Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of helicopter transport and hospital level on mortality of polytrauma patients.

BACKGROUND Despite numerous studies analyzing this topic, specific advantages of helicopter transport of blunt polytrauma patients as compared with ground ambulances have not yet been identified unequivocally. METHODS Four possible pathways in 403 polytrauma patients (Injury Severity Score [ISS] > 16) who were in reach of the helicopter emergency medical service (HEMS) Dresden were analyzed as follows: HEMS-UNI group (n = 140), transfer by HEMS into a university hospital; AMB-REG group (n = 102), transfer by ground ambulance into a regional (Level II or III) hospital; AMB-UNI group (n = 70), transfer by ground ambulance into the university hospital; and INTER group (n = 91), transfer by ground ambulance into a regional hospital, followed by transfer to the university hospital. Scores used were the ISS and the TRISS. Tests used for statistical analysis included chi2 and Fisher's tests. Statistical significance was set at p > 0.05. RESULTS Age, gender, and mean ISS (range, 33.3-35.6) revealed extensive homogeneity of the groups. Mortality of the AMB-REG group was almost doubled (41.2%) compared with HEMS-UNI (22.1%) patients (p = 0.002). The AMB-UNI group displayed the lowest mortality (15.7%, p = not significant). TRISS analysis (PRE-Chart) revealed identical outcome for AMB-UNI and HEMS-UNI patients. Rescue time averaged 90 +/- 29 minutes for HEMS-UNI patients, 68 +/- 25 minutes for AMB-UNI patients, and 69 +/- 26 minutes for the AMB-REG group. CONCLUSION Primary transfer by HEMS into a Level I trauma center reduces mortality markedly. In principle, this benefit can be attributed to superior preclinical therapy, primary admission to a Level I trauma center, or both. However, the identical probability of survival of the AMB-UNI and HEMS-UNI groups in this and comparable studies does not confirm generally better survival rates on account of a more aggressive on-site approach.
Cognitive Slowing in Closed-Head Injury

Mean response times (RTs) from a sample of 13 simple- and choice-reaction time studies (which included 353 Closed-Head Injury (CHI) subjects at various stages of injury and 329 Control, non-CHI, subjects; mean age of both groups, approximately 28 years) were analyzed using Brinley Plot/multiple regression analysis techniques to provide support for the observation that CHI results in a slowing of basic cognitive information processing. Across 101 experimental conditions, the best-fit equation that resulted from regressing the CHI data onto the Control data for matched conditions was Y(CHI)=1.54X(control)-59, and this specific regression equation accounted for approximately 89% of the variance (based on R2). These results suggest that the basic cognition processes involved in simple- and choice-reaction time performance were approximately 1.54 times slower in CHI individuals in this sample as compared to non-CHI individuals. This pattern of performance substantiates the observation the CHI results in a slowing of even very basic cognition information processes.
Does Regular Repositioning Prevent Pressure Ulcers?

BACKGROUND Prolonged exposure to pressure is the primary etiologic factor of a pressure ulcer (PU) and effective preventive interventions must avoid or minimize this exposure. Therefore, frequent repositioning of the patient has long been recommended as a means of preventing PU. OBJECTIVES To review the evidence on the efficacy of repositioning as a PU prevention intervention. SEARCH STRATEGY A systematic review of electronic databases MEDLINE and CINAHL, from January 1960 to July 2008, was undertaken. Studies were limited to prospective randomized clinical trials or quasi-experimental studies that compared repositioning to any other preventive interventions or any study that compared various techniques of repositioning such as turning frequency. Only those studies that measured the primary outcome of interest, PU incidence, were included in our review. RESULTS Limited evidence suggests that repositioning every 4 hours, when combined with an appropriate pressure redistribution surface, is just as effective for the prevention of facility- acquired PUs as a more frequent (every 2 hour) regimen. There is insufficient evidence to determine whether a 30° lateral position is superior to a 90° lateral position or a semi-Fowler's position. IMPLICATIONS FOR PRACTICE The current regulatory and legal environment has focused increased attention on PU prevention. Pressure redistribution methods and the frequency of application are among the first factors scrutinized when a PU develops. Our clinical experience validates that regular movement of the immobilized patient is important, but evidence defining the optimal frequency of repositioning or optimal positioning is lacking.
Genetic polymorphisms of the angiotensin II type 1 (AT1) receptor gene.

Numerous essential, physiological effects on the cardiovascular system are attributable to angiotensin II (Ang II). Because of this we can assume that genetic changes in the specific receptor of Ang II (Ang II type 1 receptor gene, AT1) play a decisive role in the occurrence of cardiovascular disease associated with blood pressure regulation, vascular tone, cardiac and vascular growth process. To test this hypothesis, we examined the presence of polymorphisms within the coding region of the AT1 gene using polymerase chain reaction (PCR) and subsequent non-radioactive sequencing of samples from a control group with no previous history of cardiovascular complaint in individuals or immediate family. Using the Taq-sequencing procedure we found polymorphic sites, especially in the 5' region of the gene (base pair positions 9, 16, 87, 133, 186), two of which led to an exchange of the amino acid (amino acid 6: Ser<==>Pro, amino acid 45: Gly<==>Arg). Together with the silent polymorphism at base pair position 573, which our group established previously, an additional polymorphism in the 3' region of the gene was discovered. This, however, did not confer any changes in amino acid sequence. In a preliminary study we found no association between the distribution of the C/T573 polymorphic site and cardiovascular disease, such as essential hypertension (n = 20) coronary artery disease (n = 16) hypertrophic cardiomyopathy (n = 12) or dilated cardiomyopathy (n = 21). Further studies will be needed to determine to what extent the polymorphisms described are associated with cardiovascular disease.
Phosphorylation of p53: a Novel Pathway for p53 Inactivation in Human T-Cell Lymphotropic Virus Type 1-Transformed Cells

ABSTRACT Inhibition of p53 function, through either mutation or interaction with viral or cellular transforming proteins, correlates strongly with the oncogenic potential. Only a small percentage of human T-cell lymphotropic virus type 1 (HTLV-1)-transformed cells carry p53 mutations, and mutated p53 genes have been found in only one-fourth of adult T-cell leukemia cases. In previous studies, we demonstrated that wild-type p53 is stabilized and transcriptionally inactive in HTLV-1-transformed cells. Further, the viral transcriptional activator Tax plays a role in both the stabilization and inactivation of p53 through a mechanism involving the first 52 amino acids of p53. Here we show for the first time that phosphorylation of p53 inactivates p53 by blocking its interaction with basal transcription factors. Using two-dimensional peptide mapping, we demonstrate that peptides corresponding to amino acids 1 to 19 and 387 to 393 are hyperphosphorylated in HTLV-1-transformed cells. Moreover, using antibodies specific for phosphorylated Ser15 and Ser392, we demonstrate increased phosphorylation of these amino acids. Since HTLV-1 p53 binds DNA in a sequence-specific manner but fails to interact with TFIID, we tested whether phosphorylation of the N terminus of p53 affected p53-TFIID interaction. Using biotinylated peptides, we show that phosphorylation of Ser15 alone inhibits p53-TFIID interaction. In contrast, phosphorylation at Ser15 and -37 restores TFIID binding and blocks MDM2 binding. Our studies provide evidence that HTLV-1 utilizes the posttranslational modification of p53 in vivo to inactivate function of the tumor suppressor protein.
Personality Change Among Newlyweds: Patterns, Predictors, and Associations With Marital Satisfaction Over Time

The early years of marriage are a time of significant personal and relational changes as partners adjust to their new roles, but the specific ways that spouses’ personalities may change in early marriage and how these changes are associated with spouses’ marital satisfaction trajectories have been overlooked. Using 3 waves of data collected over the first 18 months of marriage (N = 338 spouses, or 169 heterosexual newlywed marriages), we examined changes in spouses’ self-reported Big 5 personality traits over time and the association between initial levels and changes in personality and spouses’ concurrent marital satisfaction trajectories. Results indicated significant changes in personality over time, including declines in agreeableness for husbands and for wives, declines in extraversion for husbands, declines in openness and neuroticism for wives, and increases in conscientiousness for husbands. These results did not differ by spouses’ age, demographics, relationship length prior to marriage, cohabitation prior to marriage, initial marital satisfaction, or parenthood status. Initial levels of personality as well as changes in personality over time were associated with spouses’ marital satisfaction trajectories. Taken together, these findings indicate that newlywed spouses’ personalities undergo meaningful changes during the newlywed years and these changes are associated with changes in spouses’ marital satisfaction. Further research is needed to understand the processes underlying changes in personality early in marriage and to examine the mechanisms linking changes in personality and changes in marital satisfaction.
Seasonality in live births with congenital heart disease in Malta

Abstract This study was carried out to analyse seasonal variations in live births with congenital heart disease in the overall population of Malta. Included were all patients diagnosed as having congenital heart disease by echocardiography, cardiac catheterization, surgery or post mortem, by 1 year of age, and who were born between in Malta between 1990 and 1994. Results were analysed by χ2 and by Edwards' cyclic method. There were 231 cases of live born congenital heart disease, which were divided into 114 cases not requiring intervention and 117 cases requiring intervention. Although the overall prevalence of congenital heart disease did not demonstrate any seasonal variation, the lesions requiring intervention showed a significant peak in September by Edwards' method (p = 0.03), which was enhanced by seasonal analysis (p = 0.003). These results were confirmed by conventional χ2 and χ2 for trend. The lesions not requiring intervention, which were comprised almost entirely (96%) of mild pulmonary stenosis and small ventricular septal defects, failed to show any seasonal trend. The literature regarding such seasonal trends in these malformations and statistical analysis of seasonality of congenital heart disease are reviewed. An environmental factor such as a maternal viral infection or treatment of such infections during the first trimester of pregnancy from November to January may precipitate congenital heart disease in predisposed Maltese foetuses.
General Performance on a Numeracy Scale among Highly Educated Samples

Background. Numeracy, how facile people are with basic probability and mathematical concepts, is associated with how people perceive health risks. Performance on simple numeracy problems has been poor among populations with little as well as more formal education. Here, we examine how highly educated participants performed on a general and an expanded numeracy scale. The latter was designed within the context of health risks. Method. A total of 463 men and women aged 40 and older completed a 3-item general and an expanded 7-item numeracy scale. The expanded scale assessed how well people 1) differentiate and perform simple mathematical operations on risk magnitudes using percentages and proportions, 2) convert percentages to proportions, 3) convert proportions to percentages, and 4) convert probabilities to proportions. Results. On average, 18% and 32% of participants correctly answered all of the general and expanded numeracy scale items. Approximately 16% to 20% incorrectly answered the most straightforward questions pertaining to risk magnitudes (e.g., Which represents the larger risk: 1%, 5%, or 10%? ). A factor analysis revealed that the general and expanded risk numeracy items tapped the construct of global numeracy. Conclusions. These results suggest that even highly educated participants have difficulty with relatively simple numeracy questions, thus replicating in part earlier studies. The implication is that usual strategies for communicating numerical risk may be flawed. Methods and consequences of communicating health risk information tailored to a person’s level of numeracy should be explored further.
A Cross Sectional Study of Knowledge and attitudes levels about Polio Vaccination among selected sample of Technical Institute \ AL-Suwaira staff members

Background: The previous laboratory investigations confirmed local polio case was informed on 28 th January 2000 and another two wild polio cases were reported from Resafa \ Baghdad province in 2014. The date of onset of these cases were February and April 2014 and both cases were connected to 2013 of Syria outbreak. Objective:To evaluate the knowledge and attitudes levels towards polio vaccination among staff of Technical Institute AL-Suwaira. Patients and Methods: A study of cross-sectional design consisted of 170 a selected samples of Technical Institute \ AL-Suwaira staff members. Collected during January 2018.The knowledge and attitudes levels estimated by using typical design of self administered questionnaire. Descriptive statistics were used to explain the results. Results: Over all, 170 participants reacted to the questionnaire by a response rate of 93.5%. All respondents established a good knowledge and positive attitudes levels to poliovirus vaccination. Mean knowledge score (built on11 knowledge questions) and mean attitude score (built on 10 attitudes statements) of participants about polio vaccine were 14.45±2.38 and 26.5±4.5 respectively. The mainstream of respondents agreed that all children should be taken the polio vaccine (88.2%), and the sterility concerns that associated with polio vaccines (14.1%). Television (n=126, 39%) and Internet (n = 66, 21%) were the main social media sources that used by staff members to educate and modify themselves about polio vaccination. Knowledge defects were recognized in the management issues and how to dealing with vaccines (45.9%), the incubation period of poliovirus infection (38.8%) and the consequences of the poliovirus infection (56.5%) on the victims. Conclusion: Staff members of Technical Institute \ AL-Suwaira showed a good knowledge and positive attitudes levels about polio vaccination. Even though the statistics are indicative of knowledge gaps of participants, further studies are needed to assess these levels for better education program against polio.
Physical effect of work on healthy individuals: implications for FCE testing.

OBJECTIVE The objective of this study was to assess the effect of time of day and job type on performance of three functional capacity evaluation measures in healthy (asymptomatic) adults. It was queried whether or not a healthy population of adults would demonstrate a change in physical performance ability, when re-tested at the end of their work day. SETTING A convenience sample of 50 healthy adults (19-62 years, 66% male) was used from six work sites in an urban area. DESIGN Same day pre-test and post-test testing was performed, implementing use of three commonly used functional capacity tests: Jamar dynamometer grip strength test, Turning sub-test of the Complete Minnesota Dexterity Test, and the 50-foot walk test. METHODS The study compared morning and afternoon test scores, and using t-tests, assessed the effect of job type (sedentary, light, medium, heavy) on performance using ANOVA. RESULTS All three measures improved from morning to afternoon; differences were statistically significant for 50-foot walk (mean=0.2 sec, p=0.02) and manual dexterity (mean=5 sec, p< 0.001). Job type had a significant effect on dexterity. CONCLUSIONS Late day performance did not show any significant decline in this sample of healthy adults, and in fact tended to improve or stay relatively stable. Therefore, clinicians who perform functional capacity evaluations should consider alternative explanations for late-day functional declines observed in injured patients. These findings, combined with other test results, may assist clinicians with disability determination.
Curcumin induces cell‐arrest and apoptosis in association with the inhibition of constitutively active NF‐κB and STAT3 pathways in Hodgkin's lymphoma cells

Although treatment of Hodgkin's lymphoma (HL) with a multi‐drug approach has been very successful, its toxicity becomes evident after several years as secondary malignancies and cardiovascular disease. Therefore, the current goal in HL treatment is to find new therapies that specifically target the deregulated signaling cascades, such as NF‐κB and STAT3, which cause Hodgkin and Reed‐Sternberg (H‐RS) cell proliferation and resistance of apoptosis. Based on the above information, we investigated the capacity of curcumin to inhibit NF‐κB and STAT3 in H‐RS cells, characterizing the functional consequences. Curcumin is incorporated into H‐RS cells and acts inhibiting both NF‐κB and STAT3 activation, leading to a decreased expression of proteins involved in cell proliferation and apoptosis, e.g. Bcl‐2, Bcl‐xL, cFLIP, XIAP, c‐IAP1, survivin, c‐myc and cyclin D1. Interestingly, curcumin caused cell cycle arrest in G2‐M and a significant reduction (80–97%) in H‐RS cell viability. Furthermore, curcumin triggered cell death by apoptosis, as evidenced by the activation of caspase‐3 and caspase‐9, changes in nuclear morphology and phosphatidylserine translocation. The above findings provide a mechanistic rationale for the potential use of curcumin as a therapeutic agent for patients with HL. © 2008 Wiley‐Liss, Inc.
Serotonin neurotransmission in anorexia nervosa

Patients with anorexia nervosa (AN) show extreme dieting weight loss, hyperactivity, depression/anxiety, self-control, and behavioral impulsivity. 5-Hydroxytryptamine (5-HT; serotonin) is involved in almost all the behavioral changes observed in AN patients. Both genetic and environmental factors contribute toward the pathogenesis of AN. It is a frequent disorder among adolescent girls and young women and starts as an attempt to lose weight to look beautiful and attractive. Failure to see the turning point when fasting becomes unreasonable leads to malnutrition and AN. Tryptophan, the precursor of serotonin and an essential amino acid, is only available in the diet. It is therefore likely that excessive diet restriction and malnutrition decrease brain serotonin stores because the precursor is less available to the rate-limiting enzyme of 5-HT biosynthesis, which normally exists unsaturated with its substrate. Evidence shows that diet restriction-induced exaggerated feedback control over 5-HT synthesis and the smaller availability of tryptophan decreases serotonin neurotransmission at postsynaptic sites, leading to hyperactivity, depression, and behavioral impulsivity. A compensatory upregulation of postsynaptic 5-HT-1A receptors and hypophagic serotonin receptors may be involved in anxiety and suppression of appetite. It is suggested that tryptophan supplementation may improve pharmacotherapy in AN.
The causes of fever in children attending hospital in the north of England.

OBJECTIVES Fever is a common symptom in children presenting to casualty. Identifying the seriously ill is difficult. Previous studies, mainly from North America, suggest that symptoms, signs and simple investigations may help to do this. The aim of the present study was to assess the causes of fever and identify clinical and laboratory features suggesting serious disease in U.K. children presenting to hospital with temperatures >or=38 degrees C. METHODS All children with a temperature of >or=38 degrees C seen in two hospitals between August and October 1999. RESULTS One hundred and forty one children between 8 days and 16 years of age were studied, 64% male, 55% aged under 2 years. Eighty three percent had temperatures between 38 and 39 degrees C. Ninety six percent were casualty or GP referrals and 4% were tertiary referrals. Twenty nine percent (41/141) had serious disease but microbiologically or radiologically proven in only 22% (31/141); pneumonia (nine), meningitis (seven), sepsis (five), urinary tract infection (five), brain abscess (two), toxic shock syndrome (one), appendicitis (one), ischiorectal abscess (one). Forty two percent (5/12) of microbiologically proven meningitis and sepsis and 36% (8/22) of all meningitis and sepsis were meningococcal. Seventy one percent had non-serious diseases. In cases of serious disease the temperature was >39 degrees C in 15% (sensitivity: 14%, specificity: 82%, PPV: 25%). Poor feeding and restlessness predicted serious disease with a sensitivity of 78% and 76%, respectively. Full blood count (FBC) was taken in 50% of patients on admission; in 44% of serious and 24% of non-serious diseases WBC was between 5000 and 15,000/mm(3) and WBC >or=15,000/mm(3) was seen in 39% of serious diseases (sensitivity:10%, specificity: 95%, PPV: 44%). CONCLUSIONS One out of three of children referred with fever had a serious disease. Degree of temperature and WBC count were poor predictors of serious disease. Interestingly, poor feeding and restlessness were more sensitive predictors, suggesting high fever and WBC count can not replace clinical assessment of the child with a temperature.
Overgrowth of Enterococcus faecium in the feces of patients with hematologic malignancies.

The objective of this study was to characterize the overgrowth and susceptibility of Enterococcus faecium, compared with that of other enterococci, in the feces of patients with hematologic malignancy. During a 52-week period, surveillance samples of feces were cultured weekly. Three hundred thirty-three samples were obtained from 92 patients. E. faecium outnumbered other enterococci in 170 (44%) of the samples, while the opposite was true in 119 (31%) of the samples. Fecal overgrowth of E. faecium (> or = 9.0 log10 cfu/g) was found in 62 samples (16%), while overgrowth of other enterococci was documented in 20 samples (5%) (P < .001). Treatment with third-generation cephalosporins preceded the overgrowth of E. faecium in 93% of the patients. Resistance of E. faecium isolates to ampicillin, high-level gentamicin, and vancomycin was detected in 41%, 4%, and 2% of the patients, respectively. There were 6 patients with enterococcal bacteremia (due to E. faecium in 5 and Enterococcus faecalis in 1) during the study period. The high prevalence of resistance to ampicillin and imipenem rendered few (if any) intravenous antibiotics able to prevent fecal overgrowth of E. faecium.