Miracle-dz/UniFAR-FTUs huggingface dataset:
Investigation of a possible association of potentially inappropriate medication for older adults and frailty in a prospective cohort study from Germany

Abstract Objective potentially inappropriate medications (PIMs) are commonly defined as drugs that should be avoided in older adults because they are considered to have a negative risk-benefit ratio. PIMs are suspected to increase the risk for frailty, but this has yet to be examined. Design prospective population-based cohort study. Setting and participants a German cohort of community-dwelling older adults (≥60 years) was followed from October 2008 to September 2016. Methods in propensity score-adjusted logistic and Cox regression models, associations between baseline PIM use and prevalent/incident frailty were investigated. Frailty was assessed using the definition by Fried and co-workers, PIM were defined with the 2015 BEERS criteria, the BEERS criteria to avoid in cognitively impaired patients (BEERS dementia PIM), the EU(7)-PIM and the PRISCUS list. Results of 2,865 participants, 261 were frail at baseline and 423 became frail during follow-up. Only BEERS dementia PIM use was statistically significantly associated with prevalent frailty (odds ratio (95% confidence interval), 1.51 (1.04–2.17)). The strength of the association was comparable for all frailty components. Similarly, in longitudinal analyses, only BEERS dementia PIM use was associated with incident frailty albeit not statistically significant (hazard ratio, 1.19 (0.84–1.68)). Conclusions the association of PIM use and frailty seems to be restricted to drug classes, which can induce frailty symptoms (anticholinergics, benzodiazepines, z-substances and antipsychotics). Physicians are advised to perform frailty assessments before and after prescribing these drug classes to older patients and to reconsider treatment decisions in case of negative performance changes.
Across time and space: spatial-temporal binding under stress

Successful episodic memory requires binding of event details across spatial and temporal gaps. The neural processes underlying mnemonic binding, however, are not fully understood. Moreover, although acute stress is known to modulate memory, if and how stress changes mnemonic integration across time and space is unknown. To elucidate these issues, we exposed participants to a stressor or a control manipulation shortly before they completed, while electroencephalography was recorded, an encoding task that systematically varied the demands for spatial and temporal integration. Associative memory was tested 24 h later. While early event-related potentials, including the P300 and Late Positive Component, distinguished different levels of spatiotemporal discontinuity, only later Slow Waves were linked to subsequent remembering. Furthermore, theta oscillations were specifically associated with successful mnemonic binding. Although acute stress per se left mnemonic integration largely unaffected, autonomic activity facilitated object memory and glucocorticoids enhanced detail memory, indicative for mnemonic integration. At the neural level, stress amplified the effects of spatiotemporal discontinuity on early information processing. Together, our results indicate that temporal and spatial gaps recruit early neural processes, providing attentional resources. The actual binding success, however, appears to depend on later processes as well as theta power and may be shaped by major stress response systems.
Novel Dicyano-Phenylenevinylene Fluorophores for Low-Doped Layers: A Highly Emissive Material for Red OLEDs

Two efficient deep red (DR)-emitting organic dicyano-phenylenevinylene derivatives with terminal withdrawing or donor groups were synthesized. The spectroscopic properties of the neat solids and the low-doped layers in polystyrene or polyvinylcarbazole host matrixes were analyzed, and the luminescence performance was explained using density functional theory (DFT) analysis. A noteworthy 89% fluorescence quantum yield was observed for the brightest red-emissive polyvinylcarbazole (PVK) blend. This result pushed us to successfully produce an emissive red organic light-emitting device (OLED) as a preliminary feasibility test.
Environmental Pollution as a Risk Factor in Testicular Tumour Development: Focus on the Interaction between Bisphenol A and the Associated Immune Response

Bisphenol A (BPA) is an endocrine disruptor to which animals and humans are highly exposed. Many reports have established a relationship between BPA exposure and breast cancer incidence, especially during critical periods of development. However, its effects on the immune response in testicular tumour growth have not yet been described. Thus, we wanted to analyse the effect of perinatal BPA exposure in pregnant female mice and the immune response modulation and tumour growth in an intratesticular cancer model in offspring male mice. Pregnant female mice were exposed to a dose of 250 mg/kg/day/body weight of BPA in their drinking water. In adulthood, male offspring underwent intrascrotal inoculation with 4T1 cancer cells. On day 21 after inoculation, mice were euthanised, and serum was obtained to measure BPA levels using HPLC coupled to mass spectrometry. The percentages of immune cell populations in peripheral lymph nodes (PLN), the spleen and tumours were evaluated by flow cytometry. In addition, the tumour expression of IL-10, TNF-α and TGF-β was analysed by RT-PCR. Of note, we found detectable circulating levels of BPA in the offspring of mothers exposed to it while pregnant. Remarkably, BPA treatment promoted tumour growth by about 75% compared to mice coming from female mice that did not receive the compound. Perinatal exposure to BPA modulated the percentages of different immune cells in the spleen and PLN. In addition, the expression of inflammatory-related cytokines (IL-10 and TNF-α) in the tumours was significantly enhanced compared to control and vehicle groups. In conclusion, the perinatal BPA administration in pregnant female mice modulated different cellular and molecular immune components that resulted in outstanding testicular tumour size in male offspring.
Robust Analysis of PM2.5 Concentration Measurements in the Ecuadorian Park La Carolina

In this article, a robust statistical analysis of particulate matter (PM2.5) concentration measurements is carried out. Here, the region chosen for the study was the urban park La Carolina, which is one of the most important in Quito, Ecuador, and is located in the financial center of the city. This park is surrounded by avenues with high traffic, in which shopping centers, businesses, entertainment venues, and homes, among other things, can be found. Therefore, it is important to study air pollution in the region where this urban park is located, in order to contribute to the improvement of the quality of life in the area. The preliminary study presented in this article was focused on the robust estimation of both the central tendency and the dispersion of the PM2.5 concentration measurements carried out in the park and some surrounding streets. To this end, the following estimators were used: (i) for robust location estimation: α-trimmed mean, trimean, and median estimators; and (ii) for robust scale estimation: median absolute deviation, semi interquartile range, biweight midvariance, and estimators based on a subrange. In addition, nonparametric confidence intervals were established, and air pollution levels due to PM2.5 concentrations were classified according to categories established by the Quito Air Quality Index. According to these categories, the results of the analysis showed that neither the streets that border the park nor the park itself are at the Alert level. Finally, it can be said that La Carolina Park is fulfilling its function as an air pollution filter.
Evolution of Streptococcus pneumoniae Serotype 3 in England and Wales: A Major Vaccine Evader

Despite its inclusion in pneumococcal conjugate vaccine 13 (PCV13), Streptococcus pneumoniae serotype 3 remains a major cause of invasive pneumococcal disease in England and Wales. Previous studies have indicated that there are distinct lineages within serotype 3 clonal complex 180 and the clade distributions have shifted in recent years with the emergence of clade II. We undertook whole genome sequencing and genomic analysis of 616 serotype 3 isolates from England and Wales between 2003 and 2018, including invasive and carriage isolates. Our investigations showed that clade II has expanded since 2014 and now represents 50% of serotype 3 invasive pneumococcal disease (IPD) isolates in England and Wales. Genomic analysis of antibiotic resistance and protein antigen genes showed that distinct profiles are present within the clades which could account for the recent emergence of this clade. This investigation highlights the importance and utility of routine whole genome sequencing and its ability to identify new and emerging variation at the single nucleotide level which informs surveillance and will impact future vaccine development.
Radiation protection knowledge and practices in interventional cardiologists practicing in Africa: a cross sectional survey

We conducted a survey of doctors working in the cardiac catheterisation laboratories in Africa on their knowledge, attitude and practice with respect to radiation protection. Of seventy-two respondents contacted, 61 (84.7%) completed the questionnaire. Twenty-eight, (45.9%) were younger than 45 years. Thirty-seven, (60.6%) had less than 10 years of experience in the laboratory. Only 28 (45.9%) had undertaken radiation protection training. Fifty-eight, (95.1%) consistently used lead aprons. Forty-seven, (77%) reported consistently using thyroid shields. Ten (16.4%) consistently used radiation protection eyeglasses, whilst 36 (59%) never used them. Thermoluminescent Dosimeter badges were consistently used in 23 (37.7%). Forty-two, (68.9%) reported having ceiling mounted lead/acrylic shields. Level of radiation exposure in the most recent one year was ≤2 mSv in 14, between 2 and 20 mSv in 8 and between 20 and 30 mSv in 2, whilst 33 did not know their dose readings. The use of basic radiation protection tools as well as the knowledge and measurement of radiation exposure among interventional cardiologists working in Africa is low. The unavailability of some of the protective tools and a knowledge gap in terms of radiation protection and monitoring of self-exposure were some of the reasons for suboptimal self-protection against ionising radiation among our respondents. We suggest that initiatives be taken by all stakeholders to train this group of medical professionals in basic radiation protection to avoid unnecessary exposure to themselves, co-workers and patients.
The Clitoral Size of the Korean Female Newborn and the Relationship in Clitoral Hypertrophy and Androgen levels

Background: To determine mean clitoral and glans size of Korean female newborn. Materials and Methods: The size of glans and clitoris of 68 Korean female newborns born at Yeungnam University Medical Center were measured from May in 1999 to August in 1999. Results: The mean size of the 68 newborns were mm in glans length, mm in glans width and mm in clitoral length. In the premature infants the mean clitoral size was mm in glans length, mm in glans width and mm in clitoral length. In the full term infants mm in glans length, mm in glans width and mm in clitoral length. In low birth weight infants clitoral size was measured mm in glans length, mm in glans width and mm in clitoral length. In normal birth weight infants mm in glans length, mm in glans width and mm in clitoral length. In high birth weight infants mm in glans length, mm in glans width and mm in clitoral length. Conclusion: There was no significant correlation between gestational age and clitoral size or glans size, but significant negative correlation was found between birth weight and clitoral size or glans size.
A Complex Dance: Measuring the Multidimensional Worlds of Influenza Virus Evolution and Anti-Influenza Immune Responses

The human antibody response to influenza virus infection or vaccination is as complicated as it is essential for protection against flu. The constant antigenic changes of the virus to escape human herd immunity hinder the yearly selection of vaccine strains since it is hard to predict which virus strains will circulate for the coming flu season. A “universal” influenza vaccine that could induce broad cross-influenza subtype protection would help to address this issue. However, the human antibody response is intricate and often obscure, with factors such as antigenic seniority or original antigenic sin (OAS), and back-boosting ensuring that each person mounts a unique immune response to infection or vaccination with any new influenza virus strain. Notably, the effects of existing antibodies on cross-protective immunity after repeated vaccinations are unclear. More research is needed to characterize the mechanisms at play, but traditional assays such as hemagglutinin inhibition (HAI) and microneutralization (MN) are excessively limited in scope and too resource-intensive to effectively meet this challenge. In the past ten years, new multiple dimensional assays (MDAs) have been developed to help overcome these problems by simultaneously measuring antibodies against a large panel of influenza hemagglutinin (HA) proteins with a minimal amount of sample in a high throughput way. MDAs will likely be a powerful tool for accelerating the study of the humoral immune response to influenza vaccination and the development of a universal influenza vaccine.
The Design and validation of a Nursing Plan for Elderly Patients with Postoperative Delirium

Delirium is the sudden alteration of the state of consciousness and perception, fluctuating over hours or days. It predominates in older adults and is associated with the aging process. The incidence of delirium increases between 10% and 15% in surgical interventions. The objective of this study was the design and validation of a nursing care plan for elderly patients with postoperative delirium. This study was based on the Delphi method and applied to nursing professionals at the Hospital Universitario del Caribe, Cartagena. The sample consisted of 36 nurses with knowledge of the taxonomy of nursing diagnoses. The care plan was applied in two rounds. For the analysis, measures of central tendency and dispersion were used, as well as frequency and percentages. The participants were women (90.9%) from the hospitalization service (51.5%), with training in Nursing Diagnosis (NANDA), Nursing interventions classification (NIC) and Nursing Outcome Classifications (NOC) (78.8%). The validated care plan has eight diagnostic features. Highlights include “Risk for Ineffective Cerebral Tissue Perfusion” and “Disturbed Sleep Pattern” (in 98.1%; 11 results), with the highest score in the first round being “Vital Signs” (with 100%) and “Sleep” (100%) and “Mobility” (100%) in the second round. Forty-four interventions and 18 suggested activities were identified. This care plan offers the nursing professionals reliable and pertinent tools in clinical practice for the management of patients with postoperative delirium.
The Value of Adding Surveillance Cultures to Fluoroquinolone Prophylaxis in the Management of Multiresistant Gram Negative Bacterial Infections in Acute Myeloid Leukemia

Multidrug resistant Gram-Negative Bacterial Infections (MR-GNBI) are an increasing cause of mortality in acute myeloid leukemia (AML), compromising the success of antineoplastic therapy. We prospectively explored a novel strategy, including mandatory fluoroquinolone prophylaxis, weekly surveillance cultures (SC) and targeted antimicrobial therapy for febrile neutropenia, aimed to reduce infectious mortality due to MR-GNBI. Over 146 cycles of chemotherapy, cumulative incidence of colonization was 50%. Half of the colonizations occurred in the consolidation phase of treatment. Application of this strategy led to a significant reduction in the incidence of GNB and carbapenemase-producing Klebisella pneumoniae (cpKp) species, resulting in a reduction of infectious mortality (HR 0.35 [95%, CI 0.13–0.96], p = 0.042). In multivariate analysis, fluroquinolone prophylaxis in addition to SC was associated with improved survival (OR 0.55 [95% CI 0.38–0.79], p = 0.001). Targeted therapy for colonized patients did not overcome the risk of death once cpKp or XDR Pseudomonas aeruginosa infections were developed. Mortality rate after transplant was similar between colonized and not colonized patients. However only 9% of transplanted patients were colonized by cpkp. In conclusion, colonization is a common phenomenon, not limited to the induction phase. This strategy reduces infectious mortality by lowering the global incidence of GN infections and the spread of resistant species.
ANTIBIOTIC SENSITIVITY PATTERN OF ACINETOBACTER SPECIES ISOLATED FROM CLINICAL SPECIMENS IN A TERTIARY CARE HOSPITAL

Introduction: Acinetobacter , once considered as opportunistic pathogen has recently been emerged as an important nosocomial pathogen world over, mostly involving patients with impaired host defense. 1 It is rapidly evolving toward multi drug resistance against commonly prescribed antimicrobials and is becoming major challenges for physicians. 2 The aim of present study was to find sensitivity and resistance pattern of Acinetobacter species in our set up. It is a descriptive study, that was carried out in the Pathology Department, Post Graduate Medical Institute Lahore from June 2011 to May 2012. Material and Methods: This descriptive study was conducted in the department of Pathology, Post Graduate Medical Institute Lahore from June 2011 to May 2012. Total 6185 clinical specimens were inoculated. All isolations obtained were further processed and Acinetobacter species was isolated by the routine microbiological and biochemical tests. Antibiotic sensitivity test was done by modified Kirby – Bauer disc diffusion method according to the Clinical and Laboratory Standards Institutes guidelines 2011. Results and Discussion: During the study period from June 2011 to May 2012 a total of 6185 specimen were received from Lahore General Hospital. Out of 6185 clinical samples processed 2180 (35%) were culture positive and 4005 (65%) showed no growth. Acinetobacter species isolated was 90 (4.2%) in 12 months from 2180 positive cultures. In the present study the susceptibility pattern of Acinetobacter species recovered from different clinical specimens against various types of antibiotics was maximum with Cefepime 70%, Meropenem 66%, Pipercillin / Tazobactam 66%, Amikacin 66% followed by Ampicillin – Salbactum 59%, Gentamycin 50%, Ciprofloxacin 50%, Ceftriaxone 44%, Ceftazidime 40%, Tetracycline 31% and Trimethoprime – sulfamethoxazole 22%. Acinetobacter species isolated was 90 (4.2%) in 12 months from 2180 positive cultures. Conclusion: Acinetobacter species are becoming difficult to treat day by day due to increasing resistant isolates. These drug resistant infections can be minimise to some extend by judicial use of antibiotics and adopting strict infection control methods.
Decreased local immune response and retained HPV gene expression during chemoradiotherapy are associated with treatment resistance and death from cervical cancer

More than one‐third of patients with locally advanced cervical cancer do not respond to chemoradiation therapy (CRT). We aimed to characterize the transcriptional landscape of paired human cervical tumors before and during CRT in order to gain insight into the evolution of treatment response and to elucidate mechanisms of treatment resistance. We prospectively collected cervical tumor biopsies from 115 patients both before and 3 weeks into CRT. RNA‐sequencing, Gene Set Enrichment Analysis and HPV gene expression were performed on 20 paired samples that had adequate neoplastic tissue mid‐treatment. Tumors from patients with no evidence of disease (NED) at last follow‐up had enrichment in pathways related to the immune response both pretreatment and mid‐treatment, while tumors from patients dead of disease (DOD) demonstrated enrichment in biosynthetic and mitotic pathways but not in immune‐related pathways. Patients DOD had decreased expression of T‐cell and cytolytic genes and increased expression of PD‐L2 mid‐treatment compared to patients NED. Histological and immunohistochemical analysis revealed a decrease in tumor‐associated lymphocytes (TAL) during CRT in all patients but tumors from patients DOD had a significantly more pronounced decrease in TALs and CD8+ cells mid‐treatment, which was validated in a larger mid‐treatment cohort. Finally, patients DOD retained more HPV E6/E7 gene expression during CRT and this was associated with increased expression of genes driving mitosis, which was corroborated in vitro. Our results suggest that decreased local immune response and retained HPV gene expression may be acting together to promote treatment resistance during CRT in patients with cervical cancer.
Socio-Demographic Characteristics of Substance Abusers Among Intercollege Students in a District of Uttarakhand

Substance abuse by children and adolescents is a major health problem. The use of illicit substances frequently starts among school children during adolescence. Concern with the use of harmful habit forming substances in students appears to be a very natural reaction; as they constitute a vital part of the society. Their age and often sudden wide exposure to new environments may render them extremely vulnerable for substance abuse. To find out the association of socio-demographic factors with substance abuse among intercollege students, a Cross-sectional study was conducted among intercollege students of district Dehradun. Multistage random sampling was used for the selection of two intercolleges (one rural and one urban). Overall 1094 students from 9th to 12th classes were included in the study. Statistical analysis was done by entering the data in SPSS software. The prevalence of substance abuse was found to be maximum in the students belonging to the middle slab of income group (socio-economic classes II, III and IV). Nonvegetarian dietary habits, Hindu religion and fathers in professional jobs were also found to be major risk factors for substance abuse behaviour among students.
Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area

Trans women face numerous structural barriers to health due to discrimination. Housing instability is an important structural determinant of poor health outcomes among trans women. The purpose of this study was to determine if experiences of intersectional anti-trans and racial discrimination are associated with poor housing outcomes among trans women in the San Francisco Bay Area. A secondary analysis of baseline data from the Trans *National study (n = 629) at the San Francisco Department of Public Health (2016–2018) was conducted. Multivariable logistic regression was used to analyze the association between discrimination as an ordered categorical variable (zero, one to two, or three or more experiences) and housing status adjusting for age, years lived in the Bay Area, and gender identity. We found that the odds of housing instability increased by 1.25 for every categorical unit increase (1–2, or 3+) in reported experiences of intersectional (both anti-trans and racial) discrimination for trans women (95% CI = 1.01–1.54, p-value < 0.05). Intersectional anti-trans and racial discrimination is associated with increased housing instability among trans women, giving some insight that policies and programs are needed to identify and address racism and anti-trans stigma towards trans women. Efforts to address intersectional discrimination may positively impact housing stability, with potential for ancillary effects on increasing the health and wellness of trans women who face multiple disparities.