Miracle-dz/UniFAR-FTUs huggingface dataset:
Diagnostic accuracy and case management of clinical malaria in the primary health services of a rural area in south‐eastern Tanzania

Malaria control continues to rely on the diagnosis and prompt treatment of both suspected and confirmed cases through the health care structures. In south‐eastern Tanzania malaria is one of the leading causes of morbidity and mortality. The absence of microscopic examination in most of the health facilities implies that health workers must rely on clinical suspicion to identify the need of treatment for malaria. Of 1558 randomly selected paediatric consultations at peripheral health facilities throughout Kilombero District, 41.1% were diagnosed by the attending health worker as clinical malaria cases and 42.5% prescribed an antimalarial. According to our malaria case definition of fever or history of fever with asexual falciparum parasitaemia of any density, 25.5% of all children attending the health services had malaria. This yielded a sensitivity of 70.4% (IC95%=65.9–74.8%) and a specificity of 68.9% (IC95%=66.2–71.5%). Accordingly, 30.4% of confirmed cases left with no antimalarial treatment. Among malaria‐diagnosed patients, 10% were underdosed and 10.5% were overdosed. In this area, as in many African rural areas, the low diagnostic accuracy may imply that the burden of malaria cases may be overestimated. Greater emphasis on the functioning and quality of basic health services in rural endemic areas is required if improved case management of malaria is to help roll back this scourge.
Does medically induced weight loss improve obstructive sleep apnoea in the obese: review of randomized trials

Obstructive sleep apnoea is characterized by repeated periods of breathing cessation during sleep. Obstructive sleep apnoea is both common and underdiagnosed in the obese. A recent study found that as many as 86% of older obese type 2 diabetics had obstructive sleep apnoea. Obesity is independently associated with developing obstructive sleep apnoea, and the reverse may also occur. The prevalence of obstructive sleep apnoea is therefore expected to rise in the wake of the obesity epidemic. The number of partial (hypopnoea) or complete (apnoea) airway obstructions per hour (apnoea‐hypopnoea index) is used to classify obstructive sleep apnoea as mild (5–14 events per hour), moderate (15–30) or severe (>30). Severe obstructive sleep apnoea is associated with a two to sixfold increase in all‐cause mortality; the impact of mild and moderate obstructive sleep apnoea is less clear. Until recently, the evidence supporting a beneficial effect of weight loss on obstructive sleep apnoea has been limited by a lack of randomized trials. In 2009, at least three randomized controlled trials evaluated whether medically induced weight loss improves obstructive sleep apnoea. The treatment effect ranged from 42% to 62% improvement, although the highest estimate was seen in a very short duration study (9 weeks). Patients who either lost 10–15 kg or more, or had severe obstructive sleep apnoea at baseline, benefited most from treatment.
Transcatheter aortic valve-in-valve implantation and sutureless aortic valve replacement: two strategies for one goal in redo patients.

BACKGROUND The most appropriate approach for high-risk patients with degenerated bioprostheses remains a matter of debate. The aim of the study was to evaluate the clinical and hemodynamic outcome of redo patients undergoing transcatheter aortic valve-in-valve implantation (VinV-TAVI) and sutureless aortic valve replacement (AVR), with assessment of patient-prosthesis mismatch (PPM) in the perioperative and follow-up period. METHODS From 2010, 343 patients underwent TAVI and 220 patients underwent sutureless AVR at our institution. Among these, 14 patients had prior bioprosthetic AVR and indication for reintervention because of valve degeneration. Patients from the TAVI group (N.=6) underwent VinV-TAVI, and patients from the sutureless group (N.=8) underwent redo AVR. RESULTS Mean age was 78.8±3 years in the sutureless group and 80.2±2.3 in the VinV-TAVI group. Logistic EuroSCORE was 36.4±24.1% and 33.8±13.8% in the sutureless and VinV-TAVI group, respectively. There was no in-hospital death. No patient was lost to follow-up (21±13 months, range 6 to 42). Quality of life measured with the EQ-5D questionnaire improved by 65% in the sutureless group and by 67% in the VinV-TAVI group. At follow-up echocardiographic evaluation, no paravalvular leak or intraprosthetic regurgitation was observed in either group. The mean iEOA was 0.96±0.08 vs. 0.71±0.15 cm2/m2 in the sutureless vs. VinV-TAVI group. CONCLUSIONS In patients undergoing redo aortic valve surgery for degenerated bioprostheses, both VinV-TAVI and sutureless AVR are effective in terms of clinical outcome. As regards echocardiographic evaluation, no leak was observed in either group and no cases of severe PPM were recorded in the sutureless group.
SSB transceiver for vital sign detection

An integrated remote wireless sensor to measure respiration and heart rate without any contact is presented. The low-power wireless sensor system uses RF transceiver with embedded DSP algorithm to monitor cardiac and respiratory activities. The prototype system is implemented using a quadrature Low-IF Bluetooth transceiver at 2.4 GHz with a 30 KHz single-side band reference tone. The low-IF signal is digitized at 100 KHz and the embedded DSP algorithm estimates the Doppler phase shift, while reducing the system noise, LO phase noise, 1/f noise, DC offset, and minimizes the clutter, multi-path and echo signals. A new Pattern Search in Noise Subspace (PSNS) algorithm is used to estimate the sub-HZ phase shift due to heart and respiratory movement. The prototype system is tested in the lab with multiple individuals at 5-20 ft distance with less than 5% error.
A gene for autosomal dominant hypohidrotic ectodermal dysplasia (EDA3) maps to chromosome 2q11-q13.

Autosomal dominant hypohidrotic ectodermal dysplasia (ADHED) is a disorder characterized by fine, slow-growing scalp and body hair, sparse eyebrows and eyelashes, decreased sweating, hypodontia, and nail anomalies. By genetic linkage analysis of a large ADHED kindred, we have mapped a gene for ADHED (EDA3) to the proximal long arm of chromosome 2 (q11-q13). Obligate recombinations localize EDA3 to an approximately 9-cM interval between D2S1321 and D2S308, with no apparent recombinations with markers D2S1343, D2S436, D2S293, D2S1894, D2S1784, D2S1890, D2S274, and CHLC.GAAT11C03.
Twenty years of phase III trials for patients with extensive-stage small-cell lung cancer: perceptible progress.

PURPOSE All cooperative group studies performed in North America for patients with extensive-stage small-cell lung cancer (SCLC) were evaluated to determine the pattern of the clinical trials and the outcome of patients over the past 20 years. PATIENTS AND METHODS Phase III trials for patients with extensive-stage SCLC were identified through a search of the National Cancer Institute Cancer Therapy Evaluation Program database from 1972 to 1993. Patients with extensive-stage SCLC treated during a similar time interval listed in the Surveillance, Epidemiology, and End Results (SEER) database were also examined. Trends were tested in the number of trials over time, the number and sex of patients entered onto the trials, and the survival time of patients treated over time. RESULTS Twenty-one phase III trials for patients with extensive-stage SCLC were initiated between 1972 and 1990. The median of the median survival times of patients treated on the control arms of the phase III trials initiated between 1972 and 1981 was 7.0 months; for those patients enrolled onto control arms between 1982 and 1990, the median survival time was 8.9 months (P =.001). Analysis of the SEER database of patients with extensive-stage SCLC over the same time period shows a similar 2-month prolongation in median survival time. CONCLUSION Analysis of 21 phase III trials initiated in North America and the SEER database from 1972 to 1994 demonstrates that there has been a modest improvement in the survival time of patients with extensive-stage SCLC.
Effect of symptoms on executive function in bipolar illness

Background. The relationship between cognitive function and symptomatology in bipolar disorder is unclear. This study assessed executive function during the manic, depressed and remitted stages of bipolar I disorder. Method. Tasks assessing phonological and semantic verbal fluency, the Hayling Sentence Completion Test, the Stroop Neuropsychological Screening Test and the Cognitive Estimates Test were administered to manic (n=15), depressed (n=15), and remitted (n=15) bipolar I patients, and to healthy controls (n=30). Multiple regression analyses and analyses of covariance were used to identify potential determinants of executive dysfunction in the three bipolar groups. Results. Executive function deficits were particularly associated with the manic state. In general, manic patients performed less accurately than the remitted and depressed groups, and their performance deficit was related to the severity of positive thought disorder. The depressed and remitted bipolar groups showed a less widespread pattern of impairment. Deficits in response initiation, strategic thinking and inhibitory control were evident in all the bipolar groups. Conclusions. Executive function deficits in bipolar I disorder are most evident during mania, and are particularly associated with formal thought disorder. However, deficits in response initiation, strategic thinking and inhibitory control may be more related to the underlying disorder than a particular symptom profile.
Transfer of zona-free mouse eggs to uterine foster mothers.

Summary. When blastocysts from pregnant mice 3\m=1/2\days p.c. were transferred to the uteri of synchronous pseudopregnant recipients, the time of onset of implantation (judged by the appearance of pontamine blue reactivity in the uterus) was not altered by removal of the zona pellucida. The competence of zona-free blastocysts to elicit the pontamine blue reaction was similar to that of control blastocysts. The low implantation rate of eight-cell embryos from donors 2\m=1/2\days p.c. , transferred to recipients 3\m=1/2\days p.c. , was not increased by previous removal of the zona. It was concluded that, in mice, the decidualizing stimulus from the blastocyst to the uterus stems neither from the zona itself, nor from cellular contact between the vitelline surface and the uterine epithelium. Removal of the zona by treatment with pronase reduced the viability of transferred blastocysts, so that by mid-gestation the proportion of zona-free blastocysts represented by live embryos was significantly below the control level.
Bicalutamide monotherapy versus leuprolide monotherapy for prostate cancer: effects on bone mineral density and body composition.

PURPOSE Gonadotropin-releasing hormone agonists decrease bone mineral density, lean mass, and muscle size and increase fat mass in men with prostate cancer. Less is known about the effects of bicalutamide monotherapy on bone mineral density and body composition. PATIENTS AND METHODS In a 12-month, open-label study, we randomly assigned 52 men with prostate cancer and no bone metastases to receive either leuprolide or bicalutamide (150 mg by mouth daily). Bone mineral density and body composition were measured by dual energy x-ray absorptiometry and quantitative computed tomography. RESULTS Mean (+/- standard error) bone mineral density of the posterior-anterior lumbar spine decreased by 2.5% +/- 0.5% in the leuprolide group and increased by 2.5 +/- 0.5 in the bicalutamide group from baseline to 12 months (P <.001). Mean changes in bone mineral density of the total body, total hip, femoral neck, and trabecular bone of the lumbar spine also differed significantly between groups (P < or =.003 for each comparison). Fat mass increased by 11.1% +/- 1.3% in the leuprolide group and by 6.4% +/- 1.1% in the bicalutamide group (P =.01). Changes in lean mass, muscle size, and muscle strength were similar between the groups. Breast tenderness and enlargement were more common in the bicalutamide group than in the leuprolide group. Fatigue, loss of sexual interest, and vasomotor flushing were less common in the bicalutamide group than in the leuprolide group. CONCLUSION In men with prostate cancer, bicalutamide monotherapy increases bone mineral density, lessens fat accumulation, and has fewer bothersome side effects than treatment with a gonadotropin-releasing hormone agonist.
Estimated intake of vitamin D and its interaction with vitamin A on lung cancer risk among smokers

Data are very limited on vitamin D and lung cancer prevention in high‐risk populations. The authors investigated whether estimated vitamin D intake was associated with lung cancer risk and whether effect modification by vitamin A existed among current/former heavy smokers and workers with occupational exposure to asbestos. A case–cohort study selected 749 incident lung cancers and 679 noncases from the Carotene and Retinol Efficacy Trial (CARET), 1988–2005. The active intervention was supplementation of 30 mg β‐carotene + 25,000 IU retinyl palmitate/day. Baseline total intake including both diet (from food frequency questionnaire) and personal supplements (from brand names linked to the labeled potencies) was assessed. Hazard ratios (HRs) were estimated by Cox proportional hazard models. No significant association of total vitamin D intake with lung cancer was observed overall. However, total vitamin D intake ≥600 versus <200 IU/day was associated with a lower risk of non‐small cell lung cancer among former smokers [HR = 0.36, 95% confidence interval (CI) = 0.13–0.96]. Total vitamin D intake ≥400 versus <400 IU/day was associated with a lower risk of total lung cancer among participants who received the CARET active intervention (HR = 0.56, 95% CI = 0.32–0.99) and among those who had total vitamin A intake ≥1,500 µg/day retinol activity equivalent (RAE; HR = 0.46, 95% CI = 0.23–0.91). The beneficial associations were attenuated among those who did not receive the CARET active intervention or who had total vitamin A intake <1,500 µg/day RAE (p‐interaction = 0.02 for current smokers). Our observation suggests that vitamin A may assist vitamin D in preventing lung cancer among smokers.
Chagas' Heart Disease

Chagas' disease is caused by a protozoan parasite, Trypanosoma cruzi, that is transmitted to humans through the feces of infected bloodsucking insects in endemic areas of Latin America, or occasionally by nonvectorial mechanisms, such as blood transfusion. Cardiac involvement, which typically appears decades after the initial infection, may result in cardiac arrhythmias, ventricular aneurysm, congestive heart failure, thromboembolism, and sudden cardiac death. Between 16 and 18 million persons are infected in Latin America. The migration of infected Latin Americans to the United States or other countries where the disease is uncommon poses two problems: the misdiagnosis or undiagnosis of Chagas' heart disease in these immigrants and the possibility of transmission of Chagas' disease through blood transfusions. Diagnosis is based on positive serologic tests and the clinical features. The antiparasitic drug, benznidazole, is effective when given for the initial infection and may also be beneficial for the chronic phase. The use of amiodarone, angiotensin‐converting enzyme inhibitors, and pacemaker implantation may contribute to a better survival in selected patients with cardiac involvement of chronic Chagas' disease.
Motor function–muscle strength relationship in spinal muscular atrophy

The relationship between motor function and muscle strength in patients with spinal muscular atrophy (SMA) is still controversial. In 120 genetically proven SMA patients, aged 5 years or older, we measured muscle strength in the arms and legs by a hand‐held dynamometer, forced vital capacity by a spirometer, and the time needed to walk 10 m, arise from the floor, and climb steps. SMA patients had markedly reduced muscle strength, approximating 20% of that predicted from age‐ and gender‐matched normative data. Knee extensors were the weakest muscles in SMA patients. The young ambulant SMA patients performed better than adults in all the timed tests and had greater muscle strength on knee extension. This study shows a good relationship between motor ability and muscle strength in SMA and confirms that age‐related loss of function in SMA is due to loss of muscle strength. Muscle Nerve 29: 548–552, 2004
Autophagy controls everolimus (RAD001) activity in mantle cell lymphoma

Mantle cell lymphoma (MCL) is an aggressive neoplasm, which lacks effective therapy. The mechanistic target of rapamycin (MTOR) kinase inhibitor everolimus (RAD001) has shown activity in preclinical and clinical models of MCL, despite the fact that its mechanism of action has not been fully elucidated. We found that everolimus activity in MCL cells is closely linked to AKT phosphorylation status, and that the prevention of AKT rephosphorylation upon everolimus treatment by means of a selective AKT inhibitor, greatly enhances everolimus activity. Furthermore, our data show that an accumulation of autophagic vacuoles correlates with a lack of efficacy of dual AKT-MTOR targeting and that the complete therapeutic potential of this strategy can be restored by ATG gene selective knockdown or secondary inhibition of autolysosome formation by hydroxychloroquine. We thus demonstrated for the first time that the use of an autophagy inhibitor can overcome resistance to the combination of MTOR and AKT inhibitors in MCL cell lines and primary samples, demonstrating the prosurvival role of autophagy in AKT-MTOR compromised cells, and pointing out some potential opportunities using this triple combinational strategy in hematological malignancies.
Circadian bioperiodic response of mice bearing advanced L1210 leukemia to combination therapy with adriamycin and cyclophosphamide.

Abstract Cyclophosphamide, 100 mg/kg, and Adriamycin, 5 mg/kg, were synergistic in treating L1210 leukemic mice that were inoculated with 1 × 10 5 L1210 cells 4 days prior to treatment. Only one course of treatment was given. There was a dramatic circadian variation in response as monitored by mean survival time or cure rate. The variation in cure rate (mice alive and apparently free of disease 75 days post-tumor inoculation) as a function of treatment timing ranged from 8 to 68% in male animals standardized to 12 hr of light alternating with 12 hr of darkness. Similarly, in female mice standardized to 8 hr of light alternating with 16 hr of darkness, the cure rate ranged from 0 to 56% depending on when the drugs were injected during a 24-hr span. No cures were obtained with either drug alone. The maximal cure rate was recorded when the two drugs were administered during the early part of the dark portion of the light-dark cycle (whether 12 hr of light and 12 hr of darkness or 8 hr of light and 16 hr of darkness), whereas maximal mortality occurred following treatment early in the light span. Extensive evidence also documents that maximal therapeutic advantage was obtained when the two drugs were separated by 2- or 3-hr intervals and that this effect of drug sequencing was strongly circadian stage dependent. The results indicate the need for information on endogenous temporal organization in studies of order and intervals in the administration of combination therapy.
A mobile QoE Architecture for Heterogeneous Multimedia Wireless Networks

One of the main requirements in this emerging wireless multimedia era is the Quality of Experience (QoE) assurance for 2D or 3D video applications in heterogeneous multi-operator environments. Therefore, this paper proposes a QoE Architecture for Heterogeneous Multimedia Wireless Networks, called QoEHand. QoEHand extends the Media Independent Handover (MIH)/IEEE 802.21 proposal with QoE-awareness, seamless mobility, dynamic class of service mapping and a set of content adaptation schemes. The proposed solution allows the best connection and considers the QoE needs of mobile clients and available wireless resources in IEEE 802.11e and IEEE 802.16e service classes. Simulation experiments were carried out to show the impact and benefits of QoEHand on the user's perception, by using objective and subjective QoE metrics.
Brain-computer interfaces for hci and games

In this workshop we study the research themes and the state-of-the-art of brain-computer interaction. Brain-computer interface research has seen much progress in the medical domain, for example for prosthesis control or as biofeedback therapy for the treatment of neurological disorders. Here, however, we look at brain-computer interaction especially as it applies to research in Human-Computer Interaction (HCI). Through this workshop and continuing discussions, we aim to define research approaches and applications that apply to disabled and able-bodied users across a variety of real-world usage scenarios. Entertainment and game design is one of the application areas that will be considered.
Barriers to Business Start-up among Tanzanian University Graduates: Evidence from the University of Dar-es-salaam

This article assesses barriers to business start-ups among university graduates by drawing evidence from the University of Dar-es-salaam. A cross-sectional research design was used with a sample comprising 308 graduates and 10 key informants. Data was collected using a structured questionnaire and key informant interview checklist and were analysed using the Structural Equation Modeling (SEM) whereby confirmatory factor analysis was performed using Analysis of Moment Structures (AMOS) and the Statistical Package for Social Sciences (SPSS) software. Pearson’s chi-square was used to test whether graduates who had not studied entrepreneurship and those who had studied entrepreneurship reported different start-up barriers. It was found that inappropriate teaching methods, lack of business experience, deficiencies in the university programmes, commitments on extended families and bureaucratic tendencies had greater contribution to hindering business start-ups. It was concluded that entrepreneurship study influenced the way graduates perceived the barriers; it was observed that graduates who studied entrepreneurship reported different start-up barriers from those reported by their counterparts. The results were statistically significant at p-value < 0.05. Higher learning institutions should adopt competent based curricula in order to impart necessary business skills to students and use the business apprenticeship approach while students are still on studies.
A Hybrid Analytic-Numerical Algorithm of Scattering From an Object Above a Rough Surface

A hybrid algorithm, combining analytic Kirchhoff approximation (KA) and numerical method of moments (MoMs), is developed to solve the coupling electric-field integral equations (EFIEs) of scattering from a perfect electric conducting (PEC) object above a randomly rough PEC surface under TE-polarized plane-wave incidence. The MoM with the conjugate gradient approach is used to first solve the EFIE of the object. The surface fields on the rough surface are analytically expressed using the KA method, and large memory and computations for those fields are greatly reduced. An iterative approach of the surface fields induced on both object and rough surface is then utilized to take into account interactions between the object and underlying rough surface. Convergence of this hybrid algorithm is numerically validated. Making use of Monte Carlo realization, bistatic scattering from a 2-D PEC cylindrical object above a PEC rough surface is well simulated by this hybrid KA-MoM algorithm