Miracle-dz/UniFAR-FTUs huggingface dataset:
Liver transplantation and alcoholics: is the glass half full or half empty?

See article on page 421 Over the past 15 years, opinion regarding the suitability of alcoholic patients for liver transplantation has fluctuated from overt disapproval to optimism that liver transplantation might have a beneficial effect on alcoholic behaviour. The former view was evaluated by an opinion survey among the general population, general practitioners and hospital specialists in Great Britain, in which the vignette of an alcoholic in need of liver transplant was consistently rated as justifying a low priority.1 The origin of optimism about the salutary effects of transplantation on alcoholic relapse came from Thomas Starzl, who coined the aphorism that, “liver transplantation was the ultimate sobering experience”. 2The current status of liver transplantation for alcoholic liver disease rests somewhere between these two extremes. Alcoholic liver disease is a common diagnosis among patients selected for liver transplantation in North America and Europe. It often occurs in conjunction with chronic hepatitis C infection. All transplant programmes try to identify patients who will remain abstinent, although how best to achieve this end is less certain. The study by Pageaux et al , in this issue (see page 421), is unusual in not including psychiatry as part of the pretransplant assessment.4 The requirement for a fixed period of abstinence, the so called six …
Antithrombin-mediated inhibition of factor VIIa-tissue factor complex by the synthetic pentasaccharide representing the heparin binding site to antithrombin.

We examined the effect of the synthetic pentasaccharide representing the minimal binding site of heparin to antithrombin on the antithrombin-mediated inactivation of factor VIIa bound to tissue factor. This effect was compared to the effect of unfractionated heparin. Using purified recombinant human coagulation factors and either a clotting or an amidolytic assay for the determination of the residual activity of factor VIIa, we showed that the pentasaccharide was an efficient antithrombin-dependent inhibitor of the coagulant activity of tissue factor-factor VIIa complex. In our experimental conditions, assuming a mean MW of 14,000 for heparin, the molar pseudo-first order rate constants for ATIII-mediated FVIIa inhibition by ATIII-binding heparin and by the synthetic pentasaccharide were found to be similar with respective values of 104,000 +/- 10,500 min-1 and 112,000 +/- 12,000 min-1 (mean +/- s.e.m., n = 3).
Effects of duloxetine, a combined serotonin and norepinephrine reuptake inhibitor, on central neural control of lower urinary tract function in the chloralose-anesthetized female cat.

Because all three components of lower urinary tract control (parasympathetic, sympathetic and somatic) are intimately associated with serotonin (5-hydroxytryptamine [5HT])- and norepinephrine (NE)- containing terminals and receptors, in the present study, we examined the effects of increasing extracellular levels of 5HT and NE with duloxetine, a 5HT and NE reuptake inhibitor, on lower urinary tract function under "normal" or nonirritated conditions (transvesical infusion of saline) and in a model of bladder irritation (i.e., transvesical infusion of 0.5% acetic acid) in chloralose-anesthetized cats. Irritation reduced bladder capacity (to 20% of control) and produced insignificant increases in periurethral electromyographic (EMG) activity compared with nonirritated control animals. Duloxetine produced insignificant increases in bladder capacity and sphincter EMG activity when administered under nonirritated bladder conditions. However, this duloxetine "pretreatment" did prevent the typical acetic acid-induced reductions in bladder capacity and unmasked a marked activation of sphincter EMG activity on acetic acid infusion (by 8-fold). Furthermore, when administered initially under irritated bladder conditions, duloxetine produced dose-dependent increases in bladder capacity (by 5-fold) and increased periurethral striated muscle EMG activity (by 8-fold). The effects on bladder activity were due to central mechanisms since bladder contractions evoked by direct electrical stimulation of efferent fibers in the pelvic nerve were not effected by duloxetine. The effects of duloxetine on bladder capacity were antagonized by methiothepin, a non-selective 5HT receptor antagonist, but not by the other 5HT and NE receptor antagonists examined: LY53857, a 5HT2 antagonist; prazosin, an alpha-1-adrenergic receptor antagonist; idazoxan, an alpha-2-adrenergic receptor antagonist; or propranolol, a beta-adrenergic receptor antagonist. The facilitatory effects of duloxetine on periurethral sphincter EMG were significantly antagonized to various degrees by methiothepin, LY53857 and prazosin but not by idazoxan or propranolol. These results indicate that duloxetine, through inhibition of 5HT and NE reuptake, has weak effects under normal conditions. However, under conditions of bladder irritation, duloxetine suppresses bladder activity through 5HT receptor mechanisms and enhances external urethral sphincter activity through 5HT2 and alpha-1-adrenergic mechanisms.
Effect of Nerve Stimulation Use on the Success Rate of Ultrasound-Guided Subsartorial Saphenous Nerve Block: A Randomized Controlled Trial

Background and Objectives Ultrasound-guided subsartorial saphenous nerve block is commonly used to provide complete surgical anesthesia of the foot and ankle in combination with a popliteal sciatic nerve block. However, in part owing to its small caliber and absence of a prominent vascular landmark in the subsartorial plane distal to the adductor canal, the saphenous nerve is more difficult to reliably block than the sciatic nerve in the popliteal fossa. Although the saphenous nerve is a sensory nerve only, neurostimulation can be used to elicit a “tapping” sensation on the anteromedial aspect of the lower leg extending toward the medial malleolus. Our objective was to test the hypothesis that the addition of nerve stimulation use to an ultrasound (US)-guided technique will increase the success rate of subsartorial saphenous nerve block. Methods With institutional human ethics board approval and participants' written informed consent, we enrolled 80 patients undergoing foot and ankle surgery in a randomized, single-blinded, parallel-group clinical trial. Patients were randomly assigned to receive US-guided subsartorial saphenous nerve block either alone (US group) or with the use of additional nerve stimulation (NS group; time limit, 5 minutes). For saphenous nerve blockade, all patients received 10 mL of 0.5% ropivacaine. The primary end point was complete absence of sensation to pinprick at 30 minutes at two different anatomic areas in the distribution of the saphenous nerve (2 cm proximal to the medial malleolus and 10 cm distal to the medial tibial condyle). Secondary end points included decreased sensation at 30 minutes and block failure (normal sensation) at 30 minutes. This trial was registered at ClinicalTrials.gov: NCT02382744. Results All 80 patients completed the trial (40 patients in each group). Twenty-two patients (55%) in the NS group versus 18 (45%) in the US group had complete absence of sensation to pinprick at 30 minutes at both anatomic areas of assessment (Fisher exact test, P = 0.25 [one sided]; 95% confidence interval of difference in proportions, −11.9% to 31.9%). The percentages of patients with any evidence of block (decreased or complete absence of sensation) at both areas at 30 minutes were 92.5% (NS) and 97.5% (US), respectively (P = 0.62 [two sided]); corresponding failure rates (normal sensation) were 7.5% (NS) and 2.5% (US). In the NS group, no response in the saphenous nerve distribution was elicited within 5 minutes of stimulation time limit in 20% of patients (n = 8). All of the patients in the NS group with normal sensation at 30 minutes (n = 3) were among this subcohort. Conclusions The addition of the use of nerve stimulation did not improve the success rate of US-guided subsartorial saphenous nerve block. However, in the NS group, an inability to elicit a “tapping” sensation in the saphenous nerve distribution was associated with block failure.
The role of allergen‐specific T cells in the allergic immune response: relevance to allergy vaccination

Recent research has elucidated many of the immunologic mechanisms that underlie atopic allergies. In particular, it has become clear that the role of CD4+ allergen‐specific T cells is crucial for the induction of IgE and eosinophilia, factors that mediate the immediate hypersensitivity reaction and late‐phase responses, respectively. Therefore, the reactivity patterns and activation requirements of allergen‐specific T cells are important parameters for understanding and manipulating the allergic immune response. This review addresses these issues and discusses their relevance to the further development of allergy vaccines.
A prospective, controlled clinical trial evaluating the clinical and radiological outcome after 3 years of immediately placed implants in sockets exhibiting periapical pathology.

OBJECTIVES the aim of the present study was to compare the clinical and radiological outcome of immediately placed implants in sockets with or without periapical pathology 3 years after implant placement. MATERIALS AND METHODS twenty-nine patients with immediate implant placement were clinically and radiologically followed 3 years after implant placement (test group: 16 patients without periapical pathology, control group: 13 patients with periapical pathologies). Clinical (full-mouth bleeding score, full-mouth plaque score, clinical attachment level measurements and width of keratinized mucosa buccaly of the implant) and radiological parameters (vertical distance from the implant shoulder to the first bone-to-implant contact [IS-BIC]) were assessed. Both 95% confidence intervals, as well as results of statistical tests (one-sample, two-sample and paired t-test) were provided. RESULTS the implant survival rate was 100% for all 29 implants after 3 years. The clinical and radiological parameters showed no statistically significant difference between the test and the control group at 3 years (two-sample t-test). The IS-BIC was between 1.54 ± 0.88 mm (mesial, test) and 1.69 ± 0.92 mm (distal, test). Between the 1- and 3-year visit the IS-BIC increased in both groups significantly on one side of the implant: 0.30 ± 0.37 mm (mesial, test) and 0.33 ± 0.43 mm (distal, control) (one-sample t-test). None of the 13 examined radiographs of implants immediately placed in sockets with periapical pathologies revealed retrograde peri-implantitis after 3 years. CONCLUSION it is concluded within the limitations of this study, that after careful debridement of the extraction socket, immediate placement of implants into sites with periapical pathologies can be a successful treatment modality for at least 3 years with no disadvantages in clinical and radiological parameters to immediately placed implants into healthy sockets.
CAREX Nicaragua and Panama: Worker Exposures to Carcinogenic Substances and Pesticides

Abstract This study provides data on numbers of workers exposed at work to selected carcinogens and pesticides in Nicaragua (35 substances) and Panama (31), based on a modification of the CAREX data system. Population censuses provided industry- and sex-specific workforce numbers. The activity- and sex-specific proportions of exposed workers were estimated by experts from governmental agencies, workers' organizations, and employers' representatives. Finally, the numbers of those occupied in each activity/sex category were multiplied by the proportions of those exposed in the same categories, yielding numbers of those exposed in these categories for each agent. The study revealed high proportions (> 9%) of occupationally exposed workers in both countries for solar radiation and diesel engine emissions; environmental tobacco smoke in Panama; and some pesticides in Nicaragua. A high proportion of exposed was found for men for lead (12%), silica dust (10%), and hexavalent chromium (10%) in Panama.
Establishing cause of maternal death in Malawi via facility‐based review and application of the ICD‐MM classification

Maternal death review (MDR) is an accepted process that is implemented across Malawi and ‘underlying cause of death’ is assigned by healthcare providers using a standard MDR form. Mixed‐methods approach. Key informant interviews with eight stakeholders involved in MDR. Secondary analysis of MDR forms for 54 maternal deaths. Comparison of assigned cause of death by healthcare providers conducting MDR at health facility level with cause assigned by researchers using the International Classification of Diseases Maternal Mortality (ICD‐MM) classification. MDR teams, analysts and policymakers reported facing challenges in completing the forms, analysing and using information. The concepts of underlying (primary) and contributing (secondary) causes of death are often misunderstood. Healthcare providers using only MDR forms reported cause of death as non‐obstetric complications in 39.6% and pregnancy‐related infection in 11.3% of cases. For 30.2% of cases, no clear clinical cause of death was recorded. The most commonly assigned underlying cause of death using ICD‐MM was obstetric haemorrhage (32.1%), non‐obstetric complications (24.5%) and pregnancy‐related infection (22.6%). There was poor agreement between cause(s) of maternal death assigned by healthcare providers in the field and trained researchers using the new ICD‐MM classification (κ statistic; 0.219). The majority of cases could be reclassified using the ICD‐MM and this provided a more specific cause of death. A more structured and user‐friendly MDR form is required. Accurate classification of cause of death is important. Dissemination of, and training in the use of the new ICD‐MM classification system will be helpful to healthcare providers conducting MDR in Malawi.
An Empirical Evaluation of Knowledge Compilation by Theory Approximation

Computational efficiency is a central concern in the design of knowledge representation systems. Compiling a knowledgebase into a more tractable form has been suggested as a way around the inherent intractability of many representation formalisms. Because not all theories can be put into an equivalent tractable form, Selman and Kautz (1991) have suggested compiling a theory into upper and lower bounds (one logically weaker, the other logical stronger) that approximate the original information. A central question in this approach is how well the bounds capture the original knowledge. This question is inherently empirical. We present a detailed empirical evaluation of the compilation of two kinds of theories: computationally challenging randomly generated theories, and propositional encodings of planning problems. Our results show that one can answer a very high percentage of queries even using unit clause bounds, which are much easier to compute than more general tractable approximations. Furthermore, we demonstrate that many of the queries that can be answered by the bounds are expensive to answer using only the original theory: in other words, knowledge compilation does not just "skim off" easy queries. In fact, we show substantial total computational savings in using the bounds together with the original theory to answer all queries (with no errors) from a large benchmark set, over using the original theory alone. This study suggests that knowledge compilation may indeed be a practical approach for dealing with intractability in knowledge representation systems.
Improved broadband electrical detection of individual biological cells

Based on a homemade probe station on top of an inverted microscope for simultaneous microwave measurement and visual validation, broadband detection of live Jurkat cells was successfully extended from 2-3.5 GHz to 0.5-20 GHz with comparable sensitivity and reproducibility. With a carefully optimized coplanar waveguide, closely spaced microwave probes, and frequent calibrations, reference planes were established next to the microfluidic channel, which resulted in smooth and well-behaved scattering parameters without spurious resonances. From the measured scattering parameters, the extracted cytoplasm resistance of 190 kΩ was consistent with the previously reported value but validated over a much wider bandwidth.
Stakeholders’ Expectations in Urban Renewal Projects in China : A Key Step towards Sustainability

China’s fast growth of economy and urbanization have driven large-scale urban renewal projects, thus triggering a wide spectrum of unsustainable problems. Little research has systematically explored the stakeholders’ expectations in urban renewal projects in China. A deeper understanding of the divergent interests and expectations of the key stakeholder groups is an important step towards sustainable urban renewal. This paper aims to analyze the stakeholders’ expectations on urban renewal projects. Eighteen factors are identified and compared among the main stakeholders: government sectors, consulting parties, the general public and affected residents in both redevelopment and rehabilitation projects, using questionnaire survey and interviews in Chongqing, China. The results reveal that there exist enormous differences of opinions and interests among stakeholders in all economic, environmental and social aspects. To achieve sustainable urban renewal in China, the governments ought to reconsider what the “public interest” stands for. In-situ residents should be understood and treated differently, based on the type of projects. An effective dialogue mechanism as well as supportive administrative and legal system should be established. Moreover, urban-renewal-related education and publicity should be a long-term strategy to change current awareness of different stakeholders, by improving their skill and willingness to participate.
Structural and quantum chemical factors affecting mutagenic potency of aminoimidazo‐azaarenes

A set of 16 mutagenic aminoimidazo‐azaarenes, including four that have been isolated from cooked foods and identified as bacterial mutagens and rodent carcinogens, was selected from a larger series previously published [Hatch et al. (1991): Environ Mol Mutagen 17:4–19] for an in‐depth structure‐activity study using computational methods. Structural features believed to affect mutagenic potency were tabulated. Molecular orbital energies and other electronic properties of these compounds were calculated using Hückel, semiempirical AM1, and ab initio quantum mechanical methods. Factor interrelationships were studied by multiple linear regression and canonical correlation analyses. Our goal was an improved understanding of the chemical basis of mutagenicity for this class of heterocyclic amines. The major findings were as follows: 1) mutagenic potency is related to the size of the aromatic ring system; 2) potency is enhanced by the presence and location of an N‐methyl group; 3) potency is enhanced by addition of ring nitrogen atoms in pyridine, quinoline, and quinoxaline configurations; 4) potency is inversely related to the energy of the LUMO (lowest unoccupied molecular orbital) of the parent amines; 5) potency is directly, though weakly, related to the LUMO energy of the derived nitrenium ions; and 6) the calculated thermodynamic stability of the nitrenium ions (relative to the parent amine) is directly correlated with nitrenium LUMO energy and with the negative charge on the exocyclic nitrogen atom. Although this study raises several intriguing issues relating mutagenicity to chemical properties, further study will be required to determine the plausibility of the nitrenium ion as the ultimate mutagen for binding to DNA. © 1996 Wiley‐Liss, Inc.
Tumor Necrosis Factor Alpha Inhibits Type I Collagen Synthesis through Repressive CCAAT/Enhancer-Binding Proteins

ABSTRACT Extracellular matrix (ECM) formation and remodeling are critical processes for proper morphogenesis, organogenesis, and tissue repair. The proinflammatory cytokine tumor necrosis factor alpha (TNF-α) inhibits ECM accumulation by stimulating the expression of matrix proteolytic enzymes and by downregulating the deposition of structural macromolecules such as type I collagen. Stimulation of ECM degradation has been linked to prolonged activation of jun gene expression by the cytokine. Here we demonstrate that TNF-α inhibits transcription of the gene coding for the α2 chain of type I collagen [α2(I) collagen] in cultured fibroblasts by stimulating the synthesis and binding of repressive CCAAT/enhancer proteins (C/EBPs) to a previously identified TNF-α-responsive element. This conclusion was based on the concomitant identification of C/EBPβ and C/EBPδ as TNF-α-induced factors by biochemical purification and expression library screening. It was further supported by the ability of the C/EBP-specific dominant-negative (DN) protein to block TNF-α inhibition of α2(I) collagen but not TNF-α stimulation of the MMP-13 protease. The DN protein also blocked TNF-α downregulation of the gene coding for the α1 chain of type I collagen. The study therefore implicates repressive C/EBPs in the TNF-α-induced signaling pathway that controls ECM formation and remodeling.
Insulin sensitivity after metformin suspension in normal-weight women with polycystic ovary syndrome.

CONTEXT To date, the metabolic effects of the long-term metformin administration in anovulatory patients with polycystic ovary syndrome (PCOS) are known, whereas few data are available on the effects of its suspension. OBJECTIVE The objective of the study was to evaluate the effects of metformin suspension on insulin sensitivity in PCOS patients. DESIGN This was a prospective, randomized, placebo-controlled study. SETTING The study was conducted at the University "Magna Graecia" of Catanzaro, Italy. PATIENTS Patients included 30 normal-weight anovulatory PCOS women and 10 age- and body mass index-matched healthy controls. INTERVENTION PCOS patients were randomized to receive 1700 mg daily metformin (metformin group) or placebo tables (placebo group) for 12 months, whereas no treatment was administered in healthy women (control group). MAIN OUTCOME MEASURES Clinical, endocrine, and metabolic profile and clamp insulin sensitivity index were evaluated at study entry and after 6, 12, 18, and 24 months. RESULTS At baseline, the clamp insulin sensitivity index resulted significantly different (P < 0.05) in PCOS patients in comparison with healthy controls, without difference between metformin and placebo groups. During treatment, the clamp insulin sensitivity index was significantly improved (P < 0.05) in the metformin group in comparison with baseline and placebo group, without significant differences between the 6- and 12-month assessments. At 6 and 12 months after treatment suspension, in the metformin group, insulin sensitivity index significantly (P < 0.05) worsened in comparison with that observed at baseline and during treatment and with that observed in the placebo and control groups. CONCLUSION In normal-weight anovulatory PCOS patients, long-term metformin administration exerts beneficial effects on peripheral insulin sensitivity. Furthermore, this effect disappears at treatment suspension.