Miracle-dz/UniFAR-FTUs huggingface dataset:
Dopamine D2 receptor gene polymorphisms in newborn infants of drug-using women

Objectives To determine the characteristics of dopamine D2 receptor gene (DRD2) polymorphisms in drug-exposed and unexposed neonates and the relationship to neonatal abstinence syndrome (NAS). Design Retrospective case-control analysis between drug-exposed and unexposed infants between DRD2 polymorphisms, drug exposure and NAS treatment. Patients Drug-exposed (n=48) and drug-free (n=49) infants born between March 1999 and December 2006. Methods Analysis of DNA for the Taq1A, -141Ins/Del and Ser311Cys DRD2 polymorphisms. Drug exposure was determined by antenatal maternal drug and alcohol history. Frequency measures of DRD2 polymorphisms were compared between drug-exposed infants, treatment NAS medication and with control infants. Setting Tertiary maternity hospital, Sydney, Australia. Main outcome measures All infants were born in a good condition (25.7% <37 weeks gestation). Opiates (methadone and heroin) were used by 45 (93.8%) of drug-exposed mothers. The A2A2 allele was more common in drug-exposed infants (37 (77.0%) versus 23 (46.9%), p=0.003) but the A1A2 allele was more common in control infants (23 (46.9%) versus 4 (8.3%), p=0.00002). The-ins allele was more common in control (39 (79.6%) versus 20 (41.7%), p=<0.01) and unmedicated drug-exposed (14/25 (56%) versus 5/23 (21.7%), p=0.02) infants. The majority of infants (41 (83.7%) controls versus 41 (85.4%), p=1.000) expressed the least common, Ser polymorphism. Conclusions DRD2 polymorphisms are detectable from DNA obtained from stored blood spots. The –ins allele is more common in control and unmedicated drug-exposed infants. Further study is recommended to explore postneonatal outcomes especially in relation to neuropsychiatric behaviours.
Perspectives of young people and their parents in the transition of cochlear implant services: Implications for improved service delivery

Abstract Objectives Youth and young adults with cochlear implants are now transitioning from pediatric to adult services in increasing numbers. Research in other areas of health care has indicated that there is a gap in the transition from pediatric services for the young adult, and that it is important to obtain their perspectives to reduce disruption and improve care. Previous research has documented issues from the perspective of cochlear implant professionals. The objectives of this study were to examine current practices from the perspective of young adults and their families and to make recommendations for future practice. Methods Interviews were conducted with 11 individuals, including cochlear implant recipients and their parents. All patients were within 4 years of transition between pediatric and adult hospital services: four youths were pediatric patients, and two had been discharged to adult services. Qualitative research methodology was used to identify key themes. Results All participants indicated that they had not anticipated a change to an adult hospital as part of their plan of care. Key themes from interviews were differences between pediatric and adult hospitals, challenges in establishing new relationships with professionals, specific concerns about new health care settings and procedures, and the need for youth to develop independent health-related skills in the context of parental involvement. Discussion Themes identified through interviews with young people with cochlear implants and their parents were similar to research in other areas of health care, as well as to themes identified in focus groups with professionals providing cochlear implant services. There were some differences which highlight both needs in the provision of health care and opportunities for providers and patients to collaborate to provide improved service delivery.
Prevalencia de helmintos intestinales en gatos domésticos del departamento del Quindío, Colombia

Introduccion. Las enfermedades producidas por helmintos estan ampliamente distribuidas en elmundo y muchas de ellas se consideran zoonosis. Los animales de compania cumplen un papeltrascendental en la transmision a los humanos. Objetivo. Determinar la prevalencia de helmintos intestinales en gatos del departamento del Quindio. Materiales y metodos. Se estudiaron 121 gatos domesticos del departamento del Quindio, delos cuales se registraron los datos de sexo, edad y condicion corporal. Se recolectaron heces y seprocesaron mediante las tecnicas de Ritchie modificada y de Kato-Katz. Resultados. De los 121 gatos, 42,14 % (IC95%: 33,35-50,94) y 45,45 % (IC95%: 36,58-54,32) resultaronparasitados con alguna especie de helminto adulto segun la presencia de huevos en sus heces,mediante las tecnicas de Ritchie y de Kato-Katz, respectivamente. Toxocara cati fue el parasito masprevalente (Ritchie: 37,2 %; Kato-Katz: 43 %), seguido por Ancylostoma spp. (Ritchie: 7,43 %; Kato-Katz: 5,78 %) y Aelurostrongylus abstrusus (Ritchie: 0,82 %). Sesenta y cinco (53,71 %) gatos eran hembras y 56 (46,28 %) eran machos; la prevalencia de infeccionfue similar en ambos sexos. Los felinos mayores de 4 anos de edad presentaron mayor prevalenciade parasitos (81,8 %), seguidos por los de 1 a 4 anos (48,8 %) y, por ultimo, por los menores de unano (28,6 %). Se encontro una buena condicion corporal en 77,68 % y este grupo presento menorfrecuencia de helmintos intestinales. Conclusion. La prevalencia de helmintos intestinales en gatos domesticos del departamento delQuindio fue de 43,8 %, lo que hace necesario establecer programas de vigilancia y prevencion en lapoblacion humana y felina. doi: http://dx.doi. org/10.7705/biomedica.v32i3. 439
Insanity and fitness to stand trial in Canada and England: A comparative study of recent developments

Abstract The legal provisions relating to those persons who are found unfit to be tried or who successfully plead the defence of insanity have recently undergone radical change in both Canada and England. This article seeks to compare and critically evaluate the operation of these analogous but very different reforms which have resulted from major dissatisfaction about the way in which the law of both countries has treated this group of vulnerable offender patients.
Post irradiation hearing loss in head/neck patients in Lagos, Nigeria

A prospective study was conducted at Lagos University Teaching Hospital on patients with malignancies of the head and neck region treated with external beam irradiation type and severity of hearing loss. Each patient had a preirradiation and post irradiation pure tone audiogram at 3 weeks, 8 weeks and 6 months. Following completion of radiotherapy serial post irradiation audiogram threshold was compared with pre-treatment threshold. An increase of 10 dB HL (decibel hearing level) or greater was considered significant. Radiation dose ranged from 45-55Gy in twenty to twenty-five fractions per weeks over four to five weeks treatment. Patients that received chemotherapy as adjunctive to therapy during the period of the study were excluded. A total of 40 patients (80 ears) completed the audiological follow up out of ninety four patients seen during the study period . Age ranged between 4-79 years. The tumor site distribution showed 20% in the nasopharynx, 25% in the larynx, 15% in the nose and paranasal sinuses and 10% in the parotid. 7.5% in the oral cavity and mandible respectively and 5% in the ear. Majority 33 (82.5%) were sqaumous carcinoma, 10% were sarcoma and 5% were adenocarcinoma.Pre-radiation hearing assessment revealed 62 ears (77.5%) with normal hearing, 8ears (10%) with mild SNHL and 5 ears (6.25%) with mild and moderate CHL respectively. Final post radiation hearing assessment after 6 months revealed normal hearing in 64 ears (80%), 11 ears (13.8%) with mild SNHL and 2 ears (2.5%) with moderate SNHL. 1.25% with moderate conductive hearing loss and 2 ears (2.5%) with mixed loss. Negative effect of radiotherapy post radiation was seen in 5 ears (6.25%) mainly in mandibular, parotid and ear tumours. The study shows that hearing loss after external beam irradiation could be a significant side effect after radiotherapy in head and neck cancer patients, hence patients should be informed during the pre-treatment counseling period and audiological assessments should be an integral part of pre-therapy evaluation for medicolegal reasons. ABSTRAIT
Antibiotics prescribing pattern in the in‑patient departments of a tertiary care hospital

Context: Antibiotic prescribing by physicians has gained due importance across the globe, mainly because of an increase in antibiotic usage, prevalence of infections, and drug resistances. Aims: The present study aimed to evaluate the prescribing pattern of antibiotics, their adherence to essential medicines list, disease conditions for which they were prescribed, and their adverse effects. Settings and Design: A cross-sectional prospective study was carried out in six inpatients departments (Surgery, Orthopedics, ENT, Ophthalmology, Medicine, and Pediatrics) of a 550-bed tertiary care hospital in Trivandrum, India for two months (July-August 2012). Institutional Research and Ethics Committee clearance were obtained prior to the study. Materials and Methods: The data were collected in a predesigned performa from the medical case sheets, drug charts, and laboratory investigations of 100 in-patients. The enrolled patients were observed from admission till discharge. Descriptive statistics were applied to the collected data and analyzed using Microsoft Excel software. Results: The mean duration of hospitalization among the study population was 5.48 (±4.28) days. Of the 410 medicines prescribed, antibiotics contributed 151 (36.8%). They were mostly indicated for respiratory infections, and the most common antibiotic was Beta-lactams (91 (60.2%). Interestingly, 89 antibiotics (60%) were administered as injections. About 70 (46%) of the antibiotics were prescribed without any combinations. The adherences to World Health Organization’s essential medicines list were 122 (81%). A total of seven adverse drug reactions were reported in the current study. Of which, none were serious, and five (70%) were cutaneous reactions. Conclusions: Of the 100 patients analyzed from six in-patient departments, it was observed that the hospital physicians prescribed antibiotics more rationally with no banned drugs and less newer drugs. Rational prescribing of antibiotics would help avoid polypharmacy and prevent drug resistances.
Impact of Transport Control Protocol on Full Duplex Performance in 5G Networks

Full duplex (FD) communication has attracted the attention of the industry and the academia as an important feature in the design of the future 5th generation (5G) wireless communication system. Such technology allows a device to simultaneously transmit and receive in the same frequency band, with the potential of providing higher throughput and lower latency compared to traditional half duplex (HD) systems. In this paper, the interaction between Transport Control Protocol (TCP) and FD in 5G ultra- dense small cell networks is studied. TCP is a well- known transport layer protocol for providing reliability, which comes at the price of increased delay and reduced system throughput. FD is expected to accelerate the TCP congestion control mechanism and hence mitigate such consequences. System level results show that FD can outperform HD and alleviate the TCP drawbacks when the inter-cell interference is not the main limiting factor. On the other hand, under strong inter-cell interference, results show that the capabilities of the system to cope with such interference dictates the gain that FD may provide over HD.
Long-term outcome of children with oesophageal atresia type III

Objective The aim of this study was to evaluate the outcome of patients with oesophageal atresia type III (EA), focusing on the presence of late sequelae and quality of life. Methods This was a retrospective case ascertainment followed by clinical assessment of patients. The study parameters included the patients' demographic characteristics, associated abnormalities, presence of gastro-oesophageal reflux disease (GERD) and digestive or respiratory symptoms, results of a clinical examination to evaluate nutritional status, spirometry results and quality of life assessed using the PedsQL 4.0 questionnaire. Results Of 81 patients with EA type III treated in our institution over a 10-year period, 57 (mean age 13.3 (SE 2.8) years) participated in the study. 39% of the patients underwent fundoplication and 46% presented with anastomotic stenosis requiring dilation. 75% of patients had normal nutritional status (16% were obese, 9% were undernourished). Only 19% of participants had no digestive symptoms; 61% had dysphagia and 35% had symptoms of GERD at the last follow-up. The main respiratory symptoms were chronic cough (19%) and dyspnoea on exertion (37%). Only 37% of patients had no respiratory symptoms. Spirometry showed that 50% of patients had proximal obstruction and/or pulmonary distension, and 11% had restriction syndrome. Their quality of life was good but was lower than in healthy controls (80 vs 84, p<0.05) and lower in patients born prematurely, with symptoms of GERD and with a barky cough. Conclusion The high frequency of late sequelae in EA type III justifies regular and multidisciplinary follow-up through to adulthood.
Brain drain in sub-Saharan Africa: contributing factors, potential remedies and the role of academic medical centres

A double jeopardy exists in resource-limited settings (RLS) in sub-Saharan Africa (SSA): there are a disproportionately greater number of acutely ill patients, but a paucity of healthcare workers (HCW) to care for them. SSA has 25% of the global disease burden but only 3% of the world's HCW. Thirty-two SSA countries do not meet the WHO minimum of 23 HCW per 10000 population. Contributing factors include insufficient supply, inadequate distribution and migration. Potential remedies include international workforce policies, non-governmental organisations, national and international medical organisations’ codes of conduct, inter-country collaborations, donor-directed policies and funding to train more people in-country, and health system strengthening and task-shifting. Collaborations among academic institutions from resource-rich and poor countries can help address HCW supply, distribution and migration. It is now opportune to harness bright, committed people from academic centres in resource-rich and poor settings to create long-term, collaborative relationships focused on training, clinical skills and locally relevant research endeavours, who mutually strive for HCW retention, less migration, and ultimately sufficient HCW to provide optimal care in all RLS.
Multi-Dimensional SCMA Codebook Design Based on Constellation Rotation and Interleaving

Sparse code multiple access (SCMA) is a new non- orthogonal multiple access scheme, which effectively exploits the shaping gain of multi-dimensional codebook. In this paper, a multi-dimensional SCMA (MD-SCMA) codebook design based on constellation rotation and interleaving method is proposed for downlink SCMA systems. In particular, the first dimension of mother constellation is constructed by subset of lattice Z2. Then the other dimensions are obtained by rotating the first dimension. Further, the interleaving is used for even dimensions to improve the performance in fading channels. In this way, we can design different codebooks for the aim of spectral efficiency or power efficiency. And the simulation results show that the bit error rate (BER) performance of MD-SCMA codebooks outperforms that of the existing SCMA codebooks and low density signature (LDS) in downlink Rayleigh fading channels.
Recent advances in topical agents for prehospital haemostasis

The prehospital treatment of severe extremity bleeding has remained unchanged for years and relies on compression with absorbent gauze dressings. Advances in haemostasis technology have identified several new methods of improving bleeding control. These are examined with a view to possible inclusion in a new prehospital dressing aimed at reducing the degree of exsanguination and associated mortality and morbidity from a major extremity injury.
Doxapram and hypokalaemia in very preterm infants

Background We observed two preterm infants who developed severe hypokalaemia following doxapram. We therefore wished to review the possible association between doxapram and severe hypokalaemia. Study design A retrospective study of preterm infants born before 32 weeks of gestation and hospitalised in our intensive care unit in 2004. For each infant, treatment with doxapram or with any drug known to interfere with potassium metabolism, potassium intakes and episodes of hypokalaemia have been recorded. Results Out of 105 infants, 54 received doxapram. Doxapram-treated infants were significantly younger and had a lower birth weight. Doxapram treated infants were more likely to receive caffeine, furosemide, insulin and mechanical ventilation. There was no difference between the two groups for the other parameters. Hypokalaemia was frequently encountered in our population since it occurred in 76% of enrolled patients and severe hypokalaemia (potassium plasma level below 3 mmol/l) was found in 41%. Bivariate analysis underlined several risk factors for severe hypokalaemia: use of doxapram, gestational age below 28 weeks, use of mechanical ventilation, furosemide, ibuprofen, insulin and postnatal corticosteroids. Cox model's multivariate analysis showed that administration of furosemide and doxapram significantly increased the occurrence of severe hypokalaemia with relative risks of 4.9 (95% CI 1.9 to 12.5) and 8.2 (95% CI 3.1 to 21.7), respectively. Conclusions This retrospective study underlines the high incidence of severe hypokalaemia in very preterm infants and an increased risk of severe hypokalaemia during doxapram treatment. We recommend potassium monitoring during any use of doxapram.
Continuous infusion of vancomycin in neonates

A one year, retrospective audit of intermittent vancomycin therapy within the Neonatal Unit at the Royal Hospital for Sick Children, Glasgow, found that only 33% of 984 vancomycin trough levels were within the British National Formulary for children (BNFc) target range of 10–15 mg/l and 25% were <10 mg/l. A detailed, prospective review of 20 courses (15 patients) over one month, while using the same dosing guidelines, highlighted that only 23 of 50 concentration measurements (46%) were within the target range and 20% were <10 mg/l, even though the initial doses used (table 1) were higher than those recommended by the BNFc. Dose adjustments were common and up to 80 mg/kg/day was often required for older infants. Appropriate interpretation of concentration results was compromised …
School-based physical activity programme in preadolescent girls (9–11 years): a feasibility trial in Karachi, Pakistan

Background Effective strategies to combat childhood obesity are challenging, especially among South Asian girls. We conducted a pilot cluster trial of a school-based physical activity programme among preadolescent girls to determine the feasibility (recruitment, retention and implementation) of the programme and influence on blood pressure (BP) and body mass index (BMI). Methods This two-arm parallel cluster intervention trial was conducted in four similar all-girls public sector schools in Karachi over a 20-week period. All girls aged 9–11 years were included. Intervention was a physical activity programme of 30 min duration four times a week. Primary outcome was to assess the feasibility of the physical activity programme defined as recruitment and retention >70% and treatment fidelity of >80% of physical activity programme. Secondary outcomes were changes in systolic BP (SBP), diastolic BP (DBP) and BMI from baseline to follow-up. Results A total of 360 participants were invited to participate, 280 girls met eligibility criteria, and were recruited; 131 (77%) in the intervention group and 146 (87%) in control group. At follow-up, the overall retention of participants was 222 (79.2%); 105 (80.1%) in the intervention group and 117 (78.5%) in the control group. The difference in mean change from baseline to follow-up in SBP, DBP and BMI score was 1.9 mm Hg, 0.7 mm Hg and 0.55 kg/m2 between intervention and control arms, respectively. Conclusions A school-based physical activity programme in a public sector girls school of urban Pakistan is feasible. There was a favourable trend in BP and BMI at follow-up. (Clinical trial ID NCT 00533819).
Improving code churn predictions during the system test and maintenance phases

We show how to improve the prediction of gross change using neural networks. We select a multiple regression quality model from the principal components of software complexity metrics collected from a large commercial software system at the beginning of the testing phase. Our measure of quality is based on gross change, and is collected at the end of the maintenance phase. This quality measure is attractive for study as it is both objective and easily obtained directly from the source code. Then, we train a neural network with the complete set of principal components. Comparisons of the two models, gathered from eight related software systems, shows that the neural network offers much improved predictive quality over the multiple regression model. <<ETX>>
Intercultural comparison of patient satisfaction with physiotherapy care in Australia and Korea: an exploratory factor analysis

Abstract Objectives: The aim of this study was to conduct a cross-cultural comparison of the factors that influence patient satisfaction with musculoskeletal physiotherapy care in Australia and Korea. Methods: Prospective studies were conducted in Australia and Korea. Patient satisfaction data were collected using the MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care (MRPS) from a total of 1666 patients who were attending clinics for physiotherapy treatment of a musculoskeletal condition. Exploratory factor analysis was conducted to identify factors determining patient satisfaction in each cohort. Results: A four-factor solution for the MRPS was found for the Australian and Korean data sets, explaining 61 and 55% of the variance respectively. Communication and respect, convenience and quality time and person-focused care were factors common to both countries. One factor unique to Korea was courtesy and propriety. For both cultures, global patient satisfaction was significantly but weakly correlated with the outcome of treatment. Conclusions: The interpersonal aspect of care, namely effective communication and respect from the therapist, appears to be the predominant and universal factor that influences patient satisfaction with physiotherapy care, although other culturally specific factors were identified. Physiotherapists can maximize patient satisfaction with care by addressing those features that uniquely contribute to patient satisfaction in the cultural context in which they are working.