Miracle-dz/UniFAR-FTUs huggingface dataset:
Challenges of self-management when living with multiple chronic conditions: systematic review of the qualitative literature.

OBJECTIVE To explore the perspectives of patients who live with multiple chronic conditions as they relate to the challenges of self-management. DATA SOURCES On September 30, 2013, we searched MEDLINE, EMBASE, and CINAHL using relevant key words including chronic disease, comorbidity, multimorbidity, multiple chronic conditions, self-care, self-management, perspective, and perception. STUDY SELECTION Three reviewers assessed and extracted the data from the included studies after study quality was rated. Qualitative thematic synthesis method was then used to identify common themes. Twenty-three articles met the inclusion criteria, with most coming from the United States. SYNTHESIS Important themes raised by people living with multiple chronic conditions related to their ability to self-manage included living with undesirable physical and emotional symptoms, with pain and depression highlighted. Issues with conflicting knowledge, access to care, and communication with health care providers were raised. The use of cognitive strategies, including reframing, prioritizing, and changing beliefs, was reported to improve people's ability to self-manage their multiple chronic conditions. CONCLUSION This study provides a unique view into patients' perspectives of living with multiple chronic conditions, which are clearly linked to common functional challenges as opposed to specific diseases. Future policy and programming in self-management support should be better aligned with patients' perspectives on living with multiple chronic conditions. This might be achieved by ensuring a more patient-centred approach is adopted by providers and health service organizations.
Combination of Telmisartan and Linagliptin Preserves Pancreatic Islet Cell Function and Morphology in db/db Mice

Objectives The present study aimed to investigate the synergistic action of telmisartan and linagliptin in ameliorating pancreatic islet functions and morphology in type 2 diabetes mellitus and to delineate the molecular signaling pathway involved. Methods db/db mice were given telmisartan (3 mg/kg) or linagliptin (3 mg/kg) alone or in combination, daily for 8 weeks, and were studied in vivo by fasting and random blood glucose tests, oral glucose tolerance tests, and intraperitoneal insulin tolerance tests, as well as ex vivo by glucose-stimulated insulin secretion and morphology of pancreatic islets. The underlying signaling pathways were examined by Western blot, real-time quantitative polymerase chain reaction, and dihydroethidium staining analyses using mouse pancreatic islets and rat &bgr;-insulinoma cells. Results Telmisartan/linagliptin combination induced significantly better glucose homeostasis than the monotherapies. Posttreatment reactive oxygen species level was suppressed most significantly after the telmisartan/linagliptin combined therapy, whereas no significant change in peroxisome proliferator–activated receptor &ggr; expressions was observed after treatments. Conclusions The telmisartan/linagliptin combination preserved pancreatic islet cell functions and morphology via reduction of oxidative stress but independent of the peroxisome proliferator–activated receptor &ggr; pathway. Our data shed light on the therapeutic potential of using the telmisartan/linagliptin combination in the treatment of human type 2 diabetes mellitus and its related complications.
[Growth and nutritional status in a probabilistic sample of schoolchildren from Rio de Janeiro, 1999].

Growth and nutritional status were assessed in a probabilistic sample of public schoolchildren (1,705 girls and 1,682 boys) in the city of Rio de Janeiro in 1999. Nutritional status of the under-10-year group was assessed by z < -2 (undernutrition) for body mass for height and height for age and by z > +2 for body mass for height (overweight). For children over 10, the 5th and 85th percentiles of body mass index for age were used to assess underweight and overweight, respectively. Prevalence rates of overweight and obesity according to the International Obesity Task Force criteria were also calculated. Prevalence rates for undernutrition were below expected for the reference population. Prevalence of overweight was approximately 18% and 14% for girls and boys, respectively, and obesity was 5% for both sexes. The results of the present study are similar to findings from population-based surveys in Brazil: low prevalence of undernutrition and high prevalence of overnutrition.
Fermented wheat aleurone induces enzymes involved in detoxification of carcinogens and in antioxidative defence in human colon cells

Dietary fibre is fermented by the human gut flora resulting mainly in the formation of SCFA, for example, acetate, propionate and butyrate. SCFA, in particular butyrate, may be important for secondary cancer prevention by inducing apoptosis and inhibiting cell growth of cancer cells, thereby inhibiting the promotion and/or progression of cancer. Furthermore, SCFA could also act on primary cancer prevention by activation of detoxifying and antioxidative enzymes. We investigated the effects of fermented wheat aleurone on the expression of genes involved in stress response and toxicity, activity of drug-metabolising enzymes and anti-genotoxic potential. Aleurone was digested and fermented in vitro to obtain samples that reflect the content of the colon. HT29 cells and colon epithelial stripes were incubated with the resulting fermentation supernatant fractions (fs) and effects on mRNA expression of CAT, GSTP1 and SULT2B1 and enzyme activity of glutathione S-transferase (GST) and catalase (CAT) were measured. Fermented aleurone was also used to study the protection against H2O2-induced DNA damage in HT29 cells. The fs of aleurone significantly induced the mRNA expression of CAT, GSTP1 and SULT2B1 (HT29) and GSTP1 (epithelial stripes), respectively. The enzyme activities of GST (HT29) and CAT (HT29, epithelial stripes) were also unambiguously increased (1·4- to 3·7-fold) by the fs of aleurone. DNA damage induced by H2O2 was significantly reduced by the fs of aleurone after 48 h, whereupon no difference was observed compared with the faeces control. In conclusion, fermented aleurone is able to act on primary prevention by inducing mRNA expression and the activity of enzymes involved in detoxification of carcinogens and antioxidative defence.
S100B in neuropathologic states: The CRP of the brain?

In recent years there has been a proliferation of interest in the brain‐specific protein S100B, its many physiologic roles, and its behaviour in various neuropathologic conditions. Since the mid‐1960s, its wide variety of intracellular and extracellular activities has been elucidated, and it has also been implicated in an increasing number of central nervous system (CNS) disorders. S100B is part of a superfamily of proteins, some of which (including S100B) have been implicated as calcium‐dependent regulatory proteins that modulate the activity of effector proteins or cells. S100B is primarily an astrocytic protein. Within cells, it may have a role in signal transduction, and it is involved in calcium homeostasis. Information about the functional implication of S100B secretion by astrocytes into the extracellular space is scant but there is substantial evidence that secreted glial S100B exerts trophic or toxic effects depending on its concentration. This review summarises the historic development and current knowledge of S100B, including recent interesting findings relating S100B to a diversity of CNS pathologies such as traumatic brain injury, Alzheimer's disease, Down's syndrome, schizophrenia, and Tourette's syndrome. These broad implications have led some workers to describe S100B as ‘the CRP (C‐reactive protein) of the brain. ’ This review also examines S100B's potential role as a neurologic screening tool, or biomarker of CNS injury, analogous to the role of CRP as a marker of systemic inflammation. © 2007 Wiley‐Liss, Inc.
Uterine Rupture After Induction of Labour for Intrauterine Death Using the Prostaglandin E2 Analogue Sulprostone

EDITORIAL COMMENT: We accepted this case for publication to remind readers that induction of labour with prostaglandin can result in uterine rupture; in the case presented the woman had had a previous Caesarean section and the indication for induction was fetal death in utero. The authors briefly summarize their large experience with prostaglandin induction in women with intrauterine fetal deaths and review the literature concerning uterine rupture with induction of labour with prostaglandins.
The Impact of Percutaneous Coronary Interventions on Outcomes for Acute Myocardial Infarction in Pennsylvania

This research estimates the benefits associated with percutaneous coronary interventions (PCIs) for patients with acute myocardial infarction (AMI) treated at hospitals in Pennsylvania. We studied 31 351 patients with AMI in Pennsylvania during the year 2000, including 10 170 who received PCI. Univariate comparisons between groups were made using χ 2 tests for categorical outcomes and Student's t tests for continuous outcomes. A logit model for proportions was used to model the relationship between mortality and the proportion of AMI patients who received PCI. The mortality rate for patients undergoing PCI was significantly lower than for those being treated medically (1.4% vs 15.8%, P < .0001). Furthermore, significant survival benefits associated with PCI persisted when patients were stratified by age, sex, type of infarction, and severity at admission. At the hospital level, higher rates of PCI were associated with a significantly lower overall mortality rate among patients with AMI (P < .0001). (Am J Med Qual 2007;22:85-94)
Biodegradation of triclosan in biosolids‐amended soils

Land application of biosolids can constitute an important source of triclosan (TCS) input to soils, with uncertain effects. Several studies have investigated the degradation potential of TCS in biosolids‐amended soils, but the results vary widely. We conducted a laboratory degradation study by mixing biosolids spiked with [14C]‐TCS (final concentration = 40 mg/kg) with Immokalee fine sand and Ashkum silty clay loam soils at an agronomic application rate (22 Mg/ha). Biosolids‐amended soils were aerobically incubated in biotic and inhibited conditions for 18 weeks. Subsamples removed at 0, 2, 4, 6, 9, 12, 15, and 18 weeks were sequentially extracted with an operationally defined extraction scheme to determine labile and nonlabile TCS fractions. Over the 18‐week incubation, the proportion of [14C] in the nonlabile fraction increased and the labile fraction decreased, suggesting decreasing availability to biota. Partitioning of TCS into labile and nonlabile fractions depended on soil characteristics. Less than 0.5% of [14C]‐TCS was mineralized to carbon dioxide (14CO2) in both soils and all treatments. A degradation metabolite, methyl triclosan (Me‐TCS), was identified in both soils only in the biotic treatment, and increased in concentration over time. Even under biotic conditions, biosolids‐borne TCS is persistent, with a primary degradation (TCS to Me‐TCS) half‐life of 78 d in the silty clay loam and 421 d in the fine sand. A half‐life of approximately 100 d would be a conservative first approximation of TCS half‐life in biosolids‐amended soils for risk estimation. Environ. Toxicol. Chem. 2011;30:2488–2496. © 2011 SETAC
Psychological stress in the workplace and menstrual function.

The relation between psychological stress at work and menstrual function was examined for 276 healthy, working, premenopausal women who participated in the California Women's Reproductive Health Study in 1990-1991. Subjects collected daily urine samples and completed a daily diary for an average of five menstrual cycles. Metabolites of estrogen and progesterone were measured in the urine, and computer algorithms were developed to characterize each cycle as ovulatory or anovulatory and to select a probable day of ovulation. A telephone interview collected information about psychological stress at work as well as other occupational, demographic, lifestyle, and environmental factors. Logistic regression was used to model stressful work and risk of anovulation (> or = 36 days without ovulating) and measures of within-woman cycle variability. Repeated measures analyses were performed on other menstrual cycle parameters. Stressful work (high demand in combination with low control) was not strongly related to an increased risk for anovulation or cycle variability or to any of the following cycle endpoints: short luteal phase (< or = 10 days), long follicular phase (> or = 24 days), long menses (> or = 8 days), or long cycle (> or = 36 days). However, women in stressful jobs had a more than doubled risk for short cycle length (< or = 24 days) compared with women not working in stressful jobs (adjusted odds ratio = 2.24, 95% confidence interval 1.09-4.59).
Human cobalamin deficiency: alterations in serum tumour necrosis factor‐α and epidermal growth factor

Abstract: Objectives:We have previously demonstrated that vitamin B12 (cobalamin)‐deficient central neuropathy in the rat is associated with local overexpression of neurotoxic tumour necrosis factor (TNF)‐α combined with locally decreased synthesis of neurotrophic epidermal growth factor (EGF). The aims of this study were to investigate whether a similar imbalance also occurs in the serum of adult patients with clinically confirmed cobalamin deficiency and whether it can be corrected by vitamin B12 replacement therapy. Patients and methods: We studied 34 adult patients with severe cobalamin deficiency, 12 patients with pure iron deficiency anaemia and 34 control subjects. Haematological markers of cobalamin deficiency and serum TNF‐α and EGF levels were measured using commercial kits. Thirteen cobalamin‐deficient patients were re‐evaluated after 3 and 6 months of parenteral vitamin B12 treatment. Results: TNF‐α was significantly higher (p < 0.01) and EGF significantly lower (p < 0.01) in the patients with cobalamin deficiency, but both were unchanged in patients with pure iron deficiency anaemia. In cobalamin‐deficient patients the serum TNF‐α levels correlated significantly with plasma total homocysteine levels (r = 0.425; p < 0.02). In the treated patients TNF‐α and EGF levels normalised concomitantly with clinical and haematological disease remission. Conclusions: In humans, as in rats, cobalamin concentration appears to be correlated with the synthesis and release of TNF‐α and EGF in a reciprocal manner, because cobalamin deficiency is accompanied by overproduction of TNF‐α and underproduction of EGF.
Nasality in Taiwanese

This study used perceptual and articulatory data to investigate a language specific phonemic inventory, and allophonic rules for homorganic initial voiced stops versus homorganic nasal stops, and oral versus nasal vowels in Taiwanese. Four experiments were conducted: concept formation, gating, and two airflow studies. Results of a first nasal airflow study on syllable initial voiced stops and nasal stops showed that initial voiced stops were nasalized when preceded by a nasal consonant across a word boundary. Results of a concept formation experiment indicated that Taiwanese listeners grouped homorganic voiced stops and nasal stops into the same category. A gating experiment showed that subjects were insensitive to the phonetic differences between homorganic voiced stops and nasal stops. The presence or absence of nasality within the vowel nucleus was the crucial cue to the identification of oral and nasal syllables. A second nasal airflow study on vowel nuclei demonstrated that oral vowels were nasalized at their onset and offset when preceded or followed by a nasal consonant respectively. The distinction between oral and nasal vowels was maintained at the center of the vowel nuclei. By classifying homorganic initial voiced stops and nasal stops into the same category, Taiwanese speakers were able to ignore the phonetic difference between them and relied on the distinction between nasal vowel versus oral and nasalized vowel to distinguish between nasal versus oral syllables. Taiwanese speakers produced a clear distinction between oral and nasal vowels to retain the crucial role that oral versus nasal contrasts on vowel nuclei played during perception experiments. This study offers phonetic evidence to answer the controversial nasality issue in Taiwanese. Furthermore, a link was found between perception and extent of application of allophonic rules during production.
MEFV gene mutations in Henoch–Schönlein purpura

Coexistence of familial Mediterranean fever (FMF) with various systemic vasculitides, including Henoch–Schönlein purpura (HSP) and other inflammatory disorders has been reported and the MEFV gene has been suggested to play an important role in the pathogenesis of this association. In the present study, the mutation rate of the MEFV gene in HSP and its association with the clinical course of the disease were evaluated.
O BALNEÁRIO CASTREJO DO CASTRO DAS EIRAS

RESUMO: O balneario castrejo escavado no castro das Eiras em 1990 trouxe novos dados para o entendimento destas estruturas tao curiosas como raras. Este balneario, com dimensoes anormalmente grandes, apresentava uma profusa decoracao das grandes pecas graniticas que o constituiam. Este balneario e um equipamento de prestigio pertencente a um grande castro construido sob o dominio romano. A mestria artesanal necessaria ao talhe dos seus elementos decorativos, bem como a tipologia de alguns motivos, sugerem a existencia de artesaos itinerantes. Palavras-chave: Balneario tipo sauna, Cultura Castreja
Assessment of Chicken-Egg Membrane as a Dressing for Wound Healing

OBJECTIVES: To examine the efficacy of the folk remedy of chicken-egg membrane dressing on wound healing. DESIGN: Full-thickness excisional wounds were created on 14 male Sprague-Dawley rats in 2 separate trials. Each animal received 2 wounds on the upper back. One wound was untreated, and the other was dressed with chicken-egg membrane to assess its impact on wound healing. Half of the rats received egg membrane treatment on the inferior wound, whereas the other half received egg membrane treatment on the superior wound. Membrane replacement, wound debridement, and imaging were done on days 5, 8, and 10 and then imaging continued on days 12, 14, 16, 18, and 20 of the experiment. Healing rate was measured based on the wound area over the 20 days of the experiment. RESULTS: The wounds dressed with chicken-egg membrane had a significantly (P < .01) faster rate of healing compared with the control at the early stages of healing between days 0 and 5. This group healed 21% faster during this early phase, compared with the control group. Overall, however, wound healing rates were indistinguishable from days 5 to 20. CONCLUSION: Chicken-egg membrane dressing significantly improves healing of cutaneous wounds in the early stages of wound healing.
Comparative study into the robustness of compartmental modeling and model‐free analysis in DCE‐MRI studies

To evaluate and compare the reproducibility of the preferred phenomenological parameter IAUC60 (initial area under the time‐concentration curve [IAUC] defined over the first 60 seconds postenhancement) with the preferred modeling parameter (Ktrans), as derived using two simple models, in abdominal and cerebral data collected in typical Phase I clinical trial conditions.
Model Predictive Control of Distributed Air-Conditioning Loads to Compensate Fluctuations in Solar Power

Flexible loads such as residential air-conditioners (ACs) can be directly controlled to provide demand-side regulation and balance services in electricity grids. Large aggregations of ACs offer a resource akin to that of a distributed energy storage system, which may be used to compensate fluctuations in the power output of local renewable energy generation. This paper formulates distributed and centralized model predictive control (MPC) strategies to balance fluctuations in solar power generation by directly controlling the aggregate demand of clusters of distributed residential ACs. The proposed receding-horizon control strategies rely on a new second-order linear time-varying model for the aggregate demand response of a population of heterogeneous ACs to changes in thermostat setpoints under varying ambient temperature. The performance of the proposed MPC strategies is analyzed in a numerical simulation study implementing AC demand tracking of 1-min fluctuations in actual photovoltaic capacity based on persistence and sky imager short-term solar forecasts. The results show that distributed and centralized MPC strategies achieve comparable performance, with better performance of persistence forecasts in a shorter prediction horizon, and better performance with sky imager forecasts on a longer prediction horizon.
Autologous Blood Injection Works for Recalcitrant Lateral Epicondylitis.

BACKGROUND Recalcitrant lateral epicondylitis may be a disabling condition. Treatment of this condition is still controversial. AIMS In the present prospective study, we evaluated the long-term results of autologous blood injection for the treatment of recalcitrant lateral epicondylitis. STUDY DESIGN Prospective clinical study. METHODS A total of 42 elbows of 40 consecutive patients (28 female, 12 male) were enrolled in this prospective study. Seven patients left the study (3 patients moved to another city, 1 patient died in the second week due to a heart condition, 1 patient quit the study because of the resolution of pain in the fourth week and 2 patients did not agree to the second injection). Thirteen patients were lost to third year follow-up. Therefore, a total of 21 elbows of 20 patients with 3 years of follow-up were included in this study. The mean age of the patients was 47.25 years (range, 20-68 years). RESULTS Visual analogue scale (VAS), Nirschl score and grip strength were significantly improved after injections when compared to before treatment. The best improvement in terms of grip strength, Nirschl score and VAS score was detected at the one year follow-up. The improvement in Nirschl and VAS score sustained until the third year. CONCLUSION We suggest that autologous blood injection for the treatment of recalcitrant lateral epicondylitis is an effective, safe and successful procedure in the long-term.
Laboratory selection for spirodiclofen resistance and cross-resistance in Panonychus citri

Selection for spirodiclofen resistance was done in the laboratory with a susceptible strain of the citrus red mite, Panonychus citri (McGregor). Successive selections for spirodiclofen resistance through 42 generations resulted in a high level of resistance and the resistance ratio at LC 50 was 103 compared with that of the original susceptible strain. In the selected strain, the level of resistance to spirodiclofen was high at all developmental stages except eggs and P. citri adult infertility caused by spirodiclofen was decreased. Cross-resistance to spirotetramat was detected but not to 10 other acaricides. Synergist experiments indicated that, piperonyl butoxide (PBO), S,S,S-tributyl-phosphorotrithioate (DEF) and diethyl maleate (DEM) synergized the toxicity of spirodiclofen in the selected strain by 3.3, 2.3 and 1.6 fold and the resistance ratio decreased from 103 to 38, 45 and 65, respectively, but no synergism was found in the susceptible strain. Key words: Spirodiclofen, laboratory selection, cross-resistance, synergism, Panonychus citri.