Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of decolonization on methicillin-resistant Staphylococcus aureus transmission and infection in a neonatal intensive care unit

Abstract Background: The value of decolonization as a strategy for preventing methicillin-resistantStaphylococcus aureus (MRSA) in the neonatal intensive care unit (NICU) remains to be determined. Objective: After adding decolonization to further reduce MRSA transmission in our NICU, we conducted this retrospective review to evaluate its effectiveness. Method: The review included patients who were admitted to our NICU between April 2015 and June 2018 and were eligible for decolonization including twice daily intranasal mupirocin and daily chlorhexidine gluconate bathing over 5 consecutive days. Patients were considered successfully decolonized if 3 subsequent MRSA screenings conducted at 1-week intervals were negative. The MRSA acquisition rate (AR) was calculated as hospital-acquired (HA) MRSA per 1,000 patient days (PD) and was used to measure the effectiveness of the decolonization. Results: Of the 151 MRSA patients being reviewed, 78 (51.6%) were HA-MRSA, resulting in an overall AR of 1.27 per 1,000 PD. Between April 2015 and February 2016, when only the decolonization was added, the AR was 2.38 per 1,000 PD. Between March 2016 and June 2018 after unit added a technician dedicated to the cleaning of reusable equipment, the AR decreased significantly to 0.92 per 1,000 PD (P < .05). Of the 78 patients who were started on the decolonization, 49 (62.8%) completed the protocol, 11 (14.1%) remained colonized, and 13 (16.7%) were recolonized prior to NICU discharge. Conclusion: In a NICU with comprehensive MRSA prevention measures in place, enhancing the cleaning of reusable equipment, not decolonization, led to significant reduction of MRSA transmission.
Are socioeconomic inequalities in the incidence of small-for-gestational-age birth narrowing? Findings from a population-based cohort in the South of England

Objectives To investigate socioeconomic inequalities, using maternal educational attainment, maternal and partner employment status, and lone motherhood indicators, in the risk of small-for-gestational-age (SGA) births, their time trend, potential mediation by maternal smoking and body mass index, and effect modification by parity. Design Population-based birth cohort using routine antenatal healthcare data. Setting Babies born at University Hospital Southampton, UK, between 2004 and 2016. Participants 65 909 singleton live births born to mothers aged ≥18 years between 24-week and 42-week gestation. Main outcome measures SGA (birth weight <10th percentile for others born at the same number of completed weeks compared with 2013/2014 within England and Wales). Results Babies born to mothers educated up to secondary school level (adjusted OR (aOR) 1.32, 99% CI 1.19 to 1.47), who were unemployed (aOR 1.27, 99% CI 1.16 to 1.38) or with unemployed partners (aOR 1.27, 99% CI 1.13 to 1.43), were at greater risk of being SGA. There was no statistically significant change in the magnitude of this risk difference by these indicators over time between 2004 and 2016, as estimated by linear interactions with year of birth. Babies born to lone mothers were not at higher risk compared with partnered mothers after adjusting for maternal smoking (aOR 1.05, 99% CI 0.93 to 1.20). The inverse association between maternal educational attainment and SGA risk appeared greater in multiparous (aOR 1.40, 99% CI 1.10 to 1.77) compared with primiparous women (aOR 1.28, 99% CI 1.12 to 1.47), and the reverse was true for maternal and partner’s unemployment where the association was stronger in primiparous women. Conclusions Socioeconomic inequalities in SGA risk by educational attainment and employment status are not narrowing over time, with differences in association strength by parity. The greater SGA risk in lone mothers was potentially explained by maternal smoking. Preventive interventions should target socially disadvantaged women, including preconception and postpartum smoking cessation to reduce SGA risk.
Detergent- and phospholipid-based reconstitution systems have differential effects on constitutive activity of G-protein–coupled receptors

A hallmark of G-protein–coupled receptors (GPCRs) is the conversion of external stimuli into specific cellular responses. In this tightly-regulated process, extracellular ligand binding by GPCRs promotes specific conformational changes within the seven transmembrane helices, leading to the coupling and activation of intracellular “transducer” proteins, such as heterotrimeric G proteins. Much of our understanding of the molecular mechanisms that govern GPCR activation is derived from experiments with purified receptors reconstituted in detergent micelles. To elucidate the influence of the phospholipid bilayer on GPCR activation, here we interrogated the functional, pharmacological, and biophysical properties of a GPCR, the β2-adrenergic receptor (β2AR), in high-density lipoprotein (HDL) particles. Compared with detergent-reconstituted β2AR, the β2AR in HDL particles had greatly enhanced levels of basal (constitutive) activity and displayed increased sensitivity to agonist activation, as assessed by activation of heterotrimeric G protein and allosteric coupling between the ligand-binding and transducer-binding pockets. Using 19F NMR spectroscopy, we directly linked these functional differences in detergent- and HDL-reconstituted β2AR to a change in the equilibrium between inactive and active receptor states. The contrast between the low levels of β2AR constitutive activity in cells and the high constitutive activity observed in an isolated phospholipid bilayer indicates that β2AR basal activity depends on the reconstitution system and further suggests that various cellular mechanisms suppress β2AR basal activity physiologically. Our findings provide critical additional insights into GPCR activation and reveal how dramatically reconstitution systems can impact membrane protein function.
Association With Hospitalization and All-Cause Discontinuation Among Patients With Schizophrenia on Clozapine vs Other Oral Second-Generation Antipsychotics: A Systematic Review and Meta-analysis of Cohort Studies.

Importance Recent meta-analyses of randomized clinical trials (RCTs) comparing clozapine with nonclozapine second-generation antipsychotics (NC-SGAs) in schizophrenia have challenged clozapine's superiority in treatment-resistant patients. However, patients in RCTs are not necessarily generalizable to those in clinical practice. Objective To conduct a systematic review and meta-analysis to compare various outcomes of clozapine vs oral NC-SGAs in cohort studies. Data Sources Systematic literature search in PubMed, PsycINFO, and CINAHL without language restriction from database inception until December 17, 2018. Study Selection Nonrandomized cohort studies reporting effectiveness and/or safety outcomes comparing clozapine with NC-SGAs in schizophrenia or schizoaffective disorder. Data Extraction and Synthesis Independent investigators assessed studies and extracted data. Using a random-effects model, the study calculated risk ratio (RR) unadjusted for covariates and follow-up duration, number needed to treat/number needed to harm (NNT/NNH) for dichotomous data, and standardized mean difference (SMD) or mean difference (MD) for continuous data. Main Outcomes and Measures Coprimary outcomes were hospitalization and all-cause discontinuation. Secondary outcomes included all effectiveness and safety outcomes reported in at least 3 analyzable studies. Results Of 8446 hits, 68 articles from 63 individual cohort studies (n = 109 341) (60.3% male; mean [SD] age of 38.8 [6.5] years, illness duration of 11.0 [5.1] years, and study duration of 19.1 [23.3] months) were meta-analyzed. Compared with NC-SGAs, despite greater illness severity (17 studies [n = 38 766]; Hedges g, 0.222; 95% CI, 0.013-0.430; P = .04), clozapine was significantly associated with lower hospitalization risk (19 studies [n = 49 453]; RR, 0.817; 95% CI, 0.725-0.920; P = .001; NNT, 18; 95% CI, 12-40) and all-cause discontinuation (16 studies [n = 56 368]; RR, 0.732; 95% CI, 0.639-0.838; P < .001; NNT, 8; 95% CI, 6-12). Associations were statistically significant for comparisons with quetiapine fumarate and aripiprazole regarding hospitalization and all NC-SGAs, except aripiprazole, for all-cause discontinuation. Clozapine was also significantly associated with better outcomes regarding overall symptoms (SMD, -0.302; 95% CI, -0.572 to -0.032; P = .03) and Clinical Global Impressions scale severity (SMD, -1.182; 95% CI, -2.243 to -0.122; P = .03). Clozapine was significantly associated with increases in body weight (MD, 1.70; 95% CI, 0.31-3.08 kg; P = .02), body mass index (MD, 0.96; 95% CI, 0.24-1.68; P = .009), and type 2 diabetes (RR, 1.777; 95% CI, 1.229-2.570; P = .002; NNH, 27; 95% CI, 13-90). Conclusions and Relevance In cohort studies, despite more severely ill patients being treated with clozapine, use of clozapine was associated with better key efficacy outcomes and higher cardiometabolic-related risk outcomes vs NC-SGAs.
Expression of HERV Genes as Possible Biomarker and Target in Neurodegenerative Diseases

Human endogenous retroviruses (HERVs) are genetic parasites, in-between genetics and environment. Few HERVs retain some coding capability. Sometimes, the host has the advantage of some HERV genes; conversely, HERVs may contribute to pathogenesis. The expression of HERVs depends on several factors, and is regulated epigenetically by stimuli such as inflammation, viral and microbial infections, etc. Increased expression of HERVs occurs in physiological and pathological conditions, in one or more body sites. Several diseases have been attributed to one or more HERVs, particularly neurological diseases. The key problem is to differentiate the expression of a HERV as cause or effect of a disease. To be used as a biomarker, a correlation between the expression of a certain HERV and the disease onset and/or behavior must be found. The greater challenge is to establish a pathogenic role. The criteria defining causal connections between HERVs and diseases include the development of animal models, and disease modulation in humans, by anti-HERV therapeutic antibody. So far, statistically significant correlations between HERVs and diseases have been achieved for HERV-W and multiple sclerosis; disease reproduction in transgenic animals was achieved for HERV-W and multiple sclerosis, and for HERV-K and amyotrophic lateral sclerosis. Clinical trials for both diseases are in progress.
Peroxisome proliferator–activated receptor α mediates the adaptive response to fasting

Prolonged deprivation of food induces dramatic changes in mammalian metabolism, including the release of large amounts of fatty acids from the adipose tissue, followed by their oxidation in the liver. The nuclear receptor known as peroxisome proliferator-activated receptor alpha (PPARalpha) was found to play a role in regulating mitochondrial and peroxisomal fatty acid oxidation, suggesting that PPARalpha may be involved in the transcriptional response to fasting. To investigate this possibility, PPARalpha-null mice were subjected to a high fat diet or to fasting, and their responses were compared with those of wild-type mice. PPARalpha-null mice chronically fed a high fat diet showed a massive accumulation of lipid in their livers. A similar phenotype was noted in PPARalpha-null mice fasted for 24 hours, who also displayed severe hypoglycemia, hypoketonemia, hypothermia, and elevated plasma free fatty acid levels, indicating a dramatic inhibition of fatty acid uptake and oxidation. It is shown that to accommodate the increased requirement for hepatic fatty acid oxidation, PPARalpha mRNA is induced during fasting in wild-type mice. The data indicate that PPARalpha plays a pivotal role in the management of energy stores during fasting. By modulating gene expression, PPARalpha stimulates hepatic fatty acid oxidation to supply substrates that can be metabolized by other tissues.
Association between left ventricular diastolic function and right ventricular function and morphology in asymptomatic aortic stenosis

Background Aortic stenosis (AS) is a progressive disease in which left ventricular (LV) diastolic dysfunction is common. However, the association between diastolic dysfunction and right ventricular (RV) loading conditions and function has not been investigated in asymptomatic AS patients. Methods and findings A total of 41 patients underwent right heart catheterization and simultaneous echocardiography at rest and during maximal supine exercise, stratified according to resting diastolic function. Cardiac chamber size and morphology was assessed using cardiac magnetic resonance imaging (cMRI). RV stroke work index, pulmonary artery (PA) compliance, PA elastance, PA pulsatility index, and right atrial pressure (RAP) were calculated at rest and maximal exercise. Ten patients (24%) had normal LV filling pattern, 20 patients (49%) had grade 1, and 11 patients (27%) had grade 2 diastolic dysfunction. Compared to patients with normal diastolic filling pattern, patients with diastolic dysfunction had lower RV end-diastolic volume (66 ± 11 ml/m2 vs. 79 ± 15 ml/m2, p = 0.02) and end-systolic volume (25 ± 7 ml/m2 vs. 32 ± 9 ml/m2, p = 0.04). An increase in mean RAP to ≥15 mmHg following exercise was not seen in patients with normal LV filling, compared to 4 patients (20%) with mild and 7 patients (63%) with moderate diastolic dysfunction (p = 0.003). PA pressure and PA elastance was increased in grade 2 diastolic dysfunction and correlated with RV volume and maximal oxygen consumption (r = -0.71, p < 0.001). Conclusions Moderate diastolic dysfunction is associated with increased RV afterload (elastance), which is compensated at rest, but is associated with increased RAP and inversely related to maximal oxygen consumption during maximal exercise.
Reading Development in Adolescent First and Second Language English Learners: A Comparison Using Age Match Design

Fourteen Iranian-Canadian bilingual students were tested for language ability as well as cognitive and phonological processing skills in two languages: Farsi and English. They were compared to 30 Iranian monolingual chronological age matched students and 30 Canadian chronological age matched peers. Since there were not any standardized tests in Farsi, one of the aims of this study was to begin creating the language ability measures in Farsi, and to test their reliabilities. In general, from six developed and translated Farsi tasks, three of them were found to be reliable. It was found that bilingual students perform better on memory tasks, compared to two other monolingual groups. There were not any group differences on English measures of reading comprehension and word reading among Iranian bilingual students and their English age matched peers. Additionally, the results of this study showed that Iranian bilinguals performed better on the measure of receptive vocabulary, knowing more English words in comparison to Canadian monolinguals. This finding could be explained by the higher socio-economic status and greater number of English books that Iranian bilinguals have. The final key finding is that Iranian bilinguals perform more poorly on Farsi tasks, and better on English measures compared to Iranian monolinguals.
Localization of Transient Events Threatening Pipeline Integrity by Fiber-Optic Distributed Acoustic Sensing

Pipe integrity is a central concern regarding technical safety, availability, and environmental compliance of industrial plants and pipelines. A condition monitoring system that detects and localizes threats in pipes prior to occurrence of actual structural failure, e.g., leakages, especially needs to target transient events such as impacts on the pipe wall or pressure waves travelling through the medium. In the present work, it is shown that fiber-optic distributed acoustic sensing (DAS) in conjunction with a suitable application geometry of the optical fiber sensor allows to track propagating acoustic waves in the pipeline wall on a fast time-scale. Therefore, short impacts on the pipe may be localized with high fidelity. Moreover, different acoustic modes are identified, and their respective group velocities are in good agreement with theoretical predications. In another set of experiments modeling realistic damage scenarios, we demonstrate that pressure waves following explosions of different gas mixtures in pipes can be observed. Velocities are verified by local piezoelectric pressure transducers. Due to the fully distributed nature of the fiber-optic sensing system, it is possible to record accelerated motions in detail. Therefore, in addition to detection and localization of threatening events for infrastructure monitoring, DAS may provide a powerful tool to study the development of gas explosions in pipes, e.g., investigation of deflagration-to-detonation-transitions (DDT).
Arabic Compliment Responses: A transfer of Strategies?

             نـم ةيبرعلاب نيقطانلا ناك اذا ام نع فشكلا ىلا ةساردلا هذه فدهت ىـلع درـلا يـف ةمدختسملا ةيديلقتلا ةيبرعلا مهتايجيتارتس نولقني برعلا ءاـنثلاب ةـيكيرملاا ةـيزيلكنلاا يه ملاا هتغل صخش موقي امدنع ءارطلاا مهيلع . رابتعلاارظنب نيسنجلا نيب تاقورفلا ذخا مت . تانايبلا تعمج نـع فـلتخم نـم برع نيكرتشمل تيطعا يتلاو تانايبتسلاا مادختسا قيرط اهلقا ةدم نم ةيكيرملاا ةدحتملا تايلاولا يف نوشيعي نيذلاو ةيبرعلا لودلا نيرهش . مومعلا ىلع ، ةـيبرعلا مهتايجيتارتـسل لاـقن نيكرتشملا رهظي مل لادـب ةيديلقتلا ةيكيرملاا ءارطلاا دودر مادختساب اوماق امناو اـهنع . مـت ةيوغل رظن ةهجو نم جئاتنلا ليلحتو ةشقانم تاـفاقثلا ةفلتخم ةيعامتجا تافاقثلا فلاتخا راثا زاربا يف رثا نم جئاتنلا هذهلام رابتعلاا رظنب ذخاو ةيوبرتلا اهتانومضمو . Arabic Compliment Responses: A transfer of Strategies?
Systematic Review and Bayesian Network Meta-Analysis Comparing Laparoscopic Heller Myotomy, Pneumatic Dilatation, and Peroral Endoscopic Myotomy for Esophageal Achalasia.

Background: Laparoscopic Heller myotomy (LHM), pneumatic dilatation (PD), and peroral endoscopic myotomy (POEM) are common treatments for esophageal achalasia. Literature evidence is restricted to pairwise analysis and PD versus POEM comparison is missing. The aim of this network meta-analysis (NMA) was to comprehensively compare outcomes within these three surgical approaches with those of esophageal achalasia. Materials and Methods: PubMed, EMBASE, and Web of Science databases were consulted. A systematic review and a fully Bayesian study level arm-based random effect NMA were performed. Results: Nineteen studies (14 observational and 5 randomized controlled trial) and 4407 patients were included. Overall, 50.4% underwent LHM, 42.8% PD, and 6.8% POEM. The postoperative dysphagia remission was statistically significantly improved in POEM compared with LHM and PD (risk ratio [RR] = 1.21; 95% credible intervals [CIs] = 1.04-1.47 and RR = 1.40; 95% CIs = 1.14-1.79, respectively). Postoperative gastroesophageal reflux disease (GERD) rate was higher in POEM than in LHM and PD (RR = 1.75; 95% CIs = 1.35-2.03 and RR = 1.36; 95% CIs = 1.18-1.68, respectively). Postoperative Eckardt score was significantly lower in POEM than in LHM and PD (standardized mean difference (smd) = -0.6; 95% CIs = -1.4 to -0.2 and smd = -1.2; 95% CIs = -2.3 to -0.2, respectively). No statistically significant differences were found comparing LHM and PD in any of the analyzed outcomes. Conclusions: In the short-term follow-up, POEM seems to be associated with better dysphagia improvement and higher postoperative GERD than LHM and PD. The choice of the ideal initial management should be left to multidisciplinary team discussion and personalized on each patient basis.
Successful treatment of systemic lupus erythematosus pleuropericarditis with belimumab: A case report and literature review.

Systemic lupus erythematosus (SLE) is characterized by a wide variety of manifestations and a difficult disease control in some patients. We present the case of a 51-year-old woman who presented with a flare of SLE including arthritis and pleuropericarditis that responded to neither leflunomide, methotrexate, nor high doses of prednisone. After initiating treatment with belimumab, the patient experienced a quick and notorious improvement. She remains stable to this day while continuing belimumab therapy.
Compensatory changes in degenerating spinal motoneurons sustain functional sparing in the SOD1‐G93A mouse model of amyotrophic lateral sclerosis

Plastic changes have been reported in the SOD1‐G93A mouse model of amyotrophic lateral sclerosis, a disorder characterized by progressive motoneuronal loss; however, whether these changes related with the onset and development of motor impairments is still unclear. Here, the functional and anatomical changes taking place in SOD1‐G93A mice and their time course were investigated during ongoing motoneuronal degeneration. Starting from about 4 postnatal weeks, SOD1‐G93A and wild‐type (WT) mice were evaluated in the rotarod test, to be sacrificed at about 12–13 or 19 weeks of age, and their lumbar spinal cords were processed for histo‐ and immunohistochemistry. Compared to age‐matched WT controls, 12 weeks‐old SOD1‐G93A mice exhibited relatively mild or no motor impairments in the rotarod test, in spite of a dramatic (≈60%, as estimated by stereology) loss of choline acetyl‐transferase (ChAT)‐immunoreactive motoneurons which remained virtually unchanged in SOD1‐G93A mice surviving up to 19 weeks. Notably, the functional sparing in SOD1‐G93A mice at 12 weeks was paralleled by a marked ≈50% increase in motoneuron volume and a near‐normal density of acetylcholinesterase‐positive process arborization, which was significantly increased when analyzed as ratio to the decreased number of ChAT‐positive motoneurons. By contrast, at 19 weeks, when motor deficits had become dramatically evident, both measures were found reverted to about 50–60% of control values. Thus, at specific stages during the progression of the disease, robust compensatory events take place in surviving motoneurons of SOD1‐G93A mice, which sustain motor performance, and whose full understanding may highlight a valuable therapeutic opportunity window.