Miracle-dz/UniFAR-FTUs huggingface dataset:
Performance of Transcription-Mediated Amplification and Ligase Chain Reaction Assays for Detection of Chlamydial Infection in Urogenital Samples Obtained by Invasive and Noninvasive Methods

ABSTRACT Based on the amplification of chlamydia-specific rRNA sequences and the ligase chain reaction (LCR), the performance characteristics of the Gen-Probe Chlamydia trachomatistranscription-mediated amplification (TMA) assay were evaluated with endocervical, urine, and vulval specimens from women and urethral and urine specimens from men and were compared with those for cultures on endocervical, vulval, and urethral swabs. Of the 308 women and 240 men tested, 25 (8.1%) and 44 (18.3%), respectively, were shown to be infected. By using the infected individual as the expanded “gold standard” for calculations, the TMA assay and LCR gave similar performances for the sensitivity of male urethral (93.2%) and urine (88.6 and 86.4%) samples, while culture detected only half of the 44 infected men. In women, the sensitivities of the TMA assay for endocervical and vulval samples were 88 and 92%, respectively, compared to values of 92% for the LCR on both sample types and of 52 and 8%, respectively, for culture. By using first-void urine for chlamydial diagnosis in women, LCR detected 24 (96%) and TMA assay detected 19 (76%) infected individuals, showing a significantly lower sensitivity for urine in women (P = 0.0253). The results indicate a high overall agreement for both amplifying techniques for all examined specimen types, except for female urine. Furthermore, they confirm the previous observation that vulval swabs are an effective alternative noninvasive sample type for the detection of C. trachomatis infection in women by nucleic acid-based amplification technologies.
Marrow transplant experience for children with severe aplastic anemia.

PURPOSE The two major factors associated with lack of survival after allogeneic marrow transplant for severe aplastic anemia have been graft rejection and acute graft versus host disease (GVHD). As a result, survival for patients transplanted in the 1970s was approximately 68%. Improved survival during the 1980s was primarily related to the decrease in the incidence of acute GVHD with the use of combination methotrexate and cyclosporine for GVHD prophylaxis. Although the incidence of graft rejection has not changed, the time to graft rejection has been delayed. PATIENTS AND METHODS One hundred forty children < 18 years of age received a marrow transplant for severe aplastic anemia at the Fred Hutchinson Cancer Research Center between May, 1971 and June, 1991. Four recipients of syngeneic marrow received a simple marrow infusion, 119 recipients of HLA-identical family member marrow received cyclophosphamide (CY), 200 mg/kg; most recipients of alternative donor marrow received CY plus 12.0 Gy fractionated total body irradiation. GVHD prophylaxis was MTX only for 91 recipients of HLA-identical family member marrow, and was MTX plus CSP for all other allogeneic marrow patients. Estimates of graft rejection, acute and chronic GVHD, survival and event-free survival (EFS) were determined by the Kaplan-Meier method. RESULTS Two recipients of syngeneic marrow achieved engraftment with donor marrow infusion only and two required immunosuppression with CY. Among the 119 recipients of HLA-identical family member marrow the type of GVHD prophylaxis did not influence graft rejection but non-transfused patients had 10% incidence of rejection compared to 22% for transfused patients (p = 0.1). All patients with late graft rejection survive whereas those with early rejection usually do not. The incidence of acute GVHD was 27% and 11% for MTX recipients and MTX plus CSP recipients, respectively (p = 0.11), and the probability of chronic GVHD was 30% and 26%, respectively. Survival is 64% for recipients of MTX and 96% for recipients of MTX plus CSP (p = 0.007), but EFS was 60% and 71%, respectively (p = 0.48). Recipients of partially matched family member or unrelated marrow donor grafts have transplants complicated by infections and GVHD. Growth and development of CY only recipients is normal and several children have been born to these former patients. CONCLUSIONS High dose CY is usually an effective preparative regimen for children with severe aplastic anemia and an HLA-identical family member marrow donor. Additional immunosuppression with anti-thymocyte globulin may result in a further decrease in graft rejection and improved EFS. Identification of a group of children who are unlikely to respond to immunosuppressive treatment could permit earlier transplantation for patients without HLA-identical family member donors available. Children who receive CY only have normal growth and development.
Variation in the use of palliative radiotherapy at end of life: Examining demographic, clinical, health service, and geographic factors in a population-based study

Palliative radiotherapy (PRT) can improve quality of life for people dying of cancer. Variation in the delivery of PRT by factors unrelated to need may indicate that not all patients who may benefit from PRT receive it. In this study, 13,494 adults who died of cancer between 2000 and 2005 in Nova Scotia, Canada, were linked to radiotherapy records. Multivariate logistic regression was used to examine the relationships among demographic, clinical, service, and geographic variables, and PRT consultation and treatment. Among the decedents, 4188 (31.0%) received PRT consultation and 3032 (22.3%) treatment. PRT declined with increased travel time and community deprivation. Females, older persons, and nursing home residents also had lower PRT rates. Variations were observed by cancer site and previous oncology care. Variations in PRT use should be discussed with referring physicians, and improved means of access to PRT considered. Benchmarks for optimal rates of PRT are needed.
Are people being screened for colorectal cancer as recommended? Results from the National Health Interview Survey.

BACKGROUND The evidence is now compelling that colorectal cancer incidence and mortality can be reduced by screening, and medical organizations recommend regular screening among persons of average risk aged 50 years or older. We sought to determine whether appropriate screening has become more widespread now that consensus over its value has been achieved. METHODS We analyzed data from the 1992 and 1998 National Health Interview Survey, an in-person survey of a nationally representative sample of the U.S. population. Persons aged > or =50 years (4428 in 1992, 12,629 in 1998) were questioned about their use of colorectal cancer screening. RESULTS Self-reported use of fecal occult blood testing and proctoscopy increased slightly from 1992 to 1998. In 1998, however, only an estimated 22.9% of Americans aged > or =50 years had been screened with either the home-administered fecal occult blood testing in the past year or proctoscopy within 5 years. Nearly half of fecal occult blood testings were performed with a sample taken during an in-office physical examination rather than with the recommended home kit. CONCLUSION Most eligible persons are still not meeting the screening recommendations for colorectal cancer. Education is needed for both the public and health care providers to increase their compliance with current guidelines.
Does postponing Pay Off? Timing of Parenthood, Earnings Trajectories, and Earnings Accumulation in Sweden 1990-2012

In this paper, we a) study the consequences of parenthood on earnings trajectories over the life-course, and b) analyze the impact of timing of parenthood on cumulative earnings in Sweden. We argue that parenthood can have long-term impacts on earnings trajectories, which can accumulate into considerable effects over time. Such cumulative effects can shape socioeconomic and gender inequalities in earnings and at later age, pensions. We analyze data from Swedish population registers, using the full cohorts of men and women born 1972-81. Our findings indicate that parenthood has negative effects on women’s and small effects on men’s earnings trajectories. Over time, the former accumulate into major parenthood penalties. These penalties are smaller for women who postpone motherhood due to the shorter time these women have been exposed to motherhood penalties. Parenthood timing can thus affect long-term gender and socioeconomic earnings inequalities.
The effect of management commitment to safety, and safety communication and feedback on safety behavior of nurses: the moderating role of consideration of future safety consequences

Abstract This paper proposes that the consideration of future safety consequences would moderate the relationship between management commitment to safety, and safety communication and feedback on nurses’ safety behavior. Survey data was obtained from 229 nurses in Abuja’s secondary healthcare facilities in Nigeria. Bootstrapping was conducted to investigate the standard error of the estimates and the t-values using SmartPLS 3.0. Results showed that management commitment to safety positively relates to safety compliance and safety participation, while safety communication and feedback positively relates to safety participation. Furthermore, the consideration of future safety consequences was found to moderate the relationships between safety communication and feedback, and safety participation. Nevertheless, in the context of management commitment to safety and safety participation, the direction of the moderation was not as hypothesized. The research provides empirical evidence in support of the consideration of future safety consequences as a moderator. This contributes to the utility of self-efficacy theory, field theory, and construal level theory. Furthermore, to achieve optimal safety in the hospital environment, hospital managements should give high priority to nurses’ safety, provide proper safety communication and feedback, and pay closer attention to the consideration of future safety consequences when making decisions on how to improve hospital safety.
Social Support and the Development of Immune Function in Human Immunodeficiency Virus Infection

A psychosocial investigation offered to all human immunodeficiency virus (HIV)-infected men with moderately severe or severe hemophilia in Sweden was made in 1986. Most of these men had been infected in the years 1980 to 1984 and told about their infections in 1985. Forty-nine subjects had answered questions in regard to sources of emotional support in their life situation. Based on the responses to these questions a score of "availability of attachment" (AVAT) was calculated, and two groups of patients were identified: one with high AVAT and one with low AVAT scores. The subjects were followed with regard to the state of their immune system, as reflected by CD4 counts, until 1990. The results indicated that a low AVAT score in 1985 was associated with a significantly more rapid progressive deterioration in CD4 count during subsequent years. The mechanism behind this associated is unknown. Several possible confounders were not studied. However, if the association between a poor AVAT score and rapid CD4 deterioration after HIV infection is replicated in other samples, it could be important to the future clinical care of HIV-infected subjects.
The relationship between surgeon and hospital volume and outcomes for shoulder arthroplasty.

BACKGROUND As far as we know, no previous study has determined the relationship between volume and outcomes for shoulder arthroplasty. We hypothesized that surgeons and hospitals with higher caseloads of total shoulder arthroplasties and hemiarthroplasties have better outcomes as measured by decreased mortality rate, shorter length of stay in the hospital, reduced postoperative complications, and routine disposition of patients on discharge. METHODS Data on patients undergoing shoulder arthroplasty were extracted from the Nationwide Inpatient Sample databases for the years 1988 through 2000. Logistic regression with generalized estimating equations and multiple linear regression models were used to estimate the adjusted association between surgeon and hospital volume and outcomes for total shoulder arthroplasty and hemiarthroplasty after adjusting for comorbidity, age, race, household income, and sex. RESULTS The mortality rates for patients who had a total shoulder arthroplasty performed by surgeons who did fewer than two procedures per year (0.36%) or who did between two and fewer than four procedures per year (0.32%) were higher than those for patients who had a total shoulder arthroplasty performed by surgeons who did four procedures or more per year (0.20%). The risk-adjusted rate of postoperative complications after hemiarthroplasty was significantly higher for patients managed by surgeons who performed fewer than two procedures per year (1.68%) than for those managed by surgeons with a volume of five procedures or more per year (0.97%). The possibility of postoperative complications when total shoulder arthroplasty was performed in hospitals with a volume of fewer than five procedures (1.44%) or in those with a volume of five to ten procedures per year (1.45%) was significantly higher than that in hospitals where ten procedures or more were performed every year (0.64%). The mean lengths of stay in the hospital after total shoulder arthroplasty and hemiarthroplasty were significantly longer when the operations were performed by surgeons who did fewer than two procedures per year or when they were done in hospitals with a volume of fewer than five procedures per year or with a volume of five to fewer than ten procedures per year than when they were done in hospitals or by surgeons in the highest volume category (p < 0.001). CONCLUSIONS Patients who have a total shoulder arthroplasty or hemiarthroplasty performed by a high-volume surgeon or in a high-volume hospital are more likely to have a better outcome. LEVEL OF EVIDENCE Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.
Surrogate markers for atherosclerotic disease

Purpose of review Novel treatment modalities for cardiovascular prevention are emerging rapidly. Since it is virtually impossible to evaluate all these new compounds in long-term trials using clinical end points, there is an urgent need for validated surrogate markers of atherosclerosis to save both time and costs. Over the last decade, the use of imaging markers has been widely introduced into drug-development strategies. Here we will discuss the most commonly used techniques. Recent findings Whereas both testing of endothelial function, assessed as flow-mediated dilation, and assessment of carotid intima-media thickness have been shown to predict future cardiovascular events, predominantly intima-media thickness has been used successfully as a surrogate marker in intervention studies. More recently, standardization of intravascular ultrasound has also enabled reproducible assessment of coronary atheroma volume. Multidetector computed tomography and electron-beam computed tomography have proven useful in providing quantitative information on plaque burden and coronary calcium content, respectively. Although cardiovascular magnetic resonance (CMR) is improving continuously, additional technical improvements will be mandatory before this technique can be implemented in multicenter clinical studies. Summary The imaging modalities reviewed here all provide specific information on either functionality or morphology of the vasculature. The value of carotid intima-media thickness for cardiovascular risk prediction has been studied most extensively. Whereas assessment of plaque burden using intravascular ultrasound appears to be the most direct way to quantify coronary changes, its predictive value for future cardiovascular events remains to be established. Awaiting further technical improvements, CMR is expected to provide the most valuable information for the evaluation of atherosclerosis in the near future.
Lead Poisoning and the Reintroduction of the California Condor in Northern Arizona

Abstract Since 1996, The Peregrine Fund has released California condors (Gymnogyps californianus) in the Grand Canyon region of northern Arizona with the goal of establishing a self-sustaining population, disjunct from other released populations in California and Baja California. A free-ranging population of more than 60 individuals now ranges within northern Arizona and southern Utah and has produced 9 wild young. The most frequent cause of death is lead poisoning from the ingestion of lead bullet fragments and shotgun pellets in the remains of gun-killed animals. In response, the Arizona Game and Fish Department has effectively reduced lead occurrence within the foraging range of the condors through hunter education and the promotion of nonlead ammunition. Most hunters have participated in the program. Throughout the course of the reintroduction effort, veterinary science and application have played essential roles in diagnosing fatalities and treating lead-exposed condors, a species with such a low natural reproductive rate that every adult is significant to the population.
Framing the challenge of poor-quality medicines: problem definition and policy making in Cambodia, Laos, and Thailand

Falsified and substandard medicines (poor-quality medicines) represent a pressing global health threat that necessitates a stronger policy response. They pose a considerable threat to human lives and an obstacle to infectious disease control, also due to the associated risk of antimicrobial resistance. Policy efforts against poor-quality medicines include strengthening national drug regulation systems and countering the illicit trade in falsified medicines. Current global policy endeavours to improve access quality medicines however form an array of initiatives rather than a coordinated global response. Since the 1990s, academics and policy actors recognise that the circulation of poor-quality medicines represents a pressing global public health concern. This has generated widespread debate in the literature on the drivers and determinants of this policy issue. While past studies highlight widespread disagreement on definitions of the problem of poor-quality medicines, the existing body of literature pays little attention to the way that the problem is understood among policy actors across national and institutional settings. This thesis seeks to explore varying interpretations of this problem among policy actors in three low and middle-income countries. It explores the role of ideas in policy processes by evaluating the variations in perceptions of the problem and the policy developments against poor-quality medicines. The problem of poor-quality antimalarial medicines in the Greater Mekong Subregion (GMS) offers an interesting case study. Despite notable national policy efforts against poor-quality antimalarial medicines in the GMS, evidence suggests that the problem of poor-quality antimalarials persists. As trade liberalization in the region intensifies, there are concerns that reduced custom controls and higher mobility of people and goods may cause further increase in this illicit trade. Through framing analysis, I analyse variations in perceptions of this threat across institutional and national settings. A social constructivist approach to policy analysis guides the analysis of interpretations of this problem and how these interpretations influence policy developments. This study then compares similarities and differences in framings of the problem and in policy processes across countries. I reflect on the dominant frames across the three case countries (the security, health systems and regulatory frames) and on the potential for policy coordination against poor-quality essential medicines in Southeast-Asia. To operationalize this approach, this study relies on three methods of data collection, namely; a stakeholder map, a document analysis and semi-structured interviews with key policy actors.
EXTENDING THE ROTTERDAM DEMAND MODEL TO ANALYZE MARKET PARTICIPATION

Abstract The dependent variable in the Rotterdam model is shown to consist of two additive components: the proportionate change in the average product weight consumed by existing buyers and the proportionate change in the share of total consumers who actually purchase the product. Applying the extended model to household data on salmon consumption in France, results suggest prices have a larger effect on attracting new buyers to the product in question than on getting existing buyers to consume more. However, generic advertising was found to affect consumption intensity but have no effect on market participation in the short run.
Specific Residues in the Connector Loop of the Human Cytomegalovirus DNA Polymerase Accessory Protein UL44 Are Crucial for Interaction with the UL54 Catalytic Subunit

ABSTRACT The human cytomegalovirus DNA polymerase includes an accessory protein, UL44, which has been proposed to act as a processivity factor for the catalytic subunit, UL54. How UL44 interacts with UL54 has not yet been elucidated. The crystal structure of UL44 revealed the presence of a connector loop analogous to that of the processivity subunit of herpes simplex virus DNA polymerase, UL42, which is crucial for interaction with its cognate catalytic subunit, UL30. To investigate the role of the UL44 connector loop, we replaced each of its amino acids (amino acids 129 to 140) with alanine. We then tested the effect of each substitution on the UL44-UL54 interaction by glutathione S-transferase pulldown and isothermal titration calorimetry assays, on the stimulation of UL54-mediated long-chain DNA synthesis by UL44, and on the binding of UL44 to DNA-cellulose columns. Substitutions that affected residues 133 to 136 of the connector loop measurably impaired the UL44-UL54 interaction without altering the ability of UL44 to bind DNA. One substitution, I135A, completely disrupted the binding of UL44 to UL54 and inhibited the ability of UL44 to stimulate long-chain DNA synthesis by UL54. Thus, similar to the herpes simplex virus UL30-UL42 interaction, a residue of the connector loop of the accessory subunit is crucial for UL54-UL44 interaction. However, while alteration of a polar residue of the UL42 connector loop only partially reduced binding to UL30, substitution of a hydrophobic residue of UL44 completely disrupted the UL54-UL44 interaction. This information may aid the discovery of small-molecule inhibitors of the UL44-UL54 interaction.