Miracle-dz/UniFAR-FTUs huggingface dataset:
Higher protein intake strategies in human milk fortification for preterms infants feeding. Auxological and neurodevelopmental outcome.

Postnatal growth restriction and failure to thrive still remain a major problem in Extremely Low Birth Weight (ELBW) infants . The goal for the nutritional care of these infants is to achieve rate of growth similar to those of the fetus in utero at the equivalent gestational age. Human milk fortified remains the best food for all these preterms. Two groups of preterm of weight 580-1250 g and gestational age 23-32 wk, were fed with different protein intake in the human/maternal milk fortified ( 3,5 g Kg-1 per day and 4,8 g Kg-1 per day in the control and intervention group respectively). The feeding tolerance, intrahospital growth, neurological outcome and anthropometric data until 12 months of corrected age, were evaluated. The protein supplemented group (PSG) showed an intrahospital highter growth rate ( mostly in head circumference, p 0,02, and length growth, p 0,04) only in the preterms with 580-980 g and 23-30 wk. In the same preterms, Griffith Development Mental Score at 3 and 12 months corrected age showed higher score than in the control group in the Performance (p 0,04) and Hearing/Language (p 0,03) items. The auxological evaluation in the postdischarge period showed in the PSG group mean z-score values for length higher than those in the control group at 9 (p 0,04) months of corrected age.
Drill core LB‐08A, Bosumtwi impact structure, Ghana: Petrographic and shock metamorphic studies of material from the central uplift

Abstract— During a recent drilling project sponsored by the International Continental Scientific Drilling Progam (ICDP), two boreholes (LB‐07A and LB‐08A) were drilled into the crater fill of the Bosumtwi impact structure and the underlying basement, into the deep crater moat and the outer flank of the central uplift, respectively. The Bosumtwi impact structure in Ghana (West Africa), which is 10.5 km in diameter and 1.07 Myr old, is largely filled by Lake Bosumtwi.
Effects of Adrenomedullin, C‐type Natriuretic Peptide, and Parathyroid Hormone‐Related Peptide on Calcification in Cultured Rat Vascular Smooth Muscle Cells

&NA; To clarify the regulating mechanism of vascular calcification, the investigators observed the effects of three vasoactive peptides, adrenomedullin (ADM), C‐type natriuretic peptide (CNP), and parathyroid hormone‐related peptide (PTHrP) on calcification in rat vascular smooth muscle cells (VSMCs). Beta‐glycerophosphate stimulated growth and calcification in VSMCs. Adrenomedullin and CNP lowered beta‐glycerophosphate‐induced increase in VSMC growth. All three vasoactive peptides attenuated the increases of45Ca accumulation, calcium content, and alkaline phosphatase activity in calcified VSMCs. As for comparing the inhibitory effects, the strongest was PTHrP. Both ADM and PTHrP increased cyclic adenosine monophosphate (cAMP) content in calcified VSMCs, but CNP upregulated cyclic guanosine monophosphate (cGMP) content. The PKA inhibitor PKAI completely reversed the inhibition of ADM on cell growth and all inhibitory effects of PTHrP on the parameters of calcification. The PKG inhibitor H8, however, strongly antagonized all the inhibitory effects of CNP on calcification. These data suggested that beta‐glycerophosphate‐induced calcification in VSMCs was inhibited by ADM, CNP, and PTHrP. Adrenomedullin and PTHrP inhibited VSMC calcification partially through the cAMP/PKA pathway, whereas CNP inhibited VSMC calcification through the cGMP/PKG pathway. This study could be of help in understanding the pathogenesis of vascular calcification, and providing new target for clinical treatment of cardiovascular diseases associated with vascular calcification.
Comparison of disordered swallowing patterns in patients with recurrent cortical/subcortical stroke and first-time brainstem stroke.

OBJECTIVE To describe the disordered swallowing patterns in recurrent cortical/subcortical stroke and first-time brainstem stroke. DESIGN A retrospective study. SUBJECTS Forty-seven consecutive patients, 28 with recurrent cortical/subcortical stroke and 19 with first-time brainstem stroke, referred for dysphagic evaluation to the rehabilitation department of a medical centre. METHODS Thirty-five male and 12 female patients with a mean age of 62.0+/-11.5 years were included. The median post-stroke duration was 17.0 days. The records of clinical examination and a videofluoroscopic study of swallowing were collected through chart review. The percentages of abnormalities seen at clinical examination and videofluoroscopic swallowing study between recurrent cortical/subcortical stroke and first-time brainstem stroke patients were compared using a chi-square test. RESULTS The recurrent cortical/subcortical patients suffered from a higher rate of impaired tongue movement, drooling and aphasia at clinical examination and a higher percentage of swallowing abnormalities in oral-preparatory and oral phases in the videofluoroscopic swallowing study. The abnormal videofluoroscopic findings in first-time brainstem stroke patients predominantly occurred in the pharyngeal phase. Both groups had more difficulties swallowing thin barium than they did swallowing the thick and paste barium. CONCLUSION The recurrent cortical/subcortical stroke and first-time brainstem stroke patients show different manifestations in some parameters of both clinical examination and videofluoroscopic swallowing study.
White matter differences in euthymic bipolar I disorder: a combined magnetic resonance imaging and diffusion tensor imaging voxel‐based study

A broad range of subtle and markedly heterogenous neuroanatomical abnormalities of grey matter and white matter have been reported in bipolar disorder. Euthymic bipolar disorder patients represent a clinically homogenous group in which to identify trait‐based biomarkers of bipolar disorder. In this study, we sought to clarify the nature and extent of neuroanatomical differences in a large, clinically homogeneous group of euthymic bipolar disorder patients.
Implications of the Functional Integration of Adult-Born Hippocampal Neurons in Anxiety-Depression Disorders

Adult neurogenesis in the dentate gyrus of the hippocampus has gained considerable attention as a cellular substrate for both the pathophysiology and treatment of depression. Overall, the studies of adult hippocampal neurogenesis are still in their infancy because most of them explore only one stage of this process. Importantly, given the built-in homeostatic mechanisms that act at each stage during the progression from stem cells to mature neurons (proliferation, differentiation, maturation, survival), it is very difficult to extrapolate the efficiency of a drug on adult neurogenesis from analysis of one stage alone. Here, we review the most significant data on hippocampal neurogenesis, focusing on the importance of studying each stage of adult hippocampal neurogenesis and also on the importance of choosing the appropriate mouse strain to perform the experiment. Specifically, strains with a high number of basal proliferating cells in the dentate gyrus of the hippocampus should be used only under stressed conditions to detect the effects of antidepressants on adult neurogenesis. We also discuss how adult hippocampal neurogenesis could be involved in affective state disorders such as depression and anxiety. Finally, we reveal that the behavioral effects of fluoxetine are mediated through both neurogenesis-dependent and -independent actions.
Characterization of the signal transduction pathway mediating gamma ray-induced inhibition of DNA synthesis in human cells: indirect evidence for involvement of calmodulin but not protein kinase C nor p53.

Cultured cells from patients inheriting the rare cancer-prone and radiotherapy-sensitive disorder ataxia-telangiectasia (A-T) exhibit anomalies in cell cycle control and protein kinase C (PKC)-mediated upregulation of p53 protein following exposure to ionizing radiation. It remains unclear, however, as to whether this irregularity in a p53-dependent signal transduction pathway controlling the G1/S checkpoint is causally linked to the most consistent molecular hallmark of A-T-namely, marked attenuation in the inhibition of replicative DNA synthesis at early times (< or = 2 h) after irradiation [radioresistant DNA synthesis (RDS)]. We report here that treatment of normal human fibroblast strains with inhibitors of calmodulin (CaM) (i.e. W7 and W13) and CaM-dependent protein kinases II and IV (i.e. KN62) prior to radiation exposure elicits an 'A-T-like' RDS phenotype, whereas treatment with PKC inhibitors (e.g. staurosporine) does not produce this response. Moreover, at 1 h post-gamma irradiation A-T fibroblasts undergo normal induction of p53 protein while exhibiting the RDS trait. At later times (e.g. 4 h) following irradiation, however, these A-T cells contain abnormally low levels of p53 protein, as do their lymphoblastoid cell line counterparts during the entire post-gamma ray incubation period. On the other hand, human cells which either lack the p53 gene completely (i.e. HL60 leukemia cells) or harbor a germline mutation in the gene (i.e. Li-Fraumeni syndrome cells) shut down their DNA replication machinery normally upon sustaining radiation damage. We thus conclude that the transitory delay in DNA synthesis routinely experienced by human cells in the face of radiation injury is mediated through a CaM-dependent regulatory cascade which involves neither PKC nor p53 protein. Accordingly, A-T cells appear to be malfunctional in at least two distinct radiation-responsive signalling pathways, one regulating the G1/S checkpoint and governed by p53 and PKC and another controlling passage through S phase and requiring CaM.
Impact of the left ventricular mass index on the outcomes of severe aortic stenosis

Objective To elucidate the factors associated with high left ventricular mass index (LVMI) and to test the hypothesis that high LVMI is associated with worse outcome in severe aortic stenosis (AS). Methods We analysed 3282 patients with LVMI data in a retrospective multicentre registry enrolling consecutive patients with severe AS in Japan. The management strategy, conservative or initial aortic valve replacement (AVR), was decided by the attending physician. High LVMI was defined as LVMI >115 g/m2 for males and >95 g/m2 for females. We compared the risk between normal and high LVMI in the primary outcome measures compromising aortic valve-related death and heart failure hospitalisation. Results Age was mean 77 (SD 9.6) years and peak aortic jet velocity (Vmax) was 4.1 (0.9) m/s. The factors associated with high LVMI (n=2374) included female, body mass index ≥22, absence of dyslipidemia, left ventricular ejection fraction <50%, Vmax ≥4 m/s, regurgitant valvular disease, hypertension, anaemia and end-stage renal disease. In the conservative management cohort (normal LVMI: n=691, high LVMI: n=1480), the excess adjusted 5-year risk of high LVMI was significant (HR: 1.53, 95% CI 1.26 to 1.85, p<0.001). In the initial AVR cohort (normal LVMI: n=217, high LVMI: n=894), the risk did not differ significantly between the two groups (HR: 0.96, 95% CI 0.60 to 1.55, p=0.88). There was a significant interaction between the initial treatment strategy and the risk of high LVMI (p=0.016). Conclusions The deleterious impact of high LVMI on outcome was observed in patients managed conservatively, but not observed in patients managed with initial AVR. Trial registration number UMIN000012140; Post-results.
Spatio–Temporal Clustering and Active Learning for Change Classification in Satellite Image Time Series

Active learning (AL) has emerged as a versatile approach to reduce the training data required for remote sensing image classification, but its use for the analysis of satellite image time series (SITS) has not been explored yet. This study targets to explore a new object-based framework for change detection in SITS, combining the state-of-the-art spatio-temporal clustering and the use of different machine learning algorithms. Indeed, this study aims at testing whether standard machine learning algorithms can detect changes in long time series and whether AL can improve the results compared to traditional supervised learning. The tested AL algorithms comprise random forest-based heuristics that use a combination of uncertainty and diversity criteria, and a classical SVM breaking ties heuristic. The different implementations are evaluated with two datasets that depict changes around the Arcachon basin (West of France) and around the city of Colmar (East of France) spanning over more than 20 years and comprising four change classes (urban sprawl, forest gain, forest loss, and other). The tests demonstrate that steeper learning curves can be obtained with AL when compared to supervised learning. However, the performance of different AL algorithms depends on the dataset.
Improved Short-term Outcomes of Laparoscopic Versus Open Resection for Colon and Rectal Cancer in an Area Health Service: A Multicenter Study

BACKGROUND: Evidence demonstrates short-term benefits of laparoscopic surgery for colon cancer. The situation for rectal cancer is less clear. OBJECTIVES: This review assessed the use and short-term outcomes of elective open and laparoscopic colon and rectal cancer resections within an area health service. DESIGN: This was a multicenter, retrospective review of a prospective database. SETTINGS: All elective colon and rectal cancer resections in the western zone of Sydney South West Area Health Service from 2001 until 2008 were included. PATIENTS: Included were 1721 patients who underwent either a laparoscopic colon (n = 434) or rectal (n = 157) resection or an open colon (n = 742) or rectal (n = 388) resection. MAIN OUTCOME MEASURES: Outcome measures included operating time, blood loss, adequacy of resection, conversion rate, intensive care unit admission, length of stay, and 26 acute postoperative complications. RESULTS: Patients were matched for age, sex, ASA, BMI, and tumor stage. Laparoscopic surgery increased in frequency. Fewer patients experienced a complication in both the laparoscopic colon (28.8 vs 54.4%; p < 0.0001) and rectal (41.4 vs 60.3%; p < 0.0001) group irrespective of age. Laparoscopic operating time for colon and rectal cancer was 24.1 minutes (p < 0.0001) and 25.8 minutes (p < 0.0001) longer, with a low conversion-to-open rate (6.5% and 8.3%; p = 0.44). Laparoscopic surgery resulted in fewer transfusions (0.4 vs 0.7units; p = 0.0028) and length of stay (7 vs 10 days; p = 0.0011) for colon cancers, and reduced intraoperative hemoglobin drop (20.5 vs 24.8; p = 0.029) and intensive care unit admissions (26.8 vs 36.3%; p = 0.032) for rectal cancers. LIMITATIONS: This was a nonrandomized study with rectal cancers more often resected with the open technique (71.2 vs 28.8%; p < 0.001). CONCLUSIONS: Within an area health service, elective laparoscopic resection for colon and rectal cancer had improved short-term outcomes in comparison with open surgery.
Protective effect of preconditioning on the injury associated to hepatic ischemia‐reperfusion in the rat: Role of nitric oxide and adenosine

The effects of ischemic preconditioning on rat liver integrity, as well as the implication of nitric oxide (NO) and adenosine in this process, has been evaluated. Preconditioning before ischemia‐reperfusion prevented the increases in alanine transaminase (ALT), aspartate transaminase (AST), and lactate dehydrogenase (LDH) levels, but did not modify blood flow. Adenosine or NO administration previous to hepatic ischemia‐reperfusion simulated the effect of preconditioning, whereas inhibition of adenosine or NO synthesis abolished the protective effect of hepatic preconditioning. Nevertheless, inhibition of adenosine and simultaneous administration of NO in preconditioned animals offered similar results to those found in the preconditioned group, indicating that, in the absence of adenosine, NO is able to maintain the preconditioning benefits. It is suggested that, in preconditioning, adenosine stimulates NO production to protect against the injury associated with ischemia‐reperfusion.
Folic acid pathway single nucleotide polymorphisms associated with methotrexate significant adverse events in United States veterans with rheumatoid arthritis.

OBJECTIVES Methotrexate (MTX) is the cornerstone medication in the treatment of rheumatoid arthritis (RA). We examined whether single nucleotide polymorphisms (SNPs) in enzymes of the folic acid pathway (folylpoly-gamma-glutamate synthetase [FPGS], gamma-glutamyl hydrolase [GGH], and methylenetetrahydrofolate reductase [MTHFR]) associate with significant adverse events (SigAE). METHODS Patients (n=319) enrolled in the Veterans Affairs RA (VARA) registry taking MTX were genotyped for HLA-DRB1-SE and the following SNPs: FPGS (rs7033913, rs10760503, rs10106), GGH (12548933, rs7010484, rs4617146, rs719235, rs11988534), MTHFR (rs1801131, rs1801133). AE were abstracted from the medical record using a structured instrument. SigAE were defined as an AE leading to MTX discontinuation. Covariates included: age, gender, race, RA antibody status, tobacco, RA disease duration between diagnosis and MTX course, Charlson-Deyo comorbidity index, glucocorticoids, use of prior RA medications, and mean 4-variable disease activity score. Cox regression was performed to determine factors associated with time-to-SigAE. A p-value ≤ 0.005 established significance in the final model. RESULTS The presence of ≥ 1 copy of the minor allele in MTHFR rs1801131 was associated with an increased hazard ratio (HR) of SigAE (HR 3.05, 95% CI 1.48-6.29, p-value 0.003 and HR 3.88, 95% CI 1.62-9.28, p-value 0.002 for heterozygotes and homozygotes for the minor allele, respectively). An interaction term, between FPGS rs7033913 heterozygotes and GGH rs11988534 homozygotes for the minor allele, had a p-value <0.0001. CONCLUSIONS RA subjects taking MTX may have decreased time-to-SigAE with ≥ 1 copy of the minor allele in MTHFR rs1801131. Further investigation is warranted, as these SNPs may indicate susceptibility to MTX toxicity.
The Intestinal Protozoan Parasite Entamoeba histolytica Contains 20 Cysteine Protease Genes, of Which Only a Small Subset Is Expressed during In Vitro Cultivation

ABSTRACT Cysteine proteases are known to be important pathogenicity factors of the protozoan parasite Entamoeba histolytica. So far, a total of eight genes coding for cysteine proteases have been identified in E. histolytica, two of which are absent in the closely related nonpathogenic species E. dispar. However, present knowledge is restricted to enzymes expressed during in vitro cultivation of the parasite, which might represent only a subset of the entire repertoire. Taking advantage of the current E. histolytica genome-sequencing efforts, we analyzed databases containing more than 99% of all ameba gene sequences for the presence of cysteine protease genes. A total of 20 full-length genes was identified (including all eight genes previously reported), which show 10 to 86% sequence identity. The various genes obviously originated from two separate ancestors since they form two distinct clades. Despite cathepsin B-like substrate specificities, all of the ameba polypeptides are structurally related to cathepsin L-like enzymes. None of the previously described enzymes but 7 of the 12 newly identified proteins are unique compared to cathepsins of higher eukaryotes in that they are predicted to have transmembrane or glycosylphosphatidylinositol anchor attachment domains. Southern blot analysis revealed that orthologous sequences for all of the newly identified proteases are present in E. dispar. Interestingly, the majority of the various cysteine protease genes are not expressed in E. histolytica or E. dispar trophozoites during in vitro cultivation. Therefore, it is likely that at least some of these enzymes are required for infection of the human host and/or for completion of the parasite life cycle.
Personality and clinical characteristics in patients with trichotillomania.

BACKGROUND Trichotillomania, a disorder of self-directed hair pulling, has been the subject of few systematic studies. Although personality characteristics and disorders are often noted to coexist with trichotillomania, no thorough assessment of comorbidity with DSM-III-R Axis II disorders has been published. The present study was conducted to evaluate personality disorders and other personality characteristics in a large outpatient population of trichotillomanics and to compare these findings with those in a nontrichotillomanic comparison group. METHOD Forty-eight outpatient female trichotillomanics were evaluated with the Structured Interview for DSM-III-R Personality Disorders (SIDP-R) and the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Personality disorders and personality cluster symptom scores from the SIDP-R and MMPI-2 scales were compared with those derived from a comparison group of 48 age-matched female outpatient psychiatric patients. RESULTS Forty-two percent of the trichotillomanic group met criteria for a personality disorder. The only statistically significant difference in frequency of diagnoses between the trichotillomanic and comparison groups was a greater frequency of borderline personality disorder in the comparison group. Trichotillomanics demonstrated significantly less SIDP-R cluster A personality symptoms as well as less depression and better psychological adjustment on the MMPI-2. CONCLUSION Our study suggests that no particular personality disorder or trait characterizes female trichotillomanics. Female trichotillomanics seeking psychiatric intervention appear to have better psychological adjustment and less psychopathology in general than other psychiatric outpatients.
Conservative Management of Infected Necrosis Complicating Severe Acute Pancreatitis

OBJECTIVES:Patients with severe necrotizing pancreatitis are at risk for infection, a major cause of morbidity and mortality. Most patients with infected pancreatic tissue require surgical intervention (necrosectomy), which is associated with high morbidity and mortality. A subset of these patients can be managed successfully with conservative management combined with prolonged courses of antibiotics.METHODS:Three cases of severe acute pancreatitis seen at our institution are described, in which the patients developed aspirate-proven pancreatic infections. The patients were nonetheless stable from a clinical standpoint and were treated with long courses of antibiotics known to penetrate the pancreas; emergent surgery was deferred.RESULTS:In two patients, surgery was completely avoided, with good clinical outcome. In the third patient, elective surgery was undertaken 12 wk after the episode of acute pancreatitis, to perform necrosectomy on organized pancreatic necrosis and to evaluate the patient’s biliary tree. There were no postoperative complications.CONCLUSIONS:A subset of patients with severe acute pancreatitis complicated by infection can be successfully managed with long term antibiotics and other supportive measures. High risk necrosectomy can, in some instances, be delayed or avoided entirely.