Miracle-dz/UniFAR-FTUs huggingface dataset:
‘We thought if it’s going to take two years then we need to start that now’: age, infertility risk and the timing of pregnancy in older first-time mothers

Over the past few decades, the number of women having their first babies over the age of 35 in most developed societies has steadily increased. Concerns have been raised over this trend amidst warnings of both the increased risk of fertility problems and health risks to mother and child. Despite this, research into the timing of pregnancy in the context of decreasing fertility has been somewhat neglected, with research typically framed in biomedical rather than social terms. However, this area merits closer attention, given the contradictory nature of societal messages that simultaneously encourage women to pursue careers and enhance lifestyle, whilst warning of ‘risks’ of infertility and problems in ‘delaying’ motherhood. This article is based on a small-scale qualitative study that uses data drawn from 11 in-depth interviews with ‘older mothers’ about their transition to motherhood. The data were thematically analysed. We found that the women drew upon risk discourses around decreasing fertility and advancing maternal age, and that these discourses impacted on their decisions about the timing of their pregnancies. Some mothers felt that they started trying to conceive at ‘non-ideal’ times, owing to the expectations they held about decreasing fertility. We suggest that the impact of contradictory societal messages around the timing of motherhood need to be more clearly considered for their potential effects on the timing of pregnancy and note how this topic brings the personal, and, by implication, the societal, into conflict with the (narrated) biological.
Evaluation of Local Ecological Knowledge as a Method for Collecting Extensive Data on Animal Abundance

Abstract: The use of local ecological knowledge (LEK) has been advocated for biodiversity monitoring and management. To date, however, it has been underused in studying wild populations of animals and, particularly, in obtaining quantitative abundance estimates. We evaluated LEK as a tool for collecting extensive data on local animal abundance and population trends. We interviewed shepherds in southeastern Spain, asking them to estimate the local abundance of the terrestrial tortoise Testudo graeca. We quantified reliability of abundance estimates derived from interviews by comparing them with those obtained from standard field‐sampling protocols (distance sampling). We also explored the complementarity of these 2 approaches. LEK provided high‐quality and low‐cost information about both distribution and abundance of T. graeca. Interviews with shepherds yielded abundance estimates in a much wider range than linear transects, which only detected the species in the upper two‐thirds of its abundance range. Abundance estimates from both methodologies showed a close relationship. Analysis of confidence intervals indicated local knowledge could be used to estimate mean local abundances and to detect mean population trends. A cost analysis determined that the information derived from LEK was 100 times cheaper than that obtained through linear‐transect surveys. Our results should further the use of LEK as a standard tool for sampling the quantitative abundance of a great variety of taxa, particularly when population densities are low and traditional sampling methods are expensive or difficult to implement.
Seasonal Variation in the Presentation of Infectious Keratitis

Introduction: Infectious keratitis is a common ophthalmic disease with the potential for severe ocular morbidity. Multiple studies have described various risk factors for the development of infectious keratitis. The purpose of this study was to analyze the seasonal variation in the presentation of infectious keratitis, and also seasonal changes in its etiologies and risk factors. Methods: A retrospective chart review was performed on consecutive patients presenting to the emergency department at our tertiary care urban hospital center who were diagnosed with infectious keratitis from 2008 to 2013. A chi-square analysis was performed to determine whether a significant seasonal variation existed between the month, season, frequency of presentation of ulcers, and other risk factors. Results: A total of 155 patients—53 men and 102 women—with a mean age of 40 (range, 3–97; median, 36) diagnosed with infectious keratitis were included in the analysis. Sixty-nine (44.5%) ulcers presented in the summer, 19 (12.3%) in the fall, 34 (21.9%) in the winter, and 33 (21.3%) in the spring (P<0.0001). Seventeen (11%) patients experienced diabetes mellitus, 60 (39%) were contact lens wearers, 12 (8%) ulcers occurred in the setting of trauma, and 19 (12%) patients underwent previous ocular surgery. A total of 92 ulcers were cultured, of which 53.8% were positive in the summer, 42.9% in the fall, 55.0% in the winter, and 42.1% in the spring. A significant seasonal variation in the frequency of 1 organism, Pseudomonas aeruginosa, was identified (P=<0.0001); up to 47.6% of culture-positive ulcers in the summer were P. aeruginosa positive, whereas cultures in the remaining seasons were 0, 9.1% and 12.5% positive for this organism. Discussion: The summer months have a higher frequency of infectious keratitis and P. aeruginosa positivity in this study. Possible factors leading to this increased summer presentation include warmer temperatures, higher humidity, and greater ocular exposure to water. Clinicians should increase their vigilance and education to high-risk patients during these periods and potentially modify empiric treatment regimens.
The Value of Species and the Ethical Foundations of Assisted Colonization

Abstract: Discourse around assisted colonization focuses on the ecological risks, costs, and uncertainties associated with the practice, as well as on its technical feasibility and alternative approaches to it. Nevertheless, the ethical underpinnings of the case for assisted colonization are claims about the value of species. A complete discussion of assisted colonization needs to include assessment of these claims. For each type of value that species are thought to possess it is necessary to determine whether it is plausible that species possess the type of value and, if so, to what extent their possessing it justifies assisted colonization. I conducted such an assessment for each of the predominant types of value ascribed to species: ecological, instrumental (including option value), existence, and intrinsic value (including interest‐based, objective, and valuer‐dependent intrinsic value). The vast majority of species, including several that have been proposed as candidates for assisted colonization, have much less value than is often presumed. Moreover, with respect to some types of value, assisted colonization would not fully preserve the value of the target species even if it were to keep the target species in existence. Therefore, the case for assisted colonization is significantly weaker and more qualified than its advocates often suppose. There may be exceptional species for which assisted colonization is well justified—and for this reason, case‐by‐case assessment is necessary—but in general the burden of justification generated by the ecological risks associated with assisted colonization is not met by the value potentially preserved by assisted colonization. This suggests that assisted colonization ought to have, at most, a very minor role in the portfolio of ecosystem management practices, even as it pertains to species conservation under conditions of rapid climate change.
Importance of risk factors associated with malaria for Sub-Saharan African children

Abstract To assess the importance of malaria risk factors for children in sub-Saharan African countries. 61,292 children of 16 countries from DHS and MIS surveys were included in analysis. A regression model with analyse of variance and plots of mean decrease accuracy and mean decrease Gini indices were performed. The most important risk factor was the country and it contributed 52.33 % to the variance of the model. Wealth status of the child’s family was the first socio-economic factor which contributed more to the difference of malaria risk among African children. There was no geographic factor among the five most important variables. Quantity of precipitation was the sixth most important factor. Our study has the potential for driving control effort in the fight against malaria in the continent which represent the majority of global malaria cases. The study indicates that, when implementing health policies, community characteristics must be taken into account.
Thyroid Autoimmunity at Onset of Type 1 Diabetes as a Predictor of Thyroid Dysfunction

We appreciate Warren and Frier’s (1) interest in our article (2). Unfortunately, we cannot calculate the predictive value of thyroid stimulating hormone (TSH) level at diabetes onset in our cohort because this determination is not available for all patients. The fact that the high-normal TSH level was more predictive of thyroid …
Reasons Why Older Americans Use Complementary and Alternative Medicine: Costly or Ineffective Conventional Medicine and Recommendations from Health Care Providers, Family, and Friends

We studied four reasons why older adults use complementary and alternative medicine (CAM). Data were from the 2007 U.S. National Health Interview Survey and its Complementary and Alternative Medicine supplement (n = 10,096, ages 50+, representing 89.5 million adults). Logistic analyses adjusted for the sampling design and were weighted for national representation. A sample representing 25 million older adults said they used CAM because a health care provider recommended it. Other reasons were recommendations by family, friends, or coworkers (20.2 million), ineffective conventional medicine (5.2 million), and costs of conventional medicine (4.0 million). In adjusted results, women were more likely than men to use CAM for all four reasons. African Americans and Hispanics were less likely than Whites to use CAM for most of these reasons. The uninsured were much more likely to use CAM because conventional medicine was too expensive. Those with higher incomes were less likely to do so. Older adults with chronic conditions, especially musculoskeletal conditions or depression, were more likely to use CAM for most of these reasons. Health providers may be particularly likely to recommend CAM for chronic conditions. These recommendations may be reinforced by limited efficacy of conventional medicine for these conditions and its cost. CAM and conventional medicines can interact, causing risks to health. It is, therefore, useful to help health care providers identify patients most likely to use CAM and their reasons for doing so. These are the patients most likely to benefit from conversations about CAM interactions with conventional medicine.
Variation in Physiological Stress between Bridge‐ and Cave‐Roosting Brazilian Free‐Tailed Bats

Abstract: Since the late 1980s, Brazilian free‐tailed bats (Tadarida brasiliensis) have increasingly used bridges as roosts in the southern United States. We examined differences in blood cortisol levels, body condition, and parasite load, as measures of physiological stress in bats roosting in bridges and bats roosting in caves. We collected data during three periods, coinciding with female phases of reproduction. For all measures, bats were captured during the nightly emergence from the roost and immediately sampled. Cortisol levels were significantly higher during pregnancy and lactation and in individuals with lower body‐condition scores (length of forearm to mass ratio) and significantly higher in bats roosting in caves than in those roosting in bridges. Thus, we concluded that individuals of this species that roost in bridges are not chronically stressed and seem to be unaffected by human activities present at bridges. This is a rare documented instance where a human‐dominated environment does not appear to be adversely affecting the physiological health of a free‐ranging animal.
Assessing older prostate cancer patients for chemotherapy: recommendations from the International Society of Geriatric Oncology

Prostate cancer in elderly patients is a major health concern. A panel of prostate cancer specialists and geriatric oncologists has developed specific treatment guidelines for this population. These guidelines are valid, internationally accepted and compulsory. However, they must be adapted during the decision-making process as a function of the patient’s health status. Health status screening is based on dependence, nutrition and evaluation of comorbidities. Patients are divided into four health status-based groups that allow adaptations of cancer treatment with androgen deprivation, chemotherapy and palliative treatment.
Optimization of the extrusion conditions and formulation of spaghetti enriched with full-fat soy flour based on the cooking and color quality

The influence of full-fat soy flour (FFSF) 0–27.0 g/100 g, water content 31.0–35.0 g/100 g and extrusion conditions on the cooking and color characteristics of spaghetti was investigated. The process was performed with a speed of 10–40 rpm and a water circulating temperature of 35–70°C. The results showed that adding FFSF causes decreases (P≤0.05) in cooking time, cooking weight, intensity and hue characteristics. However, the cooking loss and saturation of spaghetti increased (P≤0.05). The temperature and speed of the extruder had no significant effect on the cooking and color attributes. Interaction between them and the components, however, had a slight synergistic effect on characteristics. Also, interaction between the components and the water temperature has a negative effect on the color and cooking loss. Data analysis showed that the cooking and color characteristics were optimized when 56.9 g/100 g wheat flour, 12.1 g/100 g FFSF and 31.0 g/100 g water content at a screw speed of 40 rpm and a temperature of 35°C were applied.
Assessment of quality parameters in grapes during ripening using a miniature fiber-optic near-infrared spectrometer

Changes in the chemical properties of wine grapes during ripening were studied using near-infrared (NIR) spectroscopy. A miniature fiber-optic NIR spectrometer system working in transmission mode in the spectral region (700 − 1,060 nm) was evaluated for this purpose. Spectra and analytical data were used to develop partial least square calibration models to quantify changes in the major parameters used to chart ripening in this fruit. NIR spectroscopy provided excellent precision for soluble solid content and for reducing sugars, and good precision for maturity index, while for pH and titratable acidity the miniature NIR spectroscopy instrument proved less accurate. The performance of the instrument in classifying wine grapes by grape type and by irrigation regime was also studied. Percentages of correctly classified samples ranged from 82.7% to 96.2%. The results show that the monitoring of soluble solid content and reducing sugars’ changes in wine grape quality parameters during ripening, as well as the classification of grapes, can be performed non-destructively using a miniature fiber-optic NIR spectrometer.
Doppler optical coherence tomography for monitoring the vascular effects of photodynamic therapy

Doppler optical coherence tomography (DOCT) is a powerful tool for providing not only subsurface microstructural, but also functional information. Our group's system is able to image blood vessels as small as ~ 30 μm in diameter, with blood flows as slow as ~ 20 μm/s. Photodynamic therapy (PDT), once a "novel" cancer treatment, is now a major research field in biophotonics and is gaining clinical popularity. The highly sensitive DOCT system was used to image microcirculation in normal rat colon and a rat prostate cancer model before, during, and after PDT. The results demonstrate that DOCT can monitor the vascular changes during PDT and that DOCT can highlight the differences in tissue response with different treatment protocols. Furthermore, DOCT demonstrated differences in response between normal and cancerous tissues.
Oral glucose solution as pain relief in newborns: results of a clinical trial.

BACKGROUND It was long believed that newborns could not experience pain. As it is now documented that newborns have all the necessary systems to perceive pain, pain management can no longer be ignored. The objective of this study is to investigate which concentration of glucose is most effective in reducing pain for venipuncture in the newborn. METHODS This double-blind clinical trial of 304 newborns was conducted on a maternity and neonatal ward (neonatal medium intensive care unit). During at least 1 month, one of the four selected solutions (10, 20, 30% glucose, and placebo) was administered orally, 2 minutes before the venipuncture was performed. The pain from the skin puncture was scored using a validated pain scale (the "Leuven Pain Scale"). RESULTS This study showed a significantly lower average pain score in the 30 percent glucose group (3.99) when compared with the placebo group (8.43). The average pain scores in the 20 percent glucose group (5.26) and the 10 percent glucose group (5.92) were also significantly lower than those in the placebo group. CONCLUSION Oral administration of 2 mL of 30 percent glucose 2 minutes before the venipuncture provides the most effective pain reduction in newborns.
Childhood abuse and fear of childbirth--a population-based study.

BACKGROUND Childhood abuse affects adult health. The objective of this study was to examine the association between a self-reported history of childhood abuse and fear of childbirth. METHODS A population-based, cross-sectional study was conducted of 2,365 pregnant women at five obstetrical departments in Norway. We measured childhood abuse using the Norvold Abuse Questionnaire and fear of childbirth using the Wijma Delivery Expectancy Questionnaire. Severe fear of childbirth was defined as a Wijma Delivery Expectancy Questionnaire score of ≥ 85. RESULTS Of all women, 566 (23.9%) had experienced any childhood abuse, 257 (10.9%) had experienced emotional abuse, 260 (11%) physical abuse, and 290 (12.3%) sexual abuse. Women with a history of childhood abuse reported severe fear of childbirth significantly more often than those without a history of childhood abuse, 18 percent versus 10 percent (p = 0.001). The association between a history of childhood abuse and severe fear of childbirth remained significant after adjustment for confounding factors for primiparas (adjusted OR: 2.00; 95% CI: 1.30-3.08) but lost its significance for multiparas (adjusted OR: 1.17; 95% CI: 0.76-1.80). The factor with the strongest association with severe fear of childbirth among multiparas was a negative birth experience (adjusted OR: 5.50; 95% CI: 3.77-8.01). CONCLUSIONS A history of childhood abuse significantly increased the risk of experiencing severe fear of childbirth among primiparas. Fear of childbirth among multiparas was most strongly associated with a negative birth experience.
Acupuncture of Motor-Implicated Acupoints on Subacute Stroke Patients: An fMRI Evaluation Study

Abstract Background: Motor impairment is common after stroke. Along with classic integrated physical and occupational therapy, acupuncture is also suggested as an adjunctive therapy. Objective: To evaluate the effectiveness of acupuncture on upper limb motor recovery of patients with subacute stroke. Design, Setting, and Patients: Eighteen subacute stroke patients, transferred from a regional acute hospital to a convalescent hospital for rehabilitation in Hong Kong, from March 2005 to November 2007. Two clinical and behavioral evaluations for motor function were given to each participant along with 2 functional magnetic resonance imaging (fMRI) scans. Intervention: Patients were treated with acupuncture 3 times a week over 8 weeks. The intervention set of 3 acupoints is known to influence the motor system, while a second control set does not. Physical and occupational therapy were also used as treatment (parallel to the interventions with acupuncture). Main Outcome Measures: The primary outcome measure wa.
Are first-time mothers who plan home birth more likely to receive evidence-based care? A comparative study of home and hospital care provided by the same midwives.

BACKGROUND "Place of birth" studies have consistently shown reduced rates of obstetric intervention in low-technology birth settings, but the extent to which the place of birth per se has influenced the outcomes remains unclear. The objective of this study was to compare birth outcomes for nulliparous women giving birth at home or in hospital, within the practice of the same midwives. METHODS An innovative survey was generated following a focus group discussion that compared midwifery practice in different settings. Two groups of matched, low-risk first-time mothers, one group who planned to give birth at home and the other in hospital, were compared with respect to birth outcomes and midwifery care, and in relation to evidenced-based care guidelines for low-risk women. RESULTS Survey data (response rate: 72%) revealed that women in the planned hospital birth group (n = 116) used more pharmacological pain management techniques, experienced more obstetric interventions, had a greater rate of postpartum hemorrhage, and achieved spontaneous vaginal birth less often than those in the planned home birth group (n = 109). All results were significant (p < 0.05). CONCLUSIONS Despite care by the same midwives, first-time mothers who chose to give birth at home were not only more likely to give birth with no intervention but were also more likely to receive evidence-based care. (BIRTH 39:2 June 2012).
Treatment of small‐cell lung cancer in elderly patients

Small‐cell lung cancer (SCLC) represents 15% to 20% of all lung carcinomas. Approximately 30% to 40% of these cases are diagnosed in patients older than 70 years of age. Staging of SCLC classifies patients as having either limited or extensive‐stage disease. The standard treatment for limited‐stage disease is platinum‐based chemotherapy, combined with external‐beam thoracic radiotherapy, whereas platinum‐based regimens alone represent the standard of care for extensive‐stage disease. In the elderly population, treatment of SCLC is more challenging given the decline in physiological organ reserve and the presence of comorbidities. The majority of data are drawn from retrospective studies, which are likely to suffer from selection bias. However, limited prospective data are available to guide treatment decisions in that special population. Nonetheless, these data demonstrate that standard approaches are feasible in carefully selected elderly patients. The purpose of this article is to review the currently available evidence on treatment of SCLC in patients older than 65‐70 years of age. Cancer 2010. © 2010 American Cancer Society.