Miracle-dz/UniFAR-FTUs huggingface dataset:
Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome.

OBJECTIVES Despite considerable progress in intensive care management of the acute respiratory distress syndrome (ARDS), little is known about health-related quality of life in long-term survivors. In addition, intensive care treatment can be extremely stressful, and many survivors of ARDS report adverse experiences such as respiratory distress, anxiety, or pain during intensive care unit (ICU) treatment. This study was performed to assess health-related quality of life in survivors of ARDS and to test the hypothesis that adverse experiences during ICU treatment result in posttraumatic stress disorder (PTSD) and negative effects on health-related quality of life. DESIGN Retrospective, cohort, case-controlled analyses. SETTING A 12-bed multidisciplinary ICU of a tertiary care university hospital, capable of providing extracorporeal life support for adults with severe ARDS. PATIENTS We studied 80 patients who were admitted to our hospital from 1985 to 1995 and who survived an episode of ARDS. ARDS was defined according to the criteria of the American-European Consensus Conference on ARDS. INTERVENTIONS Health-related quality of life was measured using the Health Status Questionnaire of the self-administered Medical Outcomes Study Short Form Survey that consists of 36 questions (SF-36) and the German version of the Post Traumatic Stress Syndrome 10-Questions Inventory (PTSS-10), a self-report scale for the diagnosis of posttraumatic stress disorder based on the Diagnostic and Statistical Manual (Third Edition) criteria (American Psychiatric Association). The number of adverse experiences (anxiety, respiratory distress, pain, and nightmares) during intensive care was evaluated by means of a structured questionnaire. For each patient with ARDS, three age- and gender-comparable controls were randomly selected from databases providing normal values for the SF-36 and PTSS-10 scores in populations at risk for posttraumatic stress disorder. MEASUREMENTS AND MAIN RESULTS Survivors of ARDS showed statistically significant impairments in all eight health dimensions of the SF-36 when compared with normal controls (median reduction 21.3%, p < .006) with maximal impairments in physical function (median reduction 28.9%, p = .000) and a 38% higher frequency of chronic pain (p = .0001). Three of 34 patients reporting none, or one, adverse experience had evidence of posttraumatic stress disorder vs. 19 of 46 patients remembering multiple traumatic episodes (p = .007). Patients reporting multiple adverse experiences described the lowest health-related quality of life, with maximal impairments in psychosocial functioning (p < .005) and only small limitations in physical function. CONCLUSIONS Long-term survivors of ARDS describe a good overall health-related quality of life. Major impairments in mental health domains of health-related quality of life are associated with the development of posttraumatic stress disorder and are a possible result of traumatic experiences during ICU therapy.
Ultrasound imaging of the pelvic floor: changes in anatomy during and after first pregnancy

To describe changes in the absolute values of levator hiatal dimensions and in the contractility and distensibility of the levator hiatus during pelvic floor contraction and Valsalva maneuver, using three/four‐dimensional (3D/4D) transperineal ultrasound in women during and after their first pregnancy.
Heart failure--definition and diagnosis.

Correspondence: Dr VK Bahl, Professor of Cardiology, All India Institute of Medical Sciences, New Delhi 110029. e-mail: vkbahl2002@yahoo.com The concept of heart failure (HF) has evolved considerably with time. Terms such as forward or backward, left or right-sided, high or low output, systolic or diastolic HF and more recently, HF with or without systolic dysfunction have been used to characterize HF by clinicians. Every physician recognizes the signs and symptoms of HF, yet HF is frequently underor overdiagnosed. The diagnostic difficulties are greater in the community settings, in the elderly, in the obese and in patients with other comorbidities. Diagnosing HF in advanced congested stage is not difficult. However, a combination of hepatomegaly, elevated jugular venous pressure and lower limb edema has a sensitivity of only 8% for the diagnosis of HF in the community. The clinical diagnosis of early HF in relatively asymptomatic stages remains a major challenge. Clinical history, symptoms and signs, when used in isolation, have only a limited value in diagnosing HF. Dyspnea on exertion is the most frequent symptom but is not specific. A history of acute pulmonary edema, paroxysmal nocturnal dyspnea, orthopnea and dyspnea when walking on the flat are relatively specific but not sensitive. Similarly, several signs are relatively specific but not very sensitive. On the other hand, only 54% of patients with clinically diagnosed HF have objective evidence of cardiac dysfunction. Thus, the clinical diagnosis of HF requires careful integration of all the available information. The clinicians often equate HF with congestive HF, but not all patients have volume overload at the time of initial or subsequent evaluation. Hence, the term “heart failure” is preferred over the term “congestive heart failure”. The need for a uniform definition of HF cannot be overemphasized. The absence of uniform definition and diagnostic criteria results in considerable heterogeneity among patients classified as having HF in epidemiologic and clinical studies. A wide variation in the estimated prevalence of HF, ranging from 3 to 20 cases per 1000 population reported in the various studies, results from the varied definitions used for HF. Defining HF has been a surprisingly difficult task. In this article, we highlight the different definitions and the criteria used for the diagnosis of HF. Though HF may be viewed as a failure at myocardial, cellular, molecular, neurohumoral or bio-energetic levels, we limit ourselves to the clinician’s perspective.
Frequencies of feline blood types at a referral hospital in the south east of England.

OBJECTIVES To determine the prevalence of blood types in the feline patients and blood donors of the Queen Mother Hospital for Animals (The Royal Veterinary College, London, UK), that were typed between 2000 and 2004. METHODS A retrospective study was performed using files of patients and blood donors of the Queen Mother Hospital for Animals seen between January 2000 and November 2004. Commercial blood typing cards were used to determine the blood type. RESULTS One hundred and fifty-six cats were included in the study; 51 (32.7 per cent) were pedigree and 105 (67.3 per cent) non-pedigree. Of the 51 pedigree cats, the prevalence of blood types was as follows: type A, 42 (82.4 per cent); type B, seven (13.7 per cent) and type AB, two (3.9 per cent). Of the 105 non-pedigree cats, the prevalence of blood types was as follows: type A, 71 (67.6 per cent); type B 32 (30.5 per cent) and type AB two (1.9 per cent). CLINICAL SIGNIFICANCE The prevalence of type B blood in non-pedigree cats is higher than previously suggested and shows high variability within the UK; because of this, blood typing all feline patients, not only the ones of a breed typically known to have higher prevalence of type B blood before transfusion, is absolutely necessary to avoid a fatal transfusion reaction.
Electron microscopy and immunocytochemistry in the assessment of renal biopsy specimens: actual and optimal practice.

AIMS: To determine the variation in practice of British renal histopathologists in the use of immunohistochemistry and electron microscopy in the investigation of renal biopsy specimens; to attempt to identify a consensus on what acceptable practice should be; and to satisfy requests from laboratories which have found immunoperoxidase methods unreliable on renal biopsy specimens, by disseminating methods from laboratories which have had success. METHODS: A questionnaire was sent to all 58 laboratories which participate in the UK National Renal Pathology External Quality Assessment Scheme. RESULTS: A response rate of 88% was achieved. Most laboratories use immunocytochemistry and electron microscopy to investigate most renal biopsy specimens, but a few use these methods only rarely and one, never. There is a widespread wish to switch from immunofluorescence to immunoperoxidase, but this is frustrated by the unreliability of the method. This seems to be mainly because of the need to tailor the time of enzyme pretreatment to each biopsy specimen. CONCLUSIONS: The majority view is that electron microscopy and immunocytochemistry are necessary in the investigation of most native renal biopsy specimens, and the few pathologists who report renal biopsy specimens without these methods risk accusations of negligence. Difficulty in using fixed renal tissues for immunocytochemistry stem largely from variations in the requirement for enzyme pre-digestion. Even where immunoperoxidase methods are usually successful, the occasional use of immunofluorescence in parallel to check that false negatives are not occurring is advocated. In all cases it is wise to keep some frozen cortex in reserve in case there is an unexpected or inconsistent immunoperoxidase result.
Laparoscopic hepatectomy for colorectal liver metastases located in all segments of the liver.

PURPOSE Laparoscopic hepatectomy is not a well-established treatment modality for colorectal liver metastases. Moreover, most reports have been limited to tumors in the anterolateral segments (segments 2, 3, 4b, 5, and 6). In this study we evaluated the short- and long-term outcomes after laparoscopic hepatectomy for colorectal liver metastases located in all segments, including tumors located in the posterosuperior segments (segments 1, 4a, 7, and 8). METHODS This retrospective study included 102 patients who underwent laparoscopic hepatectomy for colorectal liver metastases with radical intent between January 2009 and January 2016. The patients were divided into two groups (anterolateral and posterosuperior group) according to tumor location. The clinical and follow-up data of the two groups were reviewed. RESULTS There was no 30-day postoperative mortality. Most of the postoperative 30-day complications were classified as minor complications (Clavien-Dindo classification). There was no difference in clinicopathologic characteristics between the two groups. Although posterosuperior group patients had significantly longer operative time (p=0.008) and postoperative hospital stay duration (p=0.041), as well as a greater blood loss (p=0.012), there was no significant difference in the rate and severity of postoperative complications (p=0.314 and 1.000 respectively). During a median follow-up of 41 months, the 5-year overall survival (OS) (p=0.449), and disease-free survival (DFS) (p=0.370) showed no significant difference between the two groups. CONCLUSIONS Laparoscopic hepatectomy for colorectal liver metastases located in all segments of the liver can be safely performed in selected patients, with acceptable postoperative morbidity and oncologic results.
Strategies of arousal control: biofeedback, meditation, and motivation.

A series of four experiments assessed the effects of instructions to lower heart rate on heart rate change and general arousal reduction. Various conditions of biofeedback, cognitive load, incentive, knowledge of results, and the experimenter-subject relationship were tested. Experiment 1 compared physiological responses to the delivery of direct organ feedback (i.e., heart rate) with responses to electromyographic biofeedback from the frontalis muscle area and with responses to a nonfeedback tracking task. The results suggest that neither heart rate nor muscle tension feedback is an especially powerful method for achieving sustained reductions in heart rate. Furthermore, although some specificity of physiologic pattern is apparent, biofeedback is no more effective in lowering general activation level than simple instructions to relax accompanied by a general knowledge of results. The second experiment was designed to assess the role of cognitive load in arousal reduction. Heart rate biofeedback was compared with a procedure involving minimal external information processing--the secular meditation exercise of Wallace and Benson. The results indicated a clear superiority for the meditation strategy in effecting reductions in cardiac rate and lowering activation. However, in a third experiment, meditation subjects lowered heart rate much less than observed in the previous study, and this time the reduction did not exceed that achieved by feedback subjects. Subsequent analysis suggested that the quality of the subject-experimenter relationship (active-supportive vs. formal-distant) was a significant variable in accounting for outcome differences. The above hypothesis was supported by a fourth experiment. Under conditions of high subject-experimenter involvement, the superior meditation performance of Experiment 2 was reproduced; under low-involvement conditions the Experiment 3 result of no difference between training groups was obtained. The findings suggest that the effectiveness of any method for achieving relaxation (or physiological control) rests on a complex interaction between informational and motivational imperatives of the stimulus context and definable aspects of the interpersonal exchange between subject and experimenter. This research raises serious questions about the effectiveness of the usual biofeedback paradigm as an aid to arousal reduction and the cost efficiency of its applications in the clinical situation. Furthermore, these results demonstrate the great power in relaxation experiments of psychosocial and other moderator variables, and signal the practical difficulty of their control when these variables appear to be as potent in changing physiology as the primary training methods.
Effects of estrogen treatment on glutamate uptake in cultured human astrocytes derived from cortex of Alzheimer's disease patients

Estrogen is thought to play a protective role against neurodegeneration through a variety of mechanisms including the activation of growth factors, the control of synaptic plasticity, and the reduction of response to various insults, such as iron and glutamate. Increasing evidence indicates an increased level of extracellular glutamate and a down‐regulation of glutamate transporters in Alzheimer's disease (AD). In this study, we show that glutamate uptake in astrocytes derived from Alzheimer's patients is significantly lower than that from non‐demented controls. Estrogen treatment increases glutamate uptake in a dose‐dependent pattern. Two glutamate transporters, GLT‐1 and GLAST, are expressed in the astrocytes. Up‐regulation of the glutamate transporters is induced by estrogen treatment in AD astrocytes only. Our data suggest that the action of estrogen on glutamate uptake by astrocytes might contribute to its potential neuroprotective role in AD.
Incidence and outcome of neurological sequelae in survivors of cerebral malaria.

This hospital based study was carried out on 185 adult patients of cerebral malaria. Out of 185 patients, 62 (33.5%) died and 123 (66.5%) survived. Neurological sequelae were present in 13 (10.5%) of 123 survivors at the time of discharge (i.e. 10-15 days after recovery from coma) from the hospital. These were in form of psychosis in 5 patients (4%), cerebellar ataxia in 4 patients (3.2%), extrapyramidal rigidity in 2 patients (1.62%) and hemiplegia in 2 patients (1.62%).
Computer‐based three‐dimensional reconstruction of the anatomy of Microhedyle remanei (Marcus, 1953), an interstitial acochlidian gastropod from Bermuda

Phylogenetic analysis of the highly enigmatic and aberrant acochlidian opisthobranch gastropods is mainly hindered by the lack of reliable anatomical data. Due to their small size, marine interstitial acochlidian species are not suitable for anatomical investigations by dissecting. The tinyness and complexity of, e.g., opisthobranch central nervous and reproductive systems make data derived from older paraffin‐based histology and interpretation by hand‐based graphical reconstruction questionable. In a former study, a hermaphroditic member of the basal acochlidian genus Hedylopsis (“Hedylopsacea”) has been examined in detail. The present study uses the gonochoric Microhedyle remanei (Microhedylidae) as a model organism of the other traditional major acochlidian subgroup, the “Microhedylacea. ” More than 20 specimens with up to 2 mm body length were extracted from coarse subtidal sand near Castle Roads, Bermuda Islands. Their central nervous, digestive, circulatory, excretory, and genital systems were reconstructed three‐dimensionally from serial semithin histological sections using AMIRA software. The radula was analyzed by SEM. Our specimens closely resemble the original description of M. remanei (Marcus, 1953; as Unela) from Brazil; apparent differences regarding the number of visceral loop ganglia or details of male genitalia are assumed to be due to oversights by the former author or because of different ontogenetic stages. Microhedyle remanei differs from all congeners due to the lack (vs. presence) of eyes; further distinguishing features are discussed. In contrast to members of the hedylopsacean Hedylopsidae, Acochlidiidae, and Tantulidae, M. remanei shows a nervous system with numerous precerebral accessory “ganglia” that are not differentiated into cortex and medulla. While all Microhedylidae previously were thought to lack a heart, M. remanei shows a two‐chambered heart, as is usual for opisthobranchs. The oocytes of M. remanei are yolky and large in relation to body size and suggest intracapsular larval development. A comparative microanatomical discussion and the distribution of characters within acochlidian taxa indicate that the current classification of the Acochlidia does not reflect phylogenetic relationships. Detailed structural investigations on further poorly known species are required; the computer‐based 3D reconstruction of semithin serial sections with AMIRA is shown to be an ideal tool for efficient analysis and presentation of the microanatomy of small specimens. J. Morphol. © 2005 Wiley‐Liss, Inc.
Thermo‐expandable intraprostatic stents in bladder outlet obstruction: an 8‐year study

Objective To assess the use of a thermo‐expandable intraprostatic stent (Memokath®, Engineers and Doctors A/S, Copenhagen, Denmark) for bladder outlet obstruction in men unable to undergo transurethral resection of the prostate (TURP), assessing symptoms, complications and duration of stent life.
Survey of the accuracy of new pseudoisochromatic plates

The accuracy of three new pseudoisochrometic tests for detecting red–green colour deficiency was assessed. These were the Ishihara plates, the Ishihara test for ‘unlettered persons’ and Ohkuma's lest cards. We examined 500 subjects; 471 normal trichromats and 29 colour‐deficient people, Results obtained for the 1989 edition of the Ishiliara places were compared with the 9th edition and the most efficient plates identified. Although normal trichromats may be expected to make several interpretive misreadings, the Ishihara plates were found to be superior to the 9th edition and to the Ohkuma test (1986) for colour vision screening. The new symbol designs of the Ishihara plates for ‘unlettered persons’ (1990) were found to be very effective for colour vision screening, and a further study with young children is proposed. The 38 plate I9S9 edition of the Ishihara les; is recommended for use in clinical practice. The designs included in the concise 24 plate edition and the new abbreviated 14 plate edition are not selected from the point of view of accuracy and more reliable results are obtained if the full lest is given or if the practitioner shows only the most efficient designs.
Differential Reports of Suicidal Ideation and Attempts of Questioning Adults Compared to Heterosexual, Lesbian, Gay, and Bisexual Individuals

Many sexual minority individuals attempt suicide each year, but little is known about the suicidality of individuals who are questioning their sexual orientation. This study assessed suicidal ideation and attempts of questioning individuals compared with lesbian/gay, bisexual, and heterosexual individuals. This cross-sectional study enrolled participants (N = 2,841) from a community health center. Questioning (OR = 4.286, 95% CI [2.119–8.671]), lesbian/gay (OR = 3.024, 95% CI [2.351–3.890]), and bisexual (OR = 4.389, 95% CI [2.942–6.575]) individuals had significantly greater odds of considering suicide compared to heterosexuals. However, questioning individuals had non-significant odds of attempting suicide compared to heterosexuals. We discuss possible explanations for these findings.
The use of focus groups in social and behavioural research: some methodological issues.

The use of focus groups as a qualitative method for rapid assessment is discussed. A focus-group session is an in-depth discussion in which a small number of people (usually 8-12) from the target population discuss topics that are of importance for a particular study or project. Generally the participants are chosen purposively, and it is recommended that they should be homogeneous with respect to characteristics which might otherwise impede the free flow of discussion. Focus groups can be used for idea generation, in conjunction with a quantitative method, or as a primary data-collection method. However, if focus groups are used as a primary data-collection method, their results must be treated with caution. The main advantage of using focus-group discussions during rapid assessment is that they provide in-depth information without requiring full-scale anthropological investigations. The informal group setting is believed to make people feel at ease, encouraging them to express their views freely. However, there are a number of limitations to focus-group discussions. The samples are small and purposively selected, and therefore do not allow generalization to larger populations. In addition, as with other qualitative methods, the chances of introducing bias and subjectivity into the interpretation of the data are high. There are a number of methodological issues which still need to be addressed in order to further develop the method. Little is known about how many discussion sessions are needed to be reasonably sure that most aspects related to the subject of inquiry have been explored. (ABSTRACT TRUNCATED AT 250 WORDS)
InSAR monitoring of ground motions impacts for in-situ sea level measurement: The example of Dakar (Senegal)

Tide gauges are a unique source of information on past sea level changes over the 20th century. However, these instruments can be affected by local ground motions, which are often poorly known. Here, InSAR can provide valuable information to understand the ground deformation context at city scale. In this study, we evaluate ground motion velocities from 13 interferograms of 10 Envisat images. Within the precision limitations of the technique, our results suggest that the city of Dakar displays relatively uniform ground motions, except in the harbor. Further investigation is necessary to examine the particular case of a recent tide gauge, which could be affected by a moderate subsidence with respect to the permanent GPS station of Dakar.
Idiopathic Hypertrophic Subaortic Stenosis and Aortic Regurgitation in an 84‐Year‐Old Man

During the ninth decade of life, idiopathic hypertrophic subaortic stenosis (IHSS), particularly when associated with other cardiac disorders, presents a confusing clinical problem. Unless the physician has a high index of suspicion, the diagnosis is easily overlooked, and consequently inappropriate management of the patient may lead to serious complications. One such case in an 84‐year‐old man is described. Administration of certain drugs may only intensify symptoms. Echocardiography is invaluable for diagnosis. Pertinent clinical features of IHSS in the eighth and ninth age decades are outlined.