Miracle-dz/UniFAR-FTUs huggingface dataset:
Aldactone therapy in a peritoneal dialysis patient.

Sir, Whilst Hausmann’s [1] comments with respect to the tolerability of aldactone in peritoneal dialysis patients are important, we believe the data is over interpreted. The RALES study [2] included only individuals with, at worst, moderate renal impairment and normal baseline serum potassium. Additionally, Hausmann’s patient was not receiving a loop diuretic or an ACE-inhibitor compared with 100% and 95%, respectively, of individuals randomized to aldactone in this study. In RALES, renal function was discriminatory in terms of survival analysis in those individuals with a serum creatinine of)107 mmolul at randomization.Bauersachs et al. [3], demonstrated in Wistar rats following myocardial infarction that the combination of trandolopril and aldactone induced a striking increase in urinary sodium losses, leading to improved left ventricular haemodynamics when compared with either compound alone. This natureitic response is unlikely to exist in renal failure. It is unjustified in patients with more advanced renal disease to extrapolate the potential benefits seen in RALES. Furthermore, there may have been no additional therapeutic benefit in those individuals not already established on ACEinhibitor therapy prior to the introduction of aldactone. The 95% confidence interval for the relative risk of all cause mortality in those not receiving ACE inhibititors can be seen to cross 1.0. Hyperkalemia is obviously more likely to occur when using ACE-inhibition and aldactone in renal failure and preclude the use of this combination. It is more likely in our opinion that the benefits in the presented case are due to revascularization rather than any pharmacological effects on the myocardium. It is well documented that despite the burden of cardiovascular disease in our patients they undergo less coronary interventions. This case does however highlight that consideration for revascularization is appropriate in end-stage renal failure, but fails to convince that aldactone had anything other than a marginal effect.
Oral breathing challenge in participants with vocal attrition.

Vocal folds undergo osmotic challenge by mouth breathing during singing, exercising, and loud speaking. Just 15 min of obligatory oral breathing, to dry the vocal folds, increases phonation threshold pressure (Pth) and expiratory vocal effort in healthy speakers (M. Sivasankar & K. Fisher, 2002). We questioned whether oral breathing is more detrimental to phonation in healthy participants with a history of temporary vocal attrition. The effects of a 15-min oral or nasal breathing challenge on Pth and perceived expiratory vocal effort were compared for participants reporting symptoms of vocal attrition (N = 18, ages 19-38 years) and normal controls (N = 20, ages 19-33 years). Post-challenge-prechallenge differences in Pth (deltaPth) and effort (deltaEffort) revealed that oral breathing, but not nasal breathing, increased Pth (p < .001 ) and effort (p < .001) at low, comfortable, and high pitch. deltaPth was significantly greater in participants with vocal attrition than in normal controls (p < .001). Nasal breathing reduced Pth for all controls but not for all participants reporting vocal attrition. deltaPth was significantly and linearly correlated with deltaEffort (rvocal attrition = .81, p < .001; rcontrol = .84, p < .001). We speculate that the greater increases in Pth in participants reporting vocal attrition may result from delayed or inadequate compensatory response to superficial laryngeal dehydration. Obligatory oral breathing may place voice users at risk for exacerbating vocal attrition. That sol layer depletion by obligatory oral breathing increased Pth and vocal effort provides support for the role of superficial hydration in maintaining ease of phonation.
Mindreading in Infancy

Various dichotomies have been proposed to characterize the nature and development of human mindreading capacities, especially in light of recent evidence of mindreading in infants aged 7 to 18 months. This article will examine these suggestions, arguing that none is currently supported by the evidence. Rather, the data support a modular account of the domain-specific component of basic mindreading capacities. This core component is present in infants from a very young age and does not alter fundamentally thereafter. What alters with development are the interactions between core mindreading and other systems, including executive systems, and forms of learning that do not require radical conceptual change.
Cell therapy generates a favourable chemokine gradient for stem cell recruitment into the infarcted heart in rabbits

Stem cell recruitment into the heart is determined by a concentration gradient of stromal‐derived factor 1 (SDF‐1) from bone marrow to peripheral blood and from blood to injured myocardium. However, this gradient is decreased in chronic myocardial infarction (MI). This study evaluated the effect of cell therapy using bone marrow stromal cells (BMSCs) on an SDF‐1 gradient in post‐infarction rabbits.
Preformed class II donor‐specific antibodies are associated with an increased risk of early rejection after liver transplantation

Preformed donor‐specific human leukocyte antigen antibodies (DSAs) are considered a contraindication to the transplantation of most solid organs other than the liver. Conflicting data currently exist on the importance of preformed DSAs in rejection and patient survival after liver transplantation (LT). To evaluate preformed DSAs in LT, we retrospectively analyzed prospectively collected samples from all adult recipients of primary LT without another organ from January 1, 2000 to May 31, 2009 with a pre‐LT sample available (95.8% of the patients). Fourteen percent of the patients had preformed class I and/or II DSAs with a mean fluorescence intensity (MFI) ≥ 5000. Preformed class I DSAs with an MFI ≥ 5000 remained persistent in only 5% of patients and were not associated with rejection. Preformed class II DSAs with an MFI of 5000 to 10,000 remained persistent in 23% of patients, and this rate increased to 33% for patients whose MFI was ≥10,000 (P < 0.001). Preformed class II DSAs in multivariable Cox proportional hazards modeling were associated with an increased risk of early rejection [hazard ratio (HR) = 1.58; p = 0.004]. In addition, multivariate modeling showed that in comparison with no DSAs (MFI < 1000), preformed class I and/or II DSAs with an MFI ≥ 5000 were independently correlated with the risk of death (HR = 1.51; p = 0.02). Liver Transpl 19:973–980, 2013. © 2013 AASLD.
Developing an evidence base for intermediate care delivered by GPs with a special interest.

Although the delivery of specialised skills from GPs is not new, the NHS Plan formalised the role of the GP with a special interest (GPwSI) as part of a radical programme to reconfigure the healthcare workforce.1 This development was part of a broader policy agenda to shift the balance of care towards the primary care sector, in order to deliver more patient-centred services and reduce waiting times and avoidable admissions to secondary care. However, against a background of increasing demands on limited resources and the need to maximise the benefits of additional health service investment, the focus has shifted to cost-effectiveness.2 Building on these developments, national frameworks were developed to define skills, competencies and governance but primary care organisations were encouraged to develop innovations in service delivery based on local need.3 However, despite the policy rhetoric, the initiative has developed considerable momentum without any evidence base. The randomised controlled trial by Baker et al 4 in this month's Journal (page 912) showing no differences in clinical outcomes between orthopaedic hospital and practice-based clinics reflects an early and developing evidence base of the effectiveness of GPwSIs. With the shift in emphasis to decision making at a local level, a key question is how the evidence base can be developed to support policy decisions in a way that is relevant to local health economies. The evaluation of public policy is set across a spectrum of approaches. The dominant analytical framework for health policy research reflected in Baker et al 's study is known as a rational approach. In its broadest …
Double-immunolabeling systems for phenotyping of immune cells harboring bovine viral diarrhea virus.

Optimal staining conditions were defined for simultaneous detection of bovine viral diarrhea virus (BVDV) and mononuclear leukocyte surface antigens in tissue sections and cytospins. Because of the extreme lability of the virus antigens and the variable stability of the epitopes on the cell differentiation antigens, cryopreservation had to be used. This method gives slightly sub-optimal preservation of morphology. However, the specificity and sensitivity of the immunolabeling ensured reliable identification of the double-labeled cells, i.e., the phenotypic identification of virus-infected cells within the immune system.
On a conjecture of S. Reich

Simeon Reich (1974) proved that the fixed point theorem for single-valued mappings proved by Boyd and Wong can be generalized to multivalued mappings which map points into compact sets. He then asked (1983) whether his theorem can be extended to multivalued mappings whose range consists of bounded closed sets. In this note, we provide an affirmative answer for a certain subclass of Boyd-Wong contractive mappings.
Optimal control with stabilization for a class of hybrid dynamical systems

This paper studies the optimal control with stabilization issue for a class of hybrid dynamical systems (HDS) with hybrid performance functional (HPF). By employing Lyapunov function method and the recent results of stability of HDS, the optimal control conditions for the HDS has been derived with respect to the HPF. Under the state feedback control, the closed-loop HDS is globally asymptotically stable (GAS) and at the same time the HPF can achieve the desirable maximal (minimal) value. The results are then used to study the case of linear HDS with hybrid quadratic performance functional (HQPF). The matrix inequality conditions are derived to design the linear feedback controller under which the closed-loop linear HDS is GAS and the HQPF is optimized. Finally, one example is given for illustration.
Sketch-based 3D Object Retrieval with Skeleton Line Views - Initial Results and Research Problems

Hand-drawn sketches are a convenient way to define 3D object retrieval queries. Numerous methods have been proposed for sketch-based 3D object retrieval. Such methods employ a non-photo-realistic rendering step to create sketch-like views from 3D objects for comparison with the sketch queries. An implicit assumption here often is that the sketch query resembles a perspective view of the 3D shape. However, based on personal inclination or the type of object, users often tend to draw skeleton views instead of a perspective one. In those cases, a retrieval relying on perspective views is not the best choice, as features extracted from skeleton-based sketches and perspective can be expected to diverge vastly. In this paper, we report on our ongoing work to implement sketch-based 3D object retrieval for skeleton query sketches. Furthermore, we provide an initial benchmark data set consisting of skeleton sketches for a selection of generic object classes. Then, we design a sketch-based retrieval processing pipeline involving a sketch rendering step using Laplacian contraction. Additional experimental results indicate that skeleton sketches can be automatically distinguished from perspective sketches, and that the proposed method works for selected object classes. We also identify object classes for which the rendering of skeleton views is difficult, motivating further research.
Emergency transjugular intrahepatic portasystemic stent shunting as salvage treatment for uncontrolled variceal bleeding

Creation of a transjugular intrahepatic portasystemic stent shunt (TIPSS) was used as a rescue treatment for patients with variceal bleeding refractory to standard medical and endoscopic treatment. Over a 2‐year period 242 episodes of variceal bleeding were treated and emergency shunting was performed on 20 patients with uncontrolled bleeding (Pugh grade A, one; B, seven; C, 12). The procedure was technically successful and controlled bleeding in all patients. Six patients had early rebleeding within 5 days, and further shunting was required in two. Two had late rebleeding related to shunt occlusion and had a further TIPSS procedure followed by portacaval shunting. Twelve patients died within 40 days from liver failure and sepsis, and there were two late deaths after 2 and 6 months, unrelated to bleeding. TIPSS insertion is an effective therapeutic option in patients with acute variceal bleeding refractory to medical and endoscopic treatment. However, despite control of bleeding in this group, the hospital mortality rate was high, reflecting the severity of the underlying liver disease.
Domestic returns from investment in the control of tuberculosis in other countries.

BACKGROUND We hypothesized that investments to improve the control of tuberculosis in selected high-incidence countries would prove to be cost saving for the United States by reducing the incidence of the disease among migrants. METHODS Using decision analysis, we estimated tuberculosis-related morbidity, mortality, and costs among legal immigrants and refugees, undocumented migrants, and temporary visitors from Mexico after their entry into the United States. We assessed the current strategy of radiographic screening of legal immigrants plus current tuberculosis-control programs alone and with the addition of either U.S.-funded expansion of the strategy of directly observed treatment, short course (DOTS), in Mexico or tuberculin skin testing to screen legal immigrants from Mexico. We also examined tuberculosis-related outcomes among migrants from Haiti and the Dominican Republic using the same three strategies. RESULTS As compared with the current strategy, expanding the DOTS program in Mexico at a cost to the United States of 34.9 million dollars would result in 2591 fewer cases of tuberculosis in the United States, with 349 fewer deaths from the disease and net discounted savings of 108 million dollars over a 20-year period. Adding tuberculin skin testing to radiographic screening of legal immigrants from Mexico would result in 401 fewer cases of tuberculosis in the United States but would cost an additional 329 million dollars. Expansion of the DOTS program would remain cost saving even if the initial investment were doubled, if the United States paid for all antituberculosis drugs in Mexico, or if the decline in the incidence of tuberculosis in Mexico was less than projected. A 9.4 million dollars investment to expand the DOTS program in Haiti and the Dominican Republic would result in net U.S. savings of 20 million dollars over a 20-year period. CONCLUSIONS U.S.-funded efforts to expand the DOTS program in Mexico, Haiti, and the Dominican Republic could reduce tuberculosis-related morbidity and mortality among migrants to the United States, producing net cost savings for the United States.
The development of noun definition

ABSTRACT This study investigated the development of noun definition by grade school children and adults (N = 100). Subjects were asked to define 15 common nouns in one of two conditions: with objects present or without objects present. Definitions were classified on the basis of perceptual attributes (CONCRETE), everyday usage (FUNCTIONAL) or a combination of these (COMBINATORIAL). Results were analysed with a 5 (Grade) × 2 (Condition × 3 (Category) Analysis of Variance which indicated no effects for condition, but a Grade × Category interaction. With increasing age, there was a shift from FUNCTIONAL to COMBINATORIAL definitions; CONCRETE definitions were infrequent for all grades. In addition, age changes were found in the forms of the definitions subjects produced. In contrast to the children, adults formulated definitions in a more complex Aristotelian form. It was concluded that noun definition is a metalinguistic ability which follows a course of development similar to that for the acquisition of word meaning.
Clustering of risk factors for coronary heart disease in children and adolescents. The Cardiovascular Risk in Young Finns Study

Clustering of selected coronary heart disease (CHD) risk factors was studied in a cohort of 3457 children and adolescents, aged 3–18 years. Subjects were defined as “high‐risk1 individuals if their values for serum LDL cholesterol, systolic blood pressure and obesity index (sum of biceps, triceps and subscapular skinfolds) exceeded the age‐ and gender‐specific 75th percentile of the present study cohort. Clustering was studied by using the observed/expected ratio (O/E ratio). Statistically significant clustering was observed as 3.1% of all subjects belonged to the high‐risk group (O/E ratio = 2.0, p < 0.001). Under the assumption of no association, only 1.56% would have been expected. Clustering was stronger in boys (3.6%) than in girls (2.6%). When other lipid variables (total cholesterol, HDL cholesterol, triglycerides) or obesity indices (subscapular, biceps, triceps skinfolds, the subscapularjtriceps ratio and BMI) were used in the analyses, the degree of clustering remained essentially the same. The tendency of risk factors to cluster increased with age in boys, whereas in girls the strongest clustering was usually seen in the age group 9–12 years. When a fourth risk factor (low HDL cholesterol) was added to the analyses, the tendency of risk factors to occur simultaneously became even greater. Aggregation of multiple risk factors was strongest in boys who presented the highest levels of these risk factors. Common risk factors for CHD cluster in children and adolescents. The gender differences observed here may partly explain why males develop CHD more often than females in adulthood. Evaluation of other risk factors, in addition to adverse serum lipids, may be used as an aid to identify children at high risk of CHD.
Retinopathy of prematurity, a decrease in frequency and severity. Trends over 16 years in a Danish county.

PURPOSE To analyse the trends over 16 years (1982-97) in a Danish county regarding the clinical appearance of retinopathy of prematurity (ROP). METHODS The data for birth years 1993-97 regarding the regular ophthalmic surveillance for ROP in the region have been analysed. With gestational age (GA) 32 weeks and/or a birthweight (BW) 1750 g as attempted screening limits a total of 177 premature infants were surveyed. Comparison was made with studies of a similar set-up from the preceding four 3-year periods comprising a total of 814 subjects. RESULTS The number of survivors regarded at a higher risk of developing ROP (GA and BW both <32 weeks/1750 g, n=478) showed an even increase over the five investigation periods. The ROP frequency, however, fell from a level of 39% to 10%, there were fewer with severe sequels to ROP, and the children surveyed 'above limits' eventually avoided ROP. CONCLUSIONS Using the ROP profile as a yardstick for the quality of the neonatal service given to the most immature newborns over the period 1982-97, the risk limits regarding GA and BW have gone down. More and more of the heavier preterm babies now escape ROP. A significant decrease in frequency of ROP in the more immature groups has been observed, and fewer cases have progressed to visual impairment.
Squamous metaplasia expression of proto-oncogenes and P 53 in lung cancer patients.

BACKGROUND The question of whether bronchial squamous metaplasia is a true preneoplasia is important and demonstrated in animal for several carcinogens. We have now approached this problem in humans and in vivo. EXPERIMENTAL DESIGN Squamous metaplasia in the close vicinity of surgically resected lung tumors were evaluated for their mitotic index and screened for proto-oncogenes and P 53 protein expression by immunohistochemistry and/or in situ hybridization. RESULTS Among 16 patients, 4 had squamous metaplasia positive for either myc messages and/or for P 53 protein accumulation. In the same patients (3/4), the autologous bronchial tumors were also positive for the same markers. Squamous metaplasia positivity was observed essentially in patients with advanced diseases and only in squamous cell carcinomas. In addition, when evaluated with 5 iodo-2'-deoxyuridine systemic infusion, all patients presented hyperproliferative basal squamous metaplasic cells. CONCLUSIONS These results are reminiscent of the typical preneoplastic changes observed in familial colic adenomatosis, where genetic changes accumulate in hyperproliferative cells. They also suggest that bronchial squamous metaplasia could be an authentic preneoplasia in, at least, squamous cell carcinomas.
Adherence to Technology-Based Exercise Programs in Older Adults: A Systematic Review

Background and Purpose: Exercise participation and adherence in older people is often low. The integration of technology-based exercise programs may have a positive effect on adherence as they can overcome perceived barriers to exercise. Previous systematic reviews have shown preliminary evidence that technology-based exercise programs can improve physical functioning. However, there is currently no in-depth description and discussion of the potential this technology offers to improve exercise adherence in older people. This review examines the literature regarding older adults' acceptability and adherence to technology-based exercise interventions. Methods: A comprehensive systematic database search for randomized controlled trials, clinical controlled trials, and parallel group trials was performed, including MEDLINE, PsycINFO, EMBASE, CINAHL, EMB Reviews, and Cochrane Library, completed in May 2015. Trials reporting adherence to technology-based exercise programs aimed at improving physical function were included. Adherence was defined as the percentage of exercise sessions attended out of the total number of sessions prescribed. Results: Twenty-two studies were included. The mean cohort age range was 67 to 86 years. Studies were conducted in research facilities, aged care facilities, and people's homes. Ten studies compared outcomes between technology-based and traditional exercise programs. Adherence to both types of interventions was high (median 91.25% and 83.58%, respectively). Adherence was higher for technology-based interventions than traditional interventions independent of study site, level of supervision, and delivery mode. The majority of the studies used commercially available gaming technologies, and both types of exercise interventions were mostly supervised. A lack of detailed reporting of adherence and the pilot nature of most studies did not allow computation of a comprehensive adherence rate. Discussion: This systematic review provides evidence that technology offers a well-accepted method to provide older adults with engaging exercise opportunities, and adherence rates remain high in both supervised and unsupervised settings at least throughout the first 12 weeks of intervention. The higher adherence rates to technology-based interventions can be largely explained by the high reported levels of enjoyment when using these programs. However, the small sample sizes, short follow-up periods, inclusion of mostly healthy older people, and problems related to the methods used to report exercise adherence limit the generalizability of our findings. Conclusion: This systematic review indicates that technology-based exercise interventions have good adherence and may provide a sustainable means of promoting physical activity and preventing falls in older people. More research is required to investigate the feasibility, acceptability, and effectiveness of technology-based exercise programs undertaken by older people at home over extended trial periods.