Miracle-dz/UniFAR-FTUs huggingface dataset:
Blood pressure and cardiovascular outcomes in patients with diabetes and high cardiovascular risk

Aims Optimal blood pressure for prevention of cardiovascular (CV) events in patients with Type 2 diabetes mellitus (T2DM) remains uncertain and there is concern for increased risk with low diastolic blood pressure (DBP). This study analysed the association between blood pressure and CV outcomes in high-risk patients with T2DM. Methods and results Patients with T2DM and elevated CV risk were enrolled in the Saxagliptin Assessment of Vascular Outcomes Recorded in patients with diabetes mellitus-Thrombolysis in Myocardial Infarction 53 trial. Cardiovascular outcomes were compared in the biomarker subgroup (n = 12 175) after stratification by baseline systolic blood pressure (SBP) and DBP. Adjusted risk was calculated by blood pressure stratum using clinical covariates plus N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin-T (hsTnT). Trends were tested using linear and quadratic models. Adjusted risk of the composite endpoint of CV death, myocardial infarction (MI), or ischaemic stroke showed U-shaped relationships with baseline SBP and DBP (Pquadratic ≤ 0.01) with nadirs at SBP 130-140 or DBP 80-90 mmHg. Diastolic blood pressure <60 mmHg was associated with increased risk of MI (adjusted hazard ratio 2.30; 95% confidence interval 1.50-3.53) relative to DBP 80-90 mmHg. Adjusted odds of hsTnT concentration ≥14 ng/L showed U-shaped relationships with SBP and DBP (Pquadratic ≤ 0.01). The relationships between low DBP, elevated hsTnT, and increased MI remained after exclusion of patients with prior heart failure or NT-proBNP >median, suggesting that the relationship was not due to confounding from diagnosed or undiagnosed heart failure. Conclusions In patients with diabetes and elevated CV risk, even after extensive adjustment for underlying disease burden, there was a persistent association for low DBP with subclinical myocardial injury and risk of MI.
New Product Introduction and Capacity Investment by Incumbents: Effects of Size on Strategy

We analyze a duopoly where capacity-constrained firms offer an established product and have the option to offer an additional new and differentiated product. We show that the firm with the smaller capacity on the established market has a higher incentive to innovate and reaches a larger market share on the market for the new product. An increase in capacity of the larger firm can prevent its competitor from innovating, whereas an increase in capacity of the smaller firm cannot prevent innovation of its larger competitor. In equilibrium the firm with smaller capacity on the established market might outperform the larger firm with respect to total payoffs.
Democratic ‘empowerment’ and democratisation of politics: Radical popular movements and the May 1992 Philippine elections

Why is it that struggles for freedom, civil rights and democracy become increasingly important in the third world and not least in the Far East? Recently, when Bangkok was paralysed by huge protests against military predominance, most analysts maintained that previous disturbances in the area were usually due to peasant-based attempts at real revolutions. But later on, they said, it was rather capitalism that gained strength. The societies were "modernised". A new and increasingly broad middle-class soon emerged. And now these middle class people are instead the ones who protest – but mainly against the authoritarian state. And usually "only" for freedom, the rule of law, and democracy. This sweeping generalisation can of course be questioned. To be sure, many people from the lower classes also protest. And it is not exactly crystal clear what the new middle class actually encompasses. But generally speaking, more and more people with some skill and education in urban areas obviously have a little bit more freedom of action than other dissatisfied groups and do play a vital role. So a more important problem is, therefore, if the new middle class can not only initiate democratisation but is also capable of carrying it through – and, in case it is not, if other democratic forces are emerging.
Baseline 6‐Min Walk Distance Predicts Survival in Lung Transplant Candidates

In a large, prospectively followed, two‐center cohort of patients listed for lung transplantation (n = 376), we used Cox proportional hazards models to determine the importance of baseline 6‐min walk distance (6MWD) in predicting patient survival. 6MWD used as a continuous variable was a significant predictor of survival after adjusting for other important covariates when transplant was considered as a time‐varying covariate (HR for each 500 ft increase in 6MWD = 0.57, 95% CI: 0.43–0.77, p = 0.0002). 6MWD remained an important predictor of survival in models that considered only survival to transplant (HR for each 500 ft increase in 6MWD = 0.41, 95% CI: 0.27–0.62, p < 0.0001) or survival only after transplant (HR for each 500 ft increase in 6MWD = 0.40, 95% CI: 0.22–0.72, p = 0.002). Unadjusted Kaplan‐Meier analysis demonstrates significantly different survival by 6MWD tertiles (<900, 900–1200, or >1200 ft, p‐value = 0.0001). In the overall model, 6MWD prediction of survival was relatively homogeneous across disease category (6MWD by disease interaction term, p‐value = 0.63). Our results demonstrate a significant relationship between baseline 6MWD and survival among patients listed for lung transplantation that exists across all native disease categories and extends through transplantation. The 6MWD is thus a useful measure of both urgency and utility among patients awaiting lung transplantation.
Glucocorticoid Sensitivity in Humans-Interindividual Differences and Acute Stress Effects

The hypothalamus pituitary adrenal (HPA)- axis is one of the major output systems of the neuroendocrine stress response. Its major end products, glucocorticoids (GCs), have a plethora of effects throughout the organism, most of which are believed to be protective against disturbances of homeostasis. However, negative effects have also been described under specific conditions of hyper- or hypo(re)activity of the HPA axis. Both beneficial and adverse effects of GCs ultimately depend on the target tissue sensitivity to these steroids. Recent findings suggest that GC sensitivity (a) may vary between different target tissues in the same organism, (b) shows large individual differences and (c) can be acutely changed in times of acute stress. In the present review, data are summarized which show differences in GC sensitivities in patients suffering from diverse somatic and psychiatric diseases, as well as chronically stressed individuals. Furthermore, studies are presented that show a rapid modulation of GC sensitivity in response to exercise or psychosocial stress in healthy adults. The response pattern of acute GC sensitivity modulation seems to be influenced by age and sex hormone status of the individual. While the GC signalling cascade may be subject to modulation at several levels, the pathway for acute modulation of GC sensitivity remains to be elucidated.
Normal liver tissue sparing by intensity-modulated proton stereotactic body radiotherapy for solitary liver tumours

Abstract Background. Stereotactic body radiotherapy (SBRT) is often the preferred treatment for the advanced liver tumours which owing to tumour distribution, size and multi-focality are out of range of surgical resection or radiofrequency ablation. However, only a minority of patients with liver tumours may be candidates for conventional SBRT because of the limited radiation tolerance of normal liver, intestine and other normal tissues. Due to the favourable depth-dose characteristics of protons, intensity-modulated proton therapy (IMPT) may be a superior alternative to photon-based SBRT. The purpose of this treatment planning study was therefore to investigate the potential sparing of normal liver by IMPT compared to photon-based intensity-modulated radiotherapy (IMRT) for solitary liver tumours. Material and methods. Ten patients with solitary liver metastasis treated at our institution with multi-field SBRT were retrospectively re-planned with IMRT and proton pencil beam scanning techniques. For the proton plans, two to three coplanar fields were used in contrast to five to six coplanar and non-coplanar photon fields. The same planning objectives were used for both techniques. A risk adapted dose prescription to the PTV surface of 12.5–16.75 Gy × 3 was used. Results. The spared liver volume for IMPT was higher compared to IMRT in all 10 patients. At the highest prescription dose level, the median liver volume receiving less than 15 Gy was 1411 cm3 for IMPT and 955 cm3 for IMRT (p < 0.005); also the mean liver dose was lower with IMPT compared to IMRT (median 9.1 Gy vs. 20.0 Gy; p < 0.005). All IMPT and IMRT plans met the VD < 15 Gy > 700 cm3 constraint. For the Dmean ≤ 15 Gy constraint, nine of 10 cases could be treated at the highest dose level using IMPT whereas with IMRT, only two cases met this constraint at the highest dose level and six at the lowest dose level. Conclusion. A considerable sparing of normal liver tissue can be obtained using proton-based SBRT for solitary liver tumours.
DESICCATION OF THE PRECORNEAL FILM

The cornea is covered by a thin liquid film called the precorneal film. This film plays an important part in the nutrition, lubrication and coating of the cornea. N . Ehlers regards the precorneal film as a layer of fluid enclosed in a thin lipoid layer separating the former superficially from the air and on the inside from the corneal epithelium (Ehlers 1965 A). The precorneal film is kept distended between the palpebral borders, which act as a frame for the film. The film thus covers not only the exposed part of the cornea, but also the exposed part of the bulbar conjunctiva. I t would therefore be most correct to call it the pre-ocular film. The remaining part of the conjunctival sac, the retropalpebral space, is covered by an epithelium whose surface is marked by mucus, and not by lipoid. The precorneal film is the thickest immediately after blinking. Ehlers, in five subjects, noticed an average thickness of 8.7 p 0-2 seconds after blinking. The thickness was gradually reduced to on an average 4.5 ,p 30 seconds after blinking. The reduction took place at the fastest rate in the beginning. If the subject is called upon to avoid blinking, a hole will gradually occur in the precorneal film. This phenomenon has been observed in both normal and pathological cases.
Lymphoid lineage‐associated features in acute myeloid leukaemia: phenotypic and genotypic correlations

Summary. This study is intended to establish biological correlation between the expression of lymphoid associated features in acute myeloid leukaemia (AML). In 62 AML patients, predominantly enrolled on Eastern Cooperative Oncology Group (ECOG) treatment protocols, in whom immunoglobulin (Ig) as well as T‐cell receptor beta chain (TCR‐beta) gene rearrangement analyses had been performed, morphology, cytochemistry, antigen profile and karyotype were reviewed retrospectively. Nuclear reactivity with anti‐TdT antibody was demonstrated in 34 patients (55%) and confirmed by ribonuclease protection assay in all patients tested. Five TdT‐protein negative patients were TdT‐transcript positive. Lymphoid antigens (lyA) were detected in 24 of 51 cases tested (47%) with B‐cell antigens (CD19. CD10) being restricted to TdT+ AML (P= 0.03). Only two patients had Ig heavy, none had Ig light chain or TCR‐beta gene rearrangements. Although both patients with rearranged Ig loci were TdT+, either by protein or RNA analysis, the low incidence of such rearrangement within the TdT* AML group (6%) argues against a significant association between the presence of TdT and crosslineage Ig gene rearrangements in AML. While FAB‐diagnoses did not differ between TdT+ and TdT or lyA+ and lyA− AML, particular immunophenotypic features correlated with TdT positively, e.g. the presence of early antigens, CD34 and HLA‐DR, and the absence of the more mature myelo‐monocytic antigens, CDw65 and CD14. Certain cytogenetic abnormalities were associated with TdT+ AML such as inv(16) (p13q22) or t(16:16) (p12;q22) (five patients; P= 0.03) and t(8;21) (q22;q22) (three patients). A greater number of TdT− than TdT* AML patients had only normal karyotypes (P= 0.06). Neither immunophenotypic nor karyotypic correlations could be established for lyA4 AML.
Human recombinant C5a enhances lipopolysaccharide‐induced synthesis of interleukin‐6 by human monocytes

Abstract. The effect of human recombinant C5a (hrC5a) on the synthesis of interleukin‐6 (IL‐6) was studied in human monocytes. Monocytes incubated in the absence of hrC5a and of bacterial lipopolysacchar‐ide (LPS) produced only low amounts (< 100 U/ 2×106 cell/16 h) of IL‐6 activity. LPS in concentrations from 10 pg ml‐1 to 10 ng ml‐1 greatly stimulated the synthesis of IL‐6 to about 50.000 U/106 cells/16 h. When hrC5a was added to the monocyte media maximal IL‐6 synthesis was reached at lower LPS concentrations, i.e. at 0.1 ng ml‐1 LPS in the presence of 100 ng ml‐1 hrC5a. Maximal IL‐6 production was not significantly enhanced by hrC5a. Metabolic labelling with [35S]‐methionine followed by immunoprecipi‐tation of IL‐6 showed that the increased IL‐6 activity in the medium of hrC5a treated monocytes was due to a stimulation of the de novo synthesis of IL‐6. Increased amounts of IL‐6 mRNA were found in monocytes treated with LPS and hrC5a compared with monocytes stimulated only with LPS. HrC5a prolonged the elevation of IL‐6 mRNA levels after stimulation of monocytes with LPS. HrC5a thus enhanced the LPS‐induced synthesis of IL‐6 by human monocytes.
The prediction of response to electroconvulsive therapy.

A computer-derived method of selecting and weighting clinical factors to predict the response of depressed patients to ECT was evaluated retrospectively for a group of 105 hospitalized patients. Use of the method prospectively would have provided an 86 percent accuracy in prognosis. The results are compared with reports of correlations between specific depressive symptoms and response to imipramine and amitriptyline.
Erythropoietin attenuates intestinal inflammation and promotes tissue regeneration

Abstract Background. The prevalence of inflammatory bowel disease (IBD) is increasing. Since patients usually need long-term treatment and suffer from reduced quality of life, there is a need to develop new therapeutic strategy. The aim of this study was to investigate the therapeutic potential of erythropoietin (EPO) for the treatment of IBD. Methods. Murine colitis was induced by 3.0% Dextran Sulfate Sodium (DSS). Recombinant human EPO (rhEPO) was given to evaluate the anti-inflammatory and regenerative effects on intestinal inflammation. The effect of rhEPO on human colon epithelial cells was also evaluated. Immunohistochemical analysis of EPO receptor was performed in human IBD tissues. Results. While about 62% of control mice with severe colitis induced by 5-day DSS died, 85% of mice treated with rhEPO survived. Histological analysis confirmed that EPO treatment reduced the colonic inflammation. Furthermore, EPO treatment significantly downregulated the local expressions of IFN-γ, TNF-α and E-selectin in the colon, suggesting that the effect was associated with inhibiting local immune activation. In a 4-day DSS-induced colitis model, rhEPO significantly improved the recovery of body weight loss compared to controls. Furthermore, proliferating cell nuclear antigen expression was significantly upregulated in the colon tissue from mice treated with rhEPO compared to controls. In addition, rhEPO increased the growth of cultured human colon epithelial cells in a dose-dependent manner. Furthermore, EPO-receptor expression was confirmed in human IBD colon tissues. Conclusion. Three major functions of EPO, hematopoiesis, anti-inflammation and regeneration, may produce significant effects on intestinal inflammation, therefore suggesting that rhEPO might be useful for IBD.
Patient satisfaction with outpatient lumbar microsurgical discectomy: a qualitative study.

OBJECTIVE Lumbar microsurgical discectomy was traditionally done as an inpatient procedure, but over the last decade, there has been an ever-expanding shift toward outpatient lumbar microdiscectomy (OLM). We have been performing OLM since 1997 (MB) and 2002 (EMM), but no study of patient satisfaction has been carried out to date. the objective of our study was to investigate patient satisfaction with the experience. METHODS Between September 2004 and March 2005, we carried out a qualitative case study at Toronto Western Hospital, involving interviews with 28 patients who had recently undergone OLM. The protocol was approved by the institutional Research Ethics Board, and informed consent was obtained from each participant. Interviews were transcribed and stored anonymously and subjected to modified thematic analysis by 5 reviewers. RESULTS Analysis of the interviews yielded several overarching themes: 1) patients are surprised that back surgery can be done on an outpatient basis; 2) the amount and quality of information they receive is satisfactory; 3) the overall experience is positive; 4) trust in one's surgeon is important; and 5) some patients have significant back pain in the early postoperative period. CONCLUSIONS Most patients appreciate the need for the health care system to save money where possible so that it can be spent in other, more resource-intensive areas. Outpatient lumbar microdiscectomy satisfies this goal while retaining high patient satisfaction rates. Qualitative research can yield substantial insight, which will improve the experience for future patients. Qualitative research is rare in the surgical literature and can answer questions quantitative research methods cannot.
Efectos del uso de cubiertas vegetales en viñedo ecológico de la variedad Pedro Ximénez

El manejo de los suelos viticolas andaluces ha consistido tradicionalmente en un laboreo muy intensivo con varios pases anuales. Esta aplicacion continuada de labores provoca importantes problemas de erosion que se agravan en zonas con pendiente y con suelos de textura arcillosa. El impacto negativo que se genera tanto a nivel ambiental como economico, ha impulsado la busqueda de alternativas al laboreo tradicional, como es la implantacion de cubiertas vegetales.En este trabajo se presentan los resultados obtenidos en los anos 2015 a 2017. Se ha realizado en la finca experimental del IFAPA Centro de Cabra (Cordoba, Espana), en una parcela de la variedad Pedro Ximenez cultivada en ecologico. Se han evaluado tres tratamientos de manejo de suelo: Laboreo tradicional (L), cubierta vegetal espontanea (CVE) y cubierta vegetal sembrada (CVS). Se ha comparado los efectos de los distintos tratamientos en parametros relacionados con la fisiologia, rendimiento y calidad de la uva.El laboreo ha mantenido producciones significativamente superiores que los tratamientos de cubiertas vegetales, en dos de las tres campanas estudiadas El peso de madera de poda tambien fue significativamente mayor en las tres campanas, mientras que el contenido en solidos solubles fue menor.
Constituents within pulp mill effluent deplete retinoid stores in white sucker and bind to rainbow trout retinoic acid receptors and retinoid × receptors

Wild female and male white sucker (Catostomus commersoni) inhabiting an area receiving pulp mill effluent had reduced hepatic levels of retinol, didehydroretinol, retinyl esters, and didehydroretinyl esters, while vitamin E levels were unaffected. This disruption of the retinoid system led us to test methanol and dichloromethane extracts from the effluent of 11 pulp mills from across Canada for their ability to bind to rainbow trout (Oncorhynchus mykiss) retinoic acid receptors (RARs) from the gill and retinoid × receptors (RXRs) from the liver. Concentrated extracts of the final effluent from 6 of the 11 pulp mills were able to displace greater than 25% of the receptor‐bound [3H]all‐trans retinoic acid (RA) or [3H]9‐cis RA from trout RARs and RXRs, respectively. The ability of the extracts to displace retinoic acid did not appear to be linked to the pulping or treatment processes. Moreover, extracts with the greatest activity came from thermomechanical mills, suggesting the compounds may originate from the wood furnish. In addition, extracts prepared from wood furnish (wood chips: white spruce [50%], lodgepole pine [47%], and balsam fir [3%]) from one mill were able to displace [3H]RA from the RARs and RXRs. The 4‐hydroxy RA, a metabolite of RA that has been shown to be generated in greater quantities in fish exposed to P450‐inducing xenobiotics, was able to displace [3H]all‐trans RA from trout RARs as effectively as unlabeled all‐trans RA. These results suggest that pulp mill effluent may impact the retinoid system of fish at multiple sites, either by decreasing hepatic retinoid stores or through contributing additional ligands (from the wood furnish) that can bind to RA receptors.
Dilemmas in Managing Pregnant Women With Ebola: 2 Case Reports

We report 2 cases of Ebola viral disease (EVD) in pregnant women who survived, initially with intact pregnancies. Respectively 31–32 days after negativation of the maternal blood EVD-polymerase chain reaction (PCR) both patients delivered a stillborn fetus with persistent EVD-PCR amniotic fluid positivity.
Treatment of presumed acute cardiogenic pulmonary oedema in an ambulance system by nurses using Boussignac continuous positive airway pressure

Background: Early initiation of continuous positive airway pressure (CPAP) applied by face mask benefits patients with acute cardiogenic pulmonary oedema (ACPE). The simple disposable Boussignac CPAP (BCPAP) has been used in ambulances by physicians. In the Netherlands, ambulances are manned by nurses and not physicians. It was hypothesised that ambulance nurses are able to identify patients with ACPE and can successfully apply BCPAP. A prospective case series of patients with presumed ACPE treated with BCPAP by ambulance nurses is described. Methods: After training of ambulance nurses, all 33 ambulances in the region were equipped with BCPAP. ACPE was diagnosed on clinical signs and pulse oximetry saturation (Spo2) <95%. BCPAP (5 cm H2O, Fio2 >80%) was generated with an oxygen flow of 15 l/min. The physiological responses, experiences and clinical outcomes of the patients were collected from ambulance and hospital records, and ambulance nurses and patients received a questionnaire. Results: From March to December 2006, 32 patients (age range 61–94 years) received BCPAP during transport to six different regional hospitals. In 26 patients (81%) a diagnosis of ACPE was confirmed. With BCPAP, median (IQR) Spo2 increased from 79% (69–94%) to 96% (89–98%) within 20 min. The median (IQR) duration of BCPAP treatment was 26 min (21–32). The patients had no negative recollections of the treatment. Ambulance personnel were satisfied with the BCPAP therapy. Conclusion: When applied by ambulance nurses, BCPAP was feasible and effective in improving oxygen saturation in patients with ACPE. Although survival benefit can only be demonstrated by further research, it is considered that BCPAP can be implemented in all ambulances in the Netherlands.
A Generalized Mixed Variational Inclusion Involving (H(·, ·), ?)-Monotone Operators in Banach Spaces

In this paper, we introduce a new class of monotone operators ? (H(·, ·), ? )- monotone operators, which generalize many existing monotone operators. The resolvent operator associated with an (H(·, ·), ? )- monotone operator is defined and its Lipschitz continuity is presented. As an application, we also consider a new generalized mixed variational inclusion involving (H(·, ·), ? )-monotone operators and construct a new algorithm for solving the generalized mixed variational inclusion. Under some suitable conditions, we prove the convergence of the iterative sequences generated by the algorithm. These results improve and generalize many corresponding results in recently literatures.