Miracle-dz/UniFAR-FTUs huggingface dataset:
The Microenvironment of the Breast: Three‐Dimensional Models to Study the Roles of the Stroma and the Extracellular Matrix in Function and Dysfunction

Abstract: Sensitive assays that recapitulate the complex and dynamic interaction of cells within the breast are needed to understand the early steps by which normal breast cells become cancerous, and cancer cells become invasive. We discuss the literature of available culture systems and elaborate on two assays we have developed to study interaction of normal and tumor cells with stromal cells and ECM in three dimensions. The assays highlight the significance of cell:cell and cell‐extracellular matrix interactions in functional differentiation of the breast epithelium and should provide valuable tools in understanding breast cancer.
Mometasone furoate: an inhaled glucocorticoid for the management of asthma in adults and children

Mometasone furoate has been available for clinical use, starting with a dermatologic preparation, for nearly 20 years. An inhaled format of the drug for management of asthma had been in development during the last decade and has been available for clinical use for 6 years as a dry powder inhaler delivering either 100 mcg or 200 mcg per dose. It has a long half-life and is suitable for daily dosing. The drug is approved for use in the USA for the treatment of asthma in patients aged 4 years or over. Mometasone furoate is a topically potent glucocorticoid with a favorable risk–benefit profile. A wide variety of randomized clinical trials have shown the drug to have a clinically beneficial effect on asthma comparable to fluticasone propionate, and to permit the reduction or withdrawal of oral glucocorticoid therapy in patients with asthma. Mometasone furoate has approximately 1% oral bioavailability but does produce systemic glucocorticoid effects from the drug released from the lung and its metabolites. These effects are minimal when mometasone is used appropriately at low or moderate doses.
Clinical and ultrasonographical characterization of childhood cystic kidney diseases in Egypt

Abstract Background: Renal cystic disorders (RCD) constitute an important and leading cause of end-stage renal disease (ESRD) in children. It can be acquired or inherited; isolated or associated with extrarenal manifestations. The precise diagnosis represents a difficult clinical challenge. Methods: The aim of this study was to define the pattern of clinical phenotypes of children with renal cystic diseases in Pediatric Nephrology Center, Cairo University. We have studied the clinical phenotypes of 105 children with RCD [45 (43%) of them had extrarenal manifestations]. Results: The most common disorders were the presumably inherited renal cystic diseases (65.7%) mainly nephronophthisis and related ciliopathies (36.2%), as well as polycystic kidney diseases (29.5%). Moreover, multicystic dysplastic kidneys accounted for 18% of study cases. Interestingly, eight syndromic cases are described, yet unclassified as none had been previously reported in the literature. Conclusion: RCD in this study had an expanded and complex spectrum and were largely due to presumably inherited/genetic disorders (65.7%). Moreover, we propose a modified algorithm for clinical and diagnostic approach to patients with RCD.
Orthosis for thoracolumbar burst fractures without neurologic deficit: A systematic review of prospective randomized controlled trials

Background: Traditionally, conservative treatment of thoracolumbar (TL) burst fractures without neurologic deficit has encompassed the application of an extension brace. However, their effectiveness on maintaining the alignment, preventing posttraumatic deformities, and improving back pain, disability and quality of life is doubtful. Objective: The objective was to identify and summarize the evidence from randomized controlled trials (RCTs) to determine whether bracing patients who suffer TL fractures adds benefices to the conservative manage without bracing. Materials and Methods: Seven databases were searched for relevant RCTs that compared the clinical and radiological outcomes of orthosis versus no-orthosis for TL burst fractures managed conservatively. Primary outcomes were: (1) Loss of kyphotic angle; (2) failure of conservative management requiring subsequent surgery; and (3) disability and pain outcomes. Secondary outcomes were defined by health-related quality of life and in-hospital stay. Results: Based on predefined inclusion criteria, only two eligible high-quality RCTs with a total of 119 patients were included. No significant difference was identified between the two groups regarding loss of kyphotic angle, pain outcome, or in-hospital stay. The pooled data showed higher scores in physical and mental domains of the Short-Form Health Survey 36 in the group treated without orthosis. Conclusion and Recommendation: The current evidence suggests that orthosis could not be necessary when TL burst fractures without neurologic deficit are treated conservatively. However, due to limitations related with number and size of the included studies, more RCTs with high quality are desirable for making recommendations with more certainty.
NUTRICIÓN EN RECIÉN NACIDOS A TÉRMINO Y EN NIÑOS DE 1 A 6 MESES

SUMMARY Nutrition in newborn term and the infant up to 6 months of age Adequate nutrition during infancy and early childhood ensures the full development of the human potential of every child in any part of the world, as well as the prevention of chronic diseases related to nutrition in adulthood. They are fundamental power of good practices to achieve optimal health. The human feeding exclusively covers all nutritional requirements during the first six months of life and to be then continued together with the complementary feeding up to two years. Artificial formulas are used when human milk feeding is not possible either by medical causes inherent to the mother or the child. Human milk feeding exerts protective effect for the prevention of micronutrient deficiencies mainly of iron and vitamin A to the first six months of life. The pregnant mother and supplementation during lactation at risk of deficiency is important to the nutritional status of the child at this age.
Prucalopride for constipation

Importance of the field: Chronic constipation has a high prevalence, and current medical and pharmacological therapies do not restore normal bowel function in all patients. Areas covered in the review: A PubMed search (1965 – 2009) using the following terms alone or in combination: prucalopride, 5-HT4, R093877, safety, toxicity, pharmacokinetics, pharmacodynamics, transit, cardiac, hERG, arrhythmia, potassium current, elderly. What the reader will gain: Understanding of the mechanisms of action, safety, efficacy and indications for prucalopride in patients with chronic constipation. Take home message: Prucalopride is an efficacious and generally safe, new therapeutic option in the management of chronic constipation.
In vitro antioxidant and free radical scavenging activity of four Alkanna species growing in Iran

Background: Medicinal plants are recognized as sources of natural antioxidants that can protect biological system from oxidative stress. Objective: In this study, the antioxidant activities of four species of the Alkanna genus (Alkanna bracteosa, Alkanna frigida, Alkanna orientalis and Alkanna tricophila) were evaluated. Materials and Methods: The dried roots of plant samples (100 g) were extracted separately by percolation method with MeOH/H 2 O (80/20) and four fractions were provided respectively with hexane, chloroform, ethyl acetate, butanol and water. Antioxidant activities were investigated by using 1,1-diphenyl-2-picrylhydrazyl, ferric thiocyanate and thiobarbituric acid methods and compared with quercetin (as positive control). Results: The results indicated that the butanol fractions of four species had the highest antioxidant activity and radical scavenging activity compared with the other fractions studied (P < 0.05). The 50% effective concentration (half - effective doses) values of butanol fractions are less than quercetin and other fractions, so, these fractions showed potent antioxidant activity. This indicated that the active compounds in the root parts of Alkanna species dissolved in the butanol. All the fractions of four species of Alkanna had antioxidant activity, while, there were no significant differences (P > 0.05) between the total antioxidant activities of same fractions. The total antioxidant activity values of Alkanna fractions in a descending order are as follows: Butanol fraction > ethyl acetate fraction > total extract > hexane fraction > chloroform fraction > aqueous fraction. Conclusion: The antioxidant activities of butanol fractions of samples were higher than quercetin. This may be because most of the active compounds of Alkanna species dissolved in the butanol.
Isolation, structural characterization and in silico drug-like properties prediction of a natural compound from the ethanolic extract of Cayratia trifolia (L.)

Background: Natural products have continually played an important role in drug discovery because it serves as active principles in drugs as well as templates for synthesis of new drugs. Cayratia trifolia (L.) is a medicinal plant, which has been reported to have antiviral, antibacterial, antiprotozoal, hypoglycemic, anticancer and diuretic activities. Objective: Therefore, the objective of this study is to isolate and identify the natural compound from the ethanolic extract of Cayratia trifolia (L.) and to predict the Absorption, Distribution, Metabolism and Excretion (ADME) properties of isolated natural compound. Materials and Methods: Column chromatography and thin layer chromatography were used to isolate the natural compound and Fourier-transform infrared (FTIR) spectroscopy was used to predict the functional groups present in the isolated natural compound. The structural characterization studies were functionally carried out using 1 H, 13 C, two-dimensional nuclear magnetic resonance (NMR) and mass spectrometry methods. Results: FTIR showed that, the groups of OH, C-H, C = C may be present in the isolated natural compound. 1 H, 13 C, two-dimensional NMR and mass spectrometry data suggests that the isolated natural compound probably like linoleic acid. In silico ADME properties, prediction of the compound was under acceptable range. Conclusion: Based on the results, it can be concluded that, the isolated natural compound of linoleic acid that has been exhibited good medicinal properties.
Comparison of serum cystatin C and creatinine levels in determining glomerular filtration rate in children with stage I to III chronic renal disease

Abstract Background: Pediatric studies are relatively scarce on the superiority of cystatin C over creatinine in estimation of glomerular filtration rate (GFR). This study measured cystatin C and serum creatinine levels, and compared GFR estimated from these two parameters in patients with chronic renal disease. Methods: This prospective, observational, controlled study included 166 patients aged 1–18 years diagnosed with stage I to III chronic renal disease, and 29 age- and sex-matched control subjects. In all patients, GFR was estimated via creatinine clearance, Schwartz formula, Zappitelli 1 and Zappitelli 2 formula and the results were compared using Bland–Altman analysis. Results: Patients and controls did not differ with regard to height, body weight, BMI, serum creatinine and serum cystatin levels, and Schwartz formula-based GFR (p > 0.05). There was a significant relationship between creatinine and cystatin C levels. However, although creatinine levels showed a significant association with age, height, and BMI, cystatin C levels showed no such association. ROC analysis showed that cystatin C performed better than creatinine in detecting low GFR. Conclusion: Cystatin C is a more sensitive and feasible indicator than creatinine for the diagnosis of stage I to III chronic renal disease.
Bioinformatic analysis of specific genes in diabetic nephropathy

Abstract Objective: We attempt to explore the pathogenesis and specific genes with aberrant expression in diabetic nephropathy (DN). Methods: The gene expression profile of GSE1009 was downloaded from Gene Expression Omnibus database, including 3 normal function glomeruli and DN glomeruli from cadaveric donor kidneys. The differentially expressed genes (DEGs) were analyzed and the aberrant gene-related functions were predicted by informatics methods. The protein–protein interaction (PPI) networks for DEGs were constructed and the functional sub-network was screened. Results: A total of 416 DEGs were found to be differentially expressed in DN samples comparing with normal controls, including 404 up-regulated genes and 12 down-regulated genes. DEGs were involved in the process of combination to saccharides and the decline of tissue repairing ability of the organisms. The genes of VEGFA, ACTG1, HSP90AA1 had high degree in the PPI network. The main biological process of genes in the sub-network was related with cell proliferation and signal transmitting of cell membrane receptor. Conclusion: Significant nodes in PPI network provide new insights to understand the mechanism of DN. VEGFA, ACTG1 and HSP90AA1 may be the potential targets in the DN treatment.
The M igratory Experiences, Access to Health Care and Employment of Immigrant and Refugee Latinos and Latinas Living with HIV in Toronto

entities are created when social aspects, which form concrete phenomena, organizations and beings, are analyzed and studied separately as if they were naturally independent of each other. Positivist science often analyzes gender, race and class, as if they were separate traits generating unconnected forms of oppression (Marx Ferree, Lorber and Hess, 1999). However, one-dimensional analyses have the unintended consequence of making one form of oppression seem more important, or making one group more victimized. When one group is singled out in this way, the focus of attention moves away from relations of power among dominant and multiply oppressed groups (Weber, 2010). Kimberle Williams Crenshaw (1994) was one of the first theorists to propose an
Beyond efficacy: pharmacokinetic differences between clopidogrel, prasugrel and ticagrelor

Introduction: Clinical nonresponse to clopidogrel has been associated with variability in response. This has led to the development of other P2Y12 receptor inhibitors, such as prasugrel and ticagrelor, with different pharmacokinetic characteristics that influence their pharmacodynamics. Areas covered: Clopidogrel response variability is attributable to its complex pharmacokinetics and is vulnerable to genetic polymorphisms in genes involved in absorption, metabolism and drug–drug interactions (i.e., proton pump inhibitors). Prasugrel which has a simpler metabolism, leading to greater bioavailability, seems to be less affected by genetic or drug–drug interactions and achieves a greater antiplatelet effect. Ticagrelor is the most novel compound approved with a simpler metabolism. Both prasugrel and ticagrelor reached their antiplatelet effect faster and to a much greater extent than clopidogrel. All these differences observed in kinetics explain, to some degree, the efficacy and safety profile observed in clinical trials for these molecules associated with other antiplatelet agents (aspirin, gpIIb/IIIa inhibitors) and anticoagulants. Expert opinion: Clopidogrel is still the best standard of care. However, the pharmacokinetic advantages of both prasugrel and ticagrelor allow clinicians to center patient management by selecting the best drug for the appropriate subject.
Trauma scores and trauma outcome measures

Objective measurement and quantification of injury severity are necessary for triage, performance evaluation and research. In order to evaluate interventions, outcomes must also be compared. While this can be done using hospital stay or mortality, these will fail to detect subtle differences. Impact of injury on health can be quantified using a variety of scoring systems. Trauma scoring and outcome measurement have grown increasingly complex in recent years and are likely to become more so in the future.
Genetic Polymorphism of γ-Glutamyl Hydrolase in Chinese Acute Leukemia Children and Identification of a Novel Double Nonsynonymous Mutation

γ-Glutamyl hydrolase (GGH) plays a central role in folate metabolism and antifolate action. Polymorphism in the human GGH gene (GGH) was associated with efficacy and side effects of methotrexate for treatment of acute lymphoblastic leukemia (ALL). This study aimed to identify polymorphisms of GGH in Chinese. Seventy-one children with ALL, 25 children with acute myeloid leukemia (AML), and 132 children with nonmalignancy as control were included. Human GGH cDNAs were prepared and analyzed by reverse transcriptase–polymerase chain reaction (RT-PCR)–denaturing gradient gel electrophoresis. The detected variants were further confirmed by DNA sequencing. Novel variant GGH cDNA was cloned, expressed, and characterized. Allelic frequency of GGH 452C→T polymorphism was determined as 9.2% (CT, 11/71; TT, 1/71) in the ALL group, 8.0% (CT, 4/25; TT, 0/25) in the AML group, and 9.1% (TT, 4/132; T/C, 16/132) in the controls, respectively. The total allelic frequency in the Chinese population (9.0%) was higher than those reported in Japanese (5.6%) and African Americans (4.4%), and was similar to Caucasians (10.0%). Association of 452TT+TC with increased rate of hepatotoxicity and mucositis was observed in the ALL patients. Two novel mutations were determined in the coding region of GGH in 2 boys with ALL: one of the mutations was a double nonsynonymous heterozygote (841AG+845AG, K257E/N258S), the other was a nonsynonymous heterozygote (797AG, K242R). The corresponding double-mutant protein showed unchanged enzymatic activity by functional analysis. Allele frequency of GGH C452T polymorphism is determined for the first time among Chinese. A novel double nonsynonymous mutation of GGH was identified in a boy with ALL.
Health Sector Efficiency in Kenya : Implications for Fiscal Space

The health system in Kenya is currently going through a major transition with the implementation of the new constitution. The responsibility to deliver essential health services has been devolved to the 47 counties while the national government is responsible for policy making and operating the national referral hospitals. The government is giving a high priority to the health sector and has waived user fees at primary health facilities and introduced free maternity care at all public health facilities to increase access to essential health services. The government is also committed to achieving universal health coverage. While these are notable measures, the challenge is to ensure that there are adequate resources available to meet these commitments. More importantly, given that the available public health sector resources are limited, it is necessary to ensure that they are optimally used for providing health services to the greatest number of people possible ensuring better value for money. Unfortunately, the Ministry of Health has limited information on the operational efficiency of the health system at different levels of care. The overarching objective of this study is to assess the efficiency in the public health sector. Specifically the study: i) estimated the technical efficiency of samples of dispensaries, health centres and hospitals in urban and rural counties; ii) reviewed critically the ongoing pilots on performance based financing and output based aid to highlight potential efficiency gains and policy options for national scale-up. The study applied the Data Envelopment Analysis (DEA) approach to analyse technical efficiency of randomly selected sample of twenty four district hospitals, two hundred and ninety five health centres and thirty-eight dispensaries using output and input data for FY 2012.
Combinational therapies for HIV: a focus on EVG/COBI/FTC/TDF

Introduction: The co-formulation of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF) is a new, investigational, once-daily (q.d.) drug, currently undergoing Phase II and III clinical trials. Next to the nucleotide/nucleoside reverse transcriptase inhibitors FTC and TDF, it contains EVG, the second member of the HIV-1 integrase strand transfer inhibitor class, together with its pharmacokinetic booster COBI. Areas covered: In this article, the authors review EVG/COBI/FTC/TDF, in addition to discussing the single-tablet regimens (STRs) containing EFV/FTC/TDF or RPV/FTC/TDF, and the investigational combination pill containing dolutegravir, lamivudine and abacavir (DTG/3TC/ABC, 572-Trii pill). A Medline review was conducted of Phase II and III trials, as well as a review of abstracts from major HIV and infectious disease conferences from 2010 to 2012, involving EVG/COBI/FTC/TDF. Expert opinion: Next to the combination of EFV/FTC/TDF or RPV/FTC/TDF, the co-formulation of EVG/COBI/FTC/TDF offers a new, q.d. , single-tablet alternative in treatment-naïve HIV patients. EVG/COBI/FTC/TDF combines a high efficacy with a good tolerability profile. The effect on the renal function and virologic failure with the development of resistance to two or more compounds present in EVG/COBI/FTC/TDF, requires further monitoring. STRs certainly bring the standard for HIV treatment and drug development to a higher level.
A randomized, double-blind, placebo-controlled trial evaluating sitagliptin action on insulin resistance parameters and β-cell function

Aim: To evaluate the impact on glycemic control, insulin secretion and on insulin resistance of a sitagliptin + metformin combination compared to metformin monotherapy in type 2 diabetic, naïve to treatment, patients. Materials and methods: A total of 178 Caucasian type 2 diabetic patients were randomized to take sitagliptin 100 mg once a day or placebo in addition to previously taken metformin, for 12 months. The authors evaluated at 3, 6, 9, and 12 months: body mass index (BMI), glycemic control, fasting plasma insulin (FPI), HOMA-IR, HOMA-β, fasting plasma proinsulin (FPPr), proinsulin/fasting plasma insulin ratio (Pr/FPI ratio), C-peptide, glucagon, retinol binding protein-4 (RBP-4), visfatin, and chemerin. Before and 12 months after the addition of sitagliptin, patients underwent tests to assess insulin sensitivity and insulin secretion. Results: Sitagliptin + metformin gave a better decrease of glycemic control, HOMA-IR and glucagon levels compared to placebo + metformin; sitagliptin + metformin also better increased HOMA-β and all β-cell measurements recorded after the clamp. Regarding adipocytokines, sitagliptin + metformin better reduced RBP-4, visfatin and chemerin levels, compared to placebo + metformin. Conclusion: When metformin alone is not enough to reach an adequate glycemic control, sitagliptin can be a valid option, because of its effects in reducing insulin resistance and in preserving β-cell function.