Miracle-dz/UniFAR-FTUs huggingface dataset:
Health-related quality of life in secondary progressive multiple sclerosis

Common disability scales in multiple sclerosis (MS) are often weighted towards physical disability. Non-motor symptoms such as depression, fatigue and pain substantially influence wellbeing in MS. Health-related quality of life (HRQoL) measures the broader impact of MS and might indicate less obvious disease burdens. We analysed HRQoL, using the Nottingham Health Profile Part I (NHP-I), among 345 secondary progressive MS (SPMS) patients participating in a randomized trial of interferon-β1a (IFN-β1a), 22 μg subcutaneously weekly, or matching placebo. The results did not reveal any beneficial effect of IFN-β1a in any outcome measure. NHP-I sub- and sum scores were compared for 217 population controls and correlated with demographic and clinical disease variables. SPMS patients had lower NHP-I sum and all subscores than the controls. Patients experiencing disease progression reported worse NHP-I sum scores. Increased fatigue, Expanded Disability Status Scale (EDSS) and Arm Index scores were independently associated with reduction in several NHP-I subscores. SPMS patients had significantly lower HRQoL than controls and physical disability (EDSS and Arm Index), disease progression and fatigue strongly influenced this. MS
Prevalence, antimicrobial resistance and associated risk factors for bacteriuria in diabetic women in Dar es Salaam, Tanzania

Urinary tract infections (UTIs) occur frequently among women with diabetes. The present study aimed at determining prevalence and risk factors of bacteriuria in diabetic women and antimicrobial resistance pattern of the isolates at Muhimbili National Hospital (MNH), Dar es Salaam. Three hundred diabetic women attending clinic at MNH from June to November 2010 were included in the study. Demographic and clinical information were collected using a structured questionnaire. Urine specimens were collected for urinalysis, microscopy, culture and antimicrobial susceptibility testing. Significant, asymptomatic and symptomatic bacteriuria was found in 13.7% (41/300), 13.4% (31/231), and 14.5% (10/69) diabetic women, respectively. The isolated pathogens were Escherichia coli (39.0%),Klebsiella pneumoniae (22.0%), coagulase negative Staphylococci (14.65) and Proteus spp. (12.2%). Both Gram positive and negative bacteria showed high rate of resistance towards co-trimoxazole (55.6% and 50.0%, respectively). Gram negative bacteria showed high rate of resistance to ampicillin (62.55%), penicillin (53.1%) and moderate resistance to cefotaxime (18.8%). Advanced age and glycosuria were significantly associated with bacteriuria (P < 0.05). E. coli was the commonest aetiological agent for both symptomatic and asymptomatic bacteriuria among diabetic women, especially those with advanced age and glycosuria. Most uropathogens were resistant to co-trimoxazole, ampicillin and ciprofloxacin. Key words: Diabetes mellitus, bacteriuria, antimicrobial resistance.
CLINICAL CHARACTERIZATION OF H1N1 INFLUENZA TAQMAN REAL TIME PCR POSITIVE CASES

Background: A novel swine origin influenza virus (H1N1) is spreading worldwide and become the first pandemic of the 21st century. The currently circulating strain of swine origin influenza virus of the H1N1 strain has undergone triple reassortment and contains genes from the avian, swine and human viruses. H1N1 critical illness mostly affects young patients and it is often fatal. Aim: The aim of the present study is to evaluate the clinical characteristic of H1N1 infection in a tertiary care institute. Material & Methods: A total of 251 pharyangeal and nasal swabs from suspected cases of swineflu were processed by TaqMan real-time PCR (CDC protocol). Clinical co-relation with presenting sign and symptoms and analysis was done. Results: 36 (14%) were confirmed as positive. The clinical picture was characterized by fever (88%), cough (94%), sorethroat (35%), nasal catarrh (51%), chest pain (0.4%). Chest X-ray findings suggested association of consolidation with positive cases (47%). Discussion: Strong clinical association is seen in those who were It was also noted that 2009 H1N1 influenza illness predominantly affects young patients. Conclusion: The knowledge and technology translation previously acquired through courses by health care providers were the key in controlling the first influenza A (H1N1) 2009 cases. Hospitalized cases of H1N1 influeza should be monitored carefully and vaccination is a good alternative to control such pandemic.
Evaluation of MODS culture in diagnosis of pulmonary tuberculosis

Culture of Mycobacterium tuberculosis is the gold standard for diagnosis of tuberculosis (TB) that is a much more sensitive test than smear examination. There is a need to use the new methods in order for fast diagnostic way. The aim of this research was to compare microscopic observation drug susceptibility culture with Ziehl-Neelsen stain and Lowenstein-Jensen culture of sputum. Therefore, a diagnostic test was designed. If the patient's history revealed clinical criteria compatible with tuberculosis and the infectious specialist judgment was that of "TB" suspected case, the patient was considered as a pulmonary TB suspect. We did sputum Ziehl-Neelsen stain, culture in Lowenstein-Jensen and MODS media. 100 patients with mean of 52.9 ± 21.83 were evaluated. 40% of patients revealed positive Ziehl-Neelsen stain while 30 and 47% showed positive results in Lowenstein-Jensen and MODS media respectively. In comparison with sputum smear and Lowenstein-Jensen culture, MODS had sensitivity of 82.5 and 86%, specificity of 77 and 70%, positive predictive value of 70 and 55%, negative predictive value of 86 and 92%, respectively. MODS culture demonstrated faster recovery and higher negative predictive value. Therefore, it could be a simple and rapid method in diagnosis of pulmonary tuberculosis. Key words: Tuberculosis, Ziehl-Neelsen stain, Lowenstein-Jensen culture, sensitivity.
Giving to others and the association between stress and mortality.

OBJECTIVES We sought to test the hypothesis that providing help to others predicts a reduced association between stress and mortality. METHODS We examined data from participants (n = 846) in a study in the Detroit, Michigan, area. Participants completed baseline interviews that assessed past-year stressful events and whether the participant had provided tangible assistance to friends or family members. Participant mortality and time to death was monitored for 5 years by way of newspaper obituaries and monthly state death-record tapes. RESULTS When we adjusted for age, baseline health and functioning, and key psychosocial variables, Cox proportional hazard models for mortality revealed a significant interaction between helping behavior and stressful events (hazard ratio [HR] = 0.58; P < .05; 95% confidence interval [CI] = 0.35, 0.98). Specifically, stress did not predict mortality risk among individuals who provided help to others in the past year (HR = 0.96; 95% CI = 0.79, 1.18), but stress did predict mortality among those who did not provide help to others (HR = 1.30; P < .05; 95% CI = 1.05, 1.62). CONCLUSIONS Helping others predicted reduced mortality specifically by buffering the association between stress and mortality.
Health Inequities : Emergent Embodied Phenotypes and the Illustrative Case of the Breast Cancer Estrogen Receptor

How we think about biology—in historical, ecological, and societal context— matters for framing causes of and solutions to health inequities.Drawingonnew insights from ecological evolutionary developmental biology and ecosocial theory, I question dominant gene-centric and ultimately static approaches to conceptualizing biology, using the example of the breast cancer estrogen receptor (ER). Analyzed in terms of its 4 histories—societal,individual (life course), tumor (cellular pathology), and evolutionary—the ER is revealed as a flexible characteristic of cells, tumors, individuals, and populations, with magnitudes of health inequities tellingly changingover time. This example suggests our science will likely be better served by conceptualizing disease and its biomarkers, along with changing magnitudes of health inequities, as embodied history—that is, emergent embodied phenotype, not innate biology. (Am J Public Health. 2013;103:22–27. doi:10.2105/ AJPH.2012.300967) Nancy Krieger, PhD
Intersecting identities and the association between bullying and suicide attempt among New York city youths: results from the 2009 New York city youth risk behavior survey.

OBJECTIVES We examined the intersections of sexual minority, gender, and Hispanic ethnic identities and their interaction with experiences of bullying in predicting suicide attempt among New York City youths. METHODS We performed secondary data analysis of the 2009 New York City Youth Risk Behavior Survey, using logistic regression to examine the association of sexual identity, gender, ethnicity, and bullying with suicide attempt. We stratified results on these measures and reported adjusted odds ratios. RESULTS Compared with non-sexual minority youths, sexual minority youths had 4.39 and 1.96 times higher odds, respectively, of attempting suicide and reporting bullying. Identity variables did not interact with bullying in predicting suicide attempt individually; however, a four-way interaction term was significant. The effect of bullying on suicide attempt was strongest among non-Hispanic sexual minority male youths (odds ratio = 21.39 vs 1.65-3.38 for other groups). CONCLUSIONS Sexual minority, gender, and ethnic identities interact with bullying in predicting suicide attempt among New York City youths. Interventions to limit both the prevalence and the effect of bullying among minority youths should consider an intersectional approach that considers ethnic, gender, and sexual identities.
Effects of disease misclassification on exposure-disease association.

OBJECTIVES We explore how misclassification in disease status can distort the exposure-disease association in a study with dichotomous disease and exposure status. METHODS We define the difference in population odds ratios between populations with and without disease misclassification as population-level bias and derive the bias as a function of sensitivity and specificity for observed disease status. The magnitude and direction of bias can be elucidated through analytic derivations, as illustrated with numerical examples. RESULTS Patterns of bias exist not only for nondifferential misclassification but also for some differential misclassification scenarios. We have provided conditions defined in terms of sensitivity and specificity that correspond to each pattern of bias. CONCLUSIONS Caution is needed in interpreting results when misclassification is present. Our findings can be used to assess the effects of disease misclassification in a population when sensitivity and specificity are known or can be estimated.
Better health requires partnerships and a systems approach.

We commend Sprague Martinez et al.1 for highlighting neighborhood sanitation conditions recognized by local Black and Latino youths who then photographed these social and environmental conditions that related to their personal stress. Their experience once again demonstrates the importance of engaging community members in assessing the health of their own communities. This rediscovery2–4 has important implications for “creating the conditions in which people can be healthy. ”5 It is timely, too. For example, as a result of Internal Revenue Service regulation6 and accreditation requirements,7 nonprofit hospitals and local and state health departments must now complete community health assessment and improvement plans. Clearly, visual stories used as data are worthwhile elements of any assessment and improvement process. In addition to hospitals and public health agencies conducting these assessments collaboratively, involving community members and community organizations incentivizes engagement and collective responsibility for outcomes. As Sprague Martinez et al. point out, communities have faced similar “nasty” situations in the past. Efforts on the part of residents to identify and voice their concerns likely resulted in political processes that were instrumental in remediating unhealthy situations. We encourage students engaged in research to express their voices through local, state, and federal governmental processes to raise awareness of both visible and hidden upstream causes of injury, illness, and death. While the lives of community residents are in many ways experienced as “local,” efforts to improve the public’s health may also benefit from coordinated action from all parts of the governmental public health enterprise: local, state, and federal levels.8 Law, regulation, security, protection, and financing are important local, state, and federal responsibilities; neglect of these areas by any level of government results in the conditions documented by the students and the poor outcomes present in far too many communities. These are challenging times for local, state, and federal governmental public health agencies and for the communities they protect and keep safe. Collaboration with community partners can help make positive health outcomes more likely. Our communities will thrive as a result.
Prevalence of Intestinal Parasitic Infection in School Going Children in Amalapuram, Andhra Pradesh, India

Background: The public health impact of parasitic infection has been consistently underestimated in the past, but there is now a general consensus that diseases caused by intestinal parasites represent an important public health problem, especially children. Recent studies suggest that even moderate intensity of infection may have adverse effects on growth, iron deficiency anemia and cognitive function, practically for children of school age. Objective: Aim of the present study was to determine the intestinal parasitic infection in school going children. Materials and Methods: The stool samples were collected from different municipal school in and around Amalapuram according to the standard procedures between June 2006 to August 2006. All the stool samples were examined by the direct microscopic examination and by the formalin-ether concentration methods. Analysis of the data was carried out by using Epi info software. Results: A total 208 stool specimen were collected. The mean age group was 8.8 ± 2.11. 133 (63.9%) were infected with one or more intestinal parasites. 95 (71.4%) of the students were infected with single parasite, 38 (28.6%) with two or more parasites. The most common was Entamoeba histolytica (E.histolytica) with 41 (30.8%) single and 26 (19.54%) with multiple infections. The second most common was Giardia intestinalis (G.intestinalis) with 25 (18.8%) single and 25 (18.8%) with multiple infections. The third one was Entamoeba coli (E.coli) with 15 (11.3%) single and 17 (12.78%) with multiple infections. E.histolytica and G.intestinalis were the most commonly found parasite in multiple infections. 1.5% of Ascaris lumbricoides, 5.3% Hookworm, 0.8% Enterobius vermicularis and 0.8% of Trichuris trichuria were found in the stool sample. Conclusions: Intestinal parasitic infection is an important public health problem in Andhra Pradesh, India. Rural residence, mother education less than primary school and no hand wash with soap after toilets were the significant risk factors. Interventions including health education on personal hygiene, appropriate water management like boiling and use of latrines to the school children and to the parents.The public health impact of parasitic infection has been consistently underestimated in the past, but there is now a general consensus that diseases caused by intestinal parasites represent an important public health problem, especially children. Recent studies suggest that even moderate intensity of infection may have adverse effects on growth, iron deficiency anemia and cognitive function, practically for children of school age.
Asthma disparities and within-group differences in a national, probability sample of same-sex partnered adults.

OBJECTIVES We examined the prevalence and correlates of self-reported lifetime diagnosis of asthma and current asthma among same-sex and opposite-sex partnered adults. METHODS Data were from the 2004 Behavioral Risk Factor Surveillance System, in which same-sex partnership was a response option to a family planning item in the core questionnaire. Self-reported lifetime diagnosis of asthma and current asthma were examined in logistic regression models adjusted for demographic characteristics and asthma-related confounding factors and stratified by both gender and same-sex partnership status. RESULTS Significantly higher proportions of same-sex partnered male and female respondents reported lifetime and current asthma compared with their opposite-sex partnered peers. In adjusted analyses, same-sex partnership status remained significantly associated with asthma outcomes among men and women, with odds ratios ranging from 1.57 to 2.34. CONCLUSIONS Results corroborated past studies that indicated asthma disproportionately affects sexual minority populations. The addition of sexual minority status questions to federal survey projects is key to further exploring health disparities in this population. Future studies are needed to investigate the etiology of this disparity.
Sepsis: Current state of play

The treatment of septic shock has, until very recently, relied on eradication of the causative infection using antibiotics and surgical removal where appropriate, and individual organ support including renal dialysis and mechanical ventilation. These aspects of management are still vitally important, but years of intense research have helped elucidate many of the mechanisms underlying the sepsis response, and new sepsis-specific therapies are being developed. An important advance in our understanding of the sepsis respone has been the recognition of the link between the processes of inflammation and coagulation, which led to the development and licensing of drotrecogin alfa (activated) for the treatment of patients with severe sepsis. Other progress in the treatment of sepsis includes recent studies showing
The mortality toll of estrogen avoidance: an analysis of excess deaths among hysterectomized women aged 50 to 59 years.

OBJECTIVES We examined the effect of estrogen avoidance on mortality rates among hysterectomized women aged 50 to 59 years. METHODS We derived a formula to relate the excess mortality among hysterectomized women aged 50 to 59 years assigned to placebo in the Women's Health Initiative randomized controlled trial to the entire population of comparable women in the United States, incorporating the decline in estrogen use observed between 2002 and 2011. RESULTS Over a 10-year span, starting in 2002, a minimum of 18 601 and as many as 91 610 postmenopausal women died prematurely because of the avoidance of estrogen therapy (ET). CONCLUSIONS ET in younger postmenopausal women is associated with a decisive reduction in all-cause mortality, but estrogen use in this population is low and continuing to fall. Our data indicate an associated annual mortality toll in the thousands of women aged 50 to 59 years. Informed discussion between these women and their health care providers about the effects of ET is a matter of considerable urgency.
Metabolic Syndrome among Undergraduate Students Attending Medical Clinics for Obligatory Medical Screening

Purpose : To determine the prevalence and risk factors for metabolic syndrome (MS) among first-year undergraduate students in three Sudanese universities. Methods : A total of 384 first-year students attending university medical clinics for obligatory medical checkup in Khartoum, Sudan participated in this cross-sectional study. Anthropometric parameters, including weight, height, body mass index (BMI) and waist circumference (WC) were measured with reference to National Cholesterol Education Program’s Adult Treatment Panel III (NCEP/ATP III) guidelines. Fasting blood samples were collected from all participants and assayed for fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), and low density lipoprotein (LDL). Results : The overall prevalence of MS in the test group was 7.8 %. The prevalence of MS, though higher in females, was statistically not significant (p = 0.32). According to residential area (rural – urban), the prevalence was higher in urban than rural, 10.4 and 4.4 %, respectively (p = 0.25 and p = 0.25, respectively). In addition, frequency of MS was directly proportional to age. The weight of patients with MS was significantly different from that of non-MS subjects (p ˂ 0.001). Same was also observed when obese patients were compared with non-MS subjects. (p ˂ 0.001). Conclusion : The prevalence of MS among Sudanese first-year university students in Khartoum is moderately high. Incidence of MS among the students is directly proportional to BMI. Keywords : Metabolic syndrome, Obesity, Hypertension, Diabetes, Dyslipidemia, Anthropometric
Denial of abortion because of provider gestational age limits in the United States.

OBJECTIVES We examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities. METHODS We compared women who presented for abortion care who were under the facilities' gestational age limits and received an abortion (n = 452) with those who were just over the gestational age limits and were denied an abortion (n = 231) at 30 US facilities. We described reasons for delay in seeking services. We examined the determinants of obtaining an abortion elsewhere after being denied one because of facility gestational age limits. We then estimated the national incidence of being denied an abortion because of facility gestational age limits. RESULTS Adolescents and women who did not recognize their pregnancies early were most likely to delay seeking care. The most common reason for delay was having to raise money for travel and procedure costs. We estimated that each year more than 4000 US women are denied an abortion because of facility gestational limits and must carry unwanted pregnancies to term. CONCLUSIONS Many state laws restrict abortions based on gestational age, and new laws are lowering limits further. The incidence of being denied abortion will likely increase, disproportionately affecting young and poor women.
Work in multiple jobs and the risk of injury in the US working population.

OBJECTIVES We compared the risk of injury for multiple job holders (MJHs) with that for single job holders (SJHs). METHODS We used information from the National Health Interview Survey for the years 1997 through 2011 to estimate the rate of multiple job holding in the United States and compared characteristics and rates of self-reported injury (work and nonwork) for SJHs versus MJHs. RESULTS Approximately 8.4% of those employed reported working more than 1 job in the week before the interview. The rate of work and nonwork injury episodes per 100 employed workers was higher for MJHs than for SJHs (4.2; 95% confidence interval [CI] = 3.5, 4.8; vs 3.3; 95% CI = 3.1, 3.5 work injuries and 9.9; 95% CI = 8.9, 10.9; vs 7.4; 95% CI = 7.1, 7.6 nonwork injuries per 100 workers, respectively). When calculated per 100 full-time equivalents (P < .05), the rate ratio remained higher for MJHs. CONCLUSIONS Our findings suggest that working in multiple jobs is associated with an increased risk of an injury, both at work and not at work, and should be considered in injury surveillance.