Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence of overweight, obesity and hypertension amongst school children and adolescents in North Karnataka: A cross sectional study

Introduction: Childhood obesity& hypertension are global health problems as they caused increase in morbidity & mortality. Objective: To find out the prevalence of obesity, overweight in school going children and adolescents of north Karnataka. Also to study obesity related morbidities like Prehypertension and Hypertension and associated risk factors for sustained hypertension. Materials and Methods: Total 2800 children in age group from 10-16 years from 3 schools of Urban and rural region of Bijapur district were screened. Weight, height, BMI and Blood pressure were recorded. These values were compared with WHO child growth standards. Children then classified as overweight (OW) and obesity (OB). Blood pressure values were compared with reference charts given by American heart association guidelinesand grouped as prehypertensive (PHTN) and Hypertension (HTN). Results: This study revealed that 3.6% rural school children were overweight (OW) in age group of 13 years, 1.4% children were obese (OB) in age group of 15 years. In urban school children, 3.3% OB in age group of 12 years and 11.1% OW in age group of 10 years. In Rural school children, prevalence of systolic HTN was 21% in OW children and 25% in OB children. Among urban schoolchildren prevalence of systolic PHTN was 5.1% among OW and in OB group it was 16.6%. Conclusions: This study revealed that prevalence of hypertension was significantly higher in overweight and obese compared to children with Normal BMI. Also the prevalence of overweight and obesity is more in urban school children than rural children population. We need further large scale studies to study obesity and associated morbidities like hypertension school children and adolescents.
Characterization of adherent‐invasive Escherichia coli isolated from pediatric patients with inflammatory bowel disease

Background: Crohn's disease (CD) and ulcerative colitis (UC), known as inflammatory bowel diseases (IBD), are characterized by an abnormal immunological response to commensal bacteria colonizing intestinal lumen and mucosa. Among the latter, strains of adherent‐invasive Escherichia coli (AIEC), capable of adhering to and invading epithelium, and to replicate in macrophages, have been described in CD adults. We aimed at identifying and characterizing AIEC strains in pediatric IBD. Methods: In all, 24 CD children, 10 UC, and 23 controls were investigated. Mucosal biopsies, taken during colonoscopy, were analyzed for the presence of AIEC strains by an adhesive‐invasive test. Protein expression of the specific AIEC receptor, the carcinoembryonic antigen‐related cell adhesion molecule 6 (CEACAM6), was evaluated by western blot and immunohistochemistry, while tumor necrosis factor alpha (TNF‐&agr;) and interleukin (IL)‐8 mRNA expression was detected by real‐time polymerase chain reaction (PCR), after bacterial infection. Transmission electron microscopy and trans‐epithelial electric resistance assays were performed on biopsies to assess bacteria‐induced morphological and functional epithelial alterations. Results: Two bacterial strains, EC15 and EC10, were found to adhere and invade the Caco2 cell line, similar to the well‐known AIEC strain LF82 (positive control): they upregulated CEACAM6, TNF‐&agr;, and IL‐8 gene/protein expression, in vitro and in cultured intestinal mucosa; they could also survive inside macrophages and damage the epithelial barrier integrity. Lesions in the inflamed tissues were associated with bacterial infection. Conclusions: This is the first study showing the presence of adhesive‐invasive bacteria strains in the inflamed tissues of children with IBD. Collective features of these strains indicate that they belong to the AIEC spectrum, suggesting their possible role in disease pathogenesis. (Inflamm Bowel Dis 2011)
Crohn's disease‐associated polymorphism within the PTPN2 gene affects muramyl‐dipeptide‐induced cytokine secretion and autophagy

Background: The single nucleotide polymorphism (SNP) rs2542151 within the gene locus region encoding protein tyrosine phosphatase non‐receptor type 2 (PTPN2) has been associated with Crohn's disease (CD), ulcerative colitis (UC), type‐I diabetes, and rheumatoid arthritis. We have previously shown that PTPN2 regulates mitogen‐activated protein kinase (MAPK) signaling and cytokine secretion in human THP‐1 monocytes and intestinal epithelial cells (IEC). Here, we studied whether intronic PTPN2 SNP rs1893217 regulates immune responses to the nucleotide‐oligomerization domain 2 (NOD2) ligand, muramyl‐dipeptide (MDP). Materials and Methods: Genomic DNA samples from 343 CD and 663 non‐IBD control patients (male and female) from a combined German, Swiss, and Polish cohort were genotyped for the presence of the PTPN2 SNPs, rs2542151, and rs1893217. PTPN2‐variant rs1893217 was introduced into T84 IEC or THP‐1 cells using a lentiviral vector. Results: We identified a novel association between the genetic variant, rs1893217, located in intron 7 of the PTPN2 gene and CD. Human THP‐1 monocytes carrying this variant revealed increased MAPK activation as well as elevated mRNA expression of T‐bet transcription factor and secretion of interferon‐&ggr; in response to the bacterial wall component, MDP. In contrast, secretion of interleukin‐8 and tumor necrosis factor were reduced. In both, T84 IEC and THP‐1 monocytes, autophagosome formation was impaired. Conclusions: We identified a novel CD‐associated PTPN2 variant that modulates innate immune responses to bacterial antigens. These findings not only provide key insights into the effects of a functional mutation on a clinically relevant gene, but also reveal how such a mutation could contribute to the onset of disease. (Inflamm Bowel Dis 2011;)
Management of patients with inflammatory bowel disease and spondyloarthritis

ABSTRACT Introduction: More than half of the patients with inflammatory bowel disease (IBD) experience at least one extra-intestinal manifestation (EIM). The most common EIM in patients with IBD is spondyloarthritis (SpA). Microscopic intestinal inflammation is documented in almost 50% of the patients with SpA. Areas covered: We give an overview of the classification, the epidemiology and the diagnosis of IBD and SpA. The treatment goals, the pharmacologic management options and the available treatment guidelines in IBD patients with SpA are discussed. Expert commentary: The coexistence of IBD and SpA generates challenges and opportunities for both the gastroenterologist and the rheumatologist. The potential of drugs with a gut-specific mode of action in the treatment of IBD-related arthritis warrants further exploration.
NRAS Mutations Are Rare in Colorectal Cancer

Activating mutations in members of the RAS oncogene family (KRAS, HRAS, and NRAS) have been found in a variety of human malignancies, suggesting a dominant role in carcinogenesis. In colon cancers, KRAS mutations are common and clearly contribute to malignant progression. The frequency of NRAS mutations and their relationship with clinical, pathologic, and molecular features remains uncertain. We developed and validated a Pyroseqencing assay to detect NRAS mutations at codons 12, 13, and 61. Using a collection of 225 colorectal cancers from 2 prospective cohort studies, we examined the relationship between NRAS mutations, clinical outcome, and other molecular features, including mutation of KRAS, BRAF, and PIK3CA, microsatellite instability, and the CpG island methylator phenotype. Finally, we examined whether NRAS mutation was associated with patient survival or prognosis. NRAS mutations were detected in 5 (2.2%) of the 225 colorectal cancers and tended to occur in left-sided cancers arising in women, but did not seem to be associated with any of the molecular features that were examined.
Barriers and bridges to client-centred occupational therapy in Sweden

This study investigates barriers to client-centred practice and solutions to overcome these barriers as experienced by Swedish occupational therapists. A British questionnaire was translated into Swedish and completed by 97 occupational therapists. The questionnaire consists of three sections: background information; a list of barriers identified in a literature review; and a list of methods to resolve barriers. The results show that the highest ranked barrier was “the therapist does not know enough about client-centred practice”. The highest ranked method to resolve barriers was “management and peer support for use of client-centred practice”. Introducing client-centred practice takes time, commitment, education, training, interview skills, discussions with colleagues, and reflection on the therapists’ own attitudes.
Pharmacological management of late-onset hypogonadism

ABSTRACT Introduction: The frequency of late-onset hypogonadism (LOH) ranges between 2 and 15%. Up to 85% of LOH is due to a functional impairment of the hypothalamus–pituitary–testicular axis, mostly secondary to metabolic conditions. Areas covered: This paper provides a comprehensive review of all the available medications for treating LOH, including antiestrogens, gonadotropins and testosterone therapy (TTh). In addition, the evidence on clinical outcomes of these treatments is provided by meta-analyzing the results from the available randomized clinical trials. Expert commentary: The present data indicate that antiestrogens are able to increase testosterone levels without changing gonadotropins or even increasing them. Therefore, they may maintain, and even to stimulate spermatogenesis. However, their efficacy in treating LOH-associated symptoms has been scarcely tested and their use in LOH is off-label. In contrast, gonadotropins are indicated for hypogonadism, in particular when fertility is required. Information on the effects of gonadotropins on LOH is scanty and the impractical administration limits their use. TTh can be administered with different modalities, making it a suitable option for LOH, when fertility is not desired. The available meta-analyses show that TTh is able to improve sexual function and body composition, with more evident results obtained with transdermal and injectable preparations.
Contribution of higher risk genes and European admixture to Crohn's disease in African Americans

Background: African Americans (AAs) are an admixed population of West African (WA) and European ancestry (EA). Crohn's disease (CD) susceptibility genes have not been established. We therefore evaluated the contribution of European admixture and major established risk genes to AA CD. Methods: Ninety‐seven admixture informative markers were genotyped for ancestry estimates using STRUCTURE. Overall, 354 AA CD cases and 354 ethnicity‐matched controls were genotyped for total 21 single nucleotide polymorphisms (SNPs) in ATG16L1, NOD2, IBD5, IL23R and IRGM by TaqMan or direct sequencing. Association was evaluated by logistic regression, adjusted for ancestry. Results: Mean EA was similar among the CD cases and controls (20.9% and 20.4%, respectively, P = 0.58). No significant admixture differences were observed among 211 to 227 cases stratified by phenotypic subclassifications including onset, surgery, site, and behavior. CD was associated with NOD2 carrier (6.93% CD, 2.15% Controls, P = 0.007), ATG16L1 Thr300Ala (36.1% CD, 29.3% Controls, P = 0.003), SLC22A4 and SLC22A5 (IBD5 locus) functional SNPs (Leu503Phe [10.5% CD, 7.6% Controls, P = 0.05] and g‐207c [41.3% CD, 35.7% Controls, P = 0.03], respectively), and IL23R rs2201841 (18.2% CD, 13.8% Controls, P = 0.03), but not IRGM variants, nor three African ancestral NOD2 nonsynonymous variants. IBD5 risk was recessive. An all‐minor allele IBD5 haplotype from EA was associated (P = 0.05), whereas a more common haplotype isolating g‐207c was not. Conclusions: Specific functional gene variations contribute significantly to AA CD risk. Established NOD2, SLC22A4‐A5, and ATG16L1 variants show increased CD risk, with IBD5 recessive. Although CD is more common in whites, European admixture is similar among AA cases and controls. (Inflamm Bowel Dis 2012;)
Low Frequency of EGFR Mutations in Pleural Mesothelioma Patients, Cologne, Germany

EGFR mutations were previously found in patients suffering from peritoneal mesothelioma but have not yet been described in pleural mesothelioma. The aim of the present study was the identification of EGFR mutations in patients suffering from pleural mesothelioma. Pleural mesothelioma tissue from 31 patients was used to analyze possible mutations in the EGFR gene comprising the exons 18-21 with the codons 719, 768, 790, 858+861, 731+734, 785, 797+801, 831, and 868 with pyrosequencing. The results indicate that 31 pleural mesothelioma patients show a wild-type EGFR gene when analyzing the codons D19, 768, 790, 858+861, 731+734, 785, 797+801, 831, and 868, whereas 2 patients have a mutation in the EGFR gene in codon 719. Sanger sequencing of the EGFR codon 785 was used for the determination of a polymorphism in the sequencing of tumor-free patients and pleural mesothelioma patients with a distribution of a wild-type homozygous sequence with guanine, a wild-type heterozygous sequence having guanine and adenine, a wild-type homozygous sequence with adenine, and a wild-type heterozygous sequence with adenine and guanine. Next, the identification of less EGFR mutations in the EGFR gene of the pleural mesothelioma an up to this time unknown polymorphism in the EGFR gene was identified which could be wrongly interpreted as a mutation.
Coral Snake Bites and Envenomation in Children: A Case Series

Objective North America is home to 2 families of venomous snakes, Crotalinae (pit viper family) and Elapidae (coral snake family). Although there are several published reports describing and reviewing the management of pit viper snakebites in children, there are no recent similar publications detailing the clinical course and management of coral snake envenomation. Methods Our case series describes the hospital course of children with coral snake bites admitted to our regional pediatric intensive care. We also reviewed prior published case reports of coral snake bites in the United States. Results We identified 4 patients with either confirmed or suspected coral snake envenomation from our hospital’s records. In 2 cases, the snakebite occurred after apparent provocation. Antivenom was administered to 3 patients. The regional venom response team was consulted for management advice and supplied the antivenom. One patient had a prolonged hospital course, which was complicated by respiratory failure, bulbar palsy, and ataxia. All survived to discharge. Conclusions Admission to pediatric intensive care is warranted after all Eastern coral snake bites. A specialized regional or national venom response team can be a useful resource for management advice and as a source of antivenom.
Diagnosis of potential stressors adversely affecting benthic communities in New Bedford Harbor, MA (USA)

Diagnosing the causes of impaired ecosystems in the marine environment is critical for effective management action. When ecological impairment is based on toxicological or biological criteria (i.e., degraded benthic community composition or toxicity test results), managers are faced with the additional problem of diagnosing the cause of impairment before plans can be initiated to reduce the pollutant loading. We evaluated a number of diagnostic tools to determine their ability to identify pollutants in New Bedford Harbor (NBH), Massachusetts (USA), using a modified version of the US Environmental Protection Agency's (USEPA) stressor identification (SI) guidance. In this study, we linked chemical sources and toxic chemicals in the sediment with spatial concentration studies; we also linked toxic chemicals in the sediment with toxicity test results using toxicity identification and evaluation (TIE) studies. We used geographical information systems (GIS) maps to determine sources and to aid in determining spatially integrated inorganic nitrogen (SIIN). The SIIN values of reference and test estuaries were quantified and compared. Using this approach, we determined that toxic chemicals continue to be active stressors in NBH and that a moderate nutrient stress exists, but we were unable to link the nutrient stressor with a source. Also excess sedimentation was evaluated, but it does not appear to be an active stressor in this harbor. The research included an evaluation of the effectiveness of tools under development that may be used to evaluate stressors in water bodies. We found that the following tools were useful in diagnosing active stressors: toxicity tests, toxicity identification and evaluation (TIE) methods, comparison of grain size‐normalized total organic carbon (TOC) ratios with reference sites, and comparison of SIIN with reference sites. This approach allowed us to successfully evaluate stressors in NBH retrospectively; however, a limitation in using retrospective data sets is that the approach may underestimate current or newly emerging stressors. Integr Environ Assess Manag 2012; 8: 685–702. © 2012 SETAC
Applying biotic ligand models and Bayesian techniques: Ecological risk assessment of copper and nickel in Tokyo rivers

Biotic ligand models (BLMs) have been broadly accepted and used in ecological risk assessment of heavy metals for toxicity normalization with respect to water chemistry. However, the importance of assessing bioavailability by using BLMs has not been widely recognized among Japanese stakeholders. Failing to consider bioavailability may result in less effective risk management than would be possible if currently available state‐of‐the‐art methods were used to relate bioavailable concentrations to toxic effects. In this study, an ecological risk assessment was conducted using BLMs for 6 rivers in Tokyo to stimulate discussion about bioavailability of heavy metals and the use of BLMs in ecological risk management in Japan. In the risk analysis, a Bayesian approach was used to take advantage of information from previous analyses and to calculate uncertainties in the estimation of risk. Risks were judged to be a concern if the predicted environmental concentration exceeded the 5th percentile concentration (HC5) of the species sensitivity distribution. Based on this criterion, risks to stream biota from exposure to Cu were judged not to be very severe, but it would be desirable to conduct further monitoring and field surveys to determine whether temporary exposure to concentrations exceeding the HC5 causes any irreversible effects on the river ecosystem. The risk of exposure to Ni was a concern at only 1 of the 6 sites. BLM corrections affected these conclusions in the case of Cu but were moot in the case of Ni. The use of BLMs in risk assessment calculations for Japanese rivers requires water quality information that is, unfortunately, not always available. Integr Environ Assess Manag 2013; 9: 63–69. © 2012 SETAC
Valued ecosystem components for watershed cumulative effects: An analysis of environmental impact assessments in the South Saskatchewan River watershed, Canada

The accumulating effects of human development are threatening water quality and availability. In recognition of the constraints to cumulative effects assessment (CEA) under traditional environmental impact assessment (EIA), there is an emerging body of research dedicated to watershed‐based cumulative effects assessment (WCEA). To advance the science of WCEA, however, a standard set of ecosystem components and indicators is required that can be used at the watershed scale, to inform effects‐based understanding of cumulative change, and at the project scale, to inform regulatory‐based project based impact assessment and mitigation. A major challenge, however, is that it is not clear how such ecosystem components and indicators for WCEA can or should be developed. This study examined the use of aquatic ecosystem components and indicators in EIA practice in the South Saskatchewan River watershed, Canada, to determine whether current practice at the project scale could be “scaled up” to support ecosystem component and indicator development for WCEA. The hierarchy of assessment components and indicators used in a sample of 35 environmental impact assessments was examined and the factors affecting aquatic ecosystem component selection and indicator use were identified. Results showed that public environmental impact statements are not necessarily publically accessible, thus limiting opportunities for data and information sharing from the project to the watershed scale. We also found no consistent terminology across the sample of impact statements, thus making comparison of assessment processes and results difficult. Regulatory compliance was found to be the dominant factor influencing the selection of ecosystem components and indicators for use in project assessment, rather than scientific reasoning, followed by the mandate of the responsible government agency for the assessment, public input to the assessment process, and preexisting water licensing arrangements external to the assessment process. The current approach to project‐based assessment offered little support for WCEA initiatives. It did not provide a standard set of aquatic ecosystem components and indicators or allow the sharing of information across projects and from the project to the watershed scale. We suggest that determining priority assessment parameters for WCEA requires adoption of a standardized framework of component and indicator terminology, which can then be populated for the watershed of concern based on both watershed‐based priorities and project‐specific regulatory requirements. Integr Environ Assess Manag 2013;9:469–479. © 2012 SETAC
START Changing Practice: Implementing a Risk Assessment and Management Tool in a Civil Psychiatric Setting

The assessment and management of risk for violence among individuals with a mental illness, traditionally the responsibility of specialized forensic institutions, are now becoming increasingly necessary in civil mental health services. The Short Term Assessment of Risk and Treatability (START) is a patient-centered scheme informing multiple risk domains through a comprehensive assessment of dynamic risk factors and strengths, based on a fixed set of definitions. However, there is a dearth of literature on the implementation of such tools in real life mental health settings, their relation to future behavior and their perceived usefulness in clinical settings. In this article, we describe the process of implementing the START on a civil psychiatric hospital unit in Canada taking into account typical barriers to the dissemination of evidence-based practices. The results of a longitudinal prospective mixed method (qualitative and quantitative) implementation study indicate that the START was well integrated into the unit's clinical and administrative activities. In these times of financial constraints in mental health services, as well as the increased pressure of mental health services to manage a wide variety of challenging behaviors, risk management tools can provide help in improving patient care and empowering staff to better understand violence and other challenging behaviors. This paper concludes with a discussion of the need to develop implementation research in the field of forensic mental health services in order to reduce the gap between research and practice.