Miracle-dz/UniFAR-FTUs huggingface dataset:
Renal dysfunction among HIV-infected patients starting antiretroviral therapy

Objective:HIV-related renal dysfunction is associated with high mortality. Data on the prevalence of renal dysfunction among HIV-infected outpatients starting antiretroviral therapy (ART) in sub-Saharan Africa are limited. Recent recommendations to include the nephrotoxic drug tenofovir in first-line ART regimens make clarification of this issue urgent. Methods:We screened for renal dysfunction by measuring serum creatinine, proteinuria, and microalbuminuria in HIV-positive outpatients initiating ART in Mwanza, Tanzania. We excluded patients with pre-existing renal disease, hypertension, diabetes, or hepatitis C virus co-infection. Estimated glomerular filtration rates (eGFRs) were calculated by Cockroft–Gault and Modification of Diet in Renal Disease equations. Results:Only 129 (36%) of 355 enrolled patients had normal eGFRs (grade 0 or 1) above 90 ml/min per 1.73 m2. Grade 2 renal dysfunction (eGFR between 60 and 89 ml/min per 1.73 m2) was present in 137 patients (38.6%), and 87 patients (25%) had grade 3 dysfunction (eGFR between 30 and 59 ml/min per 1.73 m2). Microalbuminuria and proteinuria were detected in 72 and 36% of patients, respectively. Factors predictive of renal dysfunction in multivariate analysis included female sex [odds ratio (OR) 3.0, 95% confidence interval (1.8–5.1), P < 0.0001], BMI less than 18.5 [OR 2.3 (1.3–4.1), P = 0.004], CD4+ T-cell count below 200 cells/&mgr;l [OR 2.3 (1.1–4.8), P = 0.04], and WHO clinical stage II or above [OR 1.6 (1.2–2.3), P = 0.001]. Conclusion:Renal dysfunction was highly prevalent in this population of HIV-positive outpatients initiating first ART in Tanzania. This highlights the critical and underappreciated need to monitor renal function in HIV-positive patients in sub-Saharan Africa, particularly given the increasing use of tenofovir in first-line ART.
Study on Reconfigurable Coaperture Antenna Arrays Based on Time-Modulation and Retrodirective Techniques

Time-modulation (TM) technique for array design is opening the way for the development of easy-reconfiguration, low-complexity, and high-accuracy antenna systems for modern wireless applications. In this study, four different scenarios of TM-based reconfigurable coaperture antenna arrays are introduced. The aims are to make use of the common antenna elements for the coaperture and to share the RF switches needed in TM technique to form the reconfiguration. For the reconfigurable functionality, the retrodirective (RD) technique is involved, and for the reconfigurable band, the synthesized transmission line (STL) technology is involved. Four proposed arrays are single-band time-modulated retrodirective and self-null-steering array (i.e., single-band TM-RDNA), single-band time-modulated/retrodirective/time-modulated retrodirective array (i.e., single-band TM-RDA), dual-band TM-RDA, and triband TM-RDA. In the single-band TM-RDNA, a frequency offset, which is equal to the TM frequency, between two time-modulated phase conjugators is introduced to realize the array capable of RD and self-null steering simultaneously at retransmitted frequency. In the single-, dual-, and triband TM-RDAs, the introduced TM-RDA functions as a low sidelobe RDA at carrier frequency, and as an extra benefit, it can function as a low sidelobe RDA at harmonic frequencies. The features, superiority, and inferiority of these TM-based reconfigurable coaperture arrays are discussed and summarized. To experimentally verify the feasibility of the proposed schemes, a four-element single-band TM-RDNA and single-band TM-RDA structures are constructed and tested.
Peripheral and Hepatic Vein Cytokine Levels in Correlation with Non-Alcoholic Fatty Liver Disease (NAFLD)-Related Metabolic, Histological, and Haemodynamic Features

Background Haemodynamic impairment, inflammatory mediators and glucose metabolism disturbances have been implicated in the pathogenesis of Non-Alcoholic Fatty Liver Disease (NAFLD). Aim To investigate the cytokine profile in NAFLD patients in peripheral (P) and hepatic venous (HV) blood and to compare with histology, haemodynamic and metabolic parameters. Methods 40 obese patients with an indication for a transjugular liver biopsy were enrolled. Besides an extended liver and metabolic work-up, interleukin (IL) 1B, IL4, IL6, IL10, IL23, tumour necrosis factor (TNF) α and interferon (INF) γ were measured in plasma obtained from P and HV blood by means of multiplex immunoassay. The T helper (Th)1/Th2, the macrophage M1/M2 and the IL10/IL17a ratios were calculated. Results A decrease of the P-IL10/IL17-ratio and an increase of the P-M1/M2-ratio (p<0.05) were observed in NASH versus no-NASH patients. A P-M1/M2-ratio increase was detected also in patients with portal hypertension in comparison with patients without it (p<0.05). Moreover diabetic patients showed an increase of the P-Th1/Th2-ratio in comparison with non-diabetic ones (p<0.05). The P-M1/M2 ratio positively correlated with steatosis grade (r = 0.39, p = 0.02) and insulin (r = 0.47, p = 0.003). The HV-M1/M2 ratio positively correlated with fasting insulin and Hepatic Venous Pressure Gradient (r = 0.47, p = 0.003). IL6 correlated with the visceral fat amount (r = 0.36, p = 0.02). The P- and HV-IL10/IL17 ratios negatively correlated with fasting insulin (respectively r = -0.4, p = 0.005 and r = 0.4, p = 0.01). Conclusions A proinflammatory cytokine state is associated with more disturbed metabolic, histological, and haemodynamic features in NAFLD obese patients. An increase of the M1/M2 ratio and a decrease of the IL10/IL17 ratio play a key role in this process.
Productivity and economic burden associated with diabetes.

OBJECTIVES This report assessed the cost and burden of diabetes in broad terms of economic status, underlying disability, and barriers to health care--that is, as reflected in employment, income, disability days, general health status, and access to medical care. METHODS We used the 1990 to 1995 Behavioral Risk Factor Survey in Oklahoma to compare persons with diabetes with age-, sex-, and race/ethnicity-matched respondents without diabetes. RESULTS Persons with diabetes were significantly and substantially worse off on all economic, disability, and access measures. CONCLUSIONS Compared with nondiabetic persons, diabetic persons have fewer resources to deal with higher levels of disability and poorer health status.
Expression of P-Selectin at Low Site Density Promotes Selective Attachment of Eosinophils Over Neutrophils1

The selective interaction of neutrophils with E-selectin and eosinophils with P-selectin has been previously reported, but the relevance of selectin site density and fluid shear has not been studied in detail. We have developed a new approach to examine these interactions in cell suspensions that integrates an on-line cone-plate viscometer with a flow cytometer. We find that eosinophils and neutrophils both use P-selectin glycoprotein ligand-1 to form stable conjugates with P-selectin Chinese hamster ovary cell transfectants, with a preferential adhesion of eosinophils. Further, the difference in cell adhesion between neutrophils and eosinophils is magnified at P-selectin expression levels below ∼20 sites/μm2, a range likely to be relevant to endothelial cell expression levels in conditions associated with eosinophilia. The unique behavior is retained over shear rates ranging from 100 to 1500/s but is magnified at low shear. Results from parallel-plate flow chamber assays suggest that preferential eosinophil adhesion reflects an enhanced efficiency of initial PSGL-1 bond formation with P-selectin rather than a unique ability of eosinophils to mediate rolling interactions of longer duration on low-density P-selectin substrates. These differences may account in part for the increase in eosinophil accumulation in allergic diseases.
Reduced mitochondrial pyruvate carrier expression in hearts with heart failure and reduced ejection fraction patients: ischemic vs. non-ischemic origin

Introduction and objectives Mitochondrial pyruvate carrier (MPC) mediates the entry of pyruvate into mitochondria, determining whether pyruvate is incorporated into the Krebs cycle or metabolized in the cytosol. In heart failure (HF), a large amount of pyruvate is metabolized to lactate in the cytosol rather than being oxidized inside the mitochondria. Thus, MPC activity or expression might play a key role in the fate of pyruvate during HF. The purpose of this work was to study the levels of the two subunits of this carrier, named MPC1 and MPC2, in human hearts with HF of different etiologies. Methods Protein and mRNA expression analyses were conducted in cardiac tissues from three donor groups: patients with HF with reduced ejection fraction (HFrEF) with ischemic cardiomyopathy (ICM) or idiopathic dilated cardiomyopathy (IDC), and donors without cardiac pathology (Control). MPC2 plasma levels were determined by ELISA. Results Significant reductions in the levels of MPC1, MPC2, and Sirtuin 3 (SIRT3) were observed in ICM patients compared with the levels in the Control group. However, no statistically significant differences were revealed in the analysis of MPC1 and MPC2 gene expression among the groups. Interestingly, Pyruvate dehydrogenase complex (PDH) subunits expression were increased in the ICM patients. In the case of IDC patients, a significant decrease in MPC1 was observed only when compared with the Control group. Notably, plasma MPC2 levels were found to be elevated in both disease groups compared with that in the Control group. Conclusion Decreases in MPC1 and/or MPC2 levels were detected in the cardiac tissues of HFrEF patients, with ischemic or idiopatic origen, indicating a potential reduction in mitochondrial pyruvate uptake in the heart, which could be linked to unfavorable clinical features.
Predictors of postoperative delirium in paediatric patients undergoing surgery under general anaesthesia at Amhara Regional State Tertiary Hospitals: a multicenter prospective study

Introduction Postoperative delirium in paediatric patients is a recognised issue. Nevertheless, in low- and middle-income nations, researchers have had luck in determining its extent and predictors. Identifying predictors of postoperative delirium in paediatric patients having general anaesthesia at Tertiary Hospitals in Ethiopia was the aim of this study. Methods A multicenter, prospective follow up study was conducted from April 15 to June 15, 2023 at the study settings. During the study period a total of 424 paediatric surgical patients treated under general anaesthesia in all study locations, ranging in age from birth to sixteen were candidates for this study. Charts and direct observation of patient's with assessment tool [Cornell Assessment of Pediatric Delirium (CAPD)] were used from each available patient. Binary logistic regression analysis was performed to determine predictors of postoperative delirium in paediatric patients undergoing surgery under general anaesthesia. Results Postoperative delirium occurred in 160 of the 404 paediatric patients who underwent surgery under general anaesthesia. Ophthalmic surgery, corticosteroid use, anticholinergic use, severe postoperative pain, and preoperative anxiety were found to be predictors of postoperative delirium; whereas, sedative medication premedication and paracetamol used for analgesia were found to be protective against postoperative delirium. Inference and recommendation The postoperative delirium in paediatric patients undergoing surgery under general anaesthesia was higher compared to developed countries. Ophthalmic surgery, corticosteroids, anticholinergic medications, postoperative pain, and preoperative anxiety were found to be predictors. The impact of postoperative delirium might be lessened by concentrating on its screening and factor control.
Risk-Benefit Comparison Between Endoloop and Endostapler Devices for the Closure of Appendiceal Stumps in Laparoscopic Appendectomy

Introduction Acute appendicitis is a common cause of acute abdomen and the most frequent surgical emergency in the world. Since the nineteenth century, surgical resolution has been the most accepted treatment worldwide, and laparoscopic appendectomy is currently preferred as the treatment of choice because it has several benefits. The closure of the appendiceal stump is the most crucial step during appendectomy since its inadequate management can cause post-surgical complications. Throughout recent years, several methods have been proposed to perform this closure. This study was performed to compare the post-surgical outcomes of the use of endoloop and endostapler devices. Methods This is a retrospective study of 290 patients aged 18 to 83 who underwent laparoscopic appendectomy between 2016 and 2020. Demographic data, clinical history, tomographic findings, and laboratory data were collected, as well as appendicular base management technique, severity degree of appendicitis at hospital admission, postoperative complications at 30 days, hospital readmission, and in-hospital stay. Statistical tests and binary logistic regression analyses were used to identify risk factors, with a significance level of p<0.05. Results Demographic data and clinical history did not show statistically significant differences. The presence of a pre-surgical abscess with tomography was 1.58 times higher in the endostapler group. Post-surgical results showed that the use of endostapler devices represented a 2.7 times higher risk of post-surgical abscess. The endostapler group was also found to have 1.87 times the risk of post-surgical sepsis. Conclusion Our study shows that the use of an endoloop reduces the risk of postoperative abscess by 16.5% and protects against the development of post-surgical sepsis by 30%.
Trace Element and U–Pb Core Age for Zircons from Western Meiganga Gold Placer, Cameroon: Their Genesis and Archean-Proterozoic Sources

Trace element concentrations and U–Pb ages were obtained using Laser Ablation Split Stream Method from the core of 115 zircon grains from the western Meiganga gold placer deposit. The data was used to characterize zircon, to understand the history of crystallization and to locate source rocks within the local and regional geological settings. Zircon trace element geochemistry was used to distinguish between magmatic and metamorphic affinity. The magmatic zircons have characteristics compatible with their probable origin from granitoid, syenite, tonalite, charnockite and mafic to ultramafic rocks. The metamorphic zircons composition is compatible with growth from anatectic melts and by sub-solidus crystallization in equilibrium with garnet. The zircon ages reveal Archean, Paleoproterozoic, Mesoproterozic, and Neoproterozoic events with the principal source could mainly belong to Paleoproterozoic magmatic lineage. Some of the Paleoproterozoic magmatic zircons were probably sourced from two mica granite found within the local geology, whereas the remaining zircons have features indicating source rocks within the Congo Craton. We suggest that the geologic history of these zircons is related to crustal-scale magmatic and/or tectono-metamorphic events, possibly linked to Eburnean and Pan-African orogeny.
Globally Visualizing the Microtubule-Dependent Transport Behaviors of Influenza Virus in Live Cells

Understanding the microtubule-dependent behaviors of viruses in live cells is very meaningful for revealing the mechanisms of virus infection and endocytosis. Herein, we used a quantum dots-based single-particle tracking technique to dynamically and globally visualize the microtubule-dependent transport behaviors of influenza virus in live cells. We found that the intersection configuration of microtubules can interfere with the transport behaviors of the virus in live cells, which lead to the changing and long-time pausing of the transport behavior of viruses. Our results revealed that most of the viruses moved along straight microtubules rapidly and unidirectionally from the cell periphery to the microtubule organizing center (MTOC) near the bottom of the cell, and the viruses were confined in the grid of microtubules near the top of the cell and at the MTOC near the bottom of the cell. These results provided deep insights into the influence of entire microtubule geometry on the virus infection.
Role of endoscopic submucosal dissection in treatment of rectal gastroenteropancreatic neuroendocrine neoplasms

Introduction A significant rise in incidence of rectal gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has been observed in the last decade. Most detected gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are well differentiated and less than 2 cm in diameter. Endoscopic submucosal dissection (ESD) is a new method for endoscopic treatment of such tumors, difficult to resect by conventional endoscopic techniques and thus subject to surgical treatment. Aim To present the results of the endoscopic treatment of GEP NET tumors in the rectum using ESD in single academic center. Material and methods From June 2013 to April 2014, 4 cases of GEP-NET in the rectum were treated by ESD in our center. Effectiveness of dissection, complications and tumor recurrence after 3 months of treatment were then retrospectively investigated. Results The group contained 2 patients with primary rectal GEP-NET (1 male, 1 female; age range: 48–60 years) and 2 with scars after incomplete polypectomy of rectal GEP-NET (1 male, 1 female; 61–65 years). Primary rectal GEP-NET diameters were 0.6 cm and 1.5 cm. Scar resection specimen diameters were 0.7 cm and 1 cm. Mean resection time was 28 min. The en bloc resection rate was 100% (2 of 2) and the histologically complete resection was confirmed in both cases. No foci of neuroendocrine neoplasia were reported in dissected scars. No complications were observed. After 3 months, 3 patients underwent follow-up colonoscopy – no local recurrence was reported. Conclusions Endoscopic submucosal dissection of rectal GEP-NET should be recommended as a treatment of choice when dealing with lesions over 1 cm in diameter without invasion of the muscle layer. Due to technical difficulties, performing this procedure should be reserved for centers with appropriately trained endoscopic staff.
Anti-osteoporotic treatments in the era of non-alcoholic fatty liver disease: friend or foe

Over the last years non-alcoholic fatty liver disease (NAFLD) has grown into the most common chronic liver disease globally, affecting 17-38% of the general population and 50-75% of patients with obesity and/or type 2 diabetes mellitus (T2DM). NAFLD encompasses a spectrum of chronic liver diseases, ranging from simple steatosis (non-alcoholic fatty liver, NAFL) and non-alcoholic steatohepatitis (NASH; or metabolic dysfunction-associated steatohepatitis, MASH) to fibrosis and cirrhosis with liver failure or/and hepatocellular carcinoma. Due to its increasing prevalence and associated morbidity and mortality, the disease-related and broader socioeconomic burden of NAFLD is substantial. Of note, currently there is no globally approved pharmacotherapy for NAFLD. Similar to NAFLD, osteoporosis constitutes also a silent disease, until an osteoporotic fracture occurs, which poses a markedly significant disease and socioeconomic burden. Increasing emerging data have recently highlighted links between NAFLD and osteoporosis, linking the pathogenesis of NAFLD with the process of bone remodeling. However, clinical studies are still limited demonstrating this associative relationship, while more evidence is needed towards discovering potential causative links. Since these two chronic diseases frequently co-exist, there are data suggesting that anti-osteoporosis treatments may affect NAFLD progression by impacting on its pathogenetic mechanisms. In the present review, we present on overview of the current understanding of the liver-bone cross talk and summarize the experimental and clinical evidence correlating NAFLD and osteoporosis, focusing on the possible effects of anti-osteoporotic drugs on NAFLD.
Policy initiative to improve access to psychological services for people with affective and anxiety disorders: population-level analysis

Background In 2006, Australia introduced new publicly funded psychological services for people with affective and anxiety disorders (the Better Access programme). Despite massive uptake, it has been suggested that Better Access is selectively treating socioeconomically advantaged people, including some who do not warrant treatment, and people already receiving equivalent services. Aims To explore potential disparities in Better Access treatment using epidemiological data from the 2007 National Survey of Mental Health and Wellbeing. Method Logistic regression analyses examined patterns and correlates of service use in two populations: people who used the new psychological services in the previous 12 months; and people with any ICD–10 12-month affective and anxiety disorder, regardless of service use. Results Most (93.2%) Better Access psychological services users had a 12-month ICD–10 mental disorder or another indicator of treatment need. Better Access users without affective or anxiety disorders were not more socioeconomically advantaged, and received less treatment than those with these disorders. Among the population with affective or anxiety disorders, non-service users were less likely to have a severe disorder and more likely to have anxiety disorder, without a comorbid affective disorder, than Better Access users. Better Access users comprised more new allied healthcare recipients than other service users. A substantial minority of non-service users (13.5%) had severe disorders, but most did not perceive a need for treatment. Conclusions Better Access does not appear to be overservicing individuals without potential need or contributing to social inequalities in mental healthcare. It appears to be reaching people who have not previously received psychological care. Treatment rates could be improved for some people with anxiety disorders.
Fast and Portable Locking for Multicore Architectures

The scalability of multithreaded applications on current multicore systems is hampered by the performance of lock algorithms, due to the costs of access contention and cache misses. The main contribution presented in this article is a new locking technique, Remote Core Locking (RCL), that aims to accelerate the execution of critical sections in legacy applications on multicore architectures. The idea of RCL is to replace lock acquisitions by optimized remote procedure calls to a dedicated server hardware thread. RCL limits the performance collapse observed with other lock algorithms when many threads try to acquire a lock concurrently and removes the need to transfer lock-protected shared data to the hardware thread acquiring the lock, because such data can typically remain in the server’s cache. Other contributions presented in this article include a profiler that identifies the locks that are the bottlenecks in multithreaded applications and that can thus benefit from RCL, and a reengineering tool that transforms POSIX lock acquisitions into RCL locks. Eighteen applications were used to evaluate RCL: the nine applications of the SPLASH-2 benchmark suite, the seven applications of the Phoenix 2 benchmark suite, Memcached, and Berkeley DB with a TPC-C client. Eight of these applications are unable to scale because of locks and benefit from RCL on an ×86 machine with four AMD Opteron processors and 48 hardware threads. By using RCL instead of Linux POSIX locks, performance is improved by up to 2.5 times on Memcached, and up to 11.6 times on Berkeley DB with the TPC-C client. On a SPARC machine with two Sun Ultrasparc T2+ processors and 128 hardware threads, three applications benefit from RCL. In particular, performance is improved by up to 1.3 times with respect to Solaris POSIX locks on Memcached, and up to 7.9 times on Berkeley DB with the TPC-C client.