Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of a Novel Antimicrobial Surface Coating on Healthcare-Associated Infections and Environmental Bioburden at Two Urban Hospitals.

BACKGROUND Approximately 1 in 25 people admitted to a hospital in the United States will suffer a healthcare-associated infection (HAI). Environmental contamination of hospital surfaces contributes to HAI transmission. We investigated the impact of an antimicrobial surface coating on HAIs and environmental bioburden at two urban hospitals. METHODS A transparent antimicrobial surface coating was applied to patient rooms and common areas in three units at each hospital. Longitudinal regression models were used to compare changes in hospital-onset multidrug-resistant organism bloodstream infection (MDRO-BSI) and Clostridium difficile infection (CDI) rates in the 12 months before and after application of the surface coating. Incidence rate ratios (IRRs) were compared for units receiving the surface coating application and for contemporaneous control units. Environmental samples were collected pre- and post-application to identify bacterial colony forming units (CFU) and percent of sites positive for select clinically relevant pathogens. RESULTS Across both hospitals, there was a 36% decline in pooled HAIs (MDRO-BSI + CDI) in units receiving surface coating application (IRR=0.64, 95% CI=0.44-0.91), and no decline in control units (IRR=1.20, 95% CI=0.92-1.55). Following the surface application, total bacterial CFU at Hospitals A and B declined by 64% and 75%, respectively; the percentage of environmental samples positive for clinically relevant pathogens also declined significantly for both hospitals. CONCLUSIONS Statistically significant reductions in HAIs and environmental bioburden occurred in units receiving the antimicrobial surface coating, suggesting the potential for improved patient outcomes and persistent reduction in environmental contamination. Future studies should assess optimal implementation methods and long-term impact.
Detection and genetic characterization of Echinococcus granulosus mitochondrial DNA in serum and formalin-fixed paraffin embedded cyst tissue samples of cystic echinococcosis patients

Cystic echinococcosis (CE) is a worldwide zoonotic disease caused by the larval stage of Echinococcus granulosus. We investigated the presence of E. granulosus-specific DNA in the serum of CE patients by detecting the cytochrome c oxidase I (cox1) and NADH dehydrogenase subunit I (nad1) mitochondrial genes. Serum and formalin-fixed paraffin embedded (FFPE) cyst tissue samples of 80 CE patients were analyzed. The extracted DNA of samples was submitted to PCR amplification of cox1 and nad1 genes, and products were sequenced and genotyped. Nineteen (23.8%; 95% CI 15.8–34.1) serum and 78 (97.5%; 95% CI 91.3–99.3) FFPE cyst tissue samples were successfully amplified with at least one gene. Echinococcus DNA was detected in the sera of 15.0% (95% CI: 8.8–24.4) and 10.0% (95% CI: 5.2–18.5) and in cyst tissue of 91.3% (95% CI: 83.0–95.7) and 83.8% (95% CI: 74.2–90.3) of 80 patients by cox1 and nad1 gene, respectively. Four genotypes of E. granulosus were distinguished in the CE patients, with predominance of genotype G1, followed by G3, G2, and G6. The finding of E. granulosus DNA in 23.8% of serum samples from CE patients confirmed that E. granulosus releases cell-free DNA into the circulatory system, but quantities may be inadequate for the diagnosis of CE. Genotype G1 predominance suggests the sheep-dog cycle as the primary route of human infection.
Comparison of Mitochondrial Superoxide Detection Ex Vivo/In Vivo by mitoSOX HPLC Method with Classical Assays in Three Different Animal Models of Oxidative Stress

Background: Reactive oxygen and nitrogen species (RONS such as H2O2, nitric oxide) are generated within the organism. Whereas physiological formation rates confer redox regulation of essential cellular functions and provide the basis for adaptive stress responses, their excessive formation contributes to impaired cellular function or even cell death, organ dysfunction and severe disease phenotypes of the entire organism. Therefore, quantification of RONS formation and knowledge of their tissue/cell/compartment-specific distribution is of great biological and clinical importance. Methods: Here, we used a high-performance/pressure liquid chromatography (HPLC) assay to quantify the superoxide-specific oxidation product of the mitochondria-targeted fluorescence dye triphenylphosphonium-linked hydroethidium (mitoSOX) in biochemical systems and three animal models with established oxidative stress. Type 1 diabetes (single injection of streptozotocin), hypertension (infusion of angiotensin-II for 7 days) and nitrate tolerance (infusion of nitroglycerin for 4 days) was induced in male Wistar rats. Results: The usefulness of mitoSOX/HPLC for quantification of mitochondrial superoxide was confirmed by xanthine oxidase activity as well as isolated stimulated rat heart mitochondria in the presence or absence of superoxide scavengers. Vascular function was assessed by isometric tension methodology and was impaired in the rat models of oxidative stress. Vascular dysfunction correlated with increased mitoSOX oxidation but also classical RONS detection assays as well as typical markers of oxidative stress. Conclusion: mitoSOX/HPLC represents a valid method for detection of mitochondrial superoxide formation in tissues of different animal disease models and correlates well with functional parameters and other markers of oxidative stress.
Early Recognition of Behaviour Problems in Shelter Dogs by Monitoring them in their Kennels after Admission to a Shelter

Simple Summary Canine behaviour assessments are commonly used in shelters to identify behaviour problems in dogs prior to adoption. The aim of this study was to evaluate whether kennel monitoring of dogs could identify early signs of behaviour problems. Kennel behaviour was monitored for 38 dogs in their first five days in kennels at a shelter in Brisbane, Australia. This was compared to a formal assessment of exploratory, handling, play, run/freeze, and food guarding behaviour, as well as stranger and fake toddler interactions, and behaviour when the dog was alone, conducted five days after shelter admission. Kennel behaviours associated with fear, anxiety, and arousal in dogs were significantly correlated with the same behaviours in the formal assessment. With respect to outcomes, dogs that displayed more whining, tense body posture, standing leaning forward, panting, ears forward, less barking, lowered body and balanced/relaxed body posture, standing still, and standing by the wall had increased odds of failing the behaviour assessment. The study demonstrates that monitoring kennel behaviour could detect early signs of behaviour problems. Abstract Canine behaviour assessments are commonly used in shelters to identify behaviour problems in dogs prior to adoption. The aim of this study was to evaluate whether kennel monitoring of dogs could identify early signs of behaviour problems, thereby facilitating early intervention and better management of dogs displaying behaviour problems. Kennel behaviour was monitored for dogs (n = 38) in their first five days in kennels at a shelter in Brisbane, Australia. This was compared to a formal assessment of exploratory, handling, play, run/freeze, and food guarding behaviour, as well as stranger and fake toddler interactions, and behaviour when the dog was alone, conducted five days after shelter admission. Kennel behaviours associated with fear, anxiety, and arousal in dogs were significantly correlated with the same behaviours in the formal assessment. Positional correlations were also evident. With respect to outcomes, dogs that displayed more whining, tense body posture, standing leaning forward, panting, ears forward, less barking, lowered body and balanced/relaxed body posture, standing still, and standing by the wall had increased odds of failing the behaviour assessment. Over the five days in the kennel, the frequency and duration of fear-related behaviours decreased, suggesting a reduction in arousal as the dog became accustomed to the shelter environment. The study demonstrates that monitoring kennel behaviour could detect early signs of behaviour problems.
Micromonas micros: A rare anaerobic cause of late implant failure following spinal surgery

Context: Delayed, postoperative, spine infections are rare, most commonly occurring secondary to fastidious, less virulent pathogens. The etiology may involve a distant infectious focus, not related to the index operation. Patients may present months, or even years postoperatively with pain related to mechanical implant failure, often without additional signs of systemic infection. Findings: We present the case of a 59-year-old male who developed rapid disk degeneration and implant failure seven months following instrumented lumbar fusion surgery. The causal organism was found to be Micromonas micros, an anaerobic bacterium typically located in the oral cavity and associated with periodontal disease. The patient was found to have extensive oral caries, which were presumed to have occurred secondary to poor oral hygiene and his use of fentanyl lozenges for chronic back pain. The patient was treated with revision staged spinal surgery and long-term intravenous antibiotics. Conclusion/clinical relevance: This case highlights an unusual etiology of delayed postoperative spinal implant failure and provides evidence for periodontal disease as a source of hematogenous seeding in postoperative spinal infections. The orthopaedist should also be aware of the potential relationship between poor oral hygiene and the use of high sugar content fentanyl lozenges in treating chronic back pain in these patients.
Spatially resolved electrical impedance methods for cell and particle characterization

Electrical impedance is an established technique used for cell and particle characterization. The temporal and spectral resolution of electrical impedance have been used to resolve basic cell characteristics like size and type, as well as to determine cell viability and activity. Such electrical impedance measurements are typically performed across the entire sample volume and can only provide an overall indication concerning the properties and state of that sample. For the study of heterogeneous structures such as cell layers, biological tissue, or polydisperse particle mixtures, an overall measured impedance value can only provide limited information and can lead to data misinterpretation. For the investigation of localized sample properties in complex heterogeneous structures/mixtures, the addition of spatial resolution to impedance measurements is necessary. Several spatially resolved impedance measurement techniques have been developed and applied to cell and particle research, including electrical impedance tomography, scanning electrochemical microscopy, and microelectrode arrays. This review provides an overview of spatially resolved impedance measurement methods and assesses their applicability for cell and particle characterization.
El sistema de neurotransmisión hipocretinérgico/orexinérgico en la regulación de los estados de vigilia y sueño

Introduccion. Las hipocretinas/orexinas son neuropeptidos sintetizados por un pequeno grupo neuronal localizado en el hipotalamo posterolateral. Desde el momento de su descubrimiento se relacionaron, entre otras funciones, con el ciclo vigilia-sueno. Concretamente, el sistema hipocretinergico/orexinergico muestra una gran actividad durante la vigilia; ademas, la deficiencia total o parcial de estos peptidos o de sus receptores se asocia al sindrome de narcolepsia-cataplejia, que cursa con un trastorno generalizado del ciclo vigilia-sueno. Desarrollo. Las neuronas hipocretinergicas/orexinergicas: a) activan directamente la corteza cerebral; b) activan grupos neuronales noradrenergicos, serotoninergicos, dopaminergicos, colinergicos e histaminergicos que constituyen parte del sistema reticular ascendente de activacion, y a traves de este sistema, tambien pueden indirectamente producir activacion cortical y aumento del estado de vigilia; y c) inhiben la generacion de sueno REM en el tegmento pontino ventral. Durante el sueno, las neuronas hipocretinergicas/orexinergicas disminuyen su actividad y, en consecuencia, la de estos nucleos aminergicos y colinergicos del sistema reticular activador ascendente, favoreciendo una disminucion en la activacion cortical y la liberacion de la genesis de sueno REM en el tegmento pontino ventral. Conclusiones. Las hipocretinas/orexinas regulan el mantenimiento de la vigilia y la activacion del electroencefalograma, en parte a traves de la inervacion de neuronas reticulares de proyeccion cortical, y suprimen la aparicion de sueno REM mediante la inhibicion del tegmento pontino ventral. La hipoactividad de este sistema en la narcolepsia explicaria la desorganizacion y fragmentacion del sueno, asi como la intrusion de episodios de sueno REM en la vigilia.
Evaluation of Retinal Pigment Epithelium and Choroidal Neovascularization in Rats Using Laser-Scanning Optical-Resolution Photoacoustic Microscopy

Purpose: To demonstrate the value of the laser-scanning optical-resolution (LSOR)-photoacoustic (PA) microscopy (PAM) system and the conventional multimodal imaging techniques in the evaluation of laser-induced retinal injury and choroidal neovascularization (CNV) in rats. Methods: Different degrees of retinal injury were induced using laser photocoagulation. We compared the LSOR-PAM system with conventional imaging techniques in evaluating retinal injury with or without CNV. Six additional rats, treated with an anti-VEGF antibody or immunoglobulin G immediately after photocoagulation, were imaged 7 and 14 days after injection, and CNV lesion areas were compared. Results: In the retinal injury model, fundus autofluorescence showed well-defined hyperreflection, while the lesion displayed abundant PA signals demonstrating nonuniform melanin distribution in retinal pigment epithelium (RPE). RPE was detected with higher contrast in the PAM B-scan image than optical coherence tomography (OCT). Additionally, the CNV lesion was present with multiple PA signal intensities which distinctly characterized the location and area of CNV as found in fundus fluorescein angiography. Furthermore, the decreased PA signals extending from the CNV lesion were similar to those of the vascular bud in ex vivo imaging, which was invisible in other in vivo images. When treated with anti-VEGF agents, statistically significant differences can be demonstrated by PAM similar to other modalities. Conclusions: LSOR-PAM can detect the melanin distribution of RPE in laser-induced retinal injury and CNV in rats. PAM imaging provides a potential new tool to evaluate the vitality and functionality of RPE in vivo as well as to monitor the development and treatment of CNV.
Differential epigenetic factors in the prediction of cardiovascular risk in diabetic patients

Abstract Hyperglycaemia can strongly alter the epigenetic signatures in many types of human vascular cells providing persistent perturbations of protein–protein interactions both in micro- and macro-domains. The establishment of these epigenetic changes may precede cardiovascular (CV) complications and help us to predict vascular lesions in diabetic patients. Importantly, these epigenetic marks may be transmitted across several generations (transgenerational effect) and increase the individual risk of disease. Aberrant DNA methylation and imbalance of histone modifications, mainly acetylation and methylation of H3, represent key determinants of vascular lesions and, thus, putative useful biomarkers for prevention and diagnosis of CV risk in diabetics. Moreover, a differential expression of some micro-RNAs (miRNAs), mainly miR-126, may be a useful prognostic biomarker for atherosclerosis development in asymptomatic subjects. Recently, also environmental-induced chemical perturbations in mRNA (epitranscriptome), mainly the N6-methyladenosine, have been associated with obesity and diabetes. Importantly, reversal of epigenetic changes by modulation of lifestyle and use of metformin, statins, fenofibrate, and apabetalone may offer useful therapeutic options to prevent or delay CV events in diabetics increasing the opportunity for personalized therapy. Network medicine is a promising molecular-bioinformatic approach to identify the signalling pathways underlying the pathogenesis of CV lesions in diabetic patients. Moreover, machine learning tools combined with tomography are advancing the individualized assessment of CV risk in these patients. We remark the need for combining epigenetics and advanced bioinformatic platforms to improve the prediction of vascular lesions in diabetics increasing the opportunity for CV precision medicine.
Management and outcome of muscle-invasive bladder cancer with clinical lymph node metastases. A nationwide population-based study in the bladder cancer data base Sweden (BladderBaSe)

Abstract Purpose: To investigate the clinical management and outcome of patients with muscle-invasive bladder cancer with clinical lymph node involvement, using longitudinal nationwide population-based data. Methods: In the Bladder Cancer Data Base Sweden (BladderBaSe), treatment and survival in patients with urinary bladder cancer clinical stage T2–T4 N + M0 diagnosed between 1997 and 2014 was investigated. Patients´ characteristics were studied in relation to TNM classification, curative or palliative treatment, cancer-specific (CSS) and overall survival (OS). Age at diagnosis was categorised as ≤60, 61–70, 71–80 and >80 years, and time periods were stratified as follows: 1997–2001, 2002–2005, 2006–2010 and 2011–2014. Results: There were 786 patients (72% males) with a median age of 71 years (interquartile range = 64–79 years). The proportion of patients with high comorbidity increased over time. Despite similar low comorbidity, curative treatment was given to 44% and to 70% of those in older (>70 years) and younger age groups, respectively. Curative treatment decreased over time, but chemotherapy and cystectomy increased to 25% during the last time period. Patients with curative treatment had better survival compared to those with palliative treatment, both regarding CSS and OS in the whole cohort and in all age groups. Conclusions: The low proportion of older patients undergoing treatment with curative intent, despite no or limited comorbidity, indicates missed chances of treatment with curative intent. The reasons for an overall decrease in curative treatment over time need to be analysed and the challenge of coping with an increasing proportion of node-positive patients with clinically significant comorbidity needs to be met.
HMGB1 protein promotes glomerular mesangial matrix deposition via TLR2 in lupus nephritis

Lupus nephritis (LN) is the most common complication of systemic lupus erythematosus. Patients with LN mostly die of sclerosing glomerulonephritis and renal failure. The inhibition of glomerular mesangial matrix deposition is an efficient method to restrict the progress of renal injury. By recognizing and binding extracellular and intracellular ligands, Toll‐like receptor 2 (TLR2) contributes to the pathogenesis of most immune diseases. However, the relationship between TLR2 and LN is still unknown. Our previous studies confirmed that high‐mobility group box 1 (HMGB1), an important ligand of TLR2, promotes the progression of LN by inducing the proliferation of glomerular mesangial cells. However, whether or not HMGB1 participates in the pathogenesis of glomerular mesangial matrix deposition in LN remains unknown. In this study, we observed the upregulated expression of TLR2 in the glomeruli of LN patients and MRL/lpr mice. The inhibition of either TLR2 or HMGB1 inhibited the release of fibronectin and the activation of the MyD88/NF‐κB pathway in mesangial cells cultured with LN plasma. In addition, both TLR2‐ and HMGB1‐deficient mice showed reduced 24 hr urine protein levels and improved glomerular histological changes and sclerosis levels. These results indicate that TLR2 regulates glomerular mesangial matrix deposition in LN through the activation of the MyD88/NF‐κB pathway by binding to HMGB1.
Does estrogen provide "neuroprotection" for postmenopausal women?

reproductive estrogen exposure on cognitive function and A s the population bulge of the ‘‘baby boomer’’ generation continues to age, Alzheimer dementia (AD) will become an increasing burden on our healthcare system. Despite our best efforts, the etiology of AD remains unknown and there are no effective treatments for the disease. Thus, identifying effective preventive measures will be a critical issue. A number of key biological findings have demonstrated the positive impact of estrogen in neuronal development and neuroprotection. Estrogen can be synthesized locally by neurons and thereby affect neighboring neurons. Cellular and animal studies by McEwen’s laboratory and other groups have demonstrated that estrogen promotes the growth of neuronal dendritic spine growth. Estrogen also seems to have downstream impact on promoting memory and learning in the rat model. This has led to the tantalizing hypothesis in humans that estrogen may have a major role in modifying the neurodegenerative process and provide ‘‘neuroprotection. ’’This important hypothesis remains a major point of contention in those who conduct long-term studies on estrogen and its effects on dementia and the hypothesis has its scientific promoters and detractors. It has been challenging to confirm these short-term animal studies because in humans development of AD is a slow process, influenced by overall health, educational level, and overall physical activity in populations that have very diverse lifestyles and genetic backgrounds. Thus, clinical studies that examine estrogen use and development of AD must be long term (>10 y) and often usually confined to cohort design, prospective observational studies. In this issue, Matyi et al have utilized the retirement community in Cache County, Utah, consisting of 91% Mormons with low rates of mortality before 85 years, having similar, healthy lifestyles to examine the impact of lifetime
Use of Idarucizumab to reverse the anticoagulant effect of dabigatran in cardiac transplant surgery. A multicentric experience in Spain

Anticoagulation in heart transplant (HT) recipients increases the risk of hemorrhagic complications, so correct reversal of anticoagulation is needed. Dabigatran, a direct thrombin inhibitor, is increasingly used for anticoagulation in patients with non‐valvular atrial fibrillation (NVAF) whose effect can be reversed by idarucizumab.
ECMO – the clinician’s view

Background Extra corporeal membrane oxygenation (ECMO) is a complex rescue therapy used to provide cardiac and/or respiratory support for critically ill patients who have failed maximal conventional medical management. ECMO is based on a modified cardiopulmonary bypass (CPB) circuit, and can provide cardiopulmonary support for up‐to several months. It can be used in a veno venous configuration for isolated respiratory failure, (VV‐ECMO), or in a veno arterial configuration (VA‐ECMO) where support is necessary for cardiac +/‐ respiratory failure. The ECMO circuit consists of five main components: large bore cannulae (access cannulae) for drainage of the venous system, and return cannulae to either the venous ( in VV‐ECMO) or arterial (in VA ECMO) system. An oxygenator, with a vast surface area of hollow filaments, allows addition of oxygen and removal of carbon dioxide; a centrifugal blood pump allows propulsion of blood through the circuit at upto 10 L/minute; a control module and a thermoregulatory unit, which allows for exact temperature control of the extra corporeal blood.