Miracle-dz/UniFAR-FTUs huggingface dataset:
Spironolactone for hypertension.

BACKGROUND Spironolactone is an aldosterone antagonist, considered fourth line therapy for hypertension in patients already treated with multiple medications. OBJECTIVES Primary: to determine the effect of spironolactone on patient mortality, morbidity, and to quantify the magnitude of blood pressure lowering effect of spironolactone monotherapy.Secondary: to determine the prevalence of adverse reactions observed with spironolactone monotherapy and to determine if there is a blood-pressure lowering dose response with spironolactone. SEARCH STRATEGY We searched the following databases: Cochrane Central Register of Controlled Trials (3rd Quarter 2009), MEDLINE (2005 - Sept. 2009), and EMBASE (2007 - Sept. 2009). References from retrieved studies were reviewed to identify any studies missed in the initial search. No language restrictions were applied. SELECTION CRITERIA We selected RCTs studying patients with primary hypertension. We excluded studies of patients with secondary or gestational hypertension, and studies where patients were receiving multiple antihypertensives. DATA COLLECTION AND ANALYSIS Two reviewers independently reviewed the search results for studies meeting our criteria. Three reviewers extracted data and assessed trial quality using a standardized data extraction form. Data synthesis and analysis was performed using RevMan 5. MAIN RESULTS Meta-analysis of the 5 cross-over studies found a reduction in SBP of 20.09 mmHg (95%CI:16.58-23.06,p<0.00001) and a 6.75 mmHg (95%CI:4.8-8.69,p<0.00001) reduction in DBP. These results were statistically significant and there was no evidence of heterogeneity between the studies. There may be a dose response effect with spironolactone up to 50 mg/day, but the confidence intervals around the mean end-of-study blood pressure for doses ranging 25-500 mg/day all overlapped. In other words, it appears that doses >50mg/day do not produce further reductions in either SBP or DBP. One cross-over study found that spironolactone 25 mg/day did not statistically significantly change SBP or DBP compared to placebo, SBP: -9.9 (95%CI:-21.15,1.35); DBP -2.34 (95%CI:-7.92,3.06). AUTHORS' CONCLUSIONS From the limited available evidence, spironolactone appears to lower blood pressure compared to placebo to a similar degree in patients with primary (essential) hypertension when doses of 100-500 mg/day are given. A dose of 25 mg/day did not statistically significantly reduce systolic or diastolic blood pressure, compared to placebo. Given the lack of a dose-response, coupled with a possible increased risk in adverse events with higher doses, doses of 25 to 100 mg/day are reasonable. There is no evidence of the effect of spironolactone on clinical outcomes in hypertensive patients.
Tourism as a tool for economic development in poor countries

Most scientifi c literature have begun to argue that while tourism growth can infl uence the economic and sociocultural development of society, the impacts of tourism do not always lead to increased economic development, especially in less developed countries. However, in spite of these limitations, some international organizations defend that tourism has become an economic activity that many poor countries are considering or implementing as part of their eff orts to alleviate poverty. In this context, the aim of this research has been to determine whether the economic growth experienced in the poor countries over the last decade infl uences an increase in their level of economic development. Th e results prove that, in poor countries, tourism growth does not infl uence the level of economic development, which supports the claims of some of the most recent scientifi c literature, and contradicts the position of many international organizations that make an indiscriminate use of tourism as a tool to enhance economic development in the poorest countries.
Expression of Proinflammatory Cytokines and Receptors by Human Fallopian Tubes in Organ Culture following Challenge with Neisseria gonorrhoeae

ABSTRACT Infection of the Fallopian tubes (FT) by Neisseria gonorrhoeae can lead to acute salpingitis, an inflammatory condition, which is a major cause of infertility. Challenge of explants of human FT with gonococci induced mRNA expression and protein secretion for the proinflammatory cytokines interleukin (IL)-1α, IL-1β, and tumor necrosis factor alpha (TNF-α) but not for granulocyte-macrophage colony-stimulating factor. In contrast, FT expression of IL-6 and of the cytokine receptors IL-6R, TNF receptor I (TNF-RI), and TNF-RII was constitutive and was not increased by gonococcal challenge. These studies suggest that several proinflammatory cytokines are likely to contribute to the cell and tissue damage observed in gonococcal salpingitis.
Antigen-specific T-helper cells stimulate H-2-compatible and H-2- incompatible B-cell blasts polyclonally

Lipopolysaccharide (LPS)-activated B-cell blasts from C57BL/6J nu/nu spleen cells develop into IgM-secreting clones after stimulation by antigen-specific T-helper cells of C57BL/6J origin. Although induction of help is antigen-dependent, help itself acts polyclonally. 1 of 1--3 B-cell blasts is restimulated in a homologous fashion by LPS, or in a heterologous fashion by sheep erythrocyte (SRC)- or horse erythrocyte (HRC)-activated T-helper cells. The repertoire of activated B-cell blasts reflects the polyclonal nature of activation: approximately 1 in 1,000--3,000 restimulated B-cell blasts is specific for SRC, 1 in 300-- 1,000 is specific for HRC, and 1 in 100--300 specific for trinitrophenylated SRC (TNP30-SRC). B-cell blasts that are either H-2 compatible or H-2 incompatible with the antigen-activated T-cell help are stimulated polyclonally in similar high frequencies. Thus, neither antigen nor H-2 compatibility are required to stimulate a B-cell blast into the next cell cycle.
Diabetes as a Paracrinopathy of the Islets of Langerhans

The small clusters of cells scattered in the pancreas and discovered by Langerhans in 1869, currently known as the islets of Langerhans, are at the centre of the pathology of diabetes. Today they appear as sophisticated micro-organs in which various cell types function in a remarkably co-ordinated manner. Until recently, most of the interest has been centred on the β-cells, which synthesise, store and secrete insulin. Insulin deficiency is the hallmark of diabetes, with insulin resistance being associated with some forms of the disease. Although identified more than 40 years ago, a possible role of glucagon in the pathophysiology of diabetes has been largely neglected. Synthesised, stored and released by the α-cells of the islets of Langerhans, glucagon plays a key role in the main metabolic disturbances of diabetes that are hyperglycaemia and excessive lipolysis and ketogenesis. Suggested by Samols et al. decades ago, the possibility of close interactions between αand β-cells within the islets of Langerhans has recently received considerable experimental support. Unger and Orci have proposed that such paracrine interactions within the pancreatic islets play a crucial role in a vital homoeostatic domain and that disruption or dysfunction of these interactions has to be considered as a key component in the pathophysiology of diabetes. This brief article will present arguments supporting the view of diabetes as a paracrinopathy of the islets of Langerhans.
A Bottom-Up Stepwise Knowledge-Integration Approach to Large Vocabulary Continuous Speech Recognition Using Weighted Finite State Machines

A bottom-up, stepwise, knowledge integration framework is proposed to realize detection-based, large vocabulary continuous speech recognition (LVCSR) with a weighted finite state machine (WFSM). The WFSM framework offers a flexible architecture for different types of knowledge network compositions, each of them can be built and optimized independently. Speech attribute detectors are used as an intermediate block to obtain phoneme posterior probabilities over which a phoneme recognition network is designed. Lexical access and syntax knowledge integration over this phoneme network are then performed to deliver the decoded sentences. Experimental evidence illustrates that the proposed system outperforms several hybrid HMM/ANN systems with different configurations on the Wall Street Journal task while it is competitive with conventional LVCSR technology.
Comparison of Clinical and Dynamic Knee Function in Patients with Anterior Cruciate Ligament Deficiency

Background Whether passive measures of isokinetic muscle strength deficits and knee laxity are related to the dynamic function of the anterior cruciate ligament-deficient knee remains unclear. Hypotheses Arthrometer measurements are not predictive of peak external knee flexion moment (net quadriceps muscle moment), isokinetic quadriceps muscle strength correlates with peak external knee flexion moment (net quadriceps muscle moment), and isokinetic hamstring muscle strength correlates with peak external knee extension moment (net flexor muscle moment). Study Design Cross-sectional study. Methods Gait analysis was used to assess dynamic function during walking, jogging, and stair climbing in 44 subjects with unilateral anterior cruciate ligament deficiency and 44 control subjects. Passive knee laxity and isokinetic quadriceps and hamstring muscle strength were also measured. Results Arthrometer measurements did not correlate with peak external flexion or extension moments in any of the activities tested or with isokinetic quadriceps or hamstring muscle strength. Test subjects also had a significantly reduced peak external flexion moment during all three jogging activities and stair climbing compared with the control subjects and this was correlated with significantly reduced quadriceps muscle strength. Conclusions Absolute knee laxity difference did not correlate with dynamic knee function as assessed by gait analysis and should not be used as a sole predictor for the outcome of treatment. Patients with greater than normal strength in the anterior cruciate ligament-deficient limb performed low- and high-stress activities in a more normal fashion than those with normal or less-than-normal strength.
Public–private partnerships in international agricultural research

"Public-private partnerships (PPPs) in agricultural research and development are increasingly viewed as an effective means of conducting advanced research, developing new technologies, and deploying new products for the benefit of small-scale, resource-poor farmers and other marginalized groups in developing countries. There are, however, few studies that empirically establish whether PPPs fulfill this role in the context of developing-country agriculture. This brief presents the results of a study that examines how PPPs in agricultural research stimulate greater investment in pro-poor innovation in developing country agriculture. The brief provides policymakers, research managers, and business decisionmakers with a better understanding of how such partnerships operate, what types of challenges they face, and how their operation can be improved to make a greater contribution to food security and poverty reduction. " from text
A prospective cohort study of prognosis for newly diagnosed epilepsy in China

Background: Limited data are available on the outcome of antiepileptic drug t eatment response in patients of Chinese Han ethnicity with newly diagnosed epi lepsy. We sought to explore the prognosis with antiepileptic drug treatment and to identify the predi ctors of poor drug control of seizures in these patients. Methods: For at least 2 years, we prospectively followed up a cohort of pati ents with newly diagnosed epilepsy and analyzed the response to each antiepileptic drug . The patients were divided into two groups (poor and good control) and compared for clinical chara cteristics. Results: A total of 180 patients were included. Early remission was reache d in 125 (69.44%) patients, 19 (10.56%) patients entered late remission, while 36 (20%) pati ents failed to achieve remission. The response rates of the first throughout the fourth trea ment regimens were 60.0%, 16.1%, 2.8%, and 0.6%, respectively. Multiple seizure types and changes in se izure type during treatment were significantly ( p = 0.013 and 0.047, respectively) associated with a poor control. Conclusions: The prognosis of the majority of patients with newly diagnosed epilepsy is good and the clinical pattern of epilepsy during treatment is comple x. The chances of seizure control declines with each subsequent treatment regimen. The prognosis for patients with multiple seizure types and seizure type changes during treatment is unfavorable.
Review: Delirium in the Elderly: A Comprehensive Review

Delirium is a common neuropsychiatric syndrome in the elderly characterized by concurrent impairments in cognition and behaviors. The etiologies for delirium are often multifactorial and are due to underlying medical illnesses and/or due to medication effect. The diagnosis of delirium is often missed in elderly patients and this condition may be mislabeled as depression or dementia. Untreated, delirium can have devastating consequences in the elderly with high rates of morbidity and mortality. Available evidence indicates that early detection, reduction of risk factors, and better management of this condition can decrease its morbidity rates. In this review, we discuss the etiology, neurobiology, diagnosis, prevention, and treatments for this potentially lethal condition in the elderly.
Three‐dimensional bone‐implant movements in trochanteric hip fractures: Precision and accuracy of radiostereometric analysis in a phantom model

The accuracy and precision of RSA were evaluated in the experimental study of screw cut‐out complication after fixation of trochanteric fractures. A plastic bone model of a two‐part trochanteric fracture was constructed with a Gamma nail implant incorporating RSA markers. The femoral head fragment was attached to a separate rotational table and the femoral shaft was mounted on the micrometer. Three main motions were simulated: Femoral head translation and rotation along the axis of the lag screw and fracture fragment translation along anatomical axes. Accuracy and precision were determined according to ISO 16,087 and ASTM standard F2385‐04. Translations along the lag screw axis were measured with a precision within ±0.14 mm and an accuracy within ±0.03 mm. With simultaneous translations along all three anatomical axes, lowest precision was measured for the x‐axis (±0.29, 0.07 mm, respectively), but improved when analyzed as a vector (±0.08, 0.03 mm). The precision and accuracy of femoral head rotations were within 0.5° and 0.18°, respectively. The resolution of the RSA method tested in this model was high, though it varied depending on the type of analyzed motion. This information is valuable when selecting and interpreting outcome parameters evaluating implant migration and osteosynthesis stability in future clinical RSA studies. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:705–711, 2015.
The anionic permeability of the inhibitory postsynaptic membrane of hippocampal pyramidal cells

The anion permeability and current sensitivity of inhibitory postsynaptic potentials (i. p. s. ps) of CA1 hippocampal pyramidal cells have been studied with intracellular recording techniques. Passage of depolarizing current through the microelectrode increased the size of i. p. s. ps while hyperpolarizing current decreased and eventually reversed the i. p. s. ps. The early portion of the i. p. s. p. was most sensitive to current. The results obtained from the injection of anions into the pyramidal cells indicated that a sharp dichotomy existed: either the anion was permeable as shown by a depolarizing shift in the i. p. s. p., or the anion was imper meable, there being as a consequence a hyperpolarizing shift in the i. p. s. p. The permeable anions include Br¯ , NO¯2, NO¯3, SCN¯, OCN¯, CIO¯3 and HCO¯2, while the impermeable anions included citrate, glutamate, sulphate, methylsulphate, bromate, chromate, acetate and fluoride. These results are identical to those obtained by ion injection into motoneurons. Diffusion of anions into pyramidal cells supported the results from ion injection; namely, that there was a sharp dichotomy between permeant and impermeant anions. However, acetate, and to a lesser extent bromate and glutamate, were exceptions, since these anions led to an abolition or reduction of the hyperpolarizing i. p. s. p. and yet from ion injection studies these anions were clearly impermeant. Possible explanations for this paradox are given in the following paper. The present findings suggest that the anion permeability of the inhibitory postsynaptic membrane in hippocampal pyramidal cells is similar to that reported for spinal motoneurons.
Effect of antilipolysis on heart and skeletal muscle glucose uptake in overnight fasted humans.

We quantitated how lowering of free fatty acid (FFA) by an antilipolytic agent (acipimox) in the fasting state changes glucose uptake in heart and skeletal muscles. Glucose uptake in these tissues was measured two times in seven normal subjects, once after acipimox and once after placebo, using positron emission tomography-derived [18F]fluoro-2-deoxy-D-glucose kinetics. Plasma glucose and insulin remained at their fasting concentrations in both studies. Fasting FFA concentrations were 60% lower after acipimox (238 +/- 39) than placebo (645 +/- 78 mumol/l, P < 0.001). Glucose uptake increased 6 +/- 2-fold in the heart by acipimox (344 +/- 49 vs. 108 +/- 40 mumol.kg muscle-1.min-1, P < 0.002) and 1.5-fold in arm muscles (27.7 +/- 2.6 vs. 18.6 +/- 1.2 mumol.kg muscle-1.min-1, P < 0.02). Heart (r = -0.93, P < 0.001) and arm (r = -0.82, P < 0.001) glucose uptakes were inversely related to serum FFA. We conclude that serum FFA are inversely related to glucose uptake in heart and arm skeletal muscles after an overnight fast. These data indicate that compensatory glycogenolysis, although it may occur, does not prevent operation of the glucose-FFA cycle under fasting conditions.
Effects of altering transaction costs on the expiration-day effect of stock index futures

To discourage the intense fluctuations of stock index futures, CFFEX repeatedly altered futures policy and increased investors' transaction costs in 2015. With nonparametric tests, this paper compares the volume effect, volatility effect and price effect between expiration-day and non-expiration day, and then investigates the changes of expiration-day effect before and after the futures' adjustment. Abnormal trading volume in stock markets is not found on expiration-day, and the increase of transaction costs has no significant effect on volume effect. The expiration of CSI 300 stock index futures is associated with an increase in the volatility, but it is greatly weakened after the futures are restricted. This may be because the size of futures market decreases dramatically. No evidence suggests that price distortions occurred and the spot price moves along the original direction on the following trading day. This trend is strengthened after futures policy adjustment. Price shock are not found, and there are no obvious changes before and after the futures' adjustment.
Public awareness of testicular cancer and the value of self examination.

gestation and were therefore potential candidates for chorionic villus sampling. Eighteen of these patients had a non-viable pregnancy at booking and seven aborted spontaneously before testing, giving a loss in this group of 26%. Among the 59 patients booking after more than 11 weeks' gestation there were only three losses before testing leaving a total of 129 patients with continuing pregnancies, to whom tests were offered. The table shows the uptake of prenatal diagnosis, with a total of 105 patients (81%) electing to be tested. Chorionic villus sampling was successful in achieving a diagnosis in 21 of 23 patients tested, but one patient aborted a normal fetus four weeks after an uncomplicated procedure. Two chorionic villus sampling procedures failed to obtain an adequate sample; one of the patients aborted five days afterwards with ruptured membranes and the other delivered normally after an uncomplicated amniocentesis. The 82 patients electing amniocentesis all obtained a result after the first tap and none subsequently aborted.
Test Battery for Task Performance and Situational Awareness Measurement

In this study, a test instrument is developed that measure human cognitive task performance capacity, and situational awareness. Task capacity of a subject is measured before and after doing a low level of physical exercise. Signal Detection theory is applied to find the situational awareness of individuals in the form of true or false response. The tool compares the task capacity among different age and sex groups. The effect of low level stress on performance due to physical exercise is determined, and relationship is established between cognitive task and situational awareness. Response time, accuracy and repeatability are measured for statistical analysis. It compares pre and post stress effects on task performance. A stress level of the subject is measured using a questionnaire before participating on the test. The Delphi method is used to find the consensus on the test designed. The task capacity and situational awareness are expected to vary due to the effect of physical stress. Preliminary results indicate average accuracy of selecting correct answer is 84% and average time taken to complete the test 15.9 minutes. 81.4% of the task capacity related tasks and 89.9% of the situational awareness related tasks were correct in phase I of the experiment.
Rejoinder - Robust Prediction and Unrealistic Assumptions

In the response to my commentary on his 2007 editorial entitled “It's the Findings, Stupid, Not the Assumptions,” Steven Shugan raises a number of thought-provoking ideas. In this rejoinder, I focus on three issues that Shugan and I hold the most divergent views. First, while Shugan uses the terms “realistic” and “realism” in several different meanings, I define the realism of an assumption as the extent to which it corresponds with the real world. Second, Shugan makes a strong claim that predictions can be objectively evaluated whereas assumptions cannot. I refute his claim by arguing that testing predictions and testing assumptions follow the same research process of checking whether the proposition concerned corresponds with reality. Third, Shugan maintains that given predictive accuracy, assumptions need not be realistic. I hold an opposite view for the obvious reason that the same prediction may be generated by completely different mechanisms, which in turn are based on different assumptions. Last but not least, the example of socialist economic planning shows that unrealistic assumptions can generate dangerous theories.