Miracle-dz/UniFAR-FTUs huggingface dataset:
An education program for risk factor management after an acute coronary syndrome: a randomized clinical trial.

IMPORTANCE Lifestyle improvements after an acute coronary syndrome reduce cardiovascular risk but are difficult to achieve. OBJECTIVE To determine whether a nurse-led or dietician-led cardiovascular risk factor education program would improve risk factor reduction over the long term after an acute coronary syndrome. DESIGN, SETTING, AND PARTICIPANTS The Réseau Insuffisance Cardiaque (RESICARD) PREVENTION: study was a 2-arm, parallel-group, multicenter, randomized clinical trial at 6 tertiary care hospitals in France. Patients hospitalized in a cardiac intensive care unit for an acute coronary syndrome with at least 1 lifestyle risk factor (current smoking, sedentary lifestyle, or overweight or obesity) were randomized according to a computer-generated list with sequentially numbered, sealed envelopes. INTERVENTION Patients underwent an education program in a unique non-hospital setting (a House of Education) or were treated according to physicians' usual standard of care. MAIN OUTCOMES AND MEASURES The primary outcome was a composite that included at least 1 of the following: smoking cessation, at least 3 hours per week of physical activity, at least 5% reduction in weight, and at least 4% reduction in waist circumference. Patients were followed up for 1 year. An intent-to-treat analysis was performed. RESULTS From June 21, 2006, to July 30, 2008, a total of 251 patients were randomized to the House of Education and 251 to conventional care. The 2 groups did not differ significantly at 12 months in the primary composite outcome (51.8% vs 49.8% success rate; adjusted relative risk [aRR], 1.11; 95% CI, 0.90-1.37) or with correction of all risk factors (aRR, 1.22; 95% CI, 0.89-1.66). Similarly, the 2 groups did not differ by physical activity (aRR, 1.05; 95% CI, 0.92-1.21), smoking cessation (aRR, 0.99; 95% CI, 0.87-1.13), and weight or waist reduction (aRR, 1.07; 95% CI, 0.84-1.36). CONCLUSIONS AND RELEVANCE Compared with conventional care, the House of Education did not result in superior improvement in lifestyle-related cardiovascular risk factors after an acute coronary syndrome. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00337480.
Oocyte cryopreservation: where are we now?

INTRODUCTION Since the first live birth from oocyte cryopreservation three decades ago, oocyte cryopreservation has become an important component of ART. Cryopreservation techniques have evolved, leading to higher success rates and the introduction of oocyte cryopreservation into IVF clinics worldwide. Concurrently, there has been an increase in patient demand, especially for so-called 'social egg freezing' that allows women to preserve their fertility in anticipation of age-related fertility decline. This review addresses a need to evaluate the current status of oocyte cryopreservation. It explores current techniques and success rates, clinical applications, the rise of elective oocyte cryopreservation, and future implications. METHODS A search was performed using Web of Science and PubMed databases for publications between January 1980 and December 2015. Keywords used included 'egg freezing', 'oocyte freezing', 'oocyte cryopreservation', 'oocyte vitrification', and 'fertility preservation'. RESULTS The success rate of oocyte cryopreservation has risen, and the increasing use of vitrification offers has improved outcomes, with IVF pregnancy rates now similar to those achieved with fresh oocytes. There are conflicting opinions about the comparative success rates of open and closed vitrification. Patients are accessing and receiving oocyte cryopreservation for a wide range of indications, and there has been a marked increase in patient numbers and oocyte cryopreservation cycles. Oocyte cryopreservation for circumventing age-related infertility is becoming more widely accepted. CONCLUSION Oocyte cryopreservation is an established component of ART, with vitrification now being the cryopreservation technique of choice. Increasing numbers of women undergo oocyte cryopreservation for both medical and social reasons. It is important to continue auditing outcomes and reporting long-term follow-up of children born from frozen-thawed oocytes.
Tubal anastomosis after previous sterilization: a systematic review

BACKGROUND Female sterilization is one of the most common contraceptive methods. A small number of women, however, opt for reversal of sterilization procedures after they experience regret. Procedures can be performed by laparotomy or laparoscopy, with or without robotic assistance. Another commonly utilized alternative is IVF. The choice between surgery and IVF is often influenced by reimbursement politics for that particular geographic location. OBJECTIVE AND RATIONALE We evaluated the fertility outcomes of different surgical methods available for the reversal of female sterilization, compared these to IVF and assessed the prognostic factors for success. SEARCH METHODS Two search strategies were employed. Firstly, we searched for randomized and non-randomized clinical studies presenting fertility outcomes of sterilization reversal up to July 2016. Data on the following outcomes were collected: pregnancy rate, ectopic pregnancy rate, cost of the procedure and operative time. Eligible study designs included prospective or retrospective studies, randomized controlled trials, cohort studies, case-control studies and case series. No age restriction was applied. Exclusion criteria were patients suffering from tubal infertility from any other reason (e.g. infection, endometriosis and adhesions from previous surgery) and studies including <10 participants. The following factors likely to influence the success of sterilization reversal procedures were then evaluated: female age, BMI and duration and method of sterilization. Secondly, we searched for randomized and non-randomized clinical studies that compared reversal of sterilization to IVF and evaluated them for pregnancy outcomes and cost effectiveness. OUTCOMES We included 37 studies that investigated a total of 10 689 women. No randomized controlled trials were found. Most studies were retrospective cohort studies of a moderate quality. The pooled pregnancy rate after sterilization reversal was 42-69%, with heterogeneity seen from the different methods utilized. The reported ectopic pregnancy rate was 4-8%. The only prognostic factor affecting the chance of conception was female age. The surgical approach (i.e. laparotomy [microscopic], laparoscopy or robotic) had no impact on the outcome, with the exception of the macroscopic laparotomic technique, which had inferior results and is not currently utilized. For older women, IVF could be a more cost-effective alternative for the reversal of sterilization. However, direct comparative data are lacking and a cut-off age cannot be stated. WIDER IMPLICATIONS In sterilized women who suffer regret, surgical tubal re-anastomosis is an effective treatment, especially in younger women. However, there is a need for randomized controlled trials comparing the success rates and costs of surgical reversal with IVF.
Overdiagnosis in low-dose computed tomography screening for lung cancer.

IMPORTANCE Screening for lung cancer has the potential to reduce mortality, but in addition to detecting aggressive tumors, screening will also detect indolent tumors that otherwise may not cause clinical symptoms. These overdiagnosis cases represent an important potential harm of screening because they incur additional cost, anxiety, and morbidity associated with cancer treatment. OBJECTIVE To estimate overdiagnosis in the National Lung Screening Trial (NLST). DESIGN, SETTING, AND PARTICIPANTS We used data from the NLST, a randomized trial comparing screening using low-dose computed tomography (LDCT) vs chest radiography (CXR) among 53 452 persons at high risk for lung cancer observed for 6.4 years, to estimate the excess number of lung cancers in the LDCT arm of the NLST compared with the CXR arm. MAIN OUTCOMES AND MEASURES We calculated 2 measures of overdiagnosis: the probability that a lung cancer detected by screening with LDCT is an overdiagnosis (PS), defined as the excess lung cancers detected by LDCT divided by all lung cancers detected by screening in the LDCT arm; and the number of cases that were considered overdiagnosis relative to the number of persons needed to screen to prevent 1 death from lung cancer. RESULTS During follow-up, 1089 lung cancers were reported in the LDCT arm and 969 in the CXR arm of the NLST. The probability is 18.5% (95% CI, 5.4%-30.6%) that any lung cancer detected by screening with LDCT was an overdiagnosis, 22.5% (95% CI, 9.7%-34.3%) that a non-small cell lung cancer detected by LDCT was an overdiagnosis, and 78.9% (95% CI, 62.2%-93.5%) that a bronchioalveolar lung cancer detected by LDCT was an overdiagnosis. The number of cases of overdiagnosis found among the 320 participants who would need to be screened in the NLST to prevent 1 death from lung cancer was 1.38. CONCLUSIONS AND RELEVANCE More than 18% of all lung cancers detected by LDCT in the NLST seem to be indolent, and overdiagnosis should be considered when describing the risks of LDCT screening for lung cancer.
Comparison of four established questionnaires to identify highway bus drivers at risk for obstructive sleep apnea in Turkey

In Turkey, all heavy-vehicle driver’s license applicants older than 45 years and with body mass index (BMI) >25 kg/m2 are required to have polysomnography (PSG). However, this law is usually overlooked in practice due to the large number of applications. We aimed to assess the usefulness of four standardized questionnaires: Berlin, STOP, STOP-BANG and OSA50, in identifying the high-risk bus drivers for obstructive sleep apnea (OSA). Ninety highway bus drivers underwent polysomnography and completed four questionnaires. They also underwent otolaryngologic evaluation and blood testing for probable co-existing conditions such as diabetes and hypothyroidism. Neck circumference, BMI, waist circumference, prevalence of OSA and metabolic syndrome, oxygen desaturation index and duration of sleep associated with less than 90% saturation were significantly higher and mean oxygen saturation was significantly lower in drivers >45 years old than drivers <45 years old. STOP-BANG questionnaire had the highest sensitivity (87%) and the highest negative predictive value (NPV) (76%) in identifying high-risk for OSA. A cut off of 45 years old is suitable in screening highway bus drivers for OSA. Among the four questionnaires, STOP-BANG questionnaire had the highest sensitivity and negative predictive value (NPV) in identifying high risk patients for OSA in highway bus drivers and can be safely used as a screening test in this group.
Comparative Evaluation of Two Staining Techniques for Detection of Tubercular Bacilli in Lymphnodal Aspirates.

Tuberculosis is an ancient infection that has plagued humans since times immemorial and continues to remain a major public health problem especially in developing countries like India. Emergence of AIDS has added fuel to the existing fire of tuberculosis. The magnitude of the problem is so huge that it warrants rapid and accurate diagnosis to limit its spread. Objective: Study was conducted to compare standard Ziehl-Neelsen (ZN) staining technique with Bleach method of concentration for demonstrating tubercular bacilli in lymph node aspirates of suspected tubercular lymphadenitis. Results: FNA smears from 125 patients suspected clinically of tubercular lymphadenopathy were studied. Of 125 cases, 111 were diagnosed as tuberculosis and 14 as suppurative lymphadenitis. Among 111 cases of tuberculosis, 47 showed pattern 1 (Epithelioid cell granulomas with caseous necrosis); 41 showed pattern 2 (Epithelioid cell granuloma without caseous necrosis) and 24 showed pattern 3 (necrosis alone) on cytomorphology. In pattern 1, 38% were positive by ZN stain and 49% were positive by Bleach method. Out of 14 cases of suppurative lymphadenitis all were negative for tubercular bacilli on ZN stain but 3 showed positivity on Bleach method. On ZN stain smear, positivity for AFB was 22.4% but it increased to 28.8% on Bleach method. Conclusion: Bleach method for detection of tubercular bacilli in lymphnode aspirates is more sensitive than the conventional ZN method. It is simple, inexpensive, affordable method that requires little additional expertise than required for conventional ZN staining. Moreover, this method effectively kills the tubercular bacilli, rendering the specimen safe to handle and reducing the risk of laboratory infection.
Co-option of pre-existing pathways during Rhizobium-legume symbiosis evolution

Fixed nitrogen is one of the most limiting factors for plant growth. One of the most important nitrogen-fixing systems is the rhizobium root nodule symbiosis. In this Thesis I have studied the legume-rhizobium symbiosis, starting from the idea that part of pre-existing signalling pathways have been co-opted during evolution of this mutualistic interaction. Gene duplications -of which a whole genome duplication (WGD) is the most dramatic variant- are known as important driving forces in evolution of new traits. 56 to 65 million years ago an ancestral legume species within the Papilionoidae subfamily (Papilionoids) experienced a WGD event and subsequently gave rise to several major phylogenetic crowns. I hypothesize that among the orthologous gene pairs maintained are genes that are essential for nodulation. I adopted a phylogenetic strategy to identify new candidate genes involved in the legume-Rhizobium symbiosis In a targeted approach, we focussed on the cytokinin phosphorelay pathway. This resulted in the identification of one gene pair encoding type-A Response Regulators (RRs) with a positive regulatory role for these proteins in root nodule formation. Yet the illustrated role for MtRR9 and MtRR11 in rhizobial symbiosis provides a proof of principle of this method to identify gene pairs involved in legume specific characters. An unbiased search for paralogous gene pairs revealed two conserved gene duplications in the NADPH oxidases gene family. NADPH oxidases are reactive oxygen species (ROS) producing enzymes. We identified two sets of duplicated genes that have been maintained after the Papilionoid specific WGD and we show that MtRBOHA and MtRBOHG are redundant, yet essential during symbiosis. Moreover, although it is commonly believed that exclusively pericycle cells give rise to the lateral root primordium, similar as seen in Arabidopsis thaliana, we provide morphological evidence that in the studied legume species this is not the case. In both, Lotus and Medicago, also root cortical cell divisions occur during lateral root formation. Furthermore, we found a striking correlation in the cell layers that are recruited during lateral root and nodule primordium formation. This supports the hypothesis that at least parts of the lateral root developmental program have been recruited during evolution of symbiotic root nodules.
Early Childhood Special Education and Early Intervention Personnel Preparation Standards of the Division for Early Childhood

Results of the field validation survey of the revised initial and new advanced Council for Exceptional Children (CEC) Division for Early Childhood (DEC) early childhood special education (ECSE)/early intervention (EI) personnel standards are presented. Personnel standards are used as part of educational accountability systems and in teacher personnel preparation program accreditation to train highly qualified teachers. DEC and the National Association for the Education of Young Children (NAEYC) members were partners in the validation survey. The method and survey procedures are described along with the knowledge and skill standards selected as essential and retained in the final DEC ECSE/EI approved sets of standards. Purposeful sampling was used to select DEC respondents for their knowledge and expertise in personnel preparation and operation of ECSE/EI and early childhood education (ECE) programs. Results from the DEC and NAEYC respondents are compared and contrasted. Challenges and limitations are discussed.
Predictors of Large Women's Satisfaction with Health Care

This cross-sectional observational study identifies specific predictors of large women's satisfaction with health care and participation in preventive care as measured by pelvic screening examinations. A total of 87 large adult women completed a survey, including measures of self-objectification, affective experience, satisfaction with health care, and health care locus of control. Multiple regression analysis was employed to analyze results. The hypotheses of this study were as follows: (1) BMI, self-objectification, negative affect and locus of control will predict satisfaction with medical care; (2) pelvic screening examinations and patient satisfaction with medical care will be positively related (3) self-objectification and negative affect will be positively related; (4) self-objectification and external locus of control will be positively related; (5) negative affect and external health locus of control will be positively related. Participation in preventive care reduces morbidity and mortality associated with disease. Understanding predictors of large women's satisfaction with medical care is a good first step toward improving large women's participation in health care. Large Women and Health Care VI Table of
Benefits of participation in diabetes group visits after trial completion.

PTAPM-96-156-16) from the American Cancer Society (ACS). Disclaimer: The contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA or ACS. Previous Presentation: The results of this analysis were presented in poster form at the Society for General Internal Medicine 2012 meeting; May 10, 2012; Orlando, Florida. Online-Only Material: The eTable is available at http: //www.jamainternalmed. com.
The Public and the Opioid-Abuse Epidemic.

The Public and the Opioid-Abuse Epidemic A majority of the U.S. public considers addiction to prescription pain medication a major problem but does not deem it a national emergency. And only about half of the public believes there’s a treatment for prescription-painkiller addiction that’s effective in the long term.
Decision-Making in the Leech Nervous System1

Abstract Previous models of behavioral choice have described two types of hierarchy, a decision hierarchy, in which different classes of decisions are made at each level (Tinbergen, 1951), and a behavioral hierarchy, in which one behavior will take precedence over others (Davis, 1985). Most experimental work on the neuronal basis of decision-making has focussed on the latter of these: a behavioral hierarchy is described for an animal, and the neuronal basis for this hierarchy, hypothesized to depend on inhibitory interactions, is investigated. Although the concept of “dedicated command neurons” has been useful for guiding these studies, it appears that such neurons are rare. We present evidence that in the leech, most neurons, including high-level decision neurons, are active in more than one behavior. We include data from one newly-identified neuron that elicits both swimming and crawling motor patterns. We suggest that decisions are made by a “combinatorial code”: what behavior is produced depends on the specific combination of decision neurons that are active at a particular time. Finally, we discuss how decision neurons may be arranged into a decision hierarchy, with neurons at each sequential level responsible for choosing between a narrower range of behaviors. We suggest additional sensory information is incorporated at each level to inform the decision.
The dietary intake of 2-year-olds born to overweight or obese mothers and the predictors of their body mass index

The prevalence of overweight among 2-5 year olds has increased from 7.2% in 1988-94 to 13.9% in 2003-2004. Prior research has shown that children of overweight mothers are at increased risk for overweight. The purpose of this study was to determine the dietary intake and predictors of the body mass index (BMI) of 2-year-old children born to overweight/obese mothers. Participants were recruited from the Active Mothers Postpartum study, which sought to promote postpartum weight loss in women who were overweight or obese prior to pregnancy. Infant feeding information was obtained at 12 months postpartum, and a lactation score was calculated. Weight and height measurements were taken at 2 years postpartum on mothers and their children. Two 24-hour dietary recalls were obtained from the mother for their 2-year-old children. Food group and nutrient intakes were compared with MyPyramid and Dietary Reference Intake recommendations. Selected variables were used to determine the predictors of BMI at 2 years of age. Dietary information was provided by 243 participants. Twenty three percent and 22% of the children were at risk for overweight or overweight, respectively. Overweight children consumed more vegetables, 100% juice, and desserts. Recommendations for nutrient intakes were met except for dietary fiber. Overweight children consumed more kcal/d, but normal weight children more kcal/kg body weight. Infant feeding information was provided by 288 participants. Twenty two percent and 25% of the children were at risk for overweight or overweight, respectively. Breastfeeding, maternal education, gender, and birth weight significantly predicted child's BMI. High intensity/duration of breastfeeding, and higher education predicted a decrease in child BMI. Females had a lower BMI than males, and an increased birth weight predicted an increase in child BMI. Increased consumption of desserts and sweets predicted an increase in child BMI, however it was not significant. This research indicates that high intensity/duration of breastfeeding may have an effect on a child's BMI at age 2. Furthermore, the higher kcal/kg intake of normal weight children suggests they are more physically active than the at risk for overweight and overweight children.
Health Knowledge and Health Promoting Lifestyle Among Women of Childbearing age in Shiraz

Results: The results of the study indicated a significant association between health knowledge (r = 0.225, P = 0.000), rate of study in health matters (r = 0.341, P = 0.000), women’s education (r = 0.109, P = 0.035), husbands’ education (r = 0.182, P = 0.005), and socio-economic class (Spearman’ rho = 0.154, P = 0.000) and Health Promoting lifestyle (HPLS). In addition, age and education affected HPLS through health knowledge. There was no significant association between age, age at marriage, family size, marital status, experience of abortion and occupation with Health Promoting lifestyle. Conclusions: Knowledge automatically creates the desired changes in behavior. Health professionals and health education programs have to increase awareness of healthy lifestyle behaviors that enables people to apply this knowledge in their everyday lives. Therefore, the goal of health policy should be promoting the health knowledge of the population.