Miracle-dz/UniFAR-FTUs huggingface dataset:
A Study of Ventilator Associated Pneumonia Caused by Multidrug Resistant Pathogens With Special Reference to ESBL, AMPC And MBL.

Ventilator Associated Pneumonia is the most frequent intensive care unit acquired infection with increasing incidence of multidrug resistant organisms. To know the bacterial pathogens causing Ventilator Associated Pneumonia and detect the presence of ESBL, AmpC, MBL and MRSA among the isolates. This study included adult patients on mechanical ventilation for more than 48hrs. Ventilator Associated Pneumonia was diagnosed using Clinical Pulmonary Infection Score ≥ 6. Quatitatitive cultures of Endotracheal Aspirate was performed and colony count > 10 5 cfu/ml was considered. Antimicrobial susceptibility testing was done. Resistant organisms were further tested for ESBL, AmpC, and MBL & MRSA by conventional methods and E-test was done. Descriptive statistics like percentage, mean, standard deviation were applied. 478 adult patients received mechanical ventilation for > 48hrs. The incidence of Ventilator Associated Pneumonia was 59%. Enterobacteriaceae (32.21%), Acinetobacter baumannii (22.12%), Pseudomonas aeruginosa (19.3%) and Staphylococcus aureus (11.29%) were common pathogens isolated. Among the isolates 6.01 % were MBL, 45.83% ESBL, 1.01% AmpC and 9.01% MRSA respectively. Production of β-Lactamases among isolates is a major problem for treatment. Faster diagnosis and proper hygiene in ICU settings can reduce the burden of MDR and management of Ventilator Associated Pneumonia.
Novel in vivo mouse model of implant related spine infection

Post‐operative spine infections are a challenge, as hardware must often be retained to prevent destabilization of the spine, and bacteria form biofilm on implants, rendering them inaccessible to antibiotic therapy, and immune cells. A model of posterior‐approach spinal surgery was created in which a stainless steel k‐wire was transfixed into the L4 spinous process of 12‐week‐old C57BL/six mice. Mice were then randomized to receive either one of three concentrations (1 × 102, 1 × 103, and 1 × 104 colony forming units (CFU)) of a bioluminescent strain of Staphylococcus aureus or normal saline at surgery. The mice were then longitudinally imaged for bacterial bioluminescence to quantify infection. The 1 × 102 CFU group had a decrease in signal down to control levels by POD 25, while the 1 × 103 and 1 × 104 CFU groups maintained a 10‐fold higher signal through POD 35. Bacteria were then harvested from the pin and surrounding tissue for confirmatory CFU counts. All mice in the 1 × 104 CFU group experienced wound breakdown, while no mice in the other groups had this complication. Once an optimal bacterial concentration was determined, mice expressing enhanced green fluorescent protein in their myeloid cells (Lys‐EGFP) were utilized to contemporaneously quantify bacterial burden, and immune response. Neutrophil fluorescence peaked for both groups on POD 3, and then declined. The infected group continued to have a response above the control group through POD 35. This study, establishes a noninvasive in vivo mouse model of spine implant infection that can quantify bacterial burden and host inflammation longitudinally in real time without requiring animal sacrifice. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:193–199, 2017.
Double-blind placebo-controlled study of autologous transplanted epidermal cell suspensions for repigmenting vitiligo.

OBJECTIVES To investigate the efficacy of epidermal noncultured cellular grafting in patients with vitiligo and the role of postinflammatory, spontaneous, or UV-induced pigmentation in obtaining repigmentation. DESIGN A prospective, randomized, double-blind, placebo-controlled study. SETTING Ambulatory patients in an institutional practice. Patients were followed up for 3 to 12 months. PATIENTS A total of 33 paired, symmetrically distributed leukodermic lesions, all resistant to therapy, were observed in 28 patients. Nineteen patients appeared to have a stable vitiligo (group 1), whereas there was doubt about the stability of the disease in 9 patients (group 2). INTERVENTION After laser ablation, a hyaluronic acid-enriched cellular graft was applied to 1 lesion while the paired lesion received placebo. Three weeks later all lesions were exposed to UV irradiation twice per week for approximately 2 months. MAIN OUTCOME MEASURES Primarily, the percentage of repigmentation was assessed after 3, 6, and 12 months using a digital image analysis system. The repigmentation pattern was also evaluated after 1 and 3 months. RESULTS A strongly significant difference between cellular grafts and placebo was observed after 3, 6, and 12 months (P<.001, P = .002, and P = .002, respectively). In group 1, repigmentation of at least 70% of the treated area was achieved in 55%, 57%, and 77% of the actively treated lesions 3, 6, and 12 months after treatment, whereas in group 2 repigmentation of at least 70% of the treated area was not observed at any time point. The repigmentation pattern was diffuse in 94% of the responding patients. CONCLUSIONS After a strict preoperative selection for disease stability, transplantation resulted in repigmentation of at least 70% of the treated area in most actively treated vitiligo lesions. Repigmentation was primarily caused by the transplanted melanocytes.
Predictors of Drug Treatment Completion Among Parole Violators

Abstract This study examined the predictors of treatment completion among 380 state parole violators consecutively admitted to a comprehensive 12-month drug treatment program in lieu of reincarceration. Offenders were placed on intensive parole supervision throughout the 12-month treatment protocol and received three months of residential substance abuse treatment followed by nine months of outpatient counseling. Overall 123 (32.4%) of the offenders completed the 12-month treatment protocol. The primary reason for noncompletion was a positive drug screen. Bivariate analyses were performed to determine independent predictors of program completion. Four variables (age, past 30-day heroin use, total months incarcerated, and significant problems with mother) from the baseline Addiction Severity Index were found to be correlated with treatment completion (p < .10). These factors and other demographics (race, marital status, education) and variables found predictive of program completion in previous studies were entered into a multiple logistic regression model. Overall the final model found that only two factors—older age (p < .03) and no heroin use in the past 30 days (p < .02) significantly predicted treatment completion. These findings suggest that among parolees with moderate to extensive criminal justice histories younger individuals and those with recent heroin use respond less favorably to comprehensive substance abuse treatment services and intensive parole supervision.
Serum pentosidine levels are positively associated with the presence of vertebral fractures in postmenopausal women with type 2 diabetes.

CONTEXT Although type 2 diabetic patients are at increased risk of fractures, bone mineral density (BMD) may not be useful for assessing the risk. Recent studies have reported that increased bone content of pentosidine (PEN) is associated with its plasma concentration and bone fragility. OBJECTIVE AND METHODS To examine the association between serum PEN levels and vertebral fractures (VFs) in Japanese type 2 diabetic patients (77 males older than 50 yr and 76 postmenopausal females), we compared parameters including BMD, PEN, serum bone-specific alkaline phosphatase, and urinary levels of N-telopeptide between those with and without VFs. RESULTS Comparison of diabetic subjects with and without VFs revealed no significant differences in BMD values or bone metabolic markers in either gender. In contrast, PEN levels in women with VFs were significantly higher than in those without VFs (0.0440+/-0.0136 vs. 0.0321+/-0.0118 microg/ml; P<0.001). Multivariate logistic regression analysis adjusted for age, height, weight, hemoglobin A1c, estimated glomerular filtration rate, the presence of diabetic complications, histories of taking insulin or pioglitazone, risk factors for osteoporosis, and lumbar BMD identified PEN levels as a factor associated with the presence of VFs in postmenopausal diabetic women independent of BMD, risk factors for osteoporosis, diabetic status, and renal function (odds ratio 2.50, 95% confidential interval 1.09-5.73 per sd increase; P=0.0302). CONCLUSION PEN levels, but not BMD, may be useful for assessing the risk of prevalent VFs in postmenopausal diabetic women and may reflect bone quality in this group.
A Comparison of Combinations of Titanium and Resorbable Plating Systems for Repair of Isolated Zygomatic Fractures in the Adult: A Quantitative Biomechanical Study

Multiple studies have sought to determine the postreduction stability of internal fixation in zygomaticomaxillary complex (ZMC) fractures. Three-point fixation with titanium miniplates is increasingly recommended to repair these injuries. Use of bioresorbable plates has been suggested to eliminate potential postoperative hardware complications. By quantitatively comparing different combinations of titanium and resorbable plating systems, this study attempts to demonstrate which combinations will provide stable fixation of the fractured ZMC. Osteotomies were performed on 40 zygomas in 20 fresh-frozen cadaver skulls, simulating noncomminuted ZMC fractures. The control group (group 0) consisted of titanium plates at the zygomaticofrontal (ZF) suture, infraorbital rim (IOR), and zygomaticomaxillary buttress (ZMB). Group 1 consisted of titanium plates at the ZF and IOR, and a resorbable plate at the ZMB. Group 2 used a titanium plate at the ZF, and resorbable plates at the IOR and ZMB. Group 3 consisted of resorbable plates at the ZF, IOR, and ZMB. A mechanical test system was used to apply loads in the vectorial direction of the masseter. Critical forces and patterns of hardware failure were recorded. Group 0 failed at a mean force of 589 ± 146 N (60 kg). Group 1 failed at a mean force of 507 ± 124 N (52 kg). No statistically significant differences between groups 0 and 1 were found. The mean force required for failure in groups 2 and 3 was lower. Differences in the force required for failure between groups 2 and 3 and the control group was significant (P <0.05). Failure patterns were analyzed. The ZF plate tended to stretch predominantly in groups 1, 2, and 3, whereas it tended to break in group 0 (P = 0.005). The IOR plate demonstrated predictable screw failure in groups 2 and 3 (P = 0.007). For group 0, the ZF was the site of the majority of critical failures. For groups 2 and 3, the IOR was almost invariably the site of critical failure (P = 0.004). At the ZMB, there was no significant association between failure modes and it was rarely the site of critical failure, regardless of the method of fixation. However, the strength of fixation was proportional to the number of titanium plates used. Overall, the method of fixation significantly affected the force required for mechanical failure of ZMC fractures (P <0.0001). The presence of teeth significantly increases the force required for implant failure in ZMC fracture fixation when combinations of plates are used (P = 0.038). All combinations of titanium and resorbable plates may be sufficient to overcome the displacing forces produced by the masseter and may be used for internal fixation of isolated ZMC fractures in the adult.
Flight to Liquidity and Global Equity Returns

Investment practice and academic literature suggest a great degree of interaction between the world’s stock markets and most liquid and safe assets, such as U.S. Treasuries. Using data from 46 markets and a 30-year time period, we examine the impact of “flight-to-liquidity” events on global asset valuation. This wide cross-sectional and time-series sample provides a natural setting for analyzing the link between changes in the illiquidity of Treasuries and expected equity returns. Our illiquidity measure is the average percentage bid-ask spread of off-the-run U.S. Treasury bills with maturities of up to one year. We find that this proxy predicts stock market illiquidity and future equity returns in both developed and emerging markets. This predictive relation remains intact after controlling for various world and country-level variables. Asset pricing tests further reveal that Treasury bond illiquidity is a significantly priced factor even in the presence of other conventional risks, such as those of the world stock market, foreign exchange, local equity market variance and illiquidity, as well as the term spread. Our results indicate that flight-to-liquidity risk is an important determinant of returns in global equity markets.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1371 Health systems bottlenecks and evidence-based district health planning Experiences from the district health system in Uganda

Henriksson, D. K. 2017. Health systems bottlenecks and evidence-based district health planning. Experiences from the district health system in Uganda. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1371. 71 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-513-0066-5. In low-income countries where maternal and child mortality remains high, there is limited use of context-specific evidence for decision making and prioritization of interventions in the planning process at the sub-national level, such as the district level. Knowledge on the utility of tools and interventions to promote use of district-specific evidence in the planning process is limited, yet it could contribute to the prioritization of high-impact interventions for women and children. This thesis aims to investigate, in the planning process, the use of district-specific evidence to identify gaps in service delivery in the district health system in Uganda in order to contribute to improving health services for women and children. Study I evaluated the use of the modified Tanahashi model to identify bottlenecks for service delivery of maternal and newborn interventions. Study II and III used qualitative methods to document the experiences of district managers in adopting tools to facilitate the utilization of district-specific evidence, and the barriers and enablers to the use of these tools in the planning process. Study IV used qualitative methods, and analysis of district annual health work plans and reports. District managers were able to adopt tools for the utilization of district-specific evidence in the planning process. Governance and leadership were a major influence on the use of districtspecific evidence. Limited decision space and fiscal space, and limited financial resources, and inadequate routine health information systems were also barriers to the utilization of districtspecific evidence. Use of district-specific evidence in the planning process is not an end in itself but part of a process to improve the prioritization of interventions for women and children. In order to prioritize high impact interventions at the district level, a multifaceted approach needs to be taken that not only focuses on use of evidence, but also focuses on broader health system aspects like governance and leadership, the decision and fiscal space available to the district managers, limited resources, and inadequate routine health information systems.
Prospects of Treating Ocular Hypertension and Glaucoma with Peptidic and Non-Peptide Kinin Mimetic Drugs

At a simplistic level, our knowledge has advanced to a point where it is now clear that elevated intraocular pressure (IOP) results from a fundamental imbalance between the generation of aqueous humor by the ciliary body and its efflux from the anterior chamber of the eye via one of two pathways [1-3]. The most physiologically relevant mechanism of AQH drainage involves the IOP-dependent outflow via the trabecular mesh work (TM) and Schlemm’s canal (SC) route [1-3]. The lesser utilized pathways under normal conditions are the uveoscleral [1-3] and ocular lymphatic [4] pathways, but the latter can be engaged by certain drugs such as FP-class prostaglandin analogs (FPGAs) like latanoprost and tafluprost [1-6]. The chronically increased IOP, a condition generally termed as ocular hypertension (OHT), caused by blockage of the AQH drainage TM/SC pathways [7] during the aging process or due to ocular inflammation and deposition of various debris, along with apoptotic death of retinal ganglion cells, can lead to a clinically defined disease called glaucoma [8-10]. This high IOP initiates the death of RGCs and/or breakage of RGC axons at the back of the eye. These elements then cause a retrograde demise of the RGCs leading to severing of nerve fibers connecting the retina to the brain [11-13]. Many deleterious neurotoxic elements (e.g. high levels of extruded glutamate, endothelin, inflammatory cyto-and chemo-kines, noxious gases (e.g. nitric oxide; hydrogen sulfide)) and proteolytic enzymes (e.g. caspases and matrix metalloproteinases) released by activated macrophages [12-19], injured RGCs and interneurons are the culprits responsible for such neurotoxicity/chemically-induced axotomy of the RGCs. Hypoxia and ischemia [20,21] are also involved in the initiation phase of vascular dysfunction-induced death of RGCs since the thinning of the optic nerve at the level of the optic nerve head (ONH) forces the retinal blood vessels attached to the optic nerve to bend thereby restricting blood supply to the retina. While this progressive loss of RGCs occurs over several decades, if OHT is not treated to reduce the IOP the resulting glaucomatous optic neuropathy causes severe
Peroxisome Proliferator-Activated Receptor-γ Activator 15-Deoxy-Δ12,14-Prostaglandin J2 Inhibits Neuroblastoma Cell Growth through Induction of Apoptosis: Association with Extracellular Signal-Regulated Kinase Signal Pathway

Peroxisome proliferator-activated receptor-γ (PPAR-γ) ligands have been demonstrated to inhibit growth of several cancer cells. Here, we investigated whether one of the PPAR-γ ligands, 15-deoxy-Δ12,14-prostaglandin J2 (15-deoxy-PGJ2) inhibits cell growth of two human neuroblastoma cells (SK-N-SH and SK-N-MC) in a PPAR-γ-dependent manner. PPAR-γ was expressed in these cells, and 15-deoxy-PGJ2 increased expression, DNA binding activity, and transcriptional activity of PPAR-γ. 15-Deoxy-PGJ2 also inhibited cell growth in time- and dose-dependent manners in both cells. Cells were arrested in G2/M phase after 15-deoxy-PGJ2 treatment with concomitant increase in the expression of G2/M phase regulatory protein cyclin B1 but decrease in the expression of cdk2, cdk4, cyclin A, cyclin D1, cyclin E, and cdc25C. Conversely, related to the growth inhibitory effect, 15-deoxy-PGJ2 increased the induction of apoptosis in a dose-dependent manner. Consistent with the induction of apoptosis, 15-deoxy-PGJ2 increased the expression of proapoptotic proteins caspase 3, caspase 9, and Bax but down-regulated antiapoptotic protein Bcl-2. 15-Deoxy-PGJ2 also activated extracellular signal-regulated kinase (ERK) 2. In addition, mitogen-activated protein kinase kinase (MEK) 1/2 inhibitor PD98059 (2′-amino-3′-methoxyflavone) decreased 15-deoxy-PGJ2-induced ERK2 activation, and expression of PPAR-γ, capase-3, and cyclin B1. Moreover, MEK1/2 inhibitor PD98059 significantly prevented against the 15-deoxy-PGJ2-induced cell growth inhibition. We also found that PPAR-γ antagonist GW9662 (2-chloro-5-nitro-N-phenylbenzamide) reversed the 15-deoxy-PGJ2-induced cell growth inhibition, PPAR-γ expression, and activation of ERK2. These results demonstrate that 15-deoxy-PGJ2 inhibits growth of human neuroblastoma cells via the induction of apoptosis in a PPAR-γ-dependent manner through activation of ERK pathway and suggest that 15-deoxy-PGJ2 may have promising application as a therapeutic agent for neuroblastoma.
Introspectiveness and adolescent symptom reporting.

A new measure of introspectiveness--the tendency to devote diffuse attention to thoughts and feelings about the self--was used to investigate adolescent symptom reporting. Introspectiveness was correlated with psychological distress (r = .40) and with physical symptoms (r = .27) in a random sample of college freshmen, and remained the strongest correlate of distress and symptoms when controlling for a variety of other measures. Women, Jews, and certain Hispanic groups were higher on introspectiveness than other students. An unanticipated, but possibly significant, result was that economic discontinuities and discontinuities involving significant others had markedly different relationships with health. Strong associations between perceptions of parental characteristics, adolescent introspectiveness, and health suggested the importance of socialization processes for understanding distress and symptoms. Finally, measures of emotional sensitivity and time spent alone were associated with introspectiveness and symptom reporting. Taken together, these findings suggest the importance of introspectiveness and its correlates for understanding the processes leading to adolescent symptom reporting.
Variability in the Prescription of Cholinesterase Inhibitors and Memantine

Background/Aim: To estimate the prevalence of Alzheimer’s disease (AD) treatment in Aragon (Spain), analyzing differences according to age, gender and health area. Methods: Retrospective study on AD treatment prevalence of cholinesterase inhibitors and memantine during 2005, using pharmaco-epidemiological data from prescription refunds transferred monthly from pharmacies to the Health Care Service. Results: Differences between health areas were considerable, with adjusted prescription rates between 121.6 and 248.6/100,000 individuals. Treatment rates for women doubled those of men in each health area. Variability was greater among men than women. Drug prescription distribution was also different between health areas. Conclusion: Considerable variability in AD treatment has been detected. More consensus is needed to reduce variability in order to improve the quality of the pharmacotherapy for AD and assure equal treatment opportunities for every patient.
Dietary fish oils modify adipocyte structure and function

Dietary fish oils, enriched with w‐3 fatty acids (e.g., MaxEPA fish oil), inhibit lipogenesis and have a marked hypotriglyceridemic effect in man and experimental animals. Dietary w‐3 fatty acids also reduce adipose tissue trophic growth in rats. To understand the metabolic basis for this, we measured the effect of fish oil feeding upon rat plasma triglyceride concentration, fat pad mass, fat cell size, fat cell lipolysis, as well as lipoprotein binding to adipocyte plasma membranes. In adolescent (250 g) male Wistar rats fed 20% (w/w) fish oil supplemented diets for 3 weeks, plasma triglyceride levels and epididymal and perirenal fat pad mass were significantly (P<0.005) reduced compared to pair‐fed controls given 20% lard diets. These differences in fat pad mass between the diets were greater than differences in whole animal mass or in the mass of livers, testes, kidneys, spleens, or hearts. Isoproternol‐stimulated lipolvsis was significantly (P < 0.005) higher in fish oil fed rats than in pair‐fed controls. In young (100 g) rats plasma triglyceride levels were 10 times lower in the fish oil fed group after 5 weeks as compared to the lard‐fed controls. This was accompanied by a reduction in epididymal and perirenal fat pad mass as well as a 2‐3‐fold decrease in adipocyte volumes; there was no significant difference between the two groups in fat cell number in each region. Plasma membranes of epididymal adipocytes from fish oil fed rats bound significantly (P < 0.001) less HDL1 than the lard‐fed rats, possibly as a result of a reduction in fat cell size and/or alteration of plasma membrane structure. Thus in both young and old rats, the reduction in plasma triglyceride concentration in conjunction with increased hormone‐stimulated lipolysis may explain in part the selective reduction in adipose tissue trophic growth accompanying fish oil consumption.