Miracle-dz/UniFAR-FTUs huggingface dataset:
Cost-benefit Analysis of Sodium Intake Reduction Policy in Korea

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted. (Korean J Community Nutr 17(3) : 341~352, 2012)
An exploration of the views of gay and bisexual men in one London borough of both their primary care needs and the practice of primary care practitioners

This study explored the experiences of gay and bisexual men in primary care. The study was mindful of both the wider context of the HIV epidemic and the increasing acknowledgement of the role of social factors in determining health and well-being. The study informants were 17 gay and bisexual men, all of whom were registered with general practices. Two major barriers to effective communication and possibly treatment were identified. First, despite the fact that all the informants had come out – or disclosed their sexuality – in many areas of their lives, there was considerable anxiety and fear of stigmatisation in relation to doing so in the context of primary care. Second, many practices and practitioners appeared to assume that all their patients were heterosexual; there were few signals in practice environments of any awareness of gay and bisexual men. This generated problems for men wishing to discuss health needs and treatments in relation to their sexuality and to gay social networks; few practitioners had made referrals to any these networks as part of their health promotion strategy. The study raises questions about the organisation of primary care provision and its willingness to acknowledge and form partnerships with gay social networks.
Regulation of Nitric Oxide Synthesis in Wounds by IFN-γ Depends on TNF-α

Macrophage-derived nitric oxide is a critical mediator in wound healing. Its regulation in vivo, however, remains unclear. We hypothesized that interferon (IFN)-γ plays an important role in the regulation of nitric oxide in wounds. Groups of 12 male IFN-γ -knockout mice and wild-type controls underwent dorsal skin incision and polyvinyl alcohol sponges were inserted subcutaneously. Mice were sacrificed 10 days later to determine wound breaking strength and reparative collagen deposition. Synthesis of nitric oxide (NO), tumor necrosis factor (TNF)-α, and IFN-γ was measured in the wound. Wound-derived macrophages were tested for NO synthesis in the presence or absence of IFN-γ, TNF-α, and anti-TNF-α antibody. In a separate experiment, IFN-γ -knockout mice and wild-type controls were treated with molsidomine, a nitric oxide donor. It was found that wound collagen deposition and wound breaking strength were impaired in IFN-γ-knockout mice (p <. 05). Impaired healing was reflected in diminished synthesis of TNF-α and NO in wounds (p <. 05). In vivo treatment with molsidomine reversed impaired healing in IFN-γ-deficient mice. Ex vivo, addition of IFN-γ stimulated the synthesis of TNF-α and NO in wound-derived macrophages. IFN-γ -induced NO synthesis by wound-derived macrophages was abolished by anti-TNF-α-antibody-treatment, which could be fully reversed by exogenous TNF-α. Thus we conclude that IFN-γ-deficiency impairs wound healing and diminishes NO synthesis in wound-derived macrophages. The stimulatory effect of IFN-γ on macrophage NO production depends on endogenous TNF-α synthesis.
Association between thyroid hormones, lipids and oxidative stress biomarkers in overt hypothyroidism

Abstract Background: The aim of this study was to investigate the effect of hypothyroidism on lipid peroxidation and the antioxidant profile, as well as to evaluate the interaction between thyroid hormones and biomarkers of oxidative stress in patients with overt hypothyroidism. We also evaluated the influence of cholesterol concentrations on biomarkers of oxidative stress in these same patients. Methods: Total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), catalase (CAT), and vitamin E were measured in 20 subjects with overt hypothyroidism (OH) and 20 controls. Results: TC, LDL cholesterol, triglycerides, TBARS, SOD, CAT, and vitamin E were significantly higher in the OH group. Significant correlation was observed for TSH and SOD, CAT, vitamin E and TBARS. Correlation was observed for triiodothyronine (T3) and SOD, CAT, vitamin E and TBARS. Significant correlation was also observed for free thyroxine and vitamin E and TBARS. However, correlation between T3 and CAT remained significant after controlling for TC concentrations. Conclusions: Overt hypothyroidism is associated with an increase in oxidative stress, and hypercholesterolemia has a stronger influence on development of oxidative stress in hypothyroid conditions compared with thyroid hormones. Clin Chem Lab Med 2010;48:1635–9.
Review:Transport Losses in Market Weight Pigs: I. A Review of Definitions, Incidence, and Economic Impact

ABSTRACT Transport losses (dead and nonambulatory pigs) present animal welfare, legal, and economic challenges to the US swine industry. The objectives of this review are to explore 1) the historical perspective of transport losses; 2) the incidence and economic implications of transport losses; and 3) the symptoms and metabolic characteristics of fatigued pigs. In 1933 and 1934, the incidence of dead and nonambulatory pigs was reported to be 0.08 and 0.16%, respectively. More recently, 23 commercial field trials (n = 6,660,569 pigs) were summarized and the frequency of dead pigs, nonambulatory pigs, and total transport losses at the processing plant were 0.25, 0.44, and 0.69% respectively. In 2006, total economic losses associated with these transport losses were estimated to cost the US pork industry approximately $46 million. Furthermore, 0.37 and 0.05% of the nonambulatory pigs were classified as either fatigued (nonambulatory, noninjured) or injured, respectively, in 18 of these trials (n = 4,966,419 pigs). Fatigued pigs display signs of acute stress (open-mouth breathing, skin discoloration, muscle tremors) and are in a metabolic state of acidosis, characterized by low blood pH and high blood lactate concentrations; however, the majority of fatigued pigs will recover with rest. Transport losses are a multifactorial problem consisting of people, pig, facility design, management, transportation, processing plant, and environmental factors, and, because of these multiple factors, continued research efforts are needed to understand how each of the factors and the relationships among factors affect the well-being of the pig during the marketing process.
An appraisal of statistical procedures used in derivation of reference intervals

Abstract When conducting studies to derive reference intervals (RIs), various statistical procedures are commonly applied at each step, from the planning stages to final computation of RIs. Determination of the necessary sample size is an important consideration, and evaluation of at least 400 individuals in each subgroup has been recommended to establish reliable common RIs in multicenter studies. Multiple regression analysis allows identification of the most important factors contributing to variation in test results, while accounting for possible confounding relationships among these factors. Of the various approaches proposed for judging the necessity of partitioning reference values, nested analysis of variance (ANOVA) is the likely method of choice owing to its ability to handle multiple groups and being able to adjust for multiple factors. Box-Cox power transformation often has been used to transform data to a Gaussian distribution for parametric computation of RIs. However, this transformation occasionally fails. Therefore, the non-parametric method based on determination of the 2.5 and 97.5 percentiles following sorting of the data, has been recommended for general use. The performance of the Box-Cox transformation can be improved by introducing an additional parameter representing the origin of transformation. In simulations, the confidence intervals (CIs) of reference limits (RLs) calculated by the parametric method were narrower than those calculated by the non-parametric approach. However, the margin of difference was rather small owing to additional variability in parametrically-determined RLs introduced by estimation of parameters for the Box-Cox transformation. The parametric calculation method may have an advantage over the non-parametric method in allowing identification and exclusion of extreme values during RI computation. Clin Chem Lab Med 2010;48:1537–51.
Cerebral venous sinus thrombosis: an unusual initial presentation of mucinous adenocarcinoma of stomach.

There is no standard treatment protocol that has been established. The prevailing opinion is that GS with or without bone marrow involvement should be treated as AML because of the high risk of metachronous AML occurrence. Systemic chemotherapy is significantly useful for these patients to have a good long‐term survival. Surgical therapy is the only reserved presenting clinical symptom due to mass effect. The long‐term prognosis of non‐leukemia GS is still despondent.
Retrospective study of deep surgical site infections following spinal surgery and the effectiveness of continuous irrigation

Surgical site infection (SSI) is an unfortunate and unpreventable complication of any surgical intervention including spinal surgery. Early deep SSI (EDSSI) after instrumented spinal fusion are particularly difficult to manage due to the implanted, and possibly infected, instrumentation. The purpose of this study is to retrospectively review patients who underwent spinal surgery, investigate the rate of EDSSI, identify patient-related and surgery-related risk factors and to assess the effectiveness of continuous indwelling irrigation on the eradication of these infections. A total of 814 patients (319 women and 495 men) who underwent spinal surgery were enrolled. Mean age at the initial surgery was 57.4 years old. Infections that penetrated the deep fascia within 1 month after the initial operation were considered as EDSSI. The rate of EDSSI, causal organisms, infection management and resolution were studied. Furthermore, we examined the patient-related and the operation-related risk factors. An overall incidence of EDSSI of 1.1% was found. In 177 patients with diabetes mellitus (DM), two patients (1.1%) developed EDSSI. In 28 patients receiving chronic haemodialysis (HD), two patients with infections (7.1%) were identified, which was statistically significantly greater than the other patient populations. Both operative time and intraoperative blood loss were significantly greater in patients with EDSSI than in non-infected patients. Furthermore, the rate of EDSSI in patients undergoing instrumented spinal fusion (3.8%) was significantly higher than that in the other patients. In the nine patients who developed EDSSI, the causal organisms were identified and treated by surgical debridement, antibiotic therapy and continuous indwelling surgical site irrigation. All infections resolved, and no recurrence has been observed at final follow-up. Removal of the instrumentation was required in only one patient. Based on our results, we believe that continuous surgical site irrigation is an effective adjunct in the surgical treatment for early SSI following spinal surgery.
Macrolides and lincosamides.

Macrolides and lincosamides are first choice bacteriostatic antibiotics used in veterinary dermatology. The main antibiotics in these classes are erythromycin, lincomycin, clindamycin and tylosin. They are well absorbed if given orally and are able to penetrate well into infected skin. Their spectrum of action comprises bacteria commonly associated with skin infections, including staphylococci. Their main disadvantages are the rapid development of bacterial resistance and occasional gastroenteric upset, most often seen with erythromycin. More recently developed macrolides, such as azithromycin and clarithomycin, are bactericidal, have a larger spectrum of action, a longer endurance, less resistance and may be given once a day instead of two or three times daily.
Convergences and divergences in mortality

Abdel Omran's 1971 theory of "Epidemiologic Transition" was the first attempt to account for the extraordinary advances in health care made in industrialized countries since the 18th century. In the framework of the Demographic Transition, it implied a general convergence of life expectancies toward a limit imposed by the new epidemiological features of modern societies. However, important failures, occurred in the past decades (mainly the health crisis in Eastern Europe and AIDS in Africa), seem to have stopped that process of convergence. In fact such failures do not really contradict the theory. The latter is much more ruined by the unexpected dramatic improvement in the field of cardiovascular disease experienced since the seventies, which results in a new step of a more general process. On the basis of the broader concept of “Health Transition” initiated by Julio Frenk et al., the present paper tries to rethink the full process in term of divergence/convergence sequences inferred by successive major changes in health technologies and strategies.
Psychosocial Barriers to Diabetes Self-Management and Quality of Life

In Brief Diabetes self-management can be difficult and frustrating for both patients and practitioners. Information is needed about which barriers present the greatest obstacles for which types of patients, and from this, practical, cost-effective interventions need to be developed. This article reviews existing research on psychosocial and interpersonal barriers to diabetes self-management and quality of life. It also presents new data on a self-efficacy-based barriers instrument and makes recommendations for future research.
ROTEM and multiplate – a suitable tool for POC?

The early recognition of perioperative coagulation disorders is essential to identify non-surgical reasons of bleeding, to initiate appropriate haemostatic treatment and finally to reduce perioperative blood loss. Conventional laboratory coagulation tests include prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen levels and platelet counts. Although these parameters are frequently assessed, their value has been challenged at least in the setting of acute perioperative bleeding [1]. PT and aPTT are performed in an artificial ‘in vitro’ system, i.e. in plasma separated from whole blood, which is then warmed to 37 C and buffered to a pH of 7AE4. These standardized conditions often do not reflect the patient’s situation [2]. Plasmatic ‘in vitro’ tests merely reflect the time elapsing until the activation of thrombin, but provide only marginal information about the functional state of the coagulation system (e.g. platelet function, interaction of plasmatic coagulation factors with platelets and red blood cells, clot firmness, fibrinolysis). Routine coagulation tests are mostly performed in the central laboratory, i.e. remote from the operating theatre. As a consequence, test results are often not available in time or with a considerable delay [3]. Current devices designed for point-of-care (POC) monitoring of coagulation have been designed for the assessment of coagulation directly at the bedside, so that results could be available earlier. Moreover, POC tests are usually performed in whole blood, thereby comprising interactions between cellular components (i.e. platelets and red blood cells) and plasmatic coagulation factors. Commonly used POC devices for assessment of plasmatic coagulation and platelet function are listed in Table 1. This review focuses on rotation thrombelastography (ROTEM ) as a global coagulation test and multiple electrode aggregometry (MEA, Multiplate ) for assessment of platelet function. Rotation thrombelastometry (ROTEM )
Clomipramine (Anafranil) in the Treatment of Obsessional Illnesses and Phobic Anxiety States

A method of treating patients suffering from obsessional illnesses and phobic anxiety states by means of large doses of clomipramine given in slow intravenous drips is described. Eighty-five patients are reviewed, with follow-up in every available subject carried out as long as possible. The occurrence of symptom groups is examined, and finally the response to the treatment of the major constellations of the obsessional and phobic anxiety groups is compared. An overall reduction of symptom severity by a factor of about 2.4 for the obsessional group and of about 6 for the phobic anxiety group is demonstrated.
Simultaneous posterior and middle cerebral artery infarct.

On the follow-up, the patient developed painful, erythematous skin lesion of 15 cm in diameter, located on the lateral malleolus and dorsum of the foot [Figure 2]. MEFV gene investigation revealed homozygote mutation for M694V gene. Five pyrin gene mutations (E148Q, M680I, M694V, M694I and V726A) were detected by using the PRONTOTM FMF Basic Kit according to the manufacturer’s instructions. Biopsy specimens from the duedonum and rectum were negative for amyloidosis. A diagnosis of FMF with CNS demyelination was considered and colchicine therapy was started. With colchicine therapy, her symptoms regressed and no further progression of the disease was observed during two years follow-up.
The Treatment of Anxious/Depressive States: A Double-Blind Comparison of Medazepam with Fluphenazine/Nortriptyline

A double-blind comparison of medazepam 10 mg (‘Nobrium’) tds with fluphenazine 0·5 mg/nortriptyline 10 mg (‘Motival’) tds was conducted in general practice patients suffering from anxiety with mild depression. Patients were assessed on self-rating and Physician's Rating symptom scales, and by twenty-eight days fluphenazine/nortriptyline was shown to be superior to medazepam in relief of symptoms taken individually and as a whole, the level of significance reaching 0·1% on patients' self-ratings. A similar trend in favour of fluphenazine/nortriptyline was seen at seven days but only reached 5% significance levels for certain symptom clusters on the patient's self-ratings. The implications of these results for therapy with psychotropic drug combinations, and the treatment of psychiatric illness in general practice are discussed.
The effects of the NICE Technology Appraisal 121 (Gliadel and Temozolomide) on survival in high-grade glioma

Objective. The prognosis of high-grade glioma (HGG) is poor with a median survival of about 1 year for glioblastoma. In 2007, NICE published a technology appraisal (TA121) recommending the use of carmustine wafers (Gliadel) and systemic therapy with temozolomide for selected patients with HGG. Outcomes for HGG surgery in the United Kingdom with these combined treatments have not been published. Design. Retrospective audit of consecutive patients in a single unit with carmustine wafer implantation. Subjects. Fifty-nine patients had carmustine wafers implanted at primary surgery, between October 2005 and October 2010 at Wessex Neurological Centre, Southampton, UK. Methods. Patients were given chemotherapeutic treatments strictly according to NICE TA121. Survival was calculated using Kaplan-Meier method. Results. Fifty-five patients had WHO grade IV tumours and four had grade III. Median age was 61 years. At follow-up, 39 patients had died. Median survival was 15.3 months. Eight patients (13.5%) experienced post-operative complications (including five infections) for which four had the carmustine wafers removed. Forty-seven (80%) patients were treated with radical radiotherapy (55–60 Gy) and six (10%) patients received palliative radiotherapy (30 Gy). Thirty-seven patients (63%) received concomitant temozolomide chemotherapy. In the subset of 37 patients receiving multimodal treatment with radical radiotherapy and concomitant temozolomide, median survival was 15.8 months compared with 7.4 months in those not receiving multimodal treatment. Discussion. Carmustine wafers for primary HGG surgery in accordance with the NICE TA121 were associated with a median survival of 15.3 months; this is improved compared with previously reported randomised trials. Multimodal treatment with carmustine wafers, radical radiotherapy and concomitant temozolomide was associated with improved survival. Increased incidence of infections was observed in cases receiving carmustine wafers.
The impact of falls in the elderly

The number of falls in the elderly is becoming a major public health problem in our society. In the past decade, life expectancy has increased from 75 years in 1990 to 79 years in 2009 in the US. It has been estimated that the number of persons aged 65 years and older in the US will double by 2050. In 2000, falls accounted for 45% of all injury-related inpatient stays with almost 750,000 hospitalizations. Fractures were the most common primary injury diagnosis, including 314,006 hip fractures. Injury following a fall is associated with a decreased quality of life and poor functional outcome, in severe injuries these effects continue for a prolonged period of time. In 2006, fall-related medical costs in the population aged ≥65 in the US amounted to US$19 billion for non-fatal and US$0.2 billion for fatal injuries. In this article, we provide a literature overview on the impact of falls in the elderly, the demands on healthcare, and the costs for our society.