Miracle-dz/UniFAR-FTUs huggingface dataset:
Raman spectroscopy: in vivo quick response code of skin physiological status

Abstract. Dermatologists need to combine different clinically relevant characteristics for a better understanding of skin health. These characteristics are usually measured by different techniques, and some of them are highly time consuming. Therefore, a predicting model based on Raman spectroscopy and partial least square (PLS) regression was developed as a rapid multiparametric method. The Raman spectra collected from the five uppermost micrometers of 11 healthy volunteers were fitted to different skin characteristics measured by independent appropriate methods (transepidermal water loss, hydration, pH, relative amount of ceramides, fatty acids, and cholesterol). For each parameter, the obtained PLS model presented correlation coefficients higher than R2=0.9. This model enables us to obtain all the aforementioned parameters directly from the unique Raman signature. In addition to that, in-depth Raman analyses down to 20 μm showed different balances between partially bound water and unbound water with depth. In parallel, the increase of depth was followed by an unfolding process of the proteins. The combinations of all these information led to a multiparametric investigation, which better characterizes the skin status. Raman signal can thus be used as a quick response code (QR code). This could help dermatologic diagnosis of physiological variations and presents a possible extension to pathological characterization.
Pulmonary gas exchange in anaesthetised horses mechanically ventilated with oxygen or a helium/oxygen mixture.

REASON FOR PERFORMING STUDY It is unknown whether administration of gas-mixtures high in inspired fraction of oxygen (FiO2) under general anaesthesia may increase formation of pulmonary atelectasis and impair gas exchange. OBJECTIVE To evaluate the effects of different FiO2 on pulmonary gas exchange in isoflurane-anaesthetised horses breathing a helium/oxygen (He/O2) mixture. METHODS Thirty healthy mature horses were sedated with i.v. acepromazine (0.02 mg/kg bwt), detomidine (0.002 mg/kg bwt) and xylazine (02-0.4 mg/kg bwt). General anaesthesia was induced with i.v. 5% guaifenesin to effect, diazepam (0.1 mg/kg bwt) and ketamine (2 mg/kg bwt), and maintained with isoflurane. Fifteen horses (Group HX) were ventilated mechanically with gas mixtures of successively increasing FiO2 (0.25-030, 0.50-0.55, > 0.90), obtained by blending 02 with Heliox (70% He/30% O2). The other 15 horses (Group O) were ventilated immediately with 100% O2 (FiO2 > 0.90). After 20 min of ventilation at the different FiO2 levels in Group HX and after 60 min in Group O, PaO2 and PaCO2 were measured and the alveolar to arterial PO2 gradient (P(A-a)O2) was calculated. Data analysis included robust categorical regression with clustering on horse (P < 0.05). RESULTS Inhalation of a He/O2 mixture with FiO2 as low as 0.25-030 ensured adequate arterial oxygenation and was associated with a smaller P(A-a)O2 gradient than inhalation of pure O2 (P < 0.05). In Group HX, PaO2 increased with each rise in FiO2 and so did P(A-a)O2 (P < 0.05). The PaO2 was significantly lower and the P(A-a)O2 higher in Group O compared to Group HX at a FiOz >0.90 (P < 0.05). CONCLUSIONS AND POTENTIAL RELEVANCE Administration of a He/O2 gas mixture low in FiO2 can better preserve lung function than ventilation with pure oxygen. A step-wise increase of FiO2 using a He/O2 gas mixture might offer advantages with respect to pulmonary gas exchange over an immediate exposure to 100% 2O2.
How Much is Post-Acute Care Use Affected by its Availability?

OBJECTIVE To assess the relative impact of clinical factors versus nonclinical factors-such as postacute care (PAC) supply-in determining whether patients receive care from skilled nursing facilities (SNFs) or inpatient rehabilitation facilities (IRFs) after discharge from acute care. DATA SOURCES AND STUDY SETTING Medicare acute hospital, IRF, and SNF claims provided data on PAC choices; predictors of site of PAC chosen were generated from Medicare claims, provider of services, enrollment file, and Area Resource File data. STUDY DESIGN We used multinomial logit models to predict PAC use by elderly patients after hospitalizations for stroke, hip fractures, or lower extremity joint replacements. DATA COLLECTION/EXTRACTION METHODS A file was constructed linking acute and postacute utilization data for all medicare patients hospitalized in 1999. PRINCIPAL FINDINGS PAC availability is a more powerful predictor of PAC use than the clinical characteristics in many of our models. The effects of distance to providers and supply of providers are particularly clear in the choice between IRF and SNF care. The farther away the nearest IRF is, and the closer the nearest SNF is, the less likely a patient is to go to an IRF. Similarly, the fewer IRFs, and the more SNFs, there are in the patient's area the less likely the patient is to go to an IRF. In addition, if the hospital from which the patient is discharged has a related IRF or a related SNF the patient is more likely to go there. CONCLUSIONS We find that the availability of PAC is a major determinant of whether patients use such care and which type of PAC facility they use. Further research is needed in order to evaluate whether these findings indicate that a greater supply of PAC leads to both higher use of institutional care and better outcomes-or whether it leads to unwarranted expenditures of resources and delays in returning patients to their homes.
What should men living with severe haemophilia need to know? The perspectives of Canadian haemophilia health care providers

Haemophilia is a complex disease to manage. Home‐based management of haemophilia has placed greater responsibility for disease management on individuals with haemophilia, heightening the individual's need for knowledge, particularly among individuals with severe haemophilia. The aim of this study was to identify and understand the knowledge needs and gaps of Canadian men with severe haemophilia from the perspectives of health care providers. A qualitative approach was undertaken. Data were collected using semi‐structured focus groups and interviews with health care providers from Haemophilia Treatment Centres (HTCs) across Canada; data were analysed using thematic analysis. Three focus groups and two interviews were conducted; 13 individuals participated in this study. Health care providers identified the following areas of knowledge required by men with severe haemophilia: disease pathology, causes and consequences of bleeds, bleed prevention, recognition, treatment, how and when to access support, activity selection and risk reduction, benefits of exercise, genetic inheritance patterns, impact on career selection, travel and ageing. Knowledge gaps and challenges to knowledge provision were highlighted. In addition, providers emphasized the influences of timing, rapport and context on readiness to receive and assimilate information and recommended tailoring education to the individual and creating a developmental curriculum and knowledge assessment tool. Provision and uptake of disease knowledge is essential to patient self‐management. To effectively receive, retain and assimilate information, individuals with severe haemophilia require the right information, from the right source, at the right time. Education should be tailored to the needs of the individual, provided throughout the lifespan.
Diminished cartilage-lubricating ability of human osteoarthritic synovial fluid deficient in proteoglycan 4: Restoration through proteoglycan 4 supplementation.

OBJECTIVE The purposes of this study were 1) to quantify the proteoglycan 4 (PRG4) and hyaluronan (HA) content in synovial fluid (SF) from normal donors and from patients with chronic osteoarthritis (OA) and 2) to assess the cartilage boundary-lubricating ability of PRG4-deficient OA SF as compared to that of normal SF, with and without supplementation with PRG4 and/or HA. METHODS OA SF was aspirated from the knee joints of patients with symptomatic chronic knee OA prior to therapeutic injection. PRG4 concentrations were measured using a custom sandwich enzyme-linked immunosorbent assay (ELISA), and HA concentrations were measured using a commercially available ELISA. The molecular weight distribution of HA was measured by agarose gel electrophoresis. The cartilage boundary-lubricating ability of PRG4-deficient OA SF, PRG4-deficient OA SF supplemented with PRG4 and/or HA, and normal SF was assessed using a cartilage-on-cartilage friction test. Two friction coefficients (μ) were calculated: static (μ(static, Neq) ) and kinetic () (where N(eq) represents equilibrium axial load and angle brackets indicate that the value is an average). RESULTS The mean ± SEM PRG4 concentration in normal SF was 287.1 ± 31.8 μg/ml. OA SF samples deficient in PRG4 (146.5 ± 28.2 μg/ml) as compared to normal were identified and selected for lubrication testing. The HA concentration in PRG4-deficient OA SF (mean ± SEM 0.73 ± 0.08 mg/ml) was not significantly different from that in normal SF (0.54 ± 0.09 mg/ml). In PRG4-deficient OA SF, the molecular weight distribution of HA was shifted toward the lower range. The cartilage boundary-lubricating ability of PRG4-deficient OA SF was significantly diminished as compared to normal (mean ± SEM = 0.043 ± 0.008 versus 0.025 ± 0.002; P < 0.05) and was restored when supplemented with PRG4 ( = 0.023 ± 0.003; P < 0.05). CONCLUSION These results indicate that some OA SF may have decreased PRG4 levels and diminished cartilage boundary-lubricating ability as compared to normal SF and that PRG4 supplementation can restore normal cartilage boundary lubrication function to these OA SF.
The Use of Video Laryngoscopy During Air Medical Transport: A Manikin Study

Introduction This study simulated intubation with direct laryngoscopy and with a GlideScope Ranger video laryngoscope using a standard Laerdal airway manikin in a medical helicopter under various conditions. We hypothesized that the intubation times would be greater using direct laryngoscopy compared with the GlideScope under all conditions. Methods Twenty crew members of a single helicopter emergency medical service participated in the study. Participants intubated an airway manikin using both direct laryngoscopy and the GlideScope Ranger in varying conditions, including standing in a room with the lights on and off, in the helicopter while stationary on the ground and unbelted during both daytime and nighttime, and finally in the aircraft while in flight belted during both daytime and nighttime. A study investigator recorded the intubation times and independently confirmed tracheal placement of the endotracheal tube. Results For all 6 environments, the mean time for intubation was slightly greater using the GlideScope (18.7 seconds; 95% confidence interval, 17.4–20.0 seconds) compared with direct laryngoscopy (15.5 seconds; 95% confidence interval, 14.7–16.4). There was a statistically significant difference in times to intubation, in favor of direct laryngoscopy, in the settings of standing with the room lights on (P = 0.0013), on the ground in the helicopter unbelted during the daytime (P = 0.009), and in flight belted at nighttime (P = 0.0012), with the 3 other environments not reaching statistical significance. Conclusions Using the GlideScope took more time to intubate compared with direct laryngoscopy in all tested environments. Although this difference in intubation times was statistically significant, it was not clinically significant, suggesting that both modalities may be comparable in nondifficult airways.
Carotid Arterial Stiffness in Patients with Congenital Heart Disease–Related Pulmonary Hypertension Assessed with Radio Frequency Data Technique

It has been well known that pulmonary hypertension (PH) caused by congenital heart disease (CHD) leads to reduced flexibility of the small pulmonary arteries, due to hemodynamic changes in the pulmonary circulation and alterations of the vasoactive profile. However, whether CHD‐related PH affects the elasticity of the systemic arteries, such as the common carotid artery (CCA), has not been fully investigated. The purpose of this study was to explore the CCA stiffness in patients with CHD‐related PH using the radio frequency data technique.
Incorporation of the fluorescent amino acid 7‐azatryptophan into the core domain 1–47 of hirudin as a probe of hirudin folding and thrombin recognition

7‐Azatryptophan (AW), a noncoded isostere of tryptophan (W), possesses interesting spectral properties. In particular, the presence of a nitrogen atom at position 7 in the indolyl nucleus of AW results in a red shift of the absorption maximum and fluorescence emission by 10 and 46 nm, respectively, compared to W. In the present work, we report the chemical synthesis and the conformational and functional characterization of an analog (denoted as Y3AW) of the N‐terminal domain 1–47 of hirudin, a highly potent thrombin inhibitor, in which Tyr 3 has been replaced by AW. The results obtained were compared with those of the cooresponding Y3W analog. We found that the replacement W → AW reduces affinity for thrombin by 10‐fold, likely because of the lower hydrophobicity of AW compared with that of W. Measurements of the resonance energy transfer effect, which was observed between Tyr13 and the amino acid at position 3 upon disulfide‐coupled folding, demonstrate that AW behaves as a better energy acceptor than W for studying protein renaturation. The interaction of Y3AW with thrombin was studied by exciting the sample at 320 nm and recording the change in fluorescence of Y3AW on binding to the enzyme. Our results indicate that the fluorescence of AW of hirudin 1–47 in the Y3AW–thrombin complex is strongly quenched, possibly because of the presence of two structural water molecules at the hirudin–thrombin interface that can promote the nonradiative decay of AW in the excited state. The data herein reported demonstrate that the incorporation of AW can be of broad applicability in the study of protein folding and protein–protein interaction.
Evaluation of Kangaroo Aortic Valved Conduits in a Juvenile Sheep Model: Preliminary Findings

Background: Biological heart valve substitutes, manufactured from either porcine or bovine tissue, have been in use for more than 30 years. Despite low thrombogenicity and excellent performance, bioprosthetic heart valves tend to degenerate and calcify early in young patients because of patient and valve related factors. The aim of this study was to examine the calcification behavior of glutaraldehyde‐preserved kangaroo heart valves in a juvenile sheep model. Methods: Porcine (n = 10) and kangaroo (n = 10) valved conduits were implanted in the descending aortic position of juvenile sheep and retrieved after 6, 8, and 12 months. Retrieved valved conduits were examined for morphological changes and calcification of the valve tissue, using Von Kossa's stain technique and atomic absorption spectrophotometry. Results: Structural valve deterioration, characterized by increased stiffness and severe calcification, occurred in 100% of the porcine conduits within 4 months. Kangaroo valve leaflets were significantly (p > 0.001) less calcified at 6 months (3.39 ± 1.80 μg/mg), 8 months (5.86 ± 4.57 μg/mg), and at 12 months (14.38 ± 6.72 μg/mg), compared to porcine valves at 3 months (176.45 ± 42.88 μg/mg) and at 4 months (154.67 ± 52.67 μg/mg). Porcine aortic wall tissue was more calcified (118.24 ± 42.86 μg/mg) than kangaroo aortic wall tissue (79.55 ± 26.40 μg/mg). Conclusions: Kangaroo heart valves calcify less than porcine heart valves. These findings suggest that a different donor valve tissue has a lower calcification potential probably due to a difference in the morphological ultrastructura. This could result in improved long‐term durability of kangaroo heart valves.
Environmental burden of acute respiratory infection and pneumonia due to indoor smoke in Dhading.

BACKGROUND ARI and pneumonia is one of the major public health problems in Nepal which always ranks highest position among the top ten diseases. One of the risk factor of ARI and pneumonia is indoor smoke from kitchen where primary source of cooking is solid biomass fuel. This study was carried out in order to estimate the burden of ARI and pneumonia due to indoor smoke. ARI and pneumonia was chosen as it is one of the significant public health problem among under five children in Nepal and responsible for high number of premature deaths. METHODS A cross-sectional study was conducted in Dhading district. Multistage cluster sampling technique was used for data collection considering ward as a cluster. The environmental burden of ARI and pneumonia due to indoor smoke was calculated using the WHO Environmental Burden of Disease Series. RESULTS About 87 percent of households were using solid biomass fuel as a primary source of fuel. The under five children exposed to solid fuel use was 41313. The total 1284 Disability Adjusted Life Years were lost due to ARI and pneumonia and about 50 percent of it was attributed by Indoor smoke in household. CONCLUSIONS The solid biomass fuel was primary source of energy for cooking in Dhading district which is attributing about 50 percent of burden of ARI and pneumonia among under five children.
Glycogenosis Due to Liver and Muscle Phosphorylase Kinase Deficiency

Summary: A four-year-old Israeli Arab boy was found to have glycogen accumulation in both liver and muscle without clinical symptoms. Liver phosphorylase kinase (PK) activity was 20% of normal, resulting in undetectable activity of phosphorylase a. Muscle PK activity was about 25% of normal, resulting in a marked decrease of phosphorylase a activity.Two sisters showed a similar pattern, whereas one brother had normal PK activity. The patient's liver protein kinase activity was normal. Addition of exogenous protein kinase did not affect PK activity, whereas exogenous PK restored phosphorylase activity to normal.These findings indicate that these patients are affected by a rare variant of PK deficiency, which involves both muscle and liver and which apparently is not sex linked. It is possible that this defect represents an unusual mutation of a subunit of the phosphorylase kinase enzyme.Speculation: Various mutations of the gene coding for phosphorylase kinase are located on different chromosomes, leading to specific tissue involvements and different modes of inheritance.
Pelvic and hindlimb musculature of Tyrannosaurus rex (Dinosauria: Theropoda)

In this article, we develop a new reconstruction of the pelvic and hindlimb muscles of the large theropod dinosaur Tyrannosaurus rex. Our new reconstruction relies primarily on direct examination of both extant and fossil turtles, lepidosaurs, and archosaurs. These observations are placed into a phylogenetic context and data from extant taxa are used to constrain inferences concerning the soft‐tissue structures in T. rex. Using this extant phylogenetic bracket, we are able to offer well‐supported inferences concerning most of the hindlimb musculature in this taxon. We also refrain from making any inferences for certain muscles where the resulting optimizations are ambiguous. This reconstruction differs from several previous attempts and we evaluate these discrepancies. In addition to providing a new and more detailed understanding of the hindlimb morphology of T. rex—the largest known terrestrial biped—this reconstruction also helps to clarify the sequence of character‐state change along the line to extant birds. J. Morphol. 253:207–228, 2002. © 2002 Wiley‐Liss, Inc.
Risk Factors for Progression of Early Age-Related Macular Degeneration in Koreans

ABSTRACT Purpose: To identify risk factors for the progression of early age-related macular degeneration (AMD) in Koreans. Methods: This study was conducted at a health-screening center and followed a prospective cohort study design. Of 10,890 participants older than 50 years, 318 (2.92%) presented with early AMD. Among these 318 participants, we re-examined 172 participants after a mean duration of 4.4 years. Progression was defined by the Age-Related Eye Disease Study (AREDS) simplified AMD severity scale. Multivariable logistic regression was used to examine associations between AMD progression and baseline physical, demographic, behavioral, and ocular characteristics. Results: Of the 172 participants with early AMD who were re-examined, 34 (19.8%) had progression. Multivariable analyses revealed that current smoking (odds ratio, OR, 7.0, 95% confidence interval, CI, 1.4–34.4, adjusted for age, alcohol consumption, body mass index, BMI, blood pressure, BP, total cholesterol, and high density lipoprotein, HDL, cholesterol) and hypertension (OR 10.3, 95% CI 1.9–55.7, adjusted for age, smoking status, alcohol consumption, BMI, total cholesterol, and HDL cholesterol) were independently associated with progression of early AMD. Additionally, the presence of a central drusen lesion within one-third disc diameter of the macula (age-adjusted OR 4.8, 95% CI 1.3–17.6) and 20 or more drusen (age adjusted OR 7.8, 95% CI 2.5–24.0) were independently associated with progression of early AMD. Conclusion: Current smoking, hypertension, central drusen location, and increasing number of drusen were associated with an increased risk of early AMD progression in Koreans.
Patient pain and tissue trauma during syringe procedures: a randomized controlled trial.

OBJECTIVE To investigate the relationship of needle control to tissue trauma and hemorrhage during syringe procedures. METHODS Forty-seven subjects with a palpable knee effusion underwent needle and syringe aspiration. Subjects were randomized to the conventional syringe or a safety technology, the reciprocating procedure device (RPD). This trial was registered at clinicaltrials.gov. Pain was measured with the Visual Analog Pain Scale (VAPS). Cell count, crystal examination, culture, and aspirated fluid volume were determined. Red blood cell (RBC) counts were used to measure blood in aspirated fluid. RESULTS Patient pain during the syringe procedure significantly predicted blood (RBC) in aspirated fluid (r = 0. 53, p = 0.001). When compared to the conventional syringe, the RPD safety device reduced blood in aspirated fluid by 66.7% (RBC, 10(3)/ml: RPD 8.9 +/- 11.4; syringe 26.7 +/- 90.2; p 0.01), reduced patient pain by 73.9% (VAPS: RPD 1.68 +/- 2.34; syringe 6.44 +/- 2.86; p < 0.01), and improved fluid aspirate yield by 132% (aspirate volume: RPD 20.9 +/- 19.7 ml; syringe 9.00 +/- 6.58 ml; p < 0.01). CONCLUSION Inadequate control of needle and syringe during physician-performed syringe procedures is an important cause of trauma to patient tissues resulting in hemorrhage, increased patient pain, and decreased aspirate yield. The RPD -- a safety device that improves needle control and decreases needle trauma to tissues -- reduces hemorrhage and improves the safety, outcome, and aspirate yield of physician-performed syringe procedures.