Miracle-dz/UniFAR-FTUs huggingface dataset:
Pulmonary Complications After Elective Liver Transplantation—Incidence, Risk Factors, and Outcome

&NA; After liver transplantation (LT), postoperative pulmonary complications (PPC) occur in approximately 35% to 50% of the recipients. Among these PPC, pneumonia is the most frequently encountered. Pulmonary dysfunction has also been widely reported among patients awaiting LT. The links between this dysfunction and PPC have not been clearly established. In this present cohort study, we evaluated the incidence and profile of post-LT pneumonia and identified potential preoperative risk factors. Methods The postoperative clinical course of 212 liver transplant recipients between January 2008 and April 2010 was analyzed. These patients were treated in a single intensive care unit and received standardized postoperative care. Results During the postoperative period, 47 (22%) patients developed pneumonia, of whom 20 (43%) developed respiratory failure requiring mechanical ventilation. Univariate analysis showed that several preoperative factors (age of recipient, model for end-stage liver disease score, indication for LT, platelet count, and restrictive lung pattern revealed by preoperative pulmonary function tests) and the transfusion (blood units and fresh frozen plasma units) during the operative period were associated with pneumonia. Using multivariate analysis by logistic regression, only a restrictive lung pattern (odds ratio=3.14; 95% confidence interval, 1.51–6.51; P=0.002) and the international normalized ratio measured prior LT (OR=4.95; 95% confidence interval, 1.86–8.59; P=0.0004) were independent predictors of pneumonia after LT. Conclusion Pneumonia is common among patients undergoing LT and is a major cause of morbidity. A restrictive pattern on preoperative pulmonary testing and a higher international normalized ratio measured prior LT were associated with more risk of postoperative pneumonia.
Influenza vaccine effectiveness in households with children during the 2012-2013 season: assessments of prior vaccination and serologic susceptibility.

BACKGROUND There are recognized needs to identify determinants of influenza vaccine effectiveness (VE), including the effect of repeated annual vaccination. METHODS We recruited 321 households with 1426 members, including 833 children, and followed them during the 2012-2013 influenza season; specimens were collected from subjects with reported acute respiratory illnesses. We estimated the effectiveness of documented influenza vaccination in preventing laboratory-confirmed influenza, using adjusted Cox proportional hazards models. Antibody titers in a subset of subjects were determined by a hemagglutination inhibition assay to determine the subjects' preseason susceptibility to influenza. RESULTS Influenza was identified in 76 (24%) households and 111 (8%) individuals. VE point estimates indicated significant protection in adults (48%; 95% confidence interval [CI], 1%-72%), similar protection in children aged 9-17 years (49%; 95% CI, -16% to 78%), but no evidence of effectiveness in children aged <9 years (-4%; 95% CI, -110% to 49%). Lower VE was observed in those vaccinated in both the current and prior seasons, compared with those vaccinated in the current season only; susceptibility titers against type A but not type B were consistent with this observation. Residual protection from vaccination in the prior season was indicated by both VE and serologic results. CONCLUSIONS Prior vaccination appears to modify VE by both residual protection and reduced vaccine response.
Enterococcal bacteremia in a tertiary care centre in Winnipeg.

OBJECTIVE To review experience with enterococcal bacteremia before the emergence of vancomycin-resistant enterococcus at a tertiary care teaching hospital. DESIGN Retrospective chart review of episodes of enterococcal bacteremia identified through the clinical microbiology laboratory from January 1990 to December 1994. Antimicrobial susceptibilities were performed for all isolates and pulsed-field gel electrophoresis for genetic typing of selected strains. RESULTS One hundred and twenty-six episodes of bacteremia were identified in 109 patients: 108 Enterococcus faecalis, 13 Enterococcus faecium, four both E faecalis and E faecium, and one Enterococcus durans. Enterococcal isolates occurred with polymicrobial bacteremia in 62 (49%) episodes. The most common sites of infection were central venous catheters (45%) and the urinary tract (21%). Enterococcal bacteremia was usually nosocomially acquired (88%), and associated with older age, instrumentation, and prior or current antimicrobial therapy. Overall mortality was 22%, and 7.2% was partially or fully attributable to enterococcal bacteremia. Resistance to ampicillin, high level gentamicin and high level streptomycin were 0%, 32% and 31% for E faecalis, respectively, and 44%, 0% and 47% for E faecium, respectively. CONCLUSIONS During this review, the frequency and impact of enterococcal bacteremia at this institution was relatively limited. Isolates resistant to ampicillin and aminoglycosides were emerging, but differences in patient outcomes were similar for resistant and susceptible isolates.
Doxycycline Prophylaxis to Reduce Incident Syphilis among HIV-Infected Men Who Have Sex With Men Who Continue to Engage in High-Risk Sex: A Randomized, Controlled Pilot Study

Background Incident syphilis infections continue to be especially prevalent among a core group of HIV-infected men who have sex with men (MSM). Because of synergy between syphilis and HIV infections, innovative means for controlling incident syphilis infections are needed. Methods Thirty MSM who had syphilis twice or more since their HIV diagnosis were randomized to receive either daily doxycycline prophylaxis or contingency management (CM) with incentive payments for remaining free of sexually transmitted diseases (STDs). Participants were tested for the bacterial STDs gonorrhea (Neisseria gonorrhoeae), chlamydia (Chlamydia trachomatis) and syphilis at weeks 12, 24, 36, and 48 and completed a behavioral risk questionnaire during each visit to assess number of partners, condom use, and drug use since the last visit. Generalized linear mixed models were used to analyze differences between arms in STD incidence and risk behaviors at follow-up. Results Doxycycline arm participants were significantly less likely to test positive for any selected bacterial STD during 48 weeks of follow-up (odds ratio, 0.27; confidence interval, 0.09–0.83) compared with CM arm participants (P = 0.02). There were no significant self-reported risk behavior differences between the doxycycline and CM arms at follow-up. Conclusions Daily doxycycline taken prophylactically was associated with a decreased incidence of N. gonorrhoeae, C. trachomatis, or syphilis incident infections among a core group of HIV-infected MSM at high risk for these infections. Safe and effective biomedical tools should be included in the efforts to control transmission of syphilis, especially in this population. A randomized clinical trial should be conducted to confirm and extend these findings.
Hypothalamic mTOR pathway mediates thyroid hormone‐induced hyperphagia in hyperthyroidism

Hyperthyroidism is characterized in rats by increased energy expenditure and marked hyperphagia. Alterations of thermogenesis linked to hyperthyroidism are associated with dysregulation of hypothalamic AMPK and fatty acid metabolism; however, the central mechanisms mediating hyperthyroidism‐induced hyperphagia remain largely unclear. Here, we demonstrate that hyperthyroid rats exhibit marked up‐regulation of the hypothalamic mammalian target of rapamycin (mTOR) signalling pathway associated with increased mRNA levels of agouti‐related protein (AgRP) and neuropeptide Y (NPY), and decreased mRNA levels of pro‐opiomelanocortin (POMC) in the arcuate nucleus of the hypothalamus (ARC), an area where mTOR co‐localizes with thyroid hormone receptor‐α (TRα). Central administration of thyroid hormone (T3) or genetic activation of thyroid hormone signalling in the ARC recapitulated hyperthyroidism effects on feeding and the mTOR pathway. In turn, central inhibition of mTOR signalling with rapamycin in hyperthyroid rats reversed hyperphagia and normalized the expression of ARC‐derived neuropeptides, resulting in substantial body weight loss. The data indicate that in the hyperthyroid state, increased feeding is associated with thyroid hormone‐induced up‐regulation of mTOR signalling. Furthermore, our findings that different neuronal modulations influence food intake and energy expenditure in hyperthyroidism pave the way for a more rational design of specific and selective therapeutic compounds aimed at reversing the metabolic consequences of this disease. Copyright © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
The current perception threshold test differentiates categories of mechanical neck disorder.

STUDY DESIGN Cross-sectional discriminative analysis. OBJECTIVE To determine whether current perception threshold (CPT) can differentiate between categories of patients with mechanical neck disorders (MNDs). BACKGROUND Neck pain is the third most common musculoskeletal disorder and affects a third of all adults each year. It can present as neck pain without musculoskeletal signs, neck pain with musculoskeletal signs but no neurological signs, or neck pain with neurological signs. CPT testing can assess altered sensory perception that may reflect neurological changes. METHODS Patients with MNDs (n = 106) were classified into 3 groups, based on a standardized musculoskeletal examination process performed by an experienced physiotherapist who was blinded to CPT scores. The 3 groups were defined as neck pain without musculoskeletal signs (MND I) (n = 60), neck pain with musculoskeletal signs (MND II) (n = 29), and neck pain with neurological signs (MND III) (n = 17). A rapid protocol of CPT testing was performed at 3 frequencies (5, 250, and 2000 Hz), using 3 dermatomal locations on the hand. A 1-way analysis of variance with post hoc comparison and effect sizes was calculated to compare the mean CPT scores between the groups. A binary logistic-regression model was used to predict probability of higher CPT in MND III and to create a receiver-operating-characteristic curve. RESULTS Mean CPT differed significantly across the 3 MND groups (MND I, 9.7; MND II, 10.6; and MND III, 11.8; P<.001; η(2) = 0.6). Post hoc comparisons indicated differences between MND I and MND II (P = .05) and between MND II and MND III (P = .01) that had large effect sizes (MND I versus II, d = 1 and MND II versus III, d = 2.2). CPT testing was able to distinguish between MND II and III when a threshold value of greater than 11 was used to indicate MND III. The predicted probability of abnormal CPT in MND III had an estimated 73% sensitivity and 81% specificity; the odds ratio was 11.5 (P = .001) for the differentiation capacity of CPT between MND II and III, with a cutoff of 11. The area under the receiver-operating-characteristic curve was 0.84 (95% confidence interval: 0.72, 0.96; P<.001). CONCLUSION CPT testing has moderate discriminatory accuracy, specificity, and sensitivity for classification of MND categories into neck pain with or without neurological signs. J Orthop Sports Phys Ther 2014;44(7):532-540. Epub 10 May 2014. doi:10.2519/jospt.2014. 4691.
Tri-layered chitosan scaffold as a potential skin substitute

A tri-layered chitosan-based scaffold was successfully made to replicate the striation of a full-thickness skin more accurately than a single- or bi-layered scaffold, which needed weeks of co-culturing of fibroblasts and keratinocytes to achieve similar striation. Chitosan solution was freeze-dried and made into porous disks. Chitosan or chitosan–pectin in acetic acid solution was electrospun onto the chitosan disk to form a nanofibrous layer and a thin film. Examinations based on scanning electron spectroscopy showed that the scaffold was composed of a porous layer (2 mm) to simulate the dermis, a thin film (25–45 μm) to mimic the basement membrane, and a layer of nanofibers (100–200 μm) to serve as the protective epidermis. The tensile strength and modulus of the composite scaffold were significantly higher than those of the chitosan disk (p < 0.01). The composite was able to quickly absorb water and stayed intact throughout the course of the 14-day cell culture tests. The fibroblast cells seeded on both sides of the scaffolds were able to proliferate and stayed separated by the thin film.
Long‐lasting enhancement of corticostriatal neurotransmission by taurine

Taurine occurs at high concentrations in the forebrain and its distribution varies with (patho)physiological conditions; however, its role in neural function is poorly understood. We have now characterized its effects on corticostriatal synaptic transmission. Bath application of taurine (10 mm) to slices obtained from mice and rats exerted a biphasic action on corticostriatal field potentials. The fast and reversible inhibition by taurine was accompanied by a depolarization and conductance increase in medium spiny neurons and was sensitive to γ‐aminobutyric acid (GABA)A and glycine receptor (GlyR) antagonists. A long‐lasting enhancement (LLETAU) of field potentials was recorded after taurine withdrawal. The LLETAU was not prevented by N‐methyl‐d‐aspartate (NMDA)‐ or by GABAA receptor‐antagonists, but was sensitive to the GlyR‐antagonist strychnine and blocked by the competitive taurine uptake inhibitor guanidinoethylsulphonate (GES, 1 mm). GES at 10 mm evoked an enhancement of field potentials similar to LLETAU. LLETAU depended on protein kinase C activation as it was blocked by chelerythrine, but was unaffected by trifluoperazine, and thus independent of calmodulin. LLETAU was significantly smaller in juvenile than in mature rodents. Activation of GlyRs and the specific taurine transporter by taurine evoke a long‐lasting enhancement of corticostriatal transmission.
Seasonal Activation and Inactivation of Song Motor Memories in Wild Canaries Is Not Reflected in Neuroanatomical Changes of Forebrain Song Areas

Seasonal, testosterone-dependent changes in sexual behaviors are common in male vertebrates. In songbirds such seasonal changes occur in a learned behavior--singing. Domesticated male canaries (Serinus canaria) appear to lose song units (syllables) after the breeding season and learn new ones until the next breeding season. Here we demonstrate in a longitudinal field study of individual, free-living nondomesticated (wild) canaries (S. canaria) a different mode of seasonal behavioral plasticity, seasonal activation, and inactivation of auditory-motor memories. The song repertoire composition of wild canaries changes seasonally: about 25% of the syllables are sung seasonally; the remainder occur year-round, despite seasonal changes in the temporal patterns of song. In the breeding season, males sing an increased number of fast frequency-modulated syllables, which are sexually attractive for females, in correlation with seasonally increased testosterone levels. About 50% of the syllables that were lost after one breeding season reappear in the following breeding season. Furthermore, some identical syllable sequences are reactivated on an annual basis. The seasonal plasticity in vocal behavior occurred despite the gross anatomical and ultrastructural stability of the forebrain song control areas HVc and RA that are involved in syllable motor control.
Feasibility studies of Bragg probe for noninvasive carotid pulse waveform assessment

Abstract. The arterial stiffness evaluation is largely reported as an independent predictor of cardiovascular diseases. The central pulse waveform can provide important data about arterial health and has been studied in patients with several pathologies, such as diabetes mellitus, coronary artery disease and hypertension. The implementation and feasibility studies of a fiber Bragg grating probe for noninvasive monitoring of the carotid pulse are described based on fiber Bragg grating technology. Assessment tests were carried out in carotids of different volunteers and it was possible to detect the carotid pulse waveform in all subjects. In one of the subjects, the sensor was also tested in terms of repeatability. Although further tests will be required for clinical investigation, the first studies suggest that the developed sensor can be a valid alternative to electromechanical tonometers.
Extracellular matrix changes in human corneas after radial keratotomy.

Extracellular matrix and basement membrane alterations were identified in human corneas after radial keratotomy. Ten normal and five radial keratotomy autopsy corneas (two at 6 months post surgery, and three at 3 years post surgery) were studied by immunofluorescence with antibodies to 28 extracellular matrix and basement membrane components. Outside of radial keratotomy scars, all studied components had a normal distribution. Of stromal extracellular matrix, only type III collagen accumulated around the scars. The basement membrane around epithelial plugs had a normal composition except for type IV collagen. Its alpha1-alpha2 chains, normally present only in the limbal basement membrane, appeared around all plugs. alpha3 and alpha4 chains were very weak or absent in these areas, contrary to nonscarred areas. This basement membrane pattern was similar to the normal limbal but not to the central corneal pattern. Keratin 3 also had a limbal-like, suprabasal expression in the plug epithelium. The stroma around the scars accumulated tenascin-C, fibrillin-1, types VIII and XIV collagen, all of which were absent from normal corneal basement membrane and extracellular matrix. Only tenascin-C showed less staining in anterior scars 3 years post surgery than 6 months post surgery, but still persisted in posterior scars. Incomplete scar healing was evident even 3 years post radial keratotomy. It was manifested by the accumulation of abnormal extracellular matrix in the anterior and posterior scars and by the limbal-like pattern of type IV collagen isoforms in the basement membrane around epithelial plugs.
Comparison of the Reactivity of Tetradecenoic Acids, a Triacsin, and Unsaturated Oximes with Four Purified Saccharomyces cerevisiae Fatty Acid Activation Proteins (*)

Saccharomyces cerevisiae contains at least five acyl-CoA synthetases (fatty acid activation proteins, or Faaps). Four FAA genes have been recovered to date. Recent genetic studies indicate that Faa1p and Faa4p are involved in the activation of imported fatty acids, while Faa2p activates endogenous pools of fatty acids. We have now purified Faa4p from S. cerevisiae and compared its fatty acid substrate specificity in vitro with the specificities of purified Faa1p, Faa2p, and Faa3p. Among C8-C18 saturated fatty acids, Faa4p and Faa1p both prefer C14:0. Surveys of C14 fatty acids with single cis-double bonds at C2-C12 indicated that Faa4p and Faa1p prefer Z9-tetradecenoic acid, although Faa4p's preference is much greater and also evident in C16 and C18 fatty acids. Faa4p's selectivity for fatty acids with a C9-C10 cis-double bond is a feature it shares with Faa3p and is notable since in yeast Ole1p, a microsomal cis-Δ9 desaturase, accounts for de novo production of monoenoic acyl-CoAs from saturated acyl-CoA substrates. Faa4p has no detectable acyl-CoA synthetase activity when incubated with tetradecenoic acids having a trans-double bond at C2-3, C4-5, C5-6, C6-7, C7-8, or C9-10. Faa3p can only use E9-tetradecenoic acid as a substrate, while E4-, E6- and E9-tetradecenoic acids can be used by Faa1p and Faa2p. E2-tetradecenoic acid is an Faap inhibitor, with Faa2p exhibiting the greatest sensitivity (IC = 2.6 ± 0.2 μM). Triacsin C (1-hydroxy3-(E,E,E,2′,4′,7′-undecatrienylidine)-1,2,3-triazene) has trans-double bonds at positions that correspond to those in E2-, E5-, and E7-tetradecenoic acids. This compound is a potent inhibitor of Faa2p (K = 15 ± 1 nM; competitive with fatty acid), less potent against Faa4p (K = 2 μM), and not active against Faa1p or Faa3p (IC > 500 μM). Analysis of an n-tetradecanal plus a series of oximes (tridecanal oxime, 1-azadeca-1,3,5-trienol, and 1-azaundeca-1,3,5-trienol) indicated that the combination of an azenol moiety (R-CH⋕N-OH) plus adjacent unsaturation are critical for triacsin C's selective inhibition of Faa2p. Triacsin C and oxime derivatives appear to be very useful for defining differences in molecular recognition among S. cerevisiae acyl-CoA synthetases. The >25,000-fold range in the inhibitory effects of triacsin C on these four Faaps suggests that it may be possible to develop other selective inhibitors of eukaryotic acyl-CoA synthetases.
Have we underestimated the kinematic and kinetic benefits of non-ballistic motion?

Explosive upper-body movements, with which the load is not thrown (non-ballistic), may comprise a phase during which forces are produced in opposition to the motion of the load. Thirty men completed three test sessions (free weight, ballistic, and pneumatic), each consisting of a one-repetition maximum (1-RM) and four explosive repetitions of a bench press at six loads (15, 30, 45, 60, 75, and 90% 1-RM). The end of the lifting phase for the non-ballistic conditions (free weight and pneumatic) was defined by: the point of peak barbell displacement and the point at which the vertical force became negative (positive work). When analysed by peak displacement, the ballistic condition elicited significantly greater mean velocity, force, and power at loads of 15–60% 1-RM compared with the free weight condition. When the period of negative work was removed, the mean free weight velocity, force, and power at loads below 60% 1-RM increased. Consequently, the only differences between the free weight and ballistic conditions were found at loads of 15% and 30% 1-RM. Including a period of negative work may underestimate all kinematic and kinetic variables dependent on the time to, or position of, the end of the lifting phase, for non-ballistic efforts.