Miracle-dz/UniFAR-FTUs huggingface dataset:
Seizure Adequacy Markers and the Prediction of Electroconvulsive Therapy Response

Objectives Electroconvulsive therapy (ECT) is the most effective therapy for patients with treatment-resistant depression; however, some patients do not respond or relapse in a short time. Electroconvulsive therapy stimulus parameters may be related to the outcome. We carried out a retrospective study review to investigate various ECT parameters in relation to the outcome, clinical variables, and pharmacological treatments. Our aim was to understand which factors could be considered putative seizure quality markers and which are relevant to clinical practice. Methods Two physicians evaluated the seizure length, the postictal suppression index, the wave amplitude, tachycardia, and hemispheric brain wave synchronicity in a double-blind manner for 45 treatment-resistant depression patients receiving ECT. Results The analysis showed a significant association between the outcome and the ECT seizure quality measured by the parameters (P = 9.9 × 10−5). Among patients with poor-quality seizures, 61.5% relapsed after approximately 1 month from the last ECT session. Particularly, there was an association between higher symptomatology decrease and higher quality of hemispheric brain wave synchronicity (P = 5.0 × 10−6), as well as a higher wave amplitude (P = 0.01). Conclusions Our results confirm that ECT seizure quality was strongly correlated with the decrease of depressive symptomatology.
Engagement, peer production, and the learning healthcare system.

Physicians deliver about half of indicated care, and patients do about half of what it takes to stay healthy, despite the best intentions and tireless efforts of both physicians and patients. The learning healthcare system (LHS) has been proposed as a solution. As envisioned by the Institute of Medicine, an LHS would “generate and apply the best evidence for the collaborative health-care choices of each patient and provider, drive the process of discovery as a natural outgrowth of patient care, and ensure innovation, quality, safety, and value in healthcare. ”1(p354) But this model begs the question: Who is learning? And how? Traditional models suppose that highly trained experts—expert clinicians and expert researchers—are best suited for producing information, knowledge, and know-how. This reliance, however, on a small group of experts to improve health care and health outcomes has yielded the current system performance and impedes immediate, continuous, and trans-formative improvement. A new model of production is necessary.
Critical thresholds and tangible targets for ecosystem-based management of coral reef fisheries

Sustainably managing ecosystems is challenging, especially for complex systems such as coral reefs. This study develops critical reference points for sustainable management by using a large empirical dataset on the coral reefs of the western Indian Ocean to investigate associations between levels of target fish biomass (as an indicator of fishing intensity) and eight metrics of ecosystem state. These eight ecological metrics each exhibited specific thresholds along a continuum of fishable biomass ranging from heavily fished sites to old fisheries closures. Three thresholds lay above and five below a hypothesized window of fishable biomass expected to produce a maximum multispecies sustainable yield (BMMSY). Evaluating three management systems in nine countries, we found that unregulated fisheries often operate below the BMMSY, whereas fisheries closures and, less frequently, gear-restricted fisheries were within or above this window. These findings provide tangible management targets for multispecies coral reef fisheries and highlight key tradeoffs required to achieve different fisheries and conservation goals.
Haemorrhagic transformation in acute ischaemic stroke following thrombolysis therapy: classification, pathogenesis and risk factors

Haemorrhagic transformation of cerebral infarction is a common and potentially serious occurrence following acute ischaemic stroke. Though often a “natural” evolution, particularly in acute embolic stroke, haemorrhagic transformation is a prime concern with the use of thrombolytic therapy for acute ischaemic stroke. The severity of haemorrhage may range from a few petechiae to a large haematoma with space occupying effect. The pathogenesis of haemorrhagic transformation is not well established, though ischaemia and reperfusion have been proposed to cause disruption of the blood–brain barrier leading to extravasation of blood. At the molecular level, free radicals and proteolotic enzymes (metalloproteinases) may cause tissue injury. Studies have identified a number of clinical, radiological, and biochemical parameters that may serve as potential predictors of increased risk for haemorrhagic transformation. The knowledge of these factors may help in improving patient selection for thrombolytic therapy.
The mortality and pathology of HIV infection in a West African city

Background:HIV disease is epidemic in Africa, but associated mortality, underlying pathology and CD4+ T-lymphocyte counts have not previously been evaluated in a representative study. Such data help to determine the management of HIV-positive people. Both HIV-1 and HIV-2 infections are prevalent in Côte d'lvoire, and the pathology of HIV-2 infection in Africa is unclear. Methods: Consecutive adult medical admissions to a large city hospital in Côte d'lvoire were studied in 1991, and a sample of HIV-positive deaths autopsied. Results: Of 5401 patients evaluated, 50% were HIV-positive; 38% of these died, with a median survival of 1 week. At autopsy (n=294, including 24% of HIV-positive deaths in hospital), tuberculosis (TB), bacteraemia (predominantly Gram-negative rods) and cerebral toxoplasmosis caused 53% of deaths. TB was seen in 54% of cadavers with AIDS-defining pathology and Pneumocystis pneumonia in 4%. The median CD4+ T-lymphocyte counts in those who died was <90×106/l. Compared with HIV-1-positives, patients with HIV-2-positivity had a greater frequency of severe cytomegalovirus infection, HIV encephalitis and cholangitis. Conclusions: In this population, HIV-positive adults present to hospital with advanced disease associated with high mortality. The three major underlying pathologies (TB, toxoplasmosis and bacteraemia) are either preventable or treatable. TB is an underestimated cause of the 'slim' syndrome in Africa. The patterns of pathology in HIV-2-positive patients suggest a more prolonged terminal course compared with HIV-1. There is an urgent need for attention towards the issues of therapy and care for HIV disease in developing countries. AIDS 1993, 7:1569–1579
Effects of Gravity on Sheared and Nonsheared Turbulent Nonpremixed Flames

The present numerical study is concerned with the fundamental physics of the multiway interaction between turbulence, chemical reaction, and buoyancy in a nonpremixed flame. The method of direct numerical simulation (DNS) is used to solve the instantaneous, three-dimensional governing equations. Because of the present supercomputer limitations, we consider two simple flow geometries, namely an initially uniform flow without shear (equivalent to grid-generated turbulence) and an initially uniform shear flow. In each flow, the fuel and oxidant initially exist as two separate streams. As the reactants mix, chemical reaction takes place and exothermic energy is released causing variations in density. In the presence of a gravity field, the spatial and temporal distributions of the induced buoyancy forces depend on the local density gradients and the direction of the gravitational acceleration. The effects of buoyancy include the generation of local shear, baroclinic production or destruction of vorticity, and countergradient heat and mass transport. Increased vorticity and small-scale turbulence promote further mixing and reaction. However, if the strain-rates become too high, local flame extinction can occur. Our objective is to gain an understanding of the complex interactions between the physical phenomena involved, with particular attention to the effects of buoyancy on the turbulence structure, flame behavior, and factors influencing flame extinction.
Small pulmonary nodules: evaluation with repeat CT--preliminary experience.

PURPOSE To assess the use of early repeat computed tomography (CT) of solitary pulmonary nodules to determine nodule growth. MATERIALS AND METHODS The authors performed repeat CT of nodule phantoms to assess the accuracy of their measurement technique. They then used this technique to assess nodule growth (nine malignant, six benign) in 15 patients (nine men, six women; age range, 60-79 years; average age, 66 years) who underwent repeat CT as part of their routine clinical protocol. The final diagnosis was established with surgical resection or follow-up for more than 2 years after an indeterminate biopsy. RESULTS Results of phantom experiments revealed that the method used to determine area change is sensitive enough to help detect nodule growth if one pixel is added around the entire circumference of a nodule. With use of standard exponential growth curves and known tumor growth rates, malignant growth could be detected in vivo within 30 days. All 15 in vivo nodules were correctly classified with early repeat CT. CONCLUSION Preliminary experience with early repeat CT suggests that a single repeat CT scan obtained 30 days after the first scan can depict growth in most malignant tumors as small as 5 mm.
Homozygous TRPV1 315C Influences the Susceptibility to Functional Dyspepsia

Objectives Capsaicin/vanilloid (transient receptor potential vanilloid 1, (TRPV1) receptor has been shown to be expressed in gastrointestinal tract and play a role as a member of sensory ion channel superfamily. The G315C polymorphism affects the TRPV1 gene and alters its protein level. We aimed to investigate the effect of TRPV1 G315C polymorphism on functional dyspepsia (FD) in a Japanese population. Methods TRPV1 G315C polymorphism was genotyped in 98 subjects with no upper abdominal symptoms and 109 patients with FD. Severity of 7 upper gastrointestinal symptoms was assessed during cold water, and cold carbonated water drinking for randomly selected 20 healthy subjects. Results We found a significant inverse association between TRPV1 315CC genotype and FD [CC vs. others; odds ratio (OR)=0.40, 95% confidence interval (CI)=0.38-0.82]. We also found that the same genotype held a lower risk of both epigastric pain syndrome (OR=0.25, 95% CI=0.09-0.73), postprandial syndrome (OR=0.27, 95% CI=0.07-0.96) according to Rome III, and Helicobacter pylori positive FD (OR=0.28, 95% CI=0.10-0.79). The evolution of symptom severity scale of 7 total symptoms (P=0.004), and heavy feeling in stomach (P=0.02) during cold carbonated water drinking were significantly lower among 315CC genotypes compared with others. Conclusions Homozygous TRPV1 315C influences the susceptibility to FD through altering the upper gastrointestinal sensation.
LTE for Railways: Impact on Performance of ETCS Railway Signaling

The Global System for Mobile Communications-Railways (GSM-R) is an obsolete mobile technology with considerable shortcomings in terms of capacity and data transmission capabilities. Because of these shortcomings, GSM-R is becoming the element limiting the number of running trains in areas with high train concentration, such as major train stations. Moreover, GSM-R cannot support advanced data services. Hence, modern technologies, such as long-term evolution (LTE), have to be evaluated as possible railway communication technologies to replace GSM-R in the future. This article analyzes the characteristics of the LTE railway radio access network in terms of eNodeB (LTE base station) density and eNodeB transmission power. Based on this analysis, a set of computer-based simulation scenarios (e.g., OPNET) with varying numbers of eNodeBs is evaluated regarding the achieved transfer delay and data integrity of European Train Control System (ETCS) messages.
Projection from low‐threshold muscle afferents of hand and forearm to area 3a of baboon's cortex

1. The precentral and postcentral banks of the Rolandic fissure of the arm area of the baboon's cortex have been probed to their depths with extracellular micro‐electrodes under nitrous oxide and oxygen anaesthesia, supplemented by minimal intravenous pentobarbitone or chloralose.
Rate Constants for the Gas-Phase Reactions of the OH Radical with Dichlorobiphenyls, 1-Chlorodibenzo-p-dioxin, 1,2-Dimethoxybenzene, and Diphenyl Ether: Estimation of OH Radical Reaction Rate Constants for PCBs, PCDDs, and PCDFs.

Rate constants for the gas-phase reactions of 2,2'-, 3,3'-, and 3,5-dichlorobiphenyl, 1-chlorodibenzo-p-dioxin, 1,2-dimethoxybenzene, and diphenyl ether with the OH radical have been determined at 297 ± 2 K and atmospheric pressure of air using a relative rate method. The rate constants forthe OH reactions were (in cm 3 molecule -1 s -1 units) as follows : 2.0 x 10 -12 for 2,2'-dichlorobiphenyl ; 4.1 x 10 -12 for 3,3'-dichlorobiphenyl ; 4.2 x 10 -12 for 3,5-dichlorobiphenyl ; 4.7 x 10 -12 for 1-chlorodibenzo-p-dioxin ; 3.5 x 10 -11 for 1,2-dimethoxybenzene ; and 9.6 x 10 -12 for diphenyl ether. The reactions of NO 3 radicals and O 3 with 1-chlorodibenzo-p-dioxin and 2,2'-dichlorobiphenyl were also investigated, and upper limits to the rate constants for the reactions of O 3 with 1-chloro-dibenzo-p-dioxin and 2,2'-dichlorobiphenyl of <7 x 10 -20 cm 3 molecule -1 s -1 and <2 x 10 -20 cm 3 molecule -1 s -1 , respectively, were obtained. The reaction mechanism of the NO 3 radical with 1-chlorodibenzo-p-dioxin is discussed ; no reaction with 2,2'-dichlorobiphenyl was observed. The kinetic data for the OH radical reactions, together with those previously obtained for the reactions of the OH radical with dibenzo-p-dioxin, dibenzofuran, biphenyl, and the monochlorobiphenyls, were used to revise a previous method for calculating the OH radical reaction rate constants and, hence, atmospheric lifetimes for the PCBs, PCDDs, and PCDFs.
Bacterial diversity of symptomatic primary endodontic infection by clonal analysis.

The aim of this study was to explore the bacterial diversity of 10 root canals with acute apical abscess using clonal analysis. Samples were collected from 10 patients and submitted to bacterial DNA isolation, 16S rRNA gene amplification, cloning, and sequencing. A bacterial genomic library was constructed and bacterial diversity was estimated. The mean number of taxa per canal was 15, ranging from 11 to 21. A total of 689 clones were analyzed and 76 phylotypes identified, of which 47 (61.84%) were different species and 29 (38.15%) were taxa reported as yet-uncultivable or as yet-uncharacterized species. Prevotella spp. , Fusobacterium nucleatum, Filifactor alocis, and Peptostreptococcus stomatis were the most frequently detected species, followed by Dialister invisus, Phocaeicola abscessus, the uncharacterized Lachnospiraceae oral clone, Porphyromonas spp. , and Parvimonas micra. Eight phyla were detected and the most frequently identified taxa belonged to the phylum Firmicutes (43.5%), followed by Bacteroidetes (22.5%) and Proteobacteria (13.2%). No species was detected in all studied samples and some species were identified in only one case. It was concluded that acute primary endodontic infection is characterized by wide bacterial diversity and a high intersubject variability was observed. Anaerobic Gram-negative bacteria belonging to the phylum Firmicutes, followed by Bacteroidetes, were the most frequently detected microorganisms.
Bacterial recovery using sonication versus swabbing of titanium and stainless steel implants inoculated with Staphylococcus pseudintermedius or Pseudomonas aeruginosa

Summary Objective: To evaluate the use of sonication to improve recovery of bacteria from metal discs infected with bacteria commonly associated with implant infections in veterinary medicine. Methods: In vitro study in which sterile titanium (Ti6Al4V) and stainless steel (AIS1316-L) discs were incubated with either Staphylococcus pseudintermedius or Pseudomonas aeruginosa for 24 hours. The following three groups were compared: 1) the sonication group involved immersing the discs in sterile saline and sonicating for five minutes; 2) the sham group was considered a negative control in which the discs were immersed in saline for five minutes without sonication; and 3) the swab group involved systematically swabbing the implant with a sterile culturette. All samples were plated on blood agar and incubated for 24 hours. Colonies were then counted and compared. Results: For both species of bacteria, there was a significant increase in bacterial colonies isolated using sonication compared to the other two study groups (p = 0.0001). No differences in bacterial growth were found between the two types of metal implants. There was a significant increase in bacterial colony counts for S. pseudintermedius when comparing the swab group versus the sham group, but this was not significant for P. aeruginosa. Clinical significance: Sonication significantly improves recovery of bacteria commonly associated with veterinary implant-associated surgical site infections compared to swabbing of implants in vitro. A prospective clinical evaluation is indicated to determine the in vivo efficacy of sonication in veterinary patients.
Experimental Dipetalonema reconditum infections in dogs.

Dipetalonema reconditum is a filarid nematode residing subcutaneously in dogs, and is transmitted by fleas. Previous studies on experimental infections are limited to those by Pennington (1972, Diss. Abst. 33B: 772-B) and Farnell and Faulkner (1978, J. Parasit. 64: 565567). Thus the purposes of our study were: 1) to determine whether dogs could be infected experimentally with D. reconditum by subcutaneous and transmucosal inoculation; 2) to determine whether cats and jirds were susceptible to D. reconditum following subcutaneous inoculation; and 3) to compare microfilaremias during the course of infection in dogs inoculated subcutaneously or transmucosally. A stray dog with a naturally acquired infection was the original source of D. reconditum. Microfilariae were identified by morphological features (Redington, B. C., et al., 1978. In Proceedings of the heartworm symposium '77, G. F. Otto (ed.). Veterinary Medicine Publishing Co., Bonner Springs, Kansas, pp. 14-21) and acid phosphatase activity (Chalifoux and Hunt, 1971, J. Am. Vet. Med. Assoc. 158: 601-605). Ctenocephalides felis pupae were purchased from Environmental Consultants, Inc., Norfolk, Virginia, and reared to adulthood (Smith and Eddy, 1954, Bull. Wld. Hlth. Org. 10: 127-137). Adult fleas were placed on the infected dog and rem ved 10 to 14 days later. Procedures for harvesting infective nematode larvae were similar to those described for Brugia pahangi by McCall (1981, J. Georgia Entomol. Soc. 16: 283-293). In the first experiment, 11 microfilaria-free dogs were inoculated (Table I). Transmucosal and transcutaneous inoculations were performed by placing infective nematode larvae on the vestibular mucosa and shaved skin, respectively, of anesthetized dogs. In addition, two cats and six Mongolian jirds were inoculated subcutaneously with 22 to 25 larvae per animal. In the second experiment, six microfilaria-free Beagles were inoculated subcutaneously and four were inoculated transmucosally with 30 larvae per animal. Modified Knott tests were performed weekly for 28 wk PI. The degree of microfilaremia was com-
Heterogeneity of deprivation within very small areas

Area based measures of deprivation are used for resource allocation and research. In both these uses there is continuing debate about the likely proportion of deprived people who would be missed if area based indices were used for interventions or targeting resources.1–4 This report uses the same source deprivation variables at area and individual levels to quantify the degree of deprivation heterogeneity within very small areas using data from the New Zealand 1996 census. Area deprivation is characterised by the NZDep96 index of deprivation for small areas. The small areas were constructed from one, or several neighbouring, “meshblocks” and 91.5% contained between 100 and 200 people. The small areas were designed to minimise local heterogeneity while yielding a robust measure of deprivation in the neighbourhood. NZDep96 is derived from age/sex standardised proportions of people in the small area with each of nine characteristics related to deprivation: having no access to a telephone; aged 18–59 receiving a means tested benefit; aged …
Abnormal forearm vascular responses during dynamic leg exercise in patients with vasovagal syncope.

BACKGROUND We have reported previously that in some patients with normal hearts who present with exercise syncope, abnormal forearm vasodilation is seen during leg exercise and tilt table tests are positive. This suggests that exercise syncope may be a variant of vasovagal syncope. In this study we tested the hypothesis that there is loss of the normal forearm vasoconstrictor response during dynamic leg exercise in an unselected population of patients with classic vasovagal syncope. METHODS AND RESULTS We evaluated forearm vascular responses during maximal semierect cycle exercise in 28 consecutive patients with vasovagal syncope and compared them with 30 age-matched control subjects. We also evaluated blood pressure responses during erect treadmill exercise (Bruce protocol). While forearm vascular resistance at rest was similar in the patients with vasovagal syncope and the control group, forearm vascular resistance was markedly lower in the patients than in control subjects at peak exercise (85 +/- 54 versus 149 +/- 94 units, P = .002). Forearm vascular resistance fell by 3 +/- 48% during exercise in patients versus an increase of 135 +/- 103% in control subjects (P < .0001). Systolic blood pressure during erect exercise was lower in patients versus control subjects (155 +/- 32 versus 188 +/- 17 mm Hg, P < .0001). Six of the vasovagal patients complained of exercise syncope or presyncope on specific inquiry, and 4 of these 6 exhibited exercise hypotension during erect treadmill exercise testing. CONCLUSIONS Patients with vasovagal syncope exhibit a failure of the normal vasoconstrictor response in the forearm during dynamic leg exercise. Exercise syncope and presyncope are not uncommon in unselected patients with classic vasovagal syncope, as is exercise hypotension.
Diagnosis of Mycoplasma pneumoniaeInfection in Autopsy and Open-Lung Biopsy Tissues by Nested PCR

ABSTRACT A nested PCR specific for the Mycoplasma pneumoniae P1 gene was used to diagnose mycoplasma infection in two cohort patients with severe pneumonia within 24 h of tissue receipt. A postmortem diagnosis of M. pneumoniae infection was obtained for the first patient, who died without the collection of appropriate paired samples for serodiagnosis. An open-lung biopsy obtained from the second patient allowed a quick, definitive diagnosis and proper selection of therapy.