Miracle-dz/UniFAR-FTUs huggingface dataset:
Accounting for cluster randomization: a review of primary prevention trials, 1990 through 1993.

OBJECTIVES This methodological review aims to determine the extent to which design and analysis aspects of cluster randomization have been appropriately dealt with in reports of primary prevention trials. METHODS All reports of primary prevention trials using cluster randomization that were published from 1990 to 1993 in the American Journal of Public Health and Preventive Medicine were identified. Each article was examined to determine whether cluster randomization was taken into account in the design and statistical analysis. RESULTS Of the 21 articles, only 4 (19%) included sample size calculations or discussions of power that allowed for clustering, while 12 (57%) took clustering into account in the statistical analysis. CONCLUSIONS Design and analysis issues associated with cluster randomization are not recognized widely enough. Reports of cluster randomized trials should include sample size calculations and statistical analyses that take clustering into account, estimates of design effects to help others planning trials, and a table showing the baseline distribution of important characteristics by intervention group, including the number of clusters and average cluster size for each group.
Sickle Cell Disease Subphenotypes in Patients From Southwestern Province of Saudi Arabia

Sickle cell disease (SCD) is common in the Eastern and Southwestern (SW) Provinces of Saudi Arabia. We studied 159 patients with SCD to better characterize its phenotype in the SW Province, where patients usually have a HBB haplotype of African origin. All cases had history and examination, chart review, and laboratory testing. Blood tests were obtained during steady state and included: complete blood count, reticulocytes, hemoglobin electrophoresis, lactate dehydrogenase, and G6PD level. HBB haplotype and presence of &agr;-thalassemia were also determined. Frequency of various SCD complications was as follows: painful episodes of variable severity occurred in majority of patients (98%), osteonecrosis (14%), acute chest syndrome (22%), splenic sequestration (23%), gallstones (34%), stroke (7.5%), priapism (2.6%), serious infections (11.5%), and persistent splenomegaly (11%) beyond 5 years of age. No patient had leg ulcer. History of asthma and high steady state white blood cells count were associated with increased risk of acute chest syndrome. Coinheritance of &agr;-thalassemia was associated with a lower frequency of gallstones. Higher fetal hemoglobin level was associated with persistent splenomegaly but not with other complications. Splenic sequestration was more common among males and was associated with lower steady state hemoglobin. SCD phenotype in the SW Province is variable and comparable with African Americans except for the rarity of priapism and the absence of leg ulcers. Fetal hemoglobin level was not associated with SCD vaso-occlusive complications. New genetic modifiers and environmental factors might modulate the phenotype of SCD in Saudi Arabia.
On the combined estimation of technical efficiency and its application to agriculture

Assessment of effi ciency of businesses has been considered an object of interest by economists since the 1950’s. A number of methods have been developed, including the so-called parametric approaches, using the regression analysis, and the non-parametric approaches, connected with the mathematical programming techniques. However, the diversity of available methods, especially when supplying contradictory estimates, leads to confusion, hindering an objective interpretation of results. In this paper, we propose a procedure leading to the reduction of such discrepancies by the proper modifi cation of a combined method linking the non-parametric approach with a parametric one. Usefulness of the proposed solution is shown by estimation of technical effi ciency concerning the agricultural production in the USA and the selected regions of the European Union.
Peritoneal Transport Kinetics of Proteins in Children on Chronic Peritoneal Dialysis

Objective This study describes a modified 4-hour peritoneal equilibration test (PET) for analyzing peritoneal transport characteristics of proteins with different molecular weights and predicting daily peritoneal protein losses in children on chronic peritoneal dialysis (PD). Design Cross-sectional study. Setting A single regional pediatric dialysis unit in a teaching hospital. Patients 9 stable pediatric dialysis patients; 4 were on continuous ambulatory PD, 5 were on continuous cycling PD. Main Outcome Measures Serum and dialysate concentrations of IgG, albumin, β2-microglobulin, and transferrin were determined during a PET. Changes in dialysate-to-plasma (D/P) ratios were determined hourly. Agreement between PET-derived and measured daily peritoneal protein losses was examined. Results The D/P ratio decreased with increased molecular radius (p < 0.0001). Many children had low plasma levels of IgG, albumin, and transferrin, but elevated levels of β2-microglobulin. The D/P ratio increased linearly during the PET for all measured proteins, regardless of molecular weight. There was close correlation between 4-hour PET protein losses and 24-hour losses during routine PD. Conclusions Proteins are lost through the peritoneum according to their size, demonstrating linear transport kinetics during a 4-hour PET. The PET-derived data predicted daily protein losses in children on chronic PD. This approach might help to eliminate inaccuracies due to incomplete dialysate collection.
Incidence and causes of death in HIV‐infected persons receiving highly active antiretroviral therapy compared with estimates for the general population of similar age and from the same geographical area

Since the introduction of highly active antiretroviral therapy (HAART), the incidence of death in HIV‐infected patients has dramatically decreased, and causes of death other than those related to HIV infection have increased, although it is unclear how these parameters compare with those in the age‐matched general population living in the same geographical region.
Molecular Evidence for Novel Planctomycete Diversity in a Municipal Wastewater Treatment Plant

ABSTRACT We examined anoxic and aerobic basins and an anaerobic digestor of a municipal wastewater treatment plant for the presence of novel planctomycete-like diversity. Three 16S rRNA gene libraries were constructed by using a 16S rRNA-targeted universal reverse primer and a forward PCR primer specific for Planctomycetes. Phylogenetic analysis of 234 16S rRNA gene sequences defined 110 operational taxonomic units. The majority of these sequences clustered with the four known genera, Pirellula (32%), Planctomyces (18.4%), Gemmata (3.8%), and Isosphaera (0.4%). More interestingly, 42.3% of the sequences appeared to define two distantly separated monophyletic groups. The first group, represented by 35.5% of the sequences, was related to the Planctomyces group and branched as a monophyletic cluster. It exhibited between 11.9 and 20.3% 16S rRNA gene sequence dissimilarity in comparisons with cultivated planctomycetes. The second group, represented by 6.8% of the sequences, was deeply rooted within the Planctomycetales tree. It was distantly related to the anammox sequences (level of dissimilarity, 20.3 to 24.4%) and was a monophyletic cluster. The retrieved sequences extended the intralineage phylogenetic depth of the Plantomycetales from 23 to 30.6%. The lineages described here may have a broad diversity of undiscovered biochemical and metabolic novelty. We developed a new 16S rRNA-targeted oligonucleotide probe and localized members of one of the phylogenetic groups using the fluorescent in situ hybridization technique. Our results indicate that activated sludge contains very diverse representatives of this group, which grow under aerobic and anoxic conditions and even under anaerobic conditions. The majority of species in this group remain poorly characterized.
Bromocriptine for Treatment of Benign Breast Disease: A double‐blind clinical trial versus placebo

Over the last few years bromocriptine has been used for treatment of mastodynia and benign breast disease, but with contradictory results. This double‐blind clinical trial was performed to determine the efficacy of this prolactin inhibitor as compared with placebo. Subjective discomfort, clinical examination of the breast lesions, echomam‐mography and breast thermography were evaluated before, during and after 3 months of treatment and in a further follow‐up. Plasma levels of estradiol, progesterone and prolactin were measured over the same time. Significant reduction of mastodynia and significant improvement of the breast lesions were observed in the group given bromocriptine, though echomammography and breast thermography did not reveal any significant differences between the two groups. Plasma prolactin levels were significantly reduced by bromocriptine administration.
Central blockade of TLR4 improves cardiac function and attenuates myocardial inflammation in angiotensin II-induced hypertension.

AIMS Understanding the novel signalling pathways involved in the pathogenesis of hypertension is vital for the development of effective therapeutic strategies. Recent evidence suggests a role for Toll-like receptor (TLR) 4 in the development of cardiovascular diseases. Although brain has been implicated in the pathogenesis of hypertension, the role of brain TLR4 in hypertension is largely unexplored. Therefore, we investigated the role of brain TLR4 in angiotensin (Ang) II-induced hypertension and whether central TLR4 blockade has cardioprotective effects in hypertension. METHODS AND RESULTS Hypertension was induced in male Sprague-Dawley rats by delivering AngII for 14 days. The rats were administered either specific TLR4 blocker, viral inhibitory peptide (VIPER), or control peptide, intracerebroventricularly. Blood pressure, and cardiac hypertrophy and function, was evaluated by radiotelemetry and echocardiography, respectively. Blood and paraventricular nucleus were collected for measurement of plasma norepinephrine (NE), tumour necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and TLR4 expression, respectively. Heart was analysed for TNF-α, IL-1β, inducible nitric oxide synthase (iNOS), nuclear factor-kappa B (NFκB), and renin-angiotensin system (RAS) components. Hypertensive rats had dramatically increased TLR4 expression compared with normotensive rats. Central blockade of TLR4 delayed progression of hypertension and improved cardiac hypertrophy and function in hypertensive rats. TLR4 blockade significantly reduced myocardial TNF-α, IL-1β, iNOS levels, NFκB activity, and altered RAS components in hypertensive rats. These results were associated with reduced circulating NE levels in VIPER-treated hypertensive rats. CONCLUSION These results provide mechanistic evidence that AngII-induced hypertensive effects are mediated, at least in part, by brain TLR4, and that brain TLR4 blockade attenuates AngII-induced hypertensive response, possibly via down-regulation of myocardial inflammatory molecules and sympathetic activity.
Fundamentals for an Osteopathic Obesity Designed Study: The Effects of Education on Osteopathic Medical Students’ Attitudes Regarding Obesity

Abstract Context Obesity is a major health concern in the United States, and its prevalence continues to rise. Although it is a common health issue, many people, including health care professionals, are biased against people with obesity. Objective To determine whether a comprehensive obesity curriculum presented to students in medical school can positively influence their attitudes toward obesity. Methods The study was designed around a comprehensive educational obesity curriculum at Touro University College of Osteopathic Medicine-CA, involving the classes of 2013 through 2018. A survey to assess student attitudes toward obesity was distributed to first-year students before the curriculum, directly after completion, and each year after until graduation (graduating classes of 2015 through 2018). Second- and third-year medical students in 2011 (graduating classes of 2014 and 2013), who did not complete the curriculum, were given an examination to establish baseline values and served as the control group. The obesity curriculum consisted of lectures delivered during the first and second year of medical school and case study simulations during the third year. Knowledge gained from the curriculum was assessed with a multiple-choice examination, and bias was assessed using the Fat Phobia Scale. Results A total of 718 first- through fourth-year students were included. Students who completed the first year of the obesity curriculum (n=528) showed significantly greater medical knowledge regarding obesity-related epidemiology, pathogenesis, biochemistry, pathophysiology, and metabolic factors; nutrition, diet, physical activity, self-control, and behavior modification; pharmacologic and nonpharmacologic interventions; and associated chronic disorders, based on their multiple-choice examination scores compared with the control group. The examination scores indicated significant increases in medical knowledge compared with the precurriculum cohort after the curriculum (OMS I students: 130 [72.4%]; 133 [92.6%]; 133 [91.1%]; 132 [89.0%]; vs control: 105 [47.2%]; 134 [52.6%], respectively [P<.01]). In all 4 years observed, there was a significant reduction in bias among first-year medical students after obesity curriculum (before: 3.65, 3.76, 3.57, 3.61, and after: 3.47, 3.38, 3.34, 3.37, respectively) (P<.05). The reduction in bias was also significantly sustained throughout the fourth year. Conclusion A comprehensive obesity curriculum throughout medical school resulted in an improvement in students’ attitudes toward and knowledge of obesity.
Does peak nasal inspiratory flow relate to peak expiratory flow?

AIMS Measurement of Peak Nasal Inspiratory Flow (PNIF) seems to be a cheap and easily performed method to assess nasal patency. As demonstrated in a previous work, PNIF is influenced by SEX, AGE and HEIGHT. However there is a large degree of between-patient variability in PNIF levels. The purpose of this analysis is to determine whether the measurement of the pulmonary ventilatory capacity, by mean of Peak Expiratory Flow (PEF), enables more precise determination of PNIF. METHODS AND RESULTS Repeated measurements of PNIF and PEF were performed in 112 volunteers. 100 of these fulfilled the study criteria (55 females and 45 males) and all of them were non-smokers, non-asthmatic, without nose and paranasal sinuses problems, with ages ranging from 15 to 71 years. Statistical analysis was undertaken to determine whether a relationship existed between PNIF and age, sex and height, but which also considered PEF. The data from both experiments were analysed together. In both groups there is a clear tendency for PNIF to increase with PEF. As clearly demonstrated in this work the value of PEF is informative in predicting PNIF and that the larger the value of PEF, the larger the value of PNIF. CONCLUSIONS PNIF is a useful method to study nasal patency in both primary and secondary care to aid diagnosis of nasal disease, but low values of PNIF have to be confirmed by a study of the PEF as PNIF low values may be an expression of low ventilatory activity rather than an expression of nasal obstruction.
Quantitative proteome profiling of human myoma and myometrium tissue reveals kinase expression signatures with potential for therapeutic intervention

Uterine leiomyomas are benign tumors affecting a large proportion of the female population. Despite the very high prevalence, the molecular basis for understanding the onset and development of the disease are still poorly understood. In this study, we profiled the proteomes and kinomes of leiomyoma as well as myometrium samples from patients to a depth of >7000 proteins including 200 kinases. Statistical analysis identified a number of molecular signatures distinguishing healthy from diseased tissue. Among these, nine kinases (ADCK4, CDK5, CSNK2B, DDR1, EPHB1, MAP2K2, PRKCB, PRKG1, and RPS6KA5) representing a number of cellular signaling pathways showed particularly strong discrimination potential. Preliminary statistical analysis by receiver operator characteristics plots revealed very good performance for individual kinases (area under the curve, AUC of 0.70–0.94) as well as binary combinations thereof (AUC 0.70–1.00) that might be used to assess the activity of signaling pathways in myomas. Of note, the receptor tyrosine kinase DDR1 holds future potential as a drug target owing to its strong links to collagen signaling and the excessive formation of extracellular matrix typical for leiomyomas in humans.
Estrogen receptor and progesterone receptor status in breast cancer in relation to age, histological grade, size of lesion and lymph node involvement.

INTRODUCTION Breast cancer is the most common malignancy of women in Kashmir. This study was conducted with the objective of assessing hormone receptor positivity and its correlation with age at diagnosis, tumor size, histological grade and lymph node metastasis. MATERIALS AND METHODS 132 newly diagnosed cases of invasive breast cancer diagnosed at the Department of Pathology, SKIMS, Srinagar, JandK, were included after excluding biopsies, in-situ lesions and recurrence cases. RESULTS Mean age of the patients was 48.2 years, 59.1% being ≤ 50 years of age. Mean duration of symptoms was 6.32 months. Most lesions (65.1%) were 2-5 cm and 16.7% were ≥ 5.0 cm in greatest dimension. The predominant (80.3%) morphology was IDC-NOS. The majority of the cases presented as grade II (52.1%) lesions and lymph node involvement was present in 65.2%. ER and PR were positive in 66.3% and 63.4% cases, respectively, increasing with rising age. High grade lesions and larger size tumors were more likely to be ER and PR negative. No correlation was found between ER/PR status and lymph node metastasis. CONCLUSIONS ER and PR expression in breast cancers in the current study was found to be higher than studies done in India/Asia but lower than studies conducted in the West, even on Indian/Asian immigrants. Markedly lower receptor expression in Indian/Asian studies is likely due to preanalytic variables, thresholds for positivity, and interpretation criteria. American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Immunohistochemical Testing of Estrogen and Progesterone Receptors in Breast Cancer are strongly advocated for standardization of receptor evaluation and for clinical management of breast cancer patients to provide best therapeutic options.
Integration Scenarios of Demand Response into Electricity Markets: Load Shifting, Financial Savings and Policy Implications

Demand Response allows for the management of demand side resources in real-time; i.e. shifting electricity demand according to fluctuating supply. When integrated into electricity markets, Demand Response can be used for load shifting and as a replacement for both control reserve and balancing energy. These three usage scenarios are compared based on historic German data from 2011 to determine that load shifting provides the highest benefit: its annual financial savings accumulate to €3.110M for both households and the service sector. This equals to relative savings of 2.83% compared to a scenario without load shifting. To improve Demand Response integration, the proposed model suggests policy implications: reducing bid sizes, delivery periods and the time-lag between market transactions and delivery dates in electricity markets.
Cerebral blood flow, sympathetic nerve activity and stroke risk in obstructive sleep apnoea. Is there a direct link?

Abstract Obstructive sleep apnoea (OSA) is significantly associated with the risk of stroke, and this association is independent of other risk factors, including hypertension, atrial fibrillation and diabetes mellitus. Therefore, additional pathogenic mechanisms may exist, which contribute to the increased risk of stroke. OSA is characterized by prolonged sympathetic overactivity; however the role of the sympathetic nervous system in regulating cerebral circulation remains a matter of controversy. Converging data indicate that brain perfusion is significantly distorted in OSA, with reported decreases in cerebral blood flow as well as intermittent surges in blood pressure and cerebral blood flow velocity. Based on recent research, there is accumulating evidence that sympathetic nerve activity is an important element in brain protection against excessive increases in perfusion pressure during blood pressure surges and flow during rapid eye movement sleep. The aim of this article was to review: (i) the current physiological knowledge related to the role of the sympathetic system in the regulation of cerebral blood flow, (ii) how the influence of the sympathetic system on cerebral vessels is affected by apnoea (increased PaCO2) and (iii) the potential significance of the pathological sympathetic system/PaCO2 interplay in OSA. Sympathetic system seems to be at least partially involved in pathogenesis of distorted haemodynamics and stroke in OSA patients. However, there are still several open questions that need to be addressed before the effective therapeutic strategies can be implemented.
Patient-specific instruments: advantages and pitfalls

Patient-specific instruments (PSI) aim to improve the accuracy of total knee replacement (TKR) based on computer-assisted preoperative planning. In this work, the authors describe the advantages and pitfalls of PSI based on their clinical experience. The main conclusion of this work is that PSI has direct impact on the logistical and technical features of TKR with some advantages and pitfalls.
Selenium-deficient diet enhances protein oxidation and affects methionine sulfoxide reductase (MsrB) protein level in certain mouse tissues

Mammals contain two methionine sulfoxide (MetO) reductases, MsrA and MsrB, that catalyze the thioredoxin-dependent reduction of the S-MetO and R-MetO derivatives, respectively, to methionine. The major mammalian MsrB is a selenoprotein (except in the heart). Here, we show that there is a loss of MsrB activity in the MsrA–/– mouse that correlates with parallel losses in the levels of MsrB mRNA and MsrB protein, suggesting that MsrA might have a role in MsrB transcription. Moreover, mice that were grown on a selenium-deficient (SD) diet showed a substantial decrease in the levels of MsrB-catalytic activity, MsrB protein, and MsrB mRNA in liver and kidney tissues of both WT and MsrA–/– mouse strains. Whereas no significant protein-MetO could be detected in tissue proteins of young mature mice grown on a selenium-adequate diet, growth on the SD diet led to substantial accumulations of MetO in proteins and also of protein carbonyl derivatives in the liver, kidney, cerebrum, and cerebellum, respectively. In addition, accumulation of protein-MetO derivatives increased with age in tissues of mice fed with a selenium-adequate diet. It should be pointed out that even though the total Msr level is at least 2-fold higher in WT than in MsrA–/– mice, SD diet causes an equal elevation of protein-MetO (except in brain cerebellum) and carbonyl levels in both strains, suggesting involvement of other selenoproteins in regulation of the level of cellular protein-MetO accumulation. Furthermore, the development of the ``tip-toe'' walking behavior previously observed in the MsrA–/– mice occurred earlier when they were fed with the SD diet.