Miracle-dz/UniFAR-FTUs huggingface dataset:
Serial Prehospital 12-Lead Electrocardiograms Increase Identification of ST-segment Elevation Myocardial Infarction

Abstract Background. Many prehospital protocols require acquisition of a single 12-lead electrocardiogram (ECG) when assessing a patient for ST-segment elevation myocardial infarction (STEMI). However, it is known that ECG evidence of STEMI can evolve over time. Objectives. To determine how often the first and, if necessary, second or third prehospital ECGs identified STEMI, and the time intervals associated with acquiring these ECGs and arrival at the emergency department (ED). Methods. We retrospectively analyzed 325 consecutive prehospital STEMIs identified between June 2008 and May 2009 in a large third-service emergency medical services (EMS) system. If the first ECG did not identify STEMI, protocol required a second ECG just before transport and, if necessary, a third ECG before entering the receiving ED. Paramedics who identified STEMI at any time bypassed participating local EDs, taking patients directly to the percutaneous coronary intervention (PCI) center. Paramedics used computerized ECG interpretation with STEMI diagnosis defined as an “acute MI” report by GE/Marquette 12-SL software in ZOLL E-series defibrillator/cardiac monitors (ZOLL Medical, Chelmsford, MA). We recorded the time of each ECG, and the ordinal number of the diagnostic ECG. We then determined the number of cases and frequency of STEMI diagnosis on the first, second, or third ECG. We also measured the interval between ECGs and the interval from the initial positive ECG to arrival at the ED. Results. STEMI was identified on the first prehospital ECG in 275 cases, on the second ECG in 30 cases, and on the third ECG in 20 cases (cumulative percentages of 84.6%, 93.8%, and 100%, respectively). For STEMIs identified on the second or third ECG, 90% were identified within 25 minutes after the first ECG. The median times from identification of STEMI to arrival at the ED were 17.5 minutes, 11.0 minutes, and 0.7 minutes for STEMIs identified on the first, second, and third ECGs, respectively. Conclusions. A single prehospital ECG would have identified only 84.6% of STEMI patients. This suggests caution using a single prehospital ECG to rule out STEMI. Three serial ECGs acquired over 25 minutes is feasible and may be valuable in maximizing prehospital diagnostic yield, particularly where emergent access to PCI exists. Key words: prehospital emergency care; myocardial infarction; ECG; STEMI
Caveolin-1 interacts and cooperates with the transforming growth factor-beta type I receptor ALK1 in endothelial caveolae.

AIMS Activin receptor-like kinase (ALK)1 is a transforming growth factor (TGF)-beta type I membrane receptor restricted almost entirely to endothelial cells (ECs) and involved in vascular remodelling and angiogenesis. Previous reports have shown that the ubiquitous TGF-beta type I receptor ALK5 and the type II receptor are located in cholesterol-rich membrane microdomains named caveolae. The aim of this work was to assess the location of ALK1 in endothelial caveolae as well as to study the role of caveolin-1 on the TGF-beta/ALK1 signalling pathway. METHODS AND RESULTS The subcellular distribution of ALK1 was analysed by confocal microscopy and co-fractionation experiments in human ECs. The association between human ALK1 and caveolin-1 was studied in caveolin-1-deficient human epithelial cells by co-immunoprecipitation. The functional role of caveolin-1 on the ALK1-mediated TGF-beta signalling was elucidated using ALK1-specific luciferase reporters in human ECs, caveolin-1(-/-)mouse embryonic fibroblasts, and rat myoblasts. Confocal microscopy analyses, as well as cholesterol depletion experiments in the presence of cholesterol-depleting agents such as nystatin or methyl-beta-cyclodextrin, demonstrated that ALK1 is located in endothelial caveolae. Also, co-immunoprecipitation assays showed that ALK1 associates with the main caveolae component caveolin-1. Mapping of the ALK1/caveolin-1 interaction revealed that the caveolin-1 scaffolding domain and the caveolin-1 binding motif in ALK1 are responsible for this association. Moreover, this hitherto not reported interaction had a functional consequence for the ALK1-dependent signalling. In contrast with the previously published ALK5/caveolin-1 interaction, caveolin-1 enhances the TGF-beta/ALK1 signalling pathway, promoting the activity of the ALK1-specific reporters. Conversely, specific suppression of caveolin-1 abrogated the ALK1 signalling pathway. CONCLUSION ALK1 is located in endothelial caveolae where it functionally interacts with caveolin-1 through its scaffolding domain, suggesting a joint contribution of ALK1 and caveolin-1 as key mediators of the TGF-beta pathway in angiogenesis.
Role of IL-10 in the abnormalities of early cell activation events of lymphocytes from patients with systemic lupus erythematosus.

Lymphocytes from patients with systemic lupus erythematosus (SLE) exhibit abnormalities in early cell activation events as well as increased production of IL-10. We explored the possible role of IL-10 on defective cell activation events of SLE lymphocytes and first studied the in vitro effect of IL-10 on peripheral blood mononuclear cells (PBMNC) from healthy subjects. After 5 days of culture in the presence of exogenous IL-10, these cells demonstrated abnormal expression of CD69 as well as high intracellular pH and defective activation of the Na+/H+ anti-porter by PMA. We then investigated the effect of IL-10 blockade on PBMNC from SLE patients. SLE PBMNC cultured for 5 days with a blocking anti-IL-10 monoclonal antibody (mAb) partially corrected abnormalities in CD69 expression and intracellular pH; however, in 1/5 patients studied, no significant positive effect was observed. The effect of the anti-IL-10 mAb was apparently not related to protection against activation-induced cell death. We conclude that IL-10 in normal PBMNC induce some of the defects in early cell activation events seen in SLE lymphocytes. Accordingly, the blockade of IL-10 partially corrects these abnormalities in SLE cells. Our data further support the importance of IL-10 in immune dysfunction seen in SLE.
Coli surface antigens 1 and 3 of colonization factor antigen II-positive enterotoxigenic Escherichia coli: morphology, purification, and immune responses in humans

Enterotoxigenic Escherichia coli (ETEC) of serotype O6:H16, biotype A, bearing colonization factor antigen II (CFA/II) possesses two distinct coli surface antigens, CS1 and CS3, whereas CFA/II-positive ETEC of serotype O8:H9 manifests only CS3. CS1 has been shown to be fimbrial in nature, but heretofore the morphology of CS3 has not been described. Accordingly, by immune electron microscopy we investigated the morphological characteristics of CS3 on bacterial cells and after purification. CS3 was found to consist of thin (2-nm), flexible, wiry, "fibrillar" fimbriae, visible both on bacteria (O6:H16, biotype A, and O8:H9 strains) and in the pure state. In contrast, CS1 exists as wider (6-nm), rigid fimbriae on the surface of O6:H16, biotype A, strains. By the use of antisera to CS1 and CS3 in immune electron microscopy, immunodiffusion in gel, and immunoblotting techniques, CS1 and CS3 were found to be immunologically as well as morphologically distinct. Six of nine volunteers who developed diarrhea after challenge with an O139:H28 ETEC strain bearing CS1 and CS3 had significant serological rises to purified CS1 and CS3 antigens, suggesting that both antigens are elaborated in vivo, play a role in pathogenesis, and stimulate an immune response.
[Accelerated versus conventional hospital stay in total hip and knee arthroplasty III: patient satisfaction].

INTRODUCTION The goal of this study was to evaluate patient satisfaction with the hospital stay in relation to the length of stay for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA). MATERIALS AND METHODS According to the National Register on Patients, the three departments with the shortest and the three departments with the longest postoperative hospital stay at the end of 2003 were chosen for evaluation. The patients, operated on with THA or TKA from September 2004 to April 2005, from the selected departments answered a questionnaire regarding satisfaction with elected parts of their stay, co-morbidity, sex and age. RESULTS The patients from the departments with the shortest stay were not younger nor had they less co-morbidities than patients from departments with longer stays. Apart from staying a significantly shorter time, they were either as satisfied--or sometimes more satisfied--with all parts of their stay compared to patients from the departments with longer hospital stay. CONCLUSION Patients in accelerated stays are not less satisfied with their hospital stay (or any part of it) compared to patients with longer and more conventional hospital stays. These results support the implementation of fast-track total hip- and knee arthroplasty.
Improved Identification of Allodynic Migraine Patients Using a Questionnaire

Using quantitative sensory testing (QST), we found that many migraineurs seeking secondary and tertiary care exhibit cutaneous allodynia whenever they undergo a migraine attack, but not interictally (i.e. between attacks). When such patients were questionned interictally in the clinic about symptoms of skin sensitivity in past attacks, 76% of them were 'correctly' classified either as allodynic (≥1 symptom) or non-allodynic (zero symptoms) in line with the QST analysis. In this study, patients were classified as allodynic if they documented any one symptom of allodynia during an actual migraine attack which they had already cited in an earlier interictal interview. Of a total of 151 patients, 77% were classified as allodynic, citing on average four symptoms of skin hypersensitivity, three of which were consistently cited in the interictal interview and again during an attack. Among the remaining 23% of patients who were classified as non-allodynic, half cited zero symptoms as expected, while the other half cited between one and five symptoms, each of which was cited either interictally or during an attack, but not in both. Further analysis showed that 97% of patients citing two or more symptoms during an attack consisted of the patients labelled as allodynic, and that 75% of those citing just one symptom during an attack consisted of patients labelled as non-allodynic. Short of QST analysis, the results suggest that about 90% of all patients can be identified as allodynic or non-allodynic depending on whether or not they (i) consistently cited the same item(s) both interictally and during an attack or, alternatively, (ii) cited two or more symptoms during an attack.
Fracture care of friend and foe during World War I

Background: In the early years of trench warfare, compound lower limb fractures caused by gunshot missiles prompted the questioning of traditional splintage techniques and established evacuation methods. These prejudiced recovery and delayed surgery, often by many days, causing a high mortality rate especially for open femoral fractures. Importantly, battle weaponry was modified by differences in climate and terrain in Mesopotamia, Gallipoli, the Alps and the Northern European plain, to manifest differences in wound pathology. In Flanders, the static situation limited simple bullet wounds and launched a high percentage of jagged shell fragment injuries complicated by tissue destruction, in‐driven clothing and metal contaminated with mud, lethal bacteria and spores. From no‐mans‐land, soldiers with arm fractures scrambled back unaided, with tibial fractures they might hobble between two comrades, but with femoral fractures they were helpless unless stretcher bearers arrived. Often they did not, or only after a lull in fighting, by which time death from blood loss or exposure supervened. Even on a stretcher, poor fracture immobilization and long arduous carries added to shock and mortality. Remedies to these deficiencies and observations by Australasian, Austrian, British, Canadian, French, German, South African and American surgeons are noted.
Vascular abnormalities in the placenta of Chst14−/− fetuses: implications in the pathophysiology of perinatal lethality of the murine model and vascular lesions in human CHST14/D4ST1 deficiency

Collagen is one of the most important components of the extracellular matrix that is involved in the strength of tissues, cell adhesion and cell proliferation. Mutations in several collagen and post-translational modification enzyme genes cause Ehlers-Danlos syndrome (EDS) characterized by joint and skin hyperextensibility as well as fragility of various organs. Carbohydrate sulfotransferase 14/dermatan 4-O-sulfotransferase-1 (CHST14/D4ST1) is a critical enzyme for biosynthesis of dermatan sulfate, a side chain of various proteoglycans including biglycan that regulates collagen fibrils through their interaction. Mutations in CHST14 were found to cause a new form of EDS, named musculocontractural type EDS (mcEDS-CHST14). Large subcutaneous hematomas are one of the most serious complications accompanied by decreased quality of life and potential lethality. In this study, Chst14 gene-deleted mice were expected to be an animal model of the vascular abnormalities of mcEDS-CHST14. However, only limited numbers of adult mice were generated because of perinatal lethality in most Chst14 gene-deleted homozygote (Chst14-/-) mice. Therefore, we investigated the placentas of these fetuses. The placentas of Chst14-/- fetuses showed a reduced weight, alterations in the vascular structure, and ischemic and/or necrotic-like changes. Electron microscopy demonstrated an abnormal structure of the basement membrane of capillaries in the placental villus. These findings suggest that Chst14 is essential for placental vascular development and perinatal survival of fetuses. Furthermore, placentas of Chst14-/- fetuses could be a useful model for vascular manifestations in mcEDS-CHST14, such as the large subcutaneous hematomas.
The role of adjunctive Rodogyl therapy in the treatment of advanced periodontal disease. A longitudinal clinical and microbiologic study.

Several studies have indicated that the combination of metronidazole and spiramycin is synergistic against anaerobic bacteria and may be effective against oral infections. The present study sought to determine the efficacy and safety of a commercial preparation of these two antibiotics (Rodogyl) when used adjunctively in the treatment of advanced periodontal disease. In a double-blind parallel randomized trial, 56 patients (mean age = 44 years) with advanced periodontitis (50 of whom completed the study) were assigned to either the Rodogyl or placebo group. Both groups were thoroughly scaled and root planned for approximately 6 hours, with one group receiving Rodogyl for 2 weeks and the other a placebo. No other therapy was received during the study period. Two sites in each patient with probing depths of at least 7 mm were selected for study. Plaque level (P1I), gingival inflammation (GI), probing depth (PD), and attachment level (AL) were measured at baseline, 14 days, 1 month, and then at monthly intervals up to 6 months. Subgingival bacteria were monitored with dark-field microscopy. The development of resistant bacteria, as well as side effects to the medications, was also monitored. The Rodogyl group exhibited a greater gain in AL (0.67 mm) from the 2-month interval until the end of the study. Although this difference was statistically significant (P less than 0.05), it was not necessarily of biologic significance. There was a significantly greater decline in the proportion of spirochetes in the Rodogyl group at the 14-day interval, and this difference remained significant (P less than 0.05) at all study intervals. No difference in the proportion of motile organisms was observed. (ABSTRACT TRUNCATED AT 250 WORDS)
Predictors of voluntary medical male circumcision prevalence among men aged 25-39 years in Nyanza region, Kenya: Results from the baseline survey of the TASCO study

Introduction Uptake of voluntary medical male circumcision (VMMC) as an intervention for prevention of HIV acquisition has been low among men aged ≥25 years in Nyanza region, western Kenya. We conducted a baseline survey of the prevalence and predictors of VMMC among men ages 25–39 years as part of the preparations for a cluster randomized controlled trial (cRCT) called the Target, Speed and Coverage (TASCO) Study. The TASCO Study aimed to assess the impact of two demand creation interventions—interpersonal communication (IPC) and dedicated service outlets (DSO), delivered separately and together (IPC + DSO)—on VMMC uptake. Methods As part of the preparatory work for implementation of the cRCT to evaluate tailored interventions to improve uptake of VMMC, we conducted a survey of men aged 25–39 years from a traditionally non-circumcising Kenyan ethnic community within non-contiguous locations selected as study sites. We determined their circumcision status, estimated the baseline circumcision prevalence and assessed predictors of being circumcised using univariate and multivariate logistic regression. Results A total of 5,639 men were enrolled of which 2,851 (50.6%) reported being circumcised. The odds of being circumcised were greater for men with secondary education (adjusted Odds Ratio (aOR) = 1.65; 95% CI: 1.45–1.86, p<0.001), post-secondary education (aOR = 1.72; 95% CI: 1.44–2.06, p <0.001), and those employed (aOR = 1.32; 95% CI: 1.18–1.47, p <0.001). However, the odds were lower for men with a history of being married (currently married, divorced, separated, or widowed). Conclusion Among adult men in the rural Nyanza region of Kenya, men with post-primary education and employed were more likely to be circumcised. VMMC programs should focus on specific sub-groups of men, including those aged 25–39 years who are married, divorced/separated/ widowed, and of low socio-economic status (low education and unemployed).
A novel molecule ‘shati’ increases dopamine uptake via the induction of tumor necrosis factor‐α in pheochromocytoma‐12 cells

The psychostimulant properties of methamphetamine (METH) are associated with an increase in extracellular dopamine (DA) levels in the brain, via facilitation of DA’s release from pre‐synaptic nerve terminals and inhibition of its reuptake through DA transporter. Recently, we have demonstrated that tumor necrosis factor‐α (TNF‐α) increases DA uptake and inhibits METH dependence. Moreover, we have clarified ‘shati’ identified in the nucleus accumbens of mice treated with METH is involved in METH dependence. In the present study, we investigated the effects of TNF‐α on DA uptake in PC12 cells and established a PC12 cell line transfected with a vector containing shati cDNA to examine the precise mechanism behind the role of shati in DA uptake. Moreover, we examined the relationship between shati and TNF‐α. TNF‐α increased DA uptake via the mitogen‐activated protein kinase kinase pathway and inhibited the METH‐induced decrease in DA uptake in PC12 cells. Transfection of the vector containing shati cDNA into PC12 cells, induced the expression of shati and TNF‐α mRNA, accelerated DA uptake, and inhibited the METH‐induced decrease in DA uptake. These results suggest that the functional roles of shati in METH‐regulated behavioral changes are mediated through inhibition of the METH‐induced decrease in DA uptake via TNF‐α.
Onset of intractability and its course over time: The Dutch study of epilepsy in childhood

Purpose: Intractability in epilepsy is difficult to define, and little is known about its onset, course, and duration. We investigated these aspects (as well as the occurrence of intractability) during long‐term follow‐up in patients with epilepsy, focusing on possible explanations for the variation in time of onset and duration of intractability.
INTRAVENOUS THROMBOLYSIS WITH RT-PA OF DIFFERENT ETIOLOGIC STROKE: A TER- TIARY HOSPITAL DATABASE STUDY OVER THREE YEARS

Aim: To investigate the differences in thrombolytic response among various stroke subtypes and related influencing factors. Materials and methods: Clinical data of 64 AIS patients who received intravenous thrombolysis were collected. Results: Males, current/former smokers and patients with alcohol consumption history had relatively better prognosis after thrombolysis. Patients in the cardiogenic embolism and Large-artery atherosclerosis subtype groups had poorer prognosis. Logistic Regression Multivariate Analysis on the prognosis of thrombolysis among various stroke subtypes showed better prognosis in CE group than those in the other four subtype groups. The data obtained in the present study only demonstrated no statistically signifi- cant differences in thrombolytic effectiveness among various subtype groups. Conclusion: It was unnecessary to spend too much time on subtype classification of stroke within the time window of emer- gency thrombolytic therapy. Early thrombolysis would grant more benefit for the patients suspected of presenting cardiogenic stroke.
Interleukin-6 and Mycoplasma hominis as markers of preterm birth and related brain damage: Our experience

Objective. The aim of this study is to investigate whether a high concentration of interleukin-6 (IL)-6 in the amniotic fluid is associated to a higher risk of preterm delivery, premature rupture of the membranes (PROM), and periventricular leucomalacia (PVL) in preterm infants; we have further investigated whether the levels of IL-6 are related to the presence of vaginal infection by mycoplasms. Methods. One hundred eight patients were screened by vaginal swab, sonography, amniocentesis, and dosage of IL-6 in the amniotic fluid during the second trimester of pregnancy. Results. High levels of IL-6 and vaginal mycoplasms are related to preterm birth and PROM. We had no case of PLV. Conclusion. In order to achieve a good therapeutic purpose and get to an efficient strategy, the patients have to be elected by a number of criteria, which may include anamnesis elements, vaginal swab, then cytokines dosage in selected women, thus excluding the low-risk cases. Further studies are expected in order to plan guidelines including the dosage of ILs and principally of IL-6 as a main marker of preterm birth, above all during the second trimester.
Forecasting Volatility with Price Limit Hits—Evidence from Chinese Stock Market

ABSTRACT In this article, we discuss whether price limit hits (PLH) contain information for volatility forecasting. Using Chinese stock market as sample, we find that PLH display significant forecasting power for future volatilities. Furthermore, the predictive effects on volatility are asymmetric between upper price limit hits (UPLH) and lower price limit hits (LPLH), with more pronounced effect for LPLH. These results are robust after controlling for jump, leverage effect, and volume in HAR-RV models, and they hold in crisis sub-sample and other measures of PLH. Finally, we provide a possible explanation for the predictive ability of PLH and suggest that the number of PLH can be used as a proxy for investor sentiment.