Miracle-dz/UniFAR-FTUs huggingface dataset:
Morphology and electrophysiology of the mammalian atrioventricular node.

The AV node of those mammalian species in which it has been thoroughly investigated (rabbit, ferret, and humans) consists of various cell types: transitional cells, midnodal (or typical nodal cells), lower nodal cells, and cells of the AV bundle. There are at least two inputs to the AV node, a posterior one via the crista terminalis and an anterior one via the interatrial septum, where atrial fibers gradually merge with transitional cells. The role of a possible third input from the left atrium has not been investigated. Since the transition from atrial fibers to nodal fibers is gradual, it is very difficult to define the "beginning" of the AV node, and gross measurements of AV nodal length may be misleading. Histologically, the "end" of the AV node is equally difficult to define. At the site where macroscopically the AV node ends, at the point where the AV bundle penetrates into the membranous septum, typical nodal cells intermingle with His bundle cells. A conspicuous feature, found in all species studied, is the paucity of junctional complexes, most marked in the midnodal area. The functional counterpart of this is an increased coupling resistance between nodal cells. An electrophysiological classification of the AV nodal area, based on transmembrane action potential characteristics during various imposed atrial rhythms (rapid pacing, trains of premature impulses), into AN (including ANCO and ANL), N, and NH zones has been described by various authors for the rabbit heart. In those studies in which activation patterns, transmembrane potential characteristics, and histology have been compared, a good correlation has been found between AN and transitional cells, N cells and the area where transitional cells and cells of the beginning of the AV bundle merge with midnodal cells, and NH cells and cells of the AV bundle. Dead-end pathways correspond to the posterior extension of the bundle of lower nodal cells and to anterior overlay fibers. During propagation of a normal sinus beat, activation of the AN zone accounts for at least 25% of conduction time from atrium to His bundle, the small N zone being the main source of AV nodal delay. Cycle length-dependent conduction delay is localized in the N zone. Conduction block of premature atrial impulses can occur both in the N zone and in the AN zone, depending on the degree of prematurity. Several factors determining AV nodal conduction delay have been identified. (ABSTRACT TRUNCATED AT 400 WORDS)
Cardiovascular and renal prognosis in patients with arterial hypertension, type 2 diabetes mellitus and microalbuminuria.

It is known that the presence of microalbuminuria has a high predictive value for the proteinuria of patients with T2DM (Pollak & Sypniewska 2008) and is a negative predictive factor for renal and cardiovascular evolution in patients with T2DM and essential arterial hypertension. Microalbuminuria is a known risk factor both for end-stage renal disease and for cardiovascular mortality and morbidity in general population and also in patients with T2DM and arterial hypertension (Anavekar et al 2004, Pinto-Sietsma et al 2000). Studies performed in Europe, US (United States) and Australia have found a prevalence of microalbuminuria of 5-15% in the general population, approximately 20-30% in diabetic patients and 11-17% in hypertensive patients (Pollak & Sypniewska 2008). A study published in Romania in 2011 reports that the prevalence of microalbuminuria in patients with arterial hypertension and T2DM is 29%, respectively 20% in patients with T2DM without arterial hypertension and 15% in hypertensive patients without T2DM (Bacanu et al 2011). Klausen et al examined 2762 patients without known coronary heart disease pathology and concluded that microalbuminuria was a significant determinant of death and coronary heart Abstract. Diabetes Mellitus is a metabolic disease defined by hyperglycemia, secondary to insulin deficiency both in secretion and activity, which alters the metabolism of carbohydrates, lipids and proteins. Diabetic nephropathy is a microvascular complication of diabetes mellitus defined by an increased excretion of proteins in urine. The early stage is characterized by a mild albumin excretion, named as microalbuminuria or incipient diabetic nephropathy. The screening for diabetic nephropathy should be performed when the diagnosis of diabetes mellitus type 2 is confirmed, because approximately 7% of the patients already have microalbuminuria. Microalbuminuria is a known risk factor for cardiovascular morbidity and mortality and for end-stage renal disease in general population and also in patients with type 2 diabetes mellitus and arterial hypertension. Microalbuminuria is an independent predictor of cardiovascular mortality (cardiovascular diseases, cerebrovascular diseases, peripheral arterial disease) in diabetes mellitus or hypertensive patients in the general population. The microalbuminuria test is recommended as a strategy in stratifying the risk of diabetic and hypertensive patients. Albuminuria is associated with a poor renal and cardiovascular outcome. By reducing the microalbuminuria and the blood pressure values using angiotensin-converting-enzyme inhibitors or angiotensin renin blockers, we can improve the prognostic. The physicians should routinely measure urinary albumin excretion in patients with type 2 diabetes mellitus and hypertension and aggressively treat the modifiable risk factors, such as high glycemic values, cholesterol and blood pressure, in order to suppress the microalbuminuria and thus to prevent the renal and cardiovascular adverse effects.
GST Polymorphisms Interact With Dietary Factors to Modulate Lung Cancer Risk: Study in a High-Incidence Area

The aim of this study was to explore possible correlations between glutathione S-transferases (GST) polymorphisms, smoking, diet, and lung cancer susceptibility in a rural Spanish region with one of the highest incidence rates of the country. All lung cancer patients living in the area (103) and 247 matched controls were genotyped for the GST mu 1 (GSTM1) null, GST theta 1 (GSTT1) null, and GST pi 1 (GSTP1) Isoleucine (Ile) 105 valine (Val) polymorphisms and interviewed to gather information on smoking and dietary habits. Neither the presence of GST polymorphisms nor their interaction with smoking was independently associated to lung cancer risk. The intake of carotenoid-rich red and yellow vegetables was inversely associated with lung cancer (P < 0.05). Interestingly, this was observed only in carriers of the GSTM1 (P = 0.04), GSTT1 (P = 0.03), or GSTM1/T1 (P = 0.04) positive genotypes. Similarly, the consumption of citrus fruits was more frequent among cancer-free subjects who carried functional GSTM1 (P = 0.04) or both GSTM1 and GSTT1 enzymes (P = 0.04). The results show that the inverse association observed between the intake of dietary carotenoid-rich vegetables and lung cancer risk is dependent on the GST genotype. These results warrant further investigations to confirm the observed associations.
Clinical predictors of unrecognized bipolar I and II disorders.

OBJECTIVES Bipolar disorder (BD) is correctly diagnosed in only 40-50% of patients. No previous study has investigated the characteristics of bipolar patients in psychiatric care with or without clinical diagnoses of BD. We investigated the demographic and clinical predictors of the absence of a clinical diagnosis of BD I and II among psychiatric patients. METHODS In the Jorvi Bipolar Study, 1,630 psychiatric in- and outpatients were screened with the Mood Disorder Questionnaire. Suspected cases were diagnosed with the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient version (SCID-I/P) for BD. Patients with no preceding clinical diagnosis of BD, despite previous manic, hypomanic or mixed phases and treatment in psychiatric care, were classified as undiagnosed. The clinical characteristics of unrecognized BD I patients (23 of 90 BD I patients) and BD II patients (47 of 93 BD II patients) were compared to those of patients who had been correctly diagnosed. RESULTS No previous hospitalizations [odds ratio (OR) = 10.6, p = 0.001] or psychotic symptoms (OR = 4.4, p = 0.045), and the presence of rapid cycling (OR = 11.6, p = 0.001) predicted lack of BD I diagnosis. No psychotic symptoms (OR = 3.3, p = 0.01), female gender (OR = 3.0, p = 0.03), and shorter time in treatment (OR = 1.1, p = 0.03) predicted the lack of a BD II diagnosis. CONCLUSIONS Correct diagnosis of BD I is related to the severe phases of illness leading to hospitalizations. In BD II, the illness factors may not be as important as time elapsed in treatment, a factor that often leads to a delay in diagnosis or none at all. Excessive reliance on typical and cross-sectional presentations of illness likely explain the non-recognition of BD. The challenge for correctly diagnosing bipolar patients is in outpatient settings.
The branched CcsA/CckA‐ChpT‐CtrA phosphorelay of Sphingomonas melonis controls motility and biofilm formation

The CckA‐ChpT‐CtrA phosphorelay is central to the regulation of the cell cycle in Caulobacter crescentus. The three proteins are conserved in Alphaproteobacteria, but little is known about their roles in most members of this class. Here, we characterized the system in Sphingomonas melonis. We found that the transcription factor CtrA is the master regulator of flagella synthesis genes, the hierarchical transcriptional organization of which is herein described. CtrA also regulates genes involved in exopolysaccharide synthesis and cyclic‐di‐GMP signaling, and is important for biofilm formation. In addition, the ctrA mutant exhibits an aberrant morphology, suggesting a role for CtrA in cell division. An analysis of the regulation of CtrA indicates that the phosphorelay composed of CckA and ChpT is conserved and that the absence of the bifunctional kinase/phosphatase CckA apparently results in overactivation of CtrA through ChpT. Suppressors of this phenotype identified the hybrid histidine kinase CcsA. Phosphorelays initiated by CckA or CcsA were reconstituted in vitro, suggesting that in S. melonis, CtrA phosphorylation is controlled by a branched pathway upstream of ChpT. This study thus suggests that signals can directly converge at the level of ChpT phosphorylation through multiple hybrid kinases to coordinate a number of important physiological processes.
Eating disorders in adolescence in a Swiss epidemiological study.

OBJECTIVE This is a study of prevalence rates for anorexia nervosa (AN) and bulimia nervosa (BN) in an epidemiological sample of Swiss adolescents. METHOD A two-stage approach was used which involved the screening of a large sample of adolescents aged 14-17 and subsequent interviews of screen-positive and control subjects. RESULTS The prevalence rates for adolescent girls were 0.7% for AN and 0.5% for BN. DISCUSSION Full clinical syndromes of AN and BN in adolescents are by far less frequent than individual symptoms of eating disorders. There is more cross-cultural variation for prevalence rates in BN than in AN.
Bisphosphonates: an overview with special reference to alendronate

Bisphosphonates, analogues of pyrophosphate, are potent inhibitors of osteoclast-mediated bone resorption. They are used in the treatment of Paget's disease of bone, hypercalcaemia and osteolytic bone disease of malignancy, primary and secondary hyperparathyroidism, and in osteoporosis. Bisphosphonate treatment causes an early reduction in bone resorption followed by a later reduction in bone formation. The early inhibition of bone resorption induces a reduction in serum calcium which leads to increased parathyroid hormone (PTH), and subsequently an increase in 1,25-dihydroxyvitamin D. The secondary hyperparathyroidism of bisphosphonate treatment also leads to urinary calcium conservation and phosphaturia, and a reduction in serum phosphate. The increase in the PTH following bisphosphonate therapy is a response to the change in serum calcium and can occur even when there is hypercalcaemia, and this can cause confusion in the interpretation of PTH results. The hypocalcaemic response to bisphosphonates is occasionally severe, especially in patients with hypoparathyroidism. The recent elucidation of bisphosphonate action at the cellular level on the mevalonate pathway has led to interest in its effects on lipoprotein metabolism, which may prove to be of clinical significance. Newer and more potent bisphosphonates are currently undergoing clinical trials in malignant bone disease and osteoporosis, and will lead to further advances in the optimal management of these conditions.
Slipped capital femoral epiphysis

This particular ailment has many designations in the literature but none is quite adequate. Here we use the terminology slipped capital femoral epiphysis (SCFE). The anatomy of the proximal femur in all mammals reflects their growth and function. The main forces acting on the head are perpendicular to the growth plate. The thick tear‐proof perichondrium‐periosteum on the femoral neck is like a stocking attached to the epiphysis and the trochanter region. Growth in length causes a strong tensile stress in the periosteum, pressing the epiphysis against the metaphysis and thus stabilizing the vulnerable growth plate—the periosteum theory. Several factors may diminish the stability of the growth plate. SCFE begins with fissures, which coalesce to a fracture in the growth plate, invisible on a radiograph. As the slip progresses, an increasing angulation between the epiphysis and the remainder of the femur occurs. Weight and muscular forces displace the epiphysis posteriorly in a flexed hip. A rift in the ventral half of the periosteal stocking occurs at the border to the perichondrium and, after that, a longitudinal rift in the periosteum at the anterior midline of the femoral neck. This rift becomes broader as the epiphysis slips posteriorly, withdrawing the ruptured periosteum. Displacement of the epiphysis is due to a rotational slip and tilt, made possible by a compression fracture in the posterior part of the metaphysis. Parts of the periosteum function as reins steering the slip direction and counteracting the displacement. SCFE may be regarded as a pseudoarthrosis in the growing cartilage of the plate. The periosteum theory extended to a pseudoarthrosis theory has been supported by findings at surgery and on true lateral radiographs of usual and unusual cases of SCFE presented in this opus. On a true lateral view, the displacement can be measured as the slipping angle (SA) based on anatomical and geometrical considerations. SA values from 95 normal hips and from 22 contralateral asymptomatic hips from SCFE patients are presented in a histogram and bar graph. Statistically, SCFE is always bilateral, but in about 1/3 of the asymptomatic, contralateral hips, the physis ossifies and closes with SA below 13°, and surgery is not necessary. It is most important that the position of the femur on the X‐ray table is exactly defined in two dimensions: 1) the angle between the femoral shaft and the tabletop (angle of elevation), 2) the degree of rotation of the femur around its axis. A precisely defined positioning of the femur is a prerequisite for an exact reproducible measurement of the SA on a true lateral view and is also valuable for the evaluation of radiographic “signs”. An aid, the Youth Hip Triangle (YHT), has been designed to facilitate positioning of the femur and measurement of SA. YHT is recommended for routine use in every X‐ray facility. The method is quick, cost effective and makes it possible to diagnose SCFE in the contralateral hip before clinical signs or symptoms have occurred.
Stochastic Resonance in the nonautonomous Chua's Circuit

The dynamics of the nonautonomous Chua's circuit driven by a sinusoidal signal and additive noise is investigated numerically via the "two-state" dynamics method. The possibility of realizing the phenomenon of stochastic resonance (SR) is established. The SR is characterized by an increase in the signal-to-noise ratio (SNR) due to the coherent interaction between the characteristic frequencies of the chaotic bistable Chua's circuit and the modulation frequency of the input. The SNR can be controlled by both external noise and system parameter variations in this circuit. The statistical characteristics of the "chaos-chaos" type intermittency and their correlation with the optimal conditions for SR are investigated.
A resume-standby application processor for 3G cellular phones

A 389MIPS application processor for 3G cellular phones is implemented in a 0.13/spl mu/m dual-V, process. This dual-issue superscalar CPU with DSP runs at 216MHz at 1.2V and provides a resume-standby mode with a quick recovery feature using data retention of memory. The leakage current is estimated to be 98/spl mu/A when the power supply is internally cut off.
Moyamoya tipping point: fatal bilateral MCA territory infarction following cocaine abuse

An adult Caucasian man with a history of polysubstance abuse was found unresponsive by the nursing staff at his rehabilitation centre and intubated by emergency medical services. On examination, he was stuporous, his eyes did not open to stimulation, his pupils were reactive, localised to pain with bilateral upper extremities and demonstrated triple flexion to noxious stimuli in the bilateral lower extremities. Urine toxicology was positive for cocaine metabolites. A CT scan of the head was performed, which showed possible hypodensities in the bilateral temporal lobes. MRI of the brain was performed to further characterise these hypodensities, and it revealed bilateral middle cerebral artery (MCA) infarction and generalised cerebral …
The Effects of Drill and Practice Courseware on Students’ Achievement and Motivation in Learning English

 Abstract — Students’ achievement and motivation in learning English in Malaysia is a worrying trend as it is lagging behind several other countries in Asia. Thus, necessary actions have to be taken by the parties concerned to overcome this problem. The purpose of this research was to study the effects of drill and practice courseware on students’ achievement and motivation in learning English language. A multimedia courseware was developed for this purpose. The independent variable was the drill and practice courseware while the dependent variables were the students’ achievement and motivation. Their achievement was measured using pre-test and post-test scores, while motivation was measured using a questionnaire. A total of 60 students from three vernacular primary schools in a northern state in Malaysia were randomly selected in this study. The findings indicate: (1) a significant difference between the students’ pre-test and post-test scores after using the courseware, (2) no significant difference in the achievement score between male and female students after using the courseware, (3) a significant difference in motivation score between the female and the male students, and (4) while the female students scored significantly higher than the male students in the aspects of relevance, confidence and satisfaction, no significant difference in terms of attention was observed between them. Overall, the findings clearly indicate that although the female students are significantly more motivated than their male students, they are equally good in terms of achievement after learning from the courseware. Through this study, the drill and practice courseware is proven to influence the students’ learning and motivation.
Lung Cancer Ablation: Technologies and Techniques

Abstract The incidence of lung cancers in 2012 is estimated to reach 226,160 new cases, with only a third of patients suitable surgical candidates. Tumor ablation has emerged as an important and efficacious treatment option for nonsurgical lung cancer patients. This localized minimally invasive therapy is best suited for small oligonodular lesions or favorably located metastatic tumors. Radiofrequency ablation has been in use for over a decade, and newer modalities including microwave ablation, cryoablation, and irreversible electroporation have emerged as additional treatment options for patients. Ablation therapies can offer patients and clinicians a repeatable and effective therapy for palliation and, in some cases, cure of thoracic malignancies. This article discusses the available technologies and techniques available for tumor ablation of thoracic malignancies including patient selection, basic aspects of procedure technique, imaging follow-up, treatment outcomes, and comparisons between various therapies.
Trans-Situated Learning: Supporting a Network of Practice with an Information Infrastructure

This paper investigates the practice-based learning dynamics that emerge among peers who share occupational practices but do not necessarily work with each other or even know each other because of geographical or organizational distance. To do so, it draws on the literatures on situated learning, networks of practice, and information infrastructures, and on insights from a longitudinal case study of the implementation of a Web-based information system used by people working in the field of environmental health. The system was deeply involved in the transformations of local practices as well as relationships between peers. Based on a dialogue between existing literatures and observations from the case study, this research extends the practice-based perspective on learning to the computer-mediated context of a network of practice. To that effect, it proposes a model of what we call trans-situated learning that is supported by the local universality of an information infrastructure whose use becomes embedded with other infrastructures.
Improving the Use of Pneumococcal Vaccine Through a Strategy of Hospital‐based Immunization

Serious pneumococcal infections continue to be a major cause of morbidity and mortality in the United States. This is especially true for pneumococcal pneumonia. For example, in 1977 there were more than 58,000 deaths reported with pneumonia and influenza listed as the underlying cause. However, when all diagnoses mentioned on death certificates were examined, the number of pneumonia and influenza deaths approached 200,000.2 An unknown proportion of these deaths, at least several tens of thousands each year, are caused by pneumococcal pneumonia. Pneumococcal infections are still regarded as the major cause of community-acquired pneumonia requiring hospitalization, accounting for 26 to 76 per cent of cases in published seriess3s4 Bacteremic pneumococcal pneumonia continues to exact a high toll in mortality. In earlier series reported from 1964 to 1978 overall case-fatality rates ranged from 10 to 35 per cent.3 Recent studies have shown that this is unchanged; seven reports published since 1982 document overall mortality rates ranging from 13 to 31 percent (Table l). 5-11 In these studies, elderly persons (aged 60 or 65 years and older) have accounted for 23 to 49 per cent of cases, and fhtality rates have ranged from 17 to 40 per cent. The economic costs of pneumococcal pneumonia have also been substantial; with hospital care accounting for 90 per cent of the medical care costs in persons of all ages, and 97 per cent of these costs among the elderly. l2 In 1977, a first generation 14-valent pneumococcal polysaccharide vaccine appeared in the United States. Licensure was based on the vaccine’s demonstrated antigenicity, freedom from serious adverse reactions, and efficacy in preventing serious pneumococcal infections as shown in randomized controlled trials in young adults. In its