Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of Outpatients with Suspected Pulmonary Tuberculosis in a High HIV Prevalence Setting in Ethiopia: Clinical, Diagnostic and Epidemiological Characteristics

In a setting with a high prevalence of HIV we studied (i) the prevalence of pulmonary tuberculosis (PTB) and HIV; (ii) clinical and epidemiological characteristics of PTB; and (iii) the usefulness of standard procedures for diagnosing PTB. Of 509 consecutive outpatients evaluated on clinical suspicion of PTB in Addis Ababa, 33.0% were culture-verified as having PTB. PTB patients, non-TB patients and controls were HIV-1-positive in 57.1%, 38.5% and 8.3% of cases, respectively. Predictors for culture-verified PTB were age < 25 y, male gender and the presence of HIV and fever, whereas profound weight loss indicated HIV infection. Diagnosis of PTB based on clinical symptoms, sputum microscopy for acid-fast bacilli and chest radiography was sensitive (86.7%) but unspecific (64.1%). In HIV-positive patients both sensitivity and specificity were significantly lower (p < 0.05). HIV-related pulmonary infections are often misinterpreted as smear-negative PTB. HIV screening is therefore warranted not only in cases of verified TB but also as part of the diagnostic work-up in patients with respiratory symptoms suggestive of PTB. Also, increased awareness of, and improved diagnostic tools for, HIV-related pulmonary infections other than PTB are required, together with algorithms for patients with suspected PTB.
The Evaluation of the Average of Horizontal Angle of the Condylar in the Axially Plan in Patients with Degenerative Joint Disease of the Temporomandibular Joint (DJD of the TMJ)

Introduction: The temporomandibular joint (TMJ), like other joints, is exposed to a variety of injuries and, as a result it affects the DJD (Degenerative Joint Disease). DJD is the most common disease associated with joints, which is diagnosed by observation of some clinical symptoms associated with bone changes using computer tomography imaging (CT). CBCT is one of the most suitable methods for dental purposes. Considering the occurrence of condylar morphological changes in DJD and its observation in CBCT images, in this study, the mean of horizontal condyle angle in the axillary plane in TMJ was investigated using CBCT images. Materials and Methods: In this retrospective cross-sectional study, 80 CBCT images of 40 patients with bilateral DJD (group A) and control patients with no DJD-affected (group B) choose from the archives of CBCT images of patients referred to the private radiology center. The CBCT images of the patients were evaluated by on demand software in the axial view, the coronal plane was drawn perpendicular to the midsagittal plane, and angle between the long axis of the condylar and the coronal plane was considered as the horizontal condyle angle. The mean of angles in both control and patient groups was compared using t-test. Results: The results of this study showed that there is no significant difference between the horizontal angle of the right and left condyles in group A (patients who are affected by DJD disorder) and B (people who are not affected by DJD disorder). It was also shown that the mean of horizontal condyle angle between the groups A (DJD) and B (Non-DJD) was not significantly different between men and women on both sides. In the present study, the mean of horizontal condyle angle in both sides was investigated in the age group of 18 years-34 years and 35 years-74 years. The results showed that the mean of horizontal condyle angle was not significantly different between the age groups. Conclusion: The horizontal condyle angle was not significantly different between the two groups with DJD and the nonaffected group. Additionally, there was no significant difference between patients and non-patients in any of the sex and age groups.
Determination of pre‐cecal phosphorus digestibility of inorganic phosphates and bone meal products in broilers

&NA; A broiler study was performed to determine the pre‐cecal phosphorus (P) digestibility of 5 P sources, 3 from animal (Delfos, Calfos, and porcine bone meal) and 2 of inorganic (monocalcium phosphate [MCP] and dicalcium phosphate [DCP]) origin. Delfos is processed from bones resulting in a dicalcium phosphate product, and Calfos is processed from bones in which part of the gelatin is removed but in which the hydroxy‐apatite matrix is preserved. During the first 14 d, birds were housed in floor pens bedded with wood shavings and received a commercial starter diet. At d 14, broilers were randomly assigned to pens (0.9 m2, 10 birds/pen) with a slatted floor. From d 14 onwards, one of the 6 experimental diets (a basal diet, and 5 diets containing the P sources) was provided. Test diets were replicated 6 times, and the basal diet 8 times. Electron microscopy images of test products were made in order to verify whether the spatial structure of the test products could be related to the pre‐cecal P digestibility of the same products. Diets met or exceeded CVB (2011) requirements for all nutrients except for P and were formulated to contain a calcium to total P ratio of between 1.4 and 1.6 and a minimal amount of phytate P. Diets contained 5 g/kg titanium oxide as a marker to determine digestibility of P. At d 24 all birds were euthanized, after which the content of the terminal part of the ileum was sampled. The P digestibility was calculated by linear regression according to World's Poultry Science Association (WPSA) protocol for determination of pre‐cecal P digestibility. Pre‐cecal P digestibility of MCP, DCP, Delfos, Calfos, and porcine bone meal was 88.5, 82.4, 94.5, 86.9, and 78.2%, respectively. Based on visual inspection of electron microscopy images of test products, the spatial structure of the test products might be related to P digestibility. It is concluded that processing of bone meal increases the pre‐cecal P digestibility in broilers.
LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People.

BACKGROUND Previous studies have found that transgender, lesbian, and bisexual people report poorer mental health relative to heterosexuals. However, available research provides little information about mental health service access among the highest need groups within these communities: bisexual women and transgender people. This study compared past year unmet need for mental health care and untreated depression between four groups: heterosexual cisgender (i.e., not transgender) women, cisgender lesbians, cisgender bisexual women, and transgender people. MATERIALS AND METHODS This was a cross-sectional Internet survey. We used targeted sampling to recruit 704 sexual and gender minority people and heterosexual cisgendered adult women across Ontario, Canada. To ensure adequate representation of vulnerable groups, we oversampled racialized and low socioeconomic status (SES) women. RESULTS Trans participants were 2.4 times (95% confidence intervals [CI] = 1.6-3.8, p < 0.01) and bisexual people 1.8 times (95% CI = 1.1-2.9, p = 0.02) as likely to report an unmet need for mental healthcare as cisgender heterosexual women. Trans participants were also 1.6 times (95% CI = 1.0-27, p = 0.04) more likely to report untreated depression. These differences were not seen after adjustment for social context factors such as discrimination and social support. CONCLUSION We conclude that there are higher rates of unmet need and untreated depression in trans and bisexual participants that are partly explained by differences in social factors, including experiences of discrimination, lower levels of social support, and systemic exclusion from healthcare. Our findings suggest that the mental health system in Ontario is not currently meeting the needs of many sexual and gender minority people.
ERP system usage and panoptic control: The role of perceived organizational support

Enterprise Resource Planning (ERP) system provides a facility for the integration of business functions within the organisation. Previous studies proved that the potential benefits that can be obtained from ERP system had not been achieved. ERP system impacts at the individual level such as improved control becomes one of the success dimensions of ERP implementation. The purpose of this study is to develop a model that can improve the control exerted by the ERP system due to the information visibility provided by system. Two factors related to perceived organizational support, namely tecnical support and managerial support were modeled as the antecedents. Improvement in panoptic control were elaborated into three different dimensions. Empirical study was conducted using a survey involving 229 samples of ERP users. The results show that technical and managerial support influence ERP system usage, while ERP system usage also has a significant effect on dimensions of panoptic control.
Preexposure Prophylaxis for HIV Prevention in a Large Integrated Health Care System: Adherence, Renal Safety, and Discontinuation

Background:Placebo-controlled and open-label studies have demonstrated the safety and efficacy of daily oral preexposure prophylaxis (PrEP) in preventing HIV infection, but data are limited on real-world PrEP use. Methods:We conducted a cohort study from July 2012 through June 2015 of Kaiser Permanente Northern California members initiating PrEP. We assessed pharmacy refill adherence and discontinuation, decreases in estimated glomerular filtration rate (eGFR), and sexually transmitted infection (STI)/HIV incidence. Results:Overall, 972 individuals initiated PrEP, accumulating 850 person-years of PrEP use. Mean adherence was 92% overall. Black race/ethnicity [adjusted risk ratio (aRR) 3.0; 95% confidence interval: 1.7 to 5.1, P < 0.001], higher copayments (aRR 2.0; 1.2 to 3.3, P = 0.005), and smoking (aRR 1.6; 1.1 to 2.3, P = 0.025) were associated with <80% adherence. PrEP was discontinued by 219 (22.5%); female sex (aRR 2.6; 1.5 to 4.6, P < 0.001) and drug/alcohol abuse (aRR 1.8; 1.3 to 2.6, P = 0.002) were associated with discontinuation. Among 909 with follow-up creatinine testing, 141 (15.5%) had an eGFR <70 mL·min−1·1.73 m−2 and 5 (0.6%) stopped PrEP because of low eGFR. Quarterly STI positivity was high and increased over time for rectal chlamydia (P < 0.001) and urethral gonorrhea (P = 0.012). No HIV seroconversions occurred during PrEP use; however, 2 occurred in individuals who discontinued PrEP after losing insurance coverage. Conclusions:PrEP adherence was high in clinical practice, consistent with the lack of HIV seroconversions during PrEP use. Discontinuation because of renal toxicity was rare. STI screening every 6 months, as recommended by current guidelines, may be inadequate. Strategies are needed to increase PrEP access during gaps in insurance coverage.
Identification of a novel familial FGF16 mutation in metacarpal 4-5 fusion.

Manchester Centre for Genomic Medicine, University of Manchester, Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust and Department of Surgery, University Hospital South Manchester, Wythenshawe, Manchester, UK Correspondence to William G. Newman, MD, PhD, Manchester Centre for Genomic Medicine, University of Manchester, Manchester M13 9WL, UK Tel: + 44 161 276 6276; fax: + 44 161 276 6145; e-mail: william.newman@manchester.ac. uk
Ventilation of lungs in infant and adult rats and its responses to hypoxia.

Do the controls of breathing differ with age? Pulmonary ventilation was measured by body plethysmograph and pressure transducer. After birth, breathing was irregular (pneumotaxic); steadiness from breath to breath was gained at 3 days; extraction of oxygen from the inspired air became more uniform after 10 days. In pO2 20–40 mm Hg only infants survived a half hour; ventilation did not usually increase, and often decreased. Hyperventilation even in 40 mm Hg was not sustained for many minutes in the newborn, but by 6 days was large and enduring. Heartbeats decreased in frequency during severe hypoxia. Oxygen consumption decreased 75% during hypoxia that allowed survival of infants; it sometimes recovered only slowly after hypoxia ended. Tolerance of infants to low oxygen thus consisted in ability to utilize some oxygen at low pressures and to dispense with some oxygen. Some factor other than pCO2 or pO2, possibly centrogenic, often controlled ventilation in infancy. Low oxygen maximally accelerated the breathing at an age when endurance of hypoxia remained. Submitted on May 12, 1960
Cancer recurrence and mortality in women using hormone replacement therapy after breast cancer : Meta-analysis

• O B 1 E C TI V E S We compared the risk of cancer recurrence and all-cause mortality among users and nonu,sers iA estrogen replacement therapy (ERT) after the diagnosis of breast cancer, • S T' V D Y 1) E . S 1 G N Tliis was a systematic re\'iew of original research. Eligible studies were reviewed by 2 in\'estigators who independently extracted data fi'om each study a(.'cording to a predelennined form and assessed each study for validity' fsn standard characteristics, Metii-:inalyses were performed with Review Manager 4,1 to provide a summan' of reialive risks of cancer I'ecLirrence and mtjrtality, • P O P i: L A TI O N Studies included 717 subjects who used hormone re]5lacement tiierapy (IIRT) at some time after their diagnosis of breast cancer, as well as 2S45 subjects who did not use HRT, • O U T C O M H S M H A S I: R E D Outcomes included breast cancer recurrence and all-cause mortality, • H E S r L1' S Nine independent cohort studies and one 6-month pilot randomized controlled trial were identified. Studies were of variable quality. Breast cancer suivivors using ERT experienced no increase in ihe risk of recurrence compai'ed with controls (relative risk, 0,72; 93% confidence interval, 0,47-1.10) and had significantly fewer deaths (3.O"/o) than did the nonusers (11,4%) over the combined study periods (relative risk, 0,18; 95% confidence interval. 0,10-0.30, All ie,sts for heterogeneity were nonsignificant. • C O N C L i; S U) N S Although limited by observational design, existing research does not support the universal withholding of ERT frt)m well-informed women with a previous diagnosis of low-stage breast cancer. Long-term randomized controlled (rials are needed, • KEY W O R D S Estrogen replacement iherap}', hormone replacement therapy, breasi cancer, sun'i\'ors, meta-analysis, (/ Pani Pract 2002: 51: 105(^1062)
A Small Bacterial RNA Regulates a Putative ABC Transporter*

A small noncoding bacterial ribonucleic acid of 62–64 nucleotides, RydC, was identified in the genomes of Escherichia coli, Salmonella, and Shigella. In vivo, RydC binds to the RNA-binding protein Hfq, and it is unstable when Hfq is absent. Mobility assays reveal that complex formation between RydC and Hfq is specific, with an apparent binding constant of ∼300 nm. Sequence alignments combined with structural probing demonstrate that RydC folds as a pseudoknot. Hfq binds the loops crossing the deep and shallow grooves of the pseudoknotted RNA and reorganizes its overall conformation. An interaction with a polycistronic mRNA, yejABEF, which encodes a putative ABC transporter, was detected by affinity purification of immobilized RNA-Hfq complexes. In vivo, the yejABEF operon is expressed on minimal medium. Remarkably, its expression is reduced when RydC is absent, and the operon is degraded when RydC expression is stimulated. This observation correlates with the growth defects associated with a stimulation of its expression in vivo, generating a thermosensitive phenotype that affects growth on minimal media supplemented with glycerol, maltose, or ribose. We conclude that RydC regulates the yejABEF-encoded ABC permease at the mRNA level. This small RNA may contribute to optimal adaptation of some Enterobacteria to environmental conditions.
Comparison of three fluid solutions for resuscitation in dengue shock syndrome.

BACKGROUND Dengue shock syndrome is characterized by severe vascular leakage and disordered hemostasis and progresses to death in 1 to 5 percent of cases. Although volume replacement is recognized as the critical therapeutic intervention, World Health Organization management guidelines remain empirical rather than evidence-based. METHODS We performed a double-blind, randomized comparison of three fluids for initial resuscitation of Vietnamese children with dengue shock syndrome. We randomly assigned 383 children with moderately severe shock to receive Ringer's lactate, 6 percent dextran 70 (a colloid), or 6 percent hydroxyethyl starch (a colloid) and 129 children with severe shock to receive one of the colloids. The primary outcome measure was requirement for rescue colloid at any time after administration of the study fluid. RESULTS Only one patient died (<0.2 percent mortality). The primary outcome measure--requirement for rescue colloid--was similar for the different fluids in the two severity groups. The relative risk of requirement for rescue colloid was 1.08 (95 percent confidence interval, 0.78 to 1.47; P=0.65) among children with moderate shock who received Ringer's lactate as compared with either of the colloid solutions, 1.13 (95 percent confidence interval, 0.74 to 1.74; P=0.59) among children who received dextran as compared with starch in the group with severe shock, and 0.88 (95 percent confidence interval, 0.66 to 1.17; P=0.38) among children who received dextran as compared with starch in the combined analysis. Although treatment with Ringer's lactate resulted in less rapid improvement in the hematocrit and a marginally longer time to initial recovery than did treatment with either of the colloid solutions, there were no differences in all other measures of treatment response. Only minor differences in efficacy were detected between the two colloids, but significantly more recipients of dextran than of starch had adverse reactions. Bleeding manifestations, coagulation derangements, and severity of fluid overload were similar for all fluid-treatment groups. CONCLUSIONS Initial resuscitation with Ringer's lactate is indicated for children with moderately severe dengue shock syndrome. Dextran 70 and 6 percent hydroxyethyl starch perform similarly in children with severe shock, but given the adverse reactions associated with the use of dextran, starch may be preferable for this group.
Syndromic management of vaginal discharge among women in a reproductive health clinic in India.

OBJECTIVES To examine the performance of the syndromic approach in the management of vaginal discharge among women attending a reproductive health clinic in New Delhi, India. METHODS Women who sought services from the clinic and who had a complaint of vaginal discharge were interviewed, underwent a pelvic examination, and provided samples for laboratory investigations of bacterial vaginosis, candidiasis, syphilis, trichomoniasis, and Chlamydia trachomatis and Neisseria gonorrhoeae infections. Data analysis focused on the prevalence of infection and on the performance of the algorithm recommended by the national authorities for the management of vaginal discharge. RESULTS The most common infection among 319 women was bacterial vaginosis (26%). At least one sexually transmitted infection was detected in 21.9% of women. The prevalence of C trachomatis infection was 12.2%; trichomoniasis 10%; syphilis 2.2%; N gonorrhoeae was not isolated. An algorithm based on risk assessment and speculum assisted clinical evaluation was not helpful in predicting cervical infections associated with C trachomatis (sensitivity 5% and PPV 9%). This algorithm was sensitive (95%) though not specific (22%) in selecting women for metronidazole therapy effective against bacterial vaginosis or trichomoniasis, and overtreatment was a problem (PPV 38%). The sensitivity, specificity, and PPV of this algorithm for the treatment of candidiasis were 46%, 98%, and 88% respectively. The cost per case assessed using the algorithm was $2 and the cost per infection correctly treated was $4.25. CONCLUSIONS The prevalence of cervical infection associated with C trachomatis was high among these "low risk" women. The syndromic approach is not an efficient tool for detecting this condition, and alternative approaches to evaluation and intervention are required. The syndromic management of vaginal discharge among women seeking family planning and other reproductive health services should focus on vaginal infections, thus enhancing quality of care and addressing women's concerns about their health.
Head-injured patients who "talk and die": the San Diego perspective.

BACKGROUND Head-injured patients who "talk and die" are potentially salvageable, making their early identification important. This study uses a large, comprehensive database to explore risk factors for head-injured patients who deteriorate after their initial presentation. METHODS Patients with a head Abbreviated Injury Score (AIS) score of 3+ and a preadmission verbal Glasgow Coma Scale (GCS) score of 3+ were identified from our county trauma registry during a 16-year period. Survivors and nonsurvivors were compared with regard to demographics, initial clinical presentation, and various risk factors. Logistic regression was used to explore the impact of multiple factors on outcome, including the significance of a change in GCS score from field to arrival. In addition, patients were stratified by injury severity and hospital day of death to further define the relationship between outcome and multiple clinical variables. RESULTS A total of 7,443 patients were identified with head AIS 3+ and verbal GCS score 3+. Overall mortality was 6.1%. About one-third of deaths occurred on the first hospital day, with more than one-third occurring after hospital day 5. Logistic regression revealed an association between mortality and older age, more violent mechanisms of injury (fall, gunshot wound, pedestrian versus automobile), greater injury severity (higher head AIS and Injury Severity Score), lower GCS score, and hypotension. In addition, mortality was associated with a decrease in GCS score from field to arrival, the use of anticoagulants, and a diagnosis of pulmonary embolus. Two important groups of "talk-and-die" patients were identified. Early deaths occurred in younger patients with more critical extracranial injuries. Anticoagulant use was also an independent risk factor in these early deaths. Later deaths occurred in older patients with less significant extracranial injuries. Pulmonary embolus also appeared to be an important contributor to late mortality. CONCLUSIONS More severe injuries and use of anticoagulants are independent risk factors for early death in potentially salvageable traumatic brain injury patients, whereas older age and pulmonary embolus are associated with later deaths.
Rumination and Worry in Daily Life

Rumination and worry, two forms of perseverative thinking, hold promise as core processes that transect depressive and anxiety disorders. Whereas previous studies have been limited to the laboratory or to single diagnoses, we used an experience sampling methodology to assess and validate rumination and worry as transdiagnostic phenomena in the daily lives of individuals diagnosed with major depressive disorder (MDD), generalized anxiety disorder (GAD), and co-occurring MDD-GAD. Clinical and healthy control participants carried a handheld electronic device for one week. Eight times per day they reported on their current levels of rumination and worry and their theoretically postulated features: thought unpleasantness, repetitiveness, abstractness, uncontrollability, temporal orientation, and content, and overall senses of certainty and control. Both rumination and worry emerged as transdiagnostic processes that cut across MDD, GAD, and MDD-GAD. Furthermore, most psychological theories concerning rumination and worry strongly mapped onto participants’ reports, providing the first naturalistic validation of these constructs.