Miracle-dz/UniFAR-FTUs huggingface dataset:
A patient-generated health data adoption framework for diabetes management : a case study of general hospital Odan, Lagos State, Nigeria

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Effect of Metformin and Valsartan Toward Homa-IR in Metabolic Syndrome Patient with Non-Alcoholic Fatty Liver Disease (NAFLD)

ABSTRACT Background : Insulin sensitizer drugs such as metformin has suggested giving in metabolic syndrome patient and NAFLD, which both pathogeneses were insulin resistance. Angiotensin II receptor blocker (ARB), anti-hypertension drugs, has the similar properties to improve regulation of Proliferator-Activated Receptor Gama (PPARɤ). This aim of the study is to prove the improvement of insulin resistance which examined by HOMA-IR method on metabolic syndrome patient with NAFLD after receiving metformin and valsartan medication. Method : This study was conducted to the patient in Endocrinology Clinic Sardjito General Hospital aged 35-36 years who meet diagnostic criteria for metabolic syndrome based on the IDF in 2006 and NAFLD. Convenience sampling method is done for 11 months (May 2012 – March 2013) and was expected sample size 35. HOMA-IR examination made before and after administration of metformin and valsartan for 12 weeks. Cut off value for HOMA –IR on pathological metabolic syndrome and NAFLD was ≥ 2. Medical and Health Research Ethics Committee (MHREC) Faculty of Medicine Universitas Gadjah Mada approved this study protocol. Result: Subject of study retrieved 15 (43%), six males (40%) and nine females (60%) aged 43-63 years old. Median HOMA-IR baseline was 2.8 (0.6-14.5) and at the end of therapy was 3.8 (1.72-14.1). Eleven (74%) have increased HOMA-IR value and four (26%) experience declined but none of them reach the value below 2 . In general clinical improvement occurs in the form of AST and ALT reduction but not statistically significant. Conclusion: This study does not prove that administration of metformin and valsartan in-patient with metabolic syndrome with NAFLD would improve insulin resistance assessed by the HOMA-IR method. Keywords : Metformin, valsartan, metabolic syndrome, NAFLD, HOMA-IR
Alteration in cytokines secretion with Type 2 Diabetes mellitus

Back ground: The blurred unclear link between the immune system and diabetes has made this issue an exciting research area. Cytokines are excellent evaluating tools for the immune system activity in any disease. They reflect the overall state of the immune system. Therefore, we hypothesized the disruption of the Th1 pathway as a consequence of the type 2 diabetes. We evaluated IL-12 which induces Th1 pathway and IL-2 which mediates Th1 function to prove our hypothesis. Almost, no previous studies gave clear image for the relationship between these two interleukins together and type 2 diabetes. Methods:Eighty Four diabetic Egyptian patients and 105 of normal control volunteer were chosen to evaluate the level of serum IL-2 and IL-12 in their blood using ELISA technique. To provide a complete image about the state of each subject, we made routine laboratory analysis including fasting blood glucose, fasting insulin, CRP, lipid profile and CBC for each volunteer. Results: There was a difference in the mean value of both IL-2 and IL-12 serum level between both patients and control. The patients have decreased IL-2 and increased IL-12 than control volunteers. It was interesting to provide a significant correlation between the serum level of IL-2 and IL-12 in patients. Conclusion: The significant correlation between IL-2 and IL-12 and the mean difference in their serum levels between diabetic patients and control can reflect the importance of these two cytokines in the pathogenesis of type 2 diabetes. Future studies with larger sample can confirm our results.
N-Terminal Pro-B–Type Natriuretic Peptide and Long-Term Mortality in Acute Coronary Syndromes

Background— B-type natriuretic peptide (BNP) is a predictor of short- and medium-term prognosis across the spectrum of acute coronary syndromes (ACS). The N-terminal fragment of the BNP prohormone, N-BNP, may be an even stronger prognostic marker. We assessed the relation between subacute plasma N-BNP levels and long-term, all-cause mortality in a large, contemporary cohort of patients with ACS. Methods and Results— Blood samples for N-BNP determination were obtained in the subacute phase in 204 patients with ST-elevation myocardial infarction (MI): 220 with non-ST segment elevation MI and 185 with unstable angina in the subacute phase. After a median follow-up of 51 months, 86 patients (14%) had died. Median N-BNP levels were significantly lower in long-term survivors than in patients dying (442 versus 1306 pmol/L; P<0.0001). The unadjusted risk ratio of patients with supramedian N-BNP levels was 3.9 (95% confidence interval, 2.4 to 6.5). In a multivariate Cox regression model, N-BNP (risk ratio 2.1 [95%.
To Compare the Efficacy of Dexamethasone Versus Ketorolac with Ropivacaine for Nerve Stimulator Guided Infraclavicular Brachial Plexus Block: A Prospective Randomised Comparative Study

Introduction: Infraclavicular Brachial plexus block is an advanced regional anaesthetic technique well suited for hand and fore arm surgeries. The aim of the study is to determine the efficiency of Ropivacaine with Ketorolac for infraclavicular Brachial plexus block for hand and fore arm surgeries. Methodology: 50 ASA grade I and II patients, aged between 18–58 years. of both sexes were randomly allocated into two groups equally of D and K. Group D were assigned to receive Infraclavicular Brachial plexus block under nerve stimulator guided technique with 0.5% Ropivacaine 28 ml+Dexamethasone 2 ml (8 mg) [total volume of 30 cc] Group K were assigned to receive Infraclavicular Brachial plexus block with 0.5% Ropivacaine 28 ml+Ketorolac 2 ml (60 mg) [total volume of 30 cc]. Results: The mean duration of sensory and motor block was significantly prolonged in group D compared to group K,10.5 vs. 9.3 hours for sensory block and 8.5 vs. 6.40 hours for motor block, p<0.05. The mean time to first request analgesia was significantly prolonged in group D compared to group K, 17.40 hours, 12.40 hours respectively. Conclusions: Ropivacaine with dexamethasone combination produced profound analgesia and prolonged postoperative analgesia when compared to Ropivacaine with ketorolac.
Prevalence and Factors Associated with Overweight and Obesity among Healthcare Workers in Pejabat Kesihatan Daerah Melaka Tengah

Introduction Overweight and obesity are a serious public health problem globally. Healthcare workers in some countries have been reported to be having a high prevalence of overweight despite them being well informed of aetiology and risks of excessive body weight. However, the problem of overweight and obesity among Malaysian healthcare workers still poorly understood. Objective The aim of this study was to assess prevalence and factors associated with overweight and obesity among healthcare workers in Pejabat Kesihatan Daerah Melaka Tengah. Methodology This was a cross sectional study conducted between June and August 2018 involving 702 respondents sampled from all health facilities under PKD Melaka Tengah. Demographic, socio-economic and lifestyle data was collected using questionnaires and anthropometric measurements were taken using electronic weighing scale and height measuring bar. Result Mean age was 35.81 years and overall prevalence of overweight/obesity was 55.6%. Prevalence of overweight, class I obesity, class II obesity and class III obesity was 34.3%, 14.2 %, 4.8% and 2.1% respectively. The identified risk of overweight were aged forty and above (OR: 2.00, 95%CI: 1.389-2.846), non-Chinese (OR: 4.97, 95%CI: 2.129-11.620), married (OR: 1.77, 95%CI: 1.150-2.733), big family size (OR: 1.43, 95%CI: 1.074-1.991), underlying NCD (OR: 1.73, 95%CI: 1.240-2.423), family history of NCD (OR: 1.94, 95%CI: 1.328-2.817), and sedentary lifestyle (OR: 1.52, 95%CI: 1.067-2.172). Conclusion We found a higher prevalence of overweight/obesity among healthcare workers in PKD Melaka Tengah compare to general population. Older age group and non-Chinese ethnicity emerged as the most conspicuous factors of overweight/obesity. Keyword Overweight, Obesity, Healthcare workers
PD-L1 expression levels on tumor cells affect their immunosuppressive activity

Programmed cell death 1 (PD-1) is an immuno-checkpoint receptor which is primarily expressed on T cells, monocytes, natural killer cells and macrophages. Programmed death-ligand 1 (PD-L1) is the primary ligand of PD-1 and is constitutively expressed on antigen presenting cells, mesenchymal stem cells and bone marrow-derived mast cells. In addition, PD-L1 is also expressed on a wide range of tumor cells, including lung cancer, breast cancer and melanoma. PD-1 and PD-L1 are important members of the immunoglobulin super-family and participate in immune regulation. In the present study, the immune-suppressive effects of a number of tumor cell lines were determined. The breast tumor cell lines MCF-7 and MDA-MB-231 displayed the largest inhibitory effects on T-cell activation and cytokine secretion in a co-culture system. The HepG2, A549 and A375 cells displayed limited inhibitory effects. MCF-7 and MDA-MB-231 cells expressed the highest level of PD-L1 among the cells used, which may explain their higher immuno-suppressive effects. Compound A0-L, a small molecule inhibitor of the PD-1/PD-L1 interaction, restored T cell functions. Additionally, it was demonstrated that the tumor cells with higher levels of PD-L1 expression suppressed signaling pathways involved in T-cell activation, such as the T-cell receptor- zeta chain of T cell receptor associated protein kinase ZAP70-RAS-GTPase-extracellular-signal-regulated kinases and CD28-PI3K-Akt serine/threonine kinases pathways. These findings suggest that tumor cells with higher expression levels of PD-L1 may exhibit higher immuno-suppressive activity, and that drugs targeting the PD-1/PD-L1 interaction may have improved therapeutic effects on tumors expressing higher levels of PD-L1.
Influence of Low Rate of Reporting of Adverse Events Following Immunization on Immunization Dropout

Influence of Low Rate of Reporting of Adverse Events Following Immunization on Immunization Dropout by Samuel Errie Yenyi MS, University College London, 2007 BS, University of Ghana, 2003 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health – Community Health Walden University February 2019
Understanding the Link between Dairy Foods and Type 2 Diabetes: An Investigation Using Dairy Fatty Acid Biomarkers

Increasing evidence points to an inverse association between dairy intake and type 2 diabetes (T2DM) risk, however results from studies relying on self-reported questionnaires to assess dairy intake have been inconsistent and few have looked at dairy’s effect on T2DM’s underlying disorders, namely insulin sensitivity and β-cell dysfunction. Dairy (non low-fat options) contains high amounts of saturated (SFA) and naturally occurring trans fatty acids (TFA), yet recent studies suggest that different types of SFA and TFA have different metabolic effects, with dairyderived fatty acids potentially being protective. Nonetheless, there are limited data on dairy fatty acids’ impact on the underlying pathophysiology of T2DM. In my doctoral research I (1) measured baseline dairy fatty acids 15:0, t16:1n9, c9,t11 CLA, and t18:1n11 in the 4 serum FA pools [phospholipid (PL), cholesteryl ester (CE), triglyceride (TG), and non-esterified (NEFA)], and identified factors that modify their distribution across serum pools; (2) evaluated longitudinal associations of dairy fatty acids with insulin sensitivity and β-cell function over 6 years; and (3) applied statistical methods for combining biomarker and self-reported dietary
Correction: Development of a Generic Guidance Navigation & Control System for Small Satellites: Application to HuskySat-1

This paper presents the development of a generic Guidance, Navigation & Control (GNC) system for small satellites at the University of Washington that serves as a testbed for algorithm development and supports small satellite mission design. Our ultimate aim is to advance the capabilities of autonomous satellite operations by demonstrating advanced on-board control and estimation techniques, though the work is equally applicable to earth-imaging, pointing and technology demonstration missions. The work discusses the development of flight software and requisite sensor, actuator and environmental models needed to validate flight software functionality. The first mission application is the HuskySat-1 mission, undertaken by a student-led group at the University of Washington. Primarily a technology demonstration, HuskySat-1 is a 3U CubeSat equipped with a pulsed plasma thruster and a high-frequency communication antenna, equipped with a 3-axis active attitude control subsystem. We demonstrate through software and hardware-based testing that our system supports both scientific payloads. We outline our approach to algorithm development, verification and validation, and briefly hardware-in-the-loop testing.
Population based disease surveillance in Kenya : The epidemiology of selected infectious diseases

The greatest burden of infectious diseases is in low- and middle-income countries, yet obtaining precise disease burden estimates is challenging. Among other uses, data are needed to inform prioritization and targeting of resources for prevention and treatment purposes. The studies in my thesis were based on longitudinal population based disease surveillance platforms set up in two sites – almost 400 kms apart - in Kenya; Kibera in Nairobi, and Lwak in Asembo in rural western Kenya. Each site had approximately 25,000 people enrolled in the surveillance project. Project field workers visited participants every two weeks in their homes and collected data about symptoms of illness and associated care seeking for those found ill. At each site were referral clinics staffed with project medical teams where free care was available to study participants presenting with any potentially infectious condition. Demographic and clinical data as well as biological specimens were collected during the sick-visits as appropriate. The thesis describes health utilization patterns for various syndromes, characterizes the epidemiology of disease and lastly provides examples of interventions on disease. In some chapters rural-urban comparisons in disease burden are provided. The data revealed changes in health care seeking after implementation of free care by the project, and after a large-scale home-based HIV counselling and testing activity. Secondly, in characterising the epidemiology of RSV, young children bore the greatest burden of disease in both rural and urban Kenya. And lastly we demonstrated the indirect protection of adults from pneumococcal pneumonia disease after the introduction of a 10-valent pneumococcal conjugate vaccine into the infant immunization program in Kenya. In conclusion, continuous disease surveillance in well-defined populations is important in determining burden and seasonality of disease, the etiologies of such diseases, and in evaluating impact of interventions.
Evaluation funktioneller Beckenbodenstrategien und deren Einsatz in der konservativen Therapie von weiblichen Beckenbodenfunktionsstörungen

Introduction and hypothesis Although the bladder neck is elevated during a pelvic floor muscle (PFM) contraction, it descends during straining. This study aimed to investigate the relationship between bladder neck displacement, electromyography (EMG) activity of the pelvic floor and abdominal muscles and intra-abdominal pressure (IAP) during different pelvic floor and abdominal contractions. Methods Nine women without PFM dysfunction performed maximal, gentle and moderate PFM contractions, maximal and gentle transversus abdominis (TrA) contractions, bracing, Valsalva and head lift. Bladder neck position was assessed with perineal ultrasound. PFM and abdominal muscle activities were recorded with a vaginal probe and fine-wire electrodes, respectively. IAP was recorded with a rectal balloon. Results Bladder neck elevation only occurred during PFM and TrA contractions. PFM EMG and IAP increased during all tasks from 0.5 (gentle TrA) to 45.7 cmH2O (maximal Valsalva). Conclusion Bladder neck elevation was only observed when the activity of PFM EMG was high relative to the IAP increase.
Preservice Elementary Teachers’ Proficiency in Solving Word Problems versus Computational Problems

The purpose of this study was to determine if preservice elementary teachers are able to solve word problems as proficiently as they can perform related computational problems on a word problem inventory. The subjects were 44 preservice elementary teachers at SUNY College at Brockport, Brockport, NY. They were enrolled in a course titled Methods in the Teaching of Elementary School Mathematics. A word problem inventory was created for this study by selecting word problems from the Addison-Wesley Mathematics series for grades 4 to 8. The inventory consisted of two parts, word problems on part 1 and computations on norf') 1"~. &. -· For purpose of analysis, a dependent~ LesL was used to determine if there was a significant difference between the mean mathematics scores on part 2 computational problems and part 1 word problems. The amount of difference between the mean scores that was greater than the average of the related standard deviations will be the criteria which will determine if the results are educationally important. The coefficient of correlation was used to determine the degree to which computational proficiency explained word problem proficiency. The difference between the mean performance on computational problems and word problems was statistically significant. The mean scores that were obtained exceeded the criteria for educational importance. Thus, these results were educationally important. Only 50% of the variation in word problem test scores was explained by computational problem test scores. The other 50% of the variation in word problem solving ability remained unexplained.
Bilateral Breast Metastases from Epstein-Barr Virus-Associated Gastric Cancer during Pregnancy: Is There a Method to Its Madness?

Breast metastases of extramammary malignant neoplasms are rare, with an incidence of 0.3%–2.7% among all malignant mammary tumors. Breast metastases from gastric carcinoma are very rare (<0.1%), and this event is even rarer during pregnancy. Herein, we describe a 39-year-old Caucasian woman with a history of an Epstein-Barr virus-associated gastric carcinoma (EBVaGC) that was characterized by prominent tumor infiltrating lymphocytes. Three years after undergoing radical surgery, the patient developed bilateral breast nodules during her pregnancy. A breast biopsy was performed, and histology confirmed a diagnosis of EBVaGC; tumor cells showed positivity for cytokeratin 8/18 and E-cadherin, and negativity for cytokeratin 7, cytokeratin 20, cytokeratin 5/6, caudal type homebox 2, androgen receptor, mammaglobin, gross cystic disease fluid protein-15, and estrogen and progesterone receptors. We also discuss the main diagnostic pitfalls. To our knowledge, this is the first report of an EBVaGC with lymphoid stroma that developed breast metastases during pregnancy.
The symbiotic relationship of vulnerability and resilience in nursing

Background: Whilst the terms vulnerability and resilience are commonly used within professional nursing discourses, they are often poorly understood. Vulnerability is often framed negatively and linked to being at risk of harm, whilst resilience is often perceived as the ability to withstand challenges. Aim: The aim of this paper is to explore resilience and vulnerability; re-positioning them within the context of contemporary professional nursing practice. Design: Discussion paper. Method: Drawing upon historical and contemporary international literature, both concepts are de-constructed and then re-constructed, examining them from the position of patient care as well as from the perspective of nurses and the nursing profession. Conclusion: Resilience and vulnerability have an interdependent relationship as resilience comes into play in situations of vulnerability. Yet, contrary to the popular discourse they are multi-faceted, complex phenomena based on factors such as individual circumstances, supports, and resources.
Connecting the dots: understanding the relationship between religiosity, psychological
resilience and depression in breast cancer patients

Introduction: Death anxiety, fear of abundance, isolation, stigma of the disease and medication side effects are among the most common sources of anxiety and depression in patients with breast cancer. Purpose: To examine the possible relationship between religiosity, psychological resilience and depression on breast cancer patients. Materials and methods: A cross-sectional design was employed in this study which 152 breast cancer patients participated. Data were collected with the following instruments: Patient Health Questionnaire-2-item scale, Connor-Davidson Resilience Scale 25 and Centrality of Religiosity Scale and a special designed sheet reporting social, demographic and clinical characteristics. Statistical analyses were conducted with the Statistical Package for the Social Science V25. Descriptive statistics such means, and frequencies were calculated and inferential statistics such correlation test, simple and multiple regression analysis were applied. Results: Approximately 1 in 3 patients suffered symptoms of depression while they were reporting moderate religiosity and resilience values. Based on the four-step mediation analysis religiosity was strongly associated with psychological resilience but it was not found to affect directly either depression, but psychological resilience can be a mediator between religiosity and depression. Conclusion: This study supports the notion thatreligiosity and spirituality can have a beneficial influence on health outcomes.
Association between Bipolar Affective Disorder and Periodontal Diseases

Periodontitis, an inflammatory disease of periodontal tissues, is characterized by the progressive loss of support tissue and the insertion of teeth. It derives from the infection and interaction of specific bacterial species with host response components in susceptible individuals. A growing number of observational and epidemiological studies have been published, in the last decades, pointing to a possible association between stress, anxiety, and depression with the development and progression of periodontal diseases. One of the possible mechanisms of influence of stress and of the psychosocial factors, in the periodontal conditions, is the modification of the individual’s behavior. The studies that assessed the association between stress, depression, and periodontal disease are numerous in different types of design, yet their data are still conflicting. Another recurrent serious condition of mental health, frequently associated with high rates of morbidity and mortal-ity, is the bipolar affective disorder (BPAD). Although little investigated and with conflicting data, BPAD is a behavioral factor associated to the periodontal disease. In addition, little is known about its interference with the microbial and immunological response to periodontitis. The aim of this chapter is to describe the main scientific evidence of the association between BPAD and periodontitis.