Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of tailored dietary guidance for pregnant women on nutritional status: A double-cohort study.

This double cohort study aimed to evaluate the effect of tailored dietary guidance for pregnant women on dietary intake, nutritional status, and infant birth weight. Healthy pregnant women were recruited at an antenatal clinic during two phases over 2 years. The historical controls were analyzed a year prior to the intervention group. In both groups, data were collected at 19-26 gestational weeks (baseline) and at 34-37 gestational weeks (outcome measurement). The intervention included the following: (a) assessments of maternal dietary nutritional intake using the brief self-administered diet history questionnaire, (b) individual feedback based on the assessments of maternal nutritional status, (c) tailored guidance for a healthy diet, (d) original cooking recipes, and (e) goal sharing. Mann-Whitney U test was used to compare the outcome data between the groups. Of the 378 eligible women, 309 women had follow-up questionnaire data. Blood samples were obtained from 202 women. Despite a lack of improvement in reported dietary intake, plasma eicosapentaenoic acid (p = .002), docosahexaenoic acid (p < .001), arachidonic acid (p < .001), and dihomo-gamma-linolenic acid (p < .001) concentrations as well as maternal weight gain (p = .019) were significantly higher in the intervention group. However, serum folate (p = .031) concentration was significantly lower in the intervention group, and there were no significant differences between the groups in 25-hydroxy vitamin D levels, blood count, average birth weight, and rate of low birth weight infants. Assessment-based tailored guidance individualized to maternal dietary intake might partially contribute to improved nutrition in pregnant women.
Two Distinct Populations of Exosomes Are Released from LIM1863 Colon Carcinoma Cell-derived Organoids*

Exosomes are naturally occurring biological nanomembranous vesicles (∼40 to 100 nm) of endocytic origin that are released from diverse cell types into the extracellular space. They have pleiotropic functions such as antigen presentation and intercellular transfer of protein cargo, mRNA, microRNA, lipids, and oncogenic potential. Here we describe the isolation, via sequential immunocapture using anti-A33- and anti-EpCAM-coupled magnetic beads, of two distinct populations of exosomes released from organoids derived from human colon carcinoma cell line LIM1863. The exosome populations (A33-Exos and EpCAM-Exos) could not be distinguished via electron microscopy and contained stereotypical exosome markers such as TSG101, Alix, and HSP70. The salient finding of this study, revealed via gel-based LC-MS/MS, was the exclusive identification in EpCAM-Exos of the classical apical trafficking molecules CD63 (LAMP3), mucin 13 and the apical intestinal enzyme sucrase isomaltase and increased expression of dipeptidyl peptidase IV and the apically restricted pentaspan membrane glycoprotein prominin 1. In contrast, the A33-Exos preparation was enriched with basolateral trafficking molecules such as early endosome antigen 1, the Golgi membrane protein ADP-ribosylation factor, and clathrin. Our observations are consistent with EpCAM- and A33-Exos being released from the apical and basolateral surfaces, respectively, and the EpCAM-Exos proteome profile with widely published stereotypical exosomes. A proteome analysis of LIM1863-derived shed microvesicles (sMVs) was also performed in order to clearly distinguish A33- and EpCAM-Exos from sMVs. Intriguingly, several members of the MHC class I family of antigen presentation molecules were exclusively observed in A33-Exos, whereas neither MHC class I nor MHC class II molecules were observed via MS in EpCAM-Exos. Additionally, we report for the first time in any extracellular vesicle study the colocalization of EpCAM, claudin-7, and CD44 in EpCAM-Exos. Given that these molecules are known to complex together to promote tumor progression, further characterization of exosome subpopulations will enable a deeper understanding of their possible role in regulation of the tumor microenvironment.
Use of mobile telephone short message service as a reminder: the effect on patient attendance.

BACKGROUND Nonattendance for hospital outpatient appointments is a major burden on healthcare systems and the estimated financial loss can be high. Various reasons for patients not attending have been reported, including the patient/carer forgetting the appointment and confusion over the date and time of the appointment. Various reminder systems have been trialled across a variety of clinical settings. More recently, short message service (SMS) text messaging has emerged as a viable approach for delivering reminders to outpatients at a relatively low cost. AIMS AND OBJECTIVES To evaluate the effect of appointment reminders, sent as SMS text messages to patients' mobile telephones, on attendance at outpatient clinics at the ITS Centre for Dental Studies and Research (ITS-CDSR), Muradnagar, Ghaziabad, Uttar Pradesh, India. MATERIALS AND METHODS The study was conducted at ITS-CDSR in the Departments of Prosthodontics, Endodontics, Orthodontics and Paedodontics. Patients attending these departments for a period of 4 months and those who had provided a contact mobile number were sent an SMS reminder. RESULTS In this study, 206 subjects (male, 124; female, 82) participated, 96 (male, 57; female, 39) of whom were in the test group and 110 (male, 67; female, 43) of whom were in the control group. The rate of attendance on time was found to be significantly higher in the test group (79.2%) than in the control group (35.5%). CONCLUSION The study results indicate that sending appointment reminders as text messages to patients is an effective strategy to reduce nonattendance rates.
Wing patterning genes and coevolution of Müllerian mimicry in Heliconius butterflies: Support from phylogeography, cophylogeny, and divergence times

Examples of long‐term coevolution are rare among free‐living organisms. Müllerian mimicry in Heliconius butterflies had been suggested as a key example of coevolution by early genetic studies. However, research over the last two decades has been dominated by the idea that the best‐studied comimics, H. erato and H. melpomene, did not coevolve at all. Recently sequenced genes associated with wing color pattern phenotype offer a new opportunity to resolve this controversy. Here, we test the hypothesis of coevolution between H. erato and H. melpomene using Bayesian multilocus analysis of five color pattern genes and five neutral genetic markers. We first explore the extent of phylogenetic agreement versus conflict between the different genes. Coevolution is then tested against three aspects of the mimicry diversifications: phylogenetic branching patterns, divergence times, and, for the first time, phylogeographic histories. We show that all three lines of evidence are compatible with strict coevolution of the diverse mimicry wing patterns, contrary to some recent suggestions. Instead, these findings tally with a coevolutionary diversification driven primarily by the ecological force of Müllerian mimicry.
‘Fine‐tuning’ blood flow to the exercising muscle with advancing age: an update

What is the topic of this review? This review focuses on age‐related changes in the regulatory pathways that exist at the unique interface between the vascular smooth muscle and the endothelium of the skeletal muscle vasculature, and how these changes contribute to impairments in exercising skeletal muscle blood flow in the elderly. What advances does it highlight? Several recent in vivo human studies from our group and others are highlighted that have examined age‐related changes in nitric oxide, endothelin‐1, alpha adrenergic, and renin‐angiotensin‐aldosterone (RAAS) signaling.
Pharmacokinetics of von Willebrand factor and factor VIIIC in patients with severe von Willebrand disease (type 3 VWD): estimation of the rate of factor VIIIC synthesis

Nine patients (10 infusions) with a confirmed diagnosis of type 3 VWD were infused with von Willebrand factor (human), a preparation of von Willebrand factor (VWF) with a very low factor VIII content. Each patient was infused with one dose of approximately 50 or 100 iu ristocetin cofactor activity (VWF:RiCoF) per kg body weight. Bleeding times were performed during the 24 h period after infusion. Plasma samples were obtained over the 96 h period after infusion and were analysed for factor VIII coagulant activity (FVIIIC), VWF:RiCoF, von Willebrand factor antigen (VWF:Ag), and multimers. The FVIIIC data were analysed by non‐linear least‐squares analysis assuming constant FVIIIC ‘synthesis’ and exponential decay. The VWF data were fitted for exponential decay. The average decay rates for FVIIIC, VWF:RiCoF and VWF:Ag were 0.041, 0.061 and 0.056 respectively. The average calculated ‘synthesis’ rate for FVIIIC was 6.4 u/dl/h. The synthesis of FVIIIC was slightly faster and the decay slightly slower following the infusion of 100 iu VWF:RiCoF/kg than of 50 iu VWF:RiCoF/kg. Correction of the bleeding time was strongly dose dependent. At 4 h post infusion the median bleeding time was 9 min following a dose of 50 iu VWF:RiCoF/kg versus 3 min with a dose of 100 iu VWF:RiCoF/kg. There was no decrease in the bleeding time until the level of VWF:Ag or VWF:RiCoF reached >100 u/dl.
EVALUATION OF SEGMENTATION PROCEDURES USING SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN EXUDATIVE AGE-RELATED MACULAR DEGENERATION

Purpose: The purpose of this study was to evaluate standardized automated segmentation procedures of spectral domain optical coherence tomography (SD-OCT) in imaging of age-related macular degeneration. Methods: Twenty-nine eyes of 29 patients with neovascular age-related macular degeneration were included. Three groups were assigned, according to the predominant localization of extravasated fluid in the intra-, subretinal, and subretinal pigment epithelium (RPE) compartment. Automated segmentation procedures were evaluated in B scans of 512 × 128 × 1024 and 200 × 200 × 1024 scan patterns using SD-OCT (Cirrus). Alignment errors at the internal limiting membrane, actual RPE, and extrapolation of the physiologic RPE (RPE fit) were graded using a standardized classification system. Results: The rate of severe alignment failures was 56% and 41% for the 512 × 128 and the 200 × 200 raster pattern, respectively. Internal limiting membrane and actual RPE boundaries were most correctly delineated in the 200 × 200 raster pattern. Retinal pigment epithelium fit alignment was generally poor in 50% of scans. Retinal thickness values defined by internal limiting membrane and actual RPE segmentation were 90% accurate and not compromised by RPE fit misalignment. Subretinal fluid was demarcated most reliably. Alignment errors may occur together with a large spectrum of morphologic alterations. Conclusion: Automated algorithms of SD-OCT demonstrate a substantial rate of alignment failures in the assessment of exudative age-related macular degeneration pathologies, which are usually associated with misinterpretation of boundaries at the (sub) RPE level.
The Duck Hepatitis B Virus Reverse Transcriptase Functions as a Full-length Monomer*

Hepadnaviral reverse transcription occurs within cytoplasmic capsid particles and is catalyzed by a virally encoded reverse transcriptase, but the primary structure and multimeric state of the polymerase during reverse transcription are poorly understood. We measured these parameters for the duck hepatitis B virus polymerase employing active enzyme translated in vitro and derived from intracellular core particles and mature virions. In vitro-translated polymerase immunoprecipitated as a monomer, and polymerase molecules with complementary defects in the enzymatic active site and tyrosine 96, which primes DNA synthesis, could not complement or inhibit each other in priming assays. Western analysis using antibodies recognizing epitopes throughout the polymerase combined with nuclease digestion of permeabilized virion-derived capsid particles revealed that only full-length polymerase molecules were in virions and that they were all covalently attached to large DNA molecules. Because DNA synthesis is primed by the polymerase itself and only one copy of the viral DNA is in each capsid, the polymerase must function as an uncleaved monomer. Therefore, a single polymerase monomer is encapsidated, primes DNA synthesis, synthesizes both DNA strands, and participates in the three-strand transfers of DNA synthesis, with all steps after DNA priming performed while the polymerase is covalently coupled to the product DNA. Because the N-terminal domain of the polymerase is displaced from the active site on the same molecule by the viral DNA during reverse transcription, P must be structurally dynamic during DNA synthesis. Therefore, non-nucleoside compounds that interfere with this change may be novel antiviral agents.
Topical Anesthesia for Minor Gynecological Procedures: A Review

This article reviews the published literature for topical anesthetics that have been used for pain relief during minor gynecological procedures. EMLA (an eutectic mixture of the local anesthetics, lidocaine 2.5% and prilocaine 2.5%), which is the best-studied topical anesthetic, produces effective analgesia for superficial surgical procedures after application for 5 to 10 minutes and has been extensively studied in various procedures including removal of genital warts, vulval biopsy, laser treatment of CIN lesions, and hysteroscopy. EMLA is well tolerated and provides good pain relief for procedures involving the surface tissues such as removal of genital warts and hysteroscopy. For procedures involving deeper tissues, EMLA reduces the pain of local anesthetic injection. Other topical anesthetics, such as lidocaine gel and spray, benzocaine 20% gel, mepivacaine solution, tetracaine solution, and cocaine spray, have been less extensively studied in these indications, and benefits seem to be limited. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader will be able to list the various topical anesthetics studied for use in minor gynecologic procedures and to identify the efficacy of each solution in providing analgesia for minor gynecologic procedures.
Interaction of Antiepileptic Drugs with Human P-Glycoprotein in Vitro

About one-third of epilepsy patients are resistant to treatment with antiepileptic drugs (AEDs). This refractoriness is not fully understood, but is thought to be attributed to overexpression of multidrug transporters at the blood-brain barrier, particularly P-glycoprotein (Pgp). In certain cases pharmacoresistance can be overcome by add-on therapy, raising the question of whether the coadministered drugs act as inhibitors of Pgp. Indeed, several AEDs are substrates and to some extent also inducers of Pgp. To date nothing is known about possible Pgp inhibitory activities of AEDs. Therefore, we investigated whether AEDs commonly used in mono or add-on therapy inhibit Pgp using a calcein acetoxymethylester uptake assay with L-MDR1 cells and primary porcine brain capillary endothelial cells, as well as confocal laser-scanning microscopy with L-MDR1 cells and bodipy-verapamil as Pgp substrate. In the calcein assay only carbamazepine inhibited Pgp, which was confirmed in confocal laser-scanning microscopy. In this assay, also phenytoin, lamotrigine, and valproate revealed Pgp inhibitory potency. Because Pgp inhibition by AEDs appeared at significantly higher concentrations than that of well known inhibitors and because the effective concentrations exceeded therapeutic AED plasma concentrations, Pgp inhibition appears not to be of clinical relevance, at least in antiepileptic monotherapy. However, it is possible that this inhibition may contribute to the effectiveness of certain add-on therapies.
Higher-order electromechanical response of thin films by contact resonance piezoresponse force microscopy

Piezoresponse scanning force microscopy (PFM) has turned into an established technique for imaging ferroelectric domains in ferroelectric thin films. At least for soft cantilevers, the piezoresponse signal is not only dependent on the elastic properties of the material under investigation but also on the elastic properties of the cantilever. Due to this dependency, the cantilever response and, therefore, the measured properties depend on the frequency of the small alternating current (AC) testing voltage. At the contact resonance, the cantilever response is maximum, and this increased sensitivity can be used to detect very small signals or to decrease the voltage applied to the sample. We have shown that by using the hysteretic ferroelectric switching, it is possible to separate the signal into its components (viz. electromechanical and electrostatic contributions). Additionally, the measurement frequency can be tuned such that the second and third harmonics of the electromechanical response can be detected at the cantilever resonance, providing information about the higher-order electromechanical coefficients. We assume that this nonlinear behavior seen in local and macroscopic measurements is rooted in the nonlinearity of the dielectric permittivity. Our results are of crucial importance for the study of ferroelectric and electromechanical properties of nanostructures
Treatment retention among children entering a new episode of mental health care.

OBJECTIVE This study examined use of mental health services among children and adolescents with private insurance who were entering treatment. Variations in service use were examined by age, gender, diagnosis, recent psychiatric hospitalization, and type of insurance. Differences between children who received treatment from mental health professionals and those who were treated by primary care physicians were also examined. METHODS Drawn from a large database, the sample comprised 11,659 new users of mental health services. Service use was defined as the total number of days children were retained in treatment and the total number of mental health contacts recorded. RESULTS The overall mean number of visits within a six-month period was 3.9. The average duration of treatment was 75.36 days. Children who were treated by a mental health specialist were less likely to drop out of treatment and had a larger number of visits. Severity of illness, psychiatric hospitalization, and managed care insurance coverage were also associated with lower risk of dropout and greater intensity of care. CONCLUSIONS Children's access to services does not guarantee sustained involvement in treatment. To more fully address the nature of service use among children, a closer look at specific barriers to continued involvement in services is needed.
Air-Liquid Interface Biofilms of Bacillus cereus: Formation, Sporulation, and Dispersion

ABSTRACT Biofilm formation by Bacillus cereus was assessed using 56 strains of B. cereus, including the two sequenced strains, ATCC 14579 and ATCC 10987. Biofilm production in microtiter plates was found to be strongly dependent on incubation time, temperature, and medium, as well as the strain used, with some strains showing biofilm formation within 24 h and subsequent dispersion within the next 24 h. A selection of strains was used for quantitative analysis of biofilm formation on stainless steel coupons. Thick biofilms of B. cereus developed at the air-liquid interface, while the amount of biofilm formed was much lower in submerged systems. This suggests that B. cereus biofilms may develop particularly in industrial storage and piping systems that are partly filled during operation or where residual liquid has remained after a production cycle. Moreover, depending on the strain and culture conditions, spores constituted up to 90% of the total biofilm counts. This indicates that B. cereus biofilms can act as a nidus for spore formation and subsequently can release their spores into food production environments.
Clinicopathological significance of ‘subtypes with stem‐cell feature’ in combined hepatocellular‐cholangiocarcinoma

Combined hepatocellular‐cholangiocarcinoma (cHC‐CC), a malignant liver tumour with poor prognosis, is composed of hepatocellular carcinoma (HCC), cholangiocarcinoma (CC) and diverse components with intermediate features between HCC and CC, which correspond to hepatic progenitor cells. According to the WHO classification 2010, we surveyed the prevalence and clinicopathological significance of each subtype with stem‐cell features [SC subtype; typical subtype (TS), intermediate cell subtype (INT) and cholangiolocellular type (CLC)] in cHC‐CC and HCC.
Prevalence and outcomes of caregiving after prolonged (> or =48 hours) mechanical ventilation in the ICU.

OBJECTIVES (1) To estimate caregiver support required by patients 2 months after prolonged (at least 48 h) mechanical ventilation (MV) in an ICU; (2) to describe caregiver burden, caregiver depressive symptomatology, and caregiver limitations in activities; and (3) to investigate factors related to depressive symptoms at 2 months in caregivers. DESIGN Prospective cohort study. STUDY PARTICIPANTS Caregivers of 115 patients who received prolonged MV in an ICU. MEASUREMENTS Sociodemographics, employment status, hours spent providing care, help from paid caregiving sources, caregiver burden, and caregiver depressive symptoms. RESULTS The proportion of patients who survived at least 2 months and required caregiver support was 74.8%. The average age of caregivers was 52.9 years (SD, 14.2), 76.5% were women, and more than half were spouses (52.2%). Only 33 of the caregivers (28.7%) were working, and 30.3% had to reduce their time spent at work to provide care to the patient. The prevalence of risk of clinical depression (defined as Center for Epidemiological Studies depression scale [CES-D] score > or =16) among caregivers was 33.9%. The mean caregiver CES-D score was 13.2 (SD, 11; median, 10). Multiple linear regression analysis showed that higher CES-D score was associated with more hours per day helping with patients' activities of daily living and instrumental activities of daily living (p = 0.003). CONCLUSIONS Two months after being placed on MV for at least 48 h, a high proportion of patients need caregiver support. Approximately 34% of caregivers are at risk of clinical depression. Many caregivers report lifestyle changes and burden when providing care for the patients.