Miracle-dz/UniFAR-FTUs huggingface dataset:
Lipid mediator levels evidence gender-specific increases in bronchoalveolar lavage fluid of COPD patients relative to healthy smokers

Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity worldwide, which is increasing particularly among females. Lipid mediators (e.g., eicosanoids) have key roles in the pathology of the inflammatory process in the lower airways. Bronchoalveolar lavage fluid (BALF) was obtained from healthy never-smokers, non-symptomatic smokers, and COPD patients of GOLD stage I-II of both genders (20 per group, n=120). A mass spectrometry method was developed to quantify 85 lipid mediators derived from the cytochrome P450 (CYP), lipoxygenase (LOX) and cyclooxygenase (COX) pathways in BALF. An orthogonal projections to latent structures (OPLS) analysis of female COPD vs. female smokers gave the strongest model (CV-ANOVA p=8.6*10-6, R2=0.59, Q2=0.57.), with 9 lipids driving the model. Six of these lipids were from the linoleic acid pathway, including the CYP-derived epoxides and their downstream diol metabolites. Three of the lipids were derived from arachidonic acid via the thromboxane synthase pathway. These 9 lipids strongly correlated with lung function (FEV1; R2=0.91). mRNA levels of genes responsible for the lipid mediator synthesis also correlated strongly with FEV1 (R2=0.84). The principal pathway affected was CYP metabolites of linoleic acid, which includes leukotoxin/isoleukotoxin (9(10)-EpOME, 12(13)-EpOME) and leukotoxin-diol/isoleukotoxin diol (9,10-DiHOME, 12,13-DiHOME). These compounds have been previously found to be increased in acute respiratory distress syndrome (ARDS) patients, suggesting that female COPD patients have distinct markers of pulmonary damage that could offer gender-specific treatment strategies.
Dewhurst's textbook of obstetrics and gynaecology for postgraduates

Normal and abnormal developement of the genital organs intersexuality primary amenorrhoea secondary amenorrhoea gynaecological disorders in childhood and adolescence hirsutism and virilism fertization, implantation and early development of the embryo the foetus, placenta and amniotic fluid normal pregnancy - anatomy, endocrinology and physiology antenatal care in normal pregnancy and prepregnancy care antenatal diagnosis of foetal abnormality and genetic disease abortion and ectopic pregnancy antepartum haemorrhage hypertensive disorders of pregnancy heart disease in pregnancy blood disorders of pregnancy urinary tract disorders in pregnancy diabetes and other endocine diseases complicating pregnancy immunological disorders in pregnancy miscellaneous disorders complicating pregnancy natural labour and its active management special circumstances affecting labour dystocia caused by the passages or passenger malpositions of the occiput and malpresentations complications of the third sof labour maternal injuries and complications obstetric operations and procedures foetal surveillance the puerperium and its complications multiple pregnancy neonatal care for obstetricians maternal and perinatal infections vital statistics and derived information for obstetricians the coagulation and fibrinolytic systems, and their disorders in obstetrics and gyaecology trophoblastic disease contraception and streilization infertility pelvic infection endometrosis dysfunctional uterine bleeding the menopause and climacteric prolapse urinary incontinence and other disorders of the lower urinary tract in women benign and malignant disorders of the vulva benign and malignant disorders of the vagina premalignant and malignant disease of the cervix benign tumours of the uterus malignant disease of the uterine body benign and malignant tumours of the ovary premenstrual syndrome sexual function and dysfunction.
A simple current control algorithm for torque ripple reduction of brushless DC motor using four-switch three-phase inverter

In this paper, a new current control algorithm is proposed for four-switch three-phase brushless DC (BLDC) motor drives, which are suitable for low cost applications. A current reference generation scheme is developed and implemented to obtain high performance characteristics in the four-switch system, such as small torque ripple and fast dynamic speed/torque response. Moreover, the proposed scheme can successfully eliminate the torque ripple during commutations, so that it can be expected that the four-switch system can be much more practically applied for the industrial application areas. The proposed current control scheme is theoretically explained in detail and the validity is verified by simulation results, along with the comparison with the conventional six-switch system.
The year in cardiology 2016: imaging.

Cardiovascular diseases remain the main cause of death in Europe.1 Current mortality statistics show that more than 4 million people die from cardiovascular diseases every year. Non-invasive cardiovascular imaging plays a central role in the diagnosis and management of patients with cardiovascular diseases. In 2016, many articles focused on prognostic impact of current non-invasive imaging techniques and technological innovations were published. A selection of these articles on the use of non-invasive cardiovascular imaging, including echocardiography, computed tomography (CT), cardiovascular magnetic resonance imaging (CMR), nuclear imaging, and fusion imaging is presented here. Echocardiography is the imaging technique of first choice to evaluate patients with cardiovascular diseases. A recent analysis of the largest, publicly available, all-payer inpatient database of the United States has shown that during 2001 and 2011 approximately 7 669 000 echocardiograms were performed and a steady increase in the volume of echocardiograms was noted with an average annual grew rate of 3.41%. 2 Although these numbers would suggest an overuse of this diagnostic procedure, the results from the 2010 nationwide inpatient sample showed otherwise. When analysing five clinical scenarios accounting for 3.7 million hospital admissions (cerebrovascular disease, cardiac arrhythmia, chronic heart failure, acute myocardial infarction, and sepsis), echocardiography was performed only in 8% of the cases indicating a significant underuse of echocardiography. Importantly, the use of echocardiography was associated with significantly lower odds of all-cause in-hospital mortality in these five clinical scenarios. Additional studies will be warranted to provide more information on the association between access to echocardiography and clinical outcomes. Lung ultrasound is another application of echocardiography and is considered a first-line test to assess pulmonary congestion in patients with suspected acute heart failure.3 The detection of B-lines (reflection of discrete air/fluid interfaces between collapsed, fluid-filled, and well-aerated alveoli) on the anterolateral chest scan indicates a …
SYT-SSX gene fusion as a determinant of morphology and prognosis in synovial sarcoma.

BACKGROUND Synovial sarcomas account for up to 10 percent of soft-tissue sarcomas and include two major histologic subtypes, biphasic and monophasic, defined respectively by the presence and absence of glandular epithelial differentiation in a background of spindle tumor cells. A characteristic SYT-SSX fusion gene resulting from the chromosomal translocation t(X;18)(p11;q11) is detectable in almost all synovial sarcomas. The translocation fuses the SYT gene from chromosome 18 to either of two highly homologous genes at Xp11, SSX1 or SSX2. SYT-SSX1 and SYT-SSX2 are thought to tunction as aberrant transcriptional regulators. We attempted to determine the influence of the two alternative forms of the SYT-SSX fusion gene on tumor morphology and clinical outcome in patients with this sarcoma. METHODS We analyzed SYT-SSX fusion transcripts in 45 synovial sarcomas (33 monophasic and 12 biphasic) by the reverse-transcriptase polymerase chain reaction and compared the results with relevant clinical and pathological data. RESULTS The SYT-SSX1 and SYT-SSX2 fusion transcripts were detected in 29 (64 percent) and 16 (36 percent) of the tumors, respectively. There was a significant relation (P=0.003) between histologic subtype (monophasic vs. biphasic) and SSX1 or SSX2 involvement in the fusion transcript: all 12 biphasic synovial sarcomas had a SYT-SSX1 fusion transcript, and all 16 tumors that were positive for SYT-SSX2 were monophasic. Kaplan-Meier analysis of 39 patients with localized tumors showed that the 15 patients with SYT-SSX2 had significantly better metastasis-free survival than the 24 patients with SYT-SSX1 (P=0.03 by multivariate analysis; relative risk, 3.0). There were no significant correlations between the type of SYT-SSX transcript and age, sex, tumor location and size, whether there were metastases at diagnosis, or whether patients underwent chemotherapy. Histologic subtype alone was not prognostically important. CONCLUSIONS The type of SYT-SSX fusion transcript correlates with both the histologic subtype and the clinical behavior of synovial sarcoma. SYT-SSX fusion transcripts are a defining diagnostic marker of synovial sarcomas and may also yield important independent prognostic information.
Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant.

BACKGROUND AND METHODS The extent to which renal allotransplantation - as compared with long-term dialysis - improves survival among patients with end-stage renal disease is controversial, because those selected for transplantation may have a lower base-line risk of death. In an attempt to distinguish the effects of patient selection from those of transplantation itself, we conducted a longitudinal study of mortality in 228,552 patients who were receiving long-term dialysis for end-stage renal disease. Of these patients, 46,164 were placed on a waiting list for transplantation, 23,275 of whom received a first cadaveric transplant between 1991 and 1997. The relative risk of death and survival were assessed with time-dependent nonproportional-hazards analysis, with adjustment for age, race, sex, cause of end-stage renal disease, geographic region, time from first treatment for end-stage renal disease to placement on the waiting list, and year of initial placement on the list. RESULTS Among the various subgroups, the standardized mortality ratio for the patients on dialysis who were awaiting transplantation (annual death rate, 6.3 per 100 patient-years) was 38 to 58 percent lower than that for all patients on dialysis (annual death rate, 16.1 per 100 patient-years). The relative risk of death during the first 2 weeks after transplantation was 2.8 times as high as that for patients on dialysis who had equal lengths of follow-up since placement on the waiting list, but at 18 months the risk was much lower (relative risk, 0.32; 95 percent confidence interval, 0.30 to 0.35; P<0.001). The likelihood of survival became equal in the two groups within 5 to 673 days after transplantation in all the subgroups of patients we examined. The long-term mortality rate was 48 to 82 percent lower among transplant recipients (annual death rate, 3.8 per 100 patient-years) than patients on the waiting list, with relatively larger benefits among patients who were 20 to 39 years old, white patients, and younger patients with diabetes. CONCLUSIONS Among patients with end-stage renal disease, healthier patients are placed on the waiting list for transplantation, and long-term survival is better among those on the waiting list who eventually undergo transplantation.
Neurological manifestations of dengue infection

Background: The clinical profile of dengue fever (DF) is changing and neurological manifestations are being reported more frequently. The exact incidence of various neurological complications is uncertain. Objectives: The aim of this study was to observe the neurological manifestations in dengue infection. Materials and Methods: In this prospective study, 263 confirmed cases of dengue infection were observed for neurological complications. Detailed clinical examination and investigations were done to detect any neurological involvement in dengue infection. Result: In this study, neurological complication was seen in 8.3% (22/263) of patients. The most common neurological manifestation was seizure, seen in 54.54% (12/22) of cases, followed by encephalopathy and meningitis, each of which was seen in 18.18% (4/22) of the cases. The other manifestation was intracerebral hemorrhage, seen in 9.09% (2/22) of cases. Conclusion: The study findings could potentially be explored for a better understanding of neurological complications of dengue infection in endemic areas.
Racial disparities in access to renal transplantation--clinically appropriate or due to underuse or overuse?

BACKGROUND Despite abundant evidence of racial disparities in the use of surgical procedures, it is uncertain whether these disparities reflect racial differences in clinical appropriateness or overuse or underuse of inappropriate care. METHODS We performed a literature review and used an expert panel to develop criteria for determining the appropriateness of renal transplantation for patients with end-stage renal disease. Using data from five states and the District of Columbia on patients who had started to undergo dialysis in 1996 or 1997, we selected a random sample of 1518 patients (age range, 18 to 54 years), stratified according to race and sex. We classified the appropriateness of patients as data on candidates for transplantation and analyzed rates of referral to a transplantation center for evaluation, placement on a waiting list, and receipt of a transplant according to race. RESULTS Black patients were less likely than white patients to be rated as appropriate candidates for transplantation according to appropriateness criteria based on expert opinion (71 blacks [9.0 percent] vs. 152 whites [20.9 percent]) and were more likely to have had incomplete evaluations (368 [46.5 percent] vs. 282 [38.8 percent], P<0.001 for the overall chi-square). Among patients considered to be appropriate candidates for transplantation, blacks were less likely than whites to be referred for evaluation, according to the chart review (90.1 percent vs. 98.0 percent, P=0.008), to be placed on a waiting list (71.0 percent vs. 86.7 percent, P=0.007), or to undergo transplantation (16.9 percent vs. 52.0 percent, P<0.001). Among patients classified as inappropriate candidates, whites were more likely than blacks to be referred for evaluation (57.8 percent vs. 38.4 percent), to be placed on a waiting list (30.9 percent vs. 17.4 percent), and to undergo transplantation (10.3 percent vs. 2.2 percent, P<0.001 for all three comparisons). CONCLUSIONS Racial disparities in rates of renal transplantation stem from differences in clinical characteristics that affect appropriateness as well as from underuse of transplantation among blacks and overuse among whites. Reducing racial disparities will require efforts to distinguish their specific causes and the development of interventions tailored to address them.
Moisture and space charge in oil-impregnated pressboard under HVDC

Transformer oil and oil-impregnated pressboard are major insulating materials in a HVDC (high voltage direct current) converter transformer which provides electrical power transformation between an AC and a DC system. However, the dc component on the valve side of a HVDC converter transformer gives rise to special conditions, regarding space charge for example, for the insulating materials. In this paper, the relationship between moisture and space charge in oil-impregnated pressboard was investigated under dc electrical fields at room temperature. Formation, accumulation and distribution of space charge were studied using a PWP (pressure wave propagation) technique with the moisture concentration varying between 0.3% and 1.7% by weight. Experiments have shown that moisture influences seriously space charge distribution and thus electric field distribution in oil-impregnated pressboard. The higher the moisture concentration, the faster the establishment of space charge and the deeper the charge penetration into the insulation. The influence of moisture on the distribution of space charge should be taken into consideration in the design of an insulating system under HVDC.
Síndrome DRESS por carbamazepina

El sindrome DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) es una reaccion adversa grave a medicamentos. Consiste en una erupcion cutanea, acompanada de fiebre, compromiso multivisceral y eosinofilia. Con una incidencia de 1/10.000 en individuos expuestos a los farmacos implicados y con una mortalidad de un 10%-30% de los casos. Se presenta un caso clinico de una nina de 12 anos, epileptica, que a las 4 semanas de iniciar tratamiento con carbamazepina presenta fiebre y odinofagia, agregando exantema cutaneo con compromiso sistemico. Se realizo diagnostico de sindrome DRESS, con buena respuesta al tratamiento instaurado. El sindrome DRESS es una reaccion adversa grave, potencialmente mortal, cuyo inicio muchas veces se confunde con cuadros virales, por lo que hay que tener presente este sindrome ante un paciente que inicia tratamiento con anticonvulsivantes y desarrolla exantema febril.
Randomized controlled trials: a solid platform for observational research

Although it remains serious and life-threatening, there has been steady progress in pulmonary arterial hypertension (PAH) treatment over the last few decades. Physicians can now target several different pathways with a range of pulmonary vasodilators, either alone or in combination. The bulk of pulmonary vasodilators were approved using 6-min walk distance, a surrogate outcome, as the primary study endpoint. This has led to a robust conversation about the use of surrogates in PAH and their place in clinical trials. In particular, concerns have been raised as to whether haemodynamic surrogates reflect clinically relevant outcomes in PAH. A meta-analysis of PAH trials found that, while change in haemodynamics over 12 weeks was correlated with both treatment and outcomes, only a small fraction of improvement in clinical outcomes could be explained by the change in haemodynamics. If this meta-analysis is true and generalizable, reliance on haemodynamic surrogates could provide misleading impressions when evaluating drug efficacy. Pharmaceutical companies and regulators have subsequently moved away from short-term trials using surrogates and towards longer trials with a focus on clinically relevant endpoints. The best approach to identifying clinically relevant endpoints in PAH trials should be considered a work in progress. Composite outcomes, such as are used in SERAPHIN, have several merits including increased study efficiency, diminished impact of competing risks, and the ability to capture multiple aspects of a treatment effect. On the other hand, powering studies for a composite outcome diminishes the ability to discriminate differences in components of the composite and may create a false sense of equivalency. Important differences in death or hospitalization may be obscured, especially if a component of the composite outcome is driven by a surrogate endpoint with intermediate relevance to clinical progression. Nevertheless, the paradigm shift in PAH trials away from surrogate endpoints and toward clinically relevant outcomes is an important step toward further improving the quality of trials in PAH. The move toward clinically relevant endpoints in trials does not imply that surrogate endpoints are irrelevant in PAH. Proactive clinicians try not to wait for clinically relevant events, such as hospitalization or death, to make changes in therapy. Instead, for better or worse, functional, haemodynamic, or biochemical metrics are used clinically as surrogates to inform prognosis and determine whether treatment is adequate.
The prevalence of clinical signs of ankle instability in club rugby players

Background . Ankle injuries are one of the most common injuries in sport and have a high recurrence rate. Aim . To determine the prevalence of clinical signs of ankle injuries in club rugby players in South Gauteng. Methods . Institutional ethical clearance was obtained for the study. Of the 180 players from 9 clubs who were eligible for participation in the study, 76% (n=137) were recuited. Informed consent was obtained before players were asked to complete a battery of tests. Each player was asked to complete a demographic questionnaire and the Olerud and Molander questionnaire to determine the prevalence of clinical signs of perceived instability. The prevalence of clinical signs of mechanical instability was determined by the anterior drawer test (ADT) and talar tilt test (TTT). Balance and proprioception were assessed by the Balance Error Scoring System (BESS) and this was used to determine the prevalence of clinical signs of functional instability. Results . The prevalence of perceived instability was 44%. The prevalence of clinical signs of mechanical ankle instability was 33%. There was an increased prevalence of mechanical instability in players who had a history of previous ankle injuries: ADT left (p=0.003); ADT right (p=0.01); TTT left (p=0.001); TTT right (p=0.08), both tests positive left (p=0.001) and both tests positive right (p=0.03). The prevalence of clinical signs of functional ankle instability depended on the surface and visual input, and was greater as the challenge or perturbation increased. Conclusion . There was a high prevalence of clinical signs of ankle instability in club rugby players for perceived, mechanical and functional instability. Those with previously injured ankles were more likely to have unstable ankles.
Mevalonic aciduria cured by bone marrow transplantation.

To the Editor: Neven et al. (June 28 issue)1 discuss the use of bone marrow transplantation in the treatment of severe mevalonic aciduria. We provide additional evidence for the effective cure of mevalonic aciduria by hematopoietic stem-cell transplantation. In February 2006, we performed hematopoietic stem-cell transplantation in an 8-year-old boy who had mevalonic aciduria associated with a polymorphism in the TNFRSF1A gene, using allogeneic bone marrow from a matched sibling. Details of the clinical features of the case and biochemical and genetic evidence for the diagnosis of the periodic fever syndrome have been reported previously.2 The patient's severe febrile episodes, .
The effects of driving events on the stability and resting behaviour of cattle, young calves and pigs

The welfare of animals in transit may be affected by driving events, such as acceleration, braking and cornering. The relationships between driving events and the behavioural responses of the animals were examined. A single-deck, non-articulated vehicle was fitted with a video-recording system, GPS and tri-axial accelerometer. Two drivers each drove three standard journeys (two 3-h stages on different types of roads) for each animal type. Six different groups of five cattle (Bos taurus), ten calves and ten pigs (Sus scrofa) were each transported on separate journeys. Cattle stood still for most of each journey. Calves spent more time lying down during the second stage of the journey than during the first. Although pigs spent some of the time lying down, they spent more time sitting down and this time was greatest on a motorway and during the second stage of the journey. Frequent adjustments to maintain stability were required in response to acceleration, braking, cornering and rough road surfaces. Some animals experienced repeated falls. Falls occurred after a series of different types of events. The fewest losses of balance occurred on the motorway. As a motorway is a limited access multilane carriageway not crossed on the same level by other traffic lanes, the driver does not normally undertake frequent vehicular adjustments to respond to road features. Therefore, motorways give animals an opportunity to rest and avoid discomfort from repetitive driving events. If drivers anticipate potential driving events and prepare for them, it will reduce the likelihood and severity of losses of stability.