Miracle-dz/UniFAR-FTUs huggingface dataset:
Salivary microbiota reflects changes in gut microbiota in cirrhosis with hepatic encephalopathy

Altered gut microbiome is associated with systemic inflammation and cirrhosis decompensation. However, the correlation of the oral microbiome with inflammation in cirrhosis is unclear. Our aim was to evaluate the oral microbiome in cirrhosis and compare with stool microbiome. Outpatients with cirrhosis (with/without hepatic encephalopathy [HE]) and controls underwent stool/saliva microbiome analysis (for composition and function) and also systemic inflammatory evaluation. Ninety‐day liver‐related hospitalizations were recorded. Salivary inflammation was studied using T helper 1 cytokines/secretory immunoglobulin A (IgA), histatins and lysozyme in a subsequent group. A total of 102 patients with cirrhosis (43 previous HE) and 32 age‐matched controls were included. On principal component analysis (PCA), stool and saliva microbiome clustered far apart, showing differences between sites as a whole. In salivary microbiome, with previous HE, relative abundance of autochthonous families decreased whereas potentially pathogenic ones (Enterobacteriaceae, Enterococcaceae) increased in saliva. Endotoxin‐related predicted functions were significantly higher in cirrhotic saliva. In stool microbiome, relative autochthonous taxa abundance reduced in previous HE, along with increased Enterobacteriaceae and Enterococcaceae. Cirrhotic stool microbiota demonstrated a significantly higher correlation with systemic inflammation, compared to saliva microbiota, on correlation networks. Thirty‐eight patients were hospitalized within 90 days. Their salivary dysbiosis was significantly worse and predicted this outcome independent of cirrhosis severity. Salivary inflammation was studied in an additional 86 age‐matched subjects (43 controls/43 patients with cirrhosis); significantly higher interleukin (IL)−6/IL‐1β, secretory IgA, and lower lysozyme, and histatins 1 and 5 were found in patients with cirrhosis, compared to controls. Conclusions: Dysbiosis, represented by reduction in autochthonous bacteria, is present in both saliva and stool in patients with cirrhosis, compared to controls. Patients with cirrhosis have impaired salivary defenses and worse inflammation. Salivary dysbiosis was greater in patients with cirrhosis who developed 90‐day hospitalizations. These findings could represent a global mucosal‐immune interface change in cirrhosis. (Hepatology 2015;62:1260‐1271)
Erectile Function Rehabilitation after Radical Prostatectomy : Practice Patterns among AUA Membersjsm

Introduction. Despite a growing body of evidence supporting erectile function (EF) rehabilitation after radical prostatectomy (RP), there are no guidelines on this subject. Aim. To explore EF rehabilitation practice patterns of American Urological Association (AUA) urologists. Methods. A 35-question instrument was constructed assessing physician demographics, training, and EF rehabilitation practices after RP, and was e-mailed to AUA members by the AUA Office of Education. Data were acquired by the AUA and analyzed by the investigators. Main Outcome Measure. Percentage of responders who recommend EF rehabilitation practices following RP, characterization of prevalent rehabilitation practices. Results. Of the 618 urologists who completed the survey, 71% were in private practice, 28% considered themselves as sexual medicine specialists, although only 4% were fellowship-trained, 43% were urologic oncology specialists (14% fellowship-trained), 86% performed RP, and 86% of responders recommended rehabilitation practices. Being a sexual medicine or a urologic oncology specialist was not predictive of rehabilitation employment. Forty-three percent rehabilitate all patients, 57% only selected patients. Selection for rehabilitation was dependent upon preop EF by 66%, nerve-sparing status by 22%, and age by 5%. Eleven percent started rehab immediately after RP, 97% within 4 months. 24%, 45% and 18% ceased rehab at <12, 12–18, and 18–24 months, respectively. Eighty-nine percent of RP surgeons performed rehabilitation vs. only 66% who do not perform RP (P < 0.0001). Eighty-seven percent prefer phosphodiesterase type 5 inhibitors (PDE5i) as their primary strategy followed (in order) by vacuum erection device (VED), intracavernosal injection (ICI), and urethral suppositories. Conclusions. Among the respondents, penile rehabilitation is a common practice. Urologic oncologists and RP surgeons are more likely to use rehabilitation practices. The most commonly employed strategy is regular PDE5i use for 12–18 months after RP. Tal R, Teloken P, and Mulhall JP. Erectile function rehabilitation after radical prostatectomy: practice patterns among AUA members. J Sex Med 2011;8:2370–2376.
Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother‐to‐infant transmission of hepatitis B virus

The efficacy and safety of maternal tenofovir disoproxil fumarate (TDF) in reducing mother‐to‐infant hepatitis B virus (HBV) transmissions is not clearly understood. We conducted a prospective, multicenter trial and enrolled 118 hepatitis B surface antigen (HBsAg)– and hepatitis B e antigen–positive pregnant women with HBV DNA ≥7.5 log10 IU/mL. The mothers received no medication (control group, n = 56, HBV DNA 8.22 ± 0.39 log10 IU/mL) or TDF 300 mg daily (TDF group, n = 62, HBV DNA 8.18 ± 0.47 log10 IU/mL) from 30‐32 weeks of gestation until 1 month postpartum. Primary outcome was infant HBsAg at 6 months old. At delivery, the TDF group had lower maternal HBV DNA levels (4.29 ± 0.93 versus 8.10 ± 0.56 log10 IU/mL, P < 0.0001). Of the 121/123 newborns, the TDF group had lower rates of HBV DNA positivity at birth (6.15% versus 31.48%, P = 0.0003) and HBsAg positivity at 6 months old (1.54% versus 10.71%, P = 0.0481). Multivariate analysis revealed that the TDF group had lower risk (odds ratio = 0.10, P = 0.0434) and amniocentesis was associated with higher risk (odds ratio 6.82, P = 0.0220) of infant HBsAg positivity. The TDF group had less incidence of maternal alanine aminotransferase (ALT) levels above two times the upper limit of normal for ≥3 months (3.23% versus 14.29%, P = 0.0455), a lesser extent of postpartum elevations of ALT (P = 0.007), and a lower rate of ALT over five times the upper limit of normal (1.64% versus 14.29%, P = 0.0135) at 2 months postpartum. Maternal creatinine and creatinine kinase levels, rates of congenital anomaly, premature birth, and growth parameters in infants were comparable in both groups. At 12 months, one TDF‐group child newly developed HBsAg positivity, presumably due to postnatal infection and inefficient humoral responses to vaccines. Conclusions: Treatment with TDF for highly viremic mothers decreased infant HBV DNA at birth and infant HBsAg positivity at 6 months and ameliorated maternal ALT elevations. (Hepatology 2015;62:375–386
Nuclear factor kappa B–mediated CD47 up‐regulation promotes sorafenib resistance and its blockade synergizes the effect of sorafenib in hepatocellular carcinoma in mice

Sorafenib is a new standard treatment for patients with advanced hepatocellular carcinoma (HCC). However, the survival benefit of this treatment is modest, partly owing to drug resistance. Recent evidence has demonstrated the existence of tumor‐initiating cells (T‐ICs) as the culprit for treatment resistance. To examine whether sorafenib resistance was a result of the presence of liver T‐ICs, we developed sorafenib‐resistant HCC cells both in vitro and in vivo through continuous exposure to sorafenib. Using these models, we found that sorafenib‐resistant clones demonstrated enhanced T‐IC properties, including tumorigenicity, self‐renewal, and invasiveness. In addition, several T‐IC markers were found to be up‐regulated, among which CD47 was found to be most significant. Using chromatin immunoprecipitation assays and expression analyses, CD47 expression was found to be regulated by nuclear factor kappa B (NF‐κB) through a specific response element in the promoter of CD47, and the site occupancy and expression were increased and decreased upon stimulation and inhibition of NF‐κB, respectively. Consistently, NF‐κB was activated in sorafenib‐resistant HCC cells, and this finding was confirmed in clinical HCC samples, which showed a positive correlation between NF‐κB and CD47 expression. Functional characterization of CD47 in sorafenib‐resistant HCC cells was evaluated using a lentivirus‐based knockdown approach and showed increased sensitization to sorafenib upon CD47 knockdown. Furthermore, blockade of CD47 using anti‐CD47 antibody (Ab) showed a similar effect. Using a patient‐derived HCC xenograft mouse model, we found that anti‐CD47 Ab (500 μg/mouse) in combination with sorafenib (100 mg/kg, orally) exerted synergistic effects on tumor suppression, as compared with sorafenib and anti‐CD47 Ab alone. Conclusions: NF‐κB‐mediated CD47 up‐regulation promotes sorafenib resistance, and targeting CD47 in combination with sorafenib is an attractive therapeutic regimen for the treatment of HCC patients. (Hepatology 2015;62:534–545
ORIGINAL RESEARCH—ERECTILE DYSFUNCTION Low-Intensity Extracorporeal Shock Wave Therapy—A Novel Effective Treatment for Erectile Dysfunction in Severe ED Patients Who Respond Poorly to PDE5 Inhibitor Therapy

Introduction. Low-intensity shock wave therapy (LI-ESWT) has been reported as an effective treatment in men with mild and moderate erectile dysfunction (ED). Aim. The aim of this study is to determine the efficacy of LI-ESWT in severe ED patients who were poor responders to phosphodiesterase type 5 inhibitor (PDE5i) therapy. Methods. This was an open-label single-arm prospective study on ED patients with an erection hardness score (EHS) 2 at baseline. The protocol comprised two treatment sessions per week for 3 weeks, which were repeated after a 3-week no-treatment interval. Patients were followed at 1 month (FU1), and only then an active PDE5i medication was provided for an additional month until final follow-up visit (FU2). At each treatment session, LI-ESWT was applied on the penile shaft and crus at five different anatomical sites (300 shocks, 0.09 mJ/mm 2 intensity at120 shocks/min). Each subject underwent a full baseline assessment of erectile function using validated questionnaires and objective penile hemodynamic testing before and after LI-ESWT. Main Outcome Measures. Outcome measures used are changes in the International Index of Erectile Functionerectile function domain (IIEF-ED) scores, the EHS measurement, and the three parameters of penile hemodynamics and endothelial function. Results. Twenty-nine men (mean age of 61.3) completed the study. Their mean IIEF-ED scores increased from 8.8 1 (baseline) to 12.3 1 at FU1 (P = 0.035). At FU2 (on active PDE5i treatment), their IIEF-ED further increased to 18.8 1( P < 0.0001), and 72.4% (P < 0.0001) reached an EHS of 3 (allowing full sexual intercourse). A significant improvement (P = 0.0001) in penile hemodynamics was detected after treatment and this improvement significantly correlated with increases in the IIEF-ED (P < 0.05). No noteworthy adverse events were reported. Conclusions. Penile LI-ESWT is a new modality that has the potential to treat a subgroup of severe ED patients. These preliminary data need to be reconfirmed by multicenter sham control studies in a larger group of ED patients. Gruenwald I, Appel B, and Vardi Y. Low-intensity extracorporeal shock wave therapy—A novel effective treatment for erectile dysfunction in severe ED patients who respond poorly to PDE5 inhibitor therapy. J Sex Med 2012;9:259–264.
IMMUNE-BASED THERAPIES FOR SPINAL CORD INJURY

Traumatic Spinal Cord Injury (SCI) results in both focal and diffuse spinal cord pathologies that are exacerbated by an inflammatory response after the initial injur y. Resident and infiltrating immune cells contribut e significantly to the growth-refractory environment near the lesion and can intensify damage to spared tissue, resulting in impaired spontaneous functional recove ry. Numerous studies have demonstrated that several immunomodulatory therapies administered after experimental SCI may be beneficial in promoting functional recovery. In this review, we focus on the therapeut ic potential of the most abundant immune-based therapies e.g., rolipram, liposomal clodronate and TNF-α based therapy including etanercept, thalidomide an d adenosine A1 receptor therapy their contribution to eliminating secondary damage and promoting recovery after SCI.
Difficult‐to‐cure populations with chronic hepatitis c: Vanishing in the direct‐acting antiviral era?

F or more than a decade, the combination of peginterferon (Peg-IFN) and ribavirin (RBV) was the mainstay of treatment for all genotypes of chronic hepatitis C virus (HCV). During that treatment era, rates of sustained virological response (SVR) varied significantly across patient subgroups and the concept of “difficult-to-cure” populations emerged. While the terms difficult-to-cure and difficult-to-treat have been used somewhat interchangeably in the literature, the difficult-to-cure patients are those with a lower chance of SVR when appropriate treatment given, and difficultto-treat patients are those without safe, therapeutic options (Table 1). This latter group includes those patients with comorbidities or conditions that limit tolerance of specific antivirals and those with adherence issues. Of course, since patients who cannot be treated cannot be cured, these “difficult-to-treat” patients are also “difficult-to-cure. ” Linked closely with the concept of difficult-to-cure is the recognized high medical need for therapy in these populations. The U.S. Food and Drug Administration, in its first draft document on “Guidance for industry chronic hepatitis C virus infection: developing directacting antiviral drugs for treatment” in 2002 and again in 2013, highlighted populations of high unmet need, including transplant recipients, those with cirrhosis and those with human immunodeficiency virus (HIV) coinfection, all patient groups with a higher risk of cirrhosis and liver-related complications and fewer treatment options. The impact of this document on direct-acting antiviral (DAA) drug development appears positive, both in terms of the number of clinical trials conducted in these patient groups (www.clinicaltrials.gov) and the current approval of all oral antiviral regimens for many of these special populations. Given the availability of approved oral regimens for HCV-infected patients of all genotypes, both treatment na€ıve and experienced and with a wide spectrum of liver disease severity, it is worth considering whether the “difficult-to-cure” label is still applicable.
Effects of Environmental Factors on the Lung Surfactant System

The bronchoalveolar structure of the lung is in direct contact with the environment. During inspiration, the atmosphere will enter the alveoli and contact the lining fluid of the lung. There is a specialized material unit that guarantees mechanical stability of the lung by its surface tension—lowering capacity, especially during end-expiration, called "pulmonary surfactant. " Surfactant deficiency results in life-threatening alveolar instability that leads to hypoxia and increased work of breathing. Surfactant can be easily obtained by bronchoalveolar lavage, and it is composed of lipids (mainly phospholipid), proteins (surfactant proteins, [SP] A, B, C, and D), and carbohydrates. For detailed information, the reader is referred to other reviews. The type II pneumocytes synthesize and secrete this material, and components of lung surfactant modulate processes other than surface tension in the lower respiratory tract. During the last decade, our knowledge on the lung surfactant system has increased enormously. From this occurred a better understanding of pathophysiologic reactions of the lung, especially due to various environmental agents resulted. This topic will be briefly reviewed in this article.
Web-Based Acceptance and Commitment Therapy Smoking Cessation Treatment for Smokers With Depressive Symptoms

Objective: Smokers with depressive symptoms have more difficulty quitting smoking than the general population of smokers. The present study examines a web-based treatment using acceptance and commitment therapy (ACT) for smokers with depressive symptoms. The study aimed to determine participant receptivity to the intervention and its effects on smoking cessation, acceptance of internal cues, and depressive symptoms. Methods: Smokers who had positive screening results for depressive symptoms at baseline (n = 94) were selected from a randomized controlled trial (N = 222) comparing web-based ACT for smoking cessation (WebQuit.org) with Smokefree.gov. Forty-five participants (48%) completed the three-month follow-up. Results: Compared to Smokefree.gov, WebQuit participants spent significantly more time on site (p =.001) and had higher acceptance of physical cravings (p =.033). While not significant, WebQuit participants were more engaged and satisfied with their program and were more accepting of internal cues overall. There was preliminary evidence that WebQuit participants had higher quit rates (20% versus 12%) and lower depressive symptoms at follow-up (45% versus 56%) than those in Smokefree.gov. Conclusions: This was the first study of web-based ACT for smoking cessation among smokers with depressive symptoms, with promising evidence of receptivity, efficacy, impact on a theory-based change process, and possible secondary effects on depression. A fully powered trial of the ACT WebQuit.org intervention specifically for depressed smokers is needed. This was part of a clinical trial registered as NCT#01166334 at www.clinicaltrials. gov.
Continuity of Care in Dual Diagnosis Treatment: Definitions, Applications, and Implications

Objective: The goal of this work is to review the current literature on continuity of care in the treatment of people with dual diagnosis. In particular, this review set out to clarify how continuity of care has been defined, applied, and assessed in treatment and to enhance its application in both research and clinical practice. Methods: To identify articles for review, the term “continuity” and combinations of “substance” and “treatment” were searched in electronic databases. The search was restricted to quantitative articles published in English after 1980. Papers were required to discuss “continuity” in treatment samples that included a proportion of patients with a dual diagnosis. Results: A total of 18 non-randomized studies met the inclusion criteria. Analysis revealed six core types of continuity in this treatment context: continuity of relationship with provider(s), continuity across services, continuity through transfer, continuity as regularity and intensity of care, continuity as responsive to changing patient need, and successful linkage of the patient. Patient age, ethnicity, medical status, living status, and the type of mental health and/or substance use disorder influenced the continuity of care experienced in treatment. Some evidence suggested that achieving continuity of care was associated with positive patient and treatment-related outcomes. Conclusions: This review summarizes how continuity of care has been understood, applied, and assessed in the literature to date. Findings provide a platform for future researchers and service providers to implement and evaluate continuity of care in a consistent manner and to determine its significance in the treatment of people with a dual diagnosis.
Anti-tumor effects of herbal medicines on endometrial carcinomas via estrogen receptor-α-related mechanism

: This study was performed to examine the relationship between the anti-tumor effects of herbal medicine and endometrial carcinoma with ER-related mechanisms. An endometrial cancer cell line (Ishikawa) was used for this study. The cell viability and expression of estrogen receptors (ER) were determined by MTT and RT-PCR. A dose-dependent decrease of viability and apoptosis of the cancer cells was generated by exposure to the herbal medicines, Juzen-taiho-to or Shimotsu-to. The expression of ER-alpha mRNA, but not ER-beta mRNA was suppressed by Juzen-taiho-to or Shimotsu-to in an endometrial cancer cell line. The anti-tumor effect of these herbal medicines against endometrial carcinoma might be correlated to the ER-alpha related mechanism.
Effects of Dietary Palm Oil on the Performance of Broiler Chicks

Studies were conducted to assess the effect of replacing maize with palm oil at 0, 2, 4 and 6% inclusion levels, on the performance of broiler chicks. One, hundred and forty-four day old broiler chicks of Anak strain were weighed and randomly assigned to the four experimental diets. Each treatment group of 36 birds was replicated 3 times with 12 birds per replicate in a completely randomized design (CRD). There were significant (P Key Words: palm oil, maize, performance, broiler chicks. Int. J. Agric. Rural Dev. , 2003, 4: 81-86
Pet owners’ perception and satisfaction of surgery services and outcomes at the Ashanti Regional Veterinary Clinic, Kumasi, Ghana

Aim: To study pet owners’ perception of surgery services and client satisfaction in Ghana in order to improve the quality of surgery services. Method: Self-administered questionnaires were administered to owners of pets that were presented for surgery at the Ashanti Region Veterinary Clinic (ARVC). Data generated were presented in percentages with their standard error of means. Result: 80% of the respondents were satisfied with the cost of surgical management, while 92% were satisfied with doctors’ staff attitude. Conclusion: The study revealed an overall client satisfaction of veterinary surgical services at the ARVC however surgeon–client communication need to be improved with respect to knowledge of surgical procedure prior to surgery. Periodic evaluation of veterinary services by service consumers should be encouraged to facilitate service improvement toward better animal healthcare delivery in Ghana.