these networks is characterized by tensions: While on the one hand trust as well as informal control is of high importance in hub-and-spoke networks, on the other hand structural properties of these networks constitute the hub’s preference for efficient formal control, which, following a conventional view, undermines trust. Based on an exploratory case study and driven by socio-economic theory we develop a process model. The model is based on the concept of trust-sensitive context management that explains how the tensions are resolved by clarifying the relationship between different means of control (formal / informal) and different types of trust (personal trust / system trust).