Miracle-dz/UniFAR-FTUs huggingface dataset:
Nuclear factor erythroid 2–related factor 2 is a positive regulator of human bile salt export pump expression

The bile salt export pump (BSEP) is the major determinant of bile salt–dependent bile secretion, and its deficiency leads to cholestatic liver injury. BSEP/Bsep gene expression is regulated by the nuclear farnesoid X receptor. However, BSEP expression, though reduced, is retained in the livers of Fxr−/− mice, indicating that additional transcriptional factors may regulate its expression. Nuclear factor erythroid 2–related factor 2 (Nrf2) plays a major role in response to oxidative stress by binding to antioxidant‐responsive elements that regulate many hepatic phase I and II enzymes as well as hepatic efflux transporters. Computer software analysis of human BSEP reveals two musculo‐aponeurotic fibrosacroma (Maf) recognition elements (MAREs) from the sequence in the proximal promoter region where Nrf2 may bind. In this study, we assessed whether Nrf2 plays a role in human BSEP expression and if this might be mediated by MAREs. Oltipraz, a potent activator of Nrf2, increased BSEP messenger RNA expression by approximately seven‐fold in HepG2 cells and protein by approximately 70% in human hepatocytes. Small interfering RNAs lowered NRF2 expression in HepG2 cells and prevented the up‐regulation of BSEP by oltipraz. Human BSEP promoter activity was stimulated by Nrf2 in a dose‐dependent manner in luciferase reporter assays. Mutations of the predicted MARE1, but not MARE2, abolished this Nrf2 transcriptional activation. Chromatin immunoprecipitation assays also demonstrated that Nrf2 specifically bound to MARE1, but not MARE2 regions in the BSEP promoter in HepG2 cells. Electrophoretic mobility shift assays further demonstrated direct binding of MARE1 in the BSEP promoter. Conclusion: Nrf2 is a positive transcriptional regulator of human BSEP expression. Pharmacological activation of Nrf2 may be beneficial for cholestatic liver injury. (HEPATOLOGY 2009.)
Birth asphyxia in a mission hospital in Benin City, Nigeria

Background : Birth asphyxia is a leading cause of neonatal morbidity and mortality in Nigeria. Survivors have increased risk of long-term neurologic disability. Objective : To determine the incidence and document the predisposing factors and outcome. Methods : In this descriptive (cross-sectional) study at St Philomena Catholic Hospital, the one-and-five-minute Apgar scores of 2,208 live-births were recorded. Those with low Apgar scores (6 at one minute) were studied and their data analyzed. Results : Birth asphyxia occurred in 83.8 per 1000 live-births with preterm and post-term deliveries, primiparity, grandmultiparity, maternal age 19 years or 40 years and pregnancy-induced hypertension being the associated significant factors. Severe birth asphyxia was commonest in breech deliveries. Post-asphyxial seizures occurred in 11.9% of asphyxiated infants with 86.4% of these seizures occurring within the first 12 hours after birth. Birth asphyxia accounted for 25.9% of total neonatal deaths with 58.7% of these deaths occurring within the first 24 hours after birth. The rates of both severe birth asphyxia and deaths were higher in male that female neonates. Conclusion : Disease-specific burden of birth asphyxia remains enormous and will be alleviated if careful attention is paid to management of labour of high-risk expectant mothers, coupled with availability of personnel skilled in neonatal resuscitation at these deliveries. Keywords : birth asphyxia, incidence, outcome Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 34-39
A Heart Failure Initiative to Reduce the Length of Stay and Readmission Rates

Purpose/Objectives: The purpose of this pilot was to improve multidisciplinary coordination of care and patient education and foster self-management behaviors. The primary and secondary outcomes achieved from this pilot were to decrease the 30-day readmission rate and heart failure length of stay. Primary Practice Site: The primary practice site was an inpatient medical–surgical nursing unit. Finding and Conclusions: The length of stay decreased from 6.05% to 4.42% for heart failure diagnostic-related group 291 as a result of utilizing the model. The length of stay decreased from 3.9% to 3.09%, which was also less than the national rate of 3.8036% for diagnostic-related group 292. In addition, the readmission rate decreased from 23.1% prior to January 2013 to 12.9%. Implementation of standards of care coordination can decrease length of stay, readmission rate, and improve self-management. Implications for Case Management Practice: Implementation of evidence-based heart failure guidelines, improved interdisciplinary coordination of care, patient education, self-management skills, and transitional care at the time of discharge improved overall heart failure outcome measures. Utilizing the longitudinal model of care to transition patients to home aided in evaluating social support, resource allocation and utilization, access to care postdischarge, and interdisciplinary coordination of care. The collaboration between disciplines improved continuity of care, patient compliance to their discharge regimen, and adequate discharge follow-up.
Drinking and smoking among 15-and 16-year-olds in the United Kingdom: a re-examination

A study was conducted in 1999 to examine patterns of self-reported drinking and smoking among a representative United Kingdom sample of people born in 1983. These individuals were all aged 15 and 16 years. The study was also undertaken in order to compare the 1999 findings with those of a similar study of people of the same age which was conducted in 1995. Both studies are part of the European School Survey Project on Alcohol and other Drugs (ESPAD). This involved 23 countries in 1995 and approximately 30 countries in 1999. The design of the new UK study involved a cross-sectional, single-phase survey based on a stratified cluster sample of 223 UK state and private schools carried out from March to June 1999. Students completed a 326-item standardized questionnaire under examination conditions. Sixty five per cent had at some time smoked cigarettes and 94% had at some time consumed alcohol. Levels of alcohol and tobacco use remained almost constant compared to the 1995 survey. In contrast, levels of most illicit drug use had fallen significantly. It is possible that trends in youthful psychoactive substance use in the UK have reached at least a temporary ‘saturation’ point.
Epithelial‐to‐mesenchymal transitions in the liver

The outcome of liver injury is dictated by the effectiveness of repair. Successful repair (i.e., regeneration) results in replacement of dead epithelial cells with healthy epithelial cells, and reconstructs normal hepatic structure and function. Liver regeneration is known to involve replication of surviving mature hepatocytes and bile duct cells. This review discusses recent evidence for other mechanisms that might also replace dead hepatic epithelial cells and repair liver damage, particularly during chronic injury. According to this theory, certain epithelial cells in developing livers and/or injured adult livers undergo epithelial‐to‐mesenchymal transition (EMT) and move into the hepatic mesenchyme where they exhibit fibroblastic features. Some of these epithelia‐derived mesenchymal cells, however, may be capable of undergoing subsequent mesenchymal‐to‐epithelial transition (MET), reverting to epithelial cells that ultimately become hepatocytes or cholangiocytes. Although these concepts remain to be proven, the theory predicts that the balance between EMT and MET modulates the outcome of chronic liver injury. When EMT activity outstrips MET, repair is mainly fibrogenic, causing liver fibrosis. Conversely, predominance of MET favors more normal liver regeneration. In this review, we summarize evidence that certain resident liver cells are capable of EMTs in vitro and during chronic liver injury. (HEPATOLOGY 2009.)
The management of cirrhotic ascites

We read with interest the recent article by Runyon on diagnosis and treatment of ascites.1 Surprisingly, determination of cholesterol in ascitic fluid was classified as being unhelpful (table 3 of the article). The value of cholesterol in the differentiation between cirrhotic and malignant ascites was first demonstrated in this journal.2 Consequently, we compared cholesterol with other ascitic fluid parameters including the serum-ascites albumin gradient and found it superior.3 Furthermore, we suggested a pathomechanism for the increase of ascitic cholesterol in malignant ascites.4 The diagnostic value of this simple and cheap parameter was confirmed by several groups.5-8 Thus, according to the grading system used in this article, cholesterol should be recommended as Class I, Level B. In our opinion, guidelines should be based on a careful review of the existing literature and free of personal bias. May we suggest that the guidelines be corrected accordingly.
The prevalence of denture stomatitis and its predisposing conditions in an older Greek population.

BACKGROUND Pathology related to complete denture-wearing will remain an important issue because of an increase in the ageing population. OBJECTIVE To investigate the prevalence and the risk factors for denture-related stomatitis in the edentulous maxilla of older patients with a maxillary complete denture. MATERIAL AND METHODS One hundred and six patients treated in the Department of Prosthodontics of the Athens Dental School were interviewed and clinically examined. The results were analysed using chi-square tests and multiple logistic regression. RESULTS Denture stomatitis was recorded in 39.6% of the sample (pinpoint hyperaemia: 17%, diffuse erythema: 16%, papillary hyperplasia: 6.6%). Chi-square tests recorded significant associations between denture stomatitis and the continuous use of dentures (particularly the diffuse erythema type), the increased duration of denture experience and the poor retention of the maxillary denture. Other significant associations were recorded between the increased age of the current denture and pinpoint hyperaemia, and the reduced frequency of denture cleaning and papillary hyperplasia. Multiple logistic analysis revealed that the most important risk factor for denture stomatitis was the continuous use of the denture. CONCLUSION The prevalence of denture stomatitis was high in denture users. Although many predisposing conditions were recorded, the most important risk factor was the continuous use of the denture. Therefore, appropriate advice on denture maintenance should be provided.
Control of hepatitis B virus replication by innate response of HepaRG cells

Hepatitis B virus (HBV) is currently viewed as a stealth virus that does not elicit innate immunity in vivo. This assumption has not yet been challenged in vitro because of the lack of a relevant cell culture system. The HepaRG cell line, which is physiologically closer to differentiated hepatocytes and permissive to HBV infection, has opened new perspectives in this respect.HBV baculoviruses were used to initiate an HBV replication in both HepG2 and HepaRG cells. To monitor HBV replication, the synthesis of encapsidated DNA, and secretion of hepatitis B surface antigen (HBsAg), was respectively analyzed by southern blot and enzyme‐linked immunosorbent assay. The induction of a type I interferon (IFN) response was monitored by targeted quantitative reverse transcription polymerase chain reaction (qRT‐PCR), low‐density arrays, and functional assays. The invalidation of type I IFN response was obtained by either antibody neutralization or RNA interference. We demonstrate that HBV elicits a strong and specific innate antiviral response that results in a noncytopathic clearance of HBV DNA in HepaRG cells. Challenge experiment showed that transduction with Bac‐HBV‐WT, but not with control baculoviruses, leads to this antiviral response in HepaRG cells, whereas no antiviral response is observed in HepG2 cells. Cellular gene expression analyses showed that IFN‐β and other IFN‐stimulated genes were up‐regulated in HepG2 and HepaRG cells, but not in cells transduced by control baculoviruses. Interestingly, a rescue of viral replication was observed when IFN‐β action was neutralized by antibodies or RNA interference of type I IFN receptor. Conclusion: Our data suggest that a strong HBV replication is able to elicit a type I IFN response in HepaRG‐transduced cells. (HEPATOLOGY 2009.)
Evaluation of Vickers hardness of different types of acrylic denture base resins with and without glass fibre reinforcement.

OBJECTIVE To evaluate the Vickers hardness of different acrylic resins for denture bases with and without the addition of glass fibres. BACKGROUND It has been suggested that different polymerisation methods, as well as the addition of glass fibre (FV) might improve the hardness of acrylic. MATERIALS AND METHODS Five types of acrylic resin were tested: Vipi Wave (VW), microwave polymerisation; Vipi Flash (VF), auto-polymerisation; Lucitone (LT), QC20 (QC) and Vipi Cril (VC), conventional heat-polymerisation, all with or without glass fibre reinforcement (GFR) and distributed into 10 groups (n = 12). Specimens were then submitted to Vickers hardness testing with a 25-g load for 30 s. All data were submitted to anova and Tukey's HSD test. RESULTS A significant statistical difference was observed with regard to the polymerisation method and the GFR (p < 0.05). Without the GFR, the acrylic resin VC presented the highest hardness values, and VF and LT presented the lowest. In the presence of GFR, VC resin still presented the highest Vickers hardness values, and VF and QC presented the lowest. CONCLUSIONS The acrylic resin VC and VW presented higher hardness values than VF and QC resins. Moreover, GFR increased the Vickers hardness of resins VW, VC and LT.
Parenteral Ketorolac and Risk of Gastrointestinal and Operative Site Bleeding

Objective. —To evaluate the risk of gastrointestinal and operative site bleeding associated with the use of parenteral ketorolac tromethamine. Design. —Postmarketing surveillance inception cohort study. Setting. —A total of 35 hospitals throughout the Philadelphia, Pa, region, 1991 to 1993. Patients. —Patients administered 10272 courses of parenteral ketorolac therapy were compared with patients administered 10247 courses of a parenteral opiate who were matched to the ketorolac patients by hospital, admitting service, and date of initiation of study drug. Main Outcome Measures. —Medical records were reviewed for demographics, medical history, doses and duration of study drug, various aspects of the hospital course including surgery and concomitant medications, and adverse events. Results. —The multivariate adjusted odds ratio (OR) comparing ketorolac with opiates for gastrointestinal bleeding was 1.30 (95% confidence interval [CI], 1.11 to 1.52); for operative site bleeding, the OR was 1.02 (95% CI, 0.95 to 1.10). The OR was elevated further in subjects 75 years of age or older for both gastrointestinal bleeding (OR=1.66; 95% CI, 1.23 to 2.25) and operative site bleeding (OR=1.12; 95% CI, 0.94 to 1.35). A dose-response relationship was evident between average daily ketorolac dose and both gastrointestinal bleeding and operative site bleeding (trend test P Conclusions. —The overall associations between ketorolac use and both gastrointestinal bleeding and operative site bleeding are small. However, the risk associated with the drug is larger and clinically important when ketorolac is used in higher doses, in older subjects, and for more than 5 days. Improving physicians' prescribing practices by limiting the dose and duration of ketorolac use, especially in the elderly, should enhance its overall risk-benefit balance. ( JAMA . 1996;275:376-382)
Effect of sealer coating on mechanical and physical properties of permanent soft lining materials.

OBJECTIVE To evaluate the long-term effects of sealer coating on tensile bond strength and surface roughness of soft liners. BACKGROUND Failure of the bond between resilient liners and denture base significantly compromise the dentures' longevity. In addition, surface roughness contributes to bacterial adherence on prosthetic materials, increasing the risk of oral infections. METHODS Specimens were manufactured from four reliners [Mucopren Soft (MS), Dentuflex (DF); Soft Comfort Denso (SC) and Ufi Gel SC (USC)], distributed into 10 groups (n = 10), according to material and coating treatment. Tensile bond strength was performed after one year of ageing, while surface roughness was evaluated at 0, 1, 3, 6 and 12 ageing months. Bond strength data were submitted to two-way anova and Tukey-HSD tests, while roughness data were submitted to mixed model analysis for repeated measurements (p ≤ 0.05). RESULTS MS and DF without sealer coating presented the highest tensile bond strength. After coating, DF and SC presented increased tensile bond strength. No surface roughness difference was observed in the non-coated groups over time, acrylic-based reliners presented higher roughness. Among coated groups, only SC presented increased surface roughness. Acrylic-based materials presented reduced roughness at three months. CONCLUSION Surface coating was effective for acrylic reliners in maintaining their initial properties. However, sealer coating should be re-applied every 3 months.
Alcohol Expectancies as a Mediator of the Relation Between Impulsivity and Alcohol Consumption in Asian Americans

Past research on alcohol consumption in minority groups has focused on examining differences in the level of drinking. However, research has yet to fully examine racial differences in the factors that might mediate alcohol consumption. The current study sought to test whether alcohol expectancies mediated the relation of impulsivity on alcohol consumption for an Asian American sample. Participants included 57 Asian American and 70 Caucasian undergraduate students. Results showed that positive alcohol expectancies fully mediated the pathway between dimensions of impulsivity and alcohol use for Asian Americans. For Caucasian participants, only impulsivity predicted alcohol use. Future research on alcohol use and abuse by Asian Americans should consider the role of alcohol expectancies in different social contexts.
Oral health-related quality of life--associations with oral health and conditions in Swedish 70-year-old individuals.

OBJECTIVE The aim of this study was to evaluate oral health-related quality of life (OHRQoL) in relation to different chronic oral conditions and perception of oral health among elderly individuals. BACKGROUND Health-related quality of life is important to assess and understand the impact of different diseases and conditions on individuals' well-being. MATERIAL AND METHODS Randomly selected 70-year-old individuals (N = 561) were included in this analysis. They were clinically examined and answered a questionnaire. Variables used were perceived oral health, satisfaction with appearance of teeth, problems with chewing and dry mouth, burning mouth syndrome, dental anxiety and dental visiting habits. To measure the participants' perception of the impact of oral conditions on their well-being, the Oral Health Impact Profile (OHIP-14) was used. RESULTS The OHIP-14 distribution of sum of scores showed a floor effect but revealed acceptable psychometric properties with regard to reliability and validity. Multivariable logistic regression revealed three highly predictive variables for individuals with high OHIP-14 scores: using dentures, having chewing problems and being dissatisfied with appearance of teeth. CONCLUSION Use of dentures, having chewing problems and being dissatisfied with appearance of teeth are associated with high OHIP-14 sums, indicating strong influence on OHRQoL.
The social production of an enterprise clinic: nurses, clinical pathway guidelines and contemporary healthcare practices

The social production of an enterprise clinic: nurses, clinical pathway guidelines and contemporary healthcare practices In this paper I critically engage with the forming of contemporary nursing practice with/in an ‘enterprise clinic’ in order to discuss the practical potential of developing a mode of reflective practice that is a critical ontology of self. Critical engagement in the paper is secured through a ‘troubling’ of the relationship between the contemporary practices of both the self and governance, without the reduction of one to the other. The paper draws on my doctoral study in which I combined the techniques of ethnography and discourse analysis in order to critically examine registered nurses’ employment of clinical pathway guidelines through an analysis of the political technologies through which that engagement was constituted. This critical purchase was applied because of the influence of the contemporary ‘problematisation’ of healthcare provision in western society on the formation and deployment of the professional identities of nurses.
Oral medications with significant hepatic metabolism at higher risk for hepatic adverse events

Reactive metabolites generated by hepatic metabolism are thought to play an important role in the pathogenesis of drug‐induced liver injury (DILI), but supporting data are limited. If this is true, then compounds with significant hepatic metabolism should cause more DILI than those without it. We conducted a study to examine the relationship between hepatic metabolism and DILI of prescription medications. We systematically extracted the metabolism characteristics of 207 of the most widely prescribed oral medications in the United States. Compounds with >50% hepatic metabolism were characterized as those with significant hepatic metabolism (n = 149). Hepatic adverse events of interest were alanine aminotransferase >3 times the upper limit of normal, jaundice, liver failure, liver transplantation, or fatal DILI. Compared with compounds with lesser hepatic metabolism, compounds belonging to the significant hepatic metabolism group had significantly higher frequency of alanine aminotransferase >3 times the upper limit of normal (35% versus 11%, P = 0.001), liver failure (28% versus 9%, P = 0.004), and fatal DILI (23% versus 4%, P = 0.001), but not jaundice (46% versus 35%, P = 0.2) or liver transplantation (9% versus 2%, P = 0.11). Twelve compounds with no hepatic metabolism had no reports of liver failure, liver transplantation, or fatal DILI. When the relationship between hepatic adverse events and combination of hepatic metabolism and daily dose was examined, compounds with both significant hepatic metabolism and daily dose >50 mg (n = 50) were significantly more hepatotoxic than compounds belonging to other groups. Compared with medications without biliary excretion, compounds with biliary excretion (n = 50) had significantly higher frequency of jaundice (74% versus 40%, P = 0.0001). Conclusion: Our study finds an important relationship between a compound's metabolism profile and reports of hepatic adverse events. (HEPATOLOGY 2009.)