Miracle-dz/UniFAR-FTUs huggingface dataset:
Depressed 3-Adrenergic Receptor- and Endothelium-Mediated Vasodilation in Conscious Dogs With Heart Failure

Peripheral vasodilator responsiveness was examined in pacing-induced heart failure (HF) in 11 conscious dogs chronically instrumented for measurement of systemic (total peripheral resistance [TPR]) and local (iliac blood flow) vascular resistance. Dose responses to isoproterenol (ISO), acetylcholine (ACh), and nitroglycerin (NTG) were examined in the same dogs before pacing (control) and after 4 to 7 weeks of rapid ventricular pacing, which induced congestive HF, characterized by increased left ventricular end-diastolic pressure (6.7+±0.4 [control] versus 28±+1.5 [HF] mm Hg) and decreased cardiac output (-30+5%) and left ventricular dP/dt (-53+±3%), as well as ascites and peripheral edema. In the control state, TPR fell by 57+2% in response to ISO (100 ng/kg), by 61±3% in response to ACh (3 pg/kg), and by 55±2% in response to NTG (10 jig/kg). In HF, smaller decreases (P<.05) in TPR were observed with the same doses of ISO (-50+2%) and ACh (-49±2%) but not with NTG (-58+3%). Depressed responses to systemic ISO and ACh, but not NTG, were observed in HF in the presence of ganglionic blockade and also after local administration of smaller doses of the drugs in the absence of ganglionic blockade, but where systemic effects were not elicited. Inhibition of nitric oxide synthase increased TPR to a greater degree before HF (+154±28% [control]) than after (+80±22% [HF]) and eliminated the depressed responses to ACh but not to ISO. J3-Adrenergic receptor density, as determined by 1251-cyanopindolol binding in membrane preparations from mesenteric vessels was significantly decreased after HF (130±3 [control] versus 100±8 [HF] fmol/mg, P<.05) without any change in affinity. Thus, peripheral vascular f3-adrenergic receptor downregulation occurs in HF, independent of altered endothelium-mediated peripheral vasodilation. (Circ Res. 1993;73:1013-1023.)
In times of crisis , go liquid ! opyright

DOI:10.1097/CCO.0000000000000084 These are exciting times, with the continuous development of new technologies capable of gathering increasing amounts of data and ultimately of challenging our current approaches to cancer care! One of these technologies is next-generation sequencing, which allows us to characterize the genomic alterations of tumor tissue. By revealing driver mutations within every single tumor, this technology has raised tremendous medical interest and has generated a veritable ‘gold rush’ towards the sequencing of tumor biopsies. The hope is to make discoveries that could influence clinical decision making. In practice, however, biopsies are not always able to inform us adequately enough in this process. The results of the analysis of a tumor sample can be potentially misleading, not because the information received from the analysis is incorrect, but because in many cases it is incomplete and only represents a snapshot – both in time and in space – of what is really happening within a patient’s whole tumor bulk. It has become clear that a tumor is not just one disease, but rather a heterogeneous group of altered clones that evolve continuously and concurrently and are being selected over time. Consequently, a biopsy taken from a specific metastasis may not always represent clones present in another metastatic lesion. Furthermore, multiple biopsies taken from a single tumor lesion have been shown to be extremely diverse [1], raising questions such as ‘How many biopsies are needed to obtain a clear view of this so-called ‘‘genomic landscape’’ within one patient? ’. Some lesions are not accessible by any reasonable means. Biopsies involve invasive procedures and are not always without risk for the patient [2]. Depending on the size of the acquired tissue and the tumor cellularity, the biopsy procedure does not always result in a successful genomic analysis. Moreover, the decision of which biopsy to take is rarely guided by whether a lesion is demonstrated to be active, but rather by the accessibility of its location, which can obviously limit the information we glean about tumor behavior. Many pitfalls undermine the extensive genomic analysis of tumor biopsies aimed at guiding patient management, the concept of which remains unsupported by available data. Therefore, other approaches are being investigated that might circumvent the limitations of these invasive procedures and offer a
Exercise Testing and Training Strategies for Healthy and Frail Elderly

BACKGROUND A pproximately one American turns 65 years old every 8 seconds, and this trend is projected to continue until the year 2029 (7). The American College of Sports Medicine (ACSM) defines an older adult as any individual older than 65 years or any individual between the ages of 50 and 64 years with clinically significant conditions or physical limitations that influence movement, physical fitness, or physical activity (19). This definition accurately reflects the heterogeneity within the older population. Chronological age, the passage of time in years since birth, is a poor indicator of an individual’s true health status (9). Biological or physiological aging reflects changes in structures and functioning of the human body that affect an individual’s ability to survive or an individual’s appearance (9). Aging, the loss of functional reserve capacity, is a universal process that occurs in everyone, whereas disease is a selective process and not considered part of the aging process. Aging and disease are coupled with more than 50% of all older adults having at least one chronic condition (7), such as hypertension, atherosclerotic cardiovascular disease, cancers, chronic obstructive pulmonary disease, type 2 diabetes mellitus, osteoarthritis, and osteoporosis (2). Frailty is an age-associated physiological syndrome that results from the reduction in functional reserve capacity of multiple organ systems (6,13). Death, institutionalization, disability, high morbidity, acute illness, and increased health care use highlight the vulnerability of frail older adults (13). Exercise has been shown to prevent and/or remediate the inevitable loss of functional reserve capacity, the increased probability of comorbidity and disability, and the potential of becoming frail as one ages. This column presents exercise testing and training strategies specific for both healthy aging and the frail older adult.
Tissue regeneration in composite injury models of limb trauma

Severe extremity trauma often results in large zones of injury comprising multiple types of tissue and presents many clinical challenges for reconstruction. Considerable investigation is ongoing in tissue engineering and regenerative medicine therapeutics to improve reconstruction outcomes; however, the vast majority of musculoskeletal trauma models employed for testing the therapeutics consist of single-tissue defects, offering limited utility for investigating strategies for multi-tissue repair. Here we present the first model of composite lower limb bone and nerve injury, characterized by comparison to well-established, single-tissue injury models using biomaterials-based technologies previously demonstrated to show promise in those models. Quantitative functional outcome measures were incorporated to facilitate assessment of new technologies to promote structural and functional limb salvage following severe extremity trauma. Nerve injury induced significant changes in the morphology and mechanical properties of intact bones. However, BMP-mediated segmental bone regeneration was not significantly impaired by concomitant nerve injury as evaluated via radiographs, microcomputed tomography (micro-CT), and biomechanical testing. Nor was nerve regeneration a Portions of this chapter were adapted from Uhrig BA, Clements IP, Boerckel JD, Huebsch N, Bellamkonda RV, Guldberg RE. Characterization of a composite injury model of severe lower limb bone and nerve trauma. J Tissue Eng Regen Med. 2012; [Epub ahead of print].
Correlation between the plasma level of MIF and its related gene -173G/C polymorphism and risk factors of atherosclerosis in pilots

Correlation between the plasma level of MIF and its related gene -173G/C polymorphism and risk factors of atherosclerosis in pilots DAI Chuan-fen, LIU Xing-de, LUO Hui-lan, LIU Fang-fang, NA Mei-jing, MOU Zong-yang Department of Cardiology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China Department of Cardiology, Cadre Ward of Air Force General Hospital, Beijing 100142, China Department of Geriatrics, Anqing Municipal Hospital, Anqing , Anhui 246000, China Department of Cardiology, Zhuanghe Central Hospital, Zhuanghe, Liaoning 116400, China Corresponding author, E-mail: luo-huilan@sina.com This work was supported by the Key Project of "Twelfth Five-Year Plan" Medical Science Foundation of PLA (BWS11J054) [Abstract] Objective To investigate the relationship between the plasma level of macrophage migration inhibiting factor (MIF) and its related gene -173G/C polymorphism and risk factors of atherosclerosis in pilots for reducing the risk of adverse cardiovascular events in early stage. Methods Four hundred and fifty-eight military pilots undergoing medical examination (pilot group), 51 patients with coronary heart disease (CHD group), and 194 persons undergoing routine health examination (control group) were selected as the subjects under investigation. Subjects in pilot group were further grouped according to the different aircraft type they were flying and their flight time. General clinical data of the three groups were collected. ELISA was used to determine the plasma levels of MIF. MIF -173 G/C (rs755622) was detected by Taqman probe method. The differences of genotype and allele frequencies among the three groups were analyzed. Results No significant difference was found in plasma levels of MIF between pilot group and CHD group (P>0.05), but the levels were significantly higher in the both groups than in the control group (P<0.05). No statistical significant difference in plasma MIF levels was found in different aircraft types and flight time subgroups (P>0.05). There was no significant difference in genotype and allele frequencies among the three group (P>0.05). There was no significant difference of plasma MIF, TC, TG concentrations in the pilots who were with CC, GG and CG genotypes, respectively (P>0.05). Conclusions MIF -173G/C polymorphism may have no significant correlation to the early susceptibility of MIF -173G/C
Nutritional, Phytochemical and Sensory Evaluation of “Mberiagworagwo” Traditional Food of Uruagunnewi People in Anambra State, Nigeria

Nutritional, phytochemical and sensory evaluation of “Mberiagworagwo” traditional food of 6 Uruagunnewi people in Anambra State, Nigeria was investigated using standard methods. Available 7 carbohydrates (79.60± 0.13%), crude fat (12.77±0.64%), crude protein (9.80±0.16%), total free fatty 8 acid (12.81±0.16%) and total vitamins (22.39± 2.04%) were among the nutrients found in the studied 9 food sample. Phytochemicals such as saponins, flavonoids, and tannins were discovered in the food. 10 “Mberiagworagwo” had improved sensory evaluation attribute in terms of aroma, taste, texture (mouth 11 feel) and colour when compared to other traditional foods. The overall acceptability of the traditional 12 food could be compared to those of other traditional foods. The presence of nutrients and 13 phytochemicals in “Mberiagworagwo” could be indication that the food maybe beneficial to the body 14 on consumption. This study has shown the nutritional, phytochemical and sensory evaluation of 15 “Mberiagworagwo” traditional food of Uruagunnewi people in Anambra State, Nigeria. 16
Sensitivity and specificity of a qualitative RNA detection assay to diagnose HIV infection in young infants

Objective:To evaluate the sensitivity and specificity of an RNA detection assay for diagnosing perinatal HIV infection. Methods:Plasma and serum specimens taken during the first 3 months of life from HIV-infected and uninfected children enrolled in a cohort study were assayed for HIV RNA using the qualitative nucleic acid sequence-based amplification (NASBA) kit. Sensitivity, specificity, and predictive values were calculated. NASBA results from infected children were compared with DNA PCR results from the same blood samples. Autoantibody patterns of suspected false-positive specimens were compared with those of subsequent specimens from the same child to exclude specimen labelling errors. Results:Amongst 131 specimens from 105 HIV-infected children, the sensitivity of the qualitative NASBA assay was 13 out of 34 [38%; 95% confidence interval (CI), 22–56] at < 7 days, 56 out of 58 (97%; 95% CI, 88–100) at 7–41 days, and 37 out of 39 (95%; 95% CI, 83–99) at 42–93 days of life. Of 252 specimens from 206 uninfected children, six tested positive and one tested indeterminate by NASBA. Four of these positive specimens had discordant autoantibody patterns suggesting mislabelling; excluding these, the test specificity was 245 out of 248 (99%; 95% CI, 97–100). Amongst 128 paired specimens from infected children, NASBA results were more often positive than those from DNA PCR (103 versus 92; P = 0.01). Amongst infants with specimens drawn in the first week of life, the proportion born after > 4 h of membrane rupture was greater amongst those testing negative (81%) than those testing positive (46%; P = 0.05). Conclusions:The qualitative NASBA RNA assay is highly specific and more sensitive than DNA PCR. Qualitative RNA assays may be useful for diagnosing and excluding perinatal HIV infection in children after the first week of life for such purposes as initiating antiretroviral therapy and other treatment, resolving parental uncertainty, determining timing of transmission, and providing endpoints for intervention trials.
Diet and bone health in postmenopausal women : a roadmap to the future policies

In this issue of the Journal, a cross-sectional study Mirzaei et al., found a positive association between adherence to the Mediterranean diet and bone density in postmenopausal women. They also reported an inverse association between the Western dietary pattern which is high in oil and butter, refined grain, organ meat, sugar, pickles, legume and soy, potato, salt and flavor, high fat dairy and starchy vegetables and bone density in postmenopausal women (1). It must be kept in mind that this study was in postmenopausal women. The result cannot be generalized to other population.
Evidence for multiple allograft rejection mechanisms within the same experimental system

Purpose of reviewAn appreciation for the complexity, diversity, and interplay of host immune pathways activated in response to transplanted organs challenges investigators and clinicians to develop new experimental and clinical approaches that take into account the multiplicity of immune responses. This review discusses the themes that have emerged from recent studies underscoring the rationale for modification of our experimental and conceptual approaches vis à vis transplantation immunity. Recent findingsRecent studies have highlighted the importance of considering specific aspects of the experimental system that can influence the dominance of particular immune molecule(s) or pathway(s) in the process of allograft rejection or acceptance. Studies from a variety of laboratories have highlighted one or more of the following features in determining activation of particular immune pathways and transplant outcome: recipient and donor genetics, recipient immune repertoire, local immune microenvironment, and the donor tissue itself. Our laboratory has explored the influence of these features upon transplant outcome using a single experimental system of cellular transplantation. This approach has permitted us to gain insight into the determinants of ‘immune choice’ among the array of choices available in a given experimental system. SummaryConsiderations were highlighted in this review with the intent of improving future experimental designs as well as the design of individualized and targeted clinical immunotherapies. The influence of these factors in activation of specific recipient immune responses will be relevant to the design of clinical therapeutic and ‘tolerogenic’ immunosuppressive strategies, immune monitoring of transplant recipients, and development of optimal immune conditions for cell transplant therapies and for engineered tissues.
Tibial plateau fractures in the elderly

In light of an ever-aging population, the incidence of osteoporotic fractures continues to rise. The challenges of reduction and fixation in osteopenic bone are well known to orthopaedic surgeons. Treatment of tibial plateau fractures in elderly patients must be individualized to the patient and his injury. Low-energy fractures in low-demand patients may best be treated nonoperatively with early mobilization. Higher-energy patterns or higher-demand patients should lead to stronger consideration of surgical treatment. Open reduction and internal fixation and definitive external fixation, with traditional external fixation or circular fixation are options. While arthroplasty has been used for many other osteopenic fractures, especially those of the proximal femur, the benefits and indications of acute arthroplasty for tibial plateau fractures are unknown. Soft-tissue compromise, prosthetic infection, and integrity of the extensor mechanism about arthroplasty components are concerns. The exact indications and benefits of each treatment remain unknown. We reviewed these treatments and the published data that support them.
Risk of deep vein thrombosis in patients undergoing knee arthroscopy

Background In this report we attempt to estimate the incidence of deep vein thrombosis in patients undergoing low-complexity knee arthroscopy and explore possible indications for anti-embolic prophylaxis according to the calculated probability of deep vein thrombosis. Methods This is a prospective cohort study. Subjects were adult patients undergoing low-complexity knee arthroscopy between September 2001 and November 2004. Patients with a diagnosis of deep vein thrombosis before the procedure and those who were receiving anticoagulant medications were excluded. Doppler ultrasound was performed 8 and 30 days after the procedure. Multivariate logistic regression model was used to calculate the probabilities of deep vein thrombosis depending on the presence or absence of risk factors. One hundred and four patients were included. Results The estimated incidence of deep vein thrombosis was 8.6% [95% confidence interval (CI) 3% to 14%]. Bivariate analysis showed an association between tourniquet duration time longer than 40 minutes and deep vein thrombosis (P=0.019). Multivariate logistic regression analysis confirmed that association (OR=14.7, 95% CI 1.4-157, P=0.02) and showed a trend towards significance for the association between hormonal therapy and deep vein thrombosis (OR=10.9, 95% CI 0.6-187, P=0.09). According to the logistic regression model, seven different clinical scenarios showed a high probability of deep vein thrombosis. Conclusions The risk of deep vein thrombosis in patients undergoing low-complexity knee arthroscopy may be high enough to justify antiembolic prophylaxis depending on the absence or presence of risk factors. Prolonged tourniquet duration time is associated with deep vein thrombosis. Level of Evidence Level II (prognostic study with patient enrollment at the same time in their disease process and completed follow-up for more than 80% of the patients).
Community-Based Rapid HIV Testing in Brazil for Vulnerable Populations:Whom are We Reaching?

Objective: Rapid HIV testing and counselling in community settings delivered by trained peers can allow easier access to and uptake of HIV testing and care. The programme 'Live Better Knowing' offers rapid HIV testing to key populations across Brazil. This cross-sectional study aims at describing the HIV prevalence in population subgroups and at assessing the association of sex work (SW) and/or drug use with a positive HIV result. Methods: Between January 2013 and April 2016, key populations were invited for HIV rapid oral fluid tests (DPP HIV- 1/2 Bio-Manguinhos/Fiocruz, Rio de Janeiro, Brazil) by peers. HIV testing was offered in identified venues and areas where these populations socialize. Participants were interviewed using a brief questionnaire about their socio-demographic and risk behaviour. Multivariable logistic regression was used to assess the effect of SW and/or drug use on the risk of HIV. Results: Among the 43,358 participants, 42.9% were ciswomen, 2.9% were transvestites, 2.7% were transgender, 19.8% were men who have sex with men (MSM) and 31.9% were heterosexual men. Overall, 52.1% were first-time HIV testers. The HIV prevalence among the ciswomen, transvestites, transgender people, MSM and heterosexual men was 0.9%, 7.2%, 4%, 3.4% and 1%, respectively. Individuals who performed SW and used drugs had the highest HIV prevalence within each population group (ciswomen 1.7%, transvestites 8.1%, transgender 7.4%, MSM 5.9% and heterosexual men 2.6%). The adjusted odds ratios with 95% confidence intervals for selling sex combined with drug use were 2.90 (1.21-6.96) in ciswomen, 25.01 (2.67-234.57) in transgender people and 2.42 (1.31-4.48) in MSM. Conclusion: This outreach programme attracted persons with high risk practices who had never been tested. Our findings suggest that transvestites and transgender people (particularly those who sell sex) constitute a high risk population for HIV in urgent need of enhanced prevention, treatment and care services.
AP 4-5 A new system to predict operative mortality in patients undergoing cardiac surgery : PCSS ( Post Cardiac Surgery Scale )

tween gastric and urinary methods of IAP monitoring during the study varied from -0.02 mm Hg (SD 4.2 mm Hg) to 0.83 mm Hg (SD 2.7 mm Hg). Conclusion: The surgical repair of ventral hernia is accompanied by 2-folds rise in IAP and parallel increase of ΔРаСО2-EtCO2 followed by decline in arterial oxygenation. These changes can be explained by the deterioration of respiratory function af ter the increase of IAP. The measurements of IAP using gastric tube and urinary catheter demonstrate a good agreement between both methods.
OBSTRUCTIVE AIRWAYS DISEASE Physical Therapy for Adults With Bronchiectasis

Bronchiectasis, or abnormal chronic dilatation of 1 or more bronchi, often results in a reduction in the effectiveness of mucociliary clearance. Physical therapy techniques can be used to augment mucociliary clearance; for example the active cycle of breathing techniques, autogenic drainage, positive expiratory pressure, oscillating positive expiratory pressure, and high-frequency chest wall oscillation. Reduced exercise capacity and breathlessness on exertion are also problems that may be experienced by people with bronchiectasis. There is a lack of rigorous clinical studies to demonstrate efficacy, but accumulated clinical experience demonstrates benefit from physical therapy for people with bronchiectasis.