Miracle-dz/UniFAR-FTUs huggingface dataset:
Case Reports: Multifaceted Experiences Treating Youth with Severe Obesity

The management of youth with severe obesity is strongly impacted by social determinants of health and family dynamics. We present case studies of three patients seen in our tertiary care obesity treatment clinic as examples of the challenges faced by these patients and their families, as well as by the medical team. We discuss how these cases illustrate potential barriers to care, the role of child protective services, and we reflect upon lessons learned through the care of these patients. These cases highlight the need for comprehensive care in the management of youth with severe obesity, which can include: visits to multiple medical specialists, and mental and behavioral health providers; school accommodations; linkage to community resources; and, potentially, child protective services involvement. Through the care of these youth, our medical team gained more experience with using anti-obesity medications and meal replacements. The care of these youth also heightened our appreciation for the integral role of mental health services and community-based resources in the management of youth with severe obesity.
Molecular Responses of Maize Shoot to a Plant Derived Smoke Solution

Plant-derived smoke has effects on plant growth. To find the molecular mechanism of plant-derived smoke on maize, a gel-free/label-free proteomic technique was used. The length of root and shoot were increased in maize by plant-derived smoke. Proteomic analysis revealed that 2000 ppm plant-derived smoke changed the abundance of 69 proteins in 4-days old maize shoot. Proteins in cytoplasm, chloroplast, and cell membrane were altered by plant-derived smoke. Catalytic, signaling, and nucleotide binding proteins were changed. Proteins related to sucrose synthase, nucleotides, signaling, and glutathione were significantly increased; however, cell wall, lipids, photosynthetic, and amino acid degradations related proteins were decreased. Based on proteomic and immunoblot analyses, ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO) was decreased; however, RuBisCO activase was not changed by plant-derived smoke in maize shoot. Ascorbate peroxidase was not affected; however, peroxiredoxin was decreased by plant-derived smoke. Furthermore, the results from enzyme-activity and mRNA-expression analyses confirmed regulation of ascorbate peroxidase and the peroxiredoxinin reactive oxygen scavenging system. These results suggest that increases in sucrose synthase, nucleotides, signaling, and glutathione related proteins combined with regulation of reactive oxygen species and their scavenging system in response to plant-derived smoke may improve maize growth.
Oncogenes calling on a lysosomal Ca2+ channel

Oncogene‐dependent cancers upregulate and use lysosomal biogenesis for nutrient supply. It is unclear which lysosomal proteins and functions are essential for cell proliferation and tumor growth. A study by Jung et al in this issue of EMBO Reports shows that increased levels of the lysosomal Ca2+ release channel TRPML1 and its activator PI(3,5)P2 in HRASG12V‐dependent tumors are essential for cell proliferation and tumor growth . Notably, genetic and pharmacological inhibition of TRPML1 is equally effective in suppressing HRASG12V‐dependent tumors.
Patrón de Brugada: Estratificación del riesgo de muerte súbita

El síndrome de Brugada ha sido relacionado históricamente a muerte súbita; sin embargo, el diagnóstico y estimación de riesgo puede ser impreciso y variable en razón a los factores de riesgo cardiovascular, comorbilidad y evolución clínica inesperada. Se presenta el caso de un varón de 72 años admitido en el Área de emergencia con electrocardiograma sugestivo de patrón de Brugada tipo I y sincope luego de recibir propafenona “pill in the pocket”, revisando las controversias respecto al implante de un cardio desfibrilador.
Soft crystal martensites: An in situ resonant soft x-ray scattering study of a liquid crystal martensitic transformation

The martensitic nature of soft crystals is captured by soft x-ray scattering, broadening the analogy with atomic crystal systems. Liquid crystal blue phases (BPs) are three-dimensional soft crystals with unit cell sizes orders of magnitude larger than those of classic, atomic crystals. The directed self-assembly of BPs on chemically patterned surfaces uniquely enables detailed in situ resonant soft x-ray scattering measurements of martensitic phase transformations in these systems. The formation of twin lamellae is explicitly identified during the BPII-to-BPI transformation, further corroborating the martensitic nature of this transformation and broadening the analogy between soft and atomic crystal diffusionless phase transformations to include their strain-release mechanisms.
Network Pharmacology and Traditional Chinese Medicine: Development of Anti-Diabetic Therapies

Partly due to the failure of single-target drugs, diabetes mellitus, a chronic metabolic disease with complex pathogenesis and long-term medication requirements, is increasing in prevalence worldwide and urgently needs multi-component and multi-target treatments. Traditional Chinese herbs are the principal drug of Chinese medicine, which is effective against diabetes. However, Chinese herbs’ mechanism of action is difficult to elucidate due to its multiple components and multi-target effects. Based on the theories of systems biology and biological network equilibrium, network pharmacology could be applied to study disease mechanism and drug efficacy. This review postulates that network pharmacology may play a key role in revealing the anti-diabetic mechanism of Traditional Chinese Medicine (TCM) and will have potential effects on the modernization of TCM.
A case of fatal acute fatty liver of pregnancy and literature review

The process of Beta-oxidation of fatty acids in hepatic mitochondria is a complex sequence of events requiring several essential enzymes: mitochondrial trifunctional protein and its alpha-subunit, long-chain 3-hydroxyacylCoA dehydrogenase(LCHAD), are the two enzymes of this metabolic process, whose autosomally inherited genetic mutations are most closely associated with AFLP, especially the G1548C mutation of LCHAD.
A review on the advancements in the field of upper limb prosthesis

Abstract Amputation is one of the serious issue across the globe which is mainly caused by trauma, medical illness or congenital condition. Because of steep increase in amputation incidences, the need for progress in technicality of prosthesis is becoming imperative. In this article, the journey of advancements in upper arm prosthesis has been discussed step by step. Moreover, it has also been enunciated that how from a simple replacement for an arm it now has reached the mark of giving a patient a fully functional limb with the help of sensors and myoelectric transducers that are able to translate the remaining muscle signals into full movement of the prosthesis. However, researches are still going on to make the design of the prosthetic more impressive having better range of movement, to establish its interface with brain more efficiently and to make the control of prosthetic more user friendly. In this review, a special emphasis has also been given to myoelectric prosthesis as this prosthetic system possesses a decisive influence on rehabilitation results. Moreover, this prosthetic system is extremely elegant and cutting-edge in both design and technology and offers a great wearer comfort.
Fragment Hits: What do They Look Like and How do They Bind?

A “fragment hit”, a molecule of low molecular weight that has been validated to bind to a target protein, can be an effective chemical starting point for a drug discovery project. Our ability to find and progress fragment hits could potentially be improved by enhancing our understanding of their binding properties, which to date has largely been based on tacit knowledge and reports from individual projects. In the work reported here, we systematically analyzed the molecular and binding properties of fragment hits using 489 published protein–fragment complexes. We identified a number of notable features that these hits tend to have in common, including preferences in buried surface area upon binding, hydrogen bonding and other directional interactions with the protein targets, structural topology, functional-group occurrence, and degree of carbon saturation. In the future, taking account of these preferences in designing and selecting fragments to screen against protein targets may increase the chances of success in fragment screening campaigns.
Papel do Transplante Hepático no Tratamento do Colangiocarcinoma

2 Lista de abreviaturas . 3 Introdução . 4 Métodos . 4 Definição e classificação . 5 Epidemiologia . 7 Etiologia e fatores de risco . 7 Fisiopatologia . 8 Manifestações clínicas . 9 Diagnóstico . 10 Estadiamento . 11 Tratamento . 12 Transplante hepático . 13 Estudos primordiais – pré-protocolo da Mayo Clinic . 14 Ponto de Viragem – Protocolo da Mayo Clinic . 15 Experiência nos EUA – além da Mayo Clinic . 19 Experiência na Europa . 21 Experiência no Oriente . 23 Realidade atual . 24 Critérios e abordagem atuais . 25 Conclusão . 28 Referências Bibliográficas . 29
Prescription Pattern of Proton Pump Inhibitors at Hospital Admission and Discharge

Background: Proton pump inhibitors (PPI) have reportedly been used in inappropriate clinical settings, often leading to an increased risk of adverse effects, drug interactions, and costs. Aim: The aim of this study was to evaluate the adequacy of PPI prescription in an internal medicine ward. Methods: The discharged home inpatients of a segment in the medicine department of a central hospital in the first trimester of 2017 were evaluated; those who died or were transferred to another unit were excluded. Data on gender, age, admission, and discharge therapy and diagnoses which could support PPI use were collected from clinical records. Statistical analysis was performed using Microsoft Excel 2013® and IBM SPSS Statistics 20®. Results: A total of 318 hospitalizations were included, corresponding to 301 patients; 171 (56.8%) were female and the average age was 75.4 ± 14.6 years. Among the 318 hospitalizations, 148 patients (46.5%) were on PPI at admission and 175 (55%) at discharge, the majority of them without indication (n = 91, 61.5% vs. n = 109, 62.3%). The main inappropriate indication was anticoagulation alone (n = 33, 36.3% vs. n = 43, 39.4%). There was indication for PPI therapy in 93 (29.2%) of the cases at admission and 111 (34.9%) at discharge, mostly for prophylaxis of gastrointestinal bleeding in high-risk patients (n = 82, 88.2% vs. n = 96, 86.5%). Among those with indication, 57 (61.3%) were medicated at admission versus 66 (59%) at discharge. The association between PPI therapy and an indication for its prescription was lost by the time of discharge (p = 0.245). Conclusions: PPI prescription is not in agreement with existing recommendations, which is why it should be revised at hospital discharge. The primary indication for PPI therapy is the prophylaxis of gastrointestinal bleeding in high-risk patients and the main inappropriate indication is prophylaxis in low-risk patients. A large proportion of the patients indicated for PPI use were discharged without prescription.
Nonlinear analysis of coronary artery disease, myocardial infarction, and normal ECG signals

In this study, we analyze nonlinear feature extraction methods in terms of their ability to support the diagnosis of coronary artery disease (CAD) and myocardial infarction (MI). The nonlinear features were extracted from electrocardiogram (ECG) signals that were measured from CAD patients, MI patients as well as normal controls. We tested 34 recurrence quantification analysis (RQA) features, 14 bispectrum, and 136 cumulant features. The features were extracted from 10,546 normal, 41,545 CAD, and 40,182 MI heart beats. The feature quality was assessed with Student’s tt-test and the tt-value was used for feature ranking. We found that nonlinear features can effectively represent the physiological realities of the human heart.
Histopathological changes of gastric mucosa in celiac disease

Introduction: Celiac disease (CD) is a chronic autoimmune disease caused by ingestion of gluten in genetically susceptible individuals. Lymphocytic gastritis (LG) can be found in CD patients, with possible lower incidence of chronic Helicobacter pylori (Hp) positive gastritis. Aim: The aim was to assess the frequency and type of histopathological changes of gastric mucosa in patients with proven CD. Material and methods: This study included patients who underwent esophagogastroduodenoscopy (EGDS) and histopathological examination. Patients were distributed into two groups: patients with and without histopathological alterations indicative of CD. Results: The study included 351 patients. CD was detected in 145 (41.3%) patients, while the control group consisted of 206 (58.7%) patients without CD confirmation. The most common symptom in CD patients was diarrhea, while patients in the control group most often complained of dyspepsia, fatigue and bloating (p = 0.001). Chronic superficial gastritis was the most common gastritis in both groups of patients (76% and 63.6%; p > 0.05). Gastritis associated with Hp infection was present in 29.3% of CD patients, which is significantly less than in people without CD where 62% of gastritis is associated with Hp infection (p < 0.001). In this study we haven't discovered other forms of gastritis. Patients with CD had significantly lower incidence of Hp infection compared to the control group (15.7% vs. 37.9%; p < 0.001). Marsh IIIa degree was significantly more prevalent in Hp- patients compared to Hp+ patients (39.8% vs. 9.1%; p=0.005). Marsh IIIc was more prevalent in Hp+ patients (63.6% prema 35%; p = 0.011). The presence of Hp infection affects the degree of damage to duodenal mucosa (p = 0.011). Conclusion: The prevalence of Hp infection was significantly lower in CD patients. The higher degree of damage to duodenal mucosa in Hp+ CD patients may contribute to the possible synergistic effect of infection and autoimmunity in CD.
Gender differences in prescribing of zolpidem in the Veterans Health Administration.

OBJECTIVES Use of nonbenzodiazepine sedative hypnotics, especially zolpidem, has grown substantially, raising concerns about safety. Here, we evaluated prescribing patterns of zolpidem in the Veterans Health Administration. STUDY DESIGN A cross-sectional study of veterans receiving zolpidem in the outpatient setting from October 1, 2011, to September 30, 2016. METHODS The study population consisted of 500,332 zolpidem users (58,598 women and 441,734 men) and a random 10% sample (n = 631,449) of nonusers. We examined 2 outcomes related to inappropriate prescribing: high-dose zolpidem prescribing and overlap with benzodiazepines. We generated interrupted time series and logistic regression models to analyze these outcomes in men and women separately. RESULTS In 2016, 29.7% of female veterans received an inappropriately high guideline-discordant dosage compared with 0.1% of male veterans (P <.001 for all reported comparisons). Furthermore, more women than men had overlapping benzodiazepine and zolpidem prescriptions (18.8% vs 14.3%). In fully adjusted models, inappropriately high doses were more commonly received by younger women (adjusted odds ratios [AORs]: 2.75 for 21-39 years and 2.97 for 40-49 years compared with ≥80 years) and women with substance use disorder (AOR, 1.48). In the second inappropriateness outcome models, women with anxiety (AOR, 2.28) or schizophrenia (AOR, 2.05) and men with cancer (AOR, 1.42), anxiety (AOR, 2.66), or schizophrenia (AOR, 2.46) were more likely to receive an overlapping prescription of zolpidem and benzodiazepines. CONCLUSIONS We found evidence of inappropriate zolpidem prescribing among veterans, particularly women. Greater understanding of the drivers of this inappropriate prescribing is necessary to develop interventions to promote safer, more guideline-concordant prescribing.
Effect of Paired Associative Stimulation on Corticomotor Excitability in Chronic Smokers

Chronic smoking has been shown to have deleterious effects on brain function and is an important risk factor for ischemic stroke. Reduced cortical excitability has been shown among chronic smokers compared with non-smokers to have a long-term effect and so far no study has assessed the effect of smoking on short-term motor learning. Paired associative stimulation (PAS) is a commonly used method for inducing changes in excitability of the motor cortex (M1) in a way that simulates short-term motor learning. This study employed PAS to investigate the effect of chronic cigarette smoking on plasticity of M1. Stimulator output required to elicit a motor-evoked potential (MEP) of approximately 1 mV was similar between the groups prior to PAS. MEP response to single pulse stimuli increased in the control group and remained above baseline level for at least 30 min after the intervention, but not in the smokers who showed no significant increase in MEP size. The silent period was similar between groups at all time points of the experiment. This study suggests that chronic smoking may have a negative effect on the response to PAS and infers that chronic smoking may have a deleterious effect on the adaptability of M1.
Mucins: the Old, the New and the Promising Factors in Hepatobiliary Carcinogenesis

Mucins are large O-glycoproteins with high carbohydrate content and marked diversity in both the apoprotein and the oligosaccharide moieties. All three mucin types, trans-membrane (e.g., MUC1, MUC4, MUC16), secreted (gel-forming) (e.g., MUC2, MUC5AC, MUC6) and soluble (non-gel-forming) (e.g., MUC7, MUC8, MUC9, MUC20), are critical in maintaining cellular functions, particularly those of epithelial surfaces. Their aberrant expression and/or altered subcellular localization is a factor of tumour growth and apoptosis induced by oxidative stress and several anti-cancer agents. Abnormal expression of mucins was observed in human carcinomas that arise in various gastrointestinal organs. It was widely believed that hepatocellular carcinoma (HCC) does not produce mucins, whereas cholangiocarcinoma (CC) or combined HCC-CC may produce these glycoproteins. However, a growing number of reports shows that mucins can be produced by HCC cells that do not exhibit or are yet to undergo, morphological differentiation to biliary phenotypes. Evaluation of mucin expression levels in precursors and early lesions of CC, as well as other types of primary liver cancer (PLC), conducted in in vitro and in vivo models, allowed to discover the mechanisms of their action, as well as their participation in the most important signalling pathways of liver cystogenesis and carcinogenesis. Analysis of mucin expression in PLC has both basic research and clinical value. Mucins may act as oncogenes and tumour-promoting (e.g., MUC1, MUC13), and/or tumour-suppressing factors (e.g., MUC15). Given their role in promoting PLC progression, both classic (MUC1, MUC2, MUC4, MUC5AC, MUC6) and currently tested mucins (e.g., MUC13, MUC15, MUC16) have been proposed to be important diagnostic and prognostic markers. The purpose of this review was to summarize and update the role of classic and currently tested mucins in pathogenesis of PLC, with explaining the mechanisms of their action in HCC carcinogenesis. It also focuses on determination of the diagnostic and prognostic role of these glycoproteins in PLC, especially focusing on HCC, CC and other hepatic tumours with- and without biliary differentiation.
A Study of Catalytic Oxidation of a Library of C2 to C4 Alcohols in the Presence of Nanogold

The classical stoichiometric oxidation of alcohols is an important tool in contemporary organic chemistry. However, it still requires huge modifications in order to comply with the principles of green chemistry. The use of toxic chemicals, hazardous organic solvents, and the large amounts of toxic wastes that result from the reactions are a few examples of the problems that must be solved. Nanogold alone or conjugated with palladium were supported on different carriers (SiO2, C) and investigated in order to evaluate their catalytic potential for environmentally friendly alcohol oxidation under solvent-free and base-free conditions in the presence H2O2 as a clean oxidant. We tested different levels of Au loading (0.1–1.2% wt.) and different active catalytic site forms (monometallic Au or bimetallic Au–Pd sites). This provided new insights on how the structure of the Au-dispersions affected their catalytic performance. Importantly, the examination of the catalytic performance of the resulting catalysts was oriented toward a broad scope of alcohols, including those that are the most resistant to oxidation—the primary aliphatic alcohols. Surprisingly, the studies proved that Au/SiO2 at a level of Au loading as low as 0.1% wt. appeared to be efficient and prospective catalytic system for the green oxidation of alcohol. Most importantly, the results revealed that 0.1% Au/SiO2 might be the catalyst of choice with a wide scope of utility in the green oxidation of various structurally different alcohols as well as the non-activated aliphatic ones.
Mentor Development Program for Critical Care Nurses: A Key to Staff Development and Improvement in New Graduate Orientation

The mean age of the nursing workforce has increased over the last 25 years and as a result a nursing shortage is developing because these nurses are now retirement age. Precepting in a clinical setting has become a necessary method for orientation of graduate nurses with preceptors not receiving necessary training or compensation. After completion of a successful orientation it is important to give new graduate nurses continued support and encouragement while providing a safe learning environment. Research in small cohort studies has begun to demonstrate the importance of precepting programs and the development of mentor relationships as assisting in new graduate nurse retention and staff satisfaction. As a new graduate is mentored into a facility they have a greater appreciation of the organization mission and value system and also learn to promote nursing as a profession. This performance improvement project is intended to promote a mentor development program for critical care nurses. After attending a mentorship class, the nurse will be able to utilize skills and theories based on adult learning principles to develop mentor relationships with new graduate nurses and thus increase staff satisfaction and