Miracle-dz/UniFAR-FTUs huggingface dataset:
Gender differences in antiretroviral treatment outcomes of HIV patients in rural Uganda

Abstract Gender differences in treatment outcomes of 305 persons living with HIV receiving antiretroviral treatment (ART) in Kabarole district, western Uganda, were evaluated. The primary treatment outcome was virological suppression defined as HIV-1 RNA viral load (VL) <400 copies/ml and the secondary outcome measure was the increase in the CD4 cell count after six months on ART. Statistical analysis included descriptive, univariate, and multivariate methods. Proportionally, more females chose to seek treatment compared to males. After six months of treatment, females were more likely to have viral suppression (VL > 400 copies/ml) as compared to males (odds ratio 2.14, 95% confidence interval 0.99–4.63, p=0.05). While females had a significantly higher baseline CD4 cell count at initiation of treatment compared to males, the increase in CD4 cell count after six months on ART was similar in males and females. The reasons for better ART outcomes for females should be further investigated. Ideally, ART programs should work toward equitable treatment outcomes for men and women, if the cause of the gender differential lies in patient behavior and the way ART services are delivered.
Aberrant cleavage of TDP-43 enhances aggregation and cellular toxicity

Inclusions of TAR DNA-binding protein-43 (TDP-43), a nuclear protein that regulates transcription and RNA splicing, are the defining histopathological feature of frontotemporal lobar degeneration with ubiquitin-positive inclusions (FTLD-Us) and sporadic and familial forms of amyotrophic lateral sclerosis (ALS). In ALS and FTLD-U, aggregated, ubiquitinated, and N-terminally truncated TDP-43 can be isolated from brain tissue rich in neuronal and glial cytoplasmic inclusions. The loss of TDP-43 function resulting from inappropriate cleavage, translocation from the nucleus, or its sequestration into inclusions could play important roles in neurodegeneration. However, it is not known whether TDP-43 fragments directly mediate toxicity and, more specifically, whether their abnormal aggregation is a cause or consequence of pathogenesis. We report that the ectopic expression of a ≈25-kDa TDP-43 fragment corresponding to the C-terminal truncation product of caspase-cleaved TDP-43 leads to the formation of toxic, insoluble, and ubiquitin- and phospho-positive cytoplasmic inclusions within cells. The 25-kDa C-terminal fragment is more prone to phosphorylation at S409/S410 than full-length TDP-43, but phosphorylation at these sites is not required for inclusion formation or toxicity. Although this fragment shows no biological activity, its exogenous expression neither inhibits the function nor causes the sequestration of full-length nuclear TDP-43, suggesting that the 25-kDa fragment can induce cell death through a toxic gain-of-function. Finally, by generating a conformation-dependent antibody that detects C-terminal fragments, we show that this toxic cleavage product is specific for pathologic inclusions in human TDP-43 proteinopathies.
Studies of the Bradyrhizobium japonicum nodD1 promoter: a repeated structure for the nod box

Induction of nod genes in Rhizobium and Bradyrhizobium species is dependent on the presence of plant-produced flavonoids, the NodD protein, and the cis-acting nod box promoter sequence. Although the nodD (nodD1) gene in Rhizobium species is constitutively expressed, nodD1 expression in Bradyrhizobium japonicum is inducible by isoflavones in a manner similar to that of the nodYABC operon. A consensus nod box sequence is found 5' of the nodYABC operon, whereas a presumptive, nod box-like sequence is found 5' of the nodD1 gene. As an initial step toward examining the nodD1 promoter, the transcriptional start sites of the nodD1 and nodYABC operons were determined and found to be 44 and 28 bp, respectively, downstream of their respective nod box sequences. A series of deletions of the nodD1 promoter were constructed and fused to the lacZ gene. Analysis of the activity of these deletions clearly showed that the divergent nod box sequence was essential for nodD1 induction by isoflavones or soybean seed extract. The induction of nodD1 expression requires NodD1, as tested in B. japonicum and in a heterologous system, Agrobacterium tumefaciens. On the basis of these data, we analyzed the published nod box sequences and propose a new consensus sequence composed of paired 9-bp repeats. Analysis of the nodD1 nod box and synthetic constructs of the nocYABC nod box indicate that at least two 9-bp repeats are required for NodD1-mediated induction. Furthermore, insertions between the paired repeats of the nodYABC nod box suggest that orientation of the repeats on opposite faces of the DNA helix is essential for maximum nod gene expression.
Transformations of 1- and 2-carbon halogenated aliphatic organic compounds under methanogenic conditions

Several 1- and 2-carbon halogenated aliphatic organic compounds present at low concentrations (less than 100 micrograms/liter) were degraded under methanogenic conditions in batch bacterial cultures and in a continuous-flow methanogenic fixed-film laboratory-scale column. Greater than 90% degradation was observed within a 2-day detention time under continuous-flow methanogenic conditions with acetate as a primary substrate. Carbon-14 measurements indicated that chloroform, carbon tetrachloride, and 1,2-dichloroethane were almost completely oxidized to carbon dioxide, confirming removal by biooxidation. The initial step in the transformations of tetrachloroethylene and 1,1,2,2-tetrachloroethane to nonchlorinated end products appeared to be reductive dechlorination to trichloroethylene and 1,1,2-trichloroethane, respectively. Transformations of the brominated aliphatic compounds appear to be the result of both biological and chemical processes. The data suggest that transformations of halogenated aliphatic compounds can occur under methanogenic conditions in the environment.
Verification of the Antidiabetic Effects of Cinnamon (Cinnamomum zeylanicum) Using Insulin-Uncontrolled Type 1 Diabetic Rats and Cultured Adipocytes

It has long been believed that an intake of cinnamon (Cinnamomum zeylanicum) alleviates diabetic pathological conditions. However, it is still controversial whether the beneficial effect is insulin-dependent or insulin-mimetic. This study was aimed at determining the insulin-independent effect of cinnamon. Streptozotocin-induced diabetic rats were divided into four groups and orally administered with an aqueous cinnamon extract (CE) for 22 d. The diabetic rats that had taken CE at a dose of more than 30 mg/kg/d were rescued from their hyperglycemia and nephropathy, and these rats were found to have upregulation of uncoupling protein-1 (UCP-1) and glucose transporter 4 (GLUT4) in their brown adipose tissues as well as in their muscles. This was verified by using 3T3-L1 adipocytes in which CE upregulates GLUT4 translocation and increases the glucose uptake. CE exhibited its anti-diabetic effect independently from insulin by at least two mechanisms: i) upregulation of mitochondrial UCP-1, and ii) enhanced translocation of GLUT4 in the muscle and adipose tissues.
Wage Insurance, Part-Time Unemployment Insurance and Short-Time Work in the XXI Century

At the start of the XXI century, characterized by the rise of new forms of employment and of skills requirements, many countries need to adapt their labor market institutions to accompany technological changes and globalization. In this context, unemployment insurance is an essential tool to foster and smooth career paths. Its core components comprise unemployment benefits paid to full-time unemployed workers, monitoring, and counseling. But it is clear that they are not sufficient to cover all risks properly. To deal with this issue, part-time unemployment insurance, short-time work and wage insurance have been tried, at different scales, in several countries over the last decades. This paper surveys the evaluations of these schemes and draws lessons from their results for future research and for labor market institutions.
APOE genotype and cholesterol levels in lewy body dementia and Alzheimer disease: investigating genotype-phenotype effect on disease risk.

BACKGROUND APOE is the most recognized genetic risk factor for sporadic late-onset Alzheimer disease (AD). The role of APOE genotype in Lewy body dementia (LBD) is still unknown as well as the relationship between APOE genotype and cholesterol levels. OBJECTIVE The objective of this study was to explore the association between APOE genotype and cholesterol levels in patients with LBD and those with AD. METHODS Eighty-two patients with LBD were consecutively enrolled as well as a comparable number of patients with AD and comparison group. Each subject underwent a clinical and neuropsychologic evaluation and APOE genotyping. RESULTS The distribution of APOE genotypes significantly differed between AD and LBD cases compared with the comparison group, with the APOE epsilon4+ (epsilon4+/epsilon4 + or epsilon4+/epsilon4-) genotype more frequent in patient subgroups. Different models have been fitted, and total APOE epsilon4-hypercholesterolemia complete interaction effect was claimed in predicting their relationship on disease outcome. Subjects with hypercholesterolemia and heterozygous for APOE epsilon4 allele had more than threefold risk to develop AD compared both with the comparison group and with those with LBD. The risk to develop AD in hypercholesterolemic and APOE epsilon4 homozygous subjects was 13-fold compared with the comparison group and those with LBD. Conversely, there was not evidence for APOE epsilon4-hypercholesterolemia complete interaction effect in LBD and in the comparison group. CONCLUSIONS This study highlighted that APOE is a risk factor not only for AD, but also for LBD, and that the APOE-cholesterol pathway differently affects AD and LBD. This approach may aid the search for the identification of an interactive effect of APOE genotype and modifiable risk factors, i.e., hypercholesterolemia, eventually resulting in individualized and effective cholesterol-lowering therapy in at-risk subjects.
Quercetin and daidzein β-apo-14’-carotenoic acid esters as membrane antioxidants

Abstract Esterification by β-apo-14’-carotenoic acid was found to have opposite effects on antioxidant activity of quercetin (at B4’, B3’ hydroxyl) as of daidzein (at A7 hydroxyl) in phosphatidylcholine liposomes. The daidzein ester had increased activity, while quercetin had a significant decreased activity. Quantum mechanical calculations using density function theory (DFT) indicate a modest decrease in bond dissociation enthalpy, BDE, for (weakest) hydrogen–oxygen phenolic bond in daidzein from 368.4 kJ·mol− 1 to 367.7 kJ·mol− 1 compared to a significant increase in quercetin from 329.5 kJ·mol− 1 to 356.6 kJ·mol− 1 upon derivatization. These opposite changes in tendency for hydrogen atom transfer from phenolic groups to lipid radicals combined with an increase in A-to-B dihedral angle from 0.0° to 36.4° and in dipole moment from 0.40 D to 6.01 D for quercetin upon derivatization, while less significant for daidzein (36.4°–36.7° and 3.26 D–7.87 D, respectively), together provide a rationale for the opposite effect of esterification on antioxidation.
Reduction in apoptosis relative to mitosis in histologically normal epithelium accompanies fibrocystic change and carcinoma of the premenopausal human breast

The aims of this study in 227 premenopausal women were (a) to determine the mitotic index (MI), the thymidine labelling index (LI), and the apoptotic index (AI) within the epithelial cells of histologically ‘normal’ human breast biopsy material removed away from the site of either a fibroadenoma or a carcinoma; and (b) to relate differences in the kinetic indices of the ‘normal’ epithelium to the pathology in the same breast diagnosed as fibroadenoma alone (125 patients), fibroadenoma with accompanying mild fibrocystic change (79 patients), or carcinoma (23 patients). Ratios of the average indices (AI/MI, AI/LI, MI/LI) were also calculated to minimize uncertainties related to the total cell population counted, the denominator in the LI, MI, and AI All indices and ratios of indices were corrected for age, averaged over the cycle, and expressed as log‐transformed values for analysis. Significant (P<0.001) reductions in AI and in apoptosis relative to mitosis (reduced AI/MI) were found in ‘normal’ epithelium from breasts having fibrocystic change (AI = 0.17 ± 0.02; AI/MI = 1.01 ± 0.18) and carcinoma (AI = 0.19 ± 0.04; AI/MI=0.8 ± 0.29), compared with breast with fibroadenoma alone (AI = 0.27 ± 0.03; AI/MI = 1.29 ± 0.39). In the absence of significant differences in MI and LI between the ‘normal’ tissue groups, this finding raises the possibility that reduced epithelial cell apoptosis might be causally associated with the development of fibrocystic change and with an increased risk of development of carcinoma. Reduced apoptosis may lead to a shift in tissue kinetics towards expansion of cell numbers, and also to the preservation of genetically aberrant cells, favouring neoplastic development. The indices, however, are complex and must be interpreted with caution.
Viability and effectiveness of large-scale HIV treatment initiatives in sub-Saharan Africa: experience from western Kenya

Objectives:To determine the clinical and immunological outcomes of a cohort of HIV-infected patients receiving antiretroviral therapy. Design:Retrospective study of prospectively collected data from consecutively enrolled adult HIV-infected patients in eight HIV clinics in western Kenya. Methods:CD4 cell counts, weight, mortality, loss to follow-up and adherence to antiretroviral therapy were collected for the 2059 HIV-positive non-pregnant adult patients treated with antiretroviral drugs between November 2001 and February 2005. Results:Median duration of follow-up after initiation of antiretroviral therapy was 40 weeks (95% confidence interval, 38–43); 111 patients (5.4%) were documented as deceased and 505 (24.5%) were lost to follow-up. Among 1766 (86%) evaluated for adherence to their antiretroviral regimen, 78% reported perfect adherence at every visit. Although patients with and without perfect adherence gained weight, patients with less than perfect adherence gained 1.04 kg less weight than those reporting perfect adherence (P = 0.059). CD4 cell counts increased by a mean of 109 cells/μl during the first 6 weeks of therapy and increased more slowly thereafter, resulting in overall CD4 cell count increases of 160, 225 and 297 cells/μl at 12, 24, and 36 months respectively. At 1 year, a mean increase of 170 cells/μl was seen among patients reporting perfect adherence compared with 123 cells/μl among those reporting some missed doses (P < 0.001). Conclusions:Antiretroviral treatment of adult Kenyans in this cohort resulted in significant and persistent clinical and immunological benefit. These findings document the viability and effectiveness of large-scale HIV treatment initiatives in resource-limited settings.
Cyclooxygenase-2 Deficiency Enhances Th2 Immune Responses and Impairs Neutrophil Recruitment in Hepatic Ischemia/Reperfusion Injury1

Cyclooxygenase-2 (COX-2) is a prostanoid-synthesizing enzyme that is critically implicated in a variety of pathophysiological processes. Using a COX-2-deficient mouse model, we present data that suggest that COX-2 has an active role in liver ischemia/reperfusion (I/R) injury. We demonstrate that COX-2-deficient mice had a significant reduction in liver damage after I/R insult. The inability of COX-2−/− to elaborate COX-2 products favored a Th2-type response in these mice. COX-2−/− livers after I/R injury showed significantly decreased levels of IL-2, as well as IL-12, a cytokine known to have a central role in Th1 effector cell differentiation. Moreover, such livers expressed enhanced levels of the anti-inflammatory cytokine IL-10, shifting the balance in favor of a Th2 response in COX-2-deficient mice. The lack of COX-2 expression resulted in decreased levels of CXCL2, a neutrophil-activating chemokine, reduced infiltration of MMP-9-positive neutrophils, and impaired late macrophage activation in livers after I/R injury. Additionally, Bcl-2 and Bcl-xL were normally expressed in COX-2−/− livers after injury, whereas respective wild-type controls were almost depleted of these two inhibitors of cell death. In contrast, caspase-3 activation and TUNEL-positive cells were depressed in COX-2−/− livers. Therefore, our data support the concept that COX-2 is involved in the pathogenic events occurring in liver I/R injury. The data also suggest that potential valuable therapeutic approaches in liver I/R injury may result from further studies aimed at identifying specific COX-2-derived prostanoid pathways.
Cost‐effectiveness of the introduction of specialized oral care with laser therapy in hematopoietic stem cell transplantation

Oral mucositis (OM) is one of the side effects of hematopoietic stem cell transplantation (HSCT), resulting in major morbidity. The aim of this study was to determine the cost‐effectiveness of the introduction of a specialized oral care program including laser therapy in the care of patients receiving HSCT with regard to morbidity associated with OM. Clinical information was gathered on 167 patients undergoing HSCT and divided according to the presence (n = 91) or absence (n = 76) of laser therapy and oral care. Cost analysis included daily hospital fees, parenteral nutrition (PN) and prescription of opioids. It was observed that the group without laser therapy (group II) showed a higher frequency of severe degrees of OM (relative risk = 16.8, 95% confidence interval −5.8 to 48.9, p < 0.001), with a significant association between this severity and the use of PN (p = 0.001), prescription of opioids (p < 0.001), pain in the oral cavity (p = 0.003) and fever > 37.8°C (p = 0.005). Hospitalization costs in this group were up to 30% higher. The introduction of oral care by a multidisciplinary staff including laser therapy helps reduce morbidity resulting from OM and, consequently, helps minimize hospitalization costs associated with HSCT, even considering therapy costs. Copyright © 2013 John Wiley & Sons, Ltd.
Office-based sperm concentration: A simplified method for intrauterine insemination therapy.

BACKGROUND Intrauterine insemination (IUI) could become preferred to more invasive and expensive techniques of assisted reproduction therapy (ART) and should be offered as the first choice in cases with no female factors and mild male factor subfertility. However, developing countries and especially their rural areas often lack the necessary equipment and laboratory facilities. OBJECTIVE To describe a simplified one-step method to determine the sperm concentration range for IUI therapy. METHODS Semen samples from 51 sperm donors were used. Following swim-up separation, the sperm concentration of the retrieved motile fraction was counted, as well as progressive motile sperm using a standardised wet preparation. The number of sperm in a 10 µL droplet covered with a 22 x 22 mm coverslip was counted under 400 x total magnification. The observed numbers of retrieved motile sperm were divided into three groups: < 40, 40-100 and > 101 spermatozoa as recorded per intial estimation on the wet preparation. RESULTS The mean (standard deviation) estimated sperm concentration for each group compared with actual counts per Neubauer counting chamber were: estimated < 40 sperm (n = 14), mean 20 (8), Neubauer count 2.5 x 10(6)/mL; estimated 40-100 sperm (n = 14), mean 71 (15), Neubauer count 16 x 10(6)/mL; and estimated > 100 sperm (n = 23), Neubauer count 48.3 (21.7) x 10(6)/mL. CONCLUSION The results with IUI in male subfertility cases reported by Ombelet et al. in 1995 support the concept of first-line treatment of infertility by three to four cycles of IUI therapy in selected cases.
Use of the Reverse Latissimus Muscle Flap for Closure of Complex Back Wounds in Patients With Spinal Cord Injury

Study Design. Our study was designed as a retrospective review of spinal cord patients with complex back wounds in whom the reverse latissimus muscle flap was used for closure. Objectives. The objective was to evaluate the efficacy and outcomes in these patients. Summary of Background Data. Earlier publications give only anecdotal reports on the treatment of complex back wounds in patients with spinal cord syndrome. The data so far available do not allow any comparison of the various methods used. Methods. Fourteen patients with congenital or acquired spinal cord syndrome and with an average age of 31.2 years (range 12–76 years) had complex back wounds in the thoracic and lumbar regions, which were closed in each case with a reverse latissimus dorsi muscle flap. The patients had deep wound infection and wound dehiscence following spondylodesis (n = 6), dead space and wound dehiscence following laminectomy (n = 6), or decubitus ulcers over the spine (n = 2). The spinal cord syndrome was chronic in nine patients and acute in five. The pre- and postoperative treatment and the actual operation were all done in a spinal cord injury center. In nine patients, the back wound was closed in a primary procedure, and in five, a split-thickness skin graft was used to close it. In 11 patients, primary wound healing was achieved with no complications after closure, whereas in 3 patients, complications with the back wound or the donor site led to disturbances of wound healing lasting up to 25 weeks. Five operations had to be performed specifically because of these complications. Results. At follow-up 27.4 months (mean; range 8–114 months) after the operation, all back wounds were closed, free of irritation, and completely healed. The patients did not report any handicaps in everyday life, loss of strength in the upper extremities, or functional restrictions. One patient had a deep vein thrombosis in one leg. No further complications linked with the spinal cord syndrome were ascertained. The instrumentation used during the spondylodesis operation was left in place in four cases. The spondylodesis became solidly fused in each of these cases. Conclusion. Use of the reverse latissimus muscle flap is a reliable method of closing complex back wounds in patients with spinal cord syndrome. Should there be complications in the area of the flap, secondary wound healing can be achieved by wound debridement and closure of the wound by means of split-thickness skin grafting. There is no loss of function in the upper extremities. The complications typically seen in spinal cord patients can be avoided when the treatment is carried out in the conditions that obtain in a specialized spinal cord injury center.
Financial Incentives, Efforts, and Performances in the Health Sector: Experimental Evidence from the Democratic Republic of Congo

Financial incentives for service providers are increasingly used in developing countries as a tool to maximize the effort and output of public providers. Using a field experiment in the Democratic Republic of Congo, we evaluate the impact of a fee-for-service mechanism aimed to increase health service utilization. We find that relative to fixed payments, the fee-for-service mechanism slightly decreased service utilization. We show that these detrimental effects of incentives do not result from a diminution in workers’ efforts, fraud, or switching away from nonincentivized actions. But workers’ intrinsic motivation decreased and their efforts were evidently misplaced, showing that incentivized workers are not always more productive because they may not understand how to perform.