Miracle-dz/UniFAR-FTUs huggingface dataset:
Use of Antacid Medication in Patients Receiving Clozapine A Comparison With Other Second-Generation Antipsychotics

To the Editors: Dyspeptic complaints seem to be highly prevalent in chronic psychiatric patients, particularly those taking clozapine. Clozapine has also been reported to be temporally associated with the emergence of reflux esophagitis and an increased use of antacid medication. Despite this, large-scale effectiveness studies have not reported increased rates of antacid prescribing in clozapine-treated cohorts relative to those on other atypical drugs. To date, no study has attempted to establish the comparative prevalence of antacid use in those taking clozapine and those receiving other second-generation antipsychotics (SGAs). One of the reasons for this is that clozapine is dispensed only by discrete hospital pharmacies, a practice that precludes large-scale analysis of prescribing practice using computer databases. During 2009, we identified all community (ie, discharged) patients receiving SGA medication from Lambeth and Maudsley hospital pharmacy departments in southeast London. For each patient, we established sex, ethnicity, age, and prescribed medication. Data were derived from electronic case notes and prescription charts and by contacting general practitioners when necessary. We compared the prevalence of antacid use (proton-pump inhibitors [PPIs], H2 antagonists, and other antacids (alginates, magnesium trisilicate, misoprostol) in those receiving clozapine with patients receiving nonclozapine SGAs by establishing crude odds ratio (OR) and OR adjusted for statistically significant (P G 0.05) confounding variables (ie, those shown to be associated with antacid prescribing). To do this, we first constructed a univariate logistic regression model and then established a final multivariable model (using SAS Enterprise Guide version 3.0, SAS Institute Inc, Cary, NC). The characteristics of the 2 study groups are shown in Table 1. Mean dose of clozapine was 423 (SD, 162) mg/d (range, 70Y1000 mg/d). Mean duration of treatment with clozapine was 393 (SD, 256) weeks (range, 15Y994 weeks). In the nonclozapine group, 155 patients (43%) received olanzapine as the principal antipsychotic, 80 (22%) risperidone, 64 (18%) aripiprazole, 41 (11%) quetiapine, 23 (6%) amisulpride, and 1 patient (0.3%) received ziprasidone. In the clozapine group, 45 patients were prescribed PPIs (13.1%), 7 (2.0%) H2 antagonists, and 12 (3.5%) were prescribed
Calibration of a water and energy balance model: Recursive parameter estimation versus particle swarm optimization

It is well known that one of the major problems in the application of land surface models is the determination of the various model parameters. In most cases, only one or a limited number of variables are used to estimate these parameters. This study evaluates the use of two fundamentally different global optimization methods, multistart weight‐adaptive recursive parameter estimation (MWARPE) and particle swarm optimization (PSO), for the estimation of hydrologic model parameters on the basis of data for multiple variables. MWARPE iteratively uses the linear recursive filter equations in a Monte Carlo setting and therefore does not rely on the explicit minimization of an objective function. However, a major drawback of the MWARPE method is the high dimensionality, determined by the number of observations, of the matrix to be inverted. On the other hand, PSO is a stochastic optimization method based on the collective strength of a population of individuals with flocking or herding behavior, as observed in a wide number of biological systems. In situ observations of net radiation; latent, sensible, and ground heat fluxes; and the soil moisture profile are used to determine the parameters of a simplified water and energy balance model. Both optimization methods are analyzed in terms of model performance and computational efficiency. Comparable results, expressed in terms of the root mean square error values, were obtained for both methods. However, it was found that MWARPE tends to slightly overfit the data.
ESAT-6 drives MMP-10 gene expression and secretion in tuberculosis

250 Abstract Tuberculosis (TB) causes disease worldwide and multi-drug resistance is an increasing problem. Matrix metalloproteinases (MMPs), particularly the collagenase MMP-1, cause lung extracellular matrix destruction which drives disease transmission and morbidity. The role in such tissue damage of the stromelysin MMP10, a key activator of the collagenase MMP-1, was investigated in direct Mycobacterium tuberculosis ( Mtb ) infected macrophages and in conditioned medium from Mtb infected monocytes (CoMtb)-stimulated cells. Mtb infection increased MMP-10 secretion from primary human macrophages 29-fold, while CoMtb increased secretion by 4.5-fold from pulmonary epithelial cells and 10.5-fold from fibroblasts. Inhibition of MMP-10 activity decreased collagen breakdown. In two independent cohorts of TB patients from different continents, MMP-10 was increased in both induced sputum and bronchoalveolar lavage fluid compared to controls and patients with other respiratory diseases (both p<0.05). Mtb drove 3.5-fold greater MMP-10 secretion from human macrophages than the vaccine strain BCG (p<0.001), whereas both mycobacteria upregulated TNFα secretion equally. Using overlapping short linear peptides covering the sequence of ESAT-6, a virulence factor secreted by Mtb but not BCG, we found that stimulation of human macrophages with a single specific 15 amino acid peptide sequence drove 3-fold greater MMP-10 secretion than any other peptide (p<0.001). Mtb -driven MMP-10 secretion was inhibited in a dose-dependent manner by p38 and ERK MAPK blockade (p<0.001 and p<0.01 respectively), but was not affected by inhibition of NF-ĸB. In summary, Mtb activates inflammatory and stromal cells to secrete MMP-10 and this is partly driven by the virulence factor ESAT-6, implicating it in TB-associated tissue destruction.
The genetics of obsessive-compulsive disorder: a review

Obsessive-compulsive disorder (OCD) is a serious psychiatric disorder that affects approximately 2% of the populations of children and adults. Family aggregation studies have demonstrated that OCD is familial, and results from twin studies demonstrate that the familiality is due in part to genetic factors. Only three genome-wide linkage studies have been completed to date, with suggestive but not definitive results. In addition, over 80 candidate gene studies have been published. Most of these studies have focused on genes in the serotonergic and dopaminergic pathways. Unfortunately, none have achieved genome-wide significance, and, with the exception of the glutamate transporter gene, none have been replicated. Future research will require the collaboration of multidisciplinary teams of investigators to (i) achieve sufficiently large samples of individuals with OCD; (ii) apply the state-of-the-art laboratory techniques; and ( iii) perform the bioinformatic analyses essential to the identification of risk loci.
Drug treatment of obsessive-compulsive disorder

Knowledge of pharmacotherapeutic treatment options in obsessive-compulsive disorder (OCD) has grown considerably over the past 40 years. Serotonergic antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and clomipramine, are the established pharmacologic first-line treatment of OCD. Medium to large dosages and acute treatment for at least 3 months are recommended until efficacy is assessed. In case of significant improvement, maintenance treatment is necessary. Unfortunately, about half of the patients do not respond sufficiently to oral serotonergic antidepressants; augmentation with atypical antipsychotics is an established second-line drug treatment strategy. Alternatives include intravenous serotonergic antidepressants and combination with or switch to cognitive behavioral psychotherapy. Remarkably, a considerable proportion of OCD patients still do not receive rational drug treatment. Novel research approaches, such as preliminary treatment studies with glutamatergic substances, and trials with further drugs, as well as needed aspects of future research, are reviewed.
Intravascular Catheter-Related Infections

Prepared by Naomi P. O'Grady, M.D.1 Mary Alexander2 E. Patchen Dellinger, M.D.3 Julie L. Gerberding, M.D., M.P.H.4 Stephen O. Heard, M.D.5 Dennis G. Maki, M.D.6 Henry Masur, M.D.1 Rita D. McCormick, M.D.7 Leonard A. Mermel, D.O. 8 Michele L. Pearson, M.D.9 Issam I. Raad, M.D.10 Adrienne Randolph, M.D., M.Sc.11 Robert A. Weinstein, M.D.12 1National Institutes of Health, Bethesda, Maryland 2Infusion Nurses Society, Cambridge, Massachusetts 3University of Washington, Seattle, Washington 4Office of the Director, CDC, Atlanta, Georgia 5University of Massachusetts Medical School, Worcester, Massachusetts 6University of Wisconsin Medical School, Madison, Wisconsin 7University of Wisconsin Hospital and Clinics, Madison, Wisconsin 8Rhode Island Hospital and Brown University School of Medicine, Providence, Rhode Island 9Division of Healthcare Quality Promotion, National Center for Infectious Diseases, CDC, Atlanta, Georgia
Earthquake depth distributions in central Asia, and their relations with lithosphere thickness, shortening and extension

This paper examines the relationship between seismogenic thickness, lithosphere structure and rheology in central and northeastern Asia. We accurately determine earthquake depth distributions which reveal important rheological variations in the lower crust. These variations exert a fundamental control on the active tectonics and the morphological evolution of the continents. We consider 323 earthquakes across the Tibetan Plateau, the Tien Shan and their forelands as well as the Baikal Rift, NE Siberia and the Laptev Sea and present the source parameters of 94 of these here for the first time. These parameters have been determined through body wave inversion, the identification of depth phases or the modelling of regional waveforms. Lower crustal earthquakes are found to be restricted to the forelands in areas undergoing shortening, and to locations where rifting coincides with abrupt changes in lithosphere thickness, such as the NE Baikal Rift and W Laptev Sea. The lower crust in these areas is seismogenic at temperatures that may be as high as 600°C, suggesting that it is anhydrous, and is likely to have great long-term strength. Lower crustal earthquakes are therefore a useful proxy indicating strong lithosphere in places that are too small in areal extent for this to be confirmed independently by estimating effective elastic thickness from gravity–topography relations. The variation in crustal rheology indicated by the distribution of lower-crustal earthquakes has many implications ranging from the support of mountain belts and the formation of steep mountain fronts, to the localization and orientation of rifting. In combination, these processes can also be responsible for the separation of the front of the thin-skinned mountain belts from their hinterlands when continents separate.
A Novel Transforming Growth Factor- (cid:1) Receptor-interacting Protein That Is Also a Light Chain of the Motor Protein Dynein

The phosphorylated, activated cytoplasmic domains of the transforming growth factor- (cid:1) (TGF (cid:1) ) receptors were used as probes to screen an expression library that was prepared from a highly TGF (cid:1) -responsive intestinal epithelial cell line. One of the TGF (cid:1) receptor-interacting proteins isolated was identiﬁed to be the mammalian homologue of the LC7 family (mLC7) of dynein light chains (DLCs). This 11-kDa cytoplasmic protein interacts with the TGF (cid:1) receptor complex intracellularly and is phosphorylated on serine residues after ligand-receptor engagement. Forced expression of mLC7-1 induces speciﬁc TGF (cid:1) responses, including an activation of Jun N-terminal kinase (JNK), a phosphorylation of c-Jun, and an inhibition of cell growth. Furthermore, TGF (cid:1) induces the recruitment of mLC7-1 to the intermediate chain of dynein. A kinase-deﬁcient form of TGF (cid:1) RII prevents both mLC7-1 phosphorylation and interaction with the dynein intermediate chain (DIC). This is the ﬁrst demonstration of a link between cytoplasmic dynein and a natural growth inhibitory cytokine. Furthermore, our results suggest that TGF (cid:1) pathway components (Gigapack II gold; Stratagene, La Jolla, CA) and titered by infection of E. coli strain XL1-Blue, according to the manufacturer’s instructions (CLONTECH). Recombinant phage were screened using a modiﬁed CORT protocol (Skolnik et al. , 1991). Brieﬂy, the activated intracellular domains of both TGF (cid:1) receptors (prepared as de- scribed above) were incubated with ﬁlters, and interactions between phosphorylated receptors and library-expressed proteins were de- tected by autoradiography. Positive plaques were picked and enriched. Numerous positive clones were identiﬁed using this method, of which one will be described in detail herein. A partial cDNA of approx. 463 base pairs was originally isolated and se- quenced ( k athleen m ulder # 23 in the series, km23). This partial cDNA was then used to obtain the full-length rat km23 gene, including the 5 (cid:1) and 3 (cid:1) regions. A human placental cDNA library (CLONTECH) was screened to isolate human km23 (hkm23). On comparison of our sequence with human expressed sequence tags in the database, the full-length hkm23 gene was obtained. The nucle- otide sequences for human (accession no. AY026513) and rat (AY026512) km23 are available at http://www.ncbi. nlm.nih. gov: 80/entrez. The protein identiﬁcations are AAK18712 and AAK18711, respectively.
The role of clinical parapapillary atrophy evaluation in the diagnosis of open angle glaucoma

Purpose: To determine if clinical evaluation of parapapillary atrophy (PPA) significantly improves the ability to distinguish open-angle glaucoma (OAG) patients from glaucoma suspects. Methods: Patients in this study were under evaluation for glaucoma and had open angles, at least one reliable 24-2 SITA-standard automatic perimetry, and digital stereophotographs of the optic disc. PPA was identified clinically as a parapapillary region of absent ( β PPA) or hyper/hypopigmented ( α PPA) retinal pigment epithelium. A single masked observer evaluated photos for: vertical cup-to-disc ratio (CDR), clock hours of total and β PPA, β PPA as percentage width of the optic disc, presence or absence of β PPA at each disc quadrant, and ordinal rating of total PPA. Generalized linear models were used to determine odds of an abnormal or borderline glaucoma hemifield test (GHT) as a function of PPA variables and covariates; model fit was assessed using the log-likelihood ratio test. Results: Of 410 consecutive patients, 540 eyes (of 294 patients) met inclusion criteria. Mean age was greater among patients with abnormal compared with normal GHT ( P , 0.001), but sex and race/ethnicity did not differ between groups ( P $ 0.22). Age, central corneal thickness (CCT) and CDR ( P # 0.006), but not intraocular pressure (IOP) ( P = 0.71), were significant univariable predictors of the odds of an abnormal GHT. All PPA parameters significantly predicted GHT ( P # 0.03), except presence of temporal β PPA ( P = 0.25). Adjustment for age, CCT, IOP, and CDR reduced the association between PPA and GHT, and model fit was not greatly improved by addition of PPA variables. Conclusions: Addition of most PPA parameters to a model already containing commonly assessed variables including age, CCT, IOP, and CDR does not significantly improve the ability to distinguish OAG patients from glaucoma suspects. Optometry; Pharmacology eye Basic
Laboratory and Field Leaching Tests on Coastal Salt‐Bearing Soils

Laboratory and field leaching tests were carried out on a gypsiferous sandy silt to determine the effect of soluble salt leaching on the geotechnical properties of this soil known locally as Sabkha. Field tests included penetration and plate bearing tests. Laboratory tests included basic properties, permeability, consolidation, and isotropically consolidated triaxial compression tests with pore‐pressure measurements. Leaching in the laboratory was achieved using distilled water and a hydraulic gradient of 10 and lasted for 5 to 7 days. Leaching in the field was achieved using fresh water. Test results indicate that leaching has resulted in increased permeability, void ratio, and compressibility, and a reduction in the pre‐consolidation pressure in the unconfined lab specimens. The triaxial test results show a decrease in the effective stress strength parameters due to leaching. Field leaching has resulted in 50% reduction in the dynamic cone penetration resistance over a depth of 1–1.5 m but resulted in n.
Eddy forcing of the mean circulation in the western North Atlantic

This thesis addresses several aspects of the problem of determining the effect of the low-frequency eddy variability on the mean circulation of the Western North Atlantic. A framework for this study is first established by scale analysis of the eddy and mean terms in the mean momentum, vorticity, and heat balances in three regions of the Western North Atlantic -the northern recirculation, the southern recirculation, and the mid-ocean. The data from the last decade of field experiments suggest somewhat different conclusions from the earlier analysis of Harrison (1980). In the momentum balance we confirm that the eddy terms are negligible compared to the lowest order mean geostrophic balance. The eddy term may be an 0(1) term in the vorticity balance only in the northern recirculation region where the mean flow is anisotropic.
Zmiana jakości życia po zabiegu rekonstrukcji piersi

Mimo ? e liczba kobiet w Polsce zainteresowanych rekonstrukcj± piersi po amputacji stale wzrasta, nadal pozostaje niska. Coraz cze¶ciej zaleca sie leczenie oszczedzaj±ce pier¶, wiec mniej pacjentek poddaje sie mastektomii, jednak okaleczaj±cy zabieg amputacji nadal w wielu przypadkach jest konieczny. Znaczna cze¶ae pacjentek w krotszym lub d³u? szym odstepie czasu zwroci sie z pytaniem o mo? liwo¶ae rekonstrukcji piersi. Wiele z nich od samego pocz±tku oczekuje rekonstrukcji utraconej piersi po zakonczonym leczeniu onkologicznym. W tej sytuacji rodzi sie pytanie, czemu zabieg ten jest rzadko przeprowadzany, skoro dostepne badania pokazuj± istotn± poprawe jako¶ci ? ycia po zabiegu odtworzenia piersi. Badania jako¶ci ? ycia udowadniaj±, ? e kobiety z odtworzon± piersi± s± bardziej aktywne zawodowo i spo³ecznie, zainteresowane otaczaj±cym je ¶wiatem oraz chetniej nawi±zuj±ce kontakty z lud¼mi. Efekty te nie s± wynikiem jednej metody rekonstrukcyjnej — uzyskana poprawa jako¶ci ? ycia we wszystkich aspektach jest taka sama dla wszystkich metod. W procesie leczenia chorej z rakiem piersi lekarz rodzinny/ pierwszego kontaktu ma do spe³nienia bardzo wa? n± role. Powinien informowaae, przekonywaae i kierowaae pacjentke do o¶rodkow chirurgii plastycznej zajmuj±cych sie zabiegami rekonstrukcji piersi. W pracy autorzy przedstawiaj± wp³yw odtworzenia piersi na poprawe jako¶ci ? ycia pacjentek. Forum Medycyny Rodzinnej 2011, tom 5, nr 5, 414–419
Boreal winter low‐frequency variability in CMIP5 models

This study assesses the capability of CMIP5 models in representing primary modes of boreal winter extratropical low‐frequency variability. Rotated principal component analysis is applied to monthly mean output from historical simulations of 14 plus two variants models and National Centers for Environmental Prediction–National Center for Atmospheric Research reanalyses (NNR) to isolate the leading patterns of variability in 500 hPa height. For each model data set, North Atlantic Oscillation (NAO)‐like and Pacific‐North American (PNA)‐like patterns are identified using pattern correlation analysis (against NNR patterns). The relative pattern correspondence among CMIP5 models and reanalyses is further quantified via cluster analyses of the rotated empirical orthogonal function, NAO‐like, and PNA‐like patterns, respectively. For both NAO and PNA, 18.8% of the model patterns lie within the same cluster as NNR. Composite structural differences among clusters chiefly consist of (a) spatial displacements of or (b) regional magnitude disparities in the primary anomaly features. While all models replicate the basic aspects of PNA, a small minority of models fails to replicate NAO pattern. Overall, the best performing model is the “GFDL‐ESM2G. ” Interestingly, models having a well‐resolved stratosphere generally perform more poorly than those without. Model biases in low‐frequency mode structure have important consequences for the representation of associated regional anomalies in surface air temperature and storm track behavior. Those differences among clusters are linked to variations in dynamical structures and their relation to the climatological‐mean flow. It is concluded that some state‐of‐the‐art models have important deficiencies in representing low‐frequency variability and some of these deficiencies are associated with the failure of models to adequately replicate the observed climatological stationary waves.
Managing U.S. cropland to sequester carbon in soil

The effects of human activities on atmospheric concentrations of carbon dioxide (CO2) and other greenhouse gases (GHGs) are under intensive study in the United States and worldwide. Since conversion to cropland during the 17th and 18th centuries, the vegetation and soils of the U.S. forests, grasslands, and wetlands have undergone extensive change. Clearing, tilling, and draining of these soils for long-term cropland use released large amounts of CO2, a GHG, to the atmosphere from the soils' fertile soil organic matter (SOM). The SOM in topsoil often was depleted by up to half of its soil organic carbon (SOC) (Cambardella and Elliott 1992). Now, improved farming technologies, increased farmland productivity, and government programs to return highly erodible lands to permanent vegetation are producing unanticipated benefits by letting soils become major sinks for atmospheric CO2 that is stored in them as increasing levels of SOC. Estimates of total U.S. emissions of GHGs range from 1442 million metric tons of C equivalent (MMTCE), (DOE/EIA 1996), including 66 MMTCE from agricultural activities (Table …
Stabilization of Upland Agriculture under El Nino-Induced Climatic Risks: Regional and Farm Level Risk Management and Coping Mechanisms in the Kedah-Perlis Region, Malaysia

This study is an extension of the earlier study with a focus on the impact of the El Nino induced weather changes at the regional and farm levels. It provides a complete continuum of the impacts and implications of El Nino from the national to the regional and farm levels. Hence, the general objective of the study is to determine the impact of El Nino induced climate variability on agriculture at the sub-national and farm level, and to identify appropriate mechanisms to mitigate the impact so as to ensure the stability of the agricultural contribution to the regional and farm economy. In this study, the northwest region of Peninsular Malaysia was chosen as the region under study. It comprises of the states of Kedah and Perlis. The main climatic feature of the region is its distinctive two dry seasons and the resultant drought periods. The region is also an important agricultural and food producing area in the country and the agricultural sector is one of the important economic contributors to the region. As such, it is expected that El Nino induced climatic changes could result in significant impacts on the performance of the agricultural sector and the regional economy as a whole.