Miracle-dz/UniFAR-FTUs huggingface dataset:
Response to hepatitis A vaccine in HIV‐positive patients 1

Summary. The USPHS/IDSA guidelines for Prevention of Opportunistic Infections in Persons with human immunodeficiency virus (HIV) recommends that all susceptible HIV+ patients at increased risk for hepatitis A virus (HAV) or with chronic liver disease, be vaccinated against HAV. Immune response to HAV vaccine has not been well studied in HIV+ patients. In particular, there is little information in the literature regarding the effect and relationship of the CD4 count and the immune response in HIV patients. A retrospective analysis of HIV+ patients who received HAV vaccine was performed, and the antibody response to HAV (anti‐HAV) measured. Univariate and multivariate analyses were performed to determine predictors of response to vaccine administration. Of the 503 patients evaluated, 138 patients completed their HAV vaccination series and 48% of them had postvaccine anti‐HAV positive results (responders). There was no difference in age, race, antiretroviral therapy use, or hepatitis C virus exposure between responders and nonresponders. In univariate analysis, responders were more likely to be female (40.3%vs 21.1%, P = 0.01), have a higher CD4 count at vaccine (508.6 cells/mm3vs 344.3 cells/mm3, P = 0.001) and marginally lower viral load at vaccine (2.65 log copies vs 2.94 log copies, P = 0.07). Multivariate analysis showed that female gender and higher CD4 count at vaccine were independent predictors of response to vaccine. Forty‐eight per cent of our HIV+ patients responded to HAV vaccine administration. This is much lower than reported rates of 100% in HIV‐negative patients. Female gender and CD4 count at vaccine, but not CD4 nadir, predicted response to vaccine.
Understanding the inter‐relationship between improved glycaemic control, hypoglycaemia and weight change within a long‐term economic model

Background: Current guidelines for the management of type 2 diabetes advocate the attainment of sustained near normal glycaemia levels. Metformin is widely accepted as the treatment of choice for the initiation of pharmacotherapy; however, secondary failure of oral monotherapy occurs in 60% of patients resulting in the need for multiple pharmacotherapies. Therapy‐related consequences of treatment, such as weight gain and hypoglycaemia impact on the cost‐effectiveness profile of various agents. We therefore sought to ascertain the respective contribution of hypoglycaemia, weight change and improved blood glucose control on second‐line therapy options added to metformin.
[Validity and reliability of the Duke-UNC-11 questionnaire of functional social support].

OBJECTIVE The aim of this study is to analyse the validity and reliability of the functional social support questionnaire, Duke-UNC-11. DESIGN Descriptive. Crossover study. SETTING Urban health centre. PATIENTS 656 patients were interviewed in their homes. 60 had the questionnaire repeated (30 self-filled and 30 using an interviewer) an average of 6 days later. MEASUREMENTS AND MAIN RESULTS The intraclass correlation coefficients of the 11 items in the Duke-UNC-11 were above 0.50, for both self-filled and interviewer questionnaires; the ones on the scale were 0.92 and 0.80, respectively. The factorial analysis separated two sub-scales, confidential support (7 items) and affective support (4 items). Low social support was significantly associated to: being over 40, widowed or divorced, living alone, over-user, worse subjective health, greater chronic morbidity, mental health disorder and family dysfunction. The multiple linear regression equation managed to explain 30% of the variability of social support, in which family function (family APGAR) explained 23.5%, education 3.3%, perception of internal health control 2%, mental health 1.2% and perception of susceptibility to/seriousness of illness 0.3%. CONCLUSIONS The questionnaire Duke-UNC-11 is valid and reliable.
Maladaptive neural compensatory mechanisms in Bell's palsy-induced blepharospasm

We described four patients with Bell's palsy and blepharospasm and evaluated potential mechanisms that may be responsible for an apparent association between the two disorders. Eyelid movements in spontaneous blinks were studied by the search coil technique in patients with this novel disorder. Kinematic analyses documented bilateral eyelid spasm subsequent to unilateral Bell's palsy. The temporal interval between the onset of palsy and onset of blepharospasm was highly variable (weeks to >20 years). Changes in the relationship between spontaneous blink peak velocity and amplitude, the main sequence, shared features previously found in uncomplicated Bell's palsy and blepharospasm patients. Furthermore, as in patients with typical Bell's palsy and idiopathic blepharospasm, both normal blinks and spasms were conjugate in spite of interocular differences in blink amplitude/peak velocity. We suggest that there is a correlation between the eyelid palsy and subsequent blepharospasm, and have designated this potentially new disease entity as Bell's palsy-induced blepharospasm. We propose a two-stage model for Bell's palsy-induced blepharospasm in which blink adaptive systems may produce the maladaptive consequence of eyelid spasms.
Growth hormone and insulin combine to improve whole-body and skeletal muscle protein kinetics.

BACKGROUND A cooperative effect of exogenous insulin and recombinant human growth hormone (r-hGH) with respect to whole-body and skeletal muscle protein metabolism has not been demonstrated previously. This study examined the effect of r-hGH and insulin administration during euglycemic clamping and concurrent amino acid supplementation. METHODS Twenty-three normal volunteers in the postabsorptive state were either treated with r-hGH for 3 consecutive days before a metabolic study (GH group; n = 10) or not treated (CTRL group; n = 13). The r-hGH dose was 0.2 mg/kg/day (n = 5) or 0.1 mg/kg/day (n = 5). All subjects then received an infusion of 14C-labeled leucine and tritiated phenylalanine, followed by measurement of baseline protein kinetics (GH and CTRL). Subsequently a euglycemic insulin infusion (1 mU/kg/min) with concurrent amino acid infusion was administered, and protein kinetic measurements were repeated at steady state. RESULTS GH and insulin separately produced an increase in whole-body and skeletal muscle protein net balance. GH plus insulin was associated with a higher net balance of protein than was insulin alone. CONCLUSIONS r-hGH and insulin in the presence of amino acids and glucose combine to improve whole-body and skeletal muscle protein kinetics.
Primary Care Providers’ Experiences Notifying Parents of Cystic Fibrosis Newborn Screening Results

This study examines primary care provider (PCP) experiences with the initial parental disclosure of cystic fibrosis (CF) newborn screening (NBS) results in order to identify methods to improve parent-provider communication during the CF NBS process. PCPs of infants who received positive CF NBS results participated in semistructured phone interviews. Interviews were analyzed using a qualitative content analysis. PCPs acknowledged the difficulty of “breaking bad news” to parents, and emphasized minimizing parental anxiety and maximizing parental understanding. PCPs used a variety of methods to notify parents, and shared varying information about the significance of the results. Variation in the method of parental notification, information discussed, and attention to parents’ emotional needs may limit successful follow-up of children with positive CF NBS results. A multifaceted intervention to improve PCP knowledge, management, and communication could improve provider confidence, optimize information transfer, and minimize parental distress during the initial disclosure of CF NBS results.
Distribution of androstenedione and its effects on total free fatty acids in pregnant rats

Androstenedione, an anabolic steroid used to enhance athletic performance, was administered in corn oil by gastric intubation once daily in the morning to nonpregnant female rats at a dose of 5 or 60mg/kg/day, beginning two weeks before mating and continuing through gestation day (GD) 19. On GD 20, the distribution of androstenedione and other steroid metabolites was investigated in the maternal plasma and target organs, including brain and liver. The concentration of estradiol in plasma approached a statistically significant increase after treatment as compared with the controls, whereas the levels of androstenedione, testosterone and progesterone were not significantly different from the controls. In the liver, the concentrations of androstenedione and estradiol only were increased in a dose-related manner. None of these steroids was detectable in the brain. Androstenedione treatment also produced changes in the level of selected free fatty acids (FFAs) in the maternal blood, brain, liver and fetal brain. The concentrations of palmitic acid (16:0) and stearic acid (18:0) in the plasma were not significantly different between the controls and treated rats. However, oleic acid (18:1), linoleic acid (18:2) and docosahexaenoic acid (DHA, 22:6) were 17.94 ± 2.06 μg/ml, 24.23 ± 2.42 μg/ml and 4.08 ± 0.53 μg/ml, respectively, in the controls, and none of these fatty acids was detectable in the treated plasma. On the other hand, palmitic, stearic, oleic, linoleic and DHA were present in both control and treated livers. Among the FFAs in liver, linoleic and DHA were increased 87% and 169%, respectively, over controls. Palmitic, stearic and oleic acids were not significantly affected by the 60 mg/kg treatment. These were present in both control maternal and fetal brains, whereas linoleic acid was found only in fetal brain control. DHA was present only in the control maternal brain (0.02 ± 0.02 μg/mg protein) and fetal brain (0.24 ± 0.15 μg/mg protein). The results indicated that androstenedione exhibits significantly different effects on the FFA composition among target organs during pregnancy.
References ranges and sources of variation for indices of pulsed Doppler flow velocity waveforms from the uteroplacental and fetal circulation

Summary. Variation in indices used to characterize the maximum frequency outline of waveforms obtained from the uteroplacental and fetal circulations by duplex Doppler ultrasound was studied between observers, over a 24‐h period and before and after a meal. No significant differences were found. Reference ranges were derived for three indices, the A/B ratio, the resistance index and the pulsatility index, for waveforms from the fetal descending aorta, umbilical artery, and the placental and maternal sides of the uteroplacental circulation. Indices from waveforms from the uteroplacental circulation demonstrated a fall from 16 to 24 weeks gestation with no change thereafter. The umbilical artery indices demonstrated a continuing fall with increasing gestation but the A/B ratio and resistance index from the fetal descending aorta did not change with gestation. The pulsatility index from the aorta demonstrated a gentle rise.
Effects of osmotic changes on the chemoreceptor cell of rat carotid body

The carotid body plays a crucial role in cardiorespiratory regulation. In the present study we investigated the effect of osmotic changes on cytoplasmic calcium concentration ([Ca2+]c) and pH (pHi) of isolated chemoreceptor cells of the rat carotid body. In CO2/HCO3−‐buffered medium, reduction of osmolality from the control level of 300 mosmol kg−1 to 250–285 mosmol kg−1 resulted in a rise in [Ca2+]c, as measured with Indo‐1, whereas elevation of osmolality to 350 mosmol kg−1 had no effect. The Ca2+ response required extracellular Ca2+ and was reduced by application of the L‐type Ca2+ channel antagonist nifedipine (10 μm). The hyposmosis‐induced Ca2+ response could be prevented by application of niflumic acid (300 μm), an inhibitor of the swelling‐activated Cl− channel. In whole‐cell patch‐clamp experiments niflumic acid abolished the swelling‐activated Cl− current but only slightly depressed the Ca2+ current. The inhibition of Ca2+ current by niflumic acid does not account for its action in preventing of hyposmosis‐induced Ca2+ response, which seems to be initiated by Cl−‐mediated depolarisation. Withdrawal of CO2/HCO3− also prevented the Ca2+ response. Reduction of the osmotic concentration by 50 mosmol kg−1 induced a small but sustained decrease in pHi, while elevation by 50 mosmol kg−1 had an inverse effect, as measured fluorimetrically with carboxy SNARF‐1. Our conclusion is that in the rat chemoreceptor cell the activation of Cl− channels, e.g. by hyposmotic challenge, induces depolarisation, which, in turn, activates voltage‐gated Ca2+ channels.
Aeromonas species exhibit aggregative adherence to HEp-2 cells

Clinical and environmental isolates of Aeromonas species (five A. hydrophila isolates, three A. caviae isolates, and two A. sobria isolates) were tested for their adherence to HEp-2 cells. Clinical isolates of A. hydrophila and A. sobria exhibited aggregative adherence similar to that presented by enteroadherent-aggregative Escherichia coli. Bacterial aggregates adhered to cells with a typical "stacked-brick" appearance. In contrast, A. caviae strains showed a diffuse adherence pattern.
Sexual risk reduction interventions for HIV prevention among South African youth: a meta-analytic review.

OBJECTIVES To examine the efficacy of sexual risk reduction interventions among South African youth. METHODS Electronic databases were searched to identify studies published between 2007 and early 2013. Studies were eligible if they (1) targeted youth age 9-26, (2) evaluated sexual risk reduction interventions and (3) reported at least one behavioral outcome. Independent raters coded study characteristics, and intervention content. Weighted mean effect sizes were calculated; positive effect sizes indicated less sexual risk behavior and incident STIs. RESULTS Ten studies (k = 11; N = 22,788; 54% female; 79% Black-African) were included. Compared to controls, interventions were successful at delaying sexual intercourse and, among sexually active youth, at increasing condom use. A single study found reductions in the incidence of herpes simplex virus-2, but not HIV. CONCLUSIONS Implementing behavioral interventions to delay sexual debut and improve condom use can help to reduce the transmission of HIV among South African youth.
Urinary porphyrin excretion in a human population highly exposed to hexachlorobenzene.

BACKGROUND Data from an epidemic reported in Turkey (1955-1959) is the only information about the relationship between hexachlorobenzene (HCB) intake and porphyria cutanea tarda in humans. No information is available on the HCB threshold exposure level to induce porphyria cutanea tarda. OBJECTIVES To study HCB serum levels and urinary porphyrin excretion in the inhabitants of a village located near an organochlorine compound factory with high HCB concentrations in the air and to detect possible alterations in urinary porphyrin excretion and examine their relationship with HCB serum levels. DESIGN Cross-sectional study. SETTING Unit of Porphyrias of a tertiary care facility in Barcelona, Spain. PARTICIPANTS Six hundred four inhabitants of the village who were older than 14 years provided serum and urine samples (185 participants were factory workers). MAIN OUTCOME MEASURES Serum HCB was analyzed by gas chromatography coupled to electron capture detection. Quantification of urinary total porphyrins was performed by spectrofluorimetry. Porphyrin profile was determined by high-pressure liquid chromatography. RESULTS Hexachlorobenzene was detected in all serum samples (mean, 39.8 ng/mL; range, 1.1-1616.0 ng/mL), and levels were higher in factory workers. Mean +/- SD level urinary total porphyrin average concentration was 98 +/- 69 nmol/L (range, 9-1009 nmol/L). Only the urine sample with the highest porphyrin concentration showed an increase of highly carboxylated porphyrins, with a typical profile of porphyria cutanea tarda. In the remaining 603 urine samples, coproporphyrin was the predominant fraction. CONCLUSION The airborne exposure to and increased body burden of HCB in the Flix village population are not enough to trigger a significant alteration of the heme biosynthesis pathway.
Evaluation of Primary DNA Damage, Cytogenetic Biomarkers and Genetic Polymorphisms for CYP1A1 and GSTM1 in Road Tunnel Construction Workers

In tunnel construction workers, occupational exposure to dust (α-quartz and other particles from blasting), gases (nitrogen dioxide, NO2), diesel exhausts, and oil mist has been associated with lung function decline, induction of inflammatory reactions in the lungs with release of mediators that may influence blood coagulation, and increased risk of chronic obstructive pulmonary disease. The present molecular epidemiology study was designed to evaluate whether occupational exposure to indoor pollutants during road tunnel construction might result in genotoxic effects. A study group of 39 underground workers and a reference group of 34 unexposed subjects were examined. Primary and oxidative DNA damage, sister-chromatid exchanges (SCE), and micronuclei (MN) were measured in peripheral blood cells. The possible influences of polymorphisms in gene encoding for CYP1A1 and GSTM1 xenobiotic-metabolizing enzymes were also investigated. Exposure assessment was performed with detailed interviews and questionnaires. There were no significant differences in the level of primary and oxidative DNA damage and frequency of SCE between the tunnel workers and controls, whereas the frequency of MN showed a significant increase in exposed subjects compared to controls. No effects of CYP1A1 or GSTM1 variants were observed for the analyzed biomarkers. Since MN in peripheral blood lymphocytes are recognized as a predictive biomarker of cancer risk within a population of healthy subjects, the genotoxic risk of occupational exposure to various indoor environmental pollutants during road tunnel construction cannot be excluded by this biomonitoring study.
Fulcrum Assisted Soft Stabilization System: A New Concept in the Surgical Treatment of Degenerative Low Back Pain

Study Design. An experimental study on cadaver spine and spine model for biomechanical evaluation of a novel dynamic stabilization device. Objectives. First, to test the hypothesis that in dynamic stabilization of a lumbar spine using pedicle screws and ligament, addition of a fulcrum in front of the ligament can unload the disc. Second, to determine the relationship between the length and stiffness of the fulcrum and the ligament on disc unloading, lordosis and motion preservation. Summary of Background Data. Activity related low back pain may be attributable to abnormal disc loading or abnormal movement. Spinal fusion addresses both the mechanisms, but it has limitations. Soft stabilization with Graf ligament restricts abnormal movement but increases the disc pressure. The Dynesys system uses a plastic cylinder around the ligament to prevent overloading the disc, but it restricts extension and loses lordosis. Methods. A novel dynamic stabilization system (fulcrum assisted soft stabilization or FASS) was developed in which a flexible fulcrum was placed in front of a ligament between the pedicle screws. It was hypothesized that the fulcrum should transform the compressive force of a ligament behind into a distraction force in front and unload the disc. Three spine models were developed using wooden blocks for vertebral bodies and neoprene rubber of different hardness for disc. Their load-deformation character was tested and compared with that of the cadaver spine in a spine tester. The spine model with the closest load-deformation property to cadaver spine was then tested for the effect of a FASS system, consisting of high density polythene rod as fulcrums and rubber “O” rings as ligaments. The disc pressure in the spine models were recorded with strain gauge in the center. Results. Application of ligaments alone across the pedicle screws increased the disc pressure, produced a lordosis, and reduced the range of motion. Application of fulcrums reduced the disc pressure and maintained thelordosis. Increasing the fulcrum length resulted in progressive unloading of the disc but increased stiffness of the motion segment. As the fulcrum length approximatedthe height of the motion segment, the lordosis was lost, and the disc was completely unloaded. Decreasing the lateral bending stiffness of the fulcrum had minimal effect on disc unloading and motion-segment stiffness. Conclusion. The novel FASS system can unload the disc, control the range of motion, and maintain lordosis. These parameters may be controlled with a suitable combination of ligament and fulcrum system. The study provides an indication toward the desirable biomechanical properties of the fulcrum and ligament for future development of a clinically applicable prototype.
Role of TGFβ in Development of Spontaneous Autoimmune Thyroiditis in NOD.H-2h4 Mice1

Nearly 100% of NOD.H-2h4 mice develop spontaneous autoimmune thyroiditis (SAT) and produce anti-mouse thyroglobulin autoantibodies when they receive 0.05% NaI in their drinking water beginning at 8 wk of age. Our previous studies showed that TGFβ1 mRNA was constitutively expressed in thyroids and spleens of normal NOD.H-2h4 mice but not other strains of mice. To determine whether TGFβ might have a role in SAT, mice were given anti-TGFβ mAb at various times during development of SAT. Anti-TGFβ markedly inhibited development of SAT and production of anti-mouse thyroglobulin IgG1 autoantibodies. Anti-TGFβ was most effective in inhibiting SAT when given during the time thyroid lesions were developing, i.e., starting 4 wk after administration of NaI water. The active form of the TGFβ1 protein was present in thyroids of mice with SAT but not in normal NOD.H-2h4 thyroids. However, thyrocytes of normal NOD.H-2h4 thyroids did express latent TGFβ1. TGFβ1 protein expression in the thyroid correlated with SAT severity scores, and administration of anti-TGFβ inhibited TGFβ1 protein expression in both the thyroid and spleen. TGFβ1 was produced primarily by inflammatory cells and was primarily localized in areas of the thyroid containing clusters of CD4+ T and B cells. Depletion of CD8+ T cells had no effect on TGFβ1 protein expression. Activation of splenic T cells was apparently not inhibited by anti-TGFβ, because up-regulation of mRNA for cytokines and other T cell activation markers was similar for control and anti-TGFβ-treated mice. TGFβ1 may function by promoting migration to, or retention of, inflammatory cells in the thyroid.