Miracle-dz/UniFAR-FTUs huggingface dataset:
Perceptions of dental treatment need in Australian‐born and migrant populations

The objective of this study was to investigate differences in self-perceived and dentist-determined treatment need in Australian-born and migrant residents of Australia. Participants in the National Survey of Adult Oral Health 2004-06 were categorized into six groups according to country of birth. Interview and examination data were used to analyze differences between self-perceived and the 'gold standard' examiner-determined treatment need, and to compare the accuracy of self-reporting according to country of birth. Self-reported treatment needs, defined as the need for a restoration and/or extraction, were cross-tabulated with clinically observed conditions and compared using a multivariable logistic regression model. Concordance between self-reported and clinically-determined treatment need differed significantly for migrants from Europe and the UK and Australian-born individuals. In the logistic regression model, stratification according to examiner-determined treatment need revealed significantly greater reporting of treatment need by Asian-born migrants than by the Australian-born reference group. The results of this study demonstrate that self-perceived treatment need was less than the examiner-determined findings in European and UK migrant groups and Australian-born individuals. Additionally, Asian migrants were more likely than Australian-born individuals to over-report treatment need for a filling and/or extraction.
Frontal lobe function and structure in juvenile myoclonic epilepsy: A comprehensive review of neuropsychological and imaging data

Juvenile myoclonic epilepsy is the most common idiopathic epilepsy syndrome and is considered a benign seizure disorder that responds well to antiepileptic drug treatment, in particular sodium valproate. By definition, routine brain imaging shows no abnormalities, but advanced imaging studies have identified functional and structural abnormalities in the frontal cortex and thalamus. Neuropsychological studies revealed subtle cognitive deficits in patients with JME, mainly implicating the frontal lobes. These findings are in keeping with anecdotal reports of behavioral problems in JME. Cognitive dysfunction in otherwise healthy siblings of patients with JME and a high heritability support the concept of a genetically determined thalamo‐frontocortical network dysfunction, accounting for the cognitive impairment and cognitively triggered “motor seizures. ”
Public health implications of the Mediterranean Diet : its interaction with active and passive smoking

ABSTRACT Background Farmers from Crete as first studied within the framework of the Seven Countries Study, were historically known for holding the title of the “gold standard” of health status globally and had a very low prevalence of both cardiovascular dis-ease (CVD) and cancer. Taking the above into account we evaluated the changes in CVD risk factors among farmers in Crete, Greece and compared our findings to data from the 1960’s. Design: Cross sectional Methods: 502 farmers (18-79 years old) from the Valley of Messara in Crete were randomly selected and examined in 2005. Complete clinical, biochemical, dietetic, anthropometrical and lifestyle CVD risk factors were assessed, matched and com-pared to published data from the 1960s. Results : In comparison to 45 years ago, present day male farmers from Crete were found to have a 30% higher BMI (29.8 kg/m 2 vs. 22.9 kg/m 2 , p<0.001) and a 16% higher total cholesterol level (239.6 mg/dl vs. 206.9 mg/dl, p<0.001) as also a not so favourable daily dietary intake (increase in meat and saturated fat and decrease in fruit, p<0.001 respectively), while a significant reduction in systolic blood pres-sure and energy intake was noticed. In regards to changes in subcutaneous adipose tissue fatty acid composition, a decrease in monounsaturated (p<0.001) and an increase in saturated fatty acids (p<0.001) was also found elucidating the temporal change in dietary habits.
Effect of switching hepatic enzyme‐inducer antiepileptic drug to levetiracetam on bone mineral density, 25 hydroxyvitamin D, and parathyroid hormone in young adult patients with epilepsy

We sought to determine the effect of changing phenytoin therapy on bone mineral density (BMD) and 25‐hydroxyvitamin D in patients with epilepsy. Of the 90 patients, 54 patients had switched to levetiracetam, 19 patients had stopped, and 17 patients continued taking phenytoin. We proposed a 2‐year period to examine 25‐hydroxyvitamin D, parathyroid hormone, and BMD. The patients who switched or stopped phenytoin showed a significant increase in BMD of the lumbar spine and left femur, and in 25‐hydroxyvitamin D. In contrast, those who continued phenytoin had a significant decrease in BMD at both sites and in 25‐hydroxyvitamin D. Patients who were taken off phenytoin and those switching to levetiracetam did not show a significant difference in BMD, 25‐hydroxyvitamin D, parathyroid, or calcium at follow‐up. Compared with those who continued phenytoin, the BMD was significantly higher in patients switching to levetiracetam and those who stopped using phenytoin. Switching medications may be necessary in some cases to avoid low BMD.
The Experiences of Self-Monitoring of Blood Glucose Usage of Adults with Type 2 Diabetes Mellitus who are not using Insulin

of a dissertation at the University of Miami. Dissertation supervised by Professor Doris Noel Ugarriza No. of pages in text. (146) The purpose of this study was to analyze the experiences of self-monitoring of blood glucose (SMBG) usage of adults with type 2 diabetes mellitus (T2DM) who are not using insulin. The sample consisted of 11 women and 8 men who were Caucasian Americans, 38 to 79 years of age. Data were analyzed using the grounded theory method including open and axial coding and the constant comparative method. The theory of “SMBG as a Cue in T2DM Self-Care” emerged from the data and is composed of four categories (a) Engaging, (b) Checking, (c) Responding, and (d) Establishing a Pattern. Engaging marks the beginning of SMBG. Participants began on the recommendation of their physician and monitored between 2-6 times a day. Participants monitored because of curiosity and over time reduced or kept their initial frequency. Checking occurs when the blood glucose is obtained. Two subcategories emerged: Evaluating and Validating. The main items participants evaluated or validated were the effects of foods in relation to blood glucose levels. Responding involves reacting to SMBG. Two subcategories emerged: Taking Action and Experiencing Emotion. Most actions involved changing foods consumed. Participants described feeling conflicted and “being bad” when not following through with an action. Emotions such as blame and fear were experienced when blood glucose levels were higher than normal, while happiness was experienced with normal levels. Establishing a Pattern occurs when participants decide on how often to monitor. Two subcategories emerged: Using Regularly and Using Sporadically. The pattern developed was based on obtaining “normal” blood glucose patterns or on the absence of ill symptoms of T2DM. Healthcare provider disinterest in SMBG and fingertip pain contributed to a decreased monitoring frequency. Participants described cyclical, iterative episodes of Checking, Responding, and varying their established patterns throughout their experiences with monitoring. Participants discussed the value and struggles of SMBG in a T2DM self-care regimen. The theory of SMBG as a Cue in T2DM Self-Care could be used to guide the development of effective intervention strategies to help individuals with T2DM achieve blood glucose control which, in turn, leads to avoidance of ill symptoms and complications of T2DM.
HLA‐B alleles associated with severe cutaneous reactions to antiepileptic drugs in Han Chinese

HLA‐B*15:02 screening is recommended before starting carbamazepine in Han Chinese and Southeast Asians because the allele is strongly predictive of Stevens‐Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) induced by the drug. We examined whether other HLA‐B alleles are also involved and whether the association extends to other antiepileptic drugs (AEDs).
Epilepsy biomarkers

A biomarker is defined as an objectively measured characteristic of a normal or pathologic biologic process. Identification and proper validation of biomarkers of epileptogenesis (the development of epilepsy) and ictogenesis (the propensity to generate spontaneous seizures) might predict the development of an epilepsy condition; identify the presence and severity of tissue capable of generating spontaneous seizures; measure progression after the condition is established; and determine pharmacoresistance. Such biomarkers could be used to create animal models for more cost‐effective screening of potential antiepileptogenic and antiseizure drugs and devices, and to reduce the cost of clinical trials by enriching the trial population, and acting as surrogate markers to shorten trial duration. The objectives of the biomarker subgroup for the London Workshop were to define approaches for identifying possible biomarkers for these purposes. Research to identify reliable biomarkers may also reveal underlying mechanisms that could serve as therapeutic targets for the development of new antiepileptogenic and antiseizure compounds.
Timeliness of care in US emergency departments: an analysis of newly released metrics from the Centers for Medicare & Medicaid services.

to wait in an inpatient unit, and hospital units discharge patients more efficiently when their next patient is visible. The protocol has reduced ED waiting and walkouts, without increasing adverse events.7 Second, the Joint Commission should enforce standard LD.04. 03.11, which requires hospitals to have processes that support patient flow through the hospital (from ED arrival through hospital discharge) and plans for the care of admitted patients who are in temporary locations like the ED. Effective January 1, 2014, a new element of this standard requires hospitals to measure and address boarding of inpatients for longer than 4 hours. Third, payment policy should discourage boarding. Emergency department admissions are less profitable on average than elective admissions, which encourages hospitals to give them low priority.8 This is partly due to the poor payer mix of ED admissions, but the disparity also applies to insured patients, as elective admissions are likely to be for high-margin services, such as procedures. Hospital payments should be adjusted to reduce the financial disparity against emergency admissions. In addition, payers could penalize hospitals when an admitted patient boards for an extended time (eg, > 4 hours) before being placed in an inpatient bed. This would create an incentive against boarding, yet would not exert the same pressure to rapidly move all patients through the ED, as a strict overall LOS target does. We need to refocus hospitals on the everyday crisis of lengthy ED waiting and boarding time and discourage them from putting the sickest patients at the back of the line. The studies by Le and Hsia1 and Carrier et al4 bring important attention to ED and hospital crowding—critical barriers to high quality care of acute medical conditions—and raise important concerns around the use of performance measures.1,4 The availability of publicly available quality metrics will allow us to track performance; however, the challenge lies in incentivizing hospitals to improve while watching for unintended consequences.
Cancer screening rates in individuals with different life expectancies.

IMPORTANCE Routine cancer screening has unproven net benefit for patients with limited life expectancy. OBJECTIVE To examine the patterns of prostate, breast, cervical, and colorectal cancer screening in the United States in individuals with different life expectancies. DESIGN, SETTING, AND PARTICIPANTS Data from the population-based National Health Interview Survey (NHIS) from 2000 through 2010 were used and included 27 404 participants aged 65 years or older. Using a validated mortality index specific for NHIS, participants were grouped into those with low (<25%), intermediate (25%-49%), high (50%-74%), and very high (≥75%) risks of 9-year mortality. MAIN OUTCOMES AND MEASURES Rates of prostate, breast, cervical, and colorectal cancer screening. RESULTS In participants with very high mortality risk, 31% to 55% received recent cancer screening, with prostate cancer screening being most common (55%). For women who had a hysterectomy for benign reasons, 34% to 56% had a Papanicolaou test within the past 3 years. On multivariate analysis, very high vs low mortality risk was associated with less screening for prostate (odds ratio [OR], 0.65 [95% CI, 0.50-0.85]), breast (OR, 0.43 [95% CI, 0.35-0.53]), and cervical (OR, 0.50 [95% CI, 0.36-0.70]) cancers. There was less screening for prostate and cervical cancers in more recent years compared with 2000, and there was no significant interaction between calendar year and mortality risk for any cancer screening (P > .05 for all cancers). Our sensitivity analysis showed that screening was also common in individuals with less than 5-year life expectancy. CONCLUSIONS AND RELEVANCE A substantial proportion of the US population with limited life expectancy received prostate, breast, cervical, and colorectal cancer screening that is unlikely to provide net benefit. These results suggest that overscreening is common in both men and women, which not only increases health care expenditure but can lead to net patient harm.
HPV Dectection by Self-Sampling in Nunavik, Quebec: Inuit Women’s Sampling Method Preferences

There is a higher incidence of cervical cancer and prevalence of genital human papillomavirus (HPV) infection among the Inuit in Canada than the general population. Self-sampling of cervicovaginal cells for HPV testing has the potential to increase cervical cancer screening coverage in this population, but only if it is acceptable to women. We sought to determine acceptance of and preference for self-collection of cervicovaginal samples for HPV testing in comparison with provider-collection, and to explore demographic characteristics of preference for self-collection among a sample of Inuit women from Nunavik, Quebec. Women aged 18–69 years were recruited from a previously formed cohort on the natural history of HPV in Nunavik. Both self-collected and provider-collected specimens were collected with polyester-tipped swabs, and women completed a short written questionnaire immediately after specimen collection. Logistic regression was used to estimate predictors of preference. Of the 109 eligible women who were approached to participate, 93 (85%) accepted. Self-sampling was preferred by 56% of the women over provider-sampling. Education was the only predictor of preference for self-sampling, where having at least a grade 9 education was inversely associated with preference for self-sampling (OR = 0.29, 95% CI [0.09, 0.92]). Self-sampling has the potential to increase cervical cancer screening coverage, but any implementation of self-sampling should be concurrent with an education campaign on the importance of cervical cancer screening, the relationship between HPV virus and cervical cancer, and the accuracy of self-sampling.
Poliomyelitis Virus in Human Stools.

More than twenty-five years ago Kling, Pettersson and Wernstedt 1 in Sweden were successful in isolating the virus of poliomyelitis from the human intestinal tract. They found it in several active cases of the disease and in convalescence. This result was soon repeated in a single fatal case by Kling and Levaditi, 2 and in this country another single instance of its recovery during convalescence was described by Sawyer 3 in 1915. During subsequent years no one seems to have been able to repeat this work until 1937, when Harmon 4 made brief mention of five successful attempts in which the virus was obtained from the rectal washings of four patients. Kramer 5 has stated that he also has succeeded with similar material. The present report records our experiences in testing material from the intestinal tract and nasopharynx during a small epidemic of poliomyelitis which occurred in 1937. In it
Current Scientific Impact of the Institutes, Faculty of Medicine, University "Ss Kiril and Metodij", Skopje, Republic of Macedonia

Current Scientific Impact of the Institutes, Faculty of Medicine, University "Ss Kiril and Metodij", Skopje, Republic of Macedonia Background. Institutes at the Faculty of Medicine in the Republic of Macedonia are constitutive parts with integrated educational, scientific and health care protection activities. They are included in all educational programs with around 50% of theoretical and practical lectures, and are included in the health care protection in the ambulatory-polyclinic activities. Aim. The aim of this study was to investigate current scientific impact of the academic staff employed at the Institutes, Faculty of Medicine, University "Ss Kiril and Metodij", Skopje, Republic of Macedonia and to suggest more effective and productive activities of the affiliated scientists to these institutions. Material and methods. Twelve institutes at the Faculty of Medicine in Skopje, Republic of Macedonia with 140 authors were analysed with Harzing's Publish or Perish software for their current scientific impact (August, 2009). Results. There is a total number of 348 published papers with 473 citations by the academic staff employed at the Institutes. Current scientific impact of the Institutes at the Faculty of Medicine, University "Ss Kiril and Metodij", Skopje, Republic of Macedonia is very heterogeneous - with higher, intermediate and low scientific rate. Conclusion. The institutes with higher scientific impact are: Institute of Medical, Experimental and Applied Physiology with Anthropology; Institute of Immunobiology and Human Genetics; and Institute of Medical and Experimental Biochemistry.
Association between dietary whole grain intake and risk of mortality: two large prospective studies in US men and women.

IMPORTANCE Higher intake of whole grains has been associated with a lower risk of major chronic diseases, such as type 2 diabetes mellitus and cardiovascular disease (CVD), although limited prospective evidence exists regarding whole grains' association with mortality. OBJECTIVE To examine the association between dietary whole grain consumption and risk of mortality. DESIGN, SETTING, AND PARTICIPANTS We investigated 74 341 women from the Nurses' Health Study (1984-2010) and 43 744 men from the Health Professionals Follow-Up Study (1986-2010), 2 large prospective cohort studies. All patients were free of CVD and cancer at baseline. MAIN OUTCOMES AND MEASURES Hazard ratios (HRs) for total mortality and mortality due to CVD and cancer according to quintiles of whole grain consumption, which was updated every 2 or 4 years by using validated food frequency questionnaires. RESULTS We documented 26 920 deaths during 2 727 006 person-years of follow-up. After multivariate adjustment for potential confounders, including age, smoking, body mass index, physical activity, and modified Alternate Healthy Eating Index score, higher whole grain intake was associated with lower total and CVD mortality but not cancer mortality: the pooled HRs for quintiles 1 through 5, respectively, of whole grain intake were 1 (reference), 0.99 (95% CI, 0.95-1.02), 0.98 (95% CI, 0.95-1.02), 0.97 (95% CI, 0.93-1.01), and 0.91 (95% CI, 0.88-0.95) for total mortality (P fortrend < .001); 1 (reference), 0.94 (95% CI, 0.88-1.01), 0.94 (95% CI, 0.87-1.01), 0.87 (95% CI, 0.80-0.94), and 0.85 (95% CI, 0.78-0.92) for CVD mortality (P fortrend < .001); and 1 (reference), 1.02 (95% CI, 0.96-1.08), 1.05 (95% CI, 0.99-1.12), 1.04 (95% CI, 0.98-1.11), and 0.97 (95% CI, 0.91-1.04) for cancer mortality (P fortrend = .43). We further estimated that every serving (28 g/d) of whole grain consumption was associated with a 5% (95% CI, 2%-7%) lower total morality or a 9% (95% CI, 4%-13%) lower CVD mortality, whereas the same intake level was nonsignificantly associated with lower cancer mortality (HR, 0.98; 95% CI, 0.94-1.02). Similar inverse associations were observed between bran intake and CVD mortality, with a pooled HR of 0.80 (95% CI, 0.73-0.87; P fortrend < .001), whereas germ intake was not associated with CVD mortality after adjustment for bran intake. CONCLUSIONS AND RELEVANCE These data indicate that higher whole grain consumption is associated with lower total and CVD mortality in US men and women, independent of other dietary and lifestyle factors. These results are in line with recommendations that promote increased whole grain consumption to facilitate disease prevention.
Vascularization in the Bone Repair

The repair of critical-size bone defects resulted from severe traumatic injury, infection, surgery for bone cancer or congenital malformation remains a continuous challenge for orthopedists. Currently, autogenous bone grafting is a clinical gold standard for bone repair, and provides excellent osteoconduction, osteoinduction, high-healing rate and absence of immunogenic reaction after surgery. However, autogenous bone grafts are associated with the morbidity of donors, additional surgical procedures for harvest, and limitations in the quantity and available bone size. Bone tissue engineering has become a new and promising alternative approach for the repair of bone defects. Moreover, the clinical application of these advanced technologies in the field of tissue engineering seldom leads to satisfactory results. Increasing evidences have demonstrated that the key factor for the poor repair with tissue-engineered bone is poor vascularization (Nakasa et al. 2005; Kawamura et al. 2006). Bone is a highly vascularized tissue that relies on the supply of essential nutrients and oxygen from blood vessels for maintaining skeletal integrity (Kanczler and Oreffo 2008). Under the circumstance of a well-developed vascular network, the osteoblasts can produce osteoid tissues, differentiate to osteocytes, and form healthy bone. In order to provide sufficient oxygen for survival, osteoblasts must reside within 150-200 mm of a capillary lumen and no cells are greater than 0.2 mm from a blood vessel (Kannan et al. 2005). Without the perfusion of blood supply, the osteoblasts in the middle of tissue-engineered constructs will be necrosis due to ineffective transportation of oxygen, nutrients and metabolites (Smith et al. 2004; Rouwkema et al. 2008). Insufficient vascularization can often restrain the formation of new bones and delay the healing of bones. Therefore, vascularization plays a key role in bone regeneration. The rate and range of vascular growth are the determinants of the efficiency and consequence of new bone formation.