Miracle-dz/UniFAR-FTUs huggingface dataset:
Endovascular Thrombectomy for Acute Ischemic Stroke: A Meta-analysis.

IMPORTANCE Endovascular intervention for acute ischemic stroke improves revascularization. But trials examining endovascular therapy yielded variable functional outcomes, and the effect of endovascular intervention among subgroups needs better definition. OBJECTIVE To examine the association between endovascular mechanical thrombectomy and clinical outcomes among patients with acute ischemic stroke. DATA SOURCES We systematically searched MEDLINE, EMBASE, CINAHL, Google Scholar, and the Cochrane Library without language restriction through August 2015. STUDY SELECTION Eligible studies were randomized clinical trials of endovascular therapy with mechanical thrombectomy vs standard medical care, which includes the use of intravenous tissue plasminogen activator (tPA). DATA EXTRACTION AND SYNTHESIS Independent reviewers evaluated the quality of studies and abstracted the data. We calculated odds ratios (ORs) and 95% CIs for all outcomes using random-effects meta-analyses and performed subgroup and sensitivity analyses to examine whether certain imaging, patient, treatment, or study characteristics were associated with improved functional outcome. The strength of the evidence was examined for all outcomes using the GRADE method. MAIN OUTCOMES AND MEASURES Ordinal improvement across modified Rankin scale (mRS) scores at 90 days, functional independence (mRS score, 0-2), angiographic revascularization at 24 hours, symptomatic intracranial hemorrhage within 90 days, and all-cause mortality at 90 days. RESULTS Data were included from 8 trials involving 2423 patients (mean [SD] age, 67.4 [14.4] years; 1131 [46.7%] women), including 1313 who underwent endovascular thrombectomy and 1110 who received standard medical care with tPA. In a meta-analysis of these trials, endovascular therapy was associated with a significant proportional treatment benefit across mRS scores (OR, 1.56; 95% CI, 1.14-2.13; P = .005). Functional independence at 90 days (mRS score, 0-2) occurred among 557 of 1293 patients (44.6%; 95% CI, 36.6%-52.8%) in the endovascular therapy group vs 351 of 1094 patients (31.8%; 95% CI, 24.6%-40.0%) in the standard medical care group (risk difference, 12%; 95% CI, 3.8%-20.3%; OR, 1.71; 95% CI, 1.18-2.49; P = .005). Compared with standard medical care, endovascular thrombectomy was associated with significantly higher rates of angiographic revascularization at 24 hours (75.8% vs 34.1%; OR, 6.49; 95% CI, 4.79-8.79; P < .001) but no significant difference in rates of symptomatic intracranial hemorrhage within 90 days (70 events [5.7%] vs 53 events [5.1%]; OR, 1.12; 95% CI, 0.77-1.63; P = .56) or all-cause mortality at 90 days (218 deaths [15.8%] vs 201 deaths [17.8%]; OR, 0.87; 95% CI, 0.68-1.12; P = .27). CONCLUSIONS AND RELEVANCE Among patients with acute ischemic stroke, endovascular therapy with mechanical thrombectomy vs standard medical care with tPA was associated with improved functional outcomes and higher rates of angiographic revascularization, but no significant difference in symptomatic intracranial hemorrhage or all-cause mortality at 90 days.
Coriorretinopatía en perdigonada (Birdshot) en pacientes mexicanos, Espectro clínico y experiencia terapéutica

Introducción: La coriorretinopatía en perdigonada (birdshot) es una enfermedad autoinmune rara, que se observa con mayor frecuencia en personas de procedencia europea. En nuestro grupo étnico, se conoce muy poco de su prevalencia y espectro clínico. Con esta serie de casos, pretendemos mostrar las características clíni cas, complicaciones y manejo terapéutico de la enfermedad, en nuestra población. Serie de casos: Presentamos una serie de seis pacientes con coriorretinopatía en perdigonada, en diferentes etapas del curso clínico de la enfermedad, que acudieron al ◗ Abstract
Plasma concentration of thymus and activation-regulated chemokine in childhood asthma

Background: Thymus and activation-regulated chemokine (TARC) is responsible for trafficking of T helper 2 lymphocytes into sites of allergic inflammation. However, its role in assessing the severity of acute asthma in children is still unclear. Objective: We sought to evaluate plasma TARC as a marker for monitoring asthma exacerbation in terms of asthma attack severity. Methods: Plasma TARC concentration was estimated in 24 asthmatic children aged between 2 and 17 years attending the Pediatric Allergy and Immunology Unit of Children’s Hospital, Ain Shams University, and 23 age and sex-matched healthy children using a sandwich enzyme immunoassay technique. For asthmatic patients, the measurement was performed during and after the resolution of acute asthma attack. In addition, complete hemogram and plasma total IgE were evaluated and peak expiratory flow rate was assessed in asthmatic patients during and after acute asthma exacerbation. Results: Plasma TARC mean concentration was significantly higher during acute asthma (839.2 ± 453.6 pg/ml) than after resolution of symptoms (416.5 ± 324.8 pg/ml) and both were statistically higher than the control value (165.7 ± 135.2 pg/ml). During acute attacks of asthma, plasma TARC level was significantly elevated among patients with severe attacks of wheezing (1336.3 ± 431.2 pg/ml) than in those with moderate (743.8 ± 91.8 pg/ml) and mild (437.5 ± 66.1 pg/ml) attacks and inversely related to PEFR measurements during attacks (r = -98, P < 0.001). Meanwhile, no significant relationship was found between plasma TARC levels and either plasma total IgE levels or the absolute eosinophil count. Neither the history of other atopic symptoms nor family history of atopy influenced plasma TARC levels. A significant reduction in plasma TARC level was observed after treatment with inhaled s2 agonist drugs either alone or in conjunction with inhaled glucocorticoids. Conclusion: Our findings support the concept that TARC may be implicated in the pathogenesis of asthma. Plasma TARC is a useful marker in monitoring the severity of asthma exacerbation and in assessing the degree of allergic inflammation in the asthmatic airway. This would help physicians to design appropriate therapy in terms of dose and duration of treatment especially among children with quiescent asthma. Future studies should focus on using TARC antagonists as a new approach to asthma immunotherapy. Keywords: bronchial asthma, acute attacks, remission, TARC, atopy, inhaled glucocorticoids, s2 agonists Egypt J Pediatr Allergy Immunol 2003; 1(2): 86-92
Die Bedeutung der natriuretischen Peptide für die Diagnose einer diastolischen oder systolischen Funktionsstörung

The diagnostic value of natriuretic peptides in asymptomatic patients at risk for diastolic or systolic HF is contended. The prevalence of preclinical LV dysfunction in an at-risk cohort was tested. Furthermore the diagnostic accuracy of natriuretic peptides alone or in combination with clinical parameters for predicting asymptomatic left ventricular systolic or diastolic dysfunction were certified.542 primary care patients (mean age 63±11 years, 42% female) without prediagnosed HF, but with risk factors for left ventricular dysfunction underwent thorough cardiological workup including echocardiography and analysis of natriuretic peptides.23 patients (4%) showed reduced systolic function (EF<50%), 15 patients (3%) had severe diastolic dysfunction. All natriuretic peptides significantly increased with decreasing ejection fraction and with increasing degree of diastolic dysfunction. For natriuretic peptides, receiver operating characteristics analysis yielded good results for the detection of systolic dysfunction or severe diastolic dysfunction. Combining clinical parameters with natriuretic peptide data improved the diagnostic accuracy and largely reduced the number of needed screening echoes to identify patients with LV systolic or diastolic dysfunction. The prevalence of preclinical diastolic dysfunction is high in primary care patients at risk, but the relative prevalence of severe diastolic dysfunction and systolic dysfunction is only 7%. High-risk individuals may be screened most efficiently by using a score system incorporating clinical data and NT-proBNP.
Prevalence of upper lateral incisor microdontia in a mexican population

Introduction and objective: Microdoncia is an anomaly in which teeth are present with a size smaller than normal. It presents problems that affect the length of arch and facial aesthetics. When the width of the upper lateral incisor (ILS) is less than, equal to or up to 0.7 mm wider than the lower lateral incisor, the result would be excess of inferior dental material relative to the upper one. To determine the prevalence of microdoncia of the superior lateral incisor and to determine the frequency of microdoncia in relation to the side and size.Materials and methods: 1345 models of patients pre-treatment of the Specialty of Orthodontics of the Autonomous University of Nayarit between the years 2002-2012 , Of which 504 met the inclusion criteria. Measurements were made of the mesiodistal widths of the upper and lower lateral incisors and the results were summarized by descriptive statistics. RESULTS: 40.5% had ILS with microdontia, 13% on the right side, 12.7% on the left side, and 14.7% of formabilateral. For ILS with right side microdoncia the mean is 6.6 ± 0.4 mm, the left side is 6.4 ± 0.5 mm. For ILS cases with bilateral microdontia, the mean is 6.2 ± 0.6 mm on the right side and the left on the left 6.4 ± 0.5 mm. Conclusion: The study reflects a high percentage of ILS microdoncy according to the criteria of Binder and Cohenlo which should be considered in the planning of orthodontic treatment.
Statistical and mathematical modelling of HIV and AIDS, effect of reverse transcriptase inhibitors and causal inference for HIV mortality.

The HIV and AIDS epidemic has remained one of the leading causes of death in the world and has been destructive in Africa with Sub-Saharan Africa remaining the epidemiological locus of the epidemic. HIV and AIDS hinders development by erasing decades of health, economic and social progress, reducing life expectancy by years and deepening poverty [57]. The most urgent public-health problem globally is to devise effective strategies to minimize the destruction caused by the HIV and AIDS epidemic. Due to the problems caused by HIV and AIDS, well defined endpoints to evaluate treatment benefits are needed. The surrogate and true endpoints for a disease need to be specified. The purpose of a surrogate endpoint is to draw conclusions about the effect of intervention on true endpoint without having to observe the true endpoint. It is of great importance to understand the surrogate validation methods. At present the question remains as to whether CD4 count and viral load are good surrogate markers for death in HIV or there are some better surrogate markers. This dissertation was undertaken to obtain some clarity on this question by adopting a mathematical model for HIV at immune system level and the impact of treatment in the form of reverse transcriptase inhibitors (RTIs). For an understanding of HIV, the dissertation begins with the description of the human immune system, HIV virion structure, HIV disease progression and HIV drugs. Then a review of an existing mathematical model follows, analyses and simulations of this model are done. These gave an insight into the dynamics of the CD4 count, viral load and HIV therapy. Thereafter surrogate marker validation methods followed. Finally generalized estimating equations (GEEs) approach was used to analyse real data for HIV positive individuals, from the Centre for the AIDS Programme of Research in South Africa (CAPRISA). Numerical simulations for the HIV dynamic model with treatment suggest that the higher the treatment efficacy, the lower the infected cells are left in the body.
Fisiología y preservación cerebral durante el paro cardíaco: vulnerabilidad del cerebro a la anoxia-isquemia

Se hace una aproximación a la fisiología cerebral durante el paro cardíaco, destacando el concepto de darlo neuronal selectivo. Se presentan elementos que permiten modificar concepciones antiguas sobre la tolerancia del cerebro a la hipoxia severa. Además, se hace un nuevo planteamiento sobre el pronóstico cerebral luego de un paro cardíaco y se esbozan las alternativas terapéuticas utilizadas hasta la fecha para la preservación cerebral. Se hace énfasis en la inefectividad de los barbitúricos, en la investigación sobre la terapia con otras drogas y en el futuro abierto hacia los bloqueadores de los neurotransmisores excitadores, como elementos terapéuticos para la preservación cerebral.
Transcriptional regulation of insect steroid hormone biosynthesis and its role in controlling timing of molting and metamorphosis

The developmental transition from juvenile to adult is often accompanied by many systemic changes in morphology, metabolism, and reproduction. Curiously, both mammalian puberty and insect metamorphosis are triggered by a pulse of steroid hormones, which can harmonize gene expression profiles in the body and thus orchestrate drastic biological changes. However, understanding of how the timing of steroid hormone biosynthesis is regulated at the molecular level is poor. The principal insect steroid hormone, ecdysteroid, is biosynthesized from dietary cholesterol in the specialized endocrine organ called the prothoracic gland. The periodic pulses of ecdysteroid titers determine the timing of molting and metamorphosis. To date, at least nine families of ecdysteroidogenic enzyme genes have been identified. Expression levels of these genes correlate well with ecdysteroid titers, indicating that the transcriptional regulatory network plays a critical role in regulating the ecdysteroid biosynthesis pathway. In this article, we summarize the transcriptional regulation of ecdysteroid biosynthesis. We first describe the development of prothoracic gland cells during Drosophila embryogenesis, and then provide an overview of the transcription factors that act in ecdysteroid biosynthesis and signaling. We also discuss the external signaling pathways that target these transcriptional regulators. Furthermore, we describe conserved and/or diverse aspects of steroid hormone biosynthesis in insect species as well as vertebrates.
Molecular mechanism for cyclic generation of somites: Lessons from mice and zebrafish

The somite is the most prominent metameric structure observed during vertebrate embryogenesis, and its metamerism preserves the characteristic structures of the vertebrae and muscles in the adult body. During vertebrate somitogenesis, sequential formation of epithelialized cell boundaries generates the somites. According to the “clock and wavefront model,” the periodical and sequential generation of somites is achieved by the integration of spatiotemporal information provided by the segmentation clock and wavefront. In the anterior region of the presomitic mesoderm, which is the somite precursor, the orchestration between the segmentation clock and the wavefront achieves morphogenesis of somites through multiple processes such as determination of somite boundary position, generation of morophological boundary, and establishment of the rostrocaudal polarity within a somite. Recently, numerous studies using various model animals including mouse, zebrafish, and chick have gradually revealed the molecular aspect of the “clock and wavefront” model and the molecular mechanism connecting the segmentation clock and the wavefront to the multiple processes of somite morphogenesis. In this review, we first summarize the current knowledge about the molecular mechanisms underlying the clock and the wavefront and then describe those of the three processes of somite morphogenesis. Especially, we will discuss the conservation and diversification in the molecular network of the somitigenesis among vertebrates, focusing on two typical model animals used for genetic analyses, i.e., the mouse and zebrafish. In this review, we described molecular mechanism for the generation of somites based on the spatiotemporal information provided by “segmentation clock” and “wavefront” focusing on the evidences obtained from mouse and zebrafish.
Clinical expansion of cytokine induced killer (CIK) cells

Cytokine induced killer (CIK) cells are polyclonal T cells that can be expanded from marrow or peripheral blood lymphocytes with potent non‐MHC‐restricted cytotoxicity against a variety of tumor target cells. Earlier work had established the superiority of CIK cells over LAK cells in terms expansion and cytotoxicity. It has been studied extensively both in vitro and in murine experiments with promising killing activity against a wide range of haematological malignancies. Early clinical trials of CIK cells have reported safety and feasibility data as well as possible efficacy and have provided the framework for further clinical studies. As a robust and easily expandable cell population, its role in clinical adoptive immunotherapy should be investigated for translation into a good manufacturing practice (GMP) manufacturing process. Large scale culture to generate adequate number of CIK cells for clinical use involves up‐scaling from flasks to culture bags carried out in a GMP compliant cell therapy facility, use of GMP compliant materials and reagents, efficient harvesting procedures to remove foreign elements and strict release criteria with respect to viability, sterility and potency of the product. All the steps should preferably to be done in a closed system, in order to minimize the chance of contamination. A phase I/II clinical study on the use of allogeneic CIK cells has been conducted to define the role of CIK cells in the management of relapse post stem cell transplant with the aim of looking at feasibility of GMP expansion, toxicity and efficacy. A separate trial looking at autologous CIK cells was also conducted. Allogeneic CIK cells were successfully generated for a total of 24 patients including from patients’ own leukepheresed cells in 5 patients who have no access to further donor cells. The median CD3 + T cell expansion was 9·33 (1·3–38·97) fold and CD3 + CD56 + NK‐like T cells expansion was 27·77 (2·59–438·93) fold. CIK cells were infused into 16 patients who have either failed or progressed after initial response to various individualized chemotherapy regimen and donor lymphocyte infusion (DLI), for a total of 55 infusions at doses ranging from 10 to 200 million CD3/kg. Evidence of efficacy as defined by a demonstrable response attributable to CIK cell infusion was observed in five patients with minimal toxicity. Other published examples to augment CIK efficacy include co‐culture of CIK with myeloma idiotype or CA19‐9 peptide‐pulsed autologous dendritic cells. Redirecting CIK cells by bispecific antibodies to target has been shown for ovarian carcinoma and B cell lymphoma, as well as B cell ALL by engineering CIK cells to express anti‐CD19 receptor. Exploiting the heterogeneous subsets within the bulk CIK cell culture is another avenue for enhancing its potency.
Trends and risk groups for smoking during pregnancy in Finland and other Nordic countries.

BACKGROUND Reductions in maternal smoking can prevent pregnancy complications and adverse effects to foetus. Our objective was to study how the prevalence of maternal smoking differs between Nordic countries, and to identify target groups for smoking-cessation interventions. METHODS Information on maternal smoking and background factors was requested from the Nordic countries (the Danish National Board of Health, the Finnish National Institute for Health and Welfare, the Public Health Institute in Iceland, the Norwegian Institute of Public Health and the Swedish National Board of Health and Welfare). Data on maternal smoking were received from 1991 to 2010 in Denmark, 1987 to 2010 in Finland, 1999 to 2009 in Norway and 1983 to 2008 in Sweden. Trends in smoking were studied by using test for relative proportion. RESULTS The prevalence of maternal smoking in early pregnancy has declined in the countries during the past 20 years (Denmark: from 30.6 to 12.5%; Norway: 20.6 to 16.5% and Sweden: 31.4 to 6.9%), except in Finland (a steady prevalence at 15%). The highest rates of smoking in early pregnancy were among teenagers (24% in Sweden and 49% in Finland and Norway). Single women were 2-3 times more likely to smoke than married women. The women in the lowest socioeconomic group were 6-7 times more likely to smoke than women in the highest group in Finland and Norway. CONCLUSION Maternal smoking and its trends differed between the Nordic countries. The highest smoking rates during pregnancy were observed among teenagers, single women and women with a low socioeconomic position.
Lineage tracing reveals conversion of liver sinusoidal endothelial cells into hepatocytes

Although liver sinusoidal endothelial cells (LSECs) have long been known to contribute to liver regeneration following injury, the exact role of these cells in liver regeneration remains poorly understood. In this work, we performed lineage tracing of LSECs in mice carrying Tie2‐Cre or VE‐cadherin‐Cre constructs to facilitate fate‐mapping of LSECs in liver regeneration. Some YFP‐positive LSECs were observed to convert into hepatocytes following a two‐thirds partial hepatectomy (PH). Furthermore, human umbilical vein endothelial cells (HUVECs) could be triggered to convert into cells that closely resembled hepatocytes when cultured with serum from mice that underwent an extended PH. These findings suggest that mature non‐hepatocyte LSECs play an essential role in mammalian liver regeneration by converting to hepatocytes. The conversion of LSECs to hepatocyte‐like (iHep) cells may provide a new approach to tissue engineering.