Miracle-dz/UniFAR-FTUs huggingface dataset:
Síndrome de deleção 22q11.2 e cardiopatias congênitas

OBJECTIVE: To review clinical, etiological and diagnostic characteristics of the 22q11 deletion syndrome and its as-sociation with congenital heart defects. DATA SOURCES: Medline, Lilacs and SciELO databases were searched from 1980 to 2009 using specific descrip-tors as "22q11", "DiGeorge syndrome", "velocardiofacial syndrome", "congenital heart defects" and "cardiovascular malformations". DATA SYNTHESIS: Heart malformations are the most fre-quent congenital defects at birth and represent an important Public Health problem. The 22q11 deletion syndrome, also called DiGeorge syndrome, velocardiofacial syndrome and CATCH22, stands out as one of the main known causes of congenital heart defects. This is an autosomal dominant genetic disease characterized by a highly variable phenotype, which renders its difficult clinical identification. In addition, the majority of the patients present a microdeletion identified mainly by molecular cytogenetic techniques as fluorescent in situ hybridization, which are rarely available in Brazil. Similarly to other syndromes, 22q11 deletion syndrome is associated to some specific heart defects, espe-cially conotruncal. It is still not clear which patients with congenital heart defect should be screened for 22q11 dele-tion syndrome. CONCLUSIONS: Cardiologists and cardiac surgeons, particu-larly the pediatric ones, must be aware about the features and health care related to 22q11 deletion syndrome. Subjects with the syndrome very often present abnormalities of mul-tiple systems, that could result in difficulties and complica-tions during their clinical and surgical course.
Inorganic nitrate and the cardiovascular system

Fruit and vegetable-rich diets reduce blood pressure and risk of ischaemic stroke and ischaemic heart disease. While the cardioprotective effects of a fruit and vegetable-rich diet are unequivocal, the exact mechanisms of this effect remain uncertain. Recent evidence has highlighted the possibility that dietary nitrate, an inorganic anion found in large quantities in vegetables (particularly green leafy vegetables), may have a part to play. This beneficial activity lies in the processing in vivo of nitrate to nitrite and thence to the pleiotropic molecule nitric oxide. In this review, recent preclinical and clinical evidence identifying the mechanisms involved in nitrate bioactivity, and the evidence supporting the potential utility of exploitation of this pathway for the prevention and/or treatment of cardiovascular diseases are discussed.
Percutaneous mitral valve leaflet repair for mitral regurgitation: NICE guidance

Acquired valvular heart disease is an important global public health problem. Recent evidence confirms that this group of disorders is prevalent and increases with advancing age. In population-based studies of valvular heart disease, mitral regurgitation (MR) was found to be the most common valve lesion.1 The mitral valve is a complex structure consisting of anterior (aortic) and posterior (mural) leaflets, chordae tendinae, papillary muscles and the mitral annulus.2 Disease processes affecting any one of these components or distortion in the geometry of the mitral valve complex may result in MR. Common causes include myxomatous or degenerative valve disease, ischaemic heart disease, rheumatic heart disease or ‘functional’ MR due to mitral annular and left ventricular dilatation as seen in patients with dilated cardiomyopathy. Patients with chronic severe MR typically remain asymptomatic for many years; however, when symptoms become manifest outcomes with medical treatment alone are poor.3 The standard of care has been either mitral valve replacement or, preferably, mitral valve repair, if the anatomical characteristics are suitable, with a low operative risk in contemporary practice.4 In recent years, there has been great enthusiasm in the interventional community for a less invasive, percutaneous catheter-based approach to dealing with certain forms of valve disease. The clinical impetus for the development of these techniques includes the potential for lowered morbidity, shorter hospital length of stay and recovery time and application to patients who might not otherwise be considered for a traditional surgical approach. Transcatheter treatments of calcific aortic valve stenosis are already being applied in many centres world wide, and now transcatheter treatments for MR are on our doorstep. In 2008, percutaneous mitral valve leaflet repair for severe MR with the MitraClip device (Evalve, Menlo Park, CA, USA) gained CE mark approval and already over 200 procedures have been performed …
Fibrinolytic therapy and bleeding complications: risk predictors from RIKS-HIA

Background Fibrinolytic treatment for ST-elevation myocardial infarction is associated with increased bleeding risk but is still widely used world wide, mainly because of limited access to primary PCI. Objective To analyse contemporary fibrinolytic treatment patterns, in-hospital bleeding risk and prognosis during 2001 to 2006 in unselected Swedish patients. Methods and results The RIKS-HIA registry covers almost all Swedish patients treated for acute coronary syndromes. Major in-hospital bleeding was defined as lethal or intracranial bleeding or bleeding requiring surgery or blood transfusion. Survival status of the 15 373 patients was obtained from the National Cause of Death Register. The number of patients receiving fibrinolysis as reperfusion therapy decreased from 4336 patients in 2001 to 733 in 2006. Cases of major in-hospital bleeding increased from 1.2% (including 0.7% lethal or intracranial) in 2001 to 4.0% (1.1%) in 2006, p<0.001. Higher age, female gender, hypertension, kidney failure, clopidogrel treatment before admission, pre-hospital administration of fibrinolysis and fibrin-specific fibrinolytic agents were identified as predictors for bleeding. Major in-hospital bleeding was the strongest predictor of adverse prognosis with a more than threefold increase in 1-year mortality. Conclusion During 2001 to 2006 the use of fibrinolytic treatment markedly decreased while the incidence of major bleeding complications more than doubled. The latter might in part be explained by increasing use concomitant antiplatelet therapy, pre-hospital treatment and fibrin-specific fibrinolytic agents. Future close monitoring of bleeding complications is warranted, especially when considering the increased use of various combinations of antithrombotic drugs in conjunction with fibrinolysis and the great impact of bleeding on long-term mortality.
Hepatitis B Virus Vaccine: The Nigerian Story

Hepatitis B (HBV) virus in endemic in Nigeria. Infection is acquired mainly in childhood through horizontal transmission. The infection is preventable by vaccination. Universal childhood vaccination against the infection started in Nigeria less than ten years. Hepatitis B vaccine coverage in Nigeria is 41%, though now it has increased over the last few years. An example of community based privately financed vaccination project is given where HBV coverage rate is 58% and the vaccine efficacy against infection is 80%. IFEMED Journal Vol. 14 (1) 2008: pp. 4-5
Field Guide to the Detection and Control of Xerophthalmia

This monograph is published by the World Health Organization and is available in English, French, and Spanish. It was made possible through a grant from the Helen Keller International Foundation in New York and from the US Agency for International Development. The author is a distinguished American ophthalmologist who is now the principal investigator of the Indonesian Nutritional Blindness Prevention Project and visiting professor in Bandung, Indonesia. Xerophthalmia is the leading cause of blindness among young children in the developing world and one of the most frequent causes of blindness in general. Dr Sommer estimates that up to 250,000 children in Asia alone lose their sight because of this disease each year and another five to ten million are at risk. This monograph describes assessment, prevention, and evaluation procedures of this condition. It is illustrated with beautiful photographs, most of which are in color and complement the text very well.
Dissolved methane: a hurdle for anaerobic treatment of municipal wastewater.

Wastewater Ze-hua Liu,†,‡,* Hua Yin,†,‡ Zhi Dang,†,‡ and Yu Liu †College of Environment and Energy, South China University of Technology, Guangzhou 510006, China ‡Key Lab Pollution Control & Ecosystem Restoration in Industry Cluster, Ministry of Education, Guangzhou 510006, Guangdong, China Advanced Environmental Biotechnology Center, Nanyang Environment and Water Research Institute, Nanyang Technological University, CleanTech one, Singapore 637141 School of Civil and Environmental Engineering, Nanyang Technological University, Singapore 639798
Modification of myocardial substrate utilisation: a new therapeutic paradigm in cardiovascular disease

Therapies that aim to modify cardiac substrate utilisation are designed to increase metabolic efficiency. Although the main energy supply for the heart is generally provided by the oxidation of fatty acids, the heart is a metabolic omnivore and able to consume glucose as well as lactate and amino acids in varying proportions. A shift from fatty acid oxidation to glucose oxidation leads to lower oxygen consumption per unit of ATP produced. This concept of reduced oxygen utilisation underlies the use of metabolic modulating agents to treat chronic stable angina. Furthermore, the model of an energy-starved heart now forms the basis for our understanding of both ischaemic and non-ischaemic heart failure. Potential alterations in substrate utilisation and thus myocardial efficiency underlie the use of metabolic agents in heart failure. This is achieved by either promoting glucose or reducing the utilisation of fatty acids. Such a shift results in a relatively greater production of ATP per unit of oxygen consumed. With an ongoing demand for treatment options in ischaemic heart disease and a growing epidemic of heart failure, new treatment modalities beyond contemporary therapy need consideration.
Planning updates in multi-application wireless sensor networks

One of the arising issues in wireless sensor networks is running multiple applications to reduce deployment, administrative and management costs. In this paper we assume a sensor network in which nodes of a group have a set of same applications in their external flash memory that some of them are loaded and running. Occasionally, these applications should be updated for reasons that are manifold ranging from fixing software bugs to retasking. It is often that updates for a subset of applications happen at the same time, for example when a routing protocol shared among a subset of applications is changed. To bring the sensor nodes up to date with the new versions of the applications, existing strategies transfer the delta code, a smaller code obtained from the differential compression between the binary representations of the old and the new version of each application, and let the sensor nodes rebuild the new version from the received delta and the old version. We discuss that these strategies are blind to the order of updates when a set of updates occurs simultaneously. We introduce a heuristic planner that yields a sequence for a set of simultaneous updates, which minimizes the total delta size without adding overhead on the sensor nodes. We illustrate the efficiency of our planner on some TinyOS applications.
Reduction of blood pressure already in the normal range further regresses left ventricular mass

To the Editor: We read with interest the paper by Simpson and colleagues describing a reduction in left ventricular (LV) mass among predominantly hypertensive subjects with left ventricular hypertrophy (LVH) despite blood pressure being within the normal range on entry.1 Further lowering of systolic blood pressure (SBP) by 9.3 (8.6) mmHg resulted in a reduction of LV mass index by 4.7 (7.3) g. We have recently demonstrated a comparable drop in LV mass in normotensive (<130/80 mmHg) patients with early chronic kidney disease and normal LV mass at baseline …
Candesartan versus imidapril in hypertension: a randomised study to assess effects of anti-AT1 receptor autoantibodies

Background Anti-angiotensin II receptor subtype 1 (AT1 receptor) autoantibodies have previously been shown in sera of hypertensive patients. This study assessed whether anti-AT1-receptor autoantibody in serum is correlated with the efficacy of an AT1-receptor blocker (ARB; candesartan)-based regimen in hypertensive patients after 8 weeks of treatment. Design The Study of Optimal Treatment in Hypertensive Patients with Anti-AT1-Receptor Autoantibodies is a multicentre, randomised, blinded endpoint, open-label, parallel-group comparison clinical trial conducted in five centres in Wuhan, China. Treatment is designed as stepwise added-on therapy to reduce blood pressure (BP) <140/90 mm Hg. 512 patients with moderate to severe primary hypertension were randomly assigned to an 8-week treatment with either ARB (candesartan)-based regimen (n=257) or ACE inhibitor (imidapril)-based regimen (n=255). Results Systolic and diastolic BP was reduced significantly in both treatment groups. The candesartan-based regimen achieved a significantly greater systolic BP reduction than imdapril (30.8±10.3 vs 28.8±10.3 mm Hg, p=0.023). In those anti-AT1 receptor autoantibody-positive hypertensive patients, the mean systolic BP at baseline was higher than in the anti-AT1 receptor autoantibody-negative group (160.5±16.5 vs 156.2±17.7 mm Hg; p=0.006). The mean BP reduction was greater in the candesartan-based regimen than the imidapril-based regimen (−35.4±9.8/16.9±6.9 vs −29.4±9.8/14.2±6.9 mm Hg; p=0.000 and 0.002, respectively), and more patients on imidapril required add-on medications to achieve BP control (94% vs 86%; p=0.03). No correlation was observed between the titre of anti-AT1 receptor autoantibody and the efficacy of candesartan-based therapy. In those anti-AT1 receptor autoantibody-negative patients similar BP lowering was reached in the candesartan and the imidapril-based regimens. Conclusions An ARB-based regimen is more effective in BP lowering than an ACE inhibitor-based regimen in the presence of anti-AT1 receptor autoantibodies. Trial registration number This trial has been registered at http://www.register. clinicaltrials.gov/ (identifier: NCT00360763).
Short-term efficacy and long-term compliance/treatment failure of the α1 blocker naftopidil for patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

Objective. To evaluate treatment failure during a 4-year follow-up period after administration of naftopidil for patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) in real-life clinical practice. Material and methods. A total of 247 patients with LUTS/BPH who had an International Prostate Symptom Score (IPSS) of ≥8 were enrolled in the study. Naftopidil, 50 mg/day, was given to the patients. They were followed for 4 years with periodic evaluation. Treatment failure was defined as conversion to other medical treatment or to surgery. Results. Of the 247 patients, treatment failure occurred in 42 (17.0%) during the 4-year follow-up period. The 4-year treatment failure rate was on the Kaplan-Meier curve 35.0%. Among parameters assessed at baseline, prostate volume (PV) was the only significant determinant of treatment failure: patients with a PV of ≥35 ml had a 2.1 times higher hazard of treatment failure than those with a PV of <35 ml (95% CI 1.06–4.33; p=0.03). Patients with a severe IPSS at 12 weeks after administration of naftopidil had a 3.5 times higher hazard than those having a mild/moderate IPSS (95% CI 1.34–9.26; p=0.01). After 4 years, 200 patients (81%) had stopped taking naftopidil because of adverse events, treatment failure, loss to follow-up, etc. Conclusions. There were significant improvements in IPSS and urinary flow rate with naftopidil although it is unknown whether these improvements were significantly larger than the placebo effect as the study was non-randomized. However, only 19% of patients were known to have continued with the same medication for 4 years in real-life clinical practice. Patients who have a large prostate at baseline and a severe IPSS at 12 weeks after treatment are more likely to have treatment failure, although a prospective study is needed to confirm this.
A semantic solution for saving energy in wireless sensor networks

Wireless Sensor Networks (WSNs) have a very large growth in research in recent years. They are essentially adhoc networks, capable of processing, sensing and transmitting wireless information. These are networks that generate a large volume of raw data which possess natural heterogeneity. Besides, energy efficiency is an important performance measure, and one bit transmission over the network can consume as much energy as running thousands of instructions. In order to share information between different networks and decrease the amount of data sent, sensor data need to be enriched with semantic information. Trying to solve this problem, will be presented in this paper an approach to improve the power consumption in WSNs, based on a semantic solution compound by a middleware an ontology. This middleware is able to deal with the heterogeneity of data and applications, giving a semantics formal and unambiguous for data. The results showed that our approach is valid and achieve a satisfactory energy saving, with more than 30% savings between the best and worst case.
Modeling and optimizing the cache deployment with filter effect in multi-cache system

Content-Centric Network is a new and promising architecture with in-network caching. In such a system with universal caching, the cache would play as a high-cut low-pass filter and have a big influence on the requests distribution, and further on cache efficiency. This paper looks into the change of request distribution though caches and presents a model of the “filter effect” in LRU (Least Recently Used) cache. Through the simulation in two common topologies, the experiment results have verified the validity of the new model. Since our model can quantify the network load of any certain cache deployment scheme, we optimize the way of deploying cache when the total cache size is limited. Simulation results show our optimal way can effectively minimize the total network load.
A self-aware, reconfigurable architecture for context awareness

Urban environments are increasingly pervaded by ICT devices. Soon, citizens and technologies could collaboratively constitute large-scale socio-technical organisms supporting both individual and collective awareness. This paper illustrates a modern awareness framework rooted in this scenario. The framework has been designed to collect and classify data streams in a modular way. It supports service oriented, reconfigurable components and provides a solid background to put at joint work specification- and data-driven approaches. Furthermore, we use the framework to experimentally evaluate an innovative meta-classification scheme based on state-automata for (i) improving energy efficiency, (ii) improving classification accuracy and (iii) improving software engineering of aware systems.
Biological valves: is durability really the bottle neck?

The ideal valve substitute to replace a diseased aortic valve is a non-thrombogenic, infection-resistant, living autologous valve with excellent haemodynamics and an unlimited durability. Unfortunately, in real life, the available aortic valve substitutes are associated with one or more disadvantages related to their design. The main concern with biological valvular prostheses is their limited durability: in younger patients, in particular, the biological prosthesis may not outlive the patient. Valve degeneration is a slow continuous process. It may cause haemodynamic dysfunction and proneness to prosthetic valve endocarditis, lead to heart failure and possibly death, and in those patients who are managed well by their cardiologist and deemed fit enough to undergo a reintervention it may be decided to replace the degenerated biological prosthesis. Mechanical prostheses, on the other hand, carry the burden of lifelong anticoagulation due to their increased thrombogenicity. Bleeding and thromboembolic event risk depends greatly on patient characteristics, but also on the type and quality of anticoagulation management, which varies widely between countries and continents. In addition, patient outcome after aortic valve replacement is determined by factors that are not related to the implanted valve substitute, like patient comorbidity and country-specific life expectancy. These considerations should be taken into account when assessing the literature on patient …
Liver damage in juvenile inflammatory bowel disease.

— During a 12-year period, 46 children and adolescents with inflammatory bowel disease were followed from the time of diagnosis with regular biochemical tests of liver function. Thirty-four patients had ulcerative colitis and 12 had Crohn's disease. Mean age at the time of diagnosis was 10.2 years (range 7 months–17 years) and the mean follow-up period was 5.2 years (range 1–11 years). Pathological liver function tests were found in 60% of the 34 patients with ulcerative colitis: 9 of these 20 patients demonstrated more severe disturbance, usually at the time of diagnosis. Liver damage was most frequent in patients with total colitis. Liver biopsy was performed in eight patients, demonstrating “pericholangitis”, fibrosis and in one case cirrhosis. Morphometry of electron microscopical pictures revealed a significantly increased number of lysosomes and dilated cisternae of the rough endoplasmic reticulum. ERCP was performed in two patients, verifying primary sclerosing cholangitis in one. Four of the 12 patients with Crohn's disease had mildly pathological liver function tests. No correlation was found to the extent, duration or treatment of bowel disease. In our series of juvenile inflammatory bowel disease, liver damage occurred frequently, especially in ulcerative colitis. The more severe changes tended to coincide with the onset of bowel disease.
On the capacity and energy efficiency of network scheduling in future ultra-dense networks

Massive densification of the radio network infrastructure is considered to be a promising solution to meet a rapidly increasing demand in future radio access networks. In this study we investigate the feasibility of a centralized approach for the allocation of radio network resources by studying the performance of a network scheduler that implements access node on/off scheduling in ultra-dense networks. The evaluation is performed by means of simulations for different distributions of mobile nodes and for different network densities. Simulation results show that considerable improvements in the network throughput and energy efficiency can be sought with an increasing network density. The improvements are independent of the mobile node distribution and diminish steadily as the network density increases. It is also shown that the gains are higher when mobile nodes are uniformly distributed as compared to a distribution where mobile nodes are clustered due to a higher number of mobile nodes per access node.
Healthy eating in the school environment – a holistic approach*

The curriculum that pupils are taught within the classroom environment can either be reinforced or weakened by what goes on in the rest of the school environment. The study focused on pupils aged 11–12 years, to establish if healthy eating theory was put into practice in the school environment. The research encompassed three areas within the school: the pupils who are the recipients of the theory; the teacher who teaches them the importance of food and cooking skills; and the providers of food within the school environment. Three different post-primary schools located within the Coleraine area of Northern Ireland were used.