Miracle-dz/UniFAR-FTUs huggingface dataset:
Physical distance, genetic relationship, age, and leprosy classification are independent risk factors for leprosy in contacts of patients with leprosy.

BACKGROUND Close contacts of patients with leprosy have a higher risk of developing leprosy. Several risk factors have been identified, including genetic relationship and physical distance. Their independent contributions to the risk of developing leprosy, however, have never been sufficiently quantified. METHODS Logistic-regression analysis was performed on intake data from a prospective cohort study of 1037 patients newly diagnosed as having leprosy and their 21,870 contacts. RESULTS Higher age showed an increased risk, with a bimodal distribution. Contacts of patients with paucibacillary (PB) leprosy with 2-5 lesions (PB2-5) and those with multibacillary (MB) leprosy had a higher risk than did contacts of patients with single-lesion PB leprosy. The core household group had a higher risk than other contacts living under the same roof and next-door neighbors, who again had a higher risk than neighbors of neighbors. A close genetic relationship indicated an increased risk when blood-related children, parents, and siblings were pooled together. CONCLUSIONS Age of the contact, the disease classification of the index patient, and physical and genetic distance were independently associated with the risk of a contact acquiring leprosy. Contact surveys in leprosy should be not only focused on household contacts but also extended to neighbors and consanguineous relatives, especially when the patient has PB2-5 or MB leprosy.
Serum cytokine levels in human septic shock. Relation to multiple-system organ failure and mortality.

PURPOSE Cytokines have been associated with the development of sepsis and diffuse tissue injury following septic or endotoxic challenges in humans. Furthermore, relative organ-system dysfunction, not specific organ dysfunction, appears to predict outcome from critical illness. We hypothesized that persistence of inflammatory cytokines within the circulation, reflecting a generalized systemic inflammatory response, is associated with multiple-system organ failure (MSOF) and death from critical illness. In addition, since hepatic function is central to host-defense homeostasis, we further reasoned that critically ill patients with hepatic cirrhosis would have an increased incidence of MSOF and death following sepsis associated with a persistence of cytokines in the blood. PATIENTS AND METHODS We measured serum levels of tumor necrosis factor (TNF), interleukin (IL) 1, IL-2, IL-6, and interferon gamma (IFG) serially for the first 48 h following the onset of hypotension (systolic blood pressure < 90 mm Hg) thought likely to be due to sepsis in all patients presenting to one ICU. These data were correlated with initial severity of shock and retrospective determination of septic or nonseptic origin, preexistent hepatic cirrhosis, subsequent development of MSOF, and outcome. RESULTS Fifty-three specific episodes of shock in 52 patients were recorded (35 septic and 18 nonseptic episodes). Mortality was higher in septic patients (41 vs 17 percent, p < 0.01), as was the development of MSOF (29 vs 6 percent, p < 0.001), incidence of cirrhosis (21 vs 0 percent, p < 0.01), and TNF levels over the study interval (p < 0.01). Nonseptic patients also had an initial elevation in TNF over 48-h levels (p < 0.05) that were higher than serum levels reported for normal subjects (chi 2, p < 0.05). There was no relation between peak TNF level and outcome. Sixty-seven percent of the cirrhotic patients had development of MSOF and died, while only 30 percent of the noncirrhotic patients had development of MSOF or died (p < 0.05). The TNF and IL-6 levels in patients who had MSOF or who died were both elevated and did not decrease over time independent of presence or absence of sepsis (p < 0.01). Similarly, IL-6 levels after 12 h were higher in cirrhotic patients than in noncirrhotic septic patients (p < 0.05). No elevation in IL-1, IL-2, or IFG was seen in any patient subpopulation. CONCLUSIONS TNF and IL-6 serum levels are higher in septic than in nonseptic shock, but the persistence of TNF and IL-6 in the serum rather than peak levels of cytokines predicts a poor outcome in patients with shock.
Greater Neural Adaptations following High- vs. Low-Load Resistance Training

We examined the neuromuscular adaptations following 3 and 6 weeks of 80 vs. 30% one repetition maximum (1RM) resistance training to failure in the leg extensors. Twenty-six men (age = 23.1 ± 4.7 years) were randomly assigned to a high- (80% 1RM; n = 13) or low-load (30% 1RM; n = 13) resistance training group and completed leg extension resistance training to failure 3 times per week for 6 weeks. Testing was completed at baseline, 3, and 6 weeks of training. During each testing session, ultrasound muscle thickness and echo intensity, 1RM strength, maximal voluntary isometric contraction (MVIC) strength, and contractile properties of the quadriceps femoris were measured. Percent voluntary activation (VA) and electromyographic (EMG) amplitude were measured during MVIC, and during randomly ordered isometric step muscle actions at 10–100% of baseline MVIC. There were similar increases in muscle thickness from Baseline to Week 3 and 6 in the 80 and 30% 1RM groups. However, both 1RM and MVIC strength increased from Baseline to Week 3 and 6 to a greater degree in the 80% than 30% 1RM group. VA during MVIC was also greater in the 80 vs. 30% 1RM group at Week 6, and only training at 80% 1RM elicited a significant increase in EMG amplitude during MVIC. The peak twitch torque to MVIC ratio was also significantly reduced in the 80%, but not 30% 1RM group, at Week 3 and 6. Finally, VA and EMG amplitude were reduced during submaximal torque production as a result of training at 80% 1RM, but not 30% 1RM. Despite eliciting similar hypertrophy, 80% 1RM improved muscle strength more than 30% 1RM, and was accompanied by increases in VA and EMG amplitude during maximal force production. Furthermore, training at 80% 1RM resulted in a decreased neural cost to produce the same relative submaximal torques after training, whereas training at 30% 1RM did not. Therefore, our data suggest that high-load training results in greater neural adaptations that may explain the disparate increases in muscle strength despite similar hypertrophy following high- and low-load training programs.
Review of functional/anatomical imaging in oncology

Patient management in oncology increasingly relies on imaging for diagnosis, response assessment, and follow-up. The clinical availability of combined functional/anatomical imaging modalities, which integrate the benefits of visualizing tumor biology with those of high-resolution structural imaging, revolutionized clinical management of oncologic patients. Conventional high-resolution anatomical imaging modalities such as computed tomography (CT) and MRI excel at providing details on lesion location, size, morphology, and structural changes to adjacent tissues; however, these modalities provide little insight into tumor physiology. With the increasing focus on molecularly targeted therapies, imaging radiolabeled compounds with PET and single-photon emission tomography (SPECT) is often carried out to provide insight into a tumor’s biological functions and its surrounding microenvironment. Despite their high sensitivity and specificity, PET and SPECT alone are substantially limited by low spatial resolution and inability to provide anatomical detail. Integrating SPECT or PET with a modality capable of providing these (i.e. CT or MR) maximizes their separate strengths and provides anatomical localization of physiological processes with detailed visualization of a tumor’s structure. The availability of multimodality (hybrid) imaging with PET/CT, SPECT/CT, and PET/MR improves our ability to characterize lesions and affect treatment decisions and patient management. We have just begun to exploit the truly synergistic capabilities of multimodality imaging. Continued advances in the development of instrumentation and imaging agents will improve our ability to noninvasively characterize disease processes. This review will discuss the evolution of hybrid imaging technology and provide examples of its current and potential future clinical uses.
Cytoskeletal Changes in Cultured Human Glaucoma Trabecular Meshwork Cells

PurposeGlucocorticoid treatment of cultured human trabecular meshwork (TM) cells has been shown to reorganize actin microfilaments into cross-linked actin networks (CLANs) and to alter TM cell function. The purpose of the present study is to determine whether similar microfilament structural changes occur in TM cells derived from glaucoma patients. MethodsThe microfilament structures of nine different TM cell cultures, derived from four glaucoma patients and from five normal subjects, was examined by epifluorescent microscopy and by whole-mount transmission electron microscopy. The cells were cultured in the absence and presence of dexamethasone (DEX) for 7–14 days. ResultsThe normal TM cell lines and glaucoma cell line TM13 had relatively low levels of cross-linked actin networks in the absence of exogenously added glucocorticoids. In contrast, the glaucoma cell lines TM23, TM36C, and TM48D had high levels of CLANs without the addition of dexamethasone. The addition of 10−7 M DEX to the culture medium significantly increased CLAN expression in all normal as well as glaucoma TM cell lines. ConclusionCLAN formation in glaucoma TM cells or in TM cells exposed to glucocorticoids may be a factor contributing to the generation of ocular hypertension.
Escherichia coli ykfE ORFan Gene Encodes a Potent Inhibitor of C-type Lysozyme*

The complete nucleotide sequences of over 37 microbial and three eukaryote genomes are already publicly available, and more sequencing is in progress. Despite this accumulation of data, newly sequenced microbial genomes continue to reveal up to 50% of functionally uncharacterized “anonymous” genes. A majority of these anonymous proteins have homologues in other organisms, whereas the rest exhibit no clear similarity to any other sequence in the data bases. This set of unique, apparently species-specific, sequences are referred to as ORFans. The biochemical and structural analysis of ORFan gene products is of both evolutionary and functional interest. Here we report the cloning and expression ofEscherichia coli ORFan ykfE gene and the functional characterization of the encoded protein. Under physiological conditions, the protein is a homodimer with a strong affinity for C-type lysozyme, as revealed by co-purification and co-crystallization. Activity measurements and fluorescence studies demonstrated that the YkfE gene product is a potent C-type lysozyme inhibitor (K i ≈ 1 nm). To denote this newly assigned function, ykfE has now been registered under the new gene name Ivy (inhibitor ofvertebrate lysozyme) at the E. coligenetic stock center.
Factors influencing surgical outcome in patients with focal cortical dysplasia

A total of 120 patients with histologically proven focal cortical dysplasias (FCD) were retrospectively analysed for prognostic factors for successful epilepsy surgery. Multivariate data analyses showed that older age at epilepsy surgery, occurrence of secondarily generalised seizures and a multilobar extent of the dysplasia were significant negative predictors. In univariate analyses, longer duration of epilepsy, need for intracranial EEG recordings and incomplete resection of the FCD were factors which significantly reduced the chance of becoming seizure free. Histological subtype of the FCD and age at epilepsy onset had no significant predictive value. These findings strongly suggest early consideration of epilepsy surgery in FCD patients.
Early Loss of Splenic Tfh Cells in SIV-Infected Rhesus Macaques

Follicular T helper cells (Tfh), a subset of CD4 T lymphocytes, provide crucial help to B cells in the production of antigen-specific antibodies. Although several studies have analyzed the dynamics of Tfh cells in peripheral blood and lymph nodes (LNs) during Aids, none has yet addressed the impact of SIV infection on the dynamics of Tfh cells in the spleen, the primary organ of B cell activation. We show here a significant decrease in splenic Tfh cells in SIVmac251-infected rhesus macaques (RMs) during the acute phase of infection, which persists thereafter. This profound loss is associated with lack of sustained expression of the Tfh-defining transcription factors, Bcl-6 and c-Maf but with higher expression of the repressors KLF2 and Foxo1. In this context of Tfh abortive differentiation and loss, we found decreased percentages of memory B cell subsets and lower titers of SIV-specific IgG. We further demonstrate a drastic remodeling of the lymphoid architecture of the spleen and LNs, which disrupts the crucial cell-cell interactions necessary to maintain memory B cells and Tfh cells. Finally, our data demonstrated the early infection of Tfh cells. Paradoxically, the frequencies of SIV DNA were higher in splenic Tfh cells of RMs progressing more slowly suggesting sanctuaries for SIV in the spleen. Our findings provide important information regarding the impact of HIV/SIV infection on Tfh cells, and provide new clues for future vaccine strategies.
Thymidylate synthase and dihydropyrimidine dehydrogenase expression in oral squamous cell carcinoma: an immunohistochemical and clinicopathologic study.

OBJECTIVE Thymidylate synthase (TS) is the target enzyme for 5-fluorouracil (5-FU), and dihydropyrimidine dehydrogenase (DPD) is the first enzyme that metabolizes 5-fluorouracil. Until now, only the enzyme activities of TS and DPD have been investigated; however, there are few reports about the immunohistochemistry of TS and DPD and none regarding oral carcinoma. The purpose of this article was to investigate the expression of TS and DPD in oral squamous cell carcinoma. STUDY DESIGN In this study, 109 oral squamous cell carcinomas were investigated for the immunohistochemical expression of TS and DPD proteins. RESULTS The expressions of TS in carcinoma cases was significantly higher than in controls (P <.05, t test). DPD was expressed both in carcinomas and in areas adjacent to the carcinomas. There was no correlation between the clinical factors and the TS labeling index or between the clinical factors and the DPD labeling index (DPD-LI). Pathologically, DPD-LI was significantly different in both the World Health Organization classification and Anneroth's classification. The TS labeling index was significantly correlated with the Ki-67 LI (P <.05, Pearson's correlation coefficient). Although TS showed no correlation between tegafur-uracil response and TS labeling index, there was a significant correlation between the tegafur-uracil response and DPD-LI. CONCLUSIONS TS may reveal tumor cell proliferation, but DPD-LI may correlate with a response to anticancer drug treatment.
Kid-1 participates in regulating ERK phosphorylation as a part of the circadian clock output in rat kidney

Circadian clock genes play a role for the regulation of cell cycle, but the factors connecting clock to cell cycle are not fully understood. We found that mRNA of Kid-1— a zinc-finger-type transcriptional repressor was localized to cortical and juxtamedullary segments of tubules but not to glomeruli in the rat kidney. Kid-1 mRNA showed robust circadian oscillation with a peak at ZT16. Under temporal restricted feeding, the phase of the oscillation shifted along with mRNAs of the clock genes—Per1 and Per2. The rhythm of S-phase in cell cycle disappeared in the kidney under the restricted feeding. The level of phosphorylation of extracellular signal-regulated kinase (ERK) 1/2 was rhythmic with a peak at ZT16 in the kidney. We found that knockdown and overexpression of Kid-1 in NRK52E (normal rat kidney epithelial) cells induced and reduced the phosphorylation of ERK1/2, respectively. The data suggest that clock-controlled Kid-1 regulates the cell cycle of proliferating renal tubular epithelial cells through ERK phosphorylation.
Objective Clinical Evaluation of Physical Impairment in Chronic Low Back Pain

The aim of this study was to investigate physical impairment in patients with chronic low back pain, to develop a method of clinical evaluation suitable for routine use, and to consider the relationship between pain, disability, and physical impairment. Twenty-seven physical tests were investigated. Permanent anatomic and structural impairments of spiral deformities, spiral fractures, surgical scarring, and neurologic deficits were excluded as not relevant to the patient with low back pain in the absence of nerve root involvement or previous surgery. Three consecutive 20-patient reproducibility studies were used to develop reliable methods of examination for 23 of the tests. Only four tests were excluded as unreliable: sacral angle, pelvic tilt, and separate lumbar and pelvic extension, none of which ere part of routine clinical examination or have any proven relationship to disability. The remaining 23 physical tests were evaluated in 70 asymptomatic subjects and 120 patients with chronic low back pain, Passive knee flexion, passive hip flexion, hip flexion, strength, hip abduction strength, pain reproduction on each of these tests, and the prone extension strength test were excluded because they were too closely related to nonorgainic and behavioral responses to examination. Eight tests successfully discriminated patients with low back pain from normal subjects and were significantly related to self-report disability in activities of daily living: pelvic flexion, total flexion, total extention, lateral flexion, straight leg raising, spinal tenderness, bilateral active straight leg raising, and sit-up. Factor analysis failed to demonstrate an underlying statistical dimension of physical impairment, However, an empirical combination of total flexion, total extension, average- lateral flexion, average straight leg raising, spinal tenderness, bilateral active straight leg raising, and sit-up provided an equally satisfactory alternative. Simple cut-offs from normal subjects made the scale simple and quick to use. This final scale successfully discriminated 78% of patients and normal subjects and explained 25% of the variance of disability, with a specificity of 86% and sensitivity of 76%. This scale provides an objective clinical evaluation that meets the criteria for evaluating physical impairment, yet is simple, reliable, and suitable for routine clinical use. It should, however, be emphasized that all the tests included in the final scale are measures of current functional limitation rather than of permanent anatomic, or structural impairment. This raises questions about the physical basis of permanent disability due to chromic low back pain.
Relationships among plasma dehydroepiandrosterone sulfate and cortisol levels, symptoms of dissociation, and objective performance in humans exposed to acute stress.

CONTEXT Recently, a growing body of research has provided evidence that dehydroepiandrosterone sulfate (DHEA-S) is involved in an organism's response to stress and that it may provide beneficial behavioral and neurotrophic effects. OBJECTIVE To investigate plasma DHEA-S and cortisol levels, psychological symptoms of dissociation, and military performance. DESIGN Prospective study. SETTING AND PARTICIPANTS Twenty-five healthy subjects enrolled in military survival school. RESULTS The DHEA-S-cortisol ratios during stress were significantly higher in subjects who reported fewer symptoms of dissociation and exhibited superior military performance. CONCLUSIONS These data provide prospective, empirical evidence that the DHEA-S level is increased by acute stress in healthy humans and that the DHEA-S-cortisol ratio may index the degree to which an individual is buffered against the negative effects of stress.
Van Vollenhoven on Indonesian adat law : selections from Het adatrecht van Nederlandsch-Indië (volume I, 1918; volume II, 1931)

The introduction to this English translation of a selection from Van Vollenhoven's study of indigenous Indonesian law outlines the historical significance of his work, showing its background in the complex administrative and legal system of the Dutch East Indies, the trends in Dutch colonial legal and economic policy, and the development of adat law scholarship from the early 1900s onwards. The chapters chosen concentrate almost entirely on the adat law of some of the indigenous peoples of Indonesia.
Risk factors for physical symptoms after a disaster: a longitudinal study

Background Although symptoms such as fatigue, headache and pain in bones and muscles are common after disasters, risk factors for these symptoms among disaster survivors have rarely been studied. We examined predisposing, precipitating and perpetuating factors for these physical symptoms among survivors of a man-made disaster. In addition, we examined whether risk factors for physical symptoms differ between survivors and controls. Method Survivors completed a questionnaire 3 weeks (n=1567), 18 months and 4 years after the disaster. Symptoms and risk factors were measured using validated questionnaires. A comparison group was included at waves 2 and 3 (n=821). Random coefficient analysis (RCA) was used to study risk factors for symptoms. Results Female gender [beta (β)=1.0, 95% confidence interval (CI) 0.6–1.4], immigrant status (β=1.0, 95% CI 0.6–1.4) and pre-disaster psychological problems (β=0.8, 95% CI 0.1–1.4) were predisposing factors for symptoms. Although disaster-related factors were predictors, the relationship between symptoms and disaster-related factors was not very strong and the magnitude of this association was reduced when perpetuating factors were added. Intrusions and avoidance, depression, anxiety and sleeping problems were important perpetuating factors for physical symptoms among survivors and mediated the association between traumatic stress and physical symptoms. Risk factors for symptoms were comparable between survivors and controls. Conclusions The results indicate that health-care workers should be alert for physical symptoms among female survivors, immigrant survivors and individuals with a high level of psychological problems both before and after a disaster.
Left thoracotomy for middle or lower thoracic esophageal carcinoma: still Sweet enough?

BACKGROUND Esophagectomy via left thoracotomy (the Sweet procedure) has long been the conventional route for resection of esophageal carcinoma, especially in China. However, this procedure is being increasingly critiqued, mainly regarding the lymphadenectomy. The objective of this study was to compare the Sweet procedure with the right upper mediastinal lymph node resection (MS) and Ivor-Lewis (IL) procedure in the treatment of middle or lower thoracic esophageal squamous cell carcinoma (OSCC-MLT) in terms of lymphadenectomy, postoperative complications, and long-term survival. METHODS A total of 336 OSCC-MLT patients underwent radical intent surgery (188 with MS and 148 with IL procedure) between January 2007 and September 2013 in our hospital. After propensity score matching, 129 patients from each procedure were included. The efficacy of lymph node dissection at each station was estimated by the index of estimated benefit from lymph node dissection (IEBLD). RESULTS IEBLD is relatively high in stations 2L, 2R, 8, 16 and 17. The metastasis rates and ratios were similar between the MS and IL procedures at each station. The MS procedure significantly outperformed the IL procedure with a shorter operating time (212 vs. 317 min), shorter in-hospital stay (10.7 vs. 15.3 days), and fewer postoperative complications (30.2% vs. 43.4%). However, the 5-year survival rates were not significantly different between the two procedures (46.9% vs. 44.0%). CONCLUSIONS The MS procedure of esophagectomy is not inferior to the IL procedure in efficiency, moreover the MS procedure is safer.