Miracle-dz/UniFAR-FTUs huggingface dataset:
Non-Salmonella Bacteremia Among Seropositive Hiv Patients Attending Three Tertiary Hospital In Nasarawa State, Nigeria.

Background: Bacterial blood stream infections constitute a significant public-health problem and it is an important cause of morbidity and mortality in HIV infected patients. Little is known in developing countries regarding salmonella bacteraemia among HIV patients. The purpose of this study was to determine the bacterial pathogens causing blood stream infection among febrile adults attending three medical centers in Nasarawa State. Methods: A prospective cross-sectional study involving 346 consecutive, febrile adult patients admitted at three medical centers in Nasarawa State, was conducted. Demographic and other data were collected using standardized questionnaires. Blood culture was done followed by susceptibility testing using disc diffusion method. HIV testing was also performed as per Nigeria national algorithm and total white blood cell counts and CD4+ counts determined. Results: Of 346 febrile adult patients 33 (9.5%) had blood stream infections. The common isolates were Salmonella spp 13(39.4%), Escherichia coIi 8 (24.2%), Streptococcus pneumonia 5(15.2%), Staphylococcus aureus 4(12.1%), Citrobacter spp 1(3%), Streptococcus pyogenes 1(3%) and Kiebsiella pneumonia 1(3%). A total of 156 (45.1%) patients were HIV infected; of whom 12/1 56 (7.6%) were infected by non-typhoid Salmonella spp compared to 1/190 (0.5%) of non-HIV infected patients (RRR 11.2, p=0.029) infected with Salmonella typhi. HIV infected patients with bacteremia had significantly lower CD4+ count than those without bacteremia (median 28 vs. 88 cells/mI, p=0.01). Patients with salmonella bacteremia had significantly lower median of WBC than those with non-salmonella as well as those without bacteremia (median, 3.6 vs. 17.5 vs. 9.8x109, p0.0001). All Salmonella spp were sensitive to ceftriaxone and imipenem, while being 84%, 69.2%, 38% and 8% resistant to chloramphenicol, ampicillin, sulphamethaxazole/trimethoprim and ciprofloxacin respectively. Predictors of mortality were HIV infection (OR 2.3, p=0.005), Glasgow coma score of less than 15 (OR 3.4, p=0.0001) and night sweats (OR 2.4, p=0.014). Conclusion: Non-typhoid Salmonella spp that are highly resistant to common antibiotics are predominant cause of bacterial blood stream infection among HIV patients attending Three tertiary medical centers in Nasarawa State. Continuous surveillance and intervention strategies should be put in place to monitor and manage cases of bloodstream infections in HIV-positive patients in Nasarawa state.
Impact of Layover Length on Sleep, Subjective Fatigue Levels, and Sustained Attention of Long-Haul Airline Pilots

Long-haul airline pilots often experience elevated levels of fatigue due to extended work hours and circadian misalignment of sleep and wake periods. During long-haul trips, pilots are typically given 1–3 d off between flights (i.e., layover) to recover from, and prepare for, duty. Anecdotally, some pilots prefer long layovers because it maximizes the time available for recovery and preparation, but others prefer short layovers because it minimizes both the length of the trip, and the degree to which the body clock changes from “home time” to the layover time zone. The aim of this study was to examine the impact of layover length on the sleep, subjective fatigue levels, and capacity to sustain attention of long-haul pilots. Participants were 19 male pilots (10 Captains, 9 First Officers) working for an international airline. Data were collected during an 11- or 12-d international trip. The trips involved (i) 4 d at home prior to the trip; (ii) an eastward flight of 13.5 h across seven time zones; (iii) a layover of either 39 h (i.e., short, n = 9) or 62 h (i.e., long, n = 10); (iv) a return westward flight of 14.3 h across seven time zones; and (v) 4 d off at home after the trip. Sleep was recorded using a self-report sleep diary and wrist activity monitor; subjective fatigue level was measured using the Samn-Perelli Fatigue Checklist; and sustained attention was assessed using the psychomotor vigilance task for a personal digital assistant (PalmPVT). Mixed-model regression analyses were used to determine the effects of layover length (short, long) on the amount of sleep that pilots obtained during the trip, and on the pilots' subjective fatigue levels and capacity to sustain attention. There was no main effect of layover length on ground-based sleep or in-flight sleep, but pilots who had a short layover at the midpoint of their trip had higher subjective fatigue levels and poorer sustained attention than pilots who had a long layover. The results of this study indicate that a short layover during a long-haul trip does not substantially disrupt pilots' sleep, but it may result in elevated levels of fatigue during and after the trip. If short layovers are used, pilots should have a minimum of 4 d off to recover prior to their next long-haul trip. (Author correspondence: greg.roach@cqu.edu.au)
Dermatofibrosarcoma protuberans: Clinical series, national Danish incidence data and suggested guidelines

Abstract Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous sarcoma that frequently recurs locally, but rarely metastasizes. The purpose of this work is to present a clinical series of DFSP patients and national Danish incidence data in the period 2000–2012. Furthermore, the aim is to present guidelines on the management based on a review of the literature. Medical records of 26 consecutively treated patients at the Department of Plastic Surgery in Health Care Region Zealand were reviewed and histological specimens were reassessed. To investigate national Danish incidence in the period 2000–2012, data were extracted from the national pathology registry. Finally, a literature search was performed in Pubmed and Cochrane, and 23 major publications were reviewed. Studies on Mohs Micrographic surgery were excluded. All patients were treated with wide local excision (WLE) with a median margin of 2.8 cem and a median follow-up time of 36 months. We found a local recurrence rate of 4%. Our national incidence data were based on 374 patients. The overall incidence was 0.53 per 100,000 persons. The prevalence of DFSP in the age group 20–50 years was significantly higher than the group below 20 years (p < 0.0001). Surgery is the treatment of choice for primary DFSP, local recurrences, and metastases. If clear margins cannot be obtained by WLE or surgery is not an option because of unacceptable functional or cosmetic outcome, adjuvant radiotherapy or imatinib can be considered. Chemotherapy can be a final option if other treatments fail.
Protective effect of human granulocyte colony-stimulating factor on microbial infection in neutropenic mice

A purified human granulocyte colony-stimulating factor (hG-CSF) was studied for its protective effect on the induction of neutropenia and enhanced susceptibility to microbial infections in mice receiving cyclophosphamide (CPA). A severe reduction in peripheral blood neutrophils was induced 4 days after injection with 200 mg of CPA per kg although the level normalized rapidly thereafter. When mice were injected subcutaneously once a day with 2.5 micrograms of hG-CSF beginning on the day after CPA injection, the reduction was prevented markedly, even 4 days later. On the other hand, in mice receiving CPA 4 days prior to infection, a weakened resistance to intraperitoneal challenge with a strain of Pseudomonas aeruginosa was induced. This weakened resistance was dose-dependently restored to normal by four daily injections with hG-CSF. A daily dose of 1.0 microgram was required for complete restoration, although hG-CSF did not directly inhibit bacterial growth in vitro. In hG-CSF-treated mice, morphologically mature neutrophils migrated rapidly into the peritoneal cavities where bacteria were inoculated, followed by a rapid elimination of bacteria from the locality as compared with controls. In addition, the same treatment with hG-CSF was able to protect significantly against systemic infections caused by Serratia marcescens, Escherichia coli, Staphylococcus aureus, and Candida albicans. These data show the possibility that prophylactic therapy with hG-CSF may augment the resistance of immunocompromised patients to infections.
True "meaningful use": technology meets both patient and provider needs.

OBJECTIVES Voluntary patient uptake and use of electronic health record (EHR) features have been low. It is unknown whether EHRs fully meet needs of providers or patients with chronic diseases. STUDY DESIGN To explore in-depth user experiences, we conducted 6 focus groups: 3 of patients followed by 3 of providers discussing 2 key EHR components: the after-visit summary (AVS) and the patient portal (PP). Focus groups were audio-recorded, transcribed, and analyzed by 3 independent coders. METHODS Participants with moderate-to-severe asthma and prevalent comorbidities were recruited from 4 primary care and 2 asthma clinics serving low-income urban neighborhoods. Participants discussed their expectations and experience using the AVS and PP, and responded to prototype formats of these features. Additionally, one-on-one interviews were conducted with 10 patients without PP experience to assess their ability to use the system. RESULTS The 21 patient and 13 provider perspectives differed regarding AVS features and use. Patients wanted a unified view of their medical issues and health management tools, while providers wanted to focus on recommendations from 1 visit at a time. Both groups advocated improving the AVS format and content. Lack of awareness and knowledge about the PP was patients' largest barrier, and was traced back to providers' lack of PP training. CONCLUSIONS Our results underscore the importance of user-centered design when constructing the content and features of the EHR. As technology evolves, an ongoing understanding of patient and provider experiences will be critical to improve uptake, increase use, and ensure engagement, optimizing the potential of EHRs.
Determinants of visfatin in type 2 diabetes patients with diabetic kidney disease: Relationship to inflammation, adiposity and undercarboxylated osteocalcin

Abstract Background Visfatin is a proinflammatory molecule with possible actions on glucose metabolism. Interactions to bone metabolism and undercarboxylated osteocalcin (uOC) in diabetic patients (T2DP) with diabetic kidney disease (DKD) have not been reported. Materials and methods We included 51 incident T2DP with DKD. History, laboratory evaluation, anthropometry, visfatin, uOC were obtained. Fifteen T2DP without DKD were used as controls. Results Visfatin was similar in DKD patients and controls: 1.56(0.97–3.03) versus 2.04(1.08–3.21) ng/mL, p = 0.51. In controls, visfatin positively correlated with diabetes duration (r = 0.63, p = 0.01) and negatively with uOC (r = −0.57, p = 0.03). In multivariate regression, diabetes duration remained significant (p = 0.01). In patients with DKD, visfatin was positively linked to C reactive protein (r = 0.27, p = 0.05), tricipital skin fold (TSF) (r = 0.41, p = 0.004) and leukocytes (r = 0.37, p = 0.01); the latter two parameters predicted visfatin in multivariate model (p = 0.001). In normoalbuminuric patients, visfatin was linked to body mass index (r = 0.32, p = 0.04), waist circumference (r = 0.42, p < 0.0001), LDL cholesterol (r = 0.33, p = 0.03), serum glucose (r = 0.36, p = 0.03) and glycated hemoglobin (r = 0.41, p = 0.007); there was a trend towards negative correlation to uOC (r = −0.28, p = 0.07); only glycaemia remained significant in multivariate analysis (p = 0.04). Albuminuric patients displayed a positive correlation of visfatin to waist to hip ratio (r = 0.41, p = 0.04) and leukocytes (r = 0.56, p = 0.04); the latter remained significant in multivariate regression (p = 0.005). Conclusion The main determinant of visfatin in T2D patients with DKD is inflammation; in normoalbuminuric patients, a positive link to adiposity and altered glycemic control and a trend towards a negative correlation to uOC was observable; the latter relationship was evident in patients without DKD.
What Comes After the Prestige Disaster? An Entropic Approach to Modeling the Recurrence of Major Oil Tanker Spills in Galicia

A methodology is presented to investigate the recurrence of extraordinary events. The approach is fully general and complies with a canon of inference establishing a set of basic rationality requirements scientific reasoning should satisfy. In particular, we apply it to model the interarrival time between disastrous oil spills in the Galician coast in the northwest of Spain, one of the greatest risk areas in the world, as confirmed by the Prestige accident of November 2002. We formulate the problem within the logical probability framework, using plausible logic languages with observations to allow the appropriate expression of evidences. Therein, inference is regarded as the joint selection of a pair of reference and inferred probability distributions, which better encode the knowledge about potential times between incidents provided by the available evidences and other higher‐order information at hand. To solve it, we employ the REF relative entropy method with fractile constraints. Next, we analyze the variability of the joint entropic solution, as knowledge that a time has elapsed since the last recorded spill is added, by conditioning the evidences. Attention is paid to the variability of two representative parameters: the average reference recurrence time and an inferred characteristic probability fractile for the time to an event. In contrast with classical results, the salient consequence is their nonconstancy with the elapsed time and the appearance of a variability pattern indicating an observational memory, even under the assumption of one‐parameter exponential models, traditionally regarded as memoryless. Tanker accidentality is therefore dynamic, changing as time goes on with no further accidents. Generality of the methodology entails that identical conclusions would apply to hazard modeling of any other kind of extraordinary phenomena. This should be considered in risk assessment and management.
Outbreak of giardiasis associated with a community drinking-water source

SUMMARY Giardiasis is a common waterborne gastrointestinal illness. In 2007, a community giardiasis outbreak occurred in New Hampshire, USA. We conducted a cohort study to identify risk factors for giardiasis, and stool and environmental samples were analysed. Consuming tap water was significantly associated with illness (risk ratio 4·7, 95% confidence interval 1·5–14·4). Drinking-water samples were coliform-contaminated and a suspect Giardia cyst was identified in a home water filter. One well was coliform-contaminated, and testing indicated that it was potentially under the influence of surface water. The well was located 12·5 m from a Giardia-contaminated brook, although the genotype differed from clinical specimens. Local water regulations require well placement at least 15 m from surface water. This outbreak, which caused illness in 31 persons, represents the largest community drinking-water-associated giardiasis outbreak in the USA in 10 years. Adherence to well placement regulations might have prevented this outbreak.
Assesment of Genetic Diversity in Wheat Synthetic Double Haploids for Yield and Drought Related Traits Through Factor and Cluster Analyses

Wheat is an important cereal crop of the world and its productivity has been limited by abiotic stresses. An experiment was conducted at the Department of Plant Breeding and Molecular Genetics, Faculty of Agriculture, The University of Poonch Rawalakot, to assess the genetic diversity for drought tolerance in synthetic wheat double haploids. On the bases of cluster analyses, the genotypes were divided into five main groups. Highest genetic distance was observed between double haploid1 and double haploid 17. Maximum Eigen value was obtained by factor I followed by factor II while it remained minimum in factor V. From factors analysis and on the base of specific numbers larger than 1, five factors were identified and they all together justified 83.22% variation among the studied characters. Maximum variance 37.94 was observed by factor I, while factor II, III, IV and V showed 16.09, 12.11, 8.73, 8.34% variance.
Low dose radiation induced immunomodulation: Effect on macrophages and CD8+ T cells

Purpose: The aim of the present investigation was to study the effect of fractionated whole body low dose ionizing radiation (LDR) on the functional responses of T lymphocytes, their subpopulations and macrophages. Materials and methods: C57BL/6 mice were exposed to 4 cGy from a 60Co source, at 0.31 cGy/min, at 24 h intervals for 5 days (total dose 20 cGy). Phagocytic activity was measured by flow cytometry using Bioparticles® and nitric oxide generation was estimated by spectrophotometry. Proliferation of lymphocytes in response to concanavalin A (con A) and alloantigens was measured by 3H thymidine incorporation. Expression of cell surface markers was assessed by flow cytometric analysis of antibody labeled cells. Target cell killing by cytotoxic T cells (CTL) generated against allogenic cells was assessed by flow cytometry using PKH26 labeled target cells. Cytokines were estimated by enzyme linked immunosorbent assay. Results: Exposure to LDR enhanced nitric oxide secretion and phagocytosis. The expression of early activation antigen, CD69, was enhanced in CD8+ T lymphocytes concomitant with enhanced proliferation in response to con A. In addition, mixed lymphocyte reaction (MLR) and CTL response were augmented and secretion of interferon gamma (IFN-γ) was suppressed following LDR exposure. Conclusions: LDR exposure enhanced the function of macrophages and responses of CD8+ T cells in C57BL/6 mice.
Biometric study of the relationships between palmar neurovascular structures, the flexor retinaculum and the distal wrist crease

During surgical exposure of the carpal tunnel it is possible to injure the neurovascular structures closely related to the flexor retinaculum, such as the superficial palmar arch and the communicating branch between the ulnar and median nerves. Because of the importance of these structures and with the purpose of increasing knowledge of anatomical details concerning to their location, a biometric study was performed on the retinaculum and the communicating branch, and between the communicating branch and the distal wrist crease, as well as between the retinaculum and the superficial palmar arch. We dissected 56 hands from 28 Brazilian formalin‐preserved cadavers of both sexes (24 male) at the Federal University of São Paulo–Escola Paulista de Medicina, Brazil. The communicating branch was observed in 96.4% of cases and the superficial palmar arch in 78.6%. The communicating branch was found between the common palmar digital nerve of the 4th interosseous space (from the ulnar nerve) to the homonymous nerve of the 3rd interosseous space (from the median nerve). In males, the distance between the distal wrist crease and the site where the communicating branch originates from the ulnar component had an average of 33.9±5.5 mm on the right side and 30.2±8.2 mm on the left. The distance between the distal wrist crease and the junction of the communicating branch with the common palmar digital nerve of the 3rd interosseous space was 43.6±6.9 mm on the right and 40.2±6.2 mm on the left side. Conversely, in 14.8% of cases (1 female), the communicating branch was observed to emerge from the common palmar digital nerve of the 3rd interosseous space. The distance between the retinaculum and the superficial palmar arch in the axial line of the 4th metacarpal bone was on average 7.3±4.3 mm on the right and 8.3±3.5 mm on the left side. At the same level, the distance between the retinaculum and the communicating branch was 6.2±3.7 mm on the right side and 5.1±2.8 mm on the left. These results can be used as a reference during surgical procedures in the palmar region.
Exploring Geovisualization Symbology for Landscape Genetics

Landscape genetics, which considers genetic population structure in the context of spatially referenced parameters in the surrounding landscape, has been shown to be extremely useful for wildlife management. Unfortunately its widespread uptake beyond the research community is hampered due to a lack of effective communication of usable information in a suitable format for application by stakeholders such as wildlife regulators or managers. To improve the communication of suitable information, geovisualization of results should be facilitated in a comprehensible format for stakeholders without GIS or genetic expertise. While specialist applications exist, alternative accessible solutions do not provide adequate support for the visualization of multi‐attribute spatially referenced genetic population structure information. As a solution, we document our exploration for an appropriate symbology to communicate landscape genetic information through an accessible, web‐based interface. A full problem description, review of available technologies, development rationale, and discussion of the symbology exploration are provided.
Field trials with channel bit rates of 160 Gbit/s

We present two 8/spl times/170 Gbit/s DWDM/OTDM (1.28 Tbit/s) field transmission experiment both over more than 400 km in commercially operated legacy networks of France Telecom (FT) and Deutsche Telekom (DT), respectively. Conventional EDFA based amplification schemes as well as distributed Raman amplified systems are tested. For different levels of polarization mode dispersion due to different quality of the installed fibre infrastructure adaptive PMD compensation and polarization de-multiplexing is tested.
Down syndrome and acute lymphoblastic leukaemia

Acute lymphoblastic leukaemia in children with Down syndrome (ALL‐DS) is characterised by unique clinical and biological features. Notable among these are an absence of ALL in DS patients <1 year of age; a lower incidence of favourable and unfavourable chromosomal translocations; heightened sensitivity to methotrexate; and an increased propensity to infections. Although children with ALL‐DS have historically fared less well than their non‐DS counterparts (ALL‐NDS), recent data indicate that outcomes in ALL‐DS are now comparable with ALL‐NDS with risk‐adapted therapies, after adjusting for biological differences between the ALL‐DS and ALL‐NDS populations. Given the increased risk of ALL‐DS patients for treatment‐related toxicities, further intensification of therapy may not yield continued improvements in survival. Future investigations in the ALL‐DS population should focus on maintaining excellent outcomes while reducing treatment‐related complications through novel treatment strategies, such as the integration of targeted noncytotoxic agents.