Miracle-dz/UniFAR-FTUs huggingface dataset:
Influence of Emergency Room Fee on Acute Stroke Presentation in a Public Hospital in Hong Kong

A new system of emergency room fee-for-service was recently introduced at public hospitals in Hong Kong. A prospective observational study was undertaken to investigate the effects of the emergency room consultation fee system on presentation delay of acute stroke patients and evaluation of timing of patient presentation with acute stroke. We reviewed 2 specified periods (2-month interval each) before and after the consultation fee system at a public hospital. Primary outcome measures were time from onset of stroke symptoms to arrival at hospital, and predictors of such a time delay. A total of 173 subjects were recruited before institution of the consultation fee system, and 189 after inception of the new system. The mean age was 71 years. The median delay between symptom onset and arrival at hospital was 9 h. Acute ischemic stroke accounted for 91% of the stroke diagnoses. The median baseline NIHSS score measured 6. The median delay for patients before the emergency room consultation fee system was 9.7 h, compared with 8.4 h after introduction of the consultation fee (p = 0.66). At presentation, patients admitted during the consultation fee system were significantly more likely to be unconscious and be in a worse functional premorbid state. We found no difference in the frequency of general practitioner contact between the 2 study periods. Overall, univariate analyses showed that patient age, baseline NIHSS score, consciousness level upon arrival at the emergency department and premorbid ambulatory status were significant factors associated with the timing of presentation after acute stroke. A multivariate linear regression model demonstrated two independent factors: patient age younger than 70 years was independently related to presentation delay, whereas severity of stroke as indicated by unconsciousness upon arrival was associated with shorter delay. While we demonstrated no delays in acute stroke presentation accrued from enactment of the emergency room fee, physicians should endeavor to further explore strategies of reducing the late presentation of acute stroke.
Acute myopathy after liver transplantation

Acute myopathy is a cause of weakness and additional morbidity in a variety of critically ill patients, including transplant recipients. We report the incidence of and risk factors associated with acute myopathy after orthotopic liver transplantation (OLTx). One hundred consecutive adult patients were prospectively assessed for muscle weakness after OLTx. Electrodiagnostic studies and muscle biopsies were performed on consenting affected patients. Potential risk factors for myopathy were evaluated in patients with myopathy versus control subjects. Seven patients developed acute persistent weakness after OLTx. Electrodiagnostic studies were consistent with a necrotizing myopathy. Histopathologic evaluation in five revealed a necrotizing myopathy with loss of myosin thick filaments. A higher initial index of illness severity, dialysis requirement, and higher doses of glucocorticoids were associated with development of myopathy. Patients with myopathy subsequently remained in the intensive care unit (ICU) longer than unaffected patients. In conclusion, acute substantial weakness was a source of additional morbidity in 7% of patients after OLTx. Most had myopathy with loss of myosin thick filaments. Patients with greater severity of illnesses and renal failure requiring dialysis were more likely to be affected. The effect of reducing exposure to corticosteroids in high-risk patients warrants further investigation.
Achieving Successful River Restoration in Dense Urban Areas: Lessons from Taiwan

A paradigm shift in river management practice is underway, from a hard engineering-dominated emphasis that endeavours to control water, to a multi-functionality-framed approach that strives to restore a river’s ecology, scenery and ecosystem services. In Taiwan, the Laojie River in Taoyuan City, where a channelized and piped urban river was recently transformed into an accessible, linear green infrastructure feature, is widely regarded as the first extensive and successful river restoration project in Taiwan’s densely-urbanized, flood-prone areas, yet its actual performance is rarely examined in any depth. Through in-depth interviews, fieldwork and a review of government documents, this paper presents findings on the practical factors involved in the practice of river restoration and their implications for urban river management. First, local people support river restoration with de-culverting, but potential flooding is a concern that results from different flood-risk perceptions and ineffective flood-risk communication between the government and public. Second, a mix of hard and soft edges to the watercourse improves the riverside landscapes in a densely-urban, flood-prone area. Third, due to a lack of basin-wide supporting sanitary sewer systems, a combination of on-site gravel contact oxidation treatment systems and riverside sewage-intercepting facilities still fails to improve the river water quality. Fourth, people’s positive attitudes towards river restoration are largely associated with landscape aesthetics and recreational value, rather than water quality and biodiversity. It is revealed that using the Cheonggyecheon Stream in South Korea as a frame for river restoration seems effective in providing local people with an example of successful river restoration, based mainly on flood prevention and recreational and aesthetic improvement. Moreover, the effective flood-risk communication is mainly reliant on an intelligible presentation of related information to the general public. Practical, continuous and extensive public participation, with various types of involvement and resources along with a solid system of social objectives by which to assess the outcome, is central to the social aspect of river restoration.
Beneficial effects of ACTH on the serum lipoprotein profile and glomerular function in patients with membranous nephropathy.

BACKGROUND Previous studies have shown that short-term treatment with adrenocorticotrophic hormone (ACTH) has a strong and rapid lipid-lowering effect. In this long-term study of nephrotic patients with idiopathic membranous nephropathy, the influence of ACTH on the serum lipoprotein profile and glomerular function as well as the dose-effect relationship was investigated. METHODS Fourteen patients received ACTH intramuscularly at increasing doses during 56 days. Serum concentrations of lipids, lipoproteins, and apolipoproteins as well as variables of glomerular function were analyzed, and the side-effects were recorded. ACTH treatment, in the estimated optimal dosage, was then continued in five patients with severe steroid-resistant nephrotic syndrome. In these five patients, the total treatment period was 12 months, and the follow-up time after discontinuing treatment was 18 months. RESULTS Taking both the statistically significant therapeutic effects and the modest side-effects into consideration, the optimal dosage of ACTH was estimated to be 1 mg twice per week. At that dose, reductions by 30 to 60% in the serum concentrations of cholesterol, triglycerides, apolipoprotein B, and lipoprotein(a) were observed, whereas the serum concentrations of high-density lipoprotein cholesterol and apolipoprotein AI rose by 30 to 40%. In addition, the urinary albumin excretion decreased by 90%, and the glomerular filtration rate increased by 25%. Deterioration was observed in all cases when ACTH was discontinued after a treatment duration of 56 days. However, the five patients in whom ACTH therapy was resumed were still in remission 18 months after discontinuance of treatment. CONCLUSIONS In nephrotic patients with idiopathic membranous nephropathy, treatment with ACTH 1 mg twice per week was associated with significant long-term improvements in serum lipoprotein pattern and glomerular function.
Changes in Perceived Recovery Status Scale Following High-Volume Muscle Damaging Resistance Exercise

Abstract Sikorski, EM, Wilson, JM, Lowery, RP, Joy, JM, Laurent, CM, Wilson, SM-C, Hesson, D, Naimo, MA, Averbuch, B, and Gilchrist, P. Changes in perceived recovery status scale following high-volume muscle damaging resistance Exercise. J Strength Cond Res 27(8): 2079–2085, 2013—Currently no research has investigated the relationship between muscle damage, hormonal status, and perceived recovery scale (PRS). Therefore, the purpose of this study was to determine the effects of a high-volume training session on PRS and to determine the relationship between levels of testosterone, cortisol, and creatine kinase (CK) and PRS. Thirty-five trained subjects (21.3 ± 1.9 years) were recruited. All subjects participated in a high-volume resistance training session consisting of 3 sets of full squats, bench press, deadlifts, pullups, dips, bent over rows, shoulder press, and barbell curls and extensions. Pre-PRS and post-PRS measurements (0–10), soreness, CK, cortisol, and testosterone were measured before and 48 hours after training. Perceived recovery scale declined from 8.6 ± 2.3 to 4.2 ± 1.85 (p < 0.05). Leg, chest, and arm soreness increased from pre- to postexercise. Creatine kinase significantly increased from pre- to postworkout (189.4 ± 100.2 to 512 ± 222.7 U/L). Cortisol, testosterone, and free testosterone did not change. There was an inverse relationship between CK and PRS (r2 = 0.58, p < 0.05). When muscle damage was low before training, cortisol and free and total testosterone were not correlated to PRS. However, when damage peaked at 48 hours postexercise, free, but not total, testosterone showed a low direct relationship with PRS (r2 = 0.2, p < 0.05). High-volume resistance exercise lowers PRS scores. These changes are partly explained by a rise in serum indices of muscle damage. Moreover, free testosterone seems to have a positive relationship with PRS.
PD-1 Suppresses Development of Humoral Responses That Protect against Tn-Bearing Tumors

PD-1 regulates T-cell antitumor responses. PD-1 has now also been found to inhibit B-cell antitumor immunity that is based upon the recognition of tumor-specific glycans, revealing an alternative mechanism by which PD-1 blockade may elicit antitumor responses. Tn is a carbohydrate antigen uniquely exposed on tumor mucins and, thus, an ideal target for immunotherapy. However, it has been difficult to elicit protective antibody responses against Tn antigen and other tumor-associated carbohydrate antigens. Our study demonstrates this can be attributed to PD-1 immuno-inhibition. Our data show a major role for PD-1 in suppressing mucin- and Tn-specific B-cell activation, expansion, and antibody production important for protection against Tn-bearing tumor cells. These Tn/mucin-specific B cells belong to the innate-like B-1b cell subset typically responsible for T cell–independent antibody responses. Interestingly, PD-1–mediated regulation is B cell–intrinsic and CD4+ cells play a key role in supporting Tn/mucin-specific B-cell antibody production in the context of PD-1 deficiency. Mucin-reactive antibodies produced in the absence of PD-1 inhibition largely belong to the IgM subclass and elicit potent antitumor effects via a complement-dependent mechanism. The identification of this role for PD-1 in regulating B cell–dependent antitumor immunity to Tn antigen highlights an opportunity to develop new therapeutic strategies targeting tumor-associated carbohydrate antigens. Cancer Immunol Res; 4(12); 1027–37. ©2016 AACR.
Conference on ‘ Carbohydrates in health : friends or foes ’ Plenary Lecture 3 : Waterlow lecture The rise and fall of gluten !

Mankind has existed for 2·5million years but only in the last 10 000 years havewe been exposed to wheat. Wheat was first cultivated in the Fertile Crescent (South Western Asia) with a farming expansion that lasted from about 9000BC to 4000BC. Thus it could be considered that wheat (and gluten) is a novel introduction to man’s diet! Prior to 1939 the rationing system had already been devised. This led to an imperative to try to increase agricultural production. Thus it was agreed in 1941 that there was a need to establish aNutrition Society. The very roots of the society were geared towards necessarily increasing the production of wheat. This goal was achieved and by the end of the 20th century, global wheat output had expanded 5-fold. Perhaps as a result the epidemiology of coeliac disease (CD) or gluten sensitive enteropathy has changed. CD is a state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals. CD now affects 1 % or more of all adults, for which the treatment is a strict lifelong gluten-free diet. However, there is a growing body of evidence to show that a far greater proportion of individuals without coeliac disease are taking a gluten-free diet of their own volition. This clinical entity has been termed non-coeliac gluten sensitivity (NCGS), although the condition is fraught with complexities due to overlap with other gluten-based constituents that can also trigger similar clinical symptoms. This review will explore the relationship between gluten, the rising prevalence of modern coeliac disease, and the new entity of NCGS along with its associated uncertainties.
Monoclonal antibodies as probes of the antigenic structure of tobacco mosaic virus.

The antigenic structure of tobacco mosaic virus has been analysed by measuring the ability of nine monoclonal antibodies to distinguish between wild‐type virus and 13 mutants showing single and double amino acid substitutions in the coat protein. Although the majority of antibodies detected those substitutions that were located at the outer surface of the virion, some of them also recognized conformation alterations induced by exchanges occurring deep inside the subunit. In the case of five mutants, the antibody reactivity was reduced compared with wild‐type virus, while in the case of three others, it was significantly higher. Each monoclonal antibody possessed a unique discrimination pattern with respect to the different substitutions. The simultaneous presence of two exchanges led to the complete disappearance of any binding with six of the nine antibodies and to reduced binding with three others. The superior discriminatory capacity of monoclonal antibodies compared with polyclonal antisera was demonstrated by the fact that three exchanges not detected with antisera were found to alter the antigenicity when tested with monoclonal antibodies.
A case-control study of interleukin-12 1188A/C polymorphism in obsessive-compulsive disorder in Chinese population

Objective: Previous studies indicated that the levels of serum interleukin (IL)-12 at baseline were elevated in obsessive-compulsive disorder (OCD) patients compared with control subjects, suggesting that IL-12 maybe involved in the etiopathogenesis of OCD. Therefore, we study the relationship between 1188A/C polymorphism of IL-12(rs3212227) and OCD in Chinese Han population. Methods: We genotyped 194 OCD patients and 322 healthy individuals by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), then analyzed the data using case-control association test. Results: No significant differences were found in 1188A/C genotypic and allelic frequencies between OCD cases and controls (X2 = 2.12, df = 2, P = 0.35 by genotype; X2 = 0.005, df = 1, P = 0.94 by allele). Conclusions: Our results suggested that there may be lack of an association between OCD and IL-12 1188A/C polymorphism in Chinese Han population.
In vitro microleakage of luting cements and crown foundation material.

STATEMENT OF PROBLEM Microleakage is a concern for the long-term prognosis of a cemented crown and foundation. PURPOSE The aims of this investigation were, first, to evaluate microleakage of zinc phosphate cement and resin-reinforced glass ionomer cement under ideal (dry) versus contaminated (wet) conditions, and second, to compare 3 foundations under both ideal and contaminated conditions. MATERIAL AND METHODS One hundred forty extracted molar teeth were cleaned and mounted. Tooth preparations for complete veneer cast crowns were completed with a chamfer finish line. A mesial surface class II cavity preparation 4 mm wide buccolingually and 2 mm deep was made in each tooth. Seven restorative groups were formed: amalgam/cavity varnish, amalgam/dentinal bonding agent, and composite/dentinal bonding agent, each with dry and contaminated groups, and a seventh group of class II cavity preparations without foundations. Finish lines for crown margins were refined 1.5 mm gingival to the restoration. Artificial crowns were cast in type III gold. Treatment groups were divided into 4 cement groups: dry and contaminated zinc phosphate cement and dry and contaminated resin-reinforced glass ionomer cement. The specimens were thermocycled and immersed in erythrosine B solution for 24 hours. Subsequently, they were rinsed, and their coronal portions were embedded in clear resin. Teeth were sectioned mesiodistally, and standard photomicrographs were made. The microleakage of each restoration and crown was measured. RESULTS The least foundation microleakage was recorded for amalgam/dentinal bonding agents (ideal group) and composite/dentinal bonding agents (ideal group). The most microleakage was observed within the group without a foundation. In cement groups, the control and experiment sides were evaluated separately but displayed the same order of finding. The least leakage was recorded with resin-reinforced glass ionomer cement (ideal group); the most microleakage was noted with zinc phosphate cement (ideal group). An interaction was demonstrated on the experimental side between cements and the foundations (P=.0001). CONCLUSION Within the experimental conditions of this study, less microleakage was recorded with resin-reinforced glass ionomer cement (ideal or contaminated) than with zinc phosphate cement (ideal or contaminated). There also was less microleakage evident with a foundation of silver amalgam or composite when a dentinal bonding agent was used under ideal conditions.
INTRAVASCULAR COAGULATION DURING PREGNANCY AND THE PUERPERIUM

The presence of activated coagulation and fibrinolysis during pregnancy and the early puerperium was detected by measurement of fibrin monomer, fibrin degradation products (f.d.p.) and fibrinogen/fibrin degradation products (FDP) in 285 women during normal pregnancy, 57 women with a previous history of miscarriage, 35 women with pre–eclampsia, 253 women during the first week post partum and 15 women with postpartum complications including thromboembolic disease, infection and haemorrhage. The effects of age, parity, smoking, bacteriuria, ABO blood group, type of delivery, and postpartum administration of oestrogen for suppression of lactation were analyzed. Our findings indicated that activated coagulation and fibrinolysis are common occurrences during pregnancy and the puerperium. Primigravidae and women with pre–eclampsia, postpartum complications and a history of miscarriage had a significantly higher incidence and level of these fibrinogen derivatives than women with uncomplicated pregnancies and deliveries.
Haloperidol is an inhibitor but not substrate for MDR1/P‐glycoprotein

The involvement of the multidrug resistant transporter MDR1/P‐glycoprotein in the penetration of haloperidol into the brain and absorption in the intestine was investigated to examine its role in inter/intra‐individual variability, using the porcine kidney epithelial cell line LLC‐PK1 and its MDR1‐overexpressing transfectant, LLC‐GA5‐COL150. The inhibitory effect of haloperidol on other MDR1 substrates was also investigated in terms of the optimization of haloperidol‐based pharmacotherapy. The transepithelial transport of [3H]haloperidol did not differ between the two cell lines, and vinblastine, a typical MDR1 substrate, had no effect on the transport, suggesting that haloperidol is not a substrate for MDR1, and it is unlikely that MDR function affects haloperidol absorption and brain distribution, and thereby the response to haloperidol. However, haloperidol was found to have an inhibitory effect on the MDR1‐mediated transport of [3H]digoxin and [3H]vinblastine with an IC50 value of 7.84 ± 0.76 and 3.60 ± 0.64 μM, respectively, suggesting that the intestinal absorption, not distribution into the brain, of MDR1 substrate drugs could be altered by the co‐administration of haloperidol in the clinical setting, although further clinical studies are needed.
Recombinant human granulocyte colony-stimulating factor (rhG-CSF) promotes in vitro platelet aggregation

Abstract rhG-CSF is increasingly used for stimulation of granulopoiesis and stem cell mobilization in healthy donors for allogeneic stem cell transplantation. However, a possible association between thrombosis and rhG-CSF administration has been reported. For that reason, in this study, we investigated the effect of rhG-CSF on platelet aggregation in whole blood of 10 healthy volunteers. Three concentrations of rhG-CSF solution (1, 10 and 100 ng/ml) were prepared. Each concentration of rhG-CSF solution and a control diluent without rhG-CSF were incubated with whole blood. Incubation with rhG-CSF solutions would result in 0.1, 1.0 and 10 ng/ml rhG-CSF concentrations in the blood. After incubation, aggregation responses were evaluated with ADP (5 and 10 μM) and collagen (2 and 5 μg/ml) in whole blood. When compared to control, preincubation with all dilutions of rhG-CSF augmented aggregation of platelets induced by ADP and collagen in a statistically significant manner (p < 0.05 for all comparisons). There was also a relationship between rhG-CSF concentration (1, 10 and 100 ng/ml) and augmentation of platelet aggregation response (p < 0.0001 for 5–10 μM ADP; p < 0.0001 for 2–5 μg/ml collagen). In conclusion, this study with an in vitro model showed that rhG-CSF administration may lead to platelet hyperaggregability.
Airway surface fluid volume and Cl content in cystic fibrosis and normal bronchial xenografts

Zhang, Yulong, and John F. Engelhardt. Airway surface fluid volume and Cl content in cystic fibrosis and normal bronchial xenografts. Am. J. Physiol. 276 (Cell Physiol. 45): C469–C476, 1999. —We describe the use of an in vivo human bronchial xenograft model of cystic fibrosis (CF) and non-CF airways to investigate pathophysiological alterations in airway surface fluid (ASF) volume (Vs) and Cl content. Vs was calculated based on the dilution of an impermeable marker, [3H]inulin, during harvesting of ASF from xenografts with an isosmotic Cl-free solution. These calculations demonstrated that Vs in CF xenographs (28 6 3.0 μl/cm2; n 5 17) was significantly less than that of non-CF xenografts (35 6 2.4 μl/cm2; n 5 30). The Cl concentration of ASF ([Cl]s) was determined using a solid-state AgCl electrode and adjusted for dilution during harvesting using the impermeable [3H]inulin marker. Cumulative results demonstrate small but significant elevations (P , 0.045) in [Cl]s in CF (125 6 4 mM; n 5 27) compared with non-CF (114 6 4 mM; n 5 48) xenografts. To investigate potential mechanisms by which CF airways may facilitate a higher level of fluid absorption yet retain slightly elevated levels of Cl, we sought to evaluate the capacity of CF and non-CF airways to absorb both 22Na and 36Cl. Two consistent findings were evident from these studies. First, in both CF and non-CF xenografts, 22Na and 36Cl were always absorbed in an equal molar ratio. Second, CF xenografts hyperabsorbed (,1.5-fold higher) both 22Na and 36Cl compared with non-CF xenografts. These results substantiate previously documented findings of elevated Na absorption in CF airways and also suggest that the slightly elevated [Cl]s found in this study of CF xenograft epithelia does not occur through a mechanism of decreased apical permeability to Cl.