Miracle-dz/UniFAR-FTUs huggingface dataset:
A Population-based Clinical Study of Allergic and Non-allergic Asthma

Background. The aim of this study was to describe differences between allergic and non-allergic asthma in a large community-based sample of Danish adolescents and adults. Methods. A total of 1,186 subjects, 14 to 44 years of age, who in a screening questionnaire had reported a history of airway symptoms suggestive of asthma and/or allergy, or who were taking any medication for these conditions were clinically examined. All participants were interviewed about respiratory symptoms, and furthermore skin test reactivity, lung function, and airway responsiveness were measured. Results. A total of 489 individuals had clinical asthma of whom 61% had allergic asthma, whereas 39% had non-allergic asthma. Subjects with non-allergic asthma were more likely to be females, OR = 2.24 (1.32–3.72), p = 0.003, and to have cough as the predominant symptom, OR = 1.96, (1.19–3.23), p = 0.008, but were less likely to have AHR, OR = 0.40, (0.24–0.66), p < 0.001, food allergy, OR = 0.28, (0.11–0.73), p = 0.009, and symptoms of rhinitis, OR = 0.08 (0.05–0.14) compared with subjects with allergic asthma. Subjects with non-allergic asthma had had persistent symptoms within the last 4 weeks more often than subjects with allergic asthma (68% vs. 53%), p = 0.001. Conclusions. Non-allergic asthma accounts for two in every five cases of asthma in adults and constitutes symptomatically, and in terms of lung function, a more severe form of disease than allergic asthma.
Low density lipoprotein‐cholesterol variability in patients with type 2 diabetes taking atorvastatin compared to simvastatin: justification for direct measurement?

Aim: The benefit of direct, as opposed to calculated, low density lipoprotein ‐cholesterol (LDL‐C) measurement remains unclear. This study compared the biological variability of direct LDL in patients with type 2 diabetes (T2DM) on equivalent doses of the short half‐life statin, simvastatin or the longer half‐life statin, atorvastatin.
Elevated serum levels of TNF-α, IL-8, and ECP can be involved in the development and progression of bronchial asthma

ABSTRACT Objective: This study aimed to explore the value of elevated serum levels of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), and eosinophil cationic protein (ECP) in the diagnosis of bronchial asthma (BA). Methods: A total of 170 patients with BA (case group, 85 patients in acute attack and 85 patients in clinical remission) and 150 healthy individuals (control group) were enrolled in this study. Enzyme-linked immunosorbent assay and receiver operating characteristic (ROC) curves were calculated for the contents and diagnostic values of serum TNF-α, IL-8, and ECP in BA. Results: Compared with the control group, patients in acute attack and clinical remission had higher TNF-α, IL-8, and ECP levels (p < 0.05). The serum level of TNF-α was positively correlated with IL-8 and ECP (p < 0.05). ROC curves showed that the diagnostic threshold value of IL-8 was 13.53 ng/ml, its area under the curve (AUC) was 0.87, its specificity was 99.3%, and its sensitivity was 57.6%. The diagnostic threshold value of TNF-α was 1.29 ng/ml with AUC being 0.94, specificity was 89.3%, and sensitivity was 83.5%. ECP showed 7.22 ng/ml diagnostic threshold value (AUC = 0.88, specificity = 74.0%, sensitivity = 86.5%). The FEV1/pre(%) and FEV1/FVC were negatively correlated and the Z5/pre(%) and resonance frequency (Fres) were positively correlated with the serum levels of TNF-α, IL-8, and ECP in patients in acute attack and in clinical remission (all p < 0.05). Conclusion: Our findings reveal that elevated serum levels of TNF-α, IL-8, and ECP can be involved in the development and progression of BA.
Exenatide treatment did not affect bone mineral density despite body weight reduction in patients with type 2 diabetes

Preclinical studies suggest that incretin‐based therapies may be beneficial for the bone; however, clinical data are largely lacking. We assessed whether the differential effects of these therapies on body weight differed with respect to their effect on bone mineral density (BMD) and markers of calcium homeostasis in patients with type 2 diabetes (T2D). Sixty‐nine metformin‐treated patients with T2D were randomized to exenatide twice daily (n = 36) or insulin glargine once daily (n = 33). Total body BMD, measured by dual‐energy X‐ray absorptiometry, and serum markers of calcium homeostasis were assessed before and after 44‐week treatment. Exenatide or insulin glargine treatment decreased body weight by 6%. Endpoint BMD was similar in both groups after 44‐week therapy (LSmean ± s.e.m. between‐group difference −0.002 ± 0.007 g/cm2; p = 0.782). Fasting serum alkaline phosphatase, calcium and phosphate remained unaffected. Forty‐four‐week treatment with exenatide or insulin glargine had no adverse effects on bone density in patients with T2D, despite differential effects on body weight.
The effects of LY2189265, a long‐acting glucagon‐like peptide‐1 analogue, in a randomized, placebo‐controlled, double‐blind study of overweight/obese patients with type 2 diabetes: the EGO study

Aim: To evaluate the efficacy and tolerability of once‐weekly LY2189265 (LY), a novel glucagon‐like peptide‐1 (GLP‐1) IgG4‐Fc fusion protein, in patients with type 2 diabetes failing oral antihyperglycaemic medications (OAMs).
“Kiss myAsthma”: Using a participatory design approach to develop a self-management app with young people with asthma

ABSTRACT Objective: Young people with asthma often lack engagement in self-management. Smartphone apps offer an attractive, immediate method for obtaining asthma information and self-management support. In this research we developed an evidence-based asthma app tailored to young peoples needs, created using a participatory design approach to optimize user engagement. This paper describes the participatory design process. Methods: This multi-phased research included concept generation and ideation of app design by young people with asthma, and development of asthma information by the research team. Clinical review was sought regarding safety and accuracy of app content. Participants suggestions for improvement and any problems with the app were logged throughout. Our young co-designers were invited back to test a high fidelity prototype app using a “think aloud” process and completed a usability questionnaire. Results: Twenty asthma patients aged 15-24 years contributed to the initial app design. Three respiratory specialists and two pharmacists suggested minor corrections to clinical terminology in the app which were all incorporated. Nine co-designers acted as expert reviewers of the prototype app, of whom eight completed a usability questionnaire. Median usability scores (maximum score 6) indicated high satisfaction with app content, usefulness and ease of use [median item score 5.3 (range 4.7-6.0)]. All feedback was incorporated to create an updated prototype app. Conclusions: A clinically sound asthma app has been developed which is considered highly acceptable to the young co-designers. A six-week test of the engagement, acceptability, and usefulness of the app in young people not involved in the participatory design will follow.
Incretin hormones and the expanding families of glucagon‐like sequences and their receptors

Peptide hormones encoded by the proglucagon (Gcg) and glucose‐dependent insulinotropic polypeptide (Gip) genes are evolutionarily related glucagon‐like sequences and act through a subfamily of G‐protein‐coupled receptors. A better understanding of the evolutionary history of these hormones and receptors should yield insight into their biological functions. The availability of a large number of near‐complete vertebrate genome sequences is a powerful resource to address questions concerning the evolution of sequences; here, we utilize these resources to examine the evolution of glucagon‐like sequences and their receptors. These studies led to the discovery of novel genes for a glucagon receptor‐like receptor (Grlr) and a glucagon‐like sequence (exendin) in vertebrates. Both exendin and GRLR have ancient origins, early in vertebrate evolution, but have been lost on the ancestral lineage leading to extant mammals. We also show that exendin and GRLR are both expressed in the brain of the chicken and Xenopus tropicals, results that suggest that the products of these genes function in this tissue. The lack of exendin or Grlr genes in mammals suggests that other genes may have acquired the functions of exendin and Grlr during mammalian evolution.
Effects of elevating the head of bed on interface pressure in volunteers

Objective:Intensive care unit patients are at particular risk for pressure ulcers and ventilator-associated pneumonia. Current guidelines recommend that mechanically ventilated patients be kept in a semirecumbent position with the head of bed elevated 30°–45° to prevent aspiration and ventilator-associated pneumonia. We tested the effects of elevating the head of bed on the interface pressure between the skin of the sacral area and the bed with healthy volunteers. Interventions:Interface pressure profiles of the sacral area were obtained for the 0°, 10°, 20°, 30°, 45°, 60°, and 75° head of bed elevated positions from 15 subjects (14 men, one woman). Measurements and Main Results:Peak sacral interface pressures increased with large increases in head of bed elevation. The 30°, 45°, 60°, and 75° head of bed positions all had peak interface pressures that were significantly (p < 0.02) greater than the supine measurement and also were different from all other head of bed positions. Affected areas, defined as areas over which an interface pressure ≥32 mm Hg was obtained, increased with large elevation of the head of bed. The affected areas of the 45°, 60°, and 75° head of bed positions were significantly greater than the supine position and were also significantly different from all other head of bed positions. Conclusions:Raising the head of bed to 30° or higher on a intensive care unit bed increases the peak interface pressure between the skin at the sacral area and support surface in healthy volunteers. At 45° head of bed elevation or higher, the affected area attributed to a skin–intensive care unit bed interface pressure ≥32 mm Hg increased as well. Further study is needed to determine whether the increased peak interface pressures and affected areas that result from raising the head of bed actually increase the incidence of pressure ulcer formation.
Protein and calorie prescription for children and young adults receiving continuous renal replacement therapy: A report from the Prospective Pediatric Continuous Renal Replacement Therapy Registry Group

Objective:Few published reports describe nutrition provision for critically ill children and young adults with acute kidney injury receiving continuous renal replacement therapy. The goals of this study were to describe feeding practices in pediatric continuous renal replacement therapy and to evaluate factors associated with over- and under-prescription of protein and calories. Design:Retrospective database study. Setting:Multicenter study in pediatric critical care units. Patients:Patients with acute kidney injury (estimated glomerular filtration rate <75 mL/min/1.73 m2 at continuous renal replacement therapy initiation) enrolled in the Prospective Pediatric Continuous Renal Replacement Therapy Registry. Interventions:None. Measurements:Nutrition variables: initial and maximal protein (g/kg/day) and caloric (kcal/kg/day) prescription and predicted resting energy expenditure (kcal/kg/day). We determined factors predicting initial and maximal protein and caloric prescription by multivariate analysis. Results:One hundred ninety-five patients (median [interquartile range] age = 8.1 [12.8] yrs, 56.9% men) were studied. Mean protein and caloric prescriptions at continuous renal replacement therapy initiation were 1.3 ± 1.5 g/kg/day (median, 1.0; range, 0–10) and 37 ± 27 kcal/kg/day (median, 32; range, 0–107). Mean maximal protein and caloric prescriptions during continuous renal replacement therapy were 2.0 ± 1.5 g/kg/day (median, 1.7; range, 0–12) and 48 ± 32 kcal/kg/day (median, 43; range, 0–117). Thirty-four percent of patients were initially prescribed <1 g/kg/day protein; 23% never attained >1 g/kg/day protein prescription. By continuous renal replacement therapy day 5, median protein prescribed was >2 g/kg/day. Protein prescription practices differed substantially between medical centers with 5 of 10 centers achieving maximal protein prescription of >2 g/kg/day in ≥40% of patients. Caloric prescription exceeded predicted resting energy expenditure by 30%–100%. Factors independently associated with maximal protein and caloric prescription while on continuous renal replacement therapy were younger age, initial protein and caloric prescription and number of continuous renal replacement therapy treatment days (p < 0.05). Conclusions:Protein prescription in pediatric continuous renal replacement therapy may be inadequate. Inter-center variation exists with respect to nutrition prescription. Feeding practice standardization and research in pediatric acute kidney injury nutrition are essential to begin providing evidence-based feeding recommendations.
Evidence-based use of antimicrobials in veterinary practice

Antimicrobial resistance has generally been recognised as an increasing problem in both human and veterinary medicine for some time. While many organisations around the world are currently primarily focused on monitoring resistance and promoting the responsible use of antimicrobials for both medical doctors and veterinarians, many stakeholders are questioning whether we should, in fact, be reviewing how antimicrobials are used in the first place. This article considers the risk of resistance developing following the use of antimicrobials in veterinary practice, and discusses practical and effective ways of managing this risk.
Current teaching and evaluation methods in critical care medicine: Has the Accreditation Council for Graduate Medical Education affected how we practice and teach in the intensive care unit?*

Objective:To determine the impact of the Accreditation Council for Graduate Medical Education mandates for duty hours and competencies on instruction, evaluation, and patient care in intensive care units in the United States. Design:A Web-based survey was designed to determine the current methods of teaching and evaluation in the intensive care unit, barriers to changing methods of teaching and evaluation, and the impact of Accreditation Council for Graduate Medical Education regulations on teaching and patient care. Setting:An anonymous Web-based survey was used; cumulative data were analyzed. Subjects:A total of 125 of 380 program directors (33%) for pediatric critical care, pulmonary critical care, anesthesiology critical care, and surgery critical care fellowship programs completed questionnaires. Measurements and Main Results:Bedside case-based teaching and standardized lectures are the most common methods of education in the intensive care unit. Patient safety and resident demands are two factors most likely to result in changes in instruction in the intensive care unit. Barriers to changes in education include clinical workload and lack of protected time and funding. Younger respondents viewed influences to change differently than older respondents. Respondents felt that neither education nor patient care had improved as a result of the Accreditation Council for Graduate Medical Education mandates. Conclusions:Medical education teaching methods and assessment in the intensive care unit have changed little since the initiation of the Accreditation Council for Graduate Medical Education regulations despite respondents’ self-report of a willingness to change. Instead, the Accreditation Council for Graduate Medical Education regulations are thought to have negatively impacted resident attitudes, continuity of care, and even availability for teaching. These concerns, coupled with lack of protected time and funding, serve as barriers toward changes in critical care graduate medical education.
Pharmacogenomic association between a variant in SLC47A1 gene and therapeutic response to metformin in type 2 diabetes

Pharmacogenetic studies revealed that variants in genes related to the pharmacokinetics of metformin were associated with glucose‐lowering effect of metformin. The aim of this study was to investigate possible associations of the variants in genes encoding organic cationic transporters–solute carrier family 22, members A1, A2 (SLC22A1, SLC22A2) and solute carrier family 47, member A1 (SLC47A1) with response to metformin in type 2 diabetes. One hundred forty‐eight drug‐naive patients with type 2 diabetes were included in the study. Genotyping for SLC22A1 rs622342, SLC22A2 rs316019 and SLC47A1 rs2289669 variants was performed using real‐time PCR with subsequent melting‐curve analysis. SLC47A1 rs2289669 genotype was significantly associated with the reduction in haemoglobin A1c (HbA1c) after 6 months. Twenty percentage of patients with diabetes that are homozygous for A‐allele of SLC47A1 had twofold reduction in HbA1c in comparison with the patients carrying G‐allele (GG + GA: 0.55 ± 0.09% vs. AA: 1.10 ± 0.18%, p = 0.018). In conclusion, the results of this study might have in future practical implication in personalised treatment of patients with type 2 diabetes.
RNA Tumor Viruses

To the Editor. — The prodigious discovery of reverse transcriptase (the enzyme that codes for the production of DNA off an RNA template) represents a milestone in the annals of molecular biology. As such, I would like to call attention to an erroneous paragraph that appeared in a recent article in the MEDICAL NEWS section ofThe Journal(231:335, 1975). The original observation of the presence of reverse transcriptase in RNA tumor viruses was reported independently but concomitantly by Howard Temin and Satoshi Mizutani of the University of Wisconsin and by David Baltimore of the Massachusetts Institute of Technology. Both reports were published in a single issue of Nature in June 1970. 1,2 In addition, Temin and his colleagues conducted their investigations at the McArdle Laboratory for Cancer Research in Madison, Wis, not at the National Institutes of Health. Third, and least importantly, Howard Temin holds a PhD, not an MD,
Experience of diffusion tensor imaging and 1H spectroscopy for outcome prediction in severe traumatic brain injury: Preliminary results*

Objective: The objective of the study is to test whether multimodal magnetic resonance imaging can provide a reliable outcome prediction of the clinical status, focusing on consciousness at 1 year after severe traumatic brain injury (TBI). Design: Single center prospective cohort with consecutive inclusions. Setting: Critical Care Neurosurgical Unit of a university hospital. Patients: Forty-three TBI patients not responding to simple orders after sedation cessation and 15 healthy controls. Interventions: A multimodal magnetic resonance imaging combining morphologic sequences, diffusion tensor imaging (DTI), and 1H proton magnetic resonance spectroscopy (MRS) was performed 24 ± 11 days after severe TBI. The ability of DTI and MRS to predict 1-year outcome was assessed by linear discriminant analysis (LDA). Robustness of the classification was tested using a bootstrap procedure. Measurements and Main Results: Fractional anisotropy (FA) was computed as the mean of values at discrete brain sites in the infratentorial and supratentorial regions. The N-acetyl aspartate/creatine (NAA/Cr) ratio was measured in the thalamus, lenticular nucleus, insular cortex, occipital periventricular white matter, and pons. After 1 year, 19 (44%) patients had unfavorable outcomes (death, persistent vegetative state, or minimally conscious state) and 24 (56%) favorable outcomes (normal consciousness with or without functional impairments). Analysis of variance was performed to compare FA and NAA/Cr in the two outcome groups and controls. FA and MRS findings showed highly significant differences between the outcome groups, with significant variables by LDA being supratentorial FA, NAA/Cr (pons), NAA/Cr (thalamus), NAA/Cr (insula), and infratentorial FA. LDA of combined FA and MRS data clearly separated the unfavorable outcome, favorable outcome, and control groups, with no overlap. Unfavorable outcome was predicted with up to 86% sensitivity and 97% specificity; these values were better than those obtained with DTI or MRS alone. Conclusion: FA and NAA/Cr hold potential as quantitative outcome-prediction tools at the subacute phase of TBI.
Thermally induced bone necrosis during implant surgery: 3 case reports.

Thermally induced bone necrosis during implant surgery is a rare phenomenon and a potential contributing factor to implant failure. The frictional heat generated at the time of surgery causes a certain degree of necrosis of the surrounding differentiated and undifferentiated cells. The bone necro- sis occurred in the mandible in all three cases, leading to a soft tissue lesion and pain. In each case, radiolucent areas appeared in the middle and api- cal portions of the implant 4 weeks after surgery. Thermally induced bone necrosis did not improve following systemic antibiotic medication, neces- sitating surgical treatment. The nonintegrated implants were removed, and meticulous debridement of dead bone and granulation tissue was per- formed. Then, new implants were implanted along with the placement of autogenous and xenogenic bone covered with a collagen membrane. No further complications occurred after re-operation. The radiolucencies around the new implants gradually resolved entirely, and the soft tissue lesions healed successfully. At 4-5 months after reoperation, implant loading was initiated and the implant-supported restorations have been functioning. The aim of this case report is to present the successful clinical treatment of three cases suspected to be caused by thermally induced bone necrosis after implant drilling.
Comparison of gd-dtpa-induced signal enhancements in rat brain c6 glioma among different pulse sequences in 3-tesla magnetic resonance imaging

Background: T1-shortening contrast media are routinely used in magnetic resonance (MR) examinations for the diagnosis of brain tumors. Although some studies show a benefit of 3 Tesla (T) compared to 1.5T in delineation of brain tumors using contrast media, it is unclear which pulse sequences are optimal. Purpose: To compare gadopentetate dimeglumine (Gd-DTPA)-induced signal enhancements in rat brain C6 glioma in the thalamus region among different pulse sequences in 3T MR imaging. Material and Methods: Five rats with a surgically implanted C6 glioma in their thalamus were examined. T1-weighted brain images of the five rats were acquired before and after Gd-DTPA administration (0.1 mmol/kg) using three clinically available pulse sequences (spin echo [SE], fast SE [FSE], fast spoiled gradient echo [FSPGR]) at 3T. Signal enhancement in the glioma (ET) was calculated as the signal intensity after Gd-DTPA administration scaled by that before administration. Pulse sequences were compared using the Tukey-Kramer test. Results: ET was 1.12±0.05 for FSE, 1.26±0.11 for FSPGR, and 1.20±0.11 for SE. FSPGR showed significantly higher signal enhancement than FSE and comparable enhancement to SE. Conclusion: FSPGR is superior to FSE and comparable to SE in its ability to delineate rat brain C6 glioma in the thalamus region.