Miracle-dz/UniFAR-FTUs huggingface dataset:
No association found between patients receiving isotretinoin for acne and the development of depression in a Canadian prospective cohort.

BACKGROUND There has been concern that the use of isotretinoin to treat acne may lead to depression. To date, research has not conclusively determined if this concern is warranted when contemplating the use of isotretinoin. OBJECTIVE This study investigated the impact of isotretinoin use for patients with acne on mood status. The hypothesis was that an association exists between the use of isotretinoin and the development of depression, aside from acne severity. METHODS We studied the relationship between isotretinoin and depression using a prospective, controlled, cohort design. The study was conducted in a community dermatology clinic. The exposed cohort consisted of consenting patients who were initiating isotretinoin treatment for acne. Patients were either treated with isotretinoin (Acutaneï) therapy (study group) (N=100) or by oral (N=41) or topical acne therapy (control group) (N=59). The Center for Epidemiologic Studies Depression scale and the Zung Depression Status Inventory were used to assess depression both at baseline and after 2 months of prescribed use of isotretinoin or a control medication (topical or oral antibiotics). RESULTS There was no correlation between isotretinoin use and the development of depression, based on either the Centre for Epidemiologic Studies Depression scale (Fisherâs exact test, P=0.497) or Zung Depression Status Inventory (ANOVA; F=1.4, P=0.2). CONCLUSION Isotretinoin does not appear to be associated with the development of depression. Thus, denying patients with significant acne an effective medication for fear of developing depression may not be indicated at this point in time.
Integrating Patient Safety Standards Into the Accreditation Program: A Qualitative Study to Assess the Readiness of Lebanese Hospitals to Implement Into Routine Practice

Introduction Concerns about quality of care have led to the integration of patient safety standards and goals in national and international accreditation programs. Since 2005, two national hospital accreditation surveys have been conducted in Lebanon. In 2010, the Ministry of Health integrated patient safety standards into the current program. This study is one of the first efforts in Lebanon and the region to assess hospitals’ readiness to integrate patient safety standards into routine practice. Methods This cross-sectional study sampled 6807 respondents from 68 hospitals in Lebanon. This paper will detail results from the qualitative thematic analysis of the responses on 5 open-ended questions added to the Hospital Survey on Patient Safety Culture. The emerging themes were compared across regions, accreditation status, and hospital size. Results Lebanese hospitals have made progress by recognizing patient safety as a major strategic goal and priority, but gaps still exist in implementation. Very few hospitals are ready for effective implementation of these standards. Staff education and training are needed. Public awareness about patient safety and integrating these concepts into health educational curricula were cited as important strategies among others for creating a culture of patient safety. Variations in responses across regions, accreditation status, and hospital size were discussed. Discussion and Conclusions Integrating patient safety initiatives into routine practices requires a cultural shift in health-care organizations. Before assessing whether hospitals comply with patient safety standards, it is important to provide them with sufficient training and education on how to successfully implement these standards. Study findings provide valuable lessons for Lebanon and other countries, which are in the process or currently mandating the implementation of patient safety standards and/or accreditation programs.
A Congolese–US participatory action research partnership to rebuild the lives of rape survivors and their families in eastern Democratic Republic of Congo

Abstract The Democratic Republic of Congo (DRC) remains an all-too-potent reminder of how war, human rights violations and their related health and economic impacts can devastate a society. The last decade has seen the use of rape as a weapon of war in the DRC, where rebels and soldiers subject women and girls to brutalising attacks, rape, torture and mutilation. Survivors of sexual and gender-based violence (SGBV) are often further traumatised by infections, disease, poverty, stigma and social isolation. Substantial evidence exists showing an association between social determinants (e.g., poverty, stress and trauma, stigma, lack of access to health care) and health; however, limited research has been conducted to elucidate these relationships or to develop and test interventions to change social determinants of health, especially in conflict and post-conflict settings such as the DRC. The purpose of this article is to present a Congolese–US community-academic research partnership to obtain evidence to develop and implement a sustainable intervention to begin to address the social determinants of health, including poverty and traumatic stress for survivors of SGBV and their families in the South Kivu province of eastern DRC.
Enhanced contrast sensitivity confirms active compensation in blur adaptation.

PURPOSE To determine the effects of defocus-induced blur adaptation on human contrast sensitivity (CS) function. METHODS Defocused (+2 D) CS was measured for spatial frequencies between 0.5 and 12 cycles per degree (cpd) before and after adaptation to +2 D blur in six subjects with normal vision. During the 30-minute adaptation period with +2 D lens, subjects were exposed to a succession of static calibrated natural images that were also used to "top-up" adaptation between postadaptation trials. RESULTS After 30 minutes of blur adaptation, CS was found to be significantly reduced at 0.5 cpd (P = 0.023), though it was enhanced at 8 cpd (P = 0.007) and 12 cpd (P = 0.005). The average sensitivity reduction at 0.5 cpd was 0.20 log(10) units, whereas enhancements were 0.09 and 0.16 log(10) units at 8 and 12 cpd, respectively. CONCLUSIONS The present study demonstrates a novel finding that 30 minutes of defocused viewing results in enhanced high spatial frequency CS. The concurrent observation of low spatial frequency CS reduction suggests that the changes are not caused by simple learning effects but are likely caused by neural adaptation.
Sperm ultrastructure of six Australian hylid frogs from two genera (Litoria and Cyclorana): phylogenetic implications.

The spermatozoa of four fossorial (Litoria alboguttata, Cyclorana brevipes, Cyclorana novaehollandiae and Cyclorana cryptotis) and two non-fossorial australian hylid frogs (Litoria aurea and Litoria moorei) together with previously examined Litoria (Hylidae: Anura) are compared. In spermatozoal ultrastructure (in particular the structure of the sperm tail) Cyclorana includes species which appear derived (apomorphic) relative to non-fossorial species of Litoria while the fossorial L. alboguttata groups with Cyclorana. All hylid species examined here are united by the bufonoid synapomorphy of a conical subacrosomal cone consisting of separate sheaves and the eubufonoid synapomorphy of a mitochondrial sheath or collar separated by a cytoplasmic canal from the centriolar region and tail. Spermatozoal symplesiomorphies for the Eubufonoidea, seen in Litoria (with the exception of L. alboguttata), are the well developed thin undulating membrane with juxta-axonemal and axial fibre. L. alboguttata, C. novaehollandiae and C. brevipes appear monophyletic in the apomorphic modification of the undulating membrane as a thick, dense structure. In L. alboguttata and C. novaehollandiae this structure retains a swelling, at the free edge, homologized with the axial rod. C. brevipes has a further apomorphy as the undulating membrane forms a parallel-sided dense structure with no separate differentiation of an axial fibre. C. cryptotis, however, retains the plesiomorphic sperm tail with a thin undulating membrane, juxta-axonemal and axial fibre. That these differences in spermatozoal ultrastructure have phylogenetic significance is endorsed by the similarity of the fertilization biology of the species examined. On the basis of sperm ultrastructure three separate lineages are discerned within Cyclorana s. lat. : 1) C. cryptotis; 2) L. alboguttata and C. novaehollandiae; and 3) C. brevipes. The evidence of sperm ultrastructure, supported by previously published molecular, morphological and karyological data, clearly places Litoria alboguttata within the genus Cyclorana.
Distribution of neuropeptide-containing nerve fibers in the synovium and adjacent bone of the rat knee joint.

OBJECTIVE The innervation of normal rat synovium and adjacent bone, especially the communicatory nerve fibers between them, were investigated. METHODS Nerve fibers were visualized using immunohistochemistry. Antisera to substance P(SP) and antisera to calcitonin gene-related peptide (CGRP) were employed to identify sensory nerves, while antisera to neuropeptide Y (NPY) were used to identify sympathetic nerves. RESULTS In the synovium, SP-positive nerve fibers were found in the lining cell layer, with some fibers branching toward the joint space. In the sublining layer of the synovium, SP-positive and CGRP-positive fibers were observed mainly near the blood vessels. NPY-positive fibers were predominantly seen as a network around the blood vessels in the sublining layer. A large number of SP-positive and CGRP-positive fibers were seen near the attachment of the meniscus to the synovium. Toluidine blue positive mast cells were detected in close proximity to all three types of fibers, especially near the blood vessels. In bones forming the knee joint, nerve fibers immunoreactive to SP, CGRP and NPY were present in the bone marrow and some of these fibers communicated with the synovium through the synovium-bone junction located in the bare area. CONCLUSION The role of nerves, especially the role of the communicatory nerves between the synovium and the bone marrow, should be considered in the pathophysiolosy of erosive arthritis.
The inhibitory activity of the extracts of popular medicinal herbs on CYP1A2, 2C9, 2C19 and 3A4 and the implications for herb-drug interaction.

BACKGROUND Studies have suggested an increasing practice of concurrent herb-drug consumption. One of the major clinical risks of such concomitant herb-drug use is pharmacokinetic herb-drug interaction (HDI). This is brought about by the ability of phytochemicals to inhibit or induce the activity of metabolic enzymes. The aim of this study was to investigate the potential of the crude aqueous extracts of three popular medicinal herbs used in South Africa to inhibit major cytochrome P450 (CYP) enzymes. MATERIALS AND METHODS The extracts of Bowiea volubilis, Spirostachys africana and Tulbaghia violacea were incubated with human liver microsomes (HLM) to monitor the phenacetin O-deethylation, diclofenac 4'-hydroxylation, S-mephenytoin 4'-hydroxylation and testosterone 6β-hydroxylation as respective probe reactions for CYP1A2, CYP2C9, CYP2C19 and CYP3A4. The inhibitory activity, where observed, was profiled against the extract concentration. RESULTS Extracts of Bowiea volubilis inhibited the metabolic activity of CYP1A2 and CYP3A4 with IC50 values of 92.3 ± 5.5 µg/mL and 8.1 ± 0.6 µg/mL respectively. Similar observation with Spirostachys africana showed inhibitory activity against CYP1A2 and CYP3A4 with respective IC50 values of 14.3 ± 0.6 µg/mL and 47.4 ± 2.4 µg/mL. Tulbaghia violacea demonstrated relatively weak inhibitory activity against CYP1A2 (767.4 ± 10.8 µg/mL) and CYP2C9 (921 ± 15.3 µg/mL). CONCLUSION The results suggest the potential for HDI between the herbs and the substrates of the affected enzymes, if sufficient in vivo concentration is attained.
Management of the infected aortoiliac aneurysms.

PURPOSE We have reviewed ruptured and nonruptured infected aortoiliac aneurysms to study the clinical presentation, management and eventual outcome of patients managed with in situ prostheses, axillofemoral prostheses grafts and endovascular reconstruction. DESIGN A retrospective chart review of 16 cases treated at a single institution. METHODS From January 2007 to March 2008, a total of 93 patients with aortoiliac aneurysms underwent surgical repair at our institution. Among these, 16 patients (17.2%) were shown to be infected aneurysms of the infrarenal (n = 6), juxtarenal (n = 2), and pararenal aorta (n = 1); the others were 5 common, 1 external, and 1 internal iliac arteries. Fourteen patients were male and 2 were female with the mean age of 66 years (range, 45-79). In all cases, the diagnosis was confirmed by abdominal computed tomography and empirical parenteral antibiotics were administered at least 1 week, unless in patients need emergency operations. At the time of an operation, all were saccular and were classified as primary infected aortoiliac aneurysms. Thirteen patients had surgical debridement with in situ graft interposition and omental wrapping, 2 underwent aneurysm exclusion and extra-anatomic (axillo-femoral) bypass, 1 underwent aneurysmectomy of left external iliac artery and polytetrafluoroethylene (PTFE) graft interposition, and 1 underwent endovascular exclusion. The parenteral antibiotics were continued in the postoperative period for 4-6 weeks. Chronic renal disease was present in 37.5% (6/16), with diabetes mellitus present in 31.25% (5/16). The most common pathogen was Salmonella sp. (n = 6) and E. coli (n = 5). Thirty-seven percent (6/16) of the patients presented late, with a 37.5% (6/16) incidence of ruptured (4 contained, 2 free ruptured) that needed emergency surgery. RESULTS Disease-specific mortality was 31.25% (5/16). The 30-day mortality rate of ruptured cases is high 67% (4/6), because patients present late in the course of the disease. One patient who underwent aneurysm exclusion and extra-anatomic (axillo-femoral) bypass died 6 months later from burst aortic stump. Salmonella and E. coli are the most common pathogens. CONCLUSIONS Early diagnosis followed by surgical intervention with proper antibiotic coverage provides the best results. Mortality rate was still high in patients with sepsis and rupture. An in situ graft interposition and omental wrapping is a safe option for revascularization of infected aneurysms of the iliac arteries and infrarenal aorta.
High prevalence of hereditary thrombotic thrombocytopenic purpura in central Norway: from clinical observation to evidence

Essentials The population prevalence of hereditary thrombotic thrombocytopenic purpura (TTP) is unknown. We studied the prevalence of hereditary TTP and population frequencies of two ADAMTS‐13 mutations. A high frequency of hereditary TTP related to ADAMTS‐13 mutation c. 4143_4144dupA was found. Vicinity of ABO blood group and ADAMTS‐13 loci may facilitate screening of ADAMTS‐13 mutations.
Cytokine profiles in cerebrospinal fluid of human immunodeficiency virus-infected patients with cryptococcal meningitis: no leukocytosis despite high interleukin-8 levels. University of Zimbabwe Meningitis Group.

Cytokine levels were studied in the cerebrospinal fluid (CSF) of 16 adults with cryptococcal meningitis (CM). Low levels of tumor necrosis factor (TNF)-alpha and interferon-gamma, high levels of interleukin (IL)-1beta, IL-6, and IL-8, and the presence of IL-10 were documented. There were no significant differences in levels of TNF-alpha and interferon-gamma for CM and control patients. Mean CSF levels of IL-1beta (139.5 pg/mL), IL-6 (346 pg/mL), IL-8 (1160 pg/mL), and IL-10 (9.27 pg/mL) were significantly (P < .01) elevated in CM patients compared with levels in control patients. Despite the high CSF levels of IL-8, minimal leukocytosis was seen. Significant correlations between cryptococcal antigen titers and IL-10 levels (r = .8, P < .05), protein and cryptococcal antigen titer (r = .9, P < .05), and protein and IL-10 levels (r = .8, P < .05) were found.
The ideologies of positive economics: technocracy, laissez-faire, and the tensions of Friedman's methodological claims

The purpose of this paper is to address some connections between Milton Friedman's classic essay on methodology and the rise of neoliberal thinking. In order to do so, it briefly reconstructs Friedman's methodological claims and reinterprets the debate about them. Emphasis is put on the tensions between instrumentalism and realism or pragmatism, and between empiricism and the defense of Chicago price theory. Then, these tensions are related to a tension that is arguably inherent in neoliberalism, between technocracy and laissez-faire. The argument presented aims to contribute to bridging the gap between the recent literature on neoliberalism and the older one on Friedman's methodological essay.
Evaluation of Broth Microdilution Antifungal Susceptibility Testing Conditions for Trichophyton rubrum

ABSTRACT Fifty clinical isolates of Trichophyton rubrum were selected to test with ketoconazole, fluconazole, itraconazole, griseofulvin, and terbinafine by following the National Committee for Clinical Laboratory Standards susceptibility testing guidelines for filamentous fungi (M38-A). In addition, other susceptibility testing conditions were evaluated: (i) three medium formulations including RPMI 1640 (standard medium), McVeigh & Morton (MVM), and Sabouraud dextrose broth (SDB); (ii) two incubation temperatures (28 and 35°C); and (iii) three incubation periods (4, 7, and 10 days). The strains Candida parapsilosis (ATCC 22019), Candida krusei (ATCC 6258), T. rubrum (ATCC 40051), and Trichophyton mentagrophytes (ATCC 40004) were included as quality controls. All isolates produced clearly detectable growth only after 7 days of incubation. MICs were significantly independent of the incubation temperature (28 or 35°C) (P < 0.05). Different incubation periods resulted in MICs which were consistently different for each medium when azoles and griseofulvin were tested (P < 0.05). MICs obtained from different media at the same incubation time for the same isolate were significantly different when azoles and griseofulvin were tested (P < 0.05). MICs were consistently higher (usually 1 to 2 dilutions) with RPMI than with MVM or SDB (P < 0.05). When terbinafine was tested, no parameter had any influence on MICs (P < 0.05). RPMI standard medium appears to be a suitable testing medium for determining the MICs for T. rubrum. MICs obtained at different incubation times need to be correlated with clinical outcome to demonstrate which time has better reliability.
Cadmium in locally grown rice (Oryza sativa) in Nigeria

Cadmium levels were determined in locally grown rice samples in Nigeria and any potential risk involved in their consumption was assessed. The dried samples were digested with a 1:1 HNO3:HClO4 mixture and analysed with atomic absorption spectrophotometer (AAS). Mean cadmium values (mg/kg) were: Adamawa (0.50 ± 0.02), Benue (0.63 ± 0.05), Nasarawa (0.48 ± 0.10), Taraba (0.48 ± 0.10), Anambra (0.49 ± 0.09), Ebonyi (0.60 ± 0.08) and Enugu (0.59 ± 0.10). All samples exceeded the Codex Alimentarius maximum limit for cadmium in rice. The dietary intake for a 60 kg adult ranges from 235 to 309 µg/week in the northern region and 240–294 µg/week in the south-eastern region. The target hazard quotient (THQ) ranged from 0.54 to 0.71, which is less than 1, indicating that the population will not be exposed to a potential health risk from dietary cadmium. However, the measured cadmium levels in rice should be of concern.
Health by association.

In their recent account of the relationship between social capital and the political economy of public health,1 Simon Szreter and Michael Woolcock distinguish between two different forms of social capital—‘bonding’ social capital and ‘bridging’ social capital—and identify a specialized form of bridging social capital called ‘linking social capital’, which is distinguished from other manifestations of bridging social capital by its emphasis on the construction of relationships between acknowledged social unequals. Their theoretical argument is buttressed by a historical case-study of the relationship between social action and the decline of mortality in nineteenth- and early-twentieth-century Britain.
Brachial artery reconstruction for occlusive disease: a 12-year experience.

OBJECTIVE Symptomatic arterial disease of the upper extremity is an uncommon problem. In this study, we evaluate our results with brachial artery reconstruction in patients who present with symptomatic atherosclerotic occlusive disease and compare this cohort's demographics with a similar group with lower extremity ischemia. METHODS From 1986 to 1998, all patients presenting for upper extremity revascularization with chronic ischemia were prospectively entered into a vascular registry. Demographics, indications, outcomes, and patency were recorded. Patients presenting with embolus, pseudoaneurysm, or trauma were excluded. The Fisher exact and Student t tests were used to assess significance. RESULTS Fifty-one (83%) bypass grafts were performed with autogenous conduit and the remainder with polytetrafluoroethylene. Indications included 18 (30%) patients with exertional arm pain, 35 (57%) with rest pain, and 8 (13%) with tissue loss. Twenty-five (45%) patients were male, 8 (14%) had diabetes, and 30 (54%) were smokers. The mean age was 58 years (range, 33-93). The operative mortality rate was 1.8%, and follow-up ranged from 1 to 140 months. Eight occlusions were identified, with six occurring early. Five of these were in women with a smoking history. Only one of the 26 reconstructions that did not cross a joint occluded, whereas bypass grafts that did cross a joint occluded more frequently. No other major complications were recognized. CONCLUSION Arm revascularization for ischemia can be performed with reasonable mortality and morbidity rates. These patients may represent a different subgroup of atherosclerotic disease than those with lower extremity involvement: they are more commonly women and smokers and less likely to be diabetic.
Giant Inflatable Colon and Community Knowledge, Intention, and Social Support for Colorectal Cancer Screening

Introduction Colorectal cancer (CRC) is the second-leading cause of deaths from cancer in the United States. Screening decreases CRC deaths through early cancer detection and through removal of precancerous lesions. We investigated whether a health exhibit consisting of a giant inflatable colon was an effective educational tool to increase community members’ knowledge, intention, and social support for CRC screening and prevention. Methods Alaska adults (N = 880) attending community events statewide from March 2011 through March 2012 completed a short survey to assess knowledge about CRC, intention to get screened, and level of social support before and after walking through a giant interactive model of a human colon. The survey used a combination of open-ended questions and a Likert scale, where 1 was “very unlikely,” 2 was “somewhat unlikely,” 3 was “neutral,” 4 was “somewhat likely,” and 5 was “very likely. ” The model depicted CRC stages from normal tissue to advanced adenocarcinoma and displayed signs with CRC prevention tips. We used the McNemar test and paired sample t tests for univariate analyses. Results Respondents significantly improved their CRC knowledge (P < .05), intention to get screened (mean score increased from 4.3 to 4.5, P < .001), and comfort with talking to others about CRC screening (mean level of comfort increased from 3.8 to 3.9, P < .001). Multivariate analysis showed no significant differences by sex, age, or race for improvements in CRC screening knowledge, intention, or comfort. Conclusion Interactive exhibits can improve public knowledge and interest in CRC screening, which may lead to increased CRC screening rates and decreased CRC incidence and deaths.