Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of delayed lumbar punctures on the diagnosis of acute bacterial meningitis in adults

Introduction Bacterial meningitis is a medical emergency, the outcome of which is improved by prompt antibiotic treatment. For patients with suspected meningitis and no features of severe disease, the British Infection Society recommends immediate lumbar puncture (LP) before antibiotics, to maximise the chance of a positive cerebrospinal (CSF) culture. In such patients, CT scanning before LP is not needed. Methods The case notes of adults with meningitis admitted to a large district general hospital over 3 years were reviewed. Patients were classified as Likely Bacterial Meningitis or Likely Viral Meningitis based on their CSF and peripheral blood results using the Meningitest Criteria, with microbiological and virological confirmation. Results Of 92 patients studied, 24 had Likely Bacterial Meningitis, including 16 with microbiologically confirmed disease (none had PCR tests for bacteria). Sixty-eight had Likely Viral Meningitis, four of whom had viral PCR, including one with herpes simplex virus. No patient had an LP before antibiotics. CSF culture was positive for eight (73%) of the 11 patients who had an LP up to 4 h after starting antibiotics, compared with eight (11%) of 71 patients with a later LP (p<0.001). None of the 34 LPs performed more than 8 h after antibiotics was culture-positive. For 62 (67%) of the 92 patients, the delay was due to a CT scan, although only 20 of these patients had a contraindication to an immediate LP. Conclusions Too many patients with acute bacterial meningitis are being sent for unnecessary CT scans, causing delays in the LP, and reducing the chances of a positive CSF culture after starting antibiotics. However, even if antibiotics have been started, an LP within 4 h is still likely to be positive. Molecular tests for diagnosis should also be requested.
Current process in hearing-aid fitting appointments: An analysis of audiologists’ use of behaviour change techniques using the behaviour change technique taxonomy (v1)

Abstract Objectives: To observe and analyse the range and nature of behaviour change techniques (BCTs) employed by audiologists during hearing-aid fitting consultations to encourage and enable hearing-aid use. Design: Non-participant observation and qualitative thematic analysis using the behaviour change technique taxonomy (version 1) (BCTTv1). Study sample: Ten consultations across five English NHS audiology departments. Results: Audiologists engage in behaviours to ensure the hearing-aid is fitted to prescription and is comfortable to wear. They provide information, equipment, and training in how to use a hearing-aid including changing batteries, cleaning, and maintenance. There is scope for audiologists to use additional BCTs: collaborating with patients to develop a behavioural plan for hearing-aid use that includes goal-setting, action-planning and problem-solving; involving significant others; providing information on the benefits of hearing-aid use or the consequences of non-use and giving advice about using prompts/cues for hearing-aid use. Conclusions: This observational study of audiologist behaviour in hearing-aid fitting consultations has identified opportunities to use additional behaviour change techniques that might encourage hearing-aid use. This information defines potential intervention targets for further research with the aim of improving hearing-aid use amongst adults with acquired hearing loss.
Soluble Angiogenic Factors in Patients With Acute Pancreatitis

Background Angiogenic factors are involved in the physiopathology of several inflammatory diseases and they probably play a role in the pathogenesis of acute pancreatitis (AP). Aims To investigate if angiogenic factors are elevated in patients with AP, their relationship with severity and clinical evolution of AP, and their use as prognosis markers of AP. Methods A case (25)-control (30) study was carried out. Patients with AP were classified according to severity (using Ranson and Glasgow scores) and according to their clinical evolution (taking into account the development of complications during hospital stay). Platelet-derived growth factor (PDGFBB), angiopoietin-1, angiopoietin-2 (Ang-2), angiopoietin tyrosine-kinase receptor, hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), VEGF tyrosine-kinase receptor 1, and VEGF tyrosine-kinase receptor 2 were determined at 12 hours and then at 5 days after hospitalization. Results PDGFBB, Ang-2, angiopoietin tyrosine-kinase receptor, and HGF were significantly higher in cases (P<0.001), and in patients with unfavorable clinical evolution (P<0.001). PDGFBB and HGF were significantly higher in patients with severe AP (P<0.05). To predict unfavorable clinical evolution, PDGFBB, Ang-2, and HGF showed an area under receiver operating characteristic curve of 0.97. Conclusions PDGFBB and HGF are related to severity of AP. These factors along with Ang-2 are related to clinical evolution and are useful in predicting the development of several complications during hospital stay. Therefore, these angiogenic factors could be useful as prognosis markers of AP.
Reionisation and High-Redshift Galaxies: The View from Quasar Absorption Lines

Abstract Determining when and how the first galaxies reionised the intergalactic medium promises to shed light on both the nature of the first objects and the cosmic history of baryons. Towards this goal, quasar absorption lines play a unique role by probing the properties of diffuse gas on galactic and intergalactic scales. In this review, we examine the multiple ways in which absorption lines trace the connection between galaxies and the intergalactic medium near the reionisation epoch. We first describe how the Ly α forest is used to determine the intensity of the ionising ultraviolet background and the global ionising emissivity budget. Critically, these measurements reflect the escaping ionising radiation from all galaxies, including those too faint to detect directly. We then discuss insights from metal absorption lines into reionisation-era galaxies and their surroundings. Current observations suggest a buildup of metals in the circumgalactic environments of galaxies over z ~ 6 to 5, although changes in ionisation will also affect the evolution of metal line properties. A substantial fraction of metal absorbers at these redshifts may trace relatively low-mass galaxies. Finally, we review constraints from the Ly α forest and quasar near zones on the timing of reionisation. Along with other probes of the high-redshift Universe, absorption line data are consistent with a relatively late end to reionisation (5.5 ≲ z ≲ 7); however, the constraints are still fairly week. Significant progress is expected to come through improved analysis techniques, increases in the number of known high-redshift quasars from optical and infrared sky surveys, large gains in sensitivity from next-generation observing facilities, and synergies with other probes of the reionisation era.
The Effects of Foam Rolling as a Recovery Tool in Professional Soccer Players.

Foam rolling (FR) is a common strategy used after training and competition by players. However, no previous studies have assessed the effectiveness of FR as recovery tool in sports populations. The aim of this study was to examine the effectiveness of FR (20 minutes of foam rolling exercises on quadriceps, hamstrings, adductors, gluteals, and gastrocnemius) and passive recovery (20 minutes sit on a bench) interventions performed immediately after a training session on Total Quality Recovery (TQR), perceived muscle soreness, jump performance, agility, sprint, and flexibility 24 hours after the training. During 2 experimental sessions, 18 professional soccer players (age 26.6 ± 3.3 years; height: 180.2 ± 4.5 cm; body mass: 75.8 ± 4.7 kg) participated in a randomized fully controlled trial design. The first session was designed to collect the pre-test values of each variable. After baseline measurements, the players performed a standardized soccer training. At the end of training unit, all the players were randomly assigned to the FR recovery group and the passive recovery group. A second experimental session was carried out to obtain the posttest values. Results from the between-group analyses showed that FR had a large effect on the recovery in agility (Effect Sizes [ES]= 1.06), TQR (ES= 1.08), and perceived muscle soreness (ES= 1.02) in comparison to passive recovery group at 24 h post-training. Thus, it is recommended soccer coaches and physical trainers working with high-level players use a structured recovery session lasting from 15 to 20 min based on FR exercises that could be implemented at the end of a training session to enhance recovery between training loads.
Distribution pattern of psoriasis affects sexual function in moderate to severe psoriasis: a prospective case series study.

INTRODUCTION Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relationship. However, beyond genital psoriasis, the importance of the distribution pattern of the disease has not been considered. AIM To investigate the role of the distribution pattern of psoriasis in sexual dysfunction. METHODS A prospective case series study was carried out on 133 patients with moderate to severe psoriasis. MAIN OUTCOME MEASURES The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index. RESULTS Forty-four women (mean age 42.0 ± 14.1) and 79 men (mean age 47 ± 11.7) were included in the study. Psoriasis lesions on abdomen, genitals, lumbar region, and buttocks in women and chest, genitals, and buttocks in men were associated with an increase in sexual dysfunction. Multivariate logistic regression analysis showed that the involvement of these specific areas may be independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis. CONCLUSIONS This is the first study identifying body areas other than genitals as potentially related to sexual dysfunction in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when deciding on treatment for psoriasis patients.
The phagocytic fitness of leucopatches may impact the healing of chronic wounds

Chronic non‐healing wounds are significantly bothersome to patients and can result in severe complications. In addition, they are increasing in numbers, and a challenging problem to the health‐care system. Handling of chronic, non‐healing wounds can be discouraging due to lack of improvement, and a recent explanation can be the involvement of biofilm infections in the pathogenesis of non‐healing wounds. Therefore, new treatment alternatives to improve outcome are continuously sought‐after. Autologous leucopatches are such a new, adjunctive treatment option, showing promising clinical effects. However, the beneficial effect of the patches are not understood fully, although a major contribution is believed to be from the release of stimulating growth factors from activated thrombocytes within the leucopatch. Because the leucopatches also contain substantial numbers of leucocytes, the aim of the present study was to investigate the activity of the polymorphonuclear neutrophils (PMNs) within the leucopatch. By means of burst assay, phagocytosis assay, migration assay, biofilm killing assay and fluorescence in‐situ hybridization (FISH) assay we showed significant respiratory burst in PMNs, active phagocytosis and killing of Pseudomonas aeruginosa by the leucopatch. In addition, bacterial‐induced migration of PMNs from the leucopatch was shown, as well as uptake of P. aeruginosa by PMNs within the leucopatch. The present study substantiated that at least part of the beneficial clinical effect in chronic wounds by leucopatches is attributed to the activity of the PMNs in the leucopatch.
Proteomic analysis of macrophages stimulated by lipopolysaccharide: Lipopolysaccharide inhibits the cleavage of nucleophosmin

Lipopolysaccharide (LPS) is a complex glycolipid composed of a hydrophilic polysaccharide and a hydrophobic domain that is responsible for the biological activity of LPS. There are many reports about LPS stimulation, and many activated proteins have been detected after LPS stimulation in various cell types. Furthermore, most of the LPS signaling pathways are clear. However, we were interested in examining the changes of LPS‐induced total cytosolic proteins expression and the LPS signaling pathway by the proteomics technique during LPS‐induced macrophage activation. Our study employed two‐dimensional gel electrophoresis and mass spectrometry to analyze the proteins involved in LPS‐induced activation in RAW 264.7 cells. We found 11 protein spots whose expression was different between untreated cells and LPS‐treated cells. Ten protein spots were identified, seven of which, tubulin beta‐4 chain (49.6 kDa, pI 4.78), nucleophosmin (32.6 kDa, pI 4.62, two spots), 40S ribosomal protein SA (P40) (32.7 kDa, pI 4.74), transforming protein RhoA (21.8 kDa, pI 5.83), nucleolin (76.6 kDa, pI 4.69), and T‐complex protein 1 zeta subunit (58 kDa, pI 6.63) were down‐regulated, and three of which, nucleophosmin (32.6 kDa, pI 4.62, two spots) and proteosome subunit alpha type‐1 (29.5 kDa, pI 6.00), were up‐regulated. The suppression of the proteolytic degradation of nucleophosmin was associated with LPS‐induced RAW 264.7 cell activation. Cleaved caspase‐3 decreased, thus it might be involved in proteolysis of nucleophosmin in LPS‐induced macrophage activation. Our study also demonstrated that there was no change of the expression of nucleophosmin at the mRNA level.
Development of the nasolacrimal apparatus in the Mongolian gerbil (Meriones unguiculatus), with notes on network topology and function

The nasolacrimal apparatus (NLA) is a multicomponent functional system comprised of multiple orbital glands (up to four larger multicellular exocrine structures), a nasal chemosensory structure (vomeronasal organ: VNO), and a connecting duct (nasolacrimal duct: NLD). Although this system has been described in all tetrapod vertebrate lineages, albeit not always with all three main components present, considerably less is known about its ontogeny. The Mongolian gerbil (Meriones unguiculatus) is a common lab rodent in which the individual components of the adult NLA have been well studied, but as yet nothing is known about the ontogeny of the NLA. In this study, serial sections of 15 fetal and three adult Mongolian gerbil heads show that the development of the NLA falls into three fetal stages: inception (origin of all features), elongation (lengthening of all features), and expansion (widening of all features). No postnatal or juvenile specimens were observed in this study, but considerable growth evidently occurs before the final adult condition is reached. The development of the orbital glands and the VNO in the Mongolian gerbil is largely consistent with those in other mammals, despite a slight nomenclatural conundrum for the anterior orbital glands. However, the Mongolian gerbil NLD follows a more circuitous route than in other tetrapods, due mainly to the convoluted arrangement of the narial cartilages, the development of a pair of enlarged incisors as well as an enlarged infraorbital foramen. The impact of these associated features on the ontogeny and phylogeny of the NLA could be examined through the approach of network science. This approach allows for the incorporation of adaptations to specific lifestyles as potential explanations for the variation observed in the NLA across different tetrapod clades. J. Morphol. 276:1005–1024, 2015. © 2015 Wiley Periodicals, Inc.
Enhanced Exercise Performance and Survival Associated With Evidence of Autonomic Reinnervation in Pediatric Heart Transplant Recipients

Following heart transplantation (HTx), loss of autonomic input to the allograft results in elevated resting heart rate (HR) and decreased chronotropic reserve. As enhanced exercise capacity and HR recovery post exercise are suggestive of reinnervation in pediatric cohorts, we used heart rate variability (HRV) analysis to assess autonomic reinnervation in pediatric HTx recipients. Pediatric patients transplanted between 1996 and 2010 and with serial 24‐hour Holter recordings post‐HTx were analyzed for HRV using time and frequency domain measures. Of 112 patients, 68 (57%) showed evidence of autonomic reinnervation that was not associated with age at HTx. Evidence of reinnervation was associated with a significant increase in low‐frequency power spectrum (p<0.001), suggesting sympathetic reinnervation. Patients with evidence of reinnervation showed higher percent‐predicted maxVO2 on performing an exercise test (+10.2 ± 3.6%, p = 0.006) and improved HR recovery at 3 minutes (−11.4 ± 3.9 bpm, p = 0.004), but no difference in percent‐predicted maximal HR. Cox hazards modeling using presumed sinus reinnervation criteria at last Holter recording as a time‐dependent covariate was associated with decreased hazard of mortality and/or retransplantation (HR: 0.2, 95% CI 0.04–1.0, p = 0.05). In conclusion, a majority of pediatric HTx recipients demonstrate evidence of reinnervation that is associated with functional outcomes. Studies to assess graft reinnervation as a marker of long‐term prognosis are warranted.
Procedures for Rat in situ Skeletal Muscle Contractile Properties

There are many circumstances where it is desirable to obtain the contractile response of skeletal muscle under physiological circumstances: normal circulation, intact whole muscle, at body temperature. This includes the study of contractile responses like posttetanic potentiation, staircase and fatigue. Furthermore, the consequences of disease, disuse, injury, training and drug treatment can be of interest. This video demonstrates appropriate procedures to set up and use this valuable muscle preparation. To set up this preparation, the animal must be anesthetized, and the medial gastrocnemius muscle is surgically isolated, with the origin intact. Care must be taken to maintain the blood and nerve supplies. A long section of the sciatic nerve is cleared of connective tissue, and severed proximally. All branches of the distal stump that do not innervate the medial gastrocnemius muscle are severed. The distal nerve stump is inserted into a cuff lined with stainless steel stimulating wires. The calcaneus is severed, leaving a small piece of bone still attached to the Achilles tendon. Sonometric crystals and/or electrodes for electromyography can be inserted. Immobilization by metal probes in the femur and tibia prevents movement of the muscle origin. The Achilles tendon is attached to the force transducer and the loosened skin is pulled up at the sides to form a container that is filled with warmed paraffin oil. The oil distributes heat evenly and minimizes evaporative heat loss. A heat lamp is directed on the muscle, and the muscle and rat are allowed to warm up to 37°C. While it is warming, maximal voltage and optimal length can be determined. These are important initial conditions for any experiment on intact whole muscle. The experiment may include determination of standard contractile properties, like the force-frequency relationship, force-length relationship, and force-velocity relationship. With care in surgical isolation, immobilization of the origin of the muscle and alignment of the muscle-tendon unit with the force transducer, and proper data analysis, high quality measurements can be obtained with this muscle preparation.
The Effects of Tailoring Knowledge Acquisition on Colorectal Cancer Screening Self-Efficacy

Interventions tailored to psychological factors such as personal and vicarious behavioral experiences can enhance behavioral self-efficacy but are complex to develop and implement. Information seeking theory suggests tailoring acquisition of health knowledge (without concurrent psychological factor tailoring) could enhance self-efficacy, simplifying the design of tailored behavior change interventions. To begin to examine this issue, the authors conducted exploratory analyses of data from a randomized controlled trial, comparing the effects of an experimental colorectal cancer screening intervention tailoring knowledge acquisition with the effects of a nontailored control on colorectal cancer screening knowledge and self-efficacy in 1159 patients comprising three ethnicity/language strata (Hispanic/Spanish, 23.4%, Hispanic/English, 27.2%, non-Hispanic/English, 49.3%) and 5 recruitment center strata. Adjusted for study strata, the mean postintervention knowledge score was significantly higher in the experimental group than in the control group. Adjusted experimental intervention exposure (B = 0.22, 95% CI [0.14, 0.30]), preintervention knowledge (B = 0.11, 95% CI [0.05, 0.16]), and postintervention knowledge (B = 0.03, 95% CI [0.01, 0.05]) were independently associated with subsequent colorectal cancer screening self-efficacy (p < .001 all associations). These exploratory findings suggest that tailoring knowledge acquisition may enhance self-efficacy, with potential implications for tailored intervention design, but this implication requires confirmation in studies specifically designed to examine this issue.
Prevalence of Diabetic Retinopathy in Adult Chinese American Individuals: The Chinese American Eye Study.

Importance Chinese American individuals are a fast-growing segment of people in the United States, but the burden and effect of diabetic complications on this group of people is not fully understood. Objective To determine the age- and sex-specific prevalence of diabetic retinopathy (DR) overall and by severity, duration of diabetes, and treatment history in adult Chinese American individuals. Design, Setting, and Participants The Chinese American Eye Study (CHES), a population-based, cross-sectional study, was conducted from February 2010 to October 2013 for 10 census tracts in Monterey Park, California. This analysis, conducted between February 16, 2010, and October 9, 2013, included 4582 Chinese residents 50 years and older. Main Outcomes and Measures Prevalence of nonproliferative DR, proliferative DR, and macular edema, as well as stereoscopic fundus photography of 7 standard Early Treatment Diabetic Retinopathy Study fields. Results Of the 4582 survey participants, most were first-generation immigrants from China (68.7%) and female (63%). In total, 736 participants (16.1%) were identified as having type 2 diabetes. Fundus photographs were gradable for 665 (90.4%) of these participants. The reproducibility of DR grading was evaluated throughout study and showed moderate to excellent agreement (weighted κ = 0.78-0.97). Diabetic retinopathy was present in 35.8% of people with diabetes (95% CI, 32.1%-39.6%). The estimated prevalence of severe nonproliferative DR and proliferative DR was 1.7% (95% CI, 0.8%-2.9%) and 2.4% (95% CI, 1.4%-3.9%), respectively. Macular edema was observed among 4.5% of people with diabetes (95% CI, 3.0%-6.4%), and clinically significant macular edema was observed among 2.0% (95% CI, 1.1%-3.3%). The prevalence of DR was higher (56%) among participants with a longer duration of diabetes (≥15 years; P < .001). The prevalence of visual impairment (best-corrected visual acuity worse than 20/40 in the better-seeing eye) among participants with diabetes was higher than those without diabetes (6.7% vs 2.2% = difference of 4.5%; 95% CI, 3.9%-5.1%). The primary causes of visual impairment in participants with diabetes were cataracts (38% of participants; 95% CI, 36.6%-39.4%) followed by macular edema (7% of participants; 95% CI, 6.3%-7.7%). Conclusions and Relevance Data from CHES and this study indicate that the prevalence of DR in the Chinese American Eye Study Group is relatively lower than studies of Chinese individuals residing in rural northern China or Latino individuals from Los Angeles County, California.