Miracle-dz/UniFAR-FTUs huggingface dataset:
Differences in training effects following training with and without supplemental oxygen in patients with COPD

The objective of the study was to investigate whether there was any difference in training effects following a training period with or without oxygen supplementation in patients with chronic obstructive pulmonary disease (COPD). Twenty patients with moderate to severe COPD trained with or without supplemental oxygen. Two 6-min walking tests with different instructions, one standardized (6MWD) and one modified (they were stopped if they desaturated below 90%, the mod-6MWD) were performed before and after training. The Oxygen Group increased distance walked after training only in the 6MWD while the Air Group increased distance walked in both tests. The Oxygen Group showed larger increase in lactate levels and a tendency towards longer time of desaturation after compared with before training in the 6MWD. The Oxygen Group walked a longer distance and had higher lactate values after training in the 6MWD compared with the mod-6MWD. The Oxygen Group showed signs of a larger extent of anaerobic metabolism during the 6MWD and was not able to work to the same extent in the mod-6MWD. Supplemental oxygen during physical training in patients with COPD should not yet be routinely applied.
Gene-environment interactions and depression.

To the Editor: Dr Risch and colleagues1 concluded that the results of a study2 showing that the serotonin transporter gene (5-HTTLPR) genotype moderates the effect of stressful life events on the risk of depression could not be replicated in a meta-analysis of 14 studies. The authors pointed out the importance of replication studies before new findings are translated into clinical and health practices. We believe that it is also important to note that editorial practices of scientific journals may contribute to the lack of attention received by studies that fail to replicate original findings. The original study2 was published in 2003 in Science, a prominent journal with a very high impact factor that year.3 In the year following its publication, it was cited 110 times in sources indexed in the Web of Science citation report.4 In 2005, the first study that failed to replicate the original finding5 in a sample of 1091 participants was published in Psychological Medicine, a specialized journal with a relatively low impact factor. That study was cited 24 times in the following year. We believe that unless editors actively encourage the submission of null findings, replication studies, and contradictory results alike, the premature uncritical adoption of new findings will continue to influence the way resources are allocated in research and clinical practice settings. Studies that do not replicate an important finding and that meet high methodological standards should be considered for publication by influential journals at the same level as the respective original reports. This will encourage researchers to conduct replication studies and to make primary data easily accessible.
Characterization of Polyethylene Glycol‐Polyethyleneimine as a Vector for Alpha‐Synuclein siRNA Delivery to PC12 Cells for Parkinson's Disease

Gene therapy targeting the SNCA gene yields promising results in the treatment of Parkinson's disease (PD). The most challenging issue of the RNAi gene therapy strategy is maintaining efficient delivery without inducing significant toxicity and other adverse effects. This study aimed to characterize polyethylene glycol‐polyethyleneimine as a vector for alpha‐synuclein siRNA delivery to PC12 cells for Parkinson's disease.
Does Footfall Pattern in Forefoot Runners Change over a Prolonged Run

There has been much debate on the benefits of a forefoot versus rearfoot strike pattern in distance running in terms of performance and injury prevalence. Shock attenuation occurs more prominently in soft tissues at impact in forefoot runners compared to the passive skeletal loading in rearfoot runners. Recent studies indicate that a forefoot strike pattern may not be maintainable over long distance efforts. Therefore, this study tested the hypothesis that habitual forefoot runners could not maintain their strike pattern throughout a prolonged, intensive run. Fourteen forefoot runners ran to voluntary exhaustion on an instrumented force treadmill (average run duration: 15.4±2.2 minutes). Kinematic and kinetic data were sampled each minute at 200Hz and 1000Hz, respectively. Ankle plantar-flexor torque was measured during pre-and post-run isometric contractions, during which electromyographic activity was measured in the soleus, lateral, and medial gastrocnemius. iv torque decreased significantly from pre-to post-run (120.57±33.57 to 110.76±32.91 Nm, p = 0.0154). This was accompanied by a decrease in medial and lateral gastrocnemius integrated electromyographic activity (iEMG) (p=0.0387 and 0.0186, respectively). The results indicated that there were significant changes in landing mechanics in the habitual forefoot runners with increased levels of exertion, as they shifted towards strike patterns more similar to rearfoot runners throughout the run. These changes are in line with metabolic findings of other studies. There is increased eccentric loading of the ankle plantar-flexor muscles at touchdown in forefoot runners that may contribute to a decreased torque output by the end of the run. The decline in iEMG may indicate altered central drive of the system and a decline in the impact attenuation ability of the triceps surae, leading to the changes exhibited up the kinematic chain. These findings suggest that while forefoot strike patterns are good for speed, the onset of fatigue may affect the ability to maintain this pattern during a prolonged, intensive effort.
Heat Shock Protein 70 Reduces α‐Synuclein‐Induced Predegenerative Neuronal Dystrophy in the α‐Synuclein Viral Gene Transfer Rat Model of Parkinson's Disease

It has become increasingly evident that the nigrostriatal degeneration associated with Parkinson's disease initiates at the level of the axonal terminals in the putamen, and this nigrostriatal terminal dystrophy is either caused or exacerbated by the presence of α‐synuclein immunopositive neuronal inclusions. Therefore, strategies aimed at reducing α‐synuclein‐induced early neuronal dystrophy may slow or halt the progression to overt nigrostriatal neurodegeneration. Thus, this study sought to determine if adeno‐associated virus (AAV) mediated overexpression of two molecular chaperone heat shock proteins, namely Hsp27 or Hsp70, in the AAV‐α‐synuclein viral gene transfer rat model of Parkinson's disease could prevent α‐synuclein‐induced early neuronal pathology.
Open Access book

the Harris-Benedict, Owen, American College of Chest Physicians, and Mifflin equations (p > 0.05). There was poor agreement between measured and predicted REE by the Ireton-Jones equation, stratifying by sex. Ireton-Jones was the only equation that was unbiased for men and those in weight categories 1 and 2. In all cases except Ireton-Jones, predictive equations underestimated measured REE. The authors concluded that none of these equations accurately estimated measured REE in this group of mechanically ventilated patients, most underestimating energy needs. The authors concluded that is necessary to develop predictive equations for adequate assessment of energy needs.
Epidermal fatty-acid-binding protein: a new circulating biomarker associated with cardio-metabolic risk factors and carotid atherosclerosis.

AIMS Epidermal fatty-acid-binding protein (E-FABP) is highly homologous to adipocyte FABP (A-FABP), which mediates obesity-related metabolic syndrome (MetS), diabetes and atherosclerosis in animals. Combined deficiency of E-FABP and A-FABP protects against the MetS and atherosclerosis in mice. This study investigated the association of serum E-FABP with cardio-metabolic risk factors and carotid atherosclerosis in humans. METHODS AND RESULTS The presence of E-FABP in human plasma was detected by tandem mass spectrometry. Serum E-FABP levels, determined by an enzyme-linked immunosorbent assay in 479 Chinese subjects (age: 55.4 ± 13.5 years; M/F: 232/247), correlated positively (P < 0.05 to <0.001, age-adjusted) with parameters of adiposity, adverse lipid profiles, serum insulin, A-FABP, and C-reactive protein levels and were higher in subjects with the MetS (P < 0.001 vs. no MetS). The association of E-FABP with the MetS was independent of A-FABP. Furthermore, serum E-FABP correlated with carotid intima-media thickness (IMT; P < 0.001) and was independently associated with carotid IMT in men (adjusted P = 0.03). CONCLUSION E-FABP is a new circulating biomarker associated with increased cardio-metabolic risk. It may contribute to the development of the MetS and carotid atherosclerosis in humans, independent of the effect of A-FABP.
The discovery and early validation of novel plasma biomarkers in mild-to-moderate Alzheimer's disease patients responding to treatment with rosiglitazone

Abstract Recent advances in clinical, pathological and neuroscience studies have identified disease-modifying therapeutic approaches for Alzheimer's disease that are now in clinical trials. This has highlighted the need for reliable and convenient biomarkers for both early disease diagnosis and a rapid signal of drug efficacy. We describe the identification and assessment of a number of candidate biomarkers in patients with Alzheimer's disease and the correlation of those biomarkers with rosiglitazone therapeutic efficacy, as represented by a change in the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog). Plasma from 41 patients with Alzheimer's disease were analysed by open platform proteomics at baseline and after receiving 8 mg rosiglitazone for 24 weeks. From a comparison of protein expression following treatment with rosiglitazone, 97 proteins were observed to be differentially ediffer xpressed with a p-value<0.01. From this analysis and comparison to recently published data from our laboratory, a prioritized list of 10 proteins were analysed by immunoassay and/or functional assay in a wider set of samples from the same clinical study, representing a rosiglitazone dose response, in order to verify the changes observed. A number of these proteins appeared to show a correlation with change in ADAS-Cog at the higher treatment doses compared with the placebo. Alpha-2-macroglobulin, complement C1 inhibitor, complement factor H and apolipoprotein E expression showed a correlation with ADAS-Cog score at the higher doses (4 mg and 8 mg). These results are discussed in light of the pathology and other recently published data.
Evaluation of plaque characteristics in acute coronary syndromes: non-invasive assessment with multi-slice computed tomography and invasive evaluation with intravascular ultrasound radiofrequency data analysis.

AIMS Atherosclerotic plaque characteristics play an important role in the development of coronary events. We investigated coronary plaque characteristics on multi-slice computed tomography (MSCT) and virtual histology intravascular ultrasound (VH IVUS) in patients with acute coronary syndromes (ACS) and stable coronary artery disease (CAD). METHODS AND RESULTS Fifty patients (25 with ACS, 25 with stable CAD) underwent 64-slice MSCT followed by VH IVUS in 48 (96%) patients. In ACS patients, 32% of plaques were non-calcified on MSCT and 59% were mixed [corresponding odds ratio (95% confidence intervals): 3.9 (1.6-9.5), P = 0.003 and 3.4 (1.6-6.9), P = 0.001, respectively]. In patients with stable CAD, completely calcified lesions were more prevalent (61%). On VH IVUS, the percentage of necrotic core was higher in the plaques of ACS patients (11.16 +/- 6.07 vs. 9.08 +/- 4.62% in stable CAD, P = 0.02). In addition, thin cap fibroatheroma was more prevalent in ACS patients (32 vs. 3% in patients with stable CAD, P < 0.001) and was most frequently observed in mixed plaques on MSCT. Plaque composition both on MSCT and VH IVUS was identical between culprit and non-culprit vessels of ACS patients. CONCLUSION On MSCT, differences in plaque characterization were demonstrated between patients with ACS and stable CAD. Plaques of ACS patients showed features of vulnerability to rupture on VH IVUS. Potentially, MSCT may be useful for non-invasive identification of atherosclerotic plaque patterns associated with higher risk.
The Development and Characterisation of Peptides to Image αvβ6 in Cancer.

11 CHAPTER I: INTRODUCTION TO CANCER . 26 1.1 CANCER . 26 1.2 INTEGRINS . 32 1.2.1 Integrin Structure . 33 1.2.2 Integrin Function . 37 1.2.2.1 Outside-In Signalling . 40 1.2.2.2 Inside-Out Signalling . 43 1.2.2.3 Cation-Dependent Integrin Regulation . 47 1.3 INTEGRINS AND CANCER . 48 1.3. 1 Proliferation . 49 1.3. 2 Invasion . 51 1.3. 3 Migration . 56 1.3. 4 Dissemination. 59 1.3. 5 Survival mechanisms during Invasion and Metastasis . 62 1.4 V6 . 64 1.4. 1 Transcriptional Regulation of αvβ6 . 64 1.4. 2 v6 Ligands . 67 1.4. 2.1 Transforming Growth Factorβ (TGF-β) . 67 1.4. 2.2 Foot-And-Mouth Disease Virus (FMDV) . 72 1.4. 2.3 Fibronectin . 72 1.4. 2.4 Vitronectin . 73 1.4. 2.5 Tenascin-C . 73
Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) - Update 2008

EFSUMB study group M. Claudon1, D. Cosgrove2, T. Albrecht3, L. Bolondi4, M. Bosio5, F. Calliada6, J.-M. Correas7, K. Darge8, C. Dietrich9, M. D'On ofrio10, D. H. Evans11, C. Filice12, L. Greiner13, K. Jäger14, N. de. Jong15, E. Leen16, R. Lencioni17, D. Lindsell18, A. Martegani19, S. Meairs20, C. Nolsøe21, F. Piscaglia22, P. Ricci23, G. Seidel24, B. Skjoldbye25, L. Solbiati26, L. Thorelius27, F. Tranquart28, H. P. Weskott29, T. Whittingham30
Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology.

Guidelines and Expert Consensus Documents summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategies for a typical patient, suffering from a given condition, taking into account the impact on outcome, as well as the risk/benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes for textbooks. The legal implications of medical guidelines have been discussed previously. A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines and Expert Consensus Documents can be found on the ESC website (http://www.escardio.org/knowledge/guidelines/rules). In brief, experts in the field are selected and undertake a comprehensive review of the published evidence for management and/or prevention of a given condition. Unpublished clinical trial results have not been taken into account. A critical evaluation of diagnostic and therapeutic procedures is performed including assessment of the risk/benefit ratio. Estimates of expected health outcomes for larger societies are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to predefined scales, as outlined in Tables 1 and 2 . The experts of the writing panels have provided disclosure statements of all relationships they may have which might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. Any changes in conflict of interest that arise during the writing period …
Artériopathie oblitérante des membres inférieurs et diabète sucré

L’arteriopathie des membres inferieurs, complication cardiovasculaire la plus specifiquement correlee a l’hyperglycemie, concerne 20 % des diabetiques de type 2 apres 60 ans. Elle est associee a une augmentation du risque d’amputation majeure, et a une augmentation de la mortalite coronarienne. C’est cependant la complication la plus mal evaluee dans les etudes de prevention et d’intervention. L’arteriopathie des patients diabetiques peut concerner les axes proximaux mais se caracterise plus specifiquement par une atteinte des axes de jambe. Le doppler arteriel, avec description precise des axes de jambe et de pied, est l’examen de premiere intention dans le diagnostic. L’arteriographie des membres inferieurs, avec cliches tardifs permettant de visualiser la vascularisation du pied, est reservee aux situations pour lesquelles une revascularisation est envisagee. En presence d’une plaie, la mesure de la pression transcutanee en oxygene (TcPO 2), de la pression de cheville ou d’orteil peuvent avoir un interet, parallelement a l’evaluation clinique, pour evaluer la necessite d’une revascularisation par angioplastie (souvent tentee dans un premier temps) ou par pontage distal souvent possible sur une artere pedieuse restee permeable le plus souvent. La revascularisation suite au pontage permet dans plus de 80 % des cas le sauvetage de membre. C’est la survenue d’une plaie sur un pied arteritique incapable de « faire face » qui semble pouvoir expliquer la survenue secondaire de la gangrene et l’augmentation du risque d’amputation majeure chez les diabetiques. Si l’efficacite des traitements medicaux de l’arteriopathie n’est pas encore demontree, la prevention des plaies semble etre un objectif accessible.
NURSING APPROACHES OF SOCIAL TYPE HAVE A POSITIVE IMPACT ON THE TREATMENT OF POSTOPERATIVE DELIRIUM

Acute postoperative organic psychosyndrome (delirium) is a common complication after cardiac surgery. It is characterized by disorientation of the patient in terms of space and time, most often in the Intensive Care Unit, often accompanied by aggressive or self-destructive behaviour. Purpose: The purpose of this study is to investigate the effectiveness of specific nursing interventions in the treatment of delirium. Materials and methods: We included in the study 47 patients who developed delirium out of a total 184 patients undergoing major cardiac surgery (CABG, AVR, MVR, combined interventions, aneurysm and dissection thoracic aorta ) in the same period, lasting 18 months. Patients were tested for the syndrome with valid instrument scales, more specifically CAM -ICU (Confusement Assessment Method for Intensive Care Unit) and Nu DeSc (Nursing Delirium Screening Scale). They were then divided into four groups, a control group without any additional intervention, a group in which patients were given option for listening to music for 20 minutes twice a day, one group that followed an additional physiotherapy program and, finally, a group with two extra visits by friends or relatives, lasting twenty minutes daily. Results: The study included 152 (83%) men and 32 (17%) women. The average age of both sexes without delirium was 61.55± 7.9 years and with delirium 68.97±8.1. Patients supportive interventions implemented have improved behavior in delirium, based on the results of measurement scales. More specifically, patients within the music group had an average score of 4.8±0.7 prior to the intervention and an average score of 3.2±0.4 (p<0.01) after the intervention. The physical therapy group had an average pre-intervention score of 4.7±0.6 and a score of 3.6±0.4 after the intervention (p<0.05). Finally, the group with the additional visits had a pre-score of 5.0±0.7 and a score after the intervention of 4.0±0.5 (p<0.05). Duration of delirium has been much shorter in the intervention groups compared to the control group not receiving intervention (32±3, 36±4 and 38±4 vs 48±9 hours respectively). Conclusion: The supportive, non-pharmaceutical interventions can improve the image of patients with delirium after cardiac surgery.
Predictors of local recurrence after treatment of ductal carcinoma in situ - A meta-analysis

lBACKGROUND. Management of patients with ductal carcinoma in situ (DCIS) is a dilemma, as mastectomy provides nearly a 100% cure rate but at the expense of physical and psychologic morbidity. It would be helpful if we could predict which patients with DCIS are at sufficiently high risk of local recurrence after conservative surgery (CS) alone to warrant postoperative radiotherapy (RT) and which patients are at sufficient risk of local recurrence after CS + RT to warrant mastectomy. The authors reviewed the published studies and identified the factors that may be predictive of local recurrence after management by mastectomy, CS alone, or CS + RT. METHODS. The authors examined patient, tumor, and treatment factors as potential predictors for local recurrence and estimated the risks of recurrence based on a review of published studies. They examined the effects of patient factors (age at diagnosis and family history), tumor factors (sub-type of DCIS, grade, tumor size, necrosis, and margins), and treatment (mastectomy, CS alone, and CS + RT). The 95% confidence intervals (CI) of the recurrence rates for each of the studies were calculated for subtype, grade, and necrosis, using the exact binomial; the summary recurrence rate and 95% CI for each treatment category were calculated by quantitative meta-analysis using the fixed and random effects models applied to proportions. RESULTS, Meta-analysis yielded a summary recurrence rate of 22.5% (95% CI = 16.9-28.2) for studies employing CS alone, 8.9% (95% CI = 6.8-11.0) for CS + RT, and 1.4% (95% CI = 0.7-2.1) for studies involving mastectomy alone. These summary figures indicate a clear and statistically significant separation, and therefore outcome, between the recurrence rates of each treatment category, despite the likelihood that the patients who underwent CS alone were likely to have had smaller, possibly low grade lesions with clear margins. The patients with risk factors of presence of necrosis, high grade cytologic features, or comedo subtype were found to derive the greatest improvement in local control with the addition of RT to CS. Local recurrence among patients treated by CS alone is approximately 20%, and one-half of the recurrences are invasive cancers. For most patients, RT reduces the risk of recurrence after CS alone by at least 50%. The differences in local recurrence between CS alone and CS + RT are most apparent for those patients with high grade tumors or DCIS with necrosis, or of the comedo subtype, or DCIS with close or positive surgical margins. CONCLUSIONS, The authors recommend that radiation be added to CS if patients with DCIS who also have the risk factors for local recurrence choose breast conservation over mastectomy. The patients who may be suitable for CS alone outside of a clinical trial may be those who have low grade lesions with little or no necrosis, and with clear surgical margins. Use of the summary statistics when discussing outcomes with patients may help the patient make treatment decisions. Cancer 1999;85:616-28. (C) 1999 American Cancer Society.