Miracle-dz/UniFAR-FTUs huggingface dataset:
Potential Impact of Existing Interventions and of Antiretroviral Use in Female Sex Workers on Transmission of HIV in Burkina Faso: A Modeling Study

Background:The impact and cost-effectiveness of antiretroviral treatment (ART) as prevention is likely to vary depending on the local context. Burkina Faso has a concentrated mature HIV epidemic where female sex workers (FSW) are thought to have driven HIV transmission. Methods:A dynamic HIV transmission model was developed using data from the Yerelon FSW cohort in Bobo-Dioulasso and population surveys. Compared with current ART provision [status quo (SQ)], the model estimated the proportion of HIV infections averted or incremental life-years gained per additional person-year of ART over 20 years for ART targeting different subgroups or expanding eligibility to all HIV-infected individuals compared with SQ. Results:Modeling suggests that condom use within commercial sex has averted 40% of past HIV infections. Continuing SQ averts 35%–47% of new infections over 20 years compared with no ART. Expanding ART eligibility to all HIV-infected individuals and increasing recruitment (80% per year) could avert a further 65% of new infections, whereas targeting full-time FSW or all FSWs achieved less impact but was more efficient in terms of life-years gained per 100 person-years of ART. Local HIV elimination is possible with expanded ART provision to FSWs but requires condom use within commercial sex to be maintained at high levels. Conclusions:Increasing FSW recruitment onto ART could be a highly efficient method for reducing HIV transmission in concentrated epidemic settings but should not be undertaken at the expense of existing interventions for FSWs. Specialized clinics providing multiple interventions for FSWs should be a fundamental component of prevention in concentrated epidemics.
‘Balancing risk, that is my life’: The politics of risk in a hospital operating theatre department

Abstract The management of risk has become a policy priority in health systems around the world. Current orthodoxy within patient safety policy circles stresses the need to identify and manage risk to reduce harm to patients. However, this rests on an assumption that there is common agreement that risk can be managed, together with a shared set of beliefs about what constitutes risk and the methods for managing risk. The framing of particular issues as risks and the methods chosen to manage these can be interpreted as a challenge to medical autonomy. In this sense, risk management can be seen as a political tool intended to change behaviours and existing forms of organization. In this paper we present findings from a 2-year research study conducted within a hospital operating theatre department. Our findings based on observation and interviews suggest that sophisticated risk discourses can be used by those who seek to challenge the current patient safety orthodoxy. In particular, doctors were able to deploy discourses which emphasize the scientific nature of risk measurement as well as capitalizing on the ambiguous nature of probabilistic risk calculations. The implications for clinical risk management policy are discussed.
Photochemical internalization of bleomycin and temozolomide — in vitro studies on the glioma cell line F98

Here we evaluate the photosensitizer meso-tetraphenyl chlorin disulphonate (TPCS_2a) in survival studies of rat glioma cancer cells in combination with the novel photochemical internalization (PCI) technique. The tested anticancer drugs were bleomycin (BLM) and temozolomide (TMZ). Glioma cells were incubated with TPCS_2a (0.2 μg ml^−1, 18 h, 37 °C) before BLM or TMZ stimulation (4 h) prior to red light illumination (652 nm, 50 mW cm^−2). The cell survival after BLM (0.5 μm)-PCI (40 s light) quantified using the MTT assay was reduced to about 25% after 24 h relative to controls, and to 31% after TMZ-PCI. The supplementing quantification by clonogenic assays, using BLM (0.1 μm), indicated a long-term cytotoxic effect: the surviving fraction of clonogenic cells was reduced to 5% after light exposure (80 s) with PCI, compared to 70% in the case of PDT. In parallel, structural and morphological changes within the cells upon light treatment were examined using fluorescence microscopy techniques. The present study demonstrates that PCI of BLM is an effective method for killing F98 glioma cells, but smaller effects were observed using TMZ following the “light after” strategy. The results are the basis for further in vivo studies on our rat glioma cancer model using PDT and PCI.
Macrolide resistance and molecular types of Treponema pallidum causing primary syphilis in Shanghai, China.

BACKGROUND The resurgence of syphilis in China requires laboratories to update their methods for molecular epidemiology investigation and surveillance. This study focuses on implementing polymerase chain reaction (PCR) diagnostic tests for syphilis and for detection of molecular subtypes and macrolide resistance among strains causing primary syphilis in the city of Shanghai, China. METHODS Swabs were obtained from the genital lesions of 39 patients who presented with symptoms compatible with primary syphilis. Eight of the patients also provided whole blood samples. Swabs were also obtained from 10 patients without syphilis who presented with genital ulcers. PCR tests to amplify 3 common but unlinked treponemal genes were performed on DNA samples extracted from these specimens. Molecular subtyping was based on genetic characterization of 2 treponemal repeat genes, arp and tpr. Detection of macrolide resistance was accomplished by identification of the 23S ribosomal RNA gene mutation associated with the resistance pattern. RESULTS Thirty-eight patients with primary syphilis were found to have Treponema pallidum DNA in their genital lesions by PCR assays using primers that target the bmp, tpp-47, and polA genes. None of the patients without syphilis had positive PCR results. Five molecular subtypes were identified, with 1 type (14f) causing 79% of the cases. All 38 patients were found to be infected with macrolide-resistant strains. CONCLUSIONS Three common treponemal gene targets (bmp, tpp-47, and polA) were detectable by PCR in patients with primary syphilis. A single clone characterized as 14f and showing macrolide resistance appeared to have caused most of the primary syphilis cases in this study.
Study on the Prevalence of Beta Haemolytic Streptococcus Among School Children

Introduction: Βeta haemolytic streptococcal infections have a worldwide distribution among children and it poses an important health problem globally. So, a five months study was conducted to know the prevalence of beta haemolytic streptococci (BHS) in the throat of school children. Materials and Methods: Throat swabs from 200 school children of Kirtipur were collected, transported to the laboratory and were processed for BHS following standard microbiological procedures. Group A Streptococci (GAS) were identified by beta haemolytic colonies, bacitracin sensitivity and catalase negativity test. ASO test was also performed from serum samples. Result: Altogether 18 (9%) BHS isolates were identified from 200 samples, out of which 11 (5.5%) isolates were from males and 7 (3.5%) were from females. Among the 18 BHS isolates, 10 were identified as GAS isolates. The number of GAS presented only 5% of total sample. There was no significant sex difference in colonization of GAS (p> 0.05). Majority of cases were asymptomatic. All GABHS isolates were sensitive to Penicillin. In Serological examination, i.e. Antistreptolysin O (ASO) titre, all serum samples showed less than 200 IU ASO titre. Conclusion: This result highlights the current situation of GABHS throat infection in school children of Kirtipur. DOI: http://dx.doi. org/10.3126/jnps.v33i1. 7004 J Nepal Paediatr Soc. 2013;33(1):45-47
Symptoms of PTSD Among Adolescents in Malaysia 4 Years Following the 2004 Tsunami

While physical infrastructure is quickly rebuilt following a natural disaster, the psychological effects on victims are often neglected. This study investigated symptoms of posttraumatic stress disorder (PTSD) among adolescents exposed to the 2004 tsunami in Northern Peninsular Malaysia. The randomly selected participants were 216 adolescents living in small villages affected by the tsunami. The study used a cross-sectional design in which PTSD symptoms were assessed with the Child Posttraumatic Stress Reaction Index. Results showed that 8.3% of the participants had severe symptoms of PTSD, 39.8% had moderate symptoms, 42.1% had mild symptoms, and 9.7% had no significant symptoms. Females had significantly higher criterion B symptom scores than males. Multiple regression analysis results indicated that number of lifetime traumas and age were significant predictors of PTSD scores. The prevalence of PTSD symptoms was high even 4 years after the tsunami, a finding consistent with previous studies. The findings are discussed and several recommendations put forward.
Linker proteins enable ultrafast excitation energy transfer in the phycobilisome antenna system of Thermosynechococcus vulcanus

We applied a femtosecond flash method, using induced transient absorption changes, to obtain a time-resolved view of excitation energy transfer in intact phycobilisomes of Thermosynechococcus vulcanus at room temperature. Our measurement of an excitation energy transfer rate of 888 fs in phycobilisomes shows the existence of ultrafast kinetics along the phycocyanin rod subcomplex to the allophycocyanin core that is faster than expected for previous excitation energy transfer based on Förster theory in phycobilisomes. Allophycocyanin in the core further transfers energy to the terminal emitter(s) in 17 ps. In the phycobilisome, rod doublets composed of hexameric phycocyanin discs and internal linker proteins are arranged in a parallel fashion, facilitating direct rod–rod interactions. Excitonic splitting likely drives rod absorption at 635 nm as a result of strong coupling between β_84 chromophores (20 ± 1 Å) in adjacent hexamers. In comparison to the absorbance of the phycobilisome antenna system of the cyanobacterium Acaryochloris marina , which possesses a single rod structure, the linkers in T. vulcanus rods induce a 17 nm red shift in the absorbance spectrum. Furthermore, the kinetics of 888 fs indicates that the presence of the linker protein induces ultrafast excitation energy transfer between phycocyanin and allophycocyanin inside the phycobilisome, which is faster than all previous excitation energy transfer in phycobilisome subunits or sub-complexes reported to date.
Effects of delayed hypothermia on time‐dependent microglial production of inflammatory and anti‐inflammatory factors

Therapeutic hypothermia protects neurons after severe brain damage. We have previously shown that immediate hypothermic culture reduces the temporal microglial production of inflammatory and anti‐inflammatory factors. To better understand the therapeutic time window of this therapy for reducing these potential neurotoxic factors, we investigated the effects of delayed hypothermia on the temporal production of tumor necrosis factor (TNF)‐α, interleukin (IL)‐1β, IL‐10 and nitric oxide (NO) by toll‐like receptor (TLR)‐activated microglia.
Disparities in Initiation of Combination Antiretroviral Treatment and in Virologic Suppression Among Patients in the HIV Outpatient Study, 2000–2013

Objectives:The National HIV/AIDS Strategy emphasizes virologic suppression (VS) to reduce HIV incidence in the United States. We assessed temporal trends of and disparities in time to combination antiretroviral therapy (cART) initiation and HIV VS in a large demographically diverse cohort of HIV-infected patients. Design:We included antiretroviral-naive HIV Outpatient Study participants from 2000 to 2013 enrolled within 6 months of their HIV diagnosis who attended ≥2 HIV care–related visits. Methods:We evaluated time from HIV diagnosis to first use of cART, time from HIV diagnosis to VS, and time from first use of cART to VS. Kaplan–Meier time-to-event curves and Cox proportional hazards models were used to assess temporal trends and correlates of initiating cART and achieving HIV VS (<500 copies per milliliter). Results:Among 1156 HIV Outpatient Study patients [median age, 37 years; 43.2% non-Hispanic/Latino black (NHB), 14.1% Hispanic/Latino], estimated median times from HIV diagnosis to cART initiation and from HIV diagnosis to VS both shortened by >40% during the 13.5-year study period, reaching, respectively, 2.5 and 5.4 months. In multivariable analyses, NHB patients (as compared with non-Hispanic/Latino white) and those who had injected drugs (as compared with those who did not) initiated cART in a less timely fashion. After adjusting for CD4+ cell count and viral load at cART initiation, NHB patients and those aged <30 years (compared with ≥40 years) had lower rates of VS. Conclusions:Despite improvements in HIV treatment over time, patients who were NHB, younger, or used injection drugs had less favorable outcomes.
Sleep Disturbance in Lumbar Spinal Stenosis

Abstract Objectives: To determine the frequency of sleep disturbance in patients with lumbar spinal stenosis [LSS] and to reveal the relationship between the specific components of sleep disturbance and low back pain, physical disability, and psychological status in LSS. Methods: Thirty-six LSS patients [14 males and 22 females] and 30 age- and gender-matched healthy normal controls [13 males and 17 females] were enrolled in the study. Sleep disturbance was assessed using the Pittsburgh Sleep Quality Index [PSQI]. Pain was measured using a visual analog scale [VAS, 0–100 mm]. Psychological status and physical disability were assessed using the Hospital Anxiety and Depression Scale [HADS] and the Oswestry Disability Index [ODI]. Results: There were no significant differences between the LSS patients and the controls in terms of age or sex. The LSS patients had higher PSQI, HADS scores compared to the controls [p < 0.05]. Sleep disturbance [PSQI total score greater than 5] was positively correlated with VAS, HADS, and ODI [p < 0.05]. Conclusions: Sleep disturbance was associated with higher levels of pain, disability, depression, and anxiety. Sleep disturbance should be assessed when treating patients with LSS.
Are meteorological parameters associated with acute respiratory tract infections?

BACKGROUND Information on the onset of epidemics of acute respiratory tract infections (ARIs) is useful in timing preventive strategies (eg, the passive immunization of high-risk infants against respiratory syncytial virus [RSV]). Aiming at better predictions of the seasonal activity of ARI pathogens, we investigated the influence of climate on hospitalizations for ARIs. METHODS Samples obtained from 3044 children hospitalized with ARIs in Mainz, Germany, were tested for pathogens with a multiplex reverse-transcriptase polymerase chain reaction enzyme-linked immunosorbent assay from 2001 through 2006. Hospitalizations for ARIs were correlated with meteorological parameters recorded at the University of Mainz. The frequency of hospitalization for RSV infection was predicted on the basis of multiple time series analysis. RESULTS Influenza A, RSV, and adenovirus were correlated with temperature and rhinovirus to relative humidity. In a time series model that included seasonal and climatic conditions, RSV-associated hospitalizations were predictable. CONCLUSIONS Seasonality of certain ARI pathogens can be explained by meteorological influences. The model presented herein is a first step toward predicting annual RSV epidemics using weather forecast data.
Clinical Update on Testing Modalities for Encephalitozoon cuniculi in Clinically Sick Rabbits

Abstract This article describes the clinical presentation of rabbit patients infected with Encephalitozoon cuniculi that present to veterinary hospitals. The difficulty in obtaining a definitive diagnosis with this disease, even in animals with severe clinical signs, is frustrating to veterinarians and owners alike. A detailed review of current diagnostic testing methodologies and recent advances should help with the interpretation of E. cuniculi test results to communicate and inform owners on treatment and prevention of this devastating disease.
Hepatitis C Virus Transmission in Hemodialysis Units Importance of Infection Control Practices and Aseptic Technique

We investigated 4 hepatitis C virus (HCV) infection outbreaks at hemodialysis units to identify practices associated with transmission. Apparent failures to follow recommended infection control precautions resulted in patient-to-patient HCV transmission, through cross-contamination of the environment or intravenous medication vials. Fastidious attention to aseptic technique and infection control precautions are essential to prevent HCV transmission.
The A, B, BI, and Cs of Clostridium difficile.

The study by Belmares et al (1) is the most comprehensive, longitudinal study of the molecular epidemiology of Clostridium difficile infection to date. This study is impressive not only because restriction endonuclease analysis typing was performed on three-quarters of C. difficile isolates from 908 cases of C. difficile infection (CDI) at the Minneapolis Veterans Administration Medical Center (MVAMC) collected over a 10 year period, but also because the investigators recognized the importance of conducting this study despite the 18 year time span from the collection of the C. difficile isolates to publication. This study confirms what other less systematic and/or comprehensive studies have suggested, the molecular epidemiology of C. difficile in healthcare facilities is frequently both diverse and dynamic (2–8). This study must be interpreted in conjunction with knowledge of the other studies performed and activities that took place during the same time period at the MVAMC that may have affected C. difficile transmission (9–15). Infection control policies, changes in healthcare delivery, and interventions that took place over the 10 year period included: 1) placing patients with CDI in private rooms only if incontinent and unable to use a bedpan, 2) using a quaternary ammonium disinfectant for cleaning all hospital rooms, 3) authorizing nurses to send diarrheal stool for C. difficile testing without a physician order, 4) restricting the use of clindamycin starting September 1985, 5) donning gloves as the standard for handling all body fluids starting April 1988, and 6) moving all patients into a new building in June 1988. Although this study contributes significantly to our knowledge of C. difficile, it also highlights the need for more studies combining molecular epidemiology with CDI prevention efforts in order to understand the effectiveness of CDI prevention practices.
Brief Report: Consequences of Presentation With Advanced HIV Disease in Pregnancy: Data From a National Study in Italy

Abstract:Among 469 women with a diagnosis of HIV in pregnancy, 74 (15.8%) presented with less than 200 CD4 cells per cubic millimeter. The only variable significantly associated with this occurrence was African origin (odds ratio: 2.22, 95% confidence intervals: 1.32 to 3.75, P = 0.003). Four women with low CD4 (5.6%), compared with none with higher CD4 counts, had severe AIDS-defining conditions (P < 0.001) during pregnancy or soon after delivery, and one transmitted HIV to the newborn. Early preterm delivery (<32 weeks) was significantly more frequent with low CD4 (6.2% vs. 1.4%, P = 0.015). An earlier access to HIV testing, particularly among immigrants of African origin, can prevent severe HIV-related morbidity.
Beyond the 50-minute hour: increasing control, choice, and connections in the lives of low-income women.

Although poverty is associated with a range of mental health difficulties among women in this country, mainstream mental health interventions are not sufficient to meet the complex needs of poor women. This article argues that stress, powerlessness, and social isolation should become primary targets of our interventions, as they are key mediators of the relationship between poverty and emotional distress, particularly for women. Indeed, if ways are not found to address these conditions directly, by increasing women's control, choice, and connections, the capacity to improve the emotional well-being of impoverished women will remain limited at best. This is the first of 5 articles that comprise a special section of the American Journal of Orthopsychiatry, called "Beyond the 50-Minute Hour: Increasing Control, Choice, and Connections in the Lives of Low-Income Women. " Together, these articles explore the nature and impact of a range of innovative mental health interventions that are grounded in a deep understanding of the experience of poverty. This introduction: (a) describes briefly how mainstream approaches fail to address the poverty-related mental health needs of low-income women; (b) illuminates the role of stress, powerlessness, and social isolation in women's lives; (c) highlights the ways in which the articles included in this special section address each of these by either adapting traditional mental health practices to attend to poverty's role in participants' lives or adapting community-based, social-justice-oriented interventions to attend to participants' mental health; and (d) discusses the research and evaluation implications of expanding mental health practices to meet the needs of low-income communities.
Determining Feeding State and Rate of Mass Change in Insectivorous Bats Using Plasma Metabolite Analysis

Insectivorous bats regularly experience dramatic and sometimes rapid changes in nutrient stores, yet our ability to study these changes has been limited by available techniques. Plasma metabolite analysis has proven effective for studying individual rates of mass change in birds but has not been validated for other taxa. We tested the effectiveness of plasma metabolite analysis by conducting a study with captive big brown bats (Eptesicus fuscus) and little brown bats (Myotis lucifugus) in the field. In the lab, we varied food availability to induce various rates of mass change. As predicted, individual rate of mass change was positively correlated with plasma triglyceride concentration, but there was no relationship with plasma β‐hydroxybutyrate concentration, whereas such a relationship has been found in birds. In the field, we collected blood samples from postlactating females as they emerged in the evening (fasted) and when they returned from feeding in the morning. Plasma triglyceride concentration was greater in fed bats than fasted bats, and the increase was less when rain limited foraging. Contrary to predictions, β‐hydroxybutyrate concentration was also greater in fed bats than fasted bats. Analysis of plasma triglyceride concentration provides a technique for assessing individual feeding state and rate of mass change of bats and will facilitate further study of bat nutritional ecology and energetics.