Miracle-dz/UniFAR-FTUs huggingface dataset:
Molecular Characterization of Fluoroquinolone Resistance in Nontypeable Haemophilus influenzae Clinical Isolates

ABSTRACT Nontypeable Haemophilus influenzae (NTHi) is a common cause of respiratory infections in adults, who are frequently treated with fluoroquinolones. The aims of this study were to characterize the genotypes of fluoroquinolone-resistant NTHi isolates and their mechanisms of resistance. Among 7,267 H. influenzae isolates collected from adult patients from 2000 to 2013, 28 (0.39%) were ciprofloxacin resistant according to Clinical and Laboratory Standards Institute (CLSI) criteria. In addition, a nalidixic acid screening during 2010 to 2013 detected five (0.23%) isolates that were ciprofloxacin susceptible but nalidixic acid resistant. Sequencing of their quinolone resistance-determining regions and genotyping by pulse-field gel electrophoresis and multilocus sequence typing of the 25 ciprofloxacin-resistant isolates available and all 5 nalidixic acid-resistant isolates were performed. In the NTHi isolates studied, two mutations producing changes in two GyrA residues (Ser84, Asp88) and/or two ParC residues (Ser84, Glu88) were associated with increased fluoroquinolone MICs. Strains with one or two mutations (n = 15) had ciprofloxacin and levofloxacin MICs of 0.12 to 2 μg/ml, while those with three or more mutations (n = 15) had MICs of 4 to 16 μg/ml. Long persistence of fluoroquinolone-resistant strains was observed in three chronic obstructive pulmonary disease patients. High genetic diversity was observed among fluoroquinolone-resistant NTHi isolates. Although fluoroquinolones are commonly used to treat respiratory infections, the proportion of resistant NTHi isolates remains low. The nalidixic acid disk test is useful for detecting the first changes in GyrA or in GyrA plus ParC among fluoroquinolone-susceptible strains that are at a potential risk for the development of resistance under selective pressure by fluoroquinolone treatment.
The body compassion scale: Development and initial validation

As the newer mindfulness and acceptance-based cognitive behavioral therapies continue to grow, it is important that corresponding valid and reliable assessment tools are developed and evaluated. This article describes the initial development and validation of the body compassion scale. The body compassion scale is a theoretically derived measure designed to bridge the constructs of body image and self-compassion to provide a targeted measure of underlying mindfulness and acceptance-based constructs. Herein, two studies using exploratory and confirmatory factor analysis and examining subsequent relationships among other health-related constructs in college-age samples are presented.
Reply to “Therapeutic Outcomes of Pyogenic Vertebral Osteomyelitis Requiring Spinal Instrumentation”

We appreciate the [comments][1] by Park et al. ([1][2]) regarding our paper “Factors associated with treatment failure in vertebral osteomyelitis requiring spinal instrumentation” ([2][3]). In our study ([2][3]), treatment failure occurred in 22 of the 94 patients (23%), higher than reported in
Self-effectiveness in preventing diarrhea and child care: a transversal study

Objetivo : Verificar a associacao entre o nivel de autoeficacia materna para prevencao da diarreia infantil e as condicoes de saude e cuidados prestados as criancas. Metodo : Estudo transversal, realizado em Fortaleza-CE, com 448 maes de criancas menores de cinco anos. Realizaram-se entrevistas, utilizando-se a Escala de Autoeficacia Materna para Prevencao da Diarreia Infantil. Na analise, foram utilizados os testes linear by linear, quiquadrado e razao de maximoverossimilhanca. Resultados : Verificou-se associacao significante entre os niveis de autoeficacia e as variaveis: cuidados prestados a crianca fora de casa (p=0,03), amamentacao exclusiva ate os seis meses (p=0,001), existencia anterior de algum episodio diarreico (p=0,001), o fato de a crianca possuir alguma patologia (p=0,020), internacao da crianca no primeiro mes de vida (p=0,038) e vacinacao contra o rotavirus (p=0,003). Conclusao : Assim, a autoeficacia deve ser levada em consideracao no desenvolvimento e implementacao de intervencoes, com vistas a aperfeicoar o cuidado materno prestado ao filho.
Efficacy of Artemether-Lumefantrine and Dihydroartemisinin-Piperaquine for Treatment of Uncomplicated Malaria in Children in Zaire and Uíge Provinces, Angola

ABSTRACT The development of resistance to antimalarials is a major challenge for global malaria control. Artemisinin-based combination therapies, the newest class of antimalarials, are used worldwide but there have been reports of artemisinin resistance in Southeast Asia. In February through May 2013, we conducted open-label, nonrandomized therapeutic efficacy studies of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) in Zaire and Uíge Provinces in northern Angola. The parasitological and clinical responses to treatment in children with uncomplicated Plasmodium falciparum monoinfection were measured over 28 days, and the main outcome was a PCR-corrected adequate clinical and parasitological response (ACPR) proportion on day 28. Parasites from treatment failures were analyzed for the presence of putative molecular markers of resistance to lumefantrine and artemisinins, including the recently identified mutations in the K13 propeller gene. In the 320 children finishing the study, 25 treatment failures were observed: 24 in the AL arms and 1 in the DP arm. The PCR-corrected ACPR proportions on day 28 for AL were 88% (95% confidence interval [CI], 78 to 95%) in Zaire and 97% (91 to 100%) in Uíge. For DP, the proportions were 100% (95 to 100%) in Zaire, and 100% (96 to 100%) in Uíge. None of the treatment failures had molecular evidence of artemisinin resistance. In contrast, 91% of AL late-treatment failures had markers associated with lumefantrine resistance on the day of failure. The absence of molecular markers for artemisinin resistance and the observed efficacies of both drug combinations suggest no evidence of artemisinin resistance in northern Angola. There is evidence of increased lumefantrine resistance in Zaire, which should continue to be monitored.
Incremental validity of the comprehensive inventory of thriving in predicting self-reporting mental and physical health among community populations

This study examined psychometric properties and 1-year predictive validity of the Comprehensive Inventory of Thriving in China. In total, 556 participants in Chinese communities completed the Comprehensive Inventory of Thriving for confirmatory factor analysis. The other 533 individuals further completed the Flourishing Scale and Satisfaction With Life Scale and reported their physical and mental health 1 year later. The 18-factor correlated model showed a better goodness-of-fit than the seven-factor second-order related model. Thriving had higher correlation coefficients with depression, anxiety, stress, and doctor visits. The Comprehensive Inventory of Thriving is an efficient screening tool to differentiate the risk group from other groups and can predict health outcomes among community populations for active interventions.
Psychological distress in patients with obstructive sleep apnoea: The role of hostility and coping self-efficacy

We aimed to assess whether hostility and coping self-efficacy are associated with psychological distress in obstructive sleep apnoea patients. Furthermore, we examined whether coping self-efficacy mediates the association between hostility and psychological distress. We included 150 obstructive sleep apnoea patients (Apnoea-Hypopnoea Index ⩾5; 68% male; mean age: 48.9 ± 9.5 years). Regression models showed that hostility and poor coping self-efficacy were strongly associated with psychological distress in obstructive sleep apnoea patients. All assessed coping self-efficacy dimensions mediated the association between hostility and psychological distress. Coping self-efficacy for stopping unpleasant emotions and thoughts showed the strongest association with a lower level of psychological distress.
Comparison of the effects of isoflurane and thiopental on neurologic outcome and neuropathology after temporary focal cerebral ischemia in primates.

In an attempt to determine whether one anesthetic might be clearly advantageous over another in clinical situations of temporary focal ischemia, isoflurane or thiopental (in concentrations producing equal suppression of cerebral function as measured by the electroencephalogram) were studied for their effects on neurologic outcome and cerebral infarct size in pigtailed monkeys exposed to temporary focal ischemia produced by 5 h of middle cerebral artery occlusion (MCAo). Burst suppression was produced for 15 min before MCAo and maintained throughout the ischemic period by 2.18 +/- 0.11% (mean +/- SE) end-expired isoflurane or 135 +/- 18 mg.kg-1 thiopental. Mean arterial pressure was supported with phenylephrine and maintained at approximately 90 mmHg in both groups throughout the ischemic period. At the end of the ischemic period, the isoflurane or thiopental was discontinued, allowing the animals to awaken. Intensive care was provided as needed. Neurologic function was scored for 8 days at the end of which surviving animals were killed and the brains were fixed in formalin and then examined for infarct size. There was no significant difference in final neurologic outcome between the animals receiving isoflurane and those receiving thiopental as determined by the Mann-Whitney rank sum test. Neurologic deficit scores ranged from normal (one of eight in the group receiving isoflurane and three of nine in the group receiving thiopental) to death resulting from brain injury (three in the isoflurane group and five in the thiopental-treated group). There also was no significant difference in infarct size between the two groups. (ABSTRACT TRUNCATED AT 250 WORDS)
Death Attitudes and Self-reported Health- relevant Behaviors

Two studies are presented investigating the role of attitudes toward death in self- reported health-protective behavior. The Multidimensional Death Attitudes Scale (MDAS), based on three existing measures of death attitudes, was administered to a group of health professionals (N = 348). A principal components analysis revealed five factors, labeled Acceptance, Fear, Death as Passage, Death as Relief and Avoidance. The five- factor structure also was replicated in a second, somewhat different sample (N = 100). Twenty-three items loaded highly on the five factors, and the subscales showed good internal consistency. The relationship between the five death attitudes and self-reported health behaviors was explored. Acceptance of death was associated positively with physical exercise controlling for demographic and psychological variables. Accepting death but not viewing death as relief were associated with self- reported lower levels of drinking and driving.
Activity of Eravacycline against Enterobacteriaceae and Acinetobacter baumannii, Including Multidrug-Resistant Isolates, from New York City

ABSTRACT Eravacycline demonstrated in vitro activity against a contemporary collection of more than 4,000 Gram-negative pathogens from New York City hospitals, with MIC50/MIC90 values, respectively, for Escherichia coli of 0.12/0.5 μg/ml, Klebsiella pneumoniae of 0.25/1 μg/ml, Enterobacter aerogenes of 0.25/1 μg/ml, Enterobacter cloacae 0.5/1 μg/ml, and Acinetobacter baumannii of 0.5/1 μg/ml. Activity was retained against multidrug-resistant isolates, including those expressing KPC and OXA carbapenemases. For A. baumannii, eravacycline MICs correlated with increased expression of the adeB gene.
Impact of Extended-Spectrum β-Lactamase Production on Treatment Outcomes of Acute Pyelonephritis Caused by Escherichia coli in Patients without Health Care-Associated Risk Factors

ABSTRACT Extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) is increasingly identified as a cause of acute pyelonephritis (APN) among patients without recent health care contact, i.e., community-associated APN. This case-control study compared 75 cases of community-associated ESBL-EC APN (CA-ESBL) to 225 controls of community-associated non-ESBL-EC APN (CA-non-ESBL) to identify the risk factors for ESBL-EC acquisition and investigate the impact of ESBL on the treatment outcomes of community-associated APN (CA-APN) caused by E. coli at a Korean hospital during 2007 to 2013. The baseline characteristics were similar between the cases and controls; the risk factors for ESBL-EC were age (>55 years), antibiotic use within the previous year, and diabetes with recurrent APN. The severity of illness did not differ between CA-ESBL and CA-non-ESBL (Acute Physiology and Chronic Health Evaluation [APACHE] II scores [mean ± standard deviation], 7.7 ± 5.9 versus 6.4 ± 5.3; P = 0.071). The proportions of clinical (odds ratio [OR], 1.76; 95% confidence interval [CI], 0.57 to 5.38; P = 0.323) and microbiological (OR, 1.16; 95% CI, 0.51 to 2.65; P = 0.730) cures were similar, although the CA-ESBL APN patients were less likely to receive appropriate antibiotics within 48 h. A multivariable Cox proportional hazards analysis of the prognostic factors for CA-APN caused by E. coli showed that ESBL production was not a significant factor for clinical (hazard ratio [HR], 0.39; 95% CI, 0.12 to 1.30; P = 0.126) or microbiological (HR, 0.49; 95% CI, 0.21 to 1.12; P = 0.091) failure. The estimates did not change after incorporating weights calculated using propensity scores for acquiring ESBL-EC. Therefore, ESBL production did not negatively affect treatment outcomes among patients with community-associated E. coli APN.
Social Support, Health and Satisfaction among the Elderly with Chronic Conditions in Taiwan

This study examines possible relationships between perceived social support, physical and mental health, satisfaction towards hospital services, and satisfaction towards life-asa-whole, among the community elderly with chronic conditions. A sample of 172 Chinese elderly living in a metropolitan Taiwanese city were home-interviewed. Results indicated that (a) the elderly perceived good social support, and tangible support was the most important aspect; (b) the elderly did not perceive great impact of illness(es) upon their life, and both physical and mental health were satisfactory; (c) the elderly were generally satisfied with both the hospital services and life-as-a-whole; (d) apart from health and illness factors, social support appeared to have profound and pervasive protective effects on adjustment and satisfaction of the elderly.
Kidney Injury Associated with Telavancin Dosing Regimen in an Animal Model

ABSTRACT The elevation of serum creatinine levels is a concern with telavancin therapy. We examined the onset of kidney injury associated with telavancin in an animal model. Urine samples were collected at baseline and daily to determine the concentrations of kidney injury molecule 1 (KIM-1), a marker for early kidney injury. When a clinically relevant exposure of telavancin was given daily to rats, some differences in kidney injury were attributed to the dosing regimen. Further investigations of alternative telavancin dosing regimens are warranted.
Focus Groups in Health Research

Focus group method is becoming increasingly popular among qualitative researchers. After introducing focus group method and briefly overviewing its use in health research, this article shows that the distinctive (and under-used) feature of focus group method is its generation of interactive data. Illustrating my argument with examples from health- related focus group research (including my own data on breast cancer), I argue that this feature makes focus groups an ideal method for gaining access to research participants' own meanings. Interactive data result in enhanced disclosure, improved access to participants' own language and concepts, better understanding of participants' own agendas, the production of more elaborated accounts, and the opportunity to observe the co-construction of meaning in action. Focus groups are, then, an ideal method for exploring people's own meanings and understandings of health and illness.
Ceftazidime-Avibactam Activity against Multidrug-Resistant Pseudomonas aeruginosa Isolated in U.S. Medical Centers in 2012 and 2013

ABSTRACT Pseudomonas aeruginosa isolates (n = 3,902) from 75 U.S. medical centers were tested against ceftazidime-avibactam and comparator agents by the reference broth microdilution method. Overall, 96.9% of the strains were susceptible (MIC, ≤8 μg/ml) to ceftazidime-avibactam, while the rates of susceptibility for ceftazidime, meropenem, and piperacillin-tazobactam were 83.8, 81.9, and 78.5%, respectively. Multidrug-resistant and extensively drug-resistant phenotypes were observed in 14.9 and 8.7% of the strains, respectively, and 81.0 and 73.7% of the strains were susceptible to ceftazidime-avibactam, respectively.
Health, Stress and Coping among Women Caregivers

Informal family-based care of dependent adults places a significant burden on caregivers. The impact of caregiving on subjective wellbeing, preventive behaviours, lifestyle and employment is well documented, and there is good evidence for increases in risk factors for serious illness, although evidence on actual incidence of major illness varies between studies. The individual-based focus of much research on this topic has tended to obscure the social and cultural forces underlying the fact that the majority of family caregivers are women, and to ignore the gender inequities which are perpetuated by an assumption that family caregiving is naturally the work of women. This article reviews evidence on the burden of caregiving, and argues for psychological research which addresses issues of public policy rather than the individual woman and her personal ability to cope.
The Young Person's Perspective on Living and Coping with Diabetes

Adolescence and young adulthood is a time of significant psychological and psychosocial development, and for young people with Type 1 diabetes mellitus it is a time when self-care and metabolic control of diabetes may become compromised. In order to enhance services’ efforts to meet the complex needs of young people with diabetes, a qualitative interview study with eight young people (aged 16–22 years) was carried out. Young people identified an inherent vulnerability associated with having diabetes and feared that diabetes would take control and overwhelm them. Through learning to live with diabetes, and learning to manage a relationship with diabetes, the young people had developed sophisticated, interrelated self-protective strategies to manage intrapersonal and interpersonal threats from diabetes.
Generic Vancomycin Enriches Resistant Subpopulations of Staphylococcus aureus after Exposure in a Neutropenic Mouse Thigh Infection Model

ABSTRACT Previous studies have shown that “bioequivalent” generic products of vancomycin are less effective in vivo against Staphylococcus aureus than the innovator compound. Considering that suboptimal bactericidal effect has been associated with emergence of resistance, we aimed to assess in vivo the impact of exposure to innovator and generic products of vancomycin on S. aureus susceptibility. A clinical methicillin-resistant S. aureus (MRSA) strain from a liver transplant patient with persistent bacteremia was used for which MIC, minimum bactericidal concentration (MBC), and autolytic properties were determined. Susceptibility was also assessed by determining a population analysis profile (PAP) with vancomycin concentrations from 0 to 5 mg/liter. ICR neutropenic mice were inoculated in each thigh with ∼7.0 log10 CFU. Treatment with the different vancomycin products (innovator and three generics; 1,200 mg/kg of body weight/day every 3 h) started 2 h later while the control group received sterile saline. After 24 h, mice were euthanized, and the thigh homogenates were plated. Recovered colonies were reinoculated to new groups of animals, and the exposure-recovery process was repeated until 12 cycles were completed. The evolution of resistance was assessed by PAP after cycles 5, 10, 11, and 12. The initial isolate displayed reduced autolysis and higher resistance frequencies than S. aureus ATCC 29213 but without vancomycin-intermediate S. aureus (VISA) subpopulations. After 12 cycles, innovator vancomycin had significantly reduced resistant subpopulations at 1, 2, and 3 mg/liter, while the generic products had enriched them progressively by orders of magnitude. The great capacity of generic vancomycin to select for less susceptible organisms raises concerns about the role of therapeutic inequivalence of any antimicrobial on the epidemiology of resistance worldwide.
Mortality and causes of death in autism spectrum disorders

This study compared mortality among Danish citizens with autism spectrum disorders (ASDs) with that of the general population. A clinical cohort of 341 Danish individuals with variants of ASD, previously followed over the period 1960—93, now on average 43 years of age, were updated with respect to mortality and causes of death. Standardized mortality ratios (SMRs) were calculated for various times after diagnosis. In all, 26 persons with ASD had died, whereas the expected number of deaths was 13.5. Thus the mortality risk among those with ASD was nearly twice that of the general population. The SMR was particularly high in females. The excess mortality risk has remained unchanged since our first study in 1993. Eight of the 26 deaths were associated with epilepsy and four died from epilepsy. Future staff education should focus on better managing of the complex relationships between ASD and physical illness to prevent avoidable deaths.
Relationship of agr Expression and Function with Virulence and Vancomycin Treatment Outcomes in Experimental Endocarditis Due to Methicillin-Resistant Staphylococcus aureus

ABSTRACT The accessory gene regulator (agr) locus has been shown to be important for virulence in several animal models of Staphylococcus aureus infection. However, the role of agr in human infections, and specifically in antibiotic treatment, is controversial. Interestingly, agr dysfunction has been associated with reduced vancomycin responses. To systematically investigate the role of agr in virulence and treatment outcome in the context of endovascular infection, 10 well-characterized vancomycin-susceptible methicillin-resistant S. aureus (MRSA) bloodstream isolates (5 agr-I [clonal complex 45, or CC45] and 5 agr-II [CC5]) were studied for (i) agr function, (ii) RNAIII transcriptional profiles, (iii) agr locus sequences, (iv) intrinsic virulence and responses to vancomycin therapy in an experimental infective endocarditis (IE) model, and (v) in vivo RNAIII expression. Significant differences in agr function (determined by delta-hemolysin activity) correlated with the time point of RNAIII transcription (earlier RNAIII onset equals increased agr function). Unexpectedly, four MRSA strains with strong delta-hemolysin activities exhibited significant resistance to vancomycin treatment in experimental IE. In contrast, five of six MRSA strains with weak or no delta-hemolysin activity were highly susceptible to vancomycin therapy in the IE model. agr sequence analyses showed no common single-nucleotide polymorphism predictive of agr functionality. In vivo RNAIII expression in cardiac vegetations did not correlate with virulence or vancomycin treatment outcomes in the IE model. Inactivation of agr in two strains with strong delta-hemolysin activity did not affect virulence or the in vivo efficacy of vancomycin. Our findings suggest that agr dysfunction does not correlate with vancomycin treatment failures in this experimental IE model in two distinct MRSA genetic backgrounds.