Miracle-dz/UniFAR-FTUs huggingface dataset:
Detection and prognostic value of pulmonary congestion by lung ultrasound in ambulatory heart failure patients.

AIMS Pulmonary congestion is a common and important finding in heart failure (HF). While clinical examination and chest radiography are insensitive, lung ultrasound (LUS) is a novel technique that may detect and quantify subclinical pulmonary congestion. We sought to independently relate LUS and clinical findings to 6-month HF hospitalizations and all-cause mortality (composite primary outcome). METHODS We used LUS to examine 195 NYHA class II-IV HF patients (median age 66, 61% men, 74% white, ejection fraction 34%) during routine cardiology outpatient visits. Lung ultrasound was performed in eight chest zones with a pocket ultrasound device (median exam duration 2 min) and analysed offline. RESULTS In 185 patients with adequate LUS images in all zones, the sum of B-lines (vertical lines on LUS) ranged from 0 to 13. B-lines, analysed by tertiles, were associated with clinical and laboratory markers of congestion. Thirty-two per cent of patients demonstrated ≥3 B-lines on LUS, yet 81% of these patients had no findings on auscultation. During the follow-up period, 50 patients (27%) were hospitalized for HF or died. Patients in the third tertile (≥3 B-lines) had a four-fold higher risk of the primary outcome (adjusted HR 4.08, 95% confidence interval, CI 1.95, 8.54; P < 0.001) compared with those in the first tertile and spent a significantly lower number of days alive and out of the hospital (125 days vs. 165 days; adjusted P < 0.001). CONCLUSIONS Pulmonary congestion assessed by ultrasound is prevalent in ambulatory patients with chronic HF, is associated with other features of clinical congestion, and identifies those who have worse prognosis.
An analysis of the educational progress of children with special educational needs

One in five children in England are recorded as having some kind of special educational need, meaning that they receive additional help in school; yet there is very little evidence of the effect of such assistance on pupilâ€™s academic progress. This is at least partly because it is usually very difficult to define an appropriate control group for pupils with special educational needs. To overcome this issue, we make use of extremely rich data from the Avon Longitudinal Study of Parents and Children to assess the academic progress of pupils between Key Stages 1 and 2 (ages 7 and 11). Specifically, we compare the progress of children who have been formally identified by the SEN system as having non-statemented (less severe) needs with the progress of children who do not have SEN label, but whose class teacher reports that they exhibit behaviour which suggests that they might have special educational needs. Our results suggest that, despite our very similar control group, pupils with a SEN label still score about 0.3 standard deviations lower at Key Stage 2 than otherwise identical pupils without a SEN label. This is perhaps not an entirely unexpected result, given that there is no compulsion in the system for non-statemented SEN funding to be spent on children with special educational needs and in any case additional resources may not close the gap completely. Nonetheless, such a result clearly has significant policy implications: schools are provided with resources to help children with special educational needs and if these resources are not improving academic outcomes for these children, then this should be of concern to both parents and policymakers alike.
Neutrophils orchestrate post-myocardial infarction healing by polarizing macrophages towards a reparative phenotype

Aims Acute myocardial infarction (MI) is the leading cause of mortality worldwide. Anti-inflammatory strategies to reduce neutrophil-driven acute post-MI injury have been shown to limit acute cardiac tissue damage. On the other hand, whether neutrophils are required for resolving post-MI inflammation and repair is unknown. Methods and results We show that neutrophil-depleted mice subjected to MI had worsened cardiac function, increased fibrosis, and progressively developed heart failure. Flow cytometry of blood, lymphoid organs and digested hearts revealed reduced numbers of Ly6Chigh monocytes in infarcts of neutrophil-depleted mice, whereas the number of macrophages increased, which was paralleled by reduced splenic Ly6Chigh monocyte mobilization but enhanced proliferation of cardiac macrophages. Macrophage subtype analysis revealed reduced cardiac expression of M1 markers, whereas M2 markers were increased in neutrophil-depleted mice. Surprisingly, we found reduced expression of phagocytosis receptor myeloid-epithelial-reproductive tyrosine kinase, a marker of reparative M2c macrophages which mediate clearance of apoptotic cells. In agreement with this finding, neutrophil-depleted mice had increased numbers of TUNEL-positive cells within infarcts. We identified neutrophil gelatinase-associated lipocalin (NGAL) in the neutrophil secretome as a key inducer of macrophages with high capacity to engulf apoptotic cells. The cardiac macrophage phenotype in neutrophil-depleted mice was restored by administration of neutrophil secretome or NGAL. Conclusion Neutrophils are crucially involved in cardiac repair after MI by polarizing macrophages towards a reparative phenotype. Therapeutic strategies to reduce acute neutrophil-driven inflammation after MI should be carefully balanced as they might interfere with the healing response and cardiac remodelling.
Working Together: An Occupational Therapy Perspective on Collaborative Consultation.

The focus of this study was to explore the occupational therapy consultation process used with students on the autistic spectrum attending their regular school. Individual, in-depth interviews with senior occupational therapists were employed to collect the data. Grounded theory (Glaser & Strauss, 1967; Strauss, 1987; Strauss & Corbin, 1998), a qualitative research methodology, was used to develop a high-level description and conceptual ordering as an initial step towards developing a consultation model. Constant comparative analysis of the data revealed three interactive and interdependent processes, Joining Up, Finding A Way and Walking and Talking. These processes often occur simultaneously and greatly infl uence each other. The central concept was identifi ed as Working Together, which highlights the collaborative nature of the consultation process. The context of the inclusive education environment requires a strong ecological approach as an essential aspect of therapists’ practice. The consultation process described uses occupational therapists’ day-to-day experience and is grounded within the inclusive education setting in Aotearoa New Zealand.
Physical fitness levels of adolescents in the Ile de France region: comparisons with European standards and relevance for future cardiovascular risk

The aim was to assess physical fitness in French schoolchildren in the region of Ile de France and to compare the results with European countries. The relationship between physical fitness and future health profile was of particular interest. Participants were 1851 French youth in the Ile de France region. Cardiorespiratory fitness, muscular endurance, speed, flexibility and speed agility were tested. Independent t‐tests were used to compare differences between different variables. Spearman's rho correlation coefficients assessed the relationship between body mass index, socio‐economic status and physical fitness. Boys were physically fitter than girls with the most significant difference being in agility. Subjects of normal weight have significantly better results than overweight or obese adolescents (+10·9% to 56·1%) (P<0·05). Subjects with high socio‐economic status had better physical fitness than those with low socio‐economic status (+0·5% to 9·4%) (P<0·05). Results also showed that the percentage of adolescents at increased future cardiovascular risk was 15·3% and 10·2% for boys and girls, respectively. Physical fitness in French schoolchildren living in the region of Ile de France is relatively low and unfavourable, especially in girls, when compared with existing European test results. In contrast, the adolescent boys are generally fitter and also above the average of the European data. Introducing a health promotion curriculum in the schools of Ile de France is suggested to improve health and physical fitness.
Seven provocative principles for health care reform.

HEALTH CARE MANAGERS ACROSS INDUSTRIALIZED NAtions have embraced innovations such as modernized information systems, improved integration of services, and better design of financial incentives. However, debate about “big picture” policy remains highly polarized. That observation is underscored in the United States by political responses and legal challenges to the 2010 Patient Protection and Affordable Care Act (ACA). Meanwhile, north of the border, there is renewed controversy regarding the public financing of Canada’s provincial single-payer health plans. This Viewpoint accordingly sets out 7 principles for broad health care reform, with particular reference to the US and Canadian health care systems.
Frontiers in valvular heart disease.

Download the Issue @ a Glance podcast Subscribe to the EHJ Podcast ! [Graphic][1] Valvular heart disease has experienced a remarkable revival of interest since the introduction of transarterial valve implantation (TAVI). 1,2 After a difficult start with high-risk patients and initially significant complication rates, outcomes have remarkably improved, and currently equal that of surgical valve replacement, at least in elderly patients with high surgical risk. Nevertheless, it is anticipated that TAVI will be used more and more in lower risk and younger patients in the future.3 This topic is reviewed in the ‘ The future of transcatheter aortic valve implantation ’ by Christian Hamm from the University of Giessen in Germany.4 He reminds us that since the introduction of TAVI, the treatment of aortic stenosis has changed dramatically. While medical therapy with or without balloon aortic valvuloplasty was the only option for inoperable patients in the past, TAVI has become the treatment of choice for these patients. However, surgical aortic valve replacement remains the gold standard for patients at low or intermediate operative risk. As randomized trials have demonstrated comparable results between TAVI and surgical valve replacement in high-risk patients, TAVI is currently evaluated in intermediate-risk patients in randomized trials. Remaining problems are still paravalvular leaks,5 strokes, pacemaker requirements, and durability. Improvements in patient selection, imaging, and next-generation devices have decreased the incidence of such complications, but peri-operative strokes and permanent pacemaker implantation must still be addressed.6,7 Furthermore, questions related to the long-term durability of TAVI prosthesis and optimal antithrombotic management remain unanswered. The task for Heart Teams remains to determine the optimal treatment for each patient based on risk scores, frailty metrics, co-morbidities, patient preference, … [1]: /embed/inline-graphic-1.gif
Coronary and peripheral interventions: an update.

Download the Issue @ a Glance podcast Subscribe to the EHJ Podcast ! [Graphic][1] When Andreas Gruntzig started his journey to become the founder of catheter-based cardiovascular interventions, he started—and this is often forgotten—in the peripheral circulation, at first in the iliac and later in the femoral arteries, with his home-made balloon. Only later did he dare to access the coronary circulation.1 The first Current Opinion article of this issue ‘ Drug-coated balloon treatment for lower extremity vascular disease intervention: an international positioning document ’ authored by Thomas Zeller from the HerzZentrum Bad Krozingen in Germany2 reminds us that not only coronary, but also peripheral interventions have made remarkable progress ever since. In particular, drug-coated balloons provide a novel method to deliver antiproliferative drugs such as paclitaxel locally into the arterial wall without the need for a chronically implanted delivery system. Following early positive pilot studies, two large pivotal trials confirmed the superiority of drug-coated balloons over plain old balloon angioplasty in the treatment of femoro-popliteal lesions. Even long lesions and in-stent restenosis showed promising mid-term technical and clinical results in small single-centre randomized studies. Unfortunately, these results have not been reproduced for below-the-knee applications. As a result, guidelines have not yet provided recommendations regarding the use of drug-coated balloons in peripheral interventions due to the lack of robust evidence. In the coronary circulation, potent antithrombotic therapies are commonly used to reduce the risk of recurrent ischaemic events and death, particularly in patients with acute coronary syndromes.3 Of note, such interventions inevitably lead to an increase in bleeding which in turn is associated with a prolonged length of stay, greater resource consumption, and eventually with a higher morbidity and mortality.4,5 Consequently, inclusion of bleeding as a safety endpoint in randomized controlled trials is essential in the … [1]: /embed/inline-graphic-1.gif
Undergraduate Management Accounting Research in University of Tanjungpura: Past, Present and Future

This paper provides a review of 168 undergraduate theses submitted between the year 2002 and 2011 in management accounting topics. During this time, there is a changing interest of students in accounting research, especially in topic selection. To review the development of management accounting research in undergraduate level, this paper is structured according to the topics, theories and research methods used. The purposes of this review are to determine the main interest and map the past and current achievement of such research area in University of Tanjungpura. Based on the current trend and international hot debatable topics, the last section of this paper also gives a recommendation about the possible interesting topics for future research. Keywords: Management Accounting, Undergraduate Research, University of Tanjungpura, Research Directions and Bibliographic Study
Association of Warfarin Therapy Duration After Bioprosthetic Aortic Valve Replacement With Risk of Mortality , Thromboembolic Complications , and Bleeding

BIOLOGICAL PROSTHESES ARE PREferred to mechanical valves for aortic valve replacement (AVR) surgery in elderly patients older than 65 years because of shorter life expectancy and lack of a need to use anticoagulation treatment in the long term. Especially in these patients, the tradeoff between thromboembolic complications due to the valve implant and bleeding events as adverse effects from anticoagulation therapy must be balanced. Nevertheless, appropriate duration of anticoagulation treatment postoperatively is yet to be established because the risk of complications when the treatment is discontinued is unknown. Current guidelines of anticoagulation treatment after bioprosthetic AVR surgery recommends 3 months of warfarin treatment. However, this recommendation is primarily based on results from 1 retrospective study with limited number of events hampered by the observational design as well as low power like all other studies within this scope. In this nationwide study, we investigated whether discontinuation of warfarin treatment within prespecified periods after bioprosthetic AVR surgery was associated with increased risk of thromboembolic complications, cardiovascular death, and bleeding incidents during a period of 13 years. For editorial comment see p 2147. Author Affiliations: Department of Cardiology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark (Drs Mérie, Andersson, Gislason, Skov Jensen, and Torp-Pedersen); and Department of Cardiology (Dr Køber) and Department of Cardiothoracic Surgery (Dr Skov Olsen), Copenhagen University Hospital Rigshospitalet, Denmark. Corresponding Author: Charlotte Mérie, MD, Department of Cardiology, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark (c.merie@mail.dk). Context The need for anticoagulation after surgical aortic valve replacement (AVR) with biological prostheses is not well examined.
Trade-off of myocardial infarction vs. bleeding types on mortality after acute coronary syndrome: lessons from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) randomized trial

Aims Dual antiplatelet therapy reduces non-fatal ischaemic events after acute coronary syndrome (ACS) but increases bleeding to a similar extent. We sought to determine the prognostic impact of myocardial infarction (MI) vs. bleeding during an extended follow-up period to gain insight into the trade-off between efficacy and safety among patients after ACS. Methods and results In 12 944 patients with non-ST-segment elevation ACS from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial, we investigated the relative impact of MI and bleeding occurring >30 days post-ACS and subsequent all-cause mortality. Bleeding was graded according to Bleeding Academic Research Consortium (BARC) criteria. MI was associated with a five-fold increase in mortality. BARC type 2 and 3, but not type 1, bleeding had a significant impact on mortality. MI was associated with a greater risk of mortality compared with BARC 2 [relative risk (RR) 3.5; 95% confidence interval (CI) 2.08-4.77; P < 0.001] and BARC 3a bleeding (RR 2.23; 95% CI 1.36-3.64; P = 0.001), and a risk similar to BARC 3b bleeding (RR 1.37; 95% CI 0.81-2.30; P = 0.242). Risk of death after MI was significantly lower than after BARC 3c bleeding (RR 0.22; 95% CI 0.13-0.36; P < 0.001). MI and bleeding had similar time-associations with mortality, which remained significant for several months, still being higher early after the event. Conclusion In patients treated with antiplatelet therapy after ACS, both MI and bleeding significantly impacted mortality with similar time-dependency. Although BARC 2 and 3a bleeding were less prognostic for death than MI, the risk of mortality was equivalent between BARC 3b bleeding and MI, and was higher following BARC 3c bleeding.
Pregnancy and employment: a literature review

This literature review forms part of a major new research study on women’s experiences in the workplace during and after pregnancy, commissioned by the HSE Crisis Pregnancy Programme and the Equality Authority. In addition to this review the research involved a study of pregnancy discrimination cases in the Equality Tribunal and Labour Court, 1999 – 2008 (Banks & Russell, 2011) and a nationwide survey of 2,300 working mothers (Russell, Watson, Banks, forthcoming). The broad objective of the research project was to investigate the influence of pregnancy and childbirth on women’s employment experiences, including an assessment of pregnancy-related discrimination in Ireland, and how these experiences are shaped by organisational factors and women’s attitudes and characteristics. While there is a very substantial literature on the impact of childbearing on women’s employment careers and on the transitions back into work, these studies focus on the period after childbirth and rarely focus on pregnancy. Instead there is a rather separate literature on pregnancy in the workplace, which deals with the health consequences of employment during pregnancy, pregnancy discrimination and maternity rights. In this literature review we bring together evidence from both these sources to consider how pregnancy and maternity is experienced in the workplace and to understand the immediate and longer term outcomes of pregnancy and childbirth on women’s employment. Over the past few decades women’s participation in the paid labour market has risen substantially both in Ireland and internationally. As a consequence, pregnancy in the workplace has become a much more common occurrence. Nevertheless, while there is a large literature on the issue of gender and employment and on the intersection of work and family life, the experience of pregnancy in the workplace is less well researched. McDonald and Dear (2006) note that “there is a paucity of empirical work . which has explored women’s experiences of pregnancy in the workplace, much less the patterns of behaviour reported in cases where women experience disadvantage as a result of pregnancy. ” Attitudes, norms and stereotypes concerning the roles of mothers and of workers and perceived conflicts between these roles are more likely to become evident for pregnant workers (Halpert et al, 1993). Pregnancy and childbirth also necessitate a break in employment for mothers, and the way in which this interruption is managed has important implications for women’s working and family lives. The potential vulnerability of pregnant workers to unfavourable treatment and discrimination, to health and safety risks and to problems associated with reintegration into employment, is recognised in maternity-protection legislation and in anti-discrimination legislation in many European jurisdictions. Entitlements for Irish workers during pregnancy and the early period of maternity are outlined in Banks and Russell (2011).
Bisphenol A and obesity in children and adolescents--reply.

dition, and differential effects on outcomes should be attributed to this factor. The children’s fatness was reduced because of the exercise programs offered to those groups. Mediation analysis (ie, testing factors posited to be in the causal pathway) can suggest how those changes may have occurred based on contemporaneous, collinear data with varying precision. Mediation analyses on these data are in progress. As expected, puberty (ie, thelarche or gonadarche stage) was a predictor in the insulin resistance models (insulin area under the curve, P .001; fasting insulin, P .001; Matsuda index, P=.002). The adrenarche variable was not significant in any model. At the request of Short, we conducted an analysis of the interaction of thelarche or gonadarche stage (classified as Tanner I, II, or III and above) with the group time interaction in the insulin resistance models, adjusting for cohort, sex, and race. An interaction was detected only for fasting insulin, such that differential change from baseline to posttest between exercise groups and control was detected only in Tanner stage III or above. In more developed children, similar decreases in fasting insulin were seen in the low-dose (adjusted mean difference, 18.2 [95% CI, 25.8 to 10.6] U/mL) and high-dose ( 15.8 [95% CI, 23.0 to 8.5] U/mL) exercise groups (each P .001 vs the control group). Thus, more developed children might be more responsive to exercise. However, of 3 insulin resistance indicators, only 1 showed evidence of pubertal moderation. These exploratory analyses provide scant support for the hypothesis that pubertal stage affects the benefits of aerobic training in obese children. Conclusions should be tempered by the exploratory nature of these additional analyses.