Miracle-dz/UniFAR-FTUs huggingface dataset:
Increased duodenal iron absorption through up‐regulation of divalent metal transporter 1 from enhancement of iron regulatory protein 1 activity in patients with nonalcoholic steatohepatitis

Increased hepatic iron accumulation is thought to be involved in the pathogenesis of nonalcoholic steatohepatitis (NASH). Hepatic iron accumulation, as well as oxidative DNA damage, is significantly increased in NASH livers. However, the precise mechanism of iron accumulation in the NASH liver remains unclear. In this study, 40 cases with a diagnosis of NASH (n = 25) or simple steatosis (SS; n = 15) by liver biopsy were enrolled. An oral iron absorption test (OIAT) was used, in which 100 mg of sodium ferrous citrate was administered to each individual. The OIAT showed that absorption of iron from the gastrointestinal (GI) tract was increased significantly in NASH patients, compared to SS and control subjects. Iron reduction therapy was effective in patients with NASH, who exhibited iron deposition in the liver and no alanine aminotransferase improvement after other therapies (n = 9). Serum hepcidin concentration and messenger RNA (mRNA) levels of divalent metal transporter 1 (DMT1) also were significantly elevated in patients with NASH. OIAT results were correlated with grade of liver iron accumulation and DMT1 mRNA levels. Then, we demonstrated that DMT1 mRNA levels increased significantly in Caco‐2/TC7 cell monolayers cultured in transwells with serum from NASH patients. An electrophoresis mobility shift assay showed activation of iron regulatory protein (IRP) in those cells, and IRP1 small interfering RNA clearly inhibited the increase of DMT1 mRNA levels. Conclusion: In spite of elevation of serum hepcidin, iron absorption from the GI tract increased through up‐regulation of DMT1 by IRP1 activation by humoral factor(s) in sera of patients with NASH. (Hepatology 2015) Hepatology 2015;62:751–761)
Pathophysiology of premature ejaculation.

INTRODUCTION Although the characteristics of premature ejaculation (PE) are established, the exact aetiology is largely unknown. Genetic, neurobiological, pharmacological, psychological, urological and endocrine factors have all been proposed. In addition PE and erectile dysfunction are often co-morbid. AIM This article provides an overview of the proposed biological and psychological aetiologies of PE. METHODS Review of the literature. MAIN OUTCOME MEASURES Current data on the pathophysiology of PE. RESULTS This review shows that most of the proposed biological and psychological aetiologies of PE are not evidence-based and/or that attempts to confirm them have given conflicting results. There are good data to support roles for genetic and psychological factors, either causal, or secondary to PE for the latter, in lifelong PE. Conversely, more evidence-based data support the responsibility of opioid substance withdrawal, prostatic inflammation or hyperthyroidism in some cases of acquired PE, in addition to a probable role of psychological factors. CONCLUSIONS The determinants of PE are certainly complex and multifactorial, while each partner's reaction to the frustration caused by the sexual dysfunction may exacerbate or perpetuate it. It is important to understand, as far as possible, the aetiology in the individual patient to ensure appropriate assessment and treatment. It should be noted that identification of an aetiological factor does not necessarily mean the cause of the PE has been completely explained, and the patient may require a combination of treatment approaches.
Ultraschalldiagnostik am vertebrobasilären Kreislauf - I. Diagnose intrakranieller vertebro-basilärer Thrombosen mit Hilfe der konventionellen Doppler-Sonographie

To define the accuracy and the reliability of Doppler sonography carried out at the extracranial section of the vertebral artery for the detection of intracranially located significantly stenosing lesions of the vertebro-basilar trunk, 72 patients with brainstem disturbances combined with coma were examined prospectively. The Doppler findings were controlled by cerebral angiography. Doppler sonography turned out to be highly reliable for both the detection and the exclusion of high grade intracranial vertebrobasilar lesions. The parthognomonic finding was a pathologically altered time profile of extracranial flow with an abrupt deceleration during systole and discontinued flow or even reflux during diastole. This was called a "high resistance flow profile". However, if significant extracranial lesons are also present, the intracranial flow impedance may be masked. The limitations of Doppler sonography in this diagnostic field are discussed. Doppler sonography can provide the basis for a non-invasive differentiation of various types of cerebrovascular disease to define the optimal therapeutic strategy.
Optimizing Hip Musculature For Greater Sprint Running Speed

MAXIMUM-VELOCITY RUNNING (sprinting) is an important aspect of many sports, and an effective sprint technique is very important for maximizing running speed. It is generally recognized that during constant-velocity running, a runner’s speed is directly related to the horizontal force produced during the foot-ground contact portion of the swing (hip extension) phase (2). Therefore, an effective sprint technique is the sequence of limb movements that allows for optimum transfer of horizontal force to the ground with the least energy expenditure during the foot-ground contact phase. Energy expenditure is less when the resultant muscle forces applied during sprinting culminate in large horizontal forces at the footground interface with little or no energy being used to control unnecessary movements or muscle force imbalances. Thus, using resistance training to prevent unnecessary movement of core regions of the body (the pelvis, for example) and to minimize muscle strength imbalances reduces energy expenditure and ultimately improves sprinting speed, efficiency, or both. A second way to increase running velocity is to improve the power-producing ability of the muscles responsible for providing force against the ground during running. Because power is a function of both force and velocity (or strength and speed), increasing an athlete’s strength should improve that athlete’s ability to produce power. Resistance training can be an effective training method for improving a sprinter’s strength. Given that adaptations to resistance training have been shown to be specific to the constraints of training exercises, those exercises that mimic the sprint-running technique may be more beneficial than “traditional” resistance-training exercises in improving sprintspecific strength. Although movements at the knee and ankle have some influence on the horizontal force produced at foot-ground contact, this article will describe resistancetraining exercises that improve the strength and balance of muscles that act at the hip. The largest amount of force is produced at the hip during foot-ground contact (2). Unless specifically stated, the information presented here is a summary of research conducted by the authors listed in the references (1–9). Figures 1–3 detail many of the muscles referred to in this article.
Human keratin 8 variants promote mouse acetaminophen hepatotoxicity coupled with c‐jun amino‐terminal kinase activation and protein adduct formation

Keratins 8 and 18 (K8/K18) are the intermediate filaments proteins of simple‐type digestive epithelia and provide important cytoprotective function. K8/K18 variants predispose humans to chronic liver disease progression and poor outcomes in acute acetaminophen (APAP)‐related liver failure. Given that K8 G62C and R341H/R341C are common K8 variants in European and North American populations, we studied their biological significance using transgenic mice. Mice that overexpress the human K8 variants, R341H or R341C, were generated and used together with previously described mice that overexpress wild‐type K8 or K8 G62C. Mice were injected with 600 mg/kg of APAP or underwent bile duct ligation (BDL). Livers were evaluated by microarray analysis, quantitative real‐time polymerase chain reaction, immunoblotting, histological and immunological staining, and biochemical assays. Under basal conditions, the K8 G62C/R341H/R341C variant‐expressing mice did not show an obvious liver phenotype or altered keratin filament distribution, whereas K8 G62C/R341C animals had aberrant disulphide cross‐linked keratins. Animals carrying the K8 variants displayed limited gene expression changes, but had lower nicotinamide N‐methyl transferase (NNMT) levels and were predisposed to APAP‐induced hepatotoxicity. NNMT represents a novel K8/K18‐associated protein that becomes up‐regulated after K8/K18 transfection. The more pronounced liver damage was accompanied by increased and prolonged JNK activation; elevated APAP protein adducts; K8 hyperphosphorylation at S74/S432 with enhanced keratin solubility; and prominent pericentral keratin network disruption. No differences in APAP serum levels, glutathione, or adenosine triphosphate levels were noted. BDL resulted in similar liver injury and biliary fibrosis in all mouse genotypes. Conclusion: Expression of human K8 variants G62C, R341H, or R341C in mice predisposes to acute APAP hepatotoxicity, thereby providing direct evidence for the importance of these variants in human acute liver failure. (Hepatology 2015) Hepatology 2015;62:876–886)
Remote “Hovering” With Individuals With Psychotic Disorders and Substance Use: Feasibility, Engagement, and Therapeutic Alliance With a Text-Messaging Mobile Interventionist

Objective: People with serious mental illnesses and substance abuse problems (i.e., dual diagnosis) constitute a particularly challenging and costly clinical group. This study evaluated the feasibility and acceptability of a novel model of care in which a mobile interventionist used mobile phone text messaging to remotely monitor and provide daily support to individuals with psychotic disorders and substance use. Methods: Seventeen participants with dual diagnosis were enrolled in a 12-week single-arm trial. A clinical social worker served as the mobile interventionist and sent daily text messages to participants’ privately owned mobile phones to assess their medication adherence and clinical status. The mobile interventionist provided text-message feedback and support and suggested various coping strategies flexibly, in response to participants’ replies to prompts. At the end of the trial, participants completed a usability and satisfaction measure and two self-rated measures of therapeutic alliance with their clinicians. In one version, participants rated their relationship with their mobile interventionist; in the second version, they rated their relationship with their community-based treatment team. Results: Participants received an average of 139 text messages (SD = 37.5) each from the mobile interventionist over the 12-week trial. On average, participants responded to 87% of the mobile interventionist's messages that required a reply. More than 90% of participants thought the intervention was useful and rewarding and that it helped them be more effective and productive in their lives. Participants’ assessments of their relationship with the mobile interventionist were positive. Paired-sample t-test found that the therapeutic alliance ratings participants provided for their mobile interventionist were significantly higher than those provided for their community-based treatment team clinicians, who they met with regularly. Conclusions: Our findings suggest that text-message “hovering” can be conducted successfully with individuals with psychotic disorders and substance abuse. Developing a cadre of mobile interventionists who are specifically trained on how to engage patients via mobile devices while adhering to ethical guidelines and regulatory standards may be an effective way to strengthen service delivery models, improve patient outcomes, and reduce costs.
Intravascular device-related primary bacteraemia rates in a general intensive care unit

Abstract Introduction the risk of nosocomial infection is greater in an intensive care area than a general ward area. Factors demonstrated as placing intensive care patients at higher risk include the severity of their underlying illness, length of intensive care stay and prolonged exposure to invasive devices. To assess the risk of bloodstream infections associated with intravascular devices we undertook a 6-month survey in a general intensive care unit (ICU). Objective to prospectively determine, firstly, the intravascular device-related bacteraemia rate and, secondly, the central intravascular device utilisation ratio in the ICU of an Australian tertiary referral teaching hospital. Method prospective surveillance of all patients admitted to the general ICU from 11/9/95 to 11/3/96 was performed using Centers for Disease Control and Prevention definitions employed in the National Nosocomial Infection Surveillance program. Results there were 213 patient admissions in the 6-month survey, with an average age of 55.7 years (range 12-94). Mean duration of ICU stay was 6.3 days (range 1-70) and the median ICU length of stay 3 days. Eight episodes of intravascular device-related bacteraemia occurred in this patient group, with four of those burns patients. The intravascular device-related bacteraemia rate was 4.97/1000 device days and the device utilisation ratio for central devices in ICU 0.95. Conclusion we have established the baseline intravascular device-related bacteraemia rate and utilisation ratio for central devices in the general ICU at an Australian teaching hospital. Knowledge of these rates will help identify problems that lead to an increase in bacteraemia rates and allow comparison with other units that collect data using the same methodology. [AIC Aust Infect Control 1999; 4(3):8-11]
Capabilities of optical coherence tomography in laryngology

We present first result of using the optical coherence tomography (OCT) in complex clinical studies in laryngology. Mucosa of the upper and middle portions of larynx is of special interest for OCT applications: it is clinically important, easily accessed by an endoscopic OCT probe, and possesses a well defined and rich tomographic structure. We have examined several tens of patients with abnormalities in vocal folds. The diagnosis was made based on clinical data including laryngoscopy and finally confirmed morphologically. When examining larynx mucosa, an endoscopic OCT probe has been introduced through a standard laryngoscope lumen, so that OCT imaging has been performed in parallel with visual observation. The OCT studies have demonstrated that in comparison with stratified healthy mucosa, carcinomatous regions have no tomographically differentiated structure, thus allowing one to exactly define the border of a tumor. Vocal nodules are imaged as poorly scattering regions without clear boundaries under preserved epithelium. Cysts of gland mucosa are seen with OCT as sharply delineated shadows at the depth of several hundred micrometers. We have also examined several patients with carcinoma after a course of radiation therapy and observed different changes in OCT images of adjoining epithelium corresponding to metaplasia, hyperplasia, and sclerosis.
Hepatitis C guidance: AASLD‐IDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus

The pace of hepatitis C virus (HCV) drug development in recent years has accelerated dramatically. For patients to benefit from these impressive advances, practitioners need access to the most up-to-date data and to advice from experienced experts. Such information and advice can be difficult to access readily given the diverse sources from which information is available and the sometimes lengthy time needed for publication of original articles and scholarly perspectives. Traditional practice guidelines for more established areas of medicine and care often take years to develop and bring to publication. In the new era in hepatitis C treatment, such a process would not be nimble or timely enough to address the needs of patients with HCV infection, practitioners caring for these patients, or payers approving therapies for use. A living document made available in a web-based system, such as that used by the US Department of Health and Human Services for human immunodeficiency virus (HIV) treatment recommendations (http://aidsinfo.nih.gov/guidelines), was selected as the best model to provide timely recommendations for hepatitis C management. In 2013, the two major membership societies supporting liver and infectious disease specialists (American Association for the Study of Liver Diseases [AASLD] and Infectious Diseases Society of America [IDSA]) joined forces to develop guidance for the management of hepatitis C in this rapidly moving field. The International Antiviral Society-USA, which has experience in developing treatment guidelines in HIV disease, was invited to join the effort as a collaborating partner responsible for managing the panel and the guidance development process. The goal of the hepatitis C guidance is to provide upto-date recommendations for HCV care practitioners on the optimal screening, management, and treatment for adults with HCV infection in the United States, using a rigorous review process to evaluate the best available evidence. This review provides a condensed summary of recommendations from the guidance. The complete guidance, which is updated regularly, is available at www.hcvguidelines. org.
Incomplete recovery of erectile function in rat after discontinuation of dual 5-alpha reductase inhibitor therapy.

AIM The association of 5-alpha reductase inhibitor (5ARI) therapy and sexual dysfunction has been reported. Some patients claim persistent erectile dysfunction despite long-term discontinuation of 5ARI treatment. The aim of this study was to assess erectile function after cessation of 5ARI therapy using a rat model. METHODS Twenty-six adult male Sprague-Dawley rats were randomized into three groups: (i) control (N = 10); (ii) 8-week dutasteride treatment (0.5 mg/rat/day, in drinking water, N = 8); and (iii) 6-week dutasteride treatment followed by a 2-week washout period (N = 8). The experiments were performed after 8 weeks from the initiation of treatment in all groups. In vivo erectile activity and in vitro contractile and relaxant responses of cavernosal smooth muscle were investigated. RESULTS In vivo erectile activity (intracavernosal pressure [ICP]/mean arterial pressure [MAP] and total ICP) in treatment groups were significantly decreased compared with controls (ICP/MAP: P < 0.001 for 2.5 v, 5 v, and 7.5 v; total ICP: P < 0.001 for 5 v and P < 0.01 for 7.5 v). Acetylcholine-induced relaxations were diminished in treatment groups (P < 0.05). Relaxant responses to electrical field stimulation (EFS) were decreased in the 8-week treatment group (P < 0.05) but were similar to controls in the washout group. Sodium nitroprusside (SNP)-induced endothelium-independent relaxations were reduced in the 8-week dutasteride treatment group (P < 0.01), while these responses were restored in the washout group. The contractile responses to the alpha1-adrenergic agonist phenylephrine were decreased in treatment groups compared with controls (P < 0.01). Direct neurogenic contractile responses in the dutasteride groups were significantly lower than controls between 1 and 15 Hz frequencies (but not at 20 Hz) and washout partially restored the responses at 10 and 15 Hz. CONCLUSION Discontinuation of dutasteride improved the relaxant responses to EFS and SNP, while cholinergic and adrenergic responses remained depressed. Our findings suggest a time-dependent detriment of dutasteride on erectile function. The withdrawal/washout effect of 5ARIs on parameters of human sexual function warrants further investigation.
Measuring Social Inclusion: A Staff Survey of Mental Health Service Users' Participation in Community Occupations

Mental health service users frequently experience social exclusion and limited occupational engagement. A survey was conducted to gather staff reports of 199 service users' levels of engagement and social inclusion across eight domains of community occupation. The staff reported that the majority of service users (54%) engaged in two or fewer of the community occupation domains over a 7-day period, the most common being the use of local facilities (92%) and contact with family and friends (61%). The staff reports suggested that far fewer service users were engaged in the other domains: day centres (25%), education (14%), sport (13%), arts (12%), employment (11%) and faith (8%). With regard to social inclusion, activities occurred most frequently in mainstream settings for the domains of faith (100%), use of local facilities (98%), sport (80%), and family and friends (79%). Lower levels of social inclusion were reported for the other domains. Statistical analysis revealed that service users' occupational engagement related to their accommodation type, age and gender, but not to ethnicity. These findings indicate that further research is needed to explore service users' views on social inclusion and what they feel would support them to engage in community occupations at a level that suits their individual needs.
Identificação de Aedes (Stegomyia) Albopictus (Skuse) no Brasil

Em 25 de junho de 1986, o Laboratório de Entomologia da Faculdade de Saúde Pública da Universidade de São Paulo recebeu da Superintendência de Campanhas de Saúde Pública (SUCAM) e da Fundação Instituto Oswaldo Cruz (FIOCRUZ), material de Culicidae para identificação. O exame desses espécimens forneceu os resultados a seguir apresentados. On June 25, 1986, the Laboratory of Entomology, School of Public Health of the University of S.Paulo, received a lot of Culicidae of the "Superintendência de Campanhas de Saúde Pública" (SUCAM) and of the "Fundação Instituto Oswaldo Cruz" (FIOCRUZ), for identification. The results are as follow.
Active Communication of a Pharmacy Discharge Plan for Patients with Respiratory Diseases: A Pilot Study

Background: Drug-related problems (DRPs) are common following hospital discharge. Active communication of a written pharmacy discharge plan may increase the number of community pharmacists' interventions. Objective: To assess the impact of the active communication of a written pharmacy discharge plan. Methods: This was a pilot study comparing 2 groups of pharmacists over a period of 6 weeks. Participating community pharmacists were assigned to either the control group (those who provided usual patient care during hospital stay and transmission of a standard written pharmacy discharge plan) or the active communication group (those who, in addition to the usual care provided in the control group and the written pharmacy discharge plan, included a list of up to 3 DRPs with proposed interventions to resolve them and a telephone call from the hospital pharmacist to the community pharmacist to facilitate the transfer of information). The patients enrolled were adults admitted to the respiratory unit of our hospital who were returning home following their discharge. Patients were assigned to the control or the active communication group based on the community pharmacy where they usually filled their prescriptions. Results: Overall, 36 community pharmacists were included in the study and assigned to either the active communication (n = 17) or control group (n = 19). A total of 22 patients were assigned to either the control group (n = 8) or the active communication group (n = 14). The mean number of community pharmacist interventions per patient was 4.2 in the active communication group and 0.9 in the control group (p = 0.0004). The mean number of DRPs per patient for which there was at least one intervention made by the community pharmacist was 2.8 in the active communication group and 0.6 in the control group (p = 0.0001). Conclusions: Results of this pilot study demonstrate that the active communication of a written discharge plan may increase the number of interventions by community pharmacists.