Miracle-dz/UniFAR-FTUs huggingface dataset:
Severe refractory hypotension during induction of general anesthesia in patient after 48 hours of azilsartan discontinuation: A case report

Rationale: Angiotensin II receptor blockers (ARBs) are currently considered first-line antihypertensive drugs, effectively inhibiting the renin-angiotensin-aldosterone system. However, ARBs have been associated with intraoperative hypotension during general anesthesia. Although it is recommended to discontinue ARBs for 24 hours before surgery, the optimal duration of discontinuation remains unclear. We present a severe refractory hypotension encountered during general anesthesia despite discontinuing ARBs for 48 hours before anesthesia. Patient concerns: A severe refractory hypotension occurred during the induction of general anesthesia for cranioplasty in a 66-year-old male patient (170 cm/75 kg). The patient was taking azilsartan, angiotensin receptor blocker, for hypertension, which was discontinued 48 hours before anesthesia induction. Despite repeated administration of ephedrine and continuous infusion of norepinephrine, hemodynamic instability did not improve. Therefore, the surgery was postponed. Diagnosis: The patient was diagnosed with angiotensin receptor blocker-induced refractory hypotension. Interventions: Before the second surgery, the angiotensin receptor blocker was discontinued 96 hours prior to the surgery. Invasive blood pressure monitoring was performed before anesthesia induction, and vasopressin was prepared. General anesthesia was induced using remimazolam and maintained with desflurane. Outcomes: The surgery was completed successfully without occurrence of refractory hypotension. Lessons: Refractory hypotension induced by Angiotensin receptor blockers can still occur even after discontinuing the medication for 48 hours before induction of general anesthesia. Despite withholding the medication, caution should be practiced regarding hypotension during general anesthesia in patient taking ARBs.
Educational interventions for cervical cancer prevention: a scoping review

ABSTRACT Objectives: to identify, map and describe characteristics of educational interventions for cervical cancer prevention in adult women. Methods: a scoping review conducted on eleven databases and the gray literature, including studies that described educational interventions aimed at preventing cervical cancer in adult women. Results: thirty-three articles with 151,457 participants were analyzed. The most used educational strategies were participatory discussions and educational leaflets. Most of the interventions took place in a single session, ranging from 40 to 60 minutes. The most used theoretical model in interventions to improve women’s compliance with Pap smear was the Health Belief Model. Conclusions: group discussions, lectures and educational brochures can increase knowledge and reduce barriers to cervical cancer prevention. Theory-based and culturally sensitive interventions can have a positive impact on women’s health.
Static stress drop in the Mw 9 Tohoku‐oki earthquake: Heterogeneous distribution and low average value

Static stress drop distribution and its average value over the rupture area contain important information on the mechanics of large earthquakes. Here we derive static stress drop distributions from 40 published rupture models for the 2011 Mw 9 Tohoku‐oki earthquake that are based on various multidisciplinary observations. Average stress drop value over the fault area encompassed by the 5 m coseismic slip contour is not unusually large for each rupture model; the mean for the 40 models is 2.3 ± 1.3 MPa, assuming a uniform rigidity 40 GPa. The value for the entire rupture zone and with a more realistic rigidity structure will be even lower. In the majority of the models, local stress drop in parts of the rupture zone well exceeds 20 MPa. The heterogeneous stress change distribution, with large stress drop being accompanied by large stress increase, leads to the small average for the earthquake.
Electronic Tourist Guide in Thailand

Novel electronic tourist guide software, designed to be utilized on mobile phone or portable computer, is introduced in this paper. The innovative software is developed to respond to the demands of tourists to provide information on attractions and various shops. The information is communicated digitally in the forms of images, voices, videos and current news to advise tourists during their trips. The software simulates the task of a tour guide in providing information on shops and services that are available to tourists at any location. It also provides information on important attractions in details, such as providing maps, drawings to navigate inside the buildings, pedestrian directions to nearby landmarks, or coupons to nearby shops, and services, etc. The tourist who utilizes the software can create his/her path for others to see through online tourist social network to exchange ideas. Furthermore, the tour guides can create their profiles to introduce themselves and recommend places in the vicinity. The electronic tourist guide was achieved by location-aware algorithm and geographic information system (GIS) within spatial database. The tourist data contents were accumulated from multiple sources such as public POI, Tourism Authority of Thailand interfaces, and field survey for data collections of the major tourist attractions in Bangkok, Thailand. The pedestrian survey tests are experimented in many locations and the results show that the software was accurately performed.
Understanding health literacy of deaf persons with hypertension in South Korea: A cross-sectional study

Background Health literacy is strongly associated with health inequality among persons with deafness, and hypertension (HTN) is the most prevalent chronic disease among persons with deafness in South Korea. Despite its importance, research regarding the health literacy levels of persons with deafness with HTN in South Korea is lacking. This study aimed to comprehensively assess the health literacy levels of persons with deafness with HTN in South Korea, including linguistic, functional, and internet health literacy. Methods In this descriptive cross-sectional study, 95 persons with deafness with HTN were recruited through facilities associated with the deaf community. From August 2022 to February 2023, data were collected through face-to-face surveys attended by a sign language interpreter and online surveys. The data were analyzed using descriptive statistics and Spearman’s correlation. Results Approximately 62.1% of the participants exhibited a linguistic health literacy level corresponding to less than that of middle school students, and the total percentage correct of functional health literacy was 17.9%. Each domain of internet health literacy was low. Significant correlations were found between some aspects of health literacy. Conclusions The study’s findings highlight the low health literacy levels across various facets among persons with deafness with HTN in South Korea. Based on these findings, several strategies are suggested for developing HTN self-management interventions for persons with deafness. This study contributes to the foundational understanding of health literacy among persons with deafness with HTN in South Korea and provides valuable insights and guidance for developing HTN self-management interventions.
Stroke risk of COPD patients and death risk of COPD patients following a stroke: A systematic review and meta-analysis

Objective: Chronic obstructive pulmonary disease (COPD) is closely related to the development and progression of cardiovascular disease. The purpose of this study is to clarify the answers to the following questions through systematic evaluation: the risk of stroke in COPD patients; the risk of stroke in acute exacerbations of COPD (AECOPD) patients; and the risk of death after stroke in COPD patients. Methods: Two reviewers independently searched EMbase, PubMed, and the Cochrane Library for relevant literature from the date of creation to February 17, 2023, for studies relating COPD to stroke patients. Of the 8039 publications retrieved, we identified 27 articles that met our selection criteria. Fixed-effects or random-effects models were used to calculate ORs and 95% confidence intervals for the combined risk. Results: combining studies on stroke risk in COPD patients by random-effects model suggested that COPD was an independent risk factor for stroke-associated pneumonia (OR 1.40, 95% CI: 1.24–1.59, I2 = 98.4%, P = .000), with significant heterogeneity in the results, and subgroup analysis did not find a source of heterogeneity. In the combined 7 AECOPD studies, a significantly higher risk of stroke was found (OR 1.53, 95% CI: 1.44–1.63, I2 = 49.2%, P = .066). In the combined 6 short- term prognostic studies, the relationship between COPD and risk of death was not highly significant (OR 1.12, 95% CI: 1.08–1.16, I2 = 37.4%, P = .131). In 10 long-term observational prognosis studies, COPD was suggested to be associated with death after stroke by combining data using a random-effects model (OR 1.20, 95% CI: 1.13–1.27, I2 = 56.8%, P = .014), and there was moderate heterogeneity in the combination, with subgroup analysis showing that stroke type may be a source of heterogeneity and the risk of death from ischemic stroke: OR 1.23, 95% CI: 1.17–1.29, I2 = 45.0%, P = . 191 and the risk of death from both types of stroke: OR 1.12, 95% CI: 1.07–1.18, I2 =18.9%, P = . 291. Conclusion: COPD is an independent risk factor for stroke. The risk of stroke is significantly increased, especially during AECOPD. In addition, the association between COPD and short-term death in stroke patients is insignificant, while it is more associated with fatal events in the long-term prognosis.
MIRAVALLES GEOTHERMAL FIELD, COSTA RICA - EVIDENCE OF THERMAL EVOLUTION AND A COMPARISON OF THE MINERALOGY OF AN ACID WELL AND A NEUTRAL WELL

The alteration mineralogy and the measured temperature data were used to find thermal fluctuations in the Miravalles geothermal field. Zones of relative heating were defined to the north and centre of the field; these correspond to zones where the measured temperature at the top of the epidote zone is at least 20/C higher than the temperature assigned to the epidote. A large north-south trending zone of apparent thermal equilibrium was defined along the main production wells in the field. In this zone, the measured temperature corresponds to the epidote temperature (200±20/C). Cooling zones indicate measured temperatures at least 20/C lower than the temperature corresponding to the epidote; these are located to the west and east sides of the main borehole field. The cooling zones may relate to the inflow of relatively cold water along NW-SE fracture systems, as indicated by the alignment of the zones. As part of the characterization of the acid fluid in geothermal wells, a literature survey was conducted and the main types, occurrences and characteristics are summarized. Similar literature review was done for the Miravalles geothermal field. The comparison between the alteration in a neutral and an acid well indicates that there are no major differences between those wells, which suggests that the acid fluids are likely to be restricted to very narrow zones that make identification difficult. This could also indicate that the acid fluids are not in equilibrium with the alteration mineralogy, probably due to the short time of residence.
Comparison of oral indices in patients with Down syndrome and healthy individuals: A meta-analysis study

ABSTRACT Background: The aim of the present study was to compare dental indexes of pediatric Down syndrome (DS) patients to those who are healthy. Materials and Methods: This study was carried out based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guidelines. The researchers searched title and abstract of major databases, including ProQuest (ProQuest Dissertations and Theses Full Text: Health and Medicine, ProQuest Nursing and Allie Health Source), PubMed, Google Scholar, clinical key, up to date, springer, Cochrane, Scopus, Embase, and Web of Science (ISI), up to September 2020 with restriction to English and Persian language This meta-analysis study had three outcomes: decay/miss/filled index, plaque index, and gingival index. Effect size, including mean difference and its 95% of confidence interval, was calculated. The Newcastle–Ottawa Scale measured the quality of the selected studies. Heterogeneity was performed using the Q test and I2 index, and reporting bias was assessed using a funnel plot and Egger and Begg's tests. Results: Fifteen studies conducted were included in the meta-analysis process. Conclusion: It showed that DS patients had a higher plaque index and gingival index than healthy individuals, which means that the oral health status of these patients is worse and needs more attention.
Are congenital heart defects connected to more severe attention-deficit/hyperactivity disorder?: A systematic review and meta-analysis

Background: Congenital heart defects (CHDs) are the most common cause of birth defect-related infant morbidity and mortality, affecting 1% of 40,000 births per year in the United States. On the other side, the etiology of attention-deficit/hyperactivity disorder (ADHD) is multifactorial. Multiple studies have found that cardiac surgery patients have higher morbidity of having this disorder. Many studies have investigated the prevalence of ADHD in different subtypes of CHD, but few have focused on the severity of ADHD symptoms. Thus, we conducted this systematic review and meta-analysis to investigate the severity of ADHD symptoms in CHD patients. Methods: We searched PubMed, Embase, Scopus, and Web of Science were searched from inception to March 6, 2023 without any restrictions. We included observational studies published in English language that evaluated burden of symptom of ADHD in CHD patients. Moreover, the standardized mean difference (SMD) for continuous outcomes with 95% confidence interval (CI) was pooled. P-values <. 05 are considered as significant, and we performed all statistical analyses using RevMan software Version 5.4. 1. Results: Eight studies were included in our review with a total number of 120,158 patients. CHD was associated with a statistically significant increase in both ADHD index T score and ADHD Hyperactivity-Impulsivity Subscale (informant) with (SMD = 0.65, 95% CI [0.40, 0.90], P < .00001, I2 = 81%) and (SMD = 0.16, 95% CI [0.04, 0.28], P = .008, I2 = 0%). Regarding ADHD Inattention Subscale (informant), the pooled data showed that a significant increase of this score in the CHD group (SMD = 0.25, 95% CI [0.13, 0.37], P < .001, I2 = 0%), and ADHD Combined Score (informant) showed a significant increase of this score in the CHD group (SMD = 0.23, 95% CI [0.11, 0.35], P = .0002, I2 = 0%). Conclusion: Our study revealed a strong association between CHD and not only ADHD, but also the severity of ADHD, making early diagnosis of ADHD in children with CHD a mandatory step in the clinical evaluation practice to improve these children on both clinical and psychological aspects.
Deep learning-based predictive classification of functional subpopulations of hematopoietic stem cells and multipotent progenitors

Background Hematopoietic stem cells (HSCs) and multipotent progenitors (MPPs) play a pivotal role in maintaining lifelong hematopoiesis. The distinction between stem cells and other progenitors, as well as the assessment of their functions, has long been a central focus in stem cell research. In recent years, deep learning has emerged as a powerful tool for cell image analysis and classification/prediction. Methods In this study, we explored the feasibility of employing deep learning techniques to differentiate murine HSCs and MPPs based solely on their morphology, as observed through light microscopy (DIC) images. Results After rigorous training and validation using extensive image datasets, we successfully developed a three-class classifier, referred to as the LSM model, capable of reliably distinguishing long-term HSCs (LT-HSCs), short-term HSCs (ST-HSCs), and MPPs. The LSM model extracts intrinsic morphological features unique to different cell types, irrespective of the methods used for cell identification and isolation, such as surface markers or intracellular GFP markers. Furthermore, employing the same deep learning framework, we created a two-class classifier that effectively discriminates between aged HSCs and young HSCs. This discovery is particularly significant as both cell types share identical surface markers yet serve distinct functions. This classifier holds the potential to offer a novel, rapid, and efficient means of assessing the functional states of HSCs, thus obviating the need for time-consuming transplantation experiments. Conclusion Our study represents the pioneering use of deep learning to differentiate HSCs and MPPs under steady-state conditions. With ongoing advancements in model algorithms and their integration into various imaging systems, deep learning stands poised to become an invaluable tool, significantly impacting stem cell research.
Evaluating the cost of simplicity in score building: An example from alcohol research

Building a score from a questionnaire to predict a binary gold standard is a common research question in psychology and health sciences. When building this score, researchers may have to choose between statistical performance and simplicity. A practical question is to what extent it is worth sacrificing the former to improve the latter. We investigated this research question using real data, in which the aim was to predict an alcohol use disorder (AUD) diagnosis from 20 self-reported binary questions in young Swiss men (n = 233, mean age = 26). We compared the statistical performance using the area under the ROC curve (AUC) of (a) a “refined score” obtained by logistic regression and several simplified versions of it (“simple scores”): with (b) 3, (c) 2, and (d) 1 digit(s), and (e) a “sum score” that did not allow negative coefficients. We used four estimation methods: (a) maximum likelihood, (b) backward selection, (c) LASSO, and (d) ridge penalty. We also used bootstrap procedures to correct for optimism. Simple scores, especially sum scores, performed almost identically or even slightly better than the refined score (respective ranges of corrected AUCs for refined and sum scores: 0.828–0.848, 0.835–0.850), with the best performance been achieved by LASSO. Our example data demonstrated that simplifying a score to predict a binary outcome does not necessarily imply a major loss in statistical performance, while it may improve its implementation, interpretation, and acceptability. Our study thus provides further empirical evidence of the potential benefits of using sum scores in psychology and health sciences.
Exploring the mechanism of Dahuang-Tusizi drug pair in the treatment of diabetes nephropathy based on network pharmacology and immune infiltration analysis

The study aimed to explore the key targets and molecular mechanisms of Dahuang-Tusizi drug pair (DTDP) in the treatment of diabetes nephropathy (DN) based on the GEO database by using network pharmacology combined with molecular docking and immune infiltration. The active components of the DTDP were screened using the Traditional Chinese Medicine Systems Pharmacology database and the Swiss Target Prediction database. The differential genes of DN were retrieved from GEO databases. Next, the intersecting targets of drug and disease were imported into the String database for protein–protein interactions network analysis, and the core targets were identified through topological analysis. Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed with the help of the Metascape database and gene set enrichment analysis database. Subsequently, molecular docking was performed to verify the binding activity of the key component and the key target. The Nephroseq V5 database was used to verify the clinical relevance of DN and core genes. Finally, the Using CIBERSORT Algorithm to analyze the immune Infiltration of DN Gene Chip. The network analysis showed that 25 active ingredients of DTDP were associated with 22 targets in DN. The key active ingredients (Sesamin, quercetin, EUPATIN, matrine, beta-sitosterol, isorhamnetin, etc.) and the core targets (JUN, EGF, CD44, FOS, KDR, CCL2, PTGS2, and MMP2) were further identified. Enrichment analysis revealed signaling pathways including TNF, MAPK, and IL-17 signaling pathway. Molecular docking results showed that there was a strong affinity between the key components and core targets. The results of immune infiltration found that the proportion of macrophages in DN tissues was significantly increased. Our findings demonstrated that the characteristics of DTDP in treating DN are “multiple components, multiple targets and multiple pathways. ” We predicted that DTDP may inhibit inflammation related pathways by regulating key genes, reducing macrophage infiltration. Thus, inhibiting inflammatory response to reduce glomerular damage and delay the development of DN.
Neural signatures of emotional inference and experience align during social consensus

Humans seamlessly transform dynamic social signals into inferences about the internal states of the people around them. To understand the neural processes that sustain this transformation, we collected fMRI data from participants (N = 100) while they rated the emotional intensity of people (targets) describing significant life events. Targets rated themselves on the same scale to indicate the intended “ground truth” emotional intensity of their videos. Next, we developed two multivariate models of observer brain activity– the first predicted the “ground truth” (r = 0.50, p < 0.0001) and the second predicted observer inferences (r = 0.53, p < 0.0001). When individuals make more accurate inferences, there is greater moment-by-moment concordance between these two models, suggesting that an observer’s brain activity contains latent representations of other people’s emotional states. Using naturalistic socioemotional stimuli and machine learning, we developed reliable brain signatures that predict what an observer thinks about a target, what the target thinks about themselves, and the correspondence between them. These signatures can be applied in clinical data to better our understanding of socioemotional dysfunction.