Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of Community-Based Prevention on Alcohol Consumption in Adolescents

Aims: The present paper aims at evaluating the effectiveness of the community-based substance use prevention program “Wegschauen ist keine Losung”. Methods: Communities of the district of Karlsruhe were divided into a group with high (HIG) and low (LIG) program implementation fidelity. In 2011, a school survey was conducted among 892 adolescents in grades 9 and 10 of regular schools in the district of Karlsruhe. The Bavarian sample of the 2011 European School Survey Project on Alcohol and other Drugs (ESPAD) was used as external comparison group (n=1635). Results: Only few differences were found between HIG and LIG with regard to alcohol consumption and negative consequences. Compared to the external ESPAD comparison group, students in Karlsruhe showed lower 30-day prevalence of alcohol use (66.0 vs. 80.5 %), lower consumption quantity (17.17 vs. 34.91 grams of ethanol per drinking day) and lower frequency of use (0.75 vs. 1.21 days within the last week). Conclusions: Considering restrictions of the limit.
HSV suppression reduces seminal HIV-1 levels in HIV-1/HSV-2 co-infected men who have sex with men

Objectives:Suppressive herpes simplex virus (HSV) therapy can decrease plasma, cervical, and rectal HIV-1 levels in HIV-1/HSV-2 co-infected persons. We evaluated the effect of HSV-2 suppression on seminal HIV-1 levels. Design:Twenty antiretroviral therapy (ART)-naive HIV-1/HSV-2 men who have sex with men (MSM) in Lima, Peru, with CD4 >200 cells/μl randomly received valacyclovir 500 mg twice daily or placebo for 8 weeks, then the alternative regimen for 8 weeks after a 2-week washout. Peripheral blood and semen specimens were collected weekly. Anogenital swab specimens for HSV DNA were self-collected daily and during clinic visits. Methods:HIV-1 RNA was quantified in seminal and blood plasma by TaqMan real-time polymerase chain reaction (RT-PCR) or Roche Amplicor Monitor assays. HSV and seminal cytomegalovirus (CMV) were quantified by RT-PCR. Linear mixed models examined differences within participants by treatment arm. Results:Median CD4 cell count of participants was 424 cells/μl. HIV-1 was detected in 71% of 231 semen specimens. HSV was detected from 29 and 4.4% of swabs on placebo and valacyclovir, respectively (P < 0.001). Valacyclovir significantly reduced the proportion of days with detectable seminal HIV-1 (63% during valacyclovir vs. 78% during placebo; P = 0.04). Seminal HIV-1 quantity was 0.25 log10 copies/ml lower [95% confidence interval (CI) −0.40 to −0.10; P = 0.001] during the valacyclovir arm compared with placebo, a 44% reduction. CD4 cell count (P = 0.32) and seminal cellular CMV quantity (P = 0.68) did not predict seminal plasma HIV-1 level. Conclusions:Suppressive valacyclovir reduced seminal HIV-1 levels in HIV-1/HSV-2 co-infected MSM not receiving ART. The significance of this finding will be evaluated in a trial with HIV-1 transmission as the outcome.
Comparison of quantitative light-induced fluorescence, digital photography and transverse microradiography for quantification of enamel remineralization.

BACKGROUND Quantitative light-induced fluorescence (QLF) and digital photography (DP) have been proposed as clinical methods for measuring changes in enamel mineral content. The aim of this study was to compare the ability of QLF and DP with the in vitro gold standard transverse microradiography (TMR) to measure the remineralization of enamel subsurface lesions. METHODS Subsurface lesions were formed in enamel (n = 40) and exposed to remineralization solutions for 10 days. Changes were analysed by DP, QLF and TMR to determine percentage changes in luminescence (%L), fluorescence (%F) and mineral content (%R), respectively and correlation between these parameters determined. RESULTS The correlations between TMR and QLF (r = 0.63), TMR and DP (r = 0.59), and DP and QLF (r = 0.64) were all moderate but statistically significant (p < 0.001). The variability in %L and, to a lesser extent, %F values significantly impacted on the potential role of DP and QLF as methods by which mineral content changes produced by remineralization treatments could be accurately measured. CONCLUSIONS Both QLF and DP provided data that correlated moderately with TMR data. QLF images were easier to analyse, free of glare and had less variability compared with those produced using DP.
Increased incidence of leprosy following HAART initiation: a manifestation of the immune reconstitution disease

A retrospective cohort study was conducted to determine whether the incidence of leprosy varied with the duration of antiretroviral therapy (ART). Between 1992 and 2006, seven cases of leprosy were observed. The incidence of leprosy in untreated patients was 0.7 per 1000 person-years, 13 per 1000 person-years in persons receiving HAART for more than 3 months and 0.9 per 1000 person-years for persons receiving HAART for more than 3 months. The adjusted hazard ratio was 18.5 (95% confidence interval, 1.6–217) with P = 0.02. In tropical areas where HAART is increasingly available, physicians should be aware of the possibility of incident leprosy shortly after HAART initiation.
Telavancin versus vancomycin for the treatment of complicated skin and skin-structure infections caused by gram-positive organisms.

BACKGROUND Telavancin is an investigational, rapidly bactericidal lipoglycopeptide with a multifunctional mechanism of action. METHODS We conducted 2 parallel, randomized, double-blind, active-control, phase 3 studies with a prespecified pooled analysis design. Patients aged > or = 18 years who had complicated skin and skin-structure infections caused by suspected or confirmed gram-positive organisms were randomized to receive either telavancin (10 mg/kg intravenously every 24 h) or vancomycin (1 g intravenously every 12 h). RESULTS A total of 1867 patients were randomized and received > or = 1 dose of study medication. In the clinically evaluable population, at 7-14 days after receipt of the last antibiotic dose, success was achieved in 88% and 87% of patients who received telavancin and vancomycin, respectively (95% confidence interval for the difference, -2.1 to 4.6). Methicillin-resistant Staphylococcus aureus was isolated at baseline from samples from 579 clinically evaluable patients. Among these patients with methicillin-resistant S. aureus infection, cure rates were 91% among patients who received telavancin and 86% among patients who received vancomycin (95% confidence interval for the difference, -1.1 to 9.3). Microbiologic eradication among patients infected with methicillin-resistant S. aureus was 90% in the telavancin treatment group and 85% in the vancomycin treatment group (95% confidence interval for the difference, -0.9 to 9.8). Therapy was discontinued because of adverse events in 8% and 6% of patients who received telavancin and vancomycin, respectively. Except for mild taste disturbance, nausea, vomiting, and serum creatinine concentration elevation in the telavancin treatment group and pruritus in the vancomycin treatment group, adverse events were similar between groups with regard to type and severity. CONCLUSIONS Telavancin given once daily is at least as effective as vancomycin for the treatment of patients with complicated skin and skin-structure infections, including those infected with methicillin-resistant S. aureus.
USING THE HEALTH ACTION PROCESS APPROACH (HAPA) MODEL TO PREDICT ADHERENCE TO THE FIFA 11+ PROGRAM IN ELITE FEMALE YOUTH SOCCER

Background The FIFA 11+ warm-up program can significantly reduce injury risk in youth soccer, but community uptake of the program has been suboptimal. A health behaviour theory, the Health Action Process Approach (HAPA) model, may identify predictors of program uptake that can inform targeted promotion strategies. Objective To determine whether HAPA constructs (risk perceptions, outcome expectancies, self-efficacy, action and coping plans, facilitators and barriers) predict uptake intention and adherence to the FIFA 11+ in elite female youth soccer. Design Sub-analysis of data from a cluster randomized controlled trial. Setting Elite (Tier 1 and 2) female soccer teams (ages 12–16) competing in Calgary, Canada. Participants 12 teams (coaches n=12, players n=200) who were randomly recruited prior to the 2013 season as wave 1 of the larger trial. Risk factor assessment Participants completed a baseline questionnaire assessing risk perceptions, outcome expectancies and self-efficacy associated with the FIFA 11+, and barriers/facilitators to program use. Main outcome measurements Intention to follow the FIFA 11+ (from the HAPA questionnaire) and prospectively reported adherence during the season. Results Preliminary analyses demonstrate that for coaches, risk perceptions, outcome expectancies, and task self-efficacy accounted for 92.7% of uptake intention variance [F(3,3)=12.71, P=. 0327, R2=0.9271]. The most commonly identified facilitator was access to FIFA 11+ materials (videos, manuals). The largest barrier was not having enough time to complete the program. For players, the HAPA model accounted for only 41.4% of intention variance [F(7, 154)=15.53, P<. 001, R2=0.4139]. Identified facilitators included having adequate time, personal effort, and enjoying the program. Barriers included poor team leadership, uncooperative teammates, and lack of time. Relationships between HAPA constructs and adherence will also be presented. Conclusions The HAPA model appears to strongly predict coach, but not player, intentions to uptake the FIFA 11+. The development of role-targeted promotion strategies may improve program uptake.
Testing but not treating: missed opportunities and lost lives in the South African antiretroviral therapy programme.

Recently published WHO guidance recommends starting ART in HIV-infected adults with CD4 counts of ≤350 cells/μl [1]. There is mounting evidence that such a policy will lead to lower mortality among HIV-infected individuals [2]. Also modeling data suggests that expanded testing and earlier treatment will reduce HIV transmission [3]. In South Africa ART coverage is not meeting current needs, even using the CD4 count criteria of <200 cells/μl, and mortality early in ART programmes is high due to advanced immunosuppression at initiation [4]. Fortunately, following limited government leadership around HIV in the past, South African President Jacob Zuma has encouraged widespread HIV testing, and announced that he will undertake an HIV test [5].
The stiff shoulder: how, why, and when to treat

Purpose of review Primary frozen shoulder is a common condition affecting many North Americans. Controversies exist with both nonoperative and operative management. In this review, we comment on several recent studies that have advanced our understanding of the various treatment modalities for frozen shoulder. Recent findings Several recent studies have improved our understanding of the natural history and pathology of frozen shoulder. Frozen shoulder has been found to include an inflammatory response with fibroblastic proliferation. New findings in the past year have demonstrated a geographic variation in contractile proteins with a preponderance in the anterior glenohumeral joint capsule. Fibroplasia, conversely, appears to globally involve the joint capsule. Although the use of oral steroids still remains controversial, good data suggest that short-term benefits exist. The role of arthrographic distension still remains unclear, whereas the role of operative release is being better understood. Summary Frozen shoulder remains a frequent and poorly understood disorder. Recent studies have improved our understanding of the pathology of frozen shoulder, its management and the outcomes.
Successful treatment of methicillin-resistant staphylococcus aureus meningitis with daptomycin.

To the Editor—Sepsis presents a major challenge in medicine. Sepsis is associated with a high rate of mortality, especially if it is misdiagnosed or diagnosed too late. Physicians need to constantly update their knowledge regarding this common condition. The World Wide Web can assist clinicians and other medical care professionals in finding newly available information. In this educational correspondence, we attempt to identify and report information concerning freely available Internet resources with relevant information on sepsis and septic shock. Using methodology described elsewhere [1], we sought to identify Web sites that contain information for health care professionals who treat patients with sepsis, severe sepsis, or septic shock. We selected 66 sites (as of December 2007) that provide free information of educational value for people working in the field of sepsis (table 1; online only). We hope that this list of relevant Web sites can help health care professionals who are looking for information regarding some of their everyday questions. We tried to include English-language World Wide Web resources from relevant professional societies, organizations, and institutions that are respected by the great majority of clinicians and scientists worldwide. We acknowledge that we did not select the Web sites on the basis of specified explicit criteria of quality. It should be emphasized that well-standardized and widely accepted quality criteria for World Wide Web resources are not available. We selected only open-access (or freeregistration) World Wide Web resources for inclusion in our list of relevant Web sites. We did this because we wanted our list to be useful for all clinicians, especially those with Internet access who are in developing countries. We acknowledge that there are several World Wide Web resources that require paid registration for access that also include practical and useful information for various scientific fields, including sepsis. In conclusion, we created a list of open-access, English-language World Wide Web resources with information on sepsis that may be useful as an educational tool for medical students, trainees, clinicians, intensivists, and scientists with special interest in this life-threatening condition.
Most adults seek urgent healthcare when acquiring HIV-1 and are frequently treated for malaria in coastal Kenya

Background:Acute HIV-1 infection (AHI) may present with symptoms for which urgent healthcare is sought. However, little is known about healthcare seeking around the time of HIV-1 seroconversion in sub-Saharan Africa. Methods:Review of clinical, counselling, treatment and laboratory records of previously HIV-1 seronegative at-risk adults, followed at monthly or 3-monthly visits, who seroconverted and enrolled in an AHI cohort. All HIV-seronegative plasma samples were tested for p24 antigen (p24) and stored preseroconversion samples for HIV-1 RNA (RNA). Factors associated with malaria treatment while acquiring HIV-1 were evaluated in multiple logistic regression. Results:Sixty men and 12 women (95% of 75 seroconverters) were evaluated, including 43 (60%) with either p24-positive or RNA-positive or HIV-1 discordant rapid antibodies prior to seroconversion. Prior to diagnosis, 54 patients (75%) reported fever and 50 (69%) sought urgent care for symptomatic illness, including 23 (32%) who sought care in a nonresearch setting. Twenty-nine patients (40%) received presumptive malaria treatment. Only 24% of febrile patients were tested for malaria parasites. All documented smear results were negative. Malaria treatment was strongly associated with fever [adjusted odds ratio (aOR): 46, 95% confidence interval (CI): 3–725] and nonresearch setting (aOR: 5, 95% CI: 3–64). AHI was suspected in six (12%) patients who presented for urgent care during research evaluation. Conclusions:The majority of adults with AHI seek urgent healthcare. These individuals are often presumptively treated for malaria. Improved recognition of AHI in adults presenting for care may offer opportunities for optimizing HIV prevention strategies.
In vitro evaluation of the protective role of human antibodies to West Nile virus (WNV) produced during natural WNV infection.

BACKGROUND West Nile virus (WNV) is endemic in the United States and transmissible by transfusion. Since 2003, the US blood supply has been screened by nucleic-acid tests (NAT) for WNV in minipools (MP-NAT) of 6 or 16 specimens. WNV infection begins with low-level viremia detectable only by individual testing (ID-NAT) and no detectable WNV antibodies. Viremia then increases to levels detectable by MP-NAT, and antibodies become detectable; later, viremia decays to levels detectable only by ID-NAT before becoming undetectable. All but 1 documented WNV transmission by transfusion involved blood components negative for WNV antibodies, raising the question whether WNV antibody-positive blood components with low levels of WNV RNA are infectious. METHODS Specimens from 102 viremic donors with and without WNV antibodies were used to investigate infectivity in cultures of Vero cells and human monocyte-derived macrophages (MDMs). RESULTS In Vero cell culture, 54 (74%) of 73 WNV antibody-negative specimens and 10 (36%) of 28 WNV antibody-positive specimens were infectious. In a random subset of 20 specimens tested in MDM culture, 7 (88%) of 8 WNV antibody-positive specimens and 12 (100%) of 12 WNV antibody-negative specimens were infectious. CONCLUSION WNV antibodies do not always protect susceptible cells from WNV infection in vitro. RNA positivity in the presence of antibody cannot be ignored as a theoretical risk for blood recipients and needs further investigation.
A prospective study of frequency and correlates of intimate partner violence among African heterosexual HIV serodiscordant couples

Background:Intimate partner violence (IPV) is common worldwide and is an important consideration in couples HIV voluntary counseling and testing (CVCT), especially for HIV-serodiscordant couples (i.e. in which only one member is HIV-infected). Design:Prospective study of 3408 HIV-serodiscordant couples (2299 in which the HIV-infected partner was female) from seven countries from East and Southern Africa. Methods:At quarterly visits during up to 2 years of follow-up, participants were asked, separately, about IPV perpetrated against them by their partner during the prior 3 months. Correlates of IPV were determined by generalized estimating equations. Results:The majority of couples were married and living together, with an average duration of partnership of approximately 5 years. More than 39 000 quarterly visits were recorded. IPV was reported in 2.7% of visits by HIV-infected women, 2.2% by HIV-uninfected women, 0.9% by HIV-infected men, and 0.7% by HIV-uninfected men. The majority of IPV reports were verbal or a combination of verbal and physical violence. Those who were HIV-infected were more likely to report IPV [for women adjusted odds ratio (AOR) 1.33, P = 0.043; for men AOR 2.20, P = 0.001], but IPV was not significantly associated with risk of HIV seroconversion in HIV-uninfected participants. IPV incidence decreased during follow-up (P < 0.001). Conclusion:During up to 2 years of prospective follow-up, most persons in stable HIV-serodiscordant partnerships who had undergone CVCT did not report IPV. A modest increased risk of IPV was seen for HIV-infected partners, both female and male.
Autologous bone marrow stromal cells loaded onto porous gelatin scaffolds containing Drynaria fortunei extract for bone repair.

GGT-GSB composite was prepared by mixing a biodegradable GGT composite containing genipin-crosslinked gelatin and β-tricalcium phosphate with Gu-Sui-Bu extract (GSB) (Drynaria fortunei (Kunze) J. Sm. ), a traditional Chinese medicine. Then, porous GGT and GGT-GSB scaffolds were fabricated using a salt-leaching method. The GGT and GGT-GSB scaffolds thus obtained had a macroporous structure and high porosity. Rabbit bone marrow stromal cells (BMSCs) were seeded onto GGT and GGT-GSB scaffolds. The biological response of rabbit calvarial bone to these scaffolds was considered to evaluate the potential of the scaffolds for use in bone tissue engineering. After 8 weeks of implantation, each scaffold induced new bone formation at a cranial bone defect, as was verified by X-ray microradiography. The BMSC-seeded GGT-GSB scaffolds induced more new bone formation than the BMSC-seeded GGT and acellular scaffolds. These observations suggest that an autologous BMSCs-seeded porous GGT-GSB scaffold can be adopted in bone engineering in vivo and has great potential for regenerating defective bone tissue.
Acquisition and Cross-Transmission of Staphylococcus aureus in European Intensive Care Units

Objective. To study the acquisition and cross-transmission of Staphylococcus aureus in different intensive care units (ICUs). Methods. We performed a multicenter cohort study. Six ICUs in 6 countries participated. During a 3-month period at each ICU, all patients had nasal and perineal swab specimens obtained at ICU admission and during their stay. All S. aureus isolates that were collected were genotyped by spa typing and multilocus variable-number tandem-repeat analysis typing for cross-transmission analysis. A total of 629 patients were admitted to ICUs, and 224 of these patients were found to be colonized with S. aureus at least once during ICU stay (22% were found to be colonized with methicillin-resistant S. aureus [MRSA]). A total of 316 patients who had test results negative for S. aureus at ICU admission and had at least 1 follow-up swab sample obtained for culture were eligible for acquisition analysis. Results. A total of 45 patients acquired S. aureus during ICU stay (31 acquired methicillin-susceptible S. aureus [MSSA], and 14 acquired MRSA). Several factors that were believed to affect the rate of acquisition of S. aureus were analyzed in univariate and multivariate analyses, including the amount of hand disinfectant used, colonization pressure, number of beds per nurse, antibiotic use, length of stay, and ICU setting (private room versus open ICU treatment). Greater colonization pressure and a greater number of beds per nurse correlated with a higher rate of acquisition for both MSSA and MRSA. The type of ICU setting was related to MRSA acquisition only, and the amount of hand disinfectant used was related to MSSA acquisition only. In 18 (40%) of the cases of S. aureus acquisition, cross-transmission from another patient was possible. Conclusions. Colonization pressure, the number of beds per nurse, and the treatment of all patients in private rooms correlated with the number of S. aureus acquisitions on an ICU. The amount of hand disinfectant used was correlated with the number of cases of MSSA acquisition but not with the number of cases of MRSA acquisition. The number of cases of patient-to-patient cross-transmission was comparable for MSSA and MRSA.