Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of Maternal and Infant Antiretroviral Drug Regimens on Drug Resistance in HIV-infected Breastfeeding Infants

Background: The HIV Prevention Trials Network (HPTN) 046 trial evaluated the efficacy of extended infant nevirapine (NVP) administration for prevention of HIV transmission through breastfeeding. Infants received daily NVP up to 6 weeks of age. HIV-uninfected infants (the intent-to-treat group) received daily NVP or placebo up to 6 months of age. We analyzed emergence of NVP resistance in infants who acquired HIV infection despite prophylaxis. Methods: HIV genotyping was performed using the ViroSeq HIV Genotyping System. Medians and proportions were used to summarize data. Two-sided Fisher exact tests were used to evaluate associations between categorical variables. Results: NVP resistance was detected in 12 (92.3%) of 13 infants who were HIV-infected by 6 weeks and in 7 (28%) of 25 infants who were HIV-uninfected at 6 weeks and HIV-infected at 6 months of age (6/8 = 75% in the NVP arm, 1/17 = 5.9% in the placebo arm, P = 0.001). Among those 25 infants, 4 had mothers who initiated an antiretroviral treatment regimen by 6 months postpartum. In all 4 cases, the treatment regimen included a non-nucleoside reverse transcriptase inhibitor (NVP or efavirenz). NVP resistance was detected in all 4 of those infants by 6 months of age (4/4 = 100%). In contrast, only 3 (14.2%) of the remaining 21 HIV-infected infants whose mothers did not initiate antiretroviral treatment developed NVP resistance (P = 0.003). Conclusions: Extended NVP prophylaxis significantly increased the risk of NVP resistance in infants who acquired HIV infection after 6 weeks of age. Treatment of maternal HIV infection was also associated with emergence of NVP resistance in HIV-infected, breastfed infants.
Health Websites: Accessibility and Usability for American Sign Language Users

To date, there have been efforts toward creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our article focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users’ perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (n = 32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to (a) navigation to find the task, (b) website usability, and (c) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This article also describes the participants’ preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users.
Role of a Respiratory Viral Panel in the Clinical Management of Pediatric Inpatients

Background: Respiratory viral panels (RVPs) able to detect multiple pathogens are increasingly used in the management of pediatric inpatients. Despite this, few studies have examined whether the results of these tests are associated with clinically significant changes in medical management. Methods: In this retrospective cohort study, we identified pediatric inpatients between August 2009 and December 2010 for whom an RVP was ordered within 24 hours of admission to a large, tertiary-care children’s hospital. We used linear regression to determine whether RVP was associated with length of stay (LOS), duration of antibiotics and the number of diagnostic microbiology tests ordered, adjusting for potential confounders. Results: We found that the association between results of the RVP and LOS was dependent on a patient’s admission service, specifically admission to the hematology/oncology service. We also found that patients with a positive RVP had a shorter duration of intravenous antibiotic administration (P = 0.03; 42% reduction in the geometric mean), but that this was influenced by the primary admission service. We also found that positive results of the RVP were associated with decreased LOS and shorter duration of antibiotics in patients with some common respiratory diagnoses. Conclusions: This study lacked sufficient evidence to claim an association between a positive RVP and LOS in pediatric patients, adjusting for their underlying diagnosis. However, we found that a positive RVP was associated with a shorter duration of intravenous antibiotic administration in certain groups of patients and those with some common respiratory diagnoses. These findings help clarify the utility of rapid viral testing in the management of hospitalized pediatric patients.
Pediatric Bloodstream Infections in Cambodia, 2007 to 2011

Background: Pediatric bacterial bloodstream infections (BSIs) are a major cause of morbidity and mortality worldwide. Epidemiological data from resource-limited settings in southeast Asia, such as Cambodia, are sparse but have important implications for treatment and public health strategies. Methods: We retrospectively investigated BSI in children at a pediatric hospital and its satellite clinic in Siem Reap, Cambodia, from January 1, 2007, to July 31, 2011. The range of bacterial pathogens and their antimicrobial susceptibility patterns were analyzed in conjunction with demographic, clinical and outcome data. Results: Of 7682 blood cultures with results (99.9% of cultures taken), 606 (7.9%) episodes of BSI were identified in 588 children. The incidence of BSI increased from 14 to 50/1000 admissions (P < 0.001); this was associated with an increased sampling rate. Most BSI were community acquired (89.1%). Common pathogens included Salmonella Typhi (22.8% of all isolates), Staphylococcus aureus (12.2%), Streptococcus pneumoniae (10.0%), Klebsiella pneumoniae (6.4%) and Escherichia coli (6.3%). 21.5% of BSI were caused by a diverse group of uncommon organisms, the majority of which were environmental Gram-negative species. No Listeria monocytogenes or Group B streptococcal BSI were identified. Antimicrobial resistance, particularly among the Enterobacteriaceae, was common. Overall mortality was substantial (19.0%), higher in neonates (36.9%) and independently associated with meningitis/meningoencephalitis and K. pneumoniae infection. Conclusions: BSI is a common problem in Cambodian children attending hospital and associated with significant mortality. Further studies are needed to clarify the epidemiology of neonatal sepsis, the contribution of atypical organisms and the epidemiology of pneumococcal disease before the introduction of vaccine.
This item is the archived peer-reviewed author-version of: Antifouling grafting of ceramic membranes validated in a variety of challenging wastewaters

25 Compared to traditional separation and purification techniques, membrane filtration is particularly 26 beneficial for the treatment of wastewater streams such as pulp and paper mill effluents (PPME), 27 olive oil wastewater (OOWW) and oil/gas produced water (PW). However, severe membrane 28 fouling can be a major issue. 29 In this work, the use of ceramic membranes and the potential for the broad applicability of a 30 recently developed antifouling grafting was evaluated to tackle this issue. To this end, the fouling 31 behavior of native and grafted membranes was tested in the selected difficult wastewater streams, 32 both in dead-end and in cross-flow mode. In addition, the quality of the produced permeate water 33 was determined to assess the overall performance of the investigated membranes for reuse or 34 recycling of the treated wastewater. 35 The obtained results show that grafting significantly enhances the antifouling tendency of the 36 ceramic membranes. Particularly, the membrane grafted with methyl groups using the Grignard 37 technique (MGR), showed in all cases no or negligible fouling as compared to the native 38 membrane. As a consequence, the process flux or filtration capacity of the MGR membrane in 39 cross-flow is always higher and more stable than the native membrane, even though the grafting 40 lowers the pure water flux. Hence, the inert character of the MGR membrane is repeatedly proven 41 and shown to be broadly applicable and generic for anti-fouling, without loss in permeate quality. 42 Moreover, in case of OOWW, the quality of the MGR permeate is even better than that of the 43 native membrane due to its lower fouling. All results can be explained taking into account the 44 physico-chemical properties of foulants and membranes, as shown in previous work. In conclusion, 45 the use of MGR membranes could provide an optimum economical solution for the treatment of 46 the selected challenging wastewaters. 47
Adaptation of Siblings of Children Awaiting Liver Transplantation

Pediatric liver transplantation is becoming increasingly common, but specific information regarding the adaptation of the families of these children, particularly of siblings, is lacking. We examined 64 siblings from 45 families of children and adolescents evaluated for liver transplantation using the Child Behavior Checklist and the Impact-on-Family Scale. As a group, the sibling subjects did not show deficits on measures of social competence or behavioral maladjustment. However, 15 siblings showed behavioral maladjustment. These children were not distinguishable from the pool of siblings based on sex, birth order, or age spacing relative to their sibling (the patient), socioeconomic status, or duration of the patient's illness. However, these behaviorally maladjusted children came from families in which the mothers reported significantly greater personal strain than did the other parents in the study. Suggestions are made for interventions to reduce stress in families facing liver transplantation.
Doctors’ Attachment Orientations, Emotion Regulation Strategies, and Patient Satisfaction: A Multilevel Analysis

Abstract Extending recent research on emotion regulation in doctor–patient interaction, the present study examined relationships between doctors’ attachment orientations, their emotion regulation strategies, and patients’ satisfaction with the encounter. Forty doctors completed scales of attachment orientations and emotion regulation strategies, and 160 of their patients reported on a standard measure of satisfaction with their doctor. Results from multilevel analyses showed that doctors’ avoidant and anxious attachment orientations were independently associated with lower satisfaction for patients higher on serious illness perceptions. Doctors’ emotion regulation strategies did not mediate insecure attachment orientation relationships with patients’ satisfaction as anticipated, but these regulatory strategies were an independent factor associated with satisfaction levels of patients with higher illness severity perceptions. The study confirms predictions based on attachment theory that doctors’ insecure attachment can have adverse effects for doctor–patient interaction.
Effects of developmental exposure to ethanol on Caenorhabditis elegans.

BACKGROUND We investigated the effects of chronic ethanol exposure on physical development, reproduction, and life expectancy of Caenorhabditis elegans, a microscopic nematode worm. It has a small nervous system of 302 neurons and a short lifespan of 2 to 3 weeks. METHODS In this study, the worms were chronically exposed to varying concentrations of ethanol for different periods of their life: for their entire lifespan, during larval development only, and during adulthood only. In addition, the worms were exposed to ethanol acutely during different stages of embryonic development. RESULTS Chronic exposure to ethanol during larval development temporarily delayed physical growth, slowed development, delayed the onset of reproductive maturity, and decreased both reproductive fecundity and longevity. Chronic exposure to ethanol beginning when worms completed development and reached reproductive maturity resulted in reduced C. elegans body length, decreased reproductive fecundity, and life expectancy. Finally, acute embryonic exposure of C. elegans eggs to high concentrations of ethanol at different stages of development resulted in a lower probability of exposed eggs hatching into larval worms depending on when eggs were exposed during development. Furthermore, some of the worms that did hatch displayed distinct physical dysmorphologies as a consequence of acute ethanol exposure during embryonic development. CONCLUSIONS These data suggest that exposing C. elegans to ethanol during critical development periods results in characteristic phenotypic outcomes. Thus, C. elegans offers a novel model for exploring the mechanisms by which ethanol exposure affects development.
Content Analysis of Diet-Related Mobile Apps: A Self-Regulation Perspective

ABSTRACT Diet-related mobile apps hold promise in helping individuals self-regulate their eating behaviors. Nevertheless, little is known about the extent to which diet-related mobile apps incorporate the established behavior change theories and evidence-based practices that promote dietary self-regulation. Guided by the self-regulation aspect of Bandura’s social cognitive theory and the Dietary Guidelines for Americans 2010 of the U.S. Department of Agriculture, this study conducts a content analysis of diet-related mobile apps for iPhone (N = 400). In terms of the adherence to the self-regulation aspect of the social cognitive theory, results show that although 72.5% of the apps incorporate at least one theoretical construct, few apps tap all three processes of self-regulation (i.e., self-observation/monitoring, judgment process, and self-reaction). Additionally, outcome expectation is manifested in a majority of the diet-related apps. In terms of the Dietary Guidelines for Americans 2010, while the diet-related apps equally emphasize setting goals for calorie intake or nutrient consumption, more apps feature nutrient tracking than calorie tracking. Implications and limitations are discussed.
The Influence of Statistical versus Exemplar Appeals on Indian Adults’ Health Intentions: An Investigation of Direct Effects and Intervening Persuasion Processes

ABSTRACT In two separate investigations, we examined the persuasive effectiveness of statistical versus exemplar appeals on Indian adults’ smoking cessation and mammography screening intentions. To more comprehensively address persuasion processes, we explored whether message response and perceived message effectiveness functioned as antecedents to persuasive effects. Results showed that statistical appeals led to higher levels of health intentions than exemplar appeals. In addition, findings from both studies indicated that statistical appeals stimulated more attention and were perceived as more effective than anecdotal accounts. Among male smokers, statistical appeals also generated greater cognitive processing than exemplar appeals. Subsequent mediation analyses revealed that message response and perceived message effectiveness fully carried the influence of appeal format on health intentions. Given these findings, future public health initiatives conducted among similar populations should design messages that include substantive factual information while ensuring that this content is perceived as credible and valuable.
A longitudinal analysis of alcohol outlet density and assault.

BACKGROUND The majority of studies that have examined the local-level relationship between alcohol outlet density and violence have utilized cross-sectional data. These studies have consistently demonstrated that there is a spatial link between outlets and violence, but because of their design they have not been able to determine whether changes in outlet density result in changes in rates of violence. The few studies that have examined this question over time have found that the violence rates are related to changes in outlet density. This study provides further evidence of this link and examines the characteristics of regions in which changes in outlet density are most strongly associated with changes in violence rates. METHODS The study examined 9 years of data measuring alcohol outlet density (using liquor licensing records) and alcohol-related violence (using police recorded night-time assaults) from 186 postcodes in the metropolitan area of Melbourne, Australia. The relationships between 3 types of alcohol outlet density and alcohol-related violence were assessed using fixed-effects models. The postcodes were then grouped into 5 clusters based on their socio-demographic profile and separate fixed-effects models were fitted to assess whether the relationships between outlets and violence differed based on the type of region being examined. RESULTS The initial models found overall positive relationships between all 3 types of alcohol outlets and violence. When separate models were developed for postcode clusters, they demonstrated that the link between outlet density and violence was significant in all neighborhood types, but the specific relationships varied substantially. CONCLUSIONS Changes in the number of alcohol outlets in a community are linked to changes in the amount of violence the community experiences. This relationship varies across the clusters of suburbs examined, with packaged liquor outlets consistently associated with violence in suburban areas and general (hotel) and on-premise (nightclubs, restaurants, and bars) licenses associated with violence in inner-city and inner-suburban areas.
Ethanol-mediated DNA damage and PARP-1 apoptotic responses in cultured fetal cortical neurons.

BACKGROUND Prior studies by many laboratories have illustrated that ethanol can elicit a cascade of caspase-dependent apoptotic events in cultured neurons. Studies in our laboratory have connected this to oxidative stress and effects on fetal cortical neuron glutathione homeostasis. AIMS The intent of the following studies is to address mechanisms underlying ethanol-associated DNA damage that may be connected to apoptotic death of neurons. METHODS Cultures of fetal rat cerebral cortical neurons were utilized. Estimates of DNA damage was determined by Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining and nuclear condensation; Poly(ADP-ribose) polymerase-1 (PARP-1) expression was determined by immunostaining and Western blotting; and occurrence of parylation and AIF translocations were assessed by Western blotting. RESULTS Ethanol treatment of the neurons generated increases in DNA damage by 4 hours while nuclear condensation was low at the short exposure period but increased markedly by 24 hours. This was temporally related to a marked up-regulation of PARP-1 expression. Activity of PARP-1, as assessed by PolyADP-ribose (PAR) formation, occurred within 15 minutes and peaked by 6 to 8 hours of ethanol treatment. An almost complete translocation of apoptosis inducing factor (AIF) from mitochondria to the nucleus occurred by 24 hours of ethanol treatment (4.0 mg/ml). Ethanol treatment for 4, 12, and 24 hours elicited an increasing caspase-mediated cleavage of PARP-1 to its 24 kDa fragment. CONCLUSIONS These data illustrate the rapid occurrence of DNA damage following ethanol exposure and that PARP-1 pathways may play a role in the subsequent apoptotic death of these neurons.
Helicobacter pylori and its role in peptic ulcer disease

The majority of peptic ulcers are associated with Helicobacter pylori infection and it is now clear that eradication of H. pylori dramatically reduces ulcer recurrence. Other important outcomes of H. pylori infection include chronic gastritis (which may be asymptomatic), gastric cancer and lymphoma. Aims to give a brief overview of the discovery, epidemiology, pathophysiology, diagnosis and treatment of H. pylori associated disease.
Periocular Melanoma In Situ Treated With Imiquimod

Purpose: To evaluate the efficacy of topical 5% imiquimod cream in the treatment of periocular melanoma in situ (lentigo maligna). Design: Retrospective case series. Subjects: There were 12 patients in this series, and the mean patient age was 77 years. The anatomical locations were the lower eyelid (n=5), upper and lower eyelid (n=4), lower eyelid including the eyelid margin (n=1), brow (n=1), and the medial canthus (n=1). Topical 5% imiquimod cream was used as a primary treatment (n=6) or as an adjunctive therapy following local excision (n=2), cryotherapy (n=2), or excisional biopsy with cryotherapy (n=2). Methods: Twelve patients with periocular melanoma in situ were treated with topical 5% imiquimod cream daily for a mean treatment period of 3.9 months. The clinical features of the patients and the responses to treatment were evaluated in a retrospective case series. Main Outcome Measures: Histologic clearance of atypical melanocytes. Results: Eleven patients achieved complete histologic clearance of atypical melanocytes on post-treatment biopsy. One patient could not tolerate local irritation from imiquimod and stopped in the first month of therapy with residual disease. The median follow-up time was 1.5 years. Side effects included redness (n=12), discomfort (n=6), swelling (n=4), ectropion (n=1), and conjunctival chemosis (n=1). The patients experienced no systemic side effects from the treatment. Conclusions: Topical 5% imiquimod cream is an effective option as primary or adjunct therapy in the treatment of periocular melanoma in situ.
Comparison of Temporal Fossa Volume in Young Versus Senescent Human Skulls

Purpose: To determine whether bony changes in the temporal fossa occur with age. Methods: Human skulls within 2 age groups from the Hamann-Todd collection at the Cleveland Natural History Museum (Cleveland, Ohio, U.S.A.) were studied. The young group of skulls consisted of adults aged 18 to 30 years, and the senescent group of skulls consisted of individuals aged over 69 years. A modeling compound molded to each temporal fossa in an identical fashion was weighed as a proxy for volume. Calipers measured temporal fossa width and length, and the zygoma circumference was measured at 3 locations on each skull. A protractor determined the internal and external angles of the zygomatic bone for each skull. Results: Each group contained 49 skulls. The average age was 23 years (range, 18–28 years) in the young skull group and 80 years (range, 72–96 years) in the senescent group. There were 62 (63%) African American skulls and 36 (37%) Caucasian skulls. There were 30 (31%) female skulls. Mean temporal fossa compound weight was 58.5 g in the young group and 59.5 g in the senescent group (p = 0.58). The differences in temporal fossa length and width were not statistically significant between the 2 age groups (p = 0.92 and p = 0.49, respectively). There were no significant differences in the bony dimensions of the zygoma or frontozygomatic suture between the 2 age groups, or in the internal or the external zygomatico-frontal angles (p = 0.76 and p = 0.96, respectively) between the 2 age groups. Conclusion: Temporal fossa bony anatomy remains stable with age, and expansion of this space does not contribute to temporal hollows. Current and future treatments for temporal hollows should be designed with these finding in mind.