Miracle-dz/UniFAR-FTUs huggingface dataset:
Miltefosine drug concerns.

TO THE EDITOR—We share the concern about treatment failure with miltefosine among one-fifth of the individuals with visceral leishmaniasis (VL) in Nepal [1] and feel it would also be desirable to monitor the contribution through the poor quality and/or usage of any counterfeit lots of miltefosine capsules being offered to kala-azar patients in Nepal. In Bangladesh, capsules of miltefosine without any active pharmaceutical ingredient had been inadvertently given for use in the national VL elimination program. An analysis of miltefosine content at the Netherlands Cancer Institute, Amsterdam, was astounding. While there was no active drug component in 2 different lots (with a claimed content of 10 mg and 50 mg miltefosine, respectively), no active miltefosine or other pharmacologic ingredient was present in generic lots being used by 5 VL patients under treatment at health centers. Furthermore, no miltefosine could be detected in whole blood samples drawn from those treated cases [2]. Moreover, the quantum of active ingredients of miltefosine being offered for VL in the field was assessed at the Netherlands Cancer Institute. In VL-endemic foci in Nepal or kalaazar foci elsewhere, which are lacking laboratories for sophisticated tests, only the point-of-care assays would be a suitable option. Recently a simple, rapid, and inexpensive colorimetric test was developed and evaluated for the detection of miltefosine in pharmaceutical products that were being used in the field.With such an analytical technique, it was possible to determine, both qualitatively and semiquantitatively, the presence or absence of miltefosine in pharmaceutical preparations [3]. Last but not least, to ensure constant availability of potent lots of miltefosine to VL patients throughout Nepal, their storage in cold and protection from light would be important, as any inadvertent exposures to a harsh environment could lower the quantum of their active ingredients, initiating therapeutic failures [1].
Sprint interval and traditional endurance training increase net intramuscular triglyceride breakdown and expression of perilipin 2 and 5

Increases in aerobic capacity and intramuscular triglyceride (IMTG) utilization are well‐described adaptations to endurance training (ET) and contribute to improvements in insulin sensitivity. Sprint interval training (SIT) also improves aerobic capacity and insulin sensitivity with a lower time commitment than ET. This study aimed to determine whether SIT also induces improvements in insulin sensitivity and net IMTG breakdown, and to investigate the underlying mechanisms. Six weeks of ET and SIT increased net IMTG breakdown during moderate‐intensity cycling, and improved insulin sensitivity. A greater concentration of lipid droplet‐associated proteins, perilipin 2 and perilipin 5, was observed following both training modes and contributes to the increases in net IMTG breakdown following training. The results suggest a novel mechanism for the training‐induced improvements in IMTG breakdown and insulin sensitivity, and clearly demonstrate that SIT is an alternative, time‐efficient training strategy that induces similar beneficial metabolic adaptations.
Force-velocity Relationship of Muscles Performing Multi-joint Maximum Performance Tasks

Abstract Manipulation of external loads typically provides a range of force, velocity, and power data that allows for modeling muscle mechanical characteristics. While a typical force-velocity relationship obtained from either in vitro muscles or isolated muscle groups can be described by a hyperbolic equation, the present review paper reveals the evidence that the same relationship obtained from maximum-performance multi-joint movements could be approximately linear. As a consequence, this pattern also results in a relatively simple shape of the power-velocity relationship. The parameters of the linear force-velocity relationship reveal the maximum force, velocity and power. Recent studies conducted on various functional movement tasks reveal that these parameters could be reliable, on average moderately valid, and typically sensitive enough to detect differences among populations of different physical abilities. Therefore, the linear force-velocity relationship together with the associated parabolic power-velocity relationship could provide both a new and simplified approach to studies of the design and function of human muscular system and its modeling. Regarding the practical applications, the reviewed findings also suggest that the loaded multi-joint movements could be developed into relatively simple routine tests of the force-, velocity- and power-generating capacity of the neuromuscular system.
Persistent and Recurrent Clostridium difficile Colitis

Abstract Clostridium difficile infection (CDI) is the most frequent cause of nosocomial diarrhea. It has become a significant dilemma in the treatment of patients, and causes increasing morbidity that, in extreme cases, may result in death. Persistent and recurrent disease hamper attempts at eradication of this infection. Escalating levels of treatment and novel therapeutics are being utilized and developed to treat CDI. Further trials are warranted to definitively determine what protocols can be used to treat persistent and recurrent disease.
Impact of dietary nitrate supplementation via beetroot juice on exercising muscle vascular control in rats

• Inorganic nitrate (NO3−) supplementation with beetroot juice (BR) in humans lowers blood pressure and the O2 cost of exercise and may improve exercise tolerance following its reduction to nitrite (NO2−) and nitric oxide (NO). • The effect of inorganic NO3− supplementation with BR on skeletal muscle blood flow (BF) and vascular conductance (VC) within and among locomotory muscles during exercise is unknown. • Inorganic NO3− supplementation with BR in rats resulted in lower exercising mean arterial pressure, lower blood [lactate], and higher total skeletal muscle hindlimb BF and VC during submaximal treadmill running. • The greater BF and VC was found in muscles and muscle parts containing primarily type IIb + d/x muscle fibres. • These data demonstrate that inorganic NO3− supplementation improves vascular control and elevates skeletal muscle O2 delivery during exercise predominantly in fast‐twitch type II muscles, and provide a potential mechanism by which NO3− supplementation improves metabolic control.
Pregnancy outcome in HIV seropositive women in Abakaliki, Nigeria

Objective : To study the seroprevalence and the effect of HIV infection on pregnancy outcome. Methods : From January 2000 to December 2004, 231 HIV seropositve women and 200 HIV seronegative matched groups from Abakaliki, Nigeria were recruited into a prospective study and followed until delivery. Results : The HIV seroprevalence was 5.4%. All the HIV seropositive women were asymptomatic and 12.7% (n=30) defaulted (including 80% of previously diagnosed cases) during the antenatal clinic follow-up and were excluded from further analysis. Majority (52.5%) of the seropositive women were at the peak (20-29 years) of their reproductive years and women of low parity were commonly affected. The seropositive women are significantly more likely than control to have recurrent vulvovaginitis, positive syphilis serology, perineal tear, postpartum haemorrhage, puerperal infection, birth asphyxia and increased perinatal mortality (P 0.05) in both groups. Delay in management contributed to maternal morbidity and perinatal mortality among the HIV seropositive mothers. Only six (2.9%) of the mothers and none of babies had antiretroviral therapy because of irregular supply in the hospital. Conclusion : There is need for the Obstetrician to ensure proper management of HIV seropositve mothers and for government to make the subsidized antiretroviral drugs widely available so as to reduce mother to child transmission of HIV virus. Keywords : HIV, pregnancy, outcome Orient Journal of Medicine Vol. 17(3&4) 2005: 25-30
Prognostic value of apolipoprotein B and A-I in the prediction of myocardial infarction in middle-aged men and women: results from the MONICA/KORA Augsburg cohort study

Aims To investigate the association between apolipoprotein B (apoB), A-I (apoA-I), the apoB/apoA-I ratio, and the incidence of coronary events. Methods and results Analysis included 1414 men and 1436 women aged 35–64 years without a prior coronary event who participated in the population-based MONICA Augsburg survey 1984–85 (median followed-up period 13 years). Incidence of fatal and non-fatal myocardial infarction, and sudden cardiac death was assessed using data of the MONICA/KORA Augsburg coronary event registry. During follow-up, 114 incident coronary events occurred in men and 31 in women. In multivariable analysis, an increase of 1 standard deviation in the serum concentration of apoB was associated with an increased risk of coronary events in men [hazard ratio (HR)=1.49; 95% confidence interval (CI); 1.25–1.78] and in women (HR=1.73; 95% CI; 1.32–2.27). By contrast, elevated concentrations of apoA-I were not associated with a significantly decreased risk of coronary events in either sex (HR=0.91). Furthermore, the predictive power of the apoB/apoA-I ratio was similar to that of the total cholesterol/HDL cholesterol ratio in men and women. Conclusion ApoB and the apoB/apoA-I ratio were strong predictors of coronary events in middle-aged men and women, whereas apoA-I did not add significantly to the estimation of future coronary risk.
B-Type Natriuretic Peptide: Biomarker of Persistent Pulmonary Hypertension of the Newborn?

Abstract Objective We assessed the utility of plasma B-type natriuretic peptide (BNP) in infants with persistent pulmonary hypertension of the newborn (PPHN) in the prediction of inhaled nitric oxide (iNO) requirement. Methods This prospective study involved neonates (gestational age ≥ 34 weeks) with PPHN and confirmatory echocardiographic findings. Plasma BNP was assayed once within 12 hours of meeting criteria for iNO requirements and twice every 24 to 48 hours thereafter. Results Infants requiring iNO (n = 14) had higher first BNP levels compared with others (n = 5) (455.5 ± 350.6 vs. 30.1 ± 25.3 ng/dL, p < 0.003). The sensitivity, specificity, positive and negative predictive values, and 95% confidence intervals (CI) for plasma BNP greater than 30 ng/dL to predict iNO requirement were 100 (85–100), 80 (37–80), 94 (80–94), and 100 (46–100)%, respectively. Corresponding values at a cut-off plasma BNP concentration greater than 85 ng/dL were 79 (62–79), 100 (53–100), 100 (79–100), and 63 (33–63)%, respectively. Conclusion BNP had excellent sensitivity and negative predictive value for iNO requirement and above 30 ng/dl maybe a useful prognostic biomarker in PPHN.
Effects of essential oils and touch on resistance to nursing care procedures and other dementia-related behaviours in a residential care facility

Abstract Essential oils of lavender, sweet marjoram, patchouli and vetiver were blended into an aqueous cream (content of essential oil blend = 3.5ml/100g aqueous cream) and 5g was gently massaged five times/day onto the bodies and limbs of 56 aged care facility residents (age range 70–92 years) with moderate to severe dementia. Participants were divided into two groups and following a baseline period in which there was first no massage at all, followed by massage with cream only, the groups received 4 weeks of massage with cream and essential oils or 4 weeks of massage with cream alone, and then received the other treatment for 4 weeks. Full data sets over the trial period were available for 36 participants. During the period of oil application, both groups showed a significant decrease in the average frequency and severity of dementia-related behaviours occurring at times other than during nursing care, compared to during the baseline and the ‘no oil’ periods. Resistance to nursing care procedures increased, however, for participants in one of the gr oups during the essential oil application period, which may reflect increased mental alertness and awareness caused by the oils. A possible increase in mental alertness and cognitive function was also suggested by a small but significant improvement in Mini Mental State Examination (MMSE) scores after the essential oil treatment period for the seven residents who scored above 0 on the MMSE.
Cardiac‐locked bursts of muscle sympathetic nerve activity are absent in familial dysautonomia

Patients with familial dysautonomia cannot regulate their blood pressure: on being tilted upright, their blood pressure and heart rate fall, but both can rise to high levels during emotional arousal. It is believed that their inability to regulate blood pressure is due to a lack of sensory endings that monitor blood pressure (baroreceptors). We recorded muscle sympathetic nerve activity in these patients for the first time, and showed that the neurones do not fire with a characteristic bursting pattern, rather tending to fire continuously during periods of emotional arousal. This suggests that the sympathetic neurones that control blood pressure are intact, but are deprived of the normal baroreceptor inputs that constrain them to fire in the intervals between heart beats.
The essential role of peripheral respiratory chemoreceptor inputs in maintaining breathing revealed when CO2 stimulation of central chemoreceptors is diminished

Central sleep apnoea is a condition characterized by oscillations between apnoea and hyperpnoea during sleep, which can have many serous health implications. Each ventilatory overshoot following an apnoea attenuates peripheral chemoreceptor input which, in turn, has the potential to cause a further apnoea. In a decerebrate, vagotomized, in situ rat preparation, we show that central apnoeas can be overcome both physiologically (with high peripheral CO2) and pharmacologically (with peripheral pituitary adenylate cyclase‐activating peptide). We also show that the central apnoeic threshold, i.e. the CO2 level at which the animal stops breathing, can be lowered by increasing peripheral chemoreceptor stimulation. These data suggest that stimulation of peripheral chemoreceptors may prevent central apnoeas, re‐affirming the peripheral chemoreceptors as possible therapeutic targets for some sleep apnea phenotypes.
Anti-helmínticos na toxocaríase experimental: efeito na recuperação de larvas de Toxocara canis e na resposta humoral

The effects of treatment with ivermectin, mebendazole or tiabendazole, during five days, on the larval recovery and immune response to Toxocara canis in experimental chronically infected mice were studied. Animals were bled, using the retro-orbital plexus between the 30th and the 270th days post-infection (Dpi), and sera were processed by ELISA technique for IgG antibodies using ES antigen from T. canis. On day 270 all the animals were killed for larval recovery in the central nervous system, liver, lungs and carcass. Immunoenzimatic test results indicate that 20 days after treatment (50 DPI) the anti-Toxocara IgG antibody level increased in the three treated groups and remained elevated until 270 DPI. It was observed a significative decrease in larvae recovered from treated animals when compared to infected but no treated animals with no parasitological cure. The present study shows that the three drugs used in the experiment have similar efficacy.
Living donor liver transplantation for early hepatocellular carcinoma: A life‐expectancy and cost‐effectiveness perspective

Cadaveric liver transplantation (CLT) is an excellent treatment for early hepatocellular carcinoma (HCC). Its use, however, is limited by the shortage of grafts, with up to 30% of patients developing contraindications to the procedure while waiting for a donor. Living donor liver transplantation (LDLT) has emerged as an alternative to overcome this limitation. We compared the consequences of LDLT versus CLT using a Markov model balancing the gains and losses in life expectancy among donors and recipients. For a 60‐year‐old recipient with a 70% 5‐year survival after transplantation, a 4% monthly drop‐out rate, and a donor with 1% mortality, LDLT became more effective than CLT after 3.5 months on the waiting list. These results varied with the probability of developing contraindications to transplantation, the survival after transplantation, and the donor's mortality. For a 12‐month delay saved on the waiting list, the gain in survival provided by LDLT compared with CLT ranged between 0 and 2.8 life years depending on survival after transplantation, time spent on the waiting list, and drop‐out rate. LDLT was cost‐effective (less than $50,000 per quality‐adjusted life year saved) in all scenarios of waiting lists exceeding 7 months, and this figure ranged from 2 to 16 months when varying the drop‐out rate. LDLT for early HCC offered substantial gains in life expectancy with acceptable cost‐effectiveness ratios when the waiting list exceeds 7 months. The gain in life expectancy and the cost‐effectiveness of LDLT were more dependent on the drop‐out rate and the outcome after transplantation than on donor's mortality.
Effect of physician orders for life-sustaining treatment documents on antimicrobial use and antimicrobial-resistant organism infections in nursing home residents.

TO THE EDITOR—Widespread emergence of antimicrobial-resistant organism (ARO) infections represents a growing public health crisis [1, 2]. ARO infections are associated with increased morbidity, mortality, and cost [3]. Risk factors include antimicrobial exposure and nursing home residence [4–6]. Physician Orders for Life-Sustaining Treatment (POLST) forms are widely used in our region to direct healthcare compatible with the preferences of patients who may face death in the ensuing year [7–10]. Antimicrobial use is one topic about which patients or their decision makers indicate treatment preferences. They may request (1) no antibiotics except if needed for comfort; (2) no invasive (intramuscular/intravenous) antibiotics; or (3) aggressive treatment. After institutional review board approval, we performed a retrospective pilot study to determine whether patients who ordered comfort-only antimicrobial use received fewer days of therapy than those who ordered invasive or aggressive therapy, and whether fewer days of therapy correlated with fewer ARO infections. The study population consisted of 44 residents from a single nursing home in La Crosse, Wisconsin, all of whom had specified preferences for antimicrobial use in a POLST document (22 comfortfocused and 22 cure-focused) and who died between 1 September 2007 and 31 March 2008. AROs were defined as methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci (VRE), and gram-negative rod (GNR) bacteria resistant to 1 or more of the following: third-generation cephalosporins (ceftazidime only for Pseudomonas aeruginosa), fluoroquinolones, or carbapenem antimicrobials. The cohorts were demographically and clinically similar (Table 1). Urinary tract infection was the most common indication for antimicrobial therapy. Two patients in the cure-focused cohort had documented new ARO infections (1 VRE and 1 GNR), compared with none in the comfort-focused cohort. Despite their disparate preferences regarding antimicrobial use, the cohorts’ mean days of antimicrobial therapy per 1000 patient-days were not significantly different (92.7 vs 98.2 days, respectively; P = .498). These findings surprised us because POLST was previously found to be highly effective in directing patient preferences regarding cardiopulmonary resuscitation (CPR) [7–10]. Although it is unclear why POLST forms did not affect antimicrobial use, on the basis of record review and discussions with nursing home providers we speculate that medical events that necessitate consideration of CPR
Toward Increased Patient Safety? Electronic Communication of Medication Information Between Nurses in Home Health Care and General Practitioners

This study investigates how the use of an electronic messaging system influences patient safety in the medication information process between home health care nurses and general practitioners. Focus group interviews and semistructured interviews with 34 nurses and general practitioners were applied, and the results show that using a messaging system in the clinical communication and collaboration led to nurses in home health care and general practitioners more easily connecting, medication information being more accessible and medication information having a higher quality. The results also revealed that the use of a messaging system caused errors in the medication information. However, according to the nurses in home health care and general practitioners, the overall conclusion was that medication information improved and thereby patient safety increased.
The role of Internet in the development of future software projects

Purpose – The Internet has evolved, prompted in part by new Web 2.0 technologies, to become a more widespread platform for interaction, communication, and activism. Virtual communities, or groups of people informally bound together by shared expertise, synthesise this Internet evolution and the Web 2.0 technology. Users increasingly want to engage online with one another and with organisations of all kinds. These novel Internet‐based technologies dominate the new business models of the digital economy giving companies radical new ways to harvest the talents of innovators working outside corporate boundaries. One of the most illustrative examples of this new trend is the Open Source Software (OSS) projects development. This paper aims to analyse the structure and topology of the virtual community supporting one of the most successfully OSS projects, Linux. The objective is to provide conclusions for being successful in the development of future virtual communities. As companies learn to manage these virtua.
Early warning indicators for HIV drug resistance in adults in South Africa at 2 pilot sites, 2008-2010.

BACKGROUND Approximately 5.2 million people in South Africa were infected with human immunodeficiency virus (HIV) by the year 2010, with just over 30% initiated on highly active antiretroviral therapy by 2011. With such numbers involved, the potential for the emergence of HIV drug resistance (HIVDR) is high. This study piloted early warning indicators (EWIs) for HIVDR at 2 clinics in South Africa. METHODS HIV-infected individuals aged ≥15 years and receiving antiretroviral drugs were enrolled into this cohort study between March 2008 and February 2010. All analyses were performed using the 2012 World Health Organization EWI score card. RESULTS A total of 1144 subjects were enrolled. Clinic A reached the target for 2 of the 5 EWIs but missed the desired target for on-time pill pickup, pharmacy stockouts, and virological suppression. Clinic B reached the target for 1 of 4 EWIs, namely, dispensing practices. Targets were missed for on-time pill pickup, retention in care, and virological suppression. Pharmacy stockouts could not be calculated at this site. CONCLUSIONS Actual performance against the levels that the pilot sites should reach to minimize HIVDR was low. Improvements in follow-up procedures, internal adherence support, monitoring for drug stockouts, and adherence are all aspects that need support to ensure that all records are complete. This pilot study may help to inform the South African government as EWI monitoring is implemented.
Partially non‐linear stimulation intensity‐dependent effects of direct current stimulation on motor cortex excitability in humans

• Application of 2 mA cathodal transcranial direct current stimulation for 20 min results in cortical excitability enhancement instead of inhibition. • Longer or more intensive stimulation does not necessarily increase its efficacy. • Short intracortical inhibition and facilitation are shifted towards excitability enhancement after both 2 mA anodal and cathodal stimulation. • I‐waves, input–output curves and cortical silent period are unaffected immediately after 2 mA stimulation.