Miracle-dz/UniFAR-FTUs huggingface dataset:
Unraveling PBF effects beyond impact evaluation: results from a qualitative study in Cameroon

Introduction Performance-based financing (PBF) has acquired increased prominence as a means of reforming health system purchasing structures in low-income and middle-income countries. A number of impact evaluations have noted that PBF often produces mixed and heterogeneous effects. Still, little systematic effort has been channelled towards understanding what causes such heterogeneity, including looking more closely at implementation processes. Methods Our qualitative study aimed at closing this gap in knowledge by attempting to unpack the mixed and heterogeneous effects detected by the PBF impact evaluation in Cameroon to inform further implementation as the country scales up the PBF approach. We collected data at all levels of the health system (national, district, facility) and at the community level, using a mixture of in-depth interviews and focus group discussions. We combined deductive and inductive analytical techniques and applied analyst triangulation. Results Our findings indicate that heterogeneity in effects across facilities could be explained by pre-existing infrastructural weaknesses coupled with rigid administrative processes and implementation challenges, while heterogeneity across indicators could be explained by providers’ practices, privileging services where demand-side barriers were less substantive. Conclusion In light of the country’s commitment to scaling up PBF, it follows that substantial efforts (particularly entrusting facilities with more financial autonomy) should be made to overcome infrastructural and demand-side barriers and to smooth implementation processes, thus, enabling healthcare providers to use PBF resources and management models to a fuller potential.
Obstructive airways disease with air trapping among firefighters exposed to World Trade Center dust.

BACKGROUND The World Trade Center (WTC) collapse produced a massive exposure to respirable particulates in New York City Fire Department (FDNY) rescue workers. This group had spirometry examinations pre-September 11, 2001, and post-September 11, 2001, demonstrating declines in lung function with parallel declines in FEV(1) and FVC. To date, the underlying pathophysiologic cause for this has been open to question. METHODS Of 13,234 participants in the FDNY-WTC Monitoring Program, 1,720 (13%) were referred for pulmonary subspecialty evaluation at a single institution. Evaluation included 919 full pulmonary function tests, 1,219 methacholine challenge tests, and 982 high-resolution chest CT scans. RESULTS At pulmonary evaluation (median 34 months post-September 11, 2001), median values were FEV(1) 93% predicted (interquartile range [IQR], 83%-101%), FVC 98% predicted (IQR, 89%-106%), and FEV(1)/FVC 0.78 (IQR, 0.72-0.82). The residual volume (RV) was 123% predicted (IQR, 106%-147%) with nearly all participants having normal total lung capacity, functional residual capacity, and diffusing capacity of carbon monoxide. Also, 1,051/1,720 (59%) had obstructive airways disease based on at least one of the following: FEV(1)/FVC, bronchodilator responsiveness, hyperreactivity, or elevated RV. After adjusting for age, gender, race, height and weight, and tobacco use, the decline in FEV(1) post-September 11, 2001, was significantly correlated with increased RV percent predicted (P < .0001), increased bronchodilator responsiveness (P < .0001), and increased hyperreactivity (P = .0056). CT scans demonstrated bronchial wall thickening that was significantly associated with the decline in FEV(1) post-September 11, 2001 (P = .024), increases in hyperreactivity (P < .0001), and increases in RV (P < .0001). Few had evidence for interstitial disease. CONCLUSIONS Airways obstruction was the predominant physiologic finding underlying the reduction in lung function post-September 11, 2001, in FDNY WTC rescue workers presenting for pulmonary evaluation.
Enhancement of Cell-Based Therapeutic Angiogenesis Using a Novel Type of Injectable Scaffolds of Hydroxyapatite-Polymer Nanocomposite Microspheres

Background Clinical trials demonstrate the effectiveness of cell-based therapeutic angiogenesis in patients with severe ischemic diseases; however, their success remains limited. Maintaining transplanted cells in place are expected to augment the cell-based therapeutic angiogenesis. We have reported that nano-hydroxyapatite (HAp) coating on medical devices shows marked cell adhesiveness. Using this nanotechnology, HAp-coated poly(l-lactic acid) (PLLA) microspheres, named nano-scaffold (NS), were generated as a non-biological, biodegradable and injectable cell scaffold. We investigate the effectiveness of NS on cell-based therapeutic angiogenesis. Methods and Results Bone marrow mononuclear cells (BMNC) and NS or control PLLA microspheres (LA) were intramuscularly co-implanted into mice ischemic hindlimbs. When BMNC derived from enhanced green fluorescent protein (EGFP)-transgenic mice were injected into ischemic muscle, the muscle GFP level in NS+BMNC group was approximate fivefold higher than that in BMNC or LA+BMNC groups seven days after operation. Kaplan-Meier analysis demonstrated that NS+BMNC markedly prevented hindlimb necrosis (P<0.05 vs. BMNC or LA+BMNC). NS+BMNC revealed much higher induction of angiogenesis in ischemic tissues and collateral blood flow confirmed by three-dimensional computed tomography angiography than those of BMNC or LA+BMNC groups. NS-enhanced therapeutic angiogenesis and arteriogenesis showed good correlations with increased intramuscular levels of vascular endothelial growth factor and fibroblast growth factor-2. NS co-implantation also prevented apoptotic cell death of transplanted cells, resulting in prolonged cell retention. Conclusion A novel and feasible injectable cell scaffold potentiates cell-based therapeutic angiogenesis, which could be extremely useful for the treatment of severe ischemic disorders.
Effect of sea and distilled water conditioning on the overall mechanical properties of carbon nanotube/epoxy composites

The study of mechanical properties of carbon nanotube reinforced polymeric materials under different environmental conditions are very much essential as this material possesses potential for using it in structural parts, automobiles, marine field and so on. This study deals with the effect of moisture absorption on the mechanical and thermal properties of carbon nanotube/epoxy composites by immersing it in sea and distilled water at 30℃ temperature and at 75% Relative Humidity (RH) humidity. Composite specimens containing different wt. % of carbon nanotubes were prepared, tested and subjected to water immersion test. The ﬂexural properties, hardness and glass transition temperature (Tg) of water-immersed specimens were evaluated and compared with unexposed specimens as per the American Society for Testing and Material (ASTM) standard. It is concluded that the water absorption brought certain loss in the mechanical properties and reduction in Tg of the composites. It was also found that moisture uptake affected both sea and distilled water samples in different ways.
Gastrointestinal responses to a panel of lectins in rats maintained on total parenteral nutrition.

Total parenteral nutrition (TPN) causes atrophy of gastrointestinal epithelia, so we asked whether lectins that stimulate epithelial proliferation can reverse this effect of TPN. Two lectins stimulate pancreatic proliferation by releasing CCK, so we asked whether lectins that stimulate gastrointestinal proliferation also release hormones that might mediate their effects. Six rats per group received continuous infusion of TPN and a once daily bolus dose of purified lectin (25 mg ⋅ rat-1 ⋅ day-1) or vehicle alone (control group) for 4 days via an intragastric cannula. Proliferation rates were estimated by metaphase arrest, and hormones were measured by RIAs. Phytohemagglutinin (PHA) increased proliferation by 90% in the gastric fundus ( P < 0.05), doubled proliferation in the small intestine ( P < 0.001), and had a small effect in the midcolon ( P< 0.05). Peanut agglutinin (PNA) had a minor trophic effect in the proximal small intestine ( P < 0.05) and increased proliferation by 166% in the proximal colon ( P < 0.001) and by 40% in the midcolon ( P < 0.001). PNA elevated circulating gastrin and CCK by 97 ( P< 0.05) and 81% ( P < 0.01), respectively, and PHA elevated plasma enteroglucagon by 69% and CCK by 60% (both P < 0.05). Only wheat germ agglutinin increased the release of glucagon-like peptide-1 by 100% ( P < 0.05). PHA and PNA consistently reverse the fall in gastrointestinal and pancreatic growth associated with TPN in rats. Both lectins stimulated the release of specific hormones that may have been responsible for the trophic effects. It is suggested that lectins could be used to prevent gastrointestinal atrophy during TPN. Their hormone-releasing effects might be involved.
Subtle Motor Findings During Recovery from Pediatric Traumatic Brain Injury: A Preliminary Report

ABSTRACT Pediatric traumatic brain injury (TBI) is a heterogeneous condition, varying in both severity and sequelae. The long-term motor deficits following severe TBI requiring inpatient rehabilitation are better established than those following milder forms of TBI. The authors examined motor performance 2 and 12 months postinjury in children without overt motor impairment using standard measures of upper limb function and the Physical and Neurological Examination for Subtle Signs (PANESS). The PANESS was sensitive to differences between children with TBI and uninjured children as well as to changes in children with TBI over time. These data suggest that subtle motor deficits are present after milder forms of TBI and, particularly those related to balance and gait, may persist even 12 months postinjury.
Uptake and metabolism of structured triglyceride by Caco-2 cells: reversal of essential fatty acid deficiency.

Structured lipids have been proposed as efficient vehicles for the supplementation of essential fatty acids (EFA) to patients with malabsorption. We investigated how a novel structured triglyceride (STG), containing purely octanoic acid in the sn-1/ sn-3 and [14C]linoleic acid in the sn-2 positions, was incorporated into different lipid classes in Caco-2 cells. We also evaluated the contribution of gastric lipase in the uptake and metabolism of [14C]linoleic acid from the STG. We furthermore determined the potential of the STG to correct EFA deficiency induced in Caco-2 cells. The absorption of STG by Caco-2 cells was significantly greater compared with that of triolein. The addition of human gastric lipase significantly enhanced cellular uptake of the labeled substrate, reflecting the stereoselectivity of gastric lipase to hydrolyze medium chain FA. Analysis of the intracellular lipids synthesized revealed a predominance of phospholipids-monoglycerides. Most of the radioactivity in the lipoproteins isolated from Caco-2 cells was recovered in TG-rich lipoproteins (45%) and to a lesser extent in the high-density lipoprotein (36%) and low-density lipoprotein (17%) fractions. The administration of STG to Caco-2 cells rendered EFA deficient produced a marked increase of the cellular level of linoleic and arachidonic acids. This resulted in a lower ratio of 20:3(n-9) to 20:4(n-6), reflecting the correction of EFA deficiency in Caco-2 cells. Our data demonstrate that STG, in the presence of gastric lipase, have beneficial effects on lipid incorporation, lipoprotein production, and EFA status, utilizing Caco-2 cells as a model of EFA deficiency.
Motivational Climate Sport Youth Scale: Measurement Invariance Across Gender and Five Different Sports

Abstract The aim of this study was to analyze the psychometric properties of the Portuguese version of the Motivational Climate Sport Youth Scale (MCSYSp) and invariance across gender and different sports (swimming, soccer, handball, basketball, futsal). A total of 4,569 athletes (3,053 males, 1,516 females) from soccer (1,098), swimming (1,049), basketball (1,754), futsal (340), and handball (328) participated in this study, with ages between 10 and 20 years (M = 15.13; SD = 1.95). The results show that the original model (two factors/12 items) did not adjust to the data in a satisfactory way; therefore, it was necessary to change the model by removing four items (two from each factor). Subsequently, the model adjusted to the data in a satisfactory way (χ2 = 499.84; df = 19; χ2/df = 26.30; p < .001; SRMR = .037; TLI = .923; CFI = .948; RMSEA = .074; IC90% .069–.080) and was invariant by gender and team sports (soccer, handball, basketball, futsal) (ΔCFK≤.01); however, it was not invariant between swimming and team sports (soccer, handball, basketball, futsal) (ΔCFI ≥ .01). In conclusion, the MCSYSp (two factors/eight items) is a valid and reliable choice that is transversal not only to gender, but also to the different studied team sports to measure the perception of the motivational climate in athletes. Future studies can research more deeply the invariance analysis between individual sports to better understand the invariance of the model between individual and team sports.
The effects of nutritional supplementation on physical growth of children at risk of malnutrition.

The effect of food supplementation on physical growth during the last trimester of pregnancy and the first 3 yr of life was studied in a sample of families at risk of malnutrition living in the urban slums of Bogota, Colombia. Families in which the mother was pregnant and at least one-half of the children under 5 yr of age were below 85% of weight for age were selected for the study. All were provided with free obstetrical and pediatric care. The families were then randomly assigned to control and supplemented groups. The supplemented families received a daily allotment of 600 cal or 30 g of protein per capita for home consumption from the onset of the 3rd trimester of pregnancy until the subject children reached the age of 3 yr. Calorie consumption from the supplement by the study children (offspring of the target pregnancy) was 458 ± 249 calories at age 18 months and 363 ± 283 cal at age 36 months. Protein consumption at those ages was 34. 1 ± 20.6 and 23.6 ± 19.7 g,'day. However, substitution of the supplement for foods from the regular diet resulted in net supplementation of approximately 200 cal and 22 g of protein per day. There were significant differences in weight between supplemented and control groups beginning at age 3 months and in length beginning at age 6 months. Supplementation reduced the total prevalence of malnutrition (Gomez classification) only slightly; at 36 months of age, 72% of the supplemented group and 77.8% of the control group were malnourished. On the other hand, the prevalence of moderate and severe malnutrition (Gomez II and III), was significantly reduced by supplementation. At 36 months, 20.6% of the control group and 8.8% of the supplemented group fell into those categories. Despite improved physical growth in the supplemented group, their height and weight remained substantially below those of the high socioeconomic Colombian standards. The failure of supplementation to close the gap between low and high socioeconomic groups was attributed, in part, to the high incidence of diarrheal disease among subjects of the study. It is postulated that simple provision of food supplements, without effective prevention of diarrheal disease, is likely to have limited effects on physical growth among disadvantaged children. Am. J. Clin. Nutr. 34: 1885-1892, 1981.
Postsynaptic enhancement by motilin of muscarinic receptor cation currents in duodenal smooth muscle.

We have investigated a potential role of motilin in amplifying the postsynaptic muscarinic responses in the rabbit duodenal smooth muscle cells, using the whole cell variant of patch-clamp technique. Stimulation of motilin receptors by exogenously applied motilin (1 nM) resulted in a large increase in carbachol (CCh)-induced atropine-sensitive cation current ( I CCh) at threshold concentrations of CCh (0.3-1 μM) at 30°C. This potentiation was abolished in the presence of a specific blocker of motilin receptor (GM109) and was attenuated with increased concentrations of either motilin or CCh, being virtually absent with maximally effective concentrations of these agonists. Motilin failed to potentiate I CCh when the ambient temperature was reduced to 20°C or if the cation current had been directly activated by internal perfusion with guanosine 5'- O-(3-thiotriphosphate) (50 μM) bypassing the muscarinic receptor. These results suggest that some biochemical processes, such as enzymatic reactions, might be involved in the motilin-induced potentiation and that its site of action might be the muscarinic receptor and/or associated G proteins.
Effectiveness of School-Based Mental Health Playgroups for Diagnosable and At-Risk Preschool Children

Risk factors during preschool years, such as poverty and unattended social/emotional problems, are known to have a strong negative influence on children’s later functioning. This study aimed to investigate the effectiveness of an on-site integrated school-based mental health services and consultation program for preschool children and their families. The sample consisted of 47 children and parents in 3 childcare centers who came from low-socioeconomic, urban backgrounds. Parents provided questionnaire data on children’s social-emotional functioning at 2 assessment times. Children’s ages ranged between 2 and 4 years at Time 1. Approximately half of the sample consisted of children who were selected for and received twice-weekly peer play psychotherapy (PPP) and, at-times, other mental health services from clinicians (playgroup [PG] children). The other half of the sample consisted of better functioning non-playgroup (NPG) children from the same centers. When PG and NPG were compared at Time1, the PG children were significantly behind the NPG children justifying their assignment to PG. However, at Time 2, the difference between PG and NPG was no longer significant on vital measures of adaptation, revealing the ways in which Relationships for Growth & Learning (RfGL) Program arguably led to ‘catch up’. PG children’s behavioral problems and total symptomatology decreased significantly from Time 1 to Time 2. Higher dosage of PPP was linked with higher social competence and decreased behavioral problems. Areas of gain differed between internalizing and externalizing children, indicating that intervention was helpful to different types of children. Clinical and research implications were discussed.
Re-experiencing Violence Across the Life Course: Histories of Childhood Maltreatment and Elder Abuse Victimization.

OBJECTIVES This study primarily examines the associations between histories of childhood maltreatment (i.e., neglect, emotional, physical, and sexual abuse) and elder abuse victimization and explores whether gender moderates the associations. METHODS We conducted a secondary data analysis of 5,968 older adults (mean age = 71 years) based on data from the Wisconsin Longitudinal Study (2010-2011). Using retrospective self-reports of childhood and current (past 12 months) victimization experiences, logistic regression analyses were conducted to estimate the effects of early-life adversities on the likelihood of elder abuse victimization. RESULTS Results indicate that childhood emotional abuse and childhood sexual abuse (CSA) were associated with greater risk of being abused as older adults, after controlling for childhood and adult background factors. We also found that the effect of CSA on elder abuse victimization was weaker for women than men. DISCUSSION Findings suggest that the phenomenon of revictimization may occur not only in early and middle adulthood, but also in late life. To advance our understanding of victimization across the life course, future research on root causes of elder abuse should include histories of child abuse.
Phosphoinositide signaling in rat inner medullary collecting duct.

Previous studies in microdissected rat inner medullary collecting duct (IMCD) segments have demonstrated that carbachol, arginine vasopressin (AVP), and the V2 vasopressin receptor agonist 1-desamino-8-d-arginine vasopressin (DDAVP) induce a similar increase in intracellular Ca2+. The present study tested whether these agents activate the phosphoinositide hydrolysis pathway. In intracellular inositol 1,4,5-trisphosphate (IP3) measurements, we found that IMCD suspensions incubated with AVP or DDAVP (10-8 M) displayed no measurable increase in IP3, whereas IMCD suspensions incubated with the muscarinic cholinergic agent carbachol (100 μM) induced a significant increase in IP3 production. Similarly, carbachol, but not AVP or DDAVP, induced a significant increase in membrane-associated protein kinase C (PKC) enzyme activity. To test what specific PKC isoforms are activated by carbachol in IMCD, we first characterized the PKC isoforms in IMCD suspensions by immunoblotting using affinity-purified antibodies against different PKC isoforms. We identified one classic PKC isoform (α), three novel PKC isoforms (δ, ε, η), and one atypical PKC isoform (ζ) in the IMCD. Carbachol induced a cytosol-to-membrane translocation of the PKC-η isoform but did not alter the distribution of any other isoform. In contrast, AVP had no effect on the distribution of any PKC isoform tested. These data, taken together, demonstrate that carbachol is an activator of the phosphoinositide hydrolysis pathway in IMCD but do not demonstrate signaling via this pathway in response to AVP or DDAVP. These results suggest that the previously observed AVP-stimulated Ca2+ mobilization in IMCD may be due to a mechanism other than activation of the phosphoinositide hydrolysis pathway.
Hyperoxia increases keratinocyte growth factor mRNA expression in neonatal rabbit lung.

Acute hyperoxic lung injury remains a major factor in the development of chronic lung disease in neonates. A critical step in the repair of acute lung injury is the proliferation of type II alveolar epithelial cells. Type II cell proliferation is stimulated by keratinocyte growth factor (KGF), an epithelial cell-specific mitogen. We sought to investigate KGF mRNA expression in relation to type II cell proliferation during hyperoxic lung injury. We studied a previously described newborn (NB) rabbit model of acute and chronic hyperoxic injury [C. T. D'Angio, J. N. Finkelstein, M. B. LoMonaco, A. Paxhia, S. A. Wright, R. B. Baggs, R. H. Notter, and R. M. Ryan. Am. J. Physiol. 272 ( Lung Cell. Mol. Physiol. 16): L720-L730, 1997]. NB rabbits were placed in 100% O2 for 9 days and then recovered in 60% O2. RT-PCR was used to synthesize and amplify a 267-bp fragment of rabbit KGF cDNA from whole lung RNA. KGF mRNA expression was analyzed by ribonuclease protection assay, and mRNA abundance was quantified by phosphorimaging. Proliferating cell nuclear antigen immunohistochemistry was used on lung sections to identify proliferating cells. The rabbit partial cDNA sequenced was >95% homologous to human cDNA, and all amino acids were conserved. Whole lung KGF mRNA expression was increased 12-fold after 6 days of hyperoxia compared with control lungs, and remained increased throughout the 100% O2 exposure period. Proliferating cell nuclear antigen immunohistochemistry showed an increase in type II cell proliferation after 8-12 days of hyperoxia. NB rabbits exposed to hyperoxic injury exhibit increased whole lung KGF mRNA expression preceding type II cell proliferation. KGF may be an important mitogen in the regulation of alveolar epithelial repair after hyperoxic lung injury.