Miracle-dz/UniFAR-FTUs huggingface dataset:
Presence of structural heart disease and left ventricular dysfunction predict hospitalizations for new-onset heart failure after right ventricular apical pacing.

AIMS Long-standing right ventricular apical pacing (RVAP) may result in impaired left ventricular (LV) function and systolic heart failure (HF) in selected patients. However, which patients are susceptible to those harmful effects is unknown. METHODS AND RESULTS In 367 consecutive patients undergoing pacemaker implantations (PMIs) and RVAP, the clinical, laboratory, and echocardiographic data before the PMIs, electrocardiographic parameters [baseline and paced QRS duration (QRSd)], and echocardiography were analysed. The cumulative per cent of those ventricularly paced (Cum%VP) was >90% in all subjects. During a mean follow-up period of 113±69 months, the occurrence of HF requiring hospitalization for the intravenous administration of HF medications was found in 60 patients (16%; HF group), but not in the remaining 307 (84%; no-HF group). The prevalence of structural heart disease (SHD; P<0.0001), cardiothoracic ratio (P<0.0001), baseline left atrial size (P=0.0001), LV end-diastolic volume (P<0.005) and end-systolic volume (P<0.0005), LV mass index (P<0.001), and baseline and paced QRSd (both for P<0.001) were greater in the HF group than in the no-HF group. Inversely, the LV ejection fraction (LVEF) in the HF group was smaller than that in the no-HF group (P<0.001). The multivariate Cox regression analysis revealed that the presence of SHD [hazard ratio (HR)=3.12; 95% confidence interval (CI), 1.7-5.7; P<0.001] and the LVEF (<40%; HR=2.57; 95% CI, 1.09-6.07; P<0.05) were associated with hospitalizations due to HF after RVAP. CONCLUSION The presence of SHD and an impaired LV systolic function before the PMI may predict hospitalizations due to HF after RVAP.
Mobile phone intervention to improve diabetes care in rural areas of Pakistan: a randomized controlled trial.

OBJECTIVE To determine the effect of mobile phone intervention on HbA1c in type-2 Diabetes Mellitus (DM) patients living in rural areas of Pakistan. STUDY DESIGN Randomized controlled trial. PLACE AND DURATION OF STUDY Department of Endocrinology, Liaquat National Hospital, Karachi, from December 2013 to June 2014. METHODOLOGY A total of 440 patients in intervention and control groups were enrolled. All patients between 18 - 70 years of age, residing in rural areas of Pakistan, HbA1c ³ 8.0% and having personal functional mobile phone were included. The intervention group patients were called directly on mobile phone after every 15 days for a period of 4 months. They were asked about the self-monitoring blood glucose, intake of medications, physical activity, healthy eating and were physically examined after 4 months. However, the control group was examined initially and after 4 months physically in the clinic and there were no mobile phone contacts with these patients. RESULTS Patients in intervention group showed improvement (p < 0.001) in following diet plan from 17.3% at baseline to 43.6% at endline, however, the control group showed insignificant increase (p=0.522) from 13.6% at baseline to 15.9% at endline. Intervention group (RR = 2.71, 95% CI = 1.18 - 6.40) showed significant positive association with normalization of HbA1c levels. The relationship was adjusted for age, gender, socio-economic status, ethnicity, education, hypertension, medication, BMI, diet, LDL levels and physical activity. Dietary restriction and low LDL levels also showed significant associations with reduced HbA1c levels on multivariate analysis. CONCLUSION Mobile phone technology in rural areas of Pakistan was helpful in lowering HbA1c levels in intervention group through direct communication with the diabetic patients. Lowering LDL and following diabetic diet plan can reduce HbA1c in these patients and help in preventing future complications.
Fatigue Affects Health Status and Predicts Mortality Among Subjects with COPD: Report from the Population-Based OLIN COPD Study

Abstract Background: COPD is associated to increased fatigue, decreased health status and mortality. However, these relationships are rarely evaluated in population-based studies. Aims: To describe the relationship between health status, respiratory symptoms and fatigue among subjects with and without COPD. Further, to evaluate whether fatigue and/or health status predicts mortality in these groups. Methods: Data were collected in 2007 from the population-based OLIN COPD study. Subjects participated in lung function tests and structured interviews, and 434 subjects with and 655 subjects without COPD were identified. Fatigue was assessed by FACIT-Fatigue and health status by the generic SF-36 questionnaire including physical (PCS) and mental (MCS) components. Mortality data until February 2012 were collected. Results: Fatigue greatly impacts the physical and mental dimensions of health status, both among subjects with and without COPD. Among subjects with clinically significant fatigue, COPD subjects had significantly lower PCS-scores compared to non-COPD subjects. Fairly strong correlations were found between FACIT-F, SF-36 PCS and MCS, respectively. In multivariate models adjusting for covariates, increased fatigue, decreased physical and mental dimensions of health status were all associated to mortality in subjects with COPD (OR 1.06, CI 1.02–1.10, OR 1.04, CI 1.01–1.08 and OR 1.06, CI 1.02–1.10), but not in non-COPD. Conclusions: Fatigue and decreased health status were closely related among subjects with and without COPD. Not only physical health status, but also fatigue and mental health predicted mortality among subjects with COPD. Fatigue assessed by FACIT-F, can be a useful instrument of prognostic value in the care of subjects with COPD.
Non-pancreatic periampullary adenocarcinomas: an explanation for favorable prognosis.

BACKGROUND/AIMS Our previous studies demonstrate that patients with non-pancreatic periampullary adenocarcinomas have a favorable prognosis relative to those with pancreatic adenocarcinoma. This study investigates histopathologic factors that contribute to the superior outcome of these patients. METHODOLOGY A retrospective review of all patients explored for periampullary neoplasms at a single institution over a 20-year period. RESULTS 291 patients with periampullary neoplasms underwent exploratory laparotomy, of which 185 had resectable tumors. Periampullary adenocarcinomas were resected in 120: pancreatic head (n=74), distal common bile duct (n=10), duodenum (n=5), and ampulla of Vater (n=31). The resection rate for non-pancreatic adenocarcinomas was 90%, while that of pancreatic cancers was 44% (p<0.01). Median survival for resected non-pancreatic adenocarcinomas was 38.8 months; that of pancreatic tumors was 15.3 months (p<0.01). Non-pancreatic adenocarcinomas were significantly smaller (p<0.001), better differentiated (p<0.001), and less likely to have involved nodes (p<0.001), margins (p<0.001), perineural invasion (p<0.001), or vascular invasion (p<0.2) than pancreatic adenocarcinomas. CONCLUSIONS Histopathologic features of non-pancreatic periampullary adenocarcinomas significantly differentiate them from pancreatic adenocarcinoma and contribute to their relatively favorable long-term outcome following resection.
A multicentre, double-blind, placebo-controlled trial of quinapril in mild, chronic heart failure.

Angiotensin converting enzyme (ACE) inhibitors are of proven value in patients with severe chronic heart failure (CHF). Studies of the effects of ACE inhibitors on exercise capacity and quality of life in mild CHF have produced conflicting results. We have studied the effects of quinapril, a new ACE inhibitor with a relatively short plasma half-life, in mild CHF. Once daily (o.d.) dosing was compared with twice daily (b.i.d.) dosing in a three-way cross-over, double-blind, placebo-controlled trial. Thirty-two patients (two female), mean age 59 (range 32-76) years were enrolled in three cardiology centres in the U.K. in 29 patients, and non-ischaemic in three. The mean (range) radionuclide ejection fraction was 20.4% (8%-47%). Following full familiarization with the protocol, the treadmill exercise time (modified Bruce protocol) was determined for each patient during a placebo run-in phase, and at the end of each of three 8-week double-blind treatment phases with quinapril o.d. , quinapril b.i. d. (maximal total daily dose 20 mg) and placebo. Three patients were withdrawn due to adverse events while receiving quinapril (unstable angina, exacerbation of CHF and arrhythmia); there were no deaths and no patient was withdrawn due to hypotension. Mean exercise time (the primary end-point) was 65 s and 53 s longer in patients receiving quinapril o.d. and b.i. d. respectively compared to placebo (both P < 0.01, ANOVA). There was no significant period effect during the trial and no significant difference between the two quinapril dosing regimens. Quinapril had no significant effect on secondary end-points including ejection fraction, functional class and quality of life. (ABSTRACT TRUNCATED AT 250 WORDS)
Simulation of Expansion of Thermal Shock and Pressure Waves Inducaed by a Streamer Dynamics in Positive DC Corona Discharges

This paper is devoted to the simulation of the thermal shock and the induced pressure-waves expansion, generated by a dc pin-to-plan corona discharge in the air at ambient temperatures and under atmospheric pressure. The positive dc voltage applied to the tip generates a monofilamentary streamer that crosses the gap from the tip toward the plan. The simulation models are based on the coupling of a 2-D dynamics streamer model with the hydrodynamics conservation equations of a compressible gas. The source term for the gas dynamics equations takes into account the fast-energy relaxation from excited molecules to the random thermal energy. The simulation shows that the streamers generate a thermal shock near the anodic tip, which induces high pressure gradients and finally the gas expansion. The thermal shock is located just in front of the anodic tip, where the injected energy density is the highest. After 0.3 μs, the mean gas temperature increases up to around 800 K in a small volume just in front of the anodic tip while the maximum temperature reaches 1200 K. In addition, two pressure waves, a spherical and a cylindrical one, are induced with a propagation velocity of 370 m s-1 i.e., close to the speed of sound in air.
Incidence and risk factors of retinopathy of prematurity in a tertiary care newborn unit in New Delhi.

BACKGROUND Retinopathy of prematurity (RoP) has become more common in developed countries with an improvement in survival of very premature infants. Though previously rare, it is likely to emerge as a major problem in India because of improving outcome of 'at-risk' preterm infants. METHODS In a prospective study we estimated the incidence of RoP among at-risk neonates in a tertiary care unit. Infants with birth-weights of < 1500 g, gestation < 35 weeks and preterm neonates who required supplemental oxygen for > 24 hours were subjected to periodic ophthalmological evaluation for detection of RoP until full retinal vascularization occurred. RESULTS Sixty-six eligible infants completed the full protocol during the 15-month study period. The incidence of RoP was 20% in the cohort and 27% among the very low birth-weight neonates. The incidence of threshold RoP was 7% in the cohort. The occurrence of RoP was inversely related to the gestation and birth-weight. RoP typically developed at the post-conceptional age of 32-35 weeks. Blood transfusion and clinical sepsis emerged as independent risk factors of RoP on step-wise logistic regression analysis. Cryotherapy undertaken in 5 cases (9 eyes) led to amelioration of the changes of RoP. CONCLUSION The incidence of RoP in our neonates was lower than that reported from other centres. Blood transfusion and clinical sepsis are risk factors for RoP in our newborn infants.
EFFECT OF ENDURANCE TRAINING ON HYPOTHALAMIC SEROTONIN CONCENTRATION AND PERFORMANCE

1 Serotonin is a neurotransmitter that modulates several functions, such as food intake, energy expenditure, motor activity, mood and sleep. Acute exhaustive endurance exercise increases the synthesis, concentration and metabolism of serotonin in the brain. This phenomenon could be responsible for central fatigue after prolonged and exhaustive exercise. However, the effect of chronic exhaustive training on serotonin is not known. The present study was conducted to examine the effect of exhaustive endurance training on performance and serotonin concentrations in the hypothalamus of trained rats. 2 Rats were divided into three groups: sedentary rats (SED), moderately trained rats (MOD) and exhaustively trained rats (EXT), with an increase of 200% in the load carried during the final week of training. 3 Hypothalamic serotonin concentrations were similar between the SED and MOD groups, but were higher in the EXT group (P < 0.05). Performance was lower in the EXT group compared with the MOD group (P < 0.05). 4 Thus, the present study demonstrates that exhaustive training increases serotonin concentrations in the hypothalamus, together with decreased endurance performance after inadequate recovery time. However, the mechanism underlying these changes remains unknown.
Behavioral Characteristics of Applied General Equilibrium Models with Variable Elasticity of Substitution between Varieties from Different Sources

This study explores the behavioral characteristics of the Melitz-type heterogeneous and the Krugman-type homogeneous firm models that endogenize substitution elasticity as an increasing function of the total number of varieties that are available in each destination country/region. Using a case the United States (US) liberalizes imports of manufactured products from China as an example, simulation experiments with a three-region, three-sector applied general equilibrium model of global trade revealed that economic agents comply with more inefficient circumstances when the importer's preference for variety intensifies. Whereas, a more efficient environment enables countries, including those excluded from a free trade agreement, to receive welfare gains when the influence of the total number of varieties to the substitution elasticity becomes strong.
The plasma levels of the endocannabinoid, anandamide, increase with the induction of labour

Please cite this paper as: Nallendran V, Lam P, Marczylo T, Bankart M, Taylor A, Taylor D, Konje J. The plasma levels of the endocannabinoid, anandamide, increase with the induction of labour. BJOG 2010;117:863–869.
Implantable Cardiac Defibrillator Pocket Infection Due to a Previously Undescribed Cupriavidus Species

ABSTRACT The genus Cupriavidus consists of Gram-negative, nonfermenting bacteria most of which are environmental organisms, though some species have been associated with human disease. We report the recovery and identification of an isolate that represents a previously undescribed species of Cupriavidus from an implantable cardiac defibrillator pocket infection.
EAONO/JOS Joint Consensus Statements on the Definitions, Classification and Staging of Middle Ear Cholesteatoma.

The European Academy of Otology and Neurotology (EAONO) has previously published a consensus document on the definitions and classification of cholesteatoma. It was based on the Delphi consensus methodology involving the broad EAONO membership. At the same time, the Japanese Otological Society (JOS) had been working independently on the "Classification and Staging of Cholesteatoma. " EAONO and JOS then decided to collaborate and produce a joint consensus document. The EAONO/JOS joint consensus on "Definitions, Classification and Staging of Middle Ear Cholesteatoma" was formally presented at the 10th International Conference on Cholesteatoma and Ear Surgery in Edinburgh, June 5-8, 2016. The international otology community who attended the consensus session was given the chance to debate and give their support or disapproval. The statements on the "Definitions of Cholesteatoma" received 89% approval. The "Classification of Cholesteatoma" received almost universal approval (98%). The "EAONO/JOS Staging System on Middle Ear Cholesteatoma" had a majority of approval (75%). Some international otologists wanted to see more prognostic factors being incorporated in the staging system. In response to this, the EAONO/JOS steering group plans to set up an "International Otology Outcome Working Group" to work on a minimum common otology data set that the international otology community can use to evaluate their surgical outcome. This will generate a large database and help identify relevant prognostic factors that can be incorporated into the staging system in future revisions.
Excitatory Amino Acid‐Induced Toxicity in Chick Retina: Amino Acid Release, Histology, and Effects of Chloride Channel Blockers

Abstract: Acute excitotoxicity in embryonic chick retina and the ability of C1− channel blockers to prevent toxicity were evaluated by measurement of endogenous amino acid release and histology. Treatment of retina with kainate, quisqualate, or N‐methyl‐D‐aspartate resulted in a large dose‐dependent release of γ‐aminobutyric acid and taurine, moderate release of glutamine and alanine, and no measurable release of glu‐tamate or aspartate. Concentrations inducing maximal γ‐aminobutyric acid release were 50 μM quisqualate, 100 μM kainate, and 100 μM N‐methyl‐D‐aspartate. Treatment with 1 mM glutamate resulted in significant γ‐aminobutyric acid release, as well as an elevation in medium aspartate levels. Typical excitotoxic retinal lesions were produced by the agonists and, at the lower concentrations tested, revealed a regional sensitivity. There was a positive correlation between the amount of γ‐aminobutyric acid release and the extent of tissue swelling, suggesting that release may be secondary to toxic cellular events. Omission of C1− completely blocked cytotoxic effects due to kainate or glutamate. Likewise, addition of the C1−/bicarbonate anion channel blocker 4,4′‐di‐isothiocyanatostilbene‐2,2′‐disulfonate at 600 μM protected retina from cytotoxic damage from all excitotoxic analogs and restored amino acid levels to baseline values. Furosemide. which blocks Na+/K+/2C1− cotransport, was only minimally effective in reducing amino acid release induced by the agonists. Consistent with the latter, histological examination showed the continued presence of the lesion but with general reduction of cellular edema. These results indicate that although influx of C1− is a central component of the acute excitotoxic phenomenon, mechanisms other than passive Cl−flux may be involved.
Why Do Drivers Use Mobile Phones While Driving? The Contribution of Compensatory Beliefs

The current study is the first to investigate the contribution of compensatory beliefs (i.e., the belief that the negative effects of an unsafe behavior can be "neutralized" by engaging in another safe behavior; e.g., "I can use a mobile phone now because I will slow down ") on drivers’ mobile phone use while driving. The effects of drivers’ personal characteristics on compensatory beliefs, mobile phone use and self-regulatory behaviors were also examined. A series of questions were administered to drivers, which included (1) personal measures, (2) scales that measured compensatory beliefs generally in substance use and with regard to driving safety, and (3) questions to measure drivers’ previous primary mobile phone usage and corresponding self-regulatory actions. Overall, drivers reported a low likelihood of compensatory beliefs, prior mobile phone use, and a strong frequency of self-regulatory behaviors. Respondents who had a higher tendency toward compensatory beliefs reported more incidents or crash involvement caused by making or answering calls and sending or reading messages. The findings provide strong support for the contribution of compensatory beliefs in predicting mobile phone usage in the context of driving. Compensatory beliefs can explain 41% and 43% of the variance in the active activities of making calls and texting/sending messages compared with 18% and 31% of the variance in the passive activities of answering calls and reading messages. Among the regression models for predicting self-regulatory behaviors at the tactical or operational level, compensatory beliefs emerge as significant predictors only in predicting shorter conversations while on a call. The findings and limitations of the current study are discussed.
Regional and global connectivity disturbances in focal epilepsy, related neurocognitive sequelae, and potential mechanistic underpinnings

Epilepsy is among the most common brain network disorders, and it is associated with substantial morbidity and increased mortality. Although focal epilepsy was traditionally considered a regional brain disorder, growing evidence has demonstrated widespread network alterations in this disorder that extend beyond the epileptogenic zone from which seizures originate. The goal of this review is to summarize recent investigations examining functional and structural connectivity alterations in focal epilepsy, including neuroimaging and electrophysiologic studies utilizing model‐based or data‐driven analytic methods. A significant subset of studies in both mesial temporal lobe epilepsy and focal neocortical epilepsy have demonstrated patterns of increased connectivity related to the epileptogenic zone, coupled with decreased connectivity in widespread distal networks. Connectivity patterns appear to be related to the duration and severity of disease, suggesting progressive connectivity reorganization in the setting of recurrent seizures over time. Global resting‐state connectivity disturbances in focal epilepsy have been linked to neurocognitive problems, including memory and language disturbances. Although it is possible that increased connectivity in a particular brain region may enhance the propensity for seizure generation, it is not clear if global reductions in connectivity represent the damaging consequences of recurrent seizures, or an adaptive mechanism to prevent seizure propagation away from the epileptogenic zone. Overall, studying the connectome in focal epilepsy is a critical endeavor that may lead to improved strategies for epileptogenic‐zone localization, surgical outcome prediction, and a better understanding of the neuropsychological implications of recurrent seizures.