Miracle-dz/UniFAR-FTUs huggingface dataset:
Obesity, diabetes and heart disease: effects of globalization on population health, preventive efforts, and the importance of social change

Globalization has had an impact on many systems that affect daily living. Internationally, food systems have undergone substantial changes including increased availability and affordability of processed foods and an unprecedented inundation of the food supply with low-cost caloric sweeteners and more efficient production of fatty oils. These changes in the food supply have had an impact on the nutritional status of many by contributing to a paradoxical increase in obesity in countries with historically high rates of malnutrition. This higher global prevalence of obesity has been implicated in the increase in leading causes of death, namely diabetes and cardiovascular disease (CVD). This paper includes an introductory section highlighting the notable effects of globalization on our food systems followed by a more in-depth discussion of obesity, diabetes, and CVD, and its related conditions considered as significant health consequences of these changes. To address the pervasive nature of these problems, several international health promotion initiatives are discussed and organized using the five action means outlined in the World Health Organization's Ottowa Charter for Health Promotion (WHO, 2013). We conclude by highlighting the important contribution health educators can make toward improving health status in their communities by moving beyond the traditional approach of individual behavior change and becoming more proactive initiators of social change. Strategies for carrying out this charge include the assessment of social and environmental health determinants on the population level in concert with mobilizing and engaging community stakeholders through culturally appropriate interventions.
Interferon regulatory factor‐3 activation, hepatic interferon‐stimulated gene expression, and immune cell infiltration in hepatitis C virus patients

Interferon regulatory factor‐3 (IRF‐3) activation directs α/β interferon production and interferon‐stimulated gene (ISG) expression, which limits virus infection. Here, we examined the distribution of hepatitis C virus (HCV) nonstructural 3 protein, the status of IRF‐3 activation, and expression of IRF‐3 target genes and ISGs during asynchronous HCV infection in vitro and in liver biopsies from patients with chronic HCV infection, using confocal microscopy and functional genomics approaches. In general, asynchronous infection with HCV stimulated a low‐frequency and transient IRF‐3 activation within responsive cells in vitro that was associated with cell‐to‐cell virus spread. Similarly, a subset of HCV patients exhibited the nuclear, active form of IRF‐3 in hepatocytes and an associated increase in IRF‐3 target gene expression in hepatic tissue. Moreover, ISG expression profiles formed disease‐specific clusters for HCV and control nonalcoholic fatty liver disease patients, with increased ISG expression among the HCV patients. We identified the presence of T cell and plasmacytoid dendritic cell infiltrates within all biopsy specimens, suggesting they could be a source of hepatic interferon in the setting of hepatitis C and chronic inflammatory condition. Conclusion: These results indicate that HCV can transiently trigger IRF‐3 activation during virus spread and that in chronic HCV, IRF‐3 activation within infected hepatocytes occurs but is limited. (HEPATOLOGY 2007.)
A revisit of prophylactic lamivudine for chemotherapy‐associated hepatitis B reactivation in non‐Hodgkin's lymphoma: A randomized trial

Lamivudine is effective to control hepatitis B virus (HBV) reactivation in HBV‐carrying cancer patients who undergo chemotherapy, but the optimal treatment protocol remains undetermined. In this study, HBV carriers with newly diagnosed non‐Hodgkin's lymphoma (NHL) who underwent chemotherapy were randomized to either prophylactic (P) or therapeutic (T) lamivudine treatment groups. Group P patients started lamivudine from day 1 of the first course of chemotherapy and continued treatment until 2 months after completion of chemotherapy. Group T patients received chemotherapy alone and started lamivudine treatment only if serum alanine aminotransferase (ALT) levels elevated to greater than 1.5‐fold of the upper normal limit (ULN). The primary endpoint was incidence of HBV reactivation during the 12 months after starting chemotherapy. During chemotherapy, fewer group P patients had HBV reactivation (11.5% versus 56%, P = 0.001), HBV‐related hepatitis (7.7% versus 48%, P = 0.001), or severe hepatitis (ALT more than 10‐fold ULN) (0 versus 36%, P < 0.001). No hepatitis‐related deaths occurred during protocol treatment. Prophylactic lamivudine use was the only independent predictor of HBV reactivation. After completion of chemotherapy, the incidence of HBV reactivation did not differ between the 2 groups. Two patients, both in group P, died of HBV reactivation–related hepatitis, 173 and 182 days, respectively, after completion of protocol treatment. When compared with an equivalent group of lamivudine‐naïve lymphoma patients who underwent chemotherapy, therapeutic use of lamivudine neither reduced the severity of HBV‐related hepatitis nor changed the patterns of HBV reactivation. Conclusion: Prophylactic lamivudine use, but not therapeutic use, reduces the incidence and severity of chemotherapy‐related HBV reactivation in NHL patients. (HEPATOLOGY 2008;47:844–853.)
Immunomodulatory Effects of Dietary Potassium Perfluorooctane Sulfonate (PFOS) Exposure in Adult Sprague-Dawley Rats

Perfluorooctanesulfonate (PFOS) is a stable and environmentally persistent metabolic or degradation product of perfluorooctanyl compounds that were manufactured for a variety of industrial and consumer applications. PFOS itself was sold for use as a surfactant. The structurally related contaminants perfluorooctanoic acid (PFOA), perfluorodecanoic acid (PFDA), and N-ethyl perfluorooctane sulfonamide (N-EtPFOSA) were shown to suppress immune responses in laboratory rodents. Relatively low doses of PFOS were found to be immunosuppressive in mice. To assess effects of PFOS on the rat immune system at doses known to alter hepatic function, changes in the morphology and function of immune tissues and cells were measured in adult rats exposed to PFOS in their diet for 28 d at levels ranging from 2 to 100 mg PFOS/kg diet (corresponding to approximately 0.14 to 7.58 mg/kg body weight [bw]/d) and compared to those receiving control diet. Body weight reductions were significant in male and female rats exposed to 50 and 100 mg PFOS/kg diet. Liver/body weight was significantly increased in females exposed to 2 mg PFOS/kg diet and in males exposed to 20 mg PFOS/kg diet. Female rats exposed to 100 mg PFOS/kg diet exhibited a significant increase in spleen weight relative to body weight; these changes lacked a histologic correlate and were not observed in males. While thymus weights relative to body weights were not affected, numbers of apoptotic lymphocytes rose in thymus with increasing dietary PFOS. There was a significant dose-related increase in total peripheral blood lymphocyte numbers in female but not male rats. In both genders the percentages of cells within lymphocyte subclasses were altered. There was a significant trend toward increasing T and T‐helper (Th) cells and decreasing B cells with higher PFOS dose. Serum total immunoglobulin (Ig) G1 levels were significantly reduced in males exposed to 2 and 20 mg PFOS/kg diet. The ability of male and female rats to mount delayed-type hypersensitivity (DTH) responses to the T-cell-dependent antigen keyhole limpet hemocyanin (KLH) was not altered by PFOS. There was a significant trend toward elevated KLH-specific IgG in serum from male rats exposed to increasing levels of PFOS in diet. Splenic T- and B-cell proliferation in response to ex vivo mitogen exposure was unaffected by exposure to dietary PFOS. In conclusion, changes in immune parameters in rat did not manifest as functional alterations in response to immune challenge with KLH and may be secondary to hepatic-mediated effects of PFOS in this model.
Crime and Mental Disorder: An Epidemiological Approach

The analytic framework of epidemiology can be used to study the relation between crime and mental disorder, distinguishing between the true rates of crime and mental disorder, that is, the rates at which crime and mental disorder actually occur, and their treated rates, that is, the rates at which the criminal justice and mental health systems respond to them. The conclusion that emerges is that rates of true and treated criminal behavior vary independently of rates of true and treated mental disorder when appropriate controls are made for such demographic factors as age, gender, and social class and for such life history factors as prior experience in the mental health and criminal justice systems. When these controls are not applied, rates of true and treated mental disorder are higher among criminals than among the general population, and rates of true and treated crime are higher among the mentally disordered than among the general population. When these controls are applied, the observed relations tend to dissipate.
Accuracy and complications using computer-designed stereolithographic surgical guides for oral rehabilitation by means of dental implants: a review of the literature.

BACKGROUND In the last decade several stereolithographic guided surgery systems were introduced to the market. In this context, scientific information regarding accuracy of implant placement and surgical and prosthodontical complications is highly relevant as it provides evidence to implement this surgical technique in a clinical setting. PURPOSE To review data on accuracy and surgical and prosthodontical complications using stereolithographical surgical guides for implant rehabilitation. MATERIAL AND METHODS PubMed database was searched using the following keywords: "three dimensional imaging,""image based surgery,""flapless guided surgery,""customized drill guides,""computer assisted surgery,""surgical template," and "stereolithography. " Only papers in English were selected. Additional references found through reading of selected papers completed the list. RESULTS In total 31 papers were selected. Ten reported deviations between the preoperative implant planning and the postoperative implant locations. One in vitro study reported a mean apical deviation of 1.0 mm, three ex vivo studies a mean apical deviation ranging between 0.6 and 1.2 mm. In six in vivo studies an apical deviation between 0.95 and 4.5 mm was found. Six papers reported on complications mounting to 42% of the cases when stereolithographic guided surgery was combined with immediate loading. CONCLUSION Substantial deviations in three-dimensional directions are found between virtual planning and actually obtained implant position. This finding and additionally reported postsurgical complications leads to the conclusion that care should be taken whenever applying this technique on a routine basis.
Prionet Canada: A Network of Centres of Excellence for Research into Prions and Prion Diseases

PrioNet Canada's strength in basic, applied, and social research is helping to solve the food, health safety, and socioeconomic problems associated with prion diseases. Prion diseases are transmissible, fatal neurodegenerative diseases of humans and animals. Examples of prion diseases include bovine spongiform encephalopathy (BSE, commonly known as “mad cow” disease), Creutzfeldt–Jakob disease in humans, and chronic wasting disease (CWD) in deer and elk. As of March 31, 2008, PrioNet's interdisciplinary network included 62 scientific members, 5 international collaborators, and more than 150 students and young professionals working in partnership with 25 different government, nongovernment, and industry partners. PrioNet's activities are developing strategies based on a sustained, rational approach that will mitigate, and ultimately control, prion diseases in Canada.
TIS21 negatively regulates hepatocarcinogenesis by disruption of cyclin B1–Forkhead box M1 regulation loop

A functional and biochemical interaction of TIS21/BTG2/PC3 with Forkhead box M1 (FoxM1), essential transcription factor for hepatocyte regeneration and a master regulator of mitotic gene expression, was explored. Growth of hepatocellular carcinoma (HCC), developed by a single injection of diethylnitrosamine (DEN), was the same in both the TIS21+/+ and TIS21−/− mice until 6 months, whereas it was significantly higher in the TIS21−/− mice at 9 months. Expression of TIS21 was significantly lower in both human and murine HCCs than in the surrounding tissues. Forced expression of TIS21 impaired growth, proliferation, and tumorigenic potential of Huh7 cells. At the mechanistic level, TIS21 inhibited FoxM1 phosphorylation, a required modification for its activation, by reducing cyclin B1–cdk1 activity, examined by in vitro kinase assay and FoxM1 mutant analyses. These observations were further confirmed in vivo by the reciprocal control of TIS21 expression and FoxM1 phosphorylation in the diethylnitrosamine‐induced HCCs and TIS21−/− mouse embryonic fibroblast (MEF), in addition to increased expression of cyclin B1 and cdk1 activity. Conclusion: TIS21 negatively regulated hepatocarcinogenesis in part by disruption of the FoxM1–cyclin B1 regulatory loop, thereby inhibiting proliferation of transformed cells developed in mouse and human livers. (HEPATOLOGY 2008.)
Increased risk of hepatocellular carcinoma among patients with hepatitis C cirrhosis and diabetes mellitus

Recent studies suggest that diabetes mellitus increases the risk of developing hepatocellular carcinoma (HCC). The aim of this study is to quantify the risk of HCC among patients with both diabetes mellitus and hepatitis C in a large cohort of patients with chronic hepatitis C and advanced fibrosis. We included 541 patients of whom 85 (16%) had diabetes mellitus. The median age at inclusion was 50 years. The prevalence of diabetes mellitus was 10.5% for patients with Ishak fibrosis score 4, 12.5% for Ishak score 5, and 19.1% for Ishak score 6. Multiple logistic regression analysis showed an increased risk of diabetes mellitus for patients with an elevated body mass index (BMI) (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.00‐1.11; P = 0.060) and a decreased risk of diabetes mellitus for patients with higher serum albumin levels (OR, 0.81; 95% CI, 0.63‐1.04; P = 0.095). During a median follow‐up of 4.0 years (interquartile range, 2.0‐6.7), 11 patients (13%) with diabetes mellitus versus 27 patients (5.9%) without diabetes mellitus developed HCC, the 5‐year occurrence of HCC being 11.4% (95% CI, 3.0‐19.8) and 5.0% (95% CI, 2.2‐7.8), respectively (P = 0.013). Multivariate Cox regression analysis of patients with Ishak 6 cirrhosis showed that diabetes mellitus was independently associated with the development of HCC (hazard ratio, 3.28; 95% CI, 1.35‐7.97; P = 0.009). Conclusion: For patients with chronic hepatitis C and advanced cirrhosis, diabetes mellitus increases the risk of developing HCC. (HEPATOLOGY 2008;47:1856–1862.)
Book Reviews : Study of Suicide Prevention Within the European Community

Although the multidisciplinary nature of emergency work is mentioned several times in the book, it hardly gets the space and attention this aspect deserves. Tryer’s description of the skill-share model is both exceptional and interesting, yet is presented as a top-bottom gift-giving by psychiatrists to lesser mortals; a rather one-sided perspective which does not do justice to the reality of emergency work. The book should be read by all of those engaged in emergency mental health services as a good, rounded, introduction, yet its price (E45) will prohibit wide circulation. A book which focuses more in-depth on the issues which emergency work raises should follow. Professor Shulamit Ramon Interprofessional Health and Social Studies, Anglia Polytechnic University, Cambridge
Subchronic Toxicity Evaluation of a Treated Urban Sewage Sludge

Disposal of tons of sludge produced daily by sewage treatment plants in large cities is a serious problem. Because recycling and application in agriculture have been proposed, the Brazilian National Environmental Council (CONAMA, 2006) issued a legal norm that regulates the use of the sewage sludge (SS) in crops. Due to the complex chemical nature of such products, characterization by analytical methods for health and environmental risk assessment has severe limitations. To overcome such limitations, it is necessary to (1) assess the toxicological potential of SS and (2) identify possible adverse effects in vivo in order to provide critical information for future environmental regulations. The present study was conducted to determine the potential toxicity of SS obtained from a representative urban treatment plant located in the São Paulo State, Brazil. Male and female Wistar rats were fed ad libitum a pelleted diet containing varying amounts of SS. No relevant clinical, hematological, urinary, or gross organ morphological alterations were observed in both genders of rats orally exposed to SS at up to 3.8 g/kg/d for 90 d. Sewage slude produced increased incidence of centrilobular hepatocyte hyperplasia at the high dose and significantly increased aspartate aminotransferease (AST) activities at all doses in both genders. Although the present data indicate some liver involvement, these alterations were considered adaptative and not toxicologically relevant, as the responses were relatively mild, not dose dependent, and no other parameters were markedly affected. The present results may contribute to the establishment of protocols for potential usage in SS agricultural soil application.
Simplified criteria for the diagnosis of autoimmune hepatitis

Diagnosis of autoimmune hepatitis (AIH) may be challenging. However, early diagnosis is important because immunosuppression is life‐saving. Diagnostic criteria of the International Autoimmune Hepatitis Group (IAIHG) were complex and purely meant for scientific purposes. This study of the IAIHG aims to define simplified diagnostic criteria for routine clinical practice. Candidate criteria included sex, age, autoantibodies, immunoglobulins, absence of viral hepatitis, and histology. The training set included 250 AIH patients and 193 controls from 11 centers worldwide. Scores were built from variables showing predictive ability in univariate analysis. Diagnostic value of each score was assessed by the area under the receiver operating characteristic (ROC) curve. The best score was validated using data of an additional 109 AIH patients and 284 controls. This score included autoantibodies, immunoglobulin G, histology, and exclusion of viral hepatitis. The area under the curve for prediction of AIH was 0.946 in the training set and 0.91 in the validation set. Based on the ROC curves, two cutoff points were chosen. The score was found to have 88% sensitivity and 97% specificity (cutoff ≥6) and 81% sensitivity and 99% specificity (cutoff ≥7) in the validation set. Conclusion: A reliable diagnosis of AIH can be made using a very simple diagnostic score. We propose the diagnosis of probable AIH at a cutoff point greater than 6 points and definite AIH 7 points or higher. (HEPATOLOGY 2008.)
Experimental Challenge of Cattle with German Atypical Bovine Spongiform Encephalopathy (BSE) Isolates

For almost two decades after the discovery of the first bovine spongiform encephalopathy (BSE) case, it was generally accepted that only one BSE strain existed globally. However, in 2004, two novel BSE forms (L-type and H-type) were separately identified in two different European Member States, forms that differed from the classical (C-type) form by their biochemical properties and by the pattern of PrPSc deposition as determined by immunohistochemistry (IHC). 60 atypical BSE cases have been identified worldwide as of November 2010, including one H- and one L-type BSE case each in Germany. However, it was not known whether the biological properties (pathogenesis and agent distribution, as well as transmissibility to other species) of these novel forms were the same as in classical BSE cases. Eleven calves were thus challenged intracranially, five with the German H-type and six with German L-type BSE cases. The experimental design and the clinical studies, followed by laboratory testing, are described in this manuscript.
Hepatitis C virus–infected hepatocytes extrinsically modulate dendritic cell maturation to activate T cells and natural killer cells

Dendritic cell maturation critically modulates antiviral immune responses, and facilitates viral clearance. Hepatitis C virus (HCV) is characterized by its high predisposition to persistent infection. Here, we examined the immune response of human monocyte‐derived dendritic cells (MoDCs) to the JFH1 strain of HCV, which can efficiently replicate in cell culture. However, neither HCV RNA replication nor antigen production was detected in MoDCs inoculated with JFH1. None of the indicators of HCV interacting with MoDCs we evaluated were affected, including expression of maturation markers (CD80, 83, 86), cytokines (interleukin‐6 and interferon‐beta), the mixed lymphocyte reaction, and natural killer (NK) cell cytotoxicity. Strikingly, MoDCs matured by phagocytosing extrinsically‐infected vesicles containing HCV‐derived double‐stranded RNA (dsRNA). When MoDCs were cocultured with HCV‐infected apoptotic Huh7.5. 1 hepatic cells, there was increased CD86 expression and interleukin‐6 and interferon‐beta production in MoDCs, which were characterized by the potential to activate NK cells and induce CD4+ T cells into the T helper 1 type. Lipid raft‐dependent phagocytosis of HCV‐infected apoptotic vesicles containing dsRNA was indispensable to MoDC maturation. Colocalization of dsRNA with Toll‐like receptor 3 (TLR3) in phagosomes suggested the importance of TLR3 signaling in the MoDC response against HCV. Conclusion: The JFH1 strain does not directly stimulate MoDCs to activate T cells and NK cells, but phagocytosing HCV‐infected apoptotic cells and their interaction with the TLR3 pathway in MoDCs plays a critical role in MoDC maturation and reciprocal activation of T and NK cells. (HEPATOLOGY 2008.)
Improved survival in patients receiving medical therapy as compared with banding ligation for the prevention of esophageal variceal rebleeding

Both medical therapy and endoscopic variceal ligation (EVL) have proven to be comparable in the prevention of variceal rebleeding. However, the long‐term results are still lacking. Our previous study enrolled 121 patients with history of esophageal variceal bleeding and randomized to receive EVL (EVL group, 60 patients) or drug therapy, nadolol plus isosorbide‐5‐mononitrate (N+I) (N+I group, 61 patients) to prevent variceal rebleeding. The EVL group received ligation regularly until variceal obliteration. The N+I group received N+I during the study period. Patients were followed for up to 8 years. After a median follow‐up of 82 months, recurrent upper gastrointestinal bleeding developed in 28 patients (47%) in the EVL group and 49 patients (80%) in the N+I group (P = 0.001). Recurrent bleeding from esophageal varices occurred in 18 patients (30%) in the EVL group and 39 patients (64%) in the N+I group. The actuarial probability of rebleeding from esophageal varices was lower in the EVL group (P = 0.001). A total of 42 patients of the EVL group and 30 patients of the N+I group died (P = 0.013). The multivariate Cox analysis indicated that age, serum albumin, presence of encephalopathy, and treatment were the factors predictive of mortality. Conclusion: Our long‐term follow‐up study showed that combination of N+I therapy was inferior to banding ligation in the reduction of variceal rebleeding, but with enhanced survival. (HEPATOLOGY 2008;48:580–587.)