Miracle-dz/UniFAR-FTUs huggingface dataset:
A Genome‐Wide Search for Type 2 Diabetes Susceptibility Genes in an Extended Arab Family

Twenty percent of people aged 20 to 79 have type 2 diabetes (T2D) in the United Arab Emirates (UAE). Genome‐wide association studies (GWAS) to identify genes for T2D have not been reported for Arab countries. We performed a discovery GWAS in an extended UAE family (N = 178; 66 diabetic; 112 healthy) genotyped on the Illumina Human 660 Quad Beadchip, with independent replication of top hits in 116 cases and 199 controls. Power to achieve genome‐wide significance (commonly P = 5 × 10−8) was therefore limited. Nevertheless, transmission disequilibrium testing in FBAT identified top hits at Chromosome 4p12‐p13 (KCTD8: rs4407541, P = 9.70 × 10−6; GABRB1: rs10517178/rs1372491, P = 4.19 × 10−6) and 14q13 (PRKD1: rs10144903, 3.92 × 10−6), supported by analysis using a linear mixed model approximation in GenABEL (4p12‐p13 GABRG1/GABRA2: rs7662743, Padj‐agesex = 2.06 × 10−5; KCTD8: rs4407541, Padj‐agesex = 1.42 × 10−4; GABRB1: rs10517178/rs1372491, Padj‐agesex = 0.027; 14q13 PRKD1: rs10144903, Padj‐agesex = 6.95 × 10−5). SNPs across GABRG1/GABRA2 did not replicate, whereas more proximal SNPs rs7679715 (Padj‐agesex = 0.030) and rs2055942 (Padj‐agesex = 0.022) at COX7B2/GABRA4 did, in addition to a trend distally at KCTD8 (rs4695718: Padj‐agesex = 0.096). Modelling of discovery and replication data support independent signals at GABRA4 (rs2055942: Padj‐agesex‐combined = 3 × 10−4) and at KCTD8 (rs4695718: Padj‐agesex‐combined = 2 × 10−4). Replication was observed for PRKD1 rs1953722 (proxy for rs10144903; Padj‐agesex = 0.031; Padj‐agesex‐combined = 2 × 10−4). These genes may provide important functional leads in understanding disease pathogenesis in this population.
ISS groups: are we speaking the same language?

Background Despite ISS being a widely accepted tool for measuring injury severity, many researchers and practitioners use different partition of ISS into severity groups. The lack of uniformity in ISS use inhibits proper comparisons between different studies. Creation of ISS group boundaries based on single AIS value squares and their sums was proposed in 1988 during Major Trauma Study (MTOS) in the USA, but was not validated by analysis of large databases. Methods A validation study analysing 316 944 patients in the Israeli National Trauma registry (INTR) and 249 150 patients in the American National Trauma Data Bases (NTDB). A binary algorithm (Classification and Regression Trees (CART)) was used to detect the most significantly different ISS groups and was also applied to original MTOS data. Results The division of ISS into groups by the CART algorithm was identical in both Trauma Registries and very similar to original division in the MTOS. For most samples, the recommended groups are 1–8, 9–14, 16–24 and 25–75, while in very large samples or in studies specifically targeting critical patients there is a possibility to divide the last group into 25–48 and 50–75 groups, with an option for further division into 50–66 and 75 groups. Conclusions Using a statistical analysis of two very large databases of trauma patients, we have found that partitioning of ISS into groups based on their association with patient mortality enables us to establish clear cut-off points for these groups. We propose that the suggested partition of ISS into severity groups would be adopted as a standard in order to have a common language when discussing injury severity.
Maternal Genetic Heritage of Southeastern Europe Reveals a New Croatian Isolate and a Novel, Local Sub‐Branching in the X2 Haplogroup

High mtDNA variation in Southeastern Europe (SEE) is a reflection of the turbulent and complex demographic history of this area, influenced by gene flow from various parts of Eurasia and a long history of intermixing. Our results of 1035 samples (488 from Croatia, 239 from Bosnia and 130 from Herzegovina, reported earlier, and 97 Slovenians and 81 individuals from Žumberak, reported here for the first time) show that the SEE maternal genetic diversity fits within a broader European maternal genetic landscape. The study also shows that the population of Žumberak, located in the continental part of Croatia, developed some unique mtDNA haplotypes and elevated haplogroup frequencies due to distinctive demographic history and can be considered a moderate genetic isolate. We also report seven samples from the Bosnian population and one Herzegovinian sample designated as X2* individuals that could not be assigned to any of its sublineages (X2a'o) according to the existing X2 phylogeny. In an attempt to clarify the phylogeny of our X2 samples, their mitochondrial DNA has been completely sequenced. We suppose that these lineages are signs of local microdifferentiation processes that occurred in the recent demographic past in this area and could possibly be marked as SEE‐specific X2 sublineages.
Prescription medication misuse among opioid dependent patients seeking inpatient detoxification.

BACKGROUND AND OBJECTIVES Opioid related morbidity and mortality is heightened in context to the concomitant use of psychotropic medications. The aim of this project was to examine the extent to which opioid dependent patients seeking detoxification are using and misusing specific psychotropic agents. METHODS As part of a quality assurance/improvement project, we systematically assessed prospectively consecutive admissions to a public detoxification program using a self-report questionnaire to query for specific psychotropic medication use. Patients were asked about having a current prescription, appropriate use, and/or medical misuse (higher doses, using without prescription) of amphetamine salts, clonazepam, clonidine, gabapentin, and pregabalin. RESULTS We had data on 196 admissions including 162 patients with opioid dependency. Patients receiving detoxification from opioids compared to alcohol had statistically significant higher rates of medication misuse (30% vs. 0%, respectively; χ(2) = 12.8, p < . 0003). Of opioid dependent patients receiving prescription medication, 28% reported using higher amounts of each medication than prescribed. Of opioid patients, 10% self-reported misusing clonidine, 22% gabapentin, 7% pregabalin, 25% clonazepam, 11% amphetamine salts, and 36% any of these medications. DISCUSSION AND CONCLUSIONS Despite the "nonaddictive nature" of some medications (eg, gabapentin, clonidine), high rates of medication misuse in opioid dependent patients admitted for detoxification was found and appeared similar to rates of misuse among controlled substances such as clonazepam and amphetamine salts. These data suggest that opioid dependent patients should be queried for the appropriate use of prescribed medications and that practitioners need to monitor for medication misuse in opioid dependent patients.
A comparative study of two methods of large loop excision of the transformation zone

Objective To determine whether the conventional large loop excision of the transformation zone (CLLETZ) and the ‘top‐hat’ technique (THLLETZ) differ in (a) completeness of excision of the cervical lesion, (b) depth of cervical tissue excised and (c) adequacy of follow up by cytology and colposcopy.
D-cycloserine combined with cue exposure therapy fails to attenuate subjective and physiological craving in cocaine dependence.

BACKGROUND Based on preclinical studies showing that the partial N-methyl-D-aspartate (NMDA) agonist D-cycloserine (DCS) facilitates extinction of cocaine self-administration and cocaine-induced conditioned place preference, we evaluated whether 50 mg of DCS would reduce craving to cocaine cues when combined with cue exposure (CE) in cocaine dependent humans. METHODS In this double-blind placebo-controlled pilot study, 47 cocaine dependent participants were randomized to DCS or placebo (PBO), plus CE. Participants received DCS or PBO 30 minutes prior to two CE sessions, conducted one day apart. Craving and heart rate was assessed prior to CE sessions, during CE trials, and after CE trials. These measures were assessed again at a 1-week follow-up (session 3) after the second CE session. RESULTS DCS failed to significantly attenuate cocaine cue reactivity based on subjective craving and physiological reactivity (heart rate) compared to PBO. The CE protocol, consisting of repeated exposure to drug cues combined with skills training, resulted in extinction to cocaine cues as suggested by decreased craving within and between sessions in both treatment conditions. All participants exhibited elevated heart rate with repeated exposures, demonstrating a potentiation in heart rate between sessions. CONCLUSIONS 50 mg of DCS may not be effective for extinguishing reactivity to drug cues for individuals with cocaine dependence. SCIENTIFIC SIGNIFICANCE Future studies examining the effect of DCS on facilitating extinction to drug cues should examine variations in cue exposure length, number of CE presentations, and timing of DCS dose administration prior to cue exposures, which may differentially impact drug cue reactivity.
Do health visitors promote client participation? An analysis of the health visitor—client interaction

Summary •This paper presents one aspect of a larger study the aim of which was to explore and describe the extent to which clients participate in family health-promotion encounters with health visitors. •The health visitor–client interaction during a home visit was seen to be the most appropriate setting in which to carry out the study. •Analysis of 62 tape-recorded interactions and 75 paired interviews revealed that client participation is rarely initiated by the client or elicited by the health visitor. •This has implications for the future education and practice of health visitors when they are being asked to take a more empowering approach to health promotion.
Asphyxial games or “the choking game”: a potentially fatal risk behaviour

Objectives: To determine the prevalence of knowledge about and participation in asphyxial games, sometimes called “the choking game”, and how best to raise awareness of this risk-taking behaviour and provide preventive education. Design: Questionnaire; collaborative research model; lay advocacy group/university researchers. Setting: 8 middle and high schools in Texas (six) and Ontario (two). A recent death from playing the choking game had occurred in one Texas school, and two other fatalities had occurred within the state. Subjects: Students in grades 4–12, aged 9–18 years. Intervention: None. Outcome measures: None. Results: Of 2762 surveys distributed, 2504 (90.7%) were completed. The mean (SD) age of the responders was 13.7 (2.2) years. 68% of children had heard about the game, 45% knew somebody who played it, and 6.6% had tried it, 93.9% of those with someone else. Forty percent of children perceived no risk. Information that playing the game could result in death or brain damage was reported as most likely to influence behaviour. The most respected source of a preventive education message was parents for pre-adolescents (43%) or victim/victim’s family (36%) for older adolescents. Conclusions: Knowledge of and participation in self-asphyxial behaviour is not unusual among schoolchildren. The age of the child probably determines the best source (parents or victim/victim’s family) of preventive education.
ORIGINAL ARTICLE ORIGINAL ARTICLE Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidance

Background. HIV is prevalent throughout South Africa, and diarrhoea is a common presentation to the emergency department (ED) among both HIV-infected and -uninfected individuals. Method. We audited the management of diarrhoea against standard guidelines in the ED of a regional hospital in KwaZulu-Natal. Patients presenting with diarrhoea as their chief complaint were eligible and data were collected prospectively. Results. A total of 72 patients were included: 58 (81%) of patients were HIV-positive with an average CD4 + count of 180 cells/ µl. A total of 34 stool samples were sent for standard microscopy and culture (M&C), among which 26 were positive (76%). Forty-three patients (60%) received antibiotics, 15 of whom had positive stool M&C. In all cases, the final diagnosis was listed as acute gastroenteritis without further specification, and antibiotic use according to guidelines appeared inconsistent. Conclusion. Based on this audit, we suggest that current guidelines are not clear concerning management of acute diarrhoea in HIVinfected individuals, and that the lack of clear management strategies is likely to affect patient safety and increase antibiotic resistance.
Generating Speech Processor Programmes for Children Using ESRT Measurements

Abstract To optimize outcomes of early implantation accurate speech processor programmes need to be provided quickly. This usually necessitates use of objective measures. One objective method is to use electrically elicited stapedius reflex thresholds (ESRT's) to set maximum comfort level (MCL). This paper aims to outline the procedure for generating programmes from ESRT measures and demonstrate the feasibility of this fitting method through outlining a number of studies evaluating incidence and stability of ESRT's and children's acceptance of, and performance with, ESRT generated programmes. The straightforwardness of this procedure, high incidence and stability of ESRT's, ready acceptance of and satisfactory performance with ESRT generated speech processor programmes indicate this fitting technique can be used extensively with children.
Distribution of road traffic deaths by road user group: a global comparison

Background: Road traffic deaths are a major global health and development problem. An understanding of the existing burden of road traffic deaths in the population is necessary for developing effective interventions. Objective: To outline systematically the global distribution of road traffic deaths by road user groups (pedestrians, bicyclists, motorcyclists, motorised four-wheeler occupants). Methods: Comprehensive searches of PubMed, Google, Google Scholar, TransportLink, grey literature and reference lists and communication with experts from international organisations and country-level institutions were conducted to identify eligible studies and data sources. All data sources that provided a breakdown of road traffic deaths by road user group at the national or sub-national level were eligible for inclusion. A breakdown of road traffic deaths by road user group was constructed for 14 epidemiologically defined World Health Organization (WHO) sub-regions in addition to World Bank income categories. In addition, the total number of road traffic fatalities by road user group in low-income, middle-income and high-income countries was estimated. Results: The breakdown of road traffic deaths by road user group varies dramatically across epidemiological WHO sub-regions. The magnitude of pedestrian fatalities ranges from more than half in African sub-region AfrE (55%) to 15% or less in AmrA or EurA. The distribution also varies across low-income, middle-income and high-income countries. 45% of road traffic fatalities in low-income countries are among pedestrians, whereas an estimated 29% in middle-income and 18% in high-income countries are among pedestrians. The burden of road traffic injuries on vulnerable road users differs substantially across income levels. An estimated total of 227 835 pedestrians die in low-income countries, as opposed to 161 501 in middle-income countries and 22 500 in high-income countries each year. Conclusions: Ameliorating road safety requires the implementation of context-specific solutions. This review of the road traffic injury literature provides strong evidence that the distribution of road traffic fatalities varies dramatically across different parts of the world. Therefore, context-appropriate and effective prevention strategies that protect the particular at-risk road user groups should be carefully investigated.
The role of alcohol in unintentional falls among young and middle-aged adults: a systematic review of epidemiological studies

Objective: To appraise the published epidemiological evidence quantifying the risk of falls associated with acute and usual alcohol consumption among young and middle-aged adults. Design: Systematic review. Methods: Data sources: searches of electronic databases (eg, Medline, EMBASE, CINAHL, PsycINFO, Scopus), websites of relevant organisations, major injury journals, reference lists of relevant articles, and contact with experts in the field. Inclusion criteria: epidemiological studies with an English language abstract investigating alcohol use as a risk factor (exposure) for unintentional falls or related injuries among individuals aged 25–60 years. Studies were critically appraised using the GATE LITE tool. Meta-analysis was not attempted because of the heterogeneity of the eligible studies. Results: Four case–control, three cohort and one case–crossover study fulfilled the inclusion criteria. The studies showed an increased risk of unintentional falls among young and middle-aged adults with increasing exposure to alcohol use. However, the magnitude of this risk varied considerably across studies with most estimates being relatively imprecise. Modest evidence of a dose–response relationship with acute alcohol use was observed. The association between usual alcohol use and fall risk was inconclusive, and evidence of a gender difference was inconsistent. Conclusions: Alcohol use appears to be an important risk factor for falls among young and middle-aged adults. Controlled studies with sufficient power that adjust effect estimates for potential confounders (eg, fatigue, recreational drug use) are required to determine the population-based burden of fall-related injuries attributable to alcohol. This can help inform and prioritise falls prevention strategies for this age group.
Internet Technology in Service of Personal Health Care Management: Patient Perspective

Internet technology has become an informational resource for most health care consumers. Online information, discussion, and support groups, in the form of message boards, listservs, and chat rooms are emerging as parts of virtual self-health-care network. This paper examines the extent to which participation in online health discussion groups was reported to be helpful in increasing medical knowledge and in enhancing the participatory patient role of health care consumers in interaction with health care service professionals. Data for this study was collected from 350 patients who participated in Internet discussion groups for cancer patients. The findings of the study indicated the important impact of Internet health discussion groups on health care management practices as perceived by health care consumers, including empowerment through knowledge and proactive participation in cancer care management. This research contributes to understanding the patient perspective and assesses the perceived importance of Internet groups by health care consumers.
A comparison of self-report and direct observation of booster seat use in Latino families

Objective To develop a reliable self-report tool for measuring child booster seat use among Latino families. Design Cross-sectional and observational survey of a convenience sample. Setting Five retail stores in King County, Washington. Participants 50 parents of children 4–8 years old that self-identified as Latino or Hispanic. Main exposures Parent-reported measures of how often the child uses a booster seat, if the child used a booster seat on the last trip, how often the child complains about using a booster seat, how often the child asks to not use a booster seat, and how often other families they know use a booster seat. Outcome measure Observed booster seat use by child. Results 26 children (52%) were observed using a booster seat. Parent-reported booster seat use was a poor predictor of observed booster seat use. Although 34 parents reported that their child ‘always’ uses a booster seat, 8 (24%) of these children were not using a booster seat. A logistic model to predict booster seat use had a sensitivity of 81% and a specificity of 71%, and misclassified 24% of the participants' observed use. Conclusions Reliance on parent-reported booster seat use significantly overstated observed booster seat use in the study. Among this study population, accurate determination of booster seat use required direct observation.
Effect of Prolong Exposure to Gas Flaring on some Haematological Parameters of Humans in the Niger Delta Region of Nigeria.

The objective of this study was to examine the deterioration effect, if any, of prolonged exposure to gas flaring on hematological parameters. Subjects for the study were drawn from the represented groups in the oil and gas production environments and compared to the non gas flaring environment. Venous blood samples were collected from the subjects and analysed for PCV, Hb, RBC and WBC counts, and red cell morphology. The result showed that the PVC, Hb and RBC count respectively reduced, WBC count and abnormal red cell morphology increased, compared to control (p
Impact of Pharmacist Facilitated Discharge Medication Reconciliation

Preventable adverse drug events occur frequently at transitions in care and are a problem for many patients following hospital discharge. Many of these problems can be attributed to poor medication reconciliation. The purpose of this study was to assess the impact that direct pharmacist involvement in the discharge medication reconciliation process had on medication discrepancies, patient outcomes, and satisfaction. A cohort study of 70 patients was designed to assess the impact of pharmacist facilitated discharge medication reconciliation at a 204-bed community hospital in Battle Creek, Michigan, USA. Discharge summaries were analyzed to compare patients who received standard discharge without pharmacist involvement to those having pharmacist involvement. The total number of discrepancies in the group without pharmacist involvement was significantly higher than that of the pharmacist facilitated group.
Reasons for eating: An exploratory cognitive analysis

Although a great deal is known about what people eat and the demographic and life style factors associated with food habits, relatively little systematic work has been done to investigate why people choose various foods. The present study describes a common‐sense approach to this question. Based on a series of free‐ranging exploratory interviews, a questionnaire that asked persons to rate 35 menu meals and snacks in terms of four scales; pleasure, health, tradition and convenience, was administered to 248 males (N = 104) and females (N = 144) ranging in age from 17 to 72 years. Series of component and discriminant analyses were performed for each scale. Results showing significant differences for age, sex and nutrition knowledge demonstrate it is possible to identify salient, common‐sense meanings of foods that combine to determine their status as items of dietary choice. Apart from providing a rigorous technique for cognitive mapping of food meanings, these results suggest new possibilities for studying .