Miracle-dz/UniFAR-FTUs huggingface dataset:
Maternal glycemic control and umbilical artery Doppler velocimetry

Objective: To determine whether information from umbilical artery Doppler flow velocity waveforms significantly improves the prediction of adverse perinatal outcome, independently of maternal glycemic control, in pregnancies complicated by diabetes. Study design: The medical records of 277 pregnant women with diabetes were reviewed. Glycemic control was determined by glycosylated hemoglobin concentration and umbilical artery Doppler velocimetry by using systolic/diastolic ratios (S : D), both obtained during the third trimester. Pregnancies with adverse perinatal outcome were compared to those with good outcome. Logistic regression analysis was used to adjust for glycemic control, and to test whether an elevated umbilical artery Doppler S : D ratio was independently associated with pregnancy outcome. Results: Adverse pregnancy outcome occurred in 51.6% of these pregnancies (143/277). The mean third-trimester glycosylated hemoglobin (7.7 ± 1.9% vs. 6.7 ± 1.3%, p < 0.001) and the umbilical artery S : D ratio were significantly higher (2.6 ± 0.6 vs. 2.4 ± 0.3, p < 0.001) in the pregnancies with adverse outcome. Logistic regression analysis showed that umbilical artery S : D ratio was an independent predictor of adverse perinatal outcome after adjusting for the third-trimester glycosylated hemoglobin level. Forty per cent of patients with normal Doppler findings (S : D ratio of < 3.0) and normal glycemic control values (glycosylated hemoglobin level of < 7.5%) had an adverse pregnancy outcome. Sixty-three per cent of patients with an abnormal result for one of these tests had an adverse pregnancy outcome. Ninety-six per cent of patients with both abnormal Doppler findings and abnormal glycemic control had an adverse pregnancy outcome. Conclusion: Umbilical artery Doppler velocimetry improves the predictive value for adverse perinatal outcome, independently of glycemic control, in pregnancies complicated by diabetes. The combination of an abnormal umbilical artery S : D ratio and abnormal glycosylated hemoglobin was strongly associated with adverse pregnancy outcome.
Writ e Click: Editor’s Choice IS ASYMPTOMATIC HEMORRHAGIC TRANSFORMATION REALLY INNOCUOUS?

IS ASYMPTOMATIC HEMORRHAGIC TRANSFORMATION REALLY INNOCUOUS? Richard B. Libman, New Hyde Park, NY; Thomas Kwiatkowski, Lake Success, NY: Park et al.1 found that patients with asymptomatic hemorrhagic transformation of an infarct had worse functional outcome in 3 months compared to patients without hemorrhagic transformation. The concept of whether asymptomatic hemorrhagic transformation may exert subtle adverse effects that may ultimately lead to a worse outcome has been difficult to approach. Sample size has been an issue with the possibility of inadequate power to detect an adverse effect of asymptomatic hemorrhagic transformation.2 In our study of asymptomatic hemorrhagic transformation and outcome, initial analysis suggested that asymptomatic hemorrhagic transformation decreased the odds of a favorable outcome.3 However, lesion volume is associated with both hemorrhagic transformation and outcome. When controlling for lesion volume, asymptomatic hemorrhagic transformation was no longer associated with a worse longterm outcome.3 Park et al. controlled for several variables potentially associated with both functional outcome and hemorrhagic transformation, including stroke subtype, initial NIH Stroke Scale (NIHSS) score, initial fasting blood glucose, total cholesterol, thrombolytic administration, and use of heparin. They did not, however, control for lesion volume. Could the authors reanalyze their data adjusting for lesion volume to see whether the relationship between asymptomatic hemorrhagic transformation and poor outcome persists? Until this is done, the possibility of confounding remains, and the evidence that asymptomatic hemorrhagic transformation worsens long-term outcome remains tentative.
Adaptation planning in the Lower Mekong Basin: merging scientific data with local perspective to improve community resilience to climate change

The USAID Mekong Adaptation and Resilience to Climate Change project has piloted an integrative method for developing climate change adaptation plans within Lower Mekong Basin communities. Through an iterative process, traditionally distinct top-down and bottom-up approaches to decision-making are merged to improve resilience and sustainability of adaptation plans. The approach helps to broaden the understanding of both scientists and community members on the implications of climate change at the local level. Methods are highlighted within one pilot community, Huai Kang Pla, Thailand, with the primary goal of exemplifying the process, and, secondarily, to evaluate its validity in the context particular to this site. The results indicate that community members initially were most concerned with shorter term, atypical events such as irregular rainfall pattern during the growing season and/or periods of extreme temperature that intensify the annual drought. They were less troubled by other parameters that scientists had identified as additionally important, such as the more progressive, longer term shifts in average temperature and rainfall totals. Scientists defined key climate-related terms such as drought and irregular rainfall differently from community members; the distinctions around these differences were important to identify early in the process so that integration of information from the two groups could be more effective.
Anthropometric and craniofacial sexual dimorphism in obstructive sleep apnea patients: is there male–female phenotypical convergence?

Obstructive sleep apnea (OSA) is more common in men than women. Body size is greater in males (sexual dimorphism), but large body habitus is associated with OSA for both genders. We speculated that male–female phenotypical convergence (reduced sexual dimorphism via identical phenotype acquisition) occurs with OSA and tested hypotheses: (1) phenotypical features pathogenic for OSA differ between OSA and healthy subjects irrespective of gender; and (2) such characteristics exhibit phenotypical convergence. Utilizing an existing database, we calculated male–female (group average) ratios for eight anthropometric and 33 surface cephalometric variables from 104 Caucasian OSA patients [72 males; apnea–hypopnea index (events h−1): males: 42.3 ± 24.7 versus females: 42.6 ± 26.1 (P > 0.9)] and 85 Caucasian, healthy, non‐OSA, community volunteers (36 males). Log‐transformed data were analysed using a general linear model with post‐hoc unpaired t‐tests and significance at P < 0.0012 (Bonferroni multiple‐comparison correction). OSA patients were older (56.9 ± 14.4 versus 38.0 ± 13.8 years), but there were no within‐group gender‐based age differences. All anthropometric variables (except height), plus cranial base width, mandibular breadth and retromandibular width diagonal were larger in gender‐matched OSA versus healthy comparisons; thus satisfying hypothesis (1). Male–female ratios were mostly >1.0 across groups, but with no significant group × gender interactions no variable satisfied hypothesis (2). Thus, in this exploratory study, OSA patients had gender‐common phenotypical differences to healthy subjects, but sexual dimorphism was preserved. Lack of complete phenotypical convergence may indicate gender‐based critical phenotype‐level attainment for OSA and/or gender‐based OSA prevalence arises from factors other than those in this study.
Efficacy of 12-month treatment with the GH receptor antagonist pegvisomant in patients with acromegaly resistant to long-term, high-dose somatostatin analog treatment: effect on IGF-I levels, tumor mass, hypertension and glucose tolerance.

OBJECTIVE We aimed to investigate the efficacy of pegvisomant in patients with acromegaly resistant to long-term (> or = 24-month), high-dose treatment with octreotide-LAR (40 mg/month) or lanreotide (120 mg/month). DESIGN This was an open, prospective study. SUBJECTS AND METHODS We studied 16 patients with acromegaly (nine women; aged 28-61 years). The main outcome measures were IGF-I levels, blood pressure, glucose tolerance and safety (liver function and tumor size). Pegvisomant was given at doses of 10-40 mg s.c. daily. Dose titration was performed every month by IGF-I assay. RESULTS Three patients spontaneously stopped pegvisomant treatment after 6-9 months because of poor compliance; from the measurement of serum pegvisomant, another patient was found not to inject herself properly. After 6 months, IGF-I levels decreased by 63 +/- 19% (767.8 +/- 152.9 vs 299.8 +/- 162.9 microg/l, P < 0.0001, t-test); serum IGF-I levels normalized in 57%. After 12 months, IGF-I levels normalized in nine (75%) patients and were reduced by over 50% in another three (25%). The mean tumor volume remained stable during the study (1198 +/- 1234 vs 1196 +/- 1351 mm(3), P = 0.37): it did not change ( +/- 25% vs basal) in nine patients, increased by 39.4% and 40.8% in two and decreased by 30.8-46.5% in four. The total/high-density lipoprotein (HDL):cholesterol ratio (from 4.4 +/- 1.0 to 3.7 +/- 0.6, P = 0.0012), glucose levels (from 5.6 +/- 1.2 to 4.4 +/- 1.4 mmol/l, P = 0.026), insulin levels (from 12.4 +/- 6.7 to 8.1 +/- 3.0 mUl/l, P = 0.0023) and homeostasis model assessment (HOMA) index (from 3.4 +/- 2.1 to 1.9 +/- 1.0, P = 0.0017) decreased. CONCLUSIONS Treatment for 12 months with pegvisomant normalized IGF-I levels, and improved cardiovascular risk parameters and insulin sensitivity in patients with acromegaly resistant to long-term, high-dose treatment with somatostatin analogs. The tolerance of treatment was good.
Genotypic and Phenotypic Responses of a Riverine Microbial Community to Polycyclic Aromatic Hydrocarbon Contamination

ABSTRACT The phenotypic and genotypic adaptation of a freshwater sedimentary microbial community to elevated (22 to 217 μg g [dry weight] of sediment−1) levels of polycyclic aromatic hydrocarbons (PAHs) was determined by using an integrated biomolecular approach. Central to the approach was the use of phospholipid fatty acid (PLFA) profiles to characterize the microbial community structure and nucleic acid analysis to quantify the frequency of degradative genes. The study site was the Little Scioto River, a highly impacted, channelized riverine system located in central Ohio. This study site is a unique lotic system, with all sampling stations having similar flow and sediment characteristics both upstream and downstream from the source of contamination. These characteristics allowed for the specific analysis of PAH impact on the microbial community. PAH concentrations in impacted sediments ranged from 22 to 217 μg g (dry weight) of sediment−1, while PAH concentrations in ambient sediments ranged from below detection levels to 1.5 μg g (dry weight) of sediment−1. Total microbial biomass measured by phospholipid phosphate (PLP) analysis ranged from 95 to 345 nmol of PLP g (dry weight) of sediment−1. Nucleic acid analysis showed the presence of PAH-degradative genes at all sites, although observed frequencies were typically higher at contaminated sites. Principal component analysis of PLFA profiles indicated that moderate to high PAH concentrations altered microbial community structure and that seasonal changes were comparable in magnitude to the effects of PAH pollution. These data indicate that this community responded to PAH contamination at both the phenotypic and the genotypic level.
A Claims‐Made Study of Knee Injuries Due to Football in High School Athletes

This article is an analysis of the insurance claims for injuries sustained in high school football for the 1965, 1975–1977, and 1983–1985 football seasons. Thirteen percent of all injuries each season involved the knee. In 1965, 12% of patients were treated operatively, and, in 1985, 33% underwent surgery. Follow-up questionnaires completed by 446 (68%) of the players injured during 1975, 1976, and 1977, after a mean of 10 years, showed that 25% of players with ligament injuries, 30% with internal derangement of the knee, and 17% with patellar injuries claim disability for some atheletic pursuits.
The Variation of Psychopharmacological Prescription Rates for People With Autism Spectrum Disorder (ASD) in 30 Countries

There is significant variation in prescriptions among countries in clinical practice for the treatment of comorbidities associated with autism spectrum disorder (ASD). It has been suggested that many people with mental health disorders in low‐/middle‐income countries do not receive adequate treatment. Hence, this study investigated psychopharmacological treatment patterns for ASD comorbidities in 30 countries and the association between country's income and prescription rates.
Nanoemulsion as a Potential Ophthalmic Delivery System for Dorzolamide Hydrochloride

Dilutable nanoemulsions are potent drug delivery vehicles for ophthalmic use due to their numerous advantages as sustained effect and high ability of drug penetration into the deeper layers of the ocular structure and the aqueous humor. The aim of this article was to formulate the antiglaucoma drug dorzolamide hydrochloride as ocular nanoemulsion of high therapeutic efficacy and prolonged effect. Thirty-six systems consisting of different oils, surfactants, and cosurfactants were prepared and their pseudoternary-phase diagrams were constructed by water titration method. Seventeen dorzolamide hydrochloride nanoemulsions were prepared and evaluated for their physicochemical and drug release properties. These nanoemulsions showed acceptable physicochemical properties and exhibited slow drug release. Draize rabbit eye irritation test and histological examination were carried out for those preparations exhibiting superior properties and revealed that they were nonirritant. Biological evaluation of dorzolamide hydrochloride nanoemulsions on normotensive albino rabbits indicated that these products had higher therapeutic efficacy, faster onset of action, and prolonged effect relative to either drug solution or the market product. Formulation of dorzolamide hydrochloride in a nanoemulsion form offers, thus, a more intensive treatment of glaucoma, a decrease in the number of applications per day, and a better patient compliance compared to conventional eye drops.
‘We do not do any activity until there is an outbreak’: barriers to disease prevention and health promotion at the community level in Kongwa District, Tanzania

Background Little is known about the barriers to disease prevention and health promotion at the community level – within a decentralized health system. Objective This paper, therefore, presents and discusses findings on barriers (and opportunities) for instituting disease prevention and health promotion activities. Design The study was conducted in Kongwa District, Tanzania, using an explorative case study approach. Data were collected through document reviews and in-depth interviews with key informants at district, ward, and village levels. A thematic approach was used in the analysis of the data. Results This study has identified several barriers, namely decision-makers at the national and district levels lack the necessary political will in prioritizing prevention and health promotion; the gravity of prevention and health promotion stated in the national health policy is not reflected in the district health plans; gross underfunding of community-level disease prevention and health promotion activities; and limited community participation. Conclusion In this era, when Tanzania is burdened with both communicable and non-communicable diseases, prevention and health promotion should be at the top of the health care agenda. Despite operating in a neoliberal climate, a stronger role of the state is called for. Accordingly, the government should prioritize higher health-protecting physical, social, and economic environments. This will require a national health promotion policy that will clearly chart out how multisectoral collaboration can be put into practice.
Correlation between congenital heart defects and maternal copper and zinc concentrations.

BACKGROUND The aim of this study was to investigate the correlation between maternal concentrations of copper and zinc and the risk of having an infant with a congenital heart defect (CHD). METHODS A multi-center hospital-based case-control study was conducted in China. A total of 212 cases and 212 controls were recruited from pregnant women who received prenatal examinations in four tertiary hospitals accredited to perform prenatal diagnosis in the cities of Shenzhen, Zhenzhou, Fuzhou and Wuhan between February 2010 and November 2011. Correlation between CHDs and maternal copper and zinc concentrations was estimated by a 1:1 conditional logistic regression. Also the interaction between copper and zinc was analyzed. RESULTS Compared with the controls, mothers with hair copper concentrations of 17.77 μg/g or more were more likely to have a child with a CHD than those with a lower concentration. The adjusted odds ratio was 5.70 (95% confidence interval, 2.58-12.61) for CHDs and 6.32 (95% confidence interval, 2.11-18.92) for conotruncal defects. Zinc concentrations were not significantly different in the case and control groups. The results suggest that mothers whose zinc content was 104.60 μg/g or less did not have a significantly higher risk of having a child with a CHD. No interaction between maternal copper and zinc concentrations was observed in the multiplicative or additive model. CONCLUSION Women with excessive copper concentrations have a significantly increased risk of having offspring with a CHD. A low maternal zinc status might have a correlation with CHDs, and an interaction between copper and zinc might exists, but an epidemiological study with a larger sample size is needed to confirm this finding.
A randomized, controlled trial of adding expired carbon monoxide feedback to brief stop smoking advice: evaluation of cognitive and behavioral effects.

OBJECTIVE To determine the effect of adding biomarker feedback (expired air carbon monoxide) to standard quit advice on cognitive antecedents of behavior change and smoking cessation and to identify potential effect moderators and mediators. DESIGN Smokers (N = 160) were randomized to a control (quit advice plus leaflet) or an intervention condition (as control group plus carbon-monoxide level feedback). Cognitive measures were assessed immediately after the intervention and behavioral measures at 6 months' follow-up. MAIN OUTCOME MEASURES Primary outcome measures were threat and efficacy appraisal, fear arousal, and intention to stop smoking. Secondary outcome measures were quit attempts within the last 6 months and 7-day point prevalence abstinence. RESULTS Threat appraisal was significantly enhanced in the intervention compared with the control group, t(158) = 2.29, p = . 023, as was intention to stop smoking in the next month, t(151) = 2.9, p = . 004. However, this effect on intention to stop smoking was short-lived. Groups did not differ in terms of quit attempts or abstinence at follow-up, but the intervention increased the likelihood of cessation in smokers with higher self-efficacy, χ2(1) = 5.82, p = . 016. CONCLUSIONS Carbon-monoxide level feedback enhances the effect of brief quit advice on cognitive antecedents of behavior change and smoking cessation rates but further research is required to confirm the longevity of this effect and its applicability to smokers with low self-efficacy.
On the biocompatibility between TiO2 nanotubes layer and human osteoblasts.

Titanium and its alloys are the most popular biomaterials replacing hard tissues in implant surgeries. Clinicians are generally pleased by titanium mechanical properties and non-toxicity performances; on the other hand, there have been reported several cases of titanium implantation failure, phenomenon explained sometimes as "non adherence of human tissue to the metallic surface. " Yet, researchers reported that titanium surfaces are favorable for osteoblasts adhesion. Therefore, titanium integration into the human body remains an unsolved problem. In the present study, biocompatibility tests were performed on titanium and TiO(2) nanotubes substrates, involving human bone marrow cells. The combination of a newly developed analytical model based on the hybrid interphase concept, applicable to systems consisting of inert materials when in contact with living tissues, together with experimental results, confirmed previous research studies and lead to the conclusion that osteoblasts adhere efficiently to titanium surfaces. However, the present results suggest that osteoblasts strong anchorage at the very first moment of their contact with the metallic material leads to their apoptosis. It is most probable that in several cases this is the reason of failed implantation surgeries involving titanium.
Improved NADPH supply for xylitol production by engineered Escherichia coli with glycolytic mutations

Escherichia coli engineered to uptake xylose while metabolizing glucose was previously shown to produce high levels of xylitol from a mixture of glucose and xylose when expressing NADPH‐dependent xylose reductase from Candida boidinii (CbXR) (Cirino et al., Biotechnol Bioeng. 2006;95:1167‐1176). We then described the effects of deletions of key metabolic pathways (e.g., Embden–Meyerhof–Parnas and pentose phosphate pathway) and reactions (e.g., transhydrogenase and NADH dehydrogenase) on resting‐cell xylitol yield (YRPG: moles of xylitol produced per mole of glucose consumed) (Chin et al., Biotechnol Bioeng. 2009;102:209‐220). These prior results demonstrated the importance of direct NADPH supply by NADP+‐utilizing enzymes in central metabolism for driving heterologous NADPH‐dependent reactions. This study describes strain modifications that improve coupling between glucose catabolism (oxidation) and xylose reduction using two fundamentally different strategies. We first examined the effects of deleting the phosphofructokinase (pfk) gene(s) on growth‐uncoupled xylitol production and found that deleting both pfkA and sthA (encoding the E. coli‐soluble transhydrogenase) improved the xylitol YRPG from 3.4 ± 0.6 to 5.4 ± 0.4. The second strategy focused on coupling aerobic growth on glucose to xylitol production by deleting pgi (encoding phosphoglucose isomerase) and sthA. Impaired growth due to imbalanced NADPH metabolism (Sauer et al., J Biol Chem. 2004;279:6613‐6619) was alleviated upon expressing CbXR, resulting in xylitol production similar to that of the growth‐uncoupled precursor strains but with much less acetate secretion and more efficient utilization of glucose. Intracellular nicotinamide cofactor levels were also quantified, and the magnitude of the change in the NADPH/NADP+ ratio measured from cells consuming glucose in the absence vs. presence of xylose showed a strong correlation to the resulting YRPG. © 2011 American Institute of Chemical Engineers Biotechnol. Prog. , 2011
Spontaneous EEG oscillations reveal periodic sampling of visual attention

An important effect of sustained attention is the facilitation of perception. Although the term “sustained” suggests that this beneficial effect endures continuously as long as something is attended, we present electrophysiological evidence that perception at attended locations is actually modulated periodically. Subjects detected brief light flashes that were presented peripherally at locations that were either attended or unattended. We analyzed the correlation between detection performance for attended and unattended stimuli and the phase of ongoing EEG oscillations, which relate to subsecond fluctuations of neuronal excitability. Although on average, detection performance was improved by attention—indicated by reduced detection thresholds at attended locations—we found that detection performance for attended stimuli actually fluctuated over time along with the phase of spontaneous oscillations in the θ (≈7 Hz) frequency band just before stimulus onset. This fluctuation was absent for unattended stimuli. This pattern of results suggests that “sustained” attention in fact exerts its facilitative effect on perception in a periodic fashion.