Miracle-dz/UniFAR-FTUs huggingface dataset:
An investigation of historical and archaeological evidence for age‐related bone loss and osteoporosis

A growing awareness of the problems caused by osteoporosis-related fractures has led to increased investigation of the condition in past populations. The present study seeks to examine the ways in which osteoporosis-related fractures may be explored through different approaches; modern clinical information, historical records of fractures and analysis of archaeological bone may provide fuller information on the condition. The three types of fractures upon which this study focuses are fractures of the femoral neck, Colles' fractures and vertebral compression fractures. The results of the investigation clearly demonstrate the way in which the various sources produce a slightly different picture of the condition. The archaeological significance of the different types of fractures was found to be the reverse of that which would be suspected in the light of information derived from historical sources and the clinical literature. To date vertebral crush fractures have been the most commonly found osteoporosis-related fracture in archaeological material, but their significance to people in the past is likely to have been minimal. In contrast hip fractures have rarely been reported from archaeological bone material, but historical information makes it clear they were well known, and knowledge derived from clinical sources emphasizes the serious consequences of such a fracture for the affected individuals. The results indicate the value of undertaking a multi-disciplinary approach where possible. Copyright © 2002 John Wiley & Sons, Ltd.
COPD and the risk of depression.

BACKGROUND Chronic comorbidities are often associated with depression. Most previous studies exploring the association between COPD and depression were rather small and based on a cross-sectional study design. We conducted a large population-based study on the risk of developing an incident depression diagnosis in association with a previous COPD diagnosis. METHODS We used the UK-based General Practice Research Database to assess and compare the prevalence of a history of depression and to quantify the risk of developing incident depression in patients with COPD and patients without COPD between 1995 and 2005. We conducted a nested case-control analysis, matching up to four patients who did not develop depression for each case patient with depression, to further analyze the impact of COPD severity. RESULTS In a study population of 35,722 patients with COPD and 35,722 patients without COPD, the prevalence of diagnosed depression prior to the first COPD diagnosis was higher in the population with COPD (23.1%) than among patients without COPD (16.8%). The incidence rate of a new-onset diagnosis of depression after the first COPD diagnosis was 16.2/1,000 person-years (py) in the COPD group, whereas it was only 9.4/1,000 py in the COPD-free comparison group. In the nested case-control analysis, patients with severe COPD had the highest risk of developing depression (odds ratio, 2.01; 95% CI, 1.45-2.78). CONCLUSION This large observational study provides further evidence that patients with COPD are at an increased risk of developing depression.
The Effect of Using Peplau's Therapeutic Relationship Model on Anxiety of Coronary Artery Bypass Graft Surgery Candidates

Background: Anxiety is a one of the psychological aftereffect of cardiac surgery, which affects the outcome of treatment. One of the most effective ways to reduce anxiety is to train and establish a targeted relationship based on a functional model. Objectives: The present study aimed to determine the effect of Peplau's therapeutic relationship model on anxiety of patients who were candidate for coronary artery bypass graft surgery (CABG). Patients and Methods: In this clinical trial, 74 patients were enrolled according to eligibility criteria and were randomly allocated to intervention and control groups of 37 people. We evaluated anxiety of the patients using the Beck anxiety inventory before, immediately after, and two and four months after intervention. Based on Peplau's therapeutic relationship model, therapeutic communication sessions were conducted in four phases during seven sessions. Data analysis was performed with the statistical test of covariance analysis using SPSS version 16. Results: The results of our study showed that after therapeutic communication, the mean score of anxiety decreased from 30.35 to 25.38 in the intervention group (P < 0.001), while the scores decreased from 33.22 to 31.46 in the control group. Furthermore, the mean score of anxiety in the intervention group decreased at two and four months after the intervention. Conclusions: The findings showed a positive effect of therapeutic relationship based on Peplau's model on reducing anxiety of patients undergoing CABG. Therefore, health care teams, including nurses, should take advantage of appropriate communication with patients in their care procedures. In that regard, Peplau's communication model is recommended as a simple, low-cost, and efficient method.
Qualidade do cuidado ao acidente vascular cerebral isquêmico no SUS

The hospital mortality rate is an outcome measure of care used as an indicator of quality of care for stroke. Computerized tomography is the main imaging method for diagnosing and managing stroke. This study aimed to assess the quality of hospital care for acute ischemic stroke (AIS) in the Brazilian Unified National Health System (SUS), considering the severity of cases and use of computerized tomography. Multivariate analysis was used to adjust the mortality risk, evaluate the use of computerized tomography, and rank the performance of hospitals from April 2006 to December 2007. 16,879 admissions were analyzed, and at least one CT scan was performed in 28.6% of the admissions. The crude mortality rate was 34.3%, and the adjusted rate was 31.2%. Performance of a CT scan showed a protective effect: the adjusted OR was 0.27 for one test and 0.32 for two tests. Under-utilization of computerized tomography is one of the limiting factors for good medical practice in the management of ischemic stroke in the SUS.
Thrombocytopenia and thrombocytosis at time of hospitalization predict mortality in patients with community-acquired pneumonia.

BACKGROUND Platelets are inflammatory cells with an important role in antimicrobial host defenses. We speculate that an abnormal platelet count may be a marker of severity in patients with community-acquired pneumonia (CAP). The objectives of this study were to evaluate if abnormal platelet count in hospitalized patients with CAP was associated with 30-day mortality and to compare platelet count and leukocyte count as predictors of 30-day mortality. METHODS We performed a retrospective cohort study of 500 consecutive patients hospitalized with CAP at the Veterans Hospital of Louisville, Kentucky, between June 2001 and March 2006 to investigate the association of platelet count and leukocyte count with 30-day mortality. Predictor variables were platelet count and leukocyte count. Abnormal platelet count was < 100,000/L (thrombocytopenia) and > 400,000/L (thrombocytosis). The outcome variable was 30-day mortality. To control for potential confounding, a propensity score that incorporated 33 variables was used. RESULTS Platelet count was strongly associated (P = .0009) with 30-day mortality, whereas no association was observed for leukocyte count (P = .5114). High platelet counts resulted in a significantly increased risk of mortality. CONCLUSIONS Thrombocytopenia and thrombocytosis are associated with mortality in patients hospitalized with CAP. When evaluating an initial CBC test in patients with CAP, an abnormal platelet count is a better predictor of outcome than an abnormal leukocyte count.
Toxoplasmosis in HIV/AIDS patients in Shiraz, southern Iran

Background: Toxoplasma gondii is an intracellular protozoan parasite, and causes zoonotic infection. Human latent toxoplasmosis occurs in about half the world's population though most cases are asymptomatic. Toxoplasma encephalitis (TE) has become one of the more frequent opportunistic infection in HIV infected patients. Methods: This retrospective and descriptive study was carried out at the Referral Behavioral Counseling and Modification Center in Shiraz, Iran. We were able to review the medical records of 208 HIV infected patients. They were examined and their records were screened via the standardized data collection sheet for demographic characteristics. Diagnoses of TE based on the presence of at least two of the following findings: a history of neurological symptoms, neurological signs, suggestive CT, clinical and radiological response to antitoxoplasmosis medication. Results: The seroprevalence of toxoplasmosis among 208 HIV/AIDS patients was (18.2%) (38 patients) while 4 (10.4%) and 34 (89.6%) subjects showed Toxoplasma seropositivity with and without TE respectively. The majority of these patients were in the 25-34 age group, male, unemployed, single and residence in Shiraz, southern Iran. Conclusion: Toxoplasmosis is a silent disease, which poses many diagnostic and therapeutic challenges. Based on findings of this study, we support a screening program of Toxoplasma infection. Primary chemoprophylaxis should be routinely given to all HIV infected with Toxoplasma seropositive status. Also HIV infected individuals with Toxoplasma seronegative status may be advised about preventive behavioral practice.
Cardiac adaptive mechanisms of Tibetan antelope (Pantholops hodgsonii) at high altitudes.

OBJECTIVE To identify cardiac mechanisms that contribute to adaptation to high altitudes in Tibetan antelope (Pantholops hodgsonii). ANIMALS 9 male Tibetan antelope and 10 male Tibetan sheep (Ovis aries). PROCEDURES Tibetan antelope and Tibetan sheep inhabiting a region with an altitude of 4,300 m were captured, and several cardiac variables were measured. Expression of genes for atrial natriuretic peptide, brain natriuretic peptide, and calcium-calmodulin-dependent protein kinase II δ was measured via real-time PCR assay. RESULTS Ratios of heart weight to body weight for Tibetan antelope were significantly greater than those of Tibetan sheep, but ratios of right-left ventricular weights were similar. Mean ± SD baseline heart rate (26.33 ± 6.15 beats/min) and systolic arterial blood pressure (97.75 ± 9.56 mm Hg) of antelope were significantly lower than those of sheep (34.20 ± 6.57 beats/min and 130.06 ± 17.79 mm Hg, respectively). The maximum rate of rise in ventricular pressure in antelope was similar to that in Tibetan sheep, but after exposure to air providing a fraction of inspired oxygen of 14.6% or 12.5% (ie, hypoxic conditions), the maximum rate of rise in ventricular pressure of the antelope increased significantly to 145.1% or 148.1%, respectively, whereas that of the sheep decreased to 68.4% or 70.5%, respectively. Gene expression of calcium-calmodulin-dependent protein kinase II δ and atrial natriuretic peptide, but not brain natriuretic peptide, in the left ventricle of the heart was significantly higher in antelope than in sheep. CONCLUSIONS AND CLINICAL RELEVANCE Hearts of the Tibetan antelope in this study were well adapted to high-altitude hypoxia as shown by higher heart weight ratios, cardiac contractility in hypoxic conditions, and expression of key genes regulating cardiac contractility and cardiac hypertrophy, compared with values for Tibetan sheep.
HLA AND RETINAL DISEASES

Eales' disease, retinitis pigmentosa, retinal detachment, idiopathic central serous retinopathy, and juvenile hemorrhagic maculopathy have been studied for the association with HLA antigens. The results did not show any confirmed evidence that HLA would be involved in the susceptibility to any of these fundal lesions.
Power of treatment success definitions when the Canine Brief Pain Inventory is used to evaluate carprofen treatment for the control of pain and inflammation in dogs with osteoarthritis.

OBJECTIVE To determine the optimal method for use of the Canine Brief Pain Inventory (CBPI) to quantitate responses of dogs with osteoarthritis to treatment with carprofen or placebo. ANIMALS 150 dogs with osteoarthritis. PROCEDURES Data were analyzed from 2 studies with identical protocols in which owner-completed CBPIs were used. Treatment for each dog was classified as a success or failure by comparing the pain severity score (PSS) and pain interference score (PIS) on day 0 (baseline) with those on day 14. Treatment success or failure was defined on the basis of various combinations of reduction in the 2 scores when inclusion criteria were set as a PSS and PIS ≥ 1, 2, or 3 at baseline. Statistical analyses were performed to select the definition of treatment success that had the greatest statistical power to detect differences between carprofen and placebo treatments. RESULTS Defining treatment success as a reduction of ≥ 1 in PSS and ≥ 2 in PIS in each dog had consistently robust power. Power was 62.8% in the population that included only dogs with baseline scores ≥ 2 and 64.7% in the population that included only dogs with baseline scores ≥ 3. CONCLUSIONS AND CLINICAL RELEVANCE The CBPI had robust statistical power to evaluate the treatment effect of carprofen in dogs with osteoarthritis when protocol success criteria were predefined as a reduction ≥ 1 in PIS and ≥ 2 in PSS. Results indicated the CBPI can be used as an outcome measure in clinical trials to evaluate new pain treatments when it is desirable to evaluate success in individual dogs rather than overall mean or median scores in a test population.
Risk Factors Associated with Birth Asphyxia in Phramongkutklao Hospital

Objective: To determine the risk factors for birth asphyxia Materials and Methods: After obtaining the approval from the Institutional Review Board, a retrospective case-control study recruited 450 women who delivered at Phramongkutklao Hospital between January 1, and December 31, 2009 were recruited by consecutive selection. The study sample comprised 150 women who delivered newborns with an APGAR score at 1 minute of 7 or less, while the control comprised 300 women who delivered newborns with an APGAR score at 1 minute more than 7. The risk factors for birth asphyxia were determined. Result: The risk factors associated with birth asphyxia included moderate to thick meconium (OR 5.51, 95% CI 2.58-11.77), breech presentation (OR 4.53, 95% CI 1.72-11.92), birth weight < 2,500 grams (OR 2.46, 95% CI 1.4-4.29), sedation with morphine or pethidine (OR 2.29, 95% CI 1.37-3.84) and preterm delivery (OR 2.08, 95% CI 1.24-3.51). Conclusion: Most risk factors associated with birth asphyxia can be prevented. Therefore the correct, quick and accurate diagnosis and proper management can reduce severe birth asphyxia.
Evaluation of osteochondral sample collection guided by computed tomography and magnetic resonance imaging for early detection of osteoarthritis in centrodistal joints of young Icelandic horses.

OBJECTIVE To evaluate the use of CT and MRI for guidance of osteochondral sample collection for histologic detection of early osteoarthritic lesions in centrodistal (distal intertarsal) joints of horses. SAMPLE Right tarsal joints from the cadavers of 24 Icelandic horses aged 29 to 31 months. PROCEDURES CT and MRI were used to evaluate the extent of suspected osteoarthritic changes in centrodistal joints, which were graded with a semiquantitative system. The anatomic regions with the highest grade of change were identified, and osteochondral samples were obtained from these regions. Samples were also obtained from the same centrodistal joints at predetermined sites. Histologic examination of all samples was performed, with samples classified as negative or positive for osteoarthritis, and results were compared between sample collection methods. RESULTS Histologic examination revealed osteoarthritic lesions in 29% (7/24) of centrodistal joints with the predetermined method and in 63% (15/24) with the image-guided method. Significant associations were identified between histologic osteoarthritis detection and the summed image-guided sample collection site image grades, central osteophytes, articular cartilage thickness abnormalities, grade 2 articular mineralization front defects, and grade 2 marginal osteophytes. CONCLUSIONS AND CLINICAL RELEVANCE CT and MRI aided the detection of focal changes suggestive of early-stage osteoarthritis in the centrodistal joints of equine cadavers and may be useful for detection of similar disease in live horses. The first morphological changes of centrodistal joint osteoarthritis were suspected to be in the articular cartilage and the articular mineralization front regions.
Use of contrast-enhanced ultrasonography to characterize adrenal gland tumors in dogs.

OBJECTIVE To describe the contrast-enhanced ultrasonographic characteristics and vascular patterns of adrenal gland tumors in dogs and determine whether those features are indicative of malignancy or histologic type of tumor. ANIMALS 14 dogs with 16 adrenal gland lesions (10 carcinomas [8 dogs], 3 adenomas [3 dogs], and 3 pheochromocytomas [3 dogs]). PROCEDURES Unsedated dogs with adrenal gland lesions underwent B-mode ultrasonography and contrast-enhanced ultrasonography ≤ 48 hours before adrenalectomy; contrast-enhanced ultrasonographic examinations were video-recorded. Macroscopic evaluation of the adrenal gland lesions and histologic examination of removed adrenal gland tissues were subsequently performed. Surgical and histopathologic findings and the ultrasonographic and contrast-enhanced ultrasonographic characteristics were recorded for the various tumor types. Time-intensity curves were generated from the contrast-enhanced ultrasonographic recordings and used to calculate regional blood volume (value proportional to area under the curve) and mean transit time (time the lesion began to enhance to the half-peak intensity). RESULTS In adrenal gland carcinomas, tortuous feeding vessels were noticeable during the arterial and venous phases of contrast enhancement. Heterogeneity of contrast enhancement was evident only in malignant tumors. Compared with adenomas, adrenal gland carcinomas and pheochromocytomas had significantly less regional blood volume. Mean transit times were significantly shorter in adrenal gland carcinomas and pheochromocytomas than in adenomas. CONCLUSIONS AND CLINICAL RELEVANCE For dogs, evaluation of the vascular pattern and contrast-enhancement characteristics of adrenal gland tumors by means of contrast-enhanced ultrasonography may be useful in assessment of malignancy and tumor type.
Semester System of Evaluation in the Colleges of Sikkim

University and colleges have adopted semester system in undergraduate and postgraduate courses in Sikkim since 2008. Semester system facilitates intense academic period and also prompt evaluation. The system is also very useful to track and maintain an individual performance record of all the students through an intensive interactive process between students and teachers. In semester system, the final results are declared within 20 days of the last day of examinations. Moreover, evaluation pattern includes mid-semester test (weightage 20 per cent); term papers/tutorials, field visit, presentation (weightage 25 per cent) and end semester examination (weightage 50 per cent). Similarly, in the course of 12 months a student is evaluated six times. The university is following a grading system in ten point scale in the evaluation process. Five percentage points are given to class attendance above the minimum 75 per cent mandatory attendance. Thirty per cent of the end-semester scripts are evaluated by the course teacher. If there is a difference of 10–20 per cent in marking by the course teacher and the external evaluator, the marks given by the internal course teacher will be regarded as final. If, however, the difference is more than 20 per cent, the script would be sent to a third external examiner and the marks awarded by him/her would be taken as final. If the difference is found in all the papers/scripts picked up on random basis, all the scripts evaluated by the concerned internal teacher would be sent for re-evaluation. However, the semester system is not free from lacunae. The article focuses on the status of evaluation pattern and its problems in colleges of Sikkim.
Patients with obstructive sleep apnea exhibit impaired endothelial function after myocardial infarction.

BACKGROUND Impaired brachial flow-mediated dilation (FMD) is associated with risk for subsequent cardiovascular events in patients after myocardial infarction (MI). These patients often have obstructive sleep apnea (OSA). We tested the hypothesis that patients with OSA post MI will exhibit more severe impairment in FMD. METHODS We studied 64 patients with MI admitted to our hospital. OSA was determined using polysomnography. FMD was measured using high-resolution ultrasonography, with researchers blind to the OSA diagnosis. RESULTS The mean age was 60 ± 11 years, and the mean BMI was 29 (26, 32 kg/m(2)), 84% of patients were men, 39% had moderate to severe OSA (apnea-hypopnea index [AHI] > 15), and 31% of the patients had mild OSA (5 ≤ AHI < 15). FMD was severely impaired in patients with moderate to severe OSA (0.8% ± 0.7%) as compared with patients without OSA (4.7% ± 0.8%, P = .001) and with mild OSA (3.9% ± 0.8%, P = .015). Linear regression showed that FMD was associated with log nocturnal nadir oxygen saturation (minSaO(2)) (β = 31.17, P = .0001), age (β = -0.11, P = .006). MinSaO(2) was an independent predictor of FMD after adjustment for possible confounders (β = 26.15, P = .001). CONCLUSIONS FMD is severely impaired in patients with moderate to severe OSA post MI, which may be partially related to nocturnal hypoxemia. Patients with OSA may, therefore, be at higher risk for subsequent cardiovascular events after an MI. Identifying and treating OSA may have important implications in the long-term prognosis of patients post MI. Further studies are necessary to determine if the presence of OSA would affect the long-term occurrence of cardiovascular events after an MI.
Evaluation of the safety of long-term, daily oral administration of grapiprant, a novel drug for treatment of osteoarthritic pain and inflammation, in healthy dogs.

OBJECTIVE To investigate the safety of daily oral administration of grapiprant to dogs. ANIMALS Thirty-six 9-month-old Beagles of both sexes. PROCEDURES Dogs were randomly assigned to groups that received grapiprant via oral gavage at 0, 1, 6, or 50 mg/kg (total volume, 5 mL/kg), q 24 h for 9 months. Each group contained 4 dogs of each sex (ie, 8 dogs/group), except for the 50 mg/kg group, which included 4 additional dogs that were monitored for an additional 30 days after treatment concluded (recovery period). All dogs received ophthalmologic, ECG, and laboratory evaluations before treatment began (baseline) and periodically afterward. All dogs were observed daily. Dogs were euthanized at the end of the study for necropsy and histologic evaluation. RESULTS All dogs remained clinically normal during treatment, with no apparent changes in appetite or demeanor. Emesis and soft or mucoid feces that occasionally contained blood were observed in all groups, although these findings were more common in dogs that received grapiprant. In general, clinicopathologic findings remained within baseline ranges. Drug-related changes in serum total protein and albumin concentrations were detected, but differences were small and resolved during recovery. No drug-related gross or microscopic pathological changes were detected in tissue samples except mild mucosal regeneration in the ileum of 1 dog in the 50 mg/kg group. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested the safety of long-term oral administration of grapiprant to dogs. Efficacy of grapiprant in the treatment of dogs with osteoarthritis needs to be evaluated in other studies.