Miracle-dz/UniFAR-FTUs huggingface dataset:
New and Emerging Etiologies for Community‐Acquired Pneumonia with Implications for Therapy: A Prospective Multicenter Study of 359 Cases

Three hundred fifty-nine consecutive patients with community-acquired pneumonia admitted to university, community, and VA hospitals underwent a standardized evaluation, including specialized tests for Legionella spp. and Chlamydia pneumoniae (TWAR). The most common underlying illnesses were immunosuppression (36.3%), chronic obstructive pulmonary disease (32.4%), and malignancy (28.4%). The most frequent etiologic agents were Streptococcus pneumoniae (15.3%) and Hemophilus influenzae (10.9%). Surprisingly, Legionella spp. and C. pneumoniae were the third and fourth most frequent etiologies at 6.7% and 6.1%, respectively. Aerobic gram-negative pneumonias were relatively uncommon causes of pneumonia despite the fact that empiric broad-spectrum combination antibiotic therapy is so often directed at this subgroup. In 32.9%, the etiology was undetermined. Antibiotic administration before admission was significantly associated with undetermined etiology (p = 0.0003). There were no distinctive clinical features found to be diagnostic for any etiologic agent, although high fever occurred more frequently in Legionnaires' disease. Clinical manifestations for C. pneumoniae were generally mild, although 38% of patients had mental status changes. Mortality was highest for Staphylococcus aureus (50%) and lowest for C. pneumoniae (4.5%) and Mycoplasma pneumoniae (0%). We document that specialized laboratory testing for C. pneumoniae and Legionella spp. should be more widely used rather than reserved for cases not responding to standard therapy. Furthermore, realization that C. pneumoniae and Legionella spp. are common etiologies for community-acquired pneumonia should affect empiric antibiotic prescription.
Blinking Patterns and Corneal Staining

Purpose. To investigate the blinking patterns of healthy subjects and soft contact lens wearers and determine whether these blinking characteristics were associated with corneal fluorescein staining. Methods. Fifteen young soft contact lens wearers and 11 young, healthy subjects participated in the study. The subjects were selected to have no significant eyelid disease. High-speed filming (100 frames per second) was used to capture the natural blinking patterns of the subjects for approximately 3 minutes. Custom written software was used to measure the vertical palpebral aperture at the start and the end of the downward motion of the upper eyelid. The vertical gap between the lids at the lowest point of the upper lid movement during each blink was measured (closed palpebral aperture). Corneal fluorescein staining was quantified on a 0-to-4 scale for each subject. Results. Closed palpebral apertures in the healthy and soft contact lens–wearing subjects showed a wide distribution, with 22% of blinks being incomplete (<2/3 open aperture) in both groups of subjects. In soft contact lens wearers, there was a significant correlation (r2 = 0.40, P<0.05) between the mean closed palpebral aperture and the grade of corneal staining (primarily located inferiorly). The healthy subjects did not show the same degree of correlation (r2 = 0.16, P>0.1). However, the distribution of closed palpebral apertures was significantly different between those subjects with corneal staining compared to those without corneal staining (Kolmogorov–Smirnov two-sample test, healthy subjects with P=0.002 and soft lens wearers with P<0.001). Conclusions. The distribution of closed palpebral apertures of healthy and soft contact lens–wearing subjects showed no clear distinction between complete and incomplete blinks. Both groups of subjects show evidence of an association between the mean closed palpebral aperture size (degree of incomplete blinking) and the grade of corneal fluorescein staining, but the association is stronger in soft contact lens wearers.
Physical evaluation of insole materials used to treat the diabetic foot.

BACKGROUND The selection of materials for the production of multilayer insoles for diabetic feet is a difficult task owing to the lack of technical information about these materials. Therefore, objective criteria were established for the selection of these materials. METHODS Mechanical- and comfort-related tests for the mechanical characterization of different materials and their combinations were considered. These tests were conducted according to standardized test methods for polymeric cellular materials. RESULTS Criteria for the use of cellular materials were obtained. The properties of accommodation, cushioning, and filling materials were established and the most adequate polymer nature for each of the three applications was identified. Variables that affect the properties of these material combinations were studied. CONCLUSIONS These test results will allow podiatrists to select insoles in a more objective way, thus achieving a more successful treatment for diabetic foot-related injuries.
The Management of Open Fractures

Abstract This is a review of Medline and PubMed articles on open fractures published in the English literature between 1945 and April 2005. The emphasis of most published articles has been placed on definitive treatment of these injuries at sophisticated referral hospitals. The prehospital emphasis has been on rapid evacuation and referral to ensure that definitive treatment can be initiated as quickly as possible. Little has been discussed about the management of these injuries in remote settings where evacuation may consume considerably more time. Contemporary recommendations for management of these injuries are reviewed.
Successful Students Who Are Deaf or Hard of Hearing and Culturally and/or Linguistically Diverse in Inclusive Settings

The population of students who are deaf or hard of hearing is becoming more culturally and/or linguistically diverse. However, there is a paucity of practitioner literature and research available to professionals and families to guide decision making about daily practices with these students and their families. The study identified factors that contribute to the success of students who are deaf or hard of hearing and from culturally and/or linguistically diverse backgrounds who receive the majority of their education in inclusive settings. Students were recruited from two schools in two school districts in a western state. Students, educators, interpreters, and parents participated in individual in-depth, semi-structured interviews. Observations of the students were also done. Analysis of the data included coding the transcribed interviews and the field notes to identify common themes. Seven themes emerged and are reported. Recommendations for future research are provided.
Transient Climate Response in Coupled Atmospheric–Ocean General Circulation Models

The equilibrium climate sensitivity (ECS) has a large uncertainty range among models participating in the Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report (AR4) and has recently been presented as “inherently unpredictable. ” One way to circumvent this problem is to consider the transient climate response (TCR). However, the TCR among AR4 models also differs by more than a factor of 2. The authors argue that the situation may not necessarily be so pessimistic, because much of the intermodel difference may be due to the fact that the models were run with their oceans at various stages of flux adjustment with their atmosphere. This is shown by comparing multimillennium-long runs of the Goddard Institute for Space Studies model, version E, coupled with the Hybrid Coordinate Ocean Model (GISS-EH) and the Community Climate System Model, version 4 (CCSM4) with what were reported to AR4. The long model runs here reveal the range of variability (~30%) in their TCR within the same model with the same ECS. The commonly adopted remedy of subtracting the “climate drift” is ineffective and adds to the variability. The culprit is the natural variability of the control runs, which exists even at quasi equilibration. Fortunately, for simulations with multidecadal time horizon, robust solutions can be obtained by branching off thousand-year-long control runs that reach “quasi equilibration” using a new protocol, which takes advantage of the fact that forced solutions to radiative forcing forget their initial condition after 30–40 yr and instead depend mostly on the trajectory of the radiative forcing.
The Benefits of Physical Activity for Youth with Developmental Disabilities: A Systematic Review

Objective. Analyze evidence of the benefits of physical activity for youth with developmental disabilities. Data Sources. Key word searches for “disability,” “physical activity,” “exercise,” “fitness,” and “sport” in major databases. A total of 3263 citations was found. Study Inclusion/Exclusion Criteria. Systematic reviews and articles about studies quantitatively examining the effects of physical activity in youth with developmental disabilities ages 0 to 20 years were included. Only articles published in English in peer-reviewed journals were included. Data Extraction. A Measurement Tool to Assess Reviews criteria were used for systematic reviews; Grading of Recommendations, Assessment, Development, Evaluation criteria were used for observational studies; and Population, Intervention, Comparison, Outcome criteria were used for all studies. Data Synthesis. Data, shown in table format, were synthesized in relation to five research questions. Results. Three systematic reviews and 14 studies were reviewed. Strong evidence indicated that children and adolescents with developmental disabilities derive health benefits from participation in group exercise programs, treadmill training, or therapeutic riding/hippotherapy. Lesser levels of evidence indicated that health benefits might be present for adapted skiing or aquatic programs. Documented benefits of physical activity include improvements in aerobic capacity, improved gross motor function, and high levels of participant/parent satisfaction. Conclusions. Evidence exists that physical activity is beneficial for youth with developmental disabilities. Further research studies are needed that are of greater scientific rigor including larger sample sizes, control groups, and stringent, replicable methodology.
Region‐selective alterations of glucose oxidation and amino acid synthesis in the thiamine‐deficient rat brain: a re‐evaluation using 1H/13C nuclear magnetic resonance spectroscopy

Thiamine deficiency provides an effective model of selective neuronal cell death. 1H and 13C‐NMR was used to investigate the effects of thiamine deficiency on the synthesis of amino acids derived from [1‐13C]glucose in vulnerable (medial thalamus; MT) compared to non‐vulnerable (frontal cortex; FC) brain regions. Following 11 days of thiamine deficiency, a time‐point associated with the absence of significant neuronal cell death, regional concentrations of glutamate, glutamine and GABA remained unaffected in FC and MT; however, decreased levels of aspartate in MT at this time‐point were a predictor of regional vulnerability. De novo synthesis of glutamate and GABA were unaffected at 11 days of thiamine deficiency, while synthesis of [2‐13C]aspartate was significantly impaired. Glucose loading, which has been shown to exacerbate symptoms in patients with thiamine deficiency, resulted in further decreases of TCA cycle flux and reduced de novo synthesis of glutamate, aspartate and GABA in thiamine‐deficient (TD) rats. Isotopomer analysis revealed that impaired TCA cycle flux and decreased aspartate synthesis due to thiamine deficiency occurred principally in neurons. Glucose loading deteriorated TD‐related decreases in TCA cycle flux, and concomitantly reduced synthesis of aspartate and glutamate in MT.
Continuous exposure of airway epithelial cells to hydrogen peroxide: Protection by KGF

Reactive oxygen species (ROS) increase permeability in the airway epithelium. Extended periods of oxidant exposure may be experienced by those suffering from chronic inflammation of the lungs, receiving supplemental oxygen, or living in areas with high levels of air pollution. We studied the effects of long‐term, continuous exposure to hydrogen peroxide (H2O2) on the trans‐epithelial electrical resistance (TER) across cultured monolayers of a transformed cell line of human bronchial epithelial cells, 16HBE14o− (16HBE). A TER perfusion system was employed to continuously monitor the TER without disturbing the tissue model. The TER decreased in a dose‐dependent manner with increasing concentrations of H2O2 (0.1, 0.5, and 1.0 mM), regardless of pre‐incubation conditions. Cell cultures pre‐treated with 50 ng/ml keratinocyte growth factor (KGF) showed a significant delay in oxidant‐induced TER decreases caused by 0.1 mM H2O2. Exposure to 0.1 mM H2O2 for 350 min led to disruption of tight junction proteins, ZO‐1 and occludin, but KGF treatment prevented this damage. The recovery of epithelial barrier function after exposure to oxidants was also studied. Tissue models exposed to 0.5 mM H2O2 for 25 min showed complete recovery of TER after 20 h, independent of culture pre‐treatment. In contrast, KGF pre‐incubation enhanced the recovery of 16HBE cultures exposed for 50 min to 0.5 mM H2O2. © 2002 Wiley‐Liss, Inc.
Core Stability Exercises in Individuals with and without Chronic Nonspecific Low Back Pain

Marshall, PWM, Desai, I, and Robbins, DW. Core stability exercises in individuals with and without chronic nonspecific low back pain. J Strength Cond Res 25(12): 3404–3411, 2011—The aim of this study was to measure trunk muscle activity during several commonly used exercises in individuals with and without low back pain (LBP). Abdominal bracing was investigated as an exercise modification that may increase the acute training stimulus. After an initial familiarization session, 10 patients with LBP and 10 matched controls performed 5 different exercises (quadruped, side bridge, modified push-up, squat, shoulder flexion) with and without abdominal bracing. Trunk muscle activity and lumbar range of motion (LROM) were measured during all exercises. Muscle activity was measured bilaterally during each exercise from rectus abdominis (RA), external obliques (EO), and lumbar erector spinae (ES) with pairs of surface electrodes. Recorded signals were normalized to a percentage of maximal voluntary contractions performed for each muscle. The ES activity was lower for the LBP group during the quadruped (p < 0.05) and higher for RA and EO during the side bridge (p < 0.001), compared to for the healthy controls. Higher muscle activity was observed across exercises in an inconsistent pattern when abdominal bracing was used during exercise. The LROM was no different between groups for any exercise. The lack of worsening of symptoms in the LBP group and similar LROM observed between groups suggest that all exercises investigated in this study are of use in rehabilitating LBP patients. The widespread use of abdominal bracing in clinical practice, whether it be for patients with LBP or healthy individuals, may not be justified unless symptoms of spinal instability are identified.
Pediatric Acute Dacryocystitis

Purpose: To review and summarize the symptomatology, microbiology, special clinical entities, management, complications, and outcomes of pediatric acute dacryocystitis. Methods: The author performed a PubMed search of all articles published in English on acute dacryocystitis. Pediatric subpopulations of these articles were reviewed along with the scant literature of direct references to neonatal and pediatric acute dacryocystitis. Data reviewed included demographics, presentations, microbiological work up, management, complications, and outcomes. Results: Acute dacryocystitis is not very common in the pediatric age groups and occurs mostly as a complication of congenital nasolacrimal duct obstruction. The age of onset is usually in the neonatal period with a female preponderance. The clinical spectrum ranges from classic pediatric acute dacryocystitis to meningitis. Staphylococcus aureus is the commonest isolate. Occasionally acquired etiologies and rare organisms like Pantoea sp. , Epstein-Barr Virus, and Sporothrix are implicated in the etiopathogenesis. The diagnosis is usually clinical aided by laboratory investigations. Better antibiotics, well-established laboratory techniques and surgical modalities, and improved patient care logistics have contributed to good outcomes; however, complications are still being noted although infrequently. Conclusions: Pediatric acute dacryocystitis is a distinct entity with unique features of its own. It is a serious infection that warrants careful evaluation and immediate management. In the era of antibiotic resistance, microbiological work up of Pediatric acute dacryocystitis is very useful for subsequent treatment. Surgical challenges in the pediatric age group are distinct and the outcomes are good if standard protocols are followed.
Does Sciatic Parasacral Injection Spread to the Obturator Nerve? An Anatomic Study

BACKGROUND:The ability of parasacral sciatic nerve block to provide consistent obturator nerve and perineal blockade remains undetermined. In this anatomic work, we assessed the spread of a colored latex mimicking a parasacral injection, and observed the spread to the obturator nerve and sacral nerve roots. METHODS:Fourteen parasacral injections were performed bilaterally on seven human cadavers. Dissection was performed in two steps. First, the posterior approach confirmed the presence of dye on the sciatic nerve at the level of the piriformis muscle to define the success of the injection. Second, the anterior endopelvic dissection assessed the presence of dye around the pelvic portion of the obturator nerve and on the sacral roots (S1–3). The same score was used for all the nerves, from 0 (total failure) to 3 (total success). For all nerves (sciatic, obturator, sacral roots), a score of 2 or 3 was considered a successful injection. RESULTS:Eleven of 14 injections were considered successful parasacral injections. The three failed injections were excluded from further analysis. One was intravascular and two (same cadaver) in the gluteal muscles were too superficial. Of the 11 successful injections, 9 (82%) were scored as providing the spread of latex to both the obturator nerve and to the sacral roots. CONCLUSION:We conclude from this anatomical study that successful parasacral injection consistently spreads to the pelvic portion of the obturator nerve and to the sacral roots. Therefore, parasacral block should theoretically provide obturator and perineal blockade, and eliminate the need for systematic separate obturator nerve block. These results must be confirmed by further clinical studies.
Prognostic value of PD-L1 expression in tumor infiltrating immune cells in cancers: A meta-analysis

Programmed death-ligand 1 (PD-L1) is a promising target of cancer immune therapy. It not only expressed in tumor cells (TCs) but also up regulated in tumor infiltrating immune cells (TIICs). Although the previous meta-analysis have shown that PD-L1 expression in TCs was a valuable biomarker in predicting cancer prognosis, but few researches systematic evaluated the association between its expression in TIICs and survival of cancer patients. Thus, we performed this meta-analysis to evaluate the prognostic value of PD-L1 expression in TIICs in different types of cancers. Our results are valuable supplements when using PD-L1 expression to predict the survival of cancer patients and to select the beneficial patients from PD-L1 target therapy. PubMed, Embase, Web of Science and the Cochrane Central Search Library were used to perform our systematic literature search. Overall survival (OS) at 5th years and hazard ratios (HRs) were calculated using random effects models. Eighteen studies involving 3674 patients were included. The median positive rate of PD-L1 staining in TIICs was 36.37%. PD-L1 positive expression in TIICs related to a lower risk of death (HR = 0.784, 95%CI: 0.616–0.997, P = 0.047). Subgroup analyses found that PD-L1 positive expression in TIICs indicated a better prognosis especially in breast cancer patients (HR = 0.359, P = 0.041). When using whole tissue section slides, or using ‘any expression in TIICs’ as a cutoff value to assessing the results of IHC staining, PD-L1 expression in TIICs had a good prognostic value in cancer prognosis (HR = 0.587, P = 0.001 and HR = 0.549, P = 0.002). Our findings suggested that PD-L1 expression in TIICs was related to a better survival of cancer. The comprehensive evaluation of tumor cells and tumor infiltrating immune cells are required when evaluating the effect of PD-L1 expression on prognosis of cancer in future research.
Supervised Tissue Classification from Color Images for a Complete Wound Assessment Tool

This work is part of the ESCALE project dedicated to the design of a complete 3D and color wound assessment tool using a simple free handled digital camera. The first part was concerned with the computation of a 3D model for wound measurements using uncalibrated vision techniques. This paper presents the second part which deals with color classification of wound tissues, a prior step before to combine shape and color analysis in a single tool for real tissue surface measurements. As direct pixel classification proved to be inefficient for tissue wound labeling, we have adopted an original approach based on unsupervised segmentation prior to classification, to improve the robustness of the labeling step by considering spatial continuity and homogeneity. A ground truth is first provided by merging the images collected and labeled by clinicians. Then, color and texture tissue descriptors are extracted on labeled regions of this learning database to design a SVM region classifier, achieving 88% success overlap score. Finally, we apply unsupervised color region segmentation on test images and classify the regions. Compared to the ground truth, segmentation driven classification and clinician labeling achieve similar performance, around 75 % for granulation and 60 % for slough.
Evaluation of the Secretor Status of ABO Blood Group Antigens in Saliva among Southern Rajasthan Population Using Absorption Inhibition Method.

INTRODUCTION The ABO blood group system was the significant element for forensic serological examination of blood and body fluids in the past before the wide adaptation of DNA typing. A significant proportion of individuals (80%) are secretors, meaning that antigens present in the blood are also found in other body fluids such as saliva. Absorption inhibition is one such method that works by reducing strength of an antiserum based on type and amount of antigen present in the stains. AIM To check the efficacy of identifying the blood group antigens in saliva and to know the secretor status using absorption inhibition method among southern Rajasthan population. MATERIALS AND METHODS Blood and saliva samples were collected from 80 individuals comprising 20 individuals in each blood group. The absorption inhibition method was used to determine the blood group antigens in the saliva and then the results were correlated with the blood group of the collected blood sample. The compiled data was statistically analysed using chi-square test. RESULTS Blood groups A & O revealed 100% secretor status for both males and females. While blood groups B and AB revealed 95% secretor status. CONCLUSION Secretor status evaluation of the ABO blood group antigen in saliva using absorption inhibition method can be a useful tool in forensic examination.