Miracle-dz/UniFAR-FTUs huggingface dataset:
MicroRNAs as regulators of beta‐cell function and dysfunction

In the last decade, there has been an explosion in both the number of and knowledge about miRNAs associated with both type 1 and type 2 diabetes. Even though we are presently in the initial stages of understanding how this novel class of posttranscriptional regulators are involved in diabetes, recent studies have demonstrated that miRNAs are important regulators of the islet transcriptome, controlling apoptosis, differentiation and proliferation, as well as regulating unique islet and beta‐cell functions and pathways such as insulin expression, processing and secretion. Furthermore, a large number of miRNAs have been linked to diabetogenic processes induced by elevated levels of glucose, free fatty acids and inflammatory cytokines. Thus, miRNAs are novel therapeutic targets with the potential of protecting the beta‐cell, and there is proof of principle that miRNA antagonists, so‐called antagomirs, are effective in vivo for other disorders. miRNAs are exported out of cells in exosomes, raising the intriguing possibility of cell‐to‐cell communication between distant tissues via miRNAs and that miRNAs can be used as biomarkers of beta‐cell function, mass and survival. The purpose of this review is to provide a status on how miRNAs control beta‐cell function and viability in health and disease. Copyright © 2015 John Wiley & Sons, Ltd.
Physician discretion is safe and may lower stress test utilization in emergency department chest pain unit patients.

INTRODUCTION Chest pain unit (CPU) observation with defined stress utilization protocols is a common management option for low-risk emergency department patients. We sought to evaluate the safety of a joint emergency medicine and cardiology staffed CPU. METHODS Prospective observational trial of consecutive patients admitted to an emergency department CPU was conducted. A standard 6-hour observation protocol was followed by cardiology consultation and stress utilization largely at their discretion. Included patients were at low/intermediate risk by the American Heart Association, had nondiagnostic electrocardiograms, and a normal initial troponin. Excluded patients were those with an acute comorbidity, age >75, and a history of coronary artery disease, or had a coexistent problem restricting 24-hour observation. Primary outcome was 30-day major adverse cardiovascular events-defined as death, nonfatal acute myocardial infarction, revascularization, or out-of-hospital cardiac arrest. RESULTS A total of 1063 patients were enrolled over 8 months. The mean age of the patients was 52.8 ± 11.8 years, and 51% (95% confidence interval [CI], 48-54) were female. The mean thrombolysis in myocardial infarction and Diamond & Forrester scores were 0.6% (95% CI, 0.51-0.62) and 33% (95% CI, 31-35), respectively. In all, 51% (95% CI, 48-54) received stress testing (52% nuclear stress, 39% stress echocardiogram, 5% exercise, 4% other). In all, 0.9% patients (n = 10, 95% CI, 0.4-1.5) were diagnosed with a non-ST elevation myocardial infarction and 2.2% (n = 23, 95% CI, 1.3-3) with acute coronary syndrome. There was 1 (95% CI, 0%-0.3%) case of a 30-day major adverse cardiovascular events. The 51% stress test utilization rate was less than the range reported in previous CPU studies (P < 0.05). CONCLUSIONS Joint emergency medicine and cardiology management of patients within a CPU protocol is safe, efficacious, and may safely reduce stress testing rates.
International Spanish/English Internet smoking cessation trial yields 20% abstinence rates at 1 year.

INTRODUCTION There are 1.1 billion smokers worldwide. Traditional smoking cessation methods, such as nicotine replacement therapy and smoking cessation groups, yield between 14% and 27% abstinence rates at 6 months. Evidence-based Internet interventions with comparable abstinence rates could be a powerful global tool to reduce tobacco-related morbidity and mortality. METHODS We report a randomized control trial in which 500 Spanish-speaking and 500 English-speaking adult Internet users, smoking at least 5 cigarettes/day and intending to quit in the next month, were recruited online from 68 countries. Consenting participants who completed baseline measures, logged cigarettes smoked on 3 days within a week, and set a quit date were randomized to four conditions. Each condition added new elements: Condition 1 was the "Guía Para Dejar de Fumar," a static National Cancer Institute evidence-based stop smoking guide; Condition 2 consisted of Condition 1 plus E-mail reminders to return to the site; Condition 3 consisted of Condition 2 plus mood management lessons; and Condition 4 consisted of Condition 3 plus a "virtual group" (an asynchronous bulletin board). Main outcome measures were 7-day point prevalence abstinence at 1, 3, 6, and 12 months after initial quit date. RESULTS There were no significant differences among the four conditions. The overall 12-month 7-day abstinence rates were 20.2% for Spanish speakers and 21.0% for English speakers when those with missing data were assumed to be smoking. DISCUSSION Internet smoking cessation interventions with such abstinence rates provided globally in additional languages could contribute substantially to tobacco control efforts.
Central control of an insect segmental reflex. II. Analysis of the inhibitory input from the metathoracic ganglion.

1. The prothoracic grooming reflex of the locust is normally inhibited by the rest of the C.N. S. This paper examines the effect of removing the most powerful inhibitory source, the metathoracic ganglion, on the signal flow in and out of the prothoracic ganglion. 2. Removal of the metathoracic ganglion decreases the number of action potentials entering the prothoracic ganglion; the number of action potentials leaving the prothoracic ganglion increases. Since the recording samples only about 1% of the axons in the connective, mainly large ones, and since the sample is probably different in different preparations, it is concluded that removal of the input from the metathoracic ganglion causes a general disinhibition of the prothoracic ganglion. 3. Inhibition of the grooming reflex is probably due to this general inhibition of the ganglion, not to a specific inhibitory connexion with the metathoracic ganglion. It is suggested that the total input to the ganglion may, apart from its specific functions, contribute to a non-specific inhibition, possibly via a ganglionic arousal system.
The significance of the sense of coherence for various coping resources in stress situations used by police officers in on-the-beat service

BackgroundPolice officers meet many stressors as part of their occupation. The psychological resource “sense of coherence” (SOC) protects against ill-health, but its impact on coping resources for stress situations has not been studied in the population of police officers. Different approaches to investigate the significance of SOC for different outcomes have been identified in literature, leading to some difficulties in the interpretation and generalization of results. The aim was therefore to explore SOC and the coping resources, and to examine the significance of SOC for various coping resources for stress using different models in a sample of Swedish police officers providing on-the-beat service.Materials and MethodsOne hundred and one police officers (age: mean = 33 years, SD = 8; 29 females) were included, and the Orientation to Life Questionnaire (SOC-29) and the Coping Resources Inventory (CRI) were used. The dependent variable in each regression analysis was one of the coping resources: cognitive, social, emotional, spiritual/philosophical, physical, and a global resource. Global SOC-29 and/or its components (comprehensibility, manageability, and meaningfulness) were investigated as independent variables.ResultsAll CRI and SOC-29 scores except for that of spiritual/philosophical resources were higher than those of reference groups. Manageability was the most important component of SOC for various coping resources in stress situations used by police officers.ConclusionA deeper study of manageability will give useful information, because this component of SOC is particularly significant in the variation in resources used by police officers to cope with stress. Salutogenesis, the origin of well-being, should be more in focus of future research on workplaces with a high level of occupational stress.
Different responses to chronic somatostatin analogues in patients with central hyperthyroidism

Objective Central hyperthyroidism is mainly due to two different causes, TSH‐secreting pituitary adenoma (TSH‐oma) and resistance to thyroid hormone in its pituitary variant, i.e. patients presenting with signs and symptoms of hyperthyroidism (PRTH). Because therapeutic approach and the clinical follow‐up are extremely different in these two disorders, a correct differential diagnosis is mandatory. Unfortunately, no definite pathognomonic tool is presently available and an extensive biochemical and instrumental workup is frequently needed in order to reach the correct diagnosis. Aim of the present study was to investigate the use of somatostatin analogues in the differential diagnosis between TSH‐omas and PRTH, as well as the possible treatment of PRTH with these analogues.
Protein C deficiency: a cause of amaurosis fugax?

also improved. Two weeks after operation her serum thyroxine rose to 72 nmol/l; basal TSH was minimally elevated at 6 5 mu/I and after 200 pg TRH, rose to 9 8 mu/l at 20 minutes. Basal prolactin was elevated at 38 pg/l. Her basal LH (4 u/I) and FSH (2 u/l) showed no response to 100 pg LHRH, and her plasma oestradiol was undetectable. During an insulin tolerance test her plasma glucose fell to 12 mmol/l and her basal morning plasma cortisol of 175 nmol/l rose to 420 nmol/l, a substantial response. During a water deprivation test her plasma osmolality rose to 303 mosm/kg, her urine rising to a maximum of 404 mosm/kg indicating diabetes insipidus. Two months after operation her serum thyroxine had risen to 85 nmol/l and TSH fallen to 16 mu/l. She had mild symptoms of diabetes insipidus and still had amenorrhoea with galactorrhoea. Her basal prolactin was elevated at 28 pg/l. Two months later her thirst and polyuria had improved, though she still had no periods and her prolactin remained elevated at 51 ug/l, whilst at 8 months she had no further symptoms attributable to diabetes insipidus although her galactorrhoea and amenorrhoea remained. Isolated granulomatous lesions of the pituitary are rare and the differential diagnosis includes sarcoidosis, tuberculosis, syphilis and giant cell granuloma.2 Although acid fast bacilli were not seen in this case, the patient's past history, results of investigation and improvement with anti-tuberculous treatment made a pituitary tuberculoma the likely diagnosis. There have been few reports of pituitary tuberculoma in the past3 although there have also been reports of giant cell granuloma of unknown origin68 which might represent a solitary tuberculoma. Hassoun et a18 claimed that the diagnosis of a pituitary granuloma is suggested by marked hypopituitarism, out of proportion to the size of the tumour. Clearly in our case, there was significant suprasellar enlargement, and the degree of hypopituitarism was not inconsistent with this. Our patient presented as a neurosurgical emergency and although the diagnosis of tuberculoma was not considered preoperatively, the appropriate treatment was operative decompression of the optic chiasm. Post-operatively she still has some endocrine dysfunction as shown by the mild hyperprolactinaemia, gonadotrophin deficiency and mild diabetes insipidus. However, her hypothyroidism has improved, and although we do not have a pre-operative insulin stress test for comparison ofdynamic pituitary adrenal function, morning cortisols have returned towards normal. The potential importance of recognising a tuberculoma as a possible cause of a space occupying lesion within the pituitary fossa is that it may be treated conservatively with less hazard to the patient than operative intervention. Clearly, however, if the patient presents as a neurosurgical emergency, there may be no alternative to surgical decompression. We thank Mr A Crockard who performed the trans-sphenoidal surgery on this patient and Dr RD Barnard for the pathological interpretation, and Professor WI McDonald for allowing us to report his patient.
The quality of primary health care for chronically ill patients: a cross-sectional study.

BACKGROUND Patients with at least one chronic disease requiring regular contact with their GP, additional tests and systematic use of medicines constitute one of the challenges for the future of primary medical care. To date, no studies have been published describing the most important factors in increasing the quality of care for the chronically ill. OBJECTIVES To evaluate correlations between patients' characteristics and their assessments of the quality of health care and to identify the primary factors influencing the quality of care for chronically ill patients. MATERIAL AND METHODS The sample for the current analysis included 232 chronically ill adult patients of primary care clinics in Poland. The patients' opinions regarding subjective and objective examinations, their participation in clinical decision-making processes, psychosocial factors, contact with the doctor in emergency situations and confidence in the doctor were investigated. RESULTS The strongest correlations defining the quality of care for the chronically ill were identified as the occurrence of hypertension (0.248, p < 0.001), the patient's gender (0.271, p < 0.001), the patient's level of education (0.169, p < 0.01) and the patient's age (0.155, p = 0.018). The results of the ANOVA test were statistically significant (p < 0.05) for the occurrence of myocardial infarction, hypertension, type 2 diabetes, psoriasis, multiple sclerosis, the doctor's gender, the patient's gender, age and education. CONCLUSIONS The areas that the participants gave the highest ratings to are subjective and objective examinations, kindness and willingness to help. The strongest correlations between high assessments of the quality of care provided for chronically ill patients at primary care clinics were observed in the following variables: gender, age, level of education, frequency of visits, therapy conducted by a doctor at a specialist clinic, arterial hypertension, COPD and/or myocardial infarction.
CryoSat-2 SAR-Mode Over Oceans: Processing Methods, Global Assessment, and Benefits

Inspired by the synthetic aperture radar (SAR) technique, a nadir radar altimeter concept called the “Delay/Doppler altimeter” or “SAR mode altimeter” provides better precision and resolution capabilities than conventional pulse-limited altimeters (i.e., low-resolution mode). This concept was initially carried on board the CryoSat-2 satellite, then used on Sentinel-3, initially for user requirements on ice or inland water monitoring. This paper addresses geophysical parameter retrieval from Delay/Doppler altimetry over ocean surfaces. For the inversion of geophysical parameters (sea surface height, significant wave height, and backscatter coefficient), we developed an inversion method based on the numerical computation of the radar power-return equation, including instrument design features, such as the range and azimuth impulse responses. To compare this technique with respect to conventional altimetry, we also generated reduced SAR (RDSAR) measurements from the same input data. Geophysical parameter retrieval from low- and high-resolution techniques was then performed for cross-comparison, demonstrating consistency for both techniques, but with a constant 3-cm bias. The proposed processing strategy was then validated using two years of CryoSat-2 data over oceans. The SAR mode provides significant benefits for the observation of small-scale signals (below 50 km) and performs as accurately as conventional altimetry for basin or global scales. The results demonstrate what is expected from the upcoming Sentinel-3 and Sentinel-6/Jason-CS missions.
Gastrostomies in Older Patients: The 1990 National Hospital Discharge Survey

Background: Although many published case series have described patients' experiences after gastrostomy placement, generalizing from the results of case series can present problems. The purpose of this study was to examine gastrostomy placement among hospitalized older patients in a nationally representative sample. Methods: Using the 1990 National Hospital Discharge Survey, age, sex, race, primary and secondary diagnoses, and mortality were described for hospitalized patients aged 65 years and older having gastrostomies. Age-specific placement rates were calculated using mid-199O Census Bureau population estimates. Results: In 1990 an estimated 85,400 patients aged 65 years and older were discharged from hospitals with gastrostomies. Frequent primary diagnoses included cerebrovascular disease (19 percent), pneumonia with or without aspiration (12 percent), neoplasm (11 percent), and fluid and electrolyte disorders (9 percent). The in-hospital mortality rate was 16 percent Age-specific rates for gastrostomy increased from 1.2 per 1000 for those aged 65 to 74 years to 10.8 per 1000 for those aged 85 years and older. Conclusions: In 1990 older hospitalized patients had gastrostomies with surprising frequency, and their in-hospital mortality rate was substantial. An estimated 1 percent of the US population aged 85 years and older was discharged from a hospital in 1990 with a gastrostomy.
Predictive Factors in Prostate Cancer: Implications for Decision Making

Prostate cancer is the most common cancer in American men, accounting for approximately 180,000 cases and 37,000 deaths annually. To date, prostate cancer constitutes a major public health problem compounded by many controversies surrounding its optimal management. While this cancer is potentially lethal for some patients, others may be managed conservatively with a greater chance of death from other causes and without significant morbidity from the cancer itself. Since the current available tests do not allow clinicians to accurately discriminate between aggressive and indolent tumors, the decision-making process is often intricate with potential over and under treatment of the disease. These difficulties are further aggravated in face of the numerous treatment modalities, each compounded by its own pros and cons. The widespread use of the prostate-specific antigen (PSA) assay starting in the early 1990s has triggered a stage migration where the majority of patients with newly diagnosed prostate cancer present with clinically localized disease. Treatment strategies for localized prostate cancer are aimed to provide long-term cure, which is distinguished from management of locally advanced or metastatic disease intended to ensure adequate palliation and prolong survival. Management alternatives for localized prostate cancer include expectant management (watchful waiting), radical prostatectomy, and radiotherapy (external-beam radiation or interstitial brachytherapy), whereas metastatic disease is generally treated with androgen ablation and chemotherapeutic regimens. Considering the variety of treatment options available, our goal would be to tailor the therapeutic approach to each individual cancer. For instance, watchful waiting should be offered to men with low-grade, low-volume, presumably clinically insignificant cancers with a relatively short life expectancy. To date there have been no valid randomized prospective controlled studies comparing these treatment modalities, thus decisions are not based on robust comparative information but rather result from individual biases and choices made by informed patients and clinicians. While urologists and radiation oncologists do agree on a variety of issues regarding detection and treatment of prostate cancer, specialists overwhelmingly recommend the therapy that they themselves deliver. Moreover, staging methods have their limitations and up to half of men with clinically confined prostate cancers are found to have extracapsular extension at surgery. It is unclear whether clinical or pathological extraprostatic disease should
A 284-µW 1.85-GHz 20-phase oscillator using transfer gate phase couplers

We propose a transfer gate phase coupler for a low-power multi-phase oscillator (MPOSC). The phase coupler is an nMOS transfer gate, which does not waste charge to the ground and thus achieves low power. The proposed MPOSC can set the number of outputs to an arbitrary number. The test circuit in a 180-nm process and a 65-nm process exhibits 20 phases, including 90° different angles. In a 65-nm process, the measured peak DNL and 3s period jitter are, respectively, less than ±1.2° and 5.82 ps. The minimum I/Q angle error is 0.019°. The power is 284 µW at 1.85 GHz.
Factores de riesgo para enfermedad tromboembólica venosa (ETV) posterior a cirugía de reemplazo de cadera y rodilla

a) Determinar los factores de riesgo y frecuencia de que ocurra enfermedad tromboembolica venosa en pacientes sometidos a una artroplastia de cadera o de rodilla. b) Proponer los lineamientos fisicos y farmacologicos para prevenir esta. La cirugia electiva para el reemplazo total de cadera (RTC) y de rodilla (RTR) se asocia con una incidencia muy alta de ETV asintomatica. La trombosis venosa profunda (TVP) o la tromboembolia pulmonar (TEP) sintomaticas se diagnostican en solo 2 a 4% de estos pacientes. La incidencia y el tiempo de evolucion de la ETV sintomatica posterior a estos procedimientos es para el RTR alta en la pantorrilla y casi todos los eventos se diagnostican en los primeros veintiun dias despues de la cirugia. En cambio, para el RTC hay una mayor incidencia de TVP proximal sintomatica y una incidencia mediana para la ETV sintomatica, de las cuales muchas se diagnostican despues de seis a ocho semanas del alta hospitalaria. La tromboprofilaxis extendida reduce la incidencia de ETV sintomatica y asintomatica en pacientes con RTC pero menos en los pacientes con RTR, ya que algunos factores asociados al desarrollo de ETV despues de RTR no estan bien definidos. Los factores de riesgo importantes asociados al desarrollo de la ETV despues del RTC incluyen:
Inhibition of Human Cytomegalovirus Immediate-Early Gene Expression by Cyclin A2-Dependent Kinase Activity

ABSTRACT Human cytomegalovirus (HCMV) starts its lytic replication cycle only in the G0/G1 phase of the cell division cycle. S/G2 cells can be infected but block the onset of immediate-early (IE) gene expression. This block can be overcome by inhibition of cyclin-dependent kinases (CDKs), suggesting that cyclin A2, the only cyclin with an S/G2-specific activity profile, may act as a negative regulator of viral gene expression. To directly test this hypothesis, we generated derivatives of an HCMV-permissive glioblastoma cell line that express cyclin A2 in a constitutive, cell cycle-independent manner. We demonstrate that even moderate cyclin A2 overexpression in G1 was sufficient to severely compromise the HCMV replicative cycle after high-multiplicity infection. This negative effect was composed of a strong but transient inhibition of IE gene transcription and a more sustained alteration of IE mRNA processing, resulting in reduced levels of UL37 and IE2, an essential transactivator of viral early gene expression. Consistently, cyclin A2-overexpressing cells showed a strong delay of viral early and late gene expression, as well as virus reproduction. All effects were dependent on CDK activity, as a cyclin A2 mutant deficient in CDK binding was unable to interfere with the HCMV infectious cycle. Interestingly, murine CMV, whose IE gene expression is known to be cell cycle independent, is not affected by cyclin A2. Instead, it upregulates cyclin A2-associated kinase activity upon infection. Understanding the mechanisms behind the HCMV-specific action of cyclin A2-CDK might reveal new targets for antiviral strategies.