Miracle-dz/UniFAR-FTUs huggingface dataset:
Why do patients with congestive heart failure tolerate the initiation of beta-blocker therapy?

BACKGROUND Despite its negative inotropic effects, the initiation of beta-adrenergic blockade is tolerated by patients with congestive heart failure (CHF). Accordingly, we examined the acute hemodynamic effects of beta-adrenergic blockade on systolic and diastolic left ventricular (LV) function and ventriculo-arterial coupling. In addition, isolated myocardium from patients with CHF shows selective beta 1-receptor downregulation, implying a greater role for the beta 2-receptor in maintaining in vivo LV contractility. As a secondary aim, we hypothesized that nonselective beta-adrenergic blockade would have greater negative inotropic effect than beta 1-blockade in patients with CHF. METHODS AND RESULTS Patients with clinical CHF (n = 24) and control patients without CHF (n = 24) were given either the nonselective beta-blocker propranolol or the beta 1-selective blocker metoprolol. LV pressure-volume relations were obtained before and after the administration of intravenous beta-blocker, and measures of LV systolic and diastolic function were examined. Patients with CHF had a deterioration in LV systolic function with a fall in LV systolic pressure (139 +/- 6 to 125 +/- 6 mm Hg), cardiac index (2.56 +/- 0.11 to 2.20 +/- 0.11 mL.min-1 x M-1), dP/dtmax (1173 +/- 63 to 897 +/- 50 mm Hg/s), and end-systolic elastance (0.88 +/- 0.10 to 0.64 +/- 0.10 mm Hg/mL), P < . 05 for all. Although there was deterioration of active LV relaxation (isovolumetric relaxation 63 +/- 2 to 73 +/- 3 milliseconds, peak filling rate 543 +/- 33 to 464 +/- 28 mL/s, P < .05 for both), there was no change in passive LV diastolic function (pulmonary capillary wedge, 24 +/- 2 to 24 +/- 1 mm Hg; chamber stiffness, 0.0154 +/- 0.0005 to 0.0163 +/- 0.0005 mL-1, P = NS for both), and a decrease in afterload (arterial elastance 3.85 +/- 0.31 to 3.38 +/- 0.24 mm Hg/mL, P < .05). Control patients had no change in these parameters other than a prolongation of isovolumetric relaxation (48 +/- 1 to 55 +/- 2 milliseconds, P < .05). The effects of propranolol (n = 12) versus metoprolol (n = 12) on these parameters in patients with CHF were similar. CONCLUSIONS These data do not support a greater in vivo physiological role of the myocardial beta 2-receptor in CHF. The preservation of passive diastolic function and ventriculo-arterial coupling provide possible explanations of why beta-adrenergic blockade is tolerated by patients with CHF.
The experience of specialist inpatient treatment for anorexia nervosa: A qualitative study from adult patients’ perspectives

This qualitative study aimed to explore experiences of women currently undergoing specialist inpatient treatment for anorexia nervosa. Interviews were carried out with 21 women with a diagnosis of anorexia nervosa from a specialist adult inpatient eating disorder unit. Five master themes emerged using thematic analysis: (1) shifts in control, (2) experience of transition, (3) importance of supportive staff relationships, (4) sharing with peers and (5) process of recovery and self-discovery. Findings suggest that patients experience a process of change and adjustment in relation to levels of perceived personal control, attachment to the treatment environment and a sense of self-identity.
Nurses' Perceptions of Physicians' Communication: The Relationship Among Communication Practices, Satisfaction, and Collaboration

This study examined the relationships among nurses' perceptions of physician communication practices, nurse–physician collaboration, and nurses' job satisfaction. Two hundred five nurses employed at a pediatric hospital completed surveys on site that examined perceptions of nurse–physician and physician–patient communication, job satisfaction, and nurse–physician collaboration. Nurse reports of physicians who listened effectively and used clear, humorous, immediate, and empathic messages were strongly related to nurses' satisfaction in several contexts. Physicians' use of empathic messages emerged as a significant predictor of nurses' satisfaction with communication, relationships, and collaborative medical practices. Physician humor and clarity were significant predictors of nurses' job satisfaction. There was a significant positive correlation between nurses' perceptions of physicians' use of nurse-centered communication practices and patient-centered communication practices.
Focal nodular hyperplasia: a review of current indications for and outcomes of hepatic resection.

BACKGROUND Focal nodular hyperplasia (FNH) is a common benign disease of the liver with no recognized potential for malignant transformation. The term describes an entity of lobular proliferation of normally differentiated hepatocytes, frequently around a central fibrous scar. Two key issues influence surgical decision making in FNH: diagnostic certainty, and symptomatic assessment. METHODS A systematic review of studies reporting hepatic resections of FNH was performed. Indications and outcomes in adult populations were examined with a focus on diagnostic workup, patient selection and operative mortality and morbidity. RESULTS Diagnostic modalities in the majority of studies involved ultrasound and computed tomography. Fewer than half employed magnetic resonance imaging (MRI). In instances in which MRI was not available, diagnostic accuracy was inferior. CONCLUSIONS Percutaneous biopsy should be avoided to prevent the risk for tumour seeding. Patients presenting with asymptomatic definitive FNH can be safely managed conservatively. In symptomatic patients surgical resection is a safe and effective treatment for which acceptable rates of morbidity (14%) and zero mortality are reported. However, evidence of symptom resolution is reported with conservative strategies. Diagnostic uncertainty remains the principal valid indication for FNH resection, but only in patients in whom contrast-enhanced MRI forms part of preoperative assessment.
Physiologic evaluation of factors controlling glucose tolerance in man: measurement of insulin sensitivity and beta-cell glucose sensitivity from the response to intravenous glucose.

The quantitative contributions of pancreatic responsiveness and insulin sensitivity to glucose tolerance were measured using the "minimal modeling technique" in 18 lean and obese subjects (88-206% ideal body wt). The individual contributions of insulin secretion and action were measured by interpreting the dynamics of plasma glucose and insulin during the intravenous glucose tolerance test in terms of two mathematical models. One, the insulin kinetics model, yields parameters of first-phase (phi 1) and second-phase (phi 2) responsivity of the beta-cells to glucose. The other glucose kinetics model yields the insulin sensitivity parameters, SI. Lean and obese subjects were subdivided into good (KG greater than 1.5) and lower (KG less than 1.5) glucose tolerance groups. The etiology of lower glucose tolerance was entirely different in lean and obese subjects. Lean, lower tolerance was related to pancreatic insufficiency (phi 2 77% lower than in good tolerance controls [P less than 0.03]), but insulin sensitivity was normal (P greater than 0.5). In contrast, obese lower tolerance was entirely due to insulin resistance (SI diminished 60% [P less than 0.01]); pancreatic responsiveness was not different from lean, good tolerance controls (phi 1: P greater than 0.06; phi 2: P greater than 0.40). Subjects (regardless of weight) could be segregated into good and lower tolerance by the product of second-phase beta-cell responsivity and insulin sensitivity (phi 2 . SI). Thus, these two factors were primarily responsible for overall determination of glucose tolerance. The effect of phi 1 was to modulate the KG value within those groups whose overall tolerance was determined by phi 2 . SI. This phi 1 modulating influence was more pronounced among insulin sensitive (phi 1 vs. KG, r = 0.79) than insulin resistant (obese, low tolerance; phi 1 vs. KG, r = 0.91) subjects. This study demonstrates the feasibility of the minimal model technique to determine the etiology of impaired glucose tolerance.
Macroeconomic News and Asset Prices Before and after the Zero Lower Bound

With short-term policy interest rates constrained by their effective zero lower bound (ZLB), monetary policy relied on communicating the future path of policy conditional on incoming macroeconomic data. Motivated by this, we exploit intra-day prices to investigate how updates on the state of the U.S. economy affect interest rates and exchange rates before and after the ZLB. We find that releases reflecting the dual mandate of the Fed rose in importance and – as an ex-post acknowledgement of the sources of the Great Recession – additional housing market indicators and GDP revisions, that hitherto left markets unaffected, became market movers.
Low yield of gastroscopy in patients with Lynch syndrome.

BACKGROUND/AIMS Lynch syndrome (LS) is the most common hereditary colorectal cancer syndrome, caused by germline mutations in mismatch-repair genes. Besides a lifetime risk of colorectal cancer averaging 70%-80%, there is an increased risk of extracolonic tumors including gastric cancer. The utility of screening gastroscopy in Lynch syndrome has long been debated. This study aimed to determine the proportion of abnormal gastroscopies among patients screened, including the incidence of gastric cancer and prevalence of precursor lesions. MATERIALS AND METHODS Charts of patients with mutation-proven Lynch syndrome between January 1, 2004, and December 31, 2014, from the Genetics clinic and Hereditary Gastrointestinal Cancer Clinic of our institution were retrospectively reviewed. RESULTS A total of 66 Lynch syndrome patients were identified. Thirty-two gastroscopies were performed in 21 (32%) of them. No gastric cancers were found. The prevalence of precursor lesions (Helicobacter pylori gastritis, atrophic gastritis, and gastric intestinal metaplasia) was 19.05%. A family history of gastric cancer was associated with a non-significant increased risk of abnormal gastroscopy, while sex and specific gene involved did not affect the abnormality rate. CONCLUSION Gastric screening in asymptomatic individuals with Lynch syndrome is probably best reserved for high-risk individuals, based on the family history and perhaps ethnicity as suggested by several governing bodies. Larger studies are required to achieve the statistical power necessary to address this controversial issue.
Analysis of demographic characteristics in 3242 young age gastric cancer patients in Korea.

AIM To evaluate the epidemiologic features of young age gastric cancer (GC). METHODS Retrospectively, a total of 3242 patients with GC between 18 and 45 years of age and 3000 sex- and age-matched controls were reviewed. All subjects were stratified into 3 groups based on age (A, 18-30 years; B, 31-40 years; C, 41-45 years). Epidemiologic characteristics and risk factors were investigated with reference to their age and gender. RESULTS Compared to controls, more frequent intake of high risk diet (P = 0.00075), history of heavy smoking (P = 0.00087), intake of heavy alcohol (P = 0.00091), lower social economic status (P = 0.00083), body mass index > 30 (P = 0.00097), urban residence (P = 0.00065), and more frequent exposure to harmful occupational environments (P = 0.00072) were observed in all age groups and both genders in young age GC. These relationships were weaker in females compared to males of the same age, and were stronger as the age of patients increased. However, in group C of young age GC patients, environmental factors played important roles in females and males with a similar body weight. In females, older age at first delivery (> 35 years), lack of lactation history, nulliparity, and poor nutritional status during pregnancy were significantly associated with an increased risk of GC (P = 0.00034). In this study, 252 patients (7.8%) had a family history of GC with high odds ratio (OR) (3.22-4.21). In particular, family history was more closely associated with GC in males (OR, 4.21 in male vs 3.46 in female) and more advanced cases (P = 0.00051). CONCLUSION Hormonal associated factors were more commonly associated with females whereas environmental factors were more commonly associated with males in young age GC patients.
Bubbles in a Secular Stagnation Economy

The global fall in interest rates in recent decades has raised the possibility of a negative natural rate of interest. The secular stagnation hypothesis argues that a negative natural rate of interest is the underlying cause of the Great Recession. In this paper I demonstrate the role of bubbles in secular stagnation. Bubbles increase the natural rate of interest, hence they alleviate the cause of secular stagnation. This suggests a positive role for bubbles, however bubbles are intrinsically unstable. Larger bubbles are shown to be more unstable, and upon collapse the natural rate of interest falls, potentially triggering secular stagnation.
Implementing the role of the primary care mental health worker: a qualitative study.

BACKGROUND Primary care mental health workers are a new role recently introduced into primary care in England to help manage patients with common mental health problems. AIM To explore the views of GPs, primary care teams and patients on the value and development of the new role of primary care mental health workers in practice. DESIGN OF STUDY Qualitative study. SETTING The Heart of Birmingham Primary Care Teaching Trust in the West Midlands, UK. METHOD Thirty-seven semi-structured interviews involving seven primary care mental health workers, 21 patients and 11 focus groups involving 38 members of primary care teams were held with six teams with a worker. Two teams asked for the worker to be removed. Six practice managers also took part in the study. RESULTS A number of different approaches were used to implement this new role. Strategies that incorporated the views of primary care trust senior management, primary care teams and workers' views appeared most successful. Rapid access to a healthcare professional at times of stress and the befriending role of the worker were also highly valued. Workers felt that their role left them professionally isolated at times. A number of workers described tension around ownership of the role. CONCLUSION Primary care mental health workers appear to provide a range of skills valued by patients and the primary care teams and can increase patient access and choice in this area of health care. Successful implementation strategies highlighted in this study may be generalisable to other new roles in primary care.
Vascular regeneration by repeated infusions of basic fibroblast growth factor in a rabbit model of hind-limb ischemia.

OBJECTIVE Regenerative therapy is a new treatment of vascular occlusive diseases. The purpose of this study was to examine the advantages of repeated low-dose growth factor infusions compared with a single high-dose infusion in an ischemic hind-limb rabbit model. MATERIALS AND METHODS Thirty-two rabbits were used to construct an ischemic hind-limb model by resection of the left femoral artery. For the vascular regenerative method, basic fibroblast growth factor (bFGF) was impregnated into 3 mg of gelatin microspheres 30 microm in diameter and a reservoir system was implanted in the left femoral artery for infusion. The gelatin microspheres were then infused into the left internal iliac artery via the reservoir system. The rabbits were divided into three groups according to different infusion methods: single high-dose infusion, repeated low-dose infusions, and saline (control). Therapeutic effects were evaluated by thigh temperature, blood pressure, blood flow, angiography, and pathology. RESULTS There was no significant difference between the two infusion methods in thigh temperature, blood pressure, blood flow, angiography, and pathology. In pathologic analyses at 2 and 4 weeks, both the repeated low-dose infusion and the single high-dose infusion groups showed significant differences in the number of vessels when compared with the control group. CONCLUSION The efficacy of repeated bFGF infusions for neovascularization via the reservoir method was investigated. Despite the pathologic confirmation of neovascularization, there was no significant difference in treatment effect by the two administration methods.
IGF1 regulates RUNX1 expression via IRS1/2: Implications for antler chondrocyte differentiation

ABSTRACT Although IGF1 is important for the proliferation and differentiation of chondrocytes, its underlying molecular mechanism is still unknown. Here we addressed the physiologic function of IGF1 in antler cartilage and explored the interplay of IGF1, IRS1/2 and RUNX1 in chondrocyte differentiation. The results showed that IGF1 was highly expressed in antler chondrocytes. Exogenous rIGF1 could increase the proliferation of chondrocytes and cell proportion in the S phase, whereas IGF1R inhibitor PQ401 abrogated the induction by rIGF1. Simultaneously, IGF1 could stimulate the expression of IHH which was a well-known marker for prehypertrophic chondrocytes. Further analysis evidenced that IGF1 regulated the expression of IRS1/2 whose silencing resulted in a rise of IHH mRNA levels, but the regulation was impeded by PQ401. Knockdown of IRS1 or IRS2 with specific siRNA could greatly enhance rIGF1-induced chondrocyte differentiation and reduce the expression of RUNX1. Extraneous rRUNX1 might rescue the effects of IRS1 or IRS2 siRNA on the differentiation. In antler chondrocytes, IGF1 played a role in modulating the expression of RUNX1 through IGF1R. Moreover, attenuation of RUNX1 expression advanced the differentiation elicited by rIGF1, while administration of rRUNX1 to chondrocytes treated with IGF1 siRNA or PQ401 reduced their differentiation. Additionally, siRNA-mediated downregulation of IRS1 or IRS2 in the chondrocytes impaired the interaction between IGF1 and RUNX1. Collectively, IGF1 could promote the proliferation and differentiation of antler chondrocytes. Furthermore, IRS1/2 might act downstream of IGF1 to regulate chondrocyte differentiation through targeting RUNX1.
A low-power deblocking filter architecture for H.264 advanced video coding

In this paper, a low-power deblocking filter architecture for H.264/AVC is proposed. A hybrid filtering order has been adopted to boost the speed of the deblocking filter process up to 208 clock cycles per 16x16 macroblock. The processing order of the filter is optimized to reduce power consumption and filter size and this is done by reducing memory access and raising the reusability of register blocks. A hardware implementation, under Samsung 0.18 μm standard cell library, consumes 18.34K gates at a clock frequency of 125MHz. Comparing to some state- of-the-art designs, the proposed architecture delivers the lowest level of power consumption while achieving similar speed of performance.
Methodologic issues in the use of workers' compensation databases for the study of work injuries with days away from work. I. Sensitivity of case ascertainment.

BACKGROUND Case ascertainment costs vary substantially between primary and secondary data sources. This review summarizes information on the sensitivity of state administrative databases in workers' compensation systems for the ascertainment of days-away-from-work (DAFW) work injuries for use in modeling studies. METHODS Review of the literature supplemented by data from governmental or organizational reports or produced for this report. RESULTS Employers currently appear to provide workers' compensation insurance coverage for 98.9% of wage and salary workers. Wage and salary jobs account for approximately 90% of jobs in the United States. In industries such as manufacturing, the fraction of covered jobs is probably closer to 98%. In Minnesota, the number of DAFW cases ascertained by the Bureau of Labor Statistics' annual survey of occupational injuries and illnesses is approximately 92-97% concordant with the number of wage compensation claims for injuries producing DAFW over the period 1992-2000, once adjustments are made to permit direct comparisons of the numbers. The workers' compensation databases provide information for more than 95% of the total DAFW resulting from work injuries. Covariate estimates are unaffected by this less than 5% loss because effects appear dependent on time from injury. CONCLUSIONS Statewide workers' compensation administrative databases can have substantial utility for epidemiologic study of work injuries with DAFW because of their size, using high sensitivity for case ascertainment as the evaluative criterion.
The immunofluorescent profile of dermatomyositis: a comparative study with lupus erythematosus

We have demonstrated a role for microvascular injury mediated by the membrane attack complex of complement (Cr5b−9) in the genesis of cutaneous lesions of dermatomyositis (DM) (1). The purpose of this study is to revisit the immunofluorescent (IF) profile of DM, to further investigate the role of C5b−9 in the pathogenesis of cutaneous lesions, and to see if any features of the IF profile reliably distinguish DM from LE. Lesional skin biopsies from 24 patients with clinical findings characteristic of DM were received in formalin and in Michel's transport medium. Conventional light microscopy, and IF studies with antibodies monospecific for IgG, IgA, IgM, C3, fibrin and C5b−9 were performed. The control group comprised biopsies from 31 patients with well‐documented LE. A positive lupus band test (LET) correlated highly with a diagnosis of LE, with a sensitivity of 64.5% and a specificity of 95.6% (p=0.001). The LET was most sensitive in the setting of DLE and SLE and was least sensitive in the setting of SCLE. The finding of vascular C5b−9 deposition correlated with a diagnosis of DM versus LE(P=0.001) although the false positive rate was 21.4%. The false negative rate was reduced when vascular C5b−9 was seen in the absence of antibodies to Ro, La, or RNP. While a negative LBT correlated with a diagnosis of DM (p=0.001), the specificity was only 64.5%. However, when it was seen in concert with C5b−9 along the DEJ, specificity was increased to 80.6% (p=0.001). The presence of C5b−9 in vessels and along the DEJ in conceit with a negative LBT was predictive of DM (p=0.001) with a specificity of 93.5%, sensitivity of 78.3%, a false positive rate of 10% and a false negative rate of 14.7%. The combination of a negative LBT, vascular C5b−9 deposition and negative serology for Ro, La, and RNP was a predictor of DM versus LE with a sensitivity of 90.5%, a specificity of 96.8%, a false positive rate of 5% and a false negative rate of 6.2% (p=0.001). The IF profile of DM in lesional skin comprises a negative LBT, deposition of c5b−9 within vessels and along the DEJ, and variable keratinocyte decoration for IgG and C5b−9. The most statistically powerful predictor of DM is the combination of a negative LBT with vascular C5b−9 deposition and negative serology for antibodies to Ro, La, Sm, and RNP. Demonstration of a negative LBT in all but 1 case of DM suggests that the DEJ is not a primary site for antigen‐antibody interaction. We postulate that the aforementioned IF findings reflect humorally mediated injury of enclothelium and keratinocytes, effected by C5b−9.