Miracle-dz/UniFAR-FTUs huggingface dataset:
Public Health Implications of Environmental Exposure to Cadmium and Lead: An Overview of Epidemiological Studies in Belgium

Review in Depth The CadmiBel Study was a cross-sectional population study that investigated the health effects of environmental exposure to cadmium and lead. The 2327 participants constituted a random sample of the population of four Belgian districts, chosen in order to provide a wide range of environmental exposure to cadmium. After adjustment for confounding factors, such as smoking and occupational exposure, the urinary cadmium excretion, a measure of lifetime exposure, was nearly 30% higher in the polluted areas. The CadmiBel Study produced evidence inconsistent with the hypothesis that environmental exposure to cadmium and lead would lead to an increase in blood pressure and to a higher prevalence of hypertension and other cardiovascular diseases. On the other hand, the serum alkaline phosphatase activity and the urinary excretion of calcium were significantly and positively correlated with urinary cadmium in both sexes. These findings suggested that the homeostasis of calcium was gradually affected as cadmium accumulated in the body. Furthermore, several markers of renal tubular dysfunction (urinary excretion of retinol-binding-protein, N-acetyl-β-glucosaminidase, β2-microglobulin and amino acids) were significantly and positively associated with urinary cadmium. Across 10 small areas of which six were polluted with cadmium, an inverse association existed between the creatinine clearance and several indexes of environmental exposure to cadmium (cadmium concentration in the soil, cadmium content of locally grown vegetables, the inhabitants' 24 h urinary cadmium excretion). In the CadmiBel Study, the creatinine clearance was also inversely correlated with the concentrations of lead and zinc protoporphyrin in the blood. Thus, environmental exposure to cadmium and lead was associated with alterations in renal function. The significance in terms of morbidity and mortality of the functional disturbances observed in the CadmiBel Study, and the possible strategies to prevent the transfer of cadmium from the environment to man are under investigation in the prospective PheeCad Study in which half of the CadmiBel participants have been enrolled (participation rate 80%).
Childhood arterial stroke

Childhood stroke affects several hundred children in the UK each year and is in the top 10 causes of childhood death. Many children have another medical condition such as congenital heart disease or sickle cell disease. At least 10% of people with sickle cell disease will have a stroke during childhood. The physical, emotional, and social effects of stroke result in long lasting consequences both for the affected young person, their family, and society as a whole. The working party that developed this guideline was initiated by the British Paediatric Neurology Association and worked in collaboration with the Royal College of Physicians Intercollegiate group which has produced stroke guidelines for adults. The paediatric stroke guidelines1 address the diagnosis, investigation, initial management, and rehabilitation of acute arterial ischaemic stroke in children beyond the neonatal period. Many aspects of rehabilitation are also relevant to children with other causes of stroke (for example, cerebral venous infarction, neonatal stroke, intracranial haemorrhage). However, the recommendations for acute management underline the importance of distinguishing between ischaemic and other categories of stroke. The scope includes the organisation of services; only clinical practice recommendations are included in this summary. ### Primary prevention ### Initial investigations
Out of the wards and onto the streets? Deinstitutionalization and homelessness in Britain

In the last decade there has been growing concern about the numbers of mentally ill homeless people on the streets in Britain. It is widely believed that this is a direct consequence of the closure of hospital asylums. In this report we examine the existing evidence for such a link drawing on material collected in recent British studies. Several tentative conclusions can be drawn from the available information: (1) rates of severe mental illness amongst the long-term homeless are considerably in excess of what might be expected given general population rates of these disorders; (2) schizophrenia accounts for the majority of these illnesses; (3) levels of disability (both social and symptomatic) are broadly similar to those found in long-stay populations; (4) the majority have never experienced long periods of hospitalization and are not those people who have been discharged as part of the planned closure of a large mental hospital; (5) recent studies demonstrating an apparent failure to deliver effective .
Training technology and vocational education teachers for the new 9-3-4 education system in Nigeria: Its problems and prospects

The construct of this paper is to ascertain the attendant problems prevalent in the training patterns of vocational and technical education teachers in our various training institutions in the country, and its consequences in the teaching or impacting of knowledge by these trained personnel to the young ones in the post-primary schools across the state and beyond. It also suggested remedies for overcoming the bottlenecks usually encountered during the training process and made work-man-like recommendations for its rapid development. Key words: Vocational training programme, education in Nigeria.
FEMALE CIRCUMCISION AND INFIBULATION IN THE SUDAN

Female circumcision is not unique to one country. It is performed in Egypt (until recently) Sudan Kenya Abyssinia Indonesia Malaya Eastern Mexico Peru Western Brazil among the Urabunna tribes of Australia and among the Skopizy people in Russia. In Sudan the custom is so deeply ingrained that propaganda and legislation by the Sudanese Ministry of Health did not deter people from practicing it. The type of circumcision practiced in Sudan is infibulation which involves excising the labia majora and obliterating the introitus. Immediate complications of this operation include shock hemorrhage injury to adjacent structures infection retention of urine and anemia. Late gynecological complications include infertility implantation dermoids menorrhagia dysmenorrhea cryptomenorrhea keloid scar and in rare cases vaginal calculi. Marital and psychological complications are difficult to assess. General surgical and medical procedures are used in managing the complications. Prophylaxis is evidently the best treatment; however the only means of avoiding complications altogether is abolishing the practice of female circumcision.
Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia: A Systematic Review and Meta-analysis.

BACKGROUND Guidelines recommend statins as first-line therapy for dyslipidemia. Monoclonal antibodies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) is a new lipid-lowering approach. PURPOSE To assess the efficacy and safety of PCSK9 antibodies in adults with hypercholesterolemia. DATA SOURCES MEDLINE, PubMed Central, and Google Scholar; conference proceedings; and the ClinicalTrials.gov registry through 4 April 2015. STUDY SELECTION Phase 2 or 3 randomized, controlled trials (RCTs) comparing treatment using PCSK9 antibodies with no anti-PCSK9 therapy in adults with hypercholesterolemia. DATA EXTRACTION Two investigators independently extracted data on study characteristics and lipid and clinical outcomes, and rated risk of bias of trials. Prespecified primary end points were all-cause and cardiovascular mortality. DATA SYNTHESIS Twenty-four RCTs comprising 10 159 patients were included. Compared with no antibody, treatment with PCSK9 antibodies led to marked reductions in low-density lipoprotein cholesterol levels (mean difference, -47.49% [95% CI, -69.64% to -25.35%]; P < 0.001] and other atherogenic lipid fractions, and it reduced all-cause mortality (odds ratio [OR], 0.45 [CI, 0.23 to 0.86]; P = 0.015; heterogeneity P = 0.63; I2 = 0%) and cardiovascular mortality (OR, 0.50 [CI, 0.23 to 1.10]; P = 0.084; heterogeneity P = 0.78; I2 = 0%). The rate of myocardial infarction was significantly reduced with use of PCSK9 antibodies (OR, 0.49 [CI, 0.26 to 0.93]; P = 0.030; heterogeneity P = 0.45; I2 = 0%), and increases in the serum creatine kinase level were reduced (OR, 0.72 [CI, 0.54 to 0.96]; P = 0.026; heterogeneity P = 0.65; I2 = 0%). Serious adverse events did not increase with administration of PCSK9 antibodies. LIMITATION Results were derived from study-level data rather than patient-level data, and clinical outcome data are rare. CONCLUSION PCSK9 antibodies seem to be safe and effective for adults with dyslipidemia. PRIMARY FUNDING SOURCE CRC 1116 Masterswitches in Myocardial Ischemia, German Research Council DFG.
Relationship between iron deficiency anemia and febrile convulsion in infants

Purpose : The association between iron deficiency anemia and febrile convulsion in infants has been examined in several studies with conflicting results. Therefore, the authors aimed to evaluate the precise relationship involved. Methods : In this case-control study, the authors assessed 100 children with a diagnosis of febrile convulsion, aged between 9 months and 2 years, during January 2007 to July 2009. The control group consisted of 100 febrile children without convulsion; controls were closely matched to the cases by age, gender, and underlying disease. Results : The mean ages of the febrile convulsion and control group were 16.37. 4 and 15.86. 1 months, respectively, and the two groups had no differences in clinical features. Iron deficiency anemia (Hb
Identificação do linfonodo sentinela no câncer de mama com injeção subdérmica periareolar em quatro pontos do radiofármaco

The aim of this study was to identify the sentinel node by periareolar injection of the radiopharmaceutical in four points, regardless of tumor topography. The sentinel node biopsy reduces morbidity in axillary staging. Fifty-seven sentinel node biopsies were prospectively performed in two groups: group A (25 patients) and group B (32 patients). The peritumoral injection technique was used in group A and the new injection technique in four points was used in group B. The sentinel node biopsies were studied by imprint cytology and hematoxilin and eosin staining followed by axillary lymph node dissection in all patients of group A and only in the positive cases of group B. In group A, 88% (22/25) of the sentinel nodes were identified. There was no false negative case; the sensibility and specificity were of 100%. In group B, 96% (31/32) of sentinel nodes were identified and the status of the axillary lymph nodes showed a predictive positive value of 100%. The number of sentinel nodes varied from 1 to 7, mode of 1 and median of 2.7. The hotspot area was 10 to 100 times the background radiation. The periareolar injection in four points seems to be a good lymphatic mapping method for identification of the sentinel node. We suggest the standardization of this site for injections to identify the sentinel node, although further studies to confirm these findings are necessary.
Four-Week Direct-Acting Antiviral Regimens in Noncirrhotic Patients With Hepatitis C Virus Genotype 1 Infection: An Open-Label, Nonrandomized Trial.

BACKGROUND Treatment of chronic hepatitis C virus (HCV) infection with direct-acting antivirals (DAAs) for 6 weeks achieves sustained virologic response (SVR) rates of 95% in some patients. If effective, shorter therapeutic courses could improve adherence and treatment costs. OBJECTIVE To determine factors predictive of SVR to 4 weeks of DAA treatment in patients with stage F0 to F2 liver fibrosis. DESIGN Open-label, nonrandomized, phase 2a trial. (Clinical Trials.gov: NCT01805882). SETTING Single-center. PATIENTS 50 treatment-naive and predominantly African American patients with HCV genotype 1 infection and early-stage liver fibrosis were sequentially enrolled into 2 treatment groups. INTERVENTION 25 participants received a 3-drug regimen consisting of ledipasvir and sofosbuvir plus GS-9451 for 4 weeks, and 25 received a 4-drug regimen consisting of ledipasvir, sofosbuvir, GS-9451, and GS-9669 for 4 weeks. MEASUREMENTS The primary efficacy end point was SVR12 (HCV RNA level below the lower limit of quantification at posttreatment week 12). RESULTS Forty percent (10 of 25) (95% CI, 21% to 61%) of patients in the 3-drug group and 20% (5 of 25) (CI, 7% to 41%) of those in the 4-drug group achieved SVR12. Exploratory analysis suggested that lower baseline HCV viral load, younger age, and HCV genotype 1b were associated with SVR12. Ten patients had baseline HCV variants conferring greater than 20-fold resistance in vitro to at least 1 study DAA; all had viral relapse. Forty-eight percent (12 of 25) of patients receiving the 3-drug regimen and 72% (18 of 25) of those receiving the 4-drug regimen had adverse events, most of which were mild. One participant was lost to follow-up. LIMITATION Nonrandomized study design and small sample of patients with early-stage fibrosis. CONCLUSION Combination DAA therapy with 3 or 4 drugs for 4 weeks was well-tolerated but resulted in limited cure rates. PRIMARY FUNDING SOURCE National Institute of Allergy and Infectious Diseases, National Cancer Institute, and Clinical Center Intramural Program; supported in part by a cooperative research and development agreement between the National Institutes of Health and Gilead Sciences.
In vivo probe-based confocal laser endomicroscopy in chronic diffuse parenchymal lung diseases

Diagnosis of diffuse parenchymal lung diseases (DPLDs) is challenging and requires a multidisciplinary approach. Probe-based confocal laser endomicroscopy (pCLE) enables microimaging of the distal lung in vivo. Objective: to describe pCLE features in DPLD patients. Methods: pCLE was performed in 52 DPLD patients and 21 healthy volunteers (HV). Results were compared between HV and each of the pathologic groups, blindly to the diagnosis (Fisher9exact test and Bonferroni correction). The association between the pCLE and CTscan features was assessed using multivariate analysis. Results: 9 of the 17 pCLE descriptors were significantly more frequent in DPLD patients than in HV (131 areas). pCLE differed in sarcoidosis (16 patients, 105 areas) by the presence of fluorescent bronchiolar cells, convoluted acinar elastic fibers, alveolar nodules; in idiopathic pulmonary fibrosis (n=8, 36 areas) by interalveolar septal fibers and a rigid acinar elastic network; hypersensitivity pneumonitis (n=6, 34 areas) by bronchiolar and alveolar cells; non-specific interstitial pneumonia (n=6, 38 areas) by fluorescent bronchiolar cells, septal fibers and a rigid network; asbestosis (n=10, 72 areas) by alveolar mouths 20µm, septal fibers, and a rigid and dense acinar elastic network; systemic sclerosis (n=6, 38 areas) by fluorescent alveolar cells, septal fibers and a rigid network. HRCT honeycombing was associated to pCLE large alveolar mouths and a disorganized elastic network; both interlobular septa thickening and cysts were associated to the presence of septal fibers using pCLE Conclusion: pCLE could be added to the multidisciplinary discussion for the etiological diagnosis of DPLD.
Characteristics of a Good University Lecturer According to Students

Background and purpose: University lecturers are of great importance in education and achieving desired objectives so, recognizing the characteristics of a good university lecturer can promote quality of education. This study was designed to determine characteristics of a good university lecturer according to Students. Materials and methods: A cross-sectional study was conducted among 160 students in faculty of paramedics, Mazandaran University of Medical Sciences, 2012. To collect the data, a questionnaire (two parts) and analysed by statisticsl tests. Results: According to the results the most important characteristics of a good university lecturer included rhetoric, efficient teaching skills, age, scientific expertise, interest in teaching, critical acceptance, and using information technology. There is no significant differences were found between other dimensions among male and female students. Conclusion: This research found rhetoric, efficient teaching skill, and scientific expertise of university lecturer as the most influential factors in their evaluation. Moreover, personal traits of university lectures can increase the students' motivation.
Management of horn gore injury and urticaria in a dairy cow: A case report

This paper reports how a 4-year old Friesien-Sahiwal cross cow weighing 380 kg with horn gore injury on the left labia of the vulva was managed at the Large Animal Clinic, University Putra Malaysia. The lacerated wound measuring about 4-cm long was originated as a result of horn goring from another cow two weeks prior presentation of the cow to the clinic. Physical examination of the cow incidentally revealed urticaria on the left ventro-lateral aspect of the neck suspected to be sequel of hypersensitivity. The wound was treated by topical application of a mixture of Iodine, Benacillin LA, Biomectin 1% and Ilium Dermapred made into cream. While the uticaria was treated by intramuscular injection of Chlorpheniramine maleate at 0.5 mg/kg bwt. Animal management, housing design and presence of sharp horns are some of the factors that can lead to physical traumatic injuries in dairy cows. http://dx.doi. org/10.5455/javar.2015. b93
Gestational Diabetes Mellitus and Nutrient Intake in Regards to Carbohydrate, Fat, Saturated Fat, Protein and Fiber Consumption versus Blood Glucose Levels by

Troumbly Danielle M (Last Name) (First Name) (Initial) Gestational Diabetes Mellitus and Nutrient Intake in Regards to Carbohydrate, Fat, Saturated Fat, Protein, and Fiber Consumption versus Blood Glucose Levels ______ (Title) Food and Nutritional Sciences Dr. Carol Seaborn December 2003 88 (Graduate Major) (Research Advisor) (Month/Year) (# of Pages) Turbian, Kate. A Manual for Writers of Term Papers, Theses, and Dissertations. 1987 (Name of Style Manual Used in the Study) Medical management of Gestational Diabetes Mellitus (GDM) has shown that lowering blood glucose levels to normoglycemic may help prevent diabetic complications for infant and mother. The objective of this experiment was to determine if consumption of carbohydrate, saturated fat, total fat, protein, and fiber affected blood glucose levels in pregnant women diagnosed with GDM. The study included forty-two adult women from eight different medical facilities, which included Minnesota, Georgia, Florida, Tennessee, and New Mexico. The women were diagnosed by two abnormal values from an oral glucose tolerance test (OGTT) of 100 grams (g). The additional criteria for inclusion in the study were age 18-45 years, carrying a singleton pregnancy, and entry into trial between 28 to 32 weeks gestation. Three-day food records were collected. Only thirtyfour women had the required data completed for final analysis. Means and frequencies were determined for carbohydrate, protein, total fat, saturated fat, fiber, and calorie intake
Bacteriology of chronic maxillary sinusitis in Jeddah, Saudi Arabia

The objective of the present study was studying the prevailing bacterial etiology of Chronic Maxillary Sinusitis (CMS) in different age groups, to evaluate the impact predisposing factors to chronicity and to estimate the susceptibility of the isolated microorganisms to commonly used antimicrobial agents. This study was carried out on 103 patients (60 males and 43 females) in age ranged from (12 to 67 years) who were diagnosed clinically and radiologically to have CMS. Culturing of sinus aspirates from all patients on an appropriate media to isolate aerobic and anaerobic bacteria was done. The isolates were identified by conventional methods and their sensitivities against commonly used antimicrobial agents were tested. The present study revealed that CMS was higher in 40 males (66.67%) than in 25 females (58.14%) of group II and it was more frequent in adults than in children. Positive cultures were detected in 97 (94.2%) cases of which pure aerobic bacteria were isolated in 11 cases (10.7%) and pure obligate anaerobes were isolated in 9 (8.7 %), while mixed of both were found in 77 cases (74.8%). Our study showed a strong association between CMS and predisposing factors as allergic rhinitis, septal devia-tion and nasal polyposis, but it showed a poor association with aspirin sensitivity. High susceptibility of all aerobic isolates to vancoymycin, cefotaxime, cefaclor, clarithromycin was detected while, anaerobic isolates showed high susceptibility to moxifloxacin, cefotaxime and meropenem. Key words: Chronic maxillary sinusitis (CMS), aerobic isolates, antimicrobial agents.
Using a polymerase chain reaction as a complementary test to improve the detection of dermatophyte fungus in nails.

BACKGROUND Dermatomycoses are a group of pathologic abnormalities frequently seen in clinical practice, and their prevalence has increased in recent decades. Diagnostic confirmation of mycotic infection in nails is essential because there are several pathologic conditions with similar clinical manifestations. The classical method for confirming the presence of fungus in nail is microbiological culture and the identification of morphological structures by microscopy. METHODS We devised a nested polymerase chain reaction (PCR) that amplifies specific DNA sequences of dermatophyte fungus that is notably faster than the 3 to 4 weeks that the traditional procedure takes. We compared this new technique and the conventional plate culture method in 225 nail samples. The results were subjected to statistical analysis. RESULTS We found concordance in 78.2% of the samples analyzed by the two methods and increased sensitivity when simultaneously using the two methods to analyze clinical samples. Now we can confirm the presence of dermatophyte fungus in most of the positive samples in just 24 hours, and we have to wait for the result of culture only in negative PCR cases. CONCLUSIONS Although this PCR cannot, at present, substitute for the traditional culture method in the detection of dermatophyte infection of the nails, it can be used as a complementary technique because its main advantage lies in the significant reduction of time used for diagnosis, in addition to higher sensitivity.
Forefoot varus predicts subtalar hyperpronation in young people.

BACKGROUND Subtalar joint hyperpronation is a foot misalignment that has been associated with several musculoskeletal injuries. Forefoot varus is thought to result in subtalar hyperpronation during weightbearing circumstances. However, few studies have aimed to verify whether there is a significant relationship between forefoot alignment and subtalar hyperpronation. Moreover, no study has attempted to verify whether forefoot varus can predict subtalar hyperpronation in young individuals. Therefore, the purpose of this study was to verify whether forefoot varus can predict subtalar hyperpronation, measured using the rearfoot eversion angle test, the navicular drop test, and the Foot Posture Index (FPI), in young people. METHODS Fifty-four healthy adolescents volunteered for this study (28 boys and 26 girls). A single examiner evaluated the forefoot angle, rearfoot angle, navicular drop, and FPI of each participant. Statistical analysis included the Pearson correlation test and a linear regression analysis to establish the relationship between the variables. RESULTS These results showed a high positive correlation between forefoot varus and rearfoot angle (r = 0.86; P < .001), navicular drop (r = 0.76; P < .001), and FPI (r = 0.82; P < .001). Moreover, the forefoot varus variable was able to predict 74% of the variability in the rearfoot angle, 58% in the navicular drop, and 67% in the FPI (P < .001). CONCLUSIONS These findings support previous assumptions that individuals with forefoot varus present subtalar hyperpronation. Clinicians should not overlook forefoot alignment when prescribing foot orthoses for treating patients with foot misalignments.