Miracle-dz/UniFAR-FTUs huggingface dataset:
Outcomes of Influenza A(H1N1)pdm09 Virus Infection: Results from Two International Cohort Studies

Background Data from prospectively planned cohort studies on risk of major clinical outcomes and prognostic factors for patients with influenza A(H1N1)pdm09 virus are limited. In 2009, in order to assess outcomes and evaluate risk factors for progression of illness, two cohort studies were initiated: FLU 002 in outpatients and FLU 003 in hospitalized patients. Methods and Findings Between October 2009 and December 2012, adults with influenza-like illness (ILI) were enrolled; outpatients were followed for 14 days and inpatients for 60 days. Disease progression was defined as hospitalization and/or death for outpatients, and hospitalization for >28 days, transfer to intensive care unit (ICU) if enrolled from general ward, and/or death for inpatients. Infection was confirmed by RT-PCR. 590 FLU 002 and 392 FLU 003 patients with influenza A (H1N1)pdm09 were enrolled from 81 sites in 17 countries at 2 days (IQR 1–3) and 6 days (IQR 4–10) following ILI onset, respectively. Disease progression was experienced by 29 (1 death) outpatients (5.1%; 95% CI: 3.4–7.2%) and 80 inpatients [death (32), hospitalization >28 days (43) or ICU transfer (20)] (21.6%; 95% CI: 17.5–26.2%). Disease progression (death) for hospitalized patients was 53.1% (26.6%) and 12.8% (3.8%), respectively, for those enrolled in the ICU and general ward. In pooled analyses for both studies, predictors of disease progression were age, longer duration of symptoms at enrollment and immunosuppression. Patients hospitalized during the pandemic period had a poorer prognosis than in subsequent seasons. Conclusions Patients with influenza A(H1N1)pdm09, particularly when requiring hospital admission, are at high risk for disease progression, especially if they are older, immunodeficient, or admitted late in infection. These data reinforce the need for international trials of novel treatment strategies for influenza infection and serve as a reminder of the need to monitor the severity of seasonal and pandemic influenza epidemics globally. Trial Registration ClinicalTrials.gov Identifiers: FLU 002- NCT01056354, FLU 003- NCT01056185.
Outcome of Spinal Fusion for Lumbar Degenerative Disease: A Cross-Sectional Study in Korea

Study Design. Retrospective cross-sectional study. Objective. To evaluate the degree of postoperative pain and patients' satisfaction after lumbar fusion from a nationwide survey in Korea. Summary of Background Data. There have been few studies that investigated the factors related to patients' satisfaction after spinal fusion in lumbar degenerative disease (LDD). Methods. This study included 629 patients who underwent spinal fusion for LDD at clinics of designated members of the Korean Society of Spine Surgery. This survey was done in 123 hospitals with 171 spine surgeons. Questionnaires for patients included severity of present back pain and radicular pain (visual analog scale score), Oswestry Disability Index (ODI), and subjective outcomes. Questionnaire for surgeons included preoperative diagnosis, level of fusion, operative method, and presumed patient's pain. Results. The patients were 199 men and 430 women, with mean age of 62.3 years. The mean visual analog scale score of back pain and radicular pain was 5.0 ± 2.6 and 4.4 ± 3.0, respectively. The mean ODI was 44.3 ± 19.4. ODI was significantly increased with older age, workers' compensation, and increased fusion extent. Correlated factors of dissatisfaction were severe back pain, higher ODI, multiple operation, and insufficient explanation about postoperative pain. There was a significant correlation between preoperative explanation about postoperative pain and degree of patient's pain. Conclusion. Patients' satisfaction was not as high as expected after fusion for LDD. Therefore, the decision for performing a lumbar fusion in those patients must be done more carefully, and it should be explained more precisely that chronic pain may persist after spinal surgery.
Increased Hypothalamic Neuropeptide Y Concentrations in Diabetic Rat

Central and lateral hypothalamic concentrations of 10 regulatory peptides were measured by radioimmunoassay in streptozocin-induced diabetic (STZ-D) and matched control rats between 1 day and 14 wk after diabetes induction. After 2 wk, both central and lateral hypothalamic neuropeptide Y (NPY) concentrations in STZ-D rats were consistently higher than those found in control rats, with significant 30–50% increases at 4 wk in the central hypothalamus, and at 6 and 14 wk in both central and lateral hypothalamus. Immunocytochemical studies in 4- and 6-wk STZ-D animals showed the appearance of intensely NPY-positive swollen cell bodies in the supraoptic nucleus and a subjective increase in NPY staining of medial hypothalamic nerve fibers. Central hypothalamic concentrations of three other peptides were significantly greater in STZ-D animals than those in control animals at single points (neurotensin, 1 day; calcitonin gene-related peptide, 2 wk; neurokinin, 4 wk). Hypothalamic concentrations of the other six peptides examined (bombesin, galanin, neuromedin B, substance P, somatostatin, and vasoactive intestinal peptide) did not differ significantly between STZ-D and control groups at any time. However, galanin immunostaining in the supraoptic and magnocellular paraventricular nuclei was strikingly concentrated in a reduced number of distended cell bodies. Hypothalamic peptide changes in STZ-D could be related to metabolic disturbance, changes in energy and water balance, altered pituitary function, or other factors. Persistently elevated concentrations of NPY, a very potent central stimulant of eating and drinking, may mediate the hyperphagia and polydipsia characteristic of STZ-D.
Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists.

BACKGROUND Serious complications of central neuraxial block (CNB) are rare. Limited information on their incidence and impact impedes clinical decision-making and patient consent. The Royal College of Anaesthetists Third National Audit Project was designed to inform this situation. METHODS A 2 week national census estimated the number of CNB procedures performed annually in the UK National Health Service. All major complications of CNBs performed over 1 yr (vertebral canal abscess or haematoma, meningitis, nerve injury, spinal cord ischaemia, fatal cardiovascular collapse, and wrong route errors) were reported. Each case was reviewed by an expert panel to assess causation, severity, and outcome. 'Permanent' injury was defined as symptoms persisting for more than 6 months. Efforts were made to validate denominator (procedures performed) and numerator (complications) data through national databases. RESULTS The census phase produced a denominator of 707,455 CNB. Eighty-four major complications were reported, of which 52 met the inclusion criteria at the time they were reported. Data were interpreted 'pessimistically' and 'optimistically'. 'Pessimistically' there were 30 permanent injuries and 'optimistically' 14. The incidence of permanent injury due to CNB (expressed per 100,000 cases) was 'pessimistically' 4.2 (95% confidence interval 2.9-6.1) and 'optimistically' 2.0 (1.1-3.3). 'Pessimistically' there were 13 deaths or paraplegias, 'optimistically' five. The incidence of paraplegia or death was 'pessimistically' 1.8 per 100,000 (1.0-3.1) and 'optimistically' 0.7 (0-1.6). Two-thirds of initially disabling injuries resolved fully. CONCLUSIONS The data are reassuring and suggest that CNB has a low incidence of major complications, many of which resolve within 6 months.
Sleep disturbances in patients on maintenance hemodialysis: role of dialysis shift.

OBJECTIVES Subjective sleep complaints have been reported in up to 80% of patients with end stage renal disease (ESRD). In these patients, sleep disturbances manifesting as insomnia, sleep apnea syndrome, restless leg syndrome (RLS), periodic limb movement disorder and excessive daytime sleepiness (EDS) have been frequently reported. Moreover, studies about the role of dialysis shift on sleep abnormalities, morbidity and mortality are still scarce. The aim of this study was to investigate the influence of dialysis shift on the quality of sleep and sleep abnormalities in patients with ESRD. METHODS We studied one hundred consecutive patients from a dialysis center. Quality of sleep was assessed by the Pittsburgh Sleep Quality Index and subjective EDS by the Epworth Sleepiness Scale. Restless leg syndrome was diagnosed using the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Clinical and laboratory parameters were obtained by interview and chart review. Adequacy of dialysis was evaluated by the Kt/V index. RESULTS Poor quality sleep (PSQI>6) was found in 75% of cases and was associated with RLS (p=0.004) and with snoring (p=0.016). EDS (ESS>10) was present in 28% of cases. Patients with EDS (1.33+/-0.29) had lower values of the Kt/v index (P=0.01) than those without EDS (1.52+/-0.32). RLS was present in 48% of cases. Irrespective of dialysis shift, poor quality sleep, EDS and RLS were not different among patients. CONCLUSION Poor quality sleep, EDS and RLS were common and not related to dialysis shift.
Extent and time course of pain intensity upon treatment with a topical diclofenac sodium patch versus placebo in acute traumatic injury based on a validated end point: post hoc analysis of a randomized placebo-controlled trial

Objective: To investigate the extent and time course of pain intensity upon treatment with a topical diclofenac patch compared with placebo in acute traumatic sport injury based on a validated and established end point. Methods: Post hoc analysis of a randomized, placebo-controlled, double-blind, multicentre, 1-week study in 120 patients with traumatic blunt soft tissue injury. Visual analogue scale (VAS) scores (in millimetres) for pain on movement were analysed. The mean absolute VAS changes in pain intensity from baseline over the study course were calculated for the diclofenac patch formulation (active) and placebo; mean differences between active and placebo were assessed twice daily during the first 3 days after enrolment and then once daily up to day 7. Results: The diclofenac patch was consistently superior to placebo in relieving pain. The mean differences compared with placebo were greatest on day 2 (23.6 – 30.6 mm, p < 0.0001) and day 3 (24.5 – 24.6 mm, p < 0.0001). Diminishing differences were observed over the study course. Conclusion: The investigated diclofenac sodium patch provides clinically relevant pain relief in patients with acute traumatic injuries. Maximum effects versus placebo are detected at 2 – 3 days post-injury. This analysis may serve as useful information for the planning of clinical trials in acute traumatic injury.
Prognostic significance of Bcl‐2 expression and p53 nuclear accumulation in colorectal adenocarcinoma

The products of bcl‐2 and p53 genes are involved in the regulation of apoptosis and proliferation and have been associated with prognosis in several malignancies, including colorectal adenocarcinoma. Although 2 European studies have reported a prognostic significance of Bcl‐2 expression in colorectal adenocarcinomas, a study from the United States did not observe such an association. Therefore, we used immunohistochemistry to evaluate the prognostic significance of Bcl‐2 expression, p53 nuclear accumulation and their concomitant expression in 134 US patients with colorectal adenocarcinoma. Antigen retrieval was required for adequate detection of Bcl‐2 expression. Fifty percent of the colorectal tumors were classified as expressing Bcl‐2, and Bcl‐2 expression was associated with longer patient survival. Antigen retrieval was not necessary for detecting nuclear accumulation of p53 by immunohistochemistry. Nuclear accumulation of p53 was detected in 44% of colorectal adenocarcinomas and was associated with decreased patient survival. Tumors that did not express detectable levels of Bcl‐2 but exhibited nuclear accumulation of p53 were associated with the shortest patient survival (log rank, p = 0.001). Multivariate Cox regression analysis demonstrated that Bcl‐2 expression (p = 0.018), p53 nuclear accumulation (p = 0.024) and regional lymph‐node metastasis (p = 0.005) were independent prognostic factors. Although a trend toward an inverse correlation between Bcl‐2 and p53 expression was observed, the prognostic value of Bcl‐2 expression was independent of p53 status. Thus, assessment of both Bcl‐2 and p53 status may be valuable in predicting the prognosis of patients with colorectal adenocarcinomas. Int. J. Cancer 74:346–358, 1997. © 1997 Wiley‐Liss, Inc.
Bradykinin-Stimulated Cyclooxygenase Activity Stimulates Vas Deferens Epithelial Anion Secretion In Vitro in Swine and Humans1

Abstract Epithelia lining the male reproductive duct modulate fertility by altering the luminal environment to which sperm are exposed. Although vas deferens epithelial cells reportedly express high levels of cyclooxygenases (Ptgs), and activation of bradykinin (BK) receptors can lead to upregulation of PTGS activity in epididymal epithelia, it remains unknown whether BKs and/or PTGSs have any role in modulating epithelial ion transport across vas deferens epithelia. Porcine and human vas deferens epithelial cell primary cultures and the PVD9902 cell line responded to lysylbradykinin with an increase in short circuit current (ISC; indicating net anion secretion), an effect that was 60%–93% reduced by indomethacin. The BK effect was inhibited by the B2 receptor subtype (BDKRB2) antagonist HOE140, whereas the B1 receptor subtype agonist des-Arg9-BK had no effect. BDKRB2 immunoreactivity was documented in most epithelial cells composing the native epithelium and on Western blots derived from cultured cells. Gene expression analysis revealed that the PTGS2 transcript is 20 times more abundant than its PTGS1 counterpart in cultured porcine vas deferens epithelia and that BDKRB2 mRNA is likewise highly expressed. Subsequent experiments revealed that prostaglandin E2, 1-OH prostaglandin E1 (prostaglandin E receptor 4 [PTGER4] agonist) and butaprost (PTGER2 agonist) increase ISC in a concentration-dependent manner, whereas sulprostone (mixed PTGER1 and PTGER3 agonist) produced no change in ISC. These results demonstrate that autacoids can affect epithelial cells to acutely modulate the luminal environment to which sperm are exposed in the vas deferens by enhancing PTGS activity, leading to the production of prostaglandins that act at PTGER4 and/or PTGER2 to induce or enhance anion secretion.
Gender differences in sympathetic nervous activity: influence of body mass and blood pressure

Background Obesity and high blood pressure (BP) commonly coexist in patients, and both conditions are associated with elevated sympathetic nervous activity. We tested whether the sympathetic nervous system was differently affected in men and women by the body mass index (BMI), BP, leptin and weight loss. Methods We measured muscle sympathetic nerve activity (MSNA, microneurography), BP and plasma leptin concentrations in 167 age-matched normotensive and hypertensive men and women divided into three subgroups: lean, BMI < 25 kg/m2; overweight, BMI ≥ 25 and < 30 kg/m2; and obese, BMI ≥ 30 kg/m2. These measurements were repeated in a subgroup of 19 obese subjects who underwent a 12-week diet. Results Women with hypertension had increased MSNA compared with their normotensive counterparts (37 ± 2 versus 25 ± 2 bursts/min, analysis of variance, P < 0.001) and MSNA was significantly related to BP (P < 0.05, r2 = 0.236) but not to BMI. MSNA in men with hypertension was no different from that in normotensive subjects (33 ± 2 versus 30 ± 2 bursts/min), but MSNA was significantly related to BMI (P < 0.05, r2 = 0.249). Diet resulted in the same degree of weight loss in men and women, but induced a decrease in MSNA only in men (43 ± 3 to 34 ± 3 bursts/min, P < 0.01). The plasma leptin concentration was higher in women than in men, and for both groups it was related to BMI not BP (r2 = 0.497, P < 0.001 in women and r2 = 0.483, P < 0.001 in men). Conclusion These data demonstrate a gender difference in the regulation of the sympathetic nervous system, in which MSNA mainly relates to BP in women and to BMI in men.
Correlation of KIT and EGFR overexpression with invasive ductal breast carcinoma of the solid‐tubular subtype, nuclear grade 3, and mesenchymal or myoepithelial differentiation

Although KIT and EGFR overexpressions are reported to occur in breast cancer, their pathological significance is still unclear. We examined KIT, EGFR, and c‐erbB‐2 overexpressions immunohistochemically in 150 cases of surgically resected breast cancer and their correlation with the histological type and grade and mesenchymal and/or myoepithelial immunophenotype of primary tumors. To facilitate the analysis, we constructed a tissue microarray comprising 2‐mm diameter tissues cored from the representative tissue block of each tumor. KIT, EGFR, and c‐erbB‐2 overexpressions were detected in 15 (10%), 12 (8%), and 23 (15%), respectively. The KIT was more frequent in the group comprising comedo‐type ductal carcinoma in situ and invasive ductal carcinomas (IDCs) of the solid‐tubular subtype than in the group of other histological types (P = 0.027), and the EGFR was more frequent in IDCs of solid‐tubular type than in other histological types (P < 0.05). KIT and EGFR overexpressions were correlated with nuclear grade 3 (P = 0.0095 and 0.0005) and tended to be concurrent (P = 0.005). KIT overexpression was correlated with vimentin and S‐100 expression (P = 0.003 and P = 0.005), and EGFR overexpression was correlated with S100 expression (P = 0.0001). These correlations with grade and mesenchymal/myoepithelial markers were not observed for c‐erbB‐2 overexpression. KIT and EGFR appeared to be indicators of high‐grade breast carcinoma groups that often contain the carcinomas with mesenchymal and/or myoepithelial differentiation, which are distinct from the group with c‐erbB‐2 overexpression. (Cancer Sci 2005; 96: 48 –53)
Optimality of Radio Power Control Via Fast-Lipschitz Optimization

In wireless network resource allocation, the radio power control problems are often solved by fixed point algorithms. Although these algorithms give feasible problem solutions, such solutions often lack notion of problem optimality. This paper reconsiders well-known fixed-point algorithms, such as those with standard and type-II standard interference functions, and investigates the conditions under which they give optimal solutions. The optimality is established by the recently proposed fast-Lipschitz optimization framework. To apply such a framework, the analysis is performed by a logarithmic transformation of variables that gives tractable fast-Lipschitz problems. It is shown how the logarithmic problem constraints are contractive by the standard or type-II standard assumptions on the power control problem, and how sets of cost functions fulfill the fast-Lipschitz qualifying conditions. The analysis on nonmonotonic interference function allows establishing a new qualifying condition for fast-Lipschitz optimization. The results are illustrated by considering power control problems with standard interference function, problems with type-II standard interference functions, and a case of subhomogeneous power control problems. Given the generality of fast-Lipschitz optimization compared to traditional methods for resource allocation, it is concluded that such an optimization may help to determine the optimality of many resource allocation problems in wireless networks.
Increased Skeletal Muscle Capillary Density Precedes Diabetes Development in Men With Impaired Glucose Tolerance: A 15-Year Follow-Up

Gastrocnemius muscle morphology, metabolic potential, and capillarization were analyzed in 48-year-old men with regard to subsequent development of non-insulin-dependent diabetes mellitus (NIDDM) in 29 subjects with impaired glucose tolerance (IGT) and in 38 control subjects. Over a 15-year period, although participating in an intervention program, 13 of the IGT subjects developed diabetes, but none of the control subjects developed diabetes. In view of their poor aerobic capacity, lack of physical fitness, and reduced glycolytic and oxidative enzymes, these 13 subjects manifested an unexpectedly high number of capillaries around all types of muscle fibers, especially type IIb fibers, as predictors of their progression to diabetes. Moreover, the number of capillaries per muscle fiber and the 2-h insulin value in the oral glucose tolerance test were highly correlated (r = 0.82, P < 0.005), whereas no correlation was found among IGT subjects who remained nondiabetic and in the control group. With body mass index and the 2-h glucose concentration included in a regression model, 68% of the variation in the number of capillaries per muscle fiber was explained (P < 0.05), with the 2-h insulin value independently accounting for 33%. These findings may suggest that the increased circulating insulin concentrations in IGT subjects have a capillary proliferative effect, perhaps to compensate for reduced capillary insulin diffusion and metabolic capacity of the muscle.
Vancomycin‐Resistant Enterococcal Urinary Tract Infections

Enterococci are a common cause of urinary tract infections (UTIs) among hospitalized patients. The rising prevalence of vancomycin‐resistant enterococci (VRE) is of particular concern within many institutions because of its association with increased mortality and health care costs, as well as limited treatment options. Clinicians need to differentiate between VRE‐associated urinary colonization, asymptomatic bacteriuria, and UTIs in order to determine the need for treatment, optimal therapeutic options, and length of therapy. Unnecessary use of antibiotics in patients simply colonized and not infected with VRE in the urine has become a large problem in both hospitals and long‐term care facilities. A PubMed‐MEDLINE search was conducted to identify all English‐language literature published between January 1975 and March 2010 in order to summarize diagnostic criteria and treatment options for VRE UTIs. Several antimicrobials are discussed, with the specific focus on those with the potential to treat VRE UTIs and susceptibility patterns of VRE from urinary sources: ampicillin, amoxicillin, daptomycin, doxycycline, fosfomycin, imipenem‐cilastatin, linezolid, nitrofurantoin, penicillin, piperacillin, quinupristin‐dalfopristin, tetracycline, and tigecycline. Recommendations for empiric treatment of enterococcal UTIs and definitive treatment of VRE UTIs, including an evidence‐based treatment algorithm, are proposed. Ampicillin generally is considered the drug of choice for ampicillin‐susceptible enterococcal UTIs, including VRE. Nitrofurantoin, fosfomycin, and doxycycline have intrinsic activity against enterococci, including VRE, and are possible oral options for VRE cystitis. Linezolid and daptomycin should be reserved for confirmed or suspected upper and/or bacteremic VRE UTIs among ampicillin‐resistant strains. Use of other antimicrobials, such as quinupristin‐dalfopristin and tigecycline, should be evaluated on a case‐by‐case basis due to concerns of toxicity, resistance, and insufficient supportive data. Additional clinical data are needed to determine the optimal management and duration of therapy for VRE UTIs.