Miracle-dz/UniFAR-FTUs huggingface dataset:
Early Diagnosis And Management Of Malignant Distal Biliary Obstruction: A Review On Current Recommendations And Guidelines

: Malignant biliary obstruction is a challenging condition, requiring a multimodal approach for both diagnosis and treatment. Pancreatic adenocarcinoma and cholangiocarcinoma are the leading causes of malignant distal biliary obstruction. Early diagnosis is dif ﬁ cult to establish as biliary obstruction can be the ﬁ rst presentation of the underlying disease, which can already be at an advanced stage. Consequently, the majority of patients (70%) with malignant distal biliary obstruction are unresectable at the time of diagnosis. The association of clinical ﬁ ndings, laboratory tests, imaging, and endoscopic modalities may help in identifying the underlying cause. Novel endoscopic techniques such as cholangioscopy, intraductal ultrasonography, or confocal laser endomicroscopy have been developed with promising results, but are not used in routine clinical practice. As the number of patients with malignant distal biliary obstruction who will undergo curative surgery is limited, endoscopy has a crucial role in palliation, to relieve biliary obstruction. According to the last European guidelines published in the management of biliary obstruction, self-expandable metal stents have a central place in biliary drainage compared to plastic stents. Endoscopic ultrasound has evolved impressively in the last decades. When standard techniques of biliary cannulation by endoscopic retrograde cholangiopancreatography fail, endoscopic ultra-sound-guided biliary drainage is a good option compared to percutaneous drainage. intraductal forceps biopsies con ﬁ rmed the presence of malignant cells ( C ).
The case for change towards universal and sustainable national health insurance and financing for Australia: enabling the transition to a chronic condition focussed health care system

Foreword Australian governments have maintained a strong focus on health policy over many years. Much of that focus has been cast as a reform agenda, addressing pressures facing health expenditure and public funding of health care; pressures on hospitals and the health workforce, and pressures arising from an ageing population, increasing chronic diseases affecting more of the population, and the rising costs of health treatments and technologies that manage those chronic diseases and prolong life. Equally pressing is the evidence that Australia’s health policies, funding and service models are failing about one quarter of the population. Chronic conditions such as diabetes, stroke and depression affect more than seven million Australians. The proportion of people with a chronic condition increases with age, and almost one in three Australians aged 45 or over have at least one chronic health condition. The nation cannot afford to ignore an issue that affects so many of its people. A large part of the problem is that funding and service models are not geared towards preventative healthcare. Indeed, our lack of policy attention to this area means that access to preventative care is an optional extra, often limited to those with the financial and social capacities to access strategies that improve or maintain their good health. If we had maintained this same attitude towards the most prevalent health conditions of the past (infectious diseases), we would not have the economy or nation we now have today.
[Effect of Atractylodes macrocephala polysaccharide on proliferation and invasion of hepatocellular carcinoma cells in vitro].

OBJECTIVE To investigate the inhibitory effect of polysaccharide of Atractylodes macrocephala (PAM) on the proliferation and invasion of hepatocellular carcinoma cells and the underlying mechanism. METHODS Hepatocellular carcinoma HepG2 cells were treated with different concentrations of PAM, and their proliferation and invasive ability were examined using CCK-8 assay and Transwell assay. Immunofluorescence assay was performed to detect the expression level of β-catenin, and real-time PCR and Western blotting were used to detect the mRNA and protein expressions of AKT, GSK-3β and MMP-2 in the cells. The changes in the proliferation, invasiveness and the expressions of pGSK-3β and MMP2 were examined in the cells following treatment with LiCl/PAM/LiCl plus PAM. RESULTS PAM treatment significantly reduced the cell viability, the number of migration cells, and the expression levels of β-catenin and MMP-2 (P < 0.05), and obviously inhibited the phosphorylation of AKT and GSK-3β in the cells (P < 0.05) in a dose-dependent manner. The rescue experiment showed that LiCl reversed the inhibition of cell proliferation, invasiveness, and the Wnt/β-catenin pathway induced by PAM. CONCLUSIONS PAM can inhibit the proliferation and invasion of hepatocellular carcinoma cells in vitro possibly by inhibiting the Wnt/β-catenin signaling pathway.
Walking with head-mounted virtual and augmented reality devices: Effects on position control and gait biomechanics

What was once a science fiction fantasy, virtual reality (VR) technology has evolved and come a long way. Together with augmented reality (AR) technology, these simulations of an alternative environment have been incorporated into rehabilitation treatments. The introduction of head-mounted displays has made VR/AR devices more intuitive and compact, and no longer limited to upper-limb rehabilitation. However, there is still limited evidence supporting the use of VR and AR technology during locomotion, especially regarding the safety and efficacy relating to walking biomechanics. Therefore, the objective of this study is to explore the limitations of such technology through gait analysis. In this study, thirteen participants walked on a treadmill in normal, virtual and augmented versions of the laboratory environment. A series of spatiotemporal parameters and lower-limb joint angles were compared between conditions. The center of pressure (CoP) ellipse area (95% confidence ellipse) was significantly different between conditions (p = 0.002). Pairwise comparisons indicated a significantly greater CoP ellipse area for both the AR (p = 0.002) and VR (p = 0.005) conditions when compared to the normal laboratory condition. Furthermore, there was a significant difference in stride length (p<0.001) and cadence (p<0.001) between conditions. No statistically significant difference was found in the hip, knee and ankle joint kinematics between the three conditions (p>0.082), except for maximum ankle plantarflexion (p = 0.001). These differences in CoP ellipse area indicate that users of head-mounted VR/AR devices had difficulty maintaining a stable position on the treadmill. Also, differences in the gait parameters suggest that users walked with an unusual gait pattern which could potentially affect the effectiveness of gait rehabilitation treatments. Based on these results, position guidance in the form of feedback and the use of specialized treadmills should be considered when using head-mounted VR/AR devices.
Circ_KATNAL1 regulates prostate cancer cell growth and invasion through miR-145-3p/WISP1 pathway.

Prostate cancer (PCa) is the second leading cause of death in men, and current studies have shown that circular RNAs (circRNAs) play important roles in its occurrence and development. Detection of circRNAs in PCa cells found that circ_KATNAL1 was down-regulated, mainly located in the cytoplasm and contained multiple binding sites of miR-145-3p, an anti-cancer miRNA. RIP detection with anti-AGO2 antibody, RNA pull down assay with biotin-labeled circ_KATNAL1 probe or miR-145-3p mimics, and dual luciferase reporter gene assay confirmed that circ_KATNAL1 directly bound to miR-145-3p in cells, and WISP1, which was highly expressed in many tumors, was an important target gene of miR-145-3p. Circ_KATNAL1 and miR-145-3p promoted each other's expression, and down-regulated the expression of target gene WISP1. Both circ_KATNAL1 and miR-145-3p inhibited cell proliferation, invasion, migration and the expression of MMP-2 and MMP-9, promoted cell apoptosis and the activation of Caspase-3, Caspase-8, Caspase-9 and PARP, while WISP1 had the opposite effects, and the above functions of circ_KATNAL1 were performed through the miR-145-3p/WISP1 pathway. Therefore, circ_KATNAL1 plays an anti-cancer role in PCa cells through the miR-145-3p/WISP1 pathway, which may be an important target for the diagnosis and treatment of PCa.
IL-10 produces a dual effect on OGD-induced neuronal apoptosis of cultured cortical neurons via the NF-κB pathway

As a classic immunoregulatory cytokine, interleukin-10 (IL-10) can provide in vivo and in vitro neuroprotection respectively during cerebral ischemia and after the oxygen-glucose deprivation (OGD)-induced injury. However, its role in cortical neuronal survival at different post-ischemic phases remains unclear. The current study found that IL-10 had distinct effects on the neuronal apoptosis at different OGD stages: at an early stage after OGD, IL-10 promoted the OGD-induced neuronal apoptosis in the cultured primary cortical neurons by activating p65 subunit, which up-regulated Bax expression and down-regulated Bcl-xL expression; at a late OGD stage, however, it attenuated the OGD-induced neuronal apoptosis by activating c-Rel, which up-regulated Bcl-xL expression and down-regulated Bax expression. The early-stage pro-apoptosis and late-stage anti-apoptosis were both partly abolished by PDTC, an NF-κB inhibitor, and promoted by PMA, an NF-κB activator. The optimal anti-apoptotic effect appeared when the cultured neurons were treated with IL-10 at 9-24 h after OGD. Taken together, our findings suggest that IL-10 exerts a dual effect on the survival of the cultured neurons by activating the NF-κB pathway at different stages after OGD injury and that PMA treatment at a late stage can facilitate the IL-10-conferred neuroprotection against OGD-induced neuronal injury.
Implant-assisted removable prosthetic rehabilitation after distraction osteogenesis in a patient with ameloblastoma recurrence

Abstract Introduction: A resected mandibular edentulous ridge resulting from an ameloblastoma and marginal mandibulectomy is a restorative challenge. To maintain oral hygiene, recurrent examinations, and for long-term maintenance, a removable dental prosthesis is preferred to an implant-supported fixed dental prosthesis. Patient concerns: A 28-year-old Asian man was referred for evaluation of a radiolucent area on the right side of the mandible. The right mandibular area had increasingly enlarged over a period of ≥5 months. Marginal resection and inferior alveolar nerve repositioning of the mandible were performed by oral surgeons, followed by reconstruction of the resected mandible with distraction osteogenesis. After 6 years, the patient presented with swelling of the same area. Diagnosis: Histopathological examination revealed recurrence of benign ameloblastoma in the mandible. After mass excision of the recurrent benign tumor, dental implants were installed. To aid with recurrent examinations and oral hygiene maintenance, a treatment plan using implant-assisted removable dental prosthesis, instead of a fixed prosthesis, was formulated. Interventions: The edentulous area was rehabilitated with a tooth- and implant-assisted removable partial denture. Due to the insufficient intermaxillary clearance, the removable prosthesis was designed in such a manner that retention, support, and stability could be ensured by separate components. Outcomes: The tooth- and implant-assisted removable partial denture showed satisfactory function and esthetics. No complications were observed in the dental prosthesis and supporting tissues during the 3-year follow-up period. Conclusion: In recurrent ameloblastoma cases, a removable dental prosthesis may be an effective treatment option for oral rehabilitation. The type of denture design used in this study is novel for implant-assisted removable partial denture rehabilitation.
Molecular Mechanisms of Conidial Germination in Aspergillus spp

Aspergilli produce conidia for reproduction or to survive hostile conditions, and they are highly effective in the distribution of conidia through the environment. In immunocompromised individuals, inhaled conidia can germinate inside the respiratory tract, which may result in invasive pulmonary aspergillosis. The management of invasive aspergillosis has become more complex, with new risk groups being identified and the emergence of antifungal resistance. SUMMARY Aspergilli produce conidia for reproduction or to survive hostile conditions, and they are highly effective in the distribution of conidia through the environment. In immunocompromised individuals, inhaled conidia can germinate inside the respiratory tract, which may result in invasive pulmonary aspergillosis. The management of invasive aspergillosis has become more complex, with new risk groups being identified and the emergence of antifungal resistance. Patient survival is threatened by these developments, stressing the need for alternative therapeutic strategies. As germination is crucial for infection, prevention of this process might be a feasible approach. A broader understanding of conidial germination is important to identify novel antigermination targets. In this review, we describe conidial resistance against various stresses, transition from dormant conidia to hyphal growth, the underlying molecular mechanisms involved in germination of the most common Aspergillus species, and promising antigermination targets. Germination of Aspergillus is characterized by three morphotypes: dormancy, isotropic growth, and polarized growth. Intra- and extracellular proteins play an important role in the protection against unfavorable environmental conditions. Isotropically expanding conidia remodel the cell wall, and biosynthetic machineries are needed for cellular growth. These biosynthetic machineries are also important during polarized growth, together with tip formation and the cell cycle machinery. Genes involved in isotropic and polarized growth could be effective antigermination targets. Transcriptomic and proteomic studies on specific Aspergillus morphotypes will improve our understanding of the germination process and allow discovery of novel antigermination targets and biomarkers for early diagnosis and therapy.
Prenatal Effects of a 1,800-MHz Electromagnetic Field on Rat Livers

The use of devices, including mobile phones, generating electromagnetic fields (EMF) is widespread and is progressively increasing. It has also been shown that EMF may have detrimental effects. This is the first study to investigate the postnatal biochemical and histological effects of prenatal exposure of rat livers to 1,800-MHz EMF at different time intervals in uteroplacental life. The 3 EMF groups of rats were exposed to 1,800-MHz EMF for 6, 12, or 24 h daily for 20 days. Unexposed rats served as control group. All rats were subjected to anesthesia, and on postnatal day 60, the livers were excised, and blood was collected for histological and biochemical analyses. Malondialdehyde levels were significantly higher in the exposed groups than the unexposed controls (p < 0.05). In contrast, EMF-exposed groups had lower liver tissue glutathione levels than controls (p < 0.05). Serum Ca2+, alanine transaminase, and aspartate aminotransferase levels were higher in EMF-exposed groups than controls (p < 0.05). In addition, liver tissue total oxidant status levels were increased (p < 0.05), and liver tissue total antioxidant status levels were decreased (p < 0.05) compared to the control group. Furthermore, in the EMF groups, extensive vacuolation and degeneration of the hepatocytes in the portal area, as well as those surrounding the sinusoids, were evident. Affected hepatocytes had polygonally shaped nuclei and vacuolic cytoplasm imparting eosinophilic staining. Loss of cellular membrane integrity and invaginations, as well as picnotic nuclei, was prominent. This study has shown that intrauterine liver damage caused by 1,800-MHz EMF exposure persists into puberty in rats.
Immunomodulatory Role of Treg Lymphocytes in Chronic Hepatitis C Patients

Background: Regulatory T cells (Tregs) have a fundamental job in keeping up a harmony between forestalling immunopathology and enabling the insusceptible reaction to clear infections, in HCV infection, elevation of Tregs may cause insistent HCV infection. Objective: The current work aimed to clarify the immunomodulatory role of CD4+ CD25+ Foxp3+ Tregs in chronic hepatitis C (CHC) patients. Subjects and methods: This study incorporated two groups: 50 patients with chronic HCV infection of different classes of Child-Pugh classification (Child A, B and C) and control group; 25 healthy subjects. All patients were exposed to full history taking and finish clinical examination, as well as routine lab analysis including CBC, AST, ALT, ALP, GGT, PT, INR, blood urea, serum creatinine, ANA. HCV-Abs was measured for both patients and controls groups. Viral load was determined for patients group by HCV-RNA PCR. Immunophenotyping of CD4+ CD25+ FoxP3+ regulatory Treg cells were performed by flow Cytometry for patients and controls groups. Results: There was expansion of CD4+25+ FOXP3+ Treg lymphocytes in CHC patients compared with controls with significant difference. Furthermore, there was a highly significant decline in the average of CD4+25+ FOXP3+Treg lymphocytes amongst the 3 different classes of Child-Pugh classification of CHC patients on relating to the control. There were significant correlations between CD4+25+ FOXP3+Treg lymphocytes and liver fibrosis. Conclusion: There is marked increased level of CD4+25+ FOXP3+Treg lymphocytes among CHC patients, in addition to, the 3 different classes of Child-Pugh classification. This might confirm the immunomodulatory role by CD4+25+ FOXP3+Treg during chronic HCV infection that it might contribute to the immune response failure.
Targeted therapies for advanced bladder cancer: new strategies with FGFR inhibitors

Inhibitors of fibroblast growth factor receptor (FGFR) represent an outstanding treatment approach for selected patients with urothelial cancer (UC). These agents are changing the clinical approach to a subgroup of UC, the luminal-papillary subtype, characterized by FGFR mutations, fusions, or amplification. In this review, we provide an overview of the results of recent clinical trials on FGFR tyrosine kinase inhibitors (TKIs) currently in clinical development for the treatment of UC: erdafitinib, rogaratinib, infigratinib, and the monoclonal antibody vofatamab. The Food and Drug Administration recently granted accelerated approval to erdafitinib for patients with advanced UC with alterations of FGFR2 or FGFR3 after progression on platinum-based chemotherapy. We also look at future therapeutic options of combination regimens with immune-checkpoint inhibitors as strategies for improving the antitumor effects of this class of drug, and for preventing or delaying the development of resistance.
Evolving Frontier

Objective: To describe the continuum of medical app prescribing. Data Sources: A review of literature was conducted using PubMed and MEDLINE. Search terms included medical app, prescribing, healthcare apps, medical phone apps, and mobile medical apps. Studies published in English from 2005 to December 2015 were included. Study Selection and Data Extraction: A total of 2264 articles were uncovered in the initial search. The publications included studies conducted in the United States and Europe within the past 10 years. Studies with a mobile app intervention were preferred. However, studies lacking a mobile app intervention were also included. No restrictions on the type of health application discussed in studies were chosen. Non–English language publications were excluded from the review. A total of 15 articles were selected based on the inclusion criteria and reviewer screening. Data Synthesis: The literature review identified that this is an area that requires further study to analyze the extent to which prescribers recommend apps for their patients. A concern over the lack of evidence in the effectiveness of the apps still remains. Prescribing mobile apps by providers to help keep track of their patients’ symptoms and provide real-time advice on treatment and medication can be beneficial to control costs, reduce errors, and improve patients’ experiences. Conclusion: The presence of mobile technology has enabled patients to become more engaged in the decision making regarding their health care. Additional resource allocation can be recommended to increase the quantity and quality of medical apps recommended by prescribers for their patients.
Environmental Chemicals Altered in Association With Deployment for High Risk Areas.

OBJECTIVE A study was conducted using serum samples and high-resolution metabolomics (HRM) to test for changes in abundance of environmental chemicals in deployment in high-risk areas (Balad, Iraq; Bagram, Afghanistan). METHODS Pre and Post-deployment serum samples for deployment (cases) and matched controls stationed domestically were analyzed by HRM and bioinformatics for the relative abundance of 271 environmental chemicals. RESULTS Of the 271 chemicals, 153 were measurable in at least 80% of the samples in one of the pre- or post-deployment groups. Several pesticides and other chemicals were modestly elevated post-deployment in the Control as well as the Bagram and Balad samples. Similarly, small decreases were seen for some chemicals. CONCLUSION These results using serum samples show that for the 271 environmental chemicals studied, 56% were detected and small differences occurred with deployment to high-risk areas.
ERS and tobacco harm reduction

Medical experts and federal health officials in USA have recently warned the public from using e-cigarettes, as the number of people with a severe lung illness rose to over 1600 cases, 34 of these fatal. An illustrative case is reported in the European Respiratory Journal [1]. Health officials state that “vaping is a probable potential cause” but no firm conclusions can yet be drawn. In this light it is interesting to discuss the concept of tobacco harm reduction. The European Respiratory Society (ERS) Advocacy Council's Tobacco Control Committee has recently launched an ERS position paper on this topic [2]. From this paper we would like to draw attention to some of the major issues of harm reduction. ERS supports the World Health Organization's Framework Convention on Tobacco Control, which also provides regulation to novel products, and cannot recommend tobacco harm reduction as a population-based strategy http://bit.ly/2rxTZ5b