Miracle-dz/UniFAR-FTUs huggingface dataset:
Update on belimumab for the management of systemic lupus erythematosus

Introduction: Belimumab is a fully humanised mAb against B lymphocyte stimulator (B-LyS). It is the first biological drug to be licensed and approved by the US FDA and the European Medicines Evaluation Agency for use in combination with standard immunosuppressants in autoantibody-positive systemic lupus erythematosus (SLE). The clinical effectiveness and impact of this drug on lupus morbidity and mortality is evaluated in this review. Areas covered: An overview of the efficacy and safety of belimumab based on 7-year longitudinal continuation study data from SLE patients enrolled in the Phase II double-blind, randomised, placebo-controlled, 52-week study of belimumab 1, 4 and 10 mg/kg doses and an overview of the open-label 24-week extension of belimumab plus standard immunosuppressant therapy. A review of the current belimumab clinical trials, the experience of belimumab in real-world settings and a description of the impact that belimumab has had on the healthcare quality of life of SLE patients. Expert opinion: The emerging clinical data have shed light on the areas in which belimumab is of greatest benefit and areas for further evaluation in clinical trials. It is anticipated that regular updates from ongoing trials of belimumab in SLE, practising physicians, data from the continuation arms of clinical trials and data from international biologics registries will have an influence on the role of belimumab in the management of SLE.
The Impact of Bank Merger Growth on CEO Compensation

We examine the impact of bank mergers on chief executive officer (CEO) compensation during 1992–2014, a period characterised by significant banking consolidation. We show that CEO compensation is positively related to both merger growth and non-merger internal growth, with the former relation being higher in magnitude. While CEO pay–risk sensitivity is not significantly related to merger growth, CEO pay–performance sensitivity is negatively and significantly related to merger growth. Collectively, our results suggest that, through bank mergers, CEOs can earn higher compensation and decouple personal wealth from bank performance. Furthermore, we document a more severe agency problem in CEO compensation as a consequence of bank mergers relative to mergers in industrial firms. Finally, we find that the post-financial crisis regulatory reform of executive compensation in banks has limited effectiveness in curbing the merger–pay links. This article is protected by copyright. All rights reserved
Home blood pressure normalcy in non-European adolescents

Objective: Evidence on normal range of home blood pressure (BP) in adolescents relies on only one European study. This study aims to investigate the normal range of home BP in a healthy non-European population of adolescents. Methods: Cross-sectional study with a representative sample of secondary school students (12–17 years) from a Brazilian state capital. Adolescents’ heights were classified in percentiles according to age and sex. Height percentiles were divided in 50th or less or more than 50th percentile. The home BP protocol included two day-time and two evening-time measurements over 6 days. Exams were considered valid with at least 12 measurements. Results: A total of 1024 adolescents were included, mean age 15.21 ± 1.61 years, mostly women (52.4%), from public schools (68.4%) and nonwhite (51.3%). The 50th (midpoint of distribution) and the 95th percentile (upper normal limit) for home SBP and DBP in adolescents are provided by sex, age and height percentiles. There was a marked increase in the estimated 95th percentile for home SBP with increasing age in men for both height percentiles examined (16 mmHg for ⩽50th percentile and 14.5 mmHg for >50th percentile) and less so for home DBP (1 and 5 mmHg, respectively). In women, the 95th percentile increase with age was less significant for SBP and similar for DBP when compared with men in the two height percentiles evaluated (6/2 mmHg for ⩽50th percentile and 4/4 mmHg for >50th percentile). Conclusion: Reference values for home BP by height percentiles for age and sex in a non-European population of adolescents are provided.
Assessing Innovation Effects in US Merger Policy: Theory, Practice, Recent Discussions, and Perspectives

Despite a broad consensus about the importance of also considering innovation effects of mergers (in addition to the usual price effects), it is still very unclear to what extent and how innovation effects of mergers should be assessed. In this paper, the results of the first comprehensive (quantitative) empirical study on how the US antitrust authorities DoJ and FTC assessed mergers in regard to their innovation effects from 1995 to 2008 are presented. We could find 135 challenged mergers with overall 323 relevant markets, in which the authorities had also innovation concerns. Whereas in Kern/Dewenter/Kerber (2014) we have focused much more narrowly on the econometric results, this paper (in section 3) presents all our results (in a non-technical way) and analyzes them in the broad context of the theoretical discussion about innovation effects of mergers (section 2) and the recent discussion on how to deal with innovation effects in regard to the reform of the U.S. Horizontal Merger Guidelines (chapter 4). In our empirical study, we are mainly interested in the question to what extent the agencies have assessed innovation effects within the traditional product market concept or by using a more innovation-specific approach which would consider research and development already in the market definition (along basic ideas of the innovation market analysis). Important results of our study are: In more than a third of all challenged mergers also innovation concerns were raised - with no differences between the agencies and over time. However, the agencies used rather different assessment approaches, the DoJ more the traditional product market concept and the FTC more an innovation-specific approach; however, overall an innovation-specific approach was used more often. We also analyzed the cases for the applied concentration measures and levels, barriers to entry, the reasonings of the agencies, simultaneity of static price effects claims, and remedies. Our overall results are very ambivalent: The agencies have assessed innovation effects and this often also in an innovation-specific way, but they did not succeed to develop a clear and consistent approach and seemed to have gotten more cautious over time. In chapter 4, these results are confronted with the recent US antitrust discussion about the reform of the U.S. Horizontal Merger Guidelines. Both this discussion as well as the new Guidelines shows a clear reluctance of adopting a more innovation-specific approach (by sticking clearly to the product market approach) which is at odds with the practice of the agencies until 2008. This disappointing result leads the authors to develop some ideas for new research perspectives on this issue.
A Five-Year Experience With the Use of BiPAP in a Pediatric Intensive Care Unit Population

The authors retrospectively reviewed their experience with bilevel positive airway pressure (BiPAP) to treat respiratory insufficiency in pediatric patients over a 5-year period. After excluding patients on chronic home BiPAP and those in whom BiPAP was used to facilitate tracheal extubation (because there were no pre-BiPAP values on which to judge its efficacy), the study cohort included 45 patients (1.5 to 22 years) in whom BiPAP was used for acute respiratory insufficiency. The primary indication for BiPAP was a primary pulmonary parenchymal process in 29 patients and postoperative atelectasis with respiratory insufficiency following cardiac or upper abdominal surgery in 16 patients. There were no differences in the pre-BiPAP values of oxygen requirement, PCO2, oxygen saturation, and respiratory rate between the 2 groups. With the application of BiPAP in patients with primary pulmonary parenchymal disease, there was a decreased oxygen requirement, PCO2, and respiratory rate. No change in oxygen saturation was noted. In patients with postoperative respiratory insufficiency, there was an improvement in all 4 parameters. There was no difference in post-BiPAP values of oxygen requirement, respiratory rate, or PCO2 between the 2 groups. The post-BiPAP oxygen saturation was greater in patients with postoperative respiratory insufficiency (96% ± 4%) than in patients with primary pulmonary parenchymal disease (92% ± 6%,P = .02). Endotracheal intubation was required in 11 of 29 patients with primary pulmonary parenchymal pathology versus 1 of 16 patients with postoperative atelectasis and/or respiratory insufficiency (P = .03). The chances of requiring intubation were greater in patients ≤ 6 years of age (relative risk 1.9), if the oxygen requirement did not decrease to less than 60% within the first 24 hours of BiPAP use (relative risk 3.3) and if there were any PCO2 values ≥ 55 mmHg during the first 24 hours of BiPAP use (relative risk 9.8). No severe complications to BiPAP were noted. BiPAP safely and effectively improves the respiratory status of and might decrease the need for endotracheal intubation in pediatric patients with acute respiratory insufficiency of various etiologies.
Vulvodynia: New Thoughts on a Devastating Condition

Vulvodynia affects 3% to 15% of women; many suffer through years of misdiagnosis and for those who receive care cures are uncommon. Little is known about the etiology and a wide range of therapeutic options are available. With treatment approximately 50% of women will report sustained improvement in pain scores of 50% or more, however, reasons for varied response rates are yet unknown. This article will explore 3 factors that may contribute to inconsistent results with therapy; the hypothesis that vulvodynia is a systemic disorder; the idea that failure to address the psychological or emotional aspect or chronic pain may affect outcome; and the concept that chronic vulvar pain, like headache, is not a single condition but is a diverse group of disorders that produce the same symptom. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader should be able to state that vulvodynia is a complex disorder, explain that no one treatment is superior, relate that pathophysiology is important, and recall that psychological aspects of chronic pain must be appreciated.
Prevalence and Patterns of Bone Loss in the First Year After Renal Transplant in South East Asian Patients

Background. Limited data are available regarding patterns of bone loss in South East Asian renal transplant patients. We aimed to determine the prevalence of low bone density and factors contributing to bone loss in Singaporean patients in the first year after renal transplant. Methods. Seventy-nine consecutive patients who underwent renal transplant were evaluated. Bone mineral density (BMD) was evaluated at 0 (baseline), and at 6 and 12 months after transplant. Baseline parathyroid hormone and vitamin D levels were also assessed. Multivariate regression models were used to investigate the relationship between the different variables and BMD. Results. Thirty-six patients (45.6%) had low BMD at baseline. Factors correlating with the low BMD were older age, postmenopausal status, and tertiary hyperparathyroidism (P<0.0005, 0.009, and 0.027, respectively). There was a linear decrease in total hip and lumbar spine BMD from baseline to 12 months, the decrease from baseline to 6 months being significant (P=0.019 for total hip and P<0.0005 for lumbar spine). Patients with tertiary hyperparathyroidism had a greater risk of decrease in BMD at 6 months compared with patients with secondary hyperparathyroidism (odds ratio=13.5, confidence interval: 1.3, 144.4) and with those who had parathyroidectomy (odds ratio=34.9; confidence interval: 2.0, 598.8). Conclusions. The prevalence of low BMD in this population of renal transplant recipients was high. Parathyroid status was the only independent factor that correlated with low BMD at baseline and subsequent bone loss highlighting the critical role of this hormone in bone metabolism after renal transplant.
Intra-party Conflict and Cabinet Survival in 17 West European Democracies, 1945-1999

This paper makes an empirical contribution to an emerging body of scholarship modelling coalition politics not as a ‘game’ between ‘unitary actors’, but as a system of at least two interlocking political games between political parties: ‘At one level, party leaders do interact with each other, as modelled by classical coalition theorists. At another level, each decision a party leader makes has to be carried through within the party’s internal political system – and of course party leaders will anticipate the need to do this when making commitments to other party leaders'. Whilst authors such as Druckman (1996), Laver (1999), Strom (2001) or Tsebelis (1992, 2002) have made progress in developing theoretical models for the analysis of such complex two-level processes, rigorous quantitative tests of hypotheses derived from their models are rare. Druckman’s (1996) study of the influence of party factionalism on cabinet durability is the only published comparative, quantitative analysis of the intraparty sources of coalition durability in English language. Druckman demonstrates that increasing levels of party factionalism reduce the life expectancy of cabinets significantly, even if other institutional variables are held constant.
Thrombelastography and rotational thromboelastometry early amplitudes in 182 trauma patients with clinical suspicion of severe injury

BACKGROUND Viscoelastic hemostatic assays may provide means for earlier detection of trauma-induced coagulopathy (TIC). METHODS This is a prospective observational study of 182 trauma patients admitted to a Level 1 trauma center. Clinical data, thrombelastography (TEG), and rotational thromboelastometry (ROTEM) parameters were recorded upon arrival. Citrated kaolin (CK), rapid TEG (rTEG), and functional fibrinogen curves were extracted, and early amplitudes A5 and A10 were registered. Patients were stratified according to international normalized ratio of 1.2 or less and international normalized ratio greater than 1.2 (TIC patients) as well as transfusion needs (no red blood cells [RBCs], 1–9 RBCs, and ≥10 RBC in 6 hours). Correlations were analyzed by Spearman’s correlation. RESULTS TIC patients had lower amplitudes than non-TIC patients in ROTEM/TEG as follows: EXTEM, INTEM, and FIBTEM: A5, A10, and maximum clot firmness (MCF); rTEG: A10; CK: maximum amplitude (MA); and functional fibrinogen: A5, A10, and MA (p < 0.05). Furthermore, A5 and A10 had a strong correlation with MA/MCF (&rgr; > 0.7 and p < 0.01). The A10 amplitudes were significantly lower in patients transfused with 10 or more units of RBC compared with nontransfused patients (p < 0.02). Fibrinogen concentration and platelet count had moderate correlation with A10 compared with A5 and MA/MCF (0.3 < &rgr; < 0.7 and p < 0.01). Time (median [interquartile range], in minutes) to obtain a reading was faster for A10 than MA/MCF (p < 0.001) (CK, 16 [15–17] vs. 27 [25–30]; rTEG, 11 [11–11] vs. 18 [17–20]; EXTEM, 11 [11–11] vs. 29 [26–31]; and INTEM 13[12–13] vs. 25 [22–29]). CONCLUSION Early amplitudes were lower in TIC patients, had significant correlations with MA/MCF, and differentiated between nontransfused and patients receiving one to nine RBC units or 10 or more RBC units within 6 hours. A10’s superior correlation with platelet count and fibrinogen concentration suggests that A10 reflects a more dynamic part of the hemostatic process rather than MA/MCF. Early amplitudes may translate into earlier goal-directed transfusion therapy and may allow refinement of existing transfusion algorithms. LEVEL OF EVIDENCE Prognostic and diagnostic study, level III.
Avoiding Stroke During Cardiac Surgery

The life saving benefits of cardiac surgery are frequently accompanied by negative side effects such as stroke, that occurs with an incidence of 2%-13% dependent to type of surgery. The etiology is most likely multifactorial with embolic events considered as main contributor. Although stroke presents a common complication, no guidelines for any routine use of pharmacological substances or non-pharmacological strategies exist to date. Non-pharmacological strategies include monitoring of brain oxygenation and perfusion with devices such as near infrared spectroscopy and Transcranial Doppler help. Epiaortic and transesophageal echocardiography visualize aorta pathology, enabling the surgeon to sidestep atheromatous segments. Additionally can the use of specially designed aortic cannulae and filters help to reduce embolization. Brain perfusion can be improved by using antero- or retrograde cerebral perfusion during deep hypothermic circulatory arrest, by tightly monitoring mean arterial blood pressure and hemodilution. Controlling perioperative temperature and glucose levels may additionally help to ameliorate secondary damage. Many pharmacological compounds have been shown to be neuroprotective in preclinical models, but clinical studies failed to confirm these results so far. Remacemide, an NMDA-receptor-antagonist showed a significant drug-based neuroprotection during cardiac surgery. Other substances currently assessed in clinical trials whose results are still pending are acadesine, an adenosine-regulating substance, the free radical scavenger edaravone and the local anesthetic lidocaine. Stroke remains as significant complication after cardiac surgery. Non-pharmacological strategies allow perioperative caregivers to detect injurious events and to ameliorate stroke and its sequelae. Considering the multi-factorial etiology though, stroke prevention will likely have to be addressed with an individualistic combination of different strategies and substances.
Anatomic standardization: linear scaling and nonlinear warping of functional brain images.

UNLABELLED An automated method was proposed for anatomic standardization of PET scans in three dimensions, which enabled objective intersubject and cross-group comparisons of functional brain images. METHODS The method involved linear scaling to correct an individual brain size and nonlinear warping to minimize regional anatomic variations among subjects. In the linear-scaling step, the anteroposterior length and width of the brain were measured on the PET images, and the brain height was estimated by a contour-matching procedure using the midsagittal plane. In the nonlinear warping step, individual gray matter locations were matched with those of a standard brain by maximizing correlation coefficients of regional profile curves determined between predefined stretching centers (predominantly in white matter) and the gray matter landmarks. RESULTS The accuracy of the brain height estimation was compared with skull x-ray estimations, showing comparable accuracy and better reproducibility. Linear-scaling and nonlinear warping methods were validated using [18F]fluorodeoxyglucose and [15O]water images. Regional anatomic variability on the glucose images was reduced markedly. The statistical significance of activation foci in paired water images was improved in both vibratory and visual activation paradigms. A group versus group comparison following the proposed anatomic standardization revealed highly significant glucose metabolic alterations in the brains of patients with Alzheimer's disease compared with those of a normal control group. CONCLUSION These results suggested that the method is well suited to both research and clinical settings and can facilitate pixel-by-pixel comparisons of PET images.
Complex composition and co‐amplification of SAS and MDM2 in ring and giant rod marker chromosomes in well‐differentiated liposarcoma

Extra abnormal chromosomes (rings and giant rods) containing chromosome 12 sequences are characteristic of well‐differentiated liposarcoma (WDLPS). By whole chromosome painting we found in 6 WDLPS that minimally 5 chromosomes had contributed to the formation of the extra abnormal chromosomes. To the constant chromosome 12 contribution, sequences were variably added from chromosomes 1, 4, and 16. Material from chromosomes 1, 4, and 12 was identified by painting in interphase nuclear projections (“blebs”) and in micronuclei consistent with the concept that blebs are precursors to micronuclei. The complexity of the mechanisms generating the extra abnormal chromosomes in WDLPS was also attested to by the diversity and, in some cases, intricacy of the patterns of fluorescence. To begin to fathom the function of the extra abnormal chromosomes we examined the amplification of genes, including SAS, MDM2, and GADDI53/CHOP, known to be in the region 12q 13–14. SAS and MDM2 demonstrated constant co‐amplification. GADD153/CHOP, which is critically rearranged in myxoid liposarcoma, was not amplified in WDLPS. Genes Chromosom Cancer 10:85–94 (1994). © 1994 Wiley‐Liss, Inc.
Frequency variations of discrete cranial traits in major human populations. IV. Vessel and nerve related variations

This concludes a series of descriptive statistical reports on discrete cranial traits in 81 human populations from around the world. Four variants classified as vessel and nerve related characters were investigated: patent condylar canal; supraorbital foramen; accessory infraorbital foramen; and accessory mental foramen. A significant asymmetric occurrence without any side preference was detected for the accessory mental foramen. Significant intertrait associations were found between the accessory infraorbital and supraorbital foramina in the panPacific region and Subsaharan African samples. The intertrait associations between the accessory infraorbital foramen and some traits classified as hypostotic were found mainly in the samples from the western part of the Old World, and those as hyperostotic traits in the samples from eastern Asian and the related population samples. With a few exceptions, the occurrence of a patent condylar canal and a supraorbital foramen was predominant in females, but the accessory infraorbital and accessory mental foramina were predominant in males. The frequency distributions of the traits showed interregional clinality and intraregional discontinuity. A temporal trend was found in the Northeast Asian region in the frequencies of the accessory infraorbital and accessory mental foramina. The diversity of modern human discrete cranial traits may at least in part be attributable to differential retention or intensification from an ancestral pattern.