Miracle-dz/UniFAR-FTUs huggingface dataset:
The Importance of Perivitelline Fluid Convection to Oxygen Uptake of Pseudophryne bibronii Eggs

The ciliated epithelium of amphibian embryos produces a current within the perivitelline fluid of the egg that is important in the convective transfer of oxygen to the embryo’s surface. The effects of convection on oxygen uptake and the immediate oxygen environment of the embryo were investigated in Pseudophryne bibronii. Gelatin was injected into the eggs, setting the perivitelline fluid and preventing convective flow. Oxygen consumption rate () and the oxygen partial pressure (Po2) of the perivitelline fluid were measured in eggs with and without this treatment. decreased in eggs without convection at Gosner stages 17–19 under normoxia. The lack of convection also shifted embryos from regulators to conformers as environmental Po2 decreased. A strong Po2 gradient formed within the eggs when convection was absent, demonstrating that the loss of convection is equivalent to decreasing the inner radius of the capsule, an important factor in gas exchange, by 25%. also declined in stage 26–27 embryos without cilia-driven convection, although not to the extent of younger stages, because of muscular movements and a greater skin surface area in direct contact with the inner capsule wall. This study demonstrates the importance of convective flow within the perivitelline fluid to gas exchange. Convection is especially important in the middle of embryonic development, when the perivitelline space has formed, creating a barrier to gas exchange, but the embryos have yet to develop muscular movements or have a large surface area exposed directly to the jelly capsule.
Investigation of an Outbreak of 2009 Pandemic Influenza A Virus (H1N1) Infections among Healthcare Personnel in a Chicago Hospital

In May 2009, we investigated a hospital outbreak of pandemic H1N1 (pH1N1) infection among healthcare personnel (HCP). Thirteen (65%) of 20 HCP with pH1N1 infection had healthcare-associated cases, which were primarily attributed to transmission among HCP. Eleven (55%) of HCP with pH1N1 infection worked for 1 day or more after the onset of illness. Personnel working with mild illness may have contributed to transmission among HCP.
Mitochondrial Genomics and CD4 T-Cell Count Recovery After Antiretroviral Therapy Initiation in AIDS Clinical Trials Group Study 384

BackgroundMitochondrial DNA (mtDNA) variation has been associated with time to progression to AIDS and adverse effects from antiretroviral therapy (ART). In this study, full mitochondrial DNA (mtDNA) sequence data from US-based adult participants in the AIDS Clinical Trials Group study 384 was used to assess associations between mtDNA variants and CD4 T-cell recovery with ART. MethodsFull mtDNA sequence was determined using chip-based array sequencing. Sequence and CD4 cell count data was available at baseline and after ART initiation for 423 subjects with HIV RNA levels <400 copies per milliliter plasma. The primary outcome was change in CD4 count of ≥100 cells per cubic millimeter from baseline. Analyses were adjusted for baseline age, CD4 cell count, HIV RNA, and naive:memory CD4 cell ratio. ResultsRace-stratified analysis of mtDNA variants with a minor allele frequency >1% revealed multiple mtDNA variants marginally associated (P < 0.05 before Bonferroni correction) with CD4 cell recovery. The most significant single nucleotide polymorphism associations were those tagging the African L2 haplogroup, which was associated with a decreased likelihood of ≥100 cells per cubic millimeter CD4 count increase at week 48 in non-Hispanic blacks (adjusted odds ratio = 0.17; 95% confidence interval = 0.06 to 0.53; P = 0.002). ConclusionsAn African mtDNA haplogroup was associated with CD4 cell recovery after ART in this clinical trial population. These initial findings warrant replication and further investigation to confirm the role of mtDNA variation in CD4 cell recovery during ART.
Accidental deaths occurring in bed: Review of cases and proposal of preventive strategies

Abstract The bed is thought to be a safe place, but posses a number of risks that can cause deaths. To identify the causes of accidental death in bed and propose strategies for the prevention of further accidents, we surveyed and analyzed the literature on accidental deaths in bed from Japan and abroad, as well as legal cases related to accidental death in bed in Japan. A search of the medical literature in Japan (1983‐2007), abroad (1976‐2007), and Japan's legal cases (1989‐2007) located 39 cases. The vast majority of accidental deaths in bed occur among infants and elderly individuals with neurologic disorders. The main causes of death within these two groups are head injuries caused by falls from a bed and asphyxia caused by pressure to the neck when wedged against a bed rail. It is necessary to focus on prevention of falls from bed and prevention of asphyxia caused by bed rails in the case of infants and elderly individuals with neurologic disorders. Infants should be placed to sleep in beds designed for their ages and placed on their back. Elderly individuals need to sleep in beds with properly fitting bed rails to reduce wedging.
Loss to Follow-Up of Stable Antiretroviral Therapy Patients in a Decentralized Down-Referral Model of Care in Johannesburg, South Africa

AbstractA retrospective record review was conducted for patients down referred to primary health care facilities between 2007 and 2009 to assess the rate and reported reasons for loss to follow-up among stable antiretroviral patients in a down-referral model of care in Johannesburg, South Africa. Missing patients were traced telephonically. Of 3361 patients down referred, 4.11% were lost to follow-up. Most patients who were lost to follow-up were lost at the transfer stage between initiation and maintenance sites. Decentralization and nurse management of ART should be prioritized to increase access to and retention in HIV/AIDS care.
Soft-tissue management for primary closure in immediate implant placement

Background: Incomplete flap coverage or early exposure over implants and/or barrier membranes have a negative effect on bone regeneration. In cases of using regenerative techniques, complete soft tissue coverage of the implant area is necessary to promote adequate conditions for guided bone regeneration. Primary socket closure may be difficult, when periosteal releasing incision is only used, due to the opening left by extracted tooth. Therefore, Soft tissue grafting techniques are used to achieve primary soft tissue closure. Materials and Methods: Soft tissue grafting techniques, with or without barrier membranes, were performed for primary closure in four cases of immediate placements. Three different methods were used (CTG, VIP-CT, Palatal advanced flap). Clinical results of the grafting were evaluated. Result: One case showed early exposure of cover-screw and, no other complications were noted. In the others, Primary closure was achieved by soft tissue grafting techniques. One of the cases, Graft showed partial necrosis, but there were no exposure over implants and/or barrier membranes. Conclusion: The use of grafting techniques, in immediate implant placement, can predictably obtain primary closure of extraction sockets, thereby providing predictable bone formation and improved implant results. (J Korean Acad Periodontol 2008;38:253-262)
Expectancy and Readiness-Based Predictors of Treatment Uptake Among the Urban Poor Living With HIV

AbstractThere is growing evidence that early treatment with antiretroviral therapy (ART) confers benefit to HIV-infected persons and may reduce the risk of transmission. Among an urban poor sample living with HIV who meet guidelines for but are not taking ART, we explored treatment beliefs at baseline and subsequent ART uptake over the following 12 months. Most demographic/background characteristics did not differ between ART initiators and noninitiators, but baseline beliefs of expectancies about treatment ease, efficacy, and readiness sensitively predicted ART initiation. Treatment-related stigma/social concerns did not. Results offer direction for interventions to optimize treatment among those most in need.
Excellent Clinical Outcomes and High Retention in Care Among Adults in a Community-Based HIV Treatment Program in Rural Rwanda

Background: Access to antiretroviral therapy (ART) has rapidly expanded; as of the end of 2010, an estimated 6.6 million people are receiving ART in low-income and middle-income countries. Few reports have focused on the experiences of rural health centers or the use of community health workers. We report clinical and programatic outcomes at 24 months for a cohort of patients enrolled in a community-based ART program in southeastern Rwanda under collaboration between Partners In Health and the Rwandan Ministry of Health. Methods and Findings A retrospective medical record review was performed for a cohort of 1041 HIV+ adult patients initiating community-based ART between June 1, 2005, and April 30, 2006. Key programatic elements included free ART with direct observation by community health worker, tuberculosis screening and treatment, nutritional support, a transportation allowance, and social support. Among 1041 patients who initiated community-based ART, 961 (92.3%) were retained in care, 52 (5%) died and 28 (2.7%) were lost to follow-up. Median CD4 T-cell count increase was 336 cells per microliter [interquartile range: (IQR): 212–493] from median 190 cells per microliter (IQR: 116–270) at initiation. Conclusions: A program of intensive community-based treatment support for ART in rural Rwanda had excellent outcomes in 24-month retention in care. Having committed to improving access to HIV treatment in sub-Saharan Africa, the international community, including country HIV programs, should set high programmatic outcome benchmarks.
Correlação entre o posicionamento dos parafusos pediculares no corpo vertebral e sua força de arrancamento

SUMMARY The objective of this paper was to study pedicular screws fixation strength on vertebral bodies by varying its repositioning angle. For this Study, eight pigs were selected, making up a total of 40 lumbar vertebrae, which were divided into 4 study groups. In the first group, the screws were inserted at zero degree, and in the second group, they were inserted and reinserted at the same position, while in the third group, the screws were reinserted within a 14-degree range, and, in the fourth group, within a 28-degree range. All screws were tested for pullout strength. Group I presented a pullout average of 146.85N. Group II presented a pullout average of 77.34N. Group III had an average of 97.75N. Group IV had an average of 110.02. It was concluded that the procedure of replacing screws should be avoided. Should any repositioning is required, this should be performed by changing repositioning angles as much far from the first one as possible.
New Insights into Virulence Evolution in Multigroup Hosts

Many of the standard predictions in evolutionary epidemiology result from models in which all hosts are equally susceptible to acquiring an infection and equally capable of resisting pathogens once an infection has been established. This contrasts with the empirical reality that natural host populations are typically composed of individuals with various susceptibilities and vulnerabilities to pathogen exploitation that can influence all aspects of a given pathogen’s transmission-virulence phenotype. In these structured host settings, host-dependent variation in the virulence-transmission trade-off plays an important role in determining pathogen evolution. By deriving some game-theoretic equilibrium expressions that describe pathogen evolution in heterogeneous host populations, the contribution of host heterogeneity to the direction of evolution in host exploitation is made explicit. Within this framework, qualitative departures from predictions derived from theory utilizing a homogeneous host assumption can be seen as a manifestation of Simpson’s paradox in an evolutionary setting. By reconsidering some predictions from homogeneous host theory through the lens of this new perspective, it can be seen that many standard predictions are actually special cases that result when homogeneity in immunity parameters is imposed on host populations.
A STUDY OF THE NEUROFIBRILS IN DEMENTIA PARALYTICA, DEMENTIA SENILIS, CHRONIC ALCOHOLISM, CEREBRAL LUES AND MICROCEPHALIC IDIOCY

It has been indicated throughout this paper that great caution must be exercised in the interpretation of the alterations which the neurofibrils present in material from pathological sources, a caution which in the light of our present knowledge cannot be too strongly emphasized. The writer believes, nevertheless, from a study of these 14 cases and 40 others which have been examined in the laboratory of the Westborough Insane Hospital but not reported, and after due consideration of the objections which have been raised, that alterations in the neurofibrils which might well be considered pathological, may be demonstrated in the cerebral cortex of persons dying insane. (a) The alterations in the neurofibrils when taken alone do not appear to have any greater value for diagnostic purposes than the mere disintegration of the tigroid masses in a Nissl preparation. (b) The poverty in cell processes the more or less universal tinging of the nucleus and destruction of the finer intercellular fibrils characterize.
Antimicrobial Stewardship—the State of the Art in 2011 Focus on Outcome and Methods

Antimicrobial stewardship programs attempt to optimize prescribing of these drugs to benefit both current and future patients. Recent regulatory and other incentives have led to widespread adoption of such programs. Measurements of the success of these programs have focused primarily on process measures. However, evaluation of outcome measures will be needed to ensure sustainability of these efforts. Outcome efforts to date provide some evidence for improved care of individual patients, some evidence for minimizing emergence of resistance, and ample evidence for cost reduction. Attention to evaluation methods must be increased to provide convincing evidence for the continuation of such programs.
Population Regulation and Character Displacement in a Seasonal Environment

Competition has negative effects on population size and also drives ecological character displacement, that is, evolutionary divergence to utilize different portions of the resource spectrum. Many species undergo an annual cycle composed of a lean season of intense competition for resources and a breeding season. We use a quantitative genetic model to study the effects of differential reproductive output in the summer or breeding season on character displacement in the winter or nonbreeding season. The model is developed with reference to the avian family of Old World leaf warblers (Phylloscopidae), which breed in the temperate regions of Eurasia and winter in tropical and subtropical regions. Empirical evidence implicates strong winter density-dependent regulation driven by food shortage, but paradoxically, the relative abundance of each species appears to be determined by conditions in the summer. We show how population regulation in the two seasons becomes linked, with higher reproductive output by one species in the summer resulting in its evolution to occupy a larger portion of niche space in the winter. We find short-term ecological processes and longer-term evolutionary processes to have comparable effects on a species population size. This modeling approach can also be applied to other differential effects of productivity across seasons.
Associations Between HLA-DRB1*0102, HLA-B*5801, and Hepatotoxicity During Initiation of Nevirapine-Containing Regimens in South Africa

A three-drug regimen comprising nevirapine plus two nucleoside reverse transcriptase inhibitors is frequently prescribed for HIV-1 infection worldwide. Unfortunately, drug hypersensitivity which can include severe hepatotoxicity during the initial weeks of therapy with nevirapine, particularly when initiated in women with >250 CD4+ T cells/mm3, have prompted changes in prescribing guidelines. Although isolated non-severe skin rash associated with nevirapine may be managed conservatively, the major treatment-limiting side effect of nevirapine is a drug hypersensitivity syndrome comprising fever, skin rash and/or hepatitis. This affects as many as 5% of those starting the drug. Various HLA class I and II alleles have been associated with nevirapine rash and/or hepatitis across different populations [1–6]. A population based study from Western Australia first identified an association between HLA-DRB1*0101 and nevirapine-associated hepatitis among patients with ≥25% CD4+ T cells [1]. This work was complemented by ex vivo studies suggesting a CD4 T cell-dependent process. Associations were subsequently identified between various HLA class I alleles such as HLA-B*1402 and HLA-Cw8 and nevirapine hypersensitivity in Sardinian [2] and Japanese [3] populations. A case control study in a Thai population identified an association between HLA-B*3505 and nevirapine-associated rash or hypersensitivity [4]. Further analyses from Western Australia confirmed the original association between HLA-DRB1*0101 and ≥25% CD4 T cells, and identified an association between HLA-B*3501 and nevirapine-associated rash, suggesting that phenotype was particularly important for defining specific HLA associations [5]. Only in the presence of hepatitis was HLA-DRB1*0101 associated with rash, while HLA-B*3501 was associated with rash regardless of hepatitis [5]. A retrospective analysis involving 76 sites in 11 countries (none in Africa) enrolled 276 cases who had experienced severe rash and/or hepatitis within 8 weeks of nevirapine initiation, and 587 nevirapine-tolerant controls [6]. Based on two digit HLA typing, that study associated HLA-DRB1*01 with hepatitis in whites, both HLA-B*35 and HLA-Cw*04 with rash in Asians, and HLA-Cw*04 alone with rash in Whites and Blacks. Furthermore, CYP2B6 slow metabolizer genotype was associated with rash but not hepatotoxicity. The above studies suggest that diverse genetic, immunological and drug metabolism pathways contribute to nevirapine hypersensitivity syndromes, and that associations may differ by specific toxicity phenotype and population. Data from Africa, where HIV prevalence and nevirapine use is high have been scant. Herein we used data and specimens previously collected during a clinical trial in South Africa to characterize relationships between HLA I and II alleles and nevirapine hepatotoxicity.
Estimating HIV Prevalence and HIV-Related Risk Behaviors Among Heterosexual Women Who Have Multiple Sex Partners Using Respondent-Driven Sampling in a High-Risk Community in South Africa

Background:Repeated surveillance surveys are important for monitoring trends in HIV and risk behaviors over time. In countries most adversely affected by HIV and AIDS, community-level HIV biological and behavioral surveillance surveys are needed among subpopulations who engage in high-risk sexual behaviors. Purpose:To describe the effectiveness of respondent-driven sampling (RDS) to recruit heterosexual women who have multiple concurrent sexual partnerships, to report HIV prevalence and describe key characteristics among them, and to assess whether RDS-accessed women not usually recruited during routine sentinel surveillance surveys. Methods:We conducted a HIV biological and behavioral surveillance surveys using RDS among women. Participants completed an audio-computer–assisted survey interview, voluntarily provided dried blood spots for HIV testing, and were offered rapid HIV testing. Results:The analytical sample comprised 845 women whose mean age was 23.9 years. About 6.4% were married, 49.6% lived in informal dwellings, and 31.8% reported not to have enough money for food. HIV prevalence was 28.8% (95% confidence intervals: 24.3 to 33.4). Being between 20 and 29 years was significantly related to HIV infection. Women who had never attended a public health facility (10.1%) compared with those who had were more likely to be 16–19 years (P = 0.008), reported sexual debut at 10–14 years (P = 0.044), were more likely to have experienced a symptom of a sexually transmitted infection (P = 0.031), and to have taken illegal drugs (P = 0.007). Conclusions:RDS effectively recruited women who reported 2 or more male sexual partners in the past 3 months. HIV prevalence and HIV-related risk behaviors were high among women who have multiple concurrent partners.
Impact of Antiretroviral Therapy on Adult HIV Prevalence in a Low-Income Rural Setting in Uganda: A Longitudinal Population-Based Study

Objective:To estimate the contribution to HIV prevalence of lives saved due to the introduction of antiretroviral therapy (ART) in rural Uganda in 2004. Design:Open population-based cohort study. Methods:An open general population cohort with annual demographic and HIV serostatus data is used to estimate annual HIV prevalence, HIV incidence, and mortality from 2000 to 2010. We calculated standardized mortality rates among HIV-positive adults and the expected number of deaths in the cohort if ART had not been available during 2004–2010, based on the average mortality rate in the 4 years (2000–2003) before ART introduction. Results:During 2004–2010, the estimated prevalence increased by 29% from 6.9% to 8.9%. HIV incidence was 5.6 cases per 1000 person-years in 2004, falling to 3.9 cases per 1000 person-years in 2006, and slightly rising to 5.1 in 2010. There was an increase of 182 in the number of HIV-positive participants during that period, cumulatively 228 lives were saved due to ART. Expected lives saved due to ART accounted for an increasing proportion of the estimated HIV prevalence from 4.0% in 2004 to 29.4% in 2010. Conclusions:Expected lives saved due to ART largely accounted for the increased estimated HIV prevalence from 2004 to 2010. Because HIV prevalence survey results are important for planning, programming, and policy, their interpretation requires consideration of the increasing impact of ART in decreasing mortality.
Synchronous Peaks in Trap Catches of Malaria-Infected Mosquito Species at Daeseongdong, a Border Village between North and South Korea

ABSTRACT: Malaria continues to be a major health threat near the Demilitarized Zone (DMZ) that separates North and South Korea. Adult mosquitoes were collected from 20 July through 21 October, 2010 at Daeseongdong, a small village within the DMZ. Molecular techniques were used to identify Anopheles to species and for detection of Plasmodium vivax sporozoites in their head and thorax. Trap catches showed concordant peaks of Anopheles belenrae and An. kleini early in the study period and concordant peaks of An. pullus and An. sinensis later in the season. Three well defined peaks of the 107 sporozoite positive mosquitoes were observed: 34.6% were An. kleini, 23.4% were An. belenrae, 21.5% were An. sinensis, 19.6% were An. pullus, and 0.9% were An. lesteri. Estimation of the extrinsic incubation period from daily temperatures did not help identify preceding biting peaks of An. pullus and An. sinensis, when infection should have been acquired. We explore possible reasons for the sudden appearance and disappearance of sporozoite-infected mosquitoes, including the influx of infected mosquitoes from adjoining areas, and weather patterns. Regular surveillance for infected mosquitoes near border areas of the Republic of Korea may provide advance warning of increased malaria risk potential.