Miracle-dz/UniFAR-FTUs huggingface dataset:
Knowledge of adolescents regarding sexually transmitted infections and pregnancy.

Objective: To investigate the knowledge of adolescents related to sexually transmitted infections (STIs), AIDS, and pregnancy, and understand the role of school in sex education. Method: A qualitative descriptive study, developed through a semi-structured interview and a form for participant characterization, with 22 high school students from a public school aged 16 to 19 years. Data were submitted to content analysis. Results: After analysis, four thematic categories were developed: sexuality and sex education; understanding of risk behaviors; knowledge of STI/AIDS; and knowledge of and practices for prevention. Final considerations: This study showed the need for preventive educational actions for adolescents, because the lack of information contributes to their vulnerability. The adolescents recognize the importance of sex education; therefore it is important to implement strategies to promote and protect health in the school environment to encourage and strengthen self-care in health. Objetivo: investigar o conhecimento de adolescentes relacionado às Infecções Sexualmente Transmissíveis (IST), AIDS e gravidez, além de conhecer a compreensão sobre o papel da escola na educação sexual. Método: estudo qualitativo, descritivo, desenvolvido por meio de entrevista semiestruturada e formulário para caracterização dos participantes, com 22 adolescentes entre 16 e 19 anos de idade, estudantes do Ensino Médio em uma escola pública. Os dados foram submetidos à análise de conteúdo. Resultados: da análise emergiram quatro categorias temáticas: Sexualidade e educação sexual; Compreensão de comportamentos de risco; Conhecimento de IST/AIDS; Conhecimento e práticas de prevenção. Considerações finais: revelou-se a necessidade de ações educativas de prevenção para os adolescentes, pois a falta de informações contribui para a sua vulnerabilidade. Os adolescentes reconhecem a importância da educação sexual; consequentemente, é importante a implementação de estratégias de promoção e de proteção à saúde no ambiente escolar para contribuir e fortalecer o autocuidado na saúde.
Effects of Type I Interferons on the Adjuvant Properties of Plasmid Granulocyte-Macrophage Colony-Stimulating Factor In Vivo

ABSTRACT While administration of granulocyte-macrophage colony-stimulating factor (GM-CSF) can induce the local recruitment of activated antigen-presenting cells at the site of vaccine inoculation, this cellular recruitment is associated with a paradoxical decrease in local vaccine antigen expression and vaccine-elicited CD8+ T-cell responses. To clarify why this cytokine administration does not potentiate immunization, we examined the recruited cells and expressed inflammatory mediators in muscles following intramuscular administration of plasmid GM-CSF in mice. While large numbers of dendritic cells and macrophages were attracted to the site of plasmid GM-CSF inoculation, high concentrations of type I interferons were also detected in the muscles. As type I interferons have been reported to damp foreign gene expression in vivo, we examined the possibility that these local innate mediators might decrease plasmid DNA expression and therefore the immunogenicity of plasmid DNA vaccines. In fact, we found that coadministration of an anti-beta interferon monoclonal antibody with the plasmid DNA immunogen and plasmid GM-CSF restored both the local antigen expression and the CD8+ T-cell immunogenicity of the vaccine. These data demonstrate that local innate immune responses can change the ability of vaccines to generate robust adaptive immunity.
Buyer-Optimal Learning and Monopoly Pricing

This paper analyzes a bilateral trade model where the buyer's valuation for the object is uncertain and she observes only a signal about her valuation. The seller gives a take-it-or-leave-it offer to the buyer. Our goal is to characterize those signal structures which maximize the buyer's expected payoff. We identify a buyer-optimal signal structure which generates (i) efficient trade and (ii) a unit-elastic demand. Furthermore, we show that every other buyer-optimal signal structure yields the same outcome as the one we identify: in particular, the same price.
Storage of antimalarials at household level and associated factors in Kiromo ward, Bagamoyo Tanzania.

BACKGROUND Malaria is a highly debilitating and frequently fatal disease of wide distribution. Improper drug storage and rampant self-medication are some of the factors that may contribute to an increase in the development of drug resistance by malaria parasites towards antimalarials. OBJECTIVES To determine the extent of antimalarial drugs storage, sources and associated factors at household level at Kiromo ward in Bagamoyo, Coast region, Tanzania after the introduction of SP replacing chloroquine as first line. METHODS A total of 300 households from three villages making up Kiromo ward were included in this study. Swahili version of the questionnaire and a checklist were used in data collection. RESULTS Of the 300 households visited 25 (8.3%) were found to store antimalarials. The most commonly stored antimalarials were amodiaquine (30.8%) and quinine (34.6%). Most of these were in tablet form (76.9%). The source of these drugs was mostly from dispensaries. Kiromo was the only dispensary in the ward and others were outside the ward. These drugs were stored in special containers for safety. Frequent episodes of illness in the family were given as the most (56%) common reasons for drug storage in the families, followed by distance (20%). There was a statistically significant (p<0.05) association between storage of antimalarial drugs and number of children in the family and presence of a family member with febrile illness. The study further showed that out of 26 different types of antimalarials stored, only 7 (26.9%) had expiry dates on the containers because these were original containers of the drugs. CONCLUSION The study revealed that few households store antimalarial drugs with amodiaquine and quinine being the most stored. The majority of the households obtained antimalarial drugs from dispensaries. Health education should be given not only to the patients but also the entire general public on the appropriate drug use, safety, expiry dates and appropriate storage. A model dispensary like Kiromo should be implemented in other rural areas.
Long-term Lamivudine Therapy for Chronic Hepatitis B Infection in Children Unresponsive to Interferon

Objectives: Prolonged lamivudine treatment in adults has been shown to improve hepatitis B e (HBe) seroconversion rates in patients with chronic hepatitis B. This prospective open study reports the results of prolonged lamivudine treatment in a group of children with chronic hepatitis B. Patients and Methods: Twenty-two children and adolescents age 13.2 years (range, 9.5-18 years), who have been treated with lamivudine for 1 year, continued treatment with lamivudine (3 mg/kg/day, up to 100 mg/d) as long as there was evidence of continued biochemical and virological benefit compared with baseline. We evaluated virological and biochemical responses, the occurrence of YMDD mutants and adverse effects during 4 years of follow-up. Results: After 4 years on lamivudine, only 4 patients (18%) underwent HBe seroconversion. In addition, in 3 patients (13%), the treatment was stopped when lamivudine's lack of efficacy became evident. During the 4-year study period, we recorded a continuing decline in the participants' number, mostly because of lack of compliance with treatment (9/22, 41%). Only 5 children were still receiving lamivudine and showing benefit after 4 years. In 2 children, treatment termination and YMDD mutant emergence were associated with hepatitis flare. Besides subclinical elevation of creatine phosphokinase, no other adverse events were recorded during the study period. Conclusions: Four years after starting lamivudine treatment, most children from this study were off lamivudine, mainly because of lack of compliance and poor HBe seroconversion. These findings suggest that continuing treatment with lamivudine for undefined periods is hard to implement and does not improve HBe seroconversion.
Recurrent esophageal carcinoma after esophagectomy with three‐field lymph node dissection

To evaluate the effect of the extended lymphadenectomy for thoracic esophageal carcinoma, the pattern of recurrence in the 50 patients with pT3 tumors who underwent esophagectomy with cervical, mediastinal, and abdominal lymph node dissection (3‐F) (group A) was compared with that of 100 patients at pT3 who underwent esophagectomy without upper mediastinal and cervical lymphadenectomy (2‐F) (group B). The cumulative 5‐year survival rate for 115 patients who underwent 3‐F was 50.9%. Cumulative 5‐year survival rates for patients in groups A and B were 36.8% and 22.0%, respectively. The survival curve for group A was significantly better than group B (P = 0.02332). Lymphatic recurrence was noted less frequently in group A (8/23) than in group B (31/49) (χ2 = 5.1149), whereas the rate of hematogenous recurrence was similar. Extension of the field of lymph node dissection reduced the lymph node recurrence in patients with thoracic esophageal carcinoma, which may have positively affected patient survival. © 1996 Wiley‐Liss, Inc.
Differential RET Signaling Pathways Drive Development of the Enteric Lymphoid and Nervous Systems

Cis and trans signaling mechanisms direct different developmental responses to ligands for the receptor tyrosine kinase RET. RET Signaling in Cis and Trans Development of the enteric (gastrointestinal) organs requires coordinated growth of tissues from various embryonic layers. Evidence suggests that ligands of the receptor tyrosine kinase RET are used in different tissues to control distinct developmental end points. Lymphoid tissue initiator (LTin) cells are thought to function in the early development of Peyer’s patches (PPs), which are secondary lymphoid organs of the gut important for mucosal immunity. The formation of the enteric nervous system, which enervates the lymphoid tissue, depends on interactions between neural crest cells and stroma cells of the gut wall. RET signaling requires the presence of co-receptors, which bind to ligands, in the same cell (in cis), or RET co-receptors can be cleaved from cells, leading to the possibility of RET signaling in trans; however, the physiological relevance of such signaling is uncertain. Patel et al. investigated lymphoid tissue morphogenesis in mice and found that whereas development of the enteric nervous tissue depended on RET signaling in cis, aggregation of LTin cells and development of lymphoid tissue were driven by RET signaling in trans and depended on the local availability of RET co-receptors and ligands. During the early development of the gastrointestinal tract, signaling through the receptor tyrosine kinase RET is required for initiation of lymphoid organ (Peyer’s patch) formation and for intestinal innervation by enteric neurons. RET signaling occurs through glial cell line–derived neurotrophic factor (GDNF) family receptor α co-receptors present in the same cell (signaling in cis). It is unclear whether RET signaling in trans, which occurs in vitro through co-receptors from other cells, has a biological role. We showed that the initial aggregation of hematopoietic cells to form lymphoid clusters occurred in a RET-dependent, chemokine-independent manner through adhesion-mediated arrest of lymphoid tissue initiator (LTin) cells. Lymphoid tissue inducer cells were not necessary for this initiation phase. LTin cells responded to all RET ligands in trans, requiring factors from other cells, whereas RET was activated in enteric neurons exclusively by GDNF in cis. Furthermore, genetic and molecular approaches revealed that the versatile RET responses in LTin cells were determined by distinct patterns of expression of the genes encoding RET and its co-receptors. Our study shows that a trans RET response in LTin cells determines the initial phase of enteric lymphoid organ morphogenesis, and suggests that differential co-expression of Ret and Gfra can control the specificity of RET signaling.
Lack of Detectable Deleterious Effects on Metabolic Control of Daily Fructose Ingestion for 2 Mo in NIDDM Patients

The effects of a daily intake of 30 g fructose on blood glucose regulation, erythrocyte insulin receptors, and lipid metabolism have been studied in type II (non-insulin-dependent) diabetic subjects. Eight wellcontrolled patients received, in a randomly assigned crossover design over two 2-mo study periods, 30 g of fructose in exchange for an isocaloric amount of starch. Fructose could be taken at any time during the day as part of the 1400–1600 kcal allowed diet (50% carbohydrate, 30% fat, 20% protein). No significant difference was observed concerning body weight, HbA1c, fasting plasma glucose, fasting plasma insulin, uric acid, total cholesterol, high-density lipoprotein cholesterol, and triglycerides, nor was there any change in insulin binding to erythrocytes between the fructose and the control starch period. However, the mean plasma triglyceride levels after the fructose period, although still in the normal range, were significantly higher than baseline values (P < .05). We conclude that moderate amounts of fructose incorporated into the diet of well-controlled type II diabetic subjects have no significant deleterious effect on glycemic control, insulin receptors of erythrocytes, or lipid metabolism.
Prognostic significance of platelet-derived growth factor-BB expression in human esophageal squamous cell carcinomas.

BACKGROUND Cancer metastases are commonly found in the lymphatic system and tumor lymphangiogenesis requires the interplay of several growth factors. The expression of platelet-derived growth factor (PDGF)-BB and vascular endothelial growth factor (VEGF)-C in esophageal cancer was investigated to define their clinicopathological significance. MATERIALS AND METHODS Using immunohistochemistry, the expression of PDGF-BB and VEGF-C was examined, along with lymphatic vessel density (LVD) in 53 patients with esophageal cancer. RESULTS PDGF-BB and VEGF-C expression was positive in 31 cases (58.5%) and 38 cases (71.7%), respectively, and expression correlated with lymph node metastasis and lymphatic invasion. Furthermore, PDGF-BB expression correlated with the depth of tumor invasion and the size of the tumor, and PDGF-BB-positive patients had a significantly poorer prognosis than PDGF-BB-negative patients. The LVD in positive PDGF-BB or VEGF-C tumors was higher than in negative tumors. CONCLUSION PDGF-BB may play a pivotal role in lymphangiogenesis and tumor growth in esophageal cancer.
Proteoglycan expression patterns in human hair follicle

Background Proteoglycans (PGs) are known to play key roles in many cellular signalling pathways involved in hair follicle biology. Although some PG core proteins have previously been described in adult human hair follicles, their glycosaminoglycan (GAG) moieties have been less studied.
Acute asthma among adults presenting to the emergency department: the role of race/ethnicity and socioeconomic status.

OBJECTIVES To investigate racial/ethnic differences in acute asthma among adults presenting to the emergency department (ED), and to determine whether observed differences are attributable to socioeconomic status (SES). DESIGN Prospective cohort studies performed during 1996 to 1998 by the Multicenter Airway Research Collaboration. Using a standardized protocol, researchers provided 24-h coverage for a median duration of 2 weeks per year. Adults with acute asthma were interviewed in the ED and by telephone 2 weeks after hospital discharge. PARTICIPANTS Sixty-four North American EDs. RESULTS A total of 1,847 patients were enrolled into the study. Black and Hispanic asthma patients had a history of more hospitalizations than did whites (ever-hospitalized patients: black, 66%; Hispanic, 63%; white, 54%; p < 0.001; patients hospitalized in the past year: black, 31%; Hispanic, 33%; white, 25%; p < 0.05) and more frequent ED use (median use in past year: black, three visits; Hispanic, three visits; white, one visit; p < 0.001). The mean initial peak expiratory flow rate (PEFR) was lower in blacks and Hispanics (black, 47%; Hispanic, 47%; white, 52%; p < 0.001). For most factors, ED management did not differ based on race/ethnicity. After accounting for several confounding variables, blacks and Hispanics were twice as likely to be admitted to the hospital. Blacks and Hispanics also were more likely to report continued severe symptoms 2 weeks after hospital discharge (blacks, 24%; Hispanic, 31%; white, 19%; p < 0.01). After adjusting for sociodemographic factors, the race/ethnicity differences in initial PEFR and posthospital discharge symptoms were markedly reduced. CONCLUSION Despite significant racial/ethnic differences in chronic asthma severity, initial PEFR at ED presentation, and posthospital discharge outcome, ED management during the index visit was fairly similar for all racial groups. SES appears to account for most of the observed acute asthma differences, although hospital admission rates were higher among black and Hispanic patients after adjustment for confounding factors. Despite asthma treatment advances, race/ethnicity-based deficiencies persist. Health-care providers and policymakers might specifically target the ED as a place to initiate interventions designed to reduce race-based disparities in health.
El Fenómeno de los NiNis en América Latina

En los ultimos anos, y en todos los paises de la region, se ha ido incrementando la preocupacion por la situacion de los jovenes que ni se encuentran insertos en el sistema educativo ni se han integrado al mercado laboral (los llamados “NiNis”). El crecimiento de dicha preocupacion podria considerarse sorpresivo, en la medida que en los anos recientes la mayoria de los paises de la region disfruto de notables mejoras socioeconomicas: mercados laborales mas dinamicos e inclusivos, reducciones en las tasas de pobreza y desigualdad, crecimiento de la matricula escolar, etc. El aporte de este trabajo es un analisis empirico detallado de las caracteristicas de los NiNis y de las posibles razones detras del creciente interes que despierta este fenomeno. Los resultados muestran que varios aspectos de la situacion de los jovenes en la region pueden estar contribuyendo a dicho interes: 1) la reduccion en la incidencia porcentual del fenomeno NiNi entre 1992-2014 fue relativamente pequena e insuficiente para provocar una caida significativa en el numero absoluto de NiNis en el periodo; 2) en los ultimos anos (desde 2008) parece existir un estancamiento en el porcentaje de NiNis; y 3) la composicion de los NiNis se ha ido modificando en el tiempo, siendo en la actualidad mayor la participacion en este grupo de los varones, los que pueden definirse como los NiNis “mas visibles”.
Chronic Conditions May Be More Important Than Race or Ethnicity in Relation to Health Information Seeking and Use

Objective: This research examines health information (HI) seeking and use among middle-aged and older adults with chronic health conditions. Method: We used logistic regression models to analyze HI seeking (N = 7,822) and use (N = 4,541-4,547) among participants (aged 45+ years) with chronic conditions from the nationally-representative Health Tracking Household Survey. Results: Adults aged 45+ years with chronic conditions were significantly more likely to seek and use HI; however, these results varied based on the age and education. Compared with Whites, Latinos were less likely to seek HI but more likely to use HI to treat illness, and African Americans were more likely to use HI to maintain health. Conclusion: Middle-aged and older adults with chronic conditions are prominent HI seekers and users. Proficient HI seeking and use may have the potential to enhance control over one’s own health, maintain independence in the community, and reduce the impact of negative health consequences on the health care system.
Review Article: Mapping of children’s health and development data on population level using the classification system ICF-CY

Aim: The aim of this study was to investigate if essential health and development data of all children in Sweden in the Child Health Service (CHS) and School Health Service (SHS) can be linked to the classification system International Classification of Functioning, Disability and Health — Children and Youth (ICF-CY). Method: Lists of essential health terms, compiled by professionals from CHS and SHS, expected to be used in the national standardised records form the basis for the analysis in this study. The essential health terms have been linked to the codes of ICF-CY by using linking rules and a verification procedure. Results: After exclusion of terms not directly describing children’s health, a majority of the health terms could be linked into the ICF-CY with a high proportion of terms in body functions and a lower proportion in activity/participation and environment respectively. Some health terms had broad description and were linked to several ICF-CY codes. The precision of the health terms was at a medium level of detail. Conclusion: ICF-CY can be useful as a tool for documenting child health. It provides not only a code useful for statistical purposes but also a language useful for the CHS and SHS in their work on individual as well as population levels. It was noted that the health terms used by services mainly focused on health related to body function. This indicates that more focus is needed on health data related to child’s functioning in everyday life situations.
Therapeutic Modulation of Signal Transduction Pathways

Inflammatory bowel disease (IBD) is a chronic, relapsing inflammatory disorder of the gastrointestinal tract, which arises from inappropriate activation of the immune system. The inflammatory response is characterized by overproduction of immune cells, inflammatory cytokines, and tissue-destructive enzymes. IBD is treated with conventional (immunosuppressive) drugs and relatively new therapeutics, such as antiTNF. Anti-TNF medication targets and neutralizes TNF molecules, which are extra cellular mediators of inflammation. Available drugs lighten many of the symptoms of disease. However, they generally do not interfere with the underlying mechanisms, are relatively non-selective and have dose-limiting side effects. Disease relapse remains also a problem with current drug options. For these reasons, new therapeutic modalities are needed in the field of inflammatory pathology. In the last decade, much is learned about underlying pathogenic mechanisms of these diseases and this created new therapeutic options. As a result, attention has shifted toward modulation of intracellular signaling pathways for several chronic inflammatory disorders, such as psoriasis, asthma, pancreatitis, rheumatoid arthritis and IBD. There have been described many signaling pathways, that play a crucial role in inflammatory pathology. These intracellular signaling pathways connect the extracellular environment to the process of gene transcription. We distinguish two major pathways of transcription factor activation, which is shown in Figure 1. 1 The first group consists of latent cytoplasmic transcription factors, which are directly activated upon receptor-ligand interaction. The second group includes intracellular phophorylation cascades. These signaling cascades contain various protein kinases, which can activate downstream target molecules, such as transcription factors.