Miracle-dz/UniFAR-FTUs huggingface dataset:
Temporal trends in the prevalence of diabetic kidney disease in the United States.

CONTEXT Diabetes is the leading cause of kidney disease in the developed world. Over time, the prevalence of diabetic kidney disease (DKD) may increase due to the expanding size of the diabetes population or decrease due to the implementation of diabetes therapies. OBJECTIVE To define temporal changes in DKD prevalence in the United States. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional analyses of the Third National Health and Nutrition Examination Survey (NHANES III) from 1988-1994 (N = 15,073), NHANES 1999-2004 (N = 13,045), and NHANES 2005-2008 (N = 9588). Participants with diabetes were defined by levels of hemoglobin A(1c) of 6.5% or greater, use of glucose-lowering medications, or both (n = 1431 in NHANES III; n = 1443 in NHANES 1999-2004; n = 1280 in NHANES 2005-2008). MAIN OUTCOME MEASURES Diabetic kidney disease was defined as diabetes with albuminuria (ratio of urine albumin to creatinine ≥30 mg/g), impaired glomerular filtration rate (<60 mL/min/1.73 m(2) estimated using the Chronic Kidney Disease Epidemiology Collaboration formula), or both. Prevalence of albuminuria was adjusted to estimate persistent albuminuria. RESULTS The prevalence of DKD in the US population was 2.2% (95% confidence interval [CI], 1.8%-2.6%) in NHANES III, 2.8% (95% CI, 2.4%-3.1%) in NHANES 1999-2004, and 3.3% (95% CI, 2.8%-3.7%) in NHANES 2005-2008 (P <.001 for trend). The prevalence of DKD increased in direct proportion to the prevalence of diabetes, without a change in the prevalence of DKD among those with diabetes. Among persons with diabetes, use of glucose-lowering medications increased from 56.2% (95% CI, 52.1%-60.4%) in NHANES III to 74.2% (95% CI, 70.4%-78.0%) in NHANES 2005-2008 (P <.001); use of renin-angiotensin-aldosterone system inhibitors increased from 11.2% (95% CI, 9.0%-13.4%) to 40.6% (95% CI, 37.2%-43.9%), respectively (P <.001); the prevalence of impaired glomerular filtration rate increased from 14.9% (95% CI, 12.1%-17.8%) to 17.7% (95% CI, 15.2%-20.2%), respectively (P = .03); and the prevalence of albuminuria decreased from 27.3% (95% CI, 22.0%-32.7%) to 23.7% (95% CI, 19.3%-28.0%), respectively, but this was not statistically significant (P = .07). CONCLUSIONS Prevalence of DKD in the United States increased from 1988 to 2008 in proportion to the prevalence of diabetes. Among persons with diabetes, prevalence of DKD was stable despite increased use of glucose-lowering medications and renin-angiotensin-aldosterone system inhibitors.
Association between disease-modifying antirheumatic drugs and diabetes risk in patients with rheumatoid arthritis and psoriasis.

CONTEXT Rheumatoid arthritis (RA) and psoriasis have been linked with insulin resistance and diabetes mellitus (DM). Prior investigations suggest that systemic immunosuppressive drugs may improve insulin resistance and reduce the risk of DM. OBJECTIVE To compare the risk of newly recorded DM among participants diagnosed with RA or psoriasis based on use of a variety of disease-modifying antirheumatic drugs (DMARDs). DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study among 121,280 patients with a diagnosis of either RA or psoriasis on at least 2 visits. The analyses were conducted in the context of 2 large health insurance programs, 1 in Canada and 1 in the United States, using administrative data. The mean follow-up was 5.8 months and began with the first prescription for a DMARD after study eligibility was met. Drug regimens were categorized into 4 mutually exclusive groups: (1) tumor necrosis factor (TNF) inhibitors with or without other DMARDs; (2) methotrexate without TNF inhibitors or hydroxychloroquine; (3) hydroxychloroquine without TNF inhibitors or methotrexate; or (4) other nonbiologic DMARDs without TNF inhibitors, methotrexate, or hydroxychloroquine (reference exposure). MAIN OUTCOME MEASURE Newly recorded DM as evidenced by a new diagnosis of DM with use of a DM-specific medication. RESULTS The study cohort consisted of 13,905 participants with 22,493 treatment episodes starting 1 of the categories of DMARD regimens between January 1996 and June 2008. New diabetes cases and respective incidence rates per 1000 person-years were: other nonbiologic DMARDs (55 cases among 3993 treatment episodes; rate, 50.2; 95% confidence interval [CI], 47.3-53.2); TNF inhibitors (80 cases among 4623 treatment episodes; rate, 19.7; 95% CI, 19.1-20.3); methotrexate (82 cases among 8195 treatment episodes; rate, 23.8; 95% CI, 23.0-24.6); and hydroxychloroquine (50 cases among 5682 treatment episodes; rate, 22.2; 95% CI, 21.3-23.1). The multivariate adjusted hazard ratios for DM were 0.62 (95% CI, 0.42-0.91) for TNF inhibitors, 0.77 (95% CI, 0.53-1.13) for methotrexate, and 0.54 (95% CI, 0.36-0.80) for hydroxychloroquine compared with other nonbiologic DMARDS. CONCLUSION Among patients with RA or psoriasis, the adjusted risk of DM was lower for individuals starting a TNF inhibitor or hydroxychloroquine compared with initiation of other nonbiologic DMARDs.
The Episodic Nature of Experience: A Dynamical Systems Analysis

Context is an important construct in many domains of cognition, including learning, memory, and emotion. We used dynamical systems methods to demonstrate the episodic nature of experience by showing a natural separation between the scales over which within-context and between-context relationships operate. To do this, we represented an individual's emails extending over about 5 years in a high-dimensional semantic space and computed the dimensionalities of the subspaces occupied by these emails. Personal discourse has a two-scaled geometry with smaller within-context dimensionalities than between-context dimensionalities. Prior studies have shown that reading experience (Doxas, Dennis, & Oliver, 2010) and visual experience (Sreekumar, Dennis, Doxas, Zhuang, & Belkin, 2014) have a similar two-scaled structure. Furthermore, the recurrence plot of the emails revealed that experience is predictable and hierarchical, supporting the constructs of some influential theories of memory. The results demonstrate that experience is not scale-free and provide an important target for accounts of how experience shapes cognition.
Book Review: Diagnosis and Treatment of Congenital Hip Pathology in the Newborn

axis; as such, they form a most useful standard set for the guidance of the radiotherapist who needs to establish not merely the depth of a lesion, but also its diameters and directions within the thorax. In addition to the superb illustrations, there are useful chapters devoted to the physics and geometry of axial tomography, with numerous practical tips on the installation, alignment and calibration of this equipment. Whilst this book has a rather restricted appeal to the diagnostic radiologist, whose current interests in axial tomography centre around the ventricular system of the brain, the pancreas and pelvic tumours, he cannot fail to benefit from the gUidance offered in the short but lucid opening chapters of this work.
Studies suggest potential approaches for early detection of Alzheimer disease.

and use of ad hoc stenting while a patient is undergoing a diagnostic coronary angiography. Fuster said these biases should disappear because of FREEDOM. “Frankly, before our results, any of us would have said we should go with stenting; to change this, we needed to give the patient the numbers regarding risks and benefits,” Fuster said. “Now, when a physician sees a diabetic patient about to undergo diagnostic angiography, he or she has to be prepared to say, ‘I’ll stop here, and let’s talk. ’” To continue the move to appropriate revascularization strategies, better information sharing and shared decision making between clinicians and patients are essential, Edwards said. He strongly endorses the emerging concept of the heart team, in which a surgeon, an interventional cardiologist, and any other caregivers meet with the patient to discuss the benefits and risks of all treatment strategies well before the patient is on the table undergoing diagnostic angiography. “It’s ultimately the patient’s decision, but the point of these studies is to illustrate a well-accepted fact that not all procedures are equal in benefit and risk. ”
Mental health effects of Hurricane Sandy: characteristics, potential aftermath, and response.

On October 22, 2012, a late-season tropical system was named Sandy by the US National Hurricane Center. The system meandered for several days in warm Caribbean waters, intensifying slowly, gaining forward momentum, and passing directly over Jamaica, eastern Cuba, and the Bahamas. Sandy’s outer rain bands deluged Haiti’s deforested terrain, triggering severe floods and mudslides. Although Sandy was a minimal hurricane, millions were affected across 5 Caribbean nations and Puerto Rico, 100 persons were killed or reported missing, and thousands of homes were damaged. Estimated economic losses ranged from $5 million in Jamaica to $2 billion in Cuba.1 What catapulted this system into a “superstorm” was a rare climate event. At mid-latitudes, Sandy interacted with a polar jet stream that steered the system toward the mid-Atlantic coastline, transforming the system into a hybrid blend of posttropical cyclone and winter storm. The system’s cloud canopy expanded to 1000 miles in diameter as circulating winds funneled ocean waves into the New Jersey shoreline, Long Island Sound, and New York Harbor, inundating portions of Staten Island and southern Manhattan. In the United States, an estimated 60 million people across 24 states experienced a range of storm effects at varying intensities, including wind, rain, flood, coastal surge, and blizzard. The effects of the storm on vulnerable and fragile infrastructure produced power outages for more than 8 million residents; flooded New York City’s subway system and East River tunnels; set off a major fire that destroyed 111 housing units in the Breezy Point section of Queens; disrupted communications; and created acute shortages of gasoline, food, and commodities. Sandy was blamed for 113 US deaths and damaged 200 000 homes. Costs have been estimated at $50 billion, second only to Hurricane Katrina as the nation’s costliest natural disaster.2,3 Over the past 2 decades, considerable research efforts have been focused on populations affected by natural disasters. A rapidly growing body of knowledge is now available to assist in estimating the potential mental health effects of Superstorm Sandy and the differential risks for specific populations and communities. The availability of data from randomized controlled trials on the efficacy of interventions for trauma-exposed populations may enable better planning and implementation of prevention strategies to mitigate the adverse mental health effects of the disaster.
Relevance and Reason Relations.

This paper examines precursors and consequents of perceived relevance of a proposition A for a proposition C. In Experiment 1, we test Spohn's (2012) assumption that ∆P = P(C|A) - P(C|~A) is a good predictor of ratings of perceived relevance and reason relations, and we examine whether it is a better predictor than the difference measure (P(C|A) - P(C)). In Experiment 2, we examine the effects of relevance on probabilistic coherence in Cruz, Baratgin, Oaksford, and Over's (2015) uncertain "and-to-if" inferences. The results suggest that ∆P predicts perceived relevance and reason relations better than the difference measure and that participants are either less probabilistically coherent in "and-to-if" inferences than initially assumed or that they do not follow P(if A, then C) = P(C|A) ("the Equation"). Results are discussed in light of recent results suggesting that the Equation may not hold under conditions of irrelevance or negative relevance.
The Specificity of Sound Symbolic Correspondences in Spoken Language

Although language has long been regarded as a primarily arbitrary system, sound symbolism, or non-arbitrary correspondences between the sound of a word and its meaning, also exists in natural language. Previous research suggests that listeners are sensitive to sound symbolism. However, little is known about the specificity of these mappings. This study investigated whether sound symbolic properties correspond to specific meanings, or whether these properties generalize across semantic dimensions. In three experiments, native English-speaking adults heard sound symbolic foreign words for dimensional adjective pairs (big/small, round/pointy, fast/slow, moving/still) and for each foreign word, selected a translation among English antonyms that either matched or mismatched with the correct meaning dimension. Listeners agreed more reliably on the English translation for matched relative to mismatched dimensions, though reliable cross-dimensional mappings did occur. These findings suggest that although sound symbolic properties generalize to meanings that may share overlapping semantic features, sound symbolic mappings offer semantic specificity.
Hypertrophic cardiomyopathy: single gene disease or complex trait?

This editorial refers to ‘Hypertrophic remodelling in cardiac regulatory myosin light chain ( MYL2 ) founder mutation carriers’[†][1], by G.R. F. Claes et al . , on page 1815. Landmark genetic mapping studies beginning in the 1990s defined hypertrophic cardiomyopathy (HCM) as an autosomal dominant inherited disease caused by specific mutations in cardiac sarcomere genes.1 Certain mutations in large families were initially described as being more deleterious than others, giving hope that genetic testing would enable predictions of disease severity. However, a more complicated story emerged as extreme locus and phenotypic heterogeneity became evident as the rule rather than the exception in less select populations.2 Indeed, HCM is now recognized as a disease which is primarily caused by a single mutation but then modulated greatly by other factors. In fact, the variability in phenotype attributable to disease modifiers has confounded studies of genotype–phenotype correlations for the primary mutations themselves. Founder mutations offer a distinct advantage in studying disease variability in HCM. Not only is the mutation identical in all subjects, but so also is the surrounding genetic region (haplotype block), which includes the regulatory sequences immediately adjacent to and within the gene. Therefore, differences in disease expression must arise from either other genetic variation or environmental factors. Several previous studies of founder mutations in HCM have shown extreme disease variability, with a range of clinical expression similar to that found in studies of HCM with mixed genotypes. The study by Claes and colleagues adds to this growing evidence in the case of a founder mutation in MYL2 . 3 Together, these studies provide robust evidence for the importance of additional genetic and/or environmental factors in … [1]: #fn-2
Choosing wisely: low-value services, utilization, and patient cost sharing.

The June 2012 issue of Consumer Reports includes a cover story entitled “5 medical tests you don't need. ” The story reflects a joint “Choosing Wisely1 initiative by Consumer Reports and the American Board of Internal Medicine working with specialty societies aimed at “encouraging physicians, patients and other health care stakeholders to think and talk about medical tests and procedures that may be unnecessary, and [that] in some instances can cause harm. ”2 Reducing such services would improve patient safety and quality while simultaneously preserving resources that could be used in better ways to improve health.
What's needed is a health care system that learns: recommendations from an IOM report.

THE US HEALTH CARE SYSTEM IS CHARACTERIZED BY INformation overload. There is more to do, more to know, and more to manage than at any time in history. Yet in one of many paradoxes, available knowledge is too rarely applied to improve care, while information generated by the care experience is too rarely synthesized to improve available knowledge. Health care lags other industries like banking, retail, and transportation in its ability to meet the needs of patients, to offer choice, to adapt, and to become safer and more affordable. What’s needed is a care system that consistently delivers reliable performance and constantly improves, systematically and seamlessly, with each care experience—in short, a system with an ability to learn. The good news is that opportunities exist to build one. The Institute of Medicine (IOM) recently issued a report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America, which addresses a number of these issues. We served as members of the IOM committee that produced the report.
Fracture risk after cataract surgery.

To the Editor: Dr Tseng and colleagues conducted a retrospective study of the association of fracture risk after cataract surgery in a random 5% sample of Medicare beneficiaries. The authors noted that patients with decreased visual acuity have a higher incidence of fractures. Therefore, it is reasonable to propose that fracture risk would decrease after cataract surgery. When corrected for demographic data and comorbidities based on the Charlson Comorbidity Index (CCI) score, this relationship was confirmed for patients with a propensity score decile subgroup of 4 or higher (Table 5 in article) for patients aged 70 years or older, and for those with a CCI score of 3 or higher (Table 6). However, this benefit did not extend to younger and healthier patients who underwent cataract surgery. With a significance level of P . 05, the odds ratio (OR) for any fracture was actually higher for propensity score deciles 1 to 3 (ORs: 1.28 and 1.08; P .02; Table 5) and for patients with a CCI score of 2 or lower (OR, 1.03; P=.04; Table 6). For the youngest patients in the study (aged 65-69 years), cataract surgery was linked to a higher OR of hip fracture and any fracture (ORs: 1.16 and 1.09; P .02; Table 6). These subgroups comprised a significant percentage of pseudophakic Medicare beneficiaries; 19.5% were aged 65 to 69 years and 62.8% had a CCI of 2 or lower (Table 1). Why would cataract surgery result in a higher OR of hip fracture and any fracture in younger and healthier patients? Should these patients with visual impairment secondary to cataracts be counseled against cataract surgery? Ophthalmologists, other physicians, and patients with cataracts who are considering surgery would benefit from discussion of this paradoxical observation. The sequence of the diagnoses is important given the premise of the study: fracture risk after cataract surgery. The authors acknowledged their inability to distinguish whether the fracture or cataract diagnosis was noted first if both diagnoses occurred in the same calendar year. Severe cataracts, which the authors designated as “posterior subcapsular cataracts, total or mature cataract, hypermature cataract, and combined forms of cataract,” can progress rapidly, especially if the patient has diabetes mellitus or Cushing syndrome or is taking systemic corticosteroids. In these cases, the fracture diagnosis may have preceded the cataract diagnosis in the same year, which may confound the robust, reported link between extraction of severe cataracts and subsequent fracture risk.
Correlation between malondialdehyde (MDA) and uric acid levels in preeclampsia

Background: Hypertensive disorders of human pregnancy, such as preeclampsia, complicates a sizeable percentage of all pregnancies, need its early indication and warning. The aim of present study was to determine the association between lipid peroxidation product, serum malondialdehyde (MDA) and serum uric acid levels in preeclampsia and find out any association between these two parameters in preeclampsia. Methods: Thirty preeclampsia and thirty gestational age matched normotensive pregnant women attending Narayana General Hospital, Nellore were included in the study. Serum MDA levels were measured by Thiobarbituric acid reactive substances(TBARS) method and serum uric acid levels were estimated by automated chemistry analyser using commercial kits. Results: Serum MDA (Mean±SEM 24.4±2.38 vs 7.9± 0.28 nmol/ml, p value < 0.000) and serum uric acid levels (7.2 ± 0.25 vs 3.9 ± 0.14 mg/dl, p value <0.000) were significantly elevated in preeclampsia cases when compared with that of normotensive pregnant women. A weak positive correlation between serum uric acid and serum MDA (r value 0.065, p value 0.734) was noticed in preeclampsia. Conclusion: Serum MDA and uric acid may be included as additional markers for screening and progression of preeclampsia, thereby helpful in effectively treating the condition at an early stage.
Absence of parasympathetic reactivation after maximal exercise

The ability of the human organism to recover its autonomic balance soon after physical exercise cessation has an important impact on the individual's health status. Although the dynamics of heart rate recovery after maximal exercise has been studied, little is known about heart rate variability after this type of exercise. The aim of this study is to analyse the dynamics of heart rate and heart rate variability recovery after maximal exercise in healthy young men. Fifteen healthy male subjects (21·7 ± 3·4 years; 24·0 ± 2·1 kg m−2) participated in the study. The experimental protocol consisted of an incremental maximal exercise test on a cycle ergometer, until maximal voluntary exhaustion. After the test, recovery R‐R intervals were recorded for 5 min. From the absolute differences between peak heart rate values and the heart rate values at 1 and 5 min of the recovery, the heart rate recovery was calculated. Postexercise heart rate variability was analysed from calculations of the SDNN and RMSSD indexes, in 30‐s windows (SDNN30s and RMSSD30s) throughout recovery. One and 5 min after maximal exercise cessation, the heart rate recovered 34·7 (±6·6) and 75·5 (±6·1) bpm, respectively. With regard to HRV recovery, while the SDNN30s index had a slight increase, RMSSD30s index remained totally suppressed throughout the recovery, suggesting an absence of vagal modulation reactivation and, possibly, a discrete sympathetic withdrawal. Therefore, it is possible that the main mechanism associated with the fall of HR after maximal exercise is sympathetic withdrawal or a vagal tone restoration without vagal modulation recovery.
Gait performance in relation to aortic pulse wave velocity, carotid artery elasticity and peripheral perfusion in healthy older adults

Arterial stiffening is a widely known physiological change that occurs with ageing, but the functional consequences of vascular ageing are unclear. The purpose of this study was to determine whether carotid–femoral pulse wave velocity (PWV), mechanical properties of the carotid and femoral arteries and/or peripheral perfusion was associated with gait performance measured using a 400‐m walk test. Twenty‐one healthy older (68 ± 5 years) adults without cardiovascular disease participated in this study. Applanation tonometry was used to measure PWV, and Doppler ultrasound was used to measure arterial wall properties of the left common carotid and common femoral artery along with femoral blood flow. The median walk distance in the first 2 min of the test was 585 ft, and the overall gait speed was 1·5 m s−1. Gait performance was inversely correlated with PWV (distance: r = ‐0·51; speed: r = −0·48; P<0·05) and carotid artery stiffness index β (distance: r = −0·56; speed: r = −0·51; P<0·05) after adjustment for age, body mass index, waist circumference and systolic blood pressure. No significant correlations were found between gait performance and femoral artery stiffness index β or femoral artery blood flow. These results found higher central arterial stiffness, as assessed by segmental arterial stiffness or local arterial wall properties, is associated with lower gait performance in older adults independent of other confounders.