Miracle-dz/UniFAR-FTUs huggingface dataset:
Association Between Operator Procedure Volume and Patient Outcomes in Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Background—The growth of centers capable of performing percutaneous coronary intervention (PCI) has outpaced population growth despite declining incidence of myocardial infarction and prevalence of coronary artery disease, potentially increasing the proportion of operators falling below minimal yearly volume standards set by professional societies. Methods and Results—Electronic literature search of MEDLINE and the Cochrane Library for English-language articles published between 1977 and November 2012 was performed. Title and abstract review followed by full-text and references review were performed by 2 authors independently to identify studies examining the association between operator volume and outcomes in PCI. Using a standardized form, 2 authors abstracted information on study design, methods, outcomes, statistical methods, and conclusions. Studies were categorized according to methodological quality and outcomes. Meta-analyses were performed by outcome using a random-effects model. Of the 23 studies included in the analysis, 14 (61%) evaluated mortality, 7 (30%) evaluated major adverse cardiac events, and 2 (9%) evaluated angiographic success. In total, the studies evaluated 15 907 operators performing 205 214 PCIs on 1 109 103 patients at 2456 centers with a mean follow-up of 2.8 years. Eleven (48%) were considered higher quality. Studies with higher methodological quality and large sample sizes more often showed a relationship between operator volume and outcomes in PCI. Higher volume was associated with improved major adverse cardiac events at every threshold, regardless of the threshold evaluated. Conclusions—Mortality and major adverse cardiac events increase as operator volumes decrease in PCI. Among studies showing a relationship, high-volume operators were defined variably, with annual PCIs ranging from >11 to >270, with no clear evidence of a threshold effect within the ranges studied.
Differentiation of intraductal growing-type cholangiocarcinomas from nodular-type cholangiocarcinomas at biliary MR imaging with MR cholangiography.

PURPOSE To describe the magnetic resonance (MR) findings of intraductal growing (IDG)-type cholangiocarcinoma (CC) and to identify the features that differentiate it from nodular-type CC. MATERIALS AND METHODS The institutional review board approved this retrospective study and waived the informed consent requirement. Thirty-nine patients with pathologically proved IDG-type (n = 19) or nodular-type (n = 20) CCs who had undergone preoperative gadolinium-enhanced MR imaging with MR cholangiography were included in this study. Analysis of MR findings included determination of the (a) shape, enhancement degree, and pattern of the tumor; (b) outer caliber of the tumor-bearing segment; and (c) presence of tumor multiplicity, upstream and downstream bile duct dilatation, bile duct wall thickening adjacent to the tumor, and adjacent organ invasion. The significance of these findings was determined with the χ² test. RESULTS Significant features in the differentiation of IDG-type CCs from nodular-type CCs included papillary or irregular polypoid shape, lack of constriction of the tumor-bearing segment, hypoenhancement of the tumor to the liver during the equilibrium phase, tumor multiplicity, upstream and downstream bile duct dilatation, and no bile duct wall thickening adjacent to the tumor (P < .05). When at least two of these six imaging features were used in combination, sensitivity and specificity in the diagnosis of IDG-type CCs were 95% and 70%, respectively. CONCLUSION By using characteristic MR features, one can differentiate IDG-type CC from nodular-type CC with a high degree of accuracy at biliary MR imaging with MR cholangiography.
Advance care planning for cancer patients in primary care: a feasibility study.

BACKGROUND Advance care planning is being promoted as a central component of end-of-life policies in many developed countries, but there is concern that professionals find its implementation challenging. AIM To assess the feasibility of implementing advance care planning in UK primary care. DESIGN OF STUDY Mixed methods evaluation of a pilot educational intervention. SETTING Four general practices in south-east Scotland. METHOD Interviews with 20 GPs and eight community nurses before and after a practice-based workshop; this was followed by telephone interviews with nine other GPs with a special interest in palliative care from across the UK. RESULTS End-of-life care planning for patients typically starts as an urgent response to clear evidence of a short prognosis, and aims to achieve a 'good death'. Findings suggest that there were multiple barriers to earlier planning: prognostic uncertainty; limited collaboration with secondary care; a desire to maintain hope; and resistance to any kind of 'tick-box' approach. Following the workshop, participants' knowledge and skills were enhanced but there was little evidence of more proactive planning. GPs from other parts of the UK described confusion over terminology and were concerned about the difficulties of implementing inflexible, policy-driven care. CONCLUSION A clear divide was found between UK policy directives and delivery of end-of-life care in the community that educational interventions targeting primary care professionals are unlikely to address. Advance care planning has the potential to promote autonomy and shared decision making about end-of-life care, but this will require a significant shift in attitudes.
Protective Effect of Tempol on Acute Kidney Injury Through PI3K/Akt/Nrf2 Signaling Pathway

Background/Aims: Tempol is a protective antioxidant against ischemic injury in many animal models. The molecular mechanisms are not well understood. Nuclear factor erythroid 2-related factor (Nrf2) is a master transcription factor during oxidative stress, which is enhanced by activation of protein kinase C (PKC) pathway. Another factor, tubular epithelial apoptosis, is mediated by activation of phosphoinositide 3-kinase (PI3K)/protein kinase B (PKB, Akt) signaling pathway during renal ischemic injury. We tested the hypothesis that tempol activates PKC or PI3K/Akt/Nrf2 pathways to transcribe many genes that coordinate endogenous antioxidant defense. Methods: The right renal pedicle was clamped for 45 minutes and the left kidney was removed to study renal ischemia/reperfusion (I/R) injury in C57BL/6 mice. The response was assessed from serum parameters, renal morphology and renal expression of PKC, phosphorylated-PKC (p-PKC), Nrf2, heme oxygenase-1 (HO-1), Akt, phosphorylated-Akt (p-Akt), pro-caspase-3 and cleaved caspase-3 in groups of sham and I/R mice given vehicle, or tempol (50 or 100 mg/kg, intraperitoneal injection). Results: The serum malondialdehyde (MDA, marker of reactive oxygen species) doubled and the BUN and creatinine increased 5- to 10-fold after I/R injury. Tempol (50 or 100 mg/kg) prevented the increases in MDA but only tempol (50 mg/kg) lessened the increases in BUN and creatinine and moderated the acute tubular necrosis. I/R did not change expression of PKC or p-PKC but reduced renal expression of Nrf2, p-Akt, HO-1 and pro-caspase-3 and increased cleaved caspase-3. Tempol (50 mg/kg) prevented these changes produced by I/R whereas tempol (100 mg/kg) had lesser or inconsistent effects. Conclusion: Tempol (50 mg/kg) prevents lipid peroxidation and attenuates renal damage after I/R injury. The beneficial pathway apparently is not dependent on upregulation or phosphorylation of PKC, at lower tempol doses, does implicate upregulation of Akt with expression of Nrf2 that could account for the increase in the antioxidant gene HO-1 and a reduction in the cleavage of the cellular damage marker pro-caspase-3.
Sequence and organization of the complete mitochondrial genome of Hebius vibakari ruthveni from China

Abstract The mitochondrial genome sequence of Hebius vibakari ruthveni is analyzed and presented for the public for the first time. The genome was 17,259 bp in length and contained 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes, and 2 control regions. The overall base composition is A (33.9%), C (26.5%), T (26.5%), and G (13.1%). Mitochondrial genomes analyses based on maximum parsimony (MP), neighbor-joining (NJ), and Bayesian analyses yielded identical phylogenetic trees, indicating a close phylogenetic affinity of the 24 Colubridae species. It shows that two major phyletic lineages were present in Colubridae: Hebius and Thamnophis. Hebius comprised 16 species and was supported by bootstrap values of 99%. A clade (H. craspedogaster, H. metusium, H. johannis, H. bitaeniatum and H. octolineatum) as the sister taxon to another clade (H. parallelum, H. khasiense, H. Boulengeri and H. popei) was supported by bootstrap values of 66%. This clade with the H. Atemporale is the sister taxon to H. optatum, H. sauteri, and H. v. ruthveni.
Employment status of veterans receiving substance abuse treatment from the U.S. Department of Veterans Affairs.

OBJECTIVE This study examined employment outcomes of veterans with substance use disorders and comorbid general medical and psychiatric disorders following substance abuse treatment. METHODS The authors obtained employment and other information reported by 5,729 veterans at intake and at follow-up three to nine months after receiving substance abuse treatment from the U.S. Department of Veterans Affairs during 2001-2010. Random-effects logistic regression models examined the probability of having employment earnings and days of paid work during the past 30 days among veterans with comorbid conditions. RESULTS The percentage of veterans with any days of paid work rose from 28% at intake to 35% at follow-up. Veterans with comorbid anxiety and general medical conditions had lower odds of having earnings from employment or days of paid work at follow-up. CONCLUSIONS Veterans with substance use disorders, particularly those with comorbid general medical and anxiety disorders, may be at risk of employment problems.
Mycophenolate Mofetil and Valsartan Inhibit Podocyte Apoptosis in Streptozotocin-Induced Diabetic Rats

Aim: To investigate the effects of mycophenolate mofetil on apoptosis and the expression of Bax and Bcl-2 of podocytes in rats with diabetic nephropathy. Methods: A total of 40 male rats were randomly divided into two groups: healthy control group (NC, n = 8) and diabetic nephropathy group (DN, n = 32). The diabetic rat models were induced by streptozotocin, which was injected intraperitoneally. After the DN model was established successfully, the DN group was subdivided into four groups: (1) group treated with the dissolvent (DN), (2) group treated with mycophenolate mofetil (DN + M), (3) group treated with valsartan (DN + V) and (4) group treated with mycophenolate mofetil and valsartan (DN + MV). After 16 weeks of treatment, kidney and body weight, urinary protein level and serum glucose were measured. Histomorphology of renal tissue was observed by an optical microscope. Apoptosis of podocytes was determined by transferase-mediated dUTP nick-end labeling (TUNEL) test. The expression of nephrin and Wilms' tumor suppressor gene (WT1) were detected by immunohistochemistry and real-time PCR, and the protein expression of Bax and Bcl-2 were examined by Western blot. Results: The mRNA and protein expression of nephrin and WT1 were both downregulated. The apoptosis rate, the expression of Bax, caspase-3 activity and cleavage increased, while the expression of Bcl-2 decreased in the DN group compared with the NC group. However, they were all improved in the groups treated with either mycophenolate mofetil or valsartan. Conclusion: Mycophenolate mofetil can protect renal function by increasing Bcl-2 expression and decreasing Bax expression and podocyte apoptosis rate, thereby reducing proteinuria.
DETECTION AND PREVALENCE OF POLYOMA VIRUS BK AMONG IRANIAN KIDNEY TRANSPLANT PATIENTS BY A NOVEL NESTED-PCR

Background: BK virus is an increasingly recognized pathogen in transplant recipient patients associated with nephropathy and emerged as a cause of allograft failure linked to immunosuppres sive regimens in renal transplant recipients. This study develops a sensitive PCR method to detect the viremia and viruria as well as the incidence of BK virus infection in renal transplant recipients. Methods: A nested PCR method was developed and a total of 45 paired serum and urine samples from renal transplant recipient patients were collected and tested with the developed assay. Results: The threshold of the developed detection assay was 10 copies/µl of BKV DNA in samples. Our results also indicated that about 40% of the urine and 26.7% of serum samples were positive for BKV in renal transplant patients in this study.
RANK ligand inhibition plus docetaxel improves survival and reduces tumor burden in a murine model of prostate cancer bone metastasis

Tumor cells induce excessive osteoclastogenesis, mediating pathologic bone resorption and subsequent release of growth factors and calcium from bone matrix, resulting in a “vicious cycle” of bone breakdown and tumor proliferation. RANK ligand (RANKL) is an essential mediator of osteoclast formation, function, and survival. In metastatic prostate cancer models, RANKL inhibition directly prevents osteolysis via blockade of osteoclastogenesis and indirectly reduces progression of skeletal tumor burden by reducing local growth factor and calcium concentrations. Docetaxel, a well-established chemotherapy for metastatic hormone-refractory prostate cancer, arrests the cell cycle and induces apoptosis of tumor cells. Suppression of osteoclastogenesis through RANKL inhibition may enhance the effects of docetaxel on skeletal tumors. We evaluated the combination of the RANKL inhibitor osteoprotegerin-Fc (OPG-Fc) with docetaxel in a murine model of prostate cancer bone metastasis. Tumor progression, tumor area, and tumor proliferation and apoptosis were assessed. OPG-Fc alone reduced bone resorption (P < 0.001 versus PBS), inhibited progression of established osteolytic lesions, and reduced tumor area (P < 0.0001 versus PBS). Docetaxel alone reduced tumor burden (P < 0.0001 versus PBS) and delayed the development of osteolytic lesions. OPG-Fc in combination with docetaxel suppressed skeletal tumor burden (P = 0.0005) and increased median survival time by 16.7% (P = 0.0385) compared with docetaxel alone. RANKL inhibition may enhance docetaxel effects by increasing tumor cell apoptosis as evident by increased active caspase-3. These studies show that inhibition of RANKL provides an additive benefit to docetaxel treatment in a murine model of prostate cancer bone metastasis and supports clinical evaluation of this treatment option in patients. [Mol Cancer Ther 2008;7(7):2160–9]
Composition of Carotid Atherosclerotic Plaque Is Associated With Cardiovascular Outcome: A Prognostic Study

Background— Identification of patients at risk for primary and secondary manifestations of atherosclerotic disease progression is based mainly on established risk factors. The atherosclerotic plaque composition is thought to be an important determinant of acute cardiovascular events, but no prospective studies have been performed. The objective of the present study was to investigate whether atherosclerotic plaque composition is associated with the occurrence of future vascular events. Methods and Results— Atherosclerotic carotid lesions were collected from patients who underwent carotid endarterectomy and were subjected to histological examination. Patients underwent clinical follow-up yearly, up to 3 years after carotid endarterectomy. The primary outcome was defined as the composite of a vascular event (vascular death, nonfatal stroke, nonfatal myocardial infarction) and vascular intervention. The cumulative event rate at 1-, 2-, and 3-year follow-up was expressed by Kaplan–Meier estimates, and Cox proportional hazards regression analyses were performed to assess the independence of histological characteristics from general cardiovascular risk factors. During a mean follow-up of 2.3 years, 196 of 818 patients (24%) reached the primary outcome. Patients whose excised carotid plaque revealed plaque hemorrhage or marked intraplaque vessel formation demonstrated an increased risk of primary outcome (risk difference=30.6% versus 17.2%; hazard ratio [HR] with [95% confidence interval]=1.7 [1.2 to 2.5]; and risk difference=30.0% versus 23.8%; HR=1.4 [1.1 to 1.9], respectively). Macrophage infiltration (HR=1.1 [0.8 to 1.5]), large lipid core (HR=1.1 [0.7 to 1.6]), calcifications (HR=1.1 [0.8 to 1.5]), collagen (HR=0.9 [0.7 to 1.3]), and smooth muscle cell infiltration (HR=1.3 [0.9 to 1.8]) were not associated with clinical outcome. Local plaque hemorrhage and increased intraplaque vessel formation were independently related to clinical outcome and were independent of clinical risk factors and medication use. Conclusions— The local atherosclerotic plaque composition in patients undergoing carotid endarterectomy is an independent predictor of future cardiovascular events.
BLOOD COAGULATION AND FIBRINOLYSIS PARAMETER CHANGES AFTER VARIOUS TYPES OF BRAIN DAMAGE

Summary. Brain tissue, especially astrocytes, is one of the richest sources of tissue factor (TF) in the human organism. Simultaneously, tissue plasminogen activator (t-PA) has been found in brain blood vessels. Various brain damage induces release of TF and fibrinolysis activators into circulation, and leads to hemostatic disturbances. We have investigated some coagulation and fibrinolysis parameters in 120 patients with various brain damage (30 with isolated head trauma; 30 after brain tumor surgery, 30 after ischemic and 30 after haemorrhagic stroke). Blood samples taken in the first 24 hours after brain damage were determined by the following parameters: prothrombin time (PT), fibrinogen, activated partial thromboplastin time (aPTT), activity of FVII, antithrombin III (ATIII) and alpha-2 antiplasmin (alpha-2 AP), and D-dimer. Significant decreases of PT, FVII, ATIII and increase of D-dimer have been noticed in all groups, most significant after head trauma. Alpha-2 AP has been decreased only after brain tumor surgery. Although described abnormalities did not demanded supportive and/or anticoagulant treatment, their presence in most of investigated patients should be the enough of a reason for routine coagulation investigation in the first 24 hours after brain damage.
Comparison of Browning Colour Formation on the Surface of Fish Samples during Grilling

A comparison of the browning of fish species grilled using far-infrared (FIR) heating was evaluated. Japanese amberjack (Seriola quinqueradiata), Japanese Spanish mackerel (Scomberomorus niphonius), salmon (Oncorhynchus masou), and red sea bream (Pagrus major) were used. Temperature and colour (CIE L*, a*, and b* values) of the sample surface were monitored over time. The rate of L* change was evaluated by treating the browning reaction as a first-order reaction. Colour changes based on a* and b* values were correlated with L* values using empirical equations. During browning, the trajectories of sample colour changes followed almost the same pattern, except for salmon, which was probably due to astaxanthin content. Samples with higher fat content browned faster, according to their higher frequency factor (k0) of the browning rate. An empirical equation for k0 prediction based on sample fat content was obtained, giving fairly good approximations to measured values.
Validation of Radiation Volume by Analysis of Recurrence Pattern in Breast-conserving Treatment for Early Breast Cancer.

Purpose: To assess the appropriateness of radiotherapy volume for patients receiving breast-conserving treatment (BCT) through analysis of recurrence pattern and factors affecting recurrence. Methods: From 1991 to 1996, 362 patients who received BCT were retrospectively evaluated. The radiation volume was the involved breast alone in the patients with less than 4 positive axillary lymph nodes (LNs), and breast and supraclavicular fossa in patients with 4 or more positive axillary LNs. The median follow-up period was 123 months (range, 3-169 months). Results: Ten-year overall, disease-free, local recurrence-free, and regional recurrence-free survival rates were 86.2%, 82.2%, 95.9%, and 95.2%, respectively. Among 310 patients receiving radiotherapy on the breast alone, 15 (4.8%) had regional recurrence. In particular, patients with inner quadrant lesions had high regional recurrence rates (11/98, 11.2%) (p <0.001). Conclusion: These low local recurrence rates may reveal that the current radiotherapy technique was successful. However, in cases of inner quadrant lesions, there were a considerable number of regional recurrences, even in N0 cases. This may suggest a potential role for irradiation on regional LNs in this group.
Leflunomide: mode of action in the treatment of rheumatoid arthritis

Leflunomide is a selective inhibitor of de novo pyrimidine synthesis. In phase II and III clinical trials of active rheumatoid arthritis, leflunomide was shown to improve primary and secondary outcome measures with a satisfactory safety profile. The active metabolite of leflunomide, A77 1726, at low, therapeutically applicable doses, reversibly inhibits dihydroorotate dehydrogenase (DHODH), the rate limiting step in the de novo synthesis of pyrimidines. Unlike other cells, activated lymphocytes expand their pyrimidine pool by approximately eightfold during proliferation; purine pools are increased only twofold. To meet this demand, lymphocytes must use both salvage and de novo synthesis pathways. Thus the inhibition of DHODH by A77 1726 prevents lymphocytes from accumulating sufficient pyrimidines to support DNA synthesis. At higher doses, A77 1726 inhibits tyrosine kinases responsible for early T cell and B cell signalling in the G0/G1 phase of the cell cycle. Because the immunoregulatory effects of A77 1726 occur at doses that inhibit DHODH but not tyrosine kinases, the interruption of de novo pyrimidine synthesis may be the primary mode of action. Recent evidence suggests that the observed anti-inflammatory effects of A77 1726 may relate to its ability to suppress interleukin 1 and tumour necrosis factor α selectively over their inhibitors in T lymphocyte/monocyte contact activation. A77 1726 has also been shown to suppress the activation of nuclear factor κB, a potent mediator of inflammation when stimulated by inflammatory agents. Continuing research indicates that A77 1726 may downregulate the glycosylation of adhesion molecules, effectively reducing cell-cell contact activation during inflammation.
The complete mitochondrial genome of stretch spider Tetragnatha maxillosa (Araneae: Tetragnathidae)

Abstract The stretch spider Tetragnatha maxillosa (Araneae: Tetragnathidae) is found all over the world. In the present study, we investigated the complete mitochondrial genome of T. maxillosa and the mitogenome is a circular molecule of 14 414 bp in length, consists of 13 protein-coding genes, two ribosomal RNAs, 22 transfer RNAs, and a control region. The A + T content of the overall base composition of H-strand is 74.5% (T: 40.4%; C: 9.6%; A: 34.1%; G: 15.9%). COI gene begins with TTT as start codon, COII and COIII genes begin with TTG as start codon, ATP8, Cyt b, ND2, and ND4L genes begin with ATT as start codon, and other six protein-coding genes start with ATA. ATP6, ATP8, COI, COIII, ND1, ND3, and ND6 genes are terminated with TAA as stop codon, Cyt b, ND2, ND4, ND4L, and ND5 end with T, and COII ends with TAG. In addition, the phylogenetic relationships from neighbor-joining analyses based on the 13 concatenated PCGs indicated (Tetragnatha (Nephila (Argiope (Araneus, Neoscona)))).