Miracle-dz/UniFAR-FTUs huggingface dataset:
Management of Barrett’s oesophagus and intramucosal oesophageal cancer: a review of recent development

Barrett’s oesophagus is the most important and recognizable precursor lesion for oesophageal adenocarcinoma, which is the one of the fastest growing cancers in the Western World. The incidence of oesophageal adenocarcinoma has increased 600% in the United States between 1975 and 2001 and is thought to represent a real increase in burden rather than a result of histologic or anatomical misclassification or overdiagnosis. Thus, the cancer risk in Barrett’s oesophagus has to be managed and involves prevention (surveillance endoscopy), treating underlying gastroesophageal reflux disease (medically and or surgically) and endoscopic therapy to remove diseased epithelium in appropriate patient subgroups. In the last decade, new developments in imaging and molecular markers as well as an armamentarium of novel and effective endoscopic eradication therapy has become available to the endoscopist to combat this exponential rise in oesophageal adenocarcinoma. Paradoxically, the cancer risk in Barrett’s oesophagus gets progressively downgraded which raises fundamental questions about our understanding of the known and unknown risk factors and molecular aberrations that are involved in the Barrett’s metaplasia–dysplasia–carcinoma sequence. Future research has to be directed at these areas to fine tune our screening and surveillance programs to identify more accurately the high-risk group of progressors to oesophageal adenocarcinoma who would benefit most from endoscopic therapy.
Clinical and critical care concerns in severely ill obese patient

The incidence of obesity has acquired an epidemic proportion throughout the globe. As a result, increasing number of obese patients is being presented to critical care units for various indications. The attending intensivist has to face numerous challenges during management of such patients. Almost all the organ systems are affected by the impact of obesity either directly or indirectly. The degree of obesity and its prolong duration are the main factors which determine the harmful effect of obesity on human body. The present article reviews few of the important clinical and critical care concerns in critically ill obese patients.
NnSR1, a class III non-S-RNase constitutively expressed in styles, is induced in roots and stems under phosphate deficiency in Nicotiana alata.

BACKGROUND AND AIMS Non-S-ribonucleases (non-S-RNases) are class III T2 RNases constitutively expressed in styles of species with S-RNase-based self-incompatibility. So far, no function has been attributed to these RNases. The aim of this work is to examine if NnSR1, a non-S-RNase from Nicotiana alata, is induced under conditions of phosphate (Pi) deprivation. The hypothesis is that under Pi-limited conditions, non-S-RNase functions may resemble the role of S-like RNases. To date, the only RNases reported to be induced by Pi deficiency are class I and class II S-like RNases, which are phylogenetically different from the class III clade of RNases. METHODS Gene and protein expression of NnSR1 were assayed in plants grown hydroponically with and without Pi, by combining RT-PCR, immunoblot and enzymatic activity approaches. KEY RESULTS NnSR1 transcripts were detected in roots 7 d after Pi deprivation and remained stable for several days. Transcript expression was correlated based on Pi availability in the culture medium. Antiserum against a peptide based on a hypervariable domain of NnSR1 recognized NnSR1 in roots and stems but not leaves exposed to Pi shortage. NnSR1 was not detected in culture medium and was pelleted with the microsomal fraction, suggesting that it was membrane-associated or included in large compartments. The anti-NnSR1 inhibited selectively the enzymatic activity of a 31-kDa RNase indicating that NnSR1 was induced in an enzymatically active form. CONCLUSIONS The induction of NnSR1 indicates that there is a general recruitment of all classes of T2 RNases in response to Pi shortage. NnSR1 appears to have regained ancestral functions of class III RNases related to strategies to cope with Pi limitation and also possibly with other environmental challenges. This constitutes the first report for a specific function of class III RNases other than S-RNases.
Social support for spouse caregivers of persons with dementia.

OBJECTIVES This study analyzes the value of simultaneously taking helper and caregiver characteristics into account when examining social support received by spouse caregivers of persons with dementia. This study questions whether sources and types of received support vary by the gender and relationship of the helper and/or by the caregiver's race and gender. METHODS Drawing on a sample of 210 spouse caregivers of persons with dementia, the Generalized Estimating Equation (GEE) method was used to estimate a population-average logistic regression model to address cross-level helper and caregiver interactions. RESULTS Results indicate that helper and caregiver characteristics interact in complex ways. White male caregivers are more likely to receive emotional support from adult children and to receive practical assistance from formal sources compared with other types of support and to other race-gender caregiver groups. DISCUSSION Description of social status characteristics of caregivers as determinants of their social network may be less fruitful in understanding the benefits of social support than a focus on which helpers assist with what kinds of task for which groups of caregivers.
Risk factors for serious fall related injury in elderly women living at home

Objectives: To study whether balance, function, and other health status indicators can predict serious fall related injury in elderly women living at home. Methods: In this prospective study, the authors took a random sample of 307 women aged 75 years and over (mean 80.8 years, response rate 74.5%), living in the community. Serious fall injuries which occurred over a period of during one year were recorded, together with baseline registrations of health, function, and tests of walking and balance. Results: In all, 155 women (50.5%) fell one or more times. One hundred and fifty six (51%) of the 308 falls resulted in a fall related injury, 74 (24%) in a serious fall related injury, and 40 falls (13%) resulted in fractures. The presence of rheumatic disorders, inability to rise from the floor, arthrosis of the hip, having had more than one fall during the one year follow up period, and an increased tendency to sway in the frontal plane when doing a calculation task were independent and significant predictors for serious fall related injury (fractures included). The independent predictors of fall induced fractures were experiencing more than one fall in the follow up period, cognitive impairment, and receiving care from professional or other. Conclusion: The study suggests that rheumatic disorders and the inability to get up from lying on the floor were the strongest independent risk factors for serious fall related injury. Experiencing more than one fall in the follow up period and cognitive impairment are the strongest independent predictors for fall induced fractures. Age was not a significant predictor of serious fall related injury. Assessment of these markers is feasible in a clinical setting and is a useful way of identifying those who are at risk of serious fall related injuries.
A Ka-band T/R front-end for phased array radar

In this paper, a Ka-band transmitter/receiver (T/R) front-end for a phased-array radar is proposed. The transceiver includes a receiver channel and a transmitter channel. A function link shared with the receiver channel and the transmitter channel is comprised of a 5-bit phase shifter and a variable gain amplifying circuit including an attenuator and a low noise amplifier. Connection to either the final power amplifier on transmitter or the LNA on receiver is accomplished by using two single-pole double-throw switches (SPDTs). Experimental results of the front-end verify the validity of the design. A noise figure of 4.9 to 5.6dB, a receiver gain of 24.4 to 29.4dB and a output power from 0.74W to 1W are obtained within a frequency range from 34.5GHz to 35.5GHz. The digital phase shift provides 10.2° root-mean square(RMS) phase shift error at 35GHz.
Concomitant increase in neutrophil adhesion to inflammatory peritoneum and remote organs during peritonitis.

BACKGROUND Neutrophils contribute to the host defense mechanism, but they can cause remote organ injury in peritonitis. The purpose of this study was to examine neutrophil adhesion to the peritoneum and remote organs simultaneously in peritonitis using a fluorescence microscopic method. STUDY DESIGN Experiment 1: Sprague-Dawley rats (n = 16) were injected intraperitoneally (ip) with saline solution or 10(5), 10(7), or 10(9) Escherichia coli. Five hours after challenge, 1 x 10(6) fluorescein-labeled neutrophils were infused. Two minutes after neutrophil injection, five peritoneal samples (the greater omentum, mesentery, parietal peritoneum, colon, and ileum), both lungs, the liver, and the right kidney were harvested for counting of labeled neutrophils under epifluorescent microscopy. Lung myeloperoxidase (MPO) activity was also determined. Experiment 2: Rats (n = 23) were given 10(9) E. coli ip. Before challenge (0 h) or at 1, 5, or 10 h after challenge, labeled neutrophils were infused. Then, the labeled neutrophil numbers in organs and lung MPO activities were assessed as described for Experiment 1. Hemodynamic and arterial blood gas data were also obtained in another set of rats before and at 1, 5, 8 and 10 h after 10(9) E. coli ip challenge. RESULTS Experiment 1: The labeled neutrophil numbers in the peritoneum, lungs, and kidney showed significant positive correlations with the injected bacterial numbers. Lung MPO also positively correlated with E. coli number and labeled neutrophil number in the lungs. Experiment 2: Labeled neutrophil numbers in the peritoneum and kidney peaked at 5 h. The pulmonary labeled neutrophil number rose, reaching a plateau at 5 h. No remarkable change was observed in the hepatic labeled neutrophil number. There was a positive correlation between lung MPO activity and pulmonary labeled neutrophil number. Hemodynamic and blood gas data reflected a hyperdynamic state. CONCLUSIONS Concomitant dose-dependent increases in neutrophil adhesion in the peritoneum, lungs, and kidney were observed in this peritonitis model. Increased neutrophil adhesion was transient in the peritoneum and kidney but persistent in the lungs. Strategies modulating neutrophil adhesion in organs are anticipated to be useful for the treatment of peritonitis.
The Onset of Type 2 Diabetes: Proposal for a Multi-Scale Model

Background Type 2 diabetes mellitus (T2D) is a common age-related disease, and is a major health concern, particularly in developed countries where the population is aging, including Europe. The multi-scale immune system simulator for the onset of type 2 diabetes (MISSION-T2D) is a European Union-funded project that aims to develop and validate an integrated, multilevel, and patient-specific model, incorporating genetic, metabolic, and nutritional data for the simulation and prediction of metabolic and inflammatory processes in the onset and progression of T2D. The project will ultimately provide a tool for diagnosis and clinical decision making that can estimate the risk of developing T2D and predict its progression in response to possible therapies. Recent data showed that T2D and its complications, specifically in the heart, kidney, retina, and feet, should be considered a systemic disease that is sustained by a pervasive, metabolically-driven state of inflammation. Accordingly, there is an urgent need (1) to understand the complex mechanisms underpinning the onset of this disease, and (2) to identify early patient-specific diagnostic parameters and related inflammatory indicators. Objective We aim to accomplish this mission by setting up a multi-scale model to study the systemic interactions of the biological mechanisms involved in response to a variety of nutritional and metabolic stimuli and stressors. Methods Specifically, we will be studying the biological mechanisms of immunological/inflammatory processes, energy intake/expenditure ratio, and cell cycle rate. The overall architecture of the model will exploit an already established immune system simulator as well as several discrete and continuous mathematical methods for modeling of the processes critically involved in the onset and progression of T2D. We aim to validate the predictions of our models using actual biological and clinical data. Results This study was initiated in March 2013 and is expected to be completed by February 2016. Conclusions MISSION-T2D aims to pave the way for translating validated multilevel immune-metabolic models into the clinical setting of T2D. This approach will eventually generate predictive biomarkers for this disease from the integration of clinical data with metabolic, nutritional, immune/inflammatory, genetic, and gut microbiota profiles. Eventually, it should prove possible to translate these into cost-effective and mobile-based diagnostic tools.
X‐linked spondyloepiphyseal dysplasia tarda: Novel and recurrent mutations in 13 European families

X‐linked spondyloepiphyseal dysplasia tarda is a skeletal dysplasia mainly affecting the vertebrae and epiphyses and commonly associated with the early development of degenerative joint disease. Radiographically the disorder is characterized by a typical hump‐shaped deformity of the vertebral bodies. SEDT is caused by mutations in SEDL located on Xp22.12‐p22.31. To further elucidate the spectrum of underlying variations we performed a screening of all 6 exons of SEDL within 13 European SEDT families and identified 6 new (c.99delC, c.183_184delGA, c.236‐5_236‐8delATTA, c.325delT, c.345_346delTG, c.94‐? _423+? del) and 9 previously reported mutations (c.1‐? _93+? del, c.93+5G>A, c.157_158delAT, c.210G>A, c.236‐9_236‐12delTTAA, c.267_275delAAGAC, c.324‐4_324‐10delTCTTTCCinsAA). The recurrent splice site alteration c.93+5G>A (formerly described as IVS3+5G>A) was detected in 3 unrelated families. Two patients were carrying 2 changes in the allele. In one case, a novel variation in exon 4 (c.99delC) was associated with several nucleotide deletions in intron 4 (c.236‐5_236‐8delATTA), and in the second case we identified a previously reported transition c.210G>A and a novel deletion in exon 6 (c.325delT). All sequence variations identified are either deletions of complete exons or predicted to result in a premature stop codon or to lead into splicing defects and are associated with a loss of considerable parts of the sedlin protein. © 2004 Wiley‐Liss, Inc.
Expression of an insulin-responsive glucose transporter (GLUT4) minigene in transgenic mice: effect of exercise and role in glucose homeostasis.

The effects of a GLUT4 mini-transgene (containing 7 kb of 5' flanking and 1 kb of 3' flanking sequence and all exons and introns of the GLUT4 gene as well as a small foreign DNA tag) and of exercise training on expression of GLUT4 and glycemic control in mice were investigated. Transgenic mice harboring the minigene expressed < or = 2-fold the normal level of GLUT4 mRNA and protein in skeletal (gastrocnemius) muscle and adipose tissue. This modest tissue-specific increase in GLUT4 expression led to an unexpectedly rapid blood glucose clearance rate following oral glucose administration. In nontransgenic animals exercise caused a 1.5-fold increase in expression of GLUT4 mRNA and protein as well as a significant improvement of glycemic control. In transgenic animals harboring the minigene exercise increased expression of GLUT4 mRNA and protein derived from the minigene and endogenous gene and led to a further improvement of glycemic control. These findings indicate that the cis-regulatory element(s) controlling exercise-induced expression of the GLUT4 gene is located within the nucleotide sequence encompassed by the GLUT4 minigene. The fact that glycemic control is markedly improved by a relatively low level of expression of GLUT4 caused by the transfected minigene and is further enhanced by exercise in transgenic animals demonstrates that GLUT4 plays a pivotal role in glucose homeostasis in vivo. Of the effectors--i.e., cAMP, insulin, and arachidonic acid--known to down-regulate expression of GLUT4 by 3T3-L1 adipocytes in culture, only the decline in circulating arachidonate level in vivo correlated with up-regulation of GLUT4 caused by exercise.
Efficient ZVS Synchronous Buck Converter with Extended Duty Cycle and Low-Current Ripple

In this paper, an efficient zero-voltage-switching (ZVS) synchronous buck converter with extended duty cycle and low-current ripple is proposed for voltage regulator module (VRM) applications. By combining series capacitor and coupled inductors, operating duty cycle is extended considerably. Also, soft switching condition for all switches is provided without any auxiliary circuit and as a result, overall efficiency is improved. In addition, by complementary operation of the main switches of the interleaved modules, the resulting output current ripple is reduced. The converter operating modes are discussed and experimental results are presented to verify the theoretical analysis.
Environmental Toxicant Exposure During Pregnancy

This literature review is meant to serve as a brief reference for acute and chronic poisonings in pregnant women, specifically involving environmental toxicants commonly present in the home or workplace. These scenarios are familiar to primary care providers but cause great confusion for practitioners and anxiety in the pregnant patient. Herein, we review metals and metalloids, organic solvents, disinfectant byproducts, pesticides, plasticizers, and multiple air pollutants. Reviews of specific studies involving these toxicants are provided to assist practitioners in providing information to patients regarding potential sources, mechanism of action, current laboratory and epidemiological studies, and possible treatments. Literature-based associations with specific toxicants and various pregnancy outcomes are also outlined. Finally, a contact list of important federal and state toxicology support services is provided. Target Audience: Obstetricians & Gynecologists Learning objectives: After completing this CME activity, physicians should be better able to assess both acute and chronic consequences of various environmental toxic exposures in pregnancy; to evaluate possible pregnancy related specific events surrounding environmental pollutants; and to identify common exposure routes and implement therapeutic interventions where appropriate.
Enzymatic Hydrolysis of Whey Protein Concentrates: Peptide HPLC Profiles

Abstract Hydrolysis of whey protein concentrates (WPCs) at different temperatures and pHs, using three enzymes: pepsin, trypsin, and Alcalase®, was monitored during more than 5 hr by reversed phase HPLC/UV, using a column containing a polystyrene‐divinylbenzene copolymer‐based packing, and an elution gradient from 8% to 80% acetonitrile containing 0.1% TFA. Peptides were separated according to their polarity and size, and degradation of α‐lactalbumin (α‐la) and β‐lactoglobulin (β‐lg) was evaluated. The three proteolytic enzymes (pepsin, trypsin, and Alcalase®) employed for hydrolysis of WPCs led to different kinetics of degradation of β‐lg. α‐la degradation after 15 min was almost complete for the three enzymes. The hydrolysis catalysed by each enzyme resulted in different peptide profiles by HPLC/UV. Hydrolysates produced by pepsin (HP) were resolved into three main fractions of high retention times, while tripsin hydrolysates (HT) were resolved into nine major peaks and Alcalase® hydrolysates (HA) were resolved into 12 major peaks, presenting a wide range of polarities and sizes. Although, with different β‐lg hydrolysis extension, chromatographic profiles of the degradation and formation of peptides can be used as a finger print of the type of enzyme used, because peptide profile is not affected either by temperature or pH.
Frequency selective propagation effects on spread-spectrum receiver tracking

This paper presents results of investigations of frequency selective scintillation effects, due to transionosphetic propagation, on the performance of spread-spectrum receivers. Emphasis is placed on pseudonoise (PN) direct sequence systems. Pertinent features of the disturbed ionospheric propagation channel are described together with the characteristics of resulting satellite signal scintillations. Effects of frequency selective scintillations on PN spread-spectrum code correlation and tracking are illustrated in some detail. The design of the receiver PN code tracking loop is an important factor in determining the significance of these effects. Of the designs that have been investigated, a dedicated (non-time-shared) noncoherent code tracking loop appears to be least susceptible to losing code lock in the presence of frequency selective scintillation. Possible design modifications to further enhance the robustness of PN code tracking are discussed.
Patterns of comorbidities in newly diagnosed COPD and asthma in primary care.

STUDY OBJECTIVES There is increasing interest in the frequency and nature of comorbidities in patients with obstructive lung disease: COPD and asthma. We aimed to quantify baseline rates of comorbidities in COPD and asthma patients and to compare the risks to the general population. DESIGN, SETTING, AND PARTICIPANTS Within the UK General Practice Research Database, we compared incident patients with COPD (n = 2,699) and asthma (n = 7,931) physician diagnosed in 1998 with age, gender, time, and practice-matched cohorts. Rates were calculated and relative risks (RRs) were estimated for comorbidities in major organ systems and selected medical events of a priori interest. MEASUREMENTS AND RESULTS In both COPD and asthma, the total sum of diagnoses related to major organ systems was higher than in their matched population controls. Among incident COPD patients, a frequency > 1% within the first year after diagnosis was observed for angina, cataracts, bone fractures, osteoporosis, pneumonia, and respiratory infections, the highest being angina with 4.0%. Compared to the non-COPD cohort, COPD patients were at increased risk for pneumonia (relative risk [RR] = 16.0), osteoporosis (RR = 3.1), respiratory infection (RR = 2.2), myocardial infarction (RR = 1.7), angina (RR = 1.7), fractures (RR = 1.6), and glaucoma (RR = 1.3) [all p < 0.05]. Of note, 2.0% of COPD patients had cataracts recorded, but this rate was no different than that of the non-COPD cohort (RR = 0.9). Among incident asthma patients, the occurrence of events was generally lower, likely due to the younger age distribution, except for 4.0% with respiratory infection (RR = 1.84) and 1.7% with fractures (RR = 1.5). Angina prevalence was 0.7% in the asthma cohort and 1.4 times more common than in patients without asthma. CONCLUSION COPD and asthma are conditions associated with many comorbidities, albeit asthma to a lesser extent than COPD, which had not been systematically reviewed before. Baseline rates of cardiovascular-, bone-, and other smoking-related conditions are high.
Implementation of an ionizing radiation detector based on a FPGA-controlled COTS CMOS image sensor

This work presents the development and implementation of an ionizing radiation detector based on a commercial off the shelf CMOS image sensor and a FPGA. The response of the system was tested in irradiations with gamma photons, beta and alpha particles using different configurations of the image sensor. Finally, we analyze the possible uses of such configurations in the discrimination of events produced by alpha particles in mixed radiation fields.