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sinus rhythm. normal ecg.
INTRODUCTION: Surgical creation of a radiocephalic fistula is the gold standard of vascular access for hemodialysis. Recently, an endovascular approach for upper arm fistula creation (endoAVF) has been developed, which may be an alternative to open surgery. We describe a case series of eight cases showing feasibili...
To evaluate the dynamic changes of pulmonary arterial pressure (PAP) and cardiac function in neonates with pulmonary or extra-pulmonary acute respiratory distress syndrome (ARDSp/ARDSexp).</AbstractText>An observational study was conducted. A total of 128 neonates with ARDS admitted to neonatology department of the Aff...
Marfan syndrome (MFS) is a connective tissue disorder caused by mutations in the Fibrillin-1 gene (FBN1). Here, we undertook the first epigenome-wide association study (EWAS) in patients with MFS aiming at identifying DNA methylation loci associated with MFS phenotypes that may shed light on the disease process.</Abstr...
Fenofibrate is a peroxisome proliferator-activated receptor alpha agonist widely used in clinical practice, but its mechanism of action is incompletely understood.</AbstractText>The aim of the study was to assess whether improvement in subclinical inflammation or glucose metabolism contributes to its antiatherogenic ef...
Pace mapping has been used to identify the site of origin of focal ventricular arrhythmias. The spatial resolution of pace mapping has not been adequately quantified using currently available three-dimensional mapping systems.</AbstractText>The purpose of this study was to determine the spatial resolution of pace mappi...
Pleuropericardial effusion is an extremely rare complication of gemcitabine chemotherapy. The patient was a 56-year-old woman administered systemic chemotherapy with gemcitabine for local recurrence of pancreatic cancer and lymph node metastasis developing 4 years after pancreaticoduodenectomy. Four months after the st...
We have developed a novel method for estimating subject-specific hemodynamics during hemorrhage. First, a mathematical model representing a closed-loop circulation and baroreceptor feedback system was parameterized to match the baseline physiology of individual experimental subjects by fitting model results to 1 min of...
The purpose of this pre-approval access program is to give talquetamab monotherapy (treatment with single drug) to participants with relapsed or refractory multiple myeloma (a type of cancer that begins in plasma cells [white blood cells that produce antibodies] which has returned or difficult to treat) who have relaps...
The main pathologenesis of vein graft restenosis is neointimal hyperplasia associated with vascular smooth muscle cell migration and proliferation. Gene therapy offers a novel treatment method for reducing or delaying early thrombosis, intimal hyperplasia, and late atherosclerosis. In this review, we will (1) describe ...
Despite advances in myocardial reperfusion therapies, acute myocardial ischaemia/reperfusion injury and consequent ischaemic heart failure represent the number one cause of morbidity and mortality in industrialized societies. Although different therapeutic interventions have been shown beneficial in preclinical set...
This study aims to determine temperature effect on nerve conduction block induced by high-frequency (kHz) biphasic stimulation (HFBS).</AbstractText>Frog sciatic nerve-muscle preparation was immersed in Ringer's solution at a temperature of 15 or 20 °C. To induce muscle contractions, a bipolar cuff electrode ...
Bortezomib/Liposomal doxorubicin (V-DD) is preferred to bortezomib single agent in salvage therapy for Multiple Myeloma (MM). The present study is designed to assessment the efficacy and safety study of Bortezomib in combination with Liposomal Doxorubicin and Dexamethasone in treatment of Plasma Cell Leukemia (PCL). ...
To determine normal blood pressure (BP) in apparently healthy, asymptomatic school children in the age group of 6-16 years and to determine the correlation of BP values with different sex, weight, height, and body mass index (BMI) and also to find out prevalence of hypertension in school going population.</Abstr...
To investigate the genetic causes of idiopathic sporadic prenatal generalized edema.</AbstractText>In a series of 12 patients, in whom in utero generalized skin edema or hydrops fetalis had been diagnosed, we screened 3 lymphangiogenic genes, VEGFR3, FOXC2, and SOX18.</AbstractText>In 3 of the patients, we identified a...
sinus rhythm.. poor r wave progression - probable normal variant. borderline ecg.
sinus rhythm. atrial premature complex. borderline prolonged pr interval. rbbb and lpfb.
Thrombosis of vascular anastomosis in the field of reconstructive microsurgery is a clinical problem of extraordinary importance for the devastating consequences for affected patients. Sildenafil has been shown to be relaxing vascular action on the peripheral vascular system in vivo and have an ability to reduce platel...
The production of odiferous metabolites, such as 2-methlyisoborneol (MIB), is a major concern for water utilities worldwide. Although MIB has no known biological function, the presence of the earthy/musty taste and odor attributed to this compound result in the reporting of numerous complaints by consumers, which under...
BACKGROUND: Previous studies have shown that viable but stunned myocardium displays contractile reserve and exhibits cardiac cycle-dependent variations of integrated backscatter (CVIB), whereas infarcted myocardium does not. HYPOTHESIS: This study was designed to clarify whether assessment of the acoustic properties...
We report a rare finding of a pair of coronary artery anomalies noted on computed tomography coronary angiography in an asymptomatic 75-year-old woman. This patient had a single coronary artery that bifurcated into a left main coronary artery (with an unfavorable interarterial course) and a right coronary artery. T...
<AbstractText Label="BACKGROUND/PURPOSE" NlmCategory="OBJECTIVE">Human parvovirus B-19 (PB-19) is a cause of hemolysis, red blood cell aplasia, and severe conditions in patients with sickle cell anemia, but the molecular mechanisms of the infection are still insufficiently understood. This study aimed to detect PB-19 D...
Beta-blockers (BBs) and angiotensin-converting enzyme inhibitors (ACEIs) have been associated with an increased risk and severity of anaphylaxis. However, the evidence supporting these findings is contradictory.</AbstractText>We carried out a systematic review and meta-analysis of studies that assess the influence of B...
Although A1C is now recommended to diagnose diabetes, its test performance for diagnosis and prognosis is uncertain. Our objective was to assess the test performance of A1C against single and repeat glucose measurements for diagnosis of prevalent diabetes and for prediction of incident diabetes.</AbstractText>We conduc...
The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). RESONATE ¼ Twice-daily Oral Direct Thrombin Inhibitor Dabigatran Etexilate in the Long Term Prevention of Recurrent Symptomatic VTE. See Table 1 and 4 legends for ex...
Residual cardiovascular risk in patients with hypertriglyceridemia, despite optimal low-density lipoprotein cholesterol levels being achieved with intensive statin treatment, is a global health issue. The purpose of this study was to investigate the efficacy and tolerability of treatment with a combination of high-dose...
Type 2 diabetes is preceded by years of insulin resistance and is characterized by reduced bioavailability of the antiatherosclerotic signaling molecule nitric oxide (NO) and premature atherosclerosis. The relationship between resistance to the glucoregulatory actions of insulin and its effects on the vasculature (in p...
Patients with inflammatory rheumatism very often have residual pain that is not easily relieved by conventional treatments. They can then use non-drug methods, such as physiotherapy, hypnosis or even cannabis. The aim of this study is to assess the percentage of patients who use cannabis to better relieve their pain o...
We describe an elderly woman with paroxysmal atrial fibrillation who was evaluated by electrocardiogram-gated multidetector-row computed tomography (MDCT) prior to left atrial radiofrequency ablation therapy to rule out coronary artery disease and to obtain a 3-dimensional anatomical map of the left atrium and pulmonar...
To determine the prevalence of Campylobacter-contaminated transport crates and to determine whether contaminated crates represent a risk for contamination of chickens during transport to slaughter.</AbstractText>Samples were collected from cleaned transport crates before they were dispatched to the farms. Chicken group...
In-hospital hyperglycemia (HH) is frequent and related to higher morbidity and mortality. Despite the benefits of HH treatment, glycemic control is often poor and neglected. The use of health applications to support diagnosis and therapy is now incorporated into medical practice. Medical applications for inpatient glyc...
This is a phase-2 safety trial to demonstrate the ability of frameless stereotactic aspiration and thrombolysis of ICH to safely remove blood.</AbstractText>Patients with ICH in the deep basal ganglia and internal capsule of > 5 cc volume were consented to undergo computed tomographic imaging for frameless stereotac...
BACKGROUND/AIMS: The purpose of this study is to analyze the expression and biological function of lncRNA ANRIL, microRNA-199a, TLR4, and nuclear factor-kappa B (NF-κB) in acute renal injury (AKI) induced by lipopolysaccharide (LPS). METHODS: The levels of ANRIL and microRNA-199a in mouse cells and kidneys were det...
The risks and benefits of a concomitant Maze procedure for patients with LV dysfunction undergoing major cardiac surgery have not yet been elucidated. This study aimed to evaluate the clinical impacts of the Maze procedure in patients with atrial fibrillation and left ventricular (LV) dysfunction.</AbstractText>Between...
sinus rhythm. normal ecg.
Researchers will compare the effects of lidocaine versus air, as a way to fill the breathing tube cuff which is gently inflated to hold in place the trachea (airway) during surgery. Air is the traditional method used to inflate the breathing tube cuff. Researchers wish to find if lidocaine works better than air to faci...
Many centres appear to perform carotid endarterectomy solely based on the findings of duplex scanning. There are two fundamental methods aimed at assessing the stenosis degree during an altrasonographic study, i. e., planimetric examination and Doppler altrasonography. Doppler ultrasonographic criteria have an independ...
<AbstractText Label="PURPOSE/AIM">Intravitreal bevacizumab (Avastin) is an irreversible vascular endothelial growth factor (VEGF) inhibitor used to treat severe retinopathy of prematurity (ROP) in extremely low gestational age neonates (ELGANs). ELGANs who are at the highest risk for developing severe ROP often experie...
sinus bradycardia.. prolonged qt interval. borderline ecg.
The performances of implantable cardioverter defibrillators and leads are important issues for healthcare providers and patients. In 2007 Sprint Fidelis leads were found to be associated with an increased failure rate and so the purpose of the study was to evaluate long-term mortality and clinical outcomes in patients ...
Diabetic retinopathy is the leading cause of blindness in those of working age in the world. However, it is a preventable vision loss. According to current animal studies, it could be hypothesized that using angiotensin-converting enzyme inhibitors could play a crucial role as a protective factor in the progression of ...
Interaction between the complement system and carbon nanotubes (CNTs) can modify their intended biomedical applications. Pristine and derivatised CNTs can activate complement primarily via the classical pathway which enhances uptake of CNTs and suppresses pro-inflammatory response by immune cells. Here, we report that ...
Abdominal aortic aneurysm (AAA) is a common disease caused by segmental weakening of the aortic walls and progressive aortic dilation leading to the eventual rupture of the aorta. Currently no biomarkers have been established to indicate the disease status of AAA. Tenascin-C (TN-C) is a matricellular protein that is sy...
Proteomics is the measurement of one or more protein populations or proteomes, preferably in a quantitative manner. A protein population may be the set of proteins found in an organism, in a tissue or biofluid, in a cell, or in a subcellular compartment. A population also may be the set of proteins with a common charac...
BACKGROUND: Intraoperative and in-hospital mortality after surgery for acute type A dissection depends largely on preoperative conditions, specifically the presence of localized or generalized ischemia. Recently, the Penn classification of patients with acute type A aortic dissection has been described. The primary ...
A field survey was conducted to investigate the presence of Borrelia burgdorferi sensu lato (s.l.) in six counties of Taiwan. Spirochetes were successfully isolated from one rodent ear sample out of 485 rodent ears and 53 live, fed tick (Ixodes granulatus) samples. The spirochetes were confirmed to be B. burgdorferi s....
sinus rhythm. borderline prolonged pr interval. st elevation suggests acute pericarditis.
The investigators propose to test the hypothesis that the incidence of major complications related to infection or inadequate healing is reduced in morbidly obese patients given 80% inspired oxygen during, and for 12-18 hours after, surgery compared with patients given 80% oxygen only during surgery. The primary outcom...
To evaluate the clinical effectiveness and safety of acupoint catgut embedding and acupuncture on simple obesity by Meta-analysis.</AbstractText>Studies on clinical randomized controlled trials of acupoint catgut embedding for simple obesity which were published from January 2015 to November 2020 were searched in Cochr...
sinus rhythm. low qrs voltages in precordial leads. borderline ecg.
Danon disease is a rare disease caused by glycogen storage lysosomal disorder. It is related to the pathogenic mutation of the LAMP2 gene. In this case report, we present a patient with a novel pathogenic mutation (c.764_765insGA) with cardiac-only symptoms. Her family members do not carry the same mutation she doe...
The periodic paralysis (PP) and myotonic syndromes have been recognized as muscle ion channelopathies (MIC) consequent to the discovery of genetic abnormalities of muscle ion channels. Genetic studies are therefore indispensable in the diagnosis of MIC. However, it is not practical to examine all muscle ion channels im...
Myocardial infarction is a major cause of mortality and heart failure worldwide. One of the most effective methods of this injury is direct delivery of cardioprotective drugs to ischemia-reperfusion (IR) myocardium. The aim of the present study was to fabricate an adenosine (Ade) prodrug-based, atrial natriuretic pepti...
sinus rhythm. left ventricular hypertrophy.
BACKGROUND: Management of atrial fibrillation (AF), besides prevention of stroke, mainly stresses symptom control and improvement of quality of life (QOL). In patients with permanent AF, exercising may improve QOL, rhythm, and symptoms. The purpose of this study was to determine the impact of aerobic physical rehab...
Tachycardia and tachyarrhythmias are associated with increased morbidity and mortality in adult patients in the ICU. This study examines the effects of nebulized bronchodilator therapy (albuterol and ipratropium) on heart rate and arrhythmias in this population and tests the proposition that levalbuterol is safer than ...
The aim of this study was to evaluate the functional effects of bridging a gap in the sciatic nerve of the rat with either a biodegradable copolymer of DL-lactide and epsilon-caprolactone [p(DLLA-epsilon-CL)] nerve guide or an autologous nerve graft. Electromyograms (EMGs) of the gastrocnemius (GC) and tibialis anterio...
Patients with existing internal cardioverter defibrillators (ICDs) often require upgrading to a biventricular ICD for treatment of congestive heart failure (CHF). Placement of a left ventricular (LV) lead can be technically challenging in the best of circumstances. A subclavian vein stenosis or occlusion related to pre...
Patients with chronic kidney disease (CKD) experience poor outcomes after acute myocardial infarction. This study investigated how CKD affects clinical outcomes in patients with non-ST segment elevation myocardial infarction (NSTEMI) receiving PCI.</AbstractText>This retrospective study analyzed record-linked data for ...
Islets of myocytes within fibrofatty scars represent the substrate for reentrant ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC). Electroanatomic mapping can reliably identify such areas.</AbstractText>To prospectively test the association between late and fragmented electrograms withi...
Meta-analysis on immunohistological (IHC) concepts for the detection of inflammatory cardiomyopathy (InfCM) in endomyocardial biopsies (EMB). We included 61 publications, with 10,491 patients (mean age 47.1 years; men 66%) who underwent EMB and IHC evaluation. The 460 control patients were devoid of IHC proof of In...
sinus rhythm. left axis deviation. rbbb with left anterior fascicular block. left ventricular hypertrophy. abnormal ecg.
BACKGROUND: While there are convergent data suggesting that overall cardiovascular mortality is increased in patients with rheumatoid arthritis, the relative contributions of myocardial infarction and stroke remain unclear. AIMS: We sought to clarify this issue by conducting a meta-analysis of cohort studies on myoc...
Our goal was to report the transcatheter closure of a paravalvular leak after transcatheter aortic valve replacement (TAVR) using 3-dimensional (3D) printing.</AbstractText>A 66-year-old man who had undergone transapical and TAVR 2 years ago due to aortic regurgitation, presented with palpitations and shortness ...
sinus rhythm. normal ecg.
This study examined the effects of shiftwork on the cardiovascular system. The blood pressure (BP) and heart rate variability (HRV) of 134 male workers, who worked 8-hour shifts with rapid rotation of shifts at 3-day intervals, were examined for all the three shifts. In addition, the job stress was measured by Karasek'...
Tongxinluo Capsule(TXLC) is a well-known traditional Chinese medicine prescription with effects of tonifying Qi and activating blood based on the Chinese herbal medicine theory that has been recommended as routine adjuvant treatment in patients with coronary heart disease (CHD) in China.</AbstractText>This meta-analysi...
This report describes a 47-year-old woman with human immunodeficiency virus (HIV) and end-stage renal disease on hemodialysis, treated with combination antiretroviral drug therapy, who developed an acute, severe type B lactic acidosis 24 hours after homograft root replacement for endocarditis. She fully recovered a...
sinus rhythm with borderline 1st degree a-v block. leftward axis. rsr'(v1) - probable normal variant. inferior infarct - age undetermined. septal t wave changes are nonspecific. abnormal ecg.
A full-term, female neonate developed acute hypoxemic respiratory failure complicated by persistent pulmonary hypertension of the newborn (PPHN), and responded to high-frequency oscillatory ventilation (HFOV) and inhaled nitric oxide (iNO). Discontinuation of iNO was attempted three times and was followed by severe des...
Patients with Turner syndrome (TS) are at an increased risk of morbidity and mortality from cardiovascular disease. This study was undertaken to establish the prevalence of hypertension in patients with TS and to establish to what extent cardiovascular or renal abnormalities contribute to the measured blood pressure.</...
<b>Purpose:</b> Left ventricle (LV)-only pacing is non-inferior to biventricular pacing but permanent fusion pacing is needed to ensure cardiac resynchronization therapy (CRT) responsiveness. The role of systematic exercise testing (ET) in these patients has not been established. This study was designed to assess clini...
atrial fibrillation. abnormal ecg.
An emerging body of evidence from in vitro studies and in vivo animal models supports a pathogenic role of antibodies in the development of peripheral neuropathy associated with monoclonal gammopathy of undetermined significance (MGUS). Although the assessment of motor and sensory nerve fiber function is of clinical im...
To study prevalence of androgen deficiency and its relations with clinicopsychological disorders in males with ischemic heart disease (IHD).</AbstractText>A total of 87 males aged 31-60 years (58 with stable angina of effort FCII-III, 29 with progressive angina of effort) participated in the study. Clinical symptoms of...
BACKGROUND AND PURPOSE: Evolution of intracranial aneurysmal disease is known to be related to hemodynamic forces acting on the vessel wall. Low wall shear stress (WSS) has been reported to have a negative effect on endothelial cells normal physiology and may be an important contributor to local remodeling of the a...
We have previously reported that the developing rat cerebellum is affected by hypergravity exposure. The effect is observed during a period of both granule and glial cell proliferation and neuronal migration in the cerebellum and coincides with changes in thyroid hormone levels. The present study begins to address the ...
The coronavirus disease (COVID-19) pandemic has caused 2.69 million deaths and 122 million infections. Great efforts have been made worldwide to promptly develop effective vaccines and reduce morbidity and mortality rates from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Available vaccine...
Evidence suggests that caregivers of people with heart failure (HF) often experience caregiver burden and emotional distress. However, these studies measured the caregiving experience using generic tools since a disease-specific tool was not available. Recently, the Dutch Objective Burden Inventory (DOBI) was devel...
Here we present an open-source solution, comprising several 3D-printable mechanical pieces and software tools, for frameless stereotaxic targeting in young and adult pigs of varying weights.</AbstractText>Localization was achieved using an IR camera and CT imaging. The positions of the tools were followed, after regist...
South Asian refugees experience a high risk of obesity and diabetes yet are often underrepresented in studies on chronic diseases and their risk factors. The gut microbiota and gut permeability, as assessed through circulating lipopolysaccharide binding protein (LBP), may underlie the link between chronic inflammation ...
Multifactorial diseases refer to diseases having a genesis known to be influenced both by the genome and the environment. Examples include cardiovascular diseases, asthma, autoimmune diseases and various neurological and psychiatric diseases. Technical development has made possible a considerably more accurate measurem...
Data suggest that renal denervation (RDN) in treatment-resistant hypertension (TRHT) is safe in terms of renal function. However, most studies report kidney function as creatinine-based estimated glomerular filtration rate (eGFR), which may be biased by non-renal factors. Damage markers other than albuminuria have ...
Bulk and magnetic core-shell Molecularly Imprinted Polymers (MMIPs) have been introduced and compared to extract and determine amiodarone from a complex matrix, i.e., plasma, due to the importance of Therapeutic Drug Monitoring (TDM). Polymer synthesis was confirmed by FTIR, AFM, TGA, DLS, VSM, TEM, and the adsorption ...
The aim of the study was to describe our experience using a modified nasal cannula to deliver nasal continuous positive airway pressure and/or nasal intermittent positive pressure ventilation during primary neonatal resuscitation of preterm and term newborns.</AbstractText>Data were collected retrospectively for all ne...
RATIONALE: Photodynamic therapy uses light and drugs that make cancer cells more sensitive to light to kill tumor cells. This may be an effective treatment for esophageal cancer. PURPOSE: Phase II trial to study the effectiveness of photodynamic therapy in treating patients with Barrett's esophagus who have in situ es...
sinus tachycardia. probable left atrial enlargement.
This is a report on a new clinical symptom manifested in the form of an asymmetrical pattern of pulsation in the cervical vessels in healthy people. A study included 820 healthy people of different sex and age, including 40 children. The physiological asymmetry of the jugular veins was demonstrated.
OBJECTIVE: Waiting time is inevitable during cardiovascular (CV) care. This study examines whether waiting room-based CV education could complement CV care. METHODS: A 2:1 randomised clinical trial of patients in waiting rooms of hospital cardiology clinics. Intervention participants received a series of tablet-deli...
It has been reported that chronic inflammation of the vessel wall is a hallmark of atherosclerosis. Interleukin-6 (IL-6) is regarded as an important modulator of inflammatory events occurring during all stages of atherogenesis. Although many factors that induce IL-6 expression have been identified, the effect of homocy...
To investigate the effects of acute caffeine (CAFF) intake on physical performance in elite women handball players.</AbstractText>A total of 15 elite women handball players participated in a randomized, double-blind study. In 2 different trials, participants ingested either a placebo (cellulose) or 3 mg of CAFF pe...
The multibranched off-the-shelf stent graft is a promising treatment option for thoracoabdominal aortic aneurysm (TAAA). A commercially available, multibranched, off-the-shelf endograft called the t-Branch stent graft has demonstrated favourable midterm outcomes. Another two investigational off-the-shelf endografts, th...
Giant, partially-thrombosed basilar artery (BA) aneurysms are extraordinarily difficult to treat. Due to the high risk of rupture exclusion of these aneurysms from the circulation is imperative. In certain instances, direct clipping is unsuitable, and high-flow bypass and proximal parent vessel clip occlusion is requir...
Hypertrophic cardiomyopathy (HCM) is a disease of the myocardium caused by mutations in sarcomeric proteins with mechanical roles, such as the molecular motor myosin. Around half of the HCM-causing genetic variants target contraction modulator cardiac myosin-binding protein C (cMyBP-C), although the underlying pathogen...
Extending Başar's theory of event-related EEG oscillations, here we hypothesize that even in quiet wakefulness, transient increases in delta rhythms may enhance global cortical arousal as revealed by the desynchronization of alpha rhythms in normal (Nold) seniors with some derangement in Alzheimer's disease demen...
HMG-CoA reductase inhibitors (statins) have antiatherogenic effects beyond their cholesterol-lowing effect. Whether atorvastatin has a stronger antioxidant effect than other statins is uncertain.</AbstractText>To determine the effects of simvastatin and atorvastatin on markers of oxidative stress in patients with coron...
The diagnostic and therapeutic strategy for acute pulmonary thromboembolism (APTE) was published by the Japanese Circulation Society. But in Japan, there has been no report on how to improve the pre-test probability in APTE-suspected cases, to determine a practically available diagnostic strategy, nor has been a report...
To report the use of a branched, balloon-deployable stent-graft to treat abdominal aortic aneurysm (AAA) in the setting of a solitary kidney.</AbstractText>A 72-year-old man with a solitary intrapelvic kidney and multiple comorbid conditions was diagnosed with an asymptomatic 5.3-cm abdominal aortic aneurysm (AAA); the...
Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors reduce low-density lipoprotein (LDL) cholesterol and cardiovascular event rates, yet due to their high price remain underutilized and difficult to prescribe in clinical practice. In March 2018, their price was significantly reduced. We evaluated whether t...
Maladaptive neuroplasticity-related learned response in substance use disorder (SUD) can be ameliorated using noninvasive brain stimulation (NIBS); however, inter-individual variability needs to be addressed for clinical translation.</AbstractText>Our first objective was to develop a hypothesis for NIBS for learned res...

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