Miracle-dz/UniFAR-FTUs huggingface dataset:
Interventions to tackle malnutrition and its risk factors in children living in slums: a scoping review

Abstract Context: Children living in slums are at high risk of being malnourished. There are no published reviews on existing interventions promoting better nutrition for children living in slums and the risk factors for children’s malnutrition. Improved understanding of the risk factors for malnutrition in slums communities and the impact of interventions on children’s health can provide guidance to practitioners and decision-makers. The present review is designed to provide this information. Methods: The search included 30 electronic bibliographic databases and relevant eligible studies published up to December 2013. Results: The search located 1512 citations. Full text relevance screening was conducted on 226 studies and on abstracts for 16 studies. The final 58 unique studies included 22 on interventions and 38 on risk. All of the interventions were nutrition-specific, with nutritional intervention being the most dominant type. Seventy-three per cent of the interventions were assessed effective. Conclusion: The findings stressed the gaps in knowledge in terms of quality assessment and programmatic recommendations to identify children who are the most at risk of malnutrition to appropriately target interventions. Finally, the review helped to inform a systematic review (Cochrane Systematic review protocol 2015) that will examine the impact of interventions on outcome measures.
BENIGN TUMORS OF THE LARYNX: A STUDY OF SEVEN HUNDRED AND TWENTY-TWO CASES

Benign tumors of the larynx are of interest and importance to the laryngologist, not only because of the symptoms which they produce by interference with the normal functions of the vocal mechanism or by obstruction of the respiratory tract but because of the necessity of distinguishing them from malignant laryngeal lesions. Tumors of a bengin nature do not occur frequently in the larynx. During the past thirty years 722 patients with benign laryngeal growths have been examined at the Mayo Clinic. It is interesting to find that these tumors, apparently, are encountered less often than are malignant neoplasms, as approximately 1,100 malignant tumors of the larynx were observed during this same period. In any discussion of benign tumors of the larynx, there arises the need of defining the term "benign laryngeal tumor. " Occasionally, there occur benign new growths, composed of cells which resemble various normal tissue cells but which fulfill
Distribution of xenobiotic metabolising enzyme genotypes in different Tunisian populations

Abstract Background: The N-acetyltransferase 2 (NAT2) and glutathione transferase enzymes play a crucial role in the metabolism of xenobiotics. Genetic polymorphisms affecting these enzymes can modify their activities with an effect on individual susceptibility for different pathologies. These metabolic phenotypes occur with varying prevalence in different populations. Aim: This study sought to analyse the prevalence of important allelic variants of NAT2, GSTM1 and GSTT1 in different Tunisian populations and compare them to other previously reported data. Subjects and methods: A total of 253 unrelated subjects from different Tunisian populations participated in this study. Subjects were examined with respect to the frequency of slow NAT2, GSTM1*0 and GSTT1*0 genotypes. Results: The frequency of ‘slow’ NAT2, GSTM1*0 and GSTT1*0 genotypes in the Tunisian population were, respectively, estimated at 23.3%, 53.75% and 29.24%. The frequency of slow NAT2 and GSTM1*0 genotypes were significantly different between the North, Centre and South of Tunisia. However, this study doesn’t report any significant differences in the genotype distribution between Cosmopolitan, Arab and Berber populations. Conclusions: In conclusion, these data indicate that the Tunisian population is highly heterogenic and, therefore, a strict definition of the populations involved in studies investigating the clinical effect of polymorphisms is required.
Polymorphism in LRP5 (rs556442) is associated with higher TG levels in Iranian children

Abstract Background: Wnt signalling/LRP5 is involved in adipogenesis by down-regulating adipogenic transcription factors. Therefore polymorphisms in components of this pathway may lead to metabolic disorders. Aim: This study tested the impact of LRP5 polymorphism on lipid profile in Iranian children. Methods: The study population was comprised of 9–18 year old children (125 boys, 137 girls). Total cholesterol (TC), High Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), Non-HDL cholesterol and Triglyceride (TG) levels were checked. Body composition was measured by the Hologic system DXA. PCR/restriction fragment length polymorphism (RFLP) was done for LRP5 (rs556442) genotyping. Multiple association analyses for TG level and genotype frequencies were assessed using logistic regression analysis, with adjustment for age, sex, BMI and puberty. Results: The results revealed that LRP5 (rs556442) had a significant influence on TG levels in unadjusted analysis and when adjusted for interacting factors. Higher TG levels were observed in AA/AG genotype of rs566442 in comparison to GG genotype (OR = 2.028, 95% CI = 0.997–4.127, p = 0.049). Conclusion: It is concluded that allele A has an important impact on increasing TG level in LRP5 in the studied population.
Leprosy in a Lombard-Avar cemetery in central Italy (Campochiaro, Molise, 6th–8th century AD): ancient DNA evidence and demography

Abstract Background: The study of past infectious diseases increases knowledge of the presence, impact and spread of pathogens within ancient populations. Aim: Polymerase chain reaction (PCR) was used to examine bones for the presence of Mycobacterium leprae ancient DNA (aDNA) as, even when leprosy is present, bony changes are not always pathognomonic of the disease. This study also examined the demographic profile of this population and compared it with two other populations to investigate any changes in mortality trends between different infectious diseases and between the pre-antibiotic and antibiotic eras. Subjects and methods: The individuals were from a site in Central Italy (6th–8th CE) and were examined for the presence of Mycobacterium leprae aDNA. In addition, an abridged life mortality table was constructed. Results: Two individuals had typical leprosy palaeopathology, and one was positive for Mycobacterium leprae aDNA. However, the demographic profile shows a mortality curve similar to that of the standard, in contrast to a population that had been subjected to bubonic plague. Conclusions: This study shows that, in the historical population with leprosy, the risk factors for health seem to be constant and distributed across all age classes, similar to what is found today in the antibiotic era. There were no peaks of mortality equivalent to those found in fatal diseases such as the plague, probably due to the long clinical course of leprosy.
A Randomized, Double-Blind, Placebo-Controlled, Phase 2b Study to Evaluate the Safety and Efficacy of Recombinant Human Soluble Thrombomodulin, ART-123, in Patients With Sepsis and Suspected Disseminated Intravascular Coagulation*

Objectives:To determine the safety and efficacy of recombinant thrombomodulin (ART-123) in patients with suspected sepsis-associated disseminated intravascular coagulation. Design:Phase 2b, international, multicenter, double-blind, randomized, placebo-controlled, parallel group, screening trial. Setting:Two hundred and thirty-three ICUs in 17 countries. Patients:All adult patients admitted with sepsis and suspected disseminated intravascular coagulation as assessed using a modified International Society on Thrombosis and Hemostasis score. Interventions:Patients were randomized to receive IV ART-123 (0.06 mg/kg/d) for 6 days or placebo, in addition to standard of care. The primary endpoint was reduction in mortality. Secondary endpoints included reversal of overt disseminated intravascular coagulation and reduction in disease severity. Measurements and Main Results:A total of 750 patients were randomized, nine of whom did not receive the allocated treatment so that 371 patients received ART-123 and 370 received placebo. There were no meaningful differences between the two groups in any of the baseline variables. Twenty-eight-day mortality was 17.8% in the ART-123 group and 21.6% in the placebo group (Cochran–Mantel–Haenszel two-sided p value of 0.273 in favor of ART-123, which met the predefined statistical test for evidence suggestive of efficacy). There were no statistically significant differences in event-free and alive days between the two groups. d-dimer, prothrombin fragment F1.2 and TATc concentrations were lower in the ART-123 group than in the placebo group. There were no differences between the two groups in organ function, inflammatory markers, bleeding or thrombotic events or in the development of new infections. In post hoc analyses, greatest benefit from ART-123 was seen in patients with at least one organ system dysfunction and an international normalized ratio greater than 1.4 at baseline. Conclusions:ART-123 is a safe intervention in critically ill patients with sepsis and suspected disseminated intravascular coagulation. The study provided evidence suggestive of efficacy supporting further development of this drug in sepsis-associated coagulopathy including disseminated intravascular coagulation. Future study should focus on using ART-123 in the subgroup of patients most likely to respond to this agent.
Obesity and regional fat distribution in Kenyan populations: Impact of ethnicity and urbanization

Background: Obesity is increasing rapidly in Africa, and may not be associated with the same changes in body composition among different ethnic groups in Africa. Objective: To assess abdominal visceral and subcutaneous fat thickness, prevalence of obesity, and differences in body composition in rural and urban Kenya. Subjects and methods: In a cross-sectional study carried out among Luo, Kamba and Maasai in rural and urban Kenya, abdominal visceral and subcutaneous fat thicknesses were measured by ultrasonography. Height and weight, waist, mid-upper arm circumferences, and triceps skinfold thickness were measured. Body mass index (BMI), arm fat area (AFA) and arm muscle area (AMA) were calculated. Results: Among 1430 individuals (58.3% females) aged 17–68 years, abdominal visceral and subcutaneous fat, BMI, AFA and waist circumference (WC) increased with age, and were highest in the Maasai and in the urban population. AMA was only higher with increasing age among males. The prevalence of overweight (BMI ≥ 25) (39.8% vs. 15.8%) and obesity (BMI ≥ 30) (15.5% vs. 5.1%) was highest in the urban vs. rural population. Conclusion: Abdominal visceral and subcutaneous fat thickness was higher with urban residency. A high prevalence of overweight and obesity was found. The Maasai had the highest overall fat accumulation.
Doxycycline Reduces Cardiac Matrix Metalloproteinase-2 Activity but Does not Ameliorate Myocardial Dysfunction During Reperfusion in Coronary Artery Bypass Patients Undergoing Cardiopulmonary Bypass

Objectives:Matrix metalloproteinase-2 proteolyzes intracellular proteins in the heart and induces acute myocardial contractile dysfunction in ischemia-reperfusion injury. Doxycycline, a matrix metalloproteinase inhibitor, prevented matrix metalloproteinase-2-induced troponin I cleavage in rat hearts and improved contractile function following ischemia-reperfusion. In patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass, increased atrial matrix metalloproteinase-2 activity was inversely correlated with cardiac mechanical function at 3 hours reperfusion. We performed a study in patients with coronary artery disease undergoing primary elective coronary artery bypass graft surgery with cardiopulmonary bypass to determine whether doxycycline reduces cardiac mechanical dysfunction, matrix metalloproteinase activity, and troponin I degradation after reperfusion. Design:Randomized, double-blinded, placebo-controlled study. Setting:University of Alberta Hospital. Patients:Forty-two patients with coronary artery disease undergoing coronary artery bypass graft surgery with cardiopulmonary bypass. Interventions:Patients were randomized to receive either oral administration of 20 mg of doxycycline or matching placebo pill twice a day at least 2 days prior to surgery, on the day of surgery, and for the first 3 postoperative days. Measurements and Main Results:Left ventricular stroke work index was examined prior to cardiopulmonary bypass and at 24 hours reperfusion. Right atrial biopsies were collected before cardiopulmonary bypass and 10 minutes after aortic cross-clamp release to determine matrix metalloproteinase-2 activity and troponin I level. Blood was collected to determine matrix metalloproteinase activity and interleukin-6, C-reactive protein, and troponin I levels. Cardiac 72-kDa matrix metalloproteinase-2 activity was lower upon reperfusion in biopsies from the doxycycline group (p = 0.01), and the increase of matrix metalloproteinase-2 activity in the placebo group due to reperfusion did not appear in the doxycycline group (p = 0.05). Doxycycline, however, did not ameliorate cardiac mechanical dysfunction following reperfusion or the cardiopulmonary bypass-coronary artery bypass graft-induced increased plasma matrix metalloproteinase-9, interleukin-6, and C-reactive protein levels. Cardiopulmonary bypass-coronary artery bypass graft or doxycycline did not change tissue or plasma troponin I levels at 10 minutes reperfusion. Conclusions:Although doxycycline did not improve myocardial stunning following coronary artery bypass graft surgery with cardiopulmonary bypass, it reduced cardiac matrix metalloproteinase-2 activity in these patients. A larger trial and/or higher dose of doxycycline may yet be warranted.
Evolution of the nutritional situation of indigenous and non-indigenous Chilean schoolchildren

Background: Latin American countries show accelerated but ethnically or socially differentiated changes in their epidemiological profiles. Aim: The present study examined the evolution of the nutritional situation (1997–2005) in Chilean schoolchildren as related to ethnical origin (Mapuche). Subjects and methods: Using official databases, stunting (height/age ≤ − 2 z-scores), undernutrition (body mass index (BMI) ≤ − 2 z-scores) and obesity (BMI ≥95 percentile) were ascribed in first-grade schoolchildren. Ethnic groups were assigned by native parents’ surnames (none, one and two). Results: Based on 1 757 155 children (average age: 76.3 months), in 1997 stunting reached 8.4%, 4.8% and 3.1% in children with two, one and no Mapuche surnames, respectively. In 2005 it fell to 3.7%, 3.1% and 2.6% – a marked decrease in those with two Mapuche surnames (p<0.001). Obesity in 1997 was 11.8%, 12.8% and 13.3%, whilst in 2005 it changed to 17.5, 18.5 and 18.6%, respectively, demonstrating a similar trend to obesity in all groups (p=0.153). Undernutrition was rare (<1.1%) and stable. Poverty decreased clearly among the Mapuche population in this period. Conclusion: The marked decrease in stunting in children with a strong indigenous background seems related to a decrease in poverty over the period. Yet, the increase of obesity in all groups deserves further analysis.
Detection of infectious bronchitis virus in experimentally infected chickens by an antigen-competitive ELISA

An antigen-competitive enzyme-linked immunosorbent assay (Ag-C-ELISA) was developed for the detection of infectious bronchitis virus (IBV) antigens, M41 strain, in tissues from experimentally infected chickens, or in allantoic fluid harvested from inoculated embryonated eggs. The detection limit of IBV in the Ag-C-ELISA was 104.1 median embryo infective doses (EID50)/well. Tracheal and lung samples from chickens vaccinated with 102.5 EID50 of live attenuated infectious bronchitis (H120) vaccine were negative in the direct detection Ag-C-ELISA. The results indicate that the Ag-C-ELISA has the potential to detect IBV, either directly in tissue samples or when combined with the passage of material in embryonated eggs, thereby constituting an alternative method for the diagnosis of IBV.
Screening for lung cancer

Purpose of review The purpose of this review is to provide an update on the current data about low-dose computed tomography (LD-CT) lung cancer screening. Recent findings The National Lung Screening Trial (NLST) was the first study that provided statistical evidence that LD-CT screening for lung cancer significantly reduces lung cancer mortality by 20%. Three statistically underpowered European trials could not confirm the positive effect of LD-CT screening on lung cancer mortality. Major obstacles in lung cancer screening are overdiagnosis and the large number of false-positive results. In the NLST, more than 24% of the screens were positive, most of which (96.4%) proved to be benign in nature. Optimized protocols for the workup of detected nodules may help to reduce the number of false-positive screens. Summary Currently, the NLST is the only sufficiently powered trial to report a lower mortality rate with LD-CT screening. Long-term follow-up data are still anticipated on the European screening trials. Furthermore, data on the extent of the potential dangers of LD-CT screening, such as overdiagnosis, false-positive results, and the effect of cumulative radiation dose, have yet to be investigated thoroughly.
The antigenicity of the chicken anaemia virus protein VP3 (Apoptin)

Chicken anaemia virus protein VP3 (Apoptin) was cloned and expressed as a recombinant protein and evaluated for its suitability as a serodiagnostic reagent. VP3 was expressed as a fusion protein either with glutathione S -transferase or with a six-histidine tag. Both recombinant proteins reacted specifically with anti-VP3 monoclonal antibodies and with serum from vaccinated chickens by Western blot and by enzyme-linked immunosorbent assay (ELISA). However, when testing sera from birds of different ages and genetic backgrounds, high non-specific reactions were evident and false positives were observed, especially in older birds. This suggests that VP3 is poorly immunogenic during infection and low antibody concentrations are masked by non-specific reactions. Thus, VP3 is not suitable for use as antigen in ELISAs.
Benefits of moderate-intensity exercise during a calorie-restricted low-fat diet

Objective: Despite the health benefits, many people do not undertake regular exercise. This study investigated the effects of moderate-intensity exercise on cardiorespiratory fitness (lung age, blood pressure and maximal aerobic power, VO2max), serum lipids concentration and body mass index (BMI) in sedentary overweight/obese adults consuming a calorie-restricted low-fat diet. Design: Randomized diet and exercise intervention. Setting: Lincolnshire, UK. Methods: Sixty overweight/obese (BMI ≥ 25kgm−2) adults were randomized to either a calorie restricted low-fat diet (20 per cent of total energy as fat) or the same diet with the addition of moderate-intensity physical exercise (30 minutes, twice a week) for eight weeks; 20 completed the study. Participants’ serum lipids concentrations, BMI, blood pressure, resting pulse rate, VO2max and lung age were measured before the start of the intervention and during the fourth and eighth weeks. Results: Reductions in blood pressure (10 per cent versus 1 per cent), pulse rate (13 per cent versus 8 per cent) and weight (5 per cent versus 2 per cent) were greatest for the diet with exercise group. Exercise resulted in a significant (p ≤ 0.05) increase in average VO2max (by 17 per cent) and reduction in average lung age by about 19 years. Further, reduction in participants’ lung age ranged from 1 to 37 years. However, there was no significant difference in BMI, blood pressure and serum lipids concentration between groups. Conclusion: Although exercise on most days of the week would result in maximum health benefits, 30 minutes of moderate-intensity exercise twice a week could significantly improve cardiorespiratory fitness (blood pressure and lung age) and the risk of cardiovascular diseases in previously sedentary overweight/obese adults.
Making the Move to Blended Learning: Reflections on a Faculty Development Program

Lessons learned from a faculty development program that preceded the move of a traditional PhD program in nursing to a blended learning model using online and face-to-face strategies are discussed. The majority of lessons and strategies presented are universal to any faculty development program. The lessons are organized into seven topics: Situational Leadership, Adult Learners, Just in Time Teaching, Thinking About Learning and Teaching, Lifelong Learning, Transparency and Collaboration, and Community. Our far-reaching lessons are related to the contextual nature of leadership, how to effectively design and time learning experiences for adults, the importance of open and supportive communities working for a common purpose, and how each person’s perspective shapes his or her learning experience and how the lessons learned are applied.
Quantification of PFS Effect for Accelerated Approval of Oncology Drugs

By the accelerated approval (AA) mechanism (Code of Federal Regulations 1992), the FDA may grant approval of drugs or biologic products that are intended to treat serious or life-threatening diseases using a surrogate endpoint that is reasonably likely to predict clinical benefit. In oncology, progression-free-survival (PFS) is increasingly used as such a surrogate of overall survival (OS) in Phase III confirmatory trials. Improved understanding on how to deal with the PFS endpoint in trial conduct and data analysis has mitigated some regulatory concerns about this endpoint. However, a glaring gap still exists as how to determine whether the outcome from a registration trial with PFS as the primary endpoint at the time of analysis is reasonably likely to predict a clinical benefit as normally reflected through an effect on OS. Since there is no guidance on this, regulatory agencies tend to look for a compelling PFS effect coupled with an OS effect in the right direction without specification of the effect sizes and significance levels. To address this issue, we propose a synthesized approach that combines the observed OS effect and the estimated OS effect from the PFS data to explicitly test the implicit OS hypothesis at the time of primary analysis. The proposed approach is applied to hypothetical Phase III trials in metastatic colorectal cancer and adjuvant colon cancer settings using the relationships between OS effect size and PFS effect size established from historical data. Prior information on such a historical relationship is frequently cited by relevant decision makers during regulatory reviews for drug approval. However, the information is rarely fully accounted for in the actual (mostly qualitative) decision-making process. Our approach provides a simple analytic tool for deriving a more quantitative decision. It is clear that the design based on our approach may have a larger sample size than a conventional trial with PFS as the primary endpoint, but directly address the elusive OS question that a conventional PFS trial cannot, no matter how good a surrogate endpoint PFS is.