Miracle-dz/UniFAR-FTUs huggingface dataset:
Methicillin-resistant Staphylococcus aureus nosocomial pneumonia: role of linezolid in the People’s Republic of China

The burden of methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia in the People’s Republic of China is high, with methicillin-resistance rates greater than 80% reported for patients with S. aureus pneumonia treated in intensive care units. Historically, vancomycin was the treatment of choice for patients with hospital-acquired MRSA infections. Recent evidence suggests that the minimum inhibitory concentration for vancomycin is increasing. Additionally, patients treated with vancomycin require monitoring of vancomycin trough concentrations and can develop nephrotoxicity. Linezolid is a treatment option for patients with hospital-acquired MRSA infections that can be administered either intravenously or orally. Analysis of data from a worldwide linezolid surveillance program initiated in the year 2004 shows no evidence of increasing linezolid minimum inhibitory concentrations. The clinical efficacy of linezolid for patients with gram-positive, including MRSA, nosocomial pneumonia, was evaluated in numerous studies. In general, results from these studies show higher or similar clinical success with no mortality difference for linezolid compared to vancomycin treated patients. Results from a Phase IV study enrolling patients with MRSA-confirmed nosocomial pneumonia suggest higher clinical cure rates for linezolid compared to vancomycin treated patients. Although acquisition costs are higher for linezolid compared to vancomycin therapy, evidence suggests similar overall medical costs. Cost-analysis results from a Chinese perspective show that linezolid dominated vancomycin therapy for MRSA nosocomial pneumonia in ∼35% of bootstrap simulations whereas vancomycin dominated linezolid in less than 2% of bootstrap simulations. In summary, results from both clinical and economic studies, including studies conducted from a Chinese perspective, support the use of linezolid for the treatment of patients with MRSA nosocomial pneumonia.
Rainforest Endophytes and Bioactive Products

ABSTRACT: An increase in the number of people in the world having health problems caused by certain cancers, drug-resistant bacteria, parasitic protozoans, and fungi has caused alarm. An intensive search for newer and more effective agents to deal with these problems is now underway. Endophytes are a potential source of novel chemistry and biology to assist in helping solve not only human health, but plant and animal health problems also. Endophytes reside in the tissues between living plant cells. The relationship that they establish with the plant varies from symbiotic to bordering on pathogenic. Of all of the world's plants, it seems that only a few grass species have had their complete complement of endophytes studied. As a result, the opportunity to find new and interesting endophytes among the myriad of plants is great. Sometimes extremely unusual and valuable organic substances are produced by these endophytes. These compounds may contribute to the host-microbe relationship. The initial step in dealing with endophytic microorganisms is their successful isolation from plant materials. Then, the isolation and characterization of bioactive substances from culture filtrates is done using bioassay guided fractionation and spectroscopic methods. Some of the more interesting compounds produced by endophytic microbes with which we have dealt are taxol, cryptocin, cryptocandin, jesterone, oocydin, isopestacin, the pseudomycins and ambuic acid. This review discusses an approach for bio-prospecting the rainforests, not only to harvest their endophytic microorganisms, but to eventually build a better understanding of the importance and value they have to humankind.
Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis.

IMPORTANCE Evidence suggests that maternal obesity increases the risk of fetal death, stillbirth, and infant death; however, the optimal body mass index (BMI) for prevention is not known. OBJECTIVE To conduct a systematic review and meta-analysis of cohort studies of maternal BMI and risk of fetal death, stillbirth, and infant death. DATA SOURCES The PubMed and Embase databases were searched from inception to January 23, 2014. STUDY SELECTION Cohort studies reporting adjusted relative risk (RR) estimates for fetal death, stillbirth, or infant death by at least 3 categories of maternal BMI were included. DATA EXTRACTION Data were extracted by 1 reviewer and checked by the remaining reviewers for accuracy. Summary RRs were estimated using a random-effects model. MAIN OUTCOMES AND MEASURES Fetal death, stillbirth, and neonatal, perinatal, and infant death. RESULTS Thirty eight studies (44 publications) with more than 10,147 fetal deaths, more than 16,274 stillbirths, more than 4311 perinatal deaths, 11,294 neonatal deaths, and 4983 infant deaths were included. The summary RR per 5-unit increase in maternal BMI for fetal death was 1.21 (95% CI, 1.09-1.35; I2 = 77.6%; n = 7 studies); for stillbirth, 1.24 (95% CI, 1.18-1.30; I2 = 80%; n = 18 studies); for perinatal death, 1.16 (95% CI, 1.00-1.35; I2 = 93.7%; n = 11 studies); for neonatal death, 1.15 (95% CI, 1.07-1.23; I2 = 78.5%; n = 12 studies); and for infant death, 1.18 (95% CI, 1.09-1.28; I2 = 79%; n = 4 studies). The test for nonlinearity was significant in all analyses but was most pronounced for fetal death. For women with a BMI of 20 (reference standard for all outcomes), 25, and 30, absolute risks per 10,000 pregnancies for fetal death were 76, 82 (95% CI, 76-88), and 102 (95% CI, 93-112); for stillbirth, 40, 48 (95% CI, 46-51), and 59 (95% CI, 55-63); for perinatal death, 66, 73 (95% CI, 67-81), and 86 (95% CI, 76-98); for neonatal death, 20, 21 (95% CI, 19-23), and 24 (95% CI, 22-27); and for infant death, 33, 37 (95% CI, 34-39), and 43 (95% CI, 40-47), respectively. CONCLUSIONS AND RELEVANCE Even modest increases in maternal BMI were associated with increased risk of fetal death, stillbirth, and neonatal, perinatal, and infant death. Weight management guidelines for women who plan pregnancies should take these findings into consideration to reduce the burden of fetal death, stillbirth, and infant death.
Clinical outcomes for "suspicious" category in thyroid fine-needle aspiration biopsy: Patient's sex and nodule size are possible predictors of malignancy.

CONTEXT Fine-needle aspiration (FNA) is recommended as an initial screening tool for the diagnosis of thyroid nodules. Approximately 10% of thyroid FNA diagnoses are "suspicious for neoplasm," warranting surgical resection. OBJECTIVES To examine the role of a patient's age, sex, size of nodule, and morphologic features as possible predictors of malignancy in patients with cytologic diagnosis of "suspicious for neoplasm. " DESIGN Cytopathology slides and reports of 402 consecutive thyroid FNAs from 2000-2005 interpreted as "suspicious" were reviewed. Of these, 180 cases that had subsequent surgical resection were selected. RESULTS Of the 108 cases suspicious for follicular neoplasm on cytologic evaluation, histologic follow-up showed malignancy in 26 (24%). Of the 37 cases suspicious for Hürthle cell neoplasm, 15 (41%) had malignancy. Of the 35 cases suspicious for malignancy, 29 had malignant histologic diagnoses. Among cases with cytologic diagnoses of "suspicious for follicular or Hürthle cell neoplasm," the rate of malignancy in female patients was 22% as compared to 43% in male patients (P = .02). The rate of malignancy in nodules less than 2 cm was 19% compared to 47% in nodules measuring 2 cm or larger (P < .001). These differences were statistically significant. No statistically significant difference was noted between the age of the patient and the rate of benign versus malignant diagnosis. CONCLUSIONS Malignant tumors were more frequent in male patients with a cytologic diagnosis of "suspicious for follicular or Hürthle cell neoplasm" than in female patients. Risk of malignancy was higher in nodules measuring 2 cm or larger. Age of the patient was not a predictor of malignancy.
Long-term outcome of the atrioventricular node ablation and pacemaker implantation for symptomatic refractory atrial fibrillation.

AIMS To investigate long-term outcome and to determine predictors of development of heart failure (HF) in patients with atrioventricular (AV) node ablation and permanent right ventricular pacing because of symptomatic refractory atrial fibrillation (AF). BACKGROUND Atrioventricular node ablation and subsequent permanent pacing is a well-established therapy for patients with AF. Long-term right ventricular pacing may induce HF. METHODS AND RESULTS In 121 (45 with previous HF) patients with drug refractory AF, AV node ablation and implantation of a pacemaker was performed. At baseline and after a mean follow-up of 4.3 +/- 3.3 years, New York Heart Association (NYHA) functional class for HF and left ventricular (LV) and atrial diameters were assessed. During and at the end of follow-up, hospitalizations for HF, mortality, and quality of life were assessed using the SF-36 and an AVN-specific questionnaire. No significant changes in NYHA functional class (87 vs. 77% in NYHA I/II at baseline vs. end of follow-up) and LV end diastolic diameter (51 +/- 7 vs. 52 +/- 8 mm) were observed. Left ventricular end systolic diameter decreased (from 37 +/- 9 to 34 +/- 7 mm, P = 0.03) and fractional shortening improved (from 28 +/- 10 to 34 +/- 9, P = 0.02) in all patients and in patients with previous HF, but not in patients without previous HF. Hospitalizations for HF occurred in 24 patients (20%), predominantly those with previous HF. All-cause mortality occurred in 31 (26%) patients. At the end of follow-up, quality of life was comparable with the control group. CONCLUSION Long-term outcome of AV node ablation and permanent pacing is good. Atrioventricular node ablation remains a treatment option for AF.
The Indian American woman experience : the process of defining herself /

Currently, the Indian community is the fourth largest Asian American population in the United States (Durvasula & Mylvaganam, 1994; Ramisetty-Mikler, 1993; Sandhu, Portes, & McPhee, 1996) and is projected as the fastest growing Asian American population (Dasgupta, 1986; Durvasula & Mylvaganam, 1994). Yet, little research has been done on the Indian American population. In fact, Indian Americans have been noted as the "forgotten Asians" (Kurian, 1986; Rocher, 1995) since they are commonly excluded from literature on the Asian American population. Thus, the author interviewed 10 women of Asian Indian descent about their personal experiences growing up in the United States. The author and a research assistant generated codes and then coded respondents’ statements from the initial interviews. Agreement between coders was examined and a third party was sought if there was disagreement. The coded transcripts were presented to the participants for feedback during the second interview. Consensual qualitative research (Hill, Thompson, & Williams, 1997) and the interpretive methods were used to derive major domains from the data. Six domains that emerged are the following: (a) cultural influences, (b) romantic relationships, (c) caught between cultures, (d) coping mechanisms, (e) ethnic identity development, and (f) advice for parents and other Indian American women.
Evaluating the Usability of Authoring Environments for Serious Games

Background. The EMERGO method and online platform enable the development and delivery of scenario-based serious games that foster students to acquire professional competence. One of the main goals of the platform is to provide a user-friendly authoring environment for creating virtual environments where students can perform authentic tasks. Aim. We present the findings of an in-depth qualitative case study of the platform’s authoring environment and compare our findings on usability with those found for comparable environments in literature. Method. We carried out semi-structured interviews, with two experienced game developers who have authored a game for higher education, and a literature review of comparable environments. Findings. The analysis shows that the usability of the authoring environment is problematic, especially regarding understandability and learnability, which is in line with findings of comparable environments. Other findings are that authoring is well integrated with the EMERGO method and that functionality and reliability of the authoring environment are valued. Practical implications. The lessons learned are presented in the form of general guidelines to improve the understandability and learnability of authoring environments for serious games.
Asynchronous Decentralized Parallel Stochastic Gradient Descent

Most commonly used distributed machine learning systems are either synchronous or centralized asynchronous. Synchronous algorithms like AllReduce-SGD perform poorly in a heterogeneous environment, while asynchronous algorithms using a parameter server suffer from 1) communication bottleneck at parameter servers when workers are many, and 2) significantly worse convergence when the traffic to parameter server is congested. Can we design an algorithm that is robust in a heterogeneous environment, while being communication efficient and maintaining the best-possible convergence rate? In this paper, we propose an asynchronous decentralized stochastic gradient decent algorithm (AD-PSGD) satisfying all above expectations. Our theoretical analysis shows AD-PSGD converges at the optimal $O(1/\sqrt{K})$ rate as SGD and has linear speedup w.r. t. number of workers. Empirically, AD-PSGD outperforms the best of decentralized parallel SGD (D-PSGD), asynchronous parallel SGD (A-PSGD), and standard data parallel SGD (AllReduce-SGD), often by orders of magnitude in a heterogeneous environment. When training ResNet-50 on ImageNet with up to 128 GPUs, AD-PSGD converges (w.r.t epochs) similarly to the AllReduce-SGD, but each epoch can be up to 4-8X faster than its synchronous counterparts in a network-sharing HPC environment. To the best of our knowledge, AD-PSGD is the first asynchronous algorithm that achieves a similar epoch-wise convergence rate as AllReduce-SGD, at an over 100-GPU scale.
Prevalence of childhood obesity in Spain: National Health Survey 2006-2007.

INTRODUCTION Childhood Obesity has become a Public Health priority due to it high prevalence and consequences in health status. OBJECTIVE To estimate prevalence of obesity in the children included in the National Health Survey of 2006-2007 and to determine its association with socioeconomic position and other socio-demographic variables. METHODS Cross-sectional study using data available from 6,139 Spanish children between 2-15 years old, included in the National Health Survey. Parents or guardians reported weight and height to estimate obesity prevalence according to the International Obesity Task Force cut-offs for body mass index. RESULTS Obesity prevalence was 10,3% and overweight prevalence was 18,8%. Obesity was more prevalent in children from 4-5 years age (18,3%) and overweight in the 8-9 years stratus (25,5%). Overweight was more frequent in boys than girls (19,8% versus 17,8%; p = 0,04). Canary Islands, Ceuta and Melilla, Valencia and Andalusia were the Autonomous Communities with higher obesity prevalence in contrast with the Basque Country, Galicia and Madrid which showed the lowest prevalence. This distribution generates a north to south gradient in obesity prevalence. Both, obesity and overweight showed an inverse association with socioeconomic position (p < 0,05). CONCLUSION Childhood obesity rates in Spain accounts from ones of the highest in Europe, with a strong geographic and socioeconomic gradient. Priority should be given to effective interventions that can reach the most vulnerable groups as identified in this study, like restrictions on TV food advertising and tax reliefs to promote healthy eating.
Phosphorylation of Replication Protein A Middle Subunit (RPA32) Leads to a Disassembly of the RPA Heterotrimer*

Replication protein A (RPA), the major eukaryotic single-strand specific DNA binding protein, consists of three subunits, RPA70, RPA32, and RPA14. The middle subunit, RPA32, is phosphorylated in a cell cycle-dependent manner. RPA occurs in two nuclear compartments, bound to chromatin or free in the nucleosol. We show here that the chromatin-associated fraction of RPA contains the phosphorylated forms of RPA32. Treatment of chromatin with 0.4m NaCl releases bound RPA and causes a separation of the large and the phosphorylated middle RPA subunit. Unmodified RPA in the nucleosolic fraction remains perfectly stable under identical conditions. Phosphorylation is most likely an important determinant of RPA desintegration because dialysis from 0.4 to 0.1 NaCl causes the reformation of trimeric RPA only under dephosphorylating conditions. Biochemical studies with isolated Cyclin-dependent protein kinases showed that cyclin A/CDK1 and cyclin B/CDK1, but not cyclin E/CDK2, can phosphorylate human recombinant RPA in vitro. However, only a small fraction of in vitro phosphorylated RPA desintegrated, suggesting that phosphorylation may be one, but probably not the only, determinant affecting subunit interaction. We speculate that phosphorylation and changes in subunit interaction are required for the proposed role of RPA during the polymerase switch at replication forks.
Initial phase 2 trial of a nicotinic agonist in schizophrenia.

OBJECTIVE Nicotinic acetylcholine receptors are possible therapeutic targets for schizophrenia, as shown by neurobiological and molecular evidence for deficiencies in expression of alpha(7)-nicotinic receptors. Patients' heavy smoking suggests attempted self-medication through this mechanism. The agent 3-(2,4-dimethoxybenzylidene) anabaseine (DMXB-A) is a partial alpha(7)-nicotinic agonist and can be taken orally. A phase 1 trial showed evidence for cognitive enhancement in schizophrenia. METHOD Thirty-one subjects with schizophrenia received DMXB-A at two different doses and placebo for periods of 4 weeks in a three-arm, two-site, double-blind, crossover phase 2 trial. The MATRICS Consensus Cognitive Battery assessed cognitive effects, and the Scale for the Assessment of Negative Symptoms (SANS) and Brief Psychiatric Rating Scale (BPRS) assessed clinical effects. Subjects continued their current antipsychotic drug during the trial and were nonsmokers. RESULTS There were no significant differences in the MATRICS cognitive measures between DMXB-A and placebo over the three treatment arms, but the patients experienced significant improvement at the higher DMXB-A dose on the SANS total score and nearly significant improvement on the BPRS total score. Improvement was most notable on the SANS anhedonia and alogia subscales. Examination of the first treatment arm showed effects of DMXB-A on the attention/vigilance and working memory MATRICS domains, compared to baseline. Five subjects developed mild tremor, and nearly half had mild nausea while taking DMXB-A. CONCLUSION DMXB-A, a nicotinic agonist that activates alpha(7)-nicotinic receptors, improved clinical ratings of negative symptoms that are generally resistant to treatment with dopamine antagonist antipsychotic drugs. The clinical utility of this treatment is not yet determined.
Workforce Crisis in Residential Aged Care: Insights from Rural, Older Workers

In Australia, workforce shortages in residential aged care present a significant challenge for the aged care industry. The growing demand for workers in aged care, combined with the shrinking supply of younger workers entering the field, highlights a future workforce crisis. The current shortfalls are set to worsen with the retirement of a generation of women who have provided the backbone of the workforce. Although targeted retention of this group may alleviate this issue, few studies have explored the retirement decisions of this cohort. This paper reports on a qualitative study of this cohort of Victorian public sector residential aged care staff. Although current government rhetoric promotes intrinsic rewards (altruism, moral fulfilment) over extrinsic rewards (excessive workload, pay and conditions), a combination of these factors was associated with job satisfaction. It would seem timely to revisit some of these concerns to ensure an adequate and sufficiently skilled workforce.
Pharmacist-led screening program for an inner-city pediatric population.

OBJECTIVES To identify the prevalence of asthma, obesity, hypertension, and environmental tobacco smoke (ETS) exposure among youth and provide recommendations for follow-up care. METHODS This cross-sectional study consisted of 12 health screenings for children between 5 and 17 years of age in various inner city, lower socioeconomic, and predominantly black communities throughout the city of Pittsburgh, PA. The screenings were conducted by pharmacists and student pharmacists from April 2010 to April 2012. Asthma, obesity, hypertension, and ETS screenings were offered at each event. RESULTS A total of 144 children (50% girls, 89% black, non-Hispanic) were enrolled. Sixteen percent of the study population had a previous diagnosis of asthma; 4% were poorly controlled, and 18% were identified as having potential, undiagnosed asthma. Fifty-three percent were at an unhealthy weight (0.7% underweight, 24.3% overweight, 28.5% obese), 24% had abnormal blood pressure (12.8% prehypertension, 8.5% stage 1 hypertension, 2.8% stage 2 hypertension), and 26% had ETS exposure equivalent to that of smokers (0.7% light smokers, 17.5% smokers, and 7.7% heavy smokers). Overall, 177 specific referrals were made. The incidence of hypertension (P <0.001) and the proportion of ETS equivalent to heavy smokers increased (P = 0.019) with increased weight classification. CONCLUSION Within this self-selected inner city, predominantly black pediatric population, there were high rates of positive screens for potential asthma, obesity, hypertension, and smoking. Additionally, the risk for high ETS exposure and hypertension increased with increasing weight. This study highlights the importance of pharmacists in disease screening and the need for alternative prevention and management strategies in disparate pediatric populations.