Miracle-dz/UniFAR-FTUs huggingface dataset:
Early hepatitis B virus DNA reduction in hepatitis B e antigen–positive patients with chronic hepatitis B: A randomized international study of entecavir versus adefovir

This study was undertaken to compare the early antiviral activity and viral kinetic profiles of entecavir (ETV) versus adefovir (ADV) in hepatitis B e antigen positive nucleoside‐naïve adults with chronic hepatitis B (CHB). Sixty‐nine nucleoside‐naïve CHB patients with baseline HBV DNA of 108 copies/mL or more were randomized 1:1 to open‐label treatment with entecavir 0.5 mg/day or adefovir 10 mg/day for a minimum of 52 weeks. The primary efficacy analysis compared mean reduction in HBV DNA at week 12 adjusted for baseline levels using linear regression. Entecavir was superior to adefovir for mean change from baseline in HBV DNA at week 12 (−6.23 log10 copies/mL versus −4.42 log10 copies/mL, respectively; mean difference −1.58 log10 copies/mL; P < 0.0001). Both drugs demonstrated biphasic viral kinetics, with a first phase of rapid decline lasting 10 days. A significant difference favoring ETV was reached at day 10 (day 10 ETV−ADV difference estimate: −0.66 log10 copies/mL; 95% CI [−0.30, −0.01]). Early virological response was found to be predictive of subsequent virological response, with those having lower HBV DNA levels at day 10 being more likely to achieve HBV DNA of less than 300 copies/mL at week 48. In addition, there was considerably less variability in the extent of HBV DNA reductions in patients treated with entecavir versus adefovir. Both the mean decrease in serum HBV DNA and the proportion of patients achieving HBV DNA less than 300 copies/mL were greater in entecavir‐treated than adefovir‐treated patients at weeks 2, 4, 8, 12, 24, and 48. At week 48, one (3%) ETV‐treated versus 15 (47%) ADV‐treated patients had HBV DNA of 105 copies/mL or more. Both antivirals were well tolerated. Conclusion: Entecavir therapy resulted in earlier and superior reduction in HBV DNA compared with adefovir in nucleoside‐naïve HBeAg‐positive patients with CHB. (HEPATOLOGY 2009;49:72‐79.)
Men's Perspectives on Their Role in Family Planning in Nyanza Province, Kenya.

Research has indicated that gender dynamics-and in particular men's disapproval of family planning-have had an influence on the low levels of contraceptive use in sub-Saharan Africa. Limited evidence exists, however, on effective strategies to increase male approval. We conducted 12 focus group discussions with married men aged 20-66 (N = 106) in Kenya to explore FP perceptions. Men's disapproval of FP was associated with anxieties regarding male identity and gender roles. Men often distrusted FP information provided by their wives because they suspected infidelity or feared being viewed as "herded. " Men also feared that providers might pressure them into vasectomies or into disclosing extramarital sexual activity or HIV diagnoses to their wives. Suggested strategies include programs targeting couples jointly and FP education for men provided by male outreach workers. To encourage men's acceptance, community-based programs directly targeting men are needed to reduce stigma and misconceptions and to increase awareness of the benefits of FP.
The novel CD4+CD25+ regulatory T cell effector molecule fibrinogen‐like protein 2 contributes to the outcome of murine fulminant viral hepatitis

Fulminant viral hepatitis (FH) remains an important clinical problem in which the underlying pathogenesis is not well understood. Here, we present insight into the immunological mechanisms involved in FH caused by murine hepatitis virus strain 3 (MHV‐3), indicating a critical role for CD4+CD25+ regulatory T cells (Tregs) and production of the novel Treg effector molecule FGL2. Before infection with MHV‐3, susceptible BALB/cJ mice had increased numbers of Tregs and expression of fgl2 messenger RNA (mRNA) and FGL2 protein compared with resistant A/J mice. After MHV‐3 infection, plasma levels of FGL2 in BALB/cJ mice were significantly increased, correlating with increased percentage of Tregs. Treatment with anti‐FGL2 antibody completely inhibited Treg activity and protected susceptible BALB/cJ mice against MHV‐3‐liver injury and mortality. Adoptive transfer of wild‐type Tregs into resistant fgl2−/− mice increased their mortality caused by MHV‐3 infection, whereas transfer of peritoneal exudate macrophages had no adverse effect. Conclusion: This study demonstrates that FGL2 is an important effector cytokine of Tregs that contributes to susceptibility to MHV‐3–induced FH. The results further suggest that targeting FGL2 may lead to the development of novel treatment approaches for acute viral hepatitis infection. (HEPATOLOGY 2009.)
Wood smoke exposure of Portuguese wildland firefighters: DNA and oxidative damage evaluation

ABSTRACT Portugal is among the European Union countries most devastated by forest fires each year. In the last three decades, more than 3.8 million hectares of forest were burned. Wildland firefighters are exposed to a variety of hazards, including many toxic combustion products that may lead to deleterious health effects. Epidemiological studies showed a positive association between firefighting and several chronic diseases, including cancer. Results from biomonitoring studies in firefighters, particularly concerning genotoxicity evaluation, constitute a valuable tool for investigating important occupational hazards. Thus, the aim of this study was to assess genotoxicity in a group of wildland firefighters using the comet assay for DNA damage and oxidative stress. Both parameters were increased in firefighters compared to controls, but significance was only found for basal DNA damage. No significant influence was found regarding major confounding variables on the genotoxic endpoints studied, with the exception of age. Data obtained provide preliminary information on human health effects of wildland firefighting exposure at genetic and molecular levels. These findings may also provide new important data to serve as public awareness to the potential adverse health risks involving wildland firefighting. Implementation of security and hygiene measures in this sector as well as good practices campaigns may be crucial to decrease risk.
The lifespan determinant p66shc drives obesity-induced oxidative stress, mitochondrial dysfunction and vascular inflammation

Purpose: Leptin deficiency in mice (LepOb/Ob) triggers high caloric intake leading to obesity/insulin resistance and activates several reactive oxygen species (ROS) generating pathways. Recent evidence suggest that mitochondrial adaptor p66Shc is a crucial player in ROS-mediated vascular damage. The present study investigates p66Shc role in obesity-driven vascular dysfunction. Methods: Three groups of male mice were studied (C57/B6, 4-6 months old, n=14 per group): 1) wild-type (WT), 2) leptin-deficient (p66Shc-LepOb/Ob), 3) double-mutant (p66Shc-/-/LepOb/Ob;). Plasma 8-iso-prostaglandin-F2α (8-iso-PGF2α was measured as a systemic marker of oxidative stress. mRNA and protein expression were assessed by real-time PCR and immunoblotting. ESR spectroscopy assessment of superoxide anion (O2-) levels and mitochondrial swelling were performed in mitochondria isolated from mouse aortas. The interaction between p66Shc and cytochrome c was investigated by pull-down assays. Organ chamber experiments were performed to assess endothelium-dependent relaxations to acetylcholine (Ach, 10-9-10-6 mol/L). NF-kB activity was determined as p65 nuclear translocation. Results: Plasma 8-iso-PGF2α as well as mitochondrial O2- levels were significantly higher in LepOb/Ob than WT. This increase was abolished in p66Shc-/-LepOb/Ob mice. Oxidative stress in LepOb/Ob mice was associated with p66Shc upregulation, mitochondrial translocation and swelling. Consistently, co-immunoprecipitation of p66Shc with cytochrome c and impaired Ach-induced relaxations were observed in the aortas of LepOb/Ob but not in WT mice. By contrast, in p66Shc-/-/LepOb/Ob mice endothelial dysfunction and mitochondrial swelling did not occur. In agreement with these findings, a preserved activation of Akt/eNOS pathway was observed. Genetic disruption of p66Shc in obese mice also prevented vascular activation of NF-kB signalling and upregulation of VCAM-. 1, ICAM-1, IL-6, IL-8 and MCP-1 mRNAs. Conclusions: Our results suggest that p66Shc is critically involved in obesity-induced oxidative stress and vascular dysfunction. A better understanding of the molecular mechanism responsible for ROS production may provide a novel target to reduce cardiovascular health burden in this setting.
Release of chitobiase as an indicator of potential molting disruption in juvenile Daphnia magna exposed to the ecdysone receptor agonist 20-hydroxyecdysone

ABSTRACT During arthropod molting, the old exoskeleton is degraded and recycled by the molting fluid. Chitobiase, a major chitinolytic enzyme in the molting fluid, has been widely used as a biomarker to indicate endocrine disruption of molting in arthropods under environmental stress. Although release of chitobiase was extensively studied in organisms exposed to molting-inhibiting chemicals, enzymic association with molting and response of the molting hormone receptor, ecdysone receptor (EcR), is not well understood. The present study was therefore conducted to identify potential linkages between release of chitobiase, molting frequency, and EcR activation in a freshwater crustacean Daphnia magna after short-term (96 hr) exposure to endogenous molting hormone 20-hydroxyecdysone (20E). A suite of bioassays was used for this purpose, including the chitobiase activity, molting frequency, viability, and in vitro EcR activation. Effect concentrations were compared between different assays analyzed. Results showed that exposure to 20E reduced chitobiase release and molting frequency in a concentration-dependent manner. Exposure to as low as 250 nM 20E significantly decreased release of chitobiase after 72 hr exposure, whereas adverse effects on molting frequency and incomplete molting-associated mortality required higher 20E exposure concentrations. The EcR reporter assay further demonstrated that as low as 100 nM 20E may activate EcR in vitro. Data suggest that release of chitobiase may be employed as a sensitive indicator of potential molting disruption in crustaceans after exposure to EcR agonists such as 20E.
Lead (Pb) exposure induces disturbances in epigenetic status in workers exposed to this metal

ABSTRACT Previous studies showed that lead (Pb) exposure may modulate gene expression by changes in the epigenetic status. However, little is known about the impact of Pb exposure and alterations on DNA methylation patterns in humans exposed to this metal. The aim of this study was to assess the consequences of exposure to Pb on DNA global methylation, in order to gain a better understanding of the interactions between Pb exposure and epigenetic effects. The study included 100 male workers employed in automotive battery factories from Paraná State, Brazil. Concentrations of Pb in blood (B-Pb) and plasma (P-Pb) were determined by ICP-MS, the percentage (%) of global DNA methylation was determined by quantification of 5-methylcytosine using indirect ELISA, and sociodemographic data collected by questionnaire by trained interviewers. The mean age was 37 ± 10 (18–67 years); 18% of participants were smokers, while 32% reported consumption of alcoholic beverages. The B-Pb and P-Pb levels were 20 ± 11 and 0.56 ± 0.64 µg/dl, respectively; % global DNA methylation was 2.8 ± 1.1% (ranging from 1.1 to 6.5%). B-Pb and P-Pb concentrations were significantly correlated. Furthermore, a marked association was noted between Pb biomarkers and DNA global methylation. Taken together, our data demonstrated that Pb exposure induced alterations on DNA global methylation in workers who were exposed to the metal and consequently may result in disturbances in the regulation of gene expression, leading to potentially several health adverse effect outcomes.
Gray's Anatomy

The comparison, made by Dr. W. D. Jeans in your last issue*, of Gray's Anatomy with the latest revision of its American offspring is an interesting exercise; but his conclusion that the original is a ‘better buy’, though pleasing to the producers of the “British” Gray's Anatomy, a much larger and more up-to-date book, is based upon the false premise that a second version is necessary. Here a little history helps: the first edition, published by Parker and the copyright at once purchased by Longmans, was immediately popular and must have contributed much to the profits of the latter firm.
Long‐term treatment with octreotide in patients with the Zollinger‐ElIison syndrome

Abstract. This study reports the effects of 4 and 5‐year treatment with octreotide (200 μg sc bid) in the Zollinger‐Ellison syndrome (ZES). No symptoms related to acid hypersecretion were observed in the four patients throughout the study, and upper GI endoscopy was normal. Basal acid output (BAO) measured 12 h after injection, was below 10 mmol h‐1 in three to four patients and previous ranitidine treatment was discontinued. In the fourth case (pre‐treatment BAO value: 115 mmol h‐1), BAO progressively decreased to 42 mmol h‐1 after 5 years of octreotide treatment. At the end of the study, serum gastrin levels were 58.5% (30–68) of the pretreatment values and two patients had normal gastrin levels. Peak acid output (PAO) decreased markedly after 2, 4 and 5 years, by 68% (35–89) suggesting that octreotide had exerted an antitrophic effect on parietal cell mass. Diffuse hyperplasia of fundic argyrophil cells present in two patients before octreotide, decreased during the treatment. Mean argyrophil cell density for all patients was not significantly modified. Antral gastrin‐cell density was in the normal range. No long‐term side effect of octreotide treatment was observed. Although octreotide may not be considered as a substitute for benzimidazoles in the treatment of ZES, its specific properties may be of therapeutic benefit in some ZES patients.
We're Here and We're Queer: Sexual Orientation and Sexual Fluidity Differences Between Bisexual and Queer Women

ABSTRACT Theorists and researchers have noted an overlap between individuals who are bisexually-identified and queer-identified. Although early definitions of bisexuality may have been predominantly binary (i.e., attracted to women and men), in recent years there has been a move toward a more “queer” understanding of bisexuality (e.g., attraction to more than one gender beyond women and men). The purpose of this study was to examine similarities and differences between adult women who were bisexually-identified and those who were queer-identified, ages 18 to 66 years, on sociodemographic characteristics, two dimensions of sexual orientation (sexual behaviors and attractions), fluidity in attractions and sexual orientation identity, and identity centrality and affirmation in an online sample (N = 489), which was mostly from the United States (73.5%). Results indicated that women who are bisexual and queer were similar in terms of sociodemographic characteristics, with the exception of education; women identifying as queer were more educated than women identifying as bisexual. Women identifying as queer were also more likely than women identifying as bisexual to report variability in their sexual behaviors and attractions and more fluidity in their sexual orientation identity. Additionally, women identifying as queer reported higher levels of identity centrality and affirmation than women identifying as bisexual. Considerations for sexual minority women's health research are discussed.
The Doctor and the Soul: From Psychotherapy to Logotherapy

Even before Dr. Frankl's appalling experience in the concentration camps at Auschwitz and Dachau, he was searching for a psychotherapy which would go beyond that of Freud or Adler. His wartime experiences evidently helped him to formulate his ideas and methods. In 1946 he published two books in German, both of which describe his philosophy and methods. The first is a short, somewhat autobiographical account which was translated into English as From Death-Camp to Existentialism . The other, somewhat longer with more explanation of his ideas and more clinical examples, was first translated into English in 1955 as The Doctor and the Soul . The present volume represents a revision of this, with a new chapter on therapy which includes many brief case histories. Frankl states that he is concerned with a "psychotherapy in spiritual terms. " Believing that the distress of many patients is due not so much to neurosis as to
Managing Crohn's Disease in Adults

This review explores the incidence and prevalence of Crohn's disease in the United States, nutrition therapy during remission and during active disease, the nutritional consequences of the disease, and the role of conventional therapies in adults with Crohn's disease. In addition, the roles of new alternative therapies such as omega-3 fatty acids and probiotics are explored
Military Sexual Trauma in Men: A Review of Reported Rates

Military sexual trauma (MST) has historically been associated with female service members, but it is also experienced by male service members. This article reviews reported prevalence and incidence rates of men's MST in 29 studies. Sources for these studies included the Department of Defense, the U.S. military service academies, and the Department of Veterans Affairs. There is significant variability in reported rates of men's MST. Averaging across studies covering the past 30 years, we found that MST is reported by approximately 0.09% of male service members each year, with a range of 0.02% to 6%. MST is reported by 1.1% of male service members over the course of their military careers, with a range of 0.03% to 12.4%. Determining prevalence and incidence rates for both men's and women's MST is fraught with limitations, including (a) cross-study variations in sample, method, definitions, and assessment and (b) barriers to reporting MST. Each of these limitations is reviewed with an eye toward identifying male-specific issues.
Hepatitis C virus persisting after clinically apparent sustained virological response to antiviral therapy retains infectivity in vitro

Hepatitis C virus (HCV) can persist in the liver, lymphoid cells, and serum of individuals with apparently complete spontaneous or therapy‐induced resolution of hepatitis C and can replicate in vivo and in vitro in human T cells. The current study was aimed at assessing the infectivity of HCV persisting at very low levels using the previously established HCV infection system in human T cells. Naive lymphoid cells were exposed to plasma and/or supernatants from cultured peripheral blood mononuclear cells from nine individuals with apparent sustained virological response after completion of antiviral therapy. Exposed cells were analyzed for HCV RNA–positive and HCV RNA–negative strands and, in selected cases, for HCV nonstructural protein 5a (NS5a), the appearance of HCV variants, and the release of virions by immunoelectron microscopy (IEM). The results showed that 11 of the 12 established cultures became HCV RNA–positive strand–reactive, whereas 4 also expressed the virus replicative strand. NS5a protein was detected in the de novo infected cells, and clonal sequencing revealed HCV variants not found in inocula. IEM demonstrated enveloped HCV particles in plasma used as inocula and in culture supernatant from T cells exposed to that plasma. Overall, HCV carried in three of the nine individuals studied elicited productive infection in vitro. Conclusion: HCV persisting at very low levels long after therapy‐induced resolution of chronic hepatitis C can remain infectious. The retained biological competence of the virus might have implications with respect to the mechanisms of its persistence and the epidemiology of HCV infection. (HEPATOLOGY 2009.)
Perceptions of evidence‐based practice: A survey of Australian occupational therapists

Evidence-based practice (EBP) requires clinicians to access, appraise and integrate research literature with clinical experience and clients' perspectives. Currently, little is known about occupational therapists' attitudes to EBP, their perception of implementation barriers or their educational needs. A questionnaire reflecting these issues was sent to a proportionate random sample of 1491 members of the national professional occupational therapy association, OT AUSTRALIA. The questionnaire was completed by 649 (44%) participants. Occupational therapists were positive about EBP with most (96%) agreeing that EBP is important to occupational therapy. Although 56% used research to make clinical decisions, more relied on clinical experience (96%), information from continuing education (82%) and colleagues (80%). Lack of time, evidence and skills were identified as the main barriers to the implementation of EBP. Over half (52%) expressed strong interest in EBP skills training, and most (80%) indicated an interest in the availability of brief summaries of evidence. Targeted educational initiatives, resources and systems are needed to support EBP in occupational therapy.
Adaptation of the Information and Support Needs Questionnaire Into Turkish to Use in Women With Primary Relatives With Breast Cancer

Background: Breast cancer is the most frequent type of cancer among women in Turkey. Because of the high incidence of breast cancer, many women have family members who have experienced breast cancer. Objective: The aim of this study was to test the validity and reliability of the Information and Support Needs Questionnaire (ISNQ) for Turkish women, which was originally developed for use in women with primary relatives who had breast cancer. Methods: The study sample included 97 women whose primary female relatives had breast cancer. Data were collected with a Demographic Questionnaire and the ISNQ. The ISNQ was developed by Chalmers et al and was composed of 2 scales: the Importance Scale and the Needs Met Scale. Results: Linguistic validity, translation, back translation, and content validity were tested with expert opinions. Item-to-total correlation scores ranged from 0.22 to 0.72 on the Importance Scale and from 0.23 to 0.60 on the Needs Met Scale. Cronbach α coefficients were.81 and.83 on the Importance Scale and the Needs Met Scale. Conclusions: The ISNQ, adapted into Turkish, was found to have sufficient validity and reliability. Implications for Practice: The questionnaire can be used to determine information and support needs of women whose primary relatives have breast cancer. Nurses and other health professionals can conduct interventions directed toward meeting information and support needs of women whose primary relatives have breast cancer.