Miracle-dz/UniFAR-FTUs huggingface dataset:
Incidence and transmission patterns of acute hepatitis C in the United States, 1982-2006.

BACKGROUND Monitoring disease incidence and transmission patterns is important to characterize groups at risk for hepatitis C virus (HCV) infection. Clinical cases generally represent about 20% to 30% of all newly acquired infections. METHODS We used sentinel surveillance to determine incidence and transmission patterns for acute hepatitis C in the United States using data from 25 years of population-based surveillance in the general community. Acute cases of hepatitis C were identified from 1982 through 2006 by a stimulated passive surveillance system in 4 to 6 US counties. Cases were defined by a discrete onset of symptoms, alanine aminotransferase (ALT) levels greater than 2.5 times the upper limit of normal (×ULN), negative findings for serologic markers for acute hepatitis A and B, and positive findings for antibody to HCV or HCV RNA. Incidence and frequency of reported risk factors were the main outcome measures. RESULTS Of 2075 patients identified, the median age was 31 years, 91.5% had ALT values greater than 7×ULN, 77.3% were jaundiced, 22.5% were hospitalized, and 1.2% died. Incidence averaged 7.4 per 100,000 individuals (95% confidence interval [CI], 6.4-8.5 per 100,000) during 1982 to 1989 then declined averaging 0.7 per 100,000 (95% CI, 0.5-1.0 per 100,000) during 1994 to 2006. Among 1748 patients interviewed (84.2%), injection drug use (IDU) was the most commonly reported risk factor. The average number of IDU-related cases declined paralleling the decline in incidence, but the proportion of IDU-related cases rose from 31.8% (402 of 1266) during 1982 to 1989 to 45.6% (103 of 226) during 1994 to 2006. Among IDU-related cases reported during 1994 to 2006, 56 of 61 individuals (91.8%) had been in a drug treatment program and/or incarcerated. CONCLUSIONS The incidence of acute HCV declined substantially over the 25 years of population-based surveillance. Despite declines, IDU is the most common risk factor for new HCV infection.
Evaluation of Hepatitis B Transmission Risk Factors in Tehran Blood Donors

Introduction and Aims: Considering high prevalence of hepatitis B virus (HBV) in Iran and need for its prevention, determination of causes and risk factors can help health policy makers in control of disease. Materials and Methods: All blood donors of Tehran city from April 1997 to March 2000 were studied in a case control design. HBsAg positive donors who were referred to hepatitis consultation office in Tehran blood transfusion center (2447 donors) were compared with 2425 HbsAg negative donors. Demographic factors and high risk behaviors were studied in both groups and in some subjects HBsAg status in donors' mother and spouse was studied. Results: Factors predicting HBV infection included family history of positive HBsAg, history of blood transfusion, male gender, history of hospitalization, history of unsafe sex and living in city area. There was a significant difference among cases and controls regarding HBsAg status in donors' mother and spouse. Conclusions: Because of the role of mothers and other family members in transmission of HBV infection, it is important to consider screening of whole family, pregnant women and whole family vaccination for all HBsAg subjects. Adding notice to blood derivatives screening and safe work in hospitals are important steps in HBV prevention. Neonates, couples and at risk people vaccination is another effective step in HBV prevention.
Collaborative care of opioid-addicted patients in primary care using buprenorphine: five-year experience.

BACKGROUND Opioid addiction is a chronic disease treatable in primary care settings with buprenorphine hydrochloride, but this treatment remains underused. We describe a collaborative care model for managing opioid addiction with buprenorphine hydrochloride-naloxone hydrochloride dihydrate sublingual tablets. METHODS Ours is a cohort study of patients treated for opioid addiction using collaborative care between nurse care managers and generalist physicians in an urban academic primary care practice during a 5-year period. We examine patient characteristics, 12-month treatment success (ie, retention or taper after 6 months), and predictors of successful outcomes. RESULTS From September 1, 2003, through September 30, 2008, 408 patients with opioid addiction were treated with buprenorphine. Twenty-six patients were excluded from analysis because they left treatment owing to preexisting legal or medical conditions or a need to transfer to another buprenorphine program. At 1 year, 196 of 382 patients (51.3%) underwent successful treatment. Of patients remaining in treatment at 12 months, 154 of 169 (91.1%) were no longer using illicit opioids or cocaine based on urine drug test results. On admission, patients who were older, were employed, and used illicit buprenorphine had significantly higher odds of treatment success; those of African American or Hispanic/Latino race had significantly lower odds of treatment success. These outcomes were achieved with a model that facilitated physician involvement. CONCLUSION Collaborative care with nurse care managers in an urban primary care practice is an alternative and successful treatment method for most patients with opioid addiction that makes effective use of time for physicians who prescribe buprenorphine.
A study on socio-demographic profile and feasibility of DOTS provider registered under RNTCP in Varanasi district Uttar Pradesh

Introduction: Tuberculosis is a major chronic disorder affecting the larger population more than any other disease in the country. DOTS was introduced in India in 1993 as part of the Revised National Tuberculosis Programme (RNTCP) following a review of India’s National Tuberculosis Programme (NTP) a year earlier (1) . Patient satisfaction is an important parameter for assessing the quality of patient care services. There is need to assess the health care provider regarding the consumer satisfaction as often as possible, this paper summarizes our experience about role of DOTS provider in the management of TB patient in rural population of Varanasi districts Utter Pradesh. Objective: (1) To assess the perception of registered tuberculosis patients regarding DOTS provider for the treatment of tuberculosis. (2) To assess the accessibility, acceptability & availability of community DOTS provider. Design: A longitudinal study. Setting: Three microscopic centre of Cholapur Tuberculosis unit of Varanasi districts. Methods: Registered patients were interviewed twice: once in the beginning and another at the completion of the treatment or after the permanent discontinuation of the treatment. Patients were interviewed for their socio-demographic profiles, opinion about DOTS and its providers. Side effects experienced and action taken etc. Data was collected on a semi-structured, pre-tested questionnaire. DOTS providers were interviewed and treatment cards analyzed for any interruption of treatment and action taken. Data was collected from 1st June 2004 to 31th June 2005 till the completion of the regimen. Results: Majority of DOTS providers were young males (82.7%) of 26 years to 40 years, while the representation of females was only 5 (17.3%). Almost more than 80% of the patients started their treatment within 1-10 days. For majority of cases (83%) the distance of DOTS provider from patient’s house was within 1 km. Mean time spent to go to DOTS provider was 27.2 minutes. 91.5% have no effect on routine activity. 98.3% DOTS provider were regular. Regarding behavior & availability of DOTS provider majority (90%) of patient’s opinion was good & regular (98%). Among 117 patients who were enrolled for treatment through DOTS provider, 73 (92.4%) were NSP & 12 (10%) were from retreatment group. Out of 117 patients who opted for treatment from DOTS provider 108 patients took full course of treatment in Intensive phase & their success rate was (92%) out of 108 patients 103 took full course of treatment in Continuation phase & there success rate was (95%). Success rate among NSP was 89% & success rate among retreatment group was about 83%. Conclusion: Shopkeeper acts as a DOTS provider in RNTCP because of their accessibility. Availability being less time consuming and the place being convenient to the patients. Shopkeeper is an example of persons drawn from the community who can play complementary role as DOTS providers.
Evaluation of IS6110 PCR in CSF for the rapid diagnosis of tuberculous meningitis

Background: Tuberculous meningitis (TBM) is a major, global public health problem and its diagnosis remains problematic even after years of experience. Early diagnosis and treatment are of paramount importance as a delay in diagnosis can lead to irreversible central nervous system damage and mortality. Aims: To evaluate the role of cerebrospinal fluid (CSF) IS6110-based tuberculosis (TB) polymerase chain reaction analysis (PCR) as an efficient diagnostic tool for the diagnosis of TBM. Materials and Methods: This is a cross-sectional study carried out with patients clinically suspected to have TBM. A total of 102 cases were enrolled, out of which 15 patients were excluded from the study because of alternative diagnoses. An in-house IS6110-PCR method using a specific pair of primers designed to amplify the insertion sequence, IS6110 in the Mycobacterium tuberculosis genome was used to analyze CSF. Results: Our study showed PCR positivity in 51.7% cases. PCR gave a sensitivity of 100% and specificity of 68.9% against the cases of TBM confirmed by culture. Conclusion: IS6110 TB-PCR is a novel diagnostic tool that can diagnose a greater number of individuals with clinically suspected TBM with its rapidity, accuracy, and reliability, and its positivity even after 4 weeks of starting treatment makes it the diagnostic tool of choice.
The Conservative Management of Osteoarthritis — Hyaluronic Acid, Platelet Rich Plasma or the Combination?

of the injured joint. An efficient IA therapy would be achieved if modulatory proteins released from PRP+HA are capable of interfering with the catabolic micro-environment while modu‐ lating the inflammatory response, enhancing cell migration and proliferation, and controlling the angiogenic status as well as cell differentiation. A new device capable to mix PRP with HA in prefixed amounts is on the market. Un-published preliminary data suggest that this combination is useful in the treatment of different forms of OA but only prospective random‐ ized double blind studies, preferably using both HA and PRP as comparators (three armed), and a selected stage of OA severity, preferable early OA, will provide sound information about the impact of this novel approach.
Inhibition of AP-1 signaling by JDP2 overexpression protects cardiomyocytes against hypertrophy and apoptosis induction.

AIMS Expression and activity of the transcription factor AP-1 are enhanced during cardiac remodelling and heart failure progression. In order to test if AP-1 inhibition may limit processes contributing to cardiac remodelling, ventricular cardiomyocytes of mice with cardiac overexpression of the AP-1 inhibitor JDP2 were analysed under stimulation of hypertrophy, apoptosis, or contractile function. METHODS AND RESULTS Three models of JDP2 overexpressing mice were analysed: JDP2 was overexpressed either life-long, for 7 weeks, or 1 week. Then cardiomyocytes were isolated and stimulated with β-adrenoceptor agonist isoprenaline (ISO, 50 nM). This enhanced cross-sectional area and the rate of protein synthesis in WT but not in JDP2 overexpressing cardiomyocytes. To induce apoptosis, cardiomyocytes were stimulated with 3 ng/mL TGFβ1. Again, JDP2 overexpression prevented apoptosis induction compared with WT cells. Determination of contractile function under electrical stimulation at 2 Hz revealed enhancement of cell shortening, and contraction and relaxation velocities under increasing ISO concentrations (0.3-30 nM) in WT cells. This inotropic effect was abrogated in JDP2 overexpression cells. Responsiveness to increased extracellular calcium concentrations was also impaired in JDP2 overexpressing cardiomyocytes. Simultaneously, a reduction of SERCA expression was found in JDP2 mice. CONCLUSION A central role of AP-1 in the induction of hypertrophy and apoptosis in cardiomyocytes is demonstrated. Besides these protective effects of AP-1 inhibition on factors of cardiac remodelling, AP-1-inhibition impairs contractile function. Therefore, AP-1 acts as a double-edged sword that mediates mal-adaptive cardiac remodelling, but is required for maintaining a proper contractile function of cardiomyocytes.
The European Society for Immunodeficiencies (ESID) registry 2014

The current European Society for Immunodeficiencies (ESID) registry was established 10 years ago in 2004, when the system was moved from a paper-based to an online system. The purpose of the registry is to collect data on European patients with primary immunodeficiencies (PIDs) and their treatment, with the aim of building an easily accessible database for use by physicians and researchers.
Nuclear accumulation of androgen receptor in gender difference of dilated cardiomyopathy due to lamin A/C mutations.

AIMS Dilated cardiomyopathy (DCM) is characterized by ventricular dilation associated with systolic dysfunction, which could be caused by mutations in lamina/C gene (LMNA). LMNA-linked DCM is severe in males in both human patients and a knock-in mouse model carrying a homozygous p.H222P mutation (LmnaH222P/H222P). The aim of this study was to investigate the molecular mechanisms underlying the gender difference of LMNA-linked DCM. METHODS AND RESULTS A whole-exome analysis of a multiplex family with DCM exhibiting the gender difference revealed a DCM-linked LMNA mutation, p.R225X. Immunohistochemical analyses of neonatal rat cardiomyocytes expressing mutant LMNA constructs and heart samples from the LMNA-linked DCM patients and LmnaH222P/H222P mice demonstrated a nuclear accumulation of androgen receptor (AR) and its co-activators, serum response factor, and four-and-a-half LIM protein-2. Role of sex hormones in the gender difference was investigated in vivo using the LmnaH222P/H222P mice, where male and female mice were castrated and ovariectomized, respectively, or treated with testosterone or an antagonist of AR. Examination of the mice by echocardiography, followed by the analyses of histological changes and gene/protein expression profiles in the hearts, confirmed the involvement of testicular hormone in the disease progression and enhanced cardiac remodelling in the LmnaH222P/H222P mice. CONCLUSION These observations indicated that nuclear accumulation of AR was associated with the gender difference in LMNA-linked DCM.
Widening Access to undergraduate physiotherapy education in South Africa: Pointers from students records

In response to the state mandate to improve access and equityin higher education, the admission policy of universities in South Africa (SA)currently employs measures for the redress of past inequalities and racialinjustices. As there is no information on the processes to widen access toundergraduate physiotherapy education program in SA, the aim of this reportedstudy was to search for pointers from students’ records in one local university,situated in the Western Province of SA, that would inform the development ofstrategies that will widen the access for previously disadvantaged populationgroups and ensure successful academic outcomes. The records of six cohorts of students who earlier applied for andlater enrolled in the undergraduate physiotherapy program between the years 2000 and 2005 were retrospectivelyreviewed. Information pertaining to access, student characteristics, and academic persistence was extracted, reviewedand analysed descriptively. During the period reviewed, approximately equal numbers of Black and non-Black studentsapplied for admission to the program. The proportion of Black applicants meeting minimum admission requirementswas less than half of the White/Asian applicants. Less than 50% (105/212) of the offers made to Black applicantswere accepted. Forty one percent (43/105) of the enrolled Black students successfully completed the program withinthe minimum 4 years compared to 75.5% (145/192) of the White/Asian students. Strategies should be implementedto increase awareness and recruitment, improve enrolment rates, and improve retention and throughput for Blackstudents in the undergraduate physiotherapy program of a historically “white” SA university.
Early growth response 1 is an early signal inducing Cav3.2 T-type calcium channels during cardiac hypertrophy.

AIMS The Cav3.2 T-channel plays a pivotal role in inducing calcineurin/nuclear factor of activated T cell (NFAT) signalling during cardiac hypertrophy. Because calcineurin/NFAT signalling is induced early after pressure overload, we hypothesized that Cav3.2 is induced by an early signal. Our aim is to investigate when and how Cav3.2 is induced during cardiac hypertrophy. METHODS AND RESULTS The evolutionary conserved promoter Cav3.2-3500 from mouse genome was validated to express the reporter gene as endogenous Cav3.2 in cell lines and transgenic (Tg; Cav3.2-3500-Luc) mice. The early induction of luciferase in Tg mice and Cav3.2 mRNA in wild-type mice after transverse aortic banding (TAB) surgery supported our hypothesis that Cav3.2 is induced early during cardiac hypertrophy. The TAB-responding element [-81 to -41 bp upstream of the transcription start site (TSS) of mouse Cav3.2] was identified by in vivo gene transfer by injecting reporter constructs into the left ventricle followed by TAB surgery. Electrophoresis mobility shift assay and chromatin immunoprecipitation assays revealed that Egr1 bound to the TAB-responding element of Cav3.2. Egr1 level was increased with increased Cav3.2 mRNA level at 3 days after TAB. To demonstrate that Egr1 indeed regulates Cav3.2 expression after hypertrophic stimulation, knockdown of Egr1 with short hairpin RNA prevented the phenylephrine-induced up-regulation of Cav3.2 expression and cellular hypertrophy in neonatal rat ventricular myocytes (NRVMs) and H9c2 cells. Furthermore, overexpression of Cav3.2 in Egr1-knockdown cells restored the phenylephrine-induced hypertrophy. CONCLUSION Cav3.2 is induced early by Egr1 during cardiac hypertrophy and Cav3.2 is an important mediator of Egr1 in regulating cardiac hypertrophy.
Do you get the message? Defining the interpreter’s role in medical interpreting in Belgium

This paper aims to investigate the field-level realities of the codes of conduct adhered to by different agencies in Belgium for community interpreters, and the degree of interpreter discretion in the application of these codes. We focus on the specific setting of the health care sector in Brussels, where community interpreters and intercultural mediators sent out by different agencies often operate in the same hospitals. Drawing on data obtained through participant observation, interviews with key actors in the field and desk research, we analyze how the codes of conduct applied by different agencies affect multilingual and intercultural communication in a hospital context, in particular at those levels of the communication process where misunderstandings occur most often.
Evaluation of intranasal midazolam for preanasthetic sedation in paediatric patients

Most of the preschool children suffer from severe anxiety and apprehension before operation. This can largely affect the smooth conductance and emergence from anaesthesia. Above all this can lead to development of maladaptive behavioral responses in later part of life. Midazolam in current time has emerged as an ideal premedicant having all the desirable properties in this regard. It has been used by several routes for premedication. Each has its own advantage and disadvantage. The search for an ideal route and dose still exists. So the current study was planned to find out the efficacy of midazolam intranasally. Forty five paediatric patients of 2-5 years of age belonging to ASA I& II, scheduled for minor elective surgery were selected for this study. Patients were divided in three equal groups to receive normal saline (Group I), 0.2 mgkg -1 midazolam (Group II), or 0.3mgkg -1 midazolam (Group III) intranasally. Vital parameters and level of sedation (using a sedation scale) were assessed before administering the drug and at 5 min interval up to induction of anaesthesia. Standard anaesthesia technique was used intraoperatively. Recovery parameters were assessed in the recovery area using a recovery scale. A statistically significant change in the level of sedation was found at 5 min in group II and at 10 min in group III compared to control group. Parental separation was significantly easier in midazolam groups. Mask acceptance rate was also found to be significantly higher in midazolam groups. There was no statistical difference in recovery parameters in any group. No major adverse effect was seen in any midazolam group. No major advantage was found with higher dose of midazolam. Therefore we conclude that 0.2 mgkg -1 intranasal midazolam is an effective method of producing anxiolysis and sedation in paediatric patients.
A comprehensive investigation on the distribution of circulating follicular T helper cells and B cell subsets in primary Sjögren's syndrome and systemic lupus erythematosus

Follicular T helper (Tfh) cells have a crucial role in regulating immune responses within secondary lymphoid follicles by directing B cell differentiation towards memory B cells and plasma cells. Because abnormal humoral responses are key features in both primary Sjögren's syndrome (pSS) and systemic lupus erythematosus (SLE), the aim of this study was to profile the pathological connection between peripheral Tfh cells and B cells in the two diseases. Twenty‐five pSS patients, 25 SLE patients and 21 healthy controls were enrolled into the study. We determined the ratio of circulating Tfh‐like cells, their interleukin (IL)‐21 production and different B cell subsets by flow cytometry. We observed higher percentages of naive B cells in both diseases, while non‐switched and switched memory B cells showed decreased frequencies. The proportions of double‐negative B cells and plasmablasts were elevated in SLE and decreased in pSS. The percentages of transitional B cells and mature‐naive B cells were higher in SLE. Patients with more severe disease course had an elevated ratio of TFH‐like cells and increased IL‐21 production. Moreover, expansion of Tfh‐like cells correlated positively with parameters related to antibody secretion, including serum immunoglobulin (Ig)G, immune complexes (ICs) and autoantibodies. Correlation analysis between Tfh‐like cells and certain B cell subsets revealed possible defects during B cell selection. In conclusion, our observations on the profound expansion of circulating Tfh‐like cells and their IL‐21 production, along with the characteristic aberrant peripheral B cell distribution in both pSS and SLE, indicate the prominent role of Tfh cell in the regulation of B cell selection.