Miracle-dz/UniFAR-FTUs huggingface dataset:
Acute Exenatide Therapy Attenuates Postprandial Vasodilation in Humans with Prediabetes: A Randomized Controlled Trial.

Background: The state of prediabetes comprises atherosclerotic changes leading to decreased vascular function in humans. This study examined the effects on incretin mimetics on vascular physiology in the prediabetic postprandial state. Methods: Fifteen obese adults with prediabetes participated in a randomized, crossover, double-blinded trial comparing the postprandial effects of exenatide, saxagliptin, and placebo on peripheral vasodilation. All studies utilized a standardized high-fat meal. Resting and peak forearm blood flow (FBF) were measured via strain gauge venous occlusion plethysmography, and makers of vascular dysfunction were measured in plasma. Results: Exenatide attenuated resting FBF at 3 hr (P = 0.003) and 6 hr (P = 0.056) postmeal, compared to placebo. Nonsignificant reductions in resting FBF were observed between saxagliptin and placebo at the same time points. No group differences were observed for peak FBF, plasma nitrotyrosine, and plasma 8-iso-prostaglandin F2alpha. A transient increase in plasma triglyceride was abated in the exenatide group, when compared to saxagliptin and placebo groups. Only exenatide group showed no significant upsurge in plasma insulin. Plasma-free fatty acids significantly declined in all three groups, although less markedly for exenatide. Postmeal glucose increased at 2 hr with placebo and saxagliptin, but simultaneously decreased with exenatide. Conclusions: Acute treatment with exenatide blunted the postprandial vasodilatory effect of a high-fat meal in prediabetes. Exenatide's acute effects derived primarily from multiple endothelium-independent processes. Trial Registration Number: NCT02104739.
Emotional Stress Induces Structural Plasticity in Bergmann Glial Cells via an AC5–CPEB3–GluA1 Pathway

Stress alters brain function by modifying the structure and function of neurons and astrocytes. The fine processes of astrocytes are critical for the clearance of neurotransmitters during synaptic transmission. Thus, experience-dependent remodeling of glial processes is anticipated to alter the output of neural circuits. However, the molecular mechanisms that underlie glial structural plasticity are not known. Stress alters brain function by modifying the structure and function of neurons and astrocytes. The fine processes of astrocytes are critical for the clearance of neurotransmitters during synaptic transmission. Thus, experience-dependent remodeling of glial processes is anticipated to alter the output of neural circuits. However, the molecular mechanisms that underlie glial structural plasticity are not known. Here we show that a single exposure of male and female mice to an acute stress produced a long-lasting retraction of the lateral processes of cerebellar Bergmann glial cells. These cells express the GluA1 subunit of AMPA-type glutamate receptors, and GluA1 knockdown is known to shorten the length of glial processes. We found that stress reduced the level of GluA1 protein and AMPA receptor-mediated currents in Bergmann glial cells, and these effects were absent in mice devoid of CPEB3, a protein that binds to GluA1 mRNA and regulates GluA1 protein synthesis. Administration of a β-adrenergic receptor blocker attenuated the reduction in GluA1, and deletion of adenylate cyclase 5 prevented GluA1 suppression. Therefore, stress suppresses GluA1 protein synthesis via an adrenergic/adenylyl cyclase/CPEB3 pathway, and reduces the length of astrocyte lateral processes. Our results identify a novel mechanism for GluA1 subunit plasticity in non-neuronal cells and suggest a previously unappreciated role for AMPA receptors in stress-induced astrocytic remodeling. SIGNIFICANCE STATEMENT Astrocytes play important roles in synaptic transmission by extending fine processes around synapses. In this study, we showed that a single exposure to an acute stress triggered a retraction of lateral/fine processes in mouse cerebellar astrocytes. These astrocytes express GluA1, a glutamate receptor subunit known to lengthen astrocyte processes. We showed that astrocytic structural changes are associated with a reduction of GluA1 protein levels. This requires activation of β-adrenergic receptors and is triggered by noradrenaline released during stress. We identified adenylyl cyclase 5, an enzyme that elevates cAMP levels, as a downstream effector and found that lowering GluA1 levels depends on CPEB3 proteins that bind to GluA1 mRNA. Therefore, stress regulates GluA1 protein synthesis via an adrenergic/adenylyl cyclase/CPEB3 pathway in astrocytes and remodels their fine processes.
Depression, family interaction and family intervention in adolescents at clinical‐high risk for psychosis

The relationship between family behaviour and depression in adolescents at clinical high risk (CHR) for psychosis remains understudied despite high rates of depression in this population. This study examines the relationship between family problem‐solving behaviours and depression in CHR adolescents and the impact of family interventions targeting subthreshold symptoms of psychosis on reducing symptoms of depression over 2‐years.
Sickle Cell Pain Management During the First 24 Hours of Inpatient Care Compared to the National Heart Lung and Blood Institute Clinical Practice Guidelines for the Emergency Department: A Quality Improvement Project

Sickle Cell Pain Management During the First 24 Hours of Inpatient Care Compared to the National Heart Lung and Blood Institute Clinical Practice Guidelines for the Emergency Department: A Quality Improvement Project Genice T. Nelson, DNP University of Connecticut, 2017 This quality improvement project addressed the clinical practice patterns for the first 24 hours of the hospitalized adult for inpatient care in comparison to the established guidelines for the emergency department treatment of sickle cell pain with the NHLBI 2002 and 2013 guidelines in a suburban teaching hospital. The analysis focused on the treatment provided which included information regarding patient assessments, utilizations for intravenous fluids, oxygen administration, the choice of pain medications including opioids, NSAIDS, and other adjuvants. A post hoc retrospective chart review was conducted with data abstraction on the current clinical practice utilized during the inpatient admission which identified deficits that will lead to the creation of a clinical dashboard for ongoing quality improvement and outcome monitoring. This process was guided by the principles of the Dartmouth Clinical Microsystem’s and the 5 P’s: Purpose, Patients, Professionals, Processes, and Patterns for a complete system change. The overall focus for change was intravenous fluids and rates, opioid titration for pain relief, and patient reported desired pain goals. Sickle Cell Pain Management During the First 24 Hours of Inpatient Care Compared to the National Heart Lung and Blood Institute Clinical Practice Guidelines for the Emergency Department: A Quality Improvement Project
miR-216a Acts as a Negative Regulator of Breast Cancer by Modulating Stemness Properties and Tumor Microenvironment

Breast cancer is the most frequent malignancy in females in terms of both incidence and mortality. Underlying the high mortality rate is the presence of cancer stem cells, which divide indefinitely and are resistant to conventional chemotherapies, so causing tumor relapse. In the present study, we identify miR-216a-5p as a downregulated microRNA in breast cancer stem cells vs. the differentiated counterpart. We demonstrate that overexpression of miR-216a-5p impairs stemness markers, mammosphere formation, ALDH activity, and the level of Toll-like receptor 4 (TLR4), which plays a significant role in breast cancer progression and metastasis by leading to the release of pro-inflammatory molecules, such as interleukin 6 (IL-6). Indeed, miR-216a regulates the crosstalk between cancer cells and the cells of the microenvironment, in particular cancer-associated fibroblasts (CAFs), through regulation of the TLR4/IL6 pathway. Thus, miR-216a has an important role in the regulation of stem phenotype, decreasing stem-like properties and affecting the cross-talk between cancer cells and the tumor microenvironment.
Clinicopathologic and genetic features of multiple system atrophy with Lewy body disease

Background: Abnormal aggregates of α‐synuclein are pathologic hallmarks of multiple system atrophy (MSA) and Lewy body disease (LBD). LBD sometimes coexists with MSA, but the impact of co‐pathology, particularly diffuse LBD, on presentation of MSA has not been studied. We aimed to determine the frequency and clinicopathologic features of MSA with LBD (MSA+LBD). Methods: Using hematoxylin & eosin and α‐synuclein‐immunostained slides, we assessed the distribution and severity of LBD in 230 autopsy‐confirmed MSA patients collected from 1998 to 2018. Alzheimer‐type pathology was assessed to assign the likelihood of clinical presentations of dementia with Lewy body (DLB) using the consensus criteria for DLB. We reviewed medical records to characterize clinicopathologic features of MSA+LBD. Genetic risk factors for LBD, including APOE ε4 allele and mutations in GBA, SNCA, LRRK2, and VPS35, were analyzed. Results: LBD was observed in 11 MSA patients (5%); seven were brainstem type, three were transitional type, and one was diffuse type. The latter four had an intermediate or high likelihood of DLB. Three of the four had an antemortem diagnosis of Parkinson’s disease with dementia (PDD) or clinically probable DLB. Two patients had neuronal loss in the substantia nigra, but not in striatal or olivocerebellar systems with widespread glial cytoplasmic inclusions, consistent with minimal change MSA. In these cases, LBD was considered the primary pathology, and MSA was considered coincidental. APOE ε4 allele frequency was not different between MSA+LBD and MSA without LBD. Two of nine MSA+LBD patients had a risk variant of GBA (p.T408M and p.E365K). Conclusions: Although rare, MSA with transitional or diffuse LBD can develop clinical features of PDD or DLB. Minimal change MSA can be interpreted as a coincidental, but distinct, α‐synucleinopathy in a subset of patients with diffuse LBD.
Serum netrin-1 levels at presentation and delayed neurological sequelae in unintentional carbon monoxide poisoning

Abstract Objectives: The early identification of patients with a high risk of developing delayed neurological sequelae (DNS) can improve the quality of care in carbon monoxide (CO) poisoning cases. The aim of this study is to investigate whether the serum netrin-1 levels measured at presentation to the emergency department (ED) predicted the development of DNS after acute CO intoxication. Methods: This prospective observational study was conducted between 1 August 2018 and 31 July 2019 in a single tertiary hospital. The patients with acute CO intoxication and serum netrin-1 levels measured at the time of ED presentation were included in the study. All patients were followed up for six weeks regarding the development of DNS. The patients were divided into two groups, including those who developed DNS (DNS group) and those who did not (non-DNS group). Results: A total of 183 patients were included in the study, and 54 (29.5%) developed DNS. The median serum netrin-1 level at ED presentation was significantly lower in the DNS group (391.5 pg/mL [263.0–550.5]) than in the non-DNS group (626.0 pg/mL [505.9–755.6]) (p < .001). Multivariate analysis revealed that a low serum netrin-1 level (adjusted odds ratio [AOR]: 8.02, 95% CI: 2.45–26.20), low Glasgow coma scale (GCS) score at ED presentation (AOR: 0.81, 95% CI: 0.68–0.97), long CO exposure time (AOR: 1.96, 95% CI: 1.49–2.56), and the presence of acute brain lesions (AOR: 8.24, 95% CI: 2.37–28.58) on diffusion-weighted imaging were independent predictors of DNS. Serum netrin-1 levels less than 432 pg/mL predicted the development of DNS with a sensitivity of 68.5% (95% CI: 54.4%-80.5%) and a specificity of 86.0% (95% CI: 78.8%-91.5%). Conclusions: Low serum netrin-1 levels were significantly associated with the development of DNS. Therefore, serum netrin-1 at ED presentation can help identify patients at risk of developing DNS following discharge.
Frequency of hypodontia of permanent teeth in children

We analyzed 2.470 patients of both sexes of the Clinic of stomatology from Nis of the age of 10-14 years, aiming to find out the frequency of hypodontia of permanent teeth (excluding the third molars), its localization in the jaws as well as the number and kind of the missing teeth. The inborn shortage of one or more teeth was present in 155 patients (6.05%) and that is 94 girls and 61boys. With the short age of teeth in the lower jaw there were 41.21% examinees, in the upper 32.90% and in both jaws simultaneously 25.81%. The reduced amount of teeth ranged from 1 to 11. The majority of children (40.00%) had the shortage of one tooth and in a slightly smaller percentage(34.84%) the shortage of two teeth. Only one boy had the hypodontia 11 teeth. With hypodontia the second permanent premolars are most frequently taken (53.76%), then lateral incisors (30.65%) and then central incisors (8.06%). There were no cases with the hypodontia of the first permanent molars.
The Possibility of Interlocking Nail Fabrication from FFF 3D Printing PLA/PCL/HA Composites Coated by Local Silk Fibroin for Canine Bone Fracture Treatment

The biomaterials polylactic acid (PLA), polycaprolactone (PCL), and hydroxyapatite (HA) were selected to fabricate composite filaments for 3D printing fused filament fabrication (FFF), which was used to fabricate a composite biomaterial for an interlocking nail for canine diaphyseal fractures instead of metal bioinert materials. Bioactive materials were used to increase biological activities and provide a high possibility for bone regeneration to eliminate the limitations of interlocking nails. HA was added to PLA and PCL granules in three ratios according to the percentage of HA: 0%, 5%, and 15% (PLA/PCL, PLA/PCL/5HA, and PLA/PCL/15HA, respectively), before the filaments were extruded. The test specimens were 3D-printed from the extruded composite filaments using an FFF printer. Then, a group of test specimens was coated by silk fibroin (SF) using the lyophilization technique to increase their biological properties. Mechanical, biological, and chemical characterizations were performed to investigate the properties of the composite biomaterials. The glass transition and melting temperatures of the copolymer were not influenced by the presence of HA in the PLA/PCL filaments. Meanwhile, the presence of HA in the PLA/PCL/15HA group resulted in the highest compressive strength (82.72 ± 1.76 MPa) and the lowest tensile strength (52.05 ± 2.44 MPa). HA provided higher bone cell proliferation, and higher values were observed in the SF coating group. Therefore, FFF 3D-printed filaments using composite materials with bioactive materials have a high potential for use in fabricating an interlocking nail for canine diaphyseal fractures.
Transmembrane Pressure and Recovery of Serum Proteins during Microfiltration of Skimmed Milk Subjected to Different Storage and Treatment Conditions

Milk pre-processing steps-storage at 4 °C (with durations of 48, 72 or 96 h) and methods for microbiological stabilization of milk (1.4 μm microfiltration, thermization, thermization + bactofugation, pasteurization) are performed industrially before 0.1 µm-microfiltration (MF) of skimmed milk to ensure the microbiological quality of final fractions. The objective of this study was to better understand the influence of these pre-processing steps and their cumulative effects on MF performances (i.e., transmembrane pressure, and transmission and recovery of serum proteins (SP) in the permeate). Results showed that heat treatment of skimmed milk decreased ceramic MF performances, especially after a long 4 °C storage duration (96 h) of raw milk: when milk was heat treated by pasteurization after 96 h of storage at 4 °C, the transmembrane pressure increased by 25% over a MF run of 330 min with a permeation flux of 75 L·h−1·m−2 and a volume reduction ratio of 3.0. After 48 h of storage at 4 °C, all other operating conditions being similar, the transmembrane pressure increased by only 6%. When milk was 1.4 µm microfiltered, the transmembrane pressure also increased by only 6%, regardless of the duration of 4 °C storage. The choice of microbiological stabilization method also influenced SP transmission and recovery: the higher the initial heat treatment of milk, the lower the transmission of SP and the lower their recovery in permeate. Moreover, the decline of SP transmission was all the higher that 4 °C storage of raw milk was long. These results were explained by MF membrane fouling, which depends on the load of microorganisms in the skimmed milks to be microfiltered as well as the rate of SP denaturation and/or aggregation resulting from pre-processing steps.
Can measurements be physically conditioned by thought? Further observations following a focused intention experiment

Abstract Background The biofield is a controversial concept among the scientific community. Some aspects of this phenomenon relate to measurable factors of mainstream science such as electromagnetics, while others, involving nonlocal interventions, intention, and consciousness, seem to produce physical changes through mechanisms that are still unknown, making the outcomes of many studies not fully explained by our current state of scientific understanding. This study explored the hypothetical effects of intention on the conditioning of a pH system with continuous data acquisition for real-time measurements. As a follow-up study, those effects were related to changes in the physicochemical properties of water samples chosen as a target in a previous large-scale intervention of focused intention. Methods The intention experiments were conducted under controlled conditions from the 8th to September 11, 2015. During this period, 286 qualified biofield therapy practitioners meditated at a distance with the intention of changing the vibrational state of the water molecules contained in specific flasks. Several variables were evaluated, including the magnetic field and ultraviolet-visible (UV-VIS) radiation from 175 to 954 nm near the experimental spot, as well as Raman spectra, pH, and electrical conductivity of all the water samples. After this period, real-time pH measurements of water samples were taken with the same equipment and under the same experimental conditions, except for the practitioners’ awareness of those experiments, and without their focused intention. Real-time pH, electrical conductivity and the concentration of cations and anions measured by ion chromatography in the water samples were used to test the proposed hypothesis. Results Real-time pH was responsive during the intention experiments and after this period. Further continuous measurements performed after the 11th September showed that the pH variations overtime kept a systematic and consistent tendency similar to the one observed during the experimental activities involving focused intention. After the replacement of the electrode internal electrolyte, this behavior was no longer verified, and the pH was stable as the initial tests to evaluate the equipment sensitivity. Conclusions After the experimental period involving focused intention, the pH system maintained a systematic and consistent behavior while measuring the pH of new water samples. An eventual intention-mediated conditioning of the pH measurement system occurred because of changes in the properties of the electrode internal electrolyte.
Cerebrospinal fluid flow cytometry: utility in central nervous system lymphoma diagnosis

Flow cytometry of the cerebrospinal fluid (CSF) is used in isolation or as an adjunct to cytology to increase the sensitivity of detecting primary central nervous system (CNS) lymphoma. We aim to evaluate the sensitivity of CSF flow cytometry as a diagnostic tool for primary CNS lymphoma in patients presenting with undifferentiated neurologic symptoms. We retrospectively reviewed all CSF samples received by the Calgary Laboratory Services Flow Cytometry Laboratory from 2012- 2015. Clinical data, laboratory investigations, radiologic imaging studies, and pathological data were analyzed. Clinical review extended to 2 years post CSF flow cytometric testing. The number of samples of CSF flow cytometry that were positive for a hematological malignancy was 43/763 (5.6%). The overall sensitivity of the test was 69.4%. A positive result was more likely to occur in patients with a prior history of a hematological malignancy or abnormal enhancement on MRI (p<0.0001). CSF flow cytometry was negative in all patients who did not have a previous hematological malignancy or abnormal enhancement on MRI (n = 247). CSF flow cytometry has a limited role in screening for primary CNS lymphoma, unless a strictly endorsed testing algorithm is applied. It is, however, an invaluable tool in evaluating CNS involvement in patients with a previous diagnosis of hematolymphoid malignancy or abnormal enhancement on MRI. LEARNING OBJECTIVES This presentation will enable the learner to: Discuss the costs and benefits of using CSF flow cytometry to diagnose CNS lymphoma 1. Identify appropriate clinical indications for using CSF flow cytometry as a first-line test 2. Apply a testing algorithm to increase the diagnostic yield of CSF flow cytometry
Incidence and Outcome of Surfactant Therapy in Premature Neonates in ICU of KAMC

ISSN: 2319-7706 Volume 7 Number 04 (2018) Journal homepage: http://www.ijcmas. com Lung surfactant plays a key role in adequate pulmonary function throughout life. Since Surfactant replacement therapy has been introduced in 1980s, it has proven its effect in premature neonates with surfactant deficiency. Since surfactant therapy is important in various respiratory conditions in premature neonates, this proposed study reviews the incidence, outcome & their clinical issues in surfactant replacement therapy. The objective of the study is to assess the outcome of surfactant therapy in premature neonates, to find out the length of hospital stay. The secondary objective is to find the mortality rate, the effect of early administration of surfactant in premature surfactant deficient neonates. The study was conducted in neonatal intensive care units of King AbdulAziz Medical City (KAMC), Riyadh and study subjects include premature neonates undergone surfactant therapy in ICU. A sample size of 110 neonates from a population of 150 premature neonates in neonatal ICU of KAMC was selected. Out of the total 109 subjects, 69 were males and 40 were females. The mean gestational age was 30 weeks. The majority (n=83, 76.15%) had Respiratory Distress Syndrome (RDS). Subjects were treated with surfactant replacement therapy with either survanta (50.5%) or Infasurf (49.5%). The mean APGAR scoring at 1 and 6 minutes was statistically significant (P=0.001). Vital signs such as temperature (sd0.58, P=0.017), respiratory rate (sd-15.86, p=0.001), and heart rate (sd-17.84, p = 0.046) compared with improved and expired subjects and were statistically significant. Arterial blood gas in pre and post surfactant therapy was statistically significant with pH (p=0.001), Pco2 (p=0.001), and base excess (p=0.001). The administration of surfactant therapy can improve the total outcome of premature infants with respiratory distress. This study favors early use and benefits of surfactant therapy which has proven by many other relevant articles published earlier. This study shows good results after administration of surfactants like survanta and infasurf. K e y w o r d s Premature neonates, Surfactant deficiency, Respiratory distress,