Miracle-dz/UniFAR-FTUs huggingface dataset:
A Pilot Study to Enhance Preventive Asthma Care among Urban Adolescents with Asthma

Background. Low-income, minority teens have disproportionately high rates of asthma morbidity and are at high risk for nonadherence to preventive medications. Objective. To assess the feasibility and preliminary effectiveness of an innovative school-based asthma program to enhance the delivery of preventive care for 12–15 year olds with persistent asthma. We hypothesized that this intervention would (1) be feasible and acceptable among this population and (2) yield reduced asthma morbidity. Design/methods. Subjects/setting: Teens with persistent asthma and a current preventive medication prescription in Rochester, NY. Design: Single group pre-post pilot study during the 2009–2010 school year. Intervention: Teens visited the school nurse daily for 6–8 weeks at the start of the school year to receive directly observed therapy (DOT) of preventive asthma medications; 2–4 weeks following DOT initiation, they received three counseling sessions (one in-home and two via telephone) using motivational interviewing (MI) to explore attitudes about asthma management, build motivation for medication adherence, and support transition to independent preventive medication use. Primary outcome: Number of symptom-free days (SFDs)/2 weeks; outcome data were collected 2 months after baseline and at the end of school year. Results. We enrolled 30 teens; 28 participated in the intervention. All teens initiated a trial of school-based DOT. All in-home MI visits were completed successfully, and 89% completed both follow-up sessions. Teens experienced an overall reduction of symptoms with more SFDs/2 weeks from baseline to 2-month and final (end of school year) assessments (8.71 vs. 10.79 vs. 12.89, respectively, p = .046 and p = .004). Teens also reported fewer days with symptoms, less activity limitation, and less rescue medication use (all p < .05). Exhaled nitric oxide levels decreased (p = .012), suggesting less airway inflammation. At the final assessment, teens reported significantly higher motivation to take their preventive medication every day (p = .043). At the end of the study, 79% of teens stated that they were better at managing asthma on their own, and 93% said they would participate in a similar program again. Conclusions. This pilot study provides preliminary evidence of the feasibility and effectiveness of a novel school-based intervention to promote independence in asthma management and improve asthma outcomes in urban teens.
Retrospective Comparison of Early versus Late Treatment with Fluticasone Propionate/Salmeterol After an Asthma Exacerbation

Background. The benefits of inhaled corticosteroids in asthma are well established. Early use of inhaled anti-inflammatories following and exacerbation could be beneficial. Methods. A retrospective observational cohort study compared the risk of asthma-related exacerbations [hospitalization, emergency department visit, and/or treatment with systemic corticosteroid] in patients receiving treatment with fluticasone propionate/salmeterol in a single inhaler (FSC) within 90 days following an initial asthma-related exacerbation (early treatment) versus patients receiving the treatment subsequently (late treatment). Data were from a large health insurance claims database spanning from January 1998 to April 2008. Subjects included patients with ≥1 prescription for FSC ≤ 1 year after first asthma-related exacerbation. Patients with early treatment were matched to those with late treatment by propensity score and compared in terms of healthcare utilization and costs after initiation of FSC. Results. A total of 14,861 patients met study inclusion criteria, including 10,793 early and 4068 late treatment patients. After matching, 3555 pairs were well matched on all pretreatment characteristics and duration of follow-up (mean 722 vs. 717 days, p = .634). Early versus late treatment was associated with longer time to first asthma-related exacerbation (hazard ratio = 0.82, 95% CI 0.75–0.88, p < .001), fewer short-acting β-agonists prescriptions (3.3 vs. 3.6, p = .031), higher outpatient yearly per patient pharmacy costs ($1320 vs. $1163, p = .008), and lower yearly per patient asthma-related emergency department visit costs ($80 vs. $105, p = .032). Total yearly per patient asthma-related costs were similar ($2197 vs. $2064, p = .203). Conclusions. Earlier use of FSC following an asthma exacerbation was associated with reduced risk of future asthma-related exacerbation and lower use of rescue medications.
The challenge of endodontic "superbugs" in clinical practice

With a range of new methods and technologies to support modern endodontic treatment, it is useful to take stock and consider the prime goals of therapy and how these are best achieved. Current approaches to treatment are based on instrumentation, irrigation and medication of the root canal system, with the primary goal of eliminating bacteria prior to placing a root canal filling. Molecular methods have demonstrated that bacteria can be detected in the root canal system in virtually all cases of root-filled teeth which have persisting periapical radiolucencies. These bacteria are found not only within the root canal itself, but also in dentinal tubules, accessory canals, canal ramifications, apical deltas, fins and transverse anastomoses - areas which are difficult to access using mechanical instrumentation and irrigation when re-treatment is contemplated. As we and others have described in recent literature reviews,
Pediatric Patients with Asthma: A High-Risk Population for Subsequent Hospitalization

Objectives. Asthma is one of the most common chronic conditions among children and is one of the leading causes for pediatric hospitalizations. More evidence is needed to clarify the risks of repeat hospitalization and the underlying factors contributing to adverse health outcomes among pediatric patients hospitalized with asthma. The purpose of this study was to examine the risk of subsequent hospitalizations among pediatric patients hospitalized with asthma compared to a reference cohort of children hospitalized for all other diagnoses. Methods. The Washington State (WA) Comprehensive Hospital Abstract Reporting System (CHARS) was used to obtain data for the study. Data describing 81,946 hospitalized pediatric patients admitted from 2004 to 2008 were available. The risk of subsequent hospitalization among children admitted for asthma as compared to a reference cohort was examined. Results. The asthma cohort had a 33% (HR = 1.33 [99% confidence interval (CI) 1.21–1.46]; p < . 001) increased risk of subsequent hospitalization from 2004 to 2008. Children in the asthma cohort under the age of 13 years demonstrated a significant increased risk of subsequent hospitalization as compared to the age-matched reference cohort of children without asthma. Those in the asthma cohort who were 3–5 years old demonstrated the highest risk (50%) of subsequent hospitalization (HR = 1.50 [99% CI 1.23–1.83]; p < .001). Conclusions. Study results can be utilized in the development of appropriate interventions aimed at preventing and reducing hospital admissions, improving patient care, decreasing overall costs, and lessening complications among pediatric patients with asthma.
Lung-volume controlled computerised tomography in real-life acute severe asthma

Abstract Objective: It is not known how airway structure is altered during real-life acute asthma exacerbations. The aim of this study was to examine changes in airway structure during acute asthma exacerbations and at convalescence by using lung-volume controlled high resolution computerised tomography (HRCT). Methods: Eight subjects with acute asthma exacerbation admitted to hospital were recruited. HRCT was performed within 72 h of admission (n = 8) and repeated after 8 weeks of convalescence (n = 7). Individual airways were carefully matched on acute and convalescent CT data sets for comparisons of airway parameters. A novel methodology was employed for standardisation of lung volumes to permit valid comparisons of lung imaging. Measurements of bronchial cross sectional airway area (Aa) and bronchial luminal area (Ai) for each matched airway were obtained using a validated program. Results: The airway wall thickness was analysed as wall area (WA) calculated as a percentage: WA% = WA/Aa × 100. Wilcoxon signed-rank testing was used to compare acute and convalescent asthma and Spearman’s correlation to examine associations. Airway lumen (Ai) areas were similar in both acute and stable asthma phases (6.6 ± 3.1 mm2 versus 7.2 ± 3.8 mm2 p = 0.8). However, the airway wall was significantly thickened during acute asthma exacerbations compared to convalescence (62 ± 4% versus 55 ± 7%; p = 0.01). There was no correlation between airway structure dimensions and lung function measurements. Conclusions: This is the first study to demonstrate an increase in airway wall thickness during real-life acute asthma exacerbation. However, narrowing of the airway lumen area was variable and will require larger studies able to detect small differences. These results suggest that airway wall thickening linked to mucosal inflammation is likely to characterise acute asthma in vivo but that changes in the airway lumen accompanying bronchoconstriction may be more heterogeneous.
Design of Velocity Map Imaging Spectrometer Equipped with a Mass Gate Discriminating Particular Photofragments

A photoionization spectrometer for velocity map imaging has been developed for measuring the scattering distribution of fragment ions from polyatomic molecules. The spectrometer contains a mass gate and an ion reflector which are able to discriminate ions with a particular mass-to-charge ratio m/z. The basic functions and feasibility of these devices were tested experimentally and theoretically. First, the photoions from Kr and C60 were extracted into a time-of-flight (TOF) mass spectrometer by a transient or continuous electrostatic field. When the pulse application on the mass gate was tuned to the arrival timing of ions with a specific m/z, the peak of the selected ions alone was present on a TOF spectrum. Second, compatibility between velocity map imaging and ion discrimination was investigated by the computer simulations of the ion trajectories of photofragments from C60. A pulsed voltage was applied to the mass gate synchronously with the arrival timing of C58
Long term outcomes of bilateral congenital and developmental cataracts operated in Maharashtra, India. Miraj pediatric cataract study III

Aim: To study long term outcome of bilateral congenital and developmental cataract surgery. Subjects: 258 pediatric cataract operated eyes of 129 children. Materials and Methods: Children who underwent pediatric cataract surgery in 2004-8 were traced and examined prospectively in 2010-11. Demographic and clinical factors were noted from retrospective chart readings. All children underwent visual acuity estimation and comprehensive ocular examination in a standardized manner. L. V. Prasad Child Vision Function scores (LVP-CVF) were noted for before and after surgery. Statistics: Statistical analysis was done with SPSS version 16 including multi-variate analysis. Results: Children aged 9.1 years (std dev 4.6, range 7 weeks-15 years) at the time of surgery. 74/129 (57.4%) were boys. The average duration of follow-up was 4.4 years (stddev 1.6, range 3-8 years). 177 (68.6%) eyes had vision <3/60 before surgery, while 109 (42.2%) had best corrected visual acuity (BCVA) >6/18 and 157 (60.9%) had BCVA >6/60 3-8 years after surgery. 48 (37.2%) had binocular stereoacuity <480 sec of arc by TNO test. Visual outcome depended on type of cataract (P = 0.004), type of cataract surgery (P < 0.001), type of intra-ocular lens (P = 0.05), age at surgery (P = 0.004), absence of post-operative uveitis (P = 0.01) and pre-operative vision (P < 0.001), but did not depend on delay (0.612) between diagnosis and surgery. There was a statistically significant improvement for all the 20 questions of the LVP-CVF scale (P < 0.001). Conclusion: Pediatric cataract surgery improved the children's visual acuity, stereo acuity and vision function. Developmental cataract, use of phacoemulsification, older children and those with better pre-operative vision had betterlong-termoutcomes.
Does personality influence how people with asthma manage their condition?

Abstract Objective: Personality traits have been found to be associated with the management of chronic disease, however, there is limited research on these relationships with respect to asthma. Asthma management and asthma control are often suboptimal, representing a barrier to patients achieving good health outcomes. This explorative study aimed to investigate the relationship between correlates of asthma management and personality traits. Methods: Participants completed a postal survey comprising validated self-report questionnaires measuring personality traits (neuroticism, extraversion, openness to experiences, agreeableness, conscientiousness), asthma medication adherence, asthma control and perceived control of asthma. Relationships between asthma management factors and personality traits were examined using correlations and regression procedures. Results: A total of 77 surveys were returned from 94 enrolled participants. Significant relationships were found between personality traits and (i) adherence to asthma medications, and (ii) perceived control of asthma. Participants who scored high on the conscientiousness dimension of personality demonstrated higher adherence to their asthma medications. Women who scored low on the agreeableness dimension of personality and high on the neuroticism dimension had significantly lower perceived confidence and ability to manage their asthma. No statistically significant associations were found between asthma control and personality traits. Conclusions: Three of the five personality traits were found to be related to asthma management. Future research into the role of personality traits and asthma management will assist in the appropriate tailoring of interventional strategies to optimize the health of patients with asthma.
A novel method for estimating the effects of job conditions on asthma and chronic lung disease

Abstract Objective: This study uses 32 years of longitudinal job history to analyze the long-term effect of exposure to specific workplace conditions on the risk of contracting asthma or chronic lung disease later in life. Our approach allows for the estimation of occupational respiratory risks even in the absence of direct environmental monitoring. Methods: We employ a novel methodology utilizing data from the National Longitudinal Survey of Youth 1979 (NLSY79), and ratings of job exposures from the Occupational Information Network (O*NET), which are based on 70 years of empirical data compiled by the U.S. Department of Labor. A series of multivariable logistic regression analyses are performed to determine how long-term exposure to a particular occupational O*NET indicator (e.g., working in an extremely hot or cold environment) is related to asthma and COPD risk. Results: The risk of contracting COPD was significantly associated with long-term work in very hot or cold temperatures (OR = 1.50, CI: 1.07–2.10), performing physically demanding activities (OR = 1.65, CI:1.20–2.28), working outdoors exposed to weather (OR = 1.45, CI:1.06–1.99), and workplace exposure to contaminants (OR = 1.42, CI:1.05–1.96). In general, the effects of exposure were greater for COPD than for asthma. With respect to contracting asthma, only exposure to work in very hot or cold temperatures (OR = 1.35, CI:1.08–1.70) and performing physically demanding activities (OR = 1.23, CI:1.00–1.52) were statistically significant. Conclusions: Use of O*NET job descriptors as surrogate measures of workplace exposures can provide a useful way of analyzing the risk of occupationally-related respiratory disease in situations where direct exposure measurement is not feasible.
G160 Association Between External and Internal Dose of Diesel Soot (Black Carbon) in Healthy Schoolchildren: A Pilot Study

Aims Exposure to diesel soot (black carbon, BC) is linked to adverse health in children. A cross-sectional study reported that BC in airway macrophages (AM BC), a marker of inhaled dose of diesel soot, is associated with decreased lung function in healthy children [1]. These data are compatible with the reduction in growth of lung function associated with long-term exposure to elemental carbon reported in an 8 year epidemiological study of schoolchildren [2]. To date, the determinants of AM BC are unknown. This is an important evidence gap since it is unclear whether policy-makers should target background BC, or peaks of freshly generated BC from roads. Using a newly developed portable monitor for BC, we sought to determine whether peaks in BC exposure are associated with airway macrophage black carbon (AM BC) in healthy schoolchildren. Methods Sputum inductions were carried out at schools as previously described [1]. Following processing, mean AM BC (µm2) for 50 randomly selected AM was calculated using Image J software. Personal exposure to BC was measured by a portable aethalometer (MicroAeth AE51, Magee Scientific). This monitor continuously samples BC in the air and data is downloaded after 24 h using the microAethCOM PC-based software (Fig 1). The number of peaks of BC above 10000 ng/300 sec was determined for each child by inspection of the 24 h plot. Results Twenty three children underwent sputum inductions. In the 15 children (65%) who produced sufficient AM for analysis, the median AM BC was 0.26278 µm2 (interquartile range (IQR) of 0.16164 to 0.42842 µm2). Personal 24 hour BC data was obtained in 13/15 children. The median BC exposure was 783758 ng (IQR: 336583.5 to 1321364.5 ng). Exposure peaks were caused by the school journey and cooking. No significant correlation was found between the number of peaks of carbon exposure above 10000 ng/300 sec and average AM BC (µm2) (Fig 2). However the positive association (r = 0.40, Pearson coefficient) suggests that this pilot study may be underpowered. Conclusion Linking external and inhaled dose of BC is feasible in schoolchildren, and may provide important insights into the determinants of inhaled dose of BC. Abstract G160 Figure 1 Example 24 hour aethalometer trace. Peaks are associated with daily commute (1 and 3) and cooking (2). Abstract G160 Figure 2 Scatter graph showing AM BC vs. number of BC exposure peaks above 10000 ng/300 sec The correlation coeffi cient for the number of peaks above 10000 ng/300 sec against AM BC (r=0.4028, n=13, p=0.1724) shows a non-signifi cant positive correlation. References Kulkarni N, Pierse N, Rushton L, Grigg J. “Carbon in airway macrophages and lung function in children. ” The New England Journal of Medicine 6, 355 (2006): 21–30. Gauderman, WJ, E Avol, F Gilliland, H Vora, D Thomas, K Berhane, R McConnell, N Kuenzli, F Lurmann, E Rappaport, H Margolis, D Bates and J Peters. “The effect of air pollution on lung development from 10 to 18 years of age. ” The New England Journal of Medicine 351, 11 (2004): 1057–1067.
Effect of ADRB2 (adrenergic receptor β2) gene polymorphisms on the occurrence of asthma and on the response to nebulized salbutamol in South Indian patients with bronchial asthma

Abstract Introduction: Genetic mutations in the β2 receptor could alter its functioning and the response to β2 agonists. The study was done to find out the effect of two commonly occurring polymorphisms-Arg16Gly and Gln27Glu, on cause of asthma and on response to nebulized salbutamol in South Indian subjects of asthma. Methods: After baseline measurements of Forced Expiratory Volume in 1st second (FEV1), Forced Vital Capacity (FVC) and Peak Expiratory Flow Rate (PEFR), five mg of nebulized salbutamol was administered and spirometry was repeated. The increase in these parameters was calculated and patients were included for genotyping if the percentage increase in FEV1 was ≥12%. The frequencies of these polymorphisms in patients were compared with those of healthy volunteers. Results: 112 patients and 127 healthy volunteers were genotyped. The frequencies of the polymorphisms were found to be similar to previously published Dravidian population frequencies. The frequencies of genotypes in asthmatics were similar to healthy volunteers. The increase in FEV1, FVC and PEFR was similar across various genotypes and haplotypes in both the polymorphisms. The GG-CG haplotype was associated with 3.1 times increased occurrence of asthma (p value = 0.02). The G allele of the Arg16Gly polymorphism was associated with lower baseline FEV1, FVC and PEFR values, but these were not statistically significant. Conclusion: The Arg16Gly and Gln27Glu polymorphisms do not determine the occurrence of asthma individually, but the GG-CG haplotype is associated with an increased risk of asthma. There is no effect of the genotypes on the response to nebulized salbutamol.
Transcriptional and translational mechanisms contribute to regulate the expression of Discs Large 1 protein during different biological processes

Abstract Human discs large (DLG1) has been demonstrated to be involved in cell polarity and maintenance of tissue architecture. However, the mechanisms controlling DLG1 expression are not fully understood. This is relevant as DLG1 is lost during the later stages of malignant progression. We initiated a series of studies to analyse the mechanisms regulating DLG1 expression. We have previously reported the identification of an alternative splicing event in the 5′ untranslated region (5′-UTR) of DLG1 mRNA that generates transcripts with two different 5′-UTR (short and large 5′-UTR variants). In this study, we further examined the impact of the DLG1 transcription and the role of the differential expression of the alternative 5′-UTRs on DLG1 protein levels. We analysed these mechanisms during cell processes like differentiation, cell cycle progression and cell-cell contact formation, where the importance of DLG1 activities was previously established. The data presented in this report suggest that the transcriptional regulation of DLG1 strongly contributes to DLG1 abundance and that differential expression of alternative 5′-UTRs with different translational properties, also cooperates, depending on the cell type and cell situation. This study provides new evidence for understanding the transcriptional regulation of DLG1 and the changes in DLG1 expression during different biological processes.
New mutations in SERPING1 gene of Brazilian patients with hereditary angioedema

Abstract Hereditary Angioedema is an autosomal dominant inherited disease leading to oedema attacks with variable severity and localization predominantly caused by C1-INH deficit. More than 400 mutations have been already identified, however no genetic analysis of a Brazilian cohort of HAE patients with C1-INH deficiency has been published. Our aim was to perform genetic analysis of C1-INH gene (SERPING1) in Brazilian HAE patients. We screened the whole SERPING1 coding region from 30 subjects out of 16 unrelated families with confirmed diagnosis of HAE due to C1-INH deficiency. Clinical diagnosis was based on symptoms and quantitative and/or functional analysis of C1-INH. We identified fifteen different mutations among which eight were not previously described according to databases. We found five small deletions (c.97_115del19; c.553delG; c.776_782del7; c.1075_1089del15 and c.1353_1354delGA), producing frameshifts leading to premature stop codons; seven missense mutations (c.498C>A; c.550G>C; c.752T>C; c.889G>A; c.1376C>A; c.1396C>T; c.1431C>A); one nonsense mutation (c.1480C>T), and two intronic alterations (c.51+1G>T; c.51+2T>C). Despite the small number of participants in this study, our results show mutations not previously identified in SERPING1 gene. This study represents the first Brazilian HAE cohort evaluated for mutations and it introduces the possibility to perform genetic analysis in case of need for differential diagnosis.