Miracle-dz/UniFAR-FTUs huggingface dataset:
Lung deposition of nebulized surfactant in newborn piglets: Nasal CPAP vs Nasal IPPV

Nasal continuous positive airway pressure support (nCPAP) is the standard of care for prematurely born infants at risk of neonatal respiratory distress syndrome (nRDS). However, nasal intermittent positive pressure ventilation (NIPPV) may be an alternative to nCPAP in babies requiring surfactant, and in conjunction with surfactant nebulization, it could theoretically reduce the need for invasive mechanical ventilation. We compared lung deposition of nebulized poractant in newborn piglets supported by nCPAP or NIPPV.
The impact of hospital attributes on patient choice for first visit: evidence from a discrete choice experiment in Shanghai, China

Abstract The underutilization of primary care in urban China threatens the efficiency and effectiveness of the Chinese health system. To guide patient flow to primary care, the Chinese government has rolled out a sequence of health care reforms which improve the affordability, the infrastructure and workforce of the primary care system. However, these measures have not yielded the desired effect on the utilization of primary care, which is lowest in urban areas. It is unclear how the factors identified to influence facility choice in urban China are actually impacting choice behaviour. We conducted a discrete choice experiment to elicit the quantitative impact of facility attributes when choosing a health care facility for first visit and analysed how the stated choice varies with these attributes. We found that the respondents placed different weights on the identified attributes, depending on whether they perceived their condition to be minor or severe. For conditions perceived as minor, the respondents valued visit time, equipment and medical skill most. For conditions perceived as severe, they placed most importance on equipment, travel time and facility size. We found that for conditions perceived as minor, only 14% preferred visiting a facility over opting out, a percentage which would more than double to 37% if community health centres were maximally improved. For conditions perceived as severe, improvements in community health centres may almost double first visits to primary care, mostly from patients who would otherwise choose higher-level facilities. Our findings suggest that for both severity conditions, improvements to medical equipment and medical skill at community health centres in urban China can effectively direct patient flow to primary care and promote the efficiency and effectiveness of the urban health system.
Apparel Consumption and Embodied Experiences of Gay Men and Transgender Women in India: Variety and Ambivalence, Fit Issues, LGBT-Fashion Brands, and Affordability

ABSTRACT The purpose of this study was to explore Indian LGBT individuals’ apparel consumption practices and embodied experiences related to fashion, style, and the body. Specifically, our research questions were these: What are Indian LGBT individuals’ experiences like when navigating the fashion system, and how do they experience their own embodiment in what they wear and how they appear? A qualitative, phenomenological approach was used to answer the research questions. Three gay men and seven transgender women responded to a solicitation for participation and completed a semistructured interview. In our data analysis, we established four themes that relate to two larger areas of emphasis: embodiment and the fashion system. Regarding embodiment, participants related many experiences with their bodies, including (a) variety and ambivalence with bodily practices and (b) difficulty with clothing fit. The other themes centered around knowledge and desires related to the fashion system. Within the fashion system, participants expressed (a) fashion brand awareness and a need for LGBT-centered brands and (b) affordability as a barrier to clothing purchase. Overall, the essence of fashioning one’s body as a transgender woman or gay man in India is that, while there has been a significant amount of gender oppression in India, these participants were interested in and desired gender-neutral or LGBT-focused brands.
Effects of keto acid supplements on Chinese patients receiving maintenance hemodialysis: a prospective, randomized, controlled, single-center clinical study

Abstract Background: The effects of keto acid (KA) supplements on Chinese patients receiving maintenance hemodialysis (MHD) are unclear. This study aimed to evaluate the effects of KA supplementation on nutritional status, inflammatory markers, and bioelectric impedance analysis (BIA) parameters in a cohort of Chinese patients with MHD without malnutrition. Methods: This was a prospective, randomized, controlled, single-center clinical study conducted in 2011 till 2014. Twenty-nine patients with MHD were randomly assigned to a control (n = 14) or a KA (n = 15) group. The control group maintained a dietary protein intake of 0.9 g/kg/day. The KA group received additional KA supplement (0.1 g/kg/day). BIA was used to determine the lean tissue mass, adipose tissue mass, and body cell mass. The patients’ nutritional status, dialysis adequacy, and biochemical parameters were assessed at the ends of the third and sixth months with t test or Wilcoxon rank-sum test. Results: The daily total energy intake for both groups was about 28 kcal/kg/day. After 6 months, the Kt/V (where K is the dialyzer clearance of urea, t is the dialysis time, and V is the volume of the distribution of urea) was 1.33 ± 0.25 in KA group, and 1.34 ± 0.25 in the control group. The median triceps skin-fold thickness in KA group was 12.00 and 9.00 mm in the control group. In addition, the median hand-grip strength in KA group was 21.10 and 25.65 kg in the control group. There were no significant differences between the groups with respect to the anthropometry parameters, dialysis adequacy, serum calcium and phosphorus levels, inflammatory markers, and amino-acid profiles, or in relation to the parameters determined by BIA. Both groups achieved dialysis adequacy and maintained nutritional status during the study. Conclusions: In this cohort of Chinese patients with MHD, the patients in the control group whose dietary protein intake was 0.9 g/kg/day and total energy intake was 28 kcal/kg/day, maintained well nutritional status during study period. The KA supplement (0.1 g/kg/day) did not improve the essential amino acid/non-essential amino acid ratio, nor did it change the patients’ mineral metabolism, inflammatory parameters, or body compositions.
Tibiopedal arterial minimally invasive retrograde revascularization (TAMI) in patients with peripheral arterial disease and critical limb ischemia. On behalf of the Peripheral Registry of Endovascular Clinical Outcomes (PRIME)

Complex peripheral arterial disease (PAD) and critical limb ischemia (CLI) are associated with high morbidity and mortality. Endovascular techniques have become prevalent in treatment of advanced PAD and CLI, and use of techniques such as tibiopedal minimally invasive revascularization (TAMI), have been proven safe in small, single‐center series. However, its use has not been systematically compared to traditional approaches.
Pretransplant serum beta‐2 microglobulin level is a potential novel prognostic marker of overall survival after allogeneic hematopoietic cell transplantation – a retrospective observational study

Although elevated serum beta‐2 microglobulin (BMG) has been reported as a poor prognostic marker for various hematological malignancies, no study has assessed its prognostic significance in allogenec hematopoietic cell transplantation (allo‐HCT). Therefore, we conducted this retrospective observational study in 227 consecutive patients with available pretransplant serum BMG levels between April 2010 and September 2017 at our institute. We also collected and retrospectively analyzed various pretransplant variables likely related to transplant outcomes. Multivariable analysis, including major prognostic variables, such as the disease risk index and the hematopoietic cell transplant‐comorbidity index, showed a significant association between higher serum BMG levels and poorer overall survival (OS) in all three adjusted models [hazard ratio (HR) per its standard deviation (SD) (SD = 1.094): 1.67 (1.35–2.03; P < 0.001), HR per SD: 1.46 (1.14–1.86; P = 0.002), HR per SD: 2.03 (1.62–2.55; P < 0.001)], respectively, due to the significant association between higher serum BMG levels and relapse/progression [HR 1.52 (1.20–1.94; P < 0.001)] instead of nonrelapse mortality [HR 1.06 (0.70–1.60; P = 0.780)]. Moreover, DRI and serum BMG had statistically significantly higher c‐statistic estimates for OS compared with DRI alone (c‐index 0.74 and 0.68, respectively; P < 0.001). In conclusion, pretransplant serum BMG level may serve as a useful prognostic marker and help clinical decision in allo‐HCT.
Mechanisms of resistance and predictive biomarkers of response to targeted therapies and immunotherapies in metastatic melanoma.

PURPOSE OF REVIEW Thanks to mitogen-activated protein kinase inhibitors (MAPKi) and immune checkpoint inhibitors (ICI), major progress has been made in the field of melanoma treatment. However, long-term success is still scarce because of the development of resistance. Understanding these mechanisms of resistance and identifying predictive genomic biomarkers are now key points in the therapeutic management of melanoma patients. RECENT FINDINGS Multiple and complex mechanisms of resistance to MAPKi or ICI have been uncovered in the past few years. The lack of response can be driven by mutations and nonmutational events in tumor cells, as well as by changes in the tumor microenvironment. Melanoma cells are also capable of rapidly switching their molecular and cellular phenotype, leading to an initial drug-tolerant favorizing melanoma resistance. Tumor molecular profiling and circulating tumor cell analyses are of high interest as predictive biomarkers as well as studying immunogenic changes and microbiome in ICI-treated patients. SUMMARY Resistance to MAPKi and ICI is a key point in therapeutic management of metastatic melanoma patients. Validated biomarkers predicting response to therapy are urgently needed to move toward personalized medicine. Combinatory treatments guided by the understanding of resistance mechanisms will be of major importance in the future of melanoma therapy.
Harmonic Motion Imaging of Pancreatic Tumor Stiffness Indicates Disease State and Treatment Response

Purpose: Pancreatic ductal adenocarcinoma (PDA) is a common, deadly cancer that is challenging both to diagnose and to manage. Its hallmark is an expansive, desmoplastic stroma characterized by high mechanical stiffness. In this study, we sought to leverage this feature of PDA for two purposes: differential diagnosis and monitoring of response to treatment. Experimental Design: Harmonic motion imaging (HMI) is a functional ultrasound technique that yields a quantitative relative measurement of stiffness suitable for comparisons between individuals and over time. We used HMI to quantify pancreatic stiffness in mouse models of pancreatitis and PDA as well as in a series of freshly resected human pancreatic cancer specimens. Results: In mice, we learned that stiffness increased during progression from preneoplasia to adenocarcinoma and also effectively distinguished PDA from several forms of pancreatitis. In human specimens, the distinction of tumors versus adjacent pancreatitis or normal pancreas tissue was even more stark. Moreover, in both mice and humans, stiffness increased in proportion to tumor size, indicating that tuning of mechanical stiffness is an ongoing process during tumor progression. Finally, using a brca2–mutant mouse model of PDA that is sensitive to cisplatin, we found that tissue stiffness decreases when tumors respond successfully to chemotherapy. Consistent with this observation, we found that tumor tissues from patients who had undergone neoadjuvant therapy were less stiff than those of untreated patients. Conclusions: These findings support further development of HMI for clinical applications in disease staging and treatment response assessment in PDA.
Effect of diabetes on incidence of peritoneal dialysis-associated peritonitis

Background Several reports on patients with diabetes mellitus (DM) treated by peritoneal dialysis (PD) have shown a higher risk of PD-associated peritonitis compared to non-DM (NDM) patients. The aim of this study was to investigate the incidence of PD-associated peritonitis in DM patients. Methods We divided all patients who received PD at a single center between January 1980 and December 2012 into three groups according to era: Period 1 (n = 43, 1980–1993); Period 2 (n = 123, 1994–2004); and Period 3 (n = 207, 2005–2012). We investigated incidences of PD-associated peritonitis between patients with and without DM. Results In Periods 1 and 2, incidence of PD-associated peritonitis was higher in the DM group than in the NDM group (P<0.05). However, no difference according to presence of DM was seen in Period 3. Multivariate Cox regression analysis revealed DM as a risk factor for incidence of PD-associated peritonitis in Periods 1 and 2, but not in Period 3 (hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.15 to 5.23; HR, 2.36; 95%CI, 1.13 to 4.58; and HR, 0.82; 95%CI, 0.41 to 1.54, respectively). Furthermore, the peritonitis-free period was significantly shorter in the DM group than in the DM group in Periods 1 and 2, whereas no significant difference was seen in Period 3 (P<0.01, P<0.01 and P = 0.55, respectively). Moreover, a significant interaction was seen between diabetes and study period, and became less pronounced during Period 3(P<0.01). Conclusions The increased risk of peritonitis in diabetics reported in previous periods has not been evident in recent years.
Suppression of NB‐LRR genes by miRNAs promotes nitrogen‐fixing nodule development in Medicago truncatula

Abstract Plant genomes contain two major classes of innate immune receptors to recognize different pathogens. The pattern recognition receptors perceive conserved pathogen‐associated molecular patterns and the resistance genes with nucleotide‐binding (NB) and leucine‐rich repeat (LRR) domains recognize specific pathogen effectors. The precise regulation of resistance genes is important since the unregulated expression of NB‐LRR genes can inhibit growth and may result in autoimmunity in the absence of pathogen infection. It was shown that a subset of miRNAs could target NB‐LRR genes and act as an important regulator of plant immunity in the absence of pathogens. Plants not only interact with pathogens, but they can also establish symbiotic interactions with microbes. Nitrogen‐fixing symbiotic interaction and nodule formation of legumes may also require the suppression of host defence to prevent immune responses. We found that upon symbiotic interactions, miRNAs repressing NB‐LRR expression are upregulated in the developing nodules of Medicago truncatula. Furthermore, we show that the suppression of the activity of the NB‐LRR genes targeted by these miRNAs is important during nodule development. Our results suggest that the downregulation of NB‐LRR resistance genes in the developing nodule produces a suitable niche that facilitates bacterial colonization and the development of an N‐fixing nodule.
An adaptive test for meta‐analysis of rare variant association studies

Single genome‐wide studies may be underpowered to detect trait‐associated rare variants with moderate or weak effect sizes. As a viable alternative, meta‐analysis is widely used to increase power by combining different studies. The power of meta‐analysis critically depends on the underlying association patterns and heterogeneity levels, which are unknown and vary from locus to locus. However, existing methods mainly focus on one or only a few combinations of the association pattern and heterogeneity level, thus may lose power in many situations. To address this issue, we propose a general and unified framework by combining a class of tests including and beyond some existing ones, leading to high power across a wide range of scenarios. We demonstrate that the proposed test is more powerful than some existing methods in simulation studies, then show their performance with the NHLBI Exome‐Sequencing Project (ESP) data. One gene (B4GALNT2) was found by our proposed test, but not by others, to be statistically significantly associated with plasma triglyceride. The signal was driven by African‐ancestry subjects but it was previously reported to be associated with coronary artery disease among European‐ancestry subjects. We implemented our method in an R package aSPUmeta, publicly available at https://github.com/ytzhong/metaRV and will be on CRAN soon.
Incarceration and adversity histories: Modeling life course pathways affecting behavioral health.

A consequence of a growing incarceration rate is that an increasing number of children face having an incarcerated household member, a known contributor to diverse lifelong behavioral health risks such as substance use and mental health impairment. Few studies have explored how household incarceration uniquely contributes to these subsequent behavioral health concerns, nor mediational contributors to these associations, within a theoretical framework. Using state Behavioral Risk Factor Surveillance System survey data (n = 14,001), this study tests pathways of household incarceration and Adverse Childhood Experiences (ACEs) to mental health impairment and substance use in adulthood. Within a life course stress process perspective, this study uses structural equation modeling to examine mediational pathways through adulthood incarceration and indicators of adulthood adversity, low income, and supportive resources. In line with stress process theorizing, results indicate significant direct and indirect paths of ACEs through nearly all theorized mediators, and indirect pathways of household incarceration, through incarceration and low income, to adulthood mental health impairment and substance use. Implications of these findings address preventive and interventive leverage points to mitigate long-term consequences of household incarceration and other childhood adversities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Align your job with yourself: The relationship between a job crafting intervention and work engagement, and the role of workload.

This article describes a quasi-experiment that evaluates the relationship between a job crafting intervention and work engagement. More particularly, we focused on three different types of job crafting: crafting towards strengths, crafting towards interests, and crafting towards development. Building on the conservation of resources theory, we hypothesized that participating in a job crafting intervention will be positively associated with job crafting, which in turn will promote work engagement. Additionally, based on the activation theory, we hypothesized that employees with a relatively high workload will benefit more from a job crafting intervention compared with employees with a relatively low workload. In all, 99 employees from a Dutch health care organization participated in our study (n = 45 in the treatment group; n = 54 in the control group). Results indicated that there was no association between the intervention and job crafting behaviors. However, the job crafting intervention was found to be positively related to interests crafting for workers with a relatively high workload, which in turn was associated with an increase in dedication and absorption. Additionally, we found that job crafting towards strengths was associated with all aspects of work engagement (vigor, dedication, and absorption), whereas job crafting towards interests was related to dedication and absorption, and crafting towards development was not associated with work engagement. We conclude that a job crafting intervention can be an effective tool for enhancing work engagement for employees with a high workload. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Endometrial cancer in the morbidly obese: a review.

PURPOSE OF REVIEW With a worldwide increase in obesity, there has been an increase in obesity-related diseases. Endometrial cancer is a common cause of cancer for women worldwide. Incidence of endometrial cancer has risen worldwide. Accompanying these patients are risk factors and challenges that may prevent standard of care from being delivered. RECENT FINDINGS The current article describes recent literature describing surgical approaches to the obese patient and special considerations in this population. This article also reviews bariatric surgery and endometrial cancer as well as new updates in radiation, chemotherapy and hormonal therapy research in the obese population. SUMMARY The current article reviews therapeutics and surgery in the morbidly obese for the treatment of endometrial cancer.
Brothers in Arms: ABCA1- and ABCG1-Mediated Cholesterol Efflux as Promising Targets in Cardiovascular Disease Treatment

Atherosclerosis is a leading cause of cardiovascular disease worldwide, and hypercholesterolemia is a major risk factor. Preventive treatments mainly focus on the effective reduction of low-density lipoprotein cholesterol, but their therapeutic value is limited by the inability to completely normalize atherosclerotic risk, probably due to the disease complexity and multifactorial pathogenesis. Consequently, high-density lipoprotein cholesterol gained much interest, as it appeared to be cardioprotective due to its major role in reverse cholesterol transport (RCT). RCT facilitates removal of cholesterol from peripheral tissues, including atherosclerotic plaques, and its subsequent hepatic clearance into bile. Therefore, RCT is expected to limit plaque formation and progression. Cellular cholesterol efflux is initiated and propagated by the ATP-binding cassette (ABC) transporters ABCA1 and ABCG1. Their expression and function are expected to be rate-limiting for cholesterol efflux, which makes them interesting targets to stimulate RCT and lower atherosclerotic risk. This systematic review discusses the molecular mechanisms relevant for RCT and ABCA1 and ABCG1 function, followed by a critical overview of potential pharmacological strategies with small molecules to enhance cellular cholesterol efflux and RCT. These strategies include regulation of ABCA1 and ABCG1 expression, degradation, and mRNA stability. Various small molecules have been demonstrated to increase RCT, but the underlying mechanisms are often not completely understood and are rather unspecific, potentially causing adverse effects. Better understanding of these mechanisms could enable the development of safer drugs to increase RCT and provide more insight into its relation with atherosclerotic risk. SIGNIFICANCE STATEMENT Hypercholesterolemia is an important risk factor of atherosclerosis, which is a leading pathological mechanism underlying cardiovascular disease. Cholesterol is removed from atherosclerotic plaques and subsequently cleared by the liver into bile. This transport is mediated by high-density lipoprotein particles, to which cholesterol is transferred via ATP-binding cassette transporters ABCA1 and ABCG1. Small-molecule pharmacological strategies stimulating these transporters may provide promising options for cardiovascular disease treatment.