Miracle-dz/UniFAR-FTUs huggingface dataset:
Antihypertensive Therapy: Beta-Blockers and Diuretics—Why Do Physicians Not Always Follow Guidelines?

The most recent reports of the Joint National Committee (JNC VI) and the World Health Organization recommend beta-blockers and diuretics as first-line therapy for uncomplicated essential hypertension (1, 2). Similar recommendations have been issued over the past few years by many authoritative sources and influential journals. These recommendations were supposedly based on multiple prospective randomized trials attesting that only beta-blockers and diuretics, both in monotherapy and in combination, reduced morbidity and mortality in hypertension. Ever since the Veterans Administration study in the 1970s (3), multiple and prospective randomized trials have documented that diuretic-based therapy reduces the risk of stroke and, to a lesser extent, of heart attacks and cardiovascular morbidity and mortality. However, the data are much less convincing for beta-blockers (4). In fact, no trial has shown that lowering blood pressure with a beta-blocker reduces the risk of a heart attack or cardiovascular event in patients with essential hypertension compared with placebo. In contrast, several prospective studies are now available showing that blood pressure reduction with calcium antagonists diminishes cardiovascular morbidity and mortality and, at least in meta-analysis, all-cause mortality. Moreover, recent data showing that the long-term use of diuretics increases the risk of renal cell carcinoma (RCC) threw a shadow on the bright picture of diuretics as reducers of cardiovascular morbidity and mortality in hypertension (5). Clearly, not all patients with essential hypertension are ideal candidates for long-term exposure to diuretic therapy. In the following, I present some caveats for the sweeping recommendations to use beta-blockers and diuretics as “preferred” antihypertensive therapy in the majority of patients.
LH-CAM: Logic-Based Higher Performance Binary CAM Architecture on FPGA

Binary content-addressable memory (BiCAM) is a popular high speed search engine in hardware, which provides output typically in one clock cycle. But speed of CAM comes at the cost of various disadvantages, such as high latency, low storage density, and low architectural scalability. In addition, field-programmable gate arrays (FPGAs), which are used in many applications because of its advantages, do not have hard IPs for CAM. Since FPGAs have embedded IPs for random-access memories (RAMs), several RAM-based CAM architectures on FPGAs are available in the literature. However, these architectures are especially targeted for ternary CAMs, not for BiCAMs; thus, the available RAM-based CAMs may not be fully beneficial for BiCAMs in terms of architectural design. Since modern FPGAs are enriched with logical resources, why not to configure them to design BiCAM on FPGA? This letter presents a logic-based high performance BiCAM architecture (LH-CAM) using Xilinx FPGA. The proposed CAM is composed of CAM words and associated comparators. A sample of LH-CAM of size ${64\times 36}$ is implemented on Xilinx Virtex-6 FPGA. Compared with the latest prior work, the proposed CAM is much simpler in architecture, storage efficient, reduces power consumption by 40.92%, and improves speed by 27.34%.
Dietary Benefits of Fungal Associates to an Eruptive Herbivore: Potential Implications of Multiple Associates on Host Population Dynamics

Abstract We used the mountain pine beetle (Dendroctonus ponderosae Hopkins) and its two fungal associates, Grosmannia clavigera and Ophiostoma montium, to study potential nutritional benefits of fungi to bark beetles. We tested for potential effects of feeding on phloem colonized by fungi on beetle performance in field and laboratory studies. The fungi increased nitrogen levels in the phloem of attacked trees by 40%, indicating that it may be an important source of dietary nitrogen for mountain pine beetles. However, nitrogen levels of phloem inoculated with fungi in the laboratory were similar to uncolonized phloem, indicating that the fungi may redistribute nitrogen from the sapwood to the phloem rather than increase absolute levels of nitrogen. Beetles emerging from attacked trees carrying G. clavigera were larger than beetles carrying O. montium, which in turn were larger than beetles lacking fungi. Results of experimental laboratory studies varied, likely because of differences in the growth and sporulation of fungi under artificial conditions. Results indicate that the two fungi may offer complementary benefits to the mountain pine beetle because larvae preferentially fed on phloem colonized by both fungi together over phloem colonized by one fungus or uncolonized phloem. Teneral adults preemergence fed on spores in pupal chambers when they were produced and consumed little phloem before emerging. Teneral adults mined extensively in the phloem before emerging when spores were not produced in the pupal chamber. Our results provide evidence for a nutritional role of fungi in the diet of bark beetles and show that multiple associates may differentially affect beetle performance, which could have important implications for bark beetle population dynamics.
Intraoperative microvascular Doppler monitoring in intracranial aneurysm surgery

Background Surgical treatment of intracranial aneurysms is often compromised by incomplete exclusion of the aneurysm or stenosis of parent vessels. Intraoperative microvascular Doppler (IMD) is an attractive, noninvasive, and inexpensive tool. The present study aimed to evaluate the usefulness and reliability of IMD for guiding clip placement in aneurysm surgery. Methods A total of 92 patients with 101 intracranial aneurysms were included in the study. IMD with a 1.5‐mm diameter, 20‐MHz microprobe was used before and after clip application to confirm aneurysm obliteration and patency of parent vessels and branching arteries. IMD findings were verified postoperatively with digital subtraction angiography (DSA) or dual energy computed tomography angiography (DE‐CTA). Ninety consecutive patients, harboring 108 aneurysms, who underwent surgery without IMD was considered as the control group. Results The microprobe detected all vessels of the Circle of Willis and their major branches. Clips were repositioned in 24 (23.8%) aneurysms on the basis of the IMD findings consistent with incomplete exclusion and/or stenosis. IMD identified persistent weak blood flow through the aneurismal sac of 11 of the 101 (10.9%) aneurysms requiring clip adjustment. Stenosis or occlusion of the parent or branching arteries as indicated by IMD necessitated immediate clip adjustment in 19 aneurysms (18.8%). The mean duration of the IMD procedure was 4.8 minutes. The frequency of clip adjustment (mean: 1.8 times per case) was associated with the size and location of the aneurysm. There were no complications related to the use of IMD, and postoperative angiograms confirmed complete aneurysm exclusion and parent vessel patency. About 8.3% (9/108) aneurysms were unexpectedly incompletely occluded, and 10.2% (11/108) aneurysms and parent vessel stenosis without IMD were detected by postoperative DSA or DE‐CTA. IMD could reduce the rate of residual aneurysm and unanticipated vessel stenosis which demonstrated statistically significant advantages compared with aneurysm surgery without IMD. Conclusion IMD is a safe, easily performed, reliable, and valuable tool that is suitable for routine use in intracranial surgery, especially in complicated, large, and giant aneurysms with wide neck or without neck.
Icosapent Ethyl (Eicosapentaenoic Acid Ethyl Ester): Effects Upon High-Sensitivity C-Reactive Protein and Lipid Parameters in Patients With Metabolic Syndrome.

BACKGROUND The aim of this analysis was to examine the effects of icosapent ethyl (eicosapentaenoic acid ethyl ester, IPE) on high-sensitivity C-reactive protein (hsCRP) and lipid parameters in patients with metabolic syndrome, with and without stable statin therapy. METHODS This post hoc exploratory analysis evaluated patients with metabolic syndrome treated with IPE 4 grams/day, IPE 2 grams/day, or placebo in phase 3, randomized, placebo-controlled studies entitled: MARINE [triglyceride (TG) levels ≥500 and ≤2000 mg/dL] and ANCHOR [TG levels ≥200 and <500 mg/dL, despite low-density lipoprotein cholesterol (LDL-C) control with stable statin therapy]. RESULTS Compared with placebo in patients with metabolic syndrome in MARINE (n=204) and ANCHOR (n=645), at the approved dose of 4 grams/day, IPE significantly lowered hsCRP levels 40.0% (P=0.0007) in MARINE and 23.0% (P=0.0003) in ANCHOR. Compared with placebo in MARINE, which included patients with and without statin therapy, IPE 4 grams/day significantly reduced hsCRP levels 78.0% in statin-treated patients (P=0.0035, n=16). Compared with placebo in MARINE, IPE 4 grams/day significantly reduced TG levels (35.0%; P<0.0001), non-high-density lipoprotein cholesterol (non-HDL-C; 19.9%; P<0.0001), and apolipoprotein B levels (ApoB) (9.1%; P=0.0015) without raising LDL-C levels. Compared with placebo in ANCHOR, IPE 4 grams/day significantly reduced TG (21.7%; P<0.0001), non-HDL-C (13.5%; P<0.0001), ApoB (8.8%; P<0.0001), LDL-C (5.2%; P=0.0236), and HDL-C levels (4.0%; P=0.0053). CONCLUSIONS Compared with placebo, IPE 4 grams/day significantly lowered hsCRP levels and improved lipids without raising LDL-C levels in patients with metabolic syndrome and high (≥200 and <500 mg/dL) or very high (≥500 and ≤2000 mg/dL) TG levels, with or without stable statin therapy.
Explaining why larks are future-oriented and owls are present-oriented: Self-control mediates the chronotype–time perspective relationships

Recent studies provide evidence for the chronotype–time perspective relationships. Larks are more future-oriented and owls are more present-oriented. The present study expands this initial research by examining whether the associations are replicable with other time perspective measures, and whether self-control explains the observed relationships. Chronotype was assessed with the Morningness–Eveningness Questionnaire and the basic associations with the Zimbardo Time Perspective Inventory were replicated in a sample of 142 New Zealand students, but not with other measures. Self-control mediated the influence of morningness on both future time perspective and delay of gratification. Implications of the findings are discussed.
Allogeneic bone marrow transplantation for systemic AL amyloidosis

Low‐intensity chemotherapy is ineffective in most patients with AL amyloidosis, probably because clinical benefit requires regression of the amyloid deposits, and this occurs only very gradually after the underlying plasma cell dyscrasia has been suppressed. We report the first successful allogeneic bone marrow transplant (allo‐BMT) for AL amyloidosis, which after 3 years was associated with complete clinical recovery. This supports the idea that there may be a brief window of opportunity in patients with AL amyloidosis during which dose‐intensive chemotherapy is feasible and most likely to produce clinical benefit.
Screening for Psychological Well-Being in Childhood Cancer Survivors: A Preliminary Assessment of the Feasibility of the Strength and Difficulties Questionnaire as a Parent-Proxy Report

This article describes the feasibility of utilizing the Strengths and Difficulties Questionnaire (SDQ) as a brief psychosocial screener among survivors of pediatric cancer. Participants were parents of a child/adolescent diagnosed with cancer who were off treatment (n = 35) and a subset of adolescents (n = 14). Parent-proxy report using the SDQ was significantly associated with the Child Health Questionnaire. Parents who self-reported long-term uncertainty about their child's illness were more likely to report child psychosocial difficulties. A trend for concordance between patient and parent-proxy report of the SDQ was observed. These preliminary results highlight the potential utility of the SDQ as a screening tool for detection of child/adolescent psychosocial well-being. Further research, with larger samples, is needed to support these results.
Antimicrobial Use and Resistance in Swine Waste Treatment Systems

ABSTRACT Chlortetracycline and the macrolide tylosin were identified as commonly used antimicrobials for growth promotion and prophylaxis in swine production. Resistance to these antimicrobials was measured throughout the waste treatment processes at five swine farms by culture-based and molecular methods. Conventional farm samples had the highest levels of resistance with both culture-based and molecular methods and had similar levels of resistance despite differences in antimicrobial usage. The levels of resistance in organic farm samples, where no antimicrobials were used, were very low by a culture-based method targeting fecal streptococci. However, when the same samples were analyzed with a molecular method detecting methylation of a specific nucleotide in the 23S rRNA that results in resistance to macrolides, lincosamides, and streptogramin B (MLSB), an unexpectedly high level of resistant rRNA (approximately 50%) was observed, suggesting that the fecal streptococci were not an appropriate target group to evaluate resistance in the overall microbial community and that background levels of MLSB resistance may be substantial. All of the feed samples tested, including those from the organic farm, contained tetracycline resistance genes. Generally, the same tetracycline resistance genes and frequency of detection were found in the manure and lagoon samples for each commercial farm. The levels of tetracycline and MLSB resistance remained high throughout the waste treatment systems, suggesting that the potential impact of land application of treated wastes and waste treatment by-products on environmental levels of resistance should be investigated further.
The variable response of bacteria to excess ferric iron in host tissues.

The enhancement by exogenous ferric iron, both systemic and local, of the infectivity of 120 strains of bacteria, representing 17 genera, was measured in the skin of guinea-pigs. Systemic iron enhanced only 23% of 115 strains, and local iron 49% of 71 strains. Systemic iron, by an apparently anti-inflammatory action, depressed the size of lesions produced by 27 of the non-enhanced strains from nine of the genera tested. For most strains, the degree of enhancement was small, ranging from 2- to 8-fold, and often evident only with the more effective local iron; among these were some near-saprophytes like Mycobacterium phlei, M. smegmatis, Bacillus cereus and Clostridium bifermentans. Substantial enhancement, from 14- to 50-fold, was observed with the more pathogenic among the strains tested: namely BCG, Corynebacterium ovis, C. murium, Listeria monocytogenes, Erysipelothrix rhusiopathiae, Cl. perfringens, Cl. septicum, Cl. oedematiens, and some strains of Klebsiella spp. , Proteus spp. and Aeromonas hydrophila. The enhancement of BCG by a single dose of iron given locally with the inoculum was only feebly manifest after 7 days, but substantial after 14--19 days, indicating the decisive effect of interference with an early humoral defence on the establishment of chronic infection some time later. Insofar as guinea-pigs whose antibacterial defences are lowered by substantial amounts of exogenous iron in the circulation represent human subjects at risk of infection because of clinical states characterised by excess of available iron, the results of the survey suggest that only a minority among the environmental bacteria can take advantage of the decreased resistance associated with such states; but that this minority is likely to include the more virulent strains in the environment.
Self-Reference Emerges Earlier than Emotion during an Implicit Self-Referential Emotion Processing Task: Event-Related Potential Evidence

Self-referential emotion refers to the process of evaluating emotional stimuli with respect to the self. Processes indicative of a self-positivity bias are reflected in electroencephalogram (EEG) signals at ~400 ms when the task does not require a discrimination of self from other. However, when distinguishing between self-referential and other-referential emotions is required, previous studies have shown inconsistent temporal dynamics of EEG signals in slightly different tasks. Based on the observation of early self–other discrimination, we hypothesized that self would be rapidly activated in the early stage to modulate emotional processing in the late stage during an implicit self-referential emotion. To test this hypothesis, we employed an implicit task in which participants were asked to judge the order of Chinese characters of trait adjectives preceded by a self (“I”) or other pronoun (“He” or “She”). This study aimed to explore the difference of social-related emotional evaluation from self-reference; the other pronoun was not defined to a specific person, rather it referred to the general concept. Sixteen healthy Chinese subjects participated in the experiment. Event-related potentials (ERPs) showed that there were self-other discrimination effects in the N1 (80–110 ms) and P1 (170–200 ms) components in the anterior brain. The emotional valence was discriminated in the later component of N2 (220–250 ms). The interaction between self-reference and emotional valence occurred during the late positive potential (LPP; 400–500 ms). Moreover, there was a positive correlation between response time (RT) and N1 in the self-reference condition based on the positive-negative contrast, suggesting a modulatory effect of the self-positivity bias. The results indicate that self-reference emerges earlier than emotion and then combines with emotional processing in an implicit task. The findings extend the view that the self plays a highly integrated and modulated role in self-referential emotion processing.
Heat induces the splicing by IRE1 of a mRNA encoding a transcription factor involved in the unfolded protein response in Arabidopsis

Adverse environmental conditions produce endoplasmic reticulum (ER) stress in plants. In response to heat or ER stress agents, Arabidopsis seedlings mitigate stress damage by activating ER-associated transcription factors and a RNA splicing factor, IRE1b. IRE1b splices the mRNA-encoding bZIP60, a basic leucine-zipper domain containing transcription factor associated with the unfolded protein response in plants. bZIP60 is required for the up-regulation of BINDING PROTEIN3 (BIP3) in response to ER stress, and loss-of-function mutations in IRE1b or point mutations in the splicing site of bZIP60 mRNA are defective in BIP3 induction. These findings demonstrate that bZIP60 in plants is activated by RNA splicing and afford opportunities for monitoring and modulating stress responses in plants.
The relation between phonological awareness and working memory.

Previous research has failed to show a relation between children's working memory and performance on the phonological sound categorization task (M. J. Snowling, C. Hulme, A. Smith, & J. Thomas, 1994). However, the test used to assess working memory in that experiment was more comparable to a short-term memory task, which assesses storage capacity, than to a working memory task, which has both storage and processing components. In the present study, we compared the predictive power of both types of memory tasks on 2 measures of phonological awareness, the sound categorization task and a phoneme deletion task, in 7- and 8-year-olds (mean age = 8 years 1 month). The children's reading ability was also assessed. Fixed-order multiple-regression analyses showed that the sound categorization task has a higher working memory demand than the phoneme deletion task: Working memory predicted independent variance in performance only on the sound categorization task. The short-term memory task did not account for significant independent variance in performance on either of the measures of phonological awareness.
Health insurance status of US living kidney donors.

BACKGROUND AND OBJECTIVES Ensuring follow-up of living kidney donors (LKDs) is essential to long-term preventive care. We sought information on health insurance status of US LKDs, with particular attention to age, gender, and ethnicity. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The United Network for Organ Sharing/Organ Procurement Transplantation Network database was queried for associations among age at donation, race, gender, and health insurance status. We studied all US LKDs between July 2004 and September 2006. RESULTS A total of 10,021 LKDs with known health insurance status were studied, 1765 (18%) of whom lacked health insurance at donation. There were 4852 donors without health insurance information. Younger kidney donors had higher rates of being uninsured (age 18 to 34: 26.2%; age 35 to 49: 15.2%; age 50 to 64: 11.2%; age >65: 3.8%; P < 0.0001), as did men (19.5 versus 16.3% for women; P < 0.0001), and ethnic minorities (white 13.4%, black 21%, Hispanic 35.6%, Asian 26.7%; P < 0.0001). CONCLUSIONS This study confirms that younger patients, ethnic minorities, and men are less likely to have health insurance when donating a kidney, which could negatively affect adherence to long-term follow-up.
Multiple Sclerosis-Associated Fatigue during Disease-Modifying Treatment with Natalizumab, Interferon-Beta and Glatiramer Acetate

4 indicate ‘no fatigue’ (scores 6 4 to ! 5 indicate ‘borderline fatigue’) [7] . The MFIS is a 21-item questionnaire ranging from 0 to 48 (higher scores indicating more fatigue). A cut-off score of 38 discriminates ‘severely fatigued’ from ‘nonfatigued’ patients [8] . Means and SDs were used to describe patients’ characteristics. Categorical data were compared with the 2 test or Fisher’s exact test. By means of the Mann-Whitney U test, we compared the nonparametric data. We used logistic regression to investigate the influence of categorical variables on dichotomized ( ! 4 vs. 6 4) FSS scores. All tests have been performed two-sided. p ! 0.05 was considered statistically significant. Analysis was performed with SPSS 17.0 (Chicago, Ill., USA). Forty-nine patients were treated with NTZ (mean 37.0 8 9.9 years, mean disease duration 8.0 8 4.5 years, 84% females, mean EDSS 2.9 8 1.2). In the matched control group, 53 patients were treated with IFN/GA (mean age 37.9 8 8.6, mean disease duration 8.5 8 6.4 years, 78% females, mean EDSS 2.6 8 1.3): n = 2 intramuscular IFN1a 30  g once weekly, n = Dear Sir, Fatigue is one of the most common symptoms in multiple sclerosis (MS) and can result in severe impairment of quality of life [1] . Fatigue is likely multidimensional but subtle central inflammatory activity may play a role [2] . Disease modifying treatment with interferon(IFN) and glatiramer acetate (GA) successfully reduces inflammatory disease activity but does not appear to reduce levels of fatigue [3] . Natalizumab (NTZ) – a monoclonal antibody against Very-Late-ActivationAntigen 4 – reduces leukocyte migration across the blood-brain barrier and thereby unfolds strong effects on central inflammation (i.e. contrast enhancing lesions or new lesions on MRI) [4] . The objective of this study was to compare prevalence and severity of MS-associated fatigue in patients treated with NTZ in comparison to IFN and GA. This was a cross-sectional case control study. Forty-nine consecutive patients treated with NTZ (all patients treated at our center at the time of study) were compared to 320 MS patients in our database who have been investigated for fatigue before NTZ was licensed. Fifty-three patients met the inclusion criteria (relapsing patients treated with IFN or GA) and were matched for age, gender and disability (n = 31 (58.5%) treated with IFN, n = 22 (41.5%) treated with GA). The study was conductReceived: June 25, 2010 Accepted: December 22, 2010 Published online: March 31, 2011