Miracle-dz/UniFAR-FTUs huggingface dataset:
Prediction of specific depressive symptom clusters in youth with epilepsy: The NDDI‐E‐Y versus Neuro‐QOL SF

Proper assessment and early identification of depressive symptoms are essential to initiate treatment and minimize the risk for poor outcomes in youth with epilepsy (YWE). The current study examined the predictive utility of the Neurological Disorders Depression Inventory‐Epilepsy for Youth (NDDI‐E‐Y) and the Neuro‐QOL Depression Short Form (Neuro‐QOL SF) in explaining variance in overall depressive symptoms and specific symptom clusters on the gold standard Children's Depression Inventory‐2 (CDI‐2).
Oxidative stress and nitric oxide pathway in adult patients who are candidates for cardiac surgery: patterns and differences.

OBJECTIVES We investigated whether oxidative stress and the arginine/nitric oxide pathway differ in control subjects and in adult patients who are candidates for the three most common cardiac surgical operations: coronary bypass surgery, aortic valve replacement for calcific non-rheumatic aortic stenosis or mitral valve repair for degenerative mitral insufficiency. METHODS In this prospective observational study, we studied 165 consecutive patients undergoing surgery from January to June 2011 (coronary bypass surgery, n = 63; aortic valve replacement for calcific non-rheumatic aortic stenosis, n = 51; mitral valve repair for degenerative mitral insufficiency, n = 51). Thirty-three healthy subjects with cardiovascular risk factors similar to surgery patients were also studied (Controls). Oxidative stress (the ratio of reduced and oxidized glutathione and urinary isoprostane), antioxidants (alpha- and gamma tocopherol) and factors involved in nitric oxide synthesis (arginine, symmetric and asymmetric dimethylarginine) were measured before surgery. Analysis of variance general linear models and principal component analysis were used for statistical analysis. RESULTS Surgical patients had increased levels of oxidative stress and decreased levels of antioxidants. Increased levels of nitric oxide inhibitor asymmetric dimethylarginine were detected in surgical candidates, suggesting arginine/nitric oxide pathway impairment. Concerning the differences among surgical procedures, higher oxidative stress and a major imbalance of the ratio between substrate and inhibitors of nitric oxide synthesis were evidenced in patients who were candidates for mitral valve repair with respect to coronary bypass surgery patients and patients with calcific non-rheumatic aortic stenosis. CONCLUSIONS Patients undergoing cardiac surgery have increased oxidative stress and a trend towards an impaired arginine/nitric oxide pathway with respect to Controls. Patients affected by mitral valve regurgitation show more pronounced perturbations in these pathways. The clinical implications of these findings need to be investigated.
Nucleotide Formation from α- and β-2′-Deoxythioguanosine in Extracts of Murine and Human Tissues

result, the a-anomer exhibited a lower order of host toxicity in the mouse while retaining carcinostatic activity against some mouse neoplasms. In an attempt to determine whether these therapeutic advantages ofaj3-TGdR would be available in the human, a test system was devised for measuring nucleotide formation in cell-free extracts prepared from murine and human tissues. The test system was applied to a variety of normal and neoplastic tissue biopsies.3 The indications obtain ed in these tests encourage the view that these nucleosides may have utility in selected cancer cases.
Lymphatic Filariasis: Transmission, Treatment and Elimination

textabstractLymphatic filariasis (LF) is a mosquito-borne, tropical disease caused by filarial worms. Infection can lead to disabling chronic disease, characterized by swelling of extremities or external genitalia (lymphoedema, elephantiasis and hydrocele). Mass treatment with antifilarial drugs is used to reduce the parasite load in the population, in order to reduce transmission and prevent disease. This is so effective that elimination of LF seems possible. Using a mathematical for lymphatic filariasis transmission in Pondicherry, India, we predicted how long yearly mass treatment would have to be continued to achieve elimination. Six annual treatments with the recommended combination of diethylcarbamazine (DEC) and albendazole would be sufficient if population coverage is 65% per round. Only four rounds would do if coverage is 80%. The required duration of mass treatment increases with endemicity level. In a comparison of transmission efficiency for different mosquito species, we found that the relationship between infection intensity in humans and the number of infective larvae developing in mosquitoes differed markedly. Mosquito characteristics may largely influence elimination prospects and predictions for Pondicherry cannot be generalized. A further study concentrated on the role of acquired immunity. We found that existing models for such immunity, which predict a decline in infection intensity in older humans, are not valid for lymphatic filariasis. We also quantified the effects of drugs treatment on different parasite stages: DEC and ivermectin were found to affect a very large proportion of microfilariae and adult worms; these drugs were even more effective when given in combination with albendazole. In conclusion, prospects for LF elimination by mass treatment are good if population coverage is sufficiently high, but the required duration depends on local transmission dynamics, endemicity level, and the efficacy of employed treatment regimens.
Epidemiology of Cerebral Palsy in the Netherlands

textabstractChildren with cerebral palsy (CP) and their families often make strong demands on diagnostic, therapeutic, technical and social facilities. Prevalence estimates are needed to improve treatment and services. As recent Dutch data are not available, the present study aimed to assess the population prevalence of CP in the Netherlands. A representative Dutch area with 1.2 million inhabitants of which 172,000 were born between 1977 and 1988 was studied. To ascertain the children with CP from these birth years, medical practices (such as rehabilitation centres, paediatric and child neurological departments) were consecutively asked to contact their (supposed) CP cases. Next, a parents’ organisation and finally regional news media assisted in the ascertainment. In total, 170 ‘supposed’ CP cases underwent an expert examination. Of these 170, 127 children proved to be definite CP-cases, yielding a ‘crude’ average prevalence of 0.74 per 1000 inhabitants (95% CI: 0.61–0.87). Under-ascertainment was recognised and quantified. Accordingly, the population prevalence of CP over the birth year period 1977–1988 was calculated as 1.51 per 1000 inhabitants (average over the 12 birth years). The calculated CP prevalence rose significantly over time: from 0.77 (1977–1979) to 2.44 (1986–1988). This trend is in accordance with other studies.
What is the optimal revascularization technique for isolated disease of the left anterior descending artery: minimally invasive direct coronary artery bypass or percutaneous coronary intervention?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, 'What is the optimal revascularization technique for isolated disease of the left anterior descending artery (LAD) in terms of patient survival, morbidity such as myocardial infarction (MI) and need for repeat target vessel revascularization: minimally invasive direct coronary artery bypass graft (MIDCAB) or percutaneous coronary intervention (PCI)? ' Altogether 504 papers were found using the reported search, of which 13 represented the best evidence to answer the clinical question. Outcome parameters that were used in the assessment include the incidence of major adverse cardiovascular or cerebral events (MACCEs), mortality and the rate of repeat target vessel revascularization. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the papers are tabulated. One meta-analysis showed no significant difference in terms of individual incidences of MI, stroke or mortality, but when considered as a composite MACCE outcome, this was found to be significantly lower in the MIDCAB group. Moreover, further meta-analytical data have revealed a 5-fold increase in the need for repeat revascularization with PCI, with some centres reporting rates of up to 34%. However, retrospective data have shown that average length of hospital stay was longer in the MIDCAB group (7.4 ± 3.2 vs 3.4 ± 3.5 days; P < 0.001). We conclude that there are obvious proven benefits with MIDCAB, namely in terms of a reduced need for repeat target vessel revascularization and incidence of MACCE, and one study has even shown that there is a long-term survival benefit in 'real-world' clinical practice. However, given that there is a lack of well-powered randomized controlled trial and long-term follow-up data to prove a mortality benefit in support of MIDCAB, patients requiring revascularization of isolated proximal LAD stenosis and being considered for percutaneous coronary intervention should be discussed in a multidisciplinary team setting prior to intervention.
Rates and Characteristics of Paid Malpractice Claims Among US Physicians by Specialty, 1992-2014

Importance Although physician concerns about medical malpractice are substantial, national data are lacking on the rate of claims paid on behalf of US physicians by specialty. Objective To characterize paid malpractice claims by specialty. Design, Setting, and Participants A comprehensive analysis was conducted of all paid malpractice claims, with linkage to physician specialty, from the National Practitioner Data Bank from January 1, 1992, to December 31, 2014, a period including an estimated 19.9 million physician-years. All dollar amounts were inflation adjusted to 2014 dollars using the Consumer Price Index. The dates on which this analysis was performed were from May 1, 2015, to February 20, 2016, and from October 25 to December 16, 2016. Main Outcomes and Measures For malpractice claims (n = 280 368) paid on behalf of physicians (in aggregate and by specialty): rates per physician-year, mean compensation amounts, the concentration of paid claims among a limited number of physicians, the proportion of paid claims that were greater than $1 million, severity of injury, and type of malpractice alleged. Results From 1992-1996 to 2009-2014, the rate of paid claims decreased by 55.7% (from 20.1 to 8.9 per 1000 physician-years; P < .001), ranging from a 13.5% decrease in cardiology (from 15.6 to 13.5 per 1000 physician-years; P = .15) to a 75.8% decrease in pediatrics (from 9.9 to 2.4 per 1000 physician-years; P < .001). The mean compensation payment was $329 565. The mean payment increased by 23.3%, from $286 751 in 1992-1996 to $353 473 in 2009-2014 (P < .001). The increases ranged from $17 431 in general practice (from $218 350 in 1992-1996 to $235 781 in 2009-2014; P = .36) to $114 410 in gastroenterology (from $276 128 in 1992-1996 to $390 538 in 2009-2014; P < .001) and $138 708 in pathology (from $335 249 in 1992-1996 to $473 957 in 2009-2014; P = .005). Of 280 368 paid claims, 21 271 (7.6%) exceeded $1 million (4304 of 69 617 [6.2%] in 1992-1996 and 4322 of 54 081 [8.0%] in 2009-2014), and 32.1% (35 293 of 109 865) involved a patient death. Diagnostic error was the most common type of allegation, present in 31.8% (35 349 of 111 066) of paid claims, ranging from 3.5% in anesthesiology (153 of 4317) to 87.0% in pathology (915 of 1052). Conclusions and Relevance Between 1992 and 2014, the rate of malpractice claims paid on behalf of physicians in the United States declined substantially. Mean compensation amounts and the percentage of paid claims exceeding $1 million increased, with wide differences in rates and characteristics across specialties. A better understanding of the causes of variation among specialties in paid malpractice claims may help reduce both patient injury and physicians’ risk of liability.
Effect of orally administered sodium bicarbonate on caecal pH.

REASONS FOR PERFORMING STUDY Caecal acidosis is a central event in the metabolic cascade that occurs following grain overload. Buffering the caecal acidosis by enterally administered sodium bicarbonate (NaHCO3 ) may be beneficial to affected horses. OBJECTIVES To determine the effect and duration of enterally administered NaHCO3 on caecal pH in healthy horses. STUDY DESIGN Experimental study using horses with caecal cannulas. METHODS Nine horses had been previously fitted with a caecal cannula. Six horses received 1.0 g/kg bwt NaHCO3 and 3 control horses were given 3 l of water via nasogastric tube. Clinical parameters, water consumption, venous blood gases, caecal pH, faecal pH and faecal water content were measured at 6 h intervals over a 36 h study period. RESULTS Horses that received enterally administered NaHCO3 had significantly increased caecal pH that lasted the duration of the study. Treated horses increased their water intake, and developed metabolic alkalaemia, significantly increased plasma sodium concentrations and significantly decreased plasma potassium concentrations. CONCLUSIONS Enterally administered NaHCO3 may be beneficial in buffering caecal acidosis.
Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014.

1. Brinkmeyer MK, David SS. Distinct functional consequences of MUTYH variants associated with colorectal cancer: damaged DNA affinity, glycosylase activity and interaction with PCNA and Hus1. DNA Repair (Amst) 2015; 34: 39-51. 2. Adam R, Spier I, Zhao B, et al. Exome sequencing identifies biallelic MSH3 germline mutations as a recessive subtype of colorectal adenomatous polyposis. Am J Hum Genet 2016; 99: 337-51. 3. Kwiatkowski D, Czarny P, Galecki P, et al. Variants of base excision repair genes MUTYH, PARP1 and XRCC1 in Alzheimer’s disease risk. Neuropsychobiology 2015; 71: 176-86. 4. Zhang S, Wang XB, Han YD, et al. Polymorphism in ERCC1 confers susceptibility of coronary artery disease and severity of coronary artery atherosclerosis in a Chinese Han population. Sci Rep 2017; 7: 6407.
Triple valve surgery in the modern era: short- and long-term results from a single centre.

OBJECTIVES Triple valve surgery (TVS) is still a challenge for surgeons because of prolonged cardiopulmonary bypass (CPB) and myocardial ischaemic times. The reported operative mortality rate for TVS ranges between 2.5 and 25%; long-term survival is also diminished, with reported survival rates at 5 and 10 years of 75-82 and 61-75%, respectively. The objective of our study is to define early and late clinical outcomes, reporting the initial experience in the treatment of triple valve disease through a minimally invasive approach. METHODS A retrospective, observational, cohort study was undertaken of prospectively collected data on 106 patients who underwent TVS at our institution between October 2001 and June 2013. A total of 101 procedures were done through the standard median sternotomy; however, in 5 patients, the surgical procedure was carried out through a right minithoracotomy. Univariate analysis was performed to identify predictors of early and late survival. RESULTS The in-hospital mortality rate was 5.6% (6 of 107 patients). Predictors of early mortality were: previous cardiac surgery [odds ratio (OR) 4, 95% confidence interval (CI) 1.08-5.2, P = 0.04], preoperative left ventricular ejection fraction (LVEF) (OR 0.9, 95% CI 0.8-1.1, P = 0.003), prolonged CPB time (OR 1.02, 95% CI 1.01-1.04, P = 0.01) and postoperative pulmonary complications (OR 8, 95% CI 5.8-41, P = 0.0001). Five- and 10-year survival rates were 85 ± 3 and 65 ± 9%, respectively. In univariate analysis, diabetes [hazard ratio (HR) 2.5, 95% CI 1-6.2, P = 0.045], preoperative dialysis (HR 3, 95% CI 2-4.7, P = 0.001), unstable angina (HR 4.8, 95% CI 1-18, P = 0.03), preoperative LVEF (HR 0.9, 95% CI 0.8-1.1, P = 0.02), concomitant coronary artery bypass grafting (CABG) (HR 2.5, 95% CI 1.5-5.7, P = 0.006), prolonged CPB time (HR 1.02, 95% CI 1.01-1.13, P = 0.006), postoperative pacemaker (PMK) implantation (HR 6.2, 95% CI 1.3-18, P = 0.01) and postoperative pulmonary complications (HR 3.3, 95% CI 2.1-7.3, P = 0.002) were found to be significant predictors of late mortality following TVS. The freedom rates from valve-related complications and reoperation at 10 years were 95 ± 2 and 97 ± 2%, respectively. The 10-year freedom rates from thromboembolism and anticoagulation-related haemorrhage were 88 ± 5 and 88 ± 4%, respectively. CONCLUSIONS TVS offers encouraging short-term and long-term patient survival; these good results after TVS in patients with advanced valvular heart disease justify aggressive surgical therapy in these patients. TVS with a minimally invasive approach is feasible and could be another treatment option.
An assessment of intra- and interobserver agreement of reporting orthopaedic findings on presale radiographs of Thoroughbred yearlings.

REASONS FOR PERFORMING STUDY Radiography is commonly used in clinical practice but agreement of reporting of radiographically detected orthopaedic findings in horses has rarely been studied. OBJECTIVES To assess agreement within and between observers for reporting of orthopaedic findings on presale radiographs of Thoroughbred yearlings. STUDY DESIGN Retrospective analysis of archived radiographs. METHODS Four veterinary radiology specialists each twice examined 167 sets of radiographs for orthopaedic findings in the fore feet, fore and hind fetlocks, carpi, tarsi and stifles. There were 27 findings analysed for agreement. Kappa statistic (κ), percentage of positive agreement (Ppos) and percentage of negative agreement are reported. RESULTS An excellent percentage of negative agreement was observed for all findings, with the exception of regular vascular channels of the proximal sesamoid bones. Ppos and κ results were variable. The presence of extra carpal bones, osseous cyst-like lesions of the ulnar carpal bone, sagittal ridge defects of the third metacarpus, fracture of the fore and hind proximal sesamoid bones, regular vascular channels in the hind proximal sesamoids, osteochondrosis lesions of the distal intermediate ridge and/or medial malleoli of the tibia, and osseous cyst-like lesions in the medial femoral condyle was consistently observed with an intra- and interagreement κ≥0.5 and Ppos≥50%. Lucency within the proximal sesamoids consistently had an observed intra- and interagreement κ<0.4 and Ppos<40%. CONCLUSIONS Observation of orthopaedic findings on yearling repository radiographs showed generally excellent agreement on the absence of findings, but variable agreement on the presence of findings. Agreement was good for larger and easy to categorise radiographic findings. More accurate definitions and training need to be developed to improve agreement within and between observers for orthopaedic findings with poor or fair to good agreement.
Immediate outcome of neonates with maternal hypertensive disorder of pregnancy at a neonatal intensive care unit

Aims : Hypertensive disorders in pregnancy remain a major cause of maternal and neonatal morbidity and mortality worldwide. This study prospectively examined the immediate neonatal outcome of women with maternal hypertensive disorder of pregnancy( HDP). Methods : Sixty mothers and their newborn were selected. Mothers with gestational hypertension, preeclampsia, preeclampsia superimposed on chronic hypertension and chronic hypertension were included. Results : Forty five (75%) mothers were mutipara and 15(25%) were primipara. Mean maternal age was 26.4 years. Mean gestational age was 34+ 4 weeks. 38 were male and 22 were female with Male: Female ratio was 1.72: 1. Thirty six (60%) were from in patient with regular antenatal check up, 60% mothers had gestational hypertension. Fifty four (90%) mothers needed lower uterine caesarian section. Forty four (73.33%) delivered preterm before 36 weeks of pregnancy. Low birth weight (<2.5kg) babies were 30(50%), very low birth weight (<1.5kg) were 16(26.66%). Intrauterine growth retardation (IUGR) were 18(30%) and Appropriate for gestational age( AGA) were 14(23.33%). Respiratory distress 30(50%) were the most common cause of admission, other associated problems were perinatal asphyxia (PNA) with seizure and meconium aspiration syndrome and to rule out sepsis in suspected cases. Nine (15%) needed ventilator care and 6(10%) needed nasal continuous positive airway pressure (NCPAP) for respiratory problem. 6(10%) babies were expired and 54(90%) survived. Average hospital stay were 18.32(±10.68) days with a highest hospital stay of 49 days and the lowest 4 days. Conclusion : Maternal hypertensive disorder of pregnancy is associated with neonatal morbidity. Northern International Medical College Journal Vol.6(2) 2015: 57-60
How Do Nurses Spend Their Time in The Hospital

Purpose: The current study investigated the productivity of nurses in emergency department, ICU and CCU of Shahid-Madani hospital in Tabriz. Methods: A two-stage time and motion study was conducted; the observational work sampling study was undertaken by 15 nurses, followed by self-reporting work sampling study by 42 nurses over a period of five weeks. Descriptive and analytical statistics were used to analyze the data. Results: Fifty-seven work sampling data were collected, 15 through the observational study and 42 in self-reporting. Considerable differences were found in the nurses’ time distribution between two techniques. Percentage of direct, indirect and personal activities in observational versus self-reporting were observed (32.74% versus 40.52%), (24.09% versus 28.84%) and (42.30% versus 30.41%) respectively. Conclusion: A considerable proportion of nurses’ time in each shift was spent on their personal activities, which would affect their productivity as well as their direct and indirect delivered cares for patients. Identifying the percentage of spent time on nurses’ personal activities would be a useful measure for improving patient care protocols in the hospitals.