Miracle-dz/UniFAR-FTUs huggingface dataset:
Apixaban with antiplatelet therapy after acute coronary syndrome.

BACKGROUND Apixaban, an oral, direct factor Xa inhibitor, may reduce the risk of recurrent ischemic events when added to antiplatelet therapy after an acute coronary syndrome. METHODS We conducted a randomized, double-blind, placebo-controlled clinical trial comparing apixaban, at a dose of 5 mg twice daily, with placebo, in addition to standard antiplatelet therapy, in patients with a recent acute coronary syndrome and at least two additional risk factors for recurrent ischemic events. RESULTS The trial was terminated prematurely after recruitment of 7392 patients because of an increase in major bleeding events with apixaban in the absence of a counterbalancing reduction in recurrent ischemic events. With a median follow-up of 241 days, the primary outcome of cardiovascular death, myocardial infarction, or ischemic stroke occurred in 279 of the 3705 patients (7.5%) assigned to apixaban (13.2 events per 100 patient-years) and in 293 of the 3687 patients (7.9%) assigned to placebo (14.0 events per 100 patient-years) (hazard ratio with apixaban, 0.95; 95% confidence interval [CI], 0.80 to 1.11; P=0.51). The primary safety outcome of major bleeding according to the Thrombolysis in Myocardial Infarction (TIMI) definition occurred in 46 of the 3673 patients (1.3%) who received at least one dose of apixaban (2.4 events per 100 patient-years) and in 18 of the 3642 patients (0.5%) who received at least one dose of placebo (0.9 events per 100 patient-years) (hazard ratio with apixaban, 2.59; 95% CI, 1.50 to 4.46; P=0.001). A greater number of intracranial and fatal bleeding events occurred with apixaban than with placebo. CONCLUSIONS The addition of apixaban, at a dose of 5 mg twice daily, to antiplatelet therapy in high-risk patients after an acute coronary syndrome increased the number of major bleeding events without a significant reduction in recurrent ischemic events. (Funded by Bristol-Myers Squibb and Pfizer; APPRAISE-2 ClinicalTrials.gov number, NCT00831441.).
Response of canine lower esophageal sphincter to gastric distension.

The aim of this study was to localize the region of the stomach responsible for triggering distension-induced transient lower esophageal sphincter relaxation (TLESR). The canine stomach was partitioned into subsegments by a row of buttressed sutures. This separated either the fundus from the lesser curve or the proximal stomach from the antrum. After 1 mo each region was progressively distended while gastroesophageal pressures were monitored. At the time of the first TLESR, gastric wall tension was estimated from the bag pressure and volume. Distension of the intact stomach, lesser curve, or proximal stomach in 12 dogs produced a progressive increase in lower esophageal sphincter (LES) pressure, which was interrupted at low gastric wall tension (29, 35, and 40 mmHg.cm, respectively) by a superimposed TLESR. Background LES pressure fell progressively with distension of the antrum but was unchanged by distension of the fundus alone. Both the fundus and antrum had significantly higher thresholds for triggering TLESR (96 and 105 mmHg.cm). In another two dogs truncal vagotomy performed at the time of gastric partitioning prevented both the change in background LES pressure, and the triggering of TLESR, associated with proximal gastric and antral distension. We conclude that the subcardiac region of the stomach is primarily responsible for triggering TLESR induced by distension and that the effect on background LES pressure depends on the region distended.
Can small molecules provide truly effective enhancement of cognition? Current achievements and future directions

Introduction: The prevalence of age-related diseases that implicate a deterioration of cognitive abilities is increasing. Moreover, cognitive decline occurs in numerous CNS disorders affecting patients at younger ages as well, resulting in reduced functional ability and quality of life. Despite the existence of few medications treating cognition, the need for efficacious treatment options to alleviate, halt or even prevent cognitive decline is generally unmet to date. Consequently, extensive research efforts are undertaken to identify medications that can effectively enhance cognition. Areas covered: This review covers ongoing clinical trials for cognition and reflects on efforts undertaken to increase the success rates of procognitive drug treatment. The review discusses ways to optimize the drug development process for cognition enhancing agents at the preclinical to clinical interface and provides concrete examples. Expert opinion: The existing efficacy readouts addressing cognition in preclinical research offer little translational validity to the clinical situation. In order to identify truly efficacious drug candidates, biomarkers need to be developed that directly address conserved mechanisms underlying cognitive performances. To this end, technologies such as neuroimaging or electroencephalography constitute promising entry points for identifying both the cognitive domain and the patient population most responsive to drug treatment.
Glomerular mRNA expression of angiotensinase A after renal ablation.

The local concentration of angiotensin II (ANG II) in the renal microenvironment is not only controlled by the generation of this peptide but also by its enzymatic degradation. Angiotensinase A (ATA; aminopeptidase A, A.C.3.4.11.7) is a major exopeptidase of the glomerulus involvement in the metabolism of ANG II. We studied the glomerular mRNA levels of ATA in a remnant kidney model 1-12 weeks after 1 1/3 nephrectomy. Functional parameters (systolic blood pressure and albuminuria) demonstrated the progression of renal disease in this model. Glomerular ATA enzyme activity significantly increased 1-5 weeks after nephrectomy and returned to control levels 12 weeks after ablation. In general, changes in steady-state mRNA expression for ATA were rather small. mRNA expression for ATA in isolated glomeruli as evaluated by northern blots was slightly increased 1 and 3 weeks after 1 1/3 nephrectomy but was suppressed 5 and 12 weeks after renal ablation compared to age-matched 2-kidney controls. Treatment of animals with the ACE inhibitor ramipril for 5 and 12 weeks partly inhibited the decrease in ATA transcripts after 1 1/3 nephrectomy and stimulated expression in 2-kidney controls whereas the ACE inhibitor decreased glomerular ATA enzyme activity in nephrectomized rats at 5 weeks. Isolated glomeruli from normal controls superfused with 10(-6) M ANG II for 60 min demonstrated no change in ATA transcripts. Our results show that ATA steady-state mRNA levels are slightly elevated early (1-3 weeks) after renal ablation, and are subsequently suppressed (5-12 weeks). ATA enzyme activity is also increased early and returned (12 weeks) to levels measured in age-matched 2-kidney controls. (ABSTRACT TRUNCATED AT 250 WORDS)
Functional Dissection of Naturally Occurring Amino Acid Substitutions in eIF4E That Confers Recessive Potyvirus Resistance in Plants[W][OA]

Naturally existing variation in the eukaryotic translation initiation factor 4E (eIF4E) homolog encoded at the pvr1 locus in Capsicum results in recessively inherited resistance against several potyviruses. Previously reported data indicate that the physical interaction between Capsicum-eIF4E and the viral genome-linked protein (VPg) is required for the viral infection in the Capsicum-Tobacco etch virus (TEV) pathosystem. In this study, the potential structural role(s) of natural variation in the eIF4E protein encoded by recessive resistance alleles and their biological consequences have been assessed. Using high-resolution three-dimensional structural models based on the available crystallographic structures of eIF4E, we show that the amino acid substitution G107R, found in many recessive plant virus resistance genes encoding eIF4E, is predicted to result in a substantial modification in the protein binding pocket. The G107R change was shown to not only be responsible for the interruption of VPg binding in planta but also for the loss of cap binding ability in vitro, the principal function of eIF4E in the host. Overexpression of the Capsicum-eIF4E protein containing the G107R amino acid substitution in Solanum lycopersicum indicated that this polymorphism alone is sufficient for the acquisition of resistance against several TEV strains.
Effect of granulocyte macrophage colony‐stimulating factor in a patient with benign systemic mastocytosis

We report the in vitro and in vivo effects of granulocyte macrophage colony stimulating factor (GM‐CSF), a known inhibitor of in vitro mast cell differentiation, in a patient with benign, adult‐onset systemic mastocytosis. In vitro effects of GM‐CSF on bone marrow cultures before the start of treatment showed a marked inhibition of mast cell marker expression [tryptase, Kit, and high‐affinity IgE receptor (FcεRIα)] at both protein and mRNA levels. Therefore, the patient was treated with daily injections of GM‐CSF for 10 weeks. After an initial improvement, increasing worsening of clinical symptoms was noted, and the patient refused further treatment. Lesional skin biopsies showed an increase of toluidine blue‐positive mast cells, compared with uninvolved skin, with further significant increase after treatment. Similar results were obtained on staining for mast cell‐specific tryptase and Kit, as well as for CD1a and FcεRIα. These findings show that GM‐CSF inhibits human bone marrow mast cell differentiation in vitro, and also in mastocytosis. However, GM‐CSF apparently enhances recruitment of mast cell as well as dendritic cell precursors into the tissue during systemic treatment. These findings and the observed adverse clinical effects in the present patient make it unlikely that GM‐CSF monotherapy will be beneficial for the treatment of mastocytosis.
Performance of Osteoporosis Self-assessment Tool for Asian (OSTA) for Primary Osteoporosis in Post-menopausal Malay Women.

ABSTRACT The Osteoporosis Self-Assessment Tool for Asians (OSTA) score has been developed to identify women at risk of osteoporosis. It can be used as a screening tool for patients at risk who would benefit from bone mineral density measurement and treatment. It was developed based on data from eight countries including Malaysia. However, most subjects were of Chinese (59%). This study evaluated the performance of OSTA among 152 post-menopausal Malay women. OSTA score calculation and DEXA scan were performed. Our results showed that the OSTA score is a good predictor of patients at risk of osteoporosis based on BMD measurements at the proximal femur. Instrument sensitivity was 87.5%, specificity was 95.8%, positive predictive value (PPV) was 0.538, negative predictive value (NPV) was 0.993, and the area under the receiver operating characteristic curve (ROC) was 0.895. We conclude that use of the OSTA score in postmenopausal Malay women is effective and has adequate sensitivity and specificity. KEY WORDS Osteoporosis; post menopause; Malay; screening; OSTA.
Integration of absolute ventricular fibrillation voltage correlates with successful defibrillation

Previous work has suggested that at higher absolute ventricular fibrillation voltages (AVFV), the heart is more amenable to defibrillation. This study investigated in a canine model whether voltage integration of the AVFV is associated with the defibrillation success rate. The moving-average filter was used to process the ventricular fibrillation (VF) waveform recorded from Lead II of the electrocardiogram (ECG). In seven animals, defibrillation trials were analyzed using a DC shock (DCS) successful approximately 50% of the time when delivered randomly. For each of a total of 84 DCS (40% successes, 60% failures), the fibrillation waveform just prior to DCS was analyzed. The integration of the AVPV waveform was performed over various sample sizes including 1, 4, 8, 16, 64, and 128 ms, as well as the time equal to the mean VF cycle length. The results suggest that dc shocks delivered at instants of higher values of integrated AVFV over the various window sizes are associated with successful defibrillation. Window sizes less than 16 ms appeared to offer the best discrimination. The integration of AVFV over the entire VF cycle length was significantly higher for successful rather than unsuccessful DCS. This interesting observation is consistent with the clinical observation that "coarse" VF (high AVFV) is easier to defibrillate than "fine" VF (low AVFV). The use of voltage integration of AVFV may have potential implications in the improvement of defibrillation success in implantable devices. <<ETX>>
Intracellular calcium changes in mice Leydig cells are dependent on calcium entry through T‐type calcium channels

Luteinizing hormone (LH) regulates testosterone synthesis in Leydig cells by inducing an intracellular increase in cAMP concentration. LH also increases the intracellular calcium concentration ([Ca2+]i), dependent on the presence of Ca2+ in the extracellular medium ([Ca2+]e) for its effect. Despite these evidences, the identity of a pathway for calcium entry has remained elusive and the relationship between cAMP and [Ca2+]i has been questioned. Here we show that mice Leydig cells do have an inward Ca2+ current carried by T‐type Ca2+ channels. In 10 mm[Ca2+]e, the currents start to be activated at −60 mV, reaching maximal amplitude of 1.8 ± 0.3 pA pF−1 at −20 mV. Currents were not modified by Ba2+ or Sr2+, were suppressed in Ca2+‐free external solution, and were blocked by 100 μm nickel or 100 μm cadmium. The Ki for Ni2+ is 2.6 μm and concentrations of Cd2+ smaller than 50 μm have a very small effect on the currents. The calcium currents displayed a window centred at −40 mV. The half‐voltage (V0.5) of activation is −30.3 mV, whereas the half‐voltage steady‐state inactivation is −51.1 mV. The deactivation time constant (τdeactivation) is around 3 ms at −35 mV. Confocal microscopy experiments with Fluo‐3 loaded cells reveal that both LH and dibutyryl‐cAMP (db‐cAMP) increase [Ca2+]i. The db‐cAMP induced calcium increase was dependent on Ca2+ influx since it was abolished by removal of extracellular Ca2+ and by 400 μm Ni2+. [Ca2+]i increases in regions close to the plasma membrane and in the cell nucleus. Similar effects are seen when Leydig cells are depolarized by withdrawing K+ from the extracellular solution. Altogether, our studies show that Ca2+ influx through T‐type Ca2+ channels in the plasma membrane of Leydig cells plays a crucial role in the intracellular calcium concentration changes that follow binding of LH to its receptor.
In vivo measurement of T1rho dispersion in the human brain at 1.5 tesla.

PURPOSE To measure T1rho relaxation times and T1rho dispersion in the human brain in vivo. MATERIALS AND METHODS Magnetic resonance imaging (MRI) was performed on a 1.5-T GE Signa clinical scanner using the standard GE head coil. A fast spin-echo (FSE)-based T1rho-weighted MR pulse sequence was employed to obtain images from five healthy male volunteers. Optimal imaging parameters were determined while considering both the objective of the study and the guarantee that radio-frequency (RF) power deposition during MR did not exceed Food and Drug Administration (FDA)-mandated safety levels. RESULTS T1rho-weighted MR images showed excellent contrast between different brain tissues. These images were less blurred than corresponding T2-weighted images obtained with similar contrast, especially in regions between brain parenchyma and cerebrospinal fluid (CSF). Average T1rho values for white matter (WM), gray matter (GM), and CSF were 85 +/- 3, 99 +/- 1, and 637 +/- 78 msec, respectively, at a spin-locking field of 500 Hz. T1rho is 30% higher in the parenchyma and 78% higher in CSF compared to the corresponding T2 values. T1rho dispersion was observed between spin-locking frequencies 0 and 500 Hz. CONCLUSION T1rho-weighted MRI provides images of the brain with superb contrast and detail. T1rho values measured in the different brain tissues will serve as useful baseline values for analysis of T1rho changes associated with pathology.
The Evolution of Labor Supply and Unemployment in the Egyptian Economy

This paper analyzes the evolution of labor supply and unemployment in Egypt in the period from 1999 to 2012, focusing on the impact of the demographic phenomenon known as the youth bulge and the impact of the world financial crisis and the marked economic slowdown following the January 25th 2011 revolution. Data from the Egypt Labor Market Panel Survey of 2012 is used and compared to previous survey rounds. Trends in population, the labor force, employment, and unemployment are investigated and examined by age and education. Even though demographic pressures on the labor market have decreased since 2006 as the youth bulge generation has already made its way into the labor market, employment rates have decreased, labor force participation among women has decreased, unemployment has slightly increased, and under-employment has increased substantially. Overall, the labor market post-revolution is in a weaker position than in 2006.
Student and faculty perceptions about mandatory influenza vaccinations on a health sciences campus

ABSTRACT Objective: To examine the perceptions among faculty and health professional students regarding mandatory vaccination policies on a health sciences campus. Participants: A total of 296 faculty and 244 students completed surveys during Fall 2015. Methods: The online survey administered to individuals who received the influenza vaccine during the fall 2015 influenza vaccination clinic season included five items evaluating perceptions of employer mandatory vaccination requirements. Results: Chi-square analysis indicated that although faculty and students agree mandatory vaccinations in a health care environment are appropriate, faculty are more likely than students to get vaccinated in the absence of a mandate. Additionally, a small fraction of faculty would consider employment elsewhere when facing this mandate. Conclusions: Overall, faculty and students had favorable perceptions about mandatory influenza vaccine policies. Since students were less likely to be vaccinated in the absence of a mandate, education of students should be improved to support the importance of vaccinations in a health care environment.
The Institutionalist Theory of Economic Development

The institutionalist theory of the development of newly emerging societies is an extension of the general body of institutionalist theory. It draws upon the same basic conceptions of the nature of human behavior and the process of social change that have characterized the institutionalist interpretation of the evolutionary history of modern advanced industrial economies. Development is conceived as a complex cultural process rather than as a stable system of counterbalancing forces regulated by a fluid and self-adjusting market mechanism. The propelling force for economic growth has been and continues to be the utilization of technological knowledge and instruments. The forces inhibiting social progress, on the contrary, are rooted in institutional (ceremonial) patterns of behavior that are present in all societies, but seem to be particularly obstructive in the cultures of many less economically developed countries. As an extension of general institutionalist theory, contemporary development theory attributes retarded growth in the Third World to the dominant influence of archaic social institutions and the consequent failure to utilize available technical knowledge and skill. The specific form that the interplay of institutional and technological behavior takes in each country or cultural unit is governed by unique circumstances of geography, cultural history, and available resources. While technology has universal adaptability, institutions are culture specific. Each case can be fully understood only by empirical investigation utilizing
Vector Competence of Selected Mosquito Species in Kenya for Ngari and Bunyamwera Viruses

ABSTRACT Bunyamwera and Ngari viruses have been isolated from a range of mosquito species in Kenya but their actual role in the maintenance and transmission of these viruses in nature remains unclear. Identification of the mosquito species efficient in transmitting these viruses is critical for estimating the risk of human exposure and understanding the transmission and maintenance mechanism. We determined the vector competence of, Aedes aegypti (L.), Culex quinquefasciatus Say, and Anopheles gambiae Giles for transmission ofBunyamweraand Ngari viruses. Ae. aegypti was moderately susceptible to Bunyamwera virus infection at days 7 and 14. Over 60% of Ae. aegypti with a midgut infection developed a disseminated infection at both time points. Approximately 20% more mosquitoes developed a disseminated infection at day 14 compared with day 7. However, while Ae. aegypti was incompetent for Ngari virus, An. gambiae was moderately susceptible to both viruses with dissemination rates more than double by day 14. Cx. quinquefasciatus was refractory to both Bunyamwera and Ngari viruses. Our results underscore the need to continually monitor emergent arboviral genotypes circulating within particular regions as well as vectors mediating these transmissions to preempt and prevent their adverse effects. The genetic mechanism for species specificity and vector competence owing to reassortment needs further investigation.
Discrete-event control over communication networks

In this paper we investigate the problem of designing embedded discrete-event controllers over communication networks. It is assumed that there is a path between every pair of processes in the network. In each process certain events are singled out-called the significant events of the process-and the control objective is specified by a prefix-closed language over the alphabet of all significant events. The paper is focused on communication among processes necessary to meet the control objective. As such, process models are left unspecified; it is only required that disabling any of the significant events not block communication among processes. We show that the protocol design for non-coobservable specifications can be reduced to the synthesis of communicating decentralized supervisors. Solutions are proposed for a restricted class of problems where all channels are ideal, and a couple of positive results are stated for the case where channels are unreliable.
Acute Trenant Pneumonia of Possible Bacterial Etiology

A 48 years old, smoker (20 cigarettes/day), without known personal pulmonary antecedents, is presented in the emergency service accusing: dry cough, fever (38,8°C), chills, dyspnea at medium efforts, dizziness, symptoms occurred 4 days ago and gradually accelerated. Following the paraclinical tests two possible major differential diagnoses take shape: bacterial pneumonia and lung cancer. For the diagnosis of pneumonia pleads clinical appearance (fever, chills, cough) and the results of radiological examination. The diagnosis of bronchopulmonary tumor is denied by bronchoscopy, the PBTT which doesn’t reveal tumor cells and clinically well evolution. The case is interpreted as a form of trenant bacterial pneumonia in slow resorption - for this pleads the favorable clinical and radiological evolution, broad-spectrum antibiotic therapy, balancing electrolyte.