Miracle-dz/UniFAR-FTUs huggingface dataset:
Outcomes and performance of the Tesio twin catheter system placed for hemodialysis access.

PURPOSE To assess the effectiveness of and outcomes with a twin catheter system. MATERIALS AND METHODS The authors retrospectively reviewed the medical records, hemodialysis records, and clinical information system data from 132 consecutive patients who were referred for placement of a tunneled catheter for hemodialysis access. A commercially available twin catheter system was placed in all patients. Outcomes evaluated included infection rate, complication rate, and catheter malfunction and failure rates. Performance parameters evaluated included blood flow rates, urea reduction percentages, and recirculation percentages. RESULTS One hundred eighty-four twin catheter systems were placed in 132 patients from January 11, 1996, to October 23, 1997. The initial technical success rate was 100%. There were four immediate procedural complications: Air emboli occurred in two patients, and prolonged bleeding necessitating intervention occurred in two. The total number of days a catheter was in place was 13,200 (mean, 74.6 days). Thirty-one infections occurred in 20 patients (total infection rate, 0.23 episodes per 100 catheter days). Sixty-five catheters malfunctioned during the study period, 19 of which necessitated removal, for a rate of 0.14 episodes per 100 catheter days. The average blood flow rate was 281.4 mL/min (range, 117.1-405.6 mL/min; median, 295.2 mL/min). Mean and median urea reductions were both 61%. Mean and median recirculation was 6.1% and 3.5%, respectively (range, 0%-31%). CONCLUSION Percutaneous placement of the tunneled twin catheter system can be performed with excellent technical success and safety and acceptable catheter performance and outcomes for effective intermediate- to long-term hemodialysis.
Efficacy and safety of nadroparin and unfractionated heparin for the treatment of venous thromboembolism during pregnancy and puerperium.

INTRODUCTION The optimal treatment of pregnancy associated VTE (venous thromboembolism) has not been established yet. OBJECTIVE The assessment of the efficacy and safety of low molecular weight heparin (LMWH) nadroparin and unfractionated heparin (UFH) used for the treatment of pregnancy and puerperium related VTE. Primary study goals were to analyze the incidence of recurrent VTE (proximal extension or pulmonary thromboembolism), thrombocytopenia, major and minor hemorrhages and skin allergic reactions. The study also included the incidence of miscarriages, stillbirth and neonatal abnormalities. We also studied the relationship between the presence of thrombophilia and the occurrence of complications during VTE treatment. METHODS Seventy-two women with antepartal VTE treated with s.c. LMWH during entire pregnancy and 88 women with postpartal VTE initially treated with either s.c. LMWH or i.v. UFH were under follow-up during the entire treatment. Thrombophilia testing included antithrombin, protein C and protein S activity levels, Activated protein C (APC) resistance, LA, ACL, FV Leiden, FII G20210A and MTHFR C677T mutations. RESULTS Twice a day weight based therapeutic regimen was applied for LMWH and activated partial thromboplastin time (aPTT) adjusted UFH dosages. After 2-6 weeks of antepartal deep vein thrombosis (DVT) treatment the dose of nadroparin was reduced to intermediate level. The duration of LMWH therapy during pregnancy was 1-35 weeks, on average 16 weeks. One case (0.62%) of DVT propagation into the vena cava occurred in a woman with antithrombin deficiency treated with LMWH. Two women (1.25%) had minor bleeding and 5 (3.125%) had minimal bleeding, while 3 (1.9%) had skin allergic reactions. The rate of successful pregnancy outcome was 97.2%. There were no cases of stillbirth or neonatal congenital abnormalities. Thrombophilia was found in 86 women (53.7%). No statistically significant correlation between the presence of thrombophilia and treatment complications were found. CONCLUSION Nadroparin is both safe and effective for the treatment of DVT during pregnancy and puerperium.
Age-Related Changes in Growth Hormone Secretion: Should the Somatopause Be Treated?

Growth hormone (GH) secretion declines progressively with aging, and many age-related changes resemble those of the adult GH deficiency (GHD) syndrome, including a decrease in lean body mass; an increase in body fat, especially in the visceral/abdominal compartment; adverse changes in lipoproteins; and a reduction in aerobic capacity. The increase in central obesity can further inhibit GH secretion. GH replacement is effective in reversing many of these changes in adult GHD, and GH is now FDA approved for treatment of adults with documented GHD or hypopituitarism, although there is still only limited experience with its long-term benefits, side effects, and risks. This early experience with GHD has led to speculation that replacing GH or stimulating its secretion may also be beneficial in normal aging, and to widespread off-label use of GH in this context; however, there are still very few well controlled studies of the effects and side effects of GH or GH secretagogues in aging. All published studies are of 6 months or shorter treatment periods. From this limited experience there is a consensus that GH has effects on body composition, but reports disagree on effects on psychological or physical functional performance. Older adults are much more susceptible to the dose-related side effects of GH, including peripheral edema, carpal tunnel syndrome, and a variable decrease in insulin sensitivity; and it is not known whether chronic GH treatment affects the risk of malignancy or has other long-term risks. Thus while short-term results are somewhat encouraging, the evidence on risks and clinically pertinent benefits is still lacking to support the use of GH in normal aging outside of clinical studies. In evaluating patients with clinical features suggesting GHD, which can be quite nonspecific, it is important to assess the presence or absence of true GH deficiency by the context (pituitary disease or its treatment, childhood GHD) and by appropriate GH stimulation tests before considering GH replacement.
Evaluation of sister chromatid exchanges, micronuclei, and proliferating rate index in hospital workers chronically exposed to ionizing radiation.

PURPOSE The aim of this study was to determine the incidence of sister chromatid exchanges (SCE), micronuclei (MN) and proliferation rate of harvested lymphocytes obtained from medical stuff professionally exposed to low-dose ionizing radiation. The influence of tobacco smoking status and working conditions as confounding factors were also investigated. PATIENTS AND METHODS Thirty subjects chronically exposed to low-dose ionizing radiation were examined (12 workers in the radiotherapy unit and 18 workers in the cardiology unit), and were compared to 15 unexposed healthy volunteers. There were 18 nonsmokers and 12 smokers among the exposed workers and 8 nonsmokers and 7 smokers among the control group. Standard cytokinesis-block MN assay, the SCE assay, and the proliferating index (PI) rate were analyzed. RESULTS An increased frequency of SCE and MN in occupationally exposed workers were found compared to unexposed individuals. The PI was significantly lower in occupationally exposed workers in comparison to the control group. In relation to the working conditions, a significantly higher number of MN in the group of workers in the radiology unit compared to the control was found (p=0.03). The frequency of SCE was increased in occupationally exposed smokers compared with nonsmoking workers (p=0.005). Smokers in the control and radiation exposed group had lower MN frequency contrary to nonsmokers in both groups. CONCLUSION The obtained results show higher incidence of SCE and MN in the exposed groups compared to the controls. Cigarette smoking and working conditions as confounding factors should be included into genetic monitoring studies assessing the risk associated with low-level radiation exposure.
Rapid protein–ligand docking using soft modes from molecular dynamics simulations to account for protein deformability: Binding of FK506 to FKBP

Most current docking methods to identify possible ligands and putative binding sites on a receptor molecule assume a rigid receptor structure to allow virtual screening of large ligand databases. However, binding of a ligand can lead to changes in the receptor protein conformation that are sterically necessary to accommodate a bound ligand. An approach is presented that allows relaxation of the protein conformation in precalculated soft flexible degrees of freedom during ligand–receptor docking. For the immunosuppressant FK506‐binding protein FKBP, the soft flexible modes are extracted as principal components of motion from a molecular dynamics simulation. A simple penalty function for deformations in the soft flexible mode is used to limit receptor protein deformations during docking that avoids a costly recalculation of the receptor energy by summing over all receptor atom pairs at each step. Rigid docking of the FK506 ligand binding to an unbound FKBP conformation failed to identify a geometry close to experiment as favorable binding site. In contrast, inclusion of the flexible soft modes during systematic docking runs selected a binding geometry close to experiment as lowest energy conformation. This has been achieved at a modest increase of computational cost compared to rigid docking. The approach could provide a computationally efficient way to approximately account for receptor flexibility during docking of large numbers of putative ligands and putative docking geometries. Proteins 2004;54:000–000. © 2004 Wiley‐Liss, Inc.
Cholinesterase and glutathione‐S‐transferase activities in freshwater invertebrates as biomarkers to assess pesticide contamination

Studies investigating the use of biomarkers in pesticide risk assessment have greatly increased in recent years; however, issues concerning the ecological meaning of enzymatic responses have proved controversial. Ideally a good biomarker response should be modulated by the environmental contaminants alone and demonstrate a predictable behavior towards certain types of toxins. As these premises are rarely observed, the present study aims to outline research that has contributed to an understanding of the behavior of two widely used biomarkers, cholinesterase and glutathione‐S‐transferase, describing environmental and biotic factors that affect their response in freshwater invertebrates. Studies were performed in the main classes of aquatic invertebrates with these biomarkers and conclusions were reached concerning their behavior towards the main classes of pesticides. Links between biomarker responses and conventional endpoints were evaluated so that ecological relevance could be attributed to enzymatic responses. Toxicity of mixtures was investigated, and cases of synergism and antagonism were pointed out as factors changing the expected toxicity of aquatic systems and leading to misinterpretations of biomarker responses. Finally, the use of biomarkers as a tool for biomonitoring and in situ assays was investigated, with discussion of advantages and disadvantages of their use. Environ. Toxicol. Chem. 2010;29:5–18. © 2009 SETAC
Guidelines for the use of flow cytometry and cell sorting in immunological studies.

The marriage between immunology and cytometry is one of the most stable and productive in the recent history of science. A rapid search in PubMed shows that, as of July 2017, using “flow cytometry immunology” as a search term yields more than 68 000 articles, the first of which, interestingly, is not about lymphocytes. It might be stated that, after a short engagement, the exchange of the wedding rings between immunology and cytometry officially occurred when the idea to link fluorochromes to monoclonal antibodies came about. After this, recognizing different types of cells became relatively easy and feasible not only by using a simple fluorescence microscope, but also by a complex and sometimes esoteric instrument, the flow cytometer that is able to count hundreds of cells in a single second, and can provide repetitive results in a tireless manner. Given this, the possibility to analyse immune phenotypes in a variety of clinical conditions has changed the use of the flow cytometer, which was incidentally invented in the late 1960s to measure cellular DNA by using intercalating dyes, such as ethidium bromide. The epidemics of HIV/AIDS in the 1980s then gave a dramatic impulse to the technology of counting specific cells, since it became clear that the quantification of the number of peripheral blood CD4+ T cells was crucial to follow the course of the infection, and eventually for monitoring the therapy. As a consequence, the development of flow cytometers that had to be easy-to-use in all clinical laboratories helped to widely disseminate this technology. Nowadays, it is rare to find an immunological paper or read a conference abstract in which the authors did not use flow cytometry as the main tool to dissect the immune system and identify its fine and complex functions. Of note, recent developments have created the sophisticated technology of mass cytometry, which is able to simultaneously identify dozens of molecules at the single cell level and allows us to better understand the complexity and beauty of the immune system.
Characterization of mutants of Caulobacter crescentus defective in surface attachment of the paracrystalline surface layer

Strains of Caulobacter crescentus express a paracrystalline surface layer (S-layer) consisting of the protein RsaA. Mutants of C. crescentus NA1000 and CB2, isolated for their ability to grow in the absence of calcium ions, uniformly no longer had the S-layer attached to the cell surface. However, RsaA was still produced, and when colonies grown on calcium-sufficient medium were examined, large two-dimensional arrays of S-layer were found intermixed with the cells. Such arrays were not found in calcium-deficient medium even when high levels of magnesium ions were provided. The arrays could be disrupted with divalent ion chelators and more readily with the calcium-selective ethylene glycol-bis (beta-aminoethyl ether)N,N,N',N'-tetraacetic acid (EGTA). Thus, the outer membrane surface was not needed as a template for self-assembly, but calcium likely was. The cell surface and S-layer gene of assembly-defective mutants of NA1000 were examined to determine the basis of the S-layer surface attachment defect. Mutants had no detectable alteration in the rough lipopolysaccharide (LPS) or a characterized capsular polysaccharide, but another polysaccharide molecule was greatly reduced or absent in all calcium-independent mutants. The molecule was shown to be a smooth LPS with a core sugar and fatty acid complement identical to those of the rough LPS and an O polysaccharide of homogeneous length, tentatively considered to be composed of 4,6-dideoxy-4-amino hexose, 3,6-dideoxy-3-amino hexose, and glycerol in equal proportions. This molecule (termed SLPS) was detectable by surface labeling with a specific antiserum only when the S-layer was not present. The rsaA genes from three calcium-independent mutants were cloned and expressed in an S-layer-negative, SLPS-positive strain. A normal S-layer was produced, ruling out defects in rsaA in these cases. It is proposed that SLPS is required for S-layer surface attachment, possibly via calcium bridging. The data support the possibility that calcium binding is required to prevent an otherwise lethal effect of SLPS. If true, mutations that eliminate the O polysaccharide of SLPS eliminate the lethal effects of calcium-deprived SLPS, at the expense of S-layer attachment.
Age-related changes in retinal functional topography.

PURPOSE To perform a detailed topographical analysis of functional age-related changes over the retina. METHODS Fifty-nine normal phakic subjects aged 10 to 69 years were divided into six groups, according to decade of age. mfERG traces were recorded from the central 60 degrees of the retina, with a resolution of 61 and 103 scaled hexagons. Group medians of peak amplitude and latency of the first- and second-order (first slice) responses were used to generate 3-D topographical maps. RESULTS With age, there was a continuous loss of amplitude and delay of implicit time of the first- and the second-order response components, but the topography of the loss was not uniform across the retina. Trend analyses on ring group data showed a significant decrease in amplitude of first- and second-order responses although the age relationship of second-order responses was more complex. The loss of first-order kernel amplitude was generally accompanied by a rise in implicit time. Second-order kernel latencies showed no uniform alteration with age. CONCLUSIONS Consistent with previous work, a steady loss of amplitude and increase of implicit time was observed with age. The topographical 3-D data, however, reveal age-related functional alterations in the retina beyond those found in ring averages, suggesting that these are masked by the standard analysis. Thus, the choice of physiologically coherent regions of interest may increase the sensitivity of detecting age-related change in multifocal analysis of retinal function.
Essential amino acid mixtures drive cancer cells to apoptosis through proteasome inhibition and autophagy activation

Cancer cells require both energy and material to survive and duplicate in a competitive environment. Nutrients, such as amino acids (AAs), are not only a caloric source, but can also modulate cell metabolism and modify hormone homeostasis. Our hypothesis is that the environmental messages provided by AAs rule the dynamics of cancer cell life or death, and the alteration of the balance between essential amino acids (EAAs) and non‐essential amino acids (NEAAs) (lower and higher than 50%, respectively) present in nutrients may represent a key instrument to alter environment‐dependent messages, thus mastering cancer cells destiny. In this study, two AA mixtures, one exclusively consisting of EAAs and the other consisting of 85% EAAs and 15% NEAAs, were tested to explore their effects on the viability of both normal and cancer cell lines and to clarify the molecular mechanisms involved. Both mixtures exerted a cell‐dependent anti‐proliferative, cytotoxic effect involving the inhibition of proteasome activity and the consequent activation of autophagy and apoptosis. These results, besides further validating the notion of the peculiar interdependence and extensive crosstalk between the ubiquitin–proteasome system (UPS) and autophagy, indicate that variation in the ratio of EAAs and NEAAs can deeply influence cancer cell survival. Consequently, customization of dietary ratios among EAAs and NEAAs by specific AA mixtures may represent a promising anticancer strategy able to selectively induce death of cancer cells through the induction of apoptosis via both UPS inhibition and autophagy activation.
Absorption of Aluminium-26 in Alzheimer’s Disease, Measured Using Accelerator Mass Spectrometry

Although chromosomal abnormalities underpin some early onset cases of familial Alzheimer’s disease (AD), most cases are sporadic and not associated with such abnormalities. Aluminium (Al) is a significant but controversial risk factor for sporadic AD, and studies have reported associations between Al and the principal pathological features of AD, senile plaques and neurofibrillary tangles. The present study measured gastrointestinal (GI) absorption of Al under normal dietary conditions using 26Al tracer and accelerator mass spectrometry (AMS). Following overnight fast, 13 AD patients (aged 63–76 years) and 13 age-matched controls (aged 62–76 years) ingested a fruit drink containing 27 ng 26Al. Plasma samples were obtained before and 1 h after the drink and from these the fraction of 26Al absorbed across the GI tract was estimated. The GI tract rigorously excludes Al with only 0.06–0.1% of the ingested Al being absorbed. The mean fraction absorbed by AD subjects exceeded controls by a factor of 1.64 (p≤0.05, Anova). AMS is capable of determining <10–16 g of 26Al with many orders of magnitude more sensitivity than other techniques. Using this sensitivity, we have shown, under normal physiological conditions, that the ability of the GI tract to exclude Al is reduced in AD, possibly leading to greater systemic exposure to Al. Public health measures to limit Al dietary uptake or bioavailability may decrease the prevalence of AD in the community and should be considered.
Percutaneous Endoscopic Lumbar Discectomy for L5–S1 Disc Herniation Via an Interlaminar Approach Versus a Transforaminal Approach: A Prospective Randomized Controlled Study With 2-Year Follow Up

Study Design. A prospective, randomized controlled study of patients with L5–S1 lumbar disc herniations, operated with endoscopic discectomy through an interlaminar or transforaminal approach. Objective. To compare the results of percutaneous endoscopic lumbar discectomy in L5–S1 disc herniation through an interlaminar or transforaminal approach. Summary of Background Data. The transforaminal and interlaminar techniques are both acceptable approaches for L5–S1 disc herniation. This is the first study to compare these two approaches in terms of their surgical effects and advantages. Methods. From January 2010 to June 2010, 60 patients with L5–S1 disc herniation were randomly recruited into two groups; one group underwent percutaneous endoscopic interlaminar discectomy (PEID) and the other group underwent percutaneous endoscopic transforaminal discectomy (PETD). There were 30 patients in each group. The operation time, intraoperative radiation time, postoperative bed rest time, hospitalization time, and complications were compared between the groups. The surgical effectiveness was assessed according to the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), and modified MacNab criteria. Results. All the patients completed follow up with a mean of 27.6 months (range, 24–37 months). In the PEID group, the mean operation time was 65.0 ± 14.9 minutes, and the intraoperative radiation time was 0.60 ± 0.24 seconds. For the PETD group, the mean operation time was 86.0 ± 15.4 minutes, and the intraoperative radiation time was 6.50 ± 1.52 seconds. There were significant differences in operation time and radiation time between the two groups (P < 0.01) but not in the postoperative bed rest time, hospitalization time, or complication rate (P > 0.05). The postoperative ODI and VAS were obviously improved in both groups when compared with preoperation (P < 0.01). According to the MacNab criteria, the satisfactory rates were 93.3% and 90.0% in the two groups, without a significant difference (P > 0.05). Conclusion. PEID can escape the blockade of crista iliaca, and advantages include a faster puncture orientation, a shorter operation time, and less intraoperative radiation exposure. PETD requires higher punctuation skill and more intraoperative radiation exposure. Level of Evidence: 4