Miracle-dz/UniFAR-FTUs huggingface dataset:
Adrenal Failure: An Evidence-Based Diagnostic Approach

The diagnosis of adrenal insufficiency (AI) requires a high index of suspicion, detailed clinical assessment including detailed drug history, and appropriate laboratory evaluation. The clinical characteristics of adrenal insufficiency vary according to the cause, and the presentation may be myriad, e.g. insidious onset to a catastrophic adrenal crisis presenting with circulatory shock and coma. Secondary adrenal insufficiency (SAI) often presents with only glucocorticoid deficiency because aldosterone production, which is controlled by the renin angiotensin system, is usually intact, and rarely presents with an adrenal crisis. Measurements of the basal serum cortisol at 8 am (<140 nmol/L or 5 mcg/dL) coupled with adrenocorticotrophin (ACTH) remain the initial tests of choice. The cosyntropin stimulation (short synacthen) test is used for the confirmation of the diagnosis. Newer highly specific cortisol assays have reduced the cut-off points for cortisol in the diagnosis of AI. The salivary cortisol test is increasingly being used in conditions associated with abnormal cortisol binding globulin (CBG) levels such as pregnancy. Children and infants require lower doses of cosyntropin for testing. 21-hydoxylase antibodies are routinely evaluated to rule out autoimmunity, the absence of which would require secondary causes of adrenal insufficiency to be ruled out. Testing the hypothalamic–pituitary–adrenal (HPA) axis, imaging, and ruling out systemic causes are necessary for the diagnosis of AI. Cancer treatment with immune checkpoint inhibitors (ICI) is an emerging cause of both primary AI and SAI and requires close follow up. Several antibodies are being implicated, but more clarity is required. We update the diagnostic evaluation of AI in this evidence-based review.
Politics and Power in Global Health : The Constituting Role of Conflicts Comment on “ Navigating Between Stealth Advocacy and Unconscious Dogmatism : The Challenge of Researching the Norms , Politics and Power of Global Health ”

Background: Vertically oriented global health initiatives (GHIs) addressing the HIV/AIDS epidemic, including the President’s Emergency Plan for AIDS Relief (PEPFAR), have successfully contributed to reducing HIV/AIDS related morbidity and mortality. However, there is still debate about whether these disease-specific programs have improved or harmed health systems overall, especially with respect to non-HIV health needs. Methods: As part of a larger evaluation of PEPFAR’s effects on the health system between 2005-2011, we collected qualitative and quantitative data through semi-structured interviews with District Health Officers (DHOs) from all 112 districts in Uganda. We asked DHOs to share their perceptions about the ways in which HIV programs (largely PEPFAR in the Ugandan context) had helped and harmed the health system. We then identified key themes among their responses using qualitative content analysis. Results: Ugandan DHOs said PEPFAR had generally helped the health system by improving training, integrating HIV and non-HIV care, and directly providing resources. To a lesser extent, DHOs said PEPFAR caused the health system to focus too narrowly on HIV/AIDS, increased workload for already overburdened staff, and encouraged doctors to leave public sector jobs for higher-paid positions with HIV/AIDS programs. Conclusion: Health system leaders in Uganda at the district level were appreciative of resources aimed at HIV they could often apply for broader purposes. As HIV infection becomes a chronic disease requiring strong health systems to manage sustained patient care over time, Uganda’s weak health systems will require broad infrastructure improvements inconsistent with narrow vertical health programming.
Politics and Power in Global Health : The Constituting Role of Conflicts Comment on “ Navigating B tween Stealth Advocacy and Unconscious Dogmatism : The Challenge of Researching the Norms , Politics and Power of Global Health ”

Background: Nowadays, health systems are generally acknowledged to be complex social systems. Consequently, scholars, academics, practitioners, and policy-makers are exploring how to adopt a complexity perspective in health policy and system research. While leadership and complexity has been studied extensively outside health, the implications of complexity theories for the study of leadership in healthcare have received limited attention. We carried out a scoping review of complex leadership (CL) in healthcare to investigate how CL in healthcare has been defined, theorised and conceptualised and to explore how ‘CL’ has been applied in healthcare settings. Methods: We followed the methodological steps proposed by (Arksey and O’Malley, 2005): (1) specifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating and summarizing the findings, and (6) reporting the results. We searched using Medline, Psychinfo, Wiley online library, and Google Scholar. Our inclusion criteria were: publication type (peer reviewed articles, theses, and book chapters); phenomenon of interest: complex leadership; context: healthcare and period of publication: between 2000 and 2016. Results: Our search and selection resulted in 37 papers (16 conceptual papers, 14 empirical studies and 7 advocacy papers). We note that empirical studies on CL are few and almost all research reported by these papers was carried out in the North (mainly in USA and UK). We found that there is some variation in definitions of CL. Furthermore, the research papers adopt mostly an explorative or explanatory approach and do not focus on assessing effectiveness of CL approaches. Finally, we found that the majority of researchers seem to adhere to the mathematical complexity perspective. Conclusion: Complexity concepts derived from natural sciences may not automatically fit management of health services. Further research into how social complexity theories may offer researchers useful grounds to empirically test CL theories in health settings is warranted. Specific attention should be paid to the multi-layered nature of leadership.
Title : Cytokine profiling reveals increased serum inflammatory cytokines in idiopathic choroidal neovascularization

Title: Cytokine profiling reveals increased serum inflammatory cytokines in idiopathic choroidal neovascularization Version: 1 Date: 04 Mar 2019 Reviewer: Anthony Mukwaya Reviewer's report: Comments to authors Abstract lines 24-26, I guess what the authors are referring to as the background is instead the objective of their study. If so, please revise accordingly. Lines 30-32. I wonder if basic fibroblast growth factor, granulocyte-macrophage colonystimulating factor and vascular endothelial growth factor, all fall under the classification of cytokines.
OTT_A_246235 2711..2723

Xueqin Li* Qianqian Song* Xueru Guo* Limin Wang Qicheng Zhang Limin Cao Yinghui Ren Xiang Wu Zhaowei Meng Ke Xu 1 1Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, People’s Republic of China; 2Core Facility Center, Tianjin Medical University General Hospital, Tianjin 300052, People’s Republic of China; 3Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, People’s Republic of China
A software project dynamics model for process cost, schedule and risk assessment

A dynamic model of an inspection-based software lifecycle process has been developed to support quantitative evaluation of the process. In conjunction with a knowledge-based method that has been developed for cost estimation and project risk assessment, these modeling techniques can support project planning and management, and aid in process improvement. The model serves to examine the effects of inspection practices on cost, schedule and quality throughout the lifecycle. It uses system dynamics to model the interrelated flows of tasks, errors and personnel throughout different development phases and is calibrated to industrial data. It extends previous software project dynamics research by examining an inspection-based process with an original model, integrating it with the knowledge-based method for risk assessment and cost estimation, and using an alternative modeling platform. While specific enough to investigate inspection practices, it is sufficiently general to incorporate changes for other phenomena. It demonstrates the effects of performing inspections, the effectiveness of varied inspection policies, and the effects of other managerial policies such as manpower allocation. The dynamic effects are tracked throughout the time history of a project to show resource usage, task completions and defect trends per phase. Cumulative metrics and development tradeoffs for decision making are also presented. The knowledge-based method has been implemented on multiple platforms. As an extension to COCOMO, it aids in project planning by identifying, categorizing, quantifying and prioritizing project risks. It also detects cost estimate input anomalies and provides risk control advice in addition to conventional cost and schedule calculation. It extends previous work by focusing on risk assessment, incorporating substantially more rules, going beyond standard COCOMO, performing quantitative validation, and providing a user-friendly interface. The method is being used and enhanced in industrial environments as part of an integrated capability to assist in system acquisition, project planning and risk management. Several types of validation tests are performed against industrial data, existing theory and other prediction models, and practitioners are used to evaluate the model. The results indicate a valid model that can be used for process evaluation and project planning, and serve as a framework for incorporating other dynamic process factors.
Allele specific expression and methylation 1 in the bumblebee , Bombus terrestris 2

12 The social hymenoptera are emerging as models for epigenetics. DNA methylation, the addition of a methyl group, is a common epigenetic marker. In mammals and flowering plants methylation affects allele specific expression. There is contradictory evidence for the role of methylation on allele specific expression in social insects. The aim of this paper is to investigate allele specific expression and monoallelic methylation in the bumblebee, Bombus terrestris. We found nineteen genes that were both monoallelically methylated and monoallelically expressed in a single bee. A number of these genes are involved in reproduction. Fourteen of these genes express the hypermethylated allele, while the other five express the hypomethylated allele. We also searched for allele specific expression in twenty-nine published RNA-seq libraries. We found 555 loci with allele-specific expression. Genomic imprinting in mammals often involves monoallelic methylation and expression. It is tempting to associate our results with genomic imprinting, especially as a number of the genes discovered are exactly the type predicted by theory to be imprinted. Caution however should be applied due to the lack of understanding of the functional role of methylation in gene expression in insects and in the, as yet unquantified, role of genetic cis effects in insect allele specific methylation and expression. 13
Identification of Susceptibility Genes of Adult Asthma in French Canadian Women

Susceptibility genes of asthma may be more successfully identified by studying subgroups of phenotypically similar asthma patients. This study aims to identify single nucleotide polymorphisms (SNPs) associated with asthma in French Canadian adult women. A pooling-based genome-wide association study was performed in 240 allergic asthmatic and 120 allergic nonasthmatic women. The top associated SNPs were selected for individual genotyping in an extended cohort of 349 asthmatic and 261 nonasthmatic women. The functional impact of asthma-associated SNPs was investigated in a lung expression quantitative trait loci (eQTL) mapping study (n = 1035). Twenty-one of the 38 SNPs tested by individual genotyping showed P values lower than 0.05 for association with asthma. Cis-eQTL analyses supported the functional contribution of rs17801353 associated with C3AR1 (P = 7.90E − 10). The asthma risk allele for rs17801353 is associated with higher mRNA expression levels of C3AR1 in lung tissue. In silico functional characterization of the asthma-associated SNPs also supported the contribution of C3AR1 and additional genes including SYNE1, LINGO2, and IFNG-AS1. This pooling-based GWAS in French Canadian adult women followed by lung eQTL mapping suggested C3AR1 as a functional locus associated with asthma. Additional susceptibility genes were suggested in this homogenous subgroup of asthma patients.
Genetic data of museum specimens allow for inferring evolutionary history of the cosmopolitan genus [i]Sirthenea[i] (Heteroptera: Reduviidae)

1 Faculty of Biology and Environmental Protection, Department of Zoology, University of Silesia, Katowice, Poland 2 Institute of Systematic and Evolution of Animals, Polish Academy of Science, Kraków, Poland 3 Department of Ecology, Evolution, & Organismal Biology, Iowa State University, Ames, United States 4 Department of Invertebrate Zoology and Parasitology, University of Gdańsk, Gdańsk, Poland
Polydopamine-Supported Lipid Bilayers

We report the formation of lipid membranes supported by a soft polymeric cushion of polydopamine. First, 20 nm thick polydopamine films were formed on mica substrates. Atomic force microscopy imaging indicated that these films were also soft with a surface roughness of 2 nm under hydrated conditions. A zwitterionic phospholipid bilayer was then deposited on the polydopamine cushion by fusion of dimyristoylphosphatidylcholine (DMPC) and dioleoylphosphatidylcholine (DOPC) vesicles. Polydopamine films preserved the lateral mobility of the phospholipids as shown by fluorescence microscopy recovery after photobleaching (FRAP) experiments. Diffusion coefficients of ~5.9 and 7.2 µm2 s−1 were respectively determined for DMPC and DOPC at room temperature, values which are characteristic of lipids in a free standing bilayer system.
ACUTE ACHILLES TENDON RUPTURE

The Achilles tendon is the strongest and largest of human tendons, and its proper function is essential for normal gait. Most acute Achilles tendon injuries occur during sports, particularly in ball games. The purposes of this study were (1) to examine the incidence of total Achilles tendon rupture (ATR) over a 33-year period in the city of Oulu and to investigate its changes with respect to age, sex, and injury mechanism. (2) to compare ≥10-year outcomes of two postoperative regimens after ATR repair: early weightbearing with early mobilization versus early weightbearing with early immobilization in tension, (3) to compare clinical outcome and calf muscle strength recovery after conservative treatment or open surgical repair of acute ATR, followed by identical accelerated rehabilitation programs. The overall incidence per 100 000 person years increased from 2.1 in 1979 to 21.5 in 2011. The incidence increased in all age groups. The incidence of sports-related ruptures increased during the second 11-year period, whereas the incidence of non-sports-related ruptures increased steadily over the entire study period. Early mobilization and immobilization in tension after ATR repair resulted in similar clinical outcomes and isokinetic strengths. Regardless of patient satisfaction with the operative treatment, calf muscle strength did not recover normally, even at the 10-year follow-up. Surgery and conservative treatment of acute ATR resulted in similar Achilles tendon performance score after 18 months, but surgery restored calf muscle strength earlier. Surgery also resulted in better health-related quality of life in the domains of physical functioning and bodily pain. Conservative treatment with a functional protocol is recommended for a large majority of patients. However, patients with high physical expectations could still benefit from operative treatment. In conclusion, the incidence of ATR is rising, postoperative immobilization and early mobilization result in similar long-term results in terms of the Achilles tendon performance score and calf muscle function, and conservative treatment with a functional protocol is the preferred treatment for the majority of patients.
Self‐esteem and peer‐perceived social status in early adolescence and prediction of eating pathology in young adulthood

Abstract Objective Self‐esteem is implied as a factor in the development of eating disorders. In adolescence peers have an increasing influence. Support for the role of self‐esteem in eating disorders is ambiguous and little is known about the influence of social status as judged by others. The present study investigates whether self‐esteem and peer status in early adolescence are associated with eating pathology in young adulthood. Method This study is part of TRAILS, a longitudinal cohort study on mental health and social development from preadolescence into adulthood. At age 11, participants completed the Self‐Perception Profile for Children, assessing global self‐esteem and self‐perceptions regarding social acceptance, physical appearance, and academic competence. At age 13, peer status among classmates was assessed regarding likeability, physical attractiveness, academic performance, and popularity in a subsample of 1,007 participants. The Eating Disorder Diagnostic Scale was administered at age 22. The present study included peer‐nominated participants with completed measures of self‐perception at age 11 and eating pathology at age 22 (N = 732; 57.8% female). Results In a combined model, self‐perceived physical attractiveness at age 11 and peer popularity at age 13 were inversely correlated with eating pathology at 22 years, while likeability by peers at age 13 was positively related to eating pathology. Discussion Both self‐perceptions and peer status in early adolescence are significant predictors of eating pathology in young adults. Specific measures of self‐esteem and peer‐perceived status may be more relevant to the prediction of eating pathology than a global measure of self‐esteem.
Common fixed points of Geraghty-Berinde type contraction maps in partial metric spaces

In this paper, we introduce Geraghty-Berinde type contraction maps for a pair of maps in partial metric spaces and prove the existence of common fixed points in which the pair is weakly compatible and restricting the completeness of $X$ to its subspace. Also, we extend the same for two pairs of maps. We provide examples in support of our results.
Mycobacterium tuberculosis induces decelerated bioenergetic metabolism in human macrophages

How Mycobacterium tuberculosis (Mtb) rewires macrophage energy metabolism to facilitate survival is poorly characterized. Here, we used extracellular flux analysis to simultaneously measure the rates of glycolysis and respiration in real time. Mtb infection induced a quiescent energy phenotype in human monocyte-derived macrophages and decelerated flux through glycolysis and the TCA cycle. In contrast, infection with the vaccine strain, M. bovis BCG, or dead Mtb induced glycolytic phenotypes with greater flux. Furthermore, Mtb reduced the mitochondrial dependency on glucose and increased the mitochondrial dependency on fatty acids, shifting this dependency from endogenous fatty acids in uninfected cells to exogenous fatty acids in infected macrophages. We demonstrate how quantifiable bioenergetic parameters of the host can be used to accurately measure and track disease, which will enable rapid quantifiable assessment of drug and vaccine efficacy. Our findings uncover new paradigms for understanding the bioenergetic basis of host metabolic reprogramming by Mtb.
The risk of burn injury during long-term oxygen therapy: a 17-year longitudinal national study in sweden

Background: Long-term oxygen therapy (LTOT) improves the survival time in hypoxemic chronic obstructive pulmonary disease. Despite warnings about potential dangers, a considerable number of patients continue to smoke while on LTOT. The incidence of burn injuries related to LTOT is unknown. The aim of this study was to estimate the rate of burn injury requiring health care contact during LTOT. Methods: Prospective, population-based, consecutive cohort study of people starting LTOT from any cause between January 1, 1992 and December 31, 2009 in the Swedish National Register of Respiratory Failure (Swedevox). Results: In total, 12,497 patients (53% women) were included. The mean (standard deviation) age was 72 ± 9 years. The main reasons for starting LTOT were chronic obstructive pulmonary disease (75%) and pulmonary fibrosis (15%). Only 269 (2%) were active smokers when LTOT was initiated. The median follow-up time to event was 1.5 years (interquartile range, 0.55–3.1). In total, 17 patients had a diagnosed burn injury during 27,890 person-years of LTOT. The rate of burn injury was 61 (95% confidence interval, 36–98) per 100,000 person-years. There was no statistically significant difference in the rate of burn injury between ever-smokers and never-smokers, or between men and women. Conclusion: The rate of burn injuries in patients on LTOT seems to be low in Sweden. The strict requirements in Sweden for smoking cessation before LTOT initiation may contribute to this finding.
Light Enhanced Cognitive Behavioural Therapy (CBT+) for Sleep and Fatigue: Study Protocol for a Randomized Controlled Trial during Chemotherapy for Breast Cancer

Background: Women with breast cancer experience a significantly higher prevalence of sleep disturbances and insomnia compared with the general population. The experience of persistent sleep disturbance places these women at a higher risk of psychological and physical morbidity and a reduced quality of life. Treatment of sleep in this population is not part of routine care, and often is managed inadequately. This randomised controlled trial will examine the combined effects of Cognitive Behavioural Therapy (CBT) and bright light therapy (BLT) on the symptoms of insomnia, fatigue, and mental health. Method/design: Women diagnosed with breast cancer who receive intravenous chemotherapy treatment at a quaternary referral metropolitan cancer centre in Melbourne Australia will be recruited. Recruitment will occur after diagnosis and prior to completion of chemotherapy. Eligible women will be randomised to the combined CBT and BLT intervention (CBT+) or relaxation audio enhanced treatment as usual (TAU+). The CBT+ group will receive one face-to-face session on sleep strategies, one subsequent telephone call, and seven email packages containing CBT-based information and strategies. CBT+ participants will also wear Luminette® light glasses for 20 minutes each morning for the six-week duration of the intervention. Women in TAU+ will receive two relaxation audio tracks via email. Outcomes will be measured at multiple points throughout the six weeks. Primary outcomes will be symptoms of insomnia and sleep efficiency, measured using the Insomnia Severity Index and a self-reported sleep diary. Secondary outcomes include objective measures of sleep assessed using the ActiGraph wGT3X-BT; and sleep-related complaints, fatigue and mental health, all assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) measure. Data will also be collected on potential treatment moderators and mechanisms, and adherence to treatment. There will be three-month follow-up measurements of fatigue, sleep-related impairment, sleep disturbance, depression, and anxiety. Discussion: This is the first randomised controlled trial to combine CBT and BLT for the treatment of sleep disturbances in women with breast cancer. This novel design addresses the multiple causal factors for sleep complaints in this population. Results from this trial will advance knowledge in this