Miracle-dz/UniFAR-FTUs huggingface dataset:
The orthopaedic manifestation and outcomes of methicillin‐sensitive Staphylococcus aureus septicaemia

Aims The aim of this paper was to present the clinical features of patients with musculoskeletal sources of methicillin‐sensitive Staphylococcus aureus (MSSA) septicaemia. Patients and Methods A total of 137 patients presented with MSSA septicaemia between 2012 and 2015. The primary source of infection was musculoskeletal in 48 patients (35%). Musculoskeletal infection was considered the primary source of septicaemia when endocarditis and other obvious sources were excluded. All patients with an arthroplasty at the time were evaluated for any prosthetic involvement. Results The most common site of infection was the spine, which occurred in 28 patients (58%), and was associated with abscess formation in 16. Back pain was the presenting symptom in these patients, with a positive predictive value of 100%. A total of 24 patients had a total of 42 arthroplasties of the hip or knee in situ. Prosthetic joint infection occurred in six of these patients (25%). In five patients, the infection originated outside the musculoskeletal system. Three patients (6%) with MSSA septicaemia from a musculoskeletal sources died. Conclusion Amongst the musculoskeletal sources of MSSA septicaemia, the spine was the most commonly involved. We recommend an MRI scan of the whole spine and pelvis in patients with MSSA septicaemia with back pain, when the primary source of infection has not been identified or clinical examination is unreliable.
The Accuracy of Self-report in Rheumatic Diseases

Determining knowledge of accurate population prevalence of rheumatic diseases is important in assessing the burden of the illness in the community and provides a basis for healthcare provision, policy, and workforce planning. The use of self-report is an integral part of determining the population prevalence of many chronic and non-registry–based diseases. Indeed, this is often the only way to obtain prevalence information for these conditions because definitive diagnostic tests may not exist or may be impractical to administer across a large number of people. Both prevalent and incident disease can be determined in this manner; however, there is evidence of a difference in the sensitivity of self-reporting prevalent and incident disease, and differences according to the disease examined. Oksanen, et al 1 determined that the identification of true negatives was equally high for both prevalent and incident disease when compared with national registry data, but the sensitivity of incident ranged from 55% to 63% compared with prevalent disease (78%–96%) for hypertension, diabetes, asthma, coronary heart disease, and rheumatoid arthritis (RA). Both prevalent and incident self-reported diabetes have also been shown over time by Schneider, et al 2 to have 84%–97% specificity and 55%–80% sensitivity when compared with reference definitions (glucose and medication criteria). The prevalence and incidence of inflammatory rheumatic conditions, in particular, is also often only measured using self-reported information, and because of the heterogeneity of diseases within this group, the information may or may not be supplemented and validated by medication data or other relevant clinical tests. A combination of self-report and other forms of … Address correspondence to Dr. C.L. Hill, The Queen Elizabeth Hospital, Rheumatology, 28 Woodville Road, Woodville, South Australia 5011, Australia. E-mail: Catherine.Hill{at}sa.gov. au
Short, highly effective, and inexpensive standardized treatment of multidrug-resistant tuberculosis.

RATIONALE Based on expert opinion, the global guidelines for management of multidrug-resistant tuberculosis impose lengthy and often poorly tolerated treatments. OBJECTIVES This observational study evaluates the effectiveness of standardized regimens for patients with proven multidrug-resistant tuberculosis previously untreated with second-line drugs in low-income countries. METHODS Consenting patients were sequentially assigned to one of six standardized treatment regimens. Subsequent cohorts were treated with regimens adapted according to results in prior cohorts. The study was designed to minimize failure and default while reducing total treatment duration without increasing relapse frequency. MEASUREMENTS AND MAIN RESULTS We report the treatment outcome of all patients with laboratory-confirmed, multidrug-resistant tuberculosis enrolled from May 1997 to December 2007. The most effective treatment regimen required a minimum of 9 months of treatment with gatifloxacin, clofazimine, ethambutol, and pyrazinamide throughout the treatment period supplemented by prothionamide, kanamycin, and high-dose isoniazid during an intensive phase of a minimum of 4 months, giving a relapse-free cure of 87.9% (95% confidence interval, 82.7-91.6) among 206 patients. Major adverse drug reactions were infrequent and manageable. Compared with the 221 patients treated with regimens based on ofloxacin and commonly prothionamide throughout, the hazard ratio of any adverse outcome was 0.39 (95% confidence interval, 0.26-0.59). CONCLUSIONS Serial regimen formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with first-line treatment. Confirmatory formal trials in populations with high levels of human immunodeficiency virus coinfection and in populations with a higher initial prevalence of resistance to second-line drugs are required.
Embryo Transfer Catheters: Softer is Easier.

OBJECTIVE This study aimed to compare the use of semi-rigid and flexible catheters in terms of pregnancy rate and level of difficulty of the embryo transfer (ET) procedure. METHODS Seven hundred and thirty-nine consecutive follicular aspirations for IVF or ICSI performed in our private fertility clinic within a 30-month period were randomly divided into two groups. Patients were allocated to either of the groups at the time of follicular retrieval with the aid of a random number generator according to the catheter used in ET: Group 1 (n = 370) - Frydman Classic Catheter 4.5 catheters; and Group 2 (n = 369) - Frydman Ultrasoft 4.5 catheters. Only patients offered ET in the randomized cycle were included (Group 1 = 363 and Group 2 = 340). Patients did not change groups after catheter allocation. Statistical analysis was carried out using an unpaired t-test or a chi square test as appropriate. Differences with P<0.05 were considered. RESULTS A statistically significant difference in favor of the use of the Ultrasoft catheter was evident for parameters use of a tenaculum (19.8% vs. 5.9%) or a hysterometer (5.0% vs. 1.2%), presence of blood during post-ET inspection of the catheter (9.9% vs. 3.8%), and implantation rate (13.0% vs. 16.4%). Clinical pregnancy and delivery rates were comparable in both groups. CONCLUSION Our results suggest that a softer catheter may help with difficult ETs. Softer catheters, as also reported by other authors, resulted in better implantation rates.
Evaluation of the B-D urine culture kit

Split samples of urine transported to the laboratory at 5 degrees C and in a boric acid-glycerol-sodium formate preservative (B-D Urine Culture Kit; Becton, Dickinson & Co.) were cultured immediately and, in the case of preserved urine, after 24 and 48 h of storage at 25 degrees C. Agreement between the results for cultures of specimens originally yielding greater than 10(5) colony-forming units (CFU) per ml and the results for urine preserved for 24 and 48 h was 85 and 71%, respectively. One-third of the specimens originally yielding 10(4) to 10(5) CFU per ml yielded less than 10(4) CFU per ml after 24 h of storage in preservative. Provided greater than 10(4) CFU per ml in specimens preserved for up to 24 h is regarded as equivalent to greater than 10(5) CFU per ml in original urine specimens, agreement of results was greater than 90%.
Nonlinear buckling behaviour of spherical shells: barriers and symmetry-breaking dimples

The nonlinear axisymmetric post-buckling behaviour of perfect, thin, elastic spherical shells subject to external pressure and their asymmetric bifurcations are characterized, providing results for a structure/loading combination with an exceptionally nonlinear buckling response. Immediately after the onset of buckling, the buckling mode localizes into a dimple at the poles. The relations among the pressure, the dimple amplitude and the change in volume of the shell are determined over a large range of pole deflections. These results allow accurate evaluation of criteria such as the Maxwell condition for which the energies in the unbuckled and buckled states are the same and evaluation of the influences of pressure versus volume-controlled loadings. Non-axisymmetric bifurcation from the axisymmetric state, which occurs deep into the post-buckling regime in the form of multi-lobed dimples, is also established and discussed. This article is part of the themed issue ‘Patterning through instabilities in complex media: theory and applications. ’
Outcome of inflammatory bowel disease patients treated with TNF-α inhibitors: two-year follow-up

Abstract Background: Biological medications, particularly TNF-α inhibitors, are used increasingly for active inflammatory bowel disease (IBD). Even though they are superior to many older medications in achieving remission and mucosal healing, primary nonresponse and loss of response remain significant problems, and a remarkable proportion of patients still need surgery at some point. Objective: To study the outcome of IBD patients treated with TNF-α inhibitors, either infliximab or adalimumab, with a two-year follow-up. Patients and methods: Patient data from the hospital electronic patient documents of IBD patients treated with TNF-α inhibitors were studied. The main targets of interest were treatment response, the remission rate and the number of patients operated, as well as reasons for the discontinuation of treatment. Remission was defined both endoscopically and by faecal calprotectin. Results: Altogether 100 patients were included. Only 29% of the patients achieved remission during the two-year follow-up. 26% of the Crohn's disease patients and 36% of the ulcerative colitis patients underwent surgery during the follow-up. A significant proportion of patients experienced side effects of the medication (21%) or discontinued the therapy for other reasons (altogether 63%). Conclusions: In this single centre study of 100 IBD patients treated with TNF-α inhibitors, less than one-third of the patients achieved remission, and a significant proportion had side effects and needed surgery during the two-year follow-up. There is an obvious need for more effective therapies with less side effects for IBD patients.
Neutrophilic Iron-Oxidizing “Zetaproteobacteria” and Mild Steel Corrosion in Nearshore Marine Environments

ABSTRACT Microbiologically influenced corrosion (MIC) of mild steel in seawater is an expensive and enduring problem. Little attention has been paid to the role of neutrophilic, lithotrophic, iron-oxidizing bacteria (FeOB) in MIC. The goal of this study was to determine if marine FeOB related to Mariprofundus are involved in this process. To examine this, field incubations and laboratory microcosm experiments were conducted. Mild steel samples incubated in nearshore environments were colonized by marine FeOB, as evidenced by the presence of helical iron-encrusted stalks diagnostic of the FeOB Mariprofundus ferrooxydans, a member of the candidate class “Zetaproteobacteria. ” Furthermore, Mariprofundus-like cells were enriched from MIC biofilms. The presence of Zetaproteobacteria was confirmed using a Zetaproteobacteria-specific small-subunit (SSU) rRNA gene primer set to amplify sequences related to M. ferrooxydans from both enrichments and in situ samples of MIC biofilms. Temporal in situ incubation studies showed a qualitative increase in stalk distribution on mild steel, suggesting progressive colonization by stalk-forming FeOB. We also isolated a novel FeOB, designated Mariprofundus sp. strain GSB2, from an iron oxide mat in a salt marsh. Strain GSB2 enhanced uniform corrosion from mild steel in laboratory microcosm experiments conducted over 4 days. Iron concentrations (including precipitates) in the medium were used as a measure of corrosion. The corrosion in biotic samples (7.4 ± 0.1 mM) was significantly higher than that in abiotic controls (5.0 ± 0.1 mM). These results have important implications for the role of FeOB in corrosion of steel in nearshore and estuarine environments. In addition, this work shows that the global distribution of Zetaproteobacteria is far greater than previously thought.
A Spatial Econometric Approach to Measuring Pollution Externalities: An Application to Ozone Smog

This paper uses spatial econometrics to analyze air pollution externalities. State-by-state source-receptor transfer coefficients that can be used as a basis for a location-differentiated permit system are estimated. Results affirm the importance of regional transport in determin-ing local ozone air quality, although owing to non-monotonicities in ozone production the ex-ternality is not always negative. Because the origin of emissions matters, results also reject a non-spatially differentiated NOx cap and trade program as an appropriate mechanism for re-ducing ozone smog.
Attachment organizations in children with difficult life circumstances

The purpose of this study was to use the Attachment Q-Set to create categories of attachment organization that were conceptually consistent with organizational categories derived from other attachment assessments, reliable, and valid. We were particularly interested in creating categories that would describe insecure attachment organizations in children from difficult life circumstances. Our sample of relationships included 3062 teacher–child relationships. Children ranged in age from toddlers to kindergartners and were diverse in ethnic background. Two percent of the children were diagnosed with severe social and emotional problems and enrolled in a therapeutic preschool. Sixteen percent were enrolled in intervention programs on the basis of family poverty and another 34% of the children attended subsidized child care programs for low-income children. All of the children's child–teacher relationships were assessed with the Attachment Q-Set (AQS). Independent observers observed or rated children's peer play. Teachers completed behavior problem questionnaires and Student Teacher Relationships Scales. Using the AQS we created five subscales and six attachment organizational categories. These subscales and organizational categories were associated in theoretically meaningful ways with measures of behavior problems, social competence with peers, and teacher perceptions of child–teacher relationship.
A replication-defective human cytomegalovirus vaccine for prevention of congenital infection

A new replication-defective human cytomegalovirus vaccine shows promise in protecting against this dangerous virus that can cause severe neurodevelopmental defects in babies. Progress toward a human cytomegalovirus vaccine Most adults carry latent human cytomegalovirus, with no apparent symptoms. But if a pregnant woman becomes newly infected or an active infection is triggered, the fetus can be harmed and show severe neurodevelopmental deficits. Wang and colleagues report a key step toward an effective vaccine against this dangerous herpesvirus. They engineered a genetic off switch into the whole virus to render it harmless and show that it can elicit desirable immune responses such as neutralizing antibodies cell-mediated immune responses in several animal species, including nonhuman primates. Congenital human cytomegalovirus (HCMV) infection occurs in ~0.64% of infants born each year in the United States and is the leading nongenetic cause of childhood neurodevelopmental disabilities. No licensed HCMV vaccine is currently available. Natural immunity to HCMV in women before pregnancy is associated with a reduced risk of fetal infection, suggesting that a vaccine is feasible if it can reproduce immune responses elicited by natural infection. On the basis of this premise, we developed a whole-virus vaccine candidate from the live attenuated AD169 strain, with genetic modifications to improve its immunogenicity and attenuation. We first restored the expression of the pentameric gH/gL/pUL128-131 protein complex, a major target for neutralizing antibodies in natural immunity. We then incorporated a chemically controlled protein stabilization switch in the virus, enabling us to regulate viral replication with a synthetic compound named Shield-1. The virus replicated as efficiently as its parental virus in the presence of Shield-1 but failed to produce progeny upon removal of the compound. The vaccine was immunogenic in multiple animal species and induced durable neutralizing antibodies, as well as CD4+ and CD8+ T cells, to multiple viral antigens in nonhuman primates.
Model-based small area estimates of overweight prevalence using sample selection adjustment.

Using a hierarchical model with an adjustment for sample selection, we estimate the overweight prevalence for adults, by states, using data from the Third National Health and Nutrition Examination Survey (NHANES III). A two-stage hierarchical model was selected to account for geographic variability of outcomes and to model possible overdispersion of estimates due to cluster sampling. We compare our model-based estimates with design-based estimates at the national level and obtain excellent agreement. We also provide a check of our model at the state level by comparing estimates with design-based and synthetic estimates.
The effect of viewing graspable objects and actions in Parkinson's disease

Viewing action-relevant stimuli such as a graspable object or another person moving can affect the observer's own motor system. Evidence exists that external stimuli may facilitate or hinder movement in Parkinson's disease, so we investigated whether action-relevant stimuli would exert a stronger influence. We measured the effect of action-relevant stimuli (graspable door handles and finger movements) on reaction times compared with baseline stimuli (bars and object movements). Parkinson's patients were influenced by the location of the baseline stimuli, but unlike healthy controls, action-relevant stimuli did not exert a stronger influence. This suggests that external cues exert their influence in Parkinson's disease through lower-level visual processes and the influence of action-relevant stimuli on the motor system is disrupted.
The expression of the γ subunit of Na-K-ATPase is regulated by osmolality via C-terminal Jun kinase and phosphatidylinositol 3-kinase-dependent mechanisms

The α and β subunits of Na-K-ATPase are up-regulated by hypertonicity in inner-medullary collecting duct cells adapted to survive in hypertonic conditions. We examined the regulation of the γ subunit by hypertonicity. Although cultured inner-medullary collecting duct cells lacked the γ subunits, both variants γa and γb were expressed in cells adapted to 600 and 900 mosmol/KgH2O. This expression was reversible with a half-time of 17.2 ± 0.5 h. The message of the γ subunit was absent in isotonic conditions and increased with higher tonicity in adapted cells. In acute experiments the appearance of the γ subunit was found to be both time-dependent (≥24 h) and osmolality-dependent (≥500 mosmol/KgH2O). No induction was noted with urea and only minimal induction with mannitol. Increasing concentrations of the phosphatidylinositol 3-kinase inhibitor LY294002 resulted in a dose-dependent decrement in the expression of the γ subunit with total abolition at 10 μM. This was associated with a decrease in cell viability as <20% survived the treatment with 10 μM of LY294002. Neither inhibition of extracellular response kinase nor p38 mitogen-activated protein kinase inhibited osmotic induction of the γ subunit. In contrast, cells transfected with a dominant negative c-Jun N-terminal kinase 2-APF construct displayed complete inhibition of the γ subunit. Such cells have accelerated loss of viability in hypertonic conditions. This study describes the regulation of the γ subunit of Na-K-ATPase by hypertonicity. This regulation is transcriptionally regulated and involves signaling mediated by phosphatidylinositol 3-kinase and c-Jun N-terminal kinase 2 pathways.
Perceived self-efficacy and academic performance of medical students at Ataturk University, Turkey.

OBJECTIVE To determine the association of perceived self-efficacy with academic performance of pre-clinical medical students. STUDY DESIGN A cross-sectional analytical study. PLACE AND DURATION OF STUDY Medical Education Department, Ataturk University, Turkey, from March to May 2012. METHODOLOGY Participating students were members of the first to third year medical students class considered to be preclinical years at Ataturk University. A validated and reliable questionnaire consisted of 10 questions applied to assess the general self-efficacy of the medical students in pre-clinical years and evaluate whether their self-efficacy has relation to their academic performance. Responses and studied variables were compared using ANOVA and Pearson correlation test as applicable. RESULTS The mean scores of three consecutive examinations were compared with self-efficacy mean scores of three classes. A validated and reliable questionnaire was used for assessment of self-efficacy. There was no correlation found in between mean examination scores and self-efficacy mean scores in first year (r = -0.11, p = 0.276), second year (r = 0.20, p = 0.180), and third year (r = -0.040, p = 0.749). However, comparison of mean scores between male and female demonstrated significant difference (p = 0.001) and males dominant in self-efficacy scores. CONCLUSION The results illustrate in pre-clinical years at medical schools the general self-efficacy does not play any role in their performance.
Comparison of cognitive therapy and behavior therapy in the treatment of depression.

The primary purpose of this study was to evaluate the therapeutic efficacy of Beck's cognitive treatment and Lewinsohn's behavioral treatment of depression. A multiple criteria (self-report, objective, and subjective clinical ratings) approach was used in the selection of subjects for a cognitive modification group (n=8), a behavior modification group (n = 8), an attention/ass essment (nonproach was used in the selection of subjects for a cognitive modification group sessions were held over a period of 4 weeks. Results indicated that the cognitive modification group was the most effective in alleviating depression as measured by self-report and the objective clinical rating. Cognitive modification resulted in significantly fewer depressive symptoms after treatment than all other groups. The behavior modification and nondirective procedures were more effective than no treatment based on the self-report data. The results relevant to the current psychological literature on the treatment of depression are discussed. The primary purpose of this study was to evaluate the cognitive approach described by Beck (1967, 1974) and Lewinsohn's (1974) behavioral approach in the treatment of de
Earliest Recollections of Self and Others in European American and Taiwanese Young Adults

This study examined the age and content of earliest childhood memories of self and others. European American and Taiwanese participants (N = 111) retrieved their earliest memories in response to the cue words self, mother, family, friend, and surroundings. Memory for mother was from an earlier age than memory for self, and memories for mother, family, and friend were more socially oriented in content than memories for self or surroundings. In addition, in response to all cue words, Euro-Americans recalled memories from an earlier age than did Taiwanese. Euro-Americans also had a greater tendency to report memories of specific events and focused more on their own roles and autonomy than did Taiwanese, who more often described routine events and emphasized the roles of others. These findings have important implications for infantile amnesia and the memory-self interplay.