Miracle-dz/UniFAR-FTUs huggingface dataset:
Mediatory Myths in the U.S. Military: Tobacco Use as “Stress Relief”

Purpose. To examine perceptions of military personnel about tobacco use. Design. Secondary analysis of (1) focus group and (2) interview data. Setting. U.S. military. Subjects. Total participants (n = 241): Enlisted personnel, supervisors (n = 189 individuals participating in 23 focus groups), tobacco control managers, and policy leaders (n = 52 interview participants). Intervention. Not applicable. Measures. Not applicable. Analysis. Inductive, iterative coding for salient themes using an interpretive approach. Application of the concept of mediatory myths, used by institutions to cover over internal contradictions. Results. All types of participants endorsed the idea that tobacco was needed in the military for stress relief. Types of stress identified included fitting in, (relationships with coworkers and superiors) and control of workflow (taking breaks). Participants also discussed beliefs about the impact of tobacco on the military mission, and institutional sanction of tobacco use. Conclusion. Despite tobacco's well-documented negative effects on fitness, the myth that tobacco relieves stress serves several institutional functions in the military. It serves to minimize perceptions of stress on the fitness of personnel, suggests that stress can be managed solely by individuals, and institutionalizes tobacco use. Growing recognition among military leadership that countering stress is essential to fitness offers an opportunity to challenge this myth.
Long-Term Survival Results of a Randomized Trial Comparing Gemcitabine Plus Cisplatin, With Methotrexate, Vinblastine, Doxorubicin, Plus Cisplatin in Patients With Bladder Cancer

Purpose To compare long-term survival in patients with locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium treated with gemcitabine/cisplatin (GC) or methotrexate/vinblastine/doxorubicin/cisplatin (MVAC). Patients and Methods Efficacy data from a large randomized phase III study of GC versus MVAC were updated. Time-to-event analyses were performed on the observed distributions of overall and progression-free survival. Results A total of 405 patients were randomly assigned: 203 to the GC arm and 202 to the MVAC arm. At the time of analysis, 347 patients had died (GC arm, 176 patients; MVAC arm, 171 patients). Overall survival was similar in both arms (hazard ratio [HR], 1.09; 95% CI, 0.88 to 1.34; P = .66) with a median survival of 14.0 months for GC and 15.2 months for MVAC. The 5-year overall survival rates were 13.0% and 15.3%, respectively (P = .53). The median progression-free survival was 7.7 months for GC and 8.3 months for MVAC, with an HR of 1.09. The 5-year progress.
Effective interventions for adolescents with anorexia nervosa

Background: Anorexia Nervosa (AN) is a serious psychiatric illness with both psychological and medical sequelae that usually onsets during adolescence. The illness presents formidable challenges to clinicians. Despite these facts, there are few treatments studies for the adolescent age group. Aims: This report provides a critical review of the most common treatments and the empirical support for them for adolescent AN. Method: Clinical and research literature was reviewed to identify empirically supported treatments with an emphasis on identifying pertinent randomized controlled trials. However, relevant clinically oriented reports and consensus clinical guidelines were also included when other systematic research was unavailable in order to provide a more comprehensive view of current treatment strategies for adolescents with AN. Results: There are only five randomized clinical trials specifically addressing treatment for adolescent AN. Only 207 subjects were enrolled in these studies with an average cell size of about 20 subjects. Data from these trials suggest that family therapy wherein parents re-feed their adolescent offspring is effective for AN in this age group. However, other treatment approaches (e.g. individual therapy, group therapy, hospitalization, medication) have not been sufficiently or systematically studied. Conclusions: Family therapy based on parental re-feeding is an effective approach for adolescent AN. However, the superiority of family therapy over other types of interventions has not been sufficiently demonstrated. There is an urgent need to conduct treatment research in this area to guide clinical care for this vulnerable population. Declaration of interest: Dr Lock is supported by NIH Grant R01MH070621-01.
Tobacco Use Behaviors and Household Smoking Bans among Chinese Americans

Purpose. To assess the relationship between household smoking restrictions and smoking patterns among Chinese American adults. Design. This is a cross-sectional analysis based on a National Institutes of Health-funded population-based household and telephone survey of 2537 Chinese American adults. Setting. Two communities in New York City. Subjects. The analyses focused on male current smokers (N = 600). Measures. Demographic characteristics, smoking status, household smoking restrictions, cigarettes smoked per day, and past quit attempts were based on self-reported data. Results. Among current smokers, 37% reported living in a home with a complete smoking ban. Smokers with a full household smoking ban smoked fewer cigarettes on weekdays and weekends than smokers with no household smoking ban (p ≤ .05) and were 3.4 times (p ≤ .01) more likely to report having at least one quit attempt in the past 12 months. Smokers with knowledge of the dangers of environmental tobacco smoke (ETS) exposure were 2.8 times (p ≤ .01) more likely to have at least one quit attempt in the last 12 months compared with those who were unaware of the danger of ETS and more likely to live in a smoke-free household. Conclusions. Smoke-free home policies and interventions to raise awareness among smokers of the dangers of ETS have the potential to significantly reduce tobacco use and exposure to household ETS among this immigrant population.
Dao-Tan decoction inhibits tumor necrosis factor-α-induced intercellular adhesion molecule-1 expression by blocking JNK and p38 signaling pathways in human umbilical vein endothelial cells

Context: Dao-Tan decoction (DTD) is a Chinese herb prescription used to treat atherosclerosis or dizziness for centuries. Previous study shows that DTD could inhibit intercellular adhesion molecule-1 (ICAM-1) expression induced by tumor necrosis factor-α (TNF-α). However, its mechanism has never been clearly described. Objective: To examine the hypothesis that DTD might inhibit TNF-α-induced ICAM-1 expression through regulating the mitogen-activated protein kinase (MAPK) pathways, involving Jun N-terminal kinase (JNK) and p38. Materials and methods: The rats were orally administrated with DTD for 3 days (2.3 g/kg per day), then the serum was collected. Human umbilical vein endothelial cells (HUVECs) were cultured and stimulated by TNF-α with or without DTD serum. The expression of ICAM-1 mRNA was examined by reverse transcription-polymerase chain reaction and the expression of p38 and JNK was examined by Western blot analysis. Results: DTD serum significantly inhibits TNF-α-induced ICAM-1 expression by 17–41% on HUVECs. TNF-α-induced JNK and p38 activations, which were involved in ICAM-1 expression, were significantly inhibited with DTD serum treatment by 10–50% on HUVEC. Discussion and conclusion: Based on the theory of traditional Chinese medicine (TCM), pathogenesis of atherosclerosis is caused by “blood” and “phlegm” attached on blood vessels. DTD has a function of “dissolving phlegm”, thus it is chosen for the treatment of atherosclerosis. This study demonstrated that DTD could inhibit the expression of ICAM-1, by significantly preventing the activation of JNK and p38, which are important factors of atherosclerosis. Therefore, the present study indicates the pharmacological basis for treatment of atherosclerosis with DTD.
Familial Thrombophilia: A Review Analysis

The correct approach to the management of the asymptomatic carrier with a recognized inherited thrombophilic disorder is uncertain because reliable in formation of the risk of spontaneous (unprovoked) throm bosis in these disorders is not available. To determine the best available estimate of the annual incidence of spon taneous thrombosis in asymptomatic carriers of disorders that have been linked to familial thrombophilia, we per formed a literature review. Using Medline search from 1965 to 1992, supplemented by manual searches, we re trieved all articles that presented data on antithrombin III, protein C, protein S, dysfibrinogenemia, plasmino gen, histidine-rich glycoprotein, heparin cofactor II, and fibrinolysis in relation to thrombosis. Publications were included in the analysis if they (1) reported one or more probands with thrombotic disease and a heterozygous biochemical abnormality of the hemostatic system, (2) assessed the presence of this abnormality in family mem bers independent of the presence or absence of a history of thrombotic disease, and (3) assessed the presence of a history of thrombotic disease in all available family mem bers. The biochemical status and clinical details of all family members reported were extracted from each eligi ble article. For each abnormality the odds ratio for throm bosis was compared in family members with and without the biochemical abnormality. If applicable, thrombosis- free survival and age-specific incidences of thrombosis were calculated. The thrombotic episodes were classified as spontaneous or secondary to a recognized risk factor, and the proportion of spontaneous episodes was calcu lated. The influence of diagnostic suspicion bias in symp tomatic patients with a family history of thrombosis was reduced by recalculating the absolute incidence of throm bosis from the odds ratio after adjusting the incidence of venous thrombosis in nonaffected family members to that observed in the general population. Statistically signifi cant associations between the presence of a biochemical abnormality and a history of venous thrombosis were found for antithrombin III deficiency types 1 and 2a and 2b, protein C deficiency type 1, and protein S deficiency type I. Dysfibronogenemia was statistically significantly associated with venous as well as arterial thrombosis. Thirty-five to 67% of the events were classified as being provoked, as they occurred following exposure to a rec ognized risk factor for thrombosis. The recalculated an nual incidence of spontaneous thrombosis was 0.6 to 1.6%/year. It is concluded that this relatively low inci dence does not warrant life-long continuous use of anti coagulant prophylaxis since the reported risk of major and fatal bleeding associated with the use of oral antico agulants is 2-3 and 0.4%/year, respectively.
Developing the otolaryngology milestones.

Under the guidance of the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Otolaryngology (ABOto), a working group of educators, program directors, residency review committee (RRC) members, experts in the specialty, and a resident representative developed the Otolaryngology Milestones with the dual aims of (1) allowing programs to track the educational progress of their residents, culminating in readiness to enter unsupervised practice; and (2) using Milestone data aggregated to the program level to report on otolaryngology programs' educational effectiveness for accreditation purposes. Box Otolaryngology Milestone Working Group and Milestone Advisory Group Otolaryngology Milestone Working Group Terance T. Tsue, MD, University of Kansas School of Medicine, Chair Nasir I. Bhatti, MD, Johns Hopkins University Anthony E. Brissett, MD, Baylor College of Medicine Brian Burkey, MD, Cleveland Clinic Foundation Pamela Derstine, PhD, MHPE, Accreditation Council for Graduate Medical Education (ACGME) Laura Edgar, EdD, CAE, ACGME Noel Jabbour, MD, Children's Hospital of Pittsburgh Abraham Jacob, MD, University of Arizona Medical Center Michael M. Johns III, MD, Emory University Eric J. Kezirian, MD, MPH, Keck School of Medicine of the University of Southern California Daniel J. Kirse, MD, Wake Forest School of Medicine J. Walter Kutz, MD, University of Texas-Southwestern School of Medicine Anna H. Messner, MD, Stanford University School of Medicine Liana Puscas, MD, Duke University School of Medicine Matt Ryan, MD, University of Texas-Southwestern School of Medicine Ivan Wayne, MD, University of Oklahoma Health Sciences Center Otolaryngology Milestone Advisory Group Terance T. Tsue, MD, University of Kansas School of Medicine Timothy Brigham, MDiv, PhD, ACGME Brian Burkey, MD, Cleveland Clinic Sukgi Choi, MD, University of Pittsburgh School of Medicine Michael Cunningham, MD, Boston Children's Hospital Ellen Deutsch, MD, Children's Hospital of Philadelphia Marvin Fried, MD, Albert Einstein College of Medicine, Montefiore Medical Center Sonya Malekzadeh, MD, Georgetown University School of Medicine Brad Marple, MD, University of Texas-Southwestern School of Medicine Anna H. Messner, MD, Stanford University School of Medicine Robert H. Miller, MD, American Board of Otolaryngology Michael G. Stewart, MD, MPH, Weill Cornell Medical College Randal S. Weber, MD, University of Texas MD Anderson Cancer Center
Optimization of the extraction conditions and quantification by RP-LC analysis of three alkaloids in Zanthoxylum nitidum roots

Abstract Context: A classic traditional Chinese medicine, Zanthoxylum nitidum (Roxb.) DC. widely used in China, exhibits anticancer, anti-inflammatory and antianalgesic activities. Alkaloids are one of the main bioactive components. It is urgent to develop a simple and reliable method to determine the main alkaloids in Z. nitidum roots. Objective: To determine the three alkaloids in Z. nitidum roots, a reversed-phase liquid chromatographic (RP-LC) method combined with an optimum extraction condition was established. Materials and methods: A method involving four-factor-three-level orthogonal array design including the extracting solvent and the RP-LC condition was assayed. Twenty batches were collected from different areas of the Guangxi Province at different harvesting times. The determined alkaloids were nitidine chloride (NC, 1), ethoxychelerythrine (2) and liriodenine (3). The stable mobile phase was a C18 packing, and the mobile phase was acetonitril-aqueous phosphoric acid-triethylamine-buffer solution. Results: The optimum extraction and detection conditions have been determined in the process of quantification of Z. nitidum root alkaloids. The three alkaloids were detected simultaneously in the 20 batches of samples. The results clearly showed that alkaloid concentrations differed significantly among Z. nitidum collected from various collection areas. Discussion and conclusion: We have established an optimum extraction and detection conditions in the process of quantification the three alkaloids in Z. nitidum roots. From this research, the most influenced factor on Z. nitidum roots was the collecting location, and the next factor was the harvesting time. The collecting location and the harvesting time should be considered as the high-quality medicinal herbs factors.
Ferulic acid pretreatment mitigates MPTP-induced motor impairment and histopathological alterations in C57BL/6 mice

Abstract Context: Ferulic acid (FA) is a potent ubiquitous plant antioxidant found in cereals such as brown rice, whole wheat, and oats. Phytochemical-based antioxidants are shown to be effective in neurodegenerative diseases. This study hypothesizes that supplementation of FA might combat oxidative stress-induced Parkinson’s disease (PD). Objective: To explore the effect of FA on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine hydrochloride (MPTP)-induced neurotoxicity. Materials and methods: Mice were randomized into five groups: Group I mice served as control. Group II mice received 5 × MPTP [25 mg/kg body weight (i.p.)] in saline 24 h apart starting from the 3rd day and continued till the last day of the experimental period of 7 d. In addition to MPTP injections, mice in Groups III, IV, and V were given FA at a dose of 20, 40, and 80 mg, respectively, for 7 d. Mice were subjected to a battery of behavioral tests along with histological investigations. Results: Our histological findings revealed that MPTP administration enhanced Bax/Bcl2 ratio and microglial cells activation reflecting induction of apoptosis and inflammation, respectively. This dopaminergic neuronal loss caused impairment in motor balance and coordination in MPTP mice as assessed by various behavioral tests. FA at a dose of 40 mg/kg/d body weight effectively attenuated MPTP-induced neurotoxicity. Discussion: Antioxidant, free-radical quenching, and anti-inflammatory activities of FA could contribute to its neuroprotective effect. Conclusion: This study provides elementary evidence for the neuroprotective action of FA against MPTP-induced PD in mice and warrants further studies.
VITAMIN D DEFICIENCY CAUSES MUSCULOSKELETAL HYPERSENSITIVITY: THE ROLE OF NOCICEPTOR HYPERINNERVATION

Clinical studies link vitamin D deficiency and musculoskeletal pain, both of which occur more frequently in women. However, a causal relationship has been difficult to establish and it is not clear whether vitamin D metabolites directly influence nociceptors ('pain-sensing' neurons). It was shown here, via immunohistochemistry and western blot, that rat putative nociceptors contain vitamin D receptors (VDRs) and metabolic enzymes, whose expression is regulated by ovarian hormones. In ovariectomized rats a vitamin D deficient diet induces balance deficits and deep tissue mechanical hyperalgesia, concurrent with muscle hyperinnervation by presumed nociceptors. Balance deficits, muscle mechanical hypersensitivity, and hyperinnervation are not corrected by elevated dietary calcium. In primary sensory cultures, VDR is enriched in c-fiber growth cones and regulates neurite outgrowth through VDR rapid response pathways. Therefore, vitamin D metabolites act directly on nociceptive neurons to inhibit axonal sprouting, accounting for hypovitaminosis D-induced muscle hyperinnervation, and possibly contributing to hypersensitivity. iv This work is dedicated to my parents, Susan D. and Walter C. Tague, for making my education a priority. Without their continued support, this work would not have been possible.
In vitro synergistic effect of Hibiscus sabdariffa aqueous extract in combination with standard antibiotics against Helicobacter pylori clinical isolates

Abstract Context The increasing problem of drug-resistant strains has led to the failure of current treatment regimens of Helicobacter pylori (HP) infection. Recently, a new treatment strategy has been developed to overcome the problem by using natural products in combination with antibiotics to enhance the treatment efficacy. Objective The antimicrobial combinatory effect of the aqueous extract of Hibiscus sabdariffa L. (Malvaceae) (AEHS) with antibiotics (clarithromycin, CLA; amoxicillin, AMX; metronidazole, MTZ) has been evaluated in vitro against HP strains. Materials and methods Hibiscus calyces (35 g) were brewed in 250 mL of boiled water for 30 min, and minimum inhibitory concentrations (MICs) were determined by agar dilution method. The checkerboard assay was used to evaluate the antimicrobial combinatory effect according to the sum of fractional inhibitory concentration (∑FIC) indices. Results In this study, AEHS exerted remarkable bacteriostatic effect against all HP strains tested with MICs values ranging from 9.18 to 16.68 μg/mL. Synergy effect of AEHS with CLA or MTZ was obtained against four of seven HP strains tested with ∑FIC ranging from 0.21 to 0.39. The additive effect of AEHS with AMX was obtained against five of seven HP strains tested with ∑FIC ranging from 0.61 to 0.91. Conclusion This study presents AEHS as a potent therapeutic candidate alone, or in combination with antibiotics for the treatment of HP infection.
Anti-inflammatory constituents from the root of Litsea cubeba in LPS-induced RAW 264.7 macrophages

Abstract Context Litsea cubeba (Lour.) Pers. (Lauraceae) has long been used as a folk remedy in Traditional Chinese Medicine (TCM) for the treatment of rheumatic diseases. Previous studies from our laboratory indicated that L. cubeba extract showed anti-arthritic activity in rats. Objective To study L. cubeba chemically and biologically and to find the potential constituents responsible for its anti-arthritic effect. Materials and methods The compounds were isolated from the root of L. cubeba by column chromatography which eluted with PE:EtOAc gradient system, and the structures were elucidated by detailed spectroscopic data analysis; the anti-inflammatory activity of the isolated compounds was evaluated by lipopolysaccharide (LPS)-induced RAW 264.7 cells and the TNF-α and NO level were measured by ELISA (commercial kit); The iNOS and COX-2 mRNA expression were measured by RT-PCR and the phosphorylation of IκBα, IKKβ, P38 and Akt were determined by western blots. Results A novel 9-fluorenone, 1-ethoxy-3,7-dihydroxy-4,6-dimethoxy-9-fluorenone (1), together with 4 known compounds, namely pinoresinol (2), syringaresinol (3), 9,9′-O-di-(E)-feruloyl-meso-5,5′-dimethoxysecoisolariciresinol (4) and lyoniresinol (5) were isolated from the root of L. cubeba for the first time. The IC50 for NO inhibition on compounds 1 and 4 were 56.1 ± 1.2 and 32.8 ± 2.3 μM, respectively. The IC50 for TNF-α inhibition were 28.2 ± 0.9 and 15.0 ± 1.0 μM, respectively. Both 1 and 4 suppress mRNA expression of iNOS, COX-2 and protein phosphorylation of IκBα, IKKβ in LPS-induced RAW 264.7 cells. Discussion and conclusion Compounds 1 and 4 isolated from L. cubeba exhibited potent anti-inflammatory activity through the NF-κB signal pathway.
Efficacy of Rosmarinus officinalis leaves extract against cyclophosphamide-induced hepatotoxicity

Abstract Context Cyclophosphamide (CTX) is used to treat different cancer types, although it causes severe hepatotoxicity due to its oxidative stress effect. Rosmarinus officinalis, L. (Lamiaceae) has a therapeutic potential against hepatotoxicity due to its antioxidant activity. Objective The objective of this study is to investigate the phytochemical analysis of the methanol extract of Rosmarinus officianalis leaves (MEROL) and its efficacy against CTX-induced hepatotoxicity. Materials and methods The phytochemical analyses were assessed spectrophotometericaly. To assess the MEROL efficacy, 72 Swiss albino mice were divided into six groups. Group 1 was control, groups 2 and 3 included mice which were injected intraperitoneally (i.p.) with 100 or 200 mg/kg of MEROL at days 1, 4, 7, 10, 13 and 16; group 4 was injected (i.p.) with CTX (200 mg/kg) at day 17, groups 5 and 6 were injected (i.p.) with MEROL as groups 3 and 4 followed by 200 mg/kg CTX at day 17, respectively. At day 22, six mice from each group were sacrificed and the others were sacrificed at day 37. Results MEROL has a high content of total phenolics, saponins, total antioxidant capacity and DPPH radical scavenging activity. The median lethal dose (LD50) value of MEROL was 4.125 g/kg b.w. The inhibitory concentration 50 (IC50) value for DPPH radical scavenging was 55 μg/mL. Pretreatment with 100 mg/kg MEROL for 16 d ameliorated CTX-induced hepatotoxicity represented in lowering the levels of the aspartate aminotransferase (AST) and lipid profile and minimizing the histological damage. Conclusions Pretreatment with 100 mg/kg b.w. MEROL mitigated CTX-induced hepatotoxicity due to its antioxidant activity.