Miracle-dz/UniFAR-FTUs huggingface dataset:
Hypoglossal nerve stimulation improves obstructive sleep apnea: 12‐month outcomes

Reduced upper airway muscle activity during sleep is a key contributor to obstructive sleep apnea pathogenesis. Hypoglossal nerve stimulation activates upper airway dilator muscles, including the genioglossus, and has the potential to reduce obstructive sleep apnea severity. The objective of this study was to examine the safety, feasibility and efficacy of a novel hypoglossal nerve stimulation system (HGNS®; Apnex Medical, St Paul, MN, USA) in treating obstructive sleep apnea at 12 months following implantation. Thirty‐one subjects (35% female, age 52.4 ± 9.4 years) with moderate to severe obstructive sleep apnea and unable to tolerate positive airway pressure underwent surgical implantation and activation of the hypoglossal nerve stimulation system in a prospective single‐arm interventional trial. Primary outcomes were changes in obstructive sleep apnea severity (apnea–hypopnea index, from in‐laboratory polysomnogram) and sleep‐related quality of life [Functional Outcomes of Sleep Questionnaire (FOSQ)]. Hypoglossal nerve stimulation was used on 86 ± 16% of nights for 5.4 ± 1.4 h per night. There was a significant improvement (P < 0.001) from baseline to 12 months in apnea–hypopnea index (45.4 ± 17.5 to 25.3 ± 20.6 events h−1) and Functional Outcomes of Sleep Questionnaire score (14.2 ± 2.0 to 17.0 ± 2.4), as well as other polysomnogram and symptom measures. Outcomes were stable compared with 6 months following implantation. Three serious device‐related adverse events occurred: an infection requiring device removal; and two stimulation lead cuff dislodgements requiring replacement. There were no significant adverse events with onset later than 6 months following implantation. Hypoglossal nerve stimulation demonstrated favourable safety, feasibility and efficacy.
The influence of test voltage waveforms on partial discharge activity in XLPE

The influence of applied voltage waveform on partial discharges in cavities embedded in cross-linked polyethylene is investigated in this paper. The voltage waveforms dealt with are (a) 50 Hz sinusoidal, (b) 0.1Hz sinusoidal, (c) oscillating voltage waveforms having different frequencies and decay time constant of 80 ms. The results show that, under sinusoidal waveforms, 0.1Hz generally provides the lowest PDIV values, whereas PDIV increase slightly with frequency. Oscillating voltage waveforms can provide very inaccurate PDIV estimates, with errors up to about 100%.
Understanding the Nigerian Healthcare Delivery System: A Paradox of Preventive Medicine Since the Colonial Epoch

No human society is mundane to healthcare delivery method. Apparently, the process of healthcare delivery depicts the extent of the social development of a particular society. However, the healthcare delivery process in Nigeria from the colonial era attained a new paradigm by shifting from the practice of traditional medicine to the western styled patterns. Since the colonial Nigeria, both the traditional and western medicine has been dependable sources of preventive medicine for the Nigeria populace. In spite of the outright condemnation of the traditional healthcare practices, it received unbridled patronage by a larger Nigeria populace, thus the post-independence Nigeria witnessed a paradox of health care delivery. Aim: This paper aims to provide an understanding on the revolutions in the healthcare delivery system in Nigeria since the colonial period. Methodology: An extensive review of literature was carried out to elicit information on the Nigerian healthcare delivery since the colonial period. Results: The study revealed that the Nigerian healthcare delivery system is characterized by high cost. The study also showed that Nigeria has been witnessing inequitable distribution of healthcare facilities since the colonial period. Conclusion: The healthcare delivery system in Nigeria is not a colonial invention but the advent of the colonial masters brought about an outstanding transformation in the healthcare delivery process of most Nigerian societies. Thus, the practice of preventive medicine is indigenous to the Nigerian people.
Does Corruption Affect Poverty in Indonesia?

Corruption is likely to increase poverty because it reduces the potential income earning of the poor. Therefore, eradicating corruption is a crucial issue in the poverty reduction process. This study is set out to investigate and analyze the short and long-run relationship between corruption and poverty. It uses secondary data from World Bank and Transparency International then Autoregressive Distributed Lag (ARDL) and dynamic Error Correction Model (ECM), focuses on capability poverty using headcount poverty index during year 1995-2017. The results of study indicated that corruption have positive significant effect on the level of poverty ratio in 1% significance level In the long run. This implies that in the long run, there is relationship between corruption and poverty. In the long run, the coefficient of corruption effect implies that 1% increase in corruption would increase the poverty ratio by 1.36%. The negative implication of corruption on the life of the citizens is a major disaster in the economy and harmful to the growth and development of the citizens in particular and the economy in general. The simple pearson correlation findings also show that corruption has significant distributional consequences by affecting growth and government expenditures. High and rising corruption increases poverty by reducing the level and effectiveness of groth and social spending (education and health). For effective sustainable and management of this disaster, government should embark on policies that will reduce the level of corruption significantly so as to have positive influence on the standard of living of the citizens in terms of quality and efficient education, sound management of our natural resources, provision of good health facilities and other infrastructures that will transcend to the growth of the economy.
A review on the contribution of crop diversification to Sustainable Development Goal 1 “No poverty” in different world regions

I am grateful to Professor Maggie Gill and Dr Leslie Lipper for initial discussions, to Dr Leslie Lipper for arranging the meetings with the experts at the Food and Agriculture Organization (FAO) and to the experts at FAO for the valuable discussions on the topic. I would also like to thank Kirsten MacSween for revising the English. This research has been funded by the UK Natural Environment Research Council (NERC), NE/N005619/1.
Primaquine for preventing relapses in people with Plasmodium vivax malaria.

BACKGROUND Plasmodium vivax infections contribute to a significant proportion of the malaria infections in many countries. Primaquine is the most widely used drug for treating the dormant liver stage. Different primaquine dosing regimens are in use. OBJECTIVES To compare primaquine regimens for preventing relapses in people with P. vivax malaria. SEARCH STRATEGY In 2006, we searched the Cochrane Infectious Diseases Group's Specialized Register (January), CENTRAL (The Cochrane Library 2006, Issue 3), MEDLINE (October), EMBASE (January), LILACS (January). We also checked conference proceedings and reference lists, and contacted researchers, the World Health Organization (WHO), malaria mailing lists, and pharmaceutical companies. SELECTION CRITERIA Randomized and quasi-randomized controlled trials comparing primaquine plus chloroquine with chloroquine alone, and the standard primaquine regimen (15 mg/day for 14 days) with other primaquine-containing regimens in people with vivax malaria. DATA COLLECTION AND ANALYSIS All authors independently assessed trial eligibility and quality, and extracted data. We calculated odds ratios (OR) with 95% confidence intervals (CI) for dichotomous data, and used the random-effects model if there was significant heterogeneity. MAIN RESULTS Nine trials (3423 participants) met the inclusion criteria. Compared with chloroquine alone, five-day primaquine plus chloroquine was no better at preventing relapses (OR 1.04, 95% CI 0.64 to 1.69, random-effects model; 2104 participants; 3 trials), while 14-day primaquine plus chloroquine was significantly better (OR 0.24, 95% CI 0.12 to 0.45, random-effects model; 1071 participants, 6 trials). Limited data suggest the advantage for the 14-day primaquine regimen persisted for over six months (OR 0.41, 95% CI 0.29 to 0.60; 585 participants, 2 trials). Direct comparisons of the 14-day and five-day primaquine plus chloroquine regimens also confirm the superiority of the longer course (OR 13.33, 95% CI 3.45 to 51.44; 186 participants, 2 trials). Adverse effects were poorly reported, with three trials reporting skin rash, vertigo, headache, abdominal pain and/or nausea, and two trials reporting that primaquine was well tolerated. AUTHORS' CONCLUSIONS Primaquine (15 mg/kg/day for 14 days) plus chloroquine is more effective than chloroquine alone or primaquine (15 mg/kg for 5 days) plus chloroquine in preventing relapses of vivax malaria. Primaquine (five days) plus chloroquine appears no better than chloroquine. Countries should follow the WHO's recommendation for 14-day primaquine plus chloroquine regimen. Alternative regimens need to be evaluated in randomized controlled trials, which should also consider variations in regional P. vivax strains and the possibility of primaquine resistance, reinfection, and adherence in those who relapse.
Experimental surveillance using data on sales of over-the-counter medications--Japan, November 2003-April 2004.

OBJECTIVES This report describes a study to explore the possibility of using data on sales of over-the- counter (OTC) medications as part of a routine syndromic surveillance system aimed at early detection of infections of public health concern. A retrospective evaluation was conducted of sales of OTC medications used to treat the common cold. This report discusses the correlation of these data to influenza activity in Japan during the 2003-04 influenza season and evaluates the potential of using such data to predict influenza epidemics. METHODS Data from approximately 1,100 pharmacies throughout Japan collected during November 2003-April 2004 were analyzed. OTC sales data were compared with influenza incidence data (one weekly and two daily data sets) to determine correlations and predictability. Adjusted R-square was used as an index of goodness of-fit in the estimation. Data reflecting daily influenza activity were obtained from the National Surveillance of Daily Influenza Outpatients and the Mailing List-Based Influenza Epidemic Database. National sentinel surveillance data for influenza from approximately 5,000 sites nationwide also were analyzed. RESULTS Although a correlation was demonstrated between sales of OTC medications used to treat the common cold and concurrent influenza activity, analysis of sales data alone was not sufficient to determine influenza activity in advance even when sales promotion effects were excluded from the analysis. CONCLUSION Because visiting a health-care provider costs more than purchasing OTC medications, the hypothesis was formed that an ill person will purchase OTC medications first and visit a physician only if the condition does not resolve or worsens. The results of this study do not provide any clear evidence to support this hypothesis. For this reason, OTC sales do not appear to be a good candidate for a national real-time detection system for influenza epidemics in Japan.
Oligoclonal IgG and free light chains in multiple sclerosis demonstrated by thin‐layer polyacrylamide gel isoelectric focusing and immunofixation

A modified technique of isoelectric focusing on thin‐layer polyacrylamide gel followed by immunofixation with monospecific antisera was used to identify individual cerebrospinal fluid (CSF) and serum proteins and to define the oligoclonal reaction observed in multiple sclerosis (MS). “Normal” IgG gave about 20 to 30 bands at pH 3.5 to 9.5, IgA about 10 bands at pH 3.5 to 6.4, β‐trace protein a smear at pH 3.5 to 8.5, and γ‐trace protein 1 or 2 bands at pH 8.0, 9.5, or both.
Management of thoracic empyema in childhood: does the pleural thickening matter?

Aims: To determine the clinical course and long term outcome of empyema treated without decortication. Methods: Fourteen consecutive admissions to one hospital were studied; radiological resolution and lung function were subsequently followed. The children were aged 2–14 years. All were treated with intravenous antibiotics and chest drain only. Results: All patients had extensive pleural thickening evident on chest x ray examination at the time of discharge, which resolved entirely over a period of 2–16 months. Lung function was measured in 13 children, and showed no evidence of restrictive or obstructive deficit: mean (SD) values as per cent predicted for height were: forced expiratory volume in one second (FEV1) 107.5 (9.6), forced vital capacity (FVC) 95.5 (8.8), total lung capacity (TLC) 98.6 (20.7). Individual children all had values in the normal range (80–120 per cent predicted). Conclusion: Results suggest that decortication is not necessary in children to prevent long term problems with pleural thickening, and should be undertaken on the basis of the clinical picture (failure of fever resolution), rather than radiological appearance.
Reflux time estimation on air-plethysmography may stratify patients with early superficial venous insufficiency

Objectives It has been suggested that quantification of haemodynamic parameters of venous disease may complement clinical assessment and may help identify a group of patients with severe venous disease or alternatively patients with early venous disease. However, there has been very little work to prove this hypothesis. The venous filling index (VFI) of air-plethysmography (APG) can quantify severity and treatment effect but has limited discriminatory value. However, the components of the VFI, total venous volume (VV) and time to reach 90% of VV (VFT90), have never been fully studied. The aim was to investigate the contribution of VV and VFT90 to an elevated VFI and determine their relationship to great saphenous vein (GSV) diameter and clinical severity scoring. Method Ninety-three consecutive patients/legs (22–78 years) with primary GSV reflux (>0.5 seconds) awaiting endovenous treatment were recruited. CEAP (clinical, aetiological, anatomical and pathological elements) assessments were: 33 (35.5%) C2, 14 (15.0%) C3, 29 (31.2%) C4a, 5 (5.4%) C4b, 7 (7.5%) C5 and 5 (5.4%) C6. The median venous clinical severity score (VCSS) was 6 (2–20) and the averaged GSV diameter at three sites was 7.5 mm (4–12). The VFI, VV and VFT90 were recorded using APG. Results There was no correlation between the VV and the VFT90 (r = −0.103, P = 0.324). The VFI, VV and VFT90 significantly correlated (P < 0.0005, Spearman) with the GSV diameter: r = 0.623, r = 0.567, r = −0.432, respectively, and the C of CEAP (P < 0.05): r = 0.4, r = 0.225, r = −0.343, respectively. None of the 25 (26.9%) patients with a VFT90 > 25 seconds were among the 17 (18.3%) patients in categories C4b–6 or with a VCSS > 9 (P = 0.005, Fisher's exact test, corrected odds ratio: 17.3). Conclusions The VFT90 complements the VFI as a marker of severe superficial venous insufficiency. However, in contrast to the VFI, it may have discriminatory value in stratifying patients with early disease into two groups based on the severity of haemodynamic impairment.
Detection of Microcystin-Producing Cyanobacteria in Finnish Lakes with Genus-Specific Microcystin Synthetase Gene E (mcyE) PCR and Associations with Environmental Factors

ABSTRACT We studied the frequency and composition of potential microcystin (MC) producers in 70 Finnish lakes with general and genus-specific microcystin synthetase gene E (mcyE) PCR. Potential MC-producing Microcystis, Planktothrixand Anabaena spp. existed in 70%, 63%, and 37% of the lake samples, respectively. Approximately two-thirds of the lake samples contained one or two potential MC producers, while all three genera existed in 24% of the samples. In oligotrophic lakes, the occurrence of only one MC producer was most common. The combination of Microcystis and Planktothrix was slightly more prevalent than others in mesotrophic lakes, and the cooccurrence of all three MC producers was most widespread in both eutrophic and hypertrophic lakes. The proportion of the three-producer lakes increased with the trophic status of the lakes. In correlation analysis, the presence of multiple MC-producing genera was associated with higher cyanobacterial and phytoplankton biomass, pH, chlorophyll a, total nitrogen, and MC concentrations. Total nitrogen, pH, and the surface area of the lake predicted the occurrence probability of mcyE genes, whereas total phosphorus alone accounted for MC concentrations in the samples by logistic and linear regression analyses. In conclusion, the results suggested that eutrophication increased the cooccurrence of potentially MC-producing cyanobacterial genera, raising the risk of toxic-bloom formation.
Further comparisons of ABR response amplitudes, test time, and estimation of hearing threshold using frequency-specific chirp and tone pip stimuli in newborns: Findings at 0.5 and 2 kHz

Abstract Objective: To compare auditory brainstem response (ABR) amplitudes evoked by 0.5 and 2 kHz tone pip and narrowband chirp (NB CE-Chirp) stimuli when testing post-screening newborns. To determine the difference in ‘estimated hearing level’ correction values. Design: Tests were performed with tone pips and NB CE-Chirps at 0.5 or 2 kHz and the ABR threshold for each stimulus defined. Response amplitude, response quality (Fmp), and residual noise were compared for both stimuli. Study sample: Thirty-nine babies (42 ears) who passed our ABR discharge criterion at 4 kHz following referral from their newborn hearing screen. Results: NB CE-Chirp responses were, on average, 31% larger than the tone pip responses at 0.5 kHz and were 52% larger at 2 kHz. Fmp was significantly higher for NB CE-Chirps. Conclusions: The advantages of NB CE-Chirps over tone pips we previously identified at 4 and 1 kHz extends to 0.5 and 2 kHz, which supports the use of NB CE-Chirps when testing newborns. We propose that ABR nHL threshold to eHL corrections for NB CE-Chirps should be approximately 5 dB less than corrections for tone pips at 0.5 and 2 kHz, mirroring our recommendation at 4 and 1 kHz.
Variable Findings for Drug-Induced Sleep Endoscopy in Obstructive Sleep Apnea with Propofol versus Dexmedetomidine

Objective To compare VOTE classification findings (velum, oropharyngeal-lateral walls, tongue base, and epiglottis) for drug-induced sleep endoscopy (DISE) among patients with obstructive sleep apnea (OSA) using 2 sedation protocols. Study Design Case series with chart review. Setting Single tertiary institution. Subjects Patients with OSA who underwent DISE. Methods A total of 216 patients underwent DISE between November 23, 2011, and May 1, 2015. DISE findings based on VOTE classification were compared between patients receiving the propofol- and dexmedetomidine-based sedation protocols. Results Patients with OSA (N = 216; age, 44.3 ± 11.7 years; body mass index, 27.9 ± 4.8 kg/m2) underwent DISE with intravenous administration of propofol (n = 52) or dexmedetomidine (n = 164). There were no statistically significant differences between the 2 groups in baseline apnea-hypopnea index, oxygen desaturation index, Mallampati score, tonsil size, Epworth Sleepiness Scale score, peripheral oxygen saturation nadir, age, sex, or body mass index. Patients in the propofol group had a significantly increased likelihood of demonstrating complete tongue base obstruction (75%, 39 of 52) versus partial or no obstruction (25%, 13 of 52) in the anterior-posterior dimension, as compared with the dexmedetomidine group (complete obstruction: 42.7%, 70 of 164; partial or no obstruction: 57.3%, 94 of 164; odds ratio: 4.0; 95% confidence interval: 2.0-8.1; P = .0001). Obstruction of other airway subsites was not significantly different. Conclusion Use of propofol versus dexmedetomidine to induce sedation may have a significant effect on the pattern of upper airway obstruction observed during DISE. Randomized prospective studies are indicated to confirm these initial findings.
Reaction–diffusion models of within-feather pigmentation patterning

Feathers are complex, branched keratin structures that exhibit a diversity of pigmentation patterns. Feather pigments are transferred into developing feather keratinocytes from pigment cells that migrate into the tubular feather germ from the dermis. Within–feather pigment patterns are determined by differential pigmentation of keratinocytes within independent barb ridges during feather development. Little is known about the molecular mechanisms that determine which keratinocytes receive pigment. We apply reaction–diffusion models to the growth of within–feather pigment patterns based on a realistic model of feather growth. These models accurately simulate the growth of a diversity of the within–feather pigmentation patterns found in real feathers, including a central patch, a‘hollo’ central patch, concentric central patches, bars, chevrons, a central circular spot, rows of paired spots, and arrays of offset dots. The models can also simulate the complex transitions between distinct pigmentation patterns among feathers observed in real avian plumages, including transitions from bars to chevrons, bars to paired dots, and bars to arrays of dots. The congruence between the developmental dynamics of the simulated and observed feather patterns indicates that the reaction–diffusion models provide a realistic and accurate description of the determination of pigment pattern within avian feather follicles. The models support the hypothesis that within–feather pigmentation patterning is determined by antagonistic interactions among molecular expression gradients within the tubular follicle and feather germ.
Optimal joint spatial-temporal diversity for spectrum sensing in cognitive radio networks

Spectrum sensing is a critical and challenging issue in cognitive radio networks. Prior research has demonstrated that using spatial diversity or temporal diversity can lead to more efficient spectrum sensing. Based on Neyman-Pearson criterion, this paper derives a novel spectrum sensing algorithm which exploits spatial diversity among multiple cognitive sensors and temporal diversity among consecutive time slots jointly. The numerical results not only verify the improvement of the sensing performance comparing with singular (spatial or temporal) diversity is applied, but also show the reduction of sensing overhead in low signal-noise-ratio (SNR) regime.
Self-Esteem and Theoretical Mediators of Safer Sex Among African American Female Adolescents: Implications for Sexual Risk Reduction Interventions

Theories of health behavior posit that change is accomplished by modifying factors deemed as mediators. A set of mediators from several theoretical models used in sexual risk reduction programs was assessed among a sample of 522 African American female adolescents. The goal was to determine whether self-esteem was associated with sexually transmitted disease (STD), pregnancy, and the set of theoretical mediators controlling for covariates. Bivariate analyses showed no relationship between self-esteem and STD or pregnancy; multivariate regression analysis revealed a significant relation between self-esteem and the set of mediators. Girls higher in self-esteem were more likely to hold positive condom attitudes, felt more efficacious in negotiating condom use, had more frequent communication with sex partners and parents, perceived fewer barriers to using condoms, and were less fearful of negotiating condom use. Self-esteem should be considered when designing and evaluating sexual risk reduction programs for this population.