Miracle-dz/UniFAR-FTUs huggingface dataset:
Surgical Site Infection After Pediatric Cardiothoracic Surgery

Background: Surgical site infection (SSI) occurs in 0.25% to 6% of children after cardiothoracic surgery (CTS). There are no published data regarding the financial impact of SSI after pediatric CTS. We sought to determine the attributable hospital cost and length of stay associated with SSI in children after CTS. Methods: We performed a retrospective, matched cohort study in a 26-bed cardiac intensive care unit (CICU) from January 2010 through December 2013. Cases with SSI were identified retrospectively and individually matched to controls 2:1 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons–European Association for Cardiothoracic Surgery category, and primary cardiac diagnosis and procedure. Results: Of the 981 cases performed during the study period, 12 with SSI were identified. There were no differences in demographics, clinical characteristics, or intraoperative data. Median total hospital costs were higher in participants with SSI as compared to controls (US$219,573 vs US$82,623, P < .01). Children with SSI had longer median CICU length of stay (9 vs 3 days, P < .01), hospital length of stay (18 vs 8.5 days, P < .01), and duration of mechanical ventilation (2 vs 1 day, P < .01) and vasoactive administration (4.5 vs 1 day, P < .01). Conclusions: Children with SSI after CTS have an associated increase in hospital costs of US$136,950/case and hospital length of stay of 9.5 days/case. The economic burden posed by SSI stress the importance of infection control surveillance, exhaustive preventative measures, and identification of modifiable risk factors.
An in vivo Investigation on the Wound-Healing Effect of Two Medicinal Herbs Using an Animal Model with Foot Ulcer

Background/Aim: Over 190 million people in the world suffer from diabetes mellitus. Diabetics are 25 times more likely to have a leg amputated because of unhealing foot ulcers. Herbal medicine has been used in China to salvage the ulcerated limb. With the aim to study the efficacy of two commonly used herbs for ulcer healing, namely Radix Astragali and Radix Rehmanniae, a good animal model needs to be developed for a proper in vivo investigation. Methods: Firstly, a diabetic animal model was established by streptozotocin injection. Then standard wounds were created on the feet of the diabetic rats. Digital photographs were taken and analyzed by a novel image analysis software. Results: The average ulcer area in the Radix Rehmanniae treatment group was 11.45 mm2, which was significantly smaller than the 15.12 mm2 in the water treatment group (p = 0.04). Radix Astragali, on the other hand, was found to have no significant effect on ulcer shrinkage. Conclusion: Further investigation is needed for the identification of the active principles of Radix Rehmanniae.
Meal triacylglycerol profile modulates postprandial absorption of carotenoids in humans.

SCOPE Dietary lipids are considered to be primary potentiators of carotenoid absorption, yet the amount and source required to optimize bioavailability has not been systematically evaluated. The objective of this study was to examine the impact of both amount and source of triacylglycerols on postprandial absorption of carotenoids from vegetable salads. METHODS AND RESULTS Healthy subjects (n = 29) were randomized using a Latin square design (3 × 3) and consumed three identical salads with 3, 8, or 20 g of canola oil, soybean oil, or butter. Blood was collected from 0-10 h and triacylglycerol-rich fractions (TRLs) were isolated by ultracentrifugation. Carotenoid contents of TRL fractions were analyzed by HPLC-DAD. Considering all lipid sources, 20 g of lipid promoted higher absorption compared to 3 and 8 g for all carotenoid species (p < 0.05), except for α-carotene (p = 0.07). The source of lipid had less impact on the absorption of carotenoids than amount of lipid. Pooling results from all lipid amounts, monounsaturated fatty acid rich canola oil trended toward enhancing absorption of lutein and α-carotene compared to saturated fatty acid rich butter (p = 0.06 and p = 0.08, respectively). CONCLUSION While both amount and source of co-consumed lipid affect carotenoid bioavailability from vegetables, amount appears to exert a stronger effect.
On the Existence of Platelet Receptors for Factor V(a) and Factor VIII(a)

The surface of the platelet expresses procoagulant phospholipids that bind coagulation factors and contribute to the procoagulant activity of the cell. The evidence, however, also suggests that platelets may possess specific receptors for coagulation Factors V(a) and VIII(a). Examination of a limited set of the available data could lead to the controversial position that the procoagulant surface of platelets is defined exclusively by either procoagulant phospholipids, or specific receptors for the cofactors and proteases. At the present time insufficient data exist to exclusively support one or the other of these possibilities. Further work, however, should indicate clearly whether the putative receptors exist and what role they play, either alone or in concert with surface phospholipids, in the expression and regulation of platelet procoagulant activity.
Permeability and Properties of the Membranes Surrounding the Developing Egg Of Homarus Vulgaris

Subjection to a variety of fluids confirms the presence of two non-living membranes roundv the developing eggs of Homarus. It also reveals that the outer membrane has the restricted permeability of cuticle and the inner membrane the free permeability of chitin. The inner, chitinous membrane bursts when the egg contents swell; the outer membrane stretches, up to 50 % above its initial diameter, when the internal osmotic pressure rises. It also has considerable elasticity. These properties of the outer membrane enable it to withstand the pressure to which the developing eggs are subjected and also to stretch during the development of the embryo, hence they have,considerable biological significance.The inner, chitinous membrane, which does not stretch, is probably ruptured and absorbed during development.
Transcranial Magnetic Stimulation in Adolescent Depression

Objective: There are few safe and effective biological treatments for major depression in adolescents. We aimed to report the use of repetitive transcranial magnetic stimulation (rTMS) as a treatment for adolescents with this condition. Methods: The first two subjects in a double-blind, sham-controlled trial of rTMS that is evaluating the efficacy and safety of rTMS in depressed adolescents are described. Clinical response was assessed at baseline and at the end of each week. The following scales were used: Montgomery– Asberg Depression Rating Scale, Clinical Global Impression-Severity Scale, Beck Depression Inventory and Centre for Epidemiological Studies – Depression – Child Scale. A battery of cognitive tests was also used at several intervals to measure potential change in neuropsychological functioning. Results: Random allocation of both subjects was to active treatment. Both subjects improved to a clinically significant degree with rTMS treatment and reported no adverse effects. Neuropsychological testing did not demonstrate any deterioration in the domains of functioning tested. Conclusions: Repetitive transcranial magnetic stimulation shows early promise as a treatment for major depression in adolescents. Well-designed, sham-controlled studies are now indicated to test the efficacy and safety of rTMS in these patients.
A molecular marker for chloroquine-resistant falciparum malaria.

BACKGROUND Chloroquine-resistant Plasmodium falciparum malaria is a major health problem, particularly in sub-Saharan Africa. Chloroquine resistance has been associated in vitro with point mutations in two genes, pfcrt and pfmdr 1, which encode the P. falciparum digestive-vacuole transmembrane proteins PfCRT and Pgh1, respectively. METHODS To assess the value of these mutations as markers for clinical chloroquine resistance, we measured the association between the mutations and the response to chloroquine treatment in patients with uncomplicated falciparum malaria in Mali. The frequencies of the mutations in patients before and after treatment were compared for evidence of selection of resistance factors as a result of exposure to chloroquine. RESULTS The pfcrt mutation resulting in the substitution of threonine (T76) for lysine at position 76 was present in all 60 samples from patients with chloroquine-resistant infections (those that persisted or recurred after treatment), as compared with a base-line prevalence of 41 percent in samples obtained before treatment from 116 randomly selected patients (P<0.001), indicating absolute selection for this mutation. The pfmdr 1 mutation resulting in the substitution of tyrosine for asparagine at position 86 was also selected for, since it was present in 48 of 56 post-treatment samples from patients with chloroquine-resistant infections (86 percent), as compared with a base-line prevalence of 50 percent in 115 samples obtained before treatment (P<0.001). The presence of pfcrt T76 was more strongly associated with the development of chloroquine resistance (odds ratio, 18.8; 95 percent confidence interval, 6.5 to 58.3) than was the presence of pfmdr 1 Y86 (odds ratio, 3.2; 95 percent confidence interval, 1.5 to 6.8) or the presence of both mutations (odds ratio, 9.8; 95 percent confidence interval, 4.4 to 22.1). CONCLUSIONS This study shows an association between the pfcrt T76 mutation in P. falciparum and the development of chloroquine resistance during the treatment of malaria. This mutation can be used as a marker in surveillance for chloroquine-resistant falciparum malaria.
Time course of compromised urea synthesis in patients with alcoholic hepatitis

Abstract Objectives: Alcoholic hepatitis (AH) markedly decreases the urea synthesis capacity. We aimed to investigate the time course of this compromised essential liver function in patients with AH and its relation to treatment and survival. Materials and methods: Thirty patients with AH were included in a prospective cohort study. We measured the substrate-independent urea synthesis capacity, i.e., the functional hepatic nitrogen clearance (FHNC), in the patients at study entry and again at three months (survivors/available: n = 17). Patients with severe disease (Glasgow Alcoholic Hepatitis Score ≥9, n = 17) were randomized to receive either prednisolone or pentoxifylline and were in addition examined after 14 days (n = 9). Results: FHNC (normal range = 25–45 L/h) was markedly decreased at study entry (median = 5.6 (IQR = 3.0–9.6) L/h) and increased by three-fold in survivors at three months (15.1 (12.0–22.9) L/h; p < . 001). In patients with severe AH, FHNC was also increased after 14 days of pharmacologic treatment and showed the greatest increase in the patients taking prednisolone (prednisolone 25.4 (20.6–26.2) L/h vs. pentoxifylline 12.3 (8.0–15.3) L/h; p = . 05). FHNC at study entry was lower in 90-day non-survivors than in survivors (p = .04). Conclusions: The decrease in the urea synthesis capacity in patients with AH was the most marked in short-term non-survivors and partly recovered in survivors at three months. In patients on pharmacologic treatment, recovery was observed already after 14 days, and it was nearly complete in those on prednisolone. Thus, metabolic liver failure in AH seems to be prognostically important, is potentially reversible, and may recover more rapidly following treatment with prednisolone.
Downlink Resource Allocation and Frequency Reuse Schemes for WiMAX Networks

Throughout this chapter we consider the downlink of a cellular WiMAX network where a number of base stations need to communicate simultaneously with their respective active users 1. Each of these users has typically a certain Quality of Service (QoS) requirement that needs to be satisfied. To that end, base stations dispose of limited wireless resources (subcarriers and transmit powers) that should be shared between users. They also have some amount of Channel State Information (CSI) about users’ propagation channels available, if existent, typically via feedback. The problemof determining the subset of subcarriers assigned to each user and the transmit power on each of these subcarriers is commonly referred to as the resource allocation problem. This problem should be solved such that all the QoS exigencies are respected.
“Type grouping” in skeletal muscles after experimental reinnervation

APPLICATION OF histochemical techniques to the study of human muscle biopsies has helped to eludicate a number of pathologic reactions of skeletal muscle that are not evident in routinely stained paraffin-embedded tissue.1-4 One of these abnormalities has been termed “type grouping” and defined as “groups of fibers of the same histochemical type much larger than usual . consisting of 50-100 fibers or more. ”Z Normally, in histochemically mixed muscles, the two basic histochemical fiber types (types 1 and 2) are intermingled in a mosaic pattern when viewed in cross section. In normal human muscle the number of fibers of similar histochemical type in tight contiguity does not exceed 50 and is usually less than 15. Type grouping is commonly observed in muscle biopsies of patients with chronic peripheral neuropathies (Fig. 1) and somewhat less often in the advanced stage of motor neuron disease. It has been postulated to be a sign of reinnervation by “collateral sprouting. ”Z In this paper we present an experimental model in which typical type grouping was produced in histochemically mixed muscles of the guinea pig by experimental reinnervation. The results support the suggestion that collateral sprouting is at least one pathogenic mechanism which may be responsible for type grouping in disease in human beings.
The classification, natural history and radiological/histological appearance of idiopathic pulmonary fibrosis and the other idiopathic interstitial pneumonias

The idiopathic interstitial pneumonias (IIPs) are a heterogeneous group of rare interstitial lung diseases (ILDs) or diffuse parenchymal lung diseases, which, as their name implies, are of unknown aetiology. The past 10 yrs have seen important advances in the classification of the IIPs into idiopathic pulmonary fibrosis (IPF) and its corresponding histopathological pattern of usual interstitial pneumonia (UIP), plus six non-IPF IIP subtypes. The present article will look at the current classification of IIPs, arising from the Consensus Statement of the American Thoracic Society and European Respiratory Society, and discusses the importance of differential diagnosis of IPF from the non-IPF IIP subtypes, especially nonspecific interstitial pneumonia. Diagnosis of IIPs is a dynamic process involving close collaboration between pulmonologists, radiologists and pathologists. Increasingly accurate diagnosis of IPF has been made possible by the use of high-resolution computed tomography (HRCT) and refinements in surgical lung biopsy. In IPF, a lung HRCT will typically reveal irregular reticular opacities, traction bronchiestasis and, most importantly, peripheral honeycombing. In contrast, histological examination shows evidence of UIP manifesting as typically subpleural and paraseptal established fibrosis, often with honeycomb changes, associated with mild chronic inflammation and varying numbers of fibroblastic foci in continuity with the edges of areas of established fibrosis. Despite these advances, obtaining a consistent and uniform diagnosis of idiopathic interstitial pneumonias is difficult, with studies showing significant disagreement in the diagnosis of interstitial lung diseases between academic centres of expertise and community-based clinicians. Greater interaction between academic and community clinicians, together with improved education, is needed to bridge this gap.
Reoperation After Robotic and Vaginal Mesh Reconstructive Surgery: A Retrospective Cohort Study

Objectives Our primary objective was to compare reoperations after robotic-assisted sacrocolpopexy and transvaginal mesh for apical prolapse repair. Our secondary aim was to record perioperative complications after robotic and vaginal surgeries. Methods We reviewed medical records of women who underwent vaginal apical mesh support procedures or robotic sacrocolpopexy at Winthrop University Hospital between August 2009 and August 2013. We compared reoperations and perioperative complications between the 2 groups. Results There were 245 eligible cases during the 4-year study period. One hundred eighty-one women underwent robotic-assisted sacrocolpopexy and 64 women underwent transvaginal mesh. Women who underwent robotic surgery were younger and had decreased blood loss. Patients were followed up for a median of 3 months after robotic surgery and 11.5 months after transvaginal mesh. We found no difference in overall rate of reoperation between robotic and transvaginal mesh repair for apical prolapse. Specifically, there was no difference in the rate of reoperation for mesh exposure. Conclusions Despite recent controversies, transvaginal mesh offers the benefit of an effective minimally invasive procedure with shorter operative times, and may not pose additional risk for reoperation when compared to robotic-assisted sacrocolpopexy.
Radioimmunoscintigraphy in patients with early stage cutaneous malignant melanoma.

UNLABELLED CT and MRI examinations remain relatively insensitive for the detection of metastatic melanoma lesions, especially those of regional lymph nodes. Imaging cutaneous malignant melanoma patients with the Fab fragment of monoclonal antibody (MAb) NR-ML-05 labeled with 99mTc has been reported to increase the accuracy of staging. Our purpose in this study was to assess the sensitivity of 99mTc-labeled NR-ML-05 in detecting the spread of melanoma. METHODS Twenty-six adult cutaneous malignant melanoma patients were enrolled in this study and were followed for 6 to 60 mo after radioimmunoscintigraphy. At the time of imaging, 20 patients had their primary lesions resected, whereas the remaining 6 patients had their primary lesions intact. RESULTS Radioimmunoscintigraphy correctly detected 8 of 18 suspicious lesions as malignant, as well as 4 additional malignant lesions which had not been suspected previously. Radioimmunoscintigraphy also correctly identified 8 of the 18 suspicious lesions as benign. Two of the 18 suspicious lesions were found to be false negatives. The overall lesion sensitivity of radioimmunoscintigraphy was 86%. CONCLUSION Twenty-four of the 26 patients were correctly staged by radioimmunoscintigraphy. The accuracy of staging of cutaneous malignant melanoma patients by clinical and or radiologic examinations (73%) was greatly improved with the use of radioimmunoscintigraphy (93%). These results suggest that radioimmunoscintigraphy may be a clinically useful adjunct to the current armamentarium for guidance of medical, and particularly surgical, therapy of cutaneous malignant melanoma patients.
ADDIS ABABA UNIVERSITY COLLEGE OF HEALTH SCIENCES SCHOOL OF ALLIED HEALTH SCIENCES DEPARTMENT OF MEDICAL LABORATORY SCIENCES SPECTRUM AND ANTIBIOTIC SUSCEPTIBILITY PROFILE OF BACTERIURIA ISOLATED FROM PATIENTS ATTENDING ARSHO ADVANCED MEDICAL LABORATORY WITH URINARY TRACT INFECTIONS BY USING VITEK

Background: Urinary tract infection (UTI) is a very common infection both in the community and hospital patients. Development of drug resistance by bacteriuria is a growing problem. Accurate identification of bacteria implicated causing UTIs and determining their drug susceptibility pattern is critical for efficient management of patients with UTIs; that has significant clinical and financial benefits, via reduction of mortality rates and overall hospitalization costs. The aim of this study was to determine the spectrum of bacteria implicated in causing urinary tract infections and their drug susceptibility profile. Methodology: The present study was a single institutional cross-sectional study carried out at Arsho Advanced Medical laboratory, Addis Ababa, Ethiopia from March to July 2016. Cleancatch midstream urine was collected from study participants and was inoculated onto primary isolation culture media with calibrated loop. All plates were incubated at 37 C for 18-24 hours and the number of colonies was counted. Species identification and antibiotic susceptibility testing of bacteria were determined with the automated VITEK 2 compact system. Result: Out of 712 urine samples processed, 256 (36%) yielded significant bacteriuria of which 208 (81.25%) were obtained from female study participants and 48 (18.75%) were from male study participants. Cases of 75 % UTIs were recorded among age group of 15-64 years. Of the 256 bacterial isolates recovered, Escherichia coli, Klebsiella pneumoniae, Staphylococcus haemolyticus and Enterococcus faecalis were the dominant bacterial isolates. Ampicillin (21.7%) and trimethoprim/sulfamethoxazole (33.7%) were the least effective drugs against gram negative bacteria while piperacillin/tazobactam (82.3%) was the most effective drug. Erythromycin (17.8%) was the least effective drug against gram positive bacteria and daptomycin (98.1%) was the most active drugs. The overall resistance to two and more antibacterial drugs was high (75.4% and 91.3% for gram negative and positive respectively). Conclusion: Isolation of many unpredictable bacteria, urinary tract infection rate of 36%, and an overall higher resistance rate to two and more antibacterial (75.4% and 91.3% for gram negative and gram positive bacteria respectively) were documented. These highlight the need for nationwide study on the spectrum and drug sensitivity pattern bacterial uropathogens.
Changes in motoneurone firing rates during sustained maximal voluntary contractions.

Tungsten micro‐electrodes have been used to record the electrical activity of single motor units in the human adductor pollicis during maximal voluntary contractions. The potentials were characteristic of those from single muscle fibres. In brief maximal contractions, the firing rates of over 200 motor units were obtained from five normal subjects. Four subjects had a similar range (mean 26.4 +/‐ 6.5 Hz) while the fifth was slightly higher (35 +/‐ 7.4 Hz). When maximal voluntary force was sustained for 40‐120 s, there was a progressive decline in the range and mean rate of motor‐unit discharge. In the first 60 s, mean rates fell from about 27 Hz to 15 Hz. There was some evidence to suggest that those units with the highest initial frequencies changed rate most rapidly. It is suggested that this decline in motor unit discharge rates is not responsible for force loss, but that it may enable effective modulation of voluntary strength by rate coding to continue during fatigue.