Miracle-dz/UniFAR-FTUs huggingface dataset:
Task Matters: Influence of Different Cognitive Tasks on Cognitive-Motor Interference During Dual-Task Walking in Chronic Stroke Survivors

Abstract Background: The impact of unilateral brain damage, such as that caused by stroke, on the interaction between higher cognitive functions and walking remains uncertain. We compared cognitive-motor interference (CMI) during dual-task (DT) walking between chronic stroke survivors and young adults performing explicitly different cognitive tasks. Methods: Ten community-dwelling chronic stroke survivors and 10 young adults performed 3 cognitive tasks – visuomotor reaction time (VMRT), serial subtraction (SS), and Stroop test (STR) – while sitting and walking. Gait velocity was recorded using an electronic walkway. Cognitive variables included reaction time and number of correct responses. Motor and cognitive costs were computed. Results: DT walking led to significant declines in motor and cognitive performance. Significant main effect of task (P < .01) and group (P < .01) was observed for motor cost. The stroke group showed highest motor cost for SS task, whereas the young group showed highest motor cost for STR task (Group × Task interaction, P < .05). Although cognitive costs for both groups was highest for VMRT and lowest for STR tasks, cognitive cost for SS task was significantly greater for the stroke group compared with the young group (Group × Task interaction, P < .05). Conclusions: CMI pattern in chronic stroke survivors differs significantly with type of cognitive task. Gradual cognitive decline with chronicity of condition might have a role in altering the CMI pattern in this population. Future studies of DT interventions for stroke survivors might benefit from incorporating working memory tasks in their protocols.
Effects of interleukin 17A (IL-17A) neutralization on murine hepatitis virus (MHV-A59) infection

Mice infected with mouse hepatitis virus A59 (MHV-A59) develop hepatitis and autoantibodies (autoAb) to liver and kidney fumarylacetoacetate hydrolase (FAH), a fact closely related to the release of alarmins such as uric acid and/or high-mobility group box protein 1 (HMGB1). We studied the effect of neutralizing monoclonal antibodies (MAb) against IL-17A in our model of mouse MHV-A59-infection. MAb anti-IL-17F and anti-IFNγ were used to complement the study. Results showed that transaminase levels markedly decreased in MHV-A59-infected mice treated with MAb anti-IL-17A whereas plasmatic Ig concentration sharply increased. Conversely, MAb anti-IL-17F enhanced transaminase liberation and did not affect Ig levels. Serum IFNγ was detected in mice infected with MHV-A59 and its concentration increased after MAb anti-IL-17A administration. Besides, MAb anti-IFNγ greatly augmented transaminase plasmatic levels. IL-17A neutralization did not affect MHV-A59-induction of HMGB1 liberation and slightly augmented plasmatic uric acid concentration. However, mice treated with the MAb failed to produce autoAb to FAH. The above results suggest a reciprocal regulation of Th1 and Th17 cells acting on the different MHV-A59 effects. In addition, it is proposed that IL-17A is involved in alarmins adjuvant effects leading to autoAb expression.
Time-frequency analysis of human polymorphic ventricular tachycardia

This study examined whether time-frequency analysis can reveal dynamic characteristics of human ventricular tachyarrhythmias. The authors investigated 11 episodes of self-terminating polymorphic ventricular tachycardia (PVT) recorded from 7 patients during routine electrophysiology studies. The mean duration was 7.3 s (range 3.7-15.6 s). Surface ECG leads I, aVF and VI were recorded, as well as a bipolar electrogram from the right ventricular apex (RVA). The time frequency distribution (TFD) was obtained using a smoothed Wigner distribution algorithm with a time resolution of 20 ms and a frequency resolution of 0.488 Hz. An identical dominant frequency was recorded on all 3 ECG leads 34.5% of the time. There was a significant correlation between the reciprocal of DomF obtained from the RVA signal, and the W interval (r=0.82, mean difference 0.2 ms SD 24.1 ms). In 8 of the 11 PVT recordings, DomF fell and W interval increased prior to termination. This study has shown that time frequency analysis is a valuable tool for investigating human tachyarrhythmias.
Recent Advances in Color Doppler Evaluation of Valvular Regurgitation

Diagnosis of Valvular Regurgitation Valvular regurgitation results in a high velocity, turbulent flow disturbance in the receiving cardiac chamber which is readily distinguished from normal intracardiac flow by Doppler technology. Detection of this high velocity flow disturbance by either pulsed, continuous wave, or color Doppler allows accurate diagnosis of the presence of valvular regurgitation. PulsedDoppler evaluation of aortic and mitral insufficiency has been most extensively studied. In multiple trials from different institutions, the presence or absence of the characteristic diastolic left ventricular outflow tract flow disturbance, in the case of aortic insufficiency, or systolic left atrial flow disturbance, in the case of mitral insufficiency, has correlated excellently with angiographic diagnosis of valvular insufficiency.14 Pearlman recently compiled data from 15 studies comparing pulsed-Doppler to angiographic diagnosis of aortic or mitral regurgitation? Of 388 patients evaluated for aortic insufficiency, the overall sensitivity of pulsedDoppler compared to aortic root angiography was 95% (range 86%-loo%), and the overall specificity 96% (range 90%-100%). In 389 patients evaluated for mitral regurgitation, the sensitivity and specificity of pulsed-Doppler was 90% (range 72%-100%) and 93% (range 85%-loo%), respectively, compared to left ventriculography. Continuous-wave Doppler in the diagnosis of valvular regurgitation has been less extensively studied, but in one series appeared to be roughly equivalent to pulsed-Doppler, with a sensitivity of 95% and a specificity of 100% in the diagnosis of aortic insufficiency,
Deeply discounted medications: Implications of generic prescription drug wars.

OBJECTIVE To describe the history of generic prescription pricing programs at major pharmacy chains and their potential implications on prescribing, quality of care, and patient safety. DATA SOURCES Publicly available generic prescription discount program drug lists as of May 1, 2009. SUMMARY Fierce competition among major pharmacy chains such as Walgreens, CVS, and Walmart has led to a generic prescription pricing war with unclear public health implications. Introduced in 2006, currently 7 of the 10 largest pharmacy chains advertise a version of a deeply discounted medication (DDM) program, accounting for more than 25,000 locations nationally. By early 2008, almost 70 million Americans had used these programs. Although DDM programs lower drug costs for many patients, DDM formularies include potentially ineffective or harmful medications, have the potential to influence physician prescribing behavior, and may impair pharmacists' ability to review complete drug-dispensing records. CONCLUSION DDMs are widespread but have the potential for unintended consequences on patients, providers, and the health care system. A systematic review of DDMs needs to evaluate the clinical, economic, and system-level implications of such programs.
Comparison of cardiovascular risk calculation tools in pharmacy practice.

OBJECTIVE To examine the use of various cardiovascular disease (CVD) risk estimation calculators in pharmacy practice. DESIGN Longitudinal cohort study. SETTING Midwestern university worksite from August 2008 through May 2012. PARTICIPANTS University employees with hypertension, dyslipidemia, and diabetes. INTERVENTION Risk estimation calculators were applied to data from a pharmacist-run chronic disease management program. MAIN OUTCOME MEASURE Difference in estimated CVD risk from multiple estimation calculators. RESULTS At baseline and 12 months, non-lab-based tools reported significantly higher 10-year CVD risk percentages compared with lab-based tools among the same cohort of patients (10.63% vs. 8.71% at baseline, P < 0.001; 9.34% vs. 7.31% at 12 months, P < 0.001). In addition, the electronic version of 10-year CVD risk reported significantly higher values than the paper version when applied to the same patient cohort (7.31% vs. 6.60% at 12 months, P = 0.018). CONCLUSION CVD risk estimation tools report significantly different values and are not interchangeable. Pharmacists using non-lab-based tools should expect significantly higher risk estimates than estimates derived from lab-based tools and therefore should use the same version of the estimation tool over the long term.
Smoking and stress: the double-edged sword of living in a disadvantaged area

Background: Primary care-based smoking cessation interventions are often less effective among low-SES groups. Higher stress levels may explain the lower quit rate and higher prevalence of smoking in low-SES groups, and why the relative smoking prevalence rate is not declining at an equitable rate (same prevalence rate as higher SES groups). To understand these issues, this paper sought answers to two questions: is stress perceived by ex-smokers and current smokers as a barrier to quitting; and does stress act as a barrier to quitting in relation to other barriers in disadvantaged areas? Methods: This paper seeks to understand the lived experiences from participants in 2 focus groups and 11 in-depth interviews, who reside in the most disadvantaged area in metropolitan Adelaide, regarding stress as a barrier to smoking cessation. Results: The data pointed to stress as an ever-present aspect of life for people in low-SES areas for many reasons, most stemming from the social environment. Perceived stress was also found to be a major barrier to smoking cessation, more so for current smokers. Conclusions: The data analysis revealed that people in low-SES areas maybe living in environments with increased levels of perceived stress, making them more likely to start, and less likely to quit, smoking. It is argued that the “middle-ground” be taken in a structure-agency approach regarding smoking cessation, recognising the potential of social systems to create stress whilst also recognising that individuals have the capacity to change aspects of their lives (e.g. to quit smoking). Without the awareness of such an approach, primary care efforts at smoking cessation may only serve to increase current inequities in smoking prevalence rates.
Bivalirudin for Patients with Heparin-Induced Thrombocytopenia Undergoing Cardiovascular Surgery

Objective To evaluate the uso of bivalirudin in patients with heparin-induced thrombocytopenia (HIT) undergoing cardiovascular surgery. Data Sources: Relevant information was identified through a search of MEDLINE (1966–April 2008), international Pharmaceutical Abstracts (1960–April 2008), and Cochrane Databases (publications archived until April 2008) using the terms bivalirudin, heparin-induced thrombocytopenia, and cardiovascular surgery. Study Selection And Data Extraction: Prospective and retrospective studies, case reports, and case series in adults were eligible for inclusion if bivalirudin had been used in a patient with known HIT undergoing any cardiovascular surgical procedure other than percutaneous coronary intervention. Data Synthesis: Two small, open-label, multicenter clinical trials were identified that evaluated treatment with bivalirudin in patients with HIT undergoing coronary artery bypass graft surgery. Ono looked at on-pump cardiopulmonary bypass (CPB), while the other looked at off-pump CPB. Procedural success was achieved at day 7 in 94% (n = 46) of patients in the on-pump CPB study and in 92% (n = 47) of patients in the off-pump CPB study. Dosing strategies varied between the 2 trials, with the on-pump study using a 1-mg/kg bivalirudin bolus followed by a 2.5-mg/kg/h infusion; the off-pump study used a 0.75-mg/kg bolus followed by a 1.75-mg/kg/h infusion. In addition, 10 case reports met the criteria to be included in the review and are summarized. In these cases, procedural success was reported using various bivalirudin doses in valve repair and replacement, right ventricular assist device implantation, and heart transplantation. Conclusions: Growing data demonstrate procedural success with bivalirudin in patients with HIT undergoing cardiovascular surgery. However, bivalirudin dosing and goal-activated clotting times varied between the studies and case reports. Bivalirudin represents a viable alternative to heparin in patients with HIT undergoing cardiovascular surgery; however, further trials are warranted to identify optimal dosing and monitoring parameters.
Identifying Factors Related to the Survival of AIDS Patients under the Follow-up of Antiretroviral Therapy (ART): The Case of South Wollo

The expansion of HIV/ADIS epidemic has now become a burning issue globally. HIV infection has changed from a fatal condition to a manageable chronic illness mainly due to the development of antiretroviral therapy (ART). Even if ART treatment has shown significant clinical importance by meeting the goal of therapy, we are still facing a number of deaths due to certain socio-economic, demographic, behavioral risk and health factors. The aim of this study is for identifying determinant factors for the Survival of HIV/ADIS Infected Patients under the follow-up of antiretroviral therapy (ART) at Boru Meda and Dessie Referral Hospitals and Kombolcha Health Center. The data for this research were collected during the follow-up time from January 1, 2008 to December 31, 2011. Out of a population of HIV-patients who were taking antiretroviral therapy in the hospitals and health center in that period, 654 patients were selected based on simple random sampling technique for this study. The study subjects were people in the age range from 15 to 75 years. The Kaplan-Meier Method was employed to estimate survival; the Cox Proportional Hazards Regression Method was used to identify determinants of survival. After initiation of the antiretroviral treatment, HIV-positive patients the estimate median survival age was found to be 48 months (CI: 2.98-4.97 years). Living rural, order baseline age, not working due to illness, smaller CD4 count, weight, and lymphocyte count, HIV-TB co-infection developing and being in WHO clinical Stage IV were identified as a documented risk factors for shortened the survival experience of the HIV-patients who are in care of ART. The mortality among our patients was comparable to that reported from other low-income countries. Earlier initiation of ART may reduce the high mortality rates observed. Similar studies in the future need to consider predictors in addition to those considered in this study and the clinical advantage of ART that brings improvement on the clinical characteristics in the follow up period.
Recommended Nutritional Supplements for Bariatric Surgery Patients

Objective: To review nutritional supplements commonly required after bariatric surgery to provide a practical guide and reference source for generalist healthcare providers. Data Sources: A PubMed literature search (1968–July 2008) was conducted, using the search term nutritional deficiency after bariatric surgery, and was limited to English-language literature on adult (aged >19 y) human subjects. Additional references from the selected literature were also included. Study Selection and Data Extraction: Data were extracted from large clinical series and practice guidelines whenever possible. Case reports were used only when they were the sole information source. Data Synthesis: Nutritional deficiencies that occur after bariatric surgery depend significantly on the type of surgery performed. Restrictive procedures such as gastric banding are the least likely to cause nutritional deficits, since none of the Intestine is bypassed. Malabsorptive procedures such as biliopancreatic diversion or mixed restrictive/malabsorpive procedures (eg, Roux-en-Y gastric bypass) can result in serious nutritional problems when patients do not take required supplements after surgery. Vitamins and minerals that are commonly deficient in this circumstance include vitamin B12, calcium, vitamin D, thiamine, folic acid, iron, zinc, and magnesium. Rare ocular complications have been reported with hypovitaminosis A. Conclusions: Healthcare professionals, especially those who practice outside large bariatric centers, must be aware of the supplements required by patients who have had bariatric surgery. Many patients fail to follow up with the surgery centers and are managed by their primary care teams and community pharmacists, especially in the selection of multivitamin and nutritional supplements.
Systematic Review of Interventions to Improve Prescribing

Objective: To update 2 comprehensive reviews of systematic reviews on prescribing interventions and identify the latest evidence about the effectiveness of the interventions. Data Sources: Systematic searches for English-language reports of experimental and quasi-experimental research were conducted in PubMed(1951–May 2007). EMBASE (1974–March 2008), International Pharmaceutical Abstracts (1970–March 2008), and 11 other bibliographic databases of medical, social science, and business research. Following an initial title screening process and after selecting 6 specific intervention categories (identified from the previous reviews) in community settings, 2 reviewers independently assessed abstracts and then full studies for relevance and quality and extracted relevant data using formal assessment and data extraction tools. Results were then methodically incorporated into the findings of the 2 earlier reviews of systematic reviews. Data Selection And Synthesis: Twenty-nine of 26,314 articles reviewed were assessed to be of relevant, high-quality research. Audit and feedback, together with educational outreach visits, were the focus of the majority of recent, high-quality research into prescribing interventions. These interventions were also the most effective in improving prescribing practice. A smaller number of studies included a patient-mediated intervention; this intervention was not consistently effective. There is insufficient recent research into manual reminders to confidently update earlier reviews and there remains insufficient evidence to draw conclusions regarding the effectiveness of local consensus processes or multidisciplinary teams. Conclusions: Educational outreach as well as audit and feedback continue to dominate research into prescribing interventions. These 2 prescribing interventions also most consistently show positive results. Much less research is conducted into other types of interventions and there is still very little effort to systematically test why interventions do or do not work.
Influence of Clinical and Demographic Variables on Mycophenolic Acid Pharmacokinetics in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

Background Mycophenolic acid (MPA) is used off-label to treat many forms of glomerulonephritis. Objective To evaluate the pharmacokinetics of MPA and its glucuronide (MPAG) in antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis patients with renal manifestations and to determine the effects of clinical (urinary protein excretion, serum albumin, creatinine clearance) and demographic (age, race, sex) variables on MPA and MPAG pharmacokinetics. Methods Twenty-three patients taking MPA at steady-state were evaluated. Plasma and urine samples were collected over 24 hours. Analyses included noncompartmental pharmacokinetics and statistics including Mann-Whitney U test and univariate/multiple regression. Results MPA clearance (Cl/F 288 ± 154 mL/min) was approximately 2-fold higher than previously reported from transplant patients and predicted by weight and race (ranked MPA Cl/F = −11.766 + 0.2035 [wt] + 4.9578 [race]: R2 41.8%; p = 0.005). Creatinine clearance (CrCl) less than 60 mL/min resulted in higher MPA exposure, total area under the curve (AUC)0-12, and AUC6-12 as well as unbound AUC0-12. The metabolic ratio (MPAGAUC/MPAAUC) of 8.67 ± 5.57 was lower than that previously reported in renal transplant recipients. Conclusions Diminished kidney function (eg, CrCl <60 mL/min) demonstrated enhanced MPA and MPAG exposure in patients with ANCA vasculitis. However, unlike renal transplant recipients, patients with ANCA vasculitis had enhanced Cl/F and diminished metabolic ratio, suggesting the need to comprehensively evaluate the role of disease-specific factors on MPA pharmacokinetics.
Effects of Low-Dose Larch Arabinogalactan From Larix Occidentalis: A Randomized, Double-Blind, Placebo-Controlled Pilot Study

Immune-stimulating effects of low-dose Larch arabinogalactan extracted from Larix occidentalis were evaluated in a Randomized, double-blind, placebo-controlled, 4-week clinical trial. Twenty-one healthy male volunteers (22-45 years) were randomized to one of six treatment groups or placebo, three subjects in each group. Of these, 19 (90%) completed for inclusion in outcome analysis. Three concentration grades of Larch arabinogalactan in two doses, 1.5g/day and 4.5g/day, were tested. White blood cell count, monocytes, serum interferon-γ, Tumor Necrosis Factor-α, interleukin-6, and quality of life (SF-36) at baseline and 4 weeks. There were no changes in the objective immunologic and subjective measures of quality of life (p > 0.05) with low doses of Larch arabinogalactan. Understanding of possible low-dose responses to Larch arabinogalactan and the determination of clinically effective baseline doses for patient care requires further investigation, and future studies should consider larger cohort populations.
Self-reported quality of life in pharmacoresistant temporal lobe epilepsy: correlation with clinical variables and memory evaluation

AimThis work explores the effects of clinical variables on self-reported quality of life (QoL) in pharmacoresistant temporal lobe epilepsy (TLE), correlating this information with results from the Quality of Life in Epilepsy questionnaire (QOLIE-31) and selective memory tests of the Barcelona Battery and the Rey-Osterrieth figure.MethodsWe retrospectively analysed the records of 60 TLE patients and correlated patient variables (e.g. gender, aetiology; mesial TLE with hippocampal sclerosis [HS] versus lesional TLE, side of ictal onset, age, age at onset, duration of epilepsy, seizure frequency, and use of AEDs) with selective memory test scores and self-reported QoL.ResultsRight ictal onset was associated with lower emotional well-being scores. MTLE-HS patients had lower QOLIE-31 scores for seizure worry, social function, overall QoL, energy/fatigue, cognitive function, and obtained a lower overall score, compared to those with lesional TLE. Older age at epilepsy onset was associated with worse emotional well-being, energy/fatigue, medication effects, and seizure worry outcomes. Higher seizure frequency and older age at time of evaluation were associated with lower cognitive function scores. Generalised seizures were associated with lower scores based on the variables: seizure worry, overall quality of life, emotional well-being, and cognitive function. Regarding memory tests, only visuospatial memory correlated positively with cognitive function score. Patients with MTLE-HS underwent evaluation for pharmacoresistant epilepsy, on average, 10 years later than those with lesional TLE.ConclusionsMTLE-HS, right-sided epileptogenic zone, late onset, and higher seizure frequency were associated with worse QoL. Objective testing revealed specific memory deficits that were not reflected in self-reported QoL scores.