Miracle-dz/UniFAR-FTUs huggingface dataset:
Initial combination therapy with sitagliptin, a dipeptidyl peptidase-4 inhibitor, and metformin for patients with Type 2 diabetes mellitus

The two incretin hormones, glucagon-like peptide (GLP)-1 and glucose-dependent insulinotropic polypeptide potentiate nutrient-dependent insulin secretion following meal ingestion. Metabolic control can be improved markedly by administration of exogenous GLP-1, but the native peptide is almost immediately degraded by the enzyme dipeptidyl peptidase (DPP)-4 and, therefore, has little clinical value. Oral formulations that inhibit DPP-4, thereby prolonging the duration of endogenous incretin action, have, therefore, been developed. Sitagliptin, a once-daily, orally active, competitive and fully reversible inhibitor of DPP-4, was, as first in its class, introduced to the market as Januvia™. Recently, the US FDA approved initial combination therapy with sitagliptin and metformin (Janumet™) in order to help more patients with Type 2 diabetes mellitus get closer to accepted glycemic control targets, as recommended by standard guidelines. This article reviews initial treatment with Janumet as an alternative to monotherapy.
Structure and Energetics of Poly(Ethylene Glycol) Cationized by Li+, Na+, K+ and Cs+: A First-Principles Study

Density functional theoretical methods, including several basis sets and two functionals, were used to collect information on the structure and energetic parameters of poly(ethylene glycol) (PEG), also referred to as poly(ethylene oxide) (PEO), coordinated by alkali metal ions. The oligomer chain is found to form a spiral around the alkali cation, which grows to roughly two helical turns when the oligomer size increases to about the decamer for each alkali ion. Above this size, the additional monomer units do not build the spiral further for Li+ and Na+; instead, they form less organized segments outside or next to the initial spiral. The distance of the first layer of coordinating O atoms from the alkali cation is 1.9–2.15 Å for Li+, 2.3–2.5 Å for Na+, 2.75–3.2 Å for K+ and 3.5–3.8 Å for Cs+ complexes. The number of O atoms in the innermost shell is five, six, seven and eleven for Li+, Na+, K+ and Cs+. The collision cross sections with He increase linearly with the oligomer to a very good approximation. No sign of leaning towards the 2/3 power dependence characterizing spherical particles is observed. The binding energy of the cation to the oligomer increases up to polymerization degree of about 10, where it levels off for each alkali-metal ion, indicating that this is approximately the limit of the oligomer size that can be influenced by the alkali cation. The binding energy–degree of polymerization curves are remarkably parallel for the four cations. The limiting binding energy at large polymerization degrees is about 544 kJ mol−1, 460 kJ mol−1, 356 kJ mol−1 and 314 kJ mol−1 for Li, Na, K and Cs, respectively. The geometrical features are compared with the X-ray and neutron diffraction data on crystalline and amorphous phases of conducting polymers formed by alkali-metal salts and PEG. The implications of the observations concerning collision cross sections and binding energies to ion mobility spectroscopy and mass spectrometry are discussed.
The cost–effectiveness of irbesartan for hypertension

High blood pressure is a very common problem in the adult and elderly population, both in developed and developing countries. A relatively large number of drug classes are available to treat this condition and prevent its complications, which are not only more frequent in the aforementioned patients but also those affected by metabolic syndrome and/or Type 2 diabetes. Irbesartan is an angiotensin-receptor blocker class drug with good antihypertensive efficacy and specific pharmacological characteristics, whose efficacy has been more deeply evaluated in metabolically complex hypertensive patients. In this review, the authors will analyze its effectiveness in preventing or delaying organ damage in hypertensive patients, with a closer look at the economic implications of treating hypertension with irbesartan in the context of available antihypertensive drugs.
Discrete-choice experiments versus rating scale exercises to evaluate the importance of attributes

Aim: To examine the difference between discrete-choice experiments (DCE) and rating scale exercises (RSE) in determining the most important attributes using a case study. Methods: Undergraduate health sciences students were asked to complete a DCE and a RSE. Six potentially important attributes were identified in focus groups. Fourteen unlabelled choice tasks were constructed using a statistically efficient design. Mixed multinomial logistic regression analysis was used for DCE data analysis. Results: In total, 254 undergraduate students filled out the questionnaire. In the DCE, only four attributes were statistically significant, whereas in the RSE, all attributes except one were rated four or higher. Conclusion: Attribute importance differs between DCE and RSE. The DCE had a differentiating effect on the relative importance of the attributes; however, determining relative importance using DCE should be done with caution as a lack of statistically significant difference between levels does not necessarily imply that the attribute is not important.
The indirect costs of multiple sclerosis: systematic review and meta-analysis

The aim of this systematic review is to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with multiple sclerosis. Searches were conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2014 prices US$ using the consumer price index and purchasing power parity (scenario 1) and expressed as proportion of specific gross domestic product in current local currency unit to adjust for country’s development (scenario 2). Identified studies were then analyzed in order to assess their possible inclusion in the meta-analysis. The authors identified 63 records, of which 23 were eligible for meta-analysis. Overall indirect cost per patient calculated in scenario 1 was as high as US$20,167 with US$22,197 in Europe, US$17,382 in North America and US$153 in Asia. Overall indirect cost per patient calculated in scenario 2 was equal to US$16,939, with US$19,612 in Europe, US$11,592 in North America and US$899 in Asia. Overall indirect costs varied from US$3726 for patients with EDSS score less than 3 to US$19,264 for patients with Expanded Disability Status Scale score grater that 7. This review revealed the great economic burden of multiple sclerosis on society. The authors observed a great variety of the considered components of indirect costs and their definitions. Costs were higher for Europe than for other continents and were also higher for patients with a higher Expanded Disability Status Scale score.
Cost-effectiveness of adherence-enhancing interventions: a systematic review

Abstract Low patient adherence to health-related interventions is a major barrier to achieving healthcare goals and is associated with very high avoidable costs. Although several studies suggest that adherence-enhancing interventions can improve health outcomes, economic evaluations of these interventions are scarce. Systematic reviews published to date are limited to interventions to enhance adherence to pharmaceuticals or to specific diseases and interventions. The authors’ objective was to examine the evidence regarding the cost-effectiveness of adherence-enhancing interventions in healthcare and what conclusion could be drawn about these interventions. The present systematic review included 43 original studies and assessed the current evidence regarding the cost-effectiveness of a broad array of interventions aimed at enhancing adherence to medications, medical devices, screening tests and lifestyle behaviors. The authors found that although the majority of adherence-enhancing interventions were cost-effective or cost-saving, variation exists within different intervention types. Further research on the sustainability of adherence improvements is needed in order to accurately evaluate interventions’ long-term benefits.
Concomitant presentation of two chronic leukemias: Evidence for independent clonal evolution

A case of chronic lymphocytic leukemia (CLL) occurring simultaneously with Philadelphia chromosome‐positive chronic granulocytic leukemia (CGL) in a 58‐year‐old man is described. The patient presented with typical CGL (all bone marrow mitoses having a Philadelphia chromosome), but during the course of busulfan therapy, CLL became more prominent, less than half of the bone marrow mitoses having a Philadelphia chromosome. The patient is in good clinical condition after a follow‐up of 3.5 years, and the clinical picture resembles that of typical CLL.
Safety Evaluation and Risk Assessment Using Immunotoxicology Methods

This article represents a composite of ideas expressed by the authors in a symposium, Safety Evaluation and Risk Assessment Using Immunotoxicology Methods, presented at the 1996 Annual Meeting of the American College of Toxicology. The purpose of this symposium was to examine the current s tatus of immunotoxicity assessment methodology and its application in the safety evaluation and risk assessment of drugs and chemicals. Chemicaland drug-induced ef fects on the immune s ystem are thought to be manifested by either suppression or induction of aberrant immune responses , such as hypersens itivity or allergy (National Research Council, 1992). Evidence of the immunosuppressive effects of chemicals in rodents is well established (Urso and Gengozian, 1980; Holsapple et al., 1983; Pestka et al., 1987; see review by Dean and Murray, 1991) and in humans (Bekes i et al., 1978; Lew et al., 1986; Boyer, 1989) is well documented. Experimental procedures for the assessment
An interactive augmented reality coloring book

Creating entertaining and educational books not only requires providing visually stimulating content but also means for students to interact, create, and express themselves. In this paper we present a new type of mixed-reality book experience, which augments an educational coloring book with user-generated three dimensional content. We explore a “pop-up book” metaphor and describe a process by which children's drawing and coloring is used as input to generate and change the appearance of the book content. Our system is based on natural feature tracking and image processing techniques that can be easily exploited for other AR publishing applications.
Beyond Utopia: reflections on participatory design in home-based healthcare with weak users

Motivation -- Participatory Design (PD) activities in private homes challenge how we relate to the PD process, compared to PD in professional settings. Grounded in a project related to chronic dizziness among older people, we outline four challenges. These challenges, we argue, have to be carefully addressed when PD processes include the home. Research approach -- A PD project developing rehabilitation technologies for elderly people in private homes has been used to reflect on home-based PD projects compared with more traditional, workplace-oriented PD projects such as Utopia. Findings -- We identify four challenges in home-based PD. The challenges are 1) Negotiating knowledge about the home, 2) Ill, weak users, 3) Divergent interests of participants and 4) Usable and sustainable post-project solutions. These challenges are used to reflect upon differences between a home-based PD process, such as ours with non-workers, and work-place projects, such as Utopia. Through this reflection, the paper contributes to a more general discussion on PD in non-work settings with weak users. Research limitations -- The paper is grounded in one project where the elderly participants are heavily affected by their illness. Furthermore, they have no or very little experience with ICT, e.g. computers or mobile phones. Take away message -- Differences do exist between traditional PD projects in work settings, such as Utopia, and home-based PD with weak users especially in relation to knowledge about settings and how to reconcile differences in interests. The home as a place for (technology-assisted) treatment and PD must be carefully analyzed, and diverse interests and roles should be negotiated among all stakeholders.
Measuring health-related quality of life in women on hormone replacement therapy

Hormone replacement therapy has been shown to effectively relieve postmenopausal symptoms. However, its impact on health-related quality of life is not well documented. There is no gold standard instrument available for measuring the effects of hormone replacement therapy on health-related quality of life of postmenopausal women. Furthermore, no systematic comparison of health-related quality of life measures has been undertaken within the field. An overview of the health-related quality of life measures and scales used in publications on hormone replacement therapy are reviewed. In addition, an analysis to compare the performance of two generic health-related quality of life measures, the Nottingham Health Profile and the 15D are conducted. Both measures performed well in postmenopausal women. However, only preference-based measures, such as 15D, can be used in cost–utility analyses.
Feature-adaptive GPU rendering of Catmull-Clark subdivision surfaces

We present a novel method for high-performance GPU-based rendering of Catmull-Clark subdivision surfaces. Unlike previous methods, our algorithm computes the true limit surface up to machine precision, and is capable of rendering surfaces that conform to the full RenderMan specification for Catmull-Clark surfaces. Specifically, our algorithm can accommodate base meshes consisting of arbitrary valence vertices and faces, and the surface can contain any number and arrangement of semisharp creases and hierarchically defined detail. We also present a variant of the algorithm which guarantees watertight positions and normals, meaning that even displaced surfaces can be rendered in a crack-free manner. Finally, we describe a view-dependent level-of-detail scheme which adapts to both the depth of subdivision and the patch tessellation density. Though considerably more general, the performance of our algorithm is comparable to the best approximating method, and is considerably faster than Stam's exact method.
Drug Use in Prison: the experience of young offenders

This article explores young offenders' drug use in prison. Qualitative research with inmates highlighted the importance of understanding drug use in prison as a continuum of behaviour, where inmates' drug use inside was related to their drug use before custody. The inmates made choices and decisions around their drug use inside, considering the compatibility of drugs with the prison environment and their need to seek the 'right high'. Availability of drugs was crucial and the article discusses the routes of drug supply into prison via visits and the informal prison economy, where the distribution of drugs was facilitated by close inmate friendship networks.
The Relationship between Economic Status and Child Health: Evidence from the United States.

Anne Case et al. (2002), using cross-sectional data, found a positive relationship between children's health and income, with income's protective effect increasing with age. Janet Currie and Mark Stabile (2003), using a panel of Canadian children, found that low- and high-SES children respond similarly to health shocks, but the low-SES children are subject to more shocks as they age. Our study examines this relationship using panel data for US children. We find some support for the latter result of Currie and Stabile but also evidence that low- and high-SES children respond differently to specific health shocks. (JEL D31, I12, J13)
The Victims of Court-ordered Batterers

There is relatively little research describing the victims of court-ordered batterers, compared to the extensive descriptions of the batterers themselves. The partners of men ordered to batterer programs in four cities were interviewed about their backgrounds, victimization, helpseeking, and perceptions of the batterers (N = 482). These battered women tend to be from lower economic status and educational levels. A substantial portion have also suffered severe assaults and injury. More than half of these women have previously contacted the criminal justice system in response to abuse, but only about a quarter have received any counseling for domestic violence, and less than 10% have previously visited a battered women's shelter. The women's perceptions of their batterers are overly optimistic, despite the severe abuse and information from batterer programs. The victims of court-ordered batterers appear to be different at least in terms of their helpseeking than battered women in shelters and may therefore warrant special program and research attention.
In vitro effect of tigecycline against Mycobacterium tuberculosis and a review of the available drugs for tuberculosis

The study aimed to investigate the effectiveness of a novel antibiotic drug tigecycline on clinical isolates of Mycobacterium tuberculosis and, reviewing defined anti-tuberculosis effects of available agents. Minimal inhibitory concentration (MIC) of tigecycline for 50 M. tuberculosis including multidrugresistant (MDR) clinical isolates (20 MDR isolates) was determined by broth microdilution method in the study. Tigecycline MIC values were ranging between 8 and 64 µg/ml. However, there is not any defined break point for M. tuberculosis resistance. In conclusion, it seems that the in vitro effectiveness of tigecycline to M. tuberculosis is not good but further in vivo studies are needed.
Are patients with familial hypercholesterolaemia well managed in lipid clinics? An audit of eleven clinics from the Department of Health Familial Hypercholesterolaemia Cascade Testing project

Abstract Background Familial hypercholesterolaemia (FH) is an autosomal co-dominant disorder which is relatively common, leads to high levels of LDL-cholesterol and if untreated to early coronary heart disease. An audit of current practice at National Health Service Trusts in England was undertaken to determine whether FH patients meet the diagnostic criteria for FH; are being offered appropriate advice and treatment; and to what extent their families are contacted and offered testing for the disorder. Methods Medical records of known FH patients (over 18 years of age and diagnosed before 31 December 2003) were accessed to obtain information on diagnosis, treatment and family tracing. Results The records of 733 FH patients were examined, 79% met the UK ‘Simon Broome’ register criteria for the diagnosis of definite or possible FH. Analyses showed that patients were usually offered appropriate advice and treatment, with 89% being on a statin. However, the audit indicated a high variability in family tracing between the sites, with significant differences in the frequency of inclusion of a family pedigree in the notes (range 1–71%, mean 35%); the general practitioner (GP) being advised that first-degree relatives should be tested (range 4–52%, mean 27%); and the proportion of relatives contacted and tested (range 6–50%, mean 32%). Conclusion FH patients are well cared for in lipid clinics in England, are being given appropriate lifestyle advice and medication, but an increase in recording of LDL-cholesterol levels may lead to improvements in their management. Practice in family tracing appears to vary widely between clinics.
Lipid Profile of Cigarette Smokers in Calabar Municipality

Since it has been proven that high levels of LDL-Cholesterol predispose individuals to the risk of coronary heart disease, and that cigarette smoke contains toxicants that can disrupt normal metabolic processes, the present work was carried out to assess the lipid levels of smokers in Calabar, Nigeria. Total Cholesterol and triglyceride estimations were carried out using the enzymatic end point kit method. HDL- Cholesterol was estimated by precipitation of non-HDL lipoproteins, and estimations done, using the supernatant. Both LDL and VLDL were estimated by Calculation. Fifty (50) smokers and twenty (20) non- smokers were recruited for the study. The findings showed that the difference in mean total cholesterol level between smokers (5.26±0.93mmol/L) and non smokers (4.06±0.38mmol/L) was statistically significant (p<0.05). The mean HDL - Cholesterol level of Smokers was (1.45±0.54mmol/L) and that for non-smokers (1.15±0.03 mmol/L). There was no statistically significant difference in the levels of LDL-Cholesterol between the Smokers (3.27±0.42mmol/L) and non smokers (2.37±0.15mmol/L) (p <0.05). The VLDL-Cholesterol and total triglyceride values were (0.57±0.07mmol/L) and (1.22±0.27mmol/l) respectively for smokers and (0.57±0.02mmol/L) and (1.25±0.09 mmol/L) respectively for non-smokers. Among the smokers, the VLDL- Cholesterol + LDL-Cholester ol Value of (3.84±0.49mmo l/L) was found to be statistically significant when compared with the (2.94±0.17mmol/L) value obtained for the non-smokers (P<0.05). These findings indicate that the risk of coronary heart disease may exist in smokers even when HDL-cholesterol levels are within the normal range and as such public enlightenment programmes should be stepped up to create awareness on the dangers of cigarette smoking.
Non-Pharmacological Management of Hand Osteoarthritis: From A Perspective of Physiatry

Hand Osteoarthritis (OA) is a common disorder, particularly among female population aged 55 and above. It presents with pain and bony enlargements of the finger joints. Management of hand OA is based particularly on the non-pharmacological methods. These include joint protection education, use of splints intrapeziometacarpal joint OA and thermal agents for relief of pain and stiffness. In this article, a literature review was performed on the nonpharmacological management of hand OA, as a means of updating the current knowledge and revealing the level of evidence regarding the non-pharmacological modalities used for hand OA. Meta-analysis, systematic reviews, reviews and randomized controlled trials were included, whereas single case reports and non-randomized studies were excluded. In non-pharmacological management of hand OA, current evidence supports the beneficial effects of joint protection education, exercise treatment, splinting and heat application, whilst evidence on electrotherapy, aquatherapy, balneotherapy remains low. Magnetotherapy, yoga and acupuncture still require further well-designed studies with high methodological quality.