Miracle-dz/UniFAR-FTUs huggingface dataset:
Glucose content of tracheal aspirates: Implications for the detection of tube feeding aspiration

Objective: To determine, using a sensitive glucose assay, whether monitoring of tracheal aspirate glucose concentration could serve as a marker of aspiration of enteral feedings. Design: Prospective, controlled trial. Setting: Intensive care units of a tertiary care hospital. Patients: Fifteen enterally fed and 15 nonenterally fed, tracheally intubated patients who had normal lung fields on a routine chest radiograph. Interventions: Patients with endotracheal tubes undergoing routine tracheal suctioning had tracheal secretions collected three times per day with a minimum of 4 hrs between samples for up to 5 days. Daily chest radiographs were reviewed for evidence of the development of pneumonitis using defined criteria. Measurements and Main Results: Glucose concentrations in five commonly used commercial feeding formulas, as well as in the medications patients were receiving enterally or as an oral wash, were measured. Tracheal secretion glucose concentrations were 66 ± 54 (sd) mg/dL (3.7 ± 3.0 mmol/L) and 105 ± 70 mg/dL (5.8 ± 3.9 mmol/L) in the enterally fed and nonenterally fed patients, respectively ( p = NS). Of the medications administered, the majority contained negligible glucose, but ten had >3 mg/dose of glucose. However, there was no correlation between administration of these medications and the tracheal glucose concentrations. Tracheal glucose concentrations were similar in patients who received medications containing glucose and patients who received either no medications or medications with negligible glucose content. A small but significant correlation between blood glucose and tracheal secretion glucose concentrations (r2 = .15, p < .05) was observed. None of the patients developed aspiration pneumonitis. Glucose concentrations in widely used commercial formulas (44 to 202 mg/dL; 2.4 to 11.2 mmol/L) overlapped considerably with glucose concentrations in tracheal secretions in the absence of aspiration and were for the most part within 2 sd of mean values in tracheal secretions. Conclusions: Tracheal secretions contain high glucose concentrations, both in enterally fed patients without evidence of aspiration pneumonitis and in nonenterally fed patients. The concentration of glucose in tracheal secretions appears to be determined, in part, by ambient extracellular glucose concentrations. We conclude that measurement of glucose in tracheal secretions is unlikely to be useful in monitoring for tube feeding aspiration in tracheally intubated, enterally fed patients. (Crit Care Med 1994; 22:1557–1562)
Computation of Probabilities for an Island-Driven Parser

The authors describe an effort to adapt island-driven parsers to handle stochastic context-free grammars. These grammars could be used as language models (LMs) by a language processor (LP) to computer the probability of a linguistic interpretation. As different islands may compete for growth, it is important to compute the probability that an LM generates a sentence containing islands and gaps between them. Algorithms for computing these probabilities are introduced. The complexity of these algorithms is analyzed both from theoretical and practical points of view. It is shown that the computation of probabilities in the presence of gaps of unknown length requires the impractical solution of a nonlinear system of equations, whereas the computation of probabilities for cases with gaps containing a known number of unknown words has polynomial time complexity and is practically feasible. The use of the results obtained in automatic speech understanding systems is discussed. >
Biomarkers of dietary fatty acid intake and the risk of breast cancer: A meta‐analysis

The use of the fatty acid composition of adipose tissue, erythrocyte membranes, serum and plasma as biological markers of fatty acid intake was recently introduced in epidemiological studies. The biomarkers of fatty acid intake have the advantage of providing quantitative measurement independent of energy intake and of the subject's memory. We performed a meta‐analysis of published results of epidemiological studies of the composition of fatty acids in biological samples and breast cancer risk. The analysis was based on 3 cohort and 7 case‐control studies including 2,031 cases and 2,334 controls. The summary statistic used was the average of the relative risk estimated for each level of the fatty acid on study, weighted by the inverse of its variance. Random effect models were assumed when the test for heterogeneity was significant. Overall relative risks were estimated for studies including pre‐ and post‐menopausal breast cancer and separately for post‐menopausal women. In cohort studies, a significant protective effect was found for total n‐3 polyunsaturated fatty acids, while total monounsaturated fatty acids, oleic acid (C18:1 n‐9c) and palmitic acid (C16:0) were significantly associated with an increase of breast cancer risk. Total saturated fatty acids were significantly associated with breast cancer risk in cohort studies only in postmenopausal women. For case‐control studies, the only finding was for alpha linolenic acid (C18:3, n‐3), which showed an inverse association bordering on statistical significance. The findings of cohort studies fit well with hypotheses derived from experimental animal studies. More epidemiological cohort studies that integrate biological markers of dietary fatty acid intake are needed in order to determine the contribution of different types of fatty acids in the etiology of breast cancer. © 2004 Wiley‐Liss, Inc.
Adrenergic Response to Morphine‐Diazepam Anesthesia for Myocardial Revascularization

To evaluate sympathetic nervous system activity during narcotic-hypnotic “balanced anesthesia,” plasma catecholamine concentrations and hemodynamic variables were assessed simultaneously in 10 men with coronary artery disease who received, sequentially, morphine sulfate, 3 mg/kg IV, and diazepam, 0.25 to 0.35 mg/kg IV, for myocardial revascularization surgery. Infusion of morphine sulfate at rates of 5 to 10 mg/min significantly decreased both mean systemic arterial pressure (from 98 ± 6 to 84 ± 5 torr, p < 0.01) and systemic vascular resistance index (from 38 ± 3 to 30 ± 5 units, p < 0.05). These changes were associated with 2-fold increases in plasma norepinephrine levels (from 246 ± 31 to 488 ± 85 pg/ml, p < 0.01) and 4-fold increases in plasma epinephrine levels (from 129 ± 20 to 570 ± 182 pg/ml, p < 0.01). Addition of diazepam further decreased systemic arterial pressure (from 84 ± 5 to 73 ± 3 torr, p < 0.01) and was associated with significant decreases in cardiac and stroke volume indices when compared with values obtained after morphine sulfate alone. Plasma concentrations of both norepinephrine and epinephrine also declined in association with these hemodynamic changes. Following skin incision, systemic arterial pressure and systemic vascular resistance index increased, the latter to the highest measured value (50 units). Norepinephrine concentrations increased significantly more than it had after morphine-diazepam anesthesia (321 ± 63 pg/ml). It was concluded that the administration of high dose morphine anesthesia acutely activates the sympathoadrenal system while producing peripheral vasodilation. Diazepam, when used following morphine to assure loss of consciousness, exacerbates the hypotensive effects produced by morphine and is associated with decreased levels of plasma catecholamines. Surgical incision produces significant peripheral sympathetic activation and increases vascular resistance during morphine-diazepam anesthesia.
The Incidence and Risk Factors for Lumbar or Sciatic Scoliosis in Lumbar Disc Herniation and the Outcomes after Percutaneous Endoscopic Discectomy.

BACKGROUND Some patients with lumbar herniated intervertebral disc disease (HIVD) suffer from both pain and lateral shift or trunk list. In addition to pain, patients have concerns regarding whether trunk list is reversible. Surgical treatment is performed when pain is intractable to conservative management, but a reversal of trunk list is an incidental outcome. Percutaneous lumbar endoscopic discectomy (PELD) is one of the surgical treatment options for lumbar HIVD, but no results concerning its effect on trunk list have been reported. OBJECTIVES The objectives of the present study were to determine the incidence of, and risk factors for, trunk list scoliosis or lateral shift and to report the outcomes of trunk list after PELD. STUDY DESIGN Retrospective case study. IRB No. H 1111-025-384 SETTING; University medical Center, Seoul, Korea. METHODS We selected 164 patients who were less than 60 years old, complained of unilateral leg pain, and underwent PELD. We measured the maximum trunk shift from the central sacral vertical line (CSVL-max) on preoperative whole spine radiographs and classified trunk list as CSVL-max ≥ 10 mm. CSVL-max was measured on serial radiographs taken at one, 3, 6, and 12 months postoperatively in patients with trunk list. RESULTS Twenty-nine patients (17.9%) had trunk list (M:F=10:19; mean age, 37.1 ± 11.24 years). Female gender (OR 4.28; 95% CI, 1.49-12.3) and HIVD at L4-5 (OR 5.6; 95% CI, 1.8-16.7) were risk factors for trunk list. Trunk list was normalized (CSVL-max < 10 mm) in 15 (52%) patients after PELD, and the median time for normalization was 3-6 months. Prognostic factors for the recovery of trunk list were not identified. LIMITATIONS Selection bias should be considered in interpreting these results. CONCLUSION Trunk list, scoliosis or lateral shift, was observed in 18% of the patients at the time of surgery. Female gender and L4-5 disc herniation were risk factors for trunk list. Trunk list was reversible in more than 50% of patients within 6 months of PELD.
Time of Appearance of Immunoglobulin-Containing Cells in the Mucosa of the Neonatal Intestine

Summary: In 46 intestinal specimens from infants 2 hr to 6 months old, the numbers of immunoglobulin-containing cells were counted by the direct immunofluorescent or direct immunoperoxidase technique. A restudy was made of biopsy specimens taken for diagnostic purposes, 34 from the rectum and 3 from the transverse colon of 30 infants at the Children's Hospital, Helsinki in 1971–1977, and in addition, of autopsy material recently collected from the intestines of 9 infants. Up to the age of 12 days, no immunoglobulin-containing cells were seen. A small number (1 to 2) of IgM-containing cells was seen in the lymph nodes of the 2 earlier specimens taken at the ages of 6 and 12 days. A rectal specimen from a 12-day-old infant showed 24 IgA- and 60 IgM-containing cells/mm2. In rectal specimens of infants less than 1 month old, the mean number of IgM-containing cells (26/mm2) was higher than that of IgA-containing cells (14/mm2), but older infants had a significantly higher mean number of IgA-containing cells (P < 0.01). The mean number of IgM-containing cells was the same in children 1 to 3 months (53 cells/mm2) and 3 to 6 months of age (59 cells/mm2), whereas the mean number of IgA-containing cells increased with age up to 6 months (112 and 163 cells/mm2). The youngest infant who had IgG-containing cells was 13 days old, although positive staining of intercellular spaces in the lamina propria and of the capillary endothelium by anti-IgG serum was observed in all specimens. The mean number of IgG-containing cells was low (5 cells/mm2) in all age groups. Sparse IgE-contain-ing cells (less than 12/mm2) were seen in 4 of the 46 specimens. In 5 patients, 2 or 3 consecutive specimens were available for the study; in these, the increase in the numbers of IgA- and IgM-containing cells was similar to the mean increase in cell numbers for the series as a whole.Speculation: There is a deficiency of immunoglobulin-containing cells in the gut of newborn infants up to the age of 12 days, and this is probably the reason for the high permeability of the neonatal intestine to foreign proteins.
Isoform‐specific cleavage of 14‐3‐3 proteins in apoptotic JURL‐MK1 cells

The proteins of 14‐3‐3 family are substantially involved in the regulation of many biological processes including the apoptosis. We studied the changes in the expression of five 14‐3‐3 isoforms (β, γ, ε, τ, and ζ) during the apoptosis of JURL‐MK1 and K562 cells. The expression level of all these proteins markedly decreased in relation with the apoptosis progression and all isoforms underwent truncation, which probably corresponds to the removal of several C‐terminal amino acids. The observed 14‐3‐3 modifications were partially blocked by caspase‐3 inhibition. In addition to caspases, a non‐caspase protease is likely to contribute to 14‐3‐3's cleavage in an isoform‐specific manner. While 14‐3‐3 γ seems to be cleaved mainly by caspase‐3, the alternative mechanism is essentially involved in the case of 14‐3‐3 τ, and a combined effect was observed for the isoforms ε, β, and ζ. We suggest that the processing of 14‐3‐3 proteins could form an integral part of the programmed cell death or at least of some apoptotic pathways. J. Cell. Biochem. 106: 673–681, 2009. © 2009 Wiley‐Liss, Inc.
An update on Teotihuacan

Abstract At Antiquity's invitation the author offers this account of recent research and current objectives at the famous ancient Mesoamerican city of Teotihuacan. After a century of investigation, archaeologists are beginning to see something of the composition and preoccupations of one of America's first urban societies, and how it began, flourished and ended.
Infection of baboons with a simian immunodeficiency virus/HIV‐1 chimeric virus constructed with an HIV‐1 Thai subtype E envelope

Objective:To construct an infectious chimeric simian immunodeficiency virus/HIV-1 (SHIV) with the envelope of a Thai subtype E HIV-1 strain for use in a non-human primate model. Methods:A novel SHIV genome was derived using the sequences of the ectodomain of the envelope gene from the Thai subtype E strain, HIV-19466. This SHIV (SHIV9466.33) was recovered by cocultivation from human peripheral blood mononuclear cells (PBMC) after transfection of human rhabdosarcoma cells. Rhesus macaque and baboon PBMC were screened in vitro for susceptibility to infection with SHIV9466.33. After successful infection of baboon PBMC, four animals were inoculated intravenously with SHIV9466.33 and monitored for plasma viral RNA, virus isolation from the PBMC, seroconversion, T-cell subsets, and signs of disease. Results:SHIV9466.33 was able to infect PBMC from 12 out of 14 baboons. All four of the baboons selected for in vivo inoculation became infected. Peak plasma viral RNA levels of 8000 to 700 000 RNA copies/ml were measured at 2 weeks post-inoculation. Virus was isolated from the PBMC of all four baboons during acute infection, and all seroconverted. Although transient declines in CD4+ T-cells were observed during early infection, CD4+ levels remained within normal ranges thereafter. In contrast, in vitro cultures of PBMC of four rhesus macaques were not susceptible to infection with SHIV9466.33. Conclusion:SHIV9466.33 containing an HIV-1 subtype E envelope displayed tropism for baboon PBMC but not for rhesus macaque PBMC. This chimeric virus established infection and induced antiviral antibodies in baboons inoculated by the intravenous route with cell-free virus. Thus, infection of baboons with SHIV9466.33 will serve as an important animal model for future studies of HIV-1 vaccine efficacy.
Loss of AP-2alpha results in deregulation of E-cadherin and MMP-9 and an increase in tumorigenicity of colon cancer cells in vivo.

Activator protein-2 (AP-2) is a transcription factor that regulates proliferation and differentiation in mammalian cells and has been implicated in the acquisition of the metastatic phenotype in several types of cancer. Herein, we examine the role of AP-2alpha in colon cancer progression. We provide evidence for the lack of AP-2alpha expression in the late stages of colon cancer cells. Re-expression of the AP-2alpha gene in the AP-2alpha-negative SW480 colon cancer cells suppressed their tumorigenicity following orthotopic injection into the cecal wall of nude mice. The inhibition of tumor growth could be attributed to the increased expression of E-cadherin and decreased expression and activity of matrix-metalloproteinase-9 (MMP-9) in the transfected cells, as well as a substantial loss of their in vitro invasive properties. Conversely, targeting constitutive expression of AP-2alpha in AP-2-positive KM12C colon cancer cells with small interfering RNA resulted in an increase in their invasive potential, downregulation of E-cadherin and increased expression of MMP-9. In SW480 cells, re-expression of AP-2alpha resulted in a fourfold increase in the activity of E-cadherin promoter, and a 5-14-fold decrease in the activity of MMP-9 promoter, indicating transcriptional regulation of these genes by AP-2alpha. Chromatin immunoprecipitation assay showed that re-expressed AP-2alpha directly binds to the promoter of E-cadherin, where it has been previously reported to act as a transcriptional activator. Furthermore, chromatin immunoprecipitation assay revealed AP-2alpha binding to the MMP-9 promoter, which ensued by decreased binding of transcription factor Sp-1 and changes in the recruitment of transcription factors to a distal AP-1 element, thus, contributing to the overall downregulation of MMP-9 promoter activity. Collectively, our data provide evidence that AP-2alpha acts as a tumor suppressor gene in colon cancer.
Heart failure trials on pharmacological therapy in 2015: lessons learned and future outlook

ABSTRACT Much progress in the medical therapy of chronic heart failure (HF) has been made in the last decades. The last was the introduction of a new treatment strategy based on the combination of the neprilysin inhibitor sacubitril and the angiotensin receptor blocker (ARB) valsartan into the pharmacological armamentarium, as reported in the PARADIGM-HF trial and its ancillary analyses. On the other hand, in the acute setting only scant progress in pharmacological treatments has been achieved, and most published data are based on observational studies or expert opinion. This review critically presents and discusses the most intriguing evidence from clinical trials in HF published in 2015. In particular, we focused on chronic HF with reduced ejection fraction and its comorbidities, while worsening HF or acute decompensated HF were more synthetically treated.
Facial Nerve Monitoring during Parotidectomy

Objectives To determine the effectiveness of intraoperative facial nerve monitoring (FNM) in preventing immediate and permanent postoperative facial nerve weakness in patients undergoing primary parotidectomy. Data Sources PubMed-NCBI database from 1970 to 2014. Review Methods A systematic review and meta-analysis of the literature was conducted. Acceptable studies included controlled series that evaluated facial nerve function following primary parotidectomy with or without FNM (intraoperative nerve monitor vs control). Primary and secondary end points were defined as immediate postoperative and permanent facial nerve weakness (House-Brackmann score, ≥2), respectively. Results After a review of 1414 potential publications, 7 articles met inclusion criteria, with a total of 546 patients included in the final meta-analysis. The incidence of immediate postoperative weakness following parotidectomy was significantly lower in the FNM group compared to the unmonitored group (22.5% vs 34.9%; P = .001). The incidence of permanent weakness was not statistically different in the long term (3.9% vs 7.1%; P = .18). The number of monitored cases needed to prevent 1 incidence of immediate postoperative facial nerve weakness was 9, given an absolute risk reduction of 11.7% This corresponded to a 47% decrease in the incidence of immediate facial nerve dysfunction (odds ratio, 0.53; 95% CI, 0.35 to 0.79; P = .002). Conclusion In primary cases of parotidectomy, intraoperative FNM decreases the risk of immediate postoperative facial nerve weakness but does not appear to influence the final outcome of permanent facial nerve weakness.
A peptide inhibitor derived from p55PIK phosphatidylinositol 3-kinase regulatory subunit: a novel cancer therapy

p55PIK, a regulatory subunit of phosphatidylinositol 3-kinase (PI3K), specifically interacts with retinoblastoma protein (Rb) through the unique NH2 terminus of p55PIK, N24. This interaction is critical for cell proliferation and cell cycle progression. To examine p55PIK as a potential target for cancer therapy, we generated an adenovirus expressing N24 (Ad-N24-GFP) and studied its effects on the proliferation of cultured cancer cells, including human colon (HT29) and thyroid (FTC236) cancer cells. Ad-N24-GFP blocked cell proliferation and induced cell cycle arrest in all cancer cell lines tested. N24 induced cell cycle arrest at G0-G1 phase in cell lines that expressed Rb. Interestingly, N24 inhibited cell proliferation by blocking cell cycle transition at both S and G2-M phases in FTC236 cells, which did not express Rb. When Rb was knocked down by short hairpin RNA in HT29 cells, N24 also inhibited cell cycle progression at S and G2-M phases, suggesting that p55PIK regulates cell cycle progression by Rb-dependent and Rb-independent mechanisms. Finally, Ad-N24-GFP markedly decreased the growth of xenograft tumors derived from HT29 and FTC236 cancer cells in athymic nude mice. Our data strongly suggest that N24 peptide is an effective anticancer therapy, which specifically inhibits PI3K signaling pathways mediated by p55PIK. Moreover, they show that the regulatory subunit of an enzyme, in addition to its catalytic subunit, can be an important target for drug development. [Mol Cancer Ther 2008;07(12):3719–28]
Position paper of the EAACI: food allergy due to immunological cross‐reactions with common inhalant allergens

In older children, adolescents, and adults, a substantial part of all IgE‐mediated food allergies is caused by cross‐reacting allergenic structures shared by inhalants and foods. IgE stimulated by a cross‐reactive inhalant allergen can result in diverse patterns of allergic reactions to various foods. Local, mild, or severe systemic reactions may occur already after the first consumption of a food containing a cross‐reactive allergen. In clinical practice, clinically relevant sensitizations are elucidated by skin prick testing or by the determination of specific IgE in vitro. Component‐resolved diagnosis may help to reach a diagnosis and may predict the risk of a systemic reaction. Allergy needs to be confirmed in cases of unclear history by oral challenge tests. The therapeutic potential of allergen immunotherapy with inhalant allergens in pollen‐related food allergy is not clear, and more placebo‐controlled studies are needed. As we are facing an increasing incidence of pollen allergies, a shift in sensitization patterns and changes in nutritional habits, and the occurrence of new, so far unknown allergies due to cross‐reactions are expected.