Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of a direct access occupational physiotherapy treatment service.

BACKGROUND Musculoskeletal disorders (MSDs) cause significant morbidity and absence from work for both manual and sedentary occupations. AIMS To examine the impact of a direct access physiotherapy treatment service in an occupational setting. METHODS This was a pilot study carried out as a service audit. Physiotherapy patients were assessed pre- and post-treatment using the work function score (WFS), a visual analogue scale for pain (VASP) and adjusted clinical score (ACS). Self-report questionnaires were completed on sickness absence, attendance at work and the World Health Organization (five) Well-being Index. RESULTS There were 231 participants. Patient improvement was reported in WFS (63%), ACS (84%) and VASP (94%). Compared with those who had one or two sessions, improvement was most likely after three to four sessions for WFS [odds ratio (OR): 4.5; 95% confidence interval: 1.4-14.3, P < 0.05], VASP (OR: 32.2; 95% confidence interval: 3.5-294.2, P < 0.01) and five to six sessions for ACS (OR: 6.9; 95% confidence interval: 1.9-25.9, P < 0.01). While the self-reported questionnaire response rate was low at 29%, respondents indicated that there was potential to reduce and prevent sickness absence and improve mental well-being. CONCLUSIONS Brief physiotherapy treatment for MSDs may have the potential to improve not only clinical status and pain as expected but also work function, psychological well-being and sickness absence. Further research is warranted to confirm these positive impacts and to endorse physiotherapy as an effective intervention in occupational settings and a useful component in rehabilitation and 'Fit for Work' programmes.
Induction of antigen‐specific CD4+ HLA‐DR‐restricted cytotoxic T lymphocytes as well as nonspecific nonrestricted killer cells by the recombinant mycobacterial 65‐kDa heat‐shock protein

Acquired cell‐mediated immunity to intracellular parasites like mycobacteria is dependent on antigen‐specific T lymphocytes. We have recently found that mycobacteria not only induce helper T cells but also cytotoxic CD4+ and/or CD8+ T cells as well as nonspecific killer cells that lyse human macrophages in vitro. In addition, we have described that the recombinant heat‐shock protein (hsp) 65 of Mycobacterium bovis BCG/M. tuberculosis is an important target antigen for CD4+CD8− cytotoxic T cells.
Characterization of Clostridium perfringens TpeL Toxin Gene Carriage, Production, Cytotoxic Contributions, and Trypsin Sensitivity

ABSTRACT Large clostridial toxins (LCTs) are produced by at least four pathogenic clostridial species, and several LCTs are proven pivotal virulence factors for both human and veterinary diseases. TpeL is a recently identified LCT produced by Clostridium perfringens that has received relatively limited study. In response, the current study surveyed carriage of the tpeL gene among different C. perfringens strains, detecting this toxin gene in some type A, B, and C strains but not in any type D or E strains. This study also determined that all tested strains maximally produce, and extracellularly release, TpeL at the late-log or early-stationary growth stage during in vitro culture, which is different from the maximal late-stationary-phase production reported previously for other LCTs and for TpeL production by C. perfringens strain JIR12688. In addition, the present study found that TpeL levels in culture supernatants can be repressed by either glucose or sucrose. It was also shown that, at natural production levels, TpeL is a significant contributor to the cytotoxic activity of supernatants from cultures of tpeL-positive strain CN3685. Lastly, this study identified TpeL, which presumably is produced in the intestines during diseases caused by TpeL-positive type B and C strains, as a toxin whose cytotoxicity decreases after treatment with trypsin; this finding may have pathophysiologic relevance by suggesting that, like beta toxin, TpeL contributes to type B and C infections in hosts with decreased trypsin levels due to disease, diet, or age.
Cumulative exposure to lead and cognition in persons with Parkinson's disease

Dementia is an important consequence of Parkinson's disease (PD), with few known modifiable risk factors. Cumulative exposure to lead, at levels experienced in the community, may exacerbate PD‐related neural dysfunction, resulting in impaired cognition. Among 101 persons with PD (“cases”) and, separately, 50 persons without PD (“controls”), we evaluated cumulative lead exposure, gauged by tibia and patella bone lead concentrations, in relation to cognitive function, assessed using a telephone battery developed and validated in a separate sample of PD patients. We also assessed the interaction between lead and case‐control status. After multivariable adjustment, higher tibia bone lead concentration among PD cases was associated with worse performance on all of the individual telephone tests. In particular, tibia lead levels corresponded to significantly worse performance on a telephone analog of the Mini–Mental State Examination and tests of working memory and attention. Moreover, higher tibia bone lead concentration was associated with significantly worse global composite score encompassing all the cognitive tests (P = 0.04). The magnitude of association per standard deviation increment in tibia bone lead level was equivalent to the difference in global scores among controls in our study, who were approximately 7 years apart in age. The tibia lead‐cognition association was notably stronger within cases than within controls (Pdifference = 0.06). Patella bone lead concentration was not consistently associated with performance on the tests. These data provide evidence suggesting that cumulative exposure to lead may result in worsened cognition among persons with PD. © 2012 Movement Disorder Society
Do current OELs for silica protect from obstructive lung impairment? A critical review of epidemiological data

Abstract Inhalation of respirable crystalline silica (RCS) can lead to serious health effects such as silicosis and lung cancer. There also seems to be a general consensus to consider that RCS exposure is associated with obstructive lung impairment or chronic obstructive pulmonary disease (COPD), a leading cause of mortality, morbidity, and disability worldwide. It is, however, not clear whether occupational exposure levels (OELs), generally set to prevent silicosis, also protect workers from developing an obstructive impairment. This review aims at clarifying the potential relationship between RCS exposure and obstructive lung impairment as defined by spirometry. Eleven studies that reported both silica exposure levels and spirometry results were identified. We systematically extracted data pertaining to (a) the population studied, (b) level of exposure to RCS and other pollutants, (c) spirometry procedure and interpretation, and (d) methodology used to investigate the relationship between RCS exposure and spirometry. These studies add supporting evidence in favor of a qualitative association between occupational activities exposing to RCS and obstructive lung dysfunction. However, no well-founded quantitative estimate can be drawn from these investigations; the available relevant literature does not allow defining a RCS exposure threshold associated with an increased risk of obstructive lung dysfunction, as defined by spirometry, in workers without silicosis. Further research is needed, but, as highlighted in this review, conducting epidemiological studies with both valid exposure and outcome measurements is a real challenge.
Pseudomonas aeruginosa May Accumulate Drug Resistance Mechanisms without Losing Its Ability To Cause Bloodstream Infections

ABSTRACT In this study, we systematically investigated the resistance mechanisms to β-lactams, aminoglycosides, and fluoroquinolones of 120 bacteremic strains of Pseudomonas aeruginosa. Pulsed-field gel electrophoresis genotyping showed that 97 of these strains were represented by a single isolate, 10 by 2 and 1 by 3 clonally related isolates, respectively. Seventy-five percent (90 out of 120) of the bacteremic P. aeruginosa strains displayed a significant resistance to one or more of the tested antimicrobials (up to 11 for 1 strain). These strains were found to harbor a great diversity of resistance mechanisms (up to 7 in 1 strain), leading to various levels of drug resistance. Interestingly, 11 and 36% of the isolates appeared to overproduce the MexAB-OprM and MexXY-OprM efflux systems, respectively. Altogether, our results show that P. aeruginosa may accumulate intrinsic (overproduction of cephalosporinase AmpC, increased drug efflux, fluoroquinolone target mutations, and deficient production of porin OprD) and exogenous (production of secondary β-lactamases and aminoglycoside-modifying enzymes) resistance mechanisms without losing its ability to generate severe bloodstream infections. Consequently, clinicians should be aware that multidrug-resistant P. aeruginosa may remain fully pathogenic.
An Emotional Mediation Theory of Differential Age Effects in Episodic and Semantic Memories

ABSTRACT Although there is a large decrement in central episodic memory processes as adults age, there is no appreciable decrement in central semantic memory processes (Allen et al., Journal of Gerontology: Psychological Sciences, 57B, P173–P186, 2002; Allen et al., Experimental Aging Research, 28, 111–142, 2002; Mitchell, Journal of Experimental Psychology: Learning, Memory, and Cognition, 15, 31–49, 1989). The authors develop a theory of episodic memory's connections to cognitive, emotional, and motivational systems to explain these differential age effects. The theory is discussed within the context of the cognitive neuroscience research regarding limbic system connectivity in conjunction with Damasio's notion of somatic markers (Descartes’ error: Emotion, reason, and the human brain, New York: Grosset/Putnam, 1994). The central hypothesis is that elements of limbic system circuitry, including portions of the medial temporal lobes and frontal cortex, are associated with both working and long-term episodic memory performance, and by extension, with the capacity to engage in emotion-guided, self-regulatory processes that depend heavily on episodic memory. In contrast, the semantic memory system may have less shared interface with episodic and affective networks (i.e., the limbic-related system), and therefore remain independent of neurocognitive changes impacting emotional states and episodic-type memory processes. Accordingly, this framework may account for the pattern of age-related declines in episodic relative to semantic memory, particularly if older adults experience less emotional activation, and therefore fewer somatic markers, than younger adults. An initial empirical examination of this emotional mediation theory is presented, using preexisting data that include indicators of age, chronic tendency to focus on negative emotional stimuli (neuroticism), and working memory performance.
Prophylactic RhCE and Kell antigen matching: impact on alloimmunization in transfusion‐dependent patients with myelodysplastic syndromes

Thirty to 80 per cent of patients with myelodysplastic syndromes (MDS) become transfusion‐dependent and are at risk for red blood cell (RBC) alloimmunization. This study compared alloimmunization rates in transfusion‐dependent patients with MDS at an institution with a policy of prophylactic antigen matching for RhCE and K (PAM) with those transfused at institutions without such a policy (non‐PAM).
The Evolution of Poxvirus Vaccines

After Edward Jenner established human vaccination over 200 years ago, attenuated poxviruses became key players to contain the deadliest virus of its own family: Variola virus (VARV), the causative agent of smallpox. Cowpox virus (CPXV) and horsepox virus (HSPV) were extensively used to this end, passaged in cattle and humans until the appearance of vaccinia virus (VACV), which was used in the final campaigns aimed to eradicate the disease, an endeavor that was accomplished by the World Health Organization (WHO) in 1980. Ever since, naturally evolved strains used for vaccination were introduced into research laboratories where VACV and other poxviruses with improved safety profiles were generated. Recombinant DNA technology along with the DNA genome features of this virus family allowed the generation of vaccines against heterologous diseases, and the specific insertion and deletion of poxvirus genes generated an even broader spectrum of modified viruses with new properties that increase their immunogenicity and safety profile as vaccine vectors. In this review, we highlight the evolution of poxvirus vaccines, from first generation to the current status, pointing out how different vaccines have emerged and approaches that are being followed up in the development of more rational vaccines against a wide range of diseases.
Modulation of AMPA Receptors in Cultured Cortical Neurons Induced by the Antiepileptic Drug Levetiracetam

Summary: Purpose: The present study explores the hypothesis that the antiepileptic mechanism of action of levetiracetam (LEV) is related to effects on α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazole propionic acid (AMPA) receptor channels in mouse cortical neurons in culture.
Time‐Related Changes of Radiofrequency Ablation Lesion in the Normal Rabbit Liver: Findings of Magnetic Resonance Imaging and Histopathology

Rationale and Objectives: To study time‐related magnetic resonance imaging (MRI) and histopathological findings after radiofrequency ablation (RFA) in the normal liver. Methods: Under ultrasound guidance, RFA was performed in 22 rabbits with a 15‐gauge expandable probe inserted into the liver. The RF power was applied at 10 W initially with a 5‐W increment every minute until RF power “roll‐off” occurred. The rabbits subjected to postmortem MRI at 3days (n = 6), 2 weeks (n = 6), 4 weeks (n = 6), and 12 weeks (n = 4) after RFA. Spin‐echo (SE) T1‐weighted image (WI) (TR/TE=500/12) and fast SE T2‐WI (TR/TE= 3500/99) were obtained. The liver specimens were excised and processed for conventional histologic study. The MRI and pathologic findings were compared qualitatively and quantitatively. Results: The lesion diameters measured with MRI and liver specimen were well correlated (P < 0.05). The coagulated regions presented 2 of 4 laminar patterns on T1/T2‐WI 3 days after RFA, and 2 of 3 laminar patterns on T1/T2‐WI 2 to 4 weeks after RFA. 12 weeks after RFA, the signal intensity in coagulated regions increased on T1‐WI with a 2‐laminar pattern still visible on T2‐WI, the same as that of 2 to 4 weeks. The observed pathologic changes (enlarged sinusoids, marginal fibrous tissue and hepatocyte degeneration) could be responsible for the MRI laminar patterns and signal intensity changes. Conclusion: The time‐related pathologic changes of RFA lesions in rabbit livers can be reflected as laminar patterns on MR images. Understanding of the zone structure of the lesions is useful for the evaluation of follow‐up MRI.
Medication Options in the Treatment of Treatment-Resistant Depression

Aim: Less than half of those suffering major depressive episodes achieve remission with the first antidepressant provided and one-third of all patients suffering depression have a chronic condition. Clinical experience indicates that a substantial proportion of patients suffer treatment-resistant depression (TRD). Our aim is to explore the literature reporting the drug treatment of TRD, and to present such information as would be of interest to clinical psychiatrists. Method: Literature searches were conducted using PubMed and entering the words antidepressant, augmentation, combined antidepressants, treatment resistant depression and the names of individual antidepressant medications. Results: Most authors recommended that TRD should be first approached by reassessing the diagnosis, adding psychotherapy and attending to psychosocial factors. Details of the following pharmacological options were identified: (i) augmentation of the currently employed antidepressant with a medication which is not an antidepressant; (ii) change of antidepressant; and (iii) addition of a second antidepressant to the current antidepressant, or commencement of a combination of two antidepressants. Conclusions: When monotherapy provided at the maximum manufacturer-recommended doses for 3–4 weeks has failed to provide remission in depression, the diagnosis should be confirmed, psychotherapy added and psychosocial factors should receive attention. In the sustained absence of remission, a better outcome may be obtained by augmenting the antidepressant, changing from a single-action to a double- or multiple-action drug, or by combining antidepressants.
Role of Yersinia pestis Toxin Complex Family Proteins in Resistance to Phagocytosis by Polymorphonuclear Leukocytes

ABSTRACT Yersinia pestis carries homologues of the toxin complex (Tc) family proteins, which were first identified in other Gram-negative bacteria as having potent insecticidal activity. The Y. pestis Tc proteins are neither toxic to fleas nor essential for survival of the bacterium in the flea, even though tc gene expression is highly upregulated and much more of the Tc proteins YitA and YipA are produced in the flea than when Y. pestis is grown in vitro. We show that Tc+ and Tc− Y. pestis strains are transmitted equivalently from coinfected fleas, further demonstrating that the Tc proteins have no discernible role, either positive or negative, in transmission by the flea vector. Tc proteins did, however, confer Y. pestis with increased resistance to killing by polymorphonuclear leukocytes (PMNs). Resistance to killing was not the result of decreased PMN viability or increased intracellular survival but instead correlated with a Tc protein-dependent resistance to phagocytosis that was independent of the type III secretion system (T3SS). Correspondingly, we did not detect T3SS-dependent secretion of the native Tc proteins YitA and YipA or the translocation of YitA– or YipA–β-lactamase fusion proteins into CHO-K1 (CHO) cells or human PMNs. Thus, although highly produced by Y. pestis within the flea and related to insecticidal toxins, the Tc proteins do not affect interaction with the flea or transmission. Rather, the Y. pestis Tc proteins inhibit phagocytosis by mouse PMNs, independent of the T3SS, and may be important for subverting the mammalian innate immune response immediately following transmission from the flea.
Safety as experienced by patients themselves: a Finnish survey of the most recent period of care.

We examined patients' experiences of patient safety and participation in promoting safe care during their most recent care period. A survey of patients (N = 175) revealed that treatment, medication, and device safety were mostly experienced as very good or excellent, but responses varied by age and experience. Patients ages 66-75 were most critical of treatment and medication safety. Device safety was rated the worst aspect of safety. Twenty percent of respondents had experienced errors at some time during their care. Patients who had experienced errors and those who were treated at inpatient wards versus a day surgery unit were most critical towards patient participation. Open and transparent error management involving patients is needed to promote treatment, medication, and especially device safety.
Quality of sunglasses available in the Iranian market; a study with emphasis on sellers’ license

Context: Sunglasses should follow minimum requirements to sufficiently protect eyes. It is not known whether all items obtainable from the market are appropriately designed. Aims: To compare ultraviolet (UV)-protective properties of commercially available sunglasses obtained from authorized and unauthorized Iranian sellers. Settings and Study Design: An analytic-descriptive study performed in a metropolitan area (Tehran). Materials and Methods: Using a UV-visible standard spectrophotometer, the percentage transmittance was scanned between 280 and 400 nm in 348 pairs of nonprescription sunglasses (price range: 20–80 US$) obtained anonymously and randomly from authorized (permitted by the Ministry of Health, 189 pairs) and unauthorized (159 pairs) sellers in the Iranian capital city, Tehran. The Australian/New Zealand Standard (AS/NZS) and the American National Standards Institute [ANSI] standards were followed. Statistical Analysis: Chi-square test, independent samples t-test or Mann–Whitney U-test. Results: UV-protective properties of the sunglasses obtained from authorized sellers complied with AS/NZS and ANSI guidelines in 92.6% and 95.2% of items, respectively. The corresponding rates for sunglasses obtained from unauthorized sellers were 0% and 8.2%, respectively (P < 0.001 for both). The rate of defective polarizing capability of lenses was 27.4% in sunglasses obtained from authorized sellers versus 90.4% in sunglasses obtained from unauthorized sellers (P < 0.001). Neither brand nor price played significant contributions to UV protection/lens polarizing capability of sunglasses obtained from authorized sellers. Conclusions: Sunglasses provided by unauthorized sellers are alarmingly unreliable and could be potentially hazardous for the eye. Brand and price do not guarantee optimal protection against UV radiation or polarizing performance of the lens.
Echocardiographically guided catheter closure of arterial ducts in small preterm infants on the neonatal intensive care unit

Objective: To describe closure of haemodynamically significant arterial ducts in preterm infants using an echocardiographically guided cardiac catheter technique in selected infants in the neonatal nursery and in preference to cardiac surgery. Background: Persistently patent arterial ducts are common in preterm infants and are associated with significant morbidity and mortality. Cardiac catheter techniques continue to improve and occlusion of arterial ducts in preterm infants is becoming technically feasible. Closure of arterial ducts by cardiac catheter techniques would enable selected infants to avoid surgery and a lateral thoracotomy, as well as potentially obviating the need for transfer of sick preterm infants between units for duct closure. Methods and Results: This brief report describes placement of coils or Amplatzer duct devices to occlude arterial ducts in small premature infants exclusively under echocardiographic guidance in the Neonatal Intensive Care Unit. Conclusions: Closing arterial ducts in the neonatal nursery by an echocardiographically guided cardiac catheter technique with minimal morbidity is becoming achievable and is a significant advance in neonatal care. © 2010 Wiley‐Liss, Inc.