Miracle-dz/UniFAR-FTUs huggingface dataset:
On‐line Hemodiafiltration in Southeast Asia: A Three‐year Prospective Study of a Single Center

Abstract: Growing evidence suggests the superiority of on‐line hemodiafiltration (HDF) compared with the conventional hemodialysis technique in many aspects; however, on‐line HDF is still not used worldwide, including in Southeast Asia. The purpose of this study is to compare various clinical outcomes between on‐line HDF and high‐flux hemodialysis (HFHD). This was a single‐center three‐year prospective observational study that demonstrated the clinical parameters after switching from HFHD to on‐line HDF in 22 HDF patients, whose average age was 58.1 ± 13.3 years. The incidence of intradialytic undesired events, including hypotension, decreased and an apparent increase in appetite and an improvement in overall well‐being were recorded by most patients after switching to on‐line HDF. The data for dry weight, body mass index, and normalized protein nitrogen appearance, which represent nutritional status, showed a significant improvement while still maintaining a satisfactory albumin level. The adequacy in terms of urea reduction ratio significantly increased. The serum predialysis β2‐microglobulin levels were reduced by 25.7% from 31.1 ± 3.1 to 23.1 ± 4.8 mg/L (P < 0.05) at six months and remained constant during the three years of follow‐up. The patients' lipid profile was well controlled, and the mean C‐reactive protein value was still maintained in the normal range. In conclusion, our three‐year experience showed that on‐line HDF is a well‐tolerated treatment with a lower incidence of intradialytic undesired events. The potential benefits may include the effective removal of higher molecular weight uremic toxins and an improved nutritional status, along with a low inflammatory state.
Neuromuscular Fatigue Following Isometric Contractions with Similar Torque Time Integral

Abstract Torque time integral (TTI) is the combination of intensity and duration of a contraction. The aim of this study was to compare neuromuscular alterations following different isometric sub-maximal contractions of the knee extensor muscles but with similar TTI. Sixteen participants performed 3 sustained contractions at different intensities (25%, 50%, and 75% of Maximal Voluntary Contraction (MVC) torque) with different durations (68.5±33.4 s, 35.1±16.8 s and 24.8±12.9 s, respectively) but similar TTI value. MVC torque, maximal voluntary activation level (VAL), M-wave characteristics and potentiated doublet amplitude were assessed before and immediately after the sustained contractions. EMG activity of the vastus lateralis (VL) and rectus femoris (RF) muscles was recorded during the sustained contractions. MVC torque reduction was similar in the 3 conditions after the exercise (−23.4±2.7%). VAL decreased significantly in a similar extent (−3.1±1.3%) after the 3 sustained contractions. Potentiated doublet amplitude was similarly reduced in the 3 conditions (−19.7±1.5%), but VL and RF M-wave amplitudes remained unchanged. EMG activity of VL and RF muscles increased in the same extent during the 3 contractions (VL: 54.5±40.4%; RF: 53.1±48.7%). These results suggest that central and peripheral alterations accounting for muscle fatigue are similar following isometric contractions with similar TTI. TTI should be considered in the exploration of muscle fatigue during sustained isometric contractions.
Integrating interprofessional education in community-based learning activities: Case study

Faculty of Medicine/Suez Canal University (FOM/SCU) students are exposed to clinical practice in primary care settings within the community, in which they encounter patients and begin to work within interprofessional health teams. However, there is no planned curricular interaction with learners from other professions at the learning sites. As in other schools, FOM/SCU faces major challenges with the coordination of community-based education (CBE) program, which include the complexity of the design required for Interprofessional Education (IPE) as well as the attitudinal barriers between professions. The aim of the present review is to: (i) describe how far CBE activities match the requirements of IPE, (ii) explore opinions of graduates about the effectiveness of IPE activities, and (iii) present recommendations for improvement. Graduates find the overall outcome of their IPE satisfactory and believe that it produces physicians who are familiar with the roles of other professions and can work in synergy for the sake of better patient care. However, either a specific IPE complete module needs to be developed or more IPE specific objectives need to be added to current modules. Moreover, coordination with stakeholders from other health profession education institutes needs to be maximized to achieve more effective IPE.
Distributions of mRNAs for alpha‐2 adrenergic receptor subtypes in rat brain: An in situ hybridization study

Selective 35S‐labeled oligonucleotide probes were designed to sequences of the rat alpha‐2A (RG20), alpha‐2B (RNG), and alpha‐2C (RG10) adrenoreceptor mRNAs for use in in situ hybridization experiments on sections of unfixed rat brain, spinal cord and kidney. After hybridized sections were exposed to film or dipped in autoradiographic emulsion, specific and selective labeling patterns characteristic for each probe and region of the central nervous system were observed. Alpha‐2A mRNA labeling was most pronounced in neurons in layer six of the cerebral cortex, hypothalamic paraventricular nucleus, reticular thalamic nucleus, pontine nuclei, locus coeruleus, vestibular nuclei, trapezoid nuclei, deep cerebellar nuclei, nucleus tractus solitarii, ventrolateral medullary reticular formation, and the intermediolateral cell column of the thoracic spinal cord. In some of these locations, the receptor mRNA, in all probability, is present in noradrenaline and perhaps adrenaline neurons. The alpha‐2B probe, which primarily labels the kidney, gave only a very light signal in the thalamus in the central nervous system after extended exposure times. Alpha‐2C mRNA labeling was primarily observed in the olfactory bulb, cerebral cortex, islands of Calleja, striatum, hippocampal formation, cerebellar cortex, and dorsal root ganglia. Labeling patterns disappeared when excess unlabeled probes were added to their respective radiolabeled probes, or when sense probes were employed. When a hybrid antisense probe homologous to all three alpha‐2 probes was used, labeling patterns also disappeared. The present study therefore justifies the pharmacological subclassification of alpha‐2 receptors by providing anatomical evidence for specific and selective cell groups in the rat central nervous system containing mRNA for three alpha‐2 receptor subtypes. © 1993 Wiley‐Liss, Inc.
The effects of three different LDL‐apheresis methods on the plasma concentrations of E‐selectin, VCAM‐1, and ICAM‐1

Plasma concentrations of cellular adhesion molecules are associated with atherosclerotic diseases and major cardiovascular risk factors. It was shown that LDL‐apheresis with dextran sulfate lowers the levels of E‐selectin and ICAM‐1 in patients with familial hypercholesterolemia. The effects of different LDL‐apheresis methods have not been studied yet. Cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, fibrinogen, and the adhesion molecules E‐selectin, VCAM‐1, and ICAM‐1 were measured in 20 patients with coronary heart disease and severe hyperlipoproteinemia immediately before and after regular LDL‐apheresis. Treatment was performed by different apheresis methods (direct absorption, DA, n = 6; dextran sulfate adsorption, DS, n = 7; heparin precipitation, HP, n = 7). Rebound data of adhesion molecule levels were obtained from 2 patients of each group. Lipids were reduced similarly in all groups. The concentrations of all adhesion molecules were lowered during apheresis. The reduction of E‐selectin (−31 ± 7 vs. −6 ± 5 and −6 ± 5%, respectively, P < 0.001) was most prominent in the patients treated by heparin precipitation. Depending on the method of LDL‐apheresis, the concentrations of VCAM‐1 and E‐selectin in the outlets of the LDL‐apheresis columns were significantly lower compared to the concentration in the inlets. Plasma concentrations of adhesion molecules increased to their pre‐apheresis values within 2 to 4 days following LDL‐apheresis. The reductions of adhesion molecule levels observed during LDL‐apheresis are at least partly due to adsorption to the LDL‐apheresis column. The extent of absorption depends on the principle of extracorporeal LDL elimination. J. Clin. Apheresis 17:38–43, 2002. © 2002 Wiley‐Liss, Inc.
Pathophysiological effects of albumin dialysis in acute‐on‐chronic liver failure: A randomized controlled study

The pathophysiological basis of acute‐on‐chronic liver failure (ACLF) is unclear but systemic inflammatory response is thought to be important. In patients with ACLF, the molecular adsorbents recirculating system (MARS) improves individual organ function, but the effect of MARS on the proposed mediators of systemic inflammatory response is unclear. The present study was designed to determine the effect of MARS on the cytokine profile, oxidative stress, nitric oxide, and ammonia. A total of 18 patients with alcohol‐related ACLF due to inflammation‐related precipitants were randomized to receive standard medical therapy (SMT) alone, or with MARS therapy over 7 days. Plasma cytokines, malondialdehyde (MDA), free radical production, nitrate / nitrite (NOx), and ammonia were measured. Encephalopathy improved significantly with MARS (P < .01), but not with SMT. Mean arterial pressure and renal function remained unchanged. No significant change of plasma cytokines and ammonia levels were observed in either group. Plasma MDA levels did not change either. There was a fall in NOx (P < .05) with MARS, but not with SMT. In conclusion, in inflammation‐related ACLF patients, albumin dialysis using MARS results in improvement of encephalopathy, independent of changes of ammonia or cytokines, without improving blood pressure or renal function. These results should temper the liberal use of MARS until further data is available. (Liver Transpl 2004;10:1109–1119.)
Amniotic membrane and its epithelial and mesenchymal stem cells as an appropriate source for skin tissue engineering and regenerative medicine

Abstract One of the main goals of tissue engineering and regenerative medicine is to develop skin substitutes for treating deep dermal and full thickness wounds. In this regard, both scaffold and cell source have a fundamental role to achieve exactly the same histological and physiological analog of skin. Amnion epithelial and mesenchymal cells possess the characteristics of pluripotent stem cells which have the capability to differentiate into all three germ layers and can be obtained without any ethical concern. Amniotic cells also produce different growth factors, angio-modulatory cytokines, anti-bacterial peptides and a wide range of anti-inflammatory agents which eventually cause acceleration in wound healing. In addition, amniotic membrane matrix exhibits characteristics of an ideal scaffold and skin substitute through various types of extracellular proteins such as collagens, laminins and fibronectins which serve as an anchor for cell attachment and proliferation, a bed for cell delivery and a reservoir of drugs and growth factors involved in wound healing process. Recently, isolation of amniotic cells exosomes, surface modification and cross-linking approaches, construction of amnion based nanocomposites and impregnation of amnion with nanoparticles, construction of amnion hydrogel and micronizing process promoted its properties for tissue engineering. In this manuscript, the recent progress was reviewed which approve that amnion-derived cells and matrix have potential to be involved in skin substitutes; an enriched cell containing scaffold which has a great capability to be translated into the clinic.
Update of the mortality study of workers exposed to polychlorinated biphenyls (Pcbs) in two Italian capacitor manufacturing plants.

BACKGROUND PCB carcinogenicity to humans is still controversial. Cohort mortality studies in PCB-exposed workers reported elevated risks for the following causes of death: liver, stomach, digestive, brain, prostate cancers and non-Hodgkin lymphoma. OBJECTIVES The purpose of this study was to update as of December 2006 the mortality experience of two Italian cohorts of workers employed in the manufacture of capacitors impregnated with PCBs. METHODS Age-gender-and calendar period adjusted Standardized Mortality Ratios (SMRs) and 95% Confidence Intervals (CI) were calculated using regional rates. Analyses by duration of employment and time since first employment were performed Results: Vital status was ascertained for 98.9% of the study subjects. Mortality from biliary tract cancer among males (SMR 3.91; 95%CI 1.47-10.41), digestive cancer "not otherwise specified" in the whole cohort (SMR 2.54; 95%CI 1.21-5.34), and brain cancer in Plant I (SMR 2.13; 95%CI 1.02-4.48), were significantly increased. Increased risks were also observed for Hodgkin's and non-Hodgkin lymphoma. No linear associations between mortality and duration of employment or latency were observed for these cancers. Mortality from stomach cancer did not differ from expectation in the whole cohort, however an increasing risk with increasing duration of employment was detected (p for trend=0.02). CONCLUSIONS The current update suggests possibly increased cancer risks in PCB-exposed workers, affecting in particular the digestive system, brain, and lymphohemopoietic tissue. However the limited sample size, the lack of clear trends with duration of employment or with latency period, preclude to derive definite conclusions about PCB exposure and the increased cancer risks.
Tumor load in patients with multiple myeloma: β2-microglobulin levels versus whole-body MRI.

OBJECTIVE Beta-2-microglobulin is a serum maker of tumor burden in hematologic malignancies. We aimed to correlate serum β2-microglobulin levels in patients with multiple myeloma (MM) to tumor mass determined by whole-body MRI. MATERIALS AND METHODS We retrospectively included patients with newly diagnosed, untreated MM who underwent whole-body MRI at our institution between 2003 and 2011. Patients with a glomerular filtration rate of less than 60 mL/min were excluded from analysis because β2-microglobulin levels are increased in renal failure. Thirty patients could be included. Whole-body MRI examinations (T1-weighted turbo spin-echo and STIR sequences) were assessed by two musculoskeletal radiologists in consensus for focal lesions and the presence of diffuse myeloma infiltration. The presence of diffuse infiltration was confirmed by histology as the reference standard. MM was staged according to the Durie and Salmon PLUS staging system. RESULTS According to whole-body MRI findings, MM was classified as Durie and Salmon PLUS stage I (low grade) in 13 patients, stage II (intermediate grade) in six patients, and stage III (high grade) in 11 patients. As we expected, most patients with stage I disease (12/13) had normal β2-microglobulin levels (≤ 3 mg/L). Higher β2-microglobulin values were associated with a higher stage of disease (p < 0.05). However, five of six patients with stage II MM and five of 11 patients with stage III MM showed normal β2-microglobulin levels. Thus, 10 of 17 patients (58.8%) with substantial infiltration in the bone marrow showed false-negative β2-microglobulin levels. CONCLUSION Serum β2-microglobulin levels correlate with tumor stage in MM. However, it may be misleading as a marker of tumor load in a subset of patients with substantial myeloma infiltration in the bone marrow. Whole-body MRI may display the full tumor load and correctly show the extension of myeloma infiltrates.
An in vitro evaluation of fit of zirconium-oxide-based ceramic four-unit fixed partial dentures, generated with three different CAD/CAM systems, before and after porcelain firing cycles and after glaze cycles.

PURPOSE The purpose of this study was to assess in vitro the marginal fit of four-unit fixed partial dentures (FPDs) produced using three different computer aided design/computer aided manufacturing (CAD/CAM) all-ceramic systems before and after porcelain firing cycles and after glaze cycles. MATERIALS AND METHODS An acrylic resin model of a maxillary arch was fabricated. Teeth #6 and 9 were prepared; teeth #7 and 8 were absent. Forty-five four-unit zirconium-oxide-based ceramic FPDs were made following conventional impression and master cast techniques: 15 were made with the Everest system, 15 with the Procera system, and 15 with the Lava system. Marginal gaps along vertical planes were measured for each bridge before (Time 0) and after (Time 1) porcelain firing cycles and after glaze cycles (Time 2) using a total of 8 landmarks (4 for tooth #6 and 4 for tooth #9) by means of a microscope at a magnification of x50. MANOVA was performed to determine whether the 8 landmarks, jointly considered, differed between CAD/CAM systems and time phases. Two-way ANOVA was performed to investigate in detail, for each landmark, how gap measurements were related to CAD/CAM systems and time phases. Differences were considered to be significant at p < 0.05. RESULTS The mean values of the Everest system (microm) were: 63.37 (Time 0), 65.34 (Time 1), and 65.49 (Time 2); the mean values of the Lava system (microm) were: 46.30 (Time 0), 46.79 (Time 1), and 47.28 (Time 2); the mean values of the Procera system (microm) were: 61.08 (Time 0), 62.46 (Time 1), and 63.46 (Time 2). MANOVA revealed quantitative differences of the 8 landmarks, jointly considered, between the three CAD/CAM systems (p < 0.0001), but it did not reveal any quantitative differences among the three time phases (p > 0.4). Two-way ANOVA revealed that the Lava system produced gap measurements statistically smaller than the Everest and Procera systems (p < 0.0001 for each landmark). CONCLUSIONS Within the limitations of this study, it was concluded that the three zirconium-oxide-based ceramic CAD/CAM systems demonstrated a comparable and acceptable marginal fit; however, the Lava system produced gap measurements statistically smaller than the Everest and Procera systems. The porcelain firing cycles and the glaze cycles did not affect the marginal fit of the zirconium-oxide-based ceramic CAD/CAM systems.
For Good Measure: Advancing Research on Well-Being Metrics Beyond GDP

The 2009 Commission on the Measurement of Economic Performance and Social Progress (“Stiglitz-Sen-Fitoussi” Commission) concluded that we should move away from over-reliance on GDP when assessing a country’s health, towards a broader dashboard of indicators that would reflect concerns such as the distribution of well-being and sustainability in all of its dimensions. This book includes contributions from members of the OECD-hosted High Level Expert Group on the Measurement of Economic Performance and Social Progress, the successor of the Stiglitz-Sen-Fitoussi Commission, and their co-authors on the latest research in this field. These contributions look at key issues raised by the 2009 Commission that deserved more attention, such as how to better include the environment and sustainability in our measurement system, and how to improve the measurement of different types of inequalities, of economic insecurity, of subjective well-being and of trust. A companion volume Beyond GDP: Measuring What Counts for Economic and Social Performance presents an overview by the co-chairs of the High Level Expert Group, Joseph E. Stiglitz, Jean-Paul Fitoussi and Martine Durand of the progress accomplished since the 2009 report, of the work conducted by the Group over the past five years, and of what still needs to be done.
Overexpression of LDOC1 in Human Biliary Epithelial Cells Inhibits Apoptosis Through NF-&kgr;B Signaling

Objectives: Biliary atresia (BA) is a devastating pediatric cholestatic liver disease. Increasing evidence indicates that nuclear factor (NF)-&kgr;B signaling plays a key role in the pathogenesis of BA. Leucine zipper downregulated in cancer 1 (LDOC1) may control the expression of NF-&kgr;B. The aim of this study was to evaluate the relation between LDOC1 and inflammation/apoptosis mediated by NF-&kgr;B in the human intrahepatic biliary epithelial cells (HIBECs). Methods: HIBECs were divided into 3 treatment groups: control, mock transfection group, and LDOC1 transfection. Immunofluorescence, reverse transcription polymerase chain reaction, Western blot, and flow cytometry analysis were used to investigate the effectiveness of LDOC1-transfected HIBECs and the expression of NF-&kgr;B. Apoptosis was detected by Hochest/ propidium iodide staining. Interleukin (IL)-2 and tumor necrosis factor (TNF)-&agr; levels were evaluated by enzyme-linked immunosorbent assay. Results: The expression of NF-&kgr;B was higher in the LDOC1-transfected group when compared with the control and mock-transfected groups as evaluated by immunofluorescence, reverese transcription polymerase chain reaction, and Western blot analysis. The rate of apoptosis was significantly lower in the LDOC1-transfected group when compared with the control and mock-transfected groups. The levels of IL-2 and TNF-&agr; were significantly higher in the LDOC1-transfected group when compared with the control and mock-transfected groups. Conclusions: Upregulation of LDOC1 in HIBEC increases the expression of NF-&kgr;B, which may promote the activation of IL-2 and TNF-&agr; secretion and inhibit cell apoptosis.
Clinical usefulness of fusion of 131I SPECT and CT images in patients with differentiated thyroid carcinoma.

UNLABELLED Precise localization of the foci of (131)I uptake for management of patients with differentiated thyroid carcinoma can be difficult because of a lack of anatomic landmarks. The objective of the present study was to demonstrate the clinical usefulness of (131)I SPECT/CT fusion images in patients with differentiated thyroid carcinoma. METHODS CT and SPECT were performed 7 d after administration of a therapeutic dose of (131)I to 17 patients with differentiated thyroid carcinoma. External markers were placed at 3 locations on the skin of the patient to adjust the sections of CT and SPECT in the same geometric plane. Fusion images were constructed by combining the digital CT and SPECT images on a computer workstation. The data from both planar and SPECT (131)I images and CT images were first separately assessed by 2 nuclear medicine physicians. (131)I SPECT/CT fusion images were then interpreted. Fusion images were considered to improve image interpretation in comparison with CT and scintigraphy separately when they provided better localization of sites of increased radiopharmaceutical uptake. RESULTS Both CT and (131)I SPECT showed the pathologic sites in 5 of 17 patients (29%). Fusion images were considered to be of benefit in 15 of 17 patients (88%). In 4 patients, CT showed normal-sized lymph nodes, whereas (131)I SPECT showed abnormal findings. In 3 patients with bone metastasis, fusion images confirmed the precision of the localization of abnormal (131)I uptake. Five bone metastases and 1 muscle metastasis were occult and were not seen on the CT images. Finally, (131)I scintigraphy findings were abnormal for 2 patients for whom the CT findings were initially considered normal. Fusion images confirmed the precision of the localization of physiologic (131)I uptake. CONCLUSION For registration of anatomic and functional images in fusion imaging, the method using external markers was simple and practical. (131)I SPECT/CT fusion images using this technique may improve anatomically limited interpretation of (131)I scintigraphy alone in patients with differentiated thyroid carcinoma.