Miracle-dz/UniFAR-FTUs huggingface dataset:
Incidence and predictive factors for complications after uterine leiomyoma embolization.

STUDY QUESTION What is the risk of complications after uterine leiomyoma embolization and what are the factors associated with complications? SUMMARY ANSWER The cumulative risk of complications after embolization is relatively low even in the long term, but submucosal leiomyoma location may increase the risk. WHAT IS KNOWN ALREADY A broad spectrum of complications after leiomyoma embolization have been described with widely varying rates. There is uncertainty over the actual risk of complications and the factors associated with this risk. STUDY DESIGN, SIZE, DURATION This was a prospective cohort study of 288 consecutive women undergoing leiomyoma embolization in the general gynaecology clinic of a university teaching hospital between January 2001 and December 2010. PARTICIPANTS/MATERIALS, SETTING, METHODS Complications occurring after embolization were categorized as major or minor according to the severity of their impact on health, the level of care required and the outcome. Cumulative complication rates were estimated by survival analysis and log-rank tests according to baseline variables. Multivariable Cox proportional hazards analysis was performed to adjust for confounders. MAIN RESULTS AND THE ROLE OF CHANCE There were 48 patients who experienced a complication at a median of 5 months (95% confidence interval, 4.1-11.4) after embolization. Complications were minor in 38 patients and major in 10 patients. The cumulative overall complication rate was 13% (95% CI, 9.0-17.0) at 6 months, 16% (95% CI, 11.0-20.0) at 1 year, 17% (95% CI, 12.0-22.0) at 3 years and 18% (95% CI, 12.9-22.8) at 5 years. The most frequent complication (19/48, 39.6%) was leiomyoma expulsion, which occurred spontaneously in 13 (68.4%) of these cases and required assistance in 6 (31.6%) cases. Eight (2.8%) patients underwent re-intervention, including six hysteroscopic myomectomies, one laparoscopic myomectomy and one hysteroscopic adhesiolysis, as a result of a complication. Submucosal leiomyoma location was the only baseline variable associated with an increased risk for complications [Hazard ratio (HR), 2.28, 95% CI, 1.24-4.18, P = 0.008]. LIMITATIONS, REASONS FOR CAUTION Our population did not include women of African descent, who have been reported to be at higher risk of post-procedural complications compared with Causcasian women. If such women were involved in the study, higher morbidity rates might have been observed. WIDER IMPLICATIONS OF THE FINDINGS Women with submucosal leiomyomas at the time of embolization are more likely to have post-procedural complications. This is important new information for counselling patients contemplating this therapeutic approach. STUDY FUNDING/COMPETING INTERESTS The authors have no competing interests to declare. The study was not supported by any external grant.
Ponseti method in the management of clubfoot under 2 years of age: A systematic review

Background Congenital talipes equinovarus (CTEV), also known as clubfoot, is common congenital orthopedic foot deformity in children characterized by four components of foot deformities: hindfoot equinus, hindfoot varus, midfoot cavus, and forefoot adduction. Although a number of conservative and surgical methods have been proposed to correct the clubfoot deformity, the relapses of the clubfoot are not uncommon. Several previous literatures discussed about the technical details of Ponseti method, adherence of Ponseti protocol among walking age or older children. However there is a necessity to investigate the relapse pattern, compliance of bracing, number of casts used in treatment and the percentages of surgical referral under two years of age for clear understanding and better practice to achieve successful outcome without or reduce relapse. Therefore this study aims to review the current evidence of Ponseti method (manipulation, casting, percutaneous Achilles tenotomy, and bracing) in the management of clubfoot under two years of age. Materials and methods Articles were searched from 2000 to 2015, in the following databases to identify the effectiveness of Ponseti method treatment for clubfoot: Medline, Cumulative Index to Nursing and Allied Health Literature (CINHAL), PubMed, and Scopus. The database searches were limited to articles published in English, and articles were focused on the effectiveness of Ponseti method on children with less than 2 years of age. Results Of the outcome of 1095 articles from four electronic databases, twelve articles were included in the review. Pirani scoring system, Dimeglio scoring system, measuring the range of motion and rate of relapses were used as outcome measures. Conclusions In conclusion, all reviewed, 12 articles reported that Ponseti method is a very effective method to correct the clubfoot deformities. However, we noticed that relapses occur in nine studies, which is due to the non-adherence of bracing regime and other factors such as low income and social economic status.
New Environmental Governance on the Range : Voluntary Conservation to Preclude an Endangered Species Act Listing?

approved: ______________________________________________________ Dr. Emily Jane Davis Natural resource challenges in the American West feature a suite of actors and processes operating at different spatial and political scales, and crossing several administrative jurisdictions. I applied concepts of new environmental governance to Oregon’s greater sage-grouse (Centrocercus urophasianus) conservation strategy, focusing, in particular, on features of voluntary conservation arrangements that motivated participation of private landowners in conservation, and how highlevel objectives reached actors responsible for on-the-ground implementation. Data were obtained from one critical case in Lake County, Oregon through in-depth, semi-structured interviews with private landowners who had voluntarily participated in sage-grouse conservation, as well as with governmental and nongovernmental actors from low to high jurisdictional levels. I found that through voluntary conservation arrangements, landowners and midand lower-level actors had flexibility, autonomy, and financial and technical resources to carry out higher-level objectives, that is, conservation outcomes identified by the U.S. Fish and Wildlife Service (USFWS). Landowner participation in voluntary arrangements was largely motivated by well-funded program offerings that were largely aligned with production goals and gave them a sense of control over their own destinies in the context of a potential Endangered Species Act (ESA) listing of sage-grouse. Decentralization and devolution of implementation authority to midand local-level actors was facilitated by organizations acting as intermediaries between landowners and actors at high levels (e.g., the USFWS). This increased the capacity of lower-level actors who felt that they had flexibility to implement conservation while concurrently achieve their own objectives (i.e., continuing to make a living ranching). By aligning voluntary conservation offerings with the economic and cultural context of this case (e.g., using trusted intermediaries to deliver resources to landowners for improving ranching operations), voluntary conservation arrangements may enhance the capacities of local-level implementers and alleviate the need for some regulatory protections in contexts in which conservation and rural livelihoods intersect. This case, relying on voluntary conservation and decentralization of authority, is an example of how new environmental governance offers a way forward in cracking common property challenges. Further exploration of connections between higher levels of governance and local contexts will reveal important, new ways to connect policy-makers to those affected by policy. ©Copyright by Katherine L. Wollstein August 10, 2017 All Rights Reserved New Environmental Governance on the Range: Voluntary Conservation to Preclude an Endangered Species Act Listing? by Katherine L. Wollstein
Ensemble One-Dimensional Convolution Neural Networks for Skeleton-Based Action Recognition

This letter proposes an ensemble neural network (Ensem-NN) for skeleton-based action recognition. The Ensem-NN is introduced based on the idea of ensemble learning, “two heads are better than one. ” According to the property of skeleton sequences, we design one-dimensional convolution neural network with residual structure as Base-Net. From entirety to local, from focus to motion, we designed four different subnets based on the Base-Net to extract diverse features. The first subnet is a Two-stream Entirety Net , which performs on the entirety skeleton and explores both temporal and spatial features. The second is a Body-part Net, which can extract fine-grained spatial and temporal features. The third is an Attention Net, in which a channel-wised attention mechanism can learn important frames and feature channels. Frame-difference Net, as the fourth subnet, aims at exploring motion features. Finally, the four subnets are fused as one ensemble network. Experimental results show that the proposed Ensem-NN performs better than state-of-the-art methods on three widely used datasets.
Factors affecting the effectiveness of financial management information system

This study aims to analyze the factors that influence the effectiveness of management information system in the financial institution. Data were distributed to the managers in financial areas ranging from middle to top management level in Cimahi. The respondents in this study are 49 people. This study uses a quantitative and descriptive approach. The method used is an associative method. Data analysis uses regression analysis model. The unit of analysis in this study is the financial manager in the village and sub-district of Cimahi. Financial managers at the top level and middle level interact directly in the utilization of information technology. The data testing is done through validity test with Spearman Rank correlation coefficient and reliability tests with Cronbach Alpha coefficient. As for descriptive data analysis, multiple regression analysis was used. The results showed that the sophistication of the technology, manager’s knowledge, and participation affect the effectiveness of implementation of financial management information system. The problem that needs to be corrected is the technology that is still inadequate to produce accurate and relevant information.
Tax Planning and Firm Value: Evidence from Malaysia

The main objective of this study is to determine the impact of tax planning on firm value of firms listed in Bursa Malaysia. Tax planning proxies in this study are the Effective Tax Rate (ETR) and Book Tax Differences (BTDs). The 387 samples data were collected from the DataStream from period of 2014 to 2016. After controlling the firm size, leverage, asset tangibility, firm age and dividend, the regression results show that ETR has a significant and positive relationship with firm value while BTDs has insignificant negative relationship with firm value. Firm with less tax planning activities may signal investors that the firm is more transparent in publishing their financial information. Most of our control variables such as leverage, asset tangibility, firm age and dividend have negative relationship with firm value. This study suggests that ETR proxy is suitable to determine firm value rather than BTDs. For future research, this study can be expanded by using more sample size from a longer time frame of research.
Do you bend or break? : Preventing online banking fraud victimization through online resilience

concept for many. While the costs of implementing security measures are real and direct, they often have – in the case of online security – no visible outcome and the threats 54 Clicking on a hyperlink in a phishing e-mail can be the result of habits, such as the habit of being deferential to people in authority (Bullée, 2017). 55 ING (n.d.). Phishing via SMS. Retrieved from https://www.ing. nl/de-ing/veiligbankieren/belangrijke-mededelingen/phishing-per-sms.html
Clinical Presentations of Congenital Hypothyroidism and AssociatedAbnormalities in Children Treated at Western Saudi Arabia

Objectives: To determine the various clinical presentations of and abnormalities associated with congenital hypothyroidism among children diagnosed at King Abdulaziz University Hospital (KAUH), Jeddah, Western Region, Saudi Arabia. Methods: A retrospective, descriptive study of congenital hypothyroidism and associated abnormalities was conducted in Jeddah, Saudi Arabia from January 2010 to January 2015 and included 173 children aged 0 to 12 months. Data were obtained by reviewing KAUH medical records and laboratory results via the hospital’s electronic “Phoenix” system. Results were analyzed using descriptive statistics. Results: Of the 173 diagnosed cases, primary hypothyroidism was most common (95% of cases), while secondary hypothyroidism was diagnosed in 5% of cases. Of all cases diagnosed via the neonatal screening program, 57% were asymptomatic at the time of diagnosis and 43% were symptomatic. Prolonged jaundice (79%) was the most common clinical presentation. Other signs were constipation (7%), hypotonia (6%), goiter (4%), macroglossia (3%), and facial puffiness (1%). Associated congenital anomalies were found in 13% of cases. Conclusion: The findings confirm the importance of the neonatal thyroid screening program, as 57% of diagnosed children were not symptomatic at diagnosis. Pediatricians should be aware of the various clinical presentations of congenital hypothyroidism, particularly prolonged neonatal jaundice.
Periodontal condition of the elderly in Finland

Abstract Objective. To describe the periodontal condition of the elderly in Finland and its association with sociodemographic factors. Material and methods. The study was based on a subpopulation of 1460 persons (748 dentate persons) aged ≥65 years who participated in a nationally representative Health 2000 Survey in Finland. The data for this study were collected by means of an interview and a clinical oral examination. Results. Seventy-three percent of the participants in this study had gingival bleeding in at least one sextant. The proportion of participants with no teeth with deepened periodontal pockets ≥4 mm deep was 31%. Twenty-eight percent of the participants had one to three teeth with deepened periodontal pockets ≥4 mm deep, 15% had four to six and 26% had ≥7. At the individual level, a high number of teeth with deepened periodontal pockets was associated with sociodemographic factors such as high age, intermediate or higher education, and living in a rural area. Conclusion. At a national level, the greatest need for periodontal treatment presently derives from persons aged 65–74 years and/or those with low education, due to their high representation in the elderly population.
Development and outcomes of a psychiatric pharmacy clinic for indigent patients.

PURPOSE The development and outcomes of an outpatient psychiatric pharmacy clinic serving a mostly indigent Hispanic population are described. SUMMARY Su Clinica Familiar (SCF) is a community health center in Texas's Lower Rio Grande Valley that sees over 30,000 patients a year, 20% of whom have a psychiatric disorder. In 2005 SCF began collaborating with a psychiatric clinical pharmacist to provide free psychiatric services within the health center. SCF patients with mental health complications were referred to the clinic by their primary care provider. Consultation notes were reviewed by the medical director, and treatment, if approved, was begun the same day. During the period from April 2005 to June 2006, 96 (77%) of 125 patients referred to the psychiatric pharmacy clinic actually attended it. Fifty-three (72%) of the 74 patients who were asked to return for follow-up care returned. Over 90% of the pharmacist's clinical recommendations were accepted. Most referrals were for depression, anxiety, and cognitive impairment; other referrals were for insomnia, medication education, and smoking cessation. The medications most frequently prescribed were sertraline and donepezil. Cost savings were estimated at $22,380. CONCLUSION A psychiatric pharmacy clinic in an underserved region appeared to benefit patients' mental health and save money.
Self‐tolerance to host and donor following HLA‐mismatched bone marrow transplantation

The transplantation of T cell‐depleted HLA‐haploidentical bone marrow can correct the severe combined immunodeficiency disease (SCID) caused by the inherited absence of T lymphocytes. Despite a different environment, no severe graft‐vs.‐host reaction occurred and engrafted T lymphocytes became functional. We have studied tolerance of engrafted T lymphocytes to donor and host HLA antigens in four SCID patients who have been transplanted with bone marrow from one of their HLA‐haploidentical parents. Graft‐vs.‐host reaction was prevented by T cell depletion of infused bone marrow using E rosetting and by in vivo administration of cyclosporine A. Subsequent to bone marrow transplantation (BMT), the engrafted T lymphocytes were shown to be unresponsive in vitro towards host cells collected prior to BMT. Generally, this tolerance could not be explained by a suppressive mechanism. Nevertheless, in one patient suppressive cells were found transiently. In contrast to the early appearance of a tolerance towards host, a reactivity of engrafted donor cells towards donor was always observed within the first 300 days post‐grafting. This auto‐reactivity was mediated by T cells of donor origin and its targets were HLA class II molecules (at least HLA‐DR and DQ). The progressive disappearance of this auto‐reactivity was correlated with the engraftment of Ia‐positive cells (monocytes plus B lymphocytes) of donor origin and the achievement of complete immunological reconstitution. In the patient showing the strongest autoreactivity, a donor‐specific T cell line has been grown which was shown to specifically inhibit the proliferative response of donor lymphocytes. Concomittantly, the immunological reconstitution remains poor in this patient. These data suggest that tolerance to HLA class II molecules is dependent on the presence of the relevant HLA class II molecule‐expressing cells allowing the elimination or the suppression of T lymphocytes specifically directed at these molecules.
Switching of biologic disease modifying anti-rheumatic drugs in patients with rheumatoid arthritis in a real world setting

Abstract Objectives: This study examined total healthcare costs and rates of patients with rheumatoid arthritis (RA) who switch biologic disease-modifying anti-rheumatic drug (bDMARD) therapy in a real world setting. Methods: A retrospective longitudinal analysis was conducted in patients with RA using IMS PharMetrics Plus database from 1/1/2004 to 3/31/2010. The first-line cohort included patients newly initiated on abatacept or the tumor necrosis factor-alpha inhibitors (anti-TNFs) adalimumab, etanercept, or infliximab, with 12 months of continuous follow-up. The second-line cohort included patients initiating a bDMARD with evidence of a different bDMARD within the previous 2 years and with 12 months of continuous follow-up. Switching was defined as a different bDMARD claim within a 200% gap in days supply from the previous bDMARD claim. Non-switchers stayed on their bDMARD in the follow-up period. Monthly total healthcare costs for switchers and non-switchers and rates of bDMARD switching were examined. Switch rates for each bDMARD were also compared. Results: First-line switchers had significantly higher monthly total healthcare costs after the switch than non-switchers ($3759 vs $2343; p < 0.05), as did second-line switchers ($3956 vs $2616; p < 0.05). First-line abatacept (2.1%) had significantly lower rates of switching compared to adalimumab (9.5%), etanercept (9.0%), and infliximab (5.5%). Second-line abatacept (8.0%) had significantly lower rates of switching compared to adalimumab (16.7%), etanercept (14.4%), and infliximab (14.3%). Limitations: There are no clinical data available in this database and, therefore, this study did not examine the clinical drivers of healthcare costs and switch rates. Conclusions: Monthly total healthcare costs were higher for bDMARD switchers following the switch compared to non-switchers. Patients on abatacept switched less frequently than patients on anti-TNFs. This study highlights the need to identify patients who are likely to switch in order to ensure they receive the appropriate therapy which may improve outcomes and decrease healthcare costs.
Renal hemodynamics during norepinephrine and low-dose dopamine infusions in man.

OBJECTIVE To characterize the effects of pressor doses of norepinephrine and low-dose dopamine (3 micrograms/kg/min) on renal hemodynamics in man, as well as to determine the clinical relevance of combining dopamine with norepinephrine. DESIGN Prospective, single-blind, randomized study. SETTING Clinical research unit of a tertiary care hospital. SUBJECTS. Six healthy male volunteers ranging in age between 20 and 28 yrs. INTERVENTIONS The subjects were assigned randomly to four treatments (1 wk apart) in which renal hemodynamics and electrolyte excretion were assessed. Treatments consisted of 180-min infusions of the following: a) 0.9% sodium chloride (control); b) pressor doses of norepinephrine; c) dopamine at 3 micrograms/kg/min; and d) pressor doses of norepinephrine and dopamine at 3 micrograms/kg/min. Pressor doses of norepinephrine was defined as doses required to increase mean arterial pressure (MAP) by 20 mm Hg. MEASUREMENTS AND MAIN RESULTS Glomerular filtration rate and renal blood flow were derived from inulin and para-aminohippurate clearances, respectively. Urine output and urine solute excretion were also determined. The mean norepinephrine dose required to increase MAP by 22 +/- 2 mm Hg was 118 +/- 30 ng/kg/min (range 76 to 164). After the addition of dopamine, similar doses of norepinephrine resulted in an MAP increase of 15 +/- 4 mm Hg. Glomerular filtration rate and urine output were comparable under all conditions. The infusion of norepinephrine decreased renal blood flow from 1241 +/- 208 to 922 +/- 143 mL/min/1.73 m2 (p = .03). The addition of dopamine returned renal blood flow to baseline values. The clearance of urine sodium increased significantly with the infusion of dopamine alone (p = .03). All subjects completed the four treatment periods. Adverse events, manifested mostly as palpitations and flushing, were rare and self-limiting. CONCLUSIONS The addition of dopamine (3 micrograms/kg/min) to pressor doses of norepinephrine normalized renal blood flow in healthy volunteers. These hemodynamic changes were not reflected in urine output and glomerular filtration rate; hence, these monitoring parameters may be unreliable indicators of renal function in the setting of vasopressor therapy. In addition, systemic effects were observed with dopamine (3 micrograms/kg/min), as indicated by a decrease in MAP.