Miracle-dz/UniFAR-FTUs huggingface dataset:
Factors affecting attendance at postpartum diabetes screening in women with gestational diabetes mellitus

of women diagnosed with gestational diabetes mellitus (GDM) will be diagnosed with type 2 diabetes within five years. Attendance rates at postpartum screening are only 48-56%. As the barriers or facilitators to screening attendance among women diagnosed with GDM have not previously been determined, this study aimed to examine the barriers and facilitators to attendance at postpartum diabetes screening as reported by women following a recent history of GDM. This study was a cross-sectional telephone survey of Australian women diagnosed with GDM in a Queensland hospital during the period July 2006 to June 2007. Rates of attendance at postpartum diabetes screening were assessed, and reported barriers and facilitators to postpartum screening were grouped into themes. Of 187 eligible participants, 88 women were surveyed (aged 33±6 years, parity 1 (0-5)). Half (53.4%) of respondents attended postpartum diabetes screening. Barriers to screening included a lack of awareness of the need to attend screening, the inconvenience associated with the two to three hour length of the OGTT, and the need to attend screening with infants and young children. Reported facilitators included improved awareness of the need for screening, multiple reminders, and a more pleasant and convenient test. Facilitation strategies aimed at increasing the awareness of postpartum diabetes risks and promoting the provision of accurate and consistent screening advice from medical providers may assist in improving attendance at postpartum diabetes screening. A more acceptable screening test and establishment of a national database for routine screening reminders may also encourage women to attend postpartum diabetes screening. Copyright © 2011 John Wiley & Sons. Practical Diabetes Int 2011; 28(2): 64-68
Improving outcomes for older retired drivers: The UQDRIVE program

Continuation or loss of the driving role can impact on older people, their families and health professionals. Although there may be safety concerns associated with continued driving in the presence of specific medical conditions and the ageing process (e.g. Fildes, 2004), driving cessation can result in unfavourable outcomes that cannot be explained by health, age or sociodemographic factors. These may include increased depressive symptomatology (Fonda, Wallace & Herzog, 2001; Marottoli et al., 1997), decreased community engagement (Marottoli et al., 2000), isolation, and safety risks associated with alternative transport use (e.g. pedestrian fatalities) (Organisation for Economic Co-operation and Development, 2001). Retirement from driving is a transition that can be important in occupational therapy practice with older people. Occupational therapists may be involved in the assessment and rehabilitation of older drivers’ performance, and in the management of role loss and change in older age (Liddle & McKenna, 2003). Older current and retired drivers, family members and health professionals report a lack of direction and support with how to manage driving cessation (Liddle & McKenna). While there is research about the effect of driving cessation on the older population, there have been few attempts to improve outcomes for older people who retire from driving. To develop an effective, research-based, client-centred method to help older people manage driving cessation, the perspectives of key people were investigated. In an initial qualitative study, 18 people (9 retired drivers, 3 family members and 6 health professionals) were interviewed. This was followed by a primarily quantitative study using structured interviews to further investigate these findings with 234 community-dwelling older people. Detailed descriptions of the methods and findings of these studies are available (Liddle, 2005; Liddle, Carlson, & McKenna, 2004; Liddle, McKenna, & Broome, 2005). An overview of the findings is provided in this paper to describe how the UQDRIVE (University of Queensland Driver Retirement Initiative) program was developed.
The Importance of a Person-Centered Approach in Diagnostic Workups of Patients With Irritable Bowel Syndrome: A Qualitative Study

The aim of this study was to explore experiences of undergoing a diagnostic workup in patients with irritable bowel syndrome (IBS) at a unit for functional gastrointestinal disorders. Research has been sparse in addressing such experiences and the impact on well-being. Patients with IBS were invited to perform a workup of gastrointestinal tests. Of 120 patients who completed the tests, 20 were invited for an interview. Analysis of interviews was conducted through interpretative phenomenological analysis. One master theme emerged: validation of IBS experience inferred from three subthemes: the duality of suffering in IBS, coping with inflicted discomfort and pain, and capacity for resilience. Patients reported long-term suffering from symptoms including poor management within the healthcare organization. Despite inconvenience associated with the tests, patients expressed appreciation for professional attributes such as attentiveness that were perceived as a sense of being cared for and seen as a “person. ” During the workup, patients acquired greater knowledge of what IBS means, including knowledge about their own body functions and experienced relief that symptoms were not caused by any “dangerous” disease. Validation of IBS experience surfaced in the data implying that in such context, patients with IBS appear to find personal solutions to cope with everyday experiences and enhance autonomy.
Causes of Maternal Deaths in Tanta University Hospital

Objective: To assess the etiology, trends and causes of maternal mortality in Tanta University Hospital. Study design: Retrospective study of files for each case of maternal mortality during the years 2007–2009. Results: There were 21 maternal deaths out of 16,944 deliveries, yielding a rate of 123.94 deaths per 100,000 livebirths. The main causes of maternal mortality were Caesarean section (19.05%), postpartum hemorrhage (19.05%), pre-eclampsia/eclampsia (19.05%), sepsis (14.29%) and embolic phenomena (9.52%). Conclusion: Maternal mortality in Tanta University Hospital is higher than the national figure, probably because high quality obstetric health care is lacking and because of deficient therapeutic protocols. Nevertheless, the maternal mortality rate may possibly be reduced by eliminating the preventable causes.
Delamanid, a new 6-nitro-2,3-dihydroimidazo[2,1-b]oxazole for the management of tuberculosis resistant to at least isoniazid and rifampicin

Introduction: Novel therapeutic agents are urgently needed to combat drug-resistant tuberculosis. Delamanid is a new 6-nitro-2,3-dihydroimidazo[2,1-b]oxazole developed from a new chemical group to which no resistance exists. Preclinical experience found delamanid efficacious with a good safety profile except for QT prolongation; in vitro no interaction, inhibitory nor stimulatory with human and animal liver microsomes or a range of CYP enzymes have been demonstrated; interactions with antiretroviral agents are unlikely but this must still be demonstrated in clinical trials. A dose-ranging early bactericidal activity study provided proof of concept, and a controlled trial over the first 8 weeks of multidrug-resistant tuberculosis treatment found accelerated sputum culture negativity. Delamanid is in ongoing clinical trials in children, adults and HIV-infected adults receiving antiretroviral treatment. Areas covered: Using keywords, such as imidazooxazole, nitroimidazoles, OPC-67683, delamanid and antituberculosis drugs, the literature concerning the development and assessment, both in vitro and in vivo, of a new antituberculosis drug, delamanid was reviewed. Expert opinion: In view of efficacy, absence of major toxicity thus far and probable lack of interaction with antiretroviral agents, delamanid is a potential addition to the therapeutic armamentarium for tuberculosis.
Multiple‐dose, safety, pharmacokinetic, and pharmacodynamic study of sotatercept (ActRIIA‐IgG1), a novel erythropoietic agent, in healthy postmenopausal women

Ligands of the transforming growth factor‐beta superfamily and activin‐receptor signaling play an important role in erythropoiesis. Sotatercept, an activin receptor type IIA (ActRIIA) ligand trap, is a novel, recombinant, fusion protein comprising the extracellular domain of human ActRIIA linked to the Fc portion of human immunoglobulin G1. Sotatercept, originally developed to increase bone mineral density, was noted to have robust effects on erythropoiesis. Here, we evaluated the safety, pharmacokinetic properties, and pharmacodynamic effects of sotatercept in 31 healthy postmenopausal women. Sotatercept was administered at dose level 0.1, 0.3, or 1 mg/kg every 28 days subcutaneously for up to four doses. Sotatercept was generally safe and well tolerated, and elicited clinically significant, dose‐dependent increases in hemoglobin, hematocrit, and red blood cell counts that persisted for up to 4 months. The effect of sotatercept on hemoglobin was dose‐limiting. Sotatercept also increased bone mineral density and biomarkers of bone formation. The sotatercept serum exposure–dose relationship was linear, with a mean terminal half‐life of approximately 23 days. ActRIIA ligands are important regulators of erythrocyte production in healthy individuals. Clinical studies are ongoing to explore the potential of sotatercept to treat anemia and diseases of ineffective erythropoiesis as well as an agent to increase bone mineral density.
Nanostructured catalysts in fuel cells

One of the most important challenges for the ultimate commercialization of fuel cells is the preparation of active, robust, and low-cost catalysts. This review highlights some findings of our investigations in the last few years in developing advanced approaches to nanostructured catalysts that address this challenge. Emphasis is placed on nanoengineering-based fabrication, processing, and characterization of multimetallic nanoparticles with controllable size (1–10 nm), shape, composition (e.g. MlnM2100−n, M1nM2mM3100−n−m, M1@M2, where M (1 or 2) = Pt, Co, Ni, V, Fe, Cu, Pd, W, Ag, Au etc) and morphology (e.g. alloy, core@shell etc). In addition to an overview of the fundamental issues and the recent progress in fuel cell catalysts, results from evaluations of the electrocatalytic performance of nanoengineered catalysts in fuel cell reactions are discussed. This approach differs from other traditional approaches to the preparation of supported catalysts in the ability to control the particle size, composition, phase, and surface properties. An understanding of how the nanoscale properties of the multimetallic nanoparticles differ from their bulk-scale counterparts, and how the interaction between the nanoparticles and the support materials relates to the size sintering or evolution in the thermal activation process, is also discussed. The fact that the bimetallic gold–platinum nanoparticle system displays a single-phase character different from the miscibility gap known for its bulk-scale counterpart serves as an important indication of the nanoscale manipulation of the structural properties, which is useful for refining the design and preparation of the bimetallic catalysts. The insight gained from probing how nanoparticle–nanoparticle and nanoparticle–substrate interactions relate to the size evolution in the activation process of nanoparticles on planar substrates serves as an important guiding principle in the control of nanoparticle sintering on different support materials. The fact that some of the trimetallic nanoparticle catalysts (e.g. PtVFe or PtNiFe) exhibit electrocatalytic activities in fuel cell reactions which are four–five times higher than in pure Pt catalysts constitutes the basis for further exploration of a variety of multimetallic combinations. The fundamental insights into the control of nanoscale alloy, composition, and core–shell structures have important implications in identifying nanostructured fuel cell catalysts with an optimized balance of catalytic activity and stability.
Effects of Long-term Regular Exercise on Cognitive Function, Lipid Profile and Atherogenic Biomarkers in Middle-aged Men

Effects of Long-term Regular Exercise on Cognitive Function, Lipid Profile and Atherogenic Biomarkers in Middle-aged Men Several studies on exercise and its effect on cognitive function in human and animal populations have documented the beneficial impact of regular physical activity on maintenance of good cognitive abilities and satisfactory health-related quality of life well into older age. The aim of the study was to evaluate the effects of long-term regular running on metabolic profile and cognitive function in middle-aged men. A total of 24 regularly exercising, middle-age men (Group A), all being members of the Runners Club, and 22 age-matched sedentary subjects (Group B), as the control group, were enrolled in this study. The control group included 8 non-overweight (BMI=23.5±5.2) individuals (Group C) and 14 overweight/obese (BMI=30.7±1.6) subjects (Group D). Serum lipid profile, glucose and homocysteine concentrations were assessed by routine laboratory methods. Subjects' cognitive function was evaluated based on Trail Making Test (TMT) and Digit Symbol Test (DST) scores. In a majority of runners (Group A), the BMI and the parameters of lipid profile (TC, HDL, LDL, TG, glycerol) were close to those recorded in non-overweight controls (Group C) and, in both groups, results were ideally within the reference ranges for healthy male subjects. However, as compared to the whole control group (Group B), which may be considered as an average population sample of sedentary middle-age men, significant differences were observed in BMI and concentrations of TC and LDL, as well as in the pro-atherogenic biomarkers (TC/HDL, LDL/HDL), which were lower in runners. A similar tendency was found in concentrations of TG (independent cardiovascular risk factor), glycerol and TG/HDL ratio (surrogate measure of insulin resistance), however the differences did not reach the level of significance. The level of homocysteine (pro-atherogenic biomarker) was comparable in all groups, and in most cases, within the reference range for male adults. Results of cognitive function tests did not reveal any significant between-group differences. The TMT score was found to be correlated positively (r=0.492, p<0.05), whereas DST score was correlated negatively (r=-0.549, p<0.005), with age. The DST performance, as evaluated in the group of runners (Group A), appeared to be strongly dependent (r=0.809, p<0.005) on the educational level of the subject. These data provided evidence of beneficial effects of a long-term regular endurance running exercise on lipid profile and cardiovascular health in middle-aged men. However, we failed to confirm the findings of a favorable impact of regular physical activity on improvement in cognitive abilities.
Does a Self-Management Program Change Dietary Intake in Adults With Irritable Bowel Syndrome?

Making dietary changes such as increasing fiber intake is recommended for the management of irritable bowel syndrome symptoms. Few studies have explored the efficacy of education on compliance with recommendations such as increasing fiber, vegetable, and fruit intake in adults with irritable bowel syndrome. This study examined the effect of a multicomponent self-management intervention that included strategies to enhance fiber, vegetable, and fruit intake. Participants with medically diagnosed irritable bowel syndrome were randomized to usual care or individualized comprehensive self-management, delivered either in-person or by telephone. Since previously published analyses show the two delivery modes to be equally effective, the two intervention groups were combined. Of the 188 individuals randomized, 173 participants (113 in the self-management group and 60 in the usual care group; 23 men, 150 women) provided data on at least one of the three follow-up occasions (3, 6, and 12 months postrandomization). Fiber, vegetable, and fruit intakes were measured using the Food Frequency Questionnaire. Participants in the intervention group demonstrated increases (p < .05) in fiber and fruit intake and a trend in vegetable intake at 6 and 12 months postintervention. Improvement in dietary fiber intake following a self-management intervention for IBS continues to 1 year.
Comparative Analysis of Measles Morbidity and Mortality in Calabar during the Expanded Programme on Immunization and the National Programme on Immunization Eras

Background: In an apparent desire to improve the routine immunization coverage in the country, the Nigerian Government in 1997, launched the National Programme on Immunization (NPI) in place of the existing Expanded Programme on Immunization (EPI). Aim: The aim of the present retrospective study was to determine whether the desired goal was achieved, by comparing the hospital incidences, morbidities and mortalities from measles infection during the EPI (January 1992 to December 1996) and NPI (January 1997 to December 2001) eras. Subjects and Methods: The subjects were children admitted with measles infection to the University of Calabar Teaching Hospital, Calabar, during the period. Data were extracted from the relevant case files. Results: One hundred and twenty cases (representing 24 cases per year), and 36 cases (representing 7.2 cases per year) were admitted during the NPI and EPI eras, respectively (P Conclusion: There was an upsurge in the incidence, morbidity and mortality from measles during the NPI era. Adequate health education, intensification of the National Programme on Immunization, and house-to-house contact for measles vaccination are advocated. Nigerian Journal of Paediatrics 30(3) 2003:81-85
A meta‐analysis comparing the efficacy of entecavir and tenofovir for the treatment of chronic hepatitis B infection

The efficacy of entecavir and tenofovir in patients with chronic hepatitis B virus (HBV) is inconsistent. To address this issue, we conducted a meta‐analysis based on a current review of the literature addressing the efficacy and safety of entecavir and tenofovir. Electronic databases were searched through June 2014 for relevant clinical trials. We included 2 randomized controlled trials, 2 prospective cohort studies, and 7 case‐control studies that included 1,656 patients. In the entecavir group, 842 of 992 were nucleos(t)ide‐naïve chronic HBV patients, and in the tenofovir group 481 of 664 were nucleos(t)ide‐naïve. The virological response to tenofovir was superior to entecavir (RR: 0.82; 95%CI: 0.72–0.93), especially in nucleos(t)ide‐naïve chronic HBV patients at 48 weeks (RR: 0.78; 95%CI: 0.65–0.92). Additionally, there was no difference between entecavir and tenofovir for virological response at 24 weeks (RR: 0.87, 95%CI: 0.71–1.05). The alanine aminotransferase normalization rate, serological response, and adverse event rate were also not significantly different between entecavir and tenofovir at 24 or 48 weeks after treatment. These results suggest that tenofovir is a better choice to treat chronic HBV patients than entecavir as it is better able to suppress HBV viral load and has a similar safety profile.
Teaching Professionalism: A Medical Student's Opinion

S tudies repeatedly show that fourth-year medical students represent some of the most cynical members of the health care system. It seems that as we traverse the medical education system, we begin to lose the attributes that attracted us to medicine in the first place. As we are being taught within our formal curriculum how to be empathetic, kind, caring young physicians, we are somehow growing into cynical, jaded, less passionate senior students.
Population pharmacokinetics analysis of AMG 416, an allosteric activator of the calcium‐sensing receptor, in subjects with secondary hyperparathyroidism receiving hemodialysis

This study characterizes the population pharmacokinetics of AMG 416, an allosteric activator of the calcium‐sensing receptor, in subjects with secondary hyperparathyroidism receiving hemodialysis. AMG 416 doses ranging from 2.5 to 60 mg were administered intravenously as single or multiple thrice weekly (TIW) doses at the end of hemodialysis during rinseback. The influence of demographics, concomitant medications, and other disease‐related biomarkers on pharmacokinetic parameters was explored. The predictability of the final model was evaluated using bootstrapping and visual predictive checks. A 3‐compartment linear pharmacokinetic model that accounts for the hemodialysis clearance best described the data. Plasma clearance (interindividual variability) was 0.564 L/h (14.0%CV). The hemodialysis clearance was 22.2 L/h. The volume of distribution at steady‐state was approximately 624 L (82%CV). The mean time to achieve 90% steady‐state predialysis concentrations with 3‐ and 6‐hour hemodialysis TIW was 46 and 32 days, respectively. No statistically significant (P < .01) covariates effect was found on pharmacokinetic parameters. Bootstrapping and predictive checks supported model predictive ability. AMG 416 exhibits linear and stationary pharmacokinetics within the range of doses evaluated. Within the range of covariate values investigated, pharmacokinetically driven adjustments of AMG 416 dosing on the basis of these covariates were not warranted.
Finasteride use and acute pancreatitis in Taiwan

The aim of this study was to examine whether there is an association between finasteride use and the risk of acute pancreatitis. This population‐based case‐control study used the database of the Taiwan National Health Insurance Program. There were 2,530 male subjects aged 40–84 years with a first‐attack of acute pancreatitis during the period of 1998–2011 as the case group and 10,119 randomly selected subjects without acute pancreatitis as the control group. Both groups were matched by age and index year of diagnosing acute pancreatitis. Subjects who never had finasteride prescription were defined as “never use. ” Subjects who at least received 1 prescription for finasteride before the date of diagnosing acute pancreatitis were defined as “ever use. ” The association of acute pancreatitis with finasteride use was examined by the odds ratio (OR) and 95% confidence interval (CI) using the multivariable unconditional logistic regression model. The crude OR of acute pancreatitis was 1.78 (95%CI 1.33, 2.39) for subjects with ever use of finasteride, when compared with subjects with never use of finasteride. After adjusting for potential confounders, the adjusted OR of acute pancreatitis decreased to 1.25 (95%CI 0.90, 1.73) for subjects with ever use of finasteride, but no statistical significance was seen. No association can be detected between finasteride use and the risk of acute pancreatitis.
Quadriparesis as initial presentation of hyperosmolar non‐ketotic diabetes

Acute onset quadriparesis can be a manifestation of a variety of neurological and metabolic conditions. We report the case of a 47-year-old alcoholic gentleman who presented with acute onset weakness of all four limbs associated with hypokalemia and very high blood glucose (hyperosmolar nonketotic diabetes—HNKD) detected for the first time. He was confirmed as having type 2 diabetes (detectable insulin and C-peptide levels) and his quadriparesis completely resolved on potassium replacement and treatment with insulin. HNKD is discussed along with the possible mechanisms of hypokalemia in this patient presenting with reversible limb weakness as an initial manifestation of type 2 diabetes. Copyright © 2002 John Wiley & Sons, Ltd.