Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparing low-dose intravenous ketamine-midazolam with intravenous morphine with respect to pain control in patients with closed limb fracture

Background: We assessed the effects of low-dose IV ketamine-midazolam versus morphine on pain control in patients with closed limb fracture(s); and also compared the incidence of adverse events (cardio-pulmonary) between two groups. Materials and Methods: This prospective, single-blind, non-inferiority trial randomized consecutive emergency department (ED) patients aged 18-60 years to two groups: Receiving 300-500 mcg/kg ketamine plus 0.03 mg/kg midazolam, or 0.05-0.1 mg/kg morphine. Visual analogue score (VAS) and adverse events were verified during an interval of 30 minutes. Results: Two hundred and thirty — six patients were selected, among whom 207 were males (87.3%). The average age was 29 ± 2, (range, 18-60 years). The VAS score at T30 (i.e., 30 minutes after initial analgesic dose) was significantly decreased compared with VAS score at T0, in both groups. No statistically significant difference, however, was observed between the two groups (–6.1 ± 1.1 versus –6.2 ± 1.0; P = 0.16). With regard to systolic blood pressure and respiratory rate, however, a meaningful difference was noted between the two groups (1.5 ± 6.4 versus –2.1 ± 6.6; P = 0.000 for SBP, and –0.2 ± 1.1 versus –1.1 ± 6.1; P = 0.048 for RR). Conclusion: Low-dose intravenous ketamine plus midazolam has the same analgesic effects as morphine on pain control in trauma patients with closed limb fracture(s), in addition to less respiratory adverse events.
Skewness and Momentum

We document two opposite effects of return skewness on momentum profits. For individual stocks, momentum profits decrease with skewness while for industry portfolios, momentum profits increase with skewness. The findings cannot be explained by existing risk factors and stock characteristics. For individual stocks, the evidence is consistent with the behavioral theory of return skewness as well as the skewness preference theory. For industry portfolios, the evidence is consistent with the interpretation of portfolio skewness as a measure of asymmetric inefficiency.
Ethanol-lock therapy for the prevention of central venous access device infections in pediatric patients with intestinal failure.

BACKGROUND Central venous access device (CVAD) infections are a major complication in pediatric patients receiving long-term parenteral nutrition (PN) and are particularly prevalent in patients with intestinal failure. This study evaluated the outcomes of outpatient ethanol-lock therapy (ELT) for the prevention of CVAD infections in children with intestinal failure. METHODS In this retrospective analysis, the primary outcome measure was the rate of bloodstream infection (BSI) due to CVAD infections per 1,000 catheter days, and secondary measures included type of organisms cultured and complications of ELT. RESULTS Over the course of 2 years, 15 patients received outpatient ELT. Sixty-seven percent were male; patients had a mean ± standard deviation age at enrollment of 5.6 ± 6.9 years and body weight of 19.9 ± 15.4 kg. Mean duration of ELT was 263 ± 190 days. Mean BSI rate per 1,000 catheter days significantly decreased from 8.0 before ELT to 1.3 after ELT (P < .01). Seventy-three percent of patients remained infection free throughout the entire study period. Adverse events potentially related to ELT included thrombosis (n = 1), difficulty withdrawing blood from the CVAD, requiring thrombolytic administration (n = 3), and repair of the CVAD for leakage/tear (n = 20). The rate of CVAD repair for leakage/tear with ELT was compared to prior rates per 1,000 catheter days and was found to be elevated after initiation of ELT (6.4 ± 10.0 vs 3.1 ± 5.2; P = .20). No signs and symptoms of ethanol intoxication were observed. CONCLUSIONS ELT for the prevention of CVAD infections in pediatric intestinal failure patients significantly decreased BSI rates and may be used for extended periods of time in an outpatient setting.
CAROTID‐FEMORAL PULSE WAVE VELOCITY *

Simultaneous records of the pulse waves were obtained from the right common carotid artery and the right femoral artery by means of piezo‐electric microphones in 26 persons whose ages ranged from 15 to 92 years. The time difference between the foot points of the waves from these two sites was termed TCF.
Shame and emotion regulation in inflammatory bowel disease: Effects on psychosocial functioning

Although patients with inflammatory bowel disease seem to be prone to high levels of shame, the mechanisms behind the impact of chronic illness–related shame on patients’ functioning have not been explored yet. This study aims to address these gaps using a sample of 161 patients with inflammatory bowel disease who completed self-report measures on an online survey. The results from path analyses showed that chronic illness–related shame presented direct and indirect effects on psychological health (R2 = .66) and social relationships (R2 = .46). The indirect effects were mediated by experiential avoidance and uncommitted living. Possible explanations to these findings and clinical implications are discussed.
Sustainability Reporting and Firm Value: Evidence from Singapore-Listed Companies

As sustainability reporting has emerged as one of the most critical issues in the business world, this research aims to investigate the relationship between sustainability reporting and firm value based on listed companies in Singapore. We use an established sustainability reporting assessment framework and test how both the adoption and quality of sustainability reporting are related to a firm’s market value. Empirical results suggest that sustainability reporting is positively related to firm’s market value and this relationship is independent of sector or firm status such as government-linked companies and family businesses.
Measurement of the dielectric properties of the epidermis and dermis at frequencies from 0.5 GHz to 110 GHz

Numerous studies have reported the measurements of the dielectric properties of the skin. Clarifying the manner in which the human body interacts with electromagnetic waves is essential for medical research and development, as well as for the safety assessment of electromagnetic wave exposure. The skin comprises several layers: the epidermis, the dermis, and the subcutaneous fat. Each of these skin layers has a different constitution; however, the previous measurements of their dielectric properties were typically conducted on tissue which included all three layers of the skin. This study presents novel dielectric property data for the epidermis and dermis with in vitro measurement at frequencies ranging from 0.5 GHz to 110 GHz. Measured data was compared with literature values; in particular, the findings were compared with Gabriel’s widely used data on skin dielectric properties. The experimental results agreed with the data reported by Gabriel for the dermis of up to 20 GHz, which is the upper limit of the range of frequencies at which Gabriel reported measurements. For frequencies of 20–100 GHz, the experimental results indicated larger values than those extrapolated from Gabriel’s data using parametric expansion. For frequencies over 20 GHz, the dielectric properties provided by the parametric model tend toward the experimental results for the epidermis with increasing frequency.
FOREIGN DIRECT INVESTMENT AND STOCK MARKET DEVELOPMENT: EVIDENCE FROM GHANA

The paper examined the impact of Foreign Direct Investment (FDI) on stock market development. In this regard, the paper examined the complementary hypothesis vis-a-vis the substitutability hypothesis. Using ARDL model and quarterly time series data from International Financial Statistics and Bank of Ghana from 1990 to 2010, it was found that the complementary hypothesis was vindicated. FDI had positive impact on stock market development and this supported the complementary hypothesis in the short run. In addition, Inflation and Exchange rate had positive impact on stock market development. Also there was a bi-causality between FDI and stock market development. The policy implications are that government could maintenance of prudent macroeconomic policies and continue to create legal and congenial environment to stimulate the flow of foreign direct investment and encourage the re-investment of surpluses so that stock market development and economic growth could be enhanced. In other to attract FDI on sustainable bases, stock market development needs to be enhanced.
Conceptualising Luxury Residential Property For Marketing

Today, the luxury residential property segment in Malaysia has experienced product development in an exponential rate, causing the segment to encompass more than just exclusivity, fancy address and facilities. For purchasers, the luxury concept has moved beyond the physical product. As such, it is important for marketers to understand how luxury is perceived from a larger perspective so that they can gauge, shape and fulfil potential purchasers’ expectations. In the current soft market for luxury apartments, such understanding is crucial to the business sustainability of developers. This paper attempts to conceptualise luxury residential property based on an extensive review of the relevant literature. Ultimately, the findings of this paper will contribute towards an effective marketing strategy to boost the sale of luxury high-rise residential properties which are currently experiencing a soft market. The 4P’s of marketing underpinned the formulation of the concept of luxury residential spaces in this paper. Information is gleaned from texts, articles, journals, books and seminar papers from various perspectives including real estate, marketing, economics and sociology mainly from international authors. As such, the scope of this paper is much wider than simply capturing the nuances of local culture in shaping the notion of luxury residences, but rather take a global and academic view of the conceptualisation of luxury residential property. The framework of luxury residential property as presented in this paper will give practitioners and researchers an informed insight into the evolution, normalisation and development of the concepts of luxury and luxury residence with potential applications for benchmarking and research. Although far from definitive, sufficient theories, definitions and discourse from the body of knowledge on luxury real estate have been covered and thus provide a valuable reference. Keywords: Conceptualisation, Luxury, Maslow’s hierarchy of needs, Residential property.
EDTA chelation reappraisal following new clinical trials and regular use in millions of patients: review of preliminary findings and risk/benefit assessment

EDTA chelation therapy is regularly used in thousands of patients worldwide. An FDA approval of more than 50 years ago for heavy metal detoxification prompted many physicians to use EDTA as an alternative medicine for many categories of patients. Recently, NIH initiated the so-called Trial to Assess Chelation Therapy (TACT), which has been designed to evaluate whether EDTA and high dose oral vitamins and mineral therapy could offer clinical, quality of life, and economic benefits for patients with a previous myocardial infraction. A 50% reduction of urinary Pb and improvement of systolic blood pressure was observed in 33 cardiovascular patients following 20 iv administrations. In another study involving 15 patients of different categories, EDTA also has been shown to be an effective and nontoxic chelator for the removal of xenobiotic metals such as Pb, Cd, Ni and Al. Administration of iv EDTA on weekly basis appears to be a sufficient and nontoxic protocol for treating patients with suspected overload and toxicity of xenobiotic metals especially Pb and Cd. The causative effect of xenobiotic metals in cancer, cardiovascular, neurodegenerative, renal and other diseases needs further investigation. Similarly, the use of EDTA chelation therapy in other conditions, which are not related to xenobiotic metal toxicity needs further investigation and confirmation of therapeutic use from controlled randomized clinical trials. Metal balance and drug interaction studies are required to clarify the risk/benefit assessment for the long term use of EDTA in patients with excess xenobiotic metal toxicity and in other conditions.
The ins and outs of microRNAs as biomarkers in liver disease and transplantation

Ongoing research is being conducted in the field of transplantation to discover novel, noninvasive biomarkers for assessment of graft quality before transplantation and monitoring of graft injury after transplantation. MicroRNAs (miRNAs) are among the most promising in this field. MiRNAs are small noncoding RNAs that function as important regulators of gene expression in response to cellular stress and disease. An advantage that makes miRNAs attractive candidates for biomarker research is their fast release from cells in response to stress and injury, which can occur via different routes. In the context of liver transplantation (LT), noninvasive measurement and stability of extracellular miRNAs in blood, bile, and graft perfusates has been linked to cell‐type specific injury and early graft outcome following LT. Furthermore, specific intrahepatic miRNA expression patterns have been associated with graft survival and recurrent disease, like hepatitis C virus‐related fibrosis and hepatocellular carcinoma. Therefore, miRNAs with strong predictive value and high sensitivity and specificity might be successfully applied to assess hepatic injury and to diagnose (recurrent) liver disease before, during and after LT. In this review, the current features and future prospects of miRNAs as biomarkers in and out of the liver are discussed.
A Stream of Prospects or a Prospect of Streams: On the Evaluation of Intertemporal Risks

Recent debate has identified important gaps in the understanding of intertemporal risks. Critical to closing these gaps is evidence on which dimension of intertemporal risk – the risk or the time – is evaluated first. Though under discounted expected utility this ordering is of no consequence, under discounted non-expected utility models the order of evaluation is critical. We provide experimental tests in which different orderings of evaluation generate different predictions for behavior. We find more support for the notion that the risk dimension is evaluated first.
Hospital admissions for orthostatic hypotension and syncope in later life: insights from the Malmö Preventive Project

Objective(s): We explored incidence, predictors, and long-term prognosis of hospital admissions attributed to reflex syncope and orthostatic hypotension. Methods: We analyzed a cohort of 32 628 individuals (68.2% men; age, 45.6 ± 7.4 years) without prevalent cardiovascular disease over a follow-up period of 26.6 ± 7.5 years. Results: One thousand and fourteen persons (3.1%, 1.2 per 1000 person-years) had at least 1 hospitalization for orthostatic hypotension (n = 462, 1.42%) or syncope (n = 632, 1.94%). Orthostatic hypotension-related hospitalizations were predicted by age [per 1-year increase, hazard ratio 1.14, 95% confidence interval (CI): 1.12–1.16], smoking (hazard ratio 1.35, 95% CI: 1.12–1.64), diabetes (hazard ratio 1.50, 95% CI: 1.00–2.25), baseline orthostatic hypotension (hazard ratio 1.45, 95% CI: 1.05–1.98), in particular, by SBP fall at least 30 mmHg (hazard ratio 3.93, 95% CI: 2.14–7.23), whereas syncope hospitalizations by age (per 1-year increase, hazard ratio 1.09, 95% CI: 1.07–1.11), smoking (hazard ratio 1.27, 95% CI: 1.08–1.49), and hypertension (hazard ratio 1.42, 95% CI: 1.20–1.69). Both syncope-hospitalized and orthostatic hypotension hospitalized patients had higher burden of hospital admissions for other reasons such as cardiovascular, pulmonary, renal disease, or diabetes. During the follow-up, 10 727 (32.9%) died, with 419 deaths preceded by syncope/orthostatic hypotension hospitalization. After adjustment for traditional risk factors, syncope-hospitalization predicted all-cause mortality (hazard ratio 1.16, 95% CI: 1.02–1.31), whereas orthostatic hypotension hospitalization predicted cardiovascular mortality (hazard ratio 1.13, 95% CI: 1.07–1.19). Conclusion: Hospital admissions due to syncope and orthostatic hypotension occur in ≈3% of older individuals and increase with age and comorbidities. Admissions due to syncope are associated with prevalent hypertension, whereas those due to orthostatic hypotension overlap with diabetes and previously identified orthostatic hypotension. Syncope-related admissions predict higher all-cause mortality, whereas orthostatic hypotension-related admissions herald increased cardiovascular mortality.
Analysis of the thyrotropin‐releasing hormone‐degrading ectoenzyme by site‐directed mutagenesis of cysteine residues

Thyrotropin‐releasing hormone‐degrading ectoenzyme is a member of the M1 family of Zn‐dependent aminopeptidases and catalyzes the degradation of thyrotropin‐releasing hormone (TRH; Glp‐His‐Pro‐NH2). Cloning of the cDNA of this enzyme and biochemical studies revealed that the large extracellular domain of the enzyme with the catalytically active site contains nine cysteine residues that are highly conserved among species. To investigate the functional role of these cysteines in TRH‐DE we used a site‐directed mutagenesis approach and replaced individually each cysteine by a serine residue. The results revealed that the proteolytically truncated and enzymatically fully active enzyme consists of two identical subunits that are associated noncovalently by protein–protein interactions but not via interchain S‐S bridges. The eight cysteines contained within this region are all important for the structure of the individual subunit and the enzymatic activity, which is dramatically reduced in all mutant enzymes. This is even true for the four cysteines that are clustered within the C‐terminal domain remote from the Zn‐binding consensus sequence HEICH. In contrast, Cys68, which resides within the stalk region seven residues from the end of the hydrophobic membrane‐spanning domain, can be replaced by serine without a significant change in the enzymatic activity. Interestingly, this residue is involved in the formation of an interchain disulfide bridge. Covalent dimerization of the subunits, however, does not seem to be essential for efficient biosynthesis, enzymatic activity and trafficking to the cell surface.
[The role of biochemical markers of bone turnover in the diagnosis of osteoporosis and predicting fracture risk].

BACKGROUND Currently, for the diagnosis of osteoporosis, we search risk factors and measure bone mineral density (BMD) by DXA method. However, bone turnover markers, unused still in practice, have shown an interest especially in the prediction of fracture risk. aim: To determine the relationship between bone markers, BMD and osteoporotic fracture. methods: Prospective study of 65 women referred for measure of BMD during the period between May and August 2010. Each patient had a dosage of serum bone formation markers: osteocalcin (OC) and N-terminal propeptide of type I collagen (P1NP) and bone resorption markers: serum and urinary C-terminal telopeptide of type I collagen (β-CTX or CrossLaps) as well as parathyroid hormone and calcium. Risk factors of osteoporosis were identified in each case. results: Our 65 women had a mean age of 58.6 ± 12.1 years. The majority (83%) were menopausal women. Osteoporosis was found in 52%, osteopenia 26% and normal BMD 22% of cases. An increase in bone turnover markers was correlated with menopause (p = 0. 001 for the OC, p = 0.016 for urinary CTX), a low body mass index (p = 0.015 for OC, p = 0.042 for serum CTX) and osteoporosis (p <0.001 for P1NP, p <0.001 for serum and urinary CTX). Corticosteroid therapy was correlated with a decrease in bone formation markers (p = 0.002 for P1NP). The presence of fracture was only associated with increased urinary CTX (p = 0.05). CONCLUSION Bone turnover markers increase in menopausal women and in case of low BMD. However, their contribution in the diagnosis of osteoporosis is low. They are rather an interest in the prediction of fracture risk.
Effect of Melagatran on Prothrombin Time Assays Depends on the Sensitivity of the Thromboplastin and the Final Dilution of the Plasma Sample

Summary Prothrombin time (PT) assays are clotting methods that measure the activity of vitamin K-dependent coagulation factors (F) II, VII, and X. There are three main types of PT assays in general usage, namely the Quick assay, Owren’s assay and PT dry chemistry test cards. PT assays were initially developed to monitor dose-adjustments of vitamin K antagonists such as warfarin. The aim of the present study was to investigate whether commercially available PT assays are suitable for evaluating the anticoagulant activity of direct thrombin inhibitors. Melagatran, a reversible direct thrombin inhibitor, was added to human plasma at concentrations ranging from 0.1 to 2.0 μmol/l. Seventeen different commercially available PT kits were used, including thirteen Quick reagents, two Owren reagents and two PT test cards. The sensitivity of the different reagents, expressed as the concentration of melagatran that doubled the prothrombin time (IC50) varied widely, with Thromboplastin S and Thromboplastin HS being the most sensitive (IC50 = 0.9 μmol/l). The reagents with apparently the lowest sensitivity were the two Owren reagents Nycotest PT and SPA 50 with an IC50 of 2.2 and 2.9 μmol/L, respectively. This is most likely due to a higher dilution of melagatran in these assays compared to the dilution in the Quick assays. The results were also dependent on the International Sensitivity Index (ISI) of each reagent. The concentration of melagatran that produced an International Normalized Ratio (INR) of 2 was calculated from dose-response curves for each assay, and these results revealed that reagents with a high ISI value gave an INR of 2 at much lower concentrations of melagatran (0.5-0.7 μmol/L) than those with an ISI-values around one (0.9-1.2 μmol/L). It was found that INR depends not only on the plasma concentration of melagatran, but also on the sensitivity of the PT reagent and on the final dilution of the plasma sample in the prothrombin time assay. Thus, since the same melagatran concentration can be associated with widely varying PT/INR results depending on the specific assay used it is concluded that PT assays and INR can not be used to monitor melagatran activity.