Miracle-dz/UniFAR-FTUs huggingface dataset:
Microbiology of Otitis Media

The microbiology of otitis media (OM) has been documented by cultures of middle ear fluid (MEF) obtained by needle aspiration. The results of studies of bacteriology of OM from Sweden, Finland and the United States are very similar: Streptococcus pneumoniae and Haemophilus influenzae are the most important pathogens: Gram-negative enteric bacilli are isolated from MEF of ≅ 20% of infants to six weeks of age but are rarely present in MEF of older children; group A beta hemolytic streptococcus and Staphylococcus aureus are infrequent causes of otitis. Preliminary results suggest that anaerobic bacteria are responsible for some episodes of OM. Although epidemiologic data suggest that virus infection is associated with OM, the results of ten studies indicate that these agents are infrequently isolated from MEF of children with OM. Viruses were isolated from 29 of 663 patients (4.4%). Respiratory syncytial virus and influenza virus were isolated most frequently. The results of seven studies of mycoplasma infection in 771 patients with OM included only one isolation of Mycoplasma pneumoniae from MEF. These results indicate that viruses and mycoplasmas are uncommonly found in MEF of patients with OM, but few studies have been attempted in recent years. Chlamydia trachomatosis is the etiologic agent of a mild but prolonged pneumonia in infants. OM may accompany the respiratory infection, and C. trachomatis has been isolated from MEF of some of these infants. Recent studies of asymptomatic children with persistent MEF indicate that bacterial pathogens are present in some of these fluids. Investigators in Columbus, Boston, and Pittsburgh obtained MEF for culture at the time of myringotomy or placement of tympanostomy tubes. Bacteria were isolated from MEF of 50% of these children; S. pneumoniae, H. influenzae, or group A streptococcus were isolated from 10% to 20% of cases. There were only minimal differences in the rates of isolation of bacteria from serous, mucoid, or purulent fluids. The significance of these results is uncertain, but they suggest that the persistent effusion may be a result of asymptomatic but prolonged infection or may be an immune response to a persisting antigen.
Synthesis and Anti-Proliferative Effects of Quercetin Derivatives

Prostate cancer is the most common diagnosed invasive cancer in American men and is the second leading cause of cancer-related deaths. Although there are several therapies successful in treating early, localized stage prostate cancer, current treatment of advanced metastatic castration-resistant prostate cancer remains ineffective due to inevitable progression of resistance to first-line treatment with docetaxel. The natural product quercetin (3,3′,4′,5,7-pentahydroxyflavone), a flavonoid compound ubiquitous in dietary plants, possesses evidenced potential in treating advanced metastatic castration-resistant prostate cancer. However, its poor bioavailability and moderate potency hinder its advancement into clinical therapy. In order to engineer quercetin derivatives with improved potency and pharmacokinetic profiles for the treatment of advanced metastatic prostate cancer, we started this study with creating a small library of alkylated derivatives of quercetin for in vitro evaluation. The biological data and chemical reactivity of quercetin and its derivatives reported in literature directed us to design 3,4′,7-O-trialkylquercetins as our first batch of targets. Consequently, nine 3,4′,7-O-trialkylquercetins, together with four 3,7-O-dialkylquercetins, four 3,3′,4′,7-tetraalkylquercetins, and one 3,3′,4′-O-trialkylquercetin, were prepared by one step O-alkylation of commercially available quercetin mediated by potassium carbonate. Their structures were determined by 1D and 2D NMR data, and HRMS. Their anti-proliferative activities towards both androgen-refractory and androgen-sensitive prostate cancer cells were evaluated using WST-1 cell proliferation assay. The acquired structure-activity relationships indicate that 3,7-O-dialkylquercetins rather than 3,4′,7-O-trialkylquercetins were much more potent than quercetin towards prostate cancer cells.
#BlackLiteracyLivesMatter: REVEALING AFRICAN AMERICAN ADOLESCENTS’ MULTIMODAL LITERACY PRACTICES IN ONLINE SOCIAL NETWORKS AT A COMMUNITY CENTER

Title of dissertation: #BlackLiteracyLivesMatter: REVEALING AFRICAN AMERICAN ADOLESCENTS’ MULTIMODAL LITERACY PRACTICES IN ONLINE SOCIAL NETWORKS AT A COMMUNITY CENTER Kelsey Lynne Anderson Pope, Doctor of Philosophy, 2016 Dissertation directed by: Dr. Jennifer D. Turner Associate Professor, Reading Education Department of Teaching and Learning, Policy and Leadership This study investigated the multimodal literacy practices of African American adolescents as they navigated online social networks. Participants ranged from ages 13 to 17 and resided in an inner city East Coast neighborhood. Data collection tools included an online social network survey, online social networking activities log, audio recorded literacy interviews, and screenshots. Pieces of data were carefully analyzed and coded for potential literacy practices. The study revealed four distinct literacy practices of this particular group of African American adolescents: communication, entertainment, information gathering, and taking a stance. Participant data defined each multimodal literacy practice while explaining how and why skills and experiences combined to create the practice. Engagement in online social networks involved these multimodal literacy practices. Often they involved interactions with peers and family members. Participants did not readily compare their multimodal online social network literacy practices to traditional forms of literacy, however, they used traditional words such as reading, writing, and spelling to explain their skills and experiences. Literacy was brought to life in a unique way through the words and multiple modes of communication, entertainment, information gathering, and stance taking of participants. This study questions ‘what’ and possibly ‘whose’ literacy counts. Technology and its affordances allowed participants to engage in practices through multiple modes. Additionally, this group of African American adolescents exposed an avenue through which race related injustices and tensions might be expressed through multimodal literacy practices in online social networks. The results of this study encourages future research to examine what literacy counts, whose literacy counts, and how or why adolescents engage through literacy practices. #BlackLiteracyLivesMatter
Special Issue: International Perspectives on Corporate Social Responsibility

This conceptual paper seeks to explain the study of corporate social responsibility (CSR) against its recent historical past, in part by examining major factors giving rise to CSR and its diffusion in contemporary corporate practice. In doing so, it highlights some of the principal arguments for and against CSR, as well as identifies some of the tensions and dilemmas facing managers seeking to implement more socially responsible practices in the midst of common pressures to ensure firm financial performance. While many of these challenges are arguably shared across different national settings, there is far less awareness of how these realities are experienced in developing countries. This collection of papers provides some empirical evidence to address this gap.
EuroSCORE II underestimates mortality after cardiac surgery for infective endocarditis.

OBJECTIVES To better select for patients who most likely will benefit from cardiac surgery among those with infective endocarditis (IE), we aimed to identify preoperative markers associated with poor outcome after cardiac surgery for IE, and to evaluate the accuracy of European System for Cardiac Operative Risk Evaluation (EuroSCORE) II to predict mortality. METHODS We enrolled all adult patients who underwent cardiac surgery during the acute phase of definite IE (Duke Criteria) in two referral centres for cardiac surgery. Patients were identified through intensive care unit (ICU) electronic databases, and data were collected from medical charts on standardized questionnaire. RESULTS Between 2002 and 2013, 149 patients (117 males), with a median age of 64 years [interquartile range 52-73], fulfilled the inclusion criteria. Main complications before surgery were left ventricular dysfunction (23%), central nervous system symptomatic events (34%) and septic shock (24%). Most patients (95%) presented with valve regurgitation, and 49% had perivalvular abscess. Surgery was performed with a median delay of 12 days [5-24] after IE diagnosis, and mean EuroSCORE II was 15.8 (13.4-18.1). In-hospital mortality was 21%. Preoperative variables associated with mortality in multivariate analysis were obesity [odds ratio (OR) 3.67 [1.10-12.19], P = 0.03], vegetation >15 mm (OR 6.72 [1.46-30.98], P = 0.01), septic shock (OR 4.87 [1.67-14.28], P = 0.004) and mechanical prosthetic valve IE (OR 4.99 [1.72-28.57], P = 0.007). EuroSCORE II underestimated mortality in patients with predicted mortality over 10%. CONCLUSION Factors independently predictive of mortality after cardiac surgery for IE are obesity, septic shock, large vegetation and a mechanical prosthetic valve IE. EuroSCORE II underestimates post-cardiac surgery mortality in patients with IE.
A meta-analysis review of revision stapes surgery with argon laser: effectiveness and safety.

OBJECTIVE To determine whether there is an advantage in safety and outcome efficacy with the use of argon laser in revision stapes surgery as compared with conventional instruments. DATA SOURCES A search of the published English-language literature, 1970-1995, was conducted using the following key words: revision, surgery, stapes, laser, stapedotomy, and argon laser. STUDY SELECTION The following inclusion criteria were used to select articles for the meta-analysis: revision cases only, a comprehensive review of intraoperative pathological findings that led to the failure, and accurate documentation by the author, confirmed by our statisticians using a modified chi 2 test. Eleven studies without the use of the laser (n = 1,147 patients) and four studies with the use of the laser (n = 170 patients) including our own patients (n = 23) were entered into the model. DATA EXTRACTION The data had to meet strict audiometric criteria, including preoperative and postoperative audiogram pure tone average air-bone gap; postoperative audiograms had to include five classifications, and these audiograms had to be obtained a minimum of 6 months after revision surgery. DATA SYNTHESIS A log-linear model was developed for this meta-analysis study, with each study analyzed individually and collectively. CONCLUSION Revision stapes surgery using the laser demonstrated statistically significant (p = 0.002) advantage in both safety and efficacy over revision procedures using conventional instruments.
The mediating role of quality on the relationship between cultural ambidexterity and innovation performance

Firms’ competencies and competitive advantages erode and are required to continually update and change through learning. Organisational learning is a prerequisite for the creation and acquisition of knowledge, both catalysts for innovation. There are two processes of learning, exploitation (incremental) and exploration (discontinuous). Organisational excellence can in part be achieved by ambidexterity, that is, by the balanced pursuit of both incremental and discontinuous change by organisations. An ambidextrous organisational culture can be an important factor for a firm’s innovation capability. Thus, factors affecting organisational culture towards learning may advance innovative capability. Quality also plays an important role to knowledge creation and innovation behaviour. Indeed, knowledge management can improve innovation performance via total quality management practices. Quality, then, may serve as a mediator between organisational learning culture and innovation outcomes. Using the Organization's for Economic Cooperation and Development and European Union established criteria for technological intensity, as well as knowledge – intensity criteria, 480 Greek mid-to-high technology and Small and Medium Enterprises (SMEs) were contacted with 54 eventually participating. Statistical analysis (partial least squares-structural equation modeling) confirms the mediating role of the quality competitive capability on the association between exploitation and exploration-oriented organisational cultures and innovation performance. The study is cross-sectional, thus causality of the relationships under investigation cannot be justified. The cultural context should also be considered, since field research was conducted in Greece suffering from deep financial recession. The importance of quality competitive capability, in order to interpret organisational ambidexterity into innovative action in mid-to-high technology Greek SMEs during the financial crisis, guides managerial implications.
Influence of support boots on fetlock joint angle of the forelimb of the horse at walk and trot.

REASONS FOR PERFORMING STUDY Support boots are thought to reduce tension on the superficial digital flexor tendon (SDTF) of the horse and are frequently recommended for horses convalescing after tendonitis, but evidence of their effectiveness is conflicting. OBJECTIVE To document the effects of 4 different types of support boots on fetlock joint angle in comparison to the unprotected fetlock. METHODS In 26 horses, the kinematics of the forelimb fetlock joint angle was measured at walk and trot on a treadmill when wearing 3 different types of support boots and 1 protective boot, as well as without boots. As outcome parameters, maximum extension of the fetlock joint and the moment at which maximum extension occurred in the stride cycle were determined. RESULTS At walk, 2 of the support boots reduced the maximum extension significantly by 0.8 and 0.9 degrees, respectively (P<0.05). Additionally, one type of boots also delayed the occurrence of maximal extension within the stride cycle. At trot, all support boots reduced maximum extension significantly by 0.56-1.44 degrees (P<0.01), and the protective boot reduced maximum extension by 0.56 degrees (P<0.05). CONCLUSIONS AND POTENTIAL RELEVANCE The results demonstrate the effectiveness of support boots in reducing maximum extension of the fetlock, which can be assumed to reduce tension in the suspensory apparatus and SDFT. The delay of the moment of maximal extension may be relevant in reducing dynamic forces. However, it should be noted that the long-term consequences of reduction of maximum fetlock extension are still uncertain. Such a reduction over a prolonged period might negatively affect fibre alignment in the healing tendon.
Still Not Cheap: Portfolio Protection in Calm Markets

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Stable Phenotypic Changes of the Host T Cells Are Essential to the Long-Term Stability of Latent HIV-1 Infection

ABSTRACT The extreme stability of the latent HIV-1 reservoir in the CD4+ memory T cell population prevents viral eradication with current antiretroviral therapy. It has been demonstrated that homeostatic T cell proliferation and clonal expansion of latently infected T cells due to viral integration into specific genes contribute to this extraordinary reservoir stability. Nevertheless, given the constant exposure of the memory T cell population to specific antigen or bystander activation, this reservoir stability seems remarkable, unless it is assumed that latent HIV-1 resides exclusively in memory T cells that recognize rare antigens. Another explanation for the stability of the reservoir could be that the latent HIV-1 reservoir is associated with an unresponsive T cell phenotype. We demonstrate here that host cells of latent HIV-1 infection events were functionally altered in ways that are consistent with the idea of an anergic, unresponsive T cell phenotype. Manipulations that induced or mimicked an anergic T cell state promoted latent HIV-1 infection. Kinome analysis data reflected this altered host cell phenotype at a system-wide level and revealed how the stable kinase activity changes networked to stabilize latent HIV-1 infection. Protein-protein interaction networks generated from kinome data could further be used to guide targeted genetic or pharmacological manipulations that alter the stability of latent HIV-1 infection. In summary, our data demonstrate that stable changes to the signal transduction and transcription factor network of latently HIV-1 infected host cells are essential to the ability of HIV-1 to establish and maintain latent HIV-1 infection status. IMPORTANCE The extreme stability of the latent HIV-1 reservoir allows the infection to persist for the lifetime of a patient, despite completely suppressive antiretroviral therapy. This extreme reservoir stability is somewhat surprising, since the latently HIV-1 infected CD4+ memory T cells that form the structural basis of the viral reservoir should be exposed to cognate antigen over time. Antigen exposure would trigger a recall response and should deplete the reservoir, likely over a relatively short period. Our data demonstrate that stable and system-wide phenotypic changes to host cells are a prerequisite for the establishment and maintenance of latent HIV-1 infection events. The changes observed are consistent with an unresponsive, anergy-like T cell phenotype of latently HIV-1 infected host cells. An anergy-like, unresponsive state of the host cells of latent HIV-1 infection events would explain the stability of the HIV-1 reservoir in the face of continuous antigen exposure.
Treatment with 5-Fluorouracil Enhances Radiosensitivity of the Human Pancreatic Cancer Cell Line MiaPaCa-2

Background and Purpose: Several clinical studies have suggested that the combination of radiation therapy and 5-fluorouracil (5-FU) may improve outcome of patients with pancreatic cancer. However, there are few experimental studies supporting this treatment. Aim of the Study: To examine the radiosensitivity of human pancreatic cancer cells and its modulation by 5-FU. Material and Methods: MiaPaCa-2, PANC-1 and NP-18 cells growing as monolayer culture were treated with radiation and 5-FU. In addition, 5-FU was studied administered either pre- or postradiation, both as pulse or continuous exposure. Cell survival was determined by the in vitro clonogenic assay. Results: In MiaPaCa-2 cell line, both radiation and 5-FU alone reduced cell survival. The addition of 5-FU to radiation caused a significant net decrease of cell survival. Pulse exposure of 5-FU decreased survival after 2 Gy and mean inactivation dose by 1.64; continuous exposure decreased survival after 2 Gy and mean inactivation dose by about 2.4. Timing of 5-FU exposure did not modify survival. However, when adjusting for 5-FU killing effect and cell multiplicity, only continuous exposure significantly enhanced radiation cell killing. Conclusion: Both pulse and continuous exposure increase radiation cell killing, but only continuous exposure may radiosensitize MiaPaCa-2 cells.
Gastropancreatic ligament: Description, incidence, and involvement during laparoscopic sleeve gastrectomy

During laparoscopic sleeve gastrectomy (LSG), adhesions between the stomach and the pancreas are sometimes found, forming a “gastropancreatic ligament” (GPL). However, the GPL has only been described once in the literature, in 1985. The objective of this study was to determine the incidence of the GPL during LSG, describe this structure and assess its effect on the surgical technique. All patients undergoing primary LSG in our institution (n = 240) and patients referred for gastric fistula (GF) after primary LSG (n = 18) between January 2015 and December 2015 were included. The primary endpoint was the incidence of a GPL during primary LSG. The secondary endpoints were the postoperative complication rate, the postoperative GF rate, and the presence of this ligament during reoperation for GF. Among the 240 patients, a GPL was visible in 49 cases (20.4%) and was described as thin in 34 of these (69.4%). Twelve postoperative complications (5%) were observed, including seven major (2.9%). The GF rate was 2% (n = 5), not requiring reoperation. The gastric stenosis rate was 0.4% (n = 1). The GPL had been previously sectioned in one of the five patients (20%) with postoperative GF. During the study period, 18 patients were referred for GF and 14 were reoperated. A non‐sectioned GPL, not described in the operating report, was observed in four patients (28.5%). A GPL was identified in 20.4% of cases. Identification of a GPL could be important in the context of LSG, as section of the ligament allows tension‐free stapling to be performed and can therefore possibly reduce the risk of postoperative complications, particularly GF. Clin. Anat. 30:336–341, 2017. © 2017 Wiley Periodicals, Inc.
Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation.

AIMS AND OBJECTIVES To describe the change in documentation of the nursing process in all inpatient wards in a 900-bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? BACKGROUND Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well-being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. DESIGN AND METHOD A cross-sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post-test (n = 349 nursing records) to obtain data on nursing documentation. The year-long intervention comprised planned work in groups, and educational and supporting efforts. RESULTS A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. CONCLUSION At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.