Miracle-dz/UniFAR-FTUs huggingface dataset:
Optimizing the diagnostic testing of Clostridium difficile infection

ABSTRACT Introduction: Clostridium difficile infection (CDI) is the leading cause of hospital-acquired diarrhea and is associated with a considerable health and cost burden. However, there is still not a clear consensus on the best laboratory diagnosis approach and a wide variation of testing methods and strategies can be encountered. Areas covered: We aim to review the most practical aspects of CDI diagnosis providing our own view on how to optimize CDI diagnosis. Expert commentary: Laboratory diagnosis in search of C. difficile toxins should be applied to all fecal diarrheic samples reaching the microbiology laboratory in patients > 2 years old, with or without classic risk factors for CDI. Detection of toxins either directly in the fecal sample or in the bacteria isolated in culture confirm CDI in the proper clinical setting. Nuclear Acid Assay techniques (NAAT) allow to speed up the process with epidemiological and therapeutic consequences.
Hemozoin detection may provide an inexpensive, sensitive, 1-minute malaria test that could revolutionize malaria screening

ABSTRACT Malaria remains widespread throughout the tropics and is a burden to the estimated 3.5 billion people who are exposed annually. The lack of a fast and accurate diagnostic method contributes to preventable malaria deaths and its continued transmission. In many areas diagnosis is made solely based on clinical presentation. Current methods for malaria diagnosis take more than 20 minutes from the time blood is drawn and are frequently inaccurate. The introduction of an accurate malaria diagnostic that can provide a result in less than 1 minute would allow for widespread screening and treatment of endemic populations, and enable regions that have gained a foothold against malaria to prevent its return. Using malaria parasites’ waste product, hemozoin, as a biomarker for the presence of malaria could be the tool needed to develop this rapid test.
Anti-inflammatory effects of the new generation synthetic surfactant CHF5633 on Ureaplasma-induced cytokine responses in human monocytes

ABSTRACT Background: Synthetic surfactants represent a promising alternative to animal-derived preparations in the treatment of neonatal respiratory distress syndrome. The synthetic surfactant CHF5633 has proven biophysical effectiveness and, moreover, demonstrated anti-inflammatory effects in LPS-stimulated monocytes. With ureaplasmas being relevant pathogens in preterm lung inflammation, the present study addressed immunomodulatory features on Ureaplasma-induced monocyte cytokine responses. Methods: Ureaplasma parvum-stimulated monocytes were exposed to CHF5633. TNF-α, IL-1β, IL-8, IL-10, TLR2 and TLR4 expression were analyzed using qPCR and flow cytometry. Results: CHF5633 did not induce pro-inflammation, and did not aggravate Ureaplasma-induced pro-inflammatory cytokine responses. It suppressed U. parvum-induced intracellular TNF-α (p < 0.05) and IL-1β (p < 0.05) in neonatal monocytes and inhibited Ureaplasma-induced TNF-α mRNA (p < 0.05), TNF-α protein (p < 0.001), and IL-1β (p = 0.05) in adult monocytes. Ureaplasma-modulated IL-8, IL-10, TLR2 and TLR4 were unaffected. Conclusion: CHF5633 does neither act pro-apoptotic nor pro-inflammatory in native and Ureaplasma-infected monocytes. Suppression of Ureaplasma-induced TNF-α and IL-1β underlines anti-inflammatory features of CHF5633.
A proactive task set influences how response inhibition is implemented in the basal ganglia

Increasing a participant's ability to prepare for response inhibition is known to result in longer Go response times and is thought to engage a “top‐down fronto‐striatal inhibitory task set. ” This premise is supported by the observation of anterior striatum activation in functional magnetic resonance imaging (fMRI) analyses that focus on uncertain versus certain Go trials. It is assumed that setting up a proactive inhibitory task set also influences how participants subsequently implement stopping. To assess this assumption, we aimed to manipulate the degree of proactive inhibition in a modified stop‐signal task to see how this manipulation influences activation when reacting to the Stop cue. Specifically, we tested whether there is differential activity of basal ganglia nuclei, namely the subthalamic nucleus (STN) and anterior striatum, on Stop trials when stop‐signal probability was relatively low (20%) or high (40%). Successful stopping was associated with increased STN activity when Stop trials were infrequent and increased caudate head activation when Stop trials were more likely, suggesting a different implementation of reactive response inhibition by the basal ganglia for differing degrees of proactive response control. Hum Brain Mapp 37:4706–4717, 2016. © 2016 Wiley Periodicals, Inc.
Recent advances in AIDS-related cryptococcal meningitis treatment with an emphasis on resource limited settings

ABSTRACT Introduction: Recent advances in the treatment and prevention of cryptococcal meningitis have the potential to decrease AIDS-related deaths. Areas covered: Targeted screening for asymptomatic cryptococcal antigenemia in persons with AIDS is a cost effective method for reducing early mortality in patients on antiretroviral therapy. For persons with symptomatic cryptococcal meningitis, optimal initial management with amphotericin and flucytosine improves survival compared to alternative therapies; however, amphotsericin is difficult to administer and flucytosine has not been available in middle or low income countries, where cryptococcal meningitis is most prevalent. Expert commentary: Improved care for cryptococcal meningitis patients in resource-limited settings is possible, and new treatment possibilities are emerging.
The Temporal Instability of Resting State Network Connectivity in Intractable Epilepsy

Focal epilepsies, such as temporal lobe epilepsy (TLE), are known to disrupt network activity in areas outside the epileptogenic zone [Tracy et al., 2015]. We devised a measure of temporal instability of resting state functional connectivity (FC), capturing temporal variations of BOLD correlations between brain regions that is less confounded than the “sliding window” approach common in the literature.
Ototoxicidade da cisplatina e otoproteção pelo extrato de ginkgo biloba às células ciliadas externas: estudo anatômico e eletrofisiológico

Cisplatina e uma potente droga antineoplasica, largamenteutilizada para o tratamento do câncer, tanto em adultos quantoem criancas. Dentre seus efeitos colaterais, a ototoxicidade seapresenta como um dos mais importantes e leva a perda auditivairreversivel, bilateral, para as altas frequencias (4KHz#8KHz). Es-tudos tem tentado identificar drogas que, associadas a cisplatinapossam atuar como otoprotetores. Sabe-se que o mecanismo daototoxicidade pela cisplatina esta relacionado a alteracoes nosmecanismos antioxidantes das celulas ciliadas, principalmente ascelulas ciliadas externas da coclea.
Neural initialization of audiovisual integration in prereaders at varying risk for developmental dyslexia

Learning letter‐speech sound correspondences is a major step in reading acquisition and is severely impaired in children with dyslexia. Up to now, it remains largely unknown how quickly neural networks adopt specific functions during audiovisual integration of linguistic information when prereading children learn letter‐speech sound correspondences. Here, we simulated the process of learning letter‐speech sound correspondences in 20 prereading children (6.13–7.17 years) at varying risk for dyslexia by training artificial letter‐speech sound correspondences within a single experimental session. Subsequently, we acquired simultaneously event‐related potentials (ERP) and functional magnetic resonance imaging (fMRI) scans during implicit audiovisual presentation of trained and untrained pairs. Audiovisual integration of trained pairs correlated with individual learning rates in right superior temporal, left inferior temporal, and bilateral parietal areas and with phonological awareness in left temporal areas. In correspondence, a differential left‐lateralized parietooccipitotemporal ERP at 400 ms for trained pairs correlated with learning achievement and familial risk. Finally, a late (650 ms) posterior negativity indicating audiovisual congruency of trained pairs was associated with increased fMRI activation in the left occipital cortex. Taken together, a short (<30 min) letter‐speech sound training initializes audiovisual integration in neural systems that are responsible for processing linguistic information in proficient readers. To conclude, the ability to learn grapheme‐phoneme correspondences, the familial history of reading disability, and phonological awareness of prereading children account for the degree of audiovisual integration in a distributed brain network. Such findings on emerging linguistic audiovisual integration could allow for distinguishing between children with typical and atypical reading development. Hum Brain Mapp 38:1038–1055, 2017. © 2016 Wiley Periodicals, Inc.
Occupational Therapy Discharge Assessment of Elderly Patients from Acute Care Hospitals

ABSTRACT The purpose of this study was to identify effective discharge assessment tools, examine clinical reasoning skills and use of client-centered practice in discharge planning from acute care hospitals. Methodology included an ethnographic study with a mixed-method design using both quantitative and qualitative methods. The data were organized into main themes and subthemes, coded, and entered on an Excel spreadsheet for analysis. Results indicated that discharge assessment and decision making is a complex issue that is unique to each individual. Nonstandardized functional-based assessment is the most frequently used method in discharge assessment with inconsistency in the use of standardized assessments. Decision making regarding discharge involves the inclusion of multiple factors primarily safety, home support, and patients' performance in daily occupations. The results also indicated inconsistencies in following client-centered practice. Rehabilitation personnel should be offered education and training on the complexity and uniqueness of discharge assessment.
The challenges of patient satisfaction: influencing factors and the patient – provider relationship in the United States

ABSTRACT Introduction: Patient satisfaction is a phenomenon that has become influential in the inpatient setting with the introduction of the Hospital Consumer Assessment of Healthcare Practitioners and Systems (HCAHPS) survey in the United States. Patient satisfaction is a key goal of healthcare organizations and presents some challenges to providing quality patient care. Areas covered: This review will focus on the challenges patient satisfaction presents in the healthcare field, with a key focus on factors that influence patient satisfaction, the common problem of inappropriate antibiotic prescriptions and the importance of the patient-provider relationship. Expert commentary: While it is apparent that focused efforts to better understand patient satisfaction are necessary and that implementation of processes to enhance satisfaction are warranted, attention must be directed so that these interventions do not adversely influence the efficiency or quality of care. Continuous long-term relationships with healthcare providers encourage patient loyalty, effective healthcare and good lifestyle habits.
Effect of Probiotics on Diarrhea in Children With Severe Acute Malnutrition: A Randomized Controlled Study in Uganda

Objectives: The aim of the study was to assess the effect of probiotics on diarrhea during in- and outpatient treatment of children with severe acute malnutrition (SAM). Methods: A randomized, double-blind, placebo-controlled study was conducted involving 400 children admitted with SAM. Patients received 1 daily dose of a blend of Bifidobacterium animalis subsp lactis and Lactobacillus rhamnosus (10 billion colony-forming units, 50:50) or placebo during hospitalization followed by an 8- to 12-week outpatient treatment period, depending on patients’ recovery rate. All outcomes were reported for in- and outpatient treatment separately. The primary outcome was number of days with diarrhea during hospitalization. Secondary outcomes included other diarrhea outcomes, pneumonia, weight gain, and recovery. Results: There was no difference in number of days with diarrhea between the probiotic (n = 200) and placebo (n = 200) groups during inpatient treatment (adjusted difference +0.2 days, 95% confidence interval −0.8 to 1.2, P = 0.69); however, during outpatient treatment, probiotics reduced days with diarrhea (adjusted difference −2.2 days 95% confidence interval −3.5 to −0.3, P = 0.025). There were no effects of probiotics on diarrhea incidence and severity or pneumonia, weight gain or recovery during in- or outpatient treatment. Twenty-six patients died in the probiotic versus 20 in the placebo group (P = 0.38). Conclusions: Bifidobacterium animalis subsp lactis and Lactobacillus rhamnosus had no effect on diarrhea in children with SAM during hospitalization, but reduced the number of days with diarrhea in outpatient treatment by 26%. Probiotics may have a role in follow-up of hospitalized children with SAM or in community-based treatment of malnourished children, but further studies are needed to confirm this.
Pre-symptomatic Diagnosis of Celiac Disease in Predisposed Children: the Role of Gene Expression Profile.

OBJECTIVE The prevalence of Celiac Disease (CD) has increased significantly in recent years, and risk prediction and early diagnosis has become imperative especially in at risk families. In a previous study, we identified individuals with CD based on the expression profile of a set of candidate genes in peripheral blood monocytes. Here we evaluated the expression of a panel of CD candidate genes in peripheral blood mononuclear cells (PBMCs) from at risk infants long time before any symptom or production of antibodies. METHODS We analysed the gene expression of a set of 9 candidate genes, associated with CD, in22HLA predisposed children from at risk families for CD, followed from birth to 6 years of age. Nine of them developed CD (cases)and 13 did not (controls). We analysed gene expression at three different time points (age matched in the two groups): 4-19 months before diagnosis, at the time of CD diagnosis, and after at least one year of a gluten-free diet. At similar age points controls were also evaluated. RESULTS Three genes (KIAA, TAGAP and SH2B3) were overexpressed in cases, compared to controls, at least 9 months before CD diagnosis. At a stepwise discriminant analysis,4 genes (RGS1, TAGAP, TNFSF14 and SH2B3) differentiate cases from controls before serum antibodies production and clinical symptoms. Multivariate equation correctly classified CD from non-CD children in 95.5% of cases. CONCLUSIONS The expression of a small set of candidate genes in PBMCs can predict celiac disease at least 9 months before the appearance of any clinical and serological signs of the disease.
Recruitment Challenges for End-of-Life Research

Methodological challenges in conducting research with the end-of-life population are distinct, and solutions cannot be readily derived from research with individuals at other stages of life. Prominent among the methodological challenges is the issue of recruitment. The purpose of this article is to describe the interest of adult patients at end of life in research participation, consider the ethics of recruiting an end-of-life population, and define five major challenges to recruitment (the end-of-life label, selection of appropriate inclusion/exclusion criteria, individual feels too ill, individual feels overwhelmed, and family and healthcare professionals acting as "gatekeepers") with possible solutions offered. The consequences of failing to recruit an adequate sample size increases risk of type II errors, wastes research dollars, and squanders the time of those involved. With careful planning, recruitment challenges are surmountable.
Biomarkers of Environmental Enteric Dysfunction Among Children in Rural Bangladesh.

OBJECTIVES Environmental enteric dysfunction (EED) may inhibit growth and development in low- and middle-income countries, but available assessment methodologies limit its study. In rural Bangladesh, we measured EED using the widely used lactulose mannitol ratio (L:M) test and a panel of intestinal and systemic health biomarkers to evaluate convergence among biomarkers and describe risk factors for EED. METHODS In 539 18-month-old children finishing participation in a randomized food supplementation trial, serum, stool, and urine collected after lactulose and mannitol dosing were analyzed for biomarkers of intestinal absorption, inflammation, permeability and repair, and systemic inflammation. EED scores for each participant were developed using principal component analysis and partial least squares regression. Associations between scores and L:M and with child sociodemographic and health characteristics were evaluated using regression analysis. RESULTS EED prevalence (L:M > 0.07) was 39.0%; 60% had elevated acute phase proteins (C-reactive protein >5 mg/L or α-1 acid glycoprotein >100 mg/dL). Correlations between intestinal biomarkers were low, with the highest between myeloperoxidase and α-1 antitrypsin (r = 0.33, P < 0.01), and biomarker values did not differ by supplementation history. A 1-factor partial least squares model with L:M as the dependent variable explained only 8.6% of L:M variability. In adjusted models, L:M was associated with child sex and socioeconomic status index, whereas systemic inflammation was predicted mainly by recent illness, not EED. CONCLUSIONS Impaired intestinal health is widespread in this setting of prevalent stunting, but a panel of serum and stool biomarkers demonstrated poor agreement with L:M. Etiologies of intestinal and systemic inflammation are likely numerous and complex in resource-poor settings, underscoring the need for a better case definition with corresponding diagnostic methods to further the study of EED.
Common and distinct brain networks underlying verbal and visual creativity

Creativity is imperative to the progression of human civilization, prosperity, and well‐being. Past creative researches tends to emphasize the default mode network (DMN) or the frontoparietal network (FPN) somewhat exclusively. However, little is known about how these networks interact to contribute to creativity and whether common or distinct brain networks are responsible for visual and verbal creativity. Here, we use functional connectivity analysis of resting‐state functional magnetic resonance imaging data to investigate visual and verbal creativity‐related regions and networks in 282 healthy subjects. We found that functional connectivity within the bilateral superior parietal cortex of the FPN was negatively associated with visual and verbal creativity. The strength of connectivity between the DMN and FPN was positively related to both creative domains. Visual creativity was negatively correlated with functional connectivity within the precuneus of the pDMN and right middle frontal gyrus of the FPN, and verbal creativity was negatively correlated with functional connectivity within the medial prefrontal cortex of the aDMN. Critically, the FPN mediated the relationship between the aDMN and verbal creativity, and it also mediated the relationship between the pDMN and visual creativity. Taken together, decreased within‐network connectivity of the FPN and DMN may allow for flexible between‐network coupling in the highly creative brain. These findings provide indirect evidence for the cooperative role of the default and executive control networks in creativity, extending past research by revealing common and distinct brain systems underlying verbal and visual creative cognition. Hum Brain Mapp 38:2094–2111, 2017. © 2017 Wiley Periodicals, Inc.
Effects of traumatic dental injuries to primary teeth on permanent teeth--a clinical follow-up study.

AIM This study evaluated the prevalence of developmental sequelae to permanent teeth (DSP) after traumatic dental injuries to primary teeth (TDI-1) and their association with age, gender, type of injury, recurrence of injury and post-traumatic damage to primary teeth. MATERIALS AND METHODS Dental records of 2725 children treated from February 1993 to December 2008 in a private pediatric dental clinic were examined. A total of 308 records had 412 primary teeth that sustained traumatic injuries. Age at the time of injury ranged from 4 months to 7 years. A chi-squared test and logistic regression were used for statistical analyses. RESULTS One hundred forty-eight children (241 teeth) were followed up until the eruption of the permanent successor. The prevalence of DSP was 22.4%. Discoloration and hypoplasia were the most frequent abnormalities (74.1%), followed by eruption disorders (25.9%). Age at the time of TDI-1 was the only variable significantly associated with DSP. Sequelae were most prevalent among children who suffered an injury between 1 and 3 years of age. CONCLUSIONS Children who sustain traumatic dental injuries should be followed up regularly for an early diagnosis and treatment of possible DSP.
Breast Milk TGFβ is Associated with Neonatal Gut Microbial Composition.

OBJECTIVES Breast milk is a complex bioactive fluid that varies across numerous maternal and environmental conditions. While breastfeeding is known to impact neonatal gut microbiome, the milk components responsible for this effect are not well-characterized. Given the wide range of immunological activity breast milk cytokines engage in, we investigated three essential breast milk cytokines and their association with early life gut microbiota. METHODS A total of 52 maternal-child pairs were drawn from a racially diverse birth cohort based in Detroit, Michigan. Breast milk and neonatal stool specimens were collected at 1-month postpartum. Breast milk TGFβ1, TGFβ2, and IL-10 were assayed using ELISAs, while neonatal gut microbiome was profiled using 16S rRNA sequencing. RESULTS Individually, immunomodulators TGFβ1 and TGFβ2 were significantly associated with neonatal gut microbial composition (R = 0.024, p = 0.041; R = 0.026, p = 0.012, respectively) and increased richness, evenness, and diversity, but IL-10 was not. However, the effects of TGFβ1 and TGFβ2 were not independent of one another, and the effect of TGFβ2 was stronger than that of TGFβ1. Higher levels of TGFβ2 was associated with the increased relative abundance of several bacteria, including members of Streptococcaceae and Ruminococcaceae, and lower relative abundance of distinct Staphylococcaceae taxa. CONCLUSIONS Breast milk TGFβ concentration explains a portion of variability in gut bacterial microbiota composition among breastfed neonates. Whether TGFβ acts in isolation or jointly with other bioactive components to alter bacterial composition requires further investigation. These findings contribute to an increased understanding of how breastfeeding affects the gut microbiome-and potentially immune development-in early life.
Proteomics approaches in cervical cancer: focus on the discovery of biomarkers for diagnosis and drug treatment monitoring

ABSTRACT Introduction: The HPV virus accounts for the majority of cervical cancer cases. Although a diagnostic tool (Pap Test) is widely available, cervical cancer incidence still remains high worldwide, and especially in developing countries, attributed to a large extent to suboptimal sensitivities of the Pap test and unavailability of the test in developing countries. Areas covered: Proteomics approaches have been used in order to understand the HPV virus correlation to cervical cancer pathology, as well as to discover putative biomarkers for early cervical cancer diagnosis and drug mode of action. Expert commentary: The present review summarizes the latest in vitro and in vivo proteomic studies for the discovery of putative cervical cancer biomarkers and the evaluation of available drugs and treatments.