Miracle-dz/UniFAR-FTUs huggingface dataset:
Liver Fibrosis Linked to Cognitive Performance in HIV and Hepatitis C

Objective:Because HIV impairs gut barriers to pathogens, HIV-infected adults may be vulnerable to minimal hepatic encephalopathy in the absence of cirrhosis. Background:Cognitive disorders persist in up to one-half of people living with HIV despite access to combination antiretroviral therapy. Minimal hepatic encephalopathy occurs in cirrhotic patients with or without HIV infection and may be associated with inflammation. Design/Methods:A cross-sectional investigation of liver fibrosis severity using the aspartate aminotransferase to platelet ratio index (APRI) and neuropsychological testing performance among women from the Women's Interagency HIV Study. A subset underwent liver transient elastography (FibroScan, n = 303). Results:We evaluated 1479 women [mean (SD) age of 46 (9.3) years]: 770 (52%) only HIV infected, 73 (5%) only hepatitis C virus (HCV) infected, 235 (16%) HIV/HCV coinfected, and 401 (27%) uninfected. Of these, 1221 (83%) exhibited APRI ⩽0.5 (no or only mild fibrosis), 206 (14%) exhibited APRI >0.5 and ⩽1.5 (moderate fibrosis), and 52 (3%) exhibited APRI >1.5 (severe fibrosis). Having moderate or severe fibrosis (APRI >0.5) was associated with worse performance in learning, executive function, memory, psychomotor speed, fluency, and fine motor skills. In these models that adjusted for fibrosis, smaller associations were found for HIV (learning and memory) and HCV (executive functioning and attention). The severity of fibrosis, measured by FibroScan, was associated with worse performance in attention, executive functioning, and fluency. Conclusions:Liver fibrosis had a contribution to cognitive performance independent of HCV and HIV; however, the pattern of neuropsychological deficit associated with fibrosis was not typical of minimal hepatic encephalopathy.
HIV Testing, Care Referral, and Linkage to Care Intervals Affect Time to Engagement in Care for Newly Diagnosed HIV-Infected Adolescents in 15 Adolescent Medicine Clinics in the United States

Objective: To examine how the time from HIV testing to care referral and from referral to care linkage influenced time to care engagement for newly diagnosed HIV-infected adolescents. Methods: We evaluated the Care Initiative, a care linkage and engagement program for HIV-infected adolescents in 15 US clinics. We analyzed client-level factors, provider type, and intervals from HIV testing to care referral and from referral to care linkage as predictors of care engagement. Engagement was defined as a second HIV-related medical visit within 16 weeks of initial HIV-related medical visit (linkage). Results: At 32 months, 2143 youth had been referred. Of these, 866 were linked to care through the Care Initiative within 42 days and thus eligible for study inclusion. Of the linked youth, 90.8% were ultimately engaged in care. Time from HIV testing to referral (eg, ⩽7 days versus >365 days) was associated with engagement [adjusted odds ratio = 2.91; 95% confidence interval (CI): 1.43 to 5.94] and shorter time to engagement (adjusted hazard ratio = 1.41; 95% CI: 1.11 to 1.79). Individuals with shorter care referral to linkage intervals (eg, ⩽7 days versus 22–42 days) engaged in care faster (adjusted hazard ratio = 2.90; 95% CI: 2.34 to 3.60) and more successfully (adjusted odds ratio = 2.01; 95% CI: 1.04 to 3.89). Conclusions: These data address a critical piece of the care continuum and can offer suggestions of where and with whom to intervene to best achieve the care engagement goals outlined in the US National HIV/AIDS Strategy. These results may also inform programs and policies that set concrete milestones and strategies for optimal care linkage timing for newly diagnosed adolescents.
Rapid Antigen Tests for Diagnosis of Pandemic (Swine) Influenza A/H1N1

Abstract We found that the sensitivities of 3 rapid influenza antigen tests for pandemic influenza A/H1N1 virus were low to moderate: BD Directigen EZ Flu A+B test (Becton Dickinson), 46.7%; BinaxNOW Influenza A&B (Inverness Medical), 38.3%; and QuickVue Influenza A+B Test (Quidel), 53.3%. A patient with influenza-like illness who has a negative rapid antigen test result should undergo further testing using reverse-transcription polymerase chain reaction.
Evaluation of an Electronic Device for Real-Time Measurement of Alcohol-Based Hand Rub Use

Background. Observational surveys of hand hygiene compliance are time consuming. Measuring the use of a hand hygiene product is a less time-consuming method of monitoring the frequency of hand hygiene performance. Objective. To evaluate the usefulness of electronic devices for monitoring alcohol-based hand rub use. Design. Prospective observational trial. Setting. A university-affiliated teaching hospital. Methods. Prototypes of an electronic device designed to record each time a dispenser is used (hereafter referred to as a hand hygiene event) were placed in alcohol-based hand rub dispensers on the general medical ward and in the surgical intensive care unit. Data were downloaded wirelessly to a data logger and then uploaded to a dedicated Web site for analysis. Alcohol-based hand rub dispensers were located in patient rooms and in corridors. Results. During a 6-month trial, 105,462 hand hygiene events occurred in the surgical intensive care unit, and 44,845 events occurred on the general medical ward. The dispensers located in patient rooms accounted for 47% of the hand hygiene events performed in the surgical intensive care unit but for only 36% of events on the general medical ward (P<.001). The dispensers most often used were located in corridors. Hand hygiene events were most common on Tuesdays, Wednesdays, and Thursdays, between 7:00 AM and 11:00 AM. Conclusions. The use of these electronic devices provided an efficient and accurate method of monitoring the frequency of alcohol-based hand rub performance on the general medical ward and in the surgical intensive care unit, and yielded more detailed information on usage patterns than did expressing use as liters per 1,000 patient-days. The wireless downloading of data from dispensers required a limited amount of time, and the dedicated Web site facilitated data analysis. Such devices should prove useful in monitoring the impact of various interventions on the frequency of hand hygiene performance.
The Maintenance of Genetic Variation Due to Asymmetric Gene Flow in Dendritic Metapopulations

Dendritic landscapes can have ecological properties that differ importantly from simpler spatial arrangements of habitats. Most dendritic landscapes are structured by elevation, and therefore, migration is likely to be directionally biased. While the population‐genetic consequences of both dendritic landscape arrangements and asymmetric migration have begun to be studied, these processes have not been considered together. Simple conceptual models predict that if migration into branch (headwater) populations is limited, such populations can act as reservoirs for potentially unique alleles. As a consequence of the fact that dendritic landscapes have, by definition, more branches than internal habitat patches, this process may lead to the maintenance of higher overall genetic diversities in metapopulations inhabiting dendritic networks where migration is directionally biased. Here we begin to address the generality of these simple predictions using genetic models and a review of empirical literature. We show, for a range of demographic parameters, that dendritic systems with asymmetric migration can maintain levels of genetic variation that are very different, sometimes very elevated, compared with more classical models of geographical population structure. Furthermore, predicted patterns of genetic variation within metapopulations—that is, stepwise increases in genetic diversity at nodes—do occur in some empirical data.
An Investigation of Metabolic Prioritization in the European Sea Bass, Dicentrarchus labrax

We investigated the ability of European sea bass (Dicentrarchus labrax) to respond simultaneously to the metabolic demands of specific dynamic action (SDA) and aerobic exercise and how this was influenced by moderate hypoxia (50% air saturation). At 3 h after feeding in normoxia at 20°C, SDA raised the instantaneous oxygen uptake (Mo2) of sea bass by 47% ± 18% (mean ± SEM, N = 7) above their standard metabolic rate (SMR) when fasted. This metabolic load was sustained throughout an incremental exercise protocol until fatigue, with a 14% ± 3% increase in their maximum aerobic metabolic rate (MMR) relative to their fasted rate. Their incremental critical swimming speed (Ucrit) did not differ between fasted and fed states. Thus, in normoxia, the bass were able to meet the combined oxygen demands of SDA and aerobic exercise. In hypoxia, the sea bass suffered a significant decline in MMR and Ucrit relative to their normoxic performance. The SDA response was similar to normoxia (84% ± 24% above fasted SMR at 3 h after feeding), but although this load was sustained at low swimming speeds, it gradually disappeared as swimming speed increased. As a result, the hypoxic sea bass exhibited no difference in their fasted versus fed MMR. Hypoxic Ucrit did not, however, differ between fasted and fed states, indicating that the sea bass deferred their SDA to maintain exercise performance. The results demonstrate that, in normoxia, the sea bass possesses excess cardiorespiratory capacity beyond that required for maximal aerobic exercise. The excess capacity is lost when oxygen availability is limited in hypoxia, and, under these conditions, the sea bass prioritize exercise performance. Thus, environmental conditions (oxygen availability) had a significant effect on patterns of oxygen allocation in sea bass and revealed intrinsic prioritization among conflicting metabolic demands.
Susceptibility of Plasmodium falciparum isolates to doxycycline is associated with pftetQ sequence polymorphisms and pftetQ and pfmdt copy numbers.

BACKGROUND Doxycycline is used in combination with quinine for malaria treatment or alone for malaria chemoprophylaxis. However, the occurrence of malaria after doxycycline chemoprophylaxis has been reported. Identification of genetic determinants that contribute to the susceptibility of Plasmodium falciparum to doxycycline will be important for the detection and surveillance of doxycycline resistance. METHODS Sequence analysis of 11 genes (pftufA, pfEF-TS, pfmdt, pftetQ, pfrps3, pfrps7, pfrps8, pfrps9, pfrps11, pfrps14, and pfrps17) and evaluation of pfmdt and pftetQ copy numbers by quantitative real-time polymerase chain reaction were conducted in 90 African P. falciparum isolates that were obtained from 14 countries and that belonged to phenotypic groups differing in their doxycycline median inhibitory concentrations. RESULTS We found that pfmdt copy number of >1 (adjusted odds ratio [OR], 7.09 [95% confidence interval {CI}, 1.58-31.82]; P=.011), pftetQ copy number of >1 (adjusted OR, 5.23 [95% CI, 1.06-25.77]; P=.042), and KYNNNN amino acid motif repeats of <3 (adjusted OR, 3.00 [95% CI, 1.02-8.86]; P=.046) were independently associated with decreased susceptibility to doxycycline. CONCLUSIONS Our findings suggest that pfmdt and pftetQ copy numbers and pftetQ sequence polymorphisms are potential molecular markers of decreased in vitro susceptibility to doxycycline in African P. falciparum isolates.
Comparison of Clinical Features of Pediatric Respiratory Syncytial Virus and Human Metapneumovirus Infections

To the Editor—Respiratory syncytial virus (RSV) has long been known to be an important cause of morbidity and mortality in the young pediatric age group. The more recently identified human metapneumovirus (hMPV) is now increasingly recognized as a cause of acute respiratory tract disease in all age groups,' with symptomatic disease most often seen in young children, especially those less than 1 year old. Infections due to hMPV are an important cause of pediatric hospitalizations, but to our knowledge the spectrum of clinical manifestations has not been fully defined. In this study, we determined the local prevalence of hMPV infection and RSV infection among children aged 0-60 months during the winter seasons from November 2004 through April 2006 and compared the clinical manifestations of the 2 infections in a subset of the study population. We also examined the influence of comorbidities on the clinical course of the diseases. Studies were performed under a protocol approved by the institutional review board of North Shore University Hospital. Discarded respiratory tract samples (nasopharyngeal aspirates, nasopharyngeal washes, nasopharyngeal swabs in viral transport media [Universal Transport Medium, Diagnostic Hybrids], transtracheal aspirates, and sputum), collected during the period from November 2004 through April 2006 and stored at — 70°C, were obtained from 653 children (433 children aged 0-24 months and 220 children aged 25-60 months) who were symptomatic for a respiratory disease. Samples were submitted to the North Shore University Hospital Clinical Virology Laboratory, Manhasset, New York, for routine respiratory virus testing by means of direct immunofluorescence for influenza A, influenza B, parainfluenza 1, 2, and 3, adenovirus, and RSV and by means of R-Mix rapid cell culture (Diagnostic Hybrids). Total nucleic acids were extracted from a 200-/xL specimen aliquot by using NucliSENS magnetic silica extraction reagents (bioMerieux) and the NucliSENS miniMAG or NucliSENS easyMAG extraction platforms (bioMerieux). Molecular detection of RSV RNA and hMPV RNA was performed by using NucliSENS analyte-specific reagents (bioMerieux) according to in-house validated protocols and published studies. Standardized case report forms were completed by means of retrospective review of the medical records of a subset of patients who tested positive for RSV, hMPV, or both and for whom medical records were available. Patient demographics, clinical findings, comorbidities, and radiologic results were recorded. Fever was defined as any temperature greater than 38°C. Comorbidity was defined as any other diagnosis that was present at the time of the evaluation, for example, a history of substantial prematurity, reactive airway disease,
Comparative clinical study of canine and feline total blood cell count results with seven in-clinic and two commercial laboratory hematology analyzers.

BACKGROUND A CBC is an integral part of the assessment of health and disease in companion animals. While in the past newer technologies for CBC analysis were limited to large clinical pathology laboratories, several smaller and affordable automated hematology analyzers have been developed for in-clinic use. OBJECTIVES The purpose of this study was to compare CBC results generated by 7 in-clinic laser- and impedance-based hematology instruments and 2 commercial laboratory analyzers. METHODS Over a 3-month period, fresh EDTA-anticoagulated blood samples from healthy and diseased dogs (n=260) and cats (n=110) were analyzed on the LaserCyte, ForCyte, MS45, Heska CBC, Scil Vet ABC, VetScan HMT, QBC Vet Autoread, CELL-DYN 3500, and ADVIA 120 analyzers. Results were compared by regression correlation (linear, Deming, Passing-Bablok) and Bland-Altman bias plots using the ADVIA as the criterion standard for all analytes except HCT, which was compared with manual PCV. Precision, linearity, and carryover also were evaluated. RESULTS For most analytes, the in-clinic analyzers and the CELL-DYN performed similarly and correlated well with the ADVIA. The biases ranged from -0.6 to 2.4 x 10(9)/L for WBC count, 0 to 0.9 x 10(12)/L for RBC count, -1.5 to 0.7 g/dL for hemoglobin concentration, -4.3 to 8.3 fL for MCV, and -69.3 to 77.2 x 10(9)/L for platelet count. Compared with PCV, the HCT on most analyzers had a bias from 0.1% to 7.2%. Canine reticulocyte counts on the LaserCyte and ForCyte correlated but had a negative bias compared with those on the ADVIA. Precision, linearity, and carryover results were excellent for most analyzers. CONCLUSIONS Total WBC and RBC counts were acceptable on all in-clinic hematology instruments studied, with limitations for some RBC parameters and platelet counts. Together with evaluation of a blood film, these in-clinic instruments can provide useful information on canine and feline patients in veterinary practices.
Hematology and serum clinical chemistry reference intervals for free-ranging Scandinavian gray wolves (Canis lupus).

BACKGROUND Scandinavian free-ranging wolves (Canis lupus) are endangered, such that laboratory data to assess their health status is increasingly important. Although wolves have been studied for decades, most biological information comes from captive animals. OBJECTIVES The objective of the present study was to establish reference intervals for 30 clinical chemical and 8 hematologic analytes in Scandinavian free-ranging wolves. METHODS All wolves were tracked and chemically immobilized from a helicopter before examination and blood sampling in the winter of 7 consecutive years (1998-2004). Seventy-nine blood samples were collected from 57 gray wolves, including 24 juveniles (24 samples), 17 adult females (25 samples), and 16 adult males (30 samples). Whole blood and serum samples were stored at refrigeration temperature for 1-3 days before hematologic analyses and for 1-5 days before serum biochemical analyses. Reference intervals were calculated as 95% confidence intervals except for juveniles where the minimum and maximum values were used. RESULTS Significant differences were observed between adult and juvenile wolves for RBC parameters, alkaline phosphatase and amylase activities, and total protein, albumin, gamma-globulins, cholesterol, creatinine, calcium, chloride, magnesium, phosphate, and sodium concentrations. CONCLUSION Compared with published reference values for captive wolves, reference intervals for free-ranging wolves reflected exercise activity associated with capture (higher creatine kinase activity, higher glucose concentration), and differences in nutritional status (higher urea concentration).
Validation of the Sysmex XT-2000iV hematology system for dogs, cats, and horses. II. Differential leukocyte counts.

BACKGROUND The Sysmex XT-2000iV is a laser-based, flow cytometric hematology system that stains nucleic acids in leukocytes with a fluorescent dye. A 4-part differential is obtained using side fluorescence light and laser side scatter. OBJECTIVE The purpose of this study was to validate the Sysmex XT-2000iV for determining differential leukocyte counts in blood from ill dogs, cats, and horses. METHODS Blood samples from diseased animals (133 dogs, 65 cats, and 73 horses) were analyzed with the Sysmex XT-2000iV (Auto-diff) and the CELL-DYN 3500. Manual differentials were obtained by counting 100 leukocytes in Wright-stained blood smears. RESULTS Leukocyte populations in the Sysmex DIFF scattergram were usually well separated in equine samples, but were not as well separated in canine and feline samples. Correlation among the Sysmex XT-2000iV, CELL-DYN 3500, and manual counts was excellent for neutrophil counts (r >or=.97) and good for lymphocyte counts (r >or=.87) for all three species. Systematic differences between the 3 methods were seen for lymphocyte and monocyte counts. The Sysmex reported incomplete differential counts on 18% of feline, 13% of canine, and 3% of equine samples, often when a marked left shift (>10% bands) and/or toxic neutrophils were present. Eosinophils were readily identified in cytograms from all 3 species. Neither the Sysmex nor the CELL-DYN detected basophils in the 7 dogs and 5 cats with basophilia. CONCLUSIONS The Sysmex XT-2000iV automated differential leukocyte count performed well with most samples from diseased dogs, cats, and horses. Basophils were not detected. Immature neutrophils or prominent toxic changes often induced errors in samples from cats and dogs.
Health-related quality of life among hypertensive patients compared with general population norms.

The 36-item short form (SF-36) health survey is the most popular generic HRQOL instrument that has been widely used to measure several population studies and variety of health conditions, including hypertension. The objectives of this study were to compare the HRQOL of hypertensive patients with that of a general population norm and analyze differences according to the presence of comorbid conditions such as diabetes mellitus and cardiovascular comorbidities. A total of 388 hypertensive patients was included in this cross-sectional study. Socio-demographic information and the presence of diabetes mellitus and cardiovascular comorbidities were recorded. HRQOL was assessed by using SF-36 instrument. General linear models were used to identify statistically significant differences in scale scores. Hypertensive patients reported lower scores in six SF-36 dimensions except bodily pain and role emotional dimension when compared with Malaysian norms. After adjusting for socio-demographic variables (age, gender, education and employment), SF-36 scores in the presence of diabetes mellitus and cardiovascular comorbidities were comparably limited and both had statistically significantly lower scores than hypertensive patients without comorbidities. Hypertension reduced HRQOL and cardiovascular comorbidities exacerbate reductions. Hence, future research of effective interventions should include ensuring desirable HRQOL as well as controlling blood pressure to prevent or reduce comorbidities of hypertension.
Detection of antinuclear antibodies by the Inno-Lia ANA update test in canine systemic rheumatic disease.

BACKGROUND Certain systemic autoimmune diseases in dogs are characterized by high titers of circulating antinuclear antibodies (ANA), which can be demonstrated by indirect immunofluorescence (IIF). In an earlier study of IIF-ANA-positive dogs, the Ouchterlony double immunodiffusion (DID) test was used to identify specific autoantibodies. The DID test has largely been replaced with line blot tests in human diagnostic settings. OBJECTIVE The objective of this study was to investigate whether the line blot assay Inno-Lia ANA update test is a useful tool in demonstrating ANA specificities in canine patients with previously diagnosed IIF-ANA-positive rheumatic disorders. METHODS Serum samples from 3 clinically healthy control dogs and 20 canine patients with clinical signs of systemic rheumatic disease and documented positive results for IIF-ANA and DID tests were included in the study. The Inno-Lia ANA update assay was performed with an anti-canine detection antibody. RESULTS Six serum samples that had DID positivity with anti-spliceosomal small nuclear ribonucleoproteins (snRNP) reactivity showed reactivity to multiple snRNP proteins in the Inno-Lia test. Samples from 2 dogs that had other types of DID positivity also had clear SmB reactivity and 1 had weak reactivity to RNP-70K. The other serum samples, including controls, were negative. CONCLUSIONS Using the Inno-Lia ANA update test, multiple snRNP specificities were demonstrated in some canine patients with autoimmune rheumatic disorders. Other canine autoantibodies may exist that are not detected by this test. Further studies are necessary to characterize the target antigen(s) of these remaining autoantibodies in canine sera.