Miracle-dz/UniFAR-FTUs huggingface dataset:
Exogenous Re-infection by Multiple Exposures to Mycobacterium tuberculosis Contributes to Subsequent Development of Active Tuberculosis

The majority of tuberculosis (TB) exists in the world’s poorest countries, where costly biosafety level three facilities for containment of infectious TB patients and diagnostic facilities are not affordable. Health care workers (HCWs), in countries with high burdens of tuberculosis (TB) are at risk of nosocomially acquired TB, as there are increased numbers of cases of TB on open hospital wards and minimal or absent TB infection control. This setting provides a means to study development of immune profiles associated with human exposure to Mycobacterium tuberculosis (Mtb). Individuals with multiple exposures to Mtb develop a Th1 response, involving IFN-γ. However early expression of a Th2 response, consisting of IL-4, was found to be associated with development of active TB disease. A Th2 response was confined to T cells of the CD8 and γδ T cell phenotype which can result in reduced bactericidal function of mycobacterial infected cells. The facets of the immune response which are responsible for failure of elimination of intracellular Mtb leading to active disease are poorly understood.
Studies of the Effects of Hydrogen Chloride and Polyvinylchloride (PVC) Smoke in Rodents

Test methods for evaluating the toxicity of smoke generated by the combustion of materials have traditionally used the mouse or the rat as the animal model. Recently, the guinea pig was used to study the effects of combus tion gases and smoke atmospheres on respiratory function and incapacitation. The objective of this study was to compare the effects of HCl and PVC smoke in the mouse, the rat, and the guinea pig with those in the baboon to evaluate the utility of these rodents as predictive models for humans. Mice, rats and guinea pigs were exposed for 15 minutes to HCl, and the rats and guinea pigs were also exposed to nonflaming and flaming PVC smoke atmospheres containing targeted concentrations of HCl. In the rats and guinea pigs, respiratory re sponses and arterial blood gases were monitored during exposure, CO2 chal lenge response tests were conducted at 3 and 90 days following exposure, and the respiratory tracts were examined by'light microscopy at 90 days postexpo sure. The three rodent species were more sensitive than the baboon to the lethal effects of HCl and PVC smoke, with the mouse and guinea pig being more sensitive than the rat. The respiratory response of the rodents also dif fered from that of the primate. Anatomical differences in the respiratory tracts of rodents and primates may be responsible for these differences in sensitivity and response as well as for apparent differences in the severity and location of respiratory tract injury caused by HCl or PVC smoke. Although all three ro dent species have deficiencies as predictive models for the effects of irritant combustion atmospheres in humans, the mouse and the guinea pig have the most serious limitations.
2q33.1q34 Deletion in a Girl with Brain Anomalies and Anorectal Malformation

2q33 deletions are considered to constitute a distinct clinical entity (Glass syndrome or 2q33 microdeletion syndrome) with a characteristic phenotype. Most patients have moderate to severe developmental delay, speech delay, a particular behavioural phenotype, feeding problems, growth restriction, a typical facial appearance, thin and sparse hair, tooth abnormalities, and skeletal anomalies. Here, we report on a patient with a 2q33.1q34 deletion spanning 8.3 Mb of genomic DNA. Although her clinical features are very reminiscent of the 2q33 microdeletion syndrome, she also presented with brain and anorectal malformations. Based on the present and published patients with 2q33 deletions, we suggest that the critical region for the Glass syndrome may be larger than initially proposed. Moreover, we suggest that brain abnormalities might be an additional feature of the 2q33 microdeletion syndrome, but that anorectal malformation is likely not a key marker.
PTH-082 Serum Calprotectin: A Novel Biomarker to Predict Outcome in Acute Severe Ulcerative Colitis?

Introduction Acute severe ulcerative colitis (ASUC) remains an important clinical problem and is associated with significant morbidity and requirement for colectomy. Faecal calprotectin and C-reactive protein (CRP) have previously been shown to predict the need for colectomy but there is an unmet need for further biomarkers. Serum calprotectin has not previously been analysed for this purpose and may provide a novel way of determining disease activity and outcome. The aim of this study was to assess how serum calprotectin relates to faecal calprotectin and other blood markers of inflammation, and to determine whether serum calprotectin on admission predicts colectomy. Methods Blood samples were collected prospectively from patients who presented with ASUC as defined by the Truelove and Witts criteria. Blood samples were taken within the first 24 hours of admission. Faecal samples were pre-processed using PhiCal™ extraction buffer. Samples were stored at –80°C and analysed in duplicate using the PhiCal™ calprotectin ELISA according to manufacturer’s instructions. Samples with a calprotectin result of > 2500 µg/g were diluted and retested. Statistical comparisons were made between serum calprotectin and other markers of inflammation using Spearman’s correlation coefficient, and ROC curve analysis was performed to determine how well each test performed in predicting colectomy. Results There were 45 patients recruited to the study with ASUC, of which 22 (49%) were female. Median age on admission was 40 years (interquartile range [IQR] 26–62). Median disease duration was 12 years (IQR 0–59). 26 of the 45 patients had a paired faecal sample for calprotectin analysis. There was no difference in sex, age or disease extent between those with or without faecal calprotectin. Serum calprotectin correlated significantly with CRP (R2 = 0.46, p < 0.0001) and with albumin (R2 = 0.12, p = 0.023) but not with faecal calprotectin (R2 = 0.02, p = 0.450). ROC analysis gave an AUC of 0.69 for serum calprotectin compared with 0.71 for CRP and 0.58 for faecal calprotectin. A cut off for serum calprotectin of 400 µg/g gave a sensitivity of 0.68 and a specificity of 0.69. Conclusion In the setting of acute severe ulcerative colitis, serum calprotectin is comparable with serum CRP in predicting outcome. Further work is needed to establish if it may be a useful predictor of outcome in patients with ulcerative colitis who fail to mount a high CRP response despite endoscopic assessment confirming severe active inflammation. Work is also ongoing to establish its utility in the outpatient setting both in Crohn’s disease and ulcerative colitis. Abstract PTH-082 Figure 1 Disclosure of Interest None Declared.
Development of microsatellite markers for Miscanthus sinensis (Poaceae) and cross-amplification in other related species.

PREMISE OF THE STUDY We developed microsatellite loci for the biomass crop Miscanthus sinensis to investigate genetic diversity and population structure of M. sinensis and its closely related species. METHODS AND RESULTS Fourteen microsatellite loci were identified from an enriched genomic library of M. sinensis and tested in one M. sinensis population. The number of alleles per locus ranged from 1 to 15, with a mean of 7.0. The observed and expected heterozygosities varied from 0.318 to 0.864 and from 0.424 to 0.901, respectively. Of them, 12 primers could be applied to three other species in Miscanthus (M. sacchariflorus, M. floridulus, and M. lutarioriparius). CONCLUSIONS These markers will be important for further analyzing population genetics and evolutionary history, as well as facilitating molecular breeding of Miscanthus sinensis and its related species.
Therapeutic engagement in acute psychiatric inpatient services

Therapeutic engagement involves healthcare professionals spending quality time with patients and aims to empower the patient to actively participate in their care. This project was commissioned by the National Institute for Mental Health in England (NIMHE) Acute Care Programme in order to gain a greater understanding of how this process is successfully achieved and maintained on psychiatric wards. The NIMHE acute care lead in each regional development centre was asked to nominate wards that they thought were accomplishing a high level of therapeutic engagement. From this selection, a steering group identified seven ’positive practice units’ that were suitable for inclusion in the study. Representatives of the multidisciplinary teams (MDT) who worked on the positive practice units took part in focus groups, which discussed the practices employed on the units to engage patients. Thematic analysis was used to code the data and raise themes. The themes that emerged from this analysis were: Respecting and empowering patients; Staff being ’available’; Engagement-focused observation; Good MDT working; Therapeutic work; Services for discharged patients; Embracing change. The study concluded that the positive practice on the units was the result of having a dynamic ward culture which was grounded in having empathy for patients and supporting staff.
Programmable Bricks: Toys to Think With

In this paper, we discuss the applications and implications of the Programmable Brick—a tiny, portable computer embedded inside a LEGO ® brick, capable of interacting with the physical world in a large variety of ways. We describe how Programmable Bricks make possible a wide range of new design activities for children, and we discuss experiences in using Programmable Bricks in three types of applications: autonomous creatures, active environments, and personal science experiments.
Therapeutic management of Urinary Tract Infections (UTI): A retrospective study in two Teaching Hospitals in Nigeria

Urinary Tract Infection (UTI) is one of the most common diseases and a significant cause of morbidity in all age groups. There are large differences in the management of UTI with respect to definition, diagnosis and treatment. This retrospective study reviewed the diagnosis and drug treatment of UTI at the Teaching Hospitals of Ahmadu Bello University (ABUTH), Zaria and University of Maiduguri (UMTH). The results showed that majority of the infections were due to Escherichia coli, followed by Klebsiella species and Staphylococcus aureus. The symptoms were dysuria, suprapubic pain, fever and/or chills, and lower abdominal discomfort, which differed in order of occurrence at the two institutions. The infecting organisms were sensitive to pefloxacin, ceftriazone and gentamicin while the most frequently used antibiotics were gentamicin, ciprofloxacin and ampicillin/cloxacillin in decreasing order at ABUTH. At UMTH, ceftazidine, ofloxacin and gentamicin were frequently active against the infective organisms; and the most prescribed antibiotics were nitrofurantoin, ofloxacin, amoxicillin/clavulanic acid and co-trimoxazole in decreasing order. These results showed that institutional antibiotic policy in the treatment of urinary tract infections might have been based on the experience of the physician, cost of the drug and route of administration instead of prevalence and sensitivity patterns. It also showed that the guiding principle of the rational use of drugs is not strictly adhered to.
Statins Reduce Incidence of Early Perioperative Complications and Length of in-Hospital Stay after Coronary Artery Bypass Graft Surgery

Background: Coronary artery bypass grafting (CABG) is associated with several perioperative complications that may significantly prolong length of in-hospital stay, increase costs and provide worse long term outcome. The 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase inhibitors, or statins, exert anti-inflammatory and vascular protective effects. We hypothesized that pre-operatory statin therapy may reduce incidence of early perioperative complications and length of in-hospital stay following CABG.Methods: We retrospectively enrolled 103 patients (age 67±3; 18 females), who underwent CABG. Patients were allocated into 2 groups: 57 patients on statin therapy prior to CABG (St Group) and 46 patients not on statin therapy (n-St group). Demographic and clinical features, pre-operative medications use and the incidence of early adverse postoperative events were collected. Pre-operative risk of death using the European System for Cardiac Operative Risk Evaluation (EuroSCORE) was also calculated. The primary end-point was the composite of early complications occurring after surgery, including infections, bleedings, sustained ventricular and supra-ventricular tachyarrhythmias, cardiogenic shock, myocardial infarction and mortality. As secondary end-points single perioperative complications were considered. In-hospital stay length was also evaluated.Results: Clinical features, cholesterol levels and EuroSCORE were similar between two groups. Statin therapy and EuroSCORE emerged as predictors of the composite adverse outcome. n-St patients had a significant higher rate of early complications if compared with St patients: the primary endpoint occurred in 18 St patients (31%) versus 25 (54%) non-St patients (p=0.019). Multivariate analysis confirmed pre-operative statin therapy and EuroSCORE as independent predictors of the primary endpoint (OR=0.307, 95% CI=0.123-0.766, p=0.011 and OR= 2.114, 95% CI= 1.213- 4.407, p= 0.002 respectively) showing a protective role of the statin therapy.The incidence of secondary end-points did not differ significantly between the groups, while in-hospital stay was longer in n-St group if compared with St group (7.7±3,9 days vs 5,6±1,8 days; p=0,001). Conclusion: Our data suggest that statin therapy may reduce early perioperative complications after coronary artery bypass grafting. This effect is independent from cholesterol basal levels, thus supporting pre-operative statin use in patients undergoing CABG.
Quality of nursing evidence-based guidelines from the nurses’ view

Introduction: Evidence-based clinical guidelines are important tools in increasing the quality of nurses' clinical practice. Hence, this study aimed to investigate the quality of evidence-based clinical guidelines from the nurses' view. Methods: In this descriptive cross sectional study, 116 nurses were collected through census method from the intensive care units of one of the selected hospitals in Tehran in 2010. For data collection, a researcher-made questionnaire was applied. Face validity was examined by nurses and content validity by faculty members and the reliability of the test was confirmed by test retest as well as McNemar and Spearman tests (r=0.72). The data were analyzed by SPSS 17 statistical software using descriptive- analytical methods. Results: The only significant relationship was observed between marital status and the guideline quality score (p=0.04). % 53.4 of nurses expressed that the quality of guidelines was good; % 39.7 moderate and %6.9 weak. Conclusion: Although guidelines quality was considered acceptable by almost half of the nurses, up-to- dating the existing guidelines and providing specific instructions is felt for guidelines implementation in each unit.
Replacement therapy for Addison's disease: recent developments

Background: The hormone deficiencies in Addison's disease (primary adrenal insufficiency) are conventionally treated with oral glucocorticoid and mineralocorticoid replacement but the available therapies do not restore the physiological hormone levels and biorhythm. Despite such treatment these patients self-report impaired health-related quality of life (HRQoL) and recent research has indicated increased mortality. Objective/methods: We review the literature and recent developments in replacement therapy. Results/conclusion: Patients with Addison's disease require mineralocorticoid replacement, i.e., fludrocortisone 0.05 – 0.20 mg once daily. Starting doses of glucocorticoids should be 15 – 20 mg for hydrocortisone or 20 – 30 mg for cortisone acetate, divided into two or three doses, and preferentially weight-adjusted. There are indications that the synthetic glucocorticoids have undesirable metabolic long-term effects, which make them less suitable as first-line treatment. Timed-release hydrocortisone tablets and continuous subcutaneous hydrocortisone infusion are promising new treatment modalities. Studies of replacement with the adrenal androgen dehydroepiandrosterone (DHEA) in adrenal failure have shown inconsistent benefit on HRQoL. DHEA, or possibly testosterone replacement is likely to be beneficial for selected groups of patients with Addison's disease but this remains to be shown. We here give our opinion of the best treatment and future direction of research in this area.
Techniques to Obtain Good Resolution and Concentrated Time-Frequency Distributions: A Review

We present a review of the diversity of concepts and motivations for improving the concentration and resolution of timefrequencydistributions (TFDs) along the individual components of the multi-component signals. The central idea has been to obtain a distribution that represents the signal’s energy concentration simultaneously in time and frequency without blur andcrosscomponents so that closely spaced components can be easily distinguished. The objective is the precise description of spectralcontent of a signal with respect to time, so that first, necessary mathematical and physical principles may be developed, andsecond, accurate understanding of a time-varying spectrum may become possible. The fundamentals in this area of research havebeen found developing steadily, with significant advances in the recent past.
Pituitary-directed medical treatment of Cushing’s disease

The treatment of Cushing’s disease is very complex and represents a challenge for clinicians. Transphenoidal surgical excision of adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma remains the treatment of choice but, unfortunately, the rate of cure at long-term follow-up is suboptimal and recurrences are high, even in the hands of skilled neurosurgeons. Other treatment options, such as bilateral adrenalectomy and pituitary radiotherapy, are currently in use but no treatment has proven fully satisfactory during the lengthy progress of this chronic and devastating disease. Nelson’s syndrome and hypopituitarism are of particular concern as affected patients need lifelong hormone-replacement therapy and have notably increased mortality. Although medical treatment represents a second-line treatment option in patients with Cushing’s disease, so far pharmacological therapy has been considered a transient and palliative treatment. Many drugs have been employed: they may act at the hypothalamic–pituitary level, decreasing ACTH secretion; at the adrenal level, inhibiting cortisol synthesis (steroidogenesis inhibitors); or at the peripheral level by competing with cortisol (glucocorticoid receptor antagonists). Recently, there has been renewed interest in the medical therapy of Cushing’s disease and pituitary-directed drugs include old compounds commercially available for other diseases, such as cabergoline, and new promising compounds, such as pasireotide (SOM230) or retinoic acid. This review focuses on the tumor-directed pharmacological approaches for the management of Cushing’s disease based on the recent identification of possibile targets at a pituitary level.
TREATMENT OF UNILATERAL PARALYSIS AGITANS BY SECTION OF THE LATERAL PYRAMIDAL TRACT

The syndrome of alternating tremor of rest has been recognized as an incapacitating disease since the day of Celsus. Parkinson,1whose brilliant essay established its clinical characteristics, pointed out that, in many instances at least, brief periods of complete relief occur spontaneously, for example, after change of posture, under the stress of excitement or in carrying out complicated learned motor patterns. It would appear reasonable, therefore, to hope that some form of treatment might be devised which would mitigate the symptoms without seriously impairing normal function. This possibility has appeared even more attainable since the epidemic of encephalitis, which has been followed by an increase in the incidence of cases of alternating tremor in relatively young patients, in many of which, however, no history of encephalitis can be elicited. The outlook for satisfactory restitution would appear to be better in such cases than in those of the senile group
Multidrug resistant Klebsiella pneumoniae in NICU – what next? Trend of antibiotic resistance

Abstract Multidrug resistant (MDR) Klebsiella pneumoniae an increasing cause of neonatal sepsis in India. This observational study was designed to monitor temporal change in prevalence of K. pneumoniae as a causative organism for neonatal sepsis and its sensitivity pattern. The time period was divided into four time frames of six months each [designated A (1/10/2006–31/03/2007) to D (1/04/2008–30/09/2008)]. K. pneumoniae isolation in all cultures sent from neonatal intensive care units doubled in time frame D (6.3%) compared to time frame A (3.0). Similarly, the percentage of total positive cultures in the neonatal intensive care unit that were K. pneumoniae also doubled (27.8% in A to 55.6% in D). K. pneumoniae sepsis tripled in inborn neonates (15.4% in A to 47.1% in D). Incidence of MDR K. pneumoniae increased from 0% in time frame A to 76.5% in time frame D. Resistance against ampicillin and third generation cephalosporins (cefotaxime and ceftazidime) remained 100% in all time frames. Carbapenem (meropenem and imipenem) resistance increased from 0% in time frame A and B to 41.2% in time frame D. Death due to K. pneumoniae sepsis showed brisk resurgence in time frame D (17.6%) compared to time frame C (10%). Lower gestational age and birth weight were associated with higher mortality. MDR K. pneumoniae is emerging as a more frequent cause of neonatal sepsis. There is an dincreasing threat of combined quinolone and carbapenem resistant MDR K. pneumoniae.
DISCUSSION ON PREVENTION AND TREATMENT OF PARASITIC DISEASES

that her father had a '' safety valve " on the back of one hanfl. Otherwise no relevant personal or family history of cutaneous or other disease. Many remedies had been prescribed by the patient's husband and his partner without the slightest effect. The eruption disappeared after a course of autohaemotherapy combined with cignolin locally. After six weeks or so ^ fresh patch appeared, but was made to disappear again by cignolin.