Miracle-dz/UniFAR-FTUs huggingface dataset:
A novel Gymnema sylvestre extract protects pancreatic beta‐cells from cytokine‐induced apoptosis

Inflammatory cytokines such as interleukin‐1β, TNF‐α, and interferon‐γ are known to be involved in mediating β‐cells death in diabetes mellitus (DM). Thus, protecting from β‐cells death in patients with DM may be a useful target in alleviating symptoms of hyperglycemia. Traditional plant‐based remedies have been used to treat DM for many centuries and may play a role in protecting β‐cell from death. An example of these remedies is Gymnema sylvestre (GS) extract. In this study, we investigated the effect of this plant extract on β‐cells apoptosis. Om Santal Adivasi (OSA®) maintained cell membrane integrity in MIN6 cells and mouse islets. Om Santal Adivasi significantly protected MIN6 cells and mouse islets from cytokine‐induced apoptosis. In the presence of cytokines, OSA® significantly reduced the expression and activity of caspase‐3. The antiapoptotic effect of OSA® as shown by microarray analysis is largely mediated by activating pathways involved in cell survival (mainly casein kinase II pathway) and the free radical scavenger system (specifically superoxide dismutase and catalase). This study indicates that the GS isolate OSA® protects against cytokine‐induced apoptosis of β‐cells by increasing the expression of cell survival pathways and free radical scavenger system.
An Intervention to Reduce Hypoglycemia Fear in Parents of Young Kids with Type 1 Diabetes via Video-Based Telemedicine (REDCHIP): Trial Design, Feasibility, and Acceptability.

BACKGROUND Fear of hypoglycemia (FH) is common in parents of young children with type 1 diabetes (T1D) and problematically linked to maladaptive behaviors to avoid low blood glucose, parenting stress, and burn-out. This study examined the feasibility and acceptability of a novel group-based telemedicine intervention to reduce FH in parents of young children with T1D. METHODS Forty-three families of a young child with T1D (1-6 years old; diagnosed with T1D for at least 6 months) enrolled in the study and 36 completed the Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP) intervention. We assessed intervention feasibility with rates of attrition, intervention attendance, and fidelity to the treatment manual. We assessed acceptability with treatment satisfaction surveys and qualitative interviews (from a subset of completers; N=10) about intervention acceptability, facilitators, and challenges. RESULTS Study attrition was 21%, including long-term follow-up (16% before or during the treatment phase). On average, parents attended 94% of intervention sessions and fidelity to the treatment manual was 89%. Intervention completers reported high satisfaction with the treatment groups (89% average satisfaction rating). Parent-reported positive influencers of the REDCHiP intervention were increased knowledge, fear awareness, coping strategies, confidence, behavioral parenting strategies, and support; whereas intervention challenges included feeling fearful or overwhelmed, family stress, lack of trust, and difficulty connecting with other group members. CONCLUSIONS The REDCHiP intervention demonstrated initial feasibility and acceptability. Next steps include determining the intervention's impact on objective parent and child outcomes (e.g., glycemic control, parental FH, parental stress/distress) as well as large-scale efficacy testing.
Neutrophil–lymphocyte ratio as an early predictor for patients with acute paraquat poisoning

Abstract This retrospective study aimed to investigate whether the neutrophil–lymphocyte ratio (NLR) can be used as an early predictor of 90-day survival in patients with acute paraquat (PQ) poisoning. This study enrolled 105 patients with acute PQ poisoning admitted from May 2012 to May 2018. Kaplan–Meier curve, receiver operating characteristic curve, and Cox proportional hazards regression analyses were used to investigate the predictive value of NLR for 90–day survival of patients with acute PQ poisoning. The 90-day survival rate was 40.95% (43/105). Survivors had lower NLR (P <.001), which was an independent predictor of 90-day survival according to the Cox proportional hazard regression analyses. The area under the NLR curve was 0.842 (95% CI: 0.767–0.917, P <.001) in predicting 90-day survival. Our findings showed that low NLR was a valuable early predictor of 90-day survival in patients with acute PQ poisoning.
Hospital-based study of the severity and economic burden associated with rotavirus diarrhea in Sri Lanka

Abstract The objective of this study was to determine the morbidity and associated costs of rotavirus infection in Sri Lanka in anticipation of rotavirus vaccines. From April 2005 to October 2006 stool samples of 606 children (335 males) mean age 27.3 ± 31.53 months (range 1–144 months) admitted with gastroenteritis to the pediatric units of the Colombo North teaching Hospital were screened for rotavirus antigens by enzyme-immunoassay (EIA) (Rotaclone®) Severity of gastroenteritis was assessed by the Vesikari scoring system. Using an interviewer administered questionnaire the average expense incurred per-episode of rotavirus gastroenteritis was determined among randomly selected rotavirus cases (n = 45). Cost of universal rotavirus vaccination was assessed assuming a cost of US$ 7 per vaccine dose for a two-dose regime (World Bank cost-effectiveness standard for low-income countries). One hundred and sixteen (19.1%) had group A rotavirus antigens. The prevalence of rotavirus infection among the 0–4 years age group was 20.8%. The mean severity score was 12.8 and 11 in rotavirus positive and non-rotavirus diarrheas, respectively (P < 0.001). Nausea, vomiting and severe dehydration were significantly associated with rotavirus. The average cost of an episode of rotavirus gastroenteritis hospitalization was Rs. 3626 (US$ 33). The estimated annual expenditure of universal rotavirus vaccination in Sri Lanka was US$ 5 million. Cost saved through averting rotavirus hospitalizations per year was US$ 0.26 million. Deaths averted were eight per year. Rotaviruses constitute an important health and economic burden in Sri Lanka. Vaccine safety, efficacy and affordability are requirements for implementation of universal rotavirus vaccination.
Fine-Tuning Bidirectional Encoder Representations From Transformers (BERT)–Based Models on Large-Scale Electronic Health Record Notes: An Empirical Study

Background The bidirectional encoder representations from transformers (BERT) model has achieved great success in many natural language processing (NLP) tasks, such as named entity recognition and question answering. However, little prior work has explored this model to be used for an important task in the biomedical and clinical domains, namely entity normalization. Objective We aim to investigate the effectiveness of BERT-based models for biomedical or clinical entity normalization. In addition, our second objective is to investigate whether the domains of training data influence the performances of BERT-based models as well as the degree of influence. Methods Our data was comprised of 1.5 million unlabeled electronic health record (EHR) notes. We first fine-tuned BioBERT on this large collection of unlabeled EHR notes. This generated our BERT-based model trained using 1.5 million electronic health record notes (EhrBERT). We then further fine-tuned EhrBERT, BioBERT, and BERT on three annotated corpora for biomedical and clinical entity normalization: the Medication, Indication, and Adverse Drug Events (MADE) 1.0 corpus, the National Center for Biotechnology Information (NCBI) disease corpus, and the Chemical-Disease Relations (CDR) corpus. We compared our models with two state-of-the-art normalization systems, namely MetaMap and disease name normalization (DNorm). Results EhrBERT achieved 40.95% F1 in the MADE 1.0 corpus for mapping named entities to the Medical Dictionary for Regulatory Activities and the Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT), which have about 380,000 terms. In this corpus, EhrBERT outperformed MetaMap by 2.36% in F1. For the NCBI disease corpus and CDR corpus, EhrBERT also outperformed DNorm by improving the F1 scores from 88.37% and 89.92% to 90.35% and 93.82%, respectively. Compared with BioBERT and BERT, EhrBERT outperformed them on the MADE 1.0 corpus and the CDR corpus. Conclusions Our work shows that BERT-based models have achieved state-of-the-art performance for biomedical and clinical entity normalization. BERT-based models can be readily fine-tuned to normalize any kind of named entities.
Increased mortality in patients with corticosteroid-dependent asthma: a nationwide population-based study

Introduction Chronic systemic corticosteroid (CS) therapy is associated with an increased risk of mortality in patients with many chronic diseases. However, it has not been elucidated whether chronic systemic CS therapy is associated with increased mortality in patients with asthma. The aim of this study was to determine the effects of chronic systemic CS therapy on long-term mortality in adult patients with asthma. Methods A population-based matched cohort study of males and females aged ≥18 years with asthma was performed using the Korean National Health Insurance Service database from 2005 to 2015. Hazard ratio (HR) with 95% confidence interval for all-cause mortality among patients in the CS-dependent cohort (CS use ≥6 months during baseline period) relative to those in the CS-independent cohort (CS use <6 months during baseline period) was evaluated. Results The baseline cohort included 466 941 patients with asthma, of whom 8334 were CS-dependent and 458 607 were CS-independent. After 1:1 matching, 8334 subjects with CS-independent asthma were identified. The HR of mortality associated with CS-dependent asthma relative to CS-independent asthma was 2.17 (95% CI 2.04–2.31). In patients receiving low-dose CS, the HR was 1.84 (95% CI 1.69–2.00); in patients receiving high-dose CS, the HR was 2.56 (95% CI 2.35–2.80). Conclusions In this real-world, clinical practice, observational study, chronic use of systemic CS was associated with increased risk of mortality in patients with asthma, with a significant dose–response relationship between systemic CS use and long-term mortality. Chronic use of systemic corticosteroid (CS) was associated with increased risk of mortality in patients with asthma, with a significant dose–response relationship between systemic CS use and long-term mortality http://bit.ly/2ku3ZJl
Occult HBV infection in Chinese blood donors: role of N-glycosylation mutations and amino acid substitutions in S protein transmembrane domains

ABSTRACT Occult hepatitis B virus infection (OBI) is a low-level asymptomatic phase of HBV infection. Evidence of OBI clinical relevance is emerging but the mechanisms of its occurrence remain unclear. In this study, the molecular characteristics of 97 confirmed OBI from Chinese blood donors were analyzed and relevant mutations were identified. Recombinant HBsAg bearing these mutations were expressed in vitro and the antigenicity and HBsAg secretion properties were analyzed. Results showed that 45 (46.4%) genotype B, 50 (51.5%) genotype C, and 2 (2.1%) genotype D sequences were identified. Two groups of mutations in the S gene were significantly associated with OBI. The first group included mutations creating new N-linked glycosylation sites at positions s116, s123, s130, and s131 + s133 or removing the existing one at s146. Mutations TCT123-125NCT/NFT were associated with reduced antigenicity, while TST116-118NST, GTS130-132NTS, and TSM131-133NSS/NYT/NST were associated with varying levels of impaired HBsAg secretion. N146 mutations had no effect on HBsAg production pattern. The second group included substitutions within the S transmembrane domains TMD1-3. Only mutations C85R, L87R, L88R, and C90R within TMD2 were associated with defective HBsAg production. These mutations appear to be rare and mostly strain specific but they may contribute to the multifactorial occurrence of OBI.
National Trends in Utilization and 1-Year Outcomes with Transplantation of HCV-Viremic Kidneys.

BACKGROUND Recent pilot trials have demonstrated the safety of transplanting HCV-viremic kidneys into HCV-seronegative recipients. However, it remains unclear if allograft function is impacted by donor HCV-viremia or recipient HCV-serostatus. METHODS We used national United States registry data to examine trends in HCV-viremic kidney use between 4/1/2015 and 3/31/2019. We applied advanced matching methods to compare eGFR for similar kidneys transplanted into highly similar recipients of kidney transplants. RESULTS Over time, HCV-seronegative recipients received a rising proportion of HCV-viremic kidneys. During the first quarter of 2019, 200 HCV-viremic kidneys were transplanted into HCV-seronegative recipients, versus 69 into HCV-seropositive recipients, while 105 HCV-viremic kidneys were discarded. The probability of HCV-viremic kidney discard has declined over time. Kidney transplant candidates willing to accept a HCV-seropositive kidney increased from 2936 to 16,809 from during this time period. When transplanted into HCV-seronegative recipients, HCV-viremic kidneys matched to HCV-non-viremic kidneys on predictors of organ quality, except HCV, had similar 1-year eGFR (66.3 versus 67.1 ml/min per 1.73 m2, P=0.86). This was despite the much worse kidney donor profile index scores assigned to the HCV-viremic kidneys. Recipient HCV-serostatus was not associated with a clinically meaningful difference in 1-year eGFR (66.5 versus 71.1 ml/min per 1.73 m2, P=0.056) after transplantation of HCV-viremic kidneys. CONCLUSIONS By 2019, HCV-seronegative patients received the majority of kidneys transplanted from HCV-viremic donors. Widely used organ quality scores underestimated the quality of HCV-viremic kidneys based on 1-year allograft function. Recipient HCV-serostatus was also not associated with worse short-term allograft function using HCV-viremic kidneys.
Multiple Concussions Increase Odds and Rate of Lower Extremity Injury in National Collegiate Athletic Association Athletes After Return to Play

Background: Concussion in collegiate athletics is one of the most prevalent sport-related injuries in the United States, with recent studies suggesting persistent deficits in neuromuscular control after a concussion and an associated increase in risk of lower extremity injury. Purpose: To expand on the relationship between concussion and lower extremity injury by examining the effect of multiple concussions (MC) on rate and odds of future lower extremity injury in collegiate athletes after return to play (RTP) compared with matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: From 2001 to 2016, 48 National Collegiate Athletic Association Division I athletes sustaining multiple concussions at a single institution were identified. Athletes with multiple concussions (MC) were matched directly to athletes with a single concussion (SC) and to athletes with no concussion history (NC) by sex, sport, position, and games played. Incidence of, time to, and location of lower extremity injury were recorded for each group after RTP from their first reported concussion until completion of their collegiate career. Logistic regression was used to analyze odds ratios (ORs) for sustaining lower extremity injury, whereas time to injury was summarized by use of Kaplan-Meier curves and log rank test analysis. Results: The incidence of lower extremity injury after RTP was significantly greater (P = .049) in the MC cohort (36/48, 75%) than in SC athletes (25/48 = 52%) and NC athletes (27/48 = 56%). Similarly, odds of lower extremity injury were significantly greater in the MC cohort than in SC athletes (OR, 3.00; 95% CI, 1.26-7.12; P = .01) and NC athletes (OR, 1.66; 95% CI, 1.07-2.56; P = .02). Time to lower extremity injury was significantly shorter in the MC group compared with matched controls (P = .01). No difference was found in odds of lower extremity injury or time to lower extremity injury between SC and NC athletes. Conclusion: Collegiate athletes with MC were more likely to sustain a lower extremity injury after RTP in a shorter time frame than were the matched SC and NC athletes. This may suggest the presence of a cohort more susceptible to neuromuscular deficits after concussion or more injury prone due to player behavior, and it may imply the need for more stringent RTP protocols for athletes experiencing MC.
Antiviral immunity is impaired in COPD patients with frequent exacerbations

Patients with frequent exacerbations represent a chronic obstructive pulmonary disease (COPD) subgroup requiring better treatment options. The aim of this study was to determine the innate immune mechanisms that underlie susceptibility to frequent exacerbations in COPD. We measured sputum expression of immune mediators and bacterial loads in samples from patients with COPD at stable state and during virus-associated exacerbations. In vitro immune responses to rhinovirus infection in differentiated primary bronchial epithelial cells (BECs) sampled from patients with COPD were additionally evaluated. Patients were stratified as frequent exacerbators (≥2 exacerbations in the preceding year) or infrequent exacerbators (<2 exacerbations in the preceding year) with comparisons made between these groups. Frequent exacerbators had reduced sputum cell mRNA expression of the antiviral immune mediators type I and III interferons and reduced interferon-stimulated gene (ISG) expression when clinically stable and during virus-associated exacerbation. A role for epithelial cell-intrinsic innate immune dysregulation was identified: induction of interferons and ISGs during in vitro rhinovirus (RV) infection was also impaired in differentiated BECs from frequent exacerbators. Frequent exacerbators additionally had increased sputum bacterial loads at 2 wk following virus-associated exacerbation onset. These data implicate deficient airway innate immunity involving epithelial cells in the increased propensity to exacerbations observed in some patients with COPD. Therapeutic approaches to boost innate antimicrobial immunity in the lung could be a viable strategy for prevention and treatment of frequent exacerbations.
Effectiveness of Diabetes Community Sharp Disposal Education Module in Primary Care: An Experimental Study in North-East Peninsular Malaysia

Background: Structured education is needed to cultivate safe sharp disposal behavior among diabetic patients. Thus, this study aimed to assess the effectiveness of the Diabetes Community Sharp Disposal Education Module in improving knowledge and sharp disposal practice among Malaysian Type 2 diabetic patients. Methods: This quasi-experimental study was conducted at primary health clinics in two districts in Kelantan, a state in the North-East Region of Peninsular Malaysia. A total of 132 Type 2 diabetic patients on insulin therapy were involved, with 68 participants in each control and intervention group. The health education intervention was based on the validated Diabetes Community Sharp Disposal Education Module. The knowledge and practices were measured using a validated questionnaire at baseline, one month, and three months after the intervention. Results: There was a significant increment in the mean knowledge score for intervention group; from baseline to one month follow up and from baseline to three months follow up [Greenhouse-Geisser; F(1.5, 199.7) = 62.38, p < 0.001; effect size (η2) = 0.318]. Intervention group had significantly higher mean knowledge score as compared to control group; at one month and three months follow up [F(1, 134) = 17.38, p < 0.001; effect size (η2) = 0.115]. There was a statistically significant increment in the proportion of participants in the intervention group who practiced the proper community sharp disposal method over time, X2(2) = 52.061, p < 0.001. Conclusions: The Diabetes Community Sharp Disposal Education Module was an effective health education tool to improve knowledge and encourage Malaysian diabetic patients to engage with proper sharp disposal practices.
Response by Duffy et al to Letter Regarding Article, "Per-Pass Analysis of Thrombus Composition in Patients With Acute Ischemic Stroke Undergoing Mechanical Thrombectomy".

In Response: We thank Bourcier et al for their interest in our recent study. In their letter, they state that “specific immunostaining techniques are mandatory to quantify platelet content in thrombi. ” Platelets are a significant component of thrombi as shown by Niesten et al and Staessens et al. Platelets are contiguous with the fibrin and, therefore, contribute significantly to the cohesiveness and strength of the fibrin network. The main finding from our study is that cases that require multiple passes to achieve revascularization have fewer red blood cells in clot fragments captured in the later passes of the case and have a higher fibrin composition. Based on current understanding, it is likely that fibrin dominant regions contain attached platelets, thereby resulting in the same study conclusions. Preclinical models have also shown that fibrin rich clots are stiffer and more difficult to remove than red blood cell–rich clots. Immunohistological staining is still requisite to identify the presence of platelets and, while not part of the initial analysis, it is planned for future work. Despite this, the clot analysis applied in this study is in keeping with published studies that examined the red blood cell, fibrin, and white blood cell content of thrombi using Martius Scarlet Blue staining. In their correspondence, Bourcier et al highlighted the issue of using the histological findings as a gold standard in large vessel occlusions. The authors agree that the histological analysis of thrombi has limitations. These include the inability to compare the morphology of the occlusive thrombus in the vessel with the retrieved specimen, the uncertainty of how thrombus composition is altered after thrombolytic therapy or mechanical thrombectomy, and the inability to analyze thrombus material that was not successfully retrieved. As suggested by Bourcier et al, imaging studies may help to overcome these limitations. The absence of imaging analysis in this study is a limitation; however, it was beyond the scope of this work. Despite the lack of imaging findings, the histological per-pass approach adopted in this study has, for the first time, provided insight into thrombus composition during each procedural pass, which imaging may not readily permit. Overall, combining per-pass analysis of thrombi using histological analysis with imaging and immunohistochemical methods would provide a comprehensive approach that has the potential to provide further insight into mechanical thrombectomy in large vessel occlusions.