Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence of Urolithiasis by Ultrasonography Among Patients with Gout: A Cross-Sectional Study from the UP-Philippine General Hospital

Context While urolithiasis is epidemiologically and mechanistically linked to gout, urologic stone disease is not actively investigated in gout patients. Prevalence estimates on the coexistence of urolithiasis in gout have mostly relied on clinical history alone. Purpose To estimate the prevalence of urolithiasis among adult Filipinos with primary gout through clinical history and ultrasonography. Patients and Methods Patients diagnosed with primary gout were consecutively enrolled from outpatient clinics of the University of the Philippines Manila-Philippine General Hospital. Clinical data including sex; current age; age at diagnosis, duration of and attack frequency of gout; comorbidities such as hypertension, chronic kidney disease, type 2 diabetes mellitus, and dyslipidemia; personal history of urolithiasis; family history of gout; presence of tophus and laboratory samples to assess general kidney function, serum uric acid level, and urine pH were obtained from each patient who was subsequently subjected to ultrasonographic examination for urolithiasis. Lithiasic and non-lithiasic patients were identified and compared aggregately in terms of the aforementioned features. Results We recruited 121 patients, 86.8% of whom are male, and 37 (30.6%; 95% CI=23.1–39.3%) were identified to have urolithiasis of which only 12 (9.9%) had history consistent with urolithiasis and 30 (24.8%) were diagnosed solely through ultrasonography. None of the variables of interest were found to be statistically associated (P>0.05) with urologic stone formation. Conclusion Urolithiasis among adult Filipino patients with primary gout was found to be more prevalent in this study than previous estimates, which were based only on clinical history. We discovered that 25/37 (67.6%) of patients with urolithiasis denied history of urologic stone.
The Cranial Bowl in the New Millennium and Sutherland's Legacy for Osteopathic Medicine: Part 2

Cranial osteopathic medicine is practiced all over the world, respecting the dictates of the creator, Dr Sutherland. Despite the current manual approach faithfully follows the theoretical and practical bases that make up the cranial model of the last century, there are many scientific evidences that highlight the criticalities of the same model. In the first part we reviewed the role of the meninges and cerebrospinal fluid (CSF), as well as we discussed some rhythms present in the central nervous system; these latter elements are the pillars to support the theoretical idea of the movement of the skull evaluated and palpated by the osteopath. In this second part we will review the mechanical characteristics of other structures that make up the cranial system, highlighting new perspectives for clinical practice, thanks to the most recent data derived from scientific research.
Progress in Research on Colorectal Cancer-Related Microorganisms and Metabolites

Abstract Intestinal flora is an important component in the human body, which have been reported to be involved in the occurrence and development of colorectal cancer (CRC). Indeed, changes in the intestinal flora in CRC patients compared to those in control subjects have been reported. Several bacterial species have been shown to exhibit the pro-inflammatory and pro-carcinogenic properties, which could consequently have an impact on colorectal carcinogenesis. In this review, we summarize the current knowledge on the potential links between the intestinal microbiota and CRC. We illustrated the mechanisms by which intestinal flora imbalance affects CRC, mainly focusing on inflammation, microbial metabolites, and specific bacteria species. In addition, we discuss how a diet exhibits a strong impact on microbial composition and provides risks for developing CRC. Finally, we describe the potential future directions that are based on intestinal microbiota manipulation for CRC diagnosis and treatment.
The Relationship Between Acuity of Organ Failure and Predictive Validity of Sepsis-3 Criteria

Supplemental Digital Content is available in the text. Objectives: The Sepsis-3 taskforce defined sepsis as suspicion of infection and an acute rise in the Sequential Organ Failure Assessment score by 2 points over the preinfection baseline. Sepsis-3 studies, though, have not distinguished between acute and chronic organ failure, and may not accurately reflect the epidemiology, natural history, or impact of sepsis. Our objective was to determine the extent to which the predictive validity of Sepsis-3 is attributable to chronic rather than acute organ failure. Design: Retrospective cohort study. Setting: General medicine inpatient service at a tertiary teaching hospital. Patients: A total of 3,755 adult medical acute-care encounters (1,864 confirmed acute infections) over 1 year. Interventions: None. Measurements and Main Results: We measured the total Sequential Organ Failure Assessment score at the onset of infection and separated its components (baseline and acute rise) using case-by-case chart reviews. We compared the predictive validities of acuity-focused (acute rise in Sequential Organ Failure Assessment ≥ 2) and conventional (total Sequential Organ Failure Assessment ≥ 2) implementations of Sepsis-3 criteria. Measures of predictive validity were change in the rate of outcomes and change in the area under receiver operating characteristic curves after adding sepsis criteria to multivariate logistic regression models of baseline risk (age, sex, race, and Charlson comorbidity index). Outcomes were inhospital mortality (primary) and ICU transfer or inhospital mortality (secondary). Acuity-focused implementations of Sepsis-3 were associated with neither a change in mortality (2.2% vs 1.2%; p = 0.18) nor a rise in area under receiver operating characteristic curves compared with baseline models (0.67 vs 0.66; p = 0.75). In contrast, conventional implementations were associated with a six-fold change in mortality (2.4% vs 0.4%; p = 0.01) and a rise in area under receiver operating characteristic curves compared with baseline models (0.70 vs 0.66; p = 0.04). Results were similar for the secondary outcome. Conclusions: The evaluation of the validity of organ dysfunction-based clinical sepsis criteria is prone to bias, because acute organ dysfunction consequent to infection is difficult to separate from preexisting organ failure in large retrospective cohorts.
An unusual cause of reactive arthritis with urticarial: A case report

Reactive arthritis (ReA) is a syndrome of arthritis and tenosynovitis with defined extra-articular manifestations following certain infections. Despite being recognized a long time ago, debates still surrounds its definition. It is still unclear if the spectrum of the disease should include arthritis induced by other than the classical organisms. Here, we present an unusual cause of ReA. A young healthy female patient presented with acute polyarthritis and acute urticaria after 2 weeks of diarrheal illness. She was found to have blastocystis in the stool microscopy. Extensive evaluation ruled out other causes of her arthritis. She received metronidazole with a short course of NSAIDS and steroids with complete resolution of her skin and joint symptoms. She was followed for six months with no recurrence of arthritis or urticaria. Blastocystis sp. is a parasite that is prevalent in developing countries. It has been linked to isolated ReA or isolated urticaria among a few other case reports. This is the very first case to have blastocystis induced ReA that coexisted with acute urticaria. Upon review of the literature, we found that blastocystis induced ReA affects mainly young and middle-aged females such as in our case. The arthritis is usually settled with the parasite eradication. Finally, urticaria might be a distinguishing feature for blastocystis induced ReA that requires specific antimicrobial therapy.
Cerebral Thrombolysis in Rural Residents Aged ≥ 80

Purpose The proportion of older people in Poland is higher in rural areas than in urban areas. Thus, we aimed to evaluate treatment rate and factors associated with outcome and safety of intravenous thrombolysis (IVT) in rural residents aged ≥80 years admitted to primary stroke centers. Patients and Methods This study was a retrospective, observational cohort study of 873 patients treated with recombinant tissue plasminogen activator (rt-PA) in primary stroke centers between February 1, 2009 and December 31, 2017. Among them were 527 rural residents and 231 (26.5%) were ≥80 years of age. The analyses between rural and urban patients aged ≥80 and between rural patients aged <80 and aged ≥80 were performed. Results The proportion of patients aged ≥80 treated with rt-PA was comparable in rural and urban residents (27.9% vs 24.3% p = 0.24). Rural patients aged ≥80 were also characterized by lower incidence of cardiovascular risk factors and better patients’ conditions on admission to hospital. Symptomatic intracerebral hemorrhage rate among ≥80-year-old stroke patients was lower in those living in rural areas than in those living in urban areas (5.4% vs 14.3%, p = 0.02); there were no differences regarding mortality and 3-month functional outcome between both populations. The older group of rural patients was characterized by a higher 3-month mortality (28.5% vs 12.6%, p < 0.001) and lower functional independence rate (34.0% vs 50.5%, p < 0.001) than rural younger patients. Antiplatelet (OR 2.43, 95% CI 1.04–5.66, p = 0.04) and anticoagulant therapy before stroke (OR 3.64, 95% CI 1.21–10.99, p = 0.022), early ischemic changes in baseline computerized tomograprpahy (OR 2.65, 95% CI 1.03–6.82, p = 0.043) were associated with unfavorable outcome; and higher National Institute of Health Stroke Scale score on admission (OR 1.01, 95% CI 1.01–1.20, p = 0.039), higher baseline count of white blood cells (OR 1.33, 95% CI 1.10–0.62, p = 0.003) were associated with mortality in rural patients over 80. Conclusion We suggest that rural patients aged ≥80 may be safely treated with IVT in routine practice. However, lower efficacy and a higher mortality must be considered in former use of Vitamin K antagonist and antiplatelet or high white blood cells count.
Circulating miR-15a and miR-222 as Potential Biomarkers of Type 2 Diabetes

Background In recent years, considerable attention has been paid to the role of microRNAs (miRs) as biomarkers in type 2 diabetes (T2D). The aim of the study was to evaluate the expression levels of miR-15a and miR-222 in diabetic, pre-diabetic, and healthy individuals. Materials and Methods Ninety individuals, who were referred to the Yazd diabetic center, were enrolled in this study and then classified into three groups as healthy, pre-T2D, and diabetic based on the clinical manifestations. Real-time PCR was performed to explore miRs expression in the plasma samples of the studied population. The correlation between the biochemical characteristic and the expression of these miRs as well as specificity and sensitivity of different clinical markers in healthy and pre-diabetic groups was evaluated. Results miR-222 expression was significantly upregulated in the pre-T2D cases compared to the control subjects (P<0.001), while no significant difference was found between the pre-T2D and T2D groups (P<0.05). The expression of miR-15a was statistically downregulated in the pre-T2D and T2D subjects (P<0.05). The receiver operating characteristic (ROC) curve analysis of miR-15a expression with a cutoff point of 1.12 resulted in the area under the curve (AUC) of 85% (95% CI 0.865–0.912; P<0.001) with 84% and 85% sensitivity and specificity, respectively. Similarly, for miR-222, the cutoff point of 4.03 and AUC of 86% (95% CI 0.875–0.943; P<0.001) discriminated against the pre-T2D and control subjects via the sensitivity and specificity of 86% and 87%, respectively. Moreover, miR-15a values showed a negative correlation with FG (R=−0.32, P=0.005); however, miR-222 values were positively correlated with FG (R=0.25, P=0.03) in the pre-T2D group. Furthermore, miR-222 values were correlated with OGTT in the pre-T2D group (R=0.27, P=0.001). In addition, LDL-C had a negative correlation with miR-222 values in the pre-T2D group (R=−0.23, P=0.02). Conclusion This study indicated that the plasma expression levels of miR-222 and miR-15a can be considered as non-invasive, fast tools to separate the pre-T2D individuals from their healthy counterparts. Accordingly, this information could be used to predict the development of the disease as well as a direction for optimal therapy, thus refining outcomes in patients with diabetes.
Potatoes and the nutritional ecology of crested porcupines in a desert biome

SUMMARY (1) Indian crested porcupines (Hystrix indica Kerr) in the Negev desert highlands of southern Israel forage on cultivated potatoes. Here potato tubers as porcupine food are assessed and the impact of potato cultivation on the ecological status of desert porcupines is considered. (2) Captive porcupines ate potato tubers at a rate of 0.9 + 0.2 g per bite; and fasted animals consumed 530 + 37 g in the first 45 min of feeding and 148 + 42 g h-1 thereafter. New tubers had water contents of 83.9 + 1-9% and energy values of 15.4 + 1.6 kJ g' dry matter. (3) Owing to bulk food processing constraints, porcupines are unlikely to maintain energy balance on potatoes alone; but such a diet would meet the animals' water requirements. (4) Potato cultivation supplements natural food and water, and thus is a major enhancement of desert habitats. Year-round porcupine carrying capacity may have increased two-fold within 3 km of potato fields. (5) As adaptable, generalist herbivores, porcupines will rapidly exploit cultivation in desert areas and become agricultural pests. Several approaches for minimizing porcupine-agriculture conflicts are considered.
Myoglobin and Mitochondria: How Does The Ã¢ÂÂOxygen StoreÃ¢ÂÂ Work?

We have first shown that oxygen release from MbO2 at near-zero O2 concentrations (p02) only proceeds when interacting the protein with respiring mitochondria. If they are separated from MbO2 solution by a semipermeable membrane, no MbO2 deoxygenation occurs. The rates of O2 uptake by mitochondria from solution in the presence of MbO2 (V1) and MbO2 deoxygenation (V2) completely coincide for different mitochondrial preparations, the native, frozen and uncoupled by FCCP, as both V1 and V2 are determined by respiratory activity of mitochondria. However, V1 and V2 reflect different processes, because they are differently affected by the proteins, like lysozyme, competing with MbO2 for binding to mitochondria. It is found that myoglobin non-specifically interacts with phospholipid sites of the outer mitochondrial membrane, while any specific proteins or protein channels for the binding to myoglobin are lacking. The pronounced ionic strength dependence of the binding implies significant contribution of coulombic electrostatics into the formation of myoglobin–mitochondrial complex. As the total charge of myoglobin molecule does not affect the MbO2 and metMb affinity for the mitochondrial membrane, the ionic strength effect must be due to local electrostatic interactions, most probably between oppositely charged groups of phospholipids (the heads) and polar myoglobin residues in the environment of the heme cavity. The shift of the oxy- / deoxy- equilibrium toward ligand free deoxymyoglobin under anaerobic conditions in the presence of mitochondrial and artificial phospholipid membranes indicates that the myoglobin-membrane interaction results in a decreased myoglobin affinity for oxygen (and increased p50), which facilitates O2 detachment from MbO2 at physiological p02 values. Thus, in the presence of respiring mitochondria, at least two kinds of myoglobin molecules should be present in the cell. Some of them are free, with the high affinity for O2, and respectively, low p50, and the others, associated with mitochondria, with lower affinities and higher p50. For effective O2 transfer from cytoplasm, the exchange between these two kinds of MbO2 molecules must be rather fast. The Km values of MbO2 binding to mitochondria (about 104 M-1 at I = 0,15) and the lifetime of the complex (tens ns) correspond well to this demand.
SARS-CoV-2 Interstitial Pneumonia Treated With Tocilizumab in a Patient Affected by Classical Hodgkin Lymphoma

The World Health Organization on March 2020 declared the novel coronavirus SARS-CoV-2 pandemic. Corona Virus Infectious Disease 19 (COVID19) affects a wide range of patients, from asymptomatic to seriously compromised ones, displaying very heterogeneous clinical features. Severe cases may present with multiple organ dysfunctions, among which acute respiratory distress syndrome (ARDS) represents the principal cause of death. Excessive immune responses leading to a cytokine storm play a crucial role in lung damage progression, with interleukine 6 (IL-6) being one of the pivotal cytokines involved. Hence, blockade of IL-6 signaling might represent a promising approach to treat COVID-19-related ARDS. Tocilizumab, a humanized monoclonal antibody against IL-6 receptor (IL-6R), has been previously described as a potential effective treatment option in seriously non-cancer COVID-19 patients. Cancer patients are considered at higher risk of SARS-CoV-2 infection than general population, and their prognosis has been described as poorer. In the oncological setting, hematological cancer patients are expected to be particularly susceptible to infections, due to malignancy-and therapy-related immunodeficiencies. A recent report highlights a very high mortality in an heterogeneous hematological cohort. Very few preliminary data are available on the efficacy of tocilizumab for COVID-19 treatment in solid and hematological cancer patients. We therefore report a case of SARS-CoV-2 interstitial pneumonia in a patient with classical Hodgkin Lymphoma (cHL) successfully treated with tocilizumab.
GRK2 Suppresses Hepatocellular Carcinoma Metastasis and Invasion Through Down-Regulation of Prostaglandin E Receptor 2

Background Hepatocellular carcinoma (HCC) is an aggressive form of human liver cancer and the fifth most common malignancy worldwide. Novel effective treatment strategies for HCC are urgently in clinical because of its poor response to conventional therapies. G protein-coupled receptor kinases (GRKs), including GRK2 and GRK3, are known that involves in various essential cellular processes and regulates numerous signaling pathways. However, the role of GRK2/3 in invasion and metastasis of HCC still remains unclear. Materials and Methods Immunohistochemistry, Western blot, laser confocal microscopy and qRT-PCR were used to detect the expression of GRK2/3 and EP2 in liver tissues of HCC patients and DEN-induced HCC mice. Wound healing and transwell assay were applied to measure the migration and invasion of HCC cells after transfected with GRK2 siRNA. The downstream pathway of Akt and ERK was verified by Western blot. Results The expression of GRK2 was significantly decreased, while GRK3 was not significantly changed in HCC tissues compared with noncancerous tissues of HCC patients. Moreover, GRK2 expression was reduced during liver tumorigenesis in diethylnitrosamine-induced liver tumor model. In addition, our in vitro study showed that GRK2 expression was gradually decreased with increasing HCC cell line metastatic potential, and GRK2 knockdown significantly promoted the migration and invasion of HCC cells. Furthermore, low GRK2 expression was associated with increased expression of EP2 receptor translocation to HCC cell membrane, and the activation of Akt pathway. Conclusion These data suggest that GRK2 inhibits HCC metastasis and invasion may be through regulating EP2 receptor translocation, and this effect appears to be mediated by Akt pathway.
Slowed Progression of Age-Related Geographic Atrophy Following Subthreshold Laser

Purpose To determine the effect of panmacular low-intensity/high-density subthreshold diode micropulse laser (SDM) on age-related geographic atrophy (ARGA) progression. Methods The retinal images of all eyes with ARGA in a previously reported database, consisting of all eyes with dry age-related macular degeneration (AMD) active in a vitreoretinal practice electronic medical record (EMR), were identified and analyzed to determine the velocity of radial linear ARGA progression during observation and after panmacular SDM. Results Sixty-seven eyes of 49 patients with ARGA, mean age of 86 years were identified as having follow-up both before and after initiation of SDM treatment. All were included in the study. These eyes were followed a mean 910 days (2.5 years) prior to SDM treatment and a mean 805 days (2.2 years) after. Measurement masked to treatment vs observation found the radius of ARGA lesions progressed 1 to 540 µm per year (mean 137µm, SD 107) prior to treatment (controls); and −44 to 303 µm per year (mean 73µm, SD 59) after initiation of periodic panmacular SDM laser. Thus, the velocity of radial linear progression decreased 47% per year following panmacular SDM (p<0.0001). There were no adverse treatment effects. Conclusion In cohort of eyes with high-risk dry AMD, panmacular SDM slowed linear radial ARGA progression velocity 47% per year (p<0.0001) without adverse treatment effects. Validated, these findings would constitute an important advance in the prevention of age-related visual loss and a benchmark for future therapies.
Insulin-Like Proteins in Plant Sources: A Systematic Review

Abstract Type 2 diabetes mellitus (T2DM) is characterized by hyperglycemia. Proteins in plant sources that enable the maintenance of the glycemic profile may be of interest in the context of T2DM. However, their mechanisms of action are unclear, unlike other bioactive compounds. This systematic review identified and described the mechanisms of action of isolated and purified proteins and peptides extracted from vegetables on the reduction of blood glucose in T2DM in experimental studies. The research was done in PubMed, ScienceDirect, Scopus, Web of Science, Embase and Virtual Health Library (VHL) databases in March 2019. The initial search retrieved 916 articles, and, after reading the title, abstract and keywords, 24 articles were eligible for full reading. Then, five articles were eligible to build this systematic review. The evaluation of the evidence and the strength of the recommendations of the studies was evaluated with the SYstematic Review Center for Laboratory animal Experimentation - SYRCLE. Studies with proteins or peptides extracted from soybean (Glycine max), corn (Zea mays), peas (Pisum sativum), costus (Costus igneus) and ginseng (Panax ginseng) were found, and all of them decreased glycemia but not by the same mechanisms. The mechanism of action of proteins extracted from Glycine max, Pisum sativum, Costus igneus were similar, acting in the insulin-mediated pathways. The peptide derived from Zea mays increased GLP-1 expression, and the peptide from Panax ginseng reduced NF-kB signaling, both resulting in stimulating the release of insulin. Therefore, bioactive proteins and peptides of plant sources act through biochemical pathways, in the modulation of insulin resistance and the hyperglycemic state. These compounds are promising in scientific research on T2DM, because there is a probable similarity of these proteins with insulin, which enables them to act as insulin-like molecules.