Miracle-dz/UniFAR-FTUs huggingface dataset:
Genetics of Osteoarthritis: What a Pain!

textabstractOsteoarthritis (OA) is a common, chronic disabling disease characterized by pain and disability, affecting mainly the elderly population. The American College of Rheumatology defined OA as “a heterogeneous group of conditions that lead to joint symptoms and signs which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins”. Although a disease like OA will not directly lead to a higher mortality, the burden of disease and health care expenditure is enormous. In 2005, healthcare costs for OA in the Netherlands were approximately 540 million euro, which is in women higher than costs for hypertension, asthma or hip fracture. At the same time, the burden of OA is increasing because of aging and the obesity pandemic. In the Netherlands, already 650.000 persons (4% of the total population) had a diagnosis of OA in 2007. Although the incidence of disease stays stable over time, the prevalence is increasing due to the aging population and the population structure in the Netherlands. In addition, the World Health Organization showed in the Global Burden of Disease report that OA is the 4th leading cause of years lived with disability (YLD) at a global level. Only scarce symptomatic treatment options are available for OA, such as pain medication, exercise programs and eventually joint replacement. In summary, we can conclude that OA causes a large disease burden to patients and society and a better understanding of the pathophysiology is essential to discover new treatment options. Osteoarthritis is a degenerative joint disease affecting the whole joint. In Figure 1 the main structures of the joint affected by osteoarthritis are shown. The main characteristics of the disease process are articular cartilage loss, formation of new bone at the joint margins (osteophytes), increased thickness of the bone (subchondral sclerosis) and cyst formation. However, also soft-tissue structures surrounding the joint are affected, including the synovium, ligaments and muscles, making OA a whole-joint disease.
Support systems. 1. Introduction

“Employers have a key role to play in safeguarding the mental health of their workforce, both by providing a supportive work environment and by encouraging the use of the workplace to provide health education and health promotion activities” ([Department of Health (DoH), 1998 a , 4.64][1])
Percutaneous Transhepatic Biliary Drainage in Patients with Postsurgical Bile Leakage and Nondilated Intrahepatic Bile Ducts

Objective and Background: Bile leakage is a serious postoperative complication and percutaneous transhepatic biliary drainage (PTBD) may be an option when endoscopic treatment is not feasible. In this retrospective study, we established technical and clinical success rates as well as the complication rates of PTBD in a large group of patients with postoperative bile leakage. Methods: Data on all patients with nondilated intrahepatic bile ducts who underwent a PTBD procedure for the treatment of bile leakage between January 2000 and August 2012 were retrospectively assessed. Data included type of surgery, site of bile leak, previous attempts of bile leak repair, interval between surgery and PTBD placement. Outcome measures were the technical and clinical success rates, the procedure-related complications, and mortality rate. Results: A total of 63 patients were identified; PTBD placement was technically successful in 90.5% (57/63) after one to three attempts. The clinical success rate was 69.8% (44/63). Four major complications were documented (4/63; 6.3%): liver laceration, pneumothorax, pleural empyema, and prolonged hemobilia. One minor complication involved pain. Conclusions: PTBD is an effective treatment with low complication rates for the management of postsurgical bile leaks in patients with nondilated bile ducts.
Heart disease and stroke statistics--2014 update: a report from the American Heart Association.

Author(s): Go, Alan S; Mozaffarian, Dariush; Roger, Veronique L; Benjamin, Emelia J; Berry, Jarett D; Blaha, Michael J; Dai, Shifan; Ford, Earl S; Fox, Caroline S; Franco, Sheila; Fullerton, Heather J; Gillespie, Cathleen; Hailpern, Susan M; Heit, John A; Howard, Virginia J; Huffman, Mark D; Judd, Suzanne E; Kissela, Brett M; Kittner, Steven J; Lackland, Daniel T; Lichtman, Judith H; Lisabeth, Lynda D; Mackey, Rachel H; Magid, David J; Marcus, Gregory M; Marelli, Ariane; Matchar, David B; McGuire, Darren K; Mohler, Emile R; Moy, Claudia S; Mussolino, Michael E; Neumar, Robert W; Nichol, Graham; Pandey, Dilip K; Paynter, Nina P; Reeves, Matthew J; Sorlie, Paul D; Stein, Joel; Towfighi, Amytis; Turan, Tanya N; Virani, Salim S; Wong, Nathan D; Woo, Daniel; Turner, Melanie B; American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Prevalence and pattern of back pain among pregnant women attending ante-natal clinics in selected health care facilities

Back pain is (BP) is recognized as an important problem in pregnancy. The objectives of this study were to examine the prevalence and pattern of back pain (BP) in pregnancy. A survey of 2,187 pregnant women attending ante-natal clinics in selected Medical facilities in Ibadan and Ogbomoso, Nigeria was carried out using pre-tested close-ended questionnaire. Information on prevalence, pattern and characteristics of back pain in pregnancy were obtained. Data obtained was analyzed using both descriptive and inferential statistics of mean, standard deviation, and inferential statistics of independent t-tests and chi-square tests. One thousand and eight (52.5%) of the 1919 included subjects had back pain in pregnancy. The mean age of those with and without back pain was 26.8 ± 5.3 and 27.1 ± 5.4 years respectively. Mean number of pregnancy was higher in subjects with back pain than those without back pain. The pain site among the 1008 subjects with back pain was low back in 669 subjects (66.4%), posterior pelvic in 242 subjects (24.0%) and high back in 97 subjects (9.6%). Among the subjects with back pain, 315 (31.3%) and 53 (5.3%) were in their first and sixth pregnancies respectively. Postural modification relieved the back pain in about 50% of the subjects across the three back pain groups during pregnancy. It was concluded that back pain is a common and real complaint in pregnancy. It is therefore recommended that rather than dismiss it as trivial, back pain in pregnancy should be attended to as part of ante-natal care. (Afr. J. Biomed. Res. 9: 149 – 156) Keywords : Back pain; Pattern; Pregnancy
Cardiovascular Disease Prevention Preferences of a Sample of Urban American Indians

This study identified program delivery preferences and barriers to physical activity and healthy eating. Ninety-nine urban dwelling American Indians completed a questionnaire at powwows, community events, and a community health center. Most frequently selected program delivery preferences were coaching or other human contact, with fewer willing to use computer or telephone coaching. Fifty-six selected attending 8, 12, or 16 sessions. Most frequently selected barriers to physical activity were lack of time (n = 48) and pain from existing problems (n = 33). Frequently identified barriers to eating healthy foods included expense (n = 42), uncertainty regarding what foods are healthy (n = 25), extra time needed for preparation (n = 22), and lack of knowledge of how to prepare healthy food (n = 22). Findings showed the need for programs to focus on decreasing the barriers of time for physical activity and healthy eating and encourage doing organized physical activity (not necessarily exercise) with others to increase physical activity.
Bacteremia due to multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL) producing Acinetobacter baumannii

Bacteremia due to Acinetobacter baumannii is a common problem in hospitals worldwide. Physicians in the intensive care units (ICUs) encountered a serious challenge of finding a drug to cure the extended-spectrum beta-lactamase (ESBL) producing and multi-drug resistant (MDR) A. baumannii bacteremia. Our aim was to determine the frequency of A. baumannii bacteremia in an Iranian hospital ICUs, their antibiotic susceptibility patterns, and the frequency of ESBLs by a cross-sectional study. A total of 340 patients admitted to ICUs during a 6 month period of study were investigated for bacteremia due to A. baumannii. Bacteria isolates from blood specimens were identified as A. baumannii by API 20NE system. Antimicrobial susceptibility was studied with disk diffusion method. Detection of ESBLs was done by double disk synergy test. Of the 340 patients investigated, bacteremia was found in 114 cases (33%). A. baumannii was diagnosed as the etiological agent of bacteremia in 69 cases (60.5%). All the isolates were multi-drug resistant. Except one, all the remaining isolates (98.6%) were resistant to at least 7 of 13 tested antibiotics. Pandrug-resistance was observed in 4 isolates (5.6%). Of all the isolated A. baumannii, 49 (71%) were found to be resistant to cephalosporins by screening tests and among them 27 isolates (39%) were found to be ESBL producing.Our study showed a high frequency of A. baumannii bacteremia occurrence in our hospital ICUs. An urgent intervention is needed to reduce the MDR bacterial load in these critical units. Key words: Acinetobacter baumannii, bacteremia, multi-drug resistant, extended-spectrum beta-lactamase.
Daily supplementation with 15 μg vitamin D2 compared with vitamin D3 to increase wintertime 25-hydroxyvitamin D status in healthy South Asian and white European women: a 12-wk randomized, placebo-controlled food-fortification trial.

Background: There are conflicting views in the literature as to whether vitamin D2 and vitamin D3 are equally effective in increasing and maintaining serum concentrations of 25-hydroxyvitamin D [25(OH)D], particularly at lower doses of vitamin D.Objective: We aimed to investigate whether vitamin D2 or vitamin D3 fortified in juice or food, at a relatively low dose of 15 μg/d, was effective in increasing serum total 25(OH)D and to compare their respective efficacy in South Asian and white European women over the winter months within the setting of a large randomized controlled trial.Design: A randomized, double-blind, placebo-controlled food-fortification trial was conducted in healthy South Asian and white European women aged 20-64 y (n = 335; Surrey, United Kingdom) who consumed placebo, juice supplemented with 15 μg vitamin D2, biscuit supplemented with 15 μg vitamin D2, juice supplemented with 15 μg vitamin D3, or biscuit supplemented with 15 μg vitamin D3 daily for 12 wk. Serum 25(OH)D was measured by liquid chromatography-tandem mass spectrometry at baseline and at weeks 6 and 12 of the study.Results: Postintervention in the 2 ethnic groups combined, both the vitamin D3 biscuit and the vitamin D3 juice groups showed a significantly greater absolute incremental change (Δ) in total 25(OH)D when compared with the vitamin D2 biscuit group [Δ (95% CI): 15.3 nmol/L (7.4, 23.3 nmol/L) (P < 0.0003) and 16.0 nmol/L (8.0, 23.9 nmol/L) ( P < 0.0001)], the vitamin D2 juice group [Δ (95% CI): 16.3 nmol/L (8.4, 24.2 nmol/L) (P < 0.0001) and 16.9 nmol/L (9.0, 24.8 nmol/L) (P < 0.0001)], and the placebo group [Δ (95% CI): 42.3 nmol/L (34.4, 50.2 nmol/L) (P < 0.0001) and 42.9 nmol/L (35.0, 50.8 nmol/L) (P < 0.0002)]. Conclusions: With the use of a daily dose of vitamin D relevant to public health recommendations (15 μg) and in vehicles relevant to food-fortification strategies, vitamin D3 was more effective than vitamin D2 in increasing serum 25(OH)D in the wintertime. Vitamin D3 may therefore be a preferential form to optimize vitamin D status within the general population. This trial was registered at www.controlled-trials.com as ISRCTN23421591.
Challenges in identifying asthma subgroups using unsupervised statistical learning techniques.

RATIONALE Unsupervised statistical learning techniques, such as exploratory factor analysis (EFA) and hierarchical clustering (HC), have been used to identify asthma phenotypes, with partly consistent results. Some of the inconsistency is caused by the variable selection and demographic and clinical differences among study populations. OBJECTIVES To investigate the effects of the choice of statistical method and different preparations of data on the clustering results; and to relate these to disease severity. METHODS Several variants of EFA and HC were applied and compared using various sets of variables and different encodings and transformations within a dataset of 383 children with asthma. Variables included lung function, inflammatory and allergy markers, family history, environmental exposures, and medications. Clusters and original variables were related to asthma severity (logistic regression and Bayesian network analysis). MEASUREMENTS AND MAIN RESULTS EFA identified five components (eigenvalues ≥ 1) explaining 35% of the overall variance. Variations of the HC (as linkage-distance functions) did not affect the cluster inference; however, using different variable encodings and transformations did. The derived clusters predicted asthma severity less than the original variables. Prognostic factors of severity were medication usage, current symptoms, lung function, paternal asthma, body mass index, and age of asthma onset. Bayesian networks indicated conditional dependence among variables. CONCLUSIONS The use of different unsupervised statistical learning methods and different variable sets and encodings can lead to multiple and inconsistent subgroupings of asthma, not necessarily correlated with severity. The search for asthma phenotypes needs more careful selection of markers, consistent across different study populations, and more cautious interpretation of results from unsupervised learning.
An exploratory study of pet raising and health of the elderly people in Hong Kong

Pets such as dogs, cats and fish were popular in many other countries (Marx et al., 1988; Gammonley, 1991; Brodie & Biley, 1999; PIAS, 2002). In Hong Kong, pet owners increased to 0.26 million (Census and Statistics Department, 2006). Dating back to 1980s, a research study reported the association between pet ownerships and health benefits for humans (McNicholas et al., 2005). According to the report, domesticated pets brought a sense of companionship and provided pet owners with pleasure. …
A Cytokine-Like Protein Dickkopf-Related Protein 3 Is Atheroprotective

Background: Dickkopf-related protein 3 (DKK3) is a secreted protein that is involved in the regulation of cardiac remodeling and vascular smooth muscle cell differentiation, but little is known about its role in atherosclerosis. Methods: We tested the hypothesis that DKK3 is atheroprotective using both epidemiological and experimental approaches. Blood DKK3 levels were measured in the Bruneck Study in 2000 (n=684) and then in 2005 (n=574). DKK3-deficient mice were crossed with apolipoprotein E-/- mice to evaluate atherosclerosis development and vessel injury-induced neointimal formation. Endothelial cell migration and the underlying mechanisms were studied using in vitro cell culture models. Results: In the prospective population-based Bruneck Study, the level of plasma DKK3 was inversely related to carotid artery intima-media thickness and 5-year progression of carotid atherosclerosis independently from standard risk factors for atherosclerosis. Experimentally, we analyzed the area of atherosclerotic lesions, femoral artery injury-induced reendothelialization, and neointima formation in both DKK3-/-/apolipoprotein E-/- and DKK3+/+/apolipoprotein E-/- mice. It was demonstrated that DKK3 deficiency accelerated atherosclerosis and delayed reendothelialization with consequently exacerbated neointima formation. To explore the underlying mechanisms, we performed transwell and scratch migration assays using cultured human endothelial cells, which exhibited a significant induction in cell migration in response to DKK3 stimulation. This DKK3-induced migration activated ROR2 and DVL1, activated Rac1 GTPases, and upregulated JNK and c-jun phosphorylation in endothelial cells. Knockdown of the ROR2 receptor using specific siRNA or transfection of a dominant-negative form of Rac1 in endothelial cells markedly inhibited cell migration and downstream JNK and c-jun phosphorylation. Conclusions: This study provides the evidence for a role of DKK3 in the protection against atherosclerosis involving endothelial migration and repair, with great therapeutic potential implications against atherosclerosis.
The Drug Information Service at a University Hospital in Malaysia: Characteristics of Drug Inquiries

A retrospective review of the records of drug inquiries received by the Hospital Universiti Sains Malaysia Drug Information Unit (DIU) was undertaken to provide baseline data for future development of the service. The number of drug inquiries received from 1990 to 1995 ranged from 204–447 per year. The quantity and type of inquiries, and the individuals requesting drug-related information, remained relatively constant throughout the six-year period. The majority of inquiries were related directly to patient care, and came from doctors and pharmacists working at the hospital while external inquiries were minimal. Any future plan to promote and expand the service has to consider the expected increase in workload. The increasing dependence on computerized tertiary references when responding to inquiries may indicate the need to use pharmacists’ time optimally. Such systems are expensive to maintain, however, especially in a developing country such as Malaysia, thus future funding may depend on the ability of the DIU to justify its service.
Detection of Toxoplasmosis in Renal Transplant Recipients by ELISA and PCR Methods in Ahvaz, South-West of Iran

Background: Toxoplasmosis is an opportunistic infection caused by Toxoplasma gondii. That is asymptomatic in the majority of patients, but it can be life threatening in immune-compromised subjects, such as patients with HIV and organ transplant recipients. Objectives: This study aimed to determine the Toxoplasmosis in Renal Transplant Recipients in Ahvaz, South-West of Iran. Materials and Methods: A total of 100 patients and 100 healthy subjects participated in this study. The specific IgG and IgM antibodies of T. gondii were detected in the two groups by ELISA and the presence of T. gondii in the blood samples was evaluated by GRA6 PCR. Results: 34 (34%) of the renal transplant recipients and 26 (26%) of the control group were positive for anti-Toxoplasma IgG. In addition 18 (18%) of the renal transplant recipients and 4 (4%) of the control group were positive for anti-Toxoplasma IgM. For both values of the antibodies, differences were statistically significant (P < 0.025 and P < 0.001 respectively). The PCR results indicated the presence of T . gondii parasite in 2 blood samples of recipients, but not in those of the healthy control. Conclusions: According to the findings of the current study, renal transplant recipients have a higher prevalence of toxoplasmosis than healthy people and also there is disseminated infection in the patients. Therefore to prevent the severe complications screening and follow up of renal transplant recipients for toxoplasmosis should not be neglected.
Investigating successful English learners in Arab medical schools

For students in the preparatory stage of post-secondary schooling or those already engaged in studying in their area of specialisation, the most common focus of English language training, in both EFL and ESL settings, is English for academic purposes. The primary purpose of such training is to help prepare students with limited English proficiency to deal with the linguistic demands of higher education in their subject area. At the end of the period of training, it is hoped that learners will have developed sufficient skills in academic English to enable them to continue studying independently through the medium of English. In reality, at least in my experience, many learners in this situation feel far from confident with the level of English proficiency attained. However they rarely have further opportunities for formal English instruction. This is particularly true in EFL settings where opportunities to interact with native speakers may be limited and it is assumed that students are restricted in their ability to continue to improve their English proficiency independently. Although there is an everygrowing body of research concerning the beliefs and strategies of learners when they are engaged in language study in institutions, less information has been obtained about the methods learners use to improve or maintain their language proficiency once they complete formal instruction in the language. The present study examines some ways in which individuals, in a mostly Arabic language setting, manage their English learning and practice once they have entered the phase of studying medicine, by the medium of English, as well as some of their beliefs and attitudes about learning English. Background A considerable number of higher academic institutions exist in the countries of the Gulf Cooperation Council (GCC), which borders the Arabian Gulf: Kuwait, Saudi Arabia, Bahrain, Qatar, the United Arab Emirates and Oman. Virtually all of them have EAP requirements for a large proportion of their student bodies. Much of the training for medical students, especially, will be conducted through the medium of English, so English language courses are a requirement of most regional medical schools. Once these courses are completed, generally in the premedical phase of training, students must grapple, as best they can, with the considerable demands of learning medicine through English. Nonetheless, the majority do eventually succeed in their medical studies, so it may be that the lack of further English training is not a serious impediment, or they may take steps on their own to manage and upgrade their English, without the support of formal instruction. Having spent the better part of two decades teaching English to premedical students, I was curious to discover how they view their own English proficiency. What, if anything, they do on their own to improve their English? How do they manage their language learning once the compulsory language courses are over?
Racial-ethnic differences in childhood higher body mass index: insurance status explanatory model

Purpose – The purpose of this paper is to examine the prevalence of obesity/overweight using higher body mass index (BMI), assess racial/ethnic variance in overweight/obese prevalence, and to determine whether or not insurance status explains the variance. Design/methodology/approach – A cross-sectional design was used to assess medical records of children in Nemours Healthcare System during 2011. The authors reviewed the records and extracted information on normal BMI, BMI percent, higher BMI, prevalence of overweight/obese and other variables as well as race and ethnicity. χ2 statistic, Fischer's exact and logistic regression model were used to examine the data. Findings – Overall, the prevalence of higher BMI as overweight/obese was comparable to that of the US pediatric population, 33.4 percent. Compared to Caucasian/white, Asians were less likely to have higher BMI, prevalence odd ratio (POR)=0.79, 95 percent CI=0.70-0.90, but Blacks/African Americans (POR=1.22, 95 percent CI=1.18-1.27) and Some othe.