Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Features, Complications and Mortality in Type 1 (Insulin-Dependent) Diabetic Patients in Addis Ababa, Ethiopia, 1976–1990

Clinical features, complications and prognosis of 431 consecutively registered Ethiopian Type 1 (insulin-dependent) diabetic patients seen in the Diabetic Clinic in Yekatit 12 Hospital in Addis Ababa, Ethiopia, from 1976–1990 are reported. Male:female ratio was 1.4:1; mean age at diagnosis was 18.1 years (confidence interval (CI) 1.6) in women and 21.4 (CI 1.2) in men. A history of ketoacidosis at some time was present in 38 per cent, in 11 per cent at diagnosis of diabetes. Tuberculosis was the most common complicating illness, occurring at some time in 16.5 per cent of patients. In addition, 9.5 per cent (CI 4 per cent) were known to have diabetic retinopathy, 6.0 per cent (CI 2 per cent) nephropathy and 7.9 per cent (CI 2 per cent) neuropathy at their last clinic visit. During the 15 years of the study, 9.7 per cent of the patients have died, with a mean duration of diabetes at death of 9.2 years (CI 1.8), and an overall mortality rate of 15.5/1000 person-years of diabetes. Five-year survival was 96 per cent (CI 3 per cent), 15-year survival 82 per cent (CI 9 per cent), and 20-year survival 63 per cent (CI 17 per cent), calculated using the Cox proportional hazards model; prognosis was better in those diagnosed at a younger age ( p =0.029) and in those with a body mass index of > 19 kg/m2 on treatment ( p =0.096).
Self-reported childhood abuse in an adult population in a primary care setting. Prevalence, correlates, and associated suicide attempts

OBJECTIVE: To describe the prevalence of childhood physical, sexual, and emotional abuse and suicide attempts in a sample of adult patients from a primary care setting and to examine the relationship between suicide attempts and a self-reported history of childhood abuse. DESIGN: Cross-sectional sampling via a self-administered survey that included an abuse questionnaire, the Inventory to Diagnose Depression, and questions regarding suicide. SETTING: University medical center family medicine practice. PATIENTS: A convenience sample of patients aged 18 years and older presenting for care. Of the 778 patients approached, 448 patients (58%) consented and returned their surveys. We report only on the 292 surveys (38%) returned with complete information. Subjects were predominantly middle class and white, with a mean age of 37 years. MEASUREMENT AND MAIN RESULTS: Forty-four percent of the patients reported experience of childhood abuse, and 22% reported multiple forms of abuse. Eighteen percent of abused vs 3% of nonabused patients (P = .00001) reported a history of suicide attempts. Being female, younger, and less educated were associated with any abuse. Females reported more sexual abuse; less educated patients, more physical abuse; and younger patients, more physical and sexual abuse and suicide attempts. Odds ratios for suicide attempts, when adjusted by abuse status, were 6.4 for any abuse (95% confidence intervals [CI], 2.4 to 17.6), 4.1 for sexual abuse (95% CI, 1.7 to 9.9), 3.7 for emotional abuse (95% CI, 1.4 to 10.0), and 1.2 for physical abuse (95% CI, 0.5 to 3.1). CONCLUSION: A history of childhood abuse was a common experience in this sample. Patients with a history of abuse, particularly sexual and emotional abuse, are at increased risk of suicidal behavior. To facilitate more appropriate care and treatment, primary care practitioners should question patients regarding a history of abuse. Language: en
Association of CTLA-4 Polymorphisms with Improved Overall Survival in Melanoma Patients Treated with CTLA-4 Blockade: A Pilot Study

CTLA-4 blockade with monoclonal antibodies can lead to cancer regression in patients with metastatic melanoma (MM). CTLA-4 gene polymorphisms may influence the response to anti-CTLA-4 antibodies although few data are available regarding this issue. We analyzed six CTLA-4 single nucleotide polymorphisms (−1661A>G, −1577G>A, −658C>T, −319C>T, +49A>G, and CT60G>A) in 14 Italian MM patients and 45 healthy subjects. We found a significant association between the −1577G/A and CT60G/A genotypes and improved overall survival (Pc < 0.006, Bonferroni corrected), further confirmed by the diplotype analysis (−1577&CT60 GG-AA diplotype, p < 0.001). A positive trend toward an association between these genotypes and response to therapy was also observed.
Acute dengue myositis with rhabdomyolysis and acute renal failure

Dengue is an acute mosquito-borne infection caused by dengue viruses from the genus flavivirus. Neurologic complications have been attributed chiefly to metabolic alterations and to focal and sometimes massive intracranial haemorrhages, but anecdotal cases and limited case series have indicated the possibility of viral CNS and skeletal muscle invasion causing encephalitis and myositis. We present a case of a 40-year-old male who presented with severe dengue myositis resulting in quadriparesis, respiratory failure and acute renal failure with red urine. His elevated serum creatine kinase (CK), serum and urine myoglobin levels justified rhabdomyolysis as the cause of acute renal failure. A muscle biopsy revealed inflammatory myositis. He required ventilator support for respiratory failure and was treated conservatively. This case highlights the severe and persistent muscle involvement in dengue which is a rarity.
Infliximab Clearance in Children: Potential Association with Resting Energy Expenditure -

Objectives: Previous data suggest an inverse relationship between monoclonal antibody clearance and age in children. Furthermore, immunoglobulin clearance has been associated with metabolic rate; thus we evaluated the relationship between clearance and resting energy expenditure of infliximab in 117 patients with juvenile idiopathic arthritis. Methods: Standard linear and non-linear regression paradigms were used to explore the associations between age and infliximab clearance as well as resting energy expenditure and infliximab clearance by analyzing pharmacokinetic data for infliximab from a previous study in children with juvenile idiopathic arthritis (n = 117, age 4 to 17 years). Results: A significant inverse association between age and serum clearance (r2 = 0.21, p < 0.001) was appreciated. An association between resting energy expenditure and infliximab serum clearance revealed a significant positive linear association (r2 = 0.37, p < 0.001). Conclusion: These data suggest that age-dependence in infliximab serum clearance may be explained by expected developmental differences in resting energy expenditure.
Differing Patterns of Cognitive Dysfunction and Heart Rate Reactivity in Chemically-Intolerant Individuals With and Without Lifestyle Changes

AbstractThe purpose of the present study was to compare specific neuropsychological, psychological, and family history patterns, as well as cardiovascular reactivity of three community-recruited groups of nonsmoking, nonalcoholic middle-aged individuals with and without the symptom of intolerance to low levels of environmental chemicals (CI). CI is a common symptom in chronic fatigue syndrome and fibro-myalgia. The groups included: (i) CI who had made associated lifestyle changes because of the CI (CI/LSC); (ii) CI who had not made such changes (CI); and (iii) normals without CI (N). All subjects underwent an evaluation session followed by two laboratory cognitive and psycho-physiological test sessions one week apart. The CI/LSC diverged from the other groups in exhibiting poorer performance on the Continuous Visual Memory Test (CVMT) in terms of more false alarms and fewer correct hits, but normal performance on a visuospatial test of divided attention (DAT). In contrast, the CI group showed progressivel.
Safety and Efficacy of a Testosterone Patch for the Treatment of Hypoactive Sexual Desire Disorder in Surgically Menopausal Women: A Randomized, Placebo-Controlled Trial

Background Oophorectomy reduces serum testosterone levels. We studied the efficacy and safety of transdermal testosterone in treating hypoactive sexual desire disorder in surgically menopausal women. Methods A 24-week, randomized, double-blind, placebo-controlled, parallel-group, multicenter trial was conducted in women (aged 24-70 years) who developed distressful low sexual desire after bilateral salpingo-oophorectomy and hysterectomy and who were receiving oral estrogen therapy. Women were randomized to receive placebo (n = 119) or testosterone patches in dosages of 150 μg/d (n = 107), 300 μg/d (n = 110), or 450 μg/d (n = 111) twice weekly for 24 weeks. Sexual desire and frequency of satisfying sexual activity were primary efficacy outcome measures. Results Of the 447 women randomized, 318 (71%) completed the trial. Compared with placebo, women receiving the 300-μg/d testosterone patch had significantly greater increases from baseline in sexual desire (67% vs 48%; P = .05) and in frequency of satisfying sexual activity (79% vs 43%; P = .049). The 150-μg/d group showed no evidence of a treatment effect. The 450-μg/d group also was not statistically different from the 300-μg/d or placebo groups. Marginally significant linear dose-response trends were observed for total satisfying sexual activity and sexual desire at 24 weeks ( P = .06 and .06, respectively). Adverse events occurred with similar frequency in both groups; no serious safety concerns were observed. Conclusions The 300-μg/d testosterone patch increased sexual desire and frequency of satisfying sexual activity and was well tolerated in women who developed hypoactive sexual desire disorder after surgical menopause.
Temozolomide and Radiotherapy for Newly Diagnosed Glioblastoma Multiforme: A Systematic Review

To systematically review the efficacy/safety of radiotherapy/temozolomide (TMZ) vs. radiotherapy for treating glioblastoma (GBM), Medline, Current Contents, and Cochrane database were searched. Five studies were reviewed. Median survival ranged from 9.4 to 19.0 months (radiotherapy/TMZ) vs. 7.3–17.1 months (radiotherapy). Survival ranged from 80.2% to 95.0% (radiotherapy/TMZ) vs. 8.3–84.2% (radiotherapy) at 0.5 years and from 20.0% to 61.1% (radiotherapy/TMZ) vs. 5.0–50.6% (radiotherapy) at 1 year. Median progression-free survival (PFS) ranged from 5.5 to 13.0 months (radiotherapy/TMZ) vs. 4.4–7.6 months (radiotherapy). PFS rates at 0.5 years ranged from 53.9–78.0% (radiotherapy/TMZ) vs. 53.9–78.0% (radiotherapy). Radiotherapy/TMZ provides better survival outcomes than radiotherapy alone in treating GBM.
Prognostic Value of p16 Promoter Hypermethylation in Colorectal Cancer: A Meta-Analysis

Whether or not p16 promoter hypermethylation has any prognostic value on the survival of patients with colorectal cancer (CRC) is uncertain. A meta-analysis was therefore conducted on the overall survival involving 16 studies with 3968 patients and disease-free survival involving six studies with 1091 cases, respectively. The promoter hypermethylation was found to be significantly associated with shorter survival compared to controls, which was not only stable according to influence analysis and cumulative meta-analysis but also conclusive according to trial sequential meta-analysis. The meta-analysis supports the hypermethylation as an independent adverse prognostic factor for CRC.
Impact factors on cervical dilation rates in the first stage of labor

Abstract Aims: To assess cervical dilation rates of nulliparous and multiparous women in the active first stage of labor and to evaluate significant impact factors. Methods: In a retrospective cohort study between January 2007 and July 2014 at the University Hospital of Zurich in Switzerland, we analyzed 8378 women with singleton pregnancies in vertex presentation with a vaginal delivery at 34+0 to 42+5 gestational weeks. Median cervical dilation rates were calculated and different impact factors evaluated. Results: Cervical dilation rates increase during labor progress with faster rates in multiparous compared with nulliparous women (P<0.001). Dilation rates exceed 1 cm/h at a dilatation of 6–7 cm, but are very individual. Accelerating impact factors are multiparity, a greater amount of cervical dilation and fetal occipitoanterior position, whereas the use of epidural anesthesia, a higher fetal weight and head circumference decelerate dilation (P<0.001). Conclusion: Cervical dilation is a hyperbolic increasing process, with faster dilation rates in multiparous compared to nulliparous women and a reversal point of labor around 6–7 cm, respectively. Besides, cervical dilation is highly individual and affected by several impact factors. The diagnosis of labor arrest or prolonged labor should therefore be based on such rates and on the individual evaluation of every woman.
Dengue and rhabdomyolysis

The clinical signifi cance of myoglobinuric acute renal failure and other serious sequalae is att ributable to oft en subtle initial clinical manifestations of rhabdomyolysis. [2] The authors suggest that the incidence is rare, in contrast to the literature indicating underreporting and underrecognition of such a complication by physicians for many reasons. [3,4] Secondly, the authors also presume that vigorous manual labor, 2 days aft er the fever onset, might have led to the persistent infl ammation in this professional casual laborer. In general, a CK rise above 10,000 IU/L aft er exercise is not the common. The paper does not give the serial CK results to suggest the second spike in CK is secondary to this exertional rhabdomyolysis trigger. Factors such as impaired sweating, exertion in extremely humid conditions, dehydration,[5] (through hyperthermia), sleep deprivation, fasting; common drugs, such as ibuprofen, paracetamol, diazepam; emotional stress; nutritional supplements (especially in hot/humid conditions through severe hypokalaemia and hypomagnesemia);[6] and hemoglobinopathy (sickle cell trait in those who exert at a high altitude); enzymatic defi ciencies [7-9] associated with this condition, particularly impaired sweating and humid condition, might have triggered rhabdomyolysis. [810] If this was an exercise-, fastingor febrile illness-induced episode in an adult, the metabolic myopathies, particularly carnitine palmitoyl transferase II defi ciency should have been included near the top of the diff erential. If this is the cause, then there is a risk of recurrence. Lastly, the adoption of serum CK, serum and urine myoglobin, and histopathology in addition to the signs and symptoms to confi rm muscle trauma in this case sends a signal to the readers that these are mandatory to confi rm rhabdomyolysis and its clinical sequalae.
Adiponectin concentration in mid-trimester amniotic fluid varies with the α-amylase level and maternal and neonatal outcomes

Abstract Objective: Factors influencing intraamniotic adiponectin levels and their functional significance remain incompletely elucidated. We prospectively measured adiponectin in amniotic fluid and identified its associations with maternal parameters, mediators in amniotic fluid and pregnancy outcomes. Study design: Mid-trimester amniotic fluid from 571 women was tested for adiponectin, interleukin (IL)-6, IL-8 and α-amylase by enzyme-linked immunosorbant assay (ELISA), after which clinical data were obtained. Correlations between adiponectin and clinical or laboratory variables were analyzed by the Kruskal-Wallis, Mann-Whitney and Spearman rank correlation tests. Results: As compared to median levels in 462 women with a term delivery (7.8 ng/mL), adiponectin was elevated in 14 women who subsequently developed preterm premature rupture of membranes (pPROM) (17.3 ng/mL) and 24 women with an iatrogenic preterm birth (IPTB) (13.9 ng/mL) (P=0.0003), but not in 30 women who subsequently had a spontaneous preterm birth with intact membranes (8.1 ng/mL) (P>0.05). Median adiponectin was also elevated in 13 women whose babies developed fetal growth restriction (FGR) (20.6 ng/mL) (P=0.0055) and in 22 women whose babies had respiratory distress syndrome (RDS) (23.0 ng/mL) (P<0.0001). The adiponectin concentration was positively correlated with amylase (P=0.0089) and inversely correlated with maternal body mass index (P=0.0045). Conclusion: Adiponectin is a component of mid-trimester amniotic fluid and its concentration varies with maternal body mass index and subsequent development of pPROM, IPTB, FGR and RDS.
Dyschromonychia: clinical significance in a South African population

Abstract Background: The purpose of this study was to determine disease associations with dyschromonychia (DCO) in an out- and inpatient population attending Kalafong Hospital. Methods: This prospective and observational study included in- and out-patients attending the Immunology Clinic at Kalafong Hospital, Pretoria, Gauteng. The study was divided into three phases, the first of which was to evaluate the kappa values and prevalence of DCO. The second was to determine the disease associations of in-patients, and the third phase consisted of nail evaluation in an out-patient HIV-positive population. Results: The kappa value was 0.72, as obtained by three investigators. DCO was found to have a 66% sensitivity, 92% specificity, 66% positive predictive value, 92% negative predictive value, a positive likelihood ratio of 8.2 and a negative likelihood ratio of 0.4 for HIV (inpatients). Patients with DCO were found to have a significantly higher rate of infections (predominantly involving the lung), significantly lower lymphocyte counts and CD4 cell counts, and significantly lower CD4:CD8 ratios and albumin levels (p = 0.0001). The best discriminatory CD4 for DCO was 216.6 x 10 6/l (sensitivity = 89%; specificity = 63%), while a CD4 value of 134.3 x 10 6/l yielded a sensitivity of 75% and a specificity of 73%. Conclusions: This study demonstrates a close association between HIV and DCO, especially in the case of lower CD4 cell counts. The absence of DCO is a poor predictor for the presence of HIV, although its presence has a high sensitivity for HIV seropositivity. The clinical finding of DCO is a simple, quick and efficient sign for the evaluation of the immune status of our population with reasonable sensitivity and specificity for low CD4 cell counts.
A Systematic Review of Occupational Therapy Interventions With Homeless People

ABSTRACT A systematic review of the occupational therapy literature 1990–2008 was undertaken with the aim to assess the quality of evidence that supports the role of occupational therapy with homeless people. Forty articles were initially identified and critically appraised, including 16 research studies. Seven quantitative articles were included in this review and demonstrated the effectiveness of occupational therapy in providing interventions that increase employment and education prospects, money management, coping skills, and leisure activities. The literature suggests that occupational therapy has an appropriate role with people experiencing homelessness.
Production of nanoparticles using organisms

Recent developments in the biosynthesis of nanomaterials have demonstrated the important role of biological systems and microorganisms in nanoscience and nanotechnology. These organisms show a unique potential in environmentally friendly production and accumulation of nanoparticles with different shapes and sizes. Therefore, researchers in the field of nanoparticle synthesis are focusing their attention to biological systems. In order to obtain different applied chemical compositions, controlled monodispersity, desired morphologies (e.g., amorphous, spherical, needles, crystalline, triangular, and hexagonal), and interested particle size, they have investigated the biological mechanism and enzymatic process of nanoparticle production. In this review, most of these organisms used in nanoparticle synthesis are shown.
A Survey on Violence Against Female Partners in Québec, Canada

To establish the annual prevalence of violence perpetrated by male partners in Québec couples, a telephone survey was conducted with 2,120 women. Validated instruments measured physically and sexually violent behaviors as well as controlling behaviors and verbal aggression. Victimization rates were 6.1% for physical violence and 6.8% for sexual violence. Sexual and physical violence were significantly higher in the presence of controlling and humiliating behaviors than they were in the absence of such behaviors. The results confirm the association of individual and social variables with violence in other studies and illustrate the importance of understanding the sociocultural context for the family status variables.
Bioconversion of lignocellulose-derived sugars to ethanol by engineered Saccharomyces cerevisiae

Lignocellulosic biomass from agricultural and agro-industrial residues represents one of the most important renewable resources that can be utilized for the biological production of ethanol. The yeast Saccharomyces cerevisiae is widely used for the commercial production of bioethanol from sucrose or starch-derived glucose. While glucose and other hexose sugars like galactose and mannose can be fermented to ethanol by S. cerevisiae, the major pentose sugars D-xylose and L-arabinose remain unutilized. Nevertheless, D-xylulose, the keto isomer of xylose, can be fermented slowly by the yeast and thus, the incorporation of functional routes for the conversion of xylose and arabinose to xylulose or xylulose-5-phosphate in Saccharomyces cerevisiae can help to improve the ethanol productivity and make the fermentation process more cost-effective. Other crucial bottlenecks in pentose fermentation include low activity of the pentose phosphate pathway enzymes and competitive inhibition of xylose and arabinose transport into the cell cytoplasm by glucose and other hexose sugars. Along with a brief introduction of the pretreatment of lignocellulose and detoxification of the hydrolysate, this review provides an updated overview of (a) the key steps involved in the uptake and metabolism of the hexose sugars: glucose, galactose, and mannose, together with the pentose sugars: xylose and arabinose, (b) various factors that play a major role in the efficient fermentation of pentose sugars along with hexose sugars, and (c) the approaches used to overcome the metabolic constraints in the production of bioethanol from lignocellulose-derived sugars by developing recombinant S. cerevisiae strains.