Miracle-dz/UniFAR-FTUs huggingface dataset:
Wide Variation in Reported Rates of Stroke Across Cohorts of Patients With Atrial Fibrillation

Background: Oral anticoagulants decrease ischemic stroke rates in patients with atrial fibrillation (AF) but increase the risk of bleeding. For the average patient with AF, the threshold of annual ischemic stroke rate where the benefit of anticoagulation outweighs the bleeding risk (net clinical benefit) has been shown to be ≈1% to 2%. Guideline recommendations for oral anticoagulants in AF are based on the CHA2DS2-VASc stroke risk point scores, assuming that those scores translate to fixed stroke rates. However, the relationship between stroke point scores and annual stroke rates may vary substantially across populations. We sought to comprehensively assess the reported rates of stroke in patients with AF and the relationship of stroke rates to stroke risk point scores. Methods: A systematic review of cohort studies and randomized controlled trials enrolled patients with nonvalvular AF not treated with oral anticoagulants. Results: Of the 3552 studies screened, we identified 34 studies eligible for analysis. Overall stroke rates in cohort studies were highly heterogeneous (Q=5706.54, P<0.001; I2 = 99.6%) and ranged from 0.45% to 9.28% per year, despite being of similar objective study quality. The mean North American stroke rate was less than one-third that of the mean European stroke rate (P<0.0001). However, a random effects regression indicated that between-study variability was not significantly accounted for by cohort region, prospective versus retrospective design, calendar year of study, or outcome event cluster. At a CHA2DS2-VASc score of 1, 76% of cohorts reported ischemic stroke rates <1% per year and only 18% of cohorts reported a stroke rate >2% per year. At a CHA2DS2-VASc score of 2, 27% of cohorts reported stroke rates below 1% per year, 40% reported stroke rates between 1 and 2% per year, and 33% reported stroke rates >2% per year. Conclusions: Substantial variation exists across cohorts in overall stroke rates and rates corresponding to CHA2DS2-VASc point scores. These variations can affect the point score threshold for recommending oral anticoagulants in AF. The majority of cohorts did not observe stroke rates that would indicate a clear expected net clinical benefit for anticoagulating AF patients with CHA2DS2-VASc scores of 1 or 2.
Effects of Glycine-Arginine-α-Ketoisocaproic Acid Supplementation in College-Age Trained Females during Multi-Bouts of Resistance Exercise

ABSTRACT Glycine-arginine-α-ketoisocaproic acid (GAKIC) has been proposed to increase anaerobic high-intensity exercise performance in male subjects. However, the effects of GAKIC ingestion in female subjects have not been studied. Therefore, the purpose of this study was to investigate the effects of GAKIC supplementation on total load volume (i.e., mass lifted) and metabolic parameters during repeated bouts of submaximal leg extensions in college-age females. Nine resistance-trained females participated in a randomized, counterbalanced, double blind study. Subjects were randomly assigned to placebo or GAKIC (10.2 g) and performed six sets of 50% of one repetition maximum leg extensions (two legs simultaneously) to failure. One week later, subjects ingested the other supplement and performed the same exercise protocol. Furthermore, blood lactic acid, blood glucose, and heart rate were also measured preexercise and 5 s after the completion of the exercise protocol (postexercise). GAKIC supplementation significantly increased leg extension total load volume (GAKIC = 1721.7 ± 479.9 kg; placebo = 1479.1 ± 396.8 kg, p < .01). Heart rate and blood lactic acid were significantly increased (p < .01 for both measures) postexercise compared to preexercise, but were not significantly different between GAKIC and placebo (p = .40 for heart rate; p = .88 for lactic acid). Blood glucose was significantly decreased (p = .03) postexercise compared to preexercise, but was not significantly different (p = .78) between GAKIC and placebo. Collectively, these findings suggest that GAKIC increased lower body resistance performance in trained college-age females; however, these findings are not necessarily generalizable.
Design and evaluation of reconfigurable robotic systems for 2 1/2 axis based material deposition strategies

Simulation tools need to be developed to support modeling and product/process analysis activities for material deposition processes. The long term research goal is to develop a set of virtual modeling tools to support advanced tool motions and process planning strategies for this application. The goal of this research is to develop a reconfigurable robotic platform that can adapt alternative deposition strategies while respecting the unique process-related constraints for 2 1/2 axis and 2 1/2 axis + 2 axis tool paths. A variety of topologies are investigated. For the selected systems, a parametric kinematic, dynamic and control model is developed, and results presented for kinematic and dynamic reconfigurations. An adaptability assessment is performed to determine a relative effort measure to physically reconfigure a base platform to a potential new configuration. This combined with reviewing the modeling complexity issue, is used to determine an appropriate base platform. To simulate the process realistically using existing tools, a methodology is developed to illustrate material deposition in conjunction with the tool motions for the systems investigated.
User involvement in care planning

Aims and method To assess the extent of user involvement in care planning, from the users9 perspective. Fifty Care Programme Approach (CPA) meetings across five consultant teams were included using quota sampling. Data concerning user involvement was collected by direct observation, semi-structured interviews with users and keyworkers and a review of CPA documentation. Results User involvement in needs assessment and decision-making was poor, as was knowledge of care planning and information provision to users. Clinical implications Limited resources and conflict resulting from the more containing aspects of the CPA remain obstacles for user involvement. Possible improvements include user led needs assessment, information pack provision and limiting attendance at CPA meetings.
As different as Venus and Mars: time to distinguish efficacy (can it work?) from effectiveness (does it work?)

Implementation. Knowledge Translation. Dissemination. Will these words dominate the 2010s the way ‘evidence-based’, ‘systematic review’ and ‘Madonna’ dominated the 1990s? At five diverse conferences in April and May ‘implementation’ was much more than a buzz. Responding to the zeitgeist, BJSM will focus on how research can move from the shelf (publication) to actually improve health outcomes (implementation). In the clinic, in the school, in the community. Personal and public health. Given that physical activity is arguably the most powerful public health solution,1 we need to embrace the public health domain of exercise medicine. Exercise is not only Medicine but also Public Health. Thanks to Professor Caroline Finch (Monash University and Twitter @CarolineFinch) for joining our Senior Associate Editorial Board to captain the implementation team (Think Dirk Nowitzki but even smarter). Listen to Caroline's keynote talk from the World Congress on Injury and Illness in Sport on the International Olympic …
Clinical Features and Treatment Outcome of Malignant Pleural Mesothelioma

Background: Malignant pleural mesothelioma is a problematic condition due to poor prognosis and difficulties in management. We evaluated the treatment and outcome of 378 mesothelioma patients referred to 6 Italian Oncology Departments. Methods: Demographic and clinical data were collected. Treatment was assessed in terms of chemotherapy (line of treatment, pemetrexed-based regimen, other therapies), surgery, and radiotherapy. Response to therapy, progression-free survival, and overall survival were evaluated. Results: 36 and 342 patients received best supportive care and active treatment, respectively; 86 patients underwent surgery, and 26 received trimodal therapy. Disease control after first-line chemotherapy was achieved in 74.2% of patients (75.7% in patients treated with pemetrexed combined with other drugs and 69% with pemetrexed as monotherapy). The disease control rate was 82.6% in pemetrexed re-challenged individuals. Median survival time was 11.6 months with supportive care, 16.2 months with chemotherapy only, 32.4 months with surgery plus chemotherapy, and 47.2 months with trimodal therapy. A more favorable prognosis was observed in responders to first-line therapy who were then actively treated with second-line (24.8 vs. 11.8 months in non-responders, p < 0.001) and third-line chemotherapy (28.9 vs. 17.8 months in non-responders, p = 0.005). Conclusion: Mesothelioma patients benefited from chemotherapy alone only when retreated in the second line after response to first-line therapy.
Tomo-Seq Identifies SOX9 as a Key Regulator of Cardiac Fibrosis During Ischemic Injury

Background: Cardiac ischemic injury induces a pathological remodeling response, which can ultimately lead to heart failure. Detailed mechanistic insights into molecular signaling pathways relevant for different aspects of cardiac remodeling will support the identification of novel therapeutic targets. Methods: Although genome-wide transcriptome analysis on diseased tissues has greatly advanced our understanding of the regulatory networks that drive pathological changes in the heart, this approach has been disadvantaged by the fact that the signals are derived from tissue homogenates. Here we used tomo-seq to obtain a genome-wide gene expression signature with high spatial resolution spanning from the infarcted area to the remote to identify new regulators of cardiac remodeling. Cardiac tissue samples from patients suffering from ischemic heart disease were used to validate our findings. Results: Tracing transcriptional differences with a high spatial resolution across the infarcted heart enabled us to identify gene clusters that share a comparable expression profile. The spatial distribution patterns indicated a separation of expressional changes for genes involved in specific aspects of cardiac remodeling, such as fibrosis, cardiomyocyte hypertrophy, and calcium handling (Col1a2, Nppa, and Serca2). Subsequent correlation analysis allowed for the identification of novel factors that share a comparable transcriptional regulation pattern across the infarcted tissue. The strong correlation between the expression levels of these known marker genes and the expression of the coregulated genes could be confirmed in human ischemic cardiac tissue samples. Follow-up analysis identified SOX9 as common transcriptional regulator of a large portion of the fibrosis-related genes that become activated under conditions of ischemic injury. Lineage-tracing experiments indicated that the majority of COL1-positive fibroblasts stem from a pool of SOX9-expressing cells, and in vivo loss of Sox9 blunted the cardiac fibrotic response on ischemic injury. The colocalization between SOX9 and COL1 could also be confirmed in patients suffering from ischemic heart disease. Conclusions: Based on the exact local expression cues, tomo-seq can serve to reveal novel genes and key transcription factors involved in specific aspects of cardiac remodeling. Using tomo-seq, we were able to unveil the unknown relevance of SOX9 as a key regulator of cardiac fibrosis, pointing to SOX9 as a potential therapeutic target for cardiac fibrosis.
Creeping Attachment in Miller Class III Recessions: A Report of Five Cases

Introduction: Creeping attachment, a postoperative migration of gingival marginal tissue in a coronal direction, is best observed in mandibular anterior teeth with narrow recessions. In this case report, recession coverage through creeping attachment is observed in wide gingival recessions (GRs) belonging to Miller Class III cases, when gingival augmentation by free gingival graft (FGG) apical to the recession area was attempted.Case Presentation: Five patients (four males and one female, aged 27 to 30 years) with Miller Class III GRs on both mandibular central incisors, underwent FGG for gingival augmentation. The graft was placed apical to the recession. Clinical parameters were evaluated 1 year after surgery. At the end of 1 year, vestibular deepening with an increase of 3.5 to 5.5 mm of keratinized gingiva was achieved, and root coverage through creeping attachment was noticed in range of 0.4 to 2.8 mm.Conclusion: Partial root coverage through creeping attachment can be anticipated in isolated Miller .
Specific binding of leukotriene B4 to a receptor on human polymorphonuclear leukocytes

In this paper we have described the binding of nanomoler concentrations of [3H]leukotriene B4 (LTB4) to human polymorphonuclear leukocytes. Because up to 80% of the total [3H]LTB4 binding was blocked by excess (greater than 100 times) [14C]LTB4, the majority of binding is specific. Stereospecificity of the LTB4 binding is demonstrated by the diminished relative abilities of the 6-trans-and 12-epi-6-trans- isomers of LTB4 to block [3H]LTB4 binding. With these two isomers 3-10- fold higher than [14C]LTB4 concentrations were needed for equivalent inhibition of [3H]LTB4 binding. This difference is quantitatively less dramatic than the differences between these isomers in many in vitro functional assays such as chemokinesis, chemotaxis, and degranulation. Binding of [3H]FMLP is not blocked at greater than 100-fold excess of LTB4. The binding of [3H]LTB4 to cells appears to be essentially irreversible at 4 degrees C, but not at 37 degrees C where initially bound LTB4 is rapidly converted to metabolites which then enter the medium. These results suggest the presence of a saturable, stereospecific site for LTB4 on PMN. The association of LTB4 binding and the initiation of pharmacological responses to LTB4 will require further studies.
Reabilitação sensório-motora de tetraplégicos através de estimulação elétrica neuromuscular

O objetivo desta pesquisa consiste em verificar o ganho neurologico e a independencia na execucao de atividades funcionais em tetraplegicos durante o periodo de 6 meses de reabilitacao com Estimulacao Eletrica Neuro-Muscular (EENM). Foram realizados, em oito pacientes do sexo masculino, os Protocolos ASIA e FIM no periodo pre e pos tratamento que consistiu na Estimulacao de membros inferiores e superiores, com realizacao de Atividades funcionais a partir da restauracao de preensoes. Os dados desta pesquisa foram analisados por meio de estudos de caso devido a variabilidade intersujeitos. Os tetraplegicos foram capazes de realizar todas as Atividades propostas, o que sem a EENM nao seria possivel. A recuperacao sensorio-motora foi maior nos membros superiores comparado aos membros inferiores. A maioria dos pacientes apresentou ganho neurologico com consequente diminuicao do nivel de lesao, bem como, aumento no indice de independencia funcional. Portanto, estes efeitos terapeuticos da reabilitacao atraves de EENM indicam plasticidade neural.
Ruolo delle citochine pro-infiammatorie nei meccanismi patogenetici dell'aterosclerosi coronarica

Investigation of the mechanisms of atherosclerosis has determined that inflammation plays a central role in the development, progression, and outcome of acute coronary syndrome. Although C-reactive protein will remain over time a useful marker, cytokines will continue to be studied in order to understand the mechanisms of acute coronary syndrome and cytokine balance. This short review summarizes the experimental and clinical evidence regarding the role of some cytokines in acute coronary syndrome (interleukin [IL]-8, IL-10, IL-18, IL-2, tumor necrosis factor-� , interferon-� ).
Disease Activity, Smoking, and Reproductive-related Predictors of Poor Prognosis in Patients with Very Early Inflammatory Polyarthritis

Objective. To identify disease activity, smoking, and reproductive-related predictors of a poor prognosis in patients with very early inflammatory polyarthritis (IP). Methods. Patients with very early IP (symptom duration 4–11 weeks) included in our study were participants in the STIVEA (Steroids In Very Early Arthritis) randomized placebo-controlled trial. At baseline, disease-related variables were measured and patients were asked to complete a questionnaire covering smoking status and reproductive questions. Baseline predictors of poor prognosis [i.e., the need to start disease-modifying antirheumatic drug (DMARD) therapy by 6 months or the clinical diagnosis of rheumatoid arthritis (RA) at 12 months] were identified, applying logistic regression analyses adjusted for treatment group. Results. Rheumatoid factor (RF) positivity was one of the strongest clinical predictors of a poor prognosis: OR for DMARD therapy at 6 months, 4.00 (95% CI 2.00–8.00) and OR for a diagnosis of RA at 12 months, 9.48 (95% CI 4.48–20.07). There was a significant association between current smoking at baseline compared to never smoking and a diagnosis of RA at 12 months (OR 3.15, 95% CI 1.16–8.56). Conclusion. About 6 in 7 patients with very early RF-positive IP were diagnosed with RA 1 year later. In addition, 1 in 4 IP patients who smoke will develop RA later. It is recommended to treat RF-positive patients who have IP with DMARD at presentation and to advise patients to stop smoking.
Canadian Rheumatology Association Recommendations for Pharmacological Management of Rheumatoid Arthritis with Traditional and Biologic Disease-modifying Antirheumatic Drugs

Objective. The Canadian Rheumatology Association (CRA) has developed recommendations for the pharmacological management of rheumatoid arthritis (RA) with traditional and biologic disease-modifying antirheumatic drugs (DMARD) in 2 parts. Part 1 is reported here. Methods. The CRA Therapeutics Committee assembled a national working group of RA clinical experts, researchers, patient consumers, and a general practitioner. Treatment questions were developed a priori based on results of a national needs assessment survey. A systematic review of all clinical practice guidelines and consensus statements regarding treatment with traditional and biologic DMARD in patients with RA published between January 2000 and June 2010 was performed in Medline, Embase, and CINAHL databases, and the grey literature. Guideline quality was assessed by 2 independent reviewers, and guideline characteristics, recommendations, and supporting evidence from observational studies and randomized controlled trials were synthesized into evidence tables. The full working group reviewed the evidence tables and developed recommendations using a modified Delphi technique. Results. Five overarching principles and 26 recommendations addressing general RA management strategies and treatment with glucocorticoids and traditional and biologic DMARD were developed for rheumatologists, other primary prescribers of RA drug therapies, and patients with RA. Conclusion. These recommendations were developed based on a synthesis of international guidelines, supporting evidence, and expert consensus considering the Canadian healthcare context with the intention of promoting best practices and improving healthcare delivery for persons with RA.
Tumeurs de l'apex pariéto-pulmonaire : une expérience chirurgicale monocentrique de 63 cas

Objective : To evaluate the current results of surgery for superior sulcus tumours and to identify factors infl uencing the long-term survival. Methods : From January, 1986 to December, 2006, this retrospective single institution study collected 63 consecutive patients, 56 men and 7 women with a mean age of 56 years, having received surgery in a curative intent for a superior sulcus tumour. Results : 46 patients (73 %) had had a radio-chemotherapy preoperatively (n=22) or postoperatively n=24 ), 20 (32.5 %) had received both preoperative and postoperative treatments, whether only 2 patients (3,2 %) did not receive any form of additive treatment. All patients had an en-bloc chest wall and lung resection. An posterior surgical approach was used in 55 cases (85.3 %), and an anterior approach in 8: alone in 5 (7.9 %), and combined with a thoracotomy in 3 (4.8 %). Lung resection consisted of lobectomy (n=56 ; 88.9%) or wedge (n=7 ; 11.1%). Extended resections to the subclavian vessels (n=4) or spine (n=2) were performed in 6 cases. Complete R0 resection was achieved in 84.1%. In-hospital mortality was 4.8%, and 5-year overall survival rate was 40% [26-54]. At univariate analysis, complete R0 resection as well as T3 and N0 status were signifi cant predictors of an improved survival. At multivariate analysis, only T and N status were independent prognosticators. Conclusions : Integration of new surgical concepts as well as the use of multimodal therapeutic strategies allowed us to obtain results reaching international standards. Our study suggests the importance of the selection process, and the individualized approach, to achieve the pivotal goal that is complete resection.
Congenital Monoblastic Leukemia Presenting as Jaundice, Pleural Effusion, and Ascites: Case Report and Literature Review

Congenital leukemias are a rare group of hematologic neoplasms with a wide range of clinical signs and symptoms. Here we reported a neonate presenting with jaundice, pleural effusion and ascites. The total protein and serum albumin were markedly low at 48 and 12g/L. Computerized tomography showed the density of liver was asymmetry with several hypoechoic regions. Initial blood routine examination revealed only thrombocytopenia while blood white cells increased to 30.0×109/L with 17% blast cells several days later. Bone marrow biopsy showed the proportion of blasts and promonocytes increased and she was diagnosed as acute monoblastic leukemia.
Vascular Biology, Atherosclerosis and Endothelium Biology Vasculoprotective Effects of Anti-Tumor Necrosis Factor- (cid:1) Treatment in Aging

Vascular aging is associated with dysregulation of tumor necrosis factor (TNF)- (cid:1) expression. TNF- (cid:1) is a master regulator of vascular proatherogenic phenotypic changes, and it has been linked to endothelial dysfunction and apoptosis. To test the hypothesis that anti-TNF- (cid:1) treatment exerts vasculoprotective effects in aging, aged (29 months old) F344 rats were treated with etanercept (1 mg/kg/week for 4 weeks), which binds and inactivates TNF- (cid:1) . In aged carotid arteries, relaxations to acetylcholine were decreased, and endothelial O 2 . production was increased (as shown by dihydroethidine fluorescence measurements). Etanercept treatment significantly improved responses to acetylcholine and decreased vascular NAD(P)H oxidase activity and expression. In aged carotid and coronary arteries, there were increases in DNA fragmentation rate and caspase 3/7 activity (indicating an increased rate of apoptotic cell death), which were attenuated by etanercept treatment. In aged vessels, there was an up-regulation of inflammatory markers, including inducible nitric-oxide synthase and intercellular adhesion molecule-1, which was decreased by etanercept treatment. In carotid arteries of young animals, recombinant TNF- (cid:1) elicited endothelial dysfunction, oxidative stress, and increased apoptosis and proinflammatory gene expression, mimicking many of the symptoms of vascular aging. [by the TNF- (cid:1) convertase enzyme (TACE) 3 ] by vascular cells as a paracrine mediator. The resulting increased levels of TNF- (cid:1) within the vascular wall activate NAD(P)H oxidase- derived O 2 . generation leading to endothelial dysfunction, induce apoptotic endothelial cell death, and promote vascular inflammation by inducing NF- (cid:4) B activation. Etanercept is likely to neutralize both circulating and locally produced TNF- (cid:1) , attenuating oxidative stress and vascular inflamma- tion, limiting endothelial cell loss, and improving endothelial function in aging.