Miracle-dz/UniFAR-FTUs huggingface dataset:
Changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a New York hospital system, 2006-2012

Summary Introduction National efforts to curtail healthcare-associated infections (HAI) proliferated recently, though data detailing progress over time are limited. This retrospective cohort study aims to describe changes in incidence and antimicrobial susceptibility of HAI in four New York City hospitals over seven years. Methods Electronic data were collected retrospectively for all patients discharged from 2006 through 2012. Previously validated computerized algorithms based on National Healthcare Safety Network criteria detected bloodstream infections, pneumonia, surgical site infections, and urinary tract infections with Enterococcus spp. , Staphylococcus aureus, Streptococcus pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae. Antimicrobial susceptibilities were obtained from electronic laboratory records. Logistic regression was used to assess changes in odds of acquiring an HAI and odds of antimicrobial resistance over time, controlling for age, gender, severity of illness, previous hospitalizations, and admission source. Results In total, 19,052 HAI were identified among 761,426 discharges. HAI rates fell for all organisms, all infection types, and within all hospitals. Odds of acquiring an HAI decreased significantly over time for all organisms. Resistance levels were stable for Enterococcus spp. , S. aureus, A. baumannii, and S. pneumoniae. Multidrug resistance increased for P. aeruginosa and decreased for K. pneumoniae, though imipenem resistance among K. pneumoniae climbed sharply in 2011. Conclusions This study suggests that HAI incidence rates are falling, possibly due to increased federal, state and local attention to healthcare quality and patient safety. Though we found no substantial reductions in resistance, recent national attention towards antimicrobial stewardship may precipitate a change in coming years.
Mechanistic principles underlying regulation of the actin cytoskeleton by phosphoinositides

Significance Membrane phosphoinositides have emerged as key regulators of the actin cytoskeleton in cell migration, morphogenesis, cytokinesis, and endocytosis. However, the molecular mechanisms by which actin-binding proteins (ABPs) interact with phosphoinositide-rich membranes remain remarkably poorly understood. By applying a combination of biochemical, biophysical, and atomistic molecular dynamics simulation approaches on six central ABPs, we discovered that they employ multivalent electrostatic interactions for membrane binding. Strikingly, our experiments revealed that these proteins display enormous differences in their membrane interaction dynamics and in the ranges of phosphoinositide densities that they sense. These differences precisely correlate with the specific functions of these proteins in cytoskeletal dynamics. These findings uncover molecular principles by which membrane phosphoinositides regulate dynamics and architecture of the actin cytoskeleton in cells. The actin cytoskeleton powers membrane deformation during many cellular processes, such as migration, morphogenesis, and endocytosis. Membrane phosphoinositides, especially phosphatidylinositol 4,5-bisphosphate [PI(4,5)P2], regulate the activities of many actin-binding proteins (ABPs), including profilin, cofilin, Dia2, N-WASP, ezrin, and moesin, but the underlying molecular mechanisms have remained elusive. Moreover, because of a lack of available methodology, the dynamics of membrane interactions have not been experimentally determined for any ABP. Here, we applied a combination of biochemical assays, photobleaching/activation approaches, and atomistic molecular dynamics simulations to uncover the molecular principles by which ABPs interact with phosphoinositide-rich membranes. We show that, despite using different domains for lipid binding, these proteins associate with membranes through similar multivalent electrostatic interactions, without specific binding pockets or penetration into the lipid bilayer. Strikingly, our experiments reveal that these proteins display enormous differences in the dynamics of membrane interactions and in the ranges of phosphoinositide densities that they sense. Profilin and cofilin display transient, low-affinity interactions with phosphoinositide-rich membranes, whereas F-actin assembly factors Dia2 and N-WASP reside on phosphoinositide-rich membranes for longer periods to perform their functions. Ezrin and moesin, which link the actin cytoskeleton to the plasma membrane, bind membranes with very high affinity and slow dissociation dynamics. Unlike profilin, cofilin, Dia2, and N-WASP, they do not require high “stimulus-responsive” phosphoinositide density for membrane binding. Moreover, ezrin can limit the lateral diffusion of PI(4,5)P2 along the lipid bilayer. Together, these findings demonstrate that membrane-interaction mechanisms of ABPs evolved to precisely fulfill their specific functions in cytoskeletal dynamics.
Educational Research Mentoring and Coaching as Co-creative Synergy

Mentoring and coaching are rarely clearly defined and there has been a growth of confusion, as both terms tend to develop singular meanings in different professional contexts. In this paper both activities are defined and explored in terms of how they can develop as co-creative synergy where the personal and professional development of both parties results in mutual benefit. Additionally, I explore how mentoring and coaching can be generative. New generations of coaches and mentors can evolve out of pre-existing coaching and mentoring relationships and this has a particular relevance to research at a time where practitioners are encouraged to investigate their work in order to improve.
The W-Beijing Lineage of Mycobacterium tuberculosis Overproduces Triglycerides and Has the DosR Dormancy Regulon Constitutively Upregulated

ABSTRACT The Beijing family of Mycobacterium tuberculosis strains has been associated with epidemic spread and an increased likelihood of developing drug resistance. The characteristics that predispose this family to such clinical outcomes have not been identified, although one potential candidate, the phenolic glycolipid PGL-tb, has been shown to mediate a fulminant lethal disease in mice and rabbits due to lipid-mediated immunosuppression. However, PGL-tb is not uniformly expressed throughout the Beijing lineage and may not be the only unique virulence trait associated with this family. In an attempt to define phenotypes common to all Beijing strains, we interrogated a carefully selected set of isolates representing the five extant lineages of the Beijing family. Comparison of lipid production in this set revealed that all Beijing strains accumulated large quantities of triacylglycerides in in vitro aerobic culture. This accumulation was found to be coincident with upregulation of Rv3130c, whose product was previously characterized as a triacylglyceride synthase. Rv3130c is a member of the DosR-controlled regulon of M. tuberculosis, and further examination revealed that several members of this regulon were upregulated throughout this strain family. The upregulation of the DosR regulon may confer an adaptive advantage for growth in microaerophilic or anaerobic environments encountered by the bacillus during infection and thus may be related to the epidemiological phenomena associated with this important strain lineage.
COHORT PROFILE Cohort Profile : The Consortium of Health-Orientated Research in Transitioning Societies

Human Sciences Research Council and the Birth to Twenty Research Programme, University of the Witwatersrand, South Africa, Universidade Federal de Pelotas, Pelotas, Brazil, Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, S.L. Jain Hospital, New Delhi, India, MRC Lifecourse Epidemiology Unit, University of Southampton, UK, Office of Population Studies, University of San Carlos, Cebu City, Philippines, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA, Birth to Twenty Research Programme and the Department of Paediatrics, University of the Witwatersrand, South Africa, Sitaram Bhartia Institute of Science and Research, New Delhi, India and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Towards Vision-Based Smart Hospitals: A System for Tracking and Monitoring Hand Hygiene Compliance

One in twenty-five patients admitted to a hospital will suffer from a hospital acquired infection. If we can intelligently track healthcare staff, patients, and visitors, we can better understand the sources of such infections. We envision a smart hospital capable of increasing operational efficiency and improving patient care with less spending. In this paper, we propose a non-intrusive vision-based system for tracking people's activity in hospitals. We evaluate our method for the problem of measuring hand hygiene compliance. Empirically, our method outperforms existing solutions such as proximity-based techniques and covert in-person observational studies. We present intuitive, qualitative results that analyze human movement patterns and conduct spatial analytics which convey our method's interpretability. This work is a first step towards a computer-vision based smart hospital and demonstrates promising results for reducing hospital acquired infections.
Subthalamic and Pallidal Deep Brain Stimulation for Parkinson’s Disease

Deep brain stimulation (DBS) is a surgical treatment in which stimulation electrodes are permanently implanted in basal ganglia to treat motor fluctuations and symptoms of Parkinson’s disease (PD). Subthalamic nucleus (STN) and globus pallidus internus (GPi) are the commonly used targets for DBS in PD. Many studies have compared motor and non-motor outcomes of DBS in both targets. However, the selection of PD patients for DBS targets is still poorly studied. Therefore, we performed this narrative review to summarize published studies comparing STN DBS and GPi DBS. GPi DBS is better for patients with problems in speech, mood, or cognition while STN DBS is better from an economic point of view as it allows much reduction in antiparkinson medications and less battery consumption.
Vulnerability for Alcohol Use Disorder and Rate of Alcohol Consumption.

OBJECTIVE Although several risk factors have been identified for alcohol use disorder, many individuals with these factors do not go on to develop the disorder. Identifying early phenotypic differences between vulnerable individuals and healthy control subjects could help identify those at higher risk. Binge drinking, defined as reaching a blood alcohol level of 80 mg%, carries a risk of negative legal and health outcomes and may be an early marker of vulnerability. Using a carefully controlled experimental paradigm, the authors tested the hypothesis that risk factors for alcohol use disorder, including family history of alcoholism, male sex, impulsivity, and low level of response to alcohol, would predict rate of binging during an individual alcohol consumption session. METHOD This cross-sectional study included 159 young social drinkers who completed a laboratory session in which they self-administered alcohol intravenously. Cox proportional hazards models were used to determine whether risk factors for alcohol use disorder were associated with the rate of achieving a binge-level exposure. RESULTS A greater percentage of relatives with alcoholism (hazard ratio: 1.04, 95% CI=1.02-1.07), male sex (hazard ratio: 1.74, 95% CI=1.03-2.93), and higher impulsivity (hazard ratio: 1.17, 95% CI=1.00 to 1.37) were associated with a higher rate of binging throughout the session. Participants with all three risk factors had the highest rate of binging throughout the session compared with the lowest risk group (hazard ratio: 5.27, 95% CI=1.81-15.30). CONCLUSIONS Binge drinking may be an early indicator of vulnerability to alcohol use disorder and should be carefully assessed as part of a thorough clinical evaluation.
Problem-Centered Design and Personal Teaching Style: An exploratory study of Youguang Tu’s course on philosophy of education

Abstract Youguang Tu is a contemporary Chinese philosopher of education. His course on philosophy of education had a significant impact on his students. This exploratory study examines how Tu designed and taught this course. Ultimately, there are two reasons why Tu’s course had such a significant influence on his students. The first is that Tu used problem-centered design to address both central problems of education and specific problems that students encountered. The second is that Tu exhibited a personal teaching style that incorporated elegant handwriting, appropriate analogies, and fierce passion.
Lifetime Analysis of Hospitalizations and Survival of Patients Newly Admitted With Heart Failure

Background—Hospital readmissions for heart failure (HF) contribute to increased morbidity and resource burden. Predictors of hospitalization and patterns of cardiovascular events over the lifetime of patients with HF have not been elucidated. Methods and Results—We examined recurrent hospitalizations, cardiovascular events, and survival among newly discharged (April 1999–March 2001) patients with HF in the Enhanced Feedback For Effective Cardiac Treatment phase 1 study. During 10-year follow-up, we examined all new cardiovascular hospitalizations and selected predictors of readmission. Among 8543 patients (mean age, 77.4±10.5 years; 51.6% women) followed for 22 567 person-years, 60.7% had ischemic etiology, and 67.3% had HF with reduced ejection fraction (left ventricular ejection fraction ⩽45% versus >45% [HF with preserved ejection fraction]). Overall, 10-year mortality was 98.8%, with 35 966 hospital readmissions occurring over the lifetime of the cohort. Adjusted hazards ratios (HRs) for first cardiovascular hospitalization were 1.36 for ischemic HF (95% CI, 1.28–1.44; P<0.001), 1.10 for HF with reduced ejection fraction (95% CI; 1.00–1.20; P=0.045), and 1.00 for men (95% CI, 0.94–1.06; P=0.979). On repeated-events time-to-event analysis, ischemic HF was a predictor of cardiovascular (HR, 1.24; 95% CI, 1.18–1.29), HF (HR, 1.20; 95% CI, 1.13–1.27), and coronary heart disease (HR, 2.01; 95% CI, 1.81–2.24) hospitalizations (all P<0.001). Of all recurrent HF hospitalizations, 26.8% occurred in the first and 39.8% in the last deciles of cohort survival duration. Similarly, 29.7% and 52.3% of all cardiovascular readmissions occurred in the first and last deciles of the cohort survival duration, respectively. Conclusions—Among newly discharged patients with HF, cardiovascular events were clustered at early postdischarge and prefatal time periods, and were increased among those with ischemic etiology.
2016 American College of Rheumatology/European League Against Rheumatism criteria for minimal, moderate, and major clinical response in adult dermatomyositis and polymyositis

To develop response criteria for adult dermatomyositis (DM) and polymyositis (PM). Expert surveys, logistic regression, and conjoint analysis were used to develop 287 definitions using core set measures. Myositis experts rated greater improvement among multiple pairwise scenarios in conjoint analysis surveys, where different levels of improvement in 2 core set measures were presented. The PAPRIKA (Potentially All Pairwise Rankings of All Possible Alternatives) method determined the relative weights of core set measures and conjoint analysis definitions. The performance characteristics of the definitions were evaluated on patient profiles using expert consensus (gold standard) and were validated using data from a clinical trial. The nominal group technique was used to reach consensus. Consensus was reached for a conjoint analysis-based continuous model using absolute per cent change in core set measures (physician, patient, and extramuscular global activity, muscle strength, Health Assessment Questionnaire, and muscle enzyme levels). A total improvement score (range 0–100), determined by summing scores for each core set measure, was based on improvement in and relative weight of each core set measure. Thresholds for minimal, moderate, and major improvement were ≥20, ≥40, and ≥60 points in the total improvement score. The same criteria were chosen for juvenile DM, with different improvement thresholds. Sensitivity and specificity in DM/PM patient cohorts were 85% and 92%, 90% and 96%, and 92% and 98% for minimal, moderate, and major improvement, respectively. Definitions were validated in the clinical trial analysis for differentiating the physician rating of improvement (p<0.001). The response criteria for adult DM/PM consisted of the conjoint analysis model based on absolute per cent change in 6 core set measures, with thresholds for minimal, moderate, and major improvement.
Autonomous indoor exploration of mobile robots based on door-guidance and improved dynamic window approach

A two-layer navigation architecture for autonomous indoor exploration is proposed. As doors in the indoor environments are ubiquitous and informative for navigation, the high-level layer uses a stereo vision based algorithm to detect doors in order to generate a series of goal points. The low-level layer makes the robot avoid obstacles and navigate to the goal points by an improved dynamic window approach (DWA). This approach can solve the local-minima problem of DWA and can obtain smooth motion controls. The combination of high-level door-guidance and low-level goal-directed navigation enables the robot to make a door-to-door exploration. The proposed architecture was implemented on a Pioneer3 robot. Experiments show that the door detection algorithm and the improved DWA work reliably under various environments, and the robot can efficiently fulfill the task of autonomous indoor exploration.
Qualitative Research for Patient Safety Using ICTs: Methodological Considerations in the Technological Age

Considerable effort and resources have been dedicated to improving the quality and safety of patient care through health information systems, but there is still significant scope for improvement. One contributing factor to the lack of progress in patient safety improvement especially where technology has been deployed relates to an over-reliance on purely objective, quantitative, positivist research paradigms as the basis for generating and validating evidence of improvement. This paper argues the need for greater recognition and accommodation of evidence of improvement generated through more subjective, qualitative and pragmatic research paradigms to aid patient safety especially where technology is deployed. This paper discusses how acknowledging the role and value of more subjective ontologies and pragmatist epistemologies can support improvement science research. This paper illustrates some challenges and benefits from adopting qualitative research methods in patient safety improvement projects, particularly focusing challenges in the technological era. While adopting methods that can more readily capture, analyse and interpret direct user experiences, attitudes, insights and behaviours in their contextual settings, patient safety can be enhanced 'on the ground' and errors reduced and/or mitigated, challenges of using these methods with the younger "technologically-centred" healthcare professionals and patients needs to recognised.
Evaluation of diagnostic biomarkers for acute kidney injury in major burn patients

Purpose Acute kidney injury (AKI) in major burn patients is a common complication with high morbidity and mortality. The mainstream treatment is early diagnosis and rapid termination and prevention of the underlying insult. Therefore, it's essential to identify early biomarkers predicting AKI. Methods A total of 85 patients who were admitted to the burn intensive care unit from June 2012 to July 2013 were included in this prospective cohort study. Ten biomarkers (blood urea nitrogen, serum creatinine, urine creatinine, cystatin C, cystatin C glomerular filtration rate, AST, lacate dehydrogenase [LD], creatine kinase, lactic acid, and myoglobin) were obtained at time of admission and evaluated as diagnostic biomarkers to predicting AKI and early AKI. Results Out of 85 patients, 35 patients were dead and overall mortality was 41.2%. The mean age was 49.4 years and mean percentage of total body surface area was 53.2%. Area under the curve (AUC) of receiver operating characteristic curve of biomarkers on predicting AKI were 0.746, 0.718, and 0.717 in LD, lactic acid, and serum creatinine, respectively. AUC of cystatin C predicting AKI was much lower at 0.555. AUC of biomarkers on predicting early AKI were 0.833, 0.816, 0.790, and 0.759 in LD, serum creatinine, AST, and serum myoglobin. Conclusion LD, lactic acid and serum creatinine were acceptable as diagnostic biomarkers of AKI and LD, serum creatinine, AST, and serum myoglobin were reasonable as diagnostic biomarkers of early AKI. However, cystatin C was an unfavorable biomarker in major burn patients.
Diabetes insipidus is an unfavorable prognostic factor for response to glucocorticoids in patients with autoimmune hypophysitis.

INTRODUCTION Autoimmune hypophysitis (AH) has a variable clinical presentation and natural history; likewise, its response to glucocorticoid therapy is often unpredictable. OBJECTIVE To identify clinical and radiological findings associated with response to glucocorticoids. DESIGN AND METHODS 12 consecutive patients with AH, evaluated from 2008 to 2016. AH was the exclusion diagnosis after ruling out other pituitary masses and secondary causes of hypophysitis. Mean follow-up time was 30 ± 27 months (range 12-96 months). RESULTS MRI identified two main patterns of presentation: global enlargement of the pituitary gland or panhypophysitis (n = 4, PH), and pituitary stalk abnormality only, or infundibulo-neuro-hypophysitis (n = 8, INH). Multiple tropin defects were more common in PH (100%) than those in INH (28% P = 0.014), whereas diabetes insipidus was more common in INH (100%) than that in PH (50%; P = 0.028). All 4 PH and 4 out of 8 INH were treated with glucocorticoids. Pituitary volume significantly reduced in all PH patients (P = 0.012), defective anterior pituitary function recovered only in the two patients without diabetes insipidus (50%) and panhypopituitarism persisted, along with diabetes insipidus, in the remaining 2 (50%). In all INH patients, either treated or untreated, pituitary stalk diameter reduced (P = 0.008) but diabetes insipidus persisted in all. CONCLUSIONS Glucocorticoid therapy may improve anterior pituitary function in a subset of patients but has no effect on restoring posterior pituitary function. Diabetes insipidus appears as a negative prognostic factor for response to glucocorticoids.
Cross-Sectional HIV Incidence Estimation in HIV Prevention Research

Abstract:Accurate methods for estimating HIV incidence from cross-sectional samples would have great utility in prevention research. This report describes recent improvements in cross-sectional methods that significantly improve their accuracy. These improvements are based on the use of multiple biomarkers to identify recent HIV infections. These multiassay algorithms (MAAs) use assays in a hierarchical approach for testing that minimizes the effort and cost of incidence estimation. These MAAs do not require mathematical adjustments for accurate estimation of the incidence rates in study populations in the year before sample collection. MAAs provide a practical, accurate, and cost-effective approach for cross-sectional HIV incidence estimation that can be used for HIV prevention research and global epidemic monitoring.