Miracle-dz/UniFAR-FTUs huggingface dataset:
Daily fosfomycin versus levofloxacin for complicated urinary tract infections

ABSTRACT Fosfomycin, approved in the United States only for cystitis, is an attractive alternative for oral treatment of outpatient complicated urinary tract infections (cUTIs) as it has antimicrobial activity against most common uropathogens. The study was a multicenter, randomized, open-label pragmatic superiority clinical trial evaluating the efficacy of oral fosfomycin versus oral levofloxacin strategies in cUTIs (FOCUS study). The trial compared two strategies for initial or step-down oral therapy of cUTI without bacteremia after 0–48 hours of parenteral antibiotic therapy. Subjects were assigned to 3 g of fosfomycin or 750 mg (or dose adjusted for kidney function) of levofloxacin daily for 5–7 days. Clinical and microbiological cures were assessed at the end of therapy (EOT) and test of cure (TOC) (approximately 21 days from the start of antibiotics). The trial did not meet accrual goals; thus, the results were descriptive. Only 51 subjects were included in the microbiological intention-to-treat population. The subjects were mainly females (76%), with a mean age of 46.7 years (standard deviation [SD] = 20.8) and acute pyelonephritis (88%). At the end of therapy, clinical cure remained similar (69% and 68% for fosfomycin and levofloxacin strategies, respectively), and microbiological success was 100% for both strategies. At the test of cure, clinical cure was similar (84% and 86% in the fosfomycin and levofloxacin strategies, respectively); however, a numerically lower microbiological success was observed for fosfomycin (69% compared to 84% for levofloxacin). These limited data suggest that fosfomycin could be an oral alternative as a step-down therapy for the treatment of cUTIs (registry number NCT 03697993). IMPORTANCE Concerns over resistance and safety have been identified in the current treatment regimen for complicated urinary tract infections. Fosfomycin is a drug that is routinely used for the treatment of uncomplicated cystitis. This study shows that fosfomycin could be an oral alternative as step-down therapy for the treatment of complicated urinary tract infections, with a clinical cure rate comparable to levofloxacin but a lower microbiological success rate 3 weeks from start of antibiotics. Concerns over resistance and safety have been identified in the current treatment regimen for complicated urinary tract infections. Fosfomycin is a drug that is routinely used for the treatment of uncomplicated cystitis. This study shows that fosfomycin could be an oral alternative as step-down therapy for the treatment of complicated urinary tract infections, with a clinical cure rate comparable to levofloxacin but a lower microbiological success rate 3 weeks from start of antibiotics.
Effect of sex on muscle–tendon imbalances and tendon micromorphology in adolescent athletes—A longitudinal consideration

Imbalances between muscle strength and tendon stiffness may cause high‐level tendon strain during maximum effort muscle contractions and lead to tendon structural impairments and an increased risk for tendinopathy in adolescent athletes. However, it remains unclear whether the development of musculotendinous imbalances is influenced by sex. At four measurement time points during a competitive season, we measured quadriceps femoris muscle strength and patellar tendon mechanical properties in 15 female (14.3 ± 0.7 years) and 13 male (16.0 ± 0.6 years) elite handball players of similar maturity using dynamometry and ultrasonography. To estimate the tendon's structural integrity, the peak spatial frequency (PSF) of proximal tendon ultrasound scans was determined. Females demonstrated significantly lower muscle strength (p < 0.001) and patellar tendon stiffness (p < 0.001) than males with no significant changes over time (p > 0.05). Tendon strain during isometric maximum voluntary contractions and PSF neither differed between sexes nor changed significantly over time (p > 0.05). We found lower fluctuations in muscle strength (p < 0.001) in females during the season but no differences in the fluctuations of tendon strain, stiffness, and PSF (p > 0.05). Descriptively, there was a similar frequency (~40%) of athletes with high‐level tendon strain (>9%) in both sexes. These findings suggest that the lower strength capacity of female athletes is paralleled by lower tendon stiffness. Thereby, muscle–tendon imbalances occur to a similar extent in both sexes leading to increased strain levels during the season, which indicates the need for specific tendon training.
Global polymorphism of Plasmodium falciparum histidine rich proteins 2/3 and impact on malaria rapid diagnostic test detection: a systematic review and meta-analysis

ABSTRACT Background This review presents an overview of field findings on sequence variation of Plasmodium falciparum histidine-rich proteins 2/3 (PfHRP2/3) for which reference types (1–24) have been identified, and its critical impact on PfHRP2-based rapid diagnostic test (RDT) detection. Research design and methods This systematic review and meta-analysis was registered with PROSPERO, CRD42022316027, and conducted as per the PRISMA guidelines, and the methodological quality of studies was assessed. Results Of the 2184 records identified, 34 studies were included mostly from Africa (47.1%) and Asia (35.3%). The reference PfHRP2 types 1, 2, 3, 6, and 7 are invariably found at proportions ≥ 80–100% in all areas with the exception of The Americas where their proportion is very low. The proteins exhibited high diversity of variants/unknown types, especially for types 1, 2, 4, and 7. Eleven major PfHRP2 epitopes were found at pooled proportion > 90%. The existing models to predict RDT detection are greatly limited by the impact of factors such as low (very low) parasitemia, RDT brand, and PfHRP3 cross-reactivity. PfHRP2 length and presence/number of a given reference repeat type/variant did not seem to impact RDT detection. Conclusions PfHRP2/3 are highly polymorphic and current findings are insufficient, conflicting and not convincing enough to conclude on the role of PfHRP2/3 sequence polymorphism in PfHRP2-based RDT detection. Graphical abstract
Better late than never—a single-center review of delayed rib fixation for symptomatic rib fractures and nonunions

BACKGROUND Surgical stabilization of rib fractures (SSRFs) has become an emerging therapy for treatment of patients with rib fractures. More commonly, it is used in the acute setting; however, delayed SSRF can be utilized for symptomatic rib fracture nonunions. Here, we describe our institution's experience with delayed SSRF, hypothesizing it is safe and resolves patient symptoms. METHODS This is a retrospective review of patients presenting to our Level I trauma center to undergo delayed SSRF for symptomatic nonunions from January 2017 to September 2022. Delayed SSRF was defined as SSRF over 2 weeks in the outpatient setting. Basic demographics were obtained. Outcomes of interest included mean pain score (preoperatively and postoperatively), intensive care unit (ICU) and hospital length of stay (LOS), and resolution of preoperative symptoms, specifically chest wall instability, with return to activities of daily living (ADLs). RESULTS Forty-four patients met inclusion criteria with a total of 156 symptomatic nonunion rib fractures that received delayed SSRF. The average age was 59.2 ± 11.9 years and median number of days from injury to SSRF was 172.5 (interquartile range, 27.5–200). The average number rib fractures plated per patient 3.5 ± 1.8. Only three patients required ICU admission postoperatively for no longer than 2 days. Median hospital LOS was 2 days (interquartile range 1–3 days). Average preoperative and postoperative pain score was 6.8 ± 1.9 and 2.02 ± 1.5, respectively (p < 0.001). Chest wall instability and preoperative symptoms resolved in 93.2% of patients postoperatively (p < 0.001). Two patients (4.5%) had postoperative complications that resolved after additional surgical intervention. Rib fracture healing was demonstrated on radiographic imaging during postoperative follow-up. CONCLUSION Delayed SSRF is safe and demonstrates significant resolution of preoperative symptoms by decreasing pain, improving chest wall stability, and allowing patients to return to activities of daily living. LEVEL OF EVIDENCE Therapeutic/Care Management; Level IV. Delayed surgical stabilization of rib fractures for symptomatic rib fractures and nonunions is associated with post-operative decreased pain scores, resolution of pre-operative symptoms (specifically chest wall instability) and return to activities of daily living.
The solitary versus supported experience: Care inequality between rare and common cancer patients

Patients with a rare cancer (RC) often have a more complex disease trajectory than patients with a common cancer. Research involving both patient groups is needed to identify differences and resemblances. In this study, we aimed to explore and compare experiences, needs and quality of life of patients with rare and common cancer throughout the disease trajectory.
Treatment for retinopathy of prematurity in Sweden 2008-2021: Reduced gestational age of treated infants and remaining differences in treatment type and recurrence rates between hospitals.

PURPOSE This study aimed to investigate various aspects of treatment for retinopathy of prematurity (ROP) in Sweden over the past 14 years, nationally and at a hospital level. METHODS Data on screening and treatment for ROP in infants born in Sweden from 2008 to 2021 were extracted from the national ROP register, SWEDROP. During this period, Swedish screening guidelines were reduced from gestational age (GA) < 32 weeks to <31 weeks in 2012 and to <30 weeks in 2020. RESULTS Altogether, 10 959 infants were screened and 600 infants treated for ROP during the study period. Parallel to changed guidelines, the number of screened infants decreased (p < 0.000) and the incidence of ROP and frequency of treatment increased (p < 0.001), while both remained similar in infants with a GA below 30 weeks. Among treated infants, GA and BW were reduced over the years (p < 0.001). Laser treatment (85.2% of primary treatments) became less common and anti-VEGF injections (13.6%) became more common over time (p < 0.001). Altogether 16 eyes were treated with the encircling band and 13 with vitrectomy. The total frequency of retreatment (32.7% of treated eyes) remained similar over time but was more common after primary anti-VEGF injection (67.7%) than laser treatment (27.2%). There were differences between the seven university hospitals regarding type of treatment and number of retreatments (p < 0.001). CONCLUSION The frequency of treatment and retreatment for ROP remained similar over time, but the type of treatment changed and anti-VEGF injections became more common. Differences between treating hospitals emphasize the importance of centralizing the most severe cases.
t-EER: Parameter-Free Tandem Evaluation of Countermeasures and Biometric Comparators

Presentation attack (spoofing) detection (PAD) typically operates alongside biometric verification to improve reliablity in the face of spoofing attacks. Even though the two sub-systems operate in tandem to solve the single task of reliable biometric verification, they address different detection tasks and are hence typically evaluated separately. Evidence shows that this approach is suboptimal. We introduce a new metric for the joint evaluation of PAD solutions operating in situ with biometric verification. In contrast to the tandem detection cost function proposed recently, the new tandem equal error rate (t-EER) is parameter free. The combination of two classifiers nonetheless leads to a set of operating points at which false alarm and miss rates are equal and also dependent upon the prevalence of attacks. We therefore introduce the concurrent t-EER, a unique operating point which is invariable to the prevalence of attacks. Using both modality (and even application) agnostic simulated scores, as well as real scores for a voice biometrics application, we demonstrate application of the t-EER to a wide range of biometric system evaluations under attack. The proposed approach is a strong candidate metric for the tandem evaluation of PAD systems and biometric comparators.
Molecular characterization of a novel serine proteinase from Trichinella spiralis and its participation in larval invasion of gut epithelium

Background A novel serine proteinase of Trichinells spiralis (TsSPc) has been identified in the excretion/secretion (ES) antigens, but its role in larval invasion is unclear. The aim of this study was to clone and express TsSPc, identify its biological and biochemical characteristics, and investigate its role on larval invasion of gut epithelium during T. spiralis infection. Methodology/Principal findings TsSPc has a functional domain of serine proteinase, and its tertiary structure consists of three amino acid residues (His88, Asp139 and Ser229) forming a pocket like functional domain. Recombinant TsSPc (rTsSPc) was expressed and purified. The rTsSPc has good immunogenicity. On Western blot analysis, rTsSPc was recognized by infection serum and anti-rTsSPc serum, natural TsSPc in crude and ES antigens was identified by anti-rTsSPc serum. The results of qPCR, Western blot and indirect immunofluorescence test (IIFT) showed that TsSPc was expressed at diverse stage worms, and mainly localized at cuticle, stichosome and intrauterine embryos of this nematode. The rTsSPc had enzymatic activity of native serine protease, which hydrolyzed the substrate BAEE, casein and collagen I. After site directed mutation of enzymatic active sites of TsSPc, its antigenicity did not change but the enzyme activity was fully lost. rTsSPc specifically bound to intestinal epithelium cells (IECs) and the binding sites were mainly localized in cell membrane and cytoplasm. rTsSPc accelerated larval invasion of IECs, whereas anti-rTsSPc antibodies and TsSPc-specific dsRNA obviously hindered larval invasion. Conclusions TsSPc was a surface and secretory proteinase of the parasite, participated in larval invasion of gut epithelium, and may be considered as a candidate vaccine target molecule against Trichinella intrusion and infection.
Commercial hatchery processing may affect susceptibility to stress in laying hens

Directly upon hatching, laying hen chicks are exposed to multiple stressful events during large-scale hatchery processing, which may affect their later coping abilities. Commercial hatchery chicks (HC) were compared to chicks that were incubated and hatched simultaneously under calm conditions (CC). After being raised under similar, non-stressful conditions for 36 days, all chicks were exposed to a series of stressors: transportation and introduction into a novel environment followed by a regrouping event in order to characterize long-lasting consequences of hatchery treatment. Tonic immobility, corticosterone levels, and peripheral body temperature were used to assess reactions to the stress events. Tonic immobility was not affected by treatment but was significantly reduced in CC after transport. Corticosterone levels did not differ between treatments when assessed two days before and two days after regrouping. Comb temperature was significantly higher in HC following regrouping, indicating stress-induced hyperthermia. Furthermore, comb temperature dropped more following blood sampling in HC than in CC, indicating a stronger autonomic response to acute stress. In conclusion, the results suggest possible long-term negative effects of commercial hatchery processing, compared to hatching under silent and less stressful conditions, on the coping ability of laying hens to later stressful experiences.
Multiscale spatial relationship‐based model for predicting bladder wall dose in pelvic radiotherapy

Abstract Purpose This research aimed to develop a prediction model to assess bladder wall dosimetry during radiotherapy for patients with pelvic tumors, thereby facilitating the refinement and evaluation of radiotherapy treatment plans to mitigate bladder toxicity. Methods Radiotherapy treatment plans of 49 rectal cancer patients and 45 gynecologic cancer patients were collected, and multiple linear regression analyses were used to generate prediction models for bladder wall dose parameters (V10−45Gy(cm3), Dmean(Gy)). These models were based on the multiscale spatial relationship between the planning target volume (PTV) and the bladder or bladder wall. The proportion of bladder or bladder wall volume overlapped by the different distance expansions of the PTV was used as an indicator of the multiscale spatial relationship. The accuracy of these models was verified in a cohort of 12 new patients, with further refinement of radiotherapy treatment plans using the predicted values as optimization parameters. Model accuracy was assessed using root mean square error (RMSE) and mean percentage error (MPE). Results Models derived from individual disease data outperformed those derived from combined datasets. Predicted bladder wall dose parameters were accurate, with the majority of initial calculated values for new patients falling within the 95% confidence interval of the model predictions. There was a robust correlation between the predicted and actual dose metrics, with a correlation coefficient of 0.943. Using the predicted values to optimize treatment plans significantly reduced bladder wall dose (p <0.001), with bladder wall Dmean(Gy) and V10−45Gy(cm3) decreasing by 2.27±0.80 Gy (5.8%±1.8%) and 2.96±2.05 cm3 (7.9%±5.4%), respectively. Conclusion The formulated prediction model provides a valuable tool for predicting and minimizing bladder wall dose and for optimizing and evaluating radiotherapy treatment plans for pelvic tumor patients. This approach holds promise for reducing bladder toxicity and potentially improving patient outcomes.
Prevalence of soil-transmitted helminths and associated risk factors among primary school children in Kandahar, Afghanistan: A cross-sectional analytical study

Background Soil-transmitted helminth (STH) infections are global health problem, especially in low-income countries. Main objectives of this study were to estimate the prevalence and intensity of STH and its risk factors among school children in Kandahar city of Afghanistan. Methodology/principal findings This was a school-based cross-sectional analytical study, with data collected during eight-month-period (May–December, 2022) from 6- and 12-years old school children in Kandahar city, Afghanistan. All the stool samples were examined by saline wet mount method and Kato–Katz technique. Data were analyzed by using descriptive statistics, Chi square test, and multivariate logistic regression. A total of 1275 children from eight schools of Kandahar city were included in this study. Mean age of these children was 8.3 years with 53.3% boys. The overall prevalence of any intestinal parasitic infection was 68.4%. The overall prevalence of STH infection was 39.1%, with Ascaris lumbricoides (29.4%) as the most prevalent STH species. Mean intensity of overall STH infection was 97.8. Multivariate logistic regression revealed playing barefoot (AOR 1.6, 95% CI 1.1–2.2), not washing hands after defecating and before eating (AOR 1.3, 95% CI 1.0–1.7), having untrimmed nails (AOR 1.4, 95% CI 1.1–1.8), and belonging to poor families (AOR 1.3, 95% CI 1.0–1.7) as the risk factors associated with the predisposition of school children for getting STH in Kandahar city of Afghanistan. Conclusions/significance There is high prevalence of STH among school children of Kandahar city in Afghanistan. Most of the risk factors are related to poverty, decreased sanitation, and improper hygiene. Improvement of socioeconomic status, sanitation, and health education to promote public awareness about health and hygiene together with periodic mass deworming programs are better strategies for the control of STH infections in Afghanistan.
Effect of Neurotoxin Exposure on Blood Biomarkers of Neurodegeneration and Alzheimer Disease

Aim: To determine whether exposure to neurotoxins in midlife is associated with changes in blood-based biomarkers of neurodegeneration and Alzheimer disease pathology. Methods: Blood cadmium, lead, neurofilament light (NfL) chain, total tau (TTau), and amyloid beta (Aβ) 40 and Aβ42 concentrations were measured in 1516 participants in the Beaver Dam Offspring Study. Linear mixed-effect models were used to determine associations between baseline cadmium and lead levels and baseline NfL, TTau, and Aβ42/Aβ40, and 10-year change in concentrations using repeated measures of these biomarkers as the outcome. Results: In women, higher cadmium and lead levels were associated with higher baseline TTau concentrations. A higher baseline cadmium level was associated with lower baseline Aβ42/Aβ40 in both men and women. In age-sex-adjusted models, a doubling in baseline cadmium level was associated with a 0.2% (95% CI: 0.0, 0.3) higher increase per year in NfL concentrations. In men, a doubling of baseline lead level was associated with a 0.9% (95% CI: 0.1, 1.7) higher increase per year in TTau concentration. Conclusions: Participants with relatively higher levels of cadmium and lead had blood biomarker concentrations consistent with more neuronal damage and Alzheimer disease pathology. Environmental exposure to neurotoxins may contribute to neurodegeneration.
Nonlinear response of inverted flags subjected to a steady flow

The nonlinear characteristics of inverted flags, otherwise known as cantilevered plates in a reverse steady axial flow, is investigated. A Hamiltonian framework is employed to derive the nonlinear integro-differential equation of motion in terms of the rotation angle of the mid-plane with respect to the longitudinal axis of the flag. This allows for reliable predictions even at very large deflection amplitudes. The effect of a finite aspect ratio as well as the presence of an initial curvature along the length of the plate are taken into account in the modelling. The Galerkin modal decomposition technique along with various numerical schemes such as a full Newton method as well as a shooting technique are implemented to construct the bifurcation response diagram of the system as the flow velocity varies. As opposed to the case of flag-type cantilevered plates in steady axial flow, the system undergoes a static divergence via a subcritical pitchfork bifurcation followed by a saddle-node bifurcation. Extensive numerical simulations are performed to investigate the effect of the aspect ratio and initial curvature amplitude on the nonlinear response of the system. The possibility of a supercritical pitchfork bifurcation is also explored. The results of the current model are compared to and validated against measurements reported in the literature.
My child and I: self- and child-reference effects among parents with self-worth contingent on children’s performance

ABSTRACT Research shows that parents’ self-worth may be contingent on their children’s performance, with implications for their interactions with children. This study examined whether such child-based worth is manifested in parents’ recognition memory. Parents of school-age children in China (N = 527) reported on their child-based worth and completed a recognition memory task involving evaluative trait adjectives encoded in three conditions: self-reference, child-reference, and semantic processing. The more parents had child-based worth, the more they exhibited a child-reference effect – superior recognition memory of evaluative trait adjectives encoded with reference to the child rather than semantically. Parents exhibited the classic self-reference effect in comparisons of recognition memory between the self-reference and semantic processing conditions, but this effect was not evidenced among parents high in child-based worth. Only parents low in child-based worth exhibited the self-reference effect in comparisons between the self-reference and child-reference conditions. Findings suggest that when parents hinge their self-worth on children’s performance, evaluative information related to children may be an elaborate structure in memory.