Miracle-dz/UniFAR-FTUs huggingface dataset:
A study of the VaSera arterial stiffness device in US patients

The cardio‐ankle vascular index (CAVI) represents a promising index of arterial stiffness. However, neither the CAVI measure nor its measurement device, the VaSera, have undergone general testing in a North American clinical setting. To begin the process of collecting normal values in the United States, we studied 20 male and 28 female volunteers without reported cardiovascular or renal disease and no history of smoking. Their CAVIs, ankle‐brachial indices (ABIs), and four‐limb blood pressures were measured in three positions: supine, 7° Trendelenburg, and 7° reverse Trendelenburg. In addition, the ABI function was validated against an established ABI measurement technique. Position was found to affect CAVI and other hemodynamic parameters, indicating that CAVI is not robust to slight positional variations. No differences were found in the blood pressure between arms or legs (interbrachial or interankle), supporting recent findings from meta‐analyses and studies but contradicting other work. This study represents an early step in bringing the VaSera device and its CAVI measurement into clinical practice.
Association between reduced arterial stiffness and preserved diastolic function of the left ventricle in middle‐aged and elderly patients

The aim of this study was to investigate whether arterial stiffness plays a role in retaining normal diastolic function in a middle‐aged and elderly Korean population. A total of 267 patients without documented cardiovascular disease, 50 years and older (mean age, 57.3±6.3 years; 69.8% men) were retrospectively analyzed. All patients underwent both transthoracic echocardiography and brachial‐ankle pulse wave velocity measurement on the same day. Patients with septal annular peak velocity (e’) ≥8 cm/s and left atrial volume index <34 mL/m2 were considered as having normal diastolic function. Ninety‐eight patients (36.7%) had normal diastolic function. Low brachial‐ankle pulse wave velocity (<1314 cm/s) was an independent factor for determining normal diastolic function even after controlling for potential confounders in multiple logistic regression analysis (odds ratio, 2.58; 95% confidence interval, 1.46–4.57; P=.001). Our results suggest that compliant arteries may play an important role in maintaining normal left ventricular diastolic function in middle‐aged and elderly patients without documented cardiovascular disease.
DRINKING AND DRIVING: STATISTICS AND MEDICO-LEGAL ASPECTS IN NORTH-EAST OF ALGERIA

Abstract Alcohol has been recognised as a major factor in road crashes. The aim of this study is to make a descriptive analysis of the results of blood alcohol concentration (BAC) calculated in our service as part of the application of the Law 46 relating to the road organization published in 2001 (BAC <0.10g/L). This is a retrospective study covering a period of 4 years (from 2005 to 2008), based on all BAC results. We have registered 3117demands of BAC mainly by the national gendarmerie where 17.80% of the cases showed a BAC ≥ 0.10g/L. In this study, we also noted that 12.62% of the traffic accidents had occurred due to the drinking and driving under the influence of alcohol, and that 63.40% of the samples taken to check the status were positive. The toxicologist who makes these determinations can not be certain that a pre-analytical error has not been detected in the blood sample and that the official method for the determination BAC (gas chromatography and Chemical CORDEBARD method) does not give false positives around the value required in Algeria (<0.10g/L). The technique used in our laboratory is the chemical method of CORDEBARD which is reproducible (variation coefficient = 3.57%), but it gives a limit of detection of 0.14g/L which is higher than the legal value and thus poses a problem of interpretation of the results obtained around that value.
A Physician's View of Freidson's Analysis

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Orally Positioning Older People in Assessment Meetings

It has been demonstrated that persons with dementia may be positioned as less competent than participants of the same age without dementia, and that persons with dementia possibly also are positioned as less competent than other older persons without dementia. In the present study, we aim to explore this further by analyzing Swedish assessment meetings in which needs and preferences are investigated for older persons without dementia. The material consists five audio-recorded assessment meetings, where there were at least two conversational partners present (a spouse and/or a child) and where the older person applying for social services was not diagnosed with dementia. The ages of the older persons ranged from 81 to 88, while the age of the relatives ranged from 46 to 93. The results of the present study demonstrate that older persons without dementia mainly are positioned as competent. However, it may be related to the degree of frailty, because the frailest person in the present study appears to be positioned as less competent than the other participants. The present paper adds to existing knowledge on how professionals in assessment meetings contribute to the positioning of older persons as competent and capable of making decisions. The results of the present article may be useful to promote development of education and training of communication skills for care mangers in assessments. Such training would further ensure that older persons with and without cognitive impairments can be actively involved in the creation and interpretation of their applications for social services.
Effect of Sairei‐to on irreversible glomerular sclerotic lesions in rats

SUMMARY: The effects of Sairei‐to and its active components on a model of irreversible mesangial proliferative glomerulonephritis induced by injecting monoclonal antibody (MoAb) 1‐22‐3 into uninephrectomized rats were examined. the significant suppressive effects of Sairei‐to and its active components on proteinuria were demonstrated on days 7, 14, 21 after MoAb 1‐22–3 injection compared with phosphate‐buffered saline (PBS)‐treated controls. On day 21, light microscopy revealed that the drugs reduced mesangial cell proliferation, mesangial matrix expansion (matrix score: 84.5 ± 41.6 for Sairei‐to, 76.1 ± 31.9 for Syo‐saiko‐to, 66.7 ± 46.3 for its three components vs 162.4 ± 26.1 for PBS, P<0.005) and crescent formation (mean percentage: 2.25% for Sairei‐to, 1.71% for Syo‐saiko‐to, 1.43% for its three components vs 18.86% for PBS, P<0.005). the kidney weights of the groups given the drugs were significantly lower than the PBS group value (1.03 ± 0.08 g with Sairei‐to, 1.11 ± 0.12 g with Syo‐saiko‐to, 1.06 ± 0.12 g with its three components vs 1.39 ± 0.20 g with PBS, P<0.01 or P<0.05). Immunofluorescence analysis revealed that the drugs suppressed the expression of transforming growth factor‐β (TGF‐β), α‐smooth muscle actin (α‐SMA) and collagen type I in the glomeruli, and reduced the numbers of ED1‐positive cells in the glomeruli and OX8‐positive cells in the glomeruli and in the tubular interstitium. the blood biochemistry results revealed significant differences between the total cholesterol levels (70.0 ± 5.9 mg/dL with Sairei‐to, 66.0 ± 6.4 mg/dL with Syo‐saiko‐to, 76.6 ± 8.4 mg/dL with its three components vs 104.3 ± 26.6 mg/dL with PBS, P<0.05). We conclude that Sairei‐to and its active components have suppressive effects on proteinuria and mesangial matrix expansion in rats with irreversible renal sclerosis. Transforming growth factor‐β, collagen type I and α‐SMA expression and infiltration by ED1‐ and OX8‐positive cells were also suppressed by these drug preparations.
Relationship of vital capacity and selected anthropometric variables to two-mile run time

Vital capacity has been investigated widely during the last century (Hutchinson, 1846; Dreyer, 1919; Hewlett and Jackson, 1922; Cureton, 1936) and attempts have been made to relate it to physical fitness status (Cureton, 1936; Davis, 1959). Attempts were made to determine the effects of training on vital capacity without great success (Davis, 1959; Adams, 1968; Wilmore et aL, 1970). Barring pathological conditions, the questions of the contribution of vital capacity to athletic performance and the association between anthropometric parameters and vital capacity were yet unsolved.
New AMBER force field parameters of heme iron for cytochrome P450s determined by quantum chemical calculations of simplified models

The heme protein, cytochrome P450, is an oxidoreductase that plays an important role in drug metabolism. To model P450s using molecular mechanics methods and classical molecular dynamics simulations, force field parameters and atomic charges are required. Because these parameters are generally obtained by quantum chemical methods, an appropriate simplified model for the iron–porphyrin system was needed. In this study, two models with a five‐coordinated Fe(III) mimicking the sextet spin state of P450s are proposed, which are optimized by semiempirical and ab initio unrestricted Hartree–Fock methods. The results produced using the simpler of the two models were similar to those of the more complex model; therefore, the more simplified model of P450 can be used without a loss of accuracy. Furthermore, several quantum chemical calculations were carried out on the simpler model to investigate which method was most suitable for iron–porphyrin systems. The results calculated by hybrid density functional theory (DFT), with the MIDI basis set for iron, reproduced the three‐dimensional structures determined by X‐ray diffraction and extended X‐ray absorption fine‐structure experiments. From these results, atomic charges and force‐field parameters for molecular mechanics and molecular dynamics calculations were obtained. © 2005 Wiley Periodicals, Inc. J Comput Chem 26: 818–826, 2005
A Review of Treatment Options Available for Women with Uterine Fibroids

Background: The quest for ideal treatment and understanding of fibroid biology has resulted in further studies in pharmacological, radiological and surgical options with the goals of being safe, less invasive, cost - effective and enhancing reproductive potentials. However, surgery remains the mainstay of present effective management for large symptomatic fibroids. Aim: The aim is to review the treatment options available for women with uterine fibroids. Methods: Publications on the management of uterine fibroids were accessed using medline, google scholar and pubm ed databases. Relevant materials on treatment of uterine fibroids, selected references from internet services, journals, textbooks and lecture notes on management of uterine fibroids were also accessed and critically reviewed. Results: The mainstay of management for large symptomatic fibroids is surgical (myomectomy or hysterectomy). Minimally invasive procedures are becoming more commonly performed via b oth laparoscopic or hysteroscopic approaches, minimizing recovery time, postoperative pain and
Dimensions and predictors of treatment needs for female inmates: an exploratory study in Taiwan

Although female offenders have been largely neglected by researchers in the past, the recent and rapid rise in their numbers has resulted in increased scholarly attention. While there has been a substantial movement toward gender-specific rehabilitative programs, limited studies have been conducted over the past years that explore the dimensions and determinants of treatment needs for female offenders. Using data comprised of 883 women collected from 3 individual women prisons and 10 other prisons or jails, primary findings indicate that counseling and therapy services are priority concerns followed by educational and vocational training courses, health and medical services, and pre-release preparations. In terms of significant determinants, diseases, social support, depression, and imprisonment stress have a great impact on women's treatment needs. Consistent with prior studies, Taiwanese female drug offenders have also reported a higher level of treatment needs. Comparative views, policy implications, and limitations are addressed.
Maximizing Chemoprophylaxis Against Venous Thromboembolism in Abdominoplasty Patients With the Use of Preoperative Heparin Administration

BackgroundAbdominoplasty is one of the highest risk plastic surgery procedures for venous thromboembolism complications (VTE). Current recommendations for VTE prophylaxis are sequential compression devices (SCDs) in the OR and optional use of subcutaneous heparin after surgery. Subcutaneous heparin has been shown to be safe in other surgical groups. However, the large raw surface areas and dissection involved in abdominoplasty has been a relative contraindication for preoperative chemoprophylaxis. However, the period while the patient is under general anesthesia and immediately following the procedure is likely the highest risk time period for VTEs. The purpose of this study is to determine if preoperative chemoprophylaxis is safe in these patients. MethodsAll patients undergoing abdominoplasty by the senior author from January 1, 2005 to January 1, 2012 were retrospectively reviewed. All patients whose operation took place between January 1, 2005 and January 18, 2008 were given SCDs before the induction of anesthesia and heparin (unfractionated) 5000 units SQ on call to the OR. All patients whose operation took place between January 19, 2008 and January 1, 2012 received enoxaparin (low molecular weight heparin) 40 mg SQ on call to the OR and then daily for 2 days postoperatively. These groups were evaluated in regards to overall complication rate, incidence of VTE, and bleeding complications. ResultsA total of 151 patients underwent abdominoplasty during the study period. One hundred one patients received the SCD/heparin protocol and 50 had the enoxaparin protocol. The groups were similar in regard to pre-morbid conditions and risk factors for VTE. There were no VTEs diagnosed in either group. The overall incidence of any complication was similar between the 2 groups (19% vs. 14%, P = 0.503) and similar to other published series. The most common complications were seroma, cellulitis, and minor wound dehiscence. The incidence of bleeding complications was similar between the 2 groups (1% vs. 0%, P = 1.0). ConclusionsThe use of preoperative chemoprophylaxis in patients undergoing abdominoplasty can be done without an increase in bleeding complications or overall complication rate. Furthermore, enoxaparin can also be used preoperatively and continued for 2 more days during the period of time of maximum immobility with easy administration for outpatients via use of a prescription home use kit.
Immediate Transverse Rectus Abdominis Musculocutaneous Flap Reconstruction Is Associated With Improved Cancer-Specific Survival in Locally Advanced Breast Cancer

BackgroundThis study of stage III (locally advanced) breast cancer patients evaluated the survival improvement conferred by immediate breast reconstruction by transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction after modified radical mastectomy (MRM) in comparison with MRM alone. MethodsThis retrospective study analyzed data for all women who had received TRAM immediately after unilateral modified radical mastectomy for locally advanced breast cancer at a single institution from January 2002 to December 2009. The analysis included 192 patients divided into 2 groups: patients who had received MRM immediately followed by TRAM flap reconstruction (MRM-TRAM group, n = 52) and patients who had received MRM alone (MRM group, n = 140). Data collection included demographic characteristics, underlying comorbidities, and cancer characteristics. Postoperative adjuvant therapies, oncologic outcomes, and survival were compared between the 2 groups. Kaplan-Meier plots, univariate log-rank test, multivariate Cox proportional hazards regression models, and t-test were used to evaluate potential predictors of cancer recurrence and patient survival. ResultsIn comparison with the MRM group, significant differences in the MRM-TRAM group included a younger mean age, a better overall health status, and a higher education level (all P < 0.001). Severity of breast cancer disease did not significantly differ in terms of cancer characteristics. Additionally, there were no significant differences in local recurrence (P = 0.326) and distant metastasis (P = 0.338). Immediate breast reconstruction was not associated with delays in detection of local recurrence and initiation of adjuvant therapiesThe 5-year breast cancer-specific survival rate was significantly higher in the MRM-TRAM group (84.6%) compared with the MRM group (61.2%) (P = 0.003). Multivariate analysis showed that TRAM flap reconstruction is an independent predictor of survival in breast cancer patients. The MRM-TRAM group had a significantly lower hazard of death (HR, 0.235; 95% CI, 0.070–0.788; P = 0.019) compared with the MRM group. ConclusionsImmediate TRAM flap reconstruction is oncologically safe and is unassociated with delayed adjuvant therapies or delayed detection of local recurrence. Patients with locally advanced breast cancer can be considered appropriate candidates for TRAM flap reconstruction because the procedure is an independent predictor of breast cancer survival and is associated with a 76.5% decrease (HR, 0.235) in the risk of cancer death.
Predicting mental health service use: Diagnosis based systems and alternatives

One of the main features of the modern British NHS is that health should be both purchased and provided in an efficient and cost effective manner. This is particularly relevant in the resource intensive area of mental health care. The achievement of such an aim entails the measurement of service inputs and patient outputs. Knowledge of the casemix (the grouping of 'similar' patients) is vital. This paper reviews the efficiency of the most prominent description of casemix, diagnosis-related groups (DRGs), in predicting levels of mental health service utilization. The results demonstrate that the application of DRGs to psychiatry is imperfect. Refinements to DRGs and alternative systems are also reviewed. The main finding is that diagnosis is a poor indicator of the level of services that patients require. More satisfactory predictors include social functioning, patient characteristics, and severity of illness.
Impact of immediate loading on early bone healing at two-piece implants placed in fresh extraction sockets: an experimental study in the beagle dog.

OBJECTIVE To study early bone healing of immediately loaded implants placed in fresh extraction sockets versus immediate implants without occlusal loading in the dog. MATERIALS AND METHODS A total of 48 implants were placed in the distal sockets of Pm3 and Pm4 in the lower jaw of 12 Beagle dogs immediately after tooth extraction. In the control group, no loading was applied. In the test group, an immediate loading restoration with occlusal contacts was performed. Dogs were sacrificed at 2, 4 and 8 weeks for histological analysis. RESULTS At the end of the study, there was a 100% implant and prosthesis survival. Similar results for test and control groups were observed for bone-to-implant contact (%) and peri-implant bone area. Inter-thread bone area tended to decrease in the control and increase in the test. With respect to ridge alterations, bone resorption was more pronounced on the buccal aspect and was observed in both groups. CONCLUSION Immediate loading did not impair early stages of bone healing and crestal bone modelling at two-piece implants in fresh extraction sockets in the beagle dog; however, bone resorption occurred in all specimens in both groups.
Statistical Issues in Short-Term Trials in Asthma

Some current practices in designing and analyzing short-term trials in asthma are examined from a statistical point of view. The trials considered consist principally of crossover trials to examine dose response, onset of action, duration of action, and protective effects of treatments or bioequivalence. It is concluded that a proper appreciation of the way in which causality may be investigated in clinical trials would lead to an improvement in design and analysis of short-term trials in asthma.
Efficacy of periodontal plastic procedures in the treatment of multiple gingival recessions.

OBJECTIVE To systematically review the efficacy of periodontal plastic procedures (PPP) in the treatment of multiple gingival recessions (MGR). METHODS Randomized clinical trials (RCT) on MGR treatment with at least 6 months duration were identified through electronic databases and hand-searched journals. Primary outcomes were complete root coverage (CRC) and percentage of root coverage (PRC). Weighted means and forest plots were calculated for all PPP. Subgroup analysis was performed according to the type of flap. A Bayesian network meta-analysis (NM) on secondary outcomes was also performed. RESULTS Nine trials including 208 subjects and 858 recessions were identified. CRC after PPP was 24-89%. Mean weighted PRC was 86.27% (95% CI 80.71-91.83; p < 0.01). Heterogeneity of the literature prevented inter-techniques comparison. Coronally advanced flap (CAF) shows the higher variability in terms of CRC. Modified CAF and tunnel approaches show higher level of CRC. The NM suggests that CAF plus graft showed the higher probability of being the best treatment. CONCLUSIONS Limited evidence is available for MGR coverage. PPP are associated with high level of efficacy, in terms of PRC, and high variability of CRC. Indirect evidence indicates that CAF may benefit from newer variations of the technique and by the additional use of grafting.
The Dentine Hypersensitivity Experience Questionnaire: a longitudinal validation study.

AIM To validate the Dentine Hypersensitivity Experience Questionnaire in terms of responsiveness to change and to determine the minimally important difference. MATERIALS AND METHODS The study was a secondary analysis of data from three randomized controlled trials with 311 participants. Three aspects of responsiveness were examined: change within individuals, differences among people who improved, stayed the same or worsened using an external referent and change due to treatment. Responsiveness to treatments of differing efficacy was assessed in trials with negative and active controls. RESULTS The measure showed excellent internal reliability, test-retest reliability and criterion validity. The measure was highly responsive to change within individuals (Cohen's effect sizes: 0.28, 0.56, 0.86) showing decreases in the total score (i.e. improvement in OHrQoL) across all trials. The effect sizes in participants whose self-reported QoL "improved" were large (0.73-1.31). Dentine Hypersensitivity Experience Questionnaire detected a treatment effect in one of two negative control trials (effect size: 0.47). Dentine Hypersensitivity Experience Questionnaire scores were similar in the test and control groups in the active control trial. The minimally important difference range was between 22 and 39 points. CONCLUSIONS The measure is longitudinally reliable, valid and responsive and can discriminate between treatments of different efficacy.