Miracle-dz/UniFAR-FTUs huggingface dataset:
Efficacy and safety of linagliptin added to metformin and sulphonylurea in Chinese patients with type 2 diabetes: a sub-analysis of data from a randomised clinical trial

Abstract Objectives: To evaluate the efficacy and safety of linagliptin in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled by metformin and sulphonylurea. Research design and methods: Data for a pre-defined Chinese subgroup who participated in a Phase III randomised, placebo-controlled, 24 week trial (NCT00602472) were analysed. The primary endpoint was change in HbA1c from baseline to 24 weeks. Apart from safety endpoints, secondary endpoints included changes in FPG and measures of insulin secretion and resistance. Results: A total of 192 Chinese patients with T2DM participated in the pre-defined analysis; 144 and 48 patients received linagliptin or placebo, respectively, added to metformin and sulphonylurea. Baseline characteristics (mean [±SD]) for linagliptin and placebo were similar: HbA1c: 8.1% (±0.85) and 8.1% (±0.84); body mass index: 25.9 (±3.2) and 25.6 (±3.4) kg/m2, respectively. Placebo-corrected mean (±SE) change in HbA1c from baseline at 24 weeks was −0.68% (0.14) with linagliptin-based treatment (95% CI: −0.96 to −0.39; P < 0.0001). Placebo-corrected mean (±SE) change in FPG from baseline at 24 weeks with linagliptin was −18.8 (6.5) mg/dL (−1.0 [0.4] mmol/L; 95% CI: −31.7 to −5.9; P = 0.0044). Overall adverse event (AE) rates with linagliptin and placebo including background medication were similar (38.9% and 43.8%, respectively). Drug-related AEs were reported by 12.5% and 2.1% of linagliptin and placebo patients, respectively. Differences were due to hypoglycaemia (10.4% and 0.0%, respectively). No severe hypoglycaemia was reported in either group of this sub-population. Conclusion: Linagliptin in combination with metformin and sulphonylurea has a favourable safety profile and is an efficacious and well tolerated treatment option for Chinese patients with inadequately controlled T2DM. Reduction of sulphonylurea dose should be considered to minimise risk of hypoglycaemia. Although the findings of this pre-specified sub-analysis may be limited by the number of patients in the subgroup, the results were generally consistent with those for the overall population. ClinicalTrials identifier: ClinicalTrials.gov identifier: NCT00602472.
Triglycerides and total serum cholesterol in rotator cuff tears: do they matter?

Objective In this study, the serum triglycerides and total serum cholesterol levels in patients with rotator cuff tear were determined. Design Frequency-matched case-control study. Setting University teaching hospital. Participants 240 individuals who were operated on at our institution were included in the study. 120 patients (45 men and 75 women; mean age 64.86 years, range 40 to 83 years) who underwent arthroscopic repair of a rotator cuff tear were included in group 1. 120 patients (45 men and 75 women; mean age 63.91 years, range 38 to 78 years) who underwent arthroscopic meniscectomy for a meniscal tear and had no evidence of shoulder pathology were included in group 2 (control group). These patients were frequency-matched by age (within 3 years) and sex with patients of group 1. Main outcome measures Measurement of serum triglyceride and total cholesterol concentrations. Results When comparing the two groups, there was no difference either in serum triglyceride concentration or total serum cholesterol concentration. Conclusions There appears to be no association between serum triglyceride concentration and total serum cholesterol concentration in rotator cuff tears.
The Influence of Patterns of Welfare Receipt During the Child-Rearing Years on Later Physical and Psychological Health

SUMMARY This study examined interrelations among welfare receipt, social integration, and later physical and mental health in a cohort of African American mothers from the Woodlawn neighborhood on the south side of Chicago. These women (N = 681) have been followed prospectively from 1966–67 to 1997–98. Findings indicate that receiving welfare during the child-rearing stage of life is related to both social integration and later health, with those who had received welfare in young to middle adulthood being more socially isolated and having more health problems twenty to thirty years later. Findings provided no support for the hypothesis that social integration mediated the relationship between welfare receipt and later physical and psychological health problems. Welfare receipt had a direct detrimental effect on later health outcomes. Attending church regularly was protective for later physical and psychological health. The relationship between early welfare and later health remained even when the women's current poverty was added to the model.
Lithium enhances long‐term potentiation independently of hippocampal neurogenesis in the rat dentate gyrus

We measured the temporal and spatial profiles of neural precursor cells, hippocampal long‐term potentiation (LTP), and signaling molecules in neurogenesis‐induced adult rats. Chronic lithium treatment produced a significant 54% and 40% increase in the numbers of bromodeoxyuridine [BrdU(+)] cells after 12 h and 28 days, respectively, after treatment completion in the dentate gyrus (DG). Both LTP obtained from slices perfused with artificial cerebrospinal fluid (ACSF‐LTP) and LTP recorded in the presence of bicuculline (bicuculline‐LTP) were significantly greater in the lithium group than in the saline controls. Although the number of BrdU(+) cells, approximately 90% of which were double‐labeled with a neural marker neuronal nuclear protein, were markedly increased in the granule cell layer (GCL) 28 days after the completion of the 28‐day lithium treatment, the magnitude of LTP observed at this time was similar to that observed 12 h after completing the 28‐day lithium treatment. However, protein levels of calcium and calmodulin‐dependent protein kinase II, p‐Elk and TrkB were highly elevated until 28 days after the 28‐day lithium treatment. Acute lithium treatment for 2 days also enhanced LTP, which was accompanied by the elevated expression of p‐CREB, but not by neurogenesis. Our results suggest that the enhancement of LTP is independent of the increased number of neurons per se and it is more closely associated with key molecules, which are probably involved in neurogenesis.
Acceptability of Sexual Health Discussion and Testing in the Pediatric Acute Care Setting

Objective The objective of this study was to determine acceptability of sexual health discussion and testing among adolescents, parents, and health care providers (HCPs). Methods We conducted a cross-sectional study of acute care patients (aged 14–19 years), parents, nurses, and physicians/nurse practitioners. Subjects rated sexual health discussion, sexually transmitted disease and pregnancy testing as acceptable/unacceptable and verbally explained their reasoning. Reasons were transcribed verbatim, coded, and analyzed. Agreement with individual adolescent responses was determined. Controlling for visit type, logistic regression was used to evaluate association between location and acceptance with odds ratios (ORs). Visits were categorized as reproductive/nonreproductive. Results Subjects included 127 adolescents, 90 parents, and 190 HCP responses. Mean adolescent age was 15.5 years; 57% were female; 43% reported previous intercourse; 43% were black, and 39% were white. Most visits (76%) were nonreproductive. Adolescents and parents were highly accepting of discussion and testing and were more accepting than HCPs. Acceptance was more likely for reproductive versus nonreproductive visits (P ⩽ 0.05). Emergency department HCPs were more likely to accept discussion (OR, 2.8) and sexually transmitted disease testing (OR, 3.1) than urgent care HCPs. Acceptance themes among adolescents were comfort with system/HCP, confidentiality concerns, and desire for good health; among parents, acceptance themes were identification as a safe place for disclosure and desire for adolescent good health and information; and among HCPs, these were relevance to chief complaint and perception of appropriate care. Conclusions In contrast to HCPs, adolescents and parents expressed broad support for sexual health discussion and testing, which may inform HCP practice to improve access to care.
Hilar and Mediastinal Invasion of Bronchogenic Carcinoma: Evaluation by Thin‐Section Electron‐Beam Computed Tomography

The diagnostic accuracy of thin-section incremental dynamic computed tomography (IDCT) using an electron-beam scanner in evaluating hilar or mediastinal invasion of bronchogenic carcinoma was assessed. Thirty-seven patients with proven bronchogenic carcinoma, contiguous with hilar or mediastinal structures, underwent IDCT. The area of contact was scanned using 19 contiguous 3-mm thick sections during injection of contrast material. The degree of contact between mass and pulmonary artery or vein and their distortion were recorded. Irregular thickening of the bronchial wall, soft tissue within the lumen, or distortion were used to determine airway involvement. Sixty-nine sites were assessed retrospectively and compared with pathology reports. The accuracy, sensitivity, and specificity in evaluating invasion of the pulmonary artery were 75.0%, 77.8%, and 71.4%, respectively. Limited reliability also was found for invasion of the main bronchus and “secondary” carina, with accuracies of 66.7% and 70.5%, sensitivities of 75.0% and 70.0%, and specificities of 57.1% and 71.4%, respectively. Thin-section IDCT with electron beam scanner is not accurate in the detection of hilar or mediastinal invasion by bronchogenic carcinoma.
Influence of Electron and Ion Thermodynamics on the Magnetic Nozzle Plasma Expansion

A two-fluid 2-D model of the supersonic plasma flow in a propulsive magnetic nozzle (MN) is extended to include simple electron and ion thermodynamics to study the effects of electron cooling and ion thermal energy on the expansion. A faster electron cooling rate is seen to reduce plasma jet divergence, increase radial rarefaction, and enhance detachment from the closed magnetic lines. Ion thermal energy is converted to directed kinetic energy by the MN without the mediation of an ambipolar electric field, and alters the electric response of the plasma.
Decrease in Tumor Apparent Permeability‐Surface Area Product to a MRI Macromolecular Contrast Medium Following Angiogenesis Inhibition with Correlations to Cytotoxic Drug Accumulation

Background: New strategies for cancer therapy include the combination of angiogenesis inhibitors with cytotoxins. However, angiogenesis inhibitors may alter tumor microvessel structure and transendothelial permeability thereby reducing tumoral delivery of cytotoxic agents. The aim of this study was to estimate quantitatively the apparent permeability‐surface area product (KPS) in tumors to a macromolecular contrast medium (MMCM), to follow changes in KPS induced by antibodies to vascular endothelial growth factor (anti‐VEGF), and to correlate the findings with tumor accumulation of cisplatin, a highly protein‐bound cytotoxin, and 5‐fluorouracil (5‐FU), a small unbound cytotoxin.
Using Gamification to Tackle the Cold-Start Problem in Recommender Systems

The cold start problem in recommender systems refers to the inability of making reliable recommendations if a critical mass of items has not yet been rated. To bypass this problem existing research focused on developing more reliable prediction models for situations in which only few items ratings exist. However, most of these approaches depend on adjusting the algorithm that determines a recommendation. We present a complimentary approach that does not require any adjustments to the recommendation algorithm. We draw on motivation theory and reward users for rating items. In particular, we instantiate different gamification patterns and examine their effect on the average user's number of provided report ratings. Our results confirm the positive effect of instantiating gamification patterns on the number of received report ratings.
The acceptability to primary care staff of a multidisciplinary training package on acute back pain guidelines.

BACKGROUND Implementing clinical guidelines is more likely to be successful when the whole practice team is committed to the process. Practices from the MRC General Practice Research Framework in two distinct geographical centres in the UK (West Yorkshire and Greater Manchester) participated in the feasibility study for the UK Back pain Exercise And Manipulation (UK BEAM) trial. Practice teams were randomized to continue with their usual care for back pain patients, or to be trained in managing back pain in line with national guidelines. Those randomized to the intervention arm of the trial were invited to attend training, delivered by either a generic trainer or a back pain expert. OBJECTIVES Our aims were to assess the general acceptability of the training package to staff, to assess the acceptability of the multidisciplinary approach and to determine if a generic primary care educator could deliver the training as effectively as a clinical back pain expert. METHODS All staff (clinical and non-clinical) from intervention practices were invited to attend multidisciplinary training sessions on the active management of back pain. Practice staff in West Yorkshire were trained by a generic primary care educator and practice staff in Greater Manchester were trained by a clinical back pain expert. The content of sessions was standardized for both trainers and included didactic and interactive components and small group, case study discussions. Detailed notes were taken of observations made of participants during sessions, and evaluation forms were completed by all those who attended. RESULTS The majority of participants found the training useful and said that the session had lived up to their expectations. Most found that the session was well planned and that they had sufficient opportunity to participate in learning. The training package was well received by clinical staff, but was less acceptable to non-clinical staff. GPs dominated the small group work discussions. No differences were found between the preferences of participants for the two different trainers. CONCLUSION The training package was appropriate for clinical staff, but did not always meet the needs of non-clinical staff and may require modification for this group. A generic educator can successfully lead multidisciplinary educational sessions addressing clinical issues.
Analytical Model of Slotted Air-Gap Surface Mounted Permanent-Magnet Synchronous Motor With Magnet Bars Magnetized in the Shifting Direction

An analytical model is presented, which uses two-dimensional field theory in polar coordinates to determine the flux density distribution, cogging torque, back EMF and electromagnetic torque in the slotted air gap of permanent-magnet motors with surface mounted magnet bars which are magnetized in shifting direction. The magnet arc to pole pitch ratio in the motor is not necessarily equal to unity like in the case of Halbach array magnetization. The effect of stator slots is introduced by modulating the magnetic field distribution in the slotless stator by the complex relative air-gap permeance. With this complex permeance, the radial and tangential components of flux density are calculated. In the analytical and numerical study a finite number of magnet bars, which is considered sufficient to get a sinusoidal magnetization, is used. The influence of the number of magnet bars on magnetization is also investigated. The accuracy of the developed model is verified by comparing its results with those obtained from experimental measurement and previously validated linear and nonlinear numerical finite element code.
Contrast-Enhanced 3-Dimensional SPACE Versus MP-RAGE for the Detection of Brain Metastases: Considerations With a 32-Channel Head Coil

PurposeThe aim of this study was to compare the detection of brain metastases at 3 T using a 32-channel head coil with 2 different 3-dimensional (3D) contrast-enhanced sequences, a T1-weighted fast spin-echo–based (SPACE; sampling perfection with application-optimized contrasts using different flip angle evolutions) sequence and a conventional magnetization-prepared rapid gradient-echo (MP-RAGE) sequence. Materials and MethodsSeventeen patients with 161 brain metastases were examined prospectively using both SPACE and MP-RAGE sequences on a 3-T magnetic resonance system. Eight healthy volunteers were similarly examined for determination of signal-to-noise ratio (SNR) values. Parameters were adjusted to equalize acquisition times between the sequences (3 minutes and 30 seconds). The order in which sequences were performed was randomized. Two blinded board-certified neuroradiologists evaluated the number of detectable metastatic lesions with each sequence relative to a criterion standard reading conducted at the Gamma Knife facility by a neuroradiologist with access to all clinical and imaging data. ResultsIn the volunteer assessment with SPACE and MP-RAGE, SNR (10.3 ± 0.8 vs 7.7 ± 0.7) and contrast-to-noise ratio (0.8 ± 0.2 vs 0.5 ± 0.1) were statistically significantly greater with the SPACE sequence (P < 0.05). Overall, lesion detection was markedly improved with the SPACE sequence (99.1% of lesions for reader 1 and 96.3% of lesions for reader 2) compared with the MP-RAGE sequence (73.6% of lesions for reader 1 and 68.5% of lesions for reader 2; P < 0.01). ConclusionsA 3D T1-weighted fast spin echo sequence (SPACE) improves detection of metastatic lesions relative to 3D T1-weighted gradient-echo–based scan (MP-RAGE) imaging when implemented with a 32-channel head coil at identical scan acquisition times (3 minutes and 30 seconds).
Interface Magnetism and Spin Wave Scattering in Ferromagnet-Insulator-Ferromagnet Tunnel Junctions

Careful tunneling studies in high quality Co/Al2O3/Ni80Fe20 junctions show a junction magnetoresistance (JMR) of 20.2% and 27.1% at 295 and 77 K, respectively, where the latter is in agreement with Julliere's model. The temperature dependence of the JMR can be explained by the temperature dependence of surface magnetization. The decrease of the JMR with increasing dc bias is intrinsic to ferromagnetic junctions. The strong disagreement with recent theories in the low dc bias region can be attributed to magnetic excitations in these junctions, as seen in inelastic tunneling measurements.
Chemical Kindling: Implications for Antiepileptic Drugs‐Sensitive and Resistant Epilepsy Models

The efficacy of phenobarbital (PB) and phe‐nytoin (PHT) was evaluated against the convulsions in chemically (picrotoxin, PTX) kindled rats. Two protocols were used: assessment of seizures immediately after the completion of the kindling procedure and after the 2–week postkindling PTX‐free period, as compared with acute PTX seizures. Kindled convulsions were more sensitive than acute PTX seizures to the antiepileptic action of PB and PHT. On the other hand, the “postkindling state” was characterized by the enhancement of the seventy of the convulsions in comparison with both kindled and acute PTX seizures and dramatic increase in the resistance to the action of antiepileptic drugs (AEDs). It is concluded that the two paradigms—kindling proper and “postkindling”—could be applied as models for AED‐sensitive and AED‐resistant animal epilepsy models correspondingly.
Relationship between cognitive functioning and 6-month clinical and functional outcome in patients with first manic episode bipolar I disorder

Background Although cognitive deficits in bipolar disorder have been associated with diminished functional outcome, this relationship has been studied primarily through cross-sectional designs, and has not been studied in patients early in the course of illness. The purpose of this study was to evaluate the impact of cognitive functioning on longitudinal 6-month functional and clinical outcome in recently diagnosed clinically stable patients with bipolar disorder. Method A total of 53 recently diagnosed patients with DSM-IV bipolar disorder type I were assessed within 3 months of their first manic episode using a neuropsychological battery measuring verbal/pre-morbid intellectual functioning, learning/memory, spatial/non-verbal reasoning, attention/processing speed and executive function. Functional outcome was assessed at baseline and 6 months using the Multidimensional Scale of Independent Functioning (MSIF) and DSM-IV Global Assessment of Functioning Scale (GAF). Clinical outcome was assessed with symptom ratings and by monitoring onset of new mood episodes. Results Memory, particularly verbal learning/memory, was robustly associated with 6-month functional outcome on the MSIF, even after partialling out the influence of mood symptoms and substance abuse co-morbidity. Depression ratings at 6 months, but not cognitive variables, were associated with 6-month GAF scores. Cognitive functioning was not associated with 6-month clinical outcome. Conclusions Memory was associated with 6-month longitudinal functional but not clinical outcome in recently diagnosed patients with bipolar disorder. These data further support the distinction between clinical and functional outcome, and emphasize the need for identification of, and development of treatments for, cognitive impairments early in the course of bipolar disorder.
Areas, volumes, packing and protein structure.

The protein folding problem remains today one of the most intriguing and funda­ mental questions in biochemistry. For peptide chains the covalent connectivity, the general nature of the interatomic forces, and, in many cases, the final average structures are known, yet the details of the folding process remain a mystery. Some of the experimental work and differing ideas on theory are described in recent reviews ( 1 -4). When the structure of double-stranded DNA was first proposed there was wide­ spread excitement, not only because of the feeling of triumph accompanying a problem solved but also because of the apparent simplicity of the structure, one whose principal features could be characterized by a relatively small number of parameters. Great excitement also attended the first solution of the structure of a protein, myoglobin. However, this was accompanied not by rejoicing over simplicity but by wonder at the remarkable complexity of the answer. The structure did not immediately yield to simplifying descriptions. In the ensuing years a great deal of time and effort has been spent in trying to find useful descriptions. Homopolymers, or heteropolymers composed of short repeating sequences, tend to form extended structures, i.e. polyamino acids, collagen, silk, etc. The globular proteins are invariably formed from heteropolymers with nonrepeating sequences. Either type of polymer may form a-helical or fj structures, but the folding of such units into a compact particle is always associated with chains of non repeating sequence. Although globular protein structures can be described in terms of helices, extended chains, turns, and nonregular regions, this useful conformational descrip­ tion by itself has not yet led to an understanding of the structures. Some additional and different points of view are needed. This review is concerned with the packing of groups of atoms in proteins and with the area of solvent-protein interfaces. As far as possible the emphasis is on simple