Miracle-dz/UniFAR-FTUs huggingface dataset:
Asthma, the sex difference

Purpose of review Asthma is a common chronic disease with significant clinical impact worldwide. Sex-related disparities in asthma epidemiology and morbidity exist but debate continues regarding the mechanisms for these differences. There is a need to review the recent findings for asthma care providers and to highlight areas in need of additional research. Recent findings Recent data illustrate striking sex-related differences in asthma epidemiology and disease expression. Studies show an increased incidence of asthma in women. Data demonstrate that asthmatic women have a poorer quality of life and increased utilization of healthcare compared to their male counterparts despite similar medical treatment and baseline pulmonary function. Research continues to explore hypotheses for these differences including the potential influences of the female sex hormones, altered perception of airflow obstruction, increased bronchial hyper-responsiveness, and medication compliance and technique. However, no single explanation has been able to fully explain the disparities. Summary Women are more likely to be diagnosed with asthma and suffer greater morbidity than men. The physiologic mechanisms for these differences are not well understood. Understanding sex-related differences in asthma and providing patients with education geared toward these disparities are important in establishing effective, individualized asthma management strategies for all patients.
Increase in Giα Protein Accompanies Progression of Post-Infarction Remodeling in Hypertensive Cardiomyopathy

Abstract —Hypertensive cardiac hypertrophy and myocardial infarction (MI) are clinically relevant risk factors for heart failure. There is no specific information addressing signaling alterations in the sequence of hypertrophy and post-MI remodeling. To investigate alterations in β-adrenergic receptor G-protein signaling in ventricular remodeling with pre-existing hypertrophy, MI was induced by coronary artery ligation in Wistar-Kyoto rats (WKY) and spontaneously hypertensive rats (SHR). Ten weeks after the induction of MI, the progression of left ventricular dysfunction and increases in plasma atrial natriuretic peptide (ANP) and cardiac ANP mRNA were more pronounced in SHR than WKY. In addition, the impaired contractile response to β-adrenergic stimulation was observed in the noninfarcted papillary muscle isolated from SHR. Immunochemical G sα protein and β-adrenoceptor density were not significantly altered by MI in both strains. However, immunochemical G iα was increased (1.5-fold) in the noninfarcted left ventricle of the SHR in which infarction had been induced when compared with that in SHR that underwent sham operation. This increase was observed especially in rats with a high plasma ANP level. Furthermore, there was a positive correlation between G iα and the extent of post-MI remodeling in WKY. A similar correlation between G iα and the extent of hypertensive hypertrophy was observed in SHR. In conclusion, the vulnerability of hypertrophied hearts to ischemic damage is greater than that of normotensive hearts. An increase in G iα could be one mechanism involved in the transition from cardiac hypertrophy to cardiac failure when chronic pressure overload and loss of contractile mass from ischemic heart disease coexist.
Effects of prior alcohol use on head injury recovery

Alcohol and head injury are closely linked. Of 102 patients admitted to the hospital through a trauma center for medical treatment, at least 56% had a documentable blood alcohol level (BAL). These patients were studied through a retrospective review of their records and compared to patients with no BAL at the time of admission. Findings suggest that if a BAL is present and, furthermore, if the individual's BAL Is at the intoxicated level (.10), a stormier medical course is predicted. Specific findings included longer length of stay, longer duration of agitation, and lower cognitive status at discharge. The etiology and implications of these findings are discussed, and recommendations are made. It is concluded that a head-injured individual who is admitted to the hospital with a BAL will be more difficult to manage, will have slower acute recovery, will thus cost more to treat, and may return to drinking. Better identification and an improvement in resources for these patients are recommended.
Safety and efficacy of neonatal vaccination

Newborns have an immature immune system that renders them at high risk for infection while simultaneously reducing responses to most vaccines, thereby posing challenges in protecting this vulnerable population. Nevertheless, certain vaccines, such as BCG and Hepatitis B vaccine, do demonstrate safety and some efficacy at birth, providing proof of principal that certain antigen–adjuvant combinations are able to elicit protective neonatal responses. Moreover, birth is a major point of healthcare contact globally meaning that effective neonatal vaccines achieve high population penetration. Given the potentially significant benefit of vaccinating at birth, availability of a broader range of more effective neonatal vaccines is an unmet medical need and a public health priority. This review focuses on safety and efficacy of neonatal vaccination in humans as well as recent research employing novel approaches to enhance the efficacy of neonatal vaccination.
Fear of falling and activities of daily living function: mediation effect of dual-task ability

ABSTRACT Objective: The aim of the study was to explore the association between fear of falling (FOF), dual-task ability during a mobility task, and the activities of daily living (ADL) in a sample of older adults. Methods: Seventy-six older adults (mean age M = 70.87 ± 5.16 years) participated in the study. Data on FOF (using the Falls Self-Efficacy Scale-International), walking ability during both single- and dual-task performances and ADL were collected. Results: Mediation analysis demonstrated the mediation effect of dual-task ability (β = 0.238, p = 0.011) between FOF and ADL level (β = 0.559, p < 0.001). Moreover, significantly lower performances were observed during dual-task condition [F (2, 73) = 7.386, p < 0.001], and lower ADL levels were also found in older adults with FOF [F (2, 73) = 13.734, p < 0.001]. Conclusion: The study underlines the relationship between FOF, dual-task ability and ADL level. These results could be used to develop specific intervention programmes for successful ageing.
Pain interference and depressive symptoms in communicative people with Alzheimer's disease: a pilot study

ABSTRACT Objectives: To examine pain interference in verbally communicative older adults with mild to moderate Alzheimer's disease (AD) and to examine the association of pain interference with cognitive function and depressive symptoms. Method: For this pilot study, we used a cross-sectional design to examine pain interference (Brief Pain Inventory-Short Form), cognitive function (Mini-Mental State Exam), and depressive symptoms (15-item Geriatric Depression Scale) in 52 older (≥65) communicative adults with AD who reported being free from chronic pain requiring daily analgesics. Results: Pain was reported to interfere with general activity (13.5%), mood (13.5%), walking ability (13.5%), normal work (11.5%), enjoyment of life (11.5%), relationships with other people (9.6%), and sleep (9.6%). Pain interference was significantly positively correlated with both cognitive function (rs = 0.46, p = 0.001) and depressive symptomology (rs = 0.45, p = 0.001), indicating that greater reported pain interference was associated with better cognitive function and more depressive symptoms. Conclusion: Among older people with AD who report being free from chronic pain requiring daily analgesics, 2 in 10 are at risk of pain interference and depressive symptoms. Those with better cognitive function reported more pain interference and depressive symptoms, meaning pain is likely to be under-reported as AD progresses. Clinicians should regularly assess pain interference and depressive symptoms in older persons with AD to identify pain that might be otherwise overlooked.
Factor structure of depressive symptoms using the EURO-D scale in the over-50s in Europe. Findings from the SHARE project

ABSTRACT Objectives: The aims of this study are: to analyze the factor structure of the EURO-D depression scale; to explore the variables associated with depressive symptoms in the total sample and in the EURO-D factors; and to compare the presence of depressive symptoms and the factor distribution in 15 European countries. Method: 62,182 participants in Wave 5 (2013) of the Survey of Health, Aging and Retirement in Europe (SHARE) were included. Instruments: The SHARE study and the EURO-D scale. Factor, bivariate and multilevel analyses were performed. Results: Higher levels of depressive symptoms were associated with a poorer self-perception of physical health (η2 = 0.22) and economic difficulties (η2 = 0.07). Factor analysis of the EURO-D identified two factors: Suffering and Motivation. Higher levels of depressive symptoms were associated with female gender and younger age (≤60) in the Suffering factor, and with less activity and exercise, older age (≥71), widowhood and lower educational level in the Motivation factor. Poorer self-perception of physical health and economic difficulties were associated with higher depressive symptomatology in both factors. Conclusions: Poorer self-perception of physical health, female gender, economic difficulties, widowhood, lower levels of activity and exercise and lower educational level were associated with higher depressive symptomatology. In the countries of southern Europe, the Motivation factor predominated.
Frequency, diagnosis and management of fungal respiratory infections

Purpose of review This review highlights key recent advances in fungal respiratory infections, encompassing developments in epidemiology, diagnostics and management, focussing on Aspergillus, Pneumocystis and Cryptococcus as key pathogens. Recent findings Chronic pulmonary aspergillosis complicates existing lung diseases, particularly those associated with cavities or bullae, with a high global disease burden (prevalence estimate >1.1 million following tuberculosis) and significant under diagnosis (using Aspergillus IgG antibody). Several new treatment studies have been published (using caspofungin and voriconazole). Pneumocystis jirovecii demonstrates airborne transmission between infected and noninfected individuals necessitating isolation, and possibly identifying colonized patients. Early detection of serum cryptococcal antigenaemia in HIV may prevent development of meningitis, reducing morbidity and mortality, and routine testing of serum in community-acquired pneumonia cases in high endemicity areas may be helpful. Respiratory Aspergillus antigen and PCR testing is more sensitive than culture or serum testing. A new lateral flow antigen testing device may provide rapid bedside diagnosis of aspergillosis. Azole resistance to Aspergillus fumigatus is increasing across Europe. Summary The field of fungal respiratory infection continues to evolve and develop, with many recent key advances. Patients, and possibly colonized patients, with Pneumocystis require isolation in hospitals and preferably segregation in outpatients. Challenges remain in almost all areas, with further work needed to identify the true burden of Aspergillus disease and address the increasing problem of azole resistance.
Using Tongue-Strengthening Exercise Programs in Dysphagia Intervention

Abstract Purpose: The purpose of this article was to review the literature with regard to use of tongue-strengthening exercise in the management of swallowing disorders (dysphagia) such as those with cerebrovascular accident (stroke) or head and neck cancer. Methods: A database of articles published from 1984 to June 2010 was compiled from MEDLINE, CINAHL, and PubMed using combinations of the following key words: exercise, exercise therapy, swallowing, dysphagia, stroke, cerebrovascular disorder, tongue strength, tongue-strength exercise, lingual strength, age, intensity, head and neck cancer, and swallowing rehabilitation. References listed in identified publications as well as abstracts were examined. Studies that satisfied the following selection criteria were included: (1) individuals had a diagnosis of dysphagia after stroke or head and neck cancer; (2) effects of tongue-strength exercises were examined; and (3) the design of the studies was either randomized control trial (RCT), prospective cohort intervention study, or case study. Results: Analysis of candidate studies showed that tongue-strengthening exercise is applicable to dysphagia intervention in general. However, the optimum dose, frequency, and duration of the exercise required to rehabilitate tongue function has yet to be established. Conclusion: Tongue-strengthening exercise has the potential to be a simple yet effective therapeutic tool to add to the options for swallowing rehabilitation in adults.
Origins and functional basis of regulatory CD11c+CD8+ T cells

Previously, we showed that CD11c defines a novel subset of CD8+ T cells whose in vivo activity is therapeutic for arthritis; however, the mechanisms directing their development, identity of their precursors, and basis of their effector function remain unknown. Here, we show that the novel subset develops from CD11csurface−CD8+ T cells and undergoes robust expansion in an antigen‐ and 4‐1BB (CD137)‐dependent manner. CD11c+CD8+ T cells exist in naïve mice (<3%) with limited suppressive activity. Once activated, they suppress CD4+ T cells in vivo and in vitro. Suppression of CD4+ by CD11c+CD8+ T cells is related to an increase in IDO activity induced in competent cells via the general control non‐derepressible‐2 pathway. CD11c+CD8+ T cells are refractory to the effect of IDO but constrict in a novel 1‐methyl D,L‐tryptophan‐dependent mechanism resulting in reversal of their suppressive effects. Thus, our data uncover, for the first time, the origin, development, and basis of the suppressive function of this novel CD11c+CD8+ T‐cell subpopulation that has many signature features of Treg.
Induction of Treg by monocyte‐derived DC modulated by vitamin D3 or dexamethasone: Differential role for PD‐L1

Specific therapy with modulated DC may restore immunological tolerance, thereby obviating the need for chronic immunosuppression in transplantation or autoimmunity. In this study we compared the tolerizing capacity of dexamethasone (Dex)‐ and 1α,25‐dihydroxyvitamin D3 (VD3)‐modulated DC. Treatment of monocytes with either VD3 or Dex resulted in DC with stable, semi‐mature phenotypes compared with standard DC, with intermediate levels of co‐stimulatory and MHC class II molecules, which remained unaltered after subsequent pro‐inflammatory stimulation. IL‐12p70 secretion was lost by VD3‐ and Dex‐DC, whereas IL‐10 secretion was unaffected. VD3‐DC distinctly produced large amounts of TNF‐α. Both VD3‐ and Dex‐DC possessed the capacity to convert CD4 T cells into IL‐10‐secreting Treg potently suppressing the proliferation of responder T cells. However, only Treg induced by VD3‐DC exhibited antigen specificity. VD3‐, but not Dex‐, DC expressed significant high levels of PD‐L1 (programmed death‐1 ligand), upon activation. Blockade of PD‐L1 during priming redirected T cells to produce IFN‐γ instead of IL‐10 and abolished acquisition of regulatory capacity. Our findings demonstrate that both VD3‐ and Dex‐DC possess durable but differential tolerogenic features, acting via different mechanisms. Both are potentially useful to specifically down‐regulate unwanted immune responses and induce immune tolerance. These modulated DC appear suitable as adjuvant in antigen‐specific clinical vaccination intervention strategies.
Regulatory T cells and immune computation

The role of Treg in immune regulation is the topic of this Viewpoint series in the European Journal of Immunology (EJI); the question to be discussed in this section is the effector function of Treg in immune regulation. In this manuscript, we take on the following three postulates outlined by Rolf Zinkernagel on the role of Treg in the control of immunity. First, the immune response is regulated primarily by the antigen and not by Treg. Second, immune non‐responsiveness results from the deletion of specific receptor‐bearing T cells. Third, there is no definitive proof of the existence of specialized Treg that know what is needed for an equilibrated immune response. Herein, we discuss data demonstrating the existence of specialized Treg and therefore arguing against the validity of the first two postulates. However, based on the reactive nature of the immune system, we agree with Rolf’s third postulate in that Treg cannot know ahead of time an ideal set‐point for immune homeostasis.
EAE: An immunologist's magic eye

EAE comes in many shapes and colors. Individual variants of EAE present a baffling complexity of different aspects and traits, clinical, immunological, and structural. But, embedded in this seemingly chaotic image, the educated eye will discern patterns that retrace fundamental features of immune response, in particular, autoimmunity and self‐tolerance. EAE and its variants thus can be likened to an autostereogram, i.e. they are an immunologist's magic eye.
Study of fractional ablative laser in surgical and post traumatic scar

Introduction: Ablative, fractional lasers generate microscopic columns of coagulated tissue through the epidermis and dermis to evoke a wound healing response. In this study, we examined the efficacy and safety of fractional ablative 2940nm erbium: YAG laser in the treatment of surgical and post-traumatic scars. Fractional laser photothermolysis is the latest in the broad range of Er: YAG laser technique. This technique promises a novel means of providing treatments that would be as effective as traditional Er: YAG, while further reducing their down time and risk. Aim of the Work: The aim of this work is to assess the efficacy and safety of variable square pulse (VSP) fractional Er: YAG laser for the treatment of surgical and post-traumatic scars; both clinically and histopathologically. Methods: Clinical studies were conducted on a range of surgical and post-traumatic scars with a 2940nm erbium: YAG fractional ablative laser varying energy, pulse widths, treatment passes, and number of treatments: twenty subjects, with Fitzpatrick skin types III-IV, received two to five treatments at one month interval and a follow up period for 3 months. Clinical and histopathological evaluation of the results was performed. Results: Almost all patients improved both clinically and histopathologically. Clinical improvement in scars according to investigator assessment: 40% of patients had excellent improvement of 76-100% (grade 3), 50% of patients had good improvement of 50-75% (grade 2), 10% had fair improvement of 26-49% (grade 1) at three month follow up. Histologic findings demonstrated remodeling of scar tissue with renewal and reorganization of collagen fibers in the dermis was noted two weeks post-treatment. Conclusion: These data illustrate the safety and efficacy of the 2940nm erbium:YAG fractional ablative laser in the treatment of surgical and post-traumatic scars with short down time period, and almost no incidence of complication. Streszczenie
Evidencia clínica de tracoma en indígenas colombianos del departamento de Vaupés

Introduction: Trachoma is the leading cause of infectious blindness in the world. In 2008 there were 1,300,000 persons with blindness caused by trachoma and 8 million with trichiasis, which might eventually lead to blindness. In Latin America it has been documented in Brazil, Guatemala and Mexico. Objective: To inform the presence of trachoma for the first time in Colombia, amongst Amerindians of the Department of Vaupes. Materials and methods: In 2003 and 2006 the Amerindian Maku communities of San Joaquin and Santa Catalina, located 5 km from the border with Brazil, were visited. From 2007 to 2009, San Gerardo, San Gabriel and Nuevo Pueblo, at a 35 km distance from San Joaquin were visited. Results: In 2006 114 people were examined in Santa Catalina and San Joaquin; 21 patients were clinically diagnosed with trachoma (18.4%), 15 (13.2%) of them children under 15 years old. All trachoma phases were observed. Three women had corneal opacity with poor vision. In the remaining three communities, three women with advanced trachoma with corneal opacity and blindness were detected. The poor quality of living conditions without fresh water and adequate sanitary disposal systems, and the abundance of flies identified as Hippelates sp. , are risk factors for the transmission of the disease. Discussion: Trachoma exists in Colombia, and it is frequent among the studied communities. Its focalized distribution makes it amenable to elimination. It is advisable to search for trachoma in other indigenous communities in Vaupes with similar living conditions.
Effect of Peginterferon or Ribavirin Dosing on Efficacy of Therapy With Telaprevir in Treatment-Experienced Patients With Chronic Hepatitis C and Advanced Liver Fibrosis

AbstractWe investigated the safety, efficacy, and impact of ribavirin and peginterferon dose reduction on complete early virologic response and sustained virologic response (SVR) to triple therapy with telaprevir in treatment-experienced patients with advanced liver fibrosis.Treatment was initiated for 211 patients who failed treatment with peginterferon and ribavirin, with bridging fibrosis (F3, n = 68) or cirrhosis (F4, n = 143), including 103 (49%) null-responders (NR), 30 (14%) partial responders (PR), and 78 (37%) relapsers (REL). Impaired liver function (ILF) platelets <100,000/mm3 or albumin <35 g/L were present in 40 patients. The distribution of hepatitis C virus subtypes was: 1a, 1b, or 1, with undetermined subtype for 10 (5%), 187 (89%), and 14 (6%) patients, respectively. Treatment was started with peginterferon alpha-2a or alpha-2b, ribavirin, and telaprevir at standard doses.The overall SVR24 rate was 56% and was lower in cirrhotic patients (NR: 35%, PR: 40%, and REL: 63%, respectively) than in patients with bridging fibrosis (NR: 50%, PR: 75%, and REL: 75%, respectively). The lowest probability of SVR24 was in NRs with ILF (26%). The SVR24 rate significantly decreased in NRs receiving <60% vs >60% of the total ribavirin dose (23% vs 44%, respectively) or <80% vs >80% of the total ribavirin dose (33% vs 48%, respectively). A significant SVR24 decrease was noted subsequent to a total peginterferon dose reduction, both when comparing patients who received <60% vs >60% of the total dose (NR: 0% vs 44%; REL: 33% vs 68%) and patients who received <80% vs >80% of the total dose (NR: 17% vs 50%; REL: 46% vs 71%). Serious adverse events were observed in 31 patients (15%). Deaths occurred in 4 patients. All of the deceased subjects were cirrhotic members of the ILF (baseline serum albumin level <35 g/L and/or platelet count <100,000/mm3) group.Ribavirin dose reduction did not affect efficacy in REL but did in NR. Peginterferon dose reduction decreased the SVR24 rate for all groups, particularly in prior NR. ILF increased the risk of fatal complications with a low probability to achieve SVR24. One solution might be to provide wide and early access to novel, efficient, and safe interferon-free combinations to treatment-experienced patients, particularly those with liver cirrhosis.