Miracle-dz/UniFAR-FTUs huggingface dataset:
The Impact of Specialized Telephonic Guides on Employee Engagement in Corporate Well-Being Programs

Abstract Employer-sponsored well-being programs have been growing in popularity as a means to control rising health care costs and increase workplace productivity. Engagement by employees is necessary for these programs to achieve their desired effects. Extrinsic motivators in the form of incentives and surcharges are commonly introduced by employer program sponsors to promote meaningful engagement. Although these may be successful in achieving a degree of engagement, individuals benefit by being intrinsically motivated as they modify behaviors and improve short- and long-term well-being. Telephonic guides equipped with motivational interviewing and other behavioral strategies to improve engagement may bridge the gap between extrinsic and intrinsic motivation. The objectives of this study are to determine characteristics associated with employee utilization of these guides when offered and to compare subsequent program engagement rates between utilizers to a propensity score matched group of employees who were not offered the service. The data were retrieved from a well-being program provider's database. The study examined 166,258 employees across 35 employers. It found utilizers were older, proportionally more female, in the manufacturing industry, incented to use the guide service, offered a larger incentive for program participation, had healthier self-reported behaviors, and had a higher perception of their employer's focus on well-being. The study found that guide utilizers were significantly more likely to engage in telephonic coaching, digital coaching, and activity tracking up to 6 months. The study's findings suggest telephonic guides using a range of behavioral techniques are an effective strategy to drive well-being program engagement.
Frequency of Insulin Resistance in Egyptian Women with Polycystic Ovary Syndrome

Objectives:To evaluate the prevalence of insulin resistance in polycystic ovary syndrome (PCOS) women and to compare the findings (clinical and laboratory) of PCOS in insulin resistance (IR) to non-IR PCOS women. Patients and methods: Fifty PCOS women included in this cross sectional comparative study. Studied women underwent complete physical examination with calculation of BMI, assessment of hirsutism and measurement of blood pressure. Hormonal and lipid profiles of the studied PCOS women also evaluated. Fasting glucose/insulin (G/I) ratio calculated and a ratio < 4.5 was predictive of IR in PCOS women above 18 years old. Studied PCOS women divided into two groups according to presence or absence of IR to evaluate the prevalence of IR in PCOS Egyptian women and the findings of PCOS in IR to non-IR PCOS women. Results:IR (G/I ratio 8) was significantly more common in IR compared to non-IR PCOS women (20 (86.95%) versus 5 (18.5%)). There was no significant difference between IR and non-IR PCOS studied women regarding; mean age, blood pressure, age of menarche, menstrual regularity acne and baldness. In addition, there was no significant difference between the IR women and non-IR PCOS studied women regarding; ultrasound ovarian findings, hormonal and lipid profiles. Conclusion: The prevalence of IR in PCOS Egyptian women is about 46%, BMI was significantly high in IR compared to non-IR PCOS women and the hirsutism was significantly more common in IR compared to non-IR PCOS women.
The Molecular Connections between Lung and Pancreatic Cancer Metastases: are we not seeing the Forest for the Trees?

Metastases to the pancreas are rare at 1-2%. Among primaries metastasizing to the pancreas, lung cancer (LC) is frequently the culprit. Metastases to the lung from pancreatic cancer (PC) are significantly more common at about 45%, presenting striking differences in cancer behavior. There are conflicting reports regarding cancerogenicity and metastatic incidence between the lung and pancreas. Therefore, this review takes a fresh look at lung and pancreatic cancer behavior. Secondary metastases to the lung and pancreas are often indistinguishable from LC and PC primaries, and the seed and soil hypothesis is not always congruous with clinical interpretation of disease course. Sometimes single “seed” dissemination is thought to occur at the preneoplastic stage without any evidence of tumor invasion. Metastatic growth may become dormant, manifesting years later as cancer of unknown primary (CUP). Interestingly, CUPs are discovered to originate most frequently from LC and PC primaries at autopsy. The lung and pancreas are morphologically related through endoderm-level morphogenesis. The molecular basis of cancer regularity between them involves developmental signaling pathways including HEDGEHOG, NOTCH, WNT, and CXCL12/CXCR4, an evolving genetic background, and regulatory tumor-stromal interactions. Perhaps biomarkers that explain the regularity between them have been documented as we peruse the bioscience literature for information, we may be reading through viable biomarkers and solutions and not seeing the forest for the trees. On the other hand, perhaps more research is warranted to explain cancer behavior between the lung and pancreas. Observations in this review provide a framework on which to extract clues for future work regarding organspecific metastasis between the lung and pancreas.
The Association Among Serum Quantitative Hepatitis B Surface Antigen (Qhbsag), Intrahepatic HBV Markers and Liver Fibrosis in Chronic Hepatitis B (Chb) Patients

Background: Recently, quantitative HBsAg has been used as a predictor for successful antiviral therapy in chronic hepatitis B (CHB) patients. Intrahepatic HBV-DNA levels have also been tested to know their relevance with clinical manifestation. However, their associations with liver fibrosis are still debatable. Objective: This study was aimed to evaluate the association between serum qHBsAg, serum HBV-DNA, intrahepatic HBV markers and hepatic fibrosis in CHB patients. Method: A cross-sectional study was done on naive CHB patients from September 2009 to June 2011. Quantitative serum HBsAg measurement was performed using the automated chemiluminescent microparticle immunoassay (Architect HBsAg QT assay, Abbott Laboratories, IL, USA). Serum qHBsAg was measured using the automated chemiluminescent microparticle immunoassay (Architect HBsAg QT assay, Abbott Laboratories, IL, USA). Intrahepatic cccDNA was measured quantitatively from biopsy specimen (QiAmp DNA Mini Kit, Qiagen, Germany). Values were log-transformed before being analyzed. Biopsy specimens should include at least 5 portal systems and 1.5 cm length to be eligible for evaluation using the METAVIR score. Results: 103 patients enrolled; 53 (51.9%) of them were men. Mean age was 42+11.6 (range 19-70) years old. There were 60 (58.3%) patients with HbeAg negative. Mean of log serum quantitative HBsAg was 2.54 for F0-F1 patients vs. 3.48 for F2-F4 patients (p < 0.001, student t test). The mean log serum HBV-DNA was 4.65 for F0-F1 vs. 6.69 for F2-F4 patients (p < 0.001; student t test). Intrahepatic rcDNA levels was higher in F2-F4 (median 14.37; range 0-3258.4 copies/GEq) than F0-F1 patients (median 0.50; range 0-514.4 copies/GEq); p < 0.001 (Mann-Whitney U test). In contrast, virion productivity was not differed statistically between the two groups (p 0.096). Conclusion: Quantitative serum HbsAg, HBV-DNA serum, and intrahepatic cccDNA are associated with fibrosis stage in chronic hepatitis B patients. HBV seromarkers might be used to predict disease severity.
Bilateral First Rib and Associated Lower Cervical Spine Fractures

1Master Student in Anatomy, Universiti Putra Malaysia, Malaysia 2Resident, Department of Orthopaedics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Malaysia 3Lecturer, Department of Orthopaedics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Malaysia 4Professor & Consultant Hand & Microsurgeon, Department of Orthopaedics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Malaysia
Short-Term Changes in Algometry, Inclinometry, Stabilometry, and Urinary pH Analysis After a Thoracolumbar Junction Manipulation in Patients with Kidney Stones.

Abstract Objectives: To determine the efficacy of a high-velocity low-amplitude manipulation of the thoracolumbar junction in different urologic and musculoskeletal parameters in subjects suffering from renal lithiasis. Design: Randomized, controlled blinded clinical study. Settings/Location: The Nephrology departments of two hospitals and one private consultancy of physiotherapy in Valencia (Spain). Subjects: Forty-six patients suffering from renal lithiasis. Interventions: The experimental group (EG, n = 23) received a spinal manipulation of the thoracolumbar junction, and the control group (CG, n = 23) received a sham procedure. Outcome measures: Pressure pain thresholds (PPTs) of both quadratus lumborum and spinous processes from T10 to L1, lumbar flexion range of motion, stabilometry, and urinary pH were measured before and immediately after the intervention. A comparison between pre- and postintervention phases was performed and an analysis of variance for repeated measures using time (pre- and post.
Effect of Hydroalcoholic Extract of Capsella bursa pastoris on Early Postpartum Hemorrhage: A Clinical Trial Study.

OBJECTIVES Postpartum hemorrhage (PPH) is one of three main causes of maternal mortality and a life-threatening condition throughout the world. PPH can have irreversible complications for the mother even if it does not lead to death. This study was conducted to determine the effect of hydroalcoholic extract of Capsella bursa pastoris on early PPH. DESIGN The present study was a single-blinded, randomized, clinical trial. SETTING The study was conducted in Afzalipour Hospital of Kerman in 2015. SUBJECTS The subjects included 100 women who had given vaginal birth and met the study inclusion criteria. INTERVENTION The participants were selected and randomly assigned into an intervention group (n = 50) and a placebo group (n = 50). Immediately after placental expulsion, the intervention group was given 10 sublingual drops of the hydroalcoholic extract of Capsella bursa pastoris plus an infusion of 20 U of oxytocin in 1 L of Ringer's solution, and the control group was given 10 sublingual drops of the placebo plus an infusion of 20 U of oxytocin in 1 L of Ringer's solution. OUTCOME MEASURES The amount of bleeding was assessed in both groups. Hemoglobin and hematocrit levels were measured in all the participants 6 h after childbirth. The statistical analysis of the data was performed in SPSS-17 using the following tests: independent t, paired t, repeated measures ANOVA, Friedman's, Wilcoxon, Mann-Whitney, Fisher's exact, and chi square. P-value <0.05 was considered statistically significant. RESULTS There were no significant differences between groups in baseline characteristics (p > 0.05). After the intervention, there was significant decrease in the amount of postpartum bleeding in both groups. However, the mean decrease in the amount of bleeding was significantly more in the Capsella bursa pastoris group (p < 0.001). CONCLUSION Compared with the mere administration of oxytocin, sublingual Capsella bursa drops appear to be effective in reducing PPH in this study. Further research regarding the efficacy and safety of various doses of Capsella bursa pastoris is required.
Photoselective Vaporization of the Prostate Using 120 W High Performance System: A Prospective Evaluation of Results Over 2 Years.

PURPOSE This study evaluated the safety and efficacy of photoselective vaporization of prostate using the 120 W High Performance System for management of symptomatic benign prostatic hyperplasia (BPH). METHODS We prospectively obtained data from 229 patients between January 2009 and December 2012. We evaluated the serum prostate specific antigen level, International Prostate Symptom Score (IPSS), prostate volume; maximum urine flow rate (Qmax); and postvoid residual urine volume (PVR) in the patients at presentation and on follow-up at 1, 6, 12, and 24 months. The mean duration of the surgery, energy used, hospital stay, and intra- and postoperative complications were assessed. RESULTS The mean age of the patients was 71.2 ± 9.6 years, and the mean preoperative size of the prostate was 59.41 ± 28.1 mL. The mean duration of the surgery was 47.35 ± 16.14 min, and the mean energy use was 184.39 ± 101.3 kJ. The mean time to removal of the urinary catheter was 21.45 ± 11.06 h, while the mean duration of hospital stay was 24.82 ± 11.5 h. The IPSS declined and mean Qmax increased by over twofold within the first month. The PVR also declined significantly in all groups up to 6 months after the surgery and increased slightly thereafter. Urinary urgency and incontinence occurred in two patients, while four patients developed urinary strictures. Between 12 and 24 months after the surgery, four patients underwent repeat surgery. CONCLUSIONS Our findings show that photoselective vaporization is safe and effective for the management of BPH and resulted in few complications. It yielded improvements in all parameters that were sustained even up to 2 years after the surgery.
Desigualdades regionais na saúde: mudanças observadas no Brasil de 2000 a 2016

Advances in reducing poverty and inequalities in the 2000s had a paradoxical effect in Brazil. This article examines how socioeconomic transformations, and the complexity of health services, are expressed in the regions established for planning purposes and the inter-governmental management of the Brazilian Unified Health System. An effort was made to identify and explain differences in the compositions of the 438 existing health regions and their spatial distribution by comparing situations observed in 2016 with those in 2000. Factor analysis and grouping techniques were used to construct a typology in the two years of the series, which was based on a diverse set of secondary data sources. It was found that there was an evolution in terms of income levels and service provision within the health regions, with a significant improvement in the socioeconomic conditions of the population. These results suggest that there was a positive impact from the combination of strategies related to social, economic and regional policies for the promotion of development, which generated more widespread well-being within the affected areas. However, limitations remain regarding the policies implemented for the universalization of the health system.
Dysphasia Caused By Cervical Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic enthesopathy with involvement of ossification of anterior longitudinal ligament (OALL). Although DISH is usually associated with benign nature, cervical large OALL should be considered as a consideration in differential diagnosis of dysphasia. A 73 yearold-man presented with dysphasia and his radiographs showed massive OALL at C4/5. A filling defect was confirmed at the same level by video fluoroscopy. Followed by failure of conservative treatment, surgical treatment of symptomatic OALL due to DISH was performed. Satisfactory recovery of swallowing was obtained without radiographic recurrence of OALL one year after surgery.
THERAPEUTIC CONTROVERSY The Use of Radioactive Iodine in Patients with Papillary and Follicular Thyroid Cancer

ENERAL aspects of the diagnosis and management ofdifferentiated thyroid carcinoma (DTC) have been re-viewed recently (1) and guidelines for management pro-posed (2). Yet controversy continues to plague our ability todevelop specific evidence-based practice guidelines for is-sues related to initial radioiodine ablation and subsequent
Use of hapten combined cytotoxic drugs for enhancing therapeutic effect in advanced stages of pancreatic cancer

Aim: To evaluate the clinical effectiveness of double cytotoxic drugs enhanced chemo immunotherapy in the treatment of advanced pancreatic cancer compared to single cytotoxic drugs by ultra-minimum incision personalized intra-tumoral chemo immunotherapy (UMIPIC-Therapy). Method: In study of UMIPIC with double drugs, 41 patients of pancreatic cancer were randomly divided into UMIPIC and ITCT groups, UMIPIC-D (n=30) treated with a proprietary therapeutic regimens including two cytotoxic drugs (Cytosine Arabinoside: Ara-C and Bleomycin: BLM) plus an oxidant and hapten, and ITCT-D (n=11) treated with same regimens intra-tumoral without the hapten. In UMIPIC with single drug, 45 patients of pancreatic cancer were randomly divided into two groups. UMIPIC-S (n=25) treated with a proprietary therapeutic regimens, it is composed of three intra-tumoral injections of a compound with an oxidant, a cytotoxic drug (Ara-C) and hapten. ITCT-S (n=20) uses an oxidant and a cytotoxic drug (Ara-C) without hapten. Both UMIPIC and ITCT use the same clinical therapeutic procedure. Results: For single drug, median survival was 6.45 months for UMIPIC-S vs 4.98 months for ITCT-S, (P<0.05), one year survival rate was 28% for UMIPIC-S vs 5% for ITCT-S (P<0.05). For double drugs, median survival was 15.5 months for UMIPIC-D vs 3 months in ITCT-D (P<0.01). The 6-month survival rate was 76.67% for UMIPIC-D vs 18.18% for ITCT-D (P<0.01) and 1-year survival rate for 56.67% UMIPIC-D vs 9.09% ITCT (P<0.01). Conclusion: UMIPIC for pancreatic cancer is a non-invasive and potentially effective therapy, and double cytotoxic drugs applied in the UMPIC-D revealed a significant advantage in prolonging the survival time.
Coexistence of Pulmonary tuberculosis and lung cancer

Pulmonary Tuberculosis can co-exist with lung malignancy masking the underlying disorder leading to delay in diagnosis and management. Here we present an interesting case of a 72 year old female who on initial presentation was diagnosed with tuberculosis but later developed plural effusion during treatment and on investigation was found to have an underlying lung malignancy.Introduction: Pulmonary Tuberculosis and lung carcinoma are the two co morbidities that have been shown in many studies to coexist. Many of Signs and symptoms of Pulmonary Tuberculosis mimics lung carcinoma and coexistence increases mortality and morbidity. So we are presenting a case which had pulmonary Tuberculosis and later developed carcinoma lung.
Clinical and Laboratory Evaluation of the Physical Properties of Two Light Cured Fissure Sealants

Materials and methods: Helioseal and Delton Opaque fissure sealants were applied to pairs of contralateral mandibular second premolar teeth. Optically clear epoxy resin replicas were produced which were sequentially located and mounted within a defined plane. The replicas were transilluminated from below with diffused light, examined with a microscope and digital images captured. This allowed the entire fissure sealant peripheral border to be clearly identified and mapped. Categorized mapped areas were measured.
A link between osteomyelitis and IL1RN and IL1B polymorphisms—a study in patients from Northeast Brazil

Background and purpose — Treatment failure of osteomyelitis can result from genetic susceptibility, highlighting polymorphisms of the interleukin-1 (IL-1) family members, central mediators of innate immunity and inflammation. Polymorphisms are DNA sequence variations that are common in the population (1% or more) and represent multiple forms of a single gene. We investigated the association of IL1RNVNTR (rs2234663) and IL1B-511C > T (rs16944) polymorphisms with osteomyelitis development in patients operated on because of bone trauma. Patients and methods — 153 patients who fulfilled the inclusion criteria were enrolled from a referral public hospital for trauma. All the patients were followed up daily until hospital discharge and, after this, on an outpatient basis. Patients were treated with prophylactic antimicrobials and surgery according to traumatology service protocol. The IL1RNVNTR and the IL1B-511C > T polymorphisms were determined by PCR and PCR-RFLP, respectively. Results — The IL1RN*2/*2 genotype was associated (OR: 7; p < 0.001) with a higher risk of osteomyelitis and was also significantly associated with Staphylococcus aureus infection. The haplotypes (combination of different markers) *2-C and *2-T were also associated with osteomyelitis development. Interpretation — IL1B-511C > T and IL1RNVNTR polymorphisms were associated with osteomyelitis development, which may have implications for patients with bone traumas. These data may be relevant for new therapeutic strategies for this disease.
Expression of Metabolic Syndrome in Women with Severe Obesity.

BACKGROUND The prevalence of metabolic syndrome (MetS) generally rises with increasing adiposity, but tends to plateau at the highest levels of body mass index (BMI) with some individuals, even with severe obesity, expressing few or no components of MetS. We examined factors associated with the expression of MetS in severely obese women participating in a large observational study. METHODS Anthropometrics, including Heath equation-adjusted bioimpedance-determined fat-free mass (FFM) and fat mass (FM), lipids and related laboratory measurements, resting energy expenditure (REE), and respiratory quotient (RQ), were studied in 949 women with severe obesity. RESULTS Even though the mean BMI was 45.7 kg/m2 and all participants met MetS criteria for increased waist circumference, 30% of subjects did not have MetS. Unadjusted FM (P = 0.0011), FFM (P < 0.0001), and REE (P < 0.0001) were greater in the women with MetS. Surprisingly, in multivariate logistic regression FFM was positively associated with MetS (P = 0.0002), while FM was not (P = 0.89). Moreover, FFM, not FM, was significantly associated with all five components of MetS except for triglyceride levels. REE and RQ were higher in those with MetS, and REE was strongly associated with multiple components of MetS. CONCLUSIONS In women with severe obesity, higher FFM and REE were paradoxically associated with increased rather than decreased risk of MetS, while FFM-adjusted FM was unrelated to MetS.
Pathology Predictors of Response to Combined Therapy of Chronic HCV Patients; is it applicable in the DAA era?

1.1. Introduction & aim: Liver biopsy has been considered the ''gold standard'' of diagnosis, the most direct way of visualizing the necroinflammatory and architectural status of liver in HCV patients planned for therapy. We aimed to study the relation between pathological findings in liver biopsy and their impacts on sustained virological response (SVR) in HCV patients receiving pegylated interferon and ribavirin (Peg/Riba). 1.2. Methods: A retrospective analysis on data collected from 1486 HCV patients receiving Peg/Riba between May 2012 and May 2013 at the National Hepatology and Tropical Medicine Research Institute (NHTMRI). Initial labs before treatment including percutaneous liver biopsy were analyzed in relation to virological response. 1.3. Results: 982 (66.1%) of patients were males and 504 (33.9%) were females. The mean age was (43.72± 9.527y), with 1008 (67.8%) more than 40 years. Higher SVR achieved in patients with no or mild steatosis than moderate to severe degrees (96% vs 4%, p: 0.001). More than 60% of patients with no or mild fibrosis showed SVR (p: 0.04). Patients with mild activity showed much higher SVR than patients with severe or advanced activity (67.1% vs 32.9%, p: 0.001). Negative viral load at w12 was significantly higher in patients with no or mild fibrosis (96.7% vs 94.9%, p: 0.004), no or mild steatosis (95.7% vs 94%, p: 0.024), but was not related to activity (95.8% vs 95.7%, p: 0.869). 1.4. Conclusion: Steatosis, fibrosis and activity affected treatment outcome and could directly affect treatment decision. The response rate of peginterferon alpha 2a was comparable to alpha 2b. These findings are important to decide antiviral course in patients with multiple DAA RAVs leading to failure.