Miracle-dz/UniFAR-FTUs huggingface dataset:
The acquisition of full fluoroquinolone resistance in Salmonella Typhi by accumulation of point mutations in the topoisomerase targets.

OBJECTIVES To determine the contribution to fluoroquinolone resistance of point mutations in the gyrA and parC genes of Salmonella Typhi. METHODS Point mutations that result in Ser-83-->Phe, Ser-83-->Tyr and Asp-87-->Asn amino acid substitutions in GyrA and Glu-84-->Lys in ParC were introduced into a quinolone-susceptible, attenuated strain of Salmonella Typhi using suicide vector technology. This is the first time that this approach has been used in Salmonella and abrogates the need for selection with quinolone antibacterials in the investigation of resistance mutations. RESULTS A panel of mutants was created using this methodology and tested for quinolone resistance. The ParC substitution alone made no difference to quinolone susceptibility. Any single GyrA substitution resulted in resistance to nalidixic acid (MIC >or= 512 mg/L) and increased by up to 23-fold the MIC of the fluoroquinolones ofloxacin (MIC <or= 2 mg/L) ciprofloxacin (MIC <or= 1 mg/L) and gatifloxacin (MIC <or= 0.38 mg/L). Among the double substitution mutants, those with a substitution in ParC were less prone to killing with ciprofloxacin. The triple substitution mutants (Ser-83-->Phe or Tyr and Asp-87-->Asn in GyrA with Glu-84-->Lys in ParC) showed high levels of resistance to all the fluoroquinolones tested (MICs: gatifloxacin, 3-4 mg/L; ofloxacin, 32 mg/L; ciprofloxacin, 32-64 mg/L). CONCLUSIONS In Salmonella Typhi the fluoroquinolones tested act on GyrA and, at higher concentrations, on ParC. The point mutations conferred reduced susceptibility to ofloxacin and ciprofloxacin, and also reduced susceptibility to gatifloxacin. Three mutations conferred resistance to ofloxacin (32 mg/L), ciprofloxacin (32 mg/L) and to the more active fluoroquinolone gatifloxacin (MIC >or= 3 mg/L). These results predict that the use of ofloxacin or ciprofloxacin will select for resistance to gatifloxacin in nature.
Do Not Just “Higher the Low and Lower the High”

Copyright © 2007 Sage Publications 121 In 1910, WW Duke [1] noted an improvement in hemorrhagic disease after administering plateletcontaining whole blood and identified the relationship between hemostasis and platelets. Since then, platelet transfusion has made stepwise innovations and become a valuable and sometimes lifesaving intervention in various clinical conditions. Yet, in the absence of evidence-based guidelines, the decision to administer platelet concentrates prophylactically continues to often be a casual one. Despite its limitations, acknowledged by the authors, the study by Salman et al [2], in line with work by others, provides evidence that the practice of prophylactic platelet transfusion in the setting of intensive care medicine is variable and arbitrary, not translated into improved outcome, and not uncommonly associated with adverse effects. They appropriately concluded that prospective studies were warranted. Until such studies, including the one conducted by the Transfusion Medicine and Hemostasis Clinical Trial Network, clinicians are invited to use a rationalized step-by-step approach to platelet transfusion decision-making (Table 1) [3]. First, platelet clumping must be ruled out before submitting patients to unnecessary testing or platelet transfusion. Second, the possibility of disseminated intravascular coagulopathy, which requires rapid recognition and treatment, must be considered. Platelet transfusion is contraindicated in microagiopathic hemolytic syndromes, heparin-induced
A Reliable Limited Sampling Strategy for the Estimation of Mycophenolic Acid Area Under the Concentration Time Curve in Adult Renal Transplant Patients in the Stable Posttransplant Period

In renal transplant patients, there is an established relationship between mycophenolate area under the curve and clinical outcome. The authors have developed and validated a limited sampling strategy to estimate mycophenolic acid area under the curve to 12 hours (MPA AUC0-12) in a stable renal transplant Indian population prescribed a formulation of mycophenolate mofetil (Mofilet) along with prednisolone and tacrolimus. Intensive pharmacokinetic sampling was performed in 29 patients to measure mycophenolate concentration from trough to 12 hours postdose. Subsets of different timed concentrations against total measured 12-hour area under the curve were analyzed by linear regression. Three models were identified and linear regression analysis done. After all subset regression analysis, three, four, and five time point limited sampling strategies (LSS) were developed having correlation coefficients above 0.92. Validation of the models was performed using the jackknife method and their predictive performances were tested. After validation, the correlation coefficients for all three models were above 0.901. The five-point LSS had the best predictive performance with a bias (95% confidence interval) of 0.67% (-3.45 to 4.79) and mean precision 7.73%. In all patients except one, the five-point LSS estimation for total area under the curve was within ± 20% of the total measured AUC0-12. Trough concentration had a significant correlation with AUC0-12 (r2 = 0.69). However, if dosing in routine clinical practice was adjusted based only on trough concentration, 41% of our patients would require a different dose compared with monitoring using AUC0-12. The five-point LSS uses half-hourly samples from trough to 1.5 hour postdose with an additional sample at 3 hours. Ninety-three percent of our patients had a Cmax within 1.5 hour and inclusion of all the time points up to1.5 hour gave a better estimate of AUC0-12. This model simplifies area under the curve measurement with high precision in stable adult renal transplant patients.
A Systematic Review and Comprehensive Critical Analysis Examining the Use of Prednisolone for the Treatment of Mild to Moderate Croup

Background: Many randomised control trials and systematic reviews have examined the benefits of glucocorticoids for the treatment of croup in children, but they have reported mainly on dexamethasone as an oral treatment for croup. No systematic reviews have examined prednisolone alone. Aim: To determine in a systematic review of the literature whether a single dose of oral prednisolone is as effective as a single dose of dexamethasone for reducing croup symptoms in children. Search Strategy: A detailed search was conducted on the following databases: CINAHL, MEDLINE EBSCO, MEDLINE, OVID, PubMed, The Cochrane Library, ProQuest, EMBASE, JBI, Sum search, and OpenGrey. Study authors were contacted. Selection Criteria: Randomised Controlled Trials, clinical trials or chart reviews which examined children with croup who were treated with prednisolone alone, or when prednisolone was compared to a dexamethasone treatment and the effectiveness of the intervention was objectively measured using croup scores and re-attendance as primary outcomes. Data Collection and Analysis: Following PRISMA guidelines for systematic reviews, relevant studies were identified. Scores were graded agreed by two independent reviewers using QualSyst. Main Results: Four studies met the inclusion criteria, but were too heterogeneous to combine in statistical meta-analysis. The result suggests that although prednisolone appears as effective as dexamethasone when first given, it is less so for preventing re-presentation. Trial sample sizes were small, making firm conclusions difficult, however, a second dose of prednisolone the following day may be useful. More research including cost-benefit analysis is needed to examine the efficacy of prednisolone compared to dexamethasone.
Examining Reading Alouds in Preschool Education Classrooms in Turkey

This study described and examined how reading alouds were carried out in 17 public preschool classrooms in Mugla, Turkey through detailed ethnographic field observations using the OMLIT-RAP that identifies and rates teacher behavior when reading aloud to children. How often read-alouds performed during the week? How long were they? Did dialogues and follow-up activities occur? The results indicated that the quality of reading alouds in public preschool classrooms in Mugla – to be of low-to-moderate degree. Based on the findings of this study, other ways of improving reading alouds can be pinpointed, such as giving one or two vocabulary and accurate comprehension support for each word, having all children join in conversations with teachers during read alouds, expanding on children’s comments about the book, placing the book in the context by mentioning the classroom theme or how the book fits into class activities and extending children’s understanding by tapping into their own experiences to help them comprehend the story.
PROTON SPECTROSCOPY OF THE NEONATAL BRAIN FOLLOWING HYPOXIC‐ISCHAEMIC INJURY

Proton magnctic resonance spectroscopy was used to examine. within the first month of life, the brains of 11 infants born at term—10 with signs of hypoxic‐ischaernic encephalopathy (HIE) and one who was neurologically normal at birth. All the infants had peak resonances on their spectra which could be assigned to N‐acetylaspartase (NAA). choline‐containing compounds (Cho) and creatine plus phosphocreatine (Cr). When neurodevelopmental outcome at one year was correlated with initial spectroscopy findings, the NAA/Cho and NAA/Cr ratios reflected clinical outcome. This study suggests that proton spcctroxopy not only provides new information about biochemical changes occurring in the brains of infants with HIE, but also may help to predict outcomc within the first month of life.
Manipulating Ruminal Fermentation : A Microbial Ecological Perspective

The essential role of ruminal microflora in ruminant nutrition provides the potential for improvement in animal production via altering the numbers or activities of specific classes of microorganisms. Successful alterations will be facilitated by an understanding of the microbial ecology of the rumen based on its mechanistic underpinnings. Demonstrated improvements in ruminal fermentation can be traced to their consonance with well-established principles of microbial ecology (niche occupancy, selective pressure, adaptation, and interactions) and the thermodynamics and kinetics of substrate utilization. Application of these principles to several proposed alterations of the ruminal bacterial population allows a prediction of their relative feasibility. Improving fiber digestion, decreasing protein degradation, and detoxifying feed components that are present in low concentrations will be difficult to achieve in the rumen and are best approached by altering the feed, either genetically or with postharvest treatment. By contrast, the detoxification of feed components present in high concentration, and redirection of electron disposal away from methanogenesis, are more productive targets for microbiologi-
Randomized Trial A Randomized , Double-Blind , Active-Controlled Trial of Fluoroscopic Lumbar Interlaminar Epidural Injections in Chronic Axial or Discogenic Low Back Pain : Results of 2-Year Follow-Up

common, expensive, and disabling. Although it is responsible for a very small proportion of patients, disc herniation is the primary focus of modalities of treatments. In fact, chronic low back pain without disc herniation is common. Multiple modalities of treatments are utilized in managing axial or discogenic pain without disc herniation including surgery, intradiscal therapies, and epidural injections. There is, however, continued debate on the effectiveness, indications, and medical necessity of all modalities of treatments in managing axial or discogenic pain in the lumbar spine.
Cell surface domain specific postsynaptic currents evoked by identified GABAergic neurones in rat hippocampus in vitro

1 Inhibitory postsynaptic currents (IPSCs) evoked in CA1 pyramidal cells (n= 46) by identified interneurones (n= 43) located in str. oriens were recorded in order to compare their functional properties and to determine the effect of synapse location on the apparent IPSC kinetics as recorded using somatic voltage clamp at ‐70 mV and nearly symmetrical [Cl−]. 2 Five types of visualised presynaptic interneurone, oriens‐lacunosum moleculare (O‐LMC), basket (BC), axo‐axonic (AAC), bistratified (BiC) and oriens‐bistratified (O‐BiC) cells, were distinguished by immunocytochemistry and/or synapse location using light and electron microscopy. 3 Somatostatin immunoreactive O‐LMCs, innervating the most distal dendritic shafts and spines, evoked the smallest amplitude (26 ± 10 pA, s.e.m., n= 8) and slowest IPSCs (10‐90 % rise time, 6.2 ± 0.6 ms; decay, 20.8 ± 1.7 ms, n= 8), with no paired‐pulse modulation of the second IPSC (93 ± 4 %) at 100 ms interspike interval. In contrast, parvalbumin‐positive AACs evoked larger amplitude (308 ± 103 pA, n= 7) and kinetically faster (rise time, 0.8 ± 0.1 ms; decay 11.2 ± 0.9 ms, n= 7) IPSCs showing paired‐pulse depression (to 68 ± 5 %, n= 6). Parvalbumin‐ or CCK‐positive BCs (n= 9) terminating on soma/dendrites, BiCs (n= 4) and O‐BiCs (n=7) innervating dendrites evoked IPSCs with intermediate kinetic parameters. The properties of IPSCs and sensitivity to bicuculline indicated that they were mediated by GABAA receptors. 4 In three cases, kinetically complex, multiphasic IPSCs, evoked by an action potential in the recorded basket cells, suggested that coupled interneurones, possibly through electrotonic junctions, converged on the same postsynaptic neurone. 5 The population of O‐BiCs (4 of 4 somatostatin positive) characterised in this study had horizontal dendrites restricted to str. oriens/alveus and innervated stratum radiatum and oriens. Other BiCs had radial dendrites as described earlier. The parameters of IPSCs evoked by BiCs and O‐BiCs showed the largest cell to cell variation, and a single interneurone could evoke both small and slow as well as large and relatively fast IPSCs. 6 The kinetic properties of the somatically recorded postsynaptic current are correlated with the innervated cell surface domain. A significant correlation of rise and decay times for the overall population of unitary IPSCs suggests that electrotonic filtering of distal responses is a major factor for the location and cell type specific differences of unitary IPSCs, but molecular heterogeneity of postsynaptic GABAA receptors may also contribute to the observed kinetic differences. Furthermore, domain specific differences in the short‐term plasticity of the postsynaptic response indicate a differentiation of interneurones in activity‐dependent responses.
MEASURING CORPORATE SOCIAL RESPONSIBILITY PRACTICES OF MICRO AND SMALL ENTERPRISES – PILOT STUDY

Corporate Social Responsibility (CSR) is a concept of important audience during the latest years in Romania, both to practitioners and academics. However, both the definitions and the measurements of these processes are under constant debate. In the last 50 years, theoreticians failed to fully agree upon what constitutes a socially responsible corporation. One can find more consensus regarding the practices that highlight social performance of organizations. Using the stakeholder management approach, several studies revealed the impact of different groups in shaping the social orientation of companies. In our paper we investigated social responsibility relates aspects of small and medium enterprises in Oradea, Romania. The main focus relies on testing the applicability of international measures of CSR based on stakeholder approach. Assuming that in Romania we rather face normative isomorphism regarding social practices of companies, we expected that international measures will apply mostly in international large companies. Nevertheless our data supported the idea that SME’s display different forms of social involvement. More, stakeholder approach to CSR is relevant yet it the tested scale should be better adapted to fit Romanian small and medium enterprises.
Fermentation of Barley Flour with Lactobacillus reuteri A source of bioactive compounds against a leaky gut

Fermentation of foodstuffs has beneficial effects on shelf life, taste and texture and possibly also health of the consumer. Products containing microbes with beneficial health effects for the host are defined as probiotics. One probiotic bacterium, Lactobacillus reuteri, has been shown to exert positive effects on a number of diseases and disorders, including a possible protective role against increased intestinal permeability or ‘leaky gut’. Increased intestinal permeability has been linked to e.g. inflammatory bowel disease (IBD), irritable bowel disease (IBS), coeliac disease and infectious diarrhoea. This study examined the effect of different cereal substrates on the growth, general metabolism and production of potential bioactive compounds by L. reuteri, with the aim of establishing a synbiotic formulation effective against increased intestinal permeability. Combinations of six barley varieties and six strains of bacteria were evaluated using standard plate counts, chemical analysis (1H-NMR) and a small intestinal epithelial cell model (IPEC-J2). The overall growth of L. reuteri in barley flour was good and reached higher densities in untreated compared with heat-treated flours. Differences in growth were also seen between bacterial strains and barley varieties. The general metabolism was similar for all strains with a few exceptions, e.g. lower production of succinate from L. reuteri DSM 17938. Two potentially bioactive compounds, -aminobutyric acid (GABA) and 3-hydroxypropionic acid (reuterin), were detected in barley fermented by L. reuteri. GABA was present in unfermented flour at similar levels as in the fermented counterpart, indicating no or low production by L. reuteri. Reuterin production was detected as formation of 1,3-propanediol and was strain-specific, being present in fermentation with DSM 17938 and ATCC PTA 6475. Experiments with IPEC-J2 cells revealed an increase in epithelial permeability caused by untreated flour, both fermented and unfermented. Treatment with heat-treated flour had a slight increasing effect on permeability, but recovered over time. Pre-treatments with live bacteria or fermented heat-treated flour before challenge with enterotoxigenic E. coli revealed significantly lower leakage of a molecular probe (FITC-dextran, 4 kDa). However, neither live bacteria nor their metabolites had a protective effect on epithelial permeability, measured as transepithelial electrical resistance (TEER).
Fracture Strength of Standard and Small Diameter Prosthetic Abutments for Full‐Arch Implant‐Supported Restorations

&NA; This study tested the fracture strength of prosthetic abutments with different sizes and combinations to support a 5‐implant milled framework with distal extension. Prosthetic abutments with different dimensions (4.8‐mm diameter mini conical abutment and 3.5‐mm diameter microconical abutment) were screwed to 5 threaded implants. The following groups were divided (n=3): G1 with 5 miniconical abutments (standard size), G2 with 5 microconical abutments (small sized), G3 with a combination of 3 small sized abutments and 2 standard sized abutments, and G4 with a combination of 2 small sized abutments and 3 standard sized abutments. Standardized titanium frameworks for full‐arch fixed dental prosthesis were milled with equidistant holes for each of the 5 implants and abutments. A loading point was selected at 18 mm away from both distal implants. A universal testing system was used for the fracture strength tests and load was applied at a crosshead speed of 0.5 mm/min on the previously described loading points until component fracture. Mean fracture strength for each group was statistically compared (a=0.05). Prosthetic screws were the only fractured components for all tested groups. Mean fracture strength was: G1, 1130.22 N; G2, 1031.36 N; G3, 757.9 N; and G4 792.03 N (P < .05). All prosthetic abutments and combinations that were tested provide adequate fracture strength for clinical use. However, the combination of standard and small diameter abutments leads to lower fracture strength compared with when only standard sized prosthetic abutments were used, irrespective of the abutment diameter (4.8‐ or 3.5‐mm).
Parental Knowledge of Radiation Exposure in Medical Imaging Used in the Pediatric Emergency Department

Objectives We sought to quantify the knowledge base among parents and legal guardians presenting to our pediatric emergency department regarding radiation exposure during medical imaging and potential risks to children resulting from ionizing radiation. We sought to examine if a child’s previous exposure to medical imaging changed caregiver knowledge base and discern caregivers’ preference for future education on this topic. Methods A prospective convenience sample survey was performed of caregivers who presented with their child to our tertiary pediatric emergency department. Parents or legal guardians (18–89 years) who accompanied a child (0–17 years) were eligible for inclusion and approached for enrollment. A structured questionnaire was administered by trained interviewers, and a chart review was conducted to ascertain if their child had a history of previous imaging. Results Sixty percent of caregivers interviewed (n = 205 of 340) did not associate any long-term negative effects with medical imaging. Among participants who did express a perceived risk from medical imaging radiation exposure, only 50% could indicate a known negative effect from exposure. We found no significant association between a child having had documented imaging studies and awareness of long-term negative effects (P = 0.22). Participants preferred to learn more about this topic from an Internet-based resource (50%), informational pamphlet (38%), or via treating physician (33%). Conclusions Parents and legal guardians are largely unaware that exposure to radiation during medical imaging carries an inherent risk for their child. Health care providers wishing to educate caregivers should utilize reliable Internet sources, educational pamphlets, and direct communication.
Variability of Momentary Pain Predicts Recall of Weekly Pain: A Consequence of the Peak (or Salience) Memory Heuristic

Patients’ recall of their recent pain is commonly assessed by both researchers and clinicians. However, concerns have been raised about differences between recalled pain and the average of real-time recordings of pain taken over the same period, in part because of the possibility that memory processes affect how retrospective pain is reported. It was hypothesized that memory processes affect the accuracy of recall, such that those with higher versus lower variability of real-time pain will recall pain at higher levels, relative to their average momentary pain. Sixty-eight chronic pain patients with rheumatologic conditions reported their pain several times a day for 2 weeks and also recalled their weekly pain at the end of each of those 2 weeks. The hypothesis was confirmed and it was concluded that variability of real-time pain affects the recall of pain.
Troponin T and troponin I in carriers of Duchenne and Becker muscular dystrophy with cardiac involvement.

A cooling mechanism is provided for an audio speaker, which mechanism includes a plate of a thermally conductive material mounted between the driver mechanism of the speaker and the speaker basket and extending from the voice coil gap to the outside of the speaker. The spacing between this plate and the voice coil is preferably kept as small as possible. The plate is preferably a vent plate having a plurality of radial vents extending along the width of the plate from the voice coil gap side thereof to the side facing the outside of the speaker. Such a vent plate, in addition to providing radiant cooling, also provides cooling via air flow as well as conduction and convection cooling. The vents are sized and shaped so as to minimize any turbulence, and thus any audible air noise.