Miracle-dz/UniFAR-FTUs huggingface dataset:
Increasing pressure ulcer rates and changes in delivery of care: a retrospective analysis at a University Clinic.

AIM To evaluate the relation between pressure ulcers and delivery of care. BACKGROUND No decrease of pressure ulcer rates could be recognised in acute hospital care, despite intensive efforts in prevention. Furthermore, reports show increasing rates. DESIGN Retrospective analysis of hospital data. METHODS The study included all inpatients from year 1 (2003/2004) and 4 (2006/2007) of the interdisciplinary decubitus project. Information on ulcers was recorded at admission, discharge and in case of new events. We analysed the effect of age, length of stay, operation and intensive care episode. In logistic regression, we used the existence of ulcers and the appearance of new ulcers as dependent variables. RESULTS Parallel to a decrease in the number of inpatients, age, length of stay and operation frequency rose between 2003 and 2007. Higher age, longer length of stay, operation, intensive care episode and year 4 raise the odds for ulcers in univariate and with exception of operation in multivariate analyses. With exception of operation and year 4, the same variables raise the odds for new ulcers, too. CONCLUSIONS The increase of pressure ulcer frequency could be related to changes in delivery of care. The adverse event pressure ulcer will become more important in hospital care. RELEVANCE TO CLINICAL PRACTICE There is no decrease in pressure ulcer rates, albeit enormous efforts in prevention. Hospital care has been facing changes in case mix. Age, length of stay and intensive care episodes are related to increasing ulcer rates at a University Clinic. Nursing management has to be aware of additional workload for pressure ulcer management in the future.
Dose‐response Study of 22‐Oxacalcitriol in Patients with Secondary Hyperparathyroidism

Abstract: The dose–response relationships and the safety of administering 22‐oxacalcitriol (OCT) to patients with secondary hyperparathyroidism (2HPT) under regular three‐times‐weekly hemodialysis (HD) were evaluated by double‐blind parallel group design. A total of 203 patients with 2HPT were randomly allocated into four groups, and 5 µg (Group L), 10 µg (Group M), or 15 µg (Group H) OCT, or placebo (Group P) was administrated at the end of every HD for 12 weeks. Reductions of intact‐parathyroid hormone (iPTH) concentration greater than 30% from baseline were observed in 7.7% of Group P as compared to 77.3% of the pooled OCT groups after 12 weeks of treatment (Mantel test: P < 0.001). Time‐trends (slopes) of log‐iPTH concentration calculated by least‐squares line fitting to each patient's data during treatment differed between Group P and the pooled OCT groups (t‐test: P < 0.001) and these iPTH slopes decreased dose‐dependently (linear trend by t‐test: P < 0.001). Slopes of serum calcium corrected for albumin (corrected‐sCa) concentrations also differed between Group P and the pooled OCT groups (t‐test: P < 0.001), and increased dose‐dependently (linear trend by t‐test: P < 0.0001). Serum phosphorus and Ca × P product increased significantly only in high dose groups. Slopes of log(iPTH) and corrected‐sCa concentrations were reciprocally related. Most adverse events were hypercalcemia and dose‐related, but occasionally comprised pruritus or increased serum creatinine phosphokinase. These results indicate that OCT produced a strong and dose‐dependent suppression of PTH and an increase of corrected‐sCa concentration in patients with 2HPT. The recommended initial dosages of OCT would appear to be 5 µg when pretreatment iPTH concentrations are less than 500 pg/mL, and 10 µg when greater than 500 pg/mL for safe and effective treatment. As in the case of PTH, calcium and phosphorus showed dose‐dependent increases. It is therefore essential to take precautions as to possible increases in calcium and phosphorus.
Gastrointestinal damage associated with the use of nonsteroidal antiinflammatory drugs.

BACKGROUND Long-term use of nonsteroidal antiinflammatory drugs (NSAIDs) may lead to inflammation of the small intestine associated with occult blood and protein loss. The aim of this study was to investigate the prevalence and structural correlates of this enteropathy. METHODS We examined the stomach, duodenum, and small intestine of 713 patients post mortem. Of these patients, 249 had had NSAIDs prescribed during the six months before death and 464 patients had not. All visible small intestinal lesions were removed for histologic examination, and specific etiologic factors were sought. The prevalence of nonspecific small-intestinal ulcers and ulcers of the stomach and duodenum was compared in the two groups of patients. RESULTS Nonspecific small-intestinal ulceration was found in 21 (8.4 percent) of the users of NSAIDs and 3 (0.6 percent) of the nonusers (difference, 7.8 percent; 95 percent confidence interval, 5.0 to 10.6 percent; P less than 0.001). Three patients who were long-term users of NSAIDs were found to have died of perforated nonspecific small-intestinal ulcers. Ulcers of the stomach or duodenum were found in 54 (21.7 percent) of the patients who used these drugs and 57 (12.3 percent) of those who had not (difference, 9.4 percent; 95 percent confidence interval, 3.9 to 15.1 percent; P less than 0.001). CONCLUSIONS Patients who take NSAIDs have an increased risk of nonspecific ulceration of the small-intestinal mucosa. These ulcers are less common than ulcers of the stomach or duodenum, but can lead to life-threatening complications.
Colonization of Butchers with Livestock‐Associated Methicillin‐Resistant Staphylococcus aureus

Reports have documented colonization of swine in Europe, North America and more recently in China with livestock‐associated methicillin‐resistant Staphylococcus aureus (LA‐MRSA). Contamination of pig farmers, veterinarians and abattoir workers with these strains has been observed. However, although contamination levels of 10% of retail pork were reported from the Netherlands and Canada, there are limited data of contamination rates of workers handling raw meat. We investigated the rates of MRSA contamination of local butchers working in wet markets, where recently slaughtered pigs are cut up. Nasal swabs collected from 300 pork butchers at markets throughout Hong Kong were enriched in brain heart infusion broth with 5% salt and cultured on MRSASelect®. Isolates were confirmed as Staphylococcus aureus and susceptibility testing performed. The presence of mecA was confirmed, SCCmec and spa type determined and relatedness investigated by PFGE. Subjects completed a questionnaire on MRSA carriage risk factors. Seventeen samples (5.6%) yielded MRSA, 15 harbouring SCCmec IVb. Ten strains were t899 (CC9), previously reported from local pig carcasses. Five strains were healthcare associated: SCCmec type II, t701(CC6), colonizing two subjects at the same establishment, and single isolates of t008 (CC8), t002 (CC5) and t123 (CC45). The remaining isolates were t359 (CC97), previously reported from buffaloes, and t375 (CC5), reported from bovine milk. None of these butchers reported recent hospitalization or a healthcare worker in the family. Two had recently received antibiotics, one for a skin infection. Four reported wound infections within the last year. All were exposed to meat for >9 h per day. Carriage of MRSA was higher in butchers than in the general community. Although five strains were probably of healthcare origin, the high incidence of t899 (CC9) suggests that cross‐contamination from pork occurs frequently. Washing of hands after touching raw pork is advised.
Analysis and architecture design for high performance JPEG2000 coprocessor

The high throughput and less internal memory requirement are two key issues of integrating the JPEG2000 encoding system. For this bottleneck of integration, a QCB (quad code block)-based DWT method is proposed to achieve more efficient parallelism in the JPEG2000 coprocessor. Based on the QCB-based DWT engine, the code blocks can be completely generated after every fixed time slice, recursively. Thus, the overall JPEG2000 encoding system arrives higher parallelism between DWT and EBCOT processors and thus preserves the high throughput, as DWT does. By changing the output timing of the DWT process and parallelizing with EBCOT, the internal tile memory size can be reduced by a factor of 4. Moreover, with smoother encoding flow of overall encoding system, the memory access cycles between the internal tile memory and code block memory also decreases.
Human papillomavirus types in women with invasive cervical carcinoma by HIV status in Kenya

To evaluate the fraction of invasive cervical carcinoma (ICC) that could be prevented in HIV‐infected women by vaccines currently available against human papillomavirus (HPV)16 and 18, we conducted a cross‐sectional study in women with ICC in Nairobi, Kenya. Fifty‐one HIV‐positive women were frequency‐matched by age to 153 HIV‐negative women. Cervical cells were tested for HPV DNA using polymerase chain reaction‐based assays (SPF10‐INNO‐LiPA). Comparisons were adjusted for multiplicity of HPV types. As expected, multiple‐type infections were much more frequent in HIV‐positive (37.2%) than in HIV‐negative (13.7%) women, but the distribution of HPV types was similar. HPV16 was detected in 41.2% versus 43.8% and HPV16 and/or 18 in 64.7% versus 60.1% of HIV‐positive versus HIV‐negative women, respectively. The only differences of borderline statistical significance were an excess of HPV52 (19.6% versus 5.2%) and a lack of HPV45 (7.8% versus 17.0%) in HIV‐positive women compared to HIV‐negative women, respectively. We have been able to assess an unprecedented number of ICCs in HIV‐positive women, but as we did not know the age of HIV acquisition, we cannot exclude that it had occurred too late in life to affect the type of HPV involved in cervical carcinogenesis. However, if our findings were confirmed, they would suggest that the efficacy of current vaccines against HPV16 and 18 to prevent ICC is similar in HIV‐positive and HIV‐negative women, provided vaccination is administered before sexual debut, as recommended. © 2007 Wiley‐Liss, Inc.
Device Yield in Nb-Nine-Layer Circuit Fabrication Process

We are investigating device yield in our Nb-nine-layer fabrication process for single-flux-quantum (SFQ) circuits, in which the critical current density of the Nb/AlOx/ Nb Josephson junction (JJ) is 10 kA/cm2 and the minimum JJ size is 1 μm2. We fabricated several shift registers (SRs) with different sizes that exhibit bit capacities from 16 to 2560 bits on a chip on many wafers. The SR yields correlate roughly with process defect test results using diagnostic chips, which are included in all wafers and consist of various diagnostic patterns such as for interlayer and intralayer insulations. When the defect number was above a certain level, the SR yield drastically degraded. The other reason of SR yield degradation is poor size uniformity of JJ patterns. The JJ pattern resolutions using our i-line stepper depend on the several-μm-level flatness of wafers. All SRs on a chip consisting of 68 990 JJs operated correctly. We obtained both “good” and “poor” chips without intentional changes of process conditions. The “poor” chip was strongly affected by magnetic flux traps. We believe that determining the cause of this difference is key to fabricating SFQ circuits consisting of 100 000 or more JJs.
Reaction Time Is Negatively Associated with Corpus Callosum Area in the Early Stages of CADASIL

BACKGROUND AND PURPOSE: Reaction time was recently recognized as a marker of subtle cognitive and behavioral alterations in the early clinical stages of CADASIL, a monogenic cerebral small-vessel disease. In unselected patients with CADASIL, brain atrophy and lacunes are the main imaging correlates of disease severity, but MR imaging correlates of reaction time in mildly affected patients are unknown. We hypothesized that reaction time is independently associated with the corpus callosum area in the early clinical stages of CADASIL. MATERIALS AND METHODS: Twenty-six patients with CADASIL without dementia (Mini-Mental State Examination score > 24 and no cognitive symptoms) and without disability (modified Rankin Scale score ≤ 1) were compared with 29 age- and sex-matched controls. Corpus callosum area was determined on 3D-T1 MR imaging sequences with validated methodology. Between-group comparisons were performed with t tests or χ2 tests when appropriate. Relationships between reaction time and corpus callosum area were tested using linear regression modeling. RESULTS: Reaction time was significantly related to corpus callosum area in patients (estimate = −7.4 × 103, standard error = 3.3 × 103, P = .03) even after adjustment for age, sex, level of education, and scores of depression and apathy (estimate = −12.2 × 103, standard error = 3.8 × 103, P = .005). No significant relationship was observed in controls. CONCLUSIONS: Corpus callosum area, a simple and robust imaging parameter, appears to be an independent correlate of reaction time at the early clinical stages of CADASIL. Further studies will determine whether corpus callosum area can be used as an outcome in future clinical trials in CADASIL or in more prevalent small-vessel diseases.
Human T‐Cell Lymphotropic Virus Type 1 Infection of CD34+ Hematopoietic Progenitor Cells Induces Cell Cycle Arrest by Modulation of p21cip1/waf1 and Survivin

Human T‐cell lymphotropic virus type 1 (HTLV‐1) is an oncogenic retrovirus and the etiologic agent of adult T‐cell leukemia (ATL), an aggressive CD4+ malignancy. HTLV‐2 is highly homologous to HTLV‐1; however, infection with HTLV‐2 has not been associated with lymphoproliferative diseases. Although HTLV‐1 infection of CD4+ lymphocytes induces cellular replication and transformation, infection of CD34+ human hematopoietic progenitor cells (HPCs) strikingly results in G0/G1 cell cycle arrest and suppression of in vitro clonogenic colony formation by induction of expression of the cdk inhibitor p21cip1/waf1 (p21) and concurrent repression of survivin. Immature CD34+/CD38− hematopoietic stem cells (HSCs) were more susceptible to alterations of p21 and survivin expression as a result of HTLV‐1 infection, in contrast to more mature CD34+/CD38+ HPCs. Knockdown of p21 expression in HTLV‐1‐infected CD34+ HPCs partially abrogated cell cycle arrest. Notably, HTLV‐2, an HTLV strain that is not associated with leukemogenesis, does not significantly modulate p21 and survivin expression and does not suppress hematopoiesis from CD34+ HPCs in vitro. We speculate that the remarkable differences in the activities displayed by CD34+ HPCs following infection with HTLV‐1 or HTLV‐2 suggest that HTLV‐1 uniquely exploits cell cycle arrest mechanisms to establish a latent infection in hematopoietic progenitor/hematopoietic stem cells and initiates preleukemic events in these cells, which eventually results in the manifestation of ATL.
Correction of metabolic acidosis and its effect on albumin in chronic hemodialysis patients.

Serum albumin concentration has been strongly associated with risk of death in hemodialysis patients, with mortality increasing as albumin decreases. Metabolic acidosis stimulates protein catabolism and decreases protein synthesis. A study was undertaken to investigate the effect of increasing predialysis serum bicarbonate (HCO3) concentrations on the nutrition of hemodialysis patients as measured by albumin and total lymphocyte count (TLC). Metabolic acidosis was defined as a predialysis serum bicarbonate concentration of < or = 18 mEq/L. Thirty-six hemodialysis patients were enrolled in the study. Each had been stable on hemodialysis for > or = 3 months and each had a mean serum bicarbonate concentration of < or = 18 mEq/L on predialysis monthly laboratory values during the preceding 3 months. The subjects were randomized into 2 groups. The first group consisted of 18 control subjects who were dialyzed on a standard bicarbonate bath of 35 mEq/L. The second group consisted of 18 experimental patients who were dialyzed on a bicarbonate bath of 40 mEq/L. Subjects in the experimental group who had predialysis serum bicarbonate concentrations less than 22 mEq/L after 2 weeks on the higher bicarbonate bath were additionally supplemented with oral sodium bicarbonate at a dosage of 1 mEq/kg dry weight/d. Monthly predialysis laboratory values were checked for all subjects and included serum electrolytes, blood urea nitrogen, calcium, and albumin. TLCs were obtained at the initiation and at the conclusion of the study. Intact parathyroid hormone, blood pressures, and interdialytic weight gains were also followed. The study lasted 16 weeks; 32 subjects completed the study (16 in each group). There were no statistically significant differences between the two groups at the initiation of the study. The serum bicarbonate concentrations were significantly different between the two groups at the end of the study (control HCO3 17.3 +/- 3.2 mEq/L v experimental HCO3 20.2 +/- 2.9 mEq/L; P = 0.01). Serum albumin concentrations and TLCs were not statistically different (P > 0.05) between the two groups at the end of the study (control albumin 3.88 +/- 0.28 g/dL v experimental albumin 3.76 +/- 0.26 g/dL and control TLC 1,780.0 +/- 779.4/mm3 v experimental TLC 2,020.1 +/- 888.0/mm3). Potassium, intact parathyroid hormone, interdialytic weight gain, blood pressures, Kt/Vs, and protein catabolic rates did not differ. We found that the change in serum bicarbonate concentration was well-tolerated and was without any demonstrable side effects. We conclude that increasing the serum bicarbonate concentration by 3 mEq/L for 16 weeks has no effect on the indicators of nutrition that we measured (serum albumin and TLC).
The slow folding reaction of barstar: the core tryptophan region attains tight packing before substantial secondary and tertiary structure formation and final compaction of the polypeptide chain.

The slow folding of a single tryptophan-containing mutant of barstar has been studied in the presence of 2 M urea at 10 degrees C, using steady state and time-resolved fluorescence methods and far and near-UV CD measurements. The protein folds in two major phases: a fast phase, which is lost in the dead time of measurement during which the polypeptide collapses to a compact form, is followed by a slow observable phase. During the fast phase, the rotational correlation time of Trp53 increases from 2.2 ns to 7.2 ns, and its mean fluorescence lifetime increases from 2.3 ns to 3.4 ns. The fractional changes in steady-state fluorescence, far-UV CD, and near-UV CD signals, which are associated with the fast phase are, respectively, 36 %, 46 %, and 16 %. The product of the fast phase can bind the hydrophobic dye ANS. These observations together suggest that the folding intermediate accumulated at the end of the fast phase has: (a) about 20 % of the native-state secondary structure, (b) marginally formed or disordered tertiary structure, (c) a water-intruded and mobile protein interior; and (d) solvent-accessible patches of hydrophobic groups. Measurements of the anisotropy decay of Trp53 suggest that it undergoes two types of rotational motion in the intermediate: (i) fast (tau(r) approximately 1 ns) local motion of its indole side-chain, and (ii) a slower (tau(r) approximately 7.2 ns) motion corresponding to global tumbling of the entire protein molecule. The ability of the Trp53 side-chain to undergo fast local motion in the intermediate, but not in the fully folded protein where it is completely buried in the hydrophobic core, suggests that the core of the intermediate is still poorly packed. The global tumbling time of the fully folded protein is faster at 5.6 ns, suggesting that the volume of the intermediate is 25 % more than that of the fully folded protein. The rate of folding of this intermediate to the native state, measured by steady-state fluorescence, far-UV CD, and near-UV CD, is 0.07(+/-0.01) min(-1) This rate compares to a rate of folding of 0.03(+/-0.005) min(-1), determined by double-jump experiments which monitor directly formation of native protein; and to a rate of folding of 0.05 min(-1), when determined from time-resolved anisotropy measurements of the long rotational correlation time, which relaxes from an initial value of 7.2 ns to a final value of 5. 6 ns as the protein folds. On the other hand, the amplitude of the short correlation time decreases rapidly with a rate of 0.24(+/-0.06) min(-1). These results suggest that tight packing of residues in the hydrophobic core occurs relatively early during the observable slow folding reaction, before substantial secondary and tertiary structure formation and before final compaction of the protein.
Controlled release of dexamethasone acetate from biodegradable and biocompatible polyurethane and polyurethane nanocomposite

Polyurethanes and polyurethane nanocomposites can be applied to control the release of drugs previously incorporated into these materials. In this study, dexamethasone acetate (ACT) was incorporated into biodegradable and biocompatible polyurethane and polyurethane containing montmorillonite nanoparticles. Fourier transform infrared spectroscopic technique showed no strong interactions between drug and polymers. Data obtained from X-ray diffraction and small angle X-ray scattering indicated that the incorporation of ACT did not disturb the polymer morphology, but montmorillonite led to a less defined phase separation between hard and soft segments of polyurethane. The in vitro release studies demonstrated that nanoparticles increased the rate of ACT release possibly because these particles have a hydrophilic surface that increases the absorption of water and accelerates the hydrolysis of the polymer. The in vivo short-term biocompatibility studies demonstrated adequate interfacial interaction between polyurethane and subcutaneous tissue and a discreet inflammatory response which was completely resolved in 14 days.
Isolation and virulence factors of verocytotoxin-producing Escherichia coli in human stool samples.

OBJECTIVE: To evaluate the isolation rate of O157 and non-O157 verocytotoxin-producing Escherichia coli (VTEC) strains, to study the occurrence of additional virulence factors and to correlate these with clinical symptoms. METHODS: Over more than 5 years, 17 296 unduplicated fecal samples submitted for routine culture were screened for VTEC by a single PCR detecting VT1, VT2 and its variants. Verocytotoxin B subunit genotypes of the isolates obtained by testing individual colonies in positive samples were determined by a polymerase chain reaction---restriction fragment length polymorphism (PCR---RFLP) technique, the eaeA gene and the 60-MDa virulence plasmid by PCR, and the hemolytic phenotype by using CaCl2-washed blood agar. RESULTS: Verocytotoxin genes were found in 1.02% of the samples. Non-O157 VTEC strains were isolated in 0.66% and O157 in 0.17%. Overall, VTEC was less frequently isolated than Campylobacter and Salmonella but more frequently than Yersinia and Shigella. All cases except two siblings were epidemiologically unrelated. Cases of hemolytic uremic syndrome (HUS) were only observed in association with serogroup O157, which seems to be more pathogenic than the non-O157 strains. Among non-O157 VTEC strains, eaeA-positive strains are more frequently associated with clinical symptoms than are eaeA-negative strains. Other virulence factors correlate less closely with the presence of symptoms. CONCLUSIONS: VTEC is the third bacterial intestinal pathogen in our study population. All stool samples from patients with diarrhea should be screened for the most frequent serogroup, O157, or, if this is not possible, at least those from patients with bloody diarrhea. Non-O157 VTEC strains, especially if they are eaeA positive, are also associated with diarrhea, more often non-bloody. PCR or the new commercially available immunoassays could be used in selected cases, e.g. in patients suffering from HUS and in cases of outbreaks.