Miracle-dz/UniFAR-FTUs huggingface dataset:
HLA Alleles are Associated With Altered Risk for Disease Progression and Central Nervous System Impairment of HIV-Infected Children

Objective:To examine the effects of human leukocyte antigen (HLA) alleles on HIV-1-related disease progression and central nervous system (CNS) impairment in children. Design:Five hundred seventy-two HIV-1-infected children, identified as disease progressors or nonprogressors, were selected from PACTG P152 and P300 through a case-cohort sampling scheme. Study endpoints were HIV-1-related disease progression-free survival and time to CNS impairment. Methods:DNA was genotyped for HLA alleles using a Luminex 100 platform. Weighted Kaplan-Meier methods, and Cox proportional hazards models were used to assess the effects of HLA alleles on study endpoints. Results:Presence of the B-27 allele (n = 20) was associated with complete protection against disease progression and CNS impairment over the median follow-up of 26 months (P < 0.0001 for both). These findings held in multivariate analyses controlling for baseline covariates including race, gender, age, log HIV-1 RNA, CD4+ lymphocyte count and percent, weight for age z score and treatment, and for other genotypes shown to affect HIV-1-related disease progression. Also, although the Cw-2 allele protected against disease progression [Hazard ratio (HR), 0.48; 95% confidence interval (CI): 0.28 to 0.81; P = 0.006], the A-24 allele was associated with more rapid CNS impairment (HR: 2.01; 95% CI: 1.04 to 3.88; P = 0.04). The HLA class II DQB1-2 allele was associated with a delayed disease progression (HR: 0.66; 95% CI: 0.47-0.92; P = 0.01) and CNS impairment (HR: 0.58; 95% CI: 0.36 to 0.93; P = 0.02). Conclusions:Presence of B-27, Cw-2, or DQB1-2 alleles was associated with delayed HIV-1 disease progression, while B-27, A-24, and DQB1-2 alleles were associated with altered progression to CNS impairment in children.
Adaptive Thermoregulation in Golden Spiny Mice: The Influence of Season and Food Availability on Body Temperature

We studied the effect of food supplementation during summer and winter in seminatural field conditions on thermoregulation of a desert rodent, the golden spiny mouse Acomys russatus. We hypothesized that (a) under natural food availability (control conditions), mice will use less precise thermoregulation (i.e., an increase in the variance of body temperature [Tb]) during winter because of low ambient temperatures (Ta’s) and low food availability and during summer because of low food and water availability; (b) food supplementation will result in more precise thermoregulation during winter, but the effect will be smaller during summer because variation in Tb in summer is also driven by water availability during that period. We found that under natural food availability, spiny mice thermoregulated more precisely during summer than during winter. They spent more time torpid during summer than during winter even when food was supplemented (although summer nights are shorter), allowing them to conserve water. Supplementing food resulted in more precise thermoregulation in both seasons, and mice spent less time torpid. In summer, thermoregulation at high Ta’s was less precise, resulting in higher maximum Tb’s in summer than in winter and when food was supplemented, in accord with the expected effect of water shortage on thermoregulation. Our results suggest that as expected, precise thermoregulation is beneficial when possible and is abandoned only when the costs of homeothermy outweigh the benefits.
Use of UV Powder for Surveillance to Improve Environmental Cleaning

Commercially available UV powder was applied weekly to high-risk objects within patient rooms and inspected after 48 hours. We found a baseline cleaning rate of 41.8% that increased up to 80% (P < .001) after the institution of weekly electronic feedback (unit rates and rankings) to environmental services, hospital leadership, and unit administrators.
Can one accurately date a bruise? State of the science

Abstract Forensic nursing experts and other health professionals often testify regarding the injuries women and men receive from violence. Bruise discoloration can provide an opportunity for health professionals to grossly estimate the age of impact and determine if it is consistent with a given reported history. However, there is much confusion in the literature and clinical practice as to the accuracy of dating bruises. This article will demonstrate that using the color of the bruise as the primary criteria to determine its age is not the best practice. The limited available research and related literature on the topic are flawed and inconsistent. Finally, recommendations will be made for future research and clinical practice.
Division of Comparative Physiology and Biochemistry , Society for Integrative and Comparative Biology On the Evolution of Saline Tolerance in the Larvae of Mosquitoes in the Genus Ochlerotatus

We examined physiological and morphological parameters associated with saline tolerance in the larvae of 11 species of mosquito in the genus Ochlerotatus that were collected from the wild in a variety of sites around North America. Saline tolerance was assayed, and all of the species were osmoregulators. Six of the species examined were found to be physiologically restricted to freshwater habitats, while the other five could successfully osmoregulate in both freshwater and saline water, including seawater. All larvae that were obligate freshwater forms had only one rectal segment, while all of the euryhaline osmoregulators had two. We were interested in the evolutionary pathway by which saline tolerance arose in this lineage. DNA sequence data were obtained by polymerase chain reaction amplification and sequencing of the D2 region of the 28s rDNA gene in all of the freshwater and saline-tolerant Ochlerotatus species we studied. When the morphological and physiological characters were mapped on the resultant cladogram, they revealed a complex pattern, with freshwater and saline-water forms being adjacent and interspersed through the tree. The data also demonstrate that saline tolerance has been gained and then lost at least once in this lineage. Two possible evolutionary scenarios are presented, but the one we favor is that saline tolerance arose one time in this lineage and repeated reversions to the freshwater condition have occurred.
Preoperative Nasal Methicillin-Resistant Staphylococcus aureus Status, Surgical Prophylaxis, and Risk-Adjusted Postoperative Outcomes in Veterans

Objectives. To determine whether preoperative nasal methicillin-resistant Staphylococcus aureus (MRSA) carriage is a significant predictor of postoperative infections, after accounting for surgical infection risk and surgical prophylaxis. Design. Retrospective cohort study. Patients. Veterans Affairs (VA) Boston patients who had nasal MRSA polymerase chain reaction screening performed in the 31 days before clean or clean contaminated surgery in 2008–2009. Methods. Postoperative MRSA clinical cultures and infections, total surgical site infections (SSIs), and surgical prophylaxis data were abstracted from administrative databases. MRSA infections were confirmed via chart review. Multivariate analysis of risk factors for each outcome was conducted using Poisson regression. SSI risk index was calculated for a subset of 1,551 patients assessed by the VA National Surgical Quality Improvement Program. Results. Among 4,238 eligible patients, 279 (6.6%) were positive for preoperative nasal MRSA. Postoperative MRSA clinical cultures and infections, including MRSA SSIs, were each significantly increased in patients with preoperative nasal MRSA. After adjustment for surgery type, vancomycin prophylaxis, chlorhexidine/alcohol surgical skin preparation, and SSI risk index, preoperative nasal MRSA remained significantly associated with postoperative MRSA cultures (relative risk [RR], 8.81; 95% confidence interval [CI], 3.01–25.82) and infections (RR, 8.46; 95% CI, 1.70–42.04). Vancomycin prophylaxis was associated with an increased risk of total SSI in those negative for nasal MRSA (RR, 4.34; 95% CI, 2.19–8.57) but not in patients positive for nasal MRSA. Conclusions. In our population, preoperative nasal MRSA colonization was independently associated with MRSA clinical cultures and infections in the postoperative period. Vancomycin prophylaxis increased the risk of total SSI in nasal MRSA-negative patients.
The emotional challenges faced by Sexual Assault Nurse Examiners: “ER nursing is stressful on a good day without rape victims”

&NA; Although research has indicated that counselors, advocates and social workers who assist rape victims experience vicarious trauma or psychological consequences as a result of their exposure to victims' traumatic experiences, little is known about Sexual Assault Nurse Examiners' (SANEs') experiences. This qualitative research explores SANEs' experiences of vicarious trauma and burnout as a result of treating rape victims, and the coping strategies they implement to reduce both. Data from interviews with 39 SANEs reveal that when asked about their difficulties as a SANE and the hardest part of their job, the majority (67%) discussed vicarious trauma, the emotional demands associated with the job, worrying about victims after they leave the hospital, and burnout. More than half (51%) of SANEs interviewed specifically indicated that they have experienced vicarious trauma as a result of treating rape victims, and 46% indicated they have experienced burnout at least to some degree. All SANEs, regardless of whether they believe they have experienced vicarious trauma or burnout, have ways to cope after hard cases. These coping mechanisms include talking to family members, calling or reaching out to other SANEs, program coordinators or rape victim advocates and detectives, participating in meetings with other SANEs where the focus is on problems after difficult cases, and finding relaxing activities.
Prevalence of Hypovitaminosis D and Factors Associated With Vitamin D Deficiency and Morbidity Among HIV-Infected Patients Enrolled in a Large Italian Cohort

Background: A high prevalence of hypovitaminosis D (hypD) in HIV-infected patients has been reported, but reasons are unclear. Methods: The 25 hydroxy vitamin D (vitD) concentration was measured in a sample of HIV-positive patients from Italy enrolled in the Icona Foundation Study. The change in absolute levels of vitD pre/post combination antiretroviral treatment was modelled by linear regression controlling for confounders and seasonality. Factors associated with hypD were identified using logistic regression analysis, and survival analysis was employed to evaluate the prognostic value of vitD concentration to predict severe diseases (diabetes, cardiovascular, renal), AIDS, and death. Results: We studied 810 patients contributing 1408 vitD measures. Median age was 36 years (range: 20-69). VitD insufficiency (30-75 nmol/L) and deficiency (<30 nmol/L) were found in 47% and 6% of the measures. Factors independently associated with vitD deficiency were African or Centre/South American nationality [odds ratio (OR): 4.16 vs. European, P = 0.04], the sample being collected in spring (OR: 11.27, P = 0.001) or in winter (OR: 4.22, P = 0.03) vs. summer, and a previous history of severe diseases (OR: 5.43, P = 0.03) or AIDS (OR: 2.44, P = 0.04). Over a median follow-up of 6.3 years, patients with vitD insufficiency were at higher risk of subsequent severe diseases than those with normal levels (relative hazard = 1.60, P = 0.05). Conclusions: Our analysis shows that despite the relatively young age of our HIV-infected population, the prevalence of hypD was high. Classic risk factors for hypD in the general population were confirmed in this setting. HypD seems to be moderately associated with the risk of severe disease, AIDS, and death.
Prevalence of Low Estimated Glomerular Filtration Rate, Proteinuria, and Associated Risk Factors Among HIV-Infected Black Patients Using Cockroft–Gault and Modification of Diet in Renal Disease Study Equations

ObjectiveTo evaluate the prevalence of low estimated glomerular filtration rate (eGFR), proteinuria, and associated risk factors among HIV-infected black patients at primary health care. MethodsA cross-sectional screening involving consecutive HIV-infected patients 18 years and older was done. Eighty-eight percent of patients were receiving highly active antiretroviral therapy (94% on first-line regimen: zidovudine + lamivudine + nevirapine). Simplified Modification of Diet in Renal Disease Study and Cockroft–Gault (CG) equations were used to estimate glomerular filtration rate and creatinine clearance, respectively. Determinants of dipstick proteinuria and low kidney function (<60 mL·min−1·1.73 m−2) were assessed using multivariate logistic regression analysis. ResultsThree hundred HIV-infected (231 females) patients were screened. Their mean age, duration of HIV, and CD4+ count were 43 ± 9 years, 33 ± 27 months, and 397 ± 224 cells per cubic millimeter, respectively. The prevalence of low eGFR according to Modification of Diet in Renal Disease Study and CG equations was 3% and 10%, respectively. Proteinuria was observed in 20.5% of patients. Only CD4+ cell count ⩽200 cells per cubic millimeter emerged as a strong determinant of low CG creatinine clearance [adjusted odds ratio (OR) 3.03; 95% confidence interval (CI): 1.099 to 8.352], whereas age ≥45 years (adjusted OR 3.69; 95% CI: 1.756 to 7.787), familial history of diabetes mellitus (adjusted OR 2.20; 95% CI: 1.067 to 4.543), and hypertension (adjusted OR 3.07; 95% CI: 1.278 to 7.787) were significantly associated with proteinuria. ConclusionsLow eGFR and proteinuria are prevalent among these HIV-infected persons. Immunodeficiency emerged as one of the strongest determinants of renal impairment. This finding emphasizes the importance of highly active antiretroviral therapy in tackling the burden of chronic kidney disease in African HIV population.
Preservation HIV-1–Specific IFN&ggr;+ CD4+ T-Cell Responses in Breakthrough Infections After Exposure to Tenofovir Gel in the CAPRISA 004 Microbicide Trial

Abstract:The Centre for the AIDS Program of Research in South Africa 004 trial demonstrated reduction of sexual HIV-1 acquisition in women using a vaginal microbicide containing tenofovir. A better understanding of the consequences of antiretroviral-containing microbicides for immune responses in individuals with intercurrent HIV-1 infection is needed for future trials combining the use of microbicides with HIV-1 vaccines. Investigation of immune responses in women who acquired HIV-1 although using tenofovir gel showed significantly higher (P = 0.01) Gag-specific IFN&ggr;+ CD4+ T-cell responses. The use of tenofovir-containing gel around the time of infection can modulate HIV-1 immunity, and these immunological changes need to be considered in future trials combining vaccines and microbicides.
Intraspecific Variation in Aerobic Metabolic Rate of Fish: Relations with Organ Size and Enzyme Activity in Brown Trout*

Highly active animals require a high aerobic capacity (i.e., a high maximum metabolic rate [MMR]) to sustain such activity, and it has been speculated that a greater capacity for aerobic performance is reflected in larger organs, which serve as energy processors but are also expensive to maintain and which increase the minimal cost of living (i.e., the basal or standard metabolic rate [SMR]). In this study, we assessed the extent of intraspecific variation in metabolic rate within a group of brown trout (Salmo trutta L.) and tested whether the observed variation in residual (body-mass-corrected) SMR, MMR, and absolute aerobic scope could be explained by variations in the residual size (mass) of metabolically active internal organs. Residual SMR was found to correlate positively with residual MMR, indicating a link between these two metabolic parameters, but no relationship between organ mass and metabolic rate was found for liver, heart, spleen, intestine, or stomach. Instead, activity in the liver of two aerobic mitochondrial enzymes, cytochrome c oxidase and, to a lesser extent, citrate synthase, was found to correlate with whole-animal metabolic rate, indicating that causes for intraspecific variation in the metabolic rate of fish can be found at a lower organizational level than organ size.
Hematologic, Hepatic, Renal, and Lipid Laboratory Monitoring After Initiation of Combination Antiretroviral Therapy in the United States, 2000–2010

Abstract:We assessed laboratory monitoring after combination antiretroviral therapy initiation among 3678 patients in a large US multisite clinical cohort, censoring participants at last clinic visit, combination antiretroviral therapy change, or 3 years. Median days (interquartile range) to first hematologic, hepatic, renal, and lipid tests were 30 (18–53), 31 (19–56), 33 (20–59), and 350 (96–1106), respectively. At 1 year, approximately 80% received more than 2 hematologic, hepatic, and renal tests consistent with guidelines. However, only 40% received 1 or more lipid tests. Monitoring was more frequent in specific subgroups, likely reflecting better clinic attendance or clinician perception of higher susceptibility to toxicities.
Ant Societies Buffer Individual-Level Effects of Parasite Infections

Parasites decrease host fitness and can induce changes in host behavior, morphology, and physiology. When parasites exploit social insects, they influence not only infected individuals but also the society as a whole. Workers of the ant Temnothorax nylanderi are an intermediate host for the cestode Anomotaenia brevis. We studied a heavily parasitized population and found that, although parasite infection had strong and diverse consequences for individual workers, colony fitness remained unchanged. At the individual level, we uncovered differences among the three worker types, infected and healthy workers from parasitized colonies and healthy workers from nonparasitized colonies. Infected workers were smaller than healthy ones and had smaller heads as parasite load increased. Behavioral changes extended to all workers from parasitized colonies; such workers were less active than workers in nonparasitized colonies but engaged in more grooming. Healthy workers from parasitized colonies showed behavioral patterns intermediate to those of infected workers and healthy workers from nonparasitized colonies. Despite the lower activity level found in ants from parasitized colonies, an important fitness parameter, per-worker productivity, remained unaltered in parasitized colonies. However, the investment strategies of parasitized colonies changed as their sex ratio became male biased and as male body size increased. In short, ant colonies can buffer the drain of resources by the parasite despite strong effects on individual workers.
Aedes Species in Treeholes and Fruit Husks between Dry and Wet Seasons in Southeastern Senegal

ABSTRACT: During the dry season in February, 2010 and the wet season in September, 2011 we sampled mosquito larvae and eggs from treeholes of seven native hardwood species and the husks of Saba senegalensis in 18 sites in the PK-10 forest in southeastern Senegal. Larvae were reared to adults for species identification. In the dry season, we recovered 408 Aedes mosquitoes belonging to seven species. Aedes aegypti s.l. comprised 42.4% of the collection, followed by Ae. unilineatus (39%). In contrast to reports from East Africa, both Ae. aegypti aegypti and Ae. aegypti formosus were recovered, suggesting that both subspecies survive the dry season in natural larval habitats in West Africa. In the wet season, 455 mosquitoes were collected but 310 (68.1%) were the facultatively predaceous mosquito Eretmapodites chrysogaster. The remaining 145 mosquitoes consisted of ten Aedes species. Aedes aegypti s.l. comprised 55.1% of these, followed by Ae. apicoargenteus (15.2%) and Ae. cozi (11.7%). Similar to East Africa, most (90%) of Ae. aegypti s.l. in the wet season were subspecies formosus.
Senile dementia of lewy body type—a review of clinical and pathological features: Implications for treatment

Lewy body dementia has recently been described as a relatively common cause of progressive cognitive decline in the elderly, characterized by clinical features not typically found in Alzheimer’s disease (AD) or multi-infarct dementia (MID). These include a fluctuating cognitive state, episodes of acute confusion for which no physical cause can be found, prominent hallucinations (often visual), Parkinsonian symptoms, neuroleptic sensitivity (exaggerated adverse reactions to standard doses of neuroleptic medication) and unexplained falls (Byrne et al., 1990; McKeith et al., 1992a,b). These characteristics are associated with the presence of cortical Lewy bodies (LB) at autopsy and the terms ‘cortical Lewy body disease’, ‘diffuse Lewy body disease’ (DLBD) (Dickson et al., 1987) and ‘senile dementia of Lewy body type’ (SDLT) (R. H. Perry et al., 1990) have all been used to describe what are probably different points on a spectrum of LB disease. Although the presence of senile plaques and, to a lesser extent, neurofibrillary tangles has led some to consider SDLT to be a form of Alzheimer-type dementia (the Lewy body variant of Alzheimer’s disease-Hansen et al., 1990; Forstl et al., 1993), it is clear that the clinical features described above can occur in the absence of any Alzheimer-type pathology. It has also been claimed that cortical Lewy bodies may not always be associated with the atypical clinical features listed above, although such cases seem likely to account for only 5 1 0 % of the total of SDLT patients (McKeith et al., 1993). Neuropathologi-
Milk Composition in the Weddell Seal Leptonychotes weddellii: Evidence for a Functional Role of Milk Carbohydrates in Pinnipeds

We propose that secretion of milk sugar has important consequences for the metabolic economies of lactating phocid seals and their pups. Milk was collected from 21 Weddell seals Leptonychotes weddellii in McMurdo Sound, Antarctica, and assayed by standard methods. Milk composition changed over the course of lactation, but at mid- to late lactation (16–40 d postpartum), Weddell seal milk composition was relatively constant at water, fat, crude protein, sugar, ash, and kJ g−1 whole milk (WM). At this stage, milk composition varied among individual seals in all assayed constituents except ash. The concentration of sugar in the aqueous phase of Weddell seal milk ( g sugar L−1 water) was ca. of levels found in terrestrial carnivores, indicating that the low sugar concentration of WM is primarily due to its high fat content, not alteration of the aqueous phase. In early lactation, fasting Weddell seals were estimated to devote 39 g d−1 glucose to milk sugar synthesis, an amount similar to the estimated demand of the maternal brain. This additional glucose demand must be covered by gluconeogenesis in fasting animals and represents a considerable additional drain on maternal resources. However, provision of sugar to offspring at rates sufficient to meet neonatal substrate requirements appears to be essential for efficient fat and protein deposition and thus may be an important component of the phocid reproductive strategy of rapid growth and early weaning.