Miracle-dz/UniFAR-FTUs huggingface dataset:
Medical problems of porters and trekkers in the Nepal Himalaya

The purpose of this study was to assess the incidence of medical illness among members of trekking groups in the Nepal Himalaya. The design was a cohort study using interview and clinical examination by a single physician. The setting was the Manaslu area in the central Nepal Himalaya along a 22-day trekking route with elevations ranging from 487 m to 5100 m. Subjects were 155 members of commercial trekking groups: 102 Nepali porters, 31 Nepali trek staff, and 22 Western trekkers. We found that medical problems occurred in 45% of party members. The porter cohort contained the highest diversity and severity of illness. The relatively larger porter cohort experienced 77% of the medical problems recorded compared with 17% among Western trekkers and 6% among trek staff. The incidence of medical problems was not significantly different in the porter staff (52%) and Western trekkers (55%) and was significantly lower for the trek staff (13%). High-altitude pharyngitis/bronchitis was the most common illness in the party (12%) followed by acute mountain sickness (8%) and gastroenteritis (6%). Other conditions included anxiety (3%), cellulitis (3%), scabies (3%), snow blindness (3%), acute alcohol intoxication (2%), conjunctivitis (2%), fever (2%), lacerations (2%), and hemorrhoids (1%). Illness with infectious etiologies comprised 33% of the medical problems. The incidence of altitude illness was not significantly less in the Nepali porter staff than in the Western trekkers. Evacuation was required in 5% of party members, all from the porter group. This study should alert expedition medical providers and trip leaders of the need to be observant for and prepared to treat the frequent and diverse medical problems among the porter staff in their party, in addition to the Western members. Medical problems are common in remote mountainous areas, indicating that trip physicians should be experienced in primary care.
Psychosocial Issues for Older Adults Living with HIV / AIDS

Key Take-Home Messages • Older adults may be at greater risk of HIV-related neurocognitive dysfunction (2) and several stressors are associated with aging with HIV, including ageism, HIV-related stigma, declines in social support, increased feelings of loneliness, declines in health status, financial distress, mitochondrial damage that may contribute to fatigue, and changes in appearance caused by lipodystrophy. (3)
Stress, race, and body weight.

OBJECTIVE Stress has been identified as a significant factor in health and in racial/ethnic health disparities. A potential mediator in these relationships is body weight. DESIGN Cross-sectional and longitudinal relationships between stress, race, and body weight were examined in an ethnically diverse sample of overweight and obese women with Type 2 diabetes (n = 217) enrolled in a behavioral weight loss program. MAIN OUTCOME MEASURES Stress (Perceived Stress Scale) was assessed at baseline only and body weight (body mass index) was assessed at baseline and 6 months. RESULTS Stress was not related to baseline body weight. With every 1 unit lower scored on the baseline stress measure, women lost 0.10 kg +/- . 04 more at 6 months (p < .05). When women were divided into tertiles based on baseline stress scores, those in the lowest stress group had significantly greater weight loss (5.2 kg +/- 4.9) compared with those in the highest stress group (3.0 kg +/- 4.0) (p < .05). There was a trend for African Americans to report higher levels of stress (20.7 +/- 8.8) than Whites (18.3 +/- 8.3) (p = .08). CONCLUSION The association between higher stress and diminished weight loss has implications for enhancing weight loss programs for women with Type 2 diabetes.
Endoplasmic Reticulum Stress Proteins Block Oxidant-induced Ca2+ Increases and Cell Death*

Oxidants are important human toxicants. Increased intracellular free Ca2+ may be critical for oxidant toxicity, but this mechanism remains controversial. Furthermore, oxidants damage the endoplasmic reticulum (ER) and release ER Ca2+, but the role of the ER in oxidant toxicity and Ca2+ regulation during toxicity is also unclear.tert-Butylhydroperoxide (TBHP), a prototypical organic oxidant, causes oxidative stress and an increase in intracellular free Ca2+. Therefore, we addressed the mechanism of oxidant-induced cell death and investigated the role of ER stress proteins in Ca2+ regulation and cytoprotection after treating renal epithelial cells with TBHP. Prior ER stress induces expression of the ER stress proteins Grp78, Grp94, and calreticulin and rendered cells resistant to cell death caused by a subsequent TBHP challenge. Expressing antisense RNA targeted to grp78prevents grp78 induction sensitized cells to TBHP and disrupted their ability to develop cellular tolerance. In addition, overexpressing calreticulin, another ER chaperone and Ca2+-binding protein, also protected cells against TBHP. Interestingly, neither prior ER stress nor calreticulin expression prevented lipid peroxidation, but both blocked the rise in intracellular free Ca2+ after TBHP treatment. Loading cells with EGTA, even after peroxidation had already occurred, also prevented TBHP-induced cell death, indicating that buffering intracellular Ca2+ prevents cell killing. Thus, Ca2+ plays an important role in TBHP-induced cell death in these cells, and the ER is an important regulator of cellular Ca2+ homeostasis during oxidative stress. Given the importance of oxidants in human disease, it would appear that the role of ER stress proteins in protection from oxidant damage warrants further consideration.
The locus of the polymorphic epithelial mucin (PEM) tumour antigen on chromosome 1q21 shows a high frequency of alteration in primary human breast tumours

Tumour and blood leukocyte DNAs from sporadic breast cancer patients were examined for chromosome 1 loss of heterozygosity using a probe for a polymorphic epithelial mucin, PEM, which is expressed in >92% of breast carcinomas as well as in normal lactating breast tissue. Expression is detected by the monoclonal antibodies (MAbs) HMFG‐1,‐2 and SM‐3 which react with epitopes in the 20 amino‐acid repeat unit of the core protein. The PEM probe has been mapped to the chromosome band 1q21, a region that is often incriminated in chromosomal rearrangements in breast tumours. Loss of heterozygosity or alteration at the PEM locus was detected in 34% of the 70 informative patients examined. Twenty of the 24 individuals showed loss of an allele, whereas 4 showed gain of an additional allele or amplification of an existing allele. Twenty‐eight percent of informative cases exhibited alterations at the MS32 locus, 1q42–43, and 20% had alterations at the short arm locus MSI at 1p33–35. These findings identify the long arm of chromosome 1 and in particular the region around the PEM gene for localization of a gene whose loss or alteration may, in some tumours, contribute to the progression of disease in breast cancer patients.
Electron Probe Microanalysis of Thin Films and Multilayers Using the Computer Program XFILM

Abstract XFILM is a computer program for determining the thickness and composition of thin films on substrates and multilayers by electron probe microanalysis. In this study, we describe the X-ray emission model implemented in the latest version of XFILM and assess its reliability by comparing measured and calculated k-ratios from thin-film samples available in the literature. We present and discuss examples of applications of XFILM that illustrate the capabilities of the program.
T(1)--T(2) correlation spectra obtained using a fast two-dimensional Laplace inversion.

Spin relaxation is a sensitive probe of molecular structure and dynamics. Correlation of relaxation time constants, such as T(1) and T(2), conceptually similar to the conventional multidimensional spectroscopy, have been difficult to determine primarily due to the absense of an efficient multidimensional Laplace inversion program. We demonstrate the use of a novel computer algorithm for fast two-dimensional inverse Laplace transformation to obtain T(1)--T(2) correlation functions. The algorithm efficiently performs a least-squares fit on two-dimensional data with a nonnegativity constraint. We use a regularization method to find a balance between the residual fitting errors and the known noise amplitude, thus producing a result that is found to be stable in the presence of noise. This algorithm can be extended to include functional forms other than exponential kernels. We demonstrate the performance of the algorithm at different signal-to-noise ratios and with different T(1)--T(2) spectral characteristics using several brine-saturated rock samples.
Inhibition of PKCβ Improves Glucocorticoid‐Induced Insulin Resistance in Rat Adipocytes

Pretreatment with glucocorticoids for 60 min depressed insulin‐stimulated uptake of 2‐[ 3 H] deoxyglucose (2‐DOG), an effect that neither cycloheximide, an inhibitor of protein synthesis, nor RU38486, a glucocorticoid receptor antagonist, could restore. Preincubation with conventional PKC inhibitors restored dexamethasone‐induced insulin resistance. We also examined the dexamethasone‐mediated inhibitory effect on insulin‐induced 2‐DOG uptake in adipocytes overexpressed with wild‐type and dominant negative forms of PKC β. The dexamethasone‐mediated inhibitory effect on insulin‐induced 2‐DOG uptake was abrogated in adipocytes overexpressed with dominant‐negative PKC β. These results indicate that PKC βmay play an important role in glucocorticoid‐induced insulin resistance.
Mobile teledermatology for skin cancer screening A diagnostic accuracy study

Skin cancer screening has undoubted potential to reduce cancer-specific morbidity and mortality. Total-body exams remain the prevailing concept of skin cancer screening even if effectiveness and value of this method are controversial. Meanwhile, store and forward teledermatology was shown to be a reliable instrument for several diagnostic purposes mostly in specialized dermatology settings. The objective of this study was to evaluate most convenient mobile teledermatology interventions as instruments for skin cancer screening in a representative population. Prospective diagnostic study with visitors of a skin cancer screening campaign in Switzerland. Histopathology was used as reference standard. Mobile teledermatology with or without dermoscopic images was assessed for performance as a screening test (i.e., rule-in or rule-out the need for further testing). Outcomes were sensitivity, specificity, and predictive values. Seven cases of skin cancer were present among 195 skin lesions. All skin cancers were ruled-in by teledermatology with or without dermoscopic images (sensitivity and negative predictive value 100%). The addition of dermoscopic images to conventional images resulted in higher specificity (85% vs. 77%), allowing reduction of unnecessary further testing in a larger proportion of skin lesions. Store and forward mobile teledermatology could serve as an instrument for population-based skin cancer screening because of favorable test performance. Abbreviations: CI = Confidence Interval, OR = Odds ratio.
Prognostic Models: Evidence-Based Approach to Predicting Disease Outcome

Background: A thorough understanding of the techniques underlying prognostic modelling, the potential shortcomings of prognostic models, and their applicability to dermatology are important for both clinicians and researchers. Objective: This article distinguishes between prognostic and explanatory (causal) models, discusses some of the techniques used in developing a prognostic model, and addresses the importance of model generalizability. Conclusion: Prognostic models may be useful to the clinician, but must be used with care. It is important to critically appraise prognostic models and to assure that they are relevant to the population of interest. The ability to critically appraise prognostic models is predicated on a thorough understanding of the techniques used in their development and evaluation.
Motivation for Treatment in a Prison-Based Therapeutic Community

Current research concludes that participation in postprison aftercare is critical to the effectiveness of prison-based therapeutic community (TC) treatment. This conclusion makes it imperative to understand the client determinants of retention in prison treatment, particularly continuance in postprison aftercare. Currently, however, little data exist as to client predictors of seeking and remaining in prison-based TCs or entering postrelease aftercare. In the present study, significant relationships were obtained between initial motivation (i.e., Circumstances, Motivation, Readiness [CMR] scores), retention, aftercare, and outcomes in a sample of substance abusers treated in a prison-based TC program. Implications are discussed for theory, research, and treatment policy.
Mucinous Cystic Neoplasm of the Pancreas is Not an Aggressive Entity: Lessons From 163 Resected Patients

Objective:Mucinous cystic neoplasms (MCNs) of the pancreas have often been confused with intraductal papillary mucinous neoplasms. We evaluated the clinicopathologic characteristics, prevalence of cancer, and prognosis of a large series of well-characterized MCNs in 2 tertiary centers. Methods:Analysis of 163 patients with resected MCNs, defined by the presence of ovarian stroma and lack of communication with the main pancreatic duct. Results:MCNs were seen mostly in women (95%) and in the distal pancreas (97%); 25% were incidentally discovered. Symptomatic patients typically had mild abdominal pain, but 9% presented with acute pancreatitis. One hundred eighteen patients (72%) had adenoma, 17 (10.5%) borderline tumors, 9 (5.5%) in situ carcinoma, and 19 (12%) invasive carcinoma. Patients with invasive carcinoma were significantly older than those with noninvasive neoplasms (55 vs. 44 years, P = 0.01). Findings associated with malignancy were presence of nodules (P = 0.0001) and diameter ≥60 mm (P = 0.0001). All neoplasms with cancer were either ≥40 mm in size or had nodules. There was no operative mortality and postoperative morbidity was 49%. Median follow-up was 57 months (range, 4–233); only patients with invasive carcinoma had recurrence. The 5-year disease-specific survival for noninvasive MCNs was 100%, and for those with invasive cancer, 57%. Conclusions:This series, the largest with MCNs defined by ovarian stroma, shows a prevalence of cancer of only 17.5%. Patients with invasive carcinoma are older, suggesting progression from adenoma to carcinoma. Although resection should be considered for all cases, in low-risk MCNs (≤4 cm/no nodules), nonradical resections are appropriate.
Head and Neck Cancer Cell Lines Are Resistant to Mitochondrial-Depolarization-Induced Apoptosis

Purpose: Mitochondrial dysfunction has been linked to defects in the apoptotic pathway, and solid tumors, including head and neck squamous cell carcinoma (HNSCC), exhibit defects in apoptosis. Loss of mitochondrial membrane potential (ΔΨm) is an early initiating event in the mitochondrial apoptotic pathway. We investigated the apoptotic response of 3 head and neck cancer cell lines treated with a mitochondrial-membrane-depolarizing agent, valinomycin, and studied the ability of depolarization to induce release of cytochrome c in these cell lines. Experimental Design: HNSCC cell lines JHU-011, -012 and -019, and a leukemia control cell line HL-60 were assayed for ΔΨm after valinomycin treatment by staining with mitochondrial-membrane-potential-specific probe JC-1 and stained with apoptosis-specific probe annexin-V to measure their rate of apoptosis by FACS. Western blotting was also applied to detect cytoplasmic cytochrome c release. Results: ΔΨm in head and neck cell lines started to show slight loss of ΔΨm, while HL-60 showed significant loss of ΔΨm after 30 min of treatment. All cell lines demonstrated complete mitochondrial depolarization within 24 h, however, only the control cell line HL-60 underwent apoptosis. In addition, HNSCC cell lines did not demonstrate cytoplasmic cytochrome c release despite significant mitochondrial membrane depolarization, while HL-60 cell initiated apoptosis and cytochcrome c release after 24 h of treatment. Conclusions: Head and neck cancer cell lines exhibit defects in mitochondrial-membrane-depolarization-induced apoptosis as well as impaired release of cytochrome c despite significant mitochondrial membrane depolarization. Proximal defects in the mitochondrial apoptosis pathway are a feature of HNSCC.
Distribution of messenger RNAs for aldehyde dehydrogenase 1, aldehyde dehydrogenase 2, and aldehyde dehydrogenase 5 in human tissues.

BACKGROUND The distribution of aldehyde dehydrogenases in human tissues is incompletely understood, in part because of technical limitations of gel electrophoretic and other enzyme assay methods used previously and because of the instability of the enzymes. Since these enzymes participate in detoxification of endogenous and exogenous compounds, including ethanol, their tissue distribution may be relevant to the toxicology of a number of substances and to the medical consequences of alcoholism. METHODS The abundance of mRNA for aldehyde dehydrogenase 1 (ALDH1), aldehyde dehydrogenase 2 (ALDH2), and aldehyde dehydrogenase 5 (ALDH5) was determined by Northern blotting using poly A+ RNA from 16 adult human tissues and 5 fetal tissues. RESULTS The highest levels of ALDH1 mRNA were found in liver, kidney, muscle, and pancreas. ALDH2 and ALDH5 were expressed in a larger number of tissues than ALDH1, with highest levels in liver, kidney, muscle, and heart. Fetal heart, brain, liver, lung, and kidney expressed ALDH2 and ALDH5, while ALDH1 was present mainly in fetal liver, kidney, and lung. CONCLUSIONS The results are in general agreement with the distribution of enzymes studied in a limited number of tissues in the past, with the exception that the ALDH1 activity reported to exist in heart and brain may, in fact, be ALDH5. The only mRNA detected in placenta was that for ALDH5. This study extends the knowledge of the expression of these enzymes to several tissues not previously studied and establishes the tissue distribution of the new enzyme ALDH5.
Antidepressant Dose Reduction and the Risk of Relapse in Major Depressive Disorder

Background: Whether the dose of antidepressants can be reduced following clinical improvement without subsequently increasing the likelihood of depressive relapse has not been established. Thus, the aim of this work was to compare relapse rates among patients with major depressive disorder (MDD) randomized to either continue receiving the full versus a reduced dose of antidepressants following partial or full improvement of symptoms. Methods: Five double-blind, randomized clinical trials involving 1,009 patients with MDD randomized to either continue receiving the full versus a reduced dose of antidepressants following partial or full improvement of symptoms were pooled using a random-effect meta-analysis model. Results: Patients randomized to continue treatment with lower doses of antidepressants were more likely to experience a depressive relapse than patients who continued treatment with the full dose (risk ratio 1.62, 95% confidence interval: 1.52–2.80, p = 0.001). Pooled relapse rates were 25.3 and 15.1% for the two treatment groups. Conclusions: Decreasing the antidepressant dose following partial or full symptom improvement is associated with an increased risk of relapse in MDD.
Verification of National Weather Service Ensemble Streamflow Predictions for Water Supply Forecasting in the Colorado River Basin

The Ensemble Streamflow Prediction (ESP) system, developed by the National Weather Service (NWS), uses conceptual hydrologic models and historical data to generate a set, or ensemble, of possible streamflow scenarios conditioned on the initial states of a given basin. Using this approach, simulated historical probabilistic forecasts were generated for 14 forecast points in the Colorado River basin, and the statistical properties of the ensembles were evaluated. The median forecast traces were analyzed using ‘‘traditional’’ verification measures; these forecasts represented ‘‘deterministic ESP forecasts. ’’ The minimum-error and historical traces were examined to evaluate the median forecasts and the forecast system. Distribution-oriented verification measures were used to analyze the probabilistic information contained in the entire forecast ensemble. Using a single-trace prediction, for example, the median, resulted in a loss of valuable uncertainty information about predicted seasonal volumes that is provided by the entire ensemble. The minimum-error and historical traces revealed that there are errors in the data, calibration, and models, which are part of the uncertainty provided by the probabilistic forecasts, but are not considered in the median forecast. The simulated ESP forecasts more accurately predicted future streamflow than climatology forecasts and, on average, provided useful information about the likelihood of future streamflow magnitude with a lead time of up to 7 months. Overall, the forecast provided stronger probability statements and became more reliable at shorter lead times. The distribution-oriented verification approach was shown to be applicable to ESP outlooks and appropriate for extracting detailed performance information, although interpretation of the results is complicated by inadequate sample sizes.
Clinimetric properties of the Glasgow Health Status Inventory, Glasgow Benefit Inventory, Peak Nasal Inspiratory Flow, and 4-Phase Rhinomanometry in adults with nasal obstruction.

BACKGROUND The validity of many measurement instruments frequently used in rhinology is unknown. This study describes clinimetric properties of well-known subjective and objective outcomes, i.e., the Glasgow Health Status Inventory, Glasgow Benefit Inventory, Peak Nasal Inspiratory Flow, and 4-Phase Rhinomanometry, in adults with nasal obstruction. METHODOLOGY Construct validity and responsiveness were determined in 111 patients. Inter-rater and intra-rater reliability were analysed in 30 patients. We assessed content validity by interviewing patients and ENT-surgeons; construct validity by comparing hypothesised associations to calculated correlations between the outcomes; inter-rater reliability by having two researchers perform objective measurements in the same patients; intra-rater reliability by having one rater administer all instruments twice within a two-week interval; and responsiveness by comparing patients scores at baseline and three months after septoplasty or non-surgical management. RESULTS All instruments demonstrated adequate content validity, inter-, and intra-rater reliability. Analyses of construct validity yielded low Pearsons correlations between the subjective and objective outcomes. Comparing septoplasty to non-surgical management, only the Glasgow Health Status Inventory scores were different between the two groups (mean difference 10.4, 95% CI 6.9 - 13.9). CONCLUSION All measurement instruments scored appropriately on content validity and reliability, but only the subjective GHSI scored well on responsiveness.