LLukas22/scidocs huggingface dataset:
Hypertension and arterial stiffness in heart transplantation patients

OBJECTIVES
Post-transplantation hypertension is prevalent and is associated with increased cardiovascular morbidity and subsequent graft dysfunction. The present study aimed to identify the factors associated with arterial stiffness as measured by the ambulatory arterial stiffness index.


METHODS
The current study used a prospective, observational, analytical design to evaluate a group of adult heart transplantation patients. Arterial stiffness was obtained by monitoring ambulatory blood pressure and using the ambulatory arterial stiffness index as the surrogate outcome. Multivariate logistic regression analyses were performed to control confounding.


RESULTS
In a group of 85 adult heart transplantation patients, hypertension was independently associated with arterial stiffness (OR 4.98, CI 95% 1.06-23.4) as well as systolic and diastolic blood pressure averages and nighttime descent.


CONCLUSIONS
Measurement of ambulatory arterial stiffness index is a new, non-invasive method that is easy to perform, may contribute to better defining arterial stiffness prognosis and is associated with hypertension.
Minimally invasive plate osteosynthesis for tibial plateau fractures.

PURPOSE
To evaluate radiological and clinical outcome of minimally invasive plate osteosynthesis (MIPO) for tibial plateau fractures.


METHODS
35 men and 6 women aged 19 to 75 (mean, 40; standard deviation [SD], 14) years underwent MIPO for displaced tibial plateau fractures. According to the Schatzker system, the tibial plateau fractures were classified as types I (n=3), II (n=9), III (n=11), IV (n=6), V (n=7), and VI (n=5). Six patients had open fractures; 2 of them underwent debridement before MIPO. 10 patients needed additional bone grafting. Radiological (at immediate postoperation) and clinical (at the 12-month follow-up) assessments based on the Rasmussen anatomic and functional scoring system were recorded using a proforma. Patients with acceptable and unacceptable outcomes were compared in terms of age.


RESULTS
The mean Rasmussen anatomic score was 15.1 (SD, 2.2; range, 10-18); the mean Rasmussen functional score was 25.3 (SD, 3.2; range, 14-29); and the mean range of knee motion was 118 (SD, 10; range, 90-140) degrees. Anatomic outcome was excellent in 10, good in 28, and unacceptable in 3 patients (one each had Schatzker type-I, -II, and -III fractures). 27 (71%) of the 38 patients with acceptable anatomic outcome were aged 45 years or younger, whereas 2 (67%) of the 3 patients with unacceptable anatomic outcome were aged 60 years or older (p=0.001). Functional outcome was excellent in 18, good in 19, and unacceptable in 4 patients (2 had Schatzker type-III and another 2 had Schatzker type-I or -II fractures). 37 of the patients had a range of knee motion of 120 degrees or more; 27 (73%) of them were aged 45 years or younger, whereas 3 (75%) of the 4 patients with unacceptable functional outcome were aged 60 years or older (p=0.001).


CONCLUSION
MIPO for tibial plateau fractures achieved good outcome with minimal soft-tissue complications. Older age was the predictor of unacceptable outcome.
The effects of telmisartan on the nuclear factor of activated T lymphocytes signalling pathway in hypertensive patients

HYPOTHESIS
Previous studies provide links between the nuclear factor of activated T lymphocytes (NFAT) signalling pathway and the development of hypertension. Our preliminary studies indicate that telmisartan can block Kv1.3 potassium channels and effectively inhibit potassium current densities, along with Kv1.3 mRNA and protein expression levels. This paper aims to investigate whether telmisartan has an inhibitory effect on the NFAT signalling pathway after activation and proliferation of peripheral blood T lymphocytes in Kazakh patients with essential hypertension (EH) from Xinjiang, China.


MATERIALS AND METHODS
T lymphocytes were isolated using the immunomagnetic cell sorting method (MACS). The mRNA expression of NFATc1, IL-6 and TNF-α was measured by quantitative polymerase chain reaction (qRT-PCR) and relative protein levels were evaluated by Western blot. T cell samples from 50 hypertensive Kazakh patients from Xinjiang were randomly divided into control, telmisartan, cyclosporin A (CsA), VIVIT, and 4-aminopytidine (4-AP) groups. Peripheral blood T lymphocytes were first activated and proliferated in vitro, then incubated for 48 h under different treatment conditions before determination of protein and mRNA expression of NFATc1, IL-6, and TNF-α by Western blot and qRT-PCR analyses, respectively.


RESULTS
There were no significant differences in cardiovascular risk factors among the patients with samples assigned to the five groups (p > 0.05). Expression of NFATc1, IL-6, and TNF-α mRNA and protein was significantly reduced in T lymphocytes in all treatment groups (telmisartan, CsA, VIVIT, and 4-AP) compared with controls.


CONCLUSIONS
Antihypertensive function and inhibitory effects of telmisartan on the T lymphocyte NFAT signalling pathway are unlikely to affect the normal immune function of hypertensive patients. Telmisartan may exert anti-inflammatory effects by inhibition of the NFAT signalling pathway in the T lymphocytes of hypertensive patients.
Etoposide-cisplatin alternating with vinorelbine-cisplatin versus etoposide-cisplatin alone in patients with extensive disease combined with small cell lung cancer.

BACKGROUND
The aim of this study was to evaluate the efficacy of alternating etoposide-cisplatin and vinorelbine-cisplatin (EP-NP) compared with an etoposide-cisplatin (EP) regimen for advanced combined small cell carcinomas.


MATERIALS AND METHODS
Histologically confirmed combined small cell carcinoma patients who met the inclusion criteria were randomly assigned (1:1) into either the EP-NP setting (group A) or the EP setting (group B). The primary endpoint was progression-free survival in patients who received at least one dose of treatment.


RESULTS
Eighty-two patients entered into this trial, 42 in group A and 40 in group B. The objective response rates in group A and group B were 42.9% and 32.5%, respectively (p=0.334). Survival analysis showed that median progression-free survival was 6.1 months in group A, which was significantly longer than the 4.1 months in group B (p=0.041). However, as to overall survival, no significant difference was found between the two groups (11.0 vs 10.1 months in groups A and B, respectively, p=0.545). No unexpected side effects were observed in either group.


CONCLUSIONS
The EP-NP regimen for combined small cell carcinomas prolonged progression- free survival compared with the EP regimen. Further clinical investigations are warranted.
Effect of lisinopril and atenolol on aortic stiffness in patients on hemodialysis.

BACKGROUND AND OBJECTIVES
Whether improvements in arterial compliance with BP lowering are because of BP reduction alone or if pleiotropic effects of antihypertensive agents contribute remains unclear. It was hypothesized that, among patients on hemodialysis, compared with a β-blocker (atenolol), a lisinopril-based therapy will better reduce arterial stiffness.


DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
Among 200 participants of the Hypertension in Hemodialysis Patients Treated with Atenolol or Lisinopril Trial, 179 patients with valid assessment of aortic pulse wave velocity at baseline (89 patients randomly assigned to open-label lisinopril and 90 patients randomly assigned to atenolol three times a week after dialysis) were included in the secondary analysis. Among them, 109 patients had a valid pulse wave velocity measurement at 6 months. Monthly measured home BP was targeted to <140/90 mmHg by addition of antihypertensive drugs and dry weight adjustment. The difference between drugs in percentage change of aortic pulse wave velocity from baseline to 6 months was analyzed.


RESULTS
Contrary to the hypothesis, atenolol-based treatment induced greater reduction in aortic pulse wave velocity relative to lisinopril (between drug difference, 14.8%; 95% confidence interval, 1.5% to 28.5%; P=0.03). Reduction in 44-hour ambulatory systolic and diastolic BP was no different between groups (median [25th, 75th percentile]; atenolol: -21.5 [-37.7, -7.6] versus lisinopril: -15.8 [-28.8, -1.5] mmHg; P=0.27 for systolic BP; -14.1 [-22.6, -5.3] versus -10.9 [-18.4, -0.9] mmHg, respectively; P=0.30 for diastolic BP). Between-drug difference in change of aortic pulse wave velocity persisted after adjustments for age, sex, race, other cardiovascular risk factors, and baseline ambulatory systolic BP but disappeared after adjustment for change in ambulatory systolic BP (11.8%; 95% confidence interval, -2.3% to 25.9%; P=0.10).


CONCLUSIONS
Among patients on dialysis, atenolol was superior in improving arterial stiffness. However, differences between atenolol and lisinopril in improving aortic stiffness among patients on hemodialysis may be explained by BP-lowering effects of drugs.
Cardiovascular effects of cholecalciferol treatment in dialysis patients – a randomized controlled trial

BACKGROUND
Patients on chronic dialysis are at increased risk of vitamin D deficiency. In observational studies plasma 25-hydroxyvitamin D (p-25(OH) D) levels are inversely correlated with plasma BNP and adverse cardiovascular outcomes. Whether a causal relation exists has yet to be established. The aim of this study was to test the hypothesis that cholecalciferol supplementation improves cardiac function and reduces blood pressure (BP) and pulse wave velocity (PWV) in patients on chronic dialysis.


METHODS
In a randomized, placebo-controlled, double-blind study, we investigated the effect of 75 μg (3000 IU) cholecalciferol daily for 6 months, in patients on chronic dialysis. We performed two-dimensional echocardiography, with doppler and tissue-doppler imaging, 24-h ambulatory BP (24-h BP), PWV, augmentation index (AIx), central BP (cBP) and brain natriuretic peptide (BNP) measurements at baseline and after 6 months.


RESULTS
Sixty-four patients were allocated to the study. Fifty dialysis patients with a mean age of 68 years (range: 46-88) and baseline p-25(OH) D of 28 (20;53) nmol/l completed the trial. Cholecalciferol increased left ventricular (LV) volume, but had no impact on other parameters regarding LV structure or left atrial structure. LV systolic function, LV diastolic function, PWV, cBP, AIx and BNP were not changed in placebo or cholecalciferol group at follow-up. 24-h BP decreased significantly in placebo group and tended to decrease in cholecalciferol group without any difference between treatments.


CONCLUSION
Six months of cholecalciferol treatment in patients on chronic dialysis did not improve 24-h BP, arterial stiffness or cardiac function.


TRIAL REGISTRATION
NCT01312714, Registration Date: March 9, 2011.
Surgical technique and peripheral artery disease.

Invasive treatment for patients with peripheral artery disease (PAD) has changed dramatically. Medicare claims data from 1996 to 2006 reveal an almost doubling of lower-extremity vascular procedures: The use of endovascular repair increased 3-fold, bypass surgery decreased 42%, and the amputation rate decreased by 29%.1 For patients admitted to hospital for PAD between 1996 and 2005, the likelihood of undergoing surgery decreased from 34.5% to 26.3%.2 Although the rate of bypass is decreasing, surgery remains an important component in the armamentarium for treating patients with advanced vascular disease. Surgical revascularization is indicated in patients with acceptable surgical risk who require a more durable repair, in those with lesions technically unsuitable for endovascular repair, and in patients who experienced failure of endovascular repair. Despite significant increases in patient morbidity, surgical bypass has become safer over the past 2 decades. Nationally, mortality after surgical bypass decreased from 7% to 4% from the 1980s to mid-1990s. From 1998 to 2003, mortality for open and combined procedures stabilized at 3% to 4%.3 Data from the National Inpatient Survey comparing outcomes in 1998 and 2007 show significant reductions in complication rates across all categories except infection.4 Several factors may account for improved outcomes: a shift to endovascular therapy or “limited” open surgery to achieve revascularization in high-risk patients; better patient selection; more effective medication regimens consisting of a statin, an antiplatelet agent, and -blocker; and improved intraoperative care and postoperative management. This review examines the risk of adverse events after vascular surgery, identifies strategies for determining and decreasing cardiac risk, and describes contemporary surgical approaches to treating patients with PAD.
The 128 Point New Mixed Radix-2 and Radix-4 Pipeline Combined SDF-MDC FFT / IFFT Processor For MIMO-OFDM Transceiver

Multi-in Multi-out Orthogonal Frequency Division Multiplexing (MIMO-OFDM) transceiver is an advanced digital communication which aims at higher throughput. It is the main part in the software defined radio which is the trending communication platform. FFT and IFFT are the key blocks in OFDM and by optimizing those, MIMO-OFDM transceiver performance improvises. To improve the performances of MIMO-OFDM transceiver architecture, a new algorithm was developed for exhibiting frequency transformation process, called “Mixed Radix-2 and Radix-4 Pipeline combined Single path Delay Feedback (SDF)Multipath Delay Commutator (MDC)”. Along with this a new algorithm is developed for multiplication of twiddle factor structure called “Modified Bit Parallel Multiplication (MBPM)” which is shifters based parallel multiplier architecture. It had provided a high throughput (2.4 Gsample/s) with 30.605ns latency lower power consumption and less area utilization (30k logic gates).
Rodin: The Hands of Genius

Rodin - passionate, demanding, sensual: and his whole personality went into his sculpture. He created a new sculptural language, realistic and physical, highly charged with emotion, conveying sexuality more directly than ever before. Over 200 illustrations, including drawings, contemporary photographs of Rodin, his studio and models, and fascinating documents reveal Rodin's life and working practice.
Effect of change in renal replacement therapy modality on laboratory variables: a cohort study from the UK Renal Registry.

BACKGROUND
Although previous comparisons have shown differences in biochemical and haematological variables between patients on haemodialysis and peritoneal dialysis and those with functioning transplants, these could be due to case mix rather than being due to differences in the types of renal replacement therapy (RRT). The longitudinal follow-up of individual patients after the change in modality has not hitherto been described.


METHODS
From the UK Renal Registry (UKRR) database of patients receiving RRT between 1 January 1997 and 31 December 2004, we identified two cohorts: 2033 patients who had been on either haemodialysis (HD) or peritoneal dialysis (PD) for at least a year and who subsequently underwent transplantation and then survived at least a year (PD + HD to Tp); and 892 patients who had been on PD for at least a year who changed to HD and then survived at least a year (PD to HD). In both cohorts, the following variables were studied for the four quarters before and after the change of modality: blood haemoglobin and serum, ferritin, albumin, bicarbonate, cholesterol, calcium, phosphate and parathyroid hormone (PTH) concentrations. No information on drug treatment was available.


RESULTS
In the PD + HD to Tp cohort, transplantation was associated with a rise in haemoglobin, albumin and bicarbonate, a fall in ferritin and phosphate, no change in calcium, a fall (but not to normal) in PTH and a transient rise in cholesterol concentrations. In the PD to HD group, the change in modality was associated with a significant temporary fall in haemoglobin, a progressive rise in ferritin, albumin, phosphate and PTH, no change in calcium and fall in bicarbonate and cholesterol concentrations.


CONCLUSION
The change from HD to PD is associated with a significant fall in the haemoglobin concentration; anticipation of this change might enable clinicians to ameliorate it. Persistent hyperparathyroidism is common after kidney transplantation.
Left atrial dysfunction detected by speckle tracking in patients with systemic sclerosis

BACKGROUND
Cardiac involvement is a relevant clinical finding in systemic sclerosis (SSc) and is associated with poor prognosis. Left atrial (LA) remodeling and/or dysfunction can be an early sign of diastolic dysfunction. Two-dimensional speckle tracking echocardiography (STE) is a novel and promising tool for detecting very early changes in LA myocardial performance.


AIM
To assess whether STE strain parameters may detect early alterations in LA function in SSc patients.


METHODS
Forty-two SSc patients (Group 1, age 50 ± 14 years, 95% females) without clinical evidence for cardiac involvement and 42 age- and gender-matched control subjects (Group 2, age 49 ± 13 years, 95% females) were evaluated with comprehensive 2D and Doppler echocardiography, including tissue Doppler imaging analysis. Positive peak left atrial longitudinal strain (ϵ pos peak), second positive left atrial longitudinal strain (sec ϵ pos peak), and negative left atrial longitudinal strain (ϵ neg peak) were measured using a 12-segment model for the LA, by commercially available semi-automated 2D speckle-tracking software (EchoPac PC version 108.1.4, GE Healthcare, Horten, Norway).


RESULTS
All SSc patients had a normal left ventricular ejection fraction (63.1 ± 4%). SSc patients did not differ from controls in E/A (Group 1 = 1.1 ± 0.4 vs Group 2 = 1.3 ± 0.4, p = .14) or pulmonary arterial systolic pressure (Group 1 = 24.1 ± 8 mmHg vs Group 2 = 21 ± 7 mmHg, p = .17). SSc patients did not show significantly different indexed LA volumes (Group 1 = 24.9 ± 5.3 ml/m2 vs Group 2 = 24.7 ± 4.4 ml/m2, p = .8), whereas E/e' ratio was significantly higher in SSc (Group 1 = 7.6 ± 2.4 vs Group 2 = 6.5 ± 1.7, p<0.05), although still within normal values. LA strain values were significantly different between the two groups (ϵ pos peak Group 1 = 31.3 ± 4.2% vs Group 2 = 35.0 ± 7.6%, p < .01, sec ϵ pos peak Group 1 = 18.4 ± 4 vs Group 2 = 21.4 ± 7.6, p < 0.05).


CONCLUSION
2D speckle-tracking echocardiography is a sensitive tool to assess impairment of LA mechanics, which is detectable in absence of changes in LA size and volume, and may represent an early sign of cardiac involvement in patients with SSc.
Screening for cystic fibrosis: the importance of using the correct tools.

BACKGROUND
Cystic Fibrosis (CF) is a potentially lethal genetic disorder. The most frequent mutation worldwide in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene is designated as the Delta F508 mutation. This mutation was found in only 33% of Pakistani patients studied. Since the common Pakistani mutations remain to be identified, appropriate screening tools are required to identify disease. Sweat chloride determinations remain the gold standard for diagnosing CF. This study was done to emphasize the importance of using the correct tests.


METHODS
The study was conducted at the Aga Khan University Hospital. The CFTR delta F508 mutation was tested on blood samples from patients suspected with CF. Sweat chloride analysis using pilocarpine iontopharesis was done with a positive value of greater than 60 meq/L.


RESULTS
57 pediatric samples were screened for the delta F508 mutation and were positive in only 10.6% of all patients tested. 12/57 (21%) had a preliminary sweat test. 6/12 (50%) of these patients had an abnormal sweat test and 3/6 patients with an abnormal sweat chloride (50%) had deltaF508 mutations-- 2/6 (33%) were homozygotes and 1 was a compound heterozygote. Since 79% did not have a sweat test, it was difficult to assess whether this subset of patients had cystic fibrosis with a CFTR mutation other than the delta F508 tested or no CF.


CONCLUSION
Sweat chloride analysis is critical to distinguish CF from other causes of severe pulmonary and pancreatic insufficiencies and to define patients requiring further analysis.
Common pool resource management and PES: Lessons and constraints for water PES in Tanzania☆

a Centre for Social and Environmental Research on the Global Environment, University of East Anglia, Norwich, NR4 7TJ, United Kingdom b Economic Research Bureau, University of Dar es Salaam; PO Box 35096, Dar es Salaam, Tanzania c World Wildlife Fund Tanzania Programme Office, Dar es Salaam PO Box 63117, Tanzania d Conservation Science Group, University of Cambridge, Cambridge, CB2 3EJ, UK e Conservation Science Program, World Wildlife Fund, Washington DC 20037, USA
Channel dispersion and moderate deviations limits for memoryless channels

Recently, Altug and Wagner [1] posed a question regarding the optimal behavior of the probability of error when channel coding rate converges to the capacity sufficiently slowly. They gave a sufficient condition for the discrete memoryless channel (DMC) to satisfy a moderate deviation property (MDP) with the constant equal to the channel dispersion. Their sufficient condition excludes some practically interesting channels, such as the binary erasure channel and the Z-channel. We extend their result in two directions. First, we show that a DMC satisfies MDP if and only if its channel dispersion is nonzero. Second, we prove that the AWGN channel also satisfies MDP with a constant equal to the channel dispersion. While the methods used by Altug and Wagner are based on the method of types and other DMC-specific ideas, our proofs (in both achievability and converse parts) rely on the tools from our recent work [2] on finite-blocklength regime that are equally applicable to non-discrete channels and channels with memory.