Miracle-dz/UniFAR-FTUs huggingface dataset:
Analysis of observational studies in the presence of treatment selection bias: effects of invasive cardiac management on AMI survival using propensity score and instrumental variable methods.

CONTEXT Comparisons of outcomes between patients treated and untreated in observational studies may be biased due to differences in patient prognosis between groups, often because of unobserved treatment selection biases. OBJECTIVE To compare 4 analytic methods for removing the effects of selection bias in observational studies: multivariable model risk adjustment, propensity score risk adjustment, propensity-based matching, and instrumental variable analysis. DESIGN, SETTING, AND PATIENTS A national cohort of 122,124 patients who were elderly (aged 65-84 years), receiving Medicare, and hospitalized with acute myocardial infarction (AMI) in 1994-1995, and who were eligible for cardiac catheterization. Baseline chart reviews were taken from the Cooperative Cardiovascular Project and linked to Medicare health administrative data to provide a rich set of prognostic variables. Patients were followed up for 7 years through December 31, 2001, to assess the association between long-term survival and cardiac catheterization within 30 days of hospital admission. MAIN OUTCOME MEASURE Risk-adjusted relative mortality rate using each of the analytic methods. RESULTS Patients who received cardiac catheterization (n = 73 238) were younger and had lower AMI severity than those who did not. After adjustment for prognostic factors by using standard statistical risk-adjustment methods, cardiac catheterization was associated with a 50% relative decrease in mortality (for multivariable model risk adjustment: adjusted relative risk [RR], 0.51; 95% confidence interval [CI], 0.50-0.52; for propensity score risk adjustment: adjusted RR, 0.54; 95% CI, 0.53-0.55; and for propensity-based matching: adjusted RR, 0.54; 95% CI, 0.52-0.56). Using regional catheterization rate as an instrument, instrumental variable analysis showed a 16% relative decrease in mortality (adjusted RR, 0.84; 95% CI, 0.79-0.90). The survival benefits of routine invasive care from randomized clinical trials are between 8% and 21%. CONCLUSIONS Estimates of the observational association of cardiac catheterization with long-term AMI mortality are highly sensitive to analytic method. All standard risk-adjustment methods have the same limitations regarding removal of unmeasured treatment selection biases. Compared with standard modeling, instrumental variable analysis may produce less biased estimates of treatment effects, but is more suited to answering policy questions than specific clinical questions.
The Impact of Unconventional Monetary Policy Measures by the Systemic Four on Global Liquidity and Monetary Conditions

This paper examines the impact of unconventional monetary policy measures (UMPMs) implemented since 2008 in the United States, the United Kingdom, Euro area and Japan - the Systemic Four - on global monetary and liquidity conditions. Overall, the results show positive significant relationships. However, there are differences in the impact of the UMPMs of individual S4 countries on these conditions in other countries. UMPMs of the Bank of Japan have positive association with global liquidity but negative association with securities issuance. The quantitative easing (QE) of the Bank of England has the opposite association. Results for the quantitative easing measures of the United States Federal Reserve System (U.S. Fed) and the ECB UMPMs are more mixed.
The intrinsic signal‐to‐noise ratio in NMR imaging

The fundamental limit for NMR imaging is set by an intrinsic signal‐to‐noise ratio (SNR) for a particular combination of rf antenna and imaging subjects. The intrinsic SNR is the signal from a small volume of material in the sample competing with electrical noise from thermally generated, random noise currents in the sample. The intrinsic SNR has been measured for a number of antenna‐body section combinations at several different values of the static magnetic field and is proportional to B0. We have applied the intrinsic and system SNR to predict image SNR and have found satisfactory agreement with measurements on images. The relationship between SNR and pixel size is quite different in NMR than it is with imaging modalities using ionizing radiation, and indicates that the initial choice of pixel size is crucial in NMR. The analog of “contrast‐detail‐dose” plots for ionizing radiation imaging modalities is the “contrast‐detail‐time” plot in NMR, which should prove useful in choosing a suitable pixel array to visualize a particular anatomical detail for a given NMR receiving antenna. © 1986 Academic Press, Inc.
Prospects for an active optical clock using forbidden transition in trapped ions

The concept of an active optical frequency standard was proposed about 10 years ago. The idea was to use optically trapped alkaline-earth atoms as a gain medium to built an extremely narrow-line laser, whose frequency would be robust against fluctuations of the cavity length. The main challenge in the realization of this concept is the short trap lifetime of the atoms. Recently we showed, that in such a laser, neutral atoms may be replaced by charged ions in a radio-frequency (RF) Paul trap with much longer lifetime. This idea rests on two pillars: the effect of synchronization of radiating dipoles with moderate inhomogeneous broadening, and the possibility to compensate (in leading orders) micromotion-induced shifts for some ion species in specially designed traps.
Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important?

Background The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. Material/Methods There were 147 patients who had heart transplantation (HT) included in this study: mean age was 45.8±15.3 years. All study patients had coronary angiography after HT. Analyzed risk factors were: non-immunologic recipient risk factors (age of transplantation, smoking, hypertension, lipids, diabetes, obesity and weight gain after HT), immunologic recipient risk factors (acute cellular rejection (ACR), acute humoral rejection (AMR), cytomegalovirus (CMV) episodes), and donor-related risk factors (age, sex, catecholamine usage, ischemic time, compatibility of sex and blood groups, cause of death, cardiac arrest). Results CAV was recognized in 48 patients (CAV group); mean age 53.6±13.6 years. There were 99 patients without CAV (nonCAV group); mean age 48.3±15.5 years. A univariate Cox analysis of the development of coronary disease showed statistical significance (p<0.05) for baseline high-density lipid (HDL), ACR, AMR, CMV, and donor age. Multivariate Cox regression model confirmed that only baseline HDL, episodes of ACR, donor age, and CMV infection are significant for the frequency of CAV after HT. Conclusions Older donor age is highly associated with CAV development. Older donor age and low level of HDL in heart recipients with the strongest influence of immunologic risk factors (ACR, CMV infection) were linked with development of CAV.
Clinical Course and Outcome of Autoimmune Hepatitis/Primary Sclerosing Cholangitis Overlap Syndrome

Autoimmune hepatitis/primary sclerosing cholangitis (AIH/PSC) overlap syndrome is a relatively uncommon variant of PSC.AIM:To evaluate the natural history of AIH/PSC overlap syndrome compared to a group of “classical” PSC.METHODS:Forty-one consecutive PSC patients, with a regular follow-up of at least 2 years, were prospectively included in the study. Among these, 7 fulfilled the criteria for AIH/PSC overlap syndrome.RESULTS:The AIH/PSC overlap group significantly differed from the “classical” PSC group in the following parameters: mean age at presentation (21.4 ± 5.0 vs 32.3 ± 10 years, p < 0.01), AST 191.0 ± 14.8 vs 48.9 ± 34.5 U/L, p < 0.005), ALT (357.0 ± 26.5 vs 83.7 ± 60.7 U/L, p < 0.005) and serum IgG (25.6 ± 4.7 vs 12.9 ± 6.0 mg/dl, p < 0.0001). The mean follow-up was similar in the 2 groups (93.3 ± 65.9 vs 98.1 ± 65.9 months respectively). Treatment included immunosuppression + ursodeoxycholic acid (UDCA) in the AIH/PSC overlap patients, and UDCA in the “classical” PSC group. Deaths were recorded only in the classical PSC group. The median survival in the latter group was 207 months (95% C.I. 87.6-326.4). The major events during the follow-up included: OLTx (1/7 vs 6/34), and neoplasms (only in the group of “classical” PSC). The new Mayo score prognostic index only increased significantly during follow-up in the “classical” PSC group (r2 0.8117, p < 0.01)CONCLUSION:Patients with AIH/PSC overlap syndrome seem to benefit from immunosuppression + UDCA therapy, survival is apparently better than in “classical” PSC condition.
Normal Values of Insulin-Like Growth Factor I and Their Clinical Utility in Adults

The concentration of circulating insulin-like growth factor I (IGF-I) is a potential marker for growth hormone (GH) deficiency in adults. Indeed, researchers have shown that IGF-I levels are of greater diagnostic value than other possible markers, such as IGF-binding protein 3 (IGFBP-3) and the acid-labile subunit (ALS). Accurate age-matched normative data are essential to give patient data diagnostic meaning. Such data are assay specific and must exclude those individuals with certain confounding medical conditions. Post-diagnosis, monitoring of IGF-I and IGFBP-3 levels can be used to assess the efficacy and safety of GH replacement therapy. Furthermore, IGF-I levels, and possibly ALS levels, can be used to aid the diagnosis and monitoring of acromegaly. For example, acromegaly can be excluded in patients with normal IGF-I levels if liver failure and malnutrition/malabsorption are ruled out.
A sigma E dependent operon subject to catabolite repression during sporulation in Bacillus subtilis

To identify genes expressed at intermediate stages of Bacillus subtilis sporulation, we screened for sigma E-dependent promoters. One promoter that we found drives expression of an operon consisting of at least five open reading frames (ORFs). The predicted products of the first three ORFs are very homologous to enzymes involved in fatty acid metabolism, including acetyl coenzyme A (acetyl-CoA) acetyltransferase (thiolase), 3-hydroxybutyryl-CoA dehydrogenase, and acyl-CoA dehydrogenase, respectively. We showed that the fourth ORF encoded a third isozyme of citrate synthase in B. subtilis. Genetic evidence and primer extension results showed that transcription of this operon is directed by the mother cell compartment-specific sigma factor, sigma E, and so the operon was named mmg (for mother cell metabolic genes). Furthermore, we found that a sequence (mmgO) with homology to a catabolite-responsive element mediates glucose repression of mmg promoter activity during sporulation and that this repression was lost in a ccpA mutant.
Changes in Carbohydrate Metabolism in Association With Glipizide Treatment of Type 2 Diabetes

Nineteen patients with Type 2 diabetes were treated with glipizide for 2.5–6 months, and measurements made of metabolic variables before and after glipizide treatment. For purposes of analysis, the glipizide associated decrease in fasting plasma glucose concentration was used to divide patients into ‘good’ responders (decrease of 4.0 mmol I−1 or more, n = 9) or ‘fair’ responders (decrease of 3.0 mmol I−1 or less, n = 10). Good responders had a significantly greater fall in their mean (± SE) hourly plasma glucose (6.3 ± 0.6 vs 2.7 ± 0.3 mmol I−1, p < 0.001) and NEFA (164 ± 40 vs 60 ± 37 μ‐mol I−1, p < 0.05) concentrations from 0800 to 1600 h in response to meals (0800 and 1200h) than did the fair responders. However, the increase in hourly plasma insulin concentration following glipizide treatment was the same in the good (323 ± 103 to 413 ± 124 pmol I−1) and fair (276 ± 42 to 345 ± 43 pmol I−1) responders. Good responders also had a significant increase in glucose metabolic clearance rate (MCR) following glipizide treatment during glucose clamp studies performed at plasma insulin concentrations of approximately 100 pmol I−1 (39 ± 4 to 53 ± 5 ml min−1 m−2, p < 0.02) and 600 pmol I−1 (109 ± 15 to 172 ± 32 ml min−1 m−2, p < 0.05), whereas in fair responders a significant improvement in glucose MCR was seen during the clamp performed at 100 pmol I−1 (46 ± 4 to 51 ± 3 ml min−1 m−2, p < 0.05), but not when insulin concentration was increased to 600 pmol I−1 (101 ± 13 to 105 ± 15 ml min−1 m−2, NS). Although glucose MCR increased in both glucose clamp studies in the good responders, the magnitude of the insulin‐induced increment in glucose uptake did not change significantly in response to glipizide therapy in this group. Glucose transport by adipocytes isolated from good responders (n = 4) was significantly higher (p < 0.001) after glipizide treatment in both the absence and presence of insulin, but the response to insulin did not change significantly with treatment. Basal hepatic glucose production also fell significantly (p < 0.05) in good responders (0.53 ± 0.06 to 0.29 ± 0.02 mmol min−1 m−2, n = 6), but not in fair responders (0.45 ± 0.04 to 0.42 ± 0.04 mmol min−1 m−2, n = 4, NS). Neither the ability of insulin to inhibit hepatic glucose production nor insulin binding to isolated adipocytes changed significantly following glipizide treatment. These results emphasize the variability in the blood glucose response to glipizide in patients with Type 2 diabetes, and demonstrate that those individuals with the best clinical response were characterized by a greater fall in circulating NEFA levels, a significant decrease in basal hepatic glucose production, and both in vivo and in vitro evidence of enhanced glucose uptake
Modes of Elite Political Participation: Contributors to the 1972 Presidential Candidates

Contributors of more than $100 to presidential candidates offer unique opportunities for an investigation of elite behavior because they participate both extensively and intensively in political activities. Their activity can be structured around five modes of participation: Campaigning, Giving, Using Good Offices, Voting, and Mobilizing. There are basic similarities in structure between these elite participants and mass participants (as described by Verba and Nie, 1972), despite a wide difference in participation levels. The elite contributors can be aggregated, on the basis of their behavior patterns, into nine clusters that provide not only an empirical typology of campaign contributors, but also a meaningful basis for discrimination with respect to other, nonbehavioral, attribtutes. A predictive model of elite behavior is presented.
Incomplete Inhibition of Platelet Aggregation and Glycoprotein IIb-IIIa Receptor Blockade by Abciximab: Importance of Internal Pool of Glycoprotein IIb-IIIa Receptors

Summary Resting platelets contain a substantial internal pool of GPIIb-IIIa complexes that is exposed on the surface of activated platelets. Whether the exposure of internal GPIIb-IIIa complexes on the activated platelet surface affects therapy with GPIIb-IIIa antagonists is poorly understood. We addressed this issue in thirteen patients who underwent elective coronary stenting and received abciximab. Platelet aggregation, surface expression of GPIIb-IIIa and P-selectin, receptor blockade of GPIIb-IIIa, and platelet release in response to ADP and thrombin-receptor activating peptide (TRAP) were determined ex vivo by Lumi-aggregometry and flow cytometry before, during and after abciximab administration. We found that inhibition of aggregation and GPIIb-IIIa blockade of ADP-stimulated platelets was almost complete during abciximab administration. In contrast, when TRAP was used to stimulate platelets ex vivo aggregation was only partially inhibited, most likely due to release of internal pool of unblocked GPIIb-IIIa complexes. Using electron microscopy we found that 7E3-occupied GPIIb-IIIa complexes are internalized into the surface connected system (SCS) and the α-granules of washed platelets which was associated with a reduced degranulation of the α-granula membrane protein P-selectin. We conclude, that despite internalization of abciximab into the internal pool of GPIIb-IIIa, upon strong platelet activation with thrombin a significant amount of unblocked internal GPIIb-IIIa can be exposed on the platelet surface and mediate platelet aggregation. Incomplete blockade of the internal GPIIb-IIIa pool may limit clinical efficacy of abciximab.
Interspecies comparison of the mechanical properties and biochemical composition of byssal threads

ABSTRACT Several bivalve species produce byssus threads to provide attachment to substrates, with mechanical properties highly variable among species. Here, we examined the distal section of byssal threads produced by a range of bivalve species (Mytilus edulis, Mytilus trossulus, Mytilus galloprovincialis, Mytilus californianus, Pinna nobilis, Perna perna, Xenostrobus securis, Brachidontes solisianus and Isognomon bicolor) collected from different nearshore environments. Morphological and mechanical properties were measured, and biochemical analyses were performed. Multivariate redundancy analyses on mechanical properties revealed that byssal threads of M. californianus, M. galloprovincialis and P. nobilis have very distinct mechanical behaviours compared with the remaining species. Extensibility, strength and force were the main variables separating these species groups, which were highest for M. californianus and lowest for P. nobilis. Furthermore, the analysis of the amino acid composition revealed that I. bicolor and P. nobilis threads are significantly different from the other species, suggesting a different underlying structural strategy. Determination of metal contents showed that the individual concentration of inorganic elements varies, but that the dominant elements are conserved between species. Altogether, this bivalve species comparison suggests some molecular bases for the biomechanical characteristics of byssal fibres that may reflect phylogenetic limitations. Summary: An interspecies comparison of byssus produced by nine species in different natural environments shows that mechanical properties depends on the interrelationship between morphometric characteristics and their biochemical contents.
Whole‐exome sequencing diagnosis of two autosomal recessive disorders in one family

Autosomal recessive congenital ichthyosis (ARCI) is a genetically heterogeneous disorder for which subtyping through molecular analysis can help determine the eventual phenotype and prognosis. We used whole‐exome sequencing to identify a new homozygous splice‐site mutation in ST14 (IVS5+1G>A), encoding matriptase, in a 4‐year‐old girl with ARCI from a consanguineous Kuwaiti family. Clinically, she also had hypotrichosis, which supported a diagnosis of ARCI type 11. Only four previous examples of pathogenic mutations in ST14 have been reported, and our findings expand the genotype–phenotype correlation for this subtype of ARCI. Our patient was the second child born to these parents; the first (deceased) and third children had congenital brain and eye abnormalities, of uncertain aetiology and with no precise diagnosis. Further analysis of our patient's exome dataset revealed heterozygosity for a splice‐site mutation in POMT1 (IVS4+1G>T), encoding the protein O‐mannosyltransferase, a gene implicated in Walker–Warburg syndrome. DNA sequencing in the third child showed homozygosity for this mutation in POMT1. The first‐cousin parents were both heterozygous for the splice‐site mutations in ST14 and POMT1. In this family, whole‐exome sequencing provided accurate subtyping of a form of ARCI in one child and provide an explanation for an undiagnosed developmental disorder in two other children, findings that improve the prospects for diagnostic accuracy and genetic counselling, and demonstrate the impact of next‐generation sequencing technologies on clinical genetics.
Use of various models for in vitro percutaneous absorption studies of ultraviolet filters

Background: The percutaneous absorption test aims to estimate the passage of a substance across the skin. The absorption process can be described in three steps: (a) penetration of a substance into the skin layer, followed by (b) penetration from one layer into another (permeation) and finally (c) resorption into the vascular system. In vivo and in vitro models are available but owing to ethical reasons as well as the latter providing greater feasibility, in vitro models are preferred.
Strengthening agricultural extension and advisory systems : procedures for assessing, transforming, and evaluating extension systems

The purpose of this paper is to provide information on how to transform and strengthen pluralistic agricultural extension and advisory systems in moving toward the broader goal of increasing farm income and improving rural livelihoods. The focus of this book is primarily on the technical knowledge, management skills, and information services that small-scale farm households will need to improve their livelihoods in the rapidly changing global economy. In addition, the book will also include information on how extension should help all types of farmers in dealing with escalating natural resource problems, including climate change. The primary focus of this paper will be a comparative analysis of different extension strategies, organizational models, institutional innovations, and resource constraints and how an extension system might be transformed and strengthened through specific policy and organizational changes as well as needed investments. This paper is organized into nine chapters. These chapters follow an institution building strategy used by many donors and governments as they seek to improve their extension system. The diagram in Figure one outlines these basic planning, implementation, and evaluation procedures that will be considered. The sections outlined below will provide a brief overview of the different chapters included in this paper.
The proportional Venn diagram of obstructive lung disease: two approximations from the United States and the United Kingdom.

STUDY OBJECTIVES The nonproportional Venn diagram of obstructive lung disease (OLD) produced for the 1995 American Thoracic Society guidelines has not been quantified. We aim to quantify the proportion of the general population with OLD and the intersections of physician-diagnosed asthma, chronic bronchitis, and emphysema in the United States and the United Kingdom, and to examine the relationship to obstructive spirometry. DESIGN AND PARTICIPANTS We analyzed data from the US National Health and Nutrition Examination (NHANES) III survey (1988 to 1994) and the UK General Practice Research Database for the year 1998. RESULTS The areas of intersection among the three OLD conditions produced seven mutually exclusive disease groups. The asthma-only group was the largest proportion of OLD patients, accounting for 50.3% and 79.4% of all OLD patients in the United States and the United Kingdom, respectively, and decreased with increasing age. Overall, 17% and 19% of OLD patients in the United States and in the United Kingdom, respectively, reported more than one OLD condition, and this percentage increased with age. According to the spirometry data from NHANES III, only 37.4% of emphysema-only patients had objective airflow obstruction. The prevalence of airflow obstruction was significantly higher among participants with combinations of emphysema and chronic bronchitis (57.7%), with emphysema and asthma (51.9%), and with all three OLD diseases concomitantly (52.0%). CONCLUSION Concomitant diagnosis of asthma, chronic bronchitis, or emphysema is common among OLD patients from the general population, particularly in adults aged > or = 50 years.