Miracle-dz/UniFAR-FTUs huggingface dataset:
Radiofrequency Catheter Ablation of Left Atrial Tachycardia Originating Within the Pulmonary Vein in a Patient with Dextrocardia

A case is presented of a 38‐year‐old male with dextrocardia in whom radiofrequency current ablation of an incessant atrial tachycardia originating within the infero‐lateral pulmonary vein was achieved. Activation mapping with detection of the earliest atrial activation was used for identification of the arrhythmogenic focus. In addition to fluoroscopy, trans‐ esophageal echocardiography was used for catheter guidance during the transseptal puncture. The present experience suggests that location of an arrhythmogenic focus within the pulmonary venous system should be considered whenever early atrial activation during ectopic atrial tachycardia is recorded at the junction between thfi left atrium and the pulmonary veins.
Jejunal Diverticulosis: A Rare Entity with Multiple Presentations, a Series of Cases

Background/Aims: Jejunal diverticulosis (JD) is a rare disease that has a variable presentation. The signs, symptoms, diagnosis, complications and treatment of JD will be discussed through a review of the literature and a series of cases from our own institution. Methods: A retrospective analysis of the diagnosis, treatment and complications of JD was performed by a literature review. This was accompanied by a series of four cases of JD diagnosed and treated in our own institution. Conclusions: JD is a rare disease in which most patients are asymptomatic. However, JD’s different complications are serious and can be fatal. The treatment is mainly surgical; however, there have been cases where nonsurgical management was successful.
Cost-Effectiveness of Mobile App-Guided Training in Extended Focused Assessment with Sonography for Trauma (eFAST): A Randomized Trial

Abstract Purpose Ultrasound training is associated with a long learning curve and use of substantial faculty resources. Self-directed ultrasound training may decrease the need for faculty-led teaching. Mobile apps seem promising for use in self-directed ultrasound training, but no studies have examined the cost-effectiveness of mobile app-guided training versus traditional formats such as textbook-guided training. This study evaluated the cost-effectiveness of mobile app-guided versus textbook-guided ultrasound training. Material and methods First-year residents (n = 38) with no previous ultrasound experience were randomized into mobile app-guided versus textbook-guided self-directed ultrasound training groups. Participants completed a transfer test involving four patient cases and a theoretical test on diagnostic accuracy. Two ultrasound experts assessed the residents’ performance using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. The costs of developing mobile app and textbook material were calculated and used for the analysis of cost-effectiveness. Results 34 participants completed the transfer test. There was no statistically significant difference in test performance or diagnostic accuracy between the mobile app-guided (mean-OSAUS 42.3 % [95 %CI38.5 – 46.0 %]) and textbook-guided groups (mean-OSAUS 45.3 % [95 %CI39.3 – 51.3 %]) (d.f. [1.33] = 0.45, p = 0.41). However, development costs differed greatly for each instructional format. Textbook-guided training was significantly more cost-effective than mobile app-guided training (Incremental Cost Effectiveness Ratio -861 967 [95 %CI-1071.7 to-3.2] USD/pct. point change in OSAUS score). Conclusion Mobile app-guided ultrasound training is less cost-effective than textbook-guided self-directed training. This study underlines the need for careful evaluation of cost-effectiveness when introducing technological innovations for clinical skills training.
Neonatal interleukin‐12 capacity is associated with variations in allergen‐specific immune responses in the neonatal and postnatal periods

Background and objectives A reduced capacity of antigen presenting cells (APC) to provide pro‐T helper 1 (Th1) signals, such as IL‐12, to T cells during early life may be implicated in the development of T helper 2 (Th2)‐mediated allergic disease. In this study we examined the relationships between the capacity for IL‐12 responses in the neonatal period and atopic risk (family allergy), in vitro T cell responses to allergens, and the subsequent development of allergic disease at 6 years
Within colony dynamics of Nosema bombi infections: disease establishment, epidemiology and potential vertical transmission

Successful growth and transmission is a prerequisite for a parasite to maintain itself in its host population. Nosema bombi is a ubiquitous and damaging parasite of bumble bees, but little is known about its transmission and epidemiology within bumble bee colonies. The impact of host demography and colony life-cycle on the transmission and reproduction of N. bombi were examined in Bombus lucorum colonies. Parasite success was highest when infecting colonies where larval exposure to the parasite was high. The later individual bees were born in the colony life-cycle, the higher their infection intensity, but after eclosion individual parasite loads did not increase, indicating either host control of the parasite, a balance between internal infection and the production of transmission stages, or a switch in the parasite’s growth strategy after eclosion to the production of transmission stages. Finally, trans-ovarial vertical transmission of N. bombi was suggested using molecular probes.ZusammenfassungZum Verständnis der Bedeutung eines Parasiten ist es wichtig, die Dynamik seiner Übertragung im Wirt zu kennen. Das Mikrosporidium Nosema bombi parasitiert Hummeln und führt nicht nur zur Behinderung einzelner Tiere, sondern kann den Fortpflanzungserfolg ganzer Hummelvölker beeinflussen. Wir untersuchten die Übertragung dieses Parasiten in Laborvölkern von Bombus lucorum, indem wir Kolonien kontrolliert inokulierten und im Anschuss daran untersuchten, wieviele Einzeltiere infiziert waren und in welchem Ausmass sich diese Infektionen auf den Lebenszyklus der Kolonie auswirkten. Mittels molekularer Methoden untersuchten wir ausserdem, ob es zu einer vertikalen Übertragung des Parasiten vom Ei auf die Nachkommen kam. Parasiteninfektionen waren am erfolgreichsten, wenn eine grosse Zahl an Bienenlarven in Kontakt mit dem Parasiten kamen. Ausserdem nahm die Intensität der Infektionen im Verlauf des Lebenszyklus der Kolonien zu. Die Parasitenbelastung einzelner Tiere stieg jedoch nach dem Schlüpfen nicht weiter an. Mittels molekularer Methoden konnten wir zeigen, dass N. bombi Sporen bereits in Eiern zu finden sind, die von Arbeiterinnen abgelegt worden waren. Dies deutet darauf hin, dass der Parasit von einer Generation auf die nächste vertikal übertragen werden kann, ohne dass eine orale Infektion erforderlich ist. Unsere Ergebnisse tragen damit signifikant zum Verständnis dieses wichtigen Hummelparasiten bei.
The effect of advance care planning on completion of advance directives and patient satisfaction in people with HIV/AIDS

The effects of advance care planning are poorly understood. The purpose of this study was to evaluate the effect of an advance care planning intervention on the completion of advance directives (ADs) and patient satisfaction. A volunteer sample of persons with HIV/AIDS received advance directive documents, watched an educational video and received individual counselling on completing an advance directive during three face-to-face interviews over approximately six months. The advance care planning intervention was associated with an increase in advance directive completion rates from 16.4% to 40.7% (p = 0.001), but 23.1% of advance directives reported as completed were legally invalid. There was a trend towards decreased overall patient satisfaction with health care (p = 0.07). Advance are planning increases the rate of AD completion but many 'completed' advance directives are legally invalid. Advance care planning did not improve patient satisfaction with health care.
Effects of enzyme inducers and inhibitors on the pharmacokinetics of intravenous DA‐8159, a new erectogenic, in rats

In order to find what types of hepatic microsomal cytochrome P450 (CYP) isozymes are involved in the metabolism of DA‐8159 and in the formation of DA‐8164 in rats, enzyme inducers, such as dexamethasone, phenobarbital, 3‐methylcholanthrene and isoniazid, and enzyme inhibitors, such as troleandomycin and quinine, were pretreated in rats. After a 1 min intravenous administration of DA‐8159 at a dose of 30 mg/kg to rats pretreated with dexamethasone (a main inducer of CYP3A1/2 in rats), the total areas under the plasma concentration‐time curve from time zero to time infinity (AUC) values of DA‐8159 (283 versus 349 µg min/ml) and DA‐8164 (98.0 versus 79.8 µg min/ml) were significantly smaller and greater, respectively, than those in control rats. However, the AUC values of DA‐8159 were not significantly different after pretreatment with phenobarbital, isoniazid and 3‐methylcholanthrene (main inducers of CYP2B1/2, 2E1 and 1A1/2, respectively, in rats). In rats pretreated with troleandomycin (a main inhibitor of CYP3A1/2 in rats), the AUC values of DA‐8159 (435 versus 370 µg min/ml) and DA‐8164 (34.8 versus 76.5 µg min/ml) were significantly greater and smaller, respectively. However, in rats pretreated with quinine (a main inhibitor of CYP2D1 in rats), the AUC of DA‐8159 was comparable to that in control rats. The above data indicate that DA‐8159 was metabolized and DA‐8164 was formed mainly via CYP3A1/2 in rats. Copyright © 2005 John Wiley & Sons, Ltd.
Folate pathway gene alterations in patients with neural tube defects.

Periconceptional folate supplementation reduces the recurrence and occurrence risk of neural tube defects (NTD) by as much as 70%, yet the protective mechanism remains unknown. Inborn errors of folate and homocysteine metabolism may be involved in the aetiology of NTDs. Previous studies have demonstrated that both homozygosity for the C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene, and combined heterozygosity for the C677T and for another mutation in the same gene, the A1298C polymorphism, represent genetic risk factors for NTDs. In an attempt to identify additional folate related genes that contribute to NTD pathogenesis, we performed molecular genetic analysis of folate receptors (FRs). We identified 4 unrelated patients out of 50 with de novo insertions of pseudogene (PS)-specific mutations in exon 7 and 3'UTR of the FRalpha gene, arising by microconversion events. All of the substitutions affect the carboxy-terminal amino acid membrane tail, or the GPI anchor region of the nascent protein. Furthermore, among 150 control individuals, we also identified one infant with a gene conversion event within the FRalpha coding region. This study, though preliminary, provides the first genetic association between molecular variations of the FRalpha gene and NTDs and suggests that this gene can act as a risk factor for human NTD.
Sero-prevalence of Rubella Virus Antibodies in Pregnant Women in the Vicinity of Lucknow, Uttar Pradesh

Background and objectives: The acute infection caused by rubella virus during pregnancy sometimes leads to adverse fetal outcomes including congenital rubella syndrome. Data on prevalence of rubella among pregnant women is inadequate from India. Therefore, the present cross-sectional study was conducted to determine the seroprevalence of rubella among pregnant women in Lucknow region of North India. Methods: Pregnant women visiting antenatal clinics were examined for the presence of anti-rubella virus IgG antibodies using commercially available ELISA kits. Results: Of the total 152 pregnant women enrolled in the study, 134 (88.2%) women were positive for anti-rubella virus IgG antibodies. The difference in seropositivity and geometric mean titers of anti-rubella virus IgG antibodies among different age groups of pregnant women was not statistically significant (p-value: 0.35 and 0.83 respectively). No relationship was observed between parity and anti-rubella virus IgG positivity (p-value: 0.23).
ORIENTATION WITH STYLE Matching Teaching/Learning Style

Satisfaction with orientation and the link to overall job satisfaction are important because of the cost of providing new employees with orientation. Matching the teaching style of preceptors with the learning style of orientees is one way to maximize satisfaction. In this article, the author reports the results of a study conducted to determine whether there was a difference in an orientee's perceived satisfaction with orientation, based on whether the teaching style of the preceptor and the learning style of the orientee were matched or not matched. Personality type identified by the Meyers-Briggs Type Indicator (1962) was used as a measurement of teaching/learning style. The study also evaluated which of the four dimensions of personality type had the strongest relationship between matching or not matching and satisfaction. Those orientees who matched their primary preceptors on the personality preferences of introversion or extroversion reported statistically significant higher levels of satisfaction than those who did not match. Matching/not matching of the introversion/extroversion preference also showed the strongest correlation to overall satisfaction. An exploratory analysis revealed aspects of orientation having the strongest relationship to overall satisfaction. These included creativity, original thinking, experimentation, sensitivity, and flexibility.
The Clinical Usefulness of the Platelet Aggregation Test for the Diagnosis of Heparin-Induced Thrombocytopenia

Summary The platelet aggregation test is widely used for the diagnosis of heparin-induced thrombocytopenia (HIT), a potentially serious complication of heparin therapy. We have evaluated its sensitivity and specificity in comparison with those of the 14C-serotonin release test. The sensitivity of the platelet aggregation test was found to vary with the heparin concentration and the donor of the platelets used in the test. The optimal heparin concentrations were between 0.1 and 1.0 U/ml. Using these heparin concentrations, the mean sensitivity varied from 39% (with the least reactive platelets) to 81% (with the most reactive platelets). In comparison, the sensitivity of the release test ranged from 65% to 94%. The specificities of the platelet aggregation test were 82%, 90% and 100% for the following control groups: (1) non-thrombocytopenic patients given heparin, (2) patients with thrombocytopenia due to other causes, and (3) normal controls not given heparin, respectively. The corresponding specificities for the release test was 94%, 90% and 100%. The specificities can be further increased to 100% for all controls with the adoption of a two-point system which defines a positive result as one in which platelet aggregation occurs with a low heparin concentration (0.5 U/ml) but not with 100 U heparin/ml. For optimal results, a two-point platelet aggregation test should be performed with heparin concentrations of 0.5 and 100 U/ml and using platelets of more reactive donors.
Initial and Continued Knowledge Contribution on Enterprise Social Media Platforms

In recent years, social media has entered enterprises as a tool for internal communication, collaboration, and knowledge management. However, it has been reported that knowledge contribution rates are low which raises questions on the reasons for it and how to improve the situation. To address these questions, we take a deep look into the individual knowledge contribution process using an integrative model that explains the initial formation of the intention to contribute knowledge and the continued knowledge contribution. Towards this goal, we apply the theory of reasoned action, the social exchange theory, and the belief-adjustment model. In this research in progress, we present our research model and a test covering the first part of the model: the formation of the intention to contribute knowledge. The results suggest that social exchange theory and theory of reasoned action are well suited to explain this phenomenon and that they build a good basis for the second part of the longitudinal study.
Typing of coagulase‐negative staphylococci from peritonitis in CAPD‐patients by the PhP‐CS system and REA

Coagulase‐negative staphylococci (CNS) were the most common bacteria causing peritonitis in patients treated with continuous ambulatory peritoneal dialysis (CAPD). In order to investigate if the same clone was responsible for the peritonitis in the different patients and if the exit site was the source of infection we followed 68 patients on CAPD for 2 years. During this period 9 patients had 12 episodes of peritonitis caused by CNS. Cultures were taken from exit site and peritoneal fluid in all patients at peritonitis and during the first study year at monthly intervals. In each culture up to 10 isolates of CNS were randomly collected and frozen. All 437 CNS isolates from the patients with CNS peritonitis were typed using a biochemical typing method and 41 isolates identical by this method were further discriminated by a DNA fingerprinting method. Identical strains were in no case isolated from different patients, indicating that no virulent strain was spread between the patients. The isolates causing the peritonitis were never found at the exit sites before the first day of the peritonitis in any patient. In only two patients was the same strain found at the exit site and in the peritoneal fluid on the first day of peritonitis. It thus seems that no virulent clone of CNS was infecting the patients and we found no evidence of CNS at the exit site causing the peritonitis.
Imaging findings in Takayasu's arteritis.

OBJECTIVE The objective of our study was to evaluate the clinical usefulness of cross-sectional imaging for establishing the diagnosis of Takayasu's arteritis (TA), an inflammatory vascular disorder that produces arterial stenoses and aneurysms primarily involving the thoracoabdominal aorta and its branches and the pulmonary arteries. CONCLUSION CT and MRI findings of TA include vascular wall thickening and enhancement early in the disease, and arterial stenoses, occlusions, and aneurysms later in the disease. Cross-sectional imaging is useful for establishing the diagnosis of TA and for showing response to nonsurgical therapy or for planning a surgical intervention.
Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy.

BACKGROUND Diabetic nephropathy is the leading cause of end-stage renal disease. Interruption of the renin-angiotensin system slows the progression of renal disease in patients with type 1 diabetes, but similar data are not available for patients with type 2, the most common form of diabetes. We assessed the role of the angiotensin-II-receptor antagonist losartan in patients with type 2 diabetes and nephropathy. METHODS A total of 1513 patients were enrolled in this randomized, double-blind study comparing losartan (50 to 100 mg once daily) with placebo, both taken in addition to conventional antihypertensive treatment (calcium-channel antagonists, diuretics, alpha-blockers, beta-blockers, and centrally acting agents), for a mean of 3.4 years. The primary outcome was the composite of a doubling of the base-line serum creatinine concentration, end-stage renal disease, or death. Secondary end points included a composite of morbidity and mortality from cardiovascular causes, proteinuria, and the rate of progression of renal disease. RESULTS A total of 327 patients in the losartan group reached the primary end point, as compared with 359 in the placebo group (risk reduction, 16 percent; P=0.02). Losartan reduced the incidence of a doubling of the serum creatinine concentration (risk reduction, 25 percent; P=0.006) and end-stage renal disease (risk reduction, 28 percent; P=0.002) but had no effect on the rate of death. The benefit exceeded that attributable to changes in blood pressure. The composite of morbidity and mortality from cardiovascular causes was similar in the two groups, although the rate of first hospitalization for heart failure was significantly lower with losartan (risk reduction, 32 percent; P=0.005). The level of proteinuria declined by 35 percent with losartan (P<0.001 for the comparison with placebo). CONCLUSIONS Losartan conferred significant renal benefits in patients with type 2 diabetes and nephropathy, and it was generally well tolerated.
Flanker effects on motor output and the late-level response activation hypothesis

When participants must respond to a relevant central target and ignore irrelevant flanking stimuli, the flankers produce a flanker compatibility effect on behavioural measures. Current accounts of the flanker compatibility effect assume that both target and flanker stimuli affect response activation. This idea is supported by electrophysiological studies, which show that irrelevant flanker stimuli can affect the motor system. The present experiments examined the characteristics of flanker effects on the motor system by analysing the details of the motor output with response force measures. A total of 60 participants responded in the flanker task to arrows (Experiment 1) or letters (Experiment 2). Reaction time as well as response force increased on incompatible trials. Analyses of the distribution of incorrect activation revealed that both response times and correct motor output increased with the amount of incorrect activity. However, the flanker compatibility effect was only marginally modulated by incorrect activity. Results suggest that the largest part of the flanker compatibility effect cannot be attributed to response activation and competition at late levels of the response system.
Reductions in Bone Mass, Structure, and Strength in Axial and Appendicular Skeletons Associated With Increased Turnover After Ovariectomy in Mature Cynomolgus Monkeys and Preventive Effects of Clodronate

Over 16 months, we evaluated the effects of ovariectomy (OVX) and bisphosphonate clodronate (CLO) on bone in 48 cynomolgus monkeys (9‐15 years old) fed a normal calcium diet. We established three OVX groups(oral CLO at 0 [OVX control], 12, or 60 mg/kg per day) and one sham‐operated (SHAM) group. At 16 months, the bone mineral density (BMD) values (percentage of group baseline; OVX control vs. SHAM) for lumbar bone (L3‐L5), proximal femur, midfemur, radius, and tibia were −2.6% versus 11.2%, −3.5% versus 8.9%, −3.0% versus 9.0%, −5.5% versus 15.7%, and −6.7% versus 13.9%, respectively. In OVX control (i) tibia showed significant loss of bone mineral content (BMC; vs. baseline), (ii) urinary deoxypyridinoline (DPD) and serum osteocalcin (OC) levels increased (peak = 182% and 168%, respectively, of SHAM), (iii) in lumbar bone and midfemur, ultimate load (UL) was reduced (vs. SHAM), (iv) in lumbar bone, trabecular bone‐formation rates (BFRs) were not changed significantly, but tibial endocortical and intracortical bone formation rates were significantly raised (vs. SHAM), (v) the volumetric BMD (vBMD) and geometry of the tibial cortex (measured by peripheral quantitative computed tomography [pQCT]) were significantly reduced (vs. SHAM). CLO, 60 mg/kg per day but not 12 mg/kg per day, significantly inhibited OVX‐induced changes, age‐dependent increases in bone mass, and ability to maintain structure. Thus, in OVX mature cynomolgus monkeys (possibly, a unique model of the cortical bone loss secondary to estrogen deficiency), the post‐OVX increases in systemic bone markers were slight, but stimulation of local turnover in the cortical envelope was enough to cause bone loss (more so in tibia than in lumbar trabecular bone). High‐dose CLO prevented these changes.