Miracle-dz/UniFAR-FTUs huggingface dataset:
Risk of myocardial infarction, heart failure, and cerebrovascular disease with the use of valsartan, losartan, irbesartan, and telmisartan in patients

There is a lack of studies comparing the risk of cardio-cerebrovascular disease between angiotensin receptor blockers (ARBs) of different half-lives. We aimed to compare the risks of myocardial infarction (MI), heart failure (HF), and cerebrovascular disease with the use of valsartan, losartan, irbesartan, and telmisartan with different half-lives in a national claim-based retrospective cohort of patients aged ≥ 40 years with hypertension. To establish a cohort exposed to valsartan, losartan, irbesartan, or telmisartan, we performed propensity score (PS) matching and used an as-treated approach to evaluate exposure. The Cox regression model was employed to calculate hazard ratios, which were based on the incidence rate for each newly occurring event of MI, heart failure, or cerebrovascular disease. These hazard ratios were calculated to compare the risk of MI, heart failure, and cerebrovascular disease associated with valsartan, losartan, and irbesartan in comparison to telmisartan. A PS-matched cohort of 148,229 patients was established for each of valsartan, losartan, irbesartan, or telmisartan. The matched cohort analysis showed that the adjusted hazard ratio (aHRs, 95% confidence interval) for MI was higher for valsartan use (1.39, 1.33–1.45) and losartan use (1.10, 1.05–1.15) but lower for irbesartan use (0.90, 0.86–0.94) compared with the reference (telmisartan). The aHRs for HF were not different among these ARBs (angiotensin receptor blockers). The aHR for cerebrovascular disease was lower for valsartan use (0.85, 0.83–0.87) and losartan use (0.80, 0.78–0.82) but higher for irbesartan use (1.11, 1.09–1.13) compared with the reference. We found differences in the risk of MI and cerebrovascular disease with the use of different ARBs compared to telmisartan use. Valsartan, and losartan with a short half-life, which showed a higher risk of MI, had a lower risk of cerebrovascular disease. Conversely, irbesartan with a long half-life, which showed a lower risk of MI, had a higher risk of cerebrovascular disease.
Rezūm water vapor thermal therapy in patients with benign prostatic hyperplasia: Initial real-world data from Japan

Benign prostatic hyperplasia (BPH) is prevalent in older men. As surgery can be high risk in this group, minimally invasive procedures are preferrable. This study aimed to assess the initial results of minimally invasive Rezūm water vapor thermal therapy (WVTT) in patients with BPH. This single-center retrospective study included 25 consecutive patients with BPH who underwent WVTT between September 2022 and July 2023. Parameters including age, Charlson Comorbidity Index and Geriatric 8 (G8) scores, operative time, and number of vapor injections were evaluated. The International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score, and Core Lower Urinary Tract Symptom Score (CLSS) were used to assess symptoms before the procedure, and at 1 and 3 months after it. Urinary function indicators such as single voiding volume, maximum flow rate (MFR), and post-void residual volume were assessed at the same time points. The mean patient age was 76.0 years and the mean prostate volume was 54.8 mL. The mean G8 score was 14.4 and the Charlson Comorbidity Index score averaged 1.2. The mean operative time was 6.84 min, and included a mean of 4.8 vapor injections. Three months after WVTT, significant improvements were observed in the maximum flow rate (P = .02), post-void residual volume (P = .001), and urine volume (P < .001), as well as in the IPSS incomplete emptying (P = .01) and weak stream (P = .01) domains. No significant changes were observed in the remaining IPSS domains or in the Overactive Bladder Symptom Score or CLSS. This study provides the first report on Rezūm WVTT outcomes in Japan using the CLSS assessment tool. The initial results indicate a promising experience with this new treatment method. With a rapidly aging population, the incidence of BPH is expected to increase, making the minimally invasive Rezūm system a valuable addition to BPH treatment options.
Proximate and distant determinants of maternal and neonatal mortality in the postnatal period: A scoping review of data from low- and middle-income countries

Global maternal and neonatal mortality rates remain unacceptably high. The postnatal period, encompassing the first hour of life until 42 days, is critical for mother-baby dyads, yet postnatal care (PNC) coverage is low. Identifying mother-baby dyads at increased risk for adverse outcomes is critical. Yet few efforts have synthesized research on proximate and distant factors associated with maternal and neonatal mortality during the postnatal period. This scoping review identified proximate and distant factors associated with maternal and neonatal mortality during the postnatal period within low- and middle-income countries (LMICs). A rigorous, systematic search of four electronic databases was undertaken to identify studies published within the last 11 years containing data on risk factors among nationally representative samples. Results were synthesized narratively. Seventy-nine studies were included. Five papers examined maternal mortality, one focused on maternal and neonatal mortality, and the rest focused on neonatal mortality. Regarding proximate factors, maternal age, parity, birth interval, birth order/rank, neonate sex, birth weight, multiple-gestation, previous history of child death, and lack of or inadequate antenatal care visits were associated with increased neonatal mortality risk. Distant factors for neonatal mortality included low levels of parental education, parental employment, rural residence, low household income, solid fuel use, and lack of clean water. This review identified risk factors that could be applied to identify mother-baby dyads with increased mortality risk for targeted PNC. Given risks inherent in pregnancy and childbirth, adverse outcomes can occur among dyads without obvious risk factors; providing timely PNC to all is critical. Efforts to reduce the prevalence of risk factors could improve maternal and newborn outcomes. Few studies exploring maternal mortality risk factors were available; investments in population-based studies to identify factors associated with maternal mortality are needed. Harmonizing categorization of factors (e.g., age, education) is a gap for future research.
Comparison of outcomes following intravenous magnesium compared with intravenous labetalol and oral nifedipine in 355 pregnant Han Chinese women with preeclampsia

As per the American College of Obstetricians and Gynecologists in 2013, magnesium sulfate is the gold standard for the management of preeclampsia, but it has a short action time that does not provide stable maintenance of blood pressure. Labetalol is currently recommended as first-line treatment by the national UK guidance. This study included 355 pregnant Han Chinese women with preeclampsia and aimed to compare outcomes following intravenous magnesium compared with intravenous labetalol and oral nifedipine. Women received 4 g intravenous magnesium sulfate followed by the maintenance dose of 1 g/h intravenous magnesium sulfate (MS cohort, n = 104) or intravenous labetalol (LB cohort, n = 115), or oral nifedipine (NF cohort, n = 136). Therapy success: systolic blood pressure ~140 mm Hg and diastolic blood pressure ~90 mm Hg, therapy failure: persistent systolic blood pressure ≥ 160 or diastolic blood pressure ≥ 110 mm Hg after maximum dosage of therapy (EL). Women of all cohorts successfully decreased systolic and diastolic blood pressures at EL as compared to them before therapy conditions (P < .001, for all). At EL, systolic and diastolic blood pressures of women of the LB cohort decreased more than those of women of the MS and NF cohorts (P < .05, for all). Therapy was more successful in women of the LB cohort than those of the NF cohort (107 [93%] vs 112 [82%], P = .0132). More numbers of women were reduced blood pressure after 1 day of therapy from the LB cohort than those of the NF (75 [65%] vs 21 [15%]) and MS (75 [65%] vs 35 [34%]) cohorts (P < .0001 for both). Labetalol-induced tachycardia, bradycardia, and intracranial hemorrhage in pregnant women and respiratory distress syndrome and hypoglycemia in neonates. Intravenous labetalol provides proper reduction of blood pressure in Han Chinese women with preeclampsia but has the risk of undesirable maternal and neonatal adverse effects (Level of Evidence: IV; Technical Efficacy: Stage 4).
The effect of solidification on fluid–driven fracture, with application to bladed dykes

We consider fluid–driven fracture of an elastic solid, with solidification of the injected fluid. In particular, we consider buoyancy–driven horizontal propagation of a crack through a density–stratified solid at the level of neutral buoyancy of the fluid. Each part of the perimeter of the crack is in one of two regimes: at short times and far from the source, fluid reaches the tip of the crack and is able to fracture the solid and cause propagation; at longer times and closer to the source, the tip of the crack has become blocked by solidified fluid, preventing further fracture. A simple criterion for the boundary between these regimes is derived and the blocking of the perimeter is argued to be analogous to the channelling of lava flows by solidified levées at the edges. We present a model of crack propagation that combines the effects of viscous fluid flow, elastic deformation, linear fracture mechanics and buoyancy–limited vertical extent with those of fluid solidification. This model has particular relevance to the evolution of volcanic edifices, where hot magma is transported in cracks through the crust, eventually solidifying to form large, planar intrusions known as dykes.
Effect of papillary muscle and trabeculae on left ventricular function analysis via computed tomography: A cross-sectional study

Deciding whether to include or exclude the papillary muscles and trabeculae to blood pool is essential, because quantifications of left ventricular (LV) functional parameters and myocardial mass are significantly affected. As a result, such inclusion or exclusion might produce different indices for diagnosis and therapy. Using cardiac computed tomography (CT), we obtained standard values of the portion of papillary muscle and trabeculae in normal adults, and to find out how the inclusion or exclusion of papillary muscle and trabeculae affect LV functional parameters depending on the patient group. Excluding the papillary muscles from the LV mass results in easier automated contour detection using CT. The percentage portions of papillary muscle and trabeculae to LV end-diastolic volume (EDV) and LV mass (LVM) were 11.9 ± 5.6% and 20.2 ± 4.3%, respectively, significantly affecting disease diagnosis. Imaging should be consistent at follow-up and include or exclude the papillary muscles and trabeculae to avoid introducing significant differences between measurements.
Nurses Experience and Perceived Challenges of Using Nonpharmacological Pain Interventions for Musculoskeletal Pain: A Qualitative Study

Introduction Current musculoskeletal pain management guidelines encourage utilizing nonpharmacological pain measures. Despite their positive effect in alleviating musculoskeletal pain, nurses reported negative attitudes toward utilizing nonpharmacological pain measures. Therefore, assessing nurses’ perception of nonpharmacological pain measures is essential to promote patient comfort. Objective The aim of the study was to explore the nurses’ experience and perceived challenges in using nonpharmacological pain measures in caring for patients with musculoskeletal pain. Materials & Methods A descriptive qualitative design was carried out. Face-to-face semistructured interviews were conducted among 11 nurses. Colaizzi's method was employed in analyzing the data. Results Four themes emerged, namely, constant monitoring and observation, selection of nonpharmacological pain measures, and various barriers related to patients and nurses. One of the ways to overcome these barriers or challenges, we should promote interprofessional teams in planning patient-centered pain management care. Also, defining the role of the pain management nurse would be pivotal to ensuring effective pain management measures. Conclusion The nursing workforce needs to initiate and utilize these measures as a common practice in managing musculoskeletal pain and in turn create a culture that strongly supports the utilization of nonpharmacological pain measures.
ASSESSMENT OF BODY MASS INDEX AND ITS RELATIONSHIP WITH IRON STATUS INDICES AMONG WOMEN IN RURAL AREAS OF KERMAN PROVINCE, IRAN

كچ ي هد فده و هقباس : قاچ نيب طابترا ي يراميب عاونا زورب اب اه ي ًلاماك نمزم تسا هدش هتخانش . جياـتن نيـنچمه خرب ي كاح تاعلاطم زا ي هزادنا نيب طابترا زا اه ي جنس نت ي جنسارف اب ندب اه ي نوخ ي تسا نهآ تيعضو . رـب دوت هيامن تيعضو نييعت فده اب رضاح هعلاطم ،ساسا نيا ندب ه ) Body Mass Index-BMI ( رادرابريغ نانز روراب نينس رد هدريشريغ و ي ) 45 20 لاـس ( اهاتـسور نكاـس ي ياـسانش و ناـمرك ناتـسا ي اـب نآ طاـبترا جنسارف اه ي نوخ ي تفرگ ماجنا نهآ تيعضو . داوم شور و اه : هب ا دادعت روظنم ني 370 هنومن شور هب طيارش دجاو نانز زا رفن ريگ ي فداصت ي خ هشو ا ي دنديدرگ باختنا . هنومن باختنا زا سپ شسرپ طسوت كي ره زا ،اه تاصـخشم و دـمآ لمع هب هبحاصم همان راميب هقباس هب طوبرم تاعلاطا و كيفارگومد ي روراب و ي روآدرگ ي دش . هزادنا اه ي جنس نت ي و دـق لماـش ريگ هزادنا نزو ي و BMI ديدرگ هبساحم . سپس 10 ليم ي ديرو نوخ رتيل ي ريغ جنسارف و دش هتفرگ اتشان اه ي نوخ ي هزادنا اب نهآ تيعضو ريگ ي بايزرا تيركوتامه دصرد و نيتيرف و نيبولگومه تظلغ ي ديدرگ . هتفاي اه : تفاي ساسا رب اه ي نيگنايم ،هعلاطم BMI لداـعم هعلاطم دروم نانز Kg/m 3 / 24 رد هـك دوـب عيبط هدودحم ي يم دشاب . ،نينچمه 7 / 19 و دصرد 9 / 15 صرد سررب دروم نانز زا د ي هفاـضا راچد بيترت هب قاچ و نزو ي دندوب . نيگنايم BMI نس شيازفا اب ) 0001 / 0 < p ( يرادراب دادعت و اه ) 002 / 0 < p ( ـ نعم روـطب ي راد ي تفاي شيازفا . نيب نينچمه BMI نـس اب ) 32 / 0 r= ، 0001 / 0 p< ( يرادراـب دادـعت و اـه ) 26 / 0 r= ، 003 / 0 p< ( گتسبمه ي نعم تبثم ي تشاد دوجو راد . اـهكراچ نيب امسلاپ نيتيرف و نيبولگومه تظلغ نيگنايم ي فـلتخم و نزو BMI نعم توافت ي تشاد راد . يب فلاتخا نينچمه ن رد تيركوتامه دصرد نيگنايم كراچ اه ي فـلتخم
Remimazolam-based anesthesia with flumazenil allows faster emergence than propofol-based anesthesia in older patients undergoing spinal surgery: A randomized controlled trial

Background: Remimazolam is a novel, ultrashort-acting benzodiazepine that can be antagonized by flumazenil. This study aimed to determine whether remimazolam-based anesthesia with flumazenil provides a more rapid emergence than propofol-based anesthesia in older patients undergoing spinal surgery. Methods: This was a prospective, single-blind, randomized controlled trial. Forty-four patients > 75 years old who had undergone spinal surgery were enrolled in this study. They were randomly assigned to the remimazolam or propofol group (1:1) using a computer randomization system stratified by age and body weight. For anesthesia induction and maintenance, remifentanil was administered at a defined dose in both groups, and remimazolam or propofol was adjusted to maintain the bispectral index or state entropy monitoring within 40–60. All anesthetics were discontinued simultaneously after the postoperative X-ray and 0.5 mg flumazenil was administered to the remimazolam group. The primary outcome was extubation time after discontinuing anesthesia, and the secondary outcomes were time to eye opening, obeying commands, and achieving a white fast-track score (WFTS) of 12. Results: Thirty-nine patients were finally analyzed: remimazolam group (n = 20), propofol group (n = 19). There were no significant differences in intraoperative variables, such as operative time, anesthesia time, and patient background, between the 2 groups. Extubation times were significantly shorter in the remimazolam group than in the propofol group (4 vs 8 minutes, P < .001). The time to eye opening, obeying commands, and achieving a WFTS of 12 were significantly shorter in the remimazolam group (P < .001, for all comparisons). Conclusion: Remimazolam-based anesthesia with flumazenil resulted in a faster emergence than propofol-based anesthesia in older patients undergoing spinal surgery.
Factors influencing TCM syndrome types of acute cerebral infarction: A binomial logistic regression analysis

Background: Acute cerebral infarction, characterized by a rapid onset and high fatality rate, presents a significant global challenge in terms of timely and effective treatment. In recent years, research focusing on the combined approach of traditional Chinese medicine (TCM) and Western medicine has demonstrated promising results in improving therapeutic outcomes in patients with acute cerebral infarction. Diagnosis: This study adhered to the latest edition of Internal Medicine of Traditional Chinese Medicine, published by the China Press of Traditional Chinese Medicine, as a reference. It selects eight commonly encountered TCM syndrome differentiations for accurate diagnosis. Methods: This study included 151 patients admitted to the hospital between 2019 and 2022 with acute cerebral infarction. Data on various diagnostic indicators were meticulously collected and subjected to single-factor analysis. Results: Among the multiple factors analyzed, those exhibiting a significance level of P < 0.05 included blood pressure, uric acid, glucose level, triglyceride level, total cholesterol level, homocysteine level, duration of disease, and cerebral infarction site. Subsequently, a binary logistic regression analysis was performed to assess the impact of these factors on different TCM syndrome types. Conclusion: The findings of this study indicate that Wind Phlegm Obstruction syndrome, triglyceride levels, location of cerebral infarction, uric acid levels, and disease duration significantly influence the development and progression of acute cerebral infarction. Additionally, blood pressure and cerebral infarction site were found to have a statistically significant impact on the Wind Yang Disturbance syndrome. Uric acid level and blood pressure were also identified as statistically significant factors. Moreover, total cholesterol and homocysteine levels were found to significantly affect phlegm stasis-blocking collateral syndrome. The insights gained from this study will contribute to the advancement of integrated treatment approaches, combining traditional Chinese and Western medicine, for acute cerebral infarction. Furthermore, these findings can serve as a valuable reference for the general population in terms of preventive measures against this condition.
Clinical value of glucocorticoids for severe community-acquired pneumonia: A systematic review and meta-analysis based on randomized controlled trials

Background: Severe community-acquired pneumonia (sCAP) is characterized by severe symptoms and a poor prognosis, especially with the recent global impact of novel coronavirus in recent years. The use of glucocorticoids in sCAP is currently a subject of debate. To evaluate the clinical efficacy and safety of glucocorticoids and provide guidance for their rational use in clinical practice, we conducted this study. Methods: We searched PubMed, Web of Science, and China National Knowledge Infrastructure using the following search terms: “pneumonia”, “pneumonias”, “Pulmonary Inflammation”, “Pulmonary Inflammations”, “Lung Inflammation”, and “Lung Inflammations”. The primary outcomes included mortality and the length of hospital stay. The secondary outcomes included the duration of mechanical ventilation, duration of vasoactive drug use, gastrointestinal bleeding, and multiple infections. The Cochrane Collaboration was used to assess the risk of bias of the included studies. Stata/MP14 was used for meta-analysis. Results: These studies contained information on 1252 patients who received glucocorticoids and 1280 patients who did not. Meta-analysis showed that there was no difference in terms of mortality [risk ratio (RR) = 0.93, 95% confidence interval (CI): 0.81–1.07, P > . 05], gastrointestinal bleeding (RR = 1.38, 95% CI: 0.83–2.30, P < .05), multiple infections (RR = 1.17, 95% CI: 0.90–1.53, P > .05) and length of hospital stay (mean difference [MD] = −0.87, 95% CI: −2.35 to 0.61, P > .05) between the hormonal and nonhormonal groups. However, there was a significant difference in the duration of mechanical ventilation (MD = −1.54; 95% CI, −1.89 to −1.12, P < .05) and the duration of use of vasoactive drugs (MD = −14.09, 95% CI: −15.72 to −12.46, P < .05). Conclusion: Glucocorticoids reduced the duration of mechanical ventilation duration and vasoactive drug use in sCAP patients without increasing the risk of adverse events including hyperglycemia and multiple infections. However, there was no significant difference in mortality or length of hospital stay in sCAP patients between glucocorticoid and non-glucocorticoid groups. Glucocorticoids could be recommended for patients with sCAP with respiratory failure or hemodynamic instability.
Pre-contact aboriginal, and contemporary fire regimes of the savanna landscapes of northern Australia: Patterns, changes and ecological responses

Fire regimes across the fire-prone savanna landscapes of northern Australia have changed markedly in many regions since the advent of European settlers (primarily pastoralists and miners) over a period spanning, at most, 150 years. These changes have been built on a large and rapidly growing number of descriptive and experimental studies. As a result, significant concerns have been expressed recently with respect to the cultural, economic, and ecological sustainability of contemporary fire regimes across that region (e.g. McDonald and Batt 1994; Rose 1995; Grice and Slatter 1997; Jacklyn and Russell-Smith 1998; Russell-Smith et al. 2000).
Thematic maps with scatter and 4-quadrant plots in R to identity dominant entities on schizophrenia in psychiatry since 2017: Bibliometric analysis

Background: Schizophrenia affects more than 21 million people worldwide. There have been a number of articles published in the literature regarding schizophrenia. It is unclear which authors contributed the most to the field of schizophrenia. This study examines which article entities (affiliated countries, institutes, journals, and authors) earn the most research achievements (RAs) and whether keywords in articles are associated with the number of article citations. Methods: As of August 25, 2022, 20,606 abstracts published on schizophrenia in psychiatry since 2017 were retrieved from the WoS core collection (WoSCC). RAs were measured using the category, JIF, authorship, and L-index (CJAL) score. The follower-leading cluster algorithm (FLCA) was used to examine clusters of keywords associated with core concepts of research. There were 7 types of visualizations used to report the study results, including Sankey diagrams, choropleth maps, scatter charts, radar plots, and cluster plots. A hypothesis was examined that the mean number of citations for keywords could predict the number of citations for 100 top-cited articles(T100SCHZ). Results: The results indicate that the US (18861), Kings College London (U.S. (2572), Psychiatry (14603), and Kolanu Nithin (Australia) (9.88) had the highest CJAL scores in countries, institutes, departments, and authors, respectively. The journal of Schizophrenia Res had higher citations (19,017), counts (1681), and mean citations (11.31) in journals. There was a significant correlation between article citations and weighted keywords (F = 1471.74; P < .001). Conclusion: Seven visualizations were presented to report the study results, particularly with thematic maps using scatter and 4-quadrant plots produced in R programming language. We recommend that more future bibliographical studies utilize CAJL scores and thematic maps to report their findings, not restrict themselves solely to schizophrenia in psychiatry as done in this study.