Miracle-dz/UniFAR-FTUs huggingface dataset:
Management and Prevention of Recurrent Clostridium Difficile Infection in Patients After Total Joint Arthroplasty

Clostridium difficile infection (CDI) is the most common infectious cause of nosocomial diarrhea in elderly patients, accounting for 15% to 25% of all cases of antibiotic-induced diarrhea in those patients. Virulent forms of this organism have developed, increasing the associated morbidity, mortality, and complication rates. The average patient undergoing total joint arthroplasty is at particular risk of CDI because of advanced age, the use of prophylactic antibiotic coverage in the perioperative period, multiple comorbid conditions, and length of hospital stay. In addition, patients who have had one CDI are at risk of another; the rate of recurrent CDI (RCDI) is 15% to 30%. To review the available information on RCDI, we conducted an extensive literature search, focusing on its epidemiology and the management strategies for its treatment and prevention. We found the management of RCDI is a controversial topic, with as yet no consensus regarding specific treatment guidelines. Several experienced clinicians have published suggested treatment algorithms, but they are based on anecdotal experience. With regard to the prevention of RCDI, the literature is scarce, and currently, the only effective strategies remain judicious use of perioperative antibiotics and appropriate implementation of infection control procedures. There are several vaccination medications that are currently being studied but are not yet ready for clinical use. We agree with the approach to management of RCDI that has been proposed in several articles, that is, on confirmation of a first recurrence of CDI by a stool toxin assay and clinical symptoms, a 14-day course of metronidazole or vancomycin; for a second recurrence, a tapered-pulsed course of vancomycin; and, for 3 or more recurrences, a repeat course of the tapered-pulsed vancomycin and adjunctive Saccharomyces boulardii or cholestyramine.
The identification of Parkinson's disease subtypes using cluster analysis: A systematic review

The clinical variability between patients with Parkinson's disease (PD) may point at the existence of subtypes of the disease. Identification of subtypes is important, since a focus on homogeneous groups may enhance the chance of success of research on mechanisms of disease and may also lead to tailored treatment strategies. Cluster analysis (CA) is an objective method to classify patients into subtypes. We systematically reviewed the methodology and results of CA studies in PD to gain a better understanding of the robustness of identified subtypes. We found seven studies that fulfilled the inclusion criteria. Studies were limited by incomplete reporting and methodological limitations. Differences between studies rendered comparisons of the results difficult. However, it appeared that studies which applied a comparable design identified similar subtypes. The cluster profiles “old age‐at‐onset and rapid disease progression” and “young age‐at‐onset and slow disease progression” emerged from the majority of studies. Other cluster profiles were less consistent across studies. Future studies with a rigorous study design that is standardized with respect to the included variables, data processing, and CA technique may advance the knowledge on subtypes in PD. © 2010 Movement Disorder Society
Outcomes of Minimal Invasive vs Open Radical Nephrectomy for the Treatment of Locally Advanced Renal-Cell Carcinoma.

PURPOSE We compare oncologic outcomes of minimally invasive and open nephrectomy for locally advanced kidney cancer. MATERIALS AND METHODS A retrospective review of a single-institutional, prospectively maintained database from a National Comprehensive Cancer Network-designated center was conducted. All patients who underwent radical nephrectomy at Roswell Park Cancer Institute with diagnosis of pT3 and pT4 renal-cell carcinoma (RCC) between years 1998 and 2015 were reviewed. Patients who underwent partial nephrectomy and nephroureterectomy were excluded. RESULTS We identified 172 patients with pT3 or pT4 tumors resected by minimally invasive (laparoscopic and robotic) or open radical nephrectomy. Demographic characteristics were similar between the two groups. Patients in the minimally invasive group had a higher mean body mass index (31.9 vs 28.1, p = 0.002), radiologically smaller tumors (7.7 cm vs 9.1 cm, p = 0.008), lower mean estimated blood loss (277 vs 1429, p < 0.001), lower rate of blood transfusion (4.7% vs 45.5%, p < 0.001), and a shorter mean length of stay (3.5 days vs 5.7 days, p < 0.001) compared with patients who underwent open surgery. At a median follow-up of 32.8 months, there was no significant difference in overall survival (p = 0.8) between the two groups. CONCLUSION Minimal invasive nephrectomy is a safe approach with similar oncologic outcomes to open nephrectomy for select patients with locally advanced RCC.
Relationship between platelet-derived growth factor expression in leiomyomas and uterine volume changes after gonadotropin-releasing hormone agonist treatment.

The unopposed estrogen effect is the main cause of leiomyoma growth and is at the basis of the clinical use of gonadotropin-releasing hormone (GnRH) agonists. Platelet-derived growth factor (PDGF) has been indicated as the main growth factor involved, in vitro in the proliferation response of leiomyoma smooth muscle cells to estrogen stimulation. The aim of this article is to evaluate the mitogenic action of PDGF in vivo by studying the relationship between PDGF expression in leiomyomas and post-GnRH analogue treatment changes in uterine volume. Thirty-nine patients suffering from uterine leiomyomas were treated with leuprorelin acetate depot 3.75 mg for three cycles; 31 untreated patients were enrolled as control group. Uterine volume was determined twice by ultrasonography in each patient, the first time at admission and the second time after treatment in the study group and after 3 months in the control group. The change in the uterine volume was then evaluated. Patients underwent surgery, and PDGF immunohistochemical detection was performed on the obtained fibroid samples. Uterine volume decreased significantly after treatment, whereas just a poor modification was found in the controls. The decrease in the uterine volume was found to be statistically related to PDGF expression. Thus PDGF levels decreased in treated patients as compared with controls. The decreased PDGF production in leiomyomas after GnRH analogue treatment and the relationship between decreased PDGF expression and greater shrink age in uterine volume suggest that PDGF might have a mitogenic action on leiomyomas in vivo.
High fill factor piezoelectric micromachined ultrasonic transducers on transparent substrates

This study presents a high fill-factor array of aluminum nitride (AlN) piezoelectric micromachined ultrasonic transducers (PMUTs) fabricated on a transparent substrate. PMUTs with diameters ranging from 40 microns to 100 microns were fabricated, resulting in resonant frequencies from 3 MHz to 18 MHz in air. A high fill factor of 62% was achieved. Immersed pulse-echo experiments were conducted at 2.5 MHz.
Combined mutational analysis of KRAS, NRAS and BRAF genes in Indian patients with colorectal carcinoma

The epidermal growth factor receptor (EGFR) is an excellent candidate for targeted therapy in colorectal cancer. Recent studies have demonstrated that apart from wild-type KRAS, a wild-type BRAF and NRAS genotype is required for response to anti-EGFR therapy. This suggests that NRAS and BRAF genotype criteria should be used together with KRAS genotype to select patients who will likely benefit from anti-EGFR therapy. We investigated the prevalence of mutations in the KRAS, BRAF and NRAS genes and its correlation with demographic characteristics, tumor location and stage in 100 colorectal carcinoma patients from India. The frequency of KRAS, BRAF and NRAS mutations was found to be 23%, 17% and 2.0%, respectively. There was no significant difference in KRAS, NRAS and BRAF mutation with respect to gender, age, tumor location (colon vs rectum) and clinicopathological stage. In addition, we found a novel point variant (T20I) of unknown significance in NRAS exon 1 in addition to a KRAS codon 12 mutation in one of the rectal carcinoma patients. In the present study, combined evaluation of genetic biomarkers (KRAS, NRAS and BRAF) was able to classify 42% of colorectal cancer patients as likely non-responders to anti-EGFR therapy.
Induction of Telomerase Activity by Irradiation in Human Lymphoblasts

Abstract Neuhof, D. , Ruess, A. , Wenz, F. and Weber, K. J. Induction of Telomerase Activity by Irradiation in Human Lymphoblasts. Radiat. Res. 155, 693–697 (2001). Telomerase activity is a radiation-inducible function, which suggests a role of this enzyme in DNA damage processing. Since the tumor suppressor TP53 plays a central role in the regulation of the cellular response to DNA damage, our study explored the ability of ionizing radiation to change telomerase activity and telomere length in two closely related human lymphoblast cell lines with different TP53 status. TK6 cells (wild-type TP53) and WTK1 cells (mutated TP53) were exposed to different doses of X rays, and telomerase activity was measured by PCR ELISA at different times after irradiation. A dose-dependent increase in telomerase activity was observed. One hour after irradiation with 4 Gy, TK6 and WTK1 cells showed an approximately 2.5-fold increase; for lower doses (0.1 to 1 Gy), telomerase induction was seen only in TK6 cells. Telomerase induction was observed by 0.5 h after irradiation, with a further increase up to 24 h. Irradiated TK6 and WTK1 cells had longer telomeres (+1.3 kb) than unirradiated cells 14 days after exposure. Our data demonstrate a dose-dependent induction of telomerase activity and lengthening of telomeres by ionizing radiation in human lymphoblasts. Induction of telomerase activity by radiation does not generally appear to be controlled by the TP53-dependent DNA damage response pathway. However, for low doses, induction of telomerase requires wild-type TP53.
Serum lysozyme – a surrogate marker of pulmonary microvascular injury in smokers?

Progression rate of disease processes in smoke‐induced lung injuries varies greatly. Diverse pathophysiological mechanisms may trigger these divergences. The aim of this study was to evaluate whether circulating markers of monocytes/macrophages and/or neutrophil [i.e. lysozyme (LZM) or myeloperoxidase (MPO)] were associated with reduced values of diffusion capacity (DL,CO), which is considered to serve as a mirror of pulmonary microvascular derangement and an early sign of tissue remodelling in smokers. Data obtained from 134 smokers (GOLD stage ≤1) and 24 matched healthy non‐smoking volunteers were evaluated in a cross‐sectional study design. Lung function tests as well as single breath test of DL,CO were assessed according to ATS/ERS guidelines. Biomarkers were measured in serum by means of sensitive immunoassays. A subgroup of smokers with normal lung function was created to minimize confounding, by excluding datasets showing significant airflow limitation and abnormally high values of carboxy haemoglobin (COHb), the latter indicating recent smoking. The capacity of serum lysozyme to correctly identify abnormally low values of DL,CO (i.e. <1·9SD units), tended to be higher than that of Myeloperoxidase as assessed by analyses of receiver operated curves (ROC; AUC 0·81, 95%CI: 0·69–0·89 versus AUC 0·67, 95%CI: 0·60–0·81). It is concluded that serum levels of lysozyme, reflecting mainly activated monocytes/macrophages but also neutrophils, were significantly associated with isolated decrements of DL,CO in smokers with normal lung function tests. This suggests monocytes/macrophages to have a significant mechanistic role in early phases of the disease process and/or pulmonary microvascular damage.
Molecular characterization and antibiotic sensitivity testing of bacteria in blood cultures of Hepatitis B virus infected subjects

Introduction: Hepatitis B virus is one of the most common infections worldwide. Many infected people are at risk of developing liver complications. Screening for common pathogenic bacterial infections that could contribute to complications is important for early diagnosis and appropriate management. Methods: A cross sectional study was carried out on subjects aged 20-75 years for a period of 6 months (November 2016 to April 2017). Blood cultures and HBsAg rapid tests were performed on all 122 blood samples collected in Ilorin Metropolis. The screening was carried out on 92 HbsAg positive patients who presented with fever, and 30 apparently healthy HbsAg positive donors from the blood bank. Results: Of 92 symptomatic patients, 44 (47.8%) had postive blood cultures and of the 30 HBV positive blood donors, 9 (30%) had positive blood cultures. The prevalence of Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae in Hepatitis B positive subjects was 5.7% (n=7), 5.7% (n=7), 23.8% (n=29) and 9.8% (n=12) respectively. In the apparently healthy HbsAg positive blood donor group, only 9 samples showed positive bacterial growth of P. aeruginosa. All the bacterial isolates were resistant to amoxycillin-clavulanic acid, erythromycin, ceftriaxone, ceftazidime, cefuroxime, and ciprofloxacin. On PCR, Nuc, Stx2, Pf and PSUE genes were demostrated in E. coli, S. aureus, P. aeruginosa and K. pneumoniae respectively. Conclusion: This study showed a high percentage (45.1%) of bacteraemia in HBV infection. Early screening and treatment of HBV infection and concomitant bacterial infection is recommended to prevent complications.
Hazardous components and health effects of atmospheric aerosol particles: reactive oxygen species, soot, polycyclic aromatic compounds and allergenic proteins

Abstract This review outlines recent advances in the investigation of the chemical properties, molecular interactions and health effects of hazardous compounds in atmospheric aerosols, in particular reactive oxygen species (ROS), soot, polycyclic aromatic compounds (PACs) and allergenic proteins. Epidemiological studies show correlations between air particulate matter and adverse health effects of air pollution including allergy, asthma, cardiovascular and respiratory diseases, but the causative relations and mechanisms of interaction on the molecular level are still unclear. ROS generated by photochemical and heterogeneous reactions in the atmosphere seem to play a key role in aerosol health effects and provide a direct link between atmospheric and physiological multiphase processes. Soot and PACs can trigger formation of ROS in vivo, leading to inflammation and cellular damage. PACs as well as allergenic proteins are efficiently oxygenated and nitrated upon exposure to ozone and nitrogen dioxide, which leads to an enhancement of their toxicity and allergenicity.
Elevated Risky Sexual Behaviors Among Sexual Minority Girls: Indirect Risk Pathways Through Peer Victimization and Heavy Drinking

Sexual minority girls (SMGs), compared with heterosexual females, are more likely to report negative sexual outcomes including earlier age of sexual intercourse debut, more lifetime and recent sexual partners, pregnancy involvement, and sex while intoxicated. Data describing the mechanisms related to these health disparities are limited. The purpose of this study was therefore to longitudinally assess the roles of sexual minority–related peer victimization and heavy episodic drinking (HED) as mediators of the relation between sexual minority status and sexual outcomes. The girls examined in this study were recruited into a longitudinal study of adolescent health from two large, urban adolescent medicine clinics affiliated with academic medical centers. The final sample for this analysis included 79 SMGs and a comparison group of 127 heterosexual girls aged between 14 and 19 years. Mediation models were run in the structural equation modeling framework. Our results provided evidence to support a serial multiple mediation pathway. SMGs were more likely to report sexual minority–related victimization, and sexual minority–related victimization predicted increased HED, which was subsequently found to prospectively predict increased sexual risk behaviors. Taken together, these novel findings indicate that both sexual minority–related victimization and HED may play important roles in explaining disparities in risky sexual behavior among SMGs.
Effects of histone H4 depletion on the cell cycle and transcription of Saccharomyces cerevisiae.

We have constructed a yeast strain (UKY403) in which the sole histone H4 gene is under control of the GAL1 promoter. This allows the activation of H4 mRNA synthesis on galactose and its repression on glucose. UKY403 cells, pre‐synchronized in G1 with alpha‐mating factor, have been used to show that glucose treatment results in the loss of approximately half the chromosomal nucleosomes. This depletion is only partially reversible when the H4 gene is reactivated on galactose. It was found that the resultant lethality manifests itself first in S phase, the period of nucleosome assembly, but leads to highly synchronous arrest in G2 and a virtually complete block in chromosomal segregation. Histone H4‐depleted chromatin was analyzed for its efficiency as a template for all three RNA polymerases. Using pulse‐labeling, we find no evidence for altered transcription by RNA polymerase I (25S, 18S and 5.8S rRNAs) or RNA polymerase III (5S rRNA, tRNAs). Northern blot analysis was used to measure levels of RNA polymerase II transcripts. There was little effect on the activation or repression of the CUP1 chelatin gene. While there may be some decrease in the level of certain mRNAs (e.g. HIS4, ARG4) other message levels (HIS3, TRP1) show little change upon glucose repression. Therefore, nucleosome loss certainly does not have a general effect on transcription.
Web erian Bureaucracy And the Military Model

IT IS NOW OBVIOUS that few students of public administration have been moved to heed the periodic cries that the military organization be considered an integral part of their field of study. Despite the importance of the military today, more scholarly care seems to have been lavished on mosquito abatement districts. In the literature of public administration, there are neither sufficient theoretical foundations nor adequate empirical data available to enable us to comprehend the intricacies of operating this massive consumer of public energy and wealth. Such indifference has not been shared by other academics, and, of late, they have not been reluctant about offering advice on the conduct of military affairs. It is still too early to evaluate the outcome of this invasion, especially by the economists, but one can speculate that perhaps future historians of our turbulent times will judge it to have been a national disaster. Rather than repeat the futile pleas of the past for a revision of research priorities within public administration, this article takes a more subtle approach. Perhaps scholars need to be shaken out of the complacent assumption that they already know enough about military administration, having learned their lessons directly from a churlish first sergeant or indirectly from literature fairly hostile to all aspects of military life. Perhaps they might be enticed to reexamine the phenomenon more thoroughly if it could be demonstrated that military theories of administration are far more compli-
Ventilation‐Perfusion Scintigraphy in an Adult with Congenital Unilateral Hyperlucent Lung

A variety of congenital and acquired etiologies can give rise to the radiographic finding of a unilateral hyperlucent lung. An unusual case of congenital lobar emphysema diagnosed in a young adult following the initial discovery of a hyperexpanded, hyperlucent lung is reported. Although subsequent bronchoscopy and radiologic studies detailed extensive anatomic abnormalities, functional imaging also played an important role in arriving at this rare diagnosis. In particular, ventilation-perfusion scintigraphy identified the small contralateral lung as the functional lung and helped narrow the differential diagnosis to etiologies involving obstructive airway disorders.
The Frontal-Temporal Nerve Triangle: A New Concept of Locating the Motor and Sensory Nerves in Upper Third of the Face Rhytidectomy

Background: How to avoid damage to the temporal branch of the facial nerve has long been a central topic of discussion. Recently, damage to the supraorbital nerve, the auriculotemporal nerve, and other branches of the trigeminal nerve divisions has attracted much attention. Focusing on frontal and temporal rhytidectomy, the authors have investigated the course and distribution of the facial nerve branches, the supraorbital nerve, the auriculotemporal nerve, and other branches of trigeminal division. In this article, they present the concept of the frontal-temporal nerve triangle; its contents, vicinity, and clinical significances are discussed. Methods: An anatomical study was performed using 30 temporal-parietal regions of 10 fixed adult cadavers and five fresh cadavers. A step-by-step dissection from the superficial layer to the deep layer was involved; all the measurement data were analyzed, and the mean and standard deviation were calculated and expressed in centimeters. Results: The frontal-temporal nerve triangle is an approximately triangular area formed by the temporal branch of the facial nerve, the supraorbital nerve, and the auriculotemporal nerve. Together with its contents and vicinal structures, it forms a complicated three-dimensional rather than two-dimensional structure. Anatomical structures closely associated with rhytidectomy are located in or near this area. Conclusions: Acting as the anatomical body surface landmark for preoperatively locating the temporal branch, the supraorbital nerve, the auriculotemporal nerve, and its related structures, the concept of the frontal-temporal nerve triangle has practical significance in designing incisions and selecting planes of dissection in upper third of the face rhytidectomy.
Immunoglobulins to Group A Streptococcal Surface Molecules Decrease Adherence to and Invasion of Human Pharyngeal Cells

ABSTRACT The M protein is one of the most important virulence factors of group A streptococci (Streptococcus pyogenes) and may play an important role in the first steps of streptococcal infection. Since acute pharyngitis is a frequently occurring infectious disease caused by these bacteria, we wished to know whether antibodies to the M protein or other surface components inhibit adherence and internalization of streptococci to pharyngeal cells. We investigated the role of whole human secretory immunoglobulin A (sIgA), M6 protein-specific sIgA, and M6 protein-specific serum IgG in the inhibition of streptococcal adherence and internalization to cultured human pharyngeal cells. S. pyogenes D471, which produces a type 6 M protein (M+), and its isogenic M-negative (M−) derivative JRS75 were tested. Purified whole sIgA, M protein-specific sIgA, and sIgA preabsorbed with M protein were able to decrease significantly the adherence of streptococci to pharyngeal cells. Purified IgG against the M6 protein did not diminish the attachment of streptococci to the pharyngeal cells but did reduce internalization. Thus, our data suggest that secretory IgA may play a key role in preventing streptococcal infection at mucosal surfaces by blocking adherence while affinity-purified anti-M protein-specific IgG blocks epitopes responsible for invasion.