Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence of Bedwetting for Children in Mosul City

The mental and behavioral disorders, just as the other types of illnesses, creats significant economic difficulties for children, patients and their families. The main objective of this study was to determine the prevalence of bedwetting in Mosul city and some risk factors related to it. To achieve the above mentioned aim, a cross -sectional study design was adopted, some primary schools were chosen as a study setting. The questionnaire forms were sent to the selected families. Out of 600 questionnaires, (596) were received (99.3%). More than one tenth (13.8 %) of pupils aged 6-8 years were bedwetters, while boys were more affected than girls. The present study revealed that bedwetting is significantly influenced by multiple factors including gender, child's age group, family size, birth order, education of parents, socioeconomic status of the family and diseases of father; as stressful life events, in addition to sleep pattern and family history of having the same condition. Whereas mothers disease is poorly associated with the occurrence of bedwetting. The present study shows that more than one tenth of the children suffered from bedwetting, which appeared in male children, small children, large family sizes, birth order, poor education of father and mother, and family history of holding the same condition.
Needs assessment of dual diagnosis: A cross-sectional survey using routine clinical data

Aims: Department of Health guidance on dual diagnosis (DD) recommends that services measure local need, and use this to inform service planning. This study aimed to use routine clinical data to estimate the prevalence of DD and unmet treatment need in a community drug and alcohol service, and to appraise the feasibility of using routine data for such purposes. Methods: First, a screening checklist was developed to determine whether a particular service-user met DD caseness criteria. Second, the electronic care records of 227 service-users were screened for DD caseness, as well as for documentation of current and/or previous receipt of mental health treatment. Findings: Seventy-two percent screened positive for having DD. Of these, around half were not receiving current treatment for their mental health, while 37% had never received mental health treatment. Higher rates of DD were found amongst women and those in treatment for alcohol dependence. Conclusions: The findings corroborate previous research showing high prevalences of DD and unmet treatment need within drug and alcohol services in general, and amongst certain high-risk subgroups in particular. The study demonstrates that using routine data to estimate unmet treatment need is feasible within the limited resources available to frontline services.
Teaching Students with Disabilities: A Web-Based Examination of Preparation of Preservice Primary School Teachers.

Abstract: With increasing expectations that preservice teachers will be prepared to teach students with special needs in regular classrooms, it is timely to review relevant units in teacher education courses. Units relevant to special education/inclusion in primary undergraduate teacher preparation courses in Australian tertiary institutions, delivered in 2009, were examined. Information was gathered through a series of Google searches, and available information was very limited for some units. Sixty-one units in 34 courses met criteria for inclusion. Units typically ran for one semester with 30-40 hours of instruction. Just under half the instructors for whom relevant information was available had an active interest in special education/inclusion of students with disabilities. The most commonly included content was on instructional strategies, with few units aimed at promoting positive attitudes to people with disabilities and only 10% stating that the content was evidence or research-based.
Large B-cell lymphomas poor in B cells and rich in PD-1+ T cells can mimic T-cell lymphomas.

OBJECTIVES To characterize the clinicopathologic features of cases of large B-cell lymphomas, poor in B cells and densely rich in programmed cell death-1 (PD-1)+ reactive T cells, which can mimic T-cell lymphomas. METHODS A single-institute retrospective review of cases between 2010 and 2013 was performed. RESULTS Of 178 cases of large B-cell lymphomas, eight cases of large B-cell lymphomas poor in B cells and diffusely rich in sheets of PD-1+ T cells were identified. These cases either were initially misdiagnosed as a T-cell lymphoma or substantiated a broader differential diagnosis including a T-cell lymphoma. Five cases were T-cell histiocyte-rich large B-cell lymphomas, and three cases were diagnosed as large B-cell lymphomas rich in T cells. In three of these cases, a subset of the PD-1+ T cells showed either morphologic nuclear atypia or atypical expression of T-cell antigens on flow cytometry and/or immunohistochemistry. CONCLUSIONS Large B-cell lymphomas poor in B cells and rich in T cells can have diffuse sheets of reactive PD-1+ T cells, some with atypical morphologic and immunophenotypic features mimicking a T-cell lymphoma. Careful assessment of the immunoarchitecture and background inflammatory and stromal cells can prevent erroneous diagnoses in such cases.
Science on Trial: The Clash of Medical Evidence and the Law in the Breast Implant Case

M Angell W W Norton, £22 (to be published January 1997), pp 256 ISBN 0 393 03973 0 Atrend in American litigation has important implications not only for those who practise medicine but also for those who purchase and organise it and for those who make equipment that clinicians use. By describing one particular case in the United States courts, this book focuses on the clash between medical and legal definitions of evidence that has received little attention hitherto but which is relevant world wide. The story itself is relatively simple. A few women claimed that health problems, notably connective tissue disease, had resulted from their breast implants. A few “expert” witnesses asserted that this was the case and propounded theories about how such a causal relation might operate. There was not, and never has been, any strong evidence based on good epidemiological research that breast implants actually cause connective tissue disease, using conventional criteria for defining a causal relation. On the basis …
The Association between PTPN22 Genetic Polymorphism and Juvenile Idiopathic Arthritis (JIA) Susceptibility: An Updated Meta-Analysis

Background: Limited studies have focused on the association between the protein tyrosine phosphates non-receptor type 22 (PTPN22) genetic polymorphisms and Juvenile idiopathic arthritis (JIA) susceptibility in different populations, but the results were inconclusive. Therefore, this meta-analysis of PTPN22 polymorphism (1858 C>T) was performed to get a precise systematic estimation. The “rs” number of the PTPN22 polymorphism (1858 C>T) is 4. Methods: A systematic literature search strategy was carried out using English databases (PubMed, Embase.) for the eligible studies. We ultimately identified 11 records from 10 articles involving the relationship between PTPN22 genetic polymorphisms and JIA risk from PubMed and Embase databases. Overall, 4552 cases and 10161 controls were investigated in this study to evaluate the association between PTPN22 (C allele vs. T allele) genotype and JIA susceptibility. Results: Analysis using random effects model showed an increased risk of JIA with T allele of rs2476601 vs. A allele (P<0.001). Subgroup analysis suggested that the PTPN22 polymorphism (1858C>T) was significantly associated with JIA risk in America population (OR=1.52, 95% CI:1.30–1.78). Additionally, the subgroup analysis also showed that the associations were still significant in case number more than 500 (OR=1.38, 95% CI: 1.04–1.83), while in the case number less than 500 was OR=1.55, 95% CI: 1.39–1.72. Conclusions: SNPs of PTPN22 (1858C>T) showed an increased risk of developing JIA.
Human herpesvirus 8-unrelated primary effusion lymphoma-like lymphoma: report of a rare case and review of 54 cases in the literature.

OBJECTIVES To report a patient with primary effusion lymphoma who was negative for human herpesvirus-8 (HHV-8), human immunodeficiency virus, Epstein-Barr virus, hepatitis C virus, and hepatitis B virus, as well as review 54 reported cases of HHV-8-unrelated primary effusion lymphoma (PEL)-like lymphoma in the literature to clarify the nature of this entity. METHODS The patients' characteristics, clinical presentation, pathogenesis, morphologic-immunophenotypic features, clinical management, and prognosis were studied. RESULTS HHV-8-negative PEL-like lymphomas often occur in immunocompetent and elderly patients, are sometimes associated with chronic inflammation-related fluid overload, are mostly large B-cell or large B-cell with plasmacytic differentiation type, and are associated with a better prognosis. CONCLUSIONS In various aspects, HHV-8-unrelated PEL-like lymphoma is a different entity from HHV-8-related PEL. Immunophenotype, morphology, and c-myc/8q24 status should be included for differential diagnosis. A test for c-myc or 8q24 abnormalities should be recommended for subdividing HHV-8-unrelated PEL-like lymphoma, which may have benefits in patient management.
Successful triage of suspected hantavirus cardiopulmonary syndrome by peripheral blood smear review: a decade of experience in an endemic region.

OBJECTIVES In 2001, the University of New Mexico Hospitals implemented a rapid screening tool for the triage of suspected hantavirus cardiopulmonary syndrome based on peripheral blood smear morphology. Five criteria guided clinical decisions: thrombocytopenia, hemoconcentration, granulocytic left shift, absence of toxic changes, and more than 10% immunoblasts. Smears meeting four of five criteria were previously shown to have high predictive value for infection. Our retrospective study aimed to determine clinical performance of this test over the past decade. METHODS Computerized records of 188 smear results were compared with serology. RESULTS Receiver operator characteristic curve analysis confirmed that the four of five cutoff was the most clinically useful, with sensitivity and specificity of 89% and 93%, respectively. All patients meeting five of five criteria had confirmed infections. Fifteen discordant results were uncovered, explained by positive subsequent tests in the same patient or severe disease without further testing. CONCLUSIONS Our findings confirm that peripheral smear analysis is clinically useful in this endemic region.
Comparison of Caregiver Forces Required for Sliding a Patient up in Bed Using an Array of Slide Sheets

This study investigated the forces required while performing the common patient handling task of moving a patient up in bed using traditional cotton sheets or friction-reducing slide sheets. Twenty-nine healthy adult participants 18 to 36 years of age were recruited as “patients. ” Hand forces and lumbar compression and shear forces were calculated on the “caregiver” when performing the repositioning task. Significant differences in lumbar compression and lumbar sagittal shear forces at L4-L5 and at L5-S1 were found among the three sheet types. No difference in peak sum hand force was found between the slide sheets; however, the traditional cotton sheet created the greatest force at the hands and every sheet exceeded the recommended summative hand force of 35 pounds. As such, sliding patients up in bed may contribute to increased risk of musculoskeletal injuries in caregivers.
Mesothelial proliferations: useful marker is not the same as a diagnostic one.

There are solid criteria for diagnosing malignancy when the biopsy specimen is adequate, the disease is advanced, and the clinical and radiological findings are supportive. Once malignancy has been established, there are reliable immunohistochemical panels for distinguishing mesothelioma from metastatic tumors. 1 However, the diagnostic problem of dif-ferentiating benign from malignant mesothelial proliferations arises when the biopsy specimen is small, there is no invasion of pre-existing tissues such as fat, muscle, or lung, and there is no obvious expansile tumor growth. This diagnosis is even more problematic in cytologic specimens.
Artrite reumatóide como modelo de imunossenescência prematura

A artrite reumatoide (AR) e uma doenca autoimune, que alem da presenca de danos fisicos, tem sido associada com o envelhecimento prematuro do sistema imune (imunossenescencia) e morbidades relacionadas a idade, incluindo declinio no funcionamento cognitivo. Fatores como a inflamacao cronica e o uso de glicocorticoides (GCs), ambos relacionados a AR, sao potenciais mecanismos envolvidos com a disfuncao cognitiva na populacao geral. Estudos experimentais tem revelado a contribuicao benefica das celulas imunologicas sobre o sistema nervoso central (SNC). Alem disto, patologias como o dano cognitivo leve e doenca de Alzheimer apresentam alteracoes nos subtipos linfocitarios perifericos. Com base nisto, neste trabalho nos exploramos as relacoes entre funcao cognitiva, score de atividade da doenca (DAS-28), e subtipos linfocitarios na AR. Trinta pacientes com AR e dezenove controles saudaveis, que nao diferiram significativamente em relacao a sexo, idade e escolaridade, foram recrutados neste estudo. A funcao cognitiva (mini-exame do estado mental - MMSE, memoria logica e memoria de trabalho), estresse e depressao foram avaliados atraves de entrevistas onde foram aplicados questionarios clinicos especificos. Os linfocitos foram isolados das celulas mononucleares do sangue periferico (PBMCs), e imunofenotipados por citometria de fluxo para investigar a presenca dos seguintes subgrupos: celulas B, celulas T ativadas, celulas T naive/memoria, celulas T regulatoria (reg) CD4+FoxP3+, celulas IL-17+, celulas natural killer (NK), e celulas T CD28- associadas a senescencia. Os pacientes com AR tiveram um desempenho cognitivo inferior no MMSE, memoria logica e memoria de trabalho se comparado a controles saudaveis. Embora todos os individuos, de ambos os grupos, tiveram uma pontuacao superior a estabelecida pelo cutoff do MMSE. O tempo de uso de GCs e os niveis de proteina C - reativa (PCR) nao se correlacionaram com avaliacao cognitiva. Os pacientes tem aumento nas proporcoes de celulas Treg, celulas T CD4+ naive e celulas T associadas a senescencia (CD28), mas baixas porcentagens de celulas B e celulas T CD8+ de memoria do que controles saudaveis. Celulas T recem ativadas e celulas T CD8+CD28- foram negativamente associadas com a cognicao. Concluindo, pacientes com AR tem um desempenho cognitivo inferior se comparado a controles saudaveis. GCs e PCR nao se correlacionaram com memoria, no entanto, expansao da populacao de celulas T ativadas e celulas T associadas a senescencia foram correlacionadas com performance de memoria.
Thromboelastography is a suboptimal test for determination of the underlying cause of bleeding associated with cardiopulmonary bypass and may not predict a hypercoagulable state.

OBJECTIVES Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) are at risk of bleeding. The goal of this investigation was to compare thromboelastography (TEG) with standard coagulation tests (prothrombin time [PT], partial thromboplastin time [PTT], fibrinogen, and D-dimer) in patients with active bleeding. METHODS A retrospective study of patients who underwent cardiac surgery with CPB was performed. A second analysis was performed to determine if a shortened TEG R time is associated with thrombosis. RESULTS Paired TEG and standard coagulation tests were available from 21 bleeding patients; of the 15 patients with normal TEG values and three with a shortened R time, all had abnormalities of standard coagulation tests. Eighteen of 67 patients who underwent surgery with CPB had an episode of postoperative bleeding. The TEG R time and coagulation index, PT, and PTT collected after CPB were associated with postoperative bleeding in the univariate analysis, but only PT was independently associated with postoperative bleeding in the multivariate analysis. In the second analysis, three of 38 patients with a normal TEG and four of 43 patients with a shortened R time had a thrombotic event during hospitalization (P = 1.00). CONCLUSIONS TEG had limited utility in identifying the underlying cause of bleeding and was not predictive of postoperative bleeding associated with cardiac surgery compared with conventional coagulation tests. A shortened TEG R time may not represent a hypercoagulable state.
Maternal deaths following nevirapine-based antiretroviral therapy

We report 2 cases illustrating that it is too simplistic to link nevirapine (NVP) toxicity exclusively to individuals with immune preservation. Not enough is known about the mechanism of hepatotoxicity or cutaneous eruption to predict these events. This type of hypersensitivity reaction occurs rarely among HIV-exposed infants taking NVP prophylaxis or antiretroviral therapy (ART)-experienced adults with complete plasma viral load suppression. Conversely, HIV-uninfected adults and ART-naive pregnant women appear to be disproportionately affected by the adverse effects of NVP.
Barriers and facilitators to evidence-based library and information practice: An international perspective

Abstract Objective: To describe the barriers encountered when attempting to undertake evidence-based library and information practice (EBLIP). Design: Qualitative evidence synthesis and thematic synthesis of qualitative data. Data sources: PubMed MEDLINE, Library Information Science Abstracts (LISA), Library Information Science & Technology Abstracts (LISTA), Evidence Based Library and Information Practice (EBLIP) journal full text, Google Scholar and Google Desktop searches of the author’s personal collection of articles and conference proceedings. Review methods: Thematic synthesis involved line-by-line data extraction of mentions of barriers, obstacles and challenges and development of descriptive and analytical themes. Results: 55 papers that reported at least one barrier, obstacle or challenge to EBLIP were included. Five major domains, comprising 17 specific themes, were identified as key to barriers for EBLIP: the environment (pace of change, poor access to the evidence base, language and cultural .
Medication in the Treatment of Alcohol Dependence

Social,cultural, emotional and biological influences determine whether people drink to excess and whether they then experience harm or cause harm to others (Cook, 1994). Psychosocial treatments for alcohol dependence are only modestly successful, with most studies finding that at least 50% of patients return to harmful drinking in the following year. In the past decade there has been new evidence for the role of pharmacological treatments in reducing harm from drinking and in preventing relapse. However, none of the treatments described here is recommended as a solo therapy. Social and psychological factors in treatment for alcohol dependence are crucial. Firstly, the chief patient variables predicting good outcome are having a job and a supportive relationship. Secondly, the most powerful therapy variable to date is therapist empathy. Finally, compliance with medication hinges on the patient's understanding and moti
A Systematic Review of the Quality of Trials Evaluating Biomedical HIV Prevention Interventions Shows That Many Lack Power

Abstract Purpose: Several randomized, controlled trials (RCTs) have tested strategies to prevent sexual acquisition of HIV infection, but their quality has been variable. We aimed to identify, describe, and evaluate the quality of RCTs studying biomedical interventions to prevent HIV acquisition by sexual transmission. Method: We conducted a systematic review to identify all RCTs evaluating the efficacy of biomedical HIV prevention interventions. We assessed seven generic and content-specific quality components important in HIV prevention trials, factors influencing study power, co-interventions provided, and trial ethics. Results: We identified 26 eligible RCTs. The median number of quality components judged to be in adequate or unclear was 3 (range 1–4) in 1992–1998, 3 (range 1–4) in 1999–2003, and 0 (range0–2) in 2004–2008 (p < .001). Common problems that may have biased results included low retention (median 84%), poor adherence to interventions requiring on going use (median ≤78%), and lower HIV incidence than expected a priori (in 8 of 11 trials where evaluable). Conclusion: Reporting of trials of biomedical HIV prevention interventions has improved over time. However, quality improvement is needed in several key areas that influence study power, including participant retention, adherence to interventions, and estimation of expected HIV incidence.
Further Studies on the Inheritance of Factor VIII

THERE appears to be general agreement that Factor-VIII levels in healthy persons vary froin about 50 to 200 per cent of a standard designated as IOO per cent (Biggs and Macfarlane, 1962). Several observations suggest that the concentration of Factor VIII in plasma is genetically controlled. Firstly, there is a marked difference between the levels found in persons of the same age and sex living under the same conditions. Secondly, reduced Factor-VIII concentration results from gene mutation at different chromosomal loci; at an X-chromosomal locus (sex-linked haemophiha) and at least three autosomal loci (von Willebrand's disease, combined Factor-V and Factor-VIII deficiency and the hitherto unique condition due to an autosomal dominant gene and distinct from von Willebrand's disease recently described by Hensen, Mattern and Loeliger, 1965). Thirdly, in a study of healthy families Pitney, Kirk, Arnold and Stenhouse (1962) found that Factor-VIII levels varied less among siblings, and among parents and their chddren than in the general population. This familial similarity suggested that Factor VUI could be under genetic control. None of the above observations exclude a major non-genetical cause of Factor-VIII variation. Investigation is complicated by two major difficulties. These are the many environmental effects already known to influence Factor VIII (Table I) and the lack of information on internal errors inherent in Factor-VIII assay (Aronson and Marder, 1964). The former can largely be eliminated by planned investigation and results examined for any systematic effect due, for example, to age or sex which could account for part of the observed variation. Technical errors can hkewise be reduced by carefully controlled methods. Provided that residual errors do not cause a systematic bias of Factor-VIII estimation and are randomly distributed, this source of variation can be accounted for in analysis of results. We investigated the hereditary component in Factor-VIII variation by biometric methods used in analysing other continuously distributed characters in man, such as height, intelligence and finger ridge counts (Roberts, 1964). Preliminary analysis of data obtained from healthy families (Kerr, Preston, Barr and Biggs, 1965) generally supported the conclusions of Pitney et al. (1962) that Factor-VIII levels were genetically determined. Further examination of this material and additional information from a study of normal twin-pairs are presented here. Families which contained males with haemophilia were also investigated in order to provide further data on inheritance. Factor-VIII levels in females heterozygous for the mutant gene and their relatives were compared in the hope of discovering some fundamental relationship that would aid detection of the carrier state. The distribution of levels in heterozygous females was also examined in the light of recent genetical hypotheses.