Miracle-dz/UniFAR-FTUs huggingface dataset:
Incidence of cesarean section and analysis of risk factors for failed conversion of labor epidural to surgical anesthesia: A prospective, observational study in a tertiary care center

Background and Aims: This study aimed to analyze the effect of labor epidural (LE) on the incidence of cesarean section (CS) and assess the risk factors involved in failed conversion of LE to surgical anesthesia for CS. Material and Methods: A prospective observational study of 18 months from January 2012 to June 2013 was conducted on all patients who had delivered in the labor room suit of our hospital. The data collected for all 4694 patients included their demographics, parity and mode of delivery. In addition a predesigned proforma, with additional information was used for 629 parturient with LE. Results: During the study period, total numbers of deliveries performed in our hospital were 4694, with an epidural rate of 13.4% (629/4694). No significant difference (P = 0.06) was observed in the rate of CS among women with or without LE (28 % [n = 176/629] vs. 31.7 % [n = 1289/4065]), however, a statistically significant difference (P < 0.01) was observed in the rate of assisted delivery in patients receiving LE as compared to those delivering without it (8.7% [n = 55/629] vs. n = 3.7% [154/4065]). For 176 patients requiring CS, LE utilization for surgical anesthesia was 52.8% (93/176) and factors identified for not utilizing LE in 47% (83/176) were; failure to achieve surgical anesthesia in 6.8% (12/176), emergency CS in 28.4% (50/176), patient preference in 6.8% (12/176) and inadequate labor pain relief with LE in 5.1% (9/176) patients. Non-obstetric anesthesiologists were involved in 59% (49/83) of cases where LE was not used for CS. Conclusion: LE had no effect on the rate of CS; however it significantly increased (P < 0.01) the rate of assisted delivery. Factors like inadequate LE, emergency situations and non-obstetric anesthesiologists can all be responsible for failed conversion of LE to surgical anesthesia for CS.
Structural basis for agonism and antagonism of hepatocyte growth factor

Hepatocyte growth factor (HGF) is an activating ligand of the Met receptor tyrosine kinase, whose activity is essential for normal tissue development and organ regeneration but abnormal activation of Met has been implicated in growth, invasion, and metastasis of many types of solid tumors. HGF has two natural splice variants, NK1 and NK2, which contain the N-terminal domain (N) and the first kringle (K1) or the first two kringle domains of HGF. NK1, which is a Met agonist, forms a head-to-tail dimer complex in crystal structures and mutations in the NK1 dimer interface convert NK1 to a Met antagonist. In contrast, NK2 is a Met antagonist, capable of inhibiting HGF’s activity in cell proliferation without clear mechanism. Here we report the crystal structure of NK2, which forms a “closed” monomeric conformation through interdomain interactions between the N- domain and the second kringle domain (K2). Mutations that were designed to open up the NK2 closed conformation by disrupting the N/K2 interface convert NK2 from a Met antagonist to an agonist. Remarkably, this mutated NK2 agonist can be converted back to an antagonist by a mutation that disrupts the NK1/NK1 dimer interface. These results reveal the molecular determinants that regulate the agonist/antagonist properties of HGF NK2 and provide critical insights into the dimerization mechanism that regulates the Met receptor activation by HGF.
Selective Adherence of IgA to Murine Peyer’s Patch M Cells: Evidence for a Novel IgA Receptor1

M cells represent the primary route by which mucosal Ags are transported across the intestinal epithelium and delivered to underlying gut-associated lymphoid tissues. In rodents and rabbits, Peyer’s patch M cells selectively bind and endocytose secretory IgA (SIgA) Abs. Neither the nature of the M cell IgR nor the domains of SIgA involved in this interaction are known. Using a mouse ligated ileal loop assay, we found that monoclonal IgA Abs with or without secretory component, but not IgG or IgM Abs, bound to the apical surfaces of Peyer’s patch M cells, indicating that the receptor is specific for the IgA isotype. Human serum IgA and colostral SIgA also bound to mouse M cells. The asialoglycoprotein receptor or other lectin-like receptors were not detected on the apical surfaces of M cells. We used recombinant human IgA1 and human IgA2 Abs and domain swapped IgA/IgG chimeras to determine that both domains Cα1 and Cα2 are required for IgA adherence to mouse Peyer’s patch M cells. This distinguishes the M cell IgA receptor from CD89 (FcαI), which binds domains Cα2-Cα3. Finally, we observed by immunofluorescence microscopy that some M cells in the human ileum are coated with IgA. Together these data suggest that mouse, and possibly human, M cells express an IgA-specific receptor on their apical surfaces that mediates the transepithelial transport of SIgA from the intestinal lumen to underlying gut-associated organized lymphoid tissues.
Survival of Chlamydia muridarum within Dendritic Cells

ABSTRACT Immune responses to Chlamydia trachomatis underlay both immunity and immunopathology. Immunopathology in turn has been attributed to chronic persistent infection with persistence being defined as the presence of organisms in the absence of replication. We hypothesized that dendritic cells (DCs) play a central role in Chlamydia immunity and immunopathology by favoring the long-term survival of C. muridarum. This hypothesis was examined based on (i) direct staining of Chlamydia in infected DCs to evaluate the development of inclusions, (ii) titration of infected DCs on HeLa cells to determine cultivability, and (iii) transfer of Chlamydia-infected DCs to naive mice to evaluate infectivity. The results show that Chlamydia survived within DCs and developed both typical and atypical inclusions that persisted in a subpopulation of DCs for more than 9 days after infection. Since the cultivability of Chlamydia from DCs onto HeLa was lower than that estimated by the number of inclusions in DCs, this suggests that the organisms may be in state of persistence. Intranasal transfer of long-term infected DCs or DCs purified from the lungs of infected mice caused mouse lung infection, suggesting that in addition to persistent forms, infective Chlamydia organisms also developed within chronically infected DCs. Interestingly, after in vitro infection with Chlamydia, most DCs died. However, Chlamydia appeared to survive in a subpopulation of DCs that resisted infection-induced cell death. Surviving DCs efficiently presented Chlamydia antigens to Chlamydia-specific CD4+ T cells, suggesting that the bacteria are able to both direct their own survival and still allow DC antigen-presenting function. Together, these results raise the possibility that Chlamydia-infected DCs may be central to the maintenance of T-cell memory that underlies both immunity and immunopathology.
The acquisition of an inheritable 50‐bp deletion in the human mtDNA control region does not affect the mtDNA copy number in peripheral blood cells

The mitochondrial DNA (mtDNA) control region is believed to play an important biological role in mtDNA replication. Large deletions in this region are rarely found, but when they do occur they might be expected to interfere with the replication of the molecule, thus leading to a reduction of mtDNA copy number. During a survey for mtDNA sequence variations in 5,559 individuals from the general Chinese population and 2,538 individuals with medical disorders, we identified a 50‐bp deletion (m.298_347del50) in the mtDNA control region in a member of a healthy Han Chinese family belonging to haplogroup B4c1b2, as suggested by complete mtDNA genome sequencing. This deletion removes the conserved sequence block II (CSBII; region 299–315) and the replication primer location (region 317–321). However, quantification of the mtDNA copy number in this subject showed a value within a range that was observed in 20 healthy subjects without the deletion. The deletion was detected in the hair samples of the maternal relatives of the subject and exhibited variable heteroplasmy. Our current observation, together with a recent report for a benign 154‐bp deletion in the mtDNA control region, suggests that the control of mtDNA replication may be more complex than we had thought. Hum Mutat 31:1–6, 2010. © 2010 Wiley‐Liss, Inc.
A Novel Social-Based Clustering and Routing Scheme in Mobile Opportunistic Networks

In this paper, we take a real-life example to show that social relationship among nodes consists of explicit and implicit parts. Explicit social relationship comes from direct contact among nodes, and implicit social relationship can be measured through the "circle of friends". Based on effective measurement of social relationship, we propose a novel social-based clustering and routing scheme. Each node selects the nodes with close social relationship to form a local cluster, and self-control method is used to keep all cluster members always having close relationship with each other. Cluster-based message forwarding mechanism is designed for opportunistic routing, in which each node only forwards the copy of the message to nodes with the destination node as a member of local cluster. Simulation results show that the proposed social-based clustering and routing outperforms the other two classic routing algorithms.
Measuring the Issue Content of Supreme Court Opinions

The opinions of the US Supreme Court are central to volumes of research on law, courts, and politics. To understand these complex and often-lengthy documents, scholars frequently rely on dichotomous indicators of opinion content. While sometimes appropriate, for many research settings this simplification of opinion content systematically omits important information. Using all US Supreme Court opinions from 1803 to 2010 in association with structural topic models, I instead demonstrate the value of representing the Court’s attention in opinions in terms of topic proportions.
Investigation of the accuracy of search engine hit counts

This study investigates the accuracy of search engine hit counts for search queries. We investigate the accuracy of hit counts for Google, Yahoo and Microsoft Live Search, and the accuracy of single and multiple term queries. In addition, we investigate the consistency of hit count estimates for 15 days. The results show that all three provide estimates for the number of matching documents and the estimation patterns of their counting algorithms differ greatly. The accuracy of hit counts for multiple word queries has not been studied before. The results of our study show that the number of words in queries affects the accuracy of estimations significantly. The percentages of accurate hit count estimations are reduced almost by half when going from single word to two word query tests in all three search engines. With the increase in the number of query words, the error in estimation increases and the number of accurate estimations decreases.
Are Vitreous Asteroid Bodies Associated with Diabetes Mellitus?

ABSTRACT Twenty‐seven subjects having vitreous asteroid bodies were matched for age and sex with control subjects. The results of random blood glucose analysis and 2‐hr glucose tolerance tests were used to determine the presence of diabetes mellitus or impaired glucose tolerance. Five of the subjects having asteroid bodies were diabetic and four had impaired glucose tolerance. In the control group there were no diabetics; however, three subjects had impaired glucose tolerance. These results confirm that a relation exists between the occurrence of vitreous asteroid bodies and diabetes mellitus (p = 0.036). There was no statistically significant difference between random blood glucose levels of the two cohorts. Four of the five diabetics were excluded from the 2‐hr glucose tolerance tests; however, for the remainder of the asteroid body group, there was no significant difference in the results of this test compared with the control group. These results suggest that the relation between asteroid bodies and diabetes may not be dependent on blood glucose levels. Diabetics having asteroid bodies may form a special subgroup of the disease in which there is accelerated degeneration and mineralization of collagen associated with increased intraocular vascular permeability.
Health Literacy and Heart Failure: A Systematic Review

Background:Low health literacy affects millions of Americans, putting those who are affected at a disadvantage and at risk for poorer health outcomes. Low health literacy can act as a barrier to effective disease self-management; this is especially true for chronic diseases such as heart failure (HF) that require complicated self-care regimens. Purpose:This systematic review examined quantitative research literature published between 1999 and 2014 to explore the role of health literacy among HF patients. The specific aims of the systematic review are to (1) describe the prevalence of low health literacy among HF patients, (2) explore the predictors of low health literacy among HF patients, and (3) discuss the relationship between health literacy and HF self-care and common HF outcomes. Methods:A systematic search of the following databases was conducted, PubMed, CINAHL Plus, Embase, PsycINFO, and Scopus, using relevant keywords and clear inclusion and exclusion criteria. Conclusions:An average of 39% of HF patients have low health literacy. Age, race/ethnicity, years of education, and cognitive function are predictors of health literacy. In addition, adequate health literacy is consistently correlated with higher HF knowledge and higher salt knowledge. Clinical Implications:Considering the prevalence of low health literacy among in the HF population, nurses and healthcare professionals need to recognize the consequences of low health literacy and adopt strategies that could minimize its detrimental effect on the patient’s health outcomes.
Understanding barriers and facilitators to healthy eating and physical activity from patients either before and after knee arthroplasty

Abstract Purpose: We sought to identify patient-reported barriers and facilitators to healthy eating and physical activity among patients before or after knee arthroplasty. Materials and methods: Twenty patients with knee osteoarthritis aged 40–79 years who had knee arthroplasty surgery scheduled or completed within 3 months were interviewed. Interview topics included perceived barriers and facilitators to healthy eating and activity before or after surgery. Interviews were coded and analyzed using constant comparative analysis. Results: Interviews were completed with 11 pre-operative (67.1 ± 7.6 years, 45.5% female, BMI 31.2 ± 6.3) and nine post-operative patients (61.7 ± 11.7 years, 44.4% female, BMI 30.2 ± 4.7 kg/m2). The most commonly identified personal barriers to healthy eating identified were desire for high-fat/high-calorie foods, managing overconsumption and mood. Factors related to planning, portion control and motivation to improve health were identified as healthy eating facilitators. Identified personal barriers for activity included pain, physical limitations and lack of motivation, whereas facilitators included having motivation to improve knee symptoms/outcomes, personal commitment to activity and monitoring activity levels. Conclusion: Identifying specific eating and activity barriers and facilitators, such as mood and motivation to improve outcomes, provides critical insight from the patient perspective, which will aid in developing weight management programs during rehabilitation for knee arthroplasty patients. Implications for rehabilitation This study provides insight into the identified barriers and facilitators to healthy eating and physical activity in knee arthroplasty patients, both before and after surgery. Intrapersonal barriers that may hinder engagement in physical activity and rehabilitation include pain, physical limitations and lack of motivation; factors that may help to improve activity and the rehabilitation process include being motivated to improve knee outcomes, having a personal commitment to activity and tracking activity levels. Barriers that may interfere with healthy eating behaviors and knee arthroplasty rehabilitation include the desire for high-fat/high-calorie foods, overeating and mood; whereas planning and portion control may help to facilitate healthy eating. Understanding barriers and facilitators to healthy eating and physical activity can help guide rehabilitation professionals with their discussions on weight management with patients who had or are contemplating knee arthroplasty.
T Cell Proliferation by Direct Cross-Talk between OX40 Ligand on Human Mast Cells and OX40 on Human T Cells: Comparison of Gene Expression Profiles between Human Tonsillar and Lung-Cultured Mast Cells1

Mast cells (MCs) are the primary effector cells in allergic reactions and have also been found to activate T cells and to reside in close physical proximity to T cells. However, the molecular mechanisms involved in the MC-T cell interaction remain unclear. We hypothesized that human tonsillar MCs, which locate in the interfollicular areas, might interact with T cells. Thus, we first established a culture system of human tonsillar MCs and then compared gene expression profiles of tonsillar MCs with that of lung MCs before and after aggregation of FcεRI by using high-density oligonucleotide probe arrays. Here we show that resting tonsillar MCs, when compared with lung MCs, revealed significantly higher expression levels for CC chemokines (CCL3 and 4), which recruit T cells, and for TNFR superfamilies (OX40 ligand and 4-1BB ligand), which induce proliferation of T cells. After aggregation of FcεRI, not only tonsillar MCs but also lung MCs up-regulated the expression of these molecules. We confirmed that T cell proliferation is induced in direct cross-talk by the MC surface molecule OX40 ligand. These results suggest that human MCs may play important roles in adaptive immunity through the T cell responses.
BMK1 is activated in glomeruli of diabetic rats and in mesangial cells by high glucose conditions.

BACKGROUND High glucose causes renal cell injury through various signal transduction pathways, including mitogen-activated protein (MAP) kinases cascades. Big MAP kinase 1 (BMK1), also known as extracellular signal-regulated kinase 5 (ERK5), is a recently identified MAP kinase family member and was reported to be sensitive to osmotic and oxidative stress. However, the role of BMK1 in diabetic nephropathy has not been elucidated yet. METHODS We investigated whether BMK1 is activated in the glomeruli of Otsuka Long Evans Tokushima Fatty (OLETF) rats, a model of type 2 diabetes mellitus in comparison with the control Long Evans Tokushima Otsuka (LETO) rats. We also examined the effect of high glucose on BMK1 activity in cultured rat mesangial cells. RESULTS BMK1 and ERK1/2 but not p38 were activated in the glomeruli of OLETF rats, which showed diabetic nephropathy at 52 weeks of age. High glucose, in addition to a high concentration of raffinose, caused rapid and significant activation of BMK1 in rat mesangial cells. MAP kinase/ERK kinase (MEK) inhibitors, U0126 and PD98059, both inhibited BMK1 activation by high glucose in a concentration-dependent manner. Protein kinase C (PKC) inhibition by GF109203X and PKC down-regulation with long-time phorbol myristate acetate (PMA) treatment both inhibited BMK1 and Src kinase activation. Src kinase inhibitors, herbimycin A and PP2, also inhibited high glucose-induced BMK1 activation. PKC inhibitors, Src inhibitors and MEK inhibitors, all inhibited cell proliferation by high glucose. Finally, transfection of dominant-negative MEK5, which is an upstream regulator of BMK1, abolished the BMK1-mediated rat mesangial cell proliferation stimulated by high glucose. CONCLUSION In the present study, we demonstrated that high glucose activates BMK1 both in vivo and in vitro. It was suggested that high glucose induces PKC- and c-Src-dependent BMK1 activation. It could not be denied that BMK1 activation is induced through an osmotic stress-sensitive mechanism. BMK1-mediated mesangial cell growth may be involved in the pathogenesis of diabetic nephropathy.
Do Intraoperative LIV-Tilt and Disk Angle Remain Stable at 2-year Follow-up Compared With Upright Radiographs in Patients With Idiopathic Scoliosis?: A Retrospective Cohort Study

Study Design: This study was a retrospective chart and radiographic review. Objective: The aim of this study was to determine if lowest instrumented vertebra (LIV) tilt and disk wedging measured intraoperatively correlated to their respective values on standing radiographs at intermediate follow-up. Summary of Background Data: No guidelines exist regarding an acceptable intraoperative LIV-tilt. Materials and Methods: After IRB approval, a consecutive series of patients with adolescent idiopathic scoliosis (AIS) and structural lumbar curves treated with posterior spinal fusion (PSF) at a single institution between 2007 and 2010 was identified. A total of 163 patients with AIS underwent PSF during this time period. Seventeen patients had fusion of structural lumbar curves with adequate imaging and a minimum 2-year follow-up. The LIV-tilt and disk angle below the LIV was measured on the preoperative standing, intraoperative supine fluoroscopy and postoperative standing radiographs, and coronal balance was measured on the preoperative and postoperative standing radiographs using a standardized method separately by 2 authors. Results: The curve distribution was as follows: Lenke 3 (29%), Lenke 5 (47%), and Lenke 6 (24%). There was agreement on radiographic measurements between the 2 authors with a correlation coefficient of 0.98 for coronal balance, 0.91 for LIV-tilt, and 0.65 for disk angle. LIV-tilt improved from 19.4 degrees preoperatively to 3.6 degrees intraoperatively. At minimum 2-year follow-up, LIV had on average progressed to 8.6 degrees. The disk angle improved from 5.4 degrees preoperatively to 2.5 degrees intraoperatively. This improvement was maintained at 2 years (2.8 degrees). Coronal balance also improved during the postoperative period from 17.9 mm immediately following surgery to 11.1 mm at the last follow-up. Conclusions: Compared with prone intraoperative fluoroscopic images, disk wedging below LIV remains stable at 2 years postsurgery on standing radiographs in patients with AISundergoing PSF, including structural lumbar curves, whereas LIV-tilt improvement is not maintained. Intraoperative fluoroscopy provides a reliable prediction of disk wedging below LIV, 2 years after surgery on standing radiographs.