Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of Prenatal and Early Life Malnutrition: Evidence from the Greek Famine

This paper examines the long run education and labor market effects from early-life exposure to the Greek 1941-1942 famine. Given the short duration of the famine, we can separately identify the famine effects for cohorts exposed in utero, during infancy and at 1 year of age. We find that adverse outcomes due to the famine are largest for infants. Further, in our regression analysis we exploit the fact that the famine was more severe in urban than in rural areas. Consistent with our prediction, we find that urban-born cohorts show larger negative impacts on educational outcomes than rural-born cohorts.
Protein selective adsorption properties of a polyethylene terephtalate artificial ligament grafted with poly(sodium styrene sulfonate) (polyNaSS): correlation with physicochemical parameters of proteins

Immediately after surgical placement of biomaterials, a first step consists in the adsorption of proteins from the biological environment on the artificial surfaces. Because the composition of the adsorbed protein layer modulates the cell response to the implanted material, researchers in the biomaterials field have focused on coating proteins or peptides onto surfaces to improve cell response and therefore the long-term compatibility of the implant. However, some materials used in tissue engineering, mainly synthetic polymers, are too hydrophobic to allow the optimal adsorption of proteins and have to be first submitted to physical or chemical treatments. In our laboratory, we have demonstrated that grafting of poly(sodium styrene sulfonate) (polyNaSS) onto biomaterials can strongly modulate the protein adsorption and the cellular response compared to unmodified surfaces. In this study, we used a liquid chromatography strategy coupled to proteomics to evaluate the adsorptive properties of a polyethylene terephtalate (PET) artificial ligament grafted with polyNaSS, and to identify and analyse proteins adsorbed on PET fibers. Results obtained with platelet rich plasma (PRP) proteins demonstrated that grafting significantly increases the protein adsorption of the PET and also selectively modulates the adsorption of proteins on PET fibers. Finally, regarding physicochemical parameters calculated from the amino acid sequence of identified proteins, we found that the aliphatic index is highly correlated with the selective adsorption of proteins onto the polyNaSS/PET surface. Therefore, the proteomic approach complemented with physicochemical property evaluation could provide a powerful tool for the elaboration of new biomaterials based on protein layer deposition.
Start Over and Survive: A Brief Intervention for Substance Misuse in Early Psychosis

Over the last decade, brief intervention for alcohol problems has become a well-validated and accepted treatment, with bried interventions frequently showing equivalence in terms of outcome to more extended treatments (Bien et al, 1993). A recent review of this studies found that heavy drinkers who received interventions of less than 1 h were almost twice as likely to moderate their drinking over the following 6-12 months as did those not receiving intervention (Wilk etal, 1997). Some studies have used motivational interviewing (MI) strategies (Monti et al, 1999); others have simply given information ajnd advice to reduce drinking (Fleming et al, 1997). Leaflets or information on strategies to assist in the attempt or follow-up sessions are sometimes provided (Fleming et al, 1997). In general practice research, provision of one or more follow-up sessions increases the reliability of intake reductions across studies (Poikolainen, 1999).
Clinical applications of decellularized extracellular matrices for tissue engineering and regenerative medicine

Decellularization is the process of removing the cellular components from tissues or organs. It is a promising technology for obtaining a biomaterial with a highly preserved extracellular matrix (ECM), which may also act as a biological scaffold for tissue engineering and regenerative therapies. Decellularized products are gaining clinical importance and market space due to their ease of standardized production, constant availability for grafting and mechanical or biochemical superiority against competing clinical options, yielding clinical results ahead of the ones with autografts in some applications. Current drawbacks and limitations of traditional treatments and clinical applications can be overcome by using decellularized or acellular matrices. Several companies are leading the market with versatile acellular products designed for diverse use in the reconstruction of tissues and organs. This review describes ECM-based decellularized and acellular products that are currently in use for different branches of clinic.
Mismatch repair expression in testicular cancer predicts recurrence and survival

We investigated mismatch repair (MMR) gene expression in testicular cancer as a molecular marker for clinical outcome (recurrence, response to chemotherapy and death) using protein expression and specific genetic alterations associated with the presence or absence of MMR activity. One hundred sixty‐two cases of paraffin‐embedded testis cancer specimens were subjected to immunohistochemical analysis using monoclonal antibody for MLH1 and MSH2 MMR proteins and genetic analysis using specific polymorphic markers. The degree of MMR immunoreactivity and genetic instability in the form of loss of heterozygosity (LOH) and/or microsatellite instability (MSI) were determined by comparing matched normal and tumor tissue. The degree of immunohistochemical staining for MMR expression was associated with a shorter time to tumor recurrence, resistance to chemotherapy and death. Furthermore, clinical relapse and cancer specific death was also associated with tumors exhibiting a high degree of MSI, p = 0.01 and 0.04, respectively. In contrast, LOH was not associated with recurrence, resistance to chemotherapy or death. Therefore, MMR expression defines testis cancers with distinct molecular properties and clinical behavior, such that tumors with decreased MMR immunostaining and/or increased frequency of MSI have a shorter time to recurrence and death despite chemotherapy. © 2007 Wiley‐Liss, Inc.
THE PROPHYLACTIC VALUE OF SULFADIAZINE: IN THE CONTROL OF MENINGOCOCCIC MENINGITIS

From Jan. 1, 1943 to April 30, 1943 more than 1,300 cases of meningococcic meningitis occurred among military personnel in the Fourth Service Command. During this period the attack rate for the disease varied widely from post to post. In some installations only sporadic cases were found; in others the number of cases reached epidemic proportions. Generally speaking, however, the disease was more prevalent in stations where large numbers of recently inducted men were assembled for training purposes. The customary control measures employed during outbreaks of meningococcic meningitis include quarantine, prevention of overcrowding, protection from fatigue and exposure, and the prompt hospitalization or isolation of all cases of common respiratory illnesses. It is admitted, however, that these measures are only partially effective and, under conditions of active military training, can be properly applied only with considerable difficulty. It seemed desirable, therefore, to seek additional means of controlling this disease, particularly
An unhealthy holiday on Lake Bolsena

A 70-year old man (OL) was hospitalized due to fever (up to 40°C) associated with malaise and abdominal pain. Tests showed hypereosinophilic syndrome, and increased liver and inflammation indexes. Abdominal echography showed a nonhomogeneous liver and the spleen was enlarged. Abdominal computed tomography showed multiple abscesses on the liver. The patient reported that he had recently gone on holiday to Lake Bolsena where he had eaten raw fish. A specialist in infectious diseases confirmed that in that area there is an infestation of Opisthorchis felineus . Analysis of blood and stool samples confirmed the presence of this parasite. The patient was treated with praziquantel with resolution of fever and improvement in clinical tests and general condition. Opisthorchis felineus is a parasite that commonly infects dogs and cats. Infection is sometimes transmitted to man and is usually related to eating raw fish. The parasite enters the liver and its eggs are found in the patient’s stool samples. Acute symptoms are: fever, diarrhea, abdominal pain, and malaise. Hypereosinophilic syndrome and increase in liver index are typical. Chronic infection could result in cholangiocarcinoma. Presence of the parasite is confirmed through specific analysis of blood and stool. Therapy consists of praziquantel or, as second choice, abendazol. In the 20th century, there were 4 epidemics in Italy, on Lakes Trasimeno and Bolsena in Central Italy. The latest epidemic was reported in that area in summer 2012.
Electrospinning of microbial polyester for cell culture

Biodegradable and biocompatible poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV), a copolymer of microbial polyester, was fabricated as a nanofibrous mat by electrospinning. The specific surface area and the porosity of electrospun PHBV nanofibrous mat were determined. When the mechanical properties of flat film and electrospun PHBV nanofibrous mats were investigated, both the tensile modulus and strength of electrospun PHBV were less than those of cast PHBV film. However, the elongation ratio of nanofiber mat was higher than that of the cast film. The structure of electrospun nanofibers using PHBV-trifluoroethanol solutions depended on the solution concentrations. When x-ray diffraction patterns of bulk PHBV before and after electrospinning were compared, the crystallinity of PHBV was not significantly affected by the electrospinning process. Chondrocytes adhered and grew on the electrospun PHBV nanofibrous mat better than on the cast PHBV film. Therefore, the electrospun PHBV was considered to be suitable for cell culture.
Impact of definitions on trauma center mortality rates and performance

BACKGROUND Trauma center performance depends on quality metrics, such as mortality rates, but there have been few studies on how an exact definition of death can influence these statistics. The purpose of this study was to test the hypothesis that the mortality rate at one trauma center could be influenced by the interpretation of “dead on arrival. ” Personal communication suggests that this definition is applied variably throughout our state. METHODS All deaths at our Level I trauma center from January 2009 to April 2011 were reviewed. RESULTS There were 11,121 trauma admissions, predominantly male (75%), with mean +/− SD of 39 +/− 20, 72% blunt, 22% penetrating, and 7% burn injuries. There were 661 deaths, of which 582 were “hospital deaths” and an additional 79 were classified as “dead on arrival,” defined as patients arriving with no vital signs and receiving no hospital intervention. However, 23% (n = 136) of the hospital deaths also arrived with no vital signs but received some lifesaving intervention, for example, tube thoracostomy (n = 95, 70%), thoracotomy (n = 48, 35%), and/or central venous catheter (n = 21, 15%). The state-reported mortality rate each month was 5.3 +/− 1.4%. If those who arrived with no vital signs were excluded, the mortality rate each month was 4.0 +/− 1.2% (p < 0.001). CONCLUSION At this trauma center, approximately one fourth of the deaths reported to the state were patients who arrived with no vital signs. If any lifesaving intervention is attempted in these moribund patients, even if it is futile, it is termed “hospital death,” rather than “dead on arrival. ” State regulations exclude patients who received any intervention from being classified as dead on arrival, but compliance with this definition is not audited. Therefore, unless there is strict compliance and standardized definitions, any comparison of trauma center quality based on mortality could be questioned. LEVEL OF EVIDENCE Epidemiologic study, level III.
O12.5 Traditional Explanatory Models of Disease and Messaging Around HIV and STI Risk and Prevention: Findings from an Exploratory Study with Traditional Health Practitioners in South Africa

Background Research has shown that traditional medicine and Traditional Health Practitioners (THPs) represent the first line of healthcare for the majority in sub-Saharan Africa (SSA). In this context, understanding traditional beliefs is critical, if we are to design effective health messages and improve health outcomes. The aim of this study was to identify and understand how traditional knowledge and beliefs influence explanatory models of disease and patient actions to avoid risk of HIV and STI infection. Methods An exploratory qualitative study involving THPs and their patients was conducted in 2011 at five sites in provinces Gauteng and KwaZulu-Natal. THPs (n = 54) were recruited through local forums and patients (n = 48) recruited by their THP. Diviners, herbalists, traditional birth attendants and traditional surgeons were all represented. Data were analysed using NVivo 9. Results THPs provide a holistic ‘catch all’ service that would involve multiple providers within the allopathic sector. Whilst participants acknowledged allopathic risk factors and modes of transmission, beliefs around aetiology were generally located in the spiritual dimension with infection often blamed on lack of respect for/non-adherence to traditional practises resulting in ‘pollution’ and ‘dirt in the blood’. THPs demonstrated a willingness to refer patients to clinics for diagnosis and treatment, recognised benefits of circumcision, and encouraged patients on ARVs to continue treatment. However, protective and preventive properties of traditional medicines were frequently highlighted. Conclusion It was clear from this study that for many in South Africa traditional beliefs are often held alongside an acknowledgement of some aspects of germ theory. Given the pervasive traditional belief-based explanatory model of disease, health messaging and interactions that do not acknowledge this are likely to fail. It is critical that the allopathic/western system understands these core beliefs of patients accessing their services so as to optimise health messages, treatments, behaviours and clinical outcomes in SSA.
Transtibial Amputation: Preoperative Vascular Assessment and Functional Outcome

An eight-year retrospective outcomes study of 135 transtibial amputees was undertaken in which patient charts were reviewed and survivors were interviewed. The authors found the anklebrachial index to be of limited value in determining the level of amputation. Transcutaneous oxygen pressure of > 30 mmHg was a good indicator of successful healing, whereas that of 20–30 mmHg warrants further consideration. Ambulatory status after at least six months of follow-up care was found to be dependent on the etiology of limb loss, the state of the other limb, and the general health and age of the patient.
Cross-linking methods of electrospun fibrinogen scaffolds for tissue engineering applications

The purpose of this study was to enhance the mechanical properties and slow the degradation of an electrospun fibrinogen scaffold, while maintaining the scaffold's high level of bioactivity. Three different cross-linkers were used to achieve this goal: glutaraldehyde vapour, 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC) in ethanol and genipin in ethanol. Scaffolds with a fibrinogen concentration of 120 mg ml−1 were electrospun and cross-linked with one of the aforementioned cross-linkers. Mechanical properties were determined through uniaxial tensile testing performed on scaffolds incubated under standard culture conditions for 1 day, 7 days and 14 days. Cross-linked scaffolds were seeded with human foreskin fibroblasts (BJ-GFP-hTERT) and cultured for 7, 14 and 21 days, with histology and scanning electron microscopy performed upon completion of the time course. Mechanical testing revealed significantly increased peak stress and modulus values for the EDC and genipin cross-linked scaffolds, with significantly slowed degradation. However, cross-linking with EDC and genipin was shown to have some negative effect on the bioactivity of the scaffolds as cell migration throughout the thickness of the scaffold was slowed.
Thoracic trauma in Iraq and Afghanistan

BACKGROUND: Thoracic injuries are common among civilian trauma and have a high associated mortality. The use of body armor and exposure to different mechanisms of injury in combat setting could lead to different injury patterns and incidences from those found in peacetime. METHODS: Thoracic trauma incidence rates and mortality risks were calculated from data extracted from the Joint Theatre Trauma Registry. RESULTS: Among patients injured in military operations in Iraq and Afghanistan, 10.0% sustained thoracic injuries and had a mortality rate of 10.5%. Penetrating injuries were the most common mechanism of injury. The most common thoracic injury was pulmonary contusion. The highest mortality rate was in the subset of patients with thoracic vascular injuries or flail chest. The variables most strongly associated with mortality were number of units of blood transfused, admission base deficit, international normalization ratio, pH, Abbreviated Injury Scale scores for head and neck regions, and Injury Severity Score. Blunt injuries had the same mortality risk as penetrating injuries. CONCLUSION: Combat‐related thoracic trauma is common and associated with significant mortality in Iraq and Afghanistan. LEVEL OF EVIDENCE: Prognostic study, level III.
When a hospice is not a haven

Abstract There has been little research conducted with terminally ill patients in the UK to date. This case study describes statements made by a palliative care patient during a face-to-face interview while he was being treated in a hospice. His comments illustrate his unhappiness within the hospice environment to an extent that could compromise his holistic management in this setting. We would suggest that the important aspects of patient care include not just the major palliation issues of symptom control and good communications, but also attention to the rituals of daily living of individuals pertaining to the environment. The atmosphere of the hospice, as experienced by patients through their interactions with staff members within the care setting, is seen to be a significant factor for good holistic care. Hospices may need to be more aware of the impact that every member of staff, both clinical and non-clinical, can make at each patient contact. Becoming more alert to the likes and dislikes of each patient as regards the substance of these contacts may allow hospices to avoid institutionalized care practices and instead to individualize the care they offer to a greater number of their patients.
Benchmarking the incidence of organ failure after injury at trauma centers and nontrauma centers in the United States

BACKGROUND Organ failure after injury is a significant cause of morbidity and mortality, yet its true incidence is unknown. We sought to benchmark the incidence of organ failure following injury at trauma centers and nontrauma centers using a nationally representative sample of hospital discharges. We hypothesized that injured patients receiving care at trauma centers would have a lower incidence of organ failure than those at nontrauma centers. METHODS We used the 2006 Nationwide Inpatient Sample to identify injured adults (age ≥ 15 years) with organ dysfunction using specific DRG International Classification of Diseases—9th Rev. codes by system. After adjusting for hospital size, geographic region, comorbidities, Injury Severity Score (ISS), age, and sex, a multivariate logistic regression model was created to compare rates of organ dysfunction between trauma centers and nontrauma centers. RESULTS We identified 396,276 injured patients, representing the patient care experience of a total of 1,939,473 patients. Among these patients, 6.5% had concurrent organ failure. Injured patients who had acute organ failure were more likely to die than injured patients without organ failure (12.4% vs. 1.7%, p < 0.001). Mortality increased with the number of organ system failures. Patients treated at trauma centers had a higher incidence of respiratory and cardiac failure compared with nontrauma centers. CONCLUSION We offer the first national benchmark of rates of acute organ failure among injured patients. Postinjury organ failure is uncommon, but incidence increases with injury severity and correlates with mortality. Patients at trauma centers had higher rates of respiratory and cardiac failure, possibly representing differences in referral patterns or resuscitation strategies. LEVEL OF EVIDENCE Prognostic and epidemiologic study, level III.
Early treatment with lyophilized plasma protects the brain in a large animal model of combined traumatic brain injury and hemorrhagic shock

BACKGROUND Combination of traumatic brain injury (TBI) and hemorrhagic shock (HS) can result in significant morbidity and mortality. We have previously shown that early administration of fresh frozen plasma (FFP) in a large animal model of TBI and HS reduces the size of the brain lesion as well as the associated edema. However, FFP is a perishable product that is not well suited for use in the austere prehospital settings. In this study, we tested whether a shelf-stable, low-volume, lyophilized plasma (LSP) product was as effective as FFP. METHODS Yorkshire swine (42–50 kg) were instrumented to measure hemodynamic parameters, intracranial pressure, and brain tissue oxygenation. A prototype, computerized, cortical impact device was used to create TBI through a 20-mm craniotomy: 15-mm cylindrical tip impactor at 4 m/s velocity, 100-millisecond dwell time, and 12-mm penetration depth. Volume-controlled hemorrhage was induced (40–45% total blood volume) concurrent with the TBI. After 2 hours of shock, animals were treated with (1) normal saline (NS, n = 5), (2) FFP (n = 5), and (3) LSP (n = 5). The volume of FFP and LSP matched the shed blood volume, whereas NS was 3 times the volume. Six hours after resuscitation, brains were sectioned and stained with TTC (2, 3, 5-Triphenyltetrazolium chloride), and lesion size (mm3) and swelling (percent change in volume compared with the contralateral, uninjured side) were measured. RESULTS This protocol resulted in a highly reproducible brain injury, with clinically relevant changes in blood pressure, cardiac output, tissue hypoperfusion, intracranial pressure, and brain tissue oxygenation. Compared with NS, treatment with LSP significantly (p < 0.05) decreased brain lesion size and swelling (51% and 54%, respectively). CONCLUSION In a clinically realistic combined TBI + HS model, early administration of plasma products decreases brain lesion size and edema. LSP is as effective as FFP, while offering many logistic advantages. LEVEL OF EVIDENCE Therapeutic study, level V.