Miracle-dz/UniFAR-FTUs huggingface dataset:
Dosimetric impact of interplay effect in lung IMRT and VMAT treatment using in-house dynamic thorax phantom

Tumor motion due to patient's respiratory is a significant problem in radiotherapy treatment of lung cancer. The purpose of this project is to study the interplay effect through dosimetry verification between the calculated and delivered dose, as well as the dosimetric impact of leaf interplay with breathing-induced tumor motion in IMRT and VMAT treatment. In this study, a dynamic thorax phantom was designed and constructed for dosimetry measurement. The phantom had a linear sinusoidal tumor motion toward superior-inferior direction with variation of amplitudes and periods. TLD-100 LiF:Mg,Ti and Gafchromic EBT2 film were used to measure dose in the midpoint target and the spinal cord. The IMRT and VMAT treatment had prescription dose of 200 cGy per fraction. The dosimetric impact due to interplay effect during IMRT and VMAT treatment were resulted in the range of 0.5% to -6.6% and 0.9% to -5.3% of target dose reduction, respectively. Meanwhile, mean dose deviation of spinal cord in IMRT and VMAT treatment were around 1.0% to -6.9% and 0.9% to -6.3%, respectively. The results showed that if respiratory management technique were not implemented, the presence of lung tumor motion during dose delivery in IMRT and VMAT treatment causes dose discrepancies inside tumor volume.
Age-related changes in serum reproductive hormone levels and prevalence of androgen deficiency in Chinese community-dwelling middle-aged and aging men

Abstract To investigate the age-related nomograms and change trends of reproductive hormones, and prevalence of androgen deficiency (AD) in middle-aged and aging men from 2 studies. Two cross-sectional studies were conducted at 5-year intervals in Chinese community-dwelling men living in the same area. A total of 434 (Study 1, S1) and 944 (Study 2, S2) men aged 40 to 69 years were recruited as subjects and 59 (S1) and 98 (S2) men aged 20 to 39 years as controls to measure serum reproductive hormone levels. Serum total testosterone (TT) levels did not change significantly in S1, whereas TT levels increased in S2 with aging. Serum calculated free testosterone (cFT) levels gradually decreased with aging; however, only men aged 40 to 69 years showed this trend in S2. Serum luteinizing hormone (LH) and sex hormone binding globulin (SHBG) levels gradually increased, and serum testosterone secretion index (TSI) and free testosterone index (FTI) levels gradually decreased with male aging. The mean annual decrease values of serum cFT were 2.705 pmol/l in S1 and 1.060 pmol/l in S2. The cut-off values for AD in S1 and S2 were 9.13 nmol/l and 9.35 nmol/l for TT, and 169.00 pmol/l and 213.90 pmol/l for cFT. Using TT or cFT cut-off values, mean AD prevalence was 14.52% or 44.70% in S1, and 6.36% or 16.53% in S2. Based on cFT cut-off values, prevalence of AD increased gradually with male aging in a range of 25.30% to 61.63% in S1 and 1.20% to 23.03% in S2. The change patterns of serum LH, SHBG, TSI and FTI levels in middle-aged and aging males were consistent; however, there were differences in serum TT and cFT change patterns in S1 and S2 with male aging. cFT cut-off values were the optimal metric to evaluate AD, which can be present a ladder-like change in prevalence of different age groups.
The Effects of Inmate Medical Issues on Correctional Staff Job Involvement and Organizational Commitment

In the United States, institutional corrections is a major undertaking that requires substantial financial resources. Correctional staff are the essential element to ensuring the safety and security of these institutions, which house approximately 2.2 million adults. Thus, it is invaluable to explore work environment variables that contribute to their success. One area that has received scant attention is staff views of inmate medical care and their effect on job involvement and organizational commitment. This study focused on the effects of views concerning the proper handling of inmate infectious diseases, the quality of medical care provided to inmates, the timeliness of the responses to inmate medical needs, turnover of medical staff, and inmate medical privacy rights. Results indicate that proper handling of inmate infectious diseases and quality of medical care positively increase job involvement and organizational commitment.
Mediterranean Style Diet and Kidney Function Loss in Kidney Transplant Recipients.

BACKGROUND AND OBJECTIVES Despite improvement of short-term graft survival over recent years, long-term graft survival after kidney transplantation has not improved. Studies in the general population suggest the Mediterranean diet benefits kidney function preservation. We investigated whether adherence to the Mediterranean diet is associated with kidney outcomes in kidney transplant recipients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We included 632 adult kidney transplant recipients with a functioning graft for ≥1 year. Dietary intake was inquired using a 177-item validated food frequency questionnaire. Adherence to the Mediterranean diet was assessed using a nine-point Mediterranean Diet Score. Primary end point of the study was graft failure and secondary end points included kidney function decline (doubling of serum creatinine or graft failure) and graft loss (graft failure or death with a functioning graft). Cox regression analyses were used to prospectively study the associations of the Mediterranean Diet Score with study end points. RESULTS During median follow-up of 5.4 (interquartile range, 4.9-6.0) years, 76 participants developed graft failure, 119 developed kidney function decline, and 181 developed graft loss. The Mediterranean Diet Score was inversely associated with all study end points (graft failure: hazard ratio [HR], 0.68; 95% confidence interval [95% CI], 0.50 to 0.91; kidney function decline: HR, 0.68; 95% CI, 0.55 to 0.85; and graft loss: HR, 0.74; 95% CI, 0.63 to 0.88 per two-point increase in Mediterranean Diet Score) independent of potential confounders. We identified 24-hour urinary protein excretion and time since transplantation to be an effect modifier, with stronger inverse associations between the Mediterranean Diet Score and kidney outcomes observed in participants with higher urinary protein excretion and participants transplanted more recently. CONCLUSIONS Adherence to the Mediterranean diet is associated with better kidney function outcomes in kidney transplant recipients.
Refeeding syndrome is associated with increased mortality in malnourished medical inpatients

Abstract Background: Whether the occurrence of refeeding syndrome (RFS), a metabolic condition characterized by electrolyte shifts after initiation of nutritional therapy, has a negative impact on clinical outcomes remains ill-defined. We prospectively investigated a subgroup of patients included in a multicentre, nutritional trial (EFFORT) for the occurrence of RFS. Methods: In this secondary analysis of a randomized-controlled trial investigating the effects of nutritional support in malnourished medical inpatients, we prospectively screened patients for RFS and classified them as “RFS confirmed” and “RFS not confirmed” based on predefined criteria (i.e. electrolyte shifts, clinical symptoms, clinical context, and patient history). We assessed associations of RFS and mortality within 180 days (primary endpoint) and other secondary endpoints using multivariable regression analysis. Results: Among 967 included patients, RFS was confirmed in 141 (14.6%) patients. Compared to patients with no evidence for RFS, patients with confirmed RFS had significantly increased 180-days mortality rates (42/141 (29.8%) vs 181/826 (21.9%), adjusted odds ratio (OR) 1.53 (95% CI 1.02 to 2.29), P < . 05). Patients with RFS also had an increased risk for ICU admission (6/141 (4.3%) vs 13/826 (1.6%), adjusted OR 2.71 (95% CI 1.01 to 7.27), P < . 05) and longer mean length of hospital stays (10.5 ± 6.9 vs 9.0 ± 6.6 days, adjusted difference 1.57 days (95% CI 0.38–2.75), P = . 01). Conclusion: A relevant proportion of medical inpatients with malnutrition develop features of RFS upon hospital admission, which is associated with long-term mortality and other adverse clinical outcomes. Further studies are needed to develop preventive strategies for RFS in this patient population.
Epidemiology, Clinical Presentation, and Seasonal Variation in the Diagnosis of Children with Eosinophilic Esophagitis in Oklahoma

Eosinophilic esophagitis is characterized by eosinophilic infiltration of esophageal mucosa causing variable symptoms, including dysphagia, abdominal pain, reflux, and feeding issues. There have been no studies done to evaluate seasonal variation in Oklahoma; this article fills that gap. Objectives Eosinophilic esophagitis (EoE) is characterized by upper gastrointestinal tract symptoms in association with esophageal mucosal biopsy specimens containing ≥15 intraepithelial eosinophils per high-power field. The etiology of EoE remains unclear, but an immunologic response to various foods and aeroallergens has been implicated. Seasonal variation has been reported in the diagnosis of EoE. The epidemiology and seasonal variation of EoE has never been studied in Oklahoma. The aim of this retrospective study was to determine epidemiology, clinical presentation, and seasonal variation of EoE in children seen from 2008 to 2015 at The Children’s Hospital at Oklahoma University Medical Center (OUMC). Methods This was a single-center study involving the medical records of children aged 0 to 18 years with a diagnosis of EoE at OUMC in the Department of Pediatric Gastroenterology from January 2008 to December 2015. All charts with “eosinophilic esophagitis” in the diagnostic search history were reviewed. A diagnosis of EoE was defined as presence of ≥15 eosinophils per high-power field in the esophageal mucosal biopsy. The data extracted from the medical records included demographics, previous proton pump inhibitor use prediagnosis, clinical presentation, blood and skin allergy testing, and month of diagnosis. Seasons were distributed as spring (March–May), summer (June–August), fall (September–November), and winter (December–February). Results Seventy-nine patients with a diagnosis of EoE were seen at OUMC between 2008 and 2015. One patient was excluded because of insufficient medical records. The average age (±standard deviation) at diagnosis was 7.5 (±4.92) years with an age range of 1 to 17 years. χ2 analysis showed a significant sex distribution, with 72% males and 27% females (P = 0.0001). The most common presenting symptoms were dysphagia (35%) and vomiting (28%). When patients were grouped seasonally using the χ2 test, there was an increase in the diagnosis of EoE cases during the spring months when compared with other seasons (P = 0.0006). Forty-five percent of patients were diagnosed in the spring, 22% in the fall, 19% in the summer, and 14% in the winter. Conclusions Our data demonstrate that there is a seasonal variation in the diagnosis of EoE, with more cases diagnosed in the spring months. These findings relate to the increase in aeroallergens and pollen distribution during the spring months in Oklahoma.
Influence of Perfluorohexyloctane Eye Drops on Tear Film Thickness in Patients with Mild to Moderate Dry Eye Disease: A Randomized Controlled Clinical Trial.

Purpose: The aim of this mechanistic clinical study was to explore the effect of water-free perfluorohexyloctane eye drops on tear film thickness (TFT) in patients with dry eye disease (DED). Methods: Forty-eight patients with mild to moderate DED participated in this randomized, single-masked, observer-blinded parallel group study in a 1:1 ratio to receive either perfluorohexyloctane or unpreserved 0.9% saline solution (Hydrabak®, Thea, France) eye drops 4 times daily in both eyes for 4 weeks. A custom-built ultrahigh-resolution optical coherence tomography system was used to measure TFT. Furthermore, evaluation of lipid layer thickness (LLT) and noninvasive tear film breakup time, as well as standard clinical tests for signs and symptoms of DED were performed. Results: Mean TFT and LLT at baseline were comparable between the 2 treatment groups. After a single drop instillation, perfluorohexyloctane eye drops temporarily increased TFT immediately. After multiple dosing, perfluorohexyloctane eye drops gradually increased TFT over time with a maximum effect at the end of the study (least square mean difference: 6.42%; P = 0.0142 at week 4). LLT values measured before drop instillation showed a more prominent increase in LLT for perfluorohexyloctane eye drops (13.36% ± 26.33% vs. 3.21% ± 28.65%). All other parameters got better in both treatment groups with no statistical difference between groups. Conclusions: These results demonstrate that perfluorohexyloctane eye drops increase TFT as well as LLT over time. These tear film reestablishing attributes are in line with the mode of action of perfluorohexyloctane eye drops to avoid evaporation through stabilization of the lipid layer.
Maternal and Paternal Transmission of Diabetes: Influence of Nutritional Factors

Background: Pakistan is ranked at 6th place amongst the top 10 countries of the world. The number of estimated cases with diabetes in our country are 5.2 million in 2000 and projected to be 13.9 million in 2003. The objective of this research to examined risk for 2 diabetes and conditioned on directly ascertained parental diabetes status among population of Karachi, Pakistan. Methodology: This was a cross-sectional study. Young healthy subjects between 18- 24 years were inducted. They were classified according to familial history of T2DM as Single Diabetic Parent (SDP), with Both Diabetic Parents (BDP) and with No Diabetic Parents (NDP). Anthropometric measurements where BMI (Body Mass Index) and WHR (Waist Hip Ratio) was assesed and Fasting plasma glucose was analyzed by photometric technique. Results: Paternal transmission of diabetes is 73.2% and Maternal was 26.8% in our population. Significantly higher statistical values were observed in the body weight of offspring of both diabetics as compared to NDP and SDP. Mean values for BMI among BDP were 25.58 ± 5.15, 22.26 ± 6.80 in SDP and NDP it was 21.02 ± 6.19 and 4.91 ± 6.78. BDP offspring showed high risk of WHR for males i.e 14.3% and for females it was 37.5%, and SDP offsprings had 23.1% in males and 30.4% in females, whereas offsprings of NDP had a normal WHR. Conclusion: Family history of diabetes in offsprings is an insight of developing diabetes in future offspring. We determined the parental transmission of diabetes mellitus in our population and evaluated its influence on BMI, WHR and Fasting plasma glucose. There was a raised frequency of paternal history of diabetes as compared to maternal history. Anthropometric measurements and Fasting Plasma glucose are the predicting factors contributing to T2DM in subjects who have diabetic parents, either single or both diabetic.
A risk signature‐based on metastasis‐associated genes to predict survival of patients with osteosarcoma

Osteosarcoma (OS) is the most common primary solid malignant bone tumor, and its metastasis is a prominent cause of high mortality in patients. In this study, a prognosis risk signature was constructed based on metastasis‐associated genes. Four microarrays datasets with clinical information were downloaded from Gene Expression Omnibus, and 256 metastasis‐associated genes were identified by limma package. Further, a protein‐protein interaction network was constructed, and survival analysis was performed using data from the Therapeutically Applicable Research to Generate Effective Treatments data matrix, identifying 19 genes correlated with prognosis. Six genes were selected by the least absolute shrinkage and selection operator regression for multivariate cox analysis. Finally, a three‐gene (MYC, CPE, and LY86) risk signature was constructed, and datasets GSE21257 and GSE16091 were used to validate the prediction efficiency of the signature. The survival times of low‐ and high‐risk groups were significantly different in the training set and validation set. Additionally, gene set enrichment analysis revealed that the genes in the signature may affect the cell cycle, gap junctions, and interleukin‐6 production. Therefore, the three‐gene survival risk signature could potentially predict the prognosis of patients with OS. Further, proteins encoded by CPE and LY86 may provide novel insights into the prediction of OS prognosis and therapeutic targets.
Red orange and lemon extract prevents the renal toxicity induced by ochratoxin A in rats

In this work, we investigated the effects of red orange and lemon extract (RLE) on ochratoxin A (OTA)‐induced nephrotoxicity. In particular, we analyzed the change in renal function and oxidative stress in Sprague–Dawley rats treated with OTA (0.5 mg/kg body weight, b.w.) and with RLE (90 mg/kg b.w.) by oral administration. After OTA treatment, we found alterations of biochemical and oxidative stress parameters in the kidney, related to a severe decrease of glomerular filtration rate. The RLE treatment normalized the activity of antioxidant enzymes and prevented the glomerular hyperfiltration. Histopathological examinations revealed glomerular damages and kidney cortex fibrosis in OTA‐rats, while we observed less severe fibrosis in OTA plus RLE group. Then, we demonstrated that oxidative stress could be the cause of OTA renal injury and that RLE reduces this effect.
Metabolic syndrome risk in relation to posttraumatic stress disorder among trauma-exposed civilians in Gansu Province, China

Abstract This study included 1456 men and 1411 women who were trauma-exposed and underwent routine health examinations in a community epidemiological investigation. The participants completed the posttraumatic stress disorder (PTSD) Check List-Civilian Version (PCL-C) for PTSD and medical examinations to detect metabolic syndrome. Adjustments for age, marriage, exercise, education, cigarette smoking, cancer, stroke, angina, and thyroid disease were performed. The relationship between PTSD and metabolic syndrome and each of its components was analyzed by multiple logistic regression. In women, PTSD was associated with metabolic syndrome (OR = 1.53, 95% CI = 1.01–1.95, P = .047) and the high-density lipoprotein cholesterol component (OR = 1.98, 95% CI = 1.04–2.12, P = .002). In men, PTSD was related to the hypertension component of metabolic syndrome (OR = 0.54, 95% CI = 0.31–0.92, P = .023). There was also a relationship between PTSD severity and metabolism (OR = 1.141, 95% CI = 1.002–1.280, P = 0.037) in women, and PTSD was inversely associated with the hypertension component (OR = 0.54, 95% CI = 0.31–0.92, P = .023) in men. PTSD was related to metabolic syndrome only in women. We plan to further research the mechanism of sex differences and dyslipidemia.
Loss of ferritin in developing wing cells: Apoptosis and ferroptosis coincide

Simone Mumbauer and colleagues have studied ferritin’s role in the context of Hippo signaling within Drosophila melanogaster wing primordial cells [1]. Their findings suggest that H and L ferritin subunits may have noninterdependent functions. When subunit H is lost, increased levels of reactive oxygen species and cell death by apoptosis are observed, as well as mitochondrial hallmarks, which may be defined as ferroptosis [2]. Loss of Hippo signaling in this genetic background rescued cell death, despite the reactive oxygen species, which persisted. Does loss of Hippo signaling in a developmental context protect from ferroptosis? In mesenchymal and renal carcinoma cells, however, loss of Hippo signaling correlates with susceptibility to ferroptosis [3, 4]. These apparently contrasting findings call for an explanation.
Social-ecological influences on unhealthy dietary behaviours among Moroccan adolescents: a mixed-methods study

Abstract Objective: To identify the prevalence of unhealthy dietary behaviours and their social-ecological influences in adolescents. Design: The study used a sequential explanatory mixed-methods design, which begins with the collection of quantitative data, followed by the collection of qualitative data to explain and enrich the quantitative findings. Quantitative data were collected via a global school-based student health survey and were analysed using quantitative approaches. Qualitative data were obtained via focus group discussions and were analysed thematically. Setting: Middle and high secondary schools in Taza city, Morocco. Participants: Our quantitative analyses included 764 students (14–19 years). For the qualitative part, seventeen focus group discussions were conducted with 100 participants (fifty-six adolescents, twenty-six parents and eighteen teachers). Results: Of total student participants, 46·1 % skipped breakfast, 60·6 % had inadequate intake of fruits and vegetables (F&V), 39·4 % consumed soft drinks and 28·0 % consumed fast foods. All of these dietary behaviours could coexist in the same person except for inadequate intake of F&V. Gender, academic performance, age, perceived family income and education level of mother were associated with unhealthy dietary behaviours. Qualitative findings identified seven themes regarding social-ecological influences on adolescents’ dietary behaviours: cognitive, affective/biological, lifestyle, outcome expectation, social network, accessibility/availability and macro-level influences. Conclusions: The prevalence of unhealthy dietary behaviours in our study group is a concern. Dietary behaviours are the result of inseparable interactions among social-ecological influences. Modifiable factors identified may be useful when designing a future intervention aimed at improving breakfast and F&V consumption and reducing fast/snack-food consumption among adolescents.
Maternal risk markers of postnatal depression

Puerperium is a well-established period with increased risk for the development of serious mood disorders. [1] The prevalence of postpartum depression (PPD) is 6%–13% in high-income nations, but it is highly variable in non-Western countries due to variations in methodology and its manifestations across cultures. [2] In India, the prevalence of PPD varies from 11% to 16%,[3] whereas in a recent study in Bangladesh, the prevalence was 39%. [4] PPD represents a considerable public health problem affecting women and their families. Feelings of hopelessness in severe cases can threaten life and lead to suicide. [5] In addition, factors such as fear of harming the baby (36%), weak attachment to the baby (34%), and, in extreme cases, suicide attempts are seen. [6] Therefore, susceptible women need to be identified before delivery to receive proper care measures.
A class II-restricted CD8ɣ13 T cell clone protects during Chlamydia muridarum genital tract infection.

The T cell response to chlamydia genital tract infections in humans and mice is unusual because the majority of antigen-specific CD8 T cells are not class I-restricted, referred to as "unrestricted" or "atypical". We previously reported that a subset of unrestricted murine chlamydia-specific CD8 T cells had a cytokine polarization pattern that included IFN-ɣ and IL-13. Here we investigated the transcriptome of CD8ɣ13 T cells, comparing them to Tc1 clones using microarray analysis. That study revealed that CD8ɣ13 polarization included IL-5 in addition to IFN-γ and IL-13. Adoptive transfer studies were performed with Tc1 clones and a CD8ɣ13 T cell clone to determine whether either influenced bacterial clearance or immunopathology during Chlamydia muridarum genital tract infections. To our surprise, an adoptively transferred CD8ɣ13 T cell clone was remarkably proficient at preventing chlamydia immunopathology while the multifunctional Tc1 clone did not enhance clearance or significantly alter immunopathology. Mapping studies with MHC class I- and class II-deficient splenocytes showed our previously published chlamydia-specific CD8 T cell clones are MHC class II-restricted. MHC class II-restricted CD8 T cells may play important roles in protection from intracellular pathogens that limit class I antigen presentation, or diminish CD4 T cell numbers or impair their function.