Miracle-dz/UniFAR-FTUs huggingface dataset:
How We Didn’t Clean Up Until We Washed Our Hands: Shigellosis in an Elementary and Middle School in North Texas

Background Shigella outbreaks often continue for months and are linked frequently to poor hygiene and hand washing. Such outbreaks are found often in day care facilities, but rarely are reported in schools. We present the investigation of an outbreak in autumn 2007 at a building that housed an elementary school and a middle school in separate wings in a small Texas city north of Dallas-Fort Worth. Methods We canvassed local hospitals, school attendance records, and physician offices for cases. Ill individuals were interviewed using a standard questionnaire for symptoms, disease onset, and the presence of the illness in an ill person’s household. Results A music teacher was the index case for this outbreak of gastrointestinal illness caused by S. sonnei. Ten percent of the students in the school building were ill, and 15 households had secondary cases. Installing liquid soap in dispensers in student restrooms was the initial control measure, followed by sustained instruction in hand washing, scheduled hand washing times, and monitored cleaning and disinfection procedures for surfaces and inanimate objects. Enhanced surveillance detected no new cases in the school district. Conclusions Appropriate soap supplies and repeated instruction in hand washing and its monitoring were needed to control the outbreak.
Hand hygiene practices in a neonatal intensive care unit in Ghana.

BACKGROUND Compliance with hand hygiene recommendations is the most important measure in preventing health care-associated infections. The objective of this study was to assess the nature of patient contact and the hand hygiene practices of nurses and physicians in the neonatal intensive care unit in a tertiary hospital in Ghana. METHODOLOGY Unobtrusive observation of patient contact, hand hygiene practices, and hand washing technique among nurses and physicians attending randomly selected newborns for five hours daily for two weeks. Patient contact categorized as low-risk or high-risk. Hand hygiene practice before and after patient contact categorized as clean uncontaminated, clean recontaminated, new gloves, unchanged gloves. Compliance to alcohol rub use assessed. RESULTS The patient to nurse/physician ratio varied from 9:1 to 12:1. There were 97 patient contacts of which 49 were high-risk and 48 low-risk. Most (73%) patient contacts were from nurses. Compliance to hand hygiene recommendations before versus after patient contact was 15.4% versus 38.5% for physicians and 14.1% versus 9.9% for nurses. Gloves were used for 60.8% patient contacts (85.7% high-risk, 35.4% low-risk); however, compliance to recommended procedure occurred in only 12.2% of high-risk contacts and none of the low-risk contacts. Gloves were not changed between patients in 43.7% of high-risk contacts and 88.2% of low-risk contacts. Hand washing protocol was generally followed. Alcohol hand rub was always available but was not used for hand hygiene. CONCLUSIONS Hand hygiene compliance of physicians and nurses was low. Gloves and alcohol rub were not used according to recommended guidelines. Incorporating effective education programs that improve adherence to hand hygiene guidelines into the continuing education curriculum of health professionals is recommended.
A systematic review of hepatitis C virus epidemiology in Europe, Canada and Israel

Background and Aim: Decisions on public health issues are dependent on reliable epidemiological data. A comprehensive review of the literature was used to gather country‐specific data on risk factors, prevalence, number of diagnosed individuals and genotype distribution of the hepatitis C virus (HCV) infection in selected European countries, Canada and Israel.
Determinants of Health-Related Quality of Life Following Elective Total Hip Replacement

This study examined the patient perspective of surgical success through the measurement of health-related quality of life (HRQOL), in order to identify the patient characteristics and process issues associated with postoperative changes in health status. Patients completed the RAND 36-item Health Survey 1.0 (SF-36) prior to surgery and at 6 months following surgery. Baseline patient demographic and clinical information were collected from the medical record and were used to develop models of change in HRQOL for 68 patients. While many patients improved, a number experienced no change or even a decline in HRQOL in the postoperative period. Factors associated with change in HRQOL are presented. The findings suggest that factors associated with change in health status can be systematically assessed, which may lead to the development of interventions aimed at those patient characteristics or process issues that impact on HRQOL.
Development of vascular pole-associated glomerulosclerosis in the Fawn-hooded rat.

Fawn-hooded hypertensive (FHH) rats constitute a spontaneous model of chronic renal failure with early systemic and glomerular hypertension, proteinuria, and development of focal and segmental glomerulosclerosis. The goal of the present study was to elucidate a step-by-step sequence of histopathologic events leading from an initial glomerular injury to segmental sclerosis. Segmental sclerosis in the FHH rat is consistently associated with the glomerular vascular pole. The initial injury involves the expansion of primary branches of the afferent arteriole. Apposition of those capillaries to Bowman's capsule, together with the degeneration and detachment of corresponding podocytes, allows parietal cells to attach to the naked glomerular basement membrane of this capillary, i.e., allows the formation of a tuft adhesion to Bowman's capsule. The adhesion enlarges to a broad synechia by encroaching to neighboring capillaries, apparently based on progressive podocyte degeneration at the flanks of the adhesion. Capillaries inside the adhesion--before undergoing collapse or hyalinization--appear to stay perfused for some time and to maintain some kind of filtration misdirected toward the cortical interstitium. Thereby, a prominent paraglomerular space comes into existence, enlarging in parallel with the adhesion. Toward the cortical interstitium this space is delimited by a layer of sheetlike fibroblast processes, which has obviously been assembled in response to the formation of this space. Toward the urinary space, the paraglomerular space is demarcated by the parietal epithelium and by the interface between the adhesion and the "intact" tuft remnant. Thus, the sclerotic tuft portions all become enclosed within the paraglomerular space.
Pannexin 1 in erythrocytes: Function without a gap

ATP is a widely used extracellular signaling molecule. The mechanism of ATP release from cells is presently unresolved and may be either vesicular or channel-mediated. Erythrocytes release ATP in response to low oxygen or to shear stress. In the absence of vesicles, the release has to be through channels. Erythrocytes do not form gap junctions. Yet, here we show with immunohistochemical and electrophysiological data that erythrocytes express the gap junction protein pannexin 1. This protein, in addition to forming gap junction channels in paired oocytes, can also form a mechanosensitive and ATP-permeable channel in the nonjunctional plasma membrane. Consistent with a role of pannexin 1 as an ATP release channel, ATP release by erythrocytes was attenuated by the gap junction blocker carbenoxolone. Furthermore, under conditions of ATP release, erythrocytes took up fluorescent tracer molecules permeant to gap junction channels.
Decision-Making Style, Individualism, and Attitudes toward Risk of Arab Executives

In their quest to better understand managers and their work around the globe, researchers have made significant progress in the methodological and conceptual domains of international and cross-cultural management. They have called our attention to the need for theories and instruments customized to capture attributes of a particular culture or society (e.g., Adler, 1983; Ali, 1987; Hofstede, 1980; Sekaran, 1983). In this study, three important work-related attitudes have been recognized as crucial for managerial performance, namely, decision-making style, identification with the philosophy of individualism, and risk taking. An extensive review of the literature indicates that there has not
The Results of Closed Intramedullary Nailing for Intra-articular Distal Tibial Fractures

Objectives: To evaluate the long-term radiological, clinical, and functional result of the intramedullary nailing in intra-articular distal tibia fractures. Design: Retrospective clinical study. Setting: Level II Trauma Hospital. Patients/Participants: Between December 2000 and December 2006, 185 consecutive intra-articular distal tibia fractures were admitted in our institution. Fifty fractures were included in the study. According to the OTA classification, there were 28 (56%) fractures type 43 C1 and 22 (44%) type 43 C2. Intervention: All fractures were treated with closed static intramedullary nailing with distal locking. In 37 (74%) patients, reduction of the articular extension of the fracture with additional internal fixation preceded the nailing. Fibula fixation was applied in 32 (64%) fractures. Routine dynamization of the fixation was performed in all cases at a mean time of 10 weeks postoperatively. Main Outcome Measurements: The mean follow-up was 42 months (range: 36–54 months). Leg length, tibia alignment, articular reduction, and ankle arthrosis were assessed radiographically. The clinical outcome was assessed using the Olerud–Molander score. The functional limitation was assessed using the musculoskeletal functional assessment. Results: All fractures healed at an average of 16.3 weeks (range: 14–28 weeks). Anatomic reduction of the articular surface was obtained in all fractures. The average coronal plane deformity was 0.74 degree (range: 0–4 degrees) and the average sagittal plane deformity was 0.62 degree (range, 0–4 degrees). The mean Olerud–Molander score was 92.8/100 (range: 80–100). The average short musculoskeletal function assessment score was 34.55 ± 31.88 (range: 0.8–96). Conclusions: Intramedullary nailing augmented with minimal internal fixation is a safe alternative for the treatment of distal tibial fractures with a simple articular extension. Because all objectives of the treatment were obtained, the results did not deteriorate over time. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Beyond Implementation: Developing an Institutional Theory of Administrative Policy Making

The ghost of the politics-administration dichotomy haunts implementation theory. After all the critiques, administrative policy making is still seen as a component or step in the policy process that is dominated by elected officials. For example, Kelman recently examined the different institutional settings of policy making.1 Elected officials, in his view, are and should remain the primary source of policy ideas and choices with administrators, in theory, responsible for translating these ideas and choices into practice. Other scholars underscore the lack of effective control by legislators and elected executives. But even those who acknowledge administrative initiative and autonomy see administrators as servants, however weak their masters.
The endoscopic endonasal approach to the odontoid and its impact on early extubation and feeding.

OBJECT The gold-standard surgical approach to the odontoid is via the transoral route. This approach necessitates opening of the oropharynx and is associated with risks of infection, and swallowing and breathing complications. The endoscopic endonasal approach has the potential to reduce these complications as the oral cavity is avoided. There are fewer than 25 such cases reported to date. The authors present a consecutive, single-institution series of 9 patients who underwent the endonasal endoscopic approach to the odontoid. METHODS The charts of 9 patients who underwent endonasal endoscopic surgery to the odontoid between January 2005 and August 2013 were reviewed. The clinical presentation, radiographic findings, surgical management, complications, and outcome, particularly with respect to time to extubation and feeding, were analyzed. Radiographic measurements of the distance between the back of the odontoid and the front of the cervicomedullary junction (CMJ) were calculated, as well as the location of any residual bone fragments. RESULTS There were 7 adult and 2 pediatric patients in this series. The mean age of the adults was 54.8 years; the pediatric patients were 7 and 14 years. There were 5 females and 4 males. The mean follow-up was 42.9 months. Symptoms were resolved or improved in all but 1 patient, who had concurrent polyneuropathy. The distance between the odontoid and CMJ increased by 2.34 ± 0.43 mm (p = 0.03). A small, clinically insignificant fragment remained after surgery, always on the left side, in 57% of patients. Mean times to extubation and oral feeding were on postoperative Days 0.3 and 1, respectively. There was one posterior cervical wound infection; there were 2 cases of epistaxis requiring repacking of the nose and no instances of breathing or swallowing complications or velopharyngeal insufficiency. CONCLUSIONS This series of 9 cases of endonasal endoscopic odontoidectomy highlights the advantages of the approach in permitting early extubation and early feeding and minimizing complications compared with transoral surgery. Special attention must be given to bone on the left side of the odontoid if the surgeon is standing on the right side.
The Impacts of Private Standards on Global Value Chains - Literature Review Series on the Impacts of Private Standards, Part I

While standards play an increasingly important role in international trade and global value chains, little is known about their actual impacts in these chains. By applying a systematic literature approach, this paper summarizes the key research findings to this question. We provide insights into the following issues: (i) how do standards impact value chain governance, including whether standards allow for ‘hands-off’ governance, (ii) what are the effects of mainstreaming strategies, (iii) how do standards change actors’ roles following standard adoption, and (iv) what leads to exclude some and involve others. Research also provides a good understanding of how value chain structure has changed following the implementation of standards and, conversely, how a certain structure/governance type allows for standard implementation along the chain. While upgrading opportunities is an important question for producers in the developing world, only a few studies researched this issue and many questions remain open. On the other hand, studies show that smallholders struggled when adopting standards and pointed out that the distribution of benefits is not even along the chain.
The distribution of GAD67‐mRNA in the adult zebrafish (teleost) forebrain reveals a prosomeric pattern and suggests previously unidentified homologies to tetrapods

We used in situ hybridization on sections to examine the distribution of GAD67‐expressing cell populations in the entire forebrain of the adult zebrafish. GAD67 is predominantly expressed in the olfactory bulb (OB), all regions of the subpallium (including the dorsal, ventral, central, and lateral nucleus of the area ventralis [Vd, Vv, Vc, and Vl, respectively]), as well as preoptic (PPa, PPp, and PM), pretectal (PPd, PPv, PCN, PSp, and PSm), ventral (= pre‐) thalamic (I, VM, and VL), hypothalamic (Hr, Hi, and Hc), preglomerular (P, PGa, PGl, PGm, and RT), and posterior tubercular (TPp and TPm) nuclei. Only scattered GAD67‐expressing cells are seen in all pallial zones (Dm, Dd, Dc, Dl, and Dp) and in the previously unidentified bed nucleus of the stria medullaris (BNSM). The BNSM appears to be the adult teleostean derivative of the larval eminentia thalami (EmT). We identify the GAD67‐positive entopeduncular nucleus proper (EN) as being homologous to the entopeduncular nucleus of nonprimate mammals. GAD67 is strongly expressed in the anterior thalamic nucleus (A). The anterior thalamic nucleus is laterally bordered by a distinct GAD67‐expressing cell population, which we interpret as the previously unidentified reticular thalamic nucleus (RTN) of teleosts. Furthermore, we identified a GAD67‐positive thalamic nucleus, the intercalated nucleus (IC), which is sandwiched between the GAD67‐negative dorsal (DP) and central posterior (CP) thalamic nuclei. Overall, the distribution of GAD67‐expressing cells highly resembles the distribution of γ‐aminobutyric acid (GABA)/GAD67‐expressing cells found in the early zebrafish (teleost) forebrain and thus allows us to propose a prosomeric fate map of GABAergic cell populations. J. Comp. Neurol. 516:553–568, 2009. © 2009 Wiley‐Liss, Inc.
A New Method for Space Charge Measurements Under Periodic Stress of Arbitrary Waveform by the Pulsed Electro-Acoustic Method

A new method for space charge measurement resorting to the pulsed electroacoustic (PEA) method under periodic stress of arbitrary waveform is presented. The originality of the work consists in using a long memory digital oscilloscope combined to the method used to sample one period of the HV stress into several profiles. There is no need for synchronization between pulse generation and HV stress and hence no hardware change of classic PEA system. The pulse generator provides a probing pulse of 5 ns duration, at a maximum frequency of 1 kHz. With these features, the phase of the HV stress can be resolved into 200 profiles by frequency adjustment of the pulse generator. Several periods of the HV stress are necessary for obtaining the set of profiles; however the typical measurement time is less than 20 s for f > 0.2 Hz. Preliminary results obtained on a crosslinked polyethylene film under 50 Hz ac stress are shown to demonstrate the feasibility.
Origin of Whales from Early Artiodactyls: Hands and Feet of Eocene Protocetidae from Pakistan

Partial skeletons of two new fossil whales, Artiocetus clavis and Rodhocetus balochistanensis, are among the oldest known protocetid archaeocetes. These came from early Lutetian age (47 million years ago) strata in eastern Balochistan Province, Pakistan. Both have an astragalus and cuboid in the ankle with characteristics diagnostic of artiodactyls; R. balochistanensis has virtually complete fore- and hind limbs. The new skeletons are important in augmenting the diversity of early Protocetidae, clarifying that Cetacea evolved from early Artiodactyla rather than Mesonychia and showing how early protocetids swam.
Mucin Expression Profile Is Related to Biological and Clinical Characteristics of Intraductal Papillary-Mucinous Tumors of the Pancreas

Objectives: Biologic and clinical characteristics of intraductal papillary-mucinous tumors of the pancreas (IPMTs) were studied in reference to immunohistochemical mucin (MUC1, MUC2, and MUC5AC) expression. Methods: Histologic grade, immunohistochemical ki-67 and p53 expression, and findings in imaging tests of 21 IPMTs (9 carcinomas, 6 borderline tumors, and 6 adenomas) were examined according to the mucin expression profile. Results: IPMTs were divided into groups: M1 group (MUC1+, n = 4), M2 group (MUC2 + MUC1−, n = 12), and M5 group (MUC5AC + MUC1−MUC2−, n = 5). The M2 group was subdivided into M2s (strongly positive) and M2w (weakly positive) groups. The rates of carcinoma in the M1, M2s, M2w, and M5 groups were 100%, 40%, 0%, and 0%, respectively. The Ki-67 labeling indexes were significantly higher in the M1 and M2s groups. p53 staining was positive in 50% and 40% of the IPMTs in the M1 and M2s groups, respectively, but in none of the IPMT in the M2w and M5 groups. Morphologic changes in imaging tests during the observation periods were most remarkable in the M1 group. Conclusions: Our results suggest that MUC1 is related to malignant character but MUC5AC alone is related to benign character in IPMTs and that malignant potential of IPMTs expressing MUC2 depends on the degree of MUC2 expression.
Transforming Growth Factor-β1 Antagonizes Interleukin-5 Pro-Survival Signaling by Activating Calpain-1 in Primary Human Eosinophils.

BACKGROUND Eosinophils rapidly undergo apoptosis unless exposed to prosurvival cytokines such as interleukin 5 (IL-5) or granulocyte-macrophage colony stimulating factor (GM-CSF). In vivo, eosinophils are exposed to TGF-β 1 which can induce apoptosis suggesting it may function to counteract the effects of IL-5 or GM-CSF and limit, in vivo tissue eosinophilia. OBJECTIVE The objective of this study was to investigate the proapoptotic effects of TGF-β alone and in combination with IL-5 on eosinophils. METHODS Peripheral blood eosinophil (PBEos) viability was assessed using flow cytometry after exposure to TGF-β1 and IL-5. Calpain-1 activation was determined in cell extracts by western blot analysis of endogenous substrates and with a fluorogenic α-spectrin substrate. Molecular interactions between calpain1 and calpastatin were assessed by immunoprecipitation and western blotting. RESULTS Physiologic concentrations of TGF-β1 significantly antagonized the prosurvival effects of IL-5. TGF-β1-induced apoptosis was suppressed by inhibitors of calpain, or its downstream target, caspase 3. TGF-β1 signaling through Smad3 was unaffected by IL-5 and was required for the pro-apoptotic effects of TGF-β1. However, IL-5 induced Akt phosphorylation was inhibited by TGF-β1 and was associated with accelerated calpain cleavage and eosinophil death. CONCLUSION TGF-β1 induces calpain-1 activation through antagonism of Akt which induces caspase activation and eosinophil apoptosis.
CAPITAL GAINS REDUX: WHY HOLDING PERIODS MATTER

Changes in the tax rate on capital gains have profound effects on the volume of gains individuals choose to realize. While much of the recent policy debate has focused upon the magnitude of taxpayer response, this paper investigates the mechanism that underlies it—changes in the holding period of capital assets. A simple model of asset turnover is presented that captures, in an intuitive way, some of the variables that influence taxpayers to sell appreciated assets. The theory is tested using a rich and unique data source and the results are used in a dynamic simulation model of realizations and revenues. Small changes in the (mean) length of time assets are held translate into dramatic changes in aggregate realizations. The implications of the theory presented here are strong, empirically verifiable, and generally predict recent historical experience well.