Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment of neonatal progressive ventricular dilatation: a single-centre experience

Abstract Objective: To describe our experience with a cohort of 295 infants with progressive ventricular dilatation occurring in the antenatal or neonatal period. Methods: A search was performed in our cranial ultrasound database. All records and images of infants in whom an imaging diagnosis of progressive ventricular dilatation had been made were retrieved. In addition, modes of treatment were analysed. Results: Between February 1991 and March 2012, 295 neonates were admitted to our level 3 neonatal intensive care unit (NICU), and developed progressive ventricular dilatation for which they required intervention. In the majority of these infants, progressive ventricular dilatation developed following IVH grade III or IV (240/295; 81%) of whom 214/240 (89%) were preterms. Temporary treatment with lumbar punctures and punctures from ventricular reservoirs was sufficient for the majority of the preterms. A ventricular reservoir was inserted in 216/295 infants (73%). The overall infection rate was low (6%). A ventriculoperitoneal shunt (VP shunt) was inserted in 32% of the whole cohort, revision within 3 months was necessary in 20%, and shunt-related infection occurred in 12%. Conclusions: This large, single-centre cohort study reports the management of progressive ventricular dilatation in newborn infants. We have shown that with our approach, complications stay within acceptable limits.
Factorization of the feed efficiency of paraboloids and Cassegrain antennas

The first approximation to the aperture efficiency of a paraboloidal reflector antenna is called the feed efficiency. The factorization of the feed efficiency into subefficiencies which account for losses due to spillover, cross polarization, nonuniform aperture illumination, and phase errors is considered. The relations between the radiation patterns of circularly and linearly polarized feeds are also derived.
Placenta accreta and maternal morbidity in the Republic of Ireland, 2005–2010

Abstract Objective: To describe the nationwide prevalence of placenta accreta and to quantify its impact on maternal morbidity. Methods: Using discharge data for public hospitals in Ireland, years 2005–2010, deliveries with placenta accreta were identified using ICD-10-AM code for morbidly adherent placenta and compared with deliveries without the condition. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression. Results: Placenta accreta prevalence increased 34% from 2005 to 2010 (7.9/10 000 deliveries versus 10.6/10 000 deliveries). This condition was associated with a substantial increased risk of hemorrhage (aOR: 16.6, 95% CI: 13.4–20.5), hysterectomy (aOR: 950.6, 95% CI: 632.9–1427.9), procedures to reduce uterine blood flow (aOR: 72.4, 95% CI: 35.1–149.4), transfusion (aOR: 41.8, 95% CI: 33.4–52.2), anemia (aOR 15.1, 95% CI: 10.8–21.0), abdominal organ injury (aOR: 8.2, 95% CI: 5.2–13.1), bladder surgery (aOR: 38.5, 95% CI: 21.8–68.1), mechanical ventilation (aOR: 63.2, 95% CI: 28.4–140.6), intensive care unit admission (aOR: 41.3, 95% CI: 30.0–56.9), and co-existing placenta previa (aOR: 23.2, 95% CI: 16.8–31.8) as well as increased risk of cesarean section, longer hospitalization and stillbirth. Conclusions: To our knowledge, this is the first study to use a comparison group of deliveries without placenta accreta and quantitatively illustrate with odds ratios the profound adverse health effects of this condition on the mother.
The diagnostic performance of the Mass Restricted (MR) score in the identification of microbial invasion of the amniotic cavity or intra-amniotic inflammation is not superior to amniotic fluid interleukin-6

Abstract Objective: Intra-amniotic infection/inflammation are major causes of spontaneous preterm labor and delivery. However, diagnosis of intra-amniotic infection is challenging because most are subclinical and amniotic fluid (AF) cultures take several days before results are available. Several tests have been proposed for the rapid diagnosis of microbial invasion of the amniotic cavity (MIAC) or intra-amniotic inflammation. The aim of this study was to examine the diagnostic performance of the AF Mass Restricted (MR) score in comparison with interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8) for the identification of MIAC or inflammation. Methods: AF samples were collected from patients with singleton gestations and symptoms of preterm labor (n = 100). Intra-amniotic inflammation was defined as >100 white blood cells/mm3 (WBCs) in AF; MIAC was defined as a positive AF culture. AF IL-6 and MMP-8 were determined using ELISA. The MR score was obtained using the Surface-Enhanced Laser Desorption Ionization Time of Flight (SELDI-TOF) mass spectrometry. Sensitivity and specificity were calculated and logistic regression models were fit to construct receiver-operating characteristic (ROC) curves for the identification of each outcome. The McNemar’s test and paired sample non-parametric statistical techniques were used to test for differences in diagnostic performance metrics. Results: (1) The prevalence of MIAC and intra-amniotic inflammation was 34% (34/100) and 40% (40/100), respectively; (2) there were no significant differences in sensitivity of the three tests under study (MR score, IL-6 or MMP-8) in the identification of either MIAC or intra-amniotic inflammation (using the following cutoffs: MR score >2, IL-6 >11.4 ng/mL, and MMP-8 >23 ng/mL); (3) there was no significant difference in the sensitivity among the three tests for the same outcomes when the false positive rate was fixed at 15%; (4) the specificity for IL-6 was not significantly different from that of the MR score in identifying either MIAC or intra-amniotic inflammation when using previously reported thresholds; and (5) there were no significant differences in the area under the ROC curve when comparing the MR score, IL-6 or MMP-8 in the identification of these outcomes. Conclusions: IL-6 and the MR score have equivalent diagnostic performance in the identification of MIAC or intra-amniotic inflammation. Selection from among these three tests (MR score, IL-6 and MMP-8) for diagnostic purposes should be based on factors such as availability, reproducibility, and cost. The MR score requires a protein chip and a SELDI-TOF instrument which are not widely available or considered “state of the art”. In contrast, immunoassays for IL-6 can be performed in the majority of clinical laboratories.
Prevalence of self-reported hip disorders, relations to age, gender, pain, stiffness, weakness and other joint disorders

The objective was to estimate the prevalence and characteristics of self-reported hip disorders in an adult population-based sample from the general population in two defined primary healthcare districts in the south of Sweden. We used a population-based survey using a mailed questionnaire on a random sample of 2600 individuals aged 38–77 years. After two written reminders, the response rate was 86%. The prevalence of reported hip disorders was 32% and increased with age from 18% among males 38–47 years to 42% among females 48–67 years. Among the individuals reporting hip disorders (n=692), 86% experienced pain, 32% stiffness and 20% weakness, and 58% had consulted medical care for their hip disorders; 92% of the individuals with reported hip disorders also reported disorders in other joints. Females reported disorders from finger joints, ankle/toe, low back and neck significantly more often compared with males. Disorders related to the hip region are common in a population-based sample. Individuals reporting hip symptoms frequently have symptoms in other joints. Pain was the most common symptom and females more frequently than males reported symptoms from other joints. Future studies of the cohort will investigate the relationships between self-reported hip disorders and clinical symptoms of early-stage hip disease.
An objective comparison of novice trainees learning LESS versus traditional laparoscopy with the use of a pelvic trainer

Objectives To compare the differences between LESS and SL among a population of subjects inexperienced of both techniques. Materials and Methods Participants were randomly assigned to the LESS or SL arm of the course; between the population examined, none had previous laparoscopic experience. The trial consisted in performing three increasingly difficult exercises either with LESS or standard laparoscopy. Results Time of execution and Objective Structured Assessment of Technical Skills score (OSATS) were recorded. Statistical analysis failed to detect any significant difference between the two arms of the trial. A trend in favor of standard laparoscopy was observed anyway. Discussion Our study evaluates the technical performance on a surgical simulator in the laboratory setting, with the use of standardized tasks and validated metrics. We believe that a controlled and safe environment aids objective evaluation of LESS compared to SL. Literature on this particular topic is somehow conflicting and heterogeneous. Our trial demonstrated that novices performed LESS tasks without any additional difficulties compared to standard laparoscopy. The aim of such investigation is to support knowledge of this new technology in order to facilitate its use in selected patients and surgical procedures.
Perinatal outcome of pregnancies following in vitro fertilization and ovulation induction

Abstract Objective: To investigate pregnancy outcome in patient who conceived by assisted reproductive techniques. Methods: A retrospective population-based study was conducted, comparing obstetrical complications and neonatal outcomes of singleton pregnancies conceived by in vitro fertilization (IVF; n = 1296) and ovulation induction (n = 1988) as compared to singleton pregnancies conceived spontaneously (n = 172 288). Multivariable models were constructed to control for confounders. Results: A significant linear association (using the chi-square test for trends) was documented among the three groups in adverse outcomes such as gestational diabetes mellitus (17.3% in the IVF, 14.2% in the ovulation induction, 6.6% in the comparison group, p < 0.001), severe preeclampsia (2.7% in the IVF, 1.8% in the ovulation induction, 1.1% in the comparison group, p < 0.001) and perinatal mortality (3.3% in the IVF, 2.1% in the ovulation induction, 1.3% in the comparison group, p < 0.001). In vitro fertilization and ovulation induction treatments were found to be independent risk factors for gestational diabetes mellitus, using two different multiple logistic regression models controlling for confounders such as maternal age (adjusted OR = 1.77, 95% CI:1.52–2.07, p < 0.001 and adjusted OR = 1.93, 95% CI:1.69–2.21, p < 0.001; respectively). Conclusions: Pregnancies conceiving following assisted reproductive techniques are at an increased risk for adverse obstetrics outcomes. The risk is higher for pregnancies following IVF compared with these conceived following ovulation induction.
Customized weight curves for Spanish fetuses and newborns

Abstract Objectives: To construct a model of customized birthweight curves for use in a Spanish population. Materials and methods: Data of 20 331 newborns were used to construct a customized birthweight model. Multiple regression analysis was performed with newborn weight as the dependent variable and gestational age (GA), sex and maternal (M) weight, height, parity and ethnic origin as the independent variables. Using the new model, 27 507 newborns were classified as adequate for GA (AGA), large for GA (LGA) or small for GA (SGA). The results were compared with those of other customized and non-customized models. Results: The resulting formula for the calculation of optimal neonatal weight was: Optimum weight (g) = 3289.681 + 135.413*GA40–14.063*GA402–0.838*GA403 + 113.889 (if multiparous) + 165.560 (if origin = Asia) + 161.550 (South America) + 67.927 (rest of Europe) +109.265 (North Africa) + 9.392*Maternal-Height + 4.856*Maternal-Weight–0.098*Maternal-Weight2 + 0.001*Maternal-Weight3 + 67.188*Sex + GA40*(6.890*Sex + 9.032 (If multiparous) +0.006*Maternal-Height3 + 0.260*Maternal-Weight) + GA402 (−0.378*Maternal-Height – 0.008*Maternal-Height2) + GA403 (−0.032*Maternal-Height). Weight percentiles were obtained from standard data using optimum weight variation coefficient. Agreement between our customized model and other Spanish models was “good” (κ = 0.717 and κ = 0.736; p < 0.001). Conclusions: Our model is comparable to other Spanish models, but offers the advantage of being customized, updated and freely available on the web. The 30.6% of infants classified as SGA using our model would be considered as AGA following a non-customized model.
Decision-to-delivery interval in suspected placental abruption – association with pregnancy outcome

Abstract Objective: To determine the association between decision to delivery interval (DDI) and short-term perinatal outcome in cases of suspected placental abruption delivered by cesarean section (CS). Study design: A retrospective cohort study of all cases of placental abruption delivered by CS (2010–2012) in a single university affiliated tertiary center. Composite adverse neonatal and maternal outcome were assessed. Results: The rate of placental abruption was 0.5% (140/27 677 deliveries) and 65/140 (46%) were delivered by CS. Indications for CS were non-reassuring fetal heart rate (NRFHR) in 32/65 (49.3%), maternal bleeding 20/65 (30.7%) and other indications in 13/65 (20%). Obstetrical and labor characteristics were similar unrelated to the indication for CS. Gestational age at delivery was higher in the group operated due to NRFHR (36 ± 4.3, 34 ± 3.7 and 32 ± 4.1 weeks, respectively, p = 0.03). DDI was shortest when CS was due to NRFHR followed by CS due to maternal bleeding or other indications (23 ± 19, 30 ± 16, 50 ± 40 min, respectively, p = 0.001). The umbilical artery PH was lower in those who operated due to NRFHR (7.17 ± 0.17, 7.23 ± 0.06 and 7.30 ± 0.09, respectively, p = 0.002). The overall rate of neonatal and maternal composite outcome was 66% and 40%, respectively with no significant difference in relation to indication for CS. Conclusion: In cases of suspected placental abruption, fetal short-term morbidity is probably related to the indication for CS and not only to DDI.
Haptoglobin phenotype and abnormal uterine artery Doppler in a racially diverse cohort

Abstract Objective: The anti-oxidant and proangiogenic protein haptoglobin (Hp) is believed to be important for implantation and pregnancy, although its specific role is not known. The three phenotypes (1-1, 2-1 and 2-2) differ in structure and function. Hp 2-2 is associated with increased vascular stiffness in other populations. We examined whether Hp phenotype is associated with abnormal uterine artery Doppler (UAD) in pregnancy. Methods: We conducted a secondary analysis of a preeclampsia prediction cohort nested within a larger placebo-controlled randomized clinical trial of antioxidants for prevention of preeclampsia. We determined Hp phenotype in 2184 women who completed UAD assessments at 17 weeks gestation. Women with notching were re-evaluated for persistent notching at 24 weeks’ gestation. Logistic regression was used to assess differences in UAD indices between phenotype groups. Results: Hp phenotype did not significantly influence the odds of having any notch (p = 0.32), bilateral notches (p = 0.72), or a resistance index (p = 0.28) or pulsatility index (p = 0.67) above the 90th percentile at 17 weeks’ gestation. Hp phenotype also did not influence the odds of persistent notching at 24 weeks (p = 0.25). Conclusions: Hp phenotype is not associated with abnormal UAD at 17 weeks’ gestation or with persistent notching at 24 weeks.
A random protein–creatinine ratio accurately predicts baseline proteinuria in early pregnancy

Abstract Objective: Data surrounding the use of a random urine protein:creatinine ratio (PCR) in the diagnosis of preeclampsia is conflicting. We sought to determine whether PCR in early pregnancy can replace the 24-hour urine collection as the primary screening test in patients at risk for baseline proteinuria. Methods: Women requiring a baseline evaluation for proteinuria supplied a urine sample the morning after their 24-hour collection. The PCR was analyzed as a predictor of significant proteinuria (≥150 mg). A regression equation to estimate the 24-hour protein value from the PCR was then developed. Results: Sixty of 135 subjects enrolled completed the study. The median 24-hour urine protein and PCR were 90 mg (IQR: 50–145) and 0.063 (IQR: 0.039–0.083), respectively. Fifteen patients (25%) had significant proteinuria. PCR was strongly correlated with the 24-hour protein value (r = 0.99, p < 0.001) and highly predictive of significant proteinuria (AUC = 0.86). A PCR cut-point of 0.079 yielded a sensitivity of 93.3% and a specificity of 57.8%. The resulting regression equation [total protein = 46.5 + 904.2*PCR] accurately estimates the actual 24-hour protein (95% CI: ±88 mg). Conclusion: A random urine PCR accurately estimates the 24-hour protein excretion in the first half of pregnancy and can be used as the primary screening test for baseline proteinuria in at-risk patients.
Resumption Of Postpartum Fecundability In Rural Guatemala: A Multistate Approach

The purpose of this paper is to investigate and re-estimate the effects of breastfeeding patterns, women's nutritional and health status, and energy expenditure on the timing of resumption of postpartum fecundability (i.e. resumption of postpartum menses) using all the relevant information in the Instituto de Nutricion de Centroamerica y Panama longitudinal study and a more adequate estimation procedure (hazard models). The data used in this study come from a Longitudinal Study carried out in Guatemala between 1967 and 1979. In this article we use a multi-state hazard model that recognizes different pathways and states in the process of returning to the postpartum fecundability. The model relies on the existence of five states (fully breastfeeding, partial breastfeeding, weaning, infant mortality and menses). It also includes explicitly maternal nutrition and women's energy expenditure as strategic elements of the model. The study shows that the estimated effects of breastfeeding patterns, maternal nutrition and women's work patterns (energy expenditure) on resumption of fecundability in rural Guatemala are strong and significant. The contribution of this paper is to show that application of hazard models with multiple states provides estimates that are consistent with hypotheses relating lactation patterns, maternal nutritional status and maternal external stressors to processes that accelerate (decelerate) resumption of normal menstrual cycles.
Do Incoming First-Year College Students Who Think of Themselves as Adults Drink More Responsibly After Starting College?

First-year college students are at particular risk for problem drinking, especially around the time when they first begin college. The purpose of this study was to examine whether self-perception of adulthood (SPOA) was prospectively associated with drinking behaviors, the use of different types of protective behavioral strategies (PBS), and negative alcohol-related consequences in a large sample of incoming first-year college students. Participants were a national sample of 8,230 entering first-year college students required to complete a web-based alcohol education program that included a baseline survey prior to the start of the fall term and a follow-up survey one month later, after classes had started. Relevant measures included SPOA, drinking behaviors, use of PBS, and negative alcohol-related consequences. Results indicated that SPOA negatively predicted peak blood alcohol concentration (BAC) and number of heavy drinking episodes while positively predicting PBS. Implications for interventions and future research are discussed.
Do written education materials that use content and design principles improve older people's knowledge?

Background/Aim: Information may inform and empower clients to engage in their health care. Information can be provided in written form, but it is only effective if it can be read and understood by clients. This study examined whether the knowledge acquisition of participants aged 65 years and older improved more after reading leaflets revised according to content and design principles compared to the leaflets in their original form. Methods: Seven participant pairs (mean age was 74 years, 79% were women), matched according to reading ability, read either the original or the revised versions of four leaflets used by occupational therapists with older clients. Knowledge before and after reading the leaflets was measured using true/false tests developed for each leaflet. Results: After adjusting for differences in baseline knowledge scores, participants who read the revised leaflets acquired 55.3% more knowledge than those who read the original leaflets. All but one participant preferred the revised versions of the leaflets. Conclusions: Simply written and clearly presented written education materials may improve clients' understanding of the content. Further research is needed to determine if one or a combination of the content and design principles used to revise the leaflets is effective in increasing clients' knowledge.
A novel finasteride 0.25% topical solution for androgenetic alopecia: pharmacokinetics and effects on plasma androgen levels in healthy male volunteers.

OBJECTIVE Finasteride, a selective inhibitor of type 2 5-α reductase isoenzyme, inhibits the conversion of testosterone to dihydrotestosterone (DHT) and is indicated in the treatment of male androgenetic alopecia. The study objective was to evaluate a newly developed finasteride 0.25% topical solution in comparison to the marketed finasteride 1 mg tablet, with respect to finasteride pharmacokinetics and suppressive effects on plasma DHT. METHODS 24 healthy men with androgenetic alopecia were randomized in a single center, open-label, parallel-group, exploratory study, and received either multiple scalp applications of the topical solution b.i. d. or oral doses of the reference tablet o.d. for 7 days. Plasma finasteride, testosterone and DHT concentrations were determined. RESULTS After multiple doses, mean (± SD) finasteride C(max) and AUC(0-t) corresponded to 0.46 ± 0.28 ng/mL and 6.64 ± 7.50 ng/mL x h for the topical solution and to 6.86 ± 1.78 ng/mL and 57.93 ± 29.38 ng/mL x h for the tablet. Plasma DHT was reduced by ~ 68 - 75% with the topical solution and by ~ 62 - 72% with the tablet. No relevant changes occurred for plasma testosterone with either treatment. No clinically significant adverse events occurred. CONCLUSIONS A strong and similar inhibition of plasma DHT was found after 1 week of treatment with the topical and tablet finasteride ormulations, albeit finasteride plasma exposure was significantly lower with the topical than with the oral product (p < 0.0001).
Idiopathic Toe Walking

&NA; Toe walking is a bilateral gait abnormality in which a normal heel strike is absent and most weight bearing occurs through the forefoot. This abnormality may not be pathologic in patients aged <2 years, but it is a common reason for referral to an orthopaedic surgeon. Toe walking can be caused by several neurologic and developmental abnormalities and may be the first sign of a global developmental problem. Cases that lack a definitive etiology are categorized as idiopathic. A detailed history, with careful documentation of the developmental history, and a thorough physical examination are required in the child with a primary report of toe walking. Treatment is based on age and the severity of the abnormality. Management includes observation, stretching, casting, bracing, chemodenervation, and surgical lengthening of the gastrocnemius‐soleus complex and/or Achilles tendon. An understanding of idiopathic toe walking as well as treatment options and their outcomes can help the physician individualize treatment to achieve optimal results.