Miracle-dz/UniFAR-FTUs huggingface dataset:
Efficacy and safety of HT048 and HT077 for body fat and weight loss in overweight adults

Abstract Background: The prevalence of excessive body weight has rapidly increased worldwide over the past decades; however, medications are intended for moderately and severely obese patients and are associated with side effects. As an alternative approach, the use of traditional herbal medicines has gained increasing popularity among overweight individuals in recent years in East Asia. HT048 is an herbal extract of Citrus unshiu and Crataegus pinnatifida, and HT077 is an herbal extract of Nelumbo nucifera and Prunus persica. These 4 herbs have been used widely for body weight reduction in China and Korea. The aims of this trial are to investigate whether HT048 and HT077 are effective at reducing body fat and weight in overweight adults, and to determine the safety of HT048 and HT077. Methods/design: A double-blind, randomized, placebo-controlled, 3-arm parallel group trial will be conducted in adults with a body mass index (BMI) of 25 to <30 kg/m2. A total of 120 eligible participants will be randomized in a 1:1:1 ratio to receive either HT048 (1000 mg), HT077 (400 mg), or matching placebo twice daily for 12 weeks, and will be monitored for an additional 4-week follow-up period after the treatment. All participants will be assessed for efficacy and safety of the investigational product at baseline and weeks 4, 8, 12, and 16. The primary endpoint is the change in body fat mass and percent body fat measured by dual-energy X-ray absorptiometry at week 12 from the baseline. The secondary efficacy variables are abdominal fat area measured by computed tomography, body fat mass and percent body fat measured by bioelectrical impedance analysis, body weight, BMI, and serum lipids and adipocytokines concentrations. Safety will be evaluated on the basis of reported adverse events, abnormal laboratory results, vital signs, and physical examination findings. Discussion: This is a first-in-human trial of HT048 and HT077 to assess the efficacy and safety in overweight subjects. The results will provide high-quality evidence of the therapeutic benefits of HT048 and HT077 for weight management and the prevention of obesity. Trial registration: Korean Clinical Research Information Service (KCT0004271) Registered September 2, 2019.
Metabolic syndrome: pharmacological treatment

Patients with the metabolic syndrome have a clustering of the following risk factors: detrimental changes in glucose tolerance and insulin resistance, abdominal (visceral) obesity, atherogenic dyslipidemia, hypertension. In addition to appropriate changes in lifestyle, the majority of patients with the syndrome will require pharmacological treatment, usually for the remainder of their lives. We present here an exhaustive and critical review of the drug treatment of the risk factors associated with the metabolic syndrome. Emphasis will be upon antihypertensive treatment and on the influence of various drugs on insulin resistance, an important background to the metabolic syndrome. Heart Metab. 2006;30:15‐20.
Patients' and physicians' perspectives and experiences on the quality of medical consultations: a qualitative evidence.

AIM Medical consultation is not only one of the most important steps in disease diagnosis and patient treatment, but also every patient's right. The purpose of this review was to explore patients' and physicians' perspectives and experiences of the quality of medical consultations. METHODS A qualitative interview study was carried out in outpatient clinics. A combination of face-to-face and telephone interviews was used due to the geographical spread of the respondents. Interviews were recorded and transcribed verbatim. Thematic descriptive analysis was used to interpret the data. Eligible physicians (n = 21) and patients (n = 27) were invited to take part in a semistructured interview to explore the views, perceptions, and experiences of patients on various factors affecting the quality of medical consultations. RESULTS The consultation quality was categorized into three topics: structure quality, process quality, and outcome quality. Data synthesis identified the following major themes for structure quality of consultations: administrative-organizational quality (with eight subthemes), physical environment quality (with six subthemes), and educational quality (with three subthemes). In addition, process quality was categorized into two major themes: examination quality (with nine subthemes) and interpersonal quality (with 13 subthemes). Outcome quality consisted of three major themes: patient satisfaction (with four subthemes), clinical outcomes (with two subthemes), and organizational outcomes (with three subthemes). CONCLUSION Medical consultation plays a central role in the quality and effectiveness of the received health care. Using the indicators of consultation quality improvement can develop physicians' clinical competence and skills. Furthermore, decision-makers can use them to monitor and evaluate physicians' performance.
Gene and protein expression of myosin heavy chain in Nellore cattle comparing growth or meat tenderness traits

Abstract The objective was to investigate gene and protein expression of myosin heavy chain (MyHC) in Nellore cattle slaughtered at different weights (BW) or degrees of meat tenderness. Ninety animals with initial BW 370 ± 37 kg, 24 months of age, were slaughtered after 95 days on feed. We evaluated shear force (SF), myofibrillar fragmentation index, ribeye area, backfat thickness, marbling, color, and cooking losses. Subsequently, 24 animals were selected and divided into four contrasting groups, in which light (BW = 504.58 ± 32.36 kg) versus heavy animals (BW = 604.83 ± 42.97 kg) and animals with tender (SF = 3.88 ± 0.57 kg) versus tough meat (SF = 7.95 ± 1.04 kg) were compared. The MYH7, MYH2 and MYH1 genes were analyzed by real-time PCR. The MyHC isoforms (MyHC-I, MyHC-IIa, and MyHC-IIx) were quantified by SDS-PAGE electrophoresis. We found lower expression of MYH2 and MYH1 genes in heavy compared to light animals and a higher amount of MyHC-I isoform in the tough meat group compared to the tender meat group. Protein expression of MyHC-IIa was higher in the tender meat group. A negative correlation was found of this protein and SF (tenderness), suggesting MyHC-IIa as a biomarker of meat quality.
The feasibility and acceptability of a low vision self- management programme for older Singaporeans: a pilot study

Background: The self-management needs of patients suffering from vision impairment are often overlooked during routine clinical care. Aim: The primary aim of this study was to develop a socially and culturally acceptable self-management programme for people with low vision in Singapore. Method: This mixed method study was conducted in two phases. Phase 1 gathered information from community groups and phase 2 involved integrating these suggestions with an Australian programme which was modified for delivery in Singapore. A pre- and post-test design using standardized instruments was used. Narrative data were integrated with the quantitative results to provide a rich description of patients' experiences. Results: Participants reported using more low vision aids, being able to perform activities of daily living with more ease and improved self efficacy. All participants attended every session demonstrating that the programme was both feasible and acceptable. Conclusion: Despite the small sample size, the pro.
Doctors and nurses: Standing orders in primary care A literature review

Background Standing orders are a useful tool to extend the work of primary health care team members and increase access to services for patients. They have been used in secondary services and in isolated rural communities since legislation was passed allowing their development in New Zealand in 2002. Extending standing order use is one response that teams can use to deal with workforce pressure. Aim The aim of this study is to review the published literature regarding the use of standing orders in primary care to compare clinical outcomes, cost comparisons and patient satisfaction between usual care and standing order care. Methods A systematic literature review was conducted using online databases. Papers included in the study were randomised controlled trials comparing usual GP care with care provided by nurses utilising standing orders in primary care settings. Key outcomes were identified and the results from the relevant papers collated.
Prediction of Survival Among Patients Receiving Transarterial Chemoembolization for Hepatocellular Carcinoma: A Response‐Based Approach

The heterogeneity of intermediate‐stage hepatocellular carcinoma (HCC) and the widespread use of transarterial chemoembolization (TACE) outside recommended guidelines have encouraged the development of scoring systems that predict patient survival. The aim of this study was to build and validate statistical models that offer individualized patient survival prediction using response to TACE as a variable.
Sleep characteristics and health-related quality of life in 9-11 year old children from 12 countries

lower health-related quality of (HRQoL) reported sleep and most were in To address these gaps, we studied both device-measured and self-reported sleep characteristics in relation to HRQoL in a sample of children from 12 countries that vary widely in terms of economic and human development. Self-reported, rather than device-based, measures of sleep are related to HRQoL in children. The 40 discrepancy related to sleep assessment methods highlights the importance of considering both device- 41 measured and self-reported measures of sleep in understanding its health effects.
COMPARISON OF THE RISK FACTORS OF KOREAN ADOLESCENT SUICIDE RESIDING IN HIGH SUICIDAL REGIONS VERSUS THOSE IN LOW SUICIDAL REGIONS

Adjunct Research Fellow, National Evidence based healthcare Collaborating Agency, Seoul, Republic of Korea Department of Psychiatry, HaeUnDae Paik Hospital, Inje University School of Medicine, Busan, Republic of Korea National Evidence based healthcare Collaborating Agency, Seoul, Republic of Korea Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea Research Fellow, National Health Insurance Service, Wonju, Republic of Korea Hanbyul Psychiatric Hospital, Gyeonggi-do, Republic of Korea
Innate sensitivity to stress facilitates inflammation, alters metabolism and shortens lifespan in a mouse model of social hierarchy

It is known that stress alters homeostasis and may lead to accelerated aging. However, little is known about the contribution of innate susceptibility to stress to the deterioration of physiological functions, acceleration of aging and developing of age-related diseases. By using socially-submissive stress susceptible (Sub) and socially-dominant stress resilient (Dom) selectively bred mouse model we observed a marked reduction in the lifespan of both male and female Sub mice. We found that innate susceptibility to stress correlates with chronic inflammation, development of splenomegaly and a significant increase in the levels of circulating pro-inflammatory cytokines IL-1β and IL-6. Furthermore, Sub mice showed a marked hypoglycemia, reduction of insulin levels, increase in GSK3 activity and elevation of IGF-1 serum levels, as well as low skin surface temperature and body weight. Interestingly, lifelong exposure of Sub mice to chronic mild stress did not further reduce their lifespan, indicating a high level of intrinsic stress. Taken together, our data reveal that social submissiveness coupled with innate stress sensitivity coincides with inflammation, leading to the deterioration of physiological functions and early aging independent of whether an individual is exposed to stress or not.
Biomechanical Behavior of a Novel Composite Intervertebral Body Fusion Device

Purpose: Low back pain related to intervertebral disc (IVD) degeneration represents a socio-economic problem which affects quality of life. In order to solve this problem the current gold standard techniques such as spinal arthroplasty and arthrodesis (or fusion) are considered. As for spinal arthroplasty, over the past 40 yrs, IVD prostheses have been designed to maintain the correct IVD spacing and to allow for motion, while providing stability. However, there are many difficulties in incorporating important features such as viscoelastic and shock absorber behavior of natural IVDs in a prosthetic disc design. Moreover, in some cases, the use of IVD prostheses does not represent the ideal solution. Consequently, the aim of this study was to improve the design of alternative devices for spinal fusion, which overcome the problems related to metal ones currently available on the market, such as stress shielding, stress concentration effects and eventual bone corrosive or inflammatory reaction. Methods: Accordingly, a novel polyetherimide (PEI)-based cage reinforced with carbon fibers through filament winding and compression molding technologies was realized. Results: The characterization through a porcine model has produced very interesting results. The small values obtained from local compression tests have suggested that a reduction in mobility occurred, whereas distributed compression tests on IVDs prosthesized by employing the PEI-based cage reinforced with carbon fibers have highlighted a compressive stiffness of 100 MPa. This stiffness is lower than that of the IVD prosthesized through the titanium cage (146 MPa), and closer to the stiffness of natural porcine IVDs (90 MPa). Conclusions: Through a suitable composite cage design it is possible to control stress-strain distributions and the mechanical signals to bone, thus avoiding the stress-shielding phenomena, but also corrosion and metal ions release which are typical of the metallic implants. (Journal of Applied Biomaterials & Biomechanics 2008; 6: 163-9)
Insulin‐induced membrane permeability to glucose in human muscles at rest and following exercise

Increased insulin action is an important component of the health benefits of exercise, but its regulation is complex and not fully elucidated. Previous studies of insulin‐stimulated GLUT4 translocation to the skeletal muscle membrane found insufficient increases to explain the increases in glucose uptake. By determination of leg glucose uptake and interstitial muscle glucose concentration, insulin‐induced muscle membrane permeability to glucose was calculated 4 h after one‐legged knee‐extensor exercise during a submaximal euglycaemic–hyperinsulinaemic clamp. It was found that during submaximal insulin stimulation, muscle membrane permeability to glucose in humans increases twice as much in previously exercised vs. rested muscle and outstrips the supply of glucose, which then becomes limiting for glucose uptake. This methodology can now be employed to determine muscle membrane permeability to glucose in people with diabetes, who have reduced insulin action, and in principle can also be used to determine membrane permeability to other substrates or metabolites.
Evaluation of dentine thickness of middle mesial canals of mandibular molars prepared with rotary instruments: a micro-CT study.

AIM To evaluate, using micro-CT, the remaining dentine thickness after preparation of the mesiobuccal (MB), mesiolingual (ML) and middle mesial (MM) canals of mandibular first molars with the ProTaper Next rotary system. METHODOLOGY Eleven mesial roots of mandibular first molars having 3 independent canals from the furcation level up to at least 5 mm towards the apical direction were selected. Preparation of MM canals was performed in 2 steps using ProTaper Next X2 (step 1) and X3 (step 2) instruments, while MB and ML canals were prepared in a single step up to X3 instruments. The roots were scanned (pixel size of 10 µm) before and after each step and the dentine volume was calculated. Postoperative models of the roots were coregistered with their preoperative dataset and colour-coded cross-sections of the roots were used to measure the smallest dentine thickness of each canal at 1.0-mm intervals from the furcation level up to 5 mm in the apical direction, in both mesial and distal aspects of the roots. Changes in the remaining wall thickness between mesial canals were analysed with repeated-measures ANOVA and post hoc Tukey test. Significance level was set at 5%. RESULTS Mean percentage reduction of dentine volume after steps 1 and 2 was 4.66% and 5.16%, respectively. Overall, pre- and post-operative dentine thickness of the MM canal walls, in both mesial and distal aspects of the root, were significantly thinner than those of MB and ML canals (p < 0.05). No significant difference was observed when comparing dentine thickness in the mesial and distal directions of MM canal after preparation step 1 (0.88 ± 0.18 mm and 0.73 ± 0.26 mm, respectively) or 2 (0.83 ± 0.17 mm and 0.67 ± 0.26 mm, respectively) (p> 0.05). Dentine thickness values less than 0.5 mm were observed mostly towards the distal aspect of the MM canal. Mesial roots were not associated with strip perforations after canal preparation procedures. CONCLUSIONS A significant decrease in the thickness of canal walls at all levels evaluated in the mesial roots of mandibular molars suggests that files with smaller taper should be used in preference to instruments with large taper to prepare mesial canal in mandibular molars.
The association between socioeconomic position and tumour size, grade, stage, and mortality in Danish sarcoma patients – A national, observational study from 2000 to 2013

Abstract Background: Survival in sarcoma patients depends on a range of prognostic factors. An association between cancer survival and socioeconomic position is known for several other cancers. We therefore examined the relations between three socioeconomic factors and risk of presenting with known tumour related prognostic factors, and the overall mortality of the different socioeconomic and prognostic factors in 1919 patients diagnosed with sarcoma in Denmark 2000–2013. Material and methods: Patients with sarcoma in extremities or trunk wall aged 30 years or more at diagnosis were identified in the Danish Sarcoma Registry and linked on an individual level to Danish national registries. We obtained data on educational level, disposable income and cohabitation status. Odds ratios (ORs) were estimated for the association between the socioeconomic factors and grade, stage and tumour size. Hazard ratios (HRs) were estimated using Cox proportional hazard models. Results: In adjusted analyses, educational level, income and cohabitation status were not associated with high grade or dissiminated stage at time of diagnosis. However, living alone was statistically significantly associated with having a large soft tissue sarcoma (≥5 cm) at time of diagnosis (OR 1.51; CI1.12–2.03). The overall mortality was statistically significantly increased in the group of patients with ≤10 years of education (HR 1.27; CI 1.02–1.57), in patients with the 20% lowest income (HR 1.30; CI 1.00–1.67) and nearly in patients living alone (HR 1.16; CI 0.99–1.36). Conclusion: In this nationwide, multicentre, population-based study, soft tissue sarcoma patients living alone had greater risk of having a large tumour at time of diagnosis. Soft tissue and bone sarcoma patients with a short education, low income, or living alone, had a higher mortality. This might indicate that the social differences in mortality might be related to treatment aspects and the biology of the disease rather that the diagnostic process.
Diagnosis and Management of Osteomyelitis Associated With Stage 4 Pressure Ulcers: Report of a Query to the Emerging Infections Network of the Infectious Diseases Society of America.

Background Few studies exist to guide the management of patients with stage 4 pressure ulcers with possible underlying osteomyelitis. We hypothesized that infectious disease (ID) physicians would vary widely in their approach to such patients. Methods The Emerging Infections Network distributed a 10-question electronic survey in 2018 to 1332 adult ID physicians in different practice settings to determine their approach to such patients. Results Of the 558 respondents (response rate: 42%), 17% had managed no such patient in the past year. Of the remaining 464 respondents, 60% usually felt confident in diagnosing osteomyelitis; the strongest clinical indicator of osteomyelitis reported was palpable or visible bone at the ulcer base. Approaches to diagnosing osteomyelitis in patients with visible and palpable bone varied: 41% of respondents would assume osteomyelitis, 27% would attempt pressure off-loading first, and 22% would perform diagnostic testing immediately. Preferred tests for osteomyelitis were bone biopsy (for culture and histopathology) and magnetic resonance imaging. Respondents differed widely on favored route(s) (intravenous, oral, or both) and duration of antimicrobial therapy but would treat longer in the absence, vs presence, of full surgical debridement (P < .001). Overall, 62% of respondents opined that osteomyelitis under stage 4 pressure ulcers is usually or almost always treated excessively, and most (59%) suggested multiple topics for future research. Conclusions Regarding osteomyelitis underlying stage 4 pressure ulcers, ID physicians reported widely divergent diagnostic and treatment approaches. Most of the reported practice is not supported by the available evidence, which is quite limited and of low quality.
Systematic Enzyme Mapping of Cellular Metabolism by Phasor-Analyzed Label-Free NAD(P)H Fluorescence Lifetime Imaging

In the past years, cellular metabolism of the immune system experienced a revival, as it has become clear that it is not merely responsible for the cellular energy supply, but also impacts on many signaling pathways and, thus, on diverse cellular functions. Label-free fluorescence lifetime imaging of the ubiquitous coenzymes NADH and NADPH (NAD(P)H-FLIM) makes it possible to monitor cellular metabolism in living cells and tissues and has already been applied to study metabolic changes both under physiologic and pathologic conditions. However, due to the complex distribution of NAD(P)H-dependent enzymes in cells, whose distribution continuously changes over time, a thorough interpretation of NAD(P)H-FLIM results, in particular, resolving the contribution of various enzymes to the overall metabolic activity, remains challenging. We developed a systematic framework based on angle similarities of the phase vectors and their length to analyze NAD(P)H-FLIM data of cells and tissues based on a generally valid reference system of highly abundant NAD(P)H-dependent enzymes in cells. By using our analysis framework, we retrieve information not only about the overall metabolic activity, i.e., the fraction of free to enzyme-bound NAD(P)H, but also identified the enzymes predominantly active within the sample at a certain time point with subcellular resolution. We verified the performance of the approach by applying NAD(P)H-FLIM on a stromal-like cell line and identified a different group of enzymes that were active in the cell nuclei as compared to the cytoplasm. As the systematic phasor-based analysis framework of label-free NAD(P)H-FLIM can be applied both in vitro and in vivo, it retains the unique power to enable dynamic enzyme-based metabolic investigations, at subcellular resolution, in genuine environments.