Miracle-dz/UniFAR-FTUs huggingface dataset:
Pleural fluid analysis and radiographic, sonographic, and echocardiographic characteristics of hepatic hydrothorax.

BACKGROUND There are limited published data defining complete pleural fluid analysis, echocardiographic characteristics, or the presence or absence of ascites on sonographic or CT imaging in patients with hepatic hydrothorax. METHODS We reviewed pleural fluid analysis and radiographic, sonographic, and echocardiographic findings in 41 consecutive patients with hepatic hydrothorax referred to the Pleural Procedure Service for thoracentesis. RESULTS Ascites was detected on sonographic or CT imaging in 38 of 39 patients (97%). Diastolic dysfunction was found in 11 of 21 patients (52%). Contrast echocardiography with agitated saline demonstrated an intrapulmonary shunt in 18 of 23 cases (78%). Solitary hepatic hydrothorax had a median pleural fluid pH of 7.49 (fifth to 95th percentile, 7.40-7.57), total protein level of 1.5 g/dL (0.58-2.34), and lactate dehydrogenase (LDH) level of 65 IU/L (36-138). The median pleural fluid/serum protein ratio and pleural LDH/upper limit of normal serum LDH ratio were 0.25 (0.10-0.43) and 0.27 (0.14-0.57), respectively. The median absolute neutrophil count (ANC) was 26 cells/μL (1-230). Only a single patient had a protein discordant exudate despite 83% of patients receiving diuretics. When comparing solitary hepatic hydrothorax and spontaneous bacterial pleuritis, there was no statistically significant difference among pleural fluid total protein (P = .99), LDH (P = .33), and serum albumin (P = .47). ANC was higher in patients with spontaneous bacterial pleuritis (P < .0001). CONCLUSIONS Hepatic hydrothorax virtually always presents with ascites that is detectable on sonographic or CT imaging. The development of an "exudate" from diuretic therapy is a rare phenomenon in hepatic hydrothorax. In contrast, diastolic dysfunction and intrapulmonary shunting are common in patients with hepatic hydrothorax. There was no statistically significant change in pleural fluid parameters with spontaneous bacterial pleuritis, except an increased ANC.
Hormone Therapy and the Progression of Coronary-Artery Atherosclerosis in Postmenopausal Women

Background In postmenopausal women with coronary artery disease, conjugated equine estrogen with or without continuous administration of medroxyprogesterone acetate has failed to slow the progression of atherosclerosis. Whether 17β-estradiol (the endogenous estrogen molecule) alone or administered sequentially with medroxyprogesterone acetate can slow the progression of atherosclerosis is unknown. Methods We conducted a double-blind, placebo-controlled trial in 226 postmenopausal women (mean age, 63.5 years) who had at least one coronary-artery lesion. Participants were randomly assigned to usual care (control group), estrogen therapy with micronized 17β-estradiol alone (estrogen group), or 17β-estradiol plus sequentially administered medroxyprogesterone acetate (estrogen–progestin group). In all patients the low-density lipoprotein (LDL) cholesterol level was reduced to a target of less than 130 mg per deciliter. The primary outcome was the average per-participant change between base-line and follow-up c.
Comparison of directly measured arterial blood pressure at various anatomic locations in anesthetized dogs.

OBJECTIVE To determine whether directly measured arterial blood pressure differs among anatomic locations and whether arterial blood pressure is influenced by body position. ANIMALS 33 client-owned dogs undergoing anesthesia. PROCEDURES Dogs undergoing anesthetic procedures had 20-gauge catheters placed in both the superficial palmar arch and the contralateral dorsal pedal artery (group 1 [n = 20]) or the superficial palmar arch and median sacral artery (group 2 [13]). Dogs were positioned in dorsal recumbency, and mean arterial blood pressure (MAP), systolic arterial blood pressure (SAP), and diastolic arterial blood pressure (DAP) were recorded for both arteries 4 times (2-minute interval between successive measurements). Dogs were positioned in right lateral recumbency, and blood pressure measurements were repeated. RESULTS Differences were detected between pressures measured at the 2 arterial sites in both groups. This was especially true for SAP measurements in group 1, in which hind limb measurements were a mean of 16.12 mm Hg higher than carpus measurements when dogs were in dorsal recumbency and 14.70 mm Hg higher than carpus measurements when dogs were in lateral recumbency. Also, there was significant dispersion about the mean for all SAP, DAP, and MAP measurements. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that arterial blood pressures may be dependent on anatomic location and body position. Because this may affect outcomes of studies conducted to validate indirect blood pressure measurement systems, care must be used when developing future studies or interpreting previous results.
Efficacy of methylprednisolone in preventing lung injury following pulmonary thromboendarterectomy.

BACKGROUND We sought to determine the efficacy and safety of perioperative treatment with methylprednisolone on the development of lung injury after pulmonary thromboendarterectomy. METHODS This was a randomized, prospective, double-blind, placebo-controlled study of 98 adult patients with chronic thromboembolic pulmonary hypertension who were undergoing pulmonary thromboendarterectomy at a single institution. The patients received either placebo (n = 47) or methylprednisolone (n = 51) (30 mg/kg in the cardiopulmonary bypass prime, 500 mg IV bolus following the final circulatory arrest, and 250 mg IV bolus 36 h after surgery). The primary end point was the presence of lung injury as determined by two independent, blinded physicians using prospectively defined criteria. The secondary end points included ventilator-free, ICU-free, and hospital-free days and selected levels of cytokines in the blood and in BAL fluid. RESULTS The incidence of lung injury was similar in both treatment groups (45% placebo, 41% steroid; P = .72). There were no statistical differences in the secondary clinical end points between treatment groups. Treatment with methylprednisolone, compared with placebo, was associated with a statistically significant reduction in plasma IL-6 and IL-8, a significant increase in plasma IL-10, and a significant reduction in postoperative IL-1ra and IL-6, but not IL-8 in BAL fluid obtained 1 day after surgery. CONCLUSIONS Perioperative methylprednisolone does not reduce the incidence of lung injury following pulmonary thromboendarterectomy surgery despite having an antiinflammatory effect on plasma and lavage cytokine levels.
Optimal cutoff points of entropy indices for use in predicting responses elicited during determination of minimum alveolar concentration of sevoflurane in dogs.

OBJECTIVE To investigate values of spectral indices for use in predicting responses in dogs during determination of minimum alveolar concentration (MAC) of sevoflurane. ANIMALS 15 healthy German Shepherd Dogs. PROCEDURES :Sevoflurane MAC was determined by use of tail clamping. Entropy indices consisting of response entropy and state entropy were recorded during MAC determination. Optimal cutoff points of response entropy and state entropy for use in predicting responses to tail clamping were analyzed with multiple logistic regression. RESULTS Sevoflurane MAC ranged from 1.8% to 2.6% (mean ± SD, 2.2 ± 0.3%). Response entropy and state entropy were significantly higher during positive responses to tail clamping (88 ± 2 and 76 ± 2, respectively) than during negative responses to tail clamping (63 ± 3 and 52 ± 3, respectively). The difference between the 2 entropy indices did not differ between positive (11 ± 1) and negative (13 ± 1) responses to tail clamping. Response entropy and state entropy served as independent predictors of a positive response, with areas under the curve for receiver operating characteristic curves 0.810 (95% confidence interval, 0.716 to 0.903) and 0.828 (95% confidence interval, 0.741 to 0.916), respectively. Optimal cutoff points to predict a positive response were 75 for response entropy and 65 for state entropy, which corresponded to mean ± SD ORs of 25.2 ± 15.6 and 14.9 ± 7.9, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Response entropy and state entropy were good predictors of responses to tail clamping elicited during determination of sevoflurane MAC in healthy dogs.
An Epidemiology of Big Data

Federal legislation designed to transform the U.S. healthcare system and the emergence of mobile technology are among the common drivers that have contributed to a data explosion, with industry analysts and stakeholders proclaiming this decade the big data decade in healthcare (Horowitz, 2012). But a precise definition of big data is hazy (Dumbill, 2013). Instead, the healthcare industry mainly relies on metaphors, buzzwords, and slogans that fail to provide information about big data’s content, value, or purposes for existence (Burns, 2011). Bollier and Firestone (2010) even suggests “big data does not really exist in healthcare” (p. 29). While federal policymakers and other healthcare stakeholders struggle with the adoption of Meaningful Use Standards, International Classification of Diseases-10 (ICD-10), and electronic health record interoperability standards, big data in healthcare remains a widely misunderstood phenomenon. Borgman (2012) found by “studying how data are created, handled, and managed in multidisciplinary collaborations, we can inform science policy and practice” (p. 12). Through the narratives of nine leaders representing three key stakeholder classes in the healthcare ecosystem: government, providers and consumers, this phenomenological research study explored a fundamental question: Within and across the narratives of three key healthcare stakeholder classes, what are the important categories of meaning or current themes about big data in healthcare? This research is significant because it: (1) produces new thematic insights about the meaning of big data in healthcare through narrative inquiry; (2) offers an agile framework of big data that can be deployed across all industries; and, (3) makes a unique contribution to scholarly qualitative literature about the phenomena of big data in healthcare for future research on topics including the diffusion and spread of health information across networks, mixed methods studies about big data, standards development, and health policy. AN EPIDEMIOLOGY OF BIG DATA
Agreement between self-report and archival public service utilization data among chronically homeless individuals with severe alcohol problems

Public service utilization data are often used as key outcomes in studies on homelessness. Although self-report data on these outcomes are accessible and cost-effective, various factors may affect retrospective recall in homeless populations. It is therefore necessary to establish validity of self-report to ensure the integrity of studies involving such populations. Participants (N=134) were chronically homeless individuals with severe alcohol problems who participated in a housing first effectiveness trial (Larimer et al., 2009). The authors compared 30-day and 3-year retrospective self-report data on sobering center, jail, and hospital use with archival records corresponding to the same timeframes. Analyses indicated good category-specific agreement for 30-day self-report and archival data on sobering center (82%; κ=.58) and jail use (89%; κ=.60). Hospital use, however, was self-reported significantly more frequently than indicated by archival data (78%; κ=.30). Three-year data showed inadequate agreement across all three variables. © 2011 Wiley Periodicals, Inc.
Serum anti-HBs-Ag in stable hemodialysis patients and its relationship with various demographic and biochemical data.

Introduction: To evaluate the relationship between various biochemical, nutritional and demographic factors with immune response to hepatitis B vaccine in maintenance hemodialysis (HD) patients. Material and Methods: A retro-prospective study was carried out on 68 patients undergoing maintenance hemodialysis. Patients were vaccinated against hepatitis B virus with an intramuscular hepatitis B vaccination schedule, 40 micrograms at 0, 1, and 6 months. We also selected 32 age matched normal healthy persons who had vaccinated against hepatitis B previously to compare the antibody production with HD patients. Results: The value of serum antibody level against hepatitis B surface antigen ( HBs) in hemodialisis patients and healthy persons were 35±55(median=5.5) and 135±71 (median=175) mIU/ml respectively. There was a significant deference between mean serum antibody level against HBs antigen of hemodialysis patients and normal subjects (p<0.001), there were not any significant differences of antibody production against HBs antigen between males and females or diabetic and non diabetics. There were no correlation between serum antibody level against HBs-Ag and serum albumin and also with body mass index. There were not significant correlation between anti-HBs antibody level and age, amounts of hemodialysis, duration of dialysis, dialysis adequacy, serum ferritin level and serum lipids. There were not also significant correlation between anti-HBs antibody level and serum parathormone, calcium, phosphorus, serum hemoglobin and hematocrit level. Conclusion: In this study, there was not significant correlation between serum antibody level against hepatitis B surface antigen and various nutritional and demographic factors of patients under regular hemodialysis.
Tracking Benefits of Janani Suraksha Yojana—A Maternal Cash Transfer Scheme: Evidence from Rajasthan, India

Janani Suraksha Yojana (JSY) is more often than not recognized only as a cash transfer scheme for institutional deliveries. Since its pan India introduction in 2005, the scheme has passed through various stages which affected its implementation in multiple ways. The scheme, however, could not earn the reputation of an intervention which affected maternal health in any phenomenal way other than increasing institutional deliveries. After five years of its implementation, the present paper attempts to highlight the areas where JSY has positively contributed; if not directly, indirectly in affecting maternal health and the psyche of the community. The article provides evidence from primary data collected from 424 women who delivered during April 2010–March 2011 in selected villages of four districts of Rajasthan, India. Findings from other population-based studies conducted in the state of Rajasthan since the launch of JSY have also been considered to support the findings of the current study presented in the paper. It attempts to show that though JSY incentives were contingent on institutional delivery alone; it led to improvement of other services which have positively affected maternal and child health in terms of health seeking behaviour of the community. Chi square test was employed and it shows health behaviour of those who availed JSY benefits to be significantly associated with registration of pregnancy (p < 0.01), antenatal checkups (p < 0.05), duration of stay at the institution post-delivery (p < 0.01), initiation of breastfeeding (p < 0.5) and postnatal checkup (p < 0.01).
Midwives current knowledge of asthma in pregnancy and their perceived role in antenatal asthma management – a qualitative descriptive study

Introduction Asthma continues to be one of the most common potentially serious conditions that can complicate pregnancy. At least 12% of pregnant women in Australia are affected by asthma. Many studies have examined the link between poorly controlled asthma and increased exacerbations during pregnancy with increased fetal and maternal morbidity. Aim The aim of this study was to determine midwives’ current knowledge of asthma in pregnancy and what they felt their role was in providing antenatal asthma management. Method A qualitative descriptive study was undertaken with 13 registered midwives participating in one face-to-face interview. Data collected from these interviews were digitally recorded, transcribed and then analyzed using qualitative content analysis. Findings Preliminary findings from these data show that midwives’ current knowledge of asthma in pregnancy varied greatly among the sample group with some participants having some awareness of possible changes in asthma symptoms during pregnancy but few participants knowing the potential consequences of poor asthma management. The perceived role of midwives in antenatal asthma management also varied with some midwives stating they felt their role was to educate women regarding their asthma and others stating their role was to refer to other health professionals. Many barriers to providing antenatal asthma management were also identified by the midwives and suggested solutions offered. Conclusion There was no uniform approach to antenatal asthma management being undertaken in this facility. Development of an antenatal asthma clinical pathway could help change current clinical practice regarding asthma management of pregnant women and make it a more uniform process. The provision of education to those providing antenatal asthma management could also help determine the role midwives undertake when caring for a woman with asthma. The findings of this study also have implications for further research into the role of the midwife working with women with complex needs during the antenatal period.
Exercise pathophysiology in patients with chronic mountain sickness exercise in chronic mountain sickness.

BACKGROUND Chronic mountain sickness (CMS) is characterized by a combination of excessive erythrocytosis,severe hypoxemia, and pulmonary hypertension, all of which affect exercise capacity. METHODS Thirteen patients with CMS and 15 healthy highlander and 15 newcomer lowlander control subjects were investigated at an altitude of 4,350 m (Cerro de Pasco, Peru). All of them underwent measurements of diffusing capacity of lung for nitric oxide and carbon monoxide at rest, echocardiography for estimation of mean pulmonary arterial pressure and cardiac output at rest and at exercise, and an incremental cycle ergometer cardiopulmonary exercise test. RESULTS The patients with CMS, the healthy highlanders, and the newcomer lowlanders reached a similar maximal oxygen uptake at 32 1, 32 2, and 33 2 mL/min/kg, respectively, mean SE( P 5 .8), with ventilatory equivalents for C O 2 vs end-tidal P CO 2 , measured at the anaerobic threshold,of 0.9 0.1, 1.2 0.1, and 1.4 0.1 mm Hg, respectively ( P , .001); arterial oxygen content of 26 1, 21 2, and 16 1 mL/dL, respectively ( P , .001); diffusing capacity for carbon monoxide corrected for alveolar volume of 155% 4%, 150% 5%, and 120% 3% predicted, respectively( P , .001), with diffusing capacity for nitric oxide and carbon monoxide ratios of 4.7 0.1 at sea level decreased to 3.6 0.1, 3.7 0.1, and 3.9 0.1, respectively ( P , .05) and a maximal exercise mean pulmonary arterial pressure at 56 4, 42 3, and 31 2 mm Hg, respectively ( P , .001). CONCLUSIONS The aerobic exercise capacity of patients with CMS is preserved in spite of severe pulmonary hypertension and relative hypoventilation, probably by a combination of increased oxygen carrying capacity of the blood and lung diffusion, the latter being predominantly due to an increased capillary blood volume.
Moving from conversation to commitment: Optimising school-based health promotion in the Western Cape, South Africa

Background. Recent evaluation of the Interdisciplinary Health Promotion (IHP) course offered by the University of the Western Cape (UWC) at schools revealed that the needs expressed by the schools had not changed in the last five years. Objectives. This paper describes the process that was undertaken to identify specific interventions that would have an impact on the schools and, in turn, the broader community, and provides an overview of the interventions conducted in 2011 - 2012. Methods. A stakeholder dialogue explored notions of partnership between the university and the schools, sustainability of health promotion programmes in the schools, and social responsiveness of the university. An action research design was followed using the nominal group technique to gain consensus among the stakeholders as to which interventions are needed, most appropriate and sustainable. Results. A comprehensive plan of action for promoting health in schools was formulated and implemented based on the outcome of the stakeholder dialogue. Conclusion. The study’s findings reiterate that an ongoing dialogue between schools and higher education institutions is imperative in building sustainable partnerships to respond to health promotion needs of the school community.
Acute intrinsic renal failure in cats: 32 cases (1997-2004).

OBJECTIVE To determine patient demographics, clinicopathologic findings, and outcome associated with naturally acquired acute intrinsic renal failure (ARF) in cats. DESIGN Retrospective case series. ANIMALS 32 cats with ARF. PROCEDURES Cats were considered to have ARF if they had acute onset of clinical signs (< 7 days), serum creatinine concentration > 2.5 mg/dL (reference range, 0.8 to 2.3 mg/dL) and BUN > 35 mg/dL (reference range, 15 to 34 mg/dL) in conjunction with urine specific gravity < 1.025 or with anuria or increasing serum creatinine concentration despite fluid therapy and normal hydration status, and no signs of chronic renal disease. Cases were excluded if cats had renal calculi or renal neoplasia. RESULTS Causes of ARF included nephrotoxins (n = 18 cats), ischemia (4), and other causes (10). Eighteen cats were oliguric. For each unit (mEq/L) increase in initial potassium concentration, there was a 57% decrease in chance of survival. Low serum albumin or bicarbonate concentration at initial diagnosis was a negative prognostic indicator for survival. Initial concentrations of BUN, serum creatinine, and other variables were not prognostic. Seventeen (53%) cats survived, of which 8 cats had resolution of azotemia and 9 cats were discharged from the hospital with persistent azotemia. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that survival rates of cats with ARF were similar to survival rates in dogs and that residual renal damage persisted in approximately half of cats surviving the initial hospitalization.
The city that became safe: New York's lessons for urban crime and its control

Edited by Franklin E Zimring. 2011. Published by Oxford University Press, New York, 2011, pp 272, 8 chapters, References, Index, hardcover. USD29.95. ISBN 978-0199844425. The 1990s witnessed a large decrease in crime in almost all major US cities. However, while crime rates levelled off in most cities, the decrease continued in New York City throughout the 2000s. From 1990 to 2009, the homicide rate in New York City fell by 76%; the robbery rate fell by 81%, the burglary rate by 85% and the auto theft rate by 93%. ‘The size and the length of the decline are without precedent in the recorded history of American urban crime’ (p. 1). In a previous book, The Great American Crime Decline, legal scholar and criminal justice expert, Franklin Zimring, examined the broad crime decline of the 1990s and concluded that the cause remains largely a mystery. In his new book, The City that Became Safe, Zimring analyses the reasons for the continued decline in crime rates in New York City in the …