Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of efficacy and tolerability of Losartan and Ramipril combination in the management of hypertensive patients with associated diabetes mellitus in India (LORD Trial).

AIM The study was conducted to evaluate efficacy and tolerability of fixed dose combination (FDC) of Losartan and Ramipril in the management of mild to moderate hypertensive Native Asian Indian patients with associated diabetes mellitus. The secondary objective was to evaluate the efficacy of the combination in reducing microalbuminuria. MATERIAL AND METHODS The study was an open, non-comparative, multicentric clinical trial conducted in seven Indian centres in 315 eligible patients. All the patients were treated with Losartan 50 mg + Ramipril 2.5 mg or Losartan 50 mg + Ramipril 5 mg once a day in 12 weeks and consisted of a total of eight visits. RESULTS The mean age of patients was 52.93 years (range 45 - 60 years). Of the total patients, 62.86% were males and 37.14% were females. The mean prestudy systolic blood pressure was 160.56 +/- 14.44 which was significantly reduced to 126.85 +/- 9.78 at the end of 12 weeks (P < 0.001). Similarly the mean diastolic blood pressure was 98.91 +/- 8.33 at baseline (stage I) which was significantly reduced to 79.82 +/- 5.42 at the end of 12 weeks (P < 0.001). A mean fall of 33.72 mmHg in systolic blood pressure and the mean fall of 19.10 mmHg was observed in systolic and diastolic blood pressure respectively at the end of the treatment which was statistically highly significant (P < 0.001). The JNC-VII goal of blood pressure < 130/80 was achieved in 79.05% patients after the treatment which losartan and ramipril combination only. Microalbuminuria (urinary albumin excretion > 30 but < 300 mg/day) was seen in 83/250 (33.2%) patients and 135 (54%) patients had clinical proteinuria (albuminuria) at baseline. At the end of the therapy 20.8% patients achieved normoalbuminuria. Good to excellent efficacy response was reported in 98.09% patients and 98.41% patients reported good to excellent tolerability to the treatment. CONCLUSION The fixed dose combination of Losartan and Ramipril showed good to excellent efficacy response in 98.10% patients and achieved a target blood pressure of 130/80 mmHg in 79.05% patients in 12 weeks. The combination reduced the urinary albumin excretion in majority of the patients with microalbuminuria and proteinuria (the major marker of nephropathy).
Increased Long-term Measurement Variability With Scanning Laser Polarimetry Employing Enhanced Corneal Compensation: An Early Sign of Glaucoma Progression

PurposeTo investigate whether the intervisit standard deviation (ISD) of various scanning laser polarimetry parameters is increased, in progressing glaucoma. MethodsGDx-variable corneal compensation (VCC) and GDx-enhanced corneal compensation (ECC) measurements, and Octopus G2 visual field tests, were performed at 6-month intervals on 27 healthy subjects and 52 consecutive glaucoma patients. One eye per participant was analyzed. Fifteen patients progressed (on the basis of visual field criteria) and 37 remained stable, during the 2.6±0.4 years follow-up. ResultsBaseline visual field indices and the stage of glaucoma did not differ between the glaucoma groups. No regression with time was found for any GDx parameter in any group. The ISD of GDx-ECC nerve fiber indicator (NFI), but not GDx-VCC NFI, was significantly higher in progression than in the stable glaucoma group (Mann-Whitney U test with Bonferroni correction, P=0.028). Also, several other ISD values tended to increase in the progressing group. Logistic regression analysis revealed that ISD of NFI [odds ratio (OR)=1.22, P=0.013], inferior average (OR=1.80, P=0.035), and average thickness along the measuring ellipse (OR=2.00, P=0.042), as determined with GDx-ECC (but not with GDx-VCC), all associated with visual field progression, independently of patient age. ConclusionsWith GDx-ECC, increase of ISD is an early sign of glaucoma progression, precedes the development of detectable parameter changes, and is associated with visual field progression.
ANATOMIC AND PHARMACOKINETIC PROPERTIES OF INTRAVITREAL BEVACIZUMAB AND RANIBIZUMAB AFTER VITRECTOMY AND LENSECTOMY

Purpose: To determine the anatomic characteristics and pharmacokinetic properties of intravitreally placed bevacizumab and ranibizumab after pars plana lensectomy or pars plana vitrectomy and to compare these with nonoperated control eyes in a rabbit model. Methods: Three groups of six Dutch-belted rabbits each underwent pars plana vitrectomy, pars plana lensectomy, or served as nonsurgical controls. Twelve days after surgery, 3 rabbits from each group underwent intravitreal injection in one eye with 1.25 mg/0.05 mL I-124-bevacizumab or 0.5 mg/0.05 mL I-124-ranibizumab. Serial imaging with integrated positron emission and computed tomography (PET/CT) were obtained on Days 0, 2, 5, 7, 14, 21, 28, and 35. Measured radioactivity emission in becquerels/milliliter was used to calculate the half-lives for each agent. Results: The intravitreally placed radiolabeled agents were contained within the vitreous cavity for the duration of the study. The average clearance half-lives with standard error for bevacizumab and ranibizumab after correction for radioactive decay were, respectively, 4.22 ± 0.07 days and 2.81 ± 0.05 days in unoperated eyes, 2.30 ± 0.09 days (P < 0.0001) and 2.13 ± 0.05 days (P < 0.0001) after vitrectomy, and 2.08 ± 0.07 days (P = 0.0001) and 1.79 ± 0.05 days (P < 0.0001) after lensectomy. Conclusion: Intravitreal retention was longer for bevacizumab than ranibizumab within all study groups and was significantly reduced after vitrectomy and lensectomy for both agents. Consideration for more frequent intravitreal anti–vascular endothelial growth factor dosing regimens may be made for patients whose treated eyes have undergone previous vitrectomy or who are aphakic.
ANALISIS Pengaruh Current Ratio, Size, Debt To Equity Ratio, dan Total Asset Turnover Terhadap Dividend Yield dengan Return On Asset Sebagai Variabel Intervening

Financial performance has become one of the most important issues for investors before they investing their fund inside the company. There is so many factors affect the financial performance and affect their decisions. The sample used in this research consists of 25 manufacturing companies listed on the Indonesian Stock Exchange (IDX) 2010-2014. This study used the purposive sampling methods. Data obtained from the Indonesian Capital Market Directory (ICMD) and Annual Report. Data analysis method used is multiple linear regression analysis and also path analyisis for analyze the indirect effect of independent variables.The result indicates that CR, and TATO has significant positive effect on ROA, while DER has significant negative effect on ROA, while Size is the only one variable that has no effect on ROA. In the second regression, the result indicates that ROA, Size, and TATO has significant positive effect on Dividend Yield, while CR and DER has significant negative effect. More further, path analysis result indicates that CR and TATO has significant positive effect on Dividend Yield through intervening variables (ROA) while Size and DER has no significant effect on Dividend Yield through intervening variables (ROA).
The Role of Rewards in Improving the Performance of Customer Service inGovernment Sector

This paper is an exploratory study of rewards and performance, and examines the role of rewards on the performance of customer service; (also called front desk officers) in the context of Saudi Arabia government sector using content analysis on the country’s current traditional pay structures. From the review of literature and practices it is observed that the use of performance related incentives (rewards) is more problematic in the public sector than in the private sector. Nevertheless, there have been some degrees of successes even in some developing countries’ civil service in the class of Saudi Arabia. The traditional pay structures for Saudi Arabia government service based on grades and seniority, rather than performance may not produce the required productivity and efficiency. The World Bank has also recognized the problems caused by the traditional model of civil service pay structures, which it sees as central to what it terms as ‘bureaucratic dysfunction”. In view of the notable successes recorded in countries similar to Saudi Arabia in the use of reward for performance scheme, the Kingdom needs to review its current traditional pay structures for the public sector to enhance productivity and efficiency.
Ultrastructural analysis of local collaterals of rat ventral tegmental area neurons: GABA phenotype and synapses onto dopamine and GABA cells

Local synapses formed by nondopamine cells within the ventral tegmental area (VTA) are thought to provide an important regulatory influence on the activity patterns of dopamine (DA) neurons. However, ultrastructural confirmation of intra‐areal synapses formed by VTA neurons is lacking, and the synaptic targets of these connections have not been examined. We performed discrete injections of the specific anterograde tracer Phaseolus vulgaris leucoagglutinin (PHAL) and used electron microscopy to visualize immunoperoxidase labeling within the local collaterals of VTA cells. The phenotype of target neurons was determined by immunogold‐silver labeling for GABA or for tyrosine hydroxylase within DA neurons. Within or immediately adjacent to the VTA injection sites, PHAL was incorporated into the soma and dendrites of both GABA and DA cells. Tracer was also detected within myelinated and unmyelinated axons as well as axon terminals. Some labeled terminals formed identifiable synapses, the majority of which (78%) had symmetric morphology (presumably inhibitory). Both DA and GABA dendrites were contacted by these intrinsic axons. Postembedding immunogold labeling verified that local axon collaterals arose mainly from GABA cells (DA neurons are not known to issue recurrent collaterals). Nevertheless, a few synapses with asymmetric morphology (presumably excitatory) were also noted; whether these derive from local glutamate neurons requires further investigation. Hence, our data provide ultrastructural support for the long standing assumption that GABA VTA neurons synapse locally onto DA cells. The findings also suggest the presence of disinhibitory and possibly excitatory circuitry intrinsic to the VTA. Synapse 63:895–906, 2009. © 2009 Wiley‐Liss, Inc.
Treatment of Hypoxemia in Obstructive Sleep Apnea

Many patients suffering from obstructive sleep apnea (OSA) have intermittent oxygen desaturation associated with periods of apnea or hypopnea. Oxygen saturation levels below 90% are considered harmful.1 Usually, treatment is directed at correcting the apnea, which will in turn prevent hypoxemia. Unfortunately, many patients fail or are not candidates for nasal continuous positive airway pressure (CPAP) or surgical correction of their OSA. Forty-three patients with persistent OSA and nocturnal hypoxemia below 90% who were not candidates for additional surgical or CPAP therapy were treated with nocturnal oxygen supplementation. Standard symptoms associated with OSA and the Epworth Sleepiness Scale (ESS) were recorded before treatment and 30 days after the start of the treatment. In 21 patients, polysomnography studies were performed to compare the Respiratory Disturbance Index (RDI) score and minimum oxygen saturation levels when the patients were breathing room air or breathing 4 L/minute of oxygen by nasal cannula. Subjective symptoms of obstructive sleep apnea improved, and the ESS score significantly decreased after a 30-night treatment with oxygen. Split-night polysomnography showed a significant increase in minimum oxygen saturation during oxygen administration. The RDI did not significantly change with treatment. Oxygen administration for the correction of OSA-related nocturnal hypoxemia was both safe and effective in alleviation of OSA-related symptoms. It also appeared to have a beneficial effect on minimum oxygen saturation levels. Thus, oxygen therapy may be considered a treatment option in patients who fail to comply with CPAP and are not candidates for a surgical procedure.
Are All Colloids Same? How to Select the Right Colloid?

Summary The administration of intravenous fluids is one of the most common and universal interventions in medicine. Colloids are an alternative to the frequently used crystalloids, with highly variable use depending on a myriad of clinical variables. A colloid is defined as a high molecular weight (MW) substance that largely remains in the intravascular compartment, thereby generating an oncotic pressure. Colloids are considered to have a greater intravascular persistence when compared to crystalloids. All colloids, however, are clearly not the same. Differences in the physicochemical properties, pharmacokinetics and safety profile exist amongst various colloids. This review explores the different types of colloids, with their properties and usefulness as well as adverse effects. While all the available colloids are reviewed briefly (e.g., albumin, gelatin, dextran) with respect to their pharmacology, indications, advantages and disadvantages, particular emphasis is laid on the hydroxyethyl starches (HES) because of their rising prominence. It is shown that HES differ widely in their physicochemical and pharmacokinetic properties, composition, usefulness, and especially in their adverse effect profiles. The third generation HES (tetrastarches), in particular, seem to offer a unique combination of safety and efficacy. Several issues related to this are discussed in detail. This review of the available clinical data demonstrates that HES should not be regarded as one homogenous group, and data for one product should not be automatically extrapolated to another. Thus, among the synthetic colloids, the tetrastarches appear to offer the best currently available compromise between efficacy, safety profile, and cost. They also appear to be the best suited for use in the intensive care setting. Finally, balanced (rather than saline-based) HES solutions appear promising as a plasma-adapted volume replacement strategy and may further refine the ongoing quest of finding the ideal fluid therapy.
Overexpression of IGF-1 Exclusively in Skeletal Muscle Prevents Age-related Decline in the Number of Dihydropyridine Receptors*

Excitation-contraction uncoupling has been identified as a mechanism underlying skeletal muscle weakness in aging mammals (sarcopenia). The basic mechanism for excitation-contraction uncoupling is a larger number of ryanodine receptors (RyR1) uncoupled to dihydropyridine receptors (DHPRs) (Delbono, O., O’Rourke, K. S., and Ettinger, W. H. (1995) J. Membr. Biol. 148, 211–222). In the present study, we used transgenic mice overexpressing human insulin-like growth factor-1 exclusively in skeletal muscle to test the hypothesis that a high concentration of IGF-1 prevents age-related decreases in DHPR number and in muscle force. Transgenic mice express 10–20-fold higher IGF-1 concentrations than nontransgenic mice at all ages (1–24 months). The number of DHPRs is 50–100% higher, and the DHPR/RyR1 ratio is 40% higher in transgenicsoleus (predominantly type I fiber muscles), extensor digitorum longus (predominantly type II fiber muscles), and the pool of type I and type II fiber muscles than in nontransgenic young (6 months), adult (12 months), and old (24 months) mice. Furthermore, no age-related changes in DHPRs and the DHPR/RyR1 ratio were observed in transgenic muscles. The specific single twitch and tetanic muscle force in old transgenic soleus and extensor digitorum longus muscles are 50% higher than in old nontransgenic muscles. Taken together, these results support the concept that IGF-1- dependent prevention of age-related decline in DHPR expression is associated with stronger muscle contraction in older transgenic mice.
Prevention of chemotherapy- and radiotherapy-induced emesis: results of the 2004 Perugia International Antiemetic Consensus Conference.

BACKGROUND In the late 1990s, several professional organizations convened antiemetic guideline groups and published the findings of these expert panels. Each of these documents was based on analyses of the available published trials and provided nearly similar recommendations. Nonetheless, small differences in emetic risk categories and treatment recommendations led to confusion in antiemetics selection. With the emergence of new findings and agents since the guidelines were initially published, many of the oncology professional societies have updated the antiemetic guidelines. MATERIALS AND METHODS A literature review up to March 2004 was carried out using MEDLINE with evaluation of the evidence by an expert panel composed of 23 oncology professionals in clinical medicine, medical oncology, radiation oncology, oncology nursing, statistics, pharmacy, medical policy and decision making, and pharmacology. The experts represented nine oncology professional societies and came from 11 different countries on four continents. RESULTS Recommendations on antiemetic regimens to prevent emesis induced by high, moderate, low and minimal risk chemotherapy were suggested as well as management of anticipatory emesis. Furthermore, recommendations for refractory emesis, emesis induced by high-dose chemotherapy and radiotherapy and for antiemetics in children receiving chemotherapy were elaborated. CONCLUSIONS Recommendations about antiemetic prophylaxis in patients receiving treatment with chemo- and radiotherapy have been updated by representatives of nine oncological organizations.
Molecular and Immunologic Mechanisms of Cancer Pathogenesis in Solid Organ Transplant Recipients

The increased risk for the development of malignancies in transplant recipients is generally attributed to the debilitated immune system that results from chronic exposure to potent immunosuppressive drugs required to prevent graft rejection. While impaired immunity is clearly a key determinant, there is strong evidence that a constellation of other factors contribute to the pathogenesis of posttransplant cancers. In this article we discuss the underlying molecular and immunologic mechanisms that contribute to the development of de novo malignancies in transplant recipients, with particular focus on the two leading posttransplant neoplasia, skin cancer and Epstein–Barr virus (EBV)‐associated posttransplant lymphoproliferative disorder (PTLD).
SPOT: A tool for set-based prediction of traffic participants

Predicting the movement of other traffic participants is an integral part in the motion planning of most automated road vehicles. While simple predictions, e.g. based on assuming constant velocity, may suffice for deciding a driving strategy, predicting the set of all possible behaviors is required to ensure safe motion plans. In this work, we propose a novel tool for the latter problem based on reachability analysis: Set-Based Prediction Of Traffic Participants (SPOT). Our tool can predict the future occupancy of other traffic participants, including all possible maneuvers (e.g. full acceleration, full braking, and arbitrary lane changes), by considering physical constraints and assuming that the traffic participants abide by the traffic rules. However, we remove assumptions for each traffic participant individually as soon as a violation of a traffic rule is detected. Removal of assumptions automatically results in larger occupancies and thus a smaller drivable area for the ego vehicle, ensuring that the ego vehicle does not cause a collision during the time horizon of the prediction. Experimental results show that we obtain the set of future occupancies within a fraction of the prediction horizon. Our tool is available at spot.in. tum.de.
Iontophoresis In Vivo Demonstrates a Key Role for GABAA and Glycinergic Inhibition in Shaping Frequency Response Areas in the Inferior Colliculus of Guinea Pig

The processing of biologically important sounds depends on the analysis of their frequency content by the cochlea and the CNS. GABAergic inhibition in the inferior colliculus shapes frequency response areas in echolocating bats, but a similar role in nonspecialized mammals has been questioned. We used the powerful combination of iontophoresis with detailed analysis of frequency response areas to test the hypothesis that GABAergic and glycinergic inhibition operating in the inferior colliculus of a nonspecialized mammal (guinea pig) shape the frequency responses of neurons in this nucleus. Our analysis reveals two groups of response areas in the inferior colliculus: V-shaped and non-V-shaped. The response as a function of level in neurons with V-shaped response areas can be either monotonic or nonmonotonic. Application of bicuculline or strychnine in these neurons, to block inhibition mediated by GABAA or glycinergic receptors, respectively, increases firing rate primarily within the boundaries of the control response area. In contrast, neurons in the non-V-shaped group have response areas that include narrow, closed, tilted, and double-peaked types. In this group, blockade of GABAA and glycine receptors increases firing rate but also changes response area shape, with most becoming more V-shaped. We conclude that (1) non-V-shaped response areas can be generated by GABA and glycinergic synapses within the inferior colliculus and do not simply reflect inhibition acting more peripherally in the pathway and (2) frequency-dependent inhibition is an important general feature of the mammalian inferior colliculus and not a specialization unique to echolocating bats.
Momentum: The Academic and Economic Value of a 15-Credit First-Semester Course Load for College Students in Tennessee

Many students fail to complete college because the pathways they take through college are not optimal. One example is that their initial course loads are often too low. When students take too few courses in the first semester or academic year, it negatively affects their “momentum. ” Compounded over semesters, these students accumulate insufficient credits to graduate within the conventional time frame. In this paper, we explore the academic and economic consequences of taking higher or lower credit loads. Using student-level data from the Tennessee Board of Regents, we estimate differences in award completion and credit accumulation across students according to their firstsemester and first-year credit loads. We apply ordinary least squares and propensity score matching estimation to adjust for differences in student characteristics. Using an economic model, we estimate improvements in cost per completion (i.e., cost efficiency) and additional spending by students who take 15 credits in their first semester (“momentum students”) compared with those who take 12 credits. We find strong positive academic impacts on credits and degree completion for momentum students in community colleges and four-year colleges. These impacts are financially valuable to students: Over their time in college, momentum students pay 4–14 percent less per credit and 9–19 percent less per degree in tuition and fees. These savings also produce gains for colleges, because more tuition revenue is generated as more students persist. The academic and economic effects are even stronger for students who sustain momentum through the first year.