Miracle-dz/UniFAR-FTUs huggingface dataset:
Factors surrounding long-term benzodiazepine prescribing in methadone maintenance clients

Patterns of prescribed and non-prescribed benzodiazepine use among 100 patients in methadone maintenance treatment were tracked over a 2-year period. Ninety-one participants were re-interviewed 6 months after initial interview and 76% a further 18 months later. Approximately one-third of patients were prescribed diazepam at each time point, on stable doses. Those prescribed diazepam at initial interview were also likely to be prescribed the drug at the two subsequent data collection points. Clients prescribed diazepam reported significantly higher methadone doses, reported higher anxiety and depression levels, and used heroin less frequently at each interview. Low levels of non-prescribed diazepam use were reported over the study period while non-prescribed diazepam users were also on higher methadone doses and reported more alcohol consumption. The effects of long-term benzodiazepine prescribing on patterns of illicit drug use is a matter of considerable concern for providers of methadone maintenance treatment, and may require careful policy consideration around the impact of prescribing on use patterns.
The impact of the mass media on public images of mental illness: media content and audience belief

An analysis of media content in April 1993 found that two-thirds of items dealing with mental health issues forged a link between mental illness and violence. Using some of this material, the impact on the beliefs of an audience sample was explored. Six general groups and one user group took part in the study. Two-fifths of the general sample believed mental illness to be associated with violence and gave the media as their source. While some respondents with personal knowledge of mental illness, including the user group, rejected the dominant media message, others accepted it against the evidence of their own eyes. The findings indicate the importance of working with the media to destigmatise mental health problems.
Patient Outcomes Using a Rapid Response Team

The use of rapid response teams (RRT) has increased over the past several years because of the Institute for Healthcare Improvement’s call for ‘‘Protecting 5 Million Lives From Harm’’ (previously ‘‘Protecting 100,000 Lives From Harm’’). Rapid response teams are generally made up of a variety of healthcare providers who have advanced skills in airway management, central venous access devices, and drug management. The secret to the success of an RRT is that anyone who identifies a change in a patient can put the process in motion.
Operator-based robust nonlinear control system design for MIMO nonlinear plants with unknown coupling effects

In this article, operator-based robust nonlinear control system design for multi-input multi-output (MIMO) plants with unknown coupling effects is considered. That is, by using operator-based robust nonlinear control design, coupling effects existing in the MIMO nonlinear plants can be decoupled based on a feedback design and robust right coprime factorisation approach, the coupling effects caused by controllers and plant outputs can be stabilised by using definition of Lipschitz operator and contraction mapping theorem, and output tracking performance can be realised by a tracking design scheme. Finally, a simulation example about temperature control process of 3-input/3-output aluminum plate is given to support the theoretical analysis.
The pattern and presentation of myathenia gravis in Al-Shaab and Omdurman Teaching Hospitals

Introduction : Myasthenia gravis (MG) is the most common acquired autoimmune disorder of neuromuscular transmission. It has different patterns of presentation. Objective : to study the pattern and mode of presentation of Myasthenia Gravis in Al-Shaab and Omdurman Teaching Hospitals, Khartoum Sudan. Methods : The demographic and clinical characteristics of 50 patients of myasthenia gravis (MG) were reviewed in Alshab and Oumdrman Teaching Hospitals for five months period from May to October 2008. Results : Out of 2400 patients attending neurology clinics 50 were found to have Myathenia Gravis [MG] with female; male ratio of 2.5:1. The age at presentation was the second decade of life in 34%. Most of the patients [42%] were from Khartoum State followed by North Kordofan State [14%]. High occurrence of late onset fatigability and weakness was seen in 92 % of our patients. Ocular muscles involvement was detected in 78%. MG was aggravated by hot weather and fever in 12% of the patients. Quinine represented the most common drug which aggravated the myasthenia symptoms in 4%. Diabetes mellitus and thyroid diseases were the most associated auto immune diseases seen in 12% and 4 % respectively. The diagnosis was made by classic history and neurological examinations in 88% and positive neostigmin test in64%. The majority of patients were treated with steroids. Thymectomy was done in 10% patients. The outcome was excellent as 82% improved and only one [2%] patient died. Discussion : Going with literature diagnosis of MG was made depending on classical history, full neurological examination and confirmed by tensilon test. Because of different reasons more sophisticated tests were not done in our patients. Only patients with malaria who were treated with quinine showed deterioration of their symptoms in our study. Strikingly, myasthenia crisis which were reported in 27% of patients were not seen in our population. Because of lack of usage of steroid sparing agents the vast majority [96%] of our patients were treated with steroids. Conclusion : Generalized myasthenia gravis with ocular involvement is common in our patients. However, pure OMG was not seen. Thymectomy was done in a small number of our patients with reference to other studies. Keywords : autoimmune, tensilon, neostigmin, thymectomy, diplopia, ptosis.
Pediatric liver transplantation for acute liver failure at a single center: A 10‐yr experience

Heffron TG, Pillen T, Smallwood G, Rodriguez J, Sekar S, Henry S, Vos M, Casper K, Gupta NA, Fasola CG, Romero R. Pediatric liver transplantation for acute liver failure at a single center: A 10‐yr experience. Pediatr Transplantation 2010:14:228–232. © 2009 John Wiley & Sons A/S.
Engineered cartilage generated by nasal chondrocytes is responsive to physical forces resembling joint loading.

OBJECTIVE To determine whether engineered cartilage generated by nasal chondrocytes (ECN) is responsive to different regimens of loading associated with joint kinematics and previously shown to be stimulatory of engineered cartilage generated by articular chondrocytes (ECA). METHODS Human nasal and articular chondrocytes, harvested from 5 individuals, were expanded and cultured for 2 weeks into porous polymeric scaffolds. The resulting ECN and ECA were then maintained under static conditions or exposed to the following loading regimens: regimen 1, single application of cyclic deformation for 30 minutes; regimen 2, intermittent application of cyclic deformation for a total of 10 days, followed by static culture for 2 weeks; regimen 3, application of surface motion for a total of 10 days. RESULTS Prior to loading, ECN constructs contained significantly higher amounts of glycosaminoglycan (GAG) and type II collagen compared with ECA constructs. ECN responded to regimen 1 by increasing collagen and proteoglycan synthesis, to regimen 2 by increasing the accumulation of GAG and type II collagen as well as the dynamic modulus, and to regimen 3 by increasing the expression of superficial zone protein, at the messenger RNA level and the protein level, as well as the release of hyaluronan. ECA constructs were overall less responsive to all loading regimens, likely due to the lower extracellular matrix content. CONCLUSION Human ECN is responsive to physical forces resembling joint loading and can up-regulate molecules typically involved in joint lubrication. These findings should prompt future in vivo studies exploring the possibility of using nasal chondrocytes as a cell source for articular cartilage repair.
ℋ∞ stabilisation of switched linear stochastic systems under dwell time constraints

Based on the determination of a minimum dwell time, this article addresses the problem of characterising a switching strategy for ℋ∞ stabilisation of switched linear stochastic systems with adapted external inputs. Sufficient conditions that assure exponential mean square stability and an ℋ∞ performance index are established by analysing the time evolution of the second-order moment of the state and a recursive dynamic programming inequality, respectively. Alternative conditions are derived for numerical implementations. The proposed method is illustrated by numerical simulations.
Distributed fault diagnosis in a class of interconnected nonlinear uncertain systems

In this article, a distributed fault detection and isolation (FDI) method is developed for a class of interconnected nonlinear uncertain systems. In the distributed FDI architecture, a FDI component is designed for each subsystem in the interconnected system. For each subsystem, its corresponding local FDI component is designed by utilising local measurements and certain communicated information from neighbouring FDI components associated with subsystems that are directly interconnected to the particular subsystem under consideration. Under certain assumptions, adaptive thresholds for distributed FDI in each subsystem are derived, ensuring robustness with respect to interactions among subsystems and system modelling uncertainty. Moreover, the fault detectability and isolability conditions are rigorously investigated, characterising the class of faults in each subsystem that are detectable and isolable by the proposed distributed FDI method. Additionally, the stability and learning capability of the local adaptive fault isolation estimators designed for each subsystem is established. A simulation example of interconnected inverted pendulums mounted on carts is used to illustrate the effectiveness of the method.
Autoimmune disease in individuals and close family members and susceptibility to non-Hodgkin's lymphoma.

OBJECTIVE Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren's syndrome have been consistently associated with an increased risk of non-Hodgkin's lymphoma (NHL). This study was initiated to evaluate the risks of NHL associated with a personal or family history of a wide range of autoimmune diseases. METHODS A population-based case-control study was conducted that included 24,728 NHL patients in Denmark (years 1977-1997) and Sweden (years 1964-1998) and 55,632 controls. Using univariate logistic and hierarchical regression models, we determined odds ratios (ORs) of NHL associated with a personal history of hospital-diagnosed autoimmune conditions. Risks of NHL associated with a family history of the same autoimmune conditions were assessed by similar regression analyses that included 25,941 NHL patients and 58,551 controls. RESULTS A personal history of systemic autoimmune diseases (RA, SLE, Sjögren's syndrome, systemic sclerosis) was clearly linked with NHL risk, both for individual conditions (hierarchical odds ratios [OR(h)] ranged from 1.6 to 5.4) and as a group (OR(h) 2.64 [95% confidence interval (95% CI) 1.72-4.07]). In contrast, a family history of systemic autoimmune diseases was modestly and nonsignificantly associated with NHL (OR(h) 1.31 [95% CI 0.85-2.03]). An increased risk of NHL was found for a personal history of 5 nonsystemic autoimmune conditions (autoimmune hemolytic anemia, Hashimoto thyroiditis, Crohn's disease, psoriasis, and sarcoidosis) (OR(h) ranged from 1.5 to 2.6) of 27 conditions examined. CONCLUSION Overall, our results demonstrate a strong relationship of personal history of systemic autoimmune diseases with NHL risk and suggest that shared susceptibility may explain a very small fraction of this increase, at best. Positive associations were found for a personal history of some, though far from all, nonsystemic autoimmune conditions.
The Cutaneous Lupus Erythematosus Disease Activity and Severity Index: expansion for rheumatology and dermatology.

OBJECTIVE To evaluate the validity of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) for use by rheumatologists via reliability testing, and to extend the validation for dermatologists. METHODS Fourteen subjects with cutaneous lupus erythematosus (CLE; n = 10), a mimicker skin disease only (a cutaneous lesion that may appear clinically similar to CLE; n = 1), or both (n = 3) were rated with the CLASI by academic-based dermatologists (n = 5) and rheumatologists (n = 5). RESULTS The dermatology intraclass correlation coefficient (ICC) was 0.92 for activity and 0.82 for damage; for rheumatology the ICC was 0.83 for activity and 0.86 for damage. For intrarater reliability, the dermatology Spearman's rho was 0.94 for activity and 0.97 for damage; for rheumatology the Spearman's rho was 0.91 for activity and 0.99 for damage. CONCLUSION Our data confirm the reliability of the CLASI when used by dermatologists and support the CLASI as a reliable instrument for use by rheumatologists.
The use of everolimus in pediatric liver transplant recipients: First experience in a single center

Nielsen D, Briem‐Richter A, Sornsakrin M, Fischer L, Nashan B, Ganschow R. The use of everolimus in pediatric liver transplant recipients: First experience in a single center. Pediatr Transplantation 2011: 15: 510–514. © 2011 John Wiley & Sons A/S.
Stability analysis for a class of nonlinear discrete-time control systems subject to disturbances and to actuator saturation

This paper addresses the stability characterisation problem for a class of nonlinear discrete-time control systems subject to actuator saturation and energy bounded disturbance inputs. The considered class of systems covers all nonlinear discrete-time systems that can be modelled by rational difference equations. Based on quadratic and piecewise quadratic Lyapunov functions, conditions based on linear matrix inequalities are proposed to analyse the asymptotic stability (internal stability) and the ℓ2 input-to-state stability (external stability) of the closed-loop system. The proposed conditions are then incorporated into convex optimisation problems to either maximise an estimate of the region of attraction or a bound on the admissible ℓ2 disturbances, and also to obtain an estimate of the system ℓ2-gain for an admissible set of disturbances.
Activated memory B cell subsets correlate with disease activity in systemic lupus erythematosus: delineation by expression of CD27, IgD, and CD95.

OBJECTIVE Analysis of peripheral B cell subsets in patients with systemic lupus erythematosus (SLE) has provided evidence of specific alterations, such as an expansion of CD27++ plasma cells/blasts and transitional B cells. However, memory B cells in lupus have not been thoroughly investigated, and only recently a CD27- memory B cell subset was identified in the peripheral blood of lupus patients. Focusing on CD27- B cells, this study aimed to identify abnormalities in peripheral B cell subsets in patients with SLE. METHODS Three independent cohorts of lupus patients were used to characterize CD27- memory B cells, using multiparameter flow cytometry and single-cell reverse transcription-polymerase chain reaction of heavy-chain transcripts. RESULTS We identified a homogeneous subset of CD27-,IgD-,CD95+ memory B cells with an activated phenotype that was increased in patients with disease flares and that correlated with disease activity and serologic abnormalities. In contrast, the entire subset of CD27-,IgD- B cells was found to be heterogeneous, did not correlate significantly with lupus activity, and was also increased in patients with bacterial infections. CONCLUSION We conclude that CD95 is a useful marker to identify CD27- memory B cells with an activated phenotype, which might serve as a biomarker for lupus activity and as a target of further investigations aiming to elucidate the pathogenic potential of these cells and the mechanisms involved in the generation as well as regulation of this CD27-,IgD-,CD95+ memory B cell subset.
Hypoxic synovial environment and expression of macrophage inflammatory protein 3gamma/CCL20 in juvenile idiopathic arthritis.

OBJECTIVE Synovial inflammation is a major determinant of juvenile idiopathic arthritis (JIA) pathogenesis and is mediated by local chemokine secretion. Monocytic cells are an important source of chemokines. The purpose of this study was to investigate expression of CCL20, a macrophage inflammatory protein, in synovial fluid (SF) and SF-derived monocytic cells from JIA patients and its regulation by hypoxia, a common feature of the inflamed synovial environment. METHODS Mononuclear cells and monocytic cells were isolated from paired SF and peripheral blood (PB) samples from JIA patients and were maintained in a hypoxic environment or subjected to reoxygenation. CCL20 concentrations in SF, PB, and culture supernatants were measured by enzyme-linked immunosorbent assay. CCL20 expression was assessed in both freshly purified and cultured cells by reverse transcriptase-polymerase chain reaction and immunocytochemistry. Hypoxia-inducible factor 1alpha (HIF-1alpha) and HIF-2alpha were detected in the synovial tissue and cells of JIA patients by immunohistochemistry and Western blotting. RESULTS CCL20 concentrations were significantly higher in SF compared with PB samples (P < 0.0001). SF mononuclear cells, but not matched PB mononuclear cells, constitutively expressed CCL20 messenger RNA. The SF monocytic cell fraction produced higher amounts of CCL20 than did SF lymphocytes, and CCL20 expression was associated with HIF positivity. Reoxygenation abrogated HIF and CCL20 expression, which was maintained in SF monocytic cells exposed to prolonged hypoxia. CONCLUSION CCL20 is released into the SF of JIA patients, and SF monocytic cells are a major source of this chemokine. The hypoxic synovial microenvironment may directly contribute to the persistent inflammation associated with JIA by increasing CCL20 production by SF monocytic cells, thus representing a potential therapeutic target.
Analysis and design for delta operator systems with actuator saturation

This paper studies the problem of estimating the domain of attraction for delta operator systems under a pre-designed saturated linear feedback. Ellipsoids are used as the estimates of domain of attraction for delta operator systems. A condition is derived in terms of an auxiliary feedback matrix for determining if a given ellipsoid is contractive invariant. Moreover, some necessary and sufficient conditions are given for single input delta operator systems. The results are also further extended to determine the invariant sets for delta operator systems with persistent disturbances. Linear matrix inequalities based on the methods are developed for constructing feedback laws that achieve disturbance rejection with guaranteed stability requirements. Some numerical examples are given to illustrate the effectiveness of the developed techniques.
Abnormal body composition phenotypes in older rheumatoid arthritis patients: association with disease characteristics and pharmacotherapies.

OBJECTIVE To compare measures of body fat and lean mass and the prevalence of abnormal body composition phenotypes (sarcopenia, overfat, and sarcopenic obesity) in men and women with rheumatoid arthritis (RA) versus matched controls, and to explore the disease-related predictors of abnormal body composition in patients with RA. METHODS A total of 189 men and women with RA and 189 age-, sex-, and race-matched non-RA controls underwent dual-energy x-ray absorptiometry for measurement of total and regional body fat and lean mass. Continuous and categorical measures of body composition were compared between RA and control subjects by sex and according to categories of body mass index (BMI). Within the group of RA patients, demographic, lifestyle, and RA disease and treatment characteristics were compared for RA patients with healthy body composition versus those with abnormal body composition phenotypes. RESULTS Compared with non-RA controls, RA status was significantly associated with greater odds of sarcopenia, overfat, and sarcopenic obesity in women, but not in men. Relative differences in body composition phenotypes between RA and control subjects were greatest for patients in the normal weight BMI category (<25 kg/m(2)). Among RA characteristics, increasing joint deformity, self-reported disability scores, C-reactive protein levels, rheumatoid factor seropositivity, and a lack of current treatment with disease-modifying antirheumatic drugs were significantly associated with abnormal body composition. CONCLUSION Abnormal body composition phenotypes are overrepresented in patients with RA, particularly in those in the normal weight BMI range. RA-associated disease and treatment characteristics contribute to this increase in abnormal body composition.
Attainability analysis in the stochastic sensitivity control

For nonlinear dynamic stochastic control system, we construct a feedback regulator that stabilises an equilibrium and synthesises a required dispersion of random states around this equilibrium. Our approach is based on the stochastic sensitivity functions technique. We focus on the investigation of attainability sets for 2-D systems. A detailed parametric description of the attainability domains for various types of control inputs for stochastic Brusselator is presented. It is shown that the new regulator provides a low level of stochastic sensitivity and can suppress oscillations of large amplitude.
Managing patients with severe traumatic brain injury.

Causes and classifications The most common causes of TBI are falls, motor vehicle crashes, and violence, including gunshot wounds.1 TBI can be classified as penetrating or nonpenetrating, as well as focal or diffuse. Focal injuries include contusions and hematomas; diffuse injuries include concussions and diffuse axonal injury (DAI). 2 The Department of Defense and the Department of Veterans Affairs define TBI as any traumatically induced structural injury and/or physiologic disruption of brain function as a result of an external force that’s indicated by new onset or worsening of at least one of the following clinical signs immediately after the event: • any period of loss of or decreased level of consciousness • any loss of memory for events immediately before or after the injury • any alteration in mental state at the time of the injury (confusion, disorientation, slowed thinking) traumatic brain injury
Avaliação da qualidade do leite cru comercializado informalmente em feiras livres no município de Santa Maria-RS

The objective of this paper was to evaluate the quality of raw milk informally com-mercialized in street markets in the city of Santa Maria, RS. Samples of raw milk were purchased directly from merchants in street markets and the milk quality evaluation was performed through physical-chemical and microbiological analysis. Ten samples of informal raw milk were analyzed, but only two showed no variation from the titrable acidity. In these two samples, the parameters of density and fat showed satisfactory results, in opposition to the cryoscopic index, protein and fat dry extract that presented at odds with the established standards. In relation to the microbiological analyzes, 30% of the samples had count of mesophilic microorganisms greater than 6.0x105 UFC/ml and the presence of thermotolerant coliforms was confirmed in all samples of raw milk, but no samples showed contamination by Salmonella sp. Considering that this product is illegally commercialized, the obtained results show the precariousness of hygiene in the commercialized milk in street markets. The consumption of raw milk without any hygienic-sanitary control type exposes consumer health to risks.