anthonyyazdaniml/gliner-biomed-curated-corpus huggingface dataset:
The investigators will conduct a SW-CRT involving 20 participating ED clusters across Canada. The total study duration is 18 months. All clusters start the trial in a control period (usual care) for three months with no intervention being delivered at any site, then sequentially cross over from the control period to the intervention period in random sequence, with 5 clusters (EDs) crossing over after third months, until all sites have adopted the intervention (CSRS based practice recommendation).

The following principal research questions will be addressed 1) What is the effect of the knowledge translation and implementation of the CSRS-based practice recommendations on health resource utilization? The health resource utilization measures include the proportion hospitalized, the proportion investigated in the ED, and ED disposition time 2) How and why did the implementation achieve the observed effect? The embedded process evaluation measures align with the RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) framework and include: a) adoption - the proportion of physicians who attended the educational sessions and the proportion who adopted the CSRS in practice; b) reach- the proportion of eligible patients for whom the CSRS was utilized during their ED visit; c) intervention fidelity - the proportion of patients for whom the resulting CSRS recommendations were followed d) maintenance- whether observed adoption rates remain stable or increase over time. 3) What is the effect of the knowledge translation strategy on patient safety, as measured by 30-day serious outcome identification, 30-day and 1-year return ED visits, hospitalizations, and mortality? and 4) validate the ultra-low-risk criteria in a new cohort of patients and assess if the CSRS can be improved in its ability to predict 30-day serious outcomes.
Cirrhosis is considered a growing cause of morbidity and mortality, which represents a significant public health problem. Currently, there is no effective treatment to reverse cirrhosis. Treatment primarily centers on addressing the underlying liver condition, monitoring, and managing portal hypertension-related complications, and evaluating the potential for liver transplantation in cases of decompensated cirrhosis, marked by rapid progression and the emergence of complications like variceal bleeding, hepatic encephalopathy, ascites, malnutrition, and more. Malnutrition, a prevalent complication across all disease stages, is often underdiagnosed in cirrhosis due to the complexities of nutritional assessment in patients with fluid retention and/or obesity, despite its crucial impact on prognosis. Increasing emphasis has been placed on the collaboration of nutritionists within hepatology and Liver transplant teams to deliver comprehensive care, a practice that has shown to improve outcomes. This review covers appropriate screening and assessment methods for evaluating the nutritional status of this population, diagnostic approaches for malnutrition, and context-specific nutrition treatments. It also discusses evidence-based recommendations for supplementation and physical exercise, both essential elements of the standard care provided to cirrhotic patients.
Studies of valganciclovir for oral solution or tablets have not been conducted in adults older than 65 years of age. Clinical studies of valganciclovir did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Valganciclovir is known to be substantially excreted by the kidneys, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because renal clearance decreases with age, valganciclovir should be administered with consideration of their renal status. Renal function should be monitored and dosage adjustments should be made accordingly [see Dosage and Administration ( 2.5), Warnings and Precautions ( 5.2), Use in Specific Populations ( 8.6), Clinical Pharmacology ( 12.3)] .
All children will receive a single dose of 1 mcg/kg of Fentanyl intravenously prior to incision. Group TAP 2 will receive a TAP block with a total dose of 1 mL/kg given at a concentration of 0.125% bupivacaine with 1:200,000 epinephrine.
The investigator's strategy is to: (a) repurpose approved drugs with potential for salutary effect upon RBC performance attributes that contribute to O2 delivery homeostasis during stress and (b) efficiently identify lead candidates through sequential evaluation in relevant and rigorous benchtop and in vivo models that include examination for gender-specific effects. Our assay platforms are selected to characterize RBC physiology relevant to O2 delivery, with focus upon RBC O2 affinity, energetics, biomechanics, vascular interaction and control of regional blood flow. The investigator will sample RBC suspensions serially (0, 1,3h) and quantify the RBC performance attributes across the range of modeled environmental extremes, defining RBC performance constraint as \> 20% impairment in each attribute and determine pharmacologic rescue (defined as \> 20% improvement in each attribute) using mixed model RM-ANOVA, as a function of gender. The investigator will power analysis to 80% at a\<5%; based on our published data with these assays and experience, this requires 10-15 subjects/group. Drug candidates with evidence of PhIT-HyHo potential will advance to in vivo screening, prioritized by the number of RBC attributes rescued per drug. Specific description of our approach to evaluate each RBC performance attribute follows.

RBC performance attributes will be quantified under controlled conditions (Temperature: 28 - 37°C; pO2: 50 - 100 Torr, alone and in combination in our temperature-controlled thin film tonometer38 (NB temperature simulates hypothermic body temperature): (a) glycolytic flux, (b) resilience to oxidative stress, (c) deformability \& aggregation, (d) O2 affinity and Bohr effect, (e) vasoactivity.
Lofexidine tablets can cause a decrease in blood pressure, a decrease in pulse, and syncope [see Adverse Reactions (6.1), Clinical Pharmacology (12.2)]. Monitor vital signs before dosing. Monitor symptoms related to bradycardia and orthostasis.

Patients being given Lofexidine tablets in an outpatient setting should be capable of and instructed on self-monitoring for hypotension, orthostasis, bradycardia, and associated symptoms. If clinically significant or symptomatic hypotension and/or bradycardia occur, the next dose of Lofexidine tablets should be reduced in amount, delayed, or skipped.

Inform patients that Lofexidine tablets may cause hypotension and that patients moving from a supine to an upright position may be at increased risk for hypotension and orthostatic effects. Instruct patients to stay hydrated, on how to recognize symptoms of low blood pressure, and on how to reduce the risk of serious consequences should hypotension occur (e.g., sit or lie down, carefully rise from a sitting or lying position). Instruct outpatients to withhold Lofexidine tablets doses when experiencing symptoms of hypotension or bradycardia and to contact their healthcare provider for guidance on how to adjust dosing.

Avoid using Lofexidine tablets in patients with severe coronary insufficiency, recent myocardial infarction, cerebrovascular disease, chronic renal failure, and in patients with marked bradycardia.

Avoid using Lofexidine tablets in combination with medications that decrease pulse or blood pressure to avoid the risk of excessive bradycardia and hypotension.
Patients will be started on 1 mg of guanfacine extended release matching placebo tablets at week 1. A physician blind to drug status will titrate the study medication in week 2-3 to a maximum of 4 mg (4 tablets).
INTRODUCTION: Among older adults undergoing surgery, postoperative delirium is the most common complication. Cognitive impairment and dementia are major risk factors for postoperative delirium, yet they are frequently under-recognized. It is well established that applying delirium preventive interventions to at-risk individuals can reduce the likelihood of delirium by up to 40%. The aim of this study was to evaluate how often delirium preventive interventions are missing in patients at risk for delirium due to baseline cognitive impairment.
METHODS: We conducted a retrospective study using data from the observational study Perioperative Anesthesia Neurocognitive Disorder Assessment-Geriatric (PANDA-G) and clinical data from the University of California San Francisco delirium prevention bundle. Patients age 65+ received preoperative multidomain cognitive assessment as part of a research protocol prior to undergoing inpatient spine surgery at a single major academic institution. Results of the cognitive testing were not available to clinical teams. Using electronic medical records, we evaluated if patients who were cognitively impaired at baseline received delirium prevention orders, sleep orders, and avoidance of AGS Beers Criteria® potentially inappropriate medications.
RESULTS: Of the 245 patients included in the study, 42% were women. The mean [SD] age was 72 [5.2] years. Preoperative cognitive impairment was identified in 40% of participants (N = 98), and of these, 34% had postoperative delirium. Of patients with preoperative cognitive impairment, 45% did not receive delirium preventive orders, 43% received PIMs, and 49% were missing sleep orders. At least one of the three delirium preventive interventions was missing in 70% of the patients.
DISCUSSION: Undiagnosed preoperative cognitive impairment among older adults undergoing spine surgery is common. When cognitive test results were not available to clinicians, patients with baseline cognitive impairment frequently did not receive evidence-based delirium preventive interventions. These findings highlight an opportunity to improve perioperative brain health care via preoperative cognitive assessment and clinical communication.
For this single group study, all patients presenting at the laboratory facility for a 24-hour creatinine clearance and patients in the dialysis population of the Isala Clinics who came for their periodical KT/V control, were informed about the study and asked to participate. Moreover, 20 'healthy' volunteers (including the investigators of this study and staff working at the clinical chemistry department of the Isala clinics) participated in this study.
PURPOSE:To prepare a liquid mixture containing stably solubilized mixture of a sulfonamide useful as a chemotherapeutic agent for avian coccidiosis, etc. and a sulfonamide synergist, by using liquid polyethylene glycol, etc. as a solvent and alkalinizing the liquid. CONSTITUTION:An alkaline liquid mixture (having a pH of about 9-11) containing (A) a sulfonamide such as sulfamonomethoxine, sulfanylamide, etc., (B) a sulfonamide synergist such as trimethoprim, ormetoprim, pyrimethamine, etc., and (C) a liquid polyethylene glycol, and if necessary, (D) one or more low- molecular polyhydric alcohols such as propylene glycol, glycerol, etc. The mixture is useful as a chemotherapeutic agent for the infectious diseases of chicken caused by the infection with protozoan, e.g. avian coccidiosis, etc., and obtained by solubilizing the mixture of A and B stably in C or C and D as the solvent.
OBJECTIVE: Sarcopenia manifests as a chronic, low-level inflammation along with multiple inflammatory cells infiltration. Interleukin (IL)-25 can regulate the function of macrophages. However, the specific role and mechanisms through which IL-25 functions in sarcopenia are still not fully understood and require further investigation.
METHODS: Aged mice were utilized as sarcopenia models and examined the expression of inflammatory factors. To investigate the effects of IL-25 on sarcopenia, the model mice received IL-25 treatment and underwent in vivo adoptive transfer of IL-25-induced macrophages. Meanwhile, RAW264.7 cells, bone marrow-derived macrophages, satellite cells and C2C12 cells were used in vitro. Shh insufficiency was induced through intramuscular administration of SHH-shRNA adenoviruses. Then, various assays including scratch wound, cell counting kit-8 and Transwell assays, as well as histological staining and molecular biological methods, were conducted.
RESULTS: Aged mice exhibited an accelerated decline in muscle strength and mass, along with an increased muscle lipid droplets and macrophage infiltration, and decreased IL-25 levels compared to the young group. IL-25 therapy and the transfer of IL-25-preconditioned macrophages could improve these conditions by promoting M2 macrophage polarization in vivo as well as in vitro. M2 macrophage conditioned medium enhanced satellite cell proliferation and migration, as well as the vitality, migration, and differentiation of C2C12 cells in vitro. Furthermore, IL-25 enhanced Shh expression in macrophages in vitro, and activated the Shh signaling pathway in muscle tissue of aged mice, which could be suppressed by either the inhibitor cyclopamine or Shh knockdown. Mechanistic studies showed that Shh insufficiency suppressed the activation of Akt/mTOR signaling pathway in muscle tissue of aged mice.
CONCLUSION: IL-25 promotes the secretion of Shh by M2 macrophages and activates the Shh/Akt/mTOR signaling pathway, which improves symptoms and function in sarcopenia mice. This suggests that IL-25 has potential as a therapeutic agent for treating sarcopenia.
Bardet-Biedl syndrome (BBS) is a rare, monogenic, multisystem disorder characterized by retinal dystrophy, renal abnormalities, polydactyly, learning disabilities, as well as metabolic dysfunction, including obesity and an increased risk of type 2 diabetes. It is a primary ciliopathy, and causative mutations in more than 25 different genes have been described. Multiple cellular mechanisms contribute to the development of the metabolic phenotype associated with BBS, including hyperphagia as a consequence of altered hypothalamic appetite signalling as well as alterations in adipocyte biology promoting adipocyte proliferation and adipogenesis. Within this review, we describe in detail the metabolic phenotype associated with BBS and discuss the mechanisms that drive its evolution. In addition, we review current approaches to the metabolic management of patients with BBS, including the use of weight loss medications and bariatric surgery. Finally, we evaluate the potential of targeting hypothalamic appetite signalling to limit hyperphagia and induce clinically significant weight loss.
In the real world, we often fail to notice changes in our environment. In some cases, such as not noticing a car moving into our lane, the results can be catastrophic. This so-called change blindness has been seen experimentally both through failing to notice changes to images on-screen as well as failing to notice a change in other people's identity. However, less is known regarding how change blindness manifests in virtual settings varying in visual clutter or with varying types of interaction with someone prior to the change. Across two studies (n = 134), participants engaged in an online video chat with a confederate, with two levels of visual clutter (none, a lot) and three levels of interaction (none, light conversations about weather/TV, deeper conversations about goals/greatest regrets). We found no modulation of change blindness rates across perceptual clutter. Curiously, we found a large discrepancy in change blindness rates in Experiment 1 (79%; 52/66) versus Experiment 2 (16%; 11/68) that we explored, leading to some evidence that increasing the level of interaction led to greater change blindness rates, but only for pairs who identified as belonging to different ethnicities. Taken together, our work suggests that we may pay attention to people differently in virtual settings compared to in-person, that in-group and out-group biases may have an effect on change blindness rates, and that while clutter does not seem to affect change blindness rates, one's level of interaction just might. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
The invention provides a preparation method for efficiently extracting separating high-purity flavone components from ginkgo leaf. The main components are kaempferol-3-O-2'', 6''-dirhamnosylglucoside, rutin, quercetin glucosyl rhamnoside, kaempferol-3-O-rutinoside, isorhamnetin-3-O-rutinoside, quercetin p-coumaroyl glucose rhamnoside and kaempferol p-oumaroyl glucose rhamnoside. The preparation method comprises the following steps: pulverizing the medicinal material ginkgo leaf, adding an alcohol water solution to carry out extraction, concentrating, carrying out nonpolar macroporous adsorbent resin column chromatography on the filtrate, carrying out two-dimensional separation with a novel silica gel substrate bonded material, eluting with a methanol solution, collecting the eluate, concentrating, and drying to obtain the gingko flavone components. The invention enhances the target component content, and obtains the flavone components with definite content. The extraction and separation process has the advantages of high repetitiveness and favorable operability, and is suitable for large-scale preparation of flavone components by separation from ginkgo leaf. The flavone components can be used as a raw material for Shuxuening injections.
FIELD: medicine, urology. SUBSTANCE: in pre- and postoperative periods one should perform medicinal therapy due to intake of pentoxifyllin per 400 mg, escusan per 40 drops, alpha- tocopherol acetate per 100 mg, thymusamin per 20 mg, vasalamin per 20 mg, renisamin per 20 mg thrice daily. In the course of distance lithotripsy one should intravenously inject 800-1200 ml 0.9%-sodium chloride isotonic solution and 5 ml (100 ml) pentoxifyllin. The method enables to shorten terms of pre- and postoperational periods and increase efficiency of distance lithotripsy. EFFECT: higher efficiency of therapy. 2 ex
Recent evidence indicates that liver cirrhosis (LC) is a reversible condition, but there is no established intervention against liver fibrosis. Although the gut microbiota is considered involved in the pathogenesis of LC, the underlying mechanisms remain unclear. Although the antibiotic, rifaximin (RFX), is effective for hepatic encephalopathy (HE) with LC, the impact of RFX on intestinal bacteria is unknown. We investigated the bacterial compositions along the GI tract under RFX treatment using a murine LC model. RFX improved liver fibrosis and hyperammonemia and altered the bacterial composition in the small intestine. The efficacy of RFX was associated with increases in specific bacterial genera, including Akkermansia. Administration of a commensal strain of Akkermansia muciniphila improved liver fibrosis and hyperammonemia with changing bacterial composition in the small intestine. This study proposed a new concept "small intestine-liver axis" in the pathophysiology of LC and oral A. muciniphila administration is a promising microbial intervention.
We studied the effects of visceral obesity induced by a high-calorie diet and health-improving variants of its correction on morphological characteristics of the muscle tissue in male Wistar rats. At stage I, the rats received standard (StD) or high-calorie diet (HCD) for 8 weeks. At stage II, the animals were divided into the following subgroups: no correction (StD and HCD), switching from HCD to StD (HCD/StD) and/or connection of physical activity in the form of treadmill running (StD+running, HCD+running, and HCD/StD+running) for the next 8 weeks. Diet-induced visceral obesity was shown to result in a decrease in the weight of the triceps surae muscle, fatty infiltration, intracellular edema, partial lysis of contractile elements, weak inflammatory response, and decreased muscle fiber area on cross section. Treadmill running (HCD+running) exacerbates the morphological changes, but returns muscle fiber area to normal. Correction of visceral obesity and relative normalization of muscle tissue structure was noted when switching to a standard diet (HCD/StD and HCD/StD+running).
All consecutive patients with moderate/ severely calcified coronary lesions who underwent PCI facilitated by the Orbital Atherectomy The decision to perform orbital atherectomy was left to the operator's dissertation after the detection of a moderate/severely calcified lesion. Angiographic calcification was classified as moderate when it involved between 30% and 50% of the reference lesion diameter, and severe when it occupied over 50% of the reference diameter. When the initial assessment was based on IVUS finding lesion had to reach at least 2 points in the IVUS calcium score. There were no angiographic exclusion criteria regarding lesion anatomy such as the length, tortuosity, severity, or location. All procedural features(use additional lesion preparation technique; stent implantation parameters, periprocedural pharmacological therapy, use of intravascular imaging along with the left ventricular support device) were left to the discretion of the operator.
Polyenes of formula (I) (in which one of R1 and R2 = halogen or lower alkyl the other = halogen or lower alkoxy; R3 and R5 = H, lower alkyl or halogen; R4 = lower alkoxy, amino mono-or di(lower) alkyl-amino or halogen; R6 = formul, hydroxymethyl, alkoxymethyl, alkanoyloxymethyl, carboxyl, alkoxycarbonyl, alkenoxycarbonyl, alkinoxycarbonyl, carbamoyl, mono- or di-(lower)alkylcarbamoyl or N-heterocyclylcarbonyl), may be used for topical and systemic therapy and prophylaxis of benign and malignant neoplasias and pre-malignant lesions. They may also be used for topical and systemic therapy of acne. psoriasis and other dermatosis connected with increased or pathologically-altered cornification and of inflamed and allergic dermatological affections. (I) may also be used against disorders of mucus membranes with inflamed, degenerative or metaplastic alterations. The toxicity of (I) is ver low and tumor-inhibitory activity is significant. Dimethylanthracene- and croton oil-induced tumors regress in the papilloma test. Cpds. (I) are prepd. by reacting cpds. (II) and (III) in which one of A and B = oxo, the other either -P Y 3+Z- or Y = aryl; Z = the anion of an inorganic or org. acid; X = alkoxy; R7 (when B = oxo) = alkoxymethyl, dialkoxymethyl, alkanoyloxymethyl, alkoxycarbonyl, alkenoxycarbonyl or alkinoxycarbonyl. (II) and (III) are coupled using Witting reaction in the presence of acid-binding agent or an opt. alkyl-substd. alkeneoxide and opt. in solvent. Alternatively a Hormer reaction may be used with base and inert solvent. Carboxylic acids obtd. may be esterified or amidated, esters may be hydrolysed or either may be reduced to alcohols which may be etherified or esterified, then either saponified or oxidised.
FIELD: medicinal biotechnology. SUBSTANCE: invention describes method of direction of cellular response in mammals by expression of two chimeric receptors in mammalian cell that trigger specific recognition and destruction of infectious agent, cell infected with infectious agent, tumor or cancer cell or autoimmunoregenerated cell. One of expressed chimeric receptor includes extracellular protein that is able for specific recognition and binding target-cell or agent infecting target and intracellular or transmembrane moiety that is able to transfer signal to therapeutic cell for destruction of target-cell bound with receptor or bound with receptor of agent infecting target. The second chimeric receptor includes extracellular moiety that is able for specific recognition and binding target-cell or agent infecting cell and intracellular moiety that is derivative of CD28. Invention describes also pairs of useful chimeric receptors, cells that express chimeric receptors and DNA encoding chimeric receptors. EFFECT: broadened arsenal of agents used against tumor and infectious diseases. 30 cl, 38 dwg, 12 ex