Miracle-dz/UniFAR-FTUs huggingface dataset:
What Parents Think About the Risks and Benefits of Antibiotics for Their Child’s Acute Respiratory Tract Infection

Background Parental pressure is often cited as a reason for why pediatricians overuse antibiotics for children with acute respiratory tract infection (ARTI). We sought to capture parent perceptions of antibiotics at the time of their child's presentation with an ARTI. Methods We conducted semistructured interviews with parents of children who presented with ARTI symptoms to 1 of 4 diverse practices in a large hospital-affiliated network of pediatric primary care practices. Parents were interviewed before their child was seen by the pediatrician and asked about their perceptions of antibiotics. Results Interviews were conducted with 109 parents. None of the parents said they planned to ask the pediatrician for antibiotics but instead expected to gain reassurance and a plan to minimize symptoms. Three perceptions about antibiotics were identified: parents have a sense of wariness when their child is prescribed antibiotics, they have an understanding that antibiotic overuse is a problem but that it is driven by the demands of other parents, and they have a preference for alternative treatment. The majority of the parents were not concerned about antibiotic resistance. In response to closed-ended questions designed to assess their level of concern with adverse effects, parents were most concerned with their child developing an upset stomach, having an allergic reaction, and experiencing diarrhea. The parents were not concerned with antibiotic treatment failure. Conclusions Parents in our study expressed a sense of caution about antibiotics and an awareness that they should be used judiciously. Our findings indicate that parents are aware of the downsides of antibiotics and might be willing to partner with healthcare providers to improve appropriate use.
DNA-repair pathway inhibitors for the treatment of ovarian cancer.

BACKGROUND Ovarian cancer is the sixth most common cancer and seventh most common cause of cancer death in women world-wide.Three-quarters of women present when the disease has spread through-put the abdomen (stage III or IV) and treatment consists of a combination of debulking surgery and platinum-based chemotherapy, with or without taxanes. Although initial responses to chemotherapy are often good, most women will relapse and require further chemotherapy and will eventually develop resistance to chemotherapy agents. Increased understanding about the molecular basis of ovarian cancer has lead to the development of novel agents, which work in different ways to conventional chemotherapy. These include DNA-repair pathway inhibitors, the commonest of which are the PARP (poly (ADP-ribose) polymerase) inhibitors. It is therefore important to compare their effectiveness and side effects of these novel agents to assess their role in the treatment of advanced ovarian cancer, especially as treatment of advanced disease is aiming to improve length of survival and quality of life (QoL). OBJECTIVES To compare the effectiveness and harmful effects of interventions, which inhibit DNA-repair pathways, in the treatment of ovarian cancer. SEARCH STRATEGY RCTs were identified by searching The Cochrane Central Register of Controlled Trials (CENTRAL, Issue 2, 2009), The Cochrane Gynaecological Cancer Collaborative Review Group's Trial Register, MEDLINE (1990 to June 2009), EMBASE (1990 to June 2009), ongoing trials on www.controlled-trials.com/rct, www.clinicaltrials. gov, www.cancer. gov/clinicaltrials and the National Research Register (NRR), the FDA database and pharmaceutical industry biomedical literature. SELECTION CRITERIA Adult women with histologically proven ovarian cancer who were randomised to treatment groups which either compared DNA-repair pathway inhibitors with no treatment or DNA-repair pathway inhibitors together with conventional chemotherapy compared with conventional chemotherapy alone. DATA COLLECTION AND ANALYSIS Two review authors independently assessed whether potentially relevant studies met the inclusion criteria. Searches for additional data and information were also performed by two independent review authors. No trials were found and therefore no data were analysed, so only information on excluded references was collected. MAIN RESULTS The search strategy identified 473 unique references of which 461 were excluded on the basis of title and abstract. The remaining 12 articles were retrieved in full, but none satisfied the inclusion criteria. However, two ongoing randomised phase II clinical trials were identified from the clinical trials databases that met our inclusion criteria, but no preliminary data were available. AUTHORS' CONCLUSIONS There are to date no published RCT data on the effectiveness and side effects of DNA-repair pathways inhibitors used alone or in association with conventional chemotherapy in the treatment of ovarian cancer. On-going trials have been identified and results are awaited and will be included in future updates of this review.
De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock.

BACKGROUND Mortality rates among patients with sepsis, severe sepsis or septic shock are highly variable throughout different regions or services and can be upwards of 50%. Empirical broad-spectrum antimicrobial treatment is aimed at achieving adequate antimicrobial therapy, thus reducing mortality; however, there is a risk that empirical broad-spectrum antimicrobial treatment can expose patients to overuse of antimicrobials. De-escalation has been proposed as a strategy to replace empirical broad-spectrum antimicrobial treatment by using a narrower antimicrobial therapy. This is done by reviewing the patient's microbial culture results and then making changes to the pharmacological agent or discontinuing a pharmacological combination. OBJECTIVES To evaluate the effectiveness and safety of de-escalation antimicrobial treatment for adult patients diagnosed with sepsis, severe sepsis or septic shock caused by any micro-organism. SEARCH METHODS In this updated version, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 10); MEDLINE via PubMed (from inception to October 2012); EMBASE (from inception to October 2012); LILACS (from inception to October 2012); Current Controlled Trials; bibliographic references of relevant studies; and specialists in the area. We applied no language restriction. We had previously searched the databases to August 2010. SELECTION CRITERIA We planned to include randomized controlled trials (RCTs) comparing de-escalation (based on culture results) versus standard therapy for adults with sepsis, severe sepsis or septic shock. The primary outcome was mortality (at 28 days, hospital discharge or at the end of the follow-up period). Studies including patients initially treated with an empirical but not adequate antimicrobial therapy were not considered for inclusion. DATA COLLECTION AND ANALYSIS Two authors planned to independently select and extract data and to evaluate methodological quality of all studies. We planned to use relative risk (risk ratio) for dichotomous data and mean difference (MD) for continuous data, with 95% confidence intervals. We planned to use the random-effects statistical model when the estimate effects of two or more studies could be combined in a meta-analysis. MAIN RESULTS Our search strategy retrieved 493 studies. No published RCTs testing de-escalation of antimicrobial treatment for adult patients diagnosed with sepsis, severe sepsis or septic were included in this review. We found one ongoing RCT. AUTHORS' CONCLUSIONS There is no adequate, direct evidence as to whether de-escalation of antimicrobial agents is effective and safe for adults with sepsis, severe sepsis or septic shock. This uncertainty warrants further research via RCTs and the authors are awaiting the results of an ongoing RCT testing the de-escalation of empirical antimicrobial therapy for severe sepsis.
Pain and discomfort perception at IUD insertion -- effect of short-duration low-volume intracervical application of two per cent lignocaine gel (Instillagel) -- a preliminary study.

In a comparative study designed to investigate the effect of cervical anesthesia on the perception of pain during IUD insertion 102 women presenting for IUD insertion at a community family planning clinic in Leeds England were randomly assigned to 1 of 3 groups: A no pretreatment B pretreatment with 2% lignocaine gel (Instillagel) applied to the cervical canal and C pretreatment with an inert gel. Pain scores for women in groups A and C combined were significantly higher (p < 0.025) than those in group B. The percentages of women reporting the most intense pain (scores of 5-7 on a 7-point scale) were 26.3% in group A 18.2% in group B and 35.0% in group C. There were no significant differences in pain perception between nulliparous and parous women overall or by group. Postinsertion symptoms attributable to cervical stimulation (e.g. pallor lightheadedness transient brachycardia) were noted in 9 of 58 women (15.5%) in groups A and C combined but in only 2 of 44 women (4.6%) in group B. These results suggest that the Instillagel system has potential for reducing the pain and discomfort experienced by IUD acceptors at insertion. Recommended however are additional studies to determine whether a greater analgesic effect could be obtained from a longer delay between gel installation and insertion and to compare this method with paracervical infiltration.
DEFB1 gene 5′ untranslated region (UTR) polymorphisms are marginally involved in inflammatory bowel disease in south Brazilians

The possible association of three DEFB1 gene polymorphisms with susceptibility to develop ulcerative colitis (UC) and Crohn's disease (CD) was investigated in Brazilian patients and controls. Although a clear and strong association between functional 5′‐UTR DEFB1 SNPs and susceptibility/protection to IBDs cannot be drawn, our results suggest a possible involvement of DEFB1 gene in inflammatory bowel diseases, especially with the colonic localization of Crohn's disease.
The therapeutic relationship in complementary health care

Promoting Self-Healing Through the Therapeutic Relationship. The Nature of Health and Illness. Towards a Model of Treatment in Health Care. What Do Patients Want? Communication and Illness: the Meaning of Illness for Patients. What Makes Change Happen in Treatment? Power in Treatment. The Process of Treatment. The Health of the Practitioner/ Conclusion: Centrality of the Therapeutic Relationship.
Association of genetic variants of membrane receptors related to recognition and induction of immune response with Helicobacter pylori infection in Ecuadorian individuals

Helicobacter pylori (Hp) has a worldwide distribution showing its higher prevalence of infection in developing countries. Toll‐like receptors (TLRs) and C‐type lectin receptors (CLRs) are proteins that recognize pathogen‐associated molecular patterns (PAMPs) and initiate an innate immune response by promoting growth and differentiation of specialized hematopoietic cells for host defense. Gastric infections led by Hp induce a Th‐1 cellular immune response, regulated mainly by the expression of IFN‐γ. In this retrospective case‐control study, we evaluated the TLR1 1805T/G, TLR2 2029C/T, TLR4 896A/G, CD209 ‐336A/G and IFNGR1 ‐56C/T polymorphisms and their relationship with susceptibility to Hp infection. TLR1 1805T/G showed statistical differences when the control (Hp‐) and infected (Hp+) groups (P = 0.041*) were compared; the TLR1 1805G allele had a protective effect towards infection (OR = 0.1; 95% CI = 0.01‐0.88, P = 0.033*). Similarly, the IFNGR1 ‐56C/T polymorphism showed statistical differences between Hp+ and Hp– (P = 0.018*), and the IFNGR1 ‐56TT genotype exhibited significant risk to Hp infection (OR = 2.9, 95% CI = 1.27‐6.54, P = 0.018*). In conclusion, the pro‐inflammatory TLR1 1805T and IFNGR1 ‐56T alleles are related with susceptibility to Hp infection in Ecuadorian individuals. The presence of these polymorphisms in individuals with chronic infection increases the risk of cellular damage and diminishes the cellular immune response efficiency towards colonizing agents.
IL‐23R gene polymorphism rs2201841 is associated with psoriatic arthritis

We examined rs2201841 within IL‐23R gene in Serbian patients with psoriasis and healthy controls. G allele frequency was significantly increased in the group of patients with psoriatic arthritis compared with controls (0.481 vs 0.308). Carriage of G allele increases risk to develop psoriatic arthritis (P = 0.009, OR = 3.311, 95% CI 1.29–8.70).
The development of a food frequency questionnaire to be used to identify the dietary intake of phytoestrogens in a sample study group of middle aged Italian women living in the Illawarra

Menopause is one of the major biological events to occur in a women's lifetime. Although it is considered as a normal physiological change, its effects often have social and psychological implications. (Morse et al 1993). At present there is minimal information regarding the experience women face during the menopause, particularly in multicultural societies. Currently, Morse et al (1993) from the University of Wollongong are investigating the health experiences o f middle aged Italian women in the Illawarra area of N.S. W. The aims of their research are; • To identify the groups menopausal experiences and attitudes, and compare the findings with those of the dominant culture (AngloAustralians); • To examine the nutrition of these groups and to relate dietary factors to the type and severity of reported menopausal changes; • Further to consider the role if any, of acculturation of this group within a different dominant host culture that may influence the incidence and character of menopause related morbidity. (Morse et al 1993) At present evidence is mounting that nutritional intake may effect menopausal symptoms. This evidence is focused on phvtoestrogens and the oestrogenic activity of certain foods ( Wilcox et al 1990).
Oncogenic Pathway Signatures and Survival Outcome

Recent microarray technology and bioinformatics have shown the ability of analysing oncogenic cellular signalling pathways based upon gene signatures in cancers. (Bild et al., 2006; Dressman et al., 2007; Gatza et al., 2010) Epithelial ovarian cancer (EOC) is the most important cause of mortality among gynaecological cancers. Patients with EOC often present in an advanced stage. Treatment modalities consist in general of the sequence of surgical cytoreduction and platinum-taxane based chemotherapy. (Cannistra, 2004) Although the disease is relatively sensitive to cytotoxics, relapses occur in a majority of patients with advanced stage. (Cannistra, 2004) The emergence of resistance to conventional chemotherapeutics is an often-deadly event in the management of ovarian cancer patients. There is an urgent need for additional therapies that increase survival and/or quality of life in these patients. The objective of our study was to look for cellular pathways that have an effect on survival outcome by a bioinformatical approach. (Trinh et al., 2011) These pathways may guide us to find interesting targets in ovarian cancer. Survival can be used as a measure to quantify the biological relevance in this disease. Ideally, evaluation of survival outcome should be made in a homogenous population with a uniform treatment to avoid treatment-induced biases and uniform histology to find subtler differences independent from histology. Another methodology of estimating prognostic value may be the correlation with documented prognostic gene signatures that have shown to be of prognostic value in breast cancer and other types of cancer. The invasiveness gene signature (IGS) was generated using stem celllike or tumorigenic breast cancer cells. (Liu et al., 2007) This signature has shown prognostic value in lung cancer, medulloblastoma and prostate cancer. The Wound healing response (WHR) signature, based upon genes induced by wound healing, also has shown its prognostic value in breast cancer, NSLC and bladder cancer. (Chang et al., 2005; Lauss, Ringner, & Hoglund, 2010; Mostertz et al., 2010) The genomic grade index (GGI) is a signature that divides low-grade versus high-grade breast carcinomas. (Sotiriou et al., 2006) Interestingly, using this signature, histological intermediate-grade tumours could be classified as lowor high-grade tumours with the preservation of the gene signatures’ prognostic value.
ERAP1 variants are associated with ankylosing spondylitis in East Asian population: a new Chinese case–control study and meta‐analysis of published series

Endoplasmic reticulum aminopeptidase 1 (ERAP1) has been confirmed to be associated with ankylosing spondylitis (AS) in Caucasian. However, whether they are associated with AS in East Asian population remains unidentified. We investigated this relationship by a new Chinese case–control study and a meta‐analysis of published series. 368 cases and 460 controls were recruited in the Chinese case–control study. Genotyping was completed using the chip‐based matrix‐assisted laser desorption ionization time‐of‐flight mass spectrometry. Allelic associations were analysed using contingency tables. In the meta‐analysis, up to 2748 cases and 2774 controls from seven different studies and the new Chinese study were combined using Review Manager software version 5.1. 1. Mantel–Haenszel or Inverse Variance test was used to calculate fixed or random‐effects pooled ORs. In the new Chinese study, strong association with AS was observed for marker rs10050860, rs27434 and rs1065407 at P value of <0.001. Moderate association was observed for rs30187 at P value of <0.01, while no association was observed for rs27044 (P = 0.37) and rs2287987 (P = 0.23). The meta‐analysis showed that rs27037 and rs30187 were strongly associated with AS (P < 0.00001). Significant association was also observed for rs27434 (P = 0.001). No association was shown for rs27044 (P = 0.70). We concluded that ERAP1 variants are associated with AS in East Asian population, indicating a common pathogenic mechanism for AS in East Asians and Caucasians.
Association of the HLA‐G 3′UTR polymorphisms with colorectal cancer in Italy: a first insight

This study aimed to explore functional and regulatory polymorphisms and haplotypes at the HLA‐G 3′UTR region in colorectal cancer development. The presence of nonpolymorphic variants was also evaluated. Three‐hundred and eight patients with colorectal cancer and 294 healthy controls were analysed at the germinal level. We found an association with increased risk of colorectal cancer for +2960 14‐bp INDEL, +3196 C>G SNPs and UTR‐2 haplotype, and a ‘protective’ role for +3003 T>C, +3010 C>G polymorphisms and UTR‐4 haplotype. We detected in 3 distinct patients, a novel nucleotide change (+3037 C>A) and 2 already described rare variants, +3032 G/C (EUR MAF = 0.1%) and +3092 G/T (EUR MAF = 0%). This is the first study showing associations between different polymorphisms in the HLA‐G 3′UTR and colorectal cancer susceptibility.
IL33 and IL1RL1 variants are associated with asthma and atopy in a Brazilian population

Atopic asthma is a chronic inflammatory disease in airways resulting from genetic and environmental factors, characterized by production of the Th2 cytokines interleukin‐4 (IL‐4), interleukin‐5 (IL‐5) and interleukin‐13 (IL‐13). Interleukin‐33 (IL‐33) appears to be a potent inducer of Th2 immune response. This occurs when IL‐33 binds and activates its receptor, the membrane ST2 (ST2L) in mast cells, dendritic cells, basophils, eosinophils, innate lymphoids and Th2 cells, leading to the release of these cytokines and intensifying allergic inflammation. Polymorphisms in the IL33 and IL1RL1 can act as protective or risk factors for asthma and/or allergy in humans. No study was conducted to replicate such findings in a European and African descendent mixed population. DNA was extracted from peripheral blood from 1223 subjects, and the samples were genotyped using Illumina 2.5 Human Omni Beadchip. We tested for possible associations between SNPs in the IL33 and ST2 with asthma and allergy markers such as specific IgE (sIgE), IL‐5 and IL‐13 production and skin prick test (SPT). Logistics regressions were performed using PLINK software 1.07. The analyses were adjusted for sex, age, helminth infection and ancestry markers. The G allele of IL33 SNP rs12551256 was negatively associated with asthma (OR 0.71, 95% CI: 0.53–0.94, P = 0.017). In contrast, the A allele of IL1RL1 rs1041973 was positively associated with IL‐5 production (OR 1.36, 95% CI: 1.09–1.84, P = 0.044), sIgE levels (OR 1.40, 95% CI: 1.07–1.84, P = 0.013) and positive SPT (OR 1.48, 95% CI: 1.08–2.03, P = 0.014), for Blomia tropicalis mite. The same allele, in atopic subjects, was associated with decreased production of soluble ST2 (sST2) (P < 0.05). Moreover, expression quantitative trait loci (eQTL) analysis suggests that rs1041973 and rs873022 regulate the expression of IL1RL1 gene. This latest SNP, rs873022, the T allele, was also associated with a lower production of sST2 in plasma of Brazilians. The genetic risk score for rs1041973 and rs16924161 demonstrated a higher risk for SPT positivity against B. tropicalis, the greater the number of risk alleles for both SNPs. Our findings demonstrate a robust association of genetic variants in IL1RL1 and IL33 SNPs with allergy markers and asthma.
Association between Australian Hajj Pilgrims’ awareness of MERS-CoV, and their compliance with preventive measures and exposure to camels

Abstract Through a prospective cohort study the relationship between travellers’ awareness of MERS-CoV, and compliance with preventive measures and exposure to camels was evaluated among Australian Hajj pilgrims who attended Hajj in 2015. Only 28% of Australian Hajj pilgrims were aware of MERS-CoV in Saudi Arabia. Those who were aware of MERS-CoV were more likely to receive recommended vaccines [odds ratio (OR) 3.1, 95% confidence interval (CI): 1.5–5.9, P < 0.01], but there was no significant difference in avoiding camels or their raw products during Hajj between those who were aware of MERS-CoV and those who were not (OR 1.2, 95% CI: 0.3–5.2, P = 0.7). Hajj pilgrims’ awareness is reflected in some of their practices but not in all.