Miracle-dz/UniFAR-FTUs huggingface dataset:
Central Venous Catheter–Related Bloodstream Infections in Obese Hematologic Patients

To the Editor—Central venous catheter (CVC)–related bloodstream infections (CRBSI) are associated with high morbidity, especially in neutropenic patients. In general, obesity is one of the risk factors associated with CRBSI. However, this finding is inconsistent in the literature and no data are available on patients with hematologic malignancies so far. CVC insertion is often technically challenging in obese patients owing to obscured landmarks of the neck. Furthermore, with increased sweating, bandages at the CVC insertion site are frequently problematic and lead to higher risk of CRBSI. Therefore, we hypothesized that obese hematologic patients treated with chemotherapy are at higher risk of having CRBSI than non-obese hematologic patients. In the monocentric, prospective SECRECY registry (Study to Evaluate Central Venous Catheter-Related Infections in Hematology and Oncology; German Clinical Trial Register number, DRKS00006551) we evaluated CRBSI in all consecutive patients in our department from March 20, 2013, through March 13, 2015. The registry was approved by the local ethics committee (approval no. 84/14). Owing to anonymization of patients’ data, written informed consent was not required within the registry. However, written informed consent is available for the procedure of CVC insertion during routine clinical use. All patients were at least 18 years of age. CVCs were mainly used for chemotherapy or best supportive care. All CVCs were inserted under sterile conditions and ultrasound guidance by experienced physicians. To define CRBSI we used the 2012 criteria of the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Obesity was defined as body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 30 or greater according to the commonly known World Health Organization criteria. Altogether we analyzed 335 triple-lumen, short-time CVCs (including 11 coated CVCs) that were in use at least 1 day. The CVCs accounted for a total of 5,094 CVC days (mean [range], 15.2 [1–60] days). The mean (range) age of the 176 patients was 58.1 (25–81) years; 106 (60.2%) were men. Mostly, patients had acute leukemia (178 [53.1%]), multiple myeloma (83 [24.8%]), or malignant lymphoma (41 [12.2%]). Patients received a mean (range) of 1.9 (1–6) CVC insertions within the observation period. Most CVCs (314 [93.7%]) were inserted into the internal jugular vein. CRBSI were detected in 77 cases (12 [15.6%] definite, 21 [27.3%] probable, 44 [57.1%] possible), with an incidence of 15.1/1,000 CVC-days and an incidence rate of 23.0%. The most prevalent pathogen was Staphylococcus epidermidis (43 [71.7%]). At baseline—that is, at time of the first CVC insertion of the patients, the mean table 1. Data on 176 Patients, Use of 335 Central Venous Catheters (CVCs), and Occurrence of Catheter-Related Bloodstream Infection (CRBSI)
Dignity therapy for people with motor neuron disease and their family caregivers: a feasibility study.

BACKGROUND There are calls to explore psychological interventions to reduce distress in patients with motor neuron disease (MND) and their family caregivers. Dignity therapy is a short-term psychotherapy intervention shown to alleviate distress for people with life-limiting illnesses. OBJECTIVES To assess the acceptability, feasibility, and effectiveness of dignity therapy to reduce distress in people with MND and their family caregivers. METHODS The study used a repeated-measures design pre- and post-intervention. Acceptability and feasibility were assessed using participants' ratings of the helpfulness of the intervention across several domains and time and resources required. Effectiveness measures for patients included: dignity-related distress, hopefulness, and spiritual well-being; and those for family caregivers included burden, hopefulness, anxiety, and depression. RESULTS Twenty-seven patients and 18 family caregivers completed the intervention. Dignity therapy was well accepted, including those patients who required assisted communication devices. The feasibility may be limited in small or not well-resourced services. There were no significant differences in all outcome measures for both groups. However, the high satisfaction and endorsement of dignity therapy by patients suggests it has influenced various important aspects of end-of-life experience. Family caregivers overwhelmingly agreed that the dignity therapy document is and will continue to be a source of comfort to them and they would recommend dignity therapy to others in the same situation. CONCLUSIONS This is the first dignity therapy study to focus on MND and on home-based caregiving. RESULTS established the importance of narrative and generativity for patients with MND and may open the door for other neurodegenerative conditions.
Abrogation of the antifibrotic effects of natural killer cells/interferon-gamma contributes to alcohol acceleration of liver fibrosis.

BACKGROUND & AIMS Chronic alcohol drinking accelerates liver fibrosis in patients with viral hepatitis that cannot be fully explained by ethanol-enhanced liver damage. Here, we identified a novel mechanism by which alcohol accelerates liver fibrosis: inhibition of the antifibrotic effects of natural killer (NK) cells and interferon-gamma (IFN-gamma). METHODS Alcohol administration was achieved by feeding mice with a liquid diet containing 5% ethanol for 8 weeks. Liver fibrosis was induced by administration of carbon tetrachloride (CCl(4)) for 2 weeks. Hepatic stellate cells (HSCs) were also isolated and cultured for in vitro studies. RESULTS CCl(4) treatment induced greater fibrosis and less apoptosis of HSCs in ethanol-fed mice compared with pair-fed mice. Polyinosinic-polycytidylic acid (Poly I:C) or IFN-gamma treatment inhibited liver fibrosis in pair-fed but not in ethanol-fed mice. Poly I:C activation of NK cell cytotoxicity against HSCs was attenuated in ethanol-fed mice compared with pair-fed mice, which was due to reduced natural killer group 2 member D (NKG2D), tumor necrosis factor-related apoptosis-inducing ligand, and IFN-gamma expression on NK cells from ethanol-fed mice. In vitro, HSCs from ethanol-fed mice were resistant to IFN-gamma-induced cell cycle arrest and apoptosis compared with pair-fed mice. Such resistance was due to diminished IFN-gamma activation of signal transducer and activator of transcription 1 (STAT1) in HSCs from ethanol-fed mice caused by the induction of suppressors of cytokine signaling proteins and the production of oxidative stress. Finally, HSCs from ethanol-fed mice were resistant to NK cell killing, which can be reversed by transforming growth factor-beta1 (TGF-beta1) neutralizing antibody. CONCLUSIONS Chronic ethanol consumption attenuates the antifibrotic effects of NK/IFN-gamma/STAT1 in the liver, representing new and different therapeutic targets with which to treat alcoholic liver fibrosis.
Validation and extension of the PREMM1,2 model in a population-based cohort of colorectal cancer patients.

BACKGROUND & AIMS Early recognition of patients at risk for Lynch syndrome is critical but often difficult. Recently, a predictive algorithm-the PREMM(1,2) model-has been developed to quantify the risk of carrying a germline mutation in the mismatch repair (MMR) genes MLH1 and MSH2. However, the model's performance in an unselected, population-based colorectal cancer population as well as its performance in combination with tumor MMR testing are unknown. METHODS We included all colorectal cancer cases from the EPICOLON study, a prospective, multicenter, population-based cohort (n = 1222). All patients underwent tumor microsatellite instability analysis and immunostaining for MLH1 and MSH2, and those with MMR deficiency (n = 91) underwent tumor BRAF V600E mutation analysis and MLH1/MSH2 germline testing. RESULTS The PREMM(1,2) model with a >/=5% cut-off had a sensitivity, specificity, and positive predictive value (PPV) of 100%, 68%, and 2%, respectively. The use of a higher PREMM(1,2) cut-off provided a higher specificity and PPV, at expense of a lower sensitivity. The combination of a >/=5% cut-off with tumor MMR testing maintained 100% sensitivity with an increased specificity (97%) and PPV (21%). The PPV of a PREMM(1,2) score >/=20% alone (16%) approached the PPV obtained with PREMM(1,2) score >/=5% combined with tumor MMR testing. In addition, a PREMM(1,2) score of <5% was associated with a high likelihood of a BRAF V600E mutation. CONCLUSIONS The PREMM(1,2) model is useful to identify MLH1/MSH2 mutation carriers among unselected colorectal cancer patients. Quantitative assessment of the genetic risk might be useful to decide on subsequent tumor MMR and germline testing.
Yeni Bir Kalp Cerrahisi Kliniği: Diyarbakır Eğitim ve Araştırma Hastanesi'nde İlk 195 Vakanın Sonuçları

AMAC: Bu calismanin amaci, yeni faaliyete gecen Diyarbakir Egitim ve Arastirma Hastanesi Kalp ve Damar Cerrahisi Klinigi'nde yapilan ilk 195 kalp ameliyatinin sonuclarini degerlendirmektir.YONTEMLER: Haziran 2009 - Haziran 2011 tarihleri arasinda 195 ardisik olgu retrospektif olarak degerlendirildi. Toplam 144 vakada koroner arter bypass cerrahisi uygulanmis olup bunlardan 43 tanesi atan kalpte gerceklestirilmis, dort hastada es zamanli karotid endarterektomi yapilmistir. Otuz yedi hastada kapak replasmani, sekiz hastada kapak replasmani ve es zamanli koroner arter baypass greftleme, dort hastada kardiyak yaralanmaya mudahale, bir hastada koroner arter baypass greftleme ve sol ventrikul anevrizma onarimi, bir hastada da sol ventrikul duvarindan kist hidatik rezeksiyonu uygulanmistir. BULGULAR: Hastalarin yas ortalamasi 59,3±14,1 (20-84 y) idi. Hastalarin 128 tanesi erkek, 67 tanesi ise kadin idi. Hipertansiyon (%59) en sik eslik eden hastalik olup bunu sigara (%55,4), hiperlipidemi (%54,4), kronik obstruktif akciger hastaligi (%33,8) ve diabetes mellitus (%30,8) takip ediyordu. Yogun bakim unitesinde kalma suresi ortalama 20,7±15,0 saat, ortalama hastanede kalma suresi ise 6,3±4,1 gun olarak saptandi. Hastane mortalitesi toplam 12 hastada gorulmustur (%6,15). Erken donemde (ilk 30 gun icinde) postoperatif kanama nedeniyle bes hastada revizyon gerceklestirilmis olup revizyon orani %2,56'dir.SONUC: Klinigimiz, Guneydogu Anadolu Bolgesi'nin hasta yogunlugunun en cok oldugu Diyarbakir ilinde, T.C. Saglik Bakanligi ve koordinator hastanemiz olan Turkiye Yuksek Ihtisas Egitim ve Arastirma Hastanesi'nin katkilari ile acik kalp cerrahisi uygulamalarina baslamis olup basari ile devam etmektedir.
Therapeutic effects of 10‐HzPulsed wave lasers in rat depression model: A comparison between near‐infrared and red wavelengths

The application of transcranial low‐level light/laser therapy (tLLLT) in the range of red to near‐infrared (NIR) spectrum for psychological disorders is a new area that is attracting growing interest in recent years. The photomodulation effects of NIR and red coherent lights on the activity of cytochrome c oxidase in neuronal cells of brain have been recently introduced. This study, therefore, sought to compare the therapeutic effects of 10‐Hz pulsed wave NIR (810 nm) laser with red (630 nm) laser using the same delivered energy density and Citalopram in rat chronic mild stress (CMS) model of depression and anxiety.
Proliferation, migration, and expression of oral‐mucosal‐healing‐related genes by oral fibroblasts receiving low‐level laser therapy after inflammatory cytokines challenge

Increased expression of inflammatory cytokines in the oral cavity has been related to the etiopathogenesis of oral mucositis and to delayed oral mucosal repair. Low‐level laser therapy (LLLT) stimulates proliferation and migration of gingival fibroblasts, but the effects of specific inflammatory cytokines on oral mucosal cells and the modulation of these effects by LLLT have not been fully investigated. Therefore, this study investigated the effects of LLLT on oral fibroblasts after being challenged by oral‐mucositis‐related inflammatory cytokines.
Impact of a Central Line Infection Prevention Bundle in Newborn Infants

OBJECTIVE To compare central line use and central line–associated bloodstream infection in newborn infants before and after the introduction of a central line infection prevention bundle in order to determine the effectiveness of the bundle and to identify areas for further improvement. DESIGN Retrospective cohort analysis of prospectively collected data. SETTING Level 5 neonatal intensive care unit in Sydney, Australia. PATIENTS Newborn infants admitted to the Royal Prince Alfred Hospital Neonatal Intensive Care Unit who had a central venous catheter (CVC) inserted. METHODS Data regarding clinical characteristics, CVC use, and infection were collected before and after the introduction of a bundle of interventions. The bundles encompassed (1) insertion of CVC, (2) maintenance of CVC, (3) an education program, and (4) ongoing surveillance and feedback. RESULTS Baseline and intervention groups were comparable in clinical characteristics. The number of CVCs inserted was reduced in the intervention group (central line utilization rate, 0.16 vs 0.2, P<.0001). Overall CVC dwell time was reduced, resulting from significant reduction in peripherally inserted CVC dwell time (6 days [95% CI, 5.0–11.8 days] vs 7.3 days [4.0–10.4 days], P=.0004). Central line–associated bloodstream infections were significantly reduced, predominantly secondary to decreased peripherally inserted CVC–related bloodstream infections (1.2/1,000 central line–days vs 11.5/1,000 central line–days, P<.0001). CONCLUSION This central line infection bundle was effective in reducing CVC use, dwell time, and central line–associated bloodstream infections. Infect Control Hosp Epidemiol 2016;37:1029–1036
Incidence and Risk Factors for Infection Following Transcatheter Aortic Valve Implantation

We identified risk factors for infection following transcatheter aortic valve implantation (TAVI); infection occurred in 35 (13.8%) of 253 patients. Variables associated with infection included chronic obstructive pulmonary disease (OR, 1.2; 95% CI, 1.1–1.4), postprocedural hemorrhage (OR, 1.2; 95% CI, 1.0–1.3), and procedure-related stroke (OR, 1.6; 95% CI, 1.3–2.1). Infect Control Hosp Epidemiol 2016;37:1094–1097
Measurement of helical angle of the human semicircular canals using rapid-prototyped inner ear model

Three dimensional analysis of the plane that includes each semicircular canal is essential for understanding the vestibule-ocular reflex evoked in each plane. The fact that the semicircular canals do not lie in single planes has been reported. We measured the helical angle of the plane where each semicircular canal existed using a simulated 3D model of the inner ear and a software-based three-dimensional computed tomographic (3D-CT) imaging program. The diameter of each semicircular canal was also measured. The helical angle was the greatest in the anterior semicircular canal both in measurement of the models and the software-based images. The diameter was the greatest in the anterior semicircular canal when measured in the models. It is suggested that the helical angle of the semicircular canal potentially influences the sensitivity of the vestibulo-ocular reflex (VOR) that the semicircular canal evokes in each plane. A sufficient VOR may be evoked in the plane less strictly determined.
Factors Associated With Surgical Site Infection Following Gastric Surgery in Japan

BACKGROUND Surgical site infection (SSI) following gastric surgery has not been well documented. OBJECTIVE To describe and assess factors associated with SSI following gastric surgery in Japan using a Japanese national database for healthcare-associated infections. DESIGN A retrospective nationwide surveillance-based study. SETTING Japanese healthcare facilities. METHODS Data on gastric surgeries performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance. Gastric surgery was divided into 3 types of procedures: total gastrectomy (GAST-T), distal gastrectomy (GAST-D), and other types of gastric surgery (GAST-O). The incidence of and factors associated with SSI following gastric surgery were assessed by the 3 types of procedures. RESULTS The cumulative incidence of SSI following gastric surgery was 8.8% (3,156/36,052). The incidence of SSI following GAST-T (12.4%) was significantly higher than that following GAST-D (7.01%) or GAST-O (7.84%). Besides the 4 conventional risk factors for predicting SSI, additional risk factors were identified. Male sex was significantly associated with SSI following all types of gastric surgery, but the effect of the association was substantially different (adjusted odds ratio, 1.52, 1.47, and 1.28 for GAST-T, GAST-D, and GAST-O, respectively). The effect of an emergency operation was similar. Age was also identified as a risk factor, but the most suitable modification of age as a variable differed. CONCLUSIONS The incidence and factors associated with SSI following 3 types of gastric surgery differed. To accurately compare hospital performance in SSI prevention following gastric surgery, dividing surgical procedures in the surveillance system into 3 types should be considered. Infect Control Hosp Epidemiol 2016;1–6
Localization, trafficking, and significance for acid secretion of parietal cell Kir4.1 and KCNQ1 K+ channels.

BACKGROUND & AIMS K(+) recycling at the apical membrane of gastric parietal cells is a prerequisite for gastric acid secretion. Two K(+) channels are currently being considered for this function, namely KCNQ1 and inwardly rectifying K(+) channels (Kir). This study addresses the subcellular localization, trafficking, and potential functional significance of KCNQ1 and Kir4.1 channels during stimulated acid secretion. METHODS The effect of pharmacologic KCNQ1 blockade on acid secretion was studied in cultured rat and rabbit parietal cells and in isolated mouse gastric mucosa. The subcellular localization of KCNQ1 and Kir4.1 was determined in highly purified membrane fractions by Western blot analysis as well as in fixed and living cells by confocal microscopy. RESULTS In cultured parietal cells and in isolated gastric mucosa, a robust acid secretory response was seen after complete pharmacologic blockade of KCNQ1. Both biochemical and morphologic data demonstrate that Kir4.1 and KCNQ1 colocalize with the H(+)/K(+)-ATPase but do so in different tubulovesicular pools. All Kir4.1 translocates to the apical membrane after stimulation in contrast to only a fraction of KCNQ1, which mostly remains cytoplasmic. CONCLUSIONS Acid secretion can be stimulated after complete pharmacologic blockade of KCNQ1 activity, suggesting that additional apical K(+) channels regulate gastric acid secretion. The close association of Kir4.1 channels with H(+)/K(+)-ATPase in the resting and stimulated membrane suggests a possible role for Kir4.1 channels during the acid secretory cycle.
Evaluación de métodos fenotípicos y genotípicos para la detección de farmacorresistencia de Mycobacterium tuberculosis.

Introduccion. La dificultad en el diagnostico temprano y oportuno de la susceptibilidad a los medicamentos de Mycobacterium tuberculosis hace necesario el diseno y la evaluacion de nuevas tecnicas que superen la efectividad, reduzcan el costo y el tiempo que toman los metodos tradicionales. Objetivo. Evaluar y comparar dos metodologias fenotipicas y una genotipica, utiles en la determinacion rapida de susceptibilidad de M. tuberculosis, teniendo el metodo de las proporciones multiples como referencia. Materiales y metodos. Se incluyeron 21 cepas de M. tuberculosis para la evaluacion de las metodologias fenotipicas de oxidacion y reduccion de Alamar azul (Maba) y el bromuro de 3- (4-5-dimetiletiazol-2-il)-2,5-difenil tetrazolio (MTT o Tema), frente a estreptomicina, isoniacida, rifampicina y etambutol. Mediante analisis ROC (receiver operative characteristic curves) se determino el desempeno de las pruebas y se determinaron los valores pronosticos y el punto de corte para cada antibiotico. Ademas, mediante tablas de contingencia se determino el desempeno y los valores predictivos de la metodologia genotipica de PCR e hibridacion reversa o rifoligotyping, version 3, en la determinacion de las cepas multirresistentes. Resultados. Los perfiles de susceptibilidad por las pruebas colorimetricas se obtuvieron a los 7 dias, con valores de area bajo la curva menores de 0,9, sensibilidad de 100% y especificidad mayor de 80%. La metodologia de rifoligotyping resulto eficaz en la deteccion de mutirresistencia, con sensibilidad de 100% y especificidad de 93%. Conclusion. Con los resultados obtenidos consideramos las pruebas Maba, Tema y rifoligotyping como alternativas rapidas y eficaces en la deteccion de farmacorresistencia de M. tuberculosis, aplicables a pacientes con alto riesgo de desarrollar tuberculosis multirresistente.
The Effect of Absorbing Antiglobulin Reagents with Human γss Globulin Fragments

Application of papain digestion to the study of human yss globulin has revealed the molecule t o contain two antigenically distinct determinants designated S and F [3] or, alternatively, A-C and B [4]. It has been demonstrated that all normal gamma globulin molecules are composed of three sub-units, two of which have the S determinant, and the third the F determinant [S ] . I n the following study, antisera made specific for F or S determinants of gamma globulin were examined in order to define the essential components of an effective Coombs serum.
Sp1 is required for glucose-induced transcriptional regulation of mouse vesicular glutamate transporter 2 gene.

BACKGROUND & AIMS Vesicular glutamate transporter (VGLUT) has been reported to be involved in glucose-induced insulin secretion. It has been shown that glucose stimulates the expression of VGLUT isoform 2 (VGLUT2) in beta cells via transcriptional mechanism. In this study, we identified the mouse VGLUT2 (mVGLUT2) promoter and characterized the transcriptional mechanism of glucose-stimulated mVGLUT2 expression in beta-cells. METHODS A promoter region of mVGLUT2 was cloned by genomic polymerase chain reaction. The mechanism of Sp1 in glucose-induced transactivation of mVGLUT2 was investigated by luciferase assay, electrophoretic mobility shift assay, chromatin immunoprecipitation assay, and Western blot analysis. RESULTS A promoter containing 2133 base pairs of upstream sequence of the 5'-flanking region of mVGLUT2 complementary DNA was cloned. Transient transfection of various 5'-end deletion constructs of the mVGLUT2 promoter/luciferase reporter indicated that the region between -96 to +68 base pair contains the basal promoter for mVGLUT2. Mutational analysis and electromobility shift assay showed an important role for the transcription factor Sp1 in both basal and glucose-induced mVGLUT2 transcription. The interaction between Sp1 and mVGLUT2 was confirmed by chromatin immunoprecipitation assays. Glucose stimulates the phosphorylation of Sp1 via mitogen-activated protein kinase P38 and P44/42. This leads to increased binding activity of Sp1 to the mVGLUT2 promoter and results in activation of the gene. CONCLUSIONS We cloned the mouse VGLUT2 promoter and showed a novel molecular mechanism of glucose-induced mVGLUT2 transcription.