Miracle-dz/UniFAR-FTUs huggingface dataset:
Stroke in Acquired and Congenital Heart Disease Patients and Its Relationship to Hospital Mortality and Lasting Neurologic Deficits

Objective: To describe strokes in patients with acquired or congenital heart disease and investigate risk factors for in-hospital mortality and ongoing neurologic deficits. Design: Single-center, retrospective review of cardiac, neurologic, and radiologic patient databases. Setting: Tertiary care children’s hospital. Patients: All patients with acquired or congenital heart disease admitted from January 2010 to October 2014 identified with stroke. Interventions: None. Measurements and Main Results: Eighty-four stroke events were identified in 83 patients (median age, 5.9 mo; interquartile range, 0.8–33.4). Thirty-two patients (38%) had single ventricle congenital heart disease. Eight patients (9%) presented with symptoms at home, and the remainder was diagnosed while already admitted to the hospital. Forty patients (48%) presented with clinically evident neurologic deficits (e.g., weakness, seizures). Fifty-eight patients (69%) had arterial ischemic strokes, and 13 (15%) had parenchymal hemorrhages. At diagnosis, 54 patients (64%) were on inotropes. Twenty-nine patients (35%) had greater than or equal to 3 cardiac procedures during their hospitalization before stroke diagnosis. In-hospital mortality occurred in 28 patients (33%). Under multivariate analysis, inotropes, number of cardiac procedures, lack of seizure, and parenchymal hemorrhage were independently associated with in-hospital mortality (p < 0.05). Fifty-four percent of survivors with neurologic follow-up had ongoing neurologic deficits attributable to strokes (median follow-up, 15.3 mo; interquartile range, 7.0–29.9). With multivariate analysis, longer hospital stay (p = 0.02) was independently associated with ongoing deficits. Conclusions: A majority of patients with acquired or congenital heart disease who suffer stroke present while hospitalized and without focal neurologic findings. In-hospital mortality is associated with inotropes, cardiac procedures, lack of seizure, and parenchymal hemorrhage. The majority of survivors have lasting neurologic deficits associated with longer hospital stay.
PLASMA ACTH AND CORTISOL PROFILES IN ADDISONIAN PATIENTS RECEIVING CONVENTIONAL SUBSTITUTION THERAPY

Plasma ACTH and cortisol profiles were studied over 24 h in five Addisonian patients maintained in good health by conventional gluco‐ and mineralocorticoid treatment. Patients received their usual treatment (15–30 mg cortisol daily) in divided doses at 08.00 and 16.00 hours. Plasma cortisol concentrations differed from those of control subjects in being higher from 08.00 hours‐noon and 17.00–18.00 hours and were unmeasurable (>20 nmol/l) during the period of active cortisol secretion (03.00–08.00 hours) observed in normal subjects. Peak plasma ACTH levels (618‐>1600 ng/l) occurred at 08.00–09.00 hours in the Addisonian patients and were much greater than those seen in control subjects (60–220 ng/l). Despite this, plasma ACTH fell promptly within 3 h of the morning dose to less than 100 ng/l and levels were indistinguishable from those seen in normal subjects over the period 12.00–02.00 hours. These results show that there are substantial differences between treated Addisonian and control subjects in respect of plasma cortisol and ACTH concentrations. The findings may lead to a better understanding of ACTH‐cortisol relationships in disease states, including congenital adrenal hyperplasia where control of excessive ACTH secretion is clinically desirable.
Impact of Mineral Fouling on Hydraulic Behavior of Permeable Reactive Barriers

This paper describes reactive transport simulations conducted to assess the impact of mineral fouling on the hydraulic behavior of continuous‐wall permeable reactive barriers (PRBs) employing granular zero‐valent iron (ZVI) in carbonate‐rich alluvial aquifers. The reactive transport model included a geochemical algorithm for simulating corrosion and mineral precipitation reactions that have been observed in ZVI PRBs. Results of simulations show that porosity and hydraulic conductivity of the ZVI decrease over time and that flows are redistributed throughout the PRB in response to fouling of the pore space. Under typical conditions, only subtle changes occur within the first 10 years (i.e., duration of the current field experience record with PRBs), and the most significant changes do not occur until the PRB has operated for at least 30 years. However, changes can occur sooner (or later) if the rate at which mineral‐forming ions are delivered to the PRB is higher (or lower) than that expected under typical conditions (i.e., due to higher/lower flow rate or inflowing ground water that has higher/lower ionic strength). When the PRB is more permeable than the aquifer, the median Darcy flux in the PRB does not change appreciably over time because the aquifer controls the rate of flow through the PRB. However, seepage velocities in the PRB increase, and residence times decrease, due to porosity reductions caused by accumulation of minerals in the pore space. When fouling becomes extensive, bypassing and reductions in flow rate in the PRB occur.
Hypoglycemia, brain energetics, and hypoglycemic neuronal death

Hypoglycemia is a common and serious problem among diabetic patients receiving treatment with insulin or other glucose‐lowering drugs. Moderate hypoglycemia impairs neurological function, and severe hypoglycemia leads to death of selectively vulnerable neurons. Recent advances have shed new light on the underlying processes that cause neuronal death in hypoglycemia and the factors that may render specific neuronal populations especially vulnerable to hypoglycemia. In addition to its clinical importance, the pathophysiology of hypoglycemia is an indicator of the unique bioenergetic properties of the central nervous system, in particular the metabolic coupling of neuronal and astrocyte metabolism. This review will focus on relationships between bioenergetics and brain dysfunction in hypoglycemia, the neuronal cell death program triggered by hypoglycemia, and the role of astrocytes in these processes. © 2007 Wiley‐Liss, Inc.
A new policy for management of Double-crested Cormorants in the United States and an example of its implementation.

In the fall of 2003, the U.S. Fish and Wildlife Service (USFWS), in cooperation with USDA-Wildlife Services (USDA-WS), completed an Environmental Impact Statement (EIS) for the management of Double-crested Cormorants (DCCOs) in the United States. The USFWS subsequently published new regulations to implement the EIS proposed strategy. One part of the new regulations, a “public resource depredation order” (PRDO), allows state wildlife agencies, tribes, and USDA-WS to control DCCOs on a localized level to protect fish, wildlife, plants, and their habitats in 24 states. We’ll discuss this new policy and will highlight the management activities, including monitoring and evaluation efforts, occurring in one of the states working under the PRDO: those of the USDA-WS program in Michigan which, in 2004 and 2005, implemented a plan to reduce DCCO foraging in the Les Cheneaux Islands area of Lake Huron as a means of improving the yellow perch fishery.
BGPsec Design Choices and Summary of Supporting Discussions

This document captures the design rationale of the initial draft version of what became RFC 8205 (the BGPsec protocol specification). The designers needed to balance many competing factors, and this document lists the decisions that were made in favor of or against each design choice. This document also presents brief summaries of the arguments that aided the decision process. Where appropriate, this document also provides brief notes on design decisions that changed as the specification was reviewed and updated by the IETF SIDR Working Group and that resulted in RFC 8205. These notes highlight the differences and provide pointers to details and rationale regarding those design changes.
A survey of permanent magnet synchronous machine models suitable for computer simulation

Permanent magnet synchronous machines with high torque density, which is a frequent requirement for high level applications, are characterized by saturation and cross-saturation effects which need to be taken into account in simulation models used for the purpose of control system design or for optimized design of the machine geometry. In this paper three simulation models of permanent magnet machines are presented: conventional inductance based model with constant parameters in which saturation is not modelled, inductance based model with variable current dependent parameters which includes saturation effects, and flux based model in which saturation effects are also considered. All three models rely on finite element simulations. Their performance is compared using dynamic simulations of an inverter fed interior permanent magnet synchronous machine designed for traction applications.
Emergency department visits for injury in school-aged children in the United States: a comparison of nonfatal injuries occurring within and outside of the school environment.

OBJECTIVES To compare the demographic and injury characteristics of children visiting the emergency department (ED) for nonfatal injuries occurring at school with those of same-aged children who were injured outside of school. METHODS Data from a stratified probability sample of U.S. hospitals providing emergency services in the National Electronic Injury Surveillance System (NEISS) were analyzed for 2001 and 2002. School and nonschool injury-related ED visits were analyzed for patients who were 5 through 19 years of age. RESULTS There were an estimated 58,147,518 injury visits in all ages to the ED in 2001 and 2002. Injuries to school-aged children (ages 5-19) accounted for an estimated 15,405,392 (26%) visits overall, of which 1,859,215 occurred at school (16.5% of visits by school-aged children when location of injury was known). Males accounted for 63% of injuries at school; middle-school children (ages 10-14 yr) accounted for a significantly greater proportion of injuries (46%) than did primary- (5-9 yr, 24%) or secondary-school (15-19 yr, 30%) children (p < 0.001). In contrast, for injuries outside of school, secondary-school children were injured most (40%), followed by middle- (32%) and primary-aged children (27%). Nearly 11% of school injuries were classified as violent, whereas only 6.4% of the nonschool injuries in school-aged children were violent (p < 0.001). Similarly, sports injuries were significantly more common at school (53% of injuries) than outside of school (32.9%; p < 0.001). CONCLUSIONS A significant proportion of injuries to school-aged children occur at school. Notable differences exist between the epidemiology of in- and out-of-school injuries. The nature of these injuries differs by age group. Efforts to reduce school injuries will require that these differences be examined further and incorporated into prevention initiatives.
Effects of arsenite treatment on NAD(P)H:quinone acceptor oxidoreductase activity in liver, lung, kidney, and heart of the rat. Comparison to induction by the polyaromatic hydrocarbon, beta-naphthoflavone.

Arsenite is a potent toxin, a carcinogen, and an inducer of heat shock proteins. In this study we found that arsenite is also a novel inducer of NAD(P)H:quinone acceptor oxidoreductase (QOR) [EC 1.6. 99.2] in both liver and kidney. The increases in activity were unlinked to those caused by prior treatment with the polyaromatic hydrocarbon inducer, beta-naphthoflavone suggesting different mechanisms of induction. A single dose of sodium arsenite (75 mumol/kg sc) caused a 4-fold and 2-fold increase in activity in kidney and liver, respectively, whereas beta-naphthoflavone (60 mg/kg ip once daily for 4 days) caused a 10-fold and 4.7-fold increase in kidney and liver, respectively. This is the first study of a metalloid inducing QOR activity. Arsenite is chemically unlike any other inducer described for QOR, which include phenolic antioxidants and Michael acceptors, polyaromatic hydrocarbons, and hydrogen peroxide. Arsenite also increased glutathione S-transferase [EC 2.5. 1.18] activity in rat kidney. Arsenite could be inducing QOR in liver and kidney and the glutathione S-transferase activity in kidney by an oxidant stress mechanism.
Psychological Distress Is Associated with Greater Perceived Disability and Pain in Patients Presenting to a Shoulder Clinic.

BACKGROUND Shoulder disorders are a common cause of disability and pain. The Shoulder Pain and Disability Index (SPADI) is a frequently employed and previously validated measure of shoulder pain and disability. Although the SPADI has high reliability and construct validity, greater differences between individual patients are often observed than would be expected on the basis of diagnosis and pathophysiology alone. This study aims to determine how psychological factors (namely depression, catastrophic thinking, and self-efficacy) affect pain and perceived disability in the shoulder. METHODS A cohort of 139 patients completed a sociodemographic survey and elements from the SPADI, Pain Self-Efficacy Questionnaire (PSEQ), Pain Catastrophizing Scale (PCS), and Patient Health Questionnaire Depression Scale (PHQ-2). Bivariate and multivariate analyses were performed to determine the association of psychosocial factors, demographic characteristics, and specific diagnosis with shoulder pain and disability. RESULTS The SPADI score showed medium correlation with the PCS (r = 0.43; p < 0.001), PHQ-2 (r = 0.39; p < 0.001), and PSEQ (r = -0.45; p < 0.001). Current work status (F = 4.35; p = 0.006) and body mass index (r = 0.27; p = 0.002) were also associated with the SPADI score. In the multivariate analysis, greater catastrophic thinking (estimate, 0.003; p = 0.029), lower self-efficacy (estimate, -0.005; p = 0.001), higher body mass index (estimate, 0.006; p = 0.048), and being disabled (estimate, 0.15; p = 0.017) or retired (estimate, 0.16; p < 0.001) compared with being employed were associated with worse SPADI scores. The primary diagnosis did not have a significant relationship (p > 0.05) with the SPADI. CONCLUSIONS Catastrophic thinking and decreased self-efficacy are associated with greater shoulder pain and disability. Our data support the notion that patient-to-patient variation in symptom intensity and magnitude of disability is more strongly related to psychological distress than to the specific shoulder diagnosis.
[MRI of knee ligaments: error analysis with reference to meniscus and anterior cruciate ligaments in an arthroscopic controlled patient cohort].

PURPOSE To categorise discrepancies in findings of the menisci and anterior cruciate ligament (ACL) between arthroscopy and MRI. MATERIALS AND METHODS The MRIs of 236 patients were retrospectively analysed by an experienced radiologist without knowledge of clinical and/or operative findings. Discrepancies in arthroscopic findings were reevaluated together with the arthroscopist to determine their cause of error. RESULTS The diagnostic accuracies for injuries of the medial and lateral meniscus and the ACL were 92.4%, 92.4%, and 94.1%, respectively. For the menisci, causes for discrepancies in findings (n = 31) were: overinterpretation of central signal intensities with contact to the meniscal surface but without disturbance of the meniscal contour as a tear (n = 12), insufficient arthroscopie evaluation of the knee joint (n = 11), overlooked tears on MR imaging (n = 6), misinterpretation of normal anatomic structures (n = 1), "magic angle" phenomenon (n = 1), and missed tears at MRI (n = 1). Causes for discrepancies for the ACL (n = 18) were: nearly complete versus complete rupture either at MRI or arthroscopy and vice versa (n = 9), insufficient arthroscopic evaluation (n = 6), insufficient MRI technique (n = 2), and overlooked tear on MR imaging (n = 1). CONCLUSIONS Discrepant findings between MRI and arthroscopy may be also due to an insufficient arthroscopic evaluation in clinical routine. The close cooperation between surgeons and radiologists improves the understanding of the methods of each other.
[Comparison of reliability of bispectral index and sedation-agitation scale in assessing the depth of sedation in patients treated with mechanical ventilation].

OBJECTIVE To compare the reliability of bispectral index (BIS) with sedation agitation scale (SAS) in assessing the depth of sedation in ill patients on mechanical ventilation in intensive care unit (ICU). METHODS Fifteen patients, aged 18-65 years old, who were receiving mechanical ventilation in ICU for longer than 72 hours and without brain dysfunction, were enrolled in this study. Sedatives and analgesics were suspended at 7:00 am. When patients fully woke up, propofol was infused till BIS score reaching 45-60. This was maintained for 10 minutes, then propofol dosage was decreased 10 microg . kg(-1) . min(-1) for every 10 minutes till all the drug was stopped. BIS was consecutively monitored and SAS was assessed in each interval. RESULTS BIS score was markedly correlated with SAS (r=-0.6494, P<0.01). Although a significant correlation was still shown (r=-0.4566, P<0.01), there was wide variability in BIS scores when SAS reached 2-4. With decreasing of the propofol dosage, BIS score gradually increased. There was a satisfactory negative correlation between BIS scores and propofol dosage (r=-0.8076, P<0.01). SAS increased also following the decrease in propofol dosage, and a significant negative correlation was shown between SAS and the dosage of propofol (r=-0.6551, P<0.01). CONCLUSION SAS is well correlated with BIS in assessing the depth of sedation in patients treated with mechanical ventilation in ICU. BIS is an objective, efficient tool for monitoring the depth of sedation in ICU critical patients who are receiving mechanical ventilation, and it is more reliable than SAS, especially when sedated levels reaching SAS 2-4.
Primary progressive aphasia patients evaluated using diffusion tensor imaging and voxel based volumetry-preliminary results.

UNLABELLED There are individuals who have a progressive language deficit without presenting cognitive deficits in other areas. One of the diseases related to this presentation is primary progressive aphasia (PPA). OBJECTIVE Identify by means of diffusion tensor imaging (DTI) and measurements of cortical volume, brain areas that lead to dysphasia when presenting signs of impaired connectivity or reduced volume. METHOD Four patients with PPA were evaluated using DTI, and measurements of cortical volumes in temporal areas. These patients were compared with two normal volunteers. RESULTS There is a trend to a difference in the number and volume of related fibers between control group and patients with PPA. Comparing cortical volumes in temporal areas between groups yielded a trend to a smaller volume in PPA patients. CONCLUSION Patients with PPA have a trend to impairment in cortical and subcortical levels regarding relevant areas.
[Results of laparoscopic cholecystectomy for acute cholecystitis in elderly patients].

OBJECTIVES The aim of this retrospective study was to evaluate the feasibility and the morbidity of laparoscopic cholecystectomy for acute cholecystitis in elderly patients. METHODS Among 891 consecutive patients who underwent cholecystectomy, 151 had acute cholecystitis. Fifty three patients of > or = 70 years of age (group 1) were compared to 98 younger patients (group 2). Analysis was made in "intention to treat" so directly open cholecystectomies during the same period were also included. RESULTS Elderly patients had a lower success rate of laparoscopic treatment (52.8% versus 70.4%; p < 0.05). This difference was due to higher rate of directly open cholecystectomy in the elderly (17% versus 2%). There was no difference between both groups in conversion rate to laparotomy (30.2% versus 26.5%). Surgical morbidity was 7.5% in group 1 and 4% in group 2 (NS). General complications were more frequent in the elderly (p < 0.05). Five patients in group 1 (9.4%) died of general complications of which 3 were operated on directly by open cholecystectomy. There was no mortality in group 2. CONCLUSION Acute cholecystitis in the elderly remains a severe disease in which laparoscopic treatment is only possible in about fifty percent.
Humor comprehension in older adults

The goal of this study was to understand factors related to humor comprehension in old age. This study proposes that, in contrast to younger adults, older adults have greater difficulty with humor comprehension due to age-related cognitive decline. Tests of verbal and nonverbal humor comprehension and tests of cognitive flexibility, abstract reasoning, and short-term memory were administered to 40 younger and 41 older adults. In general, older adults scored lower than younger adults on tests of humor and cognitive abilities. Regression analyses support the idea that cognition affects humor comprehension, but the relative contribution of each specific mechanism remains unclear. The results of this study suggest that there may be age-related deficits in humor comprehension, but more importantly, that a more sophisticated model is needed to clarify the role of cognition in humor comprehension. Humor comprehension warrants further study because of the potential physical and psychological benefits of humor. (JINS, 2007, 13, 606–614.)
Biosynthesis of aurachins A-L in Stigmatella aurantiaca: a feeding study.

The isolation of aurachins A-L (1-11) from Stigmatella aurantiaca strain Sg a15 is described. Their structures and relative configurations were deduced from spectroscopic data, in particular NMR. Three structural types were identified: A-type aurachins (1, 2, 6) are C-3 oxygen-substituted quinolines carrying a farnesyl residue on C-4, C-type aurachins (3, 4, 7-11) are C-4 oxygen-substituted quinolines carrying a farnesyl residue on C-3, and C-type aurachin E (5) has a [1,1a,8,d]imidazoloquinoline structure. Feeding of (13)C-labeled precursors showed that the quinoline ring is constructed from anthranilic acid and acetate, and the farnesyl residue from acetate by both the mevalonate and nonmevalonate pathways. Further, feeding of labeled aurachin C (3) indicated the A-type aurachins are derived by a novel intramolecular 3,4-migration of the farnesyl residue that is induced by a 2,3-epoxidation and terminated by a reduction step. (18)O-Labeling experiments indicated the new oxygen substituents originate from atomospheric oxygen. On the basis of these results a biosynthetic scheme covering all aurachins is proposed. It is further proposed that quinolones with an unorthodox substitution pattern, such as the 2-geranylquinolones from Pseudonocardia sp. and the 3-heptylquinolones from Pseudomonas sp. , are formed by related rearrangement mechanisms.
Fast-Transient Integrated Digital DC-DC Converter With Predictive and Feedforward Control

This paper introduces a dual-mode digital dc-dc converter combining the predictive and feedforward control with the conventional PID controller to achieve fast transient response and low overshoot. An additional predictive or jerk component is added to the conventional PID controller to speed up the transient response and reduce the settling time by approximately 50%. This predictive term is based on the second derivative of the error signal and introduces zero to the loop response which leads to increased bandwidth and improved phase margin. In addition, a feedforward control is also employed to further improve the transient by evaluating the change in the inductor current during the on and off time of the power transistors. Theoretical analysis and simulations were carried out to analyze the proposed design and algorithm. The proposed design is verified on silicon with a prototype of a digital dc-dc converter fabricated in CMOS 0.18 μ m process. The digital dc-dc converter achieved a settling time of 4 μs and an overshoot of 15 mV for a step-load transient of 450 mA, which are improved significantly as compared to the prior arts.