Miracle-dz/UniFAR-FTUs huggingface dataset:
A study of clinical complications and risk factors in 1001 native and transplant kidney biopsies in Sweden

Background In Sweden, native and transplant kidney biopsies are usually performed in major renal medical centers. Purpose To clarify risk factors in native and transplant kidney biopsies to improve patient safety. Material and Methods A total of 1001 biopsies (in 352 women and 565 men) were included. The median age was 54 years (range, 16–90 years). Data were derived from 826 native kidney biopsies (640 prospective and 186 retrospective) and 175 transplant kidney biopsies (170 prospective and 5 retrospective). Various factors and complications were registered while performing native and transplant kidney biopsies, focusing on major (e.g. blood transfusions, invasive procedures) and minor complications. The prospective protocol was used at six centers and at one center data were obtained retrospectively. Results Women were at greater risk of overall complications than men (12.2% vs. 6.5%; P = 0.003; odds ratio [OR], 2.0; confidence interval [CI], 1.3–3.1) as well as of major complications (9.6% vs. 4.5%; P = 0.002; OR, 2.2, CI 1.3–3.7). Major complications occurred more commonly after biopsies from the right kidney, in women than in men (10.8% vs. 3.1%; P = 0.005; OR, 3.7; CI, 1.5–9.5), and in patients with lower BMI (25.5 vs. 27.3, P = 0.016) and of younger age (45 years vs. 52.5 years; P = 0.001). Lower mean arterial pressure in transplant kidney biopsies indicated a risk of major complications (90 mmHg vs. 98 mmHg; P = 0.039). Factors such as needle size, number of passes, serum creatinine, and eGFR did not influence complication rates. Conclusion The present findings motivate greater attention being paid to the risk of major side-effects after right-side biopsies from women’s kidneys, as well as after biopsies from younger patients and patients with lower BMI.
Sertindole: dilemmas for its use in clinical practice

Introduction: Sertindole was taken off the market by its manufacturer in 1998 due to concerns of its association with prolongation of QT intervals and serious dysrhythmia. After extensive post-marketing analysis and epidemiological studies regarding its safety, sertindole was relaunched in Europe in 2005. Areas covered: Sertindole is an efficacious antipsychotic that possesses superior efficacy compared with haloperidol, similar efficacy compared with risperidone, and slightly inferior efficacy compared with olanzapine. Sertindole has been shown in seven randomized, double-blind clinical trials to be a well-tolerated antipsychotic with placebo-level sedation and extrapyramidal symptoms. The long-term effectiveness and tolerability of sertindole was documented in a 52-week clinical trial. The United States Food and Drug Administration (FDA), however, has yet to accept the manufacturer's claims that sertindole reduces the risk of suicide and that it is safe for patients with schizophrenia. The safety concerns for sertindole, especially focusing on cardiac adverse events, are addressed through contemporary database search along with cross-reference check. Expert opinion: While it has been reapproved by the European Commission, concerns still exist regarding its association with prolongation of QT intervals and dysrhythmias. Moreover, a consensus has not yet been established for clinical practice. The most conservative clinical use of sertindole at this time should be only after at least one antipsychotic medication failure and with a clear benefit/risk evaluation.
Systemic quinolone antibiotics in children: a review of the use and safety

Historically, healthcare providers have reluctantly used systemic quinolone antibiotics to treat infections in children when they have been used at all. Concerns regarding the oral or parenteral use of quinolones in children rose from research observations demonstrating cartilage and joint toxicity in juvenile animal models following the administration of this class of antibiotics to immature animals. A voluntary moratorium on the use of quinolone and fluoroquinolone antibiotics in children resulted in restricting their use to treat in infections in specific settings such as immunocompromised states due to chemotherapy, pseudomonas infections in cystic fibrosis patients, complicated urinary tract infections, and quinolone sensitive infectious disease where parenteral antibiotic administration is not available and quinolones were the only effective therapy. This article aims to review retrospective and prospective safety and efficacy data to provide a comprehensive summary of the systemic use of this class of antibiotics in children.
Intra-arterial Thrombolysis or Stent Placement During Endovascular Treatment for Acute Ischemic Stroke Leads to the Highest Recanalization Rate: Results of a Multicenter Retrospective Study

BACKGROUND:Reperfusion therapy for acute ischemic stroke (AIS) is rapidly evolving, with the development of multiple endovascular modalities that can be used alone or in combination. OBJECTIVE:To determine which pharmacologic or mechanical modality may be associated with increased rates of recanalization. METHODS:A cohort of 1122 patients with AIS involving the anterior circulation treated at 13 stroke centers underwent intra-arterial (IA) therapy within 8 hours of symptom onset. Demographic information, admission National Institutes of Health Stroke Scale (NIHSS), mechanical and pharmacologic treatments used, recanalization grade, and hemorrhagic complications were recorded. RESULTS:The mean age was 67 ± 16 years and the median NIHSS was 17. The sites of arterial occlusion before treatment were M1 middle cerebral artery (MCA) in 561 (50%) patients, carotid terminus in 214 (19%) patients, M2 MCA in 171 (15%) patients, tandem occlusions in 141 (13%) patients, and isolated extracranial internal carotid artery occlusion in 35 (3%) patients. Therapeutic interventions included multimodal therapy in 584 (52%) patients, pharmacologic therapy only in 264 (24%) patients, and mechanical therapy only in 274 (24%) patients. Patients treated with multimodal therapy had a significantly higher Thrombolysis in Myocardial Infarction 2 or 3 recanalization rate (435 patients [74%]) compared with pharmacologic therapy only (160 patients, [61%]) or mechanical only therapy (173 patients [63%]), P < . 001. In binary logistic regression modeling, independent predictors of Thrombolysis in Myocardial Infarction 2 or 3 recanalization were use of IA thrombolytic OR 1.58 (1.21-2.08), P < . 001 and stent deployment 1.91 (1.23-2.96), P < . 001. CONCLUSION:Multimodal therapy has significantly higher recanalization rates compared with pharmacologic or mechanical therapy. Among the individual treatment modalities, stent deployment or IA thrombolytics increase the chance of recanalization.
Attitudes of Local Communities Towards Forest Conservation in Botswana: A Case Study of Chobe Forest Reserve

SUMMARY Understanding conservation attitudes of local communities is essential to the long-term sustainable management of natural resources such as forests. This paper, guided by the Social exchange theory, examined attitudes of local communities towards management of Chobe Forest Reserve (CFR) and explored factors influencing conservation attitudes in the study area. A survey instrument was administered to 183 households, randomly sampled across three communities adjacent to CFR. Additionally, in-depth interviews with selected key informants were conducted. Both descriptive and inferential statistics were used for analysing data. The study findings revealed that communities generally held positive attitudes towards forest conservation. Place of residence, age, length of residency and forest dependency were observed to be significantly influencing attitudes towards forest conservation. For sustainable forest management and conservation to be achieved, it is vital that community's needs and aspirations, their attitudes and perceptions regarding conservation are considered and factored into strategies and management planning.
Natural killer cell responses in renal transplant patients with cytomegalovirus infection

Natural killer (NK) cell function in relation to immunophenotypical signs of NK activation was studied prospectively in 15 renal transplant patients with cytomegalovirus (CMV) infection. NK activity (expressed as the percentage of K562 lysis) before onset of CMV infection reached a median of 6% (range 2-18%), comparable to values observed in noninfected controls [7% (range 7-21%), P < . 1]. During CMV infection, NK activity rose to a maximum of 25% (6-60%) (P < .001 vs. controls). Maximal values exceeded the upper level of controls in nine of 15 patients. NK activity was correlated to the number of CD56+HLADR+ cells in the peripheral blood (r = .57, P < .001). These data suggest that NK cells play a role in the recovery from CMV infection in a substantial number of patients and that immunophenotypical analysis of NK activation provides a surrogate marker of NK cell function.
TARPs γ‐2 and γ‐7 are essential for AMPA receptor expression in the cerebellum

The α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid (AMPA)‐type glutamate receptors require auxiliary subunits termed transmembrane AMPA receptor regulatory proteins (TARPs), which promote receptor trafficking to the cell surface and synapses and modulate channel pharmacology and gating. Of six TARPs, γ‐2 and γ‐7 are the two major TARPs expressed in the cerebellum. In the present study, we pursued their roles in synaptic expression of cerebellar AMPA receptors. In the cerebellar cortex, γ‐2 and γ‐7 were preferentially localized at various asymmetrical synapses. Using quantitative Western blot and immunofluorescence, we found severe reductions in GluA2 and GluA3 and mild reduction in GluA4 in γ‐2‐knockout (KO) cerebellum, whereas GluA1 and GluA4 were moderately reduced in γ‐7‐KO cerebellum. GluA2, GluA3 and GluA4 were further reduced in γ‐2/γ‐7 double‐KO (DKO) cerebellum. The large losses of GluA2 and GluA3 in γ‐2‐KO mice and further reductions in DKO mice were confirmed at all asymmetrical synapses examined with postembedding immunogold. Most notably, the GluA2 level in the postsynaptic density fraction, GluA2 labeling density at parallel fiber–Purkinje cell synapses, and AMPA receptor‐mediated currents at climbing fiber–Purkinje cell synapses were all reduced to approximately 10% of the wild‐type levels in DKO mice. On the other hand, the reduction in GluA4 in γ‐7‐KO granular layer reflected its loss at mossy fiber–granule cell synapses, whereas that of GluA1 and GluA4 in γ‐7‐KO molecular layer was caused, at least partly, by their loss in Bergmann glia. Therefore, γ‐2 and γ‐7 cooperatively promote synaptic expression of cerebellar AMPA receptors, and the latter also promotes glial expression.
Epidural steroid warning controversy still dogging FDA.

On April 23, 2014, the Food and Drug Administration (FDA) issued a letter of warning that injection of corticosteroids into the epidural space of the spine may result in rare, but serious adverse events, including "loss of vision, stroke, paralysis, and death. " The advisory also advocated that patients should discuss the benefits and risks of epidural corticosteroid injections with their health care professionals, along with the benefits and risks associated with other possible treatments. In addition, the FDA stated that the effectiveness and safety of the corticosteroids for epidural use have not been established, and the FDA has not approved corticosteroids for such use. To raise awareness of the risks of epidural corticosteroid injections in the medical community, the FDA's Safe Use Initiative convened a panel of experts including pain management experts to help define the techniques for such injections with the aim of reducing preventable harm. The panel was unable to reach an agreement on 20 proposed items related to technical aspects of performing epidural injections. Subsequently, the FDA issued the above referenced warning and a notice that a panel will be convened in November 2014. This review assesses the inaccuracies of the warning and critically analyzes the available literature. The literature has been assessed in reference to alternate techniques and an understanding of the risk factors when performing transforaminal epidural injections in the cervical, thoracic, and lumbar regions, ultimately resulting in improved safety. The results of this review show the efficacy of epidural injections, with or without steroids, in a multitude of spinal ailments utilizing caudal, cervical, thoracic, and lumbar interlaminar approaches as well as lumbar transforaminal epidural injections . The evidence also shows the superiority of steroids in managing lumbar disc herniation utilizing caudal and lumbar interlaminar approaches without any significant difference as compared to transforaminal approaches, either with local anesthetic alone or local anesthetic and steroids combined. In conclusion, the authors request that the FDA modify the warning based on the evidence.
Upright position during the first stage of labor: a randomised controlled trial.

BACKGROUND Evaluation of the upright position during the first stage of labor on pain, patient satisfaction, obstetrical and perinatal outcomes in nullipara women. METHODS This prospective, randomised, controlled trial included a group of 54 women who were informed and encouraged to adopt the upright position, and a control group of 53 women who were not given this information. The difference between groups was evaluated using the chi2, Wilcoxon and Fisher's Exact tests. Significance was defined as p<0.05. Risk ratios and 95% confidence intervals were calculated. RESULTS No statistically significant differences were found between the groups in baseline characteristics, obstetrical and perinatal outcomes; however, there was a preference among women in both groups for the upright position. CONCLUSIONS The upright position during the first stage of labor did not contribute towards a shorter duration of labor; however, it proved to be a safe and well-accepted option for the women of this study.
Studies in biochemical adaptation; the origin or urinary ammonia as indicated by the effect of chronic acidosis and alkalosis on some renal enzymes in the rat.

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Nurses' perceptions of individualized care.

AIM This paper is a report of a study of nurses' perceptions of individualized care, the factors associated with these perceptions, and nurses' perceptions of the provision of individualized care in different types of healthcare organization. BACKGROUND Although individualized care has been an internationally-challenging and long-standing research topic in nursing, the current literature on individualized care from the perspective of nurses is limited. METHODS A cross-sectional, descriptive and exploratory design using a questionnaire (Individualised Care Scale-Nurse) was employed to survey a stratified sample of 544 nurses (response rate 59%) working as Registered or Enrolled Nurses in one hospital district in Finland in 2008. Data were analysed using descriptive and inferential statistics (General Linear Model, one-way analysis of variance) and Cronbach's alpha coefficients for reliability analysis. RESULTS Nurses perceived that they supported patient individuality well and that the care they provided took into account patient individuality. Based on the General Linear Model, nurses' background variables were not associated with their perceptions of individualized care delivery. However, between-organization differences were found in all study variables: mental health ward nurses had the most positive perceptions, and nurses working in primary health centre long-term care wards the lowest. CONCLUSION Healthcare organizations and work environments need to be evaluated as they may have an influence on individualized care provision. The Individualised Care Nurse instrument is sensitive to healthcare working environments and can be used in evaluating nurses' perceptions of individualized care.
Emergence of Macrolide Resistance Gene mph(B) in Streptococcus uberis and Cooperative Effects with rdmC-Like Gene

ABSTRACT Streptococcus uberis UCN60 was resistant to spiramycin (MIC = 8 μg/ml) but susceptible to erythromycin (MIC = 0.06 μg/ml), azithromycin (MIC = 0.12 μg/ml), josamycin (MIC = 0.25 μg/ml), and tylosin (MIC = 0.5 μg/ml). A 2.5-kb HindIII fragment was cloned from S. uberis UCN60 DNA on plasmid pUC18 and introduced into Escherichia coli AG100A, where it conferred resistance to spiramycin by inactivation. The sequence analysis of the fragment showed the presence of an rdmC-like gene that putatively encoded a protein belonging to the alpha/beta hydrolase family and of the first 196 nucleotides of the mph(B) gene putatively encoding a phosphotransferase known to inactivate 14-, 15-, and 16-membered macrolides in E. coli. The entire mph(B) gene was then identified in S. uberis UCN60. The two genes were expressed alone or in combination in E. coli, Staphylococcus aureus, and Enterococcus faecalis. Analysis of MICs revealed that rdmC-like alone did not confer resistance to erythromycin, tylosin, and josamycin in those three hosts. It conferred resistance to spiramycin in E. coli and E. faecalis but not in S. aureus. mph(B) conferred resistance in E. coli to erythromycin, tylosin, josamycin, and spiramycin but only low levels of resistance in E. faecalis and S. aureus to spiramycin (MIC = 8 μg/ml). The combination of mph(B) and rdmC-like genes resulted in a resistance to spiramycin and tylosin in the three hosts that significantly exceeded the mere addition of the resistance levels conferred by each resistance mechanism alone.
Instrumental activities of daily living performance in healthy and cognitively intact seniors from a Brazilian sample and its relation to age and other socio-demographic variables

ABSTRACT Background: Studies on functional capacity in community-dwelling older people have shown associations between declines in instrumental activities of daily living (IADL) and several factors. Among these, age has been the most consistently related to functional capacity independent of other variables. We aimed at evaluating the performance of a sample of healthy and cognitively intact Brazilian older people on activities of daily living and to analyze its relation to social-demographic variables. Methods: We conducted a secondary analysis of data collected for previous epidemiological studies with community-dwelling subjects aged 60 years or more. We selected subjects who did not have dementia or depression, and with no history of neurological diseases, heart attack, HIV, hepatitis or arthritis (n = 1,111). Functional capacity was assessed using the Brazilian version of the Older American Resources and Services Questionnaire (BOMFAQ). ADL performance was analyzed according to age, gender, education, and marital status (Pearson's χ2, logistic regression). Results: IADL difficulties were present in our sample, especially in subjects aged 80 years or more, with lower levels of education, or widowed. The logistic regression analysis results indicated that “higher age” and “lower education” (p ≤ 0.001) remained significantly associated with IADL difficulty. Conclusions: Functional decline was present in older subjects even in the absence of medical conditions and cognitive impairment. Clinicians and researchers could benefit from knowing what to expect from older people regarding IADL performance in the absence of medical conditions.
The NIMA Kinase Is Required To Execute Stage-Specific Mitotic Functions after Initiation of Mitosis

ABSTRACT The G2-M transition in Aspergillus nidulans requires the NIMA kinase, the founding member of the Nek kinase family. Inactivation of NIMA results in a late G2 arrest, while overexpression of NIMA is sufficient to promote mitotic events independently of cell cycle phase. Endogenously tagged NIMA-GFP has dynamic mitotic localizations appearing first at the spindle pole body and then at nuclear pore complexes before transitioning to within nuclei and the mitotic spindle and back at the spindle pole bodies at mitotic exit, suggesting that it functions sequentially at these locations. Since NIMA is indispensable for mitotic entry, it has been difficult to determine the requirement of NIMA for subaspects of mitosis. We show here that when NIMA is partially inactivated, although mitosis can be initiated, a proportion of cells fail to successfully generate two daughter nuclei. We further define the mitotic defects to show that normal NIMA function is required for the formation of a bipolar spindle, nuclear pore complex disassembly, completion of chromatin segregation, and the normal structural rearrangements of the nuclear envelope required to generate two nuclei from one. In the remaining population of cells that enter mitosis with inadequate NIMA, two daughter nuclei are generated in a manner dependent on the spindle assembly checkpoint, indicating highly penetrant defects in mitotic progression without sufficient NIMA activity. This study shows that NIMA is required not only for mitotic entry but also sequentially for successful completion of stage-specific mitotic events.
Use of Composite Grafts in Abdominal Sacrocolpopexy

Objective: The ideal graft material for pelvic reconstructive surgery remains undetermined. The purpose of this study was to present data on novel composite biologic/synthetic grafts during use in abdominal sacrocolpopexy. Methods: A case series of 90 patients undergoing abdominal sacrocolpopexy with composite biologic/synthetic grafts was conducted. The primary outcome was graft erosion. Assuming a 3% risk of reoperation for mesh erosion, the number needed to treat with a composite graft in order to avoid erosion risk from a synthetic-only graft was calculated. The cost of a composite graft was compared to reoperation costs for mesh erosion of a synthetic-only graft. Results: Zero patients (N = 90) undergoing abdominal sacrocolpopexy with a composite biologic/synthetic graft experienced graft erosion. Based on existing data, thirty-three patients would need to be treated with a composite graft to avoid one mesh erosion from a synthetic-only graft. If a $500 composite graft is used, the cost of reoperation performed abdominally is higher. Conclusions: This study introduces a novel biologic/synthetic composite graft that offers the advantage of low erosion risk during use in abdominal sacrocolpopexy. Combined grafts may also be cost-effective. Future research should focus on exploring the role of these durable, yet low erosion risk grafts to potentially promote improved safety for our patients and cost savings for society.