Miracle-dz/UniFAR-FTUs huggingface dataset:
Differentiating Electromechanical From Non–Electrical Substrates of Mechanical Discoordination to Identify Responders to Cardiac Resynchronization Therapy

Background—Left ventricular (LV) mechanical discoordination, often referred to as dyssynchrony, is often observed in patients with heart failure regardless of QRS duration. We hypothesized that different myocardial substrates for LV mechanical discoordination exist from (1) electromechanical activation delay, (2) regional differences in contractility, or (3) regional scar and that we could differentiate electromechanical substrates responsive to cardiac resynchronization therapy (CRT) from unresponsive non–electrical substrates. Methods and Results—First, we used computer simulations to characterize mechanical discoordination patterns arising from electromechanical and non–electrical substrates and accordingly devise the novel systolic stretch index (SSI), as the sum of posterolateral systolic prestretch and septal systolic rebound stretch. Second, 191 patients with heart failure (QRS duration ≥120 ms; LV ejection fraction ⩽35%) had baseline SSI quantified by automated echocardiographic radial strain analysis. Patients with SSI≥9.7% had significantly less heart failure hospitalizations or deaths 2 years after CRT (hazard ratio, 0.32; 95% confidence interval, 0.19–0.53; P<0.001) and less deaths, transplants, or LV assist devices (hazard ratio, 0.28; 95% confidence interval, 0.15–0.55; P<0.001). Furthermore, in a subgroup of 113 patients with intermediate electrocardiographic criteria (QRS duration of 120–149 ms or non–left bundle branch block), SSI≥9.7% was independently associated with significantly less heart failure hospitalizations or deaths (hazard ratio, 0.41; 95% confidence interval, 0.23–0.79; P=0.004) and less deaths, transplants, or LV assist devices (hazard ratio, 0.27; 95% confidence interval, 0.12–0.60; P=0.001). Conclusions—Computer simulations differentiated patterns of LV mechanical discoordination caused by electromechanical substrates responsive to CRT from those related to regional hypocontractility or scar unresponsive to CRT. The novel SSI identified patients who benefited more favorably from CRT, including those with intermediate electrocardiographic criteria, where CRT response is less certain by ECG alone.
Menstrual migraine

Purpose of reviewMenstrual migraine is prevalent but it is only recently that research has specifically addressed the pathophysiology and management of this disabling condition. Recent findingsFor many years, menstrual migraine was a loose term used to describe an undefined association between migraine and menstruation. The introduction of recognized criteria has improved the diagnosis and enabled the study of a more homogenous population of women with this condition. As a consequence, studies have addressed putative mechanisms, particularly the association between oestrogen ‘withdrawal’ and migraine. It is recognised that other mechanisms have yet to be identified. Studies have confirmed the efficacy of perimenstrual prophylaxis with triptans and physiological doses of oestrogen. Despite robust data from randomized placebo-controlled studies, no treatments are licensed specifically for this indication at the time of writing. SummaryRecognition of menstrual migraine as a specific entity has resulted in improved diagnosis and increased research into the condition. However, our understanding of the pathophysiology and the consequent development of effective management strategies remain limited.
1st place, PREMUS best paper competition: workplace and individual factors in wrist tendinosis among blue-collar workers--the San Francisco study.

OBJECTIVE Workplace studies have linked hand/wrist tendinosis to forceful and repetitive hand exertions, but the associations are not consistent. We report findings from a prospective study of right wrist tendinosis among blue-collar workers. METHODS Workers (N=413) at four industries were followed for 28 months with questionnaires and physical examinations every 4 months to identify incident cases of right wrist tendinosis. Exposure assessment of force and repetition were based on field measurements and video analysis to determine repetition rate and the percent time (% time) in heavy pinch (>1 kg-force) or power grip (>4 kg-force). All exposure variables were measured at the level of the individual and task. For workers responsible for >1 task, a time-weighted average exposure was calculated based on task hours per week. A proportional hazards model was used to assess the relationship between exposures and incidence of wrist tendinosis. RESULTS During the 481 person-years of follow-up, there were 26 incident cases of right wrist tendinosis [incidence rate (IR) 5.40 cases per 100 person-years]. Adjusting for age, gender, and repetition, wrist tendinosis was associated with % time spent in heavy pinch [hazard ratio (HR) 5.01, 95% CI 1.27-19.79). Composite exposure measure American Conference of Industrial Hygienists Threshold Limit Value (ACGIH-TLV) for hand activity level (HR 3.95, 95% CI 1.52-10.26) was also associated with the outcome for the medium-exposure group using video-based total repetition rate. CONCLUSIONS The workplace factors predicting wrist tendinosis were time-weighted average values of % time spent in heavy pinch and the ACGIH-TLV for Hand Activity Level. The % time spent in power grip was not a significant predictor, nor were any measures of repetition. An exposure-response relationship was observed for the % time spent in heavy pinch. These findings may improve programs for preventing occupational wrist tendinosis.
A Catalog of Northern Stars with Annual Proper Motions Larger than 015 (LSPM-NORTH Catalog)

The LSPM catalog is a comprehensive list of 61,977 stars north of the J2000 celestial equator that have proper motions larger than 0. ″15 yr-1 (local-background-stars frame). The catalog has been generated primarily as a result of our systematic search for high proper motion stars in the Digitized Sky Surveys using our SUPERBLINK software. At brighter magnitudes, the catalog incorporates stars and data from the Tycho-2 Catalogue and also, to a lesser extent, from the All-Sky Compiled Catalogue of 2.5 million stars. The LSPM catalog considerably expands over the old Luyten (Luyten Half-Second [LHS] and New Luyten Two-Tenths [NLTT]) catalogs, superseding them for northern declinations. Positions are given with an accuracy of ≲100 mas at the 2000.0 epoch, and absolute proper motions are given with an accuracy of ≈8 mas yr-1. Corrections to the local-background-stars proper motions have been calculated, and absolute proper motions in the extragalactic frame are given. Whenever available, we also give optical BT and VT magnitudes (from Tycho-2, ASCC-2.5), photographic BJ, RF, and IN magnitudes (from USNO-B1 catalog), and infrared J, H, and Ks magnitudes (from 2MASS). We also provide an estimated V magnitude and V - J color for nearly all catalog entries, useful for initial classification of the stars. The catalog is estimated to be over 99% complete at high Galactic latitudes (|b| > 15°) and over 90% complete at low Galactic latitudes (|b| > 15°), down to a magnitude V = 19.0, and has a limiting magnitude V = 21.0. All the northern stars listed in the LHS and NLTT catalogs have been reidentified, and their positions, proper motions, and magnitudes reevaluated. The catalog also lists a large number of completely new objects, which promise to expand very significantly the census of red dwarfs, subdwarfs, and white dwarfs in the vicinity of the Sun.
Headache Associated with Airplane Travel

This study presents six cases of headache that appeared only during flights and was not associated with other headache forms. The cases had severe headache attacks during some flights, when the plane was landing and taking off, with a unilateral and generally orbital and/or supraorbital localization. The attacks lasted between 15 and 20 min on average and recovered spontaneously, without any accompanying sign. We think that barotrauma caused by pressure changes in the cabin during take-off and landing could affect ethmoidal nerves (branching from the ophthalmic branch of the trigeminal nerve) that carry the senses of the mucosa on the inner surface of the paranasal sinuses, and/or nociceptors in ethmoidal arteries, thereby activating the trigeminovascular system and leading to headache.
Clusters Not Classifications: Making Sense of Complement-Mediated Kidney Injury.

In 2010, we suggested the name C3 glomerulopathy to encompass a group of glomerular diseases characterized by the presence of glomerular C3 in the absence of substantial Ig and without deposition of the early components of the classic or lectin pathways of complement activation. [1][1] Within this
Telemedicine in Plastic Surgery: E‐Consult the Attending Surgeon

&NA; Telemedicine has evolved into a valuable but underused resource for the delivery of health care to patients at a distance, particularly where patient transport is impractical, expensive, complicated, and/or urgent. Today, over 250,000 telemedicine consults are generated annually, involving various specialties in both military and civilian health delivery systems. The ability to evaluate and triage plastic surgery patients through the use of telemedicine has not been widely explored. We have designed, developed, and tested a “store‐and‐forward” solution at UMass Memorial Hospital and Beth Israel Deaconess Hospital whereby the plastic surgery residents who responded to a consult request transmitted digital photographs by means of the Internet to the attending physician on call. The customary telephone call between resident and attending physician benefited from the additional photographic data, and patient management resulted in a clear, concise, and unambiguous treatment plan. The initial management suggested by the resident was modified on some occasions, particularly with complex problems. The use of digital images was especially helpful for evaluation of radiographs and complex wounds of the hand and face. The solution proved to be very valuable for both attending physicians and residents in plastic surgery. The photographs provide rich detail and resolution comparable to high‐quality prints. The mechanics of obtaining images and the process of sending them electronically was readily mastered. Images reached their destination in only a few minutes over standard telephone lines. No problems were encountered while sending or viewing images on Macintosh or Windows platforms. Determining course of action with a complete clinical history now includes a level of visual detail previously not available. As this application expands into wider use, data integrity and safety will have to be more formally secured and monitored. Our model of telemedicine has broad‐reaching ramifications for the improvement of health‐care delivery locally, nationally, and internationally. (Plast. Reconstr. Surg. 110: 452, 2002.)
HIV-associated distal sensory polyneuropathy in the era of highly active antiretroviral therapy: the Manhattan HIV Brain Bank.

OBJECTIVES To examine distal sensory polyneuropathy (DSP) in a highly active antiretroviral therapy era, human immunodeficiency virus (HIV)-infected cohort, to determine whether clinical manifestations are affected by demographic or other clinical variables. PATIENTS One hundred eighty-seven patients with HIV infection enrolled in the Manhattan HIV Brain Bank underwent baseline neurologic evaluations between January 29, 1999, and June 17, 2002. Distal sensory polyneuropathy was diagnosed if patients displayed abnormalities in 2 or more of the following: ankle reflexes or vibratory or pinprick perception. Patients were classified as symptomatic if they described pain, paresthesia, or numbness. Nonneurologic information was obtained by interview, laboratory testing, and medical chart review. Psychiatric and substance use disorders were elucidated by semistructured interview. In 36 patients, morphometric analysis was performed on autopsy-derived sural nerves. RESULTS Of 187 patients, 99 (53%) had DSP. Patients with neuropathy were older than those without (mean +/- SD age, 45.3 +/- 0.7 vs 41.2 +/- 0.8 years, P <.001), and DSP was significantly more common in men (58% [83/99]) than in women (37% [16/99]) (P =.02). The presence of neuropathy was not correlated with plasma viral load, decreased CD4 cell counts, or neurotoxic antiretroviral therapy. Twenty-six of 99 patients with DSP were asymptomatic. Asymptomatic neuropathy was correlated with histories of opiate and sedative abuse and dependence. Symptomatic DSP correlated with ethanol and hallucinogen syndromes, but not neurotoxic therapy. Sural nerve morphometric findings did not distinguish between patients with substance use syndromes and those without. CONCLUSIONS In contrast to populations before the era of highly active antiretroviral therapy, DSP in the Manhattan HIV Brain Bank cohort is not associated with increased viral load or decreased CD4 cell counts in this cross-sectional analysis. Symptoms in DSP are associated with substance use disorders, but no difference in morphologic structure is seen in nerves of patients with HIV infection with and without substance use histories. Previously reported virologic and immunologic underpinnings of DSP may be affected by highly active antiretroviral therapy. Furthermore, symptoms of DSP in substance users may be altered by central mechanisms of increased or decreased tolerance to sensory disturbance.
Prevalence of overweight and obesity and perception of healthy and desirable body size in urban, Ghanaian women.

OBJECTIVE To determine if the perceived ideal body size of urban women in Accra, Ghana influences current body size. METHODS The sample (n=2,814) consisted of Ghanaian women aged 18 years and older, living in the Accra Metropolitan Area. Data were collected between October 2008 and June 2009 in the Women's Health Study of Accra, Wave II household survey. Height (m), weight (kg), waist (cm) and hip (cm) measurements were used to calculate body mass index (BMI, measured in kg/m(2)), waist circumference, and waist-to-hip ratio. In addition to reported socio-demographic characteristics, medical history, and exercise and diet history, the standardized Stunkard Figure Rating Scale (FRS) was used to identify silhouettes of varying body sizes that most closely resemble a woman's current body image (CBI), the body image she sees as the ideal for Ghanaian women (IBI), and the body image she sees as healthiest (HBI). The validity of using the standardized Stunkard FRS to assess body image in a population of Ghanaian women was assessed using Receiver Operating Curve (ROC) analysis. Household wealth, a proxy for income, was assessed using an index derived by principal components analysis from a selection of 20 variables measuring quality of the dwelling (e.g water source, sewage arrangements, type of housing, roof etc.) and possession of household durable goods (e.g. television, radio, iron, refrigerator and car). 1 Logistic and linear regression was used to test the association between various socio-demographic characteristics, BMI and body image satisfaction. RESULTS Using the WHO criteria for BMI, 3.6% (95) of women were underweight, 31.5% (828) normal weight, 27.8% (730) overweight and 37.1% (973) obese. In total, 64.9% of women sampled were either overweight or obese. A WC of greater than 88 cm revealed 78.7% (2,113) obesity. A WHR cut-off for obesity of 0.8 revealed 78.9% (2,119) obesity. ROC analysis confirmed the validity of using the standardized Stunkard FRS to assess body image in a population of Ghanaian women. Age, relative wealth, being married, having grown up in an urban environment and having parity >2 are associated with higher risk of overweight or obesity. Education level is not associated with overweight status. Overall, 72.2% (1,936) of women were dissatisfied with their current body size and 41.8% of women preferred a smaller figure. Overweight and obese women were significantly more likely than normal weight women to desire weight loss (OR: 10.12, CI: 8.04 - 12.72). CONCLUSION Ideal body image in urban, Ghanaian women should not be viewed as an inhibitor to healthy weight maintenance. Interventions should be designed to help women achieve their ideal and healthy weights.
Distance-based and probabilistic record linkage for re-identification of records with categorical variables ∗

Record linkage methods are methods for identifying the presence of the same individual in different data files (re-identification). This paper studies and compares the two main existing approaches for record linkage: probabilistic and distance-based. The performance of both approaches is compared when data are categorical. To that end, a distance over ordinal and nominal scales is defined. The paper shows that, for categorical data, distance-based and probabilistic-based record linkage lead to similar results. This is parallel to comparisons in the literature for numerical data, which also showed a similar behaviour between both record-linkage approaches. As a consequence, the distance proposed for ordinal and nominal scales is implicitly validated.
Randomized Comparison of Sirolimus-Eluting Stent Versus Standard Stent for Percutaneous Coronary Revascularization in Diabetic Patients: The Diabetes and Sirolimus-Eluting Stent (DIABETES) Trial

Background— Outcomes after percutaneous coronary interventions in diabetic patients are shadowed by the increased rate of recurrence compared with nondiabetic patients. Methods and Results— We conducted a multicenter, randomized trial to demonstrate the efficacy of sirolimus-eluting stents compared with standard stents to prevent restenosis in diabetic patients with de novo lesions in native coronary arteries. The primary end point of the trial was in-segment late lumen loss as assessed by quantitative coronary angiography at 9-month follow-up. The trial was stratified by diabetes treatment status. One hundred sixty patients were randomized to sirolimus-eluting stents (80 patients; 111 lesions) or standard stent implantation (80 patients; 110 lesions). On average, reference diameter was 2.34±0.6 mm, lesion length was 15.0±8 mm, and 13.1% of lesions were chronic total occlusions. In-segment late lumen loss was reduced from 0.47±0.5 mm for standard stents to 0.06±0.4 mm for sirolimus stents (P<0.001). Target-lesion revascularization and major adverse cardiac event rates were significantly lower in the sirolimus group (31.3% versus 7.3% and 36.3% versus 11.3%, respectively; both P<0.001). Non–insulin- and insulin-requiring patients demonstrated similar reductions in angiographic and clinical parameters of restenosis after sirolimus-eluting stent implantation. During the 9-month follow-up, stent thrombosis occurred in 2 patients after standard stent implantation. Conversely, this phenomenon was not seen in the sirolimus stent group. Conclusions— This randomized trial demonstrated that sirolimus stent implantation is safe and efficacious in reducing both angiographic and clinical parameters of restenosis compared with standard stents in diabetic patients with de novo coronary stenoses.
Analysis of Free Online Physician Advice Services

Background Online Consumer Health websites are a major source of information for patients worldwide. We focus on another modality, online physician advice. We aim to evaluate and compare the freely available online expert physicians’ advice in different countries, its scope and the type of content provided. Setting Using automated methods for information retrieval and analysis, we compared consumer health portals from the US, Canada, the UK and Israel (WebMD,NetDoctor,AskTheDoctor and BeOK). The evaluated content was generated between 2002 and 2011. Results We analyzed the different sites, looking at the distribution of questions in the various health topics, answer lengths and content type. Answers could be categorized into longer broad-educational answers versus shorter patient-specific ones, with different physicians having personal preferences as to answer type. The Israeli website BeOK, providing 10 times the number of answers than in the other three health portals, supplied answers that are shorter on average than in the other websites. Response times in these sites may be rapid with 32% of the WebMD answers and 64% of the BeOK answers provided in less than 24 hours. The voluntary contribution model used by BeOK and WebMD enables generation of large numbers of physician expert answers at low cost, providing 50,000 and 3,500 answers per year, respectively. Conclusions Unlike health information in online databases or advice and support in patient-forums, online physician advice provides qualified specialists’ responses directly relevant to the questions asked. Our analysis showed that high numbers of expert answers could be generated in a timely fashion using a voluntary model. The length of answers varied significantly between the internet sites. Longer answers were associated with educational content while short answers were associated with patient-specific content. Standard site-specific guidelines for expert answers will allow for more desirable content (educational content) or better throughput (patient-specific content).
A functional T-cell receptor signaling pathway is required for p95vav activity

Stimulation of the T-cell antigen receptor (TCR) induces activation of multiple tyrosine kinases, resulting in phosphorylation of numerous intracellular substrates. One substrate is p95vav, which is expressed exclusively in hematopoietic and trophoblast cells. It contains a number of structural motifs, including Src homology 2, Src homology 3, and pleckstrin homology domains and a putative guanine nucleotide exchange domain. The role of p95vav in TCR-mediated signaling processes is unclear. Here, we show that overexpression of p95vav alone in Jurkat T cells leads to activation of the nuclear factors, including NFAT, involved in interleukin-2 expression. Furthermore, p95vav synergizes with TCR stimulation in inducing NFAT- and interleukin-2-dependent transcription. In contrast, NFAT activation by a G-protein-coupled receptor is not modulated by p95vav overexpression, suggesting that the effect is specific to the TCR signaling pathways. Although removal of the first 67 amino acids of p95vav activates its transforming potential in NIH 3T3 cells, this region appears to be required for its function in T cells. We further demonstrate that the p95vav-induced NFAT activation is not mimicked by Ras activation, though its function is dependent upon Ras and Raf. Furthermore, the activating function of p95vav is blocked by FK506, suggesting that its activity also depends on calcineurin. To further dissect p95vav involvement in TCR signaling, we analyzed various Jurkat mutants deficient in TCR signaling function or TCR expression and showed that an intact TCR signaling pathway is required for p95vav to function. However, overexpression of p95vav does not appear to influence TCR-induced protein tyrosine phosphorylation or increases in cytoplasmic free calcium. Taken together, our data suggest that p95vav plays an important role at an yet unidentified proximal position in the TCR signaling cascade.