Miracle-dz/UniFAR-FTUs huggingface dataset:
High incidence of adverse events in healthy volunteers receiving rifampicin and adjusted doses of lopinavir/ritonavir tablets

Objective:Previous research in healthy volunteers has demonstrated that rifampicin and adjusted doses of lopinavir/ritonavir soft-gel capsules resulted in adequate exposure to lopinavir. Our objective was to study the combined use of rifampicin and the newly introduced lopinavir/ritonavir tablets. Methods:A total of 40 healthy volunteers were planned to start with 600 mg rifampicin once daily from days 1–5. From days 6–15, volunteers were randomized to receive lopinavir/ritonavir tablets dosed as either 600/150 or 800/200 mg twice daily, both in addition to 600 mg rifampicin once daily. A 12 h pharmacokinetic curve was planned on day 15. Safety assessments were conducted regularly throughout the study period. Results:Eleven volunteers started as the first group in this study. No major complaints occurred during day 1–5 (rifampicin only). After addition of lopinavir/ritonavir, eight volunteers suffered from both nausea and vomiting, one from nausea only, and one from vomiting only. On day 7, increases in aspartate aminotransferase/alanine aminotransferase (AST/ALT) levels were reported in all volunteers and on day 8, the study was prematurely terminated. The AST/ALT levels continued to rise and peaked (grade 2, n = 2; grade 3, n = 1; grade 4, n = 8) on days 9–10. All values returned to normal within 6 weeks. Conclusions:The study showed a high incidence of adverse events when a higher than standard dose of the new lopinavir/ritonavir tablets was combined with rifampicin. In the future, this drug combination should not be given to healthy volunteers. Liver function should be carefully monitored when rifampicin and lopinavir/ritonavir are combined in patients.
EMERGENCY NURSES: AN IMPACT EVALUATION

Introduction: In a quasi-experimental study, control and intervention group outcomes were compared following implementation of alcohol screening, brief intervention, and referral to treatment (SBIRT) by emergency nurses. The primary hypothesis was: Trauma patients who participate in nursedelivered ED SBIRT will have greater reductions in alcohol consumption and fewer alcohol-related incidents than those who do not.
Validation of a new questionnaire for assessing habitual intake of starch, non-starch polysaccharides, sugars and alcohol

A newly developed food frequency questionnaire designed to estimate habitual intake of non-starch polysaccharide (NSP), intrinsic and extrinsic sugars, starch and alcohol was compared with 4-d weighed records using the semi-automatic Petra system in 154 subjects, men aged 40–69 years and women aged 25–69 years. There was no statistical difference between the two methods for average intake of NSP (soluble and insoluble) intrinsic sugar and Vitamin C. Where a significant difference did occur, notably in extrinsic sugar and starch, it did not exceed 12%, the food frequency questionnaire giving the higher result. With most food components, 4547% were classified in the same tertile and only 54% of subjects were classified in opposite tertiles by the two methods. We conclude that this questionnaire is a valid method of assessing habitual intake of these food components in large groups of subjects.
Spatial Patterns and Dynamic Responses of Arctic Food Webs Corroborate the Exploitation Ecosystems Hypothesis (EEH)

According to the exploitation ecosystems hypothesis (EEH), productive terrestrial ecosystems are characterized by community‐level trophic cascades, whereas unproductive ecosystems harbor food‐limited grazers, which regulate community‐level plant biomass. We tested this hypothesis along arctic‐alpine productivity gradients at the Joatka field base, Finnmark, Norway. In unproductive habitats, mammalian predators were absent and plant biomass was constant, whereas herbivore biomass varied, reflecting the productivity of the habitat. In productive habitats, predatory mammals were persistently present and plant biomass varied in space, but herbivore biomass did not. Plant biomass of productive tundra scrublands declined by 40% when vegetation blocks were transferred to predation‐free islands. Corresponding transfer to herbivore‐free islands triggered an increase in plant biomass. Fertilization of an unproductive tundra heath resulted in a fourfold increase in rodent density and a corresponding increase in winter grazing activity, whereas the total aboveground plant biomass remained unchanged. These results corroborate the predictions of the EEH, implying that the endotherm community and the vegetation of the North European tundra behaves dynamically as if each trophic level consisted of a single population, in spite of local co‐occurrence of >20 plant species representing different major taxonomic groups, growth forms, and defensive strategies.
The 16 per cent Solution and other Mysteries concerning the Accuracy of Alcohol Consumption Estimates based on Sales Data

Whether based on production, tax or sales statistics, estimates of alcohol consumption are subject to bias arising from record keeping procedures and from unrecorded consumption. Based on an analysis of the accuracy of consumption estimates derived from sales statistics in Ontario, two significant biases are identified. The first problem concerns the use of 16 per cent as the conversion factor for wine. As the consumption of 12 per cent table wines has increased, this figure is no longer appropriate and results in an overestimation of total alcohol consumption by about 2 per cent. The second major problem is the unrecorded home production of wine and wine brandy, which results in an underestimation of consumption by about 6 to 7 per cent. The available evidence concerning other types of unrecorded production indicates that they are not significant. It is concluded that sales data underestimate 'true' alcohol consumption in Ontario by about 4 to 6 per cent at this time. Language: en
What is IT? New Conceptualizations and Measures of Pediatric Nurses' Acceptance of Bar-Coded Medication Administration Information Technology

New healthcare technologies, such as bar-coded medication administration (BCMA), are implemented into rich, multiple-level work system, and jointly shape work processes. We provide theoretical and methodological rationale for studying these processes as a way to understand the impact of technologies in healthcare. Results are reported from a study conducted before and after implementation of BCMA in a pediatric hospital, in which the outcome of interest was satisfaction with the medication administration process. As predicted, two beliefs about the medication process, perceived ease of use and perceived usefulness, predicted satisfaction with the process before and after BCMA.
Patterns of soft drink consumption and primary tooth extractions in Queensland children.

BACKGROUND The authors examined the association of patterns of soft drink consumption and primary tooth extractions in Queensland children aged 12 years or less. METHODS Data were gathered through the Child Health Surveys conducted by Queensland Health in 2003 and 2008. The analysis allowed for various demographic characteristics using logistic regression analysis. RESULTS The data in both surveys showed an increased risk of tooth extraction in children who had a greater frequency and amount of soft drink consumption, and those that consumed soft drink between meals. In 2008, the percentage of children that had soft drink daily or several times a week had decreased, with an increase in those that never had soft drink. CONCLUSIONS To reduce the risk of primary tooth extraction due to decay, this paper recommends the continuing moderation of soft drink consumption frequency and the consumption of soft drinks with, rather than between, meals.
Silent mutations are selected in HIV-1 reverse transcriptase and affect enzymatic efficiency

Objective:Missense mutations in HIV-1 reverse transcriptase are frequently selected in response to therapy; we examined whether silent mutations were also selected for by HIV therapy. Design:Retrospective, observational analysis. Biochemical assays. Methods:A comparison of the reverse transcriptase gene, from antiretroviral- naive (N = 812) and experienced individuals (N = 2212), reveals two silent mutations (K65K and K66K) that are strongly associated with treatment experience. To assess reverse transcription efficiency, steady-state kinetic assays were carried out using recombinant purified HIV-1 reverse transcriptase and a series of synthetic RNA/DNA template/primer substrates. The RNA templates spanned codons 60–77 in the reverse transcriptase and included different combinations of mutations at codons 65, 66, 67, and 70. Results:Silent AAG mutations (or mixtures) at reverse transcriptase codons 65 and/or 66 were observed in 812 samples from 351 patients and 2129 samples from 829 patients, respectively. In clade B samples, there was a very strong relationship between the silent mutations and the thymidine analogue mutations, in particular D67N. Steady-state kinetic experiments demonstrated that HIV-1 reverse transcriptase exhibited a strong tendency to pause and/or dissociate at codons 65 and 66 on RNA templates that contained the D67N and K70R mutations. However, when the K66 or K66 AAA to AAG mutations were added to the background of the 67 and 70 mutational changes, these pausing and/or dissociation events were largely alleviated. Conclusion:Silent mutations at codons 65 and/or 66 are strongly coselected with thymidine analogue mutations. These data provide the first evidence for an RNA-level mechanism of direct relevance to drug resistance.
Methamphetamine in Emergency Psychiatry

ObjectivesThe purpose of this study is to determine the prevalence of methamphetamine-related diagnoses seen in the psychiatric emergency department (ED) of a large urban hospital, which serves an area with a known methamphetamine epidemic. This study also examines the characteristics and ED interventions of psychiatric patients with and without methamphetamine-related diagnoses. MethodsThe records of 904 patients admitted to the psychiatric ED of the largest urban hospital in Hawaii between March and May 2002 were reviewed. Diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders IV. Patients were classified as having a methamphetamine-related diagnosis if they were diagnosed with methamphetamine intoxication, dependency, abuse, withdrawal, methamphetamine-induced mood disorder or psychotic disorder. ResultsOne hundred sixty-six patients (18%) were diagnosed with a methamphetamine-related diagnosis. Patients with methamphetamine-related diagnoses were more likely to be male (70% vs. 57%), non-Caucasian (75% vs. 57%), and presented with suicidality (47% vs. 32%) and agitation (48% vs. 30%) more often than non-methamphetamine-related diagnosis patients. Poly-drug use (14% vs. 3%) and dual diagnosis (37% vs. 17%) were more common among patients with methamphetamine-related diagnoses. Patients with methamphetamine-related diagnoses were treated with sedating medications more frequently (37% vs. 25%), stayed longer in the ED (median 225 vs. 193 min), and were more likely to be admitted to the hospital (53% vs. 40%) than non-methamphetamine-related diagnoses patients. ConclusionsPsychiatric ED patients with methamphetamine-related diagnoses present more acutely and use more hospital resources.
Recognising Social Work: The Influence of the Politics of Recognition on Social Work

The politics of recognition is a common framework through which both individual and group demands are made today. Demands are made not only for individual distress to be validated, but also for cultural identities to be accorded positive recognition; in the acknowledgement of past trauma or abuse in the former, and in showing respect towards different lifestyles and beliefs in the latter. This paper discusses the politics of recognition in its historical specificity, in particular its interaction with the new social movements (NSMs) that came to the fore in the latter decades of the twentieth century. Such movements increasingly focused on cultural issues with a concomitant decline of a more materialist politics that emphasised economic redistribution. The forms that such demands for recognition can take are also highlighted. In addition, some implications for social policy and social work are discussed as whilst welfare recipients are often people requiring recognition, increasingly, welfare providers also articulate a desire for their professionalism and societal worth to also be accorded positive cultural recognition. In light of this, barriers to, and strategies for, the achievement of a form of ‘mutual recognition’ between professionals and social workers are also discussed.
Exceptionally Potent Cross-Reactive Neutralization of Nipah and Hendra Viruses by a Human Monoclonal Antibody

Abstract We have previously identified neutralizing human monoclonal antibodies against Nipah virus (NiV) and Hendra virus (HeV) by panning a large nonimmune antibody library against a soluble form of the HeV attachment-envelope glycoprotein G (sGHeV). One of these antibodies, m102, which exhibited the highest level of cross-reactive neutralization of both NiV and HeV G, was affinity maturated by light-chain shuffling combined with random mutagenesis of its heavy-chain variable domain and panning against sGHeV. One of the selected antibody Fab clones, m102.4, had affinity of binding to sGHeV that was equal to or higher than that of the other Fabs; it was converted to IgG1 and tested against infectious NiV and HeV. It exhibited exceptionally potent and cross-reactive inhibitory activity with 50% inhibitory concentrations below 0.04 and 0.6 μg/mL, respectively. The virus-neutralizing activity correlated with the binding affinity of the antibody to sGHeV and sGNiV. m102.4 bound a soluble form of NiV G (sGNiV) better than it bound sGHeV, and it neutralized NiV better than HeV, despite being originally selected against sGHeV. These results suggest that m102.4 has potential as a therapeutic agent for the treatment of diseases caused by henipaviruses. It could be also used for prophylaxis and diagnosis, and as a research reagent
Comparison of pneumococcal conjugate polysaccharide and free polysaccharide vaccines in elderly adults: conjugate vaccine elicits improved antibacterial immune responses and immunological memory.

BACKGROUND High functional antibody responses, establishment of immunologic memory, and unambiguous efficacy in infants suggest that an initial dose of conjugated pneumococcal polysaccharide (PnC) vaccine may be of value in a comprehensive adult immunization strategy. METHODS We compared the immunogenicity and safety of 7-valent PnC vaccine (7vPnC) with that of 23-valent pneumococcal polysaccharide vaccine (PPV) in adults >/=70 years of age who had not been previously vaccinated with a pneumococcal vaccine. One year later, 7vPnC recipients received a booster dose of either 7vPnC (the 7vPnC/7vPnC group) or PPV (the 7vPnC/PPV group), and PPV recipients received a booster dose of 7vPnC (the PPV/7vPnC group). Immune responses were compared for each of the 7 serotypes common to both vaccines. RESULTS Antipolysaccharide enzyme-linked immunosorbent assay antibody concentrations and opsonophagocytic assay titers to the initial dose of 7vPnC were significantly greater than those to the initial dose of PPV for 6 and 5 of 7 serotypes, respectively (P < .01 and P < .05, respectively). 7vPnC/7vPnC induced antibody responses that were similar to those after the first 7vPnC inoculation, and 7vPnC/PPV induced antibody responses that were similar to or greater than antibody responses after administration of PPV alone; PPV/7vPnC induced significantly lower antibacterial responses, compared with those induced by 7vPnC alone, for all serotypes (P < .05). CONCLUSION In adults, an initial dose of 7vPnC is likely to elicit higher and potentially more effective levels of antipneumococcal antibodies than is PPV. In contrast with PPV, for which the induction of hyporesponsiveness was observed when used as a priming dose, 7vPnC elicits an immunological state that permits subsequent administration of 7vPnC or PPV to maintain functional antipolysaccharide antibody levels.
Randomized, double-blind, placebo-matched, multicenter trial of abacavir/lamivudine or tenofovir/emtricitabine with lopinavir/ritonavir for initial HIV treatment

Background:Abacavir sulfate/lamivudine (ABC/3TC) and tenofovir DF/emtricitabine (TDF/FTC) are widely used nucleoside reverse transcriptase inhibitors for initial HIV-1 treatment. This is the first completed, randomized clinical trial to directly compare the efficacy, safety, and tolerability of these agents, each in combination with lopinavir/ritonavir in antiretroviral-naive patients. Methods:Six hundred and eighty-eight antiretroviral-naive, HIV-1-infected patients were randomized in this double-blind, placebo-matched, multicenter, noninferiority study to receive a once-daily regimen of either ABC/3TC 600 mg/300 mg or TDF/FTC 300 mg/200 mg, both with lopinavir/ritonavir 800 mg/200 mg. Primary endpoints were the proportion of patients with HIV-1 RNA below 50 copies/ml at week 48 (missing = failure, switch included analysis) and the proportion of patients experiencing adverse events over 96 weeks. Results:At week 48, 68% in the ABC/3TC group vs. 67% in the TDF/FTC group achieved an HIV-1 RNA below 50 copies/ml (intent-to-treat exposed missing = failure, 95% confidence interval on the difference −6.63 to 7.40, P = 0.913), demonstrating the noninferiority of ABC/3TC to TDF/FTC at week 48. Noninferiority of the two regimens was sustained at week 96 (60% vs. 58%, respectively, 95% confidence interval −5.41 to 9.32, P = 0.603). In addition, efficacy of both regimens was similar in patients with baseline HIV-1 RNA ≥ 100 000 copies/ml or CD4+ cell counts below 50 cells/μl. Median CD4+ recovery (ABC/3TC vs. TDF/FTC, cells/μl) was +250 vs. +247 by week 96. Premature study discontinuation due to adverse events occurred in 6% of patients in both groups. Protocol-defined virologic failure occurred in 14% of patients in both groups. Conclusion:Both ABC/3TC and TDF/FTC provided comparable antiviral efficacy, safety, and tolerability when each was combined with lopinavir/ritonavir in treatment-naive patients.
Discussion of the Compendium of Veterinary Standard Precautions: Preventing Zoonotic Disease Transmission in Veterinary Personnel

Veterinary practices are unique environments that bring humans into close contact with many different species of animals; therefore, the risk of exposure to infectious pathogens is inherently different in veterinary medicine than in human medicine. In contrast to the risk of exposure to blood in human medicine, infections from zoonotic diseases in veterinary personnel are primarily related to exposure to animal faeces, infected skin, wounds, droplets and puncture wounds. Infection‐control measures in veterinary practices are often insufficient to prevent zoonotic disease transmission. The Veterinary Standard Precautions (VSP) Compendium is designed to help prevent transmission of zoonotic pathogens from animal patients to veterinary personnel in private practice.
Activity, pharmacokinetics and safety of lersivirine (UK-453,061), a next-generation nonnucleoside reverse transcriptase inhibitor, during 7-day monotherapy in HIV-1-infected patients

Objective:To investigate the effects on viral load and assess dose–response relationships, pharmacokinetics, safety and tolerability of lersivirine (UK-453,061), a next-generation nonnucleoside reverse transcriptase inhibitor, in asymptomatic HIV-1-infected patients. Design:Randomized, double-blind, placebo-controlled, parallel group, multicenter phase IIa clinical study. Methods:Forty-eight HIV-1-infected patients were enrolled for the study of once-daily or twice-daily lersivirine at total daily doses ranging from 20 to 1000 mg. The primary endpoint was the change in log10 plasma HIV-1 RNA viral load from baseline to day 8. Secondary endpoints related to pharmacokinetics, safety and tolerability and potential development of viral resistance and genotyping patterns. Results:Patients treated with lersivirine achieved day 8 mean viral load reductions of 0.3, 0.8, 1.3 and 1.6 log10 after receiving 10, 30, 100 and 500 mg twice daily, respectively, and 0.9, 1.7 and 1.8 log10 after receiving 100, 500 and 750 mg once daily, respectively. Mean changes from baseline to day 8 were small in patients receiving placebo. For all dose regimens, plasma exposure increased approximately in line with lersivirine dose. Median plasma concentrations of lersivirine at steady state were above the IC90 for lersivirine at once-daily doses of at least 500 mg and twice-daily doses of at least 100 mg. The most commonly reported treatment-emergent adverse events were headache, fatigue and nausea. Conclusion:Seven-day monotherapy with lersivirine achieved mean viral load reductions up to 1.8 log10. Lersivirine was safe and well tolerated. Further studies of lersivirine in combination with other antiretroviral drugs to assess long-term durability of antiviral response, safety and tolerability are warranted.
The novel histone deacetylase inhibitors metacept-1 and metacept-3 potently increase HIV-1 transcription in latently infected cells

We investigated the ability of several novel class I histone deacetylase inhibitors to activate HIV-1 transcription in latently infected cell lines. Oxamflatin, metacept-1 and metacept-3 induced high levels of HIV-1 transcription in latently infected T cell and monocytic cells lines, were potent inhibitors of histone deacetylase activity and caused preferential cell death in transcriptionally active cells. Although these compounds had potent in-vitro activity, their cytotoxicity may limit their use in patients.
Laparoscopic Cholecystectomy - A Cross Sectional Study

Aims and Objectives: 1. To study the clinical profile of patients undergoing laparoscopic cholecystectomy. 2. To study the post operative complications of laparoscopic cholecystectomy. Methodology: Ultrasound confirmed 48 cases of either sex admitted in department of surgery with cholelithiasis, gall bladder polyp, acute or chronic cholecystitis were included in this survey. These patients underwent laparoscopic cholecystectomy after preoperative preparation during August 2011-December 2013. Results: Highest age incidence was seen in 4 th decade with female preponderance. Most common presenting symptom was pain in abdomen followed by nausea, vomiting, dyspepsia and fever. Only 1 procedure was converted to open cholecystectomy with conversion rate of 2.08%. It was due to dense adhesions from chronic infection. The overall post-operative complication rate was 6.25% with wound infection being the most common occurring in 2 cases and prolonged ileus in 1 case. Chronic cholecystitis was the major histopathological diagnosis. The median post-operative stay in our study was 3 days. Conclusion: Chronic cholecystitis is the most common presentation of cholelithiasis with female pre-ponderance and incidence more in the 4 th decade. Laparoscopic cholecystectomy is safe and feasible treatment with less complication rate and early recovery.
A Novel Method of Small Target Detection in Sea Clutter

Detecting low observable targets within sea clutter at low grazing angle is one of the research hotspots in radar signal processing community. In this paper, we have proposed a novel method based on polarimetric decomposition theorem. The polar characteristics of sea clutter has been analyzed, with the parameters after the decomposition of target scattering matrix. The scattering entropy and the scattering angle are the key parameters to discriminate the target from the sea clutter. The technique is designed to suppress unwanted sea clutter at polarimetric domain. Datasets from real marine radar are used to illustrate the performance of the new approach.