Miracle-dz/UniFAR-FTUs huggingface dataset:
Olanzapine and risperidone plasma concentration therapeutic drug monitoring: A feasibility study

Background: This study aimed to develop a clinically acceptable method of therapeutic drug monitoring (TDM) for olanzapine and risperidone and to evaluate the feasibility of its implementation. Method: A non-randomised study of inpatients from five Mental Health Trusts was conducted, with a clinical interview at the time of TDM and a subsequent 6-week follow-up review of clinical notes. The TDM intervention comprised: (a) a venous blood sample taken 12 hours post-dose, 7–10 days after drug initiation, and (b) rapid results feedback, with interpretation algorithm guidance. Results: Thirty-two participants provided samples (19 prescribed olanzapine, 13 risperidone). Twenty-six participants remained on the target drug at study end, with seven experiencing a dose change, for whom only four of the TDM results were confirmed as having been checked. Mean dose increased for olanzapine (0.9 mg/day, range 0–10) and decreased for risperidone (-0.3 mg/day, range -4–3). Conclusion: TDM can be implemented as part of routine clinical practice for both drugs. However, the lack of robust supporting evidence for or against antipsychotic TDM has probably led to a lack of enthusiasm for and interest in the results. Nevertheless, the advent of less invasive measures and the targeting of patients who might be more likely to benefit may facilitate uptake.
ErbB2 overexpression correlates with increased expression of vascular endothelial growth factors A, C, and D in human breast carcinoma

The angiogenic factor vascular endothelial growth factor (VEGF)‐A plays an important role in breast cancer progression. However, the involvement of VEGF‐C and VEGF‐D, two newer members of the VEGF family, in breast carcinoma and their relationship with clinicopathologic parameters have not been clearly demonstrated.
The endocrown: an alternative approach for restoring extensively damaged molars.

UNLABELLED Endocrown-type restorations are single prostheses fabricated from reinforced ceramics that can be acid etched, indicated for endodontically treated molar teeth that have significant loss of coronal structure. Endocrowns are formed from a monoblock containing the coronal portion integrated into the apical projection that fills the pulp chamber space, and possibly the root canal entrances. In this study, the proposal was to discuss the indication and use of the endocrown to replace single crowns with intraradicular retention, and to present a clinical case report on the 3-year follow-up of an endocrown-type restoration, fabricated from injected lithium disilicate ceramic (IPS e.Max Press/Ivoclar Vivadent) in a mandibular first molar with extensive coronal destruction from fracture. It was found that endocrown restorations could be made following the development of reinforced ceramics that can be acid etched, that have aggregate strength and esthetics, that bond to the dental structure, and that have developed from broader knowledge of the biomechanical behavior of depulped teeth restored with and without intraradicular posts. Clinical studies have shown that the endocrown has functional longevity, and has become a promising alternative in the esthetic and functional recovery of endodontically treated molar teeth. CLINICAL SIGNIFICANCE It should be borne in mind that endocrowns offer advantages for the restoration of depulped molar teeth, insofar as they promote adequate function and offer adequate esthetics, and also maintain the biomechanical integrity of the compromised structure of non-vital posterior teeth. By eliminating the use of a post and filling core, the number of adhesive bond interfaces is reduced, thus making the restoration less susceptible to the adverse effects of degradation of the hybrid layer. In this clinical case, the 3-year survival of the endocrown restoration may be considered successful.
CIRCULATING LEVELS OF ACTIVE, TOTAL AND INACTIVE RENIN (PRORENIN), ANGIOTENSIN I AND ANGIOTENSINOGEN IN CARBON TETRACHLORIDE‐TREATED RATS

1. Plasma renin activity (PRA), plasma angiotensin I concentration (ANG I), plasma angiotensinogen concentration (PAC) and the plasma levels of active, total and inactive renin (prorenin) were measured in rats with carbon tetrachloride (CCl4)‐induced acute renal failure. Rats were treated with a single oral dose of CCl4 (2.5 mL/kg) and killed 1, 2, 3 and 7 days later.
Suicidal behavior and parental psychopathology in hospitalized depressed children

This study describes the suicidal behavior of hospitalized depressed children and assesses its relationship to psychopathology and suicidal behavior in their parents. Subjects were 58 consecutively hospitalized prepubertal children with a primary diagnosis of major depressive disorder (MDD), and 58 age‐ and gender‐matched children hospitalized for psychiatric diagnoses other than a mood disorder. Clinical interviews and structured diagnostic instruments were reviewed to determine the children’s suicidal behavior and their parents’ history of psychopathology. Suicidal ideation, suicidal intent, suicidal plans, and suicide attempts were more frequent in MDD children compared to nondepressed children. When MDD and control samples were stratified as to presence of suicidal behavior in the child, psychopathology was high in parents from all subgroups. Intensity of suicidal behavior in the depressed and non‐depressed children was not associated with an altered pattern of psychopathology in their parents. Hospitalized MDD children had increased suicidal behavior compared to inpatient psychiatric control children. However, suicidal behavior in the children was not associated with increased psychopathology or an altered pattern of psychopathology in their parents. Depression and Anxiety 14:183–185, 2001. © 2001 Wiley‐Liss, Inc.
Therapeutic experiences with 947 epileptic out‐patients in oxcarbazepine treatment

Efficacy and tolerability of the new antiepileptic drug oxcarbazepine, was evaluated in a retrospective multicentre study. The records of all 947 epilepsy patients treated with oxcarbazepine in the eight participating centres from 1981 through 1990 were examined. The median daily dose of oxcarbazepine was 30 mg/kg in children, 18 mg/kg in adults, and 15 mg/kg in elderly patients, given b.i. d. or t.i. d. The mean plasma levels of the main active metabolite of oxcarbazepine was 88, 79, and 68 μmol/l in children, adults, and elderly, respectively. In patients shifted to oxcarbazepine treatment, seizure frequency was unchanged in 51‐66%, 32‐48% had a decrease, and 1‐10% an increase in seizure frequency, considering the individual seizure types separately. Adverse events were reported in one third of patients, most frequently affecting the CNS (dizziness: 6%; sedation: 6%; fatigue: 6%). Rash was reported in 6% of patients, half of these patients had previously had an allergic reaction to carbamazepine. Hyponatremia was found in about a quarter of the patients from whom data were available. No congenital malformations were seen in nine live‐born, first trimester oxcarbazepine‐exposed children.
Broadband Vortex Beam Generation Using Multimode Pancharatnam–Berry Metasurface

Vortex beams have been extensively realized using different approaches. Typically, the efficiency and bandwidth of a vortex beam are limited by impure copolarized components and the intrinsic dispersion of passive resonant structures. Here, we propose a strategy to generate wideband vortex beams by using a Pancharatnam–Berry metasurface in which two orthogonal reflections exhibit a broadband out-of-phase difference. To achieve this, a broadband strategy based on multimode operation and dispersion engineering methods was established. A dual-layer meta-atom is proposed; each layer comprises of five metallic dipoles, and the geometrical parameters are carefully adjusted to tune the resonant frequencies. Because the dipole orientations in each layer are orthogonal, the reflection responses under the two orthogonal polarizations can be independently engineered. Both numerical and experimental results indicate that our method not only enables a high-efficiency spiral beam conversion over a broad range of 6.95–18 GHz (>82%) but also causes a polarization-insensitive effect; thus, it can be adapted for any linear or circular polarization.
A Putative 12 Transmembrane Domain Cotransporter Expressed in Thymic Cortical Epithelial Cells

We have isolated a full-length cDNA clone (thymic stromal origin (TSO)-1C12) from a SCID thymus library using a probe from a PCR-based subtractive library enriched for sequences from fetal thymic stromal cells. TSO-1C12 mRNA is expressed mainly in the thymic cortex and is highly enriched in SCID thymus. Expression per cell is highest during fetal thymus development and decreases after day 16. Antipeptide Abs immunoprecipitated a hydrophobic, plasma membrane glycoprotein (thymic stromal cotransporter, TSCOT) whose translated sequence has weak homology to bacterial antiporters and mammalian cation cotransporters with 12 transmembrane domains. TSCOT represents a new member of this superfamily that is highly expressed in thymic cortical epithelial cells.
Neuromyelitis optica associated with myasthenia gravis: characteristic phenotype in Japanese population

We report two female patients with neuromyelitis optica (NMO, Devic's syndrome) following or coincidental with myasthenia gravis (MG). Their illnesses were characterized by subacute myelitis with optic neuritis, high serum levels of muscle acetylcholine receptor antibody, and autoimmune thyroid disease. Both patients fulfilled the clinical criteria of NMO, however, NMO‐IgG, autoantibody against aquaporin‐4 water channel, was absent from their sera. Both NMO and MG are relatively rare diseases. The considerable coincidence of these two disorders suggests that there is a subgroup of patients with NMO having a common immunological pathogenesis with MG.
Very early withdrawal from treatment in patients starting peritoneal dialysis

Abstract Introduction: Very early withdrawal from treatment in patients undergoing peritoneal dialysis (PD) is an increasingly important, but poorly understood, issue. Here, we identified the reasons and risk factors for very early withdrawal from PD. Methods: Incident PD patients from The First Affiliated Hospital of Sun Yat-sen University above 18 years who started treatment between January 1 2006 and December 31 2011 were included. Cessation of PD therapy within the first 90 days after beginning dialysis was classified as very early withdrawal. Results: Totally 1444 patients were enrolled. Of these, 71 (4.9%) withdrew from PD therapy during the first 90 days. Primary reasons for very early withdrawal included death (34 patients, 47.9%), transplantation (21 patients, 29.6%) and transfer to hemodialysis (14 patients, 19.7%). The leading reasons for death were cardiovascular and infectious disease, accounting for 41.2% (14 patients) and 23.5% (8 patients) of total deaths, respectively. Dialysate leakage (six patients, 42.9%) and catheter dysfunction (five patients, 35.7%) were the main reasons for transfer to hemodialysis. In multivariate analysis, predictors for very early PD withdrawal were older age (per decade increasing; hazard ratio [HR], 1.22; 95% confidence interval [CI], 1.03–1.45; p = .019), higher systolic blood pressure (per 10 mmHg increasing; HR, 1.35; 95% CI, 1.20–1.50; p < .001), lower hemoglobin (per 10 g/l increasing; HR, 0.67; 95% CI, 0.57–0.78; p < .001), lower high-density lipoprotein cholesterol (HR, 0.24; 95% CI, 0.10–0.54; p = .001) and lower residual urine volume (per 100 ml/d increasing; HR, 0.90; 95% CI, 0.84–0.95; p = .001). Conclusions: Death was the primary reason for very early withdrawal from PD. Risk factors for very early withdrawal from PD were older in age, had higher systolic blood pressure, lower hemoglobin, lower high-density lipoprotein cholesterol and lower residual urine volume.
Characteristics of early fallers on elderly patient rehabilitation wards.

BACKGROUND falls are one of the most frequent complications on rehabilitation wards for elderly patients. OBJECTIVE to study the characteristics of early and late fallers. DESIGN prospective observational study with blinded end-point evaluation. SETTING a non-acute geriatric hospital. SUBJECTS 1025 consecutive patients admitted for rehabilitation following treatment for an acute illness. MAIN OUTCOME MEASURES early/late fallers and time to first fall from admission. RESULTS we identified 824 non-fallers and 201 fallers. Seventy seven (38.3%) fell during the first week. The incidence decreased progressively in subsequent weeks. Early fallers were more likely to have a past history of falls (P=0.0009), an unsafe gait (P=0.001), confusion (P<0.0001) and be admitted from medical wards (P=0.03). Patients admitted from orthopaedic wards having sustained a lower limb fracture were significantly less likely to have an early fall compared to all other patients (P=0.027). When compared to later fallers, early fallers were more likely to have a past history of falls (P=0.045). They were less likely to be admitted from an orthopaedic ward (P=0.01) or to have sustained a fracture of the lower limbs (P=0.002). Logistic regression analysis showed that a past history of falls, confusion and an unsafe gait were independent risk factors predisposing to early falls. The Kaplan-Meier survival analysis showed a significantly higher cumulative risk of falling associated with these characteristics. CONCLUSION the initial week of patients' rehabilitation is associated with the greatest risk of falling. Early fallers can be predicted by easily identifiable characteristics. This highlights the need for early fall risk assessment.
Serum protein binding of 25 antiepileptic drugs in a routine clinical setting: A comparison of free non–protein‐bound concentrations

Given that only the free non–protein‐bound concentration of an antiepileptic drug (AED) crosses the blood–brain barrier, entering the brain and producing an antiepileptic effect, knowledge and measurement of the free drug fraction is important. Such data are sparse, particularly for newer AEDs, and have arisen from the use of disparate methodologies and settings over the past six decades. We report on the protein binding of 25 AEDs that are available for clinical use, along with two pharmacologically active metabolites (carbamazepine‐epoxide and N‐desmethyl clobazam), using standardized methodology and under set conditions.
Potential environmental determinants of physical activity in adults: a systematic review

The objective of this systematic review of observational studies was to gain insight into potential determinants of various types and intensities of physical activity among adult men and women. Studies were retrieved from Medline, PsycInfo, Embase and Social scisearch. The ANGELO framework was used to classify environmental factors. In total, 47 publications were identified. Social support and having a companion for physical activity were found to be convincingly associated with different types of physical activity [(neighbourhood) walking, bicycling, vigorous physical activity/sports, active commuting, leisure‐time physical activity in general, sedentary lifestyle, moderately intense physical activity and a combination of moderately intense and vigorous activity]. Availability of physical activity equipment was convincingly associated with vigorous physical activity/sports and connectivity of trails with active commuting. Other possible, but less consistent correlates of physical activity were availability, accessibility and convenience of recreational facilities. No evidence was found for differences between men and women. In conclusion, supportive evidence was found for only very few presumed environmental determinants. However, most studies used cross‐sectional designs and non‐validated measures of environments and/or behaviour. Therefore, no strong conclusions can be drawn and more research of better quality is clearly needed.
Behind Closed Doors: Medication Storage and Disposal in the Home

BACKGROUND More than half of all medications are inappropriately prescribed, dispensed, or sold and only 50% of patients take their medications correctly. Oftentimes, unwanted or expired medications are saved for later use, stored indefinitely, or disposed via the sink, toilet, or garbage. OBJECTIVE To determine how residents in Cook County, Illinois, use, store, and dispose of their medications to assess the possible impact of these medications on health care and the environment. METHODS Researchers at the University of Illinois conducted a survey of Cook County residents over a 13-week period. Residents were surveyed regarding their use, storage, and disposal of prescription and nonprescription medications. RESULTS From 3954 telephone numbers generated through random-digit dialing, 445 telephone interviews were completed. Eighty-one and a half percent of respondents had prescription medications and 92.4% had nonprescription medications in their homes. On average, respondents possessed 4.4 distinct prescription and 5.5 distinct nonprescription medications. Despite possessing a number of medications, approximately 30% of respondents stated that they took no medication on a regular basis; 59% of respondents reported disposing medications in the household garbage and 31% flushed them down the toilet or sink. Over 80% of respondents stated that they had never received information about proper medication disposal. Thirty-seven percent reported having leftover unexpired medications from a previous illness. Of these, 63% stopped taking their medications because they believed that they no longer needed them or because they felt better. Thirty-two percent of respondents expected to have leftover prescription medications within the next 6 months. CONCLUSIONS Almost all respondents had excess and leftover medications in their homes. This may be a result of both overprescribing and poor medication adherence. In addition to the potential human health risk of nonadherence, disposal of excess medication raises concerns about their environmental impact and safety.
An Examination of U.S. State Pensions by Total State Expenditures, State Budget Deficit, and Red v. Blue State

Pensions are important to government employees. In the USA, some states fund almost 100% of the present value of future pension obligations; while in other states, the funding is substantially lacking. Results of this study show that states with lower state expenditures per capita, relative to states with higher expenditures, have provided better funding of their state pensions. States with lower budget deficits, relative to states with higher budget deficits, paid a significantly higher percent of annual required contributions. This suggests that states that are more fiscally conservative (lower budget deficit) do a better job of making required annual contributions to their state pensions. The red (Republican) states paid a higher proportion of required annual contributions than blue (Democrat) states, 90 versus 84%, respectively; but this difference was not statistically significant. All states have an ethical responsibility to meet the pension obligations owed to their state government employees.
Study of factors that may predispose domestic cats to road traffic accidents: part 2

Between March 2000 and February 2001, six veterinary practices in Cambridgeshire collected data on 117 owned cats which they had examined after a road traffic accident (RTA). The owners of 66 of these cats completed questionnaires and the information in them was compared with the information in questionnaires from a control population of 796 cats that had never been in a road accident. The RTA cats were, on average, younger than the controls; when adjusted for age the two populations did not differ with respect to the time they spent outdoors or the time they had lived at their current address. Proportionately more of the RTA cats wore reflective collars and/or lived in areas with higher levels of traffic than the controls. The accidents were evenly distributed throughout the year, and there was a trend for more accidents to happen during the night than the day. Forty-eight per cent of the accidents whose location was known occurred just outside or very near the cat's home.
Leadership for 21st century schools: From instructional leadership to leadership for learning

A legacy of the effective schools movement has been the institutionalization of the term "instructional leadership" into the vocabulary of educational leadership and management. Instructional leadership came to prominence as a paradigm for school leadership and management in the 1980s in the USA before being eclipsed by transformational leadership in the 1990s. Instructional leadership has recently reincarnated as a global phenomenon in the form of “leadership for learning”. In this lecture, I will identify the defining characteristics of instructional leadership, elaborate on the predominant model in use, report on empirical evidence about its effects on teaching and learning, and reflect on the transformation of instructional leadership in its reincarnated form of “leadership for learning”. During the 1980s an emerging body of research on effective schools (Bossert, Dwyer, Rowan & Lee, 1982; Edmonds, 1979; Hawley & Rosenholtz, 1984; Purkey & Smith, 1983) focused the attention of policymakers and scholars on the principal leadership. This research asserted that the “instructional leadership” role of the principal was crucial to school effectiveness (Bamburg & Andrews, 1990; Bossert et al., 1983; Dwyer, 1986; Edmonds, 1979; Leithwood & Montgomery 1982). Earlier efforts to study the impact of principal leadership had begun to identify professional leadership dimensions of the principal’s role that impacted school success (e.g., Erickson, 1967; Gross & Herriott, 1965). Nonetheless, it was a key legacy of the effective schools movement to focus global attention on instructional leadership.
Platelet count/spleen diameter ratio: analysis of its capacity as a predictor of the existence of esophageal varices.

CONTEXT Upper gastrointestinal bleeding associated to esophageal varices is the most dramatic complication of cirrhosis. It is recommended screening every cirrhotic for esophageal varices with endoscopy. OBJECTIVES To evaluate the capacity of the platelet count/spleen diameter ratio in non-invasively predicting esophageal varices in a population of cirrhotics originated in an independent center from the one in which it was developed. METHODS The study included patients from the ambulatory care clinic of cirrhosis of a Brazilian hospital and studied platelet count, spleen diameter and presence of esophageal varices, as well as Child and MELD scores. It used a cutoff value of 909 for the platelet count/spleen diameter ratio, as previously published. A sample of 139 patients was needed to grant results a 95% confidence level. RESULTS The study included 164 cirrhotics, 56.7% male, with a mean age of 56.6 ± 11.6 years. In the univariate analysis, platelet count, spleen diameter, presence of ascites, Child and MELD scores and the platelet count/spleen diameter ratio were related to esophageal varices (P<0.05). The platelet count/spleen diameter ratio had sensitivity of 77.5% (95% CI = 0.700-0.850), specificity of 45.5% (95% CI = 0.307-0.602), positive predictive value of 79.5% (95% CI = 0.722-0.868), negative predictive value of 42.6% (95% CI = 0.284-0.567) and accuracy of 68.9% (95% CI = 0.618-0.760). In the multivariate analysis, platelet count was the only variable which related to esophageal varices (P<0.05). CONCLUSION Platelet count/ spleen diameter ratio is not adequate to predict esophageal varices in cirrhotics.