Miracle-dz/UniFAR-FTUs huggingface dataset:
Long-term follow-up of the randomised controlled trial to evaluate the safety and efficacy of the zotarolimus-eluting driver coronary stent in de novo native coronary artery lesions: five year outcomes in the ENDEAVOR II study.

AIMS We report here the final 5-year follow-up results from the ENDEAVOR II trial, which was the first randomised trial evaluating the Endeavor(tm) zotarolimus-eluting stent (ZES) compared with a bare metal stent (BMS) in patients with single, de novo coronary artery lesions. METHODS AND RESULTS Eligible patients were randomised 1:1 to receive ZES or BMS and were followed by telephone or clinic visit up to five years. We evaluated TVF and its components (target vessel revascularisation [TVR], Q-wave or non Q-wave myocardial infarction, or cardiac death attributed to the target vessel) at five years. Additionally, we report rates of MACE, TLR, and stent thrombosis (protocol- and ARC-defined) through five years. ENDEAVOR II enrolled 1,197 patients (598 ZES, 599 BMS). At five years of follow-up, the rates of TVF (15.4% vs 24.4%), TVR (10.7% vs 20.1%), MACE (15.4% vs 24.6%), and TLR (7.5% vs 16.3%) remained significantly lower in ZES patients compared with BMS patients. ARC definite and probable very late (>1 year) stent thrombosis remained low (0.2% ZES and 0.3% BMS) through five years. CONCLUSIONS After five years of follow-up, ZES demonstrated significantly improved clinical outcomes with sustained safety compared with BMS in patients with obstructive coronary artery disease.
Nonthermal Atmospheric Plasma Rapidly Disinfects Multidrug-Resistant Microbes by Inducing Cell Surface Damage

ABSTRACT Plasma, a unique state of matter with properties similar to those of ionized gas, is an effective biological disinfectant. However, the mechanism through which nonthermal or “cold” plasma inactivates microbes on surfaces is poorly understood, due in part to challenges associated with processing and analyzing live cells on surfaces rather than in aqueous solution. Here, we employ membrane adsorption techniques to visualize the cellular effects of plasma on representative clinical isolates of drug-resistant microbes. Through direct fluorescent imaging, we demonstrate that plasma rapidly inactivates planktonic cultures, with >5 log10 kill in 30 s by damaging the cell surface in a time-dependent manner, resulting in a loss of membrane integrity, leakage of intracellular components (nucleic acid, protein, ATP), and ultimately focal dissolution of the cell surface with longer exposure time. This occurred with similar kinetic rates among methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Candida albicans. We observed no correlative evidence that plasma induced widespread genomic damage or oxidative protein modification prior to the onset of membrane damage. Consistent with the notion that plasma is superficial, plasma-mediated sterilization was dramatically reduced when microbial cells were enveloped in aqueous buffer prior to treatment. These results support the use of nonthermal plasmas for disinfecting multidrug-resistant microbes in environmental settings and substantiate ongoing clinical applications for plasma devices.
Early clinical signs and imaging findings in Gerstmann–Sträussler–Scheinker syndrome (Pro102Leu)

Objective: To determine the clinical and radiologic features of Gerstmann–Sträussler–Scheinker syndrome caused by Pro102Leu mutation in PRNP (GSS102). Methods: The authors report 11 patients (nine families) with clinically and radiologically diagnosed GSS102. Results: All patients showed mild gait disturbance, dysesthesia and hyporeflexia of the lower legs, and truncal ataxia, and 9 of 11 patients showed proximal leg muscle weakness during the early stage of the disease. Dementia was not a main symptom during the early stage. Brain MRI and EEG abnormalities were not prominent initially. SPECT (N-isopropyl-p-[123I]iodoamphetamine) analyzed by the three-dimensional stereotactic surface projection (SSP) method detected abnormalities in five patients early during the course of the illness. SPECT findings showed diffusely decreased cerebral blood flow, demonstrated by a mosaic pattern, with the lowest perfusion noted in the occipital lobes. In contrast, blood flow to the cerebellum was preserved. These studies suggested sites of pathology in GSS102, with the main lesions probably located in the cerebrum and the spinal cord (posterior horn and spinocerebellar tract) instead of the cerebellum. Conclusions: Key features for early diagnosis of Gerstmann–Sträussler–Scheinker syndrome caused by Pro102Leu mutation in PRNP (GSS102) are truncal ataxia, dysesthesia and hyporeflexia of the lower legs, and mild dysarthria. Normal cerebellar MRI and abnormal cerebral SPECT findings are characters of early GSS102.
How patients use access to their full health records: a qualitative study of patients in general practice

Summary Objective To explore how patients use record access, its impact and the benefits and drawbacks of using it. Design Qualitative study using focus group interviews, individual interviews and telephone interviews. Setting General practice offering electronic access to full medical records using PAERS system. Participants Forty-three patients aged between 20 and 71 years participated. Of these, nine were in the healthy group, eight had long-term health conditions, 10 were in the mental health group and 16 were pregnant. Results Three themes emerged as to how patients used record access – participation in care, quality of care and self-care strategies. Record access was used to help prepare patients for consultations, compensate for poor or complex communication during consultations and to reduce the fragmentation of care. Record access had a small impact on health behavior intentions. Overall patients felt that record access reinforced trust and confidence in doctors and helped them feel like partners in healthcare. Conclusion This study suggests that record access improves shared management, with patients using their records to improve interactions with healthcare providers, make decisions about their health and improve the quality of the care they receive. These findings also suggest a possible long-term potential for record access to improve health outcomes.
Treatment of type 2 and 4 olecranon fractures with locking compression plate osteosynthesis in horses: A prospective study (2002–2008)

Summary This prospective study describes a series of 18 olecranon fractures in 16 horses that were treated with locking compression plates (LCP). Twelve of the 18 fractures were simple (type 2), whereas six were comminuted (type 4). Six fractures were open and 12 were closed. Each horse underwent LCP osteosynthesis consisting of open reduction and application of one or two LCP. Complete fracture healing was achieved in 13 horses. Three horses had to be euthanatized: two because of severe infection and one because of a comminuted radial fracture 11 days after fixation of the olecranon fracture. Complications encountered after discharge of the horses from the Equine Hospital at the Vetsuisse Faculty (University of Zurich) included implant infection (n = 2) and lameness (n = 3), which were successfully treated with implant removal. Despite being easier to use, LCP osteosynthesis resulted in a clinical outcome similar to DCP osteosynthesis.
Socio‐economic disadvantage and demographics as factors in stage of colorectal cancer presentation and survival

Colorectal cancer (CRC) is common, and early diagnosis improves outcome. Overseas studies have suggested that low socio‐economic status (SES) is related to advanced cancer stage at presentation and reduced survival. The situation in Australia is unclear. This study examines the effect of demographic and SES on CRC stage at presentation and survival in a single tertiary centre.
Estimating left ventricular filling pressure during positive end-expiratory pressure in humans.

In the critically ill, accurate measurements of left ventricular (LV) filling pressure using pulmonary artery occlusion pressure (Ppao) are important for diagnostic and therapeutic purposes. In patients receiving positive end-expiratory pressure (PEEP), Ppao may not reflect LV filling pressure because of elevated pericardial pressure (Ppc). It has been proposed that in humans, Ppc and right atrial pressure (PRA) are equal, so that referencing Ppao to PRA may improve the assessment of LV filling pressure when Ppc is elevated. Similarly, it has also been shown in the dog that nadir Ppao immediately after airway disconnection from PEEP (nadir Ppao), accurately reflects LV filling pressure when LV filling pressure is greater than or equal to 10 mm Hg. We examined methods of estimating LV filling pressure using Ppao measurements under conditions in which increases in Ppc were the primary determinants of differences in the two measurements. Using left atrial pressure (PLA) relative to Ppc, called transmural PLA (PLAtm), as LV filling pressure, we compared the accuracy of Ppao, nadir Ppao, and Ppao relative to PRA to reflect PLAtm in 15 postoperative cardiac surgery patients in whom an air-filled pericardial balloon catheter and a left atrial catheter were inserted during surgery. PEEP was sequentially increased from zero to 15 cm H2O. We found that PRA always exceeded Ppc (p less than 0.01) and increased less with PEEP than did Ppc (p less than 0.05). At less than or equal to 5 cm H2O PEEP, both Ppao and nadir Ppao were similar to each other and to PLAtm. (ABSTRACT TRUNCATED AT 250 WORDS)
The Physiology of Hibernation among Painted Turtles: The Eastern Painted Turtle Chrysemys picta picta

Eastern painted turtles (Chrysemys picta picta) from Connecticut were submerged at 3°C in normoxic and anoxic water to simulate potential respiratory environments within their hibernacula. Those in normoxic water could survive submergence for at least 150 d, while those in anoxic water could survive for a maximum of about 125 d. Turtles in normoxic water developed a slight metabolic acidosis as plasma lactate accumulated to about 50 mM in 150 d, while anoxic turtles developed a severe lactic acidosis as plasma lactate reached about 200 mM in 125 d; there was no respiratory acidosis in either group. Plasma [Na+] changed little in either group, [Cl−] fell by about one‐third in both, and [K+] increased by about fourfold in anoxic turtles but only slightly in those in normoxic water. Total plasma magnesium and calcium increased profoundly in anoxic turtles but moderately in those in normoxic water. Consideration of charge balance indicates that all major ions were measured in both groups. Plasma glucose remained unchanged in anoxic turtles until after about 75 d of submergence, when it increased and continued to increase with the duration of anoxia, with much variation among individuals; glucose remained unchanged throughout in turtles in normoxic water. Hematocrit doubled in 150 d in turtles in normoxic water; in anoxic turtles, an initial increase was no longer significant by day 100. Plasma osmolality increased markedly in anoxic turtles, largely because of accumulation of lactate, but anoxic turtles only gained about half the mass of turtles in normoxic water, who showed no increase in osmolality. The higher weight gain in the latter group is attributed to selective perfusion and ventilation of extrapulmonary gas exchange surfaces, resulting in a greater osmotic influx of water. The physiologic responses to simulated hibernation of C. picta picta are intermediate between those of Chrysemys picta bellii and Chrysemys picta dorsalis, which correlates with the severity of the winter each subspecies would be expected to encounter.
Postnatal Renal Abnormalities in Rats Exposed to Losartan during Lactation

Background/Aims: Rats exposed to losartan during lactation exhibit progressive changes in renal function and structure. This study analyzed the early events in pups from dams that received losartan during lactation. Methods: Male Wistar rats from dams that received 2% sucrose (control, n = 25) or losartan (100 mg/kg/day) diluted in 2% sucrose (n = 33) during lactation were anesthetized 21 days after birth. Blood and urine samples were collected to assess renal function, and kidneys were removed for histological, immunohistochemical, Western blot, lipid peroxidation and glutathione analyses. Results: The group exposed to losartan exhibited increased albuminuria and fractional sodium and potassium excretion, decreased glomerular area and interstitial expansion. Immunohistochemical analyses demonstrated increased tubulointerstitial macrophage infiltration, apoptosis and increased vimentin and α-smooth-muscle-actin expression in animals exposed to losartan. In addition, the glomeruli of animals exposed to losartan exhibited increased peripheral desmin expression and reduced glomerular epithelial protein 1 and podocin expression compared to controls. Lastly, renal lipid peroxidation and glutathione levels were higher in the losartan-treated pups. Conclusion: Pups exposed to losartan during lactation exhibited adverse changes in renal function and structure, and tubulointerstitial inflammation at 21 days of age that were associated with apoptosis and oxidative stress.
Molecular Changes of the Fusion Protein Gene of Chicken Embryo Fibroblast–Adapted Velogenic Newcastle Disease Virus: Effect on Its Pathogenicity

Abstract Molecular changes of cell culture–adapted Newcastle disease virus (NDV) were studied by adapting a velogenic NDV isolated from commercial layer chicken-to-chicken embryo fibroblast (CEF) cells. The isolate was passaged 50 times in CEF cells. At every 10th passage the virus was characterized conventionally by mean death time analysis, intracerebral pathogenicity index, and virus titration. As the passage level increased, a gradual reduction in the virulence of the virus was observed. Molecular characterization of the virus included cloning and sequencing of a portion of the fusion gene (1349 bp) encompassing the fusion protein cleavage site (FPCS), which was previously amplified by reverse transcription–polymerase chain reaction. Sequence analysis revealed a total of 134 nucleotide substitutions, which resulted in the change of 41 amino acids between the parent and the 50th passage virus. Pathogenicity studies conducted in 20-wk-old seronegative chickens revealed gross and histopathologic changes in the chickens injected with the parent virus and absence of the lesions in chickens injected with the adapted virus. The 50th passage cell culture virus was back-passaged five times in susceptible chickens and was subjected to virulence attribute analysis and sequence analysis of the FPCS region, with minor differences between them.
Establishing High Dimensional Immune Signatures from Peripheral Blood via Mass Cytometry in a Discovery Cohort of Stage IV Melanoma Patients

The identification of blood-borne biomarkers correlating with melanoma patient survival remains elusive. Novel techniques such as mass cytometry could help to identify melanoma biomarkers, allowing simultaneous detection of up to 100 parameters. However, the evaluation of multiparametric data generated via time-of-flight mass cytometry requires novel analytical techniques because the application of conventional gating strategies currently used in polychromatic flow cytometry is not feasible. In this study, we have employed 38-channel time-of-flight mass cytometry analysis to generate comprehensive immune cell signatures using matrix boolean analysis in a cohort of 28 stage IV melanoma patients and 17 controls. Clusters of parameters were constructed from the abundance of cellular phenotypes significantly different between patients and controls. This approach identified patient-specific combinatorial immune signatures consisting of high-resolution subsets of the T cell, NK cell, B cell, and myeloid compartments. An association with superior survival was characterized by a balanced distribution of myeloid-derived suppressor cell-like and APC-like myeloid phenotypes and differentiated NK cells. The results of this study in a discovery cohort of melanoma patients suggest that multifactorial immune signatures have the potential to allow more accurate prediction of individual patient outcome. Further investigation of the identified immune signatures in a validation cohort is now warranted.
Peripheral nerve disorders in instrumentalists

I evaluated 226 instrumentalists for playing‐related symptoms. There were 103 players (46%) of string instruments, 73 keyboard instrumentalists (32%), 44 players (19%) of wind instruments, and 6 percussionists (3%). The mean age was 32 years; 58% were women. Sixty‐five patients (29%) had a peripheral nerve disorder; 27 had symptoms of thoracic outlet syndrome; 12 had median neuropathies (carpal tunnel syndrome in 9); 9 had ulnar neuropathies; 6 had cervical radiculopathy; 5 had digital neuropathies; 3 had cranial neuropathies; and 3 had other peripheral nerve disorders. Treatment consisted of modification of playing schedules and technique, plus physical and occupational and therapy in 51 and surgical procedures in 9 patients; 5 were not treated. Follow‐up at 1 to 8 years showed 74% had a satisfactory result, 14percnt; had slight or minimal improvement, and 12percnt; had no improvement. At the time of writing, all but 4 patients remained in the music profession. It is concluded that playing‐related symptoms among instrumentalists are frequently neurological in origin and that the large majority can be helped by conservative or, on occasion, surgical means.
Unveiling epileptogenic lesions: The contribution of image processing

Magnetic resonance imaging (MRI) is a pivotal component in the investigation of patients with any form of epilepsy because of its unmatched ability in visualizing structural brain pathology. The MRI signature of newly diagnosed epilepsy is not yet fully defined, mainly because of the lack of a cohesive methodology to evaluate structural changes in the early stages of the disease. By revealing subtle lesions that previously eluded visual inspection in patients with drug‐resistant epilepsy, quantitative computer‐assisted image analysis has clearly demonstrated increased sensitivity and diagnostic accuracy compared to conventional techniques. Therefore, the application of image processing methods in patients with newly diagnosed epilepsy promises to reduce the trial–error period in potential surgical candidates, provide solid biomarkers for monitoring the disease and identifying treatment responders. A clearer understanding of brain pathology at the early stages of the disorder will help clinicians to develop better criteria for identifying patients who are at risk of secondary brain damage and for timely intervention that achieves seizure control.
The effect of intermittent high-intensity running on gastric emptying of fluids in man.

PURPOSE This study examined the effect of variable-intensity shuttle running on gastric emptying of a carbohydrate-free placebo (Plac) drink and of a 6.4% carbohydrate-electrolyte (CHO) sports drink. METHOD We compared the volume of test drink emptied during two 15-min periods of walking exercise (WE) with that during two 15-min periods of the Loughborough Intermittent Shuttle Test (LIST). Gastric emptying was measured on the four trials using a double-sampling aspiration technique in eight healthy males after ingestion of a 420 +/- 49 mL and a 168 +/- 20 mL bolus of the appropriate test drink at the start of the first and second exercise period, respectively. RESULTS During the initial 15 min of exercise, the mean (+/-SD) volume of Plac (124 +/- 95 mL) and CHO (71 +/- 43 mL) drink emptied was similar between the two LIST trials, but the volume of Plac (227 +/- 85 mL) and CHO (159 +/- 63 mL) drinks emptied on the WE trials was greater than for the respective test drinks on the LIST trials. Similar volumes of test drinks were emptied on all trials (P = 0.20) during the second 15 min of exercise. Over the 30 min of each trial, the exercise intensity of the LIST reduced the volume of the Plac (211 +/- 108 mL) and CHO (208 +/- 83 mL) drink emptied compared with that on the WE trial for the Plac (396 +/- 74 mL) and CHO (293 +/- 73 mL) drink, respectively. CONCLUSIONS The exercise intensity of the LIST is sufficient to slow gastric emptying of carbohydrate and noncarbohydrate containing drinks compared with walking. Dilute carbohydrate-electrolyte drinks empty at about the same rate as carbohydrate-free beverages during variable-intensity running.
Characteristics of leucocyte adhesion directly observed in flowing whole blood in vitro

Use of whole blood in adhesion assays allows analysis of the rheological and haematological factors that may influence adhesion, and avoids the need for isolation procedures that may modify the properties of leucocytes. We have adapted an in vitro flow model to allow videomicroscopy of leucocytes fluorescently labelled with rhodamine 6G (20 μg/ml) in anticoagulated whole blood. Blood was perfused at a range of wall shear rates (35–280/s) through a vertical glass capillary with a rectangular cross‐section (microslide) that had been coated with P‐selectin (10 μg/ml). Nearly all adherent cells were rolling in blood that had been anticoagulated with buffered citrate, but 40–50% became immobilized when heparin or thrombin inhibitor (PPACK) were used. The efficiency of leucocyte adhesion decreased steadily during 1–4 h of blood storage. Smaller fluorescent cells (lymphocytes) adhered less efficiently than larger cells (granulocytes) and rolled faster. Adhesion decreased monotonically with increasing wall shear rate or stress, but the velocity of rolling varied little. Among healthy volunteer donors, adhesion correlated with blood leucocyte count, but did not vary significantly with natural variation in haematocrit, blood viscosity or red cell aggregation. In conclusion, we have characterized adhesion of leucocytes in flowing whole blood, identified key experimental variables and demonstrated that physical environmental factors can markedly influence adhesive behaviour.
VEGF-165 serum levels and tyrosinase expression in melanoma patients: correlation with the clinical course

Vascular endothelial growth factor (VEGF) is known to play a crucial role in the growth and metastatization of solid tumours. In cancer patients, high VEGF serum levels correlate with tumour status and prognosis, but to date few data have been reported concerning VEGF in melanoma patients. In the present study, immunoenzymatic and reverse transcription-polymerase chain reaction (RT-PCR) techniques were used to detect VEGF-165 serum levels and the presence of tyrosinase mRNA, respectively, in the peripheral blood of a cohort of 155 melanoma patients at different clinical stages (30 stage I, 40 stage II, 40 stage III and 45 stage IV; AJCC classification). Data were compared with both the extent of the disease and the clinical course. The aim was to assess the relationship between VEGF serum levels, the presence of detectable circulating melanoma cells and melanoma progression. A significant increase in VEGF serum levels was found in melanoma patients, in particular in those with metastatic disease; a higher incidence of relapses was found in stage I–III disease-free patients who showed an increase in VEGF during follow-up. VEGF serum levels were significantly higher in patients with detectable circulating melanoma cells than in those with negative tyrosinase mRNA expression. The finding of both an increase in VEGF and the presence of detectable melanoma cells during follow-up was associated with a relapse rate of 81%. The relapse rate was significantly lower when either of the two parameters were present separately. Multivariate analysis of both overall survival and time-to-progression selected baseline tyrosinase expression in peripheral blood but not VEGF serum levels as an independent prognostic factor.