Miracle-dz/UniFAR-FTUs huggingface dataset:
Up-regulation of liver uncoupling protein-2 mRNA by either fish oil feeding or fibrate administration in mice.

Fish oil feeding showed less obesity in rodents, relative to other dietary oils. N-3 fatty acids rich in fish oil and fibrate compounds are peroxisome proliferator-activated receptor alpha (PPARalpha) ligands that stimulate beta-oxidation of fatty acids in liver and are used for treatment of hypertriglycemic patients. Since UCP-2, a member of an uncoupling protein family, has been shown to express in hepatocytes, the effects of these agents on the expression of UCP2 mRNA were investigated. C57BL/6J mice were divided into three groups; the first group was given a high-carbohydrate diet, and the other two groups were given a high-fat diet (60% of total energy) as safflower oil or fish oil for 5 months. Safflower oil diet fed mice developed obesity, but those fed fish oil diet did not. Therefore, the effects of fish oil feeding on the expression of UCP1, UCP2 and UCP3 in liver, skeletal muscle (gastrocnemius), white adipose tissue (WAT) and brown adipose tissue (BAT) were assessed by Northern blotting. Compared with safflower oil feeding, fish oil feeding up-regulated liver UCP2, BAT UCP2 and skeletal muscle UCP3 mRNA, while down-regulated WAT UCP2 and BAT UCP3 mRNA. Among these alterations, 5-fold up-regulation of liver UCP2 mRNA, relative to carbohydrate feeding, was noteworthy. Fenofibrate administration (about 500 mg/kg BW/d) for 2 wks also induced liver UCP2 expression by 9-fold. These data indicated that fish oil feeding and fibrate administration each up-regulated UCP2 mRNA expression in liver possibly via PPARalpha and hence each has the potential of increasing energy expenditure for prevention of obesity.
Chemical Accessibility of 18S rRNA in Native Ribosomal Complexes: Interaction Sites of mRNA, tRNA and Translation Factors

Abstract During protein synthesis the ribosome interacts with ligands such as mRNA, tRNA and translation factors. We have studied the effect of ribosomeligand interaction on the accessibility of 18S rRNA for single strandspecific modification in ribosomal complexes that have been assembled in vivo, i. e. native polysomes. A comparison of the modification patterns derived from programmed and nonprogrammed ribosomes showed that bases in the 630- and 1060- loops (530- and 790-loops in E. coli) together with two nucleotides in helices 33 and 34 were protected from chemical modification. The majority of the protected sites were homologous to sites previously suggested to be involved in mRNA and/or tRNA binding in prokaryotes and eukaryotes, implying that the interaction sites for these ligands are similar, if not identical, in naturally occurring programmed ribosomes and in in vitro assembled ribosomal complexes. Additional differences between programmed and nonprogrammed ribosomes were found in hairpin 8. The bases in helix 8 showed increased exposure to chemical modification in the programmed ribosomes. In addition, structural differences in helices 36 and 37 were observed between native 80S runoff ribosomes and 80S ribosomes assembled from isolated 40S and 60S subunits.
The Dental Practice Questionnaire: a patient feedback tool for improving the quality of dental practices.

BACKGROUND The recently introduced Practice Accreditation Scheme as part of the Australian National Safety and Quality Health Service (NSQHS) standards raises the question of how dental practices can implement valid and reliable patient experience feedback mechanisms for performance evaluation and enhancement. This article describes the development and use of a dental patient questionnaire (DPQ) that can be used for this purpose. METHODS DPQ was piloted on 58 voluntary dental practices across Australia and resulted in an average of just over 50 patient responses to 35 practices returned. Statistical properties of the DPQ were tested through validity (construct, content and criterion), structural integrity and reliability measurements. RESULTS DPQ is valid and reliable, with statistical analysis showing that there are significant differences in patients' scores depending on their age, gender, regularity of visit and number of years attending the practice. Two patient satisfaction models were derived. However, there may be scope for improving DPQ to more effectively produce patient feedback on summative aspects of services provided by dental practices. CONCLUSIONS DPQ has been shown to be 'fit for purpose' in its first pilot and may prove to be a useful tool for supporting dental practices in the Practice Accreditation Scheme.
Maternal detection of neonatal jaundice during birth hospitalization using a novel two-color icterometer

Background Mothers are frequently the first to observe the onset of jaundice in their newborn infants before the decision to seek treatment. However, simple-to-use tools that could facilitate early detection of jaundice and assist mothers to seek professional care, especially after hospital discharge, are rare. This study therefore, set out to evaluate the performance of a -two-color icterometer (Bilistrip™) as a possible screening tool for detecting significant jaundice by mothers or care-givers in the first week of life. Methods Prior to discharge, mothers in a maternity hospital were trained to use the Bilistrip™ on the blanched skin of their baby’s nose to ascertain absence (Light Yellow) or presence (Dark Yellow) of significant jaundice. Their babies had transcutaneous bilirubin (TcB) measurements independently, along with total serum bilirubin (TSB) if indicated. The reliability of Bilistrip™ as a screening test for significant jaundice was determined at different TcB and TSB thresholds. The predictive performance of Bilistrip™ was also evaluated with multivariable logistic regression. Results Some 2492 mother-infant pairs were enrolled over 15 months, of which 347 (13.9%) chose Dark Yellow. The mean TcB for Dark Yellow (10mg/dL) was significantly higher (p<0.001) than for Light Yellow (6.1mg/dL). Bilistrip™ showed increasing sensitivity (47.0% - 92.6%) and negative predictive value (NPV) (91.4% - 99.9%) for selected TcB thresholds (≥10mg/dL, ≥12mg/dL, ≥15mg/dL, and ≥17mg/dL). Among neonates with TSB measurements (n = 124), Bilistrip™ was associated also with increasing sensitivity (86.8% - 100%) and NPV (62.5% - 100%). The sensitivity and NPV for detecting neonates requiring phototherapy were 95.8% respectively. Only one of the 24 neonates who required phototherapy was missed by the Bilistrip™. Conclusions Bilistrip™ is a potential decision-making tool for empowering mothers to detect neonates with clinically significant jaundice that may require close monitoring or treatment, and neonates not requiring treatment for jaundice in the first week of life.
Gender concordance between family practice residents and their patients in an ambulatory‐care setting

To determine whether women residents are more likely than men residents to treat female patients, the author analyzed data concerning resident-patient encounters in an ambulatory care setting from 107 family practice residents completing a university training program from 1979 through 1988. While the mean numbers of encounters for the men and women residents were similar, 70.5% of the women residents' encounters were with female patients, compared with 63.1% of men residents' encounters with female patients (p less than .0001). The women residents saw 3.6 times more female than male patients aged 13 to 20 years and 3.9 times more women than men patients aged 21 to 40. The women residents had more encounters for contraception, vaginitis, prenatal care, and health maintenance for women patients and fewer encounters for prostatic/testicular problems and health maintenance for men patients.
Risk Factors for Development of Coronary Artery Disease in Women with Systemic Lupus Erythematosus

Objective. To ascertain coronary artery disease (CAD) outcomes and predictive factors in a prospective study of patients with systemic lupus erythematosus (SLE) and matched healthy controls. Methods. SLE patients and non-SLE age-matched controls without a history of CAD were recruited into a prospective study between 1997 and 1999. CAD events were assessed at clinic visit for SLE patients and through telephone interview and chart review for controls. All events were verified with patient medical records. Results. Followup information was available on 237 controls and 241 SLE patients. The mean followup time was 7.2 years. Univariate analyses identified age and postmenopausal status as predictors of CAD in both the groups. Sedentary lifestyle, hypertension, the presence of metabolic syndrome, and the number of Framingham risk factors were predictive in the control group only. The 10-year risk of CAD score was predictive in both groups but was not as marked in the SLE group as in the controls. None of the lipid subfractions were predictive for CAD in the SLE group, whereas in the controls, a high triglyceride level ≥ 2.8 was predictive. Time-to-event multivariate analysis for CAD in all subjects revealed SLE itself, older age, and triglycerides ≥ 2.8 to be highly predictive for CAD. Conclusion. In a prospective study of patients with SLE and matched controls followed over a median of 8 years, patients with SLE developed significantly more CAD events than controls. Accounting for demographic variability, CAD risk factors, and lipid factors, SLE is an independent risk factor for the development of CAD.
Four molecular subtypes of colorectal cancer and their precursor lesions.

CONTEXT In addition to chromosomal instability and microsatellite instability (MSI), a third pathway, epigenetic instability, has been implicated in progression to colorectal carcinogenesis. CpG island methylator phenotype (CIMP) refers to a subset of colorectal cancers (CRCs) that occur through the epigenetic instability pathway and that are characterized by widespread hypermethylation of promoter CpG island loci, resulting in the inactivation of several tumor suppressor genes or tumor-related genes. Colorectal cancers can be classified into 4 molecular subtypes according to their CIMP and MSI statuses: CIMP+/MSI+, CIMP+/MSI-, CIMP-/MSI+, and CIMP-/MSI-. There are differences between Western (United States and European Union) and Eastern (Korea and China) populations in the number of CRCs that are MSI+, and in the number of MSI+ CRCs that are CIMP+. OBJECTIVE To review the clinicopathologic and molecular features of the 4 molecular subtypes of CRCs and their precursor lesions, and to emphasize geographic differences in CRCs between Eastern and Western populations. DATA SOURCES This article is based on the author's own experimental data and a literature review of relevant articles indexed in PubMed (US National Library of Medicine). CONCLUSION The 4 molecular subtypes of CRC that are defined by their CIMP and MSI statuses are characterized by their own distinct clinicopathologic and molecular features and precursor lesions. In particular, the clinicopathologic features of MSI+ CRCs differ depending on the CIMP status. Further understanding of the heterogeneity in CRC molecular pathways may help to explain the diverse morphologic features of CRCs.
High rates of congenital cytomegalovirus infection linked with maternal HIV infection among neonatal admissions at a large referral center in sub-Saharan Africa.

BACKGROUND Congenital cytomegalovirus (CMV) infection is the major infectious cause of birth defects and hearing loss globally. There is a growing recognition of the potential clinical impact of congenital CMV infections in high-seroprevalence settings. METHODS A cross-sectional study of neonatal admissions at a large referral center in sub-Saharan Africa to determine the prevalence of both symptomatic and asymptomatic congenital CMV infection was performed. Real-time polymerase chain reaction was used to screen DNA-extracted sera, urine, and saliva, and an enzyme-linked immunosorbent assay was used to screen serum samples for anti-CMV immunoglobulin M. Multivariate binary logistic regression was used to identify risk factors associated with increased odds of congenital CMV infection. RESULTS Congenital CMV was detected in 3.8% (15/395) of neonates. Among these infants, 6 of 15 (40%) presented with jaundice, 1 of whom also had petechiae. Congenital CMV infection was detected in 9 of 79 (11.4%; 95% confidence interval [CI], 6.1%-20.3%) neonates born to human immunodeficiency virus (HIV)-infected mothers, and both maternal HIV (odds ratio [OR], 6.661 [95% CI, 2.126-20.876], P = .001) and jaundice (OR, 5.701 [95% CI, 1.776-18.306], P = .003) were independently linked with significantly increased odds of congenital CMV infection. CONCLUSIONS Congenital and early infant CMV infections may have important consequences for child health in sub-Saharan Africa and other high HIV and CMV seroprevalence populations globally.
Risk for Disordered Eating Relates to both Gender and Ethnicity for College Students

Objective: To estimate the frequency of disordered eating behaviors among college students and associations by gender, ethnicity, participation in social organizations and college athletics and to determine whether responses to eight health behavior and attitude questions and body weight predicted a high score on the Eating Attitudes Test (EAT)-26, a screening instrument used to identify risks of developing an eating disorder. Methods: Subjects were a convenience sample of 1,899 college students (cleaned to 1620) who attended four classes, were members of 14 sororities or lived in five residence halls. Students reported height and weight and responded to the EAT-26 and eight items regarding health behaviors and attitudes. Results: Among women and men, 4.5% and 1.4%, respectively, reported previous treatment for an eating disorder, and 10.9% of women and 4.0% of men were at risk for eating disorders (scores ≥ 20 on EAT). Among African-Americans, 8.3% of women were at risk. One group of women who lived separately in a social sorority had the highest risk of 15%. The frequency of “weight concerns interfering with academic performance” and “eliminating high fat foods” was moderately correlated to risk for disordered eating for both genders. Body mass only weakly related to risk for disordered eating and the association varied by subgroup. Conclusion: Students at risk for disordered eating report weight concerns interfering with their academic performance and include both men and African-Americans, as well as Caucasian American women. Sorority women living in separate residences might be at increased risk.
Error reporting in transfusion medicine at a tertiary care centre: a patient safety initiative

Abstract Background: Errors in the transfusion process can compromise patient safety. A study was undertaken at our center to identify the errors in the transfusion process and their causes in order to reduce their occurrence by corrective and preventive actions. Methods: All near miss, no harm events and adverse events reported in the ‘transfusion process’ during 1 year study period were recorded, classified and analyzed at a tertiary care teaching hospital in North India. Results: In total, 285 transfusion related events were reported during the study period. Of these, there were four adverse (1.5%), 10 no harm (3.5%) and 271 (95%) near miss events. Incorrect blood component transfusion rate was 1 in 6031 component units. ABO incompatible transfusion rate was one in 15,077 component units issued or one in 26,200 PRBC units issued and acute hemolytic transfusion reaction due to ABO incompatible transfusion was 1 in 60,309 component units issued. Fifty-three percent of the antecedent near miss events were bedside events. Patient sample handling errors were the single largest category of errors (n=94, 33%) followed by errors in labeling and blood component handling and storage in user areas. Conclusions: The actual and near miss event data obtained through this initiative provided us with clear evidence about latent defects and critical points in the transfusion process so that corrective and preventive actions could be taken to reduce errors and improve transfusion safety.
Family Decision Making for End-of-Life Treatment: The SUPPORT Nurse Narratives

Elizabeth F. Hiltunen, MS, RN, CS, is a Clinical Research Coordinator in the Department of Health and Social Behavior at Harvard School of Public Health, and is a Fellow in Medical Ethics at Harvard Medical School in Boston. Cynthia Medich, PhD, RN, is a Research Fellow at the University of Massachusetts-Lowell in Lowell. Susan Chase, EdD, RN, CS, is an Associate Professor at the Boston College School of Nursing. Lynn Peterson, MD, is an Associate Professor of Surgery and an Associate Professor of Medical Ethics at Harvard Medical School, and is Director of the Ethics Service at Brigham and Women’s Hospital in Boston. Lachlan Forrow, MD, is an Assistant Professor of Medicine at Harvard Medical School, and is Director of the Ethics Support Service and Palliative Care Programs at Beth Israel Deaconess Medical Center in Boston.
Frequent concomitant epigenetic silencing of SOX1 and secreted frizzled‐related proteins (SFRPs) in human hepatocellular carcinoma

Except for genetic mutations, epigenetic changes are also involved in the development of human cancers. Recently, we have identified SOX1, SRY (sex determining region Y)‐box 1, is hypermethylated in cervical cancer and ovarian cancer. Therefore, we investigated whether promoter hypermethylation of SOX1 is common in hepatocellular carcinoma (HCC).
Health Communication in Multilingual Contexts: A Study of Reading Preferences, Practices, and Proficiencies Among Literate Adults in Zambia

Comprehension of health materials and messages is a necessary, though not sufficient, condition for the development of health literacy; in the case of print materials, reading comprehension is elemental. Assessments of the population's ability to read and comprehend written materials are complex and highly salient in multilingual countries, such as Zambia, particularly when an excolonial language is but one of multiple official languages. Yet no study has contrasted adult Zambians' reading comprehension of health materials in the major Zambian languages with comparable English-language materials. This article reports the results of a survey of 2,009 literate Zambian adults who were tested for reading comprehension of health materials written at fourth- and eighth-grade levels. The analysis found that respondents who had not gone beyond primary school scored significantly higher on Zambian- than on English-language reading comprehension tests. Respondents with at least an eighth-grade education scored equally well or better on English-language compared with Zambian-language tests. Overall, respondents were more likely to pass the grade-four than the grade-eight reading comprehension tests. In the multilingual context of Zambia it is vital to produce health communication print materials written at or near a grade-four readability level in English and, when warranted, in appropriate Zambian languages.
The patient-centered medical home and health information technology.

OBJECTIVE To demonstrate that concepts of patient-centeredness and technology-centeredness must work together within the context of the transformation to the patient-centered medical home (PCMH), a primary care model that emphasizes coordinated, comprehensive, accessible, and cost-effective care. MATERIALS AND METHODS Information in this article was gathered from a workshop on the Medical Home in Alexandria, VA in June 2010 that brought together civilian and military medical providers, researchers, and other stakeholders in PCMH to discuss their experiences in transitioning from traditional primary care to PCMH in addition to a literature review of articles from medical journals. RESULTS Patient-centeredness is often only vaguely defined as being in opposition to provider-centered or technology-centered. Our analysis shows that focusing on either technological improvements or enhancing patient-centered care will not improve the fragmented healthcare system in the United States. We argue that these two concepts are not incompatible as sometimes believed, but rather it is critical that we recognize they must work together in routine practices in order to truly improve the state of healthcare. CONCLUSION Health information technology (HIT) supports many of the core principles of PCMH, but there are still several challenges as not all technologies have functionalities yet that facilitate the model. We suggest patient-centeredness be one of the main concepts that drives the redesign and implementation of new health technologies in primary care. It is no longer about just implementing new technologies; these technologies must enhance patient-provider relationships, communication, access, and patients' engagement in their own care.
Functionally relevant coronary artery disease: comparison of 64-section CT angiography with myocardial perfusion SPECT.

PURPOSE To prospectively determine the accuracy of 64-section computed tomographic (CT) angiography for the depiction of coronary artery disease (CAD) that induces perfusion defects at myocardial perfusion imaging with single photon emission computed tomography (SPECT), by using myocardial perfusion imaging as the reference standard. MATERIALS AND METHODS All patients gave written informed consent after the study details, including radiation exposure, were explained. The study protocol was approved by the local institutional review board. In patients referred for elective conventional coronary angiography, an additional 64-section CT angiography study and a myocardial perfusion imaging study (1-day adenosine stress-rest protocol) with technetium 99m-tetrofosmin SPECT were performed before conventional angiography. Coronary artery diameter narrowing of 50% or greater at CT angiography was defined as stenosis and was compared with the myocardial perfusion imaging findings. Quantitative coronary angiography served as a reference standard for CT angiography. RESULTS A total of 1093 coronary segments in 310 coronary arteries in 78 patients (mean age, 65 years +/- 9 [standard deviation]; 35 women) were analyzed. CT angiography revealed stenoses in 137 segments (13%) corresponding to 91 arteries (29%) in 46 patients (59%). SPECT revealed 14 reversible, 13 fixed, and six partially reversible defects in 31 patients (40%). Sensitivity, specificity, and negative and positive predictive values, respectively, of CT angiography in the detection of reversible myocardial perfusion imaging defects were 95%, 53%, 94%, and 58% on a per-patient basis and 95%, 75%, 96%, and 72% on a per-artery basis. Agreement between CT and conventional angiography was very good (96% and kappa = 0.92 for patient-based analysis, 93% and kappa = 0.84 for vessel-based analysis). CONCLUSION Sixty-four-section CT angiography can help rule out hemodynamically relevant CAD in patients with intermediate to high pretest likelihood, although an abnormal CT angiography study is a poor predictor of ischemia.
Comparing stress testing methods

PREVIEW Conventional exercise stress testing or stress echocardiography? Deciding between these two noninvasive cardiac evaluation techniques can be a regular occurrence, given the frequency of coronary artery disease (CAD) in the US population. When can you rely on exercise stress testing alone to do the job? What situations call for stress echocardiography? When should pharmacologic agents be substituted for exercise in stress echocardiography? In this comparison of the two techniques, Drs Tak and Gutierrez discuss indications, contraindications, and other issues that enter into selection of the appropriate test for the individual patient.