Miracle-dz/UniFAR-FTUs huggingface dataset:
Enamel cracks and ceramic bracket failure during debonding in vitro.

OBJECTIVE To test the null hypothesis that no difference in bracket failure characteristics is noted when use of a new ceramic bracket debonding instrument is compared with the use of conventional pliers. MATERIALS AND METHODS Thirty maxillary premolars were randomly assigned to one of two groups. In group 1, Clarity collapsible ceramic brackets (3M Unitek, Monrovia, Calif) were debonded with the use of conventional Utility/Weingart (3M Unitek, Monrovia, Calif) pliers. In group 2, Clarity brackets were debonded with a new Debonding Instrument (3M Unitek). For all teeth, the same bracket bonding system was used. Following debonding, teeth and brackets were examined under 10x magnification for assessment of bracket failure (fracture) and of residual adhesive on the enamel surface. Enamel surfaces were visualized with transillumination prior to bonding and after removal of the residual adhesive, so the effect of the debonding forces could be determined. RESULTS The results of Adhesive Remnant Index comparisons indicated that a statistically significant difference (chi2 = 8.73; P = .013) in bond failure patterns was apparent when the two groups were compared. Brackets debonded with the new instrument showed a greater tendency for the adhesive to be removed from the tooth during debonding. CONCLUSIONS The hypothesis is rejected. Although the incidence of enamel damage following debonding was similar in the two groups, the use of the new Debonding Instrument decreased the incidence of bracket fracture.
Evidence to Use Botulinum Toxin Injections in Tension-Type Headache Management: A Systematic Review

Tension-type headache (TTH) is the most common type of chronic recurring head pain. It can occur twice as often in women as in men. It is the most common type of headache. Its lifetime prevalence is 30% to 78% in the general population. TTH treatment should be multilevel. It often consists of taking pain medication, muscle relaxants, antidepressants, using biofeedback therapy, acupuncture, and attending behavioral therapy. Several clinical trials also suggest that botulinum toxin (BTX) may be an effective treatment option for such patients. The aim of this study was to evaluate if BTX can be used as a treatment method in TTH in the light of current medical literature. The authors searched the PubMed, EBSCOhost, OVID, Web of Knowledge, Cochrane Library and CINAHL databases to identify relevant publications. The authors finally included 11 papers—prospective and retrospective cohort studies. Among most of the selected studies, there was a significant correlation between using BTX and reduction of TTH pain intensity and severity. By analyzing qualified studies, it can be concluded that botulinum toxin seems to be effective in TTH management.
Communication for end-of-life care planning among Korean patients with terminal cancer: A context-oriented model

ABSTRACT Objective: In Korea, patients with terminal cancer are often caught out of the loop in end-of-life (EoL) care discussions. Healthcare professionals also have difficulty engaging in such communication in a variety of healthcare contexts. Therefore, the objective of our study was to develop a communication model for EoL care decision making compatible with the clinical environment in Korea. Methods: Using focus-group interview methodology, participants included eight doctors and five nurses who provide EoL care for terminal cancer patients in acute hospital settings or hospice care facilities in various provinces of Korea. Results: Five themes emerged regarding EoL care discussion, which included: (1) timing, (2) responsible professionals, (3) disclosure of bad news, (4) content areas of EoL care discussion, and (5) implementing strategies for EoL care discussions. These themes were based on development of a communication algorithm for EoL discussion among patients with terminal cancer. A structural communication step for delivery of a terminal prognosis was specified at the phase of disclosure of bad news: beginning with determination of a patient's decision-making capability, followed by a patient's perception of his/her condition, a patient's wish to know, family dynamics, and a patient's and/or family's readiness for EoL discussions. Significance of Results: The proposed context-oriented communication algorithm could provide a helpful guideline for EoL communication and, accordingly, facilitate meaningful improvements in EoL care in Korean clinical practice. The feasibility of this algorithm has not yet been determined, and its validation in a larger sample of patients with terminal cancers, using a quantitative research methodology, is a priority of research.
Control of HIV-1 in Elite Suppressors despite Ongoing Replication and Evolution in Plasma Virus

ABSTRACT A subset of HIV-1-infected patients known as elite controllers or suppressors (ES) control the virus naturally. We have previously demonstrated sequence discordance between proviral and plasma gag clones in ES, much of which can be attributed to selective pressure from the host (J. R. Bailey, T. M. Williams, R. F. Siliciano, and J. N. Blankson, J. Exp. Med. 203:1357-1369, 2006). However, it is not clear whether ongoing viral replication continues in ES once the control of viremia has been established or whether selective pressure impacts this evolution. The cytotoxic T-lymphocyte (CTL) response in ES often targets Gag and frequently is superior to that of HIV-1 progressors, partially due to the HLA class I alleles B*57/5801 and B*27, which are overrepresented in ES. We therefore examined longitudinal plasma and proviral gag sequences from HLA-B*57/5801 and -B*27 ES. Despite the highly conserved nature of gag, we observed clear evidence of evolution in the plasma virus, largely due to synonymous substitutions. In contrast, evolution was rare in proviral clones, suggesting that ongoing replication in ES does not permit the significant reseeding of the latent reservoir. Interestingly, there was little continual evolution in CTL epitopes, and we detected de novo CTL responses to autologous viral mutants. Thus, some ES control viremia despite ongoing replication and evolution.
A novel macrolide/fluoroketolide, solithromycin (CEM‐101), reverses corticosteroid insensitivity via phosphoinositide 3‐kinase pathway inhibition

Corticosteroid insensitivity is a major therapeutic problem for some inflammatory diseases including chronic obstructive pulmonary disease (COPD), and it is known to be induced by reduced histone deacetylase (HDAC)‐2 activities via activation of the phosphoinositide 3‐kinase (PI3K) pathway. The aim of this study is to evaluate effects of a novel macrolide/fluoroketolide, solithromycin (SOL, CEM‐101), on corticosteroid sensitivity induced by oxidative stress.
A precise and user‐independent quantification technique for regional comparison of single volume proton MR spectroscopy of the human brain

The aim of this work was to study and correct the influence of varying coil load and local B1 field in single volume MR spectroscopy. A simple, precise, and user‐independent way to adjust the transmitter gain has been developed and validated. It is based on a fit of the localized signal to flip angle variation around 90°. This method proved to be robust against B1 gradients and suitable for in vivo applications. Local B1 correction was combined with an external reference and decomposition of the volume into CSF and tissue to obtain a comprehensive absolute quantification of tissue water content and metabolite concentrations in human brain. STEAM localized spectra of parietal and insular gray matter and subparietal white matter (n = 11, TE = 30 ms) were analyzed using a linear combination of model spectra (LCModel). Coefficients of variation (CV) between 1.5% and 4% were obtained for the tissue water content (1–2% in a single subject). The CVs of major metabolite concentrations (4–21%) were dominated by the errors of the spectral analysis.
Does a surgical antireflux procedure decrease the incidence of esophageal adenocarcinoma in Barrett's esophagus? A meta-analysis

OBJECTIVE:The risk of adenocarcinoma of the esophagus is increased among those with Barrett's esophagus (BE). Whether the risk of cancer in the setting of BE can be decreased by a surgical antireflux procedure (SARP) is unclear. This study compared the reported incidence of esophageal adenocarcinoma in subjects with BE who underwent SARP with those with BE who had medical management.METHODS:We used MEDLINE to perform a meta-analysis of the English language literature published from 1966 through October 2001. We reviewed abstracts found with the search term “Barrett's esophagus” and the following: “adenocarcinoma,”“esophageal neoplasm,”“proton pump inhibitor,”“fundoplication,” or “antireflux procedure. ” Study entry criteria included 1) trial or cohort study with a report of cancer risk expressible in cancers per patient-year, 2) histologic confirmation of BE and any adenocarcinomas, and 3) adequate description of intervention (medical vs SARP). Data were abstracted by two reviewers using standardized forms. Subgroup comparisons were made using only medical management studies published in the last 5 yr. Multivariable regression controlling for subject age, country of origin, and BE length was performed.RESULTS:We reviewed 1247 abstracts, and 34 met the inclusion criteria. There were a cumulative 4678 patient-years of follow-up in the SARP group and 4906 patient-years in the medical group. The cancer incidence rate in the SARP group was 3.8 cancers/1000 patient-years, compared with 5.3 in the medical group (p = 0.29). Similarly, there was no significant difference between cancer rates when comparing SARP with medical series reported in the last 5 yr (3.8/1000 patient-years vs 4.2/1000 patient-years, p = 0.33). Multivariate analysis controlling for subject age, country of origin, and BE length did not alter these findings.CONCLUSION:The reported risk of adenocarcinoma in subjects with BE is low and not significantly decreased by a surgical antireflux procedure. Antireflux surgery in the setting of BE should not be recommended as an antineoplastic measure.
Pharmacogenetic of response efficacy to antipsychotics in schizophrenia: pharmacodynamic aspects. Review and implications for clinical research

Pharmacogenetics constitutes a new and growing therapeutic approach in the identification of the predictive factors of the response to antipsychotic treatment. This review aims to summarize recent finding into pharmacodynamic approach of pharmacogenetics of antipsychotics and particularly second generation. Studies were identified in the MEDLINE database from 1993 to July 2008 by combining the following Medical Subject Heading search terms: genetic, polymorphism, single nucleotide polymorphism, pharmacogenetics, antipsychotics, and response to treatment as well as individual antipsychotics names. Only pharmacodynamics studies were analyzed and we focused on efficacy studies. We also reviewed the references of ll identified articles. Most studies follow a polymorphism‐by‐polymorphism approach, and concern polymorphisms of genes coding for dopamine and serotonin receptors. Haplotypic approach has been considered in some studies. Few have studied the combinations of polymorphisms of several genes as a predictive factor of the response to antipsychotics. We present this gene‐by‐gene approach while detailing the features of the polymorphisms being studied (functionality, linkage disequilibrium) and the features of the studies (studied treatment(s), prospective/retrospective study, pharmacological dosage). We discuss the heterogeneity of the results and their potential clinical implications and extract methodological suggestions for the future concerning phenotype characterization, genotypes variants studied and methodological and statistical approach.
Dietary intake among Mexican-American women: generational differences and a comparison with white non-Hispanic women.

OBJECTIVES Although Mexican Americans consume diets that may protect them against adverse health, dietary advantages may disappear with increased acculturation. This study examined whether the nutrient intake of second-generation Mexican-American women of childbearing age deteriorates compared with that of first-generation Mexican-American women and approximates that of White non-Hispanic women. METHODS Data on the absolute and relative intake of eight nutrients were obtained from a 24-hour recall and compared among 475 first-generation and 898 second-generation Mexican-American women, and among 2326 White non-Hispanic women. RESULTS Although first-generation Mexican-American women were of lower socioeconomic status than were second-generation or White non-Hispanic women, they had a higher average intake of protein; vitamins A, C, and folic acid; and calcium than the other two groups. Whereas the mean adequacy ratio of the eight nutrients studied was highest in first-generation Mexican women, it was lowest in their second-generation counterparts. CONCLUSIONS First-generation Mexican women stand a markedly lower risk of eating a poor diet than second-generation Mexican women, whose nutrient intake resembles that of White non-Hispanic women.
Regression of Back and Posterior Pelvic Pain After Pregnancy

Study Design A prospective, consecutive cohort analysis of the regression of the incidence and intensity of back and posterior pelvic pain after delivery in pregnant women was done. Objective To identify back and posterior pelvic pain from mid‐pregnancy to 5 months after delivery and to illustrate differences between these two pain types. Summary of Background Data Chronic back pain may start during a pregnancy, and regression of unspecified back pain after delivery may be slow and incomplete. Few studies have distinguished back pain from posterior pelvic pain in pregnancy, and no study has presented follow‐up data after delivery with respect to pain types. Methods One hundred and sixty four of 368 pregnant women studied had back or posterior pelvic pain and were offered individual group physiotherapy and training. The women were observed until 5 months after delivery. Standardized clinical examination protocols and questionnaires were used. Results Posterior pelvic pain was experienced by 124 women, and back pain was experienced by 40 women during pregnancy. After delivery, however, back pain was more common. Pain intensity was higher among women with posterior pelvic pain during pregnancy, whereas after delivery pain intensity was higher among women with back pain. A correlation was found between the presence of high pain intensity during pregnancy and little regression of pain after delivery. Conclusions One of every three pregnant women studied experienced posterior pelvic pain, and one of every nine women experienced back pain. Posterior pelvic pain was more intense during pregnancy, and back pain was more intense and more common after delivery. High pain intensity in pregnancy indicated a bad prognosis.
Incisional wound healing in transforming growth factor‐β1 null mice

Expression of endogenous transforming growth factor‐β1 is reduced in many animal models of impaired wound healing, and addition of exogenous transforming growth factor‐β has been shown to improve healing. To test the hypothesis that endogenous transforming growth factor‐β1 is essential for normal wound repair, we have studied wound healing in mice in which the transforming growth factor‐β1 gene has been deleted by homologous recombination. No perceptible differences were observed in wounds made in 3–10‐day‐old neonatal transforming growth factor‐β1 null mice compared to wild‐type littermates. To preclude interference from maternally transferred transforming growth factor‐β1, cutaneous wounds were also made on the backs of 30‐day‐old transforming growth factor‐β1 null and littermate control mice treated with rapamycin, which extends their lifetime and suppresses the inflammatory response characteristic of the transforming growth factor‐β1 null mice. Again, no impairment in healing was seen in transforming growth factor‐β1 null mice. Instead these wounds showed an overall reduction in the amount of granulation tissue and an increased rate of epithelialization compared to littermate controls. Our data suggest that release of transforming growth factor‐β1 from degranulating platelets or secretion by infiltrating macrophages and fibroblasts is not critical to initiation or progression of tissue repair and that endogenous transforming growth factor‐β1 may actually function to increase inflammation and retard wound closure.
Effects of glucose on hypoxic vasoconstriction in isolated ferret lungs.

To characterize the effects of glucose on the pulmonary vascular response to anoxia and hypoxia, isolated ferret lungs were ventilated with 28% O2 and 5% CO2 and perfused at constant flow (100 ml.kg-1.min-1). Perfusate glucose concentrations were allowed to fall spontaneously to less than 1 mM (low glucose) or were controlled at 5-6 mM (normal glucose) or 12-17 mM (high glucose). At 60, 120, and 180 min of perfusion, the inspired O2 tension (PIO2) was reduced to 0, 10, or 30 Torr for 30 min, and vasomotor responses were quantified by continuous measurement of pulmonary arterial pressure. At PIO2 of 0 Torr, the response consisted of an early phase of transient intense vasoconstriction and a late phase of sustained slight vasoconstriction. High glucose markedly potentiated the magnitude of late-phase vasoconstriction with each successive anoxic exposure. This effect was not reproduced in normal glucose lungs and was not caused by a change in perfusate osmolarity, an action on blood cells, or an altered ability of pulmonary vascular smooth muscle to contract. At PIO2 of 10 Torr, high glucose not only potentiated late-phase vasoconstriction but also slowed the onset of early-phase vasoconstriction. At PIO2 of 30 Torr, high glucose had no effect on vasomotor responses, which were characterized by a slowly developing sustained vasoconstriction. Our results suggest that the vascular response of isolated ferret lungs to severe hypoxia consisted of separate early and late phases of vasoconstriction. This biphasic response may have resulted from two distinct vasoconstrictor mechanisms or from modulation of a single vasoconstrictor mechanism by a secondary vasodilator influence. (ABSTRACT TRUNCATED AT 250 WORDS)
99mTc-sestamibi imaging in the assessment of toremifene as a modulator of multidrug resistance in patients with breast cancer.

UNLABELLED Multidrug resistance (MDR) due to expression of a membrane-associated permeability glycoprotein (P-glycoprotein [Pgp]) prevents successful cytotoxic chemotherapy for breast cancer. Identification of MDR would facilitate selection of chemotherapy regimens and MDR modulators. This study aimed to evaluate (99m)Tc-sestamibi imaging for predicting overexpression of Pgp in primary breast cancer and to measure the efficacy of toremifene, the MDR modulator, in vivo. METHODS Twenty patients with untreated breast cancer had (99m)Tc-sestamibi imaging 20 and 120 min after tracer injection before and after a 3-d course of toremifene (780 mg/d). Tumor samples were obtained during surgery for correlation of imaging and Pgp immunohistochemistry. RESULTS Sixteen of 20 tumors were visualized with sestamibi. Before toremifene, there was a significant inverse correlation (Spearman rank correlation coefficient [R(S)]) between staining intensity, based on the anti-Pgp monoclonal antibodies C494 and C219, and the tumor-to-background ratio (T/B) at 120 min (R(S) = -0.85; P < 0.001 and R(S) = -0.71; P < 0.001, respectively). However, the correlation between the T/B and immunohistochemistry at 20 min was significant only for C494 (R(S) = -0.57; P < 0.01). Similarly, before toremifene, there was an inverse correlation between staining intensity and the change in the T/B between 20 and 120 min (R(S) = -0.77; P < 0.001 and -0.75; P < 0.001 for C494 and C219). After toremifene, an inverse correlation between staining intensity and the T/B was seen only at 120 min and only with C494 (R(S) = -0.68; P < 0.01). However, the change in the T/B between 20 and 120 min correlated significantly with staining intensity for C494 and C219 (R(S) = -0.68; P < 0.01 and -0.7; P < 0.01 for C494 and C219, respectively). Toremifene did not significantly alter the overall T/B at either 20 or 120 min when data were compared before and after toremifene. Nevertheless, at 120 min, 8 of 8 tumors with low Pgp expression showed reduced uptake after toremifene, whereas 5 of 6 tumors with strong expression showed increased uptake (P < 0.003). Moreover, there was a significant correlation between the change in the T/B and staining intensity with C494 (R(S) = 0.59; P < 0.05) and C219 (R(S) = 0.56; P < 0.05) at 120 min but not at 20 min. CONCLUSION (99m)Tc-Sestamibi accumulation in breast cancer correlates with Pgp expression. Toremifene has a dual effect on this accumulation, increasing it through an inhibitory effect on Pgp while at the same time reducing it by a direct competition with sestamibi. The latter implies that in response to Pgp modulation the efflux of various agents may be affected differently.
Cardiac steatosis in patients with dilated cardiomyopathy

Objective Ectopic fat accumulation within and around the heart has been related to increased risk of heart disease. Limited data exist on cardiac adiposity in subjects with dilated cardiomyopathy (DCM). The aim of the study was to examine the components of cardiac steatosis and their relationship to LV structure and function in non-diabetic DCM patients. Methods Myocardial and hepatic triglyceride (TG) contents were measured with 1.5 T magnetic resonance spectroscopy (MRS), and LV function, visceral adipose (VAT) and abdominal subcutaneous tissue (SAT), epicardial and pericardial fat by MRI in 10 non-diabetic men with DCM and in 20 controls. Results In face of comparable intra-abdominal fat depots, myocardial TG [0.41% (0.21–2.19) vs 0.86% (0.31–2.24), p=0.038] was markedly lower and epicardial (895 mm2±110 vs 664 mm2±180, p=0.002) and pericardial fat [2173 mm2 (616–3673) vs 1168 mm2 (266–2319), p=0.039] depots were larger in patients with DCM compared with controls. In subjects with DCM, the LV global function index was decreased to a greater extent than the LV EF [21%±6 vs 34% (16–40)]. Conclusions Myocardial TG content decreased and epicardial and pericardial fat depots increased in non-diabetic subjects with DCM. Although recognised as a site of ectopic fat accumulation, the derangement of myocardial TG seems to play a specific role in the myocardial energy metabolism in congestive heart failure.