Miracle-dz/UniFAR-FTUs huggingface dataset:
Sofosbuvir plus ribavirin in Japanese patients with chronic genotype 2 HCV infection: an open‐label, phase 3 trial

Genotype 2 hepatitis C virus (HCV) accounts for up to 30% of chronic HCV infections in Japan. The standard of care for patients with genotype 2 HCV – peginterferon and ribavirin for 24 weeks – is poorly tolerated, especially among older patients and those with advanced liver disease. We conducted a phase 3, open‐label study to assess the efficacy and safety of an all‐oral combination of the NS5B polymerase inhibitor sofosbuvir and ribavirin in patients with chronic genotype 2 HCV infection in Japan. We enrolled 90 treatment‐naïve and 63 previously treated patients at 20 sites in Japan. All patients received sofosbuvir 400 mg plus ribavirin (weight‐based dosing) for 12 weeks. The primary endpoint was sustained virologic response at 12 weeks after therapy (SVR12). Of the 153 patients enrolled and treated, 60% had HCV genotype 2a, 11% had cirrhosis, and 22% were over the aged 65 or older. Overall, 148 patients (97%) achieved SVR12. Of the 90 treatment‐naïve patients, 88 (98%) achieved SVR12, and of the 63 previously treated patients, 60 (95%) achieved SVR12. The rate of SVR12 was 94% in patients with cirrhosis and in those aged 65 and older. No patients discontinued study treatment due to adverse events. The most common adverse events were nasopharyngitis, anaemia and headache. Twelve weeks of sofosbuvir and ribavirin resulted in high rates of SVR12 in treatment‐naïve and previously treated patients with chronic genotype 2 HCV infection. The treatment was safe and well tolerated by patients, including the elderly and those with cirrhosis.
Combination therapy of interferon and nucleotide/nucleoside analogues for chronic hepatitis B

Chronic hepatitis B is one of the leading causes of cirrhosis and hepatocellular carcinoma globally. At present, seven drugs, including two interferons and five oral nucleos(t)ide analogues (NAs), have been approved for the treatment of chronic hepatitis B. Interferon works by immunomodulation, but is successful in less than a third of treated patients and is a relatively weak antiviral. NAs directly suppress the hepatitis B virus but have limited durability. Based on current data, combination of NA and interferon results in greater viral suppression but does not translate to off‐treatment sustained response. Concomitant or sequential treatment also does not make a difference. Combining telbivudine and interferon also runs the risk of severe peripheral neuropathy. On the other hand, interferon switch or additional therapy in patients well controlled with NAs appears to improve the durability of off‐treatment response. This article reviews current data on interferon and NA combination and discusses potential future developments.
Occupational Therapy Students' Choice of Gender-Differentiated Activities for Psychiatric Patients

Twenty-six female and seven male first-year occupational therapy students participated in an investigation into the prescription of therapeutic activities for men and women. The data collected, using fictional case studies as response opportunities, supported the experimental hypothesis that students would choose activities for patients on the basis of gender. Subjects tended to select traditional sex-role differentiated activities and their own comments about why this was so were used as a basic for discussion. This article, the last in a series of three, contributes to the debate on sex-role stereotyping, mental health and occupational therapy in psychiatry.
Rhizobium oryzicola sp. nov., potential plant-growth-promoting endophytic bacteria isolated from rice roots.

Bacterial strains ZYY136(T) and ZYY9 were isolated from surface-sterilized rice roots from a long-term experiment of rice-rice--Astragalus sinicus rotation. The 16S rRNA gene sequences of strains ZYY136(T) and ZYY9 showed the highest similarity, of 97.0%, to Rhizobium tarimense PL-41(T). Sequence analysis of the housekeeping genes recA, thrC and atpD clearly differentiated the isolates from currently described species of the genus Rhizobium. The DNA-DNA relatedness value between ZYY136(T) and ZYY9 was 82.3%, and ZYY136(T) showed 34.0% DNA-DNA relatedness with the most closely related type strain, R. tarimense PL-41(T). The DNA G+C content of strain ZYY136(T) was 58.1 mol%. The major cellular fatty acids were summed feature 8 (C18 : 1ω7c and/or C18 : 1ω6c), C16 : 0 and C16 : 0 3-OH. Strains ZYY136(T) and ZYY9 could be differentiated from the previously defined species of the genus Rhizobium by several phenotypic characteristics. Therefore, we conclude that strains ZYY136(T) and ZYY9 represent a novel species of the genus Rhizobium, for which the name Rhizobium oryzicola sp. nov. is proposed (type strain ZYY136(T) = ACCC 05753(T) = KCTC 32088(T)).
Is routine transcranial Doppler ultrasound useful in the management of subarachnoid hemorrhage

In this prospective observational study, the authors assess the impact of routine transcranial Doppler (TCD) ultrasound monitoring on the diagnosis, management, and outcome of delayed ischemic neurological deficit complicating subarachnoid hemorrhage (SAH). Over a 10-month period 186 patients admitted to a regional neurosciences center were included in the study. Three times a week, routine TCD examinations performed by neuroradiographers made an important positive contribution to the diagnosis of delayed ischemic neurological deficit in 72% of patients with this complication and altered management for the benefit of the patient in 43%. In 9% of patients with recent SAH, it was believed that the outcome might have been better if the TCD result had been acted upon appropriately. The TCD results did not adversely influence management or outcome and were accurate when compared with those obtained on angiography. The authors conclude that a routine TCD service provided by neuroradiographers is accurate and us.
Use of traditional medicine versus use of the community-based primary health care clinic by the San community at Platfontein

Abstract Introduction: Working amongst a San community led to the observation that, despite the availability of modern healthcare, high mortality and morbidity associated with disease, such as dehydration, malnutrition and tuberculosis, still prevailed. This study aimed to determine how traditional beliefs and customs influenced the utilisation of Western medicine. Methods: An observational-descriptive study was conducted. Consenting patients, facilitated by interpreters, completed questionnaires during consultations conducted by nurses and the principal investigator at the Platfontein primary health care (PHC) clinic. Results: Of the 113 participants, two-thirds were female. The median age was 40 years; 56.7% lacked formal education; 42.5% conversed only in their native tongue. The initial use of the PHC facility was high (71.4%), even though 37% of the participants visited a traditional healer in the preceding year. Circumcision was the condition for which traditional healers were consulted most commonly (28.8%). Conditions preferably requiring clinic visitation were coughing (51.4%), pain (35.1%) and diarrhoea (34.2%). Of the participants leading mostly a traditional lifestyle (n = 48), 30.6 % indicated that they did not use traditional medicine or healers; 72.9% indicated that illness could be caused by a spell. Of the participants not leading a traditional lifestyle (n = 41), 85.4% indicated that they did not use traditional medicine; 41.4% indicated that illness could be caused by a spell. Conclusion: The assumption that the mortality and morbidity observed for certain conditions were due to the preference for traditional medicine in this community could not be confirmed. Doctors working amongst isolated communities or in multicultural environments, however, should recognise that traditional medicine still plays a role in the health care of their patients.
A differential item functioning (DIF) analysis of the Communicative Participation Item Bank (CPIB): comparing individuals with Parkinson's disease from the United States and New Zealand.

PURPOSE To examine the cross-cultural applicability of the Communicative Participation Item Bank (CPIB) through a comparison of respondents with Parkinson's disease (PD) from the United States and New Zealand. METHOD A total of 428 respondents-218 from the United States and 210 from New Zealand-completed the self-report CPIB and a series of demographic questions. Differential item functioning (DIF) analyses were conducted to examine whether response bias was present across the 2 groups. RESULTS No items were identified as having statistically significant DIF across the U.S. and N.Z. cohorts. CONCLUSION The current CPIB items and scoring parameters are also suitable for use with respondents from New Zealand.
Reliability of sagittal photographic spinal posture assessment in adolescents

Posture and adolescent spinal pain may be linked, so adolescent posture measurement is important. Static photographic analysis of posture is practical for large-scale studies of adolescents, but only one adolescent study has investigated its reliability. The aim was therefore to assess the reliability of photographic spinal posture assessment in adolescents. Inter-rater reliability was measured, as the purpose was to assess the method for large-scale epidemiological studies with multiple raters. Twenty-two healthy adolescent subjects (11 males, 11 females) aged 13–17 were photographed by four different examiners while standing, sitting and slumped. Eight spinal postural angles and four distance measures were derived. Inter-rater reliability was quantified by interclass correlation coefficients (ICCs) for consistency, ICCs for absolute agreement between raters and standard errors of measurement (SEMs). Inter-rater reliability was fair (ICC >0.4) to good (ICC >0.75) for all measures in standing except pelvic tilt and sway angle, and for all measures in sitting except head flexion and craniocervical angle. Poorer ICCs for agreement than consistency were observed, reflecting a significant rater effect for most measures. Photographic analysis of adolescent posture has fair reliability, and is appropriate for large-scale adolescent studies. Future studies should observe several precautions to optimize reliability.
Interpretation of verb phrase telicity: sensitivity to verb type and determiner type.

PURPOSE The authors examine how adults use linguistic information from verbs, direct objects, and particles to interpret an event description as encoding a logical endpoint to the event described (in which case, it is telic) or not (in which case, it is atelic). Current models of aspectual composition predict that quantity-sensitive verbs combined with quantized objects produce telic predicates. Behavioral results from previous experiments have not unequivocally confirmed this prediction. The study presents a more fine-grained analysis that examines the influence of partitive verbs, resultative particles, and different determiner types on listeners' evaluations of verb phrases as telic or atelic. METHOD Forty-eight English-speaking adults participated in a truth-value judgment task to determine whether they interpreted verb phrases with different types of verbs and direct objects as telic or atelic. Participants viewed short videos and responded to a yes/no question after each one. RESULTS The presence of partitive quantity-sensitive verbs and the presence of a definite determiner versus a cardinal number in quantized direct objects had a differential impact on listeners' interpretations of sentences as telic. CONCLUSION The results indicate that actual behavioral interpretations of telicity are meaningfully influenced by the presence of partitive verbs, resultative particles, and different types of determiners.
Radical Pericardiectomy for Chronic Constrictive Pericarditis

A retrospective analysis was undertaken in 79 patients who underwent pericardiectomy for chronic constrictive pericarditis from January 1985 to February 1999. Most operations (77) were carried out with cardiopulmonary bypass, with subtotal pericardiectomy in 75 patients, and concomitant operations in 25. Postoperative complications occurred in 8 patients: cerebrovascular accident in 2, renal insufficiency in 5, bleeding in 2, low output syndrome in 4, and respiratory insufficiency in 2. The operative mortality was 5%; causes of death were cardiac-related in all cases. Actuarial survival at 1, 5, and 10 years was 89.9% ± 3.4%, 74.9% ± 5.7%, and 55.4% ± 13.5%, respectively. Regression analysis was performed using 53 clinical variables. Female gender, renal insufficiency, concomitant coronary artery bypass grafting, and preoperative right ventricular end-diastolic pressure > 20 mm Hg were found to be predictors of poor survival. At follow-up, improved functional status was noted in 88% of patients. Subtotal pericardiectomy can be performed on cardiopulmonary bypass with low mortality and good long-term survival.
Phylogenetic analysis of full‐length, early infection, hepatitis C virus genomes among people with intravenous drug use: the InC3 Study

Cross‐continental phylogenetic analysis is important to understand subtle molecular differences of currently circulating hepatitis C virus (HCV) subtypes. Existence of such differences can be crucial in pursuing a universal hepatitis C vaccine. We characterized molecular epidemiology of early HCV infections identified across nine cohorts [North America (n=4), Australia (n=4) and Europe (n=1)] in the International Collaborative of Incident HIV and Hepatitis C in Injecting Cohorts (InC3). One hundred and ninety‐two full‐length HCV genomes were amplified from plasma of incident infections and subjected to next generation sequencing to establish the largest cross‐continental, full‐length acute HCV genomic data set available to date. Genomes from the most common subtypes (1a: n=94, 2b: n=15 and 3a: n=68) were used in phylogenetic analysis. Using full genome trees, 78 sequences (44%) were found to lie within 29 phylogenetic clusters/pairs defined on the basis of molecular similarity of consensus sequences. Of these, 26 each had exclusively Australian or North American sequences indicating a strong geographical bias for molecular similarity. On further analysis of behavioural and demographic associations, binary logistic regression analysis showed that older age and non‐Caucasian ethnicity were significantly associated with clustering. HCV probably evolves in micro‐epidemics within geographically isolated communities.
Decline of cellular activation in non‐B cells after rituximab treatment in hepatitis C‐associated mixed cryoglobulinemia vasculitis

Mixed cryoglobulinemic vasculitis is associated with the monoclonal expansion of pathognomonic B cells in chronic hepatitis C. Recently, treatment with B‐cell depletion, including rituximab, a CD20 monoclonal antibody, has been successful in achieving remission from the active disease. We investigated whether B‐cell depletion therapy has an impact on activation of non‐B cells in the periphery. Results demonstrated that B‐cell depletion therapy is associated with a statistically significant decline in activated T cells, from pretherapy to follow‐up while on rituximab therapy: CD4+ CD38+ HLA‐DR+ (DR+), CD8+ CD38, CD8+ CD38+ DR+, and CD8+ DR+. Birmingham Vasculitis Activity Score and cryoglobulin had a strong correlation coefficient (R) of 0.72 (P=.0005), while cryoglobulin showed moderate correlation with CD8+ DR+ (R=.61), CD3+ CD38+ DR+ (R=.57), CD3+ DR+ (R=.50), CD4+ CD38+ DR+ (R=.53), CD4+ DR+ (R=.52), and CD8+ CD38+ DR+ (R=.67). These results suggest B‐cell expansion has a direct and indirect effect on the pathogenesis of Hepatitis C‐associated mixed cryoglobulinemic vasculitis.
Simeprevir, daclatasvir and sofosbuvir for hepatitis C virus‐infected patients with decompensated liver disease

Approximately three million individuals in the United States are chronically infected with hepatitis C virus (HCV). Chronic HCV infection may lead to the development of compensated as well as decompensated liver cirrhosis. The Phase II IMPACT study was conducted in HCV genotype 1‐ or 4‐infected cirrhotic patients with portal hypertension or decompensated liver disease and assessed for the first time the combination of the three direct‐acting antivirals simeprevir, daclatasvir and sofosbuvir. Treatment‐naïve or treatment‐experienced adults with Child‐Pugh (CP) score <7 (CP A) and evidence of portal hypertension, or CP score 7–9 (CP B), received 12 weeks of simeprevir 150 mg, daclatasvir 60 mg and sofosbuvir 400 mg, once daily. The primary efficacy endpoint was sustained virologic response 12 weeks after end of treatment (SVR12). Pharmacokinetics and safety were also assessed. Overall, 40 patients were enrolled (CP A: 19; CP B: 21). All 40 patients achieved SVR12. At week 8, the mean pharmacokinetic exposure to simeprevir, sofosbuvir, daclatasvir and GS‐331007 (sofosbuvir metabolite) was 2.2‐, 1.5‐, 1.2‐ and 1.2‐fold higher in patients with CP B than CP A, respectively. Grade 1/2 adverse events (AEs) occurred in 26 of 40 (65%) patients. One CP B patient had a Grade 3 AE (gastrointestinal haemorrhage), which was reported as a serious AE but not considered related to study drugs. Treatment for 12 weeks with simeprevir, daclatasvir and sofosbuvir was generally safe and well tolerated, and resulted in 100% of cirrhotic patients with portal hypertension or decompensated liver disease achieving SVR12.
Effectiveness and safety of sofosbuvir‐based regimens plus an NS5A inhibitor for patients with HCV genotype 3 infection and cirrhosis. Results of a multicenter real‐life cohort

Patients with HCV genotype 3 (GT3) infection and cirrhosis are currently the most difficult to cure. We report our experience with sofosbuvir+daclatasvir (SOF+DCV) or sofosbuvir/ledipasvir (SOF/LDV), with or without ribavirin (RBV) in clinical practice in this population. This was a multicenter observational study including cirrhotic patients infected by HCV GT3, treated with sofosbuvir plus an NS5A inhibitor (May 2014‐October 2015). In total, 208 patients were included: 98 (47%) treatment‐experienced, 42 (20%) decompensated and 55 (27%) MELD score >10. In 131 (63%), treatment was SOF+DCV and in 77 (37%), SOF/LDV. Overall, 86% received RBV. RBV addition and extension to 24 weeks was higher in the SOF/LDV group (95% vs 80%, P=.002 and 83% vs 72%, P=.044, respectively). A higher percentage of decompensated patients were treated with DCV than LDV (25% vs 12%, P=.013). Overall, SVR12 was 93.8% (195/208): 94% with SOF+DCV and 93.5% with SOF/LDV. SVR12 was achieved in 90.5% of decompensated patients. Eleven treatment failures: 10 relapses and one breakthrough. RBV addition did not improve SVR (RR: 1.08; P=.919). The single factor associated with failure to achieve SVR was platelet count <75×10E9/mL (RR: 3.50, P=.019). In patients with MELD <10, type of NS5A inhibitor did not impact on SVR12 (94% vs 97%; adjusted RR: 0.49). Thirteen patients (6.3%) had serious adverse events, including three deaths (1.4%) and one therapy discontinuation (0.5%), higher in decompensated patients (16.7% vs 3.6%, P<.006). In patients with GT3 infection and cirrhosis, SVR12 rates were high with both SOF+DCV and SOF/LDV, with few serious adverse events.
Necrotizing Fasciitis in a Dog

Objective:To alert emergency veterinarians of a life-threatening soft tissue infection, necrotizing fasciitis (NF) that mimics non life-threatening cellulitis. In this report, the rapid clinical progression, systemic effects produced by NF, and its successful treatment in a dog is described. Case Summary:A 2-year-old, male, castrated Doberman Pinscher was presented for lameness. Clinical and laboratory findings suggested sepsis. Rapid progression of the infection, as well as surgical and histopathological findings were characteristic for necrotizing fasciitis of a pelvic limb caused by β-hemolytic streptococcus infection. Aggressive supportive care included intravascular fluid therapy, intravenous antibiotics, plasma transfusions, nutritional support, as well as repeated surgical debridement and drainage. Mid-femoral limb amputation was required to halt the progression of the necrotizing fasciitis. New Information Provided:This is the first detailed description of successful treatment of necrotizing fasciitis caused by β-Hemolytic streptococcus in the dog.
CONGENITAL ATRESIA OF THE ESOPHAGUS: A STUDY OF THIRTY-TWO CASES

Congenital atresia of the esophagus is a rare anomaly. The experience of any one physician with this condition is necessarily limited. The literature on the subject is large, but most of the articles deal with a few individual cases plus a review of previously reported cases. The total number of reported cases is now about 300. In the past eleven years, 32 cases of congenital atresia of the esophagus have been observed in the surgical service of the Children's Hospital. Thirty patients were submitted to operation, and complete autopsy was performed on the other 2 patients. In the 30 operative cases the surgical findings were supplemented by complete postmortem examination in 22 instances. Cases observed in this hospital before 1929 are not considered here. Their inclusion would not change significantly the statistical data, and it is only since 1929 that a discussion of the forms of surgical treatment has been
Performance of the Pooled Cohort atherosclerotic cardiovascular disease risk score in hepatitis C virus‐infected persons

Chronic hepatitis C virus (HCV) infection has been associated with an increased risk for cardiovascular disease (CVD). The recommended Pooled Cohort atherosclerotic cardiovascular disease (ASCVD) risk equation for estimation of 10‐year CVD risk has not been validated in HCV‐infected populations. We examined the performance of the ASCVD risk score in HCV‐infected persons, using the national Electronically Retrieved Cohort of HCV Infected Veterans to derive a cohort of HCV‐infected and uninfected subjects without baseline ASCVD, hepatitis B, or HIV infection, and with low‐density lipoprotein cholesterol level<190 mg/dL. Performance of the ASCVD risk equation was assessed by Cox proportional hazard regression, C‐statistics and Hosmer‐Lemeshow statistic. The cohort included 70 490 HCV‐infected and 97 766 HCV‐uninfected men with mean age of 55 years, 56% White and 29% Black. Incident CVD event rates were similar between the two groups (13.2 and 13.4 events/1000 person‐years), with a higher incidence of coronary heart disease events in the HCV‐uninfected group and of stroke events in the HCV‐infected group. Adjusting for ASCVD risk score, HCV infection was associated with higher risk for an ASCVD event in the subgroup with baseline ASCVD risk ≥7.5% (HR: 1.19, P<.0001). C‐statistics were poor in both the HCV‐infected and uninfected groups (0.60 and 0.61, respectively). By Hosmer‐Lemeshow test, the ASCVD risk equation overestimated risk amongst lower risk patients and underestimated risk amongst higher risk patients in both the HCV‐infected and uninfected groups. Further investigation is needed to determine whether a modified equation to accurately predict ASCVD risk in HCV‐infected persons is warranted.