Miracle-dz/UniFAR-FTUs huggingface dataset:
Membrane cut‐off does not influence results regarding the measurement of small molecules – a comparative study between 20‐ and 100‐kDa catheters in hepatic microdialysis

Microdialysis is a method used to monitor hepatic tissue metabolism. Membranes with a molecular cut‐off of 20 kilodalton (kDa) are currently used to measure the small metabolites glucose, glycerol, lactate and pyruvate. Using membranes with higher cut‐off such as 100 kDa allows the possibility of measuring larger molecules but may affect results regarding small molecules. The aim was to compare microdialysis catheters with a cut‐off of 20 and 100 kDa in the measurement of small molecules in a pig liver model.
AMBANG PENDENGARAN RATA–RATA PADA PENDERITA DIABETES MELITUS di POLIKLINIK ENDOKRINOLOGI RSUP PROF. Dr. R. D. KANDOU MANADO

Abstract : Diabetes mellitus is a group of chronic metabolic disease which can affect nearly every organ system in the body. Complications of this disease are diverse and include retinopathy, nepropathy and neuropathy. It has a high prevalence and continued to increase. The relationship between diabetes mellitus and hearing loss have been studied. This study aimed to obtain the average of hearing threshold in patients with diabetes mellitus. This was a descriptive observational study with a cross sectional design. Total 38 diabetes mellitus patients were included in the study. Hearing threshold obtained based on air conduction pure tone audiometry average at 500, 1000, 2000, and 4000 Hz. The results showed that subjects were 65.8% females and 32.4% males. There were 9 subjects (23.6%) with normal hearing, 24 subjects (63.2%) with bilateral hearing loss, and 5 subjects (13.2%) with unilateral hearing loss. Of the 29 subjects with hearing loss, the levels were mild and moderate. None of the subjects had moderately severe, severe, or profound. Conclusion: The majority of subjects in this study had hearing loss. Keywords : diabetes mellitus, hearing threshold, pure tone audiometry Abstrak : Diabetes melitus merupakan suatu kelompok penyakit metabolik kronik yang dapat mempengaruhi hampir setiap sistem organ dalam tubuh. Komplikasi penyakit ini beragam, termasuk retinopati, nefropati dan neuropati. Prevalensinya cukup tinggi dan diperkirakan akan terus meningkat. Terdapat beberapa penelitian yang menghubungkan diabetes melitus dan gangguan pendengaran. Penelitian ini bertujuan untuk mengetahui ambang pendengaran rata – rata pada penderita diabetes melitus. Penelitian ini merupakan penelitian deskriptif observasional dengan desain penelitian potong lintang. Sampel total ialah 38 pasien diabetes melitus. Ambang pendengaran rata – rata diperoleh berdasarkan hantaran udara audiometri nada murni rata-rata pada frekuensi 500, 1000, 2000, dan 4000 Hz. Hasil penelitian memperlihatkan bahwa subjek penelitian 65,8% perempuan dan 34,2% laki – laki. Terdapat 9 orang (23,6%) yang mempunyai pendengaran normal, 24 orang (63,2 %) mengalami gangguan pendengaran bilateral dan 5 orang (13,2%) dengan gangguan pendengaran unilateral. Dari 29 subjek penelitian dengan gangguan pendengaran mengalami gangguan pendengaran kategori ringan dan sedang. Tidak ditemukan subjek penelitian dengan gangguan pendengaran kategori sedang berat, berat atau sangat berat. Simpulan: Mayoritas subjek penelitian mengalami gangguan pendengar. Kata kunci : ambang pendengaran, audiometri nada murni, diabetes melitus
Efficacy of Analgesic Effects of Low Dose Intrathecal Clonidine as Adjuvant to Bupivacaine

Clonidine (α-2-adrenergic agonist) has analgesic effect at spinal level mediated by postsynaptically situated α-2-adrenoreceptors in dorsal horn of spinal cord. Previous studies have used this drug intrathecally in higher dosages. Sixty adult patients belonging to ASA grade I and II, scheduled for gynaecological surgery under spinal anaesthesia were randomly divided into two groups. Clonidine group received clonidine 1 μg. kg -1 with 12.5 mg 0.5% bupivacaine and the Control group received an identical volume of saline mixed with 12.5mg0.5% bupivacaine. The maximum dose of clonidine used was70 μg. The meantime from injection to regression of the level of sensory analgesia by two segments was longer in the Clonidine group than in Control group (P<0.001). The duration of motor blockade was longer in Clonidine group than in Control group (P<0.05). There was also a significant difference in the duration of analgesia between the two groups (P<0.001). The rescue analgesia was required earlier in the Control group(mean 223 min) compared to the Clonidine group(mean614 min). The number of injections of diclofenacin24 hours was higher for Control group (mean2.66) than Clonidine group (mean 1.16) (P <0.05). The patients in the Clonidine group had a significant fall in mean arterial pressure and heart rate and were more sedated than those in Control group, however, no therapeutic interventions needed. We concluded that addition of clonidine to bupivacaine in the dose of 1μg. kg -1 significantly increases the duration of spinal analgesia as compared to bupivacaine alone with clinically insignificant influence on haemodynamic parameters and level of sedation.
Problemas de Salud Mental en Estudiantes Universitarios de una Universidad Regional chilena.

Background: The increase in university population in Chile has also increased the number of students presenting mental health disorders. Aim: To determine the frequency of mental health problems and its association with other relevant variables among students of a regional university in Chile. Material and Methods: A sample of 484 students aged 18 to 28 years (45% males) were assessed once using a battery of tests designed to detect mental health problems. The instruments used were Derogates SCL-90-R, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Depression, Anxiety and Stress Scales (DASS-21) and a social-demographic questionnaire. Results: Fifteen percent of the sample presented high levels of mental health symptoms, determined according to the cut-off points of Beck inventories. This symptomatic group, which also showed high levels of stress, was composed mostly of freshmen and women. There was a significant association between symptoms and socio-demographic variables such as living in rural areas, ethnicity and socioeconomic status, a higher need for psychological and psychiatric care and a lower number of extracurricular activities. Conclusions: The knowledge of mental health problems among university students will allow to generate strategies for mental health prevention, promotion and treatment. (Rev Med Chile 2013; 141: 209-216).
The analysis of digital mammograms: spiculated tumor detection and normal mammogram characterization

Liu, Sheng, Ph.D., Purdue University, May 1999. The Analysis Of Digital Mammograms: Spiculated Tumor Detection And Normal Mammogram Characterization. Major Professor: Edward J. Delp. Mammography is currently the best technique for reliable detection of early, nonpalpable, potentially curable breast cancer. In the past decade there has been tremendous interest in computer aided diagnosis (CAD) in digital mammograms. The goal has been to increase diagnostic accuracy as well as the reproducibility of mammographic interpretation. Among breast abnormalities, spiculated masses having a stellate appearance are the most difficult type of tumor to detect. We propose a multiresolution feature analysis and classification approach for the detection of spiculated lesions. In general, it is difficult to determine the size of the neighborhood that should be used to extract local features of spiculated lesions. There is a fundamental difference in our method compared to other approaches, in that we extract and classify features at multiple resolutions, hence overcoming the difficulty of choosing a neighborhood size a priori to capture tumors of varying sizes. Furthermore, the top-down classification requires less computation by starting with the coarsest resolution image and propagating detection results to finer resolutions. On the MIAS database, we achieved 84.2% true positive detection at less than 1 false positive per image and 100% true positive detection at 2.2 false positive per image. The effectiveness of algorithms for detecting cancers can be greatly increased if these algorithms work synergistically with algorithms for recognizing normal mammograms. However, little work has been done on understanding normal mammograms.
Association between azithromycin therapy and duration of bacterial shedding among patients with Shiga toxin-producing enteroaggregative Escherichia coli O104:H4.

CONTEXT An outbreak of Shiga toxin-producing enteroaggregative Escherichia coli (STEC O104:H4) infection with a high incidence of hemolytic uremic syndrome (HUS) occurred in Germany in May 2011. Antibiotic treatment of STEC infection is discouraged because it might increase the risk of HUS development. However, antibiotic therapy is widely used to treat enteroaggregative E coli infection. In the German outbreak, a substantial number of patients received prophylactic azithromycin treatment as part of a therapeutic regimen with the C5 antibody eculizumab. OBJECTIVE To analyze the duration of bacterial shedding in patients with STEC infection who did and did not receive oral azithromycin therapy. DESIGN, SETTING, AND PATIENTS At a single center in Lübeck, Germany, 65 patients with STEC infection, including patients with HUS as well as STEC-infected outpatients without manifestation of HUS, were investigated between May 15 and July 26, 2011, and were monitored for a mean of 39.3 days after onset of clinical symptoms. MAIN OUTCOME MEASURE Carriage of STEC after azithromycin therapy. RESULTS Twenty-two patients received oral azithromycin and 43 patients did not receive antibiotic treatment. Among antibiotic-treated patients, long-term STEC carriage (>28 days) was observed in 1 of 22 patients (4.5%; 95% CI, 0%-13.3%) compared with 35 of 43 patients (81.4%; 95% CI, 69.8%-93.0%) who were not treated with antibiotics (P < .001). All 22 patients receiving azithromycin treatment had at least 3 STEC-negative stool specimens after the completion of treatment, and no recurrence of STEC was observed in these patients. As proof of principle, 15 patients who initially were not treated with antibiotics and were long-term STEC carriers were treated with oral azithromycin given for 3 days and subsequently had negative stool specimens. CONCLUSION Treatment with azithromycin was associated with a lower frequency of long-term STEC O104:H4 carriage.
Hypercoagulability causes atrial fibrosis and promotes atrial fibrillation

Aims Atrial fibrillation (AF) produces a hypercoagulable state. Stimulation of protease-activated receptors by coagulation factors provokes pro-fibrotic, pro-hypertrophic, and pro-inflammatory responses in a variety of tissues. We studied the effects of thrombin on atrial fibroblasts and tested the hypothesis that hypercoagulability contributes to the development of a substrate for AF. Methods and results In isolated rat atrial fibroblasts, thrombin enhanced the phosphorylation of the pro-fibrotic signalling molecules Akt and Erk and increased the expression of transforming growth factor &bgr;1 (2.7-fold) and the pro-inflammatory factor monocyte chemoattractant protein-1 (6.1-fold). Thrombin also increased the incorporation of 3H-proline, suggesting enhanced collagen synthesis by fibroblasts (2.5-fold). All effects could be attenuated by the thrombin inhibitor dabigatran. In transgenic mice with a pro-coagulant phenotype (TMpro/pro), the inducibility of AF episodes lasting >1 s was higher (7 out of 12 vs. 1 out of 10 in wild type) and duration of AF episodes was longer compared with wild type mice (maximum episode duration 42.8 ± 68.4 vs. 0.23 ± 0.39 s). In six goats with persistent AF treated with nadroparin, targeting Factor Xa-mediated thrombin generation, the complexity of the AF substrate was less pronounced than in control animals (LA maximal activation time differences 23.3 ± 3.1 ms in control vs. 15.7 ± 2.1 ms in nadroparin, P < 0.05). In the treated animals, AF-induced &agr;-smooth muscle actin expression was lower and endomysial fibrosis was less pronounced. Conclusion The hypercoagulable state during AF causes pro-fibrotic and pro-inflammatory responses in adult atrial fibroblasts. Hypercoagulability promotes the development of a substrate for AF in transgenic mice and in goats with persistent AF. In AF goats, nadroparin attenuates atrial fibrosis and the complexity of the AF substrate. Inhibition of coagulation may not only prevent strokes but also inhibit the development of a substrate for AF.
Risk factors for heart failure are associated with alterations of the LV end-diastolic pressure-volume relationship in non-heart failure individuals: data from a large-scale, population-based cohort.

AIMS Left-ventricular (LV) remodelling impacts on the LV end-diastolic pressure-volume relationship (EDPVR), which is different in heart failure (HF) with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). In a large-scale, population-based cohort (Gutenberg Health Study), we aimed to investigate alterations of the EDPVR in HF patients and their association to risk factors and all-cause mortality in non-HF individuals. METHODS AND RESULTS Based on clinical and echocardiographic data, participants were divided into 'No HF' (n = 14487), HFrEF (n = 215), and HFpEF (n = 79). We estimated the position of the EDPVR and its stiffness-coefficient β from echocardiographic data using a single-beat method. The EDPVR was shifted rightward in HFrEF and leftward in HFpEF compared with 'No HF', while the stiffness-coefficient β was increased in both HFrEF and HFpEF. In 'No HF', a higher stiffness-coefficient β was associated with age, female gender, hypertension, diabetes, and obesity, while age and female gender were associated with a leftward shift of the EDPVR, whereas dyslipidaemia, obesity, smoking, and impaired renal function were associated with a rightward shift of the EDPVR. Both changes of the EDPVR were associated with increased all-cause mortality. CONCLUSION In a large-scale, population-based cohort, we show distinct alterations of the EDPVR in HFrEF and HFpEF. Already in non-HF individuals, the presence of risk factors for HF is linked alterations of the EDPVR, which are associated with increased mortality.
The impact of cigarette smoking on cardiovascular outcome in women

Cigarette smoking should be considered the most important known modifiable risk factor for coronary heart disease (CHD). Globally, it is responsible for 10% of all deaths from cardiovascular disease. An emerging and alarming problem is the growing incidence of smoking among women. Smoking promotes cardiovascular disease and primarily atherosclerosis through multiple direct and indirect mechanisms including increased oxidative stress and vasomotor, rheological and hematological dysfunction. Cigarette smoking also acts by potentiating other risk factors for cardiovascular disease. It is now well documented that women are as vulnerable as men to the dangers of tobacco, if not more so: indeed, women using tobacco face virtually the same risks as men and even greater risks for some diseases. The exact mechanism of gender-related differences is unclear and several possible explanations have been offered. Moreover, the relative risk of CHD associated with smoking seems to be greater for younger women than for older women. All these data suggest that including women in tobaccocontrol strategies is crucial: an approach with a gender equality policy is the key to winning the battle against smoking
Prevalence of malaria and sexually transmitted and reproductive tract infections in pregnancy in sub-Saharan Africa: a systematic review.

CONTEXT Malaria and sexually transmitted infections/reproductive tract infections (STIs/RTIs) in pregnancy are direct and indirect causes of stillbirth, prematurity, low birth weight, and maternal and neonatal morbidity and mortality. OBJECTIVE To conduct a systematic review and meta-analysis of malaria and STI/RTI prevalence estimates among pregnant women attending antenatal care facilities in sub-Saharan Africa. DATA SOURCES PubMed, MEDLINE, EMBASE, the World Health Organization International Clinical Trials Registry, and reference lists were searched for studies reporting malaria, syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, or bacterial vaginosis among pregnant women attending antenatal care facilities in sub-Saharan Africa. STUDY SELECTION Included studies were conducted in 1990-2011 with open enrollment. Studies from South Africa, where malaria is no longer endemic, were excluded. DATA EXTRACTION Point prevalence estimates were corrected for diagnostic precision. A random-effects model meta-analysis was applied to produce pooled prevalence estimates. RESULTS A total of 171 studies met inclusion criteria, providing 307 point prevalence estimates for malaria or STIs/RTIs and including a total of 340 904 women. The pooled prevalence estimates (with 95% CIs and number of women with positive diagnosis) among studies in 1990-2011 in East and Southern Africa were as follows: syphilis, 4.5% (3.9%-5.1%; n = 8346 positive diagnoses), N gonorrhoeae, 3.7% (2.8%-4.6%; n = 626), C trachomatis, 6.9% (5.1%-8.6%; n = 350), T vaginalis, 29.1% (20.9%-37.2%; n = 5502), bacterial vaginosis, 50.8% (43.3%-58.4%; n = 4280), peripheral malaria, 32.0% (25.9%-38.0%; n = 11 688), and placental malaria, 25.8% (19.7%-31.9%; n = 1388). West and Central Africa prevalence estimates were as follows: syphilis, 3.5% (1.8%-5.2%; n = 851), N gonorrhoeae, 2.7% (1.7%-3.7%; n = 73), C trachomatis, 6.1% (4.0%-8.3%; n = 357), T vaginalis, 17.8% (12.4%-23.1%; n = 822), bacterial vaginosis, 37.6% (18.0%-57.2%; n = 1208), peripheral malaria, 38.2% (32.3%-44.1%; n = 12 242), and placental malaria, 39.9% (34.2%-45.7%; n = 4658). CONCLUSION The dual prevalence of malaria and STIs/RTIs in pregnancy among women who attend antenatal care facilities in sub-Saharan Africa is considerable, with the combined prevalence of curable STIs/RTIs being equal to, if not greater than, malaria.
Studies in Specific Hypersensitiveness XI. The Familial Occurrence of Hay Fever and Bronchial Asthma

In their work upon human sensitization, in 1916, Cooke and Vander Veer (1) included a study of inheritance in a group of 504 cases of atopy 2 This group comprised cases of hay fever, bronchial asthma, urticaria, angioneurotic edema and acute gastroenteritis following the ingestion of fish and strawberries. These authors stated that their study indicated a definite hereditary factor in hypersensitiveness as shown particularly by the influence of heredity on the age of onset of clinical symptoms. The present study was undertaken to determine whether or not their results would be verified on an entirely new series. Five hundred sixty-eight cases of hay fever and asthma are now presented, in all of which the hypersensitive condition was demonstrated by a positive intradermal test which was in complete accord with the clinical history.
Successful Transcatheter Aortic Valve Implantation in A Patient With Severe Dilatation of The Ascending Aorta

Background: Transcatheter aortic valve implantation (TAVI) has become a well established method for treating severe symptomatic aortic stenosis (AS) in surgical high-risk patients. Despite increasing use there are certain contraindications for TAVI, one of them being until recently severe dilatation of the ascending aorta. Case presentation: 86-yr old female patient, with known arterial hypertension, diabetes mellitus type 2 and chronic atrial fibrillation, was admitted due to heart failure. Echocardiography showed a severe calcified aortic stenosis (aortic valve area 0,5 cm2, mean gradient 47 mmHg). Further investigations showed a severe dilatation of the ascending aorta with a maximum diameter of 52 mm. According to EuroSCORE (19.85%) and STS (12) the patient had a high risk for surgery and was rejected for surgical aortic valve replacement by the Heart Team. Successful TAVI was performed. On 6-month follow up the patient is in good clinical condition and free of symptoms. Control investigations show the bovine aortic valve in proper position with normal function and no progression of dilatation of the ascending aorta. Conclusion: In surgical high-risk patients with severe AS and dilatation of the ascending aorta of degenerative etiology (without connective tissue diseases) TAVI can be successfully performed using the Edwards XT valve. Dilatation of ascending aorta should not be an absolute contraindication for TAVI. However, decision for TAVI should be driven by all circumstances of the patient including the 1-2 year prediction of the possible progression of the aortic dilatation.
The Technique and Practice of Psychoanalysis

Psychoanalytic Techniques: A Handbook for the Practicing Psychoanalyst,edited by Benjamin B. Wolman, 596 pp, $15, New York and London: Basic Books, Inc., 1967. Psychotherapeutic techniques depend on the way the therapist understands the personality of each patient and what changes both patient and therapist strive for. The personality makeup of man may be simple in its broad essentials but is certainly complex in its details, and full of surprises. Freud opened up our understanding of it—he did not close it. Certainly no single school has all the answers, although this is the tone of much orthodox psychoanalytic writing as distinct from contributions that are free inquiries using all available knowledge. Dr. Greenson's book is based primarily on the theory of dammed-up libido, correct in itself but not expanded and enriched by the last 40 years of study which have seen such revolutionary progress in every other clinical and scientific
Very late outcomes of drug-eluting stents: the 'catch-down' phenomenon.

This editorial refers to ‘Ten-year clinical outcomes of first-generation drug-eluting stents: the Sirolimus-Eluting vs. Paclitaxel-Eluting Stents for Coronary Revascularization (SIRTAX) VERY LATE Trial’†, by K. Yamaji et al. , on page 3386 . Based on the current paradigm, drug-eluting stents (DES) are not only more effective, but also safer than bare metal stents (BMS). 1 Certainly, it was not always so: in spite of their lower risk of restenosis and target lesion revascularization (TLR) compared with BMS, first-generation DES have been blamed for years due to concerns of a ‘catch-up’ in late and very late ischaemic events that pathological and in vivo studies attribute to delayed arterial healing, polymer hypersensitivity reactions, continuous neointimal growth, late-acquired malapposition, and neoatherosclerosis.2,3 Second-generation DES with biocompatible polymers, biodegradable polymers, or polymer-free—along with improved platform design, thinner struts, and novel antiproliferative drugs—have now addressed many of these limitations, translating into better clinical outcomes. In a network meta-analysis of > 52 000 patients summarizing data from a total of 51 stent trials at a median follow-up of 4 years, second-generation DES were found to outperform BMS and first-generation DES significantly with respect to both safety and efficacy.4 These improvements notwithstanding, very late stent failure owing to permanent caging of the vessel remains a matter of concern, which has been the impetus for the introduction of fully bioresorbable DES, also known as bioresorbable scaffolds. There is evidence from intracoronary imaging studies that these devices are no longer present in the coronary arteries at 5 years from implantation.5 Therefore, the benefits of liberating the vessels from the metallic frame of DES, if any, are expected to accrue not immediately, but in the very long term. But what do we really know about the very late outcomes of DES (i.e. >5 years)? Are the …