Miracle-dz/UniFAR-FTUs huggingface dataset:
Routine rapid HIV testing in hospitals: another opportunity for hospitalists to improve care.

BACKGROUND The Centers for Disease Control and Prevention recommends routinely offering HIV testing to inpatients at hospitals with an HIV seroprevalence rate of greater than 1% or an AIDS diagnosis rate of greater than 1.0 per 1000 discharges. This recommendation has not been widely adopted, perhaps because of one of several barriers: the cost of implementing a counseling and testing program; the logistics of HIV counseling and testing on a hospital ward particularly with respect to privacy; concern about the follow-up of HIV test results necessitating patients to return after discharge; and the cultural mindset of screening as an outpatient modality complicated by the fear of raising the possibility of HIV testing and therefore eliciting a negative reaction from a patient who has not requested it. PURPOSE This article focuses on these barriers and some possible solutions, emphasizing the role of FDA-approved rapid HIV tests, which may decrease follow-up issues for HIV testing programs. It also considers hospitalists, given their frontline status and ability to coordinate the multidisciplinary services and system-wide approach required to implement such a program, as leaders in this area.
Influence of low absolute lymphocyte count of patients with nongerminal center type diffuse large B-cell lymphoma with R-CHOP therapy.

BACKGROUND Rituximab has dramatic impact on outcome of patients with diffuse large B-cell lymphoma (DLBCL), especially nongerminal center (non-GC) type. A low absolute lymphocyte count (ALC) before rituximab, cyclophosphamide, vincristine, adriamycin, and prednisone (R-CHOP) therapy as a surrogate marker of immune status is associated with poor clinical outcome in DLBCL. Therefore, we hypothesized that low ALC before R-CHOP would have effect on the survival in non-GC type. PATIENTS AND METHODS One hundred and thirty-six DLBCL patients who were treated with R-CHOP from 2003 to 2007 were analyzed in the present study. RESULTS ALC > or = 1.0 x 10(9)/l predicted a longer 3-year progression-free survival (PFS) and 3-year overall survival (OS) versus ALC <1.0 x 10(9)/l (82.6% versus 60.0%, P = 0.005 and 87.2% versus 62.0%, P < 0.001, respectively). Non-GC type had similar PFS and OS to germinal center type (68.2% versus 80.0%, P = 0.074 and 72.7% versus 82.9%, P = 0.111, respectively). However, considering clinical influence of the ALC according to immunophenotype, low ALC in non-GC type DLBCL was associated with lower PFS and OS compared with others (PFS, P = 0.002; OS, P < 0.001). Multivariate analysis revealed that low ALC in non-GC type had lower PFS [hazard ratio (HR) = 3.324, P = 0.001] and OS (HR = 4.318, P < 0.001), independent of international prognostic index. CONCLUSION A low ALC in non-GC type DLBCL counteracted the beneficial effect of rituximab on survival.
Objective Assessment of Gait in Normal-Pressure Hydrocephalus

Williams MA, Thomas G, de Lateur B, Imteyaz H, Rose JG, Shore WS, Kharkar S, Rigamonti D: Objective assessment of gait in normal-pressure hydrocephalus. Am J Phys Med Rehabil 2008;87:39–45. Objectives:Gait abnormalities are an early clinical symptom in normal pressure hydrocephalus (NPH), and subjective improvement in gait after temporary removal of CSF is often used to decide to perform shunt surgery. We investigated objective measures to compare gait before and after CSF drainage and shunt surgery. Design:Twenty patients and nine controls were studied. Quantitative gait measures were obtained at baseline, after 3 days of controlled CSF drainage, and after shunt surgery. Decision to perform surgery was based on response to drainage, and patients were assigned to shunted or unshunted groups for comparison. Results:There was no improvement after CSF drainage in the unshunted group (n = 4). In the shunted group (n = 15) velocity, double-support time, and cadence improved significantly after drainage, and improved further after shunt surgery. The degree of improvement after drainage significantly correlated to the degree of improvement postshunt for velocity, double-support time, cadence, and stride length. Conclusions:There are significant, quantifiable changes in gait after CSF drainage that correspond to improvement after shunt surgery for patients with NPH. Use of objective gait assessment may improve the process of identifying these candidates when response to CSF removal is used as a supplemental prognostic test for shunt surgery.
Relative Income Distribution in Six European Countries

Abstract The relationship between income inequality and polarization is an empirical fact: a change in equality might occur together with a change in polarization. At the same time, polarization might emerge while inequality remains constant. The outcome of this process entails relevant information on the evolution of the income distribution. We exploit the LIS database to perform a relative distribution analysis for six European countries. Our aim is describing how disposable income distributions evolved over time. The results indicate that polarization increased in all the considered countries, being the largest in the United Kingdom and the smallest in Italy. Nonetheless, in all the countries downgrading prevails over upgrading: the relevance of the middle class getting poorer is larger than the one of the middle class getting richer.
A Sociopolitical Perspective on the Illegal Take of Wildlife in the Southeastern, USA

Illegal take of wildlife is a complex and growing phenomenon, influenced by various factors. Scholars have paid limited attention to structural influences, however. We examine the structural processes that influence illegal take behavior in rural areas of the southeastern USA. Engaging historical and contemporary qualitative data from the region, we first identify that struggles between a rural hunting sub-culture and outsiders over the meaning and governance of humanwildlife interactions in rural areas emerged from several sociopolitical shifts. We then associate illegal take behavior performed by the rural hunting sub-culture with a radicalization framework consisting of injustice, vulnerability, superiority, and distrust. Regulators should not be surprised by the occurrence of illegal take behavior because sociopolitical factors contributed to delegitimization of wildlife law among the sub-culture. Engaging sub-culture gatekeepers in ways that limit exclusionary wildlife governance and imposition of external values may moderate negative outcomes caused by major sociopolitical shifts.
Measures of body shape and adiposity as related to incidence of age-related eye diseases: observations from the Beaver Dam Eye Study.

PURPOSE To examine the effect of obesity on the incidence of age-related eye disease. METHODS Participants of the Beaver Dam Eye Study were examined every 5 years over a 20-year period (1988-1990 through 2008-2010). Lens and fundus photographs were used to evaluate presence and severity of cataract and macular degeneration. Height and weight were measured at all examinations. Waist and hip circumference were measured at all examinations beginning at the first follow-up (1993-1995). Models of ocular outcomes over 15 years were stratified by sex and smoking status. RESULTS Overall, 2641 participants contributed 5567 person-visits to 15-year incidence analysis. Female nonsmokers had increased risk of late AMD associated with higher body mass index (BMI; hazard ratio [HR] per 2.5 kg/m(2) 1.31, 95% confidence interval [CI] 1.15-1.50, P < 0.001), waist to hip ratio (HR per 0.1 cm/cm 1.95, 95% CI 1.33-2.86, P < 0.001), waist circumference (HR per 5 cm 1.21, 95% CI 1.10-1.34, P < 0.001), and waist to height ratio (HR per 0.1 cm/cm 1.74, 95% CI 1.31-2.31, P < 0.001). Increased BMI was also associated with early AMD in female nonsmokers (HR 1.10, 95% CI 1.02-1.19, P = 0.02). CONCLUSIONS Female nonsmokers had risk of late AMD associated with increasing measures of greater obesity and increased risk of early AMD associated with greater BMI.
Health-related quality of life among cancer survivors in Korea: the Korea National Health and Nutrition Examination Survey.

OBJECTIVE The purpose of this study was to investigate the quality of life among cancer survivors compared with individuals without a history of cancer (noncancer controls) using the Korea National Health and Nutrition Examination Survey. METHODS The study subjects were 783 adult cancer survivors and 36 456 noncancer controls who participated in the third, fourth and fifth Korea National Health and Nutrition Examination Survey. Demographic factors, health-related behavior, clinical characteristics and health-related quality of life were assessed with self-reported questionnaires. The EuroQoL-5Dimension was used to evaluate health-related quality of life. Descriptive statistics and multiple regression analysis were used to compare health-related quality of life between cancer survivors and noncancer controls. RESULTS About 67% were women and the mean age of the cancer survivors was 60.9 ± 12.4 years. About 52% of survivors were diagnosed with cancer between 45 and 64 years, and more than half of cancer survivors were diagnosed 5 years or less before the interview. The pain/discomfort dimension was the highest reported problem: 43.6% for cancer survivors. The proportion of any reported problem was significantly higher among cancer survivors compared with noncancer controls in terms of mobility (adjusted odds ratio (aOR), 1.56, 95% confidence interval, 1.24-1.97), usual activities (aOR, 1.45, 95% confidence interval, 1.11-1.89), pain/discomfort (aOR, 1.26, 95% confidence interval, 1.04-1.52) and anxiety/depression (aOR, 1.61, 95% confidence interval, 1.29-2.01). CONCLUSIONS Cancer survivors had a significantly lower quality of life compared with noncancer controls. The pain/discomfort dimension was the highest reported problem in cancer survivors.
Usefulness of Ultrasound View of Larynx in Pre-Anesthetic Airway Assessment: A Comparison With Cormack-Lehane Classification During Direct Laryngoscopy

Background One of the main challenges in anesthesiology is difficult intubation. There are many anatomical parameters for evaluating the feasibility of tracheal intubation; one that can reliably predict a difficult intubation is the Cormack-Lehane classification obtained during direct laryngoscopy. This is an invasive procedure that cannot be performed in an awake patient or for pre-anesthetic airway assessments in patients with no prior history of tracheal intubation. Recently, ultrasound has been successfully used for several airway-related applications. Objectives The aim of this study was to compare and correlate the ultrasound view of the larynx with the Mallampati classification before anesthesia and the Cormack-Lehane classification during direct laryngoscopy under general anesthesia. Methods This cross-sectional descriptive-analytic study included 53 ASA class I - III patients aged 18 - 70 years who were scheduled for tracheal intubation under general anesthesia. Before anesthesia, an oblique transverse ultrasound view of the airway was obtained; in addition, the total time taken to achieve the final plane, the depth of the pre-epiglottic space, and the distance from the epiglottis to the mid-point between the vocal cords were all recorded. The ultrasound measurements were then compared with the Mallampati class on the preoperative evaluation and with the Cormack-Lehane grade during direct laryngoscopy under general anesthesia. Results It was observed that correlations between the pre-epiglottic space (PE) and Cormack-Lehane grades I, II, and III were weak. Correlations between the distance from the epiglottis to the vocal cords (E-VC) and Cormack-Lehane grades I, II, and III were also weak. The PE/E-VC ratio for correlations between the sonographic view and laryngoscopy had 87.5% sensitivity and 30% specificity. There was no correlation between Mallampati class and the PE/E-VC ratio (P = 0.566). Conclusions Our study revealed weak correlation between PE/E-VC and Cormack-Lehane grade, with 87% sensitivity and 30% specificity. Therefore, we concluded that sonographic measurement criteria are not accurate in airway evaluations before anesthesia.
Distribution of vesicular glutamate transporter mRNA in rat hypothalamus

Two isoforms of the vesicular glutamate transporter, VGLUT1 and VGLUT2, were recently cloned and biophysically characterized. Both VGLUT1 and VGLUT2 specifically transport glutamate into synaptic vesicles, making them definitive markers for neurons using glutamate as a neurotransmitter. The present study takes advantage of the specificity of the vesicular transporters to afford the first detailed map of putative glutamatergic neurons in the rat hypothalamus. In situ hybridization analysis was used to map hypothalamic distributions of VGLUT1 and VGLUT2 mRNAs. VGLUT2 is clearly the predominant vesicular transporter mRNA found in the hypothalamus; rich expression can be documented in regions regulating energy balance (ventromedial hypothalamus), neuroendocrine function (preoptic nuclei), autonomic tone (posterior hypothalamus), and behavioral/homeostatic integration (lateral hypothalamus, mammillary nuclei). Expression of VGLUT1 is decidedly more circumspect and is confined to relatively weak labeling in lateral hypothalamic regions, neuroendocrine nuclei, and the suprachiasmatic nucleus. Importantly, dual‐label analysis revealed no incidence of colocalization of VGLUT1 or VGLUT2 mRNAs in glutamic acid decarboxylase (GAD) 65‐positive neurons, indicating that GABA neurons do not express either transporter. Our data support a major role for hypothalamic glutamatergic neurons in regulation of all aspects of hypothalamic function. J. Comp. Neurol. 448:217–229, 2002. © 2002 Wiley‐Liss, Inc.
Association of LPA Variants With Aortic Stenosis: A Large-Scale Study Using Diagnostic and Procedural Codes From Electronic Health Records

Importance Elevated lipoprotein(a) levels are a risk factor for aortic stenosis (AS). However, a large-scale replication of associations between LPA variants and AS, their interactions with risk factors, and the effect of multiple risk alleles is not well established. Objective To replicate the association between LPA variants with AS and identify subgroups who are at higher risk of developing AS. Design, Setting, and Participants This case-control study of AS included 44 703 individuals (3469 cases) 55 years or older who were enrolled in the Genetic Epidemiology Research on Aging cohort and who were members of the Kaiser Permanente Northern California health care delivery system. The study leveraged the linkage of administrative health data, electronic medical records, genotypes, and self-reported questionnaire data. The 3469 AS cases were diagnosed between January 1996 and December 2015. Individuals with valvular congenital heart disease were excluded. Exposures Two single-nucleotide polymorphisms in the LPA locus, rs10455872 and rs3798220, that are known to associate with circulating plasma lipoprotein(a) levels and an LPA risk score. Main Outcomes and Measures Aortic stenosis or aortic valve replacement. Results The 44 703 participants were of European ancestry,of whom 22 019 (49.3%) were men. The mean (SD) age for the control group was 69.3 (8.3) years and the mean (SD) age for AS cases was 74.6 (8.5) years. Both LPA variants were associated with AS, with a per risk allele odds ratio of 1.34 (95% CI, 1.23-1.47; P = 1.7 × 10−10) for rs10455872 and 1.31 (95% CI, 1.09-1.58; P = 3.6 × 10−3) for rs3798220 after adjusting for age, age2, and sex. The results remained significant after adjusting for risk factors. The estimates were similar for an LPA risk score. Individuals with 2 risk alleles had a 2-fold or greater odds of AS compared with individuals with no risk alleles (for rs10455872, homozygous odds ratio, 2.05; 95% CI, 1.37-3.07; P = 5.3 × 10−4; for rs3798220, homozygous odds ratio, 3.74; 95% CI, 1.03-13.6; P = .05; and for compound heterygotes, odds ratio, 2.00; 95% CI, 1.17-3.44; P = .01). For rs10455872, the odds ratio for AS was greatest in individuals aged 55 to 64 years and declined with age (interaction P = .03). Each rs10455872 risk allele was also associated with AS that was diagnosed 0.71 years earlier (95% CI, −1.42 to 0; P = .05). Conclusions and Relevance We provide a large-scale confirmation of the association between 2 LPA variants and AS, reaching genome-wide significance. In addition, individuals with 2 risk alleles have 2-fold or greater odds of developing AS. Age may modify these associations and identify subgroups who are at greater risk of developing AS.
[Self-medication profile in a city of south Brazil].

OBJECTIVE The characterization of drug users, especially as regards self-medication and the determination of its prevalence in the population studied. MATERIAL AND METHOD About 413 people that had used drugs in the previous month were interviewed. RESULTS From the interviewed, 69.9% used medicines and of those 76.1% were self medicated. Headache (28.8%) was the main complaint among the self-medicated group. Acetilsalicilic acid was the most frequently used medicine (25.4%). As regards the drugs utilized, 51.2% of the users had received a recommendation from a third party and 51.7% used old prescriptions, given in previous consultations. CONCLUSION Age, schooling and absence of periodic medical consultation were significant statistical factors in self-medication.
Pregnancy loss rate following routine genetic amniocentesis at Wellington Hospital.

AIMS To determine the institutional pregnancy loss rate following second-trimester genetic amniocentesis. METHODS Data from 293 consecutive women who had routine genetic amniocentesis at Wellington Hospital from 1 January to 31 December 2001 were collected. The primary outcome measure was pregnancy loss rate up to 6-weeks post-procedure. Secondary outcomes were pregnancy loss after 6 weeks and culture failure. RESULTS Complete information on the pregnancy outcome was obtained for 269 of 293 pregnancies (92%); corresponding to 275 procedures, including two twin pregnancies and four repeat amniocentesis for culture failure (1.3%). There were two miscarriages within 6 weeks of amniocentesis; giving a pregnancy loss rate of 2/269 pregnancies (0.74 %), or 2/275 amniocentesis procedures (0.73%). Of these pregnancies, one fetus had 'trisomy 21'-giving a corrected pregnancy loss rate within 6 weeks of amniocentesis of 1/269 (0.37%) pregnancies or 1/275 (0.36%) amniocentesis procedures. The pregnancies lost after 6 weeks of amniocentesis was three in 269 pregnancies (1.1%); including one neonatal death at 31 weeks due to a lethal congenital anomaly, and two fetal deaths in utero (one at 23 weeks with a non-lethal congenital anomaly and a normal karyotype, and the other at 27 weeks from toxoplasmosis). CONCLUSIONS The pregnancy loss rate from amniocentesis and the culture failure rate in Wellington Hospital (using modern techniques) are similar to rates found in recently published studies.
Temperament and Character in Mood Disorders: Influence of DRD4, SERTPR, TPH and MAO-A Polymorphisms

Gene variants exert a complex range of effects on human normal and abnormal behavior. We previously reported the effect of gene variants in serotoninergic and dopaminergic pathways, in a range of clinical features in mood disorders, such as symptomathology, periodicity, social adjustment and treatment response. In this paper we hypothesized that the same gene variants could influence temperamental traits in mood disorders patients. We focused on genes of the serotoninergic and dopaminergic systems (dopamine receptor D4 gene, DRD4; serotonin transporter gene, promoter region SERTPR; tryptophan hydroxylase gene, TPH; monoamine oxidase A gene, MAO-A). Two hundred and seven euthymic subjects, affected by major depressive disorder (n = 73) and bipolar disorder (n = 134) were assessed by the Cloninger’s Temperament and Character Inventory (TCI) and typed using PCR-based analyses. Possible stratification factors such as demographic, clinical and other temperamental factors were also taken into account. We observed that homozygosity for the short SERTPR allele was associated with low novelty-seeking scores (p = 0.006) and genotypes containing the DRD4 long allele were marginally associated with low harm avoidance (p = 0.05). Finally, the long MAO-A allele was associated with decreased persistence scores among females (p = 0.006). Our observation of a pattern of influence on temperamental dimension exerted by serotonergic and dopaminergic genes suggests that the contribution of these polymorphisms to the clinical presentation of mood disorders could be mediated by an influence on personality differences.
If We Cannot Have Both, Then Which Union Do We Choose? Scotland’s Options after ‘Brexit’

In the space of two years, the Scottish electorate has been asked on two separate occasions to declare its position with regard the two unions to which it currently belongs – that of the UK and of the EU. This special interest piece aims to take stock of the mood in Scotland towards Brexit and to consider the various options for Scotland going forward. It is starting to look probable that Scotland will have to go to the polls one last time. If the Scots cannot belong to both unions, then ultimately they will probably have to make one final decision as to which union they favour.
θ-dependence of the lightest meson resonances in QCD

We derive the pion mass and the elastic pion-pion scattering amplitude in the QCD vacuum up to next-to-leading order in chiral perturbation theory. Using the modied inverse amplitude method, we study the -dependence of the mass and width of the light scalar meson (500) and the vector meson (770).
Mineralization of Dense Collagen Hydrogel Scaffolds by Human Pulp Cells

While advances in biomineralization have been made in recent years, unanswered questions persist on bone- and tooth-cell differentiation, on outside-in signaling from the extracellular matrix, and on the link between protein expression and mineral deposition. In the present study, we validate the use of a bioengineered three-dimensional (3D) dense collagen hydrogel scaffold as a cell-culture model to explore these questions. Dental pulp progenitor/stem cells from human exfoliated deciduous teeth (SHEDs) were seeded into an extracellular matrix-like collagen gel whose fibrillar density was increased through plastic compression. SHED viability, morphology, and metabolic activity, as well as scaffold mineralization, were investigated over 24 days in culture. Additionally, measurements of alkaline phosphatase enzymatic activity, together with immunoblotting for mineralized tissue cell markers ALPL (tissue-non-specific alkaline phosphatase), DMP1 (dentin matrix protein 1), and OPN (osteopontin), demonstrated osteo/odontogenic cell differentiation in the dense collagen scaffolds coincident with mineralization. Analyses of the mineral phase by electron microscopy, including electron diffraction and energy-dispersive x-ray spectroscopy, combined with Fourier-transform infrared spectroscopy and biochemical analyses, were consistent with the formation of apatitic mineral that was frequently aligned along collagen fibrils. In conclusion, use of a 3D dense collagen scaffold promoted SHED osteo/odontogenic cell differentiation and mineralization.