Miracle-dz/UniFAR-FTUs huggingface dataset:
Metabolic syndrome profiles, obesity measures and intake of dietary fatty acids in adults: Tehran Lipid and Glucose Study.

BACKGROUND To determine the association between fatty acid intake and the prevalence of risk factors for the metabolic syndrome. METHODS In this population-based cross-sectional study, a sample of 2750 Tehranian subjects (44% men and 56% women) aged 20-74 years, who completed a validated food frequency questionnaire, was studied. The metabolic syndrome (MetS) was defined in accordance with the modified guidelines of the National Cholesterol Education Program Adults Treatment Panel III, and waist circumference was coded according to the newly-introduced cut-off points for Iranian adults (≥95 cm for both sexes). Metabolic risk factors across quartile categories of each type of dietary fat [total fat intake, total poly-unsaturated fatty acid (PUFA) intake, total MUFA intake, total saturated fatty acid (SFA) intake expressed as percentage of energy and quartiles of the ratio of polyunsaturated fat to saturated fat (P : S)] were compared. RESULTS The mean (SD) ages of participants were 40.8 (14.6) and 38.6 (12.9) years, respectively, for men and women. The mean contribution of fat to energy intake was approximately 26% in men and women. A positive trend over successive quartiles of SFA intake with low-density lipoprotein-cholesterol (LDL-C) and triglyceride, as well as P/S ratio intake with high-density lipoprotein-cholesterol (HDL-C), was found. An inverse association between HDL-C with SFA and PUFA intake and a positive association with MUFA and the P/S ratio was found. A significant association of fatty acid consumption and risk of the MetS in this population was observed, except for total PUFA intake. CONCLUSIONS Special dietary fatty acids are associated with metabolic risk factors among the Iranian population. Because of the high prevalence of cardiovascular disease and MetS, national nutrition policies must be developed accordingly for the modification of dietary fatty acid intake with respect to causation and prevention.
Israeli Mental Health Professionals' Attitudes Towards Dissociative Disorders, Reported Incidence and Alternative Diagnoses Considered

Abstract Clinical diagnoses of dissociative disorders (DDs), including Dissociative Identity Disorder (DID), are controversial because there are mental health professionals in North America and elsewhere who are skeptical about whether these psychiatric disorders actually exist. This paper explores the attitudes of mental health professionals in Israel toward DDs and DID through a survey of 211 practicing clinicians (return rate of 39.5%). Of the sample, 95.5% scored at or above the point on a 5-point Likert scale measuring belief in the validity of DDs (m = 4.17, SD = 0.78); 84.5% declared at least a moderate belief in the validity of DID (M = 3.5, S.D. = 0.97). The average Israeli clinician surveyed had made 4.8 career-long DD diagnoses (S.D. = 18.06) and carried an average of 1.05 DD patients in his/her caseload (S.D. = 2.86). DID had a career-long diagnosis frequency of 0.14 patients per clinician (S.D. = 0.59) and was currently seen at a frequency of 0.03 cases per clinician (S.D. = 0.20). The five most frequently considered alternative diagnoses to DID in Israel were Borderline Personality Disorder (24%), Psychotic Disorder/Schizophrenia (23%), PTSD/Anxiety Disorder (10%), Malingering (8%) and Depressive Disorder (7%). The findings suggest that attitudes of Israeli clinicians are similar to those of North American clinicians despite the geographical and cultural differences between them.
Comparison of Gastric Cancer Survival Following R0 Resection in the United States and Korea Using an Internationally Validated Nomogram

Objective:To compare disease-specific survival (DSS) between the US and Korea following R0 resection for gastric carcinoma (GC). Summary Background Data:Many studies have described decreased 5-year survival after curative gastrectomy for GC in the West compared with the East. Although clinicopathological presentations of GC are known to vary widely between Eastern and Western countries, including histology, tumor location, and stage at presentation, it remains unclear whether these factors account for differences in survival. Methods:All patients undergoing curative intent resections (R0) for GC (1995–2005) were evaluated in 2 independent, single-institution prospectively maintained databases from the US (711 patients) and Korea (1646 patients). Patients receiving neoadjuvant chemotherapy were excluded from this analysis. Patient, surgical and pathologic variables were compared. DSS was determined via multivariate analysis using prognostic variables from an internationally validated GC nomogram that estimates the probability of 5- and 9-year survival. Results:Age and body mass index were significantly higher in US patients. Location of tumors was more often proximal in the United States (39% vs. 9%, P < 0.0001) and distal in Korea (54% vs. 33%, P < 0.0001). Korean patients had more early stage tumors (42% vs. 28% stage Ia, P < 0.0001) with a higher number of lymph nodes identified (97% vs. 79%, ≥15 lymph nodes, P < 0.0001). The 5-year DSS was higher in Korea than in the United States. After multivariate analysis, applying factors used in the nomogram, DSS of Korean GC patients remained significantly better than that of US patients (HR = 1.3, 95% CI; 1.0–1.6, P = 0.008). Conclusions:This study demonstrates better survival for GC patients in Korea compared with the US as determined by multivariate analysis with a validated gastric cancer nomogram. Multiple possibilities can explain this difference.
Caracterização dos problemas relacionados aos pés de idosos de uma comunidade em município do interior do Estado de São Paulo

Problems with the feet of the elderly, though frequent, are poorly recognized and valued as a condition that requires proper care. This study aimed to determine the characteristics of the problems with the feet of community elderly. This is a descriptive study on 50 elderly belonging to the catchment area of a Family Health Unit. An instrument that assesses general health and specific conditions related to foot was applied. It was found that most were female and belonged to socioeconomic classes considered poor and very poor. The most frequent health problems were decreased visual acuity, hypertension and pain in different body regions. In the evaluation of the feet, they find themselves with alterations in the wrists; long, thick and deformed nails; dry skin and hyperkeratosis; reduced pain and vibratory sensitivity. Furthermore, 70% of seniors reported that foot pain limited daily activities. It appeared that such situations, even if it is a specific condition, reveal the intensity of the problems involving this population and the importance of further attention, which requires investment in training of health professionals and the development of interdisciplinary actions with new perspectives and assumptions of care, focusing on health promotion.
The Effect of Preexisting Conditions on Hospital Quality Measurement for Injured Patients

Objective:To determine whether adjusting for comorbidities significantly affects hospital quality measurement compared with adjusting for injury severity alone. Background:Pre-existing conditions have a significant impact on mortality after injury. The impact of including comorbidities on hospital quality measurement is not well understood. Methods:Retrospective cohort study using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (2005–2006). The Trauma Mortality Probability Model (TMPM-ICD9) was re-estimated with and without the addition of the comorbidity measures in the Agency for Health Research and Quality comorbidity algorithm. Hospital quality was measured using an adjusted odds ratio (OR) obtained using hierarchical logistic regression modeling. The OR quantifies the likelihood that trauma patients treated at a specific hospital are more or less likely to die compared with patients treated at an average hospital. Hospitals with an adjusted OR significantly greater than, or less than 1 were classified as low-quality or high-quality outliers, respectively. Pairwise comparison of hospital quality based on TMPM-ICD9 with and without comorbidity information were performed using the intraclass correlation coefficient, the Spearman correlation coefficient, the Bland-Altman Plot, and the kappa statistic. Results:There was nearly perfect agreement between hospital ranking based on TMPM-ICD9 and TMPM-ICD9 with comorbidities. The intraclass correlation coefficient was 0.943 (95% CI, 0.931–0.951), the Spearman correlation coefficient was 0.953 (95% CI, 0.944–0.960), and the kappa statistic was 0.863 (95% CI, 0.792–0.934). The odds of a patient dying in the worst 5% hospitals was 1.73 (95% CI, 1.61–1.86), whereas the odds of a patient dying in the best 5% of the hospitals was 0.37 (95% CI, 0.31–0.44). Conclusion:In this large study of 148,280 trauma patients in 511 hospitals, we found no evidence that adding comorbidites to the risk-adjustment model used to benchmark hospital performance changes hospital ranking. In addition, there appears to be significant variability in mortality outcomes between the best and worst performing hospitals. This difference in outcomes across hospitals may represent a significant opportunity to improve health outcomes for injured patients.
Serum levels of interleukin 1β, interleukin 8 and tumour necrosis factor α as markers of gastric cancer

Abstract Despite the efforts made, a serum marker reliable for the screening and follow-up of patients with gastric cancer has not yet been identified. The aim of this preliminary study was to test the role of pro-inflammatory cytokines interleukin 1β, interleukin 8 and tumour necrosis factor α in patients with gastric cancer and in control groups. The statistical analysis of cytokines serum levels in the group with gastric cancer versus control groups has shown considerable differences (p<0.001) in their mean rates. The results indicate that the cytokines interleukin 1β, interleukin 8 and tumour necrosis factor α might perhaps act as diagnostic markers in patients with gastric cancer. Therefore, it is hypothesized that after more extended trials, their use in the screening and prognostic assessment of these patients could be a possibility.
Indices of adiposity as predictors of cardiometabolic risk and inflammation in young adults.

BACKGROUND Studies investigating obesity and cardiometabolic risk have focused on 'at-risk' populations and methodological inconsistencies have produced equivocal findings. The present cross-sectional study investigated indices of body composition as predictors of cardiometabolic risk and their relationship with inflammation in apparently healthy young adults. METHODS A fasting blood sample was taken from consenting adults (160 males, 32 females, aged 18-40 years) for assessment of cardiometabolic risk markers (blood pressure, lipid profiles and insulin resistance) and inflammatory markers (C-reactive protein, tumour necrosis factor-α, interleukin-6, interleukin-10 and adiponectin). Together with anthropometry, fat mass (FM) and fat-free mass (FFM) were determined by dual-energy X-ray absorptiometry. FM was expressed in absolute terms (kg), as well as relative to total body weight (%), height [FM index (FMI, kg m(-2) )] and FFM (FM : FFM,%). RESULTS Although anthropometric indices were associated with most cardiometabolic risk markers, the strongest relationship was observed with FMI. Relative to having a low cardiometabolic risk (≤2 markers above clinically relevant cut-offs), each kg m(-2) increase in FMI, increased the likelihood of having an increased cardiometabolic risk by 29% (odds ratio = 1.29; 95% confidence interval = 1.12-1.49). Inflammatory markers were not associated with body composition or cardiometabolic risk. CONCLUSIONS FMI was the strongest predictor of overall cardiometabolic risk but not inflammation per se. However, anthropometric indices, such as body mass index and waist-to-height ratio, remain valuable surrogate measures of adiposity in this group, particularly when risk markers are considered independently.
One-month prophylactic use of OKT3 in cadaver kidney transplant recipients.

Fifty-five recipients of first cadaveric renal allografts were randomly assigned to three treatment groups in order to compare the safety and efficacy of a mouse antihuman T cell monoclonal antibody (OKT3) given prophylactically for a one-month period. This long period of administration was made pos
Risk Factors for Development of Benign Cervical Strictures After Esophagectomy

Objective:To identify independent risk factors for development of benign cervical anastomotic strictures in general and specifically for refractory strictures after esophagectomy in a large series of patients. Summary Background Data:Benign strictures develop frequently when a cervical anastomosis is performed after esophagectomy, causing burdensome symptoms and poor quality of life. Methods:From 1996 to 2006, all patients in the Academic Medical Center prospective database undergoing esophagectomy with a cervical anastomosis were included. Stricture was defined as dysphagia requiring endoscopic dilation of the anastomosis. Prediction of stricture was assessed using uni- and multivariate logistic regression analysis. Evaluation of risk factors was also performed for refractory strictures (>2 times the median number of dilations in all patients with stricture) in a similar fashion. Results:A total of 607 patients underwent potentially curative esophagectomy, with an in-hospital mortality of 2.5%. During follow-up, 253 (41.7%) patients developed a stricture after a median time of 74 days, requiring a median number of 5 dilations. Cardiovascular disease (P = 0.002), gastric tube compared with colonic interposition (P = 0.03), and anastomotic leakage (P = 0.002) were predictive for development of stricture in multivariate analysis. Development of stricture within 90 days after surgery (P = 0.001), chemoradiotherapy (P = 0.02), and anastomotic leakage (P = 0.03) were independent predictors for refractory strictures requiring over 10 dilations. Conclusions:The benign cervical stricture rate after esophagectomy was relatively high. Cardiovascular disease, gastric tube compared with colonic interposition and postoperative anastomotic leakage were independent predictors for development of benign anastomotic stricture. Anastomotic leakage, chemoradiotherapy and early development of stricture were independently associated with the development of refractory strictures, requiring a higher number of dilations. Prevention of anastomotic stricture formation should be focused on prevention of anastomotic leakage.
Signal quality measures for pulse oximetry through waveform morphology analysis

Pulse oximetry has been extensively used to estimate oxygen saturation in blood, a vital physiological parameter commonly used when monitoring a subject's health status. However, accurate estimation of this parameter is difficult to achieve when the fundamental signal from which it is derived, the photoplethysmograph (PPG), is contaminated with noise artifact induced by movement of the subject or the measurement apparatus. This study presents a novel method for automatic rejection of artifact contaminated pulse oximetry waveforms, based on waveform morphology analysis. The performance of the proposed algorithm is compared to a manually annotated gold standard. The creation of the gold standard involved two experts identifying sections of the PPG signal containing good quality PPG pulses and/or noise, in 104 fingertip PPG signals, using a simultaneous electrocardiograph (ECG) signal as a reference signal. The fingertip PPG signals were each 1 min in duration and were acquired from 13 healthy subjects (10 males and 3 females). Each signal contained approximately 20 s of purposely induced artifact noise from a variety of activities involving subject movement. Some unique waveform morphology features were extracted from the PPG signals, which were believed to be correlated with signal quality. A simple decision-tree classifier was employed to arrive at a classification decision, at a pulse-by-pulse resolution, of whether a pulse was of acceptable quality for use or not. The performance of the algorithm was assessed using Cohen's kappa coefficient (κ), sensitivity, specificity and accuracy measures. A mean κ of 0.64 ± 0.22 was obtained, while the mean sensitivity, specificity and accuracy were 89 ± 10%, 77 ± 19% and 83 ± 11%, respectively. Furthermore, a heart rate estimate, extracted from uncontaminated sections of PPG, as identified by the algorithm, was compared with the heart rate derived from an uncontaminated simultaneous ECG signal. The mean error between both heart rate readings was 0.49 ± 0.66 beats per minute (BPM), in comparison to an error value observed without using the artifact detection algorithm of 7.23 ± 5.78 BPM. These results demonstrate that automated identification of signal artifact in the PPG signal through waveform morphology analysis is achievable. In addition, a clear improvement in the accuracy of the derived heart rate is also evident when such methods are employed.
Loss-of-Function Mutations in the IL-21 Receptor Gene Cause a Primary Immunodeficiency Syndrome

D Kotlarz, N Zietara, G Uzel. J Exp Med. 2013;210(3):433–443 This report of 2 unrelated kindreds with newly recognized mutations in the inteleukin-21 receptor gene (IL-21R) highlights the molecular basis and phenotype of a new form of immunodeficiency. Two sets of kindreds were studied. The first set included a 4-year-old boy and a 10-year-old sister born from consanguineous Lebanese parents with phenotypes characterized by recurrent respiratory infections and chronic cryptosporidial gastrointestinal infection and associated chronic cholangitis, biliary fibrosis, and cirrhosis. A second unrelated set included an 8-year-old boy and a 13-year-old …
Physical activity of moderately impaired elderly stroke patients during rehabilitation

In older adults, physical activity (PA) is promoted for public health preventive effort. It is also a major target in the rehabilitation process. Existing assessment tools in the clinical routine do not include any aspects of PA or participation and are often prone to floor or ceiling effects. The aim of this study was to document the process of rehabilitation by activity monitoring without floor or ceiling effects. Ninety-two stroke patients of a geriatric rehabilitation unit (mean age 82 years, ±6.21 years, 61% women) were included in an observational study to assess physical capacity (balance, chair rise, gait speed) and PA at admission and two weeks thereafter. PA was measured through an ambulatory activity monitor based on accelerometers and gyroscopes and showed no floor or ceiling effects. Floor effects were however documented for measures of physical capacity (admission 5–11%; follow-up 2–9%) and ceiling effects were registered for the balance test (admission 17.4%; follow-up 22.8%). Improvements were documented for measures of physical capacity as well as for PA (all p < 0.001). We conclude that the assessment of PA by activity monitoring is a valuable measure to document objectively the process of rehabilitation without floor or ceiling effects.
Radiosurgery for Intracranial Meningiomas

The purpose of this study was to review the results of stereotactic radiosurgery for intracranial meningiomas. A prospective computer database was queried for patient characteristics, radiosurgical parameters, tumor control, and complications of 310 patients having radiosurgery for 335 meningiomas at our center between January 1990 and October 2002. One hundred thirty-one patients (42%) had recurrent/residual tumors after prior surgical resection; 179 patients (58%) had radiosurgery as primary treatment. The majority of patients (69%) had skull-based tumors. The median tumor volume was 7.5 cc (range: 0.5–50.5 cc). The median tumor margin dose was 16 Gy (range: 12–20 Gy). Two hundred ninety-seven tumors (278 patients) had clinical and imaging follow-up at a mean of 43 months (range: 2–138 months) after radiosurgery. Two hundred seventy-nine tumors (94%) remained stable or decreased in size; 18 tumors progressed. Factors associated with progression were tumor histology and prior surgery. Treatment-related complications occurred in 26 patients (9%) and included cranial neuropathies, symptomatic edema, cyst formation, and stenosis of the internal carotid artery. Radiosurgery is safe and effective for many meningioma patients and has become the primary treatment of patients with small tumors in critical locations such as the cavernous sinus. Patients with atypical or malignant tumors have a high recurrence rate despite the use of radiosurgery. Further study is needed to determine the tumor control and complication rates 10 or more years after meningioma radiosurgery.
Feasibility of alpha tricalcium phosphate for vertical bone augmentation.

AIM Inadequate vertical bone compromises dental implant positioning and subsequent restoration. This study was carried out to investigate the feasibility of alpha tricalcium phosphate (α-TCP) for vertical bone augmentation. METHODS Nine cortical perforations were made on each side of the parietal bone of rat calvaria under continuous saline coolant. Polytetrafluoroethylene cylinders were placed under the periosteum and α-TCP particles were applied in the cylinders in the TCP group while the cylinders were left empty in the control group. The animals were sacrificed at 4 and 8 weeks after surgery and analyzed radiologically and histologically. RESULTS The augmented bone volumes in the control and TCP groups were 91.5 ± 25.6% and 76.5 ± 49.8% (mean ± SD) of the original bone at 4 weeks, and 136.3 ± 59.7% and 139 ± 62.4% at 8 weeks respectively. There was no significant difference between control and test groups. At 4 weeks the bone height was augmented by 168.8 ± 26.7% and 128.8 ± 62% in the control and TCP groups respectively (not significant), whereas significantly higher vertical bone was achieved in the TCP group than in the control group at 8 weeks (251 ± 32% vs 179.2 ± 30.3%, P < 0.05). CONCLUSION After 8 weeks α-TCP is effective in maintaining space under periosteum and potentially would be applicable in vertical bone augmentation.
Representations of chordal graphs as subtrees of a tree

In 1974, Buneman [ l ] and Gavril [2] independently showed that a connected graph G is isomorphic to the intersection graph of subtrees of a tree if and only if G is chordal. This result, which also appears in [5] , can be derived directly from a result of Lekkerkerker and Boland [4] , which states that a chordal graph has a simplicia1 point. We give a proof of this characterization and we conclude with an announcement of a criterion for a graph to be representable on Kl,3. In general, we follow the graph theoretic terminology of [3] .
Resultados da troca de lente intra-ocular de hidrogel opacificada

OBJETIVO: Avaliar os resultados da explantacao e substituicao das lentes intra-oculares (LIO) de hidrogel opacificadas. METODOS: Foram analisados retrospectivamente os prontuarios de 12 pacientes (15 olhos) submetidos a explantacao e substituicao das lentes intra-oculares de hidrogel opacificadas. RESULTADOS: A opacificacao das lentes intra-oculares de hidrogel causou perdas de linhas de visao em 13 olhos (86,7%). A troca das lentes intra-oculares opacificadas promoveu o ganho de linhas de visao em 11 olhos (73,3%). As complicacoes peroperatorias ocorreram em tres olhos (20%) e foram as seguintes: perda de oleo de silicone, ruptura total de zonula com perda do saco capsular e ruptura parcial de zonula. Durante a explantacao das lentes intra-oculares foi necessaria a realizacao de incisoes relaxantes na borda da capsulorrexe anterior em tres olhos (20%) e em dois olhos (13,3%) os hapticos foram cortados sendo retirada somente a zona optica das lentes intra-oculares. CONCLUSAO: A cirurgia para explantacao e substituicao das lentes intra-oculares opacificadas mostrou-se eficaz naqueles pacientes com perdas de linhas de visao (p > 0,05).