Miracle-dz/UniFAR-FTUs huggingface dataset:
Neighbourhoods for life: Designing dementia‐friendly outdoor environments

Design for dementia has, to date, focused on the internal, generally institutional environment of care homes and dementia care facilities. Yet the majority of older people with dementia live at home, around one third of these on their own. Unless outdoor environments are designed to help older people with dementia continue to use their local neighbourhoods they will become effectively housebound. This paper presents the findings of a three‐year research project conducted by the WISE (Wellbeing in Sustainable Environments) research unit of the Oxford Institute for Sustainable Development at Oxford Brookes University. The researchers were funded by the EPSRC EQUAL initiative to examine how the outside environment could be made dementia friendly. This unprecedented research investigated the perceptions, experiences and use of the outdoor environment by older people with dementia and identified design factors that influence their ability to successfully use and negotiate their local neighbourhoods. The research found that dementia‐friendly outdoor environments are places that are familiar, legible, distinctive, accessible, comfortable and safe. The findings have enabled the researchers to provide some preliminary recommendations for designers, at all scales from urban design to the design of street furniture, on the criteria to consider in developing dementia‐friendly urban areas.
Fleur-de-Lis abdominoplasty: a safe alternative to traditional abdominoplasty for the massive weight loss patient.

BACKGROUND Traditional abdominoplasty techniques often fail to adequately correct the complex contour deformities in the massive weight loss patient. To address these deformities, addition of a vertical skin resection to the traditional horizontal excision has become a popular procedure. The authors analyzed the impact of vertical (fleur-de-lis) excision on complications when compared with traditional transverse excision. METHODS A review of massive weight loss patients enrolled in an institutional review board-approved prospective registry was performed on consecutive patients undergoing abdominoplasty by a single surgeon. Patients were included if they underwent at least 50 pounds of weight loss. Demographic information, procedural data, and outcome measures were studied. Logistic regression and t tests were performed to analyze differences in complication rates for both procedures and identify risk factors for complications. RESULTS Four hundred ninety-nine patients met inclusion criteria, of whom 154 (31 percent) had a fleur-de-lis vertical component. The overall abdominal complication rate for all patients was 26.3 percent, with a 5.0 percent rate of major complications. Transverse-only and fleur-de-lis abdominoplasty had similar rates of complications with the exception of a higher rate of wound infection in the fleur-de-lis group on multivariate analysis. Risk factors for abdominal wound complications with either procedure included male sex, high body mass index, concurrent component separation, and previous subcostal scars. CONCLUSIONS Fleur-de-lis abdominoplasty can be safely performed with complication rates comparable to those of traditional abdominoplasty techniques. Ideal candidates are patients with upper abdominal skin laxity who may not achieve an adequate aesthetic result with transverse-only excision.
Intracranial Compartment Volume Changes in Sagittal Craniosynostosis Patients: Influence of Comprehensive Cranioplasty

Background: A retrospective analysis of intracranial compartment volume changes in children with sagittal craniosynostosis was performed to clarify the therapeutic objectives of corrective surgery. Methods: Chart and computed tomographic review of 53 consecutive children with previously unoperated sagittal synostosis was performed, and preoperative and postoperative computed tomographic scans were examined and compared with 143 age- and gender-matched controls. Results: Preoperative mean intracranial compartment volume and mean brain tissue volume of each subgroup were age dependent. Brain volume was less in unoperated male sagittal synostosis patients (<6 months old) compared with controls (672.63 ml versus 716.14 ml). Brain tissue volume was approximately the same as controls for the 7- to 12-month and 12- to 30-month age groups. Long-term brain volume, however, again became less than controls with longer periods without treatment (31 to 60 months, 1050.6 versus 1291.51 ml, respectively). Intracranial compartment volume was less in unoperated male sagittal synostosis patients (<6 months old) compared with controls (706.6 ml versus 757.76 ml). Preoperative mean intracranial compartment volume, however, was greater than in controls in the 7- to 12-month (979.78 versus 970.34 ml) and 13- to 30-month age groups (1108.23 versus 1177.52 ml). Long term (31 to 60 months), however, intracranial compartment volume was less in untreated sagittal synostosis patients (1206.3 ml versus 1311.37 ml). Comparing day-1 postoperative sagittal synostosis patient data to age- and gender-matched controls to 1 year postoperatively, the operated patients develop an equivalent increase in skull growth compared with normals. Conclusions: Intracranial compartment volume is increased preoperatively in untreated sagittal synostosis patients older than 6 months. Intracranial compartment volume enlargement is largely attributable to an increase in brain volume. Comprehensive cranioplasty before 12 months of age increases intracranial compartment volume over normal growth.
Screening for the C9ORF72 repeat expansion in a greek frontotemporal dementia cohort

Abstract The C9orf72 repeat expansion is a common genetic cause of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) in European populations. A previous study has reported a high frequency of the expansion in Greek ALS. However, no data have been reported on the frequency of the expansion in Greek FTD. Currently, we investigated the frequency of the C9orfF72 expansion in a well-characterized cohort of 64 Greek FTD patients. We detected the C9orf72 repeat expansion in 9.3% of cases. Overall, 27.7% of familial and 2.2% of sporadic cases were expansion-positive. Five out of 6 cases had a diagnosis of behavioral variant FTD. All expansion-positive cases had fairly typical FTD presentations. Clinical features included motor neuron disease, Parkinsonism and hallucinations. We conclude that the overall frequency of C9orf72-positive cases in Greek FTD is high, comparable to Greek ALS, similar to some Western European, but significantly higher than some Mediterranean FTD populations.
Pre-diagnostic plasma urate and the risk of amyotrophic lateral sclerosis

Abstract Objective: To prospectively examine for the first time the association between plasma urate levels measured in healthy participants and future amyotrophic lateral sclerosis (ALS) risk. Methods: A pooled case-control study nested in five US prospective cohorts comprising 319,617 participants who provided blood, of which 275 had ALS during follow-up. Pre-diagnostic plasma urate was determined for all participants using a clinical colorimetric enzyme assay. Gender-specific multivariable-adjusted rate ratios (RR) of ALS incidence or death estimated by conditional logistic regression and pooled using inverse-variance weighting. Results: In age- and matching factor-adjusted analyses, a 1 mg/dL increase in urate concentration was associated with RR = 0.88 (95% CI: [0.78, 0.997] p = 0.044). After adjustment for BMI, a strong predictor of ALS and urate levels, and other potential covariates, the RR = 0.89 (95% CI: [0.78, 1.02]; p = 0.08 for 1mg/dL increase in urate). Conclusion: Elevation of plasma urate was modestly inversely associated with the risk of ALS and warrants further study for a potential role in this disease.
Effects of sulpiride on mRNA levels of steroid 5α‐reductase isozymes in prostate of adult rats

Prolactin (PRL) is implicated in prostate growth and in the development and regulation of benign prostatic hypertrophy (BPH) and prostate cancer (PCa). PRL may exert its effects on prostate in synergism with androgens. The most active androgen in the prostate is the 5α‐dihydrotestosterone (DHT) obtained from testosterone by the 5α‐reductase (5α‐R) enzyme, which is expressed in the prostate as two isozymes, 5α‐R1 and 5α‐R2. In this study, sulpiride, a prolactin‐secretion inductor, was administered to male rats. mRNA levels of 5α‐R1 and 5α‐R2 were measured in prostate of controls and sulpiride‐treated rats, using one‐step quantitative RT‐PCR coupled with laser‐induced fluorescence capillary electrophoresis (LIF‐CE). Results demonstrated that sulpiride‐induced hyperprolactinemia is associated with an increase in mRNA levels of both 5α‐R1 and 5α‐R2 in prostate of adult rats. Although a direct effect of sulpiride on prostate gland cannot be ruled out, hyperprolactinemia may be a factor to be considered in aging males, in whom prostatic diseases such as BPH and PCa are more frequent. © 2007 IUBMB IUBMB Life, 60(1): 68–72, 2008
Anatomical considerations for the extreme lateral (XLIF) approach

The purpose of this paper is to review the surgical technique, anatomical considerations and clinical outcomes of the extreme lateral interbody fusion (XLIF). With substantial technological innovation and refinement in surgical technique, the field of minimally invasive surgery in the lumbar spine has seen remarkable growth over the past 20 years. Disadvantages of the posterior and anterior approaches to the lumbar spine have led to the popularization of the lateral retroperitoneal transpsoas approach. The XLIF approach may be used throughout the lumbar spine (L1/2–L4/L5); however, the most notable concern with the XLIF and generally with the lateral transpsoas approach relates to the proximity of the approach, and thus consequent injury to the lumbar plexus and genitofemoral nerve. Several studies have reported the anatomy of the lumbar plexus and its relation to the far lateral approach. These studies are outlined in the body of the text. Because of its recent popularization, limited data exist regarding the clinical outcomes of the XLIF approach; however, preliminary reports look encouraging. Reported benefits include significant reductions in hospital stay, time to ambulation, postoperative narcotic use and postoperative visual analog scale scores. Several early reports have focused on the XLIF's ability to achieve correction of spinal deformity. Although mostly transient in nature, the XLIF approach carries risk for injury to the psoas muscle, the genitofemoral nerve and the nerves of the lumbar plexus. The lateral transpsoas approach is an excellent option and effective means for gaining access to the anterior lumbar spine over the conventional anterior transperitoneal approach. Long-term prospective clinical outcomes data are still required before comparisons to the more traditional approaches for lumbar fusion can be made.
Comparison of intra‐arterial digital subtraction angiography using carbon dioxide by ‘home made’ delivery system and conventional iodinated contrast media in the evaluation of peripheral arterial occlusive disease of the lower limbs

To prospectively compare the feasibility, safety and diagnostic role of carbon dioxide (CO2) digital subtraction angiography (DSA) using a ‘home made’ delivery system with iodinated contrast medium (ICM) DSA in the evaluation of peripheral arterial occlusive diseases (PAOD) of lower limbs. Twenty‐one patients (27 limbs; all men; mean age, 47.6 years) who presented with PAOD of lower limbs underwent DSA using both intra‐arterial CO2 and ICM. Conventional ICM DSA was performed first and used as gold standard. Carbon dioxide was then injected by hand using a locally improvised home made plastic bag delivery system. Patient tolerance was assessed subjectively. Arteries from aortic bifurcation to the ankle were independently evaluated by two radiologists and graded for stenosis using a five‐point scale. For each patient, the quality of CO2 DSA images were compared with the corresponding images of ICM DSA and an overall grade of ‘good’, ‘acceptable’ or ‘poor’ was assigned. Cohen’s kappa coefficient was used to determine inter‐observer agreement. Carbon dioxide opacified 86.2% (188/195) of major arteries and depicted stenosis adequately in 84.5% (191/226) of arterial segments. A good or acceptable image quality of CO2 DSA was obtained in over 95% of patients. Infrapopliteal arteries were inadequately visualized. Mild pain was seen in six (28.6%) patients with both contrast agents; one patient developed severe pain during CO2 DSA. Inter‐observer agreement was good (k > 0.75) at 70% of the segments. Administration of CO2 into lower limb arteries is well tolerated. Carbon dioxide DSA using the locally improvised home made delivery system is a feasible and safe alternative to ICM DSA in the evaluation of PAOD. It provides adequate imaging of arteries of lower extremities except infrapopliteal segments.
Social and economic factors influencing the patronage and use of complementary and alternative medicine in Enugu

Traditional Medicine (TM) or Complementary and Alternative Medicine (CAM) covers approaches to medical treatment that are outside of mainstream medical training. Different herbal products abound and they are flagrantly advertised with claims of their ability to cure all diseases. The objective was to survey how safety, reliability, effectiveness, availability, cost, and other socioeconomic factors influence use and patronage of TM as well as check which common diseases are being treated and how the patient felt after the use of TM. A cross sectional communitybased survey using 21-item questionnaire consisting of socio-demographic and stem questions that have been standardized and validated for reliability of response. Four hundred questionnaires were randomly distributed and 300 (75%) were returned and analyzed. 203(68%) of respondents claimed they use TM while 93(31%) claimed they do not. Majority of respondents [108(57.9%)] were 21-40 years old, 26(12.7%) were within 41-50 and 40(19.7%) above 50years. There were 117 females and 86 males. 26(12.7%) of the respondents had at least primary education, while 16% used traditional medicine because it is cheaper and 31.3% because it is believed to cure many diseases. Malaria treatment 128(33%) was highest followed by typhoid 79(20.5%), sexually transmitted disease 31(8.1%), diabetes 25 (6.0%) and infertility 25(6.2%). Malaria and typhoid were the highest co-morbid infection treated with TM. Socio-economic factors such as cost, effectiveness, availability, safety of the product, educational level, average monthly income, age and sex affect the patronage and use of traditional medicine. Keywords: Complementary and alternative medicine, traditional medicine, herbs, socio-economics,
Stone size is a predictor for residual stone and multiple procedures of endoscopic combined intrarenal surgery

Abstract Objectives: The aim of this study was to identify the predictors of treatment results after endoscopic combined intrarenal surgery (ECIRS). Materials and methods: A retrospective analysis was conducted of 75 patients with renal stones who underwent ECIRS and a preoperative non-contrast computed tomography (NCCT) examination. The stone-free rate (SFR), number of primary procedures and perioperative complications were investigated, and the predictors contributing to these three outcomes were analyzed. Stone-free status was determined within 3 months postoperatively using NCCT. The number of primary procedures (defined as ECIRS and/or conventional transurethral lithotripsy) and perioperative complications were reviewed using the medical records. Results: The final SFR after further treatment was 69.3% (52/75 cases). About 70% of all cases underwent only one primary procedure, and the average number of primary procedures was 1.41. From multivariate analysis, increasing stone size (p < 0.001), increasing Charlson Comorbidity Index (p = 0.043) and unfavorable nephrostomy tract (p = 0.046) were independent significant predictors of residual stones, and increasing stone size was the only independent significant predictor of two or more primary procedures (p = 0.017). Overall, 24 out of 75 patients (32%) experienced one or more perioperative complications. Based on multivariate analysis, female gender (p = 0.014) and increasing Hounsfield units (p = 0.006) were significantly associated with perioperative complications. Conclusions: Increasing stone size was an independent predictor for residual stone and multiple procedures of ECIRS. In contrast, increasing number of involved calyces was not predictive, which may be responsible for the combined antegrade and retrograde access. Female gender and increasing Hounsfield units of the stone were significantly associated with perioperative complications of ECIRS, and ECIRS for these patients requires careful attention.
Allosteric properties of hemoglobin and the plasma membrane of the erythrocyte: New insights in gas transport and metabolic modulation

Within the red blood cell the hemoglobin molecule is subjected to modulation mechanisms, namely homo‐ and heterotropic interactions, which optimize its functional behavior to the specific physiological requirements. At the cellular level, these modulation mechanisms are utilized to perform a number of other functions that are not minor with respect to the basic function of oxygen transport. Here we report some key examples concerning: (i) the interaction of hemoglobin with band 3 and its influence on glucose metabolism; (ii) the role of the ligand‐linked quaternary transition of hemoglobin in the control of “NO bioactivity” and of gas diffusion; (iii) the interaction of plasma membrane with the various oxidative derivatives of the hemoglobin molecule. © 2008 IUBMB IUBMB Life, 60(2): 87–93, 2008
Fatal Spontaneous Haemoperitoneum from Rupture of Cirrhotic Liver Nodule

We report a rare case of acute massive fatal spontaneous hemoperitoneum in a 51year old African male. Death occurred suddenly in this patient who had no previous medical history or clinical signs of liver disease and apparently in good health. Autopsy findings showed a massive hemoperitoneum from ruptured cirrhotic liver nodule. Though rupture is a rare complication of liver cirrhosis and other nodular liver diseases, patients should be managed with this possibility in mind.
Surgically induced weight loss results in a rapid and consistent improvement of female pelvic floor symptoms

Abstract Objective: The aim of this study was to evaluate the effect over time of bariatric surgery on female pelvic floor symptoms. Methods: In total, 160 consecutive adult women were requested to complete four anonymous questionnaires [International Consultation on Incontinence Questionnaire (ICIQ), Bristol Female Lower Urinary Tract Symptoms (BFLUTS), Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12)] before bariatric surgery and at 3–6 months and 12–24 months postoperatively. Strict criteria were used to define clinically significant urinary incontinence (UI), pelvic organ prolapse (POP) and colorectal–anal (CRA) symptoms. Statistical analyses were performed using paired, two-sided, Student’s t test for continuous data, and Fisher’s exact test for categorical data. Results: Altogether, 101 women (67%, mean age 41.6 ± 11.8 years, mean preoperative body mass index 41.6 ± 4.6 kg/m²) completed all questionnaires. In women who had preoperative UI (42.6%), mean ICIQ score decreased from 9.5 ± 4.0 at baseline to 3.0 ± 3.6 (p < .001) and 2.9 ± 3.9 (p < .001) at 3–6 and 12–24 months postoperatively, respectively. In women who had preoperative POP symptoms (17.8%), mean PFDI-20/POP score decreased from 23.8 ± 10.9 at baseline to 12.7 ± 12.9 (p = .010) and 13.7 ± 17.1 (p = .025) at 3–6 and 12–24 months postoperatively. In women who had preoperative CRA symptoms (35.6%), mean PFDI-20/CRA score decreased from 26.0 ± 14.9 at baseline to 15.4 ± 15.1 (p = .001) and 18.8 ± 15.4 (p = .045) at 3–6 and 12–24 months postoperatively. De novo postoperative POP and CRA symptoms were reported by up to 16% of patients. Conclusions: Surgically induced weight loss is associated with significant improvements in UI, POP and CRA symptoms. The maximal clinical effect was achieved within 3–6 months, and remained constant throughout the second postoperative year. Nevertheless, de novo POP and CRA symptoms are expected in up to 16% of patients.
Insulin regulates Bbs4 during adipogenesis

Bardet‐Biedl syndrome (BBS) is a pleiotropic autosomal recessive disorder associated with marked obesity, increased susceptibility to insulin resistance and type 2 diabetes. However, it is unknown whether the link between BBS and diabetes is indirect or direct. Adipogenesis and adipocyte function are regulated by hormonal stimuli, with insulin and insulin growth factor (IGF) playing an important role both in normal and impaired conditions. We have previously shown augmented transcript levels of BBS genes upon induction of adipogenesis. The aim of this study was to investigate the role of insulin in BBS. Through in vitro studies in adipocytes in which Bbs4 expression was either silenced (SiBbs4) or overexpressed (OEBbs4), we showed that insulin and IGF dose‐ and time‐dependently decrease transcription and protein expression of BBS genes during adipogenesis. Silencing of Bbs4 expression in adipocytes significantly impaired and reduced glucose uptake. This effect was reversed by Bbs4 overexpression. Inhibition of PI 3‐kinase resulted in upregulation of Bbs transcripts, suggesting that the PI3K pathway is involved in the regulation of these genes. In conclusion, we showed that insulin is a direct regulator of Bbs1, 2, 4 and 6. This hormonal regulation might indicate a metabolic link of these genes to obesity and metabolic syndrome. © 2017 IUBMB Life, 69(7):489–499, 2017
Comparison of face‐to‐face versus interactive video continuing medical education delivery modalities

&NA; The challenge to provide accessible continuing medical education (CME) programs for physicians and other health care providers in rural communities is ongoing. One possible solution to facilitate physician access to CME is through distance instructional media such as interactive video (ITV). A review of the literature revealed that there is a dearth of research investigating the differences in effectiveness between CME programs delivered through ITV and CME delivered in the traditional classroom setting. The purpose of this study was to compare physician perceptions of the effectiveness of CME programs delivered by ITV and CME programs delivered in the traditional classroom setting. Results from the survey indicate that ITV and traditional face‐to‐face CME participants did not feel that the majority of attributes related to the content, speaker, and program were significantly different between the two delivery modalities. The implications from these findings are also discussed.