Miracle-dz/UniFAR-FTUs huggingface dataset:
Sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays or HIV RNA tests

Objective:Determine the sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays (EIA) or nucleic acid amplification tests (NAAT) in clinical settings. Design:Systematic review and meta-analysis. Methods:Medline, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane reviews and Cumulative Index to Nursing and Allied Health Literature were searched until 14 July 2015 for studies of adults comparing point-of-care HIV rapid tests to fourth-generation HIV EIA antibody/p24 antigen or HIV NAAT. Results:From 953 titles, 18 studies were included, involving 110 122 HIV rapid test results. Compared with EIA, the estimated sensitivity (random effects) of HIV rapid tests was 94.5% [95% confidence interval (CI): 87.4–97.7]. Compared with NAAT, the sensitivity of HIV rapid tests was 93.7% (95% CI: 88.7–96.5). The sensitivity of HIV rapid tests in high-income countries was 85.7% (95% CI: 81.9–88.9) and in low-income countries was 97.7% (95% CI: 95.2–98.9) compared with either EIA or NAAT (P < 0.01 for difference between settings). Proportions of antibody negative acute infections were 13.6 (95% CI: 10.1–18.0) and 4.7% (95% CI: 2.8–7.7) in studies from high-income and low-income countries, respectively (P < 0.01). Conclusion:In clinical settings, HIV rapid tests were less sensitive in high-income countries compared with low-income countries, missing about one in seven infections, possibly because of the larger proportion of acute infections in targeted populations. This suggests that in high-income countries, HIV rapid tests should be used in combination with fourth-generation EIA or NAAT tests, except in special circumstances. Prospective Registration of Systematic Reviews registration number CRD42015020154.Supplementary video link: http://links.lww. com/QAD/A924
Electronic patient records: the view from maternity

The Government has made the development and implementation of electronic patient records (EPRs) central to its strategy for a new, modernised NHS. EPRs are intended to improve the organization and communication of clinical information, reduce duplication, and lead to increased patient involvement in the management of both their health record and their care. The results from this survey of maternity units in England and Wales have enabled the authors to make a preliminary assessment of how far the maternity services are prepared for such developments and how likely they are to accept them. The first of three articles, will report on how current record-keeping practices in maternity, and the legacy of existing maternity information systems are all likely to present considerable challenges for the policy and implementation of EPRs.
Early evolution of human leucocyte antigen-associated escape mutations in variable Gag proteins predicts CD4+ decline in HIV-1 subtype C-infected women

Objective: HIV-1 escape from cytotoxic T-lymphocytes results in the accumulation of human leucocyte antigen (HLA)-associated mutations in the viral genome. To understand the contribution of early escape to disease progression, this study investigated the evolution and pathogenic implications of cytotoxic T-lymphocyte escape in a cohort followed from infection for 5 years. Methods: Viral loads and CD4+ cell counts were monitored in 78 subtype C-infected individuals from onset of infection until CD4+ cell count decline to less than 350 cells/&mgr;l or 5 years postinfection. The gag gene was sequenced and HLA-associated changes between enrolment and 12 months postinfection were mapped. Results: HLA-associated escape mutations were identified in 48 (62%) of the participants and were associated with CD4+ decline to less than 350 cells/&mgr;l (P = 0.05). Escape mutations in variable Gag proteins (p17 and p7p6) had a greater impact on disease progression than escape in more conserved regions (p24) (P = 0.03). The association between HLA-associated escape mutations and CD4+ decline was independent of protective HLA allele (B*57, B*58 : 01 and B*81) expression. Conclusion: The high frequency of escape contributed to rapid disease progression in this cohort. Although HLA-adaption in both conserved and variable Gag domains in the first year of infection was detrimental to long-term clinical outcome, escape in variable domains had greater impact.
Isolated Abducens Nerve Palsy in Multiple Myeloma With Hyperviscosity of the Serum

A 40-year-old woman without contributory medical history was diagnosed as having IgA type multiple myeloma, based on the immunological and pathological investigation. Blood pathology demonstrated the rouleaux formation . Then, sudden onset of left-sided complete abducens nerve palsy (6NP) without pain was preceded to initiation of chemotherapy. Cranial and orbital magnetic resonance imaging, and cerebrospinal fluid examination demonstrated no abnormalities. Under chemotherapy, 6NP was resolved within 5 weeks. This is a first reported case of multiple myeloma presenting with 6NP without intracranial lesion. We speculated that 6NP might be caused by peripheral ischemia due to hyperviscosity of the serum. doi: http://dx.doi. org/10.4021/jmc855w
Long-term nitrite inhalant exposure and cancer risk in MSM

Objectives: Nitrite inhalants (poppers) are commonly used recreational drugs among MSM and were previously associated with elevated rates of high-risk sexual behavior, HIV and human herpesvirus type 8 (HHV-8) seroconversion, and transient immunosuppressive effects in experimental models. Whether long-term popper use is associated with cancer risk among MSM in the HAART era is unclear. Design: Prospective cohort study of cancer risk in 3223 HIV-infected and uninfected MSM in the Multicenter AIDS Cohort Study from 1996–2010. Methods: Poisson regression models were used to examine the association between heavy popper use (defined as daily or weekly use for at least 1 year) and risk of individual cancers or composite category of virus-associated cancers. Results: Among all participants, heavy popper use was not associated with increased risk of any individual cancers. Among HIV-uninfected men aged 50–70, heavy popper use was associated with increased risk of virus-associated cancer with causes linked to human papillomavirus, HHV-8, and Epstein–Barr virus in models adjusted for demographics, number of sexual partners, immunological parameters (CD4+ cell counts or CD4+/CD8+ ratios), and hepatitis B and C viruses [incidence rate ratio (IRR), 95% confidence interval (CI) 3.24, 1.05–9.96], or sexually transmitted infections (IRR 3.03, 95% CI, 1.01–9.09), as was cumulative use over a 5-year period (IRR 1.012, 95% CI 1.003–1.021; P = 0.007). There was no significant association between heavy popper use and virus-associated cancer in HIV-infected men. Conclusions: Long-term heavy popper use is associated with elevated risk of some virus-associated cancers with causes related to human papillomavirus, HHV-8, and Epstein–Barr virus infections in older HIV-uninfected MSM independent of sexual behavior and immunological parameters.
Is Bergmann’s Rule Valid for Mammals?

Bergmann’s rule states that, within species of mammals, individuals tend to be larger in cooler environments. However, the validity of the rule has been debated. We examined the relationship between size and latitude as well as size and temperature within various species of mammals. We also tested the idea that smaller mammals follow Bergmann’s rule more strongly than larger mammals, as expected if heat conservation is the cause of the rule. When all studies were included, the percentage of species showing a positive correlation between size and latitude was significantly >50% (78 of 110 species). Similarly, the percentage of species showing a negative correlation between size and temperature was significantly >50% (48 of 64). Analyses using only significant studies or only studies that sampled extensively also support Bergmann’s rule. The size‐latitude and size‐temperature trends were consistent within all orders and most families for which data are available. We did not find support for the hypothesis that smaller mammals conform more strongly to Bergmann’s rule than larger mammals. Thus, we found broad support for Bergmann’s rule as a general trend for mammals; however, our analyses do not support heat conservation as the explanation.
Dextrocardia and Situs Inversus Totalis in a Nigerian Cadaver: A Case Report of Rare Anomaly

Este reporte describe a un cadaver adulto nigeriano de sexo masculino con dextrocardia y situs inversus totalis. Las ilustraciones fotograficas revelaron transposicion de algunas de las visceras, como el estomago y el bazo que se encuentra en el derecho y el higado y la vesicula biliar a la izquierda. Ademas, el pulmon izquierdo era tri-lobulado, mientras que el derecho uni-lobulado. El corazon fue aplanado y situado a la derecha, por consiguiente, transposicionando los grandes vasos. El reporte demostro que la dextrocardia y el situs inversus existen entre los nigerianos y, posiblemente, los africanos, por tanto, se recomienda un temprano examen medico, ya que pacientes con esta condicion no son conscientes de su inusual anatomia hasta que acuden al medico por atencion por una condicion no relacionada. La deteccion temprana puede conducir a un exito quirurgico y, en consecuencia, ofrecer una segura oportunidad de sobrevivir.
Why HOC+ Is Detectable in Interstellar Clouds: The Rate of the Reaction between HOC+ and H2

The recent confirmation by Ziurys and Apponi of the detection of HOC+ toward Sgr B2 (OH), and their identification of the ion in Orion-KL and several other sources show that HOC+ is far more abundant than predicted by previous ion-molecule models. In these models, the reaction HOC+ + H2 → HCO+ + H2 is assumed to rapidly destroy HOC+, based on the results of a prior calculation. We have recalculated the rate of this reaction as a function of temperature using a new ab initio potential surface and a phase space approach to the dynamics which includes tunneling. The newly calculated rate is small (≤1 × 10-10 cm3 s-1) at temperatures under 100 K.
Image segmentation applied to CT examination of lymphangioleiomyomatosis

The purpose of this study is to use modern image segmentation techniques to quantitate cyst area and number within a complete CT examination of the lungs. Lymphangioleiomyomatosis (LAM) was chosen because this disease produces many well defined thin- walled cysts of varying sizes throughout the lungs that provide a good test for 2D image segmentation techniques, which are used to separate LAM cysts from the normal lung tissue. Quantitative measures of the lung, such as cyst area versus frequency, are then automatically extracted. Three women with LAM were examined using CT slices obtained at 20 mm intervals, with 1 to 1.5 mm collimation, and a pixel size of 0.4 - 0.5 mm. Our segmentation algorithm operates in several stages. First, masks for each lung are automatically generated, thus allowing only lung pixels to be considered for the cyst segmentation. Next, we threshold the data under the masks at a level of -900 Hounsfield units. The threshold segments LAM cysts from normal lung tissue and other structures, such as pulmonary veins and arteries. In order to determine the size of individual cysts, we grow all regions having brightness values lower than the threshold within the masked regions. These regions, which correspond to cysts, are then sorted by size, and a cyst histogram for each patient is computed.
Effects of whole-body vibration exercise on human bone density – systematic review

Abstract Objectives: The effects of whole-body vibration exercise (WBVE) on human bone density are systematically reviewed. Methods: Several databases, PubMed, Cinahl, Embase and Pedro were searched and papers graded according to the Pedro scale. The grey literature was also evaluated and added to the review. Two independent reviewers evaluated the quality of the studies and evidence for an effect. Results: Eight of the nine included studies showed positive effects for WBVE on bone density in the lower half of the body particularly in post-menopausal women. Discussion/Conclusion: Because the overall strength of evidence was considered moderate, several clinical questions still need to be addressed. Existing studies, however, suggest that WBVE may be a promising training modality.
The Effects of Calcium and Vitamin D Supplementation on Blood Glucose and Markers of Inflammation in Nondiabetic Adults

OBJECTIVE We sought to compare the effects of combined calcium and vitamin D supplementation versus placebo on blood glucose and markers of inflammation in nondiabetic adults aged > or =65 years. RESEARCH DESIGN AND METHODS A total of 314 Caucasian adults without diabetes received either 500 mg calcium citrate and 700 IU vitamin D(3) or placebos daily for 3 years in a double-blind, randomized, controlled trial designed for bone-related outcomes. In a post hoc analysis, fasting plasma glucose (FPG), insulin sensitivity (estimated by homeostasis model assessment of insulin resistance [HOMA-IR]), plasma C-reactive protein, and interleukin-6, were measured at baseline and 3 years. RESULTS The effects of combined calcium-vitamin D supplementation on 3-year change in FPG depended on baseline FPG (P = 0.02 for interaction). Therefore, we conducted analyses separately in participants with normal fasting glucose (NFG) (FPG <5.6 mmol/l, n = 222) and impaired fasting glucose (IFG) (FPG 5.6-6.9 mmol/l, n = 92) at baseline. Among participants with IFG at baseline, those who took combined calcium-vitamin D supplements had a lower rise in FPG at 3 years compared with those on placebo (0.02 mmol/l [0.4 mg/dl] vs. 0.34 mmol/l [6.1 mg/dl], respectively, P = 0.042) and a lower increase in HOMA-IR (0.05 vs. 0.91, P = 0.031). In the NFG subgroup, there was no difference in the change in FPG or HOMA-IR between the two treatment arms. There were no differences in C-reactive protein or interleukin-6 between the two treatment arms in either subgroup. CONCLUSIONS In healthy, older adults with IFG, supplementation with calcium and vitamin D may attenuate increases in glycemia and insulin resistance that occur over time. However, our findings should be considered hypothesis generating and need to be confirmed in randomized trials specifically designed for the outcomes of interest.
Minimally invasive and simultaneous removal of herniated intracanal and extracanal lumbar nucleus pulposus with a percutaneous spinal endoscope

Herniated nucleus pulposus (HNP) in the lumbar spine is usually found in the neural canal (in the intracanal space) and occasionally in the extracanal space, where it is known as a lateral HNP. HNP is rarely found simultaneously in both spaces. However, we experienced such a case in a 48‐year‐old man who presented with right leg pain and lower back pain that had lasted for more than a year. MRI revealed HNP in both the right intracanal and extracanal spaces at L2‐L3. A transforaminal approach was used to complete a percutaneous endoscopic discectomy. An 8‐mm incision was made with the patient under local anesthesia, and the percutaneous endoscope was inserted at the affected disc space. First, the HNP fragments in the intracanal space were removed, and then the cannula and endoscope were extracted to the extracanal space where the extracanal fragments were removed. Two hours after the surgery, the patient stood and walked. Right leg pain and lower back pain had disappeared. Unlike other techniques such as Love's procedure and the microendoscopic discectomy technique, the use of a transforaminal approach with the percutaneous endoscopic technique enables the HNP fragments in the intracanal and extracanal spaces to be removed at the same time with a single approach.
Effect of a very low‐energy diet on moderate and severe obstructive sleep apnoea: case reports

In this article, we report two cases from our study in which we investigated the effect of a very low‐energy diet (VLED) for 9 weeks followed by a weight maintenance program for a total duration of 1 year in obese men with moderate to severe obstructive sleep apnea. The first case was a 43‐year‐old man with a body weight of 126 kg and a body mass index (BMI) of 38.8 kg/m2 at baseline. Over the 1‐year treatment program he lost 26% of his initial weight and his apnea‐hypopnea index (AHI) was improved by 60%. The second case was at baseline a 54‐year‐old man with a weight of 87 kg and BMI of 32.1 kg/m2. Over the 1‐year treatment program he lost 10% of his initial weight and his AHI improved by 66%. In summary, treatment with a VLED followed by a weight maintenance program significantly improved obstructive sleep apnea in both cases.
2. An Autopsy Case of Sudden Death in a Boy with Primary Pulmonary Hypertension

We report a rare autopsy case of sudden death due to primary pulmonary hypertension. A seven-year-old boy, who had been diagnosed with primary pulmonary hypertension at the age of four years, died suddenly. Forensic autopsy and histopathologic examination revealed extensive obstruction of small muscular pulmonary arteries by plexiform lesions and concentric intimal thickenings, compatible with primary pulmonary hypertension. We concluded that plexiform lesions of pulmonary arteries produced right ventricular hypertrophy and dilatation, decreased the preload of the left ventricle and subsequently led to biventricular failure. This autopsy and histopathologic examination suggested a possible pathophysiologic mechanism of sudden death due to primary pulmonary hypertension in a child.
Bayesian Analysis of Correlated Evolution of Discrete Characters by Reversible‐Jump Markov Chain Monte Carlo

We describe a Bayesian method for investigating correlated evolution of discrete binary traits on phylogenetic trees. The method fits a continuous‐time Markov model to a pair of traits, seeking the best fitting models that describe their joint evolution on a phylogeny. We employ the methodology of reversible‐jump (RJ) Markov chain Monte Carlo to search among the large number of possible models, some of which conform to independent evolution of the two traits, others to correlated evolution. The RJ Markov chain visits these models in proportion to their posterior probabilities, thereby directly estimating the support for the hypothesis of correlated evolution. In addition, the RJ Markov chain simultaneously estimates the posterior distributions of the rate parameters of the model of trait evolution. These posterior distributions can be used to test among alternative evolutionary scenarios to explain the observed data. All results are integrated over a sample of phylogenetic trees to account for phylogenetic uncertainty. We implement the method in a program called RJ Discrete and illustrate it by analyzing the question of whether mating system and advertisement of estrus by females have coevolved in the Old World monkeys and great apes.
The detection of EGFR mutation status in plasma is reproducible and can dynamically predict the efficacy of EGFR‐TKI

Background: The validity of epidermal growth factor receptor (EGFR) mutation in serum and plasma DNA as a surrogate of tumor tissue has been comprehensively explored. However, the concordance between peripheral blood and tumor tissue samples in EGFR mutation detection remains variable. The question as to whether real‐time samples for EGFR mutation analysis are required before epidermal growth factor receptor tyrosine kinase inhibitor (EGFR‐TKI) therapy remains unanswered.
From affected to infected? Orphanhood and HIV risk among female adolescents in urban Zimbabwe

Background:Despite the 15 million children orphaned by AIDS, and fears of sexual vulnerability, little is known about the link between orphanhood and HIV risk. Methods:A random sample of 1283 15 to 19-year-old girls in a high-density suburb of Harare was identified in a cross-sectional survey in 2004. A total of 863 agreed to be interviewed and 839 provided a specimen for HIV and herpes simplex virus type-2 (HSV-2) testing. Sexual health outcomes, sexual behaviours and marriage were assessed by type and timing of orphanhood. Results:Half of the participants were single or double orphans. Prevalence of HIV and/or HSV-2 was higher among orphans than non-orphans [17 versus 12%; age-adjusted odds ratio (aOR) = 1.5; 95% confidence interval (CI) 1.0–2.3]. Associations with orphan status were only significant among the 743 never-married participants. In comparison with non-orphaned peers, increased sexual risk (defined as HSV2-positive, HIV-positive or ever pregnant) was seen among maternal orphans (aOR = 3.6; 95% CI, 1.7–7.8), double orphans (aOR = 2.4; 95% CI, 1.2–4.9), and girls who lost their father before age 12 (aOR = 2.1; 95% CI, 0.9–4.8) but not later (aOR = 0.8; 95% CI, 0.3–2.2). Maternal and double orphans were most likely to initiate sex early and to have had multiple partners. Maternal orphans were least likely to have used a condom at first sex, and to have a regular sexual partner. Experience of forced sex was high in all groups. Conclusions:In urban Zimbabwe, female adolescent orphans are at increased risk of HIV and HSV-2 infection. Infection rates vary by type and age of orphanhood, and marital status, and are associated with high-risk sexual behaviours.
Experimental Evidence That Selection Favors Character Displacement in the Ivyleaf Morning Glory

While there is abundant evidence to suggest that pollinators influence the evolution of plant floral traits, there is little direct evidence that interactions between plant species shape the evolution of such characteristics. The purpose of this study was to determine whether the presence of the morning glory Ipomoea purpurea alters patterns of selection on floral traits of its congener, Ipomoea hederacea. We show that while selection on I. hederacea floral traits is effectively neutral when I. purpurea flowers are absent, selection acts to increase clustering of anthers about the stigma when I. purpurea flowers are present. Our results provide direct experimental evidence that the presence of flowers of a co‐occurring congener can influence patterns of natural selection on floral traits that influence the mating system and contribute to prezygotic isolation. To the extent that this result is general, it also lends support to the claim that distributional patterns interpreted as ecological and reproductive character displacement in other plant species have been caused by natural selection generated by interactions among plant species.
Major histocompatibility complex class I cytotoxic T lymphocyte immunity to human metapneumovirus (hMPV) in individuals with previous hMPV infection and respiratory disease.

Recently identified human metapneumovirus (hMPV) is an important respiratory pathogen in children and adults worldwide. Little is known about cytotoxic T lymphocyte (CTL) responses that may control hMPV infection in humans. To address this, we evaluated major histocompatibility complex (MHC) class I T cell immunity in 7 patients with previous hMPV respiratory disease. CTL responses were evident in most patients and to most proteins of hMPV. Individual patients had responses to at least 2 hMPV proteins (particularly the M protein) and had multiallele responses. In addition, we identified 9 CTL epitopes that are presented by human leukocyte antigen alleles of the most common MHC "supertypes. " Many of these CTL epitopes are conserved across hMPV types, and there is epitope similarity between hMPV and human respiratory syncytial virus. This study provides the first report of MHC class I T cell immunity to hMPV in humans. These findings have significance for understanding cellular immunity to hMPV infection and for future vaccine development.