Miracle-dz/UniFAR-FTUs huggingface dataset:
Unequal treatment: a feasibility study into epidural pain relief in childbirth

Obstetric data published by New Zealand's Ministry of Health (MoH) has demonstrated the existence of disparity between Māori and non-Māori in the provision of epidural pain relief in childbirth. The purpose of this study was to determine the feasibility of a larger study into the causes of disparity. Studies of ethnic disparity in obstetric pain relief were reviewed and then the sources of New Zealand data were investigated for their ability to provide useful information. Finally a small sample of obstetricians, anaesthetists, and midwives in Wellington were interviewed in order to gain insight that would hopefully stimulate further thought and discussion. Other studies showed that socioeconomic status, maternal education and age, and parity are influenced by ethnicity, and impact on whether a woman will receive epidural analgesia: as is the ability of clinical staff of ethnicities different to that of the woman in childbirth to accurately assess her level of pain. MoH data was found to be gathered from maternity provider funding claims rather than patient notes, there was no official definition of epidural analgesia, and local data gathering initiatives are not able to be interfaced with each other or the MoH data. In conclusion, potential sources of disparity were identified, but a larger study into disparity of epidural analgesia cannot be achieved using the available data. A study could be achieved by liaising with key providers to recruit a random sample of women who have recently given birth, using inpatient records for data collection.
Platelets and Serotonin in Migraine

Migraine headache is a disabling chronic condition, especially in women of childbearing age. Its etiology is currently unknown. The efficacy of serotonin receptor (5-HT1B/1D) agonists, triptans, in relieving attacks of migraine headache suggests a role for serotonin in the course of the headache. Platelets contain the largest reserve of serotonin stored in the body and thus, platelets may play a role in the etiology of migraine attacks. The literature is equivocal about the role of the platelet in migraine. This study has identified evidence of a bleeding diathesis, including menorrhagia, gum bleeding, gross hematuria, and ecchymosis, in migraineurs. Migraineurs also have fewer platelet dense granules in their platelets than healthy control subjects (1.61±0.14 vs. 3.85±0.14), but there are no significant differences in platelet serotonin and adenine nucleotide content.
Prevalence of Viral Hepatitis B in BPKIHS, Dharan, Nepal

Aim of the present study is to assess prevalence of viral hepatitis B in patients attending B. P. Koirala Institute of Health Science Dharan, Nepal. During a period of six months (Feb 1998 to July 1998) total 300 patients' sera were tested for hepatitis B surface antigen (HbsAg), of which 15 (5%) were found to be positive. The prevalence was higher (3.6%) in males than females (1.4%). The average age of males and females was 32 and 31 years respectively.
The Effect of Early Mild Permissive Hyperlactatemia Strategy on Patients with Acute Intracranial Hypertension Induced by Spontaneous Intracerebral Hemorrhage

Background: Dehydrating therapy to relieve brain edema is one of main methods to treat acute intracranial hypertension (ICH) after spontaneous cerebral hemorrhage. However, little is known regarding how much the negative fluid balance should be and indications of optimal fluid status. This study was to investigate whether mild permissive hyperlactatemia within initial 3-day is an available indicator guiding fluid management in patients with acute ICH. Methods: Adult patients of spontaneous cerebral hemorrhage with ICH admitted to the ICU and receiving dehydrating agents were retrospectively analyzed. The daily serum lactate concentration was collected over the first 3 days after admission. According to level of serum lactate, patients were divided into three groups (Normal-lactate group: 3.5 mmol/L respectively). And the main endpoint of this study was the 30-day mortality following ICU admission. Results: The mortality rate at 30 days in the high-lactate group patients was significantly higher than that in the other two groups (normal-group and mild-lactate group), (26.4% vs (16.5% and 10.9%), P<0.01). Furthermore, compared with the normal-lactate group, the 30-day mortality rate was significantly lower (10.9% vs 16.5%, P<0.01), the Glasgow Coma (GCS) Score at 7-day was better (10.8 ± 3.8 vs 8.3 ± 2.4, P=0.021), and the length of ICU stay was shorter (14.2 ± 7.3 vs 16.7 ± 8.6 d, P=0.015) in the mild-lactate group. Conclusions: In this retrospective cohort, mild permissive hyperlactatemia (2-3.5 mmol/L) over the first 3 days as a reference range that can be used to optimize fluid management in patients with ICH who accept dehydrating therapy.
Risk Factors for BI/NAP1/027 Clostridioides difficile Infections and Clinical Outcomes Compared With Non-NAP1 Strains

Abstract We aim to describe the characteristics, risk factors, and clinical outcomes associated with NAP1 strain Clostridioides difficile infection (CDI) in this single-center, retrospective, case–control (1:1) study. We found that the NAP1 strain accounted for 19.7% of CDI, and risk factors for acquisition included residence in skilled nursing facilities, previous CDI, and proton pump inhibitor use.
Migraine polygenic risk score associates with efficacy of migraine-specific drugs

Objective To assess whether the polygenic risk score (PRS) for migraine is associated with acute and/or prophylactic migraine treatment response. Methods We interviewed 2,219 unrelated patients at the Danish Headache Center using a semistructured interview to diagnose migraine and assess acute and prophylactic drug response. All patients were genotyped. A PRS was calculated with the linkage disequilibrium pred algorithm using summary statistics from the most recent migraine genome-wide association study comprising ∼375,000 cases and controls. The PRS was scaled to a unit corresponding to a twofold increase in migraine risk, using 929 unrelated Danish controls as reference. The association of the PRS with treatment response was assessed by logistic regression, and the predictive power of the model by area under the curve using a case-control design with treatment response as outcome. Results A twofold increase in migraine risk associates with positive response to migraine-specific acute treatment (odds ratio [OR] = 1.25 [95% confidence interval (CI) = 1.05–1.49]). The association between migraine risk and migraine-specific acute treatment was replicated in an independent cohort consisting of 5,616 triptan users with prescription history (OR = 3.20 [95% CI = 1.26–8.14]). No association was found for acute treatment with non–migraine-specific weak analgesics and prophylactic treatment response. Conclusions The migraine PRS can significantly identify subgroups of patients with a higher-than-average likelihood of a positive response to triptans, which provides a first step toward genetics-based precision medicine in migraine.
Using digital storytelling as a source of empowerment for rural women in Benin

ABSTRACT Digital storytelling offers a combination of traditional storytelling and new technologies that is attracting attention from feminist researchers aiming to co-create research in empowering ways for participants, allowing them to collaborate, build shared awareness of issues, and share their priority issues with decision-makers and power-holders. This article focuses on digital storytelling in research into the role of Mothers’ Associations in influencing families, communities, and political decision-makers to promote girls’ education in Benin.
Effects of age and gender on academic achievement of vocational and technical education (VTE) students of a Nigerian university

Age and gender differences in students' enrolment in vocational technical education necessitated the study to determine their effects on students' academic achievement. Three research questions and one hypothesis tested at 0.05 level of significance guided the study. The survey design was adopted and the study was conducted in Anambra state. The population was 117 (44 males and 73 females) 2012/2013 graduates of the programme. Their computed degree results showing age, gender and final cumulative grade point average was collected from the Department and used for the study. Linear regression, ANOVA and Chi Square were used for data analysis. Findings of the study revealed that a linear relationship does not exist between the two predictor variables and the university VTE students' academic achievement and that their combined contribution is insignificant. However, the study revealed differences in the students' academic achievement as a result of age and gender. Based on the findings, the researchers conclude that age and gender have effects on the academic achievement of university VTE students which could be as a result of the fact that the programme involves Mathematics, science and ICT as reported by earlier researchers. Based on the findings and conclusion of the study, the researchers recommend, among others, that parents and the society should eliminate fears in all students, especially female students, towards the study of Mathematics, science and ICT related courses and that university VT lecturers should adopt teaching methods that enhance learning effectiveness for all students irrespective of age and gender.
İlköğretim Okulu Yöneticilerinde Tükenmişlik

The aim of this study is to investigate if there is an association between the level of burnout and independent variables of the research and to measure the level of burnout in primary school administrators who were predisposed to burnout, and its relations with educational and managerial problems, overwork, inadequate fee, and some other factors assumed to be related with burnout. Data were collected by using a questionnaire developed by Friedman. The questionnaire was named by Friedman "Friedman School Principal Burnout Scale". The questionnaire was applied by researchers at primary schools. Frequencies, arithmetic averages, Standard deviations were tabulated and differences in school administrators perceptions by gander, kind of job , duration of service and kind of education (related to educational administration) were tasted by using variance and t test. The results indicated that there are some problems in administration of the primary schools about burnout, and some differences in perceptions of primary school administrators related to sub dimension
Applicability of lung immune prognostic index (LIPI) to predict efficacy of first-line pembrolizumab in advanced non-small cell lung cancer (NSCLC)

Abstract Background Derived neutrophils/(leukocytes-neutrophils) ratio (dNLR) and lactate dehydrogenase (LDH) level have been correlated with immune checkpoint inhibitors (ICI) outcomes. A lung immune prognostic index (LIPI) that showed association with ICI outcomes was developed by Mezquita L et al. based on these 2 systemic inflammation indicators (dNLR upper limit of normal (ULN)), characterizing 3 prognostic groups: good, 0 factors; intermediate, 1 factor; poor, 2 factors. This index hasn’t been specifically studied in first-line setting of NSCLC with pembrolizumab monotherapy. Methods This is a multicenter retrospective study to explore the prognostic value of LIPI score in treatment-naive advanced NSCLC with high PD-L1 expression ( > =50%) treated with pembrolizumab. Consecutive patients treated in 19 Spanish hospitals between March 2015 and April 2019 were included. Pretreatment LIPI score was calculated for all subjects and primary endpoint was OS. Results 223 patients were included. Mean age 67 years (SD 9.8). 77.6% were male and 75% PS Conclusions LIPI score was able to define a group of patients with poor benefit from pembrolizumab monotherapy in such a selected population (advanced NSCLC with high PD-L1 expression) with high probability to get benefit from it according to KN-024. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.
Protective effect of Zincum metallicum on rat model of Parkinson′s disease

Background: Parkinson′s Disease (PD) is one of the major neurodegenerative disorders, and oxidative stress has been implicated in playing an important role in the pathogenesis of the disease. Zincum metallicum, produces symptoms mentioned in Homoeopathic Materia Medica which are akin to PD on which basis it might be considered as one at the intermediate to treat the disease. Materials and Methods: Rats were divided into eight groups; surgery was done by stereotaxic apparatus. 6 - hydroxydopamine was used to induce parkinsonism thereafter on 16 th day of lesioning animals were assessed by the video path analyzer. Animals were sacrificed and biochemical assays (Lipid peroxidation [LPO], glutathione [GSH], glutathione peroxide [GPx], glutathione reductase [GR], glutathione-S-transferase [GST]) and level of dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), and homovanillic acid (HVA), were estimated. Further dopaminergic D 2 receptor binding was also done to confirm the induced parkinsonism. Results: The behavior activities (locomotor, distance travel, stereroevent) were decreased whereas the rest time was increased in lesion group animals as compared to the sham group. The locomotor activity and the distance traveled were protected significantly with 6C whereas rest time was protected significantly with 30C and 200C of Homoeopathic medicine Zincum metallicum. On the other hand, S + 30C and S + 200C groups have shown increased locomotor activities as compared to S group. The rest time was also increased significantly in S + 6C and S + 30C group animals as compared to S group. The elevated level of LPO and DA D 2 receptor binding density in PD group was protected significantly with Zincum metallicum (6C, 30C, and 200C). The depleted level of GSH and activity of antioxidant enzymes (GPx, GR, and GST) and DA and its metabolites DOPAC and HVA were protected significantly with Zincum metallicum (6C, 30C, and 200C). Conclusion: The study indicates the Zincum metallicum may be helpful in slowing down injury in parkinsonism and could be a beneficial drug for the prevention of PD.
Effect of Skin to Skin Contact on Maternal State Anxiety in a Cesarean Section Ward

Introduction: This study aimed at investigating the effect of skin to skin contact (SSC) on maternal state anxiety (MSA) in cesarean section unit in Akbarabadi Hospital in Tehran. Methods: In a randomized controlled trial, 60 Iranian mothers with at least one record of cesarean section delivery were assigned to two intervention (SSC) and control groups. In the morning shift and two hours after the operation, as a routine postoperative care, pain- killers were given to all mothers. Then the mothers' pain scores were measured using visual analog scale (VAS). If VAS was≤3, MSA was measured by using the State-Trait Anxiety Inventory (STAI) Scale (Spiel Berger). Thirty minutes of SSC intervention was done for mothers in the intervention group. Six hours later, in case VAS was ≤ 3, MSA was re-measured by using the Spiel Berger Scale for all mothers. Results: Six hours after implementing the intervention, there were no meaningful statistical differences between the MSA mean scores of the two groups, but severity of MSA in intervention group was less than that of the control group (P=0.037). Six hours after the intervention, there was a significant decrease in the MSA mean score in SSC group (P=0.002). Conclusion: As regards the important role of constant anxiety in developing postpartum depression, and as the results of this study indicate, SSC is recommended in postpartum and especially cesarean section wards.
psychogeriatric problems seen in the primary care arm of a tertiary hospital in calabar south south nigeria

Introduction: Mental health problems in the elderly are protean and are often under diagnosed and poorly treated. This study sought to identify common psychogeriatric problems in our setting and the factors associated with mental health challenges in elderly patients attending our Geriatric Outpatient Clinic. Materials and Methods: This work was carried out in the Family Medicine Geriatric clinic of the University of Calabar Teaching Hospital in the South-South geo-political region of Nigeria. It had an analytical cross-sectional study design. Three hundred and twenty subjects were recruited for the study by systematic random sampling. Tools used for the study included the Geriatric Depression Scale, Generalized Anxiety Disorder Scale, and Mini-Mental State Examination. Results: Of the 320 subjects recruited, 138 (43.1%) were males and 182 (56.9%) females. Depression 186(58.1%) was the commonest mental health problem in this study and some of the factors that were significantly associated with it were: female gender (p=0.010) and marital status (p=0.036). Independent predictors of mental health problems were: living arrangement (those living with family were less likely to have mental health problems [OR: 0.215, p=0.019]) and level of education (those who had at least secondary level of education were less likely to have mental health problems [OR: 0.435, p=0.025]). Conclusion: This study remarkably identified modifiable factors associated with mental health problems in the aged in our experience. The report should stimulate the desire to proffer intervention strategies to reduce these problems and generate more interest in research in this regard in our environment.
Metabolic syndrome among obese adults in Baghdad, Iraq

Background: Metabolic syndrome is a cluster of interconnected factors that directly increase the risk of coronary heart disease, other forms of cardiovascular atherosclerotic diseases, and diabetes mellitus type 2. Obesity and physical inactivity are the driving forces. Objective: To explore the magnitude of metabolic syndrome (and some associated factors) in a sample of obese adults attending the main Nutrition Clinic in Baghdad, Iraq. Materials and methods: This cross-sectional study that included 440 obese attended the Nutrition Clinic at Al-Yarmouk Teaching Hospital was conducted during a period of six months (March to September 2016). All the patients were interviewed on voluntary base. Height, weight, and waist circumference were measured to diagnose obesity. Blood pressure, fasting blood sugar, and lipid profile were also measured. Results: The prevalence of metabolic syndrome among obese was 40.6% more in females (42.8%) than males (36.5%). The main associated factor was central obesity, followed by diabetes mellitus, dyslipidemia, and hypertension. The old individuals and women who had 9 to 12 children showed the highest frequencies (55 and 61.5%), respectively. Conclusion: Metabolic syndrome among Iraqi obese is relatively common. Female gender, old age, and multiparity can be regarded as risk factors.
Phase I cancer trials: a qualitative study of specialist palliative care

Objective In recent years, a simultaneous care model for advanced cancer patients has been recommended meaning that palliative care services are offered throughout their cancer journey. To inform the successful adoption of this model in a phase I trial context, the study aimed to explore patients’ care needs and their perceptions of specialist palliative care. Methods Semi-structured interviews were conducted with 10 advanced cancer patients referred to the Experimental Cancer Medicine team. Interviews were transcribed verbatim and thematically analysed with a framework approach to data organisation. Results Despite reporting considerable physical and psychological impacts from cancer and cancer treatment, participants did not recognise a need for specialist palliative care support. Understanding of the role of specialist palliative care was largely limited to end of life care. There was perceived conflict between considering a phase I trial and receiving specialist palliative care. Participants felt specialist palliative care should be introduced earlier and educational resources developed to increase patient acceptability of palliative care services. Significance of results Patients with advanced cancer referred for phase I trials are likely to benefit from specialist palliative care. However, this study suggests patients may not recognise a need for support nor accept this support due to misperceptions about the role of palliative care. Developing a specific educational resource about specialist palliative care for this population would help overcome barriers to engaging with a simultaneous care model.
Are Hypothyroidism and Obstructive Sleep Apnea Independent Risk Factors for the Development of Non-alcoholic Fatty Liver Disease?: 901

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is defined as the accumulation of fat in the liver so that it weighs more than 5% of the total liver weight. Over the past decade, there has been growing evidence in regard to the association between NAFLD/NASH and both thyroid dysfunction and OSA. Design/Method: A retrospective analysis was performed using the National Inpatient Sample (NIS) database for 2010. The variables included in this study were identified using ICD9 codes for 2010. A Case-Control design was used to compare the cohorts. A binary and multiple logistic regression statistical tests were used to examine the prevalence and the relative risk of having NASH among people with hypothyroidism and OSA. IBM SPSS Statistics for Windows. Results: Approximately 32,000 patients with NASH and randomly selected 28,000 without NASH were identified for the study. Within the NASH group, 4,097 (11%) were found to have coexisting hypothyroidism, and 4,213 (12.7%) patients of the Non-NASH group had hypothyroidism. Patients with hypothyroid disease has almost the same probability of having NASH compared to individuals without hypothyroidism (crude odds ratio is 1.1, adjusted odd ratio is 0.7, CI 95%, P=0.00). In the Nash group, 937 (2.5%) were found to have OSA, whereas (1.25%) 383 patients only have OSA in the Non-Nash group. People with obstructive sleep apnea have 2.3 higher probabilities to have NASH than people without history of sleep apnea (crude odd ratio is 2.3, adjusted odd ratio is 1.72, P=0.00, CI 95%). Conclusion: People with obstructive sleep apnea are almost two times more likely to have NAFLD than people without obstructive sleep apnea. On the other hand, Hypothyroidism was not found to be a risk for NAFLD.
Impact of a one-year behavioral weight management program on depressive symptoms in older adults

While it has been widely recognized that both exercise and weight loss benefit older adults with obesity and depressive symptoms, the ability of these individuals to complete and benefit from lifestyle programs is unknown. This essay looks at whether older adults with mild depressive symptoms (Center for Epidemiological Studies-Depression/CES-D score of 11 or more) benefit from a one-year lifestyle intervention in terms of change in depressive symptoms, weight loss, and physical activity measured at either 5, 9, or 13 months. In the Mobility and Vitality Lifestyle Program (MOVE UP) study, no statistically significant difference was found between the drop-out rate of participants with mild depressive symptoms compared to those without mild depressive symptoms. The overall dropout rate from the study was 13.6% over 13 months. In addition, participants with mild depressive symptoms showed statistically significant improvements in their mean CES-D scores of -3.9 points at 5 months (p<0.001) and -3.1 points at 13 months (p=0.004). These changes were independent of weight loss or a change in activity levels. Although regression to the mean may play a role in this finding, the amount of change suggests a meaningful effect. Overall, this study supports the inclusion of older adults with mild depressive symptoms in lifestyle improvement programs. Our findings show that the majority of participants were able to successfully complete the program, and that over the course of the intervention, they lost weight and had a decrease in depressive symptoms.