Miracle-dz/UniFAR-FTUs huggingface dataset:
Results from more than 20 years of surgical pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension in Denmark

OBJECTIVES Chronic thromboembolic pulmonary hypertension is a fatal disease if left untreated, and pulmonary endarterectomy (PEA) is the potentially curable treatment of choice. We aimed to estimate the current in‐hospital mortality rate, complication rate and long‐term survival for patients with chronic thromboembolic pulmonary hypertension undergoing PEA in Denmark. METHODS All chronic thromboembolic pulmonary hypertension patients who underwent PEA in the period 1994 till 2016 were consecutively enrolled in our single‐centre study. All patients were followed from PEA until death or end of study. Kaplan‐Meier survival analysis was used to estimate the 3‐, 5‐ and 10‐year survival rates with 95% confidence interval (CI). RESULTS In total, 239 patients were operated in the study period. A significant reduction in mean pulmonary arterial pressure from 48 mmHg to 33 mmHg, and pulmonary vascular resistance from 800 dynes s cm−5 to 289 dynes s cm−5, was observed during the first postoperative day after PEA. Overall, in‐hospital mortality rate was 8.4%. A significantly lower mortality rate in the late decade (2005‐2016) compared with the early decade (1994‐2004) was observed (4.3% vs 22.6%, P < 0.001). In‐hospital mortality during the last 5 years (n = 80) was 2.5%. Three‐, 5‐ and 10‐year survival rates were 84% (CI: 77.8‐88), 77% (CI: 70.7‐82.7) and 62% (CI: 53‐69.1), respectively. The majority of patients improved in World Health Organization functional class from III/IV to I/II and significantly increased their 6‐min walking distance. CONCLUSIONS PEA in Denmark is associated with a low in‐hospital mortality rate and significant improvements in both haemodynamics and exercise capacity. Long‐term survival is excellent and similar to high‐volume international centres.
The health state preferences and logistical inconsistencies of New Zealanders: a tale of two tariffs

Notwithstanding the proposed use of Cost-Utility Analysis (CUA) to inform health care priority setting in New Zealand, to date there has been no research into New Zealanders’ valuations of health-related quality of life. This paper reports the results of a study of the health state preferences of adult New Zealanders generated from a postal survey to which 1360 people responded (a 50% response rate). The survey employed a self-completed questionnaire in which a selection of health states were described using the EQ-5D health state classification system and respondents’ valuations were sought using a visual analogue scale (VAS). Close attention is paid to the quality of the data, in particular to the ‘logical inconsistencies’ in respondents’ valuations. Regression analysis is used to interpolate values over the 245 possible EQ-5D states. Two tariffs of health state preferences, arising from contrasting treatments of the logical inconsistencies, are reported.
Continuous and noninvasive estimation of arterial blood pressure using a photoplethysmographic approach

Arterial blood pressure is one of the most important physiological parameters for the noninvasive diagnosis and monitoring of cardiovascular diseases. This study examines the relationships between arterial blood pressure and certain features of the photoplethysmographic (PPG) signals obtained from 15 young healthy subjects. Width of 1/2 pulse amplitude, width of 2/3 pulse amplitude, systolic upstroke time and diastolic time of the pulse were selected as features of the PPG signals. The experiment involved three sessions: rest, step-climbing exercise, and recovery from exercise. It was found that the diastolic time has higher correlation with systolic blood pressure (SBP) and diastolic blood pressure (DBF) than other features. The mean differences between the estimated and the measured blood pressure using a standard device are 0.21 mm Hg for SBP and 0.02 mm Hg for DBF. The corresponding standard deviations are 7.32 mm Hg for SBP and 4.39 mm Hg for DBF. The preliminary results indicate that it is possible to use the photoplethysmography only for cuffless and continuous estimation of arterial blood pressure.
Treatment of peri‐implantitis: clinical outcome of chloramine as an adjunctive to non‐surgical therapy, a randomized clinical trial

PURPOSE To evaluate the adjunctive clinical effects of a chloramine to non-surgical treatment of peri-implantitis. MATERIAL AND METHODS Eighteen individuals diagnosed with peri-implantitis (clinical signs of inflammation and progressive bone loss) on at least two implants were included. Clinical variables; plaque accumulation (Pl), probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BoP), were recorded at baseline and at 3-month follow-up. Primary clinical efficacy variable was the change in the number of sites with BoP. The implants were randomized into two different treatment groups: test and control. Both implants received supra- and submucosal debridement by ultrasonic instrumentation supplemented with hand instruments. The implants assigned to the test group first received local applications of a chloramine gel (Perisolv™ ; RLS Global AB, Gothenburg, Sweden) followed by mechanical instrumentation. The oral hygiene was checked at 6 weeks. RESULTS After 3 months, implants of both groups showed statistically significant reduction (P < 0.001) in the number of BoP-positive sites compared with baseline. The reduction of BoP-positive sites in the test group changed from 0.97 (SD ± 0.12) to 0.38 (SD ± 0.46), and in the control group from 0.97 (SD ± 0.12) to 0.31 (SD ± 0.42). Between-group comparisons revealed no statistically significant differences at baseline and after 3 months, for BoP or any of the other variables. CONCLUSION In the present randomized clinical trial of peri-implantitis therapy; non-surgical mechanical debridement with adjunctive use of a chloramine is equally effective in the reduction of mucosal inflammation as conventional non-surgical mechanical debridement up to 3 months.
The Association Between Normal Range TSH and Lipid Profile

Abstract Dyslipidemia in thyroid dysfunction is mostly attributed to thyrotropin (TSH) levels, especially in subclinical disorders, but the exact role of TSH in dyslipidemia has not been explained. A total of 3 020 subjects who remained euthyroid in 3 phases of the Tehran Thyroid study were enrolled and divided according to quartiles of TSH as: Q1 (0.32–1.02), Q2 (1.02–1.53), Q3 (1.53–2.27), and Q4 (2.27–5.06). General Linear model was used to determine whether there was a significant correlation between subjects’ lipid profile and quartiles of TSH from 1st to 2nd and from 1st to 3rd phase. Mean TC, LDL-C level and median TG were significantly higher for Q1 in all study phases. All lipid parameters of participants after 6 years (3rd phase study) except LDL-C were significantly varied in different TSH groups. Highest levels of TC, TG and HDL-C were observed in Q4. Thus, irrespective of TC and LDL-C in Q1 and Q4 (participants with the lowest and highest limit of TSH within the normal range), the difference in lipid parameters in middle of normal TSH range was not significant. Normal range TSH levels have a statistically significant effect on lipid profile, but the effect size is not clinically significant.
Epidemiological, clinical, diagnostic and treatment aspects of hospitalized Brucellosis patients in Hamadan

Background and Objective: Brucellosis is recognized as a clinical and health problem in underdeveloped countries. This research is a descriptive study to determine the prevalence of brucellosis, clinical aspects and laboratory results as well as epidemiological analysis of hospitalized patients in Hamadan city in a five-year period. Materials and Methods: During our study period, 809 patients (61.2% men and 38.8% women) with confirmed brucellosis based on clinical symptoms and serological tests, from all Hamadan hospitals were looked into. Patients' data concerning age, gender, occupation, date of diagnosis and observed symptoms were collected from five regional hospitals. Blood samples were obtained by venepuncture needles and all samples were analyzed using serum agglutination test (SAT), Coombs and 2-mercaptoethanol (2ME) methods. Blood culture was performed by inoculation into biphasic blood culture media for isolation the brucella organisms. Results: The highest and lowest age groups were 11-20 (23.5%) and over 80 (1.11%) years. The highest brucellosis rate was observed in housekeepers (26.46%) followed by farmers (20.51%). The most common observed symptoms were arthralgia, chill and anorexia with 83.8, 63.10 and 59.45% respectively, while the lowest was urethritis (0.24%). The most common signs were fever and splenomegaly with 83.8 and 20.76% respectively. A combination of rifampin and doxcycline was the most applied treatment protocol (40.91%). Conclusion: Brucellosis program needs to be more concerned since most affected patients were young adults with predominance among males. The majority of brucellosis cases in this study were attributed to direct contact with animals or their products. In our study cotrimoxasol-rifampin reported to have the lowest relapse rate.
Long-term stability of peri-implant tissues after bone or soft tissue augmentation. Effect of zirconia or titanium abutments on peri-implant soft tissues. Summary and consensus statements. The 4th EAO Consensus Conference 2015.

INTRODUCTION Several surgical techniques and prosthetic devices have been developed in the last decades, aiming to improve aesthetic, hygienic and functional outcomes that may affect the peri-implant tissues, such as procedures of bone and soft tissue augmentation and the use of custom-made abutments of titanium and zirconium. MATERIALS AND METHODS Three systematic reviews, based on randomized clinical trials and prospective studies covering the above reported topics were analysed, and the detected evidence was exposed to interactive experts' discussion during the group's and general assembly's meetings of the 4th EAO Consensus Conference. The results are reported using the following abbreviations: S-T: short-term evidence, M-T: medium-term evidence; L-T: long-term evidence; LE: limited evidence. RESULTS Soft tissue augmentation procedures may be indicated for the increase of soft tissue thickness and keratinized tissue, the reduction of interproximal peri-implant bone loss, and the coverage of shallow peri-implant soft tissue recessions (S-T, LE), L-T is lacking. Guided bone regeneration approaches (GBR) showed efficacy when used for ridge reconstruction after the complete healing of the soft tissues (S-T & L-T), and the stability of the augmented bone may play a role in the maintenance of the soft tissue position and dimensions (LE). No significant differences were observed between titanium and zirconia abutments when evaluating probing pocket depth, bleeding on probing, marginal bone levels and mucosal recessions. Zirconia abutments were associated with more biological complications but demonstrated superiority in terms of achieving natural soft tissue colour (S-T).
Performance Factors in a Mountain Ultramarathon

Abstract This study aimed to determine mountain ultra-marathon (MUM) performance factors in a large group of endurance mountain runners. Maximal aerobic speed (MAS) was assessed one week prior to the MUM. The level and graded (10%) energy cost of running, stiffness, knee extensors force (KEf), and jump height on a counter movement jump (CMJ) were measured in 24 male ultra runners before (pre) and immediately after (post) the Interlacs Trail (75 km and 3 930/3 700 m d+/d−). Performance time was correlated with MAS (r=− 0.74, p<0.001), fraction of MAS (FMAS) sustained (r=− 0.89, p<0.001), KEf (r=− 0.51, p<0.05), and KEf loss (r=− 0.51, p<0.05). A multiple regression analysis was performed using performance time in minutes (T) and the calculated individual characteristics, resulting in T=− 11.852×FMAS−37.195×MAS−0.118×KEf+2090.581 (R2=0.98, with 95% confidence interval). Contrary to expectations, performance was neither correlated to the level or uphill energy cost of running nor to the changes of these costs post-MUM. To perform in a MUM, training should take into account muscle strength of the KE, MAS and FMAS.
Principles of anatomy & physiology

The thirteenth edition of the phenomenally successful "Principles of Anatomy and Physiology" continues to set the standard for the discipline. The authors maintained a superb balance between structure and function and continue to emphasize the correlations between normal physiology and pathophysiology, normal anatomy and pathology, and homeostasis and homeostatic imbalances. The acclaimed illustration program continues to be refined and is unsurpassed in the market. The thirteenth edition is fully integrated with a host of innovative electronic media, including WileyPlus 5.0 (access purchased separately.) No other text and package offers a teaching and learning environment as rich and complete.
Principles of research: limitations of non-randomized studies

Abstract Controlled non-randomized trials (NRS), or cohort studies, are often used to evaluate the effectiveness of surgical treatments. NRS have limitations which must be considered carefully both when doing research and deciding whether to use research to inform practice. NRS have diverse design features. Three aspects of study design are the relationship in time between groups being compared; whether or not participants were treated before the study was conceived; and the basis for allocating a treatment to a participant. These are important because they are believed to influence the risk of bias. In randomized controlled trials (RCTs), treatment is allocated by chance: when randomization is concealed, this rules out systematic baseline differences between groups. In NRS, the decision to give a particular treatment to a patient is made either by researchers or collectively by the attending doctor and patient. Both methods are likely to give rise to imbalances in prognostic factors between the groups being compared. Imbalances can be reduced by matching, or controlled for by statistical methods, but their confounding effects can never be entirely removed. Imbalances can bias estimates of treatment effects and almost always increase their uncertainty. Recent research increases the pressure for researchers to do RCTs, if at all possible, when evaluating beneficial effects of treatments. Confounding is less likely when researching rare but serious harms, which are very difficult to investigate with RCTs. NRS may have a valuable role in this context.
The common sense model, quality of life and symptom frequency in irritable bowel syndrome (IBS)

In this thesis the application of the Common Sense Model (CSM) of illness representations (Leventhal et al., 1890; 1984) to Irritable Bowel Syndrome (IBS) was investigated. A systematic literature review and three empirical studies were conducted to investigate the factors that influence the illness representations, explore the relationship between illness representations and illness outcomes (health related quality of life (HRQOL) and symptom frequency) and to potentially alter illness representations and illness outcomes. Study 1 was an exploratory cross sectional study with 116 participants (n = 58 doctors, n= 58 IBS sufferers). Patients reported significantly more negative perceptions of the consultations than doctors; however patients perceived communication was not predictive of illness representations, or illness outcomes. Independently of perceived communication an internal locus of control was found to be predictive of illness outcomes. Study 2 was a cross sectional study with 301 participants (n = 239 general population, n= 62 IBS sufferers). IBS sufferers' perceptions of the general populations' attitudes were significantly more negative than reported attitudes. Perceived attitudes towards witnessing symptoms were predictive of HRQOL. Independently of perceived attitudes, emotional representations were predictive of HRQOL, and illness identity was predictive of diarrhoea. Study 3 was a longitudinal intervention study with 62 IBS sufferers. Significant findings were as follows: reductions in symptom frequency from pre intervention to immediately post, and two months post intervention; improvements in HRQOL from pre intervention to two months post intervention; improvements in perceived social support immediately post intervention; improvements in illness representations from pre intervention to immediately post, and two months post intervention. There were no significant predictors of change in total symptoms or HRQOL post the intervention. Overall these studies demonstrate the utility of CSM in IBS research. Further investigation of the CSM in IBS is recommended.
Patient Compliance With and Attitudes Towards Health Buddy

Abstract : This report discusses patient acceptance of a device called Health Buddy (TM). Placed in the home of a chronically ill patient (in our example, one with congestive heart failure, or CHF), this device enables two-way communication between the patient and a care provider in a case management program. Health Hero, Inc., the company that developed the Health Buddy (TM) and offers the communication service based on it, writes: "The service is designed to give care providers the frequent communication and baseline data that yield more opportunities to identify potentially serious situations sooner, help caregivers focus their attention on those who need it most and enable them to motivate and educate their patients. " Communication occurs via Health Buddy (TM) when the patient responds to a short automated survey of perhaps a dozen questions. This is in contrast to most case management programs, where the case manager (usually a nurse) takes the initiative by telephoning the patient. Accordingly, the patient's acceptance of Health Buddy (TM) and his or her willingness to use it daily is crucial to its success. This report should be of interest to any who contemplate establishing case management programs for chronically ill patients. Examples may be found in hospitals, independent practice associations, and health maintenance organizations. it should also interest those who, like Health Hero, offer services in support of case management programs. Funding for this work was provided by Health Hero.
Établissement des valeurs de référence de 15 constituants biochimiques sanguins chez l‘adulte burkinabé à Ouagadougou (Burkina Faso)

Les valeurs de reference de 15 constituants biochimiques sanguins ont ete determinees sur un echantillon de 559 sujets des 2 sexes âges de 15 a 50 ans au Burkina Faso (Afrique de l‘Ouest). Les resultats rapportent que les valeurs de reference de plusieurs de ces parametres varient avec l‘âge et le sexe. Par ailleurs, la comparaison avec les valeurs de reference europeennes montre des differences significatives qui pourraient etre liees a l‘environnement et aux habitudes alimentaires. Il ressort de cette etude que l‘utilisation des valeurs de reference europeennes pour interpreter les resultats de sujets africains pourrait induire des erreurs d‘appreciation par exces ou par defaut.
Alcohol consumption and risk of incident atrial fibrillation in women.

CONTEXT Previous studies suggest that consuming moderate to high amounts of alcohol on a regular basis might increase the risk of developing atrial fibrillation in men but not in women. However, these studies were not powered to investigate the association of alcohol consumption and atrial fibrillation among women. OBJECTIVE To prospectively assess the association between regular alcohol consumption and incident atrial fibrillation among women. DESIGN, SETTING, AND PARTICIPANTS Participants were 34 715 initially healthy women participating in the Women's Health Study, a completed randomized controlled trial conducted in the United States. Participants were older than 45 years and free of atrial fibrillation at baseline and underwent prospective follow-up from 1993 to October 31, 2006. Alcohol consumption was assessed via questionnaires at baseline and at 48 months of follow-up and was grouped into 4 categories (0, > 0 and < 1, > or = 1 and < 2, and > or = 2 drinks per day). Atrial fibrillation was self-reported on the yearly questionnaires and subsequently confirmed by electrocardiogram and medical record review. MAIN OUTCOME MEASURE Time to first episode of atrial fibrillation. RESULTS Over a median follow-up of 12.4 years, 653 cases of incident atrial fibrillation were confirmed. Age-adjusted incidences among women consuming 0 (n = 15,370), more than 0 and less than 1 (n = 15,758), 1 or more and less than 2 (n = 2228), and 2 or more (n = 1359) drinks per day were 1.59, 1.55, 1.27, and 2.25 events/1000 person-years of follow-up. Thus, compared with nondrinking women, women consuming 2 or more drinks per day had an absolute risk increase of 0.66 events/1000 person-years. The corresponding multivariate-adjusted hazard ratios (HRs) for incident atrial fibrillation were 1, 1.05 (95% CI, 0.88-1.25), 0.84 (95% CI, 0.58-1.22), and 1.60 (95% CI, 1.13-2.25), respectively. The increased hazard in the small group of women consuming 2 or more drinks per day persisted when alcohol intake was updated at 48 months (HR, 1.49; 95% CI, 1.05-2.11) or when women were censored at their first cardiovascular event (HR, 1.68; 95% CI, 1.18-2.39). CONCLUSIONS Among healthy middle-aged women, consumption of up to 2 alcoholic beverages per day was not associated with an increased risk of incident atrial fibrillation. Heavier consumption of 2 or more drinks per day, however, was associated with a small but statistically significant increased risk of atrial fibrillation.
Previously unrecognized stages of species‐specific colonization in the mutualism between Xenorhabdus bacteria and Steinernema nematodes

The specificity of a horizontally transmitted microbial symbiosis is often defined by molecular communication between host and microbe during initial engagement, which can occur in discrete stages. In the symbiosis between Steinernema nematodes and Xenorhabdus bacteria, previous investigations focused on bacterial colonization of the intestinal lumen (receptacle) of the nematode infective juvenile (IJ), as this was the only known persistent, intimate and species‐specific contact between the two. Here we show that bacteria colonize the anterior intestinal cells of other nematode developmental stages in a species‐specific manner. Also, we describe three processes that only occur in juveniles that are destined to become IJs. First, a few bacterial cells colonize the nematode pharyngeal‐intestinal valve (PIV) anterior to the intestinal epithelium. Second, the nematode intestine constricts while bacteria initially remain in the PIV. Third, anterior intestinal constriction relaxes and colonizing bacteria occupy the receptacle. At each stage, colonization requires X. nematophila symbiosis region 1 (SR1) genes and is species‐specific: X. szentirmaii, which naturally lacks SR1, does not colonize unless SR1 is ectopically expressed. These findings reveal new aspects of Xenorhabdus bacteria interactions with and transmission by theirSteinernema nematode hosts, and demonstrate that bacterial SR1 genes aid in colonizing nematode epithelial surfaces.