Miracle-dz/UniFAR-FTUs huggingface dataset:
Detection of neuropathy using a sudomotor test in type 2 diabetes

Background The sudomotor test is used to evaluate the postganglionic cholinergic sympathetic nervous system. The aim of this study was to evaluate the efficacy of a sudomotor testing device to detect peripheral distal neuropathy (PDN) and cardiac autonomic neuropathy (CAN) in patients with type 2 diabetes. Materials and methods A total of 133 type 2 diabetic patients were included in the study. The patients underwent examination at the IPC Heart Care Centre (Mumbai, India) in order to assess the diabetic neuropathy symptoms (DNS) score, using a questionnaire, and the CAN score, using heart rate variability analysis and Ewing tests. In addition, patients were given a sudomotor test using the SudoPath™ system. The diagnosis of PDN is based on the DNS score. A DNS score of 1 or higher is defined as a positive result for PDN. According to the DNS score, the patients were separated into two groups: Group 1 comprised 35 patients (21 males), with the mean age of 66 years (standard deviation [SD] =12.1), who had a DNS score ≥1. Group 2 comprised 98 patients (65 males), with the mean age of 56 years (SD =9.6), who had a DNS score =0. The SudoPath system is a galvanic skin response device that uses the quantitative sudomotor axon reflex approach to assess for small and unmyelinated fiber neuropathy. The system provides a sudomotor response (SMR) score based on these three measured sudomotor parameters. A statistical analysis was performed using the analysis of variance to compare mean differences between the groups as well as receiver operating characteristic (ROC) curves, to determine the specificity and sensitivity of SMR score to detect PDN, comparing the diabetic groups 1 and 2, and the coefficient of correlation between the CAN score and the SMR score in all the subjects included in the study. Results When comparing the diabetes groups 1 and 2, the SMR Score had a sensitivity of 91.4% and specificity of 79.1% (cutoff number >3) to detect PDN (P=0.0001). Area under the ROC curve (AUC) =0.893. A correlation analysis of the CAN score and SMR score returned a coefficient of correlation r=0.68 (P<0.0001). Conclusion The SudoPath system is easy to use, operator-independent, and fast (3-minute testing time). This study shows that the device will be useful to assess the susceptibility of type 2 diabetes patients in developing PDN complications.
Chimaeric VP2 proteins from infectious bursal disease virus containing the N-terminal M2e of H9 subtype avian influenza virus induce neutralizing antibody responses to both viruses

Subunit vaccines capable of inducing antibody against both infectious bursal disease virus (IBDV) and H9 subtype avian influenza virus (AIV) were developed. The VP2 protein of IBDV was used as a cargo protein to display a 12-amino-acid immunodominant epitope derived from the N-terminal M2 extracellular domain (nM2e) of the H9 subtype AIV. Two chimaeric proteins were constructed by insertion of one copy of the nM2e into the PBC region (VP2BCnM2e(H9)) or by fusing four copies of nM2e to the carboxyl terminal (VP2-4nM2e(H9)) of VP2. Genes that encoded the VP2 chimaeras were subsequently cloned into a baculovirus vector and expressed in Spodoptera frugiperda cells. The recombinant proteins were used to vaccinate chickens at day 0 and again after 4 weeks. Blood was collected at 2-week intervals after primary and secondary vaccination to detect the antibody titre against VP2 or the nM2e via indirect enzyme-linked immunosorbent assay. Virus neutralization tests were also performed to measure anti-IBDV or anti-H9 AIV neutralizing antibodies in chick embryo fibroblasts. Oropharyngeal and cloacal swabs were collected 3, 5 and 7 days post H9 subtype AIV infection for virus isolation. Vaccination with VP2-4nM2e(H9) induced higher levels of antibody responses against IBDV or H9 subtype AIV, and provided better protection against an IBDV virulent challenge compared with vaccination with VP2BCnM2e(H9) vaccine, the wild-type VP2 subunit vaccine or the IBDV subunit commercial vaccines. Both chimaeric VP2 vaccines showed poor efficacy in inhibiting H9 virus replication post challenge. In summary, chimaeric proteins that contain the nM2e epitope were able to induce both IBDV and H9 subtype AIV-neutralizing antibody responses.
Antiangiogenesis agents in colorectal cancer

Purpose of review The vascular endothelial growth factor (VEGF) system is a critical regulator of angiogenesis and known to promote tumor growth and invasion in colorectal cancer (CRC). Bevacizumab is currently the only VEGF inhibitor with clear proof of efficacy in CRC, but optimal use of this agent at various stages of the disease is still under investigation. Additionally, there are numerous other angiogenesis agents targeting VEGF and other proangiogenic systems in clinical development. Recent findings Although bevacizumab has been shown to improve outcomes in terms of progression-free and overall survival in the setting of metastatic CRC (mCRC), it does not appear to provide long-term benefit in the adjuvant setting. The combination of VEGF inhibition with epidermal growth factor inhibition with chemotherapy does not improve survival for patients with mCRC, and may potentially be harmful in the first-line setting. Tyrosine kinase inhibitors in combination with other therapies show promise in early clinical trials in mCRC. Summary Current evidence suggests that the benefit of VEGF inhibition with bevacizumab in CRC is limited to the metastatic setting. Dual antibody therapy with bevacizumab and an epidermal growth factor inhibitor (cetuximab or panitumumab) should not be used in mCRC. Results of ongoing trials involving tyrosine kinase inhibitors may result in an expansion of treatment options for patients with CRC.
Antimicrobial resistance and class 1 and 2 integrons in Escherichia coli from meat turkeys in Northern Italy

This study is aimed at determining the antimicrobial resistance (AMR) and the presence of class 1 and 2 integrons in 48 avian pathogenic Escherichia coli (APEC) strains isolated from meat turkeys during three sequential production cycles. Thirty avian faecal E. coli (AFEC) strains from the first cycle were also analysed. Strains were tested for AMR against 25 antimicrobials by disk diffusion test and were screened for the presence of integrons and associated gene cassettes by polymerase chain reaction followed by sequencing. Genetic relatedness of isolates was established by pulsed-field gel electrophoresis. High levels of resistance were detected to tetracyclines, penicillins and sulphonamides in APEC and AFEC. Resistance to aminoglycosides, fluoroquinolones, cephalosporins and phenicols was variable, based on the antimicrobial drug and the isolate (APEC vs. AFEC). Full susceptibility to colistin was detected. Multidrug resistance of up to seven antimicrobial classes was exhibited by APEC (93.8%) and AFEC (100%). Nearly 44% of strains tested positive for class 1 and/or class 2 integrons containing the dfrA, aadA and sat2 genes, alone or in combination, coding for streptomycin/spectinomycin, trimethoprim and streptothricin resistance, respectively. The estX and orfF genes of unknown function were also detected. A significant association was found between the presence of integrons and the resistance to aminoglycosides and potentiated sulphonamides. The results of this study showed that AMR, multidrug resistance and class 1 and 2 integrons are widespread among pathogenic and commensal E. coli from Italian turkeys. More attention should be addressed to limit the use of antimicrobials in turkeys and the AMR of turkey E. coli.
Molecular-targeted therapy of head and neck squamous cell carcinoma: beyond cetuximab-based therapy

Purpose of review Cetuximab improves the overall survival of patients with squamous cell carcinoma of the head and neck (SCCHN), in combination either with radiation therapy or with chemotherapy. However, only a minority of patients seem to benefit from cetuximab. This paper will review the different strategies developed either to overcome epidermal growth factor receptor (EGFR) resistance or to inhibit the other relevant activated molecular pathways. Recent findings Recent trials have investigated the possibility of including anti-EGFR therapies in the multimodal curative treatment of SCCHN in combination with neoadjuvant chemotherapy, concomitant chemoradiation or as maintenance therapy. Second-generation compounds (pan-HER or dual EGFR/HER-2 tyrosine kinase inhibitors) have been designed in an attempt to overcome the postulated resistance to anti-EGFR treatments in SCCHN. Alternative targeted therapies have also been developed to inhibit the other activated molecular pathways. Some of these new treatments have shown either promising activity in preclinical models or interesting preliminary activity in early phase II trials. Phase III trials are now required to validate the findings. Summary Despite an aggressive multimodal approach, more than 50% of patients with SCCHN will relapse. It is therefore essential that targeted agents continue to be evaluated in this disease in the hope of improving outcome.
Chemical Composition and Antipathogenic Activity of Artemisia annua Essential Oil from Romania

The essential oil extracted by hydrodistillation from Romanian Artemisia annua aerial parts was characterized by GC/MS analysis, which allowed the identification of 94.64% of the total oil composition. The main components were camphor (17.74%), α‐pinene (9.66%), germacrene D (7.55%), 1,8‐cineole (7.24%), trans‐β‐caryophyllene (7.02%), and artemisia ketone (6.26%). The antimicrobial activity of this essential oil was evaluated by determining the following parameters: minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC), minimal fungicidal concentration (MFC), and minimal biofilm eradication concentration (MBEC). Moreover, the soluble virulence factors were quantified with different biochemical substrates incorporated in the culture media. The reference and resistant, clinical strains proved to be susceptible to the A. annua oil, with MICs ranging from 0.51 to 16.33 mg/ml. The tested essential oil also showed good antibiofilm activity, inhibiting both the initial stage of the microbial cell adhesion to the inert substratum and the preformed mature biofilm. When used at subinhibitory concentrations, the essential oil proved to inhibit the phenotypic expression of five soluble virulence factors (hemolysins, gelatinase, DNase, lipases, and lecithinases). Briefly, the present results showed that the A. annua essential oil contained antimicrobial compounds with selective activity on Gram‐positive and Gram‐negative bacterial strains as well as on yeast strains and which also interfere with the expression of cell‐associated and soluble virulence factors.
Comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy for renal cell carcinoma: a systematic review and meta‐analysis

Laparoscopic nephrectomy is now considered to be the reference procedure for kidney cancer. It can be performed via a transperitoneal or retroperitoneal approach. Each approach has its advantages and disadvantages. No definitive conclusions regarding objective difference between the two approaches have been reached to date. This meta‐analysis indicates that in appropriately selected patients, especially patients with posteriorly located renal tumors, the retroperitoneal approach may be faster and equally safe compared with the transperitoneal approach.
A geographic analysis of male urethral stricture aetiology and location

The incidence of specific aetiologies of urethral stricture disease has been reported from a variety of series throughout the world. Most reported urethral stricture series are from single institutions or from a specific region of the world. We provide a multi‐centred series to compare aetiologic incidence between differing regional populations.
The Healthiest City: Milwaukee and the Politics of Health Reform

With the publication of Leavitt's book, there are now two major works concerned with the historical development of single municipal public health departments in the United States, the other being John Duffy's monumental two-volume record of the New York City experience. While the latter covers a much longer time span and is more comprehensive, Leavitt's opus does have certain advantages, particularly in regard to her major theme, understanding the process of health reform as it unfolded in the late 19th and early 20th centuries. Instead of chronicling how Milwaukee faced all its major public health problems, Leavitt chooses to focus on three illustrative issues—smallpox, garbage, and milk—representing, respectively, the larger areas of infectious disease, sanitation, and food control. In each of these well-researched sections, she examines how serious conflicts over policy based on economic interests, political ideology, and culture were handled and ultimately resolved. Most interesting is her discussion of
Variation of Chemical Composition in Flowers and Leaves Essential Oils Among Natural Population of Tunisian Glebionis coronaria (L.) Tzvelev (Asteraceae)

The aim of this study was to assess the percentage and constituents variations in flowers and leaves essential oil of three Glebionis coronaria (L.) Tzvelev population, growing wildly in three different ecotypes (Utique, M'saken, and Sahara Lektar) in Tunisia. The chemical compositions of these essential oils were analyzed by the GC and GC/MS systems. Qualitative and quantitative differences were recorded between essential oils extracted from plants collected from the three geographical provinces and between organs of the same plant (leaves and flowers). In fact, 161 components representing 87.2 – 96.5% of the whole oils were identified. Myrcene (3.2 – 35.7%), (Z)‐β‐ocimene (0.6 – 23.0%), camphor (0.6 – 17.2%), cis‐chrysanthenol (0 – 6.9%), cis‐chrysanthenyl acetate (1.1 – 17.9%), isobornyl acetate (1.6 – 3.5%), (E)‐β‐farnesene (0 – 6.0%), germacrene D (0 – 8.7%), and (E,E)‐α‐farnesene (0.7 – 12.4%) were the predominant components in the oils. These major constituents occur in different amounts depending on the organs (leaves or flowers) and the geographical origin of the plant. The chemotaxonomic usefulness of these data was discussed according to results of principal component analysis (PCA). The scores, together with the loadings, revealed a different chemical pattern for each population.
Comparative analysis of cervical cytology and human papillomavirus genotyping by three different methods in a routine diagnostic setting

Application of Bethesda guidelines on cervical cytology involves human papillomavirus (HPV) determinations on all ASC-US and ASC-H results. We compared HPV DNA results in view of the eventual development of a cervical intraepithelial neoplasia lesion determined either on cytology or histology. A total of 214 liquid-based cytology samples were analysed. Three different HPV DNA methods were applied: the Abbott RealTime High Risk HPV test, INNO-Lipa HPV Genotyping Extra and Full Spectrum PCR HPV Amplification and Detection/Genotyping System by Lab2Lab Diagnostic Service. A comparison of these three methods showed full concordance only for 49 samples (23%), and 27 (13%) of the samples were discordant in indicating the presence of the high-risk HPV type. Out of 214 patients, 88 were selected who presented with a cervical intraepithelial neoplasia or a VAIN lesion at follow-up cytology or histology. In this group, full concordance with HPV genotyping was present only in 19 (22%) follow-up samples. Nine (10%) follow-up samples showed discordant results for the presence of a high-risk genotype between the three genotyping methods tested either by negativity for high-risk HPV by one of the methods (n=6) or by failure to genotype HPV (n=2), or by a combination of both (n=1). Moreover, discordance for the detection of HPV16 or HPV18 was observed between the three HPV DNA genotyping methods used in 9 (10%) follow-up samples. In addition, the performance of genotyping methods on 20 external quality samples was assessed, showing discordant results for HPV16 and HPV18. Major differences were found in the genotyping results according to the HPV DNA method. Our findings highlight the importance of careful interpretation of data from studies using different HPV genotyping methods and underline the need for standardization by method validation in clinical laboratories, especially in the setting of primary HPV screening.
Metabolomic Tools to Assess the Chemistry and Bioactivity of Endophytic Aspergillus Strain

Endophytic fungi associated with medicinal plants are a potential source of novel chemistry and biology that may find applications as pharmaceutical and agrochemical drugs. In this study, a combination of metabolomics and bioactivity‐guided approaches were employed to isolate secondary metabolites with cytotoxicity against cancer cells from an endophytic Aspergillus aculeatus. The endophyte was isolated from the Egyptian medicinal plant Terminalia laxiflora and identified using molecular biological methods. Metabolomics and dereplication studies were accomplished by utilizing the MZmine software coupled with the universal Dictionary of Natural Products database. Metabolic profiling, with aid of multivariate data analysis, was performed at different stages of the growth curve to choose the optimized method suitable for up‐scaling. The optimized culture method yielded a crude extract abundant with biologically‐active secondary metabolites. Crude extracts were fractionated using different high‐throughput chromatographic techniques. Purified compounds were identified by HR‐ESI‐MS, 1D‐ and 2D‐NMR. This study introduced a new method of dereplication utilizing both high‐resolution mass spectrometry and NMR spectroscopy. The metabolites were putatively identified by applying a chemotaxonomic filter. We also present a short review on the diverse chemistry of terrestrial endophytic strains of Aspergillus, which has become a part of our dereplication work and this will be of wide interest to those working in this field.
Factors associated with the utilization of mammographic screening in Greece

Breast cancer is the most commonly diagnosed type of cancer in women and the primary cause of death by cancer in women globally. Early diagnosis and treatment can be achieved through screening, mainly mammographic; however, international experience has shown that women do not attend mammographic screening adequately. The aim of the present study was to investigate and assess the factors that affect demand for mammography by women to improve and enhance the use of mammography by women in Greece, especially those in the 50–70 age group. The data used in the analysis were extracted from the National Health Survey of 2009, conducted by the Hellenic Statistical Authority. The sample for the analysis included 2294 women aged 30–70 years. To investigate the factors that affect mammography use, binary logistic regression models were constructed for women in the 30–39, 40–49 and 50–70 age groups. 61.70% of the sample had ever undergone a mammogram, 46.80% of which were during the last 12 months. Factors associated with mammography use in at least one of the binary logistic regression models were pap-test, blood cholesterol test, level of education, income level and country of birth. In the 50–70 age group, income level [odds ratio (OR)=1.164; 95% confidence interval (CI)=1.038, 1.305], blood cholesterol test ever (OR=6.096; 95% CI=2.498, 14.872) and pap-test (OR=20.148; 95% CI=11.264, 36.040) were found to be statistically significant predictors of mammography uptake. As mammography utilization in Greece is mostly opportunistic, it is necessary to organize screening provision to cover the majority of the population through nationally organized screening programmes, with a focus on women 50–70 years of age.
Liver glycogen metabolism during short‐term insulin‐induced hypoglycemia in fed rats

The activities of glycogen phosphorylase and synthase during infusions of glucagon, isoproterenol, or cyanide in isolated liver of fed rats submitted to short‐term insulin‐induced hypoglycemia (IIH) was investigated. A condition of hyperinsulinemia/hypoglycemia was obtained with an intraperitoneal injection of regular insulin (1.0 U kg−1). The control group received ip saline. The experiments were carried out 60 min after insulin (IIH group) or saline (COG group) injection. The rats were anesthetized and after laparotomy, blood was collected from the vena cava for glucose and insulin measurements. The liver was then infused with glucagon (1 nM), isoproterenol (2 µM), or cyanide (0.5 mM) during 20 min and a sample of the organ was collected for determination of the activities of glycogen phosphorylase and synthase 5 min after starting and 10 min after stopping the infusions. The infusions of cyanide, glucagons, and isoproterenol did not change the activities of glycogen synthase and glycogen phosphorylase. However, glycogen catabolism was decreased during the infusions of glucagon and isoproterenol in IIH rats, being more intense with isoproterenol (p < 0.05), than glucagon. It was concluded that short‐term IIH promoted changes in the liver responsiveness of glycogen degradation induced by glucagon and isoproterenol without a change in the activities of glycogen phosphorylase and synthase. Copyright © 2008 John Wiley & Sons, Ltd.
Interleukin‐18 and gestosis: correlation with Helicobacter pylori seropositivity

The aim of this brief communication was to determine the correlation between pre‐eclampsia (PE), Helicobacter pylori pathogenic strains seropositivity, and interleukin‐18 (IL‐18) levels. To this purpose 25 pre‐eclamptic women and 25 healthy parturient women of similar age were evaluated for: IL‐18 levels, by ELISA H. pylori seropositivity, by anti‐IgG ELISA Anti‐Cag‐A antibodies using a commercial immunoblot assay.
Core psychiatry for tomorrow's doctors

Supervision. It has previously been suggested that training schemes establish their own guide lines as to what constitutes good training and that trainees take a lead in auditing practice against these guidelines (Davies. 1993). Our project provided the basis for such a practice on the UMDS training scheme. Consultants and trainees are able to make significant improve ments at a local level in the absence or anticipation of more explicit guidelines from the College. Such an approach allows the trainee and consultant to agree upon the content of supervision, and allows for the fact that some consultants may have special expertise in some areas and less knowledge in others. A centrally led dictate on supervision could be hard to implement effectively and maybe unsuited to the diversity of services, trainees and consul tants.