Miracle-dz/UniFAR-FTUs huggingface dataset:
The impact of obesity on the presentation of primary hyperparathyroidism.

CONTEXT Obesity has been associated with elevated serum PTH (sPTH) in the general population. Obesity may also alter the clinical presentation in patients with primary hyperparathyroidism (PHPT). OBJECTIVES The objectives of the study were to compare the clinical presentation of obese (OB) vs nonobese (NO) PHPT patients and to assess the impact of obesity on the presentation of PHPT independent of serum calcium and PTH. PATIENTS Consecutive PHPT patients who underwent parathyroidectomy between 2003 and 2012 by a single surgical group participated in the study. SETTING The study was conducted at an academic medical center. DESIGN Cross-sectional review of records of preoperative demographic, historical, laboratory, and densitometry findings and intraoperative pathological findings were compared in OB vs NO patients. MAIN OUTCOME MEASURES The prevalence of nephrolithiasis and osteoporosis was measured. RESULTS Two hundred forty-seven PHPT patients were included in this analysis. Fifty percent were OB and 79% were women. Mean body mass index was 25.3 ± 3.3 and 36.0 ± 5.2 kg/m(2) in the NO and OB groups, respectively. Age, gender, and race distribution was similar between the two groups. Serum calcium was similar between the groups (11.0 ± 0.7 mg/dL in NO vs 11.1 ± 0.9 mg/dL in OB, P = .13), whereas sPTH was higher in OB (151 ± 70 vs 136 ± 69 pg/mL, P = .03). The OB group exhibited higher prevalence of hypercalciuria (urine calcium > 400 mg per 24 h) (41% vs 23% in NO, P = .01) and nephrolithiasis (36% vs 21% in NO, P = .03). Despite higher sPTH, OB patients showed higher bone mineral density and a lower rate of osteoporosis (21% vs 35%, P = .05). Differences in the prevalence of hypercalciuria and osteoporosis between the groups persisted after adjustment for age, race, estimated glomerular filtration rate, gender, sPTH, and calcium. CONCLUSIONS In PHPT patients, obesity is a risk factor for hypercalciuria and nephrolithiasis and is protective against osteoporosis. The impact of parathyroidectomy on the clinical features of obese PHPT patients merits further evaluation.
Plant protein-based hydrophobic fine and ultrafine carrier particles in drug delivery systems

Abstract For thousands of years, plants and their products have been used as the mainstay of medicinal therapy. In recent years, besides attempts to isolate the active ingredients of medicinal plants, other new applications of plant products, such as their use to prepare drug delivery vehicles, have been discovered. Nanobiotechnology is a branch of pharmacology that can provide new approaches for drug delivery by the preparation of biocompatible carrier nanoparticles (NPs). In this article, we review recent studies with four important plant proteins that have been used as carriers for targeted delivery of drugs and genes. Zein is a water-insoluble protein from maize; Gliadin is a 70% alcohol-soluble protein from wheat and corn; legumin is a casein-like protein from leguminous seeds such as peas; lectins are glycoproteins naturally occurring in many plants that recognize specific carbohydrate residues. NPs formed from these proteins show good biocompatibility, possess the ability to enhance solubility, and provide sustained release of drugs and reduce their toxicity and side effects. The effects of preparation methods on the size and loading capacity of these NPs are also described in this review.
Equivalence of bioimpedance and thermodilution in measuring cardiac index after cardiac surgery.

OBJECTIVE To compare thoracic electrical bioimpedance (TEB) cardiography versus pulmonary artery thermodilution (TD) derived cardiac index in patients after cardiopulmonary bypass. DESIGN Prospective, blinded electronic data collection. SETTING Intensive care unit of a military hospital. PARTICIPANTS Post-cardiopulmonary bypass patients for primary comparison between technologies (n = 20) and patients for comparison of variability within each technology (n = 20). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Cardiac index values by TEB or TD were collected simultaneously. Linear regression, Lin's concordance correlation coefficient, bias, and precision measures within the large data set group and within each patient over time were calculated. Linearity in regression and Lin's concordance correlation coefficient of 0.99 were shown. A bias of 0.07 L/min/m(2) and precision of 0.40 L/min/m(2) were within acceptable clinical limits, as were equivalence test results. CONCLUSIONS TEB is equivalent to TD-derived cardiac index in postoperative cardiac surgery patients.
New simulation procedure for accurate package modeling considering chip-package interaction

This paper presents a novel simulation procedure for full-wave electromagnetic simulations for generating package models taking into account chip-package interaction. If a simulated structure is split into two sub simulations, the accuracy of the overall simulation decreases. This is mainly the case if no clean separation of a composition into sub simulations is possible due to interactions between the sub domains. We show by means of a simple example of an embedded Wafer Level Ball grid array (eWLB) package that the simulation results of a cascade of an eWLB package and a chip are different to the simulation of the complete composition. The proposed simulation procedure delivers a package model with the package-chip interactions included and therefore cascading with integrated circuit model is possible with a higher accuracy. We show that the simulation results of a cascade of a package model obtained with the new procedure and a chip are virtually equal to a simulation of the whole composition. Furthermore we show that the created model of the package obtained from the proposed procedure is independent of the electrical circuit on the chip. This proves that the separation of the package from the chip with the proposed procedure is valid.
Supporting rehabilitation training of COPD patients through multivariate sensor-based monitoring and autonomous control using a Bayesian network: prototype and results of a feasibility study

Repeated endurance training – supervised by an expert – is one of the most effective rehabilitation methods for patients with chronic obstructive pulmonary disease (COPD) to improve physical function. Monitoring of vital signs in combination with an automatic intelligent training control and emergency detection facilitates supervised training without the physical presence of an expert as well as training optimisation through individualisation. The aim of this study is the development of a suitable analysis and control method for this purpose. Healthy volunteers and patients with COPD were equipped with body sensors during ergometer training to enable measuring their vital signs continuously. Depending on these values, the exercise load of the ergometer was controlled automatically using a Bayesian network. The network, trained with expert knowledge and training data, is embedded in our system by using Java application programming interface. Extensive tests in a laboratory setting have proved safe usage of our prototype. In a case study, evaluation during training sessions with patients with COPD took place. Due to the automatic control the patients' vital signs ranged inside the predefined optimal thresholds for at least 95% of the time. Furthermore, our results suggest an increase of the training efficiency compared with the conventional method (constant exercise load).
Molecular Association of the Arabidopsis ETR1 Ethylene Receptor and a Regulator of Ethylene Signaling, RTE1*

The plant hormone ethylene plays important roles in growth and development. Ethylene is perceived by a family of membrane-bound receptors that actively repress ethylene responses. When the receptors bind ethylene, their signaling is shut off, activating responses. REVERSION-TO-ETHYLENE SENSITIVITY (RTE1) encodes a novel membrane protein conserved in plants and metazoans. Genetic analyses in Arabidopsis thaliana suggest that RTE1 promotes the signaling state of the ethylene receptor ETR1 through the ETR1 N-terminal domain. RTE1 and ETR1 have been shown to co-localize to the endoplasmic reticulum (ER) and Golgi apparatus in Arabidopsis. Here, we demonstrate a physical association of RTE1 and ETR1 using in vivo and in vitro methods. Interaction of RTE1 and ETR1 was revealed in vivo by bimolecular fluorescence complementation (BiFC) in a tobacco cell transient assay and in stably transformed Arabidopsis. The association was also observed using a truncated version of ETR1 comprising the N terminus (amino acids 1–349). Interaction of RTE1 and ETR1 was confirmed by co-immunoprecipitation from Arabidopsis. The interaction occurs with high affinity (Kd, 117 nm) based on tryptophan fluorescence spectroscopy using purified recombinant RTE1 and a tryptophan-less version of purified recombinant ETR1. An amino acid substitution (C161Y) in RTE1 that is known to confer an ETR1 loss-of-function phenotype correspondingly gives a nearly 12-fold increase in the dissociation constant (Kd, 1.38 μm). These findings indicate that a high affinity association of RTE1 and ETR1 is important in the regulation of ETR1.
The ABC‐transporter Ste6 accumulates in the plasma membrane in a ubiquitinated form in endocytosis mutants.

We are investigating the transport and turnover of the multispanning membrane protein Ste6. The Ste6 protein is a member of the ABC‐transporter family and is required for the secretion of the yeast mating pheromone a‐factor. In contrast to the prevailing view that Ste6 is a plasma membrane protein, we found that Ste6 is mainly associated with internal membranes and not with the cell surface. Fractionation and immunofluorescence data are compatible with a Golgi localization of Ste6. Despite its mostly intracellular localization, the Ste6 protein is in contact with the cell surface, as demonstrated by the finding that Ste6 accumulates in the plasma membrane in endocytosis mutants. The Ste6 protein which accumulates in the plasma membrane in endocytosis mutants is ubiquitinated. Ste6 is thus the second protein in yeast besides MAT alpha 2 for which ubiquitination has been demonstrated. Ste6 is a very unstable protein (half‐life 13 min) which is stabilized approximately 3‐fold in a ubc4 ubc5 mutant, implicating the ubiquitin system in the degradation of Ste6. The strongest stabilizing effect on Ste6 is, however, observed in the vacuolar pep4 mutant (half‐life > 2 h), suggesting that most of Ste6 is degraded in the vacuole. Secretory functions are required for efficient degradation of Ste6, indicating that Ste6 enters the secretory pathway and is transported to the vacuole by vesicular carriers.
Use of intensive care at the end of life in the United States: An epidemiologic study*

ObjectiveDespite concern over the appropriateness and quality of care provided in an intensive care unit (ICU) at the end of life, the number of Americans who receive ICU care at the end of life is unknown. We sought to describe the use of ICU care at the end of life in the United States using hospital discharge data from 1999 for six states and the National Death Index. DesignRetrospective analysis of administrative data to calculate age-specific rates of hospitalization with and without ICU use at the end of life, to generate national estimates of end-of-life hospital and ICU use, and to characterize age-specific case mix of ICU decedents. SettingAll nonfederal hospitals in the states of Florida, Massachusetts, New Jersey, New York, Virginia, and Washington. PatientsAll inpatients in nonfederal hospitals in the six states in 1999. InterventionNone. Measurements and Main ResultsWe found that there were 552,157 deaths in the six states in 1999, of which 38.3% occurred in hospital and 22.4% occurred after ICU admission. Using these data to project nationwide estimates, 540,000 people die after ICU admission each year. The age-specific rate of ICU use at the end of life was highest for infants (43%), ranged from 18% to 26% among older children and adults, and fell to 14% for those >85 yrs. Average length of stay and costs were 12.9 days and $24,541 for terminal ICU hospitalizations and 8.9 days and $8,548 for non-ICU terminal hospitalizations. ConclusionsOne in five Americans die using ICU services. The doubling of persons over the age of 65 yrs by 2030 will require a system-wide expansion in ICU care for dying patients unless the healthcare system pursues rationing, more effective advanced care planning, and augmented capacity to care for dying patients in other settings.
Heterogeneity and contact‐dependent regulation of amylase release by individual acinar cells

We have used a reverse hemolytic plaque assay to investigate the amylase release of single and aggregated pancreatic acinar cells. We have found that a minority of single acinar cells released detectable amounts of amylase under basal conditions and were modestly stimulated, in a dose‐dependent manner, during a 30‐min exposure to concentrations of carbamylcholine (CCh) ranging from 10−8 to 10−5 M. This stimulation was largely accounted for by the recruitment of additional secreting cells, rather than by a significant increase in their individual secretory output. We have also observed that aggregates comprising two to five acinar cells secreted more frequently and released more amylase than single acinar cells in the presence of each of the CCh concentrations tested. Under both basal conditions and following CCh stimulation, the proportion of secreting aggregates and their amylase output increased linearly with the aggregate size. Under basal conditions as well as in the presence of secretagogue concentrations in the 10−8−10−7 M range, individual cells contributed similarly to amylase secretion whether they were single or part of aggregates. By contrast, following stimulation by 10−6−10−5 M CCh, aggregated cells showed a much higher average secretion than single cells. Investigating the mechanism of this contact‐dependent effect, we found that 10−3 M heptanol did not significantly modify the secretion of single cells and markedly promoted the basal amylase release of acinar cell pairs. This effect was associated with a marked reduction in gap junctional communication between acinar cells, as evaluated by microinjection of Lucifer yellow, and was not observed during exposure to high concentrations of CCh, which also reduced junctional communication. These data show that pancreatic acinar cells are intrinsically heterogeneous in their ability to release amylase and that their basal as well as stimulated secretion are promoted by the establishment of direct intercellular contacts. Our experiments also suggest that junctional coupling contributes to the contact‐dependent mechanism which enhances the recruitment of secreting cells and their individual output. These observations strengthen the view that direct interactions between acinar cells are essential in the control of pancreatic secretion. © 1994 Wiley‐Liss, Inc.
Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both.

BACKGROUND Patent foramen ovale and atrial septal aneurysm have been identified as potential risk factors for stroke, but information about their effect on the risk of recurrent stroke is limited. We studied the risks of recurrent cerebrovascular events associated with these cardiac abnormalities. METHODS A total of 581 patients (age, 18 to 55 years) who had had an ischemic stroke of unknown origin within the preceding three months were consecutively enrolled at 30 neurology departments. All patients received aspirin (300 mg per day) for secondary prevention. RESULTS After four years, the risk of recurrent stroke was 2.3 percent (95 percent confidence interval, 0.3 to 4.3 percent) among the patients with patent foramen ovale alone, 15.2 percent (95 percent confidence interval, 1.8 to 28.6 percent) among the patients with both patent foramen ovale and atrial septal aneurysm, and 4.2 percent (95 percent confidence interval, 1.8 to 6.6 percent) among the patients with neither of these cardiac abnormalities. There were no recurrences among the patients with an atrial septal aneurysm alone. The presence of both cardiac abnormalities was a significant predictor of an increased risk of recurrent stroke (hazard ratio for the comparison with the absence of these abnormalities, 4.17; 95 percent confidence interval, 1.47 to 11.84), whereas isolated patent foramen ovale, whether small or large, was not. CONCLUSIONS Patients with both patent foramen ovale and atrial septal aneurysm who have had a stroke constitute a subgroup at substantial risk for recurrent stroke, and preventive strategies other than aspirin should be considered.
Notch Signaling in Mesenchymal Stem Cells Harvested From Geriatric Mice

Objectives: Morbidity associated with geriatric fractures may be attributed, in part, to compromised mesenchymal stem cell (MSC) function within the fracture callus. The Notch signaling pathway is important for the healing of nonskeletal tissues in an age-dependent manner, but the effect of Notch on age-dependent fracture healing and MSC dysfunction has not been substantiated. The objective of this study was to examine Notch signaling in MSCs obtained from young and geriatric mice. Methods: Marrow-derived MSCs were harvested from the femora of 5- and 25-month-old C57BL/6 mice. We assessed in vivo MSC number using CFU-F, proliferation using an Alamar Blue assay, osteoblast differentiation by Alizarin Red S staining, and adipogenic differentiation using Oil Red O staining. Notch receptor and ligand expression was assessed using quantitative PCR, and Notch signaling was assessed by evaluating Notch target gene expression (Hey and HES) under basal conditions and when cells were plated to Jagged-1 ligand. Results: MSC from geriatric mice exhibit reduced MSC number (CFU-F), proliferation, adipogenesis, and inconsistent osteogenesis. The highest expressed Notch receptor is Notch 2, and the highest expressed ligand is Jagged-1, but there were no differences in ligand and receptor gene expression between young and old MSCs. Interestingly, geriatric MSCs show decreased basal Notch signaling activity but are fully responsive to Jagged-1 stimulation. Conclusions: These data suggest that therapeutic targeting of Notch signaling should be explored in clinical therapies to improve geriatric fracture healing.
Is there any association between inhaled ipratropium and mortality in patients with COPD and asthma?

BACKGROUND To determine whether ipratropium was associated with premature death in patients with asthma and chronic obstructive pulmonary disease (COPD). METHODS A longitudinal cohort of 827 patients with COPD and 273 with asthma who were evaluated for compensation by two specialists in pulmonary medicine. RESULTS By June 1999, 538 of the patients with COPD and 77 of those with asthma had died. Atthe consultation, 77% ofthe COPD patients and 8.1% of the asthmatic patients were treated with inhaled ipratropium. Ipratropium was associated with mortality risk ratio (RR) of 2.0 (95% confidence interval: 1.5-2.6) for COPD and 3.6 (1.8-7.1) for asthma patients. After adjustment for confounding factors [forced expiratory volume 1 s (FEV1), smoking habits, asthma medication, and presence of cor pulmonale] the RR for COPD was 1.6 (1.2-2.1) and for asthma 24 (1.2-5.0). CONCLUSIONS The increased risk of premature death associated with ipratropium is of concern and necessitates further evaluation, e.g., in a randomised study.
KONSEPSI PEMBAGIAN KEKUASAAN NEGARA ISLAM KHILAFAH MENURUT HIZBUT TAHRIR DAN KEMUNGKINAN IMPLEMENTASINYA DI INDONESIA

The Islamic state idealized by Hizb ut-Tahrir has a system of government that is different from the existing system of government in the world today. The Islamic state has a different concept of power-sharing which is known in the growing doctrine of constitutional law. The concept of power sharing is similar to the concept of a state led by a king, since the caliph as head of state and head of government is given a very wide authority even including both judicial and legislative powers. This vast authority was given to the Caliph as an implementation of sovereignty in the hands of the Ummah who was then used to elect a caliph, so that the authority of the state derived from the Ummah was called by a caliph. The author analyzes the concept of the division of powers of Islamic countries according to Hizb ut-Tahrir to be applied in Indonesia which is a country with a majority of its population is Muslim. This analysis is based on the development of Indonesian constitutional phases since the founding of this country until today in order to find the possibility of conception to implementation of power sharing Khilafah Hizb ut-Tahrir Islamic state in Indonesia. This study suggests to Hizb ut-Tahrir for reconstruction and ijtihad new as "qoul al-jadid" to the concept of power-sharing formulated within the Islamic state Khilafah Hizb to be implemented in Indonesia and can help overcome the problems of the people associated with the concept of the Indonesian state administration, especially in the field of The division of state power.
Suppressive effects of the antiandrogen agent, chlormadinone acetate and the 5α-reductase inhibitor, dutasteride on prostate weight and intraprostatic androgen levels in rats

Abstract The objectives of this study were to investigate whether Chlormadinone acetate (CMA, Prostal®, CAS 302-22-7) more markedly decreased ventral prostate and seminal vesicle weights and exerted more beneficial effects on intraprostatic androgen levels than dutasteride (DUT, CAS 164656-23-9) in rats. Dose-dependent inhibiting effects on prostate and seminal vesicle enlargement were observed after the 14-day administration of CMA (30, 100 mg/kg/day) and DUT (0.3, 1 mg/kg/day). The prostate atrophy rates calculated as the percentages relative to the vehicle-treated group were 50.5 and 67.9% with 30 and 100 mg/kg CMA and 34.9 and 37.0% with 0.3 and 1 mg/kg DUT, respectively, and the atrophying effect of CMA was significantly greater than that of DUT (ρ < 0.05). The results of 7-day administration were similar to those of 14-day administration. While CMA dose-dependently and significantly (p < 0.05) reduced the testosterone (T) and di-hydrotestosterone (DHT) concentrations in prostate, DUT reduced the DHT concentration but markedly increased the Τ concentration (20-40 times). Even though it was carried out in rats, this study revealed for the first time that the antiandrogen CMA showed a stronger atrophying effect than the 5α-reductase inhibitor DUT on direct comparison. The difference between the atrophying effects of CMA and DUT is considered to be attributed to the present results that CMA reduced the concentrations of both androgens (T and DHT) in prostate but DUT did not, and the fact that CMA has a potent androgen receptor-blocking action but DUT does not.