Miracle-dz/UniFAR-FTUs huggingface dataset:
How to Change Behavior to Improve Maternal and Neonatal Health in Rural Areas of Latin America

The objective of this paper is to review the most relevant, recent and rigorous literature on strategies to promote changes in demand for maternal and neonatal health services in rural areas of Latin America and to identify the strategies with most impact and lowest cost. The evidence shows that: i) covering direct expenses increases the use of prenatal care and institutional delivery and appears to be costeffective; ii) community interventions have positive impacts on indicators related to social norms (contraceptive use and institutional delivery); iii) monetary incentives have moderate impacts on use of prenatal care but lead to very few changes in institutional delivery or contraceptive use, while non-monetary incentives do increase institutional delivery at a much lower cost; iv) sending reminders to women could increase the use of prenatal and postpartum visits in a cost-effective way; and v) postpartum and puerperium visits need to be promoted.
Platelet activity with hemoglobin level in patients with hemodialysis

Abstract Background: VerifyNow (VN; Accumetrics, San Diego, CA) P2Y12 reaction unit (PRU) has an inverse relation with hemoglobin level (Hb). Chronic kidney disease (CKD) is associated with low response to clopidogrel and low Hb. Our aim is to investigate the relation between PRU and Hb, and to assess whether Hb directly affects PRU or not in patients with CKD undergoing hemodialysis (HD). Methods: We analyzed the relation between PRU and Hb in 43 HD patients and compared it with a control group of 127 patients with normal renal function. Both groups underwent percutaneous coronary intervention for stable coronary artery disease. We also compared PRU between the 2 groups considering Hb as a confounding factor. Results: In the control group, Hb and PRU showed a significant inverse correlation (correlation coefficient r = −0.340; P < .001), but not in the HD group (correlation coefficient r = −0.099; P = .53). PRU was higher in the HD group than the control group after adjusting for the influence of Hb (299.2 [95% confidence interval: 278.4–316.7] vs 248.7 [95% confidence interval: 227.7–269.0]; P < .001), even after propensity score matching (299.2 [95% confidence interval: 278.4–316.7] vs 241.7 [95% confidence interval: 221.8–262.2]; P < .001). Conclusions: PRU was higher regardless of lower Hb in CKD on HD patients than normal renal function patients. Therefore, Hb was not crucial factor to decide PRU in CKD on HD patients in this study.
CD11b is a novel alternate receptor for CD154 during alloimmunity

Antagonism of the CD154/CD40 pathway is a highly effective means of inducing long‐term graft survival in preclinical models. Using a fully allogeneic murine transplant model, we found that CD154 blockade was more effective in prolonging graft survival than was CD40 blockade, raising the possibility that CD154 binds a second receptor. To test this, we queried the impact of CD154 antagonism in the absence of CD40. Data indicated that anti‐CD154 functioned to reduce graft‐infiltrating CD8+ T cells in both WT and CD40−/− hosts. Because it has recently been reported that CD154 can ligate CD11b, we addressed the impact of blocking CD154‐CD11b interactions during transplantation. We utilized a specific peptide antagonist that prevents CD154 binding of CD11b but has no effect on CD154‐CD40 interactions. CD154:CD11b antagonism significantly increased the efficacy of anti‐CD40 in prolonging allograft survival as compared to anti‐CD40 plus control peptide. Mechanistically, CD154:CD11b antagonism functioned to reduce the frequency of graft‐infiltrating CD8+ T cells and innate immune cells. These data therefore demonstrate that blocking CD154 interactions with both CD40 and CD11b is required for optimal inhibition of alloimmunity and provide an explanation for why CD40 blockers may be less efficacious than anti‐CD154 reagents for the inhibition of allograft rejection.
Dr. Duke's Phytochemical and Ethnobotanical Databases

(+)-CATECHIN Plant: ACE-Inhibitor 0.24 mg/ml rbt (weak activity) IC50=0.155 mM/l; Antiaggregant IC68=200 ug/ml; Anticoagulant; Anticomplementary 1/2 aspirin; AntiHIV EC50=4 ug/ml; Antiinflammatory IC50=40-943 uM (cf indomethacin IC50=1 uM); Antimutagenic ID50=50-100 nM; Antioxidant; Antiperoxidant; Antiprostaglandin IC50=40-943 uM (cf indomethacin IC50=1 uM); Antiradicular; Antiulcer; BetaAdrenergic Receptor Blocker 10 uM (weak activity); cAMP-PhosphodiesteraseInhibitor; Cancer-Preventive; Cardiotonic; COX-1-Inhibitor IC50=183-279 uM (cf indomethacin IC50=1 uM); COX-2-Inhibitor IC50=546-5,910 uM (cf indomethacin IC50=1 uM); Cyclooxygenase-Inhibitor; Cytotoxic TC50=>100 ug/ml; Dermatitigenic; Hemostat; Hepatoprotective; Immunostimulant; Neuroprotective 1-10 uM; NO-Inhibitor IC11=250 uM; Phagocytotic; Vasoconstrictor; Xanthine-Oxidase-Inhibitor
Incidence of Prehypertension and Hypertension in Rural India, 2012-2018: A Sex-Stratified Population Based Prospective Cohort Study.

BACKGROUND India is home to the largest number of hypertensive individuals, and factors responsible for the incidence of hypertension are poorly understood. This study examines predictors of transition to different stages of hypertension - incidence of hypertension, incidence of prehypertension, and incidence of prehypertension to hypertension. METHODS Population based survey data from the Birbhum Population Project, located in West Bengal, India was used. A cohort of 8977 individuals (male: 3934, female: 5043), participated in the 2012-13 survey, and were followed up for resurvey in 2017-18. The Seventh Report of the Joint National Committee (JNC 7) guidelines were followed to define hypertension. Bivariate and multivariate Poisson regression analyses were conducted to attain the study objective. RESULTS The incidence of hypertension, prehypertension among males (7.9% and 45.3%, respectively) is higher than that among females (5.9% and 32.7%, respectively). However, the incidence of prehypertension to hypertension is lower among males (23.6%) than among females (33.6%). Among both sexes, with age, the incidence of hypertension, and incidence of prehypertension to hypertension appeared to increase, whereas incidence of prehypertension among females increased with age. Findings indicate a diverse gradient of socioeconomic, behavioral, and anthropometric characteristics influencing the incidence of different stages of hypertension. CONCLUSION With a focus on females and the richest individuals, this study proposes that an appropriate intervention be designed in keeping with the socioeconomic, behavioral gradient of incidence of different stages of hypertension. The role of anthropometric indicators in hypertension is proposed to be further studied for better population based screening.
Microbiological profile of ventilator-associated pneumonia among intensive care unit patients in tertiary Egyptian hospitals.

INTRODUCTION Ventilator-associated pneumonia (VAP) is one of the common serious infectious diseases encountered in the intensive care unit (ICU), which highly affects the healthcare cost and patient prognosis. VAP is caused by various antimicrobial-resistant aetiological agents and the clinical manifestations lack sensitivity and specificity, making the prompt treatment is a challenge. This study aimed to investigate the microbial profile of VAP causing microorganisms among ICU patients in Egypt, antimicrobial susceptibility patterns and the genetic diversity among the frequently isolated organisms. METHODOLOGY Throughout the period from August 2016 to August 2017, endotracheal aspirate (ETA) specimens were collected from ICU patients with clinically suspected VAP in two tertiary hospitals in Cairo. ETA specimens were investigated for the microbial content. The antimicrobial susceptibility was determined by the Kirby-Bauer method. ERIC-PCR was performed for genotyping. RESULTS Fifty microbiologically confirmed VAP cases were identified. The most frequently isolated microorganisms were Klebsiella spp. , followed by Pseudomonas aeruginosa, Acinetobacter baumannii. Candida spp. was the most isolated fungi. A single isolate of each Cupriavidus pauculus and Aeromonas salmonicida was isolated. Antimicrobial susceptibility profiles indicated 40% of isolates were multidrug-resistant (MDR). ERIC-PCR revealed no genetic relatedness among K. pneumoniae isolates, the most frequently isolated microorganism. CONCLUSIONS Gram-negative bacteria are the main causative agents of VAP cases, which mostly are MDR. Microorganisms like C. pauculus and A. salmonicida should be taken into consideration as VAP causative agents. There was no common source of infection suggesting likely endogenous sources of K. pneumoniae, the main causative agent of VAP in this study.
Prediction of the Development of Severe Sepsis Among Children With Intestinal Failure and Fever Presenting to the Emergency Department

Objectives Children with intestinal failure (IF) and fever are frequently bacteremic, but risk factors for development of sepsis in this population are not well delineated. Our objective was to determine what clinical factors available on arrival to the emergency department (ED), including commonly used vital sign thresholds, predicted the subsequent development of severe sepsis in children with IF and fever. Study Design This was a retrospective cohort study of children younger than 21 years with IF presenting to a tertiary care ED between 2010 and 2016 with fever who did not have hypotensive septic shock on arrival. The primary outcome was development of severe sepsis within 24 hours of ED arrival, as defined by consensus criteria. We identified predictors of severe sepsis using both univariate and multivariate models and calculated the test characteristics of 3 different sets of vital sign criteria in determining risk of severe sepsis. Results In 26 (9.4%) of 278 encounters, the patient developed severe sepsis within 24 hours of arrival to the ED; 3 were excluded due to hypotensive shock on arrival. Predictors of severe sepsis included history of intestinal pseudo-obstruction (odds ratio, 8.2; 95% confidence interval, 2.3–30.2) and higher initial temperature (odds ratio, 1.7; 95% confidence interval, 1.2–2.3). The 3 sets of vital sign criteria had widely varying sensitivity and specificity in identifying development of severe sepsis. Conclusions History of intestinal pseudo-obstruction and higher fever predicted increased risk of severe sepsis among children with IF and fever presenting to an ED. No single set of vital sign criteria had both high sensitivity and specificity for this diagnosis.
Wertigkeit von systemischen alpha-Synuklein-Ablagerungen in der Diagnostik des idiopathischen Parkinson-Syndroms – Pro

Das idiopathische Parkinson-Syndrom zählt zu den häufigsten neurodegenerativen Erkrankungen mit Prävalenzen im europäischen Raum von mehr als 1% bei über 65-Jährigen [1]. Der in Studien belegte Nutzen einer frühzeitigen Erkennung und verlaufsorientierten individualisierten Behandlung sowie die immer noch zu weiten Teilen ungeklärte Ätiopathogenese der Erkrankung verdeutlicht den Bedarf an neuen Biomarkern und diagnostischen Verfahren [2, 3]. Alpha-Synuklein ist ein pathophysiologisch bedeutsames Protein, welches das idiopathische Parkinson-Syndrom (Morbus Parkinson) charakterisiert und daher einen hilfreichen Marker zur Unterscheidung dieser Erkrankung von anderen neurodegenerativen Erkrankungenmit Parkinsonähnlicher klinischer Manifestation, die durch abnormales Protein Tau charakterisiert sind (zum Beispiel: kortikobasale Degeneration, progressive supranukleäre Paralyse), darstellt.
Functional investigation and applications of the acetylesterase activity of the Citrus sinensis (L.) Osbeck peel

Abstract The hydrolysis of acetyl moieties on a set of commercially relevant substrates was performed by employing the whole tissue of Citrus sinensis (L.) Osbeck peel as an efficient biocatalyst in mild reaction conditions with high degree of regioselectivity. The reaction is done in aqueous media and the product is easily recovered. Optimal reaction conditions were deduced and two practical applications were investigated: the elaboration of acetylglicerols and the preparation of vitamin K1 precursor. Peel waste (flavedo and albedo) from orange juice manufacturing was successfully employed as a biocatalyst. Graphical Abstract
Physician characteristics correlate with hospital readmission rates

Abstract Hospital readmission rates are used as a metric to measure quality patient care. While several tools predict readmissions based on patient-specific characteristics, this study assesses if physician characteristics correlate with hospital readmission rates. In a 5-year retrospective electronic record review at a single institution, 31 internal medicine attending physicians’ discharges were tracked for a total of 70 physician years, and 15,933 hospital discharges. Each physician's yearly 7-day, 8 to 30-day, and 30-day readmission rates were compared. Each rate was also correlated with years of post-graduate clinical experience, discharge volume, physician sex, and fiscal year. Individual physicians had significantly different 7-day, 8 to 30-day, and 30-day readmission rates from each other. The rates were not related to sex, years after post-graduate training, or fiscal year. However, physician patient volume correlated with 7-day readmission rates. Physicians who discharged ≤100 patients per year had a higher 7-day readmission rate than physicians who discharged >100 patients per year. This correlation with patient volume did not hold for the 8 to 30-day and 30-day readmission rates. Individual physicians differ in their patient readmission rates in 7-day, 8 to 30-day, and 30-day categories. A critical level of a physician's hospital activity, as reflected by the number of patient discharges per year (>100), results in lower 7-day readmission rates. Sex, post-graduate years of clinical experience, and fiscal year did not play a role. The lack of correlation between each physicians’ 7-day and 8 to 30-day readmission rates suggests that different physician factors are involved in these 2 rates.
Desflurane anesthesia compared with total intravenous anesthesia on anesthesia-controlled operating room time in ambulatory surgery following strabotomy: a randomized controlled study

Abstract Background Ophthalmic ambulatory surgery is preferred to be performed under general anesthesia either by total intravenous anesthesia (TIVA) or by inhalational anesthesia to increase the patient comfort. However, anesthesia-controlled time (ACT) can cause increased non-operative operating room (OR) time which may adversely affect the ORs efficiency. This study was aimed to compare the ACT of desflurane with that of propofol-remifentanil in strabismus ambulatory surgery. Methods From November 2016 to December 2017, a total of 200 strabismus patients (aged 18–60 years old, and scheduled for elective ambulatory surgery at Zhongshan Ophthalmic Center) were randomly assigned to receive either propofol-based TIVA (group TIVA) or desflurane anesthesia (group DES) for maintenance of anesthesia. The primary outcome was the extubation time. Secondary outcomes included surgical time, anesthetic time, OR exit time, and Phase I and II recovery time. The intraoperative incidences of hypotension, bradycardia and oculocardiac reflex (OCR), and the incidences of any post-operative complications were recorded. Mann-Whitney U test and Chi-square or Fisher exact tests were used to compare the two groups. Results We found that the extubation time (5.5 [3.9–7.0] vs. 9.7 [8.5–11.4] min, P < 0.001) and the incidence of prolonged time to extubation (0 vs. 6%, P = 0.029) in the DES group were significantly decreased compared with those in the TIVA group. The patients in the DES group displayed shorter OR exit time as compared with that in the TIVA group (7.3 [5.5–8.7] vs. 10.8 [9.3–12.3] min, P < 0.001). The patients using desflurane exhibited more stable hemodynamics during surgery than the patients using propofol-based TIVA, as demonstrated by lower incidences of hypotension (1% vs. 22%, P < 0.001), bradycardia (2% vs. 13%, P = 0.002), and OCR (17% vs. 44%, P < 0.001). Conclusion DES enhanced the ophthalmic OR efficiency by reducing the extubation time and OR exit time, and provided more stable hemodynamics intra-operatively than TIVA in patients undergoing strabismus ambulatory surgery. Trial registration: ClinicalTrials.gov, No. NCT02922660; https://clinicaltrials.gov/ct2/show/NCT02922660? id=NCT02922660&draw=2&rank=1
Structural basis for pharmacological modulation of the TRPC6 channel

Transient receptor potential canonical (TRPC) proteins form nonselective cation channels that play physiological roles in a wide variety of cells. Despite growing evidence supporting the therapeutic potential of TRPC6 inhibition in treating pathological cardiac and renal conditions, mechanistic understanding of TRPC6 function and modulation remains obscure. Here we report cryo-EM structures of TRPC6 in both antagonist-bound and agonist-bound states. The structures reveal two novel recognition sites for the small-molecule modulators corroborated by mutagenesis data. The antagonist binds to a cytoplasm-facing pocket formed by S1-S4 and the TRP helix, whereas the agonist wedges at the subunit interface between S6 and the pore helix. Conformational changes upon ligand binding illuminate a mechanistic rationale for understanding TRPC6 modulation. Furthermore, structural and mutagenesis analyses suggest several disease-related mutations enhance channel activity by disrupting interfacial interactions. Our results provide principles of drug action that may facilitate future design of small molecules to ameliorate TRPC6-mediated diseases.
Nonspecific Resistance Training and Swimming Performance: Strength or Power? A Systematic Review

Supplemental Digital Content is Available in the Text. Abstract Muniz-Pardos, B, Gomez-Bruton, A, Matute-Llorente, A, Gonzalez-Aguero, A, Gomez-Cabello, A, Gonzalo-Skok, O, Casajus, JA, and Vicente-Rodriguez, G. Nonspecific resistance training and swimming performance: Strength or power? A systematic review. J Strength Cond Res 36(4): 1162–1170, 2022—The purpose of this systematic review was to determine the type of nonspecific resistance intervention that is more effective to enhance swimming performance and to determine the nonspecific strength- or power-related variable that better predicts swimming performance. A search was conducted on PubMed, Cochrane Plus, and SportDiscus up to June 2018. Studies were distributed into 4 categories: dry-land strength (DLS), dry-land power (DLP), combination of training methods, and strength and power in start performance. From 1,844 citations, 33 met the inclusion criteria. Cross-sectional DLS studies showed positive associations between swimming performance and DLS development (especially through upper-body isometric assessments), although the efficacy of DLS training interventions remains unclear. Dry-land power training (principally through plyometrics) was a proficient, nonspecific method to enhance swimming block start performance (SBS; the start phase off the block and during the first 5–15 m), and jump assessment was the best predictor of SBS. Some pioneering nonspecific practices such as the acute exposure to high altitude or the maintenance of a high core temperature during the transition phase before competition seem to improve performance, although more research is required to confirm their efficacy. Further high-quality intervention studies are required to clarify the effect of DLP training on sprint swimming performance.
Frailty Hinders Recovery From Influenza and Acute Respiratory Illness in Older Adults.

We examined frailty as a predictor of recovery in older adults hospitalized with influenza and acute respiratory illness. A total of 5011 patients aged ≥65 years were admitted to Canadian Serious Outcomes Surveillance Network hospitals during the 2011/2012, 2012/2013, and 2013/2014 influenza seasons. Frailty was measured using a previously validated frailty index (FI). Poor recovery was defined as death by 30 days postdischarge or an increase of more than 0.06 (≥2 persistent new health deficits) on the FI. Multivariable logistic regression controlled for age, sex, season, influenza diagnosis, and influenza vaccination status. Mean age was 79.4 (standard deviation = 8.4) years; 53.1% were women. At baseline, 15.0% (n = 750) were nonfrail, 39.3% (n = 1971) were prefrail, 39.8% (n = 1995) were frail, and 5.9% (n = 295) were most frail. Poor recovery was experienced by 21.4%, 52.0% of whom had died. Frailty was associated with lower odds of recovery in all 3 seasons: 2011/2012 (odds ratio [OR] = 0.70; 95% confidence interval [CI], 0.59–0.84), 2012/2013 (OR = 0.72; 95% CI, 0.66–0.79), and 2013/2014 (OR = 0.75; 95% CI, 0.69–0.82); results varied by season, influenza status, vaccination status, and age. Increasing frailty is associated with lower odds of recovery, and persistent worsening frailty is an important adverse outcome of acute illness.
Reversal of contractility as a signature of self-organization in cytoskeletal bundles

Bundles of cytoskeletal filaments and molecular motors generate motion in living cells, and have internal structures ranging from very organized to apparently disordered. The mechanisms powering the disordered structures are debated, and existing models predominantly predict that they are contractile. We reexamine this prediction through a theoretical treatment of the interplay between three well-characterized internal dynamical processes in cytoskeletal bundles: filament assembly and disassembly, the attachement-detachment dynamics of motors and that of crosslinking proteins. The resulting self-organization is easily understood in terms of motor and crosslink localization, and allows for an extensive control of the active bundle mechanics, including reversals of the filaments’ apparent velocities and the possibility of generating extension instead of contraction. This reversal mirrors some recent experimental observations, and provides a robust criterion to experimentally elucidate the underpinnings of both actomyosin activity and the dynamics of microtubule/motor assemblies in vitro as well as in diverse intracellular structures ranging from contractile bundles to the mitotic spindle.
The progression of thermodynamic anomalies in MX2 networks with local tetrahedral geometries

Key thermodynamic anomalies in density and compressibility, as well as the related stability limits, are determined using an ionic model for BeF2 which includes many-body polarization terms. BeF2 is chosen as an example of an archetypal network-forming system whose structure can be rationalised in terms of connected local tetrahedral coordination polyhedra. The anion dipole polarizability (which effectively controls the bond angles linking neighbouring tetrahedra) is used as a single free parameter in order to help rationalise the changes in the anomaly locations in phase space, whilst all other potential parameters remain fixed. The anomalies and stability limits systematically shift to lower temperature and higher pressure as the anion polarizability is increased. At high dipole polarizabilities the temperature of maximum density anomaly locus becomes suppressed into the supercooled regime of the phase space. The movements of the anomaly loci are analysed in terms of the network structure and the correlation with the inter-tetrahedral bond angles is considered. The high sensitivity of the anomalies to the details of the potential models applied is discussed with reference to previous works on related systems. The relationship to analogous studies on Stillinger–Weber liquids is discussed.