Miracle-dz/UniFAR-FTUs huggingface dataset:
Nutritional level and energetic source are determinants of elevated circulatory lipohydroperoxide concentration

Dietary energetic impact on oxidative stress is incompletely understood. Therefore, effects of diets on oxidative stress were studied using a crossover block design. In Expt 1, intake of metabolizable energy (ME) was restricted or ad libitum. In Expt 2, isoenergetic and isonitrogenic diets were fed, replacing carbohydrate energy by energy of fatty acids. Circulatory lipohydroperoxides (LOOH), markers of acute oxidative stress, were expressed absolutely and in terms of cholesterol or TAG levels. In Expt 1, plasma (jugularis vein) LOOH was assayed in combination with whole-body oxidative metabolism using gas exchange and heart rate (HR) during feeding periods and at rest. In Expt 2, LOOH was assayed in plasma from portal and a large udder vein and a mesenteric artery. In Expt 1, intake increased VO2, HR and LOOH following overnight fast with higher values (P < 0·05) when feeding ME ad libitum. Intake of ME ad libitum (3 weeks) increased cardiac protein of cytochrome oxidase and endothelial-type nitric oxide synthase (P < 0·05), indicating adaptation of the heart to higher activity. Transient HR responses evoked by an antidiabetic drug (levcromakalim) revealed a linear positive correlation with relative LOOH (r2 0·79), supporting the relationship between oxidative metabolic rate and lipoperoxidation. Evidence for exogenous lipids as LOOH source provided the vessel-specific rise in LOOH through replacing carbohydrate ME by lipid ME (Expt 2). Thus, dietary energy level and energetic source are important for circulatory LOOH with a role of vascular activity in production of oxidant.
Living related liver transplantation for hepatitis B–related liver disease without hepatitis B immune globulin prophylaxis

Hepatitis B immune globulin (HBIG) is routinely used in liver transplantation for hepatitis B virus (HBV)–related liver disease. With potent oral antivirals, HBIG may not be required. We conducted a prospective trial to evaluate living related liver transplantation (LRLT) without HBIG. Eighty‐nine patients with HBV‐related liver disease underwent LRLT between January 2005 and January 2012. All donors were vaccinated with the HBV vaccine. All patients were given oral antivirals for HBV before transplantation. Patients with HBV DNA levels ≤ 2000 IU/mL were not given HBIG, and patients with HBV DNA levels > 2000 IU/mL were given HBIG. Recurrence was defined as HBV DNA positivity 6 months after transplantation. Seventy‐five of the 89 patients who underwent LRLT for HBV‐related liver disease were not given HBIG. Nineteen patients received a combination of lamivudine and adefovir, 42 received entecavir, 12 received tenofovir, and 2 received a combination of entecavir and tenofovir. At the last follow‐up (median = 21 months, range = 1‐83 months), all patients were HBV DNA–negative. Sixty‐six patients cleared hepatitis B surface antigen (HBsAg), and 19 patients formed antibody to hepatitis B surface antigen (anti‐HBs). The cumulative probabilities of clearing HBsAg were 90% and 92% at 1 and 2 years after transplantation, respectively. Nine patients were HBsAg‐positive with undetectable DNA at the last follow‐up. The recurrence rate in our series was 8% (6/75). Five of these 6 patients had stopped taking oral antivirals, and 1 had entecavir resistance. All recurrences were salvaged with changes in the oral antivirals. The actuarial probability of survival in this cohort was 73.7% at 83 months. There was no mortality due to HBV recurrence. In conclusion, HBV prophylaxis with oral antivirals and without HBIG is safe and effective in LRLT. A majority of the patients will clear HBsAg, and some will develop anti‐HBs antibodies. Liver Transpl 19:1030–1035, 2013. © 2013 AASLD.
Dietary single cell protein reduces fatty liver in obese Zucker rats

There is growing evidence that dietary proteins may interfere with lipid metabolism. We therefore examined the effects of feeding obese Zucker rats a single cell protein (SCP) with low ratios of methionine:glycine and lysine:arginine for 6 weeks. SCP feeding reduced the hepatic steatosis and lowered the plasma transaminase levels when compared with casein-fed rats (controls). The fatty acid oxidation was increased in liver mitochondria and peroxisomes, whereas the activities of enzymes involved in lipogenesis and TAG biosynthesis were unaffected. SCP feeding affected the fatty acid composition of liver lipids and plasma, and reduced the mRNA levels of the fatty acid desaturases. The decreased gene expression of stearoyl-CoA desaturase suggested that the fatty acids were directed towards oxidation rather than esterification as TAG. The decreased mRNA levels of VLDL-receptor and lipoprotein lipase in the liver after SCP feeding suggested that the uptake of TAG-rich lipoprotein to the liver was decreased. To conclude, the reduced fatty liver by SCP feeding may be caused by the increased capacity for fatty acid β-oxidation in the liver, combined with changed fatty acid composition and possibly a reduced hepatic clearance of circulating VLDL. An increased awareness of the effect of dietary proteins on lipid metabolism could be of relevance in future dietary treatment of non-alcoholic fatty liver disease.
Abdominal distention results from caudo-ventral redistribution of contents.

BACKGROUND & AIMS Abdominal bloating is a frequent symptom in various categories of patients; however, its origin is unclear. Our aim was to establish the mechanisms of abdominal bloating. METHODS The study evaluated 56 patients whose predominant symptom was abdominal bloating. Of these, 47 (44 female and 3 male; aged 19-74 years) were diagnosed with functional intestinal disorder by Rome II criteria and 9 (7 female and 2 male; aged 18-64 years) were diagnosed with intestinal dysmotility by gastrointestinal manometry. Computed tomographic scans were obtained before (basal level) and during a severe bloating episode. Control scans were also obtained from 12 healthy subjects (11 female and 1 male; aged 19-62 years). Morpho-volumetric differences between basal and severe bloating scans were measured using an original computer analysis program. RESULTS During severe bloating, patients with dysmotility exhibited anterior wall protrusion (23 +/- 4 mm; P < .001 vs basal) associated with a marked increase in total abdominal volume (1.4 +/- 0.3 L; P = .002 vs basal) and with cephalic displacement of the diaphragm. By contrast, in patients with functional intestinal disorder, total abdominal volume barely increased (0.3 +/- 0.1 L; P < .001 vs dysmotility); in these patients, abdominal distention (14 +/- 2 mm anterior wall protrusion; P < .001 vs basal) was related to diaphragmatic descent (-12 +/- 3 mm; R = -0.62; P < .001). CONCLUSIONS Abdominal distention might be caused by an increase in intra-abdominal volume or abdomino-phrenic displacement and ventro-caudal redistribution of contents.
Efficacy and safety of a combined oral contraceptive containing estradiol valerate/dienogest: results from a clinical study conducted in North America.

BACKGROUND This study investigated the efficacy and safety of a combined oral contraceptive (COC) containing estradiol valerate/dienogest (E2V/DNG). METHODS This was a multicenter, noncomparative, 13-cycle (extended to 28 cycles) study conducted in the United States and Canada. Contraceptive efficacy was calculated as a Pearl Index for 13 cycles, based on all on-treatment pregnancies; bleeding patterns were calculated based on bleeding and spotting information recorded daily in diary cards. Safety events during a 16-month extension study were added to the 1-year data. RESULTS In total, 499 women, aged 18-35 years, were enrolled, and 490 of them were included in the full analysis set for contraceptive efficacy. Five pregnancies occurred in the first year (unadjusted Pearl Index=1.64). In cycles 1-12, an average 23.5% of women had absent scheduled (withdrawal) bleeding. Among women with scheduled (withdrawal) bleeding, bleeding started after a median of 2 days after intake of the last DNG-containing pill. For safety, data included from 147 women followed over an additional 16 months were added to the original 13-cycle data set. Treatment-related adverse events (AEs) occurred in 51.8% of women; 14.9% discontinued because of AEs over the entire 28-month study period. CONCLUSION A COC with E2V and DNG was shown to provide effective contraception in women aged 18-35 years in North America.
Intraoperative hemodialysis during liver transplantation: A decade of experience

Liver transplantation (LT) for patients with renal dysfunction is frequently complicated by major fluid shifts, acidosis, and electrolyte and coagulation abnormalities. Continuous renal replacement therapy (CRRT) has been previously shown to ameliorate these problems. We describe the safety and clinical outcomes of intraoperative hemodialysis (IOHD) during LT for a group of patients with high Model for End‐Stage Liver Disease (MELD) scores. We performed a retrospective study at our institution of patients who underwent IOHD from 2002 to 2012. Seven hundred thirty‐seven patients underwent transplantation, and 32% received IOHD. The mean calculated MELD score was 37, with 38% having a MELD score ≥ 40. Preoperatively, 61% were in the intensive care unit, 19% were mechanically ventilated, 43% required vasopressor support, and 80% were on some form of renal replacement therapy at the time of transplantation, the majority being on CRRT. Patients on average received 35 U of blood products and 4.8 L of crystalloids without significant changes in hemodynamics or electrolytes. The average urine output was 450 ml, and the average amount of fluid removal with dialysis was 1.8 L. The 90‐day patient and dialysis‐free survival rates were 90% and 99%, respectively. One‐year patient survival rates based on the pretransplant renal replacement status and the MELD status were not statistically different. This is the first large study to demonstrate the safety and feasibility of IOHD in a cohort of critically ill patients with high MELD scores undergoing LT with good patient and renal outcomes. Liver Transpl 20:756‐764, 2014. © 2014 AASLD.
Diagnosis and management of biliary complications in pediatric living donor liver transplant recipients

The incidence of biliary complications (BCs) after living donor liver transplantation (LDLT) can reach 40%. Published data on the pediatric population are limited, and treatment protocols vary. Our aim was to describe the clinical scenario for BCs and treatment approaches after LDLT. Between October 1995 and December 2012, 489 pediatric LDLT procedures were performed. BCs developed in 71 patients (14.5%). Biliary strictures (BSs) developed in 45 (9.2%) patients, and bile leaks (BLs) developed in 33 patients (6.7%). The BL diagnosis was clinical in all cases, and 69.7% of the patients underwent surgery. Nearly half of the BS cases had clinical features or suggestive ultrasound findings. Liver biopsy findings suggested BSs in 51.7%. Percutaneous transhepatic cholangiography was performed in 95.6% of the BS patients. The success rate was 77% [mean number of percutaneous biliary interventions (PBIs) = 3.9 ± 1.98, median drainage time = 8 months]. In conclusion, BL patients can be managed with conservative therapy, even though most of these patients will ultimately be treated with surgery. Diagnosing a BS requires a high degree of clinical suspicion because the available resources for its identification can fail in up to 50% of cases. A higher number of PBIs and the use of a drainage catheter for a longer time may be required to achieve better results with this technique. Liver Transpl 20:882‐892, 2014. © 2014 AASLD.
Evidence for Neuroendoncrine Disturbance Following Physical Exercise in Primary Fibromyalgia Syndrome

Objective: To test pituitary-adrenal responses to hysical exercise in patients with primary fibromyalgia syndrome [PFS]. Methods: Eighteen female PFS patients [1981 Yunus criteria] and 18 matched, healthy but strictly sedentary controls performed a bicycle ergometer test with stepwise increasing workload. The first 10 couples did submaximal exercise; the next 8 couples continued until volitional exhaustion. during and after the test measurement of ACTH and cortisol was done at intervals. Results; During submaximal exercise the PFS patients, compared to the controls, displayed a [very early] significantly augmented ACTH release without a corresponding cortisol response. Within the group that performed exhaustive exercise, the 8 PFS patients achieved a lower [mean] maximum workload. At exhaustion and during early recovery ATCH and cortisol reached maximum values, which tended to be higher in PFS patients. Conclusions: PFS patients show altered pituitary-adrenal responses to physical exercise, which supports.
The Apc 1322T mouse develops severe polyposis associated with submaximal nuclear beta-catenin expression.

BACKGROUND & AIMS We previously demonstrated that the 2 APC mutations in human colorectal tumors are coselected, because tumorigenesis requires an optimal level of Wnt signaling. We and others subsequently showed that the truncated APC proteins in colorectal tumors usually retain a total of 1-2 beta-catenin binding/degradation repeats (20AARs); very few intestinal tumors have proteins with no 20AARs. The coselection of the "2 hits" at APC makes it difficult to undertake further mechanistic studies in this area in humans. In mice, however, second hits appear to vary with the strain or genetic background used. This suggested the possibility of creating suboptimal Apc genotypes in the mouse. METHODS We have constructed a mouse, Apc(1322T), with a mutant protein retaining one 20AAR. After repeated backcrossing to the C57BL/6J background, we compared the 1322T animals with the widely used Min mouse in which the mutant Apc protein has zero 20AARs. RESULTS In both mice, intestinal adenomas showed copy-neutral loss of heterozygosity, making them homozygous for the mutant Apc allele. 1322T animals had markedly more severe polyposis, with earlier-onset, larger, more numerous, and more severely dysplastic adenomas. 1322T tumors also had more marked Paneth cell differentiation and higher frequencies of crypt fission. Somewhat surprisingly, nuclear beta-catenin expression was lower in 1322T than Min tumors. CONCLUSIONS We propose that the Apc(1322T) mutation produces submaximal beta-catenin levels that promote early tumor growth more effectively than the Apc(Min) mutation.
Impact of broader sharing on the transport time for deceased donor livers

Recent allocation policy changes have increased the sharing of deceased donor livers across local boundaries, and sharing even broader than this has been proposed as a remedy for persistent geographic disparities in liver transplantation. It is possible that broader sharing may increase cold ischemia times (CITs) and thus harm recipients. We constructed a detailed model of transport modes (car, helicopter, and fixed‐wing aircraft) and transport times between all hospitals, and we investigated the relationship between the transport time and the CIT for deceased donor liver transplants. The median estimated transport time was 2.0 hours for regionally shared livers and 1.0 hour for locally allocated livers. The model‐predicted transport mode was flying for 90% of regionally shared livers but for only 22% of locally allocated livers. The median CIT was 7.0 hours for regionally shared livers and 6.0 hours for locally allocated livers. Variation in the transport time accounted for only 14.7% of the variation in the CIT, and the transport time on average composed only 21% of the CIT. In conclusion, nontransport factors play a substantially larger role in the CIT than the transport time. Broader sharing will have only a marginal impact on the CIT but will significantly increase the fraction of transplants that are transported by flying rather than driving. Liver Transpl 20:1237‐1243, 2014. © 2014 AASLD.
African American women's perceptions and attitudes regarding participation in medical research: the Mayo Clinic/The Links, Incorporated partnership.

OBJECTIVE To examine perceptions and attitudes toward health-related research participation among professional African American women. METHODS Participants were members of an African American women's service organization, The Links, Incorporated. Data were collected via self-administered questionnaires at The Links, Incorporated 2012 National Assembly. Sociodemographics, prior research experience, intention to participate (ITP), willingness to participate (WTP) in a variety of research studies and attitudes about research participation were measured. RESULTS A total of 381 surveys were analyzed. A majority of respondents were married (66%), employed (69%), and college educated (96%). Median age was 59; 38% reported prior research participation. Overall, 78% agreed with the statement, "Participation in research will mean better care," 24% agreed "Participation in research is risky" and 3% agreed "Scientists cannot be trusted. " Fifty-two percent agreed with the statement, "Research conducted in the U.S. is ethical. " Mean ITP in research was 4.9±1.7 on a rating scale of 1 ("definitely no") to 7 ("definitely yes"). WTP was highest for an interview study and providing a blood sample, and lowest for clinical trial and medical record review. CONCLUSION Attitudes toward research participation were generally favorable among professional African American women; many expressed WTP in a variety of research study types.
Prognostic role of plasma vascular endothelial growth factor in patients with hepatocellular carcinoma undergoing liver transplantation

Vascular endothelial growth factor (VEGF) is pivotal in the development of hepatocellular carcinoma (HCC). Studies have demonstrated the prognostic value of circulating VEGF levels in patients undergoing liver resection or locoregional therapy (LRT) for HCC. We investigated the significance of preoperative plasma VEGF levels in patients with HCC undergoing liver transplantation (LT) at a Western transplant center. Pre‐LT plasma VEGF levels were measured with an enzyme‐linked immunoassay for 164 patients with HCC undergoing LT. The preoperative plasma VEGF level was correlated with clinicopathological variables and overall and recurrence‐free post‐LT survival. A higher pre‐LT plasma VEGF level was significantly associated with pre‐LT LRT (P = 0.01), multiple tumors (P = 0.02), a total tumor diameter ≥ 5 cm (P = 0.01), bilobar tumor distribution (P = 0.03), tumor vascular invasion (VI; P < 0.001), and HCC beyond the Milan criteria (P < 0.001). Patients with a plasma VEGF level > 44 pg/mL had significantly worse overall and disease‐free survival than those with VEGF levels ≤ 44 pg/mL (P = 0.04 and P = 0.02, respectively). In a multivariate analysis, a plasma VEGF level > 44 pg/mL was independently associated with tumor VI (P < 0.001) and recurrence‐free survival (hazard ratio = 2.12, 95% confidence interval = 1.08‐4.14, P = 0.03). In conclusion, in patients with chronic end‐stage liver disease and HCC, a pre‐LT plasma VEGF level > 44 pg/mL may be a predictor of tumor VI and recurrence‐free post‐LT survival. Liver Transpl 21:101‐111, 2015. © 2014 AASLD.
Can Iberian red deer (Cervus elaphus hispanicus) discriminate among essential minerals in their diet?

Optimal foraging predicts that animals should be able to assess the content of important nutrients in food. Ungulates discriminate salt and P, but discrimination of other minerals is controversial even though they are also essential and often limiting. Animal scientists have explained this taste through palatability, which predicts the same pattern of discrimination for calves and hinds and greater consumption by the latter. Social learning may also be involved, predicting a correlation between mother and calf and less consumption by the latter. The present study examines the consumption behaviour of free-choice supplemented minerals by hinds and calves of Iberian red deer (Cervus elaphus hispanicus) to discern between these hypotheses. Behavioural indices of intake correlated with actual mineral consumption (P < 0·001). Mother and calf behavioural indices correlated only for salt-mixed minerals. Calves showed overall behavioural indices of consumption greater than hinds (P < 0·01 and P < 0·001), and also for all single supplements except NaCl, as expected from growth needs and in contrast to the palatability hypothesis. Calves showed a greater consumption of CuSO4 and lower of Na2SeO3 than pure salt. Hinds showed a different pattern, ingesting lower amounts of all minerals except CuSO4 and salt. Additional analyses also showed discrimination between minerals unmixed with salt, such as CaHPO4 and CaCO3 (P = 0·012 and P = 0·020). The greater intake of growing calves and the different consumption patterns for hinds and calves suggest that deer can discriminate among minerals, and that they do not consume minerals for their palatability or driven by social learning. Therefore, deer may be selecting minerals according to nutritional requirements.
Investigation of visual cortex in children with cortical visual impairment: positron emission tomography

We performed this study to determine whether positron emission tomography (PET) would play a useful role in the investigation of cortical visual impairment (CVI). Eight children with CVI and 12 normal volunteers were examined using F-18 fluorodeoxyglucose PET. PET images were spatially transformed on standard templates and normalized with global counts. By using statistical parametric mapping 96 software, PET images of the CVI patients were compared with those of the normal group to display pixels with significantly decreased metabolism (p<0.05). The number of pixels with decreased metabolism in Brodmann’s area (BA) 17 and BAs 18/19 were counted for analysis. All CVI children showed reduced glucose metabolism in BA 17 as well as BAs 18/19 when compared with the normal group. The extent of the areas with decreased glucose metabolism in the occipital lobe ranged widely: from 14% to 65%. These results show that PET may be helpful in the evaluation of children with CVI.
Calcium requirements for bone growth in Canadian boys and girls during adolescence

Adequate dietary intake during the growth period is critical for bone mineral accretion. In 1997, an adequate intake (AI) of 1300 mg/d Ca was set for North American adolescents aged 9–18 years based on best available data. We determined bone Ca accrual values from age 9 to 18 years taking into account sex and maturity. Furthermore, we used the accrual data to estimate adolescents' Ca requirements. Total body bone mineral content (TBBMC) of eighty-five boys and sixty-seven girls participating in the Saskatchewan Paediatric Bone Mineral Accrual Study were used to determine annual TBBMC accumulation over the pubertal growth period. Using a similar factorial approach as the AI, we estimated Ca requirements of adolescent boys and girls for two age groups: 9–13 and 14–18 years. Between 9 and 18 years, boys accrued 198·8 (sd 74·5) g bone mineral content (BMC) per year, equivalent to 175·4 (sd 65·7) mg Ca per d with the maximum BMC accrual of 335·9 g from age 13 to 14 years. Girls had 138·1 (sd 64·2) g BMC per year, equalling121·8 (sd 56·6) mg Ca per d with the maximum annual BMC accrual of 266·0 g from age 12 to 13 years. Differences were observed between both sex and age groups with respect to Ca needs: boys and girls aged 9–13 years would require 1000–1100 mg/d Ca, and from age 14 to 18 years, the mean Ca requirements would be relatively stable at 1000 mg/d for girls but would rise to 1200 mg/d for boys.