Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence of antibiotic use for dogs and cats in United States veterinary teaching hospitals, August 2020

Abstract Background Awareness of prescribing practices helps identify opportunities to improve antibiotic use (AU). Objectives To estimate AU prevalence in dogs and cats in U.S. veterinary teaching hospitals (VTHs) and identify antibiotic drugs commonly prescribed, indications for use, and evidence of bacterial infection. Animals Medical record data were collected from dogs and cats examined at 14 VTHs. Methods Data were collected from VTH medical records of dogs and cats examined by primary care, urgent care, emergency and critical care, internal medicine, and surgery services on a single day during August 13‐September 3, 2020. Data included signalment; clinical service; inpatient or outpatient status; clinical conditions; diagnostic tests; evidence of bacterial infection; intended reason for AU; name and route of antibiotics prescribed. Results Of 883 dogs and cats, 322 (36.5%) were prescribed at least 1 antibiotic. Among 285 antibiotics administered systemically intended for treatment of infection, 10.9% were prescribed without evidence of infection. The most common class of antibiotics presribed for systemic administration was potentiated penicillin for dogs (115/346, 33.3%) and cats (27/80, 33.8%). For dogs and cats, first‐generation cephalosporins (93/346, 26.9% and 11/80, 13.8%, respectively) and fluoroquinolones (51/346, 14.7% and 19/80, 23.8%, respectively) was second or third most‐prescribed. Common AU indications included skin, respiratory, and urinary conditions, and perioperative use. Conclusions and Clinical Importance Collaborative data collection provides a sustainable methodology to generate national AU prevalence estimates and bring attention to areas requiring additional research and detailed data collection. These efforts can also identify practice improvement opportunities in settings where future veterinarians are trained.
Optimal Extraction and Deproteinization Method for Mannoprotein Purification from Kluyveromyces marxianus

Background: Mannoproteins, mannose-glycosylated proteins, play an important role in biological processes and have various applications in industries. Several methods have been already used for the extraction of mannoproteins from yeast cell-wall. The aim of this study was to evaluate the extraction and deproteinization of mannan oligosaccharide from the K. marxianus mannoprotein. Methods: To acquire crude mannan oligosaccharides, K. marxianus mannoproteins were deproteinized by the Sevage, TCA, and HCL methods. Total nitrogen, crude protein content, fat, carbohydrate and ash content were measured according to the monograph prepared by the meeting of the Joint FAO/WHO Expert Committee and standard. Mannan oligosaccharide loss, percentage of deproteinization, and chemical composition of the product were assessed to check the proficiency of different methods. Results: Highly purified (95.4%) mannan oligosaccharide with the highest deproteinization (97.33 ± 0.4%) and mannan oligosaccharide loss (25.1 ± 0.6%) were obtained following HCl method. Conclusion: HCl was the most appropriate deproteinization method for the removal of impurities. This preliminary data will support future studies to design scale-up procedures.
EXACT ASYMPTOTICS OF SAMPLE-MEAN-RELATED RARE-EVENT PROBABILITIES

Relying only on the classical Bahadur–Rao approximation for large deviations (LDs) of univariate sample means, we derive strong LD approximations for probabilities involving two sets of sample means. The main result concerns the exact asymptotics (as n→∞) of $$ {\open P}\left({\max_{i\in\{1,\ldots,d_x\}}\bar X_{i,n} \les \min_{i\in\{1,\ldots,d_y\}}\bar Y_{i,n}}\right),$$ with the ${\bar X}_{i,n}{\rm s}$ ( ${\bar Y}_{i,n}{\rm s}$ , respectively) denoting d x (d y ) independent copies of sample means associated with the random variable X (Y). Assuming ${\open E}X \gt {\open E}Y$ , this is a rare event probability that vanishes essentially exponentially, but with an additional polynomial term. We also point out how the probability of interest can be estimated using importance sampling in a logarithmically efficient way. To demonstrate the usefulness of the result, we show how it can be applied to compare the order statistics of the sample means of the two populations. This has various applications, for instance in queuing or packing problems.
Candida haemulonii complex, an emerging threat from tropical regions?

Background Candida haemulonii complex-related species are pathogenic yeasts closely related to Candida auris with intrinsic antifungal resistance, but few epidemiological data are available. Methodology/Principal findings We analyzed clinical and demographic characteristics of patients with fungemia due to C. haemulonii complex and related species (C. pseudohaemulonii, C. vulturna) reported in France during 2002–2021, and compared them to data of C. parapsilosis fungemia, as they all can be commensal of the skin. We also conducted a study on adult inpatients and outpatients colonized by C. haemulonii complex, managed at the University Hospital of Martinique during 2014–2020. Finally, we performed a literature review of fungemia due to C. haemulonii complex and related species reported in Medline (1962–2022). In total, we identified 28 fungemia due to C. haemulonii complex in France. These episodes were frequently associated with bacterial infection (38%) and high mortality rate (44%), and differed from C. parapsilosis fungemia by their tropical origin, mainly from Caribbean and Latin America. All isolates showed decreased in vitro susceptibility to amphotericin B and fluconazole. In Martinique, we found that skin colonization was frequent in the community population, while colonization was strongly associated with the presence of foreign devices in ICU patients. The literature review identified 274 fungemia episodes, of which 56 were individually described. As in our national series, published cases originated mainly from tropical regions and exhibited high crude mortality. Conclusions/Significance Multidrug-resistant C. haemulonii complex-related species are responsible for fungemia and colonization in community and hospital settings, especially in tropical regions, warranting closer epidemiological surveillance to prevent a potential C. auris-like threat.
Occupational Evaluation of Federal Highway Police Officers Exposed to Cholinesterase Inhibiting Insecticides

The results of the present work show that there are significant biochemical and neurophysiologic changes in the PRF officers when compared pre- and post-exposure moments. The real working conditions of this population are challenging and the need for periodic monitoring is indispensable. Objective The aim of this study is to evaluate the effects of occupational exposure of federal highway police (PRF) officers to cholinesterase-inhibiting insecticides. Methods We evaluate erythrocyte and plasma cholinesterase activity, pulse rate, systolic and diastolic pressure, and clinical evaluation through the Mini-Mental State Examination and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Results All PRF officers evaluated were male, between 22 and 49 years of age. Pulse rate of the subjects were statistically superior in the post-exposure moment when compared with pre-exposure moment. Inhibition of acetylcholinesterase and butyrylcholinesterase was significant in the post-exposure moment when compared with pre-exposure moment. Conclusions The results of the present work show that there are significant biochemical changes, which can be the beginning of serious deleterious effects to the health of PRF officers.
Antimicrobial Resistance Patterns Among Neonates Referred to Pediatric Emergency in North India: A Prospective Cohort Study

Background: Sepsis is a leading cause of neonatal mortality worldwide, with a disproportionately high burden in low-income and middle-income countries. There is limited prospective data on microorganism profiles and antimicrobial resistance (AMR) in outborn newborns referred to pediatric emergency in developing countries. We aimed to assess the pathogen profile and AMR patterns in outborn neonates referred to the pediatric emergency at a tertiary care center. Methods: In this prospective cohort study, we enrolled neonates with suspected sepsis and sent blood or cerebrospinal fluid cultures. Neonates were followed up daily until discharge or death. The isolated organisms were identified and tested for antimicrobial susceptibility. Standard definitions were used to define multidrug resistance. Results: Between January 1, 2020, and December 31, 2020, 1072 outborn neonates with suspected sepsis were enrolled. The rate of proven sepsis was 223.6 (95% CI:198.7–248.4) per 1000 infants. Gram-negative sepsis was the most common (n = 107,10%), followed by gram-positive sepsis (n = 81,7.6%) and fungal sepsis (n = 67,6.3%). Coagulase-negative staphylococci (n = 69), Candida spp. (n = 68), Klebsiella spp. (n = 55), Acinetobacter spp. (n = 31) and Escherichia coli (n = 9) were the most common pathogens. Over two-thirds (68.6%) of pathogens were multidrug resistance, with an alarming prevalence in Klebsiella spp. (33/53, 62%), Acinetobacter spp. (25/30, 83%) and coagulase-negative staphylococci (54/66, 82%). In total, 124 (11.6%) neonates died in the hospital (13.3% of proven cases and 11.1% of culture-negative sepsis cases). Conclusions: High sepsis burden and alarming AMR among neonates referred to tertiary care centers warrant urgent attention toward coordinated implementation of rigorous sepsis prevention measures and antimicrobial stewardship across all healthcare levels.
Exploring Food-Based Cultural Practices to Address Food Insecurity in Rural Appalachia

Background Health behaviors, like diet, are influenced by a person’s culture and the society where they reside, contributing to the presence of health disparities within a unique region. Such disparities are evident in Central Appalachia where a unique cultural identity exists. Culture-based initiatives focused on improving food security and other nutritional challenges have had success in other diverse groups, yet similar interventions considering geographically tied culture, like Appalachia, are limited. Aim This study aims to identify specific aspects of Appalachian culture that address food insecurity to inform future initiatives that may improve adult dietary habits and food security status. Methods Qualitative data were collected from five focus groups in one rural Central Appalachian community in 2021 (n=59). Data were analyzed using Grounded Theory Approach. Results Four primary themes related to culture and food insecurity emerged: 1) Community decline and economic hardship 2) Shifts in multigenerational food traditions 3) Response to limited food access and 4) Community decline and economic hardship. Participants revealed adaptations they have made in the face of geographic isolation and poverty and the pride they take in providing for themselves and one another. Conclusion These findings indicate the people of Appalachia are unknowingly leveraging cultural practices to address food insecurity, yet the impact of these practices on nutritional status remains unknown. These results have implications for future studies and interventions in Appalachia which may have greater success by accounting for cultural influences compared to traditional approaches for reducing food insecurity in the region.
Individual Listener Preference for Strength of Single-Microphone Noise-Reduction; Trade-off Between Noise Tolerance and Signal Distortion Tolerance

There are large interindividual variations in preference for strength of noise-reduction (NR). It is hypothesized that each individual's tolerance for background noise on one hand and signal distortions on the other hand form this preference. We aim to visualize and analyze this so-called trade-off between noise attenuation and signal quality. Dutch sentences in stationary background noise were processed with different NR strengths. We used an NR algorithm that allows us to separate the positive effects of NR (noise attenuation) from the negative effects (signal distortion). Stimuli consisted of speech in noise with different degrees of (1) background noise, (2) signal distortions, or (3) both (i.e., realistic NR at different NR strengths). With pairwise comparisons, participants chose which stimulus they preferred for prolonged listening. Twelve listeners with mild to moderate hearing loss participated in the study. For all participants, a trade-off between noise attenuation and signal quality was found and visualized. The strength of preference was estimated with the Bradley–Terry–Luce choice model and was different for all individuals but in the same order of magnitude for distortion effects and noise effects. Strength of preference of realistic NR was smaller by a factor of ten. This study used a unique setup to capture the individual trade-off between noise attenuation and signal quality in NR. Disturbance from signal distortions is as important as disturbance from background noise for determining preference for NR strength. Individual listeners differ in their sensitivity to both factors and as a consequence in their preferred NR strength.
The Morel‐Lavallée Lesion: Review and Update on Diagnosis and Management

Morel‐Lavallée lesion is a closed soft tissue degloving injury usually associated with high‐velocity trauma. It most commonly occurs in the thigh, hip, and pelvis. Because such lesions are prone to a missed or delayed diagnosis, it may present a potential risk of infection at the fracture site once it progresses. Therefore, timely identification and management of Morel‐Lavallée lesion is crucial. Moreover, there are no relevant guidelines for the treatment of Morel‐Lavallée lesion. Based on the above facts, we reviewed the etiology, epidemiology, pathophysiology, clinical presentation, imaging features, treatment, prognosis, and complications of Morel‐Lavallée lesion with the aim of providing a comprehensive overview of Morel‐Lavallée lesion, increasing awareness of this injury among orthopaedic surgeons, and thus providing a management algorithm that can be applied to this injury.
Nanotechnology revolutionises breast cancer treatment: harnessing lipid-based nanocarriers to combat cancer cells

Abstract One of the most common cancers that occur in females is breast cancer. Despite the significant leaps and bounds that have been made in treatment of breast cancer, the disease remains one of the leading causes of death among women and a major public health challenge. The therapeutic efficacy of chemotherapeutics is hindered by chemoresistance and toxicity. Nano-based lipid drug delivery systems offer controlled drug release, nanometric size and site-specific targeting. Breast cancer treatment includes surgery, chemotherapy and radiotherapy. Despite this, no single method of treatment for the condition is currently effective due to cancer stem cell metastasis and chemo-resistance. Therefore, the employment of nanocarrier systems is necessary in order to target breast cancer stem cells. This article addresses breast cancer treatment options, including modern treatment procedures such as chemotherapy, etc. and some innovative therapeutic options highlighting the role of lipidic nanocarriers loaded with chemotherapeutic drugs such as nanoemulsion, solid-lipid nanoparticles, nanostructured lipid carriers and liposomes, and their investigations have demonstrated that they can limit cancer cell growth, reduce the risk of recurrence, as well as minimise post-chemotherapy metastasis. This article also explores FDA-approved lipid-based nanocarriers, commercially available formulations, and ligand-based formulations that are being considered for further research. Graphical Abstract
Changes in employment status over time in multiple sclerosis following a first episode of central nervous system demyelination, a Markov multistate model study

Understanding predictors of changes in employment status among people living with multiple sclerosis (MS) can assist health care providers to develop appropriate work retention/rehabilitation programs. We aimed to model longitudinal transitions of employment status in MS and estimate the probabilities of retaining employment status or losing or gaining employment over time in individuals with a first clinical diagnosis of central nervous system demyelination (FCD).
A 14th century CE Brucella melitensis genome and the recent expansion of the Western Mediterranean clade

Brucellosis is a disease caused by the bacterium Brucella and typically transmitted through contact with infected ruminants. It is one of the most common chronic zoonotic diseases and of particular interest to public health agencies. Despite its well-known transmission history and characteristic symptoms, we lack a more complete understanding of the evolutionary history of its best-known species—Brucella melitensis. To address this knowledge gap we fortuitously found, sequenced and assembled a high-quality ancient B. melitensis draft genome from the kidney stone of a 14th-century Italian friar. The ancient strain contained fewer core genes than modern B. melitensis isolates, carried a complete complement of virulence genes, and did not contain any indication of significant antimicrobial resistances. The ancient B. melitensis genome fell as a basal sister lineage to a subgroup of B. melitensis strains within the Western Mediterranean phylogenetic group, with a short branch length indicative of its earlier sampling time, along with a similar gene content. By calibrating the molecular clock we suggest that the speciation event between B. melitensis and B. abortus is contemporaneous with the estimated time frame for the domestication of both sheep and goats. These results confirm the existence of the Western Mediterranean clade as a separate group in the 14th CE and suggest that its divergence was due to human and ruminant co-migration.
A cumulative projection-based automatic registration method for mobile laser scanning data

ABSTRACT This paper presents an automatic method for global alignment of mobile laser scanning (MLS) data in urban environments. Most of the existing algorithms either highly time consuming or invalid because of the data sets are always huge and the overlapping part always less than half. To address these problems, we propose an approach which consists of two consecutive stages. The first stage is cumulative projection transformation. In this stage, we convert the 3D-point clouds into 2D images using cumulative projection transformation. As a result, we could use the image-matching methods to fulfil the question. The second stage is image matching based on line segment. In the projection images, there are plenty of shape features, so we use the line segment detector to extract line segments and construct line-junction-line (LJL) structures, and then match the line segments and structures based on the line segment matching method. Experimentation on several data sets with tens of millions points from large regions of different cities demonstrates that our approach decreases the complexity and time-consumption significantly, and applies more accurately.
MRI order appropriateness for chronic neck pain: Comparison of ordering practices and treatment outcomes for primary care physicians and specialists

Chronic neck pain is a common reason for doctor visits in the United States. This diagnosis can be evaluated through patient history, physical examination, and judicious use of radiographs. However, possible inappropriate magnetic resonance imaging (MRI) ordering persists. We hypothesized that no difference in ordering practices, ordering appropriateness, and subsequent intervention would be appreciated regarding physician specialty, location, patient characteristics, and history and physical exam findings. A multisite retrospective review of cervical spine MRI between 2014 and 2018 was performed. A total of 332 patients were included. Statistical analysis was used to assess MRI order appropriateness, detail of history and physical exam findings, and intervention decision‐making among different specialties. If significant differences were found, multiple linear regression was performed to evaluate the association of MRI order appropriateness regarding physician specialty, location, patient characteristics and history, and physical exam findings. The significance level for all tests was set at <0.05 Orthopedic surgeons ordered MRIs most appropriately with an average American College of Radiology (ACR) score of 8.4 (p < 0.005). Orthopedic surgeons had more comprehensive physical exams as compared to the remaining specialties. The decision for intervention did not vary by physician specialty or ACR score, except for patients of pain medicine physicians who received pain management (p = 0.000). Orthopedic surgeons utilize MRI most appropriately and have more comprehensive physical exams. These findings suggest a need for increased physician education on what indicates an appropriate MRI order to improve the use of resources and further protect patient risk‐benefit profiles. Further research elucidating factors to minimize negative findings in “appropriate” MRIs is indicated. Clinical significance: More detailed physical exams may lead to more appropriately ordered MRIs, subsequently resulting in surgery or procedures being performed when appropriately indicated. This suggests the need for increased physician education on when MRI ordering is appropriate for chronic neck pain to improve the use of resources and further protect patient risk‐benefit profiles.
Isolated pulmonary metastases in pancreatic ductal adenocarcinoma: a review of current evidence

ABSTRACT Despite recent advances in cancer therapeutics, pancreatic ductal adenocarcinoma (PDAC) remains a lethal disease with a 5-year overall survival of only 10%. Since either at or within a few months of diagnosis, most patients with PDAC will present with metastatic disease, a more individualized approach to select patients who may benefit from more aggressive therapy has been suggested. Although studies have reported improved survival in PDAC and isolated pulmonary metastasis (ISP) compared to extrapulmonary metastases, such findings remain controversial. Furthermore, the added benefit of pulmonary metastasectomy and other lung-directed therapies remains unclear. In this review, we discuss the metastatic pattern of PDAC, evaluate the available evidence in the literature for improved survival in PDAC and ISP, evaluate the evidence for the added benefit of pulmonary metastasectomy and other lung-directed therapies, identify prognostic factors for survival, discuss the biological basis for the reported improved survival and identify areas for further research.