Miracle-dz/UniFAR-FTUs huggingface dataset:
A prospective randomized trial on abacavir/lamivudine plus darunavir/ritonavir or raltegravir in HIV-positive drug-naïve patients with CD4<200 cells/uL (the PRADAR study)

Background Very few data are available on treatment in HIV Late presenter population that still represents a clinical challenge. Methods Prospective, multicenter, randomized open-label, 2 arm, phase-3 trial comparing the 48-week virological response of two different regimens: abacavir/lamivudine + darunavir/r vs abacavir/lamivudine + raltegravir in antiretroviral naive with CD4+ counts < 200/mm3 and a viral load (VL)<500,000 copies/mL. The primary Endpoint was the proportion of patients with undetectable viremia (VL<50 copies/mL) after 48 weeks. The planned sample size for this trial was 350 patients. Results In 3 years, 53 patients were screened and 46 enrolled: 22 randomized to raltegravir and 24 to darunavir/r; 7 patients were excluded, 4 because of a VL >500,000 copies/mL and 3 for HLAB5701 positivity. The snapshot analysis at 48 weeks showed a virologic success of 77.3% in raltegravir and 66.7% in darunavir/r. Time to starting treatment was 34.5 days in raltegravir and 53 days in darunavir/r. At the as treated analysis, the median CD4 counts at 48 weeks was 297 cells/μL in raltegravir and 239 cells/μL in darunavir/r. No difference in total cholesterol, while triglycerides were higher in the darunavir/r arm. No statistical analyses were performed due to the low number of patients enrolled. Conclusions Late presenter patients are frequent but very difficult to enroll in clinical trials, especially in western countries. These regimens and the conditions of many patients could not allow the test and treat strategy. The rate of virologic success was higher than 65% in both arms with a median CD4 cell count >200/μL at week 48. Trial registration EUDRACT number: 2011-005973-21
Why are Chinese workers so unhappy? A comparative cross-national analysis of job satisfaction, job expectations, and job attributes

Using data from the 2015 International Social Survey Program (ISSP), this study conducts a multinational comparison of job satisfaction determinants and their drivers in 36 countries and regions, with particular attention to the reasons for relatively low job satisfaction among Chinese workers. Based on our results from a Blinder-Oaxaca decomposition analysis, we attribute a substantial portion of the job satisfaction differences between China and the other countries to different job attributes and expectations; in particular, to unmet job expectations for interesting work, high pay, and opportunities for advancement. We also note that, contrary to common belief, Chinese workers value similar attributes as Western workers but perceive their work conditions as very different from those in the West.
Tumorigenesis and Neoplastic Progression Down-Regulation of DUSP 6 Expression in Lung Cancer Its Mechanism and Potential Role in Carcinogenesis

Koji Okudela,* Takuya Yazawa,* Tetsukan Woo, Masashi Sakaeda,* Jun Ishii,* Hideaki Mitsui,* Hiroaki Shimoyamada,* Hanako Sato,* Michihiko Tajiri, Nobuo Ogawa, Munetaka Masuda, Takashi Takahashi, Haruhiko Sugimura, and Hitoshi Kitamura* From the Departments of Pathology* and Surgery, Yokohama City University Graduate School of Medicine, Yokohama; the Division of General Thoracic Surgery, Kanagawa Cardiovascular and Respiratory Disease Center Hospital, Yokohama; the Department of Anatomy, St. Marianna University School of Medicine, Kawasaki; the Division of Molecular Carcinogenesis, Center for Neurological Disease and Cancer, Nagoya University Graduate School of Medicine, Nagoya; and the Department of Pathology, Hamamatsu Medical University, School of Medicine, Hamamatsu, Japan
Immunopathology and Infectious Diseases Viral RNA Induces Type I Interferon-Dependent Cytokine Release and Cell Death in Mesangial Cells via Melanoma-Differentiation-Associated Gene-5 Implications for Viral Infection-Associated Glomerulonephritis

Viral RNA can trigger interferon signaling in dendritic cells via the innate recognition receptors melanomadifferentiation-associated gene (MDA)-5 and retinodinducible gene (RIG)-I in the cytosol or via Toll-like receptors (TLRs) in intracellular endosomes. We hypothesized that viral RNA would also activate glomerular mesangial cells to produce type I interferon (IFN) via TLR-dependent and TLR-independent pathways. To test this hypothesis, we examined Toll/Interleukin-1 receptor domain-containing adaptor-inducing interferon(TRIF)-deficient mice, which lack a key adaptor for TLR3 signaling. In primary mesangial cells, poly I:C RNA-mediated IFNinduction was partially TRIF dependent; however, when poly I:C RNA was complexed with cationic lipids to enhance cytosolic uptake, mesangial cells produced large amounts of IFNand IFNindependent of TRIF. Mesangial cells expressed RIG-I and MDA-5 and their mitochondrial adaptor IFNpromoter stimulator-1 as well, and small interfering RNA studies revealed that MDA5 but not RIG-I was required for cytosolic poly I:C RNA signaling. In addition, mesangial cells produced Il-6 on stimulation with IFNand IFN, suggesting an autocrine proinflammatory effect. Indeed, blockade of IFNor lack of the IFNA receptor reduced viral RNA-induced Il-6 production and apoptotic cell death in mesangial cells. Furthermore, viral RNA/cationic lipid complexes increased focal necrosis in murine nephrotoxic serum nephritis in association with increased renal mRNA expression of IFN-related genes. Thus, TLR-independent recognition of viral RNA is a potent inducer of type I interferon in mesangial cells, which can be an important mediator of virally induced glomerulonephritis. (Am J Pathol 2009, 175:2014–2022; DOI: 10.2353/ajpath.2009.080585)
Somatization and health seeking behavior

Background: Somatization is the state of being symptomatic which is not explained medically associated with psychological distress and health-seeking behavior and is present in at least 10% to 15% in OPD. Methods: 50 patients with long standing history of MUS were evaluated by using modified Bradford inventory. Results: Somatization was most common in younger age, female and lower socio-economical class. Feeling of weakness or lack of energy much of the time in both male and female respectively 94.7% and 96.7% are the most common symptomatic presentation in Somatization during last 2 years, although there were symptomatic differences in males and females. Severity of symptoms was higher among females. 13% of female pts had undergone hysterectomy due to persistent gynecological problems during course of illness. 82% pts had illness of more than 2 years. The mean duration of illness at the time of assessment was 6.8 years. Most of the patients had visited to multiple consultants and underwent many costly diagnostic procedures for their symptoms . Most of the patients after multiple investigations and consultations were not ready to accept psychological origin of their physical illness and continued to see next practitioner as they remained dissatisfied and distressed. One or more physical illness is the common explanation by physicians. Patients presented with somatization has an another diagnosis in significant cases like Major depressive disorder, anxiety disorder, alcohol use disorder. Conclusion: Somatization was common among female, but it was not uncommon in male. Patient suffering from somatization disorder has very high rate of health care utilization and they perceived themselves as severely ill and were willing to undergo multiple hospitalizations, diagnostic studies, and operations, remained dissatisfied. Need to strengthened consultation liaison between physician and psychiatrist.
All you need to know about innovation in healthcare: The 10 best reads

Abstract Drawing on the vast extant literature on innovation, we propose a top 10 of best reads all healthcare managers should familiarize themselves with. A Delphi study has been conducted to identify and select the 10 most relevant and informative scientific writings, which can add significantly to the knowledge of managers by offering an introduction in the academic discussion on this topic. Our must-read list provides a broad but still meaningful overview, which aims for generalizability but maintains a level of precision which can generate clear, implementable ideas; it is a mix between a theory and conceptualization of innovation and practical evidence and advice. We distinguish between four main dimensions of innovation in healthcare: the why, the what, the how, and the who. While fairly comprehensive in itself, for those interested our list can also constitute a stepping stone towards the more technical academic analyses on innovation processes and dynamics.
Vascular Biology, Atherosclerosis and Endothelium Biology Circulating Monocytes Expressing CD31 Implications for Acute and Chronic Angiogenesis

To identify the roles of various circulating cells (eg, endothelial and/or stem and progenitor cells) in angiogenesis, we parabiosed a wild-type syngeneic mouse with a transgenic syngeneic green fluorescent protein mouse. Following the establishment of a common circulation between these parabionts, we investigated acute (7 to 10 days), subacute (2 to 3 weeks), and chronic (4 to 6 weeks) phases of angiogenesis in wild-type mice using wound healing, implanted gel foam fragments, and subcutaneous tumor assays, respec-tively. We found that under in vitro conditions, circulating murine monocytes expressed F4/80, CD31, and vascular endothelial growth factor receptor 2, but neither CD133 nor von Willebrand factor, whereas murine endothelial cells expressed CD31, vascular endothelial growth factor receptor 2, and von Willebrand factor, but neither CD133 nor F4/80. Immunofluorescence analysis revealed that green fluorescent protein-positive cells in the walls of new vessels in wounds, gel foam blocks, and tumors expressed both F4/80 and CD31, that is, macrophages. Pericytes, cells that express both CD31 and desmin, were found both in the walls of tumor-associated vessels and within tumors. Collectively, these data demonstrate that monocytes (ie, cells that express both CD31 and F4/80) may be recruited to the site of tissue injury and directly contribute to angiogenesis, re-affirming
How good is that test?

In Chapter 12 we looked at probabilities of independent events – things that had nothing to do with one another. Here we think about probabilities in situations where we expect to see connections, such as in screening tests for diseases or DNA evidence for guilt in a criminal trial. Goal 13.1. Interpret and buid two way contingency tables. Goal 13.2. Understand how to compute probabilities for dependent events. Table 13.1 summarizes student enrollment at UMass Boston in 2006 by category two ways: graduate/undergraduate and male/female. We can use the data to answer some probability questions about the a random student. • What is the probability that a student chosen at random is an undergraduate? 1 See comment in instructor's manual. 2 This is real data, but not generally interesting. It's here to illustrate some important ideas – we hope to replace it with a better example for that purpose.
25-OH vitamin D3 concentrations in Chinese, Malays, and Indians.

With increasing recognition of the importance of vitamin D deficiency as a risk factor in many common diseases, such as malignancy, diabetes, and cardiovascular disease, there has been growing interest in studies to assess vitamin D concentrations in different populations. Measurement of 25-hydroxyvitamin D (25-OH-D) is accepted as the best estimate of vitamin D status. More than 95% of 25-OH-D is typically 25-OH vitamin D3 (25-OH-D3), with 25-OH vitamin D2 reaching measurable concentrations only in patients taking vitamin D2 supplements (1). Much of the interest in vitamin D status has concentrated on seasonal variation in populations living at high latitudes, with little work done in populations living closer to the equator, perhaps under the assumption that vitamin D deficiency is unlikely in regions of plentiful sunshine. This study describes the range of 25-OH-D3 concentrations seen in a multiethnic Asian population living close to the equator. We measured 25-OH-D3 concentrations in 240 anonymized leftover fasting venous serum samples from apparently healthy ambulatory outpatients undergoing health screening (40 …
Immunopathology and Infectious Diseases IL-4 R Responsiveness of Non-CD 4 T Cells Contributes to Resistance in Schistosoma mansoni Infection in PanT Cell-Specific IL-4 R-Deficient Mice

Interleukin (IL)-4 and IL-13 are T helper 2 cytokines whose biological functions are induced through a common IL-4 receptor chain (IL-4R ). CD4 T cellspecific IL-4R -mediated signaling drives susceptibility to Leishmania major infection, but is not essential to host survival following Schistosoma mansoni infection. Here we generated a novel mouse model lacking IL-4R expression specifically on all T cells (iLckIl4ra ), which was compared with CD4 T cell-specific IL-4R -deficient mice (LckIl4ra ), to investigate the possible roles of IL-4R responsive non-CD4 T cells during either L. major or S. mansoni infection. Our results demonstrate a successful generation of transgene-bearing hemizygous iLckIl4ra /lox BALB/c mice that have effective deletion of IL-4R on all T-cell populations. We show that iLckIl4ra /lox mice infected with L. major developed a healing disease phenotype as previously observed in LckIl4ra /lox mice, demonstrating that absence of IL-4R -responsive nonCD4 in addition to CD4 T cells does not further affect transformation of BALB/c to a healer phenotype. In acute schistosomiasis, however, iLckIl4ra /lox mice showed enhanced mortality compared with Il4ra /lox and LckIl4ra /lox mice. iLckIl4ra /lox mice died with similar kinetics to highly susceptible Il4ra / mice, despite controlling gut inflammation. In addition, iLckIl4ra /lox mice presented increased liver granuloma sizes, as compared with LckIl4ra /lox mice, with similar eosinophils, fibrosis, and liver damage. In conclusion, IL-4R -responsive non-CD4 T cells prolong survival to acute schistosomiasis and contribute to the better control of hepatic granulomatous inflammation. (Am J Pathol 2009, 175:706–716; DOI: 10.2353/ajpath.2009.090137)
Evaluation of the Quo-Test hemoglobin A1c point-of-care instrument: second chance.

We previously reported the evaluation of 8 different hemoglobin A1c (Hb A1c)1 point-of-care instruments (1). Two of 8 manufacturers withdrew from that study after initial unpromising results. One of the 2 instruments withdrawn was the Quo-Test A1c (Quotient Diagnostics), which was withdrawn because of a technical problem. The manufacturer claimed to have resolved the problem and asked us to reevaluate the instrument. The Quo-Test method is based on affinity separation and the use of fluorescence quenching and gives results in 3 min. The instrument was certified by the National Gycohemoglobin Standardization Program (NGSP) as of September 2009 (2). We used the same approach for evaluation as in the initial study, following the CLSI EP-5 protocol for imprecision and the CLSI EP-9 protocol for method comparison. Because the American Diabetes Association has recommended Hb A1c as the preferred test for the diagnosis of diabetes (3), we added an additional sample of approximately 6.5% Hb A1c in the EP-5 protocol. The EP-9 protocol was performed twice with 2 different lot numbers and compared with 3 IFCC and NGSP secondary reference measurement procedures (SRM): the Roche Tina-quant Hemoglobin A1c Gen.2 on Cobas Integra …
Hormonal and Metabolic Effects of Short-term Energy Imbalance in Obese-Prone as Compared to Obese-Resistant Individuals

Background: While a majority of Americans are overweight, some individuals maintain a healthy weight in spite of fluctuations in energy intake. This study investigates hormonal and metabolic responses to short-term overfeeding and underfeeding in individuals recruited as obese-resistant (OR) or obese-prone (OP) based on self-identification, BMI, and personal/family weight history. Methods: 58 subjects were studied during eucaloric, overfeeding, and underfeeding phases which included a 3-day run-in diet, 1-day intervention diet, and a study day on which a test meal containing 25% of daily energy intake for the intervention diet was provided. Following the test meal, blood was sampled every 30 minutes for hormones and metabolites, and appetite was assessed using visual analog scales. Results: Overfeeding resulted in increased meal responses for insulin, leptin and triglycerides and decreased responses for ghrelin, glucose and free fatty acids (FFA), and underfeeding resulted in decreased insulin, PYY, GLP-1 and triglycerides and increased ghrelin and FFA responses. Ghrelin levels were higher and insulin levels were lower in the OR as compared to the OP, although these effects were attenuated by overfeeding and underfeeding, respectively. Furthermore, there were greater correlations between appetite ratings and appetite-related hormones in the OR. Conclusions: Few studies have assessed hormonal effects of underfeeding, which here was found to result in decreased insulin, PYY and GLP-1, and increased ghrelin. The greater correlations between appetite ratings and appetite-related hormones in the OR suggest that they are more sensitive to short-term energy imbalance and thus may be better able to adjust energy intake accordingly.
Self-Control and Substance Use Among College Students

Gottfredson and Hirschi’s self-control theory has generated considerable academic interest and become one of the most influential theories of the past 20 years. The current study seeks to confirm and extend this line of research by examining the generality of self-control across several forms of substance use: binge drinking, marijuana use, prescription drug misuse, and other illicit drug use. Data were collected from a sample of more than 1,000 undergraduate students attending a public university in the United States. Findings indicate that students with low self-control were at greater risk for reporting binge drinking, marijuana use, and prescription drug misuse. Further analysis indicates that the influence of self-control on substance use is moderated by opportunity and peer influence. That is, self-control was significantly correlated to binge drinking and marijuana use when students reported greater opportunity to use and also when they reported substance use by their friends.
Oral cancer diagnosis via a ferrocenylnaphthalene diimide-based electrochemical telomerase assay.

BACKGROUND Telomerase is regarded as a good marker for cancer because it is unregulated in most tumor cells compared with normal cells. We evaluated telomerase activity in the lysate of tumor tissue and surrounding cells of oral cancer patients by an electrochemical technique, dubbed the electrochemical telomerase assay (ECTA). METHODS The assay used ferrocenylnaphthalene diimide (FND) as the probe. Electrochemical telomerase substrate (ETS) primer immobilized on the electrode was elongated by telomerase and FND bound to the product to give rise to a current. The data were standardized with the change in current before and after the elongation, respectively. RESULTS The change in current increased more than 30% in biopsy samples from most cancer patients, whereas the increase was 20% or lower in most healthy individuals. On the basis of this difference individual clinical samples were judged telomerase positive, ambiguous, or negative. The positive rates in the cancerous tissues and exfoliated cells (EOCs) of the patients were 85% and 90%, respectively, whereas the corresponding values were 50% and 10% by the telomerase repeat amplification protocol. Furthermore, the positive rate for the ECTA was 100% in early tumors smaller than 2 cm, and 95% and 82% of biopsy and exfoliated cells of healthy individuals were correctly judged as negative. Fifty-six unknown samples with EOCs tested were correctly judged to be cancerous or normal in 84% of cases. CONCLUSIONS The ECTA yielded high hit rates for cancerous and normal cells, especially in EOCs, results indicating that this minimally invasive test is suitable for oral cancer diagnosis.
Mathematical modelling of the effectiveness of two training interventions on infectious diseases in Uganda

Nurses, midwives and clinical officers referred to as Mid-level Practioners (MLPs) play an important role in the health care system especially in rural Africa. With particular reference to rural Uganda, due to the large shortage of doctors, MLPs handle most of the duties usually meant for doctors, at health centre IV(s). From 2009 to 2011, two training interventions of MLPs were performed at 36 sites in Uganda by the Integrated Infectious Disease Capacity Building Evaluation (IDCAP). The two interventions were: Integrated Management of Infectious Diseases (IMID) and On-site Support Services (OSS) which aimed at improving MLPs’ case management for four diseases: HIV, TB, pneumonia and malaria. In this thesis, we have developed three mathematical models to investigate the effect of the two training interventions on these infectious diseases. All the models are formulated using systems of ordinary differential equations which are structured in three age groups: [0, 5), [5, 14) and [14, 50). We explored the effect of the two training interventions in the context of malaria-pneumonia, HIV-TB co-infections and the four diseases together. Our analysis shows that: i) For malaria-pneumonia, both IMID and the combination of IMID and OSS reduce the number of cases, deaths and prevalence of disease but have no effect on the incident episodes of disease. ii) Results from the HIVTB model propose that HIV and TB testing are important steps in quality of health care and are capable of offsetting slightly negative effects of reduction in ART enrollment and provision of treatment. iii) The HIV-TB-malaria-pneumonia (HTMP) model concurs with the results of the first two models and its results demonstrate that high coverage levels of the training interventions increase the positive effects that the interventions have on mortality and morbidity. Overall, our results suggest that training of MLPs is much more effective for the short term duration diseases such as malaria and pneumonia, where the baseline values for most of the performance indicators are ≥ 0.6, but not so much for long term duration diseases such as HIV and TB, whose baseline values for most of the performance indicators are < 0.6. The results further highlight that problems such as case detection and drug stock-outs need to be addressed in order for training to have substantial impact, especially in instances where the performance indicator proportions are low. Stellenbosch University http://scholar.sun.ac.za