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Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind.

World J Diabetes 2021 Jul;12(7):916-931

Diabetes Research Institute Federation (DRIF), Division of Endocrinology and Diabetes, CTO Alesini Hospital, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00145, Italy.

To date, metformin remains the first-line oral glucose-lowering drug used for the treatment of type 2 diabetes thanks to its well-established long-term safety and efficacy profile. Indeed, metformin is the most widely used oral insulin-sensitizing agent, being prescribed to more than 100 million people worldwide, including patients with prediabetes, insulin resistance, and polycystic ovary syndrome. However, over the last decades several observational studies and meta-analyses have reported a significant association between long-term metformin therapy and an increased prevalence of vitamin B12 deficiency. Read More

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The role of NBI with flexible video-endoscope in the follow-up of head and neck cancer patients: a prospective study.

Eur Arch Otorhinolaryngol 2021 Jul 25. Epub 2021 Jul 25.

ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy.

Purpose: Narrow band imaging (NBI) enhances mucosal vasculature and could help in the identification of recurrences. We assessed the effectiveness of NBI with flexible video-endoscope in the early detection of recurrence after treatment of head and neck squamous cell carcinoma, its diagnostic advantage over high-definition white-light (HD WL) endoscopy, also in relation to recurrence site, and the influence of previous radiotherapy (RT) or chemotherapy (CT). Moreover, we investigated the association between index tumor site and the risk of developing recurrence, and the relation between index tumor site and recurrence site. Read More

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Branching and phase corrected surface hopping: A benchmark of nonadiabatic dynamics in multilevel systems.

J Chem Phys 2021 Jun;154(23):234109

Key Laboratory of Excited-State Materials of Zhejiang Province, Department of Chemistry, Zhejiang University, Hangzhou 310027, China.

Since the seminal work of Tully [J. Chem. Phys. Read More

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A reformulation of time-dependent Kohn-Sham theory in terms of the second time derivative of the density.

J Chem Phys 2021 May;154(20):204112

Department of Physics and Astronomy, University of Missouri, Columbia, Missouri 65211, USA.

The Kohn-Sham approach to time-dependent density-functional theory (TDDFT) can be formulated, in principle, exactly by invoking the force-balance equation for the density, which leads to an explicit expression for the exchange-correlation potential as an implicit density functional. It is shown that this suggests a reformulation of TDDFT in terms of the second time derivative of the density, rather than the density itself. The result is a time-local Kohn-Sham scheme of second-order in time whose causal structure is more transparent than that of the usual Kohn-Sham formalism. Read More

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Dynamic Crossover in Fluids: From Hard Spheres to Molecules.

J Phys Chem Lett 2021 Jul 7;12(27):6411-6417. Epub 2021 Jul 7.

Université de Pau et des Pays de l'Adour, e2s UPPA, TOTAL, CNRS, LFCR, UMR 5150, Laboratoire des fluides complexes et leurs reservoirs, Pau 64000, France.

We propose a simple and generic definition of a demarcation reconciling structural and dynamic frameworks when combined with the entropy scaling framework. This crossover line between gas- and liquid-like behaviors is defined as the curve for which an individual property, the contribution to viscosity due to molecules' translation, is exactly equal to a collective property, the contribution to viscosity due to molecular interactions. Such a definition is shown to be consistent with the one based on the minima of the kinematic viscosity. Read More

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The progressive fibrotic phenotype in current clinical practice.

Curr Opin Pulm Med 2021 Jul 6. Epub 2021 Jul 6.

Interstitial Lung Disease Unit, Royal Brompton Hospital National Heart and Lung Institute, Imperial College, London, United Kingdom Department of Medicine, National Jewish Health, Denver, CO, USA National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, University of Lyon, INRAE, IVPC, UMR754, member of ERN-LUNG, Lyon, France.

Purpose Of Review: The progressive fibrotic phenotype (PFP), a term that covers large sub-groups of patients with fibrotic lung diseases that clinically progress despite appropriate usual management, is now an everyday problem for patients and clinicians alike. This review covers recent data that are relevant to major clinical uncertainties.

Recent Findings: The clinical relevance of the PFP is covered by a brief review of data from which this entity was constructed. Read More

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Twin-twin transfusion syndrome and the definition of recipient polyhydramnios.

Am J Obstet Gynecol 2021 Jun 26. Epub 2021 Jun 26.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. Electronic address:

Background: Controversy exists regarding the threshold of recipient twin polyhydramnios required to diagnose twin-twin transfusion syndrome at a gestational age ≥ 20 weeks. One criterion set (Quintero staging) requires the amniotic fluid maximum vertical pocket for the recipient twin to measure ≥ 8 cm, while another (European) uses a maximum vertical pocket for the recipient twin of ≥ 10 cm.

Objective: The aim of this study was to characterize the laser treated twin-twin transfusion syndrome patients that would be excluded from laser surgery according to the European criteria. Read More

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Practice pattern variability among gastroenterologists in colorectal cancer surveillance and management of colorectal dysplasia in inflammatory bowel disease.

J Dig Dis 2021 Jun 25. Epub 2021 Jun 25.

Section of Gastroenterology, San Francisco Veterans Affairs Medical Center, San Francisco, CA.

Objective: There is debate on the best method of colorectal cancer (CRC) surveillance in inflammatory bowel disease (IBD). We aimed to examine how gastroenterologists around the world practice CRC surveillance and manage dysplastic lesions in IBD.

Methods: A 22-question survey was emailed to gastroenterologists from 34 countries. Read More

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Characterisation of mesenchymal stromal cells in clinical trial reports: analysis of published descriptors.

Stem Cell Res Ther 2021 06 22;12(1):360. Epub 2021 Jun 22.

Department of Biology, University of York, York, YO10 5DD, UK.

Background: Mesenchymal stem or stromal cells are the most widely used cell therapy to date. They are heterogeneous, with variations in growth potential, differentiation capacity and protein expression profile depending on tissue source and production process. Nomenclature and defining characteristics have been debated for almost 20 years, yet the generic term 'MSC' is used to cover a wide range of cellular phenotypes. Read More

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Rethinking the Definition of High Risk in Pediatric Salivary Gland Carcinoma.

Otolaryngol Head Neck Surg 2021 Jun 22:1945998211020301. Epub 2021 Jun 22.

Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Objective: Indications for adjuvant radiation in pediatric salivary gland carcinoma rely on high-risk criteria extrapolated from adult data. We sought to determine whether adult-derived high-risk criteria were prognostic in children aged ≤21 years or young adults aged 22 to 39 years.

Study Design: Cross-sectional analysis of a hospital-based national registry. Read More

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Optimization of an active heat engine.

Phys Rev E 2021 May;103(5-1):052134

Dipartimento di Fisica, Università di Roma Sapienza, Piazzale Aldo Moro 2, 00185 Rome, Italy.

Optimization of heat engines at the microscale has applications in biological and artificial nanotechnology and stimulates theoretical research in nonequilibrium statistical physics. Here we consider noninteracting overdamped particles confined by an external harmonic potential, in contact with either a thermal reservoir or a stochastic self-propulsion force (active Ornstein-Uhlenbeck model). A cyclical machine is produced by periodic variation of the parameters of the potential and of the noise. Read More

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Responder analysis for neuropathic impairment and quality-of-life assessment in patients with hereditary transthyretin amyloidosis with polyneuropathy in the NEURO-TTR study.

J Neurol 2021 Jun 14. Epub 2021 Jun 14.

Akcea Therapeutics, a Subsidiary of Ionis Pharmaceuticals, Boston, MA, USA.

Objective: Hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN) is a rare disease characterized by rapid neuropathic progression. In pivotal studies of gene-silencing treatments, the modified Neuropathy Impairment Score + 7 tests (mNIS + 7) and Norfolk-Quality of Life (QOL)-Diabetic Neuropathy (DN) questionnaire assessed treatment impact on neuropathic progression. Establishing responder definition (RD) thresholds for these measures would enable evaluation of clinically meaningful treatment benefit. Read More

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Using connectomics for predictive assessment of brain parcellations.

Neuroimage 2021 Sep 1;238:118170. Epub 2021 Jun 1.

Department of Applied Mathematics and Computer Science, Technical University of Denmark, Richard Petersens Plads, Building 324, DK-2800 Kgs. Lyngby, Denmark. Electronic address:

The organization of the human brain remains elusive, yet is of great importance to the mechanisms of integrative brain function. At the macroscale, its structural and functional interpretation is conventionally assessed at the level of cortical units. However, the definition and validation of such cortical parcellations are problematic due to the absence of a true gold standard. Read More

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September 2021

Promoting Health and Food Literacy through Nutrition Education at Schools: The Italian Experience with MaestraNatura Program.

Nutrients 2021 May 4;13(5). Epub 2021 May 4.

Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.

MaestraNatura is an innovative nutrition education program aimed at both enhancing awareness about the importance of a healthy food-lifestyle relationship and the ability to transfer the theoretical principles of nutrition guidelines to everyday life. The educational contents of the program resulted from the analysis of the answers to a questionnaire submitted to students aged 6-13 in order to assess their degree of knowledge about nutritional facts. Educational paths were specifically designed and implemented to address the main knowledge gaps identified through the analysis of the answers and were then tested for teachers' satisfaction in a sample of 56 schools in the north, centre, and south of Italy, involving 790 classes, 600 teachers, and 15,800 students. Read More

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Evaluation of multidisciplinary shoulder dystocia simulation training on knowledge, performance, and documentation.

Am J Obstet Gynecol MFM 2021 May 21;3(5):100401. Epub 2021 May 21.

Obstetrics and Gynecology Department, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.

Background: Research has shown the utility of simulations involving individuals, yet little data exist on whether communication and documentation are impacted by the integration of all team members into a scenario. In 2018, the obstetrics department at this tertiary hospital began a multidisciplinary team-training simulation for shoulder dystocia. An educational portion was included, teaching a new practice where the provider announces delivery events (head, shoulder, body) to be marked on the delivery record, a standardized approach was introduced, and a pre- and post-simulation test was administered. Read More

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Cytokine Storm of COVID-19 and Its Impact on Patients with and without Chronic Liver Disease.

J Clin Transl Hepatol 2021 Apr 19;9(2):256-264. Epub 2021 Apr 19.

Department of Hepatology and Liver transplantation, Gleneagles Global Hospital, Hyderabad, India.

The coronavirus pandemic has resulted in increased rates of hepatic decompensation, morbidity and mortality in patients suffering from existing liver disease, and deranged liver biochemistries in those without liver disease. In patients with cirrhosis with coronavirus disease 2019 (COVID-19), new onset organ failures manifesting as acute-on-chronic liver failure have also been reported. The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) also directly binds to enterocytes and cholangiocytes via the angiotensin converting enzyme receptor 2, although the lung remains the portal of entry. Read More

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CD2 T-helper 17-like cells differentiated from a CD133 subpopulation of non-small cell lung carcinoma cells promote the growth of lung carcinoma.

Ann Transl Med 2021 Apr;9(8):687

Institute of Basic Medicine, Hebei Medical University, Shijiazhuang, China.

Background: Cancer stem cells (CSCs) give rise to a diverse variety of differentiated cells, which comprise the bulk of the tumor microenvironment (TME). However, the exact multi-directional differentiation potential of CSCs has not been fully clarified. This study was designed to explore whether CSCs differentiate into cellular components of the TME to promote the growth of lung carcinoma. Read More

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Sonication in the diagnosis of fracture-related infections (FRI)-a retrospective study on 230 retrieved implants.

J Orthop Surg Res 2021 May 13;16(1):310. Epub 2021 May 13.

Department of Orthopedics and Trauma Surgery, BG University Clinic Bergmannsheil Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.

Background: In fracture-related infections (FRI), both the diagnosis of the infection and the identification of the causative pathogen are crucial to optimize treatment outcomes. Sonication has been successfully used for periprosthetic joint infections (PJI); however, its role in FRI remains unknown. Our aim was to determine the diagnostic accuracy (sensitivity, specificity) of sonicate fluid culture (SFC). Read More

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Pulseq-CEST: Towards multi-site multi-vendor compatibility and reproducibility of CEST experiments using an open-source sequence standard.

Magn Reson Med 2021 10 7;86(4):1845-1858. Epub 2021 May 7.

Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tuebingen, Germany.

Purpose: As the field of CEST grows, various novel preparation periods using different parameters are being introduced. At the same time, large, multisite clinical studies require clearly defined protocols, especially across different vendors. Here, we propose a CEST definition standard using the open Pulseq format for a shareable, simple, and exact definition of CEST protocols. Read More

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October 2021

Estimating effects of intervention measures on COVID-19 outbreak in Wuhan taking account of improving diagnostic capabilities using a modelling approach.

BMC Infect Dis 2021 May 5;21(1):424. Epub 2021 May 5.

Centre for Applied One Health Research and Policy Advice, City University of Hong Kong, Hong Kong, China.

Background: Although by late February 2020 the COVID-19 epidemic was effectively controlled in Wuhan, China, estimating the effects of interventions, such as transportation restrictions and quarantine measures, on the early COVID-19 transmission dynamics in Wuhan is critical for guiding future virus containment strategies. Since the exact number of infected cases is unknown, the number of documented cases was used by many disease transmission models to infer epidemiological parameters. This means that it was possible to produce biased estimates of epidemiological parameters and hence of the effects of intervention measures, because the percentage of all cases that were documented changed during the first 2 months of the epidemic, as a consequence of a gradually improving diagnostic capability. Read More

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Quantifying Child-Appeal: The Development and Mixed-Methods Validation of a Methodology for Evaluating Child-Appealing Marketing on Product Packaging.

Int J Environ Res Public Health 2021 04 29;18(9). Epub 2021 Apr 29.

Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada.

There is no standardized or validated definition or measure of "child-appeal" used in food and beverage marketing policy or research, which can result in heterogeneous outcomes. Therefore, this pilot study aimed to develop and validate the child-appealing packaging (CAP) coding tool, which measures the presence, type, and power of child-appealing marketing on food packaging based on the marketing techniques displayed. Children (n = 15) participated in a mixed-methods validation study comprising a binary classification (child-appealing packaging? Yes/No) and ranking (order of preference/marketing power) activity using mock breakfast cereal packages (quantitative) and focus group discussions (qualitative). Read More

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Public Health Expenditures and Clinical and Social Complexity of Tuberculosis Cases-Alameda County, California, July-December 2017.

J Public Health Manag Pract 2021 Apr 30. Epub 2021 Apr 30.

Tuberculosis Control Section, Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, San Leandro, California (Ms Shiau and Dr Chitnis); and Division of Pediatric Infectious Diseases, University of California San Francisco Benioff Children's Hospital of Oakland, Oakland, California (Dr Holmen).

Context: Alameda County, California, is a high tuberculosis (TB) burden county that reported a TB incidence rate of 8.1 per 100 000 during 2017. It is the only high TB burden California county that does not have a public health-funded TB clinic. Read More

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The role of intraoperative hypotension on the development of postoperative cognitive dysfunction: a systematic review.

J Clin Anesth 2021 Sep 28;72:110310. Epub 2021 Apr 28.

Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Meibergdreef, Amsterdam, the Netherlands. Electronic address:

Study Objective: To clarify whether intraoperative hypotension contributes to the development of postoperative cognitive dysfunction.

Design: A systematic review of prospective studies reporting on intraoperative hypotension and postoperative cognitive dysfunction in elective, non-cognitive impaired, adult surgical patients. PubMed, EMBASE and the Cochrane Library were searched up to the 1st of January 2021. Read More

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September 2021

Expression Levels Combined with Flow Cytometry Blast Counts for Risk Stratification of Acute Myeloid Leukemia and Myelodysplastic Syndromes.

Biomedicines 2021 Apr 6;9(4). Epub 2021 Apr 6.

Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, 84081 Baronissi, Salerno, Italy.

Wilm's tumor 1 (), a zinc-finger transcription factor and an epigenetic modifier, is frequently overexpressed in several hematologic disorders and solid tumors, and it has been proposed as diagnostic and prognostic marker of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). However, the exact role of in leukemogenesis and disease progression remains unclear. In this real-world evidence retrospective study, we investigated prognostic role of WT1-mRNA expression levels in AML and MDS patients and correlations with complete blood counts, flow cytometry counts, and molecular features. Read More

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Difference in Insulin Resistance Assessment between European Union and Non-European Union Obesity Treatment Centers (ESPE Obesity Working Group Insulin Resistance Project).

Horm Res Paediatr 2020 26;93(11-12):622-633. Epub 2021 Apr 26.

Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Introduction: The obesity epidemic has become one of the most important public health issues of modern times. Impaired insulin sensitivity seems to be the cornerstone of multiple obesity related comorbidities. However, there is no accepted definition of impaired insulin sensitivity. Read More

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Dielectric relaxation model of human blood as a superposition of Debye functions with relaxation times following a Modified-Weibull distribution.

Heliyon 2021 Mar 26;7(3):e06606. Epub 2021 Mar 26.

Department of Statistics, University of Brasilia, Brasília, Brazil.

Dielectric spectroscopy of the human blood is a powerful and convenient non-invasive testing technique that can be used to diagnose diseases such as diabetes and leukemia. One needs to consider rigorous experimental procedures and mathematical models to make the results of this type of test comparable. The present paper will discuss previously published results to further investigate the statistical modeling of the dielectric properties of human blood. Read More

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Palindromic Rheumatism: Just a Pre-rheumatoid Stage or Something Else?

Front Med (Lausanne) 2021 25;8:657983. Epub 2021 Mar 25.

Arthritis Unit, Rheumatology Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, Barcelona, Spain.

Palindromic rheumatism (PR), a unique clinical entity, has a characteristic clinical presentation with a relapsing/remitting course. It is established that most patients with PR evolve to chronic disease, of which rheumatoid arthritis (RA) is by far the most common. The relationship between PR and RA is unclear, with similarities and differences between the two, and not all patients evolve to RA in the long-term. Read More

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The Science and Biomechanics of Long-Toss.

Curr Rev Musculoskelet Med 2021 Jun 8;14(3):224-231. Epub 2021 Apr 8.

Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.

Purpose Of Review: Overhead throwing is a particularly violent motion that requires a complex sequence of timed muscle activations to efficiently transfer energy up the kinetic chain to throw a ball. Long-toss has long been utilized as a means of increasing shoulder range of motion, strength, and endurance, as well as an important component of rehabilitation in interval throwing programs. The purpose of this review is to assess the current literature on the science and biomechanics of long-toss. Read More

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Renal dysfunctions and liver disease: a brief update on management with particular attention to hepatorenal syndrome.

Minerva Gastroenterol (Torino) 2021 Apr 8. Epub 2021 Apr 8.

Gastroenterology Unit, Rivoli Hospital, Rivoli, Turin, Italy.

In 2015 the International Club of Ascites gave an accurate, exact and new definition of acute renal injury in cirrhotic patient, identifying objective criteria of severity and recoding Hepatorenal Syndrome as a particular form of renal dysfunction for which excessive renal vasoconstriction is one of the main, but not the only, pathophysiological mechanisms. In this review we have tried to outline new pathophysiological and therapeutic insights and to summarize the most recent recommendations. Vasopressor such as terlipressin and norepinephrine, in combination with albumin, still represent the first line therapy, but the new discoveries in the pathophysiology of the disease have led the search for to new pharmacological approaches, although, to date, the only definitive remedy is represented by liver (or simultaneous liver-kidney) transplantation. Read More

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Health Literacy in Multiple Sclerosis patients: A Concept Analysis Using the Evolutionary Method.

Ali Dehghani

J Caring Sci 2021 Mar 1;10(1):49-56. Epub 2021 Mar 1.

Department of Nursing, School of Nursing and Paramedical, Jahrom University of Medical Sciences, Jahrom, Iran.

Health literacy is one of the effective factors in health promotion of chronic patients. However, little attention has been paid to it; no exact and clear definition of health literacy has ever been accessible in chronic diseases. This study was conducted with aim of defining and clarifying attributes, antecedents, and consequences of health literacy in multiple sclerosis (MS) patients. Read More

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