Miracle-dz/UniFAR-FTUs huggingface dataset:
Sex and Gender: The Challenges for Epidemiologists

Gender issues are now receiving more attention on global and national health agendas. However, the evidence base for policy and practice in this area remains limited and conceptual confusion is still common. This article reviews the challenges facing epidemiologists and other researchers who aim to make their work more “gender sensitive. ” It begins by exploring the concepts of biological “sex” and social “gender” and assesses their implications for the health of both women and men. It then reviews a range of strategies for mainstreaming sex and gender into health research. The article concludes with brief comments on the links between gender equity and wider equality concerns.
Morphologic changes in annulus fibrosus during aging. An ultrastructural study in rats.

Morphologic studies of annulus fibrosus of newborn, young, and old rats were carried out to determine the tissue changes occurring with aging. Newborn annulus consists of an inner portion containing chondroblast-like cells, a middle portion showing cells with intermediate features between chondroblasts and fibroblasts, and an outer portion containing fibroblast-like cells. The cells, arranged in rows, show a prominent ergastoplasm and are surrounded by pericellular lucunae. In the inner portion, the collagen fibers in the matrix are oriented randomly; in the middle and outer portions, the fibers between adjacent cell rows are arranged parallel, forming fibrous lamellae. The collagen fibers have fairly uniform diameters (average 510 nm), are strongly positive to the PASM reaction, and are surrounded by small proteoglycan granules. Both immature and mature elastic fibers are present. Young annulus consists of a transition zone, composed of large cells with no definite arrangement and bundles of collagen fibers oriented in various directions, and a lamellar zone consisting of fibrous lamellae separated by interlamellar septa containing the cells. These show intermediate features between chondrocytes and fibrocytes and well-developed ergastoplasm. The interlamellar septa consist of collagen fibrils and proteoglycans and contain few aggregates of electron dense material. The collagen fibers have highly variable diameters (average 740 nm). The larger fibers are scarcely periodate-silver-methenamine (PASM) positive. The proteoglycans are similar in size to those in the newborn. Few, mature elastic fibers are present. In old annulus, the transition zone is larger than in the young tissue. The cells are less numerous, and most of them show a sparse ergastoplasm. (ABSTRACT TRUNCATED AT 250 WORDS)
Paired analysis of the microbiota of surface mucus and whole‐tissue specimens in patients with chronic rhinosinusitis

The role of bacteria in the pathogenesis of chronic rhinosinusitis (CRS) remains uncertain. Recent evidence suggests that bacteria are able to establish microcolonies within the underlying mucosa. However, to date there has been no systematic comparison of bacterial community composition and diversity in the surface mucosa with that of the underlying tissue.
Nonsurgical hospitalization for low-back pain. Is it necessary?

In 1988, the Diagnosis-Related Group for "Medical Back Problems" was the seventh leading reason for all U.S. hospitalizations. The authors sought to describe the content of these hospitalizations and consider the potential for shifting nonsurgical care to the outpatient setting. Three complementary data sources (the 1988 National Hospital Discharge Survey, a statewide Washington hospital discharge registry, and medical records) were used to examine the diagnoses, tests, treatments, resource use, and subsequent care associated with these hospitalizations. Nationally, nonspecific back pain and herniated discs were the most common diagnoses. Nearly half the hospitalizations were for diagnostic tests (especially myelography) and the other half for pain control. In Washington state, 43% of patients were admitted by family physicians or internists, and 40% by orthopedic or neurologic surgeons. Twenty percent of patients underwent subsequent back surgery within 1 year (most within 3 months), suggesting that many hospitalizations were "presurgical. " Most of the tests and treatments identified are known to be safe in the outpatient setting. Focused medical record review indicated frequent psychosocial problems or complicating factors, including obesity, substance abuse, prior back surgery, psychologic diagnoses, or lack of a caregiver at home. The findings support other evidence that many hospitalizations for "medical back problems" are unnecessary, but also suggest a need for improved outpatient and home-based alternatives to hospitalization.
Osteoporosis and osteopenia in India: a few more observations.

The results showed that out of the 609 persons studied, 538 (88.3%) were women and 71 (11.7%) men. The average age of persons attending these camps was 52 ± 12.8 years of which 325 (53.4%) persons were Muslims [Table 1]. In the population studied, 105/609 (17.2%) had a normal t-score, 247/609 (40.6%) were osteopenic and 257/609 (42.2%) were osteoporotic [Table 2]. Of the 257 persons with osteoporosis, 237 (92.2%) were women and the rest men. Among the 247 with osteopenia, 221 (89.5%) were women. Among the osteopenic women, the maximum number was recorded between the age group of 40-49 years (35.8%) and 50-59 years (29.4%), whereas among the osteoporotic women, maximum numbers were observed in the age groups of 60-69 years (33.8%) and 50-59 years (29.5%) respectively.
Coding algorithms for identifying patients with cirrhosis and hepatitis B or C virus using administrative data

Despite the use of administrative data to perform epidemiological and cost‐effectiveness research on patients with hepatitis B or C virus (HBV, HCV), there are no data outside of the Veterans Health Administration validating whether International Classification of Disease, Ninth Revision, Clinical Modification (ICD‐9‐CM) codes can accurately identify cirrhotic patients with HBV or HCV. The validation of such algorithms is necessary for future epidemiological studies.
Adult attachment and preparing to provide care for older relatives

A normative developmental task of middle-aged adults is to consider older family members' care needs. Preparing for future caregiving responsibilities may be an important way to prevent excessive stress responses when the caregiver role is taken on. The present study investigates the extent to which attachment style and dimensions of attachment insecurity predict whether middle-generation adults prepare for possible future caregiving responsibilities, feel prepared for these responsibilities and are satisfied with their preparation activities. Middle-generation parents of undergraduate students (N = 141) were sent questionnaires assessing adult attachment style, attachment insecurity, preparation for future care activities, feelings of preparedness, and satisfaction with preparation. Results suggest that secure attachment style and lower attachment insecurity had limited associations with preparation activities, whereas the associations with feelings of preparedness were more robust. Moreover, attachment variables predict feelings of preparedness even after controlling for the influence of actual preparation behaviors. Separate analyses for individuals already providing care vs. those not yet providing care suggest that secure attachment may be more important in predicting preparation activities for individuals not yet providing care.
Simultaneous State and Parameter Estimation Based Actuator Fault Detection and Diagnosis for an Unmanned Helicopter

Abstract Simultaneous state and parameter estimation based actuator fault detection and diagnosis (FDD) for single-rotor unmanned helicopters (UHs) is investigated in this paper. A literature review of actuator FDD for UHs is given firstly. Based on actuator healthy coefficients (AHCs), which are introduced to represent actuator faults, a combined dynamic model is established with the augmented state containing both the flight state and AHCs. Then the actuator fault detection and diagnosis problem is transformed into a general nonlinear estimation one: given control inputs and the measured flight state contaminated by measurement noises, estimate both the flight state and AHCs recursively in each time-step, which is also known as the simultaneous state and parameter estimation problem. The estimated AHCs can further be used for fault tolerant control (FTC). Based on the existing widely used nonlinear estimation methods such as the unscented Kalman filter (UKF) and the extended set-membership filter (ESMF), three kinds of adaptive schemes (KF-UKF, MIT-UKF and MIT-ESMF) are proposed by our team to improve the actuator FDD performance. A comprehensive comparative study on these different estimation methods is given in detail to illustrate their advantages and disadvantages when applied to unmanned helicopter actuator FDD.
Calibration of MITSIM and IDM car-following model based on NGSIM trajectory datasets

This paper studies the car-following behaviors of individual drivers in real traffic scenes using the trajectory datasets provided by Next Generation SIMulation (NGSIM) program. We calibrate Intelligent Driver Model (IDM) and MIcroscopic Traffic SIMulator (MITSIM) car-following models by using Genetic Algorithm (GA), with a special emphasize on MITSIM model, because there are already some nice works on the calibration of IDM model. We find that after calibration, the tracking gap errors of both models are normally below 30%. We also find that the parameter set (α<sup>+</sup>, β<sup>+</sup>, γ<sup>+</sup>, α<sup>−</sup>, β<sup>−</sup>, γ<sup>−</sup>) of MITSIM model obtained from different sampling trajectories roughly locate in a low-dimensional hyperplane rather than randomly distribute in the entire parameter space.
In Vitro Activity and Fecal Concentration of Rifaximin after Oral Administration

ABSTRACT Rifaximin showed moderately high MICs (the MIC at which 90% of the isolates tested were inhibited = 50 μg/ml) for 145 bacterial enteropathogens from patients with traveler's diarrhea acquired in Mexico during the summers of 1997 and 1998. Rifaximin concentrations in stool the day after oral administration (800 mg daily for 3 days) were high (average, 7,961 μg/g), proving the value of the drug.
Beneficial effects of dithiothreitol on relative levels of glutathione S‐transferase activity and thiols in oocytes, and cell number, DNA fragmentation and allocation at the blastocyst stage in the mouse

We analyzed the effect of in vitro aging of mouse oocytes in the presence of dithiothreitol (DTT) on relative levels of glutathione S‐transferase (GST) activity and thiols in oocytes, and cell number, DNA fragmentation and cellular allocation to the inner cell mass (ICM) and trophectoderm (TE) lineage at the blastocyst stage. Ovulated oocytes from gonadotropin primed hybrid female mice of 6–8 weeks of age were aged in vitro in the presence of 0, 5, 50, or 500 µM DTT for 6 hr prior to insemination. Relative levels of GST activity and thiols in oocytes were determined by confocal laser scanning microscopy, DNA fragmentation using a single‐step TUNEL method, and cell allocation to the ICM and TE lineage by blastocyst staining with propidium iodide and Hoechst 33258. Non‐aged oocytes exhibited higher relative levels of GST activity and thiols when compared to oocytes aged in the presence of 0, 5, and 50 µM DTT. Day 5 blastocysts from the 5, 50, and 500 µM DTT groups exhibited higher total number of cells, number of ICM cells, and ICM/TE ratio, but lower percentage of number of nuclei with DNA fragmentation/number of ICM cells than blastocyst from the 0 µM DTT group. These data show that DTT counteracts the negative effects of a post‐ovulatory aging of mouse oocytes in vitro on relative levels of GST activity and thiols in oocytes, and percentage of number of nuclei with DNA fragmentation/number of ICM cells, total number of cells, number of ICM cells and ICM/TE ratio in Day 5 blastocysts. Mol. Reprod. Dev. 74: 860–869, 2007. © 2006 Wiley‐Liss, Inc.
Traumatic Brain Injury

Traumatic brain injury (TBI) presents in various forms ranging from mild alterations of consciousness to an unrelenting comatose state and death. In the most severe form of TBI, the entirety of the brain is affected by a diffuse type of injury and swelling. Treatment modalities vary extensively based on the severity of the injury and range from daily cognitive therapy sessions to radical surgery such as bilateral decompressive craniectomies. Guidelines have been set forth regarding the optimal management of TBI, but they must be taken in context of the situation and cannot be used in every individual circumstance. In this review article, we have summarized the current status of treatment for TBI in both clinical practice and basic research. We have put forth a brief overview of the various subtypes of traumatic injuries, optimal medical management, and both the noninvasive and invasive monitoring modalities, in addition to the surgical interventions necessary in particular instances. We have overviewed the main achievements in searching for therapeutic strategies of TBI in basic science. We have also discussed the future direction for developing TBI treatment from an experimental perspective.
Improving hospital venous thromboembolism prophylaxis with electronic decision support.

BACKGROUND Venous thromboembolism (VTE) disease prophylaxis rates among medical inpatients have been noted to be <50%. OBJECTIVE Our objective was to evaluate the effectiveness and safety of a computerized decision support application to improve VTE prophylaxis. DESIGN Observational cohort study. SETTING Academic medical center. PATIENTS Adult inpatients on hospital medicine and nonmedicine services. INTERVENTION A decision support application designed by a quality improvement team was implemented on medicine services in September 2009. MEASUREMENTS Effectiveness and safety parameters were compared on medicine services and nonmedicine (nonimplementation) services for 6-month periods before and after implementation. Effectiveness was evaluated by retrospective information system queries for rates of any VTE prophylaxis, pharmacologic VTE prophylaxis, and hospital-acquired VTE incidence. Safety was evaluated by queries for bleeding and thrombocytopenia rates. RESULTS Medicine service overall VTE prophylaxis increased from 61.9% to 82.1% (P < 0.001), and pharmacologic VTE prophylaxis increased from 59.0% to 74.5% (P < 0.001). Smaller but significant increases were observed on nonmedicine services. Hospital-acquired VTE incidence on medicine services decreased significantly from 0.65% to 0.42% (P = 0.008) and nonsignificantly on nonmedicine services. Bleeding rates increased from 2.9% to 4.0% (P < 0.001) on medicine services and from 7.7% to 8.6% (P = 0.043) on nonmedicine services, with nonsignificant changes in thrombocytopenia rates observed on both services. CONCLUSIONS An electronic decision support application on inpatient medicine services can significantly improve VTE prophylaxis and hospital-acquired VTE rates with a reasonable safety profile.
Airway responsiveness and bronchial-wall thickness in asthma with or without fixed airflow obstruction.

To determine whether asthmatic subjects have an increase in airway wall thickness that could enhance airway narrowing during bronchoprovocation, we examined the relationship between airway responsiveness and bronchial wall thickness measured by high-resolution computed tomography (HRCT). We studied 24 nonsmokers with asthma, of whom 13 had a fixed component of airflow obstruction (Group 1) and 11 had an optimal FEV1 of 80% or more of the predicted value (Group 2). These subjects were compared with a control group of 10 nonasthmatic subjects (Group 3). Measurements were taken of each subject's expiratory flows, bronchodilator response, lung volumes, and methacholine responsiveness. All subjects used an inhaled beta 2-agonist on demand, and 19 also used inhaled steroids (13 in a Group 1 and six in Group 2). HRCT sections were obtained at the top and base of the lung and at the level of the intermediary bronchus (IB), although only this last level was found adequate for analysis. The ratio of IB wall thickness to outer diameter (T/D) showed a negative relationship with the outer diameter in Group 1 only. The mean T/D ratio of IB was not significantly different in Groups 1, 2, and 3, with respective values of 0.16 +/- 0.01, 0.15 +/- 0.01, and 0.18 +/- 0.01 at TLC, and 0.16 +/- 0.01, 0.20 +/- 0.01, and 0.19 +/- 0.01 at FRC. In subjects with a fixed component of airflow obstruction, the thicker the airway wall in relation to its diameter, the lower was the PC20 for methacholine. This was not observed in the other study groups. No correlation was found between the T/D ratio and baseline FEV1. (ABSTRACT TRUNCATED AT 250 WORDS)
Association between postoperative bulla neogenesis at the staple line and resected lung weight for primary spontaneous pneumothorax: a retrospective study using the inverse-probability of treatment weighted method in patients grouped according to age.

BACKGROUND Bullectomy using autosutures is the standard procedure in patients with primary spontaneous pneumothorax (PSP). However, postoperative bulla neogenesis (POBN) along the staple line is relatively common and promotes PSP recurrence. We have previously reported the relationship between POBN and resected lung weight (LW). However, recently published data indicate that young patients with PSP have a high postoperative recurrence rate. Therefore, we evaluated the relationship between POBN and LW in PSP patients, subdivided according to age. METHODS Between February 2011 and April 2016, 96 lung-resection sites in 67 patients who underwent bullectomy were evaluated. Patients were subdivided into two groups by age: Y group (<25 years, 56 sites) and O group (≥25 years, 40 sites). We used the inverse-probability of treatment weighted (IPTW) method to adjust for the heterogeneity in their backgrounds. POBN was diagnosed by computed tomography. RESULTS Cox regression analysis for the O group indicated that LW ≥3.0 g was a significant risk factor for POBN (P=0.049). For the Y group, no association between lung weight and POBN was observed. CONCLUSIONS A LW ≥3.0 g is a significant risk factor for POBN in individuals aged ≥25 years.
Tear MMP-9 levels as a marker of ocular surface inflammation in conjunctivochalasis.

PURPOSE To evaluate the efficacy of surgical treatment for conjunctivochalasis by monitoring matrix metalloproteinase (MMP)-9 levels in the tears of patients with conjunctivochalasis before and after surgery and their correlation with clinical signs and symptoms. METHODS Twelve eyes of patients with symptomatic conjunctivochalasis were included in this study as well as five eyes of healthy volunteers. Ocular surface inflammation was measured in terms of the concentration of pro-MMP-9 in tears, by enzyme-linked immunosorbent assay and zymography. Tear analysis was performed before and 1 month after surgery. The surgical technique consisted of the excision of redundant tissue and the use of organic glue for wound closure. RESULTS The concentration of pro-MMP-9 was significantly higher in the conjunctivochalasis eyes than in the healthy controls (223.4 ± 74.53 ng/mL vs. 20.32 ± 5.21 ng/mL; P < 0.001). Tear pro-MMP-9 levels decreased significantly after conjunctival resection in patients with conjunctivochalasis without dry eye compared with patients with conjunctivochalasis and dry eye associated. Zymographic analysis indicated that MMP-9 is present in its active form only in conjunctivochalasis tears. After a follow-up of 4.9 ± 1.3 weeks, all operated eyes were found to have recovered a smooth and stable conjunctival surface, epithelial defects had improved, and epiphora had been resolved in 89% of cases. CONCLUSIONS Our results indicate that inflammation is likely to play a relevant role in the pathogenesis of conjunctivochalasis. Appropriate surgery decreases inflammatory activity, leading to symptom improvement, and tear analysis may facilitate the treatment of the ocular surface.
DOR EM UNIDADE NEONATAL: CONHECIMENTO, ATITUDE E PRÁTICA DA EQUIPE DE ENFERMAGEM

Avaliar conhecimento, atitude e pratica da equipe de enfermagem no manejo da dor no recem-nascido, segundo a formacao profissional. Estudo transversal, realizado na Unidade Neonatal em hospital de referencia em Recife, estado de Pernambuco, com 105 profissionais, entre agosto e outubro de 2014. Analise realizada no Stata 12.1, utilizado teste t-Student e considerado p<0,05. Quando comparado conhecimento, atitude e pratica da equipe de enfermagem, houve melhor desempenho para atitude, embora nao tenha sido estatisticamente significante. Em conhecimento e pratica, no nivel superior, o valor foi significativo para os que receberam treinamento sobre manejo da dor. No nivel medio, todas as diferencas de medias foram significantes (p<0,05). Para todos os profissionais, a atitude apresentou maiores medias. Conclui-se que os profissionais que trabalham com o recem-nascido devem ser capacitados e treinados continuamente, para que o conhecimento teorico reflita sobre a pratica profissional.
Genetic and environmental factors in associations between infant growth and adult cardiometabolic risk profile in twins 1 – 3

Background: Accelerated infant growth is associated with an altered, mostly adverse adult cardiometabolic risk profile. The importance of genetic and environmental factors to these associations is unclear. Objective: The objective was to examine the importance of genetic and environmental factors in the associations between infant growth and adult cardiometabolic risk factors (anthropometric characteristics, lipids, insulin sensitivity, leptin, blood pressure, and fibrinogen) in twins. Design: Cardiometabolic risk factors were assessed in 240 twin pairs (aged 18–34 y) from the East Flanders Prospective Twin Survey. Infant growth was defined as change in weight z score. We regressed intrapair differences in growth during 4 growth windows (0–1, 1–6, 6–12, and 12–24 mo) against intrapair differences in the risk factors in monozygotic and dizygotic twins separately. Results: Within monozygotic twin pairs only, associations between infant growth and most adult lipids, glucose, leptin, and blood pressure (eg, systolic blood pressure: b = 5.95 mm Hg per change in z score, P = 0.01 in monozygotic twins; b = 21.64, P = 0.82 in dizygotic twins from 12 to 24 mo) were found. Within dizygotic twin pairs only, associations between growth and triglycerides and fibrinogen (eg, fibrinogen: b = 0.07 ln mg/dL per change in z score, P = 0.31 in monozygotic twins; b = 0.79, P = 0.01 in dizygotic twins from 0 to 1 mo) were identified. Most associations showed a detrimental effect of accelerated growth, but beneficial associations were also identified (eg, total–to–high-density-lipoprotein cholesterol ratio: b = 20.22 per change in z score from 1 to 6 mo, P = 0.008 in monozygotic twins). Conclusion: Our data showed that environmental factors play a role in the associations between infant growth and most adult lipids, glucose, leptin, and blood pressure, whereas genetic factors are involved regarding triglycerides and fibrinogen. Am J Clin Nutr 2013;98:994–1001.