Miracle-dz/UniFAR-FTUs huggingface dataset:
Long-term Safety and Feasibility of Left Bundle Branch Pacing in A Large Single Center Study.

Background - Left bundle branch pacing (LBBP) is a novel pacing method and has been observed to have low and stable pacing thresholds in prior small short-term studies. The objective of this study was to evaluate the feasibility and safety of LBBP in a large consecutive diverse group of patients with long-term follow up. Methods - This study prospectively enrolled 632 consecutive pacemaker patients with attempted LBBP from April 2017 to July 2019. Pacing parameters, complications, ECG, and echocardiographic measurements were assessed at implant, and during follow-up of 1, 6, 12 and 24 months. Results - LBBP was successful in 618/632 (97.8%) patients according to strict criteria for LBB capture. Mean follow-up time was 18.6±6.7 months. 231 patients had follow-up over 2 years. LBB capture threshold at implant was 0.65±0.27 mV@0.5ms and 0.69±0.24 mV@0.5ms at 2-year follow-up. A significant decrease in QRS duration was observed in patients with LBBB (167.22 ± 18.99ms vs. 124.02 ± 24.15ms, p<0.001). Post implantation left ventricular ejection fraction improved in patients with QRS≥120ms (48.82±17.78 % vs. 58.12±13.04 %, p<0.001). The number of patients with moderate and severe tricuspid regurgitation decreased at 1-year. Permanent right bundle branch injury occurred in 55 (8.9%) patients. LBB capture threshold increased to more than 3 V or loss of bundle capture in 6 patients (1%), 2 patients of them had loss of conduction system capture. Two patients required lead revision due to dislodgement. Conclusions - This large observational study suggests that LBBP is feasible with high success rates and low complication rates during long term follow up. Therefore, LBBP appears to be a reliable method for physiological pacing for patients with either a bradycardia or heart failure pacing indication.
The Vicious Cycle of Traumatic Narcissism and Dissociative Depression Among Young Adults: A Trans-Diagnostic Approach

ABSTRACT This study was concerned with associations between narcissism, childhood trauma, dissociation, attachment styles, and depression among young adults. Childhood Trauma Questionnaire, Dissociative Experiences Scale (DES), Relationship Styles Questionnaire, Beck Depression Scale, and the Five-Factor Narcissism Questionnaire were administered to 422 college students. Multivariate analyses revealed that childhood sexual abuse, physical neglect, both fearful and secure attachment styles, dissociation, and male gender predicted grandiose narcissism. Vulnerable narcissism was predicted by preoccupied attachment, depression, and female gender. Dissociative taxon members (n = 133, 31.5%) had elevated scores on all childhood trauma types, fearful attachment, and both vulnerable and grandiose narcissism. While there was a link between bodily childhood maltreatment, dissociation, and grandiose narcissism, vulnerable narcissism was related to loss of perceived security in relationships and depression. Representing ambivalence and an indirect link between childhood trauma and vulnerable narcissism, depression was associated with both emotional neglect and overprotection-overcontrol, and fearful and preoccupied attachment. Depression and grandiose narcissism as co-predictors of pathological dissociation fitted the concept of “dissociative depression”, which constituted an interface between two aspects of narcissism. Narcissism may be a trans-generational carrier of trauma as a fertile ground for dissociation. The escalation of dissociation among young adults in Turkey to an almost normative level may also be a consequence of the drastic transformations in the country throughout the period of globalism nurturing post-modern individualism in a conservative society. The trans-diagnostic overlap between two psychopathologies suggested that potential interference of concurrent dissociation needs to be considered in psychotherapy of narcissism and vice versa.
Anthropometric Outcome of Primary Unilateral Cleft Lip Repair in Indonesia

Objective: This study aimed to measure and analyze the outcome of primary unilateral cleft lip repair. Design: Observational cohort study. Setting: Surabaya Cleft Lip and Palate (CLP) Center, a major referral center for the Eastern part of Indonesia, affiliated with a tertiary center. Patients, Participants: From 69 patients who met the inclusion criteria, we excluded 31 patients who were more than 2 years of age and were operated on by junior residents under supervision. Interventions: We performed anthropometric measurements of the patients on photographs taken before, immediately after, and a year after the surgery. Main Outcome Measure(s): This study measured nasal width, vertical lip height, horizontal lip length, and philtral height ratios. Results: While nasal width and philtral height ratios decreased significantly (P = .000 and P = .000, respectively) reaching symmetry immediately after surgery, the horizontal lip length, and vertical lip height ratios remained unchanged (P = .862 and P = .981, respectively). A year after surgery, the nasal width and horizontal lip length ratios increased significantly (P = .017 and P = .006, respectively), while philtral height and vertical lip height ratios remained unchanged (P = .927 and P = .138, respectively). There was no difference in the ratios based on the initial size and completeness of the cleft. Conclusion: In Surabaya CLP Center, the symmetry of nasal width, philtral height, horizontal lip length, and vertical lip height were achieved by the unilateral cleft lip repair despite the initial size and completeness of the cleft.
Ultrafast measurements of excited state intramolecular proton transfer (ESIPT) in room temperature solutions of 3-hydroxyflavone and derivatives

Ultrafast pump-probe studies of room-temperature solutions of 3-hydroxyflavone (3-HF) and some 4'-substituted derivatives have been undertaken. Transient absorption attributable to the two zwitterionic forms of the excited tautomer arising from excited-state intramolecular proton transfer (ESIPT) was observed across most of the visible spectral region. For 3-HF in methylcyclohexane and acetonitrile, the ESIPT was found to be so rapid that it was only possible to assign a time constant of 35 fs to the process. In ethanol, however, a time constant of 60 fs was determined. The slower ESIPT in this solvent was attributed to the greater strength of the solute-solvent interactions. For the derivatives of 3-HF in all three solvents, the ESIPT step was also found to be instrument-limited. In addition to the femtosecond kinetics, there was also a picosecond component of the kinetics that is attributed to ESPT in molecules that are intermolecularly hydrogen bonded to the solvent. © 2001 American Chemical Society.
Erythrocytes as a preferential target of oxidative stress in blood

Abstract Red blood cells (RBC) are specifically differentiated to transport oxygen and carbon dioxide in the blood and they lack most organelles, including mitochondria. The autoxidation of hemoglobin constitutes a major source of reactive oxygen species (ROS). Nitric oxide, which is produced by endothelial nitric oxide synthase (NOS3) or via the hemoglobin-mediated conversion of nitrite, interacts with ROS and results in the production of reactive nitrogen oxide species. Herein we present an overview of anemic diseases that are closely related to oxidative damage. Because the compensation of proteins by means of gene expression does not proceed in enucleated cells, antioxidative and redox systems play more important roles in maintaining the homeostasis of RBC against oxidative insult compared to ordinary cells. Defects in hemoglobin and enzymes that are involved in energy production and redox reactions largely trigger oxidative damage to RBC. The results of studies using genetically modified mice suggest that antioxidative enzymes, notably superoxide dismutase 1 and peroxiredoxin 2, play essential roles in coping with oxidative damage in erythroid cells, and their absence limits erythropoiesis, the life-span of RBC and consequently results in the development of anemia. The degeneration of the machinery involved in the proteolytic removal of damaged proteins appears to be associated with hemolytic events. The ubiquitin-proteasome system is the dominant machinery, not only for the proteolytic removal of damaged proteins in erythroid cells but also for the development of erythropoiesis. Hence, despite the fact that it is less abundant in RBC compared to ordinary cells, the aberrant ubiquitin-proteasome system may be associated with the development of anemic diseases via the accumulation of damaged proteins, as typified in sickle cell disease, and impaired erythropoiesis.
Correlation between Cepheid GeneXpert and Abbott M2000 assays for HIV viral load measurements

Measurement of HIV viral load (VL) is the best indicator of success of antiretroviral therapy. We investigated the correlation between results by the Cepheid GeneXpert and a standard of care VL assay (Abbott M2000). This was a prospective study of people living with HIV who attended the department for routine VL measurement with the Abbott M2000. Consenting patients agreed to provide one extra blood sample for VL measurement with the Cepheid GeneXpert assay. One hundred patients consented to participate in the study. There were 18 patients with VL ≥ 40 copies/mL and 75 patients with VL < 40 copies on both assays. The two assays had 93% agreement, with a kappa of 0.79 (p < 0.001). Treating VL as a continuous variable found measurements to be significantly higher on the Cepheid GeneXpert assay than the Abbott (p = 0.002). Analysis of samples with VL ≥ 40 copies/mL on either assay (n = 25) found the mean difference between the two assays to be 0.31 log10 copies/mL (95% limits of agreement: −0.63, 1.25). Whilst the measurements on the two assays are relatively highly correlated, there is a clear bias, with the Cepheid GeneXpert tending to give higher VL values.
Effects of nutritional interventions on BDNF concentrations in humans: a systematic review

ABSTRACT Objectives: Brain-derived neurotrophic factor (BDNF) plays an essential role in brain and metabolic health. The fact that higher concentrations are associated with improved cognitive performance has resulted in numerous intervention trials that aim at elevating BDNF levels. This systematic review provides an overview of the relation between various nutritional factors and BDNF concentrations in controlled human intervention studies. Methods: A systematic search in May 2020 identified 48 articles that examined the effects of dietary patterns or foods (n = 3), diets based on energy intake (n = 7), vitamins and minerals (n = 7), polyphenols (n = 11), long-chain omega-3 polyunsaturated fatty acids (n = 5), probiotics (n = 8), and miscellaneous food supplements (n = 7). Results: In particular, studies with dietary patterns or foods showed increased peripheral BDNF concentrations. There are also strong indications that polyphenols tend to have a positive effect on BDNF concentrations. Four of the 11 included studies with a polyphenol intervention showed a significant increase in BDNF concentrations, one study showed an increase but this was not statistically analyzed, and two studies showed a trend to an increase. Discussion: The two polyphenol classes, phenolic acids, and other phenolic compounds were responsible for the significant effects. No clear effect was found for the other dietary factors, which might also be related to whether serum or plasma was used for BDNF analysis. More work is needed to understand the relation between peripheral and central BDNF concentrations.
Effects of morphological changes in the patellar tendon on the development of anterior knee pain after intramedullary nailing for tibial shaft fractures: A retrospective comparative study.

OBJECTIVE This study aimed to investigate the effects of morphological changes of the patellar tendon (length, width, and thickness) on the development of anterior knee pain (AKP) after intramedullary nailing (IMN) of tibial shaft fractures. METHODS A total of 39 patients, treated by IMN using the transpatellar approach for tibial shaft fractures, were retrospectively reviewed and included in the study. The patients were then divided into 2 groups based on the presence of AKP: group A, patients who developed AKP (9 men, 9 women; mean age=35.39±9.32 years), and group B, patients without AKP (13 men, 8 women; mean age=41.38±14.78 years). To assess the morphological changes in the patellar tendon, magnetic resonance imaging was performed on the operated and unoperated, contralateral knees of the patients. The patellar tendon index (PTI) was calculated using the length, width, and thickness of the patellar tendon, and a set of variables was established to be a proportion of the measurements of the operated knees to those of the unoperated ones (operated/healthy PTI ratio). PTI ratios were compared between both the groups. Furthermore, the morphological features of the patellar tendon, including the length, width, and thickness, were examined within the groups as independent variables. To assess pain intensity in group A, a 10-cm visual analogue scale (VAS) was used. To evaluate functional status, the Lysholm knee scoring system was used. RESULTS The PTI ratio was significantly higher in group A (1.37±0.12) than in group B (1.03±0.08) (p<0.001). In group A, the mean VAS score was 5.35±1.11, and a moderate linear correlation was found between PTI ratios and VAS scores (r=0.494, p=0.044). The mean Lysholm score was significantly lower in group A (80.17±3.05) than in group B (89.76±3.05) (p<0.001). In group A, the width and thickness of the patellar tendon were found to be significantly different between the operated and unoperated knees (p=0.024 and p=0.002, respectively). In group B, there was no difference between the operated and unoperated knees in terms of the 3 measurements (length, width, and thickness) (p=0.762, p=0.753, and p=0.118, respectively). CONCLUSION Evidence from this study revealed that morphological changes occurring in the patellar tendon after IMN for tibial shaft fractures using a transpatellar approach may have a significant role in the development of AKP. The increase in the tendon width and thickness may be the cause of pain and insufficient knee function in such patients. LEVEL OF EVIDENCE Level III, Therapeutic study.
Wavelet-based semblance analysis to determine muscle synergy for different handstand postures of Chilean circus athletes

Abstract The handstand is an uncommon posture, highly demanding in terms of muscle and joint stability, used in sporting and artistic practices in a variety of disciplines. Despite its becoming increasingly widespread, there is no specific way to perform a handstand, and the neuromuscular organizational mechanisms involved are unknown. The objective of this study was to determine the muscle synergy of four handstand postures through a semblance analysis based on wavelets of electromyographic signals in the upper limbs of experienced circus performers between 18- and 35-year old. The results show that there is a large difference in positive and negative correlations depending on the posture, which suggests that the more asymmetrical the position of the lower limbs, the greater the number of strategies to maintain the posture. Although it is not a statistically significant data, it is observed that the posture 3 in particular, possesses the greatest number of positive correlations, which suggests it has the greatest synergy.
SGLT‐2 inhibitors and the risk of hospitalization for community‐acquired pneumonia: A population‐based cohort study

Sodium‐glucose co‐transporter 2 inhibitors (SGLT‐2i) have been associated with an increased risk of genitourinary tract infections. Through similar biological mechanisms, they may also increase the risk of community‐acquired pneumonia. Our objective was to compare the rate of hospitalization for community‐acquired pneumonia (HCAP) with SGLT‐2i compared to dipeptidyl peptidase‐4 inhibitors (DPP‐4i) among patients with type 2 diabetes.
Improving the Measurement of Environmental Sensitivity in Children and Adolescents: The Highly Sensitive Child Scale–21 Item Version

Children differ in their sensitivity to positive and negative environmental influences, which can be measured with the Highly Sensitive Child (HSC) scale. The present study introduces the HSC-21, an adaptation of the original 12 item scale with new items and factor structure that are meant to be more informative than the original ones. The psychometric properties of the HSC-21 were investigated in 1,088 children across Belgium and the Netherlands, including child and mother reports. Results showed evidence for (a) bifactor model with a general sensitivity factor and two specific factors (i.e., Ease of Excitation–Low Sensory Threshold and Aesthetic Sensitivity); (b) (partial) measurement invariance across gender, developmental stage, country, and informants; (c) moderate child–mother agreement; (d) good reliability; (e) normally distributed item scores; and (f) meaningful associations with personality and temperament across both samples. No evidence was found for HSC-21 as a moderator in the relationship between parenting and problem behaviors.
Effectiveness of a Nurse-Led Multidisciplinary Intervention vs Usual Care on Advance Care Planning for Vulnerable Older Adults in an Accountable Care Organization: A Randomized Clinical Trial.

Importance Advance care planning (ACP), especially among vulnerable older adults, remains underused in primary care. Additionally, many ACP initiatives fail to integrate directly into the electronic health record (EHR), resulting in infrequent and disorganized documentation. Objective To determine whether a nurse navigator-led ACP pathway combined with a health care professional-facing EHR interface improves the occurrence of ACP discussions and their documentation within the EHR. Design, Setting, and Participants This was a randomized effectiveness trial using the Zelen design, in which patients are randomized prior to informed consent, with only those randomized to the intervention subsequently approached to provide informed consent. Randomization began November 1, 2018, and follow-up concluded November 1, 2019. The study population included patients 65 years or older with multimorbidity combined with either cognitive or physical impairments, and/or frailty, assessed from 8 primary care practices in North Carolina. Interventions Participants were randomized to either a nurse navigator-led ACP pathway (n = 379) or usual care (n = 380). Main Outcomes and Measures The primary outcome was documentation of a new ACP discussion within the EHR. Secondary outcomes included the usage of ACP billing codes, designation of a surrogate decision maker, and ACP legal form documentation. Exploratory outcomes included incident health care use. Results Among 759 randomized patients (mean age 77.7 years, 455 women [59.9%]), the nurse navigator-led ACP pathway resulted in a higher rate of ACP documentation (42.2% vs 3.7%, P < .001) as compared with usual care. The ACP billing codes were used more frequently for patients randomized to the nurse navigator-led ACP pathway (25.3% vs 1.3%, P < .001). Patients randomized to the nurse navigator-led ACP pathway more frequently designated a surrogate decision maker (64% vs 35%, P < .001) and completed ACP legal forms (24.3% vs 10.0%, P < .001). During follow-up, the incidence of emergency department visits and inpatient hospitalizations was similar between the randomized groups (hazard ratio, 1.17; 95% CI, 0.92-1.50). Conclusions and Relevance A nurse navigator-led ACP pathway integrated with a health care professional-facing EHR interface increased the frequency of ACP discussions and their documentation. Additional research will be required to evaluate whether increased EHR documentation leads to improvements in goal-concordant care. Trial Registration ClinicalTrials.gov Identifier: NCT03609658.
Is the extent of lymphadenectomy a prognostic factor in International Federation of Gynecology and Obstetrics stage II endometrioid endometrial cancer?

This study aimed to evaluate the prognostic significance of adequate lymph node dissection (LND) (≥10 pelvic lymph nodes (LNs) and ≥ 5 paraaortic LNs removed) in patients with International Federation of Gynecology and Obstetrics (FIGO) stage II endometrioid endometrial cancer (EEC).
Predicting Sexual Desire in Daily Life from an Attachment Perspective: An Experience Sampling study

Abstract In the present study we investigated the temporal associations between emotional intimacy, daily hassles, and sexual desire of individuals in long-term relationships, and examined the direct and moderating effects of attachment orientation. We investigated these variables by reanalyzing an existing data set. Experience sampling methodology was used to collect data 10 times per day, across seven days. Attachment orientation was assessed with the Experiences in Close Relationships questionnaire. Age, gender, and relationship duration were added as predictors. Data of 134 participants (Nfemale = 87) were analyzed. Only one of the partners of a couple participated. Men overall reported higher sexual desire than women. Longer relationship duration was associated with lower sexual desire, but age was not associated with sexual desire. Increased level of intimacy predicted sexual desire across measurements with an average time interval of 90 min, but this effect was no longer significant when assessment points were 180 min apart. Daily hassles did not predict sexual desire at subsequent assessments. Avoidant and anxious attachment were not associated with sexual desire level. No interaction effects of gender, stress, intimacy and attachment orientation on sexual desire were found. Speculative explanations are offered for the absence of stress effects.
Body donation trends in Yonsei University: a statistical analysis of donor records

Body donation trends in Korea have changed significantly over the last 3 decades. Establishing a body donation system will promote donations to universities for academic purposes. Yonsei University College of Medicine started its own body donation system in 1992, including documenting donors’ records. However, there has been no reported attempt to analyze the trend of these records, which could provide noteworthy information that can be interpreted for medical advances. This study performed a statistical analysis of the donors’ records between 1992 and 2019 to analyze the sociological and anthropological changes. Donor personal information such as sex, age, religion, and place and cause of death were extracted from the Yonsei University College of Medicine database. Our statistical analysis revealed significant correlations between donors’ records and the changes in the number of geriatric hospitals, religious beliefs, number of donations, and donor age.