Miracle-dz/UniFAR-FTUs huggingface dataset:
Analysis of the Relationship between Sacral Skin Blood Flow and Transcutaneous Oxygenation in Response to Causative Factors of Pressure Ulcers in Healthy Subjects

Pressure ulcers significantly contribute to the diminished quality of life and substantial disability in people with spinal cord injury (SCI). A broad consensus among clinicians and researchers has been reached that the best approach to reducing this burden is to implement an effective preventive treatment that would greatly reduce the incidence. The preventative intervention should eliminate/diminish causative factors and pathways involved with pressure ulcer development. The objective of this thesis is to explore the relationship between sacral skin blood flow and transcutaneous oxygenation in response to causative factors of pressure ulcers (i.e. thermal stress, mechanical stress, and sympathetic modulations) in five neurologically intact subjects.Two tests were performed to analyze the relationship between sacral skin blood flow and transcutaneous oxygenation. In test 1, skin blood flow and transcutaneous oxygenation were measured while subjects underwent orthostatic stimulation. Results from test 1 showed that both the level of heat used and the location of testing effects how skin blood flow and transcutaneous oxygenation respond to orthostatic stimulation. In test 2, skin blood flow and transcutaneous oxygenation were measured while external pressure was applied. Results from test 2 showed that a significant increase in peak skin blood flow and TcPO2 (p<0.05) occurred on average 588 and 298 seconds, respectively, following removal of occluding pressure when the skin is heated to 44 degrees C; however, at 37 degrees C, skin blood flow and transcutaneous oxygenation showed a significant peak increase (p<0.05) following removal of occluding pressure at 28 and 404 seconds, respectively.
Levels of essential and non-essential elements in raw and processed Lupinus albus L. (white lupin, gibto) cultivated in Ethiopia

White lupin ( Lupinus albus L.) cultivated in Ethiopia is locally known as ‘Gibto ’. Its seed is used as a snack, for the preparation of local alcoholic drink, ‘Areqi’ and as ‘Shiro’ flour for the people living in the north western part of Ethiopia. I t is also used for maintaining soil fertility and as a food. Certain elements are essential for plant growth, for animal and human health. However, if present in excessive concentrations they become toxic. Other elements are non -essential and toxic to human health even at trace level. Even though the levels of four of the elements are reported, there is no report in literature on the levels of other essential and non -essential elements in white lupin cultivated in Ethiopia. Therefore, t his study was carried out to determine t he level s of essential (K, Na, Mg, Ca, Cr, Mn, Fe, Co, Ni, Cu, Zn) a nd non- essential elements (Pb and Cd) in raw and processed grains Lupinus albus L. (Gibto) cultivated in Ethiopia (particularly Debretabor, Dembecha and Kosober) . The micro and macro- nutrient levels of the raw and processed white lupin grains were determined by flame atomic absorption spectrometry. Known weight of dried raw and processed samples were wet digested using 2 mL of HNO 3 , 1 mL of HClO 4 and 1 mL of H 2 O 2 at temperature round 270 0 C with 3 hours total time. The mean metal concentration (μg/g dry weight basis) ranges in raw and processed white lupin samples, respectively, we re: K (5142- 6215, 1100- 1222), Na (31.9- 50.1, 15.1- 31.1), Mg (1739 - 2159, 629- 759), Ca (502- 967, 709- 1284), Cr (11.3- 17.6, 9.40- 10.3), Mn (1657- 4095, 1075- 2265), Fe (77.9- 92.8, 70.7- 83.8), Co (16.2- 16.6, 16.7- 17.2), Ni (12.0- 15.6, 6.90 - 11.7), Cu (4.80- 9.90, 5.10- 12.2), Zn (40.3- 53.6, 55.6- 64.6) and Pb (10.8- 16.4, 9.90- 13.1). The level of Cd was below method detection limit in both the raw and processed samples from all the sample sites. The concentrations of all the nutrients were higher in raw as compared to processed white lupin samples except for Ca, Co, Cu and Zn samples from all of the sampling sites. A nalysis of variance (ANOVA) at 95% confidence level indicated that there is significant difference between the mineral contents of raw and processed samples from the three sample sites. Pearson correlation indicated positive correlation between most elements in both the raw and processed samples. In general, white lupin is rich in essential elements and safe to consume and could be an alternative source of the essential elements to the individual daily intake.
Triple-reassortant swine influenza A (H1) in humans in the United States, 2005-2009.

BACKGROUND Triple-reassortant swine influenza A (H1) viruses--containing genes from avian, human, and swine influenza viruses--emerged and became enzootic among pig herds in North America during the late 1990s. METHODS We report the clinical features of the first 11 sporadic cases of infection of humans with triple-reassortant swine influenza A (H1) viruses reported to the Centers for Disease Control and Prevention, occurring from December 2005 through February 2009, until just before the current epidemic of swine-origin influenza A (H1N1) among humans. These data were obtained from routine national influenza surveillance reports and from joint case investigations by public and animal health agencies. RESULTS The median age of the 11 patients was 10 years (range, 16 months to 48 years), and 4 had underlying health conditions. Nine of the patients had had exposure to pigs, five through direct contact and four through visits to a location where pigs were present but without contact. In another patient, human-to-human transmission was suspected. The range of the incubation period, from the last known exposure to the onset of symptoms, was 3 to 9 days. Among the 10 patients with known clinical symptoms, symptoms included fever (in 90%), cough (in 100%), headache (in 60%), and diarrhea (in 30%). Complete blood counts were available for four patients, revealing leukopenia in two, lymphopenia in one, and thrombocytopenia in another. Four patients were hospitalized, two of whom underwent invasive mechanical ventilation. Four patients received oseltamivir, and all 11 recovered from their illness. CONCLUSIONS From December 2005 until just before the current human epidemic of swine-origin influenza viruses, there was sporadic infection with triple-reassortant swine influenza A (H1) viruses in persons with exposure to pigs in the United States. Although all the patients recovered, severe illness of the lower respiratory tract and unusual influenza signs such as diarrhea were observed in some patients, including those who had been previously healthy.
Follicular Lymphoma Presenting with Skeletal Metastasis.

Follicular lymphoma is the most common low – grade lymphoma. Most patients of follicular lymphoma have widespread disease at diagnosis predominantly involving lymph nodes. Primary involvement of extranodal areas is very uncommon in follicular lymphoma. Skeletal involvement in follicular lymphoma is very rare. We present a case of follicular lymphoma that presented with bony pains and was diagnosed with follicular lymphoma with skeletal involvement.
Current concepts - Schistosomiasis

In 1851, Theodor Bilharz described a parasitic infection (bilharzia) that would later be termed schistosomiasis. Currently, 200 million people in 74 countries have this disease; 120 million of them have symptoms, and 20 million have severe illness.1 Schistosomiasis is caused by parasitic trematode worms (schistosomes) that reside in the abdominal veins of their vertebrate definitive hosts. The life cycle of the schistosome is depicted in Figure 1. Schistosomiasis is 1 of the 10 tropical diseases especially targeted for control by the Special Program for Research and Training in Tropical Diseases of the United Nations Development Program, the World Bank, . [Full Text of this Article]
Icatibant, a new bradykinin-receptor antagonist, in hereditary angioedema.

BACKGROUND Hereditary angioedema is characterized by recurrent attacks of angioedema of the skin, larynx, and gastrointestinal tract. Bradykinin is the key mediator of symptoms. Icatibant is a selective bradykinin B2 receptor antagonist. METHODS In two double-blind, randomized, multicenter trials, we evaluated the effect of icatibant in patients with hereditary angioedema presenting with cutaneous or abdominal attacks. In the For Angioedema Subcutaneous Treatment (FAST) 1 trial, patients received either icatibant or placebo; in FAST-2, patients received either icatibant or oral tranexamic acid, at a dose of 3 g daily for 2 days. Icatibant was given once, subcutaneously, at a dose of 30 mg. The primary end point was the median time to clinically significant relief of symptoms. RESULTS A total of 56 and 74 patients underwent randomization in the FAST-1 and FAST-2 trials, respectively. The primary end point was reached in 2.5 hours with icatibant versus 4.6 hours with placebo in the FAST-1 trial (P=0.14) and in 2.0 hours with icatibant versus 12.0 hours with tranexamic acid in the FAST-2 trial (P<0.001). In the FAST-1 study, 3 recipients of icatibant and 13 recipients of placebo needed treatment with rescue medication. The median time to first improvement of symptoms, as assessed by patients and by investigators, was significantly shorter with icatibant in both trials. No icatibant-related serious adverse events were reported. CONCLUSIONS In patients with hereditary angioedema having acute attacks, we found a significant benefit of icatibant as compared with tranexamic acid in one trial and a nonsignificant benefit of icatibant as compared with placebo in the other trial with regard to the primary end point. The early use of rescue medication may have obscured the benefit of icatibant in the placebo trial. (Funded by Jerini; ClinicalTrials.gov numbers, NCT00097695 and NCT00500656.)
A trial of darbepoetin alfa in type 2 diabetes and chronic kidney disease.

BACKGROUND Anemia is associated with an increased risk of cardiovascular and renal events among patients with type 2 diabetes and chronic kidney disease. Although darbepoetin alfa can effectively increase hemoglobin levels, its effect on clinical outcomes in these patients has not been adequately tested. METHODS In this study involving 4038 patients with diabetes, chronic kidney disease, and anemia, we randomly assigned 2012 patients to darbepoetin alfa to achieve a hemoglobin level of approximately 13 g per deciliter and 2026 patients to placebo, with rescue darbepoetin alfa when the hemoglobin level was less than 9.0 g per deciliter. The primary end points were the composite outcomes of death or a cardiovascular event (nonfatal myocardial infarction, congestive heart failure, stroke, or hospitalization for myocardial ischemia) and of death or end-stage renal disease. RESULTS Death or a cardiovascular event occurred in 632 patients assigned to darbepoetin alfa and 602 patients assigned to placebo (hazard ratio for darbepoetin alfa vs. placebo, 1.05; 95% confidence interval [CI], 0.94 to 1.17; P=0.41). Death or end-stage renal disease occurred in 652 patients assigned to darbepoetin alfa and 618 patients assigned to placebo (hazard ratio, 1.06; 95% CI, 0.95 to 1.19; P=0.29). Fatal or nonfatal stroke occurred in 101 patients assigned to darbepoetin alfa and 53 patients assigned to placebo (hazard ratio, 1.92; 95% CI, 1.38 to 2.68; P<0.001). Red-cell transfusions were administered to 297 patients assigned to darbepoetin alfa and 496 patients assigned to placebo (P<0.001). There was only a modest improvement in patient-reported fatigue in the darbepoetin alfa group as compared with the placebo group. CONCLUSIONS The use of darbepoetin alfa in patients with diabetes, chronic kidney disease, and moderate anemia who were not undergoing dialysis did not reduce the risk of either of the two primary composite outcomes (either death or a cardiovascular event or death or a renal event) and was associated with an increased risk of stroke. For many persons involved in clinical decision making, this risk will outweigh the potential benefits. (ClinicalTrials.gov number, NCT00093015.)
Assessment of Global Kidney Health Care Status

Importance Kidney disease is a substantial worldwide clinical and public health problem, but information about available care is limited. Objective To collect information on the current state of readiness, capacity, and competence for the delivery of kidney care across countries and regions of the world. Design, Setting, and Participants Questionnaire survey administered from May to September 2016 by the International Society of Nephrology (ISN) to 130 ISN-affiliated countries with sampling of key stakeholders (national nephrology society leadership, policy makers, and patient organization representatives) identified by the country and regional nephrology leadership through the ISN. Main Outcomes and Measures Core areas of country capacity and response for kidney care. Results Responses were received from 125 of 130 countries (96%), including 289 of 337 individuals (85.8%, with a median of 2 respondents [interquartile range, 1-3]), representing an estimated 93% (6.8 billion) of the world’s population of 7.3 billion. There was wide variation in country readiness, capacity, and response in terms of service delivery, financing, workforce, information systems, and leadership and governance. Overall, 119 (95%), 95 (76%), and 94 (75%) countries had facilities for hemodialysis, peritoneal dialysis, and kidney transplantation, respectively. In contrast, 33 (94%), 16 (45%), and 12 (34%) countries in Africa had facilities for hemodialysis, peritoneal dialysis, and kidney transplantation, respectively. For chronic kidney disease (CKD) monitoring in primary care, serum creatinine with estimated glomerular filtration rate and proteinuria measurements were reported as always available in only 21 (18%) and 9 (8%) countries, respectively. Hemodialysis, peritoneal dialysis, and transplantation services were funded publicly and free at the point of care delivery in 50 (42%), 48 (51%), and 46 (49%) countries, respectively. The number of nephrologists was variable and was low (<10 per million population) in Africa, the Middle East, South Asia, and Oceania and South East Asia (OSEA) regions. Health information system (renal registry) availability was limited, particularly for acute kidney injury (8 countries [7%]) and nondialysis CKD (9 countries [8%]). International acute kidney injury and CKD guidelines were reportedly accessible in 52 (45%) and 62 (52%) countries, respectively. There was relatively low capacity for clinical studies in developing nations. Conclusions and Relevance This survey demonstrated significant interregional and intraregional variability in the current capacity for kidney care across the world, including important gaps in services and workforce. Assuming the responses accurately reflect the status of kidney care in the respondent countries, the findings may be useful to inform efforts to improve the quality of kidney care worldwide.
TB infection among staff at Tygerberg Academic Hospital, South Africa

This study was undertaken in order to characterise the occurrence, clinical spectrum and treatment outcomes of tuberculosis (TB) infection among staff at Tygerberg Academic Hospital over an 11-year period. A retrospective analysis was performed of all patients presenting to the occupational health and infectious diseases departments at the facility for the period 1 January 1996 till 31 December 2006. One hundred and thirty cases of TB were identified; 69 cases (53.1%) occurred in healthcare workers and 41 (31.5%) in ancillary hospital staff. Nursing staff were the most commonly affected healthcare worker group. There were 100 cases of pulmonary TB (76.9%) and 23 cases of extra-pulmonary TB (17.7%). HIV infection and diabetes mellitus occurred in 14 (18.2% of patients tested) and 15 (11.5%) patients, respectively. There were six cases of MDR TB; four of these occurred in diabetic staff members. This study highlights the need for improved screening and prevention of TB among hospital staff, specifically among nursing staff. Infection control policies should further emphasise the need for protection of diabetic and HIV-infected staff members. South Afr J Epidemiol Infect 2008;23(4):17-19
Comparison of shunt types in the Norwood procedure for single-ventricle lesions.

BACKGROUND The Norwood procedure with a modified Blalock-Taussig (MBT) shunt, the first palliative stage for single-ventricle lesions with systemic outflow obstruction, is associated with high mortality. The right ventricle-pulmonary artery (RVPA) shunt may improve coronary flow but requires a ventriculotomy. We compared the two shunts in infants with hypoplastic heart syndrome or related anomalies. METHODS Infants undergoing the Norwood procedure were randomly assigned to the MBT shunt (275 infants) or the RVPA shunt (274 infants) at 15 North American centers. The primary outcome was death or cardiac transplantation 12 months after randomization. Secondary outcomes included unintended cardiovascular interventions and right ventricular size and function at 14 months and transplantation-free survival until the last subject reached 14 months of age. RESULTS Transplantation-free survival 12 months after randomization was higher with the RVPA shunt than with the MBT shunt (74% vs. 64%, P=0.01). However, the RVPA shunt group had more unintended interventions (P=0.003) and complications (P=0.002). Right ventricular size and function at the age of 14 months and the rate of nonfatal serious adverse events at the age of 12 months were similar in the two groups. Data collected over a mean (+/-SD) follow-up period of 32+/-11 months showed a nonsignificant difference in transplantation-free survival between the two groups (P=0.06). On nonproportional-hazards analysis, the size of the treatment effect differed before and after 12 months (P=0.02). CONCLUSIONS In children undergoing the Norwood procedure, transplantation-free survival at 12 months was better with the RVPA shunt than with the MBT shunt. After 12 months, available data showed no significant difference in transplantation-free survival between the two groups. (ClinicalTrials.gov number, NCT00115934.)
Modeling of coarctation of aorta in human fetuses using 3D/4D fetal echocardiography and computational fluid dynamics

We sought to develop a hemodynamic model of aortic and ductal arches using computational fluid dynamics (CFD) and 3D/4D spatio‐temporal image correlation (STIC) fetal echocardiography and to investigate the hemodynamics of coarctation of aorta (CoA) in human fetuses using this approach.
Reduced mortality after allogeneic hematopoietic-cell transplantation.

BACKGROUND Over the past decade, advances have been made in the care of patients undergoing transplantation. We conducted a study to determine whether these advances have improved the outcomes of transplantation. METHODS We analyzed overall mortality, mortality not preceded by relapse, recurrent malignant conditions, and the frequency and severity of major complications of transplantation, including graft-versus-host disease (GVHD) and hepatic, renal, pulmonary, and infectious complications, among 1418 patients who received their first allogeneic transplants at our center in Seattle in the period from 1993 through 1997 and among 1148 patients who received their first allogeneic transplants in the period from 2003 through 2007. Components of the Pretransplant Assessment of Mortality (PAM) score were used in regression models to adjust for the severity of illness at the time of transplantation. RESULTS In the 2003-2007 period, as compared with the 1993-1997 period, we observed significant decreases in mortality not preceded by relapse, both at day 200 (by 60%) and overall (by 52%), the rate of relapse or progression of a malignant condition (by 21%), and overall mortality (by 41%), after adjustment for components of the PAM score. The results were similar when the analyses were limited to patients who received myeloablative conditioning therapy. We also found significant decreases in the risk of severe GVHD; disease caused by viral, bacterial, and fungal infections; and damage to the liver, kidneys, and lungs. CONCLUSIONS We found a substantial reduction in the hazard of death related to allogeneic hematopoietic-cell transplantation, as well as increased long-term survival, over the past decade. Improved outcomes appear to be related to reductions in organ damage, infection, and severe acute GVHD. (Funded by the National Institutes of Health.).
New regimens to prevent tuberculosis in adults with HIV infection.

BACKGROUND Treatment of latent tuberculosis in patients infected with the human immunodeficiency virus (HIV) is efficacious, but few patients around the world receive such treatment. We evaluated three new regimens for latent tuberculosis that may be more potent and durable than standard isoniazid treatment. METHODS We randomly assigned South African adults with HIV infection and a positive tuberculin skin test who were not taking antiretroviral therapy to receive rifapentine (900 mg) plus isoniazid (900 mg) weekly for 12 weeks, rifampin (600 mg) plus isoniazid (900 mg) twice weekly for 12 weeks, isoniazid (300 mg) daily for up to 6 years (continuous isoniazid), or isoniazid (300 mg) daily for 6 months (control group). The primary end point was tuberculosis-free survival. RESULTS The 1148 patients had a median age of 30 years and a median CD4 cell count of 484 per cubic millimeter. Incidence rates of active tuberculosis or death were 3.1 per 100 person-years in the rifapentine-isoniazid group, 2.9 per 100 person-years in the rifampin-isoniazid group, and 2.7 per 100 person-years in the continuous-isoniazid group, as compared with 3.6 per 100 person-years in the control group (P>0.05 for all comparisons). Serious adverse reactions were more common in the continuous-isoniazid group (18.4 per 100 person-years) than in the other treatment groups (8.7 to 15.4 per 100 person-years). Two of 58 isolates of Mycobacterium tuberculosis (3.4%) were found to have multidrug resistance. CONCLUSIONS On the basis of the expected rates of tuberculosis in this population of HIV-infected adults, all secondary prophylactic regimens were effective. Neither a 3-month course of intermittent rifapentine or rifampin with isoniazid nor continuous isoniazid was superior to 6 months of isoniazid. (Funded by the National Institute of Allergy and Infectious Diseases and others; ClinicalTrials.gov number, NCT00057122.).