Miracle-dz/UniFAR-FTUs huggingface dataset:
Association between testosterone levels and the metabolic syndrome in adult men

Abstract Objective: To evaluate the relationship between testosterone levels and the metabolic syndrome (MS) in men older than 45 years. Methods: Six hundred and sixty men (45–70 years) selected from 2906 participants of a population screening for prostate cancer were included in this study. Testosterone and the components of MS were assessed in all men. MS was diagnosed according to NCEP-ATP III criteria. Triglycerides (TG)/HDL-cholesterol (chol) index was calculated. Results: The presence of MS was inversely associated with testosterone (χ2, p < 0.001), independently of age (OR 0.802, CI 95%: 0.724–0.887, p < 0.0001). Hypertension was the most frequent abnormality observed followed by elevated TG and waist circumference (WC). Testosterone correlated positively with HDL-chol (r: 0.14, p < 0.0001) and negatively with body mass index (BMI)(r: −0.29, p < 0.0001), WC (r: −0.26, p < 0.0001), TG (r: −0.20, p < 0.0001), TG/HDL-chol (r: −0.20, p < 0.0001), glucose (r: −0.11, p = 0.005) and MS score (r: −0.23, p < 0.0001). Conclusions: Our results show that in men older than 45 years, as long as testosterone levels decline, the prevalence of MS increases, independently of age. The correlations found between testosterone and four of the five components of MS, as well as with BMI and TG/HDL-chol ratio, a surrogate marker of insulin resistance, suggest considering male hypogonadism as a determinant of developmental abnormalities typical of MS.
STRESS AMONG NURSES WORKING IN CRITICAL CARE AREAS AT A TERTIARY CARE TEACHING HOSPITAL NEPAL

Stress is a part of our life. Stress can also create positive and negative influence in our daily lives. As a positive influence stress is a motivating force towards progress and it can create new awareness and exciting new perspective. As a negative influence it creates feeling of distress, rejection, depression, which leads to variety of physical and psychological problems. The aim of the study was to assess stress among nurses working in critical care areas at BPKIHS. A Descriptive explorative design was used to conduct the study in critical care areas of BPKIHS Dharan. Fifty staff nurses working in critical care areas with at least one year of critical care experience were included in this study. Random sampling technique was used to select the sample from random number table. Self administered structured questionnaire and Modified Expanded Nursing Stress Scale were used for the collection of data. Study findings revealed that majority of the respondents 56% had moderate stress followed by mild stress 34%, sever stress 6%, where as very less number of respondents 4% had no stress in their job setting. This study finding also indicate that Nepalese nurses rated factors such as lack of opportunity to discuss problems with peers 36% and inadequate emotional preparation 30%, being sexually harassed 24%, experiencing discrimination because of race or ethnicity 20%, and experiencing discrimination on the basis of gender 10% as low on the stress scale. Stress factors rated “Moderately and very much stressful” were shortage of staff to adequately cover the unit 82%, being blamed for anything that goes wrong 70%, not enough equipment supplies/not functioning well 62%, physician not being present in a medical emergency 62%, patients’ family making unreasonable demands 62%, lack of support from nursing administration 52%, having to work through breaks 54%, not enough time to complete all nursing tasks 46%. This study provides valuable insight into the actual and perceived stressful experiences of critical care nurses, thus contributing to the ongoing effort to reduce burnout in this population. DOI: http://dx.doi. org/10.3126/jcmc.v4i4. 11972
Comparison of techniques to examine the diversity of fungi in adult patients with cystic fibrosis.

This study compares conventional and molecular techniques for the detection of fungi in 77 adult cystic fibrosis (CF) patients. Three different methods were investigated, i.e., (1) conventional microbiological culture (including yeasts and filamentous fungi), (2) mycological culture with CF-derived fungal specific culture media, and (3) Non-culture and direct DNA extraction from patient sputa. Fungi isolated from environmental air samples of the CF unit were compared to fungi in sputa from CF patients. Fungi (n = 107) were detected in 14/77(18%) of patients by method 1, in 60/77 (78%) of patients by method 2 and with method 3, in 77/77(100%) of the patients. The majority of yeasts isolated were Candida albicans and C. dubliniensis. Exophiala (Wangiella) dermatitidis, Scedosporium apiospermum, Penicillium spp. , Aspergillus fumigatus, and Aspergillus versicolor were also identified by sequence analysis of the rDNA short internal transcribed spacer (ITS2) region. Conventional laboratory analysis failed to detect fungi in 63 patients mainly due to overgrowth by Gram-negative organisms. Mycological culture with antibiotics dramatically increased the number of fungi that could be detected. Molecular techniques detected fungi such as Saccharomyces cerevisiae, Malassezia spp. , Fuscoporia ferrea, Fusarium culmorum, Acremonium strictum, Thanatephorus cucumeris and Cladosporium spp. which were not found with other methods. This study demonstrates that several potentially important fungi may not be detected if mycological culture methods alone are used. A polyphasic approach employing both enhanced mycological culture with molecular detection will help determine the presence of fungi in the sputa of patients with CF and their healthcare environment.
The Effects of Perioperative Low - Moderate Doses of Dexmedetomidine Infusion on Hemodynamic and Neuroendocrine Parameters

Aim: The aim of this study was to determine the effects of low and moderate doses of dexmedetomidine infusions by evaluating hemodynamic and neuroendocrine responses in patients undergoing elective transurethral surgery. Materials and Methods: Fifty patients were randomly allocated to receive 0.45 (Group 1) or 0.6 (Group 2) µg kg -1 hr -1 dexmedetomidine infusion 10 minutes before induction of anesthesia. Heart rate, blood pressures, ETCO2 and peripheral oxygen saturation values and parameters of non-invasive cardiac output were monitored. Measurement times were baseline (I), after dexmedetomidine infusion (II), after thiopental induction (III), after intubation (IV) and at 10-minute intervals during desflurane anesthesia. Anesthesia (2L min -1 50% N2O+O2) was maintained with 4-6% desflurane corresponding to a bispectral index (BIS) value of 40-60. Venous blood samples were collected prior to intubation (I), at the 30 th min intraoperatively (II) and after extubation (III) to determine plasma adrenaline and noradrenaline levels. Chi-square, Student’s t-test and repeated measures of variance were used for statistical analysis. Results: Two different doses of dexmedetomidine infusion produced similar hemodynamic effects. The cardiovascular and neuroendocrine parameters were suppressed more in Group 2 than in Group 1. Conclusions: These findings suggest that intraoperative 0.45 and 0.6 µg kg -1 hr -1 doses of dexmedetomidine result in similar intubation, recovery and hemodynamic responses. Cardiovascular and neuroendocrine parameters were suppressed more by the moderate dose of dexmedetomidine.
Survey of obstetrician-gynecologists in the United States about Chagas disease.

Chagas disease affects an estimated 300,000 people in the United States, and as many as 300 congenital infections are estimated to occur annually. The level of knowledge about Chagas disease among obstetricians-gynecologists in the United States has not been assessed. The American College of Obstetricians and Gynecologists surveyed a representative sample of 1,000 members about Chagas disease. Among 421 respondents, 68.2% (95% confidence interval [CI] = 63.5-72.6) described their knowledge level about Chagas disease as "very limited. " Only 8.8% (95% CI = 6.2-12.0) knew the risk of congenital infection, and 7.4% (95% CI = 5.1-10.4) were aware that both acute and chronic maternal infections can lead to congenital transmission. The majority of respondents (77.9%; 95% CI = 73.5-81.9) reported "never" considering a diagnosis of Chagas disease among their patients from endemic countries. Most of those who did consider the diagnosis did so "rarely. " Knowledge of Chagas disease among obstetricians-gynecologists in the United States is limited. Greater awareness may help to detect treatable congenital Chagas cases.
Rheumatism in Miners. Part II: X-ray Study

Inafield survey ofrheumatic complaints LawrenceandAitken-Swan (1952) foundthatcoal miners suffered moredisability frompaininthe backsciatic distribution andinthekneesthanthe surrounding general population, andfromthe limited examination possible inthefield itappeared that these disabilities wereduetodisc degeneration, osteo-arthritis, andrheumatic disorders ofundetermined nature.Toinvestigate this morefully itwasdecided tocarry outadetailed clinical study anda radiological survey ofsmallbutcarefully selected groupsofcoalminers andother workers fromthepopulations covered mostcomprehensively bythefield survey: thatistosay,theunderground workers atBedford Colliery andtheemployees of theengineering yardand theadministrative offices atWalkden. Thestudywasconfined tomalesinthefifth decade. Thisagegroupwas chosenas most likely toshowtheeffects ofoccupation uponthe incidence andseverity ofdegenerative joint changes, since atthis agethese changes begin toberadiologically demonstrable ina proportion ofthe general population. Consideration ofthenumbers available between theagesof40and50showed that there were47office workers (clerks andadministrative staff), 89manualworkers(blacksmiths, machinists, carpenters, painters, and general labourers), and259miners. We decided tostudy all47office workers together withanequal number ofmanualworkers, thusmaking acomposite group of94non-miners whohadneverbeenunderground, andtocompare these with94underground workers. Allmanualand underground workersin the appropriate agegroupweretherefore numbered consecutively and thesamples forstudywere
Barriers to Outpatient Care in Community-Dwelling Elderly with Dementia

The purpose of this study was to examine the relationship between informal caregiver life satisfaction and receipt of outpatient medical care in persons with dementia. We obtained data from the National Longitudinal Caregiver Survey (NLCS), a survey of 1,269 veterans with dementia and their primary informal caregivers. NLCS data were merged with 12 months of Veteran Administration outpatient claims. Outpatient visits were classified as (a) primary, (b) specialty, or (c) mental health care. Greater levels of caregiver-reported life dissatisfaction were associated with decreased likelihood of care-recipient outpatient visits for both primary and mental health care. In addition, we found that care-recipients with African American caregivers were less likely to receive a mental health visit, and those coresiding with their caregiver were more likely to receive a specialty care visit. Our findings suggest that low caregiver life satisfaction may signal an impending breakdown in care-recipients' access to primary and mental health care.
Impact of multi drugs resistant bacteria on the pathogenesis of chronic suppurative otitis media

One hundred twenty patients with chronic suppurative otitis media (CSOM) in Basrah, 65 (54.2%) males and 55 (45.8%) females, with male: females ratio (1.2:1) and 60 individual without otological problems as control group were included in this study, which done during the period between March 2009 and January 2010. This includes the collection of aural swab samples, culturing of samples, identification of causative agent’s species and antibiotic sensitivity. Gram’s negative bacteria were the commonest microorganism comprises (60%). Pseudomonas aeruginosa was common causative agent (19.04%), followed by Staphylococcus aureus (16.7%) andKlebsiella spp. (14.3%). Mixed infection was found in high percent (74%), in which P. aeruginosa and other microorganisms were more common. The antibiotic sensitivity pattern showed that P. aeruginosa was sensitive to Ciprofloxacin, amoxicillin +clavulanic acid and gentamicin, while other is appeared resistant, S. aureus was sensitive to ciprofloxacin, amoxicillin+clavulanic acid, erthomycin, cephalexine and it is resistant to penicillin and ampicillin, klebsiella species were sensitive to ciprofloxacin, amoxicillin +clavulanic acid, gentamicin, while resistant to tetracycline. Key words: Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella spp. , chronic suppurative otitis media, aural swab, antibiotic sensitivity, gram’s negative bacteria, otological.
Aerosol sampling methods for the virus of foot-and-mouth disease and the measurement of virus penetration through aerosol filters

Single and multi-jet liquid impingers and membrane-filters were found to be efficient sampling devices for aerosols generated from suspensions of the virus of foot-and-mouth disease (FMD). Concentration of the aerosol samples with an adsorbent, Attaclay, facilitated the detection of small amounts of virus. Sodium dodecyl sulphate could be used for elution as the virus of FMD is resistant to this anionic detergent. The penetration of these aerosols through various air filtration media was determined using impinger samplers. A glass fibre paper was found to be the most efficient with a virus penetration of less than 0·001%. We wish to thank Dr D. W. Henderson and Dr H. M. Darlow, of M.R. E. and Mr R. G. Dorman of C.D. E. Porton for valuable prefatory discussions and advice. We are also indebted to Miss S. Cartwright for inoculating mice, to Miss M. Shoobridge and Mr S. Taylor for technical assistance, and to Vokes Ltd. for supplying materials.
A COMMUNITY BASED CROSS-SECTIONAL STUDY TO ASSESS THE UNMET NEED OF FAMILY PLANNING IN URBAN SLUMS AND IT'S DETERMINANTS IN WESTERN PART OF INDIA

Context: Unmet need is a valuable indicator of National Family Planning Programme. It shows how well the pro-gramme achieves the key mission of meeting the population’s felt need of family planning. It is added to the 5th MDG as an indicator concerned with maternal health. Aims: To find out 1. ) Unmet need of family planning and 2. ) Its determinants. Settings and Design: A community based cross sectional study was done among married women of age 15-45 years of urban slums in Jamnagar city. Methods and Material: total 200 study participants were selected by systemic random sampling and interviewed by using pretested semi-structured Performa. Statistical analysis used: Microsoft excel was used for data entry and analysis done by software Epi-info. Results: overall level of unmet need was 20.50%. It was found to be influenced by various socio-demographic factors (age of women, gender of last child and accessibility to the service providers) and these associations were found statistically significant. Number of living children, occupation, and period of active married life, religion and collective decision had no any effect on unmet need. (No statistically significant associations). Major reasons for not using any methods were inconvenience (51.22%), refusal by spouse/family members (21.95%) and lack of knowledge (19.51%) Conclusions: unmet need was higher in more fertile age-group therefore program should focus more on this age-group. Female education contributes significantly in reduction of unmet need. By encouraging inter-spousal communication and male participation for family planning decision-making is important in bridging the gap between met and unmet need.
The influence of chronic obstructive pulmonary disease in patients undergoing coronary artery bypass graft surgery

The objective of this study was to assess if there are any differences between patients undergoing coronary artery bypass graft surgery with COPD compared to patients without COPD. We conducted a prospective hospitalization cohort study. The study population was patients undergoing CABG by the Cardiovascular Thoracic Surgery Group. Inclusion criteria included CABG surgery between 10/1/93 and 1/1/8 and age greater than eighteen. Exclusion criteria included any other surgery performed simultaneously with the CABG surgery, repeat procedures, and any patient with incomplete data for the COPD variable. Data were collected on 225 variables concurrently with admission. We controlled for seven variables. The primary outcome was thirty-day mortality. There were eight secondary outcomes. Ten thousand, four hundred and fourteen patients meet the criteria to be included in the cohort, (1,739 with COPD and a positive smoking history, 8,675 patients without COPD). Univariate analysis comparing the patients with and without COPD for the seven potential confounders found no significant difference between the two populations. The patients undergoing CABG surgery with COPD did experience significantly longer length of stay (6.7 ± 6.0 days vs. 5.9 ± 6.1 days, p < 0.05), more likely to significantly elevate their creatinine after surgery (OR 1.46, 95% CI 1.15 to 1.85), more prolonged ventilation (OR 1.99, 95% CI 1.60 to 2.49), more likely to get pneumonia (OR 2.99, 95% CI 2.25 to 3.96) and significantly more mortality (OR 1.78, (95% CI 1.32 to 2.40). Patients with COPD undergoing CABG surgery experience significantly more mortality and more morbidity compared to patients without COPD.
Satiety quotient linked to food intake and changes in anthropometry during menopause: a MONET Study

Abstract Objectives It is unknown whether the satiety quotient (SQ) differs across the menopausal transition, and whether changes in SQ are related to changes in anthropometric/body composition variables. The objective of this study was to evaluate the changes in SQ and its association with energy intake and changes in anthropometric/body composition variables across the menopausal transition. Methods At baseline, 102 premenopausal women (aged 49.9 ± 1.9 years, body mass index 23.3 ± 2.2 kg/m2) took part in a 5-year observational, longitudinal study. Body composition (DXA), appetite (visual analog scales), energy and macronutrient intakes (ad libitum lunch and 7-day food diary) were assessed annually. The SQ (mm/100 kcal) was calculated at 60 and 180 min post-breakfast consumption. Results Overall, the SQ increased at years 3 and 4 (p = 0.01–0.0001), despite no significant differences between menopausal status groups. Lower fullness, prospective food consumption and mean SQ values predicted overall increases in lunch energy and macronutrient intakes (p = 0.04–0.01), whereas only prospective food consumption and fullness SQ predicted energy intake and carbohydrate intake, respectively, when assessed with food diaries (p = 0.01). Delta SQs were negatively correlated with changes in waist circumference (p = 0.03–0.02), whereas delta SQs were positively (p = 0.04) and negatively (p = 0.02) associated with delta fat mass between years 1 and 5, and years 4 and 5, respectively. Conclusion These results suggest that variations in SQ across the menopausal transition are related to energy and macronutrient intakes and coincide with changes in body composition and waist circumference.
A PARENT-INITIATED SCHOOL OF CHOICE: AN EXAMINATION OF THE GENESIS AND EARLY HISTORY OF KING TRADITIONAL SCHOOL

Parental activism in education in British Columbia has been manifest in a number of initiatives. In particular, within the last 20 years, a small number of "traditional" and "fundamental" schools have been proposed by parents and approved in communities such as Langley, Surrey and Abbotsford. This dissertation focuses specifically on the genesis and early years of King Traditional School in Abbotsford, which opened in 1995. King Traditional School is a school in which the wishes of parents are paramount. This dissertation enumerates the educational values of the school and acknowledges the "triad" of parent, teacher and student as the most salient factor in the school's ascendancy; indeed, although the school has some unique characteristics which primarily may be regarded as cosmetic the vibrant support of participative parents is the most significant factor in the school's successes. Through the study of documents from similar schools that were founded in Pasadena and Langley, this paper reveals the origins of King Traditional School and demonstrates the ideological framework that underlay these schools, including responses to public education In addition, through the examination of scholarly and not so scholarly -papers concerning the school and fundamental / traditional schooling in general, an understanding of the aspirations of adherents is revealed. This understanding is also illuminated through some of the articles that appeared in local newspapers whch introduced the school and the beliefs of its supporters into the public discourse. As school boards aspire to maintain h g h enrollments and do not wish to lose students to the private system, they will continue to receive pressure to provide alternatives such as traditional schools which offer to parents the veneer of private schooling without the cost. The allure of such schools is understandable, particularly in the Fraser Valley with high private school attendance, but trustees will need to exercise caution in not pandering to parents who may have a self-seeking approach to their children's schooling. The Ministry of Education may wish to consider guidelines for such schools in order to protect the principles of public education and provide local trustees with salutary parameters to guide their deliberations.
Infusional Fluorouracil, Leucovorin, Oxaliplatin, and Irinotecan (FOLFOXIRI) Compared with Infusional Fluorouracil, Levcovorin, and Irinotecan (FOLFIRI) as First-Line Treatment for Metastatic Colorectal Cancer

Rationale: This phase III study was conducted to compare fluorouracil, leucovorin, oxaliplatin and irinotecan (FOLFOXIRI) with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first line management of metastatic colorectal carcinoma. Methods: Sixty patients with unresectable metastatic colorectal adenocarcinoma were randomly assigned to FOLFOXIRI (n = 30) or FOLFIRI (n = 30) as first line for metastatic disease. The primary end point was response rate (RR) and secondary end points were progression free survival (PFS), overall survival (OS), post chemotherapy RO surgical resection (complete resection with safety margin), and toxicity. Results: The RR was significantly higher for FOLFOXIRI arm 60% (18/30) compared to FOLFIRI (33%) (p = 0.007). The rate of progression was significantly lower for patients treated with FOLFOXIRI (11% vs. 24%; p = 0.02), 5 patients (16%) underwent radical (RO) surgery of metastases in the FOLFOXIRI arm compared with one patient (3%) in the FOLFIRI arm (p = 0.02). FOLFOXIRI resulted in an increased PFS, with median PFS of 10 month vs. 7.5 months (p = 0.0099) with an HR for progression of 2.58 (95% CI, 1.2 to 5.3). The rate of early progression (patients who progressed within six months from the treatment onset) was significantly lower in the FOLFOXIRI arm (18% vs. 45%; p < 0.0001); OS is significantly longer for FOLFOXIRI (22.6 vs. 16.7 months; p = 0.032) corresponding to an HR for death of 0.70 (95% CI, 0.50 to 0.96). Patients who received FOLFOXIRI were subjected to significantly higher incidence of adverse events; grade 2 to 3 peripheral neurotoxicity (0% vs. 20%; p < 0.001) and grade 3 to 4 neutropenia (26% vs. 53%; p < 0.001). Febrile neutropenia was comparable between the two arms (3% vs. 6%) of patients; p = 2. Conclusion: Compared to FOLFIRI regimen; FOLFOXIRI regimen has significantly higher RR, PFS, OS, and improved chance for resection of metastases, with higher but tolerable toxicity in patients with metastatic colorectal cancer.