Miracle-dz/UniFAR-FTUs huggingface dataset:
Thirty-month relapse trajectory cluster groups among adolescents discharged from out-patient treatment.

AIMS To identify adolescent relapse trajectory groups following discharge from out-patient substance abuse treatment. DESIGN, SETTING AND PARTICIPANTS Adolescents aged 12-18, who were assigned randomly to one of five out-patient interventions (n = 563) in four United States communities and followed-up 3, 6, 9, 12 and 30 months post-intake. OUTCOME MEASURES Self-report measures of days using any alcohol or other drugs (AOD), days of alcohol use, days of cannabis use, days of heavy use, days of crack/cocaine use, days of heroin/opiate use, days AOD use interfered with responsibilities and days in a controlled environment. FINDINGS Adolescents can be grouped empirically into five relapse trajectories over 30 months following out-patient treatment: (a) low AOD use with limited days in a controlled environment; (b) low AOD use with high days in a controlled environment; (c) moderate/decreasing AOD use; (d) increasing AOD use; and (e) consistently high AOD use. CONCLUSIONS There was considerable heterogeneity in the relapse trajectories, varying by the initial response to treatment, the stability (versus increase/decrease) of the response and an interaction with time in a controlled environment. Cannabis and alcohol were the two main substances involved, although the two groups with the poorest trajectories had increasing levels of cocaine, opiate and other substance use at the 30-month follow-up. This study demonstrates the chronicity of substance use even among a subgroup of adolescents and the importance of studying more complex longitudinal patterns of recovery.
Effectiveness of Prevention of Mother-To-Child Transmission (PMTCT) of HIV infection Program in Lubumbashi, Democratic Republic of the Congo

Objective: The World Health Organization (WHO) recommends that countries adopt more effective antiretroviral regimens to enhance the effectiveness of the prevention of mother-to-child transmission of HIV infection (PMTCT). The present study aimed at assessing the effectiveness of PMTCT program implemented in Lubumbashi, Democratic Republic of the Congo (DRC). Methods: A cohort study was conducted in which 273 pairs of HIV-infected pregnant women (mean age: 25 ± 5 years) and their newborns participated. They were followed-up at 15 medical settings from September 2004 through December 2009 in Lubumbashi, DRC. PMTCT intervention consisted of oral administration of Nevirapine in intra partum and the association Lamivudine- Zidovudine for 5 days in post-partum to the mothers, whereas the newborns received 0.6 ml of Nevirapine within 72 hours after birth, and then 1.2 ml oral Zidovudine twice a day for 7 days. The effectiveness of the PMTCT was evaluated by considering the rate of mother-to-child transmission of HIV after delivery. Findings: Overall maternal HIV prevalence rate was 4.6%. HIV testing in infants at birth was 8.8%. In addition, a 47% increase of CD4+ cell count was noted (280 at baseline and 411 after delivery) in mothers thanks to the antiretroviral therapy (ART). Conclusion: Results from this study, the first to assess the effectiveness of PMTCT in DRC, showed reduced rates of MTCT at birth when compared to the national rate (15-20%), suggests that the PMTCT program implemented in Lubumbashi might be a useful anti-HIV/AIDS public health intervention in the country.
Expression analysis and molecular targeting of cyclin-dependent kinases in advanced melanoma

A major focus of melanoma research continues to be the search for genes/proteins that may be suitable targets for molecular therapy of primary and metastatic melanoma. In line with this effort, the objective of the study presented herein was to determine whether interfering with cell cycle progression and in particular, the expression and function of select cyclin-dependent kinases, would impair the biological features of advanced melanoma. We provide data, which document that unlike nevi and melanoma in situ, primary and metastatic melanomas express high levels of CDK2, CDK1, and CDK5. Furthermore, we present the results of in vitro and preclinical in vivo studies, which demonstrate that treatment with a small-molecule cyclin-dependent kinase inhibitor that selectively blocks the function of CDK2, CDK5, CDK1, and CDK9, leads not only to inhibition of melanoma cell proliferation and apoptosis of melanoma cells, but also impairs the growth of human melanoma xenografts.
Prevalence and Identification of Major Ixodid Tick Genera of Cattle in Dangila District, Awi Zone, North West Ethiopia

: A cross- sectional study was conducted in Dangila District, Awi zone, from November, 2014 to April, 2015 to estimate the prevalence of major ixodid ticks on cattle and to identify the prevalent ticks to the genera level. Study animals were selected randomly. Out of the total of 384 cattle examined, 216(56.2%) were found to be infested by one or more ticks. About 864 adult ticks were collected from the animal body parts, preserved with70% alcohol and were identified to genera level by using stereo-microscope. From the total ticks collected, four genera’s namely; Amblyomma, Boophilus, Rhipicephalus and Hyalomma were identified and account for 37.5, 25.0, 23.1 and 14.4%, respectively. From different variables (sex, age, breed and body condition), only body condition was statistically significant with tick infestation (p< 0.05). The prevalence of tick infestation was was found highest in poor body condition animals (62.9%) while in medium and good body condition, it was found (59.4%) and (41.2%), respectively. In logistic regression analysis only body condition has shown statistical significance. The odd of the infestation in poor body condition was 2.4 times higher than in good body condition animals. It has also been evident that the favorable predilection sites of Amblyomma tick were ventral body parts and perineum region. Boophilus preferred dewlap, udder/scrotum, belly, leg, head and perineum. Rhipicephalus had a strong affinity for perineum, dewlap, udder/scrotum, tail tips and ears. For Hyalomma the perineum region, udder/scrotum and under tail were its hiding sites. From this study we can make a conclusion that the prevalent ticks could also be responsible for transmission of tick borne diseases in addition to their physical damage to the skin. Therefore, further studies should be carried out on tick burden and tick borne diseases.
Medical clearance and screening of psychiatric patients in the emergency department.

OBJECTIVES To study the frequency of medical complaints and need for routine ED medical, laboratory, and toxicologic clearance for patients presenting with psychiatric chief complaints. METHODS A retrospective, observational analysis of psychiatric patients seen in an urban teaching hospital ED over a 2-month period was performed. The individual sensitivities of history, physical examination, vital signs, and complete blood counts and chemistry panels for identifying medical problems were determined. The sensitivities and predictive values of patient self-reporting of recent illicit drug and ethanol use were also determined. RESULTS 352 patients were seen with psychiatric chief complaints. A complete data set was available for 345 patients (98%). Of those with complete data, 65 (19%) had medical problems of any type. History, physical examination, vital signs, and laboratory testing had sensitivities of 94%, 51%, 17%, and 20%, respectively, for identifying these medical problems. Screening without universal laboratory testing would have missed 2 asymptomatic patients with mild hypokalemia. Patient self-reporting had a 92% sensitivity, a 91% specificity, an 88% positive predictive value (PPV), and a 94% negative predictive value (NPV) for identifying those with a positive drug screen, and a 96% sensitivity, an 87% specificity, a 73% PPV, and a 98% NPV for identifying those with a positive ethanol level. CONCLUSION The vast majority of medical problems and substance abuse in ED psychiatric patients can be identified by initial vital signs and a basic history and physical examination. Universal laboratory and toxicologic screening of all patients with psychiatric complaints is of low yield.
GAIT CHANGES IN ADULT ONSET HEMIPLEGIA

Multiple parameters of gait were evaluated in 50 adult acquired hemiplegic patients and 30 control patients with no history of gait abnormality and no deviation from normal gait by observational analysis. Findings in the hemiplegic group include: 1) increase in the proportion of the gait cycle spent in stance and double-limb support phases in both the normal and affected limb; 2) consistent deviation from normal gait pattern by observation and objective pattern analysis; 3) abnormal phasic activity of specific muscles and muscle groups in the affected limb; and 4) a consistent electrogoniometric deviation from normal joint ankle progression in the affected hip, knee and ankle. These data lend credence to the hypothesis that gait deviation in adult acquired hemiplegia follows a consistent pattern varying with the severity of central nervous system involvement. These data also provide a baseline from which to measure therapeutic intervention in this complex patient population.
LONGITUDINAL CHANGES IN THE SOCIAL BEHAVIOR OF CHILDREN HOSPITALIZED FOR SCHIZOPHRENIA AS ADULTS

Childhood public school records of 23 nonmigratory, hospitalized schizophrenic adults were compared with those of 69 matched control children presumed to have become normal adults. The records were analyzed by systematically coding the teachers' annual comments, focusing on longitudinal changes in social and emotional behavior. As a group the children destined to be schizophrenic adults behaved differently in school than other children. However, there was a wide range of deviation patterns and only about one-half of the preschizophrenics appeared to be distinguishable in childhood. With regard to a theory of schizophrenia, it appears that the social deviations which culminate in hospitalization are progressive over time. Whereas few of the preschizophrenic children were behaviorally distinguishable in early childhood, deviation was clear in about one-half of them by early adolescence, a crucial period for social reality testing and the development of an adult sense of social competence. During this period the boys became more irritable, aggressive, negativistic, and defiant of authority but not more introverted. By contrast, the girls became more compliant, shy, and introverted. In the rest of the preschizophrenics, deviations must not have become salient until after they left school. It is recommended that more research attention and preventive mental health action be directed to the late childhood and adolescent periods, in order to help boys develop an amiable orientation to social experience and control over aggressive impulses and to help girls to achieve emotional independence and a confident, outgoing social attitude.
Thrombosis risk and survival in cancer patients with elevated C‐reactive protein

Summary. Background: The incidence of venous thromboembolism (VTE) is increased among cancer patients. Objective: We assessed serum levels of C‐reactive protein (CRP) in order to study their prognostic significance for VTE and survival in the prospective observational Cancer and Thrombosis Study (CATS). Patients and methods: This study includes patients with recently diagnosed cancer or progression of disease after remission. Occurrence of VTE and information on the patients’ anti‐cancer‐treatment are recorded. Observation ends with occurrence of objectively confirmed VTE, death or after 2 years. CRP levels were determined by an immunonephelometric method. Results: We included 705 consecutive patients with solid tumors. During the observation period, VTE occurred in 43 (6.1%) patients and 413 (58.6%) died. The cumulative probability of VTE was 6.6% after 1 year. In univariate analysis, CRP (as metric variable, per double increase) was associated with VTE [hazard ratio (HR) 1.2, 95% confidence interval (CI) 1.1–1.3 P = 0.048]. However, in multivariable analysis including chemotherapy, surgery and radiotherapy, metastasis, cancer‐site and sP‐selectin the association with VTE (HR 1.0, 95% CI 0.9–1.2 P = 0.932) was no longer observed. CRP was clearly associated with worse survival probability with a HR of 1.3 (95% CI 1.2–1.3, P < 0.0001) in multivariable analysis. The cumulative survival after 12 months was 43% in patients with CRP above the 75th percentile (1.8 mg dL−1) and 82% in those below the 75th percentile. Conclusions: In cancer patients elevated CRP was not independently associated with VTE. CRP was significantly associated with worse survival.
Comparison of associations of outcomes after stroke with estimated GFR using Chinese modifications of the MDRD study and CKD-EPI creatinine equations: results from the China National Stroke Registry.

BACKGROUND The CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine equation estimates glomerular filtration rate (GFR) more precisely than the MDRD (Modification of Diet in Renal Disease) Study equation. The risk implications of this equation have been compared with the MDRD Study equation in different demographic and clinical characteristics. However, whether a Chinese modification of this equation performs better than a Chinese modification of the MDRD Study equation in risk prediction in Chinese patients with stroke is unknown. STUDY DESIGN Prospective cohort study, China National Stroke Registry. SETTING & PARTICIPANTS 15,791 consecutive patients with stroke enrolled from September 2007 to August 2008; follow-up time, 1 year. PREDICTOR Estimated GFR (eGFR) and eGFR categories computed using Chinese modifications of the MDRD Study and CKD-EPI creatinine equations. OUTCOMES All-cause mortality, recurrent stroke, stroke disability, combined end point of stroke or death. MEASUREMENTS GFR was estimated by Chinese modifications of the MDRD Study (eGFRMDRD(CN)) and CKD-EPI (eGFRCKD-EPI(CN)) equations. RESULTS The median value for eGFRCKD-EPI(CN) was higher than that for eGFRMDRD(CN) (87.3 vs 82.5 mL/min/1.73 m(2); P<0.001). 22.8% of patients were reclassified by the CKD-EPI China equation (11.5% [1,818/15,791] to a higher eGFR category, and 11.3% [1,789/15,791], to a lower eGFR category). Of patients with eGFRMDRD(CN) of 60-89 and 30-59 mL/min/1.73 m(2), 18.3% (1,299/7,090) and 18.4% (422/2,296) were reclassified upward to a higher eGFR category, respectively, reducing the CKD prevalence from 16.4% to 14.2%. Net reclassification improvement favored the Chinese modification of the CKD-EPI equation for the prediction of all-cause mortality, stroke recurrence, death, or stroke recurrence and stroke disability (net reclassification improvements of 0.05, 0.03, 0.04, and 0.1, respectively; all P<0.01). LIMITATIONS Relatively short follow-up time and no measurement of albuminuria. CONCLUSIONS Our findings suggest that a Chinese modification of the CKD-EPI equation may improve risk prediction of all-cause mortality, stroke recurrence, death or stroke recurrence and stroke disability more than a Chinese modification of the MDRD Study equation in Chinese stroke patients.
The impact of high- or low-fat cafeteria foods on nutrient intake and growth of rats consuming a diet containing 30% energy as fat.

The objective of this study was to determine the impact of high-fat and low-fat cafeteria foods on energy intake and body composition of growing rats. Two sets of 30 male Sprague-Dawley rats weighing either 90 g or 280 g, were each divided into two groups of eight and two groups of seven animals, matched for average weight. All animals were offered a semi-purified diet containing 30% kJ fat. After ten days, initial body composition, carcass energy and serum lipids, insulin and glucose were determined in seven rats from each age group. Seven rats in each age group continued to receive the semi-purified diet ad libitum, eight received semi-purified diet plus one high-fat cafeteria food each day and eight received semi-purified diet plus one low-fat cafeteria food each day. After 38 days, body composition, efficiency of energy retention and serum lipids, insulin and glucose were determined. Food and energy intakes were greater for rats offered cafeteria foods compared with controls. Those given low-fat foods ate the greatest quantity of food but those fed high-fat foods had the highest energy intake. High-fat foods increased fat intake to approximately 43% of energy. Low-fat foods decreased fat intake to approximately 24% kJ. There was no effect of treatment on weight gain or lean body mass of either age group. Young rats fed low-fat cafeteria foods had less body fat than their controls. There was no significant increase in body fat content of rats fed high-fat cafeteria foods. (ABSTRACT TRUNCATED AT 250 WORDS)
Omalizumab: an anti-immunoglobulin E antibody for the treatment of allergic respiratory diseases

Immunoglobulin E (IgE) is central to the development of allergic diseases. Cross-linking of cell-bound IgE by the allergen leads to the initiation of the inflammatory cascade. Omalizumab, an anti-IgE antibody, forms complexes with free IgE, thereby inhibiting the allergic reaction before its commencement. A survey of the clinical trials performed on omalizumab indicated that this anti-IgE antibody is efficacious and well tolerated in the treatment of separate and concomitant asthma and rhinitis. In patients with poorly controlled asthma, omalizumab reduced the asthma exacerbation and emergency visit rate, along with improving the quality of life. The improvement in asthma control was associated with a reduction of inhaled and oral corticosteroids. Improved nasal symptom scores and a reduced need for antihistamines were observed in patients with allergic rhinitis. Omalizumab was also proven to be effective as an add-on therapy for concomitant asthma and rhinitis. In conclusion, omalizumab provides an integrated approach for the treatment and management of allergic respiratory diseases.
Sodium Hyaluronate in the Treatment of Hallux Rigidus. A Single-Blind, Randomized Study

Background: The purpose of this study was to evaluate the effectiveness and safety of intra-articular sodium hyaluronate (Ostenil®mini) compared to intra-articular triamcinolone acetonide (Trigon depot®) in the treatment of painful hallux rigidus. Methods: Thirty-seven patients (ages 40 to 80 years) with painful early stage hallux rigidus were enrolled in the study. One group received an intra-articular injection with 1.0 ml sodium hyaluronate (SH); the other received an intra-articular injection of 1.0 ml triamcinolone acetonide (TA). Patients were evaluated on days 0, 14, 28, 56 and 84. Effectiveness was measured using the following parameters: joint pain at rest or on palpation (VAS), with passive motion, and gait pain; AOFAS hallux metatarsophalangeal score; use of analgesics and global assessment of the treatment by the patient and investigator. Safety was evaluated by the outcome of tolerance to treatment and observation of adverse events. Statistical analyses were performed using the Chi-square test, Mann-Whitney U test, Wilcoxon test and Friedman test. Results: Thirty-seven patients (40 feet) were evaluated. Pain at rest or with palpation and pain on passive mobilization decreased significantly in both treatment groups in comparison to baseline (p < 0.01), but no significant between-group differences were observed (p > 0.05). Gait pain improved substantially in the sodium hyaluronate group with significant differences compared to the triamcinolone group at days 28 and 56 (p < 0.05). The AOFAS total score improved significantly in the SH group compared to the TA group (p < 0.05). This was mainly due to improvements in the pain subscale. No between-group differences were seen regarding the use of analgesics. Global assessment of treatment by patients was good in both groups, and there was a significant between-group difference favoring SH when areas under the curves (AUC) were calculated (p < 0.05). Tolerance was good in both groups. Adverse events occurred in three patients. Conclusions: Intra-articular injections of sodium hyaluronate are effective and safe in decreasing hallux rigidus pain. The AOFAS scores in the SH group were significantly better than in the TA group.
Service use among patients with schizophrenia in psychoeducational multiple-family group treatment.

OBJECTIVES Outpatient and inpatient mental health service outcomes for outpatients with schizophrenia or schizoaffective disorder who received psychoeducational multiple-family group treatment were compared with outcomes for similar patients who received standard care. METHODS A total of 106 outpatients with schizophrenia or schizoaffective disorder who were receiving services from a large community mental health center were randomly assigned to receive standard care or standard care plus multiple-family group treatment. The two-year multiple-family intervention consisted of weekly group sessions designed to educate patients and their family members about the biological basis of mental illness and treatment, to improve illness management and coping skills, and to provide social support. The group sessions were conducted by two clinicians using a standardized protocol. Each multiple-family group included five to eight families and consumers. Service records for the year before and after random assignment to the study groups were examined in an intent-to-treat analysis. RESULTS During the year after random assignment to study groups, multiple-family group treatment was associated with a lower rate of psychiatric hospitalization than standard care. It was only marginally associated with lower use of crisis services, and it was not associated with the amount of outpatient service time. CONCLUSIONS The findings suggest that implementation of multiple-family group treatment in a capitated community mental health setting improves hospitalization outcomes without increasing the overall volume of outpatient mental health services.
Evaluation of the E‐test for susceptibility testing of the Bacteroides fragilis group

The susceptibilities of 100 clinical isolates belonging to the Bacteroides fragilis group to 9 antibiotics, i.e. ampicillin, piperacillin, ceftriaxone, cefotaxime, cefoxitin, imipenem, erythromycin, clindamycin, and metronidazole, were tested using a standard agar dilution method and the E‐test. Overall, 81% of the E‐test MICs were within one log2 dilution step of the agar dilution MICs and 95% were within two log2 dilution steps. The E‐test showed significantly lower MIC values than the agar dilution method for ampicillin, cefotaxime, and imipenem, and significantly higher MIC values for piperacillin, ceftriaxone, erythromycin, clindamycin, and metronidazole. However, this only resulted in minor discrepancies that did not change the susceptibility status. The E‐test is easy to perform and read, and the MIC values correlated well with the MICs obtained by the agar dilution method when testing susceptibility of the Bacteroides fragilis group.