Miracle-dz/UniFAR-FTUs huggingface dataset:
Cancer Prevention and Treatment by Ganoderma, a Mushroom with Medicinal Properties

Ganoderma, highly ranked in Oriental traditional medicine, has been used as a remedy for many types of chronic diseases, including hepatopathy, type II diabetes, neurasthenia, hypertension, and cancer. Various polysaccharides (i.e., β-D-glucans and glycoproteins) and triterpenoids are the major active constituents present in Ganoderma. In vitro and animal studies have indicated that Ganoderma exhibits cancer-preventive and anticancer activity. Data from a clinical study in cancer patients showed Ganopoly, a crude Ganoderma polysaccharide extract, enhanced host immune function, including increased activity of effector cells such as T lymphocytes, macrophages, and natural killer cells, despite the lack of striking objective antitumor activity. Several clinical studies revealed that treatment of prostate cancer patients with the Ganoderma-containing PC-SPES (a mixture of eight herbal extracts) gave a significant decrease in the prostate-specific antigen levels, which compares favorably with second-line hormonal therapy that has agents such as estrogens and ketoconazole. Currently available data from numerous in vitro and in vivo studies suggest that the cancer-preventive and tumoricidal properties of Ganoderma might be ascribed to its antioxidative and radical-scavenging effects, enhancement of host immune function, induction of cell-cycle arrest and apoptosis, and other biological effects. Although Ganoderma may represent a practical and promising approach for cancer prevention and cancer treatment, further experimental, epidemiological, and clinical studies are needed to identify unrevealed molecular targets, resolve the relationship between Ganoderma intake and cancer risks, and explore the optimum dosing, efficacy, and safety, alone or in combination with chemotherapy/radiotherapy.
Modern surgical outcomes following surgery for sphenoid wing meningiomas.

OBJECT Cushing and Eisenhardt were the first to describe sphenoid wing meningiomas in detail, categorizing globoid tumors into 3 groups: 1) medial; 2) middle; and 3) lateral. The authors review their experience with resection of sphenoid wing meningiomas at a single center, to examine whether this classification predicts clinical presentation and postsurgical outcome. METHODS All patients undergoing resection of sphenoid wing meningioma at the authors' institution over a 9-year period were identified. Clinical data were compared from patients with tumors arising at different points along the sphenoid wing to determine if these tumors behaved differently in terms of symptoms, radiographic characteristics, and postsurgical outcome. RESULTS A total of 56 patients underwent microsurgical resection for sphenoid wing meningioma during this period. The rates of optic canal invasion (medial 50% vs middle 5% vs lateral 0%; p<0.0001, chi-square test), supraclinoid internal carotid artery encasement (medial 32% vs middle 5% vs lateral 0%; p<0.01, chi-square test), and middle cerebral artery encasement (medial 45% vs middle 24% vs lateral 0%; p<0.01, chi-square test) were all highest with medial-third tumors. New or worsened neurological deficits occurred in 10 (19%) of 56 patients. Of all the imaging characteristics studied, only location of the tumor along the medial third of the sphenoid wing significantly predicted an increased rate of new or worsened neurological deficit (OR 2.7, p<0.05). CONCLUSIONS The authors report outcomes in a large series of sphenoid wing meningiomas that were treated using modern surgical techniques.
End-of-life care conversations with heart failure patients: a systematic literature review and narrative synthesis.

BACKGROUND Current models of end-of-life care (EOLC) have been largely developed for cancer and may not meet the needs of heart failure patients. AIM To review the literature concerning conversations about EOLC between patients with heart failure and healthcare professionals, with respect to the prevalence of conversations; patients' and practitioners' preferences for their timing and content; and the facilitators and blockers to conversations. DESIGN OF STUDY Systematic literature review and narrative synthesis. METHOD Searches of Medline, PsycINFO and CINAHL databases from January 1987 to April 2010 were conducted, with citation and journal hand searches. Studies of adult patients with heart failure and/or their health professionals concerning discussions of EOLC were included: discussion and opinion pieces were excluded. Extracted data were analysed using NVivo, with a narrative synthesis of emergent themes. RESULTS Conversations focus largely on disease management; EOLC is rarely discussed. Some patients would welcome such conversations, but many do not realise the seriousness of their condition or do not wish to discuss end-of-life issues. Clinicians are unsure how to discuss the uncertain prognosis and risk of sudden death; fearing causing premature alarm and destroying hope, they wait for cues from patients before raising EOLC issues. Consequently, the conversations rarely take place. CONCLUSION Prognostic uncertainty and high risk of sudden death lead to EOLC conversations being commonly avoided. The implications for policy and practice are discussed: such conversations can be supportive if expressed as 'hoping for the best but preparing for the worst'.
Implementing Clinical Practice Changes: A Practical Approach

Implementing changes in clinical practice is critical for insuring the highest quality patient care. Ideally, changes in clinical practice should be based upon high-quality research findings or so-called evidence-based medicine. The increase in health care expenditures and data on the variance in clinical practices are exerting external pressures on professionals to justify practice patterns and are now tightly linked to reimbursement. As these factors fuel tensions between quality practice and care on one hand and cost on the other, clinicians must increasingly be prepared to justify the processes and resources used to deliver the required care to produce optimal patient outcomes. Continuously monitoring the clinical literature and implementing clinical practice changes, when a sufficient body of evidence exists, will contribute to improved patient outcomes. This involves three practical steps: (a) examining and evaluating the research, (b) gauging the likelihood of success, and (c) recommending and implementing a clinical practice change.
Trends in Mortality From All Causes and Cardiovascular Disease Among Hypertensive and Nonhypertensive Adults in the United States

Background— Little is known about trends in the mortality rate among people with hypertension in the United States. The objective of the present study was to examine the change in the all-cause mortality rate among people with and without hypertension in the United States and whether any such changes differed by sex or race. Methods and Results— Data from 10 852 participants aged 25 to 74 years of the National Health and Nutrition Examination Survey (NHANES) I Epidemiological Follow-Up Study (1971 to 1975) and of 12 420 participants of the NHANES III Linked Mortality Study (1988 to 1994) were used. The mean follow-up times were 17.5 and 14.2 years, respectively. In each cohort, the mortality rate was higher among hypertensive adults than nonhypertensive adults, among hypertensive men than hypertensive women, and among hypertensive blacks than hypertensive whites. Among all hypertensive participants, the age-adjusted mortality rate was 18.8 per 1000 person-years for NHANES I and 14.3 for NHANES III (13.3 and 9.1 per 1000 person-years for nonhypertensive participants, respectively). The reduction among hypertensive men (7.7 per 1000 person-years; 95 confidence interval, 5.2 to 10.2) exceeded that among hypertensive women (1.9 per 1000 person-years; 95 confidence interval, [−0.4 to 4.2]) (P<0.001), and the reduction among hypertensive blacks (5.4 per 1000 person-years; 95 confidence interval, [0.6 to 10.1]) exceeded that among hypertensive whites (4.4 per 1000 person-years; 95 confidence interval, [2.2 to 6.5]) (P=0.707). Conclusions— The mortality rate decreased among hypertensive adults, but the mortality gap between adults with and without hypertension remained relatively constant. Efforts are needed to accelerate the decrease in the mortality rate among hypertensive adults.
Interleukin-1β Promotes Epithelial-Derived Alveolar Elastogenesis via αvβ6 Integrin-Dependent TGF-β Activation

Background/Aims: IL-1β creates persistent pulmonary inflammation accompanied by elevated transforming growth factor β (TGF-β levels and is associated with abnormal elastogenesis, which is observed in bronchopulmonary dysplasia (BPD). Although progress has been made in this field, the mechanisms underlying this process remain only partially understood. Methods: We assessed aberrant elastin localization-associated signaling in mouse pups exposed to 85% O2 treated with either IL-1Ra or 1D11, using morphometric analyses, quantitative RT-PCR, immunostaining, and ELISA. We also evaluated the derivation of elastin-producing cells using dual marker tracking. The regulatory mechanisms of IL-1β were investigated in vitro in lung epithelial and mesenchymal cells. Results: Elevated levels of IL-1β, αvβ6 and TGF-β1 were each associated with aberrant elastin production in O2-exposed lungs. IL-1Ra abolished TGF-β1 activation and αvβ6 upregulation, which occurred as a result of exposure to hyperoxia, whereas 1D11 had no discernible effect on the expression of either αvβ6 or IL-1β even following O2-exposure, suggesting that IL-1β was initially induced. Additionally, double staining revealed the presence of epithelium-derived elastin-producing cells, which was confirmed via in vitro IL-1β stress-induced epithelial-mesenchymal transformation (EMT) morphological and molecular marker changes, which may explain the altered lung elastin deposition and defective septation observed in BPD. Conclusions: These data support the hypothesis that IL-1β was initially induced by hyperoxia; αvβ6 subsequently interacted with and activated TGF-β1, acting as an epithelial/mesenchymal signaling molecule that contributed to excessive alveolar elastogenesis, the primary pathological feature of BPD.
The complete mitogenome of the Australian land crayfish Engaeus lyelli (Clark 1936) (Crustacea: Decapoda: Parastacidae)

Abstract The complete mitochondrial genome of the enigmatic freshwater crayfish Engaeus lyelli was sequenced using the MiSeq Personal Sequencer (Illumina, San Diego, CA). The mitogenome has 16,027 bp consisting of 13 protein-coding genes, 2 ribosomal subunit genes, 23 transfer RNAs, and a non-coding AT-rich region. The base composition of E. lyelli is 29.01% for T, 27.13% for C, 31.43% for A, and 12.44% for G, with an AT bias of 60.44%. The species has the distinctive gene order characteristic of parastacid crayfish with the exception of some minor rearrangements involving the tRNA genes.
Different characteristics of diabetic ketoacidosis between type 1 and type 2 diabetes patients in Malaysia

Background: Diabetic ketoacidosis (DKA) is increasing in patients with type 2 diabetes in Asian countries. However, there is little information regarding the frequency and characteristics of DKA for Malaysian population. Objective: To identify the different clinical and biochemical features of DKA between adult patients with type 1 and type 2 diabetes. Methods: A cross-sectional, retrospective study was performed at University Malaya Medical Centre (UMMC) between January 2000 and December 2005. All patients (aged >18 years) with type1 or type 2 diabetes were included in this study. Clinical and biochemical characteristics of DKA were studied. Precipitating factors for the development of DKA were also identified. Results: One hundred and twenty patients (61.9%) presented with DKA had type 2 diabetes. Both type 1 and type 2 patients had similar symptoms. Nausea (44.0%) and vomiting (66.4%) were most common symptoms of DKA. Infection (40.5%) was main precipitating factors of DKA. Blood pH level in previously-diagnosed type 1 diabetes patients was lower than that in previously-diagnosed type 2 diabetes (7.18±0.18 vs. 7.26±0.16, p<0.0001). Conclusion: A high proportion of DKA occurs in patients with type 2 diabetes. DKA developed severely in newly-diagnosed type 2 diabetes patients more than in previously-diagnosed type 2 diabetes patients.
Estilos de aprendizaje de Kolb en estudiantes de medicina

The objective of this work was to study the relationship of Kolb's learning styles in academic success or failure in medical students. A prospective cohort study in 116 medical students of a private Argentine university was performed between March 2005 and March 2011. The follow-up included two cut-offs; during 2005-2006 the students' learning styles were determined and five years later, when individuals had to end their career, they were grouped into graduated, delayed or dropped status. At the end of the period, 50% of the students ended successfully, 24.1% abandoned and 25.9% was delayed. Learning styles were assimilator in 60.3% of cases, divergent in 14.7%, accommodator in 6.9%, convergent in 6.0% and undefined in 12.1%. In conclusion, the follow-up during the career demonstrated that convergent or undefined styles had a tendency to abandon the career, while delayed students had a more theoretical and reflexive style than successful individuals. The results observed in convergent students differed from other reports. This difference would be explained by a particular characteristic of the sample or by the teaching and evaluation profile of the university.
Ambrisentan and Tadalafil Up-front Combination Therapy in Scleroderma-associated Pulmonary Arterial Hypertension.

BACKGROUND Scleroderma-associated pulmonary arterial hypertension (SSc-PAH) is a rare disease characterized by a very dismal response to therapy and poor survival. We assessed the effects of up-front combination PAH therapy in patients with SSc-PAH. METHODS In this prospective, multicenter, open-label trial, 24 treatment-naive patients with SSc-PAH received ambrisentan 10 mg and tadalafil 40 mg daily for 36 weeks. Functional, hemodynamic, and imaging (cardiac magnetic resonance imaging and echocardiography) assessments at baseline and 36 weeks included changes in right ventricular (RV) mass and pulmonary vascular resistance as co-primary endpoints and stroke volume/pulmonary pulse pressure ratio, tricuspid annular plane systolic excursion, 6-minute walk distance, and N-terminal pro-brain natriuretic peptide as secondary endpoints. RESULTS At 36 weeks, we found that treatment had resulted in significant reductions in median (interquartile range [IQR]) RV mass (28.0 g [IQR, 20.6-32.9] vs. 32.5 g [IQR, 23.2-41.4]; P < 0.05) and median pulmonary vascular resistance (3.1 Wood units [IQR, 2.0-5.7] vs. 6.9 Wood units [IQR, 4.0-12.9]; P < 0.0001) and in improvements in median stroke volume/pulmonary pulse pressure ratio (2.6 ml/mm Hg [IQR, 1.8-3.5] vs. 1.4 ml/mm Hg [IQR 8.9-2.4]; P < 0.0001) and mean ( ± SD) tricuspid annular plane systolic excursion (2.2 ± 0.12 cm vs. 1.65 ± 0.11 cm; P < 0.0001), 6-minute walk distance (395 ± 99 m vs. 343 ± 131 m; P = 0.001), and serum N-terminal pro-brain natriuretic peptide (647 ± 1,127 pg/ml vs. 1,578 ± 2,647 pg/ml; P < 0.05). CONCLUSIONS Up-front combination therapy with ambrisentan and tadalafil significantly improved hemodynamics, RV structure and function, and functional status in treatment-naive patients with SSc-PAH and may represent a very effective therapy for this patient population. In addition, we identified novel hemodynamic and imaging biomarkers that could have potential value in future clinical trials. Clinical trial registered with www.clinicaltrials. gov (NCT01042158).
Medicare Services Provided by Cardiologists in the United States: 1999–2008

Background— Services provided by cardiologists represent a major portion of Medicare expenditures for specialist physicians. The absolute growth and distribution of these services over the past decade have not been well described. Methods and Results— We analyzed fee-for-service Medicare Part B claims for each year from 1999–2008 and selected claims from physicians whose specialty code was cardiology. We then grouped approximately 1000 CPT-9 codes into 45 specific service groups that were then further aggregated into 3 broad service categories: evaluation and management, noninvasive procedures, and invasive procedures. Our main outcome measures were services and allowed charges per 1000 beneficiaries. Sample size ranged from 30.9 million beneficiaries in 1999 to 31.7 million in 2008. During this 10-year period, the number of claims from cardiologists increased 44% (from 2082–2997 per 1000 beneficiaries) while the allowed charges increased 28% after adjusting for inflation (in 2008 dollars, from $181 397–231 728 per 1000 beneficiaries). Evaluation and management services and invasive procedures contributed relatively little to this growth. Instead, most of the growth involved noninvasive procedures—with a 70% increase in claims. Although the most dramatic increases in noninvasive procedures involved emerging imaging technologies (cardiac CT, MRI, and PET scanning), the bulk of the growth occurred in two established technologies: resting echocardiograms and stress tests with nuclear imaging. Conclusions— Most of the growth in services provided by cardiologists over the past decade is the result of increased noninvasive imaging.
Bacterial isolates from the stools of children aged less than 5 years with acute diarrhea in Kaduna, Northwestern Nigeria

Background: Diarrhea is a significant cause of morbidity and mortality among children aged less than 5 years in sub-Saharan Africa. Bacterial organisms are important etiological agents and their identification is vital to effective management. Objective: To identify characteristics of bacterial isolates in the stools of children aged less than 5 years with acute diarrhea. Materials and Methods: The stools of children aged less than 5 years presenting with acute diarrhea were cultured using deoxycholate citrate agar and Salmonella-Shigella agar. Data were analyzed using Epi Info version 3.5. 3 and P values <0.05 were regarded as significant. Results: Stool samples were obtained from 270 children aged 0.2 to 4.9 years (mean: 1.6 ΁ 1.4 years). Majority of the children were males (156, 57.8%) and aged <2 years (64.1%). Diarrhea was bloody in 28 (11.8%) children. Antibiotic therapy was instituted in 185 (68.7%) children before presentation and mostly prescribed by caregiver (87, 47%). Metronidazole (154, 83.2%) was the commonest antibiotic prescribed. Bacteria were isolated in 175 (64.8%) samples. The commonest isolate was Escherichia coli (105, 60%). Bacteria were isolated from 7 (25%) of bloody diarrhea stools and the isolates were E. coli (2, 28.6%) and Shigella spp. (5, 71.4%). Isolates were most sensitive to ciprofloxacin (167, 95.4%). Bacterial isolation was significantly (P < 0.05) associated with age <2 years, nonuse of antibiotics, and bloody diarrhea. Conclusion: Enterobacteria are still important etiological agents of acute diarrhea among children. The study highlights the need for appropriate treatment of children with diarrhea and promotion of its prevention.
Efficacy of bendamustine and rituximab as first salvage treatment in chronic lymphocytic leukemia and indirect comparison with ibrutinib: a GIMEMA, ERIC and UK CLL FORUM study

We performed an observational study on the efficacy of ben-damustine and rituximab (BR) as first salvage regimen in chronic lymphocytic leukemia (CLL). In an intention-to-treat analysis including 237 patients, the median progression-free survival (PFS) was 25 months. The presence of del(17p), unmutated IGHV and advanced stage were associated with a shorter PFS at multivariate analysis. The median time-to-next treatment was 31.3 months. Front-line treatment with a chemoimmunotherapy regimen was the only predictive factor for a shorter time to next treatment at multivariate analysis. The median overall survival (OS) was 74.5 months. Advanced disease stage (i.e. Rai stage III-IV or Binet stage C) and resistant disease were the only parameters significantly associated with a shorter OS. Grade 3-5 infections were recorded in 6.3% of patients. A matched-adjusted indirect comparison with ibrutinib given second-line within Named Patient Programs in the United Kingdom and in Italy was carried out with OS as objective end point. When restricting the analysis to patients with intact 17p who had received chemoimmunotherapy in first line, there was no difference in OS between patients treated with ibrutinib (63% alive at 36 months) and patients treated with BR (74.4% alive at 36 months). BR is an efficacious first salvage regimen in CLL in a real-life population, including the elderly and unfit patients. BR and ibrutinib may be equally effective in terms of OS when used as first salvage treatment in patients without 17p deletion.
Current situation and trends of drug abuse and HIV/AIDS in China

Drug abuse re-emerged in mainland China in the 1980s and has spread dramatically over the last decades; the cumulative number of registered drug users increased to 1.16 million by the end of 2005. Among them, 78.3% were heroin addicts and the majority of them (50–70%) were injecting drug users. The abuse of amphetamine-type stimulants emerged at the end of the 1990s and spread quickly. Injecting drug use and unsafe sexual behavior among drug users have been the key factors in the spread of HIV/AIDS. By the end of September 2008, the cumulative total of reported HIV/AIDS cases was 264,302 in China. The Chinese government takes great measures and strategies to prevent HIV/AIDS transmission and reduce drug-related harms, including methadone-maintenance treatment and needle-exchange programs. Moreover, antiretroviral therapy has been provided for AIDS patients. The Chinese government will continue to implement strategies to prevent the spread of HIV/AIDS among drug users in the future.
Alcohol use disorders in elderly people: fact or fiction?

The number of older people is increasing in populations throughout the world. Alcohol use disorders in elderly people are a common but underrecognised problem associated with major physical and psychological health problems. Owing to the negative attitudes and inadequate training of healthcare professionals, alcohol misuse is not always being detected or effectively treated. Current diagnostic criteria and common screening instruments for alcohol use disorders may not be appropriate for elderly people. Older people are as likely to benefit from treatment as younger people and the basic principles of treatment are much the same. Better integrated and outreach services are needed. Training of healthcare professionals in this area and pragmatic research should be prioritised to improve detection, treatment and service provision for this vulnerable and neglected population.
The role of advanced glycation end products in the hyperinflammatory response of diabetic wounds

Chronic wounds are a frequent complication in diabetic patients and contribute significantly to morbidity and mortality. In the hyperglycaemic state, advanced glycation end products (AGEs) form, affecting collagen cross-linking, cytokine, nitric oxide and growth factor production and molecular signalling pathways. AGE receptors are upregulated and as it activates NF-kappaB, a host of inflammatory cytokines are expressed, exacerbating the self-sustaining inflammatory response seen in diabetic wounds. Therapeutic strategies include inhibiting the formation of AGEs, either directly or by inhibiting the formation of intermediates, and blocking the AGE receptor. A more complete understanding of the biology of the diabetic wound healing process is imperative in the development of successful treatment of diabetic wounds.