Miracle-dz/UniFAR-FTUs huggingface dataset:
Proteasome-Dependent Degradation of Guanosine 5′-Triphosphate Cyclohydrolase I Causes Tetrahydrobiopterin Deficiency in Diabetes Mellitus

Background— Tetrahydrobiopterin (BH4) deficiency is reported to uncouple the enzymatic activity of endothelial nitric oxide synthase in diabetes mellitus. The mechanism by which diabetes actually leads to BH4 deficiency remains elusive. Here, we demonstrate that diabetes reduced BH4 by increasing 26S proteasome-dependent degradation of guanosine 5′-triphosphate cyclohydrolase I (GTPCH), a rate-limiting enzyme in the synthesis of BH4, in parallel with increased formation of both superoxide and peroxynitrite (ONOO−). Methods and Results— Exposure of human umbilical vein endothelial cells to high glucose concentrations (30 mmol/L D-glucose) but not to high osmotic conditions (25 mmol/L L-glucose plus 5 mmol/L D-glucose) significantly lowered the levels of both GTPCH protein and BH4. In addition, high glucose increased both the 26S proteasome activity and the ubiquitination of GTPCH. Inhibition of the 26S proteasome with either MG132 or PR-11 prevented the high glucose–triggered reduction of GTPCH and BH4. Ex.
Interprofessional education and practice guide: Developing interprofessional community-based clinical experiences

Abstract Substantial interprofessional learning opportunities engaging with complex patients must be available to health professional students to prepare them with the necessary knowledge and experiences to function as competent care providers. In community learning experiences, interprofessional teams can target vulnerable populations who face ongoing health disparities to maximize health impact and reduce over utilization of resources such as emergency room visits. Patients from vulnerable populations often present in community settings with multiple comorbidities, which benefit from a team approach focusing on prevention and enhancing the quality of life. The planning team at Florida Atlantic University’s Christine E. Lynn College of Nursing and the Charles E. Schmidt College of Medicine implemented a real-world community-based clinical experience, incorporating learners from other colleges and universities, professionals from community health centers and patients from homeless shelters to facilitate interprofessional learning over a three-year period. These practical clinical experiences reinforced the communication and leadership skills that are part of the Team Strategies and Tools to Enhance Performance and Patient Safety or TeamSTEPPSTM evidence-based curriculum, developed by the Agency for Healthcare Research and Quality. This guide outlines the steps and lessons learned, through incorporating team-based practice experiences for nursing, medicine, pharmacy, and social work students caring for vulnerable populations within community settings.
Ridge augmentation and endosseous implant placement with a staged approach

Rehabilitation of edentulous site in the maxillary anterior area is always associated with esthetic consideration as a primary factor, especially in female patients. Simultaneously, sufficient bone quantity and quality is required for survival of endosseous implant. Hence, it is prudent to do ridge augmentation for a horizontal defect in the anterior maxillary area. Insufficient bone volume can be augmented by different methods, including particulate and block grafting materials, guided bone regeneration with or without growth and differentiation factors, ridge splitting, and expansion and distraction osteogenesis, either alone or in combination. These techniques may be used for horizontal/vertical ridge augmentation, socket preservation, and sinus augmentation. Here, we present a case of horizontal ridge augmentation achieved with allograft material and staged implant placement.
Evaluation of patients treated for diabetic retinopathy: an analysis of the administrative databases of the Lazio Region

BACKGROUND: In Italy there are an estimated 4 million patients suffering from diabetes mellitus (DM). The most important ocular complication of DM is diabetic retinopathy (DR), which affects about one third of diabetic patients.AIMS: To identify, within the Lazio Region, the cohort of patients starting treatment for DME in the years 2010-2016 and calculating the annual cost of therapy; and to assess the appropriateness of the drugs prescribed.METHODS: From the Health Information System of the Lazio Region were identified all subjects who, in the 2010-2016 period, had received at least one prescription for dexamethasone intravitreal implant (i.i.) or intravitreal triamcinolone or ranibizumab or aflibercept or bevacizumab. For the cohort of users selected, the appropriateness of the treatment were evaluated calculating the number of administrations performed in the first four months of the index prescription and the number of administrations performed during the 12 months of treatment.RESULTS: In 2016, 7,265 patients in the Lazio Region received at least one prescription of ranibizumab (43.0%), aflibercept (37.5%) and dexamethasone i.i. (19.5%). Among the 3,416 patients naïve at 6 months, who started treatment in the 2013-2015 period and who did not switch to different drugs, 78.7% started treatment with ranibizumab, 16.0% with dexamethasone i.i. and 5.3% with aflibercept. The mean annual cost for the treatment of a patient with DME and naïve at 6 months was equal to € 2,388; a total cost for only the naïve patients selected in the 2013-2015 period is therefore estimated at approximately € 8.2 million. The average annual cost of dexamethasone i.i. treatment was € 1,497, lower than that of ranibizumab (€ 2,562) and aflibercept (€ 2,485). The expenditure for patients receiving less than 3 administrations of ranibizumab or aflibercept in the first 10 months of treatment was estimate equal to € 1.3 million.CONCLUSIONS: The administrations of dexamethasone i.i. are in line with what is indicated in the prescribing information, while for ranibizumab and aflibercept a potential under-use has been identified. A greater appropriateness of the drugs prescribed, accompanied by an optimal adherence to therapy, would strongly reduce the current waste of resources.
Prospective Decision Analysis Study of Clinical Genomic Testing in Metastatic Breast Cancer: Impact on Outcomes and Patient Perceptions.

PURPOSE To evaluate the impact of targeted DNA sequencing on selection of cancer therapy for patients with metastatic breast cancer (MBC). PATIENTS AND METHODS In this prospective, single-center, single-arm trial, patients with MBC were enrolled within 10 weeks of starting a new therapy. At enrollment, tumor samples underwent next-generation sequencing for any of 315 cancer-related genes to high depth (> 500×) using FoundationOne CDx. Sequencing results were released to providers at the time of disease progression, and physician treatment recommendations were assessed via questionnaire. We evaluated three prespecified questions to assess patients' perceptions of genomic testing. RESULTS In all, 100 patients underwent genomic testing, with a median of five mutations (range, 0 to 13 mutations) detected per patient. Genomic testing revealed one or more potential therapies in 98% of patients (98 of 100), and 60% of patients (60 of 100) had one or more recommended treatments with level I/II evidence for actionability. Among the 94 genomic text reports that were released, there was physician questionnaire data for 87 patients (response rate, 92.6%) and 31.0% of patients (27 of 87) had treatment change recommended by their physician. Of these, 37.0% (10 of 27) received the treatment supported by genomic testing. We did not detect a statistically significant difference in time-to-treatment failure (log-rank P = .87) or overall survival (P = .71) among patients who had treatment change supported by genomic testing versus those who had no treatment change. For patients who completed surveys before and after genomic testing, there was a significant decrease in confidence of treatment success, specifically among patients who did not have treatment change supported by genomic testing (McNemar's test of agreement P = .001). CONCLUSION In this prospective study, genomic profiling of tumors in patients with MBC frequently identified potential treatments and resulted in treatment change in a minority of patients. Patients whose therapy was not changed on the basis of genomic testing seemed to have a decrease in confidence of treatment success.
Review of the top 5 cardiology studies of 2017-18

Each year, numerous studies are published in the discipline of cardiology. Given that many of these interventions are specialized, relatively few are relevant to primary care practice. Therefore, it can be onerous to remain knowledgeable about the current literature. This article presents a brief synopsis of the top 5 (with 1 honorable mention) recently published cardiology-based studies identified by primary care practitioners as being relevant to their practice and thus likely to affect patient care.
Mucinous cystadenocarcinoma of ovary in pregnancy: A rare case report

The ovary is a frequent site of neoplastic tumours that could be either benign or malignant. Ovarian cancer (OC) is one of the most commonly diagnosed cancers among women. Regretfully due to the broad spectrum of clinical behaviour and challenging diagnosis most cases are diagnosed at a late stage. On rare occasions, these tumors can grow to massive sizes if left untreated, worsening the prognosis of the patient. We hereby report the rare case of Primary Unilateral Mucinous Cystadenocarcinoma of ovary in a 23-year-old pregnant woman which was initially misdiagnosed as Hydatid disease. Albeit, it was a malignant tumour, it presented with torsion in the post abortal period with benign behaviour and normal levels of CA125 which is usually elevated in epithelial ovarian malignancies. The mass was removed along with unilateral salpingoophorectomy and histopathologic study revealed a mucinous cystadenocarcinoma.
Diabetic Ketoacidosis: A Review of Risk Associated Morbidity and Mortality

Diabetic ketoacidosis (DKA) is a rare yet potentially fatal hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. Due to its increasing incidence and economic impact related to the treatment and associated morbidity, effective management and prevention is key. Elements of management include making the appropriate diagnosis using current laboratory tools and clinical criteria and coordinating fluid resuscitation, insulin therapy, and electrolyte replacement through feedback obtained from timely patient monitoring and knowledge of resolution criteria. In addition, awareness of special populations such as patients with renal disease presenting with DKA is important. During the DKA therapy, complications may arise and appropriate strategies to prevent these complications are required. DKA prevention strategies including patient and provider education are important.
Ataxias espinocerebelosas de herencia autosómica dominante : nueva clasificación clínica y desarrollo de una herramienta informática para la orientación y predicción diagnóstica

Introduction. Spinocerebellar ataxias (SCA) are a group of clinically and genetically heterogeneous neurodegenerative disorders, characterized by progressive ataxia, but often associated with a broad spectrum of neurological or other clinical findings. They are genetically classified in several genetic subtypes that are continuously expanding. This genetic classification is not useful in clinical practice to orient genetic subtype diagnosis, as it does not include information regarding clinical features. Harding’s clinical classification proposed in 1984 is outdated and was not developed in a rigorous and systematic way. In clinical practice, it is a real challenge to determine the genetic subtype solely on the basis of patient’s clinical features, because of several factors, like the clinical heterogeneity within and between different families of a same genetic subtype, the absence in some cases of a family history of ataxia, the presence of certain clinical features at disease onset in the absence of ataxia, and the uncertainty of the real frequency of all clinical features associated to the different genetic subtypes. Differences in the frequency of clinical features might have an important role to orient the suspicion of the genetic subtype involved in a certain patient. Objectives. To facilitate genetic subtype prediction through clinical phenotype in patients with SCA. Methods. A systematic review of the literature was conducted to assess clinical features of the different SCA genetic subtypes. The search was performed in several electronic databases between October 2011 and actualized in January 2013 and included diverse publications types written in six different languages. Publications that potentially could contain clinical data or demographics of patients with genetically confirmed SCA were selected. Data about demographics, clinical features, imagenological studies or anatomical pathology were extracted. Results. Information of 12141 patients from 30 SCA genetic subtypes included in 1062 publications was obtained. Gait or truncal ataxia was the most frequent clinical feature at disease onset
Evaluation of Inappropriate Admission and Hospitalization According to Appropriateness Evaluation Protocol and Estimation of Direct Financial Burden

Background: Appropriateallocationof resourcesisanimportantissueinthedeliveryof servicesthatcanreducethehealthsystem costs. The inappropriateness of healthcare services is one of the problems that increase the pressure on hospitals and patients. Methods: In this study, the data were collected using the appropriateness evaluation protocol by a medicine specialist at Rasoul Akram Hospital. In total, 248 participants were selected through systematic sampling. To calculate the ﬁnancial burden simultane-ously with the evaluation of inappropriate hospitalization days, the medicine and facility costs along with the cost of bed-day were estimated. Data were analyzed by SPSS software. Results: The type of treatment was surgery in 56.8% of the patients and 43.2% of them were admitted to the hospital for internal medicine. The mean length of stay was 4 ± 6 days. The inappropriate admission rate was estimated at about 6% and the rate of in-appropriatehospitalstayswas21.5%. Themostimportantfactorsinﬂuencingtheinappropriatenessof hospitalizationweredelayed medical consultations, delayed surgery, conservative practitioner, and the follow-up of clinical test results. The sum of the direct ﬁnancial burden of inappropriate hospitalization for the patients was estimated at around 1060 dollars. Conclusions: Theﬁndingsof thisstudyindicatedthatinappropriatehospitalizationandadmissionimposedahugeﬁnancialbur-den on the health system and community. Hospital authorities by considering issues such as delayed medical consultations and delayed surgery can decrease the ﬁnancial burden of inappropriate hospitalization to a large extent.
The positive effect of metformin and metronidazole on the diabetic rats experimentally

Diabetes mellitus is considering most serious disease of endocrine, it affecting large number of people in worldwide. This study was performed to insured the effect of combination of metformin and metronidazole on disorder in metabolic that concomitant with injection of alloxan IP induced diabetes in rats. In this study forty male rats: divided into four groups including control group G1, alloxn group (150 mg/kg single dose) G2, alloxn group orally treated with metformin (150mg/kg/BW) G3, and alloxn group orally treated with metformin (150mg/kg/BW) and metronidazole (500mg/kg/BW) G4. The experiment last for 14 days. The result shows marked increase in MDA, glucose and also in liver enzymes, lipid profiles and even observed disorder in kidney function test by increased in the creatinine, urea, and uric acid levels. In addition to study the histological changes in diabetic liver of rats characterized by kupffer cells activation, dilation and congestion of central vein and hepatic sinusoids. Administration of metformin and combination of metformin and metronidazole, result in significant reduction return abnormal parameters to the normal values. Also correct the abnormal histological changes of liver.
Prevention from Ageing: A Brief Survey

There are many ageing studies. In America, Baltimore Longitudinal Study of Aging (BLSA) and Einstein Aging Study (EAS) are the largest ones funded by the National Institute of Health (NIH). The BLSA is the America’s longest-running scientific study of human aging which started in 1958 [1], while the EAS started in 1980 [2]. The main purpose of both studies is to identify risk or prevention factors for human ageing.
Neuropsychological Sequela of Mild Traumatic Brain Injury: A Contemporary Meta-Analytic Review

NEUROPSYCHOLOGICAL SEQUELA OF MILD TRAUMATIC BRAIN INJURY: A CONTEMPORARY META-ANALYTIC REVIEW David E. Marra, MS Marquette University, 2019 Mild traumatic brain injuries (MTBIs) result in a constellation of non-specific physical, cognitive, and psychological symptoms. There is significant variability in neurocognitive recovery after MTBI, ranging from a few days to a few months, and others who fail to make complete recovery. A broad literature has attempted to elucidate what individual differences explain this variability. The present study sought to build upon previous meta-analyses, which systematically aggregated and examine relevant literature, by including a more heterogenous population and utilizing contemporary metaanalytic techniques. Three online databases (PsychINFO, PubMed, MedLine) were searched for pertinent studies. Separate random-effects Analogue-to-ANOVA were utilized to examine the overall neurocognitive effects of MTBI across time points, stratified by age, psychological comorbidity, populations of interest (athletes, general medical referrals, Veterans, litigants), and whether performance validity tests (PVT) were utilized. Subsequent analyses utilized meta-regressive techniques to simultaneously examine the variables of interest. After article review, 109 studies were retained for analysis (NMTBI = 5919, NControl = 8318). Analogue-to-ANOVA analyses revealed a medium-large overall neurocognitive effect size in the first 24 hours post-injury (d = .64) that decreased to a small effect size over the first 90 days (d = .24). Driven by a higher number of Veteran and litigant samples, the effect size increased in the post-acute period (> 90 days; d = .39). Veteran samples were observed to have significantly larger effect sizes than other populations considered. Meta-regressive analyses found that, across heterogenous populations, time since injury (TSI) was predictive of overall cognitive function only prior to 90 days post-injury, but not in the post-acute period. Psychological functioning was the most important predictor of cognitive functioning after MTBI (β = .47), over and above TSI, population, demographic variables, injury parameters, age, or PVT. This study is consistent with the growing research suggesting that psychological functioning largely explains MTBI recovery and suggests that assessment of emotional well-being and psychological functioning should be part of routine clinical care for the management of MTBI.
Формальная нейроподобная модель системы мониторинга транспортного потока

This work aimed to shadow classification problem. Due to increasing traffic jams number automatic road traffic monitoring is becoming important application of computer vision. It is known that shadows of vehicles can dramatically decrease accuracy of monitoring. We developed shadow recognition algorithm which significantly decrease influence of shadows. This algorithm is based on extraction of specialized set of features and CART method usage for further classification. This shadow detection method has low computational load and this has been developed to be ported to DSP architectures.
„Drug Interaction Stewardship“ (DIS) und therapeutisches Drug-Monitoring (TDM) für die antiinfektive Therapie in der operativen Intensivmedizin, eine monozentrische Beobachtungsstudie

Zusammenfassung Einleitung Die Medikation des chirurgischen Intensivpatienten ist schwer kalkulierbar durch gestörte Organfunktionen, Organversagen, pathophysiologische Veränderungen bei schwerer Erkrankung und in der Sepsis, laufende Organersatz-, Nierenersatz- und Leberersatzverfahren sowie die unterschiedliche Pharmakokinetik/Pharmakodynamik (PK/PD) von medikamentösen Substanzen und zahlreichen Medikamenteninteraktionen. Ziel Interdisziplinäres Vorgehen im klinischen Alltag zur Optimierung sowohl der Vielfachmedikation als auch der laufenden medikamentösen Therapie von Patienten vor indizierten Operationen oder Interventionen sowie im Rahmen des peri- und postoperativen intensivmedizinischen Managements. Methode Etablierung einer „Drug Interaction Stewardship“ (DIS), analog und zeitgleich zur bereits etablierten Antibiotic Stewardship (ABS) in der Routine einer chirurgischen Intensivstation. Erweiterung des etablierten therapeutischen Drug-Monitorings (TDM) auf Standard-Antiinfektiva (Meropenem, Piperacillin-Tazobactam, Ceftazidim, Linezolid, Voriconazol, Fluconazol, Caspofungin), für die bisher kein TDM etabliert ist, an einer konsekutiven Patientenkohorte über einen definierten Zeitraum im Rahmen einer klinisch-systematischen „Single-Center“-Beobachtungsstudie (tertiäres Zentrum). Ergebnisse Im Zeitraum 01/2012 bis 08/2016 führten 1454 klinisch-pharmakologische Patientenvisiten zu 385 (26,5%) Änderungen einer vorher vom erfahrenen Intensivmediziner eingestellten medikamentösen Therapie, am häufigsten in 156 (10,7%) Fällen infolge einer neu kalkulierten PK/PD. 2333 Proben TDM ergaben in 1130 Fällen (48,4%) einen Talspiegel im gewünschten Bereich. In 427 (18,3%) Fällen war wegen eines zu niedrigen und in 776 (33,3%) Fällen wegen eines zu hohen Substanzspiegels eine Änderung der antiinfektiven Therapie nach Art, Dosis, Dosisintervall oder Applikationsart erforderlich. Schlussfolgerung DIS und TDM führen bei chirurgischen Intensivpatienten in einer hohen Rate zur Detektion von unerwünschten Medikamenteninteraktionen sowie inadäquaten Substanzspiegeln mit dem Ansatz für gezielte Therapieänderungen.
Руководители украинских университетов заинтересованы в как можно лучшем представлении научных достижений своих учреждений на национальном и международном уровне

Рассмотрены преимущества квартального подхода, учитывающего особен­ ности различных научных дисциплин, к решению проблемы эффективной финансовой поддержки публикационной активности ученых университетов. Представлены предварительные результаты внедрения практики премирова­ ния сотрудников за публикации в изданиях, индексируемых в международных наукометрических базах Scopus и Web of Science Core Collection, с учетом квартилей журналов, в Национальном университете «Киево-Могилянская академия» (Киев, Украина). Ключевые слова: наукометрия, квартили журналов, финансирование на­ уки, публикационная активность, Scopus, Web of Science, Украина.