Miracle-dz/UniFAR-FTUs huggingface dataset:
Severe penetrating head injury: a study of outcomes.

OBJECTIVE To determine and describe the demographics and functional outcomes of persons who require inpatient rehabilitation for severe penetrating head injury resulting from a gunshot wound to the head. DESIGN Data were collected prospectively from the time of admission to acute care through discharge from inpatient rehabilitation. SETTING Two sites: an urban, level I, acute care, trauma center and an inpatient rehabilitation hospital with a specialized brain injury unit. PARTICIPANTS Twenty-seven persons with severe penetrating head injury. MAIN OUTCOME MEASURES The FIM instrument, the Disability Rating Scale (DRS), and the length of stay (LOS). RESULTS Demographic data showed our population to be similar to other groups of persons at high risk for violent injury. Eighty-five percent of the subjects were men with a mean age of 34 years. The majority were African American (93%), reflective of our general patient population. Average acute care LOS was 31 days and average rehabilitation LOS was 44 days. Average FIM gain was 40.2 and, on average, DRS scores improved 7.6 points from rehabilitation admission to discharge. All study participants made enough progress to be discharged to private residences. CONCLUSION Although the mortality rate is high among patients with penetrating head injury, those who survive to receive inpatient rehabilitation can achieve functional improvement.
Self-Reported Hepatitis C Virus Antibody Status and Risk Behavior in Young Injectors

Objective. This study was conducted to assess the accuracy of self-reported hepatitis C virus (HCV) antibody (anti-HCV) serostatus in injection drug users (IDUs), and examine whether self-reported anti-HCV serostatus was associated with recent injection risk behavior. Methods. In five U.S. cities (Baltimore, Chicago, Los Angeles, New York, and Seattle), 3,004 IDUs from 15 to 30 years old were recruited for a baseline interview to determine eligibility for a randomized controlled trial of a behavioral intervention. HIV and HCV antibody testing were performed, and subject data (e.g., demographics, drug and sexual risk behavior, and history of HIV and HCV testing) were collected via audio computer-administered self-interview. Risk behavior during the previous three months was compared to self-reported anti-HCV serostatus. Results. Anti-HCV prevalence in this sample of young IDUs was 34.1%. Seventy-two percent of anti-HCV-positive and 46% of anti-HCV-negative IDUs in this sample were not aware of their HCV serostatus. Drug treatment or needle exchange use was associated with increased awareness of HCV serostatus. Anti-HCV-negative IDUs who knew their serostatus were less likely than those unaware of their status to inject with a syringe used by another IDU or to share cottons to filter drug solutions. Knowledge of one's positive anti-HCV status was not associated with safer injection practices. Conclusions. Few anti-HCV-positive IDUs in this study were aware of their serostatus. Expanded availability of HCV screening with high quality counseling is clearly needed for this population to promote the health of chronically HCV-infected IDUs and to decrease risk among injectors susceptible to acquiring or transmitting HCV.
Morphological study of resin-dentin bonding with TEM and in-lens FESEM.

PURPOSE To evaluate the morphological characteristics of the dentin-resin interface using high-magnification electron microscopy and correlate the TEM findings of resin-dentin interfaces with the corresponding in-lens Field Emission SEM (FEISEM) observation. METHODS Twelve 800 microm-thick dentin disks were obtained from middle dentin and assigned to four groups: (1) a self-etching adhesive material, Clearfil SE Bond; (2) a solvent-free total-etch simplified adhesive, One Coat Bond; (3) an acetone-based total-etch simplified adhesive, Prime&Bond NT; (4) an acetone-based total-etch simplified adhesive, Prime&Bond NT, upon a short dentin deproteinization with 10% NaOCl gel (AD Gel) for 15 seconds. Disks were restored with a 1 mm thick layer of a low-viscosity composite. Four sticks with a cross section of 1 mm2 were taken from each restored dentin disk, decalcified in buffered 10% EDTA, fixed, and stained with lead citrate followed by uranyl acetate, or kept in water. The sticks were sectioned in 85 nm-thick slices, and mounted on Ni grids. After TEM observation, the same grids were coated with a 1.5 nm Pt-C film and observed under the FEISEM. RESULTS The TEM analysis revealed an intimate adaptation of all adhesive systems to dentin, with penetrating resin tags observed in transverse sections. The FEISEM revealed novel morphological features usually observed in the resin-dentin interface with distinctive arrangement for each of the adhesive systems. FEISEM and TEM appear as mutually complementary tools for the fine observation of the ultra-structure and the spatial relationship between the resin components and the collagen fibers of the hybrid layer.
Prophylactic Antibiotics in Endoscopic Sinus Surgery: A Short Follow-Up Study

Background The study was designed to assess the usefulness of postoperative antibiotics in patients undergoing endoscopic sinus surgery (ESS). Methods The effects of antibiotics in the postoperative period of ESS patients were evaluated in a prospective, randomized, double-blind, placebo-controlled study. Fifty patients were treated with amoxicillin/clavulanate for 2 weeks after ESS, while the other half received placebo. Preoperatively, the symptom, endoscopic, and CT scores were recorded. In the postoperative period, symptom and endoscopic scores were recorded on the 5th, 12th, 21st, and 30th days. In estimating the length of the blood crust formation episode, a Kaplan-Meier plot was used. Results Seventy-five patients completed the study: forty in the antibiotic-treated group and thirty-five in the placebo group. On the 5th day, nasal obstruction and drainage were significantly better in the antibiotic-treated group. In addition, a statistically significant difference in the endoscopic scores was noted between the treatment and placebo groups on days 5 and 12. Conclusion The use of an antibiotic (amoxicillin/clavulanate) in the postoperative period is able to improve the outcome in the early blood crust healing phase: nasal obstruction and drainage are reduced and the endoscopic score objectively showed a faster recovery.
The Experience of Empowerment in In-Home Services Delivery

ABSTRACT In-home health services strive for client-centredness, involvement, and ultimately, empowerment, but economic constraint may undermine these aims. The purpose of this study was to explore the everyday experience of in-home care, with particular attention to the enactment of empowerment in the care partnership. In-depth interviews with a maximally varied sample of clients, informal caregivers, and providers uncovered relationships largely reflecting the traditional expert model of care. Findings afford insights into the unrecognized and undervalued personal knowledge of clients, caregivers, and in-home service providers, the professional and structural hegemony and consequent disempowered group behaviour of those who share the experience of care, and the hesitance of clients to engage as equitable partners in care. Strategies to achieve empowerment approaches to in-home health services are identified.
In vivo wound-healing efficacy and antioxidant activity of Achyranthes aspera in experimental burns

Context: The floral richness of the North-East Indian region cannot be neglected in context to its medicinal importance. Achyranthes aspera Linn. (Amaranthaceae; Prickly Chaff flower) is an indigenous plant species of this region. Although the local traditional healers have ethnomedical knowledge on the use of this plant, there is no scientific study on wound-healing activity of this plant. Objective: The healing efficacy of methanol leaf extract of A. aspera (MEAA) in granulation tissue of burn wound and its antioxidant activity are investigated. Materials and methods: Methanol extract of leaves of A. aspera was used for compounding 5% (w/w) ointment, which was applied topically twice daily in experimental burn wound in rats. Healing potential was assessed by rate of wound contraction, antioxidant and biochemical assay which was supported by gelatin zymography and histopathology. Results: In the present study, 5% ointment of A. aspera showed significant (p < 0.05) wound healing, which was evident by wound contraction, elevation of various antioxidant enzymes viz. SOD, catalase, vitamin C and prohealing and biochemical parameters like hydroxyproline and protein content than the control animals. Up-regulated expression of matrix metalloproteinases (MMP-2 and 9) was also observed by gelatin zymography. Histopathological examination of the granulation tissues in the A. aspera-treated animals showed collagen deposition, fibroblast proliferation and formation of epidermis. Discussion and conclusion: The methanol leaf extract of A. aspera showed excellent wound-healing activities which has great potential for development of plant-based product.
Drug-metabolizing enzyme genotypes and aggressive behavior treatment response in hospitalized pediatric psychiatric patients.

OBJECTIVE The aim of this study was to examine the association between the CYP2D6 and CYP2C19 genotype-predicted combined phenotypes and short-term measures of psychotropic efficacy and toxicity. METHODS A rater-blinded, retrospective genotype association design examined a cohort of hospitalized pediatric psychiatric patients genotyped for CYP2D6 and CYP2C19 as part of clinical care. These combined genotypes were used to predict a combined phenotype. The primary efficacy outcome measure was the behavior intervention score (BIS), a function of the number of recorded timeouts/seclusions, therapeutic holds, and physical restraints. Drug tolerability was defined as the total number of recorded adverse drug reactions. RESULTS Primary analysis was performed on 279 pediatric patients taking CYP2D6- or CYP2C19- dependent psychotropics. Combined phenotype was associated with BIS (p = 0.01) and number of adverse drug reactions (p = 0.03). Combined poor metabolizers treated with psychotropics had the lowest BIS (highest efficacy) and the highest number of adverse drug reactions. Combined ultrarapid metabolizers had the highest BIS (lowest efficacy) and the lowest number of adverse drug reactions. CONCLUSION Common variants in CYP2D6 and CYP2C19 are associated with the short-term efficacy and tolerability of psychotropic medications in hospitalized pediatric patients.
T4 Endonuclease V Protects the DNA Strand Opposite a Thymine Dimer from Cleavage by the Footprinting Reagents DNase I and 1,10-Phenanthroline-Copper (*)

The glycosylase/abasic lyase T4 endonuclease V initiates the repair of ultraviolet light-induced pyrimidine dimers. This enzyme forms an imino intermediate between its N-terminal α-NH2 group and C-1′ of the 5′-residue within the dimer. Sodium borohydride was used to covalently trap endonuclease V to a 49-base pair oligodeoxynucleotide containing a site-specific cyclobutane thymine dimer. The bound and free oligonucleotides were then subjected to nuclease protection assays using DNase I and a complex of 1,10-phenanthroline- copper. There was a large region of protection from both nucleases produced by endonuclease V evident on the strand opposite and asymmetrically opposed to the dimer. Little protection was seen on the dimer-containing strand. The existence of a footprint with the 1,10-phenanthroline-copper cleavage agent indicated that endonuclease V was interacting with the DNA predominantly via the minor groove. Methylation by dimethyl sulfate yielded no areas of protection when endonuclease V was covalently attached to the DNA, indicating that the protein may closely approach the DNA without direct contact with the bases near the thymine dimer. The Escherichia coli proteins Fpg and photolyase display a very different pattern of nuclease protection on their respective substrates, implying that endonuclease V recognizes pyrimidine dimers by a novel mechanism.
Osmolytes Stabilize Ribonuclease S by Stabilizing Its Fragments S Protein and S Peptide to Compact Folding-competent States*

Osmolytes stabilize proteins to thermal and chemical denaturation. We have studied the effects of the osmolytes sarcosine, betaine, trimethylamine-N-oxide, and taurine on the structure and stability of the protein·peptide complex RNase S using x-ray crystallography and titration calorimetry, respectively. The largest degree of stabilization is achieved with 6m sarcosine, which increases the denaturation temperatures of RNase S and S pro by 24.6 and 17.4 °C, respectively, at pH 5 and protects both proteins against tryptic cleavage. Four crystal structures of RNase S in the presence of different osmolytes do not offer any evidence for osmolyte binding to the folded state of the protein or any perturbation in the water structure surrounding the protein. The degree of stabilization in 6 m sarcosine increases with temperature, ranging from −0.52 kcal mol−1at 20 °C to −5.4 kcal mol−1 at 60 °C. The data support the thesis that osmolytes that stabilize proteins, do so by perturbing unfolded states, which change conformation to a compact, folding competent state in the presence of osmolyte. The increased stabilization thus results from a decrease in conformational entropy of the unfolded state.
Influence of balloon size on aortic regurgitation in neonates undergoing balloon aortic valvuloplasty--a retrospective study over an 11-year period.

BACKGROUND Transcatheter balloon aortic valvuloplasty has become the first-line treatment for critical or severe aortic stenosis in neonates in many centers. Aortic regurgitation following balloon aortic valvuloplasty remains a major concern. An optimal balloon size to aortic annulus ratio in order to minimize aortic regurgitation postprocedure, while relieving the obstruction, has not yet been identified. METHODS AND RESULTS In this retrospective study, data from 29 neonates with critical or severe congenital aortic valve stenosis, who underwent balloon aortic valvuloplasty in the first 28 days of life, over an 11-year period, was evaluated. The balloon size used, ranged from 71% to 160% of the annulus size, with an average of 89%, based on the aortic annulus size as measured on angiography. The aortic regurgitation immediately following the procedure was trivial in 8 (27.6%), mild in 13 (44.8%), moderate in 7 (24.1%), and severe in 1 (3.4%) patient. The balloon to annulus ratio had no statistically significant effect on the degree of aortic regurgitation immediately after the procedure (P-value of 0.25), at first follow-up within 6 weeks of the procedure (P-value of 0.76) or at follow-up at 1 year (P-value of 0.52). CONCLUSION This study did not show any significant relationship between the balloon to annulus ratio during interventional dilatation and the degree of aortic regurgitation following the procedure.
Development of medical informatics in China over the past 30 years from a conference perspective and a Sino-American comparison

Background As the world’s second-largest economy, China has launched health reforms for the second time and invested significant funding in medical informatics (MI) since 2010; however, few studies have been conducted on the outcomes of this ambitious cause. Objective This study analyzed the features of major MI meetings held in China and compared them with similar MI conferences in the United States, aiming at informing researchers on the outcomes of MI in China and the US from the professional conference perspective and encouraging greater international cooperation for the advancement of the field of medical informatics in China and, ultimately, the promotion of China’s health reform. Methods Qualitative and quantitative analyses of four MI meetings in China (i.e., CMIAAS, CHINC, CHITEC, and CPMI) and two in the US (i.e., AMIA and HIMSS) were conducted. Furthermore, the size, constituent parts and regional allocation of participants, topics, and fields of research for each meeting were determined and compared. Results From 1985 to 2016, approximately 45,000 individuals attended the CMIAAS and CPMI (academic), CHINC and CHITEC (industry), resulting in 5,085 documented articles. In contrast, in 2015, 38,000 and 3,700 individuals, respectively, attended the American HIMSS (industry) and AMIA (academic) conferences and published 1,926 papers in the latter. Compared to those of HIMSS in 2015, the meeting duration of Chinese industry CHITEC was 3 vs. 5 days, the number of vendors was 100 vs. 1,500+, the number of sub-forums was 10 vs. 250; while compared to those of AMIA, the meeting duration of Chinese CMIAAS was 2 vs. 8 days, the number of vendors was 5 vs. 65+, the number of sub-forums was 4 vs. 26. HIMSS and AMIA were more open, international, and comprehensive in comparison to the aforementioned Chinese conferences. Conclusions The current MI in China can be characterized as “hot in industry application, and cold in academic research. ” Taking into consideration the economic scale together with the huge investment in MI, conference yield and attendee diversity are still low in China. This study demonstrates an urgent necessity to elevate the medical informatics discipline in China and to expand research fields in order to maintain pace with the development of medical informatics in the US and other countries.
Incidence of Refeeding Syndrome and Its Associated Factors in South African Children Hospitalized with Severe Acute Malnutrition

Background: The judicious use of the world health organization (WHO) guidelines in the management of severe acute malnutrition (SAM) is very crucial in avoiding complications. We investigated the incidence of refeeding syndrome and its associated factors in children under 5 years with SAM receiving treatment as inpatients. Methods: A prospective study of 104 children with SAM admitted to the paediatric unit of Dr George Mukhari Academic Hospital (a teaching hospital in Pretoria, South Africa) since March 2014 to March 2015 was conducted. On admission, history on socioeconomic status and co-morbidities, a comprehensive clinical examination, and anthropometric measurements were obtained. All the patients were managed using the 10 steps of management of malnutrition with cautious feeding and broad spectrum antibiotics being instituted. Bloods were taken for calcium, magnesium, phosphorous, urea, and electrolytes on admission and compared to repeat bloods done on day 5 post admission. Results: There were a total of 46 (44%) females. The mean age was 16 months with a mean weight-for-height Z-score of -2.15 ± 1.87. The majority 63% (63/104) of the children had oedematous SAM. There was an HIV infection rate of 33% (35/104). The incidence of refeeding syndrome was 16/104 (15%). Refeeding syndrome was strongly associated with the following medical complications: diarrhoea 81% (13/16), shock 25% (4/16), and hypokalaemia 81% (13/16) (P value < 0.01). Admission potassium and phosphorus were strongly associated with refeeding syndrome with a mean of 3.04 ± 1.16 for potassium and 1.14 ± 0.39 for phosphate (P value < 0.05). Refeeding syndrome was also strongly associated with hypophosphataemia (0.65 ± 0.28), hypocalcaemia (2.34 ± 0.24), and hypomagnesaemia (0.91 ± 0.52) on day 5 repeat bloods (P value < 0.0001). Conclusions: The complication of refeeding syndrome is a major problem that occurs with the reintroduction of feeding in children with severe acute malnutrition. This detrimental complication can be avoided by practices that promote cautious feeding, and as well, clinicians being vigilant in detecting the complication in all children with severe acute malnutrition.
Automated segmentation of pathological cavities in optical coherence tomography scans.

PURPOSE To develop and evaluate a method for automated segmentation and quantitative analysis of pathological cavities in the retina visualized by spectral-domain optical coherence tomography (SD-OCT) scans. METHODS The algorithm is based on the segmentation of the gray-level intensities within a B-scan by a k-means cluster analysis and subsequent classification by a k-nearest neighbor algorithm. Accuracy was evaluated against three clinical experts using 130 bullous cavities identified on eight SD-OCT B-scans of three patients with wet age-related macular degeneration (AMD) and five patients with X-linked retinoschisis, as well as on one volume scan of a patient with X-linked retinoschisis. The algorithm calculated the surface area of the cavities for the B-scans and the volume of all cavities for the volume scan. In order to validate the applicability of the algorithm in clinical use, we analyzed 31 volume scans taken over the course of 4 years for one AMD patient with a serous retinal detachment. RESULTS Discrepancies in area measurements between the segmentation results of the algorithm and the experts were within the range of the area deviations among the experts. Volumes interpolated from the B-scan series of the volume scan were comparable among experts and algorithm (0.249 mm³ for the algorithm, 0.271 mm³ for expert 1, 0.239 mm³ for expert 2, and 0.262 mm³ for expert 3). Volume changes of the serous retinal detachment were quantifiable. CONCLUSIONS The segmentation algorithm represents a method for the automated analysis of large numbers of volume scans during routine diagnostics and in clinical trials.
An Improved Superpixel-Level CFAR Detection Method for Ship Targets in High-Resolution SAR Images

To achieve efficient ship detection in high-resolution synthetic aperture radar images, an improved superpixel-level constant false alarm rate (CFAR) detection method is proposed with three modifications. First, the weighted information entropy (WIE) describes the statistical characteristics of superpixels, yielding a better distinction between target and clutter superpixels. Second, a two-stage CFAR detection scheme is proposed to detect target superpixels, including global detection and local detection. Specifically, the WIE-based global detector is utilized to prescreen candidate target superpixels (CTSs) and then the local CFAR detector is adaptively conducted over the selected CTSs to refine target superpixels. Third, the superpixels selected by the global detection can be excluded as outliers for clutter estimation, thus the disturbance from adjacent targets in multitarget situations can be reduced and more accurate detection results can be obtained. Compared with CFAR methods implemented with the sliding window technique, the computational burden of the proposed method is significantly reduced without loss of detection performance. Experiments of ship detection on three TerraSAR-X datasets are presented to validate the effectiveness of the proposed method.