Miracle-dz/UniFAR-FTUs huggingface dataset:
Utility of Cerebroplacental Ratio in IUGR Fetuses from Pregnancy with Preeclampsia in Prediction the Risk for Perinatal Complications

Purpose. The aim of this study was to show that is the incidence of intrauterine growth restriction (IUGR) in women with preeclampsia (PE), assessment of cerebroplacental ratio (CPR) to establish the diagnostic value of CPR in fetuses with preeclampsia with/without IUGR. Material and Methods. We performed an analysis of 49 cases with gestational hypertension and PE and 16 cases with normal pregnancy for control lot, study in Obstetrics and Gynecology Clinic of the Municipal Hospital Filantropia, Craiova, between October 2013 and October 2015. It was performed clinical and laboratory evaluation and management of each case. CPR ratio was measured in the third trimester in all cases, being studied according to the normal and abnormal values obtained, following the evolution of the newborn. Results. Mild PE cases were predominant with 21 cases (19.27%), severe PE accounted for 16 cases (14.68%) and gestational hypertension was found in 16 cases in our study. Distribution of IUGR cases presented interesting and contradictory data, because we met cases of IUGR in pregnancies without PE, at a rate of only 1.54%. The incidence of IUGR was significantly higher in cases with severe early-onset PE (10.20%). Cases of severe PE, but with late-onset, had IUGR in only 2.04% of cases. We found a significant statistical significance (p <0.005) on the incidence of IUGR in cases with severe early-onset PE. CPR identified adverse perinatal outcomes in 18.46% of cases with CPR <1.08. Conclusions. This study shows that early onset severe PE and concomitantly IUGR affects a significant proportion of pregnancies. CPR can be used to identify fetuses with an increased risk of intrauterine compromise.
Squamous Esophageal Carcinoma Synchronous to Pericolic Malignant Conjunctive Tumor

Esophageal carcinoma represents a great diagnostic and therapeutic challenge due to the anatomical situation and physiopathology of the disease. The medical challenge can be even greater since esophageal carcinoma can evolve concomitant to another malignant tumor with different localization. This paper’s aim is to present a case of squamous esophageal cancer associated to another primitive malignant tumor-malignant pericolic conjunctive tumor, this kind of association being singular in medical literature from our knowledge. Upon emergency presentation the patient was sketching a sub-occlusive syndrome with mild anemia and inflammatory syndrome, somehow suggesting a possible right colon cancer. However, discreet upper digestive pole symptomatology that, on first sight, seemed secondary, made the consultant to perform a superior digestive endoscopy that raised a strong suspicion of early stage esophageal carcinoma. Further exploration was not completed because occlusive complication occurred and the patient needed emergency surgery. On laparotomy a stenotic right colic angle tumor was discovered that later proved to be extra-mucosal, with conjunctive origin. Our paper focuses on highlighting the crucial importance of the imagistic explorations in the primary diagnosis of esophageal carcinoma, in the correct staging (lymphatic extension, loco-regional or distant metastases) and also for malignant tumors with another localization that can radically modify the therapeutic strategy.
Acute Bacterial Gastroenteritis as a Healthcare-Associated Infection in Pediatrics

Despite the fact that acute gastroenteritis can be prevented, the disease still affects children, especially under the age of two. The increased levels of pediatric mortality in most developing regions make diarrheal diseases one of the most common causes of death in the children under the age of 5. The purpose of the study was to describe the cases of acute gastroenteritis reported as healthcare-associated infections in a pediatric hospital deserving the north-eastern urban and rural regions of Romania. Material and methods. A descriptive study was conducted on a group of 615 cases with acute bacterial gastroenteritis as healthcare-associated infections (HAIs), reported in “Sf. Maria” Emergency Hospital for Children, Iași, between 2012 and 2016. Results. Most cases of acute bacterial gastroenteritis were registered in 2015 (154 cases-25.04%), and the lowest in 2012 (12.84%). Male gender prevailed in almost all years of study, with no statistical significance (p≥0.05). Gastroenteritis with Campylobacter was most commonly reported in pediatric wards, especially in infants of 0-1 years old and children aged of 2-6 years. Cases of HAIs with Salmonella spp were also frequent. Conclusions. A competent management of HAIs especially as acute gastroenteritis in an emergency hospital for children from a region that includes developing rural areas, should be the most important issue for professionals involved in surveillance and control strategies, as well as clinicians, epidemiologist and microbiologist, in order to prevent HAIs burden occurrence and avoid antimicrobial resistance.
Soil nutrient loss through erosion: Impact of different cropping systems and soil amendments in Ghana

Soil erosion is a multifactor threat to crop production and the environment. Most studies on soil erosion characterization have not focused on soil nutrient loss associated with erosion. The aim of this study was therefore to quantify the magnitude of nutrient loss through soil erosion under different cropping systems and amendments to inform agronomic practices in sub-Saharan Africa (SSA). A field experiment was carried out on runoff plots with different cropping systems (sole maize, sole cowpea, sole maize and maize intercropped with soybean) as main plots and soil amendments (biochar, NPK (Nitrogen +Phosphorus +Potassium) fertilizer, NPK + biochar and a control (no amendment)) constituting the subplots in a randomized complete block design. For each block, a bare plot was included to assess the efficiency of the different crop and soil management practices on soil erosion. The study was carried out in three consecutive cropping seasons in the semi-deciduous forest zone of Ghana. The bare plots had the highest amounts of nitrogen (N), phosphorus (P), and potassium (K) eroded: 33.88, 12.35 and 12.75 kg ha-1 respectively followed by the control plots with magnitude of 20.43, 8.42 and 7.87 kg ha-1 respectively for N, P and K. Sole maize had the highest amounts of nutrient loss: 19.71, 8.12 and 7.27 for N, P and K respectively compared to all the other cropping systems where the losses varied respectively from 12.38 to 17.12, 6.67 to 7.49 and 5.81 to 6.75 kg ha-1 The legume-based cropping systems under inorganic fertilizer and biochar management effectively reduced nutrient loss more than all other treatment combinations. The off-site effect of soil erosion expressed as enrichment ratio (ER) was higher for all plots, which received inorganic fertilizer inputs varying from 1.93 to 3.06 while the other treatments had ERs of 1.51 to 2.03. The ERs of fine soil particles were greater than 1 (ranging from 1.14 to 3.6) being relatively higher than that of coarse particles (sand) with values below 1 (ranging from 0.62 to 0.88). The least cumulative monetary value of nutrient loss (30.82 US$ ha-1) was observed under cowpea cropping system which received NPK + BC treatment. Soil erosion affected directly soil nutrient depletion through nutrient loss; however, integrated soil fertility management associated with legume-based cropping systems can be alternative options to reducing its effects on croplands in SSA.
Attraction of Lutzomyia longipalpis to synthetic sex-aggregation pheromone: Effect of release rate and proximity of adjacent pheromone sources

In South America, the Protist parasite that causes visceral leishmaniasis, a potentially fatal human disease, is transmitted by blood-feeding female Lutzomyia longipalpis sand flies. A synthetic copy of the male produced sex-aggregation pheromone offers new opportunities for vector control applications. We have previously shown that the pheromone placed in plastic sachets (lures) can attract both females and males to insecticide treated sites for up to 3 months. To use the pheromone lure in a control program we need to understand how the application of lures in the field can be optimised. In this study we investigated the effect of increasing the number of lures and their proximity to each other on their ability to attract Lu. longipalpis. Also for the first time we applied a Bayesian log-linear model rather than a classic simple (deterministic) log-linear model to fully exploit the field-collected data. We found that sand fly response to pheromone is significantly related to the quantity of pheromone and is not influenced by the proximity of other pheromone sources. Thus sand flies are attracted to the pheromone source at a non-linear rate determined by the amount of pheromone being released. This rate is independent of the proximity of other pheromone releasing traps and indicates the role of the pheromone in aggregation formation. These results have important implications for optimisation of the pheromone as a vector control tool and indicate that multiple lures placed in relatively close proximity to each other (5 m apart) are unlikely to interfere with one another.
Value of preoperative spirometry test in predicting postoperative pulmonary complications in high-risk patients after laparoscopic abdominal surgery

Whether preoperative spirometry in non-thoracic surgery can predict postoperative pulmonary complications (PPCs) is controversial. We investigated whether preoperative spirometry results can predict the occurrence of PPCs in patients who had undergone laparoscopic abdominal surgery. This retrospective observational study analyzed the records of patients who underwent inpatient laparoscopic gastric or colorectal cancer surgery at Seoul National University Bundang Hospital between January 2010 and June 2017. Preoperative spirometry was performed for patients at a high risk of PPCs, such as elderly patients (age >60 years), patients aged <60 years with chronic pulmonary disease, and current smokers. The main outcome was the association between the results of spirometry tests performed within 1 month prior to surgery and the occurrence of PPCs, as determined by multivariable logistic regression analysis. Of the 898 included patients who underwent laparoscopic gastric (372 patients) or colorectal cancer surgery (526 patients), PPC occurred in 117 patients (gastric cancer: 74, colorectal cancer: 43). A 1% greater preoperative forced vital capacity (FVC) was associated with a 2% lower incidence of PPCs after laparoscopic gastric or colorectal cancer surgery (odds ratio: 0.98, 95% confidence interval: 0.97–0.99, P = 0.018). However, the preoperative forced expiratory volume in 1 second (FEV1) (%) and FEV1/FVC (%) were not significantly associated with PPCs (P = 0.059 and P = 0.147, respectively). In conclusion, lower preoperative spirometry FVC, but not FEV1 or FEV1/FVC, may predict PPCs in high-risk patients undergoing laparoscopic abdominal surgery.
An assessment of hand hygiene perception and practices among undergraduate nursing students in Lagos State: A pilot study

BACKGROUND: The contaminated hands of health-care professionals (HCPs) is an implicated vector in the transmission of potentially pathogenic organisms to vulnerable patients. The aim of this study was to derive baseline data on hand hygiene (HH) practices among a cohort of students at the Lagos State School of Nursing and to determine their perception about the adequacy of instructions they receive. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on a probability random sample of 69 nursing students at the Lagos State School of Nursing at the Alimosho Igando General Hospital. The knowledge, attitude, and practice as well as the perception of the respondents on the adequacy of their infection control instructions were obtained using an interviewer-administered questionnaire. Data entry and analysis were done using SPSS software version 20 (IBM Corp., Armonk, NY, USA), P < 0.05 was considered statistically significant. Multivariate linear and logistic regressions were done to assess which factors were truly significant predictors, with odds ratios (ORs) and 95% confidence intervals (CIs) specified as the measures of association between predictors and outcome variables. RESULTS: Majority of participants were ≤20 years old (50.7%, n = 35) and were in their second year of study (44.9%, n = 31). Participants were least knowledgeable about the importance of discarding gloves and not washing or reusing them (16 [23.1%]). The mean score on the Hand Hygiene Beliefs Scale was 86.2 ± 9.0, with scores ranging from 23 to 88 out of a possible high score of 115. The most positive health beliefs were associated with being a role model for HH (3.57 ± 0.52), while the worst was associated with imitating bad HH practices performed by senior colleagues (1.29 ± 1.20). Caring for a wound (60 [87.0%]) was most associated with the need for HH, while demonstration and clinical practice were rated as the most effective teaching methods. Results of the multivariate logistic regression analysis, with the outcome variable of good self-reported HH practices, revealed that the odds of appropriate behavior were higher if the student nurses were in their third year of study (OR = 1.59; 95% CI: 1.01–2.45). An appropriate behavior was also more likely in student nurses with a higher risk perception (OR = 1.54; 95% CI: 1.03–2.51). CONCLUSION: Despite the overwhelming evidence that HH is effective in the prevention of hospital-acquired infections, its performance among HCPs remains far less than optimal. Since students will someday be influencing future HH compliance behaviors of other health-care workers, the importance of HH should be adequately incorporated into their school curriculum.
Anaerobic methane oxidation inducing carbonate precipitation at abiogenic methane seeps in the Tuscan archipelago (Italy)

Seepage of methane (CH4) on land and in the sea may significantly affect Earth’s biogeochemical cycles. However processes of CH4 generation and consumption, both abiotic and microbial, are not always clear. We provide new geochemical and isotope data to evaluate if a recently discovered CH4 seepage from the shallow seafloor close to the Island of Elba (Tuscany) and two small islands nearby are derived from abiogenic or biogenic sources and whether carbonate encrusted vents are the result of microbial or abiotic processes. Emission of gas bubbles (predominantly CH4) from unlithified sands was observed at seven spots in an area of 100 m2 at Pomonte (Island of Elba), with a total rate of 234 ml m-2 d-1. The measured carbon isotope values of CH4 of around -18‰ (VPDB) in combination with the measured δ2H value of -120‰ (VSMOW) and the inverse correlation of δ13C-value with carbon number of hydrocarbon gases are characteristic for sites of CH4 formation through abiogenic processes, specifically abiogenic formation of CH4 via reduction of CO2 by H2. The H2 for methanogenesis likely derives from ophiolitic host rock within the Ligurian accretionary prism. The lack of hydrothermal activity allows CH4 gas to become decoupled from the stagnant aqueous phase. Hence no hyperalkaline fluid is currently released at the vent sites. Within the seep area a decrease in porewater sulphate concentrations by ca. 5 mmol/l relative to seawater and a concomitant increase in sulphide and dissolved inorganic carbon (DIC) indicate substantial activity of sulphate-dependent anaerobic oxidation of methane (AOM). In absence of any other dissimilatory pathway, the δ13C-values between -17 and -5‰ in dissolved inorganic carbon and aragonite cements suggest that the inorganic carbon is largely derived from CH4. The formation of seep carbonates is thus microbially induced via anaerobic oxidation of abiotic CH4.
Assessment correlation of the organizational agility of human resources with the performance staff of Tehran Emergency Center

BACKGROUND: Human resources are the most important tool in agility of organization and is considered to be the most valuable asset of any organization. Agile emergency system can reduce production costs, increase market share, fulfill the needs of patients, and most importantly, it reduced the mortality and morbidity from diseases and crashes. OBJECTIVE: The purpose of this study was to determine the correlation of human resource agility with performance of the staff of Tehran Emergency Center (TEC). MATERIALS AND METHODS: This research is a descriptive-correlational study and 285 operatives from TEC, with a population of 1100 were selected according to Morgan table and simple random sampling. The data of this research were collected using human resource agility capabilities questionnaire and Patterson job performance questionnaire. SPSS/18 software and descriptive-inferential tests were used to analyze the data. RESULTS: The results show that the correlation between organizational agility and employee performance is 0.754 and is significant (P = 0.01). The correlation between the employee performance and intelligence and knowledge (0.512), multiple competencies (0.61), knowledge management (0.57), empowerment culture (0.524), and information system (0.63) in significant level (P = 0.05). CONCLUSIONS: The agility of the staff of the TEC is correlated with their performance. Due to the sensitivity of the work of TEC staff, it is recommended that they are planning in such a way that they acquire the agility of themselves and their organizations by acquiring the necessary skills at all levels, especially the operational level.
Sociodemographic and Clinical Characteristics of Transgender Adults in Australia

Abstract Background: Over the last 10 years, increases in demand for transgender health care has occurred worldwide. There are few data on clinical characteristics of Australian adult transgender individuals. Understanding gender identity patterns, sociodemographic characteristics, gender-affirming treatments, as well as medical and psychiatric morbidities, including neurobehavioral conditions affecting transgender and gender-diverse adults will help to inform optimal health service provision. Purpose: In an Australian adult transgender cohort, we aimed to first, assess referral numbers and describe the sociodemographic and clinical characteristics, and second, to specifically assess the prevalence of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Methods: We performed a retrospective audit of deidentified electronic medical records in a primary care and a secondary care gender clinic in Melbourne, Australia. Annual referral rates, sociodemographic data, and prevalence of medical and psychiatric conditions were obtained. Results: Data for 540 transgender individuals were available. Rapid rises were observed in referrals for transgender health services, more than 10 times the number in 2016 compared with 2011. Median age at initial presentation was 27 years (interquartile range (22, 36), range 16–74). Around 21.3% were unemployed and 23.8% had experienced homelessness despite high levels of education. Around 44.1% identified as trans male, 36.3% as trans female, and 18.3% as gender nonbinary. Medical morbidities were rare but mental illness was very common. The prevalence of depression was 55.7%, anxiety in 40.4%, ADHD in 4.3%, and ASD in 4.8%, all higher than reported age-matched general Australian population prevalence. Conclusions: Rising demand for transgender care, socioeconomic disadvantage, and high burden of mental health conditions warrants a comprehensive multidisciplinary approach to provide optimal care for transgender individuals. Given that ASD and ADHD are prevalent, in addition to gender-affirming treatments, psychosocial interventions may assist individuals in navigating health care needs and to support social aspects of gender transition. Further studies are required to understand links between ASD, ADHD, and gender identity and to evaluate optimal models of health service provision for transgender individuals.
In vitro Interrelationship between Apical Fill and Apical Leakage Using Three Different Obturation Techniques

Aim and Objectives: To evaluate the apical fill in relation to apical leakage using three different obturating techniques – Single Cone, Ultrafil 3D, and lateral condensation. Materials and Methods: Sixty-six mandibular single-rooted premolar teeth were selected and were randomly assigned into three different groups of obturating techniques. The canals were prepared using 0.4/25 HyFlex CM (Coltene Endo) rotary system file and obturated with corresponding HyFlex CM Single Cone, Ultrafil 3D injectable technique, and lateral condensation. AH Plus (Dentsply, Detrey) has been used as the sealer. Twenty teeth each were assigned to the three experimental groups, and six teeth were used as positive and negative controls (3 in each group). Fluid filtration technique was used to determine the amount of apical leakage. The evaluation was done for 8 min at the interval of every 2 min. The same teeth were sectioned and a spectroscopic examination was done at 2 mm and 4 mm distance from the apices. The obtained data were statistically analyzed using analysis of variance test followed by post hoc turkeys test for multiple comparisons. Results: The mean apical leakage was maximum for lateral condensation when compared to the Single Cone and Ultrafil 3D. The amount of apical fill at 2 mm and at 4 mm was found to be more in the Single Cone than the other two techniques. Conclusion: The present study concluded that Single Cone obturation technique exhibited more gutta-percha filled area in the canal which led to decreased apical leakage than Ultrafil 3D and lateral condensation techniques, proving to be more effective in achieving a complete three-dimensional apical seal.
Medical students' knowledge and perception toward family planning services: A preliminary intervention study

INTRODUCTION: Family planning and contraception is the effective strategy to reduce maternal mortality, child mortality, abortion, and unwanted pregnancies. Since the medical students are the future doctors, it is important to have proper knowledge and training on family planning services. This study aimed to explore the effect of teaching-learning process at maternal and child health (MCH) clinics on the students' knowledge, perceptions toward contraception methods, and family planning counselling. METHODS: This quasi-experimental study was conducted in the private medical institution in Malaysia. The same questionnaire was used to administer twice, before and after the posting. Moreover, a qualitative question on the issues related to family planning and contraception utilizations in Malaysia was added to the after posting survey. The quantitative data were analyzed using IBM SPSS (version 20) and qualitative data by RQDA software. RESULTS: A total of 146 participants were recruited in this study. Knowledge on contraception method before posting was 5.11 (standard deviation [SD] ±1.36) and after posting was 6.35 (SD ± 1.38) (P < 0.001). Thematic analysis of the students' answer revealed four salient themes, which were as follows: (1) cultural barrier, (2) misconception, (3) inadequate knowledge, and (4) improvement for the health-care services. CONCLUSIONS: The teaching-learning process at the MCH posting has an influence on their perception and upgraded their knowledge. It also reflects the role of primary health-care clinics on medical students' clinical exposure and training on family planning services during their postings.