Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving sexually transmitted disease management in the private sector: the Jamaica experience.

OBJECTIVES To improve the quality of sexually transmitted disease (STD) case management in Jamaica by providing comprehensive continuing medical education to private practitioners who manage 60% of all STDs on the island. METHODS Six half-day STD seminars were presented at 3-4-month intervals and repeated in three separate geographic locations. All Jamaican practitioners received invitations. The subjects were as follows: urethritis, genital ulcer disease, HIV infection, vaginal discharge syndrome, STDs in children and adolescents, and a review seminar. The program effectiveness was evaluated with a written, self-reported pre-test and a telephone post-test that measured changes in clinical management. RESULTS Six hundred and twenty eight practitioners attended at least one seminar. Comparing pre- versus post-test scores, there were practitioner improvement trends in all four of the general STD management categories: counseling/education (69.8-73.3%; P > 0.05); diagnostics/screening (57.2-71.0%; P= 0.042); treatment (68.3-74.5%; P> 0.05); and knowledge (66.4-83.2%; P= 0.002). Obtaining syphilis serologies during pregnancy rose from 38.3 to 83.8% (P= 0.001), and providing effective treatment for gonorrhea rose from 57.8 to 81.1 % (P= 0.002), but correct responses on treatment for mucopurulent cervicitis at the post-test was a low 32.4%. CONCLUSION The introduction of continuing medical education for improved STD care targeting private physicians in Jamaica was successful based on high attendance rates and self-reported STD management practices. However, efforts should continue to address the weaknesses found in STD management and counseling and to reach the providers who did not participate. In the global effort to reduce HIV transmission by improving STD care services, continuing education programs that target the private sector can be successful and should be included as a standard activity to improve care and provide a public/private link to STD/HIV control.
The impact of atypia/follicular lesion of undetermined significance and repeat fine‐needle aspiration: 5 years before and after implementation of the Bethesda System

Limited studies have examined the impact of the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) and specifically the category of atypia or follicular lesion of undetermined significance (AUS/FLUS). We studied their effects on reporting rates, subsequent management, and surgical outcome over a 10‐year period, 5 years before and after implementation of the BSRTC.
Vaccine adjuvants: scientific challenges and strategic initiatives

The majority of vaccine antigens currently under investigation represent recombinant molecules or subunits of pathogens with little or no inherent immunostimulatory property. The development of safe and potent immunologic adjuvants that can increase and direct vaccine-specific immunity is, therefore, required urgently. At the same time, the discovery of Toll-like receptors and other innate immune receptors with the ability to bridge innate immune responses and adaptive immunity is offering unprecedented opportunities for the development of novel adjuvants. However, research on vaccine adjuvants has so far received little attention as an independent scientific priority from most of the main research-funding agencies and policy makers. Further, adjuvant research and development is currently spread over a wide number of highly diverse organizations, including large commercial companies, small biotech enterprises as well as publicly funded research organizations and academia. More efforts are, therefore, needed to highlight the importance of vaccine adjuvants on the global research agenda and to encourage collaboration and flow of information between different stakeholders. This article attempts to underline scientific challenges and strategic priorities in the development of vaccine adjuvants for human use.
Respiratory impedance and bronchodilator responsiveness in healthy children aged 2–13 years

The forced oscillation technique (FOT) can be used in children as young as 2 years of age and in those unable to perform routine spirometry. There is limited information on changes in FOT outcomes in healthy children beyond the preschool years and the level of bronchodilator responsiveness (BDR) in healthy children. We aimed to create reference ranges for respiratory impedance outcomes collated from multiple centers. Outcomes included respiratory system resistance (Rrs) and reactance (Xrs), resonant frequency (Fres), frequency dependence of Rrs (Fdep), and the area under the reactance curve (AX). We also aimed to define the physiological effects of bronchodilators in a large population of healthy children using the FOT.
Rotor core material and end ring length analysis for Solid-Rotor high speed Induction Motor

In this paper the effect of various rotor core material for high speed Solid Rotor Induction Motor (SRIM) have been analyzed. A comparative study, regarding the performance of high speed SRIM on variation of various material properties has been made. It has been observed that a material with good electrical conductivity gives efficient operation. The effect of end ring length of SRIM has also been analyzed. A considerable variation in torque has been observed on variation in end ring length for 180 kW, 10200 rpm high speed SRIM. It was seen that the rotor with smaller end ring provided better torque but with lower power factor. The efficiency was also increased with smaller end rings.
Pharmacotherapy for Nicotine Dependence 1

Approximately 50% of long‐term cigarette smokers die prematurely from the adverse effects of smoking, including on cancer, cardiovascular disease, lung disease, or other illness. This risk can be substantially reduced by smoking cessation, with greater benefits occurring the earlier in the smoking career that cessation occurs. However, cessation provides benefits at any stage, including after the onset of smoking‐related disease, by improving the prognosis and quality of life. Clinicians can have a significant impact on reducing tobacco use by their patients by following the US Public Health Service Clinical Practice Guidelines. Proven strategies include structured methods of advising cigarette smokers to quit and guidance to facilitate their efforts, as well as the use of various pharmacotherapies. Pharmacotherapies for tobacco dependence include nicotine replacement medications in the form of gum, transdermal patch, lozenge, sublingual tablet, nasal spray, and vapor inhaler formulations. The only nonnicotine medication that has been approved by the US Food and Drug Administration is bupropion. Combination therapies, long‐term medication therapies, and harm reduction strategies may further improve outcome with approved medications. Further, new medications such as varenicline and rimonabant are likely to reach tobacco users who are refractory to current treatments. Increasing the treatment options, increasing availability, and reducing the perceived cost of these medications may have an additional public health impact.
Results of an analysis of cardiac function in 2,812 patients treated with lapatinib.

583 Background: Lapatinib is an orally bioavailable reversible, dual tyrosine kinase ErbB1 and ErbB2 inhibitor. Trastuzumab, an ErbB2 inhibitor, has been associated with cardiotoxicity. METHODS Left ventricular ejection fraction (LVEF) was monitored every 8 weeks using MUGA or echocardiogram. Cardiac risk factors including age, underlying cardiovascular disease, previous exposure to AC, trastuzumab, or mediastinal/left sided radiation (XRT) were also collected. LVEF data were evaluated for ≥ NCI CTC grade 3, or ≥ 20% decline relative to baseline (& below institutional LLN). RESULTS 1.3%, 37 of the 2812 subjects who have received lapatinib in all trials to date have experienced decreased LVEF. 22 of 37 patients received lapatinib monotherapy, the remaining 15 received lapatinib in combination with other chemotherapeutic agents. 68% (25/37) of patients were female, median age was 59 years. Decreased LVEF occurred within 9 weeks of treatment onset in 68% of cases. The event resolved/improved in 57% of cases: in 50% of these, lapatinib treatment was continued. Average event duration was 5 weeks. Four of 37 patients were symptomatic (0.1% incidence). Most symptomatic events responded promptly to standard CHF therapy. The majority of patients (92%, 34/37) had confounding factors that may have contributed to the event, including previous exposure to AC, trastuzumab or XRT, and/or medical history. 8 of 34 patients had a positive lapatinib dechallenge (LVEF recovered): 3 were symptomatic (signs of CHF) and 5 asymptomatic. 3 patients had no contributing factors: 1 experienced symptomatic decreased LVEF, the remaining 2 died due to disease progression whilst LVEF decrease was ongoing. 16 of 1307 patients participating in placebo controlled studies experienced decreased LVEF. Of these 8 are known to have received lapatinib, giving an incidence of 1.2% (8/654). CONCLUSIONS Lapatinib-associated LVEF decrease is rarely symptomatic and generally reversible/non-progressive. Incidence was 1.3% in our population, less than the 3-6% incidence of asymptomatic LVEF decreases observed in the general population. Pharmacogenetic studies are ongoing to determine whether there is a link between ErbB2 polymorphisms and lapatinib cardiotoxicity. [Table: see text].
ChemDataBase 2: An Enhanced Chemical Database Management System for Virtual Screening

Virtual screening is a newly emerging method used in new drug research and development (R&D). The introduction of virtual screening immensely reduces R&D cycle and decreases R&D cost directly. Mass of chemical data used for virtual screening needs to be managed effectively in certain ways. We have developed the first release of ChemDataBase, but it only has the basic functions of chemical database which can not meet requirement of virtual screening fully. This paper investigates and implements the second and improved release of ChemDataBase which is better suitable for virtual screening. Compared with the first release, the second release has several new features. For one thing, it is based on CSGrid and supports accessing of Grid database created in CSGrid. For another thing, it adopts Hibernate framework for data persistence management. In addition, it can invoke data analysis software to analyze the results of virtual screening experiment. Finally, a case study in computational chemistry shows that the second release plays an important role in new drug R&D.
Isolation of enteroviruses from water, suspended solids, and sediments from Galveston Bay: survival of poliovirus and rotavirus adsorbed to sediments

The distribution and quantitation of enteroviruses among water, suspended solids, and compact sediments in a polluted estuary are described. Samples were collected sequentially from water, suspended solids, fluffy sediments (uppermost layer of bottom sediments), and compact sediment. A total of 103 samples were examined of which 27 (26%) were positive for virus. Polioviruses were recovered most often, followed by coxsackie B viruses and echoviruses 7 and 29. Virus was found most often attached to suspended solids: 72% of these samples were positive, whereas only 14% of water samples without solids yielded virus. Fluffy sediments yielded virus in 47% of the samples, whereas only 5% of compact bottom-sediment samples were positive. When associated with solids, poliovirus and rotavirus retained their infectious quality for 19 days. The same viruses remained infectious for only 9 days when freely suspended in seawater. Collection of suspended solids at ambient water pH appears to be very useful for the detection of virus; it has advantages over collecting and processing large volumes of water, with accompanying pH adjustment and salt addition for processing.
INFLUENCIA DEL NIVEL DE ALINEACIÓN Y DEL GÉNERO SOBRE LAS DECISIONES DE ADMINISTRACIÓN Y DE RECLUTAMIENTO DE PERSONAL EN LAS EMPRESAS ARGENTINAS

Cual es, en Argentina, el perfil del asalariado ideal ? Es un hombre o una mujer? Es alguien mas bien sumiso, obediente, "alineado", como ha sido observado en Francia o, al contrario, es alguien mas independiente? Por otra parte, ? ese perfil es el mismo independientemente del nivel jerarquico del asalariado, esto es, sea obrero o mando medio? Finalmente, ? el contenido de ese perfil es identico para su jefe directo, aquel que lo tiene a su cargo, que para un reclutador que no lo tendra efectivamente a su cargo? Tales son las preguntas a las cuales hemos querido responder, gracias a dos estudios cuasi experimentales. Como se expondra a continuacion, los resultados obtenidos indican una preferencia sistematica a favor de los hombres (y una discriminacion hacia las mujeres). Asimismo, confirman que la preferencia de los jefes directos de los asalariados se inclina hacia los subordinados alineados, mientras que los reclutadores eligen preferentemente el perfil del candidato no alineados (notoriamente para un puesto de mando medio y tambien notoriamente cuando el propone una mujer para ese puesto). Esos resultados seran discutidos tanto en el plano teorico, como en el nivel de implicaciones practicas
Joint Optimal Design of Digital Filters and State-Space Realizations

In this brief, a procedure for digital filters design is presented. The main purpose is to show that a digital filter and its realization can be simultaneously determined such as to minimize an upper bound of the H2 norm of the estimation error and impose a certain degree of robustness against practical uncertainties as for instance, finite word length implementation, roundoff errors, and numerical precision. The optimal filter and its state-space realization are jointly determined from the solution of a convex programming problem expressed in terms of linear matrix inequalities. A simple illustrative example is presented for comparison purposes making clear the advantages of the reported results
Disordered respiratory control in children with partial cerebellar resections

While the cerebellum is not traditionally thought of as having an important role in respiratory control, breathing involves cyclic motor acts that require cerebellar coordination. We postulate that children with partial cerebellar resections have disordered respiratory control due to altered synchronization of ventilatory muscles. We reviewed the records of 36 children following partial cerebellar resections due to neoplasms confined to the cerebellum. P aCO 2 values were elevated in 19% of patients. Six patients had apneic or bradypneic events documented within the first month after resection. Two patients required intubation with assisted ventilation, and one needed assisted ventilation for 7.3 weeks. Those with apnea had lower oxygen saturations, and a longer need for supplemental oxygen. Patients with apnea were older than those without apnea. Swallowing, which uses many of the same muscles as those needed to maintain upper airway patency, was dysfunctional in 50% of those with apneas. We conclude that children with cerebellar resections have an increased incidence of apnea, hypoventilation, and hypoxemia not otherwise explained by pulmonary disease, and some require prolonged assisted ventilation. We speculate that these abnormalities are manifestations of altered respiratory control caused by dysfunctional cerebellar coordination of ventilatory muscles. © 2005 Wiley‐Liss, Inc.
Clonal antigen receptor gene rearrangements and epstein‐barr viral DNA in tissues of Hodgkin's disease

In an initial survey of 16 cases of Hodgkin's disease, tissues from one case of nodular sclerosing Hodgkin's disease, a recurrence with numerous Reed‐Sternberg cells, demonstrated faint heavy‐ and light‐chain immunoglobulin gene rearrangements. Analysis of seven additional similar cases with extremely numerous Reed‐Sternberg cells revealed that six of these seven cases contained clonally rearranged heavy‐ or light‐chain genes. In addition, the original biopsy specimen from the index case (obtained two years prior to the recurrence) had the same pattern of rearrangements of the immunoglobulin genes. In contrast, a germline configuration was observed for the β T cell receptor gene in all cases.
The Mental Health of People Living with HIV in China, 1998–2014: A Systematic Review

Background Understanding the mental health burdens faced by people living with HIV in China is instrumental in the development of successful targeted programs for psychological support and care. Methods Using multiple Chinese and English literature databases, we conducted a systematic review of observational research (cross-sectional, case-control, or cohort) published between 1998 and 2014 on the mental health of people living with HIV in China. Results We identified a total of 94 eligible articles. A broad range of instruments were used across studies. Depression was the most widely studied problem; the majority of studies reported prevalence greater than 60% across research settings, with indications of a higher prevalence among women than men. Rates of anxiety tended to be greater than 40%. Findings regarding the rates of suicidality, HIV-related neurocognitive disorders, and substance use were less and varied. Only one study investigated posttraumatic stress disorder and reported a prevalence of 46.2%. Conflicting results about health and treatment related factors of mental health were found across studies. Conclusions Despite limitations, this review confirmed that people living with HIV are vulnerable to mental health problems, and there is substantial need for mental health services among this population.
Diving reflex: can the time course of heart rate reduction be quantified?

In this meta‐analysis of diving bradycardia in humans, we sought to quantify any heart rate (HR) reduction using a relatively simple mathematical function. Using the terms “diving reflex,”“diving bradycardia,”“diving response,”“diving plus heart rate,” databases were searched. Data from the studies were fitted using HR=c+aexp(−(t−t0)/τ), where c is the final HR, a is the HR decrease, τ is the time constant of HR decay, and t0 is the time delay. Of 890 studies, 220 were given closer scrutiny. Only eight of these provided data obtained under comparable conditions. Apneic facial immersion decreased HR with τ=10.4 s and in air alone it was less pronounced and slower (τ=16.2 s). The exponential function fitted the time course of HR decrease closely (r2>0.93). The fit was less adequate for apneic‐exercising volunteers. During apnea both with and without face immersion, HR decreases along a monoexponential function with a characteristic time constant. HR decrease during exercise with and without face immersion could not readily be described with a simple function: the parasympathetic reaction was partially offset by some sympathetic activity. Thus, we succeeded in quantifying the early time course of diving bradycardia. It is concluded that the diving reflex is useful to diagnose the integrity of efferent cardiovascular autonomic pathways.
Strategies for reducing inhibitor formation in severe haemophilia

The greatest barrier to successful haemophilia A care in resource‐rich countries is the development of inhibitors to therapeutic factor VIII. Children with inhibitors suffer through increased bleeding and joint damage as well as frequent venepuncture. Costs associated with inhibitors are beyond many healthcare systems. Over the last two decades, there has been no improvement in our ability to reduce inhibitor development. Current strategies based on early prophylaxis and avoidance of immunological danger signals have given rise to conflicting results. Registry data suggest an increasing problem. Our understanding of the immunological systems involved in inhibitor formation should inform efforts to prevent inhibitors. Great efforts with mouse models are being undertaken in this field. However, there is no guarantee of the availability of any new agents arising from experimental work in the near future. Global immunomodulatory agents may be one solution. Compounds with a long history of use in inflammatory conditions have demonstrated efficacy in preventing antibodies to protein therapeutics both in animal models and in humans. As these compounds have a long history of use in humans, including babies, it may be that these agents offer an option for reducing inhibitor formation in previously untreated patients.
Aβ imaging with 18F-florbetaben in prodromal Alzheimer's disease: a prospective outcome study

Background We assessed the clinical utility of β-amyloid (Aβ) imaging with 18F-florbetaben (FBB) in mild cognitive impairment (MCI) by evaluating its prognostic accuracy for progression to Alzheimer's disease (AD), comparing semiquantitative with visual scan assessment, and exploring the relationships among Aβ, hippocampal volume (HV) and memory over time. Methods 45 MCI underwent FBB positron emission tomography, MRI and neuropsychological assessment at baseline and 2 years and clinical follow-up at 4 years. Positive FBB (FBB+), defined by a cortical to cerebellar cortex standardised uptake value ratio (SUVR) ≥1.45, was compared with visual assessment by five readers. Amnestic MCI (aMCI) was defined by a composite episodic memory (EM) Z-score of <−1.5. Results At baseline, 24 (53%) MCI were FBB+. Majority reads agreed with SUVR classification (κ 0.96). In 2 years, 18 (75%) FBB+ progressed to AD compared with 2 (9.5%) FBB−, yielding a predictive accuracy of 83% (95% CI 61% to 94%). Four FBB− developed non-AD dementia. Predictive accuracies of HV (58% (95% CI 42% to 73%)) and aMCI status (73% (95% CI 58% to 81%)) were lower. Combinations did not improve accuracy. By 4 years, 21 (87.5%) FBB+ had AD whereas 5 (24%) FBB− had non-AD dementia yielding a predictive accuracy of 94% (95% CI 74% to 99%). While the strong baseline association between FBB SUVR and EM declined over 2 years, the association between EM and HV became stronger. FBB SUVR increased 2.2%/year in FBB+ with no change in FBB−. Conclusions 18F-florbetaben Aβ imaging facilitates accurate detection of prodromal AD. As neurodegeneration progresses, and in contrast with the early stages of the disease, hippocampal atrophy and not Aβ, seems to drive memory decline. Trial registration number NCT01138111.
Treatment of painful diabetic neuropathy

Painful diabetic neuropathy (PDN) is a debilitating consequence of diabetes that may be present in as many as one in five patients with diabetes. The objective assessment of PDN is difficult, making it challenging to diagnose and assess in both clinical practice and clinical trials. No single treatment exists to prevent or reverse neuropathic changes or to provide total pain relief. Treatment of PDN is based on three major approaches: intensive glycaemic control and risk factor management, treatments based on pathogenetic mechanisms, and symptomatic pain management. Clinical guidelines recommend pain relief in PDN through the use of antidepressants such as amitriptyline and duloxetine, the γ-aminobutyric acid analogues gabapentin and pregabalin, opioids and topical agents such as capsaicin. Of these medications, duloxetine and pregabalin were approved by the US Food and Drug Administration (FDA) in 2004 and tapentadol extended release was approved in 2012 for the treatment of PDN. Proposed pathogenetic treatments include α-lipoic acid (stems reactive oxygen species formation), benfotiamine (prevents vascular damage in diabetes) and aldose-reductase inhibitors (reduces flux through the polyol pathway). There is a growing need for studies to evaluate the most potent drugs or combinations for the management of PDN to maximize pain relief and improve quality of life. A number of agents are potential candidates for future use in PDN therapy, including Nav 1.7 antagonists, N-type calcium channel blockers, NGF antibodies and angiotensin II type 2 receptor antagonists.