Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison between Sublingual and Vaginal Misoprostol for Labor Induction at Term

Aim: To compare the efficacy and safety of 50 microgram of sub-lingual misoprostol with 25 microgram of vaginal misoprostol administered for labor induction at term. Design: Randomized control study Place and duration: Surayya Azeem (waqf) Hospital from May, 2011 to November 2012. Method: Total of 140 women at term with indication of induction were included in the study. Women were randomized to receive either 50 microgram of sub-lingual misoprostol with vaginal placebo or sub-lingual placebo with 25 microgram of vaginal misoprostol every four hours. The number of women delivering vaginally within 24 hours of labor induction. Results: 58 women (83%) in the sub-lingual misoprostol and 53 (76%) in the vaginal group delivered vaginally within 24 hours (relative risk RR 1.1). However, the induction to vaginal delivery time was significantly shorter in the sub-lingual group (15  3.7 hrs compared with vaginal group 16.7  4.1 hours. P=0.03). The incidence of tachysystole was more than three fold higher in the sublingual than in vaginal group. 14 versus 4.3%, RR 3.3, 95% (CI) confidential interval 0.9-11.6 but this was not statistically significant. There were no significant differences in the incidence of hypertonus or hyper stimulation syndrome, mode of delivery, intervention for fetal distress or neonatal outcomes between the two groups. Conclusion: A 50 microgram of sublingual misoprostol four hourly for labor induction at term seems to have similar efficacy as 25 microgram of vaginal misoprostol
Late Life: A New Frontier for Physiology

Late life is a distinct phase of life that occurs after the aging period and is now known to be general among aging organisms. While aging is characterized by a deterioration in survivorship and fertility, late life is characterized by the cessation of such age‐related deterioration. Thus, late life presents a new and interesting area of research not only for evolutionary biology but also for physiology. In this article, we present the theoretical and experimental background to late life, as developed by evolutionary biologists and demographers. We discuss the discovery of late life and the two main theories developed to explain this phase of life: lifelong demographic heterogeneity theory and evolutionary theory based on the force of natural selection. Finally, we suggest topics for future physiological research on late life.
Spirituality and support for family presence during invasive procedures and resuscitations in adults.

BACKGROUND Many health care professionals believe that they provide holistic care. The role of spirituality, a known variable of holism, has not been explored in relation to the support among health care professionals for family presence during invasive procedures and resuscitative efforts in adults. OBJECTIVE To determine the relationship between spirituality of health care professionals and their support for family presence during invasive procedures and resuscitative efforts in adults. METHODS In this descriptive correlational study, 108 participants (physicians, physician assistants, and nurses) completed the Howden Spirituality Assessment Scale and a survey to measure their support for family presence. RESULTS A significant positive relationship was found between spirituality and support for family presence during resuscitative efforts in adults (r = 0.24, P = .05) and a significant negative correlation was found between support for family presence and the age of the health care professional (r = - 0.27, P = .01). No significant correlations were found between any of the study variables and invasive procedures in adults. CONCLUSIONS Adopting a more holistic perspective may support family presence, especially during resuscitative efforts in adults. Allowing the option for patients' families to remain present promotes holistic family-centered care.
Climate, Settlement History, and Olive Cultivation in the Iron Age Southern Levant

In this article, we suggest a palaeo-climate reconstruction of the Iron Age based on pollen diagrams for sediment cores extracted from the center of the Sea of Galilee and from the Zeʾelim ravine on the western shore of the Dead Sea. We describe three pollen zones that roughly correspond to the Iron Age I, Iron Age IIA, and Iron Age IIB–C. Pollen Zone 1 (ca. 1100–950 b.c.e.) is characterized by high arboreal and olive pollen percentages in both records, representing relatively wet climate conditions and intense olive cultivation in the regions west of the lakes. Pollen Zones 2 (ca. 950–750 b.c.e.) and 3 (ca. 750–550 b.c.e.) are typified by a profound reduction in olive cultivation. Based on Mediterranean tree pollen percentages in the Sea of Galilee record and sediment characteristics in the Zeʾelim profile, climate conditions still seem to have been humid, albeit slightly less than in Pollen Zone 1. The low arboreal pollen in Pollen Zones 2 and 3 in the Zeʾelim diagram is probably the result of intense human influence on the natural vegetation in the Judaean highlands. The lowest olive pollen values during the Bronze and Iron Ages were documented in both records at ca. 700 b.c.e. , possibly the outcome of depopulation as a result of deportation and the succeeding abandonment of olive orchards. These and other trends discussed in the article show that climate is only one of the factors that influenced settlement processes and economic trends in antiquity.
Dendritic Cells Enhance the Differentiation of Naïve B Cells into Plasma Cells In Vitro

We have shown previously that in vitro‐generated human dendritic cells have an effect on the response of B cells at various stages of their differentiation. In a culture system described for the in vitro induction of plasma‐cell differentiation, it was reported that naïve B cells have a poor propensity to differentiate into plasma cells. In such a culture system, 12% of naïve B cells differentiated into plasma cells in the presence of IL‐2 and IL‐10, despite the interruption of CD40 signalling which is necessary for plasma‐cell differentiation. However, as reported herein, naïve B cells differentiated fully into plasma cells in response to dendritic cells. Addition of dendritic cells enhanced this differentiation strikingly by recruiting 57% of B cells as plasma cells producing IgM, but also IgG and IgA. In this model, dendritic cells act in synergy with IL‐2 at an early stage of CD40‐dependent B‐cell differentiation, while IL‐2 and IL‐10 act together, at a later stage, in the generation of plasma cells in a CD40‐independent manner. Thus, in addition to the key role played by dendritic cells in the initiation of T‐cell responses, our results suggest that dendritic cells regulate humoral responses.
Riaz, Muhammad and Lewis, Sarah and Coleman, Tim and Aveyard, Paul and West, Robert and Naughton, Felix and Ussher, Michael (2016) Which measures of cigarette dependence are predictors of smoking cessation during pregnancy? Analysis of data

Aims To examine the ability of different commonmeasures of cigarette dependence to predict smoking cessation during pregnancy. Design Secondary analysis of data from a parallel-group randomized controlled trial of physical activity for smoking cessation. The outcomes were biochemically validated smoking abstinence at 4weeks post-quit and end-ofpregnancy. Setting Women identified as smokers in antenatal clinics in 13 hospital trusts predominantly in southern England, who were recruited to a smoking cessation trial. Participants Of 789 pregnant smokers recruited, 784 were included in the analysis.Measurements Using random-effect logistic regression models, we analysed the effects of baseline measures of cigarette dependence, including numbers of cigarettes smoked daily, Fagerström Test of Cigarette Dependence (FTCD) score, the two FTCD subscales of Heaviness of Smoking Index (HSI) and non-Heaviness of Smoking Index (non-HSI), expired carbon monoxide (CO) level and urges to smoke (strength and frequency) on smoking cessation. Associations were adjusted for significant socio-demographic/health behaviour predictors and trial variables, and area under the receiver operating characteristic (ROC) curve was used to determine the predictive ability of the model for each measure of dependence. Findings All the dependence variables predicted abstinence at 4weeks and end-of-pregnancy. At 4weeks, the adjusted odds ratio (OR) (95% confidence interval) for a unit standard deviation increase in FTCD was 0.59 (0.47–0.74), expired CO=0.54 (0.41–0.71), number of cigarettes smoked per day 0.65 (0.51–0.84) and frequency of urges to smoke 0.79 (0.63–0.98); at end-of-pregnancy they were: 0.60 (0.45–0.81), 0.55 (0.37–0.80), 0.70 (0.49–0.98) and 0.69 (0.51–0.94), respectively. HSI and non-HSI exhibited similar results to the full FTCD. Conclusions Four common measures of dependence, including number of cigarettes smoked per day, scores for Fagerström Test of Cigarette Dependence and frequency of urges and level of expired CO, all predicted smoking abstinence in the short term during pregnancy and at end-of-pregnancy with very similar predictive validity.
Outcomes of Laparoscopic Treatment in Women with Cesarean Scar Syndrome

Background The aim of this study was to evaluate the outcomes of laparoscopic treatment of women with severe defect of a Cesarean section (CS) scar and Cesarean scar syndrome. Material/Methods A prospective longitudinal study was conducted in 11 women who were treated for Cesarean scar syndrome. Ultrasound examinations were performed transvaginally 1 day before surgery and 6 months after laparoscopy in all women. Clinical data were registered 1 day before laparoscopy and 6 months after laparoscopy. Results Of these 11 women, total dehiscence of the CS scar was present in 72.7% (8/11) of the women. Before laparoscopy, all 11 women had severe defect of the CS scar (DRC ≤0.25); however, 6 months after laparoscopy, 81.8% (9/11) of women still had severe defect of the CS scar. Mean thickness of the CS scar, measured 1 day before and 6 months after laparoscopy in all 11 women, was 0.3±0.4 mm and 1.3±1.0 mm, respectively. Accordingly, no significant differences were observed in the mean CS scar thickness (p=0.101). After laparoscopy, 63.6% (7/11) of women were fully asymptomatic, and among the remaining 4, the most common complications were dyspareunia in 36.4% (4/11, p=0.005), pelvic pain in 27.3% (3/11, p=0.014), and dysmenorrhea in 18.2% (2/11, p=0.01), and best results after laparoscopy were achieved for postmenstrual spotting in 18.2% (2/11, p<0.001). Conclusions Improvement of women’s health after laparoscopy does not necessarily mean improvement of CS scar sonomorphology. Surgery should be offered only to women with symptoms of the Cesarean scar syndrome.
Interpersonal Psychotherapy Adapted for Borderline Personality Disorder(IPT-BPD): A Review of Available Data and a Proposal of Revision

Interpersonal psychotherapy (IPT) was developed by Klerman in 1984 for patients with major depression. IPT is aimed to the resolution of interpersonal difficulties, improving both social functioning and psychiatric symptoms. The promising results that this model of psychotherapy has obtained in unipolar depression have led investigators to enlarge the application of IPT beyond this clinical population. Specific adaptations of IPT have been required to address the different psychopathological and clinical characteristics of each disorder. IPT has been proposed to treat borderline personality disorder because of the frequent comorbidity with mood disorders and the serious relational problems. Markowitz and colleagues in 2006 proposed an adaptation for this severe personality disorder, IPT-BPD, including a specific conceptualization of BPD, a prolonged length of treatment to 34 sessions, and a more flexible setting. Clinical efficacy of this adaptation of IPT was investigated in a few clinical trials during the last decade. Our research group conducted three randomized controlled trials. Our findings suggested that combined treatment with IPT-BPD and antidepressants (fluoxetine) can be considered a useful treatment option in treating BPD patients. The efficacy of this combined therapy was superior to single pharmacotherapy in improving core BPD symptom clusters, including disturbed interpersonal relationships, inadequate control of impulsive behaviors, and affective instability. The main effects of IPT-BPD registered after 32 weeks of treatment were maintained during a follow-up of two years. In particular, the superior effects of the addition of IPT-BPD on impulsive behavioral dyscontrol and interpersonal relationships instability were maintained. More severe BPD symptoms and higher degree of fear of abandonment, affective instability, and impaired identity were identified as predictors of response to combined therapy. On the basis of our experience, we present a proposal of revision of IPT-BPD (IPT-BPD-R) with the aim to deal with problems emerged from patients’ treatment.
An Exceptional, Efficient, and Resilient Therapist: A Case Study in Practice-Based Evidence

Hansen, Lambert, and Vlass (2015) offer a timely and insightful research study into the delivery of exceptional psychotherapy practice by a private practitioner name Eri. At the conceptual level, we raise points about terminology ("supershrink") and the operationalization of sudden loss, while in terms of research we draw links with models of very brief interventions and set the account within the paradigm of practice-based research. We argue that the report is an exemplar of practice-based research at the level of the individual practitioner. In relation to clinical practice, we comment on how Eri demonstrates resilience in her routine practice by maintaining a high degree of personal competence, not only towards herself (e.g., in her deliberate use of patient outcome measures) but also in the application of her clinical skills and the development of a working alliance bond with clients, evidenced particularly with patients achieving sudden gains. Consideration is given to the salient client factors that may or may not facilitate change and additional comment is made on how service-level designs could impact on the delivery of sufficient treatment depending on clients' needs.
What Happens when Elderly People Die?

Death, previously a taboo subject, is now a topic of ordinary conversation: not long ago, a person was shown on British television in the actual dying process. There is a widespread view that death can be managed, and that an ‘undignified’ death signifies deficient care. This is erroneous. In 1963, when Hinton1 looked at deaths in general wards, he found widespread distress. Thirty-four years later the SUPPORT study in the USA yielded very similar findings2: despite great advances in palliative care in the intervening period, many dying patients were still troubled by pain and other symptoms. Death and bereavement are linked, and a perception that care has been deficient can disturb bereavement reactions. This article questions some current assumptions, with particular reference to dying in old age.
Autoantibodies from patients with systemic lupus erythematosus bind a shared sequence of SmD and Epstein‐Barr virus‐encoded nuclear antigen EBNA I

SmD is one of the small nuclear ribonucleoproteins frequently targeted by autoantibodies in systemic lupus erythematosus. We isolated and characterized the antibodies present in lupus sera that are specific for the C‐terminal region of SmD (sequence 95–119). This region is highly homologous to sequence 35‐58 of the EBNA I antigen, one of the nuclear antigens induced by infection with Epstein‐Barr virus. Antibodies affinity purified over a peptide 95–119 column were able to recognize this sequence in the context of the whole SmD molecule, as they reacted with blotted recombinant SmD. Anti‐SmD 95‐119 antibodies bound also the EBNA I 35–58 peptide and detected the EBNA I molecule in a total cell extract from Epstein‐Barr virus‐infected lines. A population of anti‐SmD antibodies is, therefore, able to bind an epitope shared by the autoantigen and the viral antigen EBNA I. To investigate the involvement of this shared epitope in the generation of anti‐SmD antibodies, we immunized mice with the EBNA I 35‐58 peptide. Sera from immunized animals displayed the same pattern of reactivity of spontaneously produced anti‐SmD antibodies. They reacted in fact with the EBNA peptide as well as with SmD 95‐119 and recombinant SmD. These data suggest that molecular mimicry may play a role in the induction of anti‐SmD autoantibodies.
The dynamic elastic properties of the arterial wall

Although the response of the arterial tree to relatively slow changes in blood pressure is determined by its static elastic properties (Bergel, 1961), the rapid pressure changes occurring at each heart beat will result in rather different behaviour. This is due to the visco-elastic properties of the arterial wall. The mechanical response of a visco-elastic material depends both on the force applied (elastic response) and on the time it acts (viscous response). These substances display 'creep' (continuing extension at constant load) and stress relaxation (tension decay at constant length). The properties of such a material can be defined by measurements of either of these phenomena, but it is difficult to infer from this the response to a rapid stress. A more direct form ofenquiry is to measure the oscillatory stress-strain relationships at any required frequency, which has previously been done with strips and rings cut from arteries and recently with intact vessels in vivo (Petersen, Jensen & Parnell, 1960). When using intact vessels it is necessary to measure simultaneously the amplitude and the phase relationships of oscillatory pressure and radius changes. As arteries change very little in length with each heart beat (Lawton & Greene, 1956) they should be held at their natural length.
High-dose cyclophosphamide and rituximab without stem cell transplant: a feasibility study for low grade B-cell, transformed and mantle cell lymphomas

Abstract Relapse after autologous stem cell transplant for low grade B-cell lymphoma is common secondary to ineffective conditioning and/or tumor autograft contamination. We investigated high-dose cyclophosphamide and rituximab without stem cell rescue as first-line or salvage therapy in lymphomas. After establishing safety, accrual was increased to evaluate event-free survival (EFS). Eighty-one adults received rituximab (375 mg/m2 days 1, 4, 8, 11, 45, 52), cyclophosphamide (50 mg/kg days 15–18), and pegfilgrastim (day 20). Forty-two patients had low grade B-cell lymphoma [grade I/II follicular (69%), transformed lymphoma (17%), other (15%)]: 45% were treated without measurable disease. Thirty-nine patients had mantle cell lymphoma: 82% were treated without measurable disease. All achieved hematopoietic recovery; 46% required brief hospitalizations. The 5-year EFS and overall survival (OS) for patients with low grade B-cell and transformed lymphoma were 40% and 72%, respectively. The 5-year EFS and OS for patients with MCL were 39% and 62%, respectively. This low-toxicity therapeutic approach obviates the need for stem cell products and establishes a platform for future therapies.
Predictive factors for hand eczema

Factors related to hand eczema were studied. Their relative importance as predictors was ranked by multiple logistic regression analysis. Questionnaires were sent to 20,000 individuals aged 20–65 years, randomly selected from the population register. Those subjects (1385) considering themselves to have had hand eczema within the previous 12 months were invited to a dermatological examination. It was found that it history of childhood eczema was the most important predictive factor for hand eczema. Second was female sex, followed by occupational exposure, a history or asthma and or hay fever, and service occupation. A small decrease in risk with advancing age was also found. The difference in the probability of having hand eczema In a l‐year period, between individuals having the most important risk factors studied and those having none of them proved to be for females 48% compared to 8%, and for males 34% compared to 4%. A history of childhood eczema was found to be more common among voting persons, indicating an increase in the prevalence of atopic dermatitis. Of those individuals who reported childhood eczema, 27% reported hand eczema on some occasion during the last 12 months.
Prevalence of Low Ankle Brachial Index and Relationship With Cardiovascular Risk Factors in a Western Urban Population in Turkey

We determined the prevalence of peripheral arterial disease (PAD) and associated risk factors in an urban population age ≥30 years in Turkey and assessed the impact of incorporating ankle brachial index (ABI) measurement with coronary heart disease risk calculations to the risk reclassification of individuals. The sample was drawn from 4600 participants of Balcova Heart Study. The prevalence of low ABI (<0.9) was 6.3%. Current smoking (odds ratio [OR]: 5.07, 95% confidence interval [CI]: 1.85-13.88), cardiovascular disease history (OR: 6.83, 95% CI: 3.00-15.53), hypertension (OR: 2.58, 95% CI: 1.06-6.33), diabetes (OR: 3.25, 95% CI: 1.51-6.98), and high waist circumference (OR: 2.24, 95% CI: 1.02-4.94) were positively associated with prevalent PAD. When ABI measurement was taken into account, 3.5% of low or intermediate risk patients were reclassified as high risk. Screening individuals who have one of these risk factors with ABI can help reclassifying individuals toward the high-risk category.
Oscillation based analog testing — A case study

The Oscillation Based Testing (OBT) method represents an effective and simple solution to the testing problem of discrete continuous time analog electronic filters. Its implementation, however, still imposes need for knowledge of the circuit under test (CUT) behaviour and the simulation algorithms of oscillators in the time domain. In this paper we describe the implementation of the OBT method to a second order notch cell realized with one operational amplifier. For simulation we used LTspice. A realistic model for simulation of the operational amplifier in time domain was used. The results obtained confirm the hypothesis of usefulness of OBT. Single soft and catastrophic faults are considered with more detail while double soft faults are exemplified only. Ideas for future work are suggested.
Personality, Negative Interactions, and Mental Health

Research suggests that an individual’s personality traits may mediate the relationship between social support and mental health. This study uses two national data sets to test a conceptual model that integrates personality, social support, negative interactions, and psychological distress. Results suggest that, beyond the influence of personality, social support is negatively associated with psychological distress, and negative interactions are positively associated with such distress. The findings also suggest that personality has direct and indirect effects, through social support and negative interactions, on psychological distress. Findings specify how positive and negative facets of relationships and personality influence mental health outcomes.