Miracle-dz/UniFAR-FTUs huggingface dataset:
Detection of Antimicrobial Resistance Genes Associated with Carbapenem Resistance from the Whole-Genome Sequence of Acinetobacter baumannii Isolates from Malaysia

Background The spread of carbapenem-resistant A. baumannii (CrAb) is gaining worldwide attention. The spread of this pathogen is largely due to its ability to acquire various resistance genes of intrinsic and extrinsic origins that confer unpredictable susceptibility to β-lactams. The aim of this study was to analyze β-lactamase genetic compositions of CrAb in Malaysia. Methods Whole-genome sequencing (WGS) was carried out on 13 CrAb isolates from clinical samples in Malaysia from 2011 to 2016. Results Endotracheal aspirate was the dominant clinical sample source (n = 6), and only one isolate was obtained from wound swab. A total of 6 sequence types (STs) of the Oxford scheme were identified, including 4 reported STs and 2 novel STs. Eleven isolates were classified into clonal complex 92 (CC92/ICII), among which ST195 and ST208 were the most prevalent STs. All 13 CrAb isolates harbored multiple β-lactamase genes. blaOXA-23 (n = 13) and blaOXA-66 (n = 11) were the dominant carbapenemase gene families found in these isolates. All isolates harbor blaADC, blaOXA-51-like, and blaOXA-23-like genes. blaTEM (n = 7), blaNDM-1 (n = 3), blaCARB-8 (n = 1), and blaPER-3 (n = 1) are amongst other β-lactamase genes found in this study. ISAba1 was found upstream to blaOXA-23 (n = 13), blaOXA-66 (n = 1), and blaADC (n = 11). All blaNDM-1 isolates had ISAba125 (mobile genetic element) upstream to the genes. All isolates were positive for Tn2006/2008 and Tn2009 but were negative for Tn2007. Conclusion Most of the isolates were grouped under the CC92 clonal complex which belongs to international clonal lineage 2. These findings predict that carriage of carbapenem-resistant genes possibly constitutes the underlying basis of high level of international clone II prevalence. Therefore, molecular surveillance and antimicrobial stewardship are essential in implementing policies to prevent and control the spread of CrAb in hospital settings.
Functional analyses of small secreted cysteine‐rich proteins identified candidate effectors in Verticillium dahliae

Abstract Secreted small cysteine‐rich proteins (SCPs) play a critical role in modulating host immunity in plant–pathogen interactions. Bioinformatic analyses showed that the fungal pathogen Verticillium dahliae encodes more than 100 VdSCPs, but their roles in host–pathogen interactions have not been fully characterized. Transient expression of 123 VdSCP‐encoding genes in Nicotiana benthamiana identified three candidate genes involved in host–pathogen interactions. The expression of these three proteins, VdSCP27, VdSCP113, and VdSCP126, in N. benthamiana resulted in cell death accompanied by a reactive oxygen species burst, callose deposition, and induction of defence genes. The three VdSCPs mainly localized to the periphery of the cell. BAK1 and SOBIR1 (associated with receptor‐like protein) were required for the immunity triggered by these three VdSCPs in N. benthamiana. Site‐directed mutagenesis showed that cysteine residues that form disulphide bonds are essential for the functioning of VdSCP126, but not VdSCP27 and VdSCP113. VdSCP27, VdSCP113, and VdSCP126 individually are not essential for V. dahliae infection of N. benthamiana and Gossypium hirsutum, although there was a significant reduction of virulence on N. benthamiana and G. hirsutum when inoculated with the VdSCP27/VdSCP126 double deletion strain. These results illustrate that the SCPs play a critical role in the V. dahliae–plant interaction via an intrinsic virulence function and suppress immunity following infection.
The Prevalence of Self-reported Respiratory Symptoms, Asthma and use of Asthma Medication Among Young Adolescents from Southeast Kosovo

Introduction: Asthma is a chronic inflammatory airway disease characterized by episodes of airway narrowing leading to manifestations of symptoms such as wheeze, shortness of breath, chest tightness and cough, that may resolve spontaneously or following treatment. Aim: The aim of this paper was to present the collected data related to the prevalence of self-reported respiratory symptoms, asthma, and use of asthma medication among school children aged 13-14 years from the city of Gjilan, a municipality located in southeast Kosovo. Methods: This was a cross-sectional study realized during the year 2018 as a part of the Project of Global Asthma Network (GAN) Phase I. The study elaborated randomly selected sample of 1200 school children from the city of Gjilan, in the southeast of Kosovo. The mean age was 13.4±0.51 with median IQR=13 (13-14). About 618 (51.5%) were male and 582 (48.5%) were female with the relation between the genders of 1:1.1. The percentage difference between the genders was not statistically significant (Difference test: Difference 3% [(-0.99-6.99) CI 95%]; Chi-square=2.159; df=1 p=0.1417). The prevalence of wheezing/ whistling in the chest EVER and the last 12 months was 12.7% vs. 6.4% respectively with no significant association between gender and symptoms (p>0.05) (Table 1). About 1132 (94.3%) had no attacks of wheezing in the last 12 MONTHS, 59 (4.9%) had 1-3 attacks, 7 (0.6%) had 4-12 attacks and 2 (0.2%) had>12 attacks. The analysis did not indicate a significant association between gender and the frequency of wheezing attacks (none / 1-3 / ≥ 4) for Pearson Chi-square: 2.5501; df=2; p=0.2801. Conclusion: This study has found moderately low asthma prevalence among adolescents in the southeast region of Kosovo, with no significant association between genders. Although, should be considered as an urgent need the proper examination, because asthma seems to be under-diagnosed and also untreated. It’s possible that doctors in our country hesitate to diagnose asthma or the parents themselves and the children deny it.
Is the quality of life different in single and remarried elderly?

BACKGROUND: Due to increasing number of the world population, elderly individual's quality of life (QOL) is a matter of concern and marital status as one of the objective measures of QOL is of paramount importance. This study was done to compare the QOL between single and remarried elderly. MATERIALS AND METHODS: This case–control study was conducted on 200 elderly people in Qaen (Southern Khorasan province), Iran. The research sample consisted of two groups of single and remarried elderly, 100 in each group. A demographic and LEIPAD (an acronym deriving from the name of Leiden and Padua universities) QOL questionnaires were completed by the participants via interview. RESULTS: There was a significant difference between single and remarried elderly groups in the QOL (P < 0.001). Linear regression showed that marital status (P < 0.000), economic situation (P < 001), primary education (P < 0.0002), and diploma (P < 0.030) opposed to the illiterate were significantly related to the QOL. In other words, being married and higher economic situation and education increase the QOL. There was a significant negative correlation between the age (P < 0.000) and QOL. The strongest factor was age. CONCLUSIONS: Marital status, income, and education play an important role in all aspects of QOL in older adults. Thus, being married can be a protective factor against physical, psychological, and social problems in old age. Realizing this issue in consultation process of elderly peoples is recommended.
SARS-CoV-2 (COVID-19) and intravascular volume management strategies in the critically ill

Abstract The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread across the globe, and millions of people may be affected. While knowledge regarding epidemiologic features and diagnostic tools of coronavirus disease 2019 (COVID-19) is rapidly evolving, uncertainties surrounding various aspects of its optimal management strategies persist. A subset of these patients develop a more severe form of the disease characterized by expanding pulmonary lesions, sepsis, acute respiratory distress syndrome, and respiratory failure. Due to lack of data on treatment strategies specific to this subset of patients, currently available evidence on management of the critically ill needs to be extrapolated and customized to their clinical needs. The article calls attention to fluid stewardship in the critically ill with COVID-19 by judiciously applying the evidence-based resuscitation principles to their specific clinical features such as high rates of cardiac injury. As we await more data from treating these patients, this strategy is likely to help reduce potential complications.
Long-Term Use of Ruxolitinib in an AML Patient with Posttransplant Steroid Refractory GVHD

Ruxolitinib has become a new therapeutic option for steroid refractory graft-versus-host disease (srGVHD), with a substantial remission rate. Its anti-inflammatory properties by blocking interleukin pathways have made it a novel therapeutic approach to inflammatory disease processes, such as GVHD. The long-term use of ruxolitinib has not been explicitly studied outside the context in the treatment of multiple myeloma. With current clinical trials underway for the use of ruxolitinib in srGVHD, there are still no current guidelines or protocols for long-term clinical use. Of the available literature showing ruxolitinib utilization for srGVHD, most cases lead to resolution and eventual discontinuation. We present a case of a 32-year-old male on ruxolitinib with GVHD status postmatched unrelated donor stem cell transplant (MUD SCT) for acute myeloid leukemia (AML) with FLT3 mutation currently on ruxolitinib for 5 years who is not able to tolerate reduction in dosage due to flare-ups. We discuss the clinical implications and nuance of therapy with ruxolitinib with unknown long-term effects and weigh the risks and benefits.
Optimization of food deprivation and sucrose preference test in SD rat model undergoing chronic unpredictable mild stress

The chronic unpredictable mild stress (CUMS) model has long been considered the best model for exploring the pathophysiological mechanisms underlying depression. However, there are no widely recognised standards for strategies for modeling and for behavioral testing. The present study aimed to optimize the protocols for food deprivation and the sucrose preference test (SPT) for the CUMS model.
Pre‐empting the challenges faced in adolescence: A systematic literature review of effects of psychosocial interventions for preteens with type 1 diabetes

Numerous psychosocial interventions have been conducted in children and adolescents with type 1 diabetes, aiming to improve their self‐management and autonomy acquisition. However, these tend to address family conflict and parental perspectives, and a scarce number of interventions explore the outcomes among preteens. This review examined the outcomes of psychosocial interventions for preteens with type 1 diabetes, as an under‐researched field to date.
Fluid Management Practices After Surgery for Congenital Heart Disease: A Worldwide Survey*

Objectives: To determine common practice for fluid management after cardiac surgery for congenital heart disease among pediatric cardiac intensivists. Design: A survey consisting of 17 questions about fluid management practices after pediatric cardiac surgery. Distribution was done by email, social media, World Federation of Pediatric Intensive and Critical Care Societies website, and World Federation of Pediatric Intensive and Critical Care Societies newsletter using the electronic survey distribution and collection system Research Electronic Data Capture. Setting: PICUs around the world. Subjects: Pediatric intensivists managing children after surgery for congenital heart disease. Interventions: None. Measurements and Main Results: One-hundred eight responses from 18 countries and six continents were received. The most common prescribed fluids for IV maintenance are isotonic solutions, mainly NaCl 0.9% (42%); followed by hypotonic fluids (33%) and balanced crystalloids solutions (14%). The majority of the respondents limit total fluid intake to 50% during the first 24 hours after cardiac surgery. The most frequently used fluid as first choice for resuscitation is NaCl 0.9% (44%), the second most frequent choice are colloids (27%). Furthermore, 64% of respondents switch to a second fluid for ongoing resuscitation, 76% of these choose a colloid. Albumin 5% is the most commonly used colloid (61%). Almost all respondents (96%) agree there is a need for research on this topic. Conclusions: Our survey demonstrates great variation in fluid management practices, not only for maintenance fluids but also for volume resuscitation. Despite the lack of evidence, colloids are frequently administered. The results highlight the need for further research and evidence-based guidelines on this topic.
Interventionalist Perspective on the New Endovascular Trials

Three recently published trials have conclusively proven the benefit of mechanical endovascular thrombectomy over best medical therapy for patients with acute ischemic stroke and large vessel occlusion. These trials shared some features and differed in others. These similarities and differences in trial design and execution affect the conclusions and recommendations that can be made from the data. We will examine the implications of these studies for neurointerventionists, both for current practice and for future studies. In particular, we will focus on procedural details such as patient selection, devices, adjunctive therapies, treatment time windows, and performance metrics.
Information and decision-making preferences of men with prostate cancer.

PURPOSE/OBJECTIVES To determine whether a relationship exists between preferences for involvement in decision making and type of information in patients with cancer. DESIGN Survey, correlational. SETTING Community urology clinic in Winnipeg, Manitoba, Canada. SAMPLE Convenience sample of 57 men (mean age of 71 years). METHODS Subjects completed a card sort to elicit their preferred role in treatment decision making. A two-part questionnaire measured the type and amount of information preferred. FINDINGS The majority (57.9%) of men preferred a passive decision-making role. Information on disease advancement, likelihood of cure, and types of treatment available were the three preferred categories of information. Men in the collaborative group and those who wanted their physician to make treatment decisions-only after seriously considering their opinions-also wanted significantly more information in these three categories. Married men ranked self-care information as significantly less important than did single men. Information preferences were similar regardless of preferred decision-making role. CONCLUSIONS Although the majority of men in this sample wanted their physician to make final treatment decisions, they did want to be informed. Information preferences were similar to other groups of patients with cancer. Future clinical studies are required to determine if providing these men with more information will enable them to assume a more active decision-making role. IMPLICATIONS FOR NURSING PRACTICE Given the small variance in decision-making and information preferences accounted for by sociodemographic and treatment/disease-related factors, individual assessment of these preferences remains the best clinical approach.
Retrospective analysis of clinical and surgical results of 123 patients prediagnosed with acute appendicitis

Introduction: Acute appendicitis is a disease requiring urgent surgical intervention. It is frequently encountered in general surgical clinics. Maintaining a good medical record and physical examination are the first priorities in diagnosing appendicitis. This study aimed to evaluate the clinical and surgical results of patients prediagnosed with acute appendicitis in a Erzurum Oltu State Hospital. Materials and Methods: The records of the 123 patients [49 (39.8%) female and 74 (60.2%) male], who were diagnosed with acute appendicitis in the hospital between 2015 and 2017, were retrospectively analyzed in terms of age, gender, Alvarado score, and laboratory and radiology findings. Furthermore, surgical methods were examined with regard to the duration of surgery, hospitalization, and complications. Results: A total of 32 (26%) patients were scanned with ultrasonography (US), 91 (74%) with computed tomography (CT), and 12 (9.7%) with both US and CT. Laparoscopic appendectomy (LA) was performed in 66 (53.6%) patients, and open appendectomy (OA) in 57 patients (46.4%). Further, 71 (57.8%) of the 120 patients with intraoperatively diagnosed appendicitis had suppurative, 38 (30.9%) had catarrhal, 8 (6.5%) had perforated, 3 (2.4%) had gangrenous appendicitis. The histopathological and intraoperatively diagnosis of the remaining 3 (2.4%) patients was normal. Three (2.4%) of the patients who underwent OA developed ileus, and one (0.8%) patient had wound infections. One (0.8%) patient who underwent LA developed ileus. Conclusion: The effective use of laboratory, scoring, and assisted imaging methods can reduce the rates of negative appendectomy and postoperative complications. Laparoscopic surgery has a positive effect on postoperative pain and quality of life. If laparoscopic equipment and experience with the method are sufficient, the first choice should be laparoscopic surgery for acute appendicitis.
A comparative study of serum C-reactive protein in patients with Generalised Anxiety Disorder and Depression

Background: There is yet limited research and dearth of study on immune dysregulation and Generalised Anxiety Disorders (GAD) & Depression in India till date. Very few studies have investigated the relationship between GAD, Depression and inflammatory biomarkers, in particular C-reactive protein (CRP). Aims and Objectives: This study aimed to assess and compare serum C-reactive protein (CRP) level in Generalized Anxiety Disorder (GAD), Depression & Control group. Study Design: This was a prospective, comparative hospital based cross sectional study. Setting: The study was conducted only on the indoor patients admitted in the Department of Psychiatry, Assam Medical College and Hospital, Dibrugarh. Materials and Methods: 50 GAD and 50 Depression patients diagnosed as per ICD-10 in the age group 18-65 years admitted in the Department of Psychiatry, AMCH were included for the study. A control group of 50 individuals was selected from age & sex matched people from normal healthy population. C-reactive protein level was estimated in all respondents by particle enhanced turbidimetric immunoassay (PETIA) technique. Statistics: Statistical analyses were done using Analysis of Variance (ANOVA), Chi square test and Fischer’s exact test (where the cell count was <5). P value <0.05 was taken as significant. Results: Mean serum CRP level of GAD and Depression patients were higher than Control group and it was also noted that mean serum CRP level of Depression patients were significantly elevated than GAD patients. Conclusions: Our study findings are consistent with the role of inflammation in GAD and Depression. So, future study in this aspect with a larger sample and follow up is needed to explore the existence of a possible “psychoneuroimmune link” between GAD, Depression and inflammatory markers.
Successful maternal-foetal outcome using nitric oxide and sildenafil in pulmonary hypertension with atrial septal defect and HIV infection.

In this review, we examine the trends in cancer incidence, mortality and survival in the last decade, using published data from the Singapore Cancer Registry in the period 1998 to 2009. While overall cancer incidences have remained stable, overall cancer mortality rates have declined for both genders. Thus, it is not surprising that there was an improvement in cancer survival. A steady decrease in lung cancer among males and females was observed, thereby leading to a drop in its cancer ranking. In the last five years, the most frequently occurring cancer was colorectal cancer among the male population and breast cancer among females. Survival for both cancers remained relatively optimistic. There is good reason to pay special attention to colorectal cancer due to its high frequency of occurrence among the Singapore population and because it is amenable to early detection via screening.
Adrenoceptors on blood cells: methodological aspects and reactivity studies in hypertensive patients

(-)I-Iodocyanopindolol (ICYP) binding to intact and ultrasonically treated human mononuclear cells (MNC) was studied. Specific binding of ICYP defined as the difference in binding in the presence and absence of 2 μΜ ( ± )-propranolol displayed in intact cells a dissociation constant (Kd) of 11.8±2.7pM and a ^-adrenoceptor number (Rt) of 2371 ±154 sites/cell. This specific binding, however, still had a complex character. In broken cells a homogeneous class of binding sites with a Kd-value of 6.7+1.0 pM and a Rt-value of 883 + 89 sites/cell was found. When in intact cells nonspecific binding was determined with CGP-12177, a hydrophilic ^-adrenoceptor antagonist, a homogeneous class of binding sites was found with a Kd of 7.0 ± 0.3 pM and a Rt of 1645 + 95 sites/cell. Inhibition curves with ( + )-, ( — )-, ( + )-propranolol, timolol and CGP-12177, obtained with ultrasonically treated cells were monophasic. In intact cells propranolol and timolol not only displaced ICYP from its specific sites, but in an almost monophasic way also from nonspecific binding sites. CGP-12177, however, showed a clear plateau. It is concluded that in broken MNC a loss of binding sites may occur, whereas in intact cells additional binding interferes with the correct determination of specific ICYP binding. The latter can be reduced to a minimum by using hydrophylic ligands such as CGP-12177 to measure nonspecific binding.
Psychological Well-Being 3 Years After Severe Stroke

Background and Purpose—Stroke often has a very negative influence on the victims’ perception of their life situation. The aim of this study was therefore to assess the subjects’ long-term psychological well-being and to explore associations between subject characteristics, impairments, disabilities, and psychological well-being. Methods—Of 100 subjects rehabilitated at a specialized geriatric stroke ward after the acute phase, 47 survivors were assessed in their homes 3 years after discharge and interviewed regarding their psychological well-being with the Philadelphia Geriatric Center Morale Scale (PGCMS). Results—Sixty-four percent of the subjects were classified as having high scores for psychological well-being or fell within the middle range. In a cluster analysis, depression was shown to have the strongest association with the subjects’ PGCMS scores. Variables including the subjects’ social situation and functions as well as age, gender, ability to communicate, and need for help showed a much weaker.
The Oral Health Status and Attitudes of Saudi Adolescent Male Students in Albaha Province: A Cross-Sectional Study

There is a burgeoning amount of global literature on the impact of poor oral health status on quality of life, particularly that pertaining to adolescents. For example, tooth decay affects the willingness of children to speak, smile and eat [1]. Likewise, the adverse effects of periodontal disease on the quality of life of individuals have been observed to be substantial [2]. Thus, an exploration and evaluation of the oral health status of any community is warranted to inform the establishment and implementation of suitable oral health interventions to reduce these negative effects.