Miracle-dz/UniFAR-FTUs huggingface dataset:
Carotid endarterectomy plus medical therapy or medical therapy alone for carotid artery stenosis in symptomatic or asymptomatic patients: a meta-analysis.

OBJECTIVE The purpose of this study was to compare carotid endarterectomy (CEA) plus medical therapy (MT) with MT alone for symptomatic and asymptomatic patients suffering from carotid artery stenosis in terms of long-term stroke/death rate. DESIGN A meta-analysis of parallel randomized, controlled trials (RCTs) (blind or open) published in English. SETTING A university-based electronic search. PARTICIPANTS Patients suffering from carotid artery stenosis symptomatic or not. INTERVENTIONS Patients were subjected to CEA plus MT or MT alone. MEASUREMENTS AND MAIN RESULTS For asymptomatic patients, 6 RCTs comprising 5,733 patients (CEA = 2,853 and MT = 2,880) were included. CEA did not affect the stroke/death risk for asymptomatic patients (risk ratio [RR] = 0.93; 95% confidence interval [CI], 0.84 to 1.02; I(2) = 0%; p = 0.14). For symptomatic patients, 2 RCTs were included. They had 5,627 patients (CEA = 3,069 and MT = 2,558) of whom 2,295 patients (CEA = 1,213; MT = 1,082) had severe stenosis (North American Symptomatic Carotid Endarterectomy Trial [NASCET] technique ≥50% and European Carotid Surgery Trial technique ≥70%). CEA decreased the stroke/death risk only for patients with severe stenosis (RR = 0.69; 95% CI, 0.59-0.81; p < 0.001 [random effects model]; I(2) = 0% on the odds ratio and 17% on the RR [benefit or harm side]; number needed to treat = 11 [95% CI, 8-17]). CONCLUSIONS CEA is helpful for recently symptomatic patients with carotid artery stenosis ≥50% (NASCET technique) but adds no benefit in terms of stroke/death for asymptomatic patients.
Children with alopecia areata: psychiatric symptomatology and life events.

OBJECTIVES To examine the nature of psychopathology of children with alopecia areata (AA) and to investigate the frequency and quality of life events in the year before AA developed in comparison with a control group. METHOD Thirty-three subjects with AA, mean age 10.5 +/- 0.3 years, were compared with 30 controls who visited a pediatrician for a mild condition. In addition, 16 preschool children with AA were compared with 17 preschool children who visited the pediatrician for a mild condition. The following measures were used: Child Psychiatric Interview, Children's Depression Inventory (CDI), Children's Manifest Anxiety Scale (CMAS), Life Events Scale for Children, and Child Behavior Checklist (CBCL). RESULTS On the CBCL, children with AA had more psychological problems, in total, than controls, and in particular, they were more anxious or depressed, withdrawn, aggressive, and delinquent. They also had more somatic problems as well as problems in social relations and in attention. Girls with AA seem to have been affected more in dimensions of total problems, anxiety/depression, and internalizing/externalizing syndromes. In terms of anxiety (CMAS), more children with AA than controls seemed to worry and to have difficulties in concentration and physiological symptoms of anxiety. In the Child Psychiatric Interview, all children with AA exhibited symptomatology of anxiety or depression or both, usually of mild or moderate nature. Major depression was not detected through the CDI. Fewer children with AA had positive life events the year before AA than controls in a similar time period. CONCLUSIONS Compared with controls, children with AA had more psychiatric symptoms in general and symptoms of anxiety or depression, or both, in particular. There is also evidence that lack of positive life events in the prealopecia period played a role in their lives. Psychiatric assessment, and if necessary treatment, is warranted for all children with this condition.
Time-Domain Shielding Effectiveness of Enclosures Against a Plane Wave Excitation

Electromagnetic shielding of metallic enclosures with an aperture are simulated and measured in the frequency and time domain in this paper. Recently, several new figures of shielding effectiveness (SE) in the time domain have been proposed. Much work has been done regarding numerical simulations; however, little work related to measurements has been carried out. In this paper, we obtain the simulated and measured results for these SE definitions when an incident plane wave, with a determined bandwidth, excites the enclosure. The plane wave can be treated as a reference interference to compare with other cases. Measurements and simulations are in good agreement. This study evaluates the new definitions and compares them with the classical definition in the frequency domain. The effect of the probes, a dipole or a loop, has also been analyzed. Finally, the SE values are obtained for a sweep of the size of the aperture providing a unique value of equivalent SE for the most critical parameter and for a determined bandwidth, and allowing direct comparison with other enclosures.
Human liver CYP2B6-catalyzed hydroxylation of RP 73401.

RP 73401 is a potent inhibitor of cyclic nucleotide phosphodiesterase type IV. RP 73401 is metabolized by human liver microsomes almost exclusively by transhydroxylation of the cyclopentyl group to RPR 113406. Liquid chromatography/mass spectrometry/mass spectrometry analysis of plasma from patients given RP 73401 also revealed a molecular ion and fragmentation consistent with RPR 113406. Thus, the objective was to determine the oxidative enzyme(s) responsible for RP 73401 hydroxylation. Kinetic constants of RP 113406 formation ranged from 8 to 26 MM and 0.83 to 5.99 nmol/min/mg protein for K(m) and V(max), respectively (n = 3). Enzyme activity varied 23-fold among 15 human liver microsome samples and correlated with CYP2A6-catalyzed coumarin hydroxylase (r2 = 0.85, P < .01) and CYP2B6-catalyzed 7-ethoxytrifluoromethylcoumarin O-deethylase (r2 = 0.82, P < .01) activities. Chemical inhibition studies showed a 63% decrease in RP 73401 hydroxylation by 500 microM orphenadrine. Coumarin (10 microM), however, did not inhibit RP 73401 hydroxylation. Also, anti-CYP2B1 IgG produced 85% inhibition of RP 73401 hydroxylation, but only a negligible decline in coumarin hydroxylase activity. Of the 10 expressed P450 forms studied, only CYP2B6 catalyzed RP 73401 hydroxylation. Finally, expressed CYP2B6 showed a high affinity (K(m) = 22.5 microM) for RP 73401 hydroxylation, similar to the human liver microsome studies.
Caregiving Spouses Physical and Mental Health in Perspective

The self‐reported physical and mental health of 315 persons caring for a spouse who had been diagnosed with Alzheimer's disease or a related disorder was compared with general population norms for existing data bases controlling for age and gender. Results suggest that across all indicators of mental health, spouse caregivers are more depressed, express higher levels of negative affect, are more likely to use psychotropic drugs, and have more symptoms of psychological distress than the general population. In terms of physical health, caregivers report higher than expected rates of diabetes, arthritis, ulcers, and anemia, yet they use medical services at rates which are similar or lower than those reported by the general population. Since no simultaneous control group was studied, these results suggest, but do not prove, the presence of differences between caregivers and non‐caregivers.
Manipulation of cortical gray matter oxygenation by hyperoxic respiratory challenge: field dependence of R2* and MR signal response

The aim of this study was to quantitatively assess the field strength dependence of the transverse relaxation rate (R2*) change in cortical gray matter induced by hyperoxia and hyperoxic hypercapnia versus normoxia in an intra‐individual comparison of young healthy volunteers. Medical air (21% O2), pure oxygen and carbogen (95% O2, 5% CO2) were alternatively administered in a block‐design temporal pattern to induce normoxia, hyperoxia and hyperoxic hypercapnia, respectively. Local R2* values were determined from three‐dimensional, multiple, radiofrequency‐spoiled, fast field echo data acquired at 1.5, 3 and 7 T. Image quality was good at all field strengths. Under normoxia, the mean gray matter R2* values were 13.3 ± 2.7 s–1 (1.5 T), 16.9 ± 0.9 s–1 (3 T) and 29.0 ± 2.6 s–1 (7 T). Both hyperoxic gases induced relaxation rate decreases ΔR2*, whose magnitudes increased quadratically with the field strength [carbogen: –0.69 ± 0.20 s–1 (1.5 T), –1.49 ± 0.49 s–1 (3 T), –5.64 ± 0.67 s–1 (7 T); oxygen: –0.39 ± 0.20 s–1 (1.5 T), –0.78 ± 0.48 s–1 (3 T), –3.86 ± 1.00 s–1 (7 T)]. Carbogen produced larger R2* changes than oxygen at all field strengths. The relative change ΔR2*/R2* also increased with the field strength with a power between 1 and 2 for both carbogen and oxygen. The statistical significance of the R2* response improved with increasing B0 and was higher for carbogen than for oxygen. For a sequence with pure T2* weighting of the signal response to respiratory challenge, the results suggested a maximum carbogen‐induced signal difference of 19.3% of the baseline signal at 7 T and TE = 38 ms, but a maximum oxygen‐induced signal difference of only 3.0% at 1.5 T and TE = 76 ms. For 3 T, maximum signal changes of 4.7% (oxygen) and 8.9% (carbogen) were computed. In conclusion, the R2* response to hyperoxic respiratory challenge was stronger for carbogen than for oxygen, and increased quadratically with the static magnetic field strength for both challenges, which highlights the importance of high field strengths for future studies aimed at probing oxygen physiology in clinical settings. Copyright © 2012 John Wiley & Sons, Ltd.
Effects of fluticasone propionate and beclomethasone dipropionate on parameters of inflammation in peripheral blood of patients with asthma

Bronchial inflammation plays a central role in asthma. We investigated whether parameters of inflammation were increased in peripheral blood. Furthermore, we tested whether fluticasone propionate (FP), a new inhaled corticosteroid (ICS), and beclomethasone dipropionate (BDP) affected these parameters. FP 750 μg/day and BDP 1500 μg/day were compared in a randomized, crossover study consisting of two 6‐week treatment periods, each preceded by a 3‐week placebo period. Twenty‐one patients with symptomatic asthma completed the study. The results were compared with those of six normal subjects (controls). Immunophenotyping of inflammatory cells was performed in whole blood, and serum eosinophil cationic protein (ECP) was measured. With regard to clinical efficacy, ICS increased PCjo histamine by more than 1.9 doubling doses and FEV, by more than 0.34 1. The number of CD3/HLA‐DR+ lymphocytes was significantly increased in asthmatics compared to the normal subjects, both after placebo (P<0.01) and after therapy (P<0.05). The CD3/HLA‐DR‐H lymphocytes decreased significantly after treatment with FP (P<0.05). Serum ECP was elevated in patients without ICS and decreased after treatment with BDP (P<0.001). In conclusion, the number of CD3/HLA‐DR‐I‐ lymphocytes and serum ECP levels were raised in the peripheral blood of symptomatic asthmatics, and decreased by clinically effective doses of ICS. In this respect, FP 750 ng/day was at least as effective as BDP 1500 μg/day.
Identification of Novel Antipoxviral Agents: Mitoxantrone Inhibits Vaccinia Virus Replication by Blocking Virion Assembly

ABSTRACT The bioterror threat of a smallpox outbreak in an unvaccinated population has mobilized efforts to develop new antipoxviral agents. By screening a library of known drugs, we identified 13 compounds that inhibited vaccinia virus replication at noncytotoxic doses. The anticancer drug mitoxantrone is unique among the inhibitors identified in that it has no apparent impact on viral gene expression. Rather, it blocks processing of viral structural proteins and assembly of mature progeny virions. The isolation of mitoxantrone-resistant vaccinia strains underscores that a viral protein is the likely target of the drug. Whole-genome sequencing of mitoxantrone-resistant viruses pinpointed missense mutations in the N-terminal domain of vaccinia DNA ligase. Despite its favorable activity in cell culture, mitoxantrone administered intraperitoneally at the maximum tolerated dose failed to protect mice against a lethal intranasal infection with vaccinia virus.
Ambulatory blood pressure correlates with renal volume and number of renal cysts in children with autosomal dominant polycystic kidney disease

ObjectiveIn adult patients with autosomal dominant polycystic kidney disease (ADPKD) renal volume was found to be significantly greater in hypertensive compared to normotensive patients. The purpose of this study was to find out if blood pressure (BP) is related to renal size also in children with ADPKD, for example, in an early stage of the disease. Method and resultsSixty-two children with ADPKD and normal renal function (mean age 12.3±4.3 years) were examined by renal ultrasound and ambulatory BP monitoring (ABPM). Twenty-two children were hypertensive and 40 normotensive. Mean renal volume was significantly greater in hypertensive than in normotensive children (2.7±2.3 SDS versus 1.2±2.5 SDS, P<0.01) despite similar anthropometric data and renal function. Similarly the mean number of cysts was significantly higher in hypertensive patients than in normotensive (35±15 cysts versus 23±14 cysts, P<0.01). Renal volume correlated with daytime as well as with night-time systolic and diastolic BP (r=0.41–0.47, P<0.01). Correlations with renal length and the number of renal cysts were somewhat less (r=0.29–0.43, P<0.05 and 0.01, respectively). ConclusionsThis study revealed a significant relationship between renal volume, renal length and number of renal cysts and BP. It is suggested that children with ADPKD should regularly be checked for BP changes by ABPM, especially those who show increased renal size or a high number of renal cysts on ultrasound. All these children are at high risk for development of hypertension.
Association of ABCB1, CYP3A4*18B and CYP3A5*3 genotypes with the pharmacokinetics of tacrolimus in healthy Chinese subjects: a population pharmacokinetic analysis

What is known and Objective: Tacrolimus (TAC) is metabolized mainly by the CYP3A subfamily and extruded into the intestine by P‐glycoprotein, which is encoded by the ABCB1 gene. Several studies have suggested that the CYP3A5*3 genotype influenced the pharmacokinetics (PK) of TAC. The CYP3A4*18B and CYP3A5*3 alleles are clinically important in Chinese subjects because of their relatively high frequency. The present study aimed at evaluating the effects of ABCB1 (C1236T‐G2677T/A‐C3435T), CYP3A4*18B and CYP3A5*3 genetic polymorphisms on TAC PK in healthy Chinese subjects.
Gender differences in sleep habits and quality and daytime sleepiness in elementary and high school teachers

ABSTRACT The extensive workload of teachers inside and outside the classroom may contribute to sleep problems. Such problems may occur more frequently in women due to the combination of professional demands, domestic tasks, and their relatively greater sleep needs compared to men. The objective of this cross-sectional study was to evaluate the influence of gender on sleep habits and quality, and daytime sleepiness in a sample of 243 teachers (77 men and 166 women) using questionnaires. Linear regression models were used to examine the effect of gender on sleep measures; the unadjusted model considered only gender and the adjusted model considered chronotype and work characteristics as potential confounders. Bedtimes of women were significantly earlier than men during the week, but not on weekends, in the unadjusted and adjusted models. Time in bed was longer for women throughout the week and weekend in the unadjusted model. However, in the adjusted model, this statistical significance disappeared, and longer time in bed during the week was associated with teaching in one shift and for both levels of education. In addition, the female gender was associated with higher sleepiness scores compared to males in both models, and worse sleep quality in the adjusted model. Also, sleep quality was worse in subjects working in three shifts and in both types of schools (public and private). The tendency to eveningness was associated with later bedtimes and wake up times during both week days and weekends, higher irregularity of bedtimes and wake up times, and higher sleepiness scores in the adjusted model. Therefore, we suggest that female teachers do not fulfill their sleep needs and show higher levels of diurnal sleepiness and poor sleep quality that can be modulated by chronotype and some work characteristics. More studies are needed to evaluate the role of double workload on this pattern.
Deterioration of red blood cell mechanical properties is reduced in anaerobic storage.

BACKGROUND Hypothermic storage of red blood cells (RBCs) results in progressive deterioration of the rheological properties of the cells, which may reduce the efficacy of RBC transfusions. Recent studies have suggested that storing RBC units under anaerobic conditions may reduce this storage-induced deterioration. MATERIALS AND METHODS The aim of this study was to compare the rheological properties of conventionally and anaerobically stored RBC and provide a measure of the relationship between oxidative damage to stored RBC and their ability to perfuse microvascular networks. Three different microfluidic devices were used to measure the ability of both types of stored RBC to perfuse artificial microvascular networks. Flow rates of the RBC passing through the entire network (bulk perfusion) and the individual capillaries (capillary perfusion) of the devices were measured on days 2, 21, 42, and 63 of storage. RESULTS The bulk perfusion rates for anaerobically stored RBC were significantly higher than for conventionally stored RBCs over the entire duration of storage for all devices (up to 10% on day 42; up to 14% on day 63). Capillary perfusion rates suggested that anaerobically stored RBC units contained significantly fewer non-deformable RBC capable of transiently plugging microfluidic device capillaries. The number of plugging events caused by these non-deformable RBC increased over the 63 days of hypothermic storage by nearly 16- to 21-fold for conventionally stored units, and by only about 3- to 6-fold for anaerobically stored units. DISCUSSION The perfusion measurements suggest that anaerobically stored RBC retain a greater ability to perfuse networks of artificial capillaries compared to conventionally (aerobically) stored RBC. It is likely that anaerobic storage confers this positive effect on the bulk mechanical properties of stored RBC by significantly reducing the number of non-deformable cells present in the overall population of relatively well-preserved RBC.
Safety and Efficacy of Intravitreal Triamcinolone Acetonide for Uveitic Macular Edema

Background: To evaluate the safety and efficacy of intravitreal triamcinolone acetonide (TA) for treating macular edema secondary to non-infectious uveitis. Methods: Retrospective review of sixteen patients (20 eyes) with chronic cystoid macular edema (CME) as a consequence of controlled intermediate uveitis, posterior uveitis, or panuveitis who received at least one intravitreal injection of TA. Main outcome measures were visual acuity (VA), intraocular pressure (IOP), formation or progression of an existing cataract, and CME resolution during the follow-up period. Results: At last follow-up, VA showed improvement (compared to baseline) in 11 eyes (55%), deterioration in three eyes (15%), remained completely unchanged in one eye (5%), and showed improvement initially but returned to baseline levels in five eyes (25%). At last follow-up, CME had relapsed or was still present in 10 of the eyes (50%). The remaining eyes showed complete resolution of the CME, without evidence of recurrence during the follow-up time. Mean VA at last follow-up showed statistically significant improvement (p = 0.02) in nonvitrectomized eyes (mean baseline VA: 1.14 ± 0.58; mean final VA: 0.96 ± 0.66) compared to the almost unaltered mean visual acuity for vitrectomized eyes (mean baseline VA: 0.76 ± 0.41; mean final VA: 0.71 ± 0.48)(p = 0.40, paired samples t-test). Elevation of IOP was transient in all cases and responded well to topical medications, except for one patient who required placement of an Ahmed valve. Preexisting cataract progressed in three of the 15 phakic eyes (20%). One patient developed a retinal detachment and required additional surgery to reattach it. Patients were followed for a mean of 34 weeks (median: 32 weeks; range: 19–56 weeks). Conclusions: Intravitreal TA may play a role in the treatment of uveitis-related CME. Further controlled studies are necessary to test this hypothesis.
Caring for survivors of breast cancer: perspective of the primary care physician.

BACKGROUND AND OBJECTIVES Increasing numbers of women are surviving breast cancer, and survivorship care is becoming more complex. Primary care physicians provide care for most survivors of breast cancer in the Canadian province of British Columbia. The present study offers insight into the confidence of primary care physicians in their abilities to provide such care. It also explores potential ways to assist those providers in enhancing this aspect of their practice. METHODS A questionnaire was mailed to 1000 primary care physicians caring for survivors of breast cancer. The questionnaire explored the perspectives of the responding physicians on their ability to manage various aspects of survivorship care for breast cancer patients, identified preferences for the content and format of communication from oncologists at the time of transition from active oncology treatment to survivorship, and determined the means most commonly used to obtain knowledge about breast cancer. This 1-page, 31-item checkbox and open-answer questionnaire assessed the perceptions of primary care physicians about the care of breast cancer survivors after completion of active treatment and their personal preferences for resources providing information about breast cancer. RESULTS The questionnaire response rate was 59%. Primary care physicians reported being most confident in screening for recurrence and managing patient anxiety; they were least confident in managing lymphedema and providing psychosocial counselling. Compared with physicians following fewer survivors of breast cancer, those who followed more breast cancer survivors had higher confidence in managing the biomedical aspects of follow-up and in providing counselling about nutrition and exercise. Most physicians found discharge letters from oncologists to be useful. Point-form discharge information was preferred by 43%; detailed description, by 19%; and both formats, by 38%. The most useful information items identified for inclusion in a discharge letter were a diagnosis and treatment summary and the recommended surveillance and endocrine therapy. Continuing medical education events and online resources were the means most commonly used to obtain knowledge about breast cancer. CONCLUSIONS Primary care physicians who provide follow-up for survivors of breast cancer report that they are confident in managing care and satisfied with discharge letters containing a diagnosis and treatment summary, and recommendations for surveillance and endocrine treatment. At the time of patient discharge, additional information about common medical and psychosocial issues in this patient population would be useful to primary care physicians. Preferred means to access current breast cancer information include continuing medical education events and online resources.