Miracle-dz/UniFAR-FTUs huggingface dataset:
Cumulative trauma and partner conflict predict post‐traumatic stress disorder in postpartum African‐American women

AIM AND OBJECTIVE To describe relationships between cumulative trauma, partner conflict and post-traumatic stress in African-American postpartum women. BACKGROUND Cumulative trauma exposure estimates for women in the USA range from 51-69%. During pregnancy, most trauma research has focused on physical injury to the mother. Post-traumatic stress disorder (PTSD) is associated with trauma and more prevalent in African-American women than women of other groups. Knowledge about both the rate and impact of cumulative trauma on pregnancy may contribute to our understanding of women seeking prenatal care, and disparities in infant morbidity and mortality. DESIGN This retrospective, correlational, cross-sectional study took place on postpartum units of two Detroit hospitals. Participants were 150 African-American women aged between 18-45 who had given birth. METHODS Mothers completed the Cumulative Trauma Scale, Conflict Tactics Scale, Clinician Administered Post-traumatic Stress Scale, Edinburgh Postnatal Depression Scale and a Demographic Data form. Descriptive statistics, correlations and multiple regressions were used for data analysis. RESULTS All participants reported at least one traumatic event in their lifetime. Cumulative trauma and partner conflict predicted PTSD, with the trauma of a life-threatening event for a loved one reported by 60% of the sample. Nearly, one-fourth of the women screened were at risk for PTSD. Increased cumulative trauma, increased partner conflict and lower level of education were related to higher rates of PTSD symptoms. CONCLUSION Both cumulative trauma and partner conflict in the past year predict PTSD. Reasoning was used most often for partner conflict resolution. RELEVANCE TO CLINICAL PRACTICE The results of this study offer additional knowledge regarding relationships between cumulative trauma, partner conflict and PTSD in African-American women. Healthcare providers need to be sensitive to patient life-threatening events, personal failures, abuse and other types of trauma. Current evidence supports the need to assess for post-traumatic stress symptoms during pregnancy.
Fused monochromatic imaging acquired by single source dual energy CT in hepatocellular carcinoma during arterial phase: an initial experience.

OBJECTIVE To explore whether single and fused monochromatic images can improve liver tumor detection and delineation by single source dual energy CT (ssDECT) in patients with hepatocellular carcinoma (HCC) during arterial phase. METHODS Fifty-seven patients with HCC who underwent ssDECT scanning at Beijing Cancer Hospital were enrolled retrospectively. Twenty-one sets of monochromatic images from 40 to 140 keV were reconstructed at 5 keV intervals in arterial phase. The optimal contrast-noise ratio (CNR) monochromatic images of the liver tumor and the lowest-noise monochromatic images were selected for image fusion. We evaluated the image quality of the optimal-CNR monochromatic images, the lowest-noise monochromatic images and the fused monochromatic images, respectively. The evaluation indicators included the spatial resolution of the anatomical structure, the noise level, the contrast and CNR of the tumor. RESULTS In arterial phase, the anatomical structure of the liver can be displayed most clearly in the 65-keV monochromatic images, with the lowest image noise. The optimal-CNR monochromatic images of HCC tumor were 50-keV monochromatic images in which the internal structural features of the liver tumors were displayed most clearly and meticulously. For tumor detection, the fused monochromatic images and the 50-keV monochromatic images had similar performances, and were more sensitive than 65-keV monochromatic images. CONCLUSIONS We achieved good arterial phase images by fusing the optimal-CNR monochromatic images of the HCC tumor and the lowest-noise monochromatic images. The fused images displayed liver tumors and anatomical structures more clearly, which is potentially helpful for identifying more and smaller HCC tumors.
Enhancing Sustainable Production and Genetic Resource Conservation of Bambara Groundnut: A Survey of Indigenous Agricultural Knowledge Systems

Bambara groundnut (Vigna subterranea) is so important in most of Africa, and potentially so in other tropical regions, that improvement of its production — especially on a commercial scale — and of its germplasm both deserve renewed and intensive scientific study. Yet, compared with other legumes (such as groundnuts, beans and cowpeas), bambara groundnut has received almost no research or extension attention, although in Ghana and other parts of Africa, it has a higher market value (on a per unit weight basis) than these other legumes. Improving indigenous farm management systems and methods that have resulted from age-old experience and tradition will be difficult for local farmers if they are completely entrenched in their habits. Thus, a survey was conducted to identify and document the traditional farm management practices and key considerations used in bambara groundnut production, along with indigenous knowledge systems linked to the conservation of bambara groundnut germplasm. The study was conducted in the Upper West region of Ghana, which is an area with considerable bambara groundnut genetic diversity. Valuable information on its production and genetic resources exists within the indigenous knowledge systems studied, and ranges from economic and agronomic criteria for peasant farmer selection of particular varieties and traditional uses of the crop, to strategies for the management and conservation of locally adapted varieties, pest and disease management, and environmental and ecological monitoring systems. Research and extension requirements for improving crop production were identified. In addition, germplasm was collected and characterized for conservation.
Macroeconomic policy for employment creation in Egypt: past experience and future prospects

This paper by Tariq Haq and Chahir Zaki seeks to shed light on the nexus between macroeconomic policies and employment in Egypt through three approaches. First, it provides a detailed analysis of each macroeconomic policy area in Egypt and reflects on its relationship with employment creation. Second, an empirical approach is used to provide evidence of the impact of each macroeconomic policy on employment. Finally, on the basis of these analyses, the paper offers a range of pertinent policy recommendations in order to improve employment and labour market conditions in Egypt during its transition.
Disentangling the effects of race and SES on arthritis-related symptoms, coping, and well-being in African American and White women

This study examined both unique and interactive effects of race and socioeconomic status (SES) on arthritis-related symptoms, coping, and well-being in African American and White women. Participants included 77 African American and 98 White women, aged 45 to 90, who completed structured, face-to-face interviews. A series of 2 × 2 MANCOVAs examined race (African American, White) and SES (high/low education or high/low occupational status) differences in arthritis-related symptoms, coping, and well-being. African Americans used more religious coping, wishful-thinking, seeking social support, and emotional expression than Whites. Individuals with low SES reported worse arthritis-related symptoms, poorer well-being, and greater use of coping strategies that tend to be maladaptive. Race × SES interactions revealed higher depressive symptoms in African Americans with low versus high education and coping differences in African Americans with low versus high occupational status; however differences in depressive symptoms and coping based on SES were not evident for Whites. Results demonstrate unique and interactive race and SES differences for arthritis-related symptoms, coping, and well-being showing the complexity of race and SES in the realm of physical and mental health.
A 1H magnetic resonance spectroscopy study in patients with obstructive sleep apnea

Background and purpose: Repeated episodes of hypoxia, hypercapnia and transient blood pressure elevation in obstructive sleep apnea syndrome (OSAS) may damage neutral structures and induce cerebral metabolic impairment. This study aimed to determine the impact of OSAS on cerebral metabolites measured by 1H magnetic resonance spectroscopy (1H ‐MRS).
The association between skin blood flow and edema on epidermal thickness in the diabetic foot.

BACKGROUND Skin blood flow plays an important role in maintaining the health of the skin. The development of interstitial edema may impede oxygen diffusion to the skin. The aim of this study was to evaluate the association of skin blood flow and edema and epidermal thickness in the feet of people with and without diabetic neuropathy compared with a healthy control group. SUBJECTS AND METHODS Eighty-seven subjects (19 people with diabetic neuropathy and foot ulceration, 35 people with diabetes but without neuropathy, and 33 healthy controls without diabetes) participated in the study. High-frequency ultrasonography was used to measure the epidermal thickness and edema in papillary skin at the big toe as reflected by the thickness of the subepidermal low echogenic band (SLEB). The capillary nutritive blood flow was measured by the use of video capillaroscopy, and skin blood flux was monitored by laser Doppler flowmetry. RESULTS There was a 7.2% increase in epidermal thickness in those with diabetes but without neuropathy and a 16.5% decrease in people with diabetic neuropathy and foot ulceration compared with the healthy controls (all P<0.05). The SLEB thickness increased in all subjects with diabetes to a greater degree in those with neuropathy and ulceration than in those without (64.7% vs. 11.8%, P<0.001). Skin blood flux was shown to be higher in the diabetes groups than in the controls (all P<0.05), but no significant differences were found in the resting nutritive capillary blood flow (P>0.05). A significant negative correlation (P=0.002, r=-0.366) was demonstrated between the SLEB and epidermal thickness at the pulp of the big toe, whereas no significant correlation was demonstrated between skin blood flow and epidermal thickness (all P>0.05). CONCLUSIONS An increase in subepidermal edema was demonstrated in people with diabetic neuropathy and ulceration, which may partly contribute to reduced epidermal thickness at the pulp of the big toe. This may subsequently lead to the breaking down of skin in the diabetic foot.
Search Frictions, Credit Market Liquidity and Net Interest Margin Cyclicality

This paper contributes to the body of knowledge on search frictions in credit markets by demonstrating their ability to explain why the net interest margins of banks behave countercyclically. During periods of expansion, a fall in the net interest margin proceeds from two mechanisms: (i) lenders accept that they must finance entrepreneurs who have lower productivity; (ii) the liquidity of the credit market rises, which simplifies access to loans for entrepreneurs and thereby reinforces their threat point when bargaining the interest rate of the loan.
Complications of Laser Surgery for Recurrent Respiratory Papillomatosis

During an 8-year period, 66 patients with recurrent respiratory papillomatosis underwent 890 laser microlaryngoscopy procedures. A retrospective analysis of immediate and delayed complications occurring with laser microlaryngoscopy in the treatment of these patients revealed that complications secondary to anesthetic technique and laser methodology were remarkably low (0.3%). Delayed complications of tissue injury (36% of pediatric patients and 17% of adult patients) were more frequent and included anterior glottic webbing, interarytenoid scarring and arytenoid fixation, vocal fold fibrosis, and generalized endolaryngeal glottic stenosis. All patients were evaluated by direct visualization and recording at the time of the operative procedure, as well as by review of intraoperative photographs. A smaller group of patients underwent analysis of voice recordings and laryngeal stroboscopy. The frequency and severity of tissue injury was higher in the patients with more severe disease who underwent multiple operative procedures.
Complete Development of the Northeast Pacific Arminacean Nudibranch Janolus fuscus

Early life-history stages of the nudibranch Janolus fuscus (superfamily Arminoidea) were reared in the laboratory and collected from the field to document embryology, larval morphology, and pre-and post-metamorphic growth. This species produces Type B egg masses containing an average of 23,063 viable embryos. The spiral holoblastic cleavage pattern resembled that of other nudibranchs, with early cell divisions occurring roughly at 4-h intervals at 11–13 °C. Embryos progress through a gastrula stage with cellular extensions covering the blastopore and a trochophore-like stage before hatching as veliger larvae after 10–18 days. Veligers ranged in size from 125–153.8 μm at hatching, with size being positively correlated with the duration of encapsulated development. After a 36–41-day larval period, some veligers ceased growing at 266 μm and showed signs of approaching competence. Four larvae settled and two metamorphosed into 280-μm juveniles on the bryozoan prey of the adults, Bugula pacifica, 46 and 54 days post-hatching. Average growth of pre-ovipositional (<19 mm) J. fuscus was more rapid (8.79% per day) than growth of ovipositional individuals (3.52% per day). Growth continued to a maximum of 57 mm in the laboratory, with an estimated total lifespan of about 5 months. These data, which agree with concurrent field observations, suggest a subannual life cycle.
Successful Treatment of Total Hip and Knee Infection with Articulating Antibiotic Components: A Modified Treatment Method

There are many problems associated with the use of articulating antibiotic cement spacer blocks and articulating components in the two-stage treatment of total hip replacement and total knee replacement infections. These include loss of motion during and after treatment, bone loss, generation of cement debris, inadequate dosing of cement with the appropriate antibiotic, and biologic failure. Forty-four patients with 54 consecutive periprosthetic hip and knee infections (31 septic total knee arthroplasties and 23 septic total hip arthroplasties) had treatment with a modified two-stage reimplantation protocol using articulating components made of antibiotic–cement-only prosthetic components and antibiotic–cement-covered prosthetic components between January 1995 and May 2002. Second-stage revision, after six weeks of parenteral antibiotics, was completed an average of 84 days after the first stage. A minimum two-year followup after final treatment is evaluated. One of the 23 total hip replacement infections persisted or recurred with the original organism(s) after treatment (95.7% success) as did two of the 31 total knee replacement infections (93.5% success). Combined success rate was 94.4%. This modified treatment method incorporates early range of motion during first-stage treatment with articulating components that provide local high-dose elution of broad-spectrum antibiotics, provides the flexibility of customizing the antibiotic cement components with culture-directed antibiotics, and results in a high biologic success rate.
Allele‐specific siRNA knockdown as a personalized treatment strategy for vascular Ehlers‐Danlos syndrome in human fibroblasts

The vascular type of the Ehlers‐Danlos syndrome (vEDS) is caused by dominant‐negative mutations in the procollagen type III (COL3A1) gene. Patients with this autosomal dominant disorder have a shortened life expectancy due to complications from ruptured vessels or hollow organs. We tested the effectiveness of allele‐specific RNA interference (RNAi) to reduce the mutated phenotype in fibroblasts. Small‐interfering RNAs (siRNAs) discriminating between wild‐type and mutant COL3A1 allele were identified by a luciferase reporter gene assay and in primary fibroblasts from a normal donor and a patient with vEDS. The best discriminative siRNA with the mutation at position 10 resulted in >90% silencing of the mutant allele without affecting the wild‐type allele. Transmission and immunogold electron microscopy of extracted extracellular matrices from untreated fibroblasts of the patient with vEDS revealed structurally abnormal fibrils. After siRNA treatment, collagen fibrils became similar to fibrils from fibroblasts of normal and COL3A1 haploinsufficient donors. In addition, it was shown that expression of mutated COL3A1 activates the unfolded protein response and that reduction of the amount of mutated protein by siRNA reduces cellular stress. Taken together, the results provide evidence that allele‐specific siRNAs are able to reduce negative effects of mutated COL3A1 proteins. Thus, the application of allele‐specific RNAi may be a promising direction for future personalized therapies to reduce the severity of vEDS. —Müller, G. A. , Hansen, U. , Xu, Z. , Griswold, B. , Talan, M. I. , McDonnell, N. B. , Briest, W. Allele‐specific siRNA knockdown as a personalized treatment strategy for vascular Ehlers‐Danlos syndrome in human fibroblasts. FASEB J. 26, 668–677 (2012). www.fasebj. org
Hyperventilation in Pediatric Resuscitation: Performance in Simulated Pediatric Medical Emergencies

OBJECTIVE: To examine the hypothesis that pediatric resuscitation providers hyperventilate patients via bag-valve-mask (BVM) ventilation during performance of cardiopulmonary resuscitation (CPR), quantify the degree of excessive ventilation provided, and determine if this tendency varies according to provider type. METHODS: A retrospective, observational study was conducted of 72 unannounced, monthly simulated pediatric medical emergencies (“mock codes”) in a tertiary care, academic pediatric hospital. Responders were code team members, including pediatric residents and interns (MDs), respiratory therapists (RTs), and nurses (RNs). All sessions were video-recorded and reviewed for the rate of BVM ventilation, rate of chest compressions, and the team members performing these tasks. The type of emergency, location of the code, and training level of the team leader were also recorded. RESULTS: Hyperventilation was present in every mock code reviewed. The mean rate of BVM ventilation for all providers in all scenarios was 40.6 ± 11.8 breaths per minute (BPM). The mean ventilation rates for RNs, RTs, and MDs were 40.8 ± 14.7, 39.9 ± 11.7, and 40.5 ± 10.3 BPM, respectively, and did not differ among providers (P = .94). All rates were significantly higher than the recommended rate of 8 to 20 BPM (per Pediatric Advanced Life Support guidelines, varies with patient age) (P < .001). The mean ventilation rate in cases of isolated respiratory arrest was 44.0 ± 13.9 BPM and was not different from the mean BVM ventilation rate in cases of cardiopulmonary arrest (38.9 ± 14.4 BPM; P = .689). CONCLUSIONS: Hyperventilation occurred in simulated pediatric resuscitation and did not vary according to provider type. Future educational interventions should focus on avoidance of excessive ventilation.
Angiopoietin‐1 negatively regulates expression and activity of tissue factor in endothelial cells

Normally, tissue factor (TF) is not expressed on the surface of endothelial cells, but its expression can be induced by vascular endothelial growth factor (VEGF) and tumor necrosis factor (TNF)‐α. However, the signaling pathway(s) affecting this induction is unknown. Using human umbilical vein endothelial cells, we found that inhibitors of guanine‐cytosine‐rich DNA binding protein and nuclear factor (NF)‐κB suppressed VEGF‐ and TNF‐α‐induced expression and activity of TF. However, unexpectedly, phosphatidylinositol (PI) 3′‐kinase inhibitor enhanced the VEGF‐ and TNF‐α‐induced expression and activity of TF. Angiopoietin‐1 (Ang1), a strong activator of intracellular PI 3′‐kinase/Akt, inhibited the induction of TF by VEGF and TNF‐α, whereas Ang1 itself did not produce any significant effect on TF. Selective activation (or inactivation) of PI 3′‐kinase/Akt by using adenoviral transfer reduced (or enhanced) TNF‐α‐induced expression of TF mRNA and protein, regardless of Ang1 treatment. From these results, we conclude that Ang1 inhibits the up‐regulation of TF expression, possibly through activation of PI 3′‐kinase/Akt in endothelial cells. Ang1 may be useful as an inhibitor of VEGF‐ and TNF‐α‐induced coagulation, inflammation, and cancer progression.
The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States

Objective:We sought to project the lifetime cost of medical care for human immunodefiency virus (HIV)-infected adults using current antiretroviral therapy (ART) standards. Methods:Medical visits and hospitalizations for any reason were from the HIV Research Network, a consortium of high-volume HIV primary care sites. HIV treatment drug regimen efficacies were from clinical guidelines and published sources; data on other drugs used were not available. In a computer simulation model, we projected HIV medical care costs in 2004 U.S. dollars. Results:From the time of entering HIV care, per person projected life expectancy is 24.2 years, discounted lifetime cost is $385,200, and undiscounted cost is $618,900 for adults who initiate ART with CD4 cell count <350/&mgr;L. Seventy-three percent of the cost is antiretroviral medications, 13% inpatient care, 9% outpatient care, and 5% other HIV-related medications and laboratory costs. For patients who initiate ART with CD4 cell count <200/&mgr;L, projected life expectancy is 22.5 years, discounted lifetime cost is $354,100 and undiscounted cost is $567,000. Results are sensitive to drug manufacturers’ discounts, ART efficacy, and use of enfuvirtide for salvage. If costs are discounted to the time of infection, the discounted lifetime cost is $303,100. Conclusions:Effective ART regimens have substantially improved survival and have increased the lifetime cost of HIV-related medical care in the U.S.
Effectiveness of physiotherapy for lateral epicondylitis: a systematic review

AIM: To evaluate the available evidence of the effectiveness of physiotherapy for lateral epicondylitis of the elbow. METHOD: Randomised controlled trials (RCTs) identified by a highly sensitive search strategy in six databases in combination with reference checking. Two independent reviewers selected RCTs that included a physiotherapy intervention, patients with lateral epicondylitis, and at least one clinically relevant outcome measure. No language restrictions were made. Methodological quality was independently assessed by two blinded reviewers. A best evidence synthesis, including a quantitative and qualitative analysis, was conducted, weighting the studies with respect to their internal validity, statistical significance, clinical relevance, and statistical power. RESULTS: 23 RCTs were included in the review, evaluating the effects of lasertherapy, ultrasound treatment, electrotherapy, and exercises and mobilisation techniques. Fourteen studies satisfied at least 50% of the internal validity criteria. Except for ultrasound, pooling of data from RCTs was not possible because of insufficient data, or clinical or statistical heterogeneity. The pooled estimate of the treatment effects of two studies on ultrasound compared to placebo ultrasound, showed statistically significant and clinically relevant differences in favour of ultrasound. There is insufficient evidence either to demonstrate benefit or lack of effect of lasertherapy, electrotherapy, exercises and mobilisation techniques for lateral epicondylitis. CONCLUSIONS: Despite the large number of studies, there is still insufficient evidence for most physiotherapy interventions for lateral epicondylitis due to contradicting results, insufficient power, and the low number of studies per intervention. Only for ultrasound, weak evidence for efficacy was found. More better designed, conducted and reported RCTs are needed.