Miracle-dz/UniFAR-FTUs huggingface dataset:
meta-analysis healthcare workers : a systematic review and The prevalence of hepatitis C among and

To cite: Westermann C, Peters C, Lisiak B, et al. Occup Environ Med 2015;72:880–888. ABSTRACT The aim of this study was to estimate the prevalence of viral hepatitis C (HCV) infection among healthcare workers (HCWs) compared to the general population. A systematic search for the years 1989–2014 was conducted in the Medline, Embase and Cochrane databases. Studies on hepatitis C in HCWs were included if they incorporated either a control group or reference data for the general population. The study quality was classified as high, moderate or low. Pooled effect estimates were calculated to determine the odds of occupational infection. Heterogeneity between studies was analysed using the χ test (p<0.10) and quantified using the I test. 57 studies met our criteria for inclusion and 44 were included in the meta-analysis. Analysis of high and moderate quality studies showed a significantly increased OR for HCV infection in HCWs relative to control populations, with a value of 1.6 (95% CI 1.03 to 2.42). Stratification by study region gave an OR of 2.1 in low prevalence countries; while stratification by occupational groups gave an increased prevalence for medical (OR 2.2) and for laboratory staff (OR 2.2). The OR for professionals at high risk of blood contact was 2.7. The pooled analysis indicates that the prevalence of infection is significantly higher in HCWs than in the general population. The highest prevalence was observed among medical and laboratory staff. Prospective studies that focus on HCW-specific activity and personal risk factors for HCV infection are needed.
Congenital Muscular Torticollis and the Associated Craniofacial Changes

Congenital torticollis is a condition that results in the deviation of a child’s head to one side, with accompanying limitation in the range of motion of the neck. Although of multiple etiologies, the most common is a primary idiopathic condition resulting in fibrosis and scarring of the sternocleiodomastoid muscle. The clinical experience with torticollis at the Variety Center for Craniofacial Rehabilitation at the Institute of Reconstructive Plastic Surgery of the New York University Medical Center from 1992 to 1997 was retrospectively reviewed. Clinical records, standardized medical photographs, and cephalometric radiographs of the affected patients were examined. There was a total of 16 patients with a mean age of 33 months at the time of presentation. All patients were initially started on a program of physical therapy. Four patients (25 percent) subsequently underwent surgical correction consisting of a bipolar sternocleiodomastoid release/resection; the age of the surgical subgroup at the time of initial presentation was significantly greater than that of the nonsurgical patients (8 years, 4 months versus 12 months). Of the patients for whom longitudinal records were available (11 of 16), the mean follow-up period was 48 months. The head tilt improved in all patients—surgical and nonsurgical—but it was only completely corrected in 38 percent of the physical therapy-only patients and 25 percent of the surgical patients. All patients in the series exhibited some degree of facial asymmetry, most commonly manifest as mild retrusion of the ipsilateral forehead and zygoma with shearing of the ipsilateral auricular helix in a posterior and inferior direction. In the more severe cases, there were also changes in the shape and position of the orbit, nose, and mandible. However, in only one case was the asymmetry sufficiently severe to warrant surgical reconstruction of the affected skeleton. These changes are particularly well demonstrated in the case of the 18-year-old man in this series presenting for treatment of a previously neglected torticollis. Cephalometric analysis revealed a reduction in vertical facial height on the affected side. Evaluation of this clinical series would indicate that younger patients may be effectively managed with therapy alone; patients presenting for treatment at a later age are more likely to require surgical release/resection.
The detection of subclinical synovitis by ultrasound in oligoarticular juvenile idiopathic arthritis: a pilot study.

OBJECTIVES Adult studies have demonstrated that ultrasonography (US) is more sensitive at detecting synovitis than clinical examination. The detection of subclinical disease has implications for deciding which patients receive more aggressive therapy from the outset. This study aimed to determine whether children with clinically diagnosed oligoarticular juvenile idiopathic arthritis (JIA) had US-detectable subclinical synovitis. METHODS This was a cross-sectional pilot study conducted in a tertiary paediatric rheumatology clinic. Seventeen children with a median age of 10 years (range 3-13 years) and with oligoarticular disease of duration <12 months (median 5 months) were recruited. All subjects were DMARD and oral/i.v. corticosteroid naïve. A core set of 40 joints was clinically examined for synovitis and then scanned by a rheumatologist trained in joint US and blinded to all clinical data, at the same appointment. RESULTS In total, 680 joints were examined both clinically and by US. Twenty-three joints were found to have clinical synovitis, and of these only 17 had synovitis confirmed by US. A further 15 joints were found to have synovitis on US examination alone. Overall, subclinical synovitis was detected in 6/17 children, mostly in the hands and feet. One child was reclassified as having polyarticular disease. CONCLUSIONS This pilot study has highlighted a discrepancy between clinical examination and ultrasound when assessing the joints of children with JIA. US is a feasible tool for examining multiple joints and identifying subclinical synovitis, particularly when considering the small joints of the hands and feet.
Burns in alcohol and drug users result in longer treatment times with more complications.

Brezel, Kassenbrock, and Stein (J Burn Care Rehabil 1988;9:169-71), surveyed a group of 180 patients who were substance abusers or who were neurologically or mentally impaired and found that their inpatient care was more costly, more complicated, and more lengthy. In our institution we undertook a similar study to determine whether our findings would be similar. During a 12-month period, the charts of all patients over the age of 18 who were admitted for treatment of acute burns were reviewed. One hundred and thirty-one charts were available for study. Review of the charts revealed that 19 (14.5%) met our criterion of being impaired by drugs or alcohol, and the remaining 112 patients served as control subjects. The total body surface area burn averaged 25.8% in the impaired group and 21.3% in the control group. The amount of third-degree burns averaged 11% in the impaired group and 11% in the control group. Although the amount of third-degree burns was virtually identical in the two groups, the control group required an average of 1.2 procedures per patient, whereas the impaired group required 2.1 procedures per patient. A list of possible complications or adverse reactions that could occur was used to compare the two groups. The control group averaged 1.83 complications per patient, and the impaired group averaged 3.16 complications per patient. The average length of stay in the hospital for the control group was 19 days, and the average length of stay for the impaired group was 34.1 days. (ABSTRACT TRUNCATED AT 250 WORDS)
Repetitive Large-Dose Infusion of the Novel Hydroxyethyl Starch 130/0.4 in Patients with Severe Head Injury

In this prospective, controlled, randomized, single-center study, we investigated the safety of repetitive large-dose infusion of a novel hydroxyethyl starch solution (6% HES 130/0.4) in cranio-cerebral trauma patients. Patients were randomized to receive either HES 130/0.4 (n = 16) at repetitive doses of up to 70 mL · kg−1 · d−1 (which is the largest HES dose reported in the literature) or the control HES 200/0.5 (n = 15) up to its approved dose limit of 33 mL · kg−1 · d−1 followed by human albumin up to a total dose (HES 200/0.5 + albumin) of 70 mL · kg−1 · d−1. We found no differences between groups in mortality, renal function, bleeding complications, and use of blood products. There were also no major differences in coagulation variables. However, at some time points, factor VIII, von Willebrand factor, and ristocetin cofactor were higher in the HES 130/0.4 group despite the large HES doses administered. We conclude that HES 130/0.4 can safely be used in critically ill head trauma patients over several days at doses of up to 70 mL · kg−1 · d−1.
Immunodiagnosis of paramphistomosis using monoclonal antibody-based sandwich ELISA for detection of Paramphistomum gracile circulating 16 kDa antigen

SUMMARY In this study, we have produced a monoclonal antibody (MoAb) against 16 kDa antigen of Paramphistomum gracile (16 kDaAgPg), and developed an accurate sandwich enzyme-linked immunosorbent assay (sandwich ELISA) for the detection of circulating 16 kDaAg in the serum and fecal samples from cattle naturally infected with P. gracile. MoAb 1D10 was immobilized on a microtitre plate, and the antigen in the samples was captured and detected with biotinylated rabbit anti-16 kDaAgPg antibody. The lower detection limit of sandwich ELISA was 3·5 pg mL−1, and no cross-reaction with other parasite antigens was evaluated. The reliability of the assay was examined using the serum and fecal samples from cattle naturally infected with P. gracile, Fasciola gigantica, Moniezia benedeni, Trichuris sp. , Strongyloides sp. , strongylids and non-infected animals. The sandwich ELISA showed the sensitivity, specificity and accuracy at 98·33, 100 and 99·55% (serum samples), and 96·67, 100 and 99·09% (fecal samples). Therefore, this detection method is a rapid and excellent potential assay for the accurate diagnosis of paramphistomosis.
Soft tissue profile changes after maxillary advancement with distraction osteogenesis by use of a rigid external distraction device: a 1-year follow-up.

PURPOSE This study was conducted to evaluate the soft tissue profile changes after maxillary advancement with distraction osteogenesis (DO). PATIENTS AND METHODS Sixteen subjects underwent maxillary advancement with rigid external distraction after a high Le Fort I osteotomy. There were 11 male and 5 female patients, ages 5.2 to 25.7 years. The subjects included 9 with unilateral cleft lip and palate (UCLP), 4 with bilateral CLP, 2 with facial clefts and bilateral CLP, and 1 with cleft palate. Pretreatment and posttreatment lateral cephalograms were compared to evaluate the changes in soft tissue profile. A line 7 degrees below the SN plane was used as the horizontal coordinate, and a perpendicular line through Sella was used as the vertical coordinate in an XY coordinate system. RESULTS The preoperative facial concavity (N'SnPg') was reduced by 15.59 degrees, and the nasal tip moved 3.75 mm forward and 2.05 mm upward. These changes were positively correlated with the change of ANS position. The soft-tissue-to-hard-tissue ratio was 0.53:1 for nasal tip and ANS. The ratio was negatively correlated with the age of the patient. The ratio of soft tissue A point to skeletal A point was 0.96:1 and for the incisal edge to vermilion border of the upper lip it was 0.8:1. The soft tissue B point and Pg did not change significantly with maxillary distraction. However, the nasolabial angle increased by 4.96 degrees, the upper lip curvature flattened by 0.65 mm, and the lower lip curvature was accentuated by 0.89 mm after distraction. The amount of upper incisal exposure increased from 1.1 to 5.01 mm in the rest position. CONCLUSION Maxillary DO improved the soft tissue profile by increasing nasal projection, normalizing the nasolabial angle, and making the upper lip more prominent. More upper anterior tooth show in the rest position was obtained, but the upper lip length did not change. The concave facial profile became convex, with improved facial balance and aesthetics.
The impact of e-voting on turnout: Insights from the Belgian case

Even in countries where compulsory voting is applied, one can observe large variations in turnout across electoral districts. This paper analyses turnout rates and the number of invalid votes in local elections in Belgium and tests whether differences across municipalities can be explained by e-voting. Taking into account various elements related to the electoral system, political competition and socio-demographic factors, multivariate models demonstrate that turnout decreases in municipalities where e-voting is used. This is true for all election years (1994-2012) and the paper also finds out that the negative effect of e-voting on turnout increases over time.
Changes in Hemolymph Glutathione Status After Variation in Photoperiod and Light‐irradiance in Crayfish Procambarus clarkii and Procambarus digueti

This work studied the effect of light‐stressors, irradiance and photoperiod length on the status of hemolymph glutathione in two species of crayfish, Procambarus clarkii and Procambarus digueti. Adult animals of each species were submitted to two experimental approaches: (1) two batches of each species were placed under low or high light irradiant conditions of light–dark (LD) 24 h cycles of two different photoperiod lengths, one normal LD 12:12 and one extreme LD 20:4 low and high irradiance for 10 weeks. Time‐dependent light changes on hemolymph glutathione concentration were determined throughout the entire experimental period; and (2) three batches of the two species were submitted to independent treatments consisting of the same LD 12:12 cycles of high and low irradiance and 20:4 high‐irradiance LD cycles. Reduced and oxidized glutathione hemolymph concentrations were determined and total glutathione was calculated. In addition midgut glutathione reductase activity in both species was determined. The two species showed different hemolymph glutathione reactivity and glutathione status for the two light parameters. Dissimilar responses of both species, as well as the rate of mortality of P. digueti represent specific differences in the metabolic responses, as well as tolerance to photo‐oxidative stress produced by light. The role of glutathione in the tolerance of crayfish to photo‐oxidative stress is discussed.
Evaluation of Preoperative Cultures Before Second-Stage Reimplantation of a Total Knee Prosthesis Complicated by Infection: A Comparison-Group Study*

Background: Two-stage reimplantation has proven to be highly successful in the treatment of patients with infection at the site of a total knee arthroplasty. However, up to 20 percent of patients have a recurrence of infection following this treatment. The purpose of our study was to determine whether aspiration of the affected joint and culture of the specimen, performed before reimplantation and after discontinuation of antibiotic therapy, would help to identify patients who might have a recurrent infection.Methods: We prospectively followed sixty-nine patients who were treated for a culture-proven deep infection at the site of a total knee arthroplasty. Group I consisted of thirty-five patients who were treated with removal of the prosthetic components and irrigation and débridement of the joint, followed by six weeks of antibiotic therapy and reimplantation of a prosthesis. Group II was composed of thirty-four patients who were treated with removal of the components and irrigation and débridement of the joint, six weeks of antibiotic therapy, and then repeat culture four weeks after the antibiotic course had ended. If the culture was negative, the patient was managed with a second-stage reimplantation of a prosthesis. If the culture was positive, the protocol was repeated, beginning with irrigation and débridement. The two groups were similar with regard to male-to-female ratio, age, preoperative Knee Society scores, time since primary surgery, types of infectious organisms, duration of symptoms, duration of follow-up, and number of previous revisions. All of the patients were evaluated clinically with use of the objective scoring system of the Knee Society and were followed with serial radiographs. Success was defined as no infection and a functional prosthesis, with a Knee Society score of at least 75 points at the last (thirty-six-month-minimum) follow-up evaluation.Results: Of the thirty-five patients in Group I, five (14 percent) had recurrence of infection. One of the patients was managed with a successful second-stage revision, three were managed with arthrodesis of the knee, and one continued dwith chronic antibiotic suppressive treatment. Of the thirty-four patients in Group II, three (9 percent) had a positive culture after the course of antibiotics. The protocol was repeated for all three, and they subsequently had a successful second revision. One other patient (3 percent) in Group II, who had a negative culture, had a recurrent infection and was eventually managed with arthrodesis of the knee.Conclusions: Prerevision cultures, grown after discontinuation of antibiotic treatment and before reimplantation of the components, helped to identify the patients with infection at the site of a total knee arthroplasty in whom the infection might recur. The performance of aspiration and cultures resulted in a substantial improvement in the clinical outcome.
Star formation in galaxy mergers: ISM turbulence, dense gas excess, and scaling relations for disks and starbusts

Abstract Galaxy interactions and mergers play a significant, but still debated and poorly understood role in the star formation history of galaxies. Numerical and theoretical models cannot yet explain the main properties of merger-induced starbursts, including their intensity and their spatial extent. Usually, the mechanism invoked in merger-induced starbursts is a global inflow of gas towards the central kpc, resulting in a nuclear starburst. We show here, using high-resolution AMR simulations and comparing to observations of the gas component in mergers, that the triggering of starbursts also results from increased ISM turbulence and velocity dispersions in interacting systems. This forms cold gas that are denser and more massive than in quiescent disk galaxies. The fraction of dense cold gas largely increases, modifying the global density distribution of these systems, and efficient star formation results. Because the starbursting activity is not just from a global compacting of the gas to higher average surface densities, but also from higher turbulence and fragmentation into massive and dense clouds, merging systems can enter a different regime of star formation compared to quiescent disk galaxies. This is in quantitative agreement with recent observations suggesting that disk galaxies and starbursting systems are not the low-activity end and high-activity end of a single regime, but actually follow different scaling relations for their star formation.
Fecal M2‐pyruvate kinase (M2‐PK): A novel marker of intestinal inflammation

Background: Surrogate markers of bowel inflammation are increasingly being recognized as important, not only as markers of disease activity in inflammatory bowel disease (IBD) but also to differentiate irritable bowel syndrome (IBS) from IBD. The dimeric M2‐isoform of pyruvate kinase (M2‐PK) has been reported to be elevated in fecal specimens from colorectal cancer (CA) patients, but its role in IBD is unknown. This study investigated the usefulness of fecal M2‐PK in cohorts of patients with IBD, IBS, and CA. Methods: Stool samples were obtained for calprotectin and M2‐PK measurements in patients with previously diagnosed IBD or new patients being investigated for lower gastrointestinal (GI) symptoms in a UK university hospital. Other investigations were performed as directed by the investigating physician and patients with known IBD were assessed for disease activity by a physician global assessment, Harvey–Bradshaw index (HBI), or endoscopic grading. Results: Fecal M2‐PK and calprotectin measurements were obtained for 148 patients: 50 with ulcerative colitis (UC); 31 with Crohn's disease (CD), 43 with irritable bowel syndrome/functional bowel disorders (IBS); 7 with colorectal CA, and 17 with miscellaneous conditions (excluded from the analysis). Median M2‐PK values (U/mL) were significantly elevated in UC: 20.0 (95% confidence interval [CI] 5.4–69.0, P < 0.0001), CD: 24.3 (95% CI 6.4–44.0, P < 0.0001), and CA: 7.0 (95% CI 4.3–88.0, P < 0.0006) compared to IBS: 0.1 (95% CI 0.0–3.2). There was a strong linear correlation of M2‐PK with calprotectin levels. A predetermined cutoff level of 3.7 U/mL for a normal M2‐PK test produced a sensitivity, specificity, and positive predictive value (PPV) of 73%, 74%, and 89%, respectively, for organic disease. Furthermore, M2‐PK levels were significantly elevated in active, compared to inactive, disease for CD (30 versus 0.55 U/mL, P < 0.005) and UC (40 versus 1.2 U/mL, P = 0.006), respectively. Conclusions: Fecal M2‐PK is elevated in IBD as well as in CA patients and is a sensitive and relatively specific marker for organic GI pathology, with a PPV of 89%. Furthermore, it appears to be a potentially valuable, noninvasive marker of disease activity in IBD.
Interferon-gamma release assay for diagnosing Mycobacterium tuberculosis infections in patients with systemic lupus erythematosus

Our aim was to analyze the performance of an interferon-gamma release assay, QuantiFERON-TB Gold (QFT-2G), for diagnosing Mycobacterium tuberculosis (MTB) infection in patients with systemic lupus erythematosus (SLE). We performed the QFT-2G and tuberculin skin test (TST) in 71 SLE patients. The QFT-2G results of 279 patients with other connective tissue diseases (CTD) and 35 healthy controls were analyzed. Of the 71 SLE patients, two (2.8%) were positive and 46 (64.8%) were negative by QFT-2G. All SLE patients had no evidence of active MTB infection, apart from one. QFT-2G produced a significantly higher number of indeterminate results in patients with SLE (23/71, 32.4%) compared with those with other CTD (5.7%) or healthy controls (0%) (p < 0.0001 and p < 0.0001). Decreased lymphocyte counts and high SLEDAI scores in SLE patients were shown to be risk factors for indeterminate results by multivariate analysis (p = 0.02 and p = 0.04). Among all patients with CTD, SLE itself and lymphocytopenia were found to be independent risks for indeterminate results (p = 0.00000625 and p = 0.000107). In conclusion, QFT-2G may have more potential to assist in the diagnosis of active and latent MTB infection than TST in SLE patients. However, because of the high frequency of indeterminate results, caution must be used when interpreting the results of QFT-2G among SLE patients, especially those who have parallel or subsequent flares.
Assessment of Effective Dose Equivalent from Internal Exposure to 222 Rn in Ramsar City Tayyeb

Introduction In this study, effective dose equivalent for the public due to internal exposure to 222 radon ( 222 Rn) was evaluated in three regions of Ramsar, a northern coastal city in Iran. Materials and Methods Measurements were carried out using a radon monitoring device. Outdoor and indoor radon concentrations were measured within 24 hours with an integration interval of 3 hours. Regions were selected with respect to our previous study on areas of Ramsar with high levels of environmental background radiation. Results This study showed that indoor 222 Rn concentration reached to 465 Bq/m 3 in one of the selected regions (Talesh Mahalleh) in early morning (5-8 a.m.). Our study also showed that the average effective dose equivalents (due to both indoor and outdoor exposures) in the selected regions (Talesh Mahalleh, Sadat Mahalleh, and Chaparsar) were 9.5±2.8, 5.1±2.1, and 3.2±1.2 mSv/y, respectively. Conclusion It is clear that the annual effective dose from internal exposure to 222 Rn in areas of Ramsar with high levels of natural radiation was significantly higher than the maximum annual effective dose permissible for public.