Miracle-dz/UniFAR-FTUs huggingface dataset:
Case study of copper poisoning in a British dairy herd

Following the initial diagnosis of chronic copper poisoning (CCP), the copper (Cu) status of a British dairy herd was investigated. Eight fatal cases of CCP were identified over a 17-month period, from December 1999 to May 2001, involving seven Jersey cows and one Holstein-Friesian; seven cows were dry when CCP occurred. Case diagnostic criteria were necrotising hepatopathy associated with abnormally high liver and kidney Cu concentrations. Analysis of the ration for the high-yielding Jersey cow group revealed about 50 mg Cu/kg dry matter intake (DMI). Risk factors predisposing to fatal CCP were Jersey breed, previous high yield, first two weeks of the dry period and moderately high dietary Cu (greater than 40 mg Cu/kg DMI).
Sexual behavior and infection with cervical human papillomavirus types 16 and 18

Objective This study assessed whether sexual behavior, including engaging in early sexual intercourse and having had multiple sexual partners, can predict the risk of infection with cervical human papillomavirus (HPV) types 16 and 18. Methods Records were reviewed of women who underwent cervical cancer screening and were found to be infected with high-risk HPV. The genotypes of high-risk HPV were categorized as HPV 16, HPV 18, and other than 16 or 18. Early sexual intercourse was defined as first sexual intercourse at the age of 19 years or younger. Multiple sexual partners was defined as having more than three lifetime sexual partners. Associations between sexual behavior and HPV 16/18 infection were presented as odds ratios (ORs) and 95% confidence intervals (CIs). Results Of the 349 women included in the study, 72 (20.6%) and 30 (8.6%) were infected by HPV 16 and 18, respectively. Eighty-two women (26.0%) reported having engaged in early sexual intercourse, and 33 (10.4%) reported having had multiple sexual partners. After adjustment for age, parity, and smoking habits, we found that women who had engaged in early sexual intercourse tended to have a higher risk of HPV 16 (OR 1.74; 95% CI 0.93–3.29), and those who had had multiple sexual partners were found to be at a significantly higher risk for HPV 18 (OR 4.58; 95% CI 1.44–14.58). Conclusion Sexual behavior was associated with an increased risk of HPV 16/18 infection. Engaging in early sexual intercourse increased the risk of HPV 16 infection, and having had multiple sexual partners increased that of HPV 18.
Unpacking Loss to Follow-Up Among HIV-Infected Women Initiated on Option B+ In Northern Tanzania: A Retrospective Chart Review

Background: In 2014, Tanzania adopted the Option B+ policy for the prevention of mother-to-child transmission of HIV (PMTCT), which stipulates lifelong antiretroviral therapy (ART) for HIV-infected pregnant, postpartum and breastfeeding women, irrespective of CD4 count or WHO clinical staging. Loss to follow-up (LTFU) during pregnancy and the postpartum period may undermine the effectiveness of Option B+. Factors associated with no follow-up (NFU) care, may differ from those associated with LTFU at later time points. This study aimed to identify factors associated with NFU and LTFU among women who initiate ART under Option B+ in Moshi, Tanzania. Methods: We conducted a retrospective chart review of patients initiating ART on Option B+ between February 2014 and December 2015 in Moshi Municipality, Tanzania. Multivariable log-binomial regression was used to analyse factors associated with NFU. Kaplan-Meier survival functions were used to estimate time to LTFU. Multivariable Cox proportion hazards regression models were used to evaluate variables associated with time to LTFU. Results: Among 468 women initiating ART under the option B+ programme, 109 (23.3%) had NFU after the initial appointment. Factors associated with increased risk of NFU were: age < 25 years (adjusted hazard ratio [aRR] 1.7; 95% CI, 1.2 to 2.3), initiating ART at a hospital compared to a lower level health facilities (aRR 2.9; 95% CI, 2.1 to 3.9), and having no treatment supporter (aRR 1.5; 95% CI, 1.1 to 2.1). LTFU was higher in women aged < 25 years (aHR 1.4; 95% CI, 1.1 to 1.9), and in women with no treatment supporter (aHR 1.8; 95% CI, 1.4 to 2.3). In women who returned to the clinic after ART initiation, no factor was significantly associated with LTFU. Conclusion: The factors associated with NFU (being young, not having a treatment supporter, and being diagnosed at hospitals) reflect a vulnerable and potentially highly mobile population. Additional interventions are needed to support and retain this group at ART initiation on Option B+.
Social Demography Study of Gonorrhea and Syphilis at RSUD dr. Soedono Madiun

An understanding of the socio-demographic characteristics is the first step to conduct preventive and promotive measures to reduce the number of sexually transmitted infections. This study described the socio-demographic cha-racteristics of gonorrhea and syphilis in dr. Soedono Hospital Madiun. A descripttive study with a quantitative approach used secondary data from outpatient medical records. This research was conducted in dr. Soedono Hospital Madiun, East Java. The samples used in this study were 61 patients who had been diagnosed with gonorrhea and syphilis in the period from July 2013 - June 2016. The data consisted of 50 (82%) medical records with the diagnosis of gonorrhea and 11 (18%) medical records with a diagnosis of syphilis. Characteristics of patients/respondents are the highest age group of 21-30 years, 22 female patients (36.1%), 55 male patients (90.2%), unmarried status 33 people (54.1%), work as private employees 37 people (60.7%), pay without insurance 48 people (78.7%), and live around Madiun 52 (86.0%). The socio-demographic factors were dominant in patients with gonorrhea and syphilis in dr. Soedono Hospital period of 2013-2016 was 21-30 years old, male, unmarried, living as private sector employees, pay without insurance, and Madiun origin.
Changes in Positive and Negative Affect During Pharmacological Treatment and Cognitive Therapy for Major Depressive Disorder: A Secondary Analysis of Two Randomized Controlled Trials

The cardinal symptoms of major depressive disorder (MDD) are heightened depressed mood (negative affectivity, or NA) and diminished interest or pleasure (positive affectivity, or PA). It is unknown how well treatments for MDD repair either symptom. Two secondary analyses of randomized controlled trials were therefore conducted. In Study 1, 180 adult outpatients with MDD received 16 weeks of antidepressant medication (ADM; n = 120) or cognitive therapy (CT; n = 60). In Study 2, adult outpatients with MDD were treated until remission with ADM (n = 225) or ADM and CT (n = 227). Across trials and treatments, intake disturbances were more marked in PA than NA, there was smaller repair of PA than NA during treatment, and disturbances remained more pronounced for PA than NA after treatment. Greater change in PA and NA were independently associated with depression symptom change. These findings suggest that depression treatments more effectively repair NA than PA and that outcomes may be improved with more effective targeting of the latter.
Investigating the rates and spatial distribution of childhood ambulatory sensitive hospitalisations in New Zealand

The GeoHealth Laboratory developed this report in collaboration with the Ministry of Health to help policymakers understand the distribution of childhood ambulatory sensitive hospitalisations (ASHs) within New Zealand. This report supports actions 6 and 8 of the New Zealand Health Strategy: ensuring the right services are delivered at the right location in an equitable, clinically and financially sustainable way, and increasing the effort on prevention, early intervention, rehabilitation and wellbeing. An additional long report provides technical details on methods and more detailed results is available from GeoHealthLab@canterbury.ac. nz.
Assessment of the need for separate test set and number of medical images necessary for deep learning: a sub-sampling study

Deep learning algorithms have tremendous potential utility in the classification of biomedical images. For example, images acquired with retinal optical coherence tomography (OCT) can be used to accurately classify patients with adult macular degeneration (AMD), and distinguish them from healthy control patients. However, previous research has suggested that large amounts of data are required in order to train deep learning algorithms, because of the large number of parameters that need to be fit. Here, we show that a moderate amount of data (data from approximately 1,800 patients) may be enough to reach close-to-maximal performance in the classification of AMD patients from OCT images. These results suggest that deep learning algorithms can be trained on moderate amounts of data, provided that images are relatively homogenous, and the effective number of parameters is sufficiently small. Furthermore, we demonstrate that in this application, cross-validation with a separate test set that is not used in any part of the training does not differ substantially from cross-validation with a validation data-set used to determine the optimal stopping point for training.
Eccentric Reaming for B2 Glenoids: History, Preoperative Planning, Surgical Technique, and Outcome

Background The biconcave (B2) glenoid is characterized by preservation of the anterior portion of the native glenoid with asymmetric wear of the posterior glenoid. Surgical options for glenoid correction have evolved. The goal of shoulder arthroplasty is to place the implants in such a manner to return the humeral head to a centered position and restore the joint line to a neutral position. There is no current consensus on method of treatment and correction. Methods The current and historical literature on total shoulder arthroplasty was used to examine technique viability. Results Asymmetric remaining can be used to address up to 15° of version correction without compromise of cortical bone. It is important to have the proper presurgical planning, to understand the limitations of correction, and to have other options available to treat the biconcave glenoid.
Vitamin D status in infancy: What is the solution?

Aim: Vitamin D deficiency and insufficiency are common public health problems throughout the world. Besides important multisystemic metabolic effects, vitamin D is necessary for a healthy skeletal system. Various reasons cause vitamin D deficiency in infancy, and supplementation is one of the treatment options. A nationwide supplementation program has been implemented in Turkey since 2005. In this study, we aimed to evaluate the efficacy of this program in our city. Methods: All infants aged between one and twelve months who were referred to the pediatric outpatient clinics of the hospital and tested for serum 25-(OH)-D levels between January 1, 2015 and December 31, 2016 were enrolled in the study. Patients with chronic illnesses were excluded. Data was obtained retrospectively from the hospital registry. In accordance with the criteria of American Academy of Pediatrics, patients were divided into three groups based on serum 25-(OH)-D levels as follows: 25-(OH)-D 20 ng/ml. Results: The study group consisted of 265 infants. The mean age of the group was 7.53 (2.75) months. Approximately 15% (n=39) of the study group had vitamin D deficiency, 10.5% (n=28) had insufficiency and Vitamin D levels of 74.4% (n=198) of the group were sufficient. Serum 25 (OH) D levels did not differ with gender, age or season (P=0.12, P=0.65 and P=0.09, respectively). Vitamin D levels were sufficient in 78.5% (n=150) of the urban area residents and 69.6% (n=32) of the rural area residents, between which there was no significant difference (P=0.32). Conclusion: Our results established that supplementation is one of the ways to avoid limitations affecting serum vitamin D levels. Supplementation with 400 IU/day Cholecalciferol is provided during the first year of life by the Turkish Ministry of Health, which we believe rendered gender, age, time of measurement and residential area insignificant in terms of 25(OH) D levels. This supplementation program may solve the problem of vitamin D insufficiency or deficiency among disadvantaged groups.
Approaches to the assessment of severe asthma: barriers and strategies

Abstract Asthma is a chronic condition with great variability. It is characterized by intermittent episodes of wheeze, cough, chest tightness, dyspnea and backed by variable airflow limitation, airway inflammation and airway hyper-responsiveness. Asthma severity varies uniquely between individuals and may change over time. Stratification of asthma severity is an integral part of asthma management linking appropriate treatment to establish asthma control. Precision assessment of severe asthma is crucial for monitoring the health of people with this disease. The literature suggests multiple factors that impede the assessment of severe asthma, these can be grouped into health care professional, patient and organizational related barriers. These barriers do not exist in isolation but interact and influence one another. Recognition of these barriers is necessary to promote precision in the assessment and management of severe asthma in the era of targeted therapy. In this review, we discuss the current knowledge of the barriers that impede assessment in severe asthma and recommend potential strategies for overcoming these barriers. We highlight the relevance of multidimensional assessment as an ideal approach to the assessment and management of severe asthma.
Contrast Induced Nephropathy after Radial or Femoral Access for Invasive Management of Acute Coronary Syndrome

Background: Percutaneous coronary intervention is now the best way of management of acute coronary syndrome (ACS). Contrast induced nephropathy is a serious complication and greatly dependent on several factors. It is still unclear whether the vascular access migrates CIN risk. Objective: To study the impact of Radial Access (RA) compared with Femoral Access (FA) on developing contrast-induced nephropathy (CIN) in patients undergoing invasive management of acute coronary syndrome (ACS). Methods: Sixty patients eligible for invasive management of ACS at cardiology department (Menoufia University hospital and National Heart Institute) were randomized into two groups. Group I: included 30 patients with femoral approach and Group II: included 30 patients with radial approach. The occurrence of CIN estimated by KDIGO definition (absolute increase in serum creatinine (SCr) by ≥0.5 mg/dl within 48 hours; or increase in SCr to ≥25% of baseline) was estimated in both groups. Results: Only 9 patients (15%) developed CIN, 5 patients (55.6%) of them underwent PCI through FA without statistically significant difference between the two approaches.Conclusion: CIN is considered a potential complication of percutaneous coronary intervention (PCI). Our study did not show the preference of using an approach over the other.
Effect of 5-Aza-2'-Deoxycytidine in Comparison to Valproic Acid and Trichostatin A on Histone Deacetylase 1, DNA Methyltransferase 1, and CIP/KIP Family (p21, p27, and p57) Genes Expression, Cell Growth Inhibition, and Apoptosis Induction in Colon Cancer SW480 Cell Line

Background: Cancer initiation and progression depends on genetic and epigenetic alterations such as DNA methylation and histone modifications. Hypermethylation and deacetylation of the CIP/KIP family (p21, p27, and p57) lead to tumorigenesis. Our previous study indicated that DNA methyltransferase (DNMT) inhibitor and histone deacetylase (HDAC) inhibitors can inhibit cell growth and induce apoptosis. The aim of the present study was to investigate the effect of 5-Aza-2'-deoxycytidine (5-Aza-CdR) in comparison to valproic acid (VPA) and trichostatin A (TSA) on HDAC1, DNMT1, and CIP/KIP family (p21, p27, and p57) genes expression, cell growth inhibition, and apoptosis induction in colon cancer SW480 cell line. Materials and Methods: The effect of the compounds on the cell viability was measured by MTT assay. The expression of HDAC1, DNMT1, and CIP/KIP family (p21, p27, and p57) genes was evaluated by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). For the detection of cell apoptosis, apoptotic cells were examined by the Annexin V-FITC/PI detection kit. Results: The results of MTT assay indicated that 5-Aza-CdR, VPA, and TSA significantly inhibited cell growth (P < 0.002, P < 0.001, and P < 0.001, respectively). The results of real-time RT-PCR demonstrated that all compounds significantly down-regulated DNMT1 and HDAC1, and up-regulated p21, p27, and p57 genes expression. The result of flow cytometry assay revealed that all agents induced apoptosis significantly. Conclusion: 5-Aza-CdR, VPA, and TSA can significantly downregulate DNMT1 and HDAC1 and up-regulate p21, p27, and p57 genes expression through which enhance cell apoptosis and cell growth inhibition in colon cancer.
Phylogeny of the Infraorder Caridea Based on Mitochondrial and Nuclear Genes (Crustacea: Decapoda)

Shrimps of the infraorder Caridea occur commonly throughout marine and freshwater habitats. Despite general knowledge of the group, phylogenetic relationships within the infraorder remain poorly known. The few studies that have focused specifically on the classification and evolutionary history within the Caridea have relied entirely on morphological characters and suggest conflicting phylogenetic relationships. Robust molecular analysis is required to test current hypotheses. We present the first comprehensive molecular phylogeny of the group, combining nuclear and mitochondrial gene sequences, to evaluate the relationships among 14 superfamilies and 30 families. Bayesian and likelihood analyses were conducted on a concatenated 18S/16S alignment composed of 1835 basepairs. Results indicated no evidence contrary to hypotheses of monophyly within the families Alpheidae, Processidae, and Alvinocarididae. Ogyrididae is resolved as a sister clade to the Alpheidae, as has been previously suggested. Our findings raise questions as to the systematic placement of the Procarididae within Caridea and suggest polyphyletic and paraphyletic relationships among genera within the families Atyidae, Pasiphaeidae, Oplophoridae, Hippolytidae, Gnathophyllidae, and Palaemonidae, as currently defined. Our results in some cases confirm and in others reject placements of controversial taxa within higher-level phylogeny and provide new insights for classifications within the Caridea.
Are Cord Blood Bilirubin Values Trustable to Predict the Forthcoming Significant Hyperbilirubinemia Requiring Treatment in Healthy Term Newborns?

Background: Jaundice is a clinical condition that is often observed in pediatric practice and constitutes one of the major issues withintheneonatalperiod. Asseverejaundicecausesneurotoxicity(kernicterus),thediagnosisandtreatmentofseverehyperbiliru-binemia is very important. Early prediction will help in early discharge and will prevent hospitalization of babies and mothers. On the other hand, predicting outcome in high risk neonates for subsequent hyperbilirubinemia is required. Objectives: This study investigates the predictive value of umbilical cord serum bilirubin (UCSB) for subsequent hyperbilirubinemia which is a required treatment in healthy term newborns. Methods: In this prospective study, 238 healthy term newborns were inducted into the study. Soon after delivery, the cord blood wassentforserumbilirubinanalysis. NewbornswerefollowedupbyTCB(transcutaneousbilirubinometry)untilthethirddaypost birth and those who showed signiﬁcantly high TCB values, according to the hour-speciﬁc normogram, received the appropriate interventionandtreatment. Thedatawereanalyzedusing t -Test,ROC(receiveroperatingcharacteristic)curve,andchi-squaretests. Results: Of 238 newborns, 27 (11.4%) cases developed hyperbilirubinemia (bilirubin ≥ 15 mg/dL), which required phototherapy. Therewerenosigniﬁcantdiﬀerencesbetweenthecaseswhodidandwhodidnotdevelophyperbilirubinemia(bilirubin< 15mg/dL) with respect to various factors that might be associated with the risk of hyperbilirubinemia such as mode of delivery and gender. However, two groups were signiﬁcantly diﬀerent in terms of cord bilirubin levels. ROC (receiver operating characteristic) analysis showedthatthecriticalvalueof umbilicalcordserumbilirubin(UCSB) ≥ 2.25mg/dlhadhighsensitivity(92.6%),goodpositiveand negative predictive value (66% and 69% respectively). Conclusions: UCSB level ≥ 2.25 mg/dL can be a useful predictor of hyperbilirubinemia in healthy term newborns on the third day. Therefore, infants with UCSB level ≥ 2.25 mg/dL should be followed up strictly either in a hospital or in an outpatient department on the third day, whereas neonates with cord bilirubin level < 2.25 mg/dL are probably safe for early discharge.
Assessment of pharmacists’ knowledge, attitude and practice in chain community pharmacies towards their current function and performance in Indonesia

Background: The introduction of universal healthcare coverage in 2014 has affected the practice of community pharmacies in Indonesia. Studies regarding the practice of pharmacist in the chain community pharmacy setting in Indonesia are very limited. The chain community pharmacies in Indonesia are operated and controlled by the same management. The chain community pharmacies usually show better services compared to independent community pharmacies in Indonesia. Objective: The study aimed to assess the knowledge, attitude and practice (KAP) of pharmacist working in chain community pharmacy towards their current function and performance in delivering pharmacy services Methods: A cross-sectional study using questionnaires was conducted between January and March 2017 in KF, one of the largest chain community pharmacies in Indonesia. The total sampling method was used in the recruitment process. The data were analyzed using descriptive statistics, independent t-Test and one-way ANOVA. The KAP scores were assessed and categorized as “poor”, “moderate” and “good” based on the standardized scoring system. Results: A total of 949 KF’s pharmacists (100% response rate) were participated in the study. The majority of pharmacists showed a good score in terms of knowledge and attitude, which is in contrast to practice as majority only obtained a moderate score. Working experience, age and the availability of standard operating procedures (SOP) for both dispensing and self-medication services were found to be statistically significant (p<0.005) aspects to KAP of pharmacists in delivering pharmacy services. Conclusions: This study identified several important aspects that could affect the KAP of pharmacists working in chain community pharmacies in Indonesia. Specific policies should be conceived to improve the competencies of pharmacist and to ensure the compliance with the SOP and standardization system within pharmacy sector.