Miracle-dz/UniFAR-FTUs huggingface dataset:
Second-hand exposure to aerosolized intravenous anesthetics (fentanyl) among anesthesiologists in Jordan

ABSTRACT Objectives: Fentanyl is a potent opioid that is used as intravenous infusion in anesthesia, and it is considered the most abused opioid among anesthesiologists. This is a qualitative study conducted to provide background regarding the liability of drug abuse among anesthesia personnel. Method: The main aim of this study was to investigate the presence of fentanyl droplets in the ambient of operating rooms where it is used. In this study, tandem mass spectrometry analysis (MS/MS) was conducted on samples collected from the air of a cardiovascular operating room to detect the presence of fentanyl droplets. Results: Analysis of samples collected from the areas surrounding the sharp box and the expiratory end of the patient’s respiratory circuit confirmed the presence of fentanyl in the ambient air. Samples taken from outside the cardiovascular suite showed no presence of fentanyl. Conclusion: The study highlights the importance of raising the safety bar in the operating room to protect anesthesia personnel from the risk of long-term exposure to fentanyl and other anesthesia drugs.
Stress clash in Spanish, Catalan, and Friulian from a prosodic perspective

Abstract In several languages, two stresses cannot appear adjacently in the speech chain, and a variety of solutions have been found to be used to resolve this disfavored juxtaposition. According to various different authors, a common strategy for solving stress clash is the non-realization of the first stress and, typically, a transfer of all stress parameters to the pre-tonic syllable. This study aims to describe how stress clash is solved in three Romance languages (Spanish, Catalan, and Friulian) and two sentence-types (broad focus statements and information-seeking yes-no questions). The first two languages behave similarly, insofar as length and loudness are not stress-supporting parameters, and F0 maintains the general patterns of the type of sentence. Friulian stands out because length is the main stress parameter and tonic syllables are significantly longer, even when there is a stress clash. F0 also follows the general sentence type pattern, with one exception: declarative sentences in NP1, where the pre-tonic syllable is always higher than its corresponding tonic.
Serum vitamin d level and susceptibility to multidrug-resistant tuberculosis among household contacts

Low levels of vitamin D is a predisposing factor for Multidrug-resistant tuberculosis. Family members in contact with the patient are also at risk of infection. Currently, there is no study that compares vitamin D levels between MDR-TB patients and household contact. This study aims to identify the association between level vitamin D within MDR-TB occurrence. This was a case-control study, with the number of samples in each group (MDR-TB) patients and household contactswere40 people. Each member of each group was checked for vitamin D levels using enzyme-linked immunosorbent assay (ELISA) technique. Statistical analysis was by using Chi-Square analysis using SPSS. Mean levels of vitamin D in MDR-TB patients were 32.21, household contact 31.7. There was anosignificant association between vitamin D levels and MDR-TB occurrence (p=1.0). No significant associationbetween vitamin D level with theMDR-TB occurrence.
Evaluation of the Quasi‐Biennial Oscillation in global climate models for the SPARC QBO‐initiative

Quasi‐biennial oscillations (QBOs) in thirteen atmospheric general circulation models forced with both observed and annually repeating sea surface temperatures (SSTs) are evaluated. In most models the QBO period is close to, but shorter than, the observed period of 28 months. Amplitudes are within ±20% of the observed QBO amplitude at 10 hPa, but typically about half of that observed at lower altitudes (50 and 70 hPa). For almost all models, the oscillation's amplitude profile shows an overall upward shift compared to reanalysis and its meridional extent is too narrow. Asymmetry in the duration of eastward and westward phases is reasonably well captured, though not all models replicate the observed slowing of the descending westward shear. Westward phases are generally too weak, and most models have an eastward time mean wind bias throughout the depth of the QBO. The intercycle period variability is realistic and in some models is enhanced in the experiment with observed SSTs compared to the experiment with repeated annual cycle SSTs. Mean periods are also sensitive to this difference between SSTs, but only when parametrized non‐orographic gravity wave (NOGW) sources are coupled to tropospheric parameters and not prescribed with a fixed value. Overall, however, modelled QBOs are very similar whether or not the prescribed SSTs vary interannually. A portrait of the overall ensemble performance is provided by a normalized grading of QBO metrics. To simulate a QBO, all but one model used parametrized NOGWs, which provided the majority of the total wave forcing at altitudes above 70 hPa in most models. Hence the representation of NOGWs either explicitly or through parametrization is still a major uncertainty underlying QBO simulation in these present‐day experiments.
Mordida aberta anterior e hábitos deletérios em crianças pré-escolares de escolas públicas

Objective: this study aims to evaluate the prevalence of anterior open bite and its association with deleterious oral habits, such as use of pacifier, finger-sucking habit and baby bottle in preschool children. Material and Methods: a cross-sectional study was carried out with 142 children, aged three to five years old, from 9 schools in the city of Nova Venecia, ES, Brazil. A properly calibrated examiner conducted the examination of occlusion under natural light and with the aid of medical examination stick. In addition, a semi-structured form with closed questions on deleterious oral habits in children was sent to parents/guardians. The sociodemographic, economic and anterior open bite data was verified through the Fisher exact test and the odds ratio values were calculated with 95% confidence interval. Results: it was found a prevalence of 31.69% (45) of anterior open bite. Moreover, 45.8% (65) of the children had a pacifier sucking habit, 14.8% (21) finger sucking habit and 73.9% (105) used baby bottle. Children with habit of pacifier sucking showed 5.58 (2.54-12.24) more likely to have anterior open bite than children without the habit. Preschool children with finger sucking habit showed 3.55 (1.37-9.21) more likely to have malocclusion. Children who used baby bottle presented 2.29 (1.06-4.97) more likely to have anterior open bite. Conclusion: high prevalence of anterior open bite is observed in the studied population and it is associated with the pacifier sucking habit, finger sucking habit and use of a baby bottle.
Rare presentation of Adenoid cystic carcinoma presenting as retro-orbital mass: a case report

Primary Adenoid Cystic Carcinoma (ACC) occurring in the orbital apex is rare. We present the clinical features of a patient who initially presented with the clinical and radiologic features of an orbital pseudo tumor. She underwent surgery and pathological examination revealed ACC in the orbital apex with a normal lacrimal apparatus.
Safety and efficacy of combination therapy (Simeprevir/Sofosbuvir) in the treatment of chronic HCV genotype IV patients -

Chronic infection with HCV is a worldwide health problem that may lead to cirrhosis, portal hypertension, hepatocellular failure and hepatocellular carcinoma in most of cases. A new era in HCV treatment has been started using direct acting antiviral activity. In this study we assess the safety and efficacy of a combination therapy Sofosbuvir/Simprevir in the treatment of chronic HCV patients genotype IV either cirrhotic or non-cirrhotic. In the outpatient clinic, one hundred and seventy five chronic HCV patients were recruited from Tropical Medicine Department at Fayoum public hospital. A combination of Sofosbuvir (400 mg) and Simeprevir (150 mg) was administered for those patients once daily over a period of 12 weeks. All patients have been followed up for clinical and laboratory parameters and HCV PCR to evaluate the efficacy and safety of this therapy. Sustained Virologic Response rate (SVR12) were 97.7% (169/173) (primary end point), and same results obtained at the second end point (SVR 24). In this study, cirrhotic patients showed lower SVR (92.7%) compared to non-cirrhotic patients (98.5%) (p-value 0.085). Majority of patients (57.14%) reported adverse events (AEs) during treatment and most common AEs were headache, fatigue, pruritus, dizziness and photosensitivity. On the basis of the evidence currently available, it seems fair to suggest that the combination therapy of (SMV/SOF) in the treatment of chronic HCV genotype IV naive and experienced patient whether cirrhotic or non-cirrhotic is safe and effective. This was evidenced by monitoring patientsÂ’ clinically and using hepatic parameters after drug administration. The adverse events affected patients were mild and tolerable among patients.
Associations between trauma during adolescence and sense of purpose in middle-to-late adulthood

Early adverse experiences can hold lasting influence on later life outcomes, particularly during formative developmental periods such as adolescence. The current study evaluates the impact of different kinds of adolescent trauma on later sense of purpose in adulthood, using data from the Hawaii Longitudinal Study of Personality and Health. Participants (n = 545) retrospectively reported three kinds of trauma during adolescence: (1) non-betrayal trauma, such as a natural disaster; (2) low betrayal trauma, such as being abused by a stranger; and (3) high betrayal trauma, such as being abused by a relative. At a later assessment, participants (Mage = 60.15, SD = 1.96) reported their sense of purpose. Trauma scores were uncorrelated with sense of purpose for the overall sample. However, the associations differed when comparing two of the largest cultural groups in the sample, Japanese Americans and Native Hawaiians. For participants who identified as Japanese American, trauma scores held a negative association with later sense of purpose across multiple measures. Results are discussed with respect to how early life experiences differentially impact purpose development across individuals.
Conversion to thoracotomy in thoracoscopic surgery: damnation, salvation or timely choice?

Video-assisted thoracic surgery (VATS) is today universally adopted to perform a number of simple and more technically demanding surgical procedures including anatomical pulmonary resection for lung cancer, which are today increasingly performed following an intermediate contrasted period of proven feasibility and strong critics. In fact, the recent evolution of VATS benefitted of significant technological improvements in video-systems and instrumentation, enlarging institutional experiences, accumulation of research data documenting advantages in terms of postoperative pain, morbidity and hospital stay, and equivalent oncological outcomes with open thoracic surgery (1). On the other hand, the possibility to perform more complex surgical procedures in a closed chest as typical of modern VATS continues to stimulate the debate on indications and particularly to raise concerns as to when and how conversion to thoracotomy should be performed.
Patient Experiences in Ambulatory Care and Physiologic and Functional Health Care Outcomes as they relate to Physician and Non-Physician Providers

Nurse practitioners and our physician colleagues contribute to the promotion of positive physiologic and functional health care outcomes in a variety of ambulatory care settings. Patient experiences play an integral role in these outcomes and positive relationships between these variables were hypothesized. It was further predicted that there were no significant differences in patient experiences and health care outcomes between patients seen by physicians and those seen by other providers. Patient experiences were operationalized using the Ambulatory Care Experiences Survey. Functional health care outcomes were measured using the Short Form-36 and data on the physiologic measures of blood pressure, body mass index, and glycohemoglobin were collected directly from the patient’s electronic health record. One hundred and twenty adult patients comprised this sample of convenience. Differences in health care outcomes for patients seen by a physician versus those by a non-physician provider was assessed and no significant differences between groups were found (p=0.182). Although significant relationships did not exist between patient satisfaction and BP or HgBA1C, a statistically significant relationship was found between patient satisfaction and BMI (p=0.19, r=0.224). The mean BMI was 29.69 so that the sample population has been found to be overweight or obese and significant relationships exist between BMI and systolic and diastolic BP (p=0.000, p=0.001). The results of this study have contributed to the growing body of work demonstrating the effectiveness of non-physician providers in fostering improved health care outcomes and that positive patient experiences lead to improved health. Health care professionals must continue to play to promote health.
Turkish First-Time Supervisees’ Disclosure and Nondisclosure in Clinical Supervision

This study sought to examine Turkish first-time supervisees’ opinions regarding disclosure and nondisclosure in clinical supervision via a case study design. The data was collected from 19 volunteer first-time supervisees through a semi-structured interview form and analyzed with content analysis. Results indicated that supervisees’ content of disclosures included supervisory needs and thoughts about supervisor while content of nondisclosure consisted of personal issues, supervision-related issues, and negative feelings about client. Nevertheless, supervisee disclosure was positively influenced by supervisor’s personal characteristics and interventions; supervisee’s expectations from disclosure and personal characteristics, as well as existence of peers in supervision environment and strong supervisory relationship. However, supervisor’s personal characteristics; supervisee’s personal characteristics, negative attitudes toward disclosure, and supervision; and also peers, poor supervision time, poor structure for supervision, evaluation concerns, and weak supervisory relationship have some negative effects on supervisee disclosure. Moreover, supervisee disclosure and nondisclosure had intense effects on supervisee and supervision.
Bi-level variable selection in high-dimensional Tobit models

To study variable selection for high dimensional Tobit models, we formulate Tobit models to single-index models. We hybrid group variable selection procedures for single index models and univariate regression methods for Tobit models to achieve variable selection for Tobit models with group structures taken into consideration. The procedure is computationally efficient and easily implemented. Finite sample experiments show its promising performance. We also illustrate its utility by analyzing a dataset from an HIV/AIDS study.
Policy towards Removal of Mini Plates in Maxillofacial Trauma –A Follow up Study of 234 Patients

Aim: To analyze the incidence and factors associated with mini plates removal in maxillofacial trauma and also create a protocol for removal of miniplates in maxillofacial trauma. Material & Methods: Records of 234 patients attending the department of oral and maxillofacial surgery over a 8-year period were evaluated regarding the site of plating, the number of patients in whom plates were removed & the reasons for their removal. A total of 437 stainless steel mini plates were inserted among 234 patients, among which 245 plates were inserted in mandible, 140 in the maxilla and 52 plates in a zygomatic complex region. Results: A total of 234 patients with maxillofacial trauma were included in the study. Out of these, 172 were males and 62 were females with age range of 14 -59 yrs. A total of 437 stainless steel mini plates were inserted. A total of 48(10.98 %) mini plates were removed from 28 (11.96%) patients over a period of 8 years. Out of these 48 plates, 15 (31.25 %) plates were removed because of infection, 12 ( 25 %) plates were removed because of dehiscence, 8 ( 16.68 %) were removed because of loosened plates, 5 (10.41%) were removed because of palpable plates, 5 (10.41%) plates were removed upon patient request and 3 ( 6.25 %) plates were removed because of non-union. Conclusion: Although there are conflicting opinions about the routine removal of miniplates, we follow the principle of wait and see for reasons of plate removal. The result of the present study favors our policy that is “wait and see”.
Comparison of Solitaire-FR and Trevo-ProVue Thrombectomy in Patients with Anterior Circulation Large Artery Occlusion

Background: Recent randomized controlled trials have recommended stentriever thrombectomy as an important modality in treating acute ischemic stroke. Objectives: This study compares Solitaire-FR (ST) and Trevo-ProVue (TV) in terms of their angiographic recanalization rates and clinical outcomes in acute ischemic stroke patients with anterior circulation large artery occlusion. Patients and Methods: Forty-seven patients who underwent stentriever thrombectomy using ST or TV were retrospectively re-viewed. Successful angiographic recanalization was deﬁned as a modiﬁed treatment in cerebral ischemia (mTICI) score of 2b-3 and a good outcome was deﬁned as a modiﬁed Rankin scale score (mRS) of 0 - 2 at 3 months. We compared angiographic and clinical outcomes of ST- and TV-treated patients. Results: Twenty-one patients (mean age ± SD: 67.7 ± 13.5 years; 14 men) were treated with ST and 26 patients (70.7 ± 9.7 years; 13 men)weretreatedwithTV. Therewerenodiﬀerencesinbaselinecharacteristics,initialnationalinstituteof healthstrokescalescore, location of occlusion, onset to puncture time, or total procedure time between groups. The rate of successful recanalization and symptomatic intracranial hemorrhage (sICH) between ST [mTICI 2b-3: 19 (90.55%) and sICH: 2 (9.5%)] and TV [mTICI 2b-3: 23 (88.5%) and sICH: 3 (11.5%)] groups were not diﬀerent. Good outcomes (mRS 0 - 2) were not signiﬁcantly diﬀerent between the groups [ST: 10 (47.7%) and TV: 13 (50%); P = 0.81]. Conclusion: The two stentriever devices showed similar recanalization rates and clinical outcomes in patients with anterior circulation large artery occlusion.
Changing pattern of vascular access use for maintenance haemodialysis in a tertiary hospital in Southern Nigeria

Background: Patients who choose haemodialysis (HD) as a mode of renal replacement therapy require vascular access before initiation of dialysis. The options include a native arteriovenous fistula (AVF), a synthetic graft, and a central venous catheter. Maintaining a well functioning vascular access continues to be one of the greatest challenges in maintenance HD. Methods: A retrospective analysis of dialysis records and case notes of prevalent HD patients over a six-year period, between July 2009 and September 2014 at the University of Benin Teaching Hospital, Benin City, Nigeria. Results: A total of 591 patients with ESRD underwent dialysis during the period; male: female ratio of 1.2:1. Predominant age group with ESRD was 30-39 years (30%) and hypertension was the commonest aetiology of ESRD. All patients (100%) commenced HD with femoral catheters in 2009 while 5 (0.8%) commenced with AVF between 2011 and 2014. Only 43 (7.3%) had functional permanent vascular access. There was a progressive increase in the number of patients using (functional) AVF for HD from 2.2% in 2011, 8.5% in 2013 to 9.8% in 2014; with a reduction in the number of patients using femoral catheters from 51.5% in 2011, 41% in 2013 to 32.5% in 2014. Majority of patients (38%) were on tunneled catheters in the 6th year of review (2014). Conclusion: There is a rising trend towards the use of permanent vascular access among our HD population and a decreasing trend in the use of femoral catheters for HD. Compared with other types of vascular access, there were more patients on tunneled catheters in the 6th year of review (2014).
Evaluation of the registration status of fixed‐dose drug combinations in Nepal

Analysing the registration status and the presence of fixed‐dose drug combinations (FDCs) in different drug lists and formularies, encourages the use of rational FDCs and helps to remove the irrational combinations booming in the pharmaceutical market. This study aimed to evaluate the registration status of FDCs in different formularies and drug lists of Nepal.
Hop (Humulus lupulus L.) Volatiles Variation During Storage

Abstract Storage conditions play an important role in maintaining the integrity of hop products during processing, transport and storage, and their ultimate quality when used to brew beer. Several groups have investigated variation in alpha acids, beta acids and polyphenols under different storage conditions, but there are few studies directly linking changes in hop acid composition under pro-oxidative conditions, to either: (i) industry standard measures of the oxidative quality of hop alpha acids (hop storage index [HSI]); or (ii) changes in the volatile composition of hops. The aim of this work was to present useful information regarding the variation in hop acids and volatiles in different storage conditions, such as temperature and exposure to ambient air. A comparison between pellets and pressed hop flowers was investigated. Long term storage in oxidizing conditions can lead not only to a decrease in the essential oil content, in particular at the expense of the more volatile fraction, but also to the degradation and/or transformation of some of the main compounds to their oxidized forms. With this work, we hope to give some insight into the inter-relationship of measurable hop quality parameters (such as HSI, hop acid chemistry and volatile chemistry), as well as demonstrate how easily hop chemistry can be affected by improper storage conditions.
Treating Maternal Depression: Considerations for the Well-Being of the Mother and Child

Maternal depression is a serious mental illness that not only affects the health of the mother but also affects the fetus and child. Treatment with antidepressants (especially serotonin reuptake inhibitors [SRIs]) is common in depressed pregnant women and mothers but bears its own risk for the progeny. Due to a lack of research on the long-term consequences of each condition (i.e., untreated vs. treated depression), the question remains: whether a depressed women should take antidepressant medication during pregnancy and the postpartum. This article reviews the current state of SRI use during the perinatal period and the associated developmental effects of antidepressant medication. Furthermore, it discusses directions for improvement of future research as well as policy implications in regard to human and animal research. Without a better comprehension of the underlying mechanism that induces developmental effects, advising pregnant women and mothers will be difficult.