Miracle-dz/UniFAR-FTUs huggingface dataset:
Anthropometric Study of Proximal Femur Geometry and Its Clinical Application

The implants for fixation of proximal femur fractures and joint replacements have been designed taking into consideration of the anthropometry of the western population which vary from other ethnic groups. The present study aimed to study the morphology of the upper end of femur in relation to its various diameters and angles and compare the external and internal geometry of proximal femur as obtained from radiographs, with actual measurements on cadaveric specimens in Indian population. Seventy five pairs (150 bones) of cadaveric femora were studied morphologically and radiologically using standardized techniques to obtain various anthropometrics measurements. These values were compared with those reported in the literature for Hong Kong Chinese, Caucasian, Chinese and Western populations. Data were found to be quite different from them. It is proposed that implants designed for Western populations should be used judiciously and future implants be designed to match the morphology of the Indian bones.
Utility of voriconazole therapeutic drug monitoring: a meta-analysis.

BACKGROUND Voriconazole therapeutic drug monitoring (TDM) is increasingly used in clinical practice. However, the utility of voriconazole TDM to guide therapy remains uncertain and controversial. We conducted a meta-analysis of studies assessing the relationship between voriconazole serum concentration and clinical outcomes of success and toxicity. METHODS We searched bibliographic databases for studies on voriconazole serum concentrations and clinical outcomes. We compared success outcomes between patients with therapeutic and subtherapeutic voriconazole serum concentrations, and toxicity outcomes between patients with and without supratherapeutic serum concentrations. RESULTS Twenty-four studies were analysed. Pooled analysis for efficacy endpoint demonstrated that patients with therapeutic voriconazole serum concentrations (1.0-2.2 mg/L) were more likely to have successful outcomes compared with those with subtherapeutic voriconazole serum concentrations (OR 2.30; 95% CI 1.39-3.81). A therapeutic threshold of 1.0 mg/L was most predictive of successful outcome (OR 1.94; 95% CI 1.04-3.62). Patients with therapeutic concentrations did not have better survival rates. Pooled analysis for toxicity endpoint demonstrated that patients with supratherapeutic voriconazole serum concentrations (4.0-6.0 mg/L) were at increased risk of toxicity (OR 4.17; 95% CI 2.08-8.36). A supratherapeutic threshold of 6.0 mg/L was most predictive of toxicity (OR 4.60; 95% CI 1.49-14.16). CONCLUSIONS Patients with therapeutic voriconazole serum concentrations were twice as likely to achieve successful outcomes. The likelihood of toxicity associated with supratherapeutic voriconazole serum concentrations was 4-fold that of therapeutic concentrations. Our findings suggest that the use of voriconazole TDM to aim for serum concentrations between 1.0 and 6.0 mg/L during therapy may be warranted to optimize clinical success and minimize toxicity.
Clostridium difficile clade 5 in Australia: antimicrobial susceptibility profiling of PCR ribotypes of human and animal origin.

OBJECTIVES Increasing reports of genetic overlap between animal and human sources of Clostridium difficile necessitate an understanding of antimicrobial susceptibility and resistance in these populations. In this study, we sought to investigate the in vitro activities of 13 antimicrobials against a unique collection of clade 5 C. difficile isolates of Australian animal and human origin. METHODS The collection comprised 171 C. difficile strains of human (n = 91) and animal (n = 80) origin in Australia in the last decade. The collection encompassed seven different clade 5 PCR ribotypes (RTs; 033, 078, 126, 127, 237, 281 and 288), seven STs and three toxin gene profiles. MICs were determined by agar incorporation methodology. RESULTS All isolates were fully susceptible, with little variation between strain populations, to vancomycin, metronidazole, fidaxomicin, rifaximin, amoxicillin/clavulanate, meropenem and piperacillin/tazobactam. Resistance to one or more of tetracycline, moxifloxacin, clindamycin or erythromycin was seen in 26.9% (46 of 171) of isolates, predominantly RTs 126 and 078 of human origin. Fifty per cent of this group were MDR. Human and animal isolates belonging to RTs 033, 237, 281 and 288 presented very similar and generally susceptible phenotypic profiles. CONCLUSIONS Similar pan-susceptible phenotypic profiles seen for a large proportion of human and animal isolates of RTs 033, 237, 281 and 288 support the hypothesis of a common source. Conversely, human strain populations of RTs 126 and 127 show high proportions of antimicrobial resistance and limited phenotypic overlap with their animal counterparts.
Pyrrole‐Imidazole Polyamides: Manual Solid‐Phase Synthesis

Pyrrole‐imidazole polyamides (PAs) are a family of DNA‐binding peptides that bind in the minor groove of double‐stranded DNA (dsDNA) in a sequence‐selective, programmable fashion. This protocol describes a detailed manual procedure for the solid‐phase synthesis of this family of compounds. The protocol entails solution‐phase synthesis of the Boc‐protected pyrrole (Py) and imidazole (Im) carboxylic acid building blocks. This unit also describes the importance of choosing the appropriate condensing agent to form the amide linkages between each building block. Finally, a monomeric coupling protocol and a fragment‐based approach are described that delivers PAs in 13% to 30% yield in 8 days. © 2015 by John Wiley & Sons, Inc.
CTX-M-15-H30Rx-ST131 subclone is one of the main causes of healthcare-associated ESBL-producing Escherichia coli bacteraemia of urinary origin in Spain.

OBJECTIVES The objective of this study was to assess the prevalence and molecular epidemiology of ESBL-producing Escherichia coli causing healthcare-associated (HCA) and community-associated (CA) bacteraemia of urinary origin (BUO) in Spain. METHODS An observational cohort study was conducted at eight hospitals from different Spanish geographical areas (2010-11). BUO episodes (n = 425) were classified as HCA (n = 215) and CA (n = 210), and one blood isolate per episode was collected. Susceptibility testing was performed, ESBLs were screened by double-disc diffusion test and ESBL and OXA-1 genes were characterized (PCR and sequencing). Population structure (phylogenetic groups, XbaI-PFGE and MLST) and ST131 subtyping (PCR) were determined. Virulence genes were detected by PCR and virulence score, profiles and extraintestinal pathogenic E. coli (ExPEC) status calculated. RESULTS ESBL-producing E. coli prevalence was 9.2% (39/425). ESBL-producing E. coli episodes were significantly associated with HCA-BUO episodes [14% (30/215) versus 4.3% (9/210); P = 0.001]. The highest non-susceptibility proportions corresponded to ciprofloxacin (97.4%), amoxicillin/clavulanate (74.4%), co-trimoxazole (69.2%) and tobramycin (61.5%). Of the 39 ESBL-producing E. coli isolates, 34 produced CTX-M enzymes (21 CTX-M-15, 11 CTX-M-14 and 2 CTX-M-1). Fifteen STs were identified, the B2-ST131 clone being the most prevalent (54%; 21/39). All ST131 isolates were ExPEC and had the highest virulence scores, but they showed less diversity in virulence profiles than other STs. The H30Rx subclone accounted for most ST131 isolates (20/21), co-produced CTX-M-15 (20/20) and OXA-1 (19/20) enzymes and was associated with HCA episodes (16/20). CONCLUSIONS The CTX-M-15-ST131-H30Rx subclone is a relevant MDR pathogen causing BUO, mainly HCA episodes. The dominance of this subclone with comparatively less diversity of virulence profiles reflects the spread of a successful and MDR ESBL ST131 lineage in Spain.
Compound‐Specific Isotope Analyses to Assess TCE Biodegradation in a Fractured Dolomitic Aquifer

The potential for trichloroethene (TCE) biodegradation in a fractured dolomite aquifer at a former chemical disposal site in Smithville, Ontario, Canada, is assessed using chemical analysis and TCE and cis‐DCE compound‐specific isotope analysis of carbon and chlorine collected over a 16‐month period. Groundwater redox conditions change from suboxic to much more reducing environments within and around the plume, indicating that oxidation of organic contaminants and degradation products is occurring at the study site. TCE and cis‐DCE were observed in 13 of 14 wells sampled. VC, ethene, and/or ethane were also observed in ten wells, indicating that partial/full dechlorination has occurred. Chlorine isotopic values (δ37Cl) range between 1.39 to 4.69‰ SMOC for TCE, and 3.57 to 13.86‰ SMOC for cis‐DCE. Carbon isotopic values range between −28.9 and −20.7‰ VPDB for TCE, and −26.5 and −11.8‰ VPDB for cis‐DCE. In most wells, isotopic values remained steady over the 15‐month study. Isotopic enrichment from TCE to cis‐DCE varied between 0 and 13‰ for carbon and 1 and 4‰ for chlorine. Calculated chlorine‐carbon isotopic enrichment ratios (ϵCl/ϵC) were 0.18 for TCE and 0.69 for cis‐DCE. Combined, isotopic and chemical data indicate very little dechlorination is occurring near the source zone, but suggest bacterially mediated degradation is occurring closer to the edges of the plume.
Starting the Conversation: What are the Issues for Paramedic Student Clinical Education?

Objectives This paper examines the issues that affect the quality of paramedic student clinical placements. Participants included paramedics, paramedic educators, paramedic students and ambulance service managers who had gathered for an Australian conference in Bendigo in central Victoria. The aim of this paper is to highlight issues identified by the participants and to start a conversation about the importance of clinical placement for paramedic students. Methods This was a qualitative study utilising ‘Community conversations’ as a research methodology. ‘Community conversations’ is an action research approach. This study had 53 participants, who spent around 5 hours in conversation throughout a 3-day conference. The conversation initiated was to discuss and raise issues that related to paramedic student clinical placements, and identify creative and innovative solutions. Results In this paper, we focus on three themes that emerged from the conversations: planning and preparation of the placement; continuity of placement experience; and diversity of placements. We argue that better communication is required between the university, the ambulance service, the paramedic educator/clinical instructor and the student. Conclusions Clinical education is an essential element of student learning and skill development, yet in Australia there are no mandatory requirements in relation to duration, content or measurement of quality in student clinical placements. We strongly recommend that continuity is an essential element of a quality clinical placement and argue that students should be allocated to work in one location for 1–2 week blocks.
Heterogeneous oxacillin-resistant phenotypes and production of PBP2A by oxacillin-susceptible/mecA-positive MRSA strains from Africa.

OBJECTIVES Recent surveillance of MRSA colonizing patients and healthcare workers in two African countries (Angola and São Tomé and Príncipe) reported the frequent recovery of oxacillin-susceptible MRSA (OS-MRSA): Staphylococcus aureus strains that gave positive results with the mecA DNA probe, but had low oxacillin MIC values characteristic of susceptible S. aureus. This apparent dissociation of the drug-resistant phenotype from mecA-the primary genetic determinant of resistance-prompted us to perform a more detailed analysis on nine of the African OS-MRSA strains. METHODS Oxacillin MIC values were determined by Etest and population analysis profiles with and without induction of the stringent stress response by mupirocin. Biochemical profiling using SDS-PAGE followed by western blotting was used for the detection of PBP2A protein produced. RESULTS Cultures of the African MRSA strains (ST88-IVa and ST8-V) showed heterogeneous oxacillin resistance in which the majority of cells exhibited low oxacillin MICs (≤0.75 mg/L), but highly resistant subpopulations were also present with oxacillin MIC values up to several hundred mg/L and with frequencies of 10(-4) to 10(-6). The same strains after induction of the stringent stress response by mupirocin 'converted' the heterogeneous phenotypes into a more homogeneous and higher level resistance. After induction by oxacillin and mupirocin, each of the nine African OS-MRSA strains produced PBP2A-the protein product of mecA. CONCLUSIONS The resistant phenotype of OS-MRSA resembles the phenotypes of historically early MRSA clones. The nature of genetic determinants responsible for the heterogeneous phenotypes of OS-MRSA remains to be determined.
Efficacy of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate as treatment for primary or recent HIV infection

different technique and a definition of acute/recent HIV infection that is not exactly the same, their results are quite similar to ours. Remarkably, in terms of the prevalence of detection of polymorphic and accessory substitutions, they found 13.3% of patients with such substitutions, compared with 13.89% in our article. Moreover, even though they analyse resistance substitutions using population sequencing (with lower sensitivity than the massive sequencing performed in our centre), such an approach would not have modified our results since, in our series, all patients had a mutational load . 90% of the viral load. Thus, our prevalence would have been the same using population sequencing. As with our cohort, the patients in the series of Fabrizio et al. are mostly MSM, infected with subtype B, and the most frequently detected integrase strand-transfer inhibitor (InSTI) substitution is 157Q. Several other European studies have noticed different levels of InSTI polymorphic and accessory substitutions in naive, recently diagnosed individuals. In Austria, 6% of recently diagnosed individuals had at least potentially low-level resistance to raltegravir or elvitegravir and 1% to dolutegravir. The rates of these polymorphisms and substitutions are lower in the UK and in Switzerland, but still present. In times of extremely effective antiretroviral regimens, even patients with multiple previous virological failures can become undetectable with relatively simple regimens. In this context, we agree with Fabrizio et al. that naive HIV individuals are increasingly being identified as the main source of resistance to antiretrovirals. This has been reported already in important European studies. We think that the next step is to identify, in our cohort and in other centres, such as that of Fabrizio et al., whether these patients—who all share the same risk factor for infection, the same strains with the same tropism and the same polymorphic and accessory substitutions—represent clusters of transmission or whether they are unrelated cases. While the prevalence may not change, the epidemiological message does.
Analysis of the Family Violence Option: A Strengths Perspective

The Family Violence Option (FVO) provides exemptions from Temporary Assistance to Needy Families requirements to victims of domestic violence. This article examines the link between domestic violence and welfare and analyzes the FVO using the strengths perspective. This perspective identifies women's strengths and needs and the barriers they must overcome to become self-sufficient.
Revisiting the Relationship Between Data, Models, and Decision‐Making

We hydrologists can do a better job of supporting water‐resources decision‐making. I will argue that we can do this by recognizing that decision makers use qualitative, multiple‐narrative approaches. So, rather than providing single‐model predictions with quantitative uncertainties, we should develop teams of rival models that inform decision makers about what is known, what is possible, and what is unknown. This requires that we build ensembles of models that include biased, advocacy models that directly represent stakeholders' interests or concerns. From this inclusive platform, we can speak objectively and clearly about the risks that drive stakeholders' decisions. Furthermore, we will be promoting more appropriate use of the scientific method in making informed water‐resources decisions.
ÖĞRETMEN ADAYLARININ WEB ORTAMINDA BİLGİ ARAMA-YORUMLAMA STRATEJİLERİNİN DEMOGRAFİK DEĞİŞKENLERE GÖRE İNCELENMESİ

Cagimizda bilgi ve iletisim teknolojileri (BIT) alanindaki gelismelerin hiz kazanmasiyla beraber internet hayatimizin onemli bir parcasi haline gelmistir. Ogretmenler ve ogrenciler bilgi ile ilgili ihtiyaclarini karsilamak uzere gerek okulda gerekse gunluk yasantilarinda internetten yararlanmaktadirlar. Bu arastirmanin amaci, ogretmen adaylarinin web ortaminda arastirma yaparken kullandiklari bilgi arama-yorumlama stratejilerinin incelenmesidir. Ayrica bu stratejilerin onlarin cinsiyetine, internet kullanma sikliklarina, bolum turune ve okuduklari sinif duzeyine gore anlamli bir degisiklik gosterip gostermedigi de arastirilmistir. Arastirmanin orneklemini 2012 bahar doneminde Kocaeli Universitesi Egitim Fakultesi’nin birinci ve dorduncu sinifinda okuyan 431 ogretmen adayi olusturmaktadir. Veri toplama araci olarak “Web Ortaminda Bilgi Arama-Yorumlama Stratejileri Olcegi” kullanilmistir. Arastirmada t- testi, Manova, Bonferenni testinden yararlanilmistir. Arastirma sonuclarina gore ogretmen adaylarinin web ortaminda siklikla kullandiklari bilgi arama-yorumlama stratejisi “bilgiyi organize etme”dir. Sozel bolumde okuyan ogretmen adaylarinin web ortaminda “farkli kaynaklari sorgulama” stratejilerine ait puanlari sayisal bolumde okuyan ogretmen adaylarina gore daha yuksek cikmistir. Sayisal bolumde okuyan ogretmen adaylarinin “teknik ozellikler ve gorsellik” ile “tek kaynak kullanimi” stratejilerine ait puanlari ise sozel bolumde okuyan ogretmen adaylarina gore daha yuksektir. Gunumuzde ilkogretimden universiteye kadar tum ogrencilerin internetten yogun bir sekilde yararlandiklari dusunuldugunde, bu calismanin ilkogretim ve ortaogretimde okuyan ogrencilerle de yapilmasi onlarin stratejilerinin belirlenmesine yardim edebilir. Ortaya cikan sonuclara gore ogrencilerin “gelismis bilgi arama ve yorumlama stratejileri”nin daha gelismesi icin egitimler verilebilir.
Desenvolvimento de emulsões óleo de oliva/água: avaliação da estabilidade física

Emulsoes oleo de oliva/agua, na presenca de agentes emulsionantes nao-ionicos, foram avaliadas quanto a estabilidade fisica. Assim, prepararam-se emulsoes fazendo uso de diferentes emulsionantes, sendo um hidrofilico e o outro lipofilico, nas diferentes proporcoes. As emulsoes mais estaveis, adicionaram-se agentes auxiliares da emulsificacao, visando otimizar a estabilidade; e estudos de estabilidade foram conduzidos, submetendo as amostras em condicoes e periodos diversos de armazenamento. Para caracterizacao da estabilidade, as amostras foram examinadas macroscopicamente e submetidas as analises de pH, centrifugacao, viscosidade, potencial zeta e distribuicao de tamanho de particula. Os resultados demonstraram que as emulsoes oleo de oliva/agua nao apresentaram alteracao, ou seja mantiveram-se estaveis, quanto as propriedades organolepticas, bem como fisico-quimicas, quando armazenadas a temperatura ambiente e protegidas da luz. Das emulsoes obtidas, as que apresentaram maior estabilidade provem da associacao de agentes emulsionantes que resultaram em equilibrio hidrofilico-lipofilico (EHL) equivalente a 12. As emulsoes provenientes da associacao de agentes emulsionantes que possuem cadeias de acidos graxos insaturados similares ao oleo de oliva produziram estabilidade maxima, demonstrando que a similaridade estrutural entre os componentes da fase oleosa e os agentes emulsionantes e essencial para a estabilidade da emulsao. Palavras-chave : Emulsao O/A. Estabilidade. Oleo de Oliva. EHL. Emulsionante nao-ionico. ABSTRACT Development of olive oil-in-water emulsions: assessment of physical stability Olive oil-in-water emulsions, developed with non-ionic emulsifiers, were assessed with regard to physical stability. Emulsions were prepared with two different emulsifiers, one of which was hydrophilic and the other lipophilic, in various proportions. To improve emulsion stability, auxiliary emulsifiers were added to the stablest emulsions and stability studies were carried out, in which the samples were stored for different periods and under various conditions. To test emulsion stability, the samples were examined macroscopically and various physicochemical properties, such as pH, centrifugation, viscosity, zeta potential and particle size distribution, were assessed. The results showed that olive oil-in-water emulsions are organoleptically and physicochemically stable, when stored at room temperature and protected from the light. Out of the emulsions developed, the most stable was based on an emulsifier blend that resulted in a hydrophilic-lipophilic balance (HLB) of 12. A blend of emulsifiers with unsaturated fatty acids of similar chain length to that of olive oil produced the stablest emulsions, showing that structural similarity between the hydrocarbon moieties of the oil phase and the surfactant is essential to successful emulsion stabilization. Keywords : O/W emulsion. Stability. Olive oil. HLB. Non-ionic emulsifier.
Prediction of Coronary Heart Disease Risk in a South European Population: A Case-Control Study

Coronary heart disease (CHD) is the most common cause of death in the industrialized countries. Although the past two decades have brought considerable advances in its detection and treatment, it remains a leading cause of death and disability in Western countries (Mackay & Mensah, 2004). CHD is a complex disease, whose primary cause is atherosclerosis. It is a progressive chronic disease process with contributions from environment, lifestyle and genetic factors. This complex disease clusters in families, suggesting a substantial genetic predisposition (Marenberg et al., 1994) and we know that its susceptibility can be mediated by both genetic and environmental factors (Talmud, 2007).
Nutrition Therapy and Pathophysiology

PART I: THE ROLE OF NUTRITION THERAPY IN HEALTH CARE. 1. Chapter 1 Role of the Dietitian in the Health Care System. PART II: THE NUTRITION CARE PROCESS. 2. The Nutrition Care Process. 3. Nutrition Assessment: Foundation of the Nutrition Care Process. 4. Nutrition Intervention. 5. Methods of Nutrition Support. 6. Nutrition Monitoring and Evaluation: Documentation of the Nutrition Care Process. PART III: INTRODUCTION TO PATHOPHYSIOLOGY. 7. Fluid and Electrolyte Balance. 8. Acid-Base Balance. 9. Cellular and Physiological Response to Injury: The Role of the Immune System. 10. Nutritional Genomics. 11. Pharmacology. PART IV: NUTRITION THERAPY. 12. Energy Balance and Body Weight. 13. Diseases of the Cardiovascular System. 14. Diseases of the Upper Gastrointestinal Tract. 15. Diseases of the Lower Gastrointestinal Tract. 16. Diseases of the Liver, Gallbladder, and Exocrine Pancreas. 17. Diseases of the Endocrine System. 18. Diseases of the Renal System. 19. Diseases of Hematological System. 20. Diseases and Disorders of the Neurological System. 21. Diseases of the Respiratory System. 22. Metabolic Stress and the Critically Ill. 23. Neoplastic Disease. 24. HIV and AIDS. 25. Diseases of the Musculoskeletal System. 26. Metabolic Disorders.