Miracle-dz/UniFAR-FTUs huggingface dataset:
Pathogenetic and prognostic significance of altered coagulation and fibrinolysis in acute lung injury/acute respiratory distress syndrome*

Objective:The coagulation and inflammatory cascades may be linked in the pathogenesis of acute lung injury and acute respiratory distress syndrome. However, direct evidence for the contribution of abnormalities in coagulation and fibrinolysis proteins to outcomes in patients with acute lung injury/acute respiratory distress syndrome is lacking. Design:Retrospective measurement of plasma levels of protein C and plasminogen activator inhibitor-1 in plasma samples that were collected prospectively as part of a large multicenter clinical trial. The primary outcome was hospital mortality. To evaluate the potential additive value of abnormalities of these biomarkers, the excess relative risk of death was calculated for each combination of quartiles of protein-C and plasminogen activator inhibitor-1 levels. Setting:Ten university medical centers. Patients:The study included 779 patients from a multicenter clinical trial of a protective ventilatory strategy in acute lung injury/acute respiratory distress syndrome and 99 patients with acute cardiogenic pulmonary edema, as well as ten normal controls. Measurements and Main Results:Compared with plasma from controls and patients with acute cardiogenic pulmonary edema, baseline protein-C levels were low and baseline plasminogen activator inhibitor-1 levels were elevated in acute lung injury/acute respiratory distress syndrome. By multivariate analysis, lower protein C and higher plasminogen activator inhibitor-1 were strong independent predictors of mortality, and ventilator-free and organ-failure-free days. Plasminogen activator inhibitor-1 and protein C had a synergistic interaction for the risk of death. Conclusions:Early acute lung injury/acute respiratory distress syndrome is characterized by decreased plasma levels of protein C and increased plasma levels of plasminogen activator inhibitor-1 that are independent risk factors for mortality and adverse clinical outcomes. Measurement of plasminogen activator inhibitor-1 and protein-C levels may be useful to identify those at highest risk of adverse clinical outcomes for the development of new therapies.
There Is No Association Between the Circadian Clock Gene HPER3 and Cognitive Dysfunction After Noncardiac Surgery

BACKGROUND:The specific clock-gene PERIOD3 is important with regard to circadian rhythmicity, sleep homeostasis, and cognitive function. The allele PER35/5 has been associated with worse cognitive performance in response to sleep deprivation. We hypothesized that patients with the PER35/5 genotype would have an increased risk of postoperative cognitive dysfunction (POCD) 1 week after noncardiac surgery. METHODS:Blood samples were analyzed from 93 patients with POCD and 186 patients without POCD from a completed multicenter study. The study population comprised patients ages 40 years and older undergoing noncardiac surgery who were tested preoperatively and 1 week after surgery with a neuropsychological test battery comprising 7 subtests. PER3 genotypes were determined by polymerase chain reaction analysis of DNA from blood samples (Clinicaltrials.gov identifier NCT01088100). RESULTS:The frequencies of the 3 genotypes were 11.8% (32 patients) PER35/5, 41.7% (113 patients) PER34/5, and 46.5% (126 patients) PER34/4. No significant difference was found in the distribution of the 3 genotypes according to POCD at 1 week (P = 0.68). Twelve percent (6% to 21%) of the patients with POCD and 12% (7% to 17%) of the patients without POCD had the PER35/5 genotype. The difference of the incidence of POCD/−POCD for the PER35/5 genotype was 1% (−7% to 10%). A significantly higher Z score was found in patients having the PER34/4 in 1 of the neuropsychological tests (error score of the Concept Shifting Test) (Bonferroni corrected P = 0.042). CONCLUSION:No significant association was found between the clock-gene PER35/5 genotype and POCD at 1 week after noncardiac surgery. If PER35/5 does worsen cognitive performance, the incidence is <10% of patients.
Combination Treatment With an α-Blocker Plus an Anticholinergic for Bladder Outlet Obstruction: A Prospective, Randomized, Controlled Study

ABSTRACTPurpose: We evaluate the effect of tolterodine combined with tamsulosin on quality of life in patients with bladder outlet obstruction and concomitant detrusor instability.Materials and Methods: The study included 50 consecutive patients with urodynamically proven mild or moderate bladder outlet obstruction and concomitant detrusor instability. All patients were initially treated with 0.4 mg. tamsulosin orally once a day. A week later the patients were randomly allocated into group 1—25 who continued treatment with tamsulosin only and, group 2—25 who also received 2 mg. tolterodine orally twice daily. Reevaluation with a quality of life questionnaire and urodynamic study was performed after 3 months.Results: Two patients from group 2 stopped tolterodine while 1 patient from each group stopped tamsulosin because of hypotension. Analysis revealed statistically significant improvement in quality of life scores only in group 2 patients (mean score 525.0 and 628.4 before and after treatment, respective.
Mining Trust Values from Recommendation Errors

Increasing availability of information has furthered the need for recommender systems across a variety of domains. These systems are designed to tailor each user's information space to suit their particular information needs. Collaborative filtering is a successful and popular technique for producing recommendations based on similarities in users' tastes and opinions. Our work focusses on these similarities and the fact that current techniques for defining which users contribute to recommendation are in need of improvement. In this paper we propose the use of trustworthiness as an improvement to this situation. In particular, we define and empirically test a technique for eliciting trust values for each producer of a recommendation based on that user's history of contributions to recommendations. We compute a recommendation range to present to a target user. This is done by leveraging under/overestimate errors in users' past contributions in the recommendation process. We present three different models to compute this range. Our evaluation shows how this trust-based technique can be easily incorporated into a standard collaborative filtering algorithm and we define a fair comparison in which our technique outperforms a benchmark algorithm in predictive accuracy. We aim to show that the presentation of absolute rating predictions to users is more likely to reduce user trust in the recommendation system than presentation of a range of rating predictions. To evaluate the trust benefits resulting from the transparency of our recommendation range techniques, we carry out user-satisfaction trials on BoozerChoozer, a pub recommendation system. Our user-satisfaction results show that the recommendation range techniques perform up to twice as well as the benchmark.
Ultrasound-Guided Perineural Circumferential Median Nerve Block With and Without Prior Dextrose 5% Hydrodissection: A Prospective Randomized Double-Blinded Noninferiority Trial

BACKGROUND: Ultrasound-guided perineural peripheral nerve block using a hydrodissection technique may reduce the risk of accidental intravascular local anesthetic (LA) injection. In this prospective randomized double-blind study, we tested the hypothesis that median nerve block effectiveness is not reduced when circumferential perineural hydrodissection with dextrose 5% in water (D5W) precedes LA injection. METHODS: Patients scheduled for hand surgery were randomized to receive an ultrasound-guided median nerve block at the elbow to achieve circumferential perineural spread with either 6 mL of D5W followed by 6 mL of LA (lidocaine 1.5% with epinephrine 1:200,000) (D5W-LA group) or with 6 mL of LA alone (LA group). The primary outcome was onset time of successful anesthesia defined by a complete abolition of light touch sensation for the index finger. RESULTS: Data from 95 patients were analyzed: 43 in the D5W-LA group and 52 in the LA group. Noninferiority tests were significant (all P < 0.05) for a critical limit of 7 minutes between D5W-LA and LA groups for onset time of the primary criterion, light touch block at index finger (mean ± SD, respectively: 23.9 ± 7.4 and 22.0 ± 7.9 minutes; 95% confidence interval [CI], −5.9 to 2.1 minutes), and for cold block at index fingertip, sensory blocks at thenar eminence, and motor block. Success rate at 30 minutes (defined as complete abolition for cold and light touch at index finger) was noted in 100% and 98.1% (95% CI, −6% to 10%) and 95.2% and 96.2% (95% CI, −13% to 9%) of patients for the D5W-LA and the LA groups. CONCLUSION: Performing an ultrasound-guided perineural circumferential hydrodissection with D5W into which LA is injected leaves nerve block outcome unchanged. The assumption that this procedure may reduce the risk of intravascular injection and systemic toxicity remains to be demonstrated.
Role of adjuvants in continuous wound infusion analgesia for cesarean deliveries.

chrane Quality and Jadad scores, and such an omission would seem less likely in the setting of high quality scores. The subgroup analysis of colorectal surgery did not include the trial by Pryor et al. or a subset of patients in the PROXI trial. The trial by Pryor et al. was not included because not all of the patients in the trial had colorectal surgery and the trial did not distinguish individual rates of SSI by type of operation. The patients in the PROXI trial undergoing colorectal surgery were not included in the subgroup analysis because the PROXI trial did not publish the number of SSIs in the appendectomy group. Similarly, the appendectomy trial by Bickel et al. was included in the colorectal surgery subgroup analysis because of the proximity of the appendix to the colon, the same bacteria were present in both structures, both were clean-contaminated surgery, and higher rates of SSI were associated with both procedures. Thus, in many ways, it can be argued that surgery in the appendix should be included in a study population of colorectal surgical patients. As noted in the discussion of our article, use of different inclusion/exclusion criteria for studies incorporated in meta-analyses (and subgroup analyses) may yield different results partly because of different studies used in the final analysis. The overall result of our meta-analysis that high inspired oxygen therapy was not found to be beneficial for preventing SSI was somewhat at odds with prior published systematic reviews, but may generate additional hypothesis for study in larger randomized controlled trials similar to the ones previously performed by Meyhoff et al.
Montelukast for Chronic Asthma in 6- to 14-Year-Old Children A Randomized, Double-blind Trial

Context. —Leukotrienes are important mediators of asthma by causing bronchoconstriction, mucous secretion, and increased vascular permeability. Studies using compounds that block leukotrienes have demonstrated improvement in asthma control in adults and adolescents, but children younger than 12 years, for whom asthma is the most common chronic disease, have not been studied.Objective. —To determine the clinical effect of montelukast, a leukotriene receptor antagonist, in 6- to 14-year-old children with asthma.Design. —Eight-week, multicenter, randomized, double-blind study.Setting. —Forty-seven outpatient centers at private practices and academic medical centers in the United States and Canada.Patients. —A total of 336 children with forced expiratory volume in 1 second (FEV1) between 50% to 85% of the predicted value, at least 15% reversibility after inhaled β-agonist administration, a minimal predefined level of daytime asthma symptoms, and daily β-agonist use. Concomitant inhaled corticosteroids at a constant daily dose were used by 39% of patients receiving montelukast and 33% receiving placebo.Intervention. —After a 2-week placebo run-in period, patients received either montelukast (5-mg chewable tablet) or matching-image placebo once daily at bedtime for 8 weeks.Main Outcome Measure. —Morning FEV1 percent change from baseline.Results. —Mean morning FEV1 increased from 1.85 L to 2.01 L in the montelukast group and from 1.85 L to 1.93 L in the placebo group. This represents an 8.23% (95% confidence interval [CI], 6.33% to 10.13%) increase from baseline in the montelukast group and a 3.58% (95% CI, 1.29% to 5.87%) increase from baseline in the placebo group (P<.001 for montelukast vs placebo). Conclusion. —Montelukast improves morning FEV1 in 6- to 14-year-old children with chronic asthma.
Strong H...F hydrogen bonds as synthons in polymeric quantum magnets: structural, magnetic, and theoretical characterization of [Cu(HF2)(pyrazine)2]SbF6, [Cu2F(HF)(HF2)(pyrazine)4](SbF6)2, and [CuAg(H3F4)(pyrazine)5](SbF6)2.

Three Cu(2+)-containing coordination polymers were synthesized and characterized by experimental (X-ray diffraction, magnetic susceptibility, pulsed-field magnetization, heat capacity, and muon-spin relaxation) and electronic structure studies (quantum Monte Carlo simulations and density functional theory calculations). [Cu(HF(2))(pyz)(2)]SbF(6) (pyz = pyrazine) (1a), [Cu(2)F(HF)(HF(2))(pyz)(4)](SbF(6))(2) (1b), and [CuAg(H(3)F(4))(pyz)(5)](SbF(6))(2) (2) crystallize in either tetragonal or orthorhombic space groups; their structures consist of 2D square layers of [M(pyz)(2)](n+) that are linked in the third dimension by either HF(2)(-) (1a and 1b) or H(3)F(4)(-) (2). The resulting 3D frameworks contain charge-balancing SbF(6)(-) anions in every void. Compound 1b is a defective polymorph of 1a, with the difference being that 50% of the HF(2)(-) links are broken in the former, which leads to a cooperative Jahn-Teller distortion and d(x(2))(-y(2)) orbital ordering. Magnetic data for 1a and 1b reveal broad maxima in chi at 12.5 and 2.6 K and long-range magnetic order below 4.3 and 1.7 K, respectively, while 2 displays negligible spin interactions owing to long and disrupted superexchange pathways. The isothermal magnetization, M(B), for 1a and 1b measured at 0.5 K reveals contrasting behaviors: 1a exhibits a concave shape as B increases to a saturation field, B(c), of 37.6 T, whereas 1b presents an unusual two-step saturation in which M(B) is convex until it reaches a step near 10.8 T and then becomes concave until saturation is reached at 15.8 T. The step occurs at two-thirds of M(sat), suggesting the presence of a ferrimagnetic structure. Compound 2 shows unusual hysteresis in M(B) at low temperature, although chi vs T does not reveal the presence of a magnetic phase transition. Quantum Monte Carlo simulations based on an anisotropic cubic lattice were applied to the magnetic data of 1a to afford g = 2.14, J = -13.4 K (Cu-pyz-Cu), and J(perpendicular) = -0.20 K (Cu-F.H.F-Cu), while chi vs T for 1b could be well reproduced by a spin-1/2 Heisenberg uniform chain model for g = 2.127(1), J(1) = -3.81(1), and zJ(2) = -0.48(1) K, where J(1) and J(2) are the intra- and interchain exchange couplings, respectively, which considers the number of magnetic nearest-neighbors (z). The M(B) data for 1b could not be satisfactorily explained by the chain model, suggesting a more complex magnetic structure in the ordered state and the need for additional terms in the spin Hamiltonian. The observed variation in magnetic behaviors is driven by differences in the H.F hydrogen-bonding motifs.
Components of Cardiac Rehabilitation Other Than Exercise

Secondary prevention of coronary heart disease (CHD) includes therapeutic efforts to reduce risk of mortality and morbidity in patients with established CHD. Although traditional cardiac risk factors (such as positive family history, hypertension, hypercholesterolemia) are associated with initial CHD events, they are less predictive of recurrent fatal and nonfatal events in patients with CHD. The typical patient referred to cardiac rehabilitation (CR) is physically deconditioned, overweight, with elevated cholesterol levels, and possibly still smoking. The patient may also exhibit traits of the type A personality, signs of emotional distress such as depression and anxiety, cognitive deficits, and a history of stressful interactions at home or at work. Thus, secondary prevention necessitates not only enhancing the patient's ability to modify traditional risk factors, but also maximizing the patient's ability to make necessary life-style changes to reduce daily emotional and physical stress. In order to achieve this goal, a multidisciplinary team approach to rehabilitation is required. Supervised exercise has been widely embraced as the cornerstone of most CR programs. In addition to the physiologic benefits of exercise, psychologic benefits are often attributed to exercise, including reduced depression and anxiety, as well as more positive self-perceptions. However, studies of exercise rehabilitation programs indicate that exercise per se does not necessarily have an impact on associated health behaviors, such as diet and smoking. For example, Erdman and colleagues compared patients randomly assigned to a 6-month exercise rehabilitation program with patients assigned to a home exercise program and found significantly more exercise adherence among the rehabilitation subjects, but no difference in smoking behavior between the two groups at 6-month and 5-year follow-up. Thus, a patient's participation in exercise does not ensure compliance with other aspects of CR, and changes in other health behaviors may be difficult to achieve because of longstanding habits in the areas of diet, smoking, and alcohol consumption. Furthermore, the patient's past methods of coping with stressful circumstances may be inadequate or inappropriate for coping with CHD and subsequent life changes. CR programs have advanced in the past 20 years to incorporate treatments such as type A behavior modification and stress management interventions designed to teach strategies for coping with stressful situations more adaptively. Other interventions such as group counseling, family counseling, and vocational rehabilitation assist with adaptation to necessary changes in the home and work environments, and help to educate the patient and the patient's family about CHD and the process of rehabilitation. The purpose of this article is to review the research pertaining to components of CR other than exercise, including diet, smoking, type A behavior modification, and stress management, and to suggest directions for future research investigations and treatment.
STUDIES ON HYPERSENSITIVITY

In earlier observations with the picryl system, it was concluded that contact sensitivity was a form of delayed (cellular) hypersensitivity to conjugates of sensitizer with autologous proteins indistinguishable in its immunological mechanism from other classical forms of delayed hypersensitivity to proteins. This conclusion has been confirmed and extended with the picryl and chlorbenzoyl chloride systems. 1. It is shown that to induce a state of contact sensitivity, the minimal necessary amounts of hapten are of the same order of magnitude, whether this hapten is conjugated with protein or the free reactive chemical itself. From this, it is evident that contamination of conjugates with small amounts of unreacted sensitizer plays no part in the induction of contact reactivity by the conjugate. With the dinitrophenyl system, no contact sensitivity could be induced by the conjugates used; possible reasons for this discrepancy are discussed. 2. Animals sensitized to contact by homologous conjugate can be completely desensitized by injections of such a conjugate in large amount; a similar injection schedule has no effect on the contact sensitivity of animals sensitized with the free reactive sensitizer. 3. The capacity of heterologous (ovalbumin) conjugates to evoke anti-hapten antibodies is shown to be greater than that of homologous (guinea pig seralbumin) conjugates: the reverse is true of their capacity to induce delayed reactivity. 4. Evidence is brought forward to suggest that in animals sensitized with homologous albumin conjugates, the specificity of the delayed reaction involves more than the hapten alone, even though the carrier protein is non-antigenic on its own. The contrast with the apparent lesser specificity of the antibodies later produced is discussed.
Older people's participation in political activity—making their voices heard: A potential support role for welfare professionals in countering ageism and social exclusion

The discrimination that older people in the UK experience is replicated in barriers restricting their participation in political activity. Thus, the social exclusion that many older people encounter is compounded by political exclusion, including, significantly, exclusion from political debates and activities addressing issues that could influence outcomes in their interests across a range of policy areas. Drawing on findings from research, this paper explores key issues relating to older people's participation, highlighting their disillusion with traditional political activity and the exacerbation of their exclusion through powerlessness. Some older people are taking part in new forms of political activity, marking a shift of focus from self-help to campaigning. This indicates their need to participate in political activity around issues directly affecting them. They frequently gain strength and encouragement from campaigning achievements. This offers potential for building capacity among older people. By supporting such activity and involving older people in the development of policies and services, health and social care workers can support older people to counter discrimination and influence issues that particularly affect them. The paper thus connects two so far unrelated discussions: issues concerning user involvement, health and social care service users and workers are discussed in connection with current concerns about declining levels of political participation.
Acupuncture Is Theatrical Placebo

Pain is a big problem. If you read about pain management centers, you might think it had been solved. It has not. And when no effective treatment exists for a medical problem, it leads to a tendency to clutch at straws. Research has shown that acupuncture is little more than such a straw.Although it