Miracle-dz/UniFAR-FTUs huggingface dataset:
Weaving Babies Lost in Pregnancy Into the Fabric of the Family

During four qualitative research studies on pregnancy after perinatal loss, parents spoke of their dead babies and various ways they remembered them. Thus, they were a continued part of their lives. A secondary analysis was done of all relevant data and is reported here. The overall finding was that parents weave remembered babies into the fabric of their families in multiple ways. Specifically, the following five themes of ways babies were remembered and incorporated into family life emerged from the data: rituals, symbols, visible presence, holding a place in the family, and lifelong impressions. Clinical implications focus on recognizing the excellent care these families received that enabled them to heal and grow after the death of their babies so that such care can be expanded to other families in need. Parents could be encouraged to find their own ways of honoring their deceased babies.
Relationship of Hypertension and Systolic Blood Pressure With the Risk of Stroke or Bleeding in Patients With Atrial Fibrillation: The Fushimi AF Registry

BACKGROUND Hypertension is considered a major risk factor of stroke and systemic embolism (SE) as well as bleeding in patients with atrial fibrillation (AF). The purpose of this study was to investigate the relationship of hypertension and systolic blood pressure (SBP) with the risk of stroke/SE or bleeding in AF patients. METHODS The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, Kyoto. Fushimi-ku is densely populated with a total population of 283,000. Follow-up data were available for 3,713 patients (follow-up rate 90.0%) as of August 2015, and the median follow-up period was 1,035 days. RESULTS We compared the clinical backgrounds at baseline, and follow-up outcomes of AF patients between those with hypertension (HTN; n = 2,304, 62.1% of total) and those without (non-HTN; n = 1,409). History of hypertension was neither associated with the incidence of stroke/SE, ischemic stroke, hemorrhagic stroke nor major bleeding. However, when we divided the HTN group by baseline SBP ≥150 mm Hg (HTN-high blood pressure [HBP]: n = 305, 13.3% of HTN group) or <150 mm Hg (HTN-low blood pressure [LBP]: n = 1,983), HTN-HBP group was significantly associated with a higher incidence of both stroke/SE (hazard ratio [HR]: 1.74, 95% confidence interval [CI]: 1.08-2.72) and major bleeding (HR: 2.01, 95% CI: 1.21-3.23) compared with the non-HTN group. In contrast, HTN-LBP group was not associated with the risk of stroke/SE or major bleeding, compared with the non-HTN group. CONCLUSION The incidences of stroke/SE and bleeding were higher in AF and hypertension patients with elevated SBP. UMIN Clinical Trials Registry: UMIN000005834.
Ventricular mechanics in patients with aortic valve disease: longitudinal, radial, and circumferential components

Abstract Background Reduced long-axis shortening despite enhanced global function has been reported in aortic stenosis. We sought to improve the understanding of this phenomenon using multi-dimensional strain analysis in conjunction with the evaluation of left ventricular rotation and twist – ventricular torsion – using tissue Doppler techniques. Methods A total of 57 patients with variable severity of aortic stenosis, aortic regurgitation, or mixed aortic valve disease, subdivided into six groups, were studied. Ventricular morphology was assessed using long-axis/short-axis and mass/volume ratios, afterload using end-systolic meridional wall stress, and global performance using ejection fraction. The circumferential and longitudinal strain was measured from two-dimensional images, and left ventricular rotation and twist were estimated as the difference in rotation between the base and apex of the ventricle. Results Aortic stenosis was associated with higher mass/volume, ejection fraction, circumferential strain and left ventricular rotation and twist, significantly lower end-systolic wall stress, and a trend towards lower longitudinal strain compared with normal. Myocardial mechanics in aortic regurgitation were normal despite ventricular dilation. Mixed aortic valve disease showed findings similar to aortic stenosis. Left ventricular rotation and twist correlated with midwall circumferential strain (r = 0.62 and p < 0.0001), endocardial circumferential strain (r = 0.61 and p < 0.0001), and end-systolic wall stress (r = 0.48 and p < 0.0001), but not with longitudinal strain (r = 0.18 and p > 0.05). Conclusions Myocardial mechanics are normal in patients with aortic regurgitation, independent of abnormalities in cardiac geometry. Conversely, in aortic stenosis and mixed aortic valve disease, significant alterations in the patterns of fibre shortening are found. The effects of stenosis on cardiac function seem to dominate the effect of ventricular remodelling.
Sprint performance under heat stress: A review

Training and competition in major track‐and‐field events, and for many team or racquet sports, often require the completion of maximal sprints in hot (>30 °C) ambient conditions. Enhanced short‐term (<30 s) power output or single‐sprint performance, resulting from transient heat exposure (muscle temperature rise), can be attributed to improved muscle contractility. Under heat stress, elevations in skin/core temperatures are associated with increased cardiovascular and metabolic loads in addition to decreasing voluntary muscle activation; there is also compelling evidence to suggest that large performance decrements occur when repeated‐sprint exercise (consisting of brief recovery periods between sprints, usually <60 s) is performed in hot compared with cool conditions. Conversely, poorer intermittent‐sprint performance (recovery periods long enough to allow near complete recovery, usually 60–300 s) in hotter conditions is solely observed when exercise induces marked hyperthermia (core temperature >39 °C). Here we also discuss strategies (heat acclimatization, precooling, hydration strategies) employed by “sprint” athletes to mitigate the negative influence of higher environmental temperatures.
Gaussian mixture model‐based classification of dynamic contrast enhanced MRI data for identifying diverse tumor microenvironments: preliminary results

Tumor hypoxia develops heterogeneously, affects radiation sensitivity and the development of metastases. Prognostic information derived from the in vivo characterization of the spatial distribution of hypoxic areas in solid tumors can be of value for radiation therapy planning and for monitoring the early treatment response. Tumor hypoxia is caused by an imbalance between the supply and consumption of oxygen. The tumor oxygen supply is inherently linked to its vasculature and perfusion which can be evaluated by dynamic contrast enhanced (DCE‐) MRI using the contrast agent Gd‐DTPA. Thus, we hypothesize that DCE‐MRI data may provide surrogate information regarding tumor hypoxia. In this study, DCE‐MRI data from a rat prostate tumor model were analysed with a Gaussian mixture model (GMM)‐based classification to identify perfused, hypoxic and necrotic areas for a total of ten tumor slices from six rats, of which one slice was used as training data for GMM classifications. The results of pattern recognition analyzes were validated by comparison to corresponding Akep maps defining the perfused area (0.84 ± 0.09 overlap), hematoxylin and eosin (H&E)‐stained tissue sections defining necrosis (0.64 ± 0.15 overlap) and pimonidazole‐stained sections defining hypoxia (0.72 ± 0.17 overlap), respectively. Our preliminary data indicate the feasibility of a GMM‐based classification to identify tumor hypoxia, necrosis and perfusion/permeability from non‐invasively acquired, in vivo DCE‐MRI data alone, possibly obviating the need for invasive procedures, such as biopsies, or exposure to radioactivity, such as positron emission tomography (PET) exams. Copyright © 2013 John Wiley & Sons, Ltd.
Alpine Skiing With total knee ArthroPlasty (ASWAP): symmetric loading during skiing

The aim of this pilot study was to determine the pressure distribution, symmetry of load between operated (OP) and non‐operated (NOP) leg, and pain level during alpine skiing in participants with unilateral total knee arthroplasty (TKA). The responses of the dependent variables were analyzed following a 10‐week guided skiing intervention of 2–3 days of skiing per week. Ground reaction force (GRF) was recorded bilaterally and was determined for 13 participants with TKA (65 ± 4 years) at pre‐ and post‐test. Additionally, pain perception was determined using a numeric rating scale in the OP leg at both test sessions and after each skiing day. No statistical differences were observed between OP and NOP legs for peak and average GRF as well as the asymmetry indices at pre‐test. Pain perception was low and was not increased as a consequence of the skiing intervention. In conclusion, alpine skiing did not lead to increased or decreased loading of the OP leg compared with the NOP leg. Therefore, alpine skiing may be allowed for patients with skiing experience and a good clinical outcome.
Upper body heavy strength training does not affect performance in junior female cross‐country skiers

We investigated the effects of adding heavy strength training to a high volume of endurance training on performance and related physiological determinants in junior female cross‐country skiers. Sixteen well‐trained athletes (17 ± 1 years, 60 ± 6 kg, 169 ± 6 cm, VO2max running: 60 ± 5 mL/kg/min) were assigned either to an intervention group (INT; n = 9) or a control group (CON; n = 7). INT completed two weekly sessions of upper body heavy strength training in a linear periodized fashion for 10 weeks. Both groups continued their normal aerobic endurance and muscular endurance training. One repetition maximum in seated pull‐down increased significantly more in INT than in CON, with a group difference of 15 ± 8% (P < 0.01). Performance, expressed as average power output on a double poling ergometer over 20 s and as 3 min with maximal effort in both rested (sprint‐test) and fatigued states (finishing‐test), showed similar changes in both groups. Submaximal O2‐cost and VO2peak in double poling showed similar changes or were unchanged in both groups. In conclusion, 10 weeks of heavy strength training increased upper body strength but had trivial effects on performance in a double poling ergometer in junior female cross‐country skiers.
The role of livestock keeping in human brucellosis trends in livestock keeping communities in Tanzania.

A cross-sectional survey was carried out in Karatu and Ngorongoro districts in Arusha region and Babati, Hanang and Mbulu districts in Manyara region involving 20 agro-pastoral and 9 pastoral villages, to establish the magnitude of human brucellosis in relation to livestock brucellosis. A multistage random sampling was used to select villages, sub-village administrative units, ten cell leadership units and animal keeping households. A total of 460 humans from 90 families (19 pastoral and 71 agro-pastoral families) and 2723 domestic ruminants from 90 livestock households were sampled and bled to obtain serum samples for analysis. A competitive enzyme linked-immunosorbent assay (c-ELISA) was used to analyse these samples to detect brucella circulating antibodies. The overall livestock seroprevalence was 5.7% with 32.2% of livestock households being seropositive whereas, human seropositivity was 8.3% with 28% family households being seropositive. The highest proportion of seropositive families was observed in Ngorongoro district (46%) and the lowest in Babati district with no seropositive family household. Family members in seropositive livestock households were 3.3 (OR) times more likely to be seropositive than those with seronegative livestock households. However; 25% of seronegative family households had seropositive livestock households and 48% seropositive family households had seronegative livestock households. Therefore, Brucella infection is widespread in the human populations and their livestock in the northern Tanzania and thus humans may acquire infection from their own animals or from other sources thus prompted public health awareness creation in such communities.
Schedules for Self-monitoring Blood Pressure: A Systematic Review

Abstract BACKGROUND Self-monitoring of blood pressure better predicts prognosis than clinic measurement, is popular with patients, and endorsed in hypertension guidelines. However, there is uncertainty over the optimal self-monitoring schedule. We therefore aimed to determine the optimum schedule to predict future cardiovascular events and determine “true” underlying blood pressure. METHODS Six electronic databases were searched from November 2009 (updating a National Institute for Health and Care Excellence [NICE] systematic review) to April 2017. Studies that compared aspects of self-monitoring schedules to either prognosis or reliability/reproducibility in hypertensive adults were included. Data on study and population characteristics, self-monitoring regime, and outcomes were extracted by 2 reviewers independently. RESULTS From 5,164 unique articles identified, 25 met the inclusion criteria. Twelve studies were included from the original NICE review, making a total of 37 studies. Increasing the number of days of measurement improved prognostic power: 72%–91% of the theoretical maximum predictive value (asymptotic maximum hazard ratio) was reached by 3 days and 86%–96% by 7 days. Increasing beyond 3 days of measurement did not result in better correlation with ambulatory monitoring. There was no convincing evidence that the timing or number of readings per day had an effect, or that ignoring the first day’s measurement was necessary. CONCLUSIONS Home blood pressure should be measured for 3 days, increased to 7 only when mean blood pressure is close to a diagnostic or treatment threshold. Other aspects of a monitoring schedule can be flexible to facilitate patient uptake of and adherence with self-monitoring.
Hazardous alcohol drinking in the former Soviet Union: a cross-sectional study of eight countries.

BACKGROUND Hazardous consumption of large quantities of alcohol is a major cause of ill-health in the former Soviet Union (fSU). The objective of this study was to describe episodic heavy drinking and other hazardous drinking behaviors in eight countries of the fSU. METHODS Data from national surveys of adults conducted in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine in 2001 were used (overall sample size 18,428; response rates 71-88%). Heavy episodic drinking, high alcohol intake, drinking alcohol during the working day, and using illegally produced strong spirits were examined. RESULTS On average, 23% of men and 2% of women were defined as heavy episodic drinkers (> or = 2 l of beer or > or = 750 g bottle of wine or > or = 200 g strong spirits at least once every 2-3 weeks). This was more common in young males, women who are single or who are divorced/separated/widowed, in smokers, and in frequent alcohol drinkers. About half the respondents who drank strong spirits obtained at least some alcohol from private sources. Among drinkers, 11% of males and 7% of women usually took their first drink before the end of working day. CONCLUSIONS Heavy episodic alcohol drinking is frequent in males throughout the region--although prevalence rates may have been affected by underreporting--but is still relatively rare in women. Alcohol policies in the region should address hazardous drinking patterns and the common use of illegally produced alcohol.
Determinant factors in climbing ability: Influence of strength, anthropometry, and neuromuscular fatigue

The goal of this study was to (i) assess the physical and anthropometric differences between three levels of climbers and (ii) predict climbing ability by using a multiple regression model. The participants were divided into novice (n = 15), skilled (n = 16), and elite (n = 10) climbers. Anthropometric characteristics such as height, weight, percentage of body fat and muscle, bi‐acromial breath, arm span, and ape index were measured. General and specific strength were assessed through an arm jump test, a bench press test, and a hand and finger grip strength test in maximal and endurance conditions. All variables were combined into components via a principal component analysis (PCA) and the components used in a multiple regression analysis. The major finding of this study is that climbing ability is more related to specific rather than general strength. Only finger grip strength shows a higher level of initial strength between all samples while the arm jump test discriminates between climbers and non‐climbers. The PCA reveals three components, labeled as training, muscle, and anthropometry, which together explain 64.22% of the variance. The regression model indicates that trainable variables explained 46% of the total variance in climbing ability, whereas anthropometry and muscle characteristics explain fewer than 4%.
Hazardous alcohol use among hospital doctors in Germany.

AIMS To describe alcohol use, and the prevalence and predictors of hazardous drinking, among hospital doctors. METHODS Data were collected by anonymous mail survey in 2006, from a representative national sample of 1917 (58% response rate) hospital doctors in Germany. Alcohol use was measured using the AUDIT-C, scores of 5 or more for males and females indicating "hazardous drinking. " RESULTS There were 9.5% abstainers, 70.7% moderate drinkers, and 19.8% hazardous drinkers. The majority of doctors (90.5%) used alcohol--mainly at a sensible level, e.g., 2-4 times a month (32%) or 2-3 times a week (29%), and 1-2 glasses on one occasion (83%). Binge drinking was common (53%), but for most occurred less than once in a month (39%). When hazardous drinking was controlled for certain confounders, being male (OR 4.7; 95% CI 3.4-6.5) and having a surgical specialty (OR 1.4; 1.1-1.8) were significantly correlated to hazardous drinking. Age had no influence on this model. By contrast, the age group 40 years and younger (OR 2.1; 1.4-3.0) was a significant predictor of abstinence. CONCLUSIONS There is a higher rate of abstainers and a lower rate of binge drinkers among hospital doctors in Germany than in the general population. However, some hospital doctors drink hazardously, the risk being greater among males and among surgeons, which should be paid due attention in the interest of their health and their function as doctors.
Mediators and moderators of parental alcoholism effects on offspring self-esteem.

AIMS The goal of the proposed study was fourfold: (i) to examine the effects of parental alcoholism on adult offspring's self-esteem; (ii) to identify and test possible mediators and moderators of parental alcoholism effects on the self-esteem of adult offspring; (iii) to examine the utility and relevance of attachment theory (Bowlby J. (1969) Attachment and Loss: Vol. 1. Attachment. New York: Basic Books) in explaining parental alcoholism effects on self-esteem and (iv) to address some of the methodological limitations identified in past research on adult children of alcoholics (ACOA). METHODS Participants (N = 515) completed retrospective reports of parental alcoholism, family stressors, family communication patterns, parental attachment and a current measure of self-esteem. RESULTS The results showed support for the detrimental effects of parental alcoholism on offspring self-esteem and offered partial support for family stressors as a mediator of parental alcoholism effects on parental attachment and parental attachment as a mediator of parental alcoholism effects on offspring self-esteem, respectively. Finally, support was found for family communication patterns as a moderator of the effects of family stressors on attachment. CONCLUSIONS The study findings offer preliminary support for the utility of attachment theory in explicating parental alcoholism effects on the self-esteem of adult offspring. Findings from the present study make salient the need to consider factors beyond the identification of parental alcohol abuse when explicating individual differences in offspring self-esteem in adulthood. The identification of protective and risk factors can contribute to the development of optimal intervention strategies to help ACOAs better than simply the knowledge of family drinking patterns.
Arrhythmias in children with ventricular assist devices

Abstract Background: Children with decompensated heart failure are at high risk for arrhythmias, and ventricular assist device placement is becoming a more common treatment strategy. The impact of ventricular assist devices on arrhythmias and how arrhythmias affect the clinical course of this population are not well described. Methods and results: A single-centre retrospective analysis of children receiving a ventricular assist device between 1998 and 2011 was performed. In all, 45 patients received 56 ventricular assist devices. The median age at initial placement was 13 years (interquartile range 6–15). The median duration of support was 10 days (range 2–260). The aetiology of heart failure included cardiomyopathy, transplant rejection, myocarditis, and congenital heart disease. In all, 32 patients (71%) had an arrhythmia; 19 patients (42%) had an arrhythmia before ventricular assist device and eight patients (18%) developed new arrhythmias on ventricular assist device. Ventricular tachycardia was most common (25/32, 78%). There was no correlation between arrhythmia and risk of death or transplantation (p=0.14). Of the 15 patients who weaned from ventricular assist device, post-ventricular assist device arrhythmias occurred in nine (60%), with five (33%) having their first arrhythmia after weaning. Patients with ventricular dysfunction after ventricular assist device were more likely to have arrhythmias (p<0.02). Conclusions: Arrhythmias, especially ventricular, are common in children requiring ventricular assist device. They frequently persist for those able to wean from ventricular assist device.
The “Saltin–Grimby Physical Activity Level Scale” and its application to health research

The use of a four‐level questionnaire to assess leisure time physical activity (PA) and its validation is reviewed in this paper. This questionnaire was first published in 1968 and has then been used by more than 600 000 subjects, especially in different population studies in the Nordic countries. A number of modifications to the questionnaire have been published. These are mostly minor changes, such as adding practical examples of activities to illustrate the levels of PA. Some authors have also added duration requirements that were not included for all levels of PA in the original version. The concurrent validity, with respect to aerobic capacity and movement analysis using objective measurements has been shown to be good, as has the predictive validity with respect to various risk factors for health conditions and for morbidity and mortality.