Miracle-dz/UniFAR-FTUs huggingface dataset:
A Walking Intervention Supplemented With Mobile Health Technology in Low-Active Urban African American Women With Asthma: Proof-of-Concept Study

Background Physical inactivity is associated with worse asthma outcomes. African American women experience disparities in both physical inactivity and asthma relative to their white counterparts. We conducted a modified evidence-based walking intervention supplemented with mobile health (mHealth) technologies to increase physical activity (PA). Objective This study aimed to assess the preliminary feasibility of a 7-week walking intervention modified for African American women with asthma. Methods African American women with suboptimally controlled asthma were identified from a health system serving low-income minorities. At a baseline data collection visit, participants performed spirometry and incremental shuttle walk test, completed questionnaires, and were given an accelerometer to wear for 1 week. The intervention comprised an informational study manual and 3 in-person group sessions over 7 weeks, led by a nurse interventionist, in a community setting. The supplemental mHealth tools included a wearable activity tracker device (Fitbit Charge HR) and one-way text messages related to PA and asthma 3 times per week. A secure Web-based research platform, iCardia, was used to obtain Fitbit data in real time (wear time, moderate-to-vigorous physical activity [MVPA] and sedentary time) and send text messages. The feasibility of the intervention was assessed in the domains of recruitment capability, acceptability (adherence, retention, engagement, text messaging, acceptability, complaints, and concerns), and preliminary outcome effects on PA behavior (change in steps, duration, and intensity). Results We approached 22 women, of whom 10 were eligible; 7 consented, enrolled and completed the study. Group session attendance was 71% (5/7), 86% (6/7), and 86% (6/7), respectively, across the 3 sessions. All participants completed evaluations at each group session. The women reported being satisfied or very satisfied with the program (eg, location, time, and materials). None of them had concerns about using, charging, or syncing the Fitbit device and app. Participants wore their Fitbit device for at least 10 hours per day in 44 out of the 49 intervention days. There was an increase in Fitbit-measured MVPA from week 1 (19 min/week, SD 14 min/week) to the last week of intervention (22 min/week, SD 12 min/week; Cohen d=0.24, 95% CI 0.1 to 6.4). A slight decrease in step count was observed from week 1 (8926 steps/day, SD 2156 steps/day) to the last week of intervention (8517 steps/day, SD 1612 steps/day; Cohen d=−0.21, 95% CI −876.9 to 58.9). Conclusions The initial feasibility results of a 7-week community-based walking intervention tailored for African American women with asthma and supplemented with mHealth tools are promising. Modifications to recruitment, retention, and the intervention itself are needed. These findings support the need to conduct a further modified pilot trial to collect additional data on feasibility and estimate the efficacy of the intervention on asthma and PA outcomes.
Patient-Ventilator Interaction During Noninvasive Ventilation in Subjects With Exacerbation of COPD: Effect of Support Level and Ventilator Mode

BACKGROUND: Patient-ventilator synchrony in patients with COPD is at risk during noninvasive ventilation (NIV). NIV in neurally-adjusted ventilatory assist (NAVA) mode improves synchrony compared to pressure support ventilation (PSV). The current study investigated patient-ventilator interaction at 2 levels of NAVA and PSV mode in subjects with COPD exacerbation. METHODS: NIV was randomly applied at 2 levels (5 and 15 cm H2O) of PSV and NAVA. Patient-ventilator interaction was evaluated by comparing airway pressure and electrical activity of the diaphragm waveforms with automated computer algorithms. RESULTS: 8 subjects were included. Trigger delay was longer in PSV high (268 ± 112 ms) than in PSV low (161 ± 118 ms, P = .043), and trigger delay during NAVA was shorter than PSV for both low support (49 ± 24 ms for NAVA, P = .035) and high support (79 ± 276 ms for NAVA, P = .003). No difference in cycling error for low and high levels of PSV (PSV low −100 ± 114 ms and PSV high 56 ± 315 ms) or NAVA (NAVA low −5 ± 18 ms, NAVA high 12 ± 36 ms) and no difference between PSV and NAVA was found. CONCLUSIONS: Increasing PSV levels during NIV caused a progressive mismatch between neural effort and pneumatic timing. Patient-ventilator interaction during NAVA was more synchronous than during PSV, independent of inspiratory support level. (ClinicalTrials.gov registration NCT01791335.)
Mitochondrial and mitochondrial‐independent pathways of myocardial cell death during ischaemia and reperfusion injury

Acute myocardial infarction causes lethal injury to cardiomyocytes during both ischaemia and reperfusion (IR). It is important to define the precise mechanisms by which they die in order to develop strategies to protect the heart from IR injury. Necrosis is known to play a major role in myocardial IR injury. There is also evidence for significant myocardial death by other pathways such as apoptosis, although this has been challenged. Mitochondria play a central role in both of these pathways of cell death, as either a causal mechanism is the case of mitochondrial permeability transition leading to necrosis, or as part of the signalling pathway in mitochondrial cytochrome c release and apoptosis. Autophagy may impact this process by removing dysfunctional proteins or even entire mitochondria through a process called mitophagy. More recently, roles for other programmed mechanisms of cell death such as necroptosis and pyroptosis have been described, and inhibitors of these pathways have been shown to be cardioprotective. In this review, we discuss both mitochondrial and mitochondrial‐independent pathways of the major modes of cell death, their role in IR injury and their potential to be targeted as part of a cardioprotective strategy. This article is part of a special Issue entitled ‘Mitochondria as targets of acute cardioprotection’ and emerged as part of the discussions of the European Union (EU)‐CARDIOPROTECTION Cooperation in Science and Technology (COST) Action, CA16225.
A TP53-associated gene signature for prediction of prognosis and therapeutic responses in lung squamous cell carcinoma

ABSTRACT The tumor-suppressor gene tumor protein p53 (TP53) is one of the most commonly mutated genes in human lung cancer, and TP53 mutations are associated with a worsened prognosis and causes resistance to cancer therapy. RNA sequencing and TP53 mutation data were downloaded to determine specific TP53-associated signature based on differentially expressed genes between patients with lung squamous cell carcinoma (LUSC) with wild type (TP53 WT) and mutated (TP53 MUT) TP53. We investigated the predictive value of this signature on the immune microenvironment, tumor mutational burden (TMB), and likelihood of response to immunotherapy and chemotherapy. In total, 1,556 differentially expressed genes were identified based on TP53 mutation status. Three genes (KLK6, MUC22 and CSN1S1) identified by univariate and multivariate Cox regression analyses, comprised the prognostic signature which was an independent and specific prognostic marker of overall survival in patients with LUSC. A nomogram was also established to validate this signature for clinical use. Moreover, the high-risk group was characterized by increased infiltration of monocytes and macrophages M1, and decreased T cells CD8 and T cells follicular helper. High-risk group exhibited a higher TMB, and was much more sensitive to immunotherapy and chemotherapy. KLK6 and CSN1S1 expression and the prognostic prediction values were further validated in clinical samples. The derived TP53-associated signature is a specific and independent prognostic biomarker for LUSC patients, and could provide potential prognostic biomarker or therapeutic targets for the development of novel immunotherapies and chemotherapies.
A Review of the Potential Application of Osteocyte-Related Biomarkers, Fibroblast Growth Factor-23, Sclerostin, and Dickkopf-1 in Predicting Osteoporosis and Fractures

Bone turnover markers (BTMs) derived from the secretory activities of osteoblasts and the matrix-degrading activities of osteoclasts are useful in monitoring the progression of osteoporosis and the efficacy of anti-osteoporotic treatment. However, the usefulness of BTMs in predicting osteoporosis remains elusive. Osteocytes play a central role in regulating bone formation and resorption. The proteins secreted by osteocytes, such as fibroblast growth factor-23 (FGF23), sclerostin (SOST), and dickkopf-1 (DKK1), could be candidates for osteoporosis screening and fracture prediction. This review summarizes the current evidence on the potential of osteocyte-related proteins as biomarkers for osteoporosis and fracture prediction. The literature reports that SOST may be a potential marker for osteoporosis screening but not for fracture prediction. FGF23 is a potential marker for increased fracture risk, but more studies are needed to confirm its usefulness. The role of DKK1 as a marker to predict osteoporosis and fracture risk cannot be confirmed due to a lack of consistent evidence. In conclusion, circulating osteocyte markers are potential osteoporosis biomarkers, but more studies are warranted to validate their clinical use.
“It Is Important for Everyone as Humans to Feel Important, Right?” Findings from a Community-Based Participatory Needs Assessment with Street-level Sex Workers

ABSTRACT A community-based participatory research design informed the development and conduct of a needs assessment with street-level sex workers within a mid-sized city in Ontario, Canada. The research question was: What would help street-level sex workers to live with enhanced safety and dignity within their community? Twenty-four women who accessed a peer-driven drop-in center (SafeSpace) participated in in-depth interviews. Observational data of items requested by women who accessed SafeSpace were also documented over a 6-month time period. The overarching theme of relationships was identified as vital to participants’ ability to live and work with enhanced safety and dignity in their community. Subthemes included: Informal/formal surveillance: Relationships to public space(s); Nowhere to go for us: Relationships with/in community services; and You’re given the time you need: Relationships in a peer-driven drop-in center for/with/by sex workers. Our findings demonstrate how central relationships are, particularly peer, to enhancing or diminishing sex workers’ sense of dignity, self-worth, safety, and enhanced their access to services.
Targeting RAGE prevents muscle wasting and prolongs survival in cancer cachexia

Abstract Background Cachexia, a multifactorial syndrome affecting more than 50% of patients with advanced cancer and responsible for ~20% of cancer‐associated deaths, is still a poorly understood process without a standard cure available. Skeletal muscle atrophy caused by systemic inflammation is a major clinical feature of cachexia, leading to weight loss, dampening patients' quality of life, and reducing patients' response to anticancer therapy. RAGE (receptor for advanced glycation end‐products) is a multiligand receptor of the immunoglobulin superfamily and a mediator of muscle regeneration, inflammation, and cancer. Methods By using murine models consisting in the injection of colon 26 murine adenocarcinoma (C26‐ADK) or Lewis lung carcinoma (LLC) cells in BALB/c and C57BL/6 or Ager −/− (RAGE‐null) mice, respectively, we investigated the involvement of RAGE signalling in the main features of cancer cachexia, including the inflammatory state. In vitro experiments were performed using myotubes derived from C2C12 myoblasts or primary myoblasts isolated from C57BL/6 wild type and Ager −/− mice treated with the RAGE ligand, S100B (S100 calcium‐binding protein B), TNF (tumor necrosis factor)α±IFN (interferon) γ, and tumour cell‐ or masses‐conditioned media to analyse hallmarks of muscle atrophy. Finally, muscles of wild type and Ager −/− mice were injected with TNFα/IFNγ or S100B in a tumour‐free environment. Results We demonstrate that RAGE is determinant to activate signalling pathways leading to muscle protein degradation in the presence of proinflammatory cytokines and/or tumour‐derived cachexia‐inducing factors. We identify the RAGE ligand, S100B, as a novel factor able to induce muscle atrophy per se via a p38 MAPK (p38 mitogen‐activated protein kinase)/myogenin axis and STAT3 (signal transducer and activator of transcription 3)‐dependent MyoD (myoblast determination protein 1) degradation. Lastly, we found that in cancer conditions, an increase in serum levels of tumour‐derived S100B and HMGB1 (high mobility group box 1) occurs leading to chronic activation/overexpression of RAGE, which induces hallmarks of cancer cachexia (i.e. muscle wasting, systemic inflammation, and release of tumour‐derived pro‐cachectic factors). Absence of RAGE in mice translates into reduced serum levels of cachexia‐inducing factors, delayed loss of muscle mass and strength, reduced tumour progression, and increased survival. Conclusions RAGE is a molecular determinant in inducing the hallmarks of cancer cachexia, and molecular targeting of RAGE might represent a therapeutic strategy to prevent or counteract the cachectic syndrome.
Harnessing Dengue Rapid Diagnostic Tests for the Combined Surveillance of Dengue, Zika, and Chikungunya Viruses in Laos

Abstract. Recent expansions of vector-borne diseases highlight the need for improved surveillance, especially in resource-poor settings. Dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) share the same vectors as well as similar clinical presentations, suggesting that combined surveillance would be useful. We hypothesized that blood spotted on dengue rapid diagnostic tests (RDTs) could be harnessed for sample collection in remote areas for subsequent detection of DENV, CHIKV, and ZIKV by reverse transcription real-time polymerase chain reaction (RT-qPCR). CHIKV and ZIKV dilutions were spotted on dengue RDTs (SD BIOLINE Dengue DUO, Standard Diagnostics, Gyeonggi-do, Republic of Korea), dried, and extracted. As reference, aliquots of each viral dilution were directly extracted. Using specific RT-qPCR tests, both viruses were successfully detected from RDT extracts. However, the limit of detection was slightly lower in comparison to direct extracts, two logfold for CHIKV and one logfold for ZIKV. For analysis of temperature stability, DENV dilutions were spotted on RDTs and stored for up to 2 months at −80°C, 4°C, or 35°C before testing. Storage of RDTs for 2 months at 35°C did not compromise detection of RNA by RT-qPCR; only minimal degradation was observed. This proof-of-principle study demonstrates the potential of using dengue RDTs for DENV/CHIKV/ZIKV combined surveillance in areas without access to laboratory facilities. Further investigations are needed for evaluation of tri-viral surveillance under field conditions using patient samples. Large-scale implementation of surveillance for these viruses is of crucial public health importance for the early detection of epidemics. This method also has important implications for improving understanding of the molecular epidemiology of the three viruses.
Improving the “real life” management of schizophrenia spectrum disorders by LAI antipsychotics: A one-year mirror-image retrospective study in community mental health services

Schizophrenia poses a significant economic burden on the healthcare system as well as it has a significant impact on society at large. Reasons for such a high economic burden of schizophrenia include the frequent relapses and hospitalizations occurring in this disorder. We analyze the effectiveness of long-acting injectable antipsychotics (LAIs) compared to oral medications, in terms of “clinical process management” in a sample of patients with a diagnosis of schizophrenia spectrum disorder treated in community mental health centers. An observational, retrospective, mirror-image study was carried out to evaluate the effectiveness of LAIs compared to oral medications in terms of number of hospitalizations, emergency visits and planned visits on a 10-year period (from July 2007 to June 2017). Differences between first and second generation LAIs were also explored. Our findings show that hospitalization and emergency visits are significantly decreased with the use of LAIs, while planned visits are increased in patients treated with LAIs. Our results suggest that LAIs, in particular, second generation ones, reduce hospitalization rates and emergency visits, improving the economic burden of schizophrenia. Therefore, LAIs should be considered a cost-effective treatment in the management of schizophrenia under routine conditions.
First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020

In the WHO European Region, COVID-19 surveillance was implemented 27 January 2020. We detail the first European cases. As at 21 February, nine European countries reported 47 cases. Among 38 cases studied, 21 were linked to two clusters in Germany and France, 14 were infected in China. Median case age was 42 years; 25 were male. Late detection of the clusters’ index cases delayed isolation of further local cases. As at 5 March, there were 4,250 cases.
Incidence Rates of Four Major Non-Communicable Chronic Diseases in the Chinese Adult Population from 2007 to 2016: A Study Based on a National Commercial Claims Database

Background The spread of non-communicable chronic diseases (NCDs) is a global crisis. Understanding the dynamics of NCDs at the population level is crucial to develop prevention strategies as well as to evaluate the effectiveness of intervention. However, studies investigating the incidence rate of NCDs among the general population are limited, especially for developing countries like China. We aim to evaluate the incidence rates of four major NCDs from 2007 to 2016, based on a national commercial claims database in China. Methods Cancer, stroke, coronary heart disease (CHD) and end-stage kidney disease (ESKD) accounted for over 90% of claims data were included as major NCDs. The definition of the above diseases followed the guideline of disease definitions of critical illness insurance released by the Insurance Association of China. Age-standardized incidence rates (ASRs) of those major NCDs among subgroups of sex, demographic regions, and China city tiers were reported. The trends of incidence rates were described as annual percent change (APC) as well as average annual percent change (AAPC) and were then examined by joinpoint models. Results For the population insured in 2007, the average 10-year ASRs of cancer, CHD, stroke, and ESKD were 221.0, 55.5, 43.5, 11.0 per 100,000 person-years, respectively. For males, the ASRs of cancer, CHD, ESKD continuously increase in the past decade with AAPC of 1.4%, 5.2%, and 3.3%; while the ASRs of stroke were decreased with APC of 3.7% after 2009. For females, the increased ASRs of cancer with AAPC of 4.2% and CHD with AAPC of 2.0%; while decreased trends of ASRs were observed for stroke and ESKD. Patterns of ASRs changing varied between different demographic regions and city tiers. Conclusion Commercial claims data could be a valuable data source to evaluate the disease burden for major NCDs in China. The disease burden of severe stroke was decreasing while cancer, CHD and ESKD were still increasing in China. More efforts should be put into control of CHD, especially in the northern part of China.
Intraoperative indocyanine green fluorescence angiography to prevent anastomotic leak after low anterior resection for rectal cancer: a meta‐analysis

Anastomotic leakage (AL) is one of the most dreadful complications after rectal cancer surgery. Indocyanine green fluorescence angiography (ICG FA) is now being used to evaluate blood supply at the anastomotic site. The aim of this study is to conduct a meta‐analysis of the available literature to evaluate whether ICG FA could prevent AL after low anterior resection (LAR) for rectal cancer.
Transformation of World Health Organization’s management practice and workforce to fit the priorities of African countries

Introduction The WHO Regional Office for Africa developed an evidence-based tool, called the Dalberg tool to guide the functional review and restructuring of the workforce and management of the country offices to better fit the health priorities of Member States. Methods The Dalberg tool was used in conjunction with a series of consultations and dialogues to review twenty-two countries have undergone the functional review. Results: the “core functions” in WHO country offices (WCOs) were identified. These are health coordination, strengthening of health systems, generation of evidence and strategic information management, and preparedness against health emergencies. Results In order to standardize country office functions, categorization of countries was undertaken, based on specific criteria, such as health system performance towards Universal Health Coverage (UHC), health emergencies, burden of communicable and non-communicable diseases, subnational presence and national population size. Conclusion Following the functional review, the staff is now better aligned with country and organizational priorities. For example, the functional review has taken into consideration: (i) the ongoing polio transition planning; (ii) the implementation of the WHO emergency programme in countries; (iii) the investment case for strengthening routine immunization in Africa; and (iv) regional flagship programmes, such as adolescent health and UHC. The delivery of the core functions above will require the hiring of additional capacities and expertise in most country offices if deemed fit-for-purpose.
Human-derived Acellular Dermal Matrix Grafts for Treatment of Diabetic Foot Ulcers: A Systematic Review and Meta-analysis.

BACKGROUND Treating diabetic foot ulcers (DFUs) requires thorough understanding of available surgical tools. OBJECTIVE This meta-analysis compares human-derived acellular dermal matrices (H-ADMs) with standard of care (SOC) to evaluate the number of healed ulcers at 12 and 16 weeks and number of days to complete healing. As a secondary outcome, the efficacy of 3 H-ADM subtypes are studied. METHODS Two researchers searched PubMed, EMBASE, and The Cochrane Central Register of Controlled Trials for relevant titles from inception through July 2018. Inclusion criteria indicated articles be randomized controlled trials investigating the effects on neuropathic, nonischemic DFUs. RESULTS Data from 312 DFUs in total were included in the meta-analysis. The results show H-ADMs are more effective in healing patients within a 12-week (3.14; range, 2.04-4.83) and 16-week period (2.35; range, 1.25-4.43) in comparison with SOC. Further, the mean time to complete healing was shorter in the H-ADM group (-2.31 days; range, -2.67 to -1.95 days) in comparison with SOC. Within the subgroups, 2 H-ADMs were associated with a higher likelihood of complete healing within 12 weeks when compared with SOC. The third H-ADM had a point estimate, which suggested superiority over SOC. CONCLUSIONS This study shows H-ADMs are associated with a higher likelihood of complete healing and fewer days to complete healing within a 12-week and 16-week periods when compared with SOC. Also, the commercial products performed similarly.