Miracle-dz/UniFAR-FTUs huggingface dataset:
Simple treadmill score to diagnose coronary disease.

OBJECTIVE Our aim was to derive and validate a simplified treadmill score for predicting the probability of angiographically confirmed coronary artery disease (CAD). BACKGROUND The American College of Cardiology/American Heart Association guidelines for exercise testing recommend the use of multivariable equations to enhance the diagnostic characteristics of the standard treadmill test. Most of these equations use complicated statistical techniques to provide diagnostic estimates of CAD. Simplified scores derived from such equations that require physicians only to add points have been developed for pretest estimates of disease and for prognosis. However, no simplified score has been developed specifically for the diagnosis of CAD using exercise test results. METHODS Consecutive patients referred for evaluation of chest pain who underwent standard treadmill testing followed by coronary angiography were studied. A logistic regression model was used to predict clinically significant (> or = 50% stenosis) CAD and then the variables and coefficients were used to derive a simplified score. The simplified score was calculated as follows: (6 x maximal heart rate code) + (5 x ST-segment depression code) + (4 x age code) + angina pectoris code + hypercholesterolemia code + diabetes code + treadmill angina index code. The simplified score had a range from 6 to 95, with < 40 designated as low probability, between 40 and 60 was intermediate probability, and > 60 was high probability for CAD. RESULTS A total of 1,282 male patients without a prior myocardial infarction underwent exercise treadmill testing and coronary angiography in the derivation group, and there were 476 male patients in the validation group from another institution. The area under the receiver operating characteristic curve (+/- SE) for the ST-segment response alone was 0.67 as compared to 0.79 +/- 0.01 for the diagnostic score (p > 0.001). The prevalence of significant disease for the men was 27% in the low-probability group, 62% in the intermediate-probability group, and 92% in the high-probability group, which was similar to the prevalence in the validation group, with 22%, 58%, and 92% in low-, intermediate-, and high-probability groups, respectively. The low-probability group had < 4% prevalence of severe disease. In both populations, 7 more patients out of 100 were correctly classified than with the use of ST-segment criteria. When used as a clinical management strategy, the score has a sensitivity of 88% and a specificity of 96%. CONCLUSION This simplified exercise score that estimates the probability of CAD can be easily applied without a calculator and is a useful and valid tool that can help physicians manage patients presenting with chest pain.
Mucosal Toxicity Studies of a Gel Formulation of Native Pokeweed Antiviral Protein

Pokeweed antiviral protein (PAP), a 29-kDa plant-derived protein isolated from Phytolacca americana, is a promising nonspermicidal broad-spectrum antiviral microbicide. This study evaluated the mucosal toxicity potential of native PAP in the in vivo rabbit vaginal irritation model as well as the in vitro reconstituted human vaginal epithelial tissue model. Twenty-two New Zealand white rabbits in 4 subgroups were exposed intravaginally to a gel with and without 0.01, 0.1, or 1.0% native PAP for 10 consecutive days. The dose of PAP used represented nearly 200- to 20,000 times its in vitro anti-HIV IC50 value. Animals were euthanized on day 11 and vaginal tissues were evaluated for histologic and immunohistochemical evidence of mucosal toxicity, cellular inflammation, and hyperplasia. Blood was analyzed for changes in hematology and clinical chemistry profiles. Reconstituted human vaginal epithelial tissue grown on membrane filters was exposed to 0.1, 0.1, or 1.0% native PAP in medium or topically via a gel for 24 hours and tissue damage was evaluated by histological assessment. In the in vivo rabbit vaginal irritation model, half of all PAP-treated rabbits (8/16) exhibited an acceptable range of vaginal mucosal irritation (total score <8 out of a possible 16), whereas nearly a third of PAP-treated rabbits (5/16) developed moderate to marked vaginal mucosal irritation (total score >11). However, no treatment-related adverse effects were seen in hematological or clinical chemistry measurements. Furthermore, in vitro exposure of a 3-dimensional human vaginal tissue grown on polycarbonate membrane filters to identical concentrations of PAP either added to culture medium or applied topically via gel formulation did not result in direct toxicity as determined by histologic evaluation. These findings indicate careful monitoring of vaginal irritation will be required in the clinical development of PAP as a nonspermicidal microbicide.
COMPARISON OF XANTHINE OXIDASE INHIBITORS IN GOUTY PATIENTS WITH HYPERURICEMIA

Objective: Febuxostat is more effective/superior to Allopurinol in reducing the serum uric acid (SUA) level in the treatment of hyperuricemic with gout. Methods: This randomized control study included 200 hyperuricemic patients with gout, at Multi-center study including Outdoor Departments of Medicine from four different hospitals of Lahore, Pakistan. Patients age range 18-50 years diagnosis with hyperuricemia and gout, SUA >8 mg/dl were included while severe renal impairment and alanine aminotransferase and aspartate aminotransferase patients were excluded from the study. Results: About 200 patients treated with hyperuricemic with gout were randomly divided into four groups (50%) patients were in each group received different treatment. Out of 200 patients, 118 (59%) were male and 82 (41%) were female with mean age 42.37±9.47 years. Among the Febuxostat group, patients’ success rate of lowering SUA level was found to be 32 (64%) as compared to Allopurinol 16 (32%). Drug compliance was similar among treatment groups, i.e. Allopurinol and Febuxostat while the trend toward drug compliance in Allopurinol + Vitamin C and Febuxostat + Vitamin C groups showed similar in number. Conclusion: Febuxostat is safe and effective to Allopurinol for the treatment of hyperuricemia with gout as the Febuxostat has a significant association with lowering SUA concentration <6 mg/dl. It is concluded that although Febuxostat is safe and effect alone in gouty patients, but it has somehow a little effect with Vitamin C especially in patients who are feeble. Keywords: Febuxostat, Allopurinol, Serum uric acid.
Biotreatment of tannin-rich beer-factory wastewater with white-rot basidiomycete Coriolopsis gallica monitored by pyrolysis/gas chromatography/mass spectrometry.

Some fractions of beer-factory wastewaters represent an important environmental concern owing to their high content of polyphenols and dark-brown color. The capacity of Coriolopsis gallica to preferentially degrade lignin has been successfully applied in our laboratory to the biotreatment and decolorization of paper-industry effluents. In this work, the ability of this white-rot fungus to degrade high-tannin-containing wastewaters is evaluated. Under all the conditions studied, effluent decolorization and chemical oxygen demand reduction achieved by C. gallica at day 12 of incubation were close to 50 and 65%, respectively. No adhesion of dark color to the fungal mycelium was observed suggesting that decolorization could be ascribed to C. gallica degradation systems. Mycelium dry-weight values showed that C. gallica is tolerant to relatively high tannin content present in the effluent samples. In the sample containing the highest effluent concentration (60% v/v), dry-weight values suggested an inhibition of fungal growth at day 6 of incubation and a further adaptation of the fungus to the stressing tannin effect at day 12 of fungal treatment. Pyrolysis/gas chromatography/mass spectrometry results showed a decrease of polyphenols pyrolysis products, mainly phenol and guaiacol, with the incubation time. All these results indicate the potential use of C. gallica in bioremediation of tannin-containing industrial wastewaters and in other applications where a reduction in polyphenols content is required.
Behavioral stress potentiates the blood pressure effects of a high sodium intake.

&NA; The present study examined the blood pressure effects of a high sodium intake administered during two levels of behavioral stress. In this double‐blind study, 32 medical students were randomly assigned to receive either sodium chloride (high sodium) or placebo tablets (usual sodium). Resting blood pressure and body weight were recorded across a 14‐day period preceding examinations (high stress) and during the summer when academic demands were reduced (low stress). The high sodium intake during the high stress period was associated with greater elevations in resting systolic blood pressure and mean arterial pressure than either the usual sodium intake during the high stress period or the high sodium intake during a low stress period. These findings suggest that behaviorally induced neuroendocrine responses can potentiate a blood pressure response to a high sodium intake.
INCIDENCE OF IATROGENIC PERIPHERAL RETINAL BREAKS IN 23-GAUGE VITRECTOMY FOR MACULAR DISEASES

Purpose: To assess the incidence of iatrogenic peripheral retinal breaks in 23-gauge vitrectomy for macular diseases and to compare it with 20-gauge vitrectomy. Methods: Retrospective, comparative, interventional case series. We compared the incidence of iatrogenic peripheral retinal breaks in 176 eyes undergoing 23-gauge vitrectomy between January 2007 and November 2009 (23-gauge group) and 153 eyes undergoing 20-gauge vitrectomy between January 2004 and June 2006 (20-gauge group) for either idiopathic macular holes or idiopathic epiretinal membranes. All surgeries were performed by one surgeon at a single hospital. Main outcome measure was the incidence rate of iatrogenic peripheral retinal breaks discovered intraoperatively and postoperatively. Results: Iatrogenic peripheral retinal breaks occurred in 1 eye in the 23-gauge group and in 11 eyes in the 20-gauge group during surgery. Additional iatrogenic retinal breaks were found in 1 eye in the 23-gauge group and in 2 eyes in the 20-gauge group within 1 month after surgery. The overall incidence of iatrogenic peripheral retinal breaks was 1.1% (2 of 176) in the 23-gauge group and 8.5% (13 of 153) in the 20-gauge group. The difference was statistically significant (P = 0.0023). Conclusion: The incidence of iatrogenic peripheral retinal breaks during vitrectomy for macular diseases is significantly lower in 23-gauge vitrectomy than in 20-gauge vitrectomy.
Harnessing the Undiscovered Resource of Student Research Projects

This article suggests that undergraduate research can help advance the science of psychology. We introduce a hypothetical “question-list paradigm” as a mechanism to do this. Each year, thousands of undergraduate projects are completed as part of the educational experience. Although many of these studies may not contain sufficient contributions for publication, they provide a good test of the replicability of established findings across populations at different institutions and geographic locations. Thus, these projects could meet the needs of recent calls for increased replications of psychological studies while simultaneously benefiting the student researchers, their instructors, and the field in general.
EFFECT OF MATERNAL DEXAMETHASONE THERAPY ON THE LEVELS OF OESTROGENS, PROGESTERONE AND CHORIONIC GONADOTROPHIN IN AMNIOTIC FLUID AND MATERNAL SERUM

Ten women were given dexamethasone intramuscularly in order to accelerate fetal lung maturation. Amniotic fluid and maternal serum were assayed for oestrone, oestradiol‐l7β, oestriol, progesterone and chorionic gonadotrophin by specific radioimmunoassays before and after the treatment. No hormonal changes were observed in amniotic fluid. The serum levels of oestrogens 2 to 5 days after treatment were not significantly different from those before treatment, indicating that the previously reported suppression of oestrogen production by glucocorticoids disappears rapidly after treatment stops.
Ubiquitous expression of the Pik3caH1047R mutation promotes hypoglycemia, hypoinsulinemia, and organomegaly

Mutations in PIK3CA, the gene encoding the p110α catalytic subunit of PI3K, are among the most common mutations found in human cancer and have also recently been implicated in a range of overgrowth syndromes in humans. We have used a novel inducible “exonswitch” approach to knock in the constitutively active Pik3caH1047R mutation into the endogenous Pik3ca gene of the mouse. Ubiquitous expression of the Pik3caH1047R mutation throughout the body resulted in a dramatic increase in body weight within 3 weeks of induction (mutant 150 ± 5%; wild‐type 117 ± 3%, mean ± sem), which was associated with increased organ size rather than adiposity. Severe metabolic effects, including a reduction in blood glucose levels to 59 ± 4% of baseline (11 days postinduction) and undetectable insulin levels, were also observed. Pik3caH1047R mutant mice died earlier (median survival 46.5 d post‐mutation induction) than wild‐type control mice (100% survival > 250 days). Although deletion of Akt2 increased median survival by 44%, neither organ overgrowth, nor hypoglycemia were rescued, indicating that both the growth and metabolic functions of constitutive PI3K activity can be Akt2 independent. This mouse model demonstrates the critical role of PI3K in the regulation of both organ size and glucose metabolism at the whole animal level. —Kinross, K. M. , Montgomery, K. G. , Mangiafico, S. P., Hare, L. M. , Kleinschmidt, M. , Bywater, M. J., Poulton, I. J., Vrahnas, C. , Henneicke, H. , Malaterre, J., Waring, P. M. , Cullinane, C. , Sims, N. A. , McArthur, G. A. , Andrikopoulos, S. , Phillips, W. A. Ubiquitous expression of the Pik3caH1047R mutation promotes hypoglycemia, hypoinsulinemia, and organomegaly. FASEB J. 29, 1426‐1434 (2015). www.fasebj. org
Diminished CD4+ T cell surface CCR5 expression in alcoholic patients.

AIMS The C-C chemokine receptors, particularly the CCR5, appeared to play an important role in T cell-mediated inflammatory reactions. The aim of our study was to assess the impact of chronic alcohol consumption on the in vivo CCR5 expression. METHODS Fourteen alcoholic men hospitalized for a detoxification programme were prospectively included and compared with 49 age-matched controls. RESULTS The CD4(+) T cell surface CCR5 densities were drastically lower in alcoholic patients [mean, 5319 molecules/cell; 95% confidence interval (CI) 4477-6162] as compared with CCR5 densities of the controls (10 944 molecules/cell [CI 9929-11959]; P < 10(-4)). CONCLUSIONS Chronic alcohol consumption is associated with a significant decrease of CCR5 expression, which could favour Th1/Th2 imbalance.
Optimizing drug development: strategies to assess drug metabolism/transporter interaction potential--towards a consensus.

The issue of drug–drug interactions has generated significant concern within the pharmaceutical industry and amongst regulatory authorities in recent years. This has arisen with respect to early termination of clinical development (e.g. furafylline), refusal of approval (e.g. mibefradil in Sweden), severe prescribing restrictions and withdrawal from the market (e.g. sorivudine, terfenadine, mibefradil, astemizole, cisapride), and threatened litigation. This report summarizes the outcomes of a conference held in Basel in November 2000, under the auspices of the European Federation of Pharmaceutical Sciences (EUFEPS), the US Food and Drug Administration (FDA) and the American Association of Pharmaceutical Sciences (AAPS). The meeting followed on from two previous workshops on drug interactions held in Nuremberg (1997) and Arlington (1999) sponsored by the same groups. Whereas previous conferences had identified the main areas of contention, a specific aim of this meeting was to attempt a consensus on the conduct of in vitro and in vivo studies of metabolic and transport interactions. There were five main conference sessions, in which experienced scientists from academia, industry and regulatory bodies were invited to contribute short presentations formulated, where possible, to address specific questions: Session 1. Mechanistic considerations. Moderators: S. E. Clarke, S. Wrighton; Speakers: A. Boobis, J. B. Houston, S. D. Hall, S. Ekins, P. Maurel, H. Lennernaes. Session 2. In vitro assessment;Moderators: J. B. Houston, K. Thummel; Speakers: B. G. Lake, J. Lipscomb, T. Lave, R. S. Obach, S. Wrighton, S. E. Clarke, P. Langguth, L. Z. Benet, C. Crespi, E. LeCluyse. Session 3: In vitro prediction. Moderators: G. T. Tucker, L. Z. Benet; Speakers: K. Thummel, T. Andersson, B. Clement, H. Suzuki, V. Fischer, M. Dickens, J. Lin, P. Watkins, A. Rostami-Hodjegan. Session 4: In vivo assessment. Moderators: S-M. Huang, U. Fuhr; Speakers: K. S. Reynolds, R. A. Branch, G. Blakey, G. T. Tucker, U. Fuhr, V. Steinijans, P. Milligan, G. Alvan. Session 5: The regulatory view. Moderator: G. Alvan; Speakers: S-M. Huang, Y. Ohno. In addition, the speakers were organized into panels with chairpersons and rapporteurs to develop position statements on the main issues in breakout sessions. These were then presented in open forum at the final session and modified to take account of debate. We have attempted to distil the key features of the discussions with respect to resolved and unresolved issues.
High expression levels of IKKα and IKKβ are necessary for the malignant properties of liver cancer

IKK‐NF‐κB signaling is regarded as an important factor in hepatocarcinogenesis and a potential target for liver cancer therapy. Therefore, in this study, we analyzed the expression of mRNAs encoding components and targets of NF‐κB signaling including IKKα, IKKβ, RANK, RANKL, OPG, CyclinD3, mammary serine protease inhibitor (Maspin), CyclinD1, c‐FLIP, Bcl‐xl, Stat3, Cip1 and Cip2 by real‐time PCR in 40 patients with liver cancer. After statistical analysis, 7 indices including IKKα, IKKβ, RANK, Maspin, c‐FLIP, Cip2 and cyclinD1 were found to show significant differences between tumor tissue and its corresponding adjacent tissue. When IKKα and IKKβ were downregulated in the hepatocellular carcinoma (HCC) cell lines of MHCC‐97L and MHCC‐97H in vitro, the numbers of BrdU positive cells were decreased in both IKKα and IKKβ knockdown cells. Levels of apoptosis were also investigated in IKKα and IKKβ knockdown cells. The growth of HCC was inhibited in the subcutaneous implantation model, and lung metastatogenesis was also significantly inhibited in the kidney capsule transplantation model. Downregulation of IKKα and IKKβ in HCC cultured in vitro revealed that increased Maspin, OPG and RANKL expression was associated with metastasis of HCC. These findings were associated with downregulation of Bcl‐XL and c‐FLIP, which may be the reason for increased apoptosis. The therapeutic effect of IKKα and IKKβ downregulation depends on extent of NF‐κB inhibition and the malignant nature of the HCC. We anticipate that IKK‐targeted gene therapy can be used in the treatment of HCC, a cancer that is notoriously resistant to radiation and chemotherapy.
Thermo-mechanical modelling and thermal performance characterisation of a 3D folded flex module

This paper reports the initial investigation into the thermo-mechanical stress and thermal performance of a folded flexible substrate module. The module consists of flip chip bare die silicon onto a flex and interconnected via conductive adhesive and folding the flex to obtain the final module. From the FEM analysis it was concluded that the stresses in silicon and conductive adhesive are not significant to cause potential reliability problems. The model showed that for 525 and 250 microns thick silicon chip the stresses do not vary notably with change in polyimide or copper thickness but vary significantly below this critical value. This shows that silicon is the dominant material in the stack when the chip thickness is above 100 microns but below this thickness, stress is more dependent on copper and polyimide thickness. Thermal performance characterisation showed that for the current module set-up total power to the module rather then power to the individual chip is an important criterion for the selection of thermal management scheme. Changing the thickness of polyimide and copper has little effect on module temperature. Decreasing the chip thickness increases the thermal density and thereby increases the total temperature for the stack for any given power
Peripherally Inserted Central Catheter Complications in Neonates With Upper Versus Lower Extremity Insertion Sites

PURPOSE:To compare peripherally inserted central catheter (PICC) complication rates in upper versus lower extremity insertion sites in neonates. SUBJECTS:Neonates who had PICCs inserted while hospitalized in an urban, 84-bed, level III neonatal intensive care unit in the southwestern United States between 2004 and 2009 were included in the study. A total of 559 neonates with 626 PICCs were reviewed. Neonates who were transferred out of the hospital with an indwelling PICC or had incomplete PICC data were excluded (n = 29). DESIGN:Comparative descriptive. METHOD:Retrospective review of PICC records. Demographic data, neonate survival to PICC removal, PICCs inserted by non-PICC team members, and complications were compiled. Complications included presumed sepsis, occlusion, leaking, infiltration/edema, inadvertent removal, phlebitis, pleural effusion, tip malposition, and catheter breakage. The complications were analyzed between extremities using chi-square or independent-samples t test where appropriate. MAIN OUTCOME MEASURES:Type and rate of complication requiring PICC removal and the extremity used for insertion. PRINCIPAL RESULTS:A total of 374 PICCs (59.7%) were inserted in upper extremities and 252 (40.3%) in lower extremities. The upper and lower extremity groups were comparable in all variables except neonate survival to PICC removal, which was greater in neonates with lower extremity PICCs (95.2% in upper extremities vs 98.8% in lower extremities; P = .01). No significant difference (P = .08) was found in the overall complication rate (27% in upper extremity PICCs vs 21% in lower extremity PICCs). Presumed sepsis was the most common complication requiring PICC removal in both extremity groups. At the time of removal, upper extremity PICCs were more likely to have a noncentral tip than lower extremity PICCs (15% vs 4%, respectively). In PICCs removed because of complications, noncentral tips were found to be statistically significant in upper extremity PICCs (P < .0001). CONCLUSIONS:No significant difference was found in complications that necessitated PICC removal between upper versus lower extremity PICC insertion sites. Catheter tip location may have a significant impact on complications and deserves further investigation. The choice of a PICC insertion site in neonates should be based on the quality of appropriate, available veins and the preference and skill of the inserter. Every effort should be made to achieve and maintain a centrally located PICC tip.