Miracle-dz/UniFAR-FTUs huggingface dataset:
The Case of Vertebroplasty Trials: Promoting a Culture of Evidence-Based Procedural Medicine

Vertebroplasty is a widely used procedure to treat pain associated with vertebral fractures. Initially developed in the 1980s for treatment of spinal tumors, it was subsequently introduced into practice for treatment of painful, osteoporotic vertebral compression fractures based on published case series [1–2]. Although the exact mechanism of action remains unclear, most practitioners believe that vertebroplasty relieves pain through stabilization of microfractures. Two recently published, randomized, placebo-controlled trials demonstrated that, in terms of pain relief and improvement in function, vertebroplasty was equivalent to a sham intervention that did not involve injection of cement [3–4]. The publication of these trial results stimulated the publication of a number of editorial commentaries in which vertebroplasty practitioners and their professional societies questioned the validity of these two studies [5–7]. Criticisms were primarily focused on patient selection and whether or not the studies utilized a true “placebo,” since local anesthesia was used in the control arm. In the current article we propose a diagnostic explanation of the critical response to the two placebo-controlled vertebroplasty trials and also offer a prescribed remedy to these types of responses. The diagnostic explanation highlights the idea of the physician as “placebo reactor,” a psychological dynamic that reinforces clinicians’ belief in the value of procedures that they recommend or administer and perceive to be beneficial. The term “placebo reactor” in this discussion refers to the reaction on the part of physicians to the observed clinical outcomes in their own patients. As a result of this psychological dynamic clinicians face cognitive dissonance when their clinical experience conflicts with clinical trial results. The prescribed remedy we offer is to develop the culture of evidence-based procedural medicine, which corrects the biases naturally produced by clinical experience.
When Ideals Are Too "Far Off": Physical Self-Ideal Discrepancy and Body Dissatisfaction in Japan

There is much evidence that young Japanese adults manifest relatively low body esteem—a phenomenon often explained as an outcome of modesty or limited need for self-enhancement. The author sought to identify additional determinants of this phenomenon and to explain its sources by examining the relationship between several presumed factors and level of body satisfaction rated by 263 Japanese students. The findings confirm earlier evidence of low body satisfaction among young Japanese adults and indicate that it is predicted mainly by a discrepancy between perceptions of the actual body and the ideal, self-esteem, and a predisposition to interpersonal phobia. Although some of the factors revealed are relevant to other cultures as well, the relatively wide discrepancy between self and ideal body and predisposition to interpersonal phobia may characterize young Japanese adults in particular and stem from a specific historical background. Overall, the results suggest that culture has a significant role in shaping collective body images in Japan and that a broader conceptualization of physical self-ideal discrepancy may better explain divergent levels of body satisfaction across cultures.
Env-Independent Protection Induced by Live, Attenuated Simian Immunodeficiency Virus Vaccines

ABSTRACT Live attenuated simian immunodeficiency viruses (SIV), such asnef deletion mutants, are the most effective vaccines tested in the SIV-macaque model so far. To modulate the antiviral immune response induced by live attenuated SIV vaccines, we had previously infected rhesus monkeys with a nef deletion mutant of SIV expressing interleukin 2 (SIV-IL2) (B. R. Gundlach, H. Linhart, U. Dittmer, S. Sopper, S. Reiprich, D. Fuchs, B. Fleckenstein, G. Hunsmann, S. Stahl-Hennig, and K. Überla, J. Virol. 71:2225–2232, 1997). In the present study, SIV-IL2-infected macaques and macaques infected with thenef deletion mutant SIVΔNU were challenged with pathogenic SIV 9 to 11 months postvaccination. In contrast to the results with naive control monkeys, no challenge virus could be isolated from the SIV-IL2- and SIVΔNU-infected macaques. However, challenge virus sequences could be detected by nested PCR in some of the vaccinated macaques. To determine the role of immune responses directed against Env of SIV, four vaccinated macaques were rechallenged with an SIV-murine leukemia virus (MLV) hybrid in which theenv gene of SIV had been functionally replaced by theenv gene of amphotropic MLV. All vaccinated macaques were protected from productive infection with the SIV-MLV hybrid in the absence of measurable neutralizing antibodies, while two naive control monkeys were readily infected. Since the SIV-MLV hybrid uses the MLV Env receptor Pit2 and not CD4 and a coreceptor for virus entry, chemokine inhibition and receptor interference phenomena were not involved in protection. These results indicate that the protective responses induced by live attenuated SIV vaccines can be independent of host immune reactions directed against Env.
Hepatocellular carcinoma: contrast-enhanced MRI

It has been observed that hepatocellular carcinomas (HCCs) can differ in signal intensity on T1and T2weighted images [1–3]. The problem of limited spatial resolution of magnetic resonance imaging (MRI) needs to be solved for assessment of small lesions with low lesionto-liver contrast. To overcome the limitation of static MRI of the liver, various contrast agents have been designed to enhance the lesion-to-liver contrast for lesion detection and detailed characterization of focal lesions. This review briefly describes the recently developed, clinically available, liver-specific, contrast agents in addition to the use of dynamic MRI with nonspecific extracellular fluid space agents for the diagnostic assessment of HCCs.
GENOTYPING OF CLOSTRIDIUM PERFRINGENS ISOLATED FROM CATTLE AND PIGS WITH DIARRHEA IN HANOI AND SURROUNDING AREAS , VIETNAM

Diarrhea is a major cause of economic loss in cattle and pig farming. The aim of this study was epidemiological survey of prevalence and molecular typing of C. perfringens isolates associated with diarrhea in cattle and pigs. The study was carried out from 2007 to 2010 in Hanoi and surrounding areas (including Bac Ninh and Vinh Phuc provinces). The biochemical properties of isolated C. perfringens were tested. The results showed that: all isolates of C. perfringens had biochemical properties as described before. PCR typing of isolates was carried out by multiplex PCR. C. perfringens isolated from fecal samples of diarrheic cattle were type A (57.34%), type D (41.33%) and type C (1.33%); whereas all C. perfringens isolated from fecal samples of healthy cattle, diarrheic and healthy pigs were type A. The prevalence of cpe and cpb2 varied with isolated genotypes. There was a significant association between cpb2 positive C. perfringens isolates and diarrhea in pigs. Of the 304 isolates from pigs with diarrhea examined, 138 (45.39%) were positive for the cpb2 gene and 52 (17.11%) were positive for the cpe and cpb2 genes, whereas none of the isolates from healthy pigs were positive for the cpb2 gene.
Oligosaccharide Side Chains on Human Secretory IgA Serve as Receptors for Ricin1

Secretory IgA (sIgA) Abs are polymeric Igs comprised of two or more IgA monomers joined together at their C termini and covalently associated with a 70-kDa glycoprotein called secretory component. As the predominant Ig type in gastrointestinal sections, sIgA Abs are centrally important in adaptive immunity to enteropathogenic bacteria, viruses, and toxins. In this study, we demonstrate that sIgA Abs may also function in innate defense against ricin, a naturally occurring, galactose-specific plant lectin with extremely potent shiga toxin-like enzymatic activity. In lectin blot overlay assays, we found that ricin bound to secretory component and the H chain of human IgA, and this binding was inhibited by the addition of excess galactose. The toxin also recognized IgM (albeit with less affinity than to IgA), but not IgG. Ricin bound to both human IgA1 and IgA2, primarily via N-linked oligosaccharide side chains. At 100-fold molar excess concentration, sIgA (but not IgG) Abs inhibited ricin attachment to the apical surfaces of polarized intestinal epithelial cells grown in culture. sIgA Abs also visibly reduced toxin binding to the luminal surfaces of human duodenum in tissue section overlay assays. We conclude that sIgA Abs in mucosal secretions may serve as receptor analogues for ricin, thereby reducing the effective dose of toxin capable of gaining access to glycolipid and glycoprotein receptors on epithelial cell surfaces.
Characterization of interactions of TonB and Colicin M with FhuA reconstituted into Nanodiscs

TonB-dependent transporters are β-barrel outer membrane proteins that depend on interactions with the inner membrane protein TonB to drive import of scarce nutrients. Upon becoming ligand-loaded, TonB-dependent transporters bind TonB through a β-strand exchange. FhuA is the TonB-dependent transporter that transports hydroxamate iron siderophores, such as ferrichrome and ferricrocin, into the periplasm and also acts as the receptor and transporter of the antimicrobial protein colicin M. The interactions of FhuA with TonB have previously been investigated in detergents, which can affect the conformations of TonB-dependent transporters and alter their interaction with TonB. To exclude the potential negative effects of detergent, FhuA was reconstituted into Nanodiscs that reconstitute a membrane-like environment suitable for biochemical analysis. Binding of TonB to FhuA was found to be strongly dependent on the ligand-loaded state of FhuA. The binding affinity was relatively high (~200 nM) and enthalpy driven, suggesting a disorder-to-order interaction occurring during the β-strand exchange. Colicin M also bound Nanodisc reconstituted FhuA with a high affinity (~3.5 nM) through an entropy driven interaction that may reflect a hydrophobic interaction. The ligand ferricrocin inhibited the binding of colicin M to FhuA. While TonB is required for transport of colicin M into cells, colicin M was not observed to cause the recruitment of TonB to FhuA. Finally, the conformation of FhuA was investigated in the presence of ferricrocin and colicin M by partial proteolysis.
DNA barcoding of six Ceroplastes species (Hemiptera: Coccoidea: Coccidae) from China

Ceroplastes Gray (wax scales) is one of the genera of Coccidae, most species of which are considered to be serious economic pests. However, identification of Ceroplastes species is always difficult owing to the shortage of easily distinguishable morphological characters. Mitochondrial cytochrome c oxidase I (COI) sequences (or DNA barcodes) and the D2 expansion segments of the large subunit ribosomal RNA gene 28S were used for accurate identification of six Ceroplastes species (C. floridensis Comstock, C. japonicus Green, C. ceriferus (Fabricius), C. pseudoceriferus Green, C. rubens Maskell and C. kunmingensis Tang et Xie) from 20 different locations in China. For COI data, low G·C content was found in all species, averaging about 20.4%. Sequence divergences (K2P) between congeneric species averaged 12.19%, while intra‐specific divergences averaged 0.42%. All 112 samples fell into six reciprocally monophyletic clades in the COI neighbour‐joining (NJ) tree. The NJ tree inferred from 28S showed almost same results, but samples of two closely related species, C. ceriferus and C. pseudoceriferus, were clustered together. This research indicates that the standard barcode region of COI can efficiently identify similar Ceroplastes species. This study provides an example of the usefulness of barcoding for Ceroplastes identification.
An investigation to assess the potential of CD25highCD4+ T cells to regulate responses to donor alloantigens in clinically stable renal transplant recipients

Regulatory T cells are enriched within CD25highCD4+ leukocytes, however their role in renal transplant recipients with stable function vs. recipients with biopsy‐proven chronic allograft dysfunction remains unclear. We therefore studied the number, phenotype, and function of CD25highCD4+ cells in the peripheral blood of 30 renal transplant recipients of living‐related grafts, comprising 15 rejection‐free recipients with stable graft function (Group A) and 15 with biopsy‐proven chronic graft dysfunction (Group B). A higher absolute number of CD25highCD4+ cells were present in the peripheral blood of rejection‐free recipients (Group A) vs. those recipients with chronic graft dysfunction (Group B) (P = 0.019); but there was no significant difference with healthy volunteers (P = 0.084). In carboxyfluorescein diacetate succinimidyl ester‐mixed leukocyte culture assays, depletion of CD25highCD4+ revealed active regulation in 11 (74%) of 15 rejection‐free recipient samples (Group A) in response to donor‐ but not third party‐leukocytes, whereas no regulatory activity was observed in any samples from recipients with chronic graft dysfunction (Group B). In conclusion, these data provide evidence for the presence of an increased number of CD25highCD4+ T cells with donor‐specific regulatory activity in the peripheral blood of renal transplant recipients with stable graft function compared with recipients with chronic graft dysfunction.
Blood zinc protoporphyrin is elevated only in sickle cell patients with low fetal hemoglobin

Increased levels of various porphyrin species have been reported in sickle cell anemia (SS) patients in the absence of lead poisoning and iron deficiency anemia, but conflicting data remain. Suspecting that SS patients may be heterogenous for this abnormality, we have studied zinc protoporphyrin (ZPP) and protoporphyrin IX (PPIX) blood levels and find abnormally elevated levels of ZPP in those with low peripheral fetal hemoglobin (%HbF) levels. Two groups exist: one with <9% HbF and elevated ZPP, and one with ≥9% HbF and normal ZPP levels (P < 8.1 × 10−4). There is a strong negative correlation of ZPP levels with %Hb F (r = –0.83, P < 8.0 × 10−5), and a moderate one with total hemoglobin levels (r = –0.55, P < 0.05). These results suggest that ZPP may indeed contribute to the pathophysiology of the disease and/or serve as a marker of the severity of the disease.
Projective Test Findings for Boys with Gender Disturbance: Draw-a-Person Test, IT Scale, and Make-a-Picture Story Test

With 66 boys, aged 3 yr. to 17 yr. who were referred for potential gender-identity disorder, this study examined intrapsychic manifestations as reflected in their projections to the Draw-A-Person Test, the Brown IT Scale for Children, and the Shneidman Make-A-Picture Story Test. Without access to these projective test findings, an independent clinical psychologist provided a diagnostic rating on the severity of gender disturbance on a five-point diagnostic rating scale, based on clinical interviews of the child and his parents and a systematic behavioral assessment based on previously published normative standardization data. For each of the three projective measures, significant correlations were found between the clinician ratings on severity of gender disturbance and the test findings in the feminine direction (D-A-P, r = .44; IT Scale, r = .64; M-A-P-S, r = .35). These results validated the use of intrapsychic phenomena of fantasy and self-perception as measured by these projective tests for the diagnosis of gender disturbance in male children and adolescents.
Interleukin-6 is a negative regulator of hepatic glucose production in the isolated rat liver

Abstract The mechanism underlying the increased rate of endogenous glucose production from the liver during exercise remains unknown. The cytokine interleukin-6 (IL-6) is known to be released during exercise and is thought that either IL-6 directly or via a “contraction factor” stimulates the release of stored glucose from the liver. Here we show that IL-6 does not directly increase hepatic glucose output (HGO). Moreover, IL-6 infused at the same time as glucagon caused a significant reduction in HGO. IL-6 infused with epinephrine caused no synergenic increase in HGO. To test if an unknown “contraction factor” was needed along with IL-6 to increase HGO, we used human fasted and exercised plasma perfused with or without IL-6 in our isolated liver system. We found that exercised plasma increased HGO, as expected, but when infused with IL-6, reductions in HGO were found. Our results provide evidence that IL-6 works as a negative regulator of HGO.
Genetic inheritance of gene expression in human cell lines.

Combining genetic inheritance information, for both molecular profiles and complex traits, is a promising strategy not only for detecting quantitative trait loci (QTLs) for complex traits but for understanding which genes, pathways, and biological processes are also under the influence of a given QTL. As a primary step in determining the feasibility of such an approach in humans, we present the largest survey to date, to our knowledge, of the heritability of gene-expression traits in segregating human populations. In particular, we measured expression for 23,499 genes in lymphoblastoid cell lines for members of 15 Centre d'Etude du Polymorphisme Humain (CEPH) families. Of the total set of genes, 2,340 were found to be expressed, of which 31% had significant heritability when a false-discovery rate of 0.05 was used. QTLs were detected for 33 genes on the basis of at least one P value <. 000005. Of these, 13 genes possessed a QTL within 5 Mb of their physical location. Hierarchical clustering was performed on the basis of both Pearson correlation of gene expression and genetic correlation. Both reflected biologically relevant activity taking place in the lymphoblastoid cell lines, with greater coherency represented in Kyoto Encyclopedia of Genes and Genomes database (KEGG) pathways than in Gene Ontology database pathways. However, more pathway coherence was observed in KEGG pathways when clustering was based on genetic correlation than when clustering was based on Pearson correlation. As more expression data in segregating populations are generated, viewing clusters or networks based on genetic correlation measures and shared QTLs will offer potentially novel insights into the relationship among genes that may underlie complex traits.
How to evaluate the child presenting with an apparent life-threatening event?

BACKGROUND Infants who have experienced an apparent life-threatening event typically undergo an extensive evaluation to rule out serious underlying conditions. OBJECTIVES To evaluate the yield of different tests performed after an apparent life-threatening event and to identify high risk groups in which more extensive diagnostic tests are required. METHODS A retrospective study was conducted in a children's hospital for a 4 year period and the charts of infants who were admitted with an apparent life-threatening event were reviewed. The yield for each diagnostic test was established according to the ratio of positive results contributing to the diagnosis of the apparent life-threatening event. RESULTS The study included 69 infants between the ages of 1 week and 1 year. There were abnormal findings in 36% of the cases. Gastroesophageal reflux was the most common diagnosis (60%). In the remaining patients the diagnosis was either seizures (12%) or respiratory tract infections (28%). Tests used for the diagnosis of cardiac, metabolic and nonrespiratory infections had no yield. A positive correlation was found between abnormal test results and abnormal physical examination (P = 0.001), an abnormal perinatal history (P = 0.017), and age older than 2 months (P = 0.002). CONCLUSIONS The yield of most of the tests performed after an apparent life-threatening event is low, especially in infants with a normal perinatal history and physical examination.
Transcriptional silencing of Dickkopf gene family by CpG island hypermethylation in human gastrointestinal cancer.

AIM To clarify alterations of Dickkopfs (Dkks) and Kremen2 (Krm2) in gastrointestinal cancer. METHODS We investigated the expression profiles and epigenetic alterations of Dkks and Krm2 genes in gastrointestinal cancer using RT-PCR, tissue microarray analysis, and methylation specific PCR (MSP). Cancer cells were treated with the demethylating agent and/or histone deacetylase inhibitor. WST-8 assays and in vitro invasion assays after treatment with specific siRNA for those genes were performed. RESULTS Dkks and Krm2 expression levels were reduced in a certain subset of the gastrointestinal cancer cell lines and cancer tissues. This was correlated with promoter hypermethylation. There were significant correlations between Dkks over-expression levels and beta-catenin over-expression in colorectal cancer. In colorectal cancers with beta-catenin over-expression, Dkk-1 expression levels were significantly lower in those with lymph node metastases than in those without. Down-regulation of Dkks expression by siRNA resulted in a significant increase in cancer cell growth and invasiveness in vitro. CONCLUSION Down-regulation of the Dkks associated to promoter hypermethylation appears to be frequently involved in gastrointestinal tumorigenesis.
Formation of Lewia infectoria, the teleomorph of Alternaria infectoria, on wheat in Argentina

The trapping of pseudothecia carrying asci with mature ascospores of Lewia infectoria (teleomorph of Alternaria infectoria) from wheat stubble under natural field conditions in Buenos Aires Province, Argentina, is reported for the first time. The production of mature pseudothecia in culture is also reported. Monosporic isolates of A. infectoria, obtained from infected wheat plants in Argentina, produced conidia within a week and ascomata with fully mature ascospores within 7 months when stored on slants of PCA at 4°Cin darkness. The anamorph exhibited the sporulation pattern of Alternaria infectoria species-group, and was identified by its axenic colony morphology and the prominence of its secondary conidiophore structure. Critical examination of the teleomorph revealed it to be Lewia infectoria. The presence of the teleomorph has implications in the long-distance dispersal of A. infectoria and on resistance breeding programs. This is the first confirmed report of the sexual stage of A. infectoria in Argentina.