Miracle-dz/UniFAR-FTUs huggingface dataset:
Body Composition and Diabetes Risk in South Asians: Findings From the MASALA and MESA Studies

OBJECTIVE South Asians have a higher prevalence of type 2 diabetes compared with other race/ethnic groups. Body composition is associated with the risk for type 2 diabetes. Differences in body composition between South Asians and other race/ethnic groups are one hypothesized mechanism to explain the disproportionate prevalence of type 2 diabetes in this population. RESEARCH DESIGN AND METHODS This study used data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) and the Multi-Ethnic Study of Atherosclerosis (MESA) cohorts to determine whether body composition mediated the elevated prevalence of impaired fasting glucose and type 2 diabetes in South Asians. Participants (n = 2,615) with complete body composition data were included. Ordinal logistic regression models were calculated to determine the odds for glycemic impairment in South Asians compared with the MESA cohort. RESULTS In multivariate models, South Asians had a significantly higher prevalence of glycemic impairment and type 2 diabetes compared with all four race/ethnic groups included in the MESA (P < 0.001 for all). In unadjusted and multivariate adjusted models, South Asians had higher odds for impaired fasting glucose and type 2 diabetes compared with all other race/ethnic groups (P < 0.001 for all). The addition of body composition measures did not significantly mitigate this relationship. CONCLUSIONS We did not identify strong evidence that accounting for body composition explains differences in the risk for type 2 diabetes. Future prospective studies of the MESA and MASALA cohorts are needed to understand how adipose tissue impacts the risk for type 2 diabetes and how to best assess this risk.
Is There an End in Sight for Encapsulating Peritoneal Sclerosis?

Encapsulating peritoneal sclerosis (EPS) was first described by Gandhi et al. (1). Encapsulating peritoneal sclerosis carries high morbidity and morbidity due to abdominal pain and nutritional problems. The mortality from this condition has been estimated to be 50%, although better results have been recently reported from tertiary surgical centers (2). Epidemiological studies have been derived from various registries such as Scottish, Pan-Thames (south-east England), Netherlands, Australia-New Zealand, and Japan (3–6). There is consensus that EPS is very rare in people who were on peritoneal dialysis (PD) for less than 3 – 4 years. For those with PD exposure below 1 year, the incidence approaches 0, and for those below 3 years, it is less than 1%. However, the percentage steadily rises as the duration of PD goes beyond 3 – 5 years (8% being at the high end; Scottish Registry (4)). There is the golden truth that prevention is better than cure. To “prevent” this disease, should we limit PD exposure to our patients (e.g. to 5 years)? This question was addressed in a Position Statement by the International Society of PD (ISPD) (7) and concludes that there is not enough evidence to withhold PD because of the fear of EPS, nor should there be a single rule about optimal length of time on PD to avoid the risk of EPS. The subtext of the ISPD position statement is:
Methionine Augments Antioxidant Activity of Rice Protein during Gastrointestinal Digestion

To elucidate the influence of methionine, which is an essential sulfur-containing amino acid, on the antioxidant activity of rice protein (RP), methionine was added to RP (RM). The addition of methionine to RM0.5, RM1.0, RM1.5, RM2.0, and RM2.5 was 0.5-, 1.0-, 1.5-, 2.0-, and 2.5-fold of methionine of RP, respectively. Using the in vitro digestive system, the antioxidant capacities of scavenging free radicals (superoxide; nitric oxide; 2,2′-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt, ABTS), chelating metal (iron), and reducing power were investigated in the hydrolysates of RP and RMs. Upon pepsin-pancreatin digestion, the weakest antioxidant capacity was produced by RP. With the addition of methionine, RMs exhibited more excellent responses to free radical scavenging activities and reducing power than RP, whereas RMs did not produce the marked enhancements in iron chelating activity as compared to RP. The present study demonstrated that RMs differently exerted the free radical scavenging activities that emerged in the protein hydrolysates, in which the strongest scavenging capacities for ABTS, superoxide, and nitric oxide were RM1.5, RM2.0, and RM2.5, respectively. Results suggested that the availability of methionine is a critical factor to augment antioxidant ability of RP in the in vitro gastrointestinal tract.
Mapping of the Retrotransposable Elements Rex1 and Rex3 in Chromosomes of Eigenmannia (Teleostei, Gymnotiformes, Sternopygidae)

Transposable elements constitute a remarkable fraction of the eukaryote genome and show particular capacity to move and insert in specific regions of the genome. This study identified the retrotransposable elements Rex1 and Rex3 in the genomes of 6 cytotypes of Eigenmannia. The sequences were isolated by PCR, sequenced and physically mapped in the chromosomes of these cytotypes, aiming to investigate the organization and distribution of these elements in this fish group, mainly in the sex chromosomes. The FISH physical mapping revealed that both Rex1 and Rex3 elements are dispersed in small clusters throughout the chromosomes of all cytotypes analyzed. However, conspicuous blocks occur in several samples, including an accentuated accumulation of the Rex3 element in X1 and X2 chromosomes of Eigenmannia sp. 2 and in the X chromosome of E. virescens. The accumulations are coincident with heterochromatin-rich regions, suggesting that Rex3 played a role in the differentiation process of the sex chromosomes.
Indirect Effects of 10-Valent Pneumococcal Conjugate Vaccine Against Adult Pneumococcal Pneumonia in Rural Western Kenya.

BACKGROUND Data on pneumococcal conjugate vaccine (PCV) indirect effects in low-income countries with high HIV burden are limited. We examined adult pneumococcal pneumonia incidence before and after 10-valent PCV introduction in Kenya in 2011. METHODS From 1/1/2008 to 12/31/2016, we conducted surveillance for acute respiratory infection (ARI) among ~12,000 adults (≥18 years) in western Kenya, where HIV prevalence ~17%. ARI cases (cough or difficulty breathing or chest pain, plus temperature ≥38.0 ◦C or oxygen saturation <90%) presenting to a clinic underwent blood culture and pneumococcal urine antigen testing (UAT). We calculated ARI incidence and adjusted for healthcare seeking using data from household visits. The proportion of ARI cases with pneumococcus detected among those with complete testing (blood culture and UAT) was multiplied by adjusted ARI incidence to estimate pneumococcal pneumonia incidence. RESULTS Pre-PCV (2008-2010), crude and adjusted ARI incidence were 3.14 and 5.30/100 person-years-observation (pyo), respectively. Among ARI cases, 39.0% (340/872) had both blood culture and UAT; 21.2% (72/340) had pneumococcus detected, yielding baseline pneumococcal pneumonia incidence of 1.12/100 pyo (95% confidence interval [CI] 1.0-1.3). In each post-PCV year (2012-2016), pneumococcal pneumonia incidence was significantly lower than baseline; with incidence rate ratios (IRR) of 0.53 (95%CI 0.31-0.61) in 2012 and 0.13 (95%CI 0.09-0.17) in 2016. Similar declines were observed in HIV-infected (IRR 0.13, 95%CI 0.08-0.22), and HIV-uninfected (IRR 0.10, 95%CI 0.05-0.20). CONCLUSIONS Adult pneumococcal pneumonia declined in western Kenya following 10-valent PCV introduction, likely reflecting vaccine indirect effects. Evidence of herd protection is critical for guiding PCV policy decisions in resource-constrained areas.
Amyotrophic lateral sclerosis mortality rates in Chile: A population based study (1994–2010)

Our objective was to describe amyotrophic lateral sclerosis (ALS) mortality rates in the Chilean population over a 17-year period. Chilean death records (1994–2010) were reviewed for the ICD-10 diagnosis G.12. 2 (including motor neuron disease and similar conditions), and weighted with population data. Crude and standardized mortality rates by ALS were calculated at the nationwide level and by geographic zone. A risk analysis was performed in successive cohorts from 1910–1919 to 1960–1969, comparing mortality slopes. One thousand six hundred and seventy-one deaths were recorded during 1994–2010, with an average of 1.13 per 100,000, a 1.2:1 male/female ratio, and a statistically significant increase in mortality rate. According to geographical distribution, the Austral area, with a larger population of European origin, showed higher mortality rates compared to the national average. The cohort analysis showed an increasing risk of dying from ALS for all cohorts, and highest above 64 years of age, becoming a competitive cause of death in older ages. In conclusion, as expected, the mortality rate in Chile by ALS is higher than that reported previously in our country, and similar to other Latin American countries. ALS mortality rate has increased over time probably due to the aging of the population and decline in rates for competing causes of death.
Increased irisin versus reduced fibroblast growth factor1 (FGF1) in relation to adiposity, atherogenicity and hematological indices in metabolic syndrome patients with and without prediabetes

Abstract Background Irisin and fibroblast growth factor 1 (FGF1) are intricately involved in metabolic syndrome (MetS) and prediabetes (preDM) pathophysiology. This study aimed to compare and correlate irisin and FGF1 plasma levels, adiposity, atherogenicity and hematological indices in 29 normoglycemic MetS and 30 newly diagnosed drug naive prediabetic (PreDM) MetS patients vs. 29 lean and normoglycemic controls. Materials and methods Irisin and FGF1 plasma levels were measured using colorimetric assays. Intergroup comparisons were conducted by analysis of variance (ANOVA). Spearman’s rank correlation was also examined. Results The mean circulating irisin levels (ng/mL) were significantly higher in the normoglycemic (but not prediabetic) MetS group (p < 0.01), while the mean circulating FGF1 levels (pg/mL) were markedly lower in the prediabetic (but not normoglycemic) MetS group (p < 0.05). Of note unlike FGF1, irisin in the MetS (both normoglycemic and prediabetic;N=59) groups correlated significantly and positively with each of waist circumference (WC), hip circumference (HC), body mass index (BMI), body adiposity index (BAI) and high-density lipoprotein-cholesterol (HDL-C) but not the non-HDL-C. Distinctively MetS-irisin negatively associated with the non-HDL-C/HDL-C ratio, total cholesterol (TC)/HDL-C ratio and the low-density lipoprotein-cholesterol (LDL-C)/HDL-C ratio, but positively with the red cell distribution width (RDW). In the same pool of 59 MetS reruits; Neither biomarker had a relationship with the visceral adiposity index (VAI), the lipid accumulation product (LAP), the conicity index (CI), the waist-hip ratio (WHR), the waist-to-height ratio (WHtR), the blood ratios or the atherogenicity index of plasma (AIP). Conclusions As any potential molecular crosstalk of irisin and FGF1 in MetS or its related dysregularities cannot be ruled out; Conversely the utility of irisin and FGF1 as surrogate prognostic biomarkers and putative pharmacotherapeutic targets in the predtion/prevention/management of diabetes and MetS is strongly suggested.
Promoting Breast Cancer Awareness and Screening Practices for Early Detection in Low-Resource Settings.

Objective Breast cancer is the most common type of cancer among women in the Philippines. Philippines has one of the highest breast cancer mortality rate and the lowest mortality-to-incidence ratio in Asia. This study has three objectives: 1) explore Filipino women's knowledge, attitudes toward, and practices of breast cancer and cancer screening, 2) examine if an educational program increases women's intention to seek future breast cancer screening, and 3) examine associations between demographic variables and breast cancer screening practices. Materials and Methods A total of 944 women from two urban areas (Calasciao and Tacloban City) and one rural area (Sogood) of the Philippines participated in this cross-sectional study. Study participants attended an educational program and completed study questionnaires regarding demographics, knowledge about, and practices of breast self-exams, clinical breast exams and mammography as well as reported barriers toward future screening. Results The results showed a disparity between knowledge of routine breast cancer screening and actuals screening behaviors. Following breast health education and screening programs, participants reported greater intention to adhere to recommended breast cancer screening guidelines. The multivariate analyses showed that education level is a significant predictor for CBE and mammography uptake in current study. Conclusion This study has implications for breast cancer control among women in low-resources settings. Designing and implementing effective educational programs that increase women's awareness about breast cancer and promote screening uptake are important steps to reduce the burden affected by breast cancer among women in the Philippines and other South Asian low- to middle-income countries.
Rapamycin and CHIR99021 Coordinate Robust Cardiomyocyte Differentiation From Human Pluripotent Stem Cells Via Reducing p53‐Dependent Apoptosis

Background Cardiomyocytes differentiated from human pluripotent stem cells can serve as an unexhausted source for a cellular cardiac disease model. Although small molecule–mediated cardiomyocyte differentiation methods have been established, the differentiation efficiency is relatively unsatisfactory in multiple lines due to line‐to‐line variation. Additionally, hurdles including line‐specific low expression of endogenous growth factors and the high apoptotic tendency of human pluripotent stem cells also need to be overcome to establish robust and efficient cardiomyocyte differentiation. Methods and Results We used the H9–human cardiac troponin T–eGFP reporter cell line to screen for small molecules that promote cardiac differentiation in a monolayer‐based and growth factor–free differentiation model. We found that collaterally treating human pluripotent stem cells with rapamycin and CHIR99021 during the initial stage was essential for efficient and reliable cardiomyocyte differentiation. Moreover, this method maintained consistency in efficiency across different human embryonic stem cell and human induced pluripotent stem cell lines without specifically optimizing multiple parameters (the efficiency in H7, H9, and UQ1 human induced pluripotent stem cells is 98.3%, 93.3%, and 90.6%, respectively). This combination also increased the yield of cardiomyocytes (1:24) and at the same time reduced medium consumption by about 50% when compared with the previous protocols. Further analysis indicated that inhibition of the mammalian target of rapamycin allows efficient cardiomyocyte differentiation through overcoming p53‐dependent apoptosis of human pluripotent stem cells during high‐density monolayer culture via blunting p53 translation and mitochondrial reactive oxygen species production. Conclusions We have demonstrated that mammalian target of rapamycin exerts a stage‐specific and multifaceted regulation over cardiac differentiation and provides an optimized approach for generating large numbers of functional cardiomyocytes for disease modeling and in vitro drug screening.
Surgical treatment of moyamoya syndrome in patients with sickle cell anemia: outcome following encephaloduroarteriosynangiosis.

OBJECTIVES Children with sickle cell anemia (SCA) and moyamoya syndrome carry a significant risk of ischemic stroke. Given the success of encephaloduroarteriosynangiosis (EDAS) or pial synangiosis in the treatment of moyamoya disease, the purpose of this study was to examine whether it reliably and durably protected children with SCA and moyamoya syndrome against cerebrovascular complications. METHODS The authors retrospectively reviewed a series of 12 patients with SCA who developed clinical and/or radiological evidence of moyamoya syndrome and underwent EDAS. RESULTS Eleven patients (92%) presented following a cerebrovascular accident (CVA), transient ischemic attack (TIA), or seizure. Magnetic resonance (MR) imaging or angiography suggested moyamoya vascular changes, and cerebral angiography confirmed the diagnosis in all 12 patients. At the time of surgery, the median age was 12.3 years (range 6.8-19.4 years). Ten (83%) of 12 patients had a history of CVA, and 4 of these patients were compliant with a transfusion protocol at the time of their CVA. Bilateral (7 patients) or unilateral (5 patients) EDAS was performed without complications. The mean follow-up period was 46.8 months (range 8.1-106 months). During the follow-up period, 2 patients (16.7%) suffered cerebrovascular events. One patient, who was stroke-free preoperatively, suffered a CVA 3 weeks after the procedure. The other patient suffered a single left lower-extremity TIA 18 months following right-sided EDAS. She returned to her neurological baseline condition and remains stable 53 months postoperatively. Seven patients underwent follow-up angiography or MR angiography, and evidence of revascularization was noted in all cases. At this time, no patient has developed progressive disease requiring a contralateral procedure after unilateral EDAS. CONCLUSIONS The EDAS procedure is a safe and effective treatment option in patients with SCA who develop moyamoya syndrome.
First Case in Korea of Group B Streptococcus With Reduced Penicillin Susceptibility Harboring Amino Acid Substitutions in Penicillin-Binding Protein 2X

Ahram Yi, M.D., Chang-Ki Kim, M.D., Ph.D., Kouji Kimura, M.D., Ph.D., Yoshichika Arakawa, M.D., Ph.D., Mina Hur, M.D., Ph.D., Yeo-Min Yun, M.D., Ph.D., and Hee-Won Moon , M.D., Ph.D. Department of Laboratory Medicine, Green Cross Laboratories, Yongin, Korea; Seoul Clinical Laboratories, Yongin, Korea; Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
Extracellular Vesicles from Thyroid Carcinoma: The New Frontier of Liquid Biopsy

The diagnostic approach to thyroid cancer is one of the most challenging issues in oncology of the endocrine system because of its high incidence (3.8% of all new cancer cases in the US) and the difficulty to distinguish benign from malignant non-functional thyroid nodules and establish the cervical lymph node involvement during staging. Routine diagnosis of thyroid nodules usually relies on a fine-needle aspirate biopsy, which is invasive and often inaccurate. Therefore, there is an urgent need to identify novel, accurate, and non-invasive diagnostic procedures. Liquid biopsy, as a non-invasive approach for the detection of diagnostic biomarkers for early tumor diagnosis, prognosis, and disease monitoring, may be of particular benefit in this context. Extracellular vesicles (EVs) are a consistent source of tumor-derived RNA due to their prevalence in circulating bodily fluids, the well-established isolation protocols, and the fact that RNA in phospholipid bilayer-enclosed vesicles is protected from blood-borne RNases. Recent results in other types of cancer, including our recent study on plasma EVs from glioblastoma patients suggest that information derived from analysis of EVs from peripheral blood plasma can be integrated in the routine diagnostic tumor approach. In this review, we will examine the diagnostic and prognostic potential of liquid biopsy to detect tumor-derived nucleic acids in circulating EVs from patients with thyroid carcinoma.
Enhanced recovery after surgery in liver resection: current concepts and controversies

Enhanced recovery after surgery (ERAS) attenuates the stress response to surgery in the perioperative period and hastens recovery. Liver resection is a complex surgical procedure where the enhanced recovery program has been shown to be safe and effective in terms of postoperative outcomes. ERAS programs have been shown to be associated with lower morbidity, shortened postoperative stay, and reduced cost with no difference in mortality and readmission rates. However, there are challenges that are unique to hepatic resection such as safety after epidural catheterization and postoperative coagulopathy, intraoperative fluids and postoperative organ dysfunction, need for low central venous pressure to reduce blood loss, and non-lactate containing intravenous fluids. This narrative review briefly discusses these concerns and controversies and suggests revisiting some of the strong recommendations made by the ERAS society in light of the recent evidence.
Voltage-induced long-range coherent electron transfer through organic molecules

Significance Charge transfer through organic molecules is extensively studied theoretically and experimentally owing to its importance in basic biological processes. Long-distance electron transport through such molecules, which are typically insulating, is commonly attributed to thermally activated hopping. We introduce an additional mechanism that supports electron transfer across appreciable distances, even at zero temperature. It originates from the electric potential that is either internally created or externally applied before charge flows. The electronic wavefunctions are dramatically changed by this potential, allowing them to efficiently mediate current. This mechanism can explain recent experiments where electron transfer shows only a weak temperature dependence. Our result is an important contribution to the long-standing challenge of developing a comprehensive theory for charge transfer through organic molecules. Biological structures rely on kinetically tuned charge transfer reactions for energy conversion, biocatalysis, and signaling as well as for oxidative damage repair. Unlike man-made electrical circuitry, which uses metals and semiconductors to direct current flow, charge transfer in living systems proceeds via biomolecules that are nominally insulating. Long-distance charge transport, which is observed routinely in nucleic acids, peptides, and proteins, is believed to arise from a sequence of thermally activated hopping steps. However, a growing number of experiments find limited temperature dependence for electron transfer over tens of nanometers. To account for these observations, we propose a temperature-independent mechanism based on the electric potential difference that builds up along the molecule as a precursor of electron transfer. Specifically, the voltage changes the nature of the electronic states away from being sharply localized so that efficient resonant tunneling across long distances becomes possible without thermal assistance. This mechanism is general and is expected to be operative in molecules where the electronic states densely fill a wide energy window (on the scale of electronvolts) above or below the gap between the highest-occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO). We show that this effect can explain the temperature-independent charge transport through DNA and the strongly voltage-dependent currents that are measured through organic semiconductors and peptides.