Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of left ventricular mass and function, lipid profile, and insulin resistance in Egyptian children with growth hormone deficiency: A single-center prospective case-control study

Background: Growth hormone deficiency (GHD) in adults is associated with a cluster of cardiovascular risk factors that may contribute to an increased mortality for cardiovascular disease. In children, relatively few studies have investigated the effect of GHD and replacement therapy on cardiac performance and metabolic abnormalities that may place them at a higher risk of cardiovascular disease (CVD) at an early age. Aim: This study was aimed to assess the left ventricular function, lipid profile, and degree of insulin resistance in Egyptian children with GHD before and after 1 year of GH replacement therapy. Settings and Design: Prospective case-control study, single-center study. Materials and Methods: Thirty children with short stature due to GHD were studied in comparison to 20 healthy age- and sex-matched children. All subjects were subjected to history, clinical examination, auxological assessment, and echocardiography to assess the left ventricular function. Blood samples were collected for measuring IGF-1, lipid profile (Total, LDL, HDL cholesterol, triglyceride, and atherogenic index (AI), fasting blood sugar, and fasting insulin levels. In addition, basal and stimulated GH levels were measured in children with suspected GHD. Statistical Analysis Used: Student's t-test was used for parametric data, and the Mann-Whitney U-test was used for non-parametric data. Results: Total, LDL cholesterol, triglyceride, AI, and insulin were significantly higher in children with GHD than in healthy controls at baseline. After 12 months of GH replacement therapy, total, LDL cholesterol, triglyceride, AI and insulin were significantly decreased, while homeostatic model assessment for insulin resistance index (HOMA-IR) was significantly increased compared to both pre-treatment and control values. At baseline, the left ventricular mass (LVM) and left ventricular mass index (LVMi) were significantly lower in GHD children than in controls. After 12 months of GH replacement therapy, LVM and LVMi in GHD patients were significantly increased compared to pre-treatment values. Conclusions: GHD in children is associated with a significantly reduced cardiac mass and impairment of lipid profile. GH replacement therapy exerts beneficial effects both on cardiac mass and lipid metabolism by normalizing cardiac size and improving the lipid profile. On the contrary, an increase in insulin resistance is observed after 12 months GH treatment. The study suggests that children with GH deficiency should have echocardiography and lipid profile monitoring before and during treatment with GH.
Pregnancy and Perinatal Outcomes of Twin Pregnancies in Prapokklao Hospital

Objective: To evaluate the outcomes of twin pregnancies in Prapokklao Hospital. Materials and Methods: The outcomes of 151 women with twin pregnancies delivered at Prapokklao Hospital between 1 st January 2004 and 31 st December 2009 were retrospectively reviewed. The maternal and neonatal data were obtained from the medical records. Statistical analysis was performed. Results: The prevalence of twin deliveries at Prapokklao Hospital was 6.89 per 1,000 live births. The diagnosis of twin pregnancies in the antepartum period was made in 70.2% of cases. Cesarean section was the most common route of delivery. The three leading pregnancy complications were preterm delivery, anemia and pregnancy-induced hypertension, with a prevalence of 62.9%, 23.8% and 13.9%, respectively. There was no maternal death. In pregnancies with gestational age less than thirty-four weeks, only ten (11.1%) received corticosteroid therapy before delivery. Forty-one (43.2%) preterm cases recieved the antibiotics for group B streptococcal prophylaxis before delivery. The three most common neonatal complications were low birthweight (73.2%), an Apgar score less than 7 at 1 minute (13.9%), and sepsis (11.6%). There were 5 neonatal deaths and 11 stillbirths. Eighty one percent of the death occurred in preterm fetuses. The perinatal mortality rate was 53.0 per 1,000 births. Conclusion: Preterm delivery was the most common complication of twin pregnancies and was the leading cause of perinatal mortality. Prevention of preterm labor and improvement of neonatal care may improve outcomes in twin pregnancies.
Patrones diferenciales de mortalidad entre inmigrantes nicaragüenses y residentes nativos de Costa Rica

Utilizando datos del Registro Nacional de defunciones de los anos 1996-2005 se calcularon las tasas de mortalidad estandarizadas por edad para personas nacidas en Nicaragua versus personas nacidas en Costa Rica. Asi mismo, utilizando modelos de regresion binomial se determinaron los riesgos relativos de mortalidad de los inmigrantes nicaraguenses versus personas nativas de Costa Rica con ajustes por edad, urbanizacion, desempleo, pobreza, educacion y segregacion residencial. Los hombres y mujeres nacidos en Nicaragua tuvieron un riesgo reducido de mortalidad de 32% y 34% respectivamente con relacion a sus contrapartes nacidas en Costa Rica. Se noto que los riesgos de mortalidad por enfermedades infecciosas, cancer, enfermedades cronicas pulmonares, enfermedades cardiovasculares, y enfermedades cronicas del higado eran significativamente reducidos entre los inmigrantes nacidos en Nicaragua. El exceso significativo de mortalidad por homicidios se encontro entre los hombres nacidos en Nicaragua (RT = 1,35, 95% IC: 1,19; 1,53) y en mujeres (RT = 1,41, 95% IC: 1,02; 1,95). El riesgo relativo de causas de mortalidad de origen de tipo exogeno entre los inmigrantes nicaraguenses fue mas grande entre los grupos de edad joven en areas de baja densidad de inmigrantes nicaraguenses. La poblacion nacida en Nicaragua residiendo en Costa Rica tiene un riesgo reducido de mortalidad por causas generales versus las personas nacidas en Costa Rica en los anos entre 1996-2005. Esto se debe a una mortalidad por enfermedad reducida, la cual es bastante marcada. El homicidio es un una razon de mayor mortalidad entre los inmigrantes nacidos en Nicaragua versus los nativos costarricenses. Hay una gran necesidad de llevar acabo investigaciones adicionales sobre el rol de la migracion, estatus socioeconomico y comportamientos entorno a la salud para poder explicar mas a fondo los patrones de mortalidad diferenciales entre los inmigrantes nicaraguenses y las personas nativas de Costa Rica.
Biasing conformational ensembles towards bioactive-like conformers for ligand-based drug design

Importance of the field: In silico or virtual screening has become a common practice in contemporary computer-aided drug discovery efforts and currently constitutes a reasonably mature paradigm. Application of ligand-based approaches to virtual screening requires the ability to identify the bioactive conformers of drug-like compounds as these conformers are expected to elicit the biological activity. However, given the complexity of the energy potential surfaces of such ligands and in particular those exhibiting some degree of flexibility and the limitation of contemporary energy functions, this is not an easy task. Areas covered in this review: The current contribution provides an in-depth review of recent developments in the field of generating conformational ensembles of drug-like compounds with a particular emphasis of focusing such ensembles on bioactive conformers using both energy and structural criteria. The literature reviewed in this manuscript roughly covers the last decade. What the reader will gain: Readers of this review will gain an appreciation for the complexity of identifying bioactive conformers of drug-like compounds and an exposure to the different computational methods which were developed in order to tackle this problem as well as to the remaining challenges in this field. Take home message: The identification of ensembles of bioactive conformers of drug-like compounds is far from being a solved problem. Recent research has advanced the field to the point where bioactive conformers could be readily identified from within conformational ensembles generated by contemporary computational tools. However, as such conformers are inevitably accompanied by many other non-relevant conformations, a focusing mechanism is required. New methods in this field are showing promise but more work is clearly needed. New research lines are proposed which are believed to enhance the performances and with it the usefulness of 3D ligand-based methods in drug discovery and development.
Effects of Estrogen or Estrogen/ Progestin Regimens on Heart Disease Risk Factors in Postmenopausal Women: The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial

Objective. —To assess pairwise differences between placebo, unopposed estrogen, and each of three estrogen/progestin regimens on selected heart disease risk factors in healthy postmenopausal women. Design. —A 3-year, multicenter, randomized, double-blind, placebo-controlled trial. Participants. —A total of 875 healthy postmenopausal women aged 45 to 64 years who had no known contraindication to hormone therapy. Intervention. —Participants were randomly assigned in equal numbers to the following groups: (1) placebo; (2) conjugated equine estrogen (CEE), 0.625 mg/d; (3) CEE, 0.625 mg/d plus cyclic medroxyprogesterone acetate (MPA), 10 mg/d for 12 d/mo; (4) CEE, 0.625 mg/d plus consecutive MPA, 2.5 mg/d; or (5) CEE, 0.625 mg/d plus cyclic micronized progesterone (MP), 200 mg/d for 12 d/mo. Primary Endpoints. —Four endpoints were chosen to represent four biological systems related to the risk of cardiovascular disease: (1) high-density lipoprotein cholesterol (HDL-C), (2) systolic blood pressure, (3) serum insulin, and (4) fibrinogen. Analysis. —Analyses presented are by intention to treat. P values for primary endpoints are adjusted for multiple comparisons; 95% confidence intervals around estimated effects were calculated without this adjustment. Results. —Mean changes in HDL-C segregated treatment regimens into three statistically distinct groups: (1) placebo (decrease of 0.03 mmol/L [1.2 mg/dL]); (2) MPA regimens (increases of 0.03 to 0.04 mmol/L [1.2 to 1.6 mg/dL]); and (3) CEE with cyclic MP (increase of 0.11 mmol/L [4.1 mg/dL]) and CEE alone (increase of 0.14 mmol/L [5.6 mg/dL]). Active treatments decreased mean low-density lipoprotein cholesterol (0.37 to 0.46 mmol/L [14.5 to 17.7 mg/dL]) and increased mean triglyceride (0.13 to 0.15 mmol/L [11.4 to 13.7 mg/dL]) compared with placebo. Placebo was associated with a significantly greater increase in mean fibrinogen than any active treatment (0.10 g/L compared with -0.02 to 0.06 g/L); differences among active treatments were not significant. Systolic blood pressure increased and postchallenge insulin levels decreased during the trial, but neither varied significantly by treatment assignment. Compared with other active treatments, unopposed estrogen was associated with a significantly increased risk of adenomatous or atypical hyperplasia (34% vs 1%) and of hysterectomy (6% vs 1%). No other adverse effect differed by treatment assignment or hysterectomy status. Conclusions. —Estrogen alone or in combination with a progestin improves lipoproteins and lowers fibrinogen levels without detectable effects on postchallenge insulin or blood pressure. Unopposed estrogen is the optimal regimen for elevation of HDL-C, but the high rate of endometrial hyperplasia restricts use to women without a uterus. In women with a uterus, CEE with cyclic MP has the most favorable effect on HDL-C and no excess risk of endometrial hyperplasia. ( JAMA . 1995;273:199-208)
Assessing Sexual Communication And Condom Negotiation Among University Undergraduate Students In Sexual Relationship; In The Era Of HIV/AIDS.

This study assessed the level of sexual communication and condom negotiation among University of Lagos undergraduate students in sexual relationships in the era of HIV/AIDS. There is a heavy burden of STDs including HIV/AIDS infections and abortion in the country. The young ones account for greater number of STDs infected and affected in the nation's population. Statistics have shown that individuals, families and government at all level invest huge resources in preventing, controlling and managing various types of STDs in the country. Two hundred student participants within the age range of 18 to 30 years, selected from different faculties of the University of Lagos participated in the study. Questionnaire was developed after pilot test was carried and sexuality and reproductive literature review. The research instrument was divided into three sections consisting of the socio-demographic scale, sexual communication scale (SCS) and condom negotiation inventory (CNI). Student participants were selected from different faculties including faculty of arts, education, sciences and social sciences through random sampling technique. Results indicated that females tend to negotiate more of condom utilisation than males, (P .05). The implication of this study is that young adults are lacking in sexuality education which provides accurate information on issues relating to sexuality, helps individuals to develop sexual attitudes that will develop values and insight on how to create and develop interpersonal relationships with members of the opposite sex and also equip them with interpersonal skills such as communication, assertiveness, refusal skills and decision making that will enable them to make responsible decisions and accept responsibility for their behaviour. IFE PsychologIA Vol. 16 (2) 2008: pp. 188-209
Accounting for water molecules in drug design

Importance of the field: Water molecules often appear around ligands in protein crystal structures. Reliable prediction of the effects of water on ligand binding remains a challenge. Solvation effects are crucial for lead optimization where a 100-fold difference in binding affinity is significant but correspond to only ∼3 kcal/mol in binding free energy. Well-known examples, such as nonpeptidic urea inhibitors of HIV protease, prove that careful examination of water molecules and their energetics can contribute significantly to a successful drug design campaign. Areas covered in this review: In this review, we examine methods to account for the effect of water in ligand binding at two stages of drug discovery: lead identification via docking calculations and lead optimization. We provide a survey of the models and techniques available to account for water in drug design. What the reader will gain: The reader will become aware of common practices and pitfalls in dealing with water molecules in structure-based drug design. Take home message: Although solvation effects are not fully understood, some pragmatic recommendations at the end of the article provide guidance for modelers in this area as well as new practitioners.
Effectiveness of foot care education among people with type 2 diabetes in rural Puducherry, India

Background: The burden of diabetes and its foot complications is increasing in India. Prevention of these complications through foot care education should be explored. The objective of our study was to assess the risk factors of poor diabetic foot care and to find the effectiveness of health education in improving foot care practice among diabetes patients. Materials and Methods: A structured pre-tested questionnaire was administered to the outpatients of a rural health center with type 2 diabetes. Awareness regarding diabetes, care of diabetes and foot care practice ware assessed and scored. Individual and group health education focusing on foot care was performed. Foot care practice was reassessed after 2 weeks of education. Results: Only 54% were aware that diabetes could lead to reduced foot sensation and foot ulcers. Nearly 53% and 41% of the patients had good diabetes awareness and good diabetes care respectively. Only 22% of the patients had their feet examined by a health worker or doctor. The patients with poor, satisfactory and good practice scores were 44.7%, 35.9% and 19.4% respectively. Low education status, old age and low awareness regarding diabetes were the risk factors for poor practice of foot care. Average score for practice of foot care improved from 5.90 ± 1.82 to 8.0 ± 1.30 after 2 weeks of health education. Practice related to toe space examination, foot inspection and foot wear inspection improved maximally. Conclusion: Foot care education for diabetics in a primary care setting improves their foot care practice and is likely to be effective in reducing the burden of diabetic foot ulcer.
Factors that influence the choice of psychiatry as a career by medical students at the School of Medicine, College of Health Sciences, University of Nairobi

Abstract The aim of this paper is to assess the particular factors facilitating and those hampering the choice of psychiatry as a career by medical students at the University of Nairobi in a cross-sectional population study of medical students at the University of Nairobi, College of Health Sciences, School of Medicine using self-administered questionnaires. A total of 31 students (13%) said they would like to be psychiatrists while 44 (18%) were neutral and 170 (69%) did not want to become psychiatrists. The factors that made psychiatry interesting for the students included the view that the problems presented by psychiatric patients were often particularly interesting and challenging and the fact that mental illness presented the field of medicine with one of the greatest challenges. Discouraging factors articulated by the students included views that psychiatry was a vague and speculative speciality, psychiatry was not an important part of the curriculum in medical schools, and psychiatric patients tend to make more emotional demands on their doctors than other patients. There was a negative view of psychiatric patients who most of the students thought were strange, dangerous and incurable, although they were curious to know more about them. Most of the negative influence in psychiatry is due to the misconceptions that students have about its prestige and scope, the rewards it offers in terms of job satisfaction and opportunities and the negative views towards psychiatric patients. Integration of psychiatry into the curriculum may address these misunderstandings.
Three-dimensional structure generators of drug-like compounds: DG-AMMOS, an open-source package

Introduction: Drug discovery is a time consuming and costly process. Thus, a trend towards the use of in silico approaches such as structure- and ligand-based virtual screening methods to speed up the process has gained significant momentum in recent years. Most of these in silico applications require a good quality 3D structure of the small drug-like molecules as input. Areas covered: This article reviews the algorithm and validation of the open-source software DG-AMMOS, a tool that generates the 3D conformation of small molecules using distance geometry construction and molecular mechanics optimization comparing its performance with some related free and commercial packages. Expert opinion: The number of chemo/bioinformatics free and/or open-source tools assisting drug discovery projects is increasing, and many successful contributions making use of these computer programs have been reported. DG-AMMOS is an efficient 3D structure generator engine that provides fast and reliable generation of 3D structures and contributes to the preparation of a compound collection. DG-AMMOS can still be improved and an increased speed and user-friendly interface in addition to the implementation of workflow engines will increase its effectiveness.
Dementia in people with intellectual disability: Insights and challenges in epidemiological research with an at-risk population

Abstract The population with intellectual disability (ID) is ageing, but age-related health concerns such as dementia have received little research attention thus far. We review evidence regarding the prevalence and incidence of dementia in people with ID, and discuss some possible explanations for an increased risk, such as shared genetic risk factors, co-morbid physical and mental disorders, lifestyle factors, trauma, and lowered brain reserve. We discuss practical and theoretical challenges facing researchers in this field, before highlighting the implications of findings to date for future research and clinical care. Research on dementia in this at-risk population has the potential to help us understand dementia in general and to improve services for this group of vulnerable individuals.
ASSESSMENT OF MEDICAL WASTE MANAGEMENT IN EDUCATIONAL HOSPITALS OF TEHRAN UNIVERSITY MEDICAL SCIENCES

The management of medical waste is of great importance due to its potential environmental hazards and public health risks. In the past, medical waste was often mixed with municipal solid waste and disposed in residential waste landfills or improper treatment facilities in Iran. In recent years, many efforts have been made by environmental regulatory agencies and waste generators to better managing the wastes from healthcare facilities. This study was carried in 12 educational hospitals of Tehran University of Medical Sciences. The goals of this study were to characterize solid wastes generated in healthcare hospitals, to report the current status of medical waste management and to provide a framework for the safe management of these wastes at the considered hospitals. The methodology was descriptive, cross-sectional and consisted of the use of surveys and interviews with the authorities of the healthcare facilities and with personnel involved in the management of the wastes. The results showed that medical wastes generated in hospitals were extremely heterogeneous in composition. 42% of wastes were collected in containers and plastic bags. In 75% of hospitals, the stay-time in storage sites was about 12-24h. 92% of medical wastes of hospitals were collected by covered-trucks. In 46% of hospitals, transferring of medical wastes to temporary stations was done manually. The average of waste generation rates in the hospitals was estimated to be 4.42kg/bed/day.
Zinc transporter-8 autoantibodies can replace IA-2 autoantibodies as a serological marker for juvenile onset type 1 diabetes in India

Introduction: Zinc transporter-8 (ZnT8) is an islet cell secretory granule membrane protein recently identified as an autoantigen in type 1 diabetes (T1D). The aim of this study was to estimate the prevalence of antibodies to ZnT8 (ZnT8A) in juvenile onset T1D and to determine the utility of ZnT8A as an independent marker of autoimmunity either alone in antibody-negative subjects or in conjunction with glutamic acid decarboxylase (GAD) and insulinoma-2 antigen antibodies (GADA and IA2A). Research Design: ZnT8A, GADA, and IA2A were measured in sera of consecutive T1D patients (n = 88, age range 2-18 years) within 4 years of diagnosis and 88 sex-matched controls. Results: The prevalences of GADA, ZnT8a, and IA2A were 64.7%, 31.8% and 19.3%, respectively. In newly diagnosed patients, the frequency of ZnT8A was 45%. ZnT8A were positive in 26% of patients negative for both GADA and IA2A. IA2A were positive only in two patients who were negative for other two antibodies. Combined use of ZnT8A and GADA could detect 97% of antibody positive patients. In receiver operating characteristic (ROC) analysis, the performances of GADA and ZnT8As were better than that of IA2A; and AUCs of GADA, ZnT8A, and IA2A for the prediction of T1D were 0.8, 0.65, and 0.59, respectively. Conclusions: ZnT8A complements GADA and increases the diagnostic sensitivity for detection of autoimmunity in juvenile-onset T1D. Inclusion of ZnT8A increases the proportion of patients with antibody positivity to nearly 80%. ZnT8A can replace IA2A as a serological marker for autoimmunity in Indian T1D patients without loss of sensitivity and specificity.