Miracle-dz/UniFAR-FTUs huggingface dataset:
Long-term outcomes of autologous transplantation in multiple myeloma: significant survival benefit of novel drugs in post-transplantation relapse.

BACKGROUND Autologous stem cell transplantation (autoSCT) has an important role in the treatment of patients with symptomatic multiple myeloma (MM). Treatment options for myeloma have expanded in the past decade, and it seems that patients who are treated with novel drugs such as thalidomide and bortezomib for relapse after autoSCT have longer overall survival (OS). PATIENTS AND METHODS Herein, we describe the long-term outcome of a cohort of 185 patients with newly diagnosed MM treated with autoSCT. We have analyzed factors that might predict for long-term survival. RESULTS Following autoSCT, the overall response rate was 94% (173 of 185 patients); 29% (53 of 185 patients) were in complete remission (CR). Median time to progression (TTP) and OS from start of therapy were 39.8 months and 77.9 months, respectively. The median follow-up was 103.8 months (range, 60.8-144.8 months); 23% of the patients are alive and disease free, 21% of the patients are alive with relapse, and 56% of the patients have died. On multivariate analysis, factors associated with significantly better OS were International Staging System (ISS) disease stage < III (hazard ratio [HR], 2.6; P < .001), achievement of CR after autoSCT (HR, 2.8; P < .001) and use of thalidomide (HR, 4.3; P < .001) and/or bortezomib (HR, 7.3; P < .001) in posttransplantation relapse treatment. The patients' age, renal impairment, disease status before autoSCT and maintenance therapy with interferon-alpha (IFN-alpha) or IFN-alpha and dexamethasone did not significantly affect TTP and OS after transplantation. CONCLUSION According to our results, the achievement of CR after transplantation, ISS stage other than III, and administration of thalidomide or bortezomib in posttransplantation relapse were significant parameters favoring long-term posttransplantation survival.
Why are antiepileptic drugs used for nonepileptic conditions?

Antiepileptic drugs (AEDs) are used to treat various nonepileptic central nervous system (CNS) disorders, both in neurology and psychiatry. Most AEDs have multiple mechanisms of action (MOAs), which include modulation of γ‐aminobutyric acid (GABA)ergic and glutamatergic neurotransmission, and alteration of voltage‐gated ion channels or intracellular signaling pathways. These MOAs may explain the efficacy of AEDs in the treatment of bipolar disorder and neuropathic pain. Bipolar disorder and epilepsy have some common features, such as their episodic nature and associated kindling phenomena, which led to the regulatory approval and use of the AEDs carbamazepine (CBZ), valproic acid (VPA), and lamotrigine (LTG) in the treatment of bipolar disorder. A major limitation for the development of drugs with improved mood‐stabilizing activity is the lack of knowledge on the mechanism of treatment for bipolar disorder. In contrast to epilepsy, no animal models in bipolar disorder are universally accepted and no model is able to exhibit the characteristic mood swings. Although most AEDs have now been investigated for their mood‐stabilizing effects, only three (e.g., VPA, CBZ, and LTG) demonstrated clinical efficacy in patients. This suggests that the mechanism of drug action in mood disorder and in epilepsy only partially overlaps. Peripheral nerve damage leads to the initiation of cellular and molecular changes in the nervous system resulting in ectopic, repetitive firing perceived as chronic pain. Epileptic seizures are also characterized by hyperexcitability of neurons in the brain. The spontaneous electrogenesis in neuropathic pain has similarities to that of epilepsy. Alteration in sodium channels expression suggests that the mechanism underlying epileptic hyperexcitability may be similar to those underlying neuropathic pain. The AEDs gabapentin (GBP) and pregabalin (PGB) have become the mainstay of treatment for various neuropathic pain syndromes, owing to their ability to inhibit neuronal hyperactivity along the pain pathways. One explanation for how GBP and PGB relieve neuropathic pain is that they bind selectively to the Ca+2‐channel subunit α2‐δ in muscle tissue and brain. With 16 new AEDs having entered the market since 1990 the antiepileptic market is crowded. Consequently, epilepsy alone is not attractive in 2012 to the pharmaceutical industry, even though the clinical needs of refractory epilepsy remain unmet. Due to this situation, the future design of new AEDs must also include a potential in nonepileptic CNS disorders, such as bipolar disorder and neuropathic pain. The global market size of each of these two indications is similar to that of epilepsy, whereas they both currently have fewer approved drugs for treatment than epilepsy. Therefore, a new AED with additional approved indications in bipolar disorder and neuropathic pain might have a potential market size three times larger than that of epilepsy alone.
Motor Recovery, Functional Status, and Health-Related Quality of Life in Patients With Complete Spinal Cord Injuries

Study Design. A retrospective cohort with cross- sectional follow-up. Objectives. The primary objective was to determine motor recovery in patients with complete traumatic spinal cord injury (SCI). Secondary objectives included: 1) determining which factors predict local recovery, 2) assessing functional status using the Functional Independence Measure (FIM), and 3) assessing generic health-related quality of life using the Short Form-36 (SF-36). Summary of Background Data. Motor recovery following complete SCI has been documented in the literature; however, it has been difficult to interpret: 1) spinal shock is often not addressed; 2) the definition of complete SCI has changed over the last 10 years; and 3) few studies differentiate between local neurologic recovery in the zone of partial preservation and neurologic recovery caudal to the lesion. Methods. All patients admitted to Vancouver Hospital with a complete SCI between 1994 and 2001 were identified and included in the study if they remained complete following the resolution of spinal shock. Minimum 2-year follow-up consisted of an ASIA motor score, an FIM, and the SF-36. Results. Of 133 patients identified, 94 were eligible and 70 completed follow-up. For the tetraplegic patients, the average ASIA motor score was 11.9 ± 10.7 on admission and 20.1 ± 10.8 at follow-up, a change reflecting local recovery only. For the paraplegic patients, the average ASIA motor score was 49.3 ± 2.4 on admission and 50.6 ± 1.7 at follow-up. Conclusions. Motor recovery does not occur below the zone of injury for patients with complete SCI. Varying degrees of local recovery can be expected in tetraplegic individuals.
Factors affecting the adoption of e-books by information professionals

One of the innovations that information technology has presented within information organizations is the phenomenon of e-books. This study seeks to explore information professionals’ attitudes towards e-books adoption. The current study uses the Technology Acceptance Model, a well-known theory for explaining individuals’ technology behaviors (Davis, 1989; Venkatesh and Morris, 2000), as well as personal characteristics such as motivation and cognitive appraisal as theoretical bases from which we can predict factors that may influence information professionals adopting e-books within their organizations. An empirical study was conducted in which 169 participants took part. Using structural equation modeling, we confirm that perceived usefulness, perceived ease of use, personal innovativeness and other personal characteristics, are predictors of behavioral intention to use e-books. Results highlight the importance of individual characteristics when considering technology acceptance. Implications for research and practice are discussed.
A three-dimensional wave packet study of Ar⋯I2(B)→Ar + I + I electronic predissociation

A three‐dimensional wave packet study of Ar.I2(B)→ Ar + I(2P3/2)+ I(2P3/2) electronic predissociation, arising from the argon‐induced electrostatic coupling between the B(3Π0+u) and the repulsive a(3Π1g) state of I2, is presented. A time‐dependent golden rule approach is used. The initial wave packet corresponds to a bound vibrational wave function of the Ar.I2(B) complex (with zero total angular momentum) multiplied by the electronic coupling. A 3‐D propagation in the final dissociative surface is then performed and the predissociation rates are obtained by Fourier transform of the wave packet autocorrelation function. The potential energy surfaces are described by sums of atom–atom interactions. For the B(3Π0+u) state potential, empirically determined van der Waals parameters available from the literature are used. For the final dissociative a(3Π1g) electronic state, the van der Waals parameters are adjusted to reproduce the experimentally observed oscillations of the electronic predissociation rate.
Clinical efficacy of first- and second-line treatments for HIV-associated Pneumocystis jirovecii pneumonia: a tri-centre cohort study.

OBJECTIVES First-line therapy for Pneumocystis jirovecii pneumonia (PCP) is trimethoprim/sulfamethoxazole. Few data exist to guide the choice of second-line therapy for patients failing or developing toxicity to first-line therapy. METHODS A case note review of 1122 patients with 1188 episodes of HIV-associated PCP from three observational cohorts in Copenhagen, London and Milan, between 1989 and 2004, was conducted. RESULTS Trimethoprim/sulfamethoxazole (962 PCP episodes, 81%) was the most frequently used first-line therapy, followed by intravenous pentamidine (87 episodes, 7%), clindamycin/primaquine (72 episodes, 6%) and 'other' (atovaquone, dapsone/pyrimethamine, trimetrexate or inhaled pentamidine; 67 episodes, 6%). Rates of unchanged therapy were trimethoprim/sulfamethoxazole = 79%, clindamycin/primaquine = 65% and pentamidine = 60% (P < 0.001). First-line therapy was changed because of failure in 82 (7%) episodes and because of toxicity in 198 (17%) episodes. Three month survival rates were trimethoprim/sulfamethoxazole = 85%, clindamycin/primaquine = 81% and pentamidine = 76% (P = 0.09). After adjustment for possible confounders, pentamidine was associated with a significantly greater risk of death at 3 months [hazard ratio (HR) = 2.0, 95% confidence interval (CI) = 1.2-3.4]. Second-line therapy survival rates differed: trimethoprim/sulfamethoxazole = 85%; clindamycin/primaquine = 87%; and pentamidine = 60% (P = 0.01). Multivariable time-updated Cox regression analysis showed a greater risk of death associated with pentamidine (HR = 3.3, 95% CI = 2.2-5.0), but not for clindamycin/primaquine, when both were compared with trimethoprim/sulfamethoxazole. CONCLUSIONS Pentamidine was associated with a greater risk of death when used as first- and second-line therapy for HIV-associated PCP, and was associated with more treatment changes. Clindamycin/primaquine appeared superior to pentamidine as second-line therapy for PCP in patients failing or developing toxicity with trimethoprim/sulfamethoxazole. In patients failing first-line treatment with non-trimethoprim/sulfamethoxazole regimens, second-line therapy should be trimethoprim/sulfamethoxazole.
Trajectories of childhood aggression and inattention/hyperactivity: differential effects on substance abuse in adolescence.

OBJECTIVE Aggression and hyperactivity/inattention each are linked to risk of alcohol use disorder (AUD), but their unique contributions remain ambiguous. The present study disaggregated these two domains developmentally and examined the relation between childhood behavior trajectories and adolescent substance use. METHOD A total of 335 children of alcoholic and nonalcoholic fathers were studied prospectively. Parallel process latent trajectory class analysis was developed with behavioral ratings by parents and teachers of aggression and inattention/hyperactivity across ages 7 to 16. Membership in the four latent classes was used as a predictor for problem adolescence alcohol use and substance onset. RESULTS Youths in the four latent trajectory classes differed in number of alcohol problems at age 16: healthy class (39% of sample, mean 2.1 alcohol-related problems), inattentive/hyperactive but not aggressive (33%; mean 2.7 problems), aggressive but not inattentive/hyperactive (4%, mean 5.0 problems), and comorbid (24%; mean 4.0 problems). Survival analysis revealed that the aggressive, comorbid, and inattentive/hyperactive classes had significantly earlier onsets of drinking, drunkenness, and marijuana use than the healthy class. Illicit drug use was also significantly increased in the comorbid, aggressive, and inattentive/hyperactive classes compared to the healthy class. CONCLUSIONS Three levels of behavioral risk of substance abuse exist, the highest having trajectories of increased aggressive and inattentive/hyperactive problems throughout childhood, the next involving only an increased inattentive/hyperactive behavioral trajectory, and the lowest involving those with neither type of problem. Children with both inattention/hyperactivity and aggression have the greatest need for childhood intervention to prevent substance abuse in adolescence.
Partnership, High Performance Work Systems and Quality of Working Life

The paper measures the effects of workplace partnership and selected high performance work practices on four different dimensions of employee experience. Whilst the partnership– high performance work systems nexus seems to have little impact on employees’ job satisfaction or sense of attachment, it does, however, have a negative impact on both workplace stress and employee evaluations of union performance. The analysis thus questions common assumptions about the inevitability of ‘mutual gain’ and the necessity of employer/union partnership.
Nerve conduction velocity in the assessment of hypertension.

Motor nerve conduction velocity was measured in 52 hypertensive and 10 control subjects. Reduction of nerve conduction velocity paralleled elevation of blood pressure and retinal changes. No correlation was found between nerve conduction velocity and the duration of hypertension. Nerve conduction velocity can provide us with an objective measurable index of the severity of hypertension. Peripheral neuropathy may accompany a number of diseases of varying etiology. It is noted frequently in diabetes mellitus, uremia, and malignant tumors. Measurements of motor nerve conduction velocities in these conditions revealed that a functional conduction defect may precede the overt clinical manifestations of peripheral neuropathy. 1 Reduced motor nerve conduction velocity is therefore an early indicator of subclinical nerve involvement. The exact nature and pathogenesis of the neural lesions is unknown. There is, however, some evidence, derived mainly from studies in diabetes, which suggests that degenerative vascular changes in the vasa nervorum may be
Plasmid-Mediated Quinolone Resistance Determinants qnrA, qnrB, and qnrS among Clinical Isolates of Enterobacteriaceae in a Korean Hospital

ABSTRACT Screening of 368 consecutive nonreplicate clinical isolates of Enterobacteriaceae resistant to nalidixic acid and at least one extended-spectrum β-lactam revealed the presence of qnrA, qnrB, and qnrS determinants, and identified novel qnrB variants, in Citrobacter freundii isolates. This study also revealed, for the first time, the linkage of qnrB, armA, and extended-spectrum and/or AmpC-type β-lactamase genes on large conjugative plasmids.
Evidence-based systematic review: effects of different service delivery models on communication outcomes for elementary school-age children.

PURPOSE The purpose of this investigation was to conduct an evidence-based systematic review (EBSR) of peer-reviewed articles from the last 30 years about the effect of different service delivery models on speech-language intervention outcomes for elementary school-age students. METHOD A computer search of electronic databases was conducted to identify studies that addressed any of 16 research questions. Structured review procedures were used to select and evaluate data-based studies that used experimental designs of the following types: randomized clinical trial, nonrandomized comparison study, and single-subject design study. RESULTS The EBSR revealed a total of 5 studies that met the review criteria and addressed questions of the effectiveness of pullout, classroom-based, and indirect-consultative service delivery models with elementary school-age children. Some evidence suggests that classroom-based direct services are at least as effective as pullout intervention for some intervention goals, and that highly trained speech-language pathology assistants, using manuals prepared by speech-language pathologists to guide intervention, can provide effective services for some children with language problems. CONCLUSION Lacking adequate research-based evidence, clinicians must rely on reason-based practice and their own data until more data become available concerning which service delivery models are most effective. Recommendations are made for an expanded research agenda.
Modulation by blood glucose levels of activity and concentration of paraoxonase in young patients with type 1 diabetes mellitus.

Paraoxonase (PON) is a high-density lipoprotein (HDL)-associated esterase, which may prevent the transformation of low-density lipoproteins (LDL) into biologically active, atherogenic particles. PON concentration and activity are affected by PON1 gene polymorphisms and found to be altered in type 2 diabetes patients with retinopathy. We investigated serum PON concentration, in vitro activity and polymorphism at position 54 (L/M, Leu-Met54) in 193 Caucasian adolescents and young adults (88 males, 105 females) with type 1 diabetes mellitus, as well as its relationship to the presence of retinopathy. An inverse linear correlation was found between blood glucose levels and both serum PON concentration (r = -.20, P =.017) and its activity (r = -0.17, P =.037). Patients with elevated blood glucose values (> or =10 mmol/L) had significantly lower levels of both PON concentration (P =.003) and activity (P =.028) than those with lower glucose levels. After adjusting for blood glucose and diabetes duration, PON activity was significantly higher in patients with different stages of retinopathy compared with those without retinopathy (P =.003). The L/L genotype was closely associated with the presence of retinopathy (P <.0001). These data show that young people with type 1 diabetes and the L/L polymorphism at position 54 of PON1 gene are more susceptible to retinal complications. However, the role of serum PON concentration and activity as a possible marker for monitoring late microvascular complications in these patients has to be established.
Should seriously burned children who suffer cardiac arrest be subjected to cardiopulmonary resuscitation?

In this issue of Critical Care Medicine, Dr. Jeschke and colleagues (1) present a retrospective review of the outcome of cardiopulmonary resuscitation in a group of seriously burned children after inhospital cardiac arrest. Seventeen of 35 children who underwent cardiopulmonary resuscitation were long-term survivors. Only one of the 17 survivors suffered profound fixed neurologic deficits. These are important data on the effectiveness of this intervention in the seriously burned child, and they are in sharp contrast to the poor results reported for cardiopulmonary resuscitation in children with other conditions both inside (2) and outside (3) the hospital. The authors' experience concerns a critical time in the hospital course of a critically burned child when reassessment of the decision to continue aggressive treatments is likely to occur. Based on this report, resuscitation after cardiac arrest in the pediatric burn patient is not futile.
Lansoprazole in globus pharyngeus: double-blind, randomized, placebo-controlled trial.

OBJECTIVE To evaluate the effectiveness of once-daily lansoprazole in the typical globus pharyngeus patient, who presents with a normal head and neck examination and without other sinister otolaryngologic complaints. STUDY DESIGN Prospective, randomized, double-blind, placebo-controlled trial. SETTING Outpatient otolaryngology office practice. METHODS After meeting the inclusion criteria, patients were randomized to a 3-month course of either treatment (30 mg lansoprazole daily) or placebo (lactose). All patients were given a medication diary and instructed to take the medication daily on waking. During the office visit, counseling regarding lifestyle modifications for gastroesophageal reflux disease was provided to all patients. MAIN OUTCOME MEASURE The Glasgow-Edinburgh Throat Scale questionnaire was given prior to treatment and at 1- and 3-month intervals during treatment. RESULTS Forty patients were enrolled between June 2005 and December 2006. Nineteen patients were randomized to the lansoprazole treatment arm, whereas 21 were enrolled in the placebo arm. Both groups were similar with regard to age, sex, and smoking history. The globus symptom score improved an average of 6.7 of 70 points in the treatment group and 2.9 points in the placebo group. There was no clinically or statistically significant difference between the two groups at any time point. CONCLUSION The globus pharyngeus patient who presents with a normal head and neck examination and without sinister otolaryngologic complaints does not benefit from once-daily lansoprazole therapy.
SEDIMENT TRANSPORT AND DISPERSAL IN THE NEARSHORE OF “FLASH-FLOOD” RIVERS.

River sediment dispersal on the near-shore of “flash-flood” rivers is investigated using a coupled wave-current-sediment transport model. Besos and Llobregat rivers (short and mountainous rivers in NW Mediterranean Sea, near to Barcelona City) are used as examples to study the sediment transport under “flash-flood” regime. The modeling system COWAST which includes the coupling between the water circulation model ROMS and the wave model SWAN, is applied to assess the sediment dispersal mechanisms and deposition in the coastal area off the two river mouths. Preferential depositional areas such as mud-belts were identified from the simulations. The sediment dispersal pattern obtained by the model agrees with observational measurments. Complementary numerical simulations revealed sorting of sediment grain size in the cross-shelf direction.
Folate Deficiency and Pancreatic Acinar Cell Function

Abstract The present study was designed to determine the effect of folate deficiency on pancreatic acinar cell function. In the first series of experiments, three groups of rats were fed ad libitum regular rat feed, folate-deficient diet, or an equivalent amount of folate-sufficient diet. In the second series of experiments, rats were either fed ad libitum or rendered folate deficient by a purified folate-deficient diet; half of the folate-deficient group was replenished with oral folate. Body weight, pancreatic weight, DNA, [methyl-14C]thymidine incorporation into DNA, RNA, [8-14C]adenine incorporation into RNA, protein content, synthesis of proteins, amylase content, and basal and bethanechol-stimulated amylase secretion were determined. The parameters were the same in the rats fed a folate-sufficient diet as in those fed a regular rat feed. Feeding a folate-deficient diet resulted in impaired DNA synthesis as evidenced by diminished incorporation of [methyl-14C]thymidine into DNA. There was no change in secretion of amylase. Similar results were obtained in the second series of experiments. These studies indicate that folate deficiency (rather than antibiotic content of the diet) impaired pancreatic function. Folate deficiency may therefore contribute to pancreatic injury in malnutrition and alcoholism.