Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of a comprehensive antimicrobial stewardship program on institutional burden of antimicrobial resistance: a 14-year controlled interrupted time series study.

BACKGROUND Antimicrobial Resistance (AMR) constitutes an international public health threat widely believed to result from excessive antimicrobial use (AMU). Numerous authorities have recommended Antimicrobial Stewardship Programs (ASP) to curb the selection of AMR but, there is a lack of data confirming this benefit. METHODS A controlled interrupted time series study spanning 14-years was performed to assess impact of a comprehensive hospital-based ASP that included pharmacist-led audit-and-feedback on institutional AMR. Patient-level microbiologic and AMU data were obtained from October 2002 to September 2016. Poisson regression models were used to identify changes in the incidence and trend of hospital-acquired (HA-) Antibiotic Resistant Organisms (ARO) and Multidrug-Resistant Organisms (MDRO). Changes in community-acquired (CA-) ARO, CA-MDRO, and inpatient AMU were assessed as controls and process outcomes. RESULTS Statistically significant shifts in AMU, HA-ARO, and HA-MDRO trends coinciding with ASP implementation were observed, corresponding with a 9% reduction in HA-ARO burden (IRR 0.91, 95%CI 0.83-0.99; p=0.03) and 13% reduction in HA-MDRO burden (IRR 0.87, 95% CI 0.73-1.04; p=0.13) in the intervention period. In contrast, CA-ARO and CA-MDRO incidence continued to rise with 40% (CA-ARO IRR 1.40, 95%CI 1.28-1.54; p<0.0001) and 68% (CA-MDRO IRR 1.68, 95%CI 1.57-1·82; p<0.0001) increases in burden found. CONCLUSIONS Implementation of a comprehensive ASP resulting in reduced AMU was associated with a significant reduction in institutional AMR, even though community AMR increased during the same period. These results confirm that ASPs play an important role in the fight against AMR.
Mindfulness, Meditation, and Belief in Free Will/Determinism

Two experiments investigated the influence of mindfulness, meditation, and type of induction (free will, determinism, or neutral) on affect and beliefs in free will/determinism. In Experiment 1, it was found that high mindful participants reported experiencing more positive affect and less negative affect than low mindful participants. In the determinism induction condition in Experiment 2, high mindful participants scored higher on free will beliefs after they meditated, whereas low mindful participants scored lower on free will beliefs after they meditated. So it would seem that mindfulness can have differential effects for high and low mindful individuals. It was also found that high mindful participants (depending on the task and induction condition) sometimes had longer reaction times than low mindful participants. This could be an indication of high mindful participants having a higher decision boundary for some tasks or simply an indication that high mindful participants enjoyed some tasks more than others (i.e., processing fluency). In addition, the internal consistency of the questionnaires was compared to the internal consistency found for those questionnaires in previous research.
Primed to grow: a new role for green leaf volatiles in plant stress responses

ABSTRACT Green leaf volatiles (GLV) have been well described to prime plants against biotic and abiotic stresses resulting in an accelerated and/or enhanced protective response. Since investments in priming are considered to be minor, it has been assumed that costs for plants using this mechanism are negligible. By analyzing the costs of defense priming by GLV, we found that while initially growth rates of plants were reduced within the first hours after treatment, significantly increased growth rates were found at later time points. This primed growth response in maize seedlings differs from primed defense responses in that it also affects systemic parts of the plant and suggests a metabolic component to be involved in the regulation of this process.
Arsenal of Phytochemicals to Combat against Arsenic-Induced Mitochondrial Stress and Cancer.

SIGNIFICANCE Phytochemicals are important dietary constituents with antioxidant properties. They affect various signaling pathways involved in the overall maintenance of interior milieu of the cell. Arsenic, an environmental toxicant, is well known for its deleterious consequences, such as various diseases, including cancers in humans. Mitochondria are the cell's powerhouse that fuel all metabolic energy requirements. Dysfunctional mitochondria due to stressors may lead to abnormal functioning of the organelle, hampering the crucial cellular crosstalks and ultimately leading to cancer. Application of phytochemicals against arsenic-induced mitochondrial disorders may be a preventive measure to counteract the ruinous impacts of the metalloid. Recent advances: In recent years, extensive research on the role of mitochondria in cancer gives a better understanding of the areas the organelle covers in maintaining a healthy cell or in inducing carcinogenicity. Detailed knowledge of the mitochondrial governances would enable researchers to administer numerous phytochemicals to ameliorate altered oxidative phosphorylation, mitochondrial membrane potential, mitochondrial oxidative stress, unfolded protein response, glycolysis or even apoptosis. CRITICAL ISSUES In this review, we have addressed how various phytochemicals belonging to diverse classes combat against arsenic-induced mitochondrial oxidative stress, depletion of mitochondrial membrane potential, cell cycle abrogation, apoptosis, glycolytic damages, oncogenic regulations, chaperones, mitochondrial complexes and mitochondrial membrane pore formation in both in vitro and in vivo models. FUTURE DIRECTIONS Insightful application of mito-protective phytochemicals against arsenic-induced mitochondrial oxidative stress and carcinogenesis may guide researchers to develop pre-clinical chemopreventive agents to fight arsenic toxicity in humans.
Correlation of ACTH and Salivary Cortisol levels to diagnose Adrenal Insufficiency in cirrhotic patients.

Purpose. The prevalence of adrenal insufficiency (AI) in patients with decompensated liver cirrhosis is unknown. Because these patients have lower levels of cortisol-binding carrier proteins, their total serum cortisol (TSC) correlates poorly with free serum cortisol (FC). Salivary cortisol (SaC) correlates better with FC. We aimed to establish SaC thresholds for AI for the 250 g intravenous ACTH test and to estimate the prevalence of AI in non-critically ill cirrhotic patients. Methods. We included 39 patients with decompensated cirrhosis, 39 patients with known AI, and 45 healthy volunteers. After subjects fasted ≥8 hours, serum and saliva samples were collected for determinations of TSC and SaC at baseline 0’ (T0) and at 30-minute intervals after intravenous administration of 250
Clamping of microgears with a compliant string

We present a new clamping and handling method for microgears featuring a compliant string. The method simplifies the fixturing and setup process prior to dimensional measurements. The method has been verified experimentally and by FEM simulations. The low-cost prototype shows several advantages over conventional clamping methods like gluing or collet clamping. The clamp is part of a microenvironment that also features a particle shield, cleaning capability and sensors that monitor the direct measurement environment.
DUSP19 mediates spinal cord injury-induced apoptosis and inflammation in mouse primary microglia cells via the NF-kB signaling pathway

ABSTRACT Objective: Spinal cord injury (SCI) is a common injury that seriously threatens human health. NF-κB may be involved in the secondary injury of SCI that is mediated by inflammation and aggravates damage. Our study was aimed to investigate the role of NF-κB signaling in DUSP19-mediated cleaved Caspase-3 expression and the release of inflammatory factors in vivo and in vitro. Materials and Methods: DUSP19 mRNA expression and the content of IL-6 and IL-8 in patients with traumatic SCI (TSCI) were measured by real-time PCR and ELISA, respectively. The levels of p-NF-κBp65, NF-κBp65 and cleaved Caspase-3 expression and the concentrations of IL-6 and IL-8 were measured by western blotting and ELISA, respectively. Results: Patients with TSCI showed lower DUSP19 expression and higher concentration of IL-6 and IL-8 compared with healthy controls. DUSP19 overexpression inhibited p-NF-κBp65 level, cleaved Caspase-3 expression, and production of IL-8 and IL-6 in the mice induced by TSCI. DUSP19 silencing increased p-NF-κBp65 level, cleaved Caspase-3 expression, and concentration of IL-6 and IL-8 in mouse primary microglia cells. DUSP19 overexpression had an inverse effect. Importantly, DUSP19 silencing and overexpression mediated p-NF-κBp65 level, cleaved Caspase-3 expression, and concentration of IL-6 and IL-8 in mouse primary microglia cells were reversed by NF-κB inhibitor pyrrolidine dithiocarbamate (PDTC) and NF-κB activator 12-myristate 13-acetate (PMA), respectively. Conclusion: These results suggested that DUSP19-mediated SCI-induced apoptosis and inflammation via NF-κB signaling and might therefore serve as a potential therapeutic target for SCI.
Phytochemical and Antihyperglycemic Studies on Citrus medica l. Leaves (Etrog) Growing in Egypt

From 70% aqueous methanol extract of the defatted powdered leaves of Citrus medica L. var. Etrog, six compounds, namely, β-sitosterol-glucoside (1), sakuranetin (2), 7 -O-methylaromadendrin (3), dihydrokaempferide (4), hesperitin (5) and rutin (6) were isolated and identified by physicochemical and spectral data (UV, MS and NMR). Compounds 2 -4 are newly reported from the genus and 5 is newly reported from the species. The extract was safe up to 2g/kg.bwt. The histopathological changes on liver, kidney and pancreas were assessed. The antioxidant activity was calculated to 102. 9µg/ml. The antihyperglycemic activity exerted a signi ficant reduction in blood glucose level to (105.2±8.35) in diabetic rats after one month of treatment with a dose of 200 mg/kg and to (87.4±6.30) with 400mg, when compared to Gliclazide standard (110.8±7.24) (P< 0.05). As a conclusion, the methanol extract of the defatted powdered leaves of Etrog exhibits a significant antihyperglycemic activity which might be attributed to the presence of flavonoid compounds.
Do (Australian) jockeys have hot hands?

We extend the empirical analysis of hot hands in sports to horse racing, using the winning streaks of a sample of jockeys riding in Australia. Grouping jockeys by strike rate (win percentage), we find evidence of hot hands across almost all strike rates. But considering jockeys individually, only a minority exhibit hot hands. A wagering strategy based on hot hands yields a negative return overall and for most hot hand jockeys, although some do yield a positive return. We conclude that hot hands are present but not ubiquitous and that this is generally recognised in the betting market. JEL Classification: C53, D81, D84
Consumo de alcohol y tóxicos en pacientes con traumatismo craneoencefálico:: repercusión neuroconductual y sobrecarga del cuidador

Objetivos. Describir la frecuencia de consumo de alcohol y toxicos en pacientes con traumatismo craneoencefalico (TCE) y valorar su relacion con los trastornos neuropsiquiatricos, la funcionalidad y la sobrecarga del cuidador. Pacientes y metodos. Se valoraron 156 pacientes con historia de TCE moderado y grave. Se determino el consumo previo de alcohol y toxicos. A los informantes de los pacientes se les administro el inventario neuropsiquiatrico (NPI) y la escala de sobrecarga del cuidador de Zarit. La funcionalidad de los pacientes se valoro mediante la escala de puntuacion de discapacidad (DRS) y la escala de coma de Glasgow extendida (GOSE). Resultados. Treinta y seis pacientes (23%) eran consumidores habituales de alcohol y otros toxicos antes del traumatismo. Las alteraciones neuropsiquiatricas fueron mas frecuentes y graves en el grupo de consumidores habituales, en especial la irritabilidad y la agitacion-agresividad. Sus cuidadores percibieron una sobrecarga mayor. Despues del TCE, 16 pacientes (44,4%) recayeron en el consumo. Tener una edad superior y vivir en pareja se asociaron a una mayor tasa de abstinencia. Conclusion. El antecedente de consumo de alcohol y toxicos es frecuente en pacientes que han sufrido TCE y constituye un factor de riesgo para el desarrollo de alteraciones conductuales. Se necesitan intervenciones mas activas encaminadas a la deteccion de estos casos y a la prevencion de recaidas tras el traumatismo.
IgA Vasculitis Developed as an Adverse Effect of Tofacitinib Taken for Rheumatoid Arthritis

Tofacitinib is a new small-molecule inhibitor of the JAK/STAT signaling pathway used to treat rheumatoid arthritis. We herein report a case of IgA vasculitis apparently caused by tofacitinib. A 67-year-old woman with rheumatoid arthritis developed IgA vasculitis after taking tofacitinib for 6 months. She presented with proteinuria and purpura of the lower extremities. Biopsy specimens from her skin and kidney were compatible with IgA vasculitis. Following termination of tofacitinib, the patient completely recovered from the IgA vasculitis. Drug-induced IgA vasculitis has been previously described for anti-tumor necrosis factor-(TNF)α therapies, but this is the first report of this adverse effect with anti-JAK therapy.
Screening and management of preinvasive lesions of the cervix: Good clinical practice recommendations from the Federation of Obstetrics and Gynaecologic Societies of India (FOGSI)

In India, there are marked variations in resources for cervical cancer screening. For the first time, resource‐stratified screening guidelines have been developed that will be suitable for low middle‐income countries with similar diversities. The current article describes the process and outcomes of these resource stratified guidelines for screening and treatment of preinvasive lesions of cervix. Evidence from literature was collated and various guidelines were reviewed by an expert panel. Based on the level of evidence, guidelines were developed for screening by human papillomavirus (HPV) testing, cytology and visual inspection after application of acetic acid (VIA), and management of screen positive lesions in different resource settings. Expert opinion was used for certain country‐specific situations. The healthcare system was stratified into two resource settings – good or limited. The mode of screening and treatment for each was described. HPV testing is the preferred method for cervical cancer screening. VIA by trained providers is especially suitable for low resource settings until an affordable HPV test becomes available. Healthcare providers can choose the most appropriate screening and treatment modality. A single visit approach is encouraged and treatment may be offered based on colposcopy diagnosis (‘see and treat’) or even on the basis of HPV test or VIA results (‘screen and treat’), if compliance cannot be ensured. The Federation of Obsterician and Gynaecologists of India Good Clinical Practice Recommendations (FOGSI) GCPR are appropriately designed for countries with varied resource situations to ensure an acceptable cervical cancer prevention strategy.
Fetal and placental haemodynamic responses to hypoxaemia, maternal hypotension and vasopressor therapy in a chronic sheep model

Knowledge of the effects of maternally administered vasopressors on human fetal and placental haemodynamics is sparse and limited to elective Caesarean deliveries in uncomplicated pregnancies. We hypothesized that, after short-term fetal hypoxaemia, which activates fetal cardiovascular compensatory mechanisms, treatment of maternal hypotension with ephedrine or phenylephrine results in divergent responses in fetal and placental haemodynamics. Chronically instrumented near-term sheep fetuses with either normal placental function or increased placental vascular resistance following placental embolization were exposed to two subsequent periods of decreased fetal oxygenation caused by maternal hypoxaemia and epiduralinduced hypotension. The fetuses that underwent placental embolization were also chronically hypoxaemic. Fetal and placental haemodynamics were assessed by invasive techniques and by noninvasive Doppler ultrasonography. Our results show that umbilical artery blood flow velocity waveforms cannot be used to derive information of fetal cardiac function. Furthermore, the changes in placental volume blood flows and vascular resistances caused by maternal vasopressor treatment cannot be reliably recognized based on uterine and umbilical artery pulsatility index values. In response to acute hypoxaemia, a fetus with normal placental function redistributes its right ventricular cardiac output from the pulmonary to the systemic circulation and is able to increase its combined cardiac output, with a concomitant relative decrease in the net forward flow through the aortic isthmus. However, fetal haemodynamic responses to subsequent hypoxaemic insults may vary. Furthermore, the compensatory responses of fetuses with increased placental vascular resistance differ from those of normal fetuses. In these fetuses, repeated episodes of a further decrease in oxygenation lead to lactataemia. The effects of ephedrine on uteroplacental and umbilicoplacental circulations were more favourable than those of phenylephrine. Ephedrine restored the changes in fetal cardiovascular haemodynamics caused by maternal hypotension to the baseline conditions in both embolized and nonembolized fetuses. Phenylephrine did not reverse fetal pulmonary vasoconstriction or the relative decrease in the net forward flow through the aortic isthmus. Moreover, fetal left ventricular function was impaired by phenylephrine. Although no significant differences in fetal acid-base status were observed in fetuses with normal placental function, the lactate concentrations of the embolized fetuses increased further when maternal hypotension was treated with phenylephrine.
Older Adults in the Cardiac Intensive Care Unit: Factoring Geriatric Syndromes in the Management, Prognosis, and Process of Care: A Scientific Statement From the American Heart Association

Longevity is increasing, and more adults are living to the stage of life when age-related biological factors determine a higher likelihood of cardiovascular disease in a distinctive context of concurrent geriatric conditions. Older adults with cardiovascular disease are frequently admitted to cardiac intensive care units (CICUs), where care is commensurate with high age-related cardiovascular disease risks but where the associated geriatric conditions (including multimorbidity, polypharmacy, cognitive decline and delirium, and frailty) may be inadvertently exacerbated and destabilized. The CICU environment of procedures, new medications, sensory overload, sleep deprivation, prolonged bed rest, malnourishment, and sleep is usually inherently disruptive to older patients regardless of the excellence of cardiovascular disease care. Given these fundamental and broad challenges of patient aging, CICU management priorities and associated decision-making are particularly complex and in need of enhancements. In this American Heart Association statement, we examine age-related risks and describe some of the distinctive dynamics pertinent to older adults and emerging opportunities to enhance CICU care. Relevant assessment tools are discussed, as well as the need for additional clinical research to best advance CICU care for the already dominating and still expanding population of older adults.
A Robust Digital Watermarking with Mixed Transform Technique for Digital Image L

In this paper, we developed a robust digital watermarking technique to protect intellectual property right of digital image. A scale-invariant feature transform technique was employed for resisting geometric attacks and tw o dimensional bar code was used for its high capacity and fault tolerance to enhance digital watermarking capacity. Besides, the discrete wavelet transform (DWT) and discrete co sine transform (DCT) were joined to cope with noise problem and enhance perceptual transparency of watermarking ima ge. The algorithm performance was presented with a pluralit y of experimental results, including several attack mode ls such as lossy compression, scaling, blurring and sharpening etc. The experimental results proved the robustness of this mixed transformation technique on protecting intellectual property right of digital image. Keywords—watermark, mixed transform technique, digital image
Association of food intake with serum levels of phosphorus and potassium in hemodialysis patients

Purpose: Elevated serum phosphorus and potassium levels are a major problem for hemodialysis (HD) patients. Hyperphosphatemia and hyperkalemia are closely related to intake of dietary phosphorus and potassium. Methods: This study was conducted in order to investigate the effects of food consumed on serum phosphorus and potassium levels in 48 HD patients (20 males and 28 females). We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 21 food items. Results: The mean body mass index (BMI) was 22.2 ± 3.0 kg/㎡, mean serum phosphorus level was 4.50 ± 1.52 mg/dl, and mean serum potassium level was 4.74 ± 0.73 mEq/l. Hyperphosphatemia (＞ 4.5 mg/dl) was found in 45.8% of subjects, and hyperkalemia (＞ 5.0 mEq/l) in 35.4%. Subjects who took medication only were 56% of total, and those who took medication with dietary therapy were 27%. Patients with medication and dietary therapy showed significantly lower serum phosphorus levels compared to patients with medication only (p ＜ 0.05). Mean duration of HD was 7.9 ± 7.3 years and it showed positive correlation with serum potassium levels (p ＜ 0.05). Serum phosphorus levels showed positive correlation with intake of mixed grains and soybean milk (p ＜ 0.05). Serum potassium levels showed positive correlation with intake of mixed grains (p ＜ 0.01), potatoes, fish, and high-potassium vegetables (p ＜ 0.05). On the other hand, intake of white rice showed negative correlation with serum potassium levels (p ＜ 0.05). Conclusion: The results of our study suggest that intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels. In addition, limiting intake of soybean milk, potatoes, and fish to under three serving per week is recommended. Finally, conduct of a strict dietary therapy along with medical treatment is desirable because inappropriate food intake increases serum phosphorus and potassium levels to a higher than normal range.