Miracle-dz/UniFAR-FTUs huggingface dataset:
Assessing mobility in multiple sclerosis using the Rivermead Mobility Index and gait speed

Measurement tools assessing disability in MS patients are essential to evaluate the effect of the growing number of drug treatments and to measure rehabilitation outcome. However, the most widely used EDSS (Expanded Disability Status Scale) has been shown to be insensitive to minor changes. The assessment of disability with simple measures such as the Rivermead Mobility Index (RMI) and gait speed timed over 10 m has been suggested. Two hundred MS patients attending a rehabilitation centre were assessed at the beginning and at the end of a four-week period (median 28.2 days; interquartile range (IQR) 1.8 days) using these two measures as well as the EDSS and the Ambulation Index (AI). The RMI was the most sensitive scale and measured changes in 39% of the patients, whereas AI changed in 18.5% and EDSS in only 7.5% of the patients. The RMI assessed more precisely ambulatory patients needing walking aids, for which EDSS proposes only two options (EDSS 6.0/6.5). To measure the variability of the 10 m walking time, 25 of the 115 ambulant patients were asked to cover the distance at five different times on the same day chosen at random. Variability within one patient on test-retest was calculated by dividing the standard deviation of the five measures by the mean value of the measures. In spite of its great variability of 20 ± 8%, gait speed timed over 10 m was as sensitive as the AI and measured changes in 16.5% of these ambulatory patients (AI in 15.6%). The RMI and gait speed timed over 10 m should be used more widely to assess disability and to measure the physiotherapeutic effort devoted to improving mobility of MS patients.
Reviewing art therapy research : a constructive critique

The literature search that informed our review initially yielded 12,122 papers of potential interest, derived from seven databases. After applying a series of filters we arrived at 92 papers on which we base our findings, thoughts and recommendations for future work. Our methodological approach was informed by the systematic review guidance published by the Centre for Reviews and Dissemination (2009), and the Arts Council definition of ‘arts activities’. Hence we considered papers reporting therapeutic arts interventions conducted on 'patients' which included some measurement of a health state. After excluding any research on people less than age 18, we selected studies where participants had active (as opposed to passive) engagement with the therapy/treatment/medium. Only study types which were quantitative were included in this review. Rather than simply criticise the execution of the research we applied our own expertise to the process. It was immediately evident that definitions and categories would pose some difficulties as there is much variety in the language used to describe the arts, therapies and treatment. This is a problem of indexing, causing the literature search and initial screening to be a laborious process. The most commonly reported art activities were: writing, music, art and dance. The most numerous health condition studied was mental health followed by cognitive function, stress and cancer. Most research was carried out in the US and the UK. As a discipline, psychology featured regularly. When arts therapists were involved in the research the descriptions and possible effects of the art medium tended to be better elucidated. Future research into the use of art therapy in healthcare will benefit from a synthesis of approaches that can retain the more robust aspects of, for example, RCTs with the insights that can be derived from qualitative methods.
FETAL ORIGINS OF ADULT DISEASE: WHERE DO WE STAND?

The ‘fetal origins’ hypothesis would predict that the rising epidemic of diabetes and CHD in India would be due to poor intrauterine growth of the India babies. While this explanation may be valid to an extent, the higher prevalence of these disorders in urban compared with rural India (where birth weights are lower) would suggest a significant role for postnatal factors. In a cohort of 477 children born in the King Edward Memorial Hospital, Pune, we found that at eight years of age, current obesity strongly predicted insulin resistance. When this effect was allowed for, low birth weight was significantly associated with insulin-resistance variables and other cardiovascular risk factors. Children who were born small but had grown heavy (or tall), were the most insulin resistant and had the highest levels of cardiovascular risk factors. Accelerated growth in relation to mid parental height was similarly predictive. Poor intrauterine growth also predicted higher central adiposity at eight years of age. We have also studied maternal nutrition and fetal growth in six villages near Pune. A newborn Indian baby is small (2650g, SD score (SDS)- 1.6 compared with an average white Caucasian baby born in the UK) and ‘thin’ (ponderal index 2.45 kg/m 3 , SDS-1.2), but has preserved its subcutaneous fat (subscapular skinfold thickness SDS-0.6). The thinness of the Indian babies is due to poor muscle and small abdominal viscera. We have proposed this composition as the ‘thrifty phenotype’ of Indian babies. Maternal size and intake of certain food groups during pregnancy were important determinants of the baby’s phenotype. Thus, the small Indian babies are programmed to deposit fat from their intrauterine life. Exaggeration of this tendency in later life is associated with Insulin resistance syndrome. Control of the insulin-resistance epidemic in India might depend on improved intrauterine development and prevention of childhood obesity.
Analysis of pathologic lesions in the livestock and poultry slaughtered in the meat establishments of Lithuania.

Summary. The aim of study was to perform the analysis of pathological lesions in the livestock and poultry slaughtered in the meat establishments of Lithuania from 2000 to 2009 and to estimate the disease incidence investigating the post-mortem findings. It has been established that during the survey period, the highest number of pathologic lesions was registered in clinically healthy pigs: 14.92 ± 1.57 %, and the lowest number – in poultry: 0.95 ± 0.21 % (p < 0.001). The majority of lesions in poultry, pigs and cattle were classified as the lesions typical for non-infectious diseases − 98.70 %, 82.24 %, and 64.49 %, respectively. Although considerable lesion variations were observed in the organs or systems of different species of animals and poultry, the species influence on the incidence of lesions was statistically insignificant. The highest number of lesions was detected in the respiratory system and liver of cattle and pigs, and in the limbs and liver of turkeys.
Prevalence of Attention Deficit Hyperactivity Disorder in a Group of Elementary School Children

Objective: The purpose of this study was to examine prevalence of three subtypes of attention deficit hyperactivity disorder (ADHD) including attention deficit type, hyperactivity type, and combined type in a group of elementary school children in Shiraz. Material & Methods: For this purpose 1311 students (644 boys and 667 girls) aged 7-12 years were recruited using cluster random sampling. The instrument used in this study was the SWAN questionnaire (Swanson, Schuck, Mann, Carlson, Hartman & Sergeant, 2004). Findings: The results revealed that 5% to 8.5% of elementary school children show symptoms of one of the subtypes of ADHD. The results also revealed that the prevalence of hyperactivity disorder decreased with age while the prevalence of attention deficit increased with age. The prevalence of hyperactivity and attention deficit disorder in boys was not significantly different than in girls. However, the prevalence of combined type of disorder was significantly higher in boys than in girls. In addition, mean scores of the attention deficit, hyperactivity and combined type of disorder were significantly different in different socio-economic groups. Conclusion: Prevalence of the subtypes of the disorder was different across age and gender and children with lower socio-economic status are in danger of higher mean scores in all subtypes of the disorder.
Smoking, ACP1 and Infertility in Subjects with Varicocele

Several studies suggest that smoking may have detrimental effect on seminal parameters and that genetic polymorphisms may influence this effect. In the present paper we have examined the relationship between ACP1 genotypes and the association of smoking and infertility in a sample of men with varicocele. 126 subjects with varicocele were studied. ACP1 genotype was determined by DNA analysis and statistical analyses were performed by SPSS software. In general there is a protective action of low activity *A/*B genotype against infertility that is much more marked in smokers than in non-smokers. If confirmed in other clinical settings, determinations of ACP1 genotype could have practical importance to evaluate the risk of infertility in smokers with varicocele.
Undue Burden Beyond Texas: An Analysis of Abortion Clinic Closures, Births, and Abortions in Wisconsin

In this paper, we estimate the impacts of abortion clinic closures on access to clinics in terms of distance and congestion, abortion rates, and birth rates. Legislation regulating abortion providers enacted in Wisconsin in 2011-2013 ultimately led to the closure of two of five abortion clinics in Wisconsin, increasing the average distance to the nearest clinic to 55 miles and distance to some counties to over 100 miles. We use a difference-in-differences design to estimate the effect of change in distance to the nearest clinic on birth and abortion rates, using within-county variation across time in distance to identify the effect. We find that a hundred-mile increase in distance to the nearest clinic is associated with 25 percent fewer abortions and 4 percent more births. We see no significant effect of increased congestion at remaining clinics on abortion rates. We find significant racial disparities in who is most affected by abortion clinic closures, with increases in distance increasing birth rates significantly more for Black, Asian, and Hispanic women. Our results suggest that even small numbers of clinic closures can result in significant restrictions to abortion access of similar magnitude to those seen in Texas when a greater number of clinics closed their doors.
The influence of age and lutein status on vestibular and auditory function

Lutein (L), zeaxanthin (Z), and the stereoisomer meso-zeaxanthin comprise the macular pigment (MP). Retinal LZ are positively related to LZ in the cerebellum, a region of the brain important for vestibular function. In this study, we assessed longitudinal changes in MP density and vestibular function in 19 older adults. MP density was assessed non-invasively with heterochromatic flicker photometry. Vestibular function was assessed with the One Foot Balance test. The primary result was that MP density, on average, increased over the time periods studied. Vestibular function, as expected, decreased. MP and vestibular function were not related (likely due to low statistical power).
Long-Term Persistence of Diastolic Dysfunction and Dyspnea in Patients who Underwent Aortic Valve Replacement for Aortic Valve Stenosis

Background: Aortic stenosis (AS) requires treatment when is severe and symptomatic. However, after the correction of the AS, some patients still remain symptomatic. Severe AS can lead after aortic valve replacement to heart failure with preserved ejection fraction (HFpEF). We sought to describe the clinical status and to characterized patients based on E/e’ at 1-year follow-up of patients operated for an AS according to current guidelines. Method and Results: 236 patients were prospectively included before AVR (surgical or transcatheter) and followed-up at one year with a standardized clinical and echocardiographic evaluation. Among 191 patients evaluated at follow-up (FU), 82 (43%) remained symptomatic (NYHA ≥II). Persistence of dyspnea at 1-year FU was associated with more severe echocardiographic diastolic function indices. Diastolic dysfunction (DD) was still demonstrated in 120 (63%) patients at one year. Using E/e’ as a surrogate marker of DD and elevated filling pressures, it was possible to characterize determinants of its persistence (E/e' ≥ 14). Our model demonstrated that patients with severe pre-operative DD (baseline E/e' ratio >16 and mitral E wave velocity >111 cm/s) had persistent elevated LV filling pressures, as opposed to patients who underwent surgical valve replacement with a baseline E/e' ratio ≤ 16 who mostly normalized their LV filling pressure. Conclusion: 43% of treated AS patients remain symptomatic. DD characterization according to current standards allowed to predict E/e’ at one-year post AVR.
Moyamoya Disease:The Differences between Age Groups in Clinical Presentation and Hemodynamic Characteristics

oyamoya disease(MMD is defined as the development of collateral anastomosis pathways associated with bilateral chronic progressive stenosis of the carotid fork. We have reviewed the types of presentation angiograms and single photon emission computed tomographs(SPECT. Ninety-nine patients were divided into three groups (aged below 5 years between 5 and 15 years and 16 or over to investigate whether there were differences in clinical presentation and hemodynamic characteristics between the age groups. Mean age of the 99 patients was 13.6 years and the mean duration of symptoms was 26.2 months. In the 17 children aged less than five the duration of symptoms was shorter(4.8 months than in older patients(p<0.05. The former presented mostly with cerebral infarction(59% with a widespread cerebral perfusion defect(50%. Among 56 children who were 5 to 15 years old 42 (75% presented with transient ischemic attacks and 10(18% with cerebral infarction； the latter was less frequent in this age group than in other age groups. Twelve(46% out of 26 adult patients had hemorrhage at the initial diagnosis which was the most frequent presentation in this age group. Stenosis of the posterior cerebral artery was detected in 27% of adult MMD patients while it was detected in 39% of children. Moreover no case showed widespread perfusion defects in the adult group. The results suggest that the patterns of presentation and the hemodynamic features differ according to the age at which initial major symptoms occur. Children aged less than five suffer rapid progression of the disease and severe cerebral pefusion defect and should therefore undergo early surgery. The less frequent involvement of MMD in the posterior circulation and better-preserved cerebral perfusion are characteristic findings of the disease in adults and this seems to account for its delayed onset.
High Disease-Free and Overall Survival Rate Following Allogeneic Hematopoietic Stem Cell Transplantation for FLT3-Mutated Acute Myeloid Leukemia Even in Non-Remission Status

[Background] FMS like tyrosine kinase 3 (FLT3) mutations occur in about 30% of patients with acute myeloid leukemia (AML). Patients with FLT3-mutated AML have a poor prognosis and are referred for early allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first complete remission (CR1). So far, there is still limited data available on allo-HSCT for FLT3-mutated AML in non-remission status. [Objective and method] To assess the clinical features and outcome of allo-HSCT for FLT3-mutated AML, we retrospectively analyzed patients underwent first allo-HSCT for FLT3-mutated AML excluding acute promyelocytic leukemia (FAB M3) from January 2011 to March 2016. [Result] During the study period, 332 patients received first allo-HSCT for AML in our institute. One hundred and thirty-eight were tested for the presence of FLT3-mutation and 35 showed positive results and were subjected to the analysis. The median follow-up day of survivors was 602 (101-1867). The median age of the patients was 55 years (range, 21-72). Twenty-one patients had de novo AML, 12 had AML with myelodysplasia related changes, and 2 had therapy related AML. Eighteen had normal karyotype, 4 had complex, and 13 had others. Seven were in remission (5 in CR1, and 2 in CR2), and 28 were in non-remission (8 in primary induction failure, 13 in relapse 1, and 7 in chemo naive status). Twenty-nine patients used unrelated cord blood, 2 did unrelated bone marrow, and 4 did related peripheral blood stem cell as grafts. All but 1 received myeloablative pretransplant conditionings. At 2 years after transplantation, overall survival (OS), disease free survival (DFS), relapse rate (RR), and non-relapse mortality (NRM) of whole studied population were 65.9%, 50.2%, 28.4%, and 21.4%, respectively. Among those in non-remission before transplantation, OS, DFS, RR, and NRM at 2 years post-transplant were 62.2% (Figure 1A), 49.9%(Figure 1B), 24.3%, and 25.8%, respectively. Only younger age ( [Conclusion] Our data indicated that allo-HSCT could overcome the poor prognosis of FLT3-mutated AML even for those in non-remission status, despite the profound chemo-resistant character of FLT3-mutated AML. Disclosures Izutsu:Abbvie: Research Funding; Gilead: Research Funding; Celgene: Research Funding; Janssen Pharmaceutical K.K. : Honoraria; Eisai: Honoraria; Kyowa Hakko Kirin: Honoraria; Chugai Pharmaceutical: Honoraria, Research Funding; Takeda Pharmaceutical: Honoraria; Mundipharma KK: Research Funding.
Fluoroquinolone Resistant Escherichia Coli and Klebsiella Spp. in Community-Acquired Urinary Tract Infections in Rural Kanpur, India

Introduction: In the community, most of the patients are treated by the local physicians with empirically chosen antimicrobials, without any laboratory confirmation. The aim of the present study was to determine the aetiology and the antimicrobial susceptibility of the uropathogens in culture-positive, communityacquired urinary tract infections in the rural areas around Mandhana, Kanpur, over a period of 14 months. Materials and Methods: The patients who presented with the symptoms of Urinary Tract Infection (UTI) were included in this study. The samples were inoculated in the camp on MacConkey’s agar (MAC) and Sheep Blood Agar (SBA). The incubation, identification and the Antimicrobial Susceptibility Tests (AST) for the organisms which were done in the hospital laboratory. Results: The most common bacteria which were isolated in all the age and gender groups were Escherichia coli (54%) and Klebsiella spp (11.3%). Among the oral antimicrobials which were usually prescribed by the local physicians in Kanpur, lomefloxa cin, amoxicillin/sulbactum and nitrofurantoin were the ones to which the Enterobacteriaceae family was the most susceptible to. The resistance rate of Klebsiella to most of the antimicrobials was high (>20%). The resistance to the antimicrobials did not vary significantly with age, sex or any demographic factors. Conclusion: The empirical treatment of the Community Acquired Urinary Tract Infections (CAUTIs) in the rural areas of Kanpur with co-trimoxazole, chloramphenicol, ciprofloxacin or norfloxacin is inadequate. Amoxicillin/sulbactum, nitrofurantoin or lomefloxacin should be the drugs of choice.
Geographical distribution of gynecologists and midwives in Kermanshah province (2008-2013)

Background : Women's health and prenatal care have always been important issues for health authorities and policy makers. The purpose of this study was to investigate the geographical distribution of gynecologists and midwives and to determine their distribution trend in Kermanshah province in the period 2008-2013. Methods: Gini coefficient was used to analyze the distribution of human resources involving in women’s health and t-test was used to examine the assumption of equal distribution of the resources. Gini coefficient was calculated for gynecologists and midwives on the basis of number of live births per year and women population. Four regression models were fitted to determine the time trend of inequality. Results: Gini coefficients for gynecologists and on the basis of the number of women for the study period were 0.489, 0.587, 0.677, 0.545, 0.474 and 0.46, respectively. The minimum and maximum Gini coefficient based on the number of live births were 0.457 and 0.566, respectively. The Gini coefficient for midwives on the basis of the number of women decreased from 0.249 in 2008 to 0.215 in 2013. Moreover, the minimum and maximum Gini coefficients based on the number of live births were 0.268 and 0.397, respectively. Inequality declined during the study period, but was not statistically significant. Conclusion: the distribution of human resources associated with the women's health has improved in recent years, however, it is still far from ideal distribution of the resources. Therefore, the women are recommended to be provided with adequate healthcare services by performing the required planning.
Comparative Analysis of Safety, Efficacy and Fetomaternal Outcome of Induction of Labour with Mifepristone versus Intracervical Dinoprostone Gel.

Mifepristone and Dinoprostone used in inducing labour in late pregnancy by acting as cervical ripening drugs. Present study was done to compare and portrait the beneficial effects of both the drugs for induction of labour. The objective was comparative analysis of safety, efficacy and fetomaternal outcome of induction of labour with Mifepristone versus intracervical Dinoprostone gel. 100 patients were included after taking their informed consent. 50 patients were placed in each group A and B. Tablet Mifepristone 200mg orally was given in group A patients and intracervical gel induction was done in group B patients. Pre induction Bishop’s score was noted at beginning to compare improvement in Bishop’s score after induction, mode of delivery and induction-delivery interval in both the groups. Rate of successful IOL or vaginal delivery was 84% with Mifepristone and 56% with Dinoprostone. After induction with Mifepristone 94% women had cervical ripening as compared to 80% with Dinoprostone. 20% Mifepristone treated group required Oxytocin for augmentation as compared to 56% in Dinoprostone. Among the babies, 6% and 14% belonging to Mifepristone and Dinoprostone group respectively, required NICU admissions. In the present study, women who were induced with Mifepristone showed significantly more improvement in Bishop’score than Dinoprostone. Although overall average induction- delivery interval was more in Mifepristone group (29hours) than Dinoprostone group (21hours), vaginal mode of delivery with Mifepristone was more, decreasing the incidence of caesarean section with lesser need for augmentation with Oxytocin. Lesser NICU admissions and maternal complications were noted with Mifepristone. Thus, Mifepristone is a better drug for successful induction of labour as compared to Dinoprostone with a better fetomaternal outcome.