Miracle-dz/UniFAR-FTUs huggingface dataset:
Secular Variation in United States Rotavirus Disease Rates and Serotypes: Implications for Assessing the Rotavirus Vaccination Program

Background: Since 2006, we have conducted population-based surveillance for rotavirus disease in children seen in hospitals and emergency departments (EDs) in Monroe County, NY (Rochester), Hamilton County, OH (Cincinnati), and Davidson County, TN (Nashville). Methods: During the 2006 and 2007 rotavirus seasons, clinical information and stool specimens were obtained from county children who were <3 years presenting with diarrhea and/or vomiting to the hospital or ED of the only children's hospital in each county. Specimens were tested for rotavirus and genotyped, and rates of hospitalization and ED visits were calculated. Results: While aggregate rotavirus hospitalization rates for the 3 sites were similar in 2006 and 2007 (22.5/10,000 and 26.8/10,000, respectively), individual rates for the 3 counties differed considerably. The rotavirus hospitalization rate in Rochester between 2006 and 2007 increased 3-fold, but decreased by 33% in Cincinnati and 41% in Nashville over the 2 study years. G1 strains accounted for >80% of strains at all 3 sites in 2006. However, in 2007, the uncommon P[8], G12 strain was detected in 69% of Rochester specimens, while the P[8], G1 strain remained predominant in the other 2 sites. No subjects received rotavirus vaccine in 2006 and coverage with 2 to 3 vaccine doses reached 15% in all 3 communities by June 2007. Conclusions: During the 2006 and 2007 rotavirus seasons, with only limited vaccine use, remarkable variability was observed in the population-based rates of severe rotavirus and in the rotavirus serotypes across the 3 sites. This natural secular variability in rotavirus disease must be considered in the assessment of the impact of vaccine on disease rates and rotavirus serotypes.
Exploring Relationships Between Patient Safety Culture and Patients’ Assessments of Hospital Care

Objectives The purpose of this study was to examine relationships among 2 Agency for Healthcare Research and Quality measures of hospital patient safety and quality, which reflect different perspectives on hospital performance: the Hospital Survey on Patient Safety Culture (Hospital SOPS)—a hospital employee patient safety culture survey—and the Consumer Assessment of Healthcare Providers and Systems Hospital Survey (CAHPS Hospital Survey)—a survey of the experiences of adult inpatients with hospital care and services. Our hypothesis was that these 2 measures would be positively related. Methods We performed multiple regressions to examine the relationships between the Hospital SOPS measures and CAHPS Hospital Survey measures, controlling for hospital bed size and ownership. Analyses were conducted at the hospital level with each survey’s measures using data from 73 hospitals that administered both surveys during similar periods. Results Higher overall Hospital SOPS composite average scores were associated with higher overall CAHPS Hospital Survey composite average scores (r = 0.41, P < 0.01). Twelve of 15 Hospital SOPS measures were positively related to the CAHPS Hospital Survey composite average score after controlling for bed size and ownership, with significant standardized regression coefficients ranging from 0.25 to 0.38. None of the Hospital SOPS measures were significantly correlated with either of the two single-item CAHPS Hospital Survey measures (hospital rating and willingness to recommend). Conclusions This study found that hospitals where staff have more positive perceptions of patient safety culture tend to have more positive assessments of care from patients. This finding helps validate both surveys and suggests that improvements in patient safety culture may lead to improved patient experience with care. Further research is needed to determine the generalizability of these results to larger sets of hospitals, to hospital units, and to other settings of care.
Preventive therapy in postoperative Crohn's disease

Purpose of review Recurrence of Crohn's disease following surgical resection is common, but the optimal strategy to assess, prevent, and treat postoperative recurrence remains unclear. Recent developments in the prevention and management of postoperative recurrence have provided additional information. Recent findings Predictors of Crohn's disease recurrence after surgery include cigarette smoking, disease behavior, number of prior resections, family history, anastomotic type, and time to first surgery. Only penetrating disease behavior and continued cigarette smoking after surgery remain clear predictors of postoperative Crohn's disease recurrence. Ileocolonoscopy is the only modality to detect mucosal recurrence after surgery; however, surrogate markers of inflammation, specifically stool lactoferrin and calprotectin as well as small intestine contrast ultrasound, are promising. Due to the high rate of surgery for the treatment of complications of Crohn's disease, prevention of postoperative disease has received considerable attention. Recent studies of azathioprine/6-mercaptopurine, nitroimidazole antibiotics, and infliximab have broadened the spectrum of medication options postoperatively. Summary Smoking cessation and ileocolonoscopy for early detection of Crohn's disease recurrence should be part of any postoperative management strategy. The selection of medication and optimal time to initiate treatment after surgery is less certain. Postoperative immunomodulators and antitumor necrosis factor agents may prevent Crohn's disease in those at high risk for recurrence. Treatment of patients by predictors of recurrence and personalization of management based on genotypes/phenotypes will be the focus of future study.
Carbohydrates and the risk of breast cancer among Mexican women.

OBJECTIVE High carbohydrate intake has been hypothesized to be a risk factor for breast cancer, possibly mediated by elevated levels of free insulin, estrogens, and insulin-like growth factor-1. Therefore, we conducted a population-based case-control study among a Mexican population characterized by relatively low fat and high carbohydrate intakes. METHODS Women ages 20 to 75 years, identified through six hospitals in Mexico City (n = 475), were interviewed to obtain data relating to diet (using a food frequency questionnaire) and breast cancer risk factors. Controls (n = 1,391) were selected from the Mexico City population using a national sampling frame. RESULTS Carbohydrate intake was positively associated with breast cancer risk. Compared with women in the lowest quartile of total carbohydrate intake, the relative risk of breast cancer for women in the highest quartile was 2.22 [95% confidence interval (95% CI) 1.63-3.04], adjusting for total energy and potential confounding variables (P for trend < 0.0001). This association was present in premenopausal and postmenopausal women (for highest versus lowest quartile, odds ratio 2.31, 95% CI 1.36-3.91 in premenopausal women and odds ratio 2.22, 95% CI 1.49-3.30 in postmenopausal women). Among carbohydrate components, the strongest associations were observed for sucrose and fructose. No association was observed with total fat intake. DISCUSSION In this population, a high percentage of calories from carbohydrate, but not from fat, was associated with increased breast cancer risk. This relation deserves to be investigated further, particularly in populations highly susceptible to insulin resistance.
The Effects of Increased Prosthetic Ankle Motions on the Gait of Persons with Bilateral Transtibial Amputations

Su P-F, Gard SA, Lipschutz RD, Kuiken TA: The effects of increased prosthetic ankle motions on the gait of persons with bilateral transtibial amputations. Objective:To determine whether the provision of prosthetic ankle motion improves walking performance in persons with bilateral transtibial amputations. Design:Crossover experimental design in which 19 persons with bilateral transtibial amputations were fitted with Endolite Multiflex Ankles (flexion unit) and Otto Bock Torsion Adapters (torsion unit) to increase relative motion between the prosthetic foot and socket in the sagittal and transverse planes, respectively. Quantitative gait analyses were performed on subjects as they walked with four prosthetic configurations: baseline without flexion or torsion units, with only the flexion unit, with only the torsion unit, and with both the flexion and torsion units. Data were compared with a control group of 14 able-bodied subjects. Results:The flexion unit increased ankle sagittal plane motion (6-7 degrees) and increased positive ankle power (about 0.17 W/kg). The torsion unit increased transverse plane ankle range of motion by 1-2 degrees. Responses from questionnaires indicated that 14 of the 19 subjects preferred the prosthetic configuration that included both the flexion and torsion units. Further, the subjects perceived that the increased prosthetic ankle motion was particularly beneficial for improving stability while they walked on uneven terrain. Conclusions:Both the subjective and objective results suggest that prosthetic foot and ankle components that allow for greater sagittal and transverse plane rotations provide substantial benefit during walking and should be considered for persons with bilateral transtibial amputations. Nonetheless, clinicians should perform individual and appropriate assessments of patients to ensure that they are capable of using components that may improve mobility while possibly sacrificing some degree of stability.
The Exosporium Layer of Bacterial Spores: a Connection to the Environment and the Infected Host

SUMMARY Much of what we know regarding bacterial spore structure and function has been learned from studies of the genetically well-characterized bacterium Bacillus subtilis. Molecular aspects of spore structure, assembly, and function are well defined. However, certain bacteria produce spores with an outer spore layer, the exosporium, which is not present on B. subtilis spores. Our understanding of the composition and biological functions of the exosporium layer is much more limited than that of other aspects of the spore. Because the bacterial spore surface is important for the spore's interactions with the environment, as well as being the site of interaction of the spore with the host's innate immune system in the case of spore-forming bacterial pathogens, the exosporium is worthy of continued investigation. Recent exosporium studies have focused largely on members of the Bacillus cereus family, principally Bacillus anthracis and Bacillus cereus. Our understanding of the composition of the exosporium, the pathway of its assembly, and its role in spore biology is now coming into sharper focus. This review expands on a 2007 review of spore surface layers which provided an excellent conceptual framework of exosporium structure and function (A. O. Henriques and C. P. Moran, Jr., Annu Rev Microbiol 61:555–588, 2007, http://dx.doi.org/10.1146/annurev.micro.61.080706.093224). That review began a process of considering outer spore layers as an integrated, multilayered structure rather than simply regarding the outer spore components as independent parts.
Neurologic complications of sickle cell disease in Africa

Objective: To summarize prevalence data on the neurologic complications of sickle cell disease (SCD) in Africa. Methods: We searched EMBASE, PubMed, and African Index Medicus to identify all relevant articles published from inception to May 31, 2016. Each study was reviewed for methodologic quality. A random-effects model was used to estimate the prevalence of neurologic complications of SCD across studies. Results: Thirty-one studies were included. Methodologic quality was high or moderate in 90% of studies. Stroke, conditional and abnormal cerebral blood flow, seizures, and headache were the complications most frequently reported, with overall prevalence rates of 4.2%, 10.6%, 6.1%, 4.4%, and 18.9%, respectively. Some complications, like silent brain infarcts, peripheral neuropathies, neurocognitive deficits, or moyamoya disease, have been rarely or not studied at all in the African setting. Incidence data were scarce and of poor quality. Conclusions: The burden of neurologic complications of SCD is important in Africa and most likely underestimated. A better evaluation of this burden requires larger prospective studies using standard up-to-date screening methods. Accessibility to diagnostic tools such as neuroimaging, transcranial Doppler, EEG, and neuropsychological evaluation, as well as to preventive and therapeutic interventions and trained health care providers, should be improved in routine clinical practice.
Involvement of the Major Capsid Protein and Two Early-Expressed Phage Genes in the Activity of the Lactococcal Abortive Infection Mechanism AbiT

ABSTRACT The dairy industry uses the mesophilic, Gram-positive, lactic acid bacterium (LAB) Lactococcus lactis to produce an array of fermented milk products. Milk fermentation processes are susceptible to contamination by virulent phages, but a plethora of phage control strategies are available. One of the most efficient is to use LAB strains carrying phage resistance systems such as abortive infection (Abi) mechanisms. Yet, the mode of action of most Abi systems remains poorly documented. Here, we shed further light on the antiviral activity of the lactococcal AbiT system. Twenty-eight AbiT-resistant phage mutants derived from the wild-type AbiT-sensitive lactococcal phages p2, bIL170, and P008 were isolated and characterized. Comparative genomic analyses identified three different genes that were mutated in these virulent AbiT-insensitive phage derivatives: e14 (bIL170 [e14 bIL170]), orf41 (P008 [orf41 P008]), and orf6 (p2 [orf6 p2] and P008 [orf6 P008]). The genes e14 bIL170 and orf41 P008 are part of the early-expressed genomic region, but bioinformatic analyses did not identify their putative function. orf6 is found in the phage morphogenesis module. Antibodies were raised against purified recombinant ORF6, and immunoelectron microscopy revealed that it is the major capsid protein (MCP). Coexpression in L. lactis of ORF6p2 and ORF5p2, a protease, led to the formation of procapsids. To our knowledge, AbiT is the first Abi system involving distinct phage genes.
Auditor Consideration of Tone-atthe-top in Audit Planning : An Experimental Investigation

The objective of this study is to increase our understanding of the manner in which auditors integrate information about management tone-at-the-top with other information when making audit planning decisions related to extent of substantive testing. Audit planning is an area that requires considerable professional judgment and involves the evaluation and integration of a wide range of information, such as the client’s internal environment including both tone-at-thetop and internal controls, planning phase analytical procedures (PPAP), and characteristics of the client’s business and the industry in which it operates. This research provides evidence that auditors do consider tone-at-the-top during the audit planning process and that this information is integrated with other relevant factors in extent-of-substantive-testing judgments. We use a complex task (Bonner 1994; Kennedy, et al. 1997) providing cues across several dimensions, including client tone-at-the-top, results of internal control tests and PPAP, and various client characteristics to study planned extent-of-substantive-testing judgments made by auditors. One goal is to determine whether auditors integrate information about tone-at-the-top during audit planning into subsequent extent-of-substantive-testing judgments. In addition, we determine how tone-at-the-top interacts with other relevant factors in audit planning. To our knowledge, this is the first study to specifically address tone-at-the-top as a planning consideration within the audit risk model and to operationalize this variable within an experiment along with tests of controls. Previous studies operationalized internal control only as results of control tests (Cohen and Kida 1989; Dusenbury, et al. 2000), or only as control
PEEP only partly restores disturbed distribution of regional pulmonary blood flow in lung injury

Kleen, M. , B. Zwissler, and K. Messmer. PEEP only partly restores disturbed distribution of regional pulmonary blood flow in lung injury. Am. J. Physiol. 274 (Heart Circ. Physiol. 43): H209–H216, 1998. —The effects of lung injury, positive end-expiratory pressure (PEEP), and norepinephrine on heterogeneity of regional pulmonary blood flow (rPBF, radioactive microspheres) were investigated. We hypothesized that lung injury increases heterogeneity of rPBF and that PEEP ventilation reduces these effects. Heterogeneity of rPBF is scale dependent and was therefore assessed in detail. Local correlation (r), relative dispersion (RD), fractal dimension (D), perfusion gradients, and histograms of rPBF each measures a different aspect of heterogeneity. In eight anesthetized dogs, lung injury was induced with oleic acid and glass bead injection. Afterward, PEEP of 10–20 cmH2O was instituted. Norepinephrine was infused at 20 cmH2O PEEP. Heterogeneity increased upon lung injury (r, 0.44 6 0.09 vs. 0.24 6 0.09; RD, 0.36 6 0.06 vs. 0.64 6 0.12; both P # 0.05), but fractal dimension remained constant. PEEP did not change r, RD, or D. Perfusion gradients were reversed after lung injury (right, 227 6 18 vs. 196 6 115%; left, 224 6 18 vs. 282 6 184%; P # 0.05). PEEP (10 cmH2O) reduced gradients (116 6 73 and 143 6 62%, respectively; P # 0.05). Norepinephrine, in part, further reduced gradients (right, 50 6 58%; P # 0.05; left, 102 6 94%; P 5 NS). We conclude that oleic acidand glass bead-induced lung injury produces abnormal distribution of rPBF. Of these changes, application of PEEP only reverses perfusion gradients.
Altered CD4+ T Cell Phenotype and Function Determine the Susceptibility to Mucosal Candidiasis in Transgenic Mice Expressing HIV-11

The impairments of protective mucosal immunity which cause susceptibility to oropharyngeal candidiasis (OPC) in HIV infection remain undefined. This study used a model of OPC in CD4C/HIV MutA transgenic (Tg) mice expressing Rev, Env, and Nef of HIV-1 to investigate the role of transgene expressing dendritic cells (DCs) and CD4+ T cells in maintenance of chronic oral carriage of Candida albicans. DCs were depleted in the Tg mice and had an immature phenotype, with low expression of MHC class II and IL-12. CD4+ T cells were quantitatively reduced in the oral mucosa, cervical lymph nodes (CLNs) and peripheral blood of the Tg mice, and displayed a polarization toward a nonprotective Th2 response. Proliferation of CLN CD4+ T cells from infected Tg mice in response to C. albicans Ag in vitro was abrogated and the cells failed to acquire an effector phenotype. Coculture of C. albicans-pulsed DCs with CD4+ T cells in vitro showed that Tg expression in either or both of these cell populations sharply reduced the proliferation of CD4+ T cells and their production of IL-2. Finally, transfer of naive non-Tg CD4+ T cells into these Tg mice restored proliferation to C. albicans Ag and sharply reduced oral burdens of C. albicans. Overall, these results indicate that defective CD4+ T cells primarily determine the susceptibility to chronic carriage of C. albicans in these Tg mice.
The 500 Dalton rule for the skin penetration of chemical compounds and drugs

Abstract: Human skin has unique properties of which functioning as a physicochemical barrier is one of the most apparent. The human integument is able to resist the penetration of many molecules. However, especially smaller molecules can surpass transcutaneously. They are able to go by the corneal layer, which is thought to form the main deterrent. We argue that the molecular weight (MW) of a compound must be under 500 Dalton to allow skin absorption. Larger molecules cannot pass the corneal layer. Arguments for this “500 Dalton rule” are; 1) virtually all common contact allergens are under 500 Dalton, larger molecules are not known as contact sensitizers. They cannot penetrate and thus cannot act as allergens in man; 2) the most commonly used pharmacological agents applied in topical dermatotherapy are all under 500 Dalton; 3) all known topical drugs used in transdermal drug‐delivery systems are under 500 Dalton. In addition, clinical experience with topical agents such as cyclosporine, tacrolimus and ascomycins gives further arguments for the reality of the 500 Dalton rule. For pharmaceutical development purposes, it seems logical to restrict the development of new innovative compounds to a MW of under 500 Dalton, when topical dermatological therapy or percutaneous systemic therapy or vaccination is the objective.
Rosemary components inhibit benzo[a]pyrene-induced genotoxicity in human bronchial cells.

The commonly used spice and flavouring agent, rosemary, derived from the leaves of the plant Rosmarinus officinalis L. , displays antioxidant properties in foods and in biological systems. Moreover, in animal models rosemary components were found to inhibit the initiation and tumour promotion phases of carcinogenesis. In this work, we studied the mechanisms by which rosemary components block initiation of carcinogenesis by the procarcinogen benzo[a]pyrene (B[a]P) in human bronchial epithelial cells (BEAS-2B). Whole rosemary extract (6 micrograms/ml) or an equivalent concentration of its most potent antioxidant constituents, carnosol or carnosic acid, inhibited DNA adduct formation by 80% after 6 h co-incubation with 1.5 muM B[a]P. Under similar conditions, cytochrome P450 (CYP) 1A1 mRNA expression was 50% lower in the presence of rosemary components, and CYP1A1 activity was inhibited 70-90%. The observed reduction of DNA adduct formation by rosemary components may mostly result from the inhibition of the activation of benzo[a]pyrene to its ultimate metabolites. Carnosol also affected expression of the phase II enzyme glutathione-S-transferase which is known to detoxify the proximate carcinogenic metabolite of B[a]P. Treatment of BEAS-2B cells with carnosol (1 microgram/ml) for 24 h resulted in a 3- to 4-fold induction of GST pi mRNA. Moreover, expression of a second important phase II enzyme, NAD(P)H: quinone reductase, was induced by carnosol in parallel with GST pi. Therefore, rosemary components have the potential to decrease activation and increase detoxification of an important human carcinogen, identifying them as promising candidates for chemopreventive programs.