Miracle-dz/UniFAR-FTUs huggingface dataset:
Why Are Children With Bronchiolitis At Risk Of Urinary Tract Infections?

Abstract Viral respiratory infections are frequently eliminated from human bodies without any sequelae. Secondary serious bacterial infection (SBI) in children with acute bronchiolitis has been an apprehension expressed by health care providers. Several published studies have shown an association between acute bronchiolitis and secondary bacterial infection, including urinary tract infections (UTI). However, the proposed mechanism by which a virus can induce UTIs is not yet known. The aim of this commentary is to update the current evidence of risk of UTI in children with bronchiolitis. We present several clinical studies related to the topic as well as a brief review of the potential pathophysiology of secondary infections that could present with viral respiratory illness.
A Case Of Ipilimumab-Induced Unusual Serous Retinal Detachment In Bilateral Eyes

Purpose Ipilimumab is an immune checkpoint inhibitor that is now widely used for patients with metastatic malignant melanoma. However, this immune checkpoint inhibitor can induce related adverse events in various organs. Here, we report a case of bilateral drug (ipilimumab)-induced serous retinal detachment (SRD), and the characteristic features found during swept-source optical coherence tomography (SS-OCT). Case A 78-year-old man with metastatic melanoma received 4 cycles of dacarbazine, nimustine, vincristine, and interferon-beta starting in January 2014, followed by 47 cycles of nivolumab starting in September 2014. Treatment with ipilimumab was started in June 2017. After 2 cycles of ipilimumab, the patient noticed impairment of the visual field in both of his eyes (at day 22) and visited our department in August 2017. Best corrected visual acuity at this initial visit was 16/20 in both eyes, while a fundus examination revealed SRD and retinal pigment epithelial detachments in both eyes. When using the horizontal and vertical 12 mm B-scanned images of SS-OCT, we detected SRD accompanied by a widely distributed high reflection of the photoreceptor outer segment, including the area where the SRD appeared. In addition, the image also showed the interdigitation zone was indistinguishable. Fluorescein angiography showed little leakage in the maculae. During his course of follow-up examinations, there was an increase in the SRD at the beginning, after which it then gradually decreased. However, the obscurity of the interdigitation zone remained. Conclusion Ipilimumab may cause impairment of the outer retinal layer. We suggest that this is a presumed ipilimumab-induced SRD.
An Improved Route-Finding Algorithm Using Ubiquitous Ontology-Based Experiences Modeling

Every day, people are hired in different organizations and old and retiring employees are eliminated from enterprise systems. Eliminating these individuals from organizations leads to the loss of their spatial experiences. In addition, since new employees lack relevant experience, they need a long time to develop the correct skills for the company and may even cause damage to the organization during this learning process. Therefore, storing the spatial experience of individuals is a critical issue. Due to the intelligence of ubiquitous Geospatial Information System (GIS), any experience from any user can be received and stored. In the future, based on these experiences, an appropriate service to each user may be provided as needed. This paper aims to propose an ontology-based model to store spatial experiences in the field of ubiquitous GIS route finding. For this purpose, first ontology is designed for route finding, and then according to this ontology, an ontology-based route-finding algorithm is developed for ubiquitous GIS. Finally, this algorithm is implemented for Tehran, Iran, and its results are compared with the shortest path algorithm (Dijkstra’s algorithm) in terms of the route length and travel time for peak traffic time. The results show that while the route length obtained from the ontology-based algorithm is more than Dijkstra’s algorithm, the travel time is lower, and on some routes the difference in travel time saved reaches 35 minutes.
Role o f Nitric Oxide in Liver Cirrhosis

Introduction : Patients of liver cirrhosis suffer from deleterious effects of hyper dynamic circulation like ascites, edema etc. Increased Nitric Oxide levels may be one of the causes of them (potent vasodilator). So we have decided to study the role of Nitric Oxide in liver cirrhosis. Materials and Methods : The Nitric Oxide levels was found in the form of Total Nitrates in 40 normal controls and 40 known cases of liver cirrhosis by Cortas and Wakid method and compared it with liver functions like serum ALT activity (Kinetic Kit method), serum albumin level (Bromocresol Green method) and prothrombin time (Quick's method) in both groups. Observations and Results ; We found that the serum Nitric Oxide levels in the form of Total Nitrates were significantly high in liver cirrhosis patients (102 ± 20.3µmol/ L) as compared to normal controls (57 ± 19.9µmol/L), but having no co-relation with liver functions like serum albumin levels, serum total ALT levels and prothtrombin time. Conclusion ; This study provides the evidence that increased production of Nitric Oxide in liver cirrhosis may be responsible for the hemodynamic changes seen in patients of liver cirrhosis. So by using Nitric Oxide inhibitors patient's discomfort due to hyper dynamic circulation can be reduced.
Abundant Coexisting Multiple Attractors' Behaviors in Three-Dimensional Sine Chaotic System

This paper presents a novel and simple three-dimensional (3-D) chaotic system by introducing two sine nonlinearities into a simple 3-D linear dynamical system. The presented sine system possesses nine equilibrium points consisting of five index-2 saddle foci and four index-1 saddle foci which allow the coexistence of various types of disconnected attractors, also known as multistability. The coexisting multiple attractors are depicted by the phase plots and attraction basins. Coexisting bifurcation modes triggered by different initial values are numerically simulated by two-dimensional bifurcation and complexity plots under two sets of initial values and one-dimensional bifurcation plots under three sets of initial values, which demonstrate that the abundant coexisting multiple attractors’ behaviors in the presented sine system are related not only to the system parameters but also to the initial values. A simulation-oriented circuit model is synthesized, and PSIM (power simulation) screen captures well validate the numerical simulations.
Clinical Characteristics Of Patients With Asthma COPD Overlap (ACO) In Australian Primary Care

Purpose Many older adults with a history of smoking and asthma develop clinical features of both asthma and COPD, an entity sometimes called asthma-COPD overlap (ACO). Patients with ACO may be at higher risk of poor health outcomes than those with asthma or COPD alone. However, understanding of ACO is limited in the primary care setting and more information is needed to better inform patient management. We aimed to compare the characteristics of patients with ACO or COPD in Australian general practices. Patients and methods Data were from the RADICALS (Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers) trial, an intervention study of an interdisciplinary community-based model of care. Baseline demographic and clinical characteristics, pre- and post-bronchodilator spirometry, dyspnoea and St. George’s Respiratory Questionnaire scores were compared between 60 ACO patients and 212 with COPD alone. Results Pre-bronchodilator Forced Expiratory Volume in 1 second (mean±SD 58.4±14.3 vs 67.5±20.1% predicted) and Forced Vital Capacity (mean 82.1±16.9 v 91.9±17.2% predicted) were significantly lower in the ACO group (p<0.001), but no difference was found in post-bronchodilator spirometry. Demographic and clinical characteristics, dyspnoea, quality of life, comorbidities and treatment prescribed did not differ significantly between groups. Conclusion This is the first study describing the clinical characteristics of ACO patients in Australian general practices. Our finding of lower pre-bronchodilator lung function in the ACO group compared to those with COPD reinforces the importance of spirometry in primary care to inform management. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12614001155684.
An algorithm for structuring programs (Extended Abstract)

Structured programming emphasizes programming language constructs such as while loops, until loops, and if then else statements. Properly used, these constructs make occurrences of loops and branching of control obvious. They are preferable to goto statements, which tend to obscure the flow of control [DDH,DIJ]. This paper describes an algorithm which transforms a flowgraph into a program written using repeat (do forever) and if then else statements. The goal of the algorithm is to produce readable programs, rather than to avoid the use of goto statements entirely. goto statements are generated when there is no better way to describe the flow of control. A number of techniques for eliminating goto statements from programs have been previously published [AM, BJ, BS, COO, KF, KOS, PKT]. However, these techniques do not necessarily produce clear flow of control [KN]. Misuse of control constructs may mislead the reader into expecting patterns of control flow which do not exist in the algorithm. For example, these techniques may use a repeat statement when the contained code cannot be executed more than once or add numerous control variables to avoid goto statements. They also may avoid goto statements by copying segments of code or creating subroutines. The former method results in longer programs and bugs may be introduced when all the identical segments must be modified. The latter method may result in subroutines which appear unnatural.
An optimized trusted‐cluster–based routing in disruption‐tolerant network using experiential learning model

Disruption‐tolerant network (DTN) implementation is subject to many routing constraints like limited knowledge of the network and intermittent connections with no end‐to‐end path existence. In this paper, the researchers propose trusted‐cluster–based routing protocol (TCR) for routing in DTN. TCR uses the experiential learning model that integrates neural network‐based bipolar sigmoid activation function to form trusted‐cluster DTN. TCR works in two phases: firstly to form a trusted‐cluster and secondly to identify cluster heads to direct network traffic through them. After the formation of the trusted‐cluster, a cluster head is chosen for a set period, thus instigating stability in the network. These trust values are attached to the node's route cache to make competitive routing decisions by relaying a message to the other trusted intermediate nodes only. With negative trust value, any node is deprived of participation in the network. This way, TCR eliminates malicious or selfish nodes to participate in the DTN network and minimizes the number of messages forwarded in a densely populated DTN. Also, this implementation conserves sufficient buffer memory to reach the destined node. The TCR's performance with other DTN routing schemes, namely, epidemic and trust‐based routing, is compared using multiple simulations runs. The proposed work is verified using mobility traces from Community Resource for Archiving Wireless Data At Dartmouth, and the experimental result shows the elimination of selfish nodes participating in the DTN. The simulation result shows an increase of 19% in message delivery by forwarding only to a trusted intermediate node possible.
The effect of nurse-coordinated telecare intervention on depressed mood and diabetes-related emotional stress among community-dwelling older adults with type 2 diabetes mellitus in Southeastern Ontario

The purpose of the study was to examine the effects of nurse-coordinated telephone monitoring among community-dwelling older adults with type 2 diabetes. In a randomized controlled trial 28 participants (aged 65-84yrs) with type 2 diabetes living in Southeastern Ontario were randomly assigned to an intervention group (15) and control group (13). The intervention group received weekly nurse-coordinated telephone monitoring and the control group received usual care from their family doctor. The main outcome measures were depression and diabetes-related stress as measured by measured by the Geriatric Depression Scale (GDS) and the Problem Areas In Diabetes (PAID) questionnaire at baseline and 12weeks. All participants completed the study. At 12 weeks, mean scores for the intervention group were significantly lower for the GDS (p = .00) and the PAID (p = .03). Participants were receptive to the intervention. Nurse telephone monitoring may decrease depressive symptoms and diabetes-related stress among community-dwelling older adults.
Case Report: Umbilical Metastasis as the Manifestation of an Asymptomatic Gallbladder Carcinoma

Sister Mary Joseph's nodule (SMJN) is an eponym used to describe the metastatic lesion of the umbilicus. Umbilical metastases are rare and its occurrence as a first manifestation of an asymptomatic primary malignancy is very rare. The gallbladder is the source of SMJN in 2%-3% of cases. SMJN can present in any one of the following ways; first manifestation of an occult primary malignancy, an indication of recurrence in a patient with a previous malignancy, or as progression of an underlying symptomatic primary disease. Our study emphasizes the importance of identifying this very useful and easily applicable clinical sign by careful physical examination of the abdomen, and also the need for proper clinical evaluation of any umbilical lesion, and the histological diagnosis. In the present study we report on a case of Sister Mary Joseph's Nodule as the presentation of an asymptomatic gallbladder carcinoma, and review the relevant literature.
Development of an interprofessional ECMO education curriculum for registered nurse and respiratory therapist maintained ECMO at Providence Healthcare

Supervisory Committee Dr. Joan MacNeil RN, MSN, PhD, Associate Professor, School of Nursing Supervisor Dr. Rosalie Starzomski RN, BN, MN, PhD, Professor, School of Nursing, Associate Director for Research and Scholarship Project Committee Member As a result of the national and international shortage of cardiovascular perfusionists, members of the critical care program at Providence Healthcare want to pursue the implementation of an interprofessional extracorporeal membrane oxygenation (ECMO) education program for registered nurses (RNs) and respiratory therapists (RTs). My original intent in this project was to develop the curriculum for the in-house interprofessional ECMO program for RNs and RTs based upon the vision of the stakeholders. However, due to findings in the curriculum development process, my aim changed to that of developing a curriculum with another facility that currently conducts interprofessional ECMO education. The goal for the curriculum remained unchanged— for RNs and RTs to participate in and successfully complete the ECMO education so that they could develop the cognitive, affective, and psychomotor skills needed to collaboratively, safely, and competently maintain ECMO on adult patients in the intensive care unit (ICU). Achieving this goal would lessen the effects of the perfusionist shortage, meet the desire for interprofessional education in the ICU, strengthen collaboration, and possibly create the capacity to expand services provided to patients including bridging to transplantation. In this paper, I outline the process I followed in developing the curriculum. I clearly identify the problem, perform a general and targeted needs assessment, establish goals and objectives, identify philosophical and theoretical
FRI0597 Near-Infrared Spectroscopic Hand Imaging: A New Tool to Assess Microcirculatory Impairment in Systemic Sclerosis

Background Patients affected by systemic sclerosis (SSc) develop functional and structural microcirculatory dysfunction, which leads to skin fibrosis initially affecting distal extremity. Recent studies have tested the possibility of evaluating the skin microcirculation of the entire hand and its spatial heterogeneity by means of optical Near-Infrared Spectroscopic (NIRS) of blood HbO2 saturation (stO2). The NIRS-sensitive camera is a non-invasive tissue oxygenation measurement system based on near infrared light. The camera reports and approximates value of stO2 in superficial tissue. Processing software of the NIRS-camera generates 2D imaging maps automatically in real time. Objectives To test whether NIRS hand imaging may evaluate microcirculatory dysfunction in SSc Methods Forty-two SSc patients (90% women, mean age 55.1±15.6 years) and 18 sex and age-matched healthy controls (86% women, mean age 54.3±14.5 years, p=.89) underwent evaluation of the hand microcirculation by NIRS 2D imaging. A blood pressure cuff was applied to the forearm and 3-min ischemia was induced. Images were acquired at basal conditions at each 10 seconds during 3 minutes of ischemia and during reperfusion condition. Four regions of interest (ROI) were positioned on each fingertip, from the second to the fifth finger. Results A significant difference was found between controls and SSc in basal stO2 (84.4±9.9 vs 75.9±12.5%, p<.01), minimum stO2 (65.6±10.2 vs 54.4±10.9%, p<.001), maximum stO2 (92.4±3.9 vs 86.8±6.6%, p<.001), time to maximum stO2 (247±42 vs 277±60 msec, p<.05). Patients with anti-topoisomerase positivity had lower values of basal stO2 compared to patients without (78.8±11.7 vs 69.3±12.7, p<.05). No significant differences were found among different degrees of impairment at nailfold capillaroscopy (early, active, late). Conclusions Data show that NIRS hand imaging is a simple, automated promising tool to non-invasively assess the skin microcirculation of the entire hand, which can complement information deriving from nailfold capillaroscopy. Acknowledgements We thank Mr. Gennaro D'Angelo for his technical support. Disclosure of Interest None declared
Therapy for Severe Histoplasmosis: What's Best?

myositis and skin abscesses presenting as IRS in a patient receiving HAART. There were previous single reports of MAC pyomyositis [5] and MAC skin abscesses [6] in patients with AIDS during the era before HAART. Of interest, however, in both of these earlier reports, the unusual clinical presentations developed shortly after the patients had started zidovudine monotherapy. We speculate that these may have been due to IRS that was not recognized in the pre-HAART era.
Evaluation of a purified diet to obtain a biomodel of anemic rats

Introduction: the scientific and technological development of biological and biomedical sciences has been possible due to the use of experimental animal models. Iron(Fe-) deficiency anemia affects about one third of the world population. Just weaned rats have been the animal model most commonly used to obtain an experimental biomodel of anemia. The disease is obtained by the hemoglobin (Hb) depletion method, feeding the animal an iron-deficient diet. Objective: evaluate the efficacy of a purified diet based on casein to obtain anemic rats. Method: a study was conducted of 40 just weaned (21-24 days) Sprague Dawley rats, 20 of each sex. The animals were housed in groups of 3 rats of the same sex in stainless steel boxes with mesh bottoms. For 8 weeks the animals were administered deionized water and a casein diet of 12.58% protein and 1.28 mgFe/kg. Body weight was measured every two weeks. Hb concentration was gauged from the fourth week onwards. Results: a significant increase in body weight was obtained, with no differences between male and female rats. The criterion for anemia was at least a 30% decrease in Hb with respect to the average baseline value per group. The percentage of anemic animals at 8 weeks was higher for females (75%) than for males (60%). Conclusions: the diet used for the study made it possible to obtain female anemic rats with acceptable efficiency in relation to the percentage of anemic animals and the increase in body weight.
CURRENT STATUS OF MICROBIOLOGY AND MEDICAL MICROBIOLOGY RESEARCH IN SAARC COUNTRIES

There are 8 countries in SAARC region which have common feature in the form of geography and climate conditions. Although region has huge population but scientific output from the region is very less compared to European or North American countries and especially in specialized fields such as microbiology and medical microbiology. The present study is to highlight current status of microbiology research in the region. The whole SAARC region produced 8,540 and 6,726 publications in microbiology and medical microbiology respectively in 10 years (2004-13) which are almost 5 times less then USA alone. In addition, the whole region produced 997 and 727 publication in microbiology and medical microbiology respectively in 2013 which are very less compared to USA alone. There are specialized microbiology related science societies in half of the SAARC countries while Afghanistan, Maldives, Bhutan and Sri Lanka don’t have a specialized society yet. There are just 3 specialized journals with IF from the whole region and all of them are based in India. Overall scientific progress in the field of microbiology is less which concrete efforts to promote this important field of research and it needs need cooperation at all levels.
Prevention of ACL Injuries

Athletes are particularly at risk for anterior cruciate ligament injury, and there is some evidence that female athletes are more at risk than males. The conflicting principles of stability and mobility are at odds within the knee, setting the stage for potentially serious injuries. Some investigators suggest that the size of the intercondylar notch should be used to identify athletes at risk for ACL damage, but more research is required before clinical decisions can be based on notch width measurements. Athletic shoe modifications and artificial playing surfaces may influence the incidence of ACL injures. Functional knee braces appear to have beneficial strain shielding effect on the ACL for anterior directed loads and internal–external torques applied to the tibia, but this effect appears to decrease as the magnitude of these anterior directed loads and torques increases. Ski equipment is often pointed to as a contributing factor in ACL injuries, but there is no evidence that modifications in ski equipm.
Prevalencia de sobrepeso y obesidad en estudiantes adolescentes ecuatorianos del área urbana

SUMMARY. Prevalence of overweight and obesity in Ecuadorian adolescent students in the urban area. This is the first study to establish the prevalence of overweight and obesity among Ecuadorian adolescent students. The population studied was made up of 2.829 students, 1.461 females and 1.368 males between 12 and 95. Results indicate that 21.2% of adolescents had excess weight: 13.7% were overweight and 7.5% had obesity. Excess weight was higher in the Coast (24.7%) than in the Andean Region (17.7%; P<0.0001). In the same way, excess weight was higher among students attending private schools (25,3%) than in those attending public schools (18.9%; P<0.0001). Data also indicate that excess weight was more common in women than in men, 21.5% versus 20.8%, respectively (P<0.02). The study also indicated that 16.8% of adolescents were underweight. Taken together, these data indicate that 38% of the studied population was malnourished. It is necessary to take measures to prevent and treat these important public health