Miracle-dz/UniFAR-FTUs huggingface dataset:
A Review of Maternal and Child Health Status in Canada and Japan – Reinvigorating Maternal and Child Health Handbook

Objective: The objective of this study is to identify the challenges in Canadian health-care system that contributes to higher perinatal, infant, and maternal mortality rate (MMR) compared to other Organization for Economic Co-Operation and Development (OECD) countries, especially Japan, and to make a recommendation based on available data. Materials and Methods: Systematic literature search was performed through PubMed, Cochrane Library, and University of Toronto online library. Available data on maternal and child health (MCH) were collected from relevant literature, Statistics Canada and OECD database for secondary analysis. Results: We identified that, throughout the period from 2006 to 2016, Canada had a higher rate of maternal mortality compared to Japan, especially in 2014, when MMR in Canada (6.0) was almost twice the rate of Japan (3.3). Between 2005 and 2018, there was a gradual decline in infant mortality rate for both countries, but Japan performed well in keeping the infant mortality rate significantly lower than Canada (1.9 for Japan and 4.5 for Canada in 2017). Introduction of MCH Handbook contributed to keeping up the national health indicators high in Japan even before Japan attained a stable economy. However, differences in national registration practice among OECD countries and inconsistencies in data coverage across Canada caused difficulty in making comparisons. Conclusion: Nationally standardized process is needed to investigate and document maternal deaths, which will help Canada take concrete actions to make pregnancy safer for women. Effective partnerships among government agencies, health-care institutions, and pregnant women and their families are needed to ensure the best care.
The Correlation of Age, Gender, Heredity, Smoking Habit, Obesity, and Salt Consumption with Hypertension Grade in Cirebon, Indonesia

Background: Hypertension is one of the most global killer diseases that causes death. The World Health Or- ganiza on es mated around 1.5 billion people in the world will be diagnosed with hypertension every year. The increasing incidences of hypertension in the world may be affected by several predictors including age, sex-linked, heredity, smoking habit, obesity, and salt consump on. This study has objec ve to examine those predictors to hypertension grade. Methods: This research was used observa onal analy c method with cross-sec onal study. This study involved 136 respondents who came to Kalijaga Permai Public Health Center, Cirebon City. The variables were measured by microtoise, sphygmomanometer, stethoscope, scales, and ques onnaires. Spearman correla on test and lo- gis c regression test was analyzed for this study. Results: 59.9% of respondents were in hypertension grade 1 and 54% of respondents were in high risk age. The bivariate results revealed that age, sex-linked, heredity, and salt consump on were sta s cally correlated with hypertension grade (p=0.001). However, smoking habit and obesity were not sta s cally correlated. Mul vari- ate analysis found that those who add extra salt were 3.3 mes more likely to have hypertension grade 2 and those in high risk age were 3.1 more likely to have hypertension grade 2 as well. Compared with female and those who have nega ve heredity, male and posi ve heredity were 2.7 mes more likely to have hypertension grade 2. Conclusion: Salt consump on, age, sex-linked, heredity was significantly correlated with hypertension grade. Salt consump on was a risk factors which has the highest impact. Public health center should educate people about the recommenda on of daily salt intake to prevent the excessive intake that may affect hypertension.
Comparison of olecranon fixation techniques following transolecranon approach in intra-articular fractures of distal humerus in adult patients

Background: In this study, we assessed functional outcomes among olecranon fixation techniques used following transolecranon approach in patients with comminuted fracture of distal humerus. Methods: The study included 37 elbows that underwent olecranon osteotomy due to distal humerus fracture. Functional outcomes were assessed among patients who underwent fixation via tension band technique, plate, or screw fixation. Results: The implant irritation was seen in 18% of patients who underwent K-wire plus tension band fixation, in 75% of patients who underwent olecranon plate plus screw fixation, and in 18% of patients who underwent cancellous screw fixation. The rate for implant removal was 2.6 folds lower in K-wire plus tension band fixation when compared to olecranon plate plus screw fixation. Conclusion: We concluded that K-wire plus tension band technique and cancellous screw fixation performed in accordance with technical principles caused less skin problem when compared to other techniques. In olecranon fixation, both methods with enhanced stability by tension band can be preferred.
Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017

Introduction Falls in older aged adults are an important public health problem. Insight into differences in fall-related injury rates between countries can serve as important input for identifying and evaluating prevention strategies. The objectives of this study were to compare Global Burden of Disease (GBD) 2017 estimates on incidence, mortality and disability-adjusted life years (DALYs) due to fall-related injury in older adults across 22 countries in the Western European region and to examine changes over a 28-year period. Methods We performed a secondary database descriptive study using the GBD 2017 results on age-standardised fall-related injury in older adults aged 70 years and older in 22 countries from 1990 to 2017. Results In 2017, in the Western European region, 13 840 per 100 000 (uncertainty interval (UI) 11 837–16 113) older adults sought medical treatment for fall-related injury, ranging from 7594 per 100 000 (UI 6326–9032) in Greece to 19 796 per 100 000 (UI 15 536–24 233) in Norway. Since 1990, fall-related injury DALY rates showed little change for the whole region, but patterns varied widely between countries. Some countries (eg, Belgium and Netherlands) have lost their favourable positions due to an increasing fall-related injury burden of disease since 1990. Conclusions From 1990 to 2017, there was considerable variation in fall-related injury incidence, mortality, DALY rates and its composites in the 22 countries in the Western European region. It may be useful to assess which fall prevention measures have been taken in countries that showed continuous low or decreasing incidence, death and DALY rates despite ageing of the population.
Update on chronic wasting disease (CWD) III

Abstract The European Commission asked EFSA for a Scientific Opinion: to revise the state of knowledge about the differences between the chronic wasting disease (CWD) strains found in North America (NA) and Europe and within Europe; to review new scientific evidence on the zoonotic potential of CWD and to provide recommendations to address the potential risks and to identify risk factors for the spread of CWD in the European Union. Full characterisation of European isolates is being pursued, whereas most NA CWD isolates have not been characterised in this way. The differing surveillance programmes in these continents result in biases in the types of cases that can be detected. Preliminary data support the contention that the CWD strains identified in Europe and NA are different and suggest the presence of strain diversity in European cervids. Current data do not allow any conclusion on the implications of strain diversity on transmissibility, pathogenesis or prevalence. Available data do not allow any conclusion on the zoonotic potential of NA or European CWD isolates. The risk of CWD to humans through consumption of meat cannot be directly assessed. At individual level, consumers of meat, meat products and offal derived from CWD‐infected cervids will be exposed to the CWD agent(s). Measures to reduce human dietary exposure could be applied, but exclusion from the food chain of whole carcasses of infected animals would be required to eliminate exposure. Based on NA experiences, all the risk factors identified for the spread of CWD may be associated with animals accumulating infectivity in both the peripheral tissues and the central nervous system. A subset of risk factors is relevant for infected animals without involvement of peripheral tissues. All the risk factors should be taken into account due to the potential co‐localisation of animals presenting with different disease phenotypes.
Clinical Study on 1 Case of Cervical Dystonia Treated by Korean Medicine and Transfer Energy Capacitive and Resistive (TECAR) Therapy

Won-Jun Lee, K.M.D.*, Young-Suk Yoon, K.M.D.*, Jong-Ho Kim, K.M.D.*, Keun-Jae Lee, K.M.D.*, Mi-Hye Kim, K.M.D.*, Ho-Sun Ryu, K.M.D.*, Su-Bin Han, K.M.D.*, Byung-Hak Park, K.M.D.*, Jae-Min Son, K.M.D.*, Nam-Woo Lee, K.M.D.*, Jeong-Hun Han, K.M.D.*, Hye-Jin Seo, K.M.D., Ji-Hoon Kim, K.M.D. Departments of Korean Medicine Rehabilitation*, Internal Korean Medicine, Jaseng Hospital of Korean Medicine, Department of Korean Medicine Rehabilitation, College of Korean Medicine, Dongshin University
The Effectiveness of Multidimensional Counseling in the Intervention of Student Anxiety

This research was motivated by the phenomenon of students’ anxiety in the school, with the intervention purpose of innovating the quality of the counseling process, through a multidimensional model. Student anxiety affects their study performance in class, especially with the absence of proper attention; therefore, the multidimensional counseling tool is proposed to resolve this challenge. This study involved 7 students who have anxiety problems, and the Hamilton Anxiety Rating Scale was the instrument used for analyzing the data accessed on www.osf. io/7rd5w/, using a single-subject research design A-B-A and JASP. Therefore, the results identified multidimensional counseling as a tool capable of reducing student anxiety.
Correlation Between Serum PON1 Arylesterase Activity and Rs 854573 PON1 A < G Polymorphism with Type 2 Diabetes in an Eastern Indian Cohort

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder of glucose and lipids and characterized by defect in insulin secretion or action. Oxidative imbalance has also been implicated in the etiology of diabetes. Paraoxonase-1 (PON1) is an esterase and lactonase which is found in the circulation bound to high-density lipoproteins (HDL). Alterations and associations of circulating PON1 levels with a variety of diseases including diabetes encourages us to investigate the possible association between PON1 A/G rs854573 polymorphism and serum PON1 activity with T2DM. The study essentially follows a population based case-control format with 101 diabetic and 102 healthy controls. The findings revealed association of polymorphism with the diseased status (p value 0.0002, OR 3.49, 95% CI 1.77 to 6.9). With significantly higher range of mean serum PON1 Arylesterase (AREase) activity in control (9.99 – 0.96 kU/L) than in diabetic patients (5.25 - 0.508 kU/L) (p value,<0.001), a large difference between common diabetic AA genotype and combined diabetic heterozygous and homozygous genotypes (AG+GG) for risk allele G (assymptometic p value,<0.001), or in between two AA genotypes (Diabetic/Non diabetic, p<0.001), was explored by parametric and non parametric statistical pairwise comparison. Serum PON1 activity was found to be independent of other clinical factors such as plasma glucose levels. Western blot analysis of serum samples detected a significant difference of PON1 proteins in diabetic patients and control subjects (p value 0.008). In conclusion serum PON1 AREase activity which to an extent correlated with PON1 promoter polymorphism might be a good predictor of the disease risk.
Early intervention models of diabetes care to address adverse glycaemia in hospital

III DECLARATION . V PREFACE. VII ACKNOWLEDGEMENTS . IX PUBLICATIONS . XI CONFERENCE PRESENTATIONS. XII ABBREVIATIONS . XIII TABLE OF CONTENTS . XV LIST OF TABLES . XIX CHAPTER ONE: LITERATURE REVIEW . 1 1.1 DIABETES MELLITUS . 1 1.2 THE MODERN HOSPITAL IN AUSTRALIA . 3 1.3 DIABETES IN HOSPITAL . 4 1.3.1 Prevalence of diabetes in hospital . 4 1.3.2 Prevalence of new hyperglycaemia in hospital . 5 1.3.3 The significance of diabetes and new hyperglycaemia in hospital . 8 1.3.3.1 Mortality . 8 1.3.3.2 Infection . 11 1.3.3. 3 Length of stay and readmissions . 11 1.3. 4 Mechanisms for diabetes-related adverse outcomes in hospital . 12 1.4 ADVERSE GLYCAEMIA IN HOSPITAL . 14 1.4. 1 Acute hyperglycaemia . 14 1.4. 1.1 Pathophysiology . 14 1.4. 1.2 Adverse outcomes in different hospital settings . 15 1.4. 1.2.1 Acute myocardial infarction . 15 1.4. 1.2.2 Stroke . 16 1.4. 1.2. 3 Cardiac Surgery . 17 1.4. 1.2. 4 Critical Care . 17 1.4. 1.2. 5 Noncritical care . 19 1.4. 1.3 Summary . 21 1.4. 2 Acute hypoglycaemia. 22 1.4. 2.1 Pathophysiology . 22 1.4. 2.2 Adverse outcomes . 23 1.4. 3 Glycaemic variability . 26 1.4. 4 Glycaemic targets . 26 1.4. 5 Definition of adverse glycaemia . 27 1.5 DIABETES MANAGEMENT IN CRITICAL CARE . 28 1.6 DIABETES MANAGEMENT IN NONCRITICAL CARE . 29 1.6. 1 Traditional ‘reactive’ model of diabetes care . 29
Non-invasive Electroencephalography Method Development and Validation using Carbamazepine

Context: Recording of neurophysiological properties in a rodent model by stereotaxic surgery is well known, while the non-invasive method used to investigate the neurophysiological effects of studied using carbamazepine (CBZ). Aims: The effects of CBZ electrical activity of the brain recorded using a non-invasive technique and validated by an experiment involving stereotaxic surgery procedure are described in this paper. Settings and Design: To minimize painful procedures in rodents, an affordable technique was developed to record electroencephalogram (EEG) in the rodent model, and to the test drug molecules screened without giving any anesthetic agent. Methods and Materials: The present invention provides a disposable plastic foam EEG leads relates to a EEG component device for recording rat brain physiological changes in the form of EEG. This study was performed to quantify the pharmacodynamic properties of the CBZ. Rat surgery involving stereotaxic experiment used for validation process is described for the non-invasive method in this paper. Statistical Analysis Used: Paired t test used to calculate the differences in different EEG bands. Results: EEG analysis showed CBZ significantly increased in the delta and theta power and no effects on other the frequencies of the EEG. Similar observations were found in the invasive method of EEG in rats. Clinical and neurophysiological assessment using the simple, inexpensive technique of EEG observed. Conclusions: The results have shown CBZ induced a significant increase in slow activity waves represented by delta and theta waves. Administration of the carbamazepine in rats detected major neurological changes in the form of EEG and the technique of non-invasive EEG measurement found to be a useful tool to detect changes in the EEG.
Our experience of managing intertrochanteric fractures in osteoporotic patients with trochanteric femoral nail (TFN) and proximal femoral anti-rotation augmentation nail (PFNA2)

Introduction: Managing intertrochanteric fractures, especially the unstable variety has often been a challenge to the orthopaedic surgeon. However there is little data available when comparing the Trochanteric femoral nailing (TFN) and the Proximal femoral antirotation augmentation nail (PFNA2), especially in the background of an osteoporotic population. Aim: To compare the outcome of management of intertrochanteric fractures fixed with TFN and PFNA2 in the setting of osteoporosis. Materials and Methods: From June 2016 to October 2019, 40 cases of both stable and unstable intertrochanteric fractures were managed with TFN and PFNA II were followed prospectively. Postoperatively clinical and radiological outcomes assessed by tip-apex distance, union rate, Harris hip score, Singhs index. Patients were followed up for a period of six months. Result: This study was done in 40 patients with both stable and unstable intertrochanteric fractures, of which 20 of them managed with TFN and 20 managed with PFNA2. The most common mode of injury was a trivial fall followed by RTA. Fracture pattern segregated under Boyd and Griffin classification and majority of patients were found to fall under Type 2. Patients operated with PFNA2 had an average hospital stay of 15.2 days and 16 days for TFN. Patient was allowed to weight bear fully at 12.6 weeks in TFN and 12.2 weeks in PFNA2 averagely. Visible marked Union in X-rays was noted around 12-14 weeks in both TFN and PFNA2. Excellent results were found in about 90% of cases in PFNA2 group and in 85% of cases in the TFN group. The average Harris Hip Score was 84.57 and 86.56 in TFN and PFNA2 groups (p=0.54) respectively among patients with Singh’s grade 3, 2 (25%) in TFN group suffered from implant related complication whereas all 13 patients in PFNA2 group had successful outcome (p=0.04). Conclusion: In our study, PFNA2 is a technically and biomechanically more stable than TFN in the management of intertrochanteric fractures in setting of osteoporosis. Hence, we highly recommend use of the PFNA2 for the treatment of intertrochanteric fractures.
Comparative Outcomes of Bladder Cancer in Patients Under 40 Years of Age

Background and ObjectivesBladder tumours are rare in young patients. Consequently, the literature is sparse and studies provide con-flicting reports on clinicopathological data and patient outcomes. This study examines, to our knowledge, the largest UK series of patients aged less than 40 years diagnosed with bladder cancer, and examines their risks and outcomes.Material and MethodsA prospectively recorded database (2008-2018) was used to identify patients aged under 40 years diagnosed with bladder cancer. Data were retrospectively analyzed. Patients were then sub-divided into 2 groups based on age: group 1 was aged below 20 years and group 2 was aged 20–39 years.ResultsA total of 27 patients were identified with a median age of 34 years (range 14–39). Male to female ratio was 2.86:1. Median follow-up was 41.5 months (range 3–108). 61.9% presented with visible hematuria and 54.2% had one or more risk factors such as cigarette smoking. A total of 96.3% of patients had urothelial carcinoma and 92.3% of these were non-muscle invasive tumours. 7.7% presented with muscle invasive disease with 3.8% having positive nodes at diagnosis. Patients with non-muscle invasive urothelial tumours were risk-stratified according to the EAU-Guidelines Panel risk grouping with 39.1% low-risk, 4.3% intermediate-risk and 56.5% high-risk of recurrence and/or progression. During follow-up 30.4% recurred and 4.3% progressed to invasive disease. 23.1% underwent cystectomy and overall 11.5% died during follow-up, all due to metastatic disease. Patients in group one showed a statistically significant incidence of lower-grade disease at diagnosis with lower risk-group stratification but there was no significant difference in other parameters.ConclusionThe majority of young patients in our series presented with non-muscle invasive urothelial bladder tumours but a significant proportion of these had high-risk disease. Some patients presented with aggressive, muscle invasive bladder cancer and consequently bladder cancer remains an important differential diagnosis in symptomatic patients regardless of age.
Second malignancies in Philadelphia-positive and -negative myeloproliferative neoplasms: A single center study

Introduction: Leukemic transformation (LT) of both Philadelphia (Ph) -positive and -negative myeloprolifetarive neoplasms (MPNs) is a well-known subject. However sufficient data are not available in literature from Turkey about the frequency of second malignancies (SMs) except LT in patients with MPNs. In this study, it was aimed to investigate the frequency of SMs in Ph-positive or -negative MPN cases. Materials and Methods: A total of 438 patients diagnosed with classical MPN according to WHO 2008 diagnostic criteria were included in the study.Results: SMs were detected in 15 out of 438 patients (3.4%). In this study, cancer incidence rate was found higher (1149.8/100.000 person-years for males and 540.8/100.000 person-years for females with MPNs) compared with Turkey data. Conclusion: SM frequency is significantly higher than normal population in patients with MPNs. Therefore these patients should be carefully examined for SM symptoms and signs.
Assessment of Knowledge and Awareness on the Disposal of Expired and Unused Medicines among Medication Consumers

Objectives: Safe disposal of expired, unwanted, or unused medications by the consumers is a major challenge worldwide. The knowledge, attitude and practice of consumers on disposal of unused and expired medicines were assessed. Methods: Data on demographics, educational, occupation, socioeconomic status, drugs purchased, number of unused or expired drugs were obtained from medicine consumers. Knowledge, attitude and practice of safe disposal methods, number, most common class, dosage forms of leftover drugs and the reasons were assessed using a questionnaire. Effect of educational, occupational, socioeconomic status on purchase of drugs, awareness on the consequences of improper disposal of drugs were assessed using chi square test. Results: Of 145 participants, 46 % were females and 54% were males with a mean age of 36.76 + 13.60 years. 66 participants stated 1-5 drugs as leftover at home and the reason for possession of unused medicines as self-discontinuation after the condition was resolved. Most common drugs left unused at home were analgesics and the dosage form was tablets. 76.6% were unaware of the consequences of improper drug disposal. 65.5% stated the acceptable method to dispose medicines as collection of unused drug by Municipality. Majority (88%) disposed unused or expired medicines in the garbage. There was a statistically significant association between educational, occupational and socio economic status, purchase of drugs and awareness on consequences of improper drug disposal (P Key words: Drug disposal, Unused drugs, Expiry drugs, Knowledge, Awareness, Medicine consumers.
What Are the New Challenges of the Current Cancer Biomarkers?

Biomarkers are emerging research filed in the past decade. Even though numerous biomarkers were reported, the efficiency of cancer therapy remains low. So the question emerges as to how much can we trust the current biomarkers on cancer therapy? In this upcoming chapter, we would like to illustrate the outcomes of classical cancer therapies on advanced pancreatic cancer disclosed successful, neutral and failed in clinical trials. The analysis will be carried on the perspective interdisciplinary on the biomarkers including anatomy, physiology, pharmacology, biochemistry, history path and development of pharmacy. Particular in-depth insight may open a window for new researches and lighting the therapies.