Miracle-dz/UniFAR-FTUs huggingface dataset:
Anti-Angiotensin Type 1 Receptor Antibodies Associated With Antibody Mediated Rejection in Donor HLA Antibody Negative Patients

Background. Angiotensin type 1 receptor (AT1R) mediates most physiologic and pathophysiologic actions of its endogenous ligand, angiotensin II, with overactivity leading to vascular remodeling and hypertension. Antibodies to AT1R are implicated in several vascular pathologies. The aim of our study was to determine the impact of antibody to AT1R on clinical outcomes including antibody mediated rejection (AMR), with or without C4d deposition, in patients whose sera contained no donor human leukocyte antigen (HLA)-specific antibody (HLA-DSA). Methods. Pretransplant sera from 97 recipients and sera obtained at the time of acute rejection (AR) were tested by Luminex-based single-antigen bead assays to determine HLA-DSA and antibodies to major histocompatibility class I chain-related gene A (MICA). The presence of antibody to AT1R was determined by a cell-based ELISA method using a cutoff of 17 units to distinguish high from low binding. Results. Sera from 63 recipients were determined to have no HLA-DSA and no donor-specific MICA antibodies pretransplant and at the time of AR, and 16 of these recipients were diagnosed with AR including 7 with AMR and 9 with cellular AR (cell-mediated rejection). High-binding AT1R antibodies were identified for six of seven in the AMR+ group and zero of nine in the cell-mediated rejection+ group (P=0.0009). Conclusions. A strong association was observed between the presence of high binding to AT1R and AMR in recipients whose sera contained no antibody to donor HLA or MICA. Assessing the AT1R antibody status along with the HLA-DSA provides additional information to determine the immunologic risk for recipients.
Calcium and vitamin D intakes in an adult Canadian population.

PURPOSE Calcium and vitamin D intakes from food and supplements were estimated in Canadian men and women. METHODS Calcium intakes from both diet and supplements and vitamin D intakes from fortified milk and supplements were estimated using cross-sectional data from 9423 randomly selected subjects aged 25 years or older, who were participating in a longitudinal study on osteoporosis. Subjects completed an abbreviated food frequency questionnaire administered by a trained interviewer between July 1995 and December 1997. RESULTS The mean (standard deviation) daily intake for calcium was estimated to be 1038 (614) mg for women and 904 (583) mg for men; for vitamin D, mean intakes were 5.6 (5.9) microg and 4.8 (5.5) microg for women and men, respectively. CONCLUSIONS Mean intakes for calcium and vitamin D in men and women under age 51 were close to the adequate daily intake levels. Older adults, however, may be at risk of deficiency.
The AST/ALT ratio as an indicator of cirrhosis in patients with PBC

Abstract: Objectives: A non‐invasive, simple and non‐expensive test to predict cirrhosis would be highly desirable. The aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio has been proven to be such an indicator of cirrhosis in alcoholic liver disease, hepatitis C.
Whole-body vibration-related health disorders in occupational medicine – an international comparison

Workers with whole-body vibration (WBV) exposure are likely to report non-specific health complaints. Health and safety providers may not recognise such occupational injuries and may be unfamiliar with appropriate exposure assessment and prevention. This is a review of clinical studies, medical evidence, differential diagnostic evaluation protocols, surveillance programmes, national and international standards, and interventions recommendations utilising PubMed and other online resources. In summary, several studies show a clear trend: with increasing duration and intensity of occupational WBV exposure, primarily musculoskeletal or neurological disorders of the spine occur. Other organ damage has also been reported. In some European Union countries, spinal injury caused by WBV is recognised as an occupational disease and may be compensable. The WBV-related injury diagnosis includes a review of the work history, exposure assessment and differential diagnostic evaluation. WBV health surveillance should assess health status of WBV-exposed workers and address preventive measures. Practitioner Summary: Workers with whole-body vibration exposure report a variety of physical disorders. Health and safety providers may not recognise such injuries, or may be unfamiliar with exposure assessment and prevention. This review addresses health issues, exposure assessment and an international review of compensation criteria, trends and prevention efforts.
Abnormal spontaneous brain activity in minimal hepatic encephalopathy: resting-state fMRI study.

PURPOSE We aimed to assess the abnormality of baseline spontaneous brain activity in minimal hepatic encephalopathy (MHE) by amplitude of low frequency fluctuation (ALFF) and fraction ALFF (fALFF). METHODS A total of 14 MHE patients and 14 healthy controls were included in our study. Both ALFF and fALFF of functional magnetic resonance imaging were calculated for statistical analysis. RESULTS Compared with healthy controls, patients with MHE had significantly decreased ALFF in the bilateral medial prefrontal cortex (MPFC), left superior frontal gyrus, right precentral gyrus, left opercular part of inferior frontal gyrus, left gyrus rectus, bilateral precuneus, and the posterior lobe of right cerebellum; and they had significantly decreased fALFF in the bilateral MPFC, right middle frontal gyrus, right superior temporal gyrus, and the posterior lobe of left cerebellum. CONCLUSION ALFF and fALFF changes in many brain regions demonstrate abnormality of the spontaneous neuronal activity in MHE. Especially the impairment of right precuneus and left MPFC may play a critical role in manifestation of MHE. Changes of ALFF and fALFF in the precuneus and the MPFC can be used as a potential marker for MHE.
Diffusion of responsibility attenuates altruistic punishment: A functional magnetic resonance imaging effective connectivity study

Humans altruistically punish violators of social norms to enforce cooperation and pro‐social behaviors. However, such altruistic behaviors diminish when others are present, due to a diffusion of responsibility. We investigated the neural signatures underlying the modulations of diffusion of responsibility on altruistic punishment, conjoining a third‐party punishment task with event‐related functional magnetic resonance imaging and multivariate Granger causality mapping. In our study, participants acted as impartial third‐party decision‐makers and decided how to punish norm violations under two different social contexts: alone (i.e., full responsibility) or in the presence of putative other third‐party decision makers (i.e., diffused responsibility). Our behavioral results demonstrated that the diffusion of responsibility served as a mediator of context‐dependent punishment. In the presence of putative others, participants who felt less responsible also punished less severely in response to norm violations. Our neural results revealed that underlying this behavioral effect was a network of interconnected brain regions. For unfair relative to fair splits, the presence of others led to attenuated responses in brain regions implicated in signaling norm violations (e.g., AI) and to increased responses in brain regions implicated in calculating values of norm violations (e.g., vmPFC, precuneus) and mentalizing about others (dmPFC). The dmPFC acted as the driver of the punishment network, modulating target regions, such as AI, vmPFC, and precuneus, to adjust altruistic punishment behavior. Our results uncovered the neural basis of the influence of diffusion of responsibility on altruistic punishment and highlighted the role of the mentalizing network in this important phenomenon. Hum Brain Mapp 37:663–677, 2016. © 2015 Wiley Periodicals, Inc.
The Multidisciplinary Evaluation and Management of Cleft Lip and Palate

Cleft lip with or without a cleft palate (CLP) and cleft palate alone (CPA) are common birth defects, with a combined birth prevalence of about 1 to 2/1,000.1 Affected children have a number of medical issues and potential complications, and therefore require a wide variety of healthcare specialists beyond plastic surgeons and dental specialists. For this reason, the best environment in which to deliver this care is a multidisciplinary cleft clinic (MCC) that features a team of healthcare providers, including audiology, pediatric otolaryngology, speech pathology, occupational/feeding therapy, and genetics. In this setting, the many medical issues that these children face are comprehensively addressed in the most convenient manner, as all the specialists can be seen in a single busy day. Furthermore, the referring primary care provider (PCP) will receive a concise letter that documents the team evaluation, including future management plans and recommendations for therapy. Unfortunately, few papers are available in the literature that review the workings of these clinics. In this paper we will provide such an overview, discussing the management issues for children with CLP/CPA, and how these are addressed by members of the MCC.
Mismatch repair causes the dynamic release of an essential DNA polymerase from the replication fork

Mismatch repair (MMR) corrects DNA polymerase errors occurring during genome replication. MMR is critical for genome maintenance, and its loss increases mutation rates several hundred fold. Recent work has shown that the interaction between the mismatch recognition protein MutS and the replication processivity clamp is important for MMR in Bacillus subtilis. To further understand how MMR is coupled to DNA replication, we examined the subcellular localization of MMR and DNA replication proteins fused to green fluorescent protein (GFP) in live cells, following an increase in DNA replication errors. We demonstrate that foci of the essential DNA polymerase DnaE–GFP decrease following mismatch incorporation and that loss of DnaE–GFP foci requires MutS. Furthermore, we show that MutS and MutL bind DnaE in vitro, suggesting that DnaE is coupled to repair. We also found that DnaE–GFP foci decrease in vivo following a DNA damage‐independent arrest of DNA synthesis showing that loss of DnaE–GFP foci is caused by perturbations to DNA replication. We propose that MutS directly contacts the DNA replication machinery, causing a dynamic change in the organization of DnaE at the replication fork during MMR. Our results establish a striking and intimate connection between MMR and the replicating DNA polymerase complex in vivo.
Immunity and early atherosclerosis in the course of systemic lupus erythematosus, mixed connective tissue disease and antiphospholipid syndrome

Atherosclerosis is a chronic inflammatory disease of the arteries associated with various risk factors that promote lipid abnormalities, development and progression of atherosclerotic lesions, plaque rupture, and vascular thrombosis. Atherosclerosis is accelerated in autoimmune diseases. Non-invasive investigations showed increased intima-media thickness (IMT), carotid plaque, and coronary artery calcifications in patients with antiphospholipid syndrome, systemic lupus erythematosus and mixed connective tissue disease compared to controls. The balance between the proinflammatory and anti-inflammatory cytokines allows the immune equilibrium to be maintained. In autoimmune diseases the prevalence of proinflammatory factors leads to premature atherosclerosis. This review presents complementary knowledge on innate and adaptive immunity, cytokines and the role of inflammasomes in progression of early atherosclerosis.
Effect of pulse energy and numbers on fused silica surface by ultraviolet laser pulses at 355nm in vacuum

High–purity fused silica irradiated by UV laser in vacuum with different laser pulse parameters were studied experimentally. The defects induced by UV laser are investigated by UV absorption, fluorescence spectra and the structural modifications in the glass matrix are characterized by Raman spectra. Results show that, for laser fluence below the laser–induced damage threshold (LIDT), irradiation results in the formation of an absorption band and four defect–related fluorescence (FL) bands, and the intensities of absorption band and FL bands were increased with laser power and/or number of laser pulses. The optical properties of these point defects were discussed in detail. Analyzed these spectra, it indicates that the presence of different centers whose spectral features are modulated by structural disorder typical of the glass matrix.
Five-Year Follow-Up of 10 Patients Treated with Globus Pallidus Internus Deep Brain Stimulation for Segmental or Multisegmental Dystonia

Introduction: Globus pallidus internus (GPi) deep brain stimulation (DBS) represents a validated, effective, and safe treatment for patients affected by generalized dystonia resistant to conservative treatment. Segmental and multisegmental dystonia have more recently been proposed as further indications for GPi DBS despite the lack of long-term homogenous follow-up. Here we present an original and detailed long-term follow-up (5 years) of a homogeneous population of 11 patients affected by segmental or multisegmental dystonia. Materials and Methods: Ten patients underwent bilateral GPi DBS electrode implantations under a Leksell stereotactic guide, with intraoperative neurophysiological monitoring. The follow-ups at 1, 3 and 5 years were collected using video-BFMDRS for motor and disability scores. The statistical analysis of the results is provided. Results: We reported a statistically significant improvement in motor and disability overall scores until 5 years after treatment. At the last follow-up, even the single motor subitems were statistically improved. Discussion: We observed a continuous and statistically significant improvement in all of the motor subitems and in the overall disability score until the 3-year follow-up. These results did not improve any further but they appeared steady at the last follow-up. We also report a significant improvement in the cranial-cervical subitems. Conclusions: GPi DBS should definitely be considered a safe and effective treatment also for segmental and multisegmental dystonia even in cases of relevant or prevalent cranial-cervical involvement.
Angiotensin converting enzyme inhibitors and angiotensin II antagonists as therapy in chronic liver disease

Portal hypertension is the major complication of chronic liver disease and is associated with reduced survival.1Pharmacological treatment is based on the premise that a sustained reduction in portal pressure will reduce the consequences of portal hypertension—that is, variceal bleeding, hepatic encephalopathy, and development of ascites.2 Non-selective β-blockers have proved effective in reducing portal pressure by lowering splanchnic blood inflow3 and are used in primary and secondary prevention of variceal bleeding.4 5 However, the mean decrease in portal pressure in response to propranolol is only approximately 15%6 and one third of cirrhotic patients do not respond despite adequate blockade.7 During the last decade, increased knowledge of the pathophysiology of portal hypertension has resulted in the use of new pharmacological targets; most importantly for the reduction of intrahepatic resistance, which is now recognised to be due in part to activated stellate cell contraction (myofibroblasts). These represent mesenchymal cells that reside in the perisinusoidal space of Disse and resemble tissue pericytes, a cell type with smooth muscle features that is thought to regulate blood flow via pericapillary constriction.8During liver injury they undergo “activation”, characterised by production of increased amounts of extracellular matrix and are responsible for fibrosis.9 Moreover, experimental data provide strong evidence that activated stellate cells are contractile and may regulate sinusoidal blood flow, especially in the injured liver.10 The renin-angiotensin-aldosterone system (RAAS) is usually activated in patients with liver cirrhosis and this represents a homeostatic response to counterbalance the vasodilatation, arterial hypotension, and renal hypoperfusion observed in portal hypertension.11Plasma renin activity (PRA) is elevated in cirrhotics and is correlated with the hepatic venous pressure gradient (HVPG). 12Angiotensin II (ANG-II) is considered a potential mediator of intrahepatic portal hypertension because its plasma levels are elevated in cirrhosis,13 …
Neonatal Exendin-4 Reduces Growth, Fat Deposition and Glucose Tolerance during Treatment in the Intrauterine Growth-Restricted Lamb

Background IUGR increases the risk of type 2 diabetes mellitus (T2DM) in later life, due to reduced insulin sensitivity and impaired adaptation of insulin secretion. In IUGR rats, development of T2DM can be prevented by neonatal administration of the GLP-1 analogue exendin-4. We therefore investigated effects of neonatal exendin-4 administration on insulin action and β-cell mass and function in the IUGR neonate in the sheep, a species with a more developed pancreas at birth. Methods Twin IUGR lambs were injected s.c. daily with vehicle (IUGR+Veh, n = 8) or exendin-4 (1 nmol.kg-1, IUGR+Ex-4, n = 8), and singleton control lambs were injected with vehicle (CON, n = 7), from d 1 to 16 of age. Glucose-stimulated insulin secretion and insulin sensitivity were measured in vivo during treatment (d 12–14). Body composition, β-cell mass and in vitro insulin secretion of isolated pancreatic islets were measured at d 16. Principal Findings IUGR+Veh did not alter in vivo insulin secretion or insulin sensitivity or β-cell mass, but increased glucose-stimulated insulin secretion in vitro. Exendin-4 treatment of the IUGR lamb impaired glucose tolerance in vivo, reflecting reduced insulin sensitivity, and normalised glucose-stimulated insulin secretion in vitro. Exendin-4 also reduced neonatal growth and visceral fat accumulation in IUGR lambs, known risk factors for later T2DM. Conclusions Neonatal exendin-4 induces changes in IUGR lambs that might improve later insulin action. Whether these effects of exendin-4 lead to improved insulin action in adult life after IUGR in the sheep, as in the PR rat, requires further investigation.
Delta Cell Hyperplasia in Adult Goto-Kakizaki (GK/MolTac) Diabetic Rats

Reduced beta cell mass in pancreatic islets (PI) of Goto-Kakizaki (GK) rats is frequently observed in this diabetic model, but knowledge on delta cells is scarce. Aiming to compare delta cell physiology/pathology of GK to Wistar rats, we found that delta cell number increased over time as did somatostatin mRNA and delta cells distribution in PI is different in GK rats. Subtle changes in 6-week-old GK rats were found. With maturation and aging of GK rats, disturbed cytoarchitecture occurred with irregular beta cells accompanied by delta cell hyperplasia and loss of pancreatic polypeptide (PPY) positivity. Unlike the constant glucose-stimulation index for insulin PI release in Wistar rats, this index declined with GK age, whereas for somatostatin it increased with age. A decrease of GK rat PPY serum levels was found. GK rat body weight decreased with increasing hyperglycemia. Somatostatin analog octreotide completely blocked insulin secretion, impaired proliferation at low autocrine insulin, and decreased PPY secretion and mitochondrial DNA in INS-1E cells. In conclusion, in GK rats PI, significant local delta cell hyperplasia and suspected paracrine effect of somatostatin diminish beta cell viability and contribute to the deterioration of beta cell mass. Altered PPY-secreting cells distribution amends another component of GK PI's pathophysiology.
[A comparative study between bupivacaine and clonidine associated with bupivacaine in cervical plexus block for carotid endarterectomy].

BACKGROUND AND OBJECTIVES Neurological evaluation can be done during cervical plexus block for endarterectomy, which also maintains postoperative analgesia. The objective of this study was to compare the analgesic effects of clonidine associated with bupivacaine to those of bupivacaine in cervical plexus block. METHODS A randomized double-blind study was undertaken with 30 patients divided in two groups: G1 received 1.5 mg.kg-1 of 0.375% bupivacaine associated with 150 (1/4)g of clonidine (2 mL), and G2 received 1.5 mg.kg-1 of 0.375% bupivacaine associated with NS (2 mL). The following parameters were evaluated: heart rate and blood pressure at 0 (block), 30, 60, 90, and 120 minutes; the need for anesthetic supplementation; time until the first analgesic supplementation; amount of analgesic used; and pain severity at 0 (end of the surgery), 30, 60, 120, 240, and 360 minutes. RESULTS Group 1 received 3.8 mL of lidocaine for anesthetic supplementation, while G2 received 3.6 mL of lidocaine, but this difference was not statistically significant. In G1, the time until the first supplementation was 302.6 +/- 152.6 minutes, and in G2 it was 236.6 +/- 132.9 minutes, which was not statistically significant. Differences between the doses of dypirone and tramadol were not observed. Differences in pain severity between both groups were not observed either. CONCLUSION The association of 150 (1/4)g of clonidine and bupivacaine in cervical plexus block for carotid endarterectomy did not improve significantly the analgesic effects evaluated by pain severity, time until the first analgesic supplementations and amount of supplementary analgesics.
An evidence‐based approach for providing cautionary recommendations to sulfonamide‐allergic patients and determining cross‐reactivity among sulfonamide‐containing medications

Prescribing sulfonamide‐containing medications for patients with sulfonamide allergy continues to complicate medical decisions. We examined the cautionary recommendations in the approved drug monographs and primary literature, and formulated an evidence‐based grading of cautionary recommendations for sulfonamide allergy and cross‐reactivity among sulfonamide‐containing medications.
The Importance of Trust in the Development and Delivery of a Decision Support Tool to Reduce Environmental Nutrient Losses from Pasture Systems

Managing uncertainty and risk is an increasing challenge for running profitable grazing systems. There is continual pressure to increase efficiency and productivity, while at the same time there is mounting scrutiny of the impact of grazing systems on the environment. Of particular interest is the impact of nitrogen and phosphorus losses from grazed pasture systems to water and the atmosphere. A combination of industry demand for information on environmental management of nutrients on farms, and the few existing decisions support systems (DSS) to help manage these issues in Australia led to a government and industry funded project (the Better Fertiliser Decisions project, BFD) for developing a new decision support system, the Farm Nutrient Loss Index (FNLI). The objective of the FNLI was to provide a DSS that can be used to identify where and when there is a risk of nutrient loss to the environment from grazed pasture systems in Australia.