Miracle-dz/UniFAR-FTUs huggingface dataset:
Rates of Diabetic Ketoacidosis: International Comparison With 49,859 Pediatric Patients With Type 1 Diabetes From England, Wales, the U.S., Austria, and Germany

OBJECTIVE Diabetic ketoacidosis (DKA) in children and adolescents with established type 1 diabetes is a major problem with considerable morbidity, mortality, and associated costs to patients, families, and health care systems. We analyzed data from three multinational type 1 diabetes registries/audits with similarly advanced, yet differing, health care systems with an aim to identify factors associated with DKA admissions. RESEARCH DESIGN AND METHODS Data from 49,859 individuals <18 years with type 1 diabetes duration ≥1 year from the Prospective Diabetes Follow-up Registry (DPV) initiative (n = 22,397, Austria and Germany), the National Paediatric Diabetes Audit (NPDA; n = 16,314, England and Wales), and the T1D Exchange (T1DX; n = 11,148, U.S.) were included. DKA was defined as ≥1 hospitalization for hyperglycemia with a pH <7.3 during the prior year. Data were analyzed using multivariable logistic regression models. RESULTS The frequency of DKA was 5.0% in DPV, 6.4% in NPDA, and 7.1% in T1DX, with differences persisting after demographic adjustment (P < 0.0001). In multivariable analyses, higher odds of DKA were found in females (odds ratio [OR] 1.23, 99% CI 1.10–1.37), ethnic minorities (OR 1.27, 99% CI 1.11–1.44), and HbA1c ≥7.5% (≥58 mmol/mol) (OR 2.54, 99% CI 2.09–3.09 for HbA1c from 7.5 to <9% [58 to <75 mmol/mol] and OR 8.74, 99% CI 7.18–10.63 for HbA1c ≥9.0% [≥75 mmol/mol]). CONCLUSIONS These multinational data demonstrate high rates of DKA in childhood type 1 diabetes across three registries/audits and five nations. Females, ethnic minorities, and HbA1c above target were all associated with an increased risk of DKA. Targeted DKA prevention programs could result in substantial health care cost reduction and reduced patient morbidity and mortality.
[Triptolide combined with irbesartan synergistically blocks podocyte injury in a type 2 diabetes rat model].

OBJECTIVE To investigate the protective effect of combination of triptolide and irbesartan on the podocytes in a type 2 diabetic(T2DM) rat model, and evaluate its mechanism. METHODS T2DM rats were induced by fed with high-sucrose-high-fat diet combined with a low dose of streptozocin. The rats were randomly divided into 5 groups: normal control group (NC, n = 10), diabetes group (DM, n = 11), triptolide treatment group (DT, n = 12), irbesartan treatment group (DI, n = 12) and triptolide combined with irbesartan treatment group (DTI, n = 13). Ultrastructure of podocytes was observed by electronic microscopy and urinary albumin (UAL) excretion by ELISA was determined after 8 weeks. The expression of nephrin and bone morphogenetic protein-7 (BMP-7), connective tissue growth factor (CTGF), transforming growth factor (TGF)β(1) mRNA and proteins were detected by immunohistochemistry, real-time PCR and Western blot. RESULTS Increased UAL was significantly attenuated in all treatment groups. Compared to NC group, UAL in DM group was increased significantly (0.45 ± 0.09 vs 6.36 ± 0.87, P < 0.01), while decreased in triptolide or irbesartan alone treatment group (2.48 ± 0.37 and 2.68 ± 0.42, both P < 0.01). Compared with those in control groups, kidney expression of nephrin, BMP-7 mRNA and proteins were downregulated while CTGF, TGFβ(1) mRNA and proteins were significantly upregulated in T2DM rats. Triptolide or irbesartan each alone moderately ameliorated albuminuria and podocyte damage. However, their combined usage showed a dramatic therapeutic synergism, manifested by prevention of progressive albuminuria, restoration of the glomerular filtration barrier, reversal of the decline in slit diaphragm proteins, reduction expression of CTGF, TGFβ(1), and upregulation of BMP-7. CONCLUSION Our findings show that triptolide can increase the efficacy of irbesartan, leading to a more effective prevention of kidney disease in T2DM rat model, which may through upregulation of BMP-7 and inhibition the over-expression of CTGF and TGFβ(1).
Neutrophils in acidotic haemodialysed patients have lower intracellular pH and inflamed state.

BACKGROUND The effect of intracellular pH (pHi) on neutrophils has not been clearly defined. METHODS We used pre-dialysis neutrophils from three groups of haemodialysis (HD) patients having different levels of pre-dialysis plasma bicarbonate concentrations (PHCO3) and pH values (pre-dialysis PHCO3 of groups A, B and C were consistently<or=21, 21-26 and>or=26 mmol/l [mEq/l], respectively) and neutrophils from age- and sex-matched healthy controls to determine pHi, apoptosis, phagocytosis and oxidative burst reactions in vivo. We also studied, in group A, the effect of metabolic acidosis correction on neutrophil function. Furthermore, we investigated the effect of intracellular acidification on neutrophil functioning in vitro. RESULTS Neutrophils from the HD patients in group A exhibited significantly lower pHi than those in groups B and C. In addition, group A neutrophils had significantly delayed apoptosis, enhanced phagocytosis and increased oxidative burst reactions compared with those in groups B and C. These alterations in neutrophil function in group A were reduced by correcting metabolic acidosis over a period of 1 month. Moreover, our in vitro studies demonstrated that the pHi of neutrophils is positively correlated with apoptosis and inversely correlated with phagocytosis and oxidative burst reactions. CONCLUSION HD patients having low PHCO3 exhibited low neutrophil pHi. This intracellular acidification may contribute to the delayed apoptosis, enhanced phagocytosis and increased oxidative burst reactions observed in these neutrophils compared with neutrophils having normal or higher pHi.
Novel molecular pathways in Gorham disease: Implications for treatment

Rapid advances in evidence‐based treatment schedules are a hallmark of modern oncology. In rare neoplastic diseases, however, clinical expertise is hard to build and evidence based on randomized trials almost impossible to collect. Gorham disease is a rare form of lymphatic proliferation accompanied by osteolysis, which usually occurs in young adults. Despite the fact that the clinical course of Gorham disease is often devastating and occasionally fatal, insights into its biological background are sparse and standardized treatment unavailable. Interestingly, recent knowledge on the mechanisms of lymphangiogenesis may help elucidate the pathophysiology of Gorham disease and lead to novel treatment targets. Here, we discuss our current understanding of Gorham disease, discuss established and emerging therapeutic strategies, and attempt to frame a treatment rationale. Pediatr Blood Cancer 2014;61:401–406. © 2013 Wiley Periodicals, Inc.
The Short- and Long-Term Benefit in Chronic Low Back Pain Through Adjuvant Electrical Versus Manual Auricular Acupuncture

Acupuncture is an established adjuvant analgesic modality for the treatment of chronic pain. Electrical stimulation of acupuncture points is considered to increase acupuncture analgesia. In this prospective, randomized, double-blind, controlled study we tested the hypothesis that auricular electroacupuncture (EA) relieves pain more effectively than conventional manual auricular acupuncture (CO) in chronic low back pain patients with insufficient pain relief (visual analogue scale [VAS] ≥5) treated with standardized analgesic therapy. Disposable acupuncture needles were inserted in the auricular acupuncture points 29, 40, and 55 of the dominant side and connected to a newly developed battery-powered miniaturized stimulator worn behind the ear. Patients were randomized into group EA (n = 31) with continuous low-frequency auricular EA (1 Hz biphasic constant current of 2 mA) and group CO (n = 30) without electrical stimulation (sham-electroacupuncture). Treatment was performed once weekly for 6 wk, and in each group needles were withdrawn 48 h after insertion. During the study period and a 3-mo follow-up, patients were asked to complete the McGill questionnaire. Psychological well being, activity level, quality of sleep, and pain intensity were assessed by means of VAS; moreover, analgesic drug consumption was documented. Pain relief was significantly better in group EA during the study and the follow-up period as compared with group CO. Similarly, psychological well-being, activity, and sleep were significantly improved in group EA versus group CO, the consumption of analgesic rescue medication was less, and more patients returned to full-time employment. Neuropathic pain in particular improved in patients treated with EA. There were no adverse side effects. These results are the first to demonstrate that continuous EA stimulation of auricular acupuncture points improves the treatment of chronic low back pain in an outpatient population.
Phase I study of thiotepa in combination with the glutathione transferase inhibitor ethacrynic acid.

The glutathione transferases comprise a family of isoenzymes, one or more of which are involved in the conjugation of alkylating agents to glutathione (GSH). Increased GSH transferase activity has been shown to underlie acquired resistance to several alkylating agents. Ethacrynic acid inhibits the isoenzymes of GSH transferase with 50% inhibitory concentration values ranging from 0.3 to 6.0 microM and has been shown to restore sensitivity to alkylating agents in drug-resistant animal tumor models. We entered 27 previously treated patients with advanced cancer on a study of ethacrynic acid (25 to 75 mg/m2 p.o. every 6 h for 3 doses) and thiotepa (30 to 55 mg/m2 i.v. 1 h after the second dose of ethacrynic acid). The major toxicity of ethacrynic acid was diuresis, which was observed at every dose level; in addition, severe metabolic abnormalities occurred at 75 mg/m2. At 50 mg/m2, the diuretic effects were manageable. Myelosuppression was the most important effect of the combination. Two of seven courses of ethacrynic acid, 50 mg/m2, and thiotepa, 55 mg/m2, were associated with grade 3 or 4 neutropenia and/or thrombocytopenia. Nausea/vomiting greater than or equal to grade 2 was observed in 16% of courses. GSH transferase activity was assayed spectrophotometrically in the peripheral mononuclear cells of all patients. At each dose level, activity decreased following ethacrynic acid administration, with recovery by 6 h. Administration of ethacrynic acid, 50 mg/m2, resulted in a mean nadir of transferase activity of 37% of control. The pharmacokinetics of thiotepa and its principal metabolite TEPA were studied in 23 patients. The plasma disappearance of thiotepa fit a two-compartment open model with a terminal half-life of approximately 2 h. Plasma TEPA levels peaked at a mean of 2.16 h following thiotepa administration. The harmonic mean terminal half-life of TEPA was 10.4 h, and the TEPA area under the curve (AUC) did not increase with increasing thiotepa dose. The AUC of thiotepa was approximately twice, and the clearance about one-half, of the values obtained in a previous study of single agent thiotepa. The AUC of TEPA was lower than that previously observed. The data suggest that ethacrynic acid inhibits enzymes involved in the metabolic disposition of thiotepa, including its oxidative desulfuration to TEPA. The severity of the platelet toxicity was correlated with the AUC of thiotepa, but not with that of TEPA. This combination of thiotepa and ethacrynic acid will be tested further in Phase II trials.
Influence of variation of liquidity in asset pricing: panel analysis of the brazilian market for the period january 2000 to june 2008

The influence of liquidity on return on assets has been subject of much research in recent years, from the point of view of individual assets as well as considering the liquidity of the market as a whole. This study aims to evaluate the influence of change in liquidity in the pricing of assets. The measures of liquidity consisted of variations in the quantity of securities, in the number of trades and in financial volume, as well as these variables weighted by the Bovespa index and also the same variables lagged. The sample is made up of the shares traded in the Sao Paulo Stock Exchange. Monthly data were collected for the period of January 2000 through June 2008. The results show that return on assets is positively influenced by the Bovespa index and by variations in liquidity. In general, it is the companies with the lower liquidity levels that show the highest positive variations of their own liquidity, therefore, having higher returns.
Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta‐analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion

Aims Continuous subcutaneous insulin infusion (CSII) is a recommended treatment for reducing severe hypoglycaemia in Type 1 diabetes, but the change in hypoglycaemia compared with multiple daily insulin injections (MDI) is unclear. We therefore conducted a meta‐analysis comparing severe hypoglycaemia and glycaemic control during CSII and MDI.
Analysis of RAD51 polymorphism and BRCA1 mutations in Polish women with breast cancer.

AIM Breast cancer is one of the major killers worldwide. The objectives of this study were to determine the frequency of BRCA1 germ-line mutations and the RAD51 G/C polymorphism in patients with breast cancer. METHODS 100 breast cancer women provided blood for mutation analysis. Blood samples age matched healthy individuals (n = 106) served as control. The G/C polymorphism and BRCA1 mutations were determined by PCR-RFLP methods. RESULTS The distribution of the genotypes of the G/C polymorphism RAD51 in both control and patients did not differ significantly from those predicted by the Hardy - Weinberg distribution. There were no significant differences in the genotype distributions and allele frequencies between node-positive and node-negative patients. In present study one Ex20insC mutations of BRCA1 gene was identified in women with breast cancer. CONCLUSION Our study implies that the G/C polymorphism of the RAD51 gene may not be directly involved in the development and=or progression of breast cancer.
Using a STATCOM to retire urban generation

Austin Energy is a municipally owned electric utility located in Austin, Texas and is a part of the Electric Reliability Council of Texas (ERCOT). Austin Energy's ten year energy resource plan calls for the Holly power plant to be retired by December 31, 2007. The Holly plant is being retired due to its age and reduced use, the availability of more cost effective internal generation now under construction at the Sand Hill Energy Center, the availability of excess generation in Texas, and the plant's less than desirable location next to a residential neighborhood. The power plant has been kept in operation largely to provide voltage support in case of a contingency that causes a depression in system voltage, also known as reliability must run generation (RMR). Austin Energy searched for an innovative FACTS solution to meet both reliability and environmental requirements and selected a STATCOM solution to provide the dynamic voltage support that the power plant had provided in the past.
Value creation of EVA and traditional accounting measures: Indian evidence

Purpose - – The purpose of this paper is to examine the superiority of economic value added (EVA) over the traditional accounting performance measures, i.e. earnings per share, return on assets and return on equity. For this purpose, the relative and incremental information content of EVA and accounting measures are tested by examining the relationship of these measures with stock returns. Design/methodology/approach - – The analysis is performed for a sample of 50 Indian companies selected from the index Nifty 50 for the period of 2008-2011. The penal regression models are applied to examine the relative and incremental information content of EVA and traditional performance measures. Findings - – The study finds that EVA has more relevant and incremental information content than accounting measures for analyzing shareholder value creation. These results confirm that EVA is better performance measure than traditional accounting measures. Research limitations/implications - – The study could be further extended for the sample of other firms covering the specific industries and sectors. The calculation of EVA could be modified with respect to the adjustment in profit after tax and the calculation of cost of capital. Practical implications - – The study has implications for the managers who are responsible to generate the wealth of shareholders by formulating the corporate financial policies. The findings also help investors who are closely concerned with the financial health of the firm while taking their investment decisions. Originality/value - – The novelty of this study is that it relates total return of firm’s stock with the financial measures unlike the previous literature.
Married Women’s Experience of Domestic Violence in Malawi: New Evidence From a Cluster and Multinomial Logistic Regression Analysis

Violence against women is a global issue with estimates indicating that 35% of all women worldwide have experienced either physical and/or sexual intimate partner violence or nonpartner violence in their life time. In Malawi, 42% of ever-married women have experienced some form of violence perpetrated by their current or most recent spouse. A number of studies have investigated intimate partner violence in Malawi within the context of HIV/AIDS, girls’ sexual abuse, and psychological distress, and a few studies report on the role of sociocultural factors in influencing gender-based violence. No study has used cluster analysis to systematically analyze different levels of abuse among married women in Malawi. Using the 2015 Malawi Demographic and Health Survey data, we employed cluster analysis and multinomial logistic regression to analyze the distribution of different levels of abuse among married women in Malawi and the key attributes associated with each level of abuse. Correlates of domestic violence significantly differ by levels of abuse and are distributed as follows: controlling behavior (11.8%), general controlling behavior (GCB; 27.1%), moderate physical and emotional abuse (27.2%), and the high and complete abuse (8.5%). Alcohol consumption, ethnicity, and women working status were significantly associated with all four levels of abuse, but age and religion were only associated with controlling behavior and generalized controlling behavior. The strength of association between husband’s alcohol consumption, woman’s working status, and marriage type and domestic violence increased by level of abuse. On each of these factors, the odds of experiencing violence were lowest in the controlling behavior group and highest in the high physical and emotional abuse group. Policies and programs that are designed to tackle violence against married women in Malawi should incorporate strategies that discourage excessive alcohol consumption, promote messages that women can be bread winners, and discourage polygamous marriage.
The CD40-Induced Signaling Pathway in Endothelial Cells Resulting in the Overexpression of Vascular Endothelial Growth Factor Involves Ras and Phosphatidylinositol 3-Kinase1

Ligation of endothelial cell (EC) CD40 induces the expression of several proinflammatory cytokines as well as angiogenesis factors, including vascular endothelial growth factor (VEGF). Moreover, despite the reported importance of CD40 in cell-mediated immunity, little is known of the CD40-induced signaling pathways in EC. In this study, we have investigated the function of the Ras signaling pathway(s) for CD40-induced overexpression of VEGF. EC were transiently transfected with a full-length VEGF promoter-luciferase construct and a dominant-inhibitory mutant of Ras (Ras17N). Following transfection, ligation of CD40 with soluble CD40 ligand resulted in a significant increase in VEGF transcriptional activation, and the inhibitory mutant of Ras blocked this CD40-induced VEGF overexpression. Using EMSA and Western blot analysis, we demonstrated that CD40-dependent binding of nuclear protein(s) to the VEGF promoter and CD40-induced VEGF protein expression in EC were also inhibited by the Ras mutant. Immunoprecipitation studies revealed that ligation of CD40 on EC promoted an increased association of Ras with its effector molecules Raf, Rho, and phosphatidylinositol 3-kinase (PI3K). But, cotransfection of effector-loop mutants of Ras determined that only PI3K was functional for Ras-induced VEGF transcription. Also, wortmanin and a dominant-inhibitory mutant of PI3K inhibited CD40-induced overexpression of VEGF. Together these findings demonstrate that both Ras and PI3K are intermediaries in CD40-induced regulation of VEGF in EC. We believe our findings are of importance in several chronic inflammatory diseases, including atherosclerosis and allograft rejection associated with both CD40-CD40 ligand signaling as well as VEGF expression and function.
Analysis of Tuberculous Meningitis in Albacete ( Spain )

Introduction: TBM is the most severe manifestation of extrapulmonary TB with a high mortality rate and high rate of secondary results among survivors. Cerebrovascular complications of TBM are common, and this may represent its most serious legacy. Objectives: The aim our study is to analyze the epidemiologic, clinic and laboratory features of patients with TBM in a regional hospital in Albacete (Spain). It is a retrospective study of TBM cases which were admitted to the General University Hospital Albacete, from 1991 to 2010. Results: 29 patients were diagnosed with TBM. The average age of the patients was 36.2 years of which 18 (62.1%) were males, 22 (75.9%) were adults, and 2 (6.9%) were nonnationals. Among the total patients, 4 patients were HIV-infected (13.8%). The most common clinical presentations were fever (79.3%) and headache (48.3%). CSF examinations showed increased protein and ADA levels, low glucose levels and lymphocytic pleocytosis in most cases. Corticosteroids were administrated to 75.9% of the patients. There were cases of brain stroke in 10 patients (34.5%). Other complications encountered were syndrome of inappropriate ADH secretion (SIADH) (41.4%) and hydrocephalus (13.8). Neurological sequelae were observed in 31% of the patients, and 3 patients (10.3%) died. Discussion: In our case study, lower mortality rates were observed than in other studies probably due to the adequate use of corticosteroids, early treatment and the lower rate of HIV-patients, whereas the percentage of cases with fever, SIADH, meningeal signs and brain strokes were similar as observed in other case studies. Conclusions: TBM is still a diagnostic problem. A high index of suspicion is required in order to make an early diagnosis and treatment.