Miracle-dz/UniFAR-FTUs huggingface dataset:
Ancillary service needs among persons new to HIV care and the relationship between needs and late presentation to care

ABSTRACT Ancillary service needs likely influence time to diagnosis and presentation for HIV care. The effect of both met and unmet needs on late presentation to HIV care is not well understood. We used baseline data from 348 people with HIV (PWH) with no prior HIV care who enrolled in iENGAGE (a randomized controlled trial (RCT) of an intervention to support retention in care) at one of four HIV clinics in the US. A standardized baseline questionnaire collected information on ancillary service needs, and whether each need was presently unmet. We examined covariates known to be associated with disease stage at presentation to care and their association with needs. We subsequently assessed the relationship of needs with CD4 accounting for those other covariates by estimating prevalence ratios (PR) using inverse probability weights. Most patients enrolling in the RCT were male (79%) and the majority were Black (62%); median age was 34 years. Prevalence of any reported individual need was 69%. One-third of the sample had a baseline CD4 cell count <200, 42% between 200 and 499 and 27% ≥500. There was no statistically significant association between need or unmet need and baseline CD4. In general, psychiatric health and SU issues (depression, anxiety, and drug use) were consistently associated with higher prevalence of need (met and unmet). Additionally, the Black race was associated with higher basic resource needs (housing: PR 1.67, 95%CI 1.08–2.59; transportation: PR 1.65, 95% CI 1.12–2.45). Ancillary service needs (met and unmet) were common among patients new to HIV care and impacted vulnerable subgroups. However, we found no evidence that reporting a specific individual need, whether met or unmet, was associated with a timely presentation to HIV care. The impact of needs on subsequent steps of the HIV care continuum will be examined with longitudinal data.
Clown Intervention on Psychological Stress and Fatigue in Pediatric Patients With Cancer Undergoing Chemotherapy

Background Clown intervention has been shown to enhance emotional and behavioral processes, but few studies have comprehensively examined the effectiveness of this practice using biomarkers. Objective The aim of this study was to evaluate the effect of a clown intervention on the levels of psychological stress and cancer-related fatigue in pediatric patients with cancer undergoing chemotherapy. Methods Sixteen patients who met all criteria from a pediatric oncology inpatient unit in a Brazilian comprehensive cancer care hospital participated in this quasi-experimental study. Eight saliva samples were collected, comprising 4 at baseline and 4 after clown intervention (+1, +4, +9, and +13 hours after awakening). Salivary cortisol and α-amylase levels were determined using high-sensitivity enzyme-linked immunosorbent assay kits. Stress and fatigue were measured by the Child Stress Scale-ESI and the PedsQL Multidimensional Fatigue Scale, respectively. Relationships among stress, fatigue, and biomarker levels were investigated using nonparametric statistics. Results In comparison with baseline measurements, the total psychological stress and fatigue levels improved after the clown intervention at the collection time point +4 hours (P = .003 and P = .04, respectively). Salivary cortisol showed a significant decrease after clown intervention at the collection time points +1, +9, and +13 hours (P < .05); however, α-amylase levels remained unchanged. Conclusion These findings provide preliminary evidence that clown intervention merits further study as a way to reduce stress and fatigue in pediatric cancer inpatients, and that self-report and biomarker measures are feasible to collect in this patient group. Implications for Practice Clown intervention as a nonpharmacological intervention may improve stress and fatigue levels in pediatric inpatients with cancer undergoing chemotherapy.
MicroRNA-186-5p controls GluA2 surface expression and synaptic scaling in hippocampal neurons

Significance Homeostatic mechanisms maintain stable neuronal and circuit function in the brain, in particular during development and learning, when synapses undergo constant changes. Synaptic scaling is a form of homeostatic synaptic plasticity responsible for maintaining neuronal network activity within a physiological range, mainly through the regulation of AMPA receptors at synaptic sites. However, the intrinsic mechanisms promoting synaptic scaling are still largely unknown. Here, we have uncovered miR-186-5p as an activity-regulated miRNA, which targets the GluA2 AMPA receptor subunit and mediates synaptic scaling triggered by prolonged blockade of synaptic activity. Homeostatic synaptic scaling is a negative feedback response to fluctuations in synaptic strength induced by developmental or learning-related processes, which maintains neuronal activity stable. Although several components of the synaptic scaling apparatus have been characterized, the intrinsic regulatory mechanisms promoting scaling remain largely unknown. MicroRNAs may contribute to posttranscriptional control of mRNAs implicated in different stages of synaptic scaling, but their role in these mechanisms is still undervalued. Here, we report that chronic blockade of glutamate receptors of the AMPA and NMDA types in hippocampal neurons in culture induces changes in the neuronal mRNA and miRNA transcriptomes, leading to synaptic upscaling. Specifically, we show that synaptic activity blockade persistently down-regulates miR-186-5p. Moreover, we describe a conserved miR-186-5p-binding site within the 3′UTR of the mRNA encoding the AMPA receptor GluA2 subunit, and demonstrate that GluA2 is a direct target of miR-186-5p. Overexpression of miR-186 decreased GluA2 surface levels, increased synaptic expression of GluA2-lacking AMPA receptors, and blocked synaptic scaling, whereas inhibition of miR-186-5p increased GluA2 surface levels and the amplitude and frequency of AMPA receptor-mediated currents, and mimicked excitatory synaptic scaling induced by synaptic inactivity. Our findings elucidate an activity-dependent miRNA-mediated mechanism for regulation of AMPA receptor expression.
Biological Basis of Therapeutic Lymphangiogenesis

The lymphatic vascular system is crucial for the regulation of tissue fluid homeostasis, immune function, and fat metabolism. Lymphatic dysfunction, either due to gene mutations or secondary to damage to the lymph vessels, may lead to lymphedema, a debilitating condition characterized by chronic tissue edema, impaired immunity, and accumulation of subcutaneous fat. The lymphatic and blood vascular systems function in concert to regulate the tissue fluid homeostasis of the body. The pumping force of the heart generates a hydrostatic pressure, which pushes fluid out of the semipermeable blood capillaries into the interstitial space. Most of the extravasated interstitial fluid and macromolecules are absorbed back by the lymphatic vessels, whereas some reabsorption may also occur in the venules, depending on the tissue (Figure 1). 1 Increased endothelial permeability, venous obstruction or insufficiency, and lymphatic vessel dysfunction lead to tissue swelling, or edema (Figure 1). Figure 1. Contributions of the blood and lymphatic vascular systems to tissue fluid homeostasis. A through D , Mechanisms leading to tissue edema.1 Normal fluid homeostasis in tissues is schematically illustrated in A : Colloid proteins and associated water are constantly filtrated from the arterial side of the capillary bed into the interstitial space (red arrows). The majority of the filtrate is collected by the lymphatic capillaries (green arrows); some of the fluid may be reabsorbed into the capillaries on the venous side of the capillary bed (blue arrows). B , Under the conditions of increased blood vascular permeability, such as in inflammation, the amount of filtrate is dramatically increased. Although the lymphatic vessels have a remarkable capacity to increase their drainage, sometimes the system is overwhelmed and net edema remains. C , Obstruction of the veins, for example, due to venous thrombosis or venous insufficiency will impair reabsorption (Reabs) and increase blood pressure within the …
Parenting and Future Anxiety: The Impact of Having a Child with Developmental Disabilities

This study examined differences in future anxiety (FA) among mothers and fathers of children with and without developmental disabilities (DD), and it also analyzed differences in FA within the group of parents of children with DD taking into consideration parent-related factors and child-related factors. A group of 167 parents of children with DD were compared to a group of 103 parents of children with typical development. The group with DD included children with autism spectrum disorders, sensory disorders, and intellectual disability. Parents completed the Future Anxiety Scale-FAS1. Mothers of children with DD had a higher general level of FA than fathers of children with and without DD. Mothers of children with DD reported higher anxiety about their future health and the meaning of their future life than fathers of children with DD. For parents of children with DD, those with lower education, male children, and older children reported higher FA. The group at risk of highest general FA are mothers of children with DD, especially those without a professional career. Similarly, parents of teenagers and/or sons with DD are at increased risk of FA.
Nonprofessionals’ perceptions of the causes of behavioral and substance addictions

Abstract We assessed nonprofessionals' perceptions of etiological explanations of behavioral and substance addictions in a nationwide sample. A total of 612 adults (51% male) residing in the United States were recruited using Mechanical Turk. Participants rated the perceived likelihood of seven psychosocial and biological etiologies for one of five randomly assigned types of “addiction” (i.e., alcohol, marijuana, heroin, gambling, or pornography). Significantly fewer participants rated social pressure a likely cause of addiction to pornography (31%) than to marijuana (53%), alcohol (55%), and heroin (64%); significantly fewer rated traumatic childhood events a likely cause of addiction to gambling (33%) and marijuana (36%) than to pornography (56%), heroin (57%), and alcohol (64%); significantly fewer rated the way a person was raised a likely cause of addiction to marijuana (37%) than to heroin (55%) and alcohol (65%); and significantly more rated genetics a likely cause of an addiction to alcohol (65%) than to pornography (26%), marijuana (33%), gambling (41%), and heroin (45%). The proportions who rated stressful circumstances and character problem as likely causes were not significantly associated with type of addiction. In addition, participants rated an average of three or four separate etiologies as likely causes of each target addiction. Our results suggest that lay individuals recognize the multi-determined nature of addictive disorders and rate some causes as more or less likely depending on the specific addictive substance or behavior.
Ultrasound Measures of the Abdominal Wall in Patients with Low Back Pain Before and After an 8‐week Lumbar Stabilization Exercise Program, and Their Association With Clinical Outcomes

Lumbar stabilization exercise programs (LSEPs) act positively on clinical outcome measures in patients with low back pain (LBP), but the underlying mechanisms are not well understood. Among the various neuromuscular mechanisms, a good candidate is better activation of the abdominal wall, as measured with rehabilitative ultrasound imaging (RUSI).
Angiogenic Factor Estimation as a Warning Sign of Preeclampsia-Related Peripartum Morbidity Among Hospitalized Patients

Preeclampsia-related morbidity and mortality is rising predominantly because of delayed identification of patients at risk for preeclampsia with severe features and associated complications. This study explored the association between angiogenic markers (sFlt1 [soluble fms-like tyrosine kinase-1]) and PlGF [placental growth factor]) and preeclampsia-related peripartum complications. Normotensive women or those with hypertensive disorders of pregnancy were enrolled. Blood samples were collected within 96 hours before delivery, and angiogenic markers were measured on an automated platform. Our study included 681 women, 375 of which had hypertensive disorders. Of these, 127 (33.9%) had severe preeclampsia, and 71.4% were black. Compared with normotensive women, women with severe preeclampsia had higher levels of sFlt1 (9372.5 versus 2857.0 pg/mL; P<0.0001), lower PlGF (51.0 versus 212.0 pg/mL; P<0.0001), and a high sFlt1/PlGF (212.0 versus 14.0; all P<0.0001). A similar trend in sFlt1, PlGF, and sFlt1/PlGF was found in those women with complications secondary to preeclampsia (all P<0.001). The highest tertile of sFlt1/PlGF was strongly associated with severe preeclampsia in a multivariable analysis. Among patients with a hypertensive disorder of pregnancy, 340 (90.7%) developed postpartum hypertension, of which 50.4% had mild, and 40.3% had severe postpartum hypertension. The sFlt1/PlGF ratio was significantly higher for severe and mild postpartum hypertension compared with women with normal postpartum blood pressures (73.5, 46.0, and 13.0, respectively; P values<0.0001). Furthermore, the highest tertile of antepartum sFlt1/PlGF was associated with postpartum hypertension (P=0.004). This study demonstrates a significant association between an abnormal angiogenic profile before delivery and severe preeclampsia and peripartum complications.
Perceived barriers to and facilitators of physical activity in people living with HIV: A qualitative study in a French sample

Objectives The benefits of physical activity in people living with HIV (PLHIV) are numerous and are largely reported in the literature. Understanding why PLHIV engage or not in physical activity is key to better accompanying health behaviors. Through a qualitative approach, our study sought to identify barriers to and facilitators of physical activity participation in PLHIV. Methods PLHIV were recruited by purposive sampling. Semi-structured interviews were carried-out in Center and Southern France. The data were analyzed following the principals of thematic analysis. Physical activity level was assessed through questions related to physical activity recommendations and a physical activity questionnaire. Results Fifteen semi-structured interviews (seven men and eight women; Mage = 46.6; SD = 10.3) were analyzed. Only a third of our sample was considered physically active with almost half being considered inactive according to recommendations. A multidimensional perspective of physical activity barriers and facilitators emerged. Barriers to and facilitators of physical activity were related to the physical, psychological and socio-environmental domains. Discussion Our research sought to better understand the beliefs and attitudes of PLHIV towards physical activity. Physical activity was overall viewed as beneficial by both active and less active PLHIV; however, PLHIV remain insufficiently active. This is discussed through our multidimensional approach of the barriers to and facilitators of physical activity.
Perioperative metabolic acidosis: The Bradford Anaesthetic Department Acidosis Study

Metabolic acidosis is considered deleterious but is common in post-surgical patients admitted to intensive care unit. We evaluated the prevalence and time course of metabolic acidosis in elective major surgery, and generated hypotheses about causes, by hourly arterial blood sampling in 92 patients. Metabolic acidosis began before incision and most had occurred by the next hour. Seventy-eight per cent of patients had a significant metabolic acidosis post-operatively. Two overlapping phases were observed. The early phase started before incision, characterised by a rising chloride and falling anion gap, unrelated to saline use. The late phase was partly associated with lactate, related to surgery type, and early fluids appeared protective. There was a trend towards longer intensive care unit (+1.3 days) and hospital (+3.2 days) stay with metabolic acidosis. This is the first large study of the evolution of this common finding, demonstrating a pre-incision component. The early phase appears unavoidable or unpredictable, but the late phase might be modified by early fluid administration. It remains unclear whether acidosis of this type should be avoided.
A meta-analysis of plant responses to light intensity for 70 traits ranging from molecules to whole plant performance.

Contents Summary I. Introduction II. Concepts and methodology III. Dose-response curves IV. The overall response of plants to DLI V. Molecular response and regulation VI. Shade-tolerant and light-demanding species VII. Relation to field conditions VIII. Concluding remarks Acknowledgements References Appendix A1 SUMMARY: By means of meta-analyses we determined how 70 traits related to plant anatomy, morphology, chemistry, physiology, growth and reproduction are affected by daily light integral (DLI; mol photons m-2 d-1 ). A large database including 500 experiments with 760 plant species enabled us to determine generalized dose-response curves. Many traits increase with DLI in a saturating fashion. Some showed a more than 10-fold increase over the DLI range of 1-50 mol m-2 d-1 , such as the number of seeds produced per plant and the actual rate of photosynthesis. Strong decreases with DLI (up to three-fold) were observed for leaf area ratio and leaf payback time. Plasticity differences among species groups were generally small compared with the overall responses to DLI. However, for a number of traits, including photosynthetic capacity and realized growth, we found woody and shade-tolerant species to have lower plasticity. We further conclude that the direction and degree of trait changes adheres with responses to plant density and to vertical light gradients within plant canopies. This synthesis provides a strong quantitative basis for understanding plant acclimation to light, from molecular to whole plant responses, but also identifies the variables that currently form weak spots in our knowledge, such as respiration and reproductive characteristics.
Effect of acute physiological free fatty acid elevation in the context of hyperinsulinemia on fiber type-specific IMCL accumulation.

It is well described that increasing free fatty acids (FFAs) to high physiological levels reduces insulin sensitivity. In sedentary humans, intramyocellular lipid (IMCL) is inversely related to insulin sensitivity. Since muscle fiber composition affects muscle metabolism, whether FFAs induce IMCL accumulation in a fiber type-specific manner remains unknown. We hypothesized that in the setting of acute FFA elevation by lipid infusion within the context of a hyperinsulinemic-euglycemic clamp, IMCL will preferentially accumulate in type 1 fibers. Normal-weight participants (n = 57, mean ± SE: age 24 ± 0.6 yr, BMI 22.2 ± 0.3 kg/m2) who were either endurance trained or sedentary by self-report were recruited from the University of Minnesota (n = 31, n = 15 trained) and University of Pittsburgh (n = 26, n = 14 trained). All participants underwent a hyperinsulinemic-euglycemic clamp in the context of a 6-h infusion of either lipid or glycerol control. A vastus lateralis muscle biopsy was obtained at baseline and end-infusion (6 h). The muscle biopsies were processed and analyzed at the University of Pittsburgh for fiber type-specific IMCL accumulation by Oil-Red-O staining. Regardless of training status, acute elevation of FFAs to high physiological levels (~400-600 meq/l) increased IMCL preferentially in type 1 fibers (+35 ± 11% compared with baseline, +29 ± 11% compared with glycerol control: P < 0.05). The increase in IMCL correlated with a decline in insulin sensitivity as measured by the hyperinsulinemic-euglycemic clamp (r = -0.32, P < 0.01) independent of training status. Regardless of training status, increase of FFAs to a physiological range within the context of hyperinsulinemia shows preferential IMCL accumulation in type 1 fibers.NEW & NOTEWORTHY This novel human study examined the effects of FFA elevation in the setting of hyperinsulinemia on accumulation of fat in specific types of muscle fibers. Within the context of the hyperinsulinemic-euglycemic clamp, we found that an increase of FFAs to a physiological range sufficient to reduce insulin sensitivity is associated with preferential IMCL accumulation in type 1 fibers.
Coronary Physiology in the Cardiac Catheterization Laboratory

Coronary angiography has been the principle modality for assessing the severity of atherosclerotic coronary artery disease for several decades. However, there is a complex relationship between angiographic coronary stenosis and the presence or absence of myocardial ischemia. Recent technological advances now allow for the assessment of coronary physiology in the catheterization laboratory at the time of diagnostic coronary angiography. Early studies focused on coronary flow reserve (CFR) but more recent work has demonstrated the physiologic accuracy and prognostic value of the fractional flow reserve (FFR) and instantaneous wave free ratio (iFR) for the assessment of coronary artery disease. These measurements have been validated in large multi-center clinical trials and have become indispensable tools for guiding revascularization in the cardiac catheterization laboratory. The physiological assessment of chest pain in the absence of epicardial coronary artery disease involves coronary thermodilution to obtain the index of microcirculatory resistance (IMR) or Doppler velocity measurement to determine the coronary flow velocity reserve (CFVR). Physiology-based coronary artery assessment brings “personalized medicine” to the catheterization laboratory and allows cardiologists and referring providers to make decisions based on objective findings and evidence-based treatment algorithms. The purpose of this review is to describe the theory, technical aspects, and relevant clinical trials related to coronary physiology assessment for an intended audience of general medical practitioners.
Expression of Metastatic Tumor Antigen 1 Splice Variant Correlates With Early Recurrence and Aggressive Features of Hepatitis B Virus–Associated Hepatocellular Carcinoma

Overexpression of metastatic tumor antigen 1 (MTA1) was correlated with poor prognosis of hepatitis B virus (HBV)‐associated hepatocellular carcinoma (HBV‐HCC). The aim of this study was to examine the clinical significance of the expression of MTA1 and its exon 4‐excluded form (MTA1dE4), the most abundant spliced variant of MTA1, in patients receiving curative resection for HBV‐HCC. We collected 102 patients with HBV‐HCC and received curative resection retrospectively and examined the expressions level of total MTA1/MTA1dE4 in their paired nontumor and tumor liver tissues by using RT‐qPCR. The association between MTA1/MTA1dE4 expression and various tumor features as well as tumor recurrence was analyzed. During the median follow‐up period of 4 years, 25 patients (24.5%) showed early recurrence (within 12 months postresection) and 42 (54.5%) showed late recurrence. In Kaplan‐Meier analysis, MTA1dE4 overexpression in tumor, but not MTA1, was associated with early recurrence (P = 0.0365), but not late recurrence. In multivariate analysis, only alpha‐fetoprotein (AFP) ≥200 ng/mL (P = 0.006) and large tumor size (P = 0.027) were correlated with early recurrence. In the subgroup of patients with AFP <200 ng/mL, high MTA1dE4, but not total MTA1, expression could help predict early recurrence (P = 0.0195). In vitro, wound healing and invasion assays were performed in HCC cells, and MTA1dE4 was found to exhibit a higher ability in promoting migration and invasion of hepatoma cells than full‐length MTA1. Conclusion: MTA1dE4 expression is correlated with more aggressive tumor characteristics and might serve as a more sensitive marker for early recurrence of HBV‐HCC, especially for low‐AFP patients.