Miracle-dz/UniFAR-FTUs huggingface dataset:
How to Deal With Kidney Retransplantation—Second, Third, Fourth, and Beyond

Kidney transplantation is the best health option for patients with end-stage kidney disease. Ideally, a kidney transplant would last for the lifetime of each recipient. However, depending on the age of the recipient and details of the kidney transplant, there may be a need for a second, third, fourth, or even more kidney transplants. In this overview, the outcome of multiple kidney transplants for an individual is presented. Key issues include surgical approach and immunologic concerns. Included in the surgical approach is an analysis of transplant nephrectomy, with indications, timing, and immunologic impact. Allograft thrombosis, whether related to donor or recipient factors merits investigation to prevent it from happening again. Other posttransplant events such as rejection, viral illness (polyomavirus hominis type I), recurrent disease (focal segmental glomerulosclerosis), and posttransplant lymphoproliferative disease may lead to the need for retransplantation. The pediatric recipient is especially likely to need a subsequent kidney transplant. Finally, noncompliance/nonadherence can affect both adults and children. Innovative approaches may reduce the need for retransplantation in the future.
Divergent metabolism between Trypanosoma congolense and Trypanosoma brucei results in differential sensitivity to metabolic inhibition

Animal African Trypanosomiasis (AAT) is a debilitating livestock disease prevalent across sub-Saharan Africa, a main cause of which is the protozoan parasite Trypanosoma congolense. In comparison to the well-studied T. brucei, there is a major paucity of knowledge regarding the biology of T. congolense. Here, we use a combination of omics technologies and novel genetic tools to characterise core metabolism in T. congolense mammalian-infective bloodstream-form parasites, and test whether metabolic differences compared to T. brucei impact upon sensitivity to metabolic inhibition. Like the bloodstream stage of T. brucei, glycolysis plays a major part in T. congolense energy metabolism. However, the rate of glucose uptake is significantly lower in bloodstream stage T. congolense, with cells remaining viable when cultured in concentrations as low as 2 mM. Instead of pyruvate, the primary glycolytic endpoints are succinate, malate and acetate. Transcriptomics analysis showed higher levels of transcripts associated with the mitochondrial pyruvate dehydrogenase complex, acetate generation, and the glycosomal succinate shunt in T. congolense, compared to T. brucei. Stable-isotope labelling of glucose enabled the comparison of carbon usage between T. brucei and T. congolense, highlighting differences in nucleotide and saturated fatty acid metabolism. To validate the metabolic similarities and differences, both species were treated with metabolic inhibitors, confirming that electron transport chain activity is not essential in T. congolense. However, the parasite exhibits increased sensitivity to inhibition of mitochondrial pyruvate import, compared to T. brucei. Strikingly, T. congolense exhibited significant resistance to inhibitors of fatty acid synthesis, including a 780-fold higher EC50 for the lipase and fatty acid synthase inhibitor Orlistat, compared to T. brucei. These data highlight that bloodstream form T. congolense diverges from T. brucei in key areas of metabolism, with several features that are intermediate between bloodstream- and insect-stage T. brucei. These results have implications for drug development, mechanisms of drug resistance and host-pathogen interactions.
The Box Task: A novel tool to differentiate the primary progressive aphasias

Differentiating the primary progressive aphasia (PPA) variants in clinical settings remains complex and challenging, especially for the logopenic (lv‐PPA) and non‐fluent variants (nfv‐PPA). Recent studies suggest that visuospatial memory is more compromised in lv‐PPA than in nfv‐PPA and is relatively spared in the semantic variant (sv‐PPA). Accordingly, assessment of visuospatial memory performance may assist in the differential diagnosis of PPA variants. Here, we investigated the utility of a novel computerised visuospatial working memory test—the Box Task—to differentiate the three PPA variants and typical Alzheimer’s disease (AD).
Risk factors associated with stress symptoms during pregnancy and postpartum: integrative literature review

ABSTRACT Stressful events during prenatal and postpartum have been associated with an increase in the susceptibility to the onset of various diseases, threatening mental and physical health of mother and baby. The aim of this study was to synthesize and analyze the literature related to risk factors associated with stress symptoms during pregnancy and immediate postpartum by means of an integrative review. The search was conducted from January 2013 to July 2020, consulting the following databases: PubMed, PsycINFO, CINAHL, Web of Science and LILACS. In total, 1,677 studies were identified, resulting in 38 articles included in this review. The risk factors most associated with stress in pregnancy and postpartum were related to emotional factors (including mental health, traumatic events and obstetric complications); social and economic factors; mother’s health conditions and life style behaviors, and social support and partner related stress. The results are discussed under the light of the biopsychosocial model, which proposes that biological, psychological, and social domains should be considered in order to minimize psychosocial risk conditions. It is concluded that strategies to promote psychological care, education, additional social support and health behaviors should be considered to prevent adverse birth outcomes and to increase maternal well-being.
Personality, Polyculturalism, and Cultural Intelligence: A Cross-Cultural Survey Study

The ability to function effectively in intercultural contexts is increasingly important in our globalized world. This ability has been conceptualized as cultural intelligence (or CQ), and many studies have focused on the factors associated with high CQ. The present study explored personality traits and the lay theory of polyculturalism as factors that predict CQ in two cultural groups (300 Chinese, 247 Filipinos) of university students. The respondents completed a questionnaire that included scales measuring the Big Five personality factors, polyculturalism, and CQ. Hierarchical regression analyses of questionnaire responses from the two samples indicated that consistent with the previous literature, openness to experience and polyculturalism positively predicted CQ in both samples; in addition, emotional stability predicted CQ among the Chinese, and conscientiousness predicted CQ among the Filipinos. The results are discussed in terms of cultural similarities and differences in the experience of CQ. Kepribadian, Polikulturalisme, dan Kecerdasan Budaya: Studi Survei Lintas-Budaya
Global cascade of care for chronic hepatitis C virus infection: A systematic review and meta‐analysis

The World Health Organization 2030 targets for hepatitis C virus (HCV) elimination include diagnosing 90% of people with HCV and treating 80% of people diagnosed with HCV. This systematic review assessed reported data on the HCV care cascade in various countries and populations, with a focus on direct‐acting antiviral (DAA) treatment uptake. Bibliographic databases and conference presentations were searched for studies reporting the HCV care cascade (DAA treatment uptake was a requirement) among the overall population with HCV or sub‐populations at greater risk of HCV. Population‐based studies, with participants representative of a city, province/state or country were eligible. Twenty eligible studies were included, reporting HCV care cascade in 28 populations/sub‐populations from 11 countries. DAA treatment uptake at national levels was reported from Iceland (95%), Egypt (92%), Georgia (79%), Norway (18%) and Sweden (8%), and at sub‐national levels from the Netherlands (52%), Canada (50%), the United States (29%) and Denmark (5%). Among people with HIV‐HCV co‐infection, DAA treatment uptake was 62% in Canada, 44% in the Netherlands, 21% in Switzerland and 18% in the United States. Among people who inject drugs, DAA treatment uptake was 50% in Georgia, 40% in Canada, 37% in Australia and 13% in the United States. Data among people experiencing homelessness were only available from the United States (treatment uptake: 12%–14%). We found no eligible study reporting HCV care cascade data in prisons. Relatively few countries reported HCV care cascade at the national level. DAA treatment uptake was widely varied across populations/sub‐populations, with higher rates reported in recent years.
Efficacy and safety of CD19‐directed CAR‐T cell therapies in patients with relapsed/refractory aggressive B‐cell lymphomas: Observations from the JULIET, ZUMA‐1, and TRANSCEND trials

Chimeric antigen receptor (CAR)‐T cell therapies have improved the outcome for many patients with relapsed or refractory aggressive B‐cell lymphomas. In 2017, axicabtagene ciloleucel and soon after tisagenlecleucel became the first approved CAR‐T cell products for patients with high‐grade B‐cell lymphomas or diffuse large B‐cell lymphoma (DLBCL) who are relapsed or refractory to ≥ 2 prior lines of therapy; lisocabtagene maraleucel was approved in 2021. Safety and efficacy outcomes from the pivotal trials of each CAR‐T cell therapy have been reported. Despite addressing a common unmet need in the large B‐cell lymphoma population and utilizing similar CAR technologies, there are differences between CAR‐T cell products in manufacturing, pivotal clinical trial designs, and data reporting. Early reports of commercial use of axicabtagene ciloleucel and tisagenlecleucel provide the first opportunities to validate the impact of patient characteristics on the efficacy and safety of these CAR‐T cell therapies in the real world. Going forward, caring for patients after CAR‐T cell therapy will require strategies to monitor patients for sustained responses and potential long‐term side effects. In this review, product attributes, protocol designs, and clinical outcomes of the key clinical trials are presented. We discuss recent data on patient characteristics, efficacy, and safety of patients treated with axicabtagene ciloleucel or tisagenlecleucel in the real world. Finally, we discuss postinfusion management and preview upcoming clinical trials of CAR‐T cell therapies.
Unintentional injury and its determinants among adolescents

Background: Globally, unintentional injury has been a documented public health problem among adolescents having debilitating consequences and accountable for economic burden. The study was undertaken to estimate the prevalence of unintentional injury, identify the determinants and consequences among adolescents. Design and Methods: This cross-sectional study recruited 222 adolescents using systematic random sampling from a site covered under UHTC Srinagar Garhwal, Uttarkhand. Binary and multivariate logistic regression was used to compute crude and adjusted odds ratio (95% CI) for establishing an association between risk factors and unintentional injury. Descriptive measures (causes, consequences, etc.) describing injuries were presented in tabular, graphical form in proportions. Results: 73.1% of the adolescents suffered from unintentional injury. The risk factors associated (statistically insignificant) with unintentional injury was males (AOR=1.019, 95% CI=0.524-1.979), living in nuclear family (AOR=1.540, 95% C =0.766-3.093), smoked tobacco (AO=2.797, 95% CI=0.227-34.4377), visually impaired (AOR=1.629 95% CI=0.548-6.458) and living in house with overcrowding (AOR =1.66, 95% CI=0.818-3.395). Five percent of those affected with unintentional injury had disability. % of those affected with unintentional injury had disability. Conclusions: Health education addressing causes, risk factors, consequences of unintentional injury among adolescents, parents, school, and district health authorities should be mandated for the formulation of policy to prevent unintentional injuries. Significance for public health Adolescence is often a period of life that connects adolescence to maturity and is marked by significant physical, psychological, and social changes. The country's changing disease profile is profoundly embedded in the country's recent social, fiscal, and environmental developments. The cost of adolescent accidental injury to the country is rising as a result of damage and death. As a result, avoiding accidental accidents is crucial. More evidence on the overall costs and benefits of injury prevention is also required. This will assist governments in prioritising investments, and it is a subject on which leading scholars and organisations will collaborate. Injury prevention can be low-cost, with a high return on investment in terms of preventable years of life loss and disability-adjusted life years for young children.
Safety, Feasibility, Yield, Diagnostic and Prognostic Implications of Transjugular Liver Biopsy in Children and Adolescents

Supplemental Digital Content is available in the text ABSTRACT Objectives: The objectives of the study were to evaluate the indications, feasibility, complications and clinical implications of transjugular liver biopsy (TJLB) in children. Methods: Data of all TJLB performed in children <18 years old was retrieved from the computerized hospital information system. TJLB was done using a 19 G quick-core needle biopsy system with 20 mm throw length. Hepatic venous pressure gradient was additionally measured in children with portal hypertension. A single pathologist reviewed all the biopsies again and provided structured information. Results: A total of 102 children, including 5 with acute liver failure underwent TJLB with technical success in 101 (99%). A mean of 2.3 ± 0.9 passes (range: 1–5) was taken for the biopsy. The most common indications for TJLB in our cohort were elevated international normalized ratio >1.5 (66, 64.7%), ascites (46, 45.1%) and thrombocytopenia (platelet count < 60,000/mm3) (42, 41.2%). Mean size of the tissue received was 14.5 ± 5.6 mm with an average of 10.2 ± 4.7 portal tracts. Only one child developed major (category D) complication (hemobilia) and 12 (11.8%) developed minor complications post-procedure. Etiological diagnosis could be made in a total of 64 (63.9%) children undergoing TJLB, the most common diagnosis being autoimmune hepatitis (n = 31), non-cirrhotic portal fibrosis (n = 16) and drug-induced liver injury (n = 4). Conclusion: TJLB is well tolerated, feasible and helps make a diagnosis in close to 64% children allowing timely medical and/or surgical intervention. It is especially useful for diagnosis of autoimmune liver diseases, drug-induced liver injury and non-cirrhotic portal fibrosis.
Dietary omega-3 and omega-6 fatty acids and neonatal liver metabolism

ii PREFACE. iii TABLE OF CONTENTS . v LIST OF TABLES. ix LIST OF FIGURES. xi LIST OF ABBREVIATIONS . xiii COMMON NAMES OF FATTY ACIDS. xv ACKNOWLEDGEMENTS. xvi CHAPTER 1: Introduction . 1 1.1 Background and rationale . 1 1.2 Literature review. 2 1.2.1 Fatty acids. 2 1.2.2 The n-3 and n-6 fatty acids . 7 1.2.2.1 Definitions and dietary sources of n-3 and n-6 fatty acids . 7 1.2.2.2 Historical perspectives of research and dietary recommendations for essential fatty acids. 9 1.2.2.3 Contemporary dietary recommendations for essential fatty acids. 12 1.2.2.4 Competition between n-3 and n-6 fatty acids . 17 1.2.2.5 Functional roles of n-3 and n-6 fatty acids . 20 1.2.2.6 Essential fatty acids and regulation of liver metabolism and gene expression . 25 1.2.3 Essential fatty acids in development . 29 1.2.3.1 Placental transfer of essential fatty acids. 29 1.2.3.2 Essential fatty acids in milk. 33 1.2.3.3 Tissue accretion and functions of essential fatty acids during fetal and infant development. 39 1.2.4 Adaptations in macronutrient metabolism at birth . 43 1.2.5 Summary. 46 1.3 Purpose of the research. 47 vi 1.4 Research rationale and objectives. 48 1.4. 1 Rationale and objectives for Chapter 2. 48 1.4. 2 Rationale and objectives for Chapter 3. 49 1.4. 3 Rationale and objectives for Chapter 4. 51 CHAPTER 2: High dietary omega-6 fatty acids contribute to reduced docosahexaenoic acid in the developing brain and inhibit secondary neurite growth. 53 2.1 Chapter synopsis. 53 2.2 Introduction . 54 2.3 Experimental procedures . 56 2.3.1 Animals and diets . 56 2.3.2 Tissue collection . 57 2.3.3 Primary neuron cultures. 57 2.3. 4 Analytical methods . 58 2.3. 5 Statistical analyses. 59 2.4 Results . 59 2.4. 1 Effect of dietary 18:2n-6 and the 18:2n-6/18:3n-3 balance on piglet frontal cortex. 59 2.4. 2 Effect of dietary 22:6n-3 and 20:4n-6 on piglet frontal cortex. 62 2.4. 3 Effects of dietary n-6 and n-3 fatty acids on plasma compared to the brain . 62 2.4. 4 Primary neuronal cell uptake of 22:6n-3 and 22:5n-6. 64 2.4. 5 Effects of 22:6n-3 and 22:5n-6 on neurite outgrowth . 65 2.4. 6 Effects of dietary n-6 and n-3 fatty acids on heart and liver . 66 2.5 Discussion. 68 CHAPTER 3: Metabolic development in the liver and the implications of the n-3 fatty acid supply. 74 3.1 Chapter synopsis. 74 3.2 Introduction . 75 3.3 Materials and methods. 77 3.3.1 Animals and diets . 77 3.3.2 Proteomic studies to identify novel protein targets . 82 3.3.3 Gene expression. 84
In vitro activity of SPR719 against Mycobacterium ulcerans, Mycobacterium marinum and Mycobacterium chimaera

Nontuberculosis mycobacterial (NTM) infections are increasing in prevalence across the world. In many cases, treatment options for these infections are limited. However, there has been progress in recent years in the development of new antimycobacterial drugs. Here, we investigate the in vitro activity of SPR719, a novel aminobenzimidazole antibiotic and the active form of the clinical-stage compound, SPR720, against several isolates of Mycobacterium ulcerans, Mycobacterium marinum and Mycobacterium chimaera. We show that SPR719 is active against these NTM species with a MIC range of 0.125–4 μg/ml and that this compares favorably with the commonly utilized antimycobacterial antibiotics, rifampicin and clarithromycin. Our findings suggest that SPR720 should be further evaluated for the treatment of NTM infections.
Cortical excitability signatures for the degree of sleepiness in human

Sleep is essential in maintaining physiological homeostasis in the brain. While the underlying mechanism is not fully understood, a ‘synaptic homeostasis’ theory has been proposed that synapses continue to strengthen during awake and undergo downscaling during sleep. This theory predicts that brain excitability increases with sleepiness. Here, we collected transcranial magnetic stimulation measurements in 38 subjects in a 34 hr program and decoded the relationship between cortical excitability and self-report sleepiness using advanced statistical methods. By utilizing a combination of partial least squares regression and mixed-effect models, we identified a robust pattern of excitability changes, which can quantitatively predict the degree of sleepiness. Moreover, we found that synaptic strengthen occurred in both excitatory and inhibitory connections after sleep deprivation. In sum, our study provides supportive evidence for the synaptic homeostasis theory in human sleep and clarifies the process of synaptic strength modulation during sleepiness.
Development of a Video-Observed Therapy System to Improve Monitoring of Tuberculosis Treatment in Thailand: Mixed-Methods Study

Background Directly observed therapy programs for monitoring tuberculosis (TB) treatment in Thailand are unsustainable, especially during the COVID-19 pandemic. The current video-observed therapy (VOT) system, the Thai VOT (TH VOT), was developed to replace the directly observed therapy program. Objective This study aimed to describe the VOT system design and identify the potential for system improvements. Methods This pilot study was conducted in Na Yong district, a small district in Trang province, south of Thailand. The TH VOT system consists of a smartphone app for patients, a secured web-based platform for staff, items used, and standard operating procedures. There were three groups of users: observers who were TB staff, healthy volunteers as simulated patients, and patients with active TB. All participants were trained to follow the standard operating procedures. After 2-week usage, VOT session records were analyzed to measure the compliance of the patients and observers. The User Experience Questionnaire was used to lead the participant users to focus on 6 standard dimensions of usability, and was supplemented with an in-depth interview to identify potential system improvements from users’ experience. Results Only 2 of 16 patients with currently active TB had a usable smartphone. Sixty of 70 drug-taking sessions among 2 patients and 3 simulated patients in 2 weeks were recorded and uploaded. Only 37 sessions were inspected by the observers within 24 hours. All participants needed a proper notification system. An audit system was also requested. Conclusions Before upscaling, the cost of smartphone lending, audit management, and notification systems should be elucidated.
Effectiveness of Syphilis Partner Notification After Adjusting for Treatment Dates, 7 Jurisdictions

Counting infected partners treated 0 to 90 days after the patient's interview as opposed to using disposition code assignments reduced variability in reporting across jurisdiction and can facilitate quality assurance. Background Disease intervention specialists (DIS) prevent syphilis by ensuring treatment for patients' sex partners through partner notification (PN). Different interpretations of how to measure partners treated due to DIS efforts complicates PN evaluation. We measured PN impact by counting partners treated for syphilis after DIS interviewed the patient. Methods We reviewed data from early syphilis cases reported during the 2015–2017 period in 7 jurisdictions. We compared infected partners brought to treatment using the following: (1) DIS-assigned disposition codes or (2) all infected partners treated 0 to 90 days after the patient's interview (adjusted treatment estimate). Stratified analyses assessed patient characteristics associated with the adjusted treatment estimate. Results Disease intervention specialists interviewed 23,613 patients who reported 20,890 partners with locating information. Many of the 3569 (17.1%) partners classified by DIS as brought to treatment were treated before the patient was interviewed. There were 2359 (11.3%) partners treated 0 to 90 days after the patient's interview. Treatment estimates were more consistent between programs when measured using our adjusted estimates (range, 6.1%–14.8% per patient interviewed) compared with DIS-assigned disposition (range, 6.1%–28.3%). Treatment for ≥1 partner occurred after 9.0% of interviews and was more likely if the patient was a woman (17.9%), younger than 25 years (12.6%), interviewed ≤7 days from diagnosis (13.9%), HIV negative (12.6%), or had no reported history of syphilis (9.8%). Conclusions Counting infected partners treated 0 to 90 days after interview reduced variability in reporting and facilitates quality assurance. Identifying programs and DIS who are particularly good at finding and treating partners could improve program impact.