Miracle-dz/UniFAR-FTUs huggingface dataset:
Exercise testing in asymptomatic patients after revascularization: are outcomes altered?

BACKGROUND Although exercise echocardiography (ExE) of asymptomatic patients early (2 years after percutaneous coronary intervention [PCI] or 5 years after coronary bypass graft surgery [CABG]) after revascularization is considered inappropriate, the appropriateness of later testing is indeterminate. Treatment responses to positive test results in either setting have uncertain outcome implications. We sought to identify whether predictors of increased risk by ExE could lead to interventions that change outcome in asymptomatic patients with previous coronary revascularization. METHODS Exercise echocardiography was performed in 2105 asymptomatic patients (mean [SD] age, 64 [10] years; 310 [15%] were women; 845 [40%] had a history of myocardial infarction; 1143 [54%] had undergone PCI and 962 [46%] had undergone CABG 4.1 [4.7] years prior to the ExE). Ischemia was identified as a new or worsening wall motion abnormality. Patients were followed for a mean (SD) period of 5.7 (3.0) years for cardiac mortality. The association of ischemia during ExE with survival was assessed using Cox proportional hazard models, and an interaction with revascularization was sought. RESULTS Of 262 patients with ischemia (13%), only 88 (34%) underwent subsequent revascularization. Mortality (97 patients [4.6%]) was associated with ischemia (hazard ratio, 2.10; 95% CI, 1.05-4.19; P=.04) in groups tested both early (P=.03) and late (≥2 years after PCI or ≥ 5 years after CABG) (P=.001). However, the main predictors of outcome were clinical and stress testing findings rather than echocardiographic features. Subgroup analysis showed that asymptomatic patients without diabetes mellitus, with normal ejection fraction (≥50%), and normal exercise capacity (>6 METs [metabolic equivalent for task]) were unlikely to have a positive test result or events. Even high-risk patients did not seem to benefit from repeated revascularization. CONCLUSIONS Asymptomatic patients who undergo ExE after coronary revascularization may be identified as being at high risk but do not seem to have more favorable outcomes with repeated revascularization. From a health economic standpoint, appropriateness of such testing must be carefully reviewed.
Differentiation of malignant thrombus from bland thrombus of the portal vein in patients with hepatocellular carcinoma: application of diffusion-weighted MR imaging.

PURPOSE To investigate the utility of diffusion-weighted (DW) imaging in distinguishing bland thrombus from neoplastic thrombus in the portal vein in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS In this retrospective institutional review board-approved HIPAA-complaint study, the imaging results in 25 patients (16 men [average age, 62.3 years; range, 35-75 years] and nine women [average age, 58.4 years; range, 32-69 years]; overall average age, 60.1 years; range, 32-75 years) with HCC and portal vein thrombosis who were examined with both contrast material-enhanced computed tomography (CT) and 1.5-T magnetic resonance (MR) imaging were reviewed. Axial echo-planar two-dimensional DW imaging was performed by using b values of 50, 400, and 800 sec/mm(2). A thrombus was considered neoplastic if it expanded the vessel or enhanced on the dynamic CT and MR images; otherwise it was considered bland. The signal intensity (SI) of the thrombus and HCC lesions in the same patients was compared on DW images. The results were evaluated by using the Fisher exact test. The apparent diffusion coefficients (ADCs) of HCC and thrombus were used to compute the ratio of the ADC of the thrombus to the ADC of the tumor. RESULTS On DW images, 15 of 19 neoplastic thrombi demonstrated same SI and four showed lower SI than the primary HCC. Each of the six bland thrombi had lower SI than the primary HCC (P < .001). The mean ADC of HCC and thrombus in the neoplastic thrombus group was 0.87 x 10(-3) mm(2)/sec and 0.88 x 10(-3) mm(2)/sec, respectively (P = .45). The ADC of the bland thrombus was 2.89 x 10(-3) mm(2)/sec, significantly higher than the ADC of the HCC (1.0 x 10(-3) mm(2)/sec, P < . 0003). The ratio of the ADC of the thrombus to the ADC of the tumor in the bland thrombus group was 2.9 compared with 0.998 in the neoplastic group (P = .0003). CONCLUSION DW imaging enables discrimination between bland and neoplastic portal vein thrombi when the ratio of the ADC of the thrombus to the ADC of HCC was lower than 2 and when the thrombi showed similar SI as the primary HCC when qualitative analysis was performed.
Endotracheal Tubes Coated with Antiseptics Decrease Bacterial Colonization of the Ventilator Circuits, Lungs, and Endotracheal Tube

Background: Formation of a bacterial biofilm within the endotracheal tube (ETT) after tracheal intubation is rapid and represents a ready source of lung bacterial colonization. The authors investigated bacterial colonization of the ventilator circuit, the ETT, and the lungs when the ETT was coated with silver-sulfadiazine and chlorhexidine in polyurethane, using no bacterial/viral filter attached to the ETT. Methods: Sixteen sheep were randomized into two groups. Eight sheep were intubated with a standard ETT (control group), and eight were intubated with a coated ETT (study group). Animals were mechanically ventilated for 24 h. At autopsy, the authors sampled the trachea, bronchi, lobar parenchyma, and ETT for quantitative bacterial cultures. Qualitative bacterial cultures were obtained from the filter, humidifier, inspiratory and expiratory lines, and water trap. ETTs were analyzed with light microscopy, scanning electron microscopy, and laser scanning confocal microscopy. Results: In the control group, all eight ETTs were heavily colonized (105–108 colony-forming units [cfu]/g), forming a thick biofilm. The ventilator circuit was always colonized. Pathogenic bacteria colonized the trachea and the lungs in five of eight sheep (up to 109 cfu/g). In the study group, seven of eight ETTs and their ventilator circuits showed no growth, with absence of a biofilm; one ETT and the respective ventilator circuit showed low bacterial growth (103–104 cfu/g). The trachea was colonized in three sheep, although lungs and bronchi showed no bacterial growth, except for one bronchus in one sheep. Conclusions: Coated ETTs induced a nonsignificant reduction of the tracheal colonization, eliminated (seven of eight) or reduced (one of eight) bacterial colonization of the ETT and ventilator circuits, and prevented lung bacterial colonization.
A fuzzy clustering approach on the classification of non uniform cosmetic defects

In this paper a fuzzy clustering approach for the classification of cosmetic defects is presented. The paper investigates the solution of this classification problem with the Gustafson-Kessel (GK), and Geth-Geva (GG) with Abonyi-Szeifert (AS) fuzzy algorithms. The clustering process is achieved on multidimensional feature vectors that represent the cosmetic defects. The performance of the GK algorithm may be considered similar to a human inspector which is between 85% and 90% approximately. However, the fuzzy clustering technique has the advantage to be very consistent, contrary to a human inspector that can change her/his mind due to subjective influences. The paper also presents the comparison between the fuzzy approach and the artificial neural network approach. The problem faced in this work also helped to compare the performance of FC algorithms with ANN in real world applications.
Graph Entropy, Network Coding and Guessing games

We introduce the (private) entropy of a directed graph (in a new network coding sense) as well as a number of related concepts. We show that the entropy of a directed graph is identical to its guessing number and can be bounded from below with the number of vertices minus the size of the graph's shortest index code. We show that the Network Coding solvability of each specific multiple unicast network is completely determined by the entropy (as well as by the shortest index code) of the directed graph that occur by identifying each source node with each corresponding target node. Shannon's information inequalities can be used to calculate upper bounds on a graph's entropy as well as calculating the size of the minimal index code. Recently, a number of new families of so-called non-shannon-type information inequalities have been discovered. It has been shown that there exist communication networks with a capacity strictly less than required for solvability, but where this fact cannot be derived using Shannon's classical information inequalities. Based on this result we show that there exist graphs with an entropy that cannot be calculated using only Shannon's classical information inequalities, and show that better estimate can be obtained by use of certain non-shannon-type information inequalities.
Eight new species and an annotated checklist of Microgastrinae (Hymenoptera, Braconidae) from Canada and Alaska

Abstract Based on the study of 12,000+ specimens, an annotated checklist of 28 genera and 225 species of Microgastrinae braconids from Canada and Alaska is provided, increasing by 50% the number of species for the region. The genera Distatrix, Iconella, Protomicroplitis and Pseudapanteles for Canada, and Diolcogaster for Alaska are recorded for the first time; all but Iconella and Protomicroplitis represent the northernmost extension of their known distribution. Eight new species are described: Apanteles huberi sp. n. , Apanteles jenniferae sp. n. , Apanteles masmithi sp. n. , Apanteles roughleyi sp. n. , Apanteles samarshalli sp. n. , Distatrix carolinae sp. n. , Pseudapanteles gouleti sp. n. , and Venanus heberti sp. n. For the more diverse genera, especially Cotesia, Microplitis, Apanteles, Dolichogenidea and Glyptapanteles, many more species are expected to be found. DNA barcode sequences (cytochrome c oxidase I, or CO1) for 3,500+ specimens provided an additional layer of useful data. CO1 sequences were incorporated to the new species descriptions whenever possible, helped to clarify the limits of some species, and flagged cases where further study is needed. Preliminary results on the latitudinal gradient of species/genera richness (45–80° N); as well as biogeographical affinities of the Canadian/Alaska fauna, are discussed. Taking into account the number of specimens in collections still to be studied, data from the barcoded specimens, and extrapolations from Lepidoptera diversity (the host group of the subfamily) the actual diversity of Microgastrinae in the region is estimated to be at least twice that currently known.
Early anti-TNF/immunomodulator therapy is associated with better long-term clinical outcomes in Asian patients with Crohn’s disease with poor prognostic factors

Although early treatment of Crohn’s disease (CD) patients with anti-tumor necrosis factor (TNF) agents or immunomodulators (IMs) may improve long-term outcomes, especially those with poor prognostic factors, their effectiveness in Asians remains unclear. In this study, Korean patients with CD naïve to both intestinal surgery and intestinal complications, and with at least two risk factors for progression (diagnosis at age <40 years, systemic corticosteroid treatment <3 months after diagnosis, and perianal fistula at diagnosis) were retrospectively analyzed. Patients were classified into those who started anti-TNFs, or IMs but not anti-TNFs, within 2 years of diagnosis, and those who started anti-TNFs and/or IMs later. Their probabilities of intestinal surgery and intestinal complications were compared. A total of 670 patients were enrolled, 79 in the early anti-TNF, 286 in the early IM, and 305 in the late treatment group. Kaplan-Meier analysis with the log-rank test showed that from starting anti-TNFs/IMs, times to intestinal surgery (P < 0.001), stricturing complications (P = 0.002), and penetrating complications (P < 0.001) were significantly longer in the early anti-TNF/IM groups than in the late treatment group. Multivariate Cox regression analysis showed that, from starting anti-TNFs/IMs, late anti-TNF/IM treatment was independently associated with higher risks of intestinal surgery (adjusted hazard ratio [aHR] 2.321, 95% confidence interval [CI] 1.503–3.584, P < 0.001), behavioral progression (aHR 2.001, 95% CI 1.449–2.763, P < 0.001), stricturing complications (aHR 1.736, 95% CI 1.209–2.493, P = 0.003), and penetrating complications (aHR 3.315, 95% CI 2.094–5.249, P < 0.001) than early treatment. In conclusion, treatment of Asian CD patients having poor prognostic factors with anti-TNFs/IMs within 2 years of diagnosis is associated with better clinical outcomes than later treatment.
Interactions between electronic article surveillance systems and implantable cardioverter-defibrillators.

BACKGROUND In patients with implantable cardioverter-defibrillators (ICDs). inappropriate shocks have been reported with exposure to electronic article surveillance systems. The risk to patients with ICDs of walking through or lingering near surveillance systems requires further investigation. METHODS AND RESULTS We evaluated the response in ICD function in 170 subjects during a 10- to 15-second midgate walk-through of and during extreme (2 minutes within 6 in of the gate) exposure to 3 common article surveillance systems. Complete testing was done in 169 subjects. During a 10- to 15-second (very slow) walk-through of the 3 surveillance systems, no interactions were observed that would negatively affect ICD function. During extreme exposure (169 subjects) and during extreme exposure and pacing via the ICD (126 subjects), interactions between the ICD and the article surveillance systems were observed in 19 subjects. In 7 subjects, this interaction was clinically relevant and would have likely (3 subjects) and possibly (4 subjects) resulted in ICD shocks. In 12 subjects, the interaction was minor. CONCLUSIONS It is safe for a patient with an ICD to walk through electronic article surveillance systems. Lingering in a surveillance system may result in an inappropriate ICD shock.
Microbubble administration accelerates clot lysis during continuous 2-MHz ultrasound monitoring in stroke patients treated with intravenous tissue plasminogen activator.

BACKGROUND AND PURPOSE We sought to evaluate the effects of administration of microbubbles (MBs) on the beginning, speed, and degree of middle cerebral artery (MCA) recanalization during systemic thrombolysis and continuous 2-MHz pulsed-wave transcranial Doppler (TCD) monitoring. METHODS We evaluated 111 patients with acute stroke attributable to MCA occlusion treated with intravenous tissue plasminogen activator (tPA). Thirty-eight patients were treated with tPA plus continuous 2-hour TCD monitoring plus 3 doses of 2.5 g (400 mg/mL) of galactose-based MBs given at 2, 20, and 40 minutes after tPA bolus (MB group). These patients were compared with 73 patients who were allocated to receive tPA plus continuous 2-hour TCD ultrasound (US) monitoring (tPA/US group) or tPA plus placebo monitoring (tPA group), most of whom were enrolled in a previous study of US-enhanced thrombolysis. The beginning, degree, and time to maximum completeness of recanalization during the first 2 hours of tPA bolus were recorded. RESULTS Median prebolus National Institutes of Health Stroke Scale (NIHSS) score was 18. Eighty patients (72%) had a proximal and 31 (28%) a distal MCA occlusion on TCD. Thirty-seven patients (33%) received tPA/US, 38 (34%) received tPA/US/MB, and 36 (32%) were treated with tPA alone. Stroke severity, time to treatment, location of MCA occlusion, and presence of carotid artery disease were similar among groups. Two-hour recanalization was seen in 14 (39%), 25 (68%), and 27 patients (71%) in the tPA, tPA/US, and tPA/US/MB groups, respectively (P=0.004). Two-hour complete recanalization rate was significantly (P=0.038) higher in the tPA/US/MB group (54.5%) compared with tPA/US (40.8%) and tPA (23.9%) groups. The time to beginning of recanalization after tPA bolus was 26+/-18 minutes in the tPA/US group and 19+/-12 minutes in the tPA/US/MB group (P=0.12). Four patients (3.6%) experienced symptomatic intracranial hemorrhage: 2 (5.5%), 1 (2.7%), and 1 patient (2.6%) who received tPA only, tPA/US, and tPA/US/MB, respectively, experienced symptomatic intracranial hemorrhage. At 24 hours, 31%, 41%, and 55% of tPA, tPA/US, and tPA/US/MB improved >4 points in the NIHSS score. CONCLUSIONS Administration of MBs induces further acceleration of US-enhanced thrombolysis in acute stroke, leading to a more complete recanalization and to a trend toward better short- and long-term outcome.
The Canon Score Language

Canon is a computer language designed to help composers create note-level control information for synthesizers or synthesis software. Canon was motivated by my need for a simple yet powerful language for teaching second-semester students of electronic and computer music, and also by my interest in putting concepts from the language Arctic (Dannenberg, McAvinney, and Rubine 1986; Rubine and Dannenberg 1987) to practical use in a MIDI studio. Canon is something of a cross between a music notation and a programming language. The main idea in Canon is to combine and transform simple scores to form more complex ones. Since time is
Efficacy and tolerability of urate-lowering drugs in gout: a randomised controlled trial of benzbromarone versus probenecid after failure of allopurinol

Objectives: To investigate the efficacy and tolerability of allopurinol as the first-choice antihyperuricaemic treatment for gout, and compare the efficacy and tolerability of benzbromarone and probenecid as second-choice treatment. Methods: Prospective, multicentre, open-label, two-stage randomised controlled trial in gout patients with normal renal function. Enrolled patients were given 300 mg allopurinol for 2 months (stage 1). Those patients who could not tolerate allopurinol or who did not attain the target serum urate concentration (sUr) ⩽0.30 mmol/l (5.0 mg/dl), which was defined as successful, were randomised to benzbromarone 200 mg/day or probenecid 2 g/day for another 2 months (stage 2). Results: 96 patients were enrolled in stage 1. 82 patients (85%) were eligible for the analysis at the end of stage 1: there was a mean (SD) decrease in sUr concentration of 35 (11)% from baseline; 20 patients (24%) attained target sUr ⩽0.30 mmol/l; and 9 patients (11%) stopped allopurinol because of adverse drug reactions. 62 patients were enrolled in stage 2. 27 patients received benzbromarone (3 patients not eligible for analysis) and 35 received probenecid (4 patients not eligible for analysis). Treatment with benzbromarone was successful in 22/24 patients (92%) and with probenecid in 20/31 patients (65%) (p = 0.03 compared with benzbromarone). Compared with baseline values, there was a mean (SD) decrease of sUr concentration of 64 (9)% with benzbromarone and 50 (7)% with probenecid (p<0.001). Conclusion: This study showed that allopurinol 300 mg/day has a poor efficacy and tolerability profile when used to attain a biochemical predefined target level of sUr ⩽0.30 mmol/l, following 2 months of treatment. In stage 2, benzbromarone 200 mg/day was more effective and better tolerated than probenecid 2 g/day. Trial registration number: ISRCTN21473387.
A survey of linear programming in randomized subexponential time

Three papers were published in 1992, each providing a combinatorial, randomized algorithm solving linear programming in subexponential expected time. Bounds on independent algorithms were proven, one by Kalai, and the other by Matousek, Sharir, and Welzl. Results by G&auml;rtner combined techniques from these papers to solve a much more general optimization problem in similar time bounds.Although the algorithms by Kalai and Sharir-Welzl seem remarkably different in style and evolution, this paper demonstrates that one of the variants of Kalai's algorithm is identical (although dual) to the algorithm of Sharir-Welzl. Also the implication of G&auml;rtner's framework on future improvements is examined more carefully.
Roche tomography of cataclysmic variables – IV. Star‐spots and slingshot prominences on BV Cen

We present Roche tomograms of the G5 - G8 IV/V secondary star in the long-period cataclysmic variable BV Cen reconstructed from Magellan Inamori Kyocera Echelle spectrograph echelle data taken on the Magellan Clay 6.5-m telescope. The tomograms show the presence of a number of large, cool star-spots on BV Cen for the first time. In particular, we find a large high-latitude spot which is deflected from the rotational axis in the same direction as seen on the K3 - K5 IV/V secondary star in the cataclysmic variable AE Aqr. BV Cen also shows a similar relative paucity of spots at latitudes between 40. and 50. when compared with AE Aqr. Furthermore, we find evidence for an increased spot coverage around longitudes facing the white dwarf which supports models invoking star-spots at the L1 point to explain the low states observed in some cataclysmic variables. In total, we estimate that some 25 per cent of the Northern hemisphere of BV Cen is spotted. We also find evidence for a faint, narrow, transient emission line with characteristics reminiscent of the peculiar low-velocity emission features observed in some outbursting dwarf novae. We interpret this feature as a slingshot prominence from the secondary star and derive a maximum source size of 75 000 km and a minimum altitude of 160 000 km above the orbital plane for the prominence. The entropy landscape technique was applied to determine the system parameters of BV Cen. We find M-1 = 1.18 +/-(0.28)(0.16) M-circle dot and M-2 = 1.05 +/-(0.23)(0.14) M circle dot and an orbital inclination of i = 53 degrees +/- 4 degrees at an optimal systemic velocity of gamma = -22.3 km s(-1). Finally, we also report on the previously unknown binarity of the G5IV star HD 220492.
Long-Term Outcome and Disability of Diabetic Patients Hospitalized for Diabetic Foot Ulcers

OBJECTIVE—The long-term outcome and functional status of subjects hospitalized for diabetic foot ulcers have been poorly studied and thus are the topics of this study. RESEARCH DESIGN AND METHODS—Ninety-four consecutive diabetic subjects hospitalized for diabetic foot ulcers between January 1998 and December 2000 were prospectively followed for mean ± SD 79.5 ± 13.3 months. We calculated rates of primary healing, new ulcers, amputations, mortality, and disability and evaluated the global therapeutic success (GTS) of foot care management as defined by the association of primary healing without recurrence or disability at the end of follow-up. RESULTS—Follow-up was successful in 89 of 94 subjects (63 men and 31 women; age 63.7 ± 10.8 years). Of these, 69 (77.5%) experienced primary healing without major amputation, 39 (43.8%) underwent amputation (24 minor and 15 major), and 46 died (51.7%), including 23 from cardiovascular events. Forty-two of 69 patients who experienced primary healing (60.9%) had ulcer recurrence. At the end of the follow-up period, 25 patients (28.1%) were dependent and 40 subjects (44.9%) had achieved GTS. Multivariate analysis showed the role of age as an independent predictor of GTS (P < 0.05) and of impaired renal function/albuminuria as independent predictors of healing failure, first amputation, and mortality (P < 0.01). CONCLUSIONS—Despite a satisfactory initial healing rate, the global long-term outcome of patients hospitalized for diabetic foot ulcers was poor. Nephropathy appears to be an important predictor of long-term outcome. Further studies are needed to establish recognized criteria for therapeutic success going beyond just the evaluation of healing rate in the management of diabetic foot ulcers.