Miracle-dz/UniFAR-FTUs huggingface dataset:
Incidence of Deep Sternal Wound Infection in Diabetic Patients Undergoing Off-Pump Skeletonized Internal Thoracic Artery Grafting

Objectives: To evaluate the impact of skeletonized bilateral or single internal thoracic artery (ITA) grafting on the risk of deep sternal wound infection (DSWI) in diabetic patients undergoing off-pump coronary artery bypass grafting (OPCAB). Materials and Methods: A total of 803 diabetic patients undergoing OPCAB surgery from January 2010 to December 2014 were enrolled into this study and assigned to the pSITA group (patients undergoing pedicled single ITA grafting, n = 362), the sSITA group (skeletonized single ITA grafting, n = 295), or the sBITA group (skeletonized bilateral ITA grafting, n = 146). The primary end point was the diagnosis of a DSWI. Results: Eighteen patients developed postoperative DSWI, with an incidence of 2.2%. Patients in the sSITA group had a significantly lower incidence of DSWI than those in the pSITA group (1.0 vs. 3.6%, p = 0.0408). In multivariate logistic regression analysis, the risk of DSWI in the sSITA group was 0.41 times that in the pSITA group. Conclusions: sSITA grafting lowered the risk of DSWI in diabetic patients undergoing OPCAB surgery compared to pSITA grafting. Multicenter clinical trials involving larger sample sizes are needed to determine the merit of pSITA grafting in reducing the risk of DSWI following OPCAB surgery.
Premenstrual Dysphoric Disorder Symptoms Following Ovarian Suppression: Triggered by Change in Ovarian Steroid Levels But Not Continuous Stable Levels.

OBJECTIVE Premenstrual dysphoric disorder (PMDD) symptoms are eliminated by ovarian suppression and stimulated by administration of ovarian steroids, yet they appear with ovarian steroid levels indistinguishable from those in women without PMDD. Thus, symptoms could be precipitated either by an acute change in ovarian steroid levels or by stable levels above a critical threshold playing a permissive role in expression of an underlying infradian affective "pacemaker. " The authors attempted to determine which condition triggers PMDD symptoms. METHOD The study included 22 women with PMDD, ages 30 to 50 years. Twelve women who experienced symptom remission after 2-3 months of GnRH agonist-induced ovarian suppression (leuprolide) then received 1 month of single-blind (participant only) placebo and then 3 months of continuous combined estradiol/progesterone. Primary outcome measures were the Rating for Premenstrual Tension observer and self-ratings completed every 2 weeks during clinic visits. Multivariate repeated-measure ANOVA for mixed models was employed. RESULTS Both self- and observer-rated scores on the Rating for Premenstrual Tension were significantly increased (more symptomatic) during the first month of combined estradiol/progesterone compared with the last month of leuprolide alone, the placebo month, and the second and third months of estradiol/progesterone. There were no significant differences in symptom severity between the last month of leuprolide alone, placebo month, or second and third months of estradiol/progesterone. Finally, the Rating for Premenstrual Tension scores in the second and third estradiol/progesterone months did not significantly differ. CONCLUSIONS The findings demonstrate that the change in estradiol/progesterone levels from low to high, and not the steady-state level, was associated with onset of PMDD symptoms. Therapeutic efforts to modulate the change in steroid levels proximate to ovulation merit further study.
A CASE STUDY OF THE FOUR-DAY SCHOOL WEEK: AN ALTERNATIVE SCHEDULE FOR PUBLIC SCHOOLS

With the pressures of global competition and the adoption of the No Child Left Behind Act, many school districts across the United States are experimenting with alternative school calendars in an attempt to raise student achievement. This poses a dilemma for many school districts as they face societal pressures to increase student achievement with limited funding to do so. In an effort to improve, some schools have adopted a four-day school week schedule in hopes of saving money while improving classroom instruction and raising student achievement. This study gives insight to the impact of the change to a four-day school week schedule on students, teachers, and parents in a particular community through an illustrative case study. Both quantitative and qualitative research methods were used to gather data. Analysis of the data revealed mixed results for the four-day school week schedule. The perceptions of the responding groups pointed toward a positive and overall beneficial impact of the four-day school week. The research provides opportunities for further study and observations. This study could have implications for other school districts with similar demographics.
Recomendações para atividade física e saúde: consensos, controvérsias e ambiguidades

OBJETIVO: Comparar o resultado da classificacao de atividade fisica (AF) segundo cinco diretrizes internacionais (American College of Sports Medicine, Advisory Committee on International Physical Activity Questionnaire, Institute of Medicine, Organizacao Mundial da Saude e Uniao Europeia). METODOS: Estudo transversal com dados de 52 779 adultos de ambos os sexos, domiciliados nas capitais brasileiras e no Distrito Federal, selecionados em amostra probabilistica. Informacoes sobre duracao, intensidade e frequencia semanal de AF foram obtidas junto ao sistema de Vigilância de Fatores de Risco e Protecao para Doencas Cronicas por Inquerito Telefonico (VIGITEL RESULTADOS: As cinco recomendacoes classificaram os participantes inativos de forma coincidente. Dentre os que relataram praticar AF, 45% foram classificados de modo concordante pelas cinco recomendacoes estudadas (24,8% como ativos insuficientes, 10,6% como ativos e 9,1% como muito ativos). Os demais foram classificados ora como insuficientemente ativos, ora como suficientemente ativos ou ainda como muito ativos. CONCLUSOES: Nuances na formulacao das recomendacoes modificaram a classificacao da frequencia de AF. Mesmo que, em linhas gerais, todas as diretrizes tenham os mesmos objetivos, a falta de harmonizacao na definicao da dose minima de AF interfere na elaboracao e na avaliacao de politicas de promocao da AF.
Women with Co-Occurring Substance Abuse Disorders and PTSD: How Women Understand their Illness

This article reports the findings of a qualitative study that explored women's understanding about their “illness” co-occurring substance use disorders (SUD), and post-traumatic stress disorder (PTSD). The findings are part of a larger study that investigated the effectiveness of “Seeking Safety Treatment” within a therapeutic community among women with SUD and PTSD co-morbidities.Seventy-eight women in treatment, who met the diagnostic criteria for Post Traumatic Stress Disorder, participated in the study. Typical study participants were Caucasian, heterosexual, single women between 25 and 38 years old, with 2 children, a high school level education, unemployed, and had annual incomes of less than $10,000.This study summarized responses to a questionnaire given to the women when they entered treatment. Responses are summarized according to question. The following represents a general summary: Drugs or addiction caused the illness that brought me to treatment, and it was largely the result of my family li.
The Impact of Residual Renal Function on Hospitalization and Mortality in Incident Hemodialysis Patients

Background/Aims: Few data are available on the impact of residual renal function (RRF) on mortality and hospitalization in hemodialysis (HD) patients. The objective of our study was to compare clinical outcomes for HD patients with and without RRF. Methods: In a cohort of 118 incident HD patients with RRF (n = 51) and without RRF (n = 67) who started dialysis in a single center, we recorded demographics, laboratory data, medication, hospitalizations and mortality. Results: Patients without RRF were older (p = 0.007), had lower baseline serum albumin levels (p = 0.002) and spent 18.6 more days in hospital per year than those with RRF (p = 0.055). Mean survival time was significantly lower in patients without RRF (p = 0.027). In a Cox proportional hazards model, only RRF remained as a significant independent predictor. Conclusions: RRF is associated with significantly reduced mortality and hospital days, but does not decrease the hospitalization rate and time to first hospitalization.
Antioxidant Therapy in Neurologic Disease

Free radical or oxidative injury may be a fundamental mechanism underlying a number of human neurologic diseases. Therapy using free radical scavengers (antioxidants) has the potential to prevent, delay, or ameliorate many neurologic disorders. However, the biochemistry of oxidative pathobiology is complex, and optimum antioxidant therapeutic options may vary and need to be tailored to individual diseases. In vitro and animal model studies support the potential beneficial role of various antioxidant compounds in neurologic disease. However, the results of clinical trials using various antioxidants, including vitamin E, tirilazad, N-acetylcysteine, and ebselen, have been mixed. Potential reasons for these mixed results include lack of pretrial dose-finding studies and failure to appreciate and characterize the individual unique oxidative processes occurring in different diseases. Moreover, therapy with antioxidants may need to be given early in chronic insidious neurologic disorders to achieve an appreciable clinical benefit. Predisease screening and intervention in at-risk individuals may also need to be considered in the near future. Arch Neurol. 2000;57:1265-1270
Sarcopenia: a clinical review

Although sarcopenia has been used to define muscle mass loss in older subjects, muscle mass is not directly linked to muscle function. Recent definitions consider sarcopenia as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes, such as physical disability, poor quality of life, and death. It is closely linked with physical frailty, and also with other muscle wasting disorders, including cachexia and malnutrition. This review focuses on the incorporation of sarcopenia into clinical practice, reviews case finding and diagnosis of sarcopenia, proposes a syndromic approach for the diagnostic work-up of sarcopenic patients, and looks at intervention trials with physical exercise and nutrition, as drugs to treat this condition are not expected to be available in the near future.
Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA.

PURPOSE To identify and evaluate the spectrum and prevalence of celiac axis (CA) and common hepatic artery (CHA) variations by using spiral computed tomography (CT) and digital subtraction angiography (DSA). MATERIALS AND METHODS Institutional review board approval was obtained, and the requirement for informed patient consent was waived. The findings in 5002 patients who underwent spiral CT and DSA were retrospectively evaluated. CHA was defined as an arterial trunk containing at least one segmental hepatic artery and the gastroduodenal artery. The pattern of the aortic origin of the branches of the CA and superior mesenteric arteries was analyzed. The CHA anatomy was then investigated. RESULTS Of 15 possible types of CA variation, 13 types were identified. A normal CA was noted in 4457 (89.1%) of the 5002 patients. Twelve types of CA variation were identified in 482 (9.64%) patients. In the remaining 63 (1.26%) patients, the CA anatomy was classified as ambiguous because the CHA was absent owing to separate origins of the hepatic arteries and the gastroduodenal artery (n = 55) or because the origin of the CHA could not be determined owing to persistent anastomotic channels (n = 8). Seven CHAs originating from the normal CA had a retroportal (n = 6) or transpancreatic (n = 1) course. All eight CHAs originating from the left gastric artery passed the fissure of the ligamentum venosum. The 148 CHAs originating from the superior mesenteric artery showed diverse relationships with the pancreas--being supra-, trans-, or infrapancreatic--and the superior mesenteric-portal venous axis--being pre- or retroportal. The 20 CHAs originating from the aorta had a normal suprapancreatic preportal course. CONCLUSION Known or newly found CA and CHA variations could be systematically described in detail. The authors propose a hypothetical anatomic model for summarizing the observed CHA variations.
Listening to the dementia workforce: Local providers' perceptions of dementia services

This article reports on the findings of a small research study exploring provision at local level for people with dementia. The study involved a survey of practitioners and managers, and the difficulties of this approach are illustrated and explored. Responses contained a range of relevant opinions about service delivery, particularly perceived levels of quality and adequacy. Those providing care pointed to the unfulfilled potential of services for people with dementia, and their views provide a perspective on the workings of local services and their inter‐relationships. The views of staff may be helpful to the development of planning and quality mechanisms. While they cannot substitute for those of users and carers, they are views emanating from experience and concern.
Developing an Assessment of Pharmacy Practice Knowledge.

An assessment of pharmacists’ practice knowledge was developed as part of a multi-year project investigating continuing competence. Trained pharmacy practitioners used a previously validated competency blueprint to prepare 673 assessment items. Each item was related to a specific competency and presented in a selection-type format. Using a series of three pretests, the item pool was refined through an examination of the psychometric characteristics of the questions. Items remaining in the pool after the pretests were content validated using panels of pharmacy practitioners. The content-validated items were then used to construct two parallel forms of the assessment, each containing 120 items. Both forms were pilot-tested with final-year pharmacy students and pharmacists. Pilot-test results indicate the scores were reliable and permitted a valid assessment of a pharmacist’s general practice knowledge. Evidence is presented supporting the acceptability and feasibility of the knowledge assessment as a general screen of competence.
Noise-Robust Modes of the Retinal Population Code Have the Geometry of “Ridges” and Correspond to Neuronal Communities

An appealing new principle for neural population codes is that correlations among neurons organize neural activity patterns into a discrete set of clusters, which can each be viewed as a noise-robust population codeword. Previous studies assumed that these codewords corresponded geometrically with local peaks in the probability landscape of neural population responses. Here, we analyze multiple data sets of the responses of approximately 150 retinal ganglion cells and show that local probability peaks are absent under broad, nonrepeated stimulus ensembles, which are characteristic of natural behavior. However, we find that neural activity still forms noise-robust clusters in this regime, albeit clusters with a different geometry. We start by defining a soft local maximum, which is a local probability maximum when constrained to a fixed spike count. Next, we show that soft local maxima are robustly present and can, moreover, be linked across different spike count levels in the probability landscape to form a ridge. We found that these ridges comprise combinations of spiking and silence in the neural population such that all of the spiking neurons are members of the same neuronal community, a notion from network theory. We argue that a neuronal community shares many of the properties of Donald Hebb's classic cell assembly and show that a simple, biologically plausible decoding algorithm can recognize the presence of a specific neuronal community.
Sex Differences in Running Economy of Young Children

The purpose of this study was to quantify running economy (RE) during level treadmill running in 6-year-old children and to identify the potentially mediating effects of resting oxygen uptake and body fat percentage on sex differences in RE. Resting oxygen uptake (VO2), body fat, and RE at 5 mph were quantified in 15 boys and 20 girls following 30 min of treadmill accommodation. While absolute VO2 and mass-related values of gross and net VO2 were significantly higher in boys compared to girls, gross VO2 expressed relative to fat-free mass was not different between sexes. These results indicate that 6-year-old girls exhibit better RE compared to 6-year-old boys when VO2 is expressed as a function of total body mass. This sex difference in VO2 may reflect an increase in aerobic energy demands associated with the presence of a greater muscle mass in boys.
Monitoring of coagulation factor therapy in patients with von Willebrand disease type 3 using a microchip flow chamber system

Summary Patients with type 3 von Willebrand disease (VWD-3) have no measurable levels of VW factor (VWF) and usually require treatment with VWF-FVIII concentrate to prevent and/or stop bleeding. Even though the patients are treated prophylactically, they may experience bleeding symptoms. The aim of this study was to evaluate the effect of VWF-FVIII concentrate treatment in VWD-3 patients with the Total Thrombus Analysis System (T-TAS®), which measures thrombus formation under flow conditions. Coagulation profiles of 10 VWD-3 patients were analysed using T-TAS before and 30 minutes after VWF-FVIII concentrate (Haemate®) injection. Results were compared to VWF- and FVIII activity in plasma, and results with thromboelastometry and ris-tocetin-activated platelet impedance aggregometry (Multiplate®) in whole blood. For comparison, 10 healthy controls were also analysed with T-TAS. A median dose of 27 (range 15–35) IU/kg of VWF-FVIII concentrate increased VWF- and FVIII activity as expected. T-TAS thrombus formation was enhanced when a tissue factor/collagen-coated flow chamber was used at low shear, but treatment effects at high shear using a collagen-coated flow chamber were minimal. Whole blood coagulation assessed by thromboelastometry was normal and did not change (p > 0.05) but ristocetin-induced platelet aggregation improved (p < 0.001). In conclusion, T-TAS detects effects of VWF-FVIII concentrate treatment on coagulation-dependent thrombus formation at low shear, but minor effects are observed on platelet-dependent thrombus formation at high shear. The poor prediction of bleeding by conventional laboratory monitoring in VWD-3 patients might be related to insufficient restoration of platelet-dependent thrombus formation.
Application of Large-Scale Aptamer-Based Proteomic Profiling to Planned Myocardial Infarctions

Background: Emerging proteomic technologies using novel affinity-based reagents allow for efficient multiplexing with high-sample throughput. To identify early biomarkers of myocardial injury, we recently applied an aptamer-based proteomic profiling platform that measures 1129 proteins to samples from patients undergoing septal alcohol ablation for hypertrophic cardiomyopathy, a human model of planned myocardial injury. Here, we examined the scalability of this approach using a markedly expanded platform to study a far broader range of human proteins in the context of myocardial injury. Methods: We applied a highly multiplexed, expanded proteomic technique that uses single-stranded DNA aptamers to assay 4783 human proteins (4137 distinct human gene targets) to derivation and validation cohorts of planned myocardial injury, individuals with spontaneous myocardial infarction, and at-risk controls. Results: We found 376 target proteins that significantly changed in the blood after planned myocardial injury in a derivation cohort (n=20; P<1.05E-05, 1-way repeated measures analysis of variance, Bonferroni threshold). Two hundred forty-seven of these proteins were validated in an independent planned myocardial injury cohort (n=15; P<1.33E-04, 1-way repeated measures analysis of variance); >90% were directionally consistent and reached nominal significance in the validation cohort. Among the validated proteins that were increased within 1 hour after planned myocardial injury, 29 were also elevated in patients with spontaneous myocardial infarction (n=63; P<6.17E-04). Many of the novel markers identified in our study are intracellular proteins not previously identified in the peripheral circulation or have functional roles relevant to myocardial injury. For example, the cardiac LIM protein, cysteine- and glycine-rich protein 3, is thought to mediate cardiac mechanotransduction and stress responses, whereas the mitochondrial ATP synthase F0 subunit component is a vasoactive peptide on its release from cells. Last, we performed aptamer-affinity enrichment coupled with mass spectrometry to technically verify aptamer specificity for a subset of the new biomarkers. Conclusions: Our results demonstrate the feasibility of large-scale aptamer multiplexing at a level that has not previously been reported and with sample throughput that greatly exceeds other existing proteomic methods. The expanded aptamer-based proteomic platform provides a unique opportunity for biomarker and pathway discovery after myocardial injury.
Developing teenagers’ views on their health and the health of their future children

Purpose – The purpose of this paper is to report the outcome of a city‐wide survey of teenagers’ views on their health, and compare this with the outcomes of a science‐oriented health intervention called LifeLab, a hospital‐based classroom aimed at developing teenagers’ attitudes towards their health and that of their future children.Design/methodology/approach – A questionnaire survey of 597 14‐year olds across the city of Southampton was conducted to gauge their views and behaviour in relation to their own health. The views of 37 students who took part in innovative, hospital‐based, hands‐on LifeLab activities were compared with those of their peers six months after the intervention to analyse long‐term impacts of the experience. Interviews were carried out with ten LifeLab students to gain further insights.Findings – The intervention created a wider appreciation among students that food they eat now could affect their long‐term health and the health of their future children. Students became significant.
Bronchial Carcinoid Tumor in a Young Man with Neurofibromatosis. Case Report and Review of the Literature

Neurofibromatosis 1 is a relatively common autosomal dominant disease characterized by the occurrence of distinctive skin pigmentation (cafe-au-lait spots and axillary/groin freckling) and multiple neuroectodermal and mesenchymal lesions (e.g. neurofibroma). Patients with NF1 also have a predilection for other types of tumors, such as carcinoid tumors in the duodenum, particularly in the periampullary region. Case presentation: An 18-year-old man with neurofibromatosis 1 presented with obstructive pneumonia. Bronchoscopy showed an endobronchial tumor obstructing the superior segment of the left lower lobe. Pathologic studies showed a carcinoid tumor. Two weeks later, the patient underwent left lower lobe lobectomy with lymph node dissection. Metastatic carcinoid tumor was present in subaortic lymph node.