Miracle-dz/UniFAR-FTUs huggingface dataset:
Texting improves testing: a randomized trial of two-way SMS to increase postpartum prevention of mother-to-child transmission retention and infant HIV testing

Objective:Many sub-Saharan African countries report high postpartum loss to follow-up of mother–baby pairs. We aimed to determine whether interactive text messages improved rates of clinic attendance and early infant HIV testing in the Nyanza region of Kenya. Design:Parallel-group, unblinded, randomized controlled trial. Methods:HIV-positive pregnant women at least 18 years old and enrolled in the prevention of mother-to-child transmission of HIV programme were randomized to receive either text messages (SMS group, n = 195) or usual care (n = 193). Messages were developed using formative focus group research informed by constructs of the Health Belief Model. The SMS group received up to eight text messages before delivery (depending on gestational age), and six messages postpartum. Primary outcomes included maternal postpartum clinic attendance and virological infant HIV testing by 8 weeks postpartum. The primary analyses were intention-to-treat. Results:Of the 388 enrolled women, 381 (98.2%) had final outcome information. In the SMS group, 38 of 194 (19.6%) women attended a maternal postpartum clinic compared to 22 of 187 (11.8%) in the control group (relative risk 1.66, 95% confidence interval 1.02–2.70). HIV testing within 8 weeks was performed in 172 of 187 (92.0%) infants in the SMS group compared to 154 of 181 (85.1%) in the control group (relative risk 1.08, 95% confidence interval 1.00–1.16). Conclusions:Text messaging significantly improved maternal postpartum visit attendance, but overall return rates for these visits remained low. In contrast, high rates of early infant HIV testing were achieved in both arms, with significantly higher testing rates in the SMS compared to the control infants.
Mathematics Anxiety, Mathematics Performance and Academic Hardiness in High School Students

Abstract The paper has shown the relationship between Mathematics anxiety, Mathematics performance and Academic hardiness in high school students. The sample comprised 284 (144 males and 140 females) 10th grade high school students from Karnataka state. Pearson correlation analysis and two independent samples T-test are used to analyze the data. The results have revealed that mathematics anxiety has significant negative correlation with mathematics performance but no significant correlation is detected with academic hardiness. It is also found that the gender differences in mathematics anxiety are significant, whereas no significant differences are detected between boys and girls in mathematics performance and academic hardiness. This study has established the fact that the performance of students in mathematics can be perceived by mathematics anxiety and females scored slightly higher on this variable but this relation has not observed with academic hardiness.
Yeast Nucleosome DNA Pattern: Deconvolution from Genome Sequences of S. cerevisiae

Abstract Positional correlation analysis for the complete genome of Saccharomyces cerevisiae is performed with the aim to reveal possible chromatin-related sequence features. A strong periodicity with the period 10.4 bases is detected in the distance histograms for the dinucleotides AA and TT, with the characteristic decay distance of approximately 50 base pairs. The oscillations are observed as well in the distributions of other dinucleotides. However, the respective amplitudes are small, consistent with secondary effects, due to dominant periodicity of AA and TT. The observations are in accord with earlier data on the chromatin sequence periodicities and nucleosome DNA sequence patterns. The autocorrelations of AA and TT dinucleotides in yeast include also a counter-phase component. A tentative DNA sequence pattern for the yeast nucleosomes is suggested and verified by comparison of its autocorrelation plots with the respective natural autocorrelations. The nucleosome mapping guided by the pattern is in accord with experimental data on the linker length distribution in yeast.
More than Meets the Eye: Social, Economic, and Emotional Impacts of Work-Related Injury and Illness

The impact of an occupational illness or injury on an injured worker can be severe. This study assessed several dimensions of the impact on a group of 50 injured workers, all patients at an Occupational Health Center. The dimensions assessed included aspects of access to health care, support from treating physicians in obtaining Workers' Compensation benefits, financial impacts, the role of attorneys and “Independent Medical Examiners,” and the impact on mental health. The results showed almost two-thirds of respondents lost their health insurance after diagnosis with a work-related illness or injury, most for more than a year. Many reported that their treating physician did not want to become involved in Workers' Compensation, despite indicating a belief that the health condition was work-related. The financial impacts of a work-related diagnosis were particularly striking, with respondents reporting that they were burdened with both costs directly related to the medical care of their condition, and with coping with ongoing general expenses on a reduced income. Many respondents reported depleting savings, borrowing money, taking out retirement funds, and declaring bankruptcy in efforts to cope. Emotionally, respondents almost universally reported their diagnosis and related issues were associated with depression, anxiety, and loss of identity and self-worth. This study demonstrates how a work-related injury or illness can extend far beyond the physical impact for injured workers. Existing systems fail to adequately compensate or rehabilitate injured workers, leaving them to their own devices to deal with their losses, medical or otherwise.
The effects of physical activity on psychogenic movement disorders

Psychogenic movement disorders (PMD) are a diagnostic fascinating challenge in both neurologic and psychiatric setting. Many factors influence response to treatment, but few treatment strategies are available. Physical activity proves to be effective in the treatment of depression, anxiety, and other psychiatric disorders, but the effects of regular walking exercise on patients with PMD have never been investigated in a single‐blind study. Sixteen outpatients [13 women; mean age 33.0 years (range 22–51)] with primarily mild‐to‐moderate PMD completed a thrice‐weekly, 12‐weeks mild walking program. Assessments included DSM‐IV interview, the Psychogenic Movement Disorder Rating Scale (PMDRS), Beck Anxiety Inventory (BAI), Hamilton Depression Scale (HDS), V02 Max, and body mass index (BMI). Changes in total score on the PMDRS were the primary endpoint. A comparison of all measures taken at study onset and after completing the exercise program indicates statistically significant improvements. We observed a relevant improvement in 10 of 16 patients (62%). The mean difference for the primary outcome (PMDRS total) corresponded to about 70%. Compliance was good, and there were no adverse effects. This study provides preliminary evidence for regular low‐medium intensity exercise as a safe, adequate, and pleasing intervention for PMD. Furthermore, well‐designed studies appear justified to confirm these findings. © 2010 Movement Disorder Society
Perceived barriers to diabetic eye care: qualitative study of patients and physicians.

OBJECTIVES To address inadequate retinopathy screening at a largely indigent clinic and to explore perceived barriers, using qualitative techniques. METHODS Responses were analyzed from structured focus groups of patients and key informant interviews of primary diabetic physicians and ophthalmologists at the Medical Center of Louisiana in New Orleans. The number of diabetic patients screened at the center from 2000 to 2002 was obtained by quantitative analysis of an administrative database. RESULTS Participants cited finances as the major barrier, while physicians cited inadequate patient education. Patients largely believed that diabetic education was adequate, yet there was a gap between patient education provided and their understanding. All sources agreed that poor access to care, particularly the 1-year wait for an appointment, was a barrier. No respondent mentioned constraints of the system to provide eye care to the number of diabetic patients as a possible barrier, despite the 1-year wait for an eye appointment and a 29% increase in eye examinations within 2 years. CONCLUSIONS Perceptions of barriers to diabetic eye care differed among physicians and patients, although both groups agreed that access to care was a barrier. A gap exists between educational material provided to patients and what patients understand. A large unrecognized workload stresses the capacity of the current system.
Postdischarge community pharmacist-provided home services for patients after hospitalization for heart failure.

OBJECTIVE To establish a community pharmacist-provided home health service to improve medication adherence and reduce 30-day heart failure-related hospital readmissions. SETTING Visiting Nurse Services of Newport and Bristol Counties located in Portsmouth, RI, from December 2013 to April 2014. PRACTICE DESCRIPTION Each patient received one in-home visit provided by a Postgraduate Year 1 community pharmacy resident within 1 week of admission to visiting nurse services followed by two follow-up telephone calls, 1 week and 4 weeks after the visit. The in-home visit consisted of a baseline assessment of medication adherence using the Morisky 8-Item Medication Adherence Questionnaire as well as pharmacist-provided education regarding chronic heart failure management. The follow-up telephone calls were used to reassess patient adherence and to monitor for hospital readmission within 30 days of the initial in-home visit. PRACTICE INNOVATION Community pharmacist-provided in-home medication reconciliation and medication teaching has not been described in the literature previously. In addition, pharmacists are often not included on home health care teams placing patients undergoing transitions in care at risk for potential medication-related errors. MAIN OUTCOME MEASURES Improvement in medication adherence and reduction in 30-day heart failure-related hospital readmission rates. RESULTS Ten patients were enrolled from December 2013 through April 2014. Following intervention, all patients saw improvements in adherence questionnaire scores during follow-up. Hospital readmission rates for patients seen by the pharmacist were lower compared with agencywide figures over a similar time period. CONCLUSION A community pharmacist-provided in-home medication teaching service for patients following recent hospital discharge helps facilitate successful transitions of care from an inpatient to outpatient setting, improves medication adherence and has produced lower observed 30-day heart failure-related hospital readmission rates. Expansion of this or a similar service within the community pharmacy to reach as many patients as possible, including those not using visiting nurse services, could serve to only augment these benefits.
Prevalence of human papillomavirus types, viral load and physical status of HPV16 in head and neck squamous cell carcinoma from the South Swedish Health Care Region.

Incidence of human papillomavirus (HPV)-positive head and neck squamous cell carcinoma (HNSCC) is rising in several countries. Intriguingly, large variations of HPV16 viral load and different proportions of the physical viral status among HNSCC have been reported. We analysed fresh biopsies of 275 HNSCC patients from the South Swedish Health Care Region for HPV types with modified general primer PCR and Luminex. Seventy-eight HPV16-positive HNSCC cases were further investigated for viral DNA load and physical status using quantitative PCR for HPV E2 and E7 genes. Presence of intact E2 gene, as a surrogate marker for episomal HPV, was investigated with conventional PCR. Fifteen different HPV types were detected in HNSCC cases and HPV16 was present in 74 % of the HPV-positive cases. HPV was detected in 65 % (92/141) and 11 % (15/134) of oropharyngeal and non-oropharyngeal carcinomas, respectively (P<0.0001). HPV was detected in 73 % (75/103) of tonsillar carcinomas. The median load of HPV16 was 13 copies cell-1 (range 0.003-1080). Among HPV16-positive patients with oropharyngeal carcinoma, metastases to regional lymph nodes were observed in 100 % (17/17) and 68 % (40/58) for those with <1 HPV16 copy cell-1 and >1 HPV16 copy cell-1, respectively (P=0.007). Among HPV16 cases, purely integrated HPV16 was found in 6 %, whereas entirely episomal and mixed virus was detected in 51 and 42 % of cases, respectively. Conclusively, HPV16 viral DNA load demonstrated a large diversity among HNSCCs. Although integration of HPV16 is common (48 %), the episomal HPV16 is salient (93 %) among HPV16 HNSCCs. In addition, low amount of HPV16 was associated with lymph node metastases among oropharyngeal carcinomas.
Human Pat1b Connects Deadenylation with mRNA Decapping and Controls the Assembly of Processing Bodies

ABSTRACT In eukaryotic cells, degradation of many mRNAs is initiated by removal of the poly(A) tail followed by decapping and 5′-3′ exonucleolytic decay. Although the order of these events is well established, we are still lacking a mechanistic understanding of how deadenylation and decapping are linked. In this report we identify human Pat1b as a protein that is tightly associated with the Ccr4-Caf1-Not deadenylation complex as well as with the Dcp1-Dcp2 decapping complex. In addition, the RNA helicase Rck and Lsm1 proteins interact with human Pat1b. These interactions are mediated via at least three independent domains within Pat1b, suggesting that Pat1b serves as a scaffold protein. By tethering Pat1b to a reporter mRNA, we further provide evidence that Pat1b is also functionally linked to both deadenylation and decapping. Finally, we report that Pat1b strongly induces the formation of processing (P) bodies, cytoplasmic foci that contain most enzymes of the RNA decay machinery. An amino-terminal region within Pat1b serves as an aggregation-prone domain that nucleates P bodies, whereas an acidic domain controls the size of P bodies. Taken together, these findings provide evidence that human Pat1b is a central component of the RNA decay machinery by physically connecting deadenylation with decapping.
Pore-Forming and Enzymatic Activities of Bordetella pertussis Adenylate Cyclase Toxin Synergize in Promoting Lysis of Monocytes

ABSTRACT Bordetella adenylate cyclase (AC) toxin-hemolysin (CyaA) targets myeloid phagocytes expressing the αMβ2 integrin (CD11b/CD18) and delivers into their cytosol an AC enzyme that converts ATP into cyclic AMP (cAMP). In parallel, CyaA acts as a hemolysin, forming small membrane pores. Using specific mutations, we dissected the contributions of the two activities to cytolytic potency of CyaA on J774A.1 murine monocytes. The capacity of AC to penetrate cells and deplete cytosolic ATP was essential for promoting lysis and the enzymatically inactive but fully hemolytic CyaA-AC− toxoid exhibited a 15-fold-lower cytolytic capacity on J774A.1 cells than intact CyaA. Moreover, a two- or fourfold drop of specific hemolytic activity of the CyaA-E570Q and CyaA-E581P mutants was overpowered by an intact capacity to dissipate cytosolic ATP into cAMP, allowing the less hemolytic proteins to promote lysis of J774A.1 cells as efficiently as intact CyaA. However, an increased hemolytic activity, due to lysine substitutions of glutamates 509, 516, and 581 in the pore-forming domain, conferred on AC− toxoids a correspondingly enhanced cytolytic potency. Moreover, a threefold increase in hemolytic activity could override a fourfold drop in capacity to convert cellular ATP to cAMP, conferring on the CyaA-E581K construct an overall twofold increased cytolytic potency. Hence, although appearing auxiliary in cytolytic action of the toxin on nucleated cells, the pore-forming activity can synergize with ATP-depleting activity of the cell-invasive AC enzyme and complement its action toward maximal cytotoxicity.
Association of mycoplasma and human immunodeficiency virus infection: detection of amplified Mycoplasma fermentans DNA in blood.

A cross-sectional study was undertaken to determine the prevalence of Mycoplasma fermentans infection in patients with human immunodeficiency virus (HIV) infection using polymerase chain reaction methodology. Targeted M. fermentans DNA sequences could be amplified from the DNA extracted from the blood of 6 (11%) of 55 HIV-seropositive patients but from none of 26 HIV-seronegative subjects at low risk for HIV infection (P = .17). There was no correlation between M. fermentans infection and HIV clinical stage. There was a nonsignificant trend toward an association between M. fermentans infection and a history of syphilis. Infection with M. fermentans may occur more commonly in HIV-infected patients; however, a role as a copathogen or opportunistic infection was not established in this study.
Spermatogenic cell‐specific type 1 hexokinase is the predominant hexokinase in sperm

Hexokinase is the first enzyme in the glycolytic pathway and utilizes ATP to convert glucose to glucose‐6‐phosphate (G6P). We previously identified three variant transcripts of Hk1 that are expressed specifically in spermatogenic cells, have different 5′ untranslated regions, and encode a protein (HK1S, spermatogenic cell‐specific type 1 hexokinase) in which the porin‐binding domain (PBD) of HK1 is replaced by a novel N‐terminal spermatogenic cell‐specific region (SSR). However, the level of expression of the individual variant transcripts or of the other members of the hexokinase gene family (Hk2, Hk3, and Gck) in spermatogenic cells remains uncertain. We show that Hk1, Hk2, and Hk3 transcripts levels are quite low in spermatocytes and spermatids and Gck transcripts are relatively abundant in spermatids, but that glucokinase (GCK) is not detected in spermatozoa. Using real time RT‐PCR (qPCR) with primers specific for each of the three variant forms and RNA from whole testis and isolated germ cells, we found that transcripts for Hk1_v2 and Hk1_v3, but not for Hk1_v1, are relatively high in spermatids. Similar results were seen using spermatogenic cells isolated by laser‐capture microdissection (LCM). Immunoblotting studies found that HK1S is abundant in sperm, and immunostaining confirmed that HK1S is located mainly in the principal piece of the sperm flagellum, where other spermatogenic cell‐specific glycolytic enzymes have been found. These results strongly suggest that HK1, HK2, HK3, and GCK are unlikely to have a role in glycolysis in sperm and that HK1S encoded by Hk1_v2 and Hk1_v3 serves this role. Mol. Reprod. Dev. 75: 632–640, 2008. © 2007 Wiley‐Liss, Inc.
Cost of Joint Replacement Using Bundled Payment Models

Importance Medicare launched the mandatory Comprehensive Care for Joint Replacement bundled payment model in 67 urban areas for approximately 800 hospitals following its experience in the voluntary Acute Care Episodes (ACE) and Bundled Payments for Care Improvement (BPCI) demonstration projects. Little information from ACE and BPCI exists to guide hospitals in redesigning care for mandatory joint replacement bundles. Objective To analyze changes in quality, internal hospital costs, and postacute care (PAC) spending for lower extremity joint replacement bundled payment episodes encompassing hospitalization and 30 days of PAC. Design, Setting, and Participants This observational study followed 3942 total patients with lower extremity joint replacement at Baptist Health System (BHS), which participated in ACE and BPCI. Exposures Lower extremity joint replacement surgery under bundled payment at BHS. Main Outcomes and Measures Average Medicare payments per episode, readmissions, emergency department visits, prolonged length of stay, and hospital savings from changes in internal hospital costs and PAC spending. Results Overall, 3942 patients (mean [SD] age, 72.4 [8.4] years) from BHS were observed. Between July 2008 and June 2015, average Medicare episode expenditures declined 20.8%, from $26 785 to $21 208 (P < .001) for 3738 episodes of joint replacement without complications. It declined 13.8% from $38 537 to $33 216 (P = .61) for 204 episodes of joint replacement with complications. Readmissions and emergency department visits declined 1.4% (P = .14) and 0.9% (P = .98), respectively, while episodes with prolonged length of stay decreased 67.0% (P < .001). Patient illness severity remained stable. By 2015, 51.2% of overall hospital savings had come from internal cost reductions and 48.8% from PAC spending reductions. Reductions in implant costs, down on average $1920.68 (29%) per case, contributed the greatest proportion of hospital savings. Average PAC spending declined $2443.12 (27%) per case, largely from reductions in inpatient rehabilitation and skilled nursing facility spending but only when bundles included financial responsibility for PAC. Conclusions and Relevance During a period in which Medicare payments for joint replacement episodes increased by 5%, bundled payment for procedures at BHS was associated with substantial hospital savings and reduced Medicare payments. Decreases in PAC spending occurred only when it was included in the bundle.
Androgenic-Anabolic Steroids Associated with Mechanical Loading Inhibit Matrix Metallopeptidase Activity and Affect the Remodeling of the Achilles Tendon in Rats

Background The indiscriminate use of anabolic-androgenic steroids has been shown to induce pathologic changes in the Achilles tendon in several situations. Purpose To study tendon remodeling in rats treated with anabolic-androgenic steroids combined with an exercise program. Study Design Controlled laboratory study. Methods Wistar rats were grouped as follows: sedentary (group I), injected with anabolic-androgenic steroids only (group II), trained only (group III), and trained and injected with anabolic-androgenic steroids (group IV). The trained groups performed jumps in water: 4 series of 10 jumps each, with an overload of 50% to 70% of the animal's body weight and a 30-second rest interval between series, for 6 weeks. Anabolic-androgenic steroids (5 mg/kg) were injected subcutaneously. Activity of matrix metallopeptidases, a marker for tendon remodeling, was analyzed in tissue extracts by zymography on gelatin–sodium dodecyl sulfate–polyacrylamide gel electrophoresis. Results Morphological analyses of tendons showed that in group II, the most external layer that covers the tendon was thicker with aggregation of the collagen fibers, suggesting an increase in collagen synthesis. In group IV, an inflammatory infiltrate and fibrosis in tendons as well as a pronounced increase of the serum corticosterone level were observed. This training protocol upregulated matrix metallopeptidase activity, whereas anabolic-androgenic steroid treatment strongly inhibited this activity. The appearance of lytic bands with molecular masses of approximately 62 and 58 kDa suggests the activation of matrix metallopeptidase–2. Conclusion Anabolic-androgenic steroid treatment can impair tissue remodeling in the tendons of animals undergoing physical exercise by downregulating matrix metallopeptidase activity, thus increasing the potential for tendon injury. Clinical Relevance Since the AAS abuse is so widespread, a better comprehension of the pathological effects induced by these drugs may be helpful for the development of new forms of therapy of AAS-induced lesions.