Miracle-dz/UniFAR-FTUs huggingface dataset:
Antihypertensive treatment based on conventional or ambulatory blood pressure measurement. A randomized controlled trial. Ambulatory Blood Pressure Monitoring and Treatment of Hypertension Investigators.

CONTEXT Ambulatory blood pressure (ABP) monitoring is used increasingly in clinical practice, but how it affects treatment of blood pressure has not been determined. OBJECTIVE To compare conventional blood pressure (CBP) measurement and ABP measurement in the management of hypertensive patients. DESIGN Multicenter, randomized, parallel-group trial. SETTING Family practices and outpatient clinics at regional and university hospitals. PARTICIPANTS A total of 419 patients (> or =18 years), whose untreated diastolic blood pressure (DBP) on CBP measurement averaged 95 mm Hg or higher, randomized to CBP or ABP arms. INTERVENTIONS Antihypertensive drug treatment was adjusted in a stepwise fashion based on either the average daytime (from 10 AM to 8 PM) ambulatory DBP (n=213) or the average of 3 sitting DBP readings (n=206). If the DBP guiding treatment was above (>89 mm Hg), at (80-89 mm Hg), or below (<80 mm Hg) target, 1 physician blinded to the patients' randomization intensified antihypertensive treatment, left it unchanged, or reduced it, respectively. MAIN OUTCOME MEASURES The CBP and ABP levels, intensity of drug treatment, electrocardiographic and echocardiographic left ventricular mass, symptoms reported by questionnaire, and cost. RESULTS At the end of the study (median follow-up, 182 days; 5th to 95th percentile interval, 85-258 days), more ABP than CBP patients had stopped antihypertensive drug treatment (26.3% vs 7.3%; P<.001), and fewer ABP patients had progressed to sustained multiple-drug treatment (27.2% vs 42.7%; P<.001). The final CBP and 24-hour ABP averaged 144.1/89.9 mm Hg and 129.4/79.5 mm Hg in the ABP group and 140.3/89.6 mm Hg and 128.0/79.1 mm Hg in the CBP group. Left ventricular mass and reported symptoms were similar in the 2 groups. The potential savings in the ABP group in terms of less intensive drug treatment and fewer physician visits were offset by the costs of ABP monitoring. CONCLUSIONS Adjustment of antihypertensive treatment based on ABP monitoring instead of CBP measurement led to less intensive drug treatment with preservation of blood pressure control, general well-being, and inhibition of left ventricular enlargement but did not reduce the overall costs of antihypertensive treatment.
Long-Term Follow-Up after Extracranial Internal Carotid Artery Dissection

Objective: To evaluate long-term outcome after extracranial internal carotid artery dissection (eICAD) in consideration of the applied antithrombotic therapy. Material and Methods: Among 33 consecutive eICAD patients initially treated either with anticoagulation (n = 25) or with antiplatelets (n = 8), a standardized interview was performed after 28 ± 22.1 months to analyze risks and benefits of both agents. Ischemic and hemorrhagic complications, occurrence of seizure and rates of arterial recanalization were compared and long-term clinical outcome was assessed using the modified Rankin Scale (mRS) and Barthel Index (BI). Results: Among anticoagulated patients, 1 died due to brain herniation. In 3 patients stroke (n = 2) or TIA (n = 1) recurred. In the antiplatelet group, none died and no subsequent ischemic events happened. Hemorrhagic complications were noted in neither treatment group. Functional outcome among anticoagulated patients was BI 92 ± 21.6 and mRS 1.48 ± 1.50, which did not differ from patients initially treated with antiplatelets (BI 89 ± 18.9, mRS 1.50 ± 1.41, p > 0.05). Four anticoagulated patients developed seizures, compared to 2 patients with antiplatelets (p > 0.05). Arterial recanalization occurred in 16 of 22 antico- agulated patients with ultrasound follow-up, compared to 6 of 6 patients with antiplatelets (p > 0.05). Conclusion: In the absence of iatrogenic side effects, both anticoagulation and antiplatelets seem to be safe for eICAD. The rates for death and stroke were low and outcome ratings did not differ between both agents. These findings may indicate that a controlled randomized trial comparing anticoagulation and antiplatelets is ethically justified.
Metabolism of aflatoxin, ochratoxin, zearalenone, and three trichothecenes by intact rumen fluid, rumen protozoa, and rumen bacteria

The effect of rumen microbes on six mycotoxins (aflatoxin B1, ochratoxin A, zearalenone, T-2 toxin, diacetoxyscirpenol, and deoxynivalenol ) considered to be health risks for domestic animals was investigated. The mycotoxins were incubated with intact rumen fluid or fractions of rumen protozoa and bacteria from sheep and cattle in the presence or absence of milled feed. Rumen fluid had no effect on aflatoxin B1 and deoxynivalenol . The remaining four mycotoxins were all metabolized, and protozoa were more active than bacteria. Metabolism of ochratoxin A, zearalenone, and diacetoxyscirpenol was moderately or slightly inhibited by addition of milled feed in vitro. The capacity of rumen fluid to degrade ochratoxin A decreased after feeding, but this activity was gradually restored by the next feeding time. Ochratoxin A was cleaved to ochratoxin alpha and phenylalanine; zearalenone was reduced to alpha-zearalenol and to a lesser degree to beta-zearalenol; diacetoxyscirpenol and T-2 toxin were deacetylated to monoacetoxyscirpenol and HT-2 toxin, respectively. Feeding of 5 ppm (5 mg/kg) of ochratoxin A to sheep revealed 14 ppb (14 ng/ml) of ochratoxin A and ochratoxin alpha in rumen fluid after 1 h, but neither was detected in the blood. Whether such conversions in the rumen fluid may be considered as a first line of defense against toxic compounds present in the diet is briefly discussed.
Ribotype diversity of Listeria monocytogenes isolates from two salmon processing plants in Norway

Abstract The purpose of this study was to use automated ribotyping procedure to track Listeria monocytogenes transmission in the cold smoked fish production chain and to characterize L. monocytogenes subtypes associated with the salmon processing industry. A total of 104 isolates, which had previously been obtained from a raw fish slaughter and processing plant (plant B) and an adjacent, downstream, salmon smoking operation (plant A), were characterized. These isolates had been obtained through a longitudinal study on Listeria presence, which covered a 31-week period, in both plants. Isolates had been obtained from samples taken from different machinery used throughout the production process. In addition, six isolates obtained from products produced in plant A two years after the initial study were included, so that a total of 110 isolates were characterized. Automated ribotyping was performed using both the restriction enzymes EcoRI and PvuII to increase the discriminatory power. The 110 L. monocytogenes isolates could be divided into 11 EcoRI ribotypes; PvuII ribotype data yielded multiple subtypes within 7 EcoRI ribotypes for a total of 21 subtypes based on both EcoRI and PvuII ribotyping. A total of three EcoRI ribotypes (DUP-1023C, DUP-1045B, and DUP-1053E) were isolated at multiple sampling times from both plants. In addition, one subtype (DUP-1053B) was isolated at multiple sampling times in only plant A, the salmon smoking operation. These data not only support that L. monocytogenes can persist throughout the salmon production system, but also showed that L. monocytogenes may be transmitted between slaughter and smoking operations or may be unique to smoking operations. While the majority of subtypes isolated have been rarely or never linked to human listeriosis cases, some subtypes have previously caused human listeriosis outbreaks and cases. Molecular subtyping thus is critical to identify L. monocytogenes transmission and niches in order to allow design and implementation of control strategies at the appropriate stage of production and in order to reduce the prevalence of L. monocytogenes linked to human disease.
A historical review of the concept of labor support in technocratic, humanistic and holistic paradigms of childbirth

Background In the past century, maternal support during childbirth has been changed according to the different approaches suggested by various health care paradigms. Objective The aim of this review was to argue the maternity supportive care paradigms of the past century and to closely analyze each paradigm. Methods This is a historical review, in which published articles were retrieved from databases including Scopus, Science Direct, PubMed and Google Scholar. Sage Journals and Springer’s publications were also searched due to the high citation rate of their articles. The keywords entered were “Labor support”, “Normal delivery”, “Birth attendance”, “Supportive approaches”, “Health care paradigms”, and “Midwifery models of care”. They were entered alone or in combinations using “AND”. Also, Persian articles were searched in local databases including Irandoc, SID, IranMedex, and Magiran using the above-mentioned keywords in Persian. Sixty articles met inclusion criteria. Results The review revealed four main themes including the definitions of continuous labor support, the technocratic paradigm, the humanistic paradigm and the naturalistic paradigm as models of labor support. According to the evidence, labor support has changed from technocratic to humanistic and holistic approaches, which in turn, caused some changes in midwifery models of care used by midwives in the practice. Conclusion Labor support based on the holistic approaches and the naturalistic paradigms could bring about remarkable outcomes, the most important being satisfied with the birth experience, increased mother’s self-confidence, enhanced mother’s ability in childbirth and better completion of the childbirth process.
Advanced Laser Techniques for Filler‐Induced Complications

BACKGROUND The increasing use of injectable fillers has been increasing the occurrence of disfiguring anaerobic infection or granulomas. This study presents two types of laser‐assisted evacuation of filler material and inflammatory and necrotic tissue that were used to treat disfiguring facial nodules after different types of gel fillers. MATERIALS AND METHODS Infectious lesions after hydrogels were drained using a lithium triborate laser at 532 nm, with subsequent removal of infected gel and pus (laser assisted evacuation). Granuloma after gels containing microparticles were treated using an 808‐nm diode laser using intralesional laser technique. The latter melted and liquefied the organic and synthetic components of the granulomas, facilitating subsequent evacuation. Both lasers had an easily controllable thin laser beam, which enabled the physician to control tissue damage and minimize discomfort and pain. RESULTS All 20 patients experienced reduction or complete resolution, the latter increasing with repeated treatments. CONCLUSION Laser‐assisted treatment offers a successful solution for patients who have been suffering from disfiguring nodules from injected fillers—often for many years. The procedure broadens the range of treatment options in cases of untoward reactions to fillers, in line with surgical removal but with lower morbidity and less cosmetic disfigurement. The authors have indicated no significant interest with commercial supporters.
Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis.

BACKGROUND Antibiotic administration to individuals with Shiga toxin-producing Escherichia coli (STEC) infection remains controversial. We assessed if antibiotic administration to individuals with STEC infection is associated with development of hemolytic uremic syndrome (HUS). METHODS The analysis included studies published up to 29 April 2015, that provided data from patients (1) with STEC infection, (2) who received antibiotics, (3) who developed HUS, and (4) for whom data reported timing of antibiotic administration in relation to HUS. Risk of bias was assessed; strength of evidence was adjudicated. HUS was the primary outcome. Secondary outcomes restricted the analysis to low-risk-of-bias studies employing commonly used HUS criteria. Pooled estimates of the odds ratio (OR) were obtained using random-effects models. RESULTS Seventeen reports and 1896 patients met eligibility; 8 (47%) studies were retrospective, 5 (29%) were prospective cohort, 3 (18%) were case-control, and 1 was a trial. The pooled OR, including all studies, associating antibiotic administration and development of HUS was 1.33 (95% confidence interval [CI], .89-1.99; I(2) = 42%). The repeat analysis including only studies with a low risk of bias and those employing an appropriate definition of HUS yielded an OR of 2.24 (95% CI, 1.45-3.46; I(2) = 0%). CONCLUSIONS Overall, use of antibiotics was not associated with an increased risk of developing HUS; however, after excluding studies at high risk of bias and those that did not employ an acceptable definition of HUS, there was a significant association. Consequently, the use of antibiotics in individuals with STEC infections is not recommended.
Correspondences Among Parent, Teacher, and Student Perceptions of Adolescents' Learning Disabilities

A group of 26 adolescents with learning disabilities (Grades 9 through 12), their parents, and their special education teachers were asked to rate the students' skills in each of 21 specific areas covering general ability, oral language, reading, written language, math, study skills, motivation, social skills, attention, and nonverbal skills. Correspondences in the absolute and relative ratings of parents, teachers, and students across the 21 skill areas were examined. The parents' ratings were consistent with those of the teachers in 16 areas and significantly lower than the teachers in 5 areas. The students' ratings were generally higher than those of their parents and teachers. The student-teacher differences were significant in 6 areas, whereas the student-parent differences were significant in 11 areas. Although generally lower in absolute terms than the ratings of their children, the parents' relative ratings were strikingly parallel to their children's ratings across skill areas (r= .80). Differences in the reference groups used for the ratings did not seem to account for the discrepant ratings. Possible implications of the differing perceptions of students' learning disabilities for students' self-esteem and academic progress are discussed.
The national incidence of iatrogenic popliteal artery injury during total knee replacement

Introduction The aim of this study was to characterize national characteristics of patients who have a total knee replacement complicated by popliteal artery injury by incidence and patient demographics. Methods All patients with ICD-9 confirmed total knee replacement who had an iatrogenic popliteal artery injury were included from the national in-patient sample from 1998 to 2011. Age, gender and race, procedure type, time to popliteal artery injury, limb outcome, length of stay and hospital inpatient charges were reported. Results A total of 1,297,369 patients underwent a total knee replacement of which 43 were complicated by popliteal artery injury (0.003%); 93% had osteoarthritis as their primary diagnosis. The mean age was 61.7 ± 12.3 years. In all, 96% of patients had their popliteal injuries detected intra-operatively or on the day of total knee replacement surgery. The majority of these patients either received stent placement (44%) or peripheral bypass (30%) as their treatment modality for popliteal artery injury. There were no amputations or deaths in this cohort. The median hospital charges for this group were $27,570 (2014 USD). Conclusion The national incidence of iatrogenic popliteal artery injury in patients undergoing TKR is 0.003%. There were no amputations in our study population and 96% of patients had their injury detected intra-operative or immediately post-operatively.
Thirty‐Nine Novel Neurofibromatosis 1 (NF1) Gene Mutations Identified in Slovak Patients

We performed a complex analysis of the neurofibromatosis type 1 (NF1) gene in Slovakia based on direct cDNA sequencing supplemented by multiple ligation dependent probe amplification (MLPA) analysis. All 108 patients had café‐au‐lait spots, 85% had axilary and/or inguinal freckling, 61% neurofibromas, 36% Lisch nodules of the iris and 31% optic pathway glioma, 5% suffered from typical skeletal disorders, and 51% of patients had family members with NF1.
The enhanced biodegradation of fenamiphos in soils from previously treated sites and the effect of soil fumigants

The application of fenamiphos either alone or in combination with soil fumigants is a common practice in greenhouses and potato‐cultivation areas in Greece. However, repeated applications of fenamiphos in the same field for a number of years can lead to the development of enhanced biodegradation of the nematicide. Studies in previously treated greenhouse sites and potato field sites in Greece were employed in order to investigate the development of enhanced biodegradation of fenamiphos and the respective effect of soil fumigants on the development of the phenomenon. Enhanced biodegradation of fenamiphos in a soil from a previously treated greenhouse site from the area of Aggelohori in Northern Greece was observed using both incubation and bioassay studies with nematodes. Fumigation of the enhanced soil with methyl bromide (MeBr) only temporarily inhibited degradation of fenamiphos unlike metham sodium (MS) whose application significantly reduced microbial degradation of fenamiphos. Similarly, enhanced biodegradation of fenamiphos was evident in soil from potato fields that had a history of previous exposure to fenamiphos. The slow rates of fenamiphos degradation observed in soils from the previously treated sites after sterilization with broad‐spectrum antibiotics and also in soils from previously untreated sites suggested that soil microorganisms were responsible for its rapid degradation. The inhibition of enhanced biodegradation of fenamiphos in soil from the previously treated greenhouse site caused by the antibiotic penicillin probably indicates that Gram+ or other bacteria sensitive to penicillin are responsible for the rapid degradation of fenamiphos in this soil. No cross‐adaptation was observed between fenamiphos and other nematicides registered in Greece for the control of root‐knot and potato cyst nematodes, including cadusafos, ethoprophos, and oxamyl. According to our results, applications of MS followed by fenamiphos or in rotation with other registered nematicides are the most promising means for minimizing the risk of development of enhanced biodegradation of fenamiphos in soils.
Quantitative Profiling and Identification of Plasma Proteins of Spinocerebellar Ataxia Type 2 Patients

Background: Spinocerebellar ataxia type 2 (SCA2) is an autosomal-dominant hereditary ataxia characterized by progressive gait and limb ataxia, dysarthria, slow saccades, neuropathy and dementia. The expansion of trinucleotide CAG repeats in the coding region of the ATXN-2 gene leads to expanded polyglutamine stretch in the mutated protein which causes neuronal death. Objective: In this study, we investigated the blood plasma of SCA2 patients to find protein biomarkers. Methods: Thirty-two ataxia patients clinically suspected for SCA2 were evaluated by the International Co-operative Ataxia Rating Scale followed by genetic analysis using PCR. Plasma proteomics of SCA2 patients and age- and gender-matched healthy controls was done using 2D-difference in-gel electrophoresis, LC-MS/MS and Western blot. Results: Genetic analysis confirmed 10 of 32 suspected SCA2 patients. Proteomic data revealed nine differentially expressed proteins in SCA2. These proteins find good association with oxidative stress, calcium-dependent apoptosis, neuropathy, and cognitive impairment in SCA2 patients. Interestingly, the elevated levels of the voltage-dependent calcium channel γ-3 subunit showed a direct correlation with calcium-generated apoptosis of Purkinje cells. The cognitive deficit, a common symptom in SCA2 patients, seems to correlate with decreased levels of transthyretin and retinol-binding protein-4. Conclusions: Some of these identified proteins in SCA2 can be useful for therapeutic, diagnostic and prognostic purposes.
Evaluation of job satisfaction and working atmosphere of dental nurses in Germany.

OBJECTIVES The purpose of the study was to assess the level of job satisfaction of dental nurses in ambulatory care and to explore the impact of aspects of working atmosphere on and their association with job satisfaction. METHODS This cross-sectional study was based on a job satisfaction survey. Data were collected from 612 dental nurses working in 106 dental care practices. Job satisfaction was measured with the 10-item Warr-Cook-Wall job satisfaction scale. Working atmosphere was measured with five items. Linear regression analyses were performed in which each item of the job satisfaction scale was handled as dependent variables. A stepwise linear regression analysis was performed with overall job satisfaction and the five items of working atmosphere, job satisfaction, and individual characteristics. RESULTS The response rate was 88.3%. Dental nurses were satisfied with 'colleagues' and least satisfied with 'income. ' Different aspects of job satisfaction were mostly associated with the following working atmosphere issues: 'responsibilities within the practice team are clear,' 'suggestions for improvement are taken seriously,' 'working atmosphere in the practice team is good,' and 'made easier to admit own mistakes. ' Within the stepwise linear regression analysis, the aspect 'physical working condition' (β = 0.304) showed the highest association with overall job satisfaction. The total explained variance of the 14 associated variables was 0.722 with overall job satisfaction. CONCLUSIONS Working atmosphere within this discrete sample of dental care practice seemed to be an important influence on reported working condition and job satisfaction for dental nurses. Because of the high association of job satisfaction with physical working condition, the importance of paying more attention to an ergonomic working position for dental nurses to ensure optimal quality of care is highlighted.
A Reliability Perspective of the Smart Grid

Increasing complexity of power grids, growing demand, and requirement for greater reliability, security and efficiency as well as environmental and energy sustainability concerns continue to highlight the need for a quantum leap in harnessing communication and information technologies. This leap toward a ¿smarter¿ grid is widely referred to as ¿smart grid. ¿ A framework for cohesive integration of these technologies facilitates convergence of acutely needed standards, and implementation of necessary analytical capabilities. This paper critically reviews the reliability impacts of major smart grid resources such as renewables, demand response, and storage. We observe that an ideal mix of these resources leads to a flatter net demand that eventually accentuates reliability challenges further. A gridwide IT architectural framework is presented to meet these challenges while facilitating modern cybersecurity measures. This architecture supports a multitude of geographically and temporally coordinated hierarchical monitoring and control actions over time scales from milliseconds and up.