Miracle-dz/UniFAR-FTUs huggingface dataset:
Indices of Central and Peripheral Obesity; Anthropometric Measurements and Laboratory Parameters of Metabolic Syndrome and Thyroid Function.

BACKGROUND Metabolic syndrome (MetS) and obesity are serious health problems in the World, including Turkey. Contemporary studies have suggested a meaningful association between insulin resistance (IR), MetS parameters, and thyroid function tests. AIMS We aimed to elucidate the impact of fat distribution on the anthropometric and laboratory parameters, especially indices of MetS, IR and thyroid function, in obese women. STUDY DESIGN Cross-sectional study. METHODS Anthropometric measurements of all participants and biochemical tests in their serum samples were performed. RESULTS Weight, waist circumference (WC), body mass index (BMI), and other parameters of fat distribution were significantly increased in all obese compared to control subjects; but there was no significant difference between central and peripheral obese groups. The central obese group had significantly higher insulin levels, components of MetS, the ratio free triiodothyronine (fT3) to free thyroxin fT4, and fT4 than those of peripheral obese and control groups. CONCLUSION Elevated triglyceride, glucose and insulin levels may be associated with increased IR, which in turn is related to MetS. Body fat composition may affect thyroid tests in the obese; the changes in fT3/fT4 could be the consequence of fat distribution.
Cutaneous squamous cell carcinoma: a comprehensive clinicopathologic classification

Abstract: Cutaneous squamous cell carcinoma (SCC) includes many subtypes with widely varying clinical behaviors, ranging from indolent to aggressive tumors with significant metastatic potential. However, the tendency for pathologists and clinicians alike is to refer to all squamoid neoplasms as generic SCC. No definitive, comprehensive clinicopathological system dividing cutaneous SCCs into categories based upon their aggressiveness has yet been promulgated. Therefore, we have proposed the following based upon the malignant potential of SCC variants, separating them into categories of low (≤2% metastatic rate), intermediate (3–10%), high (greater than 10%), and indeterminate behavior. Low‐risk SCCs include SCC arising in actinic keratosis, HPV‐associated SCC, tricholemmal carcinoma, and spindle cell SCC (unassociated with radiation). Intermediate‐risk SCCs include adenoid (acantholytic) SCC, intraepidermal epithelioma with invasion, and lymphoepithelioma‐like carcinoma of the skin. High‐risk subtypes include de novo SCC, SCC arising in association with predisposing factors (radiation, burn scars, and immunosuppression), invasive Bowen's disease, adenosquamous carcinoma, and malignant proliferating pilar tumors. The indeterminate category includes signet ring cell SCC, follicular SCC, papillary SCC, SCC arising in adnexal cysts, squamoid eccrine ductal carcinoma, and clear‐cell SCC. Subclassification of SCC into these risk‐based categories, along with enumeration of other factors including tumor size, differentiation, depth of invasion, and perineural invasion will provide prognostically relevant information and facilitate the most optimal treatment for patients.
Multi-Scale Difference Map Fusion for Tamper Localization Using Binary Ranking Hashing

The block-based analysis for tamper localization is a prevailing mechanism in hash-based forgery detection algorithm. One of the main problems with a block-based analysis is its rough localization stemming from the demand to use relatively large blocks to reduce hash length. While decreasing the block size can improve the localization resolution, the hash length tends to become too long to be practical. In this paper, we propose a binary ranking hashing approach that satisfies both the requirements of compact hash length and small block size, to obtain a binary map combined with spatial information. Meanwhile, we investigate a multiscale difference map fusion approach that fuses multiple candidate difference maps, resulting from the analysis of the subtraction between two binary maps with different sliding windows, to obtain a single, more reliable tampering map with better localization resolution. We use manifold ranking to model this multiscale difference map fusion problem and propose a two-stage scheme, namely, ranking with tampering queries and nontampering queries. Our results indicate that the proposed tamper detection method can improve the tamper localization resolution compared with state-of-the-art methods.
Iatrogenic Respiratory Distress Syndrome Following Elective Repeat Cesarean Delivery

Objective: To determine the incidence of iatrogenic respiratory distress syndrome (RDS) following elective repeat cesarean delivery and to identify whether it was associated with departures from accepted management guidelines. Methods: Between January 1986 and March 1991, there were 23,125 deliveries at Northwestern Memorial Hospital, of which 1207 were repeat cesarean births without labor. During this period, 18 neonates of 37 weeks' gestation or greater or 2500 g or greater who were delivered by elective repeat cesarean were admitted to the neonatal intensive care unit (NICU) for respiratory difficulties. Results: Five of the 18 neonates admitted to the NICU with respiratory difficulty following elective repeat cesarean delivery met the criteria for RDS. This represents an incidence of 0.41% (five of 1207), or one case of RDS for every 241 repeat cesarean deliveries without labor. Four of the five neonates required mechanical ventilation for an average of 6.8 days. The average NICU stay was 11.2 days. Complications included pneumothorax (one) and pulmonary hemorrhage (one). Departures from accepted management guidelines included a discrepancy between ultrasound and menstrual dates (two), no confirmation of menstrual dates (one), and delivery before 39 weeks' gestation (two). Conclusion: Iatrogenic RDS continues to occur in the setting of elective repeat cesarean delivery and is associated with a failure to adhere to clinical protocols.
Differential Spike Timing and Phase Dynamics of Reticular Thalamic and Prefrontal Cortical Neuronal Populations during Sleep Spindles

The 8–15 Hz thalamocortical oscillations known as sleep spindles are a universal feature of mammalian non-REM sleep, during which they are presumed to shape activity-dependent plasticity in neocortical networks. The cortex is hypothesized to contribute to initiation and termination of spindles, but the mechanisms by which it implements these roles are unknown. We used dual-site local field potential and multiple single-unit recordings in the thalamic reticular nucleus (TRN) and medial prefrontal cortex (mPFC) of freely behaving rats at rest to investigate thalamocortical network dynamics during natural sleep spindles. During each spindle epoch, oscillatory activity in mPFC and TRN increased in frequency from onset to offset, accompanied by a consistent phase precession of TRN spike times relative to the cortical oscillation. In mPFC, the firing probability of putative pyramidal cells was highest at spindle initiation and termination times. We thus identified “early” and “late” cell subpopulations and found that they had distinct properties: early cells generally fired in synchrony with TRN spikes, whereas late cells fired in antiphase to TRN activity and also had higher firing rates than early cells. The accelerating and highly structured temporal pattern of thalamocortical network activity over the course of spindles therefore reflects the engagement of distinct subnetworks at specific times across spindle epochs. We propose that early cortical cells serve a synchronizing role in the initiation and propagation of spindle activity, whereas the subsequent recruitment of late cells actively antagonizes the thalamic spindle generator by providing asynchronous feedback.
Risk factors for high-risk proliferative diabetic retinopathy and severe visual loss: Early Treatment Diabetic Retinopathy Study Report #18.

PURPOSE To identify risk factors for the development of high-risk proliferative diabetic retinopathy (PDR) and for the development of severe visual loss or vitrectomy (SVLV) in eyes assigned to deferral of photocoagulation in the Early Treatment Diabetic Retinopathy Study (ETDRS). METHODS Multivariable Cox models were constructed to evaluate the strength and statistical significance of baseline risk factors for development of high-risk PDR and of SVLV. RESULTS The baseline characteristics identified as risk factors for high-risk PDR were increased severity of retinopathy, decreased visual acuity (or increased extent of macular edema), higher glycosylated hemoglobin, history of diabetic neuropathy, lower hematocrit, elevated triglycerides, lower serum albumin, and persons with mild to moderate nonproliferative retinopathy, younger age (or type 1 diabetes). The predominant risk factor for development of SVLV was the prior development of high-risk PDR. The only other clearly significant factor was decreased visual acuity at baseline. In the eyes that developed SVLV before high-risk proliferative retinopathy was observed, baseline risk factors were decreased visual acuity (or increased extent of macular edema), older age (or type 2 diabetes), and female gender. CONCLUSIONS These analyses supported the view that the retinopathy-inhibiting effect of better glycemic control extends across all ages, both diabetes types, and all stages of retinopathy up to and including the severe nonproliferative and early proliferative stages and the possibility that reducing elevated blood lipids and treating anemia slow the progression of retinopathy.
The effects of poling on energy consumption , kinematics and kinetics in roller ski skating

The current study investigated the effect of poling on physiological, kinematic and kinetic responses at different velocities by comparing the G4 skating technique with (G4-P) and without (G4-NP) poling. The G4 involves a “strong side” with poling action and a “weak side” with arm swing. 17 elite male cross-country skiers performed 4-min submaximal tests at 10, 15 and 20 km·h on a 2% inclined treadmill using G4-P and G4-NP. Physiological, kinematic and kinetic variables were assed with opencircuit indirect calorimetry, blood lactate analysis, Qualisys Pro Reflex system and roller skis integrated with two full bridged strain gauges. Gross efficiency (GE) was calculated by the external work rate against friction and gravity divided by the metabolic rate in aerobic steady state conditions. O2 consumption, ventilation and blood lactate concentration were lower with G4-P than G4-NP at all velocities and thus, GE was higher in the two examined velocities with G4-P compared to G4-NP (11,1% vs 9,9%; 12,5% vs 10,6%; all P < 0.05). Longer cycle lengths at lower cycle rates, as well as less ski angling and edging were demonstrated with G4-P compared to G4-NP from low to high velocities, with a 15% difference in cycle length at high velocity (all P < 0.05). Force impulse was lower with G4-P compared to G4-NP for the “strong side” at low and high velocity (both P < 0.05). Rate of force development and peak force were lower for both strong and weak sides with G4-P compared to G4-NP, and the ski velocity was on average higher on the strong side for G4-P at all velocities (all P < 0.05). Altogether, these results demonstrated lower physiological demands and higher gross efficiency at a given work rate when elite skiers added poling to the G4 skating technique. At the same time, skiers increased their cycle lengths and showed significant changes in the cycle characteristics by increasing the ski velocity and reducing the applied ski forces of both the strong and weak sides when poling.
Osteoporotic Spinal Deformity: A Biomechanical Rationale for the Clinical Consequences and Treatment of Vertebral Body Compression Fractures

This review article develops a biomechanical rationale for the clinical consequences and treatment of osteoporotic vertebral body compression fracture. In patients with osteoporotic vertebral fractures and spinal deformity, altered spinal biomechanics and global spinal imbalance are important factors in the increased morbidity and mortality reported in this population. Severe spinal deformity impairs physical functioning, health, and quality of life. The spinal deformity itself, independent of pain, is a significant cause of disability. Spinal deformity is also an independent risk factor for hip fracture. Treatments directed at osteoporotic vertebral compression fractures should ideally address spinal deformity as well as pain. Balloon kyphoplasty, the minimally invasive technique of reduction and internal fixation of osteopenic vertebral body compression fractures that addresses pain and spinal deformity, is discussed.
Stigma, self-blame, and satisfaction with care among patients with lung cancer

ABSTRACT Objective: We sought to understand the experiences of patients with lung cancer and to see if attitudes varied by demographic factors. Methods: We administered a 63-question survey by phone or online among 174 patients with lung cancer. Factor analysis was used to identify two groups of questions with a conceptual relationship and high Cronbach's alphas, stigma and satisfaction with care. We used a multivariable analysis to identify predictors of self-blame and the factors of stigma and satisfaction with care. Results: Patients were satisfied with the quality of their care and treatment choices but did not feel that there is enough public support for or research in lung cancer. Predictors of lower satisfaction with care were never being a smoker, lack of college education, not living in a rural location, refusing to report income, and not knowing/not being sure of stage. Self-blame was modest; in multivariable analysis, predictors of self-blame were believing that smoking was a cause of their lung cancer, younger age, male sex, living in a suburban location, and not knowing/not being sure of the stage of the cancer. Reported stigma was low and the only predictor for stigma was being married. Despite low scores on their personal experience of stigma, patients reported a high degree of stigmatization of lung cancer in general. Smoking was a significant predictor of personal stigma. Conclusion: Despite satisfaction with their treatment and care, lung cancer patients feel that society stigmatizes them as a general population. Patients who smoke are more likely to report that they have personally experienced stigma.
Pretreatment neutrophil-to-lymphocyte ratio in metastatic castration-resistant prostate cancer patients treated with ketoconazole: association with outcome and predictive nomogram.

BACKGROUND The neutrophil-to-lymphocyte ratio (NLR), an inflammation marker, is prognostic in several cancers. We assessed the association between the pretreatment NLR and outcome of patients with metastatic castration-resistant prostate cancer (mCRPC) treated with the CYP17 inhibitor ketoconazole. METHODS This was an international, retrospective study of 156 mCRPC patients treated with ketoconazole. The independent effect of the pretreatment NLR and factors associated with treatment outcome were determined by multivariate analysis. RESULTS Seventy-eight patients (50%) had a ≥50% decline in prostate-specific antigen (PSA). The median progression-free survival (PFS) time was 8 months. Excluded from the analysis were 23 patients without available data on their NLR and those with a recent health event or treatment associated with a blood count change. Sixty-two patients (47%) had a pretreatment NLR >3. Risk factors associated with the PFS outcome were a pretreatment NLR >3 and PSA doubling time (PSADT) <3 months and a prior response to a gonadotropin-releasing hormone agonist of <24 months or to an antiandrogen of <6 months. The number of risk factors was used to form a predictive nomogram by patient categorization into favorable (zero or one factor), intermediate (two factors), and poor (three or four factors) risk groups. CONCLUSIONS In mCRPC patients treated with ketoconazole, the pretreatment NLR and PSADT, and prior response to androgen-deprivation therapy, may be associated with the PFS time and used to form a risk stratification predictive nomogram.
Circulating tumor cells as a marker of response: implications for determining treatment efficacy and evaluating new agents

Purpose of review To assess the current and future potential of using circulating tumor cells (CTC) as a biomarker to assess staging/prognosis and treatment efficacy. Recent findings The shedding of prostate cancer cells by the primary tumor into the circulation can occur very early in the disease process but the detection of CTC at the time of initial presentation is not necessarily a poor prognostic. Furthermore, some patients who have undergone a radical prostatectomy and have no evidence of disease for 5 years still have detectable tumor cells in their bone marrow. In some cases these dormant tumor cells can eventually be activated and form a metastasis. In other situations the shed cells might contain aggressive stem-like cells. Overall, a pattern of an evolving genomic and molecular profile appears to be apparent over the course of initial dissemination to development of overt metastases. Clinically, several studies suggest that the enumeration of CTC prior to and during chemotherapy is predictive of the overall therapeutic response. Additionally, the absolute count or CTC threshold could be patient specific and not universal, suggesting the change in CTC count on a case-by-case basis may be more significant for patient management. Summary CTC are clinically significant in the management of prostate cancer. However, to determine the true efficacy of CTC detection in the active clinical arena, coordinated multi-institutional studies with a standardized detection methodology need to be undertaken.
The lived experience of clinical development unit (nursing) leadership in Western Sydney, Australia.

BACKGROUND A network of nine Clinical Development Units (Nursing) (CDU(N)) were recently created in the Western Sydney Area Health Service. These units are designed to develop patient-focused nursing practice through group process and action research, based on principles of transformational leadership. AIMS OF THE STUDY Although there is documented evidence from Australia and the United Kingdom (UK) that CDUs and Nursing Development Units (NDUs) are very successful in improving both patient and staff satisfaction, there is also growing evidence that the stressors experienced by nurse leaders are threatening the survival of some of these units. This study set out to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership when these stressors were likely to impinge. STUDY DESIGN Hermeneutic phenomenology was employed in order to identify how these experiences changed over time. Two rounds of interviews were conducted: approximately 4--6 months after the launch and, again, 12 months later. FINDINGS The Clinical Development Unit (Nursing) philosophy provided a framework on which these very motivated leaders began to enhance nursing accountability in their units through reflective practice and participatory governance. While reinforcing many previously published positive and negative aspects of Clinical Development Units and Nursing Development Units, this paper also highlights how the expectations and experiences of these leaders changed over time with unanticipated pressures of work, a high turnover of clinical leaders, a perceived diminution of management support and unrealistic self-expectations. A significant theme that emerged as these stressors began to impinge was the leaders' own need for leadership in order to sustain their confidence and motivation. IMPLICATIONS FOR NURSING Insights harvested from this study have since been incorporated into a revised leadership preparation programme and support mechanisms for the leaders of eight new Clinical Development Units (Nursing) in the Western Sydney Area Health Service.
African American Parents’ Experiences Navigating Breast Cancer While Caring for Their Children

African American parents who are navigating breast cancer while parenting their school-age children are an understudied population. We used family systems and sociocultural theories to conduct three focus groups with a total sample of 9 African American parents to understand how they cared for their school-age children (ages 11 to 18) while coping with the diagnosis and treatment of breast cancer. Our content analysis of these focus groups yielded themes that described a variety of ways they protected their children from the emotional consequences of breast cancer. Seven primary themes emerged: (a) increased desire to protect their children, (b) parental concerns for children’s coping, (c) openness and transparency with children, (d) reliance on children for support, (e) calibration of their own responses, (f) use of the illness experience as a teachable moment for children, and (g) reliance on others for parenting support. Clinicians and researchers can improve their care by developing culturally sensitive family intervention programs that promote family resilience.
Predispositions and the Political Behavior of American Economic Elites: Evidence from Technology Entrepreneurs

Author(s): Broockman, DE; Ferenstein, G; Malhotra, N | Abstract: ©2018, Midwest Political Science Association Economic elites regularly seek to exert political influence. But what policies do they support? Many accounts implicitly assume economic elites are homogeneous and that increases in their political power will increase inequality. We shed new light on heterogeneity in economic elites' political preferences, arguing that economic elites from an industry can share distinctive preferences due in part to sharing distinctive predispositions. Consequently, how increases in economic elites' influence affect inequality depends on which industry's elites are gaining influence and which policy issues are at stake. We demonstrate our argument with four original surveys, including the two largest political surveys of American economic elites to date: one of technology entrepreneurs—whose influence is burgeoning—and another of campaign donors. We show that technology entrepreneurs support liberal redistributive, social, and globalistic policies but conservative regulatory policies—a bundle of preferences rare among other economic elites. These differences appear to arise partly from their distinctive predispositions.
Gender Gap in Earnings in Vietnam: Why Do Vietnamese Women Work in Lower Paid Occupations?

Abstract:Differences in earnings between male and female workers persist in developed and developing countries despite a narrowing of gaps in educational attainment. This paper examines the gender wage gap in Vietnam and shows that a non-trivial part of the gap is associated with occupational sorting. The study considers three explanations for why occupational sorting emerges. First, data from Labour Force Surveys support the hypothesis that women sort into occupations with better non-monetary characteristics, such as paid leave and shorter hours. Second, the findings do not support the hypothesis of occupational sorting among the adult labour force as being driven by social norms about gender roles learned at an early age. Specifically, the analysis simulates what the gender wage gap would be if children pursued the occupations they aspired for at the age of twelve, and the distribution of salaries remained unchanged. Finally, there is no evidence to support the claim that individuals with higher education sort during the school-to-work transition, when women face higher barriers in finding a job in their field of study. Overall, the findings suggest that, in Vietnam gender-specific preferences for non-monetary job characteristics play a key role in the emergence of occupational sorting.