Miracle-dz/UniFAR-FTUs huggingface dataset:
Resumption of sinus rhythm in patients with heart failure and permanent atrial fibrillation undergoing cardiac resynchronization therapy: a longitudinal observational study.

AIMS To investigate the temporal patterns, predictors, and prognostic impact of spontaneous sinus rhythm resumption (SRR) of heart failure (HF) patients with permanent atrial fibrillation (AF) treated with cardiac resynchronization therapy (CRT). METHODS AND RESULTS This multicentre, retrospective, longitudinal study analysed 330 consecutive HF patients with permanent AF treated with a CRT device (mean age 70 +/- 9 years, male 83%, ischaemic aetiology 44%, NYHA class III-IV 93%, mean QRS duration 167 +/- 40 ms, and mean ejection fraction 26 +/- 7%). Clinical, echocardiographic, and outcome data were collected during follow-up. Thirty-four patients experienced SRR after CRT (10.3%) at a median 4-month follow-up. The strongest independent predictors were end-diastolic diameter (EDD) [hazard ratios (HR) 4.03, 95% confidence intervals (95% CI) 1.43-11.36, P = 0.008], post-CRT QRS <or=150 ms (HR 2.63, 95% CI 1.02-6.67, P = 0.05), left atrium (LA) diameter <or=50 mm (HR 4.76, 95% CI 1.72-11.82, P = 0.002), and atrioventricular junction (AVJ) ablation (HR 4.27, 95% CI 1.54-11.84, P = 0.02). The coexistence of three predictors vs. zero to two predictors increased by 3.5-fold the likelihood of SRR; while the presence of all four factors improves the probability by a factor of 5.7-fold. Sinus rhythm resumption was associated with a significantly better long-term survival (log rank P = 0.03). CONCLUSION One in every 10 HF patients with permanent AF may experience SRR after CRT. Baseline EDD <or=65 mm, CRT-paced QRS <or=150 ms, LA <or=50 mm, and AVJ ablation appear to be predictive of this phenomenon.
Interferons in cutaneous T-cell lymphomas

Cutaneous lymphomas are a heterogeneous group of rare lymphoproliferative disorders. In most cases, they are characterized by the accumulation of clonal lymphocytes in the skin. Extracutaneous involvement is present in late stages only. Unfortunately, only few drugs are registered for these disfiguring diseases. Skin directed therapies using topical formulations are the preferred first line modalities. Interferon alpha and Interferon gamma are successfully used as monotherapy or as important substances in combination therapies for cutaneous t-cell lymphomas. An intralesional therapy with Interferon alpha is very successful in primary cutaneous B-cell lymphomas, especially marginal zone lymphomas. Recent approaches using gene therapy resulting in local expression of Interferon gamma have resulted in the regression of injected and non-injected lymphoma manifestations in cutaneous lymphoma patients.
Prolonged cold storage using a new histidine-tryptophan-ketoglutarate-based preservation solution in isogeneic cardiac mouse grafts.

AIMS The aim of this study was to evaluate a new histidine-tryptophan-ketoglutarate (HTK)-based cold preservation solution in comparison with traditional HTK solution in a mouse cardiac transplant model and to assess the impact of chloride ions and of iron chelators. METHODS AND RESULTS After 24 h cold ischaemia, traditional HTK-preserved hearts survived up to 13 days (4.4 ± 1.7 days; n = 8)). Hearts stored in the new solution without iron chelators (N46) showed significantly prolonged survival up to 2 months (N46: 11.9 ± 8.7 days; P < 0.01; n = 7) and with iron chelators (DesfLK) up to 3 months (N46 DesfLK: 12.7 ± 13.7 days; n = 6). Re-beating time was significantly shorter with the new solution (HTK: 14.5 ± 5.9 min, N46: 9.2 ± 2.7 min, N46 DesfLK: 7.1 ± 3.7 min; P < 0.01). The new solution showed significantly decreased release of creatine kinase (HTK: 25998 ± 8471 U/L, N46: 13829 ± 7679 U/L, N46 DesfLK: 3093 ± 597 U/L; P < 0.01 and n = 7 each) and lactate dehydrogenase (HTK: 5391 ± 1062 U/L, N46: 3428 ± 1890 U/L, P < 0.05; N46 DesfLK: 682 ± 344 U/L, P < 0.01) and decreased histological evidence of injury. A chloride-poor variant of the new solution showed inferior graft survival. CONCLUSION The new solution markedly attenuates myocardial injury and yields better graft survival than traditional HTK solution. The presence of chloride ions is crucial for heart preservation. Some protective effects are obviously caused by iron chelators.
Human Influence and Classical Biogeographic Predictors of Rare Species Occurrence

Biogeographic theory predicts that rare species occur more often in larger, less‐isolated habitat patches and suggests that patch size and connectivity are positive predictors of patch quality for conservation. However, in areas substantially modified by humans, rare species may be relegated to the most isolated patches. We used data from plant surveys of 81 meadow patches in the Georgia Basin of Canada and the United States to show that presence of threatened and endangered plants was positively predicted for patches that were isolated on small islands surrounded by ocean and for patches that were isolated by surrounding forest. Neither patch size nor connectivity were positive predictors of rare species occurrence. Thus, in our study area, human influence, presumably due to disturbance or introduction of competitive non‐native species, appears to have overwhelmed classical predictors of rare species distribution, such that greater patch isolation appeared to favor presence of rare species. We suggest conservation planners consider the potential advantages of protecting geographically isolated patches in human‐modified landscapes because such patches may represent the only habitats in which rare species are likely to persist.
Cost‐Effectiveness of Alternative Conservation Strategies with Application to the Pacific Leatherback Turtle

Although holistic conservation addressing all sources of mortality for endangered species or stocks is the preferred conservation strategy, limited budgets require a criterion to prioritize conservation investments. We compared the cost‐effectiveness of nesting site and at‐sea conservation strategies for Pacific leatherback turtles (Dermochelys coriacea). We sought to determine which conservation strategy or mix of strategies would produce the largest increase in population growth rate per dollar. Alternative strategies included protection of nesters and their eggs at nesting beaches in Indonesia, gear changes, effort restrictions, and caps on turtle takes in the Hawaiian (U.S.A.) longline swordfish fishery, and temporal and area closures in the California (U.S.A.) drift gill net fishery. We used a population model with a biological metric to measure the effects of conservation alternatives. We normalized all effects by cost to prioritize those strategies with the greatest biological effect relative to its economic cost. We used Monte Carlo simulation to address uncertainty in the main variables and to calculate probability distributions for cost‐effectiveness measures. Nesting beach protection was the most cost‐effective means of achieving increases in leatherback populations. This result creates the possibility of noncompensatory bycatch mitigation, where high‐bycatch fisheries invest in protecting nesting beaches. An example of this practice is U.S. processors of longline tuna and California drift gill net fishers that tax themselves to finance low‐cost nesting site protection. Under certain conditions, fisheries interventions, such as technologies that reduce leatherback bycatch without substantially decreasing target species catch, can be cost‐effective. Reducing bycatch in coastal areas where bycatch is high, particularly adjacent to nesting beaches, may be cost‐effective, particularly, if fisheries in the area are small and of little commercial value.
Contribution of Urban Expansion and a Changing Climate to Decline of a Butterfly Fauna

Butterfly populations are naturally patchy and undergo extinctions and recolonizations. Analyses based on more than 2 decades of data on California's Central Valley butterfly fauna show a net loss in species richness through time. We analyzed 22 years of phenological and faunistic data for butterflies to investigate patterns of species richness over time. We then used 18–22 years of data on changes in regional land use and 37 years of seasonal climate data to develop an explanatory model. The model related the effects of changes in land‐use patterns, from working landscapes (farm and ranchland) to urban and suburban landscapes, and of a changing climate on butterfly species richness. Additionally, we investigated local trends in land use and climate. A decline in the area of farmland and ranchland, an increase in minimum temperatures during the summer and maximum temperatures in the fall negatively affected net species richness, whereas increased minimum temperatures in the spring and greater precipitation in the previous summer positively affected species richness. According to the model, there was a threshold between 30% and 40% working‐landscape area below which further loss of working‐landscape area had a proportionally greater effect on butterfly richness. Some of the isolated effects of a warming climate acted in opposition to affect butterfly richness. Three of the 4 climate variables that most affected richness showed systematic trends (spring and summer mean minimum and fall mean maximum temperatures). Higher spring minimum temperatures were associated with greater species richness, whereas higher summer temperatures in the previous year and lower rainfall were linked to lower richness. Patterns of land use contributed to declines in species richness (although the pattern was not linear), but the net effect of a changing climate on butterfly richness was more difficult to discern.
Multiscale Factors Affecting Human Attitudes toward Snow Leopards and Wolves

The threat posed by large carnivores to livestock and humans makes peaceful coexistence between them difficult. Effective implementation of conservation laws and policies depends on the attitudes of local residents toward the target species. There are many known correlates of human attitudes toward carnivores, but they have only been assessed at the scale of the individual. Because human societies are organized hierarchically, attitudes are presumably influenced by different factors at different scales of social organization, but this scale dependence has not been examined. We used structured interview surveys to quantitatively assess the attitudes of a Buddhist pastoral community toward snow leopards (Panthera uncia) and wolves (Canis lupus). We interviewed 381 individuals from 24 villages within 6 study sites across the high‐elevation Spiti Valley in the Indian Trans‐Himalaya. We gathered information on key explanatory variables that together captured variation in individual and village‐level socioeconomic factors. We used hierarchical linear models to examine how the effect of these factors on human attitudes changed with the scale of analysis from the individual to the community. Factors significant at the individual level were gender, education, and age of the respondent (for wolves and snow leopards), number of income sources in the family (wolves), agricultural production, and large‐bodied livestock holdings (snow leopards). At the community level, the significant factors included the number of smaller‐bodied herded livestock killed by wolves and mean agricultural production (wolves) and village size and large livestock holdings (snow leopards). Our results show that scaling up from the individual to higher levels of social organization can highlight important factors that influence attitudes of people toward wildlife and toward formal conservation efforts in general. Such scale‐specific information can help managers apply conservation measures at appropriate scales. Our results reiterate the need for conflict management programs to be multipronged.
Predicting the conservation status of data‐deficient species

There is little appreciation of the level of extinction risk faced by one‐sixth of the over 65,000 species assessed by the International Union for Conservation of Nature. Determining the status of these data‐deficient (DD) species is essential to developing an accurate picture of global biodiversity and identifying potentially threatened DD species. To address this knowledge gap, we used predictive models incorporating species’ life history, geography, and threat information to predict the conservation status of DD terrestrial mammals. We constructed the models with 7 machine learning (ML) tools trained on species of known status. The resultant models showed very high species classification accuracy (up to 92%) and ability to correctly identify centers of threatened species richness. Applying the best model to DD species, we predicted 313 of 493 DD species (64%) to be at risk of extinction, which increases the estimated proportion of threatened terrestrial mammals from 22% to 27%. Regions predicted to contain large numbers of threatened DD species are already conservation priorities, but species in these areas show considerably higher levels of risk than previously recognized. We conclude that unless directly targeted for monitoring, species classified as DD are likely to go extinct without notice. Taking into account information on DD species may therefore help alleviate data gaps in biodiversity indicators and conserve poorly known biodiversity.
Low-dose aspirin use and performance of immunochemical fecal occult blood tests.

CONTEXT Immunochemical fecal occult blood tests (iFOBTs) are potentially promising tools for colorectal cancer screening. Low-dose aspirin use, which increases the likelihood of gastrointestinal bleeding, is common in the target population for colorectal cancer screening. OBJECTIVE To assess the association of low-dose aspirin use with the performance of 2 quantitative iFOBTs in a large sample of patients undergoing colorectal cancer screening. DESIGN, SETTING, AND PARTICIPANTS Diagnostic study conducted from 2005 through 2009 at internal medicine and gastroenterology practices in southern Germany including 1979 patients (mean age, 62.1 years): 233 regular users of low-dose aspirin (167 men, 67 women) and 1746 who never used low-dose aspirin (809 men, 937 women). MAIN OUTCOME MEASURES Sensitivity, specificity, positive and negative predictive values, and area under receiver operating characteristic (ROC) curves in detecting advanced colorectal neoplasms (colorectal cancer or advanced adenoma) with 2 quantitative iFOBTs. RESULTS Advanced neoplasms were found in 24 users (10.3%) and 181 nonusers (10.4%) of low-dose aspirin. At the cut point recommended by the manufacturer, sensitivities of the 2 tests were 70.8% (95% confidence interval [CI], 48.9%-87.4%) for users compared with 35.9% (95% CI, 28.9%-43.4%) for nonusers and 58.3% (95% CI, 36.6%-77.9%) for users compared with 32.0% (95% CI, 25.3%-39.4%) for nonusers (P = .001 and P = .01, respectively). Specificities were 85.7% (95% CI, 80.2%-90.1%) for users compared with 89.2% (95% CI, 87.6%-90.7%) for nonusers and 85.7% (95% CI, 80.2%-90.1%) for users compared with 91.1% (95% CI, 89.5%-92.4%) for nonusers (P = .13 and P = .01, respectively). The areas under the ROC curve were 0.79 (95% CI, 0.68-0.90) for users compared with 0.67 (95% CI, 0.62-0.71) for nonusers and 0.73 (95% CI, 0.62-0.85) for users compared with 0.65 (95% CI, 0.61-0.69) for nonusers (P = .05 and P = .17, respectively). Among men, who composed the majority of low-dose aspirin users, the areas under the ROC curve were 0.87 (95% CI, 0.76-0.98) for users compared with 0.68 (95% CI, 0.63-0.74) for nonusers and 0.81 (95% CI, 0.68-0.93) for users compared with 0.67 (95% CI, 0.61-0.72) for nonusers (P = .003 and P = .04, respectively). CONCLUSION For 2 iFOBTs, use of low-dose aspirin compared with no aspirin was associated with a markedly higher sensitivity for detecting advanced colorectal neoplasms, with only a slightly lower specificity.
Evaluation of consistency in dosing directions and measuring devices for pediatric nonprescription liquid medications.

CONTEXT In response to reports of unintentional drug overdoses among children given over-the-counter (OTC) liquid medications, in November 2009 the US Food and Drug Administration (FDA) released new voluntary industry guidelines that recommend greater consistency and clarity in OTC medication dosing directions and their accompanying measuring devices. OBJECTIVE To determine the prevalence of inconsistent dosing directions and measuring devices among popular pediatric OTC medications at the time the FDA's guidance was released. DESIGN AND SETTING Descriptive study of 200 top-selling pediatric oral liquid OTC medications during the 52 weeks ending October 30, 2009. Sample represents 99% of the US market of analgesic, cough/cold, allergy, and gastrointestinal OTC oral liquid products with dosing information for children younger than 12 years. MAIN OUTCOME MEASURES Inclusion of measuring device, within-product inconsistency between dosing directions on the bottle's label and dose markings on enclosed measuring device, across-product use of nonstandard units and abbreviations, and presence of abbreviation definitions. RESULTS Measuring devices were packaged with 148 of 200 products (74.0%). Within this subset of 148 products, inconsistencies between the medication's dosing directions and markings on the device were found in 146 cases (98.6%). These included missing markings (n = 36, 24.3%) and superfluous markings (n = 120, 81.1%). Across all products, 11 (5.5%) used atypical units of measurement (eg, drams, cc) for doses listed. Milliliter, teaspoon, and tablespoon units were used for doses in 143 (71.5%), 155 (77.5%), and 37 (18.5%) products, respectively. A nonstandard abbreviation for milliliter (not mL) was used by 97 products. Of the products that included an abbreviation, 163 did not define at least 1 abbreviation. CONCLUSION At the time the FDA released its new guidance, top-selling pediatric OTC liquid medications contained highly variable and inconsistent dosing directions and measuring devices.
Intermittent oxaliplatin (oxali) administration and time-to-treatment-failure (TTF) in metastatic colorectal cancer (mCRC): Final results of the phase III CONcePT trial

4010 Background: About 60% of mCRC patients (pts) discontinue oxali prior to disease progression (PD), largely driven by cumulative neurotoxicity (NT). CONcePT (Combined Oxaliplatin Neurotoxicity Prevention Trial) was initiated to test if an intermittent oxali (IO) schedule of FOLFOX/bevacizumab (BV) allows pts to remain on therapy longer compared to a conventional oxali (CO) “treat-to- failure” approach. To explore the impact of IV calcium/magnesium (CaMg: Ca-gluconate 1g, Mg-sulfate 1g, pre/post oxali) on NT, pts were randomized in a 2x2 factorial design (IO vs. CO) x (CaMg vs. placebo [PL] - double-blinded). Methods: Eligibility criteria included measurable disease, PS 0–1, no neuropathy. In CO arms, pts received mFOLFOX7 (oxali 85mg/m2, LV 200mg/m2, 5FU 2,400mg/m2 x 46h) plus BV (5mg/kg) q2wks. In the IO arms, pts alternated every 8 cycles with and without oxali. After 140 pts, a protocol amendment eliminated the CaMg vs. PL randomization and 40 subsequent pts all received CaMg. TTF (primary endpoint).
Assessing the components of adaptive capacity to improve conservation and management efforts under global change

Natural‐resource managers and other conservation practitioners are under unprecedented pressure to categorize and quantify the vulnerability of natural systems based on assessment of the exposure, sensitivity, and adaptive capacity of species to climate change. Despite the urgent need for these assessments, neither the theoretical basis of adaptive capacity nor the practical issues underlying its quantification has been articulated in a manner that is directly applicable to natural‐resource management. Both are critical for researchers, managers, and other conservation practitioners to develop reliable strategies for assessing adaptive capacity. Drawing from principles of classical and contemporary research and examples from terrestrial, marine, plant, and animal systems, we examined broadly the theory behind the concept of adaptive capacity. We then considered how interdisciplinary, trait‐ and triage‐based approaches encompassing the oft‐overlooked interactions among components of adaptive capacity can be used to identify species and populations likely to have higher (or lower) adaptive capacity. We identified the challenges and value of such endeavors and argue for a concerted interdisciplinary research approach that combines ecology, ecological genetics, and eco‐physiology to reflect the interacting components of adaptive capacity. We aimed to provide a basis for constructive discussion between natural‐resource managers and researchers, discussions urgently needed to identify research directions that will deliver answers to real‐world questions facing resource managers, other conservation practitioners, and policy makers. Directing research to both seek general patterns and identify ways to facilitate adaptive capacity of key species and populations within species, will enable conservation ecologists and resource managers to maximize returns on research and management investment and arrive at novel and dynamic management and policy decisions.
Materialities of clinical handover in intensive care : challenges of enactment and education

1! Acknowledgments. 3! Chapter717Situating7Handover . 5! Introduction . 6! 24/7:7night7and7day . 10! Structure7of7thesis . 16! Chapter727The7Literature7Review . 20! Introduction7to7the7literature7on7handover.20! Medical! training! and! education . 23! Nursing! training! and! education.25! Clinical! handover.26! Handover! and! the! social . 27! Handover:! sacred! and! profane . 35! Handover! in! industry.36! Handover! in! Intensive! Care.40! Handover! and! the! material . 44! Handover! and! geography.50! Handover! and! the! person . 54! Research7questions7and7conclusions7from7the7literature7review . 55! Chapter737Methodology . 57! Introduction . 57! Research7methodology7and7finding7the7research7philosophy . 58! ActorNNetwork7Theory.62! Research7approach:7mixing7the7methods . 65! Selection! of! the! research! subject! and! the! place . 70! The! research! context:! detailed! consideration . 71! Research! design,! participant! selection,! data! collection! and! data! generation . 73! Participant! selection . 75! Data! collected . 78! Images! and! words . 79! Boards! without! meetings.81! Transcription . 82! Ethical7considerations.82! Informed! consent! and! power . 85! Confidentiality.86! Storage! of! Data . 87! Outcomes.87! Analysis7of7the7data:7how7I7got7to7now.87! Reflexivity.90! iii The! environment! which! we! have! taken! for! granted.92! And! finally! (from! the! beginning) . 94! Conclusions . 95! Chapter747Handovers7in7Practice7in7Intensive7Care. 96! Introduction . 97! Handovers7in7intensive7care.97! Handover! of! the! ICU! from! nurse! in! charge! to! nurse! in! charge . 105! Handovers! in! the! doctors’! room . 113! Death! arising! in! handover . 132! Handover! nurse! to! nurse! at! the! bedside . 137! Conclusions . 149! Chapter757Assemblages7and7Agencies7of7Handover. 151! Introduction . 152! Talking7handover.152! What! can! the! patient! say? 152! Patients! enacted! through! verbal! handover . 154! How7is7the7person7enacted7through7the7free7text7of7typed7admission7comments? 178! Care7enacted7by7staff7of7staff . 186! Them7and7us7and7outliers:7the7hospital7others . 191! Learning7in7handover.203! What! happens! after! handover? 206! Conclusions . 208! Chapter767Conclusions7and7Recommendations . 210! Introduction . 211! Implications7for7professional7practice . 215! Implications7for7professional7education.217! Signposting7future7research.219! Conclusions . 223! References . 225! Appendices . 239! Appendix717Participants7in7the7research.239! Appendix727Ethics7consent7form.240! Appendix737Wardwatcher7data . 241!