Miracle-dz/UniFAR-FTUs huggingface dataset:
Unnecessary Antimicrobial Use in Patients with Current or Recent Clostridium difficile Infection

Objective. To determine the fraction of unnecessary antimicrobial use among patients with current and/or recent Clostridium difficile infection (CDI). Design. Retrospective review from January 2004 through December 2006. Setting. Minneapolis Veterans Affairs Medical Center (MVAMC). Participants. Patients with new-onset CDI diagnosed at the MVAMC without another CDI diagnosis in the prior 30 days. Methods. Pharmacy and medical records were reviewed to identify incident CDI cases, non-CDI antimicrobial use during and up to 30 days after completion of CDI treatment, and patient characteristics. Two infectious disease physicians independently assessed non-CDI antimicrobial use, which was classified as unnecessary if not fully indicated. Factors associated with only unnecessary use were identified through univariable and multivariable analysis. Results. Of 246 patients with new-onset CDI, 141 (57%) received non-CDI antimicrobials during and/or after their CDI treatment, totaling 2,147 antimicrobial days and 445 antimicrobial courses. The two reviewers agreed regarding the necessity of antimicrobials in more than 99% of antimicrobial courses (85% initially, 14% after discussion). Seventy-seven percent of patients received at least 1 unnecessary antimicrobial dose, 26% of patients received only unnecessary antimicrobials, and 45% of total non-CDI antimicrobial days included unnecessary antimicrobials. The leading indications for unnecessary antimicrobial use were putative urinary tract infection and pneumonia. Drug classes frequently used unnecessarily were fluoroquinolones and β-lactams. Conclusions. Twenty-six percent of patients with recent CDI received only unnecessary (and therefore potentially avoidable) antimicrobials. Heightened awareness and caution are needed when antimicrobial therapy is contemplated for patients with recent CDI.
Histopathological findings in pregnancy associated cutaneous hyperpigmentation

Hyperpigmentation in pregnancy is a common phenomenon, experienced to some degree by up to 90% of pregnant women. It mainly involves sun‐exposed areas, but it can extend to non‐exposed zones. Cases with extensive hyperpigmentation are rarely reported. In this paper, we describe the case of a 30‐year‐old phototype V woman in her 37th week of pregnancy, who presented with brownish hyperpigmentation of the skin in extensive areas, including both axillae, the abdomen and the lowest part of the back. In the abdomen, there was a reinforcement of the hyperpigmentation through the linea nigra and the umbilicus. The hyperpigmentation affected the buttocks as well and involved the intertriginous area between them. Histopathologic analysis showed a hyperpigmented basal layer of the epidermis with no melanocytic atypia or melanocytic nests. Histochemical staining for iron did not show any deposits. Immunohistochemical studies for HMB‐45, Melan A and SOX10 demonstrated an increased number of melanocytes. There was hyperpigmentation of basal layer keratinocytes. We also performed immunohistochemical stains for estrogen and progesterone receptors, which were both negative. The patient was examined 3 months after delivery, evidencing a significant clearing of the lesions.
Association of killer cell immunoglobulin‐like receptors with spontaneous clearance of hepatitis C virus in the Chinese population

Natural killer (NK) cells are critical components in innate immune response to viral infection. Killer cell immunoglobulin‐like receptors (KIRs) are involved in regulating the balance of activation or inhibitory function of NK cells. However, the association of KIRs with the spontaneous clearance of hepatitis C virus (HCV) remains unclear in the Chinese population.
Nurses’ Perceptions of Competence in Providing Spiritual Care

Purpose: The study examined nurses’ perception of competence in providing spiritual care. Design of Study: A descriptive correlational research design with a convenience sample was used. Method: Participates completed a demographic questionnaire and the Spiritual Care Competence Scale, which has six domains: assessment and implementation of spiritual care, professionalization and improving the quality of spiritual care, personal support and patient counseling, referral to professionals, attitude toward the patient’s spirituality, and communication. Findings: The domain of communication had the most favorable perception among participants and the domain of professionalization and improving the quality of spiritual care had the least favorable perception. Conclusions: It is important for nurses to have the opportunity to gain knowledge regarding this significant component of holistic care.
Classification of Patients with Ménière’s Disease Using Otoacoustic Emissions

Otoacoustic emissions (OAEs) were studied in patients with Ménière’s disease in order to assess their usefulness for distinguishing between different stages of the disease. An accurate classification of Ménière’s patients is expected to allow optimalization of the treatment for each particular stage. Click-evoked and distortion product OAEs were evaluated in both ears for 70 Ménière’s patients. Based on these measurements, Ménière’s patients can be divided into four different categories. In patients with small hearing losses OAEs are found, whereas patients with pure-tone thresholds larger than 60 dB exhibit no OAEs at all. In the intermediate range (30- to 60-dB thresholds) two categories of patients are distinguished: patients with relatively large emissions and patients without measurable emissions. These findings suggest the presence of various stages in the pathophysiological mechanism involved in Ménière’s disease. Additionally, Ménière’s patients with contralateral ears with normal thresholds have significantly smaller emissions than normal-hearing adults. This observation could represent a very early manifestation of bilateral Ménière’s disease, which cannot be detected by other diagnostic methods.
Caregiving Load and Respite Service Use: A Comparison between Older Caregivers and Younger Caregivers

ABSTRACT Study aims were to explore differences in predictors of respite care use between older (aged 65+) and younger caregivers (aged 18–64 years), and associations between caregiving load and respite care use using multivariate logistic regression analysis and unpaid caregiver (n= 10,500) data from the 2009 California Health Interview Survey. Caregiving load comprised number of care recipients, weekly hours in caregiving, and caregiving duration. Variables with a significant association with respite care for older caregivers were female gender, income, and health insurance. For younger caregivers, respite care use associations were with ethnicity, caregiving relationship, education, and availability of substitute help.
Factors affecting outcome in myasthenia gravis

Introduction and Methods: Information from myasthenia gravis (MG) patients treated and evaluated for at least 2 years between 1980 and 2014 was reviewed to assess the effect of demographics, antibody status and titer, thymus histology, and clinical severity on outcome after 2, 5, and 10 years of treatment. Results: Among 268 patients, 74% had acetylcholine receptor antibodies, 5% had muscle specific tyrosine kinase‐antibodies, and 22% had neither. Optimal outcome was achieved by 64% of patients at 2 years of follow‐up, 73% at 5 years, and 75% after 10 years. Optimal outcome was achieved more often in patients with late onset, in those who had thymectomy, and in those with ocular‐only disease at maximum severity. The only consistent independent predictor of optimal outcome was onset after age 50 years on multivariate analysis. Conclusions: Prognosis is favorable for the majority of MG patients, regardless of age, maximum disease severity, or antibody status. Muscle Nerve, 2016 Muscle Nerve 54: 1041–1049, 2016
The brains of lampreys and hagfishes: characteristics, characters, and comparisons.

A comparison of the brains of lampreys and hagfishes is carried out in an attempt to reconstruct the anatomy of the brain of the last common ancestor of craniates: i.e., the morphotype of the craniate brain. This brain consisted of tel-, di-, mes-, and rhombencephalic divisions; the presence of a metencephalic/cerebellar division is questionable. All major sensory and motor systems (with the possible exception of the oculomotor system) that are typical of craniates were present in the morphotype. There were extensive bilateral secondary olfactory projections to the telencephalic pallium, as well as bilateral retinofugal projections to diencephalic, pretectal, and tectal targets. The rhombencephalon was subdivided into dorsal (viscero- and somatosensory) and ventral (branchiomotor) zones. The spinal cord projected to most rhomb- and mesencephalic areas; in turn, it received descending projections from the mes- and rhombencephalic reticular formation and from the octaval nuclei. The reconstruction of such a morphotype depends on the recognition of characters that are plesiomorphic for craniates, as determined by comparative, cladistic analysis. In many cases (gross morphological, topological and cytoarchitectural characters), such an analysis cannot be carried out, because characters that appear as discrete entities in one taxon are lacking or difficult to delineate from other characters in other taxa. The distribution of these characters in lampreys and hagfishes, and the developmental mechanisms that brought them about, offer a challenging problem in evolutionary neurobiology.
Chronic Treatment with Angiotensin II Type 1 Receptor Antagonist Suppresses Glomerular Activator Protein–1 Activity in Salt–Sensitive Hypertensive Rats

We examined the effects of angiotensin–converting enzyme inhibitor (ACEI) and angiotensin II type 1 receptor antagonist (AT1a) on the action of protooncogene c–fos in salt–sensitive hypertensive rats. Seven–week old Dahl salt–sensitive rats fed a high (8%)–salt diet were treated with ACEI, cilazapril (10 mg/kg) or AT1a, TCV–116 (1mg/ kg) every day for 6 weeks. The control animals were fed a low (0.3%)–salt diet. Systolic blood pressure gradually increased in high–salt–loaded rats and was higher than low–salt–treated rats throughout the study. However, both medications had no significant antihypertensive effect. After 6 weeks of therapy, glomerular mRNA and nuclear protein were extracted from the resected kidneys. Competitive reverse transcription–polymerase chain reaction showed a high level of glomerular c–fos mRNA in high–salt–loaded rats and that ACEI or AT1a treatment did not significantly change its level. Electrophoretic mobility shift assay demonstrated that treatment with AT1a significantly decreased the activator protein–1 (AP–1) binding activity in the glomerular nuclear extract compared to ACEI. Our findings suggest that, compared with ACEI treatment, long–term treatment with AT1a may contribute to attenuation of the glomerular injury in salt–sensitive hypertension by inhibiting AP–1 transcription activity independent of its antihypertensive effect.
Internal Borderzone Infarction in Patients with Ischemic Stroke

Objective: The mechanism underlying cerebral infarction in the borderzone between the territories of deep and superficial perforating arteries has not yet been clarified. This study was performed to investigate the prevalence, volume, site, and etiology of this type of subcortical infarction in a large unselected group of stroke patients. Methods and Patients: We analyzed a continuous series of 383 patients with recent cerebral infarction observed in our Stroke Unit. Patients underwent a complete clinical and instrumental workup. The subgroup of subjects with internal borderzone infarct alone were compared with the subgroups of patients with other types of cerebral infarcts by uni- and multivariate statistical tests. Results: There were 90 internal borderzone infarcts of 725 ischemic lesions (12% of the total), with a median volume of 0.32 ml (95% confidence interval 0.24–0.44; range: 0.012–20.2 ml). Internal borderzone infarcts alone occurred in only 13 of 383 (3.4%) patients. A comparison between patients with ‘pure’ internal borderzone infarction and patients with other types of cerebral infarcts by multiple logistic regression analysis demonstrated a significant independent causal role of carotid stenosis or occlusion. Conclusion: Our study suggests that ‘pure’ internal borderzone infarctions are quite rare findings in patients with ischemic stroke, and that the hemodynamic impairment due to atherosclerotic occlusion or stenosis of the carotid system could be the cause in the large majority of cases.
Seeding of the mucosal leukocytes in the HALT and trachea of White Leghorn chickens

ABSTRACT Characterising the immune cells of the head-associated lymphoid tissues (HALT) and trachea during maturation in young birds is critical to understanding the immunological responses to avian respiratory diseases and vaccines. Selected mucosal leukocytes of the conjunctiva-associated lymphoid tissue (CALT), Harderian gland (HG), nasal-associated lymphoid tissue (NALT) and trachea from 4-, 6-, 8-, and 10-week-old chickens were enumerated and phenotyped. HG, NALT, and trachea cellularity increased as the birds aged with cell viability varying by tissue. The results showed that the T cell subset numbers, but not B cell numbers, increased in the mucosal tissues of chickens during aging.
Feasibility study of scripting Indonesian traditional dance motion in XML format

Indonesia is a great country with many cultural diversities, including traditional dances. With the increasing trend toward digitalization, the need to preserving these priceless treasures in digital format is unavoidable. The storing of dances in the form of video format seems inadequate since studying, comparing, and analyzing the video is cumbersome task. This paper discuses about the feasibility study of scripting the Indonesian traditional dances in XML format. Some studies related to these attempts are presented such as Indonesian traditional dances and current technological approach, the motion / gesture capture and recognition, and many more. The proposed approach of dance motion scripting and turn it into XML format seem promising.
Modern perspectives on the health benefits of kefir in next generation sequencing era: Improvement of the host gut microbiota

ABSTRACT Kefir is a natural complex fermented milk product containing more than 50 species of probiotic bacteria and yeast, and has been demonstrated to have multiple properties conferring health benefits, including antiobesity, anti-hepatic steatosis, antioxidative, antiallergenic, antitumor, anti-inflammatory, cholesterol-lowering, constipation-alleviating, and antimicrobial properties. To better understand the underlying mechanisms of these benefits, we here review research on the effect of kefir (and kefir microorganisms) consumption to modulate the host gut microbiota. Owing to its excellent gastrointestinal resistance and colonization ability and wide ranges of microbial interaction, kefir has shown significant and wide-spectrum modulatory effects on the host gut microbiota. In particular, as a bacteria- and yeast-containing food, kefir can modulate both the gut microbiota and mycobiota. Since the association of this modulation with health benefit has only been addressed in a small number of recent studies thus far, further studies are needed to determine the precise mechanisms of the beneficial effects of kefir in relation to the modulation of the gut microbiota and mycobiota. Gaining this insight will surely help to take full advantage of this unique probiotic food.
Questionnaire‐based Analysis of Owner‐reported Scratching and Pain Signs in Cavalier King Charles Spaniels Screened for Chiari‐like Malformation and Syringomyelia

Background Chiari‐like malformation (CM) and syringomyelia (SM) cause a pain syndrome in Cavalier King Charles spaniels (CKCS). Clinical signs are not consistently apparent on neurologic examination, and owner reporting of signs provides vital clinical history. However, owner questionnaires for this disease are not well developed. Objectives To develop a tool to capture owner‐reported clinical signs for use in clinical trials and to compare owner‐reported signs with the presence of pain on neurologic examination and SM on magnetic resonance imaging (MRI). Animals Fifty client‐owned CKCS. Methods Owners completed a questionnaire and pain/scratch map. Each dog underwent a neurologic examination and craniocervical magnetic resonance imaging (MRI). Questionnaire responses were developed into scores, area of shading for pain/scratch maps was measured, and consistency of responses between these tools was assessed. Owner‐reported findings were compared with neurologic examination findings and presence and severity of SM on MRI. Results Thirty‐three dogs were symptomatic and 17 asymptomatic; 30 had SM. The most common sign of pain was crying out when lifted (n = 11). Extent of shaded areas on maps positively correlated with questionnaire scores for pain (r 2 = 0.213, P = 0.006) and scratch (r 2 = 0.104, P = 0.089). Owner‐reported findings were not significantly associated with presence or severity of SM or neurologic examination findings. Owner‐reported lateralization of signs was significantly associated with SM lateralization (P < 0.0001). Conclusions The questionnaire and maps may be useful for clinical trials. Lack of association of owner‐reported signs with SM highlights our lack of understanding of the pathophysiology of pain in this disease.
Pain and somatic sensation are transiently normalized by illusory body ownership in a patient with spinal cord injury.

PURPOSE Spinal cord injury (SCI), a profound impairment of sensorimotor functions, is often associated with pain related phenomena, including mechanical allodynia, a condition in which non-painful tactile sensation is perceived as pain. Pain and somatic sensation are undeniable markers of normal bodily awareness. However, the mechanism by which they are integrated into a coherent sense of the bodily self remains largely unclear. In this study, we investigated the effect of high-level multisensory manipulation on subjective experiences of pain, touch, and body-ownership. METHODS We administered visuo-tactile stimulation based on the rubber hand illusion. In a longitudinal study, we compared the strength of the illusion in a male with SCI, who initially had lost somatosensation in all his fingers, but a few months later reported signs of tactile allodynia restricted to the left C6-dermatome. RESULTS After the restoration of some somatosensation, even if it were painful, synchronous but not asynchronous visuo-tactile stimulation induced body illusion. Previously painful stimuli were temporarily perceived as less painful, and the patient further regained tactile sensations in adjacent numb areas. CONCLUSIONS The sensations of touch and pain are mutually influenced and inextricably linked to a coherent representation of one's own body. Multisensory manipulations affecting the perception and representation of the body might thus offer a powerful opportunity to mitigate nociceptive and somatic abnormalities.
Violence, addiction, recovery: An anthropological study of Mexico’s anexos

Informal, coercive residential centers for the treatment of addiction are widespread and growing throughout Latin America. In Mexico these centers are called “anexos” and they are run and utilized by low-income individuals and families with problems related to drugs and alcohol. This article draws on findings from a 3-year anthropological study of anexos in Mexico City. Participant observation and in-depth interviews were used to describe and analyze anexos, their therapeutic practices, and residents’ own accounts of addiction and recovery. Our findings indicate that poverty, addiction, and drug-related violence have fueled the proliferation of anexos. They also suggest that anexos offer valuable health, social, and practical support, but risk exacerbating the suffering of residents through coercive rehabilitation techniques. Emphasizing this tension, this article considers the complex relationship between coercion and care, and poses fundamental questions about what drug recovery consists of in settings of poverty and violence.
Histomorphology of an Ileal Orthotopic Neobladder: 24 Year’s Follow-Up

No morphological data are so far available about long-term (over 15 years) adaptation and outcome of ileal neobladders. In this single case report we have studied a 72-year-old man who underwent reconstruction of an ileal neobladder 24 years ago. The ileal epithelium shows changes toward a colonic aspect with villous atrophy and increased goblet cell number although, as in normal ileum, sialomucins are the most abundant secretory products. Neuroendocrine cells are reduced to a few elements of a single morphological class. Even in the presence of a low apoptotic rate reduced cell proliferation causes mucosal thinning. These adaptive mechanisms grant an excellent clinical and functional result even beyond 20 years after surgery. It is suggested that ileal neobladder can constitute an important model for the study of epithelial differentiation control.
Antibacterial effect of hydrogen peroxide-titanium dioxide suspensions in the decontamination of rough titanium surfaces

Abstract The chemical decontamination of infected dental implants is essential for the successful treatment of peri-implantitis. The aim of this study was to assess the antibacterial effect of a hydrogen peroxide-titanium dioxide (H2O2–TiO2) suspension against Staphylococcus epidermidis biofilms. Titanium (Ti) coins were inoculated with a bioluminescent S. epidermidis strain for 8 h and subsequently exposed to H2O2 with and without TiO2 nanoparticles or chlorhexidine (CHX). Bacterial regrowth, bacterial load and viability after decontamination were analyzed by continuous luminescence monitoring, live/dead staining and scanning electron microscopy. Bacterial regrowth was delayed on surfaces treated with H2O2–TiO2 compared to H2O2. H2O2-based treatments resulted in a lower bacterial load compared to CHX. Few viable bacteria were found on surfaces treated with H2O2 and H2O2–TiO2, which contrasted with a uniform layer of dead bacteria for surfaces treated with CHX. H2O2–TiO2 suspensions could therefore be considered an alternative approach in the decontamination of dental implants.