Miracle-dz/UniFAR-FTUs huggingface dataset:
Female Genital Mutilation in Iraqi Kurdistan: Description and Associated Factors

The high prevalence of female genital mutilation has been a concern in Iraqi Kurdistan. This study was undertaken to estimate its prevalence and describe factors associated with its occurrence. A cross-sectional survey was undertaken from March to April 2011 of females aged up to 20 years using interviews and clinical examination. The survey included 1,508 participants with mean age of 13.5 years (SD 5.6). Overall female genital mutilation prevalence was 23%, and the mean age at which it had been performed was 4.6 years (SD 2.4). Type I (partial or total removal of the clitoris) comprised 76% of those who had had female genital mutilation; in 79% of cases the decision to perform it was made by the mother; and in 54% of cases it was performed by traditional birth attendants/midwives. Women aged 16 years and over were more likely to have had female genital mutilation compared to children aged below 6 years (OR 11.9, p < .001). Children of uneducated mothers were eight times as likely to have had genital mutilation compared to children of mothers with over nine years of education (OR 8.0, p < .001). Among women aged 17 years and younger, 34% of those who were married had been circumcised versus 17% of those who were not married (p < .001). Participants residing in the northeast of Kurdistan region were more likely to have been circumcised. The study results show that female genital mutilation is a frequent practice in Iraqi Kurdistan. Attention and intervention is needed to address this aspect of the well-being of girls and women.
Featured Articles for CME Credit December 2014 Hyperfibrinolysis, physiologic fibrinolysis, and fibrinolysis shutdown: The spectrum of postinjury fibrinolysis and relevance to antifibrinolytic therapy

Impact Statement: Death from hemorrhage remains the leading cause of preventable death from trauma. One in three severely injured patients presents to the hospital with trauma-induced coagulopathy (TIC). Despite our growing knowledge of the mechanistic pathways driving TIC there are still many questions to be answered in regards to optimal therapeutic interventions. One of the most important observations in the last two years has been the appreciation that TIC has distinct phenotypes that relate to dysfunctional blood clot formation versus blood clot degradation (fibrinolysis). Fibrinolysis is a physiologic process to maintain microvascular patency by removing excess fibrin deposition. Hyperfibrinolysis occurs when this system lacks regulation and is association with high mortality due to uncontrolled bleedning. However, the shutdown of fibrinolysis (impairment) can also occur in severely injured trauma patients shortly after injury and associated with an elevated mortality, primarily due to delayed multi-organ failure. There appears to be a protective role of fibrinolysis in the injured patient as patients with a moderate degree of fibrinolysis have the lowest mortality rates. These findings support a more targeted approach in treating trauma patients with antifirbinolytic medication as iatrogenic impairment of fibrinolysis may lead to worse outcomes. Learning Objective: Understand the physiologic role of fibrinolysis, and the distinct phenotypes of fibrinolysis that exist in severely injured patients.
Asset Pricing and Momentum: A South African Perspective

ABSTRACT Both the capital asset pricing model and Fama and French’s (1993) three-factor model have consistently failed to explain momentum in stock returns, with only Carhart’s (1997) four-factor model having some success in this regard. This study examines whether an alternative three-factor model proposed by Chen, Novy-Marx, and Zhang (2011) and a five-factor model forwarded by Fama and French (2015), which both include profitability and investment as pricing factors, can explain momentum on the South African market. Consistent with international evidence, the pricing errors from these two models are lower and although these errors remain significant, the results reveal that profitability and, to a lesser extent, investment are important risk-based factors that must be considered in explaining the short-term continuation in stock returns.
The Association of Suicide and Bullying in Childhood to Young Adulthood: A Review of Cross-Sectional and Longitudinal Research Findings

Objective: To review the research addressing the association of suicide and bullying, from childhood to young adulthood, including cross-sectional and longitudinal research findings. Method: Relevant publications were identified via electronic searches of PsycNet and MEDLINE without date specification, in addition to perusing the reference lists of relevant articles. Results: Cross-sectional findings indicate that there is an increased risk of suicidal ideation and (or) suicide attempts associated with bullying behaviour and cyberbullying. The few longitudinal findings available indicate that bullying and peer victimization lead tosuicidality but that this association varies by sex. Discrepancies between the studies available may be due to differences in the studies' participants and methods. Conclusions: Bullying and peer victimization constitute more than correlates of suicidality. Future research with long-term follow-up should continue to identify specific causal paths between bullying and suicide.
Effect of an individualized dose/schedule strategy for sunitinib in metastatic renal cell cancer (mRCC) on progression-free survival (PFS): Correlation with dynamic microbubble ultrasound (DCE-US) data.

356 Background: Sunitinib area under the curve (AUC) correlates with response and PFS (Houk et al). Current recommendations for dose modification do not take this into account. METHODS A single center retrospective review identified mRCC patients (pts) where individualized (individ) sunitinib dose/schedule modifications (DSM) were used to maximize dose and minimize time off therapy (Rx). Pts were started on 50 mg 28 days (d) on/14 d off. DSM were done to keep toxicity (fatigue, skin, GI) at ≤ grade-2. DSM-1 was 50 mg 14 d/7 d with individ increases in d on Rx based on toxicity. DSM-2 was 50 mg 7 d/7 d with individ increases in d on Rx. DSM-3 was 37.5 mg continuously with individ 7 d breaks. DSM-4 was 25 mg continuously with individ 7 d breaks. RESULTS In 171 pts; median age was 60y; 20% good, 60% intermediate, 20% poor prognosis by Heng criteria; 80% had nephrectomy; 79% clear cell histology; 60% were previously untreated. At a median follow-up of 10.7 months (mo), overall median PFS was 7.9 mo. Of 39 pts still on therapy, 37 were on a DSM Rx. Pts were allocated to three groups based on the dose/schedule used for the longest time. The PFS/response% (PR+SD) for each group was 4.4 mo/65.6% (standard 50 mg 28 d/14 d; 43 pts), 8.0 mo/78.2% (DSM-1/DSM-2; 69 pts) and 10.4 mo/81.3% (DSM-3/DSM-4; 59 pts) with improved PFS (p=0.001) in both DSM groups vs. the standard schedule but no difference in response. 30 pts were studied by DCE-US at baseline, and after 7 d and 14 d on Rx or after 14 d and 28 d on Rx. In responding pts, tumor blood volume decreased at d 7 and again at d 14 vs. baseline but was stable or increased at d 28 vs. d 14. A rebound was seen after 14 d off Rx. CONCLUSIONS Based on the U.S. data, previous pharmacokinetic data (steady state at 10-14 d) and this clinical data, starting pts on 50 mg 14 d/7 d followed by individ DSM may be safe and active. This DSM strategy, was associated with a favorable toxicity profile, apparent improvement in PFS and a good PR+SD rate in a group of unselected mRCC pts, warranting confirmation in a prospective trial. Pts that tolerate 50 mg 28 d/14 d with minimum toxicity may need dose escalation and/or less time off therapy to optimize PFS. [Table: see text].
Prevalence and Sociodemographic Factors of Malnutrition among Children in Malaysia

Background For many developing countries undergoing rapid economic growth and urbanization, trends in nutritional status indicate a decrease in malnutrition with an associated rise in the prevalence of obesity. An understanding of the situation among children in Malaysia is lacking. Objective To examine the prevalence, trends and sociodemographic factors described for underweight and overweight children in Malaysia. Methods The literature from January 1996 to November 2010 on the prevalence of underweight and over-weight among children in Malaysia was reviewed. Results Twelve studies were identified that reported on both underweight and overweight among children in Malaysia, of which only one was a nationally representative survey. Based on the National Health and Morbidity Survey in 2006, 13.2% (95% CI, 12.6 to 13.9) of children aged 0 to 18 years were underweight (weight-for-age < −2SD), and 8.0% (95% CI, 7.5 to 8.6) of those aged 0 to 13 years were overweight (weight-for-height > +2SD). Both underweight and overweight were more prevalent in males than females. Children in rural areas were more likely to be underweight and less likely to be overweight than urban children. Ethnic differences between Malays, Chinese, and Indians were inconsistent across studies and less clear. Aborigines were more likely to be underweight and less likely to be overweight than the general population. The available evidence, although limited and sparse, suggests that over the past decade the prevalence of both underweight and overweight among children in Malaysia has been stable or has shown an increasing trend. Conclusions Long-term national monitoring and longitudinal cohort studies will be critical for understanding, preventing, and managing the double burden of malnutrition among children in Malaysia.
Beliefs about Climate Beliefs: The Importance of Second-Order Opinions for Climate Politics

When political action entails individual costs but group-contingent benefits, political participation may depend on an individual’s perceptions of others’ beliefs; yet detailed empirical attention to these second-order beliefs – beliefs about the beliefs of others – remains rare. We offer the first comprehensive examination of the distribution and content of second-order climate beliefs in the United States and China, drawing from six new opinion surveys of mass publics, political elites and intellectual elites. We demonstrate that all classes of political actors have second-order beliefs characterized by egocentric bias and global underestimation of pro-climate positions. We then demonstrate experimentally that individual support for pro-climate policies increases after respondents update their second-order beliefs. We conclude that scholars should focus more closely on second-order beliefs as a key factor shaping climate policy inaction and that scholars can use the climate case to extend their understanding of second-order beliefs more broadly.
Diclofenac poisoning as a cause of vulture population declines across the Indian subcontinent

Summary 1 Rapid population declines of the vultures Gyps bengalensis, Gyps indicus and Gyps tenuirostris have recently been observed in India and Pakistan, continuing at least up to 2003. Surveys indicate annual rates of decline of 22–50% for G. bengalensis and G. indicus during 2000–03. Previous studies in Pakistan have shown that the non-steroidal anti-inflammatory drug diclofenac causes renal failure and is lethal to G. bengalensis when it feeds on the carcass of a domestic animal that received a normal veterinary dose shortly before death. In Pakistan, diclofenac poisoning was found to be by far the most frequent cause of death. 2 A simulation model of vulture demography, described in this paper, demonstrated that the observed rates of population decline could be caused by contamination with a lethal level of diclofenac in a small proportion (between 1 : 130 and 1 : 760) of ungulate carcasses available to vultures. 3 Proportions of adult and subadult vultures found dead or dying in the wild that had signs of diclofenac poisoning were similar to the proportions of deaths expected from the model if the observed population decline was due entirely to diclofenac poisoning. The proportion of the excess mortality required to cause the observed population declines that could be attributable to diclofenac was estimated to be between 71% and 100%, depending on model assumptions. However, across all or most of the plausible range of assumed values for adult survival, the upper 95% confidence limit for the proportion of excess mortality due to diclofenac was 100%. Hence, available data are consistent with diclofenac poisoning being at least the major cause, and possibly the only cause, of rapid population declines of Gyps vultures across the Indian subcontinent. 4 Synthesis and applications. We recommend that urgent action is taken in the range states of the three currently threatened vulture species to prevent the exposure of vultures to livestock carcasses contaminated with diclofenac. Research is also needed to identify alternative drugs that are effective in livestock and safe for vultures. Efforts should also be made to raise awareness, among veterinarians, pharmacists, livestock owners and the general public, of the problem of diclofenac contamination and the availability of safe alternatives. Captive holding and breeding of vultures until diclofenac is controlled is recommended as a precaution to ensure the long-term survival of the threatened species and to provide a stock of birds for future reintroduction programmes.
Bank Lines of Credit as Contingent Liquidity: Covenant Violations and Their Implications

We examine the relation between banks’ liquidity risk and their willingness to supply capital to borrowers under previously committed credit lines. We show that during the collapse of the asset-backed commercial paper (ABCP) market in the last quarter of 2007 and the first half of 2008, banks with higher exposure to ABCP conduits renegotiated significantly tougher conditions on the outstanding credit lines offered to borrowers in violation of a covenant. Specifically, we find that borrowers faced higher spreads over the prime rate and LIBOR as well as higher commitment fees on undrawn amounts. Our paper suggests that an increase in lender liquidity risk can bear financial implications for firms that use credit lines as an instrument of liquidity management.
Acute administration of cannabidiol in vivo suppresses ischaemia‐induced cardiac arrhythmias and reduces infarct size when given at reperfusion

Background and purpose: Cannabidiol (CBD) is a phytocannabinoid, with anti‐apoptotic, anti‐inflammatory and antioxidant effects and has recently been shown to exert a tissue sparing effect during chronic myocardial ischaemia and reperfusion (I/R). However, it is not known whether CBD is cardioprotective in the acute phase of I/R injury and the present studies tested this hypothesis.
Health shocks and labour market outcomes: evidence from professional football

The negative association between health shocks and labour market outcomes is a well-established finding in the health and labour economics literatures. However, due to lack of data, most of the contributions focus on elderly workers and analyse labour force participation as their main outcome. This paper uses traumatic injuries as a source of exogenous variation in professional football playersâ€™ health to provide estimates of the causal impact of a health shock on two main labour market outcomes: annual net wages and the probability of renegotiating the contract between club and player. We have built a unique longitudinal dataset recording information about wages, injuries and other characteristics of the universe of professional football players in the Italian Serie A from 2009 to 2014. We employ panel fixed effects models combined with an IV strategy, which uses the average number of yellow cards received by the team as an instrument. We find that injuries reduce the net wage in the following season by around 12%. This result is mainly driven by precautionary reasons due to the clubâ€™s concern about depreciation in the playerâ€™s human capital rather than by a direct effect of the shock on the playerâ€™s productivity.
Beta-2-microglobulin is superior to N-acetyl-beta-glucosaminidase in predicting prognosis in idiopathic membranous nephropathy.

BACKGROUND An accurate prediction of prognosis in patients with idiopathic membranous nephropathy (iMN) would allow restriction of immunosuppressive treatment to patients who are at highest risk for end-stage renal disease (ESRD). Several markers of proximal tubular cell injury have been used as predictors of prognosis. In this study we compared the accuracy of urinary beta-2-microglobulin (U beta 2m) and N-acetyl-beta-glucosaminidase (U beta-NAG) in predicting renal insufficiency and remission rates. METHODS Fifty-seven patients with iMN (38 M, 19 F; age 48 +/- 16 years), a nephrotic syndrome and a serum creatinine level <135 micromol/l were studied prospectively. At baseline, a standardised measurement was carried out to determine renal function and protein excretion. The end-point renal failure was defined as a serum creatinine exceeding 135 micromol/l or an increase in serum creatinine by >50%. Remission was defined as a proteinuria <2.0 g/day with stable renal function. RESULTS The mean follow-up was 80 +/- 36 months. The mean serum creatinine concentration was 89 +/- 20 micromol/l, serum albumin 24 +/- 5.3 g/l and proteinuria 8.9 +/- 4.8 g/24 h. Thus far, 28 (49%) patients have reached the predefined end point of renal failure. Multivariate analysis identified U beta 2m as the strongest independent predictor for the development of renal insufficiency. Sensitivity and specificity were 81 and 90% respectively for U beta 2m (threshold value 54 microg/mmol cr), and 74 and 81% respectively for U beta-NAG (threshold value 2.64 U/mmol cr). The overall remission rate was 44%. A remission occurred in 78% of patients with low U beta 2m and in 14% of patients with high U beta 2m, and respectively in 71% of patients with low U beta-NAG and 21% of patients with high U beta-NAG. CONCLUSIONS Although both U beta 2m and U beta-NAG predicted progression and remission in iMN, U beta 2m was more accurate. High specificity in predicting prognosis should be pursued to avoid unnecessary immunosuppressive therapy. We therefore conclude that U beta 2m is superior to U beta-NAG in predicting prognosis in patients with iMN.
Standardized peripheral blood mononuclear cell culture assay for determination of drug susceptibilities of clinical human immunodeficiency virus type 1 isolates. The RV-43 Study Group, the AIDS Clinical Trials Group Virology Committee Resistance Working Group

A standardized antiviral drug susceptibility assay for clinical human immunodeficiency virus type 1 (HIV-1) isolates has been developed for use in clinical trials. The protocol is a two-step procedure that first involves cocultivation of patient infected peripheral blood mononuclear cells (PBMC) with seronegative phytohemagglutinin-stimulated donor PBMC to obtain an HIV-1 stock. The virus stock is titrated for viral infectivity (50% tissue culture infective dose) by use of serial fourfold virus dilutions in donor PBMC. A standardized inoculum of 1,000 50% tissue culture infective doses per 10(6) cells is used in the second step of the procedure to acutely infect seronegative donor PBMC in a 7-day microtiter plate assay with triplicate wells containing zidovudine (ZDV) concentrations ranging from 0 to 5.0 microM. The ZDV 50% inhibitory concentrations (IC50) for reference ZDV-susceptible and ZDV-resistant HIV-1 isolates ranged from 0.002 to 0.113 microM and from 0.15 to > 5.0 microM, respectively. Use of this consensus protocol reduced interlaboratory variability for ZDV IC50 determinations with reference HIV-1 isolates. Among eight laboratories, the coefficient of variation ranged from 0.85 to 1.25 with different PBMC protocols and was reduced to 0.39 to 0.98 with the standardized assay. Among the clinical HIV-1 isolates assayed by the standardized drug susceptibility assay, the median ZDV IC50 increased gradually with more ZDV therapy. This protocol provides an efficient and reproducible means to assess the in vitro susceptibility to antiretroviral agents of virtually all clinical HIV-1 isolates.
Performance of visual inspection with acetic acid and human papillomavirus testing for detection of high‐grade cervical lesions in HIV positive and HIV negative Tanzanian women

The aim of this cross sectional study was to assess type distribution of human papillomavirus (HPV) among HIV positive and HIV negative women who underwent cervical cancer screening, and to examine the ability of visual inspection with acetic acid (VIA), the standard detection method in Tanzania, and HPV‐testing to detect cytologically diagnosed high grade lesions or cancer (HSIL+). Women from different areas in Tanzania were invited by public announcement to cervical cancer screening organized by Ocean Road Cancer Institute (Dar‐es‐Salaam). A total of 3,767 women were enrolled. Women underwent gynecological examination with collection of cervical cells for conventional cytological examination, and swab for HPV‐DNA detection (Hybrid‐Capture2) and genotyping (LiPAv2 test). Subsequently VIA was performed. The participants were also tested for HIV. HPV16, HPV52 and HPV18 were the three most common HR HPV types among women with HSIL+ cytology with prevalences of 42.9, 35.7 and 28.6%, respectively, in HIV positive women which was higher than among HIV negative women (30.2, 21.9 and 16.7%). A total of 4.5% of the women were VIA positive, and VIA showed a low sensitivity compared to HPV‐testing for detection of HSIL+. The sensitivity of VIA varied with staff VIA experience, HIV status and age. Vaccines including HPV16, HPV52 and HPV18 will likely reduce the number of HSIL+ cases independently of HIV status. The frequency of HSIL+ was high among HIV positive women, emphasizing the importance of establishing a screening program which also reaches HIV positive women. Our results highlight the importance of continuous training of staff performing VIA, and also point to the need for other screening methods such as HPV‐testing at low cost.
A System of Contradictory Goals and Realization of Ambidexterity: A Case Study of a Municipal Corporation

ABSTRACT Pursuit of contradictory goals is inherent in the activities of any typical public-sector organization. Bulk of the existing literature on how contradictory goals can be pursued successfully focuses on a single pair of contradictory goals, largely pursued by private sector organizations. This empirical study identifies a system of multiple pairs of contradictory goals associated with structural separation of subunits of a public-sector organization in India, where the organization is a municipal corporation and two of its subunits engaged in the business of Public Urban Transport are involved. Emergence of contradictory goals was observed to be linked with the dynamics of key stakeholder interests. The study revealed that the top and middle managers may respond differently to a pair of contradictory goals, and the same manager also responds differently to different pairs of contradictory goals. Three pairs of contradictory goals were identified. These goals involved subunit identity and shared identity, contractor compliance and maintaining relationship with the contractor, and performance and learning. Realization of organizational ambidexterity appeared linked to how well the simultaneity and variety of contradictory goals are matched by simultaneity and variety of responses, namely a combination of structural, contextual and behavioral arrangements by the organization and individuals.