Miracle-dz/UniFAR-FTUs huggingface dataset:
Premedication with N-acetylcysteine and simethicone improves mucosal visualization during gastroscopy: a randomized, controlled, endoscopist-blinded study

Objectives Diagnostic gastroscopy provides a unique opportunity to diagnose early oesophagogastric neoplasia; however, intraluminal mucus and bile can obscure mucosal visualization. The aim of this study was to determine whether the use of a premedication solution containing the mucolytic agent N-acetylcysteine and the surfactant simethicone improves mucosal visualization within a UK diagnostic gastroscopy service. Materials and methods A total of 75 consecutive patients were recruited from a single (S.J.) endoscopist’s diagnostic gastroscopy list. They were randomized into three treatment groups: (a) standard control=clear fluids only for 6 h, nil by mouth for 2 h; (b) water control=standard control+100 ml sterile water (given 20 min before gastroscopy); and (c) solution=standard control+100 ml investigated solution (20 min before gastroscopy). The endoscopist was blinded to patient preparation. Inadequate mucosal visualization was defined as fluid/mucus during gastroscopy that could not be suctioned and required flushing with water. The volume of flush, the site at which it was used and the total procedure times were recorded. Results All three groups showed no statistical difference for age, sex ratio, procedure priority or indication. The mean volume of flush required to obtain clear mucosa was significantly less in the solution group compared with the other groups. The mean overall procedure time was also less in the solution group compared with the other groups. Discussion Premedication with N-acetylcysteine and simethicone markedly improves mucosal visibility during gastroscopy. It also reduces the time taken for the procedure. This low-cost and well-tolerated intervention may improve detection of early neoplasia.
Distributed fiber-optic intrusion sensor system

A distributed sensor system for detecting and locating intruders based on the phase-sensitive optical-time-domain reflectometer (/spl phi/-OTDR) is described. The sensing element is a cabled single-mode telecommunications fiber buried along the monitored perimeter. Light pulses from a continuous-wave Er:fiber Fabry-Pe/spl acute/rot laser with a narrow (/spl ap/3 kHz) instantaneous linewidth and low (few kilohertz per second) frequency drift are injected into one end of the fiber, and the backscattered light is monitored with a photodetector. The effect of phase changes resulting from the pressure of the intruder on the ground immediately above the buried fiber are sensed by subtracting a /spl phi/-OTDR trace from an earlier stored trace. In laboratory tests with fiber on reels, the effects of localized phase perturbations induced by a piezoelectric fiber stretcher on /spl phi/-OTDR traces were observed. In field tests, people walking on the ground above a buried fiber cable induced phase shifts of several-/spl pi/ radians.
Induction of Id1 and Id3 by Latent Membrane Protein 1 of Epstein-Barr Virus and Regulation of p27/Kip and Cyclin-Dependent Kinase 2 in Rodent Fibroblast Transformation

ABSTRACT Latent membrane protein 1 (LMP1), the Epstein-Barr virus oncoprotein, activates NF-κB, phosphatidylinositol 3-kinase, mitogen-activated protein kinase, and c-Jun N-terminal kinase signaling. To determine global transcriptional changes induced by LMP1 in epithelial cells, genomic analysis of C33A cells stably expressing LMP1 was performed. Relatively few genes were induced by LMP1. Expression of two members of the Id (inhibitor of differentiation) family of proteins, Id1 and Id3, was induced in the presence of LMP1 and confirmed by mRNA and protein in C33A and Rat-1 cells. In Rat-1 foci transformed by LMP1, Id1 protein was also increased. Id proteins are known negative regulators of E-box proteins that positively regulate p16 and potentially other cyclin-dependent kinase inhibitors (cdki's). In LMP1-expressing Rat-1 cells, cdki p27 was specifically downregulated. Decreased p27 was correlated with increased levels of Cdk2 and increased levels of phosphorylated retinoblastoma protein. This study describes new properties of LMP1 that likely contribute to transformation and oncogenesis.
Environment, education, and society in the Asia-Pacific: local traditions and global discourses

Preface Rupert Maclean, UNESCO Office for Asia and the Pacific Introduction David Yencken, John Fien and Helen Sykes 1. Attitudes to nature in the East and West David Yencken 2. The research David Yencken, John Fien and Helen Sykes 3. One country two perspectives: South China Philip Stimpson 4. Oya-Shima-Kuni: Japan Brendan Barrett, Osamu Abe, Eiichiro Harako and Satoshi Ichikawa 5. Living traditions: India M.J. Ravindranath and Usha Iyer-Raniga 6. Unity and Diversity: Southeast Asia Lily Kong with Irene Teh-Cheong Poh Ai, Panji Tisna, Purisima Remorin, Rapeepun Suwannatachote and Wisat Lee 7. Songlines and the Gondwanan inheritance: Australia David Yencken and John Fien 8. Voices from the South-West Pacific John Fien with Gewa Au, Paul Keown, Premila Kumar and Sereana Takivakatini 9. Environmental attitudes, knowledge and behaviour of young people in the Asia-Pacific region Helen Sykes, David Yencken, John Fien and Florence Choo 10. Young people and the environment: the implications for environmentalism David Yencken 11. Listening to the voices of youth: Implications for educational reform John Fien
Management of multidrug-resistant tuberculosis: an update

Multidrug-resistant tuberculosis (MDR-TB) is threatening control of TB in many parts of the world. As a result of limited treatment options, patients have a poor prognosis and low chances of cure. This situation can be exacerbated by HIV epidemics. In some cases, the risk exists of a real shift from susceptible to resistant strains. Despite its relevance, currently there are more contradictions and confusion surrounding MDR-TB than hard evidence. No randomized controlled trials have been performed and published evidence is limited. Rather than just the selection of expensive drugs, MDR-TB management requires well-structured programmes with a comprehensive approach, which involve the actions of a wide range of participants. Even with current investments in research and development, new drugs and vaccines will take many years to be applied in low and middle income countries. The most successful results will depend on the optimization of existing tools. The majority of the patients, even those with extensive patterns of bacilli resistance, have a possibility of cure if current clinical knowledge and effective logistics are applied. This paper is a critical review of current best practice regarding the diagnosis and treatment of MDR-TB.
Antihypertensive Therapy and Central Hemodynamics in Women With Hypertensive Disorders in Pregnancy

OBJECTIVE: To estimate the changes in central hemodynamics features of pregnant women presenting with hypertensive disorders and to analyze the effects of standard antihypertensive treatment on maternal central hemodynamics. METHODS: Applanation tonometry was used to record the radial artery pulse waveform in 80 women presenting with preeclampsia or gestational hypertension and 80 normotensive controls matched for gestational age. In each case, an averaged aortic waveform was derived and analyzed to calculate augmentation pressure and augmentation index at heart rate 75 beats per minute (bpm). RESULTS: In women with preeclampsia and gestational hypertension, both augmentation pressure (P<.001 and P<.05, respectively) and augmentation index at heart rate 75 bpm (P<.001 and P<.001, respectively) were significantly higher than in controls. Augmentation pressure and augmentation index at heart rate 75 bpm were significantly higher in early- compared with late-onset preeclampsia (P<.001) and in severe compared with mild preeclampsia (P<.001). Antihypertensive therapy with alpha methyldopa resulted in a significant fall in both augmentation pressure and augmentation index at heart rate 75 bpm in preeclampsia (P<.001) but not in gestational hypertension. CONCLUSION: Arterial stiffness is increased in women with hypertensive disorders of pregnancy compared with normotensive controls. In preeclampsia, vascular stiffness was significantly improved by antihypertensive treatment with alpha methyldopa, but remained higher than in normotensive controls. LEVEL OF EVIDENCE: II
Swimmer's Itch in Belgium: First Recorded Outbreaks, Molecular Identification of the Parasite Species and Intermediate Hosts.

BACKGROUND Cercarial dermatitis or swimmer's itch is a skin condition in humans due to the larval forms of bird schistosomes of some species of the genus Trichobilharzia. The life cycle of these schistosomes requires freshwater snails (intermediate host) and waterfowl (definitive host). Repeated exposures to cercariae can lead to skin sensitization with the induction of pruritic skin lesions. METHODS We describe, in this study, two outbreaks of human cercarial dermatitis at the Eau d'Heure Lakes, Belgium. In July and August 2012, a total of, respectively, 78 and 10 people reported a sudden skin rash accompanied by pruritus following recreational activities in the Plate Taille Lake. However, no ocellate furcocercariae were detected following light exposure of the snails collected between September 2012 and September 2013 (n = 402). No outbreaks were recorded in 2013 and 2014. In August 2015, about 30 new cases were recorded. Snails were collected (n = 270) in different locations around the lake. PCR was used to identify accurately the intermediate hosts and the parasite species involved. RESULTS After light exposure, seven Radix spp. (2.6%) shed ocellate furcocercariae. Molecular identification based on the rDNA internal transcribed spacer 2 sequence ascribed the infected snails to R. balthica ( = R. peregra = R. ovata) (6/7) and R. auricularia (1/7). Based on the amplification of the D2 domain of the 28S rDNA, the cercariae were shown to belong to two different haplotypes of Trichobilharzia franki. CONCLUSIONS This is the first record in Belgium of T. franki and associated skin condition.
Neuroprotective effect of Shenqi Fuzheng injection pretreatment in aged rats with cerebral ischemia/reperfusion injury

Shenqi Fuzheng injection is extracted from the Chinese herbs Radix Astragali and Radix Codonopsis. The aim of the present study was to investigate the neuroprotective effects of Shenqi Fuzheng injection in cerebral ischemia and reperfusion. Aged rats (20-22 months) were divided into three groups: sham, model, and treatment. Shenqi Fuzheng injection or saline (40 mL/kg) was injected into the tail vein daily for 1 week, after which a cerebral ischemia/reperfusion injury model was established. Compared with model rats that received saline, rats in the treatment group had smaller infarct volumes, lower brain water and malondialdehyde content, lower brain Ca 2+ levels, lower activities of serum lactate dehydrogenase and creatine kinase, and higher superoxide dismutase activity. In addition, the treatment group showed less damage to the brain tissue ultrastructure and better neurological function. Our findings indicate that Shenqi Fuzheng injection exerts neuroprotective effects in aged rats with cerebral ischemia/reperfusion injury, and that the underlying mechanism relies on oxygen free radical scavenging and inhibition of brain Ca 2+ accumulation.
Diplopia and Enophthalmos in Blowout Fractures

Abstract The aim of this study was to compare the changes of diplopia and enophthalmos in patients with blowout fractures. Three hundred sixty-two patients who presented with blowout fractures between March 2006 and February 2011 were analyzed. The sequential time changes of diplopia and enophthalmos were measured in the operated group and the observed group according to (1) the duration of preoperative observation (early: within 7 days, late: 8–14 days, delayed: >15 days); (2) the defect size (minimal: <1 cm2, small: 1.1–2.0 cm2, medium: 2.1–3.0 cm2, large: >3.0 cm2); and (3) the age of the patients (<20, 21–40, 41–60, >61 years). Among the 362 patients, 242 (66.9%) had an operation, and 120 (33.1%) did not. The duration of preoperative observation did not affect the postoperative diplopia or enophthalmos. There were significant differences of enophthalmos among the operated groups with a different defect size at the preoperative period (P = 0.036 [Pearson &khgr;2]). There were significant differences of diplopia among the operated groups with different defect sizes at the 6 months’ follow-up period (P = 0.014 [Pearson &khgr;2]). The diplopia in the older age group (>60 years) was significantly greater than that of the other 3 groups at 6 months (P = 0.023) and at 12 months (P = 0.023, [Pearson &khgr;2]). We think surgery should be delayed until the swelling is decreased unless the medial rectus muscle is incarcerated. We also think that the defect size is not an important factor for whether to perform surgery. We think that the reason for the greater diplopia in the older age group is that the adaptation of binocular convergence is decreased in the older age group.
Professional codes in a changing nursing context: literature review.

BACKGROUND Professional codes played a definitive role during a specific period of time, when the professional context of nursing was characterized by an increasing professionalization. Today, however, this professional context has changed. AIM This paper reports on a study which aimed to explore the meaning of professional codes in the current context of the nursing profession. METHOD A literature review on professional codes and the nursing profession was carried out. The literature was systematically investigated using the electronic databases PubMed and The Philosopher's Index, and the keywords nursing codes, professional codes in nursing, ethics codes/ethical codes, professional ethics. CONCLUSION Due to the nursing profession's growing multidisciplinary nature, the increasing dominance of economic discourse, and the intensified legal framework in which health care professionals need to operate, the context of nursing is changing. In this changed professional context, nursing professional codes have to accommodate to the increasing ethical demands placed upon the profession. Therefore, an ethicization of these codes is desirable, and their moral objectives need to be revalued.
TLR2 Is Constitutively Expressed within the Kidney and Participates in Ischemic Renal Injury through Both MyD88-Dependent and -Independent Pathways1

TLRs are an evolutionarily conserved family of cell membrane proteins believed to play a significant role in innate immunity and the response to tissue injury, including that induced by ischemia. TLR signaling pathways activate transcription factors that regulate expression of prosurvival proteins, as well as proinflammatory cytokines and chemokines through one of two proximal adapter proteins, MyD88 or Toll/IL-1R domain-containing adaptor-inducing IFN-β (Trif). Our study defines the constitutive protein expression of TLR2 in kidneys of humans and mice, and provides insight into the signaling mechanisms by which a deficiency of TLR2 protects from ischemic organ injury. Our study compared and contrasted the effects of renal ischemia in wild-type mice and mice deficient in TLR2, MyD88, Trif, and MyD88 × Trif. TLR2 protein was evident in many cell types in the kidney, including renal tubules of the outer stripe of the medulla, glomeruli, and in the renal vasculature. The pattern of protein expression was similar in humans and mice. The absence of TLR2, MyD88, and MyD88 × Trif conferred both physiologic and histologic protection against sublethal ischemia at 24 h. Interestingly, TLR2-deficient mice were better protected from ischemic renal injury than those deficient for the adapter protein MyD88, raising the intriguing possibility that TLR-2-dependent/MyD88-independent pathways also contribute to kidney injury. We conclude that TLR2 protein is constitutively expressed in the kidney and plays an important role in the pathogenesis of acute ischemic injury by signaling both MyD88-dependent and MyD88-independent pathways.
Immunoisolation of Caveolae with High Affinity Antibody Binding to the Oligomeric Caveolin Cage

Defining the molecular composition of caveolae is essential in establishing their molecular architecture and functions. Here, we identify a high affinity monoclonal antibody that is specific for caveolin-1α and rapidly binds caveolin oligomerized around intact caveolae. We use this antibody (i) to develop a new simplified method for rapidly isolating caveolae from cell and tissue homogenates without using the silica-coating technology and (ii) to analyze various caveolae isolation techniques to understand how they work and why they yield different compositions. Caveolae are immunoisolated from rat lung plasma membrane fractions subjected to mechanical disruption. Sonication of plasma membranes, isolated with or without silica coating, releases caveolae along with other similarly buoyant microdomains and, therefore, requires immunoisolations to purify caveolae. Shearing of silica-coated plasma membranes provides a homogeneous population of caveolae whose constituents (i) remain unchanged after immunoisolation, (ii) all fractionate bound to the immunobeads, and (iii) appear equivalent to caveolae immunoisolated after sonication. The caveolae immunoisolated from different low density fractions are quite similar in molecular composition. They contain a subset of key signaling molecules (i.e. G protein and endothelial nitric oxide synthase) and are markedly depleted in glycosylphosphatidylinositol-anchored proteins, β-actin, and angiotensin-converting enzyme. All caveolae isolated from the cell surface of lung microvascular endothelium in vivo appear to be coated with caveolin-1α. Caveolin-1β and -2 can also exist in these same caveolae. The isolation and analytical procedures as well as the time-dependent dissociation of signaling molecules from caveolae contribute to key compositional differences reported in the literature for caveolae. This new, rapid, magnetic immunoisolation procedure provides a consistent preparation for use in the molecular analysis of caveolae.
National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults

OBJECTIVES: This study examined national trends in 12-month prevalence of major depressive episodes (MDEs) in adolescents and young adults overall and in different sociodemographic groups, as well as trends in depression treatment between 2005 and 2014. METHODS: Data were drawn from the National Surveys on Drug Use and Health for 2005 to 2014, which are annual cross-sectional surveys of the US general population. Participants included 172 495 adolescents aged 12 to 17 and 178 755 adults aged 18 to 25. Time trends in 12-month prevalence of MDEs were examined overall and in different subgroups, as were time trends in the use of treatment services. RESULTS: The 12-month prevalence of MDEs increased from 8.7% in 2005 to 11.3% in 2014 in adolescents and from 8.8% to 9.6% in young adults (both P < .001). The increase was larger and statistically significant only in the age range of 12 to 20 years. The trends remained significant after adjustment for substance use disorders and sociodemographic factors. Mental health care contacts overall did not change over time; however, the use of specialty mental health providers increased in adolescents and young adults, and the use of prescription medications and inpatient hospitalizations increased in adolescents. CONCLUSIONS: The prevalence of depression in adolescents and young adults has increased in recent years. In the context of little change in mental health treatments, trends in prevalence translate into a growing number of young people with untreated depression. The findings call for renewed efforts to expand service capacity to best meet the mental health care needs of this age group.
Tuberculous Peritonitis: A Study Comparing Cirrhotic and Noncirrhotic Patients

Tuberculous peritonitis is a rare disease, which often goes unrecognized because of the subtle clinical clues and its insidous onset. We retrospectively analyzed the records of 37 cases of tuberculous peritonitis diagnosed over a 15-year period, and compared the clinical and diagnostic features of cirrhotic and noncirrhotic patients. In cirrhotic patients, tuberculous peritonitis can simulate as-cites from liver disease or spontaneous bacterial peritonitis. The diagnosis is difficult in these patients because the ascitic fluid may not be of the exudative type as a result of the low albumin level in serum, and lymphocytes do not predominate in all cases. Adenosine deaminase (ADA) activity in ascitic fluid was elevated (higher than 40 U/L) in all 11 patients (four patients with hepatic cirrhosis). The time required to achieve a correct diagnosis was significantly longer in cirrhotic than in noncirrhotic patients. The overall mortality was 13%, with deaths occurring exclusively among cirrhotic patients. We emphasize that tuberculous peritonitis in cirrhotic patients can present an atypical picture. A considerable element of suspicion is necessary.
Lobular Dissecting Hepatitis in the Dog

Ascites and acquired portosystemic shunts were consistent findings in six dogs with a chronic hepatitis of unusual morphology and unknown etiology. The hepatitis was characterized by a mixed inflammatory infiltrate and dissection of the lobular parenchyma by reticulin and fine collagen fibers. While limiting plates were disrupted by this process, portal inflammation was inconstant and seldom marked. Biopsy samples generally had very small, sublobular regenerative nodules, but larger nodules sometimes were present postmortem. Dilated vascular channels, representing sinusoids and portal venous radicles were a prominent feature of most affected livers. The lesions differ from previously documented chronic hepatitis in the dog, and from the chronic hepatitides in man.
Ancient Recombination Events between Human Herpes Simplex Viruses

Herpes simplex viruses 1 and 2 (HSV-1 and HSV-2) are seen as close relatives but also unambiguously considered as evolutionary independent units. Here, we sequenced the genomes of 18 HSV-2 isolates characterized by divergent UL30 gene sequences to further elucidate the evolutionary history of this virus. Surprisingly, genome-wide recombination analyses showed that all HSV-2 genomes sequenced to date comprise HSV-1 fragments. Using phylogenomic analyses, we could also show that two main HSV-2 lineages exist. One lineage is mostly restricted to sub-Saharan Africa while the other has reached a global distribution. Interestingly, only the worldwide lineage is characterized by ancient recombination events with HSV-1. Our findings highlight the complexity of HSV-2 evolution, a virus of likely zoonotic origin which later recombined with its human-adapted relative. They also suggest that co-infections with HSV-1 and 2 may have genomic and potentially functional consequences and should therefore be monitored more closely.