Miracle-dz/UniFAR-FTUs huggingface dataset:
A Boceprevir Failure in a Patient Infected with HCV Genotype 1G: Importance and Limitations of Virus Genotyping Prior to HCV Protease-Inhibitor-Based Therapy

A patient classified as HCV-1a-positive by both LiPA Siemens 2.0 and Abbott RealTime HCV Genotype II was instead found to be infected with HCV-1g, as determined by phylogenetic analysis of NS3 sequences. HCV-1g NS3 sequences available to date naturally harbour the resistance substitution T54S, plus P131S and L135F changes, located in the highly conserved NS3 positions within the boceprevir-binding site, as determined by structural modelling. HCV-1g NS3 sequences show some similarities to HCV-4 and are poorly responsive to interferon/ribavirin and to boceprevir/telaprevir; this patient was also a null-responder to boceprevir treatment. Baseline genotypic resistance testing may provide crucial information for the management of first-generation protease-inhibitor-based regimens, including both HCV genotype/subtype and natural resistance.
Colorectal Surgery. A Companion to Specialist Surgical Practice

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Pattern of Liver Diseases

Background: The knowledge of distribution and pattern of liver disease in a tertiary care center provides an overview of disease pattern in a community. It also helps in planning and prioritizing strategies to treat the diseases and reduce their burden in the community. Methods: A retrospective study was conducted among patients admitted to the Liver unit, Bir Hospital from April 13, 2008 to October 16, 2008. Demographic profile and disease pattern was studied. Descriptive analysis was used to calculate frequencies and percentage and their relations. Results: Male to female ratio was 2.3:1. The mean age was 41.9 (SD 14.8). Median hospital stay was 8.0 days (Q25-75 6.0-12.0). The top three diseases were alcoholic liver disease 50 (38.5%), viral hepatitis 44 (33.8%), and liver abscess 11 (8.5%). Fifty (38.5%) patients had acute, 74 (56.9%) had chronic liver disease and 6 (4.6%) were malignancy. The main cause of acute disease were infections 41 (82.0%) especially Hepatitis E Virus (HEV). HEV was associated with acute liver failure and pregnancy which was 4 (18.2%) and 2 (12.5%) respectively. Chronic diseases were caused by alcohol 45 (60.8%) followed by infection of hepatitis B and C viruses 11 (14.8%). Cirrhosis was diagnosed in 37 (28.5%) with alcohol as the main cause. Conclusions: Majority had chronic liver disease (CLD), mostly due to alcohol, HBV and HCV. Alcohol was the leading cause of cirrhosis. Prevalence of Hepatitis E was found to be high in acute illness. Therefore, an initiative needs to be taken to decrease alcohol consumption along with HEV, HBV and HCV transmission through community health program.
Patients with Schizophrenia and Self-Care

Abstract INTRODUCTION: Patients with schizophrenia have severe problems with self-care which affects their quality of life. OBJECTIVE: The aim of the paper was to monitor self-care in patients with schizophrenia and to find out the differences regarding socio-demographic characteristics and ambulatory and day hospital treatment. METHOD: The investigation included 120 subjects each with diagnosis F20 according to ICD 10 criteria; divided in two groups of 60 patients regarding their actual treatment (the first group received ambulatory care whereas those from the second group had a day hospital treatment). Patients were of different age and gender, receiving regular antipsychotic therapy. They were included in individual and group psychosocial therapeutic procedures during the day hospital treatment. The investigation utilized the following diagnostic instruments: standardized clinical interview and Personal and social performance scale (PSP scale), non-standardized questionnaire of socio-demographic data, family support and existence of mental disorder in other family members. RESULTS: The results have shown better personal and social functioning in patients who had family support, in those who are employed, in those with no mental disorder in other family members and in patients on day hospital treatment against patients receiving ambulatory care. CONCLUSION: Day hospital treatment, family support and social support improve self-care of patients with schizophrenia.
Computer Assessment of Mild Cognitive Impairment

Abstract Many older individuals experience cognitive decline with aging. The causes of cognitive dysfunction range from the devastating effects of Alzheimer's disease (AD) to treatable causes of dysfunction and the normal mild forgetfulness described by many older individuals. Even mild cognitive dysfunction can impact medication adherence, impair decision making, and affect the ability to drive or work. However, primary care physicians do not routinely screen for cognitive difficulties and many older patients do not report cognitive problems. Identifying cognitive impairment at an office visit would permit earlier referral for diagnostic work-up and treatment. The Computer Assessment of Mild Cognitive Impairment (CAMCI) is a self-administered, user-friendly computer test that scores automatically and can be completed independently in a quiet space, such as a doctor's examination room. The goal of this study was to compare the sensitivity and specificity of the CAMCI and the Mini Mental State Examination (MMSE) to identify mild cognitive impairment (MCI) in 524 nondemented individuals > 60 years old who completed a comprehensive neuropsychological and clinical assessment together with the CAMCI and MMSE. We hypothesized that the CAMCI would exhibit good sensitivity and specificity and would be superior compared with the MMSE in these measures. The results indicated that the MMSE was relatively insensitive to MCI. In contrast, the CAMCI was highly sensitive (86%) and specific (94%) for the identification of MCI in a population of community-dwelling nondemented elderly individuals.
A Contextual Analysis of Battered Women’s Safety Planning

This study explored a frequently overlooked area of research—battered women’s safety planning strategies. Interviews were conducted with 160 women who experienced violence from an intimate partner and had at least one child aged 5 to 12. Women employed numerous and diverse strategies in attempting to keep themselves and their children safe. Their choices depended on several contextual factors, including severity of violence and relationship with assailant. Although contacting domestic violence programs and staying at domestic violence shelters were most likely to improve women’s situations, no strategies were universally effective. Clusters of safety planning strategies were identified to further understand women’s actions. Women who experienced the most violence and had assailants who engaged in the most behaviors indicative of potential lethality were most actively engaged in safety planning but remained in serious danger. These findings highlight the importance of community response and support in protecting survivors and holding assailants accountable.
Molecular Diagnosis of Activating EGFR Mutations in Non–Small Cell Lung Cancer Using Mutation-Specific Antibodies for Immunohistochemical Analysis

Purpose: Therapeutic responses of non–small cell lung carcinoma (NSCLC) to epidermal growth factor receptor (EGFR)–targeted drugs, such as gefitinib and erlotinib, are closely associated with activating EGFR mutations. The most common mutations are delE746-A750 in exon 19 and L858R in exon 21, accounting for ∼90% of all EGFR mutations. Recently, EGFR mutation-specific antibodies were developed and did well in immunohistochemical analysis, giving a sensitivity of ∼90%. We have investigated whether this method detects activating EGFR mutations with sensitivity comparable with direct DNA sequencing, which is used to detect these mutations in NSCLC. Experimental Design: We used antibodies specific for the E746-A750 deletion mutation in exon 19 and the L858R point mutation in exon 21 in Western blot analysis and immunohistochemistry to determine the presence of these mutations in NSCLC cell lines. We also examined these EGFR mutations in NSCLC tumor samples from 60 patients by immunohistochemically and direct DNA sequencing. Results: We were able to identify EGFR mutations in NSCLC tumor samples immunohistochemically with a sensitivity of 79% using the anti–delE746-A750 antibody and 83% using the anti-L858R antibody. Additional DNA sequencing markedly improved the sensitivity obtained by immunohistochemistry. Conclusions: This simple and rapid assay for detecting EGFR mutations, even in the small bronchial biopsies obtained in stage IV NSCLC patients, will be useful for diagnosing responsiveness to EGFR-targeted drugs in patients with NSCLC. Combining this with DNA sequencing is recommended for the development of improved personalized EGFR-targeted therapeutics. Clin Cancer Res; 16(12); 3163–70. ©2010 AACR.
Family needs after brain injury: A cross cultural study.

OBJECTIVE The objective of this study was to explore differences by country in the importance of family needs after traumatic brain injury (TBI), as well as differences in met/unmet needs. METHOD Two hundred and seventy-one family members of an individual with TBI in Mexico, Colombia, Spain, Denmark, and Norway completed the Family Needs Questionnaire. RESULTS Eight of the ten needs rated as most important globally were from the Health Information subscale. Importance ratings on the Health Information, Professional Support, and Involvement With Care subscales were similar across countries, but Mexican family members rated Instrumental Support needs as less important than Colombian, Spanish, and Danish family members, and also rated their Community Support needs as less important than Danish and Spanish family members. Mexican family member's rated emotional support needs as less important than Colombian, Spanish, and Danish family members. Globally, the needs rated as most often met were from the Health Information subscale, and the most unmet needs were from the Emotional Support subscale. CONCLUSION Despite some similarities across countries several differences were identified, and these can help professionals to provide more culturally appropriate rehabilitation services for family members in order to improve informal care for TBI.
Epidemiology of the Comorbidity Between Depression and Heart Disease

The relationship between mood states and the heart has been known since antiquity. Across various cultures, statements in present-day languages such as ‘my heart aches’ are used to communicate depressive emotions. Over the past three decades, a large body of evidence has emerged that documents the adverse impact of depressive disorders on cardiovascular disease. This confirms the early suspicion of astute clinicians that psychological factors play a significant role in the genesis and the course of heart disease, as well as the ancient belief in a mind–body connection in general and humanmoods and the heart in particular. This chapter examines epidemiological studies that have investigated the relationship between depression and heart disease, with specific focus on the prevalence of depression in different populations
Saccade and vestibular ocular motor adaptation.

PURPOSE This paper focuses on motor learning within the saccadic and vestibulo-ocular reflex (VOR) oculomotor systems, vital for our understanding how the brain keeps these subsystems calibrated in the presence of disease, trauma, and the changes that invariably accompany normal development and aging. We will concentrate on new information related to multiple time scales of saccade motor learning, adaptation of the VOR during high-velocity impulses, and the role of saccades in VOR adaptation. The role of the cerebellum in both systems is considered. METHODS Review of data involving saccade and VOR motor learning. RESULTS Data supports learning within the saccadic and VOR oculomotor systems is influenced by 1). Multiple time scales, with different rates of both learning and forgetting (seconds, minutes, hours, days, and months). In the case of forgetting, relearning on a similar task may be faster. 2). Pattern of training, learning and forgetting are not similarly achieved. Different contexts require different motor behaviors and rest periods between training sessions can be important for memory consolidation. CONCLUSIONS The central nervous system has the difficult task of determining where blame resides when motor performance is impaired (the credit assignment problem). Saccade and VOR motor learning takes place at multiple levels within the nervous system, from alterations in ion channel and membrane properties on single neurons, to more complex changes in neural circuit behavior and higher-level cognitive processes including prediction.
Comparison of Endobronchial Ultrasound and Computed Tomography With Fluoroscopy in the Guidance of Lung Cancer Biopsies

Open lung biopsy is the gold standard for diagnosing lung cancer, but it is an invasive approach. There have been several noninvasive methods developed to biopsy the lung. This literature review compares the use of endobronchial ultrasound (EBUS) and computed tomography with fluoroscopy (CTF) guidance in the biopsy of lung nodules. Computed tomography with fluoroscopy has a higher diagnostic yield than endobronchial ultrasound but has more postprocedural complications. Endobronchial ultrasound guided lung biopsy is effective when the lesions are located in the right middle lobe of the lung, and overall EBUS has a low rate of complications when compared to CTF.
Wnt and extraocular muscle sparing in amyotrophic lateral sclerosis.

PURPOSE The extraocular muscles (EOM) and their motor neurons are spared in amyotrophic lateral sclerosis (ALS). In limb muscle, axon retraction from the neuromuscular junctions occurs early in the disease. Wnts, a conserved family of secreted signaling molecules, play a critical role in neuromuscular junction formation. This is the first study to examine Wnt signaling for its potential involvement in maintenance of normal morphology in EOM in ALS. METHODS Extraocular muscle and limb muscle axons, neuromuscular junctions, and myofibers from control, aging, and ALS subjects and the SOD1(G93A) mouse model of ALS were quantified for their expression of Wnt1, Wnt3a, Wnt5a, Wnt7a, and β-catenin. RESULTS All four Wnt isoforms were expressed in most axon profiles in all human EOM. Significantly fewer were positive for Wnt1, Wnt3a, and Wnt7a in the human limb muscles. Similar differential patterns in Wnt myofiber expression were also seen except in the case of Wnt7a, where expression was elevated. In the SOD1(G93A) mouse, all four Wnt isoforms were significantly decreased in the neuromuscular junctions at the terminal stage compared to values in age-matched controls. β-Catenin was activated in a subset of myofibers in EOM and limb muscle in all subjects. CONCLUSIONS The differences in expression of Wnts in EOM and limb muscle, particularly at the neuromuscular junction level, suggest that they play a role in the pathophysiology of ALS. Collectively, the data support a role for signaling of Wnts in the preservation of the EOM in ALS and their dysregulation and the subsequent development of pathology in the ALS limb muscles.
Multi-Modal Pain Therapy of Fibromyalgia Syndrome with Integration of Systemic Whole-Body Hyperthermia – Effects on Pain Intensity and Mental State: A Non-Randomised Controlled Study

Abstract Objectives: This controlled study evaluates a multi-modal pain therapy for treating severe progressions of fibromyalgia [FMS] syndrome. The aim is to establish whether the use of multi-modal therapy with inclusion of whole-body hyperthermia represents a useful therapeutic addition to inpatient therapy of FMS syndrome at a high level of chronification. Methods: The study involved 130 patients who fulfilled the criteria of the American College of Rheumatology [ACR] for FMS and whose disease showed severe progression. One group of patients [HTG] received whole-body hyperthermia, while the control group [CG] did not. The main parameters of the study were pain intensity and the mental state of the patients. Further study parameters were the diagnoses additional to FMS syndrome and the therapy density of the treatment provided in the two groups. Results: The integration of whole-body hyperthermia into the multi-modal pain therapy showed superior pain reduction [p = 0.023] and an improvement in the mental state of the patients [p = 0.055]. In addition to the primary disease, the patients presented with an average of 6.7 accompanying diseases, primarily from major diagnostic categories 8 [diseases and disturbances of the musculoskeletal system and connective tissues], 19 [mental diseases and disturbances] and 10 [endocrine, nutritional and metabolic diseases]. Analysis of the therapy density of the inpatient multi-modal pain therapy revealed a close-meshed and high-frequency therapy. Conclusions: Multi-modal pain therapy was also found to be a highly effective therapy option in the case of severely progressive FMS syndrome. Extension of the multi-modal therapy setting to include whole-body hyperthermia can be considered as a useful and effective complement for pain relief and stabilisation of the mental state.
Energy-balance studies reveal associations between gut microbes, caloric load, and nutrient absorption in humans.

BACKGROUND Studies in mice indicate that the gut microbiome influences both sides of the energy-balance equation by contributing to nutrient absorption and regulating host genes that affect adiposity. However, it remains uncertain as to what extent gut microbiota are an important regulator of nutrient absorption in humans. OBJECTIVE With the use of a carefully monitored inpatient study cohort, we tested how gut bacterial community structure is affected by altering the nutrient load in lean and obese individuals and whether their microbiota are correlated with the efficiency of dietary energy harvest. DESIGN We investigated dynamic changes of gut microbiota during diets that varied in caloric content (2400 compared with 3400 kcal/d) by pyrosequencing bacterial 16S ribosomal RNA (rRNA) genes present in the feces of 12 lean and 9 obese individuals and by measuring ingested and stool calories with the use of bomb calorimetry. RESULTS The alteration of the nutrient load induced rapid changes in the gut microbiota. These changes were directly correlated with stool energy loss in lean individuals such that a 20% increase in Firmicutes and a corresponding decrease in Bacteroidetes were associated with an increased energy harvest of ≈150 kcal. A high degree of overfeeding in lean individuals was accompanied by a greater fractional decrease in stool energy loss. CONCLUSIONS These results show that the nutrient load is a key variable that can influence the gut (fecal) bacterial community structure over short time scales. Furthermore, the observed associations between gut microbes and nutrient absorption indicate a possible role of the human gut microbiota in the regulation of the nutrient harvest. This trial was registered at clinicaltrials.gov as NCT00414063.
O manejo não medicamentoso da hipertensão arterial sistêmica no Sul do Brasil

A cross-sectional population-based study was carried out among individuals aged 20 to 69 years in the urban area of Pelotas, Rio Grande do Sul, Brazil. The objective was to analyze characteristics of hypertensive patients in relation to management of arterial hypertension. Among the 1,968 interviewees, 380 were hypertensive (19.3%), and 44.1% of these always consulted the same physician. Of the entire sample, 85.5% were sedentary, 48.2% showed excessive fat consumption, and 47.4% smoked. Most physicians recommend the following: lowering salt consumption (98.4%), cessation of alcohol consumption (93.7%), for losing weight, diet and consumption of low-fat food (88.2%), smoking cessation (73.2%), and physical activity (68.9%). The clinical management was classified as inadequate in 284 individuals (74.7%). Increased probability of adequate management was found among: women, individuals > 50 years, upper and middle-class patients, non-smokers, and patients with diabetes mellitus. Some findings showed positive aspects, but differences according to socioeconomic status evidenced lack of equity in care.
A few-gene plastid phylogenetic framework for mycoheterotrophic monocots.

PREMISE OF THE STUDY Few-gene studies with broad taxon sampling have provided major insights into phylogeny and underpin plant classification. However, they have typically excluded heterotrophic plants because of loss, pseudogenization, or rapid evolution of plastid genes. Here we performed a phylogenetic survey of three commonly retained plastid genes to assess their utility in placing mycoheterotrophs. METHODS We surveyed accD, clpP, and matK for 34 taxa from seven monocot families that include full mycoheterotrophs and a broad sampling of photosynthetic taxa. After screening for weak contaminants, we conducted phylogenetic analyses and characterized among-lineage rate variation. KEY RESULTS Likelihood analyses strongly supported local placements of fully mycoheterotrophic taxa for Corsiaceae, Iridaceae, Orchidaceae, and Petrosaviaceae, in positions consistent with other studies. Depression of likelihood bootstrap support values near mycoheterotrophic clades was alleviated when each mycoheterotrophic family was considered separately. Triuridaceae (Sciaphila) monophyly was recovered in a partitioned likelihood analysis, and the family then placed as sister to Cyclanthaceae-Pandanaceae. Burmanniaceae placed in Dioscoreales with weak to strong support depending on analysis details, and we inferred a plastid-based phylogeny for the family. Thismiaceae species may retain a plastid genome, based on accD retention. The inferred position of Thismiaceae is unstable, but was close to Taccaceae (Dioscoreales) in some analyses. CONCLUSIONS Long branches/elevated substitution rates, missing genes, and occasional contaminants are challenges for plastid-based phylogenetic inference with full mycoheterotrophs. However, most mycoheterotrophs can be readily integrated into the broad picture of plant phylogeny using several plastid genes and broad taxonomic sampling.
Stories to communicate risks about tobacco

Objective: To evaluate the construct and criterion validity of the Video Transportation Scale (VTS). Setting: Inpatient service of a safety net hospital in Birmingham, Alabama, USA. Method: We administered the VTS in the context of a randomized controlled trial of a DVD-delivered narrative-based intervention (stories) designed to encourage smoking cessation among hospitalized patients. Results: Factor analysis yielded a two-factor solution relating to engagement and attentional focus. Patients receiving the stories-based intervention had a higher score for engagement than control but stories patients and controls did not differ in reported attentional focus. The engagement factor demonstrated predictive validity in that patients with higher scores were more likely to report quitting smoking at two weeks. Conclusion: The VTS provides a rapid assessment of transportation that can be used in applied settings using video-based narratives.