Miracle-dz/UniFAR-FTUs huggingface dataset:
Snoring, daytime sleepiness, and incident cardiovascular disease in the health, aging, and body composition study.

OBJECTIVES To examine the association between snoring and incident cardiovascular disease (CVD). DESIGN SETTINGS AND PARTICIPANTS This is a prospective study in which community dwelling older adults were evaluated at baseline, and followed up for an average of 9.9 years. MEASUREMENTS Data on snoring, daytime sleepiness, as well as demographic and clinical characteristics of study participants was collected at baseline, and participants were followed up every six months for an average of 9.9 years. Based on snoring and sleepiness status, 4 groups of participants were created: (1) No Snoring, No Sleepiness; (2) No Snoring, Sleepiness; (3) Snoring, No Sleepiness; (4) Snoring, Sleepiness. Incident CVD was defined as a diagnosis of myocardial infarction, angina pectoris, or congestive heart failure that resulted in overnight hospitalization during the follow-up period. Cox proportional hazard was used to estimate the risk of incident cardiovascular disease during follow-up by baseline snoring and sleepiness status. RESULTS A total of 2,320 participants with a mean age of 73.6 (2.9) years at baseline were included in the analysis. Fifty-two percent were women, and 58% were white. A total of 543 participants developed CVD events during the follow-up period. Participants who reported snoring associated with daytime sleepiness had significantly increased hazard ratio for CVD events (HR = 1.46 [1.03-2.08], P = 0.035) after adjusting for demographic and clinical confounding factors. CONCLUSION The results suggest that self-reported snoring and daytime sleepiness status are associated with an increased risk of future cardiovascular disease among older adults.
Implementing Public Programs: Equal Employment Opportunity, Affirmative Action, and Administrative Policy Options

An increasingly controversial area within the realm of governmental hiring policies lies in the distinction between the passive or colorblind approach to equal employment opportunity and the results-based orientation more commonly associated with affirmative action programs. A national survey of urban personnel managers revealed a marked tendency to prefer policies perceived to be less compensatory toward protected classes and more compatible with merit norms. The authors conclude that the EEO bias characteristic of most city officials coupled with the staffing and personnel management philosophy of the Reagan Administration does not augur well for the future of affirmative action program implementation.
Ear Acupressure for Perennial Allergic Rhinitis: A Multicenter Randomized Controlled Trial

Background Perennial allergic rhinitis (PAR) has a high and increasing prevalence worldwide. Ear acupressure (EAP) is a noninvasive semi–self-administered form of acupuncture. Previous studies indicated that EAP could be effective and safe for AR symptom management. However, there was insufficient evidence to confirm this. This study investigated whether EAP, a noninvasive clinical alternative to acupuncture, is effective and safe for PAR. Methods This is an international, multicenter, randomized, single-blind, sham-controlled trial. The trial was conducted at two centers: Royal Melbourne Institute of Technology University (Melbourne, Australia) Clinical Trial Clinic and Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. PAR participants were randomized to receive real or sham EAP treatment once a week for 8 weeks and then were followed-up for 12 weeks. Participants were instructed to administer EAP stimulation three times daily. Symptom severity and quality of life (QoL) were evaluated. Adverse events (AEs) were also monitored. Intention-to-treat analysis on change of symptom scores and QoL was applied. Results Two hundred forty-five participants were randomly assigned to real (n = 124) and sham EAP (n = 121) groups. Twenty-five participants discontinued during treatment and 15 participants dropped out during follow-up. At the end of treatment and follow-up periods, changes of global QoL score were significantly greater in the real EAP group compared with the sham group. At the end of follow-up, scores for total nasal symptom, runny nose, and eye symptoms in the real EAP group had a greater reduction compared with the sham group. Overall, both real and sham EAP were well tolerated. Two severe AEs were reported but were not considered related to the EAP procedures. Conclusion In conclusion, EAP showed short-term and extended benefit for improving PAR symptoms and QoL for PAR patients.
Poly-D-L-Lactic Acid Membranes for Bone Regeneration

Purpose:To histologically and histomorphometrically evaluate the biocompatibility and the biological properties of perforated and nonperforated poly-D-L-lactic acid (PDLLA) resorbable membranes, using a model of calvarial monocortical bone defects in domestic pigs. Methods:A total of 6 10 × 10 × 10 mm circular calvarial bone defects were prepared in each of the 3 adult female large white domestic pigs and assigned to the following experimental groups: negative control, nonperforated membrane only, perforated membrane only, bone only, bone + nonperforated membrane, and bone + perforated membrane. The PDLLA membranes were fixed by PDLLA pins by means of an ultrasonic device. After 40 days, bone blocks containing the defects were harvested and histologically processed. Results:A close contact between the PDLLA devices and the surrounding bone was found, and no trace of inflammatory tissue or signs of infection were detected. Bone regeneration occurred from the preexisting bone with a centripetal pattern. Incomplete bone filling was found in empty defects, whereas all sites filled with bone showed a complete bone formation, irrespectively of the presence and the type of membrane used. Conclusion:PDLLA membranes and pins showed to be highly biocompatible toward bone tissue and to do not interfere with the bone healing process of monocortical calvaria defects in domestic pigs. No adjunctive effect of PDLLA membranes, irrespectively of their perforated/nonperforated structure, could be evidenced in terms of bone regeneration under the present experimental conditions. Further studies are needed to investigate the regenerative potential of such devices in other clinically relevant models.
Effects of maternal hyperoxia with and without normocapnia in uteroplacental and fetal Doppler studies

One hundred percent oxygen is given in pregnancy to improve fetal oxygenation, yet has been shown in both animal and human studies ex utero to increase cerebral vascular resistance. Adjusting end‐tidal pCO2 (ET‐pCO2) levels to normocapnic levels during hyperoxygenation offsets this effect in non‐pregnant individuals. We aimed to evaluate the effect of maternal hyperoxygenation with and without maintaining normocapnia on the fetal and uteroplacental circulations in healthy near‐term human pregnancies.
The Continuous Recording of Blood Pressure in Patients Undergoing Carotid Surgery Under Remifentanil Versus Sufentanil Analgesia

We compared the hemodynamic stability during carotid endarterectomy of remifentanil with that of sufentanil anesthesia. Fifty-six patients were randomly assigned into Remifentanil (n = 27) or Sufentanil (n = 29) groups. In the Remifentanil group, IV propacetamol (2 g) and morphine (0.1 mg/kg) were infused 30 min before skin closure. In the Sufentanil group, patients received 2 g propacetamol. Beat-to-beat recordings of systolic arterial blood pressure (SBP) and heart rate (HR) were stored on a computer. The maximum and minimum values of BP and HR after induction, at intubation, during the surgical procedure, and after the operation and the coefficients of variation of SBP and HR were used as indices of hemodynamic stability. The coefficients of variation of SBP and HR were similar in both groups during and after surgery. However, at intubation, maximal SBP was higher in the Sufentanil group (P < 0.05). Decreased propofol doses and isoflurane end-tidal concentrations were used in the Remifentanil group. At recovery, a similar profile of SBP and HR was found in both groups. We conclude that intra- and posthemodynamic stability was similar with remifentanil or sufentanil in patients undergoing carotid endarterectomy. However, remifentanil was more effective for blunting the increase in SBP at intubation without increasing the blood pressure-decreasing effect of induction. Intraoperative remifentanil use was associated with a decreased amount of hypnotic drug administered.
Aroused versus calm positive affects as predictors of lipids.

OBJECTIVE The authors hypothesized that high-pleasure low-arousal (HPLA) would predict a subsequent decrease of low-density lipoprotein cholesterol (LDL-C) and triglycerides (TRI), as well as a subsequent increase of high-density lipoprotein cholesterol (HDL-C). The authors also hypothesized that high-pleasure high-arousal (HPHA) would have the opposite effects on these blood lipids, predicting a subsequent increase of LDL-C and TRI, and a decrease of HDL-C. DESIGN Participants were 990 male and 595 female apparently healthy employees who underwent a routine periodic health examination at two points in time, Time 1 (T1) and Time 2 (T2), about 24 months apart. Data were analyzed separately for the men and women, and the authors controlled for possible confounders shown in past research to be implicated with hyperlipidemia. MAIN OUTCOME MEASURES HPHA and HPLA were assessed based on the Job-Related Affective Well-Being Scale, while LDL-C, TRI, and HDL-C were assessed based on fasting blood samples. RESULTS For the men, support for our hypotheses was found relative to HDL-C and TRI. The authors did not find support for our hypotheses for thee women. CONCLUSION Our findings suggest that for men, the two types of positive affects may have opposite physiological consequences with respect to subsequent changes in blood lipid levels.
Patient Relationships and the Personal Physician in Tomorrow's Health System: A Perspective from the Keystone IV Conference

A group of senior leaders from the early generation of academic family medicine reflect on the meaning of being a personal physician, based on their own clinical experiences and as teachers of residents and students in academic health centers. Recognizing that changes in clinical care and education at national and local systems levels have added extraordinary demands to the role of the personal physician, the senior group offers examples of how the discipline might go forward in changing times. Differently organized care such as the Family Health Team model in Ontario, Canada; value-based payment for populations in large health systems; and federal changes in reimbursement for populations can have positive effects on physician satisfaction. These changes and examples of changes in medical student and residency education also have the potential to positively affect the primary care workforce. The authors conclude that, without substantive educational and health system reform, the ability to truly serve as a personal physician and adhere to the values of continuity, responsibility, and accountability will continue to be threatened.
Immunotherapy Added to Antibiotic Treatment Reduces Relapse of Disease in a Mouse Model of Tuberculosis

&NA; Immune‐modulating drugs that target myeloid‐derived suppressor cells or stimulate natural killer T cells have been shown to reduce mycobacterial loads in tuberculosis (TB). We aimed to determine if a combination of these drugs as adjunct immunotherapy to conventional antibiotic treatment could also increase therapeutic efficacy against TB. In our model of pulmonary TB in mice, we applied treatment with isoniazid, rifampicin, and pyrazinamide for 13 weeks alone or combined with immunotherapy consisting of all‐trans retinoic acid, 1,25(OH)2‐vitamin D3, and &agr;‐galactosylceramide. Outcome parameters were mycobacterial load during treatment (therapeutic activity) and 13 weeks after termination of treatment (therapeutic efficacy). Moreover, cellular changes were analyzed using flow cytometry and cytokine expression was assessed at the mRNA and protein levels. Addition of immunotherapy was associated with lower mycobacterial loads after 5 weeks of treatment and significantly reduced relapse of disease after a shortened 13‐week treatment course compared with antibiotic treatment alone. This was accompanied by reduced accumulation of immature myeloid cells in the lungs at the end of treatment and increased TNF‐&agr; protein levels throughout the treatment period. We demonstrate, in a mouse model of pulmonary TB, that immunotherapy consisting of three clinically approved drugs can improve the therapeutic efficacy of standard antibiotic treatment.
Propolis allergy (IV) Studies with further sensitizers from propolis and constituents common to propolis, poplar buds and balsam of Peru

26 different compounds have been investigated experimentally for their sensitizing capacity in guinea pigs. 19 of these occur in propolis as well as in poplar bud exudates, and 14 of them are also found in balsam of Peru. 4 caffeates and benzyl isoferulate were found to be strong Sensitizers. 7 compounds were moderate, and 13 compounds showed only weak sensitizing potency. Methyl cinnamate was negative. Patch tests in 11 propolis‐sensitive patients once more revealed 3‐methyi‐2‐butenyl caffeate and phenylethyl caffeate as the major sensitizers. In addition to the 8 compounds already known to occur in propolis as well as in balsam of Peru, we detected 5 further substances that both materials have in common. Among these, benzyl isoferulate is considered a noteworthy sensitizer. Coniferyl benzoate, which was shown to be a moderate sensitizer, is present in fresh samples of balsam of Peru, while in propolis it has been detected only once so far. The flavonoid aglycones occurring in poplar bud exudates, and hence also in propolis, are weak sensitizers which play only a minor role m propolis hypersensitivity.
Observer-based continuous-time networked control system design

This paper is concerned with observer-based H∞ control for a networked control system (NCS) under simultaneous consideration of time-varying network-induced delays and packet dropouts. By taking the sensor-to-controller and controller-to-actuator network-induced delays and packet dropouts into full consideration and proposing a linear estimation-based delay compensation method, a new model for an observer-based NCS is established. Then the stabilization criteria for the considered NCS are derived. When transferring nonlinear matrix inequalities into linear matrix inequalities (LMIs), new bounding inequalities are proposed. A numerical example is given to illustrate the merits and effectiveness of the obtained results.
Longterm Safety of Tocilizumab: Results from 3 Years of Followup Postmarketing Surveillance of 5573 Patients with Rheumatoid Arthritis in Japan

Objective. To evaluate the longterm safety of tocilizumab (TCZ) for the treatment of rheumatoid arthritis (RA) in a real-world clinical setting in Japan. Methods. In this longterm extension of a single-arm, observational postmarketing surveillance study, a total of 5573 patients who initiated intravenous TCZ between April 2008 and July 2009 were observed for 3 years, regardless of its continuation, for incidence of fatal events, serious infections, malignancy, gastrointestinal perforations, and serious cardiac dysfunction. Results. Of the 5573 patients who were enrolled, 4527 patients (81.23%) completed 3 years of followup. There were no increases in the proportions of patients with fatal events, serious infection, malignancy, GI perforation, or serious cardiac dysfunction over 3 years. The all-cause mortality rate during followup was 2.58% (0.95/100 patient-yrs), and the standardized mortality ratio was 1.27 (95% CI, 1.08 to 1.50). Patients who were older with longer disease duration and respiratory comorbidities were more likely to discontinue TCZ treatment following serious infection during the first year. Among patients who completed 3 years of TCZ treatment, serious infection developed at a constant rate during the 3-year treatment period. The proportion of malignancy during followup was 2.24% (0.83/100 patient-yrs), and the standardized incidence ratio was 0.79 (95% CI, 0.66 to 0.95). Conclusion. The safety profile of TCZ was consistent over time regarding mortality, serious infections, malignancy, gastrointestinal perforation, and serious cardiac dysfunction. These data confirm the longterm safety of TCZ use in patients with RA in a real-world clinical setting.
Leadership: A Case Study on the Importance of Ethics and Trust

This research is important because it empirically tests why ethical behavior by business and government leaders is essential for good management—which is to earn trust from customers and constituents—thus ensuring organizations are successful, for the greater good, over the long term, especially in the global marketplace. Law and morality are two standards by which business and government leaders are judged, but these norms fail whenever laws are not enforced and morality is disregarded. Five research questions on leadership are statistically tested, using a Likert-scale response measure questionnaire—based on “perceptions of societal corruption” and “trust levels,” using Bandura’s “aggressive behavior modification theory,” as the model for analysis. Nigeria is selected as the location of this case study on leadership ethics and trust, because Nigerian government officials have a long history of unethical and corrupt behavior. Descriptive statistics, along with chi-square quantitative research methods reveals “perceptions of societal corruption” in Nigeria are high and “trust levels” for government leaders are very low. Leaders in Nigeria are only as ethical as the code-of-conduct prevalent in their country—where cultural, economic and legal factors contribute to the nation’s corrupt society—which may cause Nigeria to become a failed state. To change the Nigerian culture of societal corruption—education is necessary—to instruct elected officials, civil servants, business leaders and Nigerian society, at large, on the importance of ethics and trust. Nigerian government and business leaders should institute an ethics policy—and implement five suggested reforms presented in this paper—which will help establish government leader’s ethical integrity and improve citizens’ trust and confidence in their government. Recommendations for future research on government and business leadership ethics and trust are offered.
Significant association between nonsyndromic oral clefts and arylhydrocarbon receptor nuclear translocator (ARNT)

The etiology of nonsyndromic oral clefts (cleft lip, cleft palate, or cleft lip and palate) is still controversial, but is considered to involve both genetic and environmental factors. One of suspected environmental factors is 2,3,7,8‐tetrachlorodibenzo‐p‐dioxin (TCDD) found in tobacco, herbicides, contaminated soil, and food. TCDD administered during organogenesis in mice causes a high incidence of CP in fetuses. There is ample evidence that aryl hydrocarbon receptor (AHR), AHR nuclear translocator (ARNT), and cytochrome P450 1A1 (CYP1A1) are involved in TCDD metabolism. We assessed whether there is any association in the Japanese population of nonsyndromic oral clefts with single nucleotide polymorphisms (SNPs) in the AHR, ARNT, and CYP1A1 genes using transmission disequilibrium test (TDT) and case‐control study. We identified and investigated three SNPs in ARNT; 567G/C (V189V), IVS12‐19T/G, and 2117C/T (P706L). Two amino acid substitutions, R554L in AHR and I462V in CYP1A1, were also investigated. In the TDT, the C allele of ARNT 567G/C was preferentially transmitted to patients (P = 0.033). When a haplotype consisting of 567G/C and IVS12‐19T/G in ARNT was considered, the preferential transmission of the CT (567C‐IVS12‐19T) haplotype was observed (P = 0.0012). In a case‐control study, a significant association of IVS12‐19T/G in ARNT was observed (P = 0.021). The SNPs studied in AHR and CYP1A1 were not associated with the disease. Our results suggest that ARNT is involved in the development of nonsyndromic oral clefts in the Japanese population. © 2004 Wiley‐Liss, Inc.
Associations between benefit finding and adjustment outcomes in thyroid cancer

Objective: Few studies have examined psychological adjustment in thyroid cancer (TC) patients and no published studies have investigated benefit finding (BF) in this population. This study examined the relationship between BF and adjustment in TC using an expanded conceptualisation of adjustment that incorporated higher order cognitive and motivational states (HOCMS) and health behaviour changes, and a BF measure that accounted for positive and negative changes. Partner ratings of patient's BF and health behaviour changes were examined as sources of external validity for these constructs.
Polymorphism in the angiotensin converting enzyme but not in the angiotensinogen gene is associated with hypertension and type 2 diabetes: the Skaraborg Hypertension and diabetes project.

OBJECTIVE To study the association between polymorphisms in the angiotensin converting enzyme (ACE) gene and angiotensinogen (AGT) gene and hypertension and/or type 2 diabetes in a community population. PATIENTS AND METHODS The insertion (I)/deletion (D) polymorphism of the ACE gene and the M235T polymorphism of the AGT gene were genotyped in 773 nondiabetic individuals with hypertension, 193 normotensive patients with type 2 diabetes, 243 patients with type 2 diabetes and hypertension, and in 820 normotensive control individuals identified in a community-based study. RESULTS The DD genotype was associated with hypertension in individuals less than 70 years [odds ratio (OR) = 1.54, confidence interval (CI) = 1.09-2.18] and remained so when patients with type 2 diabetes were excluded from the analysis (OR = 1.45, CI = 1.01-2.09). The strongest association was with the combination of type 2 diabetes and hypertension (OR = 2.19, CI = 1.09-4.38). There was no association with type 2 diabetes without hypertension. No association was observed between the M235T variant or the 3'-microsatellite polymorphism of the AGT gene and hypertension. CONCLUSION The D-allele of the ACE gene ID polymorphism increases susceptibility to hypertension, particularly when associated with type 2 diabetes. No association was observed between the M235T variant or 3'-microsatellite polymorphism of the AGT gene and hypertension.