Miracle-dz/UniFAR-FTUs huggingface dataset:
Challenges of Multidrug-resistant New Delhi Metallo-beta-Lactamase (NDM-1)-producing Enterobacteriaceae in Kidney Transplant Patients

Abstract Background: The emergence of multidrug-resistant NDM-1-producing enterobacteriaceae strains has become a threat to inpatients, especially to immunosuppressed ones, such as kidney transplant recipients. NDM-1 is a carbapenemase that makes gram-negative bacteria resistant to many types of antibiotics. The incidence of carbapenemase-producing enterobacteria infection in solid organ transplant recipients is around 3 to 10%, with a mortality rate of up to 30%. Methods: We present a case series of 4 patients with NDM-1-producing enterobacteria isolated in urine cultures or rectal swabs. We also conducted a cross-sectional study 30 days after patient identification, collecting surveillance cultures (rectal swab) from all inpatients to assess the extent of spread of this resistance mechanism; a total of 101 patients were included. Results: Two patients were adequately treated with negative control cultures. The other two patients were not treated because they were asymptomatic and had subsequent negative urine cultures. No new colonization was identified in the cross-sectional screening, and no new cases of urinary NDM-1 infection were recorded after a 4-year follow-up. Conclusion: Surveillance for infections caused by multidrug-resistant strains in hospitals treating immunosuppressed patients should be continued and prompt action should be taken in cases of outbreaks of multidrug-resistant infections.
Predictors of fever response in tuberculous meningitis: A clinical, MRI and biomarker study

Central nervous system (CNS) has a different immune surveillance system; therefore, fever at admission and timeline of fever response after antitubercular treatment (ATT) may follow a different course in CNS infection. We report the predictors of fever response in tuberculous meningitis (TBM) including the effect of tumour necrosis factor‐α (TNF‐α) in cerebrospinal fluid (CSF) and its gene expression at mRNA of peripheral blood mononuclear cells (PBMCs).
Sulfur‐driven autotrophic denitrification of nitric oxide for efficient nitrous oxide recovery

Nitrous oxide (N2O) was previously deemed as a potent greenhouse gas but is actually an untapped energy source, which can accumulate during the microbial denitrification of nitric oxide (NO). Compared with the organic electron donor required in heterotrophic denitrification, elemental sulfur (S0) is a promising electron donor alternative due to its cheap cost and low biomass yield in sulfur‐driven autotrophic denitrification. However, no effort has been made to test N2O recovery from sulfur‐driven denitrification of NO so far. Therefore, in this study, batch and continuous experiments were carried out to investigate the NO removal performance and N2O recovery potential via sulfur‐driven NO‐based denitrification under various Fe(II)EDTA‐NO concentrations. Efficient energy recovery was achieved, as up to 35.5%–40.9% of NO was converted to N2O under various NO concentrations. N2O recovery from Fe(II)EDTA‐NO could be enhanced by the low bioavailability of sulfur and the acid environment caused by sulfur oxidation. The NO reductase (NOR) and N2O reductase (N2OR) were inhibited distinctively at relatively low NO levels, leading to efficient N2O accumulation, but were suppressed irreversibly at NO level beyond 15 mM in continuous experiments. Such results indicated that the regulation of NO at a relatively low level would benefit the system stability and NO removal capacity during long‐term system operation. The continuous operation of the sulfur‐driven Fe(II)EDTA‐NO‐based denitrification reduced the overall microbial diversity but enriched several key microbial community. Thauera, Thermomonas, and Arenimonas that are able to carry out sulfur‐driven autotrophic denitrification became the dominant organisms with their relative abundance increased from 25.8% to 68.3%, collectively.
Modeling fomite‐mediated SARS‐CoV‐2 exposure through personal protective equipment doffing in a hospital environment

Abstract Self‐contamination during doffing of personal protective equipment (PPE) is a concern for healthcare workers (HCW) following SARS‐CoV‐2‐positive patient care. Staff may subconsciously become contaminated through improper glove removal; so, quantifying this exposure is critical for safe working procedures. HCW surface contact sequences on a respiratory ward were modeled using a discrete‐time Markov chain for: IV‐drip care, blood pressure monitoring, and doctors’ rounds. Accretion of viral RNA on gloves during care was modeled using a stochastic recurrence relation. In the simulation, the HCW then doffed PPE and contaminated themselves in a fraction of cases based on increasing caseload. A parametric study was conducted to analyze the effect of: (1a) increasing patient numbers on the ward, (1b) the proportion of COVID‐19 cases, (2) the length of a shift, and (3) the probability of touching contaminated PPE. The driving factors for the exposure were surface contamination and the number of surface contacts. The results simulate generally low viral exposures in most of the scenarios considered including on 100% COVID‐19 positive wards, although this is where the highest self‐inoculated dose is likely to occur with median 0.0305 viruses (95% CI =0–0.6 viruses). Dose correlates highly with surface contamination showing that this can be a determining factor for the exposure. The infection risk resulting from the exposure is challenging to estimate, as it will be influenced by the factors such as virus variant and vaccination rates.
Nationwide paediatric cohort study of a protective association between allergy and complicated appendicitis

Abstract Background In a nationwide cohort the potentially protective association between allergy and complicated appendicitis was analysed, and the influence of seasonal antigens, antihistamine treatment, and timing of allergy onset assessed. Methods Some 1 112 571 children born between 2000 and 2010 were followed from birth until the end of 2014. A cross-sectional analysis of appendicitis cases, with comparison of allergic versus non-allergic children for absolute risk and odds of complicated appendicitis was first undertaken. This was followed by a longitudinal analysis of children with allergy and matched controls who had never had an allergy, for incidence rate and hazard of subsequent complicated or simple appendicitis. Results Of all children, 20.4 per cent developed allergy and 0.6 per cent had appendicitis during follow-up. Among children with appendicitis, complicated appendicitis was more common among non-allergic children (18.9 per cent, 948 of 5016) than allergic children (12.8 per cent, 173 of 1351) (P < 0.001), and allergic children had a lower adjusted odds of complicated appendicitis (adjusted odds ratio (OR) 0.80, 95 per cent c.i. 0.67 to 0.96; P = 0.021 ). The risk of complicated appendicitis among children with manifest allergy was reduced by one-third in the longitudinal analysis (incidence rate 0.13 versus 0.20 per 1000 person-years; hazard ratio (HR) 0.68, 95 per cent c.i. 0.58 to 0.81; P < 0.001), whereas the risk of simple appendicitis remained unchanged (incidence rate 0.91 versus 0.91; HR 1.00, 0.94 to 1.07; P = 0.932 ). Seasonal antigen exposure was a protective factor (adjusted OR 0.82, 0.71 to 0.94; P = 0.004) and ongoing antihistamine medication a risk factor (adjusted OR 2.28, 1.21 to 4.28; P = 0.012). Conclusion Children with allergy have a lower risk of complicated appendicitis, but the same overall risk of simple appendicitis. Seasonal antigen exposure reduced, and antihistamine treatment increased, the risk of complicated disease.
Cardiometabolic comorbidity in the selection of treatment in spondyloarthritis: one step closer to truly personalized medicine?

Spondyloarthritis (SpA) are interrelated entities that share clinical and imaging traits, and a common genetic background through HLA-B27 and other loci. The pathogenesis of these diseases is strongly linked to aberrant signaling dependent on the IL23-Th17 axis. Cytokines of this axis, such as IL23, IL22, and IL17A, are key to explain most clinical and radiographic manifestations observed in SpA [1]. These entities are relatively common in rheumatology practice. Thus, the prevalence of axial SpA has been estimated between 0.20% and 1.6% of the general population, this prevalence varying depending on the prevalence of HLA-B27 in the target population [1]. For its part, a recent epidemiological study raised the prevalence of psoriatic arthritis (PsA) to almost 0.6% of the adult population in Spain [2]. Apart from their frequency, these diseases seriously affect the quality of life and social participation, so the impact they generate on patients and health-care systems is enormous.
Third generation cephalosporin resistance in clinical non-typhoidal Salmonella enterica in Germany and emergence of bla CTX-M-harbouring pESI plasmids

Non-typhoidal Salmonella enterica is an important gastrointestinal pathogen causing a considerable burden of disease. Resistance to third generation cephalosporins poses a serious threat for treatment of severe infections. In this study occurrence, phylogenetic relationship, and mechanisms of third generation cephalosporin resistance were investigated for clinical non-typhoidal S. enterica isolates in Germany. From 2017 to 2019, we detected 168 unique clinical S. enterica isolates with phenotypic resistance to third generation cephalosporins in a nation-wide surveillance. Compared to previous years, we observed a significant (P=0.0002) and consistent increase in resistant isolates from 0.41 % in 2005 to 1.71 % in 2019. In total, 34 different serovars were identified, most often S. Infantis (n=41; 24.4 %), S. Typhimurium (n=27; 16.1 %), S. Kentucky (n=21; 12.5 %), and S. Derby (n=17; 10.1 %). Whole genome analyses revealed extended-spectrum β-lactamase (ESBL) genes as main cause for third generation cephalosporin resistance, and most prevalent were bla CTX-M-1 (n=55), bla CTX-M-14 (n=25), and bla CTX-M-65 (n=23). There was no strict correlation between serovar, phylogenetic lineage, and ESBL type but some serovar/ESBL gene combinations were detected frequently, such as bla CTX-M-1 and bla CTX-M-65 in S. Infantis or bla CTX-M-14b in S. Kentucky. The ESBL genes were mainly located on plasmids, including IncI, IncA/C variants, emerging pESI variants, and a novel bla CTX-M-1harbouring plasmid. We conclude that third generation cephalosporin resistance is on the rise among clinical S. enterica isolates in Germany, and occurrence in various S. enterica serovars is most probably due to multiple acquisition events of plasmids.
A Descriptive Study of Emergency Department Visits Within 30 Days of Discharge

Background Unnecessary emergency department (ED) visits are a crucial consideration in discharge planning for acutely admitted patients. This study aimed to identify the reasons for unnecessary visits to the ED within 30 days of discharge from a medical hospitalist unit. Methods We performed a retrospective review of patients discharged in 2018 from a medical unit of tertiary teaching hospital in Korea. The authors discussed in-depth and determined whether or not an ED visit was unnecessary, and further classified the causes of unnecessary visits into three categories. Results The mean age of the patients was 62.9 years (range, 15–99 years), and among the 1,343 patients discharged from the unit, 720 (53.6%) were men. Overall, 215 patients (16.0%) visited the ED within 30 days after discharge; among them, 16.3% were readmitted. Of the 215 cases of ED visits within 30 days after discharge, 57 (26.5%) were considered unnecessary. Of these, 30 (52.6%) were categorized as having failed care transition, 15 (26.3%) had unestablished care plans for predictable issues, and 12 (21.1%) had insufficient patient education. Conclusion A substantial number of short-term ED visits by discharged multimorbid or older medical patients were considered unnecessary. Discharging patients with a thorough discharge plan is essential to avoid unnecessary ED visits.
Rehabilitation outcomes after major lower limb amputation in the oldest old: a systematic review

Background: Because the population grows older and the burden of chronic disease increases, many individuals will undergo major lower limb amputation (LLA) at advanced ages. There is a scarcity of literature focusing on the outcomes of rehabilitation for people who acquire LLA at 80 years of age and older. Objectives: To determine the scope of empirical evidence regarding prosthetic rehabilitation for newly acquired LLA in the oldest old (≥80 years of age). Study design: Systematic Review. Methods: The databases CINAHL, EMBASE, MEDLINE, and Scopus were searched from inception through June 6, 2020 (PROSPERO: #CRD 42020188623). Two authors independently reviewed all titles and abstracts for inclusion. Inclusion criteria, LLA of any etiology at the transtibial level or above, those who were ≥80 years of age at the time of amputation, and had rehabilitation outcomes reported. Results: Of 11,738 articles identified from databases, 117 underwent full-text review and 10 met inclusion criteria. Multiple rehabilitation outcomes were assessed by the selected studies, including general outcomes, prosthetic-related outcomes, and functional abilities. Individuals ≥80 years of age were able to successfully use a prosthesis, discharged home, and performed activities independently or with support. However, increased age was negatively associated with prosthesis fitting and rehabilitation success was not uniform in some participants. Conclusions: The oldest old with major LLA can be successful in prosthetic rehabilitation. Age alone should not disqualify individuals from assessment or participation in an amputee rehabilitation program. More research is needed to better understand the rehabilitation outcomes in this population of people with LLA.
Characterization of head impact exposure in boys’ youth ice hockey

ABSTRACT Ice hockey has one of the highest concussion rates among youth sports. Sensor technology has been implemented in contact and collision sports to inform the frequency and severity of head impacts experienced on-ice. However, existing studies have utilized helmet-mounted sensors with limited accuracy. The objective of this study was to characterize head kinematics of contact events in a sample of youth boys’ hockey players using a validated instrumented mouthpiece with improved accuracy. Head kinematics from 892 video-verified events were recorded from 18 athletes across 127 sessions. Median peak resultant linear acceleration, rotational velocity, and rotational acceleration of video-verified events were 7.4 g, 7.7 rad/s, and 576 rad/s2, respectively. Contact events occurred at a higher rate in games (2.48 per game) than practices (1.30 per practice). Scenarios involving head contact had higher peak kinematics than those without head contact. This study improves our understanding of head kinematics in boys’ youth hockey.
Salt‐Sensitive Hypertension, Renal Injury, and Renal Vasodysfunction Associated With Dahl Salt‐Sensitive Rats Are Abolished in Consomic SS.BN1 Rats

Background Abnormal renal hemodynamic responses to salt‐loading are thought to contribute to salt‐sensitive (SS) hypertension. However, this is based largely on studies in anesthetized animals, and little data are available in conscious SS and salt‐resistant rats. Methods and Results We assessed arterial blood pressure, renal function, and renal blood flow during administration of a 0.4% NaCl and a high‐salt (4.0% NaCl) diet in conscious, chronically instrumented 10‐ to 14‐week‐old Dahl SS and consomic SS rats in which chromosome 1 from the salt‐resistant Brown‐Norway strain was introgressed into the genome of the SS strain (SS.BN1). Three weeks of high salt intake significantly increased blood pressure (20%) and exacerbated renal injury in SS rats. In contrast, the increase in blood pressure (5%) was similarly attenuated in Brown‐Norway and SS.BN1 rats, and both strains were completely protected against renal injury. In SS.BN1 rats, 1 week of high salt intake was associated with a significant decrease in renal vascular resistance (−8%) and increase in renal blood flow (15%). In contrast, renal vascular resistance failed to decrease, and renal blood flow remained unchanged in SS rats during high salt intake. Finally, urinary sodium excretion and glomerular filtration rate were similar between SS and SS.BN1 rats during 0.4% NaCl and high salt intake. Conclusions Our data support the concept that renal vasodysfunction contributes to blood pressure salt sensitivity in Dahl SS rats, and that genes on rat chromosome 1 play a major role in modulating renal hemodynamic responses to salt loading and salt‐induced hypertension.
CADMIO, TALIO Y VANADIO AFECTAN DIFERENCIALMENTE LA GERMINACIÓN Y CRECIMIENTO INICIAL DE TRES VARIEDADES DE CHILE

The effects of the metals cadmium (Cd), thallium (Tl) and vanadium (V) in concentrations of 0, 25 and 50 µM each were evaluated independently in indicators of germination and initial growth in three varieties of chili pepper: jalapeno, poblano, and serrano. The seeds were treated for 15 days, and the number of germinated seeds was quantified in 24-h intervals to obtain the percentage of germination (PG). At the end of this period, the relative percentage of germination (RPG), lengths of shoots (LS) and roots (LR), relative radicle growth (RRG), germination index (GI) and the coefficient of germination speed (CGS) were evaluated. The PG and the RPG were not affected by the treatments. The main effects of the study factors were observed in indicators related to the initial plant growth. The tolerance of the varieties to the metals under study is, in decreasing order, jalapeno > poblano > serrano. Tl in particular was highly phytotoxic in the serrano variety. Conversely, Tl increased the LS in the jalapeno and poblano varieties. Cd stimulated the LS of poblano, while V stimulated the CGS in jalapeno, and the LS of the poblano pepper. It is concluded that Cd, Tl, and V produce differential effects on chili peppers, which are dependent on the genotype tested, the concentration of the metal evaluated and the developmental phase (germination or initial growth).
From pregnancy to 3 months after birth:the beginning of mother-infant relationship from a maternal perspective

ABSTRACT Background An early positive mother-child relationship is a central factor in the development of a psychologically balanced personality. The study aims to identify risk and protective factors for the development of a balanced maternal-infant postnatal attachment. We explored the association between maternal-infant attachment and prenatal and postnatal variables potentially implicated in the development of this early bond: maternal-foetal prenatal attachment, social support, memories of parental care, romantic attachment, dyadic adjustment, parity, breastfeeding, planning pregnancy, woman’s and infant’s age, and difficulty of delivery. Methods 123 pregnant women participated in the longitudinal study; they were assessed on the MAAS, PBI, ECR-R, MSPSS (t1: pregnancy), MPAS (t2: 3-months postnatally), DAS , and CES-D (t1, t2). Results Four significant predictors of maternal-infant postnatal attachment (MPAS) emerged: maternal-foetal prenatal attachment (β = 0.379, p < .001), anxiety in the romantic relationships (β=−0.237, p=0.019), prenatal and postnatal dyadic adjustment (t1, β=−0.323, p=0.025 ;t2, β=0.329, p=0.014) in the couple’s relationship. These variables explained 20.2% of variance in mother-infant attachment (R 2adjusted=0.202). Discussion The study highlights associations of maternal-infant postnatal attachment with prenatal and postnatal relational variables and with other variables related to the woman’s reproductive and pregnancy history. Clinical attention to these factors could help protect the well-being of mother and child
Anthropometric Cranial Measurements in Metopic Craniosynostosis/Trigonocephaly: Diagnostic Criteria, Classification of Severity and Indications for Surgery

Supplemental Digital Content is available in the text Abstract Metopic craniosynostosis is the second most frequent type of craniosynostosis. When the phenotypic presentation has been deemed severe the treatment is surgical in nature and is performed in infancy with fronto-orbital advancement and cranial vault remodeling. At the time of this writing, there is no consensus regarding an objective evaluation system for severity, diagnostic criteria, or indications for surgery. This study aims to review the anthropometric cranial measurements and the relative diagnostic criteria/classification of severity/surgical indications proposed so far for this skull malformation, and to investigate if there is any scientific support for their utility.
[Effect of high-concentration fluoride on apoptosis of human periodontal ligament stem cells].

PURPOSE To explore the effects of high-concentration fluoride(F) on apoptosis of human periodontal ligament stem cells (PDLSCs). METHODS PDLSCs were isolated from periodontal ligament tissues of extracted third molars, and treated with different concentrations (0-40 ppm F) of NaF for indicated period of time. CCK-8 assay was performed to detect cell viability. After stained with Annexin V-PI and JC-1, cell apoptosis and mitochondrial membrane potential were analyzed by flow cytometry. Immunofluorescence staining and confocal microscopic assay were used to detect the protein expression level of cyt-c, cleaved-caspase-9 and -3. The mRNA level of caspase -9 and -3 were examined by RT-PCR. The protein expression level of total and phosphate-ERK, JNK and p38 were analyzed by Western blot. SPSS 13.0 software package was used for statistical analysis. RESULTS Fluoride treatment inhibited cell viability (CCK-8 assay) and induced apoptosis of PDLSCs (Annexin V-PI staining) in a dose- and time-dependent manner. Immunofluorescence assay showed that fluoride with a dose ≥10 ppm significantly induced release of cyt-c from the mitochondria to cytosol, and up-regulation of expression of cleaved-caspase -9 and -3. RT-PCR confirmed that the mRNA level of caspase-9 and -3 increased with the dose of fluoride. Western blot assay confirmed that fluoride induced up-regulation of p-ERK, but not that of p-JNK and p-p38, and specifically blocking ERK pathway with U0126 could partially rescue the fluoride-induced cell apoptosis. CONCLUSIONS High concentrations of fluoride induces apoptosis of PDLSCs via intrinsic mitochondrial pathway, and phosphation of MAPK/ERK is involved in the F-induce cell apoptosis.