Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictors of sustained virological response after antiviral treatment for hepatitis C recurrence following liver transplantation

Factors associated with sustained virological response (SVR) in patients treated for hepatitis C virus (HCV) recurrence after liver transplantation (LT) are unclear. Ninety‐nine HCV‐positive/hepatitis B surface antigen–negative patients received antiviral treatment (AVT) with interferon/peginterferon plus ribavirin for HCV recurrence after LT. Cyclosporine (CyA) or tacrolimus (TAC) was used as the main immunosuppressor in 37 (37%) and 62 (63%) patients, respectively. Twenty‐five patients (25%) achieved an SVR. Twenty‐seven donor‐related, recipient‐related, HCV‐related, and immunosuppression‐related variables were investigated for their association with SVR. In logistic regression analysis, donor age < 60 years (odds ratio = 4.45, 95% confidence interval = 1.39‐14.19, P = 0.01), viral genotype other than 1 (odds ratio = 4.97, 95% confidence interval = 1.59‐15.48, P = 0.006), and the use of CyA during treatment (odds ratio = 6.85, 95% confidence interval = 2.15‐21.73, P = 0.001) were predictors of SVR. Patients treated with CyA (SVR rate: 43%) and those treated with TAC (SVR rate: 14%) were comparable for all variables, except for a shorter ischemia time and shorter timing of AVT initiation in the TAC group (P = 0.02 and P = 0.005, respectively) and a greater use of anti‐CD25 antibodies, azathioprine, and mycophenolate mofetil in the CyA group (P = 0.03, P < 0.001, and P = 0.001, respectively). The rate of AVT discontinuation due to side effects was similar between groups (16% versus 8%, P = 0.3). In conclusion, the type of immunosuppression during AVT may predict SVR in patients treated for HCV recurrence after LT. Liver Transpl 15:782–789, 2009. © 2009 AASLD.
Pulse dynamics in a power-law falling film

Abstract We examine the stability, dynamics and interactions of solitary waves in a two-dimensional vertically falling thin liquid film that exhibits shear-thinning effects. We use a low-dimensional two-field model that describes the evolution of both the local flow rate and the film thickness and is consistent up to second-order terms in the long-wave expansion. The shear-thinning behaviour is modelled via a power-law formulation with a Newtonian plateau in the limit of small strain rates. Our results show the emergence of a hysteresis behaviour as the control parameter (the Reynolds number) is increased which is directly related to the shear-thinning character of the liquid and can be quantified with both linear analysis arguments and a physical interpretation. We also study pulse interactions, observing that two pulses may attract or repel each other either monotonically or in an oscillatory manner. In large domains we find that for a given Reynolds number the final state depends on the initial condition, a consequence of the presence of multiple solutions.
Esophageal chemical clearance is impaired in gastro‐esophageal reflux disease – a 24‐h impedance‐pH monitoring assessment

Impedance‐pH monitoring allows assessment of retrograde and antegrade intra‐esophageal movement of fluids and gas. Reflux is followed by volume clearance and chemical clearance, elicited by secondary and swallow‐induced peristalsis, respectively. We aimed to assess whether chemical clearance is impaired in gastro‐esophageal reflux disease (GERD).
An assessment of medical resource utilization and hospitalization cost associated with a diagnosis of anemia in women with obstetrical bleeding in the United States.

OBJECTIVE Anemia during pregnancy has been associated with adverse maternal and fetal outcomes. Although women with obstetrical bleeding are at increased risk for developing anemia, little is known about the prevalence and burden associated with anemia in hospitalized women with this condition. This study was conducted to estimate the prevalence, demographic characteristics, medical resource utilization, and hospitalization cost associated with a diagnosis of anemia in hospitalized women with obstetrical bleeding in the United States. METHODS The Healthcare Cost and Utilization Project Nationwide Inpatient Sample (2003) was queried using ICD-9-CM codes to identify all pregnancy-related discharges as well as discharges with diagnosis codes for conditions associated with obstetrical bleeding. Descriptive statistics were used to evaluate demographic characteristics, medical resource utilization components and hospitalization cost for two groups: patients with a diagnosis of anemia and patients without a diagnosis of anemia. RESULTS Of the estimated 4,525,714 pregnancy-related discharges in the United States in 2003, more than 250,000 recorded diagnosis codes associated with obstetrical bleeding. Nearly 1 in 5 of these women had an anemia diagnosis. A diagnosis of anemia in hospitalized women with obstetrical bleeding was associated with a 9-fold increase in blood transfusion (p < 0.0001), 33% longer average length of stay (p < 0.0001), and 50% higher average total cost per hospitalization (p < 0.0001). CONCLUSIONS Anemia and blood transfusion are frequently observed in hospitalized women with obstetrical bleeding. To improve outcomes in these patients and alleviate the adverse impact of anemia on postpartum health status, greater provider awareness of the prevalence and burden of illness associated with a diagnosis of anemia in hospitalized women with obstetrical bleeding is warranted.
Conversion from a calcineurin inhibitor to everolimus therapy in maintenance liver transplant recipients: A prospective, randomized, multicenter trial

Calcineurin inhibitors (CNIs) contribute to renal dysfunction following liver transplantation. This prospective, randomized, multicenter, 6‐month study (with an additional 6 months of follow‐up) evaluated whether everolimus with CNI reduction or discontinuation would improve renal function in maintenance liver transplant recipients experiencing CNI‐related renal impairment. Patients started everolimus therapy with CNI reduction or discontinuation (n = 72) or continued receiving standard‐exposure CNI (n = 73). At month 6, 80% of the patients who had converted to everolimus had discontinued the CNI. The mean change in creatinine clearance (CrCl) from baseline to month 6 was similar between groups (everolimus, 1.0 ± 10.2 mL/minute; controls, 2.3 ± 7.8 mL/minute; P = 0.46), so the primary study endpoint (8 mL/minute difference in the change in CrCl) was not achieved. Among patients who continued everolimus according to the protocol, the mean increase in CrCl was 2.1 (n = 53) and 3.8 mL/minute (n = 38) at months 6 and 12, respectively, versus 2.4 (n = 68) and 3.5 mL/minute in controls (n = 51). The high frequency of CNI dose reductions in controls (77% of the patients) and the relatively long mean time post‐transplant (>3 years) likely contributed to the small difference in CrCl. Biopsy‐proven acute rejection occurred in 1.4% of the patients in each group, with no graft losses. Study drug discontinuation was higher in everolimus‐treated patients, and adverse events were more frequent. These data demonstrate that everolimus allows for discontinuation or a major reduction of CNI exposure in liver allograft recipients suffering CNI‐related renal dysfunction without a loss of efficacy. Trials targeting earlier conversion post‐transplantation are required to confirm the efficacy and safety of everolimus for improving renal function after liver transplantation. Liver Transpl 15:1262–1269, 2009. © 2009 AASLD.
Dynkin games with heterogeneous beliefs

We study zero-sum optimal stopping games (Dynkin games) between two players who disagree about the underlying model. In a Markovian setting, a verification result is established showing that if a pair of functions can be found that satisfies some natural conditions then a Nash equilibrium of stopping times is obtained, with the given functions as the corresponding value functions. In general, however, there is no uniqueness of Nash equilibria, and different equilibria give rise to different value functions. As an example, we provide a thorough study of the game version of the American call option under heterogeneous beliefs. Finally, we also study equilibria in randomized stopping times.
Curcumin acts via transient receptor potential vanilloid‐1 receptors to inhibit gut nociception and reverses visceral hyperalgesia

An antinociceptive effect has been reported for curcumin in animal models and in humans, but the molecular mechanisms of curcumin's effect remain undefined. In this study, we explored the possibility that curcumin inhibit visceral nociception via antagonizing the transient receptor potential vanilloid‐1 (TRPV1) receptor.
Factors influencing liver transplant length of stay at two large‐volume transplant centers

Length of stay (LOS) is considered a reliable surrogate for liver transplant resource utilization. Little information exists about how donor and recipient variables interact to affect transplant LOS. Data for adult, non–status 1 transplants (1998–2005), including the donor risk index (DRI) and Model for End‐Stage Liver Disease (MELD) scores, were collected from 2 institutions (n = 745 for center A and n = 710 for center B). Cox proportional hazards models identified variables associated with LOS for the separate and combined cohorts. The cohorts differed significantly in donor, recipient, and transplant factors. DRI (1.46 for center A and 1.40 for center B, P = 0.0013) and MELD (22.4 for center A and 20.4 for center B, P = 0.046) were both higher at center A, but LOS was comparable (13.7 days for center A and 13.3 days for center B, P = 0.052). Three factors at center A (nonlocal donor, recipient age, and MELD) and 7 factors at center B (donor age and weight, recipient female gender, retransplant status, international normalized ratio, MELD, and cold ischemia time) were associated with transplant LOS. For the combined cohort, donor age, weight, nonlocal status, recipient age, female gender, retransplant status, MELD, and transplant center were LOS risk factors. In conclusion, the impact of donor and recipient variables on LOS varies by institution. However, the MELD score exerts a potent and consistent effect across institutions, emphasizing the dominant role of disease severity in liver transplant resource utilization. Liver Transpl 15:1570–1578, 2009. © 2009 AASLD.
S59 The Role of Lymphocytes in Acute Lung Injury

Introduction Acute lung injury (ALI) is caused by the uncontrolled activation immune cells, resulting in dysregulated inflammation which irreversibly damages the lung architecture and function. Whilst the role of myeloid cells in the pathophysiology of ALI is well established, the function of lymphoid cells is less well understood. Hypothesis Lymphocytes may play a role inthe regulation of inflammation in acute lung injury. Methods We have utilised both human and murine in vivo models of lipopolysaccharide(LPS) induced ALI, as well as patient samples, to characterise lung infiltrating cells by flow cytometry. Lymphocyte associated cytokines were quantified by luminex or via ex vivo stimulation andintra-cellular cytokine staining. Results Rapid infiltration of T cells(both aβ and aβ T cells), including regulatory T cells (Tregs), NKT and NKcells was observed. The cytokine Interleukin (IL)-17 is a potent recruiter of neutrophilsto sites of inflammatory sites. We observed a significant elevation in IL-17 levels in bronchoalveolar lavage fluid (BALF) in the humans postLPS inhalation; high levels of IL-17 were also seen in BALF from ALI patients. AnIL-17 KO mouse was utilised to confirm the key role for this cytokine in neutro philrecruitment to the lung during ALI. The transcription factor RORγt induces transcription of the genes encoding IL-17. Flow cytometric analysis revealed RORγt+ lung lymphocytes were predominantly CD4+ T cells (18%), CD8+ T cells (20%)and the recently described innate lymphoid cells (40%). Small percentages of RORγt+natural killer (NK) cells, NK T cells, gamma delta T cells were also seen. The role of Tregs in the early regulation of ALI was examined using a Treg inducibleKO murine model (FOXP3GFP DTR). When Tregs were depleted prior to LPS administration there was an increased recruitment of neutrophils into the lung. Conclusion We have demonstrated that both lymphocyte released IL-17 and Tregs modulate the recruitment of neutrophils to the lung in ALI. These results reveal the importance of lymphocytes in the immunopathology of ALI. Increased understanding of the lymphocyte function could open new avenues of exploration for therapeutic strategies to regulate immune responses in ALI. Abstract S59 Figure 1
Jigsaw percolation on random hypergraphs

The jigsaw percolation process on graphs was introduced by Brummitt, Chatterjee, Dey, and Sivakoff as a model of collaborative solutions of puzzles in social networks. Percolation in this process may be viewed as the joint connectedness of two graphs on a common vertex set. Our aim is to extend a result of Bollob\'as, Riordan, Slivken, and Smith concerning this process to hypergraphs for a variety of possible definitions of connectedness. In particular, we determine the asymptotic order of the critical threshold probability for percolation when both hypergraphs are chosen binomially at random.
Diffusion of School-Based Substance Abuse Prevention Programs

Despite promising evidence of the effectiveness of psychosocial-based approaches to drug abuse prevention, these programs have not been widely adopted by schools. This article considers the feasibility of widespread diffusion of empirically based prevention programs in school settings. The literature on determinants of diffusion is reviewed, results of recent research on strategies to increase diffusion are discussed, and barriers to successful diffusion in school settings are identified. The article concludes by presenting implications of these research findings for policy, practice, and future research.
Pretransplant predictors of recovery of renal function after liver transplantation

The Model for End‐Stage Liver Disease system has given priority on the liver transplant waiting list to candidates with renal failure. This study determined the predictors of spontaneous recovery of renal function after transplantation in 1041 liver transplant recipients on renal replacement therapy (RRT) at the time of transplant (from February 2002 to January 2007). Data from these patients were obtained from the US Organ Procurement and Transplantation Network and US Renal Data System databases. Univariate and multivariate survival models were constructed along with multivariate logistic regression models to find independent predictors of spontaneous renal recovery. Seven hundred seven recipients (67.9%) had spontaneous recovery of renal function after liver transplantation. Those recovering spontaneously had a significantly shorter course of RRT in the pretransplant time period (15.6 versus 36.6 days, P < 0.001). Recovery of renal function was observed in 70.8% and 11.5% of recipients on RRT for less than 30 days and more than 90 days, respectively. Other statistically significant pretransplant variables independently associated with recovery of renal function included recipient age, recipient pretransplant diabetes, and donor age. In conclusion, the duration of pretransplant RRT is highly predictive of spontaneous renal recovery post‐transplant. Liver transplant candidates requiring less than 30 days of pretransplant RRT are likely to spontaneously recover renal function after liver transplantation, whereas those on RRT for more than 90 days are not. Liver Transpl, 2010. © 2010 AASLD.
HBsAg Seroclearance in chronic hepatitis B in Asian patients: replicative level and risk of hepatocellular carcinoma.

BACKGROUND & AIMS Our aims were to study the virologic, histologic, and clinical outcome in chronic hepatitis B (CHB) patients with hepatitis B surface antigen (HBsAg) seroclearance. METHODS We determined the age of HBsAg seroclearance that is associated with a lower risk for hepatocellular carcinoma (HCC) in 298 CHB patients (median follow-up, 108 months). The following virologic and histologic features were also determined: liver stiffness (n = 229), liver histology, serum HBV DNA levels over time (n = 265), intrahepatic HBV DNA with covalently closed circular DNA (cccDNA) levels, and messenger RNA (mRNA) expression. RESULTS The median age of HBsAg seroclearance was 49.6 years. Seven (2.4%) patients developed HCC. Cumulative risk for HCC was higher in patients with HBsAg seroclearance at ages >or=50 years compared with those with HBsAg seroclearance at ages <50 (P = .004) years. Of these 2 groups of patients, 29.5% and 7.9%, respectively, had significant fibrosis by liver stiffness measurement (P = .001), and 15.4% of patients had mild histologic fibrosis. Intrahepatic total HBV DNA and cccDNA were detected in 100% and 79.3% of patients, respectively. All patients had undetectable surface and precore/pregenomic RNA transcripts. One (9.1%) patient had X mRNA expression. Serum HBV DNA were detectable in 13.4%, 6.1%, and 3.7% of patients within 1 year and 5-10 and >10 years after HBsAg seroclearance, respectively, and 82.1% patients had persistently normal alanine aminotransferase levels. CONCLUSIONS HBV persisted at low replicative and transcriptional levels after HBsAg seroclearance. HBsAg seroclearance at age <50 years was associated with a lower risk for the development of HCC.
Association between obesity and depression in Canadians.

OBJECTIVE To determine the age and sex variations in the associations between obesity and depression. METHODS This analysis was based on data from 59,652 adults >or=18 years of age in the provinces of Nova Scotia, Quebec, Saskatchewan, Alberta, and British Columbia, who participated in the Canadian Community Health Survey conducted in 2005. The survey included a set of 27 questions about symptoms of depression, which were taken from the Composite International Diagnostic Interview. Based on these questions, depression scores were calculated and used to define depression, which corresponds to a 90% likelihood of a positive diagnosis of major depressive episode. Body weight and height were based on self-report. RESULTS The prevalence of depression was 5.3% in adults living in the five provinces and was higher in women than in men. People with abnormal body weight tended to have an increased risk of depression. On average, obesity and being underweight were associated with approximately 30% and 40% increases in depression, respectively. Particularly in women, depression was more markedly associated with obesity in the 18-39 year age group (OR 1.67, 95% CI 1.29-2.15) and with being underweight in the 40-59 year age group (OR 2.23, 95% CI 1.45-3.42) than other age groups. CONCLUSIONS Obesity is associated with an increased risk of depression in younger women.
The nature and purpose of acute psychiatric wards: The tompkins acute ward study

Background: Acute inpatient care in the UK is being subjected to increasing critical scrutiny, highlighting concerns about content and quality. There is an absence of clarity and consensus on what acute inpatient care is for, adding to difficulties in developing this service sector. Aim: To define the function of acute psychiatric wards. Methods: Interviews were conducted with multidisciplinary staff (13 Ward Managers, 14 F Grade nurses, 11 Occupational Therapists and 9 Consultant Psychiatrists), on rationales for admission, their care and treatment philosophy, and the roles of different professionals. Results: Patients are admitted because they appear likely to harm themselves or others, and because they are suffering from a severe mental illness, and/or because they or their family/community require respite, and/or because they have insufficient support and supervision available to them in the community. The tasks of acute inpatient care are to keep patients safe, assess their problems, treat their mental illness, meet their basic care needs and provide physical healthcare. These tasks are completed via containment, 24-hour staff presence, treatment provision, and complex organisation and management. Conclusions: Professional education, audit, research and the structuring of services all need to be oriented towards these tasks. Declaration of interest: This study was funded by the Tompkins Foundation and the Department of Health Nursing Quality initiative.
Reactive oxygen species mediate human hepatocyte injury during hypoxia/reoxygenation

Increasing evidence shows that reactive oxygen species (ROS) may be critical mediators of liver damage during the relative hypoxia of ischemia/reperfusion injury (IRI) associated with transplant surgery or of the tissue microenvironment created as a result of chronic hepatic inflammation or infection. Much work has been focused on Kupffer cells or liver resident macrophages with respect to the generation of ROS during IRI. However, little is known about the contribution of endogenous hepatocyte ROS production or its potential impact on the parenchymal cell death associated with IRI and chronic hepatic inflammation. For the first time, we show that human hepatocytes isolated from nondiseased liver tissue and human hepatocytes isolated from diseased liver tissue exhibit marked differences in ROS production in response to hypoxia/reoxygenation (H‐R). Furthermore, several different antioxidants are able to abrogate hepatocyte ROS–induced cell death during hypoxia and H‐R. These data provide clear evidence that endogenous ROS production by mitochondria and nicotinamide adenine dinucleotide phosphate oxidase drives human hepatocyte apoptosis and necrosis during hypoxia and H‐R and may therefore play an important role in any hepatic diseases characterized by a relatively hypoxic liver microenvironment. In conclusion, these data strongly suggest that hepatocytes and hepatocyte‐derived ROS are active participants driving hepatic inflammation. These novel findings highlight important functional/metabolic differences between hepatocytes isolated from normal donor livers, hepatocytes isolated from normal resected tissue obtained during surgery for malignant neoplasms, and hepatocytes isolated from livers with end‐stage disease. Furthermore, the targeting of hepatocyte ROS generation with antioxidants may offer therapeutic potential for the adjunctive treatment of IRI and chronic inflammatory liver diseases. Liver Transpl 16:1303‐1313, 2010. © 2010 AASLD.
Correlation between oropharyngeal pH‐monitoring and esophageal pH‐impedance monitoring in patients with suspected GERD‐related extra‐esophageal symptoms

24‐hour esophageal pH‐impedance (pH‐MII) is not totally reliable for laryngopharyngeal reflux (LPR). Oropharyngeal (OP) pH‐monitoring with the Dx‐pH probe may detect LPR better. The correlation between these two techniques is not thoroughly established. Aim of this study is to examine the correlation between OP pH‐metry and esophageal pH‐MII monitoring.
Infection control practices among doctors and nurses in a tertiary care hospital

Background: Basic infection control measures in any healthcare setup can reduce the rates of healthcare-associated infections. A study to assess the knowledge and practice of 400 healthcare personnel regarding hospital infection control practices was performed. Materials and Methods: A structured questionnaire was distributed to the study group and collected the same day. Knowledge and practices of 329 nurses and 71 doctors regarding hand hygiene, SPs, hospital environmental cleaning and needle stick injury were collected and analyzed. Results: The study group had suboptimal knowledge regarding the SPs (55.3%) and risks associated with NSI (31.8%). The implementation of SPs was biased towards the HIV positive status of the patient. Only 57% of the doctors and nurses followed the maximal barrier precautions before a CVC insertion. Discussion: The lack of knowledge and practices regarding basic infection control protocols should be improved by way of educational intervention, in the form of formal training of the doctors and nurses and reinforcement of the same.