Miracle-dz/UniFAR-FTUs huggingface dataset:
Influence of nebivolol and enalapril on metabolic parameters and arterial stiffness in hypertensive type 2 diabetic patients

Objective To compare the effects of a cardioselective beta-blocker (nebivolol) with those of an angiotensin-converting enzyme inhibitor (enalapril) on parameters of insulin sensitivity, peripheral blood flow and arterial stiffness during one extended glucose clamp experiment. Design A randomized, double-blind crossover trial, consisting of two 12-week treatment phases separated by a 4-week wash-out phase. Methods Patients with type 2 diabetes and arterial hypertension were randomly assigned to one of two treatment sequences (nebivolol–enalapril, enalapril–nebivolol). Haemodynamic, metabolic and other laboratory measurements were carried out on the first and last day of each treatment period by means of a glucose clamp experiment that also involved the measurement of blood flow and arterial stiffness. Results Twelve patients were included in this study, of which two dropped out early. Efficacy parameters were therefore available for 10 patients. There was no significant difference in any of the primary efficacy parameters. Moreover, the effects on blood pressure did not significantly differ between both treatments. Six adverse events happened during treatment with nebivolol compared with two during treatment with enalapril, but only one was regarded as possibly related to the treatment. Conclusions This pilot study shows that the combined measurement of insulin sensitivity, blood flow and arterial stiffness is feasible. Nebivolol and enalapril did not show different effects with regard to these parameters in hypertensive diabetic patients. If these results are confirmed in larger clinical trials, this would argue against the reservations against beta-blockers as drugs of first choice in patients with diabetes because of potential metabolic side-effects.
Randomized clinical trial of therapeutic exercise in subacute stroke.

BACKGROUND AND PURPOSE Rehabilitation care after stroke is highly variable and increasingly shorter in duration. The effect of therapeutic exercise on impairments and functional limitations after stroke is not clear. The objective of this study was to determine whether a structured, progressive, physiologically based exercise program for subacute stroke produces gains greater than those attributable to spontaneous recovery and usual care. METHODS This randomized, controlled, single-blind clinical trial was conducted in a metropolitan area and 17 participating healthcare institutions. We included persons with stroke who were living in the community. One hundred patients (mean age, 70 years; mean Orpington score, 3.4) consented and were randomized from a screened sample of 582. Ninety-two subjects completed the trial. Intervention was a structured, progressive, physiologically based, therapist-supervised, in-home program of thirty-six 90-minute sessions over 12 weeks targeting flexibility, strength, balance, endurance, and upper-extremity function. Main outcome measures were postintervention strength (ankle and knee isometric peak torque, grip strength), upper- and lower-extremity motor control (Fugl Meyer), balance (Berg and functional reach), endurance (peak aerobic capacity and exercise duration), upper-extremity function (Wolf Motor Function Test), and mobility (timed 10-m walk and 6-minute walk distance). RESULTS In the intention-to-treat multivariate analysis of variance testing the overall effect, the intervention produced greater gains than usual care (Wilk's lambda=0.64, P=0.0056). Both intervention and usual care groups improved in strength, balance, upper- and lower-extremity motor control, upper-extremity function, and gait velocity. Gains for the intervention group exceeded those in the usual care group in balance, endurance, peak aerobic capacity, and mobility. Upper-extremity gains exceeded those in the usual care group only in patients with higher baseline function. CONCLUSIONS This structured, progressive program of therapeutic exercise in persons who had completed acute rehabilitation services produced gains in endurance, balance, and mobility beyond those attributable to spontaneous recovery and usual care.
[Differences between unipolar and bipolar affective disorders. Review and results from a clinical population].

OBJECTIVE On account of the different therapeutic options in mood disorders, differences between unipolar and bipolar disorders are described by reviewing the literature and evaluating data of a psychiatric basic documentation system (DGPPN-BADO). METHODS Based upon a sample of 18 846 psychiatric in-patients of the Bezirksklinikum Regensburg between 1989 and 1999, data of 2644 patients with unipolar depression (UD) and bipolar affective disorders (BAS) were analysed and compared with findings from previous studies. RESULTS 77,8 % suffer from unipolar depression, 22,2 % from bipolar affective disorders. Patients with BAS fall ill 10 years earlier than patients with UD, they have a 50 percent higher number of hospital stays and longer cumulative length of stay, and they are significantly more ill at admission. In both patient groups we found a mean duration of hospital stay of about 45 days and a clinical improvement of nearly 25 points in GAF. Patients with BAS attempt suicide more often and have comorbid alcoholism more frequently. At discharge they show greater deficits in their psychosocial capability (measured with GAF) than patients with UD do. CONCLUSION Patients with BAS, which had to be hospitalised, have a more severe course of illness, but they can be treated equally as effective and efficient as patients with UD.
Distance-Aware Bandwidth-Adaptive Resource Allocation for Wireless Systems in the Terahertz Band

Terahertz (0.06-10 THz) band communication is envisioned as a key technology to satisfy the increasing demand for ultrahigh-speed wireless links. In this paper, a distance-aware bandwidth-adaptive resource allocation scheme is developed for THz band communication networks, which has the objective to improve the distance. The proposed scheme captures the unique channel peculiarities including the relationship between the distance and the bandwidth, and strategically utilizes the spectrum to enable multiple ultrahigh-speed links. Based on the developed scheme, the subwindows of the THz spectrum, the modulations, and the transmit power are adaptively allocated, for both single-user and multiuser communications. The numerical results show that the developed resource allocation scheme improves the distances and exploitation of the THz spectrum significantly. Specifically, 10 Gb/s can be supported at 4 m in the multipath channel, while 100 Gb/s is achieved up to 21 m in the line-of-sight transmission with the use of 20 dB gain antennas. Furthermore, in the multiuser network, 14 10 Gb/s links can be supported simultaneously in the multipath channel. With the use of 20 dB gain antennas, 13 100 Gb/s links can be supported at the same time. Moreover, the developed resource allocation scheme outperforms the existing millimeter-wave systems and the nonadaptive scheme. This paper achieves the design objective and contributes to enable multiple ultrahigh-speed links in the THz band communication network.
Impact of Rural Residence on Warfarin Use and Clinical Events in Patients with Non-Valvular Atrial Fibrillation: A Canadian Population Based Study

Background and Purpose We studied whether anticoagulant use and outcomes differed between rural versus urban Canadian non-valvular atrial fibrillation (NVAF) patients prior to the introduction of direct oral anticoagulant drugs. Methods Retrospective cohort study of 25,284 adult Albertans with NVAF between April 1, 1999 and December 31, 2008. Results Compared to urban patients, rural patients were older (p = 0.0009) and had more comorbidities but lower bleeding risk at baseline. In the first year after NVAF diagnosis, urban patients were less likely to be hospitalized (aOR 0.82, 95%CI 0.77–0.89) or have an emergency department visit for any reason (aOR 0.61, 95%CI 0.56–0.66) but warfarin dispensation rates (72.2% vs 71.8% at 365 days, p = 0.98) and clinical outcomes were similar: 7.8% died in both groups, 3.2% rural vs. 2.8% urban had a stroke or systemic embolism (SSE) (aOR 0.92, 95%CI 0.77–1.11), and 6.6% vs. 5.7% (aOR 0.93, 95%CI 0.81–1.06) had a bleed. Baseline SSE risk did not impact warfarin dispensation (73.0% in those with high vs. 72.8% in those with low CHADS2 score, p = 0.85) but patients at higher baseline bleeding risk were less likely to be using warfarin (69.2% high vs. 73.6% low HASBLED score, p<0.0001) in the first 365 days after diagnosis. In warfarin users, bleeding was more frequent (7.5% vs 6.2%, aHR 1.51 [95%CI 1.33–1.72]) but death or SSE was less frequent (7.0% vs 18.1%, aHR 0.60 [0.54–0.66]). Conclusion Warfarin use and clinical event rates did not differ between rural and urban NVAF patients in a universal access publically-funded healthcare system.
Predicting the Risk of Venous Thromboembolism in Patients Hospitalized With Heart Failure

Background— Whether heart failure (HF) increases the risk of venous thromboembolism (VTE) is not well established. In the phase III MAGELLAN (Multicenter, rAndomized, parallel Group Efficacy and safety study for the prevention of venous thromboembolism in hospitalized medically iLL patients comparing rivaroxabAN with enoxaparin) trial, extended-duration rivaroxaban was compared with standard-duration enoxaparin followed by placebo for VTE prevention in 8101 hospitalized acutely ill patients with or without HF. The aim of this analysis was to evaluate the relationship between HF severity and the risk of VTE in MAGELLAN patients. Methods and Results— Hospitalized patients diagnosed with HF were included according to New York Heart Association class III or IV at admission (n=2593). HF severity was determined by N-terminal probrain natriuretic peptide (NT-proBNP) plasma concentrations (median 1904 pg/mL). Baseline plasma D-dimer concentrations ranged from 0.6 to 1.7 &mgr;g/L for the less and more severe HF subgroups. Patients with more severe HF had a greater incidence of VTE versus patients with less severe HF, with a significant trend up to Day 10 (4.3% versus 2.2%; P=0.0108) and Day 35 (7.2% versus 4.1%; P=0.0150). Multivariable analysis confirmed that NT-proBNP concentration was associated with VTE risk up to Day 10 (P=0.017) and D-dimer concentration with VTE risk up to Day 35 (P=0.005). The association between VTE risk and HF severity that was observed in the enoxaparin/placebo group was not seen in the extended-duration rivaroxaban group. Conclusions— Patients with more severe HF, as defined by high NT-proBNP plasma concentration, were at increased risk of VTE. NT-proBNP may be useful to identify high short-term risk, whereas elevated D-dimer may be suggestive of high midterm risk. Clinical Trial Registration— URL: http://www.clinicaltrials. gov. Unique identifier: NCT00571649.
Disabled1 Regulates the Intracellular Trafficking of Reelin Receptors*

Reelin is a huge secreted protein that controls proper laminar formation in the developing brain. It is generally believed that tyrosine phosphorylation of Disabled1 (Dab1) by Src family tyrosine kinases is the most critical downstream event in Reelin signaling. The receptors for Reelin belong to the low density lipoprotein receptor family, most of whose members undergo regulated intracellular trafficking. In this study, we propose novel roles for Dab1 in Reelin signaling. We first demonstrated that cell surface expression of Reelin receptors was decreased in Dab1-deficient neurons. In heterologous cells, Dab1 enhanced cell surface expression of Reelin receptors, and this effect was mediated by direct interaction with the receptors. Moreover, Dab1 did not stably associate with the receptors at the plasma membrane in the resting state. When Reelin was added to primary cortical neurons, Dab1 was recruited to the receptors, and its tyrosine residues were phosphorylated. Although Reelin and Dab1 colocalized well shortly after the addition of Reelin, Dab1 was no longer associated with internalized Reelin. When Src family tyrosine kinases were inhibited, internalization of Reelin was severely abrogated, and Reelin colocalized with Dab1 near the plasma membrane for a prolonged period. Taken together, these results indicate that Dab1 regulates both cell surface expression and internalization of Reelin receptors, and these regulations may play a role in correct laminar formation in the developing brain.
Molecular cloning and spatio-temporal expression of the prostaglandin transporter: A basis for the action of prostaglandins in the bovine reproductive system

Prostaglandins (PGs) play important roles in mammalian reproductive function through autocrine, paracrine, and endocrine actions. However, they predominate as charged anions and diffuse poorly across the plasma membrane. Recently, a PG transporter (PGT) has been found to mediate PG transport across cell membranes. In ruminants, endometrial PGs are transported by a vascular pathway to the ovary to regress or rescue the corpus luteum. There is no report on the role of PGT in the reproductive functions of any species. We have cloned and characterized the bovine PGT (bPGT) that transports different PGs in the following affinity order: PGE2 = PGF2α ≥ PGD2 much greater than arachidonate. bPGT mRNA and protein are expressed in endometrium, myometrium, and the utero-ovarian plexus (UOP) during the estrous cycle. The level of bPGT expression is higher in endometrium and UOP on the side of corpus luteum between days 13 and 18 of the estrous cycle. bPGT protein is localized in endometrial stroma, luminal epithelial cells, myometrial smooth muscle cells, and vascular smooth muscle cells of uterine vein and artery. In UOP, bPGT is selectively expressed in vascular smooth muscle cells of uterine vein and ovarian artery. Spatio-temporal expression of bPGT in uterine tissues and UOP supports a significant role of bPGT in cellular and compartmental transport of PGs to mediate the endocrine action at the time of luteolysis or establishment of pregnancy in bovine. This study describes and proposes a role of PGT in the regulation of reproductive processes.
The nature of androgen action on male sexuality: a combined laboratory-self-report study on hypogonadal men.

Sexual function and the effects thereon of testosterone enanthate were studied in six hypogonadal men with the objective of delineating the specific components of male sexuality affected by androgen. To obtain a detailed picture of these components, prospective self-report data (from daily logs) of sexual activity and feelings, recordings of all night penile tumescence, and laboratory psychophysiological data were assessed. Double blind placebo experiments with cross-over design were used to compare the effects of placebo and 200- and 400-mg doses of testosterone enanthate. Erectile responses to erotic film and fantasy were not lower in the hypogonadal patients than in normal men and, in fact, were higher on some parameters, especially prolongation of detumescence time after exposure to film or fantasy. Three subjects who kept consistent daily logs had increased frequencies of sexual acts and feelings, orgasms, and spontaneous erections after testosterone administration. Nocturnal penile tumescence and spontaneous daytime erections were reduced in untreated hypogonadal men and were significantly increased after testosterone treatment, but the laboratory-tested erectile responses to film and fantasy were not affected by testosterone. These data and previous findings lead to the conclusion that the major androgen action on male sexuality involves libido factors (i.e. sexual motivation/interest). Though stimulus-bound erections elicited in the laboratory were not reduced in hypogonadal men, spontaneous (sleep or waking) erections were clearly testosterone dependent.
Thinning intensity and growth of mixed spruce-birch stands on drained peatlands in Finland

The impacts of thinning at various intensities on the growth and mortality of mixed sprucebirch stands were investigated in thinning experiments on spruce swamps in northern and south-eastern Finland. At the time of establishment, three of the stands had recently reached the first commercial thinning stage and four were more advanced. The monitoring period was mainly 15 years, and the thinning intensity varied from heavy thinning (ca. 46 per cent of the basal area removed) to no thinning. Basal area removals of light and moderate thinning were ca. 22% and 39%, respectively. Unthinned plots had the highest volume increment. Light and moderate thinning slightly decreased the 15-year volume increment by, on an average, 1% and 8%, respectively. Heavy thinning led to a greater reduction (22%) in volume increment. The growth response to thinning intensity was evident as a higher relative volume and mean diameter increment of the living trees with decreasing stand density. Part of the volume increment on the unthinned plots was lost through natural mortality. Even light thinning significantly decreased natural mortality.
Phase-vocoder: about this phasiness business

The phase-vocoder is a well-known tool for the frequency domain processing of speech or audio signals, with applications such as time compression or expansion, pitch-scale modification, noise reduction, etc. In the context of time-scale or pitch-scale modification, the phase-vocoder is usually considered to yield high quality results, especially when large modification factors are used on polyphonic or non-pitched signals. However, the phase-vocoder is also known for an artifact that plagues its output, and has been described in the literature as either "phasiness", "reverberation", or "loss of presence". Research has been devoted to understanding and reducing this artifact, and solutions have been proposed which either significantly improve the quality of the output at the cost of a very high additional computation time, or are inexpensive but only marginally effective. This paper examines the problem of phasiness in the context of time-scale modification of signals, and presents two new phase synchronization schemes which are shown to both significantly improve the sound quality, and reduce the computational cost of such modifications.
Invariance principles for switched Differential-Algebraic Equations under arbitrary and dwell-time switching

We investigate the invariance properties of a class of switched systems in which the value of a switching signal determines the current mode of operation (among a finite number of them) and, for each fixed mode, its dynamics are described by a Differential-Algebraic Equation (DAE). Motivated by the lack of invariance principles for such systems, we develop such principles for switched DAE systems under arbitrary and dwell-time switching. By obtaining a hybrid system model that describes the switched DAE system, we build from invariance results for hybrid systems and generate invariance principles for such switched systems. Examples are included to illustrate the results.
A novel homozygous mutation (1619delC) in GPIIb gene associated with Glanzmann thrombasthenia, the decay of GPIIb-mRNA and the synthesis of a truncated GPIIb unable to form complex with GPIIIa

Summary The absence of agonist-induced platelet aggregation and the lack of fibrinogen receptor (GPIIb/IIIa) on the platelet surface demonstrated that the severe hemorrhagic complications of a child of Romany descent were caused by Glanzmann thrombasthenia. DNA sequencing revealed a novel homozygous deletion of a cytosine (1619delC) in the GPIIb gene causing a frameshift and predicting a novel stop codon at position 533 following 24 altered amino acids. Both parents possessed the same deletion in heterozygous form. The amount of GPIIb mRNA in the patient’s platelets was 0.06% of the amount measured in control platelets. Neither GPIIb nor its truncated form could be detected in the platelets of the patient by Western blotting, while a small amount of GPIIIa was demonstrated. Quantitative flow cytometric analysis showed an elevated number of vitronectin receptors, a component of which is GPIIIa, on the patient’s platelets. The surface expression of vitronectin receptor on thrombasthenic, but not on normal platelets was further increased by activation with thrombin receptor agonist peptide. BHK cells transfected with wild type GPIIIa and mutated GPIIb failed to express any mature GPIIb or pro-GPIIb. Immunoprecipitation with a polyclonal antibody recognizing both GPIIb and GPIIIa recovered a 60 kDa truncated form of GPIIb. This band was absent when immunoprecipitation was carried out with an antibody recognizing GPIIIa, suggesting that the truncated protein, lacking calf-1, calf-2 domains and major part of the thigh domain, is unable to form complex with GPIIIa.
Ventricular Receptors Activated following Myocardial Prostaglandin Synthesis Initiate Reflex Hypotension, Reduction in Heart Rate, and Redistribution of Cardiac Output in the Dog

Arachidonic acid (250 μg) injected into the left circumflex coronary artery of anesthetized dogs, with carotid arteries tied to reduce baroreflex-induced changes, caused a reduction in heart rate (−15 ±1.6 beats/min), mean arterial pressure (−27 ± 3.4 mm Hg), and left ventricular dP/dt (−939 ±138 mm Hg/sec). In contrast, injection of arachidonic acid into the left anterior descending coronary artery caused smaller changes in heart rate (−4.6 ± 1.6 beats/min), arterial pressure (−14 ± 2.8 mm Hg), and left ventricular dP/dt (118118 ± 131 mm Hg/sec). The hypotension following the injection of arachidonic acid results from an increase in perfusion of the kidney and skeletal muscle (as measured by radioactive microspheres), and is entirely reflex, since the changes in renal blood flow, as well as the reduction in heart rate and the hypotension, are eliminated by bilateral vagal section. Increasing the dose of arachidonic acid results in dose-related changes in heart rate, arterial pressure, and left ventricular dP/dt. Prostacyclin and prostaglandin E2, the two principle coronary vasodilator metabolites of arachidonic acid, but not nitroprusside, cause a fall in blood pressure and heart rate, establishing that coronary vasodilation per se is not responsible for initiating the reflex fall in arterial pressure and heart rate. In two dogs with sinoaortic denervation, circumflex injection of arachidonic acid caused large reductions in heart rate (−21 ±1.5 beats/min) and mean arterial pressure (−51 ± 3.5 mm Hg). In summary, the intracardiac production of prostaglandins causes activation of left ventricular receptors, particularly in the posterior wall of the heart, and results in a reflex reduction in heart rate and reflex hypotension which stems from vasodilation in kidney and skeletal muscle.