Miracle-dz/UniFAR-FTUs huggingface dataset:
An Observational Study to Evaluate Efficacy and Safety of Anti-TNF Agents in Patients with Moderate to Severe Psoriasis

Background: With the introduction of novel therapeutics, evaluation of efficacy becomes critical to prioritize therapeutic potential and minimize patient risk in psoriasis. Methods: A total of 86 patients with moderate to severe psoriasis receiving antitumor necrosis factor (TNF) treatment were included in a 24-week, national, multi-center, observational study to evaluate efficacy and safety of antiTNF agents. Efficacy was evaluated via psoriasis area and severity index (PASI) and static/dynamic photographic physician psoriasis global assessment (PGA). Patient-reported outcomes for dynamic photographic scale, dermatology life quality index (DLQI), and work productivity and activity impairment questionnaire-psoriasis (WPAI-PSO) were also recorded. Results: Median (interquartile range) psoriasis area and severity index score significantly decreased from 20 (15) to 2 (5); and 70.9% of the patients had a ≥ 75% reduction in at week 24 (p <0.05). Baseline median (interquartile range) DLQI score has decreased from 16 (10) to 1.5 (7) at week 24 (p <0.001), with no or minimal impact on patients’ lives in 72.1% of the patients. PASI reduction was significantly correlated to DLQI reduction and reductions in presenteeism, WPAI-PSO. Clear or almost clear psoriatic lesions were reported in 60.5% of patients and dynamic PGA revealed median alteration in psoriasis severity to be 1.5 (3) at week 24. Adverse events were noted in 17.4% of the patients and most were mild or moderate (57.7%). Conclusions: Our findings presenting reduction in disease severity, disappearance of psoriatic lesions, and improvement in DLQI and WPAI-PSO indicate 24-week anti-TNF therapy to be safe and effective in the control of moderate to severe psoriasis.
Tissue oxygenation in hemorrhagic shock measured as transcutaneous oxygen tension, subcutaneous oxygen tension, and gastrointestinal intramucosal pH in pigs

Background and MethodsTissue oxygenation, measured in peripheral tissue as transcutaneous Po2 (Ptco2) and subcutaneous Po2, was compared with the oxygenation in GI mucosa, which was measured as intramucosal wall pH (pHi), during experimental hemorrhagic shock and resuscitation in pigs. The pigs were hemorrhaged stepwise to a BP of 80 and 45 mm Hg, followed by retransfusion. Ptco2 was measured in the groin and subcutaneous Po2 was measured in the hip region. Intraluminal Pco2 was measured in the stomach, in the small intestine, and the sigmoid colon using silicone catheters. A simultaneous determination of arterial blood HCO3 concentration allowed pHi to be calculated using Henderson-Hasselbalch equation. Cardiac output was determined by thermodilution, and oxygen delivery (Do2) was calculated. ResultsEarly indications of shock were decreases in Ptco2 and intestinal pHi (p < .01). All measured variables decreased at the second step of bleeding. Ptco2 and subcutaneous Po2 was correlated to Do2 through the entire experiment (r2 = .25 and .49, respectively). Also, the pHi of the small intestine and the sigmoid colon correlated with Do2 (r2 = .36 and .25, respectively). Ptco2 and subcutaneous Po2 correlated with pHi in the small intestine and sigmoid colon. ConclusionsPtco2 and pHi in the small intestine and sigmoid colon were the variables that most rapidly indicated blood volume loss. Subcutaneous Po2 and Ptco2, and small intestine and sigmoid colon pHi were correlated to total body oxygen transport. Peripheral tissue perfusion followed intestinal perfusion to some extent. (Crit Care Med 1991; 19:205)
Expression of Familial Alzheimer’s Disease-Linked Human Presenilin 1 Variants Impair Enrichment-Induced Adult Hippocampal Neurogenesis

Presenilin 1 (PS1) plays a critical role in neurogenesis both during development and in the adult. We recently reported that ubiquitous expression of familial, early-onset Alzheimer’s disease-linked PS1 mutants impairs enrichment-induced proliferation and neurogenesis of hippocampal neural progenitor cells (NPCs) in a non-cell autonomous manner. The impairments in proliferation and neurogenesis are, at least in part, due to alterations in the levels of specific chemokines and growth factors secreted from microglia expressing familial Alzheimer’s disease-linked PS1 variants. To test our hypothesis that the fate of hippocampal NPCs in PS1 mutant mice is largely determined by cellular factors produced within the niche itself, we are examining the fate of NPCs from hippocampi of wild-type human PS1 or PS1 mutant mice that are marked with green fluorescent protein and BrdU following transplantation into heterologous hosts. In parallel, we have generated transgenic mice that harbor a transgene encoding the PS1ΔE9 variant flanked with loxP sites that can be conditionally deleted in a temporal and/or spatial manner using specific cre driver lines. These studies will allow us to assess the contributions of varying cell types within the hippocampal stem cell niche that express mutant PS1 to NPC proliferation and differentiation.
Predictors and outcomes of early coronary angiography in patients with prior coronary artery bypass surgery presenting with non-ST elevation myocardial infarction

Introduction The best strategy in patients with prior coronary artery bypass graft surgery (CABG) who present with non-ST elevation myocardial infarction (NSTEMI) remains less well defined. We compare the characteristics, therapeutic interventions and outcomes of patients with prior CABG presenting with NSTEMI. Methods All patients who presented to our hospital during 2007–2012 with available electronic records were analysed retrospectively. Outcomes were compared between patients who underwent coronary angiography or percutaneous coronary intervention (PCI) versus those who were treated medically. Results A total of 117 patients were analysed. Of that, 79 patients were managed medically while 38 underwent early angiography, of which only 11 (9.5%) received PCI. Patients treated medically (did not undergo angiography) were older (74±10 vs70±8; p=0.05). ECG changes were the only independent predictor for early angiography (OR 0.4, 95% CI 0.15 to 0.99; p=0.05) while recurrent chest pain (OR 0.2, 95% CI 0.05 to 0.97; p=0.05) predicted PCI on multivariate analysis. The PCI group had higher Global Registry of Acute Cardiac Events (GRACE) score (176±29 vs 150±31; p=0.01). No significant difference was found in readmission rates, morbidity (unstable angina pectoris, NSTEMI, ST elevation myocardial infarction (STEMI), or combination) or mortality at 12 months between the groups who underwent angiography, PCI, or treated medically on univariate and multivariate analysis. Conclusions The opportunity to intervene in prior CABG patients presenting with NSTEMI is often low. Initial medical management may be a reasonable option in carefully selected patients particularly in the absence of ongoing symptoms, ECG changes or very high GRACE scores. Further studies are required to evaluate the safety of non-invasive strategies in managing this population.
Using Diffusion of Innovations Theory to Implement the Confusion Assessment Method for the Intensive Care Unit

Routine screening of mechanically ventilated patients for delirium is essential for prompt recognition and management; however, this represents a change in practice. Rogers' Diffusion of Innovations Theory can be useful as a strategy to facilitate adoption of a practice change. This case study describes the effectiveness of identifying barriers to a change in practice and developing strategies, specific to Rogers' innovation decision process, for implementing the Confusion Assessment Method for the intensive care unit.
Clinical Nosologic and Genetic Aspects of Joubert and Related Syndromes

Joubert syndrome is an autosomal-recessive disorder characterized by cerebellar hypoplasia, hypotonia, developmental delay, abnormal respiratory patterns, and abnormal eye movements. The biochemical and genetic basis of Joubert syndrome is unknown and a specific chromosomal locus for this disorder has not been identified. Review of this disorder and related syndromes suggests that (1) hypoplasia of the cerebellar vermis in Joubert syndrome is frequently associated with a complex brain stem malformation represented as the "molar tooth sign" on magnetic resonance imaging, (2) the "molar tooth sign" could be present in association with the Dandy-Walker malformation and occipital encephalocele, (3) cerebellar hypoplasia is present in conditions related to Joubert syndrome such as Arima syndrome; Senior-Loken syndrome; cerebellar vermian hypoplasia, oligophrenia, congenital ataxia, coloboma, and hepatic fibrosis syndrome; and juvenile nephronophthisis due to NPH1 mutations, and (4) the brainstem-vermis malformation spectrum is probably caused by at least two and probably several genetic loci. We have ascertained previously a cohort of 50 patients with a putative diagnosis of Joubert syndrome in order to evaluate the presence of associated malformations, and to initiate studies leading to the identification of genes causing Joubert and related syndromes. Among the associated malformations found in patients ascertained as having Joubert syndrome, 8% of patients had polydactyly, 4% had ocular colobomas, 2% had renal cysts, and 2% had soft-tissue tumors of the tongue. The WNT1 gene has been tested as a candidate gene for Joubert syndrome based on its expression in the developing cerebellum and an associated mutation in the swaying mouse. A search for mutations in WNT1 in a series of patients with Joubert syndrome did not detect mutations at this locus. This analysis suggested that mutations in WNT1 might not have a significant role in Joubert syndrome, and other functional candidate genes related to development of the cerebellum need to be examined. A genome-wide linkage analysis carried out in 10 Joubert syndrome pedigrees did not identify a specific chromosomal locus for this disorder. This observation, along with those from clinical studies, provides further evidence that Joubert and related syndromes are genetically heterogeneous. (J Child Neurol 1999;14:660-666).
A thermodynamic analysis of the SO 2 /H 2 SO 4 system in SO 2 -depolarized electrolysis

The hybrid sulfur thermochemical cycle has been proposed as a means to produce efficiently massive quantities of clean hydrogen using a high-temperature heat source like nuclear or solar. The cycle consists of two steps, one of which is electrolytic. The reversible cell potential for this step and, hence, the resulting operating potential will depend on the concentrations of dissolved SO2 and sulfuric acid at the electrode. To understand better how these are related as functions of temperature and pressure, an Aspen Plus phase equilibrium model using the OLI Mixed Solvent Electrolyte physical properties method was employed to determine the activities of the species present in the system. These activities were used in conjunction with the Nernst equation to determine the reversible cell potential as a function of sulfuric acid concentration, temperature and pressure. A significant difference between the reversible and actual cell potentials was found, suggesting that there may be considerable room for reducing the operating potential.
THE SIZES OF MASSIVE QUIESCENT AND STAR-FORMING GALAXIES AT z ∼ 4 WITH ZFOURGE AND CANDELS

We study the rest-frame ultraviolet (UV) sizes of massive ( ∼ 0.8 × 10 11 M ☉ ? > ) galaxies at 3.4 ≤ z < 4.2 ? > , selected from the FourStar Galaxy Evolution Survey, by fitting single Sérsic profiles to Hubble Space Telescope/WFC3/F160W images from the Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey. Massive quiescent galaxies are very compact, with a median circularized half-light radius r e = 0.63 ± 0.18 ? > kpc. Removing 5 / 16 ? > (31%) sources with signs of active galactic nucleus activity does not change the result. Star-forming galaxies have r e = 2.0 ± 0.60 ? > kpc, 3.2 ± 1.3 × ? > larger than quiescent galaxies. Quiescent galaxies at z ∼ 4 ? > are on average 6.0 ± 1.7 × ? > smaller than at z ∼ 0 ? > and 1.9 ± 0.7 × ? > smaller than at z ∼ 2 ? > . Star-forming galaxies of the same stellar mass are 2.4 ± 0.7 × ? > smaller than at z ∼ 0 ? > . Overall, the size evolution at 0 < z < 4 ? > is well described by a power law, with r e = 5.08 ± 0.28 ( 1 + z ) − 1.44 ± 0.08 ? > kpc for quiescent galaxies and r e = 6.02 ± 0.28 ( 1 + z ) − 0.72 ± 0.05 ? > kpc for star-forming galaxies. Compact star-forming galaxies are rare in our sample: we find only 1 / 14 ⁢ ? > (7%) with r e / ( M / 10 11 M ☉ ) 0.75 < 1.5 ? > , whereas 13 / 16 ? > (81%) of the quiescent galaxies are compact. The number density of compact quiescent galaxies at z ∼ 4 ? > is 1.8 ± 0.8 × 10 − 5 Mpc − 3 ? > and increases rapidly, by > 5 × ? > , between 2 < z < 4 ? > . The paucity of compact star-forming galaxies at z ∼ 4 ? > and their large rest-frame UV median sizes suggest that the formation phase of compact cores is very short and/or highly dust obscured.
A Study of Online Perceived Value in Vietnamese Low Cost Carriers Market

For the first time in over 30 years, Vietnam Airlines – the biggest airline in Vietnam – announces they still have plenty tickets left for people travelling before and after Lunar New Year 2013, thanks to the fierce competition from low cost carriers (LLCs) such as Vietjet Air, Jetstar Pacific and Mekong Air. The emergence of low cost carriers and the popularity of Internet in Vietnam have dramatically changed how Vietnameses travel nowadays. This study examines online service attributes that determine the perceived value of online transactions. In doing so, we address the concerns that LCCs have in matching expectations and perceptions of Vietnamese consumers towards online flight ticket purchases. The result from study found that some of the antecedents are very different to previous findings in other markets. Therefore the findings have implications for managerial decision makers in low cost carriers charged with the responsibility of increasing perceived value of their service through online consumer engagement.
Reproductive studies in ipecac (Psychotria ipecacuanha (Brot.) stockes; Rubiaceae): pollen development and morphology

The aim of this work was to carry out the reproductive studies on Brazilian accessions of ipecac, Psychotria ipecacuanha. It presented heterostyly, with brevistylous and longistylous flowers. The pollen development was observed from the sections of the anthers embedded in resin. Anther development was normal as usually observed in dicotyledones, displaying four layers: outer epidermis, endothecium, middle layer and inner tapetum. The pollen was bicellular and filled with starch at the microspore stage. Pollen morphology was studied using SEM, which showed pollen polymorphism within and between the two floral morphs. Five types of pollen with reticulate or perforate exine were identified. The characteristics showed that the sexual process was as important as the vegetative propagation for the reproduction of this species.
Mass treatment/prophylaxis during an outbreak of infectious syphilis in Vancouver, British Columbia.

Syphilis is a sexually transmitted disease (STD) caused by the spirochete Treponema pallidum which is restricted to humans. Transmission occurs primarily during the infectious phase which consists of primary, secondary, and early latent syphilis. Primary syphilis is characterized by a painless ulcer approximately 3 weeks after exposure. Secondary syphilis is characterized by a generalized eruption 4 to 6 weeks after the primary stage in untreated patients. After weeks or several months, secondary manifestations resolve and about one-third of untreated cases become clinically latent sometimes leading to late manifestations involving the cardiovascular system, the central nervous system, skin, bones, and viscera. A diagnosis of early latent syphilis is made when the clinical situation and nontreponemal antibody titres reflect recent infection for which aggressive follow-up is necessary. Perinatal transmission can occur, especially during the infectious phase. The diagnosis of syphilis relies on clinical examination, darkfield demonstration of spirochetes in lesion exudate, nonspecific treponemal antibody tests (rapid plasma reagin test and Venereal Disease Research Laboratory test), and specific treponemal antibody tests (microhemagglutination for Treponema pallidum and fluorescent treponemal antibody absorption test). The current treatment of choice is intramuscular benzathine penicillin G.
Impacts of a provincial asthma guidelines continuing medical education project: The Ontario Asthma Plan of Action's Provider Education in Asthma Care Project.

BACKGROUND The Ontario Ministry of Health and Long-Term Care funded the Ontario Lung Association to develop and implement a continuing medical education program to promote implementation of the Canadian asthma guidelines in primary care. OBJECTIVES To determine baseline knowledge, preferred learning format, satisfaction with the program and reported impact on practice patterns. METHODS A 3 h workshop was developed that combined didactic presentations and small group case discussions. Outcome measures included a workshop evaluation, baseline assessment of asthma management knowledge and three-month postreflective evaluations. RESULTS One hundred thirty-seven workshops were delivered to 2783 primary care providers (1313 physicians, 1470 allied health) between September 2002 and March 2005. Of the 2133 participants, 1007 physicians and 1126 allied health professionals submitted workshop evaluations. Most (98%) of the attendees indicated they would recommend the workshop to a colleague. The majority preferred the combination of didactic lecture plus interactive case discussions. A subset of physicians provided consent to use these data for research (n=298 pediatric and 288 adult needs assessments; n=349 postreflective evaluations). Important needs identified included appropriate medication for chronic asthma and development of written action plans. On the postreflective evaluations, 88.7% remained very satisfied, 95.5% reported increased confidence, 91.9% reported an influence on practice and 67.2% reported using a written action plan. CONCLUSIONS This continuing medical education program addresses identified needs of primary care providers. Participants reported improvements in asthma care, including prescribing practices, use of spirometry and written action plans. Similar programs should be considered as part of multifaceted asthma guidelines dissemination and implementation initiatives in other provinces and nationally.
The lipopolysaccharide-triggered mesangial transcriptome: Evaluating the role of interferon regulatory factor-1.

BACKGROUND Presently, we do not have a clear picture of how the mesangial transcriptome evolves following stimulation. The present study was designed to address this, using an innate trigger to stimulate murine mesangial cells. METHODS Three independent mesangial cell lines derived from C57BL/6 mice were stimulated with lipopolysaccharide (LPS). The mesangial cell transcriptomes were defined 1, 6, 24, and 60 hours poststimulation with LPS, using a 17,000 gene oligonucleotide array. RESULTS Interferon regulatory factor-1 (IRF-1), ScyA2/MCP1, ScyA20/MIP3alpha (ScyB1/Gro1, and ScyB2/MIP2alpha/Gro2 were the earliest genes to be hyperexpressed after LPS stimulation. Later-appearing genes included ScyA7/MCP3, ScyD1/fractalkine, GM-CSF/CSF-2, PDGF, epiregulin, NfKb, C/EBP, TIMP-1, MMP11, MMP13, PTGS2/COX2, SpI2-1, Spp1, PAI-1, VCAM-1, C3, and defensin-beta1, among others. Several of these changes were validated by real-time polymerase chain reaction (PCR) or enzyme-linked immunosorbent assay (ELISA). Rapid IRF-1 hyperexpression was also noted following stimulation of mesangial cells with peptidoglycan, poly I:poly C, interferon-gamma? (IFN-gamma), and heat-aggregated IgG. However, the blocking of IRF-1 using RNA interference and the use of mesangial cells isolated from IRF-1-deficient mice could not substantiate an obligatory role for IRF-1 in LPS-induced mesangial cell activation. Likewise, IRF-1 deficiency did not impact the development of anti-glomerular basement membrane (GBM)-induced immune nephritis. CONCLUSION Innate stimuli such as LPS appear to trigger successive waves of mesangial cell gene expression. Although IRF-1 surfaces as an "early-on, early-off" transcription factor following several different triggers, it does not appear to be an essential molecule for mesangial cell activation by innate triggers or for anti-GBM disease.
Prevalence of Neuropathy in Newly Diagnosed NIDDM and Nondiabetic Control Subjects

We evaluated the prevalence of peripheral neuropathy by clinical and electrophysiological criteria and the prevalence of autonomic parasympathetic nerve dysfunction by heart-rate variation during deep breathing (expiration-to-inspiration ratio [E:I]) in 132 newly diagnosed non-insulin-dependent diabetic (NIDDM) subjects aged 45–64 yr and 142 randomly selected nondiabetic control subjects. The relationship of nerve dysfunction to the degree of hyperglycemia and insulin-secretion capacity were also investigated. Single and scattered symptoms and signs of peripheral neuropathy were found in both diabetic and control subjects. Symptomatic polyneuropathy was found in 1.5% of diabetic subjects but none of the control subjects. Polyneuropathy defined by clinical signs was found in 2.3% of the diabetic subjects and 1.4% of the control subjects. No subjects with both symptoms and signs were seen. Nerve conduction velocities (NCVs) were significantly slower in diabetic than control subjects. Polyneuropathy according to electrophysiological criteria was found in 15.2% of diabetic subjects but was not found in any control subjects. Electromyographic abnormalities were more common in diabetic than control women, but no significant differences were found in men. The resting heart rate was higher in diabetic than control women, but no significant difference was found in men. The mean E:I was significantly lower in diabetic men and women than control men and women. An abnormally low E: I was found in 9.2% of the diabetic men, 3.3% of the control men, 3.3% of the diabetic women, and none of the control women. NCV parameters, but not E:I, were inversely correlated with fasting blood glucose and glycosylated hemoglobin levels. A positive correlation between NCV and fasting and postglucose serum insulin levels was found in both groups. These results show that clinical diabetic neuropathy is not common at diagnosis of NIDDM, but disturbances in peripheral and autonomic nerve function, detected by electrophysiological and cardiovascular reflex methods, are often present at that stage of the disease. The prevalence of neuropathy is also highly dependent on the criteria used. The degree of peripheral nerve dysfunction was associated with the degree of hyperglycemia, but an association between glycemic control and autonomic dysfunction could not be demonstrated.