Miracle-dz/UniFAR-FTUs huggingface dataset:
P1631Machine-learning defined predictors of mortality in ischemic and non-ischemic heart failure patients undergoing CRT-P or CRT-D implantation

Both Cardiac Resynchronization Therapy Pacemakers (CRT-P) and CRT Defibrillators (CRT-D) improve mortality in heart failure patients with reduced ejection fraction and wide QRS complex. However, not every patient benefits equally from each type of treatment and determinants of mortality may vary across the subgroups of patients with different etiologies and devices. Our aim was to investigate the differences in the predictors of long-term mortality in heart failure patients with different etiologies undergoing CRT-P or CRT-D implantation using machine learning. We created 4 separate random forest models to predict 5-year all-cause mortality (models for ischemic and non-ischemic etiology in both CRT-P and CRT-D subgroups). A registry of 1650 patients (66±10 years, 1258 [76%] males, 751 [46%] CRT-D) was used as the training cohort for the prediction models. Forty-seven pre-implant parameters including cardiovascular risk factors and clinical variables were utilized to train our models. For each clinical parameter, we calculated the mean decrease in Gini impurity (dG). Based on the extent of decline, the 10 most important features were selected for each model. To keep the data comparable between the different models, we took the union of these features and plotted the results on radar charts. There were 879 (53%) deaths during the follow-up period. The mortality benefit of adding an Implantable Cardioverter Defibrillator could be observed only in ischemic patients (Hazard Ratio = 0.83, 95% Confidence Interval: 0.72–0.97, p<0.005), but not in the entire cohort or in patients with non-ischemic etiology. In patients with non-ischemic etiology, the pattern of mortality predictors were almost similar: in CRT-P patients the most important predictors were age, serum urea levels and left ventricular ejection fraction (LVEF) (dG: 0.114, 0.054 and 0.053, respectively) whereas in the CRT-D subgroup these factors were age, LVEF and serum sodium (dG: 0.116, 0.060 and 0.052, respectively). In CRT-P patients with non-ischemic etiology, the most relevant variables were age serum urea and LVEF in decreasing order (dG: 0.085, 0.060 and 0.050, respectively). The strongest predictors of mortality were age, hemoglobin and serum creatinine in ischemic patients with CRT-D (dG: 0.088, 0.060 and 0.052, respectively). CRT-P vs. CRT-D by ischemic etiology In patients with ischemic heart failure, CRT-D was associated with a mortality benefit compared to CRT-P. Our results also suggest that machine-learning may identify distinct patterns in clinical characteristics for a better mortality prediction. Taking these factors into consideration during the management of heart failure patients with CRT, risk stratification and outcomes could be improved.
Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Predict All-Cause Mortality in Acute Pulmonary Embolism

The aim of this study was to investigate the utility of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to predict all-cause mortality in patients presenting with acute pulmonary embolism (PE). Three hundred consecutive patients with acute PE between March 2016 and December 2018 were retrospectively analyzed. We identified 191 patients who met the study inclusion criteria. Twenty-eight patients died during the study period. There was a significant difference in PLR, but not NLR, between patients with low risk, submassive, and massive risk PE (P = .02 and P = .58, respectively, by the Kruskal-Wallis test). Elevated NLR and PLR were associated with all-cause mortality (P < .01 and P < .01, respectively). Neutrophil-to-lymphocyte ratio of 5.46 was associated with all-cause mortality with sensitivity of 75.0% and specificity of 66.9% (area under the curve [AUC]: 0.692 [95% confidence interval, CI]: 0.568-0.816); P < . 01). Platelet-to-lymphocyte ratio of 256.6 was associated with all-cause mortality with sensitivity of 53.6% and specificity of 82.2% (AUC: 0.693 [95% CI: 0.580-0.805]; P < .01). Neutrophil-to-lymphocyte ratio and PLR are simple biomarkers that are readily available from routine laboratory values and may be useful components of PE risk prediction models.
Isolation, Purification and Neutralizing potential of chicken egg yolk immunoglobulin (IgY) against mastitis causing Escherichia coli in dairy cows in Coimbatore District

Chicken egg yolk antibodies were raised in 24 week old white leg horn chicken against mastitis causing Escherichia coli. Booster injections of increasing concentrations of antigen were given to raise the antibody level in egg yolk. The antibodies were purified from immunized chicken egg yolk by Polson et al.(1980) and further purified by DEAE cellulose ion exchange column chromatography. High titre of more than 1:10000 antibodies were detected by ELISA at 150th day of observation. IgY concentration varied in the range of 0.5 – 7.1mg/ml of yolk throughout the immunization period. Growth inhibition assay showed the absence of growth when the specific egg yolk antibodies was added to the E.coli culture. The results indicate that antibodies generated in chicken could be used for Diagnosis and therapeutic purposes in case of bovine mastitis.
Abortion in sheep

ABORT ION accounts for about 12 per cent of all ovine material submitted to the veterinary investigation centres in England, Wales and Scotland. And in the last three years nearly 60 per cent of that material was undiagnosed. All flocks experience the odd sporadic abortion in most years but when two or more per cent of the ewes in a flock are affected the farmer has a problem. Up to 30 per cent have been recorded following the introduction of specific infections into previously clean flocks. Losses also accrue from deaths due to the development of post parturient metritis in affected ewes. Many causes of abortion in sheep have been identified, both infectious and non-infectious. The latter are frequently associated with sporadic incidents, eg, following the stress of handling heavily pregnant animals near parturition or as a side effect of pregnancy toxaemia. It is usually difficult to be absolutely sure of the diagnosis. These probably represent many of the large number of cases undiagnosed on laboratory examination. Where more than 2 per cent of the ewes in a flock are affected, it is probable that a specific infectious cause is responsible. In the United Kingdom, the conditions most commonly seen are enzootic abortion of ewes and toxoplasmosis, followed some way behind by vibriosis (C fetus var. intestinalis infection) and salmonellosis. The other infectious agents listed are very sporadic. However, laboratory returns on the diagnoses of these infections may be misleading as frequently inadequate numbers of specimens are received from an outbreak, the whole range of specimens are not submitted and those submitted may be in a poor state of preservation. This also accounts for the high number of incidents of abortion which go undiagnosed.
Delirium in the Elderly Patients-How can we Improve Outcomes?

The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) describes delirium as a condition characterized by a disturbance in attention (i.e., reduced ability to direct, focus, sustain and shift attention) and awareness (reduced orientation to the environment)[1]. In addition, there is a change in cognition (such as memory deficit, disorientation, language disturbance, visuospatial ability or perception). Furthermore, these disturbances are not better accounted for by a preexisting, established or evolving neurocognitive disorder and occur due to the direct physiological consequences of another medical condition, substance intoxication or withdrawal.
The Teaching Strategies GOLD Assessment System: Measurement Properties and Use

This paper describes the development and use of a relatively new, widely adopted authentic assessment measure and presents an overview of findings from four studies regarding its reliability and validity. The Teaching Strategies GOLD is a teacher rating assessment system designed to assess the development and learning of children birth - kindergarten, inclusive of children with disabilities and English language learners. Study samples were large and diverse. Children attended Head Start, private child care, and school-based programs in all areas of the United States and were representative of the nation's population of similarly aged children. Overall results indicate that the GOLD yields valid and reliable inferences for the intended population and that teachers are able to use the measure to accurately assess children's development and learning across the designated age range. Limitations and implications for practice and future research are discussed.
Automated Attribute Inference for IoT Data Visualization Service

As data becomes vital to urban development of modern cities, Thailand has initiated a smart city project on pilot cities around the country. We have implemented an interoperable data platform for smart city to enable Internet of Things (IoT) data exchanges among organizations through APIs. One of the key success is that people can access and visual the data. However, data can have various attributes since standard has not completely established and adopted. Therefore, it is difficult to automate the process to achieve comprehensive visualization. Traditionally, we require developers to manually examine data streams to determine which data attribute should be presented. This process can be very time consuming. The visualization system must be manually updated whenever a source stream modifies its data attributes. This problem becomes an impediment to implement a scalable cloud-based visualization service. To mitigate this challenge, we propose an automated attribute inference approach to automatically select key visualizable attribute from heterogeneous streams of data sources. We have experimented with different data attribute selection algorithms, namely an empirical rule-based system and the chosen machine learning algorithms. We implement and evaluate the proposed selection algorithms through our 3D visualization program in order to get the feedback from users.
Phase I trial of romidepsin, a histone deacetylase inhibitor, given on days one, three and five in patients with thyroid and other advanced cancers

3571 Background: Romidepsin (FK228 or depsipeptide) is a potent histone deacetylase inhibitor (HDI) with cytotoxic activity in preclinical models and significant activity in patients with cutaneous and peripheral T-cell lymphoma. As responses have been infrequently observed in solid tumors it is important to test HDIs in combination therapy. One strategy is to use HDIs to induce expression of genes that can be targeted therapeutically. Metastatic thyroid cancer refractory to RAI offers one such opportunity. In vitro, HDIs restore expression of the sodium iodine symporter in refractory cells and sensitivity to RAI. Methods: We initiated a phase I trial of romidepsin in a new schedule, administered on days 1, 3 and 5 with the goal of enhancing gene expression and evaluating RAI uptake in patients with RAI-refractory thyroid cancer. Results: We have completed the dose escalation stage of the protocol with 26 patients with solid tumors enrolled, including 9 patients with thyroid cancer. Doses tested were 1, 2.
A randomized controlled trial evaluating the effectiveness of an acceptance and commitment therapy–based bibliotherapy intervention among adults living with chronic pain

ABSTRACT Background Chronic pain has a significant impact on the physical and psychological functioning of those living with this condition. It is now recognized that acceptance and commitment therapy (ACT) is an effective intervention in managing chronic pain; however, several barriers limit its accessibility. Aims The current study aimed to evaluate the effectiveness of an 8-week bibliotherapy-type self-administered psychological intervention with minimal therapeutic contact, based on ACT, in the management of chronic pain. Methods This was a randomized controlled trial with three measurement periods (pretest, posttest, and 3 months after the intervention; ClinicalTrials.gov Identifier: NCT03924687). A total of 140 adults with chronic pain were randomly assigned to an ACT self-help condition or a wait-list control condition. Results Two-way repeated measures analysis of variance (ANOVA) models showed statistically significant differences between pretest and posttest in terms of pain-related disability (main variable), depression (secondary variable), pain-related acceptance, and psychological inflexibility (d = 0.46–0.88) in favor of the ACT self-help condition. At the 3-month follow-up, these differences were maintained and nearly 54% of participants reported an overall improvement of their physical and mental health. Conclusion These results suggest that a psychological intervention self-administered through ACT bibliotherapy with minimal therapeutic support can improve the physical and emotional functioning of adults from the community who live with chronic pain.
The radiological alignment of components after total knee arthroplasty and its relation to functional outcome

Aim: The main aim of this study is to radiologically assess the components alignment in various planes in total knee replacement and to assess its relationship to the functional outcome using the knee society score. Materials and Methods: This hospital based prospective observational study of 30 patients was conducted in the department of Orthopaedics at Maharaja Agrasen Hospital, New Delhi on patients who underwent elective primary Total Knee Arthroplasty and the period of study being 24 months from June 2016 to May 2018. All patients were assessed clinically and functionally using the Knee Society Score pre and post operatively for a follow up period of 6 months. Results: The mean coronal alignment and rotational alignment of femoral component in our study was 5.87 degrees and 2.99 degrees of external rotation respectively. The mean tibial component coronal and rotational alignment in our study was 90 degrees and 17.77 degrees respectively. The mean preoperative flexion of 81.33 degrees increased to 113.5 degrees postoperatively with a significant p value of <0.001. There was significant improvement of Knee Clinical Score and Knee Functional Score following Total Knee Arthroplasty with a p value <0.001. Conclusion: In our study the use of conventional extra medullary guide for tibia and intramedullary guide for femur to align a total knee replacement provided acceptable alignment and gives a good functional outcome as measured by knee society score.
Static and Dynamic Balance After Ankle Plantarflexor Fatigue in Older Adults

ABSTRACT Aims: The purpose of this study was to evaluate how fatigue of the ankle plantarflexors would affect both static and dynamic standing balance in a healthy older population. Understanding how conditions of muscle fatigue may effect balance control of older adults may lend insight to rehabilitation strategies useful for the screening and prevention of fall risks. Methods: 18 healthy older adults (mean age = 74.67 years) were randomly divided into either a fatigue group or a control group. Baseline measurements were collected using the NeuroCom Smart® Balance Master's limits of stability (LOS) test and the sensory organization test (SOT). Participants in the control group rested for 5 min after the baseline testing and then repeated the tests, while participants in the fatigue group repeated the tests after performing heel raises until they became fatigued. Results: LOS parameters decreased after muscle fatigue but were significant only for the interaction of directional control (DCL). The findings for SOT were nonsignificant. Conclusion: This research suggests that plantarflexor fatigue may have a negative effect on the DCL of an older adult when challenging their LOS and therefore may decrease their ability to avoid a fall.
Lipid Profile Variations of the Different ABO Blood Group of Apparently Healthy Subjects in Ekpoma

Dyslipidemia is a recognized major risk factors of cardiovascular diseases, but the impact of the different blood groups has not been extensively investigated; at least in Nigeria where the prevalence is on the increase. This study, therefore assesses serum lipid profile among different ABO blood groups in Ekpoma, Nigeria. The study involved 100 subjects comprising of 25 each of blood groups A and B, 15 and 25 subjects with AB and O blood groups respectively. The subjects were male and female within 18-30 years who gave consent and met the inclusion criteria. Following standard procedures blood samples were obtained for serum lipid profile and the results were analyzed using appropriate statistical test (ANOVA) at p 0.05) in the serum mean total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein and very low density lipoprotein levels in the different blood groups. However, the AB blood group was more likely to present higher lipid variables. There was significant gender differences in HDL in the A and AB blood groups. Judging by the findings of this study, there is likely no marked effect of blood group on serum lipid profile in apparently healthy individuals.
Comparison of Glomerular Filtration Rate Measurement Methods between Radionuclide in vivo Scintigraphic Gates’ and Plasma Sampling

AIM: To correlate between the radionuclide in vitro plasma sampling method (using single and dual blood samples) and Gates’ GFR measurement using Tc-99m diethylene triamine penta-acetic acid (Tc-99m DTPA) renal scintigraphy (in vivo method). METHODS: This study included 40 renal donors (group 1) and 40 patients with obstructive uropathy (group 2). Group 1 included 22 males and 18 females with an age range from 22 to 65 years, while group 2 included 24 males and 16 females with age range 27 to 64 years. Both groups subjected to renal Scintigraphy after administration of 5 mCi 99m-Tc DTPA, GFR was calculated using Gates’ method (in vivo method), then plasma sampling was acquired at 60 mins and 180 mins post-injection of the tracer, samples were counted in well counter and GFR was calculated using in vitro technique either using single plasma sample (SPSM 60 mins) or dual sample (DPSM 60 & 180 min). Additionally, GFR was measured by estimated equations based on serum creatinine. RESULTS: In group 1, the mean GFR using in vivo Gates’ method was 115.7 ± 29 ml/min, while using the SPSM was 100.1 ± 16.1 ml/min, and the DPSM was 100.3 ± 20.1 ml/min. In group 2, mean GFR using in vivo method was 74.1 ± 14.5 ml/min, while using in vitro SPSM it was 77.5 ± 24.9 ml/min and DPSM was 76.8 ± 24.8 ml/min. There was no significant difference between mean GFR values using in vivo and in vitro methods (single or dual samples) in group 1 and 2 (p > 0.05). There is high significant correlation between SPSM and DPSM in groups 1 and 2 (r = 0.90, r = 0.91 respectively), moderate significant correlation was found between in vivo Gates’ method and in vitro SPSM in group 1 and 2 (r = 0.46 and 0.57 respectively) and moderate correlation was evident between in vivo and in vitro DPSM in both groups (r = 0.42 and 0.68 respectively). By using the DPSM as the reference standard significant high correlation was found with SPSM and significant-high moderate correlation with in vivo Gates’ scintigraphic method. Conclusion: In vitro plasma sampling considered as a reliable, accurate |method for GFR calculation yet it considered relatively complex, both single and dual sample in vitro techniques showed a very high correlation, and hence SPSM can replace DPSM. CONCLUSION: Renal scintigraphy and GFR estimation using Gates’ in vivo method is considered inaccurate, yet given its simplicity in performance it can still be used if corrected GFR is standardised for Egyptian population-based on studies with large numbers of patients from multiple centres.
Why not to look for a vasculitis etiology in a patient presenting with coronary aneurysm, aortic pseudoaneurysm, and deep vein thrombosis such as Behçet's disease?

Correspondence: Didem Melis Öztaş, MD. Bağcılar Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği, 34100 Bağcılar, İstanbul, Turkey. e-mail: didem_mls@hotmail.com 1Department of Cardiovascular Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey 2Department of Cardiovascular Surgery, Sultanbeyli State Hospital, Istanbul, Turkey 3Department of Cardiovascular Surgery, Istanbul Medipol University Medical Faculty, Istanbul, Turkey 4Department of Cardiovascular Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
The Role of EGFR, HER 2-4, Heregulin and Downstream Signalling in Prostate Adenocarcinoma

Background Currently evidence regarding influence of the HER tyrosine kinase family - EGFR, HER2, HER3 and HER4 - during disease progression in prostate adenocarcinoma is conflicting – both poor prognosis and no influence on outcome are reported. A small cohort pilot study of paired hormone sensitive (HSPC) and refractory (HRPC) specimens demonstrated HER2/HER4 as positively prognostic in HSPC. Heregulin (HRG), a principle HER family ligand, has previously been noted to have a differential effect on HSPC (decreased proliferation) and HRPC (increased proliferation) cell lines. This study determines influence of HER family and HRG in a larger HSPC cohort and whether influence mechanisms involve proliferation or apoptosis. Patients and Methods Immunohistochemical staining for HRG, KI67 (proliferation), TUNEL (apoptosis) was performed on pilot study specimens. Further IHC for EGFR, HER2, HER3, HER4, HRG, KI67 and TUNEL was performed on HSPC tissue microarrays. Correlations between target protein expression and the outcomes time to biochemical relapse and overall survival were determined. Result High expression of HER/HRG was correlated with improved prognosis particularly in androgen deprivation treated subcohort (e.g. high EGFR and longer time to relapse p=0.02, high HER2 and delayed relapse p=0.002, high HRG and delayed relapse-p=0.004). High expression of multiple markers increased association significance (e.g. high HER1-4 and delayed relapse p=0.001). No correlations between HER and proliferation or apoptosis were seen. Conclusion The HER family and HRG are positively prognostic in prostate adenocarcinoma. This has implications for the use of HER family as outcome predictors to guide management.
Trends in the Prevalence of Helicobacter Pylori Infection in Fardis, Iran, 2011 - 2014

Background: One of the most common causes of chronic bacterial infections is H. pylori and there is evidence indicative of its strong association with gastric cancer. Objectives: We aimed to determine the prevalence of H. pylori infection using Gram staining, IgG, urea breath test (UBT), and stool antigen from patients with gastrointestinal (GI) symptoms. Materials and Methods: Patients with GI symptoms who were referred to Fardis Central Laboratory, Fardis, Iran for identification of H. pylori from different clinical specimens from 2011 to 2014 were included in this study. Demographic data were retrieved from the medical records of enrolled patients. Results: A total of 16002 patients were referred to Fardis Central Laboratory, Fardis, Iran over the past 3 years. Among them, 5662 (35.38%) were males and 10340 (64.62%) females; their mean age was 48 years (range 3 to 93 years). Of 16002 patients tested, 6770 (83.77%), 137 (1.69%), and 1174 (14.54%) were positive for H. pylori according to the results of immunoglobulin G (IgG), urea breath test (UBT), and H antigen, respectively. Conclusions: H. pylori infection rate in patients referring to Fardis Lab with GI symptoms was relatively high which could be due to some health habits. Although this kind of infection is considerably common, it can easily be diagnosed by noninvasive tests.