Miracle-dz/UniFAR-FTUs huggingface dataset:
Nosocomial febrile illness in the elderly: frequency, causes, and risk factors.

BACKGROUND Although nosocomial febrile illness (NFI) is common in hospitalized patients, it has been less extensively studied in the elderly. OBJECTIVE To determine the frequency, causes, and risk factors of NFI in elderly inpatients. METHODS This prospective study involved 608 patients (> or = 65 years of age) admitted in an acute geriatric unit. Investigators followed this cohort until 1 of the following events occurred: development of NFI, discharge from the geriatric unit, or death. The cause of NFI was classified into 3 groups: infectious, noninfectious, and no apparent diagnosis. We systematically studied 17 comorbid conditions, 6 drugs, and 7 invasive procedures. For comparison, the patients were stratified into 2 groups: patients with NFI and patients without NFI. RESULTS Sixty-six patients (10.9%) with NFI were identified. They were compared with the remaining 542 patients without NFI. In 49 patients (74%) with NFI, the cause was infectious; in 9 (13.5%), it was noninfectious; and in 8 (12.5%), there was no apparent cause. After multivariate analysis, only fecal incontinence (odds ratio [OR], 5.54; 95% confidence interval [CI], 2.13-14.5), congestive heart failure (OR, 2.97; 95% CI, 1.53-5.76), and pressure ulcers (OR, 2.93; 95% CI, 1.19-7.17) were independent risk factors for NFI. The number of invasive procedures preceding the febrile episode was a significant predictor of infection (OR, 3.68; 95% CI, 1.14-9.21). CONCLUSIONS Nosocomial febrile illness is a common event in elderly hospitalized patients. In 74% of the patients with NFI, an infection is found. Measures to decrease infectious NFI in the elderly require a reduction in the number of invasive procedures.
Expression of stromal cell markers in distinct compartments of human skin cancers

Background: The importance of changes in the supporting tumor stroma for cancer initiation and progression is well established. The characteristics of an activated tumor stroma, however, are not completely understood. In an effort to better characterize the desmoplastic response to human skin tumors, we evaluated the expression pattern of three stromal cell markers, fibroblast‐activation protein (FAP), endoglyx‐1, and endosialin, in a series of melanocytic and epithelial skin tumors.
Losing Neutrality: The Neural Basis of Impaired Emotional Control without Sleep

Sleep deprivation has been shown recently to alter emotional processing possibly associated with reduced frontal regulation. Such impairments can ultimately fail adaptive attempts to regulate emotional processing (also known as cognitive control of emotion), although this hypothesis has not been examined directly. Therefore, we explored the influence of sleep deprivation on the human brain using two different cognitive–emotional tasks, recorded using fMRI and EEG. Both tasks involved irrelevant emotional and neutral distractors presented during a competing cognitive challenge, thus creating a continuous demand for regulating emotional processing. Results reveal that, although participants showed enhanced limbic and electrophysiological reactions to emotional distractors regardless of their sleep state, they were specifically unable to ignore neutral distracting information after sleep deprivation. As a consequence, sleep deprivation resulted in similar processing of neutral and negative distractors, thus disabling accurate emotional discrimination. As expected, these findings were further associated with a decrease in prefrontal connectivity patterns in both EEG and fMRI signals, reflecting a profound decline in cognitive control of emotion. Notably, such a decline was associated with lower REM sleep amounts, supporting a role for REM sleep in overnight emotional processing. Altogether, our findings suggest that losing sleep alters emotional reactivity by lowering the threshold for emotional activation, leading to a maladaptive loss of emotional neutrality. SIGNIFICANCE STATEMENT Sleep loss is known as a robust modulator of emotional reactivity, leading to increased anxiety and stress elicited by seemingly minor triggers. In this work, we aimed to portray the neural basis of these emotional impairments and their possible association with frontal regulation of emotional processing, also known as cognitive control of emotion. Using specifically suited EEG and fMRI tasks, we were able to show that sleep deprivation alters emotional reactivity by triggering enhanced processing of stimuli regarded previously as neutral. These changes were further accompanied by diminished frontal connectivity, reduced REM sleep, and poorer performance. Therefore, we suggest that sleep loss alters emotional reactivity by lowering the threshold for emotional activation, leading to a maladaptive loss of emotional neutrality.
Increased physical activity decreases hepatic free fatty acid uptake: a study in human monozygotic twins

Exercise is considered to be beneficial for free fatty acid (FFA) metabolism, although reports of the effects of increased physical activity on FFA uptake and oxidation in different tissues in vivo in humans have been inconsistent. To investigate the heredity‐independent effects of physical activity and fitness on FFA uptake in skeletal muscle, the myocardium, and liver we used positron emission tomography (PET) in nine healthy young male monozygotic twin pairs discordant for physical activity and fitness. The cotwins with higher physical activity constituting the more active group had a similar body mass index but less body fat and 18 ± 10% higher (P < 0.001) compared to the less active brothers with lower physical activity. Low‐intensity knee‐extension exercise increased skeletal muscle FFA and oxygen uptake six to 10 times compared to resting values but no differences were observed between the groups at rest or during exercise. At rest the more active group had lower hepatic FFA uptake compared to the less active group (5.5 ± 4.3 versus 9.0 ± 6.1 μmol (100 ml)−1 min−1, P= 0.04). Hepatic FFA uptake associated significantly with body fat percentage (P= 0.05). Myocardial FFA uptake was similar between the groups. In conclusion, in the absence of the confounding effects of genetic factors, moderately increased physical activity and aerobic fitness decrease body adiposity even in normal‐weighted healthy young adult men. Further, increased physical activity together with decreased intra‐abdominal adiposity seems to decrease hepatic FFA uptake but has no effects on skeletal muscle or myocardial FFA uptake.
aIncisional Negative Pressure Wound Therapy (INPWT) for Coronary Artery Bypass Grafting Patients

Background: Surgical site infections are major complications of coronary artery bypass grafting using bilateral internal thoracic arteries. In this study we reviewed the results of using INPWT for high risk patients with coronary artery bypass grafting (CABG) using bilateral internal mammary arteries. Patients and methods: From January 2013 to December 2016, patients with coronary artery bypass grafting using bilateral mammary arteries were enrolled in this study. Patients were from Kasr El-Einy, Beni-Suef and Fayoum University Hospitals. The total number was 427 patients, where INPWT was used in 161 patient, and conventional sterilized dressing was done in 266 patients. 2 groups were matched for statistical analysis, the first group was the control and the second group was where INPWT was used. Results: The results related to sternal wound infections were similarly attributed to the conventional group (10.9%) and the INPWT group (10.2%) (P=1.00). Patients treated with INPWT had less rate of infection than those with conventional dressing (5.5% versus 10.2%, P= 0.210), this difference was not statistically significant. Interaction tests also showed comparable results for SSI (surgical site infections) among patients with or without significant co-morbidities. Conclusion: This study suggests that the use of INPWT did not decrease the incidence of sternal wound infections in patients who had CABG surgery using bilateral internal mammary harvesting (BIMA). A larger randomized study is needed to evaluate the efficacy of this technique.
Contribution of the Pmra Promoter to Expression of Genes in the Escherichia coli mra Cluster of Cell Envelope Biosynthesis and Cell Division Genes

ABSTRACT Recently, a promoter for the essential gene ftsI, which encodes penicillin-binding protein 3 of Escherichia coli, was precisely localized 1.9 kb upstream from this gene, at the beginning of the mra cluster of cell division and cell envelope biosynthesis genes (H. Hara, S. Yasuda, K. Horiuchi, and J. T. Park, J. Bacteriol. 179:5802–5811, 1997). Disruption of this promoter (Pmra) on the chromosome and its replacement by the lac promoter (Pmra::Plac) led to isopropyl-β-d-thiogalactopyranoside (IPTG)-dependent cells that lysed in the absence of inducer, a defect which was complemented only when the whole region from Pmra to ftsW, the fifth gene downstream from ftsI, was provided in trans on a plasmid. In the present work, the levels of various proteins involved in peptidoglycan synthesis and cell division were precisely determined in cells in which Pmra::Placpromoter expression was repressed or fully induced. It was confirmed that the Pmra promoter is required for expression of the first nine genes of the mra cluster:mraZ (orfC), mraW(orfB), ftsL (mraR),ftsI, murE, murF, mraY,murD, and ftsW. Interestingly, three- to sixfold-decreased levels of MurG and MurC enzymes were observed in uninduced Pmra::Placcells. This was correlated with an accumulation of the nucleotide precursors UDP–N-acetylglucosamine and UDP–N-acetylmuramic acid, substrates of these enzymes, and with a depletion of the pool of UDP–N-acetylmuramyl pentapeptide, resulting in decreased cell wall peptidoglycan synthesis. Moreover, the expression of ftsZ, the penultimate gene from this cluster, was significantly reduced when Pmra expression was repressed. It was concluded that the transcription of the genes located downstream fromftsW in the mra cluster, from murGto ftsZ, is also mainly (but not exclusively) dependent on the Pmra promoter.
Intergenerational transmission of violence and resilience in conflict-affected Burundi: a qualitative study of why some children thrive despite duress

Background Research suggests that in environments where community conflict and violence are chronic or cyclical, caregiving can impact how children may begin to reproduce violence throughout the various stages of their lives. The aim of this study is to understand how caregiving affects processes of reproducing violence and resilience among children in conflict-affected Burundi. Methods We combined a socio-ecological model of child development with a child-actor perspective. We operationalized the core concepts ‘vulnerable household’, ‘resilience’, and ‘caregiving’ iteratively in culturally relevant ways, and put children's experiences at the center of the inquiry. We carried out a comparative case study among 74 purposively sampled vulnerable households in six collines in three communes in three provinces in the interior of Burundi. Burundian field researchers conducted three consecutive interviews; with the head of the household, the main caregiver, and a child. Results Our findings reveal a strong congruence between positive caregiving and resilience among children. Negative caregiving was related to negative social behavior among children. Other resources for resilience appeared to be limited. The overall level of household conditions and embedment in communities attested to a generalized fragile ecological environment. Conclusions In conflict-affected socio-ecological environments, caregiving can impact children's functioning and their role in reproducing violence. Interventions that support caregivers in positive caregiving are promising for breaking cyclical violence.
Hyperacute stroke: ultrafast MR imaging to triage patients prior to therapy.

PURPOSE To test diffusion- and perfusion-weighted MR imaging techniques within the extreme time constraints of stroke evaluation before therapy, and then, with MR imaging, stratify patients into those without ischemia, those with noncortical ischemia, and those with cortical ischemia. MATERIALS AND METHODS T2-weighted turbo gradient- and spin-echo images and echo-planar diffusion- and perfusion-weighted images were obtained. Trace diffusion-weighted images and time-to-peak perfusion maps were automatically postprocessed and immediately available for interpretation. RESULTS Forty-one patients with acute stroke symptoms underwent imaging within 6 hours of symptom onset; 35 were eligible for the therapy protocol. The mean time from entering the emergency department to beginning MR imaging was 45 minutes; the mean total MR imaging time was less than 15 minutes. Immediate image analysis directly affected individual clinical management. Four patients showed evidence of no infarct; seven, of lacunar infarct; and 24, of acute cortical infarct. Sixteen patients underwent angiography, thirteen had large-vessel occlusion, eleven were treated intraarterially, and in seven, recanalization was achieved. CONCLUSION Echo-planar diffusion- and perfusion-weighted MR imaging for acute stroke is feasible and applicable before therapy decisions. Ultrafast MR imaging permitted immediate triage of 35 patients with symptoms of hyperacute stroke and thus helped avoid the risks from angiography and thrombolytic agents in some or spurred the judicious use of more aggressive intervention in others.
Real‐time imaging of transcriptional activation in live cells reveals rapid up‐regulation of the cyclin‐dependent kinase inhibitor gene CDKN1A in replicative cellular senescence

Cellular replicative senescence is a permanent growth arrest state that can be triggered by telomere shortening. The cyclin‐dependent kinase (Cdk) inhibitor p21CIP1/WAF1 (p21), encoded by the CDKN1A gene, is a critical cell cycle regulator whose expression increases as cells approach senescence. Although the pathways responsible for its up‐regulation are not well understood, compelling evidence indicates that the upstream triggering event is telomere dysfunction. Studies of replicative senescence have been complicated by the asynchrony of its onset, which is caused by the continuous and stochastic variability in individual cell lifespans. In fact, the actual entry into senescence has never been observed in a single unperturbed cell. We report here a new in vitro human model system that allows entry into senescence to be monitored in real‐time in individual viable cells. We used homologous recombination to generate non‐immortalized fibroblast cells with the enhanced yellow fluorescence protein (EYFP) gene knocked into one CDKN1A gene copy, allowing promoter activity to be visualized as fluorescence intensity. Gamma irradiation, DNA‐damaging drugs, expression of p14ARF or oncogenic Ras, and replicative exhaustion all resulted in elevated EYFP expression, demonstrating its proper control by physiological signalling circuits. Analysis by time‐lapse microscopy of cultures approaching replicative senescence revealed that p21 levels rise abruptly in individual aging cells and remain elevated for extended periods of time.
Laparoscopic and Open Abdominal Staging for Early-Stage Ovarian Cancer: Our Experience, Systematic Review, and Meta-analysis of Comparative Studies

Objectives The aim of this study was to analyze perioperative and long-term survival outcomes after either laparoscopic or open abdominal staging for apparent early-stage ovarian cancer. Methods Data of consecutive women with early-stage ovarian cancer undergoing comprehensive laparoscopic staging between 2003 and 2010 were matched with a historical cohort of patients undergoing open surgery. Five-year survival outcomes were analyzed using the Kaplan-Meier method. In addition, a systematic review of the literature and meta-analysis of comparative studies was performed Results A total of 35 women undergoing staging via laparoscopy were compared with a cohort of 32 patients undergoing open surgery. Baseline characteristics were similar between groups. Spillage occurred in 6 and 4 patients in laparoscopic and open group, respectively (P = 0.59). Patients undergoing laparoscopy experienced longer operative time (P < 0.001), shorter hospital stay (P = 0.03), and lower postoperative complication rate (3% vs 28%; P = 0.005) than patients undergoing staging via open surgery. The median (range) follow-up period was 64 (37–106) and 100 (61–278) months for case and control, respectively (P < 0.001). Five-year disease-free survival (P = 0.12, log-rank test) and overall survival (P = 0.26, log-rank test) were not influenced by surgical approach. Pooled analyses of the literature results corroborate our results suggesting an improvement of perioperative results in the laparoscopic group in comparison with the open abdominal one. In comparison with open surgery, laparoscopy did not influenced spillage (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.35–1.73) and upstaging rate (OR, 0.7; 95% CI, 0.38–1.27). No between-group differences in survival were observed (OR, 0.5; 95% CI, 0.21–1.21). Conclusions Laparoscopy upholds open surgery in long-term oncologic control, reducing morbidity.
On-call work: To sleep or not to sleep? It depends

ABSTRACT On-call working time arrangements are increasingly common, involve work only in the event of an unpredictable incident and exist primarily outside of standard hours. Like other non-standard working time arrangements, on-call work disrupts sleep and can therefore have negative effects on health, safety and performance. Unlike other non-standard working time arrangements, on-call work often allows sleep opportunities between calls. Any sleep obtained during on-call periods will be beneficial for waking performance. However, there is evidence that sleep while on call may be of substantially reduced restorative value because of the expectation of receiving the call and apprehension about missing the call. In turn, waking from sleep to respond to a call may be associated with temporary increases in performance impairment. This is dependent on characteristics of both the preceding sleep, the tasks required upon waking and the availability and utility of any countermeasures to support the transition from sleep to wake. In this paper, we critically evaluate the evidence both for and against sleeping during on-call periods and conclude that some sleep, even if it is of reduced quality and broken by repeated calls, is a good strategy. We also note, however, that organisations utilising on-call working time arrangements need to systematically manage the likelihood that on-call sleep can be associated with temporary performance impairments upon waking. Given that the majority of work in this area has been laboratory-based, there is a significant need for field-based investigations of the magnitude of sleep inertia, in addition to the utility of sleep inertia countermeasures. Field studies should include working with subject matter experts to identify the real-world impacts of changes in performance associated with sleeping, or not sleeping, whilst on call.
The influence of corporate social responsibility on customer perspective in private universities

The goals of organizations, despite maximization of profits should be directed at satisfying customers, particularly with respect to societal values, purposeful and strategic business gains. Previous studies have been on enhancing the financial gains without adequate prospects for corporations’ responsiveness to their operational environment and customers. However, there are no substantial empirical studies on the influence of organizations corporate exercises, perceptions, and responsibility to those of customers’ satisfactions, principally when considered in the context of Private Universities (PUs). In this paper therefore, the effects of organization’s corporate social responsibility (CSR) on customer perspective (CP) was investigated with respect to Yemen’s PUs and Higher Education Institutions. A structured questionnaire using Partial Least Square-Structural Equation Modeling methodology was used for data collection; respondents were top-management staffs from these organizations. Results revealed that CSR has a positive influence on the Customer Perception of Yemen’s PUs. This study therefore justified the support and contribution to the dearth of knowledge on the impacts of CSR on organisational CP.
Unified Growth Theory Contradicted by the GDP/cap Data

Mathematical properties of the historical GDP/cap distributions are discussed and explained. These distributions are frequently incorrectly interpreted and the Unified Growth Theory is an outstanding example of such common misconceptions. It is shown here that the fundamental postulates of this theory are contradicted by the data used in its formulation. The postulated three regimes of growth did not exist and there was no takeoff at any time. It is demonstrated that features interpreted as three regimes of growth represent just mathematical properties of a single, monotonically-increasing distribution, indicating that a single mechanism should be used to explain the historical economic growth. It is shown that using different socio-economic conditions for different perceived parts of the historical GDP/cap data is irrelevant and scientifically unjustified. The GDP/cap growth was indeed increasing slowly over a long time and fast over a short time but these features represent a single, uniform and uninterrupted growth process, which should be interpreted as whole using a single mechanism of growth.
Pituitary-bone connection in skeletal regulation

Abstract Pituitary hormones have traditionally been thought to exert specific, but limited function on target tissues. More recently, the discovery of these hormones and their receptors in organs such as the skeleton suggests that pituitary hormones have more ubiquitous functions. Here, we discuss the interaction of growth hormone (GH), follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), adrenocorticotrophic hormone (ACTH), prolactin, oxytocin and arginine vasopressin (AVP) with bone. The direct skeletal action of pituitary hormones therefore provides new insights and therapeutic opportunities for metabolic bone diseases, prominently osteoporosis.
The impact of social influences on the financial knowledge, attitudes and behavior of teenagers and young adults

This paper examines the effect on rates of achievement of the interaction of student gender and school socioeconomic status, using ordinary least squares and probit regressions. The data used is school achievement by students taking externally assessed accounting standards in their final year at New Zealand secondary schools, and covers the period 2004 to 2008. The paper concludes that the interaction of gender and school decile have a significant impact on achievement rates for Maori, Pacific Island and Asian girls relative to Maori, Pacific Island and Asian boys in low decile schools. A secondary contribution of this paper is to demonstrate that comparing the achievement of gender or socioeconomic status groups in isolation is insufficient when examining academic performance and evaluating subject curriculum. Interactions between variables need to be considered, whether they be gender and decile as this paper examines, or other variables not examined within this paper.