Miracle-dz/UniFAR-FTUs huggingface dataset:
Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study

Abstract Background: Serum thyroid stimulating hormone (TSH) levels are frequently elevated in obese children and are most likely to be associated with insulin resistance. However, clinical relevance of this association remains unclear. Objectives: To assess the prevalence of hyperthyrotropinemia; to analyze the relationship between TSH and homeostasis model assessment – insulin resistance (HOMA-IR); and to verify whether TSH levels and HOMA-IR vary with weight loss in obese children. Subjects and Methods: Retrospective longitudinal study with data from baseline and 1 year after lifestyle intervention in a pediatric obese group (344 children were recruited and 100 among them completed follow-up). For postintervention analysis, three groups were considered according to body mass index-standard deviation score (BMI-SDS) variations: ≤–0.5 (significant weight loss); 0.5–0 (weight loss); and >0 (weight gain). Statistical analysis was performed using SPSS 19.0®. Results: The prevalence of increased TSH levels was 9.3%. At baseline TSH (p=0.007), fT4 (p=0.006), and HOMA-IR (p<0.001) were positively correlated to BMI-SDS (n=344). Weight reduction was verified in 67 out of 100 cases but significant loss was present in only 21 cases. Decreases in both TSH and BMI-SDS were independently associated with decreases in HOMA-IR (p=0.005 and p=0.016, respectively). There was no correlation between TSH and BMI-SDS variation. Significant decreases in the HOMA-IR (p=0.006) were only achieved in the significant weight loss group. Conclusions: The prevalence of hyperthyrotropinemia was lower than previously reported. However, cutoff values were adjusted to pubertal stage, suggesting an over report in other studies. Insulin resistance and TSH were positively correlated, independent of body status. Although weight loss was not associated with TSH variation, a decrease in TSH levels was independently associated with decreases in HOMA-IR.
The relation of BMI and skinfold thicknesses to risk factors among young and middle-aged adults: The Bogalusa Heart Study

Objective: Although adverse levels of cardiovascular disease risk factors are related to skinfold thicknesses and BMI among adults, the relative strengths of these associations are unknown. We examine whether the triceps and subscapular skinfold thicknesses are more strongly related to adult levels of lipids, fasting insulin and blood pressure than BMI. Design and subjects: Cross-sectional (n = 3318) and longitudinal (n = 1593) analyses of 18- to 44-year-olds examined in the Bogalusa Heart Study from 1983 to 2002. Principal components analysis was used to derive a summary index of the six examined risk factors (triglycerides, low- and high-density lipoprotein cholesterol, insulin, and systolic and diastolic blood pressures). Results: The magnitudes of the differences were generally small, but all comparisons indicated that BMI was at least as strongly related to adverse risk factor levels as was the sum of subscapular and triceps skinfold thicknesses (SF sum). For example, adjusted cross-sectional associations with the risk factor summary were r = 0.55 (BMI) and r = 0.49 (SF sum), p < 0.001 for difference between correlations. Similar differences were seen in longitudinal analyses, with changes in the risk factor summary being more strongly associated with changes in BMI (r = 0.50) than with changes in the SF sum (r = 0.38). Conclusion: BMI appears to be at least as accurate as skinfold thicknesses in identifying metabolic risk among adults. The advantages of BMI should be considered in the design and interpretation of clinical and epidemiologic studies.
Study of cytomorphology of solid pseudopapillary tumor of pancreas and its differential diagnosis

Background: Solid pseudopapillary tumor is a rare pancreatic neoplasm with uncertain to low malignant potential. This is an uncommon neoplasm with many pseudonyms, occurring predominantly in young woman under the age of thirty years. Aims: To study the cytomorphological features of six cases of solid and pseudopapillary epithelial neoplasm of pancreas diagnosed on fine needle aspiration cytology (FNAC) in years 2005 to 2007 and its cyto-histological correlation. Materials and Methods: Image-guided FNAs was done in these six patients preoperatively. Alcohol-fixed smears were stained with Papanicolaou stain, cytomorphological findings were evaluated and diagnosis was made. Diagnosis was later confirmed by histology in all cases. Results: All six cases show characteristic cytological features such as hypercellular smears with presence of abundant delicate papillary fragments, dyscohesive cells, monomorphic tumor cells with delicate folded nuclear membranes, and foamy macrophages in the background. Conclusions: Preoperative correct diagnosis of solid pseudopapillary tumor of pancreas is possible on FNAC and by doing so it helps in management of this surgically curable neoplasm.
Prevalence of angiotensin-converting enzyme, methylenetetrahydrofolate reductase, Factor V Leiden, prothrombin and apolipoprotein E gene polymorphisms in Morocco

Background: Evidence of the influence of genetic risk factors on cardiovascular diseases is more or less established. These genetic factors are involved in several pathways affecting blood pressure regulation, blood coagulation, homocysteine and lipid metabolisms. Aim: We evaluated frequencies of five genetic polymorphisms to assess their informativeness as markers for prospective clinical studies. Subjects and methods: 182 healthy Moroccan subjects were genotyped for ACE I/D by amplification alone and by amplification followed by enzymatic digestion for other polymorphisms. Results: Allele frequencies of ACE ID, MTHFR C677T were 76.6%, 26.9% for D and T alleles, respectively. APOE polymorphism showed 11.3%, 78.6% and 10.2% for the alleles E2, E3 and E4, respectively. The frequency for FII G20210A polymorphism was around 2.7% for A allele. Our data showed an absence of FVL mutation. Using allele frequencies, genetic distances between Moroccan and other populations revealed an independent variability of these polymorphisms. Conclusion: These values appear to be influenced by findings in European and African peoples, and may be considered in assessing the clinical significance of a predisposition to cardiovascular disease.
EFFECT OF ANTIRETROVIRAL THERAPY ON SURVIVAL OF HIV/TB-INFECTED PATIENTS IN UKRAINE

Introduction: There is little information from Ukraine about the effect of highly active antiretroviral therapy (HAART) on survival of HIV/ TB-infected patients. We evaluated the survival and the effect of HAART on mortality on these patients. Methods: Prospective cohort study of HIV patients who developed TB from January 2005 to December 2006 in a Zaporizhzhya AIDS Center, and were tracked for 60 months after start HAART. Survival was determined by Kaplan-Meier method and effect of HAART on survival was evaluated using Cox proportional hazards models. Results: Eighty patients were studied (mean age 34 years, 50% male, median CD4 count 103 cell/μL). In 60 months of HAART 14 patients died. The probability of survival was 82%. In multivariate analysis, patients with a CD4 cell count <100 μL had a 5-fold higher risk of mortality (HR 5, 2; 95% CI 1.4-19, 4) and those with extra pulmonary tuberculosis a 2, 2-fold increased risk (HR 2, 2, 95% CI 1, 1-8, 3). Conclusions: HAART significantly increased probability of survival and reduced the risk of death for HIV/TB-infected patients in Ukraine.
Cell Cannibalism: A cytological study in effusion samples

Background: Cytological examination of effusion fluid is a relatively easy and quick method for the diagnosis of primary or secondary malignancy. Aims: To analyze the cytological significance of cell cannibalism in malignant effusion samples. Materials and Methods: A retrospective review of 100 cases of malignant effusion was done. These 100 cases included 50 cases of contiguous, local spread to pleural/ascitic fluid. The remaining 50 cases were of disseminated malignancy. Effusions due to hematolymphoid malignancies were excluded. Smears from these cases were assessed for the presence of cell cannibalism, tumor cell within a tumor cell. Results: The cannibalistic cells were more common in effusions with disseminated malignancy (nine out of 50 cases i.e. 18%) compared with cases of contiguous, local spread (two out of 50 cases i.e. 4%). Chi square test showed this difference to be statistically significant (x2 5.005, P=0.025). The majority of the cases were of carcinoma lung (6/11). Cytomorphologically, histiocytes displaying phagocytosis can simulate tumor cells and need to be distinguished. Conclusions: Presence of cell cannibalism in malignant effusions is more often an indicator of disseminated malignancy with secondaries and higher tumor stage. Furthermore, cannibalism may provide a reliable predictor of progression of tumor from primary to the metastatic site.
Mucinous carcinoma in a male breast

Male breast cancer is rare as compared to female counterpart. Pure mucinous carcinoma is an extremely rare histological subtype representing less than 1% of male breast cancers. So far very few cases of pure mucinous carcinoma of male breast have been reported in the literature, most of which were diagnosed after surgical resection. Fine-needle aspiration cytology is a well-established procedure for the evaluation of female breast masses but the diagnosis of malignancy in aspirates from male breast masses is rare. We herein present one case of mucinous carcinoma of breast in a 75-year-old male diagnosed by fine-needle aspiration and confirmed by histopathology. After a follow-up of 12 months the patient is free of any recurrence or metastasis.
Morphology to morphometry in cytological evaluation of thyroid lesions

Aim: To evaluate the cytomorphometric features in fine needle aspiration cytology (FNAC) of thyroid lesions. Materials and Methods: FNAC of 36 thyroid cases was reviewed. The study included 10 cases each of follicular lesion, adenomatous goiter, papillary carcinoma, 4 cases of medullary carcinoma and 2 cases of anaplastic carcinoma. Their ages ranged from 28 to 50 years, and there were nine females and one male. Morphometric analysis was done on aspiration smears from 36 thyroid lesions. Hematoxylin and Eosin stained smears were examined using image analyzer Proplus V software. Morphological parameters measured included mean nuclear diameter, mean nuclear perimeter, mean nuclear area, circular rate, largest to smallest dimension ratio (LS ratio) and coefficient of variation of nuclear area (NACV). Statistical Analysis: Statistical evaluation was carried out using the analysis of variance (ANOVA) test for the five variables, both within the group and in between the groups. The result was considered significant when P < 0.05. Results: The follicular carcinomas had higher LS ratio than patients with adenomatous goiters. Mean nuclear diameter and the mean nuclear perimeter were higher in anaplastic carcinomas when compared to other subtypes and were the least for follicular neoplasms. Conclusion: When correctly applied, quantitative estimation of cytological nuclear features can play an important role in preoperative assessment and can complement morphological features in thyroid lesions.
The interrealtionship between locally applied heat, ageing and skin blood flow on heat transfer into and from the skin

In response to a thermal stress, skin blood flow (BF) increases to protect the skin from damage. When a very warm, noxious, heat source (44°C) is applied to the skin, the BF increases disproportionately faster than the heat stress that was applied, creating a safety mechanism for protecting the skin. In the present investigation, the rate of rise of BF in response to applied heat at temperatures between 32°C and 40°C was examined as well as the thermal transfer to and from the skin with and without BF in younger and older subjects to see how the skin responds to a non-noxious heat source. Twenty male and female subjects (10 – 20–35 years, 10 – 40–70 years) were examined. The arms of the subjects were passively heated for 6 min with and without vascular occlusion by a thermode at temperatures of 32, 36, 38 or 40°C. When occlusion was not used during the 6 min exposure to heat, there was an exponential rise in skin temperature and BF in both groups of subjects over the 6-min period. However, the older subjects achieved similar skin temperatures but with the expenditure of fewer calories from the thermode than was seen for the younger subjects (p < 0.05). BF was significantly less in the older group than the younger group at rest and after exposure to each of the three warmest thermode temperatures (p < 0.05). As was seen for noxious temperatures, after a delay, the rate of rise of BF at the three warmest thermode temperatures was faster than the rise in skin temperature in the younger group but less in the older group of subjects. Thus, a consequence of ageing is reduced excess BF in response to thermal stress increasing susceptibility to thermal damage. This must be considered in modelling of BF.
Emergency Management: The American Experience 1900–2010 (2nd Edition)

In Emergency Management: The American Experience, Claire Rubin brings together a team of highly esteemed scholars and practitioners to examine the history of emergency management in the United States, while addressing several important questions regarding the growth and appropriate role of the federal government in responding to disaster events. This second edition builds upon the original text – first published in 2007 – and retains not only its critical perspective and analytical framework, but also its underlying purpose: “to illuminate changes in public policies, administration, and organizations in response to major disasters and to identify the implications of those changes for emergency management today” (p. 3). In Chapter 1, Rubin lays the groundwork for the study by advancing the hypothesis that changes in emergency management policies, processes, and authorities are essentially driven by focusing events, which capture policy attention by exposing critical failures in the existing administrative and/or policy systems. In fact, as Rubin denotes, “virtually all major federal laws, executive directives, programs, policies, organizational changes, and response systems have resulted from major and catastrophic disasters” (pp. 6–7). In Chapter 2, David Butler examines the dramatic impacts of several focusing events in the first half of the twentieth century. According to Butler, this period was marked by ad hoc and reactive policy responses, all of which were implemented under a veil of limited federal involvement. Indeed, despite the frequency of event-specific legislation, “disaster assistance was considered the responsibility of the states or, more often, local governments, charities, and other social institutions such as churches” (p. 14). The period was also defined by a general ontological view of disasters as “unavoidable ‘acts of God,’ which, by definition, transcend the power of government to prevent,” thereby reinforcing public indifference and neglect (p. 14). In turn, Butler explores the negative consequences of hubris, denial, and complacency in the storm-related devastation of
Pictorial essay: Anatomical variations of paranasal sinuses on multidetector computed tomography-How does it help FESS surgeons?

Abstract With the advent of multidetector computed tomography (MDCT), imaging of paranasal sinuses prior to functional endoscopic sinus surgery (FESS) has become mandatory. Multiplanar imaging, particularly coronal reformations, offers precise information regarding the anatomy of the sinuses and its variations, which is an essential requisite before surgery.
Textbook of biochemistry with clinical correlations

Textbook of biochemistry with clinical correlations , 4th edn. TM Devlin, ed. pp xvii + 1186, illustrated. Wiley-Liss, New York, 1997. £29.95, hardback This beautifully illustrated and well-written book, with an impressive array of authors, is aimed at both undergraduate and postgraduate level. As the editor states in the preface, it is not intended to be a compendium of biochemistry but rather emphasises the biochemistry of mammalian cells. The first 22 chapters cover …
Students Satisfaction towards the University: Does Service Quality Matters?

This study examines the relationship between service quality (SQ) and the level of student’s satisfaction (SS) using a field study of 100 undergraduate students in one of the university in Malaysia. The findings of this study reveals that SQ is a vital factor that determines the level of SS. Specifically, the result of this study reveals that the better the SQ provided by the university, the higher the level of SS. Responsiveness, assurance, and empathy are the three dimensions of SQ that is significantly related to the level of SS. The findings of this study have made significant contribution to the body of knowledge in student’s satisfaction management in higher education institutions. The findings of this study also made practical implication to management of higher education especially in the area where SQ improvement
Rationale, design and clinical performance of the mechanical response tissue analyser: a non-invasive technology for measurement of long bone bending stiffness

Abstract Prediction of osteoporotic fractures is currently an imperfect science and new tools are desperately needed to identify at-risk patients at an earlier stage in the disease process. The mechanical response tissue analyser (MRTA) is a novel, non-invasive, radiation-free device that measures the bending stiffness of long bones in vivo, an indicator of a bone’s ability to resist deformation under a given load and a strong predictor of long bone structural integrity and strength. Bone bending stiffness measured with the MRTA has been consistently shown to be a stronger predictor of post-mortem and ex vivo bone breaking strength compared to bone mineral measured with dual-energy X-ray absorptiometry. Bone bending stiffness measured with MRTA also decreases with advanced age and disease states and increases with chronic physical activity, independent of bone mineral changes. The MRTA measures different parameters than DXA (bone quality vs bone mineral content and density) and may be a more robust tool for identifying those at risk for fracture. Research initiatives focused on improving long-term repeatability and optimizing the signal-to-noise ratio of the measurement are currently underway to further advance the clinical usefulness of this technology.
Fatness, faltering metabolism and fecundity: an expanding challenge in reproductive medicine

Increasing adiposity worldwide is having a negative impact on health with a rise in metabolic disorders and co-morbid conditions including reduced reproductive capacity in men and women. Furthermore, maternal adiposity and hyperglycaemia are strongly associated with adverse outcomes for both mother and baby, with the potential for long-term impact on the offspring. Introduction of a spectrum of public health strategies covering the entire reproductive lifespan are required to minimise the clinical burden of obesityrelated disease. Br J Diabetes Vasc Dis, 2009;9:36–37
Automated EEG signal analysis for identification of epilepsy seizures and brain tumour

Abstract Electroencephalography (EEG) is a clinical test which records neuro-electrical activities generated by brain structures. EEG test results used to monitor brain diseases such as epilepsy seizure, brain tumours, toxic encephalopathies infections and cerebrovascular disorders. Due to the extreme variation in the EEG morphologies, manual analysis of the EEG signal is laborious, time consuming and requires skilled interpreters, who by the nature of the task are prone to subjective judegment and error. Further, manual analysis of the EEG results often fails to detect and uncover subtle features. This paper proposes an automated EEG analysis method by combining digital signal processing and neural network techniques, which will remove error and subjectivity associated with manual analysis and identifies the existence of epilepsy seizure and brain tumour diseases. The system uses multi-wavelet transform for feature extraction in which an input EEG signal is decomposed in a sub-signal. Irregularities and unpredictable fluctuations present in the decomposed signal are measured using approximate entropy. A feed-forward neural network is used to classify the EEG signal as a normal, epilepsy or brain tumour signal. The proposed technique is implemented and tested on data of 500 EEG signals for each disease. Results are promising, with classification accuracy of 98% for normal, 93% for epilepsy and 87% for brain tumour. Along with classification, the paper also highlights the EEG abnormalities associated with brain tumour and epilepsy seizure.
Risk and protective factors for the psychological well-being of children orphaned by AIDS in Cape Town, South Africa

Background: Orphanhood is a major consequence of the HIV/AIDS epidemic in sub-Saharan Africa. There is little evidence concerning psychological problems for AIDS-orphaned children. This thesis explores the relationship between orphanhood status and mental health. It also examines mediating influences of environmental risk and protective factors, and interactions between factors, on children’s psychological problems. Methods: 1200 isiXhosa-speaking children were interviewed, using standardised questionnaires, in deprived urban settlements of Cape Town. A qualitative stage with 60 AIDS-orphaned children, 42 caregivers and 20 professionals explored participant perceptions of risk and protective factors. A quantitative stage compared 1025 AIDS-orphaned children to control groups of other-orphans and non-orphans. Data were analysed with t-tests, chi-sq, anovas, regression and log-linear analyses. The study took place in collaboration with Cape Town Child Welfare. Results: AIDS-orphaned children reported more depression (p<.001), peer relationship problems (p<.001), post-traumatic stress (p<.001), suicidal ideation (p<.05), delinquency (p<.001) and conduct problems (p<.001) than other-orphans and non-orphans. Anxiety showed no differences. Compared to Western norms, AIDS-orphaned children showed higher levels of internalising problems and delinquency, but lower levels of conduct problems. These differences remained when controlling for socio-demographic factors. A number of factors strongly mediated the relationship between AIDS-orphanhood and mental health. These include poverty-related factors (food, education and social security, p<.001). caregiving-related factors (caregiver illness, p<.001, excessive housework p<.001, being a streetchild, p<.001) and AIDS-related stigma (p<.001). Cumulative effects were also found. Food insecurity and AIDS-related stigma interacted to raise likelihood of disorder from 19% to 83%, and orphanhood status and bullying interacted to raise likelihood from 12% to 76%. Conclusions: This thesis shows clear evidence of heightened psychological problems amongst AIDS-orphaned children. It also indicates mediating factors and points to areas of possible intervention. The South African Ministry of Social Development plans to scale up the study to a national survey of AIDS-orphanhood.