Miracle-dz/UniFAR-FTUs huggingface dataset:
Podocytopenia in Diabetic Nephropathy: A Role for the Thromboxane A2 TP Receptor

Although the etiology of diabetic nephropathy is still uncertain, proteinuria due to podocyte injury and loss (podocytopenia) are early features of the disease. Significant increases in thromboxane A2 (TXA2) production as well as expression of its receptor in animal models of diabetic nephropathy led to the hypothesis that TXA2 acting via its thromboxane-prostanoid (TP) receptor induces podocytopenia resulting in proteinuria. Systemic infusion of a TP antagonist demonstrated an important role of TXA2/TP signalling in our model of streptozotocin induced type-1 diabetic nephropathy by reducing kidney damage including proteinuria. Podocyte specific TP overexpressing mice did not demonstrate more pathologic or dynamic kidney damage than non-transgenic mice in STZ-induced diabetic nephropathy. Further assessment of the TP transgene functionality in this mice line is necessary to validate those results. Whereas the importance of TXA2/TP signalling is undeniable in diabetic nephropathy, it appears that podocyte TP receptors might not be directly targeted.
Oncologic Outcomes After Robotic Pancreatic Resections Are Not Inferior to Open Surgery

Objective: Compare oncologic outcomes after open and robotic pancreatic resections for pancreatic adenocarcinoma (PDAC). Summary of Background Data: Receipt of adjuvant chemotherapy improves survival after resected PDAC. Complications after pancreatectomy have been shown to prohibit the administration of adjuvant chemotherapy and survival. We examined the effect of surgical approach on receipt of adjuvant chemotherapy, complications, and overall survival after pancreatectomy. Methods: A single-institution retrospective review of all patients with PDAC who underwent robotic or open pancreatectomy from 2011 to 2016 with 24-month follow-up. Results: Four hundred fifty-six patients underwent resection: 226 robotic and 230 open. No significant difference was identified in major complications or receipt of adjuvant chemotherapy between robotic and open pancreatectomy, nor was approach an independent predictor of these outcomes. Robotic pancreatectomy patients had a shorter length of stay than patients who underwent open pancreatectomy (7 days vs 9 days; P < 0.001). Additionally, wound infection rate (32.3% vs 12.4%, P < 0.0001) and transfusion (39.6% vs 12.4%, P < 0.0001) was improved in robotic pancreatectomy group with no differences in perioperative mortality. Improved median overall survival approached statistical significance for the robotic cohort (25.6 months vs 23.9 months; P = 0.055); however, on multivariable analysis the robotic approach predicted overall survival, (hazard ratio 0.77, P = 0.041). Robotic approach was an independent predictor of decreased blood loss and less transfusions than the open approach. Conclusions: Robotic pancreatectomy was not inferior compared to open pancreatectomy in a high-volume experienced center for oncologic outcomes and due to decreased blood loss and transfusion may have improved survival.
Healthcare needs and programmatic gaps in transition from pediatric to adult care of vertically transmitted HIV infected adolescents in India

Treatment transition for 'adolescents living with perinatally acquired HIV' (ALPH) from paediatric to adult care is not addressed adequately. This study explores the ALPH's health care needs and programmatic gaps in health systems for the care of ALPH in India. Forty-nine in-depth interviews were conducted with purposively selected primary and key stakeholders in India. Thematic analysis utilizing grounded theory was performed in QSR NUD*IST 6. Stakeholders explicitly recognized adolescent HIV to be a critical public health issue which requires a separate mandate in India. It was found that none of the health policies in India focus on adolescent age group; ALPH is therefore even more neglected population. No/partial HIV disclosure to ALPH is the first crisis for retention in care continuum and adherence to the treatment becomes sub-optimal. Unmet needs of transitioning from paediatric to adult care in existing settings was the major gap. Age-specific counselling guidelines and counselling skills among HCPs were found lacking where tailored counseling and capacity building of HCPs was an expectation. Need of holistic approach for adolescents led to consensus on establishing 'adolescent transition clinic' with a strict 'no' for 'standalone Adolescent HIV' clinics. School setting having peer-based counselling provision was recommended. Age disaggregated health data is required to inform the policymakers about adolescents’ specific needs for developing interventions. Situational analysis to identify and shape health priorities of adolescents is recommended.
Establishment of an Anti-acne Vulgaris Evaluation Method Based on TLR2 and TLR4-mediated Interleukin-8 Production

Background/Aim: To date, no cell-based assay that focuses on the prime cause of acne initiation through activation of toll-like receptor2 and 4 and interleukin-8 (IL-8) production exists. Herein, we present an assay that evaluates acne by determining TLR2 and 4 expression and activation. Materials and Methods: Viability of keratinocytes was determined by the MTT assay. IL-8 was evaluated by ELISA. Immunocytochemistry was performed for determining receptor expression. Results: Lipoteichoic acid (LTA), peptidoglycan (PGN) and lipopolysaccharide (LPS) induced IL-8 production. Pre-treatment of cells with TLR2 and TLR4 inhibitors, before stimulation, reduced IL-8 production. Zinc gluconate was used for verification. Zinc can significantly suppress IL-8 production in the system. Treatment of cells with LTA+PGN or LPS resulted in increased TLR2 and TLR4 expression on the cell surface. This effect was prevented by zinc treatment. Conclusion: The measurement of IL-8 and TLR2 and TLR4 levels can be used for the evaluation of anti-acne treatment.
The association of resilience with health-related quality of life (HRQoL) in adolescent students

Abstract Objectives Identifying the factors associated with HRQoL in adolescents is a prerequisite of interventions aimed at improving the overall quality of life and health status among them. Studies have identified many factors associated with HRQoL in different populations; however, very little is known about the role of resilience on HRQoL in adolescent students. Subjects This cross-sectional study was conducted on 1500 high school students (750 boys and 750 girls) in Tehran. The subjects were selected through the cluster and multistage sampling methods. Methods The data collection tool included three questionnaires; a demographic information questionnaire, the Health-Related Quality of Life Questionnaire (KIDSCREEN-27), and the Children and Youth Resilience Measurement (CYRM-28). Data were analyzed with SPSS 23 software. Regression analysis was performed to determine the association of resilience with HRQoL. Results The mean score of overall health-related quality of life and overall resilience were 57.51 ± 15.03 and 98.35 ± 16.48, respectively. Individual sub-scale (β = 0.402, p < 0.001), caregiver sub-scale (β = 0.279, p < 0.001) and context sub-scale (β = 0.122, p < 0.001) of resilience were, respectively, the positive and significant predictors of HRQoL in students. The resilience sub-scales explained 49% of the total variance of HRQoL, and the individual sub-scale was the strongest predictive factor for HRQoL in students. Conclusion It is recommended to incorporate resilience training programs into the regular school education in order to improve the quality of life and health of students in all high schools and educational centers of the country.
Racial/Ethnic and Socioeconomic Disparities in Use of Direct-Acting Antivirals Among Medicare Beneficiaries with Chronic Hepatitis C, 2014-2016.

BACKGROUND New hepatitis C virus (HCV) drugs-direct-acting antivirals (DAAs)-are highly effective but costly, which raises a concern about limited access to DAAs by vulnerable populations. Previous studies of disparities in DAA use across patient groups showed mixed results, but their generalizability was limited due to using data from commercial insurers or from 2014 only-the first year DAAs were available. Disparities in DAA use in a national cohort in the years when more DAAs were available is unknown. OBJECTIVE To examine whether disparities in DAA use by patient race/ethnicity and socioeconomic status in Medicare changed between 2014 and 2016. METHODS The study population was made up of chronic hepatitis C patients in fee-for-service Medicare with Part D between 2014 and 2016. We used multinomial logistic regression to estimate adjusted odds ratios (aOR) of using DAAs by patient race/ethnicity and socioeconomic status. We estimated the model separately for 2014 and 2014-2016. RESULTS Of 281,810 Medicare patients who were followed to the end of 2016, a total of 90,419 (32.1%) filled prescriptions for DAAs. In the 2014 analysis, blacks were less likely to use DAAs than whites (aOR = 0.95; 95% CI = 0.91-0.99). However, in the 2014-2016 analysis, blacks had higher odds of using DAAs than whites (aOR = 1.24; 95% CI = 1.22-1.27). No significant Hispanic-white gap existed during the study period. Income was positively associated with DAA use in both periods. Between 2014 and 2016, patients who received a Part D low-income subsidy had lower odds of using DAAs than patients who did not (aOR = 0.90; 95% CI = 0.88-0.92), and patients in areas with the higher income tertiles were more likely to initiate DAAs than those in areas with the lowest income tertile. CONCLUSIONS DAA use among Medicare patients remained far below the level needed to eradicate HCV. The black-white gap in HCV treatment was closed by 2016, but disparities by patient socioeconomic status remained. DAA use also varied by patient age and health risk, as well as across geographic regions. Continued efforts to improve DAA uptake in all HCV patients are needed to eradicate HCV. DISCLOSURES This study was supported by the National Institute on Aging (1 R01 AG055636-01A1) and National Institute of Child Health & Human Development (R24 HD04025). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Feldman owns stock in Gilead Sciences and Abbvie. No other potential competing interest exists.
Pharmacokinetic (PK) and Pharmacodynamic Profiles of Artemisinin Derivatives Influence Drug Neurotoxicity in Animals

In the past decade, there have been major advances in our knowledge of severe CNS neurotoxicity in mice, rats, dogs, and rhesus monkeys repeatedly administered the oil-soluble artemisinins (ARTs) of arteether (AE) or artemether (AM), and water-soluble artelinic acid (AL). Studies have shown that those drugs are toxic to the central nervous system and induce neuropathologic changes in these animals (Li & Hickman, 2011). Pharmocokinetic and toxicokinetic studies of model animals administered various artemesinin derivitives through different routes have yielded important information that is relevant and useful in predicting possible neurotoxicity in man, particularly as artemesinin drugs are used more widely for other indications beyond malaria treatment such as cancer therapy.
Microbiome‐immune‐metabolic axis in the epidemic of childhood obesity: Evidence and opportunities

Obesity epidemic responsible for increase in diabetes, heart diseases, infections and cancer shows no signs of abating. Obesity in children is also on rise, indicating the urgent need of strategies for prevention and intervention that must begin in early life. While originally posited that obesity results from the simple concept of consuming more calories, or genetics, emerging research suggests that the bacteria living in our gut (gut microbiome) and its interactions with immune cells and metabolic organs including adipose tissues (microbiome‐immune‐metabolic axis) play significant role in obesity development in childhood. Specifically, abnormal changes (dysbiosis) in the gut microbiome, stimulation of inflammatory cytokines, and shifts in the metabolic functions of brown adipose tissue and the browning of white adipose tissue are associated with increased obesity. Many factors from as early as gestation appear to contribute in obesity, such as maternal health, diet, antibiotic use by mother and/or child, and birth and feeding methods. Herein, using evidence from animal and human studies, we discuss how these factors impact microbiome‐immune‐metabolic axis and cause obesity epidemic in children, and describe the gaps in knowledge that are warranted for future research.
Task-Specific Sensitivity in Physical Function Testing Predicts Outcome in Patients With Low Back Pain.

STUDY DESIGN Prospective cohort study nested in a randomized controlled trial. BACKGROUND Low back pain (LBP) is the leading cause of pain and disability globally. Few prognostic factors are consistently reported to predict outcome in patients with LBP and findings from clinical examination and physical task performance levels (e.g. walking distance) lack prognostic value. However, recent findings suggest measuring patients' pain sensitivity to task performance tests (task-specific sensitivity) may be of predictive value. OBJECTIVE To investigate the prognostic value of task-specific sensitivity in patients with LBP by exploring whether task-specific sensitivity during physical function testing is associated with self-reported change in pain and disability. METHODS The study included 260 patients with LBP, referred for evaluation in secondary care setting. All patients completed questionnaires and underwent clinical examination by a physiotherapist. Patients rated their pain intensity before and after completing a test battery measuring physical function and were classified into four categories; worse, unchanged, better or no pain, depending on their pain response. At 3-month follow-up, outcomes were obtained by a postal questionnaire. RESULTS Task-specific sensitivity significantly predicted pain, when adjusting for known prognostic factors. Patients classified as no pain, better and unchanged improved significantly more in pain score compared to patients classified as worse. Patients classified as no pain also improved significantly more in disability score compared to patients classified as worse after adjusting for known prognostic factors. CONCLUSION Measuring task-specific sensitivity is predictive of pain intensity after 3 months in patients with LBP. The prognostic value appears limited in respect to disability. LEVEL OF EVIDENCE Prognosis, level 1b. J Orthop Sports Phys Ther, Epub 30 Oct 2019. doi:10.2519/jospt.2020. 8953.
Aspirin associated with decreased rate of intracranial aneurysm growth.

OBJECTIVE Aspirin has emerged as a potential agent in the prevention of rupture of intracranial aneurysms (IAs). In this study, the authors' goal was to test if aspirin is protective against aneurysm growth in patients harboring multiple IAs ≤ 5 mm. METHODS The authors performed a retrospective review of a prospectively maintained database covering the period July 2009 through January 2019. Patients' data were included if the following criteria were met: 1) the patient harbored multiple IAs; 2) designated primary aneurysms were treated by surgical/endovascular means; 3) the remaining aneurysms were observed for growth; and 4) a follow-up period of at least 5 years after the initial treatment was available. Demographics, earlier medical history, the rupture status of designated primary aneurysms, aneurysms' angiographic features, and treatment modalities were gathered. RESULTS The authors identified 146 patients harboring a total of 375 IAs. At the initial encounter, 146 aneurysms were treated and the remaining 229 aneurysms (2-5 mm) were observed. During the follow-up period, 24 (10.48%) of 229 aneurysms grew. All aneurysms observed to grow later underwent treatment. None of the observed aneurysms ruptured. Multivariate analysis showed that aspirin was significantly associated with a decreased rate of growth (odds ratio [OR] 0.19, 95% confidence interval [CI] 0.05-0.63). Variables associated with an increased rate of growth included hypertension (OR 14.38, 95% CI 3.83-53.94), drug abuse (OR 11.26, 95% CI 1.21-104.65), history of polycystic kidney disease (OR 9.48, 95% CI 1.51-59.35), and subarachnoid hemorrhage at presentation (OR 5.91, 95% CI 1.83-19.09). CONCLUSIONS In patients with multiple IAs, aspirin significantly decreased the rate of aneurysm growth over time. Additional prospective interventional studies are needed to validate these findings.
Preventing unintentional home injuries among children: exploring the perceptions of Iranian health professionals

Abstract Background: Health professionals are key stakeholders who potentially have important roles in preventing unintentional child home injuries. This study aimed to identify facilitators and barriers to the prevention of unintentional child home injuries perceived by health professionals. Design: A generic qualitative study involving semi-structured interviews. Setting: The capital city of Iran. Method: Data for this study were collected through 28 in-depth interviews with health professionals. Purposive sampling was conducted from three areas of Tehran based on their socio-economic development. Findings: Thematic data analysis yielded nine overarching themes: prioritising child home injury, knowledge, the nature of injury and injury prevention, child-related factors, parent-related factors, living environment, cultural issues, resources and management. Conclusions: Health professionals can potentially be supportive to meet families’ needs. However, further support and resources will be required if they are to fully develop their potential in preventing injuries in the home. The lack of a national action plan was a significant constraint for health professionals.
Selective Inactivation of Reelin in Inhibitory Interneurons Leads to Subtle Changes in the Dentate Gyrus But Leaves Cortical Layering and Behavior Unaffected

Abstract Reelin is an extracellular matrix protein, known for its dual role in neuronal migration during brain development and in synaptic plasticity at adult stages. During the perinatal phase, Reelin expression switches from Cajal-Retzius (CR) cells, its main source before birth, to inhibitory interneurons (IN), the main source of Reelin in the adult forebrain. IN-derived Reelin has been associated with schizophrenia and temporal lobe epilepsy; however, the functional role of Reelin from INs is presently unclear. In this study, we used conditional knockout mice, which lack Reelin expression specifically in inhibitory INs, leading to a substantial reduction in total Reelin expression in the neocortex and dentate gyrus. Our results show that IN-specific Reelin knockout mice exhibit normal neuronal layering and normal behavior, including spatial reference memory. Although INs are the major source of Reelin within the adult stem cell niche, Reelin from INs does not contribute substantially to normal adult neurogenesis. While a closer look at the dentate gyrus revealed some unexpected alterations at the cellular level, including an increase in the number of Reelin expressing CR cells, overall our data suggest that Reelin derived from INs is less critical for cortex development and function than Reelin expressed by CR cells.
Understanding serious case reviews and their impact - a biennial analysis of serious case reviews 2005-07

Serious case reviews are undertaken when a child dies or is seriously injured, and abuse or neglect are known or suspected to be factors in the death. They are carried out under the auspices of Local Safeguarding Children Boards so that lessons can be learnt locally. This is the fourth biennial overview of serious case reviews across England and was commissioned to draw out themes and trends so that lessons learnt from these cases can inform both policy and practice. The child protection database was analysed to establish which of the 464 notifications of critical child care incidents reported progressed to become a serious case review. Of the 189 cases that became serious case reviews, descriptive statistics were obtained about the children, their families, the environment in which the children were living, and also some detail about professional involvement.
Quality of Life Assessment of Opioid Substance Abusers on Methadone Maintenance Therapy (MMT) in University Malaya Medical Center

Objective: In Malaysia, opioid abuse is an acknowledged problem with severe health and economic repercussions. Until recently, drug addicts were mainly criminalised and forcefully rehabilitated in correctional facilities. However, the high relapse rates of this approach, coupled with the high rates of blood borne infections among drug users, led to increasing acceptance of a healthcare-based approach in the rehabilitation of drug addicts. Methadone was among the medications introduced as substitution maintenance therapy in 2005 and Universiti Malaya Medical Centre (UMMC) is a centre for MMT. This study aimed to determine the effects of MMT on quality of life in patients here. Methods: The sample was 46 patients who attended the Psychiatric outpatient clinic in fill in UMMC. The instrument used to assess quality of life was the WHOQOL-BREF. Results: The study design was cross-sectional with retrospective elements. Baseline QOL scores were obtained from case records and follow-up scores from the month of September 2007. Statistically significant improvements in all four domains of WHOQOL-BREF were found. Physical: p 1.46-3.05. Psychological: p 0.66-3.05. Environmental: p Methadone maintenance therapy substantially improves quality of life in ex-opioid abusers.
Transfer-Free Graphene-Like Thin Films on GaN LED Epiwafers Grown by PECVD Using an Ultrathin Pt Catalyst for Transparent Electrode Applications

In this work, we grew transfer-free graphene-like thin films (GLTFs) directly on gallium nitride (GaN)/sapphire light-emitting diode (LED) substrates. Their electrical, optical and thermal properties were studied for transparent electrode applications. Ultrathin platinum (2 nm) was used as the catalyst in the plasma-enhanced chemical vapor deposition (PECVD). The growth parameters were adjusted such that the high temperature exposure of GaN wafers was reduced to its minimum (deposition temperature as low as 600 °C) to ensure the intactness of GaN epilayers. In a comparison study of the Pt-GLTF GaN LED devices and Pt-only LED devices, the former was found to be superior in most aspects, including surface sheet resistance, power consumption, and temperature distribution, but not in optical transmission. This confirmed that the as-developed GLTF-based transparent electrodes had good current spreading, current injection and thermal spreading functionalities. Most importantly, the technique presented herein does not involve any material transfer, rendering a scalable, controllable, reproducible and semiconductor industry-compatible solution for transparent electrodes in GaN-based optoelectronic devices.