Miracle-dz/UniFAR-FTUs huggingface dataset:
Mechanisms of Antiarrhythmic Drug Action on Termination of Atrial Flutter

TAI, C. ‐T. , et al.: Mechanisms of Antiarrhythmic Drug Action on Termination of Atrial Flutter. Atrial flutter is an important arrhythmia in clinical practice. Although the reentrant circuit of human typical atrial flutter is well characterized, the action of antiarrhythmic drugs on this tachycardia is less understood. Based on the recent clinical trials, pure Class III drugs like ibutilide or dofetilide are more effective in acute termination of human atrial flutter than Class I drugs like procainamide or flecainide. The mechanisms of drug induced termination of atrial flutter include refractory block due to cycle length oscillation, fixed block due to a reduced safety factor for conduction, or a collision of opposing wavefronts due to loss of the lateral boundaries or return reexcitation. Because ventricular proarrhythmia is a major concern with ibutilide or dofetilide therapy, development of new drugs with more specific target profiles is a future direction for treatment of human atrial flutter.
The emotional sequelae of whistleblowing: findings from a qualitative study.

AIMS AND OBJECTIVES To highlight and illuminate the emotional sequelae of whistleblowing from whistleblowers and subjects of whistleblowing complaints. BACKGROUND Whistleblowing has the potential to have a negative impact on individuals' physical and emotional well-being. However, few empirical studies have been conducted using qualitative methods to provide an in-depth exploration of the emotional consequences for those involved in whistleblowing incidents. DESIGN Qualitative narrative inquiry design. METHOD Purposive sampling was used to recruit participants who had been involved in whistleblowing incidents. During interviews participants' accounts were digitally recorded and then transcribed verbatim. Data were then analysed by two researchers until consensus was reached. RESULTS Findings revealed that participants' emotional health was considerably compromised as a result of the whistleblowing incident. Analysis of the data revealed the following dominant themes: 'I felt sad and depressed': overwhelming and persistent distress; 'I was having panic attacks and hyperventilating': acute anxiety; and, 'I had all this playing on my mind': nightmares, flashbacks and intrusive thoughts. CONCLUSIONS While it has been previously acknowledged that whistleblowing has the potential to have a negative impact on all aspects of an individual's life, this study notably highlights the intensity of emotional symptoms suffered by participants as well as the extended duration of time these symptoms were apparent. RELEVANCE TO CLINICAL PRACTICE As professionals, nurses, as well as organisations, have a responsibility to identify those who may be suffering the emotional trauma of whistleblowing and ensure they have access to appropriate resources.
High Loading of Polygenic Risk for ADHD in Children With Comorbid Aggression

Objective Although attention deficit hyperactivity disorder (ADHD) is highly heritable, genome-wide association studies (GWAS) have not yet identified any common genetic variants that contribute to risk. There is evidence that aggression or conduct disorder in children with ADHD indexes higher genetic loading and clinical severity. The authors examine whether common genetic variants considered en masse as polygenic scores for ADHD are especially enriched in children with comorbid conduct disorder. Method Polygenic scores derived from an ADHD GWAS meta-analysis were calculated in an independent ADHD sample (452 case subjects, 5,081 comparison subjects). Multivariate logistic regression analyses were employed to compare polygenic scores in the ADHD and comparison groups and test for higher scores in ADHD case subjects with comorbid conduct disorder relative to comparison subjects and relative to those without comorbid conduct disorder. Association with symptom scores was tested using linear regression. Results Polygenic risk for ADHD, derived from the meta-analysis, was higher in the independent ADHD group than in the comparison group. Polygenic score was significantly higher in ADHD case subjects with conduct disorder relative to ADHD case subjects without conduct disorder. ADHD polygenic score showed significant association with comorbid conduct disorder symptoms. This relationship was explained by the aggression items. Conclusions Common genetic variation is relevant to ADHD, especially in individuals with comorbid aggression. The findings suggest that the previously published ADHD GWAS meta-analysis contains weak but true associations with common variants, support for which falls below genome-wide significance levels. The findings also highlight the fact that aggression in ADHD indexes genetic as well as clinical severity.
Swimming Performance, Metabolic Rates, and Their Correlates in the Iceland Scallop Chlamys islandica

The dramatic escape response of some scallops is modified by reproductive investment and by acclimation temperature. Despite considerable knowledge of the physiology of the escape response, functional links between escape response performance, organismal rates of oxygen uptake, and tissue metabolic capacities are little known. We measured oxygen consumption rates (standard, maximal, and aerobic scope), escape behavior (initial and repeat performance), tissue mass, condition index, protein content, and tissue metabolic capacities in the Iceland scallop Chlamys islandica to examine links between these parameters. Postexercise oxygen consumption rates were positively linked to contraction rate (repeat test) and to pyruvate kinase activity in the adductor muscle but negatively linked to digestive gland wet mass. Swimming behavior was mainly related to activity of glycolytic enzymes, and enzymatic activities were related to anatomic parameters. Scallop behavior and physiology change with size, both within our samples and on a larger scale. Small scallops showed more intense swimming activity and had higher arginine kinase activities but lower glycolytic enzyme activities in their adductor muscle than larger scallops. This corresponds to the ontogenetic change in susceptibility to predation and in habitat use observed in C. islandica.
Malignant Disease in the Accident and Emergency Department

INTRODUCTION Malignant disease is a common cause for admission to hospital. Although malignant disease is most commonly characterised by a progressive and often insidious type of illness presenting to the General Practitioner or Outpatient Clinic, a number of patients present for the first time with acute symptoms of malignancy such as a pathological fracture,' an obstructing colorectal tumour or a perforated abdominal neoplasm. ': 3 In addition, there is a group of patients with malignant disease who present to an Accident and Emergency Department in a manner somewhere between these two extremes, with symptoms of a less dramatic nature, and Casualty Officers should be aware of this problem. There is little information on the magnitude of the problem of cancer presenting to Accident and Emergency Departments, although one study of patients presenting with acute abdominal pain' suggested that a higher proportion than might have been expected had malignant disease. The present study extends this approach to cancer in general and investigates the nature and extent of the problem of undiagnosed malignant disease presenting to an Accident and Emergency Department and examines the treatment and outcome of those patients.
Faecal markers of gastrointestinal inflammation

Gastrointestinal (GI) symptoms including abdominal pain, bloating and diarrhoea are a relatively common reason for consulting a physician. They may be due to inflammatory bowel disease (inflammatory bowel disease; Crohn's disease, ulcerative colitis and indeterminate colitis), malignancy (colorectal cancer), infectious colitis or irritable bowel syndrome (IBS). Differentiation between these involves the use of clinical, radiological, endoscopic and serological techniques, which are invasive or involve exposure to radiation. Serological markers include C-reactive protein, erythrocyte sedimentation rate and antibodies (perinuclear antineutrophil cytoplasm antibody and anti-Saccharomyces cerevisiae antibody). Faecal markers that can aid in distinguishing inflammatory disorders from non-inflammatory conditions are non-invasive and generally acceptable to the patient. As IBS accounts for up to 50% of cases presenting to the GI clinic and is a diagnosis of exclusion (Rome III criteria), any test that can reliably distinguish IBS from organic disease could speed diagnosis and reduce endoscopy waiting times. Faecal calprotectin, lactoferrin, M2-PK and S100A12 will be reviewed.
Intraoperative Fluoroscopic Evaluation of Screw Placement During Pelvic and Acetabular Surgery

Summary: The surgical treatment of pelvic and acetabular fractures can be technically challenging. Various techniques are available for the reconstruction of pelvic and acetabular fractures. Less invasive percutaneous fracture stabilization techniques, with closed reduction or limited open reduction, have been developed and are gaining popularity in the management of pelvic and acetabular fractures. These techniques require knowledge and interpretation of various fluoroscopic images to ensure appropriate and safe screw placement. Given the anatomic complexity of the intrapelvic structures and the 2-dimensional nature of standard fluoroscopy, multiple images oriented in different planes are needed to assess the accuracy of guide wire and screw placement. This article reviews the fluoroscopic imaging of common screw orientations during pelvic and acetabular surgery.
Senior Resident Training on Educational Principles (STEP): A Proposed Innovative Step from a Developing Nation

Resident-as-teacher courses are pretty common in Western medical schools however they are a rarity in Asian and developing countries. The current report is a scholarly analysis of a three day orientation program for senior residents in order to improve their functioning by providing new template either for supplementing basic workshops for faculty or to advocate a change in system. The experience gained by Medical Education Unit of University College of Medical Sciences can be used to conduct training breeding grounds at national or regional levels. Resident as teachers educational interventions need to be designed taking into account their impact on education system.
Extended hepatectomy in patients with hepatobiliary malignancies with and without preoperative portal vein embolization.

HYPOTHESIS Preoperative portal vein embolization (PVE) allows potentially curative hepatic resection without additional morbidity or mortality in patients with hepatobiliary malignancies who are marginal candidates for resection based on small liver remnant size. DESIGN A retrospective review of a consecutive series of patients in a multi-institutional database who underwent extended hepatectomy. SETTING University-based referral centers. PATIENTS Forty-two patients underwent preoperative determination of the future liver remnant (FLR) volume before extended hepatectomy (> or = 5 segments) for hepatobiliary malignancy without chronic underlying liver disease. Patients were stratified by treatment with or without preoperative PVE. INTERVENTION Preoperative percutaneous PVE. MAIN OUTCOME MEASURES Clinical characteristics, FLR volume, operative morbidity, and survival. RESULTS There was no difference between the groups that did and did not undergo PVE for the number of tumors, tumor size, estimated blood loss, duration of the operation, complexity of resection, or surgical margins. The FLR at presentation was significantly smaller in patients who underwent PVE than in patients who did not undergo PVE (18% vs 23%; P<.001). After PVE, FLR volumes increased significantly (P =.003); preoperative FLR volumes were similar in both groups (patients who underwent PVE, 25%; and patients who did not undergo PVE, 23%). There was no perioperative mortality and no statistical difference in the incidence of perioperative complications between those who did and those who did not undergo PVE (5 [28%] of 18 patients vs 5 [21%] of 24 patients). The overall 3-year survival was 65% and the median survival duration was equivalent in the 2 groups (40 vs 52 months for those who did vs those who did not undergo PVE). CONCLUSION Portal vein embolization enables safe and potentially curative extended hepatectomy in a subset of patients who would otherwise be marginal candidates for resection based on a small liver remnant size.
Mobile phone changing prediction based on large-scale user behavioral data

The behavior that people change their cell phones is very important for phone manufactures and mobile operators to make commercial plans and competing strategies to attain maximum benefit. In this paper, we aim to evaluate four existing prediction models in phone changing events, based on user behavior data collected from one telecommunication operator. First we adopt the feature extraction algorithms to distinguish which attributes are closely related with the changing phone label. Secondly undersampling, synthetic minority oversampling technique(SMOTE) and cost-sensitive methods are discussed and implemented. Then four classifiers(i.e. logistic regression, back propagation(BP) neural network, support vector machine(SVM) and random forest(RF)) are compared through extensive experiments and we concluded that BP algorithm in the undersampling scenario can attain better and satisfactory performance.
Evaluation and Pharmacologic Approach to Patients with Resistant Hypertension

Abstract Patients are diagnosed as having resistant hypertension when they have blood pressure readings that remain above goal despite the concomitant use of 3 optimally dosed antihypertensive agents from different classes, with 1 of the agents being a diuretic. Prior to diagnosing a patient as having resistant hypertension, it is important to document adherence and exclude white–coat hypertension, inaccurate measurement of blood pressure, and secondary causes of hypertension (eg, aldosterone excess). After determining resistance, optimization of the medication regimen is essential. Combination strategies, which might include dual renin–angiotensin–aldosterone blockade with spironolactone as 1 agent, have been proven successful. This article focuses on the safety and efficacy of spironolactone when added to an optimized 3–drug regimen. Additionally, the use of spironolactone in chronic kidney disease and obstructive sleep apnea complicated by resistant hypertension is discussed. These 2 clinical entities are frequently accompanied by resistant hypertension and are indications for the use of spironolactone as well.
Thyroid Hormone Regulates the Expression of Laminin in the Developing Rat Cerebellum1.

In the rat cerebellum, migration of neurons from the external granular layer to the internal granular layer occurs postnatally and is dependent upon the presence of thyroid hormone. In hypothyroidism, many neurons fail to complete their migration and die. Key guidance signals to these migrating neurons are provided by laminin, an extracellular matrix protein that is fixed to the surface of astrocytes. Expression of laminin in the brain is developmentally timed to coincide with neuronal growth spurts. In this study, we examined the role of thyroid hormone on the expresssion and distribution of laminin in the rat cerebellum. We show that laminin content steadily increased 2- to 3-fold from birth to maximal levels on postnatal day 8–10 then steadily decreased to a plateau by postnatal day 12 in the euthyroid cerebellum. Immunoreactive laminin appeared in the molecular layer of the euthyroid cerebellum by postnatal day 4, reached maximal intensity by postnatal day 8–10, and was gone by postnatal day 14. In co.
Effect of Cranial Irradiation on Pituitary Size in Patients Cured of Acute Lymphoblastic Leukaemia: Retrospective Study

Objective: To evaluate the pituitary glands of patients previously treated for acute lymphoblastic leukaemia with cranial irradiation. Patients and Methods: Thirty nine patients who were cured of acute lymphoblastic leukaemia and who were regularly followed up from 1979 to 1992 were recruited. Sagittal T1-weighted magnetic resonance imaging of the pituitary gland was performed in a 1.5-T magnetic resonance machine. Sixteen age- and sex-matched patients who had been treated during childhood for solid extracranial neoplasms with systemic chemotherapy, but not intracranial irradiation, were recruited as controls. Results: The height of the adenohypophysis was significantly smaller in patients who had had acute lymphoblastic leukaemia (mean, 3.9 mm; standard deviation, 1.2 mm) than in control patients (mean, 5.3 mm; standard deviation, 1.1 mm) [p < 0.001]. For both patients who had had acute lymphoblastic leukaemia and for controls, there was no significant correlation between pituitary height and age at diagnosis or age at the time of the study. In the group of patients who had had acute lymphoblastic leukaemia, the pituitary was shorter in those treated with more than 18 Gy of radiation (mean, 3.0 mm; standard deviation, 1.3 mm) than in those treated with exactly 18 Gy (mean, 4.1 mm; standard deviation, 1.1 mm) [p = 0.037]. Conclusion: Children cured of acute lymphoblastic leukaemia with previous cranial irradiation show a significant reduction in the height of the adenohypophysis. The effect on the size of the pituitary gland appears greater with a higher radiation dose.
Debt Covenants, Bankruptcy Risk, and Issuance Costs

Riskier firms use more covenants, yet effective covenants should reduce the probability of bankruptcy by restricting management’s actions. We disentangle these two relations between covenant use and bankruptcy risk by considering predicted and actual covenant use. We find that predicted covenant use is associated with a higher probability of bankruptcy and shorter firm survival, whereas actual covenant use is associated with a lower probability of bankruptcy and longer firm survival. This evidence is consistent with the notion that the use of covenants reduces bankruptcy risk. However, theory suggests that two covenants -- stock issuance restrictions and rating decline puts -- do not reduce the probability of bankruptcy. Empirically, we find that the use of either of these covenants implies a higher probability of bankruptcy and a shorter survival time. On the cost side, we find evidence that corporate bonds with more restrictive covenants have higher issuance costs. While we find some evidence that bonds with more covenants are more difficult to sell, we argue that this covenant-issue cost relation is mainly driven by the risk to underwriters. Overall, these results both confirm some essential aspects of, and expand upon, Smith and Warner’s (1979) costly contracting hypothesis.
Injuries Associated with Mandible Fractures Sustained in Motor Vehicle Collisions

Motor vehicle collisions are second only to altercations as the most common cause of mandible fractures. This article details in a retrospectively studied group the incidence of isolated mandible fractures and associated injuries in patients who were involved in motor vehicle collisions. This group consisted of 148 patients with mandible fractures listed in the University of Mississippi's trauma registry during the past 5 years. In almost all patients, associated injuries occurred with mandible fractures that were caused by motor vehicle collisions, with an incidence of 99.3 percent. Facial and head lacerations and facial fractures were the leading associated injuries, occurring in more than half of the patients who had a mandible fracture. Closed head injury is the major life‐threatening associated injury and cause of mortality. The life‐threatening injuries occurred in 64.8 percent of patients in this study. The mortality rate in this group of patients was 8.1 percent. These data suggest that mandible fractures from motor vehicle collisions should never be viewed as an isolated injury but rather as part of a spectrum of significant and sometimes life‐threatening injuries that require thorough trauma evaluation at the time of presentation. (Plast. Reconstr. Surg. 108: 328, 2001.)
On the Use of Problem-Specific Candidate Generators for the Hybrid Optimization of Multi-Objective Production Engineering Problems

In the field of production engineering, various complex multi-objective problems are known. In this paper we focus on the design of mold temperature control systems, the reconstruction of digitized surfaces, and the optimization of NC paths for the five-axis milling process. For all these applications, efficient problem-specific algorithms exist that only consider a subset of the desirable objectives. In contrast, modern multi-objective evolutionary algorithms are able to cope with many conflicting objectives, but they require a long runtime due to their general applicability. Therefore, we propose hybrid algorithms for the three applications mentioned. In each case, the problem-specific algorithms are used to determine promising initial solutions for the multi-objective evolutionary approach, whose variation concepts are used to generate diversity in the objective space. We show that the combination of these techniques provides great benefits. Since the final solution is chosen by a decision maker based on this Pareto front approximation, appropriate visualizations of the high-dimensional solutions are presented.
Influence of Alcohol and Drug Use on AIDS Risk Behavior among Youth in Dropout Prevention

Youth enrolled in dropout prevention and alternative school programs engage in a number of high risk behaviors in greater numbers than those in traditional school settings [1, 2]. However, data on alcohol and drug use influences and risky sexual behavior are often not collected or reported among these youth due to small enrollments and rapid turnover. In this study alcohol and drug use and sexual behaviors were surveyed among 212 youth in dropout prevention. A risk profile score for HIV/AIDS was developed and the contribution of alcohol and drug use to HIV/AIDS risk was determined. Results showed that use of alcohol and drugs and age of sexual initiation were significantly associated with a high risk profile score. Of sexually active youth, 28 percent reported using alcohol or drugs prior to having sexual intercourse and more than half reported not using condoms during their last sexual experience. Males were more likely than females to use alcohol and drugs before having sex, and were more likely to have had sex with two or more partners. Findings from this study suggest that among youth in dropout prevention, the association of alcohol and drug use to HIV/AIDS risk is significant and that prevention programs need to target alcohol and drug use as important influences on risky sexual behavior.