Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence, awareness, treatment, and control of diabetes and hypertension among elderly persons in a rural area of Ballabgarh, Haryana

Background: In India, from 1971 to 2011, the proportion of elderly population has increased from 5.3% to 8.6%. According to the National Sample Survey, 60th round (2004), out of every 1000 elderly persons living in rural India, 40 were estimated to be diabetic, and 36 were estimated to be hypertensive. The objective of the study was to find the prevalence of diabetes and hypertension in elderly persons in a rural area of Ballabgarh, Haryana, and to assess the awareness, treatment, and control among them. Method: A total of 420 persons aged 60 years and above were selected by simple random sampling. House-to-house visit was done. A pretested interview schedule was administered. Blood pressure was measured using digital blood pressure machine. Two milliliters of venous blood was collected in vials for HbA1c estimation. Results: Of the 420 participants, 386 were available for blood pressure measurement, and 374 were available for HbA1c estimation. The prevalence of diabetes was 21.7%, and that of hypertension was 50.3%. Among diabetics, 45.7% were aware, of which, 94.6% were treated, and among them, 34.3% had their blood sugar under control. Among hypertensives, 58.8% were aware, of which, 96.5% were treated, and of the treated participants, 24.5% had controlled blood pressure. Conclusion: The high prevalence, low awareness, and low proportion of controlled diseased population highlights the importance of strengthening primary care and improving awareness about diabetes and hypertension among elderly persons in rural areas.
Can the Use of Bayesian Analysis Methods Correct for Incompleteness in Electronic Health Records Diagnosis Data? Development of a Novel Method Using Simulated and Real-Life Clinical Data

Background: Patient health information is collected routinely in electronic health records (EHRs) and used for research purposes, however, many health conditions are known to be under-diagnosed or under-recorded in EHRs. In research, missing diagnoses result in under-ascertainment of true cases, which attenuates estimated associations between variables and results in a bias toward the null. Bayesian approaches allow the specification of prior information to the model, such as the likely rates of missingness in the data. This paper describes a Bayesian analysis approach which aimed to reduce attenuation of associations in EHR studies focussed on conditions characterized by under-diagnosis. Methods: Study 1: We created synthetic data, produced to mimic structured EHR data where diagnoses were under-recorded. We fitted logistic regression (LR) models with and without Bayesian priors representing rates of misclassification in the data. We examined the LR parameters estimated by models with and without priors. Study 2: We used EHR data from UK primary care in a case-control design with dementia as the outcome. We fitted LR models examining risk factors for dementia, with and without generic prior information on misclassification rates. We examined LR parameters estimated by models with and without the priors, and estimated classification accuracy using Area Under the Receiver Operating Characteristic. Results: Study 1: In synthetic data, estimates of LR parameters were much closer to the true parameter values when Bayesian priors were added to the model; with no priors, parameters were substantially attenuated by under-diagnosis. Study 2: The Bayesian approach ran well on real life clinic data from UK primary care, with the addition of prior information increasing LR parameter values in all cases. In multivariate regression models, Bayesian methods showed no improvement in classification accuracy over traditional LR. Conclusions: The Bayesian approach showed promise but had implementation challenges in real clinical data: prior information on rates of misclassification was difficult to find. Our simple model made a number of assumptions, such as diagnoses being missing at random. Further development is needed to integrate the method into studies using real-life EHR data. Our findings nevertheless highlight the importance of developing methods to address missing diagnoses in EHR data.
A Population Model of Deep Brain Stimulation in Movement Disorders From Circuits to Cells

For more than 30 years, deep brain stimulation (DBS) has been used to target the symptoms of a number of neurological disorders and in particular movement disorders such as Parkinson’s disease (PD) and essential tremor (ET). It is known that the loss of dopaminergic neurons in the substantia nigra leads to PD, while the exact impact of this on the brain dynamics is not fully understood, the presence of beta-band oscillatory activity is thought to be pathological. The cause of ET, however, remains uncertain, however pathological oscillations in the thalamocortical-cerebellar network have been linked to tremor. Both of these movement disorders are treated with DBS, which entails the surgical implantation of electrodes into a patient’s brain. While DBS leads to an improvement in symptoms for many patients, the mechanisms underlying this improvement is not clearly understood, and computational modeling has been used extensively to improve this. Many of the models used to study DBS and its effect on the human brain have mainly utilized single neuron and single axon biophysical models. We have previously shown in separate models however, that the use of population models can shed much light on the mechanisms of the underlying pathological neural activity in PD and ET in turn, and on the mechanisms underlying DBS. Together, this work suggested that the dynamics of the cerebellar-basal ganglia thalamocortical network support oscillations at frequency range relevant to movement disorders. Here, we propose a new combined model of this network and present new results that demonstrate that both Parkinsonian oscillations in the beta band and oscillations in the tremor frequency range arise from the dynamics of such a network. We find regions in the parameter space demonstrating the different dynamics and go on to examine the transition from one oscillatory regime to another as well as the impact of DBS on these different types of pathological activity. This work will allow us to better understand the changes in brain activity induced by DBS, and allow us to optimize this clinical therapy, particularly in terms of target selection and parameter setting.
Sensitivity to Climate and Weather Changes in Euthymic Bipolar Subjects: Association With Suicide Attempts

Background Climate and weather are known to affect multiple areas of human life, including mental health. In bipolar disorder (BD), seasonality represents an environmental trigger for mood switches, and climatic variables may contribute to recurrences. Several studies reported seasonal and climatic-related variations in the rate of suicide attempts. Suicide risk is relevant in BD, with approximately 25% of patients attempting suicide. Therefore, this study aimed to assess sensitivity to weather and climatic variations in BD subjects and its relationship with lifetime suicide attempts. Methods Three hundred fifty-two euthymic BD and 352 healthy control subjects, homogeneous with respect to socio-demographic characteristics, were enrolled. All participants were administered the METEO-Questionnaire (METEO-Q) to evaluate susceptibility to weather and climatic changes. We also investigated the potential relationship between sensitivity to climate and weather and lifetime suicide attempts in BD patients. Results METEO-Q scores and the number of subjects reaching the cut-off for meteorosensitivity/meteoropathy were significantly higher in BD patients. Within the clinical group, BD subjects with lifetime suicide attempts obtained higher METEO-Q scores, with no differences between BD-I and BD-II. The number of suicide attempts directly correlated with METEO-Q scores. The presence of suicide attempts was associated with the physical and psychological symptoms related to weather variations. Discussion Our findings support the relevance of sensitivity to weather and climate variations in a large sample of BD subjects and point out the association of this feature with lifetime suicide attempts.
Resting State Glucose Utilization and Adult Reading Test Performance

Adult reading tests (ART) have been widely used in both research and clinical settings as a measure of premorbid cognitive abilities or cognitive reserve. However, the neural substrates underlying ART performance are largely unknown. Furthermore, it has not yet been examined whether the neural substrates of ART performance reflect the cortical regions associated with premorbid intelligence or cognitive reserve. The aim of the study is to identify the functional neural correlates of ART performance using 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging in the cognitively normal (CN) middle- and old-aged adults. Voxel-wise analyses revealed positive correlations between glucose metabolism and ART performance in the frontal and primary somatosensory regions, more specifically the lateral frontal cortex, anterior cingulate cortex and postcentral gyrus (PCG). When conducted again only for amyloid-β (Aβ)-negative individuals, the voxel-wise analysis showed significant correlations in broader areas of the frontal and primary somatosensory regions. This is the first neuroimaging study to directly demonstrate the cerebral resting-state glucose utilization associated with ART performance. Our findings provide important evidence at the neural level that ART predicts premorbid general intelligence and cognitive reserve, as brain areas that showed significant correlations with ART performance correspond to regions that have been associated with general intelligence and cognitive reserve.
Rural-Urban differentials in predicting tobacco consumption pattern among males above 15 years: A cross-sectional community survey

Introduction: Globally, every year, more than 6 million people die because of tobacco use. 20% of all global deaths attributed to tobacco occur in India. The behavioral difference in the rural and urban communities is an important aspect of tobacco problem in the country. In this context, we conducted a community-based cross-sectional study to determine the effect of area (rural-urban) in predicting tobacco consumption pattern. Materials and Methods: A community-based observational, cross-sectional study was conducted in a rural and an urban community of West Bengal from May 2014 to April 2015. A predesigned pretested schedule adapted from the Global Adult Tobacco Survey India Questionnaire was used for data collection. Males above 15 years of age, residing in the study areas, were interviewed during house-to-house visit. Results: Data obtained from the interview of 704 males (352 each from urban and rural area) above 15 years revealed that the prevalence of current tobacco use in any form is significantly higher in rural area (75.6%) than in urban area (67.6%). This was related to the fact that awareness and perception of the people in rural areas are significantly less than their urban counterparts. In bivariate analysis satisfactory consumption pattern was significantly more in urban area but when adjusted with all potentially explanatory variables, the odds of satisfactory consumption pattern in urban area was attenuated significantly. Conclusion: An appropriate intervention strategy, based on local area-wise behaviors of people to curb out the menace of tobacco use, is the need of the hour.
Can bladder shear wave elastography be an alternative method for detection of neurogenic bladder instead of urodynamic study?

Background: In the normal physiology of the bladder wall, it has sufficient elasticity so that it can maintain normal pressure during filling phase of bladder. Bladder functional pathology can cause many problems for patients. Method: This evaluation is a cross-sectional study conducted on patients suspected of neurogenic bladder. In this study, patient refered for urodynamic testing at first, urodynamic test performed by urologist and then Shear wave elastography was performed by radiologist. Data such as age, sex, height, and weight, and other demographic data were also evaluated. Patients were informed before and after the urodynamic and Shear wave sonography tests. Finally, the data were entered into SPSS software and were statistically analyzed. Results: We observed that the mean and standard deviation of the age was 15.7 ± 6.2 years. Also found that in gender 19 (63.3%) patients were males and 11 (36.7%) were female. On the other hand, in terms of BMI, most patients were normal in this regard (50%), as well as in other cases, including weight loss in 3 (10%) patients, overweight in 8 (26.6%) patients, and obese were in 4 patients (13.3%). in our assessment about the efficacy of the ultrasound elastography approach to the anterior wall, which showed that the specificity of the test in the diagnosis of neurogenic bladder was 83% and this is statistically significant in patients (P < 0.05). We also observed in the posterior wall posture that the specificity of this test was 85% in the diagnosis of neurogenic bladder, which indicates a high diagnostic capability of this test, and this is statistically significant in patients (P < 0.05). Conclusion: Based on the results observed in this evaluation, ultrasound elastography has a high specificity for neurogenic bladder detection in comparison with urodynamic study. Accordingly, due to the less invasive nature of this method than urodynamic study, this method can be used to identify patients with neurogenic bladder.
Prevalence of pulmonary thromboembolism in nephrotic syndrome patients: A systematic review and meta-analysis

This study was aimed to assess the prevalence of pulmonary thromboembolism in patients with nephrotic syndrome. An electronic search was conducted through nine electronic databases for selection of relevant articles reporting the prevalence of pulmonary thromboembolism in patients with nephrotic syndrome. National Institute of Health was used to assess the quality of each study. Meta-analysis was used to pool the results. Of total 2267 reports screened, we finally included 11 studies including five retrospective cohorts, four prospective cohorts, and two case series studies. Out of these, ten articles were eligible for meta-analysis. The overall prevalence was 7.93% with 95% CI of 4.27 to 14.73. However, a significant heterogeneity (P < 0.001) was observed with I2= 96% and τ2= 0.899. Moreover, Egger's regression test showed a significant risk of bias (P = 0.006). Patients with nephrotic syndrome are prone to pulmonary embolism, therefore early management is critical to decreasing mortality burden.
Influence of the previous dental visit experience in seeking dental care among young adults

Introduction: Dental fear is one of the highly prevalent types of fear which deters patients from seeking dental cares. Aim: This study aims to assess the influence of a previous dental visit experience for seeking dental care among adults. Methodology: Young adults (n = 150, 15–26 years) with previous dental visit for care were selected randomly among outpatients' visit in tertiary dental teaching hospital. To assess the influence of previous experience of dental visit in seeking care, we self-administered a Post-traumatic Check List-Civilian Version [posttraumatic stress disorder (PTSD)], an Autobiographical Memory Questionnaire (AMQ), and a Dental Fear Survey (DFS). The relationship of negative and positive experience of previous dental treatment, dental fear, and symptoms of PTSD was assessed using Pearson's correlations. Spearman's rho was used to find out the correlation between the DFS and PCL-C and history of dental treatment undergone. Results: The mean score of the DFS and PCL-C was found to be 69.57 and 40.17, respectively. The characteristics of the most negative experience including physical reactions (P = 0.936), emotional intensity (P = 0.935), sight (P = 0.941), smell (P = 0.917), and sound (P = 0.911) of dental treatment showed a significant relationship with dental fear, whereas the characteristics of the most positive memory of dental treatment showed only a few statistically significant associations with dental fear. Most of the symptoms of PTSD also show significant associations (P < 0.05) with characteristics of the most negative memory. Spearman's correlation between the DFS and the PCL-C was also statistically significant, r (150) =0.365, indicating that dental fear is indeed associated with symptoms of PTSD. Conclusion: There is a significant association between the characteristics of the most negative experiences of dental treatment and increased dental fear in young adults, while positive experiences did not show the inverse relationship with dental fear.
Evaluation of maxillary anterior teeth proportion with Chu’s Gauge in a population of Central India: an in vivo study

Aim To evaluate the width/height proportions in maxillary anterior natural dentition and its correlation with Chu’s esthetic proportion Gauge. Settings and Design Observational cross-sectional study with the inclusion criteria of well aligned maxillary anterior teeth. Purpose The present study attempts to perceive the application of Chu’s Esthetic Proportion Gauge in a group of the central Indian population. Methods A total number of 150 participants within the age group 18–30 years were screened, out of which 80 participants were selected, who fulfilled the inclusion criteria of well aligned maxillary anterior teeth with pleasing smile, unrestored, periodontally sound, no fracture, no missing, absence of diastema teeth and no H/O orthodontic treatment. The selected participants were seated on the dental chair with the Frankforts horizontal plane parallel to the floor. The participants were observed for height and width proportions using the Chu’s esthetic proportion gauge and measured using digital vernier calliper. The proportion and measured height and width ratios were then compared. Results The recorded data was compiled and entered in a spreadsheet computer program (Microsoft Excel 2007) and then exported to data editor page of SPSS version 20.0 (SPSS Inc., Chicago, Illinois, USA). Intergroup comparison between gauge and vernier caliper was done using Chi-square test for proportions percentages (Qualitative data) and Mann-Whitney U test of width and height and then categorized into esthetic and unesthetic anterior teeth. Level of significance was set at 0.05. Conclusions Within the limitations of the study, it was concluded that maxillary anterior teeth did show similarity with Chu’s esthetic proportion scale.
Effectiveness of generic direct-acting agents for the treatment of hepatitis C: systematic review and meta-analysis

Abstract Objective To compare the efficacy of generic direct-acting agents and brand-name medicines for treating hepatitis C virus (HCV) infection by conducting a systematic review and meta-analysis. Methods We searched online databases for studies that reported sustained virological responses 12 weeks after the end of HCV treatment with generic direct-acting agents. We derived pooled proportions of treated patients with a sustained virological response from intention-to-treat and per-protocol analyses. In addition, we calculated the pooled relative risk (RR) of a sustained virological response brand-name versus generic direct-acting agents using a random-effects model (DerSimonian–Laird) from the data available. Between-study heterogeneity was assessed using the I2 statistic. Findings We identified 19 studies involving a total of 57 433 individuals from eight territories or regions. The pooled overall proportions of patients with a sustained virological response were 98% (95% confidence interval, CI: 97–99; 18 studies; I2 = 94.1%) in per-protocol analyses and 96% (95% CI: 93–98; 8 studies; I2 = 68.1%) in intention-to-treat analyses. The likelihood of a sustained virological response with brand-name medicines was similar to that with generic direct-acting agents (RR: 1.00; 95% CI: 0.98–1.02; I2 = 0.0%). The likelihood of a sustained virological response was significantly higher in patients without than with cirrhosis (RR:1.03; 95% CI: 1.01–1.06; 7 studies) but was not significantly affected by either previous treatment (3 studies) or human immunodeficiency virus coinfection (3 studies). Conclusion Generic direct-acting agents are highly effective for treating hepatitis C. Generic agents should be considered in resource-constrained settings for decreasing the burden of liver disease in HCV-infected patients.
Sensitivity Comparison of Refractive Index Transducer Optical Fiber Based on Surface Plasmon Resonance Using Ag, Cu, and Bimetallic Ag–Cu Layer

A single-mode optical fiber sensor uses surface plasmon resonance (SPR) with a bimetallic silver–copper (Ag–Cu) coating compared to a single layer of Ag and Cu itself. Bimetallic Ag–Cu sensors are constructed by simple fabrication on a side-polished optical fiber, followed by an electron beam evaporation of Ag and Cu films. For this investigation, the thickness of the single Ag layer was set to 30 nm and the single Cu layer was set to 30 nm; whereas for the bimetallic combined Ag–Cu layer the thickness of Ag was 7 nm and Cu 23 nm. The sensor performance was analyzed and compared experimentally and numerically using the COMSOL Multiphysics. A white light source was used with a broad optical bandwidth to provide a range of wavelengths to the optical fiber. The characteristics of the thin layers of Ag, Cu, and Ag–Cu as alcohol sensors were evaluated. We found that Cu was the most sensitive metallic layer compared to the Ag and the bimetallic Ag–Cu layers. For a 100% alcohol concentration, Cu showed a sensitivity of 425 nm/RIU followed by the bimetallic Ag–Cu layer with 108.33 nm/RIU, whereas the Ag layer was not detected. Interestingly, sensitivity reached saturation beyond the 20 nm thick layer of Ag. This shows that the Cu and the bimetallic Ag–Cu layers are suitable for an alcohol-based optical sensor.