Miracle-dz/UniFAR-FTUs huggingface dataset:
Understanding the seasonal pattern of childhood asthma: results from the National Cooperative Inner-City Asthma Study (NCICAS).

OBJECTIVE To contrast the seasonal patterns of asthma symptoms and utilization and determine the impact of allergen sensitivity, environmental tobacco smoke (ETS) exposure, and air pollution on the seasonal patterns of asthma. STUDY DESIGN Participants in the National Cooperative Inner-City Asthma Study (NCICAS) were tracked for approximately 4 years after allergen skin testing and determination of exposure to ETS. Air pollution data were obtained from EPA monitoring sites in NCICAS cities. RESULTS Asthma symptoms (wheeze) and health care utilization (unscheduled visits and hospitalization) had similar seasonal patterns, with low points during the summer months of June through August and a distinct autumn peak beginning in September. Seasonal patterns were similar among children with no allergen skin test reactivity, those reactive only to indoor allergens, and those reactive to outdoor allergens. ETS exposure, whether defined by self-report or urinary cotinine/creatinine ratio, was not related to the observed seasonal patterns. Among the pollutants evaluated, only the seasonal pattern of SO(2) coincided with that of asthma morbidity. CONCLUSIONS Atopy, ETS, and most air pollutants do not appear to contribute to the distinct asthma seasonal pattern. On a population level, changes in symptoms are mirrored by changes in utilization.
Characterizing trends in fruit and vegetable intake in the USA by self-report and by supply-and-disappearance data: 2001–2014

Abstract Objective To examine the comparability of fruit and vegetable (F&V) intake data in the USA from 2001 to 2014 between data acquired from two national data collection programmes. Design Cross-sectional analysis. Linear regression models estimated trends in daily per capita intake of total F&V. Pooled differences in intake of individual F&V (n 109) were examined by processing form (fresh, frozen, canned, dried and juice). Setting What We Eat in America (WWEIA, 2001–2014) and Loss-Adjusted Food Availability data series (LAFA, 2001–2014). Results No temporal trends were observed in daily per capita intake of total F&V from 2001 to 2014 using WWEIA and LAFA. Modest differences between WWEIA and LAFA were observed in mean pooled intake of most individual F&V. Conclusions WWEIA and LAFA produced similar estimates of F&V intake. However, WWEIA may be best suited for monitoring intake at the national level because it allows for the identification of individual F&V in foods with multiple ingredients, and it is structured for sub-population analysis and covariate control. LAFA does retain advantages for other research protocols, specifically by providing the only nationally representative estimates of food losses at various points in the food system, which makes it useful for examining the adequacy of the food supply at the agricultural, retail and consumer levels.
The sugar absorption test in the evaluation of the gastrointestinal intolerance to bisphosphonates: Studies with oral pamidronate

Some bisphosphonates induce gastrointestinal side effects, but the localization in the gastrointestinal tract and the underlying mechanism are unknown. The feasibility of the sugar absorption test was investigated to assess the gastrointestinal effects of oral enteric‐coated pamidronate. The sugar absorption test measures the urinary excretion of lactulose, mannitol, and sucrose after oral intake. Increases in the lactulose/mannitol ratio and sucrose excretion indicate increased small intestinal permeability and gastroduodenal disease, respectively.
[A novel Krit-1 mutation in Han family with cerebral cavernous malformation].

OBJECTIVE To detect the mutations of Krit-1 gene that cause familial cerebral cavernous malformation (CCM) in the Han ethnic origin. METHODS The subjects were hospitalized in the Department of Neurosurgery, Tiantan Hospital affiliated to Capital University of Medical Sciences. Two families (A and B) and 8 apparently sporadic individuals affected with CCM were screened for mutations of Krit-1 gene. Members of the family CCM have a wide range in age of onset with seizures, headaches and skin lesions. The gene was screened by PCR amplification of 16 exons and mutation was detected by direct sequencing. RESULTS In family A samples, analysis of the Krit-1 gene revealed a new point mutation in exon 14 [a heterozygous C to G transition at nucleotide 1 289 (counting from the start codon or nt 2 308 counting from the first nt of the mRNA, aligned according to Gene Bank AF388384)] which predicts the substitution of a premature termination codon for Serine at codon 430 (S430X), belonging a nonsense point mutation. No mutation was identified in one of family A members as well as in any of the sporadic individuals with the exception of a single nucleotide polymorphism. CONCLUSIONS Report the first family in the Han with CCM having a novel mutation in the CCM1 gene on the continent of Asia. The newly identified mutation creates a premature termination codon and is predicted to produce a truncated Krev1 interaction-trapped 1 protein, KRIT1. This result allows efficient presymptomatic molecular diagnosis.
Cognitive profile in CADASIL

Background: The spectrum of cognitive alterations associated with CADASIL, a model of pure vascular dementia, has not been thoroughly evaluated. Objectives: The aims of this study were: (i) to describe the cognitive profile in CADASIL patients according to age; (ii) to compare the profile of patients with dementia with that of patients without dementia; and (iii) to determine the association between alterations in performance in different cognitive domains. Methods: Forty two consecutive individuals with CADASIL (35–73 years old) were investigated. Cognitive skills were analysed in five domains (executive functions, reasoning, attention, memory, visuospatial abilities) according to age and compared between patients with and without dementia. Associations between cognitive performance and stroke were tested. Results: The youngest patients presented with attention (69%), memory (70%), and executive disturbances (100%). Visuospatial abilities and reasoning deteriorated with age, mainly after the age of 60. About one quarter of patients had dementia, and 75% of these were >60 years of age. Age >60 years was associated with a Rankin score >3 and a significant deficit in all cognitive domains. No association was found between dementia and the number of ischaemic attacks. Episodic memory disorder was characterised by difficulties in retrieval rather than impairment of the encoding process. Conclusion: Cognitive decline in CADASIL is dominated by early impairment of executive functions. Skills in other cognitive domains deteriorate with age and are found to be diffusely impaired in patients with dementia. The relative preservation of the encoding process in episodic memory impairment, even in individuals with dementia, is noteworthy.
Effet chez le porcelet d’une exposition à un régime co-contaminé en mycotoxines, et appréciation des stratégies de lutte

Les mycotoxines sont des metabolites secondaires des moisissures qui peuvent naturellement contaminer de nombreuses denrees alimentaires, notamment les cereales. Dans les travaux de these, nous nous sommes interesses a deux mycotoxines majeures produites par des champignons du genre Fusarium, le Deoxynivalenol (DON) et la Fumonisine (FB). Les objectifs de la these ont ete de determiner les effets individuels et combines d’une contamination en DON et FB chez le porc, une espece cible et sensible aux mycotoxines. Les effets sur les fonctions immunitaires lors d’un challenge antigenique ainsi que sur les fonctions intestinales ont ete evalues. Par ailleurs, dans le cadre d’un partenariat avec un industriel, nous avons evalue in vivo les effets de methodes de detoxification par biotransformation et ciblant specifiquement ces deux toxines. Chez le porc, l’ingestion d’aliments contamines avec de faibles doses de mycotoxines (DON, 3 mg/kg ; FB, 6 mg/kg) a provoque des lesions tissulaires (foie, reins et poumons) et a fortement altere la mise en place d’une reponse immunitaire specifique de l’antigene (expression des cytokines, proliferation des lymphocytes et anticorps specifiques). Les animaux ont ete significativement plus affectes apres la consommation du regime co-contamine, et l’interaction a pu etre consideree comme additive. De plus, les parametres intestinaux examines ont revele des changements dans la morphologie, dans le profil de secretion des cytokines et dans l’adhesion cellulaire. L’interaction des deux toxines a pu ici etre caracterisee comme moins qu’additive. Les approches de detoxification biologique proposees par l’industriel etaient basees sur la transformation par voie enzymatique du DON et des FB, a partir d’un microorganisme entier et d’une enzyme respectivement. La strategie d’elimination des FB a suscite un interet plus important etant donne que cette methode est non commercialisee et en cours de developpement. Ainsi, la toxicite du produit d’hydrolyse de la FB1 (mycotoxine principale de la famille des FB) obtenu initialement par traitement enzymatique, a ete comparee in vivo a celle de la molecule mere la FB1. Les resultats ont montre que l’hydrolyse de la FB1 reduisait fortement la toxicite hepatique et intestinale chez les porcelets. L’experimentation animale avec le DON et la FB, seuls ou en combinaison a ensuite ete reproduite afin de determiner l’efficacite d’hydrolyse de ce procede chez le porc apres incorporation de l’enzyme dans les aliments contamines. Dans ces aliments, le microorganisme entier ciblant le DON avait egalement ete inclus. La nette diminution du marqueur d’exposition des FB et la neutralisation partielle ou totale des effets ont suggere que le procede avait fortement reduit la biodisponibilite des FB dans le tractus gastro-intestinal. Cette observation a aussi ete en partie confirmee pour l’approche de degradation du DON. La biotransformation par voie enzymatique des mycotoxines represente ainsi une strategie biotechnologique prometteuse dans la lutte contre ces contaminants.
[Immunoinflammatory changes (myocarditis?) in chronic heart failure in alcoholic patients].

AIM To estimate the contribution of immuno-inflammatory changes to the formation of clinical and hemodynamic features in alcoholic patients with chronic heart failure (CHF). SUBJECTS AND METHODS Forty-five males with CHF in the presence of alcohol-induced heart damage (AIHD) who had been admitted to therapeutic units for decompensated heart failure were examined. A control group consisted of 20 men with the CHF severity comparable with the NYHA classification in the presence of prior myocardial infarction. All the patients underwent examination of the immune-inflammatory status--the cytokines: interleukin (IL) 6, IL-8, IL-12, tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta1, endotoxin, cellular immune parameters, and cardiac structure and function by echocardiography. RESULTS The patients with CHF in the presence of AIHD, as compared to those with ischemic cardiomyopathy, showed the higher levels of inflammatory cytokines (IL-6, TNF-alpha, IL-12, and endotoxin) and cell-mediated immunity changes (the smaller count of suppressor T cells, natural killer cells, and a shift of the T-helper/T-suppressor ratio towards the T-helper population). The magnitude of these changes correlated with the severity of CHF and cardiac morphofunctional changes. CONCLUSION The relationship of immuno-inflammatory changes to the severity of CHF and the morphofunctional state of the heart irrespective of the etiology of heart failure demonstrated the role of immune inflammation in its pathogenesis particularly in alcoholic patients who were found to have more marked immuno-inflammatory changes than in those with ischemic cardiomyopathy.
Cranial MR imaging in Wilson's disease.

OBJECTIVE The purpose of the study was to describe the range of abnormalities seen on cranial MR images of patients with Wilson's disease and correlate the findings with clinical severity, duration of disease, and duration of neurologic signs and symptoms before treatment. In those patients with serial studies, the changes on MR images were compared with the clinical response. SUBJECTS AND METHODS Twenty-five patients with Wilson's disease underwent MR imaging of the brain using conventional spin-echo sequences (n = 25), phase maps (n = 8), and partially refocused interleaved multiple-echo sequences (n = 5). RESULTS MR imaging findings were abnormal in 22 patients and normal in three patients. The basal ganglia were interpreted as abnormal in 19 (86%) of 22 patients, involving the putamen in 19 (86%), the thalami in 12 (54%), the caudate head in 10 (45%), and the globus pallidus in nine (41%). We found a predilection for involvement of the outer rim of the putamen and the ventral nuclear mass of the thalami. The claustrum was abnormal in three patients. The midbrain was abnormal in 17 (77%) of these 22 patients, affecting predominantly the tegmentum but also the substantia nigra, red nuclei, inferior tectum, and crura. The pons was abnormal in 18 (82%) of 22 patients, and the cerebellum was abnormal in 11 patients (50%), with involvement of the superior and middle cerebellar peduncles. Atrophy was present in 18 (82%) of 22 patients, and cortical white matter changes were apparent in 13 (59%) of 22 patients. The scan of one untreated patient revealed shortening of the T1 relaxation time in the thalami, which was consistent with the paramagnetic effects of copper. Phase maps and partially refocused interleaved multiple-echo sequences performed in eight and five patients, respectively, and used to reveal a susceptibility change induced by iron or copper showed normal findings. We found a significant inverse relationship between severity, but not extent, of change in signal intensity and the length of untreated disease (p = .030) and the total duration of disease (p = .015). The study group was too small to show a correlation with clinical findings. Changes seen on MR images matched the clinical response to treatment in only two of the seven patients who underwent follow-up studies. CONCLUSION MR imaging revealed abnormalities in the basal ganglia, cerebral white matter, midbrain, pons, and cerebellum. The paramagnetic effects of copper were detected only in untreated patients. Patients with a longer duration of disease had less severe changes in signal intensity. MR imaging was of limited value in follow-up.
[Stigmatisation of psychiatric patients by general practitioners and medical students: a review of the literature].

BACKGROUND In clinical practice general practitioners (GPS) and society tend to stigmatise patients with psychiatric problems. AIM To attempt to describe this stigmatisation by GPS and medical students on the basis of information given in the literature. METHOD We searched the literature via PubMed using mesh terms: 'family practice', 'physicians', 'family', 'mental disorder', 'attitude' and 'psychiatry' and the word 'stigma'. In addition, literature was supplied by experts and articles were located by the snowball method. RESULTS Stigmatisation constitutes a major obstacle in the psychiatric and somatic care that gps provide for patients with a psychiatric disorder. Although such patients have a higher somatic vulnerability as a result of their psychiatric problems, they receive fewer technical and exploratory investigations than other categories of patients. Medical students too have a negative attitude towards patients with a psychiatric disorder. More education and training could lead to less stigmatisation but the effect would probably be only temporary. Personal experience is the main factor that leads to greater empathy. CONCLUSION The literature suggests that psychiatric patients are victims of self-inflicted stigmatisation and stigmatisation by society and doctors. This leads to social exclusion and poorer healthcare. By tackling the problem of stigmatisation we could greatly improve the quality of life and healthcare for this group of patients.
Health anxiety among older people: an exploratory study of health anxiety and safety behaviors in a cohort of older adults in New Zealand

ABSTRACT Background: Despite a stereotype that characterizes older people as excessively anxious about their health, there is little research into this phenomenon. The present exploratory study examined: (a) whether a cohort of older adults was unduly health anxious, (b) which demographic and health factors predicted health anxiety (HA), and (c) whether an aspect of the cognitive behavioral model of HA was applicable to older adults by investigating the relationship between HA and safety behaviors. Method: Participants were a convenience sample of adults aged over 65 and living independently in Auckland, New Zealand. Participants (104 women and 41 men) completed an anonymous self-report questionnaire measuring demographic factors, physical health and function, health anxiety, safety behaviors, and medical utilization. Results: This cohort of adults over 65 were not unduly health anxious. Occurrence of severe HA was similar to that found in younger populations. Decreased physical function and lower education predicted scores on the HA measure. Consistent with the cognitive behavioral model, HA was a unique significant predictor of safety behaviors. HA and decreased physical function predicted medical utilization. Conclusions: Generally low levels of HA among this cohort of older individuals challenged the pervasive stereotype of the “hypochondriacal” older person. Factors contributing to HA were similar to those reported in studies with younger cohorts. Findings provided preliminary support for the applicability of the cognitive behavioral model of HA to adults over 65. Implications of the findings and directions for future research were discussed.
Clitocypin, a New Type of Cysteine Proteinase Inhibitor from Fruit Bodies of Mushroom Clitocybe nebularis *

A novel inhibitor of cysteine proteinases has been isolated from fruit bodies of a mushroom Clitocybe nebularis. The inhibitor was purified to homogeneity by affinity chromatography and gel filtration, followed by reverse-phase high pressure liquid chromatography. The active inhibitor has an apparent molecular mass of about 34 kDa by gel filtration and by SDS-polyacrylamide gel electrophoresis without prior boiling of the sample. Boiling in 2.5% SDS or incubation in 6 m guanidine hydrochloride resulted in a single band of 17 kDa, indicating homodimer composition with no intersubunit disulfide bonds. The inhibitor in nondenaturing buffer is resistant to boiling in water, retaining its activity and dimer composition. The mushroom protein is a tight binding inhibitor of papain (K i = 0.59 nm), cathepsin L (K i = 0.41 nm), cathepsin B (K i = 0.48 μm), and bromelain (K i = 0.16 μm) but is inactive toward cathepsin H, trypsin, and pepsin. Its isoelectric point is 4.4, and sugar analysis indicates the absence of carbohydrate. A single protein sequence of 150 amino acids, containing no cysteine or methionine residues, was obtained by amino acid sequencing. The calculated molecular mass of 16854 Da corresponds well with the value obtained by mass spectrometry. A major part of this sequence was verified by molecular cloning. The monomer sequence is clearly devoid of typical cystatin structure elements and has no similarity to any other known cysteine proteinase inhibitors but bears some similarity to a lectin-like family of proteins from mushrooms. The inhibitor, which is present in at least two other members of the Clitocybegenus, has been named clitocypin (Clitocybe cysteine proteinase inhibitor).
Network meta-analysis of Chinese herbal injections combined with the chemotherapy for the treatment of pancreatic cancer

Background: This study sought to use a network meta-analysis to assess the effectiveness and safety of Chinese herbal injections (CHIs) combined with the chemotherapy for the treatment of pancreatic cancer. Methods: Randomized controlled trials (RCTs) regarding CHIs to treat pancreatic cancer were searched in PubMed, the Cochrane library, Embase, the China National Knowledge Infrastructure Database (CNKI), the Wan-Fang Database, the Chinese Scientific Journals Full-text Database (VIP), and the Chinese Biomedical Literature Database (SinoMed) up to November 2016. The quality assessment was conducted by the Cochrane risk of bias tool and network meta-analysis was performed to compare the effectiveness and safety of different CHIs combined with the chemotherapy. Data were analyzed using STATA 12.0 and Win-BUGS 1.4 software. Results: A total of 278 records were searched, and 22 eligible RCTs involving 1329 patients and 9 CHIs were included. The results of the network meta-analysis demonstrated that compared with the chemotherapy alone, Compound Kushen, Kangai or Kanglaite injection combined with chemotherapy yielded significantly higher probability of improving performance status. Aidi injection combined with chemotherapy was more effective in relieving leucopenia than using chemotherapy single. And these between-group differences were statistically significant. However, CHIs combined with chemotherapy could not achieve a better effect in the total clinical effect, nausea and vomiting. As for the cluster analysis for the adverse reactions (ADRs), the chemotherapy alone and Huachansu injection combined with the chemotherapy were inferior to relieve ADRs than the other CHIs plus chemotherapy for patients with pancreatic cancer. Conclusions: The current evidence showed that using CHIs on the basis of the chemotherapy could be beneficial for patients with pancreatic cancer in improving performance status and reducing the ADRs.
Intraoperative US in patients undergoing surgery for liver neoplasms: comparison with MR imaging.

PURPOSE To retrospectively compare intraoperative ultrasonography (US) and preoperative magnetic resonance (MR) imaging with contrast material enhancement for the depiction of liver lesions in patients undergoing hepatic resection. MATERIALS AND METHODS A radiologist (D.V.S.) and a surgeon (K.K.T.) retrospectively identified 79 patients (36 female and 43 male patients; age range, 10-78 years; mean age, 57 years) who had undergone surgical resection for primary liver tumor or metastasis and had also undergone preoperative contrast-enhanced MR imaging within 6 weeks before surgery. MR imaging was performed with a 1.5-T system. Dedicated intraoperative US of the liver was performed or supervised by a gastrointestinal radiologist using a 7.5-MHz linear-array transducer, after adequate hepatic mobilization by the surgeon. Histopathologic evaluation of the 159 resected hepatic lesions served as the reference standard. The lesion distribution included colon cancer metastasis (n = 122), hepatocellular carcinoma (n = 23), cholangiocarcinoma (n = 6), cavernous hemangioma (n = 4), focal nodular hyperplasia (n = 2), hamartoma (n = 1), and metastatic embryonal sarcoma (n = 1). RESULTS Of 159 lesions, 138 (86.7%) were identified at both MR imaging and intraoperative US. Twelve additional lesions (7.5%) in 10 patients were detected only at intraoperative US (eight metastases, one hepatocellular carcinoma, one cholangiocarcinoma, one hemangioma, and one biliary hamartoma). Both modalities failed to depict nine lesions (5.6%) (four metastases, four hepatocellular carcinomas, and one cholangiocarcinoma). The sensitivities of MR imaging and intraoperative US for liver lesion depiction were 86.7% and 94.3%, respectively. Surgical management was altered on the basis of the intraoperative US findings in only three of 10 patients (4%). CONCLUSION Contrast-enhanced MR imaging is as sensitive as intraoperative US in depicting liver lesions before hepatic resection.