Miracle-dz/UniFAR-FTUs huggingface dataset:
Mortality benefit of primary transportation to a PCI‐capable center persists through an eight‐year follow‐up in patients with ST‐segment elevation myocardial infarction

BACKGROUND The purpose of this study was to compare long-term outcomes of primary transport (PT) and secondary transport (ST) in patients with STEMI. METHOD We assigned consecutive 869 patients referred for STEMI during a 2-year period (2008-2009). The primary endpoint was to compare long-term outcomes and mortality of PT to a catheterization laboratory and ST from regional hospitals to a catheterization laboratory. Six hundred seventy-seven patients (77.9%) were enrolled for the final evaluation, 192 (22.1%) having been excluded. RESULTS The median DBT was 34 ± 15.92 min for PT patients (n = 354) and 100 ± 28.82 min for ST patients (n = 323) (P < 0.005). One-month mortality was 3.95% in the PT group versus 9.46% in the ST group (P = 0.002). One-year mortality in the PT was 7.35% and 20.51% in the ST group (P < 0.005). Eight-year mortality was in the PS 26.8% versus 32.6% in the ST group (P = 0.035). Left ventricular ejection fraction (LVEF) was 45 ± 12.14% versus 45 ± 12.48% (P = 0.21); creatine kinase (CK) was 22.78 ± 78.69 ukat/L versus 23.21 ± 82.61 ukat/L, (P = 0.58); and length of hospitalization was 4.98 ± 4.61 days in the PT group versus 5.25 ± 5.86 days in the ST group (P = 0.22). The air transport was used in the PT group (RR 0.85, 95% CI 0.63-1.09); and ST group (RR 1.17, 95% CI 0.91-1.40); P = 0.22). Time distribution of cardiac arrest median for PT 1432 days (n = 25) versus ST 266 (n = 31) P = 0.24. CONCLUSION The mortality benefits of PT to a PCI capable hospital persist throughout an 8-year follow-up.
Evaluation of vulnerable coronary plaques and non-alcoholic fatty liver disease (NAFLD) by 64-detector multislice computed tomography (MSCT).

BACKGROUND Multislice computed tomography (MSCT) permits direct visualization of not only coronary artery stenosis but also the characteristics of plaques in patients with coronary artery disease (CAD). Also, because of its potential to be a novel risk factor for cardiovascular disease, interest in non-alcoholic fatty liver disease (NAFLD) is increasing. METHODS AND RESULTS Participants comprised 298 consecutive patients who received MSCT to diagnose CAD. Patients with an alcohol intake exceeding 20 g/day or with a history of known liver disease were excluded from the study. Liver steatosis and 4 coronary artery findings, including remodeling lesions, lipid core plaques, calcified plaques and narrowing of lumen, were assessed. Liver steatosis was evaluated by computed tomography density of the liver and spleen. In the study, NAFLD was defined as having a liver and spleen (L:S) ratio of <1.1. The L:S ratios of patients with remodeling lesions or lipid core plaques were significantly lower than those without. NAFLD was related significantly to those findings, but there was no correlation between calcified plaques, narrowing of lumen and L:S ratios. Adjusted odds ratio of NAFLD for remodeling lesions was 2.41 (95% confidence interval (CI), 1.24-4.67; p=0.009), and those for lipid core lesions was 2.29 (95% CI, 1.15-4.56; p=0.018). CONCLUSION NAFLD is a novel risk factor for vulnerable plaques.
Barriers to Antihypertensive Medication Adherence Among Adults— United States, 2005

Antihypertensive agents are one of the most commonly prescribed classes of medications in the country, but patient adherence rates are low. To better understand why rates are low, the authors used data from the 2005 HealthStyles survey and found that among the 1432 respondents who received prescriptions for antihypertensive medications, 407 (28.4%) reported having difficulty taking their medication. ``Not remembering'' was the most common reason reported (32.4%), followed by cost (22.6%), having no insurance (22.4%), side effects (12.5%), other reasons (12.3%), not thinking there is any need (9.3%), and having no health care provider (4.7%). In a multivariate model, younger age, lower income, having mental function impairment, and having had a blood pressure check more than 6 months earlier were factors significantly associated with reporting difficulty taking prescribed antihypertensive drugs. Control of hypertension is a significant public health issue, and alleviating barriers to medication adherence should be a major goal toward hypertension management.
Comparison of Several Independent Population Means When Their Samples Contain Log‐Normal and Possibly Zero Observations

Summary. In this paper, we consider the problem of testing the mean equality of several independent populations that contain log‐normal and possibly zero observations. We first showed that the currently used methods in statistical practice, including the nonparametric Kruskal–Wallis test, the standard ANOVA F‐test and its two modified versions, the Welch test and the Brown–Forsythe test, could have poor Type I error control. Then we propose a likelihood ratio test that is shown to have much better Type I error control than the existing methods. Finally, we analyze two real data sets that motivated our study using the proposed test.
Enhanced Security Framework for E-Health Systems using Blockchain

An individual’s health data is very sensitive and private. Such data are usually stored on a private or community owned cloud, where access is not restricted to the owners of that cloud. Anyone within the cloud can access this data. This data may not be read only and multiple parties can make to it. Thus, any unauthorized modification of health-related data will lead to incorrect diagnosis and mistreatment. However, we cannot restrict semipublic access to this data. Existing security mechanisms in e-health systems are competent in dealing with the issues associated with these systems but only up to a certain extent. The indigenous technologies need to be complemented with current and future technologies. We have put forward a method to complement such technologies by incorporating the concept of blockchain to ensure the integrity of data as well as its provenance.
S-mote: SMART Home Framework for Common Household Appliances in IoT Network

SMART home is one of the most popular applications of Internet-of-Things (IoT) technologies, which is expanding in terms of range of applications. SMART home technology provides convenience at home by connecting household appliances to a single network, control, and management. However, many general home appliances do not support the network functions yet; hence, enjoying such convenient technology could be difficult, and it could be expensive in the beginning to build the framework. In addition, even though products with SMART home technologies are purchased, the control systems could differ from device to device. Thus, in this paper, we propose a SMART home framework, called an S-mote that can operate all the IoT functions in a single application by adding an infrared or radio frequency module to general home appliances. The proposed framework is analyzed using four types of performance tests by five evaluators. The results of the experiment show that the SMART home environment was implemented successfully and that it functions appropriately, without any operational issues, with various home appliances, including the latest IoT devices, and even those equipped with an infrared or radio frequency module.
User Preferences Analysis Using Visual Stimuli

Recommender systems aim at enhancing user experience on the Web by employing the results of users behavior analysis for recommending items. However, user behavior is usually influenced by various aspects. Even though visual stimuli greatly influence almost every part of our life, it is yet poorly reflected in the domain of recommendation. In our work, we study the impact of visual stimuli (specifically images) on recommendation process on the Web. We focus on the domains where the impact of images is substantial (e.g.,~movies and shopping). First results of our experiments suggest that features extracted from the images are able to improve the ranking of the current recommendation approaches.
Analysis of the Sociality and Democratic-Citizenship Changes from the Application of the Scratch Remix Function in Cooperative Learning

This study analyzed changes in sociality and democratic-citizenship among elementary school students in the information class and the science class at the Science Education Institute for the Gifted, who were divided into an experimental group and a control group. The experimental group engaged in the Learning Together (LT) cooperative form of learning for which the remix function of Scratch, an educational programming language, was applied, while the control group was given general instructor-led lessons. Members in the experimental group were able to modify processes during projects through the usage of the remix function, thereby actively participating in the projects and eventually generating team-based results. The post-class t-tests showed a greater degree of improvements in sociality and democratic citizenship for the experimental group that was offered the remix-function-based cooperative learning than the control group. Statistically significant differences were present between two groups particularly in “cooperative spirit” sub-domain of sociality and the “community” and “responsibility” sub-domains of democratic citizenship.
Proton Magnetic Resonance Spectroscopy and Gadolinium‐DTPA Perfusion Imaging of Asymptomatic MRI White Matter Lesions

In the elderly, asymptomatic white matter hyperintensities are common on T2‐weighted magnetic resonance imaging (MRI). In symptomatic patients, such MRI appearances correlate with varied postmortem findings including demyelination or stroke. What structural correlates underlie the T2 hyperintensities in patients whose lesions are asymptomatic is controversial. Therefore, in order to investigate the underlying metabolism and perfusion in white matter lesions (exhibiting T2 hyperintensity), 13 patients underwent proton magnetic resonance spectroscopy and dynamic gadolinium‐DTPA perfusion‐weighted MR imaging. N‐acetyl aspartate (NA) levels were reduced in the lesions compared with age‐matched controls (P = 0.031), implying neuronal/axonal loss. Creatine levels were also reduced (P = 0.001). Choline levels were unchanged in the lesions. Lactate was identified in the lesions of 5 of the 13 patients. Although not statistically significant, perfusion studies exhibited a trend toward lower cerebral blood volumes in patients with high grade extracranial carotid stenosis and lactate‐containing lesions. These findings suggest that neuronal/axonal loss underlies the majority of T2‐weighted asymptomatic lesions in the older population, and in many cases these changes may be due to chronic ischemia.
Correlation between the presence of circulating tumor cells and the pathologic type and staging of non-small cell lung cancer during the early postoperative period

This study investigated possible correlations between the presence of circulating tumor cells (CTCs) and the pathologic types and staging of non-small cell lung cancer (NSCLC) during the early postoperative period. Sixty-nine patients with NSCLC were enrolled in the study. Clinical staging was performed by postoperative pathological examination and imaging. Multiple mRNA in situ analyses targeting specifically expressed genes were carried out to identify the presence of CTCs. Correlations between age, sex, TNM stage and pathological types with the detection rate of CTCs were also established. The results showed the positivity rate of CTCs in patients >55 years was significantly higher than that of patients <55 years (94.74 vs. 70.97%, P<0.05). There was no significant difference in the positivity rate of CTCs between male and female patients (85.71 vs. 85.29%, P>0.05). The correlations between the detection rate of epithelial type or mixed type CTCs with tumor size, lymph node metastasis and distant metastasis TNM in patients with NSCLC were not significant (P>0.05). However, higher TNM stages correlated with higher detection rates of mesenchymal CTCs (P<0.05). There were also significant differences in the detection rates of CTCs amongst the three different pathologic types (adenocarcinoma, squamous cell and large cell carcinomas) (P<0.05). Based on our results, the detection of mesenchymal CTCs during the early postoperative period can help prognosticate the recurrence and metastasis of NSCLC, which is beneficial to the development of individualized treatment strategies.
Population Attributable Risk Fraction for Selected Chronic Diseases in India

Background: India’s current health transition stage poses a critical challenge of dealing with the unfinished agenda of communicable diseases and the steadily rising burden of noncommunicable diseases. A significant burden of chronic diseases in India is attributable to household and individual level health risk factors coupled with socioeconomic conditions. From this perspective, this article made a first time effort to assess disease burden attributable to health risk factors using cross-sectional population health survey data. Methods: Population attributable fractions (PAF) were estimated for a cluster of health risk factors that include unsafe water, lack of sanitation, exposure to cooking smoke, tobacco and alcohol use, physical inactivity, and socioeconomic conditions on a set of widely prevalent chronic diseases such as tuberculosis, malaria, diarrhea, diabetes, angina, and asthma. Data from the 2003 World Health Survey was used. Results: The analysis revealed evidence of a significant contribution of health risk factors to India’s escalating chronic disease burden. The contribution of health risk factors toward chronic disease burden varied by residence. Conclusion: Results suggest that promotional health care based policies to deal with health risks should be a major priority in policy agenda to combat with the challenge of emerging noncommunicable disease coupled with the persistent burden of communicable diseases. Disease burden in India could be halved by effectively modifying exposure to the risk factors through promotional health care.
Recours au spiromètre de bureau par les médecins généralistes picards, applications à la prise en charge de BPCO

Introduction : L’objectif de notre travail etait d’identifier dans la population des medecins generalistes picards les determinants du recours a la spirometrie par spirometre de bureau, d’identifier les freins et facteurs pouvant encourager son utilisation et d’evaluer la legitimite du medecin generaliste a realiser ces tests. Methode : Nous avons realise une etude transversale descriptive aupres d’un echantillon de 400 medecins generalistes tires au sort dans la population des medecins generalistes picards. Resultats : 71 questionnaires ont ete recueillis. 14,1% des medecins utilisaient un spirometre de bureau. 60% d’entre eux etaient des hommes, d’une moyenne d’âge de 45 ans. Les medecins pratiquants etaient formes dans 76,9% des cas contre 42,2% pour les non pratiquants. L’attrait pour les actes techniques etait le principal determinant (60%). Les principaux freins etaient le manque de temps (57,8%), le manque de formation (40%), le manque d’experience (37,8%). Les facteurs pouvant augmenter l’utilisation de spirometres par les medecins generalistes etaient la majoration de la cotation de l’acte (46,7%), l’amelioration de la formation (33,3%), la baisse du cout de l’equipement (31,1%). 60,6% des medecins de l’echantillon estimaient legitime que le medecin generaliste realise des tests spirometriques. Conclusion : Une minorite de medecins avaient recours a un spirometre de bureau. L’amelioration de la formation et le renforcement de la prise en charge en addictologie sont des objectifs prioritaires.
Spectroscopic Properties of Amine‐substituted Analogues of Firefly Luciferin and Oxyluciferin

Spectroscopic and photophysical properties of firefly luciferin and oxyluciferin analogues with an amine substituent (NH2, NHMe and NMe2) at the C6' position were studied based on absorption and fluorescence measurements. Their π‐electronic properties were investigated by DFT and TD‐DFT calculations. These compounds showed fluorescence solvatochromism with good quantum yields. An increase in the electron‐donating strength of the substituent led to the bathochromic shift of the fluorescence maximum. The fluorescence maxima of the luciferin analogues and the corresponding oxyluciferin analogues in a solvent were well correlated with each other. Based on the obtained data, the polarity of a luciferase active site was explained. As a result, the maximum wavelength of bioluminescence for a luciferin analogue was readily predicted by measuring the photoluminescence of the luciferin analogue in place of that of the corresponding oxyluciferin analogue.
Exchange rates 'overshooting': an empirical study of Bangladesh and India

Exchange rates are difficult to forecast because the market is continually reacting to unexpected events or news. Even in the absence of any major news, exchange rates adjust through the day as foreign exchange dealers manage their inventories and respond to trades with others who may be better informed. The role of exchange rate changes in eliminating international trade imbalances suggests that we should expect countries with current trade surpluses to have an appreciating currency, whereas countries with trade deficits should have depreciating currencies. Such exchange rate changes would lead to changes in international relative prices that would work to eliminate the trade imbalance. This paper analyses the movement of the exchange rates of Bangladesh and India over the period 1973-98. From the log-linear model of exchange rate finds that Consumer Price Index for both the country is the main variable causing the exchange rate fluctuations during this period. Exports, Imports, Interest Rates and Forward Rates of these countries do result in the movement of the exchange rates. Aus. Aca. Acc & Fin. Rev Vol 1(1), July 2015, P 86-102
Transcranial Doppler Emboli Identifies Asymptomatic Carotid Patients at High Stroke Risk: Why This Technique Should be Used More Widely

With modern intensive medical therapy, the annual risk of ipsilateral stroke in asymptomatic carotid stenosis (ACS) is now ∼0.5%. Therefore, even the relative low risks reported from the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) trial do not justify routine intervention in most (90%) of the patients with ACS. It is therefore necessary to identify the ∼10% to15% of patients with ACS who have a stroke risk high enough to justify intervention. Transcranial Doppler (TCD) embolus detection has been shown in 2 prospective studies (one with 468 patients and the other with 467 patients) to identify patients at high risk and distinguish them from those who would be better served by medical therapy. There is no valid reason why carotid intervention should be carried out in ACS without first identifying that the patient’s risk of stroke is higher than the risk of intervention. The best validated way to do this is by TCD embolus detection, and the cost of TCD equipment and training is approximately the same as the cost of 2 carotid stenting procedures in the United States. This procedure should be used more widely.
PCSK9 inhibitors

Purpose of review To summarize the therapeutic strategies to inhibit PCSK9 and to describe the main results obtained in phase I and II trials with monoclonal antibodies targeting PCSK9. Recent findings Among the various approaches for PCSK9 inhibition, human data are only available for inhibition of PCSK9 binding to LDL receptor by monoclonal antibodies. Promising preclinical studies have also been reported with other strategies, including inhibition of PCSK9 synthesis by gene silencing agents. The two most advanced monoclonal antibodies in development are SAR236553/REGN727 and AMG145. In phase II, these two monoclonal antibodies administered subcutaneously are well tolerated and effective to decrease atherogenic lipoproteins. A dramatic decrease in LDL cholesterol up to 70% can be obtained. The efficacy has been evaluated so far in addition to statins in hypercholesterolemic patients with or without familial hypercholesterolemia, in patients with intolerance to statin therapy and in monotherapy. Summary The short-term efficacy, safety and tolerability of two monoclonal antibodies to PSCK9 have been demonstrated in several phase II trials. These PCSK9 inhibitors are now tested in larger phase III studies to provide insights into the long-term safety and clinical efficacy of this very promising approach.
Cd4+, Cd8+, Cd3+ Cell Counts And Cd4+/cd8+ Ratio Among Patients With Mycobacterial Diseases (leprosy, Tuberculosis), Hiv Infections, And Normal Healthy Adults: A Comparative Analysis Of Studies In Different Regions Of India

In this study, we estimated the CD4+, CD8+, CD3+ cell counts and the CD4/CD8 ratio among normal healthy controls (adults and children), leprosy patients (without any complications and during reactional states), TB patients (with and without HIV), and HIV-positive patients (early infection and full-blown AIDS) and correlated the changes with disease progression. In our study, it was observed that among adults, CD4+ cell counts ranged from 518–1098, CD8+ from 312–952, whereas CD4/CD8 ratio from 0.75–2.30. Among children, both CD4+ and CD8+ cells were more and the CD4/CD8 ratio varied from 0.91–3.17. With regard to leprosy patients, we observed that CD4+ and CD8+ cell counts were lower among PB (pauci-bacillary) and MB (multi-bacillary) patients. CD4/CD8 ratio was 0.99 ± 0.28 among PB patients while the ratio was lower, 0.78 ± 0.20, among MB patients. CD4+ cell counts were raised during RR (reversal reactions) and ENL (erythema nodosum leprosum) among the PB and MB patients whereas the CD8+ cell counts were lower among PB and MB patients. CD4/CD8 ratio doubled during reactional episodes of RR and ENL. Among the HIV-negative tuberculosis (TB) patients, both the CD4+ and CD8+ cell counts were found to be less and the CD4/CD8 ratio varied between 0.53–1.75. Among the HIV-positive TB patients and HIV-positive patients, both the CD4+ and CD8+ cells were very less and ratio drops significantly. In the initial stages of infection, as CD4+ counts drop, an increase in the CD8+ cell counts was observed and the ratio declines. In full-blown cases, CD4+ cell counts were very low, 3–4 to 54 cells, CD8+ cells from 12–211 and the ratio drops too low. This study is the first of its kind in this region of the country and assumes importance since no other study has reported the values of CD4+ and CD8+ T-lymphocyte counts among patients with mycobacterial diseases (leprosy and TB), HIV infections along with normal healthy individuals of the region, and correlation with clinical presentations of patients.
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