Miracle-dz/UniFAR-FTUs huggingface dataset:
Increasing Prevalence of HIV Pretreatment Drug Resistance in Women But Not Men in Rural Uganda During 2005‐2013

Abstract The prevalence of HIV pretreatment drug resistance (PDR) is increasing in sub‐Saharan Africa. We sought to describe correlates of PDR and evaluate effects of PDR on clinical outcomes in rural Uganda. We analyzed data from the Uganda AIDS Rural Treatment Outcomes study, a cohort of antiretroviral therapy (ART)‐naive adults with HIV (2005‐2015). We performed resistance testing on pre‐ART specimens. We defined PDR as any World Health Organization (WHO) 2009 surveillance drug resistance mutation and classified PDR level using the Stanford algorithm. We fit unadjusted and sex‐stratified log binomial regression and Cox proportional hazard models to identify correlates of PDR and the impact of PDR on viral suppression, loss to follow‐up (LTFU), and death. We analyzed data from 738 participants (median age 33 years, 69% female). Overall, prevalence of PDR was 3.5% (n = 26), owing mostly to resistance to non‐nucleoside reverse transcriptase inhibitors. PDR increased over time in women (1.8% in those enrolling in clinic in 2001‐2006, vs. 7.0% in 2007‐2013; p = 0.006), but not in men (1.15% vs. 0.72%, p = 0.737). Lower pre‐ART log10 HIV RNA was also associated with higher prevalence of PDR. We identified longer time to viral suppression among those with PDR compared with without PDR (0.5 and 0.3 years, respectively, p = 0.023), but there was no significant relationship with mortality or LTFU (p = 0.139). We observed increasing rates of PDR in women in southwestern Uganda. Implications of this trend, particularly to prevention of mother‐to‐child transmission programs in the region, require attention due to delayed viral suppression among those with PDR.
Exoskeleton robot control for synchronous walking assistance in repetitive manual handling works based on dual unscented Kalman filter

Prolong walking is a notable risk factor for work-related lower-limb disorders (WRLLD) in industries such as agriculture, construction, service profession, healthcare and retail works. It is one of the common causes of lower limb fatigue or muscular exhaustion leading to poor balance and fall. Exoskeleton technology is seen as a modern strategy to assist worker’s in these professions to minimize or eliminate the risk of WRLLDs. Exoskeleton has potentials to benefit workers in prolong walking (amongst others) by augmenting their strength, increasing their endurance, and minimizing high muscular activation, resulting in overall work efficiency and productivity. Controlling exoskeleton to achieve this purpose for able-bodied personnel without impeding their natural movement is, however, challenging. In this study, we propose a control strategy that integrates a Dual Unscented Kalman Filter (DUKF) for trajectory generation/prediction of the spatio-temporal features of human walking (i.e. joint position, and velocity, and acceleration) and an impedance cum supervisory controller to enable the exoskeleton to follow this trajectory to synchronize with the human walking. Experiment is conducted with four subjects carrying a load and walking at their normal speed- a typical scenario in industries. EMG signals taken at two muscles: Right Vastus Intermedius (on the thigh) and Right Gastrocnemius (on the calf) indicated reduction in muscular activation during the experiment. The results also show the ability of the control system to predict spatio-temporal features of the pilots’ walking and to enable the exoskeleton to move in concert with the pilot.
Complex interaction between mutant HNRNPA1 and gE of varicella zoster virus in pathogenesis of multiple sclerosis

Abstract Multiple sclerosis (MS) is a demyelinating disease of the central nervous system causing axonal injury, neuronal loss, and atrophy of the central nervous system leading to permanent neurological and clinical disability. Presence of mutations in M9 domain of HNRNPA1 and detection of autoantibodies against this domain in HNRNPA1 qualifies it as a strong candidate for causing MS. These two aspects indicate the presence of a facilitator in associating them. Varicella zoster virus (VZV), known to cause chicken pox infection in humans, is a significant contender in sensitizing the infected people towards MS. Reactivation of latent herpes viruses by other infectious agents and cross-recognition of common viral antigens with antigens found in the myelin sheath induces molecular mimicry or superantigens. Mutations in HNRNPA1 cause mislocalization to the cytoplasm, and co-localize with stress granules (SG) causing cellular apoptosis, this creates the first step toward MS pathogenesis. Mutant HNRNPA1 accumulates in SG allowing the cells to display peptides of HNRNPA1 on surfaces of major histocompatibility complex (MHC) I triggering a cascade of immune reactions. Since glycoprotein E (gE) of VZV shares >62% amino acids sequence similarity with Prion-like domain (PrLD) of HNRNPA1, signifying the reason behind autoantibodies against M9 and PrLD of HNRNPA1. This review attempts to delineate the interactions of VZV, gE of VZV, with M9 domain and PrLD of HNRNPA1 in a step-by-step process. This supports the tripartite model that an environmental trigger in genetically susceptible individuals causes an autoimmune response to self-CNS antigens that result in the pathology observed in the brain and spinal cord of MS patients.
Evidence-Based Best-Practice Guidelines for Preventing Anterior Cruciate Ligament Injuries in Young Female Athletes: A Systematic Review and Meta-analysis

Background: Injury prevention neuromuscular training (NMT) programs reduce the risk for anterior cruciate ligament (ACL) injury. However, variation in program characteristics limits the potential to delineate the most effective practices to optimize injury risk reduction. Purpose: To evaluate the common and effective components included in ACL NMT programs and develop an efficient, user-friendly tool to assess the quality of ACL NMT programs. Study Design: Systematic review and meta-analysis. Methods: Study inclusion required (1) a prospective controlled trial study design, (2) an NMT intervention aimed to reduce incidence of ACL injury, (3) a comparison group, (4) ACL injury incidence, and (5) female participants. The following data were extracted: year of publication, study design, sample size and characteristics, and NMT characteristics including exercise type and number per session, volume, duration, training time, and implementer training. Analysis entailed both univariate subgroup and meta-regression techniques using random-effects models. Results: Eighteen studies were included in the meta-analyses, with a total of 27,231 participants, 347 sustaining an ACL injury. NMT reduced the risk for ACL injury from 1 in 54 to 1 in 111 (odds ratio [OR], 0.51; 95% CI, 0.37-0.69]). The overall mean training volume was 18.17 hours for the entire NMT (24.1 minutes per session, 2.51 times per week). Interventions targeting middle school or high school–aged athletes reduced injury risk (OR, 0.38; 95% CI, 0.24-0.60) to a greater degree than did interventions for college- or professional-aged athletes (OR, 0.65; 95% CI, 0.48-0.89). All interventions included some form of implementer training. Increased landing stabilization and lower body strength exercises during each session improved prophylactic benefits. A meta-regression model and simple checklist based on the aforementioned effective components (slope = −0.15, P = .0008; intercept = 0.04, P = .51) were developed to allow practitioners to evaluate the potential efficacy of their ACL NMT and optimize injury prevention effects. Conclusion: Considering the aggregated evidence, we recommend that ACL NMT programs target younger athletes and use trained implementers who incorporate lower body strength exercises (ie, Nordic hamstrings, lunges, and heel-calf raises) with a specific focus on landing stabilization (jump/hop and hold) throughout their sport seasons. Clinical Relevance: Clinicians, coaches, athletes, parents, and practitioners can use the developed checklist to gain insight into the quality of their current ACL NMT practices and can use the tool to optimize programming for future ACL NMT to reduce ACL injury risk.
Bronchoscopic local steroid spray to prevent bronchial tuberculosis-induced cicatricial bronchial stenosis

Ratonale: Cicatricial bronchial stenosis or obstruction occurring in the healing process of endobronchial tuberculosis (ET) is a problematic complication of tuberculous airway lesions. Prevention by internal medical treatment is desired. Patient concerns: This case series describes four patients who diagnosed ET with Type IIIb (protruding ulcer-type) based on Arai's classification of bronchoscopic findings of bronchial tuberculosis. Diagnoses: Endobronchial tuberculosis. Interventions: A local steroid spray was applied bronchoscopically to active protruding ulcer-type lesions (which are likely to cause cicatricial stenosis) that extended in the transverse direction and occupied one-half or more of the circumference on bronchoscopy. Outcomes: Cicatricial stenosis was prevented in two of four patients. Treatment was discontinued in athird patient because tolerance could not be achieved, although the patient's condition had improved. In the fourth patient, treatment was switched to systemic steroid administration because of a problem with tolerance and the broad range of the lesion; however, stenosis remained. Lessons: Local steroid spray-applied bronchoscopically to bronchial tuberculosis lesions in the ulcer formation and granulation periods may help prevent stenosis.
A Cross-Sectional Study of Smoking Behaviors and Attitudes of Parents in Pediatric Primary Care Settings

Environmental tobacco smoke (ETS) exposure is considered an important public health issue in pediatric population. In this study, we aimed to investigate parents’ knowledge on side effects of passive smoking and counseling for parental smoking among pediatricians and family practitioners. Participants were biological parents of pediatric patients up to the age of 18 years old who attended Pediatric Hospital of Medical University of Warsaw. The questionnaire included 28 questions and queries on environmental tobacco smoke in children’s environment. Medical students identified potential subjects and handed out previously created questionnaires. In total, 506 parents of children aged 0–18 years old were interviewed; 41% (207/506) of parents were smokers, 23% (114/506) were asked about ETS exposure by their pediatricians and 41% (205/506) by family physicians during routine visits. Only a minority of the respondents confirmed having “no smoking” policy in their car 31% (157/506) or in their households 24% (121/506). All parents believed that passive smoking could cause at least one harmful effect: most common were more frequent respiratory infections (43%), asthma (40%), and low birth weight (37%). Among smoking parents, 38% (78/207) has tried to quit smoking for their child’s health sake; 63% (131/207) of smokers have never been asked to quit smoking by their doctor. Parents’ understanding of passive smoking among children differs from current medical knowledge. Rates of screening and counseling for parental smoking in pediatric and family practices are still unsatisfactory.
Change of Petals′ Color and Chemical Components in Oenothera Flowers during Senescence

Oenothera flower petals change color during senescence. When in full bloom, the flowers of O. tetraptera are white and those of O. laciniata and O. stricta are yellow. However, the colors change to pink and orange, respectively, when the petals fade. We analyzed the flavonoid components in these petals as a function of senescence using HPLC-DAD and LC-MS. In all three species, cyanidin 3-glucoside (Cy3G) was found in faded petals. The content of Cy3G increased in senescence. In full bloom (0 h), no Cy3G was detected in any of the petals. However, after 12 h, the content of Cy3G in O. tetraptera was 0.97 µmol/g fresh weight (FW) and the content of Cy3G in O. laciniata was 1.82 µmol/g FW. Together with anthocyanins, major flavonoid components in petals were identified. Quercitrin was detected in the petals of O. tetraptera and isosalipurposide was found in the petals of O. laciniata and O. stricta. The content of quercitrin did not change during senescence, but the content of isosalipurposide in O. laciniata increased from 3.4 µmol/g FW at 0 h to 4.8 µmol/g FW at 12 h. The color change in all three Oenothera flowers was confirmed to be due to the de novo biosynthesis of Cy3G.
Comparative out‐of‐hospital mortality of long‐acting opioids prescribed for non‐cancer pain: A retrospective cohort study

Despite significant growth of opioid prescriptions, only limited data are available regarding the comparative safety of long‐acting opioids for chronic non‐cancer pain. Recent data suggest that transdermal fentanyl and oxycodone CR may have greater toxicity than morphine SR in patients with non‐cancer pain. Thus, we compared the risk of out‐of‐hospital deaths in patients with non‐cancer pain filling prescriptions for transdermal fentanyl or oxycodone CR with that for morphine SR.
The Dark Core of Personality

Many negatively connoted personality traits (often termed “dark traits”) have been introduced to account for ethically, morally, and socially questionable behavior. Herein, we provide a unifying, comprehensive theoretical framework for understanding dark personality in terms of a general dispositional tendency of which dark traits arise as specific manifestations. That is, we theoretically specify the common core of dark traits, which we call the Dark Factor of Personality (D). The fluid concept of D captures individual differences in the tendency to maximize one’s individual utility—disregarding, accepting, or malevolently provoking disutility for others—accompanied by beliefs that serve as justifications. To critically test D, we unify and extend prior work methodologically and empirically by considering a large number of dark traits simultaneously, using statistical approaches tailored to capture both the common core and the unique content of dark traits, and testing the predictive validity of both D and the unique content of dark traits with respect to diverse criteria including fully consequential and incentive-compatible behavior. In a series of four studies (N > 2,500), we provide evidence in support of the theoretical conceptualization of D, show that dark traits can be understood as specific manifestations of D, demonstrate that D predicts a multitude of criteria in the realm of ethically, morally, and socially questionable behavior, and illustrate that D does not depend on any particular indicator variable included.
Serving Size and Nutrition Labelling: Implications for Nutrition Information and Nutrition Claims on Packaged Foods

The presentation of nutrition information on a serving size basis is a strategy that has been adopted by several countries to promote healthy eating. Variation in serving size, however, can alter the nutritional values reported on food labels and compromise the food choices made by the population. This narrative review aimed to discuss (1) current nutrition labelling legislation regarding serving size and (2) the implications of declared serving size for nutrition information available on packaged foods. Most countries with mandatory food labelling require that serving size be presented on food labels, but variation in this information is generally allowed. Studies have reported a lack of standardisation among serving sizes of similar products which may compromise the usability of nutrition information. Moreover, studies indicate that food companies may be varying serving sizes as a marketing strategy to stimulate sales by reporting lower values of certain nutrients or lower energy values on nutrition information labels. There is a need to define the best format for presenting serving size on food labels in order to provide clear and easily comprehensible nutrition information to the consumer.
OsATX1 Interacts with Heavy Metal P1B-Type ATPases and Affects Copper Transport and Distribution1[OPEN]

OsATX1 controls root-to-shoot translocation of copper and its delivery to developing tissues in rice by interacting with the rice heavy metal P1B-ATPases HMA4, HMA5, HMA6, and HMA9. Copper (Cu) is an essential micronutrient for plant growth. However, the molecular mechanisms underlying Cu trafficking and distribution to different organs in rice (Oryza sativa) are poorly understood. Here, we report the function and role of Antioxidant Protein1 (OsATX1), a Cu chaperone in rice. Knocking out OsATX1 resulted in increased Cu concentrations in roots, whereas OsATX1 overexpression reduced root Cu concentrations but increased Cu accumulation in the shoots. At the reproductive stage, the concentrations of Cu in developing tissues, including panicles, upper nodes and internodes, younger leaf blades, and leaf sheaths of the main tiller, were increased significantly in OsATX1-overexpressing plants and decreased in osatx1 mutants compared with the wild type. The osatx1 mutants also showed a higher Cu concentration in older leaves. Yeast two-hybrid and bimolecular fluorescence complementation assays showed that OsATX1 interacts with the rice heavy metal P1B-ATPases HMA4, HMA5, HMA6, and HMA9. These results suggest that OsATX1 may function to deliver Cu to heavy metal P1B-ATPases for Cu trafficking and distribution in order to maintain Cu homeostasis in different rice tissues. In addition, heterologous expression of OsATX1 in the yeast (Saccharomyces cerevisiae) cadmium-sensitive mutant Δycf1 increased the tolerance to Cu and cadmium by decreasing their respective concentrations in the transformed yeast cells. Taken together, our results indicate that OsATX1 plays an important role in facilitating root-to-shoot Cu translocation and the redistribution of Cu from old leaves to developing tissues and seeds in rice.
Do bednets including piperonyl butoxide offer additional protection against populations of Anopheles gambiae s.l. that are highly resistant to pyrethroids? An experimental hut evaluation in Burkina Fasov

Malaria control is dependent on the use of longlasting insecticidal nets (LLINs) containing pyrethroids. A new generation of LLINs containing both pyrethroids and the synergist piperonyl butoxide (PBO) has been developed in response to increasing pyrethroid resistance in African malaria vectors, but questions remain about the performance of these nets in areas where levels of pyrethroid resistance are very high. This study was conducted in two settings in southwest Burkina Faso, Vallée du Kou 5 and Tengrela, where Anopheles gambiae s.l. (Diptera: Culicidae) mortality rates in World Health Organization (WHO) discriminating dose assays were < 14% for permethrin and < 33% for deltamethrin. When mosquitoes were pre‐exposed to PBO in WHO tube assays, mortality rates increased substantially but full susceptibility was not restored. Molecular characterization revealed high levels of kdr alleles and elevated levels of P450s previously implicated in pyrethroid resistance. In cone bioassays and experimental huts, PBO LLINs outperformed the pyrethroid‐only equivalents from the same manufacturers. Blood feeding rates were 1.6–2.2‐fold lower and mortality rates were 1.69–1.78‐fold greater in huts with PBO LLINs vs. non‐PBO LLINs. This study indicates that PBO LLINs provide greater personal and community‐level protection than standard LLINs against highly pyrethroid‐resistant mosquito populations.
A novel Atg5-shRNA mouse model enables temporal control of Autophagy in vivo

ABSTRACT Macroautophagy/autophagy is an evolutionarily conserved catabolic pathway whose modulation has been linked to diverse disease states, including age-associated disorders. Conventional and conditional whole-body knockout mouse models of key autophagy genes display perinatal death and lethal neurotoxicity, respectively, limiting their applications for in vivo studies. Here, we have developed an inducible shRNA mouse model targeting Atg5, allowing us to dynamically inhibit autophagy in vivo, termed ATG5i mice. The lack of brain-associated shRNA expression in this model circumvents the lethal phenotypes associated with complete autophagy knockouts. We show that ATG5i mice recapitulate many of the previously described phenotypes of tissue-specific knockouts. While restoration of autophagy in the liver rescues hepatomegaly and other pathologies associated with autophagy deficiency, this coincides with the development of hepatic fibrosis. These results highlight the need to consider the potential side effects of systemic anti-autophagy therapies.
Organisational interventions designed to reduce caesarean section rates: a systematic review protocol

Introduction There is a growing body of evidence to indicate that both primary and subsequent caesarean sections are associated with increased maternal and perinatal morbidity. Efforts to reduce the number of clinically unnecessary caesarean sections are urgently required. Our objective is to systematically review published evidence on the effectiveness of maternity service organisational interventions, such as models of maternity care, that aim to reduce caesarean section rates. Methods and analysis Databases will be searched, including the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Maternity and Infant Care, EMBASE and SCOPUS. Search terms related to caesarean section and organisational intervention will be used. Research published before 1980 will be excluded and only randomised controlled trials, cluster-randomised controlled trials, quasi-randomised controlled trials, controlled before and after studies and interrupted time series studies will be included. Data extraction and quality assessments will be undertaken by two authors. Ethics and dissemination Ethics approval is not required for this systematic review. The results of this study will be disseminated via peer-reviewed publication and presentation at professional conferences. PROSPERO registration number CRD42016039458.
Trends in Neisseria gonorrhoeae Antimicrobial Resistance over a Ten-Year Surveillance Period, Johannesburg, South Africa, 2008–2017

Background: In South Africa, sexually transmitted infections (STIs) are managed through a syndromic approach at primary healthcare centres (PHCs). Neisseria gonorrhoeae is the predominant cause of male urethritis syndrome. We describe antimicrobial resistance patterns and trends in Neisseria gonorrhoeae during a ten-year surveillance period at a large PHC in Johannesburg. Methods: Neisseria gonorrhoeae was cultured from genital discharge swab specimens obtained from consenting adult patients presenting at the Alexandra Health Centre in Johannesburg between 2008 and 2017. Isolates were tested for antimicrobial susceptibility by Etest™ (cefixime, ceftriaxone, ciprofloxacin) or agar dilution (penicillin, tetracycline, azithromycin). Results: During the period of surveillance, high-level resistance prevalence increased from 30% to 51% for penicillin (p-value for trend < 0.001), 75% to 83% for tetracycline (p-value for trend = 0.008), and 25% to 69% for ciprofloxacin (p-value for trend < 0.001). Analysis did not reveal high-level resistance to spectinomycin or a minimum inhibitory concentration (MIC) creep for extended-spectrum cephalosporins, and the prevalence of intermediate-resistance to azithromycin was less than 5%. Conclusions: High prevalence resistance to penicillin, tetracycline, and ciprofloxacin in N. gonorrhoeae obviates their use in future national treatment algorithms for genital discharge. It is essential to continue monitoring for emerging resistance to currently recommended antimicrobial therapy in this rapidly evolving pathogen.