Miracle-dz/UniFAR-FTUs huggingface dataset:
Home syrup of ipecac use does not reduce emergency department use or improve outcome.

BACKGROUND The usefulness of syrup of ipecac as a home treatment for poisoning and the need to keep it in the home has been increasingly challenged. Many poison centers do not recommend any use of syrup of ipecac. OBJECTIVE To determine if use of syrup of ipecac in children at home is associated with reduced utilization of emergency department (ED) resources or improved outcome after unintended exposure to a pharmaceutical. DESIGN Cohort comparison. SETTING American Association of Poison Control Centers' Toxic Exposure Surveillance System Database. PATIENTS Blinded data for each of the 64 US poison centers included ED referral recommendation rate, actual rate of ED use, actual home use of syrup of ipecac, and outcome. These data were derived from cases in 2000 and 2001 involving children <6 years of age who unintentionally ingested a pharmaceutical agent and in which the call to a poison center came from home (752 602 children). OUTCOME MEASURES Correlation between rate of home use of syrup of ipecac and rate of recommendation for ED referral was the primary outcome sought. Rate of adverse outcome was also compared. In addition, the actual ED use and home syrup of ipecac utilization rates at 7 specific centers were identified and compared with the published rates from these same centers from 1990 data to look for the trend in practice for this subgroup. RESULTS Mean rate of referral to ED was 9% (range: 3%-18%). Mean home use of syrup of ipecac was 1.8% (range: 0.2%-14%). Increased home use of syrup of ipecac was not associated with referral to ED (r = 0.18; 95% confidence interval of r = -0.06-0.41). Adverse outcome was rare: 0.6% (range: 0.2%-2.1%). There was no difference in referral rate or adverse outcome rate between 2 groups of 32 centers divided by relative syrup of ipecac use. In the 7 centers, ED use decreased from a mean of 13.5% in 1990 to a mean of 8.1% in 2000-2001. Ipecac use decreased from a mean of 9.6% to 2.1%. CONCLUSIONS This study suggests there is no reduction in resource utilization or improvement in patient outcome from the use of syrup of ipecac at home. Although these data cannot exclude a benefit in a very limited set of poisonings, any benefit remains to be proven.
Cholera outbreak in South Africa, 2008-2009: laboratory analysis of Vibrio cholerae O1 strains.

BACKGROUND A total of 720 Vibrio cholerae O1 strains were recovered for investigation from an outbreak of cholera in South Africa between November 2008 and April 2009. METHODS Strains were characterized by serotype testing. Antimicrobial susceptibility testing. Genetic diversity of 248 strains was investigated using pulsed-field gel electrophoresis (PFGE) analysis. Extended characterization was performed on 90 strains. Molecular analysis included: polymerase chain reaction (PCR) identification of ctxA and tcpA genes, sequencing the ctxAB gene, and investigation of molecular mechanisms conferring antimicrobial resistance. RESULTS The majority of strains were characterized as serotype Ogawa. Strains showed multidrug resistance. Approximately 1.0% of strains displayed extended-spectrum β-lactamase (ESBL) activity. Strains showed very similar PFGE patterns. Ninety strains selected for extended characterization showed the following results: Strains possessed the cholera toxin (CT) and all were PCR positive for the tcpA-El Tor variant. Sequencing of the ctxB gene matched the B-1 allele. Strains harbored the SXT element. Strains that displayed ESBL activity possessed a 140-kilobase-pair plasmid that produced the TEM-63 β-lactamase. Nalidixic acid-resistant strains harbored mutations in GyrA (Ser83-Ile) and ParC (Ser85-Leu). CONCLUSIONS These data highlight the rapid development of antimicrobial resistance and spread of V. cholerae O1 El Tor variants expressing the classical CT within South Africa.
The international school nurse asthma project: barriers related to asthma management in schools.

AIM This article is a report of an international study of barriers to asthma care from the perspectives of school nurses in Reykjavik, Iceland and St. Paul, Minnesota, in the context of their schools, communities and countries. BACKGROUND Globally, asthma affects the health and school performance of many adolescents. School nurses play a key role by providing care to adolescents with asthma in school settings. Understanding universal barriers to asthma management in schools is important for developing interventions that are effective in multiple societal contexts. DESIGN Exploratory, descriptive study. METHODS Parallel studies were conducted from September 2008-January 2009, through six focus groups among school nurses (n = 32, in Reykjavik n = 17 and St. Paul n = 15) who were managing asthma in adolescents. Focus groups were audio-recorded and transcribed verbatim in English or Icelandic. The Icelandic transcripts were translated into English. Descriptive content analytic techniques were used to systematically identify and categorize types of barriers to asthma care. RESULTS School nurses in both countries identified common barriers, such as time constraints, communication challenges and school staff barriers. The primary difference was that St. Paul school nurses identified more socio-economic and health access barriers than school nurses in Reykjavik. CONCLUSION Greater cultural and linguistic diversity and socio-economic differences in the student population in St. Paul and lack of universal healthcare coverage in the US contributed to school nurses' need to focus more on asthma management than school nurses in Reykjavik, who were able to focus more on asthma prevention and education.
Thymic marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue-type in a patient with Sjögren's syndrome and cryoglobulinaemia.

1. McGregor DM, Cherian R, Romanas MM, Ulusarac O, Mathur SC, Feldman MM. Amelanotic malignant melanoma: two collision tumours presenting as basal cell carcinoma and atypical fibroxanthoma. Ann Clin Lab Sci 2008; 38: 157–62. 2. Dettrick A, Strutton G. Atypical fibroxanthoma with perineural or intraneural invasion: a report of two cases. J Clin Pathol 2006; 33: 318– 22. 3. Jain M, Singh S, Argawal K. Spindle cell neoplasm of skin: diagnostic dilemma. Indian J Pathol Microbiol 2007; 50: 814–6. 4. Weedon D, Williamson R, Mirza B. CD10, a useful marker of atypical fibroxanthomas. Letter to the editor.Am J Dermatopathol 2005; 27: 181. 5. Mirza B, Weedon D. Atypical fibroxanthoma: a clinicopathological study of 89 cases. Australas J Dermatol 2005; 46: 235–8. 6. Hultgren TL, DMaio DJ. Immunohistochemical staining of CD10 in atypical fibroxanthomas. J Cutan Pathol 2007; 34: 415–9. 7. De Feraudy S, Mar N, McCalmont TH. Evaluation of CD10 and Procollagen 1 expression in atypical fibroxanthoma and dermatofibroma. Am J Surg Pathol 2008; 32: 1111–22. 8. Sangueza M, Zelger B. Melanoma simulating atypical fibroxanthoma. Am J Dermatopathol 2007; 29: 551–4. 9. Wilsher MJ, Cheerala B. WT1 as a complementary marker of melanoma, an immunohistochemical study of whole sections. Histopathology 2007; 51: 605–10. 10. Banerjee SS, Eyden B. Divergent differentiation in malignant melanoma: a review. Histopathology 2008; 52; 119–29. 11. Al-Brahim N, Salama S. Malignant melanoma with osteoclast-like giant cells: an unusual host response. Immunohistochemcal and ultrastructural study of three cases and literature review. Am J Dermatopathol 2005; 27; 126–9. 12. Youker SR, Billingsley EM. Combined Merkel cell carcinoma and atypical fibroxanthoma. J Cutan Med Surg 2005; 9: 6–9.
Community dissemination of vancomycin-resistant Enterococcus faecium.

BACKGROUND AND OBJECTIVE In the United States, vancomycin-resistant enterococci (VRE) are predominantly acquired in the hospital. The extent of dissemination of VRE into the community in the United States has not been examined. Our objective was to determine the prevalence of VRE among nonhospitalized patients. METHODS We conducted a cross-sectional surveillance study in an ambulatory care clinic. One hundred ambulatory patients participated in the study. Measurements included a written questionnaire on patient demographics, clinical data, and prior exposure to health care settings and antibiotics; rectal swabs; pulsed-field gel electrophoresis; and polymerase chain reaction genotyping. RESULTS Three of 100 subjects (3%) were colonized with VRE, including one person who did not have any exposure to a health care setting or antibiotics. CONCLUSIONS VRE was recovered from nonhospitalized patients. Physicians should be alert to the potential of VRE transmission in the ambulatory care setting.
Predictors of Hypertension and Changes of Blood Pressure in HIV-Infected Patients

Objective We assessed predictors of changes in systolic (SBP) and diastolic (DBP) blood pressure during follow-up and of the development of hypertension in HIV-infected individuals. Methods International cohort collaborative study (D:A:D) of established prospective cohorts of HIV-1-infected patients. Longitudinal analysis of changes in blood pressure (BP) was performed using mixed effects models in 17170 patients. Predictors of development of hypertension during follow-up (systolic BP ≥140 and/or diastolic BP ≥90 mmHg or initiation of antihypertensive treatment) were assessed using Cox models in 8 984 patients with a normal BP level at baseline. Results 73548 BP measurements with a median of 4 per patient (interquartile range [IQR]: 2–6) were recorded over a median follow-up of 2.3 years (IQR: 1.5–2.6). Risk factors significantly associated with a development of higher systolic BP and diastolic BP (differences ≥5 mmHg and P-values <0.001) during follow-up were: older age, male sex, higher body mass index (BMI) and use of BP-lowering drugs. In patients with normal BP at baseline, 1186 developed hypertension for an incidence of 72.1 per 1000 person-years (95% confidence interval: 68.2–76.0). Factors associated with development of hypertension were: male sex, higher BMI, older age, higher BP at baseline, high total cholesterol and clinical lipodystrophy. Cumulative duration of exposure to nucleoside reverse transcriptase inhibitors (P=0.75), protease inhibitors (P=0.92) as well as type of antiretroviral treatment at baseline (P=0.18) were not associated with a higher risk of hypertension. Cumulative duration of exposure to non-nucleoside reverse transcriptase inhibitors (NNRTIs) was significantly associated with lower risk of hypertension (hazard ratio=0.78 and 0.67 for those treated ≤10 months and >10 months compared with no exposure; P=0.005). Conclusions Increased blood pressure in HIV-infected individuals is associated with established risk factors for hypertension. There was no evidence for an independent deleterious effect of any class of antiretroviral drugs on BP, although the use of NNRTIs was associated with a lower risk of development of hypertension.
Using transparent polyurethane film and hydrocolloid dressings to prevent pressure ulcers.

OBJECTIVE To compare the performance and effectiveness of a hydrocolloid dressing (HD) and a transparent polyurethane film (PF) in preventing pressure ulcer (PU) development. METHOD The study was conducted in the intensive care unit, coronary care unit and medical clinic of the Holy House of Mercy of Passos, Brazil. Data were collected 48 hours after admission and during hospitalisation. The Braden scale was used for PU risk assessment. Consecutive eligible patients without PUs were randomly assigned by lottery to the two groups, either the HD or PF group. RESULTS Of the 160 eligible patients, significant between-group differences were found in the mean total number of dressing changes (HD, 6.09±1.655 changes; PF, 5.59±2.036 changes; p=0.010), and mean number of dressing changes in the sacral region (HD, 2.50±0.871; PF, 2.05±0.825; p=0.001), with the PF group requiring significantly fewer changes than the HD group. The most common reasons for changing dressings in both groups were moisture (PF 51.1%; HD 47.9%) and shear (HD 43%; PF 38.9%), with a significant difference in shear between groups. The incidence of PUs was significantly lower (p=0.038) in the PF group (8.7%) compared with that in the HD group (15%). CONCLUSION The results suggest that the transparent polyurethane film had a better performance and was more effective than the hydrocolloid dressing in preventing PU development.
Cell association and invasion of Caco-2 cells by Campylobacter jejuni

Adherence and invasion studies were conducted in monolayers of Caco-2 cells. Three-day-old monolayers were inoculated with Campylobacter jejuni 81-176 at a bacterium/cell ratio of 1,000:1. Saturation studies demonstrated time- and dose-dependent saturation curves for C. jejuni cell association and invasion into Caco-2 cells. Electron microscopy revealed intracellular C. jejuni located within membrane-bound vacuoles. Cell association and invasion were inhibited by 0.3 and 0.5 M concentrations of various sugars, including D-glucose, D-mannose, and D-fucose. However, there was no inhibition with the corresponding L-sugars, indicating physiological specificity. The inhibition of cell association with phloridzin was less pronounced. There was no inhibition of bacterial entry with monodansylcadaverine or g-strophanthin, indicating that it was unlikely that coated-pit formation is important in the invasion of C. jejuni into Caco-2 cells. Furthermore, there was no inhibition with cytochalasin D, vincristine, or vinblastine. Inhibition of cell association was demonstrated at 4 degrees C. Significantly decreased cell association and invasion were seen in potassium-depleted cells. Treatment of cells with bromelain also caused reduction in the number of C. jejuni binding to cells. A nonmotile aflagellate variant of C. jejuni also showed reduced invasion. The results of this study are consistent with energy-dependent invasion mechanisms. The results do not support an endocytic method of invasion for C. jejuni into Caco-2 cells.
The Theta Ideal , Dense Submodules and the Forcing Linearity Number for a Multiplication Module

In this article we study the theta ideal of a multiplication module and obtain some results involving them. We further look at the dense submodules of a multiplication module and show that they are themselves multiplication. We also show that the forcing linearity number of a multiplication module is zero. MSC 2000: 13C13, 13C99, 13E05
A Communication–Human Information Processing (C–HIP) approach to warning effectiveness in the workplace

Warnings are one of several hazard control methods used to protect employees and property against danger and loss. This article surveys a set of factors known to influence the effectiveness of workplace warnings. The description of empirical research is organized around a communication–human information processing (C–HIP) model. The model begins with a source entity attempting to relay a warning message through one or more media/sensory channels to one or more receivers. At the receiver, processing begins when attention is switched to the warning message and then maintained while information is extracted. Processing continues through the successive stages of comprehension, beliefs and attitudes, motivation, and ends with compliance behaviour. Any of these stages can be a bottleneck that causes processing to stop, diminishing the effectiveness of the warning. The factors that are influential at each stage are described. The C–HIP model provides a structure to systematically examine factors that can cause risk communication to fail and for finding ways to improve risk communication in the workplace.
Electric Blanket or Mattress Cover Use and Breast Cancer Incidence in Women 50–79 Years of Age

Previous research has demonstrated inconsistent associations between electromagnetic radiation, especially from electric blanket use, and breast cancer. Breast cancer risk according to electric blanket or mattress cover use was examined as part of a multicenter population-based case-control study. Breast cancer patients 50–79 years of age (N = 1949) were identified from statewide tumor registries in Massachusetts, New Hampshire, and Wisconsin from the period June 1994 to July 1995. Women of similar age were randomly selected from population lists as controls. Information regarding electric blanket and mattress cover use and breast cancer risk factors was obtained through telephone interviews. After adjustment for age, body mass index, and other breast cancer risk factors, the risk of breast cancer was similar among ever-users (relative risk = 0.93; 95% confidence interval = 0.82–1.06) and lower among current users than among never-users (relative risk = 0.79; 95% confidence interval = 0.66–0.95). There was no evidence of a dose-response relation with increasing number of months that electric blankets had been used. This study provides evidence against a positive association between electric blanket or mattress cover use and breast cancer.
Migration, marriage, and mortality: correcting sources of bias in English family reconstitutions.

The impact of excluding migration data from family reconstitutions has usually focused on a comparison of migrant and non-migrant characteristics rather than on the bias occurring in age at marriage or life expectancy. The topic of this discussion is the bias in marriage age and life expectancy in family reconstitution data under preindustrial English demographic conditions. The bias is illustrated with the MOMSIM microsimulation model where migration histories can be assigned at random according to assumptions about age-specific migration. The differences between the general population and the reconstructed subpopulation are attributed to migration effects. Migration is simulation models do not correct the bias. The model is explained and a simulation begun of 50000 married couples who survive to the age of 50 years. Alain Blums model is evaluated and new methods are proposed. The results of the microsimulation show that the mean age at marriage is raised by a little over half a year when mortality censoring is eliminated. When results are subject to both migration and mortality censoring the reconstituted estimates for women understate age at marriage by 2.6 years in the low migration model and understate age at marriage by 4.5 years in the high migration model. In order to achieve unbiased estimates 90% of the cases had to be eliminated in the high migration and high mortality model. For this reason and because English reconstitutions are usually based on 20-30% of marriages that are linked to baptismal records small reconstitutions may not be feasible. The results of Alain Blums minimum mortality procedure show that life expectancies are comparable to life expectancies in the general population. For medium and low migration males life expectancies at age 20 are higher in the general population compared to the expected high life expectancies in the minimum mortality population estimates. An alternative strategy which works well with small populations proposes a new minimum estimate of mortality and is not sensitive to differences in demographic behavior of non-migrants and eventual migrants.
DNA packaging by the Bacillus subtilis defective bacteriophage PBSX

Defective bacteriophage PBSX, a resident of all Bacillus subtilis 168 chromosomes, packages fragments of DNA from all portions of the host chromosome when induced by mitomycin C. In this study, the physical process for DNA packaging of both chromosomal and plasmid DNAs was examined. Discrete 13-kilobase (kb) lengths of DNA were packaged by wild-type phage, and the process was DNase I resistant and probably occurred by a head-filling mechanism. Genetically engineered isogenic host strains having a chloramphenicol resistance determinant integrated as a genetic flag at two different regions of the chromosome were used to monitor the packaging of specific chromosomal regions. No dramatic selectivity for these regions could be documented. If the wild-type strain 168 contains autonomously replicating plasmids, especially pC194, the mitomycin C induces an increase in size of resident plasmid DNA, which is then packaged as 13-kb pieces into phage heads. In strain RB1144, which lacks substantial portions of the PBSX resident phage region, mitomycin C treatment did not affect the structure of resident plasmids. Induction of PBSX started rolling circle replication on plasmids, which then became packaged as 13-kb fragments. This alteration or cannibalization of plasmid replication resulting from mitomycin C treatment requires for its function some DNA within the prophage deletion of strain RB1144.
Intrinsic point-defect equilibria in tetragonal ZrO2: Density functional theory analysis with finite-temperature effects

We present a density functional theory (DFT) framework taking into account the finite temperature effects to quantitatively understand and predict charged defect equilibria in a metal oxide. Demonstration of this approach was performed on the technologically important tetragonal zirconium oxide, T-ZrO2. We showed that phonon free energy and electronic entropy at finite temperatures add a nonnegligible contribution to the free energy of formation of the defects. Defect equilibria were conveniently cast in Kröger–Vink diagrams to facilitate realistic comparison with experiments. Consistent with experiments, our DFT-based results indicate the predominance of free electrons at low oxygen partial pressure (PO2 10−6 atm) and low temperature (T 1500 K). In the same regime of PO2 but at higher temperatures, we discovered that the neutral oxygen vacancies (F-centers) predominate. The nature of the predominant defect at high oxygen partial pressure has been a long-standing controversy in the experimental literature. Our results revealed this range to be dominated by the doubly charged oxygen vacancies at low temperatures (T 1500 K) and free electrons at high temperatures. T-ZrO2 was found to be hypostoichiometric over all ranges of T and PO2 , mainly because of the doubly charged oxygen vacancies, which are responsible for inducing n-type conductivity via a self-doping effect. A range of 1.3 eV in the band gap of T-ZrO2 starting from the middle of the gap toward the conduction band is accessible to the chemical potential of electrons (Fermi level) by varying T and PO2 without extrinsic doping. The approach presented here can be used to determine the thermodynamic conditions that extremize certain desirable or undesirable defects to attain the optimal catalytic and electronic performance of oxides.