Miracle-dz/UniFAR-FTUs huggingface dataset:
Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their Clostridium difficile infection (CDI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion. 1. Increasing rates of CDI C. difficile now rivals methicillin-resistant Staphylococcus aureus (MRSA) as the most common organism to cause healthcare-associated infections in the United States. a. In the United States, the proportion of hospital discharges in which the patient received the International Classification of Diseases, Ninth Revision discharge diagnosis code for CDI more than doubled between 2000 and 2003, and CDI rates continued to increase in 2004 and 2005 (L. C. McDonald, MD, personal communication, July 2007). These increases have been seen in pediatric and adult populations, but elderly individuals have been disproportionately affected. CDI incidence has also increased in Canada and Europe. b. There have been numerous reports of an increase in CDI severity. c. Most reports of increases in the incidence and severity of CDI have been associated with the BI/NAP1/027 strain of C. difficile. This strain produces more toxins A and B in vitro than do many other strains of C. difficile, produces a third toxin (binary toxin), and is highly resistant to fluoroquinolones.
Health-related quality of life and cancer clinical trials

The measurement of patient-reported outcomes, including health-related quality of life, is a new initiative which has emerged and grown over the past four decades. Following the development of reliable and valid self-report questionnaires, health-related quality of life has been assessed in tens of thousands of patients and a wide variety of cancers. This review is based on a selection of data published in the last decade and is intended primarily for healthcare professionals. The assessments in clinical trials have been particularly useful for elucidating the effects of various cancers and their treatments on patients’ lives and have provided additional information that enhances the usual clinical endpoints used for determining the benefits and toxicity of treatment. With growing experience the quality of the health-related quality of studies has improved and, in general, recent studies are more likely to be methodologically robust than those that were performed in earlier decades. Health-related quality of life has become a more accurate predictor of survival than some other clinical parameters, such as performance status. The overall outlook for the routine assessment of patient-reported outcomes in clinical trials is assured and, eventually, it is likely to become a standard part of clinical practice. However, there is still a need for a clear method for determining the clinical meaningfulness of changes in scores. The answer will probably come from the greater use of patient-reported outcomes and the consequent growth of experience that is necessary to make such judgements.
Evidence of Pathogenic Subgroups among Atypical Enteropathogenic Escherichia coli Strains

ABSTRACT We describe the characterization of 126 atypical enteropathogenic Escherichia coli (aEPEC) isolates from 1,749 Brazilian children. Classic aEPEC strains were more frequently found in children with diarrhea than in controls (P < 0.001), showing their importance as acute diarrhea agents in our country. Only aEPEC strains carrying either the ehxA or paa gene were significantly associated with diarrhea.
Leukotriene receptor antagonists in the treatment of asthma: an update

Leukotriene receptor antagonists (LTRAs), such as montelukast and zafirlukast, have been demonstrated in a number of studies to possess bronchodilating and anti‐inflammatory properties, that make these drugs ideal candidates for the treatment of asthma. The last 1998‐updating of the GINA Guidelines for the diagnosis and therapy of asthma recommends the use of LTRAs in the treatment of moderate and mild asthma. In patients with moderate asthma not completely controlled with moderate doses of inhaled corticosteroids, the addition of a LTRA is indicated in alternative to either the increase of the inhaled corticosteroid dose or the addition of an inhaled long‐acting beta2‐agonist. Both in vitro and in vivo evidences indicate that LTRAs possess an anti‐inflammatory activity that is presumably complementary to that presented by corticosteroids. Moreover, clinical studies show that the addition of an LTRA, montelukast, is able to improve clinical and functional indexes in patients with asthma not controlled with inhaled corticosteroids, and to allow a reduction in corticosteroid dosage in patients with asthma well controlled by inhaled corticosteroids. In patients with mild persistent asthma monotherapy with an LTRA is indicated in alternative to a low‐dose inhaled corticosteroid, an inhaled cromone, or an oral slow‐release theophylline. Previous clinical studies in patients with mild to moderate asthma had demonstrated that monotherapy with LTRAs is able to improve airway function, asthma symptoms, use of as‐needed medications, exacerbation rate, and quality of life, without evidence of tolerance with prolonged use. Recently, in a subgroup analysis of patients with mild persistent asthma, a 6‐week treatment with oral montelukast or inhaled beclomethasone gave similar improvements in ‘rescue‐free’ days, days with well controlled asthma, FEV1, blood eosinophils, beta‐agonist use, and nocturnal awakes due to asthma.
Levobupivacaine versus bupivacaine in epidural anesthesia for cesarean section. Comparative study.

BACKGROUND AND OBJECTIVES Local anesthetic bupivacaine is found in two different enantiomers: levobupivacaine - S (-) and dextrobupivacaine - R (+). Based on studies showing that S(-) enantiomers are less cardiotoxic, their use has been increasing in clinical practice. This study aimed at comparing racemic bupivacaine and levobupivacaine in epidural anesthesia for elective cesarean section. METHODS Randomized, double blind clinical trial enrolling physical status ASA I and II parturients. Patients were assigned to receive either 20 mL of 0.5% racemic bupivacaine or 20 mL of 0.5% levobupivacaine, both with 10 microg sufentanil and epinephrine 1:200,000. RESULTS Participated in this study 47 patients being 24 in the levobupivacaine group and 23 in the bupivacaine group. Both groups were comparable regarding maternal-fetal characteristics. Fifteen minutes after epidural anesthesia, 62.5% of levobupivacaine group patients experienced Bromage 2 or 3 motor block, whereas the same event was documented in 72.7% of bupivacaine group patients (p = 0.83). After 20 minutes, 66.7% of levobupivacaine group patients experienced Bromage 2 or 3 motor block versus 86.3% of bupivacaine group patients (p = 0.21). Most common complication was hypotension, detected in 16 (66.7%) levobupivacaine group patients and in 10 (43.5%) bupivacaine group patients (p = 0.11). CONCLUSIONS Levobupivacaine and bupivacaine were equally effective for epidural block in patients undergoing cesarean section.
Frontal lobe connections of the superior temporal sulcus in the rhesus monkey

The frontal lobe connections of different architectonic areas of the superior temporal sulcus (STS) in the rhesus monkey were investigated with the aid of both anterograde and retrograde tracing techniques. The proisocortical area in the rostralmost STS connects with proisocortical regions on the ventral and medial surfaces of the frontal lobe. The frontal lobe projections of polymodal cortex (area TPO) in the upper bank of the STS are organized according to the rostral‐to‐caudal topography of the sulcus. Rostral TPO interconnects with ventral (areas 13, 12, 11, and 14), medial (areas 24, 32, 14, and 9), and lateral (areas 10, 12, and 46) sectors of the frontal lobe. The midportion of polymodal cortex projects to, and receives fibers from, rostral subdivisions of lateral prefrontal cortex, viz. dorsal area 46, areas 9 and 10, whereas the caudal segment of TPO has reciprocal connections with caudal subdivisions (areas 46, 8, and 6) of the lateral frontal lobe.
Evaluating Competency Enhancement Needs of Lecturers for Quality Teaching and Learning in South-East Universities of Nigeria

This study was a quest aimed at evaluating competency enhancement needs of lecturers for quality teaching and learning in South-East universities of Nigeria. Reviewed literatures revealed that there is a steady decline in the quality of university graduates; as such the researchers sought to find out possible inputs that could enhance and guarantee quality instructional delivery in our universities in particular and other tertiary institutions in general. The study adopted the survey research design and randomly sampled 372 respondents from six universities (3 federal and 3 states) who are academic staff. The results of data analysis using simple percentages and contingency Chi-square statistical analysis technique at 95% confidence interval revealed that above 90% of male and female lecturers opined that teaching staff are in dare need of competency enhancement inputs such as regular training workshops and conferences (local and international), functional ICT units for staff and students, inter and intra collaborative teaching experience amongst institutions within and outside the country for cross fertilization of ideologies and skills, and regular up-grading of teaching and learning facilities. The need for proactive funding of tertiary education was recommended. More so, the administrative echelons of higher institutions in Nigeria were encouraged to devise mechanisms of ensuring an updated pool of academic staff for qualitative pedagogical delivery.
The Nuclear Gasdynamics and Star Formation of NGC 7469

We report interferometric radio CO 2-1 and HCN 1-0 observations at resolutions of 0. ″7 and 2. ″0, respectively, and 0. ″085 resolution adaptive optics K-band spectroscopy, including H2 1-0 S(1) line emission and CO 2-0 stellar absorption, of the inner few arcseconds of NGC 7469. The CO 2-1 map shows a ring of molecular clouds (which in general lie outside the compact knots seen in K-band images) and a bright extended nucleus, with a bar or pair of spiral arms between them. The dynamical structure of both the radio CO 2-1 and the K-band H2 1-0 S(1) lines at their different resolutions can be reproduced using a single axisymmetric mass model comprising three components: a broad disk, a ring 4''-5'' across, and an extended nucleus, which we interpret as an inner nuclear ring about 0. ″5 across. The velocity residuals between the model and the data have a standard deviation of 25 km s-1, and no noncircular motions faster than this are seen, although this may be because in some cases a secondary bar is not expected to cause gas inflow. From the dynamical mass and estimates of the stellar mass we find that the CO-to-H2 conversion is 0.4-0.8 times that for the Milky Way, following the trend to small factors that has been reported for intense star-forming environments. The central H2 1-0 S(1) morphology has a strong peak at the nucleus, but this does not trace the mass distribution; the rotation curves indicate that there is no strong nuclear mass concentration. The origins of the 1-0 S(1) emission are instead likely to lie in X-ray and UV irradiation of gas by the active galactic nucleus rather than via processes associated with star formation. Using the 2.3 μm stellar CO 2-0 band head absorption and the slope of the continuum, we have directly resolved the nuclear star cluster to be 0. ″15-0. ″20 across and find that it is asymmetric. This cluster has an age of less than about 60 Myr and contributes 20%-30% of the nuclear K-band light and about 10% of the nuclear bolometric luminosity. Within a radius of ~4'' gas contributes more than half the total mass, but in the nucleus, within a radius of 0. ″1, it is likely that most of the mass is due instead to stars.
Methylation of HACE1 in gastric carcinoma.

BACKGROUND We recently examined the methylation status of the HACE1 gene in primary carcinomas derived from 32 patients with colorectal cancer. A significant increase was observed in the maximal tumor size of the tumors with methylated HACE1 (p=0.0304). Moreover, a trend was shown toward preferentially developing lymph node metastasis in the carcinomas with methylated HACE1 (p=0.0612), suggesting that HACE1 might present a malignant potential in colorectal cancer. These results prompted us to examine the methylation status of the HACE1 gene in gastric carcinomas. MATERIALS AND METHODS The methylation status of the HACE1 gene was examined in primary carcinomas and the corresponding normal tissues derived from 34 patients with gastric carcinoma using quantitative methylation-specific PCR (qMSP) and the correlation between the methylation status and the clinicopathological findings was evaluated. RESULTS An aberrant methylation of the HACE1 gene was detected in 9 out of 34 (26%) primary gastric carcinomas. Subsequently, clinicopathological data were tested for correlation with the methylation score. A significant difference was observed in patient gender (p=0.0429). CONCLUSION HACE1 was frequently methylated in gastric carcinoma derived from male patients.
Effect of DL-alpha-lipoic acid on neural antioxidants in aged rats.

The effect of DL-alpha-lipoic acid on lipid peroxidation and antioxidants were evaluated in various brain regions of young and aged rats. In aged rats, the levels of ascorbic acid, alpha-tocopherol and glutathione were low whereas the lipid peroxidation rate, as revealed by malonaldehyde content, was found to be high. Lipoic acid, an antioxidant, was administered intraperitoneally (100 mg/kg body weight/day) for 7 and 14 days. Lipoate-administered aged rats brought about reduction in lipid peroxidation and elevation in the levels of antioxidants. The modulatory effect of lipoate in decreasing age-associated alterations observed in our study proves its role as a potent antioxidant in the brain of aged rats.
Effect of photoemission from electrode on photo-stimulated discharge spectra

Photo-stimulated discharge (PSD) method is a direct and powerful method to obtain the charge trap depths in polymeric materials. However, PSD spectra are induced not only by the de-trapping space charges in the film but also by the photoemission from electrodes or polymer. Therefore, the study on the photoemission mechanisms in PSD measurement is of great significance for correctly interpreting the PSD spectra. In this study, monochromatic light irradiates the polypropylene film which is covered by deposited finger or solid electrodes (Au or Al). The measurements are carried out when the sample is under different DC voltages. It is found that, when the sample has solid Au electrodes on its both sides, the photocurrent peak positioned at 320 nm is due to the photo-stimulated de-trapping charges in polypropylene and that the peak positioned at 270 nm generates not only from photo-stimulated de-trapping charges but also partially from photoemission from electrode when solid Au electrodes are used.
Assessment of 2 Cervical Screening Methods in Mongolia: Cervical Cytology and Visual Inspection with Acetic Acid

Objective. The aim of the study was to evaluate the test parameters of visual inspection with acetic acid (VIA) and cervical cytology in 3 Mongolian aimags. Methods. From February 18, 2002, to December 12, 2004, sexually active women, 30 years or older who had never been screened, underwent cervical cytology and VIA in the aimags' central hospital. Women with abnormal test results and 5% of women with normal results were recommended to have colposcopy with or without biopsy. Results. Two thousand nine women underwent both tests. Visual inspection with acetic acid was abnormal in 254 (12.6%); Pap smear showed atypical squamous cells of undetermined significance or worse in 3%. Using cervical intraepithelial neoplasia 2 or higher disease on biopsy as the end point, the test parameters for VIA are sensitivity of 82.9% (95% CI = 81.3%-84.5%), specificity of 88.6% (95% CI = 87.2%-90.0%), positive predictive value of 12.2% (95% CI = 10.8%-13.6%), and negative predicative value of 99.7% (95% CI = 99.5%-99.9%). The test parameters for Pap smear are sensitivity of 88.6% (95% CI = 87.2%-90.0%), specificity of 98.5% (95% CI = 98.0%-99.0%), positive predictive value of 51.7% (95% CI = 49.5%-53.9%), and negative predicative value of 99.8% (95% CI = 99.6%-100%). Conclusion. Visual inspection with acetic acid has an acceptable test parameter for population-based cervical screening in Mongolia.
Coagulase-negative staphylococci and the epidemiological typing of Staphylococcus epidermidis.

INTRODUCTION. 126 HISTORY. 126 CLASSIFICATION. 127 EPIDEMIOLOGICAL TYPING OF S. EPIDERMIDIS . 131 Antibiograms and Biotyping. 131 Phage Typing. 132 Serotyping. 133 Molecu lar Analysis of Plasmids. 133 Plasmid profiles. 134 Restriction enzyme analysis and nucleic acid hybridization . 134 Slime Production . 134 CONCLUSIONS. 134 ACKNOWLEDGMENT . o o. o o. 135 LITERATURE CITED. 135
Genetic evidence for ubiquitin‐specific proteases USP24 and USP40 as candidate genes for late‐onset Parkinson disease

Linkage studies have defined susceptibility regions for late‐onset Parkinson disease (PD) on chromosomes 1 and 2, but specific genetic variants have not been definitively identified. Here we report the results of a case‐control study to identify disease‐associated single nucleotide polymorphisms (SNPs) in these loci. In the initial phase of our study, we genotyped two putative functional SNPs in ubiquitin‐specific protease 24 (USP24), a biological candidate gene within the chromosome 1 linkage region, and scanned the chromosome 2 linkage peak with 43 SNPs in a sample set of 224 PD cases and 186 matched controls. Both USP24 SNPs were significantly associated with disease risk (p = 0.0037 for rs1165222:T>C, p.Thr195ILe, and p = 0.037 for rs13312:C>G, a SNP in the 3′‐untranslated region), and one marker, rs1048603:C>T, p.Arg1123Cys, in USP40 was significant from the chromosome 2 scan (p = 0.038). Further genotyping of the region surrounding these initial markers led us to identify 19 additional SNPs with strong disease association. In the second phase, we genotyped the 22 significant markers in an additional 110 cases and 162 controls, which together with part of the initial sample set (201 cases and 149 controls) constitute an expanded sample set of 311 age‐ and gender‐matched case‐control pairs. Twenty‐one markers were significant in the expanded sample set (most significant allelic p‐value: 0.0006 for rs287235:C>G on chromosome 1, and 0.005 for rs838552:T>C on chromosome 2), and six SNPs in USP24 remained significant after conservatively adjusting for testing 27 markers (pBonferroni = 0.017–0.049). It is unlikely that population stratification contributed to this finding, as population stratification was undetectable in our sample set using 78 null markers. Our data suggest that genetic variants in USP24 and USP40 affect the risk for late‐onset PD, which is consistent with the predicted role of the ubiquitination pathway in PD etiology. Hum Mutat 27(10), 1017–1023, 2006. © 2006 Wiley‐Liss, Inc.
Dose reduction of asparaginase under pharmacokinetic and pharmacodynamic control during induction therapy in children with acute lymphoblastic leukaemia

The enzyme asparaginase is an important element in the therapy of acute lymphoblastic leukaemia (ALL). The usual asparaginase dose as prescribed in the ALL‐BFM‐86/90 treatment protocol for the therapy of ALL is 10 000 IU/m2 at 3 d intervals and had been developed on the basis of the E. coli asparaginase preparation CrasnitinTM from the Bayer company. Using the described schedule the E. coli asparaginase preparation from the Medac company shows significantly higher biological activity than the Bayer preparation. These findings prompted an attempt to reduce the dose of the Asparaginase medacTM under careful pharmacokinetic and pharmacodynamic monitoring. At the first step of dose reduction in ALL treatment protocol I, 11 children received 5000 IU/m2 of Asparaginase medacTM. Another 15 children were given 2500 IU/m2 of the enzyme at the second step of dose reduction. Prior to each asparaginase dose, blood samples were taken to determine amino acids and trough enzyme activity. Concurrent with the asparaginase monitoring, the coagulation parameters were measured. 96% of samples from the first step of dose reduction (5000 IU/m2 every third day) showed complete L‐asparagine depletion (<0.1 μM), the median trough enzyme acitivity was 265 IU/l. At the second step of dose reduction (2500 IU/m2) complete L‐asparagine depletion was seen in 97% of samples, and the median trough enzyme acitivity was 102 IU/l. Cerebrospinal fluid (CSF) depletion was complete in all samples tested (11/11). We concluded that an Asparaginase medacTM dose reduced from the usual 10000 IU/m2 down to 5000 IU/m2 or 2500 IU/m2, applied at 3 d intervals, was sufficient to achieve complete L‐asparagine depletion in serum. Changes of the fibrinogen levels was significantly less pronounced in the group on 2500 IU.
Drivers and Performance Outcomes of Supplier Innovation Generation in Customer-Supplier Relationships: The Role of Power-Dependence

While innovations generated by supply channel relationships, as opposed to individual partners, play an increasingly important role in the success of all supply chain partners, there has been a dearth of research in the literature on how supply chain relationships cultivate the process of such innovation generation. We explore supplier market knowledge acquisition, relationship learning, systems collaboration, and technological uncertainty as antecedents of supplier innovation generation, which is in turn hypothesized to positively affect the relationship performance of the supplier. Furthermore, supplier dependence on the buyer is investigated as a moderator of the effects of such antecedents on supplier innovation generation. Empirical tests, which used a sample of 236 Taiwanese executives, supported most of the hypotheses, and some implications of the results are discussed.
Evidence of an Expectation Gap in Corporate Environmental Reporting in South Africa

Research evidence has suggested that the environmental reports produced by listed South African companies, like in other countries are perceived to be deficient in decision-usefulness, thus not of a standard that can satisfy the decisionmaking needs of users of these reports. This article explores whether the perceived deficiency in the decision-usefulness of the reports is due to differing perceptions between users and preparers of the reports with regard to what decision-useful reports ought to be. The article thus explores whether an environmental reporting expectation gap exists within South Africa with regard to what attributes the reports ought to have to be decision-useful. Using a questionnaire survey, this study elicited the perceptions of 54 individuals from three user groups, namely, ethical investors, environmental groups and accounting academics, as well as those of 42 preparers from the Top 100 South African companies listed on the Johannesburg Securities Exchange (JSE). Up on comparing the responses, significant differences were found between the views of users and preparers in relation to the attributes that decision-useful environmental reports ought to have. The differences are con-