Miracle-dz/UniFAR-FTUs huggingface dataset:
A placebo-controlled clinical trial of nadolol in the prophylaxis of growth of small esophageal varices in cirrhosis.

BACKGROUND & AIMS Beta-blockers are extensively used to prevent variceal bleeding in patients with large esophageal varices. It is not established if beta-blockers delay the growth of small varices. METHODS A total of 161 patients with cirrhosis and small esophageal varices (F1 according to the classification of Beppu et al.) without previous bleeding were enrolled. A total of 83 patients were randomized to nadolol (dose adjusted to decrease resting heart rate by 25%; mean dose given, 62 +/- 25 mg/day) and 78 to placebo. The principal end point was occurrence of large esophageal varices (F2 or F3 according to the classification of Beppu et al.). Endoscopic examination was performed after 12, 24, 36, 48, and 60 months of follow-up. Mean follow-up was 36 months. RESULTS The 2 groups were well matched for demographic and clinical characteristics. During the study period, 9 patients randomized to nadolol and 29 randomized to placebo had growth of esophageal varices. At the end of follow-up, the cumulative risk was 20% versus 51% (P < 0.001) (absolute risk difference, 31%; 95% confidence interval, 17%-45%). When possible confounding factors were taken into account, treatment was a significant factor predicting growth of varices (odds ratio, 4.0; 95% confidence interval, 1.95-8.4). The cumulative probability of variceal bleeding was also lower in patients randomized to nadolol (P = 0.02). Survival was not different (P = 0.33). Adverse effects resulting in withdrawal of drug occurred in 9 in the nadolol group and one in the placebo group (P = 0.01). CONCLUSIONS This study suggests that beta-blocker prophylaxis of variceal bleeding in patients with compensated cirrhosis should be started when small esophageal varices are present.
Effects of carvedilol on isolated heart mitochondria: evidence for a protonophoretic mechanism.

Carvedilol (¿1-[carbazolyl-(4)-oxy]-3-[2-methoxyphenoxyethyl)amino]-pro panol-(2) ¿) is a novel compound used in clinical practice for the treatment of congestive heart failure, mild to moderate hypertension, and myocardial infarction. Carvedilol was also shown to protect cardiac mitochondria from oxidative stress events. Because mitochondria are the main suppliers of ATP for cardiac muscle work, a study of the effects of carvedilol in mitochondrial bioenergetics is necessary to fully understand the basis of its protective role in myocardial energetics. In this work we show that carvedilol acts as an uncoupler of oxidative phosphorylation, decreasing mitochondrial electric potential (DeltaPsi) by a weak protonophoretic mechanism. Theoretical studies were carried out to determine the relevance of conformation and proton affinity of the protonable amino side-chain group in the proton-shuttling activity across the inner mitochondrial membrane. BM910228, a hydroxylated metabolite of carvedilol, was also studied for comparison with the parent compound. Implications for the protective role of carvedilol in heart mitochondrial bioenergetics are discussed.
Selective Effect of Neurocognition on Different Theory of Mind Domains in First-Episode Psychosis

Abstract The aim of this study was to investigate the influence of neurocognition on affective and cognitive theory of mind (ToM) tasks in early phases of psychosis. In a cross-sectional study of 60 first-episode schizophrenia/schizoaffective disorder patients, the implication of neurocognition in first- and second-order ToM stories, Hinting Task, and Reading the Mind in the Eyes Test (RMET) was analyzed. Regression models were used, controlling for clinical symptoms and antipsychotic dose. Spatial span backward (odds ratio [OR], 0.34; p = 0.01) and intrusions in the Rey Auditory Verbal Learning Test (OR, 4.86; p = 0.04) were the best factors to predict second-order ToM failure. Trail Making Test B (B = 0.01; p = 0.04) and negative symptoms (B = 0.09; p = 0.01) predicted Hinting task performance while Block design (B = 0.1; p = 0.04) was related to RMET outcome. Executive functions and clinical symptoms were related to ToM performance in first-episode schizophrenia patients, although different patterns of relationship were observed in each ToM task.
Ectopic pregnancy: a five year review

A survey of all women between the ages of 15-50 who underwent laparotomy at the Women's Hospital, Liverpool, from January 1970 to December 1974, was performed to identify etiological factors in ectopic pregnancy. There were 49 ectopic pregnancies during this peirod. The majority of patients were 30-35 years of age (20), 16 were in the 25-29 group. 63.3% had a previous viable pregnancy, 16.3% had a previous abortion, and 3 patients had a previous ectopic pregnancy. The major sysmptoms were vaginal bleeding followed by abdominal pain. Only 16.3% gave a history of previous pelvic infection. However, 53.5% were found to have evidence of previous pelvic infection. 4 patients. Results indicate that pelvic inflammatory disease is still the greatest cause of ectopic pregancy.
Complexity in language learning and treatment.

PURPOSE To introduce a Clinical Forum focused on the Complexity Account of Treatment Efficacy (C. K. Thompson, L. P. Shapiro, S. Kiran, & J. Sobecks, 2003), a counterintuitive but effective approach for treating language disorders. This approach espouses training complex structures to promote generalized improvement of simpler, linguistically related structures. Three articles are included, addressing complexity in treatment of phonology, lexical-semantics, and syntax. METHOD Complexity hierarchies based on models of normal language representation and processing are discussed in each language domain. In addition, each article presents single-subject controlled experimental studies examining the complexity effect. By counterbalancing treatment of complex and simple structures across participants, acquisition and generalization patterns are examined as they emerge. RESULTS In all language domains, cascading generalization occurs from more to less complex structures; however, the opposite pattern is rarely seen. The results are robust, with replication within and across participants. CONCLUSIONS The construct of complexity appears to be a general principle that is relevant to treating a range of language disorders in both children and adults. While challenging the long-standing clinical notion that treatment should begin with simple structures, mounting evidence points toward the facilitative effects of using more complex structures as a starting point for treatment.
Successful Treatment of Legionnaires’ Disease with Tigecycline in an Immunocompromised Man with a Legion of Antibiotic Allergies

Legionella species are Gram-negative bacilli that are relatively rare causes of community-acquired pneumonia but can be associated with significant morbidity and mortality if unrecognized or improperly treated. Limited data exist regarding the use of tigecycline, a third generation glycylcycline, in the treatment of Legionnaires' disease. We present an immunocompromised patient with Legionnaires' disease and allergies to both fluoroquinolones and macrolides, which are first-line treatment options for Legionnaires' disease. He was successfully treated using tigecycline, a third generation glycylcycline, indicating that tigecycline may serve as a safe and effective alternative therapeuticl option for treatment of Legionnaires’ disease.
Systemic lupus erythematosus in three ethnic groups. XIX. Natural history of the accrual of the American College of Rheumatology criteria prior to the occurrence of criteria diagnosis.

OBJECTIVE To determine how the American College of Rheumatology (ACR) criteria for the classification of systemic lupus erythematosus (SLE) accrue in a multiethnic cohort of SLE patients. METHODS SLE patients enrolled in a longitudinal study of outcome were analyzed (LUMINA; Lupus in Minorities: Nature versus nurture) for the manner in which ACR criteria manifestations occurred prior to the accrual of 4 of them. Time at which a criterion was said to be present was determined by review of all previously available medical records and interview. Univariable and multivariable Cox proportional hazard models were examined for the association with time to accrual of 4 ACR criteria; results were reported as hazard ratios. RESULTS There were 103 Texas Hispanic (of Mexican or Central America ancestry) patients, 55 Puerto Rico Hispanics, 176 African Americans, and 137 Caucasians. The mean +/- SD and median (range) time to accrual of 4 ACR criteria were 29.4 +/- 52.0 months and 9.1 (0-328.7) months; time was shortest for the Texas Hispanics (18.4 +/- 42.8 and 5.0 [0-248] months) and longest for the Caucasians (39.9 +/- 59.3 months and 17.7 [0-324.6] months). Arthritis was the most frequent first criterion (34.5%); it was followed by photosensitivity (18.8%). When 2 criteria occurred from the outset, the most frequent combination was arthritis and antinuclear antibody positivity followed by malar rash and photosensitivity. A Cox-regression multivariable model identified Hispanic ethnicity (from Texas) and HLA-DRB1*0301 as predictors of short time to criteria accrual, whereas older age and married/living together were associated with long time to criteria accrual. CONCLUSION Significant variability in the evolution of ACR criteria manifestations does occur. Texas Hispanics are more likely to have a rapid evolution of criteria manifestations, but several years may elapse before ACR criteria are accrued.
Response of the oligodendrocyte progenitor cell population (defined by NG2 labelling) to demyelination of the adult spinal cord

Elucidation of the response of oligodendrocyte progenitor cell populations to demyelination in the adult central nervous system (CNS) is critical to understanding why remyelination fails in multiple sclerosis. Using the anti‐NG2 monoclonal antibody to identify oligodendrocyte progenitor cells, we have documented their response to antibody‐induced demyelination in the dorsal column of the adult rat spinal cord. The number of NG2+ cells in the vicinity of demyelinated lesions increased by 72% over the course of 3 days following the onset of demyelination. This increase in NG2+ cell numbers did not reflect a nonspecific staining of reactive cells, as GFAP, OX‐42, and Rip antibodies did not co‐localise with NG2+ cells in double immunostained tissue sections. NG2+ cells incorporated BrdU 48–72 h following the onset of demyelination. After the onset of remyelination (10–14 days), the number of NG2+ cells decreased to 46% of control levels and remained consistently low for 2 months. When spinal cords were exposed to 40 Grays of x‐irradiation prior to demyelination, the number of NG2+ cells decreased to 48% of control levels by 3 days following the onset of demyelination and remained unchanged at 3 weeks. Since 40 Grays of x‐irradiation kills dividing cells, these studies illustrate a responsive and nonresponsive NG2+ cell population following demyelination in the adult spinal cord and suggest that the responsive NG2+ cell population does not renew itself. GLIA 22:161–170, 1998. © 1998 Wiley‐Liss, Inc.
Changes in students' attitudes toward HIV‐infected patients as the students progress through medical school

PURPOSE. To examine how medical students' attitudes and intentions toward the treatment of persons infected with human immunodeficiency virus (HIV) changed as the students progressed through medical school. METHOD. Similar 44-item self-administered questionnaires, to be completed anonymously, were given to 394 medical students at the University of Michigan Medical School in February 1989, when the students were in their first or second years, and to 378 of the same students in February 1991, when they were in their third or fourth years. Seven subscale variables were created, and their effects on students' willingness to treat HIV-infected patients were assessed. Bivariate statistics and logistic regression were used to relate the dependent and independent variables. RESULTS. In 1989, 201 (51%) of the students responded; in 1991, 208 (55%) responded. The students showed a high–but declining–degree of willingness to care for patients infected with HIV or at high risk of infection. Homophobic attitudes decreased, but so did the students' intentions to follow infection-control guidelines. The students who expressed a career interest in surgery specialties indicated less willingness to provide care for HIV-infected patients, presumably because these students felt that they would be at a higher risk of exposure. CONCLUSION. Overall, the students' responses indicated that over the two years of the study they became more restrictive in their attitudes toward HIV-positive patients, felt less personal obligation toward caring for these patients, and were less likely to use appropriate infection-control methods to ensure their own safety.
Clinical characteristics of IgA nephropathy associated with low complement 4 levels

Abstract Objective: C4 deficiency is the most commonly inherited immune disorder in human. The present study investigated the characteristics of the IgAN patients with low serum C4 levels. Methods: We performed a prospective observational study. Clinical as well as histopathologic parameters were assessed. A Kaplan–Meier survival analysis was performed concerning the primary outcome defined as the serum creatinine increased 1.5-fold from baseline. The prognostic significances of clinical and histopathologic parameters were determined using Cox proportional hazards models. Results: Five-hundred twelve biopsy proven IgAN cases were available for analysis with a median follow-up of 38.4 months. Ninety-nine cases (19.34%) presented with low C4 levels (LowC4 group) and the other 413 cases did not (NlowC4 group). At the time of renal biopsy, renal injury was lighter in the LowC4 group compared with the NlowC4 group. Renal C4 deposition was significantly decreased while IgM deposition was increased in the LowC4 group. A correlation analysis shows that lower C4 levels were associated with better renal presentations at biopsy. However, the risk of developing the primary outcome was significantly greater in those with low C4 levels. Specifically, during the follow-up period, the risk of developing primary outcome was nearly ten folds higher in those with low C4, compared to those without low C4. Conclusion: There is a high prevalence of low C4 levels in IgAN patients. These patients with low C4 levels exhibited better renal presentations at the time of renal biopsy, whereas might be associated with a poor prognosis.
Multinationality and Performance

Abstract: This study aims to find the multinationality and performance relationship for the largest Indian software companies. It further tests the moderating influence of internationalization motives (marketing- versus labor-seeking) and resources on this relationship. Results show an inverted U-shaped relationship between multinationality and performance for Indian software firms. Additionally, this relationship is moderated by the internationalization motives of these firms. In the process, we add to the literature with our unique context and moderating variables.
DM9 Domain Containing Protein Functions As a Pattern Recognition Receptor with Broad Microbial Recognition Spectrum

DM9 domain was first identified in Drosophila melanogaster, and it was subsequently found to integrate with or without other protein domains across a wide range of invertebrates and vertebrates. In the present study, a member of DM9 domain containing protein (DM9CP) family from marine invertebrate Crassostrea gigas (designated CgDM9CP-1), which was only composed of two DM9 domains, was taken as a protein model to study the biological functions of DM9 domain and its molecular determinants. CgDM9CP-1 was found to exhibit high binding specificity and avidity toward d-mannose residue. It served as a pattern recognition receptor (PRR) with a broad range of recognition spectrum to various pathogen-associated molecular patterns, including lipopolysaccharide, peptidylglycan, mannan, and β-1, 3-glucan in a d-mannose-dependent manner, as well as bacteria and fungi. In order to reveal the molecular mechanism underlying its pattern recognition activity, the crystal structures of wild-type and loss-of-function mutants were solved, and Asp22 and Lys43 were found to be the critical residues for ligand recognition. Moreover, CgDM9CP-1 protein was found to mainly distribute on the surface of C. gigas hemocytes, and it could be translocated into cytoplasm and colocalized with the engulfed microbes during hemocyte phagocytosis. The present result clearly indicated that CgDM9CP-1 was a PRR, and it provided an important clue for the better understanding of DM9CP function.
Type III secretion systems and the evolution of mutualistic endosymbiosis

The view that parasites can develop cooperative symbiotic relationships with their hosts is both appealing and widely held; however, there is no molecular genetic evidence of such a transition. Here we demonstrate that a mutualistic bacterial endosymbiont of grain weevils maintains and expresses inv/spa genes encoding a type III secretion system homologous to that used for invasion by bacterial pathogens. Phylogenetic analyses indicate that inv/spa genes were present in presymbiotic ancestors of the weevil endosymbionts, occurring at least 50 million years ago. The function of inv/spa genes in maintaining symbiosis is demonstrated by the up-regulation of their expression under both in vivo and in vitro conditions that coincide with host cell invasion.
Real-Time Status Updates for Markov Source

For timely sensor update, the traditional approach is to send new information at every available opportunity. Recent research has shown that with limited receiver feedback, sensors can improve the update timeliness by transmitting differential information for slowly varying correlated sources. One can elect to transmit either the actual or the differential state information based on a differential encoding threshold for a general Markov source. This threshold captures the natural trade-off between differential transmission opportunities and the coding gains. Using matrix-geometric method, we find the limiting age distribution for a Markov source as a function of the encoding threshold, from which several other performance metrics of interest, such as mean age, peak age, and the probability of decoding failure can be derived.
Laterality in detour behaviour: interspecific variation in poeciliid fish

We measured whether males of five species of poeciliid fish made detours to the right or left of a vertical-bar obstacle in order to approach a group of females. Three of these species, Gambusia holbrookiGambusia nicaraguensis and Poecilia reticulata showed a significant bias to the left, whereas Brachyrhaphis roseni and Girardinus falcatus showed a significant bias to the right. When tested for direction of turning in front of an opaque barrier, or when a dummy predator was used as a target in a detour test, G. holbrooki and G. falcatus showed similar biases to the right (opaque barrier) and left (predator), thus suggesting that the difference observed when females were used as a target could arise from species differences in the degree of sexual motivation in a novel environment. The two species that showed bias to the right with the females were less likely to exhibit sexual behaviour when placed in a novel environment. Moreover, manipulation of the factors affecting the relative strength of sexual motivation and of fear of a novel environment, such as how long fish were maintained in captivity or in the test apparatus before being tested, caused shifts in the direction of the lateral asymmetries. These results suggest that the presence of functional asymmetries in behaviour could be widespread among vertebrates and that the direction of such asymmetries tends to be strikingly similar in closely related species, thus supporting the hypothesis of an early evolution of laterality in brain and behaviour.Copyright 1997 The Association for the Study of Animal Behaviour1997The Association for the Study of Animal Behaviour
Prediction of MRI erosive progression: a comparison of modern imaging modalities in early rheumatoid arthritis patients

Objectives To examine the associations between modern imaging modalities and joint damage measured as 1-year MRI erosive progression, in early rheumatoid arthritis (RA) patients. Methods 84 RA patients with disease duration of less than 1 year were included in this inception cohort. Patients were evaluated at baseline, 3, 6 and 12 months by core measures of disease activity, MRI and ultrasound grey-scale (USGS) of inflammation, conventional radiography and digital x-ray radiogrammetry (DXR) bone mineral density (BMD) of cortical hand bone. Results 53 of the 79 patients (67%) who completed the follow-up had MRI erosive progression (dependent variable). USGS and MRI bone marrow oedema (BME) were in multivariate analyses independent predictors of 1-year MRI erosive progression. There was a trend towards higher MRI synovitis score and 3-month DXR BMD loss in patients developing MRI erosions. On an individual level, USGS inflammation, MRI synovitis and MRI BME also somewhat better predicted outcome than rheumatoid factor, anticitrullinated protein antibodies and disease activity score 28. Conclusions USGS inflammation and MRI BME were independent predictors of MRI erosive progression in early RA patients on a group level. The exact prognosis of the individual patients could not be determined by imaging alone.
[Effect of diclofenac on human osteoblasts and their stromal precursors in vitro in relation to arthroplasty].

INTRODUCTION Results of animal experiments have demonstrated that the osseous integration of non-cemented prostheses can, at the very least temporarily, be impaired by the application of non-steroidal antiphlogistic agents (such as diclofenac). It is the objective of this study to examine whether there is a direct influence of diclofenac used in usual clinical dosages (3 times 50 mg daily) on bone cells and their progenitor cells which would explain the observed slow integration of the prostheses. METHODS To investigate this, cultivated human in vitro osteoblasts and stromal bone marrow cells were incubated with increasing doses of the medications. Our study focused on the effect of diclofenac application on proliferation and functional metabolism in both cell lines. The measurable maximal plasma concentration 2 h after the application of one tablet Voltaren 50 reached 1.6 micrograms/ml. This correlated with diclofenac concentrations between 1 and 10 ml found in our experiments. The detected values were correlated to the control group (0 microgram/ml diclofenac). RESULTS The drug effect upon osteoblasts was higher than on progenitor cells. The proliferation of in vitro stromal bone marrow cells, compared to untreated cells, was found to be decreased. We observed a decrease to 82% at a diclofenac concentration of 1 microgram/ml, Osteoblasts exhibited a decrease to 97.5% at the same concentration. The DNA synthesis increased to 118% in stromal bone marrow cells, in osteoblasts to 144%. In contrast, we detected a neglectible decrease to 92% in the collagen synthesis of osteoblasts compared to untreated cells. The synthesis of osteocalcin by osteoblasts increased to 119%. The alkaline phosphatase activity was found to be decreased to 88% in stromal bone marrow cells and increased in osteoblasts to 111%. CONCLUSION Temporary inhibiting effects on osseous integration in non-cemented prosthesis by diclofenac could be caused by a disturbance in the anabolic bone metabolism, exhibited by an increase of osteoblastic osteocalcin expression. Osteocalcin as a known negative regulator of the osteoneogenesis is most likely inhibiting the collagen matrix deposition.